THIS INFORMATIONAL HEARING,
LETTING MEMBERS KNOW WE'RE
STARTING. WE'RE NOT TAKING A
VOTE SO WE DON'T NEED TO TAKE A
QUORUM. JUST JUST TO REPEAT. I
UNDERSTAND THERE'S SOME
CONFUSION ABOUT THE ROOM NUMBER.
IT IS ROOM 1200 IN THE SWING
SPACE. WE'RE IN 1200 SWING SPACE
. GOOD AFTERNOON, EVERYBODY. AND
THANKS FOR BEING HERE. AS YOU
KNOW, THIS IS OUR FIRST SENATE.
INFORMATIONAL HEARING DEALING
WITH THE REDO OF THE THIS BILL
WILL START LEGISLATIVELY IN THE
ASSEMBLY, BUT THE SENATE WANTED
TO GET A CHANCE TO BE ABLE TO
TALK ABOUT IT A LITTLE BIT AND
LET OUR ALL OF OUR MEMBERS GET
SOME EYES ON IT BEFORE WE START.
I'M SURE THE STAFF WROTE ME UP
TALKING POINTS, BUT I'M JUST
GOING TO TALK. SO WE THANK YOU
ALL FOR BEING HERE TODAY AND
BEING A PART OF IT HAS BEEN A
LONG TIME IN COMING AND I WANT
TO THANK EVERYBODY WHO HAD
ANYTHING TO DO WITH PULLING THIS
TOGETHER. I ALSO WANT TO THANK
HEALTHCARE STAFF RAISED DIAZ FOR
THE VERY FINE BACKGROUND PAPER
PREPARED FOR US ALL KIND OF LAYS
OUT A LOT OF THE HISTORY. AND I
WILL SAY SOMEBODY POINTED OUT TO
ME THAT ONE PIECE OF HISTORY
THAT WASN'T INVOLVED WAS ROSE
KING WHO IS ALSO VERY INVOLVED
IN THE BEGINNING OF THIS AND A
HUGE ADVOCATE WHO LOST HER LIFE,
NOT TOO LONG AGO, SO WE ALSO
WANT TO MAKE SURE SHE IS
MENTIONED IN THIS AND I THINK
SOME OF THE CRITICISM SHE LOVED
AT THE TIME AND THROUGH THE
YEARS WE ARE NOW BEGINNING TO
REALLY ADDRESS AT A MUCH DEEPER
LEVEL. SO AS EVERYONE KNOWS, WE
HAVE A CRISIS ON OUR HANDS WITH
OUR WORLD OF MENTAL HEALTH. AND
AS EVERYONE KNOWS, 20 YEARS AGO,
WE PASSED THE IMAGE, PERHAPS 63
TO REALLY REDEFINED HOW WE DO
MENTAL HEALTH SERVICES. GREAT
LEADERSHIP OF A MAYOR DALE
STEINBERG AND MR SESAY AT THE
TIME AND THEN ROSE KING AND THEN
THROUGH THE IMPLEMENTATION, IT
WAS MEANT TO BE FOCUSED ON THE
SICK OF PEOPLE WHO HAD STRUGGLED
WITH THE MOST AS WE KNOW. AFTER
THE CLOSURE OF THE STATE
HOSPITALS. A LOT OF PROMISES
WERE MADE ABOUT ONGOING SUPPORT
, WHICH NEVER MATERIALIZED. THIS
WAS A HUGE ATTEMPT HAS DONE A
LOT OF GOOD THINGS.
UNFORTUNATELY JUST BECAUSE EVERY
COUNTY DOES IT A LITTLE BIT
DIFFERENTLY. WE'VE HAD TROUBLE
HAVING SOME STANDARDIZATION WITH
DATA ISSUES AND BY ALL
APPEARANCES, JUST NEEDING TO
WALK OUTSIDE IN ANY CITY IN
CALIFORNIA. YOU CAN SEE THE
IMPACT OF THE INCREASING AMOUNT
OF PEOPLE WITH SERIOUS AND
PERSISTENT MENTAL HEALTH ISSUES
AND SUBSTANCE USE ISSUES AND
THEIR HOUSING ON OUR STREETS,
CORNERS AND ALLEYWAYS. WHICH
ISN'T GOOD FOR ANYBODY. SO OVER
THE YEARS, FOLKS NOW WE'VE BEEN
DOING A LOT OF WORK ON THIS
SPACE. AND THIS THEN WILL REALLY
FORM A CORNERSTONE OF THAT WORK
GOING FORWARD. HUGE THING TO THE
GOVERNOR AND ADMINISTRATION. IT
CAN'T BE SAID ENOUGH THAT THERE
IS NO GOVERNOR WHO HAS MADE
MENTAL HEALTH ISSUES OF PRIORITY
AS THIS GOVERNOR HAS, AND FOR
THAT WE HAVE A LOT TO BE
GRATEFUL FOR. TODAY WE'RE
TALKING ABOUT THE REDESIGN OF
THE MENTAL HEALTH SERVICES ACT
AND THE BUCKETS AND THE WAY THE
MONEY IS SPENT IS BEING SPENT
AND ALLOCATED. AND IT IS TRUE.
WE ARE PRIORITIZING THOSE WHO
WHO SUFFER THE MOST ON IT IN THE
SYSTEMS, AND WE ARE ALSO MAKING
THE STATE A LOT MORE RESPONSIBLE
AND MAKING SURE THAT WE DON'T DO
THINGS DIFFERENT EVERY COUNTY
WHILE PROVIDING FOR FLEXIBILITY
THAT WE'RE ABLE TO MEASURE AND
STANDARDIZE THINGS A LITTLE BIT
MORE SO THINGS CAN BE SCALED
SOME OF THE GREAT INNOVATIONS
THAT WE'VE COME UP WITH. CAN
THEN BE IMPLEMENTED AND USED IN
OTHER PARTS OF THE SYSTEM, AND
WE DON'T HAVE TO CREATE RE KEEP
RECREATING THE WHEEL, SO WE
APPRECIATE THE ADMINISTRATION'S
AND ENGAGEMENT WITH US AS WE
CONTINUE TO WORK TOGETHER TO GET
TO THE FINISH LINE OF THIS, IT
REALLY TAKES EVERYBODY DOING
THIS KIND OF WORK. SO WE
APPRECIATE ALL OF THAT. AND WITH
THAT, I'D ASK ANY OF MY
COLLEAGUES IF THEY LIKE TO MAKE
ANY OPENING COMMENTS. SEEING
NONE. WE'RE GOING TO GO AHEAD
AND INVITE DR MARC GALLE, THE
SECRETARY OF HEALTH AND HUMAN
SERVICES AGENCY, AND MICHELLE
BASH TO COME FORWARD. UM SIT
HERE AT OUR FINE TABLE OR HAVING
PEOPLE BACK AT JOIN US IN THIS
CONVERSATION AND BE ABLE TO WALK
US ALL THROUGH, UM, THE CHANGES
THAT WE SEE BEFORE US TODAY IN
MORE DETAIL. ALL RIGHT. WELCOME.
GOOD AFTERNOON. THANK YOU FOR
INVITING US, INCLUDING US IN
THIS IMPORTANT DAY ON BEHALF OF
MICHELLE AND MYSELF REALLY
APPRECIATE THE CHANCE TO BE IN
FRONT OF THE COMMITTEE AND
SENATOR EDMUND FOR YOUR
LEADERSHIP TODAY REPRESENTS
ANOTHER KEY MILESTONE IN
CALIFORNIA'S JOURNEY TO BUILD A
PERSON'S CENTERED WHOLE PERSON
FOCUSED, EQUITY ANCHORED
BEHAVIORAL HEALTH SYSTEM THAT'S
ACCESSIBLE TO ALL WHO NEED IT.
WHEN THEY NEED IT AND WHERE THEY
NEED IT. TODAY'S DISCUSSION
ABOUT REFORMING THE MHS IS ABOUT
HOW TO STRENGTHEN A KEY PILLAR
THAT HAS BEEN AN ANCHOR OF OUR
SYSTEM FOR A LONG TIME. NOT SO
THAT IT ONLY PLUGS THE HOLES AND
FILLS THE GAPS, BUT THAT IT
BOLTS TOGETHER SOME OF THESE
OTHER REALLY IMPORTANT PIECES OF
OUR BEHAVIORAL HEALTH
TRANSFORMATION. HAD DIRECTOR
BOSSES DEPARTMENT AND OTHER
DEPARTMENTS WITHIN CALIFORNIA
HEALTH AND HUMAN SERVICES AGENCY
AND OTHER AGENCIES IN CALIFORNIA
ARE PUTTING TOGETHER WE'RE
STARTING TO SEE THE FRUITS OF
SOME OF THOSE PROGRAMS TODAY.
AH! REPRESENTS TODAY. THREE OUT
OF EVERY $10 ROUGHLY OF PUBLIC
BEHAVIORAL HEALTH DOLLARS THAT
ISN'T ENOUGH TO BUOY UP THE
ENTIRE SYSTEM, BUT IT'S TOO
IMPORTANT TO CONTINUE TO
OVERLOOK ITS IMPACT BY LOOSE AND
WEAK ACCOUNTABILITY STRUCTURES.
OVERSIGHT STRUCTURES TODAY IS
ONE OF THE KEY PRIORITIES AS YOU
ALREADY, SAID SENATOR EDMUND IS
TO MAKE SURE THAT WE CAN
UNDERSTAND WHAT THOSE DOLLARS
ARE BEING USED FOR HOW THEY'RE
IMPACTING CALIFORNIANS IN NEED
TODAY, AND NOW WE'RE BUILDING
THE KIND OF SYSTEM THAT WE WANT
IN THE FUTURE. A LOT HAS CHANGED
IN 20 YEARS SINCE IT WAS FIRST
PASSED, WE HAVE THE BENEFITS OF
THE AFFORDABLE CARE ACT. WE'VE
TALKED ABOUT THAT PREVIOUSLY TO
ALLOW MILLIONS LITERALLY.
MILLIONS OF CALIFORNIANS WHO
DIDN'T HAVE COVERAGE BEFORE TO
HAVE COVERAGE TODAY THROUGH
MEDICAID OR COVERED CALIFORNIA
TO REALLY INCREASE THE
AVAILABILITY OF BEHAVIORAL
HEALTH SERVICES THAT ARE PART OF
MEDICAID. TO START CONVERSATIONS
ABOUT WHAT THE HEALTH PLANS
ROLES ARE NOT JUST COUNTY
BEHAVIORAL HEALTH AND PROVIDING
THOSE FOR THOSE WITH THE MOST
SEVERE CONDITIONS. BUT WHAT
ABOUT THOSE WITH THE MILD AND
MODERATE CONDITIONS? I APPLAUD
DIRECTOR BOSS AND HER TEAM'S
EFFORTS IN THE LAST YEAR TO UP
THE ANTE FOR HEALTH PLANS TO DO
MORE TO BE MORE FOCUSED ON
BEHAVIORAL HEALTH THROUGH THEIR
NEW CONTRACTS. AND THESE ARE
IMPORTANT ASPECTS THAT BUILD
UPON THE CHILDREN BEHAVIORAL
HEALTH INITIATIVE, THE
INVESTMENTS IN THE DEPARTMENT OF
STATE HOSPITAL IN OUR IS
POPULATION BUILDING UP THE
INFRASTRUCTURE THROUGH B CHIP
AND THE COMMUNITY CARE EXPANSION
APPROACHES AT DEPARTMENT OF
SOCIAL SERVICES, ALL MEANT TO
COME TOGETHER. HELP SUPPORT THIS
BROAD TAPESTRY IF YOU WILL OF A
PLAN TO REALLY IMPROVE
BEHAVIORAL HEALTH FOR ALL
CALIFORNIANS, BUT WITHIN THAT,
AND WE HAD THESE CONVERSATIONS
LAST YEAR IN THE DISCUSSIONS OF
CARE ACT AND THIS NEW PATHWAY
THAT'S BEING UNLEASHED IN
CALIFORNIA AND EIGHT COUNTIES
THIS YEAR SEVEN IN OCTOBER, THEN
THE L. A AT THE END OF THE YEAR.
THAT REALLY REQUIRE US TO HAVE A
NEW APPROACH FOR THOSE WHO OFTEN
FALL THROUGH THE CRACKS LEAD HIT
THE PAVEMENT, LITERALLY BECAUSE
OF SOME OF THE HOLES IN OUR
SAFETY NET SYSTEM AND SUFFER THE
MOST. WE'VE TALKED ABOUT HOW
OFTEN WE WAIT FOR THOSE
INDIVIDUALS TO ENCOUNTER LAW
ENFORCEMENT OR THE MOST SEVERE
PARTS OF OUR SYSTEMS BEFORE THEY
GET HELP THAT CARE PATHWAY IN
SOME WAYS IS SUPPORTED BY THE
CHANGE THAT WE'VE BEEN TALKING
ABOUT OVER THE LAST MANY MONTHS,
FRANKLY, MANY YEARS WITH
STAKEHOLDERS, LEGISLATORS
ADVOCATES YOU NAME THEM THROUGH
LETTERS AND CONVERSATIONS. TO
REALLY CHANGE OUR APPROACH, AND
WE HAVE USED THE WORD OFTEN
MODERNIZE OUR BEHAVIORAL HEALTH
SERVICES ACT TO INCLUDE THINGS
LIKE SUBSTANCE USE DISORDERS TO
MAKE SURE THAT HOUSING WHICH HAS
ALWAYS BEEN SEEN AS ONE OF THE
KEY SERVICES IS NOT JUST SEEN AS
A SERVICE BUT PRIORITIZE AS THE
THING THAT MIGHT MATTER THE MOST
FOR PEOPLE WHO ARE SUFFERING
WITH THE MOST SEVERE DISORDERS
IN OUR COMMUNITIES. BECAUSE OF
YOUR LEADERSHIP, SENATOR EDMUND
AND THE GOVERNOR'S EXPENSIVE
BROADVISION. WE STAND HERE TODAY
WITH A FRESH SET OF AMENDMENTS
IN PRINT JUST LAST NIGHT, WHICH
SOME PEOPLE HAVE SAID OH, I SEE
WE HAVE COMPROMISED. I'M GOING
TO CHALLENGE THAT PREMISE ALL
DAY. LONG COMPROMISE MEANS I
WANTED THREE. YOU WANTED ONE. WE
SETTLED AT TWO. NEITHER OF US
REALLY GOT WHAT WE WANTED. IN MY
VIEW, THE AMENDMENTS THAT
CROSSED RECENTLY IN PRINT THIS
MORNING REPRESENT IMPROVEMENTS
TO THE PROPOSAL. THEY DO THINGS
THAT FOR WHATEVER REASON,
WEREN'T PART OF THAT FIRST SET
OF PROPOSED CHANGES TO THE
BEHAVIORAL HEALTH SERVICES ACT.
THEY HELP US MOVE FORWARD WITH
SOME OF THE KEY THINGS THAT HAVE
EVADED LAWMAKERS AND PROPONENTS
OF CHANGE FOR THE NHS FOR QUITE
SOME TIME, FOR EXAMPLE, COUNTY
FLEXIBILITY. I KNOW THE COUNTY'S
I'VE HAD THE PRIVILEGE OF
WORKING OUT BEFORE COMING TO
SACRAMENTO THAT WE FELT
RESTRICTED BY HEY, DOLLARS IN
THIS BUCKET. WHAT ABOUT THIS
BUCKET? WE NEED A LITTLE BIT
MORE OVER HERE. HOW DO WE ALLOW
FOR THAT CHANGE? THE PROPOSED
AMENDMENT TO ALLOW IN THE FIRST
PLANNING CYCLE UP TO 7% OF
ANYONE BUCKET TO MOVE ACROSS TO
A DIFFERENT BUCKET. TOTAL OF 14%
PROVIDES THAT KIND OF
FLEXIBILITY THAT ALLOWS THE
FRAMEWORK OF THE BEHAVIORAL
HEALTH SERVICES ACT TO BE
MAINTAINED WHILE PROVIDING THAT
UNIQUE ASPECT COUNTY BY COUNTY
TO HAVE US RECOGNIZE FULLY
CALIFORNIA ISN'T ONE CALIFORNIA
THAT WE HAVE NORTH AND SOUTH
COASTAL AND INLAND CENTRAL ALL
THE DIFFERENT, UNIQUE
CHARACTERISTICS OF WHAT WE NEED
IN CALIFORNIA CAN BE COVERED
THERE. WE ALSO PROPOSED CHANGES
TO HOW WE'RE LOOKING AT
PREVENTION. ORIGINALLY IN THE
ORIGINAL PROPOSAL, IT WAS
PROPOSED TO HAVE A STANDALONE 5%
PREVENTION BUCKET FOR POPULATION
BASED PREVENTION TOO LONG, WE
CONFLICTED EARLY INTERVENTION
WITH PREVENTION, AND IN THE
FIRST PROPOSAL, IT WAS
DETERMINED. LET'S HAVE A 5%
PREVENTION BUCKET. HEARING LOTS
OF FEEDBACK, CONSIDERING HOW TO
MAKE 5% GO AS FAR AS POSSIBLE IN
STATEWIDE POPULATION PREVENTION
APPROACHES. THE SUGGESTION IS TO
MOVE THAT 5% TURN IT INTO A 4%
BUCKET AND HAVE IT RUN THROUGH
THE STATE'S DEPARTMENT OF PUBLIC
HEALTH. CALIFORNIA DEPARTMENT OF
PUBLIC HEALTH WITH COLLABORATION
WITH THE OVERSIGHT AND
ACCOUNTABILITY COMMISSION, AS
WELL AS THE DEPARTMENT OF HEALTH
CARE SERVICES TO MAKE SURE THAT
WE'RE ABLE TO TOUCH IN MANY WAYS
THAT BROAD POPULATION PREVENTION
NEEDS THAT THIS STATE NOT ONLY
NEEDS BUT DESERVES TO STAY IN
FRONT OF SOME OF THE MOST
EMERGING ISSUES. BY MOVING THAT
4% UP TO THE STATE LEVEL. WE
HAVE NOW THREE REMAINING LOCAL
BUCKETS. THE HOUSING
INTERVENTION POCKET AT 30% THE
FULL SERVICE PARTNERSHIP BUCKET
AT 35% IN THE BEHAVIORAL HEALTH
SERVICES AND SUPPORT BUCKET THAT
INCLUDES EARLY INTERVENTION AT
35. ANOTHER SET OF AMENDMENTS,
WHICH I THINK REALLY REINFORCE
CALIFORNIA'S COMMITMENT TO YOUNG
PEOPLE, THE RECOGNITION THAT
YOUNG PEOPLE HAVE UNIQUE NEEDS
THAT BEING ABLE TO GET IN FRONT
OF SOME OF THOSE EARLIEST SIGNS
AND SYMPTOMS. SOME OF THOSE
IMPORTANT ANTI STIGMA, BREAKDOWN
BARRIERS. CONVERSATIONS AROUND
PREVENTION NORMALIZING
CONVERSATIONS AROUND MENTAL
HEALTH, SUBSTANCE USE DISORDER,
IMPORTANT FOR YOUNG PEOPLE THAT
BOTH WITHIN OUR EARLY
INTERVENTION. ALLOCATIONS AND
OUR PREVENTION ALLOCATIONS TO
SAY THAT 51% OF THOSE DOLLARS
ARE FOCUSED ON YOUNG PEOPLE AND
MAINTAINING HARD EARNED GAINS
OVER FRANKLY, NOT JUST YEARS,
BUT DECADES TO ADVOCATE WITHIN
CURRENT REGULATION TO BUILD THAT
NOW INTO STATUTE AND CONTINUE
THAT IMPORTANT WORK. AH! WE ALSO
HAVE WITHIN THE BEHAVIOR, HOUSE
SERVICES AND SUPPORT BRACKETS
ALLOWED SOME ADDITIONAL
ALLOWANCES THAT PEOPLE SAID WERE
MISSING. AGAIN MAKES
IMPROVEMENTS TO THE PLAN AND THE
PROPOSAL TO ALLOW OUTREACH AND
ENGAGEMENT ACTIVITIES, WHICH ARE
CRITICAL TO BE FUNDED THROUGH
THE BEHAVIOR, HOUSE SERVICES AND
SUPPORT BUCKET IS SOMETHING THAT
CERTAINLY WAS OVERLOOKED
INITIALLY, BUT WE THINK IS
REALLY KEY AND IMPORTANT. AND
WHEN YOU THINK ABOUT OTHER
UPCOMING CHANGES AND ADDITIONS
TO OUR BROAD TAPESTRY IF YOU
WILL. BEHAVIORAL HEALTH
RESOURCES DIRECTOR BOSSES WORK
WITH HER DEPARTMENT ON ADVANCING
THE BH CONNECT PROPOSAL IS
OPENING UP THE DOORS TO A WHOLE
ANOTHER SET OF SERVICES AND
RESOURCES AVAILABLE TO COUNTIES
OF WHICH OUTREACH AND ENGAGEMENT
WILL BE HIGHLIGHTED. WE ALSO
RECOGNIZE THAT CERTAIN SMALLER
COUNTIES NEED FLEXIBILITY, MAYBE
EVEN EARLIER THAN LARGER
COUNTIES. IN ADDITION TO SOME OF
THOSE BROAD BUCKET FLEXIBILITIES
, ALLOWING SMALLER COUNTIES TO
RECEIVE SOME ADDITIONAL ABILITY
TO INVEST IN CAPITAL FOR HOUSING
EARLIER IN THE PROCESS WILL
ALLOW US TO MAKE SURE THAT WE'RE
NOT LEAVING RESOURCE IS LOCKED
UP. IN SOME WAYS, HELD HOSTAGE
TO OUR RULES AND ALLOWING THOSE
TO BE MORE FLEXIBLE IN USED USED
IN A IN A BETTER WAY. WE ALSO
ADJUSTED THE DEFINITION TO
CHRONICALLY HOMELESS. WE HEARD
LOUD AND CLEAR. FRANKLY WE
SHOULD HAVE IMPLEMENTED THIS
EARLY ON. WE KNOW HISTORICALLY
THAT THE FEDERAL DEFINITION OF
CHRONICALLY HOMELESS SOMETIMES
LEAVES OUT PEOPLE THAT
CALIFORNIA HAS ALL IS
PRIORITIZING SOUGHT. TO SERVE
WITH OUR HOUSING RESOURCES,
ALLOWING THE DEPARTMENT OF
HEALTH CARE SERVICES TO DEFINE
CHRONICALLY HOMELESS IN A WAY
THAT MEETS CALIFORNIA'S AND EADS
CREATES THE FLEXIBILITY AND NOT
JUST ALLOWS US BUT FORCES US NOT
TO CONTINUE TO OVERLOOK SOME
INDIVIDUALS WHO GETS SOME LEVEL
OF SERVICE AND THEN SUDDENLY
FIND OUT BECAUSE THEY WERE
TEMPORARILY HOUSED, OR EVEN
INCARCERATED, THAT THEY'RE
INELIGIBLE FOR THOSE FEDERALLY
FEDERALLY SUPPORTED SERVICES. WE
SPENT A LOT OF TIME IN THE
ORIGINAL PROPOSAL TALKING ABOUT
HOW WE'RE FOCUSED ON
ACCOUNTABILITY, TRANSPARENCY AND
OVERSIGHT. I WANT TO REEMPHASIZE
THE FOCUS ON THE THREE YEAR PLAN
AND THE ROBUSTNESS OF THAT PLAN
. THE REQUIREMENT TO COUNTIES
BRING TOGETHER A WHOLE SET OF
STAKEHOLDERS THAT AREN'T ALWAYS
AT THE TABLE IN THE THREE YEAR
PLANNING PROCESS THAT IT'S DATA
DRIVEN THAT THEY'RE USING THE
DATA THAT IS UNIQUE TO THEIR
COUNTIES. IT HAS A STATE WISE
LENS TO MAKE THOSE PLANTS BUT
THAT THAT IN THAT WE'RE ALLOWING
SUBSTANCE. YOU STOOD DISORDERS
ALONE. THANK YOU, SENATOR EDMUND
FOR BILLS IN PAST YEARS THAT
ALLOWED US TO RECOGNIZE CO
OCCURRING DISORDERS AS A
ALLOWABLE USE FOR FUNDING IN THE
BEHAVIORAL HEALTH SERVICES ACT
PROPOSAL. WE'RE ALLOWING
COUNTIES BASED ON DATA DRIVEN BY
THE EVIDENCE DRIVEN BY THEIR
VOICES AT THE TABLE TO
PRIORITIZE PROGRAMS THAT ARE
JUST FOCUSED ON SUBSTANCE USE
DISORDER. NOT A REQUIREMENT PER
SE, BUT DRIVEN BY THE DATA.
THERE IS AN ALMOST A COUNTY I
CAN IMAGINE IN CALIFORNIA THAT
ISN'T GOING TO HAVE SOME
COMPELLING DATA AND VOICE AT THE
TABLE TO START TO INVEST SOME OF
THESE DOLLARS IN SUBSTANCE USE
DISORDER SERVICES ALONE. WE HOPE
THAT THAT HAPPENS IN AN
INTEGRATED WAY. WE'RE GOING TO
PUSH THAT IT HAPPENS IN AN
INTEGRATED WAY, AND I'M NOT JUST
TALKING ABOUT INTEGRATION OF
MENTAL HEALTH AND SUBSTANCE USE
DISORDER SERVICES, BUT I STARTED
WITH THE WHOLE PERSON FOCUS.
THAT MEANS HEALTH AS WELL. ALL
THREE COMING COMING TOGETHER. WE
HAVE ALSO HAD QUITE A BIT OF
CONVERSATION ABOUT OUR ONGOING
SUPPORT AND RELATIONSHIP WITH
THE OVERSIGHT AND ACCOUNTABILITY
COMMISSION. I'M PROUD OF SOME OF
THE CONVERSATIONS WE'VE HAD TO
DATE IN THE LAST MANY WEEKS
ABOUT HOW WE USE THE BREADTH OF
TALENT, THE BREADTH OF ENERGY
AND FRANKLY PERSON POWER TO PUSH
US NOT JUST IN THE REALM OF
OVERSIGHT AND ACCOUNTABILITY.
WHAT IS THE PLAN? THE PLAN COME
TO ABSOLUTELY PART OF IT DOING
THAT TRANSPARENTLY. BUT
PROVIDING REALLY CRITICAL
TECHNICAL ASSISTANCE. NONE OF US
TODAY HAVE THE SKILL SET YET TO
DO WHAT WE NEED TO DO TO REALIZE
THIS SYSTEM TOMORROW, WHETHER
IT'S DATA SYSTEMS OR JUST THE
CHOPS TO GET IT DONE ON THE
MEDICAID BILLING SIDE, SO BEING
ABLE TO WORK TOGETHER WITH THE
TO ADVANCE UNITED FRONT AROUND
SUPPORTING THESE. THESE ARE
SKILLS TO PROLIFERATE AROUND
CALIFORNIA AND SUPPORT COUNTIES
AND OTHER PARTNERS IS A KEY
PIECE THAT THROUGH CONSULTATION
AND ADVISEMENT BETWEEN THE
DEPARTMENT OF HEALTH CARE
SERVICES THE AND IN THE CASE OF
PREVENTION, CDP PH, MAKING SURE
THAT WE CHOOSE OUTCOMES AND
METRICS THAT MAKES SENSE FOR
CALIFORNIA AS A WHOLE AND ALLOW
AH, THE SUPPORT OF THE COUNTY
DATA TO BUILD THOSE PLANS
LOCALLY. I'M LOOKING FORWARD TO
THOSE ONGOING CONVERSATIONS AND
OVER MONTHS AND YEARS TO COME TO
BUILD THAT STRONGER PARTNERSHIP
. AH WE ALSO PROVIDED
CLARIFICATION AND HEARD THIS
LOUD AND CLEAR THAT WE NEEDED TO
BE CERTAIN THAT THROUGH THIS
REFORM, WE WEREN'T PULLING IN
THE KITCHEN SINK THAT WE WEREN'T
REQUIRING COUNTIES TO SAY EVERY
PENNY OF REALIGNMENT EVERY PENNY
FROM THIS OTHER BUCKET THAT HAS
UNIQUE AND IMPORTANT. NEED TO
SPEND ON THOSE OTHER NEEDS AS
WELL. CLARIFYING THAT THIS NEEDS
TO BE DONE WITH THE FUNDS THAT
WE HAVE WITH THE IDA LEVERAGE
THEM AS MUCH AS POSSIBLE. WE
HAVE HAD CONVERSATIONS WITH SOME
INDIVIDUAL COUNTIES IN LARGER
GROUPS, RECOGNIZING THAT TODAY
SOME SERVICES THAT WE FULLY FUND
WITH DOLLARS COULD ACTUALLY
LEVERAGE ADDITIONAL MEDICAID
DOLLARS, AND THAT'S A BENEFIT.
THAT'S ONE OF THE MOST IMPORTANT
ASPECTS OF OUR TRANSFORMATION OF
THE PAST TWO DECADES THAT WE
WANT. WANT TO MAKE SURE THAT WE
LEVERAGE MORE AND MORE. IT'S
GOING TO TAKE BANDWIDTH. IT'S
GOING TO TAKE TECHNICAL
ASSISTANCE, BUT WE HAVE A STRONG
BELIEF THAT THAT IS GOING TO
HELP US TAKE OUR SCARCE
RESOURCES AS PLENTIFUL AS THEY
MIGHT SEEM THERE NEVER ENOUGH TO
DO EVERYTHING WE WANT. SO HOW DO
WE CONTINUE? TO MAKE THEM GO AS
FAR AS HUMANLY POSSIBLE. I THINK
THOSE ARE THE MOST IMPORTANT
ASPECTS OF THE PROPOSED
AMENDMENTS, BUT I WANT TO RETURN
TO SOMETHING YOU SAID SENATOR
EGGMAN. TRANSFORMATIONS ALTHOUGH
WE WANT TO, I OFTEN TALK ABOUT
WE WANT TO RAISE ALL BOATS, BUT
FRANKLY, SOME MORE THAN OTHERS.
THE BOAT WE WANT TO RAISE THE
MOST ARE THOSE WHO WE SO OFTEN
OVERLOOKED AND ALLOWED TO LIVE
WITH THE MOST SEVERE CONDITIONS
AND SOME OF THE HARDEST
CONDITIONS IN CALIFORNIA, AND WE
HAVE HAD VERY ROBUST, MEANINGFUL
CONVERSATIONS ON HOW BEST TO DO
THAT AND CHANGING THE FUNDING.
CATEGORIES ALONE DOES NOT ASSURE
THAT BUT IT DOES HELP US TAKE
ONE IMPORTANT STEP. SO THIS KING
ANGEL. THIS TRANSFORMATION THIS
MODERNIZATION TAKEN INTO CONTEXT
OF ALL THE OTHER CHANGES THAT
THIS LEGISLATURE THIS GOVERNOR,
HIS ADMINISTRATION HAVE ADVANCED
. GIVE US A REAL HOPE AND CHANCE
TO PUT SOMETHING TOGETHER THAT
WE CAN SOON ENOUGH. LOOK BACK AT
AND BE REALLY PROUD AS WE WALK
OUT OUR DOOR AND OUR OFFICES. TO
SEE IMPROVEMENT IN CHANGE, NOT
JUST IN THE STREETS AND WHERE WE
MIGHT DRIVE PAIN AND KIM IT. BUT
WHEN OUR KIDS COME HOME FROM
SCHOOL WHEN THEY'RE HAVING THEIR
CONVERSATIONS WITH THEIR FRIENDS
THAT WE KNOW THAT SOME OF THE
THINGS IMPACTING ALL
CALIFORNIANS ARE PART OF THIS
TRANSFORMATION OF TODAY. THANK
YOU FOR YOUR TIME. THANK YOU.
DR. KELLY WILL JUST GO TO
DIRECTOR BOSS BEFORE WE TAKE
QUESTIONS. SURE HERE JUST TO
ANSWER ANY TECHNICAL QUESTIONS
THAT MAY COME UP. THANK YOU,
OKAY. OKAY WELL, THANK YOU, DR
GALLEY FOR THAT OVERVIEW, AND I
THINK AS YOU SAID, THIS IS THIS
IS ANOTHER STEP AND EVERYTHING
ELSE THAT HAS TRANSPIRED OVER
THE LAST 20 YEARS AS FAR AS THE
AFFORDABLE CARE ACT EXPANSION OF
MEDIC, AL CAL AIM AND BEING ABLE
TO PAY FOR MORE SERVICES. SO
THIS IS IN CONCERT WITH ALL OF
THOSE QUESTIONS OR COMMENTS FROM
MY COLLEAGUES AT THIS TIME? YEAH
GO AHEAD, SENATOR ROSS, AND THEN
WE'LL GO TO RUBIO AND MENJIVAR
WISH SENATOR RUBIO UP FIRST. I'M
SORRY. I THOUGHT SHE WAS
FIRSTLY, WRONG. TRYING TO BE
COLLABORATIVE HERE. FIRST OF
ALL, I JUST WANT TO SAY THANK
YOU SO MUCH. I KNOW THIS IS A
LOT OF HARD WORK BEHIND THE
SCENES LATE HOURS IN THE DAY, SO
I JUST NIGHT. I MEAN, I WANT TO
THANK OUR CHAIR, EGGMAN AND ALL
YOUR TEAM AS WELL AS GOVERNOR
FOR TRYING TO DO THIS IMPORTANT
WORK, WHICH I KNOW IS ONE OF THE
MOST PRESSING AND AT LEAST MY
PERSONAL OPINION HERE IN
CALIFORNIA. AND SO I KNOW WE
HAVE HAD A LOT OF CONCERNS ABOUT
YOUTH PROGRAMS, AND WE'VE HEARD
A LOT OF THE CONCERNS AND
CLEARLY, YOU KNOW, I HAVE TO AT
LEAST IRISH SCIENTIST SPEAK FOR
MY COLLEAGUES PHILOSOPHY FOR
MYSELF AS AN EDUCATOR BEING IN
THE SCHOOL SYSTEM, NÂNG. HOW
MUCH NEED THERE IS IN THAT AREA
OF TRYING TO SUPPORT OUR YOUTH
WITH MENTAL HEALTH SERVICES. I
KNOW THAT YOU'VE DONE A GREAT
JOB IN TRYING TO STRIKE THAT
BALANCE. YOU KNOW, WE WANT TO
TAKE CARE OF HOMELESSNESS BUT
ALSO MAKING SURE THAT OUR YOUTH
DOESN'T FALL THROUGH THE CRACKS
. I JUST WANT TO SAY THANK YOU
FOR THAT IN PARTICULAR I WANT
YOU AND I MIGHT HAVE MISSED IT.
JUST EXPAND A LITTLE FURTHER.
SINCE I HAVE YOU HERE. YOU
DISCUSSED SMALLER COUNTIES
HAVING THE FLEXIBILITY TO INVEST
EARLIER. CAN YOU JUST ELABORATE
ON THAT CONCEPT, PLEASE? SURE SO
A FEW THINGS FIRST IN THE
ORIGINAL IN THE ORIGINAL
PROPOSAL BEFORE THESE AMENDMENTS
WE REALLY WANTED TO LIMIT THE
AMOUNT OF CAPITAL INVESTMENT
THAT THE HOUSING INTERVENTION
RESOURCES COULD GO TO, IN ORDER
THAT WE IMMEDIATELY ACTIVATE
THOSE DOLLARS TO FIND AVAILABLE
HOUSING UNITS. AND NOT
NECESSARILY WAIT BECAUSE WE HAVE
BEHAVIORAL HEALTH INFRASTRUCTURE
PROGRAMS. CC OTHER INVESTMENTS
IN SOME OF THE BRICK AND MORTAR
FACILITY BUILDS SO THAT WE COULD
USE THOSE DOLLARS IMMEDIATELY TO
HOUSE PEOPLE RECOGNIZING THAT
NOT EVERY COUNTY HAS THE SAME
OPPORTUNITY THAT CREATING
ADDITIONAL ACCESS TO CAPITAL
FUNDING. IN THOSE HOUSING
INTERVENTIONS FOR SMALLER
COUNTIES EARLIER IN THE PROCESS
WILL ALLOW US TO MAKE SURE THAT
COUNTY PLANS COULD CREATE SOME
OF THE INFRASTRUCTURE THAT THEY
MIGHT NEED TO ACHIEVE SOME OF
THE HOUSING. ADDITIONALLY SOME
OF THE ADMINISTRATIVE UH, NEEDS
WITH THE INCREASED FOCUS ON
REPORTING AND ACCOUNTABILITY,
ALLOWING SOME OF OUR SMALLER
COUNTIES TO HAVE ADDITIONAL
WELL. FUNDING TO FUND THOSE
ADMINISTRATIVE NEEDS SO THAT
THEY COULD MEET SOME OF THE
HOPES AND EXPECTATIONS IN THE
REPORTING MOVING FORWARD, SO
THOSE ARE 22 MAIN AREAS.
MICHELLE, IS THERE ANYTHING
ELSE? THOSE ARE THE TWO KEY
ONES? THANK YOU. LASTLY I GUESS
I WANTED TO SAY, BECAUSE YOU
KNOW THE AMOUNT OF COSTS THAT WE
RECEIVED IN CONCERNS. I ALSO
WANT TO SAY TO EVERYONE
LISTENING THAT SAVVY KENYAN FOR
THOSE USED PROGRAMS THAT WE WERE
DISCUSSING IS THAT I MEAN, YOU
KNOW, THIS IS JUST ONE PROGRAM,
BUT MY COLLEAGUES AND I CONTINUE
TO BE COMMITTED TO FINDING
RESOURCES AND FUNDING ANOTHER
WAY. SO THIS IS JUST ONE PIECE
OF THE PUZZLE BUT WILL CONTINUE
TO PUSH. AND ONCE AGAIN THANK
YOU FOR YOUR WORK. COULD YOU
TALK A LITTLE BIT MORE ABOUT
ABOUT THE SERVICES FOR KIDS AND
HOW WE HAVE ADAPTED THAT? YEAH
SO LET LET LET ME TAKE IN A
LITTLE BIT MORE AND ONE OF THE
KEY INITIATIVES THAT FRANKLY
EMBARRASSED A LITTLE THAT I
OVERLOOKED DIMENSION AS PART OF
THIS BROAD TAPESTRIES, THE
CHILDREN OF OUR HEALTH
INITIATIVE. YOU ALL IN CONCERT
WITH THE GOVERNOR TWO YEARS AGO
, PUT IN PLACE OF $4.7 BILLION
INVESTMENT IN CHILDREN. YOUTH
BEHAVIORAL HEALTH, SOME REALLY
TRANSFORMED OF THINGS THAT
BECOMING ENVIOUS ACROSS OTHER
STATES WHEN WE HAVE THE
PRIVILEGE OF SHARING WHAT WE'RE
DOING HERE. PART OF THAT IS ALSO
NEEDS A NEW NAME. WE CALL IT THE
FEE SCHEDULE. I CALL IT THE
SCHEDULE OF OPPORTUNITY FOR
SCHOOLS TO BE ABLE TO DELIVER
DIRECTLY CERTAIN BEHAVIORAL
HEALTH SERVICES TO THEIR
STUDENTS THAT ALLOW US TO NOT
JUST PAY FOR IT THROUGH MEDICAID
RESOURCES, BUT IS PART OF OUR
AGREEMENT. COMMERCIAL HEALTH
PLANS WILL ALSO BE SUPPORTING
THOSE SO OVER THE NEXT HANDFUL
OF YEARS, STARTING WITH SOME
PHASE ONE COUNTIES IN 2024, WE
WILL BE USING THIS FEE SCHEDULE
TO ALLOW US TO PROVIDE SOME OF
THOSE SERVICES THAT AS YOU
MENTIONED THE FOCUS ON SCHOOLS,
WE SHOULD SEE THAT INCREASE WITH
RESPECT TO THE BEHAVIORAL HEALTH
SERVICES ACT. REFORMS AND
AMENDMENTS. WE ARE MADE TESSA
ORIGINALLY HAD THROUGH ITS
REGULATION PROTECTIONS FOR A
CERTAIN AMOUNT OF THE PREVENTION
AND EARLY INTERVENTION FUNDING
GOING TO YOUNG PEOPLE WITH THE
AMENDMENTS TODAY AND THE EARLY
INTERVENTION AND PREVENTION
BUCKET THAT ARE NOW IN PRINT. WE
ACTUALLY COMMIT TO EVEN GREATER
TOTAL DOLLAR AMOUNT THAN IN THAT
ORIGINAL REGULATION. TO SUPPORT
PREVENTION AND EARLY
INTERVENTION SERVICES FOR YOUNG
PEOPLE UNDER THE AGE OF 26.
SENATOR SENATOR MANTRA FOR
SENATOR ROTH AND THEN SENATOR
NGUYEN. THANK YOU, MADAM CHAIR
SECRETARY DIRECTOR. THANK YOU SO
MUCH. YOU KNOW, SOME OF THE
EXCITING THINGS THAT I LOOKED AT
IT WAS CLARIFYING THE USAGE OF
THESE FUNDS FOR SUDDEN,
ESPECIALLY FOR OUR YOUTH. I TOOK
A TOUR OF TARZANA TREATMENT
CENTER IN L. A COUNTY. WHICH IS
THE LEADER IN, UM UM, TREATMENT
AND SO FORTH, AND I FOUND AN L.
A COUNTY, ONE OF THE LARGEST
COUNTIES, THERE'S ONLY ONE
FACILITY FOR YOUTH RESIDENTIAL
TREATMENT. ONE FOR L. A COUNTY
THAT'S IN ON CASTRO. AN AREA
THAT OFTENTIMES AND YOU DON'T
WANT TO GO TO, RIGHT? SO I'M
HOPING THAT WE CLARIFYING. THIS
WILL GET MORE FACILITIES LIKE
THAT AND SO FORTH AND HAPPY
ABOUT THE ACCOUNTABILITY FOR
COUNTIES, THE OVERSIGHT ON THE
COUNTIES AND SO FORTH. I'M HAPPY
WITH THESE AMENDMENTS AND JUST
TO CLARIFY BECAUSE ONE OF THE
CONCERNS WAS THAT WE WERE
MISSING THE TAPE POPULATION. SO
ALL THE PROBLEMS PROGRAM
SECRETARY MENTIONED EVERYBODY 26
AND UNDER WHEN WE TALK ABOUT
CHILDREN AND YOUTH. CORRECT
CORRECT. PERFECT. OKAY, SO INTO
THE QUESTIONS MENTIONED T Y B H
I'VE COUPLE OF TIMES. ONE TIME
FUNDING. HOWEVER YOU KNOW THAT
FUNDING WILL END AND IT'S BEEN
LOOKED AT IF CORRECT ME IF I'M
MISUNDERSTANDING THIS AS
SOMETHING TO SUPPLEMENT THIS,
I'M WONDERING WHERE WE'RE GOING
TO CONTINUE, IF THERE'S A
CONVERSATION, OR IS THE IDEA OF
HOW TO CONTINUE FUND THAT, UM,
IF THIS IS BEING LOOKED AT AS
SOMETHING TO AGAINST SUPPLEMENT
, SO THERE ARE DEFINITELY PART
OF THE CHILDREN YOUTH BEHAVIORAL
HEALTH INITIATIVE THAT ARE ONE
TIME START UP IN NATURE
INVESTMENTS IN THE PLATFORM,
SOME OF THE WORKFORCE
INVESTMENT, BUT THERE ARE
ASPECTS OF IT THAT ARE ONGOING
THE FEE SCHEDULE. THIS
OPPORTUNITY SCHEDULES. I'D LIKE
TO THINK ABOUT IT. THAT'S
ONGOING. THAT'S NOT GOING AWAY.
WE HAVE COMMITTED TO FUNDING
THOSE SERVICES, SOME OF THE
OTHER THINGS LIKE DIETETIC
SERVICES THAT IS NOW A BENEFIT
IN MEDICAID. THAT'S NOT GOING
AWAY, EITHER. SO SOME OF THE
CORE FEATURES OF THE CHILDREN
WOULD BE EVER OFF INITIATIVE ARE
NOT ONE TIME THEY WILL BE
CONTINUING. THAT SAID BETWEEN
CHILDREN HEALTH INITIATIVE SOME
OF THE IMPORTANT ASPECTS OF THE
BH CONNECT INITIATIVE, WHICH
WERE EXCITED TO HAVE DIRECTOR
BOSSES TEAM CONTINUE TO SHARE
WITH THE LEGISLATURE AND OTHERS
WHAT WE HAVE IN PLACE A PLAN
THERE WITH OUR FEDERAL PARTNERS.
EYES SEE THESE AS REALLY NOT
JUST ON RAMPS, BUT CONTINUED
ROADS TO FUND SOME OF THESE
CRITICAL SERVICES INTO THE
FUTURE. SO I THINK IT'S REALLY
IMPORTANT I OFTEN HEAR. WELL,
THAT'S ONE TIME IN NATURE. THERE
ARE SOME START UP AND BUILD UP
COSTS THAT ARE ONE TIME, OF
COURSE, BUT THERE ARE ASPECTS OF
IT THAT WILL CONTINUE ON INTO
THE FUTURE. IF I MAY ALSO JUST
ADD IN TERMS OF THE EARLY
INTERVENTION, ALLOTMENT OF
DOLLARS. WE HAVE NEW LANGUAGE
HERE, REALLY REQUIRING THE
DEPARTMENT TO COME UP WITH THE
KIND OF A BIENNIAL LIST IN
CONSULTATION WITH THE ATTACKS
AND OTHER PARTNERS OF EVIDENCE
BASED PROGRAMS THAT MAKE KIND OF
THE EARLY INTERVENTION
OBJECTIVES, AND WE HAVE A
REFERENCE TO THOSE THAT ARE
ESTABLISHED THROUGH THE CHILDREN
AND YOUTH, BEHAVIORAL AND HEALTH
INITIATIVES. RECOGNIZING SOME OF
THOSE INITIATIVE GRANT DOLLARS
ARE INTENDED TO SCALE UP SOME OF
THESE PROGRAMS STATEWIDE WHERE
WE KNOW THEY'RE WORKING
SOMEWHERE, BUT REALLY, TO SCALE
THESE UP AND ABIDING MEDICAL
DOLLARS SUPPORT SUPPORT SOME OF
THE REIMBURSABLE SERVICES AND
THEN A AS KIND OF THE GROUT THAT
IS NEEDED FOR SERVICES THAT ARE
NOT MEDICAL REIMBURSABLE. SO,
REALLY THINKING ABOUT HOW DO WE
SCALE UP AND KIND OF PUT THIS IS
A LIST OF WHAT COUNTIES ARE
REQUIRED TO PROVIDE. THANK YOU
MANTRA TO MORE IF THAT'S OKAY.
MY SECOND ONE IS ON TECHNICAL
ASSISTANCE, YOU KNOW, COUNTING
PHENOMENON PAPER, BUT I THINK
EVERY PROVIDER WILL TELL YOU.
IT'S HELL FOR THEM. THEY CAN'T
BUILD EVEN THOUGH THE RESOURCES
ARE THERE. THEY'RE UNABLE TO
BRING THOSE TWO INDIVIDUALS. I
AM LOOKING AT THIS AS SIMILAR TO
COUNT IN. WHAT HAVE WE LEARNED
FROM THAT? WHAT TECHNICAL
ASSISTANCE. ARE WE GOING TO
PROVIDE ACCOUNTING TO ENSURE
THAT THIS ISN'T THE SAME AS
COUNTING COINS, SO I WILL SAY
IT. WE HAVE LEARNED A LOT WITH
KELLY AND REALLY JUST GOING
THROUGHOUT THE STATES. WE HAVE
AND ARE MAKING POLICY CHANGES TO
TRY TO SIMPLIFY AND STANDARDIZE
SOME OF THE KIND OF THE PROGRAM
REQUIREMENTS ELIGIBILITY
REQUIREMENTS BUILDING
REQUIREMENTS. BUT THESE CHANGES
ARE ROLLING OUT NOW AND KIND OF
WILL BE COMING THROUGH THE AND
THE END OF THIS YEAR. BUT IS
PART OF THIS. WE DO HAVE JUST
KIND OF ACKNOWLEDGEMENT THAT
TECHNICAL ASSISTANCE IS NEEDED.
THAT WILL BE PART OF THOSE
CONVERSATIONS. TO REALLY
UNDERSTAND. WHAT DOES IT TAKE TO
IMPLEMENT? WHAT DO OUR PROVIDERS
NEED? WHAT GUIDANCE? A LOT OF
THIS, TOO IS GOING TO BE ABOUT
THAT BLENDING AND BRAIDING AND
THE OPPORTUNITIES TO LEVERAGE
EACH OTHER'S PROGRAMS AND
DOLLARS. AND HOW DO WE HELP
COUNTIES AND PROVIDERS IN CBO'S
THINK THROUGH HOW TO LEVERAGE
AND REALLY TAKE ADVANTAGE OF
REALLY PULLING THIS TOGETHER?
THE OTHER THING I'LL ADD, IS,
UM, I THINK THE CONVERSATIONS
AROUND HEALTH SERVICES ACT
REFORM THE CALEN CONVERSATIONS.
THERE ARE OTHER CONVERSATIONS,
WHICH REALLY HIGHLIGHT THAT
CALIFORNIA'S PLAN AND DREAM TO
LEVERAGE COMMUNITY BASED
PROVIDERS IS INCOMPLETE WITHOUT
A CLEAR UNDERSTANDING OF HOW
WE'RE GOING TO DO THAT TECHNICAL
ASSISTANCE AND SUPPORT. SOME OF
THESE GROUPS TO ACTUALLY BE ABLE
TO ACCESS THOSE FUNDS THROUGH
MEDICAID. AND FRANKLY SPEAKING
SOME OF THE GROUP'S TOP WE OFTEN
TALK ABOUT WORK TO THE TOP OF
YOUR LICENSE, DOING ALL OF THE
ADMINISTRATIVE ACTIVITIES IN
MEDICAID, OR PROBABLY NOT THE
BEST USE OF SOME FOLKS TIME, SO
WE OR ON THE HUNT FOR STRATEGIES
TO FIGURE OUT HOW TO MAKE THAT
EASIER ON THE HALL, AND I THINK
THAT'S NOT JUST RELEVANT TO THIS
NOT JUST RELEVANT TO CAL AIM. I
THINK THAT'S AN ACROSS THE BOARD
ASPECT OF OUR SUCCESS MOVING
FORWARD TO REALLY BENEFIT FROM
THIS IDEA OF HEY, WE'RE MOVING
OUTSIDE OF HOSPITALS AND CLINICS
IN THE COMMUNITY BASED SERVICES
PROVIDED BY PEOPLE WITH LIVED
EXPERIENCE PEOPLE WITH YOU KNOW
WHO COME TO WORK AND LIVE IN THE
COMMUNITIES THAT THEY WORK IN SO
THAT WE CAN REALLY MAXIMIZE THIS
OPPORTUNITY. SO I JUST WANT TO
TAKE THAT MOMENT TO SAY THIS IS
A BROAD IMPORTANT ISSUE THAT
GOES BEYOND JUST BITS AND PIECES
OF TECHNICAL ASSISTANCE AT THE
COUNTY LEVEL. WE NEED TO FIGURE
OUT HOW TO DO THIS MORE BROAD,
AND I KNOW DIRECTOR BOSSES TEAM
IS THINKING HARD ABOUT THAT.
QUICK FOLLOW UP. I'M SORRY. I
SAID, I PROMISE. JUST QUICK,
FOLLOW GUYS SAUCE FOR FOLLOW UP
DIRECTOR BECAUSE YOU MENTIONED
ABOUT LEVERAGING THE COMMUNITY
PARTNERSHIPS, YOU KNOW, AND
FOCUSING ON THE YOUTH AND
CHILDREN THE IMPORTANCE BUT I
DON'T SEE SCORES INVOLVEMENT IN
THAT COLLABORATION. MAYBE I
MISSED THAT. SCHOOLS ARE
DEFINITELY PART OF THIS. SO AS
PART OF THAT COUNTY INTEGRATED
PLAN THAT WE'RE ASKING IS REALLY
REPLACING THE THREE YEAR PLAN.
IT INCLUDES SCHOOLS, EARLY
EDUCATION, HIGHER EDUCATION K 12
. IT'S REALLY THE LIST OF
STAKEHOLDERS AND PARTNERS
INVOLVED IN THAT PROCESS IS
EXPANDED TREMENDOUSLY. AREA
AGENCIES ON AGING. I JUST
APPRECIATE MY FINAL QUESTION. MY
ACTUAL THIRD ONE CAN YOU BREAK
DOWN THE 3% THAT IS BEING PULLED
AWAY FROM COUNTIES FOR WORKFORCE
. AND WHAT WOULD THAT LOOK LIKE
? SURE SO FIRST, THE ONE OF THE
FIRST THINGS THAT A PORTION OF
THAT 3% IS GOING TO BE USED FOR
IS TO SUPPORT AN ASPECT OF THE
BH CONNECT PROPOSAL, WHERE IN
ROUGHLY $36 MILLION A YEAR FOR
FIVE YEARS WILL BE TAKEN FROM
THAT 3. AND USED TO LEVERAGE A
TOTAL OF ALMOST $2.4 BILLION AT
THE FEDERAL LEVEL TO INVEST IN
WORKFORCE INITIATIVES, IN PART
TO BUILD UP ALL OF THE PROGRAMS
TO ALLOW US TO, FRANKLY STAFF
AND SUPPORT A LOT OF THE
MEDICAID SERVICES THAT ARE
CRITICAL TO THE BH CONNECT
PIECE. A PORTION OF THAT 3% IN
THE FIRST FIVE YEARS IS GOING TO
BE COMMITTED TO LEVERAGING
FEDERAL DOLLARS. WE HOPE FRANKLY
EXPECT THAT WE MAY BE ABLE TO DO
THAT A SECOND TIME TO ALLOW US
TO HAVE THIS LEVERAGE
OPPORTUNITY BEYOND FIVE YEARS UP
TO 10. OTHER FUNDS WILL BE USED
IN COLLABORATION WITH OUR LABOR
PARTNERS ARE COUNTY PARTNERS OR
OTHER PROVIDER PARTNERS TO MAKE
SURE THAT WE ARE SUPPORTING
INITIATIVES. WHETHER IT'S UP
SKILLING EXISTING WORKFORCE OR
INVITING OTHERS THROUGH
INVESTMENTS IN BREAD AND BUTTER
, SOCIAL WORK PROGRAMS OR OTHER
TYPES OF PROGRAMS OR AND I WOULD
ARGUE PART OF CALIFORNIA'S
CHALLENGE IS TO FIND THE NEW
TYPES OF CLASSIFICATIONS AND
BEHAVIORAL HEALTH THAT ARE GOING
TO HELP US IN CALIFORNIA IN THE
FUTURE. SO BIG PART OF IT IS
REALLY LEVERAGING MEDICAID AND
THE WORKFORCE INITIATIVE THROUGH
BH CONNECT, AND THEN BEYOND THAT
, IT'S WORKING WITH LOCAL
PARTNERS TO DESIGN WORKFORCE
PROGRAMS. NOT JUST ONE TIME
SPEND THIS WILL BE ONGOING
MONEY. TO BE ABLE TO SUPPORT
BUILDING UP THE WORKFORCE
LOCALLY AND WITH A PRIORITY OF
UNDERSTANDING WHAT THE COUNTY
BEHAVIORAL HEALTH DEPARTMENT
NEEDS ARE SO THAT WE MAKE SURE
TO BUILD WHETHER ITS LOS ANGELES
OR A SMALLER COUNTY, WE'RE
HELPING SUPPORT THEM AND
BUILDING UP AND RECRUITING THE
WORKFORCE. THEY NEED TO DELIVER
THESE PROGRAMS. THANK YOU. THANK
YOU. SOUNDS LIKE SAME DAY
BILLING COULD FIT RIGHT IN THERE
JUST WHILE WE'RE STREAMLINING
SENATOR ROSS. THANK YOU, TOO,
FOR WORKING THIS VERY, VERY
IMPORTANT ISSUE I HAVE TO
CONFESSION TO MAKE AT THE OUTSET
AND THAT IS I HAVEN'T BEGUN TO
MASTER THE ORIGINAL BILL, AND I
REALLY HAVEN'T EVEN HAD A CHANCE
TO LOOK AT THE 200 SOMETHING
PAGE OF VERSION AS AMENDED THAT
APPARENTLY CAME OUT, BUT AND
WE'VE BEEN ASKED TO LIMIT OUR
QUESTIONS. SO THAT'S GOOD, SO I
CAN'T HAVE SPECIFIC ONES BECAUSE
I WOULD REALLY REVEAL HOW LITTLE
I KNOW ABOUT THIS, SO I'LL ASK A
GENERAL ONE. YOU KNOW WHAT I WAS
ABLE TO READ IN THE MATERIAL
THAT WAS AVAILABLE TALKS A LOT
ABOUT ALLOCATION OF MONEY INTO
BUCKETS AND PERCENTAGES OF MONEY
INTO BUCKETS AND CATEGORIES OF
MONEY AND WHAT IT IS, AND IT
SORT OF REMINDS ME OF EDUCATION
FINANCE WHERE WE HAD CATEGORICAL
AND WE WORKED THROUGH LOCAL
CONTROL FUNDING AND HOW WE WERE
GOING TO DEAL WITH THAT WITH
SCHOOL DISTRICTS, AND WE HAVE
LARGELY MOVED AWAY FROM
CATEGORICAL FOR GOOD REASON,
BECAUSE SCHOOL DISTRICTS AND
COMMUNITIES DIFFER AROUND THE
STATE. GIVEN THE VARIATION AND
DIFFERENCES BETWEEN THE MANY
COUNTIES THAT WE HAVE IN TERMS
OF HOUSING AND TREATMENT
PROGRAMS AND POPULATIONS AND
POPULATION NEEDS. INSTEAD OF
TRYING TO DO THIS IN A BUCKET BY
BUCKET APPROACH BY PERCENTAGES
WHEN IT BE BETTER TO SET GOALS
AND OBJECTIVES AND ESTABLISHED
DESIRED OUTCOMES, WHETHER THEIR
GENERAL OR A SPECIFIC WHETHER WE
DO IT AS A STATE, OR WE LET THE
COUNTY'S DO IT AND SUBMIT IT FOR
APPROVAL AND ADJUSTMENT BY US.
WOULDN'T IT BE BETTER TO DO THAT
AND THEN LET THE COUNTY'S FIGURE
IT OUT? IT WAS AT LEAST WITH
SOME GUARDRAILS AS OPPOSED TO
THE CURRENT MODEL, WHICH IS
BUCKET CENTRIC PERCENTAGE
CENTRIC. WE'RE GOING TO HOLD OUT
BUT JUST BY 7% WHAT IF ONE
COUNTIES HOUSING NEEDS ARE
MINIMAL FOR WHATEVER THE REASON
IN COMPARISON TO ANOTHER
COUNTIES NEEDS AND ANOTHER PART
OF THE STATE, ONE OF ONE
COUNTY'S POPULATION NEEDS LESS
TREATMENT OR MORE TREATMENT. OR
EARLY INTERVENTION THAN ANOTHER
COUNTY. AND YET WE HAVE CREATED
THEM. WE HAVE CREATED IN A IN
SOMETHING THAT THIS GOES TO THE
BALLOT DOESN'T IN SOMETHING
THAT'S GONE TO THE BALLOT OF
FIXED SYSTEM THAT IS ALMOST
IMPOSSIBLE TO ADJUST. JUST LIKE
THE ORIGINAL M H S A. AND THEN
WE HAVE TO GO BACK THROUGH THIS
PROCESS AGAIN AND GO BACK TO THE
BALLOT IS THAT QUESTION MAKES
SENSE. IT MAKES LOTS OF SENSE
AND RESPOND A FEW DIFFERENT WAYS
FIRST. IN TODAY'S SYSTEM. WE
HAVE FAIRLY RIGID BUCKETS
WITHOUT SOME OF THE OTHER PARTS
THAT YOU'RE RIGHT, ACCURATELY
CALLING FOR OUTCOMES METRICS
ABILITY TO ACTUALLY COLLECT DATA
AROUND THOSE PRESENTED
TRANSPARENTLY, NOT JUST LET THE
STATE OR DEPARTMENT LEVEL TO THE
LEGISLATURE, BUT ALL
CALIFORNIANS TO UNDERSTAND WHAT
THIS IMPORTANT VOTER RATIFIED.
TWO DECADES OLD POCKET OF
RESOURCES IS ACTUALLY HELPING US
ACHIEVE, SO I'LL START BY SAYING
ABSOLUTELY AND ANCHOR OF THIS
REFORM IS ESTABLISHING THOSE
METRICS BOTH AT THE STATE LEVEL,
SO STATEWIDE METRICS THAT COULD
BE UNIVERSALLY APPLIED AND
FOCUSED ON BUT ALLOWING THROUGH
THE PLANNING PROCESS THAT
DIRECTOR PASS MENTIONED. FAIRLY
ROBUST TO CREATE SOME LOCAL
METRICS THAT MATTER OR DRIVEN BY
THEIR OWN, NEEDS THEIR OWN DATA,
THEIR OWN SORT OF. WHERE DO THEY
WANT TO MOVE? WHAT ARE THE
PARTNERS, SPEAKING AROUND ONE OF
THE FAMILIES APPEARS OTHER
GROUPS SING, SO ESTABLISHING
THAT I THINK IS CRITICAL TO THIS
PIECE ON THE FUNDING SIDE,
RECOGNIZING THAT, AH. THE
OPPORTUNITY TO MAKE SURE THAT
THE VARIOUS BROAD ELEMENTS OR
INVESTED IN ADEQUATELY WITH SOME
FLEXIBILITY IN THE BUCKET TO BE
ABLE TO MOVE ACROSS. WE BELIEVE
WITH THE NORTH STAR BEING THOSE
STATEWIDE AND COUNTY LED METRICS
THAT THESE BUCKETS WITH THAT
FLEXIBILITY ARE GOING TO ALLOW
COUNTIES TO REALLY ACHIEVE. WHAT
WE EXPECT TO SEE AND DO IT IN A
WAY THAT WE WILL BE ABLE TO
REPORT NOT JUST TO YOU, BUT TO
POPULATIONS BROADLY ABOUT THE
IMPACT, SO SURE THERE MAY BE
OTHER APPROACHES THAT ONE COULD
IMAGINE. BUT WE BELIEVE THAT
THIS APPROACH WITH THE
FLEXIBILITY ANCHORED WITH THIS
ACCOUNTABILITY STRUCTURE, THAT'S
FRANKLY NEW TO HAVE ITS
STATEWIDE. NOT THAT YOU KNOW,
IT'S THERE HASN'T BEEN ELEMENTS
COUNTY BY COUNTY OR ON SPECIFIC
ISSUES, HISTORICALLY, FOR A
PERIOD OF TIME, BUT TO HAVE THIS
NOW BE KIND OF THE LEADING EDGE
OF THIS ENTIRE REFORM. THINK IS
REALLY IMPORTANT. WELL, THANK
THANK YOU FOR THAT RESPONSE.
THANK YOU, MADAM CHAIR.
APPRECIATE IT. WHEN DID YOU HAVE
SOMETHING? THANK YOU, MADAM.
CHAIR MRS. SECTOR A COUPLE
COUPLE THINGS. ONE IS, YOU KNOW,
I KNOW THE METAL HEALTH SERVICES
OVERSIGHT OF ACCOUNTABILITY
COMMISSION. THEY SERVE A VERY
IMPORTANT ROLE AS THOUGH AND
VERY INDEPENDENT. HOW DOES THE
PLAN PRESERVED THAT?
INDEPENDENCE IN THAT COMMISSION
AND ITS ROLE, I THINK IMPORTANT
GOOD QUESTION, AND, UH IN THE
ORIGINAL PROPOSAL THAT
INDEPENDENCE WAS PRESERVED. I
THINK SOME OF THE AMENDMENTS ALL
THOSE SUBTLE IN TODAY'S IN THE
UPDATED LANGUAGE REALLY PUT THE
ONUS ON THE DEPARTMENT AND THE
OVERSIGHT COMMISSION, THE
DEPARTMENT OF HEALTH CARE
SERVICES, THE OVERSIGHT
COMMISSION, AND IN SOME PLACES
CD PH TO WORK TOGETHER ON COMING
UP WITH WHAT THE STATEWIDE
METRICS ARE DETERMINING WHAT
TECHNICAL ASSISTANCE LOOKS LIKE
AND NOT HAVING IT FALL JUST IN
ONE PLACE OR THE OTHER. SO NOT
ONLY DO WE THINK THAT
INDEPENDENCE IS PRESERVED, BUT
IT ALSO THROUGH THIS LANGUAGE
AND UPDATE CREATES OPPORTUNITIES
TO FRANKLY COLLABORATE IN WAYS
THAT THE OVERSIGHT COMMISSION
AND THE ADMINISTRATION'S
DEPARTMENTS HAVEN'T HISTORICALLY
DONE MY HOPE IS THAT WE'RE SORT
OF USHERING AND SHARING IN A NEW
APPROACH WITH THESE PARTNERS TO
MAKE SURE THAT WE'RE PUTTING OUR
BEST FOOT FORWARD THEIR STAFF IN
BOTH PLACES AND THAT STAFF
SHOULD BE UNLEASHED IN A
COLLABORATIVE WAY. SO WE BELIEVE
THE INDEPENDENCE IS MAINTAINED,
BUT WE HAVE TAKEN OPPORTUNITIES
TO MAKE SURE THERE'S
OPPORTUNITIES WHERE APPROPRIATE
, AND WHERE PRESCRIBED TO WORK
TOGETHER, AND IT'S STRONGER WAY
IF I MAY. JUST ADD. SOME OF
THOSE OPPORTUNITIES ARE AREAS
WHERE THEY HAVE EXPERTISE WHERE
THEY'VE HAD A LOT OF WORK IN THE
PAST FEW YEARS. FULL SERVICE
PARTNERSHIPS, FOR EXAMPLE, AS WE
DEVELOPED THE LEVEL OF CARE THE
STANDARDS OF CARE FOR FULL FULL
SERVICE PARTNERSHIPS WORKING
WITH ON THAT DEFINITION, IN
ADDITION, INNOVATION WE WANT
INNOVATION SPRINKLED THROUGHOUT
ALL OF THOSE BUCKETS AND SO
REALLY LOOKING TO THEM
PRODUCTIVE, PROVIDE GUIDELINES
IDEAS KIND OF A STATEWIDE LIST
OF WHAT ARE SOME INNOVATIVE
PROGRAMS THAT BELONG IN EACH OF
THOSE BUCKETS FOR OUR COUNTIES.
AND I APPRECIATE THAT I WANT TO
COLLABORATION, BUT I ALSO GET
WANT TO MAKE SURE THAT THEY CAN
GIVE US THEIR OPINION WITHOUT
HAVING TO BE FELT LIKE THEY'RE
BEING INFLUENCED OR ARE EXPECTED
TO GO A CERTAIN WAY. WE UM WE
BOTH EXPECT THAT HEARD THAT LOUD
AND CLEAR AND REALLY TRIED, AND
I THINK ACHIEVED LANGUAGE THAT
PRESERVES THAT INDEPENDENCE
WHILE ALLOWING US TO REALLY WORK
TOGETHER IN A WAY THAT
HISTORICALLY MAYBE HAS BEEN
UNDER RECOGNIZED. ONE MORE
QUESTION MATTER ON THE
ALLOCATION THAT PROPOSED FUNDING
CATEGORIES YOU HAVE THERE,
WHEREAS THE HOUSING INTERVENTION
ONE OF IT IS, SAYS 50% MUST BE
INDIVIDUAL WHO ARE CHRONICALLY
HOMELESSNESS. WHAT WHAT ARE WE
DOING DIFFERENT OR THAN SECTION
EIGHT OR THE OTHER COUNTY
FUNDINGS ALREADY FOR BECAUSE
THERE'S COUNTY FIGHTING TODAY
VERY SPECIFIC FOR INDIVIDUALS
WHO ARE CHRONICALLY, I MEAN,
HOMELESS THAT NEEDS TO GET
HOUSING IMMEDIATELY. ARE WE
DOING THE SAME THING OR WE DO
SOMETHING DIFFERENT. RETARDANTS
A DIFFERENT BASE. YEAH I MEAN,
FIRST OFF THE INDIVIDUALS WHO
WILL BE ELIGIBLE FOR HOUSING
INTERVENTIONS ARE PEOPLE WITH,
YOU KNOW SEVERE, PERSISTENT
BEHAVIORAL HEALTH CONDITIONS.
FIRST AND FOREMOST, THAT ISN'T
ALWAYS THE PRIORITY AND OTHER
PROGRAMS. SO THAT IS SORT OF THE
FIRST CRITERIA FOR ENTRANCE AND
THEN HAVING THAT FOCUS ON THOSE
WHO ARE HAVE EXPERIENCED CHRONIC
HOME JUSTICE IS. TO SAY THAT
OFTEN. INDIVIDUALS WHO ARE IN
ENCAMPMENTS SUFFERING SOME OF
THE HARDEST PARTS OF SEVERE
BEHAVIORAL HEALTH CHALLENGES ARE
EASY TO PASS BY EASY TO MOVE ON
TO SOMEBODY ELSE, AND THIS IS
REALLY REQUIRING COUNTIES AND
THEIR PARTNERS TO FOCUS ON THOSE
INDIVIDUALS NOT ONLY FIRST AND
FOREMOST, BUT IN ADDITION TO
OTHER POPULATIONS AS WELL, THIS
IS OUR WAY OF MAKING SURE SURE
THAT PEOPLE DON'T FALL THROUGH
THE CRACKS ARE TYPICALLY DO SO
WE'RE GOING TO ACTUALLY HAVE
SPECIFIC UM, GUIDELINES FOR THIS
FUNDING, THEN? OH YES. JUST
WANNA MAKE SURE BECAUSE BECAUSE
EVERY TIME WE SEND FUNDING DOWN
, UM YOU KNOW, WE LOVE THE
COUNTIES WERE NOT AS BIG AS A
WAY, COUNTY, BUT WE'RE NOT A
SMALL COUNTY. I HAVE MOSTLY MY
DISTRICTS IN ORANGE COUNTY, SO
WE'RE KIND OF IN BETWEEN. AND
JUST IT'S A SOMETIMES WE GET
FUNDING THAT JUST IT'S JUST SO
OVERLY BROAD AND I WANT THE
FUNDING TO GO SPECIFICALLY TO
WHAT WE BELIEVE IS NEEDED. I
THINK THAT WITHIN THE HOUSING
INTERVENTION BACK IT WE BELIEVE
THAT THAT ABILITY TO GUIDE IT TO
THOSE WITH SEVERE BEHAVIORAL
HEALTH CONDITIONS WHO NEED
HOUSING EXISTS, WHILE ALSO
MAKING SURE WE FOCUS ON THOSE
WHO AS YOU KNOW VERY WELL IN
ORANGE COUNTY ARE EXPERIENCING
STREET BASED OR CHRONICLE,
MUSLIM. THANK YOU. THANK YOU.
AGAIN THESE ARE PEOPLE WHO ARE
MAKING UP. THESE ARE PEOPLE WHO
ALREADY LIVE IN EVERY COUNTY
RIGHT AND WHO THEORETICALLY ARE
UNDER THE UMBRELLA OF MHS A. AND
SO I MEAN LEAVE, LEAVING IT JUST
A FOR COUNTIES TO DO HAS YOU
KNOW AND AGAIN? NOT JUST NOT
NOT. COUNTIES AREN'T BAD, BUT
IT'S THOSE ARE VERY HARD
POPULATION TO TREAT UNLESS YOU
REALLY MANDATED IT'S HARDER.
SENATOR WIENER. THANK YOU,
MADAM. CHAIR THAT MR SECRETARY.
THANK YOU. AND THANK YOU AND THE
CHAIR AND THE GOVERNOR FOR THIS
WORK AND I SUPPORT WHAT YOU'RE
WHAT YOU'RE DOING. I ALSO DO
WANT TO THANK YOU FOR WORKING
WITH THE YOUTH ADVOCATES AND
MAKING CLEAR THAT THIS FUNDING
STILL NEEDS TO PRIORITIZE THE
NEEDS OF YOUTH. WE KNOW THAT
THAT'S WHEN MENTAL HEALTH
CHALLENGES TEND TO ARISE AND WE
HAVE JUST IT'S JUST DEMORALIZING
. HELP YOU RESOURCES THERE ARE
FOR THE MENTAL HEALTH NEEDS OF
YOUNG PEOPLE. AND IN FACT, BUT I
KNOW THIS IS HARD BECAUSE IN
2018 I DID A BILL SB 1004 FOR
THEIR EARLY PREVENTION. EARLY
INTERVENTION PIECE OF WORKING
WITH MAYOR STEINBERG. TO
PRIORITIZE SOME OF THOSE FUNDS
FOR THE NEEDS OF YOUTH AND OTHER
STAKEHOLDERS QUICKLY CAME OUT
AND PUSH BACK AGAINST THAT, AND
IT WAS SO I GOT TO LOOK UNDER
THE HOOD AND SEE THE POLITICS OF
MHS A AND SO I WANT TO COMMEND
YOU FOR DOING THAT WORK, SO
THANK YOU. THANK YOU BEFORE WE
MOVE TO THE NEXT PANEL, COULD
ONE OF YOU AND MAYBE TOBY WILL
DO THIS WHEN IT COMES UP TO IT,
BECAUSE I THINK ONE OF THE MOST
EXCITING, NECESSARY THINGS WE'RE
DOING AROUND. UM, EARLY
INTERVENTION IS BEING ABLE TO
FOCUS ON EARLY PSYCHOSIS. WE
KNOW THAT IF YOU INTERVENE THERE
AND AGAIN THAT'S YOUNG PEOPLE
BETWEEN THE AGES OF 15 AND 20.
FOR THE MOST PART AND I THINK
THE U. S IS KIND OF BEHIND ON
REALLY PRIORITIZING THAT AND
STANDARDIZING IT AND MAKING IT
JUST SO ANY ANY COUNTY CAN
FOLLOW A PROTOCOL. CAN YOU TALK
ABOUT THAT? AS ONE EXAMPLE
BEFORE WE MOVE ON HOW WE MIGHT
REALLY BE ABLE TO SCALE THAT UP
TO A LARGER PLACE EARLY
PSYCHOSIS? SURE JUST QUICKLY,
AND I APPRECIATE TOBY'S COMMENT
ON THIS WHEN HE HAS A CHANCE TO
TESTIFY AS WELL. AND DIRECTOR
BOSS AND I HAVE HAD LOTS OF
CONVERSATIONS LEARNED QUITE A
BIT, ESPECIALLY EVEN THINKING
ABOUT THE CHILDREN YOUTH
BEHAVIOR HEALTH INITIATIVE ABOUT
WHAT SOME OF THE COUNTIES ACROSS
CALIFORNIA ARE TRYING TO DO
ACROSS COUNTY LINES AS WELL WITH
HEALTH SYSTEMS TO BE ABLE TO
PRIORITIZE EARLY INTERVENTION
FOR EARLY PSYCHOSIS AS DIRECTOR
BOSS MENTIONED ONE OF THE
FEATURES OF THE EARLY
INTERVENTION FUNDING IS FOCUS ON
YOUNG PEOPLE, BUT ALSO A
BIANNUAL LIST OF EVIDENCE BASED
PROGRAMS THAT WILL BE ON A MENU
IF YOU WILL, FOR COUNTIES TO
CHOOSE FROM. BUT ON THAT MENU,
THERE WILL BE SOME REQUIRED
ASPECTS AND HAVING A REQUIREMENT
TO FOCUS ON EARLY PSYCHOSIS
BASED ON THE EVIDENCE AND THE
DEMONSTRATION THAT IT MAKES A
DIFFERENCE THAT WE KNOW THAT SO
MANY OF THE PSYCHOTIC DISORDERS
THAT AFFECT ADULTS START EARLIER
HAVING THE ABILITY TO MAKE SURE
THAT FIRST EPISODE, PSYCHOSIS IS
MET WITH THE KIND OF INTENSE
RESOURCES IN COMMUNICATION WITH
FAMILIES WITH YOUNG PEOPLE TO
MAKE SURE THAT THERE CAPTURED IN
EVIDENCE BASED PROGRAMS IS ONE
OF THE PRIORITIES AND WILL BE A
FEATURE ACROSS CALIFORNIA
SUPPORTED NOT JUST THROUGH
BEHAVIORAL HEALTH SERVICES ACT
FUNDING, BUT ADDITIONALLY
THROUGH CHILDREN'S BEHAVIORAL
HEALTH FUNDING AND HOPEFUL
INNOVATIONS THAT WE DISCOVER AND
BUILD HERE FIRST NOT IMPORT FROM
ABROAD BECAUSE WE HAVE THAT
ABILITY HERE IN CALIFORNIA TO
PUSH THE NEEDLE AS WELL. SO I
THINK THAT'S AN EXCITING FEATURE
. THANKS FOR LETTING US
HIGHLIGHTED. ABSOLUTELY AND I
JUST WANT TO JUST TAKE
COMPLIMENT DR GALLEY. HE HAS
BEEN BULLISH ON BEING ABLE TO
OFFER YOUTH AND FAMILIES AND
SCHOOLS TO BE ABLE TO PULL DOWN
AS MUCH PRIVATE DOLLARS AS
POSSIBLE THAT WE DON'T NEED TO
USE PUBLIC DOLLARS FOR
EVERYTHING. THERE'S A LOT OF
WAYS TO BE ABLE TO ACCESS THAT,
ESPECIALLY IN SCHOOLS. I
APPRECIATE THAT. MAYOR STEINBERG
HAS REACHED OUT TO ME TO ASK ME
IF HE CAN GO NEXT. JUST FOR A
BRIEF TIME. I DON'T KNOW.
SECRETARY STAY AND DIRECTOR
STAYED BY CLOSE BECAUSE
EVERYBODY TAXES. PROBABLY GONNA
YOU MIGHT WANT TO RESPOND SO
MAYOR STEINBERG COME UP AND THEN
AND THEN TOBY AND MY FRIEND WILL
WITH A BEAUTIFUL VOICE THAT CAN
START MAKING YOUR WAY UP AS
WELL. BECAUSE THEN YOU'LL BE ON
NEXT. THE MAYOR STEINBERG, HEAD
OF THE BAY AREA, SO HE'S JUST
GOING TO BRIEF AND BE HERE FOR A
COUPLE OF MINUTES TO TALK ABOUT
IS THE FOUNDER. THANK YOU,
MANAGER. THANK YOU FOR YOUR
COURTESY OF THE OTHER MEMBERS OF
THE PANEL. I DO HAVE TO HAVE A
FAMILY MATTER HAVE TO GET TO THE
BAY AREA, SO I REALLY APPRECIATE
IT GOOD TO BE WITH YOU. MEMBERS
OF THE COMMITTEE OLD COLLEAGUES
. UM THANK YOU FOR HAVING ME. I
THOUGHT MY BEST VALUE TODAY
WOULD BE TO PROVIDE A LITTLE BIT
OF THE HISTORY OF THE MENTAL
HEALTH SERVICES ACT AND HOW IT
RELATES TO TODAY'S PROPOSAL AS
AMENDED, WHICH, BY THE WAY I
WHOLEHEARTEDLY SUPPORT, AND I
COMMEND YOU COMMEND THE
GOVERNOR, SECRETARY GALLEY
DIRECTOR BOSS EVERYONE WHO HAS
WORKED VERY HARD TO BRING THIS
FORWARD. THIS PROPOSAL WAS GREAT
PRIOR TO THE AMENDMENTS. IT'S
EVEN BETTER NOW. THE HISTORY IS
IMPORTANT. HOW DID THIS ALL GET
STARTED WHEN I WAS A YOUNG
ASSEMBLY MEMBER ELECTED IN 1998
? I WAS GIVEN SOME SAGE ADVICE.
WORK ON SOMETHING IN YOUR SIX
YEARS BECAUSE IT WAS JUST GOING
TO BE SIX. THAT IS REALLY
IMPORTANT TO THE STATE THAT NO
ONE ELSE IS WORKING ON. YOU'LL
BE ABLE TO HAVE YOUR OWN
NORTHSTAR AND WILL BE ABLE TO
MAKE A CONTRIBUTION. AND I MET A
GENTLEMAN BY THE NAME OF RUSTY
SEE LICKS THE LATE GREAT RUSTY
SEE LICKS WHO WAS THE HEAD OF
THE COMMUNITY COUNCIL, MENTAL
HEALTH AGENCIES AND TOGETHER IN
1998. WE WROTE A B 34 AND A B 34
WHICH BECAME A B 2034 OVER THE
COURSE OF TWO YEARS WE WERE ABLE
, EVEN IN TOUGH ECONOMIC TIMES
TO CONVINCE THE GOVERNOR DAVIS
AND THE LEGISLATURE TO ABOUT $55
MILLION. INTO WHAT WE CALLED
INTEGRATED SERVICES FOR THE
HOMELESS, MENTALLY ILL. WHATEVER
IT TAKES. SORT OF OUTREACH CASE
MANAGEMENT, WRAPAROUND SERVICES
, SHELTER AND HOUSING FOR PEOPLE
OVER THE COURSE OF THOSE FIRST
YEARS, WE SHOULD DRAMATIC
IMPROVEMENTS IN IN REDUCTIONS IN
RATES OF HOSPITALIZATION. RATES
OF HELP. DAYS OF HOMELESSNESS,
THE NUMBER OF ARRESTS, INCREASED
HOUSING PLACEMENT AND EVEN THE
BEGINNING OF INCREASED
EMPLOYMENT. IN ABOUT 2003. WE
LOOKED AT EACH OTHER AND SAID,
ARE WE SATISFIED WITH WITH $55
MILLION A YEAR BECAUSE THE
ORIGINAL PREMISE WAS TO TRY TO
GET THE STATE TO UPHOLD THE
PROMISE MADE BY GOVERNOR REAGAN
IN THE LEGISLATURE BACK IN THE
19 SIXTIES, WHEN THEY SHUT THE
STATE HOSPITALS TO FUND A DECENT
SYSTEM OF COMMUNITY MENTAL
HEALTH CARE. AND WE THOUGHT,
MAYBE AUDACIOUSLY THAT IF WE
WENT TO THE BALLOT THAT WE COULD
UPHOLD THAT PROMISE, AND SO WE
DID, AND WE PUT TOGETHER
PROPOSITION 63 AND WERE THE
FIRST TO CHOOSE THE
MILLIONAIRE'S TAX AND UNDER THE
RADAR CAMPAIGN, MANY OTHER
THINGS GOING ON. WE PASSED IT
53% OF THE VOTE. AND OVER 20
YEARS THE ACT IS, I THINK, MAYBE
A LITTLE BIT OF AUTHORS. BIAS
HERE HAS BEEN A GREAT SUCCESS. I
DON'T THINK THE COUNTIES HAVE
MISSPENT THE MONEY. JUST THE
OPPOSITE. I THINK THEY'VE DONE A
GOOD JOB WITH THE MONEY. BUT IF
WE'RE HONEST ABOUT IT, IF WE'RE
HONEST ABOUT THE WORLD HAS
CHANGED OVER 20 YEARS. NO ONE
WAS WORKING ON MENTAL HEALTH.
THEN NOW, MENTAL HEALTH IS THE
ISSUE OF OUR TIME. IF WE'RE
HONEST ABOUT IT UP UNTIL
GOVERNOR NEWSOME TOOK OFFICE.
AND APPOINTED SECRETARY GALLEY
AND MADE THESE ISSUES AS
SIGNATURE PRIORITY. THE FLAW IN
THE MENTAL HEALTH SERVICES ACT
HAS NOT BEEN THE COUNTY'S FAULT
HAS BEEN THAT THE STATE OF
CALIFORNIA HAS NEVER SET
STATEWIDE PRIORITIES AND WHAT
THEY WANT IS MASSIVE AMOUNT OF
MONEY BECAUSE IT'S NOW $4
BILLION PLUS TO GO TOWARDS OVER
20 YEARS. THE COUNTIES HAVE DONE
A GOOD JOB WITH THE MONEY. BUT
IF WE'RE ALSO HONEST, WE WILL
SAY THAT THE FULL SERVICE
PARTNERSHIPS WHICH ARE THE
WRAPAROUND SERVICES, THE COIN OF
AROUND THE ABBEY 34 MODEL HAVE
NOT BEEN FOCUSED ON THE
CHRONICALLY HOMELESS. THEY JUST
HAVE NOT. AND FOR MANY REASONS,
ONE. IT'S A REALLY HARD PROBLEM
AND HARD POPULATION. AND MAYBE
IT'S A LITTLE BIT MORE
EXPENSIVE, AND I DON'T SAY THE
COUNTIES OF CREAMED OR THE
PROGRAM FIGHTERS OF CREAMED
THERE HELPING PEOPLE WITH
SERIOUS ILLNESSES, BUT THEY ARE
NOT FOCUSED ON THE PEOPLE LIVING
IN THE TENT ENCAMPMENTS.
GOVERNOR NEWSOM COMES ALONG AND
HIS ADMINISTRATION AND SENATOR
EGGMAN WITH YOUR YOUR NOW THE
LEGISLATURE'S LEADER ON THESE
SETS OF ISSUES. THANK YOU. ARE
SAYING, HOW DO WE FULFILL THAT
PROMISE FROM NOW? WHAT 60 YEARS
AGO? 50 60 YEARS AGO. WELL IT'S
NOT JUST MHSC BECAUSE, FRANKLY,
ONE OF THE BURDENS OF IS IT HAS
HAD TO BEAR ALL OF THE ALTHOUGH
THE PUBLIC MENTAL HEALTH
RESPONSIBILITY BECAUSE THERE
HASN'T BEEN MUCH ELSE, BUT NOW
YOU HAVE CALLUM. NOW YOU HAVE
THE YOUTH INITIATIVE. NOW YOU
HAVE A REAL COMMITMENT. AND SO
THERE'S AN OPPORTUNITY NOW TO
ACTUALLY BUILD THE SYSTEM. AND
GO BACK TO THE ORIGINAL INTENT,
WHICH WAS NOT TO FOCUS
EXCLUSIVELY ON CHRONIC
HOMELESSNESS. AND THAT'S NOT THE
WAY WE WROTE IT. RUSTY AND I
SAID 20% FOR PREVENTION, EARLY
INTERVENTION 5% FOR INNOVATION.
BUT TO FOCUS IT PRIMARILY AT
LEAST THE SERVICE POT ON THE
PEOPLE WHO ARE THE SICKEST OF
THE SICK. AND THAT'S WHAT THIS
MODERNIZATION PROPOSAL WOULD DO.
IT IS CONSISTENT WITH THE
ORIGINAL INTENT AND AS AMENDED
NOW IT GIVES THE COUNTY'S PROPER
FLEXIBILITY. SECRETARY GALLEY IS
RIGHT. THE. ADDING THE 51% FOR
YOUTH WAS WAS A VERY GOOD MOVE.
THERE'S ACTUALLY MORE MONEY FOR
EARLY INTERVENTION THAN THERE
WAS IN THE ORIGINAL ACT. EXCEPT
NOT EXCEPT AND THE STATE IS
SIMPLY SAYING WE WANT YOU
COUNTIES TO FOCUS ON THE
STRATEGIES OF YOUR CHOICE, BUT
THEY NEED TO BE EVIDENCE BASED,
AND I'M SO GLAD SENATOR EDMUND
THAT YOU RAISED THE EARLY
PSYCHOSIS IDENTIFICATION
INTERVENTION STRATEGY BECAUSE
THE TRUTH OF THE MATTER IS THAT
IS EVIDENCE BASED. IT'S WORKING
AND YET, AND WE HAVE A 30 OR SO
PROGRAMS AROUND THE STATE, WHICH
ARE NOT NEARLY TWO SCALE AND
WITH THIS KIND OF PUSH, WE COULD
GET THAT TO SCALE AND THINK HOW
MANY TEENAGERS WE CAN GET INTO
WRAPAROUND SERVICES BEFORE THEY
HAVE THAT FIRST PSYCHOTIC BREAK
OR JUST AFTER AND SO I'M REALLY
ENTHUSIASTIC ABOUT THIS BECAUSE
FOR ME, THIS ACTUALLY FULFILLS
THIS OVERALL MEASURE FULFILLS
THE ORIGINAL INTENT THAT
MOTIVATED ME 20 YEARS AGO TO
WANT TO DO THIS HOMELESSNESS WAS
A PROBLEM. THEN NOW IT'S A WORSE
PROBLEM AND A WORSE CRISIS NOW,
BUT WE MUST FOCUS THESE
RESOURCES MORE OF THEM. ON
HELPING PEOPLE AND HELPING OUR
STATE AND OUR COMMUNITIES CHANGE
THIS CYCLE THAT IS TEARING US
APART AND IS ACCOMMODATING
WHETHER WE ADMIT IT OR NOT
UNNECESSARY SUFFERING. AROUND
THE BOARD. SO THANK YOU. FOR THE
FOR THE MOMENT AND THE TIME I'M
JOINED, I KNOW BY MY KAREN
LARSON AND THE STEINBERG
INSTITUTE TEAM HAVE ALSO BEEN
REALLY, REALLY INSTRUMENTAL IN
WORKING WITH THE ADMINISTRATION
WITH YOU NOT JUST THIS YEAR, BUT
FOR THE PAST COUPLE OF YEARS TO
LEAD US TO THIS HISTORIC MOMENT
, GIVING GREAT PARTNERS. GREAT
PARTNERS. THANK YOU. QUESTIONS
FOR THE MAYOR. OKAY WE DO
APPRECIATE YOUR LEADERSHIP SO
MUCH. AND I THINK WHEN WE TALK
ABOUT THIS EARLY PSYCHOSIS THAT
THE YOUNG MEN AND DAVIS HAD JUST
MURDERED THREE PEOPLE, RIGHT IF
YOU LOOK AT HIS CASE STUDY, THAT
IS AN EARLY EPISODE. IT WAS 20
YEARS OLD, JUST STARTED SHOW
SIGNS LAST YEAR OF HIGH SCHOOL
FIRST YEAR OF COLLEGE, AND NOW
HE'S MURDERED THREE PEOPLE, SO
MANY TRAGEDIES CAN BE AVOIDED
AND SO MUCH SUFFERING COULD BE
AVOIDED. DEMONIZING PEOPLE
DEMONIZING PEOPLE, LET'S HELP
THEM. BUT I HAVE HOPE AND I KNOW
YOU DO TO THANK YOU. THANK YOU
VERY MUCH. MAYOR NOW WE'RE GONNA
INVITE UP TOBY EWING FROM THE
OVERSIGHT AND ACCOUNTABILITY AND
WILL WILL OWENS. WITH THE AND
RYAN MILLER ALSO COMING FROM THE
LOW WELCOME, GENTLEMEN. COME ON
, WILL YOU ARE LISTED FIRST YOU
WANT TO START OUT. I LOVE HIS
VOICE. I WANTED TO SING IT FOR
US, AND HE DOES THINK I ASKED
HIM. HE'S IN YOUR BAND CHOIR.
UNFORTUNATELY HAVING PREPARED
ANYTHING THIS AFTERNOON, BUT
MORE ADVANCED NOTICE. I'M SURE
WE CAN PUT SOMETHING TOGETHER.
WE'LL ALL SING WITH YOU, BROTHER
. WELL THANK YOU VERY MUCH FOR
HAVING US CHAIR AND THE
COMMITTEE. MY NAME IS WILLOW
ONES WITH THE LEGISLATIVE
ANALYST'S OFFICE. I'M HERE WITH
MY COLLEAGUE RYAN MILLER. AND
TODAY WE'LL BE TALKING A LITTLE
BIT ABOUT THE POST WE'VE DONE ON
THE GOVERNOR'S PROPOSAL. AS WELL
AS SOME OF THE CONCLUSIONS WE'VE
DRAWN FROM THEM. I WILL NOTE
THAT OUR POSTS AND OUR ANALYSIS
OR ON THE PRE AMENDMENT VERSION
OF THIS LEGISLATION. TO THAT
EXTENT, WE ARE STILL EVALUATING
THE IMPACT OF THIS, BUT, UM,
THAT IS THE FOCUS OF OUR
ANALYSIS. UM IF YOU LOOK IN YOUR
HANDOUT, MISTER OWENS, WOULD YOU
WOULD YOU SAY THAT? AS FAR AS
YOU'VE BEEN ABLE TO LOOK AT THE
AMENDMENTS THEY ADDRESS MANY OF
THE ISSUES THAT YOU BROUGHT UP
AND YOU WERE ALSO IN A HEARING
WITH US? YES I WOULD SAY THAT
THE IT APPEARS THAT MANY OF THE
AMENDMENTS DO MAY HAVE SOME
IMPACT ON THE VARIOUS ISSUES FOR
CONSIDERATION THAT WE RAISED
BEFORE THE LEGISLATURE. TO THE
EXTENT THAT WE ARE KNOW WHAT
THOSE IMPACTS ARE, AND THE
IMPACT OF THOSE IS UNCLEAR AT
THIS TIME, AND WE'RE STILL
WORKING THROUGH THOSE. THANK
YOU. SO IF YOU LOOK IN YOUR
HANDOUT, WE HAVE FOUR POSTS THAT
WE DISCUSSED AND ANNOUNCED THAT
WE'LL TALK ABOUT TODAY. THE
FIRST BEING KIND OF THE CHANGE
IN CATEGORIES AND THE IMPACT OF
THOSE ON COUNTY SPENDING, THE
SECOND BEING THE IMPACT OF THE
PROPOSAL ON FUNDING FOR CHILDREN
YOUTH, THE THIRD WOULD BE THE
GENERAL REVENUE, VOLATILITY OF
THE IMAGE AND THE PROPOSALS TO
REDUCE THE ALLOWABLE COUNTY
RESERVES AND THE IMPACT THAT MAY
HAVE AND FINALLY, WE WILL TALK
ABOUT THE PROPOSED CHANGES TO
THE ALWAYS ROLL AND AUTHORITIES
IN THE PROPOSAL ON PAGE TWO OF
YOUR HAND OUT, WE HAVE THE KEY
TAKEAWAYS FROM OUR POSTS JUST
REFERENCE TO TALK THROUGH THESE
AND TRY TO EMPHASIZE THE POINTS
FROM OUR ANALYSIS THAT WE THINK
ARE PARTICULARLY PERTINENT,
ESPECIALLY IN LIGHT OF THE
AMENDMENTS. SO THE FIRST POST
WILL TALK ABOUT IS THE IMPACT OF
THE CATEGORIES GENERALLY WHAT WE
FIND WITH THE GOVERNMENT'S
PROPOSAL IS THAT THERE IS A
SHIFT IN FUNDING FOCUS TOWARDS
FULL SERVICE PARTNERSHIPS AND
HOUSING INTERVENTIONS. UH SO.
SOME OF THE IMPACTS OF THAT
BEING THAT THERE ARE A NUMBER OF
CURRENT SERVICES THAT ARE FUNDED
BY THE USA THAT COULD SEE
REDIRECTION OR REDUCTION IN
FUNDING ABILITY. AVAILABILITY UM
, THOSE PRIMARILY BEING
OUTPATIENT SERVICES, CRISIS
STABILIZATION, WELLNESS CENTERS
, OUTREACH THAT WOULD BE FUNDED
THROUGH THAT BE HSS BUCKET,
WHICH WE ESTIMATE IS CURRENTLY
MAYBE OVERPRESCRIBED IN TERMS OF
CURRENT SERVICES. SO GENERALLY
WE FIND THAT THERE WOULD BE A
REDIRECTION. SOME OF THE ISSUES
THAT WERE RAISED FOR LEGISLATIVE
CONSIDERATION IS THAT WE FIND
THE ADMINISTRATION'S ANALYSIS OF
THE IMPACT ON CURRENT SERVICES
TO BE INCOMPLETE AND THAT AT
THIS TIME IT IS UNCLEAR. WHAT
SERVICES AND WHAT POTENTIAL
IMPACTS. THIS KIND OF REFOCUSING
ON FSB AND HOUSING COULD CAUSE
WE DO KNOW THAT AVAILABLE
RESEARCH SUGGESTS THAT BOTH SPS
AND HOUSING INTERVENTIONS ARE
EFFECTIVE WAYS TO TREAT CERTAIN
COMPONENTS OF BEHAVIORAL HEALTH,
BUT AT THE SAME TIME WITH THE
REDIRECTION OF FUNDING, IT'S
UNCLEAR WHAT THE NET IMPACT ON
BEHAVIORAL HEALTH OUTCOMES IN
THE STATE WOULD BE. WITH THAT
ONE TO TOUCH BRIEFLY ON THE
IMPACT OF THE PROPOSAL AND
CHILDREN YOUTH, AS NOTED BY THE
SECRETARY. THERE WERE RECENT
AMENDMENTS THAT INCLUDED A
FUNDING REQUIREMENT FOR CHILDREN
AND YOUTH UNDERCURRENT. THERE IS
NO CURRENT STATUTORY REQUIREMENT
FOR CHILDREN YOUTH FUNDING ON
THEIR IMAGES, AND THEY SAY IT'S
DONE BY REGULATIONS. AND SO WITH
THE AMENDED PROPOSAL, WE STILL
FIND A LITTLE UNCLEAR HOW MUCH
CHILDREN YOUTH FUNDING WOULD BE
, UM, AVAILABLE AND WHAT
SERVICES WOULD BE KEPT EVEN LIKE
OF THIS NEW FUNDING REQUIREMENT.
IT'S UNCLEAR TO US AND, UH WE
HAVEN'T SEEN ANALYSIS BY THE
MINISTRATIONS OF THE SPECIFIC
SERVICES THAT WOULD BE KEPT.
WITH THEM GOING TO TURN OVER TO
MY COLLEAGUE, RYAN MILLER TO
TALK ABOUT THE REVENUE
VOLATILITY AND RESERVES. RYAN
MILLER, ELIO. TO ADDRESS YOUR
QUESTION, MADAM CHAIR. WE ARE
STILL LOOKING THROUGH THE
AMENDMENTS ON A NUMBER OF THE
ASPECTS OF THE CHANGES. BUT UPON
OUR FIRST REVIEW, IT DOES NOT
SEEM THAT THE AMENDMENTS IMPACT
THE ANALYSIS THAT I'M ABOUT TO
COVER. UM SO THE NHS A, AS MAYOR
STEINBERG MENTIONED IS FUNDED BY
THE SO CALLED MILLIONAIRE'S TAX
AND 1% SURCHARGE ON INCOME OVER
$1 MILLION AND THE REVENUE IS
EXTREMELY VOLATILE. WE HAVE A
FIGURE ON PAGE NINE OF THE HAND
OUT IN FRONT OF YOU THAT
ILLUSTRATES AND COMPARES THE
REVENUE TO THE STATE PERSONAL
INCOME TAX AND ESTATE SALES TAX.
AND AS YOU'LL SEE IN THE FIGURE
IN MANY YEARS, THE YEAR OVER
YEAR CHANGE IN THE REVENUE CAN
BE TWO OR THREE TIMES MORE THAN
THE PERSONAL INCOME TAX, WHICH
IS WHAT REALLY IS THE SOURCE OF
THE STATE'S REVENUE VOLATILITY
THAT MANY OF YOU HAVE PROBABLY
HEARD ABOUT. SO THIS CREATES A
PRETTY CHALLENGING SITUATION FOR
COUNTIES IN TERMS OF TRYING TO
MANAGE THEIR FUND AND PROVIDE
ONGOING AND CONSISTENT MENTAL
HEALTH SERVICES. UM. SO IN THIS
CONTEXT THE ADMINISTRATION HAS
PROPOSED REDUCING THE AMOUNT OF
ELIGIBLE APOLOGIES, REDUCING THE
AMOUNT OF ALLOWABLE RESERVES
FROM 33% IN CURRENT LAW TO PUT
IT ON AN APPLES TO APPLES BASIS.
IT WOULD BE TOO ABOUT 20% FOR
LARGE COUNTIES IN 25% FOR SMALL
COUNTIES. IN ORDER TO REVIEW
THIS PROPOSAL. WE LOOKED AT
HISTORICAL, JUST SAY REVENUE AND
TRIED TO LOOK AT WHAT ALLOWABLE
RESERVES WOULD HAVE BEEN IN
COMPARED THOSE TWO REVENUE
DECLINES THAT COULD HAVE
HAPPENED THAT HAD HAPPENED IN
THE PAST TO GET A SENSE OF HOW
THE CAPS WOULD PERFORM IN THE
FUTURE. AND IN OUR VIEW, WE
ACTUALLY THINK THAT THE CAPS
SHOULD BE HIGHER THAN THEY ARE
IN CURRENT LAW. AND SO WE WOULD
SAY THAT THE GOVERNOR'S PROPOSAL
WOULD MOVE THE RESERVE CAPS THE
COUNTY RESERVE CAPS IN THE WRONG
DIRECTION. IN ADDITION, WE THINK
THAT THE THIS THIS CONVERSATION
CREATES THIS CONVERSATION
PRESENTS AN OPPORTUNITY TO SORT
OF REVISIT THE FUNDING SOURCE.
WE'VE ACTUALLY RECOMMENDED THAT
THE LEGISLATURE CHANGE THE
FUNDING SOURCE WHEN WE'VE
OFFERED SOME IDEAS THAT COULD
INVOLVE SORT OF DEPOSITING THE
MONEY INTO DIFFERENT ACCOUNTS,
THEY WOULDN'T NECESSARILY
INVOLVES CHANGING TAXPAYER
CHANGING TAXES THAN ANY TAXPAYER
PAYS. BUT THERE ARE IDEAS THAT
COULD SUBSTANTIALLY REDUCE
COUNTY REVENUE VOLATILITY WHILE
REALLY HAVING A SMALL IMPACT ON
THE STATE, AND WE WOULD ALSO
NOTE THAT THERE ARE SOME THAT
ARE IDEAS ARE NOT THE ONLY ONES
OUT THERE THAT THE COUNTIES WE
UNDERSTAND. ALSO TALKING ABOUT
POTENTIALLY SOME KIND OF LIKE
ROLLING AVERAGE OR OTHERS, SO
THERE ARE OTHER IDEAS. BUT
ULTIMATELY, UH, WE THINK THAT
IT'S REALLY IMPORTANT THAT THE
LEGISLATURE TRY TO MATCH THE
LEVEL OF RESERVES TO THE REVENUE
VOLATILITY. AND SO IF THERE
ISN'T ANY KIND OF CHANGE TO
ADDRESS THAT, THEN WE THINK THAT
THE GOVERNOR'S PROPOSAL MIGHT
PUT SOME EXCESSIVE FISCAL RISK
THE COUNTIES IN ADDITION, WE
ALSO JUST THINK THAT THE
COUNTIES COULD USE SOME
ADDITIONAL FLEXIBILITY WHEN IT
COMES TO MANAGING THEIR RESERVES
, FOR EXAMPLE, WE'RE NOT REALLY
SURE THAT IT MAKES SENSE THAT
THE STATE WOULD IMPOSE BOTH
ACCUMULATIVE CAP BUT THEN ALSO A
CAP ON THE ANNUAL AMOUNT THAT
COULD BE DEPOSITED SO HAPPY TO
TAKE QUESTIONS AFTER MY
COLLEAGUE WILL HAS FINISHED. SO
THE FINAL POST THAT WE WANT TO
TALK ABOUT IS THE IMPACT OF THE
GOVERNMENT'S PROPOSAL ON THE
ROLE AND AUTHORITIES. SO
GENERALLY WE FIND THAT THE
ATTACK IS A VALUABLE PARTNER TO
THE LEGISLATURE IN TERMS OF ITS
INDEPENDENT ROLE IN OVERSEEING
THE MHS S¼. HOWEVER UNDER THE
PROPOSAL, THE GOVERNOR THE
GOVERNOR'S PROPOSAL, I SHOULD
SAY REDUCES THE AUTHORITY AND
DIRECT PROGRAM OVERSIGHT THAT
THE US HAS OVER MANY OF THE
PROGRAMS. UM IN PARTICULAR WITH
THE REMOVAL OF THE PREVENTION,
EARLY INTERVENTION BUCKET AS IT
STANDS THE ROLE IN PRIORITY
SETTING RULEMAKING AND DIRECT
OVERSIGHT OF THOSE PROGRAMS HAS
BEEN REMOVED. NOW, WITH THE
RECENT AMENDMENTS. THERE ARE
SOME CHANGES, BUT GENERALLY WE
FIND THAT THE ALWAYS TO BE ABLE
TO ACT FULLY AND INDEPENDENTLY
AND TO PERFORM PERFORMANCE ROLE.
UM ABSENT COMPELLING
JUSTIFICATION BY THE
ADMINISTRATION. WE WOULD
RECOMMEND THAT THE FOLKS ROLE IN
TERMS OF DIRECT PROGRAM
OVERSIGHT RULE MAKING AUTHORITY
AS WELL AS PRIORITY SETTING BE
MAINTAINED, WHICH IT IS
CURRENTLY NOT UNDER THE PROPOSAL
WITH THAT HAPPY TO TAKE
QUESTIONS ON ANY OF THE POINTS
WE MADE OR ANYTHING ELSE. I
THINK WE'LL HEAR FROM FROM MR
EWING FIRST AND THEN WE'LL TAKE
QUESTIONS. THANK YOU, MADAM
CHAIR AND MEMBERS AND I
APPRECIATE THAT THE REFERRED TO
US AS VALUABLE PARTNER. IT'S
ESPECIALLY IN THAT WONDERFUL
VOICE. AS YOU POINTED OUT, UM,
TOBY EWING ON BEHALF OF THE
MENTAL HEALTH SERVICES OVERSIGHT
ACCOUNTABILITY COMMISSION REALLY
APPRECIATE THE CHANCE TO JOIN
YOU. AND MANY OF MY COLLEAGUES
AND TO ENGAGE ON THIS VERY
SIGNIFICANT DISCUSSION ABOUT
WHAT'S HAPPENING IN CALIFORNIA
AROUND MENTAL HEALTH NEEDS AND
OUTCOMES AND HOW WE CAN DO
BETTER. AS MANY OF YOU KNOW, AND
AS MAYOR, STEINBERG POINTED OUT
, THE MENTAL HEALTH SERVICES ACT
REALLY IS THIS IS A LANDMARK
BODY OF POLICY THAT WAS REALLY
DESIGNED TO SUPPORT
TRANSFORMATIONAL CHANGE, AND IT
HAD A COUPLE OF COMPONENTS. IT
HAS A COUPLE OF COMPONENTS. IT
REALLY EMPHASIZES THE NEED TO
PROVIDE TAILORED BASED CARE TO
FOLKS WHO ARE STUDYING WITH THE
GREATEST NEEDS. WE CAN TALK
ABOUT WHETHER OR NOT IT'S DOING
THAT. BUT THE DESIGN OF THE
POLICY REALLY WAS WAS TOO REALLY
MOVE US AWAY FROM DECADES OF
RATIONING CARE WITH VERY
RESTRICTIVE SETS OF RULES AROUND
WHAT WE COULD DO AND TO BEGIN TO
SHIFT OUR STRATEGIES TO BE MORE
RESPONSIVE TO WHAT'S HAPPENING
IN LOCAL COMMUNITIES AND IN
INDIVIDUAL LIVES AND FAMILIES.
IT'S LANGUAGE AND EARLY
INTERVENTION. I APPRECIATE THE
MENTION AROUND EARLY PSYCHOSIS,
IT REQUIRED PREVENTION AND IT
ENDED ARTICULATES A VERY BROAD
DEFINITION OF PREVENTION THAT
REALLY GETS AT WHAT'S HAPPENING
IN OUR COMMUNITIES IN TERMS OF
THREATS TO WELL BEING. THERE'S
LONG BEEN THIS TENSION OVER
WHETHER LIMITED FUNDING SHOULD
FOCUS ON THOSE WITH THE GREATEST
NEEDS VERSUS DOING THE EXTREME
KIND OF WORK TO PREVENT THOSE
NUMBERS FROM HAPPENING. WE FIND
THAT THAT TENSION ISN'T AS REAL
AS IT'S OFTEN MADE OUT TO BE,
BECAUSE IF WE THINK ABOUT MENTAL
HEALTH RESOURCES AS MHS A
DOLLARS OR REALIGNMENT DOLLARS
THAT TENSION ARISES THAT WE
THINK ABOUT MENTAL HEALTH
RESOURCES MUCH MORE BROADLY AND
HOW WE CAN DEPLOY YOUR COMMENT
ABOUT SCHOOLS THE WORKPLACE
PARKS, EMPLOYMENT OPPORTUNITIES
, MENTAL HEALTH AND WELL BEING
IS REALLY ABOUT HAVING A PLACE
TO LIVE THAT WE WERE COMFORTABLE
WITH PEOPLE AROUND US THAT CARE
FOR US AND HAVING HOPE, WHICH IS
OFTEN IN THE FORM OF A JOB OR OR
EDUCATION OPPORTUNITIES OR TIME
TO SPEND. PEOPLE TO SPEND TIME
WITH THE GOVERNOR'S PROPOSAL IS
VERY TIMELY AND IT HIGHLIGHTS
THE AREAS WHERE WE'VE REALLY
FAILED TO DO ENOUGH, AND I JUST
WANT TO BE VERY CLEAR ON THAT. I
DON'T THINK THAT'S YOU KNOW FOR
DEBATE, HOUSING ADDICTION
PREVENTION OR THE PSYCHOSIS AND
OTHER FORMS OF INTERVENTION AND
HOW WE THOROUGHLY LEVERAGE
OPPORTUNITIES TO TAILOR CARE
AGAIN THROUGH FULL SERVICE
PARTNERSHIPS BECAUSE OF THE
EMPHASIS ON FOLKS WITH THE
HIGHEST LEVEL OF NEED. WE ARE
STILL WORKING THROUGH THE
AMENDMENTS, BUT THEY DO ADDRESS
MANY OF THE CONCERNS OF THE
COMMISSION IS RAISED AND WE DO
NOT HAVE A FORMAL POSITION.
WE'RE TALKING WITH THE
COMMISSION AS SOON AS NEXT WEEK.
UM BUT I M BEHALF OF THE
COMMISSION. AND PERSONALLY I
WANT TO THANK SECRETARY GALLEY
FOR THE TIME THAT HE HAS AND HIS
TEAM HAVE SPENT WITH ME AND WITH
THE COMMISSION TO REALLY WORK
THROUGH AND UNDERSTAND OUR
CONCERNS, AND OUR CONVERSATIONS
ARE CONTINUING. YOU KNOW THERE,
THERE'S THE THERE'S OFTEN THIS
CONCERN ABOUT THE COMMISSION IN
OUR INDEPENDENCE. WE ARE AN
INDEPENDENT BODY TODAY. WE'RE
ALSO A CORE PARTNER WITH THE
ADMINISTRATION. WE HAVE DONE
SOME PHENOMENAL THINGS WITH THE
DEPARTMENT OF AGING WITH THE
GOVERNOR'S OFFICE OF PLANNING
AND RESEARCH, AS RECENTLY AS
LAST WEEK AROUND SOME OF THE
PRECISION MEDICINE GRANTS AROUND
DEPRESSION. WITH THE DEPARTMENT
OF MANAGED HEALTH CARE WITH
SHUAIBI H I. AND, OF COURSE,
WITH THE DEPARTMENT OF HEALTH
CARE SERVICES WHO REALLY IS OUR
CLOSEST PARTNER. WHEN IT COMES
TO TRANSFORMATIONAL CHANGE. THAT
DOESN'T MEAN WE AGREE ON
EVERYTHING. I USED THE REFERENCE
OF WHERE, LIKE SIBLINGS WHO
OFTEN SHARE A BATHROOM, WE GET
ALONG IN MANY, MANY WAYS, BUT AT
TIMES THERE IS CONFLICT AND SO
APPRECIATE THE COMMENTS ABOUT
OUR ABILITY TO SPEAK
INDEPENDENTLY. THAT DOES NOT GET
IN THE WAY OF OUR ABILITY TO
ACTUALLY WORK VERY CLOSELY ROW
IN THE SAME DIRECTION WITH THE
ADMINISTRATION. WE DO HAVE SOME
CONCERNS THAT WE HAVE NOT YET
BEEN ABLE TO CLARIFY IN TERMS OF
THE AMENDMENTS. THEY MAY BE
ADDRESSED IN THE AMENDMENTS.
THEY MAY NOT. WE'RE NOT SURE BUT
FIRST STRONGLY URGED THE STATE
TO NOT TIE ITS OWN HANDS BY
HAVING TO GO BACK TO THE VOTERS
TO MAKE AMENDMENTS THAT LEVEL OF
CHANGE THAT IS BEING PURSUED THE
COMPLEXITY OF THE MENTAL HEALTH
SYSTEM THE OPPORTUNITIES WE HAVE
TO LEVERAGE, PRIVATE SECTOR
DOLLARS, PRIVATE SECTOR CAPACITY
RESEARCH, ALL THE ACCOUNTABILITY
WORK. THIS IS A BIG INITIATIVE
AND THE MORE IN WHICH THE
LEGISLATURE AND ADMINISTRATION
CAN RETAIN THE AUTHORITY TO MAKE
ADJUSTMENTS OVER TIME WILL SERVE
SERVE THE STATE'S NEEDS AS WE
LEARN AS NEEDS EVOLVE AS OUR
EXPERIENCES IMPROVED AS THESE
CHANGES ARE IMPLEMENTED SECOND
FLEXIBILITY IS ALWAYS PREFERRED
, WHERE FEASIBLE AND WE'RE
CONCERNED. THAT THE FISCAL
CATEGORIES, PARTICULARLY IN
STATE OPERATIONS, MAY NOT HAVE
SUFFICIENT FLEXIBILITY. ONE OF
OUR QUESTIONS IS WILL, THOUGH
THAT 10% BE SUBJECT TO BUDGET
APPROPRIATIONS, AND WILL THERE
BE FLEXIBILITY AS AS WE THINK
ABOUT THE KIND OF, UM URGENT
ISSUES THAT HAVE ARISEN OVER
TIME? JUST IN THE LAST FEW
YEARS? WE DON'T KNOW WHAT THE
NEXT PANDEMIC WILL BE THE SPIKE
IN SUICIDES AND SO FORTH. AND SO
, UM, IF THE SO IT'S JUST A READ
OF THE LANGUAGE, IS IT DOES IT
BYPASSED THE BALLOT THE BUDGET
PROCESS AS WE GO THROUGH THE
BUDGET PROCESS, AND IS THERE
FLEXIBILITY CONSISTENT WITH THE
LANGUAGE IN IN THE IN THE BALLOT
MEASURE? THE STATE AND COUNTIES
HAVE REALLY BEEN ABLE TO
LEVERAGE THE EXISTING INNOVATION
COMPONENT OF THE IMAGES TO
SUPPORT FUNDAMENTAL IMPROVEMENTS
IN SERVICE DELIVERY. SOLANO
COUNTY SAW 300% INCREASE IN
ACCESS TO CARE FOR THE HARDEST
TO REACH COMMUNITIES BECAUSE
TRUST LEVELS WERE LOW. 40
COUNTIES ARE LEARNING FROM THAT
. SOLANO INNOVATION PLAN EARLY
PSYCHOSIS PROGRESS THAT WE HAVE
MADE TO DATE STARTED WITH
COUNTIES USING INNOVATION FUNDS
TO GET THERE. CRIMINAL JUSTICE
DIVERSION ACTIVITIES HAVE BEEN
SUPPORTED WITH INNOVATION, AND
WE'RE SCALING THOSE AS FAST AS
WE CAN ACROSS THE STATE HOUSING
MOBILE CRISIS INTEGRATED
INTEGRATED ELECTRONIC HEALTH
RECORDS ACROSS COUNTY STIGMA
REDUCTION, YOUTH EMPOWERMENT,
SCHOOL MENTAL HEALTH
ADMINISTRATION IS CLEARLY
COMMITTED TO INNOVATION ABOVE
AND BEYOND WHERE WE ARE TODAY.
WE'RE NOT CLEAR WHAT THE
MECHANISM IS. TO ENSURE THAT
THAT ACTUALLY HAPPENS, AND SO
WE'RE STILL TALKING WITH THEM
ABOUT HOW WE CAN ENSURE THAT
INNOVATION HAPPENS IN THE PUBLIC
SECTOR FROM OUR PURVIEW.
INNOVATION HAPPENS EVERY DAY IN
THE MIDDLE HEALTH SPACE. IT'S
OFTEN FUNDED BY THE PRIVATE
SECTOR, AND UNFORTUNATELY,
PRIVATE SECTOR INNOVATIONS DON'T
ALWAYS TOUCH PUBLIC SECTOR
NEEDS. THAT WE HAVE BEEN WORKING
UNDER THE CURRENT SCENARIO TO
TRY TO BUILD STRONGER BRIDGES
BETWEEN PRIVATE SECTOR AND
PUBLIC SECTOR INNOVATION TO
REALLY BRING THE FULL FORCE AND
INFLUENCE OF ALL OF CALIFORNIA
TO BEAR ON THE CHALLENGES IN
FRONT OF US, AND SO WE'RE
CONTINUING TO TALK TO THE
ADMINISTRATION ABOUT HOW WE CAN
RETAIN THAT OPPORTUNITY. WE'RE
VERY APPRECIATIVE OF THE WORK
THAT'S BEEN DONE ON SCHOOL
MENTAL HEALTH WITH THE PASSAGE
OF THE MENTAL HEALTH STUDENT
SERVICES ACT AND SEE WHY BH AYE.
AND TREMENDOUS STEP FORWARD ON
THE INTEGRATED PLANNING,
BRINGING IN AREA AGENCIES ON
AGING IN SCHOOLS AND OTHER
PARTNERS WHO TOUCH MENTAL HEALTH
AND WELL BEING. WE WOULD
ENCOURAGE SOME ADDITIONAL
ATTENTION ON ENSURING THAT
LEADERSHIP AT THE STATE LEVEL ON
SCHOOL MENTAL HEALTH IS
SUSTAINED BEYOND C Y B H I
PROBABLY NOT THE TIME TO DO THAT
IN THIS MOMENTOUS REFORM, BUT
JUST PUT A PLACEHOLDER THERE IS
THAT WE THINK SCHOOL MENTAL
HEALTH NEEDS TO CONTINUE TO GET
THE ATTENTION AND INVESTMENTS.
WE WANT TO MAKE SURE THAT THAT
AFTER THE THIS REFORM IS FORWARD
THAT WE DON'T FORGET OR MISS THE
OPPORTUNITY. TO REALLY CONTINUE
LEVERAGING SCHOOLS. UM AH. OUR
ANALYSIS. WE CALLED OUT THE NEED
FOR FISCAL FLEXIBILITY. WE
APPRECIATE THE AMENDMENTS ON
THAT ISSUE. WE ARE A LITTLE
UNCLEAR IF A 7% SHIFT IN THE
HOUSING CATEGORY, FOR EXAMPLE,
MEANS COUNTIES WOULD BE ABLE TO
SHIFT FROM 23% TO 37% OR IF IT'S
7% OF 30, WHICH IS 2% AND THAT
WOULD BE A 28% TO 32% SHIFT. SO
THE LANGUAGE AGAIN. I'M NOT SURE
IF WE JUST AREN'T READING IT
RIGHT. BUT SOME CLARIFICATION ON
THAT A SIMPLE 2% SHIFT IN A 30%
BUCKET MAY NOT BE SUFFICIENT TO
ADDRESS CHANGES NEEDS OVER TIME
OR ACROSS DIVERSE CALIFORNIA
COUNTIES. WALES SPEND MORE TIME
REVIEWING THAT, BUT WE HOPE THAT
SOME OF THE SMARTER FOLKS THAT
YOU HAVE ON YOUR TEAM MIGHT BE
ABLE TO HELP US UNDERSTAND THAT
BETTER. WE REALLY APPRECIATE THE
FOCUS AND RESTATEMENT TO THIS
COMMITMENT ON ACCOUNTABILITY.
THE STATE AND THE COUNTIES HAVE
NOT YET FULFILLED THAT
COMMITMENT TO THE PUBLIC. WE
HAVE WORKED HARD ON THAT, BUT WE
CLEARLY ARE NOT THERE. AND SO WE
LOOK FORWARD TO WORKING WITH THE
ADMINISTRATION TO DEVELOP AN
IMPLEMENTATION PLAN TO GET
THERE. I THINK THAT'S YOU KNOW,
THAT'S THAT'S THE SORT OF THE
GIST OF MY COMMENTS IS THAT THE
SCALE OF THESE STATUTORY CHANGES
WILL REQUIRE A COMPARABLE LEVEL
OF EFFORT ON AN IMPLEMENTATION
PLAN, AND THAT'S GOING TO TAKE
TIME THAT SHOULD NOT BE DONE
THROUGH THE BALLOT MEASURE THAT
THAT NEEDS TO BE RECOGNIZED IN
STATUTE SHOULD PRIMARILY BE DONE
THROUGH THE BUDGET PROCESS AND
THROUGH CONVERSATIONS WITH
DEPARTMENTS OVER TIME. THAT'S MY
COMMENTS ABOUT SECURING
FLEXIBILITY ON THE STATE
ADMINISTRATIVE SIDE,
PARTICULARLY IF THE LEGISLATURE
CAN RETAIN THAT SO THAT WE CAN
MAKE SURE THAT THE REAL WORK
WHICH IS FOLLOWING THROUGH ON
THE STATUTORY CHANGES OVER TIME
, CAN BE DONE IN WAYS THAT ARE
RESPONSIVE FOR THOSE CONCERNS.
WE KNOW OF TODAY BUT MOST
IMPORTANTLY FOR THE CONCERNS WE
HAVE NOT YET ANTICIPATED. THANK
YOU FOR THE CHANCE TO JOIN YOU
HAPPY TO ANSWER ANY QUESTIONS.
THANK YOU SO MUCH. I LOVE THAT.
I THINK THAT'S INCREDIBLY
IMPORTANT. IT WILL BE ABLE TO I
THINK, JUST USE THE EXAMPLE OF
HOW THINGS HAVE CHANGED IN 20
YEARS TO BE ABLE TO MAKE SOME
STATEMENTS BEFORE GOES TO VOTERS
ABOUT SOME ROOM FOR FLEXIBILITY
AS THINGS CHANGE THAT ARE IN THE
SPIRIT OF WHAT WE'RE DOING. I
DON'T THINK IT CAN BE WORKED ON
QUESTIONS FROM MEMBERS. SER
LAMONT. THANK YOU. AND I JUST
APPRECIATE JUST KIND OF
FOLLOWING UP ON THAT COMMENT AND
FLEXIBILITY TO I THINK THAT YOU
KNOW, ONE OF THE IMPORTANT
THINGS AS WELL AS THINKING, UM,
I LOVE THE IDEA OF THE
LEGISLATURE MAINTAINING CONTROL
OF FLEXIBILITY JUST TO BE CLEAR
. NOT THAT THAT'S THAT'S WHAT I
LIKE ABOUT THAT. UM BUT THE
OTHER PIECE IS, YOU KNOW,
FLEXIBILITY. WE HAVE 58
DIFFERENT COUNTIES. UM AND SO,
AND I THINK THAT THIS IS WHAT
YOU KNOW, SOME OF MY COLLEAGUES
HAVE ALLUDED TO, BUT I THINK A
LOT OF WHAT IT TAKES. WEEKS TO
CREATE FACILITIES AND SUSTAINED
FACILITIES WITH BEDS AND WHAT
THAT MEANS IN AREAS ACROSS OUR
STATE, WHETHER THEY'RE RURAL
URBAN INLAND COASTAL CENTRAL IN
TERMS OF REAL ESTATE MARKET AND
IN TERMS OF ACTUALLY FINDING
FACILITIES THAT CAN BE SUSTAINED
RENTS THAT CAN BE PAID BY
FACILITIES. AND THAT'S ANOTHER
BIG PIECE THAT I THINK IS
IMPORTANT. IN YOUR COMMENTS.
DISTRICT HEARD MY THINKING ON
THAT BECAUSE WE WILL NEED ALSO
FLEXIBILITY TO UNDERSTAND HOW WE
DELIVER IN 58 DIFFERENT COUNTIES
. IT'S NOT GOING TO LOOK THE
SAME THE WAY WE WOULD DELIVER IN
A POTENTIALLY RURAL AREA OF THE
STATE IS GOING TO LOOK DIFFERENT
THAN IN AN URBAN AREA. THERE ARE
REAL, YOU KNOW, IMPACTS. ALSO
GEOGRAPHICAL AND LOCAL COUNTY
REGIONAL IMPACTS THAT WILL HAVE
. SOME KIND OF PROVIDE SOME TYPE
OF DIRECTION ON HOW AND WHEN,
AND THE TYPE OF DELIVERY THAT
CAN BE MADE. SO I HOPE THAT WE
KEEP THAT IN MIND AND THAT WE
ARE CLEAR WITH THE VOTERS THAT
WE ALL WANT THE SAME OUTCOMES,
BUT PERHAPS HOW WE GET TO THOSE
OUTCOMES IN DIFFERENT PARTS, AND
THIS IS NOT TO FAVOR ANYONE OVER
THE OTHER AS MUCH AS TO
UNDERSTAND THAT THE IDEA OF
CREATING SPECIFICALLY AROUND
FACILITIES RIGHT CREATING BEDS
IS NOT AN IDEA THAT CAN BE
IMPLEMENTED IN THIS EXACT SAME
WAY EVERYWHERE AND IT MIGHT LOOK
SLIGHTLY DIFFERENT AND TAKE
DIFFERENT LEVEL OF HUMAN FISCAL
MATERIAL RESOURCES TO BE ABLE TO
ACHIEVE. THANK YOU, SENATOR.
THANK YOU. TO ALL OF YOU. UM, DR
GILLIAN. I ALREADY BEEN LIKE
MINE BUILDING EACH OTHER ON THE
ON THE FLEXIBILITY PART AND ALSO
ON THE ON THE VOLATILE ABILITY
ISSUE. WHEN WE FIRST TALKED
ABOUT THAT I FOUND IT VERY
INTERESTING AND CONTINUE TO DO
TO BE ABLE TO USE THE BIG
MESSAGE STATE GENERAL FUND AS A
BACKDROP TO BE ABLE TO STEADY
OUT THE MAIL COUNTIES CAN EXPECT
TO COME DOWN EVERY YEAR. I JUST
THINK THAT MAKES TOTAL SENSE. SO
WE REALLY THANK YOU. THANK YOU.
OKAY I APPRECIATE YOUR SERVICE
AND YOUR PARTNERSHIP HAVE BEEN
INTEGRAL PARTS IN ALL OF THIS
FIRST. OKAY SO NOW WE'RE MOVING
ON TO OUR NEXT PANEL OF
STAKEHOLDERS AND AGAIN, AS THE
LAST PANEL SAYS AGAIN, RIGHT? WE
HAD WHAT WE'RE DOING, THEN ALL
THESE IMPLEMENTATION ISSUES,
WRITES ALL THE WEED. THE DEVIL'S
IN THE DETAILS. AND THEN WE WANT
TO BE ABLE TO HEAR FROM
STAKEHOLDERS WHO ARE ACTUALLY
GOING TO BE ON THE GROUND AS
THESE THINGS COME DOWN, SO WE
ALREADY HEARD FROM MAYOR
STEINBERG. NOW WE'RE ALSO GOING
TO INVITE UP. SEE YOU WITH MATT
J. KIM LEWIS AND DR LEANDRA
CLARK HARVEY. LIONS TIGERS AND
BEAR. WE'RE DOING THESE FOUR AND
THEN WE'LL DO THE NEXT GROUP.
BUT THANK YOU FOR THE PROMPT
OKAY, MATT, YOU'RE LISTED FIRST.
YOU WANT TO GO FIRST? CERTAINLY.
I THANK YOU. CHAIR IN MEMBERS
FOR LETTING ME SPEAK TODAY. IT
IS MY PLEASURE TO BE HERE ON
BEHALF. HIÂU CALIFORNIA TO
EXPRESS THEIR SUPPORT FOR THE
PROPOSAL TO MODERNIST THEM INTO
HEALTH SERVICES ACT AS HIÂU
REPRESENTS A WIDE RANGE OF
BEHAVIORAL, HEALTH AND SERVICE
PROFESSIONALS ACROSS COUNTY AND
COMMUNITY BASED ORGANIZATIONS
FROM CASEWORKER TREATMENT
COUNSELORS. PIERS NAVIGATORS
AND, OF COURSE, OF COURSE,
SOCIAL WORKERS TO EVERYTHING
ELSE IN BETWEEN, AS WELL AS MANY
OF YOU MAY KNOW HOW YOU PLAYED A
CRITICAL ROLE IN THE PASSAGE OF
PROPOSITION 63. WE WORK BOTH
HERE IN THE LEGISLATURE ANTHEM
AND AT THE BALLOT BOX TO SEE IT
COMING TO FRUITION BECAUSE OF
OUR MENTAL HEALTH, PUBLIC MENTAL
HEALTH SERVICES WERE NOT MEETING
THE GROWING NEEDS OF CALIFORNIA.
AND FRANKLY, THE M S. CHASE HAS
NOT KEPT UP WITH THE TYPE OF
CARE THAT OUR COMMUNITIES NEED
TODAY AS WELL. AND NOW WE'RE
FACING GREATER CHALLENGES THAN
WE DID IN 2004 WHEN THE IMAGE
WAS PASSED BY VOTERS ARE
CHALLENGES ARE MULTIFACETED,
INCLUDING A GROWING OPIOID
EPIDEMIC HOUSING CRISIS THAT HAS
LED TO MANY HOMELESSNESS GROWING
POPULATION THAT IS LEADING THE
NATION. UNFORTUNATELY, IN
ADDITION TO GROWING DEMAND FOR
BEHAVIORAL HEALTH SERVICES ON
TOP OF ALL OF THIS AND PARTLY
THAT DEMAND IS NOT BEING MET
BECAUSE WE HAVE A SHRINKING
BEHAVIORAL HEALTH WORKFORCE TO
TRY TO SERVE THESE NEEDS AND
MEET THE DEMAND FOR SERVICES
THAT WORKFORCE IS FACING
IMPENDING RETIREMENTS IN THE
NEED TO CONTINUE TO DIVERSIFY TO
REFLECT THE POPULATIONS THAT WE
SERVE. FOR EXAMPLE, IN SAN DIEGO
ALONE, WHICH HAS A REPORTED 8100
BEHAVIORAL HEALTH WORKERS. BY
2027 IS ESTIMATED THAT THEY'RE
GOING TO NEED 18,000 BEHAVIORAL
HEALTH WORKERS, WHICH IS MORE
THAN 200% INCREASE FOR THAT
COUNTY. THAT'S JUST ONE COUNTY
ALONE. WE ARE SO WE'RE HERE.
SOUNDING THE ALARM AROUND THE
WORKFORCE CRISIS IS, OF COURSE
ACROSS THE HEALTHCARE WORKFORCE.
BUT I WOULD SAY, ALSO ACUTELY
FELT ON THE BEHAVIORAL HOUSE
SIDE. UM AND YOU KNOW, THIS IS
NOT JUST FOR THE HEALTHCARE
WORKERS WHO REALLY NEED TO HAVE
FAIR WAGES AND THE RESOURCES TO
BE ABLE TO DELIVER CARE, BUT
ALSO HERE ON BEHALF OF THE STU
MEMBERS, BOTH THE MOTHERS, THE
FATHERS WHO DAY IN AND DAY OUT
OR GRAPPLING WITH THE PAINFUL,
PAINFUL CHALLENGES AROUND
DEALING WITH THE POTENTIAL OF
LOSING A CHILD DUE TO SUBSTANCE
ABUSE. AND YOU KNOW MANY.
UNFORTUNATELY SOME OF OUR
WORKERS ARE ALSO LIVING IN THE
CARS AND DEALING WITH THE
HOUSING CRISIS AND DEALING WITH
THAT MENTAL HEALTH CRISIS THAT
HAPPENS FROM BEING HOUSING AND
OR BEING HOUSING INSECURE
BECAUSE THEY CAN NO LONGER
CONTINUE TO LIVE IN THEIR CAR TO
TRY TO, YOU KNOW, NOT BE ABLE TO
GET THE BASIC SUPPORTS. THEY
NEED SO WITH THAT, JUST, YOU
KNOW, WANT TO PROVIDE THAT
CONTEXT. BUT FIRST AND FOREMOST
, YOU KNOW, S E I U SUPPORTS
THIS BECAUSE WE BELIEVE IT'S A
HOLISTIC, COMPASSIONATE APPROACH
TO CARE WITH A FOCUS ON EQUITY
AND THIS PROPOSAL WE THINK IS A
GOOD START. WE MUST ENSURE
CONSUMERS WITH SEVERE AND
SERIOUS MENTAL HEALTH ILLNESSES
AND SUBSTANCE USE DISORDERS OR
THOSE WHO ARE AT RISK HAVE THE
ABILITY TO ACCESS QUALITY CARE.
THEY NEED BOTH PHYSICALLY AND
MENTALLY, AND WE MUST PROVIDE
THEM WITH THE TOOLS THEY NEED TO
LIVE, PRODUCTIVE INDEPENDENT
LIVES. WE MUST PRIORITIZE THE
SERVICES FOR THE MOST MENTALLY
ILL AND TREAT THOSE WITH
SUBSTANCE ABUSE DISORDERS WHILE
CONTINUING TO INVEST IN THE
PREVENTION OR EARLY INTERVENTION
FOR ALL CALIFORNIANS. THIS
PROPOSAL ALSO GOES FURTHER BY
MODERNIZING COUNTY HOUSING
ALLOCATIONS AND AUTHORIZING
HOUSING INTERVENTIONS, WHICH ARE
CRITICAL TO ADDRESSING SOME OF
THOSE SERIOUS HEALTH ISSUES.
SECONDLY A PATHWAY SUPPORTING
THIS BECAUSE OF PATHWAY FOR
QUALITY JOBS AND QUALITY
SERVICES IS NO SECRET THAT WE
ARE FACING THAT SHORTAGE OF
BEHAVIORAL HEALTH CARE WORK.
WORKERS AND WE CAN ONLY MEET OUR
CARE GOALS IF WE HAVE A
WORKFORCE TO DELIVER THOSE ON
THOSE NEEDS. THIS INCLUDES, YOU
KNOW, SO WE'RE SUPPORTIVE,
INCLUDING RECRUITMENT, TRAINING
AND RETENTION OF THAT WORKFORCE
IN PARTICULARLY WANTED TO CALL
OUT THE EXPANSION OF
APPRENTICESHIP PROGRAMS AND
CREATING PAID PATHWAYS TO ALLOW
WORKERS TO ADVANCE IN THEIR
CAREERS, ATTAINING ADDITIONAL
TRAININGS AND CERTIFICATIONS.
AND THIS IS WHY WE THINK THAT'S
3% OF THE ANNUAL BEHAVIORAL
HEALTH SERVICE ACT. FUNDS ARE
IMPORTANT TO BE ALLOCATED FOR
THAT TO REALLY LEVERAGE THAT
SORT OF SMALL 30 SOMETHING
MILLION DOLLAR AMOUNT TO GET
THAT $2.4 BILLION INVESTMENT AND
THROUGH THE 11 15 WAIVER. UM IN
THIS PROPOSAL ALSO AUTHORIZED
THE COUNTIES TO FUND ADDITIONAL
LOCAL WORKFORCE AND INITIATIVES
USING THEIR LOCAL BHS A
ALLOCATION PRIORITIZED FOR
BEHAVIORAL HEALTH SUPPORTS. YOU
KNOW, THERE IS NO MAGIC WAND TO
CREATING EXPERIENCED AND TRAINED
HEALTHCARE WORKERS. IT TAKES
TIME AND, UNFORTUNATELY, A
CRISIS SEVERAL DECADES DECADES
AND MAKING IS GOING TO TAKE SOME
TIME AND INVESTMENT TO OVERCOME
. AND SO WE THINK THAT THIS IS A
IMPORTANT STEP IN THAT DIRECTION
AND WILL LIKELY, YOU KNOW,
UNFORTUNATELY, CONTINUES TO NEED
MORE FINALLY, ON ACCOUNTABILITY
AND STANDARDS OF REPORTING. ONE
OF THE ASTONISHING THINGS HAS
BEEN THAT THERE HAS BEEN A
LITTLE LITTLE ACCOUNTABLE AND
TRANSPARENCY SO FAR WITH THE USA
. AND THIS MEASURE DOES PUT
ADDITIONAL MEASURES IN PLACE TO
INCLUDE STATE OVERSIGHT,
ACCOUNTABILITY AND ENSURE THAT
STREAMLINE THIS PROPOSAL
ADDRESSES THIS ISSUE BY
ESTABLISHING A NEW ANNUAL COUNTY
BEHAVIOR OUTCOMES,
ACCOUNTABILITY AND TRANSPARENCY.
REPORT. WHICH WILL HELP PROVIDE
BOTH THE PUBLIC AND BEHAVIORAL
HEALTH WORKFORCE MORE
TRANSPARENCY IN HIS COUNTY
SPENDING WITH THE EYE TOWARDS
THE RESULTS, WE WILL HAVE MORE
INFORMATION TO BE ABLE TO
RECTIFY ANY ISSUES ON PIECES
THAT THEY ARE WHERE THEY'RE
PRIVATIZED, THAT WE CAN ENSURE
THAT WE ARE NOT WASTING TAXPAYER
DOLLARS. THE PROPOSAL ALSO
REQUIRES COUNTY REPORT ANNUAL
SERVICE UTILIZATION DATA.
EXPENDITURES OF THE STATE AND
FEDERAL HEALTH, FEDERAL
BEHAVIORAL HEALTH FUNDS, UNSPENT
DOLLARS. ANOTHER INFORMATION AND
THEN OF COURSE, THE LOCAL AND
STATE PLANNING PROCESS IS GOING
TO BE CRITICAL TO THE OVERSIGHT
TO INCLUDE TO ENSURE WORKERS
HAVE ARE AT THE TABLE WITH
COUNTY ADMINISTRATORS, COMMUNITY
BASED ORGANIZATION, HEALTH PLANS
AND OTHER STAKEHOLDERS SO WE CAN
COORDINATE AND STREAMLINE THIS
CARE. AND PROVIDE THE SUPPORT.
WE THINK THESE MEASURES GO A
LONG WAY TO PROVIDING MUCH
NEEDED ACCOUNTABILITY AND WE
WILL GET THE PUBLIC MORE TRUST
AND CONFIDENCE THAT WE ARE
DELIVERING ON THE CARE THAT THEY
REALLY DEMANDING EVERY DAY. SO
JUST IN CLOSING, ADDRESSING
CALIFORNIA'S BEHAVIORAL HEALTH
CRISIS IS A COMPLEX AND
MULTIFACETED PROBLEM, AND THIS
IS A PROPOSAL IN THIS PROPOSAL
IS IMPORTANT STEP TO MODERNIZING
THE SYSTEM. THE WHOLE PERSON
APPROACH, ROBUST PLANNING
PROCESS, ACCOUNTABILITY
PROVIDERS AND INVESTMENT IN THE
WORKFORCE ARE CRITICAL TO
DELIVERING ON THE CARE THAT
EVERY CALIFORNIA IS ENTITLED TO.
FOR THESE REASONS OUTLINED. SEE
YOU SUPPORTS THIS PROPOSAL AND
WE THANK YOU FOR THE TIME. THANK
YOU VERY MUCH TRAVEL OVER TO DR
CLARK HARVEY. GOOD AFTERNOON,
EVERYONE. THANK YOU FOR THE
INVITATION. I'M DR LEANDRO CLARK
HARVEY, A PSYCHOLOGIST AND THE
CEO OF THE CALIFORNIA COUNCIL OF
COMMUNITY. BEHAVIORAL HEALTH
AGENCIES ARE ORGANIZATION
INCLUDES PROVIDERS WHO TREAT
EVERY POPULATION FROM JUSTICE
INVOLVED DEVELOPMENTAL
DISABILITIES AND THE ENTIRE AGE
SPECTRUM. IN 2004, OUR FOUNDER,
WORKED ALONGSIDE OTHER ADVOCATES
TO PROVIDE CRITICAL INPUT ABOUT
SHAPING THE MENTAL HEALTH
SERVICES ACT. SO WE'RE FOREVER
GRATEFUL TO MERE STEINBERG FOR
BEING THE CHAMPION OF THE ACT.
IN FACT, IN 2019, WE MET AGAIN
WITH THE STEINBERG INSTITUTE AND
DISCUSSED HOW TO BEST IN
RESPONSIBLY REFRESH THE ACT AND
WE SHARED AT THAT TIME WE SAW AS
THE POSSIBILITIES, INCLUDING
INCLUDING SUBSTANCE USE
DISORDERS, FLEXIBILITIES FOR
RURAL POPULATION, ADDING
ADDITIONAL FUNDING FOR OLDER
ADULTS, MORE FSP FUNDS AND
GREATER ACCOUNTABILITY OVERALL
AND HOW THE FUNDS WERE USED,
HOWEVER, AND 2019, WE DID NOT
ANTICIPATE THE AVALANCHE OF
CHANGE THAT WAS ABOUT TO COME TO
US A PANDEMIC. PAYMENT REFORM,
WHICH, AS OF THIS VERY MOMENT IS
CURRENTLY THREATENING THE
FINANCIAL HEALTH OF OUR MEMBERS
. CARE COURT. YOU NAME IT, YOU
GET THE PICTURE. BEHAVIORAL
HEALTH HAS NOT SEEN THIS MUCH
ATTENTION BY OUR LEADERS AND 20
YEARS. THANK YOU FOR THE
ATTENTION. THANK YOU TO THE
ADMINISTRATION AND THE
LEGISLATIVE LEADERS FOR YOUR
COMMITMENT HERE. PROVIDERS ARE
SIMPLY OVERWHELMED. ANY EFFORT
THAT RECOGNIZES THE TREMENDOUS
PRESSURE THAT OUR MEMBERS ARE
EXPERIENCING BY PHASING IN
IMPLEMENTATION IS APPRECIATED
BECAUSE 2026 IS NOT THAT FAR
OFF. IT'S NOT AS FAR AS OFF AS
IT SEEMS. WE APPRECIATE ALSO THE
FOCUS ON TRANSITION TO CARE
BASED ON HISTORY, THOUGH WE ARE
CONCERNED ABOUT MANAGED CARE
PLANS, PICKING UP THE SLACK
IMMEDIATELY AND FULLY SO WE'RE
HOPEFUL FOR A PHASED IN APPROACH
WITH CLEAR ACCOUNTABILITY.
PROVIDERS, BUT ALSO FOR MANAGED
CARE PLANS. SUBSTANCE USE
DISORDER PROVIDERS ARE CRITICAL.
AND SO MANY OF OUR CLIENTS WITH
MENTAL HEALTH NEEDS ALSO HAVE
SUBSTANCE USE DISORDER
CHALLENGES. THE NEWLY ADDED
FLEXIBILITY FOR COUNTIES TO
DETERMINE HOW TO USE FUNDS FOR
SUBSTANCE USE DISORDER SERVICES
IS QUITE WELCOME. THE ADDITION
TO THE BHS, AS IS ALSO
APPRECIATED, AS WELL AS THE
EXPANDED PARAMETERS AROUND EARLY
INTERVENTION ARE GOOD. WE
ENCOURAGE MUCH MORE FLEXIBILITY
HERE. I THINK WHEN PEOPLE HEAR
EARLY INTERVENTION, THEY THINK
ABOUT AWARENESS CAMPAIGNS AND
BILLBOARDS, BUT EACH COUNTY USES
THESE FUNDS REALLY DIFFERENTLY,
SOME TO FUND SPECIFIC PROJECTS
FOR CULTURALLY DIVERSE
POPULATIONS AND OTHERS FOR
FOSTER YOUTH AND YOUNG ADULT
INTERVENTIONS. AND AT THE SAME
TIME OUR MEMBERS CONTINUE TO
WORRY ABOUT THE TIGHT SQUEEZE ON
OUTPATIENT AND CRISIS SERVICES
FUNDED OR PROPOSED TO BE FUNDED
THROUGH BHS S, ESPECIALLY FOR
ADULTS AND OLDER ADULT
POPULATIONS, WHO ARE AT HIGH
RISK OF BECOMING AN HOUSED
WORKFORCE CONTINGENT CONTINUES
TO BE A CRITICAL COMPONENT OF
ALL OF THIS. I RECEIVED MENTAL
HEALTH SERVICES ACT. WHAT FUNDS
DURING MY POST DOC AT UCLA
CHILDREN? IT'S WHAT HELPED ME
GET TO THIS VERY CHAIR THAT I'M
SPEAKING FROM TODAY, SO WE
APPRECIATE ANY ADDITIONAL EFFORT
TO SUPPORT THE WORK FORCE WITHIN
THE ACT OR OTHER POLICY CHANGES
THAT WILL BOLSTER THE ACT AND
THIS PROPOSAL BECAUSE WITHOUT
WORKFORCE, NONE OF THIS IS
POSSIBLE. I THINK MY FIND
MINUTES IS UP, SO I'LL END WITH
GRATITUDE AND A NOTE OF CAUTION
. YES IT IS TIME TO IT'S PAST
TIME TO REEXAMINE THE ACT, AND
IT MUST BE BASED ON DATA THAT
DRIVES DECISIONS AND CLEAR AND
ACHIEVABLE ACCOUNTABILITY
MEASURES. SO THE ROLE OF
COUNTIES PROVIDERS, THE
OVERSIGHT AND ACCOUNTABILITY
COMMISSION, LOCAL STAKEHOLDERS
AND COMMUNITY VOICES IS CRITICAL
TO GET THIS RIGHT BECAUSE THERE
IS MUCH ON THE LINE. C B H A
APPRECIATE AND WILL CONTINUE TO
COLLABORATE WITH THE
ADMINISTRATION AND THE
LEGISLATURE AS THIS PROPOSAL TO
CONTINUE AT THIS PROPOSAL
CONTINUES, AND OUR CHIEF CONCERN
IS THOSE WHO HAD IMPACTS THAT
PROVIDERS WHO ARE IN THE
TRENCHES ACTUALLY DOING THE WORK
AND, MOST IMPORTANTLY, THE
SAFETY NET CLIENTS THAT THEY
SERVE. THANK YOU. THANK YOU. AND
I WANT TO THANK BOTH OF YOU FOR
JUST BRINGING THE VOICE OF THE
WORKER TO US, BECAUSE THAT'S
INCREDIBLY IMPORTANT IN THIS AND
WITH BURNOUT AND THE HARDER WE
MAKE THE SYSTEM, THE FASTER WE
LOSE CLINICIANS. WE HAVE TO MAKE
SURE THAT WE KEEP OUR EYES ON
THAT AND AGAIN. WE WILL CONTINUE
TO FOCUS ON YOUR FEEDBACK AND BE
ABLE TO ADJUST IT. AS WE CAN
OTHERS. OH, I'M SORRY. WE HAVE
ANOTHER PARTICIPANT AT THIS TIME
WHO IS ON ZOOM HIM. THANKS OKAY.
YES, WE CAN. KIM. THANK YOU.
THANK YOU. GOOD AFTERNOON
TREATMENT AND COMMITTEE MEMBERS
. MY NAME IS KIM LEWIS AND I'M
THE MANAGING ATTORNEY AND THE
DIRECTOR OF CALIFORNIA POLICY AT
THE NATIONAL HEALTH PROGRAM. AND
HELP IS A PUBLIC INTEREST LAW
FIRM THAT WORKS TO PROTECT AND
ADVANCE THE RIGHTS OF LOW INCOME
AND UNDERSERVED INDIVIDUALS AND
ENSURE EQUITABLE ACCESS TO
AFFORDABLE QUALITY HEALTH CARE,
INCLUDING COMPREHENSIVE
BEHAVIORAL SERVICES. I
PERSONALLY WORKED ON POLICY
ISSUES IN CALIFORNIA'S MENTAL
HEALTH SYSTEM FOR OVER 30 YEARS
AND THE ADMINISTRATION'S
BEHAVIORAL THEMATIC
MODERNIZATION PROPOSAL IS
INTENDED TO STRENGTHEN
CALIFORNIA'S MENTAL HEALTH AND
SUBSTANCE USE DISORDER SYSTEM
AND PROMOTE ACCESS TO HIGH
QUALITY AND APPROPRIATE
BEHAVIORAL HEALTH SERVICES,
WHILE ALSO ENSURING THAT FEDERAL
AND STATE DOLLARS ARE MAXIMIZED.
THE PROPOSAL ATTEMPTS TO STRIKE
A BALANCE BETWEEN MEETING THE
BEHAVIORAL HEALTH NEEDS AND
HOUSING NEEDS OF CALIFORNIANS
WITH SERIOUS AND MODERATE NOW ON
BEHAVIORAL HEALTH CONDITIONS,
WHILE ALSO REQUIRING AN ONGOING
FOCUS ON PREVENTION AND EARLY
INTERVENTION SERVICES AS WELL AS
PROMOTE PROMISING PRACTICES AND
COMMUNITY TO FIND PRACTICES SUCH
AS FULL SERVICE PARTNERSHIPS. WE
FULLY BELIEVE THAT BHS A SHOULD
ADDRESS THE NEEDS OF CHILDREN,
YOUTH AND YOUNG ADULTS AND ARE
PLEASED TO SEE THE RECENT
CHANGES TO EMPHASIZE THE FOCUS
ON THE NEEDS OF YOUTH AGE 25 AND
YOUNGER, BUT WE ALSO WANT TO
REMIND THE COMMITTEE THAT
BEHAVIORAL HEALTH SERVICES ARE
COVERED MEDICAL ARE COVERED BY
MEDICAL MUST BE PROVIDED WHEN
NECESSARY TO APPROVE THE
BEHAVIOR HEALTH CONDITION,
REGARDLESS OF WHETHER COUNTIES
RELY ON BHS A FUNDING TO PAY FOR
THEM. MEDICAID'S BROAD EARLY AND
PERIODIC SCREENING, DIAGNOSTIC
AND TREATMENT BENEFIT IS A
FEDERAL ENTITLEMENT FOR MEMBERS
UNDER AGE 21 AND THEREFORE STATE
OBLIGATION AND WE FEEL CONFIDENT
IN SAYING THAT THOSE NEEDS ARE
STILL NOT CONSISTENTLY BEING MET
BY COUNTY BEHAVIORAL HEALTH
PLANS. SO THIS LEADS ME TO WHAT
I WANT TO FOCUS MY TIME ON
BEFORE THIS COMMITTEE, WHICH IS
THE NEED FOR GREATER
ACCOUNTABILITY AND TRANSPARENCY.
AS OTHERS HAVE SAID THEM IT JUST
SAY WHICH WAS ORIGINALLY
INTENDED TO AUGMENT THE
PROVISION OF SERVICES SUPPORTS
AND HOUSING NETWORK UNAVAILABLE
AT THE TIME UNDER MEDICAL AND
THE AFFORDABLE CARE ACT HAS
SINCE TRANSFORMED MEDICAL
MEDICAL PROGRAM, INCREASING THE
NUMBER OF MEMBERS NUMBER OF
COVERED META MENTAL HEALTH AND
SUBSTANCE USE DISORDER SERVICES,
AND CALLUM IS MAKING IMPORTANT
REFORMS TO MEDICAL AS WELL.
CALIFORNIA STILL LACKS OR ROBUST
SYSTEM TO MONITOR AND TRACK HOW
BEHAVIORAL FUNDING FROM VARIOUS
RESOURCES AS BEING ACCOUNTED FOR
SUCH A SYSTEM IS NECESSARY IN
ORDER TO ENSURE THE BEHAVIORAL
SERVICES ARE PROVIDED AND
CLAIMED UNDER MEDICAL AND THAT
FEDERAL MATCHING FUNDS ARE
MAXIMIZED. CALIFORNIA DOESN'T
LEAVE FEDERAL DOLLARS ON THE
TABLE. MEDICAID IS THE SINGLE
LARGEST PAIR OF BEHAVIORAL
SERVICES IN THE COUNTRY,
INCLUDING IN CALIFORNIA, SO IT'S
ESSENTIAL TO KNOW HOW STATE AND
LOCAL FUNDS ARE BEING UTILIZED
TO DELIVER THE REQUIRED STATE
PLAN AND WAIVER COVERED SERVICES
FOR MEDICAL MEMBERS, MEDICAL
MANAGED CARE PLANS AND COUNTING
BEHAVIORAL HEALTH PLANS ARE
DIRECTLY RESPONSIBLE FOR MEETING
THOSE NEEDS FOR PEOPLE ON
MEDICAL GIVEN 88% OF MEDICAL
MEMBERS ARE MANAGED CARE. THE
COUNTY PLANS RESPONSIBLE FOR
SPECIALTY MENTAL HEALTH SERVICES
AND ALMOST ALL SUBSTANCE USE
DISORDER SERVICES FOR THE ENTIRE
MEDICAL POPULATION. INDEED HIS
ROLE AND LEGAL RESPONSIBILITY AS
A SINGLE STATE MEDICAID AGENCIES
TO OVERSEE MEDICAL EXPENDITURES
SERVICE DELIVERY AND IT KEPT
ACCOUNTABILITY BY THE COUNTY
BEHAVIORAL HEALTH DELIVERY
SYSTEM. TO THAT END, THE
DEPARTMENT NEEDS TO KNOW HOW
REALIGNMENT FUNDS AND THEN MHS A
FUNDS ARE BEING SPENT BY
COUNTIES TO BETTER UNDERSTAND
HOW THEY'RE BEING UTILIZED. TO
MEET THE ONGOING BEHAVIORAL
HEALTH SERVICE NEEDS OF CHILDREN
, YOUTH, ADULTS AND OLDER ADULTS
IN MEDICAL AND IN LIGHT OF THE
ADMINISTRATION'S BH CONNECT
PROPOSAL. WHICH COULD EXPAND
MEDICAL COVERAGE TO
INSTITUTIONAL PSYCHIATRIC
TREATMENT IN CERTAIN SITUATIONS.
TRANSPARENCY IS PARTICULARLY
IMPORTANT. WE WANT TO KNOW
WHETHER AND HOW MUCH OF THESE
SERVICE RESOURCES THE COUNTIES
ARE SPENDING ON
INSTITUTIONALIZATION.
PSYCHIATRIC INPATIENT SERVICES E
D VISITS RATHER THAN SERVICES TO
SUPPORT AND MAINTAIN CHILDREN
AND ADULTS WITH BEHAVIORAL
HEALTH NEEDS AT HOME AND IN
THEIR COMMUNITY. WITHOUT SUCH A
SYSTEM OF ACCOUNTABILITY
MEASURES AND FISCAL TRANSPARENCY
WILL CONTINUE TO RAISE CONCERNS
THAT THE UNMET NEEDS OF MEDICAL
MEMBERS AND LACK OF
ACCOUNTABILITY AND TRANSPARENCY
BY COUNTIES AND MEETING THOSE
REQUIREMENTS REGARDING QUALITY
AND ACCESS TO SERVICES. THOSE
REQUIREMENTS THAT DON'T EXIST
CURRENTLY UNDER MHS A. THE
CURRENT PROPOSAL WOULD ADDRESS
SOME OF THESE CONCERNS BY
REQUIRING COUNTIES TO ALWAYS
BUILD MEDICAL FOR COVERED
SERVICES. REQUIRING GREATER
COUNTY ACCOUNTABILITY AND
TRANSPARENCY THROUGH ADDITIONAL
REPORTING ON METRICS, SUCH AS
THE ALLOCATION OF EACH SOURCE OF
FUNDING. UNSPENT FUNDS WORKFORCE
QUALITY, AS WELL AS DATA RELATED
TO BEHAVIORAL HEALTH DISPARITIES
AND OUTCOMES TO ACHIEVE HEALTH
EQUITY, ESTABLISHING METRICS TO
MEASURE AND EVALUATE THE QUALITY
AND EFFICACY OF SERVICES UNDER
MEDICAID, HEALTH, COUNTY
BEHAVIORAL HEALTH DELIVERY
SYSTEM AND REQUIREMENT,
REPORTING ANNUALLY TO THE COUNTY
BOARD OF SUPERVISORS ON MEDICAL
BEHAVIORAL HEALTH UTILIZATION
CALL EDDIE EXPENDITURES AND
OTHER DATA IS CRITICAL.
STATEWIDE QUALITY AND
EFFECTIVENESS METRICS FOR
MEDICAL BEHAVIORAL HEALTH
SERVICES HAVE BEEN LACKING AND
ARE NEEDED TO DEMONSTRATE THE
INTENDED IMPACT OF SERVICES, NOT
JUST PENETRATION RATES THAT
MEASURE BASIC ACCESS.
AUTHORIZING THE DEPARTMENT TO
ALIGN CONTRACTUAL REQUIREMENTS
BY COUNTY MENTAL HEALTH PLANS,
SUBSTANCE USE DISORDER PLANS AND
MEDICAL MANAGED CARE PLANS IS
ALSO CRITICAL STATE SHOULD MOVE
TOWARDS INTEGRATION AND BETTER
COORDINATION AND ALIGNMENT OF
BEHAVIORAL, HEALTH AND HEALTH
SERVICES, PARTICULARLY FOR
MEDICARE BENEFICIARIES, WHO MUST
OFTEN NAVIGATE A COMPLICATED AND
SOMETIMES DUPLICATIVE SYSTEM. SO
IN CLOSING THE MODERNIZATION OF
CALIFORNIA'S BEHAVIORAL SYSTEM
IS A COMPLEX TASK BECAUSE OTHERS
HAVE SAID, AND IT WILL TAKE TIME
AND SIGNIFICANT EFFORT. BUT THE
CURRENT PROPOSALS AND IMPORTANCE
STARTING POINT TO ACHIEVE THE
NEEDED ACCOUNTABILITY AND
TRANSPARENCY THAT WE BELIEVE
WILL SIGNIFICANTLY HELP IMPROVE
ACCESS TO QUALITY BEHAVIOR,
HEALTH SERVICES ACROSS THE STATE
AND LEAD TO BETTER AND MORE
EQUITABLE OUTCOMES FOR
CALIFORNIA'S LOW INCOME AND
VULNERABLE POPULATIONS WOULD
BEHAVIOR HOT NEEDS? THANKS FOR
THE OPPORTUNITY TO TESTIFY
BEFORE THE COMMITTEE. THANK YOU
VERY MUCH. QUESTIONS FROM MY
COMMITTEE MEMBERS. ALL RIGHT. I
MEAN, WE THANK YOU ALL VERY MUCH
. THIS IS AN ONGOING ITERATIVE
PROCESS AS YOU CAN ALL SEE
AGAIN. IT'S JUST AN
INFORMATIONAL HEARING TODAY.
WE'RE NOT GONNA BE VOTING FIRST
VOTE NEXT WEEK, BUT WE WANT TO
GIVE A CHANCE FOR THE SENATORS
TO BE ABLE TO WEIGH AND THANK
YOU VERY, VERY MUCH FOR YOUR
PARTNERSHIP AND CONTINUING TO BE
A PART OF THIS. AND NOW THE NEXT
GROUP OF STAKEHOLDERS. PHOEBE
BILL, BEHAVIORAL HEALTH
DIRECTORS, NEVADA COUNTY. SEAN
FRANCIS, SENIOR DIRECTOR OF
BEHAVIORAL HEALTH CHILDREN, NOW
JOSEPHINA ALVARADO, MINA MINA
CEO, S¼ PASSAGES, AND DR MARIAN
OWEN, SUPERINTENDENT OF SCHOOLS
SANTA CLARA COUNTY WELCOME.
PHOEBE SAT DOWN FIRST, SO I'LL
LET YOU GO AND I SHARE A SCHOOL
BOTH WENT IMPORTANT STATES.
EXACTLY MASTER'S MIND FOR MY PHD
. LET'S SEE IF WE CAN GET THIS
STUFF. I'M SCREEN SHARING.
SORRY, QUICK TECH THING.
STARTING TO HAVE SOMEONE ELSE
START WHILE YOU'RE GETTING
READY. I SHOULD BE GOOD SCREEN
SHARING. CAN YOU GUYS SEE IT UP
THERE? YEAH. THERE HE GOES.
THERE HE GOES. EXCELLENT OKAY,
WELL DELAY GREAT. GOOD AFTERNOON
CHAIR AND MEMBERS. THANKS SO
MUCH FOR HAVING ME HERE TODAY.
MY NAME IS PHOEBE BALAN, THAT
BEHAVIOR HEALTH DIRECTOR FOR
NEVADA COUNTY AND PAST PRESIDENT
OF C BHD. A I'M HERE TODAY TO
PROVIDE THE COUNTY PERSPECTIVE
ON THE RESTRUCTURING OF THE
IMAGES AS PROPOSED IN SP 3 26.
MITCHELL SAYS, COMPLETELY
TRANSFORMED HOW WE DELIVER
ESPECIALLY MENTAL HEALTH
SERVICES IN CALIFORNIA OVER THE
LAST 20 YEARS FOR THE BETTER.
MHM HAS GIVEN US THE OPPORTUNITY
TO MAKE TRUE INVESTMENTS AND
PREVENTION, EARLY INTERVENTION
AND TO BUILD A MORE ROBUST
CONTINUUM ABOUT PATIENT
SERVICES. IN FACT, AN
INDEPENDENT, PEER REVIEWED STUDY
OUT OF USC FOUND THAT THANKS TO
THE WE PREVENTED OVER 5500
DEATHS BY SUICIDE. TODAY THE
IMAGES HAS BECOME A CORE SOURCE
OF FUNDING FOR A BROAD RANGE OF
SERVICES MAKES UP ONE THIRD OF
OUR STATE DEDICATED FUNDING
STREAMS, AND IT'S A CRUCIAL
SOURCE OF MATCH FOR MEDICAL IT'S
ALSO TRANSFORMED HOW WE DELIVER
CARE BY REQUIRING US TO MORE
MEANINGFULLY ENGAGE OUR
COMMUNITIES IN BUILDING OUT
SERVICES. NOT A PENNY CAN BE
SPENT WITHOUT LOCAL INPUT AND
SIGN OFF. CANDIES ARE
APPRECIATIVE. THE AUTHOR AND THE
ADMINISTRATION'S ACKNOWLEDGEMENT
OF THE MANY OUTSTANDING ISSUES
AND CHALLENGES WE FACE AS A
PUBLIC SAFETY NET FOR MENTAL
HEALTH AND SUBSTANCE USE
DISORDERS IN BRINGING FORWARD SP
3 26, INCLUDING AN IMAGE TO SAY
FUNDING STRUCTURE, WHICH IS
OVERLY RESTRICTIVE AT TIMES AND
LIMITS OUR ABILITY TO PAY FIRST
IN THE LOAN, SUBSTANCE USE OR
SUD CONDITIONS. LACK OF ACCESS
TO HOUSING FOR OUR CLIENTS AND
THE OPPORTUNITY FOR MORE
TRANSPARENCY ABOUT OUR SERVICES
AND EXPENDITURES, THE PUBLIC
SYSTEM IS OPEN TO BEING HELD
ACCOUNTABLE FOR OUTCOMES RELATED
TO HOW WE DO OUR WORK. I ALSO
WANT TO ACKNOWLEDGE THE VARIOUS
AMENDMENTS THAT WENT TO PRINT
YESTERDAY, SEVERAL OF THESE
ADDRESS CONCERNS RAISED BY
COUNTIES AND OTHER STAKEHOLDERS
AND WE APPRECIATE THE
OPPORTUNITY FOR FURTHER
ENGAGEMENT ON SOME OF OUR
OUTSTANDING CONCERNS. WHILE
WE'RE STILL WORKING TO DIGEST
THE EXTENT OF THE AMENDMENTS,
ESPECIALLY WANT TO THANK THE
AUTHOR AND THE ADMINISTRATION
FOR MANY OF THE IMPROVEMENTS,
INCLUDING RECOGNIZING THE NEEDS
OF SMALLER COUNTIES SUCH AS MY
OWN AND OUR UNIQUE
CIRCUMSTANCES. SO WHAT I'LL
SHARE TODAY REFLECTS WORK DONE
ACROSS ALL COUNTIES TO ANALYZE
THE IMPACT OF THE PROPOSED SP 3
26 RESTRUCTURING AS PUT FORWARD
PRIORITY YESTERDAY'S AMENDMENTS
, BUT I'LL TRY TO ACKNOWLEDGE
THIS WHERE I CAN. SO FIRST IN
THIS, UM, LOOK AT THE IMAGES SAY
BUCKETS. WE CAN BASICALLY SEE
THE BIGGEST CHANGE TO HOW WILL
BE FUNDED IS THE NEW ADDED
REQUIREMENT. THOSE SHADES OF
PURPLE, WHICH IS THE HOUSING
REQUIREMENTS, ADDING ONE THIRD
OF OUR FUNDS BEING USED FOR
HOUSING. AND WHAT WE INITIALLY
ESTIMATED THAT PREVENTION EARLY
INTERVENTION FUNDING WOULD
LARGELY BE MAINTAINED THE SHIFT
FUNDING TO THE POPULATION
PREVENTION CATEGORY TO THE STATE
WOULD CREATE ADDITIONAL
SHORTFALLS THAT AREN'T
REPRESENTED HERE. HOWEVER, THE
MOST SIGNIFICANT SHIFT WOULD
OCCUR IN THAT ORANGE CATEGORY
CALLED GENERAL SERVICES
DEVELOPMENT, WHICH TODAY
CONSISTS OF BACKBONE PROGRAMS
SUCH AS OUTPATIENT SERVICES,
CRISIS, PEER SUPPORT AND
RECOVERY SERVICES. THAT HELP OUR
CLIENTS ACHIEVE STABILITY AND
AVOID THE NEED FOR CRISIS, FULL
SERVICE PARTNERSHIP AND HOUSING
SERVICES. THIS VIEW BRINGS INTO
PLAY THE ADDITION OF SUBSTANCE
USE DISORDER FUNDING THE
POTENTIAL IMPACTS THAT WOULD
HAPPEN IF WE DIVERT EXISTING
FUNDS TO ADD SUD CAPACITY AND I
DO WANT TO HIGHLIGHT THAT IN
2019 C BHD. A AND C SAC WORKED
TOGETHER ON A JOINT SET OF
IMAGES, A REFORM PRINCIPLES
WHICH CALLS FOR CALLED FREEZING
MHM, MORE FLEXIBLY FOR SUD ONLY
SERVICES. SO WE ARE VERY MUCH
ALIGNED WITH THIS GOAL. IT'S
INCREDIBLY IMPORTANT. AND AS
CURRENTLY DRAFTED, THE BILL
WOULD REQUIRE TO DIVERT FUNDING
THAT TODAY'S SUPPORTS MENTAL
HEALTH SERVICES IN ORDER TO
BUILD OUT NEW SUD SERVICES. WE
UNDERSTAND TODAY'S AMENDMENTS
MAY ADDRESS SOME OF THESE
CONCERNS FOR WHICH WE'RE
GRATEFUL, HOWEVER, WE THINK IT'S
IMPORTANT TO ACKNOWLEDGE THAT
MANY CASES FUNDING SUD SERVICES
APPEARS TO REMAIN A REQUIREMENT
WITHOUT ADDITIONAL NEW FUNDING
TO ENSURE CURRENTLY FUNDED
MENTAL HEALTH SERVICES CAN BE
SUSTAINED. IN THIS VIEW,
COUNTIES WORKED WITH C B H DAY
AND HOW TO MODEL OUR EXISTING
PROGRAMS AND SERVICES AND HOW
THOSE WOULD TRANSLATE TO THE NEW
FAN FUNDING CATEGORIES AND MORE
GRANULAR WAY HERE, YOU CAN SEE
AN EXAMPLE OF A LARGE COUNTY,
WHICH IS SAN JOAQUIN AND MEDIUM
COUNTY, WHICH IS MONTEREY AND A
SMALL COUNTY, WHICH IS NEVADA,
MY COUNTY, USING CURRENT
EXPENDITURES BY CATEGORY AND
AGAIN, YOU CAN SEE THE ADDITION
OF THE LAVENDER HOUSING CATEGORY
AND THE PRETTY SIGNIFICANT
DECLINE IN WHAT WAS CALLED
GENERAL SERVICES DELIVERY SORT
OF THAT BROAD BUCKET CATEGORY.
BECOMES B HSS. UM AGAIN. WHAT WE
SEE IS A LOSS OF FUNDING. UM
ACROSS THAT GENERAL SERVICES
BUCKET. THAT'S ANYWHERE FROM 50
TO 80% FOR COUNTIES. THESE
SERVICES ARE ALSO LARGELY
MATCHABLE THROUGH MEDICAL, WHICH
WOULD INCREASE THE IMPACT OF THE
LOSSES TO OUR COMMUNITIES WITH
THE RELATED LOSS OF FEDERAL
FUNDING MATCH OR TO SAY THAT
ANOTHER WAY IF WE CUT $100 OF
MHM SAY FROM A PROGRAM WE HAVE
TO CUT $200 OF SERVICES BECAUSE
OF THE LOSS OF THE MATCH. SO
HERE'S A LITTLE BIT OF A DEEPER
DIVE INTO WHAT IT LOOKS LIKE IN
NEVADA COUNTY, MY COUNTY, IT
LOOKS LIKE I'LL NEED TO MOVE
ABOUT THREE QUARTERS OF A
MILLION DOLLARS OUT OF MY $4.3
MILLION FSP PROGRAM IN ORDER TO
MEET THE SPENDING REQUIRED IN
THE OTHER CATEGORIES, AND THIS
WOULD BE IF ALL THE FUNDING
WE'RE ONLY SPENT ON MENTAL
HEALTH SERVICES. IF I ADDED IN
SUD SPECIFIC SERVICES THAT WOULD
BE MORE IMPACTFUL. WE WOULD ALSO
LIKELY LOSE ABOUT $1.3 MILLION
IN MEDICAL REVENUES. IN
ADDITION, THIS PHOTO IS FROM OUR
PURE RESPITE PROGRAM THAT WE
OPERATE WITH GST DOLLARS. IT'S
STAFFED ENTIRELY BY PEERS. IT'S
A SIX BED HOUSE WHERE PEOPLE CAN
STAY FOR UP TO 28 DAYS, OFTEN
AVOIDING HOSPITALIZATION OR
USING IT AS A TRANSITION SPACE
AFTER AN INPATIENT STAY. IT'S AN
INCREDIBLE PROGRAM BELOVED BY
OUR COMMUNITY. IT COSTS US ABOUT
$750,000 OF GST DOLLARS THAT ARE
AT RISK, GIVEN THE CUTS WILL
NEED TO MAKE IN THE END OUR
PRIMARY CONCERNS WITH THE
POTENTIAL LOSS OF CORE FUNDING
FOR OUTPATIENT CRISIS AND
RECOVERY SERVICES, ALONG WITH
PREVENTION DOLLARS, AND HOW
STRICT FUNDING CATEGORIES
ACTUALLY MAY HAVE THE UNINTENDED
CONSEQUENCES OF FORCING COUNTIES
LIKE MINE TO DECREASE FUNDING TO
F SPS. ANOTHER CONCERN WE HAVE
IS THE INHERENT VOLATILITY OF
THE ATTACKS, WHICH THE LAO HAS
THOROUGHLY DESCRIBED. MANAGING
AND UNPREDICTABLE AND VOLATILE
FUNDING STREAM, WITH NUMEROUS
VERY RIGID CATEGORIES OF FUNDING
IS EXTREMELY CHALLENGING. WE
BELIEVE THAT SOLVING FOR THIS
IMPACTS SOLVING FOR THE IMPACTS
OF THIS VOLATILITY IS A CRUCIAL
REFORM AND LOOK FORWARD TO
FURTHER ENGAGEMENT ON THIS
TOPIC. LOTS OF SPECIFIC EXAMPLES
OF HOW THAT CAN PLAY OUT ANOTHER
. YOU DO FEEL THE IMPACT? YEAH
THE VOLATILITY YEAH, 100% AND
TRYING TO MANAGE THAT VOLATILITY
TO THOSE RIGID CATEGORIES. YOU
GET MORE MONEY THAN YOU EXPECT.
AND YOU WANT TO SPEND IT ON
SOMETHING LIKE HOUSING, BUT YOU
CAN'T BECAUSE THEY'LL THROW YOUR
RATIOS OFF UNTIL YOU SIT ON THE
MONEY UNTIL YOU CAN RAMP UP ALL
THE OTHER PARTS TO GET TO THE
RIGHT RATIOS, AND THAT
CATEGORICAL FUNDING IS REALLY
IMPEDES THE ABILITY TO BE
ADAPTIVE, OKAY? UM SO IN SUMMARY
, WE BELIEVE THAT WE HAVE A
SHARED INTEREST WITH THE STATE
IN TRYING TO STABILIZE AND
SUSTAINABLY FUND OUR SERVICES.
UNDERSTANDING THE POTENTIAL
IMPACTS OF THIS PROPOSAL IS
CRITICAL TO AVOIDING UNINTENDED
HARM TO THE SYSTEM. WE WANT TO
ACKNOWLEDGE THE AUTHOR AND
ADMINISTRATION FOR ADDRESSING
SEVERAL OF THE CONCERNS RAISED
BY COUNTIES, INCLUDING THE NEED
FOR RURAL EXEMPTIONS AND
FLEXIBILITY AND HOW WE DEFINE
HOUSING AND CHRONIC HOMELESSNESS
INVESTMENTS. WHAT WE APPRECIATE
THE WILLINGNESS TO ALLOW
TRANSFERS BETWEEN COMPONENTS. WE
CONTINUE TO BE CONCERNED ABOUT
THE IMPLICATIONS OF MANAGING
STRICT FIXED PERCENTAGE
REQUIREMENTS WITHIN THE STATE.
SMITH VOLATILE FUNDING SOURCE AS
SENATOR ROTH WAS SPEAKING TO
EARLIER THAT SAME ISSUE. FINALLY
COUNTIES ARE ACUTELY AWARE OF
THE NEED TO MAKE CHANGES IN HOW
WE'RE DELIVERING AND REPORTING
ON OUR SERVICES. WE CONTINUE TO
ANALYZE THE PROPOSED CHANGES TO
THIS PART OF THE BILL AS AMENDED
YESTERDAY. TO ENSURE THAT NEW
COMPLIANCE REQUIREMENTS ARE
APPROPRIATELY RESOURCED AND
CONSISTENT WITH THE GOAL OF
CALLUM TO STREAMLINE
DOCUMENTATION AND ADMINISTRATIVE
BURDEN. WE WELCOME
ACCOUNTABILITY IN THE EXPANDED
OPPORTUNITIES TO INVEST IN SUD
AND HOUSING SERVICES. THESE ARE
CAUSES AND CONCERNS THAT WE HAVE
CHAMPIONED AS WELL. AND WE LOOK
FORWARD TO CONTINUED PARTNERSHIP
WITH THE LEGISLATURE AND THE
ADMINISTRATION TO ENSURE THAT AS
WE MAKE THESE CHANGES, WE CAN
CONTINUE TO USE THESE FUNDS AND
PARTNERSHIP WITH COMMUNITIES IN
WAYS THAT BEST MEET THE NEEDS OF
OUR COMMUNITY MEMBERS AND
PREVENT UNNECESSARY SUFFERING.
AS MAYOR, STEINBERG SAID, AND
EVEN DEATH FOR THOUSANDS OF
CALIFORNIANS HAPPY TO ANSWER ANY
QUESTIONS. THANK YOU VERY MUCH,
AND WE'LL MOVE ON. BUT DR LEE,
I'LL ASK YOU TO RESPOND TO THE
REDUCTION IN FUNDING THAT
DIRECTOR BELL IS TALKING ABOUT
WHEN EVERYBODY IS DONE. OKAY?
LOTTERY. MR FRANCIS AFTERNOON.
GOOD AFTERNOON SHARE EGGMAN AND
COMMITTEE MEMBERS. THANK YOU.
THANK YOU FOR THE OPPORTUNITY TO
ADDRESS YOU TODAY. MY NAME IS
LASHAWN FRANCIS AND I'M WITH
CHILDREN. NOW CHILDREN NOW IS A
STATEWIDE RESEARCH POLICY AND
ADVOCACY ORGANIZATION. FIRST WE
REALLY, REALLY WANT TO THANK THE
ADMINISTRATION FOR BEING SO
WILLING TO WORK WITH US ON THESE
AMENDMENTS. WE WERE REALLY
EXCITED TO SEE A NUMBER OF
THINGS, PRIMARILY THE SET ASIDE
FOR KIDS IN THE PREVENTION,
EARLY INTERVENTION BUCKET, THE
ALIGNS DEFINITION OF BEHAVIORAL
HEALTH TREATMENT NEED WITH THAT
OF CALLUM, AS WELL AS THE
EXPANSION OF THE HOMELESS
POPULATION BEYOND CHRONIC
HOMELESSNESS. SO I WANT TO FLAG
THAT MY COMMENTS THAT FOLLOW
TODAY. THEY'RE NOT EXHAUSTED
BECAUSE WE'RE STILL REVIEWING
THE AMENDMENTS. SO BASICALLY, I
RESERVE THE RIGHT TO BE WRONG.
BUT WE DO HAVE A FEW THAT WE DO
HAVE A FEW OUTSTANDING QUESTIONS
THAT AROSE FOR US WHEN WE WERE
REVIEWING THE FIRST IS WITH THE
SEPARATION OF PREVENTION AND
EARLY INTERVENTION INTO
DIFFERENT POTS OPERATIONALLY,
HOW WOULD PROGRAMS WHO DO BOTH
RECEIVED FUNDS, FOR EXAMPLE, WE
HAVE SCHOOL WELLNESS CENTERS
THAT HAVE BOTH POPULATION HEALTH
PROGRAM. DAMS AS WELL AS EARLY
INTERVENTION. PROGRAMS WITH
WELLNESS CENTERS HAVE TO APPLY
FOR FUNDING TWICE. WE STILL HAVE
QUESTIONS AROUND THE SERVICES
THAT CAN BE COVERED UNDER EARLY
INTERVENTION AND WHETHER IT'S
LIMITED TO EARLY PSYCHOSIS TYPE
PROGRAMS. OF COURSE, WE WOULD
LIKE TO ENSURE THAT EARLY
INTERVENTION SERVICE LIST IS
BROADER THAN THAT OF EARLY
PSYCHOSIS PROGRAMS. WE'RE ALSO
NOTICING THAT WITH THE ALIGNMENT
OF THE BEHAVIORAL TREATMENT NEED
DEFINITION, THERE IS SOME
INCONSISTENCY ON HOW THE BILL
DEFINES CHILDREN AND YOUTH BY
AGE, SO IN SOME PLACES, IT'S
UNDER 21 AND OTHER PLACES UNDER
25, SO WE REALLY WOULD LIKE TO
TAKE ANOTHER LOOK AT THAT. WE OF
COURSE, WOULD WANT IT TO BE
UNDER 25 AND UNDER THROUGHOUT WE
ALSO HAVE QUESTIONS. WE
UNDERSTAND THAT THERE'S A LOT OF
EXCITEMENT AROUND THE
FLEXIBILITY FOR COUNTIES UNDER
THESE NEW AMENDMENTS, BUT OUR
QUESTION IS ALWAYS GOING TO BE
WITH THAT FLEXIBILITY. WHAT DOES
THAT MEAN FOR THE POPULATIONS
THAT ARE LESS SEEN? LIKE
CHILDREN AND YOUTH? WE FEEL THIS
TENSION UNDER THE FULL SERVICE
PARTNERSHIP PROGRAM. WE'RE
REALLY BIG FANS OF IT OR
WHATEVER IT TAKES APPROACH HAS
BEEN REALLY HELPFUL FOR CHILDREN
AND YOUTH, CURRENTLY FSP
POPULATION HAS ABOUT 50% OF THE
FSB POPULATION SERVES YOUNG
PEOPLE, AND WE WANT TO MAKE SURE
THAT THAT REMAINS LASTLY, I WANT
TO HIGHLIGHT OUR JULY LETTER AS
WELL AS SOME OF OUR SUGGESTED
AMENDMENTS, WHERE WE REQUESTED
ADDITIONAL SET ASIDES FOR KIDS,
ONE OF THE THINGS THAT THOSE OF
US IN THE CHILDREN'S SPACE
RECOGNIZE IS THAT OUR BOOK AND
POPULATIONS ARE OFTEN FORGOTTEN.
AND WHEN I SAY BOOK END I'M
REFERRING TO ARE 0 TO 5
POPULATION AND OUR TRANSITION
AGE YOUTH, AND THAT'S PRIMARILY
BECAUSE THERE IS NO FORMAL
SYSTEM THAT SUPPORTS THEM
CONSISTENTLY LIKE SCHOOLS FOR
SCHOOL AGE CHILDREN, SO FOR
THESE REASONS WERE STILL
REQUESTING A SET ASIDE FOR THE 0
TO 5 POPULATION WITHIN
PREVENTION. WE UNDERSTAND THAT
THIS IS NOT CURRENT PRACTICE.
HOWEVER OUR EXPERIENCE WITH THE
IMAGES, SAYING ITS CURRENT FORM
IS THAT IT'S BEEN A LOT OF WORK
TO ENSURE LITTLE KIDS ARE
THOUGHT OF ON THE LOCAL LEVEL.
LEVEL. THE STATE VOCALIZING. ITS
DESIRE TO SUPPORT SMALL CHILDREN
REALLY COULD GO A LONG WAY.
SECONDLY WE'RE STILL REQUESTING
A SET ASIDE FOR UNACCOMPANIED
YOUTH UNDER HOMELESSNESS. WE
BELIEVE IT'S CRITICAL TO HAVE
SEPARATE HOUSING SUPPORTS AND
SERVICES DEDICATED TO YOUTH THAT
IS DESIGNED TO MEET THE UNIQUE
NEEDS. I ALSO WANT TO POINT OUT
THAT THE STATE ACTUALLY HAS A
NUMBER OF PROGRAMS RIGHT NOW IN
HOMELESSNESS THAT SET ASIDE
FUNDING FOR YOUTH. SO, FOR
EXAMPLE, THE HOMELESS HOUSING
ASSISTANCE AND PREVENTION
PROGRAM HAS A YOUTH SET ASIDE
THAT REQUIRES LOCAL
JURISDICTIONS TO INVEST AT LEAST
10. OF THEIR TOTAL FUNDING TO
ADDRESS YOUTH, HOMELESSNESS AND
AS AN F Y I. THIS SET ASIDE
RESULTED IN A 21% REDUCTION IN
YOUTH HOMELESSNESS SINCE 2020.
FRANKLY THOSE ARE NUMBERS THAT
WERE REALLY ONLY SEEING IN THE
YOUTH SPACE. SO I REALLY DO LOVE
MAYOR STEINBERG'S TAKE ON THE
DESIRE FOR THE STATE TO SET
PRIORITIES FOR THE COUNTY'S WE
AGREE, AND WE THINK IT'S
IMPORTANT THAT THE STATE SET
THOSE PRIORITIES WERE JUST
ASKING THAT THOSE PRIORITIES
REFLECT THE NEEDS OF CHILDREN
AND YOUTH THROUGHOUT THE ENTIRE
BILL. WE'RE REALLY LOOKING
FORWARD TO CONTINUE WORKING WITH
THE ADMINISTRATION. HOPEFULLY ON
THE NEXT ROUND OF AMENDMENTS, SO
THAT S P 3 26 CAN BE A BILL THAT
DOESN'T JUST KEEP THE STATUS QUO
FOR CHILDREN BUT ENSURE CHILDREN
AND YOU HAVE AN EVEN GREATER
OPPORTUNITY TO THRIVE OVER THE
NEXT 30 YEARS. THANK YOU. THANK
YOU VERY MUCH, AND I'M VERY
PROUD TALKING, KENNY. WE ARE
WORKING AND TO OPEN A OPERATION
HOME KEY FOR TRANSITIONAL AGE
YOUTH, PLEASE DOCTOR DELEON.
GOOD AFTERNOON, MADAM CHAIR AND
MEMBERS OF THE COMMITTEE. I'M DR
MARY ANTOINE I'M THE COUNTY
SUPERINTENDENT OF SCHOOLS AND
SANTA CLARA COUNTY, REPRESENTING
A COALITION OF MORE THAN A DOZEN
EDUCATION, LABOR IN MANAGEMENT
GROUPS WE DID DISTRIBUTE EARLIER
, AND MEMBERS OF THE COMMITTEE
SHOULD HAVE IN FRONT OF THEM
PRINTED COPY OF OUR SLIDE DECK
AS WELL AS OUR COALITION JOINT
LETTER. AND THE EDUCATION GROUPS
THAT I MENTIONED ARE REFLECTED
ON THE FIRST SLIDE THAT IS BEING
PROVIDED TO YOU. WE ARE DEEPLY
GRATEFUL TO THE LEGISLATURE AND
TO THE ADMINISTRATION FOR THE
RECENT HISTORIC INVESTMENTS AND
POLICY CHANGES THAT REALLY DID
INCREASE SUPPORT FOR YOUTH
BEHAVIORAL HEALTH AND IS
BEGINNING TO MOVE CALIFORNIA
TOWARD AN INTEGRATED SYSTEMS
APPROACH. THESE EFFORTS ARE
POSITIVE STEPS TOWARDS ALIGNMENT
AND COORDINATION BETWEEN SCHOOLS
AND HEALTH PROVIDERS, WHICH IS
ESSENTIAL. FROM THE EDUCATION
PERSPECTIVE, ADDRESSING THE
NEEDS OF THE WHOLE CHILD IS
REALLY NECESSARY TO OUR SUCCESS.
RESEARCH TELLS US THAT WHEN
CHILDREN ARE HUNGRY WHEN THEY
HAVE UNMET MEDICAL NEEDS,
EXPERIENCING ANXIETY AND TRAUMA
AND STRESS WHEN THEY HAVE
EMERGING MENTAL HEALTH NEEDS
EARLY PSYCHOSIS OR ENTREATED
TRAUMA. THEIR BRAINS CANNOT
PROCESS INFORMATION EFFECTIVELY
AND SCHOOLS MUST MEET THOSE
PHYSICAL AND BEHAVIORAL NEEDS OF
CHILDREN WHILE ALSO PROVIDING
QUALITY CURRICULUM AND
INSTRUCTION. THIS IS WHY WE'RE
SO PLEASED TO SUPPORT THE MENTAL
HEALTH STUDENT SERVICES ACT AND
THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE,
WHICH INCLUDED A SPECIFIC FOCUS
ON SCHOOL BASED BEHAVIORAL
HEALTH SERVICES, AND I DON'T
KNOW IF WE CAN GET THE DECK OUT.
BUT IN YOUR PACKET ON SLIDE, TWO
REFERENCING THAT THESE HISTORIC
INVESTMENTS REFLECT. THAT
CHILDREN AND YOUTH ARE 21 TIMES
MORE LIKELY. TO ACCESS AND
BENEFIT FROM MENTAL HEALTH
SERVICES WHEN THEY ARE PROVIDED
ON A SCHOOL CAMPUS. PROVIDING
SERVICES AT SCHOOL SIGNIFICANTLY
REDUCES THE MANY BARRIERS TO
ACCESS THAT YOUTH FACE IN THE
UNIQUE PRIMARY BARRIERS THAT YOU
FACE TO MENTAL HEALTH ACCESS,
INCLUDING TRANSPORTATION AND
COST AND OFTEN COMMUNITIES
STIGMA. WE APPRECIATE THAT THE
ADMINISTRATION HAS RESTORED THE
PROVISION REQUIRING 51% OF THE
EARLY INTERVENTION FUNDS WE
SPENT ON CHILDREN AND YOUTH.
HOWEVER WE STILL NOTE THAT NONE
OF THIS FUNDING IS PROTECTED FOR
SCHOOL BASED BEHAVIORAL HEALTH
SERVICES, AND THIS IS A
NECESSARY PART OF OUR STATE'S
WHOLE CHILD APPROACH. FLIGHT
THREE. WE'RE PROVIDING SOME
INFORMATION ABOUT OUR CURRENT
UNDERSTANDING AND THE STRUCTURE
OF FUNDING. WELL SOME HAVE
ARGUED THAT PERHAPS 63 IS NO
LONGER UNNECESSARY FUNDING
SOURCE FOR SCHOOL BASED
BEHAVIORAL HEALTH PROGRAMS.
BECAUSE NEW ONE TIME GRANTS AND
BUILDING OPTIONS HAVE BEEN MADE
AVAILABLE OR WILL BECOME
AVAILABLE. WE UNDERSTAND THAT
THAT PERSPECTIVE REFLECTS A
FUNDAMENTAL MISUNDERSTANDING OF
BOTH THE TYPES OF SERVICES THAT
CHILDREN MOST NEED AND THE
LIMITATIONS OF ONE TIME FUNDING
AS WELL AS THE LIMITATIONS OF
SOME OF THE VEHICLES FOR BILLING
FOR SCHOOL BASED SERVICES. IT'S
NOW WIDELY ACCEPTED THAT OTHER
THAN MOST SEVERE CASES
DIAGNOSING CHILDREN WITH THE
MENTAL ILLNESS IS NOT BEST
PRACTICE. WELL ONE AND FIVE
CALIFORNIA CHILDREN HAVE
EXPERIENCED TRAUMA IN THE LAST
THREE YEARS. THE VAST MAJORITY
WOULD NOT MEET THE MEDICAL
NECESSITY REQUIREMENT FOR
BUILDING MANAGED CARE. CHILDREN
STILL NEED SERVICES TO MITIGATE
THE ONSET OF BEHAVIORAL HEALTH
SYMPTOMS. TO PROMOTE HEALTHY
SELF REGULATION SKILLS AND TO
SUPPORT THEIR SCHOOL ATTENDANCE
AND LEARNING. AS ILLUSTRATED ON
SLIDE. THREE SCHOOLS HAVE
LIMITED DIRECT ACCESS TO ONGOING
FUNDS FOR STUDENT BEHAVIORAL
HEALTH AND ONLY ONE SOURCE OF
ONGOING FUNDING FOR TIER ONE
SERVICES, PERHAPS 63 PREVENTION
AND EARLY INTERVENTION FUNDS.
YOU'LL NOTICE THAT THE SLIDE
DOES NOT INCLUDE COMMUNITY
SCHOOLS OR GRANTS AND THE C Y B
H B H I. THAT IS BECAUSE THESE
COMPETITIVE ONE TIME GRANTS DID
NOT PROVIDE FOR ONGOING FUNDING
TO SUSTAIN NECESSARY SCHOOL
BASED SERVICES, AND THE BILLING
OPTIONS ARE NOT YET ONLINE AND
WILL NOT FULLY COVER THE COST OF
SERVICES ONCE THEY ARE. P E. I
IS THEREFORE CRITICAL TO
CREATING THAT CONTINUUM OF CARE
FOR CHILDREN AND ENSURING THAT
SCHOOLS ARE SIGNIFICANT PART OF
THAT CONTINUUM OF CARE. SEVERAL
COUNTIES ARE DEMONSTRATING HOW
PE I SUPPORT STUDENT MENTAL
HEALTH NEEDS. SOLANO COUNTY
CURRENTLY ALLOCATES $8 MILLION
TO FUND 40 STUDENT WELLNESS
CENTERS AND SCHOOL CAMPUSES. L A
COUNTY PROVIDES 10 MILLION TO L.
A USD FOR TRAUMA AND RESILIENCE
AND FORMED EARLY ENRICHMENT
PROGRAMS AND SANTA CLARA NEARLY
20 MILLION FOR SCHOOL LINK
SERVICES IS BUDGETED. IN FRESNO
COUNTY COMMITTED $110 MILLION TO
BUILD OUT SCHOOL BASED
BEHAVIORAL HEALTH SERVICES.
SCHOOL BASED BEHAVIORAL HEALTH
MUST BE PRIORITIZED WITHIN THE
NEW PROPOSED EARLY INTERVENTION
CATEGORY IN ORDER TO PROTECT
THESE PROGRAMS. MOVING TO SLIDE
. FOUR REOPENING, PERHAPS 63
CREATES AN EXCITING OPPORTUNITY
TO INCREASE SCHOOL BASED
BEHAVIORAL HEALTH SERVICES AND
STRENGTHEN CALIFORNIA'S EFFORTS
TO BUILD AN INTEGRATED SYSTEM OF
CARE FOR CHILDREN. WE ENCOURAGE
MEMBERS OF THE COMMITTEE TO
CONSIDER THESE IMPACTS ON SCHOOL
BASED SERVICES IN YOUR DISTRICT.
INCLUDING OUR COALITION'S
REQUESTED AMENDMENTS, WHICH
SIGNIFICANTLY STRENGTHEN
COORDINATION OF CARE AND
PRESERVE NECESSARY SERVICES. THE
RESOURCES LINKED ON SLIDE FOR
PROVIDE INFORMATION ABOUT WHY
SCHOOL BASED APPROACHES TO YOUTH
MENTAL HEALTH ARE NECESSARY AND
WHY IT'S ESSENTIAL THAT
EDUCATORS BE INCLUDED AS THE
STATE CREATES AN INTEGRATED
SYSTEM OF CARE FOR CHILDREN. I'D
LIKE TO POINT OUT IN OUR
COALITION LETTER AND NUMBER OF
PLACES WHERE WE ARE RECOMMENDING
EDUCATION AND EDUCATION LEADERS
AND PROVIDERS BE INCLUDED. WE
APPRECIATE THE AMENDMENTS TO
DATE, WHICH DID REFLECT ONE OF
OUR RECOMMENDATIONS, BUT THERE
ARE SEVERAL OTHERS THAT HAVE NOT
BEEN ADDRESSED YET. SUCH AS IN
SECTION 20 SECTION, 39 AND
SECTION 41 AND SECTION 50. THANK
YOU ALL SO MUCH FOR YOUR
OPPORTUNITY TO SERVE AS A MEMBER
OF THIS PANEL, AND I'M HAPPY TO
ANSWER ANY QUESTIONS AT THE
APPROPRIATE TIME. THANK YOU SO
MUCH. WE'LL MOVE ON NOW TO
JOSEPHINE ALVARADO, MINA. THANK
YOU, CHAIR EGGMAN AND MEMBERS OF
THE COMMITTEE. THANK YOU FOR THE
OPPORTUNITY TO APPEAR ON THE
PANEL BEFORE YOU TODAY. MY NAME
IS JOSEPHINA ALVARADO MENA, AND
IT'S BEEN MY GREATEST HONOR TO
SERVE MARGINALIZED COMMUNITIES
OF COLOR IN LGBTQ PLUS
COMMUNITIES IN OAKLAND, ALAMEDA
COUNTY IN THE GREAT STATE OF
CALIFORNIA. THIS MONTH MARKS MY
20TH ANNIVERSARY SERVING AS THE
CEO OF SAFE PASSAGES OF
MULTISERVICE, COMMUNITY BASED
NONPROFIT ORGANIZATION DEDICATED
TO THE SOCIAL, EMOTIONAL AND
ECONOMIC WELL BEING OF THE
COMMUNITIES WE SERVE. OUR
COMMUNITIES BELIEVED IN THE
PROMISE OF THE IMAGES AND ITS
STATED GOALS OF REDUCING THE
SEEMINGLY INTRACTABLE BEHAVIORAL
HEALTH DISPARITIES. HOWEVER
BEHAVIORAL HEALTH DISPARITIES
CONTINUE TO HINDER THE WELL
BEING OF OUR COMMUNITIES, AS
EVIDENCED BY THE FOLLOWING DATA.
IN CALIFORNIA, AFRICAN AMERICAN
, LATIN X NATIVE AMERICAN, ASIAN
AND PACIFIC ISLANDER AND LGBTQ.
PLUS ADULTS FROM THESE GROUPS
HAVE HIGH RATES OF SERIOUS
MENTAL ILLNESS HIGH ABOVE THE
STATE AVERAGE, AS SEEN IN DATA
EVIDENCE TO THE CALIFORNIA
REDUCING DISPARITIES PROJECT.
2019 AGENCY. REPORT 6.3% OF
AFRICAN AMERICAN CALIFORNIANS
REPORTS SERIOUS PSYCHOLOGICAL
DISTRESS, NEARLY DOUBLE THE RATE
OF WHITE CALIFORNIANS AT 3.3.
AFRICAN AMERICANS MAKE UP 6.5%
OF CALIFORNIA'S POPULATION, BUT
NEARLY 40% OF CALIFORNIA'S AND
HOUSED POPULATION PACIFIC
ISLANDERS SUFFER FROM THE
HIGHEST RATES OF DEPRESSIVE
DISORDER, 20% AMONG ALL RACIAL
GROUPS AND THE SECOND HIGHEST
RATE OF ANXIETY DISORDERS, 15.7%
LATINOS. LATIN X MAKES UP 39.4%
OF CALIFORNIA'S POPULATION AND
FACE SIGNIFICANT BARRIERS TO
MENTAL HEALTH CARE. FOR EXAMPLE
, ONLY 9% OF MEXICAN IMMIGRANTS
WHO REQUIRE COUNSELING SERVICES
ARE ABLE TO RECEIVE CULTURALLY
IN LINGUISTICALLY APPROPRIATE
CARE. NATIONALLY NATIVE AMERICAN
COMMUNITIES ARE TWICE AS LIKELY
AS THE WHITE POPULATION TO
EXPERIENCE SERIOUS PSYCHOLOGICAL
DISTRESS. 11.6% VERSUS 5.6% AND
HAVE MORE DIFFICULTY THAN WHITE
CLIENTS. 10.6% VERSUS 6.8%
ACCESSING MENTAL HEALTHCARE LGBT
Q. PLUS INDIVIDUALS FACE SEVERE
MENTAL HEALTH DISPARITIES,
INCLUDING HIGHER RATES OF MENTAL
HEALTH DISORDERS, HIGHER RATES
OF SUBSTANCE ABUSE AND HIGHER
RATES OF SUICIDE. BEEN NON LGBT
CLUB NINE LGBTQ, PLUS
POPULATIONS AND UP TO 40% OF
CALIFORNIA'S UNHEARD HOUSED
YOUTH POPULATION IDENTIFIES AS
LGBTQ PLUS IN ORDER TO TRULY
ANCHOR IN EQUITY, THE LANGUAGE
OF THE LEGISLATION AND
SUBSEQUENT AMENDMENTS MUST
INCLUDE THE LANGUAGE OF EQUITY.
WE MUST EXPLICITLY STATE THAT
REDUCING RACIAL AND ETHNIC AND
LGBT TO LGBTQ PLUS MENTAL HEALTH
DISPARITIES IS A GOAL OBJECTIVE
AND EXPECTED OUTCOME OF THE
MODERNIZATION LEGISLATION. WE
MUST ENSURE THAT OUR STATE AND
LOCAL JURISDICTIONS ARE ACTUALLY
ACCOUNTABLE FOR REDUCING
DISPARITIES IN MENTAL HEALTH AND
IN SERVICES TO ALL CALIFORNIANS
EXPERIENCING HOMELESSNESS. OVER
THE PAST SIX YEARS, WE HAVE BEEN
IN DEEP PARTNERSHIP WITH THE 34
COMMUNITY BASED ORGANIZATIONS,
THE RACIAL, ETHNIC MENTAL HEALTH
DISPARITIES, COALITION AND OTHER
ALLIES FUNDED BY THE CALIFORNIA
REDUCING DISPARITIES PROJECT TO
IMPLEMENT COMMUNITY TO FIND
EVIDENCE BASED PRACTICES WITH
LASER FOCUS ON REDUCING
BEHAVIORAL HEALTH DISPARITIES
AMONG THE FIVE POPULATION GROUPS
. AFRICAN AMERICANS, LATIN X, ÁP
, NATIVE AMERICAN AND L G B T Q.
PLUS COMMUNITIES. THE C R D P
REPRESENTS CALIFORNIA'S GREATEST
INVESTMENT IN REDUCING RACIAL,
ETHNIC AND LGBTQ, PLUS MENTAL
HEALTH DISPARITIES. WE REPRESENT
A UNIQUE COALITION OF OVER 60,
LOCAL AND STATEWIDE BEHAVIORAL
HEALTH ORGANIZATIONS DEDICATED
TO ENSURING THAT ALL
CALIFORNIANS HAVE EQUITABLE
ACCESS TO BEHAVIORAL HEALTH
SOLUTIONS THAT WORK IN THE
HISTORICAL, CULTURAL AND
COMMUNITY CONTEXT. HOWEVER THE
SUSTAINABILITY AND SCALABILITY
OF THIS EFFORT RESTS WITH THE
STATE'S ONGOING COMMITMENT TO
ADDRESSING THE HISTORICAL AND
ONGOING RACIAL AND ETHNIC
DISPARITIES AND HOMOPHOBIA,
TRANSFORMING AND TRANSPHOBIA
FIRMLY RESTS WITH THE STATE'S
POLITICAL WILL TO EXPAND
INVESTMENTS IN SOLUTIONS THAT
WORK FOR OUR COMMUNITY. WE
STRONGLY BELIEVE THAT 5% CAP NOW
4% CAP ON POPULATION BASED
PREVENTION PROGRAMS. IS BOTH
INADEQUATE AND UNACCEPTABLE. THE
STATE SHOULD NOT ABDICATE ITS
LEADERSHIP ON THIS VITAL ISSUE
OF EQUITY. ALTHOUGH WE
APPRECIATE THE EFFORTS TO
ADDRESS THE SITUATION OF IN
HOUSE CALIFORNIANS AND THE
RECENT AMENDMENTS, WE REMAIN
DEEPLY CONCERNED ABOUT HE
PROVISIONS OF THE IMAGES THEY
TARGETED IN THIS PROPOSAL. THE
IMAGES SAY IS THE MOST
SIGNIFICANT AND CONSISTENT
FUNDING SOURCE OF BEHAVIORAL
HEALTH PREVENTION AND EARLY
INTERVENTION SERVICES IN
CALIFORNIA WITHOUT UPSTREAM
INVESTMENT IN PREVENTION
SERVICES, THE UNDERLYING CAUSES
OF COMPLEX SOCIAL PROBLEMS WILL
NOT BE EFFECTIVELY ADDRESSED,
INCLUDING HEALTH DISPARITIES AND
HOMELESSNESS, RESULTING IN MORE
CRISIS SITUATIONS. INTERVENTIONS
AND EVEN GREATER DISPARITIES.
RESEARCH PROVES THAT INVESTING
INVESTMENT UPSTREAM IN
PREVENTION CAN REDUCE THE ONSET
OF MENTAL ILLNESS, INCLUDING
SERIOUS MENTAL ILLNESS. A RECENT
GROUNDBREAKING STUDY
COMMISSIONED BY THE STATE ON THE
IMAGES S¼ FUNDED CALIFORNIA
REDUCING DISPARITIES PROJECT BY
THE PSYCHOLOGY APPLIED RESEARCH
CENTER OF LEOLA MARYMOUNT
UNIVERSITY SHOWS. THAT THE
EVALUATED PREVENTION PROGRAMS
YIELDED POSITIVE FINANCIAL
BENEFITS FOR THE STATE OF
CALIFORNIA AND ITS TAXPAYERS
BASED ON A COST BENEFIT ANALYSIS
FOR EVERY DOLLAR INVESTED, THERE
WAS ESTIMATED RETURN ON
INVESTMENT OF ABOUT $5, OFTEN
THE ONLY FUNDING FOR THESE TYPES
OF PREVENTION PROGRAMS COMES
FROM P E. I AND THE INNOVATION
COMPONENTS PROVIDED BY THE MHS
S¼. PLEASE CONSIDER THE
FOLLOWING POINTS IN YOUR
DELIBERATIONS. P E I SERVICES
CAN NAVIGATE CHILDREN, YOUTH
FAMILIES AND OLDER ADULTS OUT OF
THE MORE RESTRICTIVE SYSTEMS OF
CARE, RESULTING IN FAMILY
PRESERVATION IN MAJOR SAVINGS TO
THE PUBLIC. THE LOSS OF PE I
FUNDING THE LOSS OF FUNDING OR
DRAMATICALLY REDUCED FUNDING FOR
SERVICES FOR HISTORICALLY
UNDERSERVED UNSERVED AND
INAPPROPRIATELY SERVED BY PACK
AND L G B T Q. PLUS COMMUNITIES.
OTHER FUNDING LIKE THE C Y B H I
R ONE TIME INVESTMENTS IN
CALIFORNIA'S BEHAVIORAL HEALTH
LANDSCAPE SOLUTIONS THAT WORK
REQUIRED CONSISTENT, SUSTAINED
MULTI GENERATIONAL INVESTMENT TO
SCALE MEANINGFUL OUTCOMES FOR
ALL CALIFORNIANS OVER 80% OF
CALIFORNIA'S CHILDREN IN GRADES
K THROUGH 12 ARE CHILDREN OF
COLOR IN L G B TO LGBTQ PLUS
MAKING IT ABSOLUTELY ESSENTIAL
THAT BEHAVIORAL SOLUTIONS ARE
CULTURALLY RESPONSIVE.
SIGNIFICANT DATA CONFIRMS THAT
THE ONGOING AMPLIFICATION OF
BEHAVIORAL HEALTH DISPARITIES,
PARTICULARLY AMONG CHILDREN,
YOUTH AND OLDER ADULTS, BECAUSE
OF THE PANDEMIC, NOW IS NOT THE
TIME TO REDUCE LIFE AND
ANCHORING P I SERVICES THE NEW
AMENDMENTS ACTUALLY REDUCED THE
PROPOSED 5% FOR PREVENTION
PROGRAMS TO ONLY 4% GOING TO ASK
YOU TO WRAP UP. THANK YOU. WE
HEARD AGENCY STATE THAT EARLY
INTERVENTION WOULD SCALE
EVIDENCE BASED PRACTICES. EARLY
INTERVENTION MUST INCLUDE
COMMUNITY TO FIND EVIDENCE BASED
PRACTICES TO MOVE THE NEEDLE AND
REDUCE BEHAVIORAL HEALTH
DISPARITIES FOR OUR COMMUNITIES.
AND CURRENTLY THE GOVERNOR'S
PROPOSAL TO MODERNIZE THE
BEHAVIORAL SYSTEM DOES NOT
SPECIFICALLY STATE ANY
COMMITMENT TO REDUCE DISPARITIES
FOR BIPAC AND LGBTQ, PLUS
COMMUNITIES. WE REMAIN COMMITTED
TO LEVERAGING OUR SUPPORT AND
COLLABORATION TOWARDS REALIZING
THE PROMISE OF THE IMAGES SAY,
INCLUDING THE ELIMINATION OF
THESE DISPARITIES. THANK YOU.
THANK YOU VERY MUCH. OKAY NOW,
DR GALLEY, COULD YOU RESPOND TO
MISS BELL AND THE LACK OF THE
REDUCTION OF MONEY AND BEING
ABLE TO PULL DOWN MORE? IF YOU
WOULD, YOU'RE WELCOME TO COME
BACK UP. BECAUSE AGAIN HER HER
POINT WAS, WE'RE GOING TO PULL
BECAUSE OUR GOAL IS TO PULL DOWN
MORE, AND SHE'S SAYING WE'RE
GOING TO PULL DOWN LESS RIGHT?
SITTING RIGHT NOW? NO NOT
AWKWARDLY. UM SO I THINK A FEW
POINTS FIRST, UH, AS WE HAVE
INTRODUCED A NUMBER OF NEW
OPPORTUNITIES IN TERMS OF
SERVICES THAT ARE REIMBURSABLE
BY MEDICAID. THERE IS A BELIEF
IN YOU KNOW IF WE SPEND TIME IN
EACH COUNTY ABILITY TO DISCOVER
SOME SERVICES THAT WE FUND
ENTIRELY WITH TESSA DOLLARS THAN
MIGHT HAVE AN OPPORTUNITY TO
BRING DOWN NEW MEDICAID DOLLARS,
SO IN SOME WAYS, LEAVING SOME
FEDERAL FINANCIAL PARTICIPATION
DOLLARS ON THE TABLE. SECONDLY
WE KNOW THAT JUST OVER THE LAST
20 YEARS, THERE'S A NUMBER OF
NEW OPPORTUNITIES THAT MAYBE
HAVE HISTORICALLY BEEN THE
RESPONSIBILITY OF COUNTY
BEHAVIORAL HEALTH THAT 100% WE
HAVE TO WORK ON BRINGING HEALTH
PLANS ALONG BUT SHOULD BE THAT
RESPONSIBILITY TO BE PAID FOR
OUTSIDE OF THE SPECIALTY MENTAL
HEALTH SYSTEM. THE OTHER CONCEPT
HERE IS THAT THAT FLEXIBILITY
INTRODUCED IN TODAY'S AMENDMENTS
WE EXPECT ARE GOING TO ALLOW US
COUNTY BY COUNTY TO INTRODUCE
ADDITIONAL FUNDING FROM ONE BACK
TO ANOTHER TO MAKE SURE VITAL
SERVICES THAT A ARE IMPORTANT TO
THE COMMUNITIES AND BE DRAWDOWN,
ADDITIONAL DOLLARS. OUTPATIENT
SERVICES AS AN EXAMPLE, CAN BE
FULLY MET. SO THESE TOOLS ALL
COMING TOGETHER, WE BELIEVE ARE
ACTUALLY NOT GOING TO REDUCE
AVAILABLE FEDERAL DOLLARS BUT
AUGMENT THEM. THE LAST POINT I
THINK THIS IS A VERY CRITICAL
ONE. WE OFTEN TALK ABOUT IMAGE
HAS A FUNDING IS FUNDING
PROGRAM. HOW OUTSIDE OF WHAT WE
TALK ABOUT IS A OR B H S A
FUNDED PROGRAMS. THERE IS A
CLEAR RESPONSIBILITY. SPECIALTY
BEHAVIORAL HEALTH. AT THE LOCAL
LEVEL HAS TO DELIVER ENTITLEMENT
MEDICAID SERVICES. SO THOSE
SERVICES WHETHER THE FUNDING
COMES OUT OF SUPPORTED BY MHS A
FUNDING OR ARE REALIGNMENT,
DOLLARS OR OTHER FUNDING OUR
ENTITLEMENT SERVICES THAT WE
EXPECT, REGARDLESS OF HOW YOU
LOOK AT THE REFORMS OF TODAY ARE
DELIVERED THAT OBLIGATION. TO
CONTINUE TO DELIVER THOSE
FEDERALLY MATCHABLE SERVICES
EXISTS AND IS MAINTAINED AND
SHOULD ALLOW FOR THE SAME AMOUNT
, IF NOT ADDITIONAL DOLLARS TO
BE DRAWN DOWN, FEDERALLY OKAY?
MISS BELL. CAN I JUST ADD ON TO
THAT, UM, ABSOLUTELY AGREE THAT
THE LANDSCAPE IS CHANGING
RAPIDLY. THERE'S TONS OF
EXCITING INITIATIVES COMING TO
PLAY THAT WILL ENHANCE OUR
SYSTEM OF CARE AND SO MANY WAYS
THAT WE'RE EXCITED ABOUT AND I
THINK IT'S IMPORTANT TO REMEMBER
THAT, OF COURSE, WE'RE ALWAYS
GOING TO PARALYZE THE MANDATED
SERVICES, AND WE'VE COME TO RELY
ON IMAGES TO PROVIDE THE
SERVICES THAT ADD QUALITY TO OUR
SYSTEM. ADD CONNECTEDNESS TO OUR
COMMUNITY, SO LIKE THAT PEER
SUPPORT PROGRAM NOT MANDATED
PLAYS. A BIG ROLE ALLOWS US TO
HOSPITALS AS PEOPLE SUPPORT
PEOPLE IN A COMMUNITY SETTING
PROVIDE PEER SERVICES. WE CAN
PULL A LITTLE BIT OF MEDICAL BUT
NOT ENOUGH TO COVER THE COSTS.
OR IN OUR CRISIS SYSTEM. WE HAVE
A CRISIS STABILIZATION UNIT. IT
RUNS UP 500 TO $750,000 DEFICIT
A YEAR. AND IT'S BELOVED BY OUR
COMMUNITY. IT'S SIGNIFICANTLY
BETTER EXPERIENCE THAN SITTING
IN A CROWDED EDIE WITH STRESSED
LEADING NURSES TRYING TO FIGURE
OUT HOW TO MANAGE YOU, AND
THEY'RE SEVEN OTHER PATIENTS AND
THOSE ARE THE KINDS OF THINGS
THAT WE FEAR, LOSING AND
ABSOLUTELY UNDERSTAND. WE WANT
TO PROVIDE A COMPREHENSIVE
SERVICE. WE WANT TO PROVIDE A
QUALITY SERVICE AND HOW TO HOW
TO STRETCH THE DOLLARS TO MEET.
ALL THESE NEEDS IS THE REALITY
IS THAT ZERO SUM GAME APPROACH
OF TRYING TO DO MORE WITH
HONESTLY LESS BECAUSE WE'RE
PUTTING MORE TO THE STATE LEVEL?
AND HOW DO WE DO THAT
EFFECTIVELY? YEAH JUST DO THIS
BACK AND FORTH A LITTLE BIT
LONGER. AND THEN SENATOR WANT TO
MAKE SURE I DON'T TAKE ALL THE
TIME AWAY. A COUPLE OF RESPONSES
TO THAT AND WE ARE OBVIOUSLY
ONGOING CONVERSATIONS ABOUT HOW
TO, UH, NOT JUST ACHIEVE WHAT IS
PROPOSED IN THE B F L SERVICES
ACT, BUT IN NO WAY DIMINISH THE
ABILITY TO DELIVER, YOU KNOW.
CULTURALLY APPROPRIATELY,
COMMUNITY DRIVEN, COMMUNITY
BASED SERVICES THAT ARE BELOVED
BY THE COMMUNITY TODAY AND GIVE
OPPORTUNITY TO CREATE ADDITIONAL
NEW PROGRAMS THAT WE EXPECT WILL
BE BELOVED BY COMMUNITIES
TOMORROW, AND I WOULD SAY THAT
AS WE TURN EVERY CORNER AND LOOK
AT A SPECIFIC PROGRAM AND SEE
WHERE THERE MIGHT BE FEARED
DEFICITS THAT THROUGH SUPPORT,
TECHNICAL ASSISTANCE,
UNDERSTANDING WHAT OTHER
OPPORTUNITIES MIGHT BE AVAILABLE
THAT THESE PROGRAMS. NOT ONLY
COULD BE MAINTAINED, BUT
HOPEFULLY STRENGTHENED AND IN
SOME CASES, WE HOPE TO TAKE THE
BEST IDEAS FROM SMALL COUNTIES,
BIG COUNTIES WHICHEVER SIZE AND
HELP THEM BECOME AVAILABLE
STATEWIDE. SO YOU KNOW, I THINK
THIS THIS IS AH, I APPRECIATE
THE WORD FEAR. BEING USED
BECAUSE I THINK THEY'RE CHANGING
THE AGENCY HERE OFTEN, AND I
THINK CALIFORNIA HAS IMMUNIZED A
BIT AGAINST SOME OF THOSE FEARS
COMING TRUE BY PUTTING SO MANY
NEW OPPORTUNITIES ON THE TABLE
BUILDING THE KNOW HOW AND THE
CAPACITY TO DO. THOSE ARE
IMPORTANT NEXT STEPS. AND IT IS
GOING TO BE A LITTLE BIT COUNTY
BY COUNTY DETERMINING WHAT IS
FEARED TO BE LOST. AND HOW DO WE
MAKE SURE THAT GIVEN OUR FOCUS
ON PRIORITIES, GIVEN OUR FOCUS
ON YOU KNOW MANY OF THE THINGS
THIS PANEL HAS RAISED, WHICH ARE
STATE PRIORITIES. UH HOW DO WE
MAKE SURE THAT THESE DOLLARS
GETS STRETCHED AS FAR AS
POSSIBLE, INVITING OTHER
ENTITIES PLANS BOTH PUBLIC PLANS
IN PRIVATE PLANS TO PICK UP
THEIR WEIGHT IN MAKING SURE THAT
THESE SERVICES ARE FUNDED AND BH
CONNECT, WHICH I KNOW WE'RE JUST
GETTING MORE FAMILIAR WITH IS
OPENING EVEN MORE DOORS TO DO
THAT. THANK YOU AND AGAIN,
THAT'S PART OF THE GOAL THAT
WE'RE TRYING TO POST THINGS UP
SO WE CAN HAVE THAT MENU OF
HERE'S HOW YOU DO IT HERE. IS
THAT WHAT YOU PULL THE FUNDING
DOWN? AND HERE'S SOME MODELS,
BUT ALL YOUR POINTS ARE WELL
TAKEN. SENATOR AUSTIN AND
SENATOR MENJIVAR THANK YOU,
MADAM CHAIR. I HAVEN'T SEEN THE
AMENDMENTS. SO PERHAPS MY NEXT
COMMENT IS GOING TO BE OBI AND I
HOPE SO. BUT I HAVE LISTENED TO
THE COMMENTS OF THE BEHAVIORAL
HEALTH FOLKS ABOUT THE
VARIATIONS IN ANNUAL FUNDING
IMAGE S¼ FUNDING AND THEN THE
DEALING WITH THE CONSTRAINTS
THAT THE FIXED RATIOS AS THEY
REFER TO THEM. I CALL THEM
BUCKETS, BUT THE FIXED RATIOS UM
AND THE ISSUES THAT ARE CREATED
THERE. IT SEEMS TO ME AND I'LL
SAY IT ONCE AGAIN THAT IF WE SET
OUT STRONG, CLEAR OUTCOME.
EXPECTED OUTCOMES IN ADVANCE BY
CATEGORY WITH CONSEQUENCES. THAT
WE SHOULD BE ABLE TO ALLOW
COUNTIES TO INDIVIDUAL COUNTIES
TO FLEX THE RATIOS SOMEWHAT. OR
OR LESS. UM. TO DEAL WITH THE
FUNDING VARIATIONS AS WE AT THE
STATE LEVEL LEVEL OUT THAT
FUNDING AND WHATEVER WAY WE
FIGURE OUT TO DO SO, UM, TO MAKE
THE PROGRAM WORK WITHOUT HAVING
AND I'M NOT TALKING ABOUT THE
MANDATED PROGRAMS. I THINK THE
BEHAVIORAL FOLKS WERE TALKING
ABOUT THOSE THAT AREN'T WHETHER
IT'S IN HOUSING OR SOMETHING
ELSE. WE OUGHT TO BE ABLE TO
MAKE THIS WORK AND AGAIN, YOU
KNOW, THE ONLY CONCERN I HAVE
BEYOND THAT IS, YOU KNOW WE'RE
PUTTING SOMETHING IN PLAY
THROUGH A BALLOT INITIATIVE. I
THINK EVEN MAYOR STEINBERG PRO
TIM STEINBERG MENTIONED THAT THE
LANDSCAPE HAS CHANGED
DRAMATICALLY SINCE 2004 WHEN
THEY DID IT THE FIRST TIME SO AS
THE LANDSCAPE CHANGES ONCE AGAIN
AND WERE SUCCESSFUL IN ONE OR
MORE OF THESE BUCKETS, THESE
CATEGORIES THAT ARE STATE
PRIORITIES AND LOCAL PRIORITIES.
SITUATION IS GOING TO CHANGE
THAT. WE'RE GOING TO BE RIGHT
BACK HERE DOING ANOTHER BALLOT
INITIATIVE TO CHANGE THE IMAGE
SAY TO FIT THE SECOND HALF OF
THE 21ST CENTURY. AND I DON'T
KNOW WHAT THE ANSWER IS DR
GALLEY, BUT I WILL TELL YOU I
APPRECIATE THE FACT THAT YOU
HAVE DEVOTED SO MUCH TIME YOU
AND YOUR STAFF HAVE DEVOTED SO
MUCH TIME TO THIS. IT'S A VERY
IMPORTANT ISSUE, WHATEVER FORM
AND FINALLY TAKES, BECAUSE
WHATEVER FORM IT FINALLY TAKES
HIS PROBABLY UNDOUBTEDLY GOING
TO BE BETTER THAN WHAT WE HAVE
NOW. SO JUST IF I MAY RESPOND A
LITTLE BIT FIRST, I APPRECIATE
THE ACKNOWLEDGMENT OF MY EFFORT
IN THE TEAM'S EFFORT. I THINK I
JUST WANT TO REITERATE SO MANY
PEOPLE HAVE SPENT LOTS OF TIME
WRITING LETTERS READING LETTERS
HAVING CONVERSATIONS NOT JUST
FROM INDIVIDUALS AT THIS TABLE,
BUT FRANKLY, HUNDREDS MORE
PEOPLE WHO HAVE REALLY BEEN
THERE THROUGH A 20 YEAR JOURNEY
EVEN MORE THAN THAT, FOR SOME
AND HOPE TO BE HERE THE NEXT 20
YEARS AND DON'T WANT TO MAKE
SOME OF THE SAME CHALLENGING. I
DON'T WANT TO CALL THEM MISTAKES
, BUT CONSTRAINTS THAT WE FOUND
OURSELVES TODAY, SO NOT THE PRO
AT THE BALLOT INITIATIVES, BUT
CERTAINLY HOW DO WE CREATE SOME
FLEXIBILITY BY HONORING BUT YET
HONORING THE INTENT OF WHAT
THESE DOLLARS ARE MEANT TO DO,
WHICH IS ACTIVATES SO MANY OF
THE OUTCOMES AND PROGRAMS THAT
YOU'VE HEARD REPRESENTED HERE
AND EARLIER, SO THAT'S THE FIRST
THING OPEN TO THINKING ABOUT HOW
THAT LOOKS AND WHAT TALK WITH
ALLEGED COUNCIL ABOUT
FLEXIBILITY. LOOKS LIKE SECOND
THING IS, UH, THE VOLATILITY AT
THE COUNTY LEVEL OR AT THE STATE
LEVEL, I THINK IS SOMETHING THAT
ISN'T ADDRESSED IN THE
AMENDMENTS AND HAS BEEN RAISED
NOT JUST BY OUR COUNTY PARTNERS,
BUT THE LAO IN HIS WORTH FURTHER
CONSIDERATION. I DON'T HAVE MORE
TO SAY ABOUT THAT NOW. IT'S NOT
CAPTURED IN TODAY'S AMENDMENTS,
BUT I THINK IT'S AN IMPORTANT
ONE ON YOUR LAST POINT AND
WITHOUT BEING SORT OF THE BROKEN
RECORD. I DO THINK SOME OF THE
BUCKET BY BUCKET FLEXIBILITY
THAT IS BEING PROVIDED HELPS US
WITHOUT LOSING THE OVERALL
FRAMEWORK OUT WITHOUT LOSING
SOME OF THESE REALLY KEY
GUARDRAILS AROUND. WHAT ARE THE
MOST GERMAN CRITICAL ANCHORS OF
BEHAVIORAL HEALTH SERVICES,
ESPECIALLY FOR THOSE WITH THE
MOST SEVERE IMPACT SEVERE
CONDITIONS. I THINK THAT
FLEXIBILITY ALLOWS FOR SOME OF
THOSE SHIFTS AND JUST TO REVISIT
A QUESTION THAT TOBY EWING HAD
THE 7% OUT OF EACH BUCKET ISN'T
7% OF THAT BUCKET. IT'S 7% OF 30
OR 7% OF 35, SO IT'S A MORE
SUBSTANTIAL ABILITY TO SHIFT
THINGS AROUND TO ADDRESS SOME OF
THOSE UNIQUE EITHER TIMELY
ISSUES OR UNIQUE COUNTY ISSUES
THAT RISE UP THROUGH THE
PLANNING PROCESS. THANK YOU.
THANK YOU, SENATOR. MENJIVAR AH
, THANK YOU SO MUCH. I WANTED TO
ECHO. SOME OF THE CONCERNS ARE
ESPECIALLY AROUND THE CRISIS.
STABILIZATION LIKE COUNTY HAS
INVESTED A LOT OF THOSE
PROGRAMS. I'M PRETTY SURE A LOT
OF COUNTIES HAVE AND
UNDERSTANDING THAT IT'S NOT
PRESCRIPTIVE FOR IMAGES SAY, BUT
IT'S JUST THE CREATIVE WAYS THAT
WE'RE APPROACHING THIS IN THE
STREET TEAMS ARE SO BENEFICIAL
RIGHT NOW. SO JUST DIDN'T WANT.
I WANTED TO ECHO, YOU KNOW,
UTILIZING SOME OF THE FUNDS
BEING ABLE TO PULL THE FEDERAL
FUND DOLLARS TO SUPPLEMENT THESE
KIND OF PROGRAMS, BUT ONE OF THE
QUESTIONS I HAD WHAT I WANTED TO
ASK SOME GLAD YOU'RE BACK. HERE
IS A NEW I FORGOT WHO MENTIONED
IT. BUT L A OH, NOTED THAT WHEN
IT COMES TO THE HOUSING CATEGORY
THAT IT COULD POTENTIALLY MISS
OUR YOUTH. WHEN IT COMES TO
HOUSING OUR YOUTH, SO I WANTED
TO KNOW, SECRETARY IF YOU COULD
TOUCH ON THAT, HOW WE CAN TAKE
ADVANTAGE OF THIS SCENE AS LGBTQ
, PLUS INDIVIDUALS MAKE UP
DISPROPORTIONATELY THE AMOUNT
AND HOMELESS YOUTH AND SO FORTH
IF YOU COULD TOUCH ON THAT, YEAH
, I THINK THAT THE FIRST THING
TO SAY IS JUST A REAL
ACKNOWLEDGEMENT ABOUT SOME OF
THAT UNIQUE HOUSING TALLINN JIZZ
THAT COME, ESPECIALLY FOR YOUNG
PEOPLE WHO ARE LGBTQ YOUTH,
FORMER OR CURRENT SYSTEM
INVOLVED. YOUTH WHETHER THAT'S
PROBATION, CHILD WELFARE WIDELY
RECOGNIZED SOME OF THE UNIQUE
NOT JUST BEHAVIORAL HEALTH
CHALLENGES, BUT HOUSING
INSTABILITY, HOMELESSNESS
CHALLENGES THAT EXIST. SO REALLY
PUTTING FORWARD THAT THAT SHOULD
BE ACCOUNTED FOR IN THE DATA AND
THE PLANNING PROCESS AS THE
COUNTY BY COUNTY PRIORITIZATION
OF HOW THEIR TOTAL FUNDS OF
FUNDS ARE DEPLOYED TO EXECUTE ON
THE PLAN. THINK THERE IS PART
THERE IS OPPORTUNITY AND THAT
PLANNING PROCESS TO MAKE SURE
THAT THE COUNTY LEVEL THAT
POPULATIONS ARE PRIORITIZED. WE
BELIEVE THAT THAT IS A REALLY
IMPORTANT, UH CABLE TO SET SOME
OF THOSE PRIORITIES AS IS
NEEDED, SO WE HAVE TALKED ABOUT
THE NEED AROUND OLDER
CALIFORNIANS AND THE GROWING
NEED FOR OLDER CALIFORNIANS WITH
BEHAVIORAL HEALTH CONDITIONS
EXPERIENCING HOMELESSNESS.
SIMILARLY FOR YOUNGER
CALIFORNIANS TODAY, YOUTH THAT
MIGHT HAVE THE SAME NEEDS SO
CREATING THAT LATITUDE IN THE
PLANNING PROCESS AT THE COUNTY
LEVEL. WE BELIEVE IS GOING TO
ALLOW FOR THIS INTENTION TO
REALLY MANIFEST COUNTY BY
COUNTY. AND DR MY QUESTION TO
YOU. YOU WERE TALKING ABOUT THE
SCHOOL BASED SERVICES AND I
REMEMBER I EARLY ON. I ASKED
DIRECTOR THE DIRECTOR REGARDING
THE SCHOOL INVOLVEMENT AND
HEARING YOU, IT SEEMED THAT
THERE NEEDS TO BE MORE
INVOLVEMENT. I GUESS MY QUESTION
FOR YOU IS WE COULD EXPAND A
LITTLE BIT MORE ABOUT DOES IT
SOUND LIKE FROM YOUR PERSPECTIVE
THAT SCHOOLS AREN'T AT THE
TABLE? YES WE VERY MUCH
APPRECIATE THAT AMENDMENT WAS
MADE FROM OUR COALITION LETTER
WHERE WE REQUESTED UNDER SECTION
67 FOR THAT COORDINATION IN
TERMS OF THE INTEGRATED SERVICE
PLAN, BUT WE HAD ALSO
RECOMMENDED SEVERAL OTHER PARTS
OF THE GOVERNANCE STRUCTURE AND
INPUT STRUCTURE INTO THE REFORM
MEASURE. WHERE SCHOOLS WERE
MISSING, AND THE VOICE OF
CHILDREN AND YOUTH IN EDUCATION
WERE MISSING AND IN OUR
COALITION LETTER, THOSE ARE
NOTED AS PART OF SECTION 20
SECTION, 39 AND SECTION 41 B ANY
CHANCE YOU HAVE A SMALL CLIP OF
WHAT THOSE SECTIONS ARE SURE. SO
IN SECTION 20. THAT'S THE
COMPLIANCE ADVISORY COMMITTEE
SECTION 39 IS THE COMMISSION'S
ADVISORY COMMITTEE FOR SCHOOL
AND MADE HER ADMINISTRATOR AND A
MENTAL HEALTH PROFESSIONAL TO BE
REPRESENTED THERE AND TO BE
REPRESENTED ON THAT ADVISORY
BODY. AND BECAUSE IT'S SO
IMPORTANT THAT WE ADDRESS THE
PRIMARY PROVIDERS OF MENTAL
HEALTH SERVICES SECTION 41 B
WOULD REQUIRE COUNTIES TO
COLLABORATE WITH SCHOOLS IN THE
DEVELOPMENT OF THEIR EARLY
INTERVENTION, SERVICES AND
PROGRAMS. LISTEN TO LONG SO YOU
DON'T HAVE TO RENO THAT AND THEN
LASTLY, MY LAST COMMENT IS JUST
TO ECHO AGAIN. WHEN YOU
MENTIONED THE AGES, 0 TO 5. I
THINK THIS IS A GREAT
OPPORTUNITY TO TAKE ADVANTAGE OF
THIS AS WE'RE MODERNIZING. THIS
IS TO LOOK AT JUST REALLY THE
PREVENTION PREVENTION AND I KEEP
SAYING IT STARTS WITH THEIR LAST
WITH YOUR FIRST BREATH AND ENDS
WITH YOUR LAST BREATH ON HOW
EARLY WE CAN START INTERVENTION
. SO PERHAPS HOW WAS HOW ELSE
CAN WE TAKE ADVANTAGE OF THAT?
NO NEED TO ANSWER SECRETARY JUST
PUTTING OUT THERE? NO AND I
THINK, IN THE SPIRIT OF SOME OF
THE COMMENTS MADE WHAT? I
APPRECIATE THIS ACKNOWLEDGMENT
THAT WE HAVE MADE PROGRESS
ALREADY IN ADVANCE OF TODAY, AND
THERE'S OPPORTUNITIES TO
CONTINUE TO LET CONVERSATION SO
WERE CONTINUED TO BE COMMITTED
TO THAT APPROACH. AND JUST I
THINK ALSO JUST THE AS PEOPLE
SAY THE BLENDING AND THE
BRAIDING RIGHT BECAUSE WE DID
START THE NEW BIG PLATFORM
BACKBONE AND BEING ABLE TO
PROVIDE SERVICES DIRECTLY IN
SCHOOL, SO WE DON'T WANT TO MISS
SOME OF THOSE OTHER THINGS. WE
HAVE ALREADY CREATED. AND HOW DO
WE? HOW DO WE BRING THEM
TOGETHER? FIRST FIVE AND ALL OF
THIS, RIGHT? I MEAN, THERE'S A
LOT OF THINGS TO BE TALKED
ABOUT. SO WE WORST WE'RE STILL
HEARING AND LISTENING AND MAKING
THE PRODUCT BETTER. AND I THINK
THAT BUILDING AND THAT
FLEXIBILITY WILL BE INCREDIBLY
IMPORTANT IN THE INITIATIVE AS
WELL AS WORKING ON THE FUNDING
VOLATILITY, OKAY? SENATOR RUBIO
. THANK YOU, MADAM CHAIR AND I
THINK, UM, GREAT SENATOR FROM
SAN FERNANDO VALLEY. I BELIEVE
IT IS JUST AS STATED THE
EDUCATIONAL PIECE BECAUSE I
THINK I HEARD YOU SAY EARLIER.
IT WAS PART OF THE PROCESS AND
THEN I HEAR YOU AND I KNOW THAT
I THINK JUST THE WAY THAT WE
FUNCTION. WE HAVE THE AMENDMENTS
COME OUT LAST NIGHT, AND SO IT'S
REALLY HARD TO READ EVERYTHING
AND UNDERSTAND IT, AND THERE'S A
LOT OF MISSING PIECES, BUT I DO
WANTED TO HAVE MY VOICE TO THAT
PART OF THE CONVERSATION BECAUSE
I HEARD YOU SAY DR MARIANA RIGHT
, THAT THERE IS A LITTLE BIT
MORE THAT CAN BE DONE. AND I,
BUT I'M YOU KNOW, I WANT TO BE
GIVING CREDIT WORDS DO, UH, DR.
KELLY HAS HAD SEVERAL TIMES
THROUGHOUT THIS PRESENTATION IN
THE YOU WILL CONSIDER YOU KNOW,
AND THERE'S FURTHER
CONSIDERATION FOR THIS AND THAT
SO CLEARLY YOU'RE WILLING TO
LISTEN. BUT I DO WANT TO SEE
MORE COLLABORATION THAT RESPECT
AND YOU KNOW, IN MY HEART BREAKS
IN SO MANY WAYS, BECAUSE I THINK
I HEARD SOMEONE SAY RIGHT NOW
THAT YOU KNOW THERE'S PROGRAMS
ARE NOT NECESSARY, NECESSARILY
PART OF THIS CONVERSATION THERE
IN PLACE, AND WE'RE NOT GONNA
FUND IT. BUT THESE PROGRAMS, I
THINK YOU MENTIONED SOME OF THE
PROGRAMS THAT YOU PUT IN PLACE
THAT MAY SUFFER. AS A
CONSEQUENCE, AND YOU KNOW, BEING
A TEACHER. I REMEMBER JUST
CREATING PROGRAMS AND THEN
FUNDING WOULD GO AWAY AND WE
HAVE TO DO AWAY WITH IT. BUT
THEY WERE SO SIGNIFICANT EVEN
THOUGH THEY'RE NOT PART OF THE
CONVERSATION, PART OF WHAT'S
MANDATED, BUT IT'S THINGS THAT
WE CAME UP WITH THAT WORKED AND
UNFORTUNATELY HAD TO DO AWAY
WITH IT. AND SO IT'S JUST MAKING
SURE THAT WE JUST KEEP IT IN
MIND. NOT NECESSARY. WE COULD
TACKLE SPECIFICALLY BUT KEEPING
IN MIND THAT A LOT OF THE TIMES
EVEN AS IN A SCHOOL SETTING OR
ANY ORGANIZATION. YOU COME TO
RELY ON CERTAIN FUNDING TO
CREATE PROGRAMS AND THE
EXPECTATION IS THERE AND EVEN
THOUGH WE'RE RESHUFFLING, I
WOULD SAVE MONEY AROUND PROGRAMS
WILL SUFFER. SO JUST KEEPING IN
MIND THAT WE WANT TO KEEP SOME
OF THOSE PROGRAMS OUT WORK AND
CONTAINERS SUPPORT PEOPLE, BUT
IT IS JUST A COMMENTARY. BUT I
DO WANT TO TAKE INTO ACCOUNT. I
THINK WHAT ALBARADO MINA SAID.
BECAUSE YOU WERE, UM THERE'S A
LOT OF DATA AT THAT YOU OFFERED
AND IT WAS A YOU KNOW,
INCREDIBLY IMPACTFUL FOR ME TO
HEAR SOME OF THE STATISTICS AND
DATA THAT YOU STATED AND I DON'T
WANT TO DISMISS THAT. SO I DO
WANT TO GIVE DR KELLY THE
OPPORTUNITY TO JUST YOU KNOW,
YOU TALKED ABOUT SOME OF THE
LGBTQ BULLETS TALK A LITTLE BIT
MORE ABOUT THE STATISTICS AS SHE
DISCUSSED IN TERMS OF BUCKS BY
PARK COMMUNITIES AND JUST AROUND
, UM YOU KNOW, LATINOS AND SO ON
AND SO FORTH, SO I WON'T BELABOR
THE POINT. IT JUST, YOU KNOW,
GIVE US A LITTLE BIT MORE ON
THAT LENS AND HOW YOU KNOW THAT
PLAYS INTO THIS PROJECT. SO I'M
GOING TO CONFESS THAT I DIDN'T
HEAR ALL OF THE COMMENTS BECAUSE
I WASN'T IN THE ROOM THE ENTIRE
TIME, BUT I DO WANT TO SAY A
COUPLE OF THINGS IN MY OPENING.
I MENTIONED HOW WE BELIEVE THAT
OUR NORTH STAR IS A PERSON
CENTERED, WHOLE PERSON APPROACH
THAT EQUITY ANCHORED AND AH I
THINK ONE OF THE COMMENTS THAT
WE HAVEN'T HAD A CHANCE TO TALK
ABOUT TODAY IS, UH, THE LEVEL OF
INEQUITY AND FRANKLY, UH,
CHALLENGE AND DISPROPORTIONALITY
AMONG RACIAL GROUPS IN THOSE WHO
EXPERIENCE HOMELESSNESS WITH
SEVERE BEHAVIORAL HEALTH
CONDITIONS. AND I THINK THE AH
PROPOSAL TAKES THAT INTO ACCOUNT
IN A VERY SIGNIFICANT WAY TO
PROVIDE SOME RESOURCES THAT
TODAY ARE MISSING TO MAKE SURE
THAT WE CAN ERASE SOME OF THOSE,
YOU KNOW SO CLEAR AND OBVIOUS
DISPARITIES THAT ALSO SAID, UH I
APPRECIATE SOME OF THE FEEDBACK
AROUND HOW WE MAY NEED TO BE A
LITTLE BIT MORE LASER FOCUSED IN
SOME OF THE WORDS THAT WE USE
WITHIN THE LEGISLATION TO MAKE
SURE THAT WE ARE ALLOWING FOR
COMMUNITY BASED COMMUNITY
DIRECTED EQUITY ANCHORED
PRACTICES THAT HAVE EVIDENCE
BEHIND THEM. WE OFTEN SAY
EVIDENCE BASED PROGRAMS AND WE
RECOGNIZE THAT THERE IS A BROAD
SWATH OF WHAT MIGHT BE SUPPORTED
BY EVIDENCE. AND THEY LOOK A
LITTLE DIFFERENT AND MAKE SURE
THAT THOSE ARE ADDED TO THE LIST
OF THINGS THAT MIGHT CONSTITUTE
AN EARLY INTERVENTION PROGRAM
STATEWIDE. SO AGAIN, I THINK
OPPORTUNITIES TO MAKE SURE WE
DON'T MISS THE MARK MOVING
FORWARD. BUT THAT ASPECT OF
EQUITY THAT I DON'T KNOW THAT
WE'RE SPENDING ENOUGH TIME ON IS
THAT AROUND THOSE EXPERIENCING
HOMELESSNESS, NOT JUST CHRONIC
HOMELESSNESS, BUT OTHER OTHER
LESS MAYBE PERSISTENT FORMS OF
HOMELESSNESS IN OUR COMMUNITIES
WHO HAVE SOME OF THE MOST
CHALLENGING, NOT JUST MENTAL
HEALTH, SUBSTANCE USE DISORDERS
AS WELL, THAT JUST ONE OF THE I
THINK ONE OF THE REASONS THAT
WE'RE DOING THIS IS BECAUSE OF
THE VERY ISSUES YOU RAISED THAT
PEOPLE HAVE COLOR LGBT OR ARE
SUFFERING THE MOST. CLEARLY,
WHAT WE'RE DOING IS NOT RIGHT.
WE NEED TO REFOCUS AND FIGURE
OUT HOW TO DO IT. TO ADDRESS
THESE VERY ISSUES OF EQUITY, AND
I JUST WANT TO FINISH BY SAYING
AND CLEARLY WHAT WE'RE ALL
HEARING TODAY IS THAT IT'S NOT
QUITE A FINAL FORM. WE CONTINUE
TO HEAR AND LISTEN AND TAKE WHAT
EVERYONE SAID INTO CONSIDERATION
AND PERHAPS JUST KEEP AN OPEN
MIND AND YOU KNOW? HOW DO WE
CREATE THE BEST PRODUCT WHERE IT
SO WE'RE NOT HERE YEARS FROM NOW
TRYING TO RE FIGURE IT OUT
AGAIN, BUT WANT TO THANK ALL THE
PANELISTS BECAUSE THE
INFORMATION PROVIDED YOUR
INSIGHT THE WORK THAT DR
KILLINGTON AND OF COURSE, OUR
CHAIR IS REALLY MEANINGFUL. AND
I THINK THAT IF WE CONTINUE TO
JUST ALL COME TO THE TABLE, WE
REALLY CAN HAVE SOMETHING VERY
SPECTACULAR REGIONS HAVE TO HAVE
AN OPEN MIND. SO THANK YOU TO
ALL OF YOU THE PERCENTAGE. IT
WAS EYE OPENING. THANK YOU AND
DOCTOR KELLY. THANK YOU FOR YOUR
WORK. THANK YOU VERY MUCH. I'LL
PUT ON MY PROFESSOR HAT FOR A
MINUTE AND TELL PEOPLE THAT THE
FIRST DRAFT IS THE FIRST DRAFT
RIGHT? AND IT GETS BETTER WITH
EVERY ITERATION, AND I THINK
WE'VE CLEARLY SEEN THIS
THROUGHOUT THE PROCESS AND WILL
CONTINUE TO WE REALLY THANK YOU
FOR YOUR INPUT AND YOUR SERVICE
AND THE WORK YOU DO EVERY DAY ON
THE GROUND, NOT JUST COMING UP
TO TELL US ABOUT IT. BUT THE
WORK YOU DO EVERY SINGLE DAY YOU
ARE VALUED. YOU ARE WONDERFUL
PARTNERS, AND WE REALLY
APPRECIATE TEACHER PARTICIPATION
AND THIS IS THE END OF THE
CONVERSATION. RIGHT? WELL WE'LL
KEEP GOING. WE DON'T HAVE OUR
FIRST COMMITTEE HEARING UNTIL
NEXT WEEK. SO AGAIN. THIS WAS
INFORMATIONAL. WE'RE STILL IN
THE WORKS, BUT I WANT TO GIVE
THE SENATE A CHANCE TO HEAR INTO
WEIGH IN AND TO AND WILL BE
BETTER BY THE TIME WE GO TO NEXT
WEEK, OKAY? SO THANK YOU ALL
VERY, VERY MUCH. OKAY WE'RE
GOING TO TURN TO PUBLIC COMMENTS
NOW. UM AND SO WE'RE GOING TO
ALLOW A MINUTE EACH HERE IN
PERSON, AND THEN WE'LL GO TO OUR
PHONE LINES. OKAY GOOD AFTERNOON
, MADAM CHAIR AND MEMBERS
MICHELE CABALLERO WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA, AND WE WANT TO ALIGN
OURSELVES WITH THE COMMENTS OF
NEVADA COUNTY BEHAVIORAL
DIRECTOR PHOEBE BELL. COUNTY
BEHAVIORAL HEALTH DEPARTMENTS
HAVE BECOME EXPERTS AT BREEDING
FUNDING, DRAWING DOWN FEDERAL
MATCHING FUNDS THROUGH MEDICAL
AND EMBRACING CHANGE. WE REMAIN
CONCERNED WITH THE MAGNITUDE OF
THE CUTS THAT WOULD BE COMPELLED
THROUGH THE FUND SHIFTS AND WILL
NOT BE OF OFFSET THROUGH
TECHNICAL ASSISTANCE OR REVENUE
MAXIMIZATION OPPORTUNITY, SO WE
VERY MUCH APPRECIATE THE
OPPORTUNITY TO CONTINUE
DISCUSSIONS WITH THE AUTHOR AS
WELL AS THE ADMINISTRATION ON
POTENTIAL SOLUTIONS TO MITIGATE
THOSE IMPACTS. AND THANK YOU ALL
FOR THE ROBUST DISCUSSION TODAY.
THANK YOU VERY MUCH. GOOD
AFTERNOON, STACY HERA MOTO WITH
REMCO, THE RACIAL AND ETHNIC
MENTAL HEALTH DISPARITIES
COALITION. I DO WANT TO MENTION
THAT 20 YEARS AGO, RUSTY FELIX
ASKED ME TO WORK FOR HIM
SPECIFICALLY IN THE AREA OF
REDUCING DISPARITIES AND BECAUSE
HE IS A PRINCIPLE CO AUTHOR OF
THIS ACT, HE SAID ON MANY
OCCASIONS TO ME THAT IT WAS NOT
JUST FOR PEOPLE WITH SERIOUS
MINERALS. OF COURSE, THE IMAGES
SEE SERVES THEM MOST, BUT IT IS
ALSO, HE SAID. PE I, HE SAID, IS
FOR THE COMMUNITIES YOU
REPRESENT. NOW. HE DIDN'T USE
THE WORD SEE DEPTH OR COMMUNITY
DEFINED PRACTICES. BUT THAT'S
WHAT HE MEANT, BECAUSE THAT'S
WHAT THAT WAS SUPPOSED TO BE
USED FOR. TO REDUCE DISPARITIES
. HERE'S THE LETTER WITH OVER 60
OF THE LEADING ORGANIZATIONS
THAT SERVE RACIAL, ETHNIC AND
LGBTQ COMMUNITIES. WHAT WE ASKED
FOR WAS MORE THAN THE 5% FOR
PREVENTION. WE DIDN'T GET THAT
THE LATEST VERSIONS ACTUALLY CUT
IT. WE ASKED THAT PE I NOT BE
SEPARATED. YOU SEPARATED IT
STILL SO AS FAR AS WE'RE
CONCERNED, THE BILL YES, IT'S
GOTTEN BETTER IN SOME WAYS, BUT
NOT FOR US. THANK YOU. THANK YOU
VERY MUCH. GOOD AFTERNOON. MY
NAME IS SUSAN GALLAGHER. I'M THE
EXECUTIVE DIRECTOR OF CAL VOICES
. WE ARE REALLY, REALLY KIND OF
BEYOND SHOCKED TO SEE THAT NOT
ONE CLIENT BEHAVIORAL HEALTH
SERVICES WAS ON THIS PANEL TODAY
. NOT ONE PERSON WOULD LIVED
EXPERIENCE THE PRIMARY
STAKEHOLDERS IN THE ENTIRE
BEHAVIORAL SYSTEM HAS BEEN
CONSULTED TODAY, AND IT'S SORT
OF THE ENTIRE APPROACH THAT THAT
YOU GUYS HAVE TAKEN WITH THIS
LEGISLATION THAT THE
ADMINISTRATION HAS TAKEN. IT'S
SORT OF LIKE SQUEEZE OUT THE
PEOPLE MOST IMPACTED. THIS HAS
BEEN SO HARD TO UNDERSTAND. WE
HAVE SPENT HUNDREDS OF HOURS
WITH WHITE BOARDS AND FIGURING
OUT WHAT THIS LEGISLATION DOES
AND HOW IT IMPACTS OUR PEOPLE.
AND YET YOU DON'T HAVE MARINE
EVEN EXPLAIN IT TO OUR PEOPLE.
LITERALLY HUNDREDS OF THOUSANDS
OF PEOPLE ARE GOING TO BE
IMPACTED BY THIS. THE CSS BUCKET
IS NOT BIG ENOUGH. THE WAY
YOU'RE DOING IT. YOU CAN'T OPEN
IT UP TO SUBSTANCE ABUSE AND CUT
IT AS MUCH AS YOU ARE AND EXPECT
THERE NOT TO BE THE UNFUNDED
MANDATES AND PEOPLE NOT GETTING
SERVED. THAT IS GOING TO HAPPEN
. THAT IS A GIVEN. I DON'T KNOW
WHERE YOU GUYS ARE GOING TO SEND
THOSE PEOPLE. YEAH YOU HAVE AN
OBLIGATION YET THE COUNTIES HAVE
A MANDATE TO SERVE THEM. BUT
WITH WHAT NOW YOU'RE TAKING ALL
THE MONEY AWAY. I DON'T
UNDERSTAND IT. I REALLY DON'T.
NONE OF THIS MAKES SENSE TO ME.
IT SEEMS VERY ORWELLIAN. IT
SEEMS LIKE YOU'RE TELLING US YOU
CARE ABOUT EQUITY. BUT YET NONE
OF US ARE INVOLVED IN ANY OF IT.
SO HOW IS THAT EQUITABLE? WE
REPRESENT THOUSANDS OF MENTAL
HEALTH CLIENTS IN THE SYSTEM,
AND NONE OF THEM HAVE BEEN
BROUGHT TO THE TABLE. IT'S LIKE
YOU GUYS SEE US AS AN
AFTERTHOUGHT, AND THAT IS REALLY
DISGUSTING. IT TAKES A LOT OF
HUBRIS TO LOOK AT AN ENTIRE
COMMUNITY THAT WAY. THIS LACKS
COMPASSION AND LACKS DIGNITY.
AND IT DEHUMANIZES US BECAUSE
YOU DON'T THINK WE'RE CAPABLE OF
GIVING FEEDBACK. YOU DON'T THINK
WE'RE CAPABLE OF MAKING
DECISIONS FOR OURSELVES AND LET
ME TELL YOU WE ARE AND WE DO
RECOVER AND WE CAN RECOVER AND
WE'RE GOING TO BE HERE NEXT WEEK
WITH OUR T SHIRTS ON TO OPPOSE
THIS BILL. THANK YOU VERY MUCH.
THANK YOU. NEXT PERSON, PLEASE.
GOOD AFTERNOON TARGET BO EASTMAN
WITH THE STEINBERG INSTITUTE IN
SUPPORT FOR THE SAKE OF BREVITY.
I'LL JUST ALLOW MY COMMENTS WITH
THOSE OF MAYOR STEINBERG. THANK
YOU FOR YOUR LEADERSHIP. THANK
YOU TO THE LEADERSHIP OF THE
ADMINISTRATION AND LOOK FORWARD
TO ONGOING CONVERSATIONS. THANK
YOU. GOOD AFTERNOON, COURTNEY
ARMSTRONG WITH THE FIRST FIVE
ASSOCIATION. THANK YOU FOR YOUR
COMMENTS EARLIER. WE'RE HERE.
WE'RE HAPPY TO BE PART OF THIS
CONVERSATION. WE WANTED TO ALIGN
OURSELVES WITH THE COMMENTS OF
LOTION FRANCIS FROM CHILDREN.
NOW WE ARE VERY GRATEFUL FOR THE
INCLUSION OF THE 0 TO 26
POPULATION IN THE P E I FUNDING
. WE ALSO CONTINUE TO CALL FOR
US AT ASIDE FOR THE CHILDREN, 0
TO 5 RESEARCH SHOWS THAT
INFINITE EARLY CHILDHOOD MENTAL
PROGRAM MENTAL HEALTH PROGRAMS
MITIGATE LATER. HEALTH MENTAL
HEALTH CHALLENGES AND ARE TRULY
AN UPSTREAM PREVENTATIVE IN
NATURE. IF WE WANT DIFFERENT
MENTAL HEALTH OUTCOMES AMONG OUR
OLDER POPULATION, WE MUST INVEST
IN THEIR MENTAL HEALTH FROM THE
BEGINNING OF THEIR LIVES. WHEN
THE FOUNDATION OF BRAIN
DEVELOPMENT ARE SET. WE LOOK
FORWARD TO CONTINUING TO WORK
WITH THE LEGISLATURE AND THE
ADMINISTRATION TO ENSURE THAT
THE 0 TO 5 POPULATION IS ABLE TO
ACCESS THE CARE THAT THEY NEED.
THANK YOU. THANK YOU VERY MUCH.
GOOD AFTERNOON, LEAH BURROWS ON
BEHALF OF CALIFORNIA HOSPITAL
ASSOCIATION, REPRESENTS MORE
THAN 400 HOSPITALS AND HEALTH
SYSTEMS ACROSS CALIFORNIA, AND
WE'RE PLEASED TO SUPPORT THE
BEHAVIORAL HEALTH MODERNIZATION
AND EVERYTHING THAT'S HAPPENING
RIGHT NOW. ALL THE CONVERSATIONS
THAT HAVE BEEN HAD ROBUST
STAKEHOLDERS SUPPORT AND BASED
ON HOSPITALS EXPERIENCES. WE
JUST WANT TO MAKE IT VERY CLEAR
THAT IN TREATING YOUTH AND
ADULTS EVERY DAY IN CRISIS, WE
KNOW THAT REFORMS MUST FOCUS ON
THOSE WHO NEED IT THE MOST
BECAUSE OF THIS SUPPORTS
BEHAVIOR. HEALTH MODERNIZATION
AND RESPECTFULLY PROPOSES
CHANGES THAT WOULD ONE REQUIRE
COUNTIES AND THEIR STAKEHOLDERS
TO CONSIDER THE NEEDS OF THOSE
WHO HAVE BEEN PLACED ON
INVOLUNTARY HOLDS OR HAVE BECOME
BECOME CONSERVED AND TO CLARIFY
THE MHS. A FUNDS AREN'T
AVAILABLE SOURCE OF FUNDS THAT
COUNTIES MAY USE FOR ADULTS WHO
ARE RECEIVING SHORT TERM CRISIS
TREATMENT IN THE HOSPITAL'S WE
WANT TO THANK YOU ALL AGAIN FOR
YOUR HARD WORK AND DEDICATION ON
THIS VERY IMPORTANT AND TIMELY
ISSUE. THANK YOU. NEXT PERSON,
PLEASE. PERSECUTORS HERE ON
BEHALF OF THE CALIFORNIA ACADEMY
OF CHANNEL ANALYST PSYCHIATRY.
WE JUST WANT TO ALSO ECHO ARE
COMMENTS FROM CHILDREN NOW
REALLY APPRECIATE. YOU KNOW, WE
STILL NEED MORE TIME TO REVIEW
THE LANGUAGE BUT APPRECIATE THE
ADMINISTRATION'S WORK WITH
WORKING WITH THE CHILDREN,
GROUPS AND THE AMENDMENTS AND
HAPPY TO SEE THAT THERE IS A SET
ASIDE FOR PREVENTION, EARLY
INTERVENTION, HOWEVER, WE STILL
HAVE CONCERNS THAT THERE MAY BE
INCONSISTENCY WITHOUT THROUGHOUT
THE BILL. IN REGARDS TO THE
DEFINITION OF CHILDREN AND YOUTH
, ADDITIONALLY, WANT TO ENSURE
THAT THIS MEASURE SETS ASIDE FOR
UNACCOMPANIED YOUTH UNDER
HOMELESSNESS. WE LOOK FORWARD TO
CONTINUE WORKING WITH THE
ADMINISTRATION IN THE GROUPS AND
ALSO ON BEHALF OF THE BOARD OF
SUPERVISORS. CURRENT COUNTY WERE
EXPRESSING CONCERNS AS OUTLINED
IN THEIR LETTER ON AUGUST 14TH.
THANK YOU. THANK YOU VERY MUCH.
GOOD AFTERNOON CHAIR AND MEMBERS
NICKEL MILLION ON BEHALF OF THE
SILICON VALLEY LEADERSHIP GROUP.
LG IS PLEASED TO SUPPORT THEIR
REFORMS TO THE MENTAL HEALTH
SERVICES ACT CONTAINED IN SP 3
TO 6 IN THE BOND FUNDING
PROPOSAL. AND MAYBE 531 S FIELD
YOU WOULD LIKE TO THANK GOVERNOR
NEWSOM, SENATOR EGGMAN AND
ASSEMBLYMEMBER'S IRWIN FOR THEIR
LEADERSHIP IN THIS IMPORTANT
ISSUE. THANK YOU. THANK YOU.
GOOD AFTERNOON CHAIR EGGMAN AND
SENATORS. MY NAME IS TO
RECOMMEND SKI WITH THE
ASSOCIATION OF CALIFORNIA SCHOOL
ADMINISTRATORS. WE REPRESENT
OVER 17,000 SCHOOL
ADMINISTRATORS THROUGHOUT THE
STATE. THANK YOU, SENATOR EDMUND
FOR YOUR LEADERSHIP ON THIS
IMPORTANT ISSUE. WE HAVE BEEN
WORKING IN PARTNERSHIP WITH
CHILDREN NOW AND MANY OF THE
OTHER CHILD ADVOCACY GROUPS AND
SHARE THE APPRECIATION TO THE
ADMINISTRATION FOR MEETING WITH
US AND THE CONTINUING DIALOGUE
ON THE CONCERNS RAISED BY MY
COLLEAGUE, MS FRANCIS TODAY. I
ALSO WANT TO REINFORCE SOME OF
DR DURBAN'S COMMENTS ABOUT THE
IMPORTANCE OF TIER ONE SUPPORTS
ON SCHOOL CAMPUSES ARE
ADMINISTRATORS ARE OBSERVING
STUDENTS COMING TO SCHOOL WITH
ENHANCED NEEDS COMING ON THE
HEELS OF DISTANCE LEARNING, AND
A PERIOD OF REDUCE SOCIALIZATION
WITH PEERS ACCESS, OF COURSE,
STILL COMING THROUGH THE
AMENDMENTS, BUT WE REALLY DO
WANT TO ENSURE THAT THE CRITICAL
SERVICES SUCH AS WELLNESS
CENTERS ON SCHOOL CAMPUSES MIGHT
STILL BE FUNDED THROUGH THESE
FRIENDS AND REALLY WANT TO
APPRECIATE THE COMMENTS MADE BY
AS SENATOR RUBIO AND SENATOR
MENJIVAR THROUGHOUT THE HEARING.
THANK YOU. WE ALSO WANT TO
CAUTION AGAINST THE RELIANCE ON
C Y B H I ONE TIME FUNDINGS.
THANK THANK YOU. THANK YOU,
MADAM CHAIR MEMBERS, MR MORTON
HERE ON BEHALF OF THE CALIFORNIA
CHILDREN'S HOSPITAL ASSOCIATION
, WERE IN SUPPORT OF HIM ENDED
POSITION ON THE LAST VERSION,
STILL EVALUATING THE AMENDMENTS.
I WOULD ALSO ALIGN MYSELF WITH
THE COMMENTS OF MISS FRANCES
FROM CHILDREN. NOW OUR HOSPITALS
ARE GENERALLY SUPPORTIVE OF
DOING MORE TO ADDRESS ACUTE
MENTAL HEALTH AND SUBSTANCE USE
DISORDER ISSUES, BUT THIS HELP
SHOULD NOT COME AT THE EXPENSE
OF PREVENTION. EARLIER
INTERVENTION AND THE ENTIRE
CONTINUUM OF CARE FOR CHILDREN
AND YOUTH. OUR CHILDREN'S
HOSPITAL BEDS ARE INCREASINGLY
OVERRUN WITH CHILDREN IN CRISIS
, ONE HOSPITAL'S CASE THEY'VE
SEEN AN 1800% INCREASE IN
CHILDREN WITH MENTAL HEALTH
CRISES OVER THE LAST DECADE. BUT
THEY ALSO STRONGLY BELIEVE THAT
THIS DOWNSTREAM CRISIS NEEDS TO
BE ADDRESSED WITH INCREASED
INVESTMENT IN UPSTREAM SOLUTIONS
AND ENSURING THAT ROBUST
CONTINUUM OF CARERS IS SUPPORTED
FOR THESE REASONS. WE'RE REALLY
GRATEFUL FOR THE AMENDMENTS THAT
CAME OUT TODAY AND WE LOOK
FORWARD TO WORKING WITH YOU ON
THE FINAL APPROACH. THANK YOU
VERY MUCH. SIX PERSON. GOOD
AFTERNOON, THE OTHER KIM LEWIS,
REPRESENTING THE CALIFORNIA
COALITION FOR YEARS. I
APPRECIATE YOUR TIME TODAY AND
THE ATTENTION OF ASSOCIATE OUR
COMMENTS WITH LASHAWN FRANCIS
WITH CHILDREN NOW, BUT I DID
WANT TO ELEVATE TWO KEY PIECES
IN THIS. I THINK THE LEGISLATURE
AND THE ADMINISTRATION HAVE
PRIORITIZED SETTING ASIDE AND
DOLLARS FOR OUR YOUNG PEOPLE
EXPERIENCING HOMELESSNESS, AND I
THINK IT WOULD BE IMPERATIVE
THAT WE CONTINUE THAT. SET ASIDE
IT IS ENSURED THAT WE HAVE HAD
THE ATTENTION TO OUR YOUTH THAT
IS NEEDED AT THE LOCAL LEVEL,
AND THAT'S THE BEST WAY THAT WE
CAN GUARANTEE THAT TO HAPPEN AND
THE EVIDENCE BASED PRACTICES I
WOULD CAUTION AGAINST JUST
LIMITING IT TO THAT OUR
COMMUNITY FIND PRACTICES OR
SEVERELY IMPORTANT AND CRITICAL
FOR OUR YOUTH, ESPECIALLY THOSE
WHO ARE NOT IN FAMILIES AND DO
NOT HAVE THAT ROBUST SUPPORT
SYSTEM THAT'S AVAILABLE TO THEM.
SO I WANT TO MAKE SURE THAT
WE'RE NOT LIMITING THAT FOR THEM
AND THANK YOU FOR YOUR
ATTENTION, AND WE LOOK FORWARD
TO CONTINUING WORKING WITH YOU
AND PROVIDING SUGGESTIONS. THANK
YOU. GOOD AFTERNOON, MADAM CHAIR
AND MEMBERS TAIWAN OR INDIA ON
BEHALF OF THE CALIFORNIA MY
ANSWER, CHILD AND FAMILY
SERVICES REPRESENTING CHILDREN'S
SERVICE PROVIDERS WOULD LIKE TO
THANK YOU AND THE ADMINISTRATION
TODAY FOR THE NEW AMENDMENTS IN
PRINT, PRESERVING THE
REQUIREMENT THAT A MAJORITY OF
THE SPENDING AND BE SPENT ON
CHILDREN IN NEW SERVICES WITHIN
THE POPULATION BASED PREVENTION
AND EARLY INTERVENTION BRACKETS
AND THEN ALSO THE ALIGNMENT OF
THE ELIGIBILITY FOR SERVICES
WITH THE COW AM DEFINITION.
ADDITIONALLY WE WOULD LIKE TO
HIGHLIGHT THAT THE PROPOSED
HOUSING COMPONENT NEEDS TO BE
FLEXIBLE ENOUGH TO MEET THE
NEEDS OF TRANSITION AGE. YOUTH,
HOMELESSNESS, TRANSITION, AGE,
YOUTH HOMELESSNESS, BUT IT NEEDS
TO LOOK VERY DIFFERENT THAN
ADULTS, AND ADDITIONALLY, THERE
ARE MANY INDIVIDUAL LEVEL
SERVICE PREVENTION SERVICES
CURRENTLY DELIVERED UNDER THE
COMPONENT THAT WE REQUEST THAT
THE LIST UNDER EARLY
INTERVENTION. YOU KNOW SERVICES
BE BROAD ENOUGH TO ENCOMPASS THE
RANGE OF LIFE SAVING SERVICES
DELIVERED TODAY. THANK YOU.
THANK YOU VERY MUCH NEXT PERSON,
PLEASE. GOOD AFTERNOON SHARING
COMMITTEE MEMBERS. MY NAME IS
DANNY DEREK ON BEHALF OF MENTAL
HEALTH AMERICA IN THE CALIFORNIA
YOUTH EMPOWERMENT NETWORK. I
WOULD LIKE TO THANK THE AUTHOR
AND ADMINISTRATION FOR LISTENING
TO THE CONCERNS AND ADVOCATES
AND MAKING SOME CONFORMING
CHANGES. UM HOWEVER, I WANT TO
FIRST I GOT THE CONCERNS THAT WE
HAVE HEARD FROM FELLOW PEERS AND
FAMILY MEMBERS. WE STAND IN
OPPOSITION OF SP 3 26. THE
AMENDMENTS PROPOSED TAKE A FIRST
STEP TO INCLUDING TAE AND PURE
VOICES IN THE DECISION MAKING
PROCESS. AND WE APPRECIATE THIS,
HOWEVER, REPRESENTATION IS JUST
ONE FACTOR THAT CONTRIBUTES TO
THE DELIVERY OF SUPPORT AND
SERVICES THAT DEPEND ON THE
FUNDING FROM THE MATRIX. A
DIRECT PREVENTION SERVICES, NOT
POPULATION BASED, AND NOT EARLY
INTERVENTION ARE VITAL, UPSTREAM
SERVICES THAT SHOULD BE INCLUDED
IN THE NEW VERSION OF THE BILL.
EARLY INTERVENTION SERVICES WILL
STILL BE DECREASED FROM WHAT
THEY ARE TODAY THAT DECREASES
MORE THAN UM, THERE'S MORE NOW
THAT 10% OF THE BHS SAY FRIENDS
WILL BE TAKEN OFF THE TOP,
RESULTING IN A 5% DECREASE THE
FUNDS DISTRIBUTED TO THE
COUNTIES. THIS COMBINED WITH THE
30% OF FUNDS DIVERTED FOR
HOUSING WILL RESULT IN DECREASED
COMMUNITY BASED SERVICES.
SPECIFICALLY THE SERVICES. THANK
YOU IN THE BHS BUCKET. THANK YOU
FOR ALLOWING ME TO TESTIFY TO
THANK YOU VERY MUCH NEXT PERSON,
PLEASE. BEGIN ONE MINUTE. GOOD
AFTERNOON CHAIR AND MEMBERS
ANDREA RIVERA ON BEHALF OF THE
CALIFORNIA PEN ETHNIC HEALTH
NETWORK. PENN HAS BEEN OPEN TO
DISCUSSIONS ON THIS PROPOSAL
SINCE THE VERY BEGINNING, AND WE
LOOK FORWARD TO HAVING CONTINUED
CONVERSATIONS WITH THE AUTHOR
ADMINISTRATION AND THE
LEGISLATURE. OUR SUGGESTIONS ARE
PURELY TO ENSURE THAT WE ARE
REDUCING THE NEGATIVE IMPACTS
FOR COMMUNITIES OF COLOR AND
THAT THEY ARE NOT LEFT BEHIND.
HOWEVER WE ARE HERE TODAY IN A
POSE UNLESS AMENDED POSITION.
I'D LIKE TO ALIGN MY COMMENTS
WITH SAFE PASSAGES AND REITERATE
THAT COMMUNITIES OF COLOR ARE
CONTINUED TO BE LEFT BEHIND IN A
MENTAL HEALTH CARE SYSTEM THAT
HAS NOT BEEN ADAPTED TO FIT
THEIR UNIQUE NEEDS AND DOES NOT
PRIORITIZE. DIVERSITY MIGHT JUST
SAY IS ONLY ONE SLICE OF THE
DELIVERY SYSTEM AND 33 26
APPROACH OF ONLY LOOKING AT MHS
A AND NOT THE BROADER CONTINUUM
OF CARE RISKS LEAVING GAPS.
RECENT AMENDMENTS MAKE IT
OPTIONAL FOR COUNTIES TO PROVIDE
SERVICES FOR INDIVIDUALS WHO ARE
EXPERIENCING SUBSTANCE USE
TREATMENTS. THANK YOU. THANK
YOU. THANK YOU. GOOD AFTERNOON,
PAUL SIMMONS WITH THE DEPRESSION
AND BIPOLAR SUPPORT ALLIANCE OF
CALIFORNIA. WHAT I'VE HEARD.
TODAY IS A LOT OF REALLY GOOD
QUESTIONS AND A LOT OF NON
ANSWERS. UM, GENERALLY WHEN THE
QUESTIONS ARE BEING ASKED AH!
WHAT WE'RE HEARING IS OH, WE'RE
GOING TO CONTINUE CONVERSATIONS
. WE'RE GOING TO KEEP WORKING ON
THIS. SO WE'RE GOING TO TRY TO
ACCOMMODATE THIS. OH THE
COUNTIES WILL FIGURE IT OUT. BUT
WHAT I'M LOOKING AT IS AT THE
BOTTOM LINE OF THIS. WHAT WE'RE
DOING IS TAKING $700 MILLION
AWAY FROM TREATMENT. AND THAT'S
NO MATTER HOW YOU SLICE IT,
THAT'S REALLY THE BOTTOM LINE OF
WHAT WE'RE DOING HERE OF WHAT
THIS BILL WOULD DO. IT IS. IT'S
ORWELLIAN TO TALK ABOUT THIS
BEING A MODERNIZATION ACT. IT'S
NOT MODERNIZING ANYTHING. IT MAY
BE. IT MAY BE ACCOMMODATING THE
CHANGES IN THE POLITICAL
ENVIRONMENT, BUT NOT IN THE
MENTAL HEALTH ENVIRONMENT. UM
FELIX WAS REFERENCED TODAY AND I
THINK YOU'D BE TURNING OVER IN
HIS GRAVE. HIS WORK EVISCERATED.
THANK YOU. HELLO SARAH CAT ON
BEHALF OF THE RURAL COUNTY
REPRESENTATIVES OF CALIFORNIA.
WE APPRECIATE THE COUNTY
FLEXIBILITY AND EXEMPTIONS
INCLUDED IN THE AMENDMENTS. BUT
WE ARE CONCERNED WITH THE
MECHANISM AND THAT ADDITIONAL
WORK WILL BE NEEDED TO
STREAMLINE IT TO ENSURE COUNTIES
CAN ACTUALLY ACCESS THESE
EXEMPTIONS AND IT'S NOT OVERLY
BURDENSOME, WERE ALSO CONCERNED
THAT THE REPORTING PROVISIONS
WILL BE INCREDIBLY CHALLENGING
TO ACHIEVE EVEN FOR THE SMALL
COUNTIES WITHOUT EXTRA BUMP IN
FUNDING. ADDITIONAL WORK WILL BE
NEEDED TO CREATE MANAGEABLE
REPORTING REQUIREMENTS THAT MEET
THE GOALS OF THE PROPOSAL AND
AWAY FROM THE HCS. TO STREAMLINE
OR CREATE ALTERNATIVE REPORTING
FOR SMALL COUNTIES THAT
RECOGNIZE STAFFING RESOURCE
CHALLENGES IN A VASTLY DIFFERENT
CAPACITY IN THOSE COUNTIES. AND
FINALLY, WHILE WE APPRECIATE THE
AMENDMENTS THAT WOULD RETURN,
WITHHOLDING A PENALTIES TO THE
COUNTY OF ORIGIN WERE STILL
REALLY CONCERNED THAT THE
SANCTION PROCESS IS NOT
GRADUATED AND LACKS IN A PILL
MECHANISM TO ENSURE DUE PROCESS.
THANK YOU. THANK YOU VERY MUCH.
THANK YOU, MADAM CHAIR MEMBERS,
JEAN, HER SPEAKING TODAY ON
BEHALF OF THE URBAN COUNTIES OF
CALIFORNIA, WE WANT TO THANK YOU
AND THE ADMINISTRATION FOR THE
WORK ON THE AMENDMENTS THAT WENT
INTO PRINT. TODAY WE ARE LIKE
EVERYONE ELSE STILL ANALYZING
THEM AND ACKNOWLEDGE THAT
IMPROVEMENTS HAVE BEEN MADE IN
THE LANGUAGE. WE DO WANT TO
HIGHLIGHT THE FOLLOWING
REMAINING CONCERNS. WE DO SHARE
THE LOWS, CONCERN THAT THE
PROPOSAL WILL RESULT IN COUNTY
SPENDING LESS ON OUTPATIENT
SERVICES IN CRISIS SERVICES.
IT'S NOT CLEAR WHETHER THE
ADDITIONAL FLEXIBILITY IN THE
AMENDMENTS WILL ADDRESS THIS
PROBLEM. UM, SUFFICIENTLY NEXT.
WE SHARE THE CONCERNS WITH
REVENUE VOLATILITY IN THE
RESERVE CAMPS WANT TO NOTE THAT
THE MOST RECENT AMENDMENTS
REDUCE THE RESERVED CAPS EVEN
FURTHER THAN THE ORIGINAL
PROPOSAL. REVENUE VOLATILITY
ALSO CREATES ISSUES FOR COUNTIES
IN AN ENVIRONMENT WHERE WE ARE
PENALIZED FOR NOT HITTING STRICT
CATEGORICAL SPENDING
REQUIREMENTS. MORE WORK NEEDS TO
BE DONE TO THINK ABOUT HOW TO
SMOOTH REVENUE VOLATILITY AND
NOT SET UP A CONTINUOUS CYCLE OF
SANCTIONS AND PENALTIES ON
COUNTIES. FINALLY WE WOULD LIKE
TO SEE ADDITIONAL CHANGES TO THE
SANCTIONS COMPONENT TO INCLUDE
DUE PROCESS SUCH AS GRADUATED
PENALTY. THANK YOU THE
OPPORTUNITY TO APPEAL. THANK
YOU. THANK YOU VERY MUCH NEXT
PERSON, PLEASE. GOOD AFTERNOON.
JOHN DRIVING WITH THE CALIFORNIA
COUNCIL OF COMMUNITY, BEHAVIORAL
HEALTH AGENCIES ONLINE. MY
COMMENTS WITH OUR CEO DR LEANDRA
CLARK. HARVEY JUST WANTED OUT A
BRIEF THANKS TO SENATOR EDMOND
FOR TODAY'S AMENDMENTS. WE LOOK
FORWARD TO WORKING WITH THE
LEGISLATURE AND THE
ADMINISTRATION TO CONTINUE TO
REFINE THE PROPOSAL. THANK YOU.
THANK YOU. AFTERNOON SHARON
MEMBER ZABIHULLAH THIS ENTITY ON
BEHALF OF CAM, PRO CALIFORNIA
ASSOCIATION OF MENTAL HEALTH,
PARENT ORGANIZATIONS, CAMERAS
FOUNDERS, SALLY ZINMAN WAS ONE
OF THE FIERCE ADVOCATES WHO
PERSISTENTLY ORGANIZED, RALLIED
AND FOUGHT FOR THE PASSAGE OF
THE MHS S¼. AND WE OPPOSE 33 26
. THIS BILL HAS BEEN MOVING
INCREDIBLY FAST FOR THE AMOUNT
OF THE CHANGES THAT HAVE BEEN
PROPOSED. IT WAS DRAFTED FOR
SUBMISSION TO VOTE IN MARCH AT
THE PROPOSED CHANGES WERE NOT
INCLUDED IN THE BILL UNTIL JUNE,
19TH PROVIDING INSUFFICIENT TIME
FOR STAKEHOLDERS TO PROVIDE
MEANINGFUL INPUT AND AN ALREADY
OVERBURDENED PUBLIC SYSTEM. THE
SEVERE REDUCTION TO PREVENTION
AND EARLY INTERVENTION SERVICES
IN ADDITION TO THE ELIMINATION
OF INNOVATIVE COMMUNITY BASED
PROGRAMS WILL ALIENATE MENTAL
HEALTH CARE CONSUMERS BY PARK
COMMUNITIES. LGBT Q. I A PLUS
COMMUNITIES WHILE RETURNING
LARGELY TO THE SAME MEDICAL
MODEL OF COUNTY SERVICES WITHIN
FULL SERVICE PARTNERSHIPS. OVER
THE LAST FEW MONTHS AND YEARS
THE MENTAL HEALTH COMMUNITY HAS
BEEN WITH CONTINUED. THANK YOU.
THANK YOU. THANK YOU, MADAM
CHAIR AND MEMBERS DOUG SUPERS ON
BEHALF OF THE CALIFORNIA
PROFESSIONAL FIREFIGHTERS. WE
HAVE THE HONOR OF REPRESENTING
NEARLY 35,000, PROFESSIONAL
FIREFIGHTERS AND EMS PERSONNEL
STATEWIDE. WE'RE PLEASED TO BE
HERE AND SUPPORT OF SB 3 26. WE
APPLAUD THE CHAIR
ASSEMBLYMEMBER'S IRWIN AND THE
GOVERNOR ON THEIR WORK TO
MODERNIZE THE BEHAVIORAL HEALTH
SYSTEM. OUR MEMBERS ARE IN THE
FIELD EVERY DAY, SEEING
INDIVIDUALS THAT ARE
EXPERIENCING BEHAVIORAL HEALTH
CRISIS AND MENTAL HEALTH
CHALLENGES AND ALL TOO OFTEN OUR
MEMBERS PROVIDE. AH CARE AND
COMFORT AND TAKE A PATIENT TO
ANOTHER SITE TO HOPEFULLY GET
DEFINITIVE CARE. BUT ALL TOO
OFTEN THAT SYSTEM IS FAILING
THEM AND THEY ARE BACK IN IN THE
COMMUNITY. EXPERIENCING THOSE
ONGOING CHALLENGES. CPF HAS BEEN
BEFORE THIS COMMITTEE WORKING ON
EFFORTS AROUND COMMUNITY PARA
MEDICINE TO CORRECT THAT CONNECT
THE RIGHT THE PATIENT WITH THE
RIGHT CARE AT THE RIGHT TIME. WE
NEED TO ENSURE THAT THE ENTIRE
SYSTEM IS ROBUST SO THAT INITIAL
CARE TURNS INTO ONGOING CARE AND
GETS FOLKS THE CARE THEY NEED.
THE LAST TWO POINTS. WE
APPRECIATE THE FOCUS AND EFFORT
ON WORKFORCE DEVELOPMENT AND PRE
APPRENTICESHIP AND
APPRENTICESHIP PROGRAMS. WE
THINK THAT'S GOING TO BE REALLY
HELPFUL AND STRONG. AND FINALLY
WE DO APPRECIATE THE WORK ON
OVERSIGHT AND REPORTING BECAUSE
WE THINK THANK YOU. THANK YOU.
GOOD AFTERNOON CHAIR AND
COMMITTEE MEMBERS. MY NAME IS
CAROL SCHWARTLANDER. I'M THE
EXECUTIVE DIRECTOR OF THE
CALIFORNIA COMMISSION ON AGING.
THE COMMISSION SERVES AS THE
PRINCIPAL ADVOCATE FOR OLDER
CALIFORNIANS, ADVISES THE
GOVERNOR AND LEGISLATURE,
FEDERAL, STATE AND LOCAL
AGENCIES ON PROGRAMS IMPACTING
ORDER ADULTS. WE APPLAUD THE
GOVERNOR AND LEGISLATURES
ATTEMPT TO IMPROVE THE
BEHAVIORAL HEALTH SYSTEM OF CARE
AND IMPROVE RESIDENTIAL SETTINGS
OPTIONS. UM AND WHILE
HOMELESSNESS, FOR EXAMPLE, IS
EXPERIENCED AMONG ALL AGE GROUPS
, IT'S IMPORTANT TO HIGHLIGHT
THAT THE AGE GROUP THAT'S THE
FASTEST GROWING POPULATION OF
EXPOSE EXPERIENCING HOMELESSNESS
FOR THE FIRST TIME. FIRST TIME
IS AGING FOLKS AGE 50 OLDER AND
INDIVIDUALS, AGE 65 AND OLDER
HAD THE HIGHEST RATES OF
SUICIDE. IN THE NATION. UM SO WE
WOULD REALLY LIKE TO ENCOURAGE
THE COMMITTEE TO CONSIDER THE
NEEDS OF OLDER ADULTS AS A
UNIQUE SEGMENT OF THE
CALIFORNIA'S POPULATION, FOR
EXAMPLE, WE APPRECIATE THE
AMENDMENTS THAT ADDED A
REPRESENTATIVE, SOMEONE
REPRESENTING AGING AND
DISABILITY ORGANIZATIONS TO THE
OVERSIGHT COMMISSION. HOWEVER WE
WOULD RECOMMEND THAT YOU HAD TWO
DISTINCT SEE, IT'S ONE FOR AGING
AND ONE FOR INDIVIDUALS WITH
DISABILITIES BECAUSE THE
BEHAVIORAL HEALTH NEEDS DIFFER
AMONG THOSE POPULATIONS. THANK
YOU VERY MUCH. JOHN LEE. BEFORE
PROP 13. I WAS A COUNTY MENTAL
HEALTH ADMINISTRATOR AND WITH
THE SHORT DRILL OPERATIONS
SUBCOMMITTEE CHAIR FOR THE
CALIFORNIA COUNCIL OF MENTAL
HEALTH DIRECTORS, THE ONLY
PERSON THAT SPOKE THE TRUTH
WITHIN ABOUT A DIRECTOR, AND
WHEN SHE PUT HER BUDGET UP THERE
, YOU SAW THE LOSS YOU SAW THAT
CUTS. DR GALLEY IS TALKING MAGIC
. HE CAN PUT MONEY IN THREE
CATEGORIES AT THE SAME TIME.
IT'S NOT WHAT HE'S DOING. IT'S
NOT WHAT TRANSLATES INTO REAL
PEOPLE AT THE BOTTOM. WE DON'T
HAVE ENOUGH PEOPLE IN THE
WORKFORCE CARE COURT IS GOING TO
TAKE AWAY PEOPLE FROM MENTAL
HEALTH NOW PLASTER COUNTIES
LICENSE THEY CAN LICENSE PEOPLE
HAVE 30% VACANCY RATES. THE
COUNTY MENTAL HEALTH PROGRAM
CANNOT AFFORD TO DO THE CHANGES
THAT YOU'RE PROPOSING WITH 3 26.
YOU NEED TO PROGRAM EVALUATION.
YOU DON'T THANK YOU. HELLO MY
NAME IS CHRISTOPHER BUT NOW
REPRESENTING THE 17 PRICE, SIR
FROM STOCKTON, CALIFORNIA THE
VERY IMPORTANT, VERY NONPROFIT.
THE HONORABLE SUSAN EGGMAN IS
THE SIT IN BRINGING INTO
FRUITION. HOUSING CAMPAÑA AT THE
CEMETERY BRIGHT CENTER. WE
CURRENTLY ARE FUNDED MAINLY ON C
RDP FROM THE CALIFORNIA REDUCING
DISPARITIES PROGRAM THAT WAS
TALKED ABOUT BY JOSEPHINA FROM
STATE PASSENGERS, ALONG WITH
STACY. TODAY I COME BEFORE YOU
TO ADDRESS THE MATTER OF UTMOST
IMPORTANCE OF PREVENTION AND
EARLY INTERVENTION FOR MENTAL
HEALTH OF THE LGBTQ COMMUNITY.
THE STRUGGLES THEY FACE ARE
OFTEN BORN FROM DISCRIMINATION,
PREJUDICE AND MISUNDERSTANDING
AND HAVE LONG LASTING EFFECTS ON
THEIR WELL BEING. I WANT TO
REITERATE THE CONCERN AROUND
FUNDING STREAMS FALLING FROM
FALLING AWAY FROM BETTER THAN
EARLY PREVENTATIVE AND EARLY
INTERVENTION, WILLING FUNDING
AWAY WILL LET THE COMMUNITY
RESOURCES WERE ABLE TO PROVIDE
AT THE SALMON KEEP RIGHT CENTER
PROVIDING FROM CLINICAL CLINICAL
SERVICES LGBT COMMUNITY TRANS
CARRY, INCLUDING RESOURCES AND
LEGAL NAME, CHANGES THE CLOCK AS
WELL AS CREATING OVERALL
COMMUNITY FOR THE YANKEE PRIDE
CENTER. THANK YOU VERY MUCH.
OKAY SEEING NOBODY ELSE
APPROACHING THE MIC AT THIS TIME
WHERE TO GO TO THE PHONE LINES
WERE JUST GOING TO TAKE 15
MINUTES OF PHONE COMMENTS. 15
MINUTES, WE'RE GOING TO SHUT IT
DOWN, MODERATOR AND AGAIN,
PEOPLE ARE STILL WELCOME TOO
BRIGHT TO CALL. THIS IS STILL A
PROCESS SO YOU STILL HAVE TIME
TO OFFER FEEDBACK. MODERATOR,
ARE YOU THERE? YES THANK YOU FOR
PUBLIC COMMENT. YOU MAY PRESS
ONE, THEN ZERO. THANK YOU
CALLERS. ONE MINUTE. 58 YOUR
LINE IS OPEN. GOOD AFTERNOON,
TURNING TOO MANY MEMBERS MY NAME
AND I WORK WITH CENTRAL VALLEY
IMMIGRANT INTEGRATION
COLLABORATIVE IN THE CENTRAL
VALLEY. I'M CALLING TO EXPRESS
MY OPPOSED UNLESS AMENDED
POSITION ON SP 3 26 COMMUNITIES
OF COLOR CONTINUE TO HAVE THE
HIGHEST UNMET MENTAL HEALTH
NEEDS IN CALIFORNIA, DESPITE
COUNTY AND COMMUNITY EFFORTS TO
ADDRESS THAT THIRTIES REMAINS
STUBBORNLY EMBEDDED AND
UNCHANGED. WE BELIEVE A TRUE
MODERNIZATION OF MENTAL HEALTH
REQUIREMENTS ENHANCEMENTS ACROSS
THE CONTINUUM OF CARE, NOT JUST
IMAGERY AND ALSO THE USE OF
VOLUNTARY SERVICES TO AVOID
CREATING ADDITIONAL GAPS FOR
COMMUNITIES OF COLOR. I MET YOU
. M H S A IS ONLY ONE SLICE OF
THE DELIVERY SYSTEM AS THE 3 26
AND ITS APPROACH OF MODERNIZING
ONLY THE ESSAY WITHOUT REGARD
FOR THE REST OF THE DELIVERY
SYSTEM, LEAVING THOUSANDS OF
CALIFORNIANS OFTEN BEFORE WITH
US SAID WE STRONGLY URGE THE
LEGISLATOR TO CONSIDER THESE
AMENDMENTS TO ENSURE RESOURCES
ARE DELIVERED TO COMMUNITIES
THAT NEED THEM THE MOST. THANK
YOU VERY MUCH, PLEASE. THANK
YOU. LINE 13. YOUR LINE IS OPEN.
YES THIS IS ERIKA HOFFMANN WITH
THE CALIFORNIA SCHOOL BOARDS
ASSOCIATION. I WOULD FIRST OFF
LIKE, SAY, THANK YOU FOR THE
AMENDMENTS THAT WERE JUST PUT
INTO THE BILL LAST NIGHT. THEY
DO ADDRESS SOME OF THE CONCERNS.
WE HAD A LITTLE LINE OUR
POSITION WITH DOCTOR DO ONE FROM
THE SANTA CLARA COUNTY OFFICE OF
EDUCATION. THERE IS A STRONG
NEED TO ENSURE THAT SCHOOLS ARE
INCLUDED IN THE LOCAL PROGRAM
DISCUSSIONS AND ADVISORY GROUP.
UM AND I WOULD ALSO LIKE TO
ALIGN WITH THE COMMENTS OF
SARETTE KAMINSKY WITH THE
ASSOCIATION OF CALIFORNIA SCHOOL
ADMINISTRATORS. WE LOOK FORWARD
TO MORE AMENDMENTS AND MORE
DISCUSSIONS ON THIS. THANK YOU
VERY MUCH FOR YOUR TIME. THANK
YOU VERY MUCH FOR YOUR CALL.
NEXT CALLER, PLEASE. THANK YOU,
65. GOOD AFTERNOON. THIS IS
REBECCA GONZALEZ, THE
NATIONALIST ASSOCIATION OF
SOCIAL WORKERS. CALIFORNIA
CHAPTER. I WANT TO THANK THE
COMMITTEE FOR THIS HEARING, AND
I WANT TO ACKNOWLEDGE THAT THANK
YOU FOR THE ACKNOWLEDGEMENT THAT
THIS IS A WORK IN PROGRESS. I
WANT TO ASSOCIATE AND SUPPORTS
COMMENTS FROM JOSE PENA ALVARADO
, MENA AND UPLIFT VHF STATION
CENTER THEIR GOALS AND REDUCING
RACIAL, ETHNIC AND LGBTQ
DISPARITIES. I APPRECIATE THAT
SECRETARY GALLI SAID THE
ACTIVITY CENTERED IN EQUITY, BUT
IT COULD BE FURTHER CLARIFIED.
IT WAS ALSO UNCLEAR TO ME OF
COMMUNITY BEHIND EVIDENCE
PRACTICES OR SEE THAT ARE STILL
AN ACCEPTED PRACTICE. UNDER THE
PROPOSED REFORMS UNDER THE
CALIFORNIA REDUCING DISPARITIES
PROJECT, IT WAS SHOWN THAT
SUPPORT TO ENSURE THAT CERTAIN
CULTURAL PRACTICES ARE
INCORPORATED ME THE NEEDS OF
DIFFERENT COMMUNITIES. WE ARE
ALSO CONCERNED THAT PREVENTION
HAS BEEN SEPARATED FROM EARLY
INTERVENTION AND ARE NOT SURE
WHY THAT WAS DONE. ALSO
CONCERNED ABOUT THE REDUCTION
FROM FIVE AND 4% PREVENTION
BUCKETS. THANK YOU. THANK YOU.
NEXT CALLER, PLEASE. THANK YOU
LINE 30. HELLO YEAH, MY NAME'S
GOALBOUND. AND I JUST KIND OF
SAY THAT ITS PROVISIONS FOR THE
GOVERNOR'S VAMP IS TRULY ABOUT
PROVIDING SERVICES TO THOSE MOST
IN NEED. THERE ARE NO GROUPS
MORE THAN YOU TO BE VERSUS THAN
THOSE TYPE TALKING LGBTQ
COMMUNITY ALLUDED TO BY MR
ALVARADO PEANUTS REVISIONS TODAY
, INCLUDING THE MOST RECENT
AMENDMENTS, THEIR IN STATE
LITTLE, IF ANY INVOLVEMENT OF
THEIR LIVED EXPERIENCES. NO
LANGUAGE RELATED TO COMMUNITY,
FIND EVIDENCE PRACTICES OR SEE
THAT APPROACHES HAVE BEEN
DEMONSTRATING TO MOST
EFFECTIVELY MEET THEIR KNEES.
SADLY MANY OF THOSE DISPARITIES
, COMMUNITY SPACE ARE GROUNDED
IN THE FAILURE OF CANDIDATES
SERVICES TO ADDRESS THEM AND
CULTURALLY APPROPRIATE WAYS.
FAILURE ARISES IN MANY WAYS, A
FUNDAMENTAL LACK OF TRUST THAT
THEIR EXPERIENCES, LET ALONE
THEIR MENTAL HEALTH DUDES WILL
BE AUTHENTICALLY ADDRESSED. SEE
THAT IRAN BY FROM AND FOR THESE
COMMUNITIES, SEE THAT ALSO OFFER
A PIPELINE FOR FUTURE PROVIDERS
THAT ARE BEING CALLED FOR IN THE
REVISION. PLEASE RESTORE THE
FUNDING FOR PREVENTION ACT. AT
LEAST 5. THANK YOU VERY MUCH.
TEXT COLOR, PLEASE. THANK YOU
LINES 71. HELLO AND GOOD
AFTERNOON. MY NAME. I AM A
SPECIFIC ENERGY SENT AND I
WORKED FOR ASIAN AMERICAN
REPUBLISHED HEALTH RATE 60. OUR
PROJECT IS THE ESSENCE AMOUNT OF
PROGRAM, WHICH IS A CULTURAL
PROGRAM THAT IS PART OF
CALIFORNIA, REDUCING THIS VERY
GAMES REDUCED MUCH CHRIS
CONNECTIONS OF MENTAL WELLNESS
ARE EFFECTIVE. MENTAL HEALTH
DISPARITIES OUR COMMUNITIES AND
BE ONE OF 35 SECURITY. WE HAVE
BEEN ABLE TO STIGMA AROUND
MENTAL HEALTH CONDITIONS OF THE
TABOO TOPICS. SYMPTOMS AND RISK
FACTORS AND FORCES OF POULTRY BY
OUR FOCUS SPECIFIC PROGRAMMING.
ON YOUR VILLAGE. LET ME READ
THAT PART SPECIFIC. ONDERS
VILLAGE, REPORTS COMMENTS,
POSSIBLY ALVARADO. THEN EVERY
PARTY NOT UNDERSTOOD COMMUNITIES
AND CONTINUOUS NEEDS TO WEAVE.
THIS MAP OF CALIFORNIA OCCUPY
LAVA, WHICH MEANS THANK YOU AND
THANK YOU VERY MUCH NEXT COLOR,
PLEASE. 74. GOOD AFTERNOON. MY
NAME IS MESSINA, REPRESENTING
THE CALIFORNIA REDUCING THE
SECURITIES PROJECTS, UM, CALLING
IN STRONG SUPPORT OF THE
COMMENTS MADE BY ALVARADO NO,
THANK YOU. THANK YOU, 63 GOOD
AFTERNOON CHAIR EGGMAN AND
COMMITTEE MEMBERS. MY NAME IS
ANDY LEAVE IN BALM ON BEHALF OF
THE COUNTY OF LOS ANGELES, AND
WE SINCERELY APPRECIATE YOUR
WORK, ADDRESSING BEHAVIORAL
HEALTH AND THOUGHTFUL
PERSPECTIVES PRESENTED TODAY.
LIKE MANY HERE WE'RE STILL
CAREFULLY REVIEWING THE
AMENDMENTS. THE 3 26 IN PRINT
LAST NIGHT AND WE LOOK FORWARD
TO WORKING WITH YOU. ASSEMBLY
AND OUR COUNTY COALITION
PARTNERS ON ADDITIONAL
AMENDMENTS AND NEXT STEP. WE
APPRECIATE THE ADMINISTRATION'S
EFFORTS THUS FAR, WE APPRECIATE
YOUR LEADERSHIP AND WE WILL
REMAIN ACTIVELY INVOLVED TO GET
SP 3 26 PLACE WHERE WE CAN
SUCCESSFULLY IMPLEMENT THIS
IMPORTANT EFFORT. THANK YOU.
THANK YOU VERY MUCH. NEXT
CALLER, PLEASE. 32. YES THANK
YOU, ANGELA, BUT ON BEHALF OF
THE CHILDREN'S PARTNERSHIP THE
CHILDREN'S PARTNERSHIP WISHES TO
THANK YOU, SENATOR EDMUND FOR
THEIR CURIOSITY. IMPACT OF THESE
MODERNIZATION EVER USED,
ESPECIALLY THOSE FROM
HISTORICALLY MARGINALIZED
COMMUNITIES. EVALUATING THE
AMENDMENTS, PLEASE DEFEAT SET
ASIDE FOR CHILDREN AND YOUTH PUT
INTO THE BILL LANGUAGE AND WE
APPLAUD THESE. THESE EFFORTS
AVOID UNFAIRLY NEEDS THAT. OUR
AGAINST THE INSEPARABLE AND
POLITICAL NEEDS OF ADULTS WITH
SEVERE MENTAL ILLNESS. ALIGNMENT
WITH THE COMMENTS MADE BY
ELECTION, FRANCIS. WE DO HOPE
THE CONVERSATION AROUND
TRANSITION A JEW. AND AS WELL AS
GETTING GREAT CLARITY AROUND
PREVENTIVE AND TIER ONE
DIRECTION. AND THANK YOU AGAIN
FOR CONTINUED DIALOGUE
PARTNERSHIP ON CHILDREN AND
YOUTH. THANK YOU VERY MUCH.
THANKS, CALLER, PLEASE. YEAH,
FINE. 56. COME ON BEHALF OF
MAYOR OF LONDON BREED OF SAN
FRANCISCO AND THE CITY AND
COUNTY OF SAN FRANCISCO AND
SUPPORT AND WANT TO THANK THE
AUTHOR. UM AND THEY'RE STARING
IN GENERAL FOR THE WORK ON THIS
ISSUE. THANK YOU. THANK YOU. I'M
42. OH, DID YOU HEAR ME? WE CAN
YES. OKAY I'M DOUGLAS DOWN A
MEMBER ECONOMIC COMFORT HELPS
AND THE PARENTS OF SEVERELY
MENTALLY ILL ONE VERY BRIEFLY,
UH, I PERSONALLY OPPOSES BUILT
FURTHER AMENDED ALONG THE LINES
OF ESPECIALLY HOUSING WASN'T
REALLY TALKED ABOUT SUB ACUTE
CARE HOUSE IN HIS LEFT OUT OF
THE BOND MEASURE INCLUDED WITH
THIS DEVASTATING EFFECT
THROUGHOUT THE STATE FOR THE
RAMS CORPORATION IN 2700 BEDS,
CAUSING TERRIBLE PROBLEMS HERE
IN CONTRA COSTA COUNTY. THANK
YOU FOR YOUR TIME. THANK YOU
VERY MUCH NEXT COLOR, PLEASE. 61
. THEY'RE HONORABLE STATE
SENATORS AND CHAIRWOMAN EGGMAN
I'M MONTANA MAYOR AQUA NET. A
WARRANT ON BEHALF OF THE CITY OF
FONTANA. I'M HERE TO EXPRESS MY
STRONG SUPPORT FOR SP 3 TO 6
WILL HELP ME FORM THE MENTAL
HEALTH SERVICES ACT. CALIFORNIA
SPACE IN CONFORMANCE OF CRISIS,
HOMELESSNESS, MENTAL HEALTH AND
SUBSTANCE ABUSE. AS YOU KNOW,
THERE ARE OVER 40,000 HOMELESS
PEOPLE WITH MENTAL HEALTH ISSUES
, AND MANY ARE VETERANS WHO
BRAVELY SERVED OUR COUNTRY. IT'S
LONG OVERDUE THAT WE MODERNIZE
OUR APPROACH, DISTURBING FELLOW
CALIFORNIANS WHO ARE UNABLE TO
HELP THEMSELVES. OUR CITIES AND
COMMUNITIES ARE ON THE FRONT
LINE EVERY DAY, AND WE NEED A
BOWL ACTION NOW. IN THE CITY OF
MONTANA. WE ARE WORKING WITH OUR
FEDERAL PARTNERS TO BUILD THE
REGION'S PURSE HOMELESS
PREVENTION CENTER, AND WE HOPE
IN THE FUTURE WE CAN PARTNER
WITH THE STATE TO EXPAND THOSE
SERVICES. BUT THESE REASONS THAT
SUPPORT SP 3 TO 6 THANK YOU FOR
YOUR VISION CHAIRWOMAN EDMUND
AND THE REST OF OUR GREAT
SENATORS, AND THIS IS MY
OPPORTUNITY TO TELL YOU HOW MUCH
I THANK YOU FOR THIS FIELD.
THANK YOU VERY MUCH. MAYOR. NEXT
COLOR, PLEASE. 68. GOOD
AFTERNOON, RACHEL ALCOHOL HEALTH
CENTER PRODUCED FLAGS WERE
ALIGNED WITH COMMENTS OFFERED
PILOT FRANCIS AT CHILDREN NOW
AND OTHER CHILD ADVOCATES WHO
HAVE SPOKEN ABOUT THE IMPORTANCE
OF ENSURING DEDICATED FUNDING
FOR CHILDREN AND USED FROM THEIR
EARLIEST KANSEN EARS THROUGH
THEIR HEAD AGES. 0 TO 5 25 FOR
HER TO THE KITCHEN PROCESS.
THERE'S STILL REVIEWING THE
DETAILS OF BEING THAT. EVERY
DIFFERENT QUESTIONS THAT WE WANT
TO SAY THAT WE HAVE ON FITNESS
CONCERNS AND INCLUSION OF ASIDE
FOR CHILDREN AND YOUTH PEOPLE
SUSPECT AND NOT ADDRESSED
HOMELESSNESS. IT NEEDS THE NEEDS
OF ITS CHILDREN ACROSS THE BROAD
SPECTRUM. THANK YOU. THANK YOU
NEXT CALLER. 69. MY NAME IS
AARON TRULY WITH THE SOUTHEAST
RESOURCE ACTION CENTER, IRAQ AND
WE OPPOSE THE SECOND AMENDMENT
THAT ONE ADDRESS INVESTMENT AWAY
FROM SERVICES INCORPORATE
QUICKLY EQUITY AND CULTURAL
LANGUAGE IN THE APPROPRIATE
MANNER AND THREE CROWNS, BEAT UP
AND REALLY INTERVENTION,
SERVICES AND FLOOR PUSH TO ADD
EVEN MEDICAL BENEFITS. AND WE
BELIEVE THESE ARE LOSING
NECESSARILY CHANGES. THANK YOU
SO MUCH. THANK YOU. NEXT CALLER,
PLEASE. 72. GOOD AFTERNOON.
DEBORAH DISABILITY RIGHTS,
CALIFORNIA FIRST OF ALL, I WANT
TO ALIGN. MY TESTIMONY WITH CAL
VOICES WERE VERY DISAPPOINTED
THAT THERE IS NO CLIENTS WITNESS
BEING HEARD ON YOUR PANEL.
SECOND. THERE MAY BE SOME GOOD
STUFF IN THIS BILL. WE'RE STILL
TRYING TO DIGEST THE AMENDMENT.
BUT WE DO OPPOSE THE MOST
IMPORTANTLY BECAUSE OF THE WAY
IT'S BEEN PUT TOGETHER AND
RECEIVING. THIS IS A MASSIVE
REWRITE OF SOMETHING CREATED BY
THE VOTERS, AND THIS WAS DRAFTED
LARGELY BEHIND CLOSED DOORS.
ADMINISTRATION DID NOT MEET WITH
US. AND OTHER PEOPLE WITH
DISABILITIES AND WHICH IS
DISAPPOINTED, SO THAT'S HOW I
WOULD SAY ABOUT THAT. THANK YOU.
THANK YOU. NICE COLOR, PLEASE.
75 SURE. HELLO. HELLO. THANK
YOU. HI MY NAME IS MARCEL. VAL
DOES I AM A CASE MANAGER ASIAN
AMERICAN RECOVERY SERVICES IN A
CEMETERY COUNTY ARE PROGRAMS
SERVING A ENERGY COMMUNITY IN
OUR COMMUNITY. POPULATION IN OUR
COMMUNITY, PROVIDING MENTAL
HEALTH AND PREVENTION SERVICES,
WHICH WILL BE NEGATIVE. WE
IMPACTED BY THE PROPOSITION. UM
AMENDMENTS. PLEASE SUPPORT THE
COMMENTS BY YOU KNOW, ALVARADO,
I DON'T THANK YOU. THANK YOU
VERY MUCH. OKAY. AND THIS NEXT
COLOR, YOU'LL BE OUR LAST
CALLER. GO AHEAD, PLEASE. MADAM
CHAIR. WE HAVE NO FURTHER
COMMENT. THANK YOU TIME THAT
PERFECTLY THEN. OKAY THANK YOU
VERY MUCH MODERATOR. AND THANK
YOU FOR EVERYBODY COMING TODAY
AND PARTICIPATING AGAIN. WE'RE
ALMOST YOU AGAIN NEXT WEEK, BUT
WE HAVE OUR FIRST ASSEMBLY
HEARING. WE THANK YOU FOR YOUR
INPUT AND PARTICIPATION INTO THE
STAFF FOR THEIR WORK TODAY. THIS
INFORMATIONAL HEARING IS
ADJOURNED.