GOOD AFTERNOON.
THIS WILL BEGIN TODAY'S SOMEONE
HEARING ON APRIL SIXTEENTH OF
TWENTY EIGHTEEN.
WE'RE GOING TO HAVE MEMBERS
INTERMITTENTLY PRESENT AND SO IF
WE CAN WILL BEGIN WITH ISSUE
ONE.
FULLER.
HE'S VERY CLOSE.
ALSO THE NORMAL.
US A GOOD AFTERNOON JENNIFER CAN
DEPARTMENT OF HEALTH CARE
SERVICES.
SO JUST I WANTED TO QUICKLY THE
AGENDA CERTAINLY DOES A NICE
JOB.
OF LAYING OUT THE.
.
TWO DIFFERENT KINDS OF SUBSTANCE
YOU SERVICES THAT THE MEDICAL
PROGRAM OFFERS TODAY BUT IN.
HIGH TERMS OTHER TWO MODALITIES.
SLASH DELIVERY SYSTEM SO WE
HAVE WHAT WE CALL TWO STATE PLAN
COUNTIES AND THEN WE HAVE ODS
COUNTIES SO A FEW YEARS AGO.
WE SOUGHT AND RECEIVED AN
ELEVEN FIFTEEN MEDICAID WAIVER
TO CREATE AN ORGANIZED ON
DELIVERY SYSTEM AS IT PERTAINS
TO SUBSTANCE USE TREATMENT SO
IT'S THE FIRST IN THE NATION. ON
IT WAS DONE IN AUGUST OF TWENTY
FIFTEEN AND WHAT IT REALLY MEANS
IS THAT COUNTIES ON A VOLUNTARY
BASIS CAN OPT INTO THIS WAIVER.
THEY WILL BE YOU.
ALLOWED TO PROVIDE A FULL
CONTINUUM OF CARE RANGING FROM
INPATIENT RESIDENTIAL TREATMENT
SERVICES FOR I'M SUBSTANCE USE
ALL THE WAY DOWN TO MEDICATION
ASSISTED TREATMENT OUTPATIENT
THERAPY.
CASE MANAGEMENT.
AND WAS REALLY KIND OF AN
EXCITING.
EXPANSION OF THE SERVICES THAT
ARE OTHERWISE TRADITIONALLY BEEN
PROVIDED IN THE STATE. THE OTHER
COUNTIES THAT HAVE NOT OPTED
INTO THE WAIVER OR AIR THAT ARE
STILL IN THE PROCESS OF WORKING
THROUGH THE WAIVER PROCESS.
WE REFER TO AS OUR STATE PLAN
SERVICES SO THERE'S FIVE MEAN.
MODALITIES INPATIENT.
INTENSIVE OUTPATIENT THERAPY
OUTPATIENT DRUG FREE SERVICES.
MEDICATION TREATMENT I E. UM
METHADONE.
BOB PARRY NAIL RESIDENTIAL AND
I'M FORGETTING THE LAST ONE.
.
BUT IT'S IT'S FAIRLY LIMITED AND
IT HAS.
IN LARGE PART.
.
BEEN AND CHALLENGING I THINK
FROM THE STANDPOINT THAT IS NOT.
INCLUDE ANY KIND OF RESIDENTIAL
OR.
INPATIENT DETOX TREATMENT SO
THAT HAS BEEN I THINK
CHALLENGING DEPENDING ON THE
ADDICTION.
ISSUE THAT YOU ARE CONTENDING
WITH.
WHEN WE IMPLEMENTED THE
AFFORDABLE CARE ACT IN TWENTY
FOURTEEN THERE WERE ADDITIONAL
BENEFITS THAT WE NEEDED TO ADOPT
IN THE MEDICAID PROGRAM IN ORDER
TO HAVE.
A FULL A SET OF SERVICES THAT
MET THE ESSENTIAL HEALTH
BENEFITS.
STRUCTURE SO WE ADDED.
.
THAT S. BIRD SO THIS.
SCREENING BRIEF INTERVENTION.
ASSIST SERVICE THAT IS.
WRITTEN UP IN YOUR AGENDA AS
AND BRIEF COUNSELING SESSION
THAT INDIVIDUALS.
CAN RECEIVE.
WHEN A PROVIDER BELIEVES ARE
THAT THEY INDICATE THAT THEY
HAVE A SUBSTANCE USE DISORDER
PROBLEM.
IN LAST WEEK SENATE BUDGET
COMMITTEE AND WE WERE ASKED BY
THE COMMITTEE AND CHAIR AND
MEMBERS ABOUT THE IMPORTANCE OF
THE FEDERAL FUNDING AS IT
PERTAINS TO THE.
ELEVEN FIFTEEN WAIVER AND
WHETHER WE THOUGHT THAT WAS AT
RISK. AND WHAT WAS INTERESTING
IN WHAT I BROUGHT BECAUSE I
THOUGHT IT WAS SUCH A GOOD
QUESTION I'M TO SHARE WITH THIS
COMMITTEE AS WELL IS THE
IMPORTANCE OF THE FEDERAL
FUNDING THAT HAS REALLY MADE THE
ELEVEN FIFTEEN. ODS WAIVER
RELEVANT AND SO FOR THE COUNTIES
THAT WE HAVE.
IMPLEMENTED SINCE WE STARTED.
LAST FEBRUARY.
FOR EXAMPLE.
COUNTY RIVERSIDE WAS ONE OF THE
FIRST COUNTIES TO IMPLEMENT THE
WAIVER.
AND THEN JUST LOOKING AT THEIR
EXPENDITURES IN TERMS OF THEIR
BEHAVIORAL HEALTH SUB ACCOUNTS
OF THIS IS THE MONEY THAT WE AS
A STATE. REALIGNED TO THE
COUNTIES THEY'VE USE NINE
HUNDRED AND FOURTEEN THOUSAND
DOLLARS OF THEIR BEHAVIORAL
HOUSE OF ACCOUNT BUT THEY'VE
DELIVERED FIFTEEN MILLION
DOLLARS IN SERVICES.
TH TWELVE POINT THREE MILLION
OF THAT IS FEDERAL FUNDS.
IN THE REMAINING PORTION THE
TWO MILLION IS ABOUT AS GENERAL
FUNDS FROM FOR LOS ANGELES WHICH
WAS.
WENT LIVE LAST JULY.
THEY HAVE SPENT SEVEN POINT
FOUR MILLION IN BEHAVIORAL
HEALTH SUB ACCOUNT FUNDING SO
THEIR OWN COUNTY FUNDING. BUT
DRAWN DOWN FORTY MILLION DOLLARS
IN FEDERAL MATCHING FUNDS AND
SPENT FIFTY TWO MILLION DOLLARS
TOTAL. SO I REALLY WANTED TO
KIND OF.
BOTH HIGHLIGHT ON THE
IMPORTANCE OF WHAT THE WEAVER
HAS ALLOWED FOR THE COUNTIES TO
DELIVER BUT ALSO THE. ENORMOUS
RAMIFICATIONS FOR WHAT THAT DOES
FOR IMPROVING AN INCREASING.
SERVICES AND US IN THE STATE.
I WILL PAPPY THE OFFICE OR
INSERT QUESTIONS BUT I THINK IT
ALSO.
HIGHLIGHTS SOME OF THE
INNOVATIVE WORK THAT WE'VE DONE
AROUND SUBSTANCE USE ESPECIALLY
IN CALIFORNIA WE WERE THE FIRST
IN THE NATION SAID BOTH RECEIVE.
AND OBTAIN THI WAIVER.
IT ALLOWED FOR US TO WAIVE.
WHAT'S KNOWN AS THE I. M. D.
RESTRICTIONS SO MEDICAID
PROGRAMS HAVE TRADITIONALLY BEEN
PREVENTED FROM.
COVERING SERVICES IN INSTITUTES
FOR MENTAL DISEASE WE RECEIVED A
WAIVER OF THE I AM THE
RESTRICTION SPECIFICALLY FOR
SUBSTANCE TREATMENT FACILITY SO
THAT ALLOWS FOR US TO DRAW DOWN.
MONEY FOR THE RESIDENTIAL
PORTION OF THE BENEFIT
ALTOGETHER SO WITHOUT I'M HAPPY
TO.
INTO QUESTIONS.
THANK YOU DIRECTOR CAN'T.
NEXT WE HAVE TOM RAN FREELY
FROM THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION.
THANK YOU MISTER CHAIR GOOD
AFTERNOON. MEMBERS.
SO I AM TOM RENT FREE I'M DEPUTY
DIRECTOR FOR SUBSTANCE USE
DISORDER SERVICES FOR THEIR
COUNTY HERE ON HEALTH DIRECTORS
ASSOCIATION.
I THINK BUT BETWEEN WHAT
DIRECTOR CAN'T JUST GAVE US AN
OVERVIEW AND THE EXCELLENT.
ANALYSIS AND RIGHT UP IN IN THE
AYE AGENDA.
COVERED A LOT OF GROUND AYE I
WOULD JUST SAY THE ONE ISSUE
THAT THEY ASKED ARE COUNTIES TO
RESPOND TO WOULD BE TO DESCRIBE
THE WHAT WE. PERCEIVE AS THE
OVERALL SENSE OF THE QUALITY AND
THE ACCESS TO SUBSTANCE USE
DISORDER SERVICES.
AND THERE ARE A COUPLE OF OF
ISSUES THAT WE WERE ASKED TO
RESPOND TO IN TERMS OF
STAKEHOLDER CONCERNS.
OVERALL I MEAN.
THIS.
THE EXPANSION OF DRUG MEDI CAL
IS THE BIGGEST THING TO HIT OUR
SYSTEM OF CARE AND IT IN THE
EIGHTEEN YEARS THAT I'VE BEEN
INVOLVED IN THIS FIELD I MEAN
THIS IS THIS IS HUGE FOR
COUNTIES I MEAN IT TOOK A
SYSTEM.
THAT WAS TRADITIONALLY VERY FEW
BENEFITS BASICALLY METHADONE AND
GROUP COUNSELING.
VERY LOW RATES ARE YOU KNOW
REIMBURSEMENT RATES AND IT
REALLY EXPANDED INTO A FULL
CONTINUUM OF CARE SO NOW THAT. I
COUNTIES THAT OF THAT OPT INTO
THE.
TO THE DELIVERY SYSTEM
ORGANIZED DELIVERY SYSTEM ARE
ABLE TO OFFER FROM THE BEGINNING
WITH SCREENING AND BRIEF
INTERVENTION THROUGH DETOX ALL
THE WAY THROUGH RESIDENTIAL HOW
PATIENT INTENSIVE OUTPATIENT.
RECOVERY SUPPORTS CASE
MANAGEMENT THINGS THAT WE NEVER
HAD THE ABILITY TO.
TO BE ABLE TO RE UP BE
REIMBURSED FOR UNLIKE A DIRECTOR
CAN SET A GOT ACCESS TO A WHOLE.
ROW RAY OF FEDERAL OF FEDERAL
FUNDINGS WHICH HAS BEEN HELPFUL
WHAT WE'VE HEARD FROM THE
COUNTIES THAT HAVE IMPLEMENTED
THE TEN COUNTIES THAT HAVE THAT
ARE NOW. FULLY IMPLEMENTING THE
SYSTEM IS THAT.
IT'S A IT'S A CHALLENGE
ADMINISTRATIVELY I MEAN THERE'S
A HUGE WORK LOAD A FOR THE
COUNTIES BUT THAT THEY'RE ABLE
TO DELIVER SO MANY MORE SERVICES
PROVIDES BEFORE.
TAG BEING ABLE TO HELP SO MANY
MORE PEOPLE AND ESPECIALLY IN
THIS DAY WERE FACING AN OPIOID
CRISIS SINCE
IT'S REALLY GREAT THAT WE CAN
GET MORE PEOPLE INTO SERVICES
THAT'LL HELP THEM.
IT YOU KNOW IMPROVE THEIR LIVES
AND AND AND AND GET INTO
RECOVERY FROM THEIR ADDICTION.
ARE WE WE ARE GRATEFUL FOR AND
WE SUPPORT THE.
THE STATE GENERAL FUND
ALLOCATION THAT THE STATE HAS
HAS PUT END OF FOR THE ODF
SERVICES. AYE WE DID HAVE ONE.
.
RECOMMENDATION THAT.
PERHAPS LANGUAGE COULD BE
ALLOWED FOR THE USE OF THIS
STATE GENERAL FUNDING TO COVER.
OTHER BENEFITS OTHER THAN
RESIDENTIAL AN INTENSIVE
OUTPATIENT RIGHT NOW COUNTIES.
WITH THE STATE GENERAL FUND CAN
ONLY CLAIM THAT FUNDING FOR A
RESIDENTIAL INTENSIVE OUTPATIENT
WE WOULD LIKE TO SEE. PERHAPS A
MORE FLEXIBILITY WHERE OF
COUNTIES WANTED TO THEY COULD
UTILIZE THAT FOR SOME OF THE
OTHER BENEFITS THAT HAVE BEEN
ADDED SUCH AS RECOVERY SUPPORTS
AND CASE MANAGEMENT.
THAT WAS INDICATED IN IN OUR
LETTER.
IN TERMS OF SPECIFIC UP
BENEFITS THE SCREENING BRIEF
INTERVENTION ARE REFERRAL TO
TREATMENT SOMETIMES KNOWN AS S.
BERT.
IS ONLY REIMBURSABLE FOR
ALCOHOL ARE WE DID HAVE A EIGHTY
A RECOMMENDATION THAT.
.
THE.
FUNDING WOULD BE ABLE TO BE
EXPANDED SO THAT THAT IT WOULD
HAVE TO REQUIRE NEW FUNDING FOR
THE DEPARTMENT TO EXPAND THE
BENEFIT TO INCLUDE A SCREENING
AND COUNSELING. FOR THE MIS USE
OF OPIOIDS ANOTHER ILLICIT DRUGS
AS WELL IT'S BEEN SUCCESSFUL FOR
ALCOHOL WE THINK EXCRETE THIS
KIND OF SCREENING COULD BE
VALUABLE.
FOR OTHER I'D ADD DRUGS AS WELL.
IN REGARD TO.
THERE'S ONE BENEFIT THAT'S NOT
A DRUG MEDI CAL BENEFITS
ACTUALLY IT WAS A NEW BENEFIT
BUT IT WAS A ADDED UNDER MEDI
CAL FEE FOR SERVICE FOR
VOLUNTARY INPATIENT DETOX.
THIS CAN BE PROVIDED ONLY END
UP ACUTE CARE HOSPITALS WE ARE
WE UNDERSTAND THAT IT'S THIS IS
A BENEFIT ON PAPER THAT IS NOT
REALLY BEING. A VERY ACCESSIBLE
BECAUSE A LOT OF HOT MOST
HOSPITALS. DON'T OFFER DETOX
SERVICES AND THE ONES THAT DO
WORSE THERE ARE REPORTING THAT
THEY'RE HAVING A VERY DIFFICULT
TIME BUILDING AND BEING.
REIMBURSED OTHER SOME SORT A
SNAG IN THE SYSTEM WHERE THEY'RE
HAVING A REAL HARD TIME GETTING
REIMBURSED. AND THAT'S KIND OF A
DISINCENTIVE THEN FOR REFER THEM
TO.
OFFER THIS BENEFIT.
DETOX IS IS EXTREMELY IMPORTANT
WE WOULD LIKE TO SEE THIS
BENEFIT EXPANDED YOU'RE GOING TO
HEAR A PROPOSAL A LITTLE BIT
LATER THAT. THAT WE SUPPORT THAT
WOULD ALLOW THE A FOR THE
EXPANSION OF THIS AND THEN
FINALLY. A WE DO SUPPORT THE.
WORKFORCE CAPACITY TRAINING
THAT YOU'LL HEAR ALSO ABOUT FROM
ONE OF OUR.
PROVIDER AFFILIATES THE ONE
AREA AND I'LL JUST CLOSE WITH
THIS.
OUT.
PROBABLY THE BIGGEST CHALLENGE.
IN IMPLEMENTING THE PROGRAM
THERE'S IS THIS TRANSITION THAT
HAPPENED RECENTLY BETWEEN COUNTY
OF SERVICE AND COUNT TO COUNTY
OF RESPONSIBILITY. IT GETS KINDA
COMPLICATED BUT UNDER THE OLD
SYSTEM.
BECAUSE IT IN OUR FIELD A
CLIENTS TEND TO MOVE THEY THEY.
MIGHT SEEK SERVICES IN COUNTIES
OTHER THAN THAT I COUNTY WHERE
THEY ARE RESIDE OR WHERE THERE
MEDI CAL WAS ESTABLISHED AND SO
WE HAVE A LOT OF MOVEMENT. OF
CLIENTS TO GO TO OTHER COUNTIES
UNDER THE OLD SYSTEM THE
PROVIDER THAT WAS LOCATED IN IN
ONE COUNTY EVEN IF THEY WERE
SERVING. RESIDENTS FROM OTHER
COUNTIES THAT THAT COUNTY
RESPONSIBILITY WAS HAVE THE
CONTRACT OF THE COUNTY OF
SERVICE HAD THE CONTRACT WITHOUT
PROVIDER SO THE PROVIDER WOULD
BASICALLY. YOU KNOW SEND THE
CLAIM TO THE COUNTING WHICH THEY
WERE LOCATED THAT I UP COUNTY
WOULD PAY THEM AND THEN WOULD
WOULD SUBMIT THE CLAIMS TO THE
STATE REGARDLESS OF WHERE THE
CLIENTS CAME FROM.
UNDER THE TRANSITION TO COUNTY A
RESPONSIBILITY NOW EACH COUNTY
IS RESPONSIBLE TO FOR THE IN THE
PEOPLE THAT RESIDE IN THAT
COUNTY REGARDLESS OF WHERE THEY
GO FOR SERVICES SO THIS MEANS.
THAT ONE COUNTY FOR EXAMPLE
MIGHT HAVE ITS RESIDENTS GETTING
SERVICES IN FIVE OR SIX OTHER
COUNTIES. SO THEY HAVE TO NOW
ESTABLISH CONTRACTS WITH
PROVIDERS AND ALL THOSE OTHER
COUNTIES.
.
THE COUNTY CONTRACTING SYSTEM
ISN'T YOU KNOW IS NOT SIMPLE
THAT'S REQUIRES GOING TO THEIR
BOARDS AND GETTING NEW CONTRACTS
IT'S BEEN KIND OF AN
ADMINISTRATIVE.
BURDEN IN A SENSE TO GET ALL
THESE NEW KIND AND IT AND IT
TAKES TIME YOU KNOW TO GET THESE
CONTRACTS STARTED IN THE
MEANTIME THE PROVIDERS YOU KNOW
THEY'RE HAVING TO SCRAMBLE TO
SEE WHO THEY CAN YOU KNOW WHO
THEY'RE GOING TO BE ABLE TO GET
PAID. BY AND SO THAT IS
SOMETHING I THINK WE NEED TO WE
NEED TO CONTINUE WORKING ON A IS
IS HOW TO DEAL WITH THAT
TRANSITION THAT BECAME VERY
COMPLICATED ONCE ONCE WE MADE
THAT MOVE. ARE YOU GOING TO HEAR
MORE ABOUT THAT SO I THINK I'LL
IN HERE AND HAPPY TO ANSWER ANY
QUESTIONS.
THANK YOU MISTER.
BEFORE WE GO ON TO OUR NEXT
PRESENTER I'D LIKE TO ESTABLISH
FORM.
ARAMBULA HERE. HARPER.
MATHIS RUBIO HERE WOULD.
THINK YOUR WE'LL HEAR FROM HELEN
ASHAR.
MR CHAIRMAN MEMBERS HOLDING
MEASURE HAVE WITH CALIFORNIA
ASSOCIATION OF ALCOHOL AND DRUG
PROGRAM EXECUTIVES.
OTHERWISE KNOWN AS CAD. CAD
VIEWS THE.
STATEWIDE ASSOCIATION COMPRISED
OF COMMUNITY BASED NONPROFIT
SUBSTANCE USE DISORDER TREATMENT
SERVICES.
ALL OF OUR MEMBERS ARE STATE
LICENSED AND CERTIFIED BY THE
STATE AND ARE SUBJECT TO ALL OF
THE. STATE LAWS AND REGULATIONS
A REGARDING.
A TREATMENT PROGRAM SO I JUST
WANTED TO LET YOU KNOW THAT THAT
THAT WAS IT.
UP THE FIRST I'D LIKE TO THANK
GOD AND THINK YOUR STAFF WHO DID
AN EXCELLENT JOB OF. OF REALLY
IDENTIFYING THE ISSUES AND.
REALLY CLARIFYING THEM
CRYSTALLIZING THEM ON THE
COMMITTEE AND SECONDLY I'D LIK
TO TO ALSO.
ACKNOWLEDGES. THAT DHEA S.
DIRECTOR JENNIFER KENT'S DATA WE
HAVE SPENT A LOT OF TIME TALKING
TO HER ABOUT THESE ISSUES AND.
.
OF WE HAVE FOUND HER TO BE OPEN
AND.
LOW OR. NO WILLING TO LISTEN TO
US SO WHERE THEY'RE NOT WE AGREE
ON THINGS IS SOMETHING DIFFERENT
BUT I'M. THAT THE DEPARTMENT HAS
BEEN VERY OPEN TO.
TO MEETING WITH US AND TALKING
TO US ABOUT THESE ISSUES SO
HOPEFULLY WE KEEP THIS YEAR WILL
BE ABLE TO RESOLVE SOME OF THEM.
I'M.
SO I'D LIKE TO START OUT WITH
THAT OF THE ISSUES THAT ARE IN
THE HOME.
.
IN THE ANALYSIS.
AND ACTUALLY THE WORKFORCE
CAPACITY BUILDING WE HAVE A WE
SUPPORT THAT.
UP WE HAVE NO NONE NO COMMENT
ON THE SCREENING A BRIEF
INTERVENTION PROPOSAL AS IT IS.
.
THAT WOULD SUPPORTIVE. OF THE
WORK FOR FORCED CAPACITY
BUILDING ISSUE IS AN ISSUE THAT
RECEIVE THAT IS PART OF.
A THE AYE IMPLEMENTATION OF THE
DMC ó DS WAIVER. AYE ALONG
WITH THE WAIVER CAME A VERY LONG
LIST OF.
TERMS AND CONDITIONS AND NEW
ARE REQUIREMENTS THAT WE AS
PROVIDERS.
WHO PROVIDE THE SERVICES MUCH
MUST MEET AND WE MUST DOCUMENT
ALA THAT IN A WAY THAT IS
ACCEPTABLE BOTH TO THE STATE AND
TO THE FEDERAL GOVERNMENT IN
TERMS OF CMS IN THE REQUIREMENTS
FOR? A THE FUNDING.
OUR OUR STAFF HAVE.
ASKED FOR AND WE ARE WORKING
WITH THE DEPARTMENT CHIU CRAFT
OUT A TRAINING PROGRAM. THAT
WOULD.
TRAIN OUR STAFF IN COMPLIANCE
EYES SO THAT WHEN. I THE TIME
COMES FOR.
OF COMPLIANCE REVIEWS. A THAT
OUR DOCUMENTATION AND OUR.
INFRASTRUCTURE AND OUR
PROCESSES AND PROCEDURES MEET
THE REQUIREMENTS OF BOTH THE
FEDERAL AND THE STATE TO STATE
LAWS.
I AND THE TERMS AND CONDITIONS
OF THE WAIVER SO. UP WE ARE
ASKING FOR.
BUT IF IT IF WE BEGAN
DISCUSSIONS WITH THE DEPARTMENT
IN JANUARY ABOUT WORKING OUT A
TRAINING PROGRAM. A SPECIFICALLY
ON THIS ISSUE A REVIEW IT IS AN
INVESTMENT IN.
.
I IN MAKING SURE THAT.
EVERYBODY IS.
DOING.
WHAT THEY NEED TO DO IN ORDER
TO?
I HAVE ACCEPTABLE REPORTS TO
THE FEDERAL GOVERNMENT ON THIS.
AND IT BECAME CLEAR TO US AS WE
WERE OF MEETING WITH THE
DEPARTMENT DAD ON THE TRAIN THAT
TECHNICAL ASSISTANCE CONTRACT
SAID THEY CURRENTLY HAVE. A A
ARE NOT SUFFICIENT TO SUPPORT
THE LEVEL OF.
A EXPERTISE IT IS NEEDED. A TWO
UP PROVIDE THE TRAINING SO WE
HAVE ASKED OF FOR AN ADDITIONAL
TEN MILLION DOLLARS WHICH WOULD
BE SPENT OVER.
TWO YEARS.
IN THE TWENTY COUNTIES THAT
HAVE.
IMPLEMENTED THE. UP ODS WAIVER.
AYE TO MAKE SURE THAT.
STAFF.
IS.
TRAINED AND UP TO DATE ON OUT
WHAT KINDS OF COMPLIANCE OF
PROCEDURES THE STATE WILL BE
REQUIRING SO THAT WE CAN MEET
THOSE.
SO THAT'S THE.
THOSE THE ONE PROPOSAL THAT
WE'RE TALKING ABOUT.
AND OTHER THAT WOULD AGAIN BE
OVER TWO YEARS IT WOULD BE THAT
IN THE TWENTY CAPITA ALL THE
PROVIDERS IN THE TWENTY
COUNTIES.
.
SO THE SECOND ISSUE IS THE ISSUE
THAT MY COLLEAGUE TOM RENT FREE
MENTION FROM THE COUNTY BEAVER
HEALTH DIRECTORS WHICH IS THE
COUNTY OF SERVICEMEN COUNTY OF.
RESPONSIBILITY UP FROM.
PEOPLE COME TO OUR TREATMENT
PROGRAMS.
THE COUNTY DID THEY REALLY
DON'T.
DIFFERENTIATE BETWEEN WHETHER OR
NOT THERE IN ORANGE COUNTY OR. A
LOS ANGELES COUNTY THEY GO TO
THE NEAREST PLACE THAT THAT THEY
CAN WORK WITH. AYE IS SOMETIMES
AS IN ORANGE COUNTY AND LOS
ANGELES COUNTY OR AS IN SAN
FRANCISCO IN SOUTH SAN
FRANCISCO.
AND SOMETIMES THOSE BORDERS ARE.
A STREET THAT DIVIDE ONE COUNTY
FROM THE OTHER. THE TREATMENT
PROGRAM MAYBE ACROSS THE STREET
BUT BECAUSE THEY ARE IN ONE
COUNTY THEY HAVE TO GO TRAVEL AN
HOUR OR TWO. TO.
RECEIVE THE TREATMENT THAT WE
JUST DON'T THINK MAKES ANY SENSE
FROM THE STANDPOINT OF A
PROVIDER. IT ALSO DOESN'T MAKE
ANY SENSE FOR PEOPLE WHO ARE
WORKING AND MAY WORK IN AN AREA
THAT IS CLOSE TO A TREATMENT
PROGRAM BUT THEY MAY HAVE TO
TRAVEL. UP BUT THAT JOB MAYBE AN
HOUR FROM THEIR HOME. BUT IT'S
CLOSE TO THE TREATMENT PROGRAM
AND IT MAY BE JUST IN ANOTHER
COUNTY SO.
WE'RE LOOKING FOR SOME
RESOLUTION OF THIS ISSUE WE'VE
LAID OUT A COUPLE OF.
ALTERNATIVES THAT WE THINK MIGHT
WORK
BUT WERE OPEN TO ANYTHING THAT
WILL RESOLVE THE ISSUES SO THAT
PEOPLE DON'T HAVE TO WORRY ABOUT
TRAVELING OR BEING DENIED
SERVICES BECAUSE THEY'RE NOT IN
THE RIGHT. COUNTY IN THEM NOT AT
THE RIGHT PLACE AT THE RIGHT
TIME IS IT WHERE SO.
I SO I THINK THAT'S.
.
A THAT'S A MAJOR ISSUE FOR US
ALSO.
A AYE AND THEN. A THE THIRD
ISSUE IS THE MEDI CAL
ELIGIBILITY OF INDIVIDUALS ARE
LEADING A COMMUNITY TREATMENT
PROGRAMS.
FOR A COMPLICATED ISSUE SO.
WITHOUT.
A THE DEPARTMENT OF HEALTH CARE
SERVICES.
IN DECEMBER ISSUED IN
INFORMATION BULLETIN THAT
IDENTIFIED THREE SUBSTANCE USE
TREATMENT PROGRAMS. THAT ARE
COMMUNITY BASED NONPROFIT.
A FIVE OH ONE C. THREE.
ORGANIZATIONS UNDER A FEDERAL
IRS.
A THEY HAVEMISLABELLED THEM AND
HAS
PUBLIC INSTITUTIONS.
OR. PRISONS.
BECAUSE A NUMBER OF THE PEOPLE
WHO ARE.
RECEIVING TREATMENT AND WHO
RESIDE IN US TREATMENT PROGRAMS.
OUR IN THE CDC OURS. PRE RELEASE
TREATMENT PROGRAM.
THERE'S BEEN A DECISION MADE IN
AND RIGHTLY SO BECAUSE OF THE
STATE LAW THAT.
THE NUMBER OF PEOPLE WHO ARE IN
THE TREATMENT PROGRAMS WHO ARE
IN PRE RELEASE.
ARE.
STILL.
UNDER JURISDICTION OF CDC OUR
AND THEY ARE INELIGIBLE FOR MEDI
CAL THEIR MEDI CAL HAS BEEN
SUSPENDED BECAUSE THEY STILL ARE
UNDER THE JURISDICTION OF THE.
A CDC ARE HOWEVER THERE'S A
MIXED POPULATION IN OUR
COMMUNITY TREATMENT PROGRAM STE.
AND. THE FACT THAT THE TREATMENT
PROGRAM HAS BEEN IDENTIFIED. AS
A PRISON.
MAKES ALL THE OTHER PEOPLE WHO
ARE YOU LIVING AND OF APART
PARTICIPATING IN THE TREATMENT
PROGRAM.
POTENTIALLY INELIGIBLE FOR
MEDICAID OUT EVEN THOUGH THEY
ARE.
BECAUSE OF THE DESIGNATION THE
ADDRESS THAT MEDICARE ALL
ELIGIBILITY GOES BYTHE ADDRESS.
AND THE THE INFORMATION BULLETIN
IDENTIFIES THE THREE TREATMENT
PROGRAMS WITH THE ADDRESS SO. IT
DOESN'T MATTER WHAT CATEGORY OF
PERSON IS LIVING AT THE FACT
THAT THE ADDRESS.
UP IS IDENTIFIED AS A.
MISIDENTIFIED AS A PUBLIC
INSTITUTION.
A THEN EVERYBODY REGARDLESS OF
THEIR OWN STATUS IS POTENTIALLY
INELIGIBLE. CDC ARE WE'VE
ESTIMATED THERE'S APPROXIMATELY
ELEVEN HUNDRED PEOPLE IN THE
STATE.
WHO ARE CDC ARE?
ARE UNDER CDC ARE JURISDICTION
AND WE'VE WORKED WITH THE
DEPARTMENT OF CORRECTIONS IN THE
DEPARTMENT HEALTHCARE SERVICES
IN THE DEPARTMENT CORRECTIONS.
HAS WORKED WITH THE.
.
UP TO FIGURE OUT THAT THOSE
ELEVEN HUNDRED PEOPLE WHO ARE
ACTUALLY STILL UNDER THE
JURISDICTION OF.
CDC ARE IN PRE RELEASE.
I'M A BIG CITIES NOW NEGOTIATING
A STATE ONLY HEALTH CARE PROGRAM
FOR THOSE PEOPLE BECAUSE THEY
WILL BE SUSPENDED FROM MEDI CAL.
IT'S THE OTHER PEOPLE WHO ARE
LEFT
UP VULNERABLE TO BE.
DISQUALIFIED FROM THERE MEDI
CAL. AND THERE IS NO OTHER
SAFETY NET FOR THEM AND NO PLACE
ELSE THAT THEY CAN GO FOR HEALTH
CARE SERVICES IF THEY ARE
DISQUALIFIED EXCEPT TO.
EMERGENCY ROOMS AND THAT WORD
AND OTHER HIGH COST HEALTH CARE.
OF PROVIDERS AND THAT WE THINK
IS JUST UNDERMINES THE STATE'S
OUR WHOLE EFFORT OF.
OF REDUCING HEALTHCARE COSTS AND
PROVIDING ACCESS TO TREATMENT.
A SO UP SOMEHOW RATHER WE WOULD
JUST LIKE TO. GET THAT RESOLVED
SO THAT ARE TREATMENT PROGRAMS
WHO ARE. NONPROFIT COMMUNITY
BASED.
FIVE OH ONE C. THREE
ORGANIZATIONS ARE NOT IDENTIFIED
ON A PUBLIC WEBSITE AS THE
PRISON.
A IT IT ALSO FOR OUR OTHER
TREATMENT PROGRAMS IS BECOME
PUTS A CHILL ON OTHER TREATMENT
PROGRAMS WHO MIGHT. WANT TO
PARTICIPATE IN A CDC OUR PROGRAM
SUCH AS THIS.
BUT IT IT PUTS A CHILL ON THEIR
EFFORTS TO EXPAND SERVICES.
SO.
PERSON OTHER REASON THAT WE ARE
INTERESTED IN HAVING THIS
BULLETIN EITHER REVISED OR.
INFORMATION LETTER REVISED OR
RESCINDED SO THAT IT ACCURATELY
REFLECTS.
DOT THE CURRENT STATUS.
IT'S A. A COMPLICATED ISSUE.
SO.
THAT I THINK IS A FOR FOR THIS
SECTION THAT IS OUR OUR THREE
ISSUES THAT WE ARE.
WE ARE CONCERNED ABOUT AND
WOULD WELCOME ANY QUESTIONS YOU
MIGHT HAVE THANK YOU MISS MUCH
OUR NEXT WE'LL HEAR FROM
DEPARTMENT OF FINANCE AND THE LA
SHOW ON ISSUE.
IF YOU HAVE NO COMMENT THAT'S
OKAY TO.
NEXT WILL IT TAKE PUBLIC COMMENT
ON ISSUE ONE.
HI SHERRY DAILY CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS REPRESENTING
OVER FIVE HUNDRED. TREATMENT
CENTERS AND SEVERAL LIVINGS AND
THE STATE AND OVER TWENTY FIVE
THOUSAND COUNSELORS I WOULD JUST
URGE THE SUBCOMMITTEE TO TAKE A
SERIOUS LOOK.
AT THE WORK FORCE ISSUE AN
EXPANSION REQUIRES THAT WE HAVE
PROFESSIONALS WHO CAN TREAT
ADDICTION. AVAILABLE TO US STAFF
AND WORK WITH THE PEOPLE WHO
COME IN THE DOORS. ANDA OCPD AS
WELL AS THE FEDERAL GOVERNMENT
HAS. INDICATED THAT OUR
WORKFORCE IS A DISTRESSED WORK
FORCE SO. I CAPACITY EXPANSION
IS REALLY IMPORTANT SUIT TO OUR
CONCERNS WORKFORCE DEVELOPMENT
THANK YOU.
THANK YOU VERY MUCH SEEING NO
FURTHER PUBLIC COMMENT ON BRING
IT UP TO THE DYESS FOR ANY
QUESTIONS OR COMMENTS WE MAY
HAVE.
WHY?
HOW DID I MISS THAT AN ISSUE
ONE?
WE WERE TALKING ABOUT.
.
WE SEE. THAT THE TREATMENT
FACILITIES.
ARE WE COLLECTING COLLECTING
DATA ON THE NUMBER OF PATIENTS
ARE BEING DENIED INITIAL ACCESS
TO THOSE THAT ARE DISCHARGED
FROM TREATMENT AS A RESULT OF
THE OF THE CHANGES.
SO I THINK THIS IS IN REGARDS TO
THE REENTRY FACILITY YES. YES SO
I'M WE ARE WORKING AND BETWEEN
THAT COUNTIES.
AN OURSELVES TO.
READ YOU LOOK AT THE GUIDANCE
THAT WE ISSUED SO WE DON'T HAVE.
ANY AND DATA WE HAVEN'T HEARD
FROM ANYONE BEING REJECTED THIS
REALLY WAS.
.
AN ISSUE IN WHICH WE HAD
INDIVIDUALS WHO ARE NOT ELIGIBLE
TO RECEIVE MEDICAID SERVICES
BECAUSE THEY WERE NOT.
ON PAROLE SO THERE WAS A VERY
KIND OF FINE LEGAL DISTINCTION
BETWEEN THEM AND SO THE
FACILITIES THAT WERE.
IDENTIFIED IN THE LETTER
CERTAINLY ARE WE DON'T DISAGREE
THERE FIVE ONE C. THREES THEIR
TREATMENT FACILITIES THEY'RE
LICENSED AND OPERATED AS SUCH.
AND SO WE'RE WORKING TO EITHER
REVISE OR CLARIFY THE GUIDANCE
FOR INDIVIDUALS BECAUSE.
.
THE INDIVIDUALS THAT ARE WITHIN
THE CORRECTIONAL JURISDICTION
ARE IN A RE ENTRY PROGRAM AND
THERE'S A NUMBER OF.
WHO HAD THIS?
HAS QUITE STRONG THUNDER AND
THERE ARE SEVERAL REENTRY
PROGRAMS OF CORRECTIONS OPERATES
SO THERE'S LIKE THE FEMALE
OFFENDER PROGRAM THERE'S THE
SOMETHING SOMETHING AND SO WE
WANTED TO MAKE SURE WHEN WE
ISSUE THE GUIDANCE TO THE
COUNTIES BECAUSE THEY WERE ALSO.
CONFUSED BECAUSE YOU HAD
INDIVIDUALS THAT WERE SAYING
THAT THEY LIVE IN THESE
FACILITIES BUT THEY WERE UNDER A
CORRECTIONAL JURISDICTION SO
WE'RE TRYING TO MAKE SURE THAT.
THE GUIDANCE THAT WE GIVE TO THE
COUNTIES IS CLEAR WHICH IS IF
YOU'RE IN A CORRECTIONAL REENTRY
PROGRAM. NO MATTER WHERE YOU ARE
IN A IN THIS FACILITY OR AND.
A DIFFERENT TYPE OF.
HALFWAY HOUSE THAT IT'S NOT
NECESSARILY THAT ADDRESS THAT
MATTERS IT'S THE FACT THAT YOU
ARE STILL UNDER THE JURISDICTION
OF CORRECTIONS AND SO WE'RE
WORKING ON. KIND OF CLARIFYING
WHAT THAT BIDEN SAYS YEAH BUT MY
QUESTION WAS I AM.
HAS ANYBODY BEEN DENIED SERVICE
BECAUSE OF THIS NOW.
THERE HAD A PERCENT CORRECT.
I'M NOT AYE IT WE HAVE CHECKS
AND WE'VE BEEN WORKING CLOSELY
WITH CORRECTIONS WE'VE BEEN IN
CONVERSATIONS WITH THE PROVIDERS
AND. WE HAVE NO. DATA NO
EVIDENCE NOT A SINGLE COMPLAINT
THAT ANYONE HAS BEEN DENIED
SERVICE.
OKAY.
I WAS INTERESTED IN THE PUBLIC
COMMENT IF I COULD WE ARE
DESCRIBING MORE SERVICES AND.
TAKEN CARE OF MORE PEOPLE. WHAT
WHAT ARE WE DOING ON THE WORK
FOR SIDE OF THE EQUATION AND
SHOULD WE BE DOING MORE?
SURE SO I THINK.
.
THERE'S CERTAINLY A LOT OF
EFFORT UNDERWAY ON WAS A SISTER
DEPARTMENT OF OURS RATE SO
AWESOME IT WHICH IS OFFICES
STATEWIDE HEALTH PLANNING AND
DEVELOPMENT. THEY RUN SEVERAL.
WORK FORCE TYPE OF PROGRAMS I
KNOW THAT THERE HAS BEEN A LOT
OF EFFORT AND INTEREST ON THEIR
PART. I'M FOR BEHAVIORAL HEALTH.
PROVIDERS WHICH COULD SPAN THE
SPECTRUM OF ALL KINDS OF AND
DIFFERENT TYPES OF THINGS. WE
WORK AND WE CERTIFY THE
ORGANIZATIONS
TWO CERTIFYING ORGANIZATIONS
WITHIN OUR DEPARTMENT THAT
CERTIFIED DRUG AND ALCOHOL
COUNSELLORS THEY'RE NOT
LICENSED.
IN THE STATE PER SE BUT THEY
ARE CERTIFIED AND WE OVERSEE THE
CERTIFYING BODIES THEMSELVES.
TAKING A STEP BACK FROM ALL OF
THAT I THINK THAT WE.
HAVE ALWAYS ACKNOWLEDGED THAT
YOU CAN'T.
.
YOU CAN'T LIMIT THE NUMBER OF
PROVIDERS AND IN THIS PARTICULAR
AREA TO SPECIALTY PROVIDERS AND
SO WE HAVE BEEN TRYING REALLY
HARD TO GROW.
THE COMFORT LEVEL OF PRIMARY
CARE PHYSICIANS IN PARTICULAR.
AND THAT WOULD SPAN FROM
PRIMARY CARE PHYSICIANS TO NURSE
PRACTITIONERS AND OTHERS AND SO
WE HAVE AN INITIATIVE UNDER WAY
THAT'S USING FEDERAL MONEY.
CALLED THE HUB AND SPOKE
APPROACH AND SO WE HAVE.
NINETY MILLION DOLLARS OVER TWO
YEARS AND FEDERAL FUNDING WHERE
THE THE HUB IS A SPECIALIZED
PROVIDER LIKE A NARCOTIC
TREATMENT PROVIDER AND THE
SPOKES ARE PRIMARY CARE.
PROVIDERS AND OR CLINICS OUT IN
THE COMMUNITY AND REALLY WHAT
THE INTENT IS TO GROW THAT WORK
FORCE COMFORT AND.
THE AND GROW THE PIPELINE AND
CAPACITY BECAUSE IF INDIVIDUALS
HAVE A SUBSTANCE USE PROBLEM.
WHAT HAS TRADITIONALLY BEEN THE
RESPONSE FROM A PRIMARY CARE
PROVIDER IS IS?
I'M GONNA HAND YOU OFF TO
SOMEONE ELSE WHO HAS A SPECIALTY
AND SUBSTANCE USE TREATMENT AND
I THINK THAT WE. ALL KNOW THAT
THAT'S JUST SIMPLY NOT POSSIBLE
GIVEN THEN NUMBER OF INDIVIDUALS
THAT STRUGGLE WITH THIS DISEASE
AND SO.
A LOT OF WORK BETWEEN OSP HEAD
AND WITH OUR FEDERAL GRANT HAS
BEEN AROUND ON INCREASING THE
CAPACITY AND AVAILABILITY OF
THOSE PROVIDERS.
THELAST THING I KNOW IS THAT
THERE'S CERTAINLY BEEN AN EYE
FOR AN INTEREST IN AND
DEVELOPING PEER. SUPPORT
SPECIALISTS IN THE LEGISLATURE I
THINK THERE'S SOME LEGISLATION
THAT IS PENDING THIS YEAR THERE
WERE SOME AND A COUPLE OF
PREVIOUS YEARS AGO WHERE.
IT'S SOMEWHAT SIMILAR TO
PERMITS PHOTOS IN TERMS OF YOU
HAVE INDIVIDUALS WHO HAVE THE
LIVED EXPERIENCE OF ON THEIR OWN
STRUGGLES WITH ADDICTION AND
WORKING WITH OTHER INDIVIDUALS
THAT ARE UNDERGOING A SIMILAR.
PROCESS AND SO WE'VE BEEN I'M
TALKING ABOUT HOW WOULD THAT BE.
BOTH DEVELOPED FROM A
CURRICULUM AND OVERSIGHT
PERSPECTIVE ON THE FUNDING IS
CERTAINLY OBVIOUSLY IMPORTANT.
HILL TO GET OVER BUT I THINK
THAT ALL KIND OF GHOST YOUR
LARGER QUESTION WHICH IS WE
THINK THAT WE NEED MORE CAPACITY
IN THE STATE AND THERE'S A.
BUNCH OF DIFFERENT INITIATIVES
THAT ARE GEARED TOWARDS THAT.
IS PRIMARY CARE THE ONLY AVENUE
WE SHOULD BE LOOKING AT TO
TACKLE THIS COMPLEX PROBLEM.
IT SEEMS THAT OUR SAFETY NET
HAS.
A MULTITUDE OF ENTRY POINTS AND
I'M JUST REFLECTING BACK ON MY
EXPERIENCE IN THE ER.
AND HOW MANY PEOPLE I SAW WHO
CAME TO SEE ME. I WONDER IF
THERE'S A PLACE TO DISCUSS
DETOXING IN AN EMERGENCY ROOM.
ONLY BECAUSE YOU'RE MORE
SUPERVISED.
YOU'RE ACTUALLY CONNECTED TO
EQUIPMENT YOU HAVE THE
AVAILABILITY TO DO THE.
MORE INTENSE DETOXIFICATION THIS
THAT CAN OCCUR IN I'M JUST
TRYING TO WAY THROUGH. IF IT'S
ONLY PRIMARY CARE THAT WERE
FOCUSED ON OR OFF WERE CAPABLE
OF. HAVING A DISCUSSION ABOUT
THE MULTITUDE OF AREAS I MEAN I
THINK.
IT COMES IN A MULTITUDE OF
VARIOUS RIGHTS OF THE VOLUNTARY
INPATIENT DETOX BENEFIT.
.
AS US THE BEACH DAY PREVIOUSLY
NOTED WAS A BENEFIT THAT WE
ADDED IN TWENTY FOURTEEN ON IT
IS ONLY IN A HOSPITAL SETTING.
DUE TO A LOT OF REASONS AT THE
TIME WE DIDN'T HAVE AN AYE ANDY
WAIVER BECAUSE WE HADN'T GOTTEN
ELEVEN FIFTEEN WAIVER. ON
MEDICAID HISTORICALLY HAS A THE.
A BIAS TOWARDS IT THEY CALLED
AN INSTITUTIONAL BIAS RIGHT
MEDICAID PROGRAMS IN THIS IS NOT
JUST CALIFORNIA BUT NATIONALLY.
MEDICAID FUNDS INSTITUTIONAL
CARE THEY DON'T FUND RESIDENTIAL
OR LOWER LEVELS OF CARE AND SO
WOULD NOT BENEFIT WAS
CONSTRUCTED IN TWENTY FOURTEEN
IT WAS DONE KIND OF IN THE
MINDSET OF WHAT WAS ALLOWED AT
THE. UNDER THE FEDERAL GUIDANCE.
THAT BEING SAID I THINK THAT.
.
THE ONLY THING I WOULD WANT TO
SAY ABOUT EMERGENCY ROOMS IS THE
CAPACITY FOR OTHER TYPES OF BEDS
RATE AND OBVIOUSLY WITH THE
SERIOUS MENTAL ILLNESS.
AND SOME OF THE INDIVIDUALS
THAT COME INTO EMERGENCY ROOMS
AND A AND A SERIOUS CASE THERE
YOU WOULDN'T WANNA. THERE'S A
REALLY LIMITED THAT CAPACITY.
THE LAST THING I'LL SAY AND I
THINK THAT COMMITTEE HEARD THIS
LAST WEEK.
IN TERMS OF SENATOR MITCHELL'S
BILL AND TO IMPLEMENT THE
ALLOWANCE FOR SUBSTANCE USE
TREATMENT AND.
SPECIAL TO IN A WHOLE SERVICES
AN FQHC SETTINGS AND HOW WE'RE
GOING TO DO THE. BOTH THE
BILLION AND THE PAYMENT
ASSOCIATED WITH THAT I THINK
THAT THERE'S ELEVEN HUNDRED
FQHCS IN THE STATE OF
CALIFORNIA.
CRITICAL BACKBONE OF PROVIDER
SUPPORTER AND CAPACITY AND SO.
IT THERE'S A HOT BUT THERE'S A
ROLE FOR HOSPITALS THERE'S A
ROLE FOR CLINICS THERE'S A ROLE
FOR PRIVATE PROVIDERS THERE'S A
ROLE FOR PEER SUPPORT ANY. THERE
IS A FULL KIND OF COMPLEMENT OF
BOTH SERVICES AND CAPACITY THAT
WE AS A DEPARTMENT THAT MORE
BROADLY ARE YOU KNOW ALL KINDS.
PITCHING AND ON DIFFERENT
ASPECTS OF IT CAN YOU TALK A
LITTLE BIT MORE ABOUT S. BIRD.
.
AND.
ONE OF THE QUESTIONS WE HAD ON
OUR AGENDA WAS IS IT ONLY
REIMBURSABLE AND PRIMARY CARE
SAID SON I'M TRYING TO.
PUSH AGAIN ON PRESS ANGLED BUT.
CAN YOU ELABORATE ON WHAT WE
HEARD THAT IT'S ONLY ALCOHOL
SURE IS IT POSSIBLE FOR US TO
CONSIDER WHAT. WOULD HAPPEN IF
WE WANTED TO EXPAND ITS OR TO
INCREASE THE SCOPE SURE. SO.
.
STEPPING BACKTO TWENTY FOURTEEN
WHEN I SAID THAT WE HAD A COUPLE
OF BENEFITS WE HAD TO ADD AS A
AS A.
TO COME INTO COMPLIANCE WITH
THE ESSENTIAL HEALTH BENEFITS
ASPER WAS ONE OF THEM. AND I CAN
GET BACK TO YOUR STAFF TO
CONFIRM THIS BUT WHEN WE ADOPTED
THAT PARTICULAR BENEFIT IT WAS
USING THE U. S. PREVENTATIVE.
SERVICES TASK FORCE
RECOMMENDATIONS SO THEY HAVE A
IN BE RECOMMENDATIONS AND SO I
THINK WE TOOK WHAT AT THE TIME
WAS THE U. S. PREVENTIVE TASK
FORCE RECOMMENDATION WHICH WAS
PRIMARY CARE SETTING. ALCOHOL
AND I THINK THAT IT IS POSSIBLE
TO ADD EITHER ADDITIONAL
LOCATIONS.
OR ADDITIONAL.
EITHER ALCOHOL AND OTHER DRUGS
IT JUST GETS INTO THAT'S JUST A
FISCAL THING WHICH IS
APPROPRIATE FOR THIS KIND OF
COMMITTEE TO CONSIDER WHETHER
YOU WANTED TO EXPAND THAT.
.
SO WAS THAT DECISION THAT AGAIN
SHOWS ONLY PRIMARY CARE AND
ALCOHOL TRACK AND YOU SAID THERE
WERE A AND B..
UP I GUESS ALL FOLLOW UP AT A
DIFFERENT TIME IF I CAN.
.
I WANTED TO TRANSITION IF I
COULD TO COUNTY OF SERVICE
RECESS COUNTY OF RESPONSIBILITY.
MAYBE IT WAS BECAUSE ALSO STILL
COUNTY LINE.
BUT.
.
I'VE SEEN THIS ONE TOO MANY
TIMES YEAH AND I'M WONDERING IF
THERE'S A STATEWIDE FIX AND
LOOKING FOR. REAL ANSWERS IT. IT
SEEMS THAT.
THE ADVOCATE BEFORE IT SAID
THAT THERE WERE THREE THAT THEY
PLACED ON THE TABLE. IS THERE
SOMETHING AT THE STATEWIDE LEVEL
THAT WE SHOULD BE LOOKING AT SO
THAT WE'RE NOT. REINVENTING THE
WHEEL EACH TIME A COUNTY IS
LOOKING TO TO THE US
SURE SO ASSEMBLY BILL TWELVE
NINETY NINE BY A FORMER
ASSEMBLYMEMBER RIDLEY THOMAS
WAS.
.
SUPPOSED TO BE THAT FIX.
I THINK IT WAS MULTI YEARS IN
THE NEGOTIATING I THINK IT IS
STILL FAIRLY NEW I BELIEVE IT
WAS SCIENCE TWO SESSIONS AGO.
BECAME.
EFFECTIVE MAYBE A YEAR A YEAR
AGO LAST JANUARY NOT THIS
PREVIOUS JANUARY.
.
THERE'S A COUPLE THINGS THERE'S
THE AB TWELVE NINETY NINE
IMPLEMENTATION WHICH ESSENTIALLY
SAYS WHENEVER AND. RECEIVES
SERVICES AND COUNTY IT IS THAT
COUNTIES RESPONSIBILITY TO.
PAY FOR THOSE SERVICES.
AND I'M SIMPLIFYING IT VISITS
COMPLICATED AND THERE'S ALSO THE
INTERACTION WITH COUNTY
REALIGNMENT SO WHEN WE DID
REALIGNMENT AND TWO THOUSAND AND
ELEVEN AND THAT WAS THEN
CODIFIED BY THE BALLOT
INITIATIVE AND PUTTING INTO THE
CONSTITUTION THE
RESPONSIBILITIES BETWEEN THE
COUNTIES IN THE STATE IN THE.
REVENUE SOURCES.
THE COUNTIES ARE NOW PAID.
THROUGH THEIR BEHAVIORAL HEALTH
SUB ACCOUNT.
FOR CERTAIN SERVICES AND
SUBSTANCE USE DISORDER SERVICES
ARE ONE OF THOSE AND SO THAT
COUNTIES HAVE THE FUNDING THAT
HAS BEEN PROVIDED TO THEM FOR
THOSE SERVICES. AND SO WHAT
YOU'RE SEEING I THINK ARE THE
GROWING PAINS.
AND STILL TRYING TO FIGURE OUT
THE WRINKLES BETWEEN COUNTY OF
RECORD COUNTY OF SERVICE.
YOU HAVE CERTAIN COUNTIES THAT
ARE.
.
MORE WILLING AND CAPABLE OF
CONTRACTING WITH PROVIDERS AND
DOING THAT.
WE ALSO STRUGGLE WITH OTHER
PROVIDERS ARE OTHER COUNTIES
THAT ARE NOT AS NIMBLE WHEN IT
COMES TO CONTRACTING WITH
PROVIDERS AND SO WE HAVE ISSUED
GUIDANCE.
TO THE COUNTIES ON THROUGH OUR
SIDE ON THE INFORMATION NOTICE.
I THINK I'M AND WE'VE BEEN
WORKING WITH THE PROVIDERS AS
WELL TO KIND OF HIGHLIGHT THE
FACT THAT COUNTIES HAVE
RESPONSIBILITIES IN THIS AREA IT
IS STILL NOT.
AB TWELVE NINE NINE DIDN'T
NECESSARILY SOLVE ALL OF THOSE
THINGS IMMEDIATELY AND SO WE'RE
STILL KIND OF COMMITTED TO.
TRYING TO WORK THROUGH WITH BOTH
THE PROVIDERS IN THE COUNTIES AS
TO HOW THEY SHOULD BE BOTH
CONTRACTING WITH EACH OTHER AND
ARE PAYING FOR SERVICES. IS
THERE ANYTHING WE SHOULD BE
DOING ON THE SHORT TERM TO HELP
WITH THAT IT'S THIS.
JUST GROWING PAINS GETTING
THROUGH TWELVE NINE TO NINE ARE
IS THERE SOMETHING STATUTORILY.
THAT WOULD BE NEEDED.
I DON'T KNOW I DON'T KNOW THE
ANSWER TO THAT.
IT ALSO HAS RAMIFICATIONS NOT
JUST ON SUBSTANCE USE DISORDER
IT HAS.
RAMIFICATIONS ON THE CHILD
WELFARE SIDE WHICH IS WHERE A
LOT OF THE CONVERSATIONS ARE
OCCURRING TODAY.
AS THE DEPARTMENT OF SOCIAL
SERVICES.
IMPLEMENTING THEIR CONTINUUM OF
CARE REFORM AND.
.
TURNING GROUP POEMS INTO SHORT
TERM THERAPEUTIC.
PROGRAMS.
THOSE ES CHARITY PEAS AS THEY'RE
KNOWN I'M ARE GOING TO BE IN
DIFFERENT COUNTIES AND CHILDREN
FROM DIFFERENT COUNTIES ARE
GONNA BE PLACED IN S. YOUR
TEEPEES AND SO THIS. ISSUE
AROUND COUNTY OF RESIDENCE IN
COUNTY OF SERVICES ALSO VERY
MUCH.
A BIG DISCUSSION ITEM AND SO WE
WILL BE AND WE HAVE BEEN TALKING
WITH THE COUNTIES BOTH ON THE
CHILD WELFARE SIDE. AS WELL AS
ON THE BEHAVIORAL HEALTH SIDE
ABOUT THOSE FISCAL
RESPONSIBILITIES.
THE SAME.
KIND OF TENSION APPLIES ON THE
SUBSTANCE YOU SIDE AND SO I'M
SITTING IN BOTH CONVERSATIONS
AND I'M NOT SURE THAT WE.
COLLECTIVELY HAVE A.
I THOUGHT AROUND STATUTORY
IMPROVEMENTS BUT CERTAINLY TO
THE EXTENT THAT WE IDENTIFY
SOMETHING THAT WOULD MAKE THAT.
MORE AND NIMBLE IN TERMS OF HOW
THOSE FUNDS GET EITHER. RELEASE
DISTRIBUTED OR HOW CONTRACTING
CAN BE BETTER DONE I THINK.
WE WOULD CERTAINLY COME BACK TO
THE LEGISLATURE ON THE.
IRV.
A PLEASE NO.
WELL THAT WAS MY.
OKAY SOME.
MY FINAL QUESTION IF I CAN AND
I.
.
ALWAYS TALK ABOUT OUTCOMES BUT
REALLY I'M TRYING TO. FIGURE OUT
WHAT IS IT THAT WE'RE DRIVING
FOR WITH OUR. CURRENT STATE PLAN
WHICH OUTCOMES ARE METRICS ARE
WE. WORKING ON IN RELATIONS TO
SUBSTANCE ABUSE THAT ARE MAKING
DIFFERENCES AND.
OUR WE TRACKING ALMOND AND WHEN
DO WE EXPECT OUR FIRST DATA
POINTS BACK YEAH GREAT QUESTION.
SO THE COUNTIES THAT ARE.
DISSIPATING IN THE ELEVEN
FIFTEEN WAIVER AS A CONDITION
FOR THE FEDERAL FUNDS AND FOR
BEING A WAIVER WE HAVE TO DO AN
EVALUATION. SO.
UCLA IS OUR.
DESIGNATED.
ENTITY THAT WILL BE DOING THAT
OUTSIDE INDEPENDENT
EVALUATION SAID THEY HAVE BEEN.
BOTH RECEIVING AND GETTING DATA
FROM THE OUTSIDE AND I THINK
WHAT'S GOING TO BE INTERESTING
IN TERMS OF.
DOES THIS EXPERIMENT WORK IS WE
HAVE A REALLY GOOD.
TEST CASE IN CALIFORNIA NOW
BECAUSE WE HAVE COUNTIES THAT
ARE IMPLEMENTING IT VERSUS
COUNTIES THAT ARE NOT.
INDIVIDUALS THAT ARE USING THE.
THAT.
KEPT.
BENEFICIARIES THAT ARE IN THE
COUNTIES WHERE THE WEAVER EXISTS
HAVE THE ABILITY TO ACCESS THOSE
SERVICES IT IS A CASE IT IS
LIMITED TO THE RESIDENTS OF THAT
COUNTY SO IF YOU ARE AND. I'M
FOR SAY.
ORANGE COUNTY AND YOU WANT TO
PARTICIPATE IN LA COUNTY'S
WAIVER IT'S LIMITED ONLY TO THE.
RESIDENTS WITHIN THAT COUNTY IF.
SERVICE AND THAT'S THAT WAS
VERY MUCH.
SPECIFIC TO THE FEDERAL TERMS
AND CONDITIONS OF THE WAIVER.
SO I THINK THAT ON SOME OF THE
DATA THAT WE ARE ABLE TO SEE IN
THERE IN TERMS OF.
POSITIVE OUTCOMES.
REDUCTION IN UTILIZATION OF E.
R. I'M CERTAINLY WE ARE TRACKING
CLOSELY AND.
YOU'LL PROBABLY HEAR FROM
DEPARTMENT OF PUBLIC HEALTH
LATER AND I I LIKE TO GIVE THEM
PROPS ON THEIR APPEAL A
DASHBOARD. SO WERE ALSO YOU KNOW
AS A STATE INTERESTED IN.
EITHER THE. OVERDOSE OR DEATH
RATES ASSOCIATED WITH OPIOIDS
THE REALLY KEY INDICATOR WE
OVERSEE THE AND DO YOU AYE
PROGRAMS IN THE STATE SO WE'RE
ALSO LOOKING AT OBVIOUSLY RATES
OF.
ARREST LATE IN A BECAUSE OF
IMPAIRED DRIVING SO THERE'S A
LOT OF DIFFERENT METRICS THAT WE
USE ARE THEY ALL KIND OF ROLLED
UP INTO ONE NEEDS. DASHBOARD
PROBABLY NOT THE OPIOID
DASHBOARD IS ONE THAT I THINK IS
REALLY GOOD BUT THE.
EVALUATION HAS BEEN SUBMITTED
TO THE FEDERAL GOVERNMENT TERMS
OF THE PLAN BY UCLA AND SO I'M
HAPPY TO SHARE THAT WITH YOU IS
AS WELL AS BECAUSE THAT'S
CRITICAL TO GETTING. CONTINUED
SUPPORT FOR THOSE FUNDS IS
SHOWING THAT IT ACTUALLY WORKS.
SOMEONE WHO RUBIO.
.
THIS IS ALL ABOUT FUNDING.
WHEN I WALKED IN THAT WE WERE
TALKING ABOUT.
THE DIFFICULTIES AND AND SOME
OF THE OPERATORS BEING PAID CAN
YOU TALK A LITTLE BIT ABOUT WHAT
THAT THE HOLD UP IS.
WHICH.
YOU'RE KIDDING ME.
.
WHICH WHICH WHICH TO SLIP UP
PROVIDED COULDN'T.
IT WAS JUST ON THE COUNTY OF
RESPONSIBILITY VERSUS THE COUNTY
OF RECORD WHICH IS WHAT THAT
THAT'S THE TWELVE NINETY NINE
ISSUE THAT I JUST TALKED ABOUT.
SO I THINK THAT'S KIND OF WHAT
THAT'S JUST WHAT WE WERE JUST
TALKING ABOUT IS THAT WRITER
BUDDIES I DIDN'T HEAR THE FIX
THOUGH I I IT WASN'T SPECIFIC IT
WAS A WHOLE BUNCH OF INFORMATION
BUT. IS THERE A SPECIFIC FIX OUR
IS OUR TIMEFRAME IS THERE
ANYTHING THAT I THAT WE CAN
EXPECT AND I IN TERMS OF
OUTCOMES.
.
DO YOU EXPECTED FOR THIS WE FIX
THIS YEAR WHAT YOU EXPECT.
AND I THINK A LOT OF IT DEPENDS
ON THE I'M SO THE LAWS THE LAW
RATES OF THE STATUTE THAT WAS
PASSED
COUPLE OF YEARS AGO.
AND WAS CARRIED BY MR RIDLEY
THOMAS WAS WHAT'S CLEAR IT SAID
THAT THE COUNTY IS RESPONSIBLE
FOR. THE SERVICES I THINK THAT
WE HAVE BEEN PUTTING AS MUCH ON
TECHNICAL ASSISTANCE AND
INTENTIONAL EFFORT INTO WORKING
WITH THE COUNTIES WHO DO HAVE
THE FISCAL RESPONSIBILITIES AND
HAVE THE REALIGNMENT FUNDING. TO
DELIVER THE SERVICES I THINK WE.
WORK CLOSELY WITH THE PROVIDERS
AND THE COUNTIES TO TRY TO HELP
BRIDGE THOSE
COMMUNICATION GAPS AND KIND OF
CREATE THOSE RELATIONSHIPS THAT
HAVE NOT BEEN IN PLACE BEFORE
BUT. WE DON'T HAVE A SOLUTION AS
A STATE BECAUSE THE FUNDING IS
NO LONGER OURS TO ADMINISTER AND
THE CONTRACTS ARE NO LONGER OURS
TO.
EITHER DEVELOPER EMPLOYMENT
THERE BETWEEN THE COUNTIES IN
THE PROVIDERS AND SO.
WE CAN ENFORCE THE LAW THE WAY
IT IS BUT I THINK WE'RE ALSO
TRYING TO.
HELP.
HELP THEM CREATE THESE
RELATIONSHIPS I DON'T HAVE A.
THAT NECESSARILY A SOLUTION OR A
TIME FRAME SO YOU SAW IN THE
MEANTIME WHILE THIS IS HAPPENING
THERE'S NOTHING BEING DONE AND
THEN THERE AND FROM TO MAKE SURE
THAT THESE GUYS SERVICES ARE
BEING PAID FOR SOME PEOPLE ARE
JUST BASICALLY. NOT RECEIVING
THE SERVICES NO I WOULDN'T I
WOULD NOT SAY THAT.
ON THE SUBSTANCE YOU SIDE IN
PARTICULAR WE HAVE BEEN WORKING.
WITH THE COUNTIES TO. VALIDATE
THE SERVICES THAT THEY ARE
CERTIFIED TO PROVIDE WE HAVE
BEEN LOOKING AT THE SERVICES
THAT THEY HAVE BEEN BILLION
THROUGH OUR SYSTEM.
I THINK THAT THAT COUNTIES HAVE
ALSO.
BEEN HEARING FROM BOTH THE
PROVIDERS AND US AS A STATE TO
SAY YOU HAVE A RESPONSIBILITY TO
PROVIDE THE SERVICES AND IT'S
YOUR RESPONSIBILITY TO CONTRACT
WITH THE PROVIDERS TO DELIVER
THE SERVICES. AND I THINK WE
HAVE HAD.
VARYING DEGREES OF.
RECEPTIVITY FROM THE COUNTIES I
THINK THAT YOU HAVE SOME
POLITICAL. ON ISSUE SOMETIMES IN
DIFFERENT COUNTIES WERE BOARDS
OF SUPERVISORS MAY OR MAY NOT.
WANT TO CONTRACT FOR THE
SERVICES I THINK SOME COUNTIES
ARE LESS AND SOPHISTICATED IN
THEIR CONTRACT IN A PRESS I CAN
YOU CAN YOU REPEAT THAT SO THAT
THEY'RE NOT WILLING TO TO
CONTRACT FOR THE SERVICES BUT
YET THEY WERE RECEIVING THE
MONEY.
SO THEN WHAT'S HAPPENING TO THE
MONEY I'M SO THOSE COUNTIES ARE.
GOING TO BE PUT UNDER A
CORRECTIVE ACTION PLAN BY US
WHEN WE WE'VE HAD NUMEROUS
CONVERSATIONS WITH ONE
PARTICULAR COUNTY WHERE WE'VE
SAID IT'S YOUR RESPONSIBILITY TO
DO THIS AND THEY HAVE.
DECLINED AND SO WE'RE GOING TO
THERE IS A MECHANISM IN THE LAW
THAT ALLOWS FOR US TO TAKE THE
FUNDS OUT OF THEIR BEHAVIOR
HOUSE OF ACCOUNT AND DELIVER THE
SERVICES ON AROUND.
AND THE ENTIRE STATUTE THAT
ALLOWS RIGHT AND THEN.
CAN I HAVE MORE INFORMATION ON
WHAT THE STATUE OF RELATES LIKE
HOW LONG.
DO WE WAIT UNTIL WE HOLD THESE
COUNTIES ARE ACCOUNTABLE FOR THE
MONEY THAT THEY'RE NOT BEING.
NOT HAPPY TO PROVIDE YOU A FIFTY
HAVING LATELY AND NOW THAT YOU.
IS IT A YEAR IS A TWO YEARS THAT
THAT WE HAVE.
THERE.
THIS COUNTY WE HAVE BEEN IN
DISCUSSIONS WITH THEM ABOUT
PROVIDING AND NEEDING TO PROVIDE
SERVICES FOR PUBLIC SIX MONTHS.
AND WERE AT THE END OF OUR
LIMITS IN TERMS OF WHAT WE'RE
WILLING TO PUT UP WITH IN TERMS
OF DELAYS SO SO SO FOR ANY OTHER
COUNTY DOES THE SAME THING WOULD
YOU EXPECT SOME KIND OF.
.
ACCOUNTABILITY MECHANISMS TO
HAPPEN WITHIN SIX MONTHS OF THEM
NOT DELIVERING THE SERVICES
THERE ARE MECHANICAL ISSUES THAT
WE HAVE TO WORK OUT WITH
DEPARTMENT OF FINANCE THE
STATUTES VERY CLEAR. ABOUT.
WHAT HAPPENS WHEN A COUNTY
REFUSES TO ADMINISTER A CONTRACT
FOR EXAMPLE AND THEN THE
DEPARTMENT OF FINANCE HOUSE TO
WE HAVE TO MAKE A FINDING TO THE
DEPARTMENT OF FINANCE THEN THE
STATUE LAYS OUT THAT THE
DEPARTMENT OF FINANCE RECEIVES?
AND CAN TAKE MONEY FROM THAT
BEHAVIORAL HEALTH SUB ACCOUNT
WITHIN AND AND IN TERMS OF THAT
SO BEFORE ALL OF THIS HAPPENED
SO THEY THEY WERE FIGHTING THE
SERVICES ARE WE WERE PROVIDING
THE SERVICE THE STATE WAS
PROVIDING DIRECT.
SERVICES OKAY AND NOW THAT THE
MONEY'S BEEN TRANSFERRED THERE
JUST AND REFUSING TO DO THE
TRACKS IT SAYS.
IT WAS OF IT SAID NADA.
NOT A BAD THING IT WAS JUST A
NATURAL AND.
DOCTOR OF HOW REALIGNMENT WORK
TRACE OF THE STATE WHEN THEY DID
THE REALIGNMENT DEAL SAID THESE
ARE SERVICES THAT WILL BE
DELIVERED AT A LOCAL LEVEL. AND
AS A RESULT OF THEM BEING
DELIVERED AT A LOCAL LEVEL
THERE'S A DEDICATED REVENUE
SOURCE THAT COMES TO THEM TO
DELIVER THOSE SERVICES. AND WE
KNOW WE HAVE FIFTY EIGHT
COUNTIES AND OBVIOUSLY FIFTY
EIGHT DIFFERENT WAYS OF DOING
THINGS AND SOME COUNTIES HAVE.
DONE THAT AND OTHER COUNTIES
HAVE BEEN A LITTLE BIT SLOWER
AND SO WE TRY TO WORK ON A
TECHNICAL ASSISTANCE BASIS FIRST
AND.
.
YOU KNOW WHAT KIND OF HELP
PEOPLE ALONG AND THEN IF IN THIS
CASE WE HAVE ONE COUNTY THAT HAS
JUST NOT COOPERATED AND SO
THERE.
THEY'RE GONNA HAVE SOMETHING
DIFFERENT HAPPENED SO SO IF THE
MONEY IS I'VE TAKEN AWAY FROM
FROM THE COUNTIES AND THE STATE
IS BACK TO. WRITING THE SERVICES
WE WILL TAKE THE MONEY OUT OF
THE COUNTIES ACCOUNT.
I MEAN I UNDERSTAND BUT BUT THE
SERVICES ARE NOT BEING ARE NOW
I'M I'M PRESUMING THAT THAT
SERVICES ARE BEING PROVIDED
WITHIN THAT COUNTING FROM STIFF
FOR WITH THE COUNTY THEY'RE
GETTING SERVICES THROUGH
PROVIDERS IN OTHER COUNTIES OKAY
AND SO THAT IS THE THAT IS THE
RUB IS THAT SOME OF THESE
PROVIDERS. ARE WE WORRIED THAT
THEY'RE NOT GOING TO RECEIVE
FUNDING BECAUSE THAT PARTICULAR
COUNTY IS NOT WANTING TO. PAY
FOR THEM AND SO WE ARE NOT GOING
TO LET THAT HAPPEN RIGHT THAT IS
WHY WE ARE IN THIS SO WE HAVE
THE ASSURANCE THAT EVEN.
THAT BAD OF FOLKS ARE GETTING
TREATMENT AND ABOUT WHETHER THE
COUNTY PAYS SOME OF THE STATE
PEACE SOMEDAY WE'LL GET PAID FOR
THOSE SURPRISE. MY BOTTOM LINE
SOME BOTH MY STAFF AND OTHERS IS
PEOPLE NEED SERVICES THEY ARE.
ENTITLED TO THE SERVICES
BECAUSE WE RUN AN ENTITLEMENT
PROGRAM AND SO THEY'RE ENTITLED
TO RECEIVE WHAT THEY'RE ENTITLED
TO RECEIVE. AND WE WILL TAKE
CARE OF IT AND THEN IF WE NEED
TO BACK OUT MONEY FROM THE
COUNTIES ON THE BACK AND THEN
WE'LL DO THAT THAT WERE NOT IN
THE.
BUSINESS OR INTEREST OF HAVING
SERVICES GET TONIGHT WHAT AB AND
NOW MY CONCERN THOUGH IS THAT IN
THE MEANTIME.
Y. WHERE YOU KNOW GOING THROUGH
THIS.
PROCESS TO IT FOLKS HAVE A MAN
GETTING. EITHER SERVICES OR
PROVIDERS HAVE BEEN PAID FOR SIX
MONTHS ITSELF I'M A PROVIDER I'M
DISCOURAGED I THINK WAS SAID
EARLIER I'M DISCOURAGED FROM
PROVIDING SERVICES BECAUSE I
HAVEN'T GOTTEN PAID. AND THEN IF
I'M.
THIS YEAR OF A BENEFICIARY OF
THESE SERVICES I'M NOT GETTING
THE SERVICES BECAUSE IN THE
MEANTIME. THE THE PROVIDERS ARE
BEING SKEPTICAL THAT THEY'RE NOT
GOING TO GET PAID SO SOMEWHERE
ALONG THE LINE THERE'S SOME
FOLKS THAT ARE NOT RECEIVING
TREATMENT.
IS WHAT. KIND OF I'M LOOKING
THROUGH THE WE'VE BEEN WORKING
ON.
COUNTY BY COUNTY PROVIDER BY
PROVIDER BASIS ON CONTRACTING
ISSUES AND SO I'M AT THIS POINT
IN TIME I AM NOT AWARE THAT
PEOPLE ARE NOT GETTING SERVICES
BUT IF YOU HAVE EVIDENCE THAT
CONTRARY AND HAPPY TO FRIGHTEN
ANNOYED SO I WOULD LIKE. TO SEE
IF THERE IS EVIDENCE OFNO I AND
I KNOW YOU GUYS HAVE SOME KIND
OF A DATABASE I WOULD. PRESUME
THAT THAT TELLS YOU HOW MANY
PEOPLE HAVE BEEN SERVICE AND WE
CAN COMPARE FROM THE LAST YEAR
TO THIS YEAR OR WHATEVER IT MAY
BE. THAT'S NUMBER ONE BUT NUMBER
TWO.
BE OUT IN TERMS OF OUTCOMES
HAVE WE SEEN AN INCREASE AYE AND
SERVICES OR AN INCREASE AND.
YOU KNOW ISSUES THAT THESE
FOLKS ARE HAVING BECAUSE THEY'RE
NOT RECEIVING SERVICES OR IS
THERE ANY NO EVIDENCE OF OF.
OVERDOSES OR DEATH BECAUSE OF
THE SERVICES ARE NOT BEING
PROVIDED TO WE KEEP ANY KIND OF
IDEA LIKE THAT.
SO THE OPI DASHBOARD THAT I
REFERENCED EARLIER THAT'S
MAINTAINED BY DEPARTMENT PUBLIC
HEALTH SHOWS OPIOID OVERDOSE AND
DEATH RATES BY COUNTY HOME.
I THINK GIVEN THE.
DOES IT DO A COMPARISON FROM
THE PREVIOUS YEAR AND THE YEAR
BEFORE COULD NOT BELIEVE SO BUT
I WOULD. I WOULD CERTAINLY DEFER
TO MY COLLEAGUES AT THE
DEPARTMENT OF PUBLIC HEALTH.
.
WE DON'T HAVE A WE KNOW HOW MANY
UNITS OF SERVICE THAT WE'VE
DELIVERED ON A YEAR TO YEAR
BASIS.
SO FOR EXAMPLE ENOUGH IN THE
DATA THAT I CITED EARLIER.
FOR LOS ANGELES COUNTY WITH THE
FUNDING SOURCES THAT THEY HAVE
RECEIVED UNDER THE ODS WAIVER.
THEY'VE DELIVERED APPROXIMATELY
THREE MILLION UNITS OF SERVICE
AND THAT COULD BE RESIDENTIAL
THAT COULD BE OUT PATIENT COULD
BE MEDICATIONS HAS TO TREATMENT.
I'M ON A COUNTY BY COUNTY BASIS
WE CAN SAY YEAR OVER YEAR HOW
MANY UNITS OF SERVICE WERE
DELIVERED.
BUT IT ALSO.
.
IS INCLUSIVE OF ALCOHOL OTHER
SUBSTANCES I'M SO IT'S NOT
NECESSARILY LIMITED TO OPIOID SO
THERE'S THERE ARE.
HOW MANY UNITS OF SERVICE HAVE
BEEN DELIVERED BY THE COUNTIES.
I THINK.
WOULD REDUCE WHICH. I KNOW I
SAID LAST QUESTION BUT THIS IS
THE LAST QUESTION.
REGARDING PROP SIXTY FOUR IT
CAN WE TALK A LITTLE BIT ABOUT
WHEN WE EXPECT TO START
COLLECTING REVENUE SPENDING
PRIORITIES.
TO SOME OF THE GENERAL
QUESTIONS WE HAD THE AGENDA SO
CHRIS CUT FROM FINANCE.
I BELIEVE THE BUDGET YEAR AND I
DON'T HAVE THAT FORGIVE ME I
DON'T HAVE THE EXACT NUMBER OF
FROM ME BUT I BELIEVE THE BUDGET
YEAR DOES. REFLECT SOME REVENUES
COMING IN FOR. PROPOSITION SIXTY
FOUR.
.
SPECIFICALLY FOR DH CSO THE
BUDGET HERE DOES NOT REFLECT ANY
REVENUE SPECIFICALLY FOR THAT
DEPARTMENT SO BASED ON THE TAX
THAT THE. THE LAW THAT WAS
IMPLEMENTED.
THERE'RE A PRIORITIES TO WHICH
WHICH DEPARTMENTS RECEIVE
FUNDING DHS BEING NOT IN THE TOP
PRIORITY BUT ONE OF THEM.
ON THE LOWER END OF THE SPENT
ON THE PARTY LIST.
AND SO THEY HAVE. THOSE ARE NOT
CONTEMPLATED FOR EIGHTEEN
NINETEEN AT THIS TIME.
FOR. THE NEXT FISCAL YEAR HAVE
WE ARE IN THE START TO DIG TO
SET SOME OF THOSE. PRIORITIES
ARE WE. LETTING THE NEXT
ADMINISTRATION DECIDE.
HOW IT YEAH I MEAN I THINK
THERE'S IT'S A TWO IF IT'S A TWO
PART PROCESS RIGHT SO FINANCE?
WILL OBVIOUSLY ASSESSED ALL THE
REVENUES THAT COME IN ON PROP
SIXTY FOUR AND THERE'S A LOT OF
OTHER BUCKETS THAT HAVE TO BE
FILLED BEFORE IT COMES DOWN TO
OUR AND BUCKET. I THINK THEN
THAT.
INITIATIVE BOTH CONTEMPLATES
AND THIS IS OUR PROCESS AND
THOUGHT GOING FORWARD IS THAT WE
WOULD HAVE KIND OF BROAD
STAKEHOLDER.
GROUPS AROUND WHAT THAT MONEY
COULD AND SHOULD BE USED FOR
BECAUSE I THINK THE INITIATIVE
KIND OF OUTLINES BROADLY WHAT IT
CAN BE USED FOR.
.
BUT IS A DIFFERENT DISCUSSION.
IF IT'S YOU KNOW AND I'M MAKING
UP A NUMBER OF ITS NINE MILLION
DOLLARS VERSUS NINETY MILLION
DOLLARS. THERE'S THERE'S A VERY
DIFFERENT DISCUSSION ABOUT WHAT
YOU COULD USE WITH THOSE FUNDS
AND SO I THINK.
.
I WOULD SAY IT'S NOT NECESSARILY
WAITING FOR THE NEXT
ADMINISTRATION IS THAT YOU NEED
TO HAVE A NUMBER TO KNOW WHAT
YOU'RE TALKING ABOUT BEFORE YOU
SPEND THE MONEY BECAUSE IT HELPS
ALSO. ON SET EXPECTATIONS AND
SOME KIND OF FISCAL BOUNDARY
AROUND WHAT'S APPROPRIATE FOR
THE FUNDING SOURCE.
SO I THINK I THINK WE'RE
COMMITTED TO THE PROCESS THAT
THE INITIATIVE LAYS OUT IN TERMS
OF WORKING WITH A LOT OF
DIFFERENT PEOPLE TO DEVELOP
SOMETHING. WHETHER IT BE USED IN
TREATMENT OR PREVENTION OR A
COMBINATION ON THAT WE DON'T
HAVE ANY WE HAVEN'T STARTED THAT
YET BECAUSE WE JUST HAVEN'T.
HAD IN IT ANY.
CONCRETE FISCAL NUMBERS TO TALK
ABOUT
TO.
PLEASE.
NO I JUST.
.
SO THERE HAVE BEEN NO ESTIMATES
FOR EIGHTEEN NINETEEN BECAUSE WE
DON'T ASSUME THAT THERE WILL BE
ANY FUNDING NOT WHERE I DO.
DO WE HAVE ANY ASSUMPTIONS FOR
WHAT. WOULD BE THERE FOR THE
NEXT FISCAL YEAR SO THAT WE CAN
HAVE THOSE DISCUSSIONS ORDER
THOSE ONLY COME AFTER A YEAR'S
WORTH OF RECEIPTS SO THAT WE CAN
THEN. PREDICT BASED OFF OF
THAT'S CORRECT WE DON'T
CURRENTLY HAVE A MULTI YEAR HOW
LOOK FOR REVENUE PROCEEDS
SPECIFIC TO PROPOSITION SIXTY
FOUR.
.
YEAH THAT THAT'S WHERE I WAS
GOING TO FOR HIS AND WOMEN RUBIO
YEAH I JUST WERE ARE GOING BACK
TO OUR ORIGINAL CONVERSATION IS
THERE A REMEDY.
FOR THE COUNTY OF SERVICE.
VERSES THE KIND OF COUNTIES.
THE PAYMENT BASICALLY IS A IS
ARE WE GOING TO PAY BUT
COUNTIES.
THAT PROVIDED THE SERVICE EVEN
THOUGH THEY'RE IN A DIFFERENT
COUNTY IS THERE A REMEDY FOR
THAT.
OKAY SO GOING BACK TO THE.
COUNTY OF.
OF SERVICE VERSUS THE COUNTY OF
RESIDENCE.
THERE'S SOME DISPUTE AS TO WHO'S
GOING TO PAY IN THE MEANTIME
SOMEBODY'S NOT BEING PAID HOW IS
ARE WE HANDLING THAT.
SO.
IT'S NOT A DISPUTE AS TO WHO'S
RESPONSIBLE RIGHT THE STATUTE IS
CLEAR AS TO HOW MUCH COUNTY IS
RESPONSIBLE. ON THE MECHANICS
THAT I REFERENCE THAT WE'RE
WORKING THROUGH WITH FINANCE IS.
I'M THE STATE MAY FRONTS THAT
PAYMENTS.
FOR THE PROVIDERS BUT WE WILL
REIMBURSE OURSELVES USING THE
COUNTIES FUNDING RIGHT RIGHT SO
SO IF I'M I'M THE COUNTY THAT
PROVIDED THE SERVICES AND. IN
THIS CASE NAY IN MY AREA I'M
CLOSE DECEMBER NINETEEN OH
COUNTY AND LA COUNTY. SOLD SO IF
THERE'S A DISPUTE THEN YOU WILL
PAVE WHOEVER. IS.
WHO THAT WHATEVER THE? PERSON
THAT ARE IN WE WILL REIMBURSE
OURSELVES RIGHT FROM THE COUNTY
OKAY FROM THE COUNTY'S POT OF
MONEY THAT. OKAY.
AND IS THAT GOING TO HAPPEN
AGAIN I'M ASKING FOR TIME FRAME
BECAUSE I DON'T WANT FOLKS TO BE
DISCOURAGED.
.
IN TERMS OF PROVIDING SERVICES
BECAUSE THEY'RE NOT GETTING PAID
AND SO IS THAT GOING TO BE IN A
TIMELY MANNER AGAIN COUPLE
MONTHS SIX MONTHS WHAT THE
DIRECTOR NOTED WE'RE STILL
WORKING THROUGH A LOT OF THE
MECHANICS AND HOW THIS IS
ACTUALLY GOING TO WORK NOT ONLY.
WITH THE COUNTY WITHIN THE CAMP
BETWEEN THE COUNTIES IN THE
DEPARTMENT BUT ALSO WITH FINANCE
AND WHAT THE SCO. TO KIND OF
MAKE SURE THAT WE'RE TRACKING
THOSE FUNDS AND AND.
RECORDING THEM APPROPRIATELY.
PEOPLE WILL GET PAID
I JUST WANT TO MAKE SURE THAT
WHERE YOU HAVE TO COUNTIES THAT
OUR WAIVER COUNTY CIVIL SABATINO
AND LA ARE NOT PART OF THIS
ISSUE OKAY. RIGHT NOW USE THOSE
EXAMPLES TO BECAUSE I'M ON THE
LINE COUNTY DOES A GOOD EXAMPLES
BECAUSE THERE'S A WAIVER
COUNTIES OKAY. THANK YOU.
SEEING AS WERE ONE HOUR INTO OUR
HEARING IN SALON ISSUE ONE.
WE'RE GOING TO HOLD ISSUE ONE
OPEN AND MOVE ON TO ISSUE TO
THANK YOU.
ASSEMBLYMEMBER SANTIAGO.
FAMOUS CARE.
THIS WILL LEAD US INTO OUR
SECOND HOUR.
I WANTED THE OPPORTUNITY Q..
AND THE COMMITTEE MEMBERS FOR
ON ALLOWING US TO PRESENT ON
THIS. AYE TODAY REPRESENTING ON.
TO APPROPRIATE TWENTY MILLION
DOLLARS FOR THE BUDGET FOR PILOT
PROGRAM ABOUT PLACING A
CERTIFIED DRUG OR ALCOHOL
COUNSELOR IN EMERGENCY ROOMS.
AND APARTMENTS ACROSS STATE OF
CALIFORNIA.
THERE'S REAL GOOD REASON FOR
THIS AND WE KNOW THAT PLAN AT
THAT AND SIGNIFICANT AMOUNT OF
FOLKS WHO END UP EMERGENCY ROOMS
AND UP THERE FOR DIFFERENT
REASONS THEM WHAT WOULD YOU AND
I MAY CONSIDER. AN ACTUAL
EMERGENCY SOME DRUG RELATED.
.
SUMMITAND REQUIRED.
COUNSELORS I DO MENTAL HEALTH
CARE ISSUES OPTICAL IN AREAS
THAT I REPRESENT LIKE DOWNTOWN
LOS ANGELES WHERE YOU HAVE A
HEAVY POPULATION. OF FOLKS WERE
HOMELESS AND WHO ENTER AND.
COULD SEEK.
THAT BUT I'M COULD SEEK.
MENTAL HEALTH CARE SERVICES AND
OR DRUG AND ALCOHOL COUNSELING
AND WE THINK THAT WOULD BE A
BETTER USE IN FACT.
THE DATA DEMONSTRATES
I DURING THE PILOT PROGRAM THAT
WHEN AN INDIVIDUAL.
ENCOUNTERS WITH THESE
COUNSELORS OTHERS LESS
PERCENTAGE OF A POSSIBILITY THAT
THEY RETURN TO THAT SAME
HOSPITAL MORE PARTLY BECAUSE I'M
ON A PATHWAY TOWARDS SUCCESS.
THINGS CHAIR.
DOCTOR MULLIN.
I MAYBE MULLIN I'M REPRESENTING
THE CALIFORNIA CHAPTER AMERICAN
COLLEGE OF EMERGENCY PHYSICIANS
AND I'M AN EMERGENCY DOCTOR.
THERE WERE TWO POINT FIVE
MILLION E. R. VISITS INVOLVING
DRUG ABUSE AND MISUSE.
AND I DON'T BELIEVE THAT NUMBER
FOR A SECONDS IT DOES NOT COME
NEAR COUNTING CAR ACCIDENTS
SUICIDES INFECTIONS AND OTHER
CONSEQUENCES OF DRUG ABUSE.
SAM SAID ESTIMATES TWENTY
MILLION ADULTS SUFFER FROM A
SUBSTANCE USE DISORDER AND I
DON'T BELIEVE THAT NUMBER EITHER
BECAUSE I CHALLENGE EVERYONE IN
THIS ROOM WHO DOES NOT KNOW
SOMEONE WHOSE LIFE HAS BEEN.
SILENTLY TORN APART BY
ADDICTION.
I SAW THESE PATIENTS EVERY DAY
AND I SAW THEM SPIRAL AND THEIR
LIVES ON RAVEL AND I WAS ON ABLE
TO INTERVENE IN ANY WAY.
I'M NOT CHANGED FOR ME TWO YEARS
AGO WE HAD A SUBSTANCE USE
COUNSELOR IN MY EMERGENCY
DEPARTMENTS.
HE'S JUST THERE DURING THE WEEK
BUT I CAN OFFER THESE PATIENTS A
LIFELINE AND NOW PATIENTS THAT I
USED TO SEE. MY FREQUENT FLYERS
AND I WOULD WATCH THEIR LIVES
UNRAVEL NOW I CAN GIVE THEM A
LIFELINE AND A PATHWAY OUT.
WE HAVE SEEN PATIENTS ACTUALLY
SUMMER PATIENTS I DON'T SEE ANY
MORE.
I CAN TELL YOU ABOUT SO MANY
STORIES OF PEOPLE WHO I SAW OVER
AND OVER AND OVER AGAIN UNTIL WE
WERE ABLE TO GET THEM INTO
TREATMENT AND NOW I DON'T SEE
THEM ANYMORE.
WE DO HEAR FROM PEOPLE WHO'VE
GOT THEIR LIVES TOGETHER WHO'VE
GOTTEN OFF THE STREETS
WHO APPROVED REALLY TURNED THEIR
LIVES AROUND.
I CAN TELL YOU THE PATIENT
POPULATION THAT WE'VE BEEN
SEEING IS A REAL VULNERABLE
POPULATION. SEVENTY ONE PERCENT
WERE COVERED BY MEDICARE HOW
ABOUT FORTY FOUR PERCENT SELF
IDENTIFIED AS HOMELESS.
THIRTY THREE PERCENT HAD A DUAL
DIAGNOSIS SO WHERE CONCURRENT
PSYCHIATRIC DIAGNOSIS.
SERVICE IS A VERY BOND OF A
PATIENT POPULATION THAT WE'VE
BEEN ABLE TO MAKE A POSITIVE
IMPACT ON.
YOU HAD MENTIONED MEDICAL DETOX.
SO BEFORE WE HAD A SUBSTANCE
USED. BEFORE WE WERE LINKING
PATIENTS TO TREATMENTS. I WAS
DETOXING PATIENTS IN MY
EMERGENCY DEPARTMENTS.
FOR NO REASON I WOULD GO THROUGH
THE PROCESS BECAUSE THEY HAVE A
LONG E. OUR STATE WE WOULD DO
OUR DETOX AND THEN I WOULD SEND
THEM BACK TO THE STREET ONLY TO
RETURN AGAIN.
SO ALL THAT WORK THAT WE HAD
DONE IN THE EMERGENCY DEPARTMENT
WAS GOING NOWHERE.
SO I THINK THAT THIS IS A HUGE
OPPORTUNITY THAT THE STATE HAS
TO ADDRESS SUBSTANCE USE
DISORDERS AT THE MOMENT WHEN
PATIENTS ARE MOST RECEPTIVE.
TREATMENTS THANK YOU THANK YOU
DOCTOR MARIN.
NEXT WE WILL HAVE PUBLIC COMMENT
ON ISSUE TO.
MISTER CHAIR MEMBERS ROBERT
HARRIS ON THE HAVE CALIFORNIA
SOCIETY OF ADDICTION MEDICINE.
CALIFORNIA SPECIALIST AND
TREATMENT OF ADDICTION.
WERE WERE JUST HAPPY ABOUT THIS
HEARING OR HAPPY MOSTLY FOR THIS
PROPOSAL IT ISN'T JUST ABOUT
PRIMARY CARE DOCTORS. RETRAINING
UP SEVENTY TWO IN THE CLINICS AS
PART UP AND SPOKE MODEL.
WE HAVE LIKE FOUR HUNDRED
MEMBERS WERE SPECIALISTS IN
CALIFORNIA BUT EVERY DOCTOR AND
EVERY SITUATION WHERE THEY CAN
PEOPLE WITH ADDICTIONS. SHOULD
FEEL CONFIDENT DE THE REFERRING
TO SOMEONE RIGHT THERE OR TO
BEGIN THE TREATMENT PROCESS
BECAUSE THAT'S THE ONLY WAY THIS
THINGS EVER GOING TO WORK. THANK
YOU VERY MUCH THANK YOU SIR.
MARVEL CHAIR MEMBERS SHARE IDEAS
OF THE CALIFORNIA CONSORTIUM OF
ADDICTION PROGRAMS AND
PROFESSIONALS. AYE WE THINK THIS
IS A TERRIFIC IDEA NOT ONLY DOES
A A PROGRAM LIKE THIS SAVE
HOSPITALS ON THEIR COST
EXPENSES.
IF INTERVENE EARLY ENOUGH IN THE
PROGRESSION OF THE DISEASE THE
PERSON GENERALLY HAS BETTER
HEALTH OUTCOMES AND A BETTER
OPPORTUNITY FOR. LONG TERM
SOBRIETY. A IN ADDITION TO THAT
HAVING A COUNSELOR AVAILABLE AT
A. EMERGENCY ROOM.
THE CANCERS MAY HAVE DECADES OF
EXPERIENCE SO WHEN THEY'RE
WORKING WITH FAMILIES THEY CAN
THEY CAN DETERMINE WHETHER THE
THE YOUNG PERSON I HAVE IN FRONT
OF THEM. IS I'M SUFFERING FROM A
BIT OF BINGE DRINKING AND NEED
SOME SUPPORT AND DIRECT THEM
TOUR AND ON CAMPUS.
CLUBBER ENVIRONMENT THAT HELPS.
HEALTHY BEHAVIOR OR THEY CAN
DETERMINE WHETHER THAT PERSON
NEEDS IMMEDIATE CARONA A THIRTY
DAY INPATIENT PROGRAM SO THROUGH
IMPORTANT HAVE SOMEONE THERE WHO
HAS THAT SORT OF EXPERIENCE. AND
FINALLY THE GOAL OF THE
DEPARTMENT AS WELL AS INDUSTRY
HAS TO.
BRING TOGETHER MORE INTEGRATION
BETWEEN PRIMARY CARE AND
ADDICTION TREATMENT AND WHAT%
BETTER WAY THAN HAVING ONE OF
OUR EXPERTS THERE TO SHOW WHAT
WE NOW AND AND WHAT WE'VE
LEARNED AND ALSO TO SHOW US.
WHAT'S HAPPENED TO THOSE THOSE
CLIENTS WHO DON'T TAKE THE
REFERRAL WHERE DO THEY GO WE
NEVER SEE THEM IF THEY DON'T
COMMON FOLLOW UP ON REFERRAL. WE
DON'T KNOW WHY THEY AREN'T SO
THEY'D BE REALLY GREAT TO HAVE
OUR PEOPLE IN THE EMERGENCY
ROOMS UNDERSTAND NOT ONLY WHAT
WE CAN PROVIDE THEM BUT WHAT IS
THE MISSING LINK IN GETTING SOME
OF THE. WOMEN FOR TREATMENT
THANK YOU.
LARA THOMAS AND THE INTERIM
STATE DIRECTOR FOR THE DRUG
POLICY ALLIANCE.
WE SEE THIS PROPOSAL IS BEING
VERY COMPLIMENTARY TO THE BUDGET
PROPOSAL THAT WE HAVE FOR OPIOID
TREATMENT NAVIGATORS ARE VERY
SIMILAR IDEAS INTO DIFFERENT.
TYPES OF LOCATIONS AND WE SEE
THEM BOTH AS WORKING TO CATCH
PEOPLE WHEREVER THEY ARE AYE IN
THE PROGRESSION OF THEIR
SUBSTANCE USE DISORDER. AND WE
THINK THAT THE TWO WOULD WORK
VERY WELL HAND IN HAND IN
SUPPORT OF THANK YOU.
AFTERNOON MISTER CHAIR MEMBERS
ADRIN SHELTON WITH STEINBERG
INSTITUTE WE ARE IN SUPPORT OF
THIS PROPOSAL AND COMMEND THE
AUTHOR AND SPONSORS FOR BRINGING
THIS FORWARD WE BELIEVE THIS
PROPOSAL WILL SAVE LIVES AND
ACHIEVE COST SAVINGS. WITH A
REALLY IMPORTANT OPPORTUNITY TO
ADDRESS THIS THANK YOU THANK
YOU.
GOOD AFTERNOON MISTER CHAIRMAN
BIRTH MICHELLE BACO AT THE
CALIFORNIA MEDICAL ASSOCIATION
WE BELIEVE THIS IS A VERY IT'S A
GREAT ONE TIME OPPORTUNITY
INVESTMENT TO. IMPROVE OUTCOMES
THAT'S COMMONSENSE APPROACH AND
WE STRONGLY SUPPORT IT THINKING.
KID AFTERNOON PAULA WILL HOME
REPRESENTING THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION AND WE'RE ALSO IN
SUPPORT OF THIS PROPOSAL FOR THE
REASONS OUTLINED BY MANY OTHERS
ALREADY THANK YOU. THANK YOU.
WHEN MAY SHARMA HAVE THE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES.
SHOULD BE USE TO ADDRESS THE
SECOND EPIDEMIC TODAY SO WE
SUPPORT THE THANK YOU THANK YOU.
AFTERNOON MISTER CHAIRMAN
MEMBERS JOHN VALENCIA HERE ON
BEHALF OF ALL KERN MUSIC WERE
THE MAKERS OF LONG ACTING
MALTREXONE. ONCE MONTHLY
INJECTABLE ANTAGONISED FOR
OPIOID USE DISORDER.
IT INDUCES AT THE POINT OF
MEDICALLY SUPERVISED
DETOXIFICATION.
SO THE PROPOSAL MEETS THAT
PATIENT POTENTIALLY BUT WERE
FIRMLY COMMITTED TO THE RIGHT
PATIENT FOR THE RIGHT PRODUCT AT
THE RIGHT TIME. SO WHATEVER
CHOICE THEY MAKE IF THIS
PROPOSAL HELPS GUIDE THEM THERE
IS A GOOD IDEA THANK YOU.
GIVE.
TOUCH CHAIR MEMBERS DEMAND
REPRESENT CALIFORNIA CHAPTER OF
AMERICA BECAUSE EMERGENCY
PHYSICIANS AND JUST TO FINISH
OFF AND OUT ON DEDUCTIBLES
COMMENTS WHEN LOOKING AT THE
PROGRAM THAT WAS DONE A DAVIS A
COUPLE FISCAL ITEMS. WHAT THEY
SAW WAS A SIXTY PERCENT
REDUCTION IN THE POPULATION
THERE RECEIVED INTERVENTION POST
INTERVENTION? AND WHEN WE LOOKED
AT THE PHYSICAL ASPECT OF IT
LOOKING SPECIFICALLY AT THE
MEDICAL POPULATION. WE SAW FOR
EVERY DOLLAR THAT WAS SPENT ON
THE DRUG ALCOHOL COUNSELOR SEVEN
DOLLARS WAS SAVED WITHIN THE
MEDICAL PROGRAMS I WAS JUST
LOOKING AT THE ANNOUNCES DOESN'T
LIKE JOB AT PULLING THOSE
NUMBERS OUT.
BUT SPECIFICALLY WE JUST LOOKED
AT THE COST OF THE ACTUAL
EMERGENCY DEPARTMENT VISITS THAT
DOES NOT INCORPORATE. ANY ASPECT
OF THE PATIENT WAS ADMITTED INTO
THE HOSPITAL WHICH AS WE KNOW IS
A HIGHER NUMBER SO FOR THOSE
REASONS WE THINK THIS IS A. A
FISCALLY PRUDENT APPROACH TO A A
BIG PROBLEM THANK YOU. THANK YOU
SIR.
SEE NO MORE PUBLIC COMMENT ON
BRING IT UP TO THE DYESS FOR ANY
COMMENTS OR QUESTIONS THAT WE
MAY HAVE.
SEEING NONE I WANTED TO IF I
COULD.
.
HIGHLIGHT THIS PROPOSAL I HAD.
THE PLEASURE OF MEETING THE COM
DRUG AND ALCOHOL COUNSELOR AT
LAST WEEK TOMMY WHO'S WORKING
HERE AND.
.
SACRAMENTO.
AND HAVING PRACTICED IN ANY ARE
WHAT STRUCK ME ABOUT I'M WAS HOW
HAPPY HE WAS.
THAT THAT HE ENJOYED HIS LIFE HE
ENJOYED HIS DAY HE ENJOYED
TAKING CARE OF HIS COMMUNITY.
AND.
.
HAVING BEEN ON THE FRONT LINES
WHERE I FELT LIKE I WAS
OVER UTILIZED AND UNDER RESOURCE
THIS IS A VERY TIMELY PROPOSAL.
AND ONE THAT I THINK.
WILL DO GREAT FOR HELPING OUR
STATE TO. POTENTIALLY DECREASE
E. R. VISITS AS WAS SHOWN HERE
IN SACRAMENTO AS WELL AS TO SAVE
OUR STATE MONEY. BY DOING
APPROPRIATE INVESTMENT.
WITH THAT WE WILL HOLD ISSUE TO
OPEN THE WANTED TO THANK YOU FOR
BRINGING THIS FORWARD TODAY.
AGAINST CHAIR MEMBERS.
WILL MOVE ON TO ISSUE THREE.
THANK YOU MISTER CHAIR AND
COMMITTEE. OF THANK YOU FOR
HEARING OUR BUDGET REQUESTS TO
DIRECT AN ADDITIONAL TWENTY
MILLION DOLLARS TO THE
DEPARTMENT OF HEALTH CARE
SERVICES. IN ORDER TO INCREASE
MEDI CAL REIMBURSEMENT. RATE FOR
MEDICATION ASSISTED TREATMENT M.
EIGHTY. ARE A MATCH FOR OPIOID
ADDICTION. AS WE KNOW OPIATE
DEPENDENCE HAS BECOME A LEADING
FORM OF DRUG ABUSE IN THE UNITED
STATES. AND MEDICATION ASSISTED
TREATMENT IS AN INNOVATIVE
TREATMENT.
PROGRAM THAT USES MEDICATIONS
WITH COUNSELLING AND BEHAVIORAL
THERAPIES TO TREAT SUBSTANCE
ABUSE DISORDERS DESPITE. THE
INCREASING SUCCESS OF MATT
TREATMENTS FOR OPIOID ABUSE
LESSEN TWO PERCENT OF CALIFORNIA
PHYSICIANS ARE CERTIFIED TO
BIRTH PRESCRIBE. PROVEN OFFERING
THE LOCKS ON TREATMENT AND EVEN
LESS ARE TRAINED TO ADMINISTERED
NALTREXONE.
PROVIDING ACCESS TO MATT AND
RURAL AREAS IS PIVOTAL IN
MANAGING THE OPIOID ECHO
EPIDEMIC.
THEY'LL TRICKS ON WHICH IS AN
INJECTABLE ADMINISTERED ONCE A
MONTH BY IN FRONT OF THOSE
CERTIFY PHYSICIANS OFFICE.
REDUCES CRAVINGS A BLOCK STILL
PRETTY HIGH FOR UP TO THIRTY
DAYS OTHER MEDICATION ASSISTED
TREATMENT DRUGS BICU PLAN
OFFERING BLUEPRINT OFFERING LOW
OXON COMBINATIONS MAY BE
PRESCRIBED.
BY CERTIFIED PHYSICIANS.
IN ON A PRESCRIPTION BASIS FOR
AT HOME USE UNDER A THERAPY AS
WELL INCREASED ACCESS TO THESE
MEDICATIONS SIGNIFICANTLY.
INCREASES ACCESSIBILITY OF
TREATMENTS IN RURAL COMMUNITIES
WHERE WE KNOW THE OPIOID
EPIDEMIC IS RAMPANT.
IN OUR STATE HOWEVER THE NUMBER
OF CERTIFIED PROVIDERS IN
CALIFORNIA IS FAR LESS THAN WHAT
IS NEEDED TO COMBAT OPIOID
ABUSE.
IN AN EFFORT TO INCENTIVIZE MORE
MEDICAL PROVIDERS TO BECOME
CERTIFIED PRESCRIBERS OF MATT
WE.
NEED TO INCREASE THE MEDI CAL
REIMBURSEMENT RATES THAT THEY
RECEIVE FOR THAT TREATMENT.
AND THIS BUDGET ASK WILL DO JUST
THAT.
THANK YOU MISTER CHAIR. AND ASK
THE SUBCOMMITTEE TO DIRECT
TWENTY MILLION DOLLARS TO THE
DEPARTMENT OF HEALTH CARE
SERVICES.
TO INCREASE THE MEDI CAL
REIMBURSEMENT RATE FOR
MEDICATION ASSISTED TREATMENT
FOR OPIOID ADDICTION.
THANK YOU SOMEONE OVER WALDRON
WILL NOW TAKE PUBLIC COMMENT ON
ISSUE THREE.
MISTER CHAIRMAN MEMBERS ROBERT
HARRIS WHAT THE US CALIFORNIA
SOCIETY OF ADDICTION MEDICINE.
IT'S TRUE AND THE DEPARTMENT IS
BEEN DOING A PHENOMENAL JOB WITH
THE HUB AND SPOKE TRYING TO GET
TREATMENT THE RURAL AREAS BUT
IT'S LIKE A TWO YEAR. PROGRAM
FROM FROM THE FEDERAL GOVERNMENT
AND WE NEED ONGOING SUPPORT I'M
GOING TRAINED DOCTORS NON GOING
COUNSELORS AND ONGOING ABILITY
TO PRESCRIBE.
WEEK THINK THE FEDERAL LIMITS
ARE TOO LOW RIGHT NOW ON HOW
MANY CAN BE. DO IT BUT WE CAN'T
AFFECT THAT IN CALIFORNIA SO WE
NEED TO TRAIN MORE PEOPLE.
THANK YOU SIR.
FOLLOW WILL HOME WITH THE COUNTY
BEHAVIORAL HEALTH DIRECTORS
ASSOCIATION AND WERE IN SUPPORT
OF THIS PROPOSAL.
DO YOU.
WHEN MEASURE BY HAVE THE
CALIFORNIA ASSOCIATION OF
ALCOHOL DRUG PROGRAM EXECUTIVES
WE ALSO IN SUPPORT OF THIS
ISSUE.
AS CHAIRMAN JOHN VALENCIA FOR
ALL KERN MUSIC ASSOCIATE WITH
THE A PRIOR COMMENTS AND SUPPORT
THIS PROPOSAL THANK YOU SIR.
MICHELLE POCKET WITH THE
CALIFORNIA MEDICAL ASSOCIATION
ALSO IN SUPPORT.
SHERRIE DEAN WITH CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS IN SUPPORT.
ACUMEN.
SEEING NO FURTHER PUBLIC COMMENT
OR BRING IT UP TO THE DYESS FOR
IN THE COMMENTS THAT WE HAVE
ASSEMBLYMEMBER MATHIS.
SHE MIGHT THINK.
AND YOU FOR BRINGING THIS UP AND
WE NEED.
THE IT THE NOW ON THE HEAD THIS
ISN'T VERY MUCH NEEDED AN INTEL
THESE REIMBURSEMENT RATES GO UP
IT'S VERY HARD TO INCENTIVIZE
DOCTORS TO DO THE PROGRAMS.
SO LOOK FORWARD TO HASH IN THE
SOUND MAY.
IF I MAY ASK A QUESTION OF THE
DEPARTMENT.
I DON'T KNOW IF YOU'RE ABLE TO
RESPOND IN REAL TIME.
.
WANTED TO. UNDERSTAND.
THERE WERE CURRENTLY UNDER A TWO
YEAR BUDGET CYCLE WITH THE
FEDERAL GRANT.
WHAT HAPPENS AFTERWARDS?
WHAT WHAT WOULD THIS PROPOSAL DO
IN LIGHT OF THAT FEDERAL
UNCERTAINTY?
AND. THEN THE SECOND QUESTION
IS REALLY GONNA BE TO TRY AND
DRILL DOWN ON TO RATES NOW.
WHERE ARE WE WITH OUR CURRENT
RATE STRUCTURE AND IS THIS
SOMETHING THAT WE NEED TO BE
ADDRESSING?
CRACK SO.
THE FIRST I'M AS IT PERTAINS TO
THE NINETY MILLION DOLLARS UNDER
THE CURES ACT WHEN WE APPLIED
FOR THE FEDERAL GRANT FUNDS.
WE HAD INCLUDES SOMETHING
AROUND SUSTAINABILITY AFTER THE
GRANT FUNDS WENT AWAY THAT WAS
PART OF THE FEDERAL
REQUIREMENTS.
SO IT WAS GIVEN TO STATES WITH
THE VERY CLEAR AND EXPLICIT
UNDERSTANDING THAT THEY WERE NOT
GOING TO BE PERPETUALLY
CONTINUING TO FUND THE SO.
SUSTAINABILITY WAS PART OF OUR
APPLICATION.
IN TERMS OF THIS PARTICULAR
PIECE.
.
PROPOSAL SO MOST OF THE.
MEDICATION ASSISTED THERAPY THE
RATES ARE NOT SET BY US AT THE
STATE LEVEL PER SE BECAUSE THE
FULL COMPLEMENT OF THOSE DRUGS
ARE PROVIDED. ONLY IN THE ODS.
WAIVER COUNTY'S FOR TEN THAT OR
THAT CURRENTLY UP AND RUNNING
AND THEY SET RATES
SO THE REIMBURSEMENT WOULD BE
STRUCTURED UNDER THE COUNTY. I'M
NOT UNDER THE STATE SO WE SET
RATES IN THE NON ODS COUNTIES
BUT MOST OF THESE DRUGS ARE NOT
COVERED AS A DRUG MEDICAL
BENEFIT SO THERE'S.
AGAIN IT'S BACK TO THE
COMPLEXITY OF THE RELATIONSHIP
BETWEEN THE STATES AND THE
COUNTIES AS IT PERTAINS TO
SUBSTANCE USE DISORDER SO IF THE
STATE WANTED TO. INCREASE THESE
RATES FOR THESE PARTICULAR SETS
OF DRUGS IT WOULD BE.
ABOVE THE PROPOSITION THIRTY
COSTS THAT WOULD OTHERWISE BE
ALIGNED TO THE COUNTIES FOR
RESPONSIBILITY.
UNDERSTOOD.
.
ASSEMBLYMEMBER WALDRON THIS IS
THE SECOND YEAR YOU'VE BROUGHT
THIS PROPOSAL HAPPENED I. OWN
SORRY AT THAT THERE WAS A
PROPOSAL YOU HAD LAST YEAR I
SAWYER STAFFER I YEAH I WILL
HAVE THE HOPE BACK THE HEROIN AN
OPIOID. A PUBLIC EDUCATION.
THAT WAS THE.
PUBLIC EDUCATION.
I WANTED TO THANK YOU FOR YOUR
INTEREST AND CONTINUED INTEREST
IN THIS AREA AND WILL CONTINUE
TO WORK WITH YOU TO SEE WHAT WE
CAN DO REGARDING THIS PROPOSAL
BUT OKAY. REALLY APPRECIATE ALL
THE TIME THEY SPENT.
THANK YOU WITH THAT WE WILL HOLD
ISSUE THREE OPEN AND MOVE ON TO
ISSUE FOR.
YEAH.
MISTER CHAIRMAN MEMBERS HOLDING
MEASURE BEHALF OF THE CALIFORNIA
ASSOCIATION ALCOHOL DRUG PROGRAM
EXECUTIVES.
THIS IS A PROPOSAL THAT I THINK
YOU'RE CONSULT DOWN CAPSIZED
VERY VERY SPECIFICALLY AND A
VERY CORRECTLY IN. A DENOUNCES.
THIS IS A REQUEST FOR FUNDING
FOR.
.
CATCH ME BASED.
HOSPITAL COMMUNITY BASED DE TAX
SERVICES.
UNDER THE ODS WAIVER.
THE WAIVER.
.
THAT THERE PROVIDERS WORK WITH
THE DEPARTMENT IN CRAFTING THE.
OF DRUG MEDICAID ALL ORGANIZED
DELIVERY SYSTEM WAIVER. AND
ENDED.
THE FEDERAL GOVERNMENT ALSO
AGREED THAT.
SUBSTANCE USE.
TREATMENT DETOX SERVICES
INTOXICATION SERVICES WOULD BE A
REIMBURSABLE.
SERVICE.
.
THE OUT WHEN THE WAIVER WAS.
IMPLEMENTED.
A FUNDING FOR THE DETOXIFICATION
SERVICES WERE NOT INCLUDED IN
THE COUNTY ALLOCATIONS.
SO THIS REQUEST IS TO.
OF FUNDS THAT ALLOCATION ACT.
TWENTY FIVE MILLION DOLLARS PER
YEAR A IN ORDER FOR THE.
DETOXIFICATION SERVICES AT THE
COUNTY LEVEL.
YEAH.
THANK YOU.
I IF I JUST MIGHT WANT TO
MENTION THAT.
DETOXIFICATION SERVICE IS THE
KEY TO.
SERVICES TO TO HAVING PEOPLE
MOVE ON THEIR.
ROAD TO RECOVERY AND IT IS
CRUCIAL.
AND IT IS A LIFE SAVING.
PROPOSAL AND IT WILL.
WITH.
DE TAX SERVICES AVAILABLE
THROUGH A DAY'S TO PARTICULAR
KINDS OF THE TAXI CAB.
COMMUNITY DETOXIFICATION
PROGRAMS IT WILL DIVERT PEOPLE
OUT OF EMERGENCY ROOMS AND SAVE
MONEY.
THANK YOU.
BUT COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION IN SUPPORT
OF THIS PROPOSAL THANK YOU.
THANK YOU MA'AM.
AS CHAIRMAN JOB WALESA FELKER
MUSIC WE SUPPORT PROPOSAL
AWESOME THANK YOU THANK YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO THE DYESS FOR
ANY COMMENTS.
SEEING NONE WANTED TO THANK
GOODNESS ME SHARP FOR BRINGING
THIS FORWARD WE WILL HOLD ISSUE
FOR OPEN. AND MOVE ON TO ISSUE
FIVE.
GOOD AFTERNOON CHAIRMAN AND
MEMBERS I'M ABLE GRANT DIRECTOR
OF POLICY FOR ALL COMMITTEES WE
MANUFACTURE A MEDICATION FOR THE
TREATMENT OF OPIOID USE
DISORDER.
AND I'M HERE TO RESPECTFULLY
FIVE LEGISLATION THAT PASSED
LAST SESSION BEFORE WE
IMPLEMENTED AND FUNDED.
AB THREE NINETY FIVE MADE SOME
KEY CHANGES TO THE HEALTH AND
SAFETY CODE IN ORDER TO EXPAND
TREATMENT FOR OPIATE USE
DISORDER DURING THIS PUBLIC
HEALTH CRISIS OUR NATION IS
FACING. ONE CHANGE WAS THAT
ALLOWED NARCOTIC TREATMENT
PROGRAMS ALSO NOTICE AND TEEPEES
TO ADMINISTER RELAPSE
PREVENTION.
MEDICATION ALSO KNOWN AS
ANTAGONISE THERAPY.
PRIOR TO THIS LEGISLATION AND
TEEPEES WERE RESTRICTED TO USING
REPLACEMENT THERAPY OR AGONIST
TREATMENT.
THIS WAS IMPORTANT BECAUSE
AGONIST AND ANTAGONISE TREATMENT
HAVE DIFFERENT MECHANISMS OF
ACTION AND THIS CHANGE
RECOGNIZED PATIENT CHOICE
RECOVERY AS WELL AS THE
IMPORTANCE OF THESE TREATMENT
PROGRAMS BEING ABLE TO OFFER ALL
THREE FDA APPROVED MEDICATIONS.
THIS WAS ESPECIALLY IMPORTANT AS
CALIFORNIA HAD RECENTLY BEEN
AWARDED A NINETY MILLION DOLLAR
GRANT FROM SANSA TO EXPAND
MEDICATION ASSISTED TREATMENT.
THE GRANT SPECIFICALLY STATED
THESE FUNDS SHOULD BE USED TO
REMOVE BARRIERS TO ACCESS TO
MEDICATION ASSISTED TREATMENT BY
REMOVING PRIOR AUTHORIZATIONS
STEP THERAPY AN IMPORTANCE THIS
BILL EXPANDING PROVIDER
NETWORKS.
IN CALIFORNIA WE CREATE A HUB
AND SPOKE MODEL WHERE THE NDP'S
ARE THE HUBS MEANING THEY
DIAGNOSE START TREATMENT AND ONE
APPROPRIATE TRIAGE PATIENTS TO
SPOKES FOR FOLLOW UP TREATMENT.
IN THE RECENTLY PASSED FEDERAL
BUDGET ADDITIONAL AMOUNTS WERE
ALLOCATED AND BASED ON
PRELIMINARY ANALYSIS WE EXPECT
CALIFORNIA WILL BE RECEIVING A
MINIMUM OF AN ADDITIONAL ONE
HUNDRED MILLION DOLLARS. TO
CONTINUE THE EXPANSION OF
MEDICATION ASSISTED TREATMENT.
AB NOT THREE NINETY FIVE MEANT
THE HUBS COULD USE ALL THREE FDA
APPROVED MEDICATIONS.
HOWEVER ON JANUARY TENTH THIS
YEAR TEACH CS DISTRIBUTE A MEMO
TO THE ANTI PEACE STATING THAT
WHILE THEY WERE AUTHORIZED TO
USE THE MEDICATION THEY WOULD
NOT BE REIMBURSED FOR THE
SERVICES REQUIRED INCLUDING
TOXICOLOGY. CASE MANAGEMENT AND
COUNSELING ASSOCIATED WITH THE
PRODUCT.
YET THESE SERVICES ARE
REIMBURSABLE FOR METHADONE AND
BUPRENORPHINE IN THE SETTINGS
TO CLEAR WE'RE NOT ASKING FOR
THE FUNDING OF THE ACTUAL
PRODUCT IS THAT IS ALREADY
COVERED AS BOTH A MEDICAL. AND
PHARMACY BENEFIT THROUGH
MEDICARE OUT BUT FOR THE
SERVICES REQUIRED TO ADMINISTER
THE PRODUCT AND TO SUPPORT
PATIENTS AND RECOVERY.
THE COST OF COVERING THE
SERVICES WERE ANALYZED BY THE
ASSEMBLY AND SENATE
APPROPRIATIONS COMMITTEES AND
BOTH CAME TO THE CONCLUSION THAT
THE COST TO THE STATE WOULD BE
NOMINAL AND DID NOT PUT A FISCAL
NOTE ON THE LEGISLATION.
WE BELIEVE IT IS IMPERATIVE THAT
THESE IMPORTANT TREATMENT
PROGRAMS HAVE ACCESS TO AN
APPROPRIATELY. REIMBURSED FOR
ALL THREE MEDICATION ASSISTED
TREATMENTS AND THAT WOULD BE A
GOOD USE OF A VERY SMALL AMOUNT
OF THE NINETY MILLION DOLLARS
AWARDED TO THE STATE TO COVER
THESE SERVICES. THEREFORE WE
RESPECTFULLY REQUEST THAT D. H.
CS DIRECT THE STATE READING RATE
SETTING COMMITTEE TO SET A CODE
AND APPROPRIATELY. REIMBURSED
RATES FOR LONG ACTING INJECTABLE
TRACKS ON SO ANTI PEACE CAN
TRULY OFFER ALL THREE APPROVED
MEDICATIONS TO THEIR PATIENTS.
THANK YOU MA'AM.
WE WILL NOW TAKE PUBLIC COMMENT
ON ISSUE FIVE.
HOLY MEASUREMENT HAVE THE
CALIFORNIA ASSOCIATION ALCOHOL
DRUG PROGRAM EXECUTIVES AND WE
ARE IN SUPPORT OF THIS PROPOSAL
THANK YOU.
HUMAN.
GOOD AFTERNOON PALLO WELL HOME
WITH A COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION AND.
DERECHOS SPONSOR IN SUPPORTER
OF AB THREE NINETY FIVE LAST
YEAR AND CONTINUE TO SUPPORT THE
GOALS OF THIS LEGISLATION WHICH
IS. TO MAKE MEDICATIONS FOR
ADDICTION TREATMENT MORE WIDELY
AVAILABLE AND TO.
REMOVE ANY BARRIERS AND
ADMINISTRATOR OF OUR REGULATORY
TO MAKING ALL OF THOSE
MEDICATIONS AVAILABLE SO WE ARE
IN SUPPORT OF THIS PROPOSAL I'M
ON THE CONDITION THAT THAT
FUNDING PROVIDED IS SUFFICIENT
TO COVER THE SERVICES. THANK YOU
THANK YOU MA'AM.
FROM SEEING NO FURTHER PUBLIC
COMMENT ON BRING IT UP TO THE
DIES FOR QUESTIONS AND.
.
IF I CAN AGAIN.
DIRECTOR CAN TASK ABOUT.
THIS RATE SETTING COMMITTEE AND.
AB THREE NINETY FIVE IF THERE IS
A PLAN FROM OUR SIDE.
SURE SO AND THE BILL. AND GOT
TECHNICAL ASSISTANCE FROM US
LAST YEAR AND THE REASON THAT
THERE WAS NO FISCAL IS THAT IT
DIDN'T REQUIRE CHANGE ANY OF OUR
COVERAGE SPECIFICATION.
SO THE WAY THAT THE BILL WAS
INTENTIONALLY DRAFTED WAS IT WAS
TO ALLOW. FOR THE NARCOTIC
TREATMENT PROVIDERS TO.
HAVE THE DRUG ON SITE WITHIN
THEIR FACILITIES AND BE ABLE TO
OFFER TO PATIENTS BUT IT WAS
NOT.
DRAFTED IN SUCH A WAY AS TO
REQUIRE US TO EITHER CHANGE OR
OTHERWISE EXPANDS.
OUR EXISTING COVERAGE OF THE
DRUG SO THAT'S WHY THERE'S NO
FISCAL ASSOCIATED WITH IT WAS
WAY WAS DRAFTED.
IF THEY IF THAT SPONSORS HAD
WANTED US TO COVER AND SET THE
RATE IT WOULD HAVE HAD A FISCAL
ATTACHED TO IT SO THE. BILL WAS
INTENTIONALLY WE WE ANALYZED IT
AND HELPED WITH THE TECHNICAL
ASSISTANCE NOT PERSPECTIVE.
THE DRUG AS IT IS CURRENTLY.
COVERED UNDER MEDICARE WHILE
IT'S UNDER THE PHARMACY BENEFIT
IT'S NOT UNDER THE DRUG MEDI CAL
PROGRAM.
IT IS LIMITED ON TO THE EIGHTY
ONE OR NINE POPULATIONS SO FOR
INDIVIDUALS THAT ARE COMING OUT
OF CORRECTIONS.
AND IT IS A PHYSICIAN
ADMINISTERED DRUG MEANING THE
PHYSICIAN HAS TO PURCHASE THE.
DRUG AND THEN WE REIMBURSE THEM
AND THEN ADD A DISPENSING FEE ON
TO THE COST OF THAT. SODEN NONE
OF THAT HAS CHANGED IN TERMS OF
THE COVERAGE IN THE ALLOW
ABILITY SO TO THE EXTENT THAT. I
AM A BENEFICIARY WANTS THAT
PARTICULAR.
DRUG CAN BE ADMINISTERED IN A
PHYSICIAN OFFICE THE PHYSICIAN
HAS TO PURCHASE IT WE REIMBURSE
ON AND THEY WOULD HAVE TO GET
TREATMENT AUTHORIZATION FIRST.
BUT IF THEY'RE NOT AB ONE ON
NINE RECIPIENT.
SO CAN YOU. GET YOUR COMMENT IF
I CAN BUT CAN YOU EXPLAIN THEN
WHAT THE PURPOSE OF THE BILL
WAS.
LAST YEAR WHAT WHAT. DID IT
ALLOW WHAT DID EXPAND SURE SO IN
THIS THIS.
THIS MY MEMORY BANKS GOING BACK
TO LAST YEAR IS THAT NARCOTIC
TREATMENT PROVIDERS ON OUR
TIGHTLY OVERSEEN AND REGULATED
BY BOTH OF US AS A STATE AND BY
THE FEDERAL D. E. A.. AND THEY
ARE.
SPECIFICALLY ALLOWED TO CARRY
CERTAIN DRUGS ON SITE WITHIN THE
NARCOTIC TREATMENT PROVIDER
OFFICES AND SO THIS BILL ALLOWED
FOR THEM TO CARRY THAT
PARTICULAR DRUG.
IN THEIR.
FACILITIES ON THEIR GROUNDS AND
DISPENSE IT TO PATIENTS FOR THE
PURPOSE FOR WHICH IS INTENDED.
SO THAT'S ALL THE BILL WAS
INTENDED THAT'S FROM THE
STANDPOINT OF HOW WE. BOTH
ANALYZE AND PROVIDED TECHNICAL
ASSISTANCE IS THAT'S ALL THAT
THE BILL ALLOWED. SO YOUR AND
REPUTATION OF THE BILL WAS THAT
IT WAS TO ALLOW. THE PRESENCE OF
THIS MEDICATION WITHIN THE
PHARMACIES
BUT UNDER NO THE NARCOTIC
TREATMENT PROVIDERS THAT'S
THAT'S DIFFERENT THAN A
PHARMACY.
CORRECT
BUT THAT THERE WAS NO INTENT FOR
US TO.
FUND OR TO TREAT PEOPLE WITH
THIS MEDICATION IT DOES ONLY TO
ALLOW.
THE TREATMENT FACILITIES TO
HAVE THIS CAPABILITY IF YOU HAD
IF THE LEGISLATURE HAD WANTED IT
TO BE A COVERED BENEFIT.
EITHER MORE BROADLY OR IF THEY
HAD WANTED US TO DISTRIBUTE THE
DRUG WITHOUT TREATMENT
AUTHORIZATIONS OR IF THEY HAD
WANTED TO EXPAND COVERAGE THAT
WOULD HAVE HAD TO OF BEEN BOTH
EXPLICIT IN THE BILL. AND WE
WOULD HAVE A FISCAL ASSOCIATED
WITH THAT BUT THE BILL IS ON
PERMISSIVE ON THE PROVIDER TO
CARRY THAT DRUG IT IS NOT
REQUIRE US AS A DEPARTMENT TO
COVER THE DRUG. USE GRANT I'M
THE ONE CORRECTION ONE TO MAKE
AN AND WE WE THANK D. H. CS
BECAUSE IN THEIR WISDOM THEY
THOUGHT THEY SOUGHT AND.
DECEMBER TWENTIETH THEY
ACTUALLY MADE.
THAT PATROL THE LONG ACTING AND
CHECKED ON THE TRACKS ON A FULL
PHARMACY BENEFIT FOR ALL
MEDICARE RECIPIENTS NOT
RESTRICTED TO THE AB ONE OF
NINE.
IT'S AN THEY ALSO ACTUALLY
CHANGED IT SO IT'S BOTH A
MEDICAL AND A PHARMACY BENEFIT
WHICH MEANS THAT THE ANTI PEACE
ACTUALLY CAN BUY IT IN BILL IT.
OR THEY CAN DO IT THROUGH A
MEDICAL BENEFIT.
AS REALLY AS IT RELATES TO THE
MEDI CAL ODS SERVICES.
THERE ARE TO OPTIMIZE THE FIRST
OPTED FOR STDS SERVICES IS FOR
METHADONE IN PEOPLE OR FUND THE
SECOND OPT IN SERVICE IS FOR.
LIVE TRIAL WHICH IS LONG ACTING
THE TRACKS ON WHEN THE JANUARY
TENTH.
.
D. H. CS MEMO WENT OUT WE
CONTACTED KAREN BAYLOR
IMMEDIATELY.
AFTER TALKING TO SOME OF OUR
OUR FRIENDS ARE IN THE.
NARCOTIC TREATMENT PROGRAMS AND
QUESTIONED HER ABOUT OKAY WE
UNDERSTAND THAT THERE AUTHORIZED
BUT THERE YOU HAVE A SPECIFIC
LINE THAT SAYS THERE'S NO
FUNDING ATTACHED.
SHE SAID THAT IS CORRECT WHAT I
SUGGEST TO YOU IS ONE OF TWO
THINGS EITHER TO RUN LEGISLATION
IN THIS NEXT YEAR TO. FUND THIS
LEGISLATION OR TO GO THROUGH THE
BUDGET PROCESS AND BRING IT TO
THE BUDGET COMMITTEE AND
RESPECTFULLY REQUEST THAT THERE
BE FUNDING ALLOCATED. FROM THE
DEPARTMENT I'M SHE THOUGHT GIVEN
THAT THERE THERE WAS A NUMBER OF
FUNDING STREAMS COMING IN TO.
TEACH CS THAT THAT THIS WOULD
BE THE BEST OPPORTUNITY FOR THIS
ACTUALLY TO BE FUNDED SO THAT
THE PRODUCT COULD BE AVAILABLE
AND REINFORCED IN THAT SETTING.
.
THOUGHTS ON THAT AND TREPIDATION
I'M JUST TRYING TO.
.
SERVICE IN ODS COUNTIES THEN
IT'S A COUNTY.
IT'S AT THE COUNTIES OPTION.
IF THE STATE DECIDES TO MANDATE
IT BENNETT'S.
A REQUIREMENT THEN IT'S THE
STATE'S FISCAL RESPONSIBILITY
WHICH IS SQUARELY IN THIS
COMMITTEE STIR SECTION DECIDE IF
THEY WANT TO PROCEED WITH THAT
BUT WE AS A DEPARTMENT DON'T
HAVE OBSESSION.
WE CAN AND JUST ONE THING WE'RE
NOT ASKING THEM TO ACTUALLY
COVER THE DRUG WITH THIS WEEK WE
UNDERSTAND THE LIMITATIONS THERE
WHAT. WE'RE ASKING IS THAT THEY
ACTUALLY SEPARATE FOR THE
SERVICES AND THAT'S A MUCH
SMALLER AMOUNT THAN THE ACTUAL
COVERAGE OF THE MEDICATIONS SO
WHERE JUST TO BE CLEAR WE'RE NOT
ASKING FOR THE WHOLE MEDICATION
WAS ASKING FOR THAT VERY SMALL
AMOUNT TO BE COVERED BY THE
STATE. FOR THE ACTUAL SERVICES
ASSOCIATED WITH THE MEDICATION.
SEEING NO FURTHER QUESTIONS FROM
THE DYESSWILL HOLD ISSUE FIVE
OPEN AND MOVE ON TO ISSUE SIX.
THINK IF.
WELCOME DOCTOR SMITH.
GOOD AFTERNOON DOCTOR KAREN
SMITH THE DIRECTOR OF THE
CALIFORNIA DEPARTMENT OF PUBLIC
HEALTH.
THINK YOU CHAIR ARAMBULA
MEMBERS OF THE COMMITTEE FOR THE
OPPORTUNITY TO UPDATE YOU ON THE
NALOXONE GRANT DISTRIBUTION
PROGRAM. AS YOU KNOW IN SET IN
TWENTY SIXTEEN SENATE BILL EIGHT
THIRTY THREE.
PROVIDED THE DEPARTMENT ONE TIME
FUNDING TO ESTABLISH NALOXONE
GRANT PROGRAM WITH THE GOAL OF
REDUCING THE NUMBER FATAL OPIOID
OVERDOSE IS IN CALIFORNIA.
THROUGH THE INCREASED ACCESS TO
LIFE SAVING DRUG NALOXONE.
THREE MILLION DOLLARS OF GENERAL
FUND WAS ALLOCATED TO THE
PROGRAM THROUGH JUNE THIRTIETH
THE TWENTY NINETEEN WHICH
INCLUDED THREE HUNDRED THOUSAND
DOLLARS FOR CD PH ADMINISTRATIVE
COSTS IN TWO POINT SEVEN MILLION
DOLLARS. FOR NALOXONE PURCHASE
AND LOCAL OF LEVEL
ADMINISTRATIVE COSTS.
SEEPAGE DEVELOPED AND
IMPLEMENTED THE PLOT PROGRAM BY
LEVERAGING THE DEPARTMENT OF
GENERAL SERVICES ABILITY TO
PURCHASE NALOXONE AT A REDUCED
PRICE.
AND SUBSEQUENTLY OFFERED NON
COMPETITIVE GRANTS TO ALL SIXTY
ONE LOCAL HEALTH JURISDICTIONS
FOR NALOXONE PRODUCT IN THE FORM
OF NOR CAN NASAL SPRAY. AND
FUNDING TO CONDUCT A LOCAL
NALOXONE DISTRIBUTION PROJECT.
THE GRANT FUNDED AMOUNTS OFFERED
TO EACH LOCAL HEALTH DEPARTMENT
WERE BASED ON A FORMULA
DEVELOPED TO MAXIMIZE THE
POTENTIAL FOR SAVING LIVES.
THE FORMULA INCLUDE INFORMATION
ON EFFECTIVE NALOXONE
DISTRIBUTION AN OVERDOSE READ.
REVERSALS FROM THE CAT.
CENTERS FOR DISEASE CONTROL AND
PREVENTION AND IT CALCULATES A
COUNTY SPECIFIC ESTIMATES NEED
FOR NALOXONE BASED ON THE
AVERAGE NUMBER OF OPIOID
INVOLVED. OVERDOSE DEATHS IN
EMERGENCY DEPARTMENT VISITS IN
THAT COUNTY FOR EACH OF THE
PRECEDING THREE YEARS.
OF THE SIXTY ONE LOCAL HEALTH
DEPARTMENTS SIXTY HAVE ACCEPTED
THE OFFER OF A GRANT.
TWENTY OPTED TO FOREGO THE
AVAILABILITY OF LOCAL FUNDING
FOR ADMINISTRATION IN ORDER TO.
.
PURCHASE ADDITIONAL I KNOW I OR
TO RECEIVE ADDITIONAL THE LOCKS
AND. AND FORTY SIX LOCAL HEALTH
DEPARTMENTS HAVE ALREADY
RECEIVED A TOTAL OF THIRTY NINE
THOUSAND ONE HUNDRED TWENTY
DOSES OF NOR CAN.
AS OF IN FACT AN ADDITIONAL
EIGHT A LOCAL HEALTH DEPARTMENTS
AS OF THIS WEEK WILL RECEIVE A
TOTAL OF. ANOTHER ALMOST TWO
THOUSAND DOSES FURTHER SHIPMENTS
WILL OCCUR IN JUNE OF TWENTY
EIGHTEEN. AND WE ANTICIPATE THAT
THE REMAINING ARE CANDICE'S WE
DELIVERED TO LOCAL HEALTH
DEPARTMENTS IN THE SUMMER TWENTY
EIGHTEEN. FOR A TOTAL OF SIXTY
NINE THOUSAND SEVEN HUNDRED AND
SEVENTY SIX DOSES DISTRIBUTED
THROUGH THE PROGRAM.
IN IMPLEMENTING THIS PROGRAM ARE
THE PRIMARY GOALS THE DEPARTMENT
WERE TO MAXIMIZE THE NUMBER OF
DOSES PURCHASED WITH AVAILABLE
FUNDS. AND ENSURE THOSE JUICES
GOT TO THE PEOPLE AT HIGHEST
RISK AS QUICKLY AS POSSIBLE
BECAUSE WE ARE IN FACT IT A
CRISIS.
THROUGH PURCHASING NALOXONE AT
THE JUSTICE DEPARTMENT OF
GENERAL SERVICES WE WERE ABLE TO
SIGNIFICANTLY INCREASE THE
NUMBER OF DOSES OVER WHAT WOULD
HAVE BEEN POSSIBLE HAD IT.
GRANT RECIPIENTS PURCHASED
INDEPENDENTLY AND BY CONTRACTING
WITH LOCAL HEALTH DEPARTMENTS
WITH WHOM WE HAVE PRE EXISTING
RELATIONSHIPS WE WERE ABLE TO
MARKEDLY.
SPEED UP THE CONTRACTING
PROCESS.
TO DECREASE LOCAL COSTS AND
MINIMIZE DELAYS IN IN VARIOUS TO
LOCAL HEALTH DEPARTMENT
PARTICIPATION IN THE PROGRAM WE
TOOK PAINS TO MINIMIZE THE LOCAL
ADMINISTRATIVE BURDEN IN AND
MAXIMIZE FLEXIBILITY IN
IMPLEMENTING THE PROGRAM.
TO ENSURE OUR THAT NALOXONE.
THAT THE NALOXONE THAT THE LOCAL
DEPARTMENTS ARE RECEIVING GETS
TO THOSE AT HIGHEST RISK.
THOSE PARTICIPATING IN THE
PROGRAM ARE CHOIR TO A HOP
DEVELOP DISTRIBUTION SYSTEMS
DESIGNED TO MAXIMIZE THE LIVES
SAVED FROM. OPIOID OVERDOSE
INCLUDING BOTH PRESCRIPTION
OPIOIDS HEROIN AND FENTANYL.
AND LOCAL HEALTH DEPARTMENTS ARE
PARTNERING WITH EXISTING LOCAL
PROGRAMS AGENCIES AND COMMUNITY
BASED ORGANIZATIONS WITHIN THEIR
JURISDICTIONS THAT BOTH SERVE
THE POPULATIONS AT HIGH RISK
HIGHEST RISK FOR ABUSE
OVERDOSES.
AND ALREADY HAVE FUNCTIONAL AND
DISTRIBUTION SYSTEMS.
ACCORDING TO THE DISTRIBUTION
PLANS RECEIVED THUS FAR FROM
FIFTY THREE LOCAL HEALTH
DEPARTMENTS
TWENTY FOUR SYRINGE EXCHANGE
PROGRAMS WILL RECEIVE JUST OVER
THIRTEEN THOUSAND DOSES. SIXTY
NINE SUBSTANCE USE DISORDER
TREATMENT SERVICES WILL RECEIVE
TALL APPROXIMATELY TWELVE
THOUSAND DOSES.
TWENTY HOMELESS PROGRAMS WILL
RECEIVE UP ALMOST THREE THOUSAND
DOSES FIFTY EIGHT LAW
ENFORCEMENT AGENCIES WILL
RECEIVE ALMOST THIRTEEN THOUSAND
DOSES. SEVEN JAILS WILL RECEIVE
FOUR HUNDRED AND FORTY DOSES AND
FIFTY TWO OTHER TYPES OF
ENTITIES WILL RECEIVE
APPROXIMATELY TWELVE THOUSAND
DOSES. THOSE INCLUDE COMMUNITY
HEALTH CENTERS FEDERALLY
QUALIFIED HEALTH CENTERS PUBLIC
HEALTH DEPARTMENT CLINICS AND
SCHOOLS.
A LOT OF THE ASPECTS OF THE WAY
THAT WE IMPLEMENTED THIS PROGRAM
THAT I DESCRIBED EARLIER
INNOVATIVE AND MAKE PROGRAM
EVALUATION AND EVEN MORE
IMPORTANT.
FOR US THAN USUAL LOCAL HEALTH
DEPARTMENTS WILL BE SUBMITTING
FINAL REPORTS TO SEE PH BY APRIL
FIRST TWENTY NINETEEN ON HOW
THEY DISTRIBUTED THE NALOXONE.
THEY WILL REPORT ON THE TYPES OF
ENTITIES RECEIVE THE PRODUCT THE
TARGET POPULATION AND THE NUMBER
OF INDIVIDUALS WHO RECEIVED
WHERE THE INFORMATION IS
AVAILABLE THE NUMBER OF OVERDOSE
REVERSALS WILL ALSO BE? REPORTED
CITY PH WILL COMPILE THE
INFORMATION INCOMPLETE A SUMMARY
REPORT BY JUNE TWENTY NINETEEN.
THAT COMPLETES MY UPDATE
THANK YOU DOCTOR SMITH.
BERMAN FINANCE ALIONA COMMENTS
ON ISSUE SIX.
WE WILL NOW TAKE PUBLIC COMMENT
ON ISSUE SIX.
SEEN NONO BRING IT UP TO THE
DYESS FOR ANY COMMENTS OR
QUESTIONS THAT WE MAY HAVE.
DOC LOOKED AT.
WHAT PERFORMANCE THAT ARE THAT
THE SUMMER ALONSO TAKING IT
SONORA CAN SO IT'S N. NASAL
TODAY MISTLETOES?
AND.
I'M.
HE SAID WE GOT A GOOD DEAL FROM.
.
I DID YES I WAS JUST TRYING TO
DO NAPKIN MATH OR HOWEVER YOU
WANT THAT OF ANY FIVE DOLLARS
FOR IT TO DO THIS.
A PACKAGE
SO I WAS UNDER FIFTY DOLLARS PER
SIDE LIKE WHERE YOUR NAPKIN MATH
IS BETTER THAN MINE IT'S NOT
IT'S IT'S WRITTEN DOWN. THE MATH
IN MY HEAD.
TO CAN YOU WALK THROUGH WHAT A
FUNCTIONAL NOW OXEN DISTRIBUTION
SYSTEM LOOKS LIKE YOU GIVE US
SOME EXAMPLES.
YEAH WE MAKE SURE THIS IS
REACHING OUR RURAL AREAS AND
COMMUNITIES THAT MIGHT NOT HAVE
THE INFRASTRUCTURE. SOUND. I HAD
THE PLEASURE WHILE I WAS IN
FRESNO OF WORKING OUT A NEEDLE.
SYRINGE EXCHANGE THAT WE HAD
NEAR REDDING PARK AND.
JUST WANTS TO MAKE SURE THAT THE
STATE'S STYLE OF. PROGRAMS ARE
OUT THERE HELPING AND WANTED TO.
THEY ARE AS I SAID IT.
TWENTY NINE SYRINGE EXCHANGE
PROGRAMS SOME OF WHICH SERVE
MULTIPLE COUNTIES ARE
PARTICIPATING IN THE PROGRAM.
EACH LOCAL JURISDICTION THIS IS
WHAT WAS SO IMPORTANT TO US
ABOUT WORKING THROUGH.
AN ENTITY THAT NEW THE
JURISDICTION WELL AS OPPOSED TO
THE STATE DECIDING WHO SHOULD
GET THE NOR CAN IN THE LOCAL
JURISDICTIONS INTO.
THE LOCAL HEALTH DEPARTMENTS
WERE REQUIRED TO DETERMINE WHO
IN THEIR JURISDICTIONS ACTUALLY
HAVE NALOXONE DISTRIBUTION
PROGRAMS AND SO. IN SOME CASES
AT LEAST ONE CASE THERE'S THERE
WAS NINE AND SO THAT LOCAL
HEALTH DEPARTMENT CLINIC
ACTUALLY DEVELOPED A PROGRAM. IN
GENERAL WHAT THE REQUIREMENTS TO
WERE TO AT HOW TO BE AN ENTITY
WHO WAS ALREADY SERVING THE AT
RISK POPULATION SO IN DEPENDING
ON THE JURISDICTION HOMELESS. IV
DRUG USERS.
AT SAUDARA AND HAVE A RECORD OF
ACTUALLY BEING ABLE TO.
RELIABLY REPORT BACK ON THE
DISTRIBUTION OF MATERIALS THAT
THEY WERE USING IN SOME CASES
IT'S THE SAME ENTITIES THAT ALSO
TAKE ADVANTAGE OF. THE.
SYRINGE EXCHANGE.
OPPORTUNITIES FROM THE OFFICE
OF AIDS AND OTHER HITS BUT IT
WAS REQUIRED TO ALREADY BE
EXISTING WE DID NOT WANT TO.
PUT.
THE GRANT OUT AND THEN TAKE SIX
MONTHS TO EIGHT MONTHS BEFORE
ANYONE ACTUALLY JUST. DEVELOPED
A PROGRAM THAT WE DIDN'T KNOW
WAS GOING TO WORK SO. I AM NOW
JUST MY CURIOSITY.
STORING OF.
MARK CAN INTRANASAL IS IT.
SOMETHING THAT NEEDS TO BE AT
ROOM TEMPERATURE OR DOESN'T NEED
TO BE REFRIGERATED MY
UNDERSTANDING IT'S A ROOM
TEMPERATURE DROP.
IS IT IS IT SOMETHING THAT CAN
STAND SOMEONE'S CAR FOR AWHILE
IS THIS I'M I'M I DON'T KNOW I
MEAN. IF WE'RE GIVING THIS TO
LAW ENFORCEMENT IS THIS
SOMETHING THAT THEY CARRY ON
THEIR PERSON HOW OFTEN DO THEY
NEED TO BE.
SO UPDATING OR REPLACING IT.
SO THIS THE.
THAN OUR CAN DISTRIBUTION
ENTITIES ALSO HAVE TO PROVIDE
TRAINING TO EACH INDIVIDUAL WHO
I DON'T KNOW THE SPECIFICS I'VE
NOT GONE THROUGH THE TRAINING.
BUT THE TRAINING INCLUDES HOW TO
USE THE PRODUCT HOW TO STORE THE
PRODUCT.
THE THE EXPIRATION DATE ON THE
PRODUCT FIND THE EXPIRATION DATE
ON THE PRODUCT ITS UTTERANCE
SUITS ACTUALLY YOU DON'T YOU CAN
JUST HAND IT TO ANYBODY WHO
WALKS IN THEY HAVE TO ACTUALLY
GO THROUGH. A TRAINING IN HOW TO
USE IT AND THAT INCLUDES LAW
ENFORCEMENT IN THE CASE OF MOST
LAW ENFORCEMENT ENTITIES THEY
ACTUALLY HAVE MEDICAL DIRECTION
OF SOME FORMER THE OTHER AND SO.
I DON'T KNOW FOR SPECIFICALLY
BUT I WOULDN'T IMAGINE THAT
THOSE INDIVIDUALS ARE ALSO
INVOLVED IN THE PROCESS.
I SEE NO FURTHER QUESTIONS WE
WILL HOLD ISSUE SIX OPEN AND
MOVE ON TO ISSUE SEVEN THANK
.
WHEN YOU'RE READY.
THANK YOU AND.
AS.
LARA THOMAS IN STATE DIRECTOR
FOR THE DRUG POLICY ALLIANCE FOR
A ITEM NUMBER SEVEN. THIS IS OUR
PROPOSAL FOR A LEVIN MILLION
DOLLARS IN STATE GENERAL FUND
DOLLARS TO BE SPENT OVER FOUR
YEARS. TO HELP ADDRESS THE
OPIATE CRISIS OTHER WE'RE
EXPERIENCING HERE IN CALIFORNIA
IN THE GOAL OF OUR PROPOSAL IS
TO PROVIDE FUNDING TO THE HARM
REDUCTION AND SYRINGE ACCESS.
PROGRAMS THAT WE HAVE ACROSS THE
STATE. WHICH ARE VERY OUT BY AND
LARGE VERY.
SHOESTRING BUDGET ORGANIZATIONS
DOING FANTASTIC WORK REACHING
EXACTLY THE SORT OF FOLKS WHO
ARE USING DRUGS OFTEN WHO ARE
ALSO HOMELESS IN MARGINALLY
HOUSE. WITH THE GOAL OF
CONNECTING THEM TO SERVICES THAT
THEY MAY NEED IN PARTICULAR
TAKING ADVANTAGE OF THE FEDERAL
DOLLARS AT THE HUB AND SPOKE.
BAD SYSTEM SO THAT WE CAN
INSURE THAT FOLKS WHO ARE
INJECTING DRUGS WERE COMING
THROUGH SYRINGE ACCESS PROGRAMS
FOR SOME OF THE FIRST IN LINE TO
BE ABLE TO ACCESS THE NEW
TREATMENT OPPORTUNITIES. THAT WE
HAVE THANKS TO THOSE FEDERAL
DOLLARS SO THE GOAL OF OUR
PROPOSAL IS TO BE ABLE TO
PROVIDE A FUNDED STAFF PERSON
FOR MOST OF THE SYRINGE ACCESS
PROGRAMS THAT WE HAVE IN THE
STATE. AS WELL AS FUNDING THE
STATE ADMINISTRATION.
AND FUNDING SOME TO TRAINING
AND TECHNICAL ASSISTANCE FOR
THEIR STAFFERS SO VERY HAPPY TO
GO INTO ANY DETAIL.
A QUESTIONS YOU MIGHT HAVE
ABOUT.
WHY WE FORMULATED THE WAY WE
HAVE AND WHAT WE WANNA DO WITH
US?
THANK YOU MISS THOMAS.
WE WILL NOW TAKE PUBLIC COMMENTS
ON ISSUE SEVEN.
A YES ELIMINATES DALLAS
BLANCHARD I'M THE DIRECTOR OF
THE FRESNO NEEDLE EXCHANGE
PROGRAM.
AND IN THE PAST YEAR WE'VE.
DISTRIBUTED.
FOUR THOUSAND. DOSES OF DARK
CAN.
AND OR PRESCRIPTIONS FOR. AND
WORD ALL VOLUNTEER PROGRAM
THAT'S DOING NEARLY IN MILLION
SYRINGES SO YEAR SO THIS WILL BE
VERY HELPFUL AND.
YEAH PROVIDING FOLLOW UP IN CASE
MANAGEMENT FOR OUR CLIENTS THANK
YOU THANK YOU ALISON WHEN I WAS
REFERENCING EARLIER ABOUT THE
NEEDLE EXCHANGE WAS WORKING IN
COLLABORATION WITH DOCTOR LASHER
WHO I KNOW YOU.
KNOW QUITE WELL KNOWN. AS WELL.
WHEN MEASURE BEHALF OF THE
CALIFORNIA ASSOCIATION OF
ALCOHOL DRUG PROGRAM EXECUTIVES.
EVERY TOOL IS NEEDED TO.
COMBAT THE OPIOID.
A EPIDEMIC INTO REDUCE SUBSTANCE
USE. THEM AND WE SUPPORT THIS
ISSUE
THE GAME.
HANDLING WITHIN THE PRISON LAW
OFFICE AND WERE IN STRONG
SUPPORT OF THIS PROPOSAL AND
YOU'LL. HEAR FROM ME SOON AND
THIS REALLY COMPLIMENTS AWARE AS
WELL THANK YOU
THANK YOU.
UGH UGH EVEN WE'LL WITH THOUGH
HOMELESS HEALTHCARE LOS ANGELES
A CENTER FOR HARM REDUCTION AND
YET WE SUPPORT THIS OF.
BUDGET REQUEST WERE.
IN IN NEED OF.
STAFF FOR OUR MEDICAID ASSISTED
TREATMENT PROGRAM OR SOME BOX IN
A.
SUBMITTED PROGRAM.
THAN A LOT SOME PROGRAM WE.
PROVIDE SERVICES TO PROP CLOSE
TO A HUNDRED PEOPLE A DAY.
AT AT THE CENTER.
WE HAVE WOUND CARE AND.
A THERAPIST WHOSE CONTRACT
ABOUT TO DIE OR WHO ARE AND. SO
HERE WE CANNOT USE A SUPPORT THE
IN IN IN LOS ANGELES AND WE
SUPPORT THE SUB BUDGET REQUEST.
THANK YOU SIR.
HI HANK AND LOWERS MATIX
EXECUTIVE DIRECTOR OF HIV
EDUCATION PREVENTION PROJECT OF
ALAMEDA COUNTY WERE BASED IN
OAKLAND AND WE PROVIDE SYRINGE
ACCESS SERVICES FOR THE CITY OF
OAKLAND. AND CONTRA COSTA
COUNTY.
I AM IN FULL SUPPORT OF GPAS
BUDGET REQUEST UP TO PUT THINGS
IN PERSPECTIVE ON MY PROGRAM
WE'RE CURRENTLY DOING HIV
SCREENING HEPATITIS C.
SCREENING.
TREATMENT PRIMARY CARE AND THE
LOCKS ON DISTRIBUTION THE
MISSING LINK FOR US REALLY ARE
SYRINGE EXCHANGE SITES IS OPIATE
TREATMENT NAVIGATION.
THANKS.
HUMAN.
HI THERE MY NAME IS NICOLE
GOUDREAU AND I AM FROM HARM
REDUCTION COALITION BASED IN
OAKLAND CALIFORNIA I MEAN WE
CAME ALL THE WAY I'M HERE JUST
TO SAY THAT WE STRONGLY SUPPORT
EPA'S I'M BUDGET REQUEST.
THANK YOU THANK YOU.
MY NAME IS NINA MILE I'M I'M
WITH AT THE SAN FRANCISCO AIDS
FOUNDATION IN SAN FRANCISCO AND
WE STRONGLY SUPPORT THIS BUDGET
REQUEST.
AS SOMETHING THAT WE SEE OFTEN
WITH OUR SYRINGES ACCESS PROGRAM
IS PEOPLE COMING IN
CONTEMPLATING TREATMENT HAVING A
LOT OF QUESTIONS ABOUT IT ASKING
IF WE CAN PROVIDE A REFERRAL TO
TREATMENT OR GET FOLKS AND.
OUR STAFF MAINTAINED GOOD
RELATIONSHIPS WITH TREATMENT IN
THE NEIGHBORHOOD.
AND DO WHAT THEY CAN IN ORDER
TO GET PEOPLE AND THIS WOULD
MAKE IT SO MUCH EASIER FOR FOLKS
GET INTO TREATMENT. WHEN THEY
WANT TO KNOW AND.
I GET OFF ON THEIR OWN TIME
THANK YOU THANK YOU.
MISTER CHAIR MEMBERS ROBERT
HARRIS ON BEHALF CALIFORNIA'S
SOCIETY OF ADDICTION MEDICINE.
IMPORTANTLY WE'VE.
FOR TEN IN GLOVE WITH THE DRUG
POLICY ALLIANCE FROM THE START
FROM DIANE WATSON'S BILLS TRIP
MAKING NEEDLE EXCHANGES HAPPEN
IN CALIFORNIA.
AND THESE ARE THE BEST WAYS.
THESE KINDS OF PROGRAMS OF
GETTING PEOPLE INTO TREATMENT
AND NOT STIGMATIZING THEM BUT
REINTEGRATING AND SOCIETY SO WE
SUPPORT.
THANK YOU SIR.
SEEING NO MORE PUBLIC COMMENT ON
BRING IT UP TO THE DYESS FOR ANY
COMMENTS WE MAY HELP.
.
YOU KNOW I I HAD THE PRIVILEGE
THIS LAST YEAR OF RECOGNIZING
DOCTOR LASHER AND I'M JUST
REMINISCING FROM WHEN I WAS BACK
IN RESIDENCY AND HELPING OUT AT
THE NEEDLE EXCHANGE BUT IT WAS
THESE PROGRAMS AND BEING ON THE
FRONT LINES.
THAT REALLY DOES MAKE A WORLD OF
DIFFERENCE IN ITS MEETING PEOPLE
WHERE THEY'RE AT.
I THANK YOU FOR THIS PROPOSAL WE
WILL HOLD ISSUE SEVEN OPEN IN
THE BOND ISSUE EIGHT THINKING
CARE.
WHICH IS ALSO ME.
READY.
AM SO AS A ISSUE EIGHT III IS
RELATED BUT SLIGHTLY DIFFERENT.
A NUMBER OF YEARS AGO WE WORKED
WITH.
THEN ASSEMBLY MEMBER.
SKINNER ADD TO AUTHOR ASSEMBLY
BILL SIX OH FOREST THAT GIVE THE
AND STATE DEPARTMENT OF PUBLIC
HEALTH THE ABILITY TO AUTHORIZE
SYRINGE ACCESS PROGRAMS. AYE IN
COUNTIES WHERE THERE WAS A
DEMONSTRATED HIGH NEED BUT WHERE
THE COUNTIES HAD NOT.
TAKEN ACTION TO DO THAT.
THAT WILL.
WOULD IF NOT.
AMENDED SUNSET AT THE END OF
THIS YEAR SO THIS.
PROPOSAL IS COMING THROUGH THE
BUDGET IN LARGE PART BECAUSE WE
DON'T WANT THERE TO BE A GAP.
IN FUNDING OR IN STAFFING OR AN
AUTHORIZATION AS INSTEAD OF
WAITING FOR THE SUNSET BUT
MOVING THIS FORWARD TO THE
BUDGET.
IT'S A POOR PROPOSING TRAILER
BILL LANGUAGE TO DELETE THE SONS
THAT REDUCE THE PUBLIC COMMENT
PERIOD OUT FROM NINETY DAYS TO
FORTY FIVE DAYS TO BETTER
STREAMLINE. THESE PROGRAMS AND.
THEM HAVE THE ADDED BENEFIT OF
SAVING US SOME FUNDING IN THE
PROCESS AND THEN.
ANOTHER MINOR RELATIVELY MINOR
AMENDMENT TO GIVE THE A LOCAL
AND STATE. GOVERNMENTS THE
ABILITY TO DETERMINE WHAT
MATERIALS NEED TO BE PURCHASED.
FOR THESE PROGRAMS AND GIVING
THEM THE ABILITY TO DETERMINE
WHAT IS NEEDED BY THOSE PROGRAMS
AS SOME.
THINGS ARE STILL CAUGHT UNDER
THE PARAPHERNALIA.
HELL LANGUAGE WE WEREN'T QUITE
BROAD ENOUGH IN THE ORIGINAL
LANGUAGE AND SOME OF THE I'M
PROGRAM MATERIAL SUPPLIES I HAVE
NOT BEEN ABLE TO BE PURCHASE OF
THIS WITHOUT THEM TO THE LIST.
THANK YOU.
WE WILL NOW TAKE PUBLIC COMMENT
ON ISSUE EIGHT.
AGAIN AND MAYBE HAVE HOPEFULLY
FOR THE FINAL TIME. ROBERT
HARRIS ON BEHALF OF CALIFORNIA
SOCIETY OF ADDICTION MEDICINE.
NEEDLE EXCHANGES.
WORK REALLY CONTROVERSY ON NOW
WE KNOW THEY WORK.
STREAMLINING GIVING MORE FROM
OPEN.
THE BEST POSSIBLE THING WE CAN
DO BUT TO SAVE LIVES TO STOP THE
SPREAD OF DISEASE AND GET PEOPLE
INTO TREATMENT AND SO WE
SUPPORT.
A HELLO DEL SPLINTERED WITH THE
PRESIDENT ELECT SHANGE PROGRAM
AND WERE IN STRONG SUPPORT THANK
YOU THANK YOU SIR.
LIVING WITH YOUR HOME WITHOUT A
LOS ANGELES CENTER FOR ARMY
DUCKS IN AND AND WE STRONGLY
SUPPORT THIS.
DRUG POLICY ALLIANCE A BUDGET
REQUEST.
YES SIR.
I GAMBLERS MATIX ALONE HAVE PACK
AND OAKLAND AND WE STRONGLY
SUPPORT DP IS BUDGET REQUEST.
HI THERE NICOLE DROVE OFF FROM
HARM REDUCTION COALITION WE
STRONGLY SUPPORT GPAS BUDGET.
THANK YOU.
NINA MYELIN WHAT OF SAN
FRANCISCO AIDS FOUNDATION WE
STRONGLY SUPPORT THIS REQUEST
HUMAN.
WHO IMAGE SHARMA HAVE THE
CALIFORNIA ASSOCIATION OF
ALCOHOL DRUG PROGRAM EXECUTIVES
SAU ALL TOOLS ARE NEEDED FOR?
COMBATING THIS CRISIS IN THE
CERTAINLY IS ONE OF AND WE
SUPPORTED THANK YOU THANK YOU
AND.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO THE DYESS FOR
ANY QUESTIONS WE MAY HAVE.
SEEING NONE I WILL.
THAT.
REITERATE MY SUPPORT FOR THE
INITIAL PIECE OF LEGISLATION AND
WILL WORK ON TRAILER BILL
LANGUAGE
WITH THE ADVOCATES HERE BEFORE
US TODAY.
BUT WILL HOLD THIS ISSUE OPEN
FOR NOW AND MOVE ON TUITION.
THANK YOU VERY MUCH.
YOU
.
I THINK YOU CHAIR ARAMBULA AND I
MEMBERS OF THE COMMITTEE FOR
THIS OPPORTUNITY TO SPEAK HERE
MONEY WITH WHEN WILL.
I'M I WORK AT THE PRISON LAW
OFFICE IN ORDER TO GIVE PEOPLE
LEAVING CALIFORNIA STATE PRISONS
THE OPPORTUNITY TO CONNECT TO
SUBSTANCE ABUSE TREATMENT.
OUR OFFICE RESPECTFULLY REQUEST
THAT YOU AND A HALF MILLION
DOLLARS BE ALLOCATED TO THE
DEPARTMENT OF HEALTH OFFICE OF
AIDS. TO PROVIDE OVERDOSED
EDUCATION.
TO I INCARCERATED PEOPLE AND
ALSO TWO DOSES OF NALOXONE A
HIGHLY EFFECTIVE OPIOID
REVERSING TRIED TO THOSE WHO
WANT IT UPON RELEASE.
THE RISK OF A FATAL DRUG
OVERDOS AMONG PEOPLE DURING THE
FIRST TWO WEEKS AFTER RELEASE
FROM PRISON HAS BEEN FOUND TO BE
ONE HUNDRED AND TWENTY NINE
TIMES AS HIGH AS THAT OF THE
GENERAL POPULATION.
A NORWEGIAN STUDY FOUND THAT
EIGHTY FIVE PERCENT.
OF DEATH IN THE TWO WEEKS AFTER
RELEASE WERE FROM DRUG OVERDOSE
AND IN NEW YORK CITY JAILS
THIRTY SEVEN POINT TWO PERCENT
OF DEATHS IN THE FIRST SIX WEEKS
AFTER RELEASE. WERE FROM OPIOID
OVERDOSES.
THESE HIGH RATES OF OVERDOSE
DEATHS ARE DUE TO THE FACT THAT
INCARCERATION OFTEN LEADS TO A
LOWER TOLERANCE THE TYPES OF
DRUGS THAT ARE AVAILABLE UPON
RELEASE. AND THIS IS BECAUSE
PEOPLE USE LESS DRUGS OTHER CARS
RATED OR NO DRUGS I HAVE AND
ALSO BECAUSE THE DRUGS IN PRISON
ARE USUALLY OF LOWER PURITY AND
STRENGTHENS STREET DRUGS.
IN CALIFORNIA WE'VE A
PARTICULARLY DRAMATIC RATE OF
SUBSTANCE ABUSE PROBLEMS IN OUR
PRISON POPULATION. PEOPLE
INCARCERATING CALIFORNIA STATE
PRISONS ARE NEARLY FOUR TIMES AS
LIKELY AS PEOPLE IN OTHER STATE
AND FEDERAL PRISONS TO DIE OF
DRUG OR ALCOHOL INTOXICATION.
THE DRUG OVERDOSE DEATH AND TCR
IS FIFTY PERCENT HIGHER THAN THE
GENERAL CALIFORNIA POPULATION
AND THIS UNDERSCORES THE
IMPORTANCE OF PROVIDING OVERDOSE
PREVENTION AND EDUCATION AND
ACCESS TO LOCK SEVEN. TO PEOPLE
THAT ARE INCARCERATING
CALIFORNIA'S THEY REENTER THE
COMMUNITY.
PROVIDING A LOT THAT PEOPLE
LEAVING THE PRISON AND HAS BEEN
SHOWN TO REDUCE MORTALITY RATES
TWENTY SEVEN TO FORTY SIX
PERCENT IN THE FIRST WEEKS AFTER
RELEASE THAT GIVE THEM TIME TO
CONNECT.
TO COMMUNITY BASED SERVICES AND
HELP THEM RECOVER FROM SUBSTANCE
ABUSE. AND IN THE LONG TERM.
OUR PROPOSAL IS MODELED AFTER
REALLY SUCCESSFUL PROGRAM IN SAN
FRANCISCO THE BEGINNING TWENTY
THIRTEEN. THAT DISTRIBUTES
PEOPLE TO ADD THAT DISTRIBUTES
INTO PEOPLE LEAVING THE JAIL
ANYONE WHO WATCHES THE
EDUCATIONAL VIDEO CAN OPT TO
RECEIVE IT. I'M PARTICULARLY IN
CORRECTIONAL SETTINGS THIS IS
DONE TO AVOID THE STIGMA. AND.
BARRIERS ASSOCIATE WITH SELF
IDENTIFYING ARE BEING IDENTIFIED
AS SOMEONE WITH A SUBSTANCE
ABUSE PROGRAM. AT SUBSTANCE
ABUSE PROBLEM.
THE DOPE PROJECTS DRUG OVERDOSE
PREVENTION EDUCATION COORDINATES
THE DISTRIBUTION OF NALOXONE IN
SAN FRANCISCO JAIL LINKAGE TO
COMMUNITY IS AN INTEGRAL PART OF
IMPROVING HEALTH OUTCOMES FOR
PEOPLE LEAVING JAIL AND PRISON.
BEYOND JUST REDUCING OVERDOSE
DEATHS IMMEDIATELY AFTER
RELEASED AND THIS IS WHY WE ALSO
SUPPORT THE BUDGET REQUEST THAT
YOU HEARD ABOUT FROM EPA TO
SUPPORT CARE NAVIGATORS AND HARM
REDUCTION PROGRAMS. I'M LIKE THE
DOUGH PROJECT.
I REQUEST FOR TWO AND A HALF
MILLION DOLLARS. IS BASED ON THE
PRICE OF MARK AND THE NASAL
SPRAY FORMULATION.
IT COST SEVENTY FIVE DOLLARS AS
YOU HEARD PREVIOUSLY FOR TWO
DOSES AND THERE ARE
APPROXIMATELY THIRTY FIVE
THOUSAND PEOPLE THAT ARE
RELEASED.
FROM CDC R. COSTA EACH YEAR SO
THAT COSTA THEN ARE CAN IS
APPROXIMATELY ONE POINT SEVEN
SIX MILLION. AND THE REMAINING
FUNDS WOULD BE AWARDED TO
COMMUNITIES ORGANIZATIONS TO
DEVELOP EDUCATIONAL MATERIALS
PROVIDE TECHNICAL ASSISTANCE.
SUPPORT OR ESTABLISH HARM
REDUCTION NAVIGATION PROGRAMS
THAT CONNECTS PEOPLE BEING
RELEASED
FROM PRESENT TO PROGRAMS IN
THEIR COMMUNITIES.
THANK YOU MA'AM. WILL NOW TAKE
PUBLIC COMMENTS ON ISSUE MONEY.
FULLER THOMAS A DRUG POLICY
ALLIANCE IN STRONG SUPPORT OF
THIS.
THANK YOU.
SEEING NO FURTHER PUBLIC COMMENT
I'LL BRING IT UP TO THE DYESS
FOR ANY QUESTIONS WE MAY HAVE.
I I JUST HAVE ONE AND IT'S A
BUDGETING ISSUE ON TRYING TO
UNDERSTAND.
PUBLIC HEALTH VERSUS CDC ARE SO.
DUMB IS THIS A RESPONSIBILITY OF
THEM LEAVING CORRECTIONS THAT
SINCE THEY'RE UNDER THEIR THE
BUDGET ITEM SHOULD COME
FROM CDC OUR PURSES.
FROM PUBLIC HEALTH AND I'M
TRYING TO UNDERSTAND HOW YOUR
AND YOUR TO SAY YEAH AND I
DISCUSSED THIS WITH SUB FIVE AS
WELL AND SO THE.
THERE HAVE BEEN A LOT OF
DISCUSSIONS ABOUT THIS I ALSO
TALK TO PEOPLE IN VARIOUS.
DEPARTMENTS LAKE CITY PEACH AND
I'M THE REASON IT'S.
THROUGH PUBLIC HEALTH IS
BECAUSE WE'RE TRYING TO CONNECT
THEM NOT ONLY TO.
YOU KNOW TO MAKE SURE THAT THEY
ARE.
NOT OVER NOTHING IN THOSE THOSE
FIRST FEW WEEKS AFTER RELEASE
BUT ALSO TO CONNECT THEM TO
SERVICES AND PROGRAMS AND I'M
IT'S ALSO A LOT THERE'S AS THE
VERY SIMILAR PROGRAM IN NEW
YORK.
AND THAT IS ALSO.
YOU KNOW THAT THE FOCUS IS
REALLY ON GETTING PEOPLE
CONNECTED TO TREATMENT AND SO
WHILE CORRECTIONS IS INVOLVED
BECAUSE THEY HAVE TO PROVIDE THE
MEDICATION.
THE MAIN GOAL IS TO CONNECT
THEM TO SERVICES IN THE
COMMUNITY AND BECAUSE MOST
PEOPLE OF RE ENTER IN
COMMUNITIES I'M. THAT ARE NOT IN
THE COUNTY WHERE THERE PRISON
IS.
THIS IS A WAY TO TO MAKE THAT
AN EASIER TRANSITION.
I'M.
SEE NO FURTHER QUESTIONS WE WILL
HOLD ISSUE NINE OPEN AND MOVE ON
TO ISSUE TEN. THANK YOU
WHEN YOUR EDITOR.
GOOD AFTERNOON MISTER CHAIRMAN
MEMBERS.
MULLIN THE DIRECTOR DEPARTMENT
STATE HOSPITALS.
DEPARTMENTS TO HOSPITALS OBSCENE
FRIDAY OF FEEL WAS ESTABLISHED
JULY FIRST TWO THOUSAND TWELVE
TO MANAGE AND OPERATE THE STATE
HOSPITAL SYSTEM FOR MENTALLY ILL
PATIENTS. A CALIFORNIA.
WE CURRENTLY HAVE FIGHTS STATE
HOSPITALS ONE IN NORTHERN
CALIFORNIA TO IN CENTRAL
CALIFORNIA AND TWO DOWN IN
SOUTHERN CALIFORNIA.
WE ALSO OPERATE OVERSEE A
CONDITIONAL RELEASE PROGRAM.
REFERRED TO AS CONRAD FOR
OUTPATIENTS.
WE ALL SAID OVERSEE GEL BASED
COMPETENCY TREATMENT PROGRAM
WITHIN MANY MANY AND GELS THIS
PLANE TIME.
OTHER PATIENTS ARE COMMITTED TO
THE DEPARTMENT THROUGH THE
COURTS AND BE A COURT ORDERS.
THROUGH THE CDC ARE ABBIA IMHO
YOU. AND ARE ALSO OUR CIVIL
PATIENTS ARE THROUGH THE
CONSERVATIVE PART.
UNSERVED SHIP PROCESS.
OVER THE PAST TWENTY TO TWENTY
FIVE YEARS THE DEPARTMENT'S
POPULATION DEMOGRAPHICS HAS
SHIFTED FROM PRIMARY CIVIL COURT
COMMITMENTS TO FRIENDS
POPULATION REFERRED THROUGH THE
CRIMINAL COURT SYSTEM.
IT'S ABOUT NINETY ONE PERCENT OF
OUR POPULATION NOW AS FORENSIC
IN ABOUT NINE PERCENT SEVERAL.
I'VE READ OUR FRIENDS OF
POPULATION IS REFERRED TO AS ARE
NOT GUILTY BY REASON OF INSANITY
OR INCOMPETENT TO STAND TRIAL.
MENTALLY DISORDERED OFFENDERS
ARE MENTALLY ILL PRISONERS AND
ARE SUCH A VIOLENT PREDATORS.
NOT NINE PERCENT IS.
CIVIL.
POPULATION WHICH IS CONSERVE TO
THE LANTERN MEN PETRA SHORT.
PROCESS.
WE LOOK AT OUR POPULATION AS
SHORT TERM AND LONG TERM OR
SHORT TERM ARE ARE INCUMBENT
STAND TRIALS WHICH HAVE AN
AVERAGE LIKE THE STATE ABOUT
HUNDRED SIXTY FOUR DAYS. AND ARE
AM MENTALLY ILL PRISONERS WHICH
ARE BETWEEN SIX AND SEVEN
MONTHS.
THE LONGER TERM OR THE OTHER
COMMITMENTS SUCH AS INDIA AYE
ESCAPEES INDIOS AND LPS AND THAT
THE TIMES LIKE TO FINDS VERY.
WE HAVE SEVERAL TYPE TREATMENT
PROGRAMS BEEN INPATIENT
OUTPATIENT AGAIN OUR JAIL BASED
PROGRAM AND THIS YEAR WERE
ACTIVATING OUR ASSESSMENT
EVALUATION STABILIZATION CENTER
WHICH IS AN KERN VALLEY.
AND WE ARE ALSO PROPOSING SOME
DIVERSION PROGRAMS WHICH YOU'LL
HEAR ABOUT A LITTLE BIT LATER.
OUR CLINICAL TREATMENT INCLUDES
MEDICAL MENTAL HEALTH AND
DENTAL.
AND WE ALSO FOCUS OUR TREATMENTS
ON TRINA PATHWAYS DEPENDING ON
THE COMMITMENT THAT WE'RE
TREATING.
WE HAVE OUR WHICH PETER PATIENTS
WITH MULTI DISCIPLINARY TRAINING
AND TREATMENT TEAMS WHICH ARE.
PHYSICIANS PSYCHIATRISTS
PSYCHOLOGISTS SOCIAL WORKERS
REHAB THERAPISTS AND NURSES
WHICH INCLUDES LIKE TEX AND OURS
I'M REGISTERED NURSES.
WE HAD SOME SIGNIFICANT CHANGES
ONE AS I SAID WE CAME FROM THE
DEPARTMENT OF ALCOHOL THAT WE
ESTABLISH A DEPARTMENT STATE
HOSPITALS JULY FIRST TWO
THOUSAND TWELVE.
WE FOCUSED ON BECOMING AN
ENTERPRISE ORGANIZATION WE
WANTED TO LEVERAGE OPPORTUNITIES
TOWARDS EFFICIENCIES.
AND.
LOOK AT OUR RESOURCES SYSTEMS
OF BEST PRACTICES.
PRIOR TO TWO THOUSAND TWELVE WE
OPERATED FIVE SEPARATE AND.
HOSPITALS AND OUR KIND OF
FOCUSING ON ENTERPRISE AND
BECOMING ONE SYSTEM.
WE ALSO IT ESTABLISHED A
CLINICAL OPERATIONS DIVISION
WHICH WAS BRINGING OUR
CLINICIANS FROM THE HOSPITAL'S
I'M SUCH AS NURSES ALL OF THE
DISCIPLINES THAT WE HAVE. INTO
FOCUSING ON EMBRACING.
I'M POLICY AND MAKING DECISION
MAKING PROCESSES WITH US
BRINGING THEM INTO OUR
SACRAMENTO BASE HEADQUARTERS.
FINALLY WE ARE NOW FOCUSING ON
OUR PHILOSOPHY A LITTLE BIT
BEYOND VETS.
WE TALK ABOUT CAPACITY YOU HEARD
US LAST YEAR TALK ABOUT CAPACITY
WE HAVE WAIT LIST YOU'LL HEAR
ABOUT THAT AGAIN THIS YEAR.
BUT WE NOW WE'RE LOOKING ON.
BEYOND CAPACITY MEANING.
LOOKING AT THE DEMAND WISER
DEMAND OUT THERE WE ALSO LOOK AT
OUR SYSTEMS THAT ARE
EFFICIENCIES HELP WE BETTER
SERVE HAVE WE BETTER MANAGE THE
POPULATION BECAUSE WE HAVE A
LIMIT ABOUT A CAPACITY IN STATE
HOSPITALS.
SO WE'LL LOOK AT.
HOW DO WE STRATEGICALLY POUND
FOR OUR DEPARTMENT IN THE STREET
CATEGORY?
SO WE ALSO HAD A MAJOR CHANGE IN
JULY ONE TO TWO THOUSAND
SEVENTEEN WHICH I KNOW YOU ARE
FAMILIAR WITH AS WELL WE TOOK
OUR THREE PSYCHIATRIC PROGRAMS
THAT WE OPERATED FOR MANY YEARS
INSIDE THE PRISON SYSTEM AND WE
TRANSFER THOSE BACK TO CDC ARE.
AND. I AM PROUD TO SAY THAT
THEY'RE RUNNING THEM VERY WELL.
WE HAVE TO PROPOSALS FOR THIS
YEAR'S BUDGET MY MINUTE HAVE
THAT OFTEN MISS CLINTON MY CHIEF
DEPUTY DIRECTOR.
I THINK IT'S NOT LIKELY THAT
ANTI PEPPY DIRECTOR FOR THE
DEPARTMENT OF STATE HOSPITALS
AND I'LL START OFF WITH JUST A
WROTE A QUICK BRIEF AND.
HIGH LEVEL OVERVIEW OF THE
DEPARTMENT BUDGET AND THEN GET
INTO THE PROPOSALS THAT MARK
COVERED ELSEWHERE IN THE AGENDA.
I AM AS JUST AS A GOOD OVERVIEW
OF THE BUDGET ARE PROPOSED
BUDGET FOR TWO THOUSAND EIGHTEEN
NINETEEN TOTALS ONE POINT NINE
BILLION DOLLARS WHICH IS AN
INCREASE OF TWO HUNDRED EIGHTY
EIGHT POINT SIX MILLION FROM THE
UMPIRE BUDGET.
THIS YEAR WE HAVE REORGANIZED
OUR BUDGET DISPLAY A MINT ADD TO
IN ORDER TO INCREASE
TRANSPARENCY IN BELT BETTER
ILLUSTRATE ON BUDGET DETAILS.
FURTHER WE CONTINUE TO PROVIDE
ANNUAL REPORTS TO THE
LEGISLATURE ON FINANCIAL
EXPENDITURES OF THE STATE
HOSPITALS AND PATIENT OUTCOMES
TO PROVIDE ADDITIONAL
TRANSPARENCY HONOR SYSTEM.
WE HAVE AN THREE MAJOR
CATEGORIES A PROPOSAL'S THIS
YEAR THEY INCLUDE INCREASED
CAPACITY IN POPULATION CASELOAD
ADJUSTMENTS I AM RELATED TO THE
POPULATION THAT WE SERVE. WE
HAVE I'M SEVERAL INFORMATION
TECHNOLOGY BUDGET CHANGE
PROPOSALS AND I'M SEVERAL
CAPITAL OUTLAY CONTINUING
PROJECTS AND THAT YOU'LL HEAR
LATER ON IN THE AGENDA.
SO FOR THE PROPOSALS THAT ARE
INCLUDED ELSEWHERE IN THE AGENDA
OF THE FIRST IS.
EVERY QUEST RELATED TO ENHANCE
TREATMENT PROGRAM. WE'RE
REQUESTING TWO POINT EIGHT
MILLION AND TWENTY THREE POINT
TWO POSITIONS IN THE BUDGET YEAR
AND EIGHT POINT THREE MILLION
AND SIXTY FIVE POINT SEVEN
POSITIONS IN. FISCAL YEAR
NINETEEN TWENTY AN ON GOING FOR
THE ACTIVATION OF THE REMAINING
TWO UNITS OF OUR NEW ENHANCE
TREATMENT PROGRAM. AND JUST BY
WAY OF KIND OF A REFRESHER ON
THE BACKGROUND ON THIS BECAUSE
WE HAVE BEEN BEFORE THE
COMMITTEE.
IT IN PREVIOUS YEARS BOTH IN A
CAPITAL OUTLAY CAPACITY AS WELL
AS AND FOR PROGRAMMATIC AND
BENDING. AND SO AB THIRTEEN
FORTY AUTHORIZES THE DEPARTMENT
TO IMPLEMENT AND OPERATE A PILOT
ENHANCE TREATMENT PROGRAM FOR A
LIMITED PERIOD OF TIME. WHICH IS
TO TREAT PATIENTS ARE AT HIGH
RISK OF THE MOST DANGEROUS
BEHAVIOR IN ORDER TO DETERMINE
WHETHER A MORE.
INTENSIVE TREATMENT PROGRAM IN
A HIGHER SECURITY SETTING IS AN
EFFECTIVE WAY TO IMPROVE THE
PATIENT'S CONDITION REFER THEM
TO THE GENERAL PATIENT
POPULATION. AND THIS WAS IN
RECOGNITION OF THE CHANGE IN OUR
PATIENT POPULATION OVER THE LAST
TWENTY FIVE YEARS FROM A PRIMARY
CIVIL HAS CIVILLY COMMITTED
PATIENT POPULATION TO.
A PRIMARY FORENSIC POPULATION
WHO COME WITH CHALLENGES WITH
RESPECT TO I'M CRIMINAL
BEHAVIORS AND.
AT A HIGHER PROPENSITY FOR
VIOLENCE.
AND SO WITH THIS PROPOSAL WE
HAVE ANY.
LAST YEAR WE CAME BEFORE THE
COMMITTEE REQUESTING THAT
FUNDING FOR THE FIRST TWO ACTING
UNIT ACTIVATIONS AD AT
ATASCADERO STATE HOSPITAL
THERE'S A TOTAL OF THREE UNITS
PROPOSED PARKS USING. FOUR UNITS
PROPOSED FOR THIS PROJECT THREE
AT ATASCADERO STATE HOSPITAL TWO
OF WHICH WERE FUNDED IN I'M THIS
YEAR'S BUDGET. AND THIS REQUEST
IS FOR THE FUNDING FOR THE THIRD
UNIT OUT ATASCADERO STATE
HOSPITAL AND THE FOURTH UNIT OUT
PATENTS IN THE ONE UNIT BUT
FOURTH UNIT AT PATTON STATE
HOSPITAL.
.
THIS ALSO INCLUDES.
AS SAVINGS I HAVE RELATED TO IN
THE CURRENT YEAR RELATED TO
DELAYS IN THE ACTIVATION OF THE
FIRST TWO UNITS. AND WE'VE HAD
AND THAT UNAVOIDABLE DELAYS DUE
TO ATTAINING STATE FIRE MARSHAL
I'M APPROVALS ON THE
CONSTRUCTION PLANS DUE TO THIS
YEAR'S FIRE SITUATION.
AND SO FOR THE THESE UNITS.
WE ARE PROPOSING STAFFING ON
THESE UNITS.
AT A NURSING STAFFING RATIO OF
ONE TO ONE POINT FIVE I'M FOR
ARE IN MP TIAN AND IN PM.
AND ONE TO THREE FOUR THAT NOT
SHIFT AND WE HAVE MEANING I'M
ENHANCE TREATMENT TEAM PROPOSES
AND THE GOAL HERE REALLY IS
PROVIDE. DE VERY ENHANCE
TREATMENT IN THIS.
IN THESE.
UNITS AND WHICH ADDS A
PSYCHOLOGIST AND REHAB SERVICE
TO OUR NORMAL COMPLEMENT OF. OF.
TREATMENT TEAM THIS INCLUDES
HOSTILE PLACES OFFICERS AS WELL
AS OTHER AND ANCILLARY AND
STAFFING AND. OTHER POSITIONS.
.
SO THAT IS THE ENHANCE TREATMENT
PROGRAM TO LET ME CONTINUE GO
THROUGH EACH ONE OR STOP.
I MAY STOP YOU ON ISSUE TEN IF I
MAY AND THEN IF WE NEED TO WE
CAN ADDRESS THEM AS THEY'RE
COMING UP.
WANTED TO TAKE PUBLIC COMMENT
ON ISSUE TEN AT THIS MOMENT.
THIS TREND MEMBERS COULD BE
BESIDE WITH CALIFORNIA
ASSOCIATION OF PSYCHIATRIC
TECHNICIANS WE WHOLEHEARTEDLY
SUPPORT.
THE SET PROPOSAL IN A.
THE REQUEST FOR STAFFING.
AS YOU KNOW THE SAKE TECHS WERE
PART OF A COALITION THAT.
.
WROTE THE LEGISLATION FOR THE
ENHANCE TREATMENT PROGRAM SO WE
ARE ABSOLUTELY.
THRILLED TO SEE THAT THE
STAFFING START TO COME ONLINE AS
WELL AS THE CONSTRUCTION OF
THESE FACILITIES. THANK YOU.
YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT
ON ISSUE TEN I'LL BRING IT UP TO
THE DYESS RUNNING.
QUESTIONS OR COMMENTS THAT WE
MAY HAVE.
SEEING NONE I WANTED TO.
.
THIS.
QUESTION ABOUT I S. T. IS ONE
THAT HAS BEEN REOCCURRING AND
I'M REALLY LOOKING FOR A LITTLE
DIRECTION IF I CAN.
ARE WE EFFECTIVELY STEMMING THE
TIDE AND.
ARE WE MAKING HEADWIND. IN LIGHT
OF WHAT NUMERICALLY WE ARE
SEEING IN TERMS OF VOLUME.
AND ARE WE DECREASING THE AMOUNT
OF TIME THAT I CITIES ARE
AWAITING PLACEMENT.
HOW OF OUR METRICS CHANGED?
SINCE THE PAST YEAR AND HOW
WOULD THESE POTENTIAL PROGRAM'S
IMPACT THOSE METRICS GOING
FORWARD.
SO AND WITH RESPECT TO THE
INCOMPETENT TO STAND TRIAL.
POPULATION.
YEAH I MEAN HOLD ISSUED TEN OPEN
A MOVE TO ISSUE ELEVEN WHICH IS
ABOUT HIGHEST HE'S.
AND IF YOU WOULD LIKE TO MAKE
YOUR COMMENTS FIRST AND THEN
SAVE THAT QUESTION FOR.
AFTERWARDS THAT'S OKAY TOO LATE
BECAUSE SOME OF THEIR COMMENTS
MIGHT ADDRESS SOME OF THOSE
QUESTIONS.
THINKING.
SO I WITH RESPECT TO THE
PROPOSALS RELATED TO THE END AND
COMPETENT TO STAND TRIAL.
.
AND POPULATION AND JUST BY WAY
OF BACKGROUND AND SOME OF THE
EFFORTS THAT WE HAVE UNDERTAKEN
OVER THE LAST SEVERAL YEARS AND.
SO IT AND BACK IT STARTED BACK
IN TWO THOUSAND THIRTEEN WHEN WE
BEGAN TO EXPERIENCE AN INCREASE
IN THE NUMBER OF REFERRALS AND
THEN A GROWING WEIGHTLESS AND.
HAVE OF INDIVIDUALS PENDING
PLACEMENT TO A STATE HOSPITAL.
THE.
.
WE HAVE FOCUSED ON ADDRESSING
THAT GROWING REFERRAL BASE AS
WELL AS THE GROWING WEIGHTLESS
IN AND IN THE KIND OF THREE
DIFFERENT DOMAINS.
THE FIRST WHEN YOU KNOW WE START
TO SEE A WEIGHTLESS INCREASE
FIRST THING WE USUALLY DO IS
OPEN CAPACITY AND SO THAT'S HOW
WE STARTED ADDRESSING. THE
CHALLENGES WITH CAPACITY
INCREASES AND OVER THE PAST
SEVERAL YEARS WE HAVE OVER AND
OVER FOUR HUNDRED AND ELEVEN
EXCUSE ME FOUR HUNDRED ELEVEN
BEDS IN THE STATE HOSPITALS. AND
OVER TWO HUNDRED BEDS AND THE
JOB IS COMPETENCY TREATMENT
PROGRAMS OR TWO HUNDRED AND
SEVENTEEN BEDS TODAY.
AND WITHOUT CAPACITY WE HAVE
I'M SIGNIFICANTLY GROWN OUR
pABILITY TO TREAT INCOMPETENT TO
STAND TRIAL PATIENTS WITHIN OUR
SYSTEM. SO WE NOW HAVE AN
AVERAGE DAILY CENSUS IN IN
SIXTEEN SEVENTEEN WE HAD AN
AVERAGE DAILY CENSUS OF ONE
THOUSAND FIVE HUNDRED AND TWENTY
FIVE.
BIASED HE'S IN OUR SYSTEM
COMPARED TO ONE THOUSAND TWO
HUNDRED AND TWENTY EIGHT I'M
BACK INTO AND TWO THOUSAND
TWELVE THIRTEEN.
THE AND WE HAVE ALSO AND IT
IT'S.
JUST KIND OF WITH NOT ONLY
CAPACITY EXPANSIONS BUT NOW I'M
CUDDLING I'M SYSTEMS
IMPROVEMENTS. AND THOSE FIGHT
FIFTEEN HUNDRED AND TWENTY FIVE.
AVERAGE REALLY SUNSETS WERE
ACTUALLY SERVING FIVE THOUSAND
THREE HUNDRED AND.
SIXTY ONE TOTAL BETWEEN OUR
STATE HOSPITALS IN JAIL MAYES
TREATMENT PROGRAMS NOW AND TODAY
SO THERE'S QUITE A FEW.
ON AN ANNUAL BASIS THAT ARE
SERVED EVEN THOUGH BETWEEN THE
STATE HOSPITALS AND THE JOB IS
COMPANIES TREATMENT PROGRAMS WE
HAVE YOU KNOW AN AVERAGE DAILY
CENSUS OF ONE THOUSAND FIVE
HUNDRED TWENTY FIVE THE STATE
HOSPITALS AND.
HUNDRED AND FORTY ONE LAST YEAR
IN THE.
.
AND THE AGE OF IS COMPLICATED IN
TOTAL WE SERVED OVER FIVE
THOUSAND HIGHEST HE'S IN THOSE
TWO SYSTEMS.
AND SO THERE'S BEEN A
SUBSTANTIAL AMOUNT OF INCREASING
CAPACITY IN THROUGHPUT ON THOSE
BEDS AND IN TURN AND TURN OVER
OF WHO WERE TRAINING IN THOSE
BEDS. AND LOOKING BACK JUST KIND
OF WALKING BACK THROUGH THE AND
THE WAIT LIST YOU KNOW IN IN
JUNE OF TWO THOUSAND AND FIFTEEN
IT WAS A THREE HUNDRED AND
EIGHT.
JUNE OF TWO THOUSAND AND
SEVENTEEN IT WAS FIVE HUNDRED
AND FORTY AND TODAY WE'RE
SITTING OUT.
LYNN APRIL IS NINE HUNDRED AND
SEVENTY TWO SO WE HAVE ADDED A
SUBSTANTIAL AMOUNT OF CAPACITY
BUT CONTINUE TO SEE INCREASING
REFERRAL BASE.
SO THAT'S WHEN WE STARTED
LOOKING AT IT WE'RE NOT BUILDING
WHO ARE WAY OUT OF THIS AND SO
REALLY HOW DO WE ADDRESS THIS
FROM. FROM A DIFFERENT
PERSPECTIVE I'M FIRST FONG WERE
WERE OUT OF CAPACITY WENT MONTHS
WE AND MAKE THESE PROPOSALS.
THIS YEAR THAT'S REALLY THE
EXTENT OF CAPACITY IN THE STATE
HOSPITAL SYSTEM. AND WE CONTINUE
TO YOU KNOW PROPOSED ADDITIONS
TO THE JAIL BASS COMPENSATE
TREATMENT PROGRAM BUT REALLY
LOOKING AT WHAT ARE THOSE OTHER
SOLUTIONS AND SO I'M WILL TALK
AND IT WILL GO THROUGH THE
PROPOSAL'S BUT. AND TO THE
PROPOSALS ARE REALLY AND
DIFFERENT FOR US THIS YEARAND
ONE BEING.
A PARTNERSHIP WITH LA COUNTY TO
TREAT INCOMPETENT TO STAND TRIAL
PATIENTS IN THE COMMUNITY.
AND THEN THE SECOND BEING THE
DIVERSION PROGRAM.
WHICH IS LOOKING TOWARDS AND
GETTING OUT IN FRONT OF THESE
INDIVIDUALS WHO ARE CYCLING
THROUGH THE CRIMINAL JUSTICE
SYSTEM.
DIVERT THEM FROM THE CRIMINAL
JUSTICE SYSTEM AND BEFORE THEY
COME TO US AS AN INCOMPETENT TO
STAND TRIAL PATIENT. AND GET
THEM CONNECTED TO THE SERVICES
THAT THE RIVER 'M SHOULD BE
RECEIVING AND THE IN THE
COMMUNITY.
SO THAT'S KIND OF LIKE A HIGH
LEVEL OVERVIEW OF AND THE
PROPOSALS COMING BY.
THAT'S KIND OF THE THE
CHALLENGES OF WHERE WE STAND FOR
THE WE'VE BEEN DOING A LOT
WORKING FEVERISHLY TO TRY TO
STEM THE TIDE AND GET OUT IN
FRONT. BUT THE REFERRALS DO
CONTINUE TO INCREASE.
FASTER THAN WE CAN OPEN
CAPACITY AND AND IT'S NOT JUST A
PROBLEM HERE IN CALIFORNIA IT'S
A NATIONAL TREND.
WE YOU KNOW ARE IN CONTACT WITH
OUR STATE HOSPITAL PARTNERS AT A
NATIONWIDE AND AND. YOU KNOW
NATIONALLY STATES ARE BEING SUED
FOR FOR GROWING WEIGHTLESS AND
AND HAVING CHALLENGES AND
OPENING CAPACITY FAST ENOUGH TO
MEET THE THE GROWING THE GROWING
REFERRALS.
SO THAT'S KIND OF THE HISTORY.
SO REJECTED A START WITH THE
PURPLE THROUGH THE PROPOSAL'S.
YES ON ISSUE ELEVEN OKAY.
SO AND WE HAVE A NUMBER OF ON
PROPOSALS.
RELATED TOO INCOMPETENT TO
STAND PARTNER AYE TRIAL BOTH IN
THE STATE HOSPITALS IN ARE
CONTRACTED PROGRAMS AND THEN
ALSO THE DIVERSION PROGRAM.
SO AND THE FIRST I AM WE HAVE
THE METROPOLITAN STATE AND
HOSPITAL SECURE ABOUT BED
CAPACITY INCREASED WE'RE
REQUESTING FIFTY THREE MILLION
AND THREE HUNDRED FORTY SIX
POINT ONE POSITIONS AND EIGHTEEN
NINETEEN. AND SIXTY EIGHT.
MILLION NINE HUNDRED FIFTY
THREE THOUSAND FORTY SEVENTY
FOUR HUNDRED SEVENTY THREE POINT
FOUR POSITIONS IN NINETEEN
TWENTY AN ON GOING. AND THIS IS
TO ACTIVATE TWO HUNDRED THIRTY
SIX FRIENDS AT TREATMENT BEDS AT
METROPOLITAN STATE HOSPITAL TO
HELP ADDRESS THE INCOMPETENT TO
STAND TRIAL WEIGHTLESS. AND THIS
IS AND THE CLERK THE CULMINATION
OF SEVERAL PROPOSALS THAT WE'VE
BEEN I'M HERE BEFORE THE
COMMITTEE BEFORE IN THE PAST
COUPLE YEARS BOTH ON A CAPITAL
OUTLAY. PROJECT TO I'M IS
CONSTRUCT THE I'M SECURE TRABANT
SECURITY INFRASTRUCTURE AROUND
IN EXISTING PATIENT BUILDING
LAST YEAR'S PROPOSAL WAS TO AND.
TO HELP US MOVE THE EXISTING
PATIENTS WHO ARE CIVILLY
COMMITTED PATIENTS I AM PROVIDE
US THE FUNDING TO MOVE THEM INTO
AN ALTERNATE BUILDING. AND ALSO
TO GIVE US THE ABILITY TO EXPAND
OUR.
POLICE ACADEMY IN ORDER TO
BEGIN TO I'M HIRE AND TRAIN THE
POLICE OFFICERS THAT WOULD BE
NEEDED FOR THIS ITEM EXPANSION
OF OUR SECURE TREATMENT
CAPACITY.
SO THERE THIS YEAR'S PROPOSAL IS
THE STOPPING TO REACTIVATE THE
UNITS.
WITH INCOMPETENT TO STAND TRIAL
POPULATION AND THE WITH THE
STAFFING LEVEL BEING AT THE Q.
LEVEL STAFFING FOR SYSTEM WHICH
IS I'M ONE TO SIX ON ON NURSING
ON THE AM AND PM. WE HAVE
TREATMENT TRAIN RATIO OF ONE TO
FIFTEEN WE HAVE PROGRAM
SUPERVISION ANCILLARY STAFFING A
PROTECTIVE SERVICES STOPPING ALL
WITHIN THIS PACKAGE AS WELL.
AND THE ACTIVATION TIMELINE THAT
WE'RE PROPOSING FOR THESE BEDS.
WAS.
EDGE OPENING ONE AT ONE UNIT
EVERY OTHER MONTH AND THEY ARE
AND FORTY EIGHT THAT UNITS AND
THERE'S THREE FORTY EIGHT BED
UNITS INTO FORTY SIX BUT UNITS.
THERE'S A COMPANION PUT
PROPOSAL TO DIED.
FOR THE.
.
AS DISSOCIATED.
ONLY ANY OPERATING EXPENSE I'M.
COSTS RELATED TO PATIENTS AND
THIS IS A BASED ON AN AVERAGE OF
FIFTEEN THOUSAND FIVE HUNDRED
FIFTY FIVE. DOLLARS OUT ON
AVERAGE PER PATIENT THAT WILL
WILL BE ADDING AND THIS IS FOR
THE COSTS LIKE OUTSIDE MEDICAL
EXPENSES. CLOTHING AND PERSONAL
PLAYS I'M RECREATION RELIGION
SUPPLIES FOOD AND AND THOSE TYPE
OF THINGS THINGS THAT ARE.
IMPORTANT TO US BE ABLE DE
PROVIDE THE CARE AND TREATMENT
FOR THE PATIENTS.
AND WE ALSO HAVE.
A REQUEST TO INCREASE CAPACITY
AT. COALINGA STATE HOSPITAL THIS
IS A REQUEST FOR ELEVEN POINT
FIVE MILLION DOLLARS AND EIGHTY
ONE POINT TWO POSITIONS AND
EIGHTEEN NINETEEN. AND THIRTEEN
POINT SEVEN MILLION IN NINETY
SIX POINT NINE POSITIONS ON
GOING AND THIS IS RELATED TO
INCREASING CAPACITY FOR MENTALLY
DISORDERED OFFENDERS.
IN THIS IS BECAUSE WITH THE INC
ENHANCE TREATMENT PROGRAM.
CONSTRUCTION THAT WE.
JUST I'M DISCUSSED THAT WE WILL
BE AND LOSING CAPACITY AT
ATASCADERO STATE HOSPITAL
BECAUSE WILL BE CONVERTING FORTY
SIX BUT UNITS TO THIRTEEN BAD
ENHANCE TREATMENT PROGRAM UNITS.
AND SO WITHOUT BECAUSE.
ATASCADERO OPERATES AT MAXIMUM
CAPACITY AS THAT WOULD BE A LOSS
OF CAPACITY WHICH WOULD
ULTIMATELY IMPACT INCOMPETENT TO
STAND TRIAL SO BY MOVING
MENTALLY DISORDERED OFFENDERS
FROM CALLING GUEST ARE FROM
ATASCADERO TO CALLING ALLOW US
TO MAINTAIN THE CAPACITY LEVEL
FOR INCOMPETENCE STATEMENTS TO
STAND TRIAL PATIENTS. OUT.
I'M ATASCADERO.
THIS IS FOR.
AS TO INCREASE CURRENTLY THEY
HAVE FOR A FIFTY BED UNITS OUT.
COALINGA WE'D BE TAKING OUR
TIME THEM CURRENTLY FROM A
CAPACITY FORTY TO THE MAXIMUM OF
FIFTEEN. ACROSS EIGHT UNITS.
AND THIS PROVIDES THIS THAT
STAFF BEING THAT WE NEED IN
ORDER TO INCREASE THOSE UNITS.
TO CARE FOR THOSE ADDITIONAL
TEN PATIENTS PER UNIT.
WE HAVE ALSO AND.
SCENE LOOKING OUT OUR.
PROPOSALS FOR JAIL BASED
COMPETENCY TREATMENT PROGRAM
WE'RE REQUESTING EIGHT MILLION
IN THE BUDGET YEAR AND NINE
POINT TWO MILLION ON GOING TO
ESTABLISH SEVEN JOB BASE COME.
TREATMENT PROGRAMS THIS IS AN
EXPANSION OF OUR PROGRAMS WE
HAVE PROGRAMS.
AT CURRENTLY OPERATING
STATEWIDE WE HAVE SIX PROGRAMS
THAT THIS WOULD BE SEVEN
ADDITIONAL NEW PROGRAMS.
LOCATED BOTH AND NORTHERN
SOUTHERN AND CENTRAL CALIFORNIA.
THESE PROGRAMS WOULD RUN IN THE
APPROXIMATE BEING APPROXIMATELY
FROM FIVE TO TWELVE BEDS
DEPENDING ON THE COUNTY.
AND SO THIS IS THE FUNDING TO
FOR US TO BE ABLE TO CONTRACT
WITH ADDITIONAL SHOULD.
ES SHERIFFS AND TO PROVIDE
ADDITIONAL ABOUT CAPACITY FOR
INCOME STAND TRIAL TREATMENT.
AND THEN FOR OUR MISSION
EVALUATION STABILIZATION CENTER
WE ARE JUST REFLECTING A ONE
POINT SEVEN MILLION DOLLAR I'M
SAVINGS IN CURRENT YEAR DUE TO
AND. ELAINE ACTIVATION OF THE.
SIXTY BED EMISSION EVALUATION
STABILIZATION CENTER AT ITS
ACTUALLY WILL BE ACTIVATING THIS
MONTH.
AND AND IT WAS DUE TO THE
DELAYS WERE REALLY DUE TO THE
COUNTY.
PROCURE OUT OF PROCURING SEES
ME CONTRACTING WITH A A CLINICAL
SERVICES PROVIDER IN THE TIME
THAT IT TOOK TWO. TO DO THAT AND
HIRE THE STAFF SO WE'RE PLEASED
AND WE'RE VERY EXCITED THAT I
GOT BACK TO PASS IN THIS NEW
PROGRAM IS COMING ONLINE THIS
MONTH.
AND AND THEN WE HAVE OUR TO NEW
ON PROPOSALS THIS YEAR WHICH IS
THE.
THE FIRST IS THE REQUEST FOR
OUR PARTNERSHIP WITH LOS ANGELES
COUNTY AND THIS IS FOR
RESTORATION SERVICES IN THE
COMMUNITY FOR INCOMPETENT TO
STAND TRIAL PATIENTS. REFERRED
TO THIS DEPARTMENT SAY HOSPITALS
IT WOULD BE I AM REQUESTING
FOURTEEN POINT EIGHT MILLION.
IN EIGHTEEN NINETEEN AN ON
GOING AND WE'RE CURRENTLY IN THE
PROCESS OF NEGOTIATING A
CONTRACT WITH LA COUNTY FOUR
HUNDRED AND FIFTY BEDS IN THE
COMMUNITY.
AND IT WOULD BE A CAUGHT BY
ACROSS THE CONTINUUM OF THE
LOCATIONS.
INSIGHTS I WE ARE PROPOSING
FIVE BEDS IN AN ACUTE
PSYCHIATRIC HOSPITAL FORTY FIVE
BEDS IN EITHER I AM DETERMINED
TO HOW THREE HAVE CENTER TYPE
LOCATIONS AND HUNDRED BEDS AND
RESIDENTIAL FACILITIES WITH
CLINICAL ENHANCED SERVICES
PROVIDED. AND THE PROPOSAL
INCLUDES I'M STOPPING FOR LA
COUNTY BOTH IN THE FORM OF A
CLINICAL TEAM WHO WILL PROVIDE
SERVICES TO THE PATIENT IN JAIL
WHILE WHERE THEY ARE WORKING AND
THE WORK TO STABILIZE THAT
PATIENTS TO. A PREPARE THEM FOR
TRANSITION INTO THE COMMUNITY
AND THE NAVIGATION TEAM OF TWO
THREE PEOPLE TO HELP.
THEY INDIVIDUALS NAVIGATE.
SERVICES IN THE COMMUNITY.
AND AND THEN WE HAVE THE
INCOMPETENT TO STAND TRIAL
DIVERSION PROGRAM. WHICH IS A
HUNDRED MILLION DOLLARS IN
EIGHTEEN NINETEEN AND THREE
HUNDRED AND SEVENTY SIX THOUSAND
AND NINETEEN TWENTY AND TWENTY
TWENTY ONE. AND THEN THIS IS TO
CONTRACT WITH COUNTIES TO
DEVELOP NEW OR EXPAND EXISTING
JAIL DIVERSION PROGRAMS FOR
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS. WHO HAVE THE POTENTIAL
TO BE FOUND INCOMPETENT TO STAND
TRIAL ON FELONY CHARGES THEIR
GOAL IS TO REALLY IS TO DIVERT
THESE INDIVIDUALS IN TWO MORE
APPROPRIATE COMMUNITY BASED
SETTINGS BEFORE THEY BECOME AND
AND AND FOUND INCOMPETENT TO
STAND TRIAL?
AND THE PROPOSAL IN THE
GOVERNOR'S BUDGET INCLUDES
TRAILER BILL LANGUAGE WE'VE BEEN
MEETING WITH.
STAKEHOLDERS AND I'M WORKING TO
AND FINE TUNE THAT PROPOSAL FOR
ME REVISION.
CURRENTLY HAS ITS PROPOSES
WHERE I AM PROPOSING TO CONTRACT
WITH COUNTIES TO DEVELOP NEW OR
EXPAND EXISTING PROGRAMS FOR
INDIVIDUALS WHO ARE PRIMARILY
I'M DIAGNOSED WITH ON
SCHIZOPHRENIA OF SCHIZOPHRENIA.
AND SCHIZOAFFECTIVE DISORDER OR
BIPOLAR DISORDER AND FUNDING CAN
BE USED FOR EITHER PRE BACKING
OR POST BOOKING DIVERSION
PROGRAMS THAT PROVIDE EVIDENCE
BASED COMMUNITY MENTAL HEALTH
TREATMENT AND OTHER SERVICES AND
SUPPORTS THAT ARE NECESSARY IN
ORDER TO. HELP THESE INDIVIDUALS
BE SUCCESSFULLY TREATED IN THE
COMMUNITY.
OUR GOAL IS TO TARGET
INDIVIDUALS THAT HAVE SERIOUS
MENTAL ILLNESS AND I AM. AND
WHERE THERE IS A NEXUS BETWEEN
THE SERIOUS MENTAL ILLNESS AND
THE ALLEGED CRIME AND THEIR
SIGNIFICANT EVIDENCE THAT THE
SERIOUS MENTAL ILLNESS AT THE
TIME IN WHICH CRIME OR THAT
CRIME IS DRIVEN BY CONDITIONS OF
HOMELESSNESS.
I'M IN THAT THERE AND THE
INDIVIDUAL DOES NOT POSE A
SIGNIFICANT SAFETY RISK IF
TREATED IN THE COMMUNITY.
AND WE ARE TARGETING A MINUTE
MINIMUM REDUCTION OF TWENTY
PERCENT OF ICE T. REFERRALS WITH
THE GOAL OF UP TO THIRTY PERCENT
REDUCTION IN REFERRALS FROM THE
COUNTIES. AND COUNTIES ARE AND
WE ARE PROPOSING THE COUNTIES
AND PROVIDE MATCHING FUNDS I'M
CURRENTLY AT TWENTY PERCENT. AND
A TOTAL OF.
NINETY NINE POINT FIVE MILLION
OF THE FUNDING IS A EARMARKED
FOR THE CONTRACTS WITH THE
COUNTIES I'M WE EXPAND TO
SEPARATE THAT THIS WILL FUND
APPROXIMATELY SEVEN HUNDRED
PLACEMENTS.
AND WE ARE TARGETING.
THE HEIGHT THE FIFTEEN COUNTIES
WITH THE.
HIGHEST NUMBER OF REFERRALS TO
THE DEPARTMENT BUT ALSO SETTING
SITE ME.
APPROXIMATELY EIGHT POINT FIVE
MILLION OF THE FUNDING FOR.
OTHER COUNTIES TO PARTICIPATE
AS WELL.
AND THEN WAITED WITH THIS
PROPOSAL AND WE HAVE PROPOSED
SOME PROGRAM RESOURCE IS.
WHICH INCLUDES FOR AND PROGRAM
SUPPORT OVERSIGHT WHICH HAS A
CHIEF PSYCHOLOGIST AND HEALTH
PROGRAM SPECIALISTS ARE PRETTY
EXPENSIVE EQUIPMENT AND I HAVE
SOME FUNDING WE HAD TO AND HAVE
A RESEARCH CONTRACT WITH YOU
SEE.
PARTNER.
THANK YOU FOR THE PRESENTATION.
WE WILL NOW TAKE PUBLIC COMMENT
ON ISSUE ELEVEN POSAR DEPARTMENT
OF FINANCE LA.
THANK YOU MISTER CHAIR AND
MEMBERS WE HAVE THREE GROUPS OR
RECOMMENDATIONS ON THESE ICE TEA
PROPOSALS ONE ON THE ICE TEA
WEIGHTLESS.
SECOND ON THE ICY CAPACITY AND
THIRD ON ICE T. DAY VERSION I
WILL TRY TO GROUP THEM FURTHER.
IN THE INTEREST OF BEING CONCISE
FIRST ON THE ICE TEA WAIT LIST
AS AN APARTMENT XIN THERE'S
CURRENTLY NINE HUNDRED AND
SEVENTY TWO OR SO PEOPLE ON THAT
WAY LESS. AS CURRENTLY DEFINED
THAT INCLUDES BOTH PEOPLE
WAITING JUST BECAUSE THERE'S A
LIMITED.
A PASSIVE THE IN STATE HOSPITALS
IN JAIL BASED COMPETENCY
PROGRAMS BUT IT ALSO INCLUDES
SOME PEOPLE WHO ARE BEING
PROCESS TO DETERMINE WHERE THE
APPROPRIATE TREATMENT LOCATION
FOR THEM IS GOING TO BE.
REGARDLESS OF ADDING ADDITIONAL
CAPACITY THAT PROCESSING TIME
THOSE PEOPLE WHO ARE ON THEIR AS
THEIR DETERMINE WHERE TO TREAT
THEM. THEY'RE STILL GOING TO BE
ON THAT WAIT LIST EVEN IF WE
INCREASE CAPACITY.
SO WE RECOMMEND IS THAT THE
LEGISLATURE TO FIND WHAT IT
THINKS IS AN APPROPRIATE
DEFINITION FOR THE WAIT LIST SO
THAT I CAN TARGET HOW MANY
ADDITIONAL BEDS.
TO ADD AND WE SUGGEST IS
DEFINING THE WAIT LIST AS
CONSISTING OF THOSE PATIENTS WHO
ARE NOT THAT PLACE WITHIN SIX
WEEKS OF BEING DECLARED
INCOMPETENT TO STAND TRIAL.
WHICH IS KIND OF A HIGHER LOW ON
AN AVERAGE OF WHAT IT CURRENTLY
TAKES THAT APARTMENT TO PROCESS
SOMEBODY.
AND THAT THE LEGISLATURE ADOPT
ASSOCIATED BUDGET TRAILER
LEGISLATION SO THEY GET
REPORTING EVERY MONTH ON HOW
MANY PEOPLE ARE ON THAT WAIT
LIST
ONCE IT HAS THIS CLEAR
DEFINITION IN MIND OF WHAT THE
WAIT LIST IS. A GOOD THAT THE
LEGISLATURE THEM IN A POSITION
TO DECIDE HOW MANY BEDS IT NEEDS
IN ORDER TO REDUCE OR ELIMINATE
THAT WAY LAST.
SO THEN ON TO DE ICE TEA
CAPACITY PROPOSALS. IT THE
LEGISLATURE DEFINED DICEY WAIT
LIST AS.
NOT BEING PLACE WITHIN SIX WEEKS
WE THINK A LARGE PORTION OF THAT
WAY THIS COULD BE SERVICE WITH
THE.
PELE COUNTY PROGRAM THE
DEPARTMENT OUTLINED AS WELL AS
THE EXPANSION OF THE GEL BASED
COMPETENCY TREATMENT PROGRAMS.
IT IS LIKELY THAT SOME
ADDITIONAL BEDS WILL BE NEEDED
AT A MORE INTENSIVE LEVEL THAT
THE STATE HOSPITALS THEMSELVES
PROVIDE SO WE DO RECOMMEND. THAT
IF. THE WEIGHTLESS WERE DEFINED
IN THIS MANNER TO ACTIVATE TO OF
THE UNITS AT THEM AT
METROPOLITAN STATE HOSPITAL. IF
THE WAIT LIST CONTINUES TO.
CHANGE AS WE GET TO MY REVISION
THE REMAINING UNITS THAT ARE
REQUESTED. DO YOU SAGE
METROPOLITAN COULD BE ACTIVATED.
AT A LATER TIME.
ONTO THE JAIL BASED COMPETENCY
TREATMENT PROGRAMS WE WOULD JUST
RECOMMEND THAT THE LEGISLATURE
CONTINUE TO A DIRECT APARTMENT
AT HEARINGS TO UPDATE ON THE
NEGOTIATING PROCESS FOR WHICH
COUNTIES ARE GOING TO OPERATE
THESE PROGRAMS. AND.
THERE PROP PROGRESS IN IN THOSE
NEGOTIATIONS AND ON THE LA
COUNTY PROGRAM SPECIFICALLY
GIVEN IT'S A NEW APPROACH WE
RECOMMEND PROVIDING THE FUNDS ON
A LIMITED TERM BASIS AND INCLUDE
A. AN EVALUATION OF THE PROGRAM
TO DETERMINE WHETHER IT'S
EFFECTIVE AND WARRANTS. ONGOING
FUNDING.
AND THEN ON THE COALINGA
EXPANSION.
WE WOULD KNOW THAT THE
DEPARTMENT IS GOING TO STAFF
THESE FACILITY SIMILAR TO HOW IT
STAFF IT'S OTHER INDIO FACILITY
SO WE RECOMMEND APPROVING. THE
REQUESTED POSITIONS AND FUNDING
COVER WE WOULD ALSO NOTE THAT
THE DEPARTMENTS CURRENTLY
UNDERGOING A STAFFING STUDY TO
DETERMINE APPROPRIATE STAFFING
LEVELS ACROSS THE DEPARTMENT.
AND SO WE WOULD RECOMMEND
PROVISIONAL LANGUAGE IN THE
BUDGET TO REQUIRE THE DEPARTMENT
TO COMPLETE THAT'S
STUDY BY JANUARY TEN TWENTY
NINETEEN. SO THAT THE
LEGISLATURE'S IN A POSITION TO
ASSESS THE OVERALL DEPARTMENT
STAFFING LEVELS AND MAKE ANY
NECESSARY.
I BUDGET ADJUSTMENTS.
AND FINALLY IN REGARDS TO I T.
DIVERSION.
WE THINK TRYING TO DEVELOP
PROGRAMS TODAY BURKE PEOPLE AWAY
FROM STATE HOSPITALS. HOUSE A
LOT OF STUFF.
MERIT AS IT COULD REDUCE FUTURE
COSTS AND BE BETTER FOR THE
PATIENTS WHO ARE PARTICIPATING
IN THESE PROGRAMS. HOWEVER WE DO
RECOMMEND REJECTING THE
GOVERNOR'S PROPOSAL AS WE CAN
FIND THAT IT'S STRUCTURED TO
ACHIEVE THE INTENDED BENEFITS OF
ICE TEA DIVERSION.
THERE ARE THREE REASONS FOR THIS
FIRST WE FOUND THAT THE KEY
PROGRAM DETAILS ARE UNCLEAR SUCH
AS HOW THE FUNDING WILL BE
ALLOCATED WHAT SPECIFIC PROGRAMS
COUNTIES WILL PROVIDE.
WE FOUND THE COUNTY INCENTIVES
ARE UNCLEAR SUCH AS WHETHER
COUNTIES WOULD BE INTERESTED
ENOUGH UP TO PROVIDE MATCHING
FUNDING GIVEN THAT FELONY ICE
TEA TREATMENT IS FINANCIALLY A
STATE RESPONSIBILITY. AND THIRD
THE IMPACT OF THE PROPOSAL WOULD
LIKELY BE MINIMAL BECAUSE IT
WOULD TAKE TIME FOR THESE
DIVERSION PROGRAMS TO DEVELOP.
AND BECOME EFFECTIVE AND MEASURE
WHAT'S WORKING HOWEVER THE
FUNDING IS ONLY PROVIDED ON A
ONE TIME BASIS AS OPPOSED TO ON
A LONGER TERM BASIS AND THERE
ISN'T A MEETING FOR EVALUATION
OF THESE PROGRAMS FOR THE
LEGISLATURE TO ASSESS WHETHER
THEY'RE EFFECTIVE.
SO IT'S AS AN ALTERNATIVE WE
RECOMMEND THE LEGISLATURE DIRECT
THE DEPARTMENT TO WORK WITH
COUNTIES TO DEVELOP SPECIFIC
PROPOSALS. WITH THOSE KEY
PROGRAM DETAILS LAID OUT. AND
INCLUDING A PLAN TO EVALUATE
THEIR EFFECTIVENESS SO THAT THE
LEGISLATURE COULD DETERMINE
THOSE PROPOSALS EITHER IN THIS
YEAR'S BUDGET OR IN FUTURE
BUDGETS.
IF THE LEGISLATURE CHOSE TO
APPROVE SUCH PROPOSALS WE
RECOMMEND PROVIDING FUNDING ON A
LIMITED TERM BASIS OVER A FEW
YEARS SO THAT THE PROGRAM CAN
START.
AND HOPEFULLY BECOME SUCCESSFUL
IN NOT REQUIRE A LOCAL MATCH
AND TO THE EXTENT THAT A
PARTICULAR PROGRAM IS EFFECTIVE
IN A COUNTY WE RECOMMEND THE
LEGISLATURE AT THAT TIME COULD
CONSIDER ON GOING FUNDING.
IF IF WE HAVE AN EFFECTIVE
PROGRAM ON OUR HANDS THAT IT
MIGHT BE WORTH CONTINUE IN AN ON
GOING BASIS HAPPY TO TAKE ANY
QUESTIONS.
THANK YOU VERY MUCH DEPARTMENT
OF FINANCE.
CHRIS GOT DEPARTMENT FINANCE SO
WHILE FINANCING NOTES ARE
KNOWLEDGE IS THE ILLEGAL
CONCERNS ON THE FUNDING SPECIFIC
TO THE HIGHEST HE.
PROPOSAL THAT IT'S A LIMITED
TERM IN NATURE AND OVER THE
COURSE OF THREE YEARS.
WHAT WE VIEW THIS AS PROVIDING
COUNTIES WITH A LOT OF
FLEXIBILITY TO QUICKLY RAMP UP
AND EXPAND ON A LOT OF THEIR?
CURRENT MISDEMEANOR PROGRAMS
THAT THEY MARRY HAVE MANY OF
THESE COUNTIES IN WHICH.
THAT.
THE FUNDING HAS BEEN PROVIDED
TO YOU AS NOTED A HOUSE A LARGE
REFERRALS OF THESE AND I IS
TEASING TO THE STATE HOSPITAL
SYSTEM SO A LOT OF THEM HAVE. A
MENTAL HEALTH COURTS AND I
SYSTEMS IN PLACE WHERE THEY
COULD QUICKLY RAMP UP.
AND SO.
WE VIEW THIS AS PROVIDING THE
COUNTY SOME FLEXIBILITY TO
QUICKLY RAMP UP AND PROVIDE
ADDITIONAL SERVICES WERE NEEDED
UTILIZING A LOT OF THEIR OTHER
FUNDS.
THAT THEY CURRENTLY HAVE WHETHER
THAT BE THROUGH MHSAA OR.
REALIGNMENT.
AND THAT.
WE VIEW THAT.
THE MODEST AND INVESTMENT FOR
COUNTIES FOR TWENTY PERCENT
MATCH REALLY INCENTIVIZE THEM TO
BEGIN CONTINUING TO USE THEIR
OWN MONEY AFTER THE END OF THE
THREE YEARS.
TO CONTINUE TO SUPPORT THESE
EFFORTS IN THE COMMUNITY. AND
THEN AT THE END OF THE THREE
YEAR PERIOD.
THEN THE ADMINISTRATION.
COULD CONTEMPLATE THE ONGOING
NATURE OF THEY DIS INVESTMENTS
TO THE EXTENT.
I MEAN. AT THAT TIME WHERE THE
OTHER PARTIES MAYBE.
AND THEN SO BUT GOING BACK TO
LAST LA THOSE OTHER CONCERNS IN
REGARDS TO SOME OF THE RESOURCES
THAT WE CURRENTLY HAVE.
SPECIFICALLY TO BUILDING UP
CAPACITY AS THE HOSPITAL'S I
JUST WANTED TO NOTE THAT A LOT
OF THESE RESOURCES THAT WE'RE
CONTINUING TO DO REQUIRE CAPITAL
OUTLAY PROJECTS.
AND A LOT OF.
INVESTMENTS MADE.
BY THE STATE TO EXPAND THE
SERVICES AND A LOT OF THESE
PROPOSALS THAT WE HAVE IN PLACE
ARE REALLY FOR THE STAFFING AND
SO.
JUST WANTED TO MAKE THAT.
I.
AND TO HAVE A.
YEAH.
THANK YOU.
HAPPY TO ANSWER ANY FURTHER
QUESTIONS. WE WILL NOW MOVE ON
THE PUBLIC COMMENT FOR ISSUE
ELEVEN THANK YOU FOR BEING
PATIENT. THANK YOU MISTER
CHAIRMAN MEMBERS.
KOBE PRESIDING AGAIN WITH
CALIFORNIA ASSOCIATION OF
PSYCHIATRIC TECHNICIANS AND WE
JUST LIKE TO NOTE THAT WE DO
SUPPORT EVERYTHING THAT THE
DEPARTMENT IS TRYING TO DO IN
ORDER.
TO STEM THIS GROWING I S. T.
PROBLEM.
HOWEVER. I THINK IT'S VERY
IMPORTANT TO NOTE THAT THE IST
REFERRALS ARE FAR OUTPACING OUR
ABILITY TO BUILD CAPACITY.
I THINK EVENTUALLY THIS
LEGISLATURE AND THE
ADMINISTRATION ARE GONNA HAVE TO
COME TO THE CONCLUSION.
THAT A NEW FACILITY IS GONNA
HAVE TO BE BILL AT SOME POINT IN
TIMEIN THE NEAR FUTURE BECAUSE
THERE'S JUST NO WAY. TO HANDLE
THE AMOUNT OF REFERRALS THAT ARE
COMING IN.
ADDITIONALLY AS MANY OF YOU HAVE
ACTUALLY TOURED SOME OF THE
FACILITIES THE MOST RECENT
FACILITY IF YOU TAKE OUT GOING
TO STAY HOSPITALS WHICH IS WAS
DESIGNED FOR RECIPES. WAS BUILT
IN NINETEEN FIFTY FOUR AND THAT
WAS ATASCADERO STATE HOSPITAL IF
YOU'VE BEEN TO NAPA PATTON OR
METROPOLITAN SPECIAL INEPT
METROPOLITAN. YOU'LL FIND THAT
THESE FACILITIES WERE DESIGNED
FOR SIMPLY COMMITTED PEOPLE NOT
FRIENDS GLEE COMMITTED PEOPLE
THE LINES OF SAY ARE DIFFICULT
ESPECIALLY WHEN.
THERE'S POTENTIALLY PREDATORS
LYING IN WAIT.
TO ATTACK WE'VE HAD MANY
VICTIMS AYE THERE ARE STAFF. BE
ATTACKED AND INSULTED FROM JUST
HAVING POOR SIGHTLINES.
.
ADDITIONALLY. WE WOULD JUST
REALLY LIKE THE LEGISLATURE TO
HAVE THE SEED PLANTED IN THEIR
HEAD. AS TO START THINKING ABOUT
THINGS TO DO IN THE FUTURE.
IT'S A CAPACITY ISSUE IT'S ALSO
SAFETY AND SECURITY ISSUE AS
WELL AS.
AS WELL AS A TREATMENT
ENVIRONMENT ISSUE.
AND THAT'S WHERE WE CAN PROVIDE
A BETTER TREATMENT EMPIRE
ENVIRONMENT IN A MORE SECURE.
MORE COULD USE ANYMORE SETTING
THAT'S MORE CONDUCIVE TO
TREATMENT SO THANK YOU. THANK
YOU SIR.
THANK YOU MISTER CHAIRMAN
MEMBERS I'M FAIRLY STATE TING ON
BEHALF OF THE CALIFORNIA STATES
ASSOCIATION OF COUNTIES I'M ALSO
SPEAKING TODAY ON BEHALF OF. THE
COUNTY BEHAVIORAL HEALTH RECORDS
ASSOCIATION AND URBAN COUNTIES
OF CALIFORNIA A WHERE IN SUPPORT
OF THE GOVERNOR'S PROPOSAL TO
APPLY FUNDING TO THIS LONG
STANDING PROBLEM WITH THIS
PROBLEM THAT'S REALLY BECOME
ACUTE IN THE LAST FEW YEARS. AYE
BUT WE ARE LIKE ATLEO UNCLEAR ON
THE DETAILS.
WE DO WANT TO SAY THAT THE ON
THE DEPARTMENT STATE HOSPITALS
AND THE DEPARTMENT FROM FINANCE
HAVE BEEN VERY EAGER AND WILLING
TO WORK WITH COUNTIES IN OUR
STAKEHOLDERS TO FIGURE OUT
SOMETHING THAT WILL WORK AND
WE'RE STILL IN PROCESS OF DOING
SO. AND SO I WANT TO SAY THAT
YOU KNOW WE APPRECIATE THE
GOVERNOR'S APPLICATION OF SOME
FUNDING WE THINK THAT WILL HELP
BUT HOW WE DESIGNED THIS
DIVERSION PROGRAM IS REALLY THE
DEVIL'S GOING TO BE IN THE
DETAILS. WE REMAIN COMMITTED TO
THAT PROCESS ON AGAIN WANT TO
THANK EVERYBODY INVOLVED.
TO GIVE YOU.
MISTER CHAIR KERR CHILD
DISABILITY RIGHTS CALIFORNIA.
WE ARE OPPOSED TO THE EXPANSION
OF THE JAIL BASED.
TREATMENT PROGRAMS WE HAVE
HISTORICALLY BEEN AND CONTINUE
TO BE.
BECAUSE AFTER ALL THEY ARE JOB
BASED.
TREATMENT PROGRAMS BUT WE DO
SUPPORT QUITE STRONGLY THE
EXPANSION.
OF THE LA PROGRAM IN THE.
SUCCESS THAT THEY'VE HAD IN
WORKING WITH MISDEMEANORS.
AND DIVERSION DOWN THERE.
WERE ALSO VERY PLEASED THAT THE
ADMINISTRATION HAS DECIDED TO
PUT IN THE HUNDRED MILLION
DOLLARS FOR.
EXPANSION AND FURTHER DIVERSION
PROGRAMS.
TO HOPEFULLY DO THE UPSTREAM.
.
THE DAMMING OF OTHER FOLKS
COMING INTO OF THE STATE
HOSPITALS HOWEVER WE WOULD
SUGGEST THAT.
THE HUNDRED MILLION DOLLARS IS
NOT VERY MUCH MONEY OR PERIOD
OVER THREE YEARS TIME LIMITED
DOLLARS. THAT REALLY THE FOCUS.
SHOULD BE MORE ON FELONIES NOW
AND DOING THE HEAVY LIFTING THAT
IT TAKES A COMMUNITY BASED
FELONY.
PROGRAMS WE'VE SEEN THE
MISDEMEANOR PROGRAMS AND WE KNOW
THAT THEY ARE QUITE SUCCESSFUL
AND WE OUGHT OF LEVERAGE THE.
IMAGES SAY DOLLARS TO.
CONTINUE
THOSE.
MISDEMEANOR PROGRAMS BUT WE
SHOULD REALLY LOOK AT BUILDING A
FOUNDATION FOR LEARNING ON THE.
FELONY BASED.
PROGRAMS AND AND ACTUALLY
REDUCING A BED SPACE IN THE
STATE HOSPITALS AS LONG AS.
IT IS PROVIDED THROUGH
COMMUNITY BASED TREATMENT
PROGRAMS STRONG SUPPORTIVE
HOUSING AND OF COURSE VERY.
STRONG EVALUATION COMPONENT AND
OF THE PERIOD THANK YOU.
GOOD EVENING MISTER CAIRMAN
RESIGNED ELIZABETH ESPINOSA HERE
TODAY ON BEHALF OF THE RIVERSIDE
COUNTY BOARD OF SUPERVISORS IN
SUPPORT OF THE IN A GOVERNOR'S
PROPOSAL TO INVEST. A HUNDRED
MILLION DOLLARS IN OF THE
DIVERSION PROGRAMS FOR THE
HIGHEST HE POPULATIONS
REGRETTABLY RIVERSIDE COUNTY
FINDS ITSELF.
AT DATA US LOT NUMBER FIFTY
SEVEN OUT OF FIFTY EIGHT
COUNTIES IN TERMS OF THE OVERALL
I ALLOCATION OF HEALTH AND
MENTAL HEALTH. OF FUNDING.
BUT SO UNFORTUNATELY AS A
RESULT THEY HAVEN'T BEEN ABLE TO
DEVELOP THE KIND OF ROBUST
SERVICE SYSTEM OF THAT THEY
MIGHT LIKE THE VIEW OF THE THE
ICY PROPOSAL IS AN OPPORTUNITY.
UP TO BEGIN INVESTING AND
DIVERTING AND TREATING SOME OF
THE MOST VULNERABLE IN OUR
COMMUNITY WE UNDERSTAND THE
DETAILS I NEED SOME ADDITIONAL
WORK AND ATTENTION I WOULD JUST
ENCOURAGE THE CONVERSATION TO
CONTINUE THANK YOU.
HUMAN.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO THE DYESS FOR
QUESTIONS ASSEMBLYMEMBER RUBIO.
COUPLE QUESTIONS AND COMMENTS I
DID I WAS ONE OF THOSE THAT
VISITED A WHEN THE STATE
HOSPITALS AND.
BUT MY CONCERN IS I YOU KNOW I
AGREE ON THE MANY THE PROBLEM
THAT I SAW THOUGH IS.
WE DON'T HAVE ENOUGH FOLKS TO
TO.
COMMON WORK AT THESE FACILITIES
YOU FIRST OF ALL WHEN I WENT IT
WAS VERY DANGEROUS I FELT.
AND I WAS WITH MY WHOLE ENTIRE
STAFF AND WITH SECURITY AND IT
WAS JUST REALLY.
DIFFICULT FOR ME TO TO BE.
THERE AND SEE THE ARM THE
WORKERS A RESULT LACK OF. OF.
SUPPORT.
I SAW THE LITTLE.
THE DISTRESS OF BUTTONS WHICH
ARE GREAT BUT THE PROBLEM IS
THAT IF YOU DON'T HAVE ENOUGH.
PEOPLE WORKING AT THE HOSPITALS
WE CAN INVEST ALL THE MONEY
THAT.
.
YOU WE ONE BUT IF YOU DON'T HAVE
PEOPLE TO FILL THOSE POSITIONS
AND IF YOU CAN ANSWER.
HOW MANY POSITIONS ARE YOU
CURRENTLY HAVE AND HOW MANY ARE
VACANT?
THAT'S THE DOUBLE THE ONE
QUESTION THE OTHER QUESTION IS.
I ALSO SIT ON.
HUMAN SERVICES AND.
AGING AND LONG TERM CARE AND
THE NUMBER ONE.
THE NUMBER ONE. I GUESS ISSUE
FOR THOSE.
PROGRAMS IS THE LACK OF NURSES
AS WELL IF THEY'RE HAVING A HARD
TIME HIRING THESE FOLKS AND
THERE YOU KNOW BY ALL ACCOUNTS A
SAFER.
ENVIRONMENT TO WORK IN HOW ARE
WE EXPECTED TO EMPLOY A ALL OF
THESE. OF FOLKS WERE TRAIN THEM
AND BE IN A POSITION.
WHERE IT'S HIGHER RISK IF LIKE
I SAID IF WE'RE HAVING AN ISSUE
WITH A LOWER RISK?
YOU KNOW BUT SENIORS AND THOSE
TYPES OF A POSITION HOW IN THE
WORLD THAT WE'RE GOING TO FILL
THESE POSITIONS AND.
IF YOU CAN FIND THAT NUMBER I
REALLY WOULD APPRECIATE IT
BECAUSE WE CAN OUT ALL OF THE
POSITIONS THAT WE WANT BUT IF
YOU DON'T HAVE FOLKS TO FILL
THEM. HOW DO WE EXPECT TO MOVE
FORWARD AND I APPRECIATE THE
COMMENTS ABOUT HOW MANY BEDS
WERE GOING TO BE ABLE TO SERVE
WITH WHAT PEOPLE WHAT WHAT
POPULATION OF FOLKS ARE GOING TO
BE ABLE TO SERVICES FOLKS?
IN IN IN ON THIS CAPACITY SO
THAT'S KIND OF A LONG WINDED
QUESTION BUT THE THE POINT TO IT
IS THAT. WE CAN INVEST ALL OF
THIS MONEY BUT IF WE DON'T HAVE.
FOLKS.
THAT ARE GOING TO FEEL SECURE
BECAUSE OF THE RATIOS THEN HOW
ARE YOU GOING TO FILL THE
POSITIONS NUMBER ONE NUMBER TWO.
YET THERE ARE ALL OF THESE
INCREASES SUPPOSED TO.
.
TO STOP THE WAIT LIST.
REDUCE SAID OR IS IT JUST OF OUR
BEING ARE WE.
CHASING OUR TAIL AT THIS POINT
BECAUSE AS THE WAIT LIST
INCREASE SAYS ARE WE JUST
SERVICE SINGLES.
IF YOU FOLKS AND THEN WE HAVE.
I IN INCREASE IN AND THAT
POPULATION WHICH SOUNDS LIKE
IT'S IS.
IS WHAT WORD WE ARE FACING HERE
SO LIKE I SAID I APPRECIATE ALL
OF THE INFORMATION AND ALL OF
THAT STATISTICS BY.
.
I FOUND THAT ARE ARE A. OR.
INFORMATION UP HERE. IS GREAT
BUT SPREADSHEETS ARE FANTASTIC
BUT IMPLEMENTING.
THE SPREADSHEETS AND VERY
DIFFERENT ON THE GROUND THAN IT
IS HERE IN ARGUES AN EXAMPLE.
AS MY TEACHING CAREER WAS A
TEACHER AND HAD. X. AMONG THE
STUDENTS AND I WASN'T SUPPOSED
TO HAVE OVER YOU KNOW THIRTY
FOUR I THINK AND I HAVE THEM IN
THE DISTRICT OFFICE CENTER
REPORTS THAT VERY SIMPLE.
THIRTY TO THIRTY TWO POINT HAVE
OF FIVE KIDS IN THIS ROOM AND
THIRTY TWO POINT FIVE KIDS IN
THAT ROOM. AND MY RESPONSE WAS
WHICH COULD DO YOU WANT ME TO.
CUT UP BECAUSE ON THE SPREAD
SHEET IT LOOKS FANTASTIC BUT
IMPLEMENTING THOSE IS VERY
DIFFICULT SO AGAIN LONG WINDED
BUT I WOULD LIKE SOME
CONVERSATION OR SOME DISCUSSION
AS TO HOW WE EXPECT TO FILL
THOSE POSITIONS THAT WERE. YOU
KNOW.
GOING TO GIVE YOU ALL THIS
MONEY FOR.
CERTAINLY SO I'LL START WITH THE
BIG CANCERS WHEN WE CAN TALK
ABOUT THE WAIT LIST SO.
IT IN KIND OF IN THE CONTEXT OF
IT THERE WAS AND NOT ONLY THE
VACANCIES BUT THE CONCERN FOR
SAFETY AND SO I WANT TO TAKE I
JUST TALK ABOUT AND. AS SAFETY
FIRST AND THEN AND THEN THE
POSITION SO AND YOU KNOW WE HAVE
AND SAFETY IS.
FOR OUR STAFF AND OUR PATIENTS
BOTH IS ONE OF OUR MEMORY IS OUR
HIGHEST PRIORITY FOR THE
DEPARTMENT AND SO. A LOT OF. OUR
EFFORTS OVER THE LAST SEVERAL
YEARS HAVE BEEN.
HAVE BEEN FOCUSED ON THAT
PRIORITY AND ONE OF THE
PROPOSALS TODAY IS IS.
THE ENHANCE TREATMENT PROGRAM
IS A COMBINATION OF A LOT OF
WORK THAT WE'VE DONE AND I AM
REALLY AND LEARNING AND
UNDERSTANDING AND CATEGORIES
SAYING AND THEN AND. AND
DEVELOPING TREATMENT PROGRAMS
FOR.
THAT THE TYPES OF AGGRESSION
THAT WE SEE WITH OUR FACILITIES
AS WELL AS THE.
AND ENHANCING OUR ENVIRONMENT
BECAUSE YOU DID HEAR FROM OUR
PARTNER I'D AND NOT CAPTIVES AS
WELL AS YOUR OWN EXPERIENCING
AND IT THE FACILITIES WERE NOT
NECESSARILY DESIGNED FOR. AND
THE POPULATION THAT WE SERVE AND
SO IT'S A REAL IT'S A REAL
CHALLENGE EVERY DAY SO YOU KNOW
THROUGH OUR PERSONAL DURESS
ALARM SYSTEMS THAT YOU YOU DID
GET TO SEE.
DOES HAVE AND BROUGHT A
TREMENDOUS AMOUNT OF RESPONSE TO
SITUATIONS WHEN THEY DO OCCUR IN
THE FACILITIES AND ND WE HAVE
SEEN IS.
SUBSTANTIAL REDUCTION AND AND
PATIENT ON.
AND PATIENT IMPATIENCE STAFF
VIOLENCE OVER THE LAST AND THE
OVER THE YEARS AS A RESULT OF
OUR EFFORTS.
AND WITH RESPECT TO VACANCY IS
I'M GONNA LOOK TO SEE IF I CAN
POP NUMBER REALLY QUICK BUT AND
HAVE IT WITH ME DATA YET SO.
MY.
I HAVE WITH ME.
AND SO IT'S GOING TO BURY IT
WITH RESPECT TO EACH OF THE THE
CLASSIFICATION
AND AND YOU KNOW WITH RESPECT
TO.
.
THAT BED PROPOSAL AT
METROPOLITAN STATE HOSPITAL
WE'RE VERY FORTUNATE THERE THAT
WE HAVE LOWER VACANCY RATES
BECAUSE IT'S A MAJOR
METROPOLITAN AREA THAT WERE ABLE
TO.
TO STAFF IN.
BUT LOOKING AT.
THE TOP AM OUR TOP TEN VACANCIES
YOU KNOW WE RUN ANYWHERE FROM.
LIKE A SEVEN PERCENT STATEWIDE
AND SITE TAX TO OUR PSYCHIATRIST
RATES.
ARE MUCH GREATER I'M STATEWIDE
AND RUNNING AT APPROXIMATELY
THIRTY PERCENT SO AND THE WE DO
HAVE CHALLENGES WITH RESPECT TO.
FILLING POSITIONS AND WE DO
ADDRESS THAT IN A NUMBER OF
WAYS.
AND WE DO CONTRACT FOR SERVICES
WHERE I'M WHERE UNABLE TO.
HIGHER LIKE IN ATASCADERO AND
AND COALINGA AND SOMETIMES WE DO
HAVE TO BRING AND CONTRACTED TO
PSYCHIATRISTS AND AND AND OTHER
I'M CLASSIFICATIONS IN ORDER TO
HELP US MEET THAT THEY NEED. AND
WE DO A LOT OF RECRUITMENT AND
WE PARTNER WITH.
YOU KNOW THE.
EDUCATIONAL TRAINING PROGRAMS.
PARTICULARLY FOR THE NURSING
I'M POSITIONS AND WE HAVE DIRECT
PARTNERSHIPS WITH THE JUNIOR
COLLEGES IN THE. AND THE IT AND
UNIVERSITIES.
THAT I'M. A TRAIN THOSE
INDIVIDUALS SO THAT WE CAN NINE
AND HAVE THAT DIRECT PIPELINE
YOU ACTUALLY OFFER A
PSYCHIATRIC.
TECHNICIAN TRAINING PROGRAM
RIGHT ON THE CAMPUS I HAD TO.
AT ATASCADERO SO WE WORK REALLY
HARD TO HAVE PRIORITIZE THE
FILLING OF OUR POSITIONS.
AND.
AND TO.
ENSURE THAT WE.
WE CAN FILL THE POSITIONS BUT I
THINK IT'S IMPORTANT THAT WE
ALWAYS REGARDLESS OF THE
POSITION VACANCIES HAVE TO MEET
THE STAFFING MINIMUMS FOR
LICENSING AND WE DO MEET THE OF
THE STAFFING MATT I'M
REQUIREMENTS FOR FOR LICENSING
SO. WE DON'T HAVE THE.
THE ABILITY TO TO DROP DOWN
BELOW THOSE.
.
WITH RESPECT TO THE WAIT LIST.
AND WE.
.
IT.
THAT'S HARD AND THAT'S HARD TO
PROJECT.
IT WHETHER ALL OF THIS CAPACITY
AND WILL DEFINITELY.
.
ELIMINATE THE IT'S A PROBLEM I
KNOW IT IS I THINK THIS YEAR
IT'S.
IMPORTANT HERE IN THAT WE ARE
LOOKING AT THE DEMAND SIDE
VERSES JUST CAPACITY SO CHANGING
THE.
THEDIRECTION THAT AN
INDIVIDUAL AND SORT OF CYCLING
THROUGH THE STATE HOSPITAL IN
AND AND. BEING IN AND BEING
IDENTIFIED AS ENCOMPASSING ON
TRIAL AND ENDING UP WITH A
CRIMINAL.
IT WITH CONVICTION OR A YOU
KNOW A RECORD OF SOME SORT
CYCLING BACK THROUGH THE SYSTEM
WE ARE AND.
PUTTING THE AND THE RESOURCES
INTO THE DEMAND SIDE SO
PROVIDING THE COUNTIES THE NEED
THE ASSISTANCE TO DATE NO
DEVELOP THESE DIVERSION PROGRAMS
THAT WILL HOPEFULLY CONNECT
THESE INDIVIDUALS IN A
MEANINGFUL WAY. AND PROVIDE IN
THE MEANINGFUL SERVICES TO KEEP
THEM FROM DOING THAT CYCLING
THROUGH AND COMING BACK THROUGH
THE STATE HOSPITAL
SO I THINK WITHOUT UNDERSTANDING
WHAT DIET AND.
YOU KNOW WHAT THE WHAT GREAT
IMPACT THAT CAN HAVE IT'S HARD
TO TELL BUT WE ALSO HAVE THE WE
HAVE IT WE DON'T HAVE CONTROL
OVER THE REFERRAL SO THEY DO
CONTINUE TO GO UP LIKE THEY HAVE
IN THE PAST.
WHICH WE HOPE THEY'RE NOT
BECAUSE WE'RE TRYING TO SEND
THEM OFF ON THAT ON THE FRONT
END.
IS YOU KNOW WE WE ANTICIPATE
BASED ON THE CURRENT REFER ALL A
PATTERN THAT WE WE SHOULD SEE OF
SUBSTANTIAL DROP OVER THE NEXT
COUPLE YEARS. I HAVE WITH ME AS
WE BACK TO BEAT THIS CAPACITY IN
THE WEIGHTLESS.
THEN TO STOP.
I VISITED A.
.
CRUMBLING.
INFRASTRUCTURE AYE WHAT FROM
WHAT I SAW AND.
AT SOME POINT ARE WE GOING TO
AND I KNOW IT'S A COSTLY
ENDEAVOR AND I BUT I DO HAVE TO
ASK A REBIRTH HAVING ANY PLANS
ON. ON.
YOU DON'T PUT IN SOME MONEY
INTO THE MAINTENANCE OF THESE
PLACES AND THE ONE THAT I
VISITED. THAT REALLY WAS NOT
CONDUCIVE TO THE TYPE OF WORK
THAT THAT.
WERE DOING AND SO TO BE HONEST
WITH YOU IN MY MIND AND I'M NOT
AN EXPERT BY ANY MEANS BUT IN MY
MIND THAT THINGS TO BE. YOU KNOW
COMPLETELY.
TOWARD TORN DOWN AND AND
REBUILT I MEAN THAT'S THE ONLY
THING THE ONLY WAY I THINK.
BECAUSE IT WASN'T EVEN.
.
IT WASN'T EVEN EASY TO ACCESS.
AND THE UNITED.
DANGEROUS SITUATION IF YOU CAN
ACCESS SAID THAT ALSO MEANS YOU
CAN GET OUT AND SO SO JUST
WANTED TO MAKE SURE THAT THAT
WAS INCLUDED IN THE COMMENTS
BECAUSE I SEE THE INFRASTRUCTURE
IS BEING CRITICAL TO. TO THE
ABILITY OF OF YOU KNOW FOR THESE
WORKERS TO DO THEIR JOB IT WAS
AND I WAS JUST REALLY KEEPING I
DO HAVE TO. TO TO SAY IT I AM
I'M NOT USED TO THAT BUT THE
FACILITY I VISITED THE. NURSES
STATION WAS IN THE MIDDLE AND
THEN.
THE THE INMATES WERE SO THEY'VE
GOT NOWHERE ELSE TO GO ALSO ALL
CIRCLING THE NURSES STATION AND
JUST ME. OUTSIDE LIKE WHILE IT
JUST FELT LIKE A SHARK CIRCLING
AND IT I'D I HONESTLY WAS WAS
VERY DISTURBED BY THAT. AND
THAT'S THE FIRST THING THAT I
THOUGHT OF YOU KNOW WHEN I WAS.
LOOKING AT THE WORKERS IS HOW
DO THEY COME IN EVERY DAY AND
NOT ONLY AS A WORKER BUT THE
FAMILY MEMBERS IT I FELT LIKE IT
WAS A POLICE OFFICER. YOU KNOW
WHEN THE THE POLICE OFFICER.
GOES OUT TO WORK IN THE FAMILY
DOES ENOUGH THEY'RE COMING BACK
OR NOT AND I AND THAT'S REALLY
HOW I FELT SO I THINK WE NEED
TO.
REALLY BE MINDFUL ABOUT HOW WE
SET THESE TREATMENT PROGRAMS UP
AND AND I CAN GO ON ABOUT THEY
HOW ARE YOU GOING TO FENDED OFF
ON THE FRONT AND I IT'S NOT LIKE
YOU KNOW ENDS IN SCHOOL I CAN. I
JOIN TORRENTIAL WITH KIDS AND
ANTIETAM SO THAT THEY DON'T GO
BACK HOW DO YOU PREVENT AND THE
BATTLE I LEAVE FOR ANOTHER
CONVERSATION AND MAYBE YOU CAN
HELP ME BY SENDING ME BE YOU
KNOW WHAT THE PROPOSAL IS.
SO THAT I CAN READ ABOUT IT I
WON'T TAKE TOO MUCH TIME HERE TO
DO IT BUT THAT'S ALSO CONCERNED
HOW IS IT THAT. YOU KNOW YOU CAN
PREDICT WHO'S GOING TO BE.
INCOMPETENCE HISSED AS TO STAND
TRIAL AND AND BE ABLE TO PREVENT
THAT I THAT JUST DOESN'T FIT IN
MY MY MIND HOW WE CAN PREVENT
SOMETHING LIKE THAT. LIKE I SAID
WITH KIDS YOU CAN PREVENTED BY
EDUCATING THEM A LITTLE MORE BUT
HOW DO YOU HOW CAN YOU PREDICT
WHO'S GOING TO BE INCOMPETENT TO
STAND TRIAL SO. YOU KNOW IF YOU
CAN.
LOOK AT THAT SOME OF THOSE
QUESTIONS AND PERHAPS SEVENTY
SOME INFORMATION SO THAT WE CAN.
YOU KNOW BETTER UNDERSTAND HOW
THAT'S GOING TO HAPPEN I KNOW.
IT'S A DIFFICULT TASK BUT I
REALLY DO.
I SUPPORT THE PROGRAM ORDERED
THAT THE REQUESTS.
BUT WITH A TON OF QUESTIONS ON
HOW THIS IS GOING TO ACTUALLY.
BE IMPLEMENTED.
LET HIM MAKE A WEIRD SEGUE IF I
CAN PUT IN MEDICINE.
YOU EITHER TREATED THE SYMPTOMS
ARE TREATED THE DISEASE PROCESS.
AND INCOMPETENT TO STAND TRIAL
IS A SYMPTOM.
IT'S NOT THE DISEASE PROCESS
THAT WORD TREATING.
AND SO THEN I HAVE TO ASK WHY
DID WE END UP IN THIS PLACE AND
SO. IT SEEMS LIKE WE HAVE
INCREASED CAPACITY WE'VE
INCREASED TURNOVER. BUT IT'S THE
INCREASED REFERRAL BASE AND SO
I'M. WONDERING IF THERE
SOMETHING UPSTREAM WERE NOT
DOING WELL ENOUGH TO HELP TO
TREAT.
PEOPLE WHO.
BEFORE THEY GET TO THIS POINT SO
MY QUESTION IS REALLY GOING TO
STAND AROUND.
WHAT WERE WEREN'T THESE?
PATIENTS ACCESSING SERVICES
PRIOR TO BECOMING AN ICED TEA.
IS THERE SOME CORRELATION TO.
RECENT MENTAL HEALTH VISITS DO
WE HAVE SOME OPPORTUNITY WITHIN
THE PREVIOUS SIX MONTHS OF THEM
BEING DECLARED IN THE HIGHEST
T..
TO HAVE IMPACT AND WHY I BRING
THAT UP IS REALLY AN OPPORTUNITY
FOR US TO TAKE A LOOK AT THIS
DIVERSION PROGRAM. AND SEE IF
THERE'S AN OPPORTUNITY FOR US TO
MAKE AN IMPACT.
YEAH AND I'M I'M JUST BEEN
JOINED BY A DOCTOR WORK WITH
BARBERTON OUR MEDICAL DIRECTOR
AND I'M I'M GOING TO TURN OVER
TO JUST SECONDS HAD TO TALK
ABOUT THE.
THE DATA WITH RESPECT TO.
THAT WE HAVE LOOKED AT AND TO
ANSWER SOME OF YOUR QUESTIONS
BUT I AM. DID WANTED TO KIND OF
TO A TALK ABOUT.
THE.
THAT JUST TO KIND OF MAKE SURE
THERE'S A.
THERE'S A DIFFERENCE BETWEEN
WHAT WE UNDER STATUTE OR
REQUIRED TO DO IN PROVIDE
TREATMENT VERSES THE AND
TREATMENT THAT'S RECEIVED IN THE
COMMUNITY AND WHEN YOU SAY.
TREATING THE SYMPTOMS YOU ARE
OUR FOCUS IS WHEN WHEN THEY ARE
DETERMINED TO BE INCOMPETENT TO
STAND TRIAL AND REFERRED TO THE
DEPARTMENT OF STATE HOSPITALS.
WE ARE OUR GOAL IS IDENTIFYING
THE BARRIER TO COMPETENCY.
CONTINUOUS ESTIMATE THAT BARRIER
IS PROVIDING THE TREATMENT AND
WHEN WE DETERMINE THAT THAT
BARRIER HAS BEEN RESOLVED. WE
IDENTIFY THEM AS BEING OF
RESTORED AND SEND THEM ON TO
BACK TO COURT TO GO THROUGH
THEIR DUE PROCESS IT'S VERY
DIFFERENT THAN A COMPREHENSIVE
FULL SCALE. YOU AND IT TREATMENT
SO THAT'S AN IMPORTANT
DISTINCTION BECAUSE WHEN YOU ASK
ABOUT YOU KNOW AND TREATING THE
SYMPTOMS VERSUS TREATING.
AND YOU KNOW THAT THE BEST PLACE
FOR THEM TO GET TREATMENT IS TO
BACK IT UP AND WHICH IS WHY THIS
PROPOSAL IS COMING FOR YOU
TODAY.
THE BUT I WOULD WE HAVE DONE A
QUITE A BIT OF DATA ANALYSIS AND
SO I TALKED. TURN IT OVER TO
DOCTOR WERE BURNED TO TALK
ABOUT.
THANK YOU MY NAME'S KATE WERE
WRITTEN ON THE MEDICAL DIRECTOR
AT STATE HOSPITALS IN MY FRIENDS
EXPECT HIGH INTEREST AND WE'VE
BEEN STUDYING ARE HIGHEST TEETH
POPULATION FOR A LONG TIME SINCE
TWO THOUSAND EIGHT IN
CONJUNCTION. WITH THE UNIVERSITY
OF CALIFORNIA DAVIS DEPARTMENT
OF PSYCHIATRY IN THE LAW.
SO WE HAVE BEEN ACTUALLY CODING
EVERY SINGLE ICED TEA ADMISSIONS
SINCE THAT TIME AND NAPA STATE
HOSPITAL OVER FOUR THOUSAND
EMISSIONS. OF THUS FAR AND WE
HAVE A LOT OF LONGITUDINAL DATA
DESCRIPTIVE DATA ON THESE
PATIENTS AND. THE SHORT ANSWER
IS THERE HAS NOT BEEN AN
APPRECIABLE CHANGE IN THEIR
DIAGNOSTIC PROFILE IN THE RATE
OF MALINGERING IN THE RED
COGNITIVE DISORDERS IN THE RATE
OF SUBSTANCE USE DISORDERS.
HOWEVER WE HAVE SEEN.
MARKET INCREASE IN THE NUMBER
OR THE PERCENTAGE OF PATIENTS
COMING AND WHO'VE HAD. A FIFTEEN
OR MORE PRIOR ARRESTS.
THAT NUMBER'S GONE FROM AROUND
FIFTEEN PERCENT OF THE
POPULATION TO ABOUT FORTY FIVE
PERCENT.
SO AS WE DIG DOWN AND LOOK AT
THEIR ARREST REPORTS AND THEIR
RAPSHEETS WHAT WE'RE SEEING. A
QUALITATIVELY AS A PATTERN OF
INDIVIDUALS WHO ARE HAVING THE.
UNCONTROLLED PSYCHOTIC SYMPTOMS
CORPS IN CRISIS WHO ARE NOT HOW
MOST WHO ARE GETTING INTO.
ARREST SITUATIONS THAT.
ARE RELATED TO THE CONDITIONS
OF THEIR HOMELESSNESS POVERTY OR
THEIR UNCONTROLLED PSYCHOTIC
SYMPTOMS. AND THEY'RE SORT OF
RACKING UP MORE OFFENSES
MISDEMEANORS AND THEN THEY'RE
FINALLY GETTING THAT FELONY
CHARGE AND SOMETIMES THOSE
CHARGES. ARE AND.
I CHARGED AS FELONIES ONCE THE
POLICE OFFICER GETS INVOLVED IN
THE PATIENT IS PARANOID IT
BECOMES COMBATIVE. SO WITH SO
QUANTITATIVELY WE CAN
DEMONSTRATE THAT INCREASE AND
PRIOR ARRESTS QUALITATIVELY WE
CAN TALK ABOUT. OTHER CONDITIONS
SURROUNDING THOSE ARRESTS.
AND.
LOOKING AT THAT SAMPLE WE
DECIDED TO TAKE THE COATING
PROCESS STATEWIDE TO SEE IF THIS
WE GOT THE SAME RESULTS DID.
IN THE PROCESS OF DOING THAT
SAMPLE WHICH IS ABOUT FOUR
HUNDRED PEOPLE LAST YEAR.
WE ADDED IN QUESTIONS ABOUT
HOMELESSNESS BECAUSE OF WHAT WE
SAW WHEN WE LOOKED AT THE ARREST
REPORTS. AND WHAT WE SEE WHAT WE
FOUND IS THAT FORTY SEVEN
PERCENT OF THE SAMPLE. OF.
IC PATIENTS THAT WE ADMITTED.
WARNING AND SHELTERED HOMELESS
STATUS AT THE TIME OF THEIR
ARREST SO.
IF THEY WERE STAYING IN A
SHELTER ON CITIES COUCH.
IN SOMEBODY'S YARD IN THE TEN
WE DO NOT COUNT THAT AS ON
SHELTER TO THESE ARE THE FOLKS
LIVING ON THE STREET. ON JUST
ABOUT HALF THE SAMPLE.
WE ALSO DID A DATA SHARING
AGREEMENT WITH D. H. CS. OF
WHERE WE GOT MEDI CAL
UTILIZATION DATA TO TRY TO
FIGURE OUT TO YOUR POINTS ARE
THESE PEOPLE ACCESSING SERVICES.
AND IN THAT.
SAMPLE.
.
FOUR HUNDRED THAT WE DID LAST
YEAR WE KIND OF GAVE THE
IDENTIFYING INFORMATION D. H.
THIS AND THEY GAVE BACK THE
UTILIZATION DATA. AND WHAT WE
FOUND IS THAT.
ABOUT FORTY SEVEN PERCENT DID
NOT ACCESS TO MEDICAL
REIMBURSABLE MEN HEALTH SERVICES
IN THE SIX MONTHS PRIOR TO THEIR
ARREST.
A SO WHAT WE'RE SEEING IS KIND
OF THIS COMBINATION OF
INDIVIDUALS WHO HAVE
UNCONTROLLED SOMETIMES OF
PSYCHOSIS WHO ARE IN AN
UNSHIELDED HOMELESS STATUS WHO
ARE NOT. UTILIZING UMOJA
SERVICES IN THE COMMUNITY AND
WHO ARE GETTING INTO MORE AND
MORE AND MORE TROUBLE WITH THE
LAW ON A GRADUAL BASIS OVERTIME.
AND WE DID DO A NATIONAL STUDY
LAST YEAR. WHERE WE SENT OUT THE
SORT OF SURVEY TO?
FIFTY ONE JURISDICTIONS
INCLUDING THE DISTRICT OF
COLUMBIA IN ALL FIFTY STATES.
AND WE GOT A RESPONSE RATE OF A
FIFTY AND FIFTY ONE I
JURISDICTIONS RESPONDING. I AM
REALLY SEVENTY PERCENT OF STATES
RESPONDING SAID THAT THEY'RE
SEEING THESE INCREASES.
SIXTY SOME PERCENT SAID THEY
HAVE A WAIT LIST AND FORTY ONE
PERCENT ARE CURRENTLY FACING
LITIGATION AS A RESULT OF THAT
WE LIST IN UNFORTUNATELY WHAT
HAPPENS WITH THE LITIGATION. IS
THE HONESTY IS SUIT AND FEDERAL
COURT IN THE FEDERAL COURT PUT
SAY. ON MANDATORY MINIMUM
TIMELINE FOR ADMITTING THIS
PATIENTS
I SAW YOUR SENSUALLY FORCIBLY
OVERCROWDING YOUR HOSPITALS ON
YOU KNOW PEOPLE ARE ADMITTING
PATIENTS TO TREATMENT SPACES.
AND OFFICE SPACES IN RESPONSE TO
A FEDERAL.
TIMELINE MANDATES US SO WE'RE
SEEING THIS. SOMEWHAT BIZARRE
SITUATION OF OF.
PATIENTS.
BUT.
ESSENTIALLY SUING TO BECOME
INSTITUTIONALIZED IN THE
HOSPITALS IN RESPONSE ARE KIND
OF BREAKING DOWN BECAUSE THEY
CAN'T HANDLE THE ADMISSION RATE
SO WE'RE REALLY TRYING TO.
FIND A WAY TO CUT OFF THE
DEMANDS AND.
I AND DO SOMETHING ABOUT THE
PRIMARY PROBLEM BECAUSE AS MS
CLINTON AND NOTED. COMMENTS HE
RESTORATION IN NO RIGHT WAY
RESEMBLES COMPREHENSIVE MENTAL
HEALTH TREATMENT AND WE'RE
REMOVING THE VERY TO CONFIDENCE
AND SEND THEM BACK INTO THE SAME
MASS. EITHER THEY WERE IN
BEFORE.
HE SHARED A TON OF REALLY GET
INFORMATION.
ONE OF THE FIRST THINGS THAT
CANNOT POPS IN MY HEAD IS.
WHEN DID YOU START GATHERING THE
WHAT DAY.
FOR HONOR DATA COLLECTION DID
YOU BEGAN.
AND THAT NAPSTER DO WE STARTED
IN TWO THOUSAND EIGHT.
SOME I'M JUST AS THERE'S A LOT
OF QUESTIONS OUT THERE IN
REGARDS TO PROPS FORTY. WITH
PEOPLE GOING IN AND OUT.
WITH.%
DEGRADING WHAT WAS ONCE FELONY
TO A MISDEMEANOR IN IN PEOPLE.
WHO ARE IN A ALTERED MENTAL
STATUS NOT QUITE GETTING? IT
THEY DON'T UNDERSTAND THAT SO.
.
I'M CURIOUS TO NUMBERS WITH
CORRELATIONS ON ON THOSE NOW
POPULATIONS.
TO SEE IF ANY OF THAT GOES INTO
OR MENTAL HEALTH FOLKS.
.
BECAUSE OF OF TALKED TO A LOT OF
FOLKS LA LOCAL.
IN A LOT OF PEOPLE THAT DEAL
WITH THESE POPULATIONS AND. YOU
KNOW IS IT'S SAD THAT.
THERE IS BEEN FOR A LONG TIME
THIS KIND OF.
LOG GO ALL DO SOMETHING NOT GET
ARRESTED. AND NOW I KNOW I'M
SOMEWHERE SAFE BECAUSE I'M IN
JAIL.
MENTALITY.
AND THEN THOSE STAY IN IN THE
GET RELEASED AND THEY DON'T KNOW
HOW TO ACT IN SOCIETY BECAUSE IF
CONTINUE TO FALL THROUGH THE
CRACKS OF A GOOD TO ANOTHER
CRIME TO GO BACK IN.
AND SO I'M REALLY CURIOUS ON ANY
DATA. WITHIN THAT POPULATION
BECAUSE IT IT'S REALLY SAD AND
IT'S TRAGIC BUT IT'S HAPPENING.
BECAUSE THAT'S WHAT THESE FOLKS
NOW.
.
THERE'S JUST A LOT OF DATA A LOT
IN NUMBERS.
.
HEY WE'VE GOT TO MAKE SURE THAT
WE'RE LOOKING AT THE RIGHT
THINGS.
LIKE THE CHAIR SAID.
YOU KNOW THE PIECE OF STRING
THINGS WHAT IT WHAT ARE THESE
OTHER CAUSES OF ME AND THINK YOU
WE HEAR ALL THE TIME YOU KNOW
MORE MONEY ON EDUCATION.
GEL.
BUT WHAT ARE WE REALLY LOOKING
AT YOU KNOW WE SAID THROUGH
HEARINGS DOWN. LAST WEEK.
TYROD ACES SCORES IN IN YOUTH
AND POVERTY IN AND HOW THESE
THINGS ARE AFFECTING THEIR
BRAINS.
MIA SO WHERE DOES IT REALLY
START TO GET SOMEBODY TO THE
POINT WHERE THEY CAN'T STAND
TRIAL. ON THEIR MENTAL HEALTH IS
THAT THAT.
THAT WE CAN ACTUALLY FOCUS OUR
EFFORTS IN THE RIGHT SPOTS.
IT'S TRAGIC THAT WE HAVE A
POPULATION OUT THERE NOW.
THAT WE NEED TO BE ABLE TO
MANAGE BUT WE ALSO NEED TO LOOK
AT. HOW TO DECREASE IT INSTEAD
OF CONTINUALLY FIGHTING AT THE
WRONG WAY AS IT INCREASES?
YOU'VE VERY PHONY ó ABSOLUTELY
AGREE MORE AND I THINK. I THINK
THIS BUDGET REFLECTS OUR
ACKNOWLEDGEMENT OF YOUR POINT
WITCHES WE CAN'T JUST KEEP
BUILDING MORE HOSPITAL BEDS TO.
RESTORE CONFIDENCE IN
INDIVIDUALS WHO CLEARLY HAVE
SIGNIFICANT PSYCHIATRIC AND
SOCIAL ISSUES THAT NEED
ADDRESSING TO STOP THE CYCLE.
WILK WHO.
.
I WOULD BE REMISS NOT TO COMMENT
ON THE FACT THAT THE STATE HAS
INVESTED A FAIR AMOUNT OF
RESOURCES INTO THE MENTAL HEALTH
SERVICES.
AND THAT THE COUNTIES DO HAVE A
RESPONSIBILITY TO PROVIDE.
OUT PATIENT THE MENTAL HEALTH
SERVICES AS WELL AND.
.
I GUESS THAT REALLY IS THE
QUESTION THE PLO HAS PUT IN
FRONT OF US IN IS ASKING
POLICIES.
IS THIS DIVERSION PACKAGING
ANYWAY. SUPERIOR TO THE MENTAL
HEALTH SERVICES THAT ARE
COMMUNITIES ARE GETTING THAT.
IS THIS MEANT TO SUPPLANT IT TO
WORK TO SUPPLEMENT.
THE MENTAL HEALTH SERVICES ACT.
AND I ASK. PARTICULARLY IN LIGHT
OF HOW MUCH RESERVES THEY HAVE.
AND WONDERING WITH WHERE WE ARE
TODAY. IF WE WOULD NOT HAVE BEEN
BETTER SERVED HAVING SPENT SOME
OF THOSE RESERVES AND HELPING TO
GET UPSTREAM OF SOME OF THESE
ISSUES THAT ARE. BEFORE US NOW.
I HAVE CONCERNS WHEN I.
.
SEE THE SCOPE OF THIS PROBLEM
AND THE TRAJECTORY THAT WE HAVE
TAKEN AS A STATE. THAT IT SEEMS
THAT WE HAVE LED A SYMPTOM
FASTER FOR AWHILE.
AND HAVE GONE UNTREATED THE
TRUE.
DISEASE PROCESS WHICH IS.
THE MENTAL HEALTH CRISIS THAT
OUR STATE FACES.
AND.
THEME UNTREATED MENTAL HEALTH
CRISIS.
I GUESS THE QUESTION I'M REALLY
TRYING TO DO AGAIN IS SPECIFICS
OF THE DIVERSION PROGRAM IF I'M.
AND I'D LIKE TO.
ASK IF I CAN.
THE LA WHAT MADE A SUGGESTION
ABOUT SIX WEEKS TO THEN BE
DEFINED AS BEING ONTO A WAIT
LIST.
IS THAT A REASONABLE TIMEFRAME.
IS.
IS THE
WEEKS A REASONABLE TIMEFRAME.
ETCETERA.
AND THEN ALMOST
TRYING LEAD YOU DOWN THE PATH.
IS THERE AN OPPORTUNITY IN THE
FIFTEEN PREVIOUS ARRESTS.
BEFORE SOMEONE GETS DEEMED
INCOMPETENT TO STAND TRIAL. THAT
WE HAVE A REAL OPPORTUNITY TO
HELP TO DIVERT AND A FEW.
WAIT WAIT WAIT WITHOUT I THINK
SOME OF THE SAUCE GETS INTO THE
DIAGNOSES.
ON ON THE WHITE THE MENTAL
ILLNESS IS AN AND I HATE TO USE
THE TERM NOT WIRED RIGHT.
BUT SOME FOLKS.
AND CERTAIN ILLNESSES OR JUST AN
AUTOMATIC.
I MEAN A I HATE TO SAY IT
BECAUSE IT'S TRAGIC BUT WHEN I'M
IN THERE.
THERE ARE CERTAIN THINGS.
THEY COULD BE WRONG WITH
SOMEBODY WHERE THERE IS NO HOPE
FOR THEM
THE AND WE HAVE TO PUT THEM IN A
SITUATION THAT'S BEST SUITED TO
KEEP THEM SAFE AND KEEP SOCIETY
SAFE IS WHILE.
.
SO WE ALSO NEED TO LOOK AT THAT
BECAUSE THERE'S. THERE'S NO
AMOUNT OF HELP THAT CERTAIN
INDIVIDUALS ARE GOING TO GET
THAT'S GONNA MAKE THEM READY TO
STAND TRIAL.
IT'S JUST NOT GONNA HAPPEN IT'S
PHYSICALLY IMPOSSIBLE. AND IT'S
A REALITY ASSIGNS.
AND IN IT IT'S TRAGIC AT THE
SAME TIME.
SO WE WE NEED TO MAKE SURE THAT
I MEAN THERE'S THERE'S SOME
PEOPLE INCOMES ADDICTIONS AND
DRUGS AND STUFF LIKE THAT THAT
THAT WE CAN HELP WITH THERE'S
OTHER MENTAL STUFF WHERE IF
THEY'RE ON CERTAIN MEDICATIONS
BUT.
THE SAMETIME THERE ARE SOME
PEOPLE THAT JUST FLAT ON OUR
LARA WIRED RIGHT AND THERE'S NO
MATTER HELP THIS GOING TO HELP
THEM. BE READY TO STAND TRIAL
WOULD BE READY FOR SOMETHING
ELSE TO BE READY. TO BE SAFELY
LET OUT IN SOCIETY BECAUSE
THEY'RE JUST THEY'RE NOT THERE.
SO A AS YOU DO THAT PLEASE
COMPARE AND CONTRAST DIFFERENT
DIAGNOSIS.
THAT WEEK THAT IT WE KNOW THAT
YOU KNOW SO I I KNOW YOU GOT THE
NUMBERS.
BUT BUT PEOPLE IN THIS BUILDING.
DAHLE COMPREHEND ALL OF THAT
WITHOUT IT BEING SPELLED OUT ON
A REALLY PRETTY SPREADSHEET
UNFORTUNATELY.
SORRY I ASKED ABOUT THE SIX
WEEKS THOUGH AND WANTED TO SEE
HOW WE COULD HELP TO GET UP ST.
SO WITH RESPECT TO THE SIX WEEKS
I MEAN COMPRESSION WHAT OF THE
LA DOES PROPOSAL IS AN AND
UNDERSTAND.
WHAT THE GOAL IS A THINK AND WE
WOULD HAVE A CONCERN WITH AND
SIX WEEKS?
GIVEN THAT I. AND THEIR YOU
KNOW THERE'S A NUMBER OF FACTORS
AT PLAY WITH RESPECT TO AND. AS
THE THE WAY LESS STAND AND FIRST
OF ALL RIGHT NOW WE HAVE A LOT
OF TIME IN A BEFORE SOMEBODY IS
ADMITTED TO A STATE HOSPITAL AND
SO. AND ADD ANDERSON ENDING THAT
RIGHT NOW THAT ISN'T THE RATE
LIMITING STEP SO THINGS MAY BE
TAKING LONGER FOR US TO PROCESS
PAPERWORK BECAUSE. WE DON'T NEED
TO PROCESS IT TODAY VERSES EIGHT
IF WE HAD SORT OF WAIT TIMES
THAT DOT PROCESS WOULD GET I'M
CONDONES.
WRITTEN FIFTY TWO DAYS I THINK
THAT'S HOW MANY DAYS HE SAID THE
AVERAGE.
INCOMPETENT TO STAND TRIAL IS ON
THE WAITING LIST IS THAT
ACCEPTABLE OR WHAT IS AN
ACCEPTABLE.
AMOUNT OF TIME AND.
AND.
AND THAT'S UP FOR DEBATE WITH
THE COURTS RIGHT NOW.
SO I THINK THAT'S WHERE WE WE
ARE ARE CHALLENGED IS WE DON'T
HAVE ANY.
A ARE VERY CLEAR.
.
GUIDANCE FROM ON THIS BECAUSE
ULTIMATELY THE WE HAVE BEEN
PRIOR UNDER PRIOR COURT
DIRECTION TO ADMIT INDIVIDUALS
WITHIN THIRTY DAYS.
WHO NATIONALLY WE HAVE BEEN YOU
KNOW SEEN FEDERAL COURT CASES
RESULT IN INDIVIDUAL AND
HOSPITALS BEING BEING REQUIRED
TO ADMIT WITHIN SEVEN DAYS? AND
SO.
AND WE ARE CONSTANTLY.
BEING BROUGHT BEFORE THE COURTS
ON ORDERS TO SHOW CAUSE.
WERE IN COURTS DEAL ONLY.
AND WHEN WE NEED BECAUSE WE ARE
NOT ADMITTING INDIVIDUALS TIMELY
AND WE'VE BEEN UNDER COURT
ORDERS FROM ANYWHERE FROM TWO
WEEKS TO SIXTY DAYS OURSELVES
SO.
I THINK CITING AS A SIX WEEK
TIME FRAME DOESN'T NECESSARILY
RECOGNIZE THAT THAT KIND A
DYNAMIC THAT WERE IN WITH WITH
RESPECT TO THE CORE I'M BUT WE'D
BE HAPPY THAT YOU KNOW CONTINUE
TIME. DIALOGUE AND AND SEE IF
THERE'S SOMETHING THAT DOES MAKE
SENSE AND.
I WANT TO GET THE LA DOES.
REASONING BEHIND BY WE HAD SIX
WEEKS. WRONG BUT DO WANT TO
FOCUS THE CONVERSATION FOR THE
REMAINDER OF TODAY IF I CAN ON
THE DIVERSION PROGRAM. THAT'S
BEFORE US TO ENSURE THAT WE CAN
HAVE AS MUCH INPUT INTO IT AS WE
CAN.
.
IT.
DON'T KNOW HOW TO SAY THIS.
WITHOUT JUST JUMPING TO IT.
.
THAT MANY OF THE MEMBER
PROPOSALS WE HEARD HAD.
A LOT MORE DETAILS THAN WHAT I'M
SEEING IN FRONT OF ME WITH THIS
DIVERSION PROGRAM.
AND FEEL THAT THERE'S MORE
DETAILS I NEED TO BE ADDED TO
IT.
WHAT I'M HEARING FROM YOU WAS
WANTING FLEXIBILITY?
AND.
WANTS TO REALLY MAKE SURE THAT
WE BUILT IN THE ACCOUNTABILITY
AND OVERSIGHT TO.
TO HAVE EARNED THAT FLEXIBILITY
IN SOME TRYING TO HEAR FROM THE
DEPARTMENT. WHAT THE REASONING
WAS BEHIND THIS PROPOSAL AS IT
PLAYED OUT TODAY?
THANK YOU MISTER SHARIA OF WITH
WITH RESPECT TO THIS SIX WEEK
TIME PERIOD WE AGREE THAT THERE
THERE ARE ALTERNATIVE WAYS TO
DEFINE THE WILL BE THE
WEIGHTLESS IN A WAY THAT REALLY
SEPARATES THE PROBLEM OF.
PROCESSING PEOPLE TO DETERMINE
THE APPROPRIATE TREATMENT
LOCATION WITH.
OUR OUR OTHER PROBLEMS OF NOT
HAVING ENOUGH CAPACITY.
AND SO TRYING TO FOCUS IN ON HOW
MANY PEOPLE ARE ON THAT WAY LESS
BECAUSE WE REALLY DON'T HAVE
CAPACITY AND WHAT. CHANGES TO
CAPACITY DO WE NEED TO DO IN
ORDER TO MAKE SURE THAT THEY GET
INTO TREATMENT AT THE
APPROPRIATE TREATMENT AS QUICKLY
AS POSSIBLE.
WERE OPEN TO DISCUSSING
ALTERNATIVES TO THE SIX WEEK
TIME PERIOD WE WANTED TO MAKE
SURE. THAT THE DEPARTMENT HAD A
SUFFICIENT AMOUNT OF TIME TO DO
THE WORK THEY NEEDED TO DO TO
MAKE SURE THERE.
IN THE RIGHT PROGRAM BECAUSE.
WE CERTAINLY WOULDN'T WANT TO BE
IN A POSITION WHERE WE'RE
RUSHING PEOPLE INTO THE WRONG
PROGRAM.
AND SOURCES
IF IT'S SIX WEEKS OR SIXTY DAYS
IF THE COURT CAME IN AND SAID
THERE'S ANOTHER STANDARD. OUR
GOAL IS JUST TO MAKE SURE WE
KNOW WHAT THE PROBLEM IS SO THAT
WE CAN FOCUS.
THE LIMITED RESOURCES WE HAVE ON
THAT PROBLEM RATHER THAN TRY TO.
ON TACKLE WEIGHTLESS THAT WE'RE
NOT GOING TO BE ABLE TO
ELIMINATE BECAUSE WILL NEED SOME
PROCESSING.
EARLIER WE HAD HEARD FROM
DISABILITY RIGHTS OF A DIVERSION
PROGRAM. RELATING TO
MISDEMEANORS.
WAS WONDERING IF YOU COULD SPEAK
TO THE SUCCESS OF THAT PROGRAM.
AND IF THAT'S SOMETHING WE AS A
STATE ARE LOOKING OUT
CONSIDERING THIS CURRENT
TEMPERATURE.
ON OCCASION ACTUALLY VISITED
THAT PROGRAM DO ON A TALK ABOUT
IT A LITTLE BIT. YEAH AND I
THINK MAYBE I CAN LIVE TO SINCE
HERE EARLIER QUESTION ABOUT THE
FLEXIBILITY. I'M AND AND ALSO
OTHER QUESTIONS ABOUT WIRE CITY
HOSPITALS ADMINISTERING COUNTY
FUNDS FOR DIVERSION LA ALL
QUESTIONS THAT WE'VE GOT ALL
GREAT QUESTIONS AND I THINK. AND
REALLY THE ANSWER IS WE KNOW THE
PATIENT POPULATION WE'VE BEEN
STUDYING THE PATIENT POPULATION.
WE UNDERSTAND WHO THESE FOLKS
ARE AND WHERE UNDERSTANDING MORE
AND MORE EVERYDAY ABOUT THE
COURSE THAT THERE.
I TRAVERSING TO COME TO US WOULD
LIKE NOTHING MORE THAN TO SHUT
OUR DOORS AND CLOSE DOWN DUE TO
LACK OF BUSINESS. AND TO SEE ALL
THESE FOLKS SUCCESSFULLY
TRANSITION TO THE COMMUNITY.
THAT COUNTIES HAVE VARIOUS
DIFFERENCE.
A DIVERSION PRACTICES IN PLACE.
THE CONCEPT OF JAIL DIVERSION IS
A FAIRLY WELL STUDIED WELL
ARTICULATED.
CONSTRUCT.
WHERE YOU CAN HAVE DIVERSION AT
ANY NUMBER OF POINTS WHERE AN
INDIVIDUAL COMES INTO CONTACT
WITH THE CRIMINAL JUSTICE
SYSTEM?
AYE THERE HAVE BEEN.
NATIONAL STEPPING UP
INITIATIVES THE COUNCIL ON STATE
GOVERNMENTS AND CERTAIN COUNTIES
IN CALIFORNIA HAVE QUOTE UNQUOTE
STEPPED UP TO TRY TO.
REDUCE THE NUMBER OF A MENTAL
HEALTH PATIENTS WHO ARE
INCARCERATED.
SO WE DO SEE AND WE'VE BEEN ON A
LITTLE.
NUMBER FIELD TRIPS LOOKING A
COUNTIES HAVE IN PLACE WE DO SEE
COLLABORATIVE COURTS WE DO SEE
FOR EXAMPLE THE MISDEMEANOR ICED
TEA PROGRAM IN IN LOS ANGELES
WHICH IS EXTREMELY IMPRESSIVE.
WE SEE.
YOU KNOW.
GOTTA COUNTIES THAT ARE STARTING
OUT THE CLEVER OF COURT MODEL
BUT DON'T HAVE THE PLACE TO
DIVERT TO SAID THERE'S. VARIOUS.
DIVERSION EFFORTS BASED ON
VARIOUS COUNTY NEEDS IN VARIOUS
COUNTY RESOURCES THAT ARE SORT
OF BEING STOOD UP.
AYE AND THE FLEXIBILITY THAT'S
IN THEIR LANGUAGE IS TO ALLOW.
US TO SUPPORT THOSE EFFORTS AND
GET THE COUNTIES TO THE PLACE.
WHERE THEY CAN START DIVERTING
MORE OF THE FOLKS THAT WE
UNDERSTAND USING THESE
MECHANISMS THAT ARE ALREADY
BEING DEVELOPED IF THAT MAKES
SENSE SO THAT BECAUSE WE
UNDERSTAND THE POPULATION? CAN
WE.
.
ROOT BEER OR RETOOL THE
MECHANISMS THEY HAVE A PLACE TO
TARGET THE POPULATION THAT WE
UNDERSTAND SO WELL AND IN ORDER
TO DO THAT NECESSARILY THERE HAS
TO BE SOME FLEXIBILITY.
I AND AND WE'RE HOPING THAT.
THE COLLABORATION I AS WELL AS
ASKING FOR OUTCOMES HAVE YOU
REDUCED THE NUMBER OF FELONY
ICED TEA ADMISSION THAT HAVE YOU
REDUCE THE RATE OF REFERRAL OF
FUNNY ICE TEA EMISSIONS. HAVE
YOU READ IT REDUCED RECIDIVISM
HAVE YOU HAD SUCCESSFUL PROGRAM
COMPLETION HAVE YOU HAD
SUCCESSFUL TRANSITION OF
COMPLETED. UP PROGRAM HAVE FOLKS
INTO LONG TERM COMMUNITY
SERVICES AYE WE WERE HOPING THAT
THAT COMBINATION OF FLEXIBILITY
IN COLLABORATION AROUND HOW. AND
AND ACCOUNTABILITY AROUND THE
OUTCOMES WOULD.
TO BE THE BEST WAY TO APPROACH
DIVERSION IF THAT MAKES ANY
SENSE AS LONG AS THERE'D HEARING
TO EVIDENCE BASED PRACTICES AND
PRINCIPLES OF I'M AYE.
SEQUENTIAL INTERCEPT JAIL
DIVERSION.
SO I SEE WHERE YOU'RE. GOING
WITH THIS AND I APPRECIATE IT I
GUESS DEPUTY DIRECTOR WHAT I'M
TRYING TO FIGURE OUT IS.
AT HOW DO WE GET COUNTY TO HAVE
SKIN IN THE GAME HOW. WOULD YOU
WE'VE SAID THAT THEY WILL.
CONTRIBUTE TWENTY PERCENT OF
COUNTY FUNDS TO MATCH STATE
FUNDS.
HOW HOW CAN WE GUARANTEE THAT
INTO THIS AND SECOND HOW DO HOW
DO WE AFTER WE'VE COLLECTED
OUTCOMES HAVE ANY AMOUNT OF
OVERSIGHT OVER? THE COUNTIES IF
THEY DO NOT MEET THE THRESHOLDS
THAT WE'RE RECOMMENDING THE
TWENTY OR THIRTY PERCENT
REDUCTIONS AND ICED TEA
REFERRALS.
IT SEEMS AS IF WE HAVE CONTROL
OVER THE MONEY GOING OUT BUT
ONCE IT GOES OUT WE DON'T HAVE
AS MUCH OVERSIGHT AND
ACCOUNTABILITY.
AND I'M. HESITANT BASED OFF OF
OUR DISCUSSION LAST WEEK BEFORE
THIS COMMITTEE.
TO GO THROUGH THIS WITHOUT A
HARD AND.
PLAN THAT'S BEFORE US EVEN
THOUGH WERE ADDRESSING A
CRITICAL.
SYMPTOM AND DISEASE THAT WE NEED
TO ADDRESS ON TRYING TO. REALLY
WANT TO WORK WITH YOU AND MAYBE
THAT'S A GOOD PLACE IF. YOU
DON'T HAVE HARD ANSWERS NOW IS.
FOR US TO WANT TO WORK TOGETHER
AFTERWARDS TO ENSURE THAT WE
HAVE A DIVERSION PROGRAM THAT.
IS IS READY.
FULL TIME SO.
I'M IF YOU HAVE ANY CLOSING
COMMENTS THAT WE WILL HOLD ISSUE
ELEVEN OPEN AND MOVE ON TO ISSUE
.
YOU HAVE MISTER HARPER CHAIR
JUST FOR ONE MINUTE I'LL BE
RIGHT.
THANK YOU MISTER HARPER AND
MEMBERS I'M RANGING SEARS CHIEF
INFORMATION OFFICER WITH THE
DEPARTMENT OF STATE HOSPITALS.
VERY QUESTION ONE POINT TWO
MILLION OF FALL FOR. AND FOR
FULL TIME POSITIONS IN FISCAL
YEAR EIGHTEEN NINETEEN. AND
SEVEN HUNDRED THIRTEEN THOUSAND
IN FISCAL YEAR NINETEEN TWENTY
TO PREPARE FOR AN ELECTRONIC
HEALTH RECORD.
DS H. IS COMPLETED BUSINESS
ANALYSIS THE ALTERNATIVE
ANALYSIS AND PROGRESS IN WILL
SOON. AFTER INCREASED FOCUS ON
ORGANIZATIONAL READINESS
EFFORTS.
GIVEN THE SIZE OF A COST AND
COMPLEX GROUP OF THE ELECTRONIC
HEALTH RECORD THIS PROPOSAL
FOCUSES ON SOLUTION DEVELOPMENT
PROCUREMENT AND PROJECT
READINESS FOR DEPLOYMENT OF THE
PRIMARY CARE SOLUTION.
AND INTEGRATING THAT WITH OUR
INTERNAL FORENSIC BEHAVIORAL
HEALTH SYSTEM.
DS H.'S MADE GREAT PROGRESS
TOWARDS CONSOLIDATE IN AND
DEVELOPING ENTERPRISE CLINICAL
BUSINESS PROCESSES.
AFTER THESE KEY READINESS
ACTIVITIES THE NEXT STEP IS
PROVIDING THEM WITH THE TOOL TO
EFFECTIVELY IMPLEMENT THE
REFINED PROCESSES.
THIS PROJECT WILL ALLOW DSA
TOSSED BILLS TO. TREAT PATIENTS
VIA UNIFIED PATIENT RECORD
ENABLING ALL PATIENT CARE DATA
TO BE ANALYZED.
TOGETHER TO IMPROVE INDIVIDUAL
TREATMENT SYSTEM DECISION
MAKING.
IMPROVE THE REGISTRATION PROCESS
FOR PATIENTS AND STAFF.
IMPROVE PHARMACY SERVICES FOR
PATIENTS WHILE ALLOWING DS AGE
TO COME INTO COMPLIANCE HE WAS
STATE FEDERAL REGULATIONS.
PERMITS BETTER ACCURACY FOR
PATIENT COST OF CARE IMPROVE THE
QUALITY AND EFFICIENCY OF
PRIMARY MEDICAL CARE FOR BOTH
PATIENTS AND HEALTHCARE
PROVIDERS.
OUR STAGE THREE SOLUTION
DEVELOPMENT KICK OFF WILL BEGIN
IN JULY TWO THOUSAND EIGHTEEN.
APPROVAL A STAGE THREE'S STAGE
THREE SOLUTION DEVELOPMENT IN
JUNE TWO THOUSAND NINETEEN AND
APPROVAL OF STAGE FOUR PROJECT
READINESS IN APPROVAL.
AND CONTRACT AWARD ENGINE TWENTY
TWENTY.
WHEN WHEN DEPARTMENT OF FINANCE
AND GIVEN THE SIZE AND SCOPE OF
THIS UNDERTAKING A WEARING
SUPPORTED THIS AND CRIES OUT
BEACH TO BE SURE THAT IT'S PLAN
NOW PROPERLY.
JONATHAN PETERSON WITH THE LA A
WE DIDN'T RAISE ANY CONCERNS
WITH THIS PROPOSAL.
FOR.
NO SIR.
OKAY.
ISSUE THIRTEEN IS OUR
INFORMATION SECURITY PROGRAM
EXPANSION WE'RE REQUESTING THREE
POINT ONE MILLION INTO FULL TIME
POSITIONS IN FISCAL YEAR
EIGHTEEN NINETEEN. AND ONE POINT
SEVEN MILLION IN OUT YEARS
ALLOWING THE DEPARTMENT TO
REMEDIATE SECURITY ASSESSMENT
FINDINGS.
LAST FISCAL YEAR DS AGE
PERFORMED TO SECURITY
ASSESSMENTS IN COMPLIANCE WITH
GOVERNMENT CODE SECTION ONE ONE
FIVE FOUR NINE POINT THREE.
STATE ADMINISTRATIVE MANUAL
FIFTY THREE HUNDRED AND THE
HEALTH INSURANCE PORTABILITY
ACCOUNTABILITY ACT SECURITY
COMPLIANCY.
BOTH ASSESSMENTS IDENTIFIED
SIMILAR FINDINGS CRITICAL TO THE
PRODUCTION PROTECTION OF DS H.
INFORMATION.
TO MITIGATE THESE FINDINGS WERE
REQUESTING SUPPORT TO IMPLEMENT
AN INVENTORY AND ASSET
MANAGEMENT SOLUTION SOLUTION.
TWENTY FOUR BY SEVEN SECURITY
MONITORING ACROSS THE ENTERPRISE
ON PREMISE ROAD DEVICE DETECTION
PAIRED WITH MOBILE
CLOUD-SECURITY SOLUTIONS TO
LIMIT
ACCESS AUTHORIZED DEVICES.
AND SECURE CODE SOLUTION
APPLICATION PENETRATION TESTING
AND THEN ALSO SOME TRAINING FOR
OUR APPLICATION DEVELOPERS.
AS A RESULT OF THIS PROJECT THE
ESTATE WILL BE ABLE TO HELP
PROTECT OUR INFORMATION ASSETS
AGAINST EMERGING THREATS AS WELL
AS A CHIEF THE COMPLIANCE
NECESSARY TO AVOID POTENTIAL
SANCTIONS.
OUR TIMELINE IS PROJECT KICK OFF
OUR PROCUREMENT JULY TWO
THOUSAND EIGHTEEN.
SUPPORTING SYSTEM IMPLEMENTATION
BEGINNING IN JANUARY TWO
THOUSAND NINETEEN AN ONGOING
PROGRAM MAINTENANCE IN EARLY TWO
THOUSAND NINETEEN.
WE WILL NOW TAKE PUBLIC COMMENT
ON ISSUE THIRTEEN.
SEEING NONE WILL BRING IT UP TO
THE DYESS FRONT QUESTIONS.
SEEING NONE WILL HOLD ISSUE
THIRTEEN OPEN AND MOVE ON TO
ISSUE FOURTEEN.
WE'RE REQUESTING TWO POINT SEVEN
MILLION IN FISCAL YEAR EIGHTEEN
NINETEEN IN OUT YEARS TO
INCREASE EXPENSES ASSOCIATED
WITH REFRESHING OUR PERSONAL
DRESS ALARM SYSTEM EQUIPMENT.
IN OCTOBER TWENTY TEN A PATIENT
ON STAFF ASSAULT RESULTED IN
DEATH.
RAISING SERIOUS CONCERNS
REGARDING SECURITY AND SAFETY AT
DS EIGHT HOSPITALS.
TO ADDRESS THIS TRAGEDY STARTING
IN TWO THOUSAND TWELVE DS EIGHT
SUCCESSFULLY DEPLOYED THE
PERSONAL ADDRESS ALARM SYSTEM
APPLICATION.
THE SYSTEM IS USED SUCCESSFULLY
ON A DAILY BASIS TO ALERT
HOSPITAL POLICE IN NEARBY
EMPLOYEES WHEN ADDRESS INCIDENT
OCCURS.
PREVIOUSLY APPROVED PROJECT
FINING PAYS FOR SOFTWARE AND
HARDWARE SUPPORT THIS PROPOSAL
WILL ALLOW DS AGE TO REFRESH THE
PERSONAL DRESS ALARM SYSTEM
HARDWARE.
YES AGES UNABLE TO INTERNALLY
FUND MAINTENANCE FOR THESE
CRITICAL LIFE AND SAFETY SYSTEMS
WITHOUT AN ADDITIONAL BUDGET
ALLOCATION. THAT THE DEVICES ARE
NOT REPLACE THE SYSTEM MAY
BECOME UNRELIABLE. STAFF AND
PATIENT SAFETY MAY ONCE AGAIN BE
JEOPARDY.
WE WILL NOW TAKE PUBLIC COMMENT
ON ISSUE FOURTEEN.
DEPARTMENT OF FINANCE LA ONLY
COMMENTS ON ISSUE FOURTEEN.
I ONE DEPARTMENT OF FINANCE
GIVEN THE AMOUNT OF THE ASSAULT
IN A STATE HOSPITALS WEARING A
SUPPORT OF THE SCRIPT.
SEEING NO COMMENT FROM THE DYESS
WE WILL HOLD ISSUE FOURTEEN OPEN
IN THE BOND ISSUE FIFTY.
WE'RE REQUESTING THREE HUNDRED
AND FIFTY NINE THOUSAND TWO FULL
TIME POSITIONS IN FISCAL YEAR
EIGHTEEN NINETEEN. FOUR POINT
SIX MILLION IN FISCAL YEAR
NINETEEN TWENTY SEVEN POINT
SEVEN MILLION AND FISCAL YEAR
TWENTY TWENTY ONE AND THREE
POINT SEVEN IN OUT YEARS.
TO SUPPORT THE ONGOING COST FOR
THE UNIFIED HOSPITAL
COMMUNICATION PUBLIC ADDRESS
PHASE ONE PROJECT AT BOTH
PATENTING KALINGA. ADDITIONALLY
THIS REQUEST WILL FUND
IMPLEMENTATION OF PHASE TWO AT
THE REMAINING THREE STATE
HOSPITALS.
THE PROPOSED SOLUTION PROVIDES
DS SAGE WITH A COMPREHENSIVE AND
RELIABLE NETWORK MAYES PA SYSTEM
THE SYSTEM INTEGRATES INTO
REPLACE THE EXISTING PA SYSTEM
AND SUPPORTING NETWORK.
IT PROVIDES FULL CAMPUS
COVERAGE.
WILL NOTIFY STAFF OF THE MANSON
REAL. TIME DURING EMERGENCY
SITUATIONS PROVIDES TWO WAY
COMMUNICATION BETWEEN THE PUBLIC
ADDRESS SPEAKERS IN KEY AREAS
LIKE THE NURSES STATION AND
DISPATCH.
HASN'T ANNOUNCEMENTS TARGETED TO
SPECIFIC CAMPUS LOCATIONS TO
PREVENT DISRUPTION AND NON
IMPACTED AREAS.
THE SYSTEM ALLOWS FOR MESSAGE
PRIORITIZATION TO PREVENT
CONCURRENT MESSAGE DELIVERY AND
THE SYSTEM WILL INTEGRATE WITH
THE DEPARTMENT'S PERSONAL
ADDRESS SYSTEM.
AS A RESULT THE NEW PUBLIC
SYSTEM WILL INCREASE WORKER IN
PATIENT SAFETY.
PHASE ONE FIRST IMPLEMENTATION
AND TOOK PLACE IN MARCH OF TWO
THOUSAND EIGHTEEN AND WOULD BE
COMPLETED IN JUNE TWO THOUSAND
EIGHTEEN.
OUR COMPLETELY WE'VE GOT A
HUNDRED PERCENT OF ALL OF OUR
SPEAKERS INSTALLED AT COALINGA
NON SECURE TREATMENT AREAS LIVE
NOW. AND THEN WE ARE SEVENTY
PERCENT OF THE SPEAKERS
INSTALLED IT PATTON ALIVE AND
ONE AND THEN NODS.
SECURE TREATMENT AREAS.
PHASE TWO PROJECT SHIPPED OFF A
CURRENT WOULD BEGIN IN OCTOBER
TWO THOUSAND EIGHTEEN.
A METROPOLITAN WOULD IMPLEMENT
MARCH TWENTY TWENTY ONE.
TASCA DARROW DECEMBER TWENTY
TWENTY ONE NAPA ENGINE TWENTY
TWENTY TWO AND THEN WE GO ON TO
SYSTEM STABILIZATION BY JUNE
TWENTY TWENTY THREE. FINAL
PROJECT IMPLEMENTATION REPORT
WOULD BE DUE IN JANUARY TWENTY
TWENTY FOUR.
DEPARTMENT OF FINANCE A LEóN
ISSUE FIFTEEN.
ANY PUBLIC COMMENT ON THE ISSUE
FIFTEEN.
SEEING NONE WE WILL HOLD ISSUE
FIFTEEN OPEN AND MOVE ON TO
ISSUE SIXTY THINKING.
THANK YOU
.
SHARE CHAIR DR ADAM ALONG. A NEW
BALANCE OF THE S. DEPUTY
DIRECTOR OF ADMINISTRATION FOR
THE DEPARTMENT OF STATE
HOSPITALS. WITH YOUR PERMISSION
I'D LIKE TO DO A BRIEF SUMMARY
OF THE ITEM NUMBER SIXTEEN IF
THAT'S OKAY WITH YOU. WITH IT
THINKING SO WITH RESPECT TO THE
FIVE PROJECTS AND FENDI VIEW ALL
FIVE OF THEM ARE CONTINUING
EXISTING PROJECTS.
FOUR OF THE FIVE PROJECTS ARE
CONSTRUCTION EITHER TO STAR AND
ARE A COMPLETE ITS CONSTRUCTION
AND THREE OF THEM ARE
REAPPROPRIATION. ALL OF THE FIVE
EXISTING PROJECTS ARE EITHER
FIRE LIFE SAFETY OR THEIR
PATIENT RELATED.
WITH RESPECT TO THE FIRST ISSUE
COALINGA NEW ACTIVITY COURTYARD
WE ARE ASKING FOR EVERY
APPROPRIATION OF FIVE POINT
SEVEN MILLION AND THIS IS
SPECIFICALLY TO FUND THE
CONSTRUCTION PHASE. WERE
EXPECTING CONSTRUCTION TO START
JUNE OR JULY OF THIS YEAR.
FOR THE NEXT ON FOR THE
METROPOLITAN CONSOLIDATION OF
POLICE OPERATIONS IT WOULD BE TO
SUPPORT THE WORKING DRAWINGS
PHASE AND WE ARE REQUESTING ONE
POINT FIVE MILLION.
THE NEXT ONE ALSO IDEA SAGE
METROPOLITAN FOR THE CT
FIRE ALARM SYSTEM UPGRADE OR
REQUESTING THREE POINT FOUR
MILLION AND IT IS A
REAPPROPRIATION. IT WOULD
SUPPORT THE CONSTRUCTION FUNDING
AND WE'RE EXPECTING CONSTRUCTION
TO STAR IN NOVEMBER OF THIS
YEAR.
FOR THE PATENT FIRE ALARM SYSTEM
UPGRADE WERE REQUESTING NINE
POINT FOUR MILLION TO SUPPORT
CONSTRUCTION AND WE ARE
EXPECTING CONSTRUCTION TO START
IN OCTOBER OF TWO THOUSAND
EIGHTEEN.
AND FINALLY FOR THE LAST FUND
ALL SET PATENT PATENT EXCUSE ME
TO CONSTRUCT THE NAMING KITCHEN
IT IS EVERY APPROPRIATION
REQUEST.
SPECIFIC FOR A CONSTRUCTION AND
IT'S TO FINALIZE OUR
CONSTRUCTION AND OR REQUESTING
THIRTY THREE POINT ZERO EIGHT
SIX MILLION AND FISCAL YEAR
EIGHTEEN NINETEEN. AND IT WOULD
BE TO SUPPORT THE FINAL PHASE OF
THE CONTINUING PROJECT UNDER
CONSTRUCTION AND THIS
APPROPRIATION THIS
REAPPROPRIATION BUT ALLOW US TO.
HAVE THE DISH NO TIME FOR THE
ENCUMBRANCE PERIOD.
THE BERMAN FINANCE FELLOW.
JONATHAN PETERSON WITH THE LA A
WE DID HAVE ONE.
CONCERN ON THE SPRING FINANCE
LETTER FOR THE KITCHEN ANTAEUS
EACH PATTON WE DON'T RAISE
CONCERNS WITH THE REQUESTED
AMOUNT TO FINISH THE PROJECT.
HAVE HAVE A RELATIVELY MINOR
TECHNICAL BUDGETING ISSUE SINCE
THE TWO POINT NINE MILLION
NEEDED TO FINISH THE PROJECT WAS
NEVER ENCUMBERED BEFORE. THE
EXPIRATION OF THE ENCUMBRANCE
PERIOD WE DON'T BELIEVE THAT IT
CAN BE REPORT RE APPROPRIATED
INSTEAD WE. WE BELIEVE THAT IT
WOULD BE MORE APPROPRIATE IF THE
DEPARTMENT SOUGHT A NEW
APPROPRIATION FOR THIS TWO POINT
NINE MILLION.
TO COMPLETE THE KITCHEN.
KRILLIN ROBIN HER SUPPORT AND
FINANCE AND WE WOULD
RESPECTFULLY DISAGREE WITH THAT
BECAUSE WE TYPICALLY AGREE
APPROPRIATE THEM WHEN THEY COME
IN STRAIGHT HAS EXPIRED. WHILE
THE LION'S SHARE OF
REVERBERATIONS DO DEAL WITH RE
APPROPRIATING FORTS EXPIRED WE
DO ALSO ROUTE REPURPOSE THEM
WHEN THEY HAVE EXPIRED SO FOR
EXAMPLE. THEM WITH THE S. H.
THERE WAS AN APPROPRIATION IN
TWO THOUSAND SEVEN. THAT M.
WOULD NEED TO HAVE BEEN.
ENCUMBERED WITHIN THREE YEARS AT
THE END OF.
A TWO THOUSAND SEVEN EIGHT
BUILDING AT NIGHT THAT AT THE
END OF TWO THOUSAND.
NINE TEN IT WOULD HAVE HAD TO OF
BEEN ENCUMBERED AND THEN THERE'S
TWO YEARS TO LIQUIDATE AFTER
THAT. AND IT WAS NOT DONE AND IT
WAS REALLY APPROPRIATE TO
THOUSAND TWELVE THIRTEEN BUDGET
ACT SO. WELL IT'S NOT THE
MAJORITY OF THE REVERBERATIONS
THAT DEFINITELY CAN BE DONE AND
I WOULD SAY IT PROBABLY ISN'T
EVERY YEAR.
PUBLIC COMMENT ON ISSUE SIX.
XENON ON BRING IT UP TO THE
DYESS AND WILL HOLD ISSUE
SIXTEEN OPEN FOR NOW AND THAT
WILL CONCLUDE TODAY'S MEETING
THANK YOU ALL