AND I'D LIKE TO CALL THIS SAD
JOINT HEARING OF THE
ACCOUNTABILITY AND
ADMINISTRATIVE REVIEW COMMITTEE
AND THE ASSEMBLY HEALTH
COMMITTEE TO ORDER THE SUBJECT
FOR TODAY'S HEARING IS
CALIFORNIA'S MENTAL HEALTH
SERVICES ACT FINES. SINCE THE
TWO THOUSAND FOUR PASSAGE OF
PROP SIXTY THREE THE MENTAL
HEALTH SERVICES ACT THREE
CRITICAL REPORTS HAVE RAISED
SERIOUS QUESTIONS ABOUT THE
STATE'S FAILURES TO DIRECT
SPENDING AND OVERSEE THE
SPENDING OF THIS PROGRAM.
TODAY'S HEARING WILL FOCUS ON
THE ONGOING ACCOUNTABILITY AND
CORRECTIVE MEASURES THAT WERE
PUT IN PLACE SINCE LAST YEAR'S
REPORT FROM THE CALIFORNIA
STATE AUDITOR CHAIR WITH THANK
YOU SO MUCH FOR JOINING MY
COMMITTEE FOR THIS HEARING. AND
I WOULD ALSO LIKE TO THANK
MAYOR MAYOR DARRELL STEINBERG
AND THE SIGN BURKE INSTITUTE
BUT FOR THEIR ONGOING WORK ON
THIS CRITICAL ISSUE AND TO ASK
FOR THEIR INPUT IN AS WE
PREPARED FOR THIS HEARING. IT'S
NO SECRET THAT CALIFORNIA'S
BATTLING A MENTAL HEALTH
CRISIS. NEARLY ONE IN SIX
CALIFORNIANS EXPERIENCE SOME
TYPE OF MENTAL ILLNESS. MENTAL
ILLNESS HAS TOUCHED THE LIVES
OF NEARLY EVERYONE IN
CALIFORNIA AND I WAITED HAZARD
TO GAS NEARLY EVERYONE IN THIS
ROOM. BUT OUR MENTAL HEALTH
SYSTEM AND IS STRUGGLING. AND
IT'S NOT BECAUSE OF A LACK OF
FUNDING IN TWO THOUSAND FOR
CALIFORNIA TAXPAYERS APPROVED
PROP SIXTY THREE MILLION YEARS
TAX THAT NOW DIRECTS MORE THAN
TWO MINUTES TWO BILLION DOLLARS
A YEAR INTO SERVICE AS AN ALL
TOLD AS THE AS A STATE WE'RE
SPENDING NEARLY TEN BILLION
DOLLARS A YEAR I MENTAL HEALTH
SERVICES. GET THE CRISIS
CONTINUES TO GET WORSE AND
WE'RE ALL LIVING WITH THE
CONSEQUENCES THERE ARE A
BURGEONING NUMBER AS MENTALLY
ILL PEOPLE LIVING ON CALIFORNIA
STREETS WITH AN ESTIMATED ONE
THIRD OF THE INDIVIDUALS
EXPERIENCING HOMELESSNESS HERE
IN CALIFORNIA ALSO BATTLING A
SERIOUS MENTAL ILLNESS. THE
SAME STORY IN OUR JAILS AND
PRISONS WHERE ONE THIRD THE
PEOPLE THAT WE HAVE LIVING
BEHIND BARS HAD A SERIOUS
MENTAL DISORDER THAT'S A
HUNDRED AND 50% INCREASE SINCE
TWO THOUSAND. SUICIDE RATES ARE
ALSO CLIMBING. MENTAL HEALTH
WHICH IS VIRTUALLY EVERY MAJOR
PUBLIC POLICY ISSUE HEALTHCARE
EDUCATION CRIMINAL JUSTICE
HOMELESSNESS. AND I THINK FOR
ME THE FUNDAMENTAL QUESTION IS
HOW ARE WE FALLING SO SHORT ON
SOMETHING THAT IS SO VERY
IMPORTANT. AS CHAIR OF THE
ASSEMBLY IS ACCOUNTABILITY
COMMITTEE I AM PARTICULARLY
FOCUSED ON ENSURING THAT WE ARE
SPENDING. CALIFORNIA'S TAX
PAYERS DOLLARS AS EFFECTIVELY
AND AS EFFICIENTLY AS POSSIBLE.
SOUP BUT SIMPLY IN TODAY'S
HEARING I REALLY WANT
UNDERSTAND WHAT'S WORKING
WHAT'S NOT. WHAT ARE THE ROOT
CAUSES AND WHAT ARE WE DOING TO
ADDRESS THEM. SO THANK YOU SO
MUCH TO ALL OF OUR PANELISTS
FOR BEING HERE TODAY LOOK FOR
TO A REALLY ROBUST DISCUSSION.
CHAIR WHICH THANK YOU AGAIN FOR
JOINING US WOULD YOU LIKE TO
MAKE AN OPENING STATEMENT. YES
SIR THANK YOU VERY MUCH MISS
BETWEEN NORRIS AND THANKS FOR
SUGGESTING HEARING. EXAMINING
THE MHS M. HSA THE EFFORTS
TAKEN TO CORRECT THE ISSUES
IDENTIFIED THE STATE'S
AUDITOR'S REPORT IS VERY TIMELY.
AS YOU SAID OUR MENTAL HEALTH
SYSTEM IN CALIFORNIA'S BROKEN.
DESPITE THE EFFORTS AND
COMMITMENT OF WELL INTENDED
INDIVIDUALS AND NEARLY TEN
BILLION DOLLARS ARE MENTAL
HEALTH REPORT CARD IS
INCREASINGLY REFLECTING THAT WE
ARE FAILING IN OUR EFFORTS TO
ASSIST CALIFORNIANS WITH MENTAL
HEALTH NEEDS. WE WERE SUFFERING
AND WE HAVE NOT YET FOUND
APPROPRIATE SOLUTIONS TO
ADEQUATELY ADDRESS ARE
SUFFERING. AND I WILL NOTE THAT
YOUR YOUR NOTE ABOUT YOUR YOUR.
YOUR COMMENT ABOUT PEOPLE THAT
ARE INCARCERATED HAVING HIGH
LEVELS OF MENTAL MENTAL
ILLNESS. IN ONE OF MY COUNTY
JAILS THAT NUMBER IS 50% OF THE
POPULATION YOU MENTION A THIRD
SO IT BURIES GEOGRAPHICALLY AND
I THINK THAT'S AN IMPORTANT
POINT. SO BEAR WITH ME A MINUTE
WHILE I ROUTE REVIEW A FEW OF
OUR REPORT CARD STATISTICS.
REPORTED BY CAL MATTERS
PUBLISHED IN APRIL TWO THOUSAND
NINETEEN INDICATES THAT AS AS
ARE CHAIR SAID NEARLY ONE IN
SIX CALIFORNIANS EXPERIENCE
SOME MENTAL ILLNESS. WITH ONE
IN TWENTY FOUR INEXPERIENCE IN
ILLNESSES SO SEVERE IT BECOMES
DIFFICULT FOR THEM TO FUNCTION
IN DAILY LIFE. CALIFORNIA'S
TWELVE TO SEVENTEEN YEARS OLD
EXPERIENCE MAJOR DEPRESSION
SYMPTOMS AT A HIGHER RATE THAN
THE NATIONAL AVERAGE. SUICIDE
AMONG ADOLESCENTS AGE FIFTEEN
TO NINETEEN INCREASE 63%
TRINITY COUNTY AND MY DISTRICT
HAS FOUR TIMES THE NUMBER
RESIDENTS DYING BY SUICIDE THAN
LA COUNTY. THE LRGEST
PSYCHIATRIC INSTITUTIONS OF THE
STATE OF IN THE STATE OR NOT
HOSPITALS THEIR JAILS AND
PRISONS WITH WITH HUGE NUMBERS
OF PRISONERS CURRENTLY
RECEIVING TREATMENT FOR SERIOUS
MENTAL MENTAL HEALTH DISORDER.
AN INCREASE OF A HUNDRED PER
50% IN NEARLY TWO DECADES AND
ARE FEDERALLY QUALIFIED HEALTH
CENTERS NEARLY ONE IN FOUR
PATIENTS THEIR REQUIRES SOME
SORT OF MENTAL HEALTH CARE. THE
NUMBER CALIFORNIA INMATES
DEEMED INCOMPETENT TO STAND
TRIAL IN ORDER TO STATE
HOSPITALS IS INCREASED 60% IN
THE LAST FIVE YEARS AND WE HAVE
A 46% VACANCY RATE FOR
PSYCHIATRISTS IN OUR STATE
HOSPITAL. SO CLEARLY PEOPLE
CLEARLY WE HAVE A DISCONNECT
AND HOW WE GET CARE TO PEOPLE A
SITE TRACK PSYCHIATRIC HOSPITAL
BEDS ARE DECLINING WITH ALMOST
HALF A COUNTIES HAVING NO ADULT
ACUTE PSYCHIATRIC BEDS IN THE
VAST MAJORITY WITH NO
PSYCHIATRIC SUCH PSYCHIATRIC
BEDS FOR CHILDREN THOSE
CHILDREN OFTEN END UP IN
EMERGENCY ROOMS FOR DAYS. AND
DAYS AND DAYS CALIFORNIA ALSO
LAGS BEHIND THE COUNTRY. IN
PROVIDING MENTAL HEALTH
SERVICES IN THE COMMUNITY
RESOURCE SETTING. AND EVEN IF
WE HAVE THE FACILITIES HAVE THE
BAD HAVE THE RESOURCES. WE
SIMPLY DON'T HAVE ENOUGH MENTAL
HEALTH PROVIDERS. THAN THOSE
THAT DO EXIST ARE LESS LIKELY
THAN THEIR OTHER HEALTH CARE.
PROG PROFESSIONAL COUNTERPARTS
TO ACCEPT INSURANCE. PEOPLE CAN
ONLY ATTAIN CARE IF THEY HAVE
ACCESS TO CARE AND ACCESS TO
MENTAL HEALTH SERVICES
DIFFICULT. AND FRANKLY IN MY
NECK OF THE WOODS ACCESS TO ALL
HEALTH CARE SERVICES IS
DIFFICULT. THE STATISTICS ARE
STAGGERING AND EVEN MORE THAN
THAT THEY'RE SO BRING THESE
MEASUREMENTS DON'T EVEN CLEAN
CLEAR THE COMPLICATIONS OF COKE
OCCURRING ISSUES SUCH AS
HOMELESSNESS AND SUBSTANCE
ABUSE DISORDERS. IN FEBRUARY
MARCH OF THIS YEAR THE ASSEMBLY
AND SENATE HELP COMMITTEE'S
HELD TO JOIN HEARINGS TO
DISCUSS MEDICARE OUR MENTAL
HEALTH DELIVERY SYSTEM. TODAY
WE'RE EXAMINING ASPECTS OF THE
IMAGE TO M. H. ESSAYS PROGRAM
AND DELIVERY SYSTEM I HOPE TO
HEAR TODAY THAT THE STATE THE
COMMISSION AND THE COUNTIES OF
ALL ADOPTED A NEW STRATEGY OF
COLLABORATION AND COOPERATION.
THAT THE ISSUES IDENTIFIED
THROUGH THE AUDIT HAVE BEEN
ADDRESSED AND PUT THE BAD AND
THEY WERE MOVING FORWARD WITH A
STRONGER SENSE OF PARTNERSHIP.
WITH IMPROVED OUTCOMES AS THE
FOCUS AND I JUST WANNA SAY I
REALLY APPRECIATE EVERYBODY
BEING HERE TODAY AND I LOOK
FORWARD TO A ROBUST DISCUSSION.
THANK YOU MISTER MADAM CHAIR.
THANK YOU CHAIR WED. ARE THERE
ANY OTHER MEMBERS WHO WOULD
LIKE TO MAKE AT AND BRIEF
OPENING STATEMENTS. GOOD
MORNING MADAM CHAIR AND MEMBERS
MEMBERS AND YES THIS TOPIC IS
VERY IMPORTANT TO ME PERSONALLY
AS NOT LESS THAN A YEAR AGO
OCTOBER. I DID HAVE MY OWN
BROTHER WHO STRUGGLED WITH NOT
ONLY MENTAL HEALTH BUT
ADDICTION ISSUES PASSED AWAY.
BUT THAT BEING SAID I FELT HAVE
FOUND PARTICULARLY IN THE
COUNTY OF ORANGE AND NOT ONLY
ORANGE COUNTY BUT I'M ASSUMING
OTHER COUNTIES THAT IT'S ALMOST
BEEN A LIKE AN ONION WHERE
WE'VE HAD TO KIND OF CONTINUE
TO PEEL BACK THE LAYERS TO FIND
OUT. EXACTLY HOW FUNDS ARE
BEING USED FROM THE STATE MHS
FUNDS IN OUR CASE ORANGE COUNTY
WHY ARE FUNDS WERE IN MANY WAYS
NOT USED IN A TIMELY MANNER.
BUT WHY NOW THAT THERE IS AN
EFFORT TO USE THEM THERE'S A
VARIOUS ISSUES WITH SOMETIMES
USING THE FUNDS SO MY HOPE
THROUGH THIS A HEARING IS THAT
WE GET A CLEAR UNDERSTANDING OF
WHAT THE FUNDS CAN BE USED FOR
WHAT THE FUNDS CANNOT BE USED
FROM BECAUSE WE GET MIXED
MESSAGES. FROM THAT AS WELL AND
HOW WE START TO TAKE WHAT IS
MEANT TO HELP WITH THE MENTAL
HEALTH ISSUES IN OUR CITIES IN
STATE AND GET THEM TO BE USED
SO THAT WE CAN START TO RECTIFY
SOME OF THE PROBLEMS THAT WE
ARE NOT ONLY SEEN EVERY SINGLE
DAY BUT THAT ARE BECOMING
INCREASINGLY. CONCERNING AND IN
MANY MY CITIES IN NORTH ORANGE
COUNTY THEY'VE ACTUALLY
DECLARED A CRISIS FOR
HOMELESSNESS AND WE KNOW WITH
HOMELESSNESS MANY TIMES SOME OF
THOSE THAT ARE EXPERIENCING
HOMELESSNESS ARE INDEED HAVE
SOME MENTAL HEALTH ISSUES SO I
THINK WE HAVE A LOT. TO TALK
ABOUT AND LOOK FORWARD TO
HEARING FROM THE PANELISTS.
THANK YOU ASSEMBLY MEMBER QUIRK
SILVA. WITH THAT WE'LL GO AHEAD
AND GET STARTED WITH OUR PANELS
IN PANEL ONE THAT LEGISLATIVE
ANALYST'S OFFICE IS GOING TO
PROVIDE AN OVERVIEW OF MENTAL
HEALTH FUNDING. AND THE AN HSA
OVERSIGHT AND ACCOUNTABILITY
COMMISSION WILL PROVIDE AN
UPDATE ON STEPS TAKENSINCE
LAST YEAR'S AUDIT A GO AHEAD
AND LET OUR PANELIST. PLEASE
INTRODUCE YOURSELVES THANK YOU.
GOOD MORNING TO THE COMMITTEE
MY NAME IS BEN JOHNSON WITH THE
LEGISLATIVE ANALYST'S OFFICE.
RAMBLES THE LEGISLATIVE
ANALYST'S OFFICE. GOOD MORNING
MADAM CHAIR TO CHAIR MEMBERS
TOBY DOING I'M THE EXECUTIVE
DIRECTOR OF THE MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION THANK
YOU FOR THE OPPORTUNITY TODAY.
THANK YOU ALL FOR JOINING US
TODAY AND I THINK WE'LL GO
AHEAD AND GET STARTED WITH THE
LA L. UPDATE THANK YOU GREAT
GREAT AND SO WE HAVE ô
SHOULD BE A HAND OUT AND ALL OF
YOUR PACKETS THAT WILL FORM THE
BASIS OF OUR A MARKS. I'M GONNA
OPEN BY TALKING A LITTLE BIT
ABOUT FINANCING FOR THE MENTAL
HEALTH SYSTEM AND THEN MY
COLLEAGUE GRAN WE'LL SEE WILL
DISCUSS THE MOST RECENT AUDIT
AS WELL AS PROVIDE SOME
ADDITIONAL ISSUES FOR
CONSIDERATION. TURNING TO PAGE
ONE. THE HAND OUT. AND COME IN
CALIFORNIA COUNTIES HAVE A
MAJOR ROLE IN PROVIDING MENTAL
HEALTH SERVICES PRIMARILY BEING
RESPONSIBLE FOR PROVIDING THESE
SERVICES TO LOW INCOME
INDIVIDUALS. INCLUDING
INDIVIDUALS ON MEDI CAL. AS
WELL AS THOSE WITH THE HIGHEST
MENTAL HEALTH NEEDS. IN
ADDITION COUNTIES ARE LARGELY
RESPONSIBLE FOR ADMINISTERING
MHA PROGRAMS ON THE GROUND. ON
PAGE TWO OF THE HAND OUT WE
HAVE A FIGURE THAT PROVIDES A
HIGH LEVEL SUMMARY OF FUNDING
FOR THE MENTAL HEALTH SYSTEM.
MY REMAINING ROOM REMARKS HERE
WILL LARGELY SUMMARIZE OUR WALK
THROUGH THIS FIGURE. AS YOU CAN
SEE AT THE BOTTOM. ABOUT 80% OF
TOTAL FUNDING FOR MENTAL HEALTH
SERVICES IN THE STATE GOES TO
COUNTIES. GIVEN THEIR LARGE
RESPONSIBILITIES WITH THE
REMAINING 20% GOING TO THE
DEPARTMENT OF HEALTH CARE
SERVICES WHICH ADMINISTERS THE
MEDICARE PROGRAM AND IS ALSO
PRIMARILY RESPONSIBLE FOR.
OVERSEEING MENTAL HEALTH
SERVICES IN THE STATE. IN TERMS
OF FUNDING ON THE TOP RIGHT
YOU'LL SEE THAT FEDERAL FUNDS
PRIMARILY THROUGH MEDI CAL
COMPRISE THE LARGEST SINGLE
SOURCE OF FUNDING FOR.
COMMUNITY MENTAL HEALTH
PROVIDING OVER FOUR BILLION
DOLLARS IN TWENTY SEVENTEEN
EIGHTEEN THESE THESE FUND THIS
FUNDING IS ONLY AVAILABLE FOR
MEDI CAL SERVICES AND TO ANSWER
A COMMITTEE MEMBER'S QUESTION A
MAJOR COMPONENT THAT IS NOT
FUNDED THROUGH MEDI CAL IS ANY
SORT OF HOUSING SERVICES. AS
WELL AS CERTAIN RESIDENTIAL
SERVICES FOR INDIVIDUALS WITH
MENTAL ILLNESS. MOVING TO THE
TOP LEFT LOCAL OF THE FIGURE
LOCAL REALIGNMENT REVENUES
COMPRISE A MAJOR SOURCE REALLY
THE NEXT LARGEST SOURCE OF
FUNDING THESE ARE PORTIONS OF
THE STATE SALES TAX AND VEHICLE
LICENSE FEE REVENUES. THAT THE
STATE DEDICATES DIRECTLY TO
COUNTIES FOR THEM TO. REALLY AS
A FLEXIBLE FUND SOURCE FOR
THESE COUNTIES TO PAY FOR THEIR
VARIOUS MENTAL HEALTH
RESPONSIBILITIES WHICH INCLUDE
PAYING FOR THE NON FEDERAL
SHARE OF COST. FOR MEDI CAL
SERVICES AS WELL AS SUCH
SERVICES AS THE RESIDENTIAL
CARE FOR INDIVIDUALS WITH
SEVERE MENTAL ILLNESS AND SO
FORTH. THE NEXT BOX TO THE
RIGHT SHOWS THE IMAGE OF SAY
AND THAT IT IS A MAJOR FUND
SOURCE PROVIDING TWO BILLION
DOLLARS OR ABOUT 20% OF TOTAL
FUNDING WITHIN THE SYSTEM. AND
THIS DAMAGE SAY WAS APPROVED BY
VOTERS IN TWO THOUSAND FOUR IS
FUNDED THROUGH A SALE AN ATTACK
SO A 1% TAX ON INCOMES OVER ONE
MILLION DOLLARS IN THE STATE.
HOW EXPAND A LITTLE BIT MORE ON
HOW THE IMAGE SAY WILL BE USED
CAN BE USE LATER IN MY REMARKS.
AS YOU CAN SEE THE SMALLEST OF
THE FUNDING SOURCES NEXT TO
FEDERAL FUNDS IS THE STATE
GENERAL FUND. BEING ABOUT EIGHT
HUNDRED MILLION DOLLARS AND
SEVENTEEN EIGHTEEN AND GENERAL
FUND IS GENERALLY USED FOR
FUNDING PSYCHOTROPIC
MEDICATIONS FOR INDIVIDUALS ON
MEDI CAL. AS WELL AS FUNDING
NEW SERVICE REQUIREMENTS THAT
WERE PUT IN PLACE BY THE STATE
OR FEDERAL GOVERNMENT CENTS TWO
THOUSAND ELEVEN. NEXT GONNA
JUMP ALL THE WAY TO PAGE FIVE
OF THE HAND OUT WHICH SHOWS HOW
FUNDING IS CHANGED OVER TIME.
THIS SHOWS THAT FUNDING HAS
GROWN FAIRLY SIGNIFICANTLY
SINCE THE LAST RECESSION
AVERAGING ALMOST 8% ANNUAL
GROWTH DURING THIS TIME PERIOD
WHICH FOR REFERENCES FASTER
THAN THEIR LITTLE MORE THAN 5%
ANNUAL GROWTH IN GENERAL FUND
REVENUES THAT HAS HAS OCCURRED
OVER THIS TIME PERIOD. I'M NEXT
GOING TO TURN TO DISCUSSING AN
HSA IN GREATER DETAIL. THE
IMAGES SAY ESTABLISHES A
VARIETY OF PARAMETERS OF HOW
THIS FUNDING MAY BE SPENT AND
WE SUMMARIZE THIS ON PAGE SEVEN
OF THE HAND OUT IN THE FIGURE.
SO AS YOU CAN SEE IN THE TOP
CIRCLE THE STATE DAMAGE SAY
RESERVES 5% OF TOTAL IMAGE SAY
FUNDING FOR STATE
ADMINISTRATIVE ACTIVITIES. THIS
FUNDING IS AVAILABLE FOR THE
LEGISLATURE TO APPROPRIATE AND
IS OFTEN KNOWN AS THE STATE CAP
SO AND WHILE SOME OF THIS
FUNDING IS USED FOR SAY
DIRECTED MINISTRATION GOING TO
THE OVERSIGHT AND
ACCOUNTABILITY COMMISSION OR DH
YES. SOME FUNDING IS AVAILABLE
FOR GRANT OR OTHER PROGRAMS FOR
LEGISLATURE SUCH AS TO SEND
GRANTS TO COUNTIES TO HIRE
CRISIS PERSONNEL AND SO FORTH
SO THIS IS ANOTHER USE OF WITH
A OF THAT 5% STAKE CAP DOLLARS.
THE LARGER A PART OF THAT THAT
THE CIRCLE THERE IS THEN GOES
TO COUNTIES THIS 95% AND IT
GOES DIRECTLY TO COUNTIES. THIS
FUND THIS 95% OF FUNDING MUST
BE SPENT IN SPECIFIED
PERCENTAGES IN ONE OF THREE
WAYS. FOR AND THAT'S AND SO THE
BOTTOM CIRCLE ON THIS FIGURE
WILL DESCRIBE HOW THIS FUNDING
IS ULTIMATELY PRESCRIBED TO BE
USED. 76% OF THIS FUNDING MUST
BE USED FOR COMMUNITY SERVICES
AND SUPPORTS WHICH ARE DIRECT
SERVICES OFTEN FOR INDIVIDUALS
WITH FAIRLY SEVERE MENTAL
ILLNESS. 19% OF THIS FUNDING
MUST BE USED FOR PREVENTION AND
EARLY ENTER INTERVENTION
INTERVENTION ACTIVITIES AND
THEN 5% IS TO BE USED FOR
INNOVATIVE PROGRAMS TO TRY TO
EXPERIMENT WITH NEW APPROACHES.
TO AMELIORATING MENTAL ILLNESS.
BUT I'D THESE COULD BE SUICIDE
AWARENESS CAMPAIGNS OR OR EVEN
SORT OF MORE DIRECT SERVICES
FOR INDIVIDUALS WHO ARE
EXPERIENCING EARLY ONSET SO FOR
MAYBE A TRANSITIONAL AGE USE TO
RECEIVE SORT OF TREATMENT
BEFORE THEIR ILLNESS BECOMES
TRULY DEBILITATING. I'M AND
THEN IN ADDITION TO THESE THREE
BUCKETS THEM WHICH IS A DOES
ALLOW COUNTIES TO DEDICATE A
MAXIMUM OF 20% OF FUNDING
WITHIN THE COMMUNITY IS
SERVICES AND SUPPORTS COMPONENT
TO SUPPORT THEIR LOCAL MENTAL
HEALTH SYSTEM IN ONE OF FOUR
WAYS CAPITAL FACILITY
DEVELOPMENT. WORKFORCE
DEVELOPMENT ADDRESSING THEIR
TECHNOLOGY NEEDS. OR PLACING
FUNDING INTO A PRUDENT RESERVE.
HOW FINALLY NOTE THAT THE IMAGE
SAY REQUIRES THAT IMAGE SAY
FUNDING THAT GOES TO COUNTIES
BE SPENT WITHIN THREE OR FIVE
YEARS WITH ANY UNSPENT FUNDING
REVERTING TO THE STATE TO BE
REDISTRIBUTED TO OTHER
COUNTIES. THAT CONCLUDES MY
REMARKS NOW I'M GOING TO PASS
IT ALONG TO BRIAN WELLS A TO
CONTINUE THANK YOU AS DESCRIBED
EARLIER IN FEBRUARY TWENTY
EIGHTEEN THE STATE AUDITOR
RELEASED A REPORT. ABOUT AND
FUNDING OVERSIGHT RELATED TO
THE MENTAL HEALTH SERVICES ACT.
THE AUDIT IDENTIFIED SEVERAL
DEFICIENCIES THAT I WILL
SUMMARIZE ONE OF THE MAJOR
FINDINGS WAS THAT COUNTIES HAD
ACCUMULATED SIGNIFICANT.
UNSPENT MENTAL HEALTH SERVICES
ACT FUNDS AM I SPEAKING FROM
PAGE TEN AND HAND OUT FOR
REFERENCE. RELATED TO THIS
ISSUE THE AUDITOR FOUND THAT
THE DEPARTMENT OF HEALTH CARE
SERVICES HAD NOT DEVELOPED A
PROCESS TO RECOVER. THE END
SPEND FUNDS THAT MY COLLEAGUE
MENTIONED ARE SUBJECT TO
REVISION AND THE AMOUNT OF
THOSE FUNDS AT THE TIME OF THE
AUDIT WAS ESTIMATED TO BE TWO
HUNDRED AND THIRTY ONE MILLION
DOLLARS. THE PROCESS IDEALLY
WOULD HAVE REDISTRIBUTED THESE
FUNDS TO OTHER COUNTIES. BUT
I'M NOT BEEN DEVELOPED OR
IMPLEMENTED AT THAT TIME.
FURTHER THE HEALTH DEPARTMENT
HEALTH CARE SERVICES HAD NOT
ESTABLISHED GUIDANCE ON HOW
INTEREST THAT'S EARNED ON. ON
SPENT MENTAL HEALTH SERVICES
ACT FUNDS SHOULD BE TREATED FOR
PURPOSES A REVERSION. AND
ADDITIONALLY GUIDANCE AND NOT
BEEN ESTABLISHED ON HOW MUCH
RESERVES COUNTIES SHOULD. BE
KEEPING AND THE AUDITOR FOUND
THAT AN ESTIMATED FIVE FOR
THIRTY FIVE MILLION DOLLARS
WERE HELD IN RESERVES AND WHICH
THE OUTER CONSIDERED EXCESSIVE.
THE NEXT MAJOR FINDING WAS THAT
THE DEPARTMENT OF HEALTH CARE
SERVICES HAD. AT THAT TIME
PROVIDED MINIMAL OVERSIGHT OF
COUNTIES USE OF IMAGES A
FUNDING. SOME ISSUES IN THIS
AREA INCLUDED. THAT THE
DEPARTMENT HAS NOT IN FORCE
DEADLINES FOR COUNTIES TO TURN
IN THEIR ANNUAL EXPENDITURE
REVENUE REPORTS AND IN MANY
CASES THESE REPORTS FOR
SUBMITTED SIGNIFICANTLY AFTER
DEADLINES. THE DEPARTMENT HAD
NOT COMPLETED FISCAL AUDITS FOR
COUNTIES AS OF DECEMBER TWENTY
SEVENTEEN. WHICH WAS A NEAR THE
TIME THE AUDIT WAS RELEASED I'M
AT ALSO NOT IMPLEMENTING
REGULATIONS RELATED TO THESE
PROCESSES. AND FINALLY THE
DEPARTMENT HAD NOT IMPLEMENTED
A PROCESS TO CONDUCT PROGRAM
REVIEWS TO ENSURE THE COUNTIES
OPERATIONS WERE CONSISTENT WITH
THE ACT. THE AUDIT ALSO HAD
SOME FINDINGS RELATIVE TO THE
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. IN PARTICULAR THE
AUDITOR FOUND THAT COUNTIES HAD
SOME CHALLENGES IN GETTING.
FUNDING PROPOSALS FOR
INNOVATION PROJECTS THIS IS ONE
OF THE AREASWHERE STATE
APPROVAL IS REQUIRED. SOME
CONFUSION ABOUT WHAT TYPES OF
PROJECTS THE COMMISSION WOULD
APPROVE WHICH CONTRIBUTED IN
PART TOO DIFFICULT IF BY THE
COUNTIES IN SPENDING INNOVATION
FUNDS. AND THEN ADDITIONALLY
AND THE OVERSIGHT AND
ACCOUNTABILITY COMMISSION AT
THE TIME AND NOT IMPLEMENTED
PROCESS IS TO YOU OVER AND
EVALUATE THE- EFFECTIVENESS OF
AN HSA FUNDED PROGRAMS.
INCLUDING THE CLICK THE PROGRAM
THAT PROVIDES. FUNDING FOR
CRISIS WORKERS AT MY COLLEGE
COLLEAGUE MENTIONED EARLIER.
TURNING TO PAGE TWELVE WE'VE
INCLUDED A TABLE THAT INCLUDES
ALL THE AUDITOR'S
RECOMMENDATIONS FROM THIS
FEBRUARY AUDIT REPORT. AS WELL
AS A LISTING OF SEVERAL
DEVELOPMENTS STEPS THAT HAVE
BEEN TAKEN IN RELATION TO THE
RECOMMENDATIONS SINCE THE AUDIT
WAS RELEASED. I'LL JUST
HIGHLIGHT A FEW OF THESE ITEMS
FIRST THE DEPARTMENT HAS SINCE
IMPLEMENTED A PROCESS FOR
REVERTING. ON SPENT AN HSA
FUNDS. THE LEGISLATURE ALSO
PASSED A LAW THAT LIMITS
RESERVES FOR COUNTIES 233% OF
THE AVERAGE AMOUNT OF COMMUNITY
SUPPORT FUNDING OVER THE LAST
FIVE YEARS. AND THAT'S BEEN
IMPLEMENTED THE DEPARTMENT ALSO
HAS IMPLEMENTED A PROCESS TO
WITHHOLD A PORTION OF FUNDING
FROM COUNTIES THAT SUBMIT THEIR
ANNUAL EXPENSE REPORTS LATE. ON
THE A SEASIDE. THE COMMISSION
HAS IMPLEMENTED SEVERAL
PROCESSES AND TOOLS FOR
COUNTIES TO USED TO DEVELOP
BETTER INNOVATION PROGRAM
APPLICATIONS AND THAT THE
COMMISSION HAS ALSO LAUNCHED
SEVERAL ANTICIPATED DATA TOOLS
THAT PROVIDE PUBLIC FACING
INFORMATION ABOUT HOW IMAGES A
FUNDS ARE SPENT AND SOME
INFORMATION ABOUT OUTCOMES.
I'LL CONCLUDE OUR PRESENTATION
WITH SOME ADDITIONAL OVER
ARCHING ISSUES FOR THE
LEGISLATURE TO KEEP IN MIND IN
THIS AREA AND THE FIRST IS THAT
STATE OVERSIGHT. OF THE IMAGES
SAY REMAINS CHALLENGING. STEPS
HAVE BEEN TAKEN TO STRENGTHEN
STATE OVERSIGHT OVER THIS
PROGRAM. BUT MANY OF THE STEPS
ARE NOT YET FULLY IMPLEMENTED.
AND OTHER CHALLENGES REMAIN FOR
EXAMPLE FRAGMENTED OVERSIGHT
HAVING OVERSIGHT IN TWO
DIFFERENT AGENCIES WILL
CONTINUE TO REQUIRE AN ENHANCED
LEVEL OF COORDINATION IN ORDER
TO BE EFFECTIVE. ANOTHER ISSUE
AT AT AT A HIGH LEVEL IS THAT
AND SERVICE COORDINATION ACROSS
THE MULTIPLE SYSTEMS OF CARE
INVOLVED IN BEHAVIORAL HEALTH
AND MENTAL HEALTH IS ALSO A
CHALLENGE THE IMAGES SAY FUNDED
ACTIVITIES THAT WE'RE FOCUSING
ON TODAY MAKE UP ONLY A PORTION
OF THE STATE'S PUBLIC COMMUNITY
MENTAL HEALTH SYSTEM. AND IN
GENERAL THE SYSTEM IS
FRAGMENTED WITH A VARIETY OF
OVERLAPPING FUNDING STREAMS AND
PROGRAM REQUIREMENTS AND TARGET
POPULATIONS. AND ADDITIONALLY
MENTAL HEALTH SERVICES ARE NOT
WIDELY INTEGRATED WITH PHYSICAL
HEALTH SERVICES SO YOU CAN HAVE
INDIVIDUALS INTERACTING WITH
MULTI PUBLIC SYSTEMS AND
COORDINATION AMONG THE SYSTEMS
IS DIFFICULT. FINALLY THE M.
HSA IS DESIGNED TO PROVIDE
SIGNIFICANT FLEXIBILITY TO
LOCAL GOVERNMENTS IN HOW THEY
STRUCTURE OPERATE THEIR
SERVICES. THIS FLEXIBILITY
ALLOWS FOR LOCAL INNOVATION. AN
ADAPTATION BUT CAN POTENTIALLY
CONFLICT WITH STATE LEVEL
INTEREST IN PROVIDING POLICY
DIRECTION AND MORE CONSISTENT
SERVICES AND OUTCOMES. SINCE
THE IMAGES THEY WAS ENACTED BY
VOTER INITIATIVE THERE ARE SOME
LIMITATIONS ON WHAT THE
LEGISLATURE CAN DO TO CHANGE
THIS BALANCE HOWEVER THE
LEGISLATURE CAN AND HAS TAKEN
SOME ACTIONS TO PROVIDE
INCREASED STATE DIRECTION AND
ALSO TO INCREASE THE TECHNICAL
ASSISTANCE THAT IS PROVIDED TO
COUNTIES. TO PROMOTE BETTER
OUTCOMES IN THIS WILL BE
CONTINUE TO BE AN IMPORTANT
THING FOR THE FOR THE STATE TO
DO WITH THAT WILL CONCLUDE OUR
PRESENTATION HAVING TO TAKE ANY
QUESTIONS YOU HAVE ABOUT THIS
MATERIAL. ANY QUESTIONS FROM
COMMITTEE MEMBERS BEFORE WE
HEAR AN UPDATE FROM THE IMAGES
SAY OVERSIGHT AND
ACCOUNTABILITY COMMITTEE.
ASSEMBLY MEMBER QUIRK SILVA. AS
WAS NOTED THERE'S BEEN MORE
MONEY PUT INTO THE SYSTEM OVER
THE LAST HANDFUL OF YEARS AND
YET WE STILL SEE MANY ISSUES
THAT HAVEN'T BEEN RECTIFIED BUT
I WANTED TO TALK ABOUT THE
COUNTIES. THAT HAVE HAD THE
LARGE RESERVE. AND YOU SAID 33%
IS WHAT IS ACCEPTABLE IS THAT
WHAT YOU SAID. THAT'S CORRECT
LEGISLATION WAS PASSED THAT
LIMITS THE RESERVES 233% OF THE
AVERAGE AMOUNT OF MANY SERVICES
AND SUPPORT FUNDING THAT THEY
RECEIVE AND YET WE KNOW THAT
THERE ARE COUNTIES THAT HAD
MUCH MORE THAN THAT. AND NOT
ALL NOTE ONE THING MY
UNDERSTANDING IS THAT A LOT OF
THE LARGE BALANCES IN COUNTY
ACCOUNTS WERE NOT NECESSARILY
IN WHAT IS CONSIDERED THE
RESERVE THESE WERE UNSPENT
FUNDS THAT WERE. MEANT TO BE
SPENT WITHIN OTHER AND
COMPONENTS OF THE ACT I THINK
PRIMARILY OFTEN WITHIN THE
INNOVATION COMPONENT OF THE
ACTS OF THAT 5% IS RESERVED SO
THESE FUNDS WERE REALLY OUTSIDE
OF THE PRUDENT RESERVE AND
SHOULD HAVE BEEN REVERTED
ACCORDING TO FOR THE THREE OR
FIVE YET WELL IT STARKLY WAS A
THREE YEAR WINDOW. SO YES SO I
DON'T I DON'T HAVE A GOOD SENSE
MAYBE OUR MAYBE TOBY CAN HELP
US IN TERMS OF HOW WHAT THE
PRUDENT RESERVE LEVELS ARE BUT
THESE ARE SORT OF SEPARATE TO
SOME DEGREE SEPARATE ISSUES.
THANK YOU AGAIN TOBY LAYING THE
EXACT DIRECTOR OF THE MENTAL
HEALTH SERVICES OVERSIGHT
ACCOUNTABILITY COMMISSION I
APPRECIATE THE OPPORTUNITY. SO
THE AUDITOR'S REPORT. GENERALLY
USE OF THE TERM RESERVE FOR
UNSPENT FUND BALANCES AND IT
REALLY REFLECTS TO DIFFERENT
POTS OF MONEY. ONE IS A FORMAL
PRUDENT RESERVE THAT IS IN A
SPECIFIED BANK ACCOUNT. THAT
CAN ONLY BE TOUCHED UNDER
CERTAIN CONDITIONS. AND THAT
PRUDENT RESERVE IS NOT SUBJECT
TO REVERSION IT IS INTENDED TO
BE A RAINY DAY FUND.
RECOGNIZING THAT THIS IS A
VOLATILE REVENUE STREAM. THERE
HAS BEEN A WIDE VARIATION IN
THE AMOUNT OF FUNDS THAT
COUNTIES WERE HOLDING IN THEIR
PRUDENT RESERVE. I JUST PART ME
LEGISLATION WAS PASSED TO
BELIEVE LAST YEAR. THAT LIMITED
AMOUNT OF FUN TO BE HELD IN A
PRUDENT RESERVE TO AS THE LA
HAS REPORTED A THIRD OF YOUR
AVERAGED CSS FUND. THE VAST
BULK OF THE DOLLARS THAT
LEGISLATORS MEMBERS OF THE
PUBLIC AND KIND OF SUPERVISORS
HAVE BEEN CONCERNED ABOUT ARE
FUNDS THAT ARE ON SPENT SORT OF
HEALTH AND WHAT WE MIGHT CALL
THE CASH FLOW OR AN INFORMAL
RESERVE. THERE ARE NO
RESTRICTIONS ON THE AMOUNT OF
FUNDS THAT CAN BE THAT CAN BE
LEFT IN THE ACCOUNT. HOWEVER
THERE IS A REQUIREMENT
ORIGINALLY THE IMAGE TO SAY
SAID COUNTIES HAVE THREE YEARS
TO USE THE FUNDS. FOR THE FUNDS
SHALL BE RETURNED TO THE STATE
FOR REDISTRIBUTION TO OTHER
COUNTIES. AS PART OF
LEGISLATION IN TWENTY SEVENTEEN
AB ONE FOURTEEN THE THREE YEAR
RULE WAS AMENDED TO BE THREE
YEARS FOR MOST COUNTIES FIVE
YEARS FOR SMALL COUNTIES. THE
ARGUMENT WAS THAT COUNTY STATED
MORE TIME TO PLAY SMALLER
COUNTIES WHO ARE REQUIRED TO
DISTRIBUTE THEIR DOLLARS INTO
AT LEAST THREE POTS COMMUNITY
SERVICES SUPPORTS PREVENTION OR
INTERVENTION AND INNOVATION IN
THE ARGUMENT WAS THAT. THEY
THEY WOULD NEED MORE TIME TO
ACCUMULATE FUNDS TO THE FOR
INNOVATION SO THEY COULD INVEST
IN SIGNIFICANT PROJECTS. THE
DATE AT THAT I'M MY MEMORY IS
THAT OF THE UNSPENT FUNDS THAT
WEREN'T IN A PRUDENT RESERVE
THAT WERE BEYOND THE THREE YEAR
LIMITATION ABOUT 57% OF THAT
WITH INNOVATION MAYBE SIXTY
FIVE BUT CLOSE TO HALF WAS
PREVENTION EARLY INTERVENTION
OR COMMUNITY SERVICES AND
SUPPORTS. SO WE THOUGHT THIS
CHALLENGE SORT OF ACROSS THE
FIND ACROSS THE COMPONENTS OF
THE M. HSA I'M WE ALSO SAW MANY
COUNTIES THAT DID NOT HAVE A
CHALLENGE AND SPENDING DOWN
THERE FUND BALANCE BUT A LARGER
PROPORTION OF COUNTIES THAT
WERE ACCRUING LARGE FUND
BALANCES AND IN THIS SORT OF
CASH FLOW RESERVE. I HOPE THAT
ANSWERS. A IT DOES BUT IT BUT I
GUESS WHAT I'M LOOKING AT IS
AND TWENTY JUNE OF TWENTY
EIGHTEEN ON THE FLOOR OF THE
SUDDENLY THERE WAS A BILL THAT
WAS BEING MOVE FORWARD THAT IF
COUNTY TENANTS SPENT THEIR
MONEY THAT IT WOULD GO BACK
INTO A POOL OF FUNDING AND THEN
THEY STILL COULD REAPPLY FOR IT.
I WASN'T NECESSARILY AGAINST
THAT IN THE SENSE THAT THEY
SHOULD BE USING THEIR FUNDS AND
BECAUSE THEY'RE NOT USING THE
FUNDS THEY ARE PUTTING THEM
INTO DIFFERENT ACCOUNTS. AND
EVEN FOR THE AUDITOR AND I'M
TALKING ABOUT ORANGE COUNTY IS
VERY DIFFICULT FOR THEM TO FIND
OKAY WHY ARE THESE IN DIFFERENT
ACCOUNTS AND THEN YOU HAVE
INTEREST AND ALL THOSE THINGS.
BUT I DIDN'T SUPPORT THAT BILL
BECAUSE I FELT THAT AT THAT
POINT IT WOULD GIVE COUNTIES
WHO HAVEN'T REALLY WANTED TO
USE THE FUNDS AND THAT'S A
PHILOSOPHY ISSUE OR A POLITICAL
ISSUE. THE REASON TO SAY WE'LL
SEE NOW THE STATE TOOK THE FUN
SO WE CAN'T USE THEM SO I
PUSHED FOR US TO NOT PASS THAT
YOU REMEMBER THAT. AND IT
DIDN'T PASSED SO THEN IF YOU
CAN JUST GIVE ME UP TO SPEED
AFTER THAT THAT DIDN'T PASSED
IN JUNE. AND THEN YOU SAID THAT
THERE WAS. AND I SHOULD KNOW
THIS BUT I'M COMPLETELY
FORGETTING THEN DID YOU SAY WE
PASSED ANOTHER BILL AND NOW
THAT DOES PUT A THREE TO FIVE
YEARS. ON IT. ON USING THE
FUNDS YES THANK YOU IT'S A
LITTLE BIT HISTORY HERE THAT'S
IMPORTANT WHEN THE MENTAL
HEALTH SERVICES ACT WAS FIRST
IMPLEMENTED. THE FUNDS CAME TO
THE STATE'S MENTAL HEALTH FUND
MEDICAL SERVICES FUND AND IT
SAT THERE AND ACCUMULATED
COUNTIES DEVELOPED EXPENDITURE
PLANS SUBMITTED THEM TO THE
DEPARTMENT OF MENTAL HEALTH.
FOR REVIEW AND APPROVAL. WHEN
THE STATE APPROVED AN
EXPENDITURE THEY WOULD IN
ESSENCE ALLOCATE THOSE FUNDS TO
THE COUNTY AND THAT STARTED THE
CLOCK THE THREE O'CLOCK AND THE
ARGUMENT WAS THAT YOU HAVE
THREE YEARS TO IMPLEMENT YOUR
PLAN AND IF YOU FAIL TO
IMPLEMENT YOUR PLAN. GIVE THE
MONEY BACK MUCH LIKE A GRANT.
OVER TIME THERE WERE DELAYS IN
THE COUNTY IN IN THE ABILITY OF
THE STATE TO ACTUALLY REVIEW
AND APPROVE A COUNTY PROPOSAL.
AT THE SAME TIME REVENUES WERE
ACCUMULATING IN THE STATE FUND
THE STATE COULD NOT DISTRIBUTE
THE MONEY FAST ENOUGH. THE
LEGISLATURE CHANGE THE RULES
AND DETERMINED THAT THE FUNDS
THAT COME INTO THE STATE MENTAL
HEALTH SERVICES FUND WOULD NOW
BE DISTRIBUTED TO THE COUNTIES.
THINK OF THIS AS A DIRECT
DEPOSIT SO EVERY MONTHDOLLARS
COME IN THEY GET DISTRIBUTED TO
THE COUNTIES BASED ON A
FORMULA. HI MY COLLEAGUES AT
THE DEPARTMENT HEALTHCARE
SERVICES CAN ARTICULATE MORE
THAN WHAT THAT FORMULA IS AND
HOW THAT WORKS. THE RULES
REGARDING REVERSION HAD BEEN
WRITTEN. IN THE CONTEXT OF THE
STATE AUTHORIZING A AN
EXPENDITURE AND IN ESSENCE
WRITING A CHECK WIN THE
LEGISLATURE RECOGNIZED THE
LARGE FUND BALANCES AND MOVED
TO A DIRECT DEPOSIT STRATEGY
THE REVERSION ROLES WERE NOT
UPDATED TO REFLECT THAT AND IT
CREATED CONFUSION OVER WIND
IT'S THE CLOCK STARTS. AND IT
AND WE REALLY DIDN'T HAVE A
RIVERS POLICY THAT WAS OUTLINED
WITH THE CASH FLOW PROCESS THAT
WAS NOW IN PLACE. WHEN THE
COMMISSION LOOKED AT THIS WE
LOOKED AT THIS ISSUE OF FIRST
FISCAL REPORTING BECAUSE WE
DON'T KNOW HOW MUCH FUNDS HAVE
BEEN RECEIVED SPENT OR ARE LEFT
IN THE BANK WITHOUT ACTUALLY
GETTING THE REPORTS AND THAT
WAS A PROBLEM AND THE AUDITOR
IDENTIFIED THAT AS WELL. AND
THEN WE LOOKED AT THE ISSUE OF
HOW CAN WE CALCULATE UNSPENT
FUNDS WHAT HAPPENS TO THEM. WE
KNEW BASED ON A REPORT TO WE
DID HAVE THAT THERE WERE FUNDS
THAT HAD BEEN SITTING IN COUNTY
ACCOUNTS GOING BACK EIGHT YEARS
AND SO THE THREE O'CLOCK HAD
CLEARLY EXPIRED. YET BUT THE
STATE DID NOT HAVE A PROCESS
FOR ACTUALLY CALCULATING
UNSPENT FUNDS AND CAPS FOR
BRINGING THOSE DOLLARS BACK
THIS PUT THE COUNTIES IN A
PARTICULAR BEHIND. BECAUSE THEY
WERE RECEIVING THESE FUNDS ON A
DIRECT DEPOSIT BASIS. BUT THEY
HADN'T SPENT THE MEN OF THE
DEADLINE. THEY WERE THE THERE
WAS NO PROCESS THAN TO GIVE THE
DOLLARS BACK. SO IF THEY WERE
TO SPEND DOLLARS THAT THEY
LATER HAD TO RETURN TO THE
STATE. THEY WOULD BE STOCK
HAVING TO FIND ADDITIONAL
REVENUES TO PAY BACK THE STATE
SO TO SPEAK. THIS WASN'T THE
ONLY REASON BUT IT WAS ONE OF
THE REASONS WHY WE STARTED TO
SEE LARGE BALANCES BECAUSE WE
DIDN'T HAVE THE PROCESS IN
PLACE TO. SPEND THE MONEY
QUICKLY IN SOME INSTANCES BUT
ALSO TO REVERT THE DOLLARS AT
THE POINT IN TIME THAT
REVERSION WAS REQUIRED. THE
COMMISSION'S WORK THE AUDITOR'S
WORK REALLY FOCUSED ON THE
STATE PUTTING IN PLACE THE
STRATEGY TO CREATE CLARITY.
AROUND WHAT THE RULES ARE HOW
MUCH MONEY UNDER WHAT
CONDITIONS AND HOW THOSE MONIES
COME BACK. I'M I'M NOT FAMILIAR
WITH THE BILL AS YOU DESCRIBED
IT. BUT THE REVERSION ROLE WAS
WRITTEN INTO THE ORIGINAL
INITIATIVE IN TWO THOUSAND AND
FOUR. AND THERE WAS A BILL TO
CREATE A MENTAL HEALTH FOR
VERSION FUND AND THE
RECOMMENDATION THAT THE
COMMISSION HAD MADE WAS THAT
ANY REVERTED FUND SHOULD GO
INTO THAT FUND FOR THREE
REASONS ONE WE WANTED TO CREATE
TRANSPARENCY AROUND FUNDS THAT
WERE SEPARATE TO REVERSION WE
FELT THAT. HIGHLIGHTING THAT
THE REALITY OF COUNTIES NOT
SPENDING FUNDS WOULD CHANGE
BEHAVIOR. WE ALSO THE WHAT THE
LAW SAYS IS REVERTED FINDS WILL
BE REDISTRIBUTED TO OTHER
COUNTIES TO MEET ADDITIONAL
NEEDS. IN THE TIME WHEN THE
STATE WAS APPROVING COUNTY
EXPENDITURE PLANS IN WRITING
CHECKS THAT MADE TREMENDOUS
SENSE THE MONEY IS NOW BACK IN
THE BANK ACCOUNT. AND THAT
PROCESS WOULD MOVE FORWARD.
CURRENTLY FUNDS ARE DISTRIBUTED
THROUGH A WAITED FORMULA
LARGELY BASED ON POPULATION WE
WERE CONCERNED THAT. REVERTED
FUNDS WOULD JUST GO BACK INTO
THE MAIN POT AND WOULD BE
DISTRIBUTED IN SUCH A WAY THAT
IF A LARGE PERCENTAGE OF THOSE
FOR INNOVATION FUNDS THEY WOULD
LOSE THE INNOVATION STATUS AND
BECOME CORE SERVICES FUNDS AND
SO WE FELT THAT THE
REDISTRIBUTION SHOULD BE
INTENTIONAL RATHER THAN JUST
BASED ON A WEIGHTED FORMULA.
AND WE RAISE THE ISSUE OF THE
LEGISLATURE BEING IDENT BEING
ABLE TO IDENTIFY KEY STATEWIDE
PRIORITIES FOR DISTRIBUTION OF
THOSE FUNDS. AGAIN SO THAT IT
WAS INTENTIONAL. THE SENATOR
BELL HAD A BILL THAT ESTABLISH
THE FINE FOR REVERSION BUT IT
DID NOT PUT ANY REQUIREMENTS OR
DIRECTION ON HOW THE FUNDS
WOULD BE USED. SO TO MY
KNOWLEDGE THE ANY MONEY THAT IS
SUBJECT TO RIVERS AND WOULD
SIMPLY BE REDISTRIBUTED. IN
THAT FORMULA ONE OF THE
CHALLENGES WE HAVE IS THE
INTERPRETATION OF THE ORIGINAL
LANGUAGE THAT SAYS TWO OTHER
COUNTIES SO THAT WOULD MEAN IN
THE ORANGE COUNTY CASE. WOULD
THEY GET A PERCENTAGE OF THEIR
OWN FUNDS BACK OR WHAT THE
DEPARTMENT BE REQUIRED TO COME
UP WITH A WAITED FORMULA THAT
REDISTRIBUTED COUNTIES FUNDING
FROM A SINGLE COUNTY TO ALL OF
THE OTHER COUNTIES WHICH JUST
BECOMES. VERY COMPLICATED
OVERTIME. WELL I THINK ONE OF
THE THINGS THAT WAS INTERESTING
TO ME WAS AT ONE POINT THE
ORANGE COUNTY OUR AUDITOR WAS
NOTING THAT HE BELIEVES THAT
THERE WAS UP TO TWO. BETWEEN
TWO HUNDRED AND TWO HUNDRED AND
FIFTY MILLION DOLLARS AND- IN
RESERVES. WHICH WAS VERY
UPSETTING TOO MANY PEOPLE IN
THE COUNTY AS WE HAD CONTINUED
TO SEE A LARGE NEED TO USE
THOSE FUNDS. SO THAT WAS ONE OF
THE ISSUES BUT THEN IT WAS A
TODD GLORIA BILL I DON'T
REMEMBER THE NUMBER. AND HE WAS
FRUSTRATED WHICH IS WHY HE
BROUGHT IT TO THE FLOOR AND IN
ADDITION TO THE COUNTY IS BEING
ABLE TO RE APPLY FOR THE FUNDS
IF THEY WERE REVERTED. THEY
WERE ALSO GOING TO ADD SPECIAL
DISTRICTS IN I BELIEVE SCHOOL
DISTRICTS THAT DIDN'T MOVE
FORWARD AND- SO MIKE RATIONALE
IN ASKING THESE QUESTIONS IS.
THAT YOU WERE RIGHT IN THE
SENSE THAT MAKING THIS MUCH
MORE TRANSPARENT HAS PUSHED. AT
LEAST ORANGE COUNTY AND I'M
ASSUMING OTHER COUNTIES IN TO
STARTING TO USE THESE FUNDS IN
A MUCH MORE AGGRESSIVE WAY AND
I DO GET. YOU KNOW SAY THEY
WANT TO BUILD A MENTAL HEALTH
FACILITY IN YOUR USING SOME OF
THOSE DOLLARS THAT CAN BE USED
THAT DOESN'T NECESSARILY JUST
TAKE. TWO YEARS OR IT COULD
STRETCH AND A THREE TO FIVE BUT
THE URGENCY HAS BEEN THERE AND
NOW I THINK SOME OF THIS
PRESSURE IS FORCING THEM. TO
USETHEM AND TO BE MORE
TRANSPARENT SO THAT'S A GOOD
THING WE JUST WANT TO SEE THE
MONEY. FROM THE STATE GET TO
THE COUNTY AND THE MUSIC.
DIRECTOR EWING I THINK NOT
THERE'S A GREAT TIME IF YOU CAN
JUST YOU KNOW KIND OF GIVE US
AN OVERVIEW AND AN INTERACTION
OF THAT MENTAL HEALTH SERVICES
OVERSIGHT. AND ACCOUNTABILITY
COMMISSION AND THE WORK THAT
YOU ALL HAVE BEEN DOING
PARTICULARLY IN RESPONSE TO.
THE AUDIT AND IN RESPONSE TO
SOME THE SAME CONCERNS THAT.
ASSEMBLY MEMBER QUIRK SILVA
ANOTHER HAVE RAISED THANK YOU.
ABSOLUTELY I GUESS WHAT I'D
LIKE TO. KIND OF PREFACE MY
COMMENTS AROUND THE FISCAL
TRANSPARENCY PACE WHICH ALL AUG
GET INTO A LITTLE BIT OF
DETAIL. WITH QUITE OFTEN WHEN
WE PRESENT PUBLICLY ABOUT THE
MENTAL HEALTH SERVICES ACT WE
REALLY TRY TO HIGHLIGHT THE
POLICY SIDE OF THE MENTAL
HEALTH SERVICES ACT. IN
ADDITION TO THE FUNDING THE
FUNDING IS TREMENDOUS IN IN IN
THE OPPORTUNITY THAT IT
CREATES. BUT THERE ARE A COUPLE
OF PIECES TO THE MENTAL HEALTH
SERVICES ACT THAT ARE REALLY
QUITE UNIQUE AND THAT. ALLOWS
CALIFORNIA TO STAND APART FROM
THE REST OF THE COUNTRY. ONE IS
THE MANDATE FOR PREVENTION AND
EARLY INTERVENTION. OF THE DAY
THE MAIL HOW SERVICES ACT
RECOGNIZED VERY EARLY ON THAT
OUR SYSTEM IS WHAT WE OFTEN
REFERRED TO AS A FAIL FIRST
SYSTEM. BECAUSE MEDIC HOW AND
MANY OF OUR PROGRAMS ARE
DIAGNOSIS BASED YOU HAVE TO
MEET A LEVEL OF SEVERITY BEFORE
YOU'RE ELIGIBLE FOR CARE. WE
DON'T DO THIS IN OTHER ASPECTS
OF HEALTH CARE WE DON'T DO THIS
IN IN IN TERMS OF OUR
EDUCATIONAL SYSTEMS OR THE
OTHER WAYS WHICH WE TRY TO
SERVE FAMILIES. BUT SO MUCH OF
OUR MENTAL HEALTH SYSTEM HAS
BEEN BUILT UPON A SYSTEM THAT.
THAT THE LITTLE WHO ARE
COMMISSION IN THE YEAR TWO
THOUSAND DESCRIBED AS RATIONING
ACCESS TO CARE THAT YOU HAVE TO
MEET A LEVEL OF SEVERITY. IF
YOU'RE IF YOU IN ORDER TO BE
ELIGIBLE FOR SERVICES. MENTAL
HEALTH SERVICES ACT CREATES A
MANDATE FOR PREVENTION WHICH IS
HIGHLY UNUSUAL. ANDERSON MORE
RECENTLY ENACTED LEGISLATION
THE COMMISSION HAS BEEN
DIRECTED TO ACTUALLY. DEVELOP A
STATEWIDE FRAMEWORK AND
STRATEGY AROUND PREVENTION AND
EARLY INTERVENTION. BUT IT'S
THE POLICY OF THE MENTAL HEALTH
SERVICES ACT WHICH IS SO
IMPORTANT TO RECOGNIZE THAT IF
WE ARE GOING TO ADDRESS THE
ISSUES OF HOMELESSNESS.
UNEMPLOYMENT OF MENTAL HEALTH
CONSUMERS OF JAIL INVOLVEMENT
OF EDUCATIONAL CHALLENGES
FACING A CHILLED OUR CHILDREN
WE REALLY NEED TO THINK ABOUT
THAT IN TERMS OF PREVENTION.
EARLY INTERVENTION STRATEGY AND
THAT'S THAT THAT'S A
SIGNIFICANT CULTURAL SHIFT FOR.
MENTAL HEALTH FIELD IN GENERAL
BUT CERTAINLY FOR AT THE STATE
LOCAL FOR OUR STATE OF
CALIFORNIA AND FOR COUNTIES IN
TERMS OF HOW WE DELIVER MENTAL
HEALTH CARE. THE SECOND PIECE
OF THE MENTAL HEALTH SERVICES
ACT THAT THAT ALLOWS US TO
STAND APART EVEN MORE AND
CREATES TREMENDOUS OPPORTUNITY
IS THE INNOVATION COMPONENT
TONIGHT I HAVE TO. RECOGNIZE MY
COLLEAGUES IN THE ALLEY WE TRY
REALLY HARD TO CREATE THESE
VISUALS OF HOW THE MONEY FLOWS
AND IT'S VERY DIFFICULT BECAUSE
THAT THERE'S A LOT OF
COMPLEXITY TO IT. THERE IS A 5%
SET ASIDE FOR INNOVATION THAT'S
RUNNING ABOUT A HUNDRED MILLION
DOLLARS A YEAR AS THE LA
COMMENTED THAT IS THE ONE
COMPONENT. TO SPEND THOSE
DOLLARS WE ALLOW THOSE DOLLARS
TO BE SPENT ACROSS FIVE FISCAL
YEARS WHICH MEANS THERE'S FIVE
HUNDRED MILLION DOLLARS IN PLAY
FOR INNOVATION. THE REASON THIS
IS SO IMPORTANT IS BECAUSE IT'S
THIS VERY EXPLICIT POLICY THAT
SAYS WE HAVE TO IMPROVE AND IT
IS NOT JUST A TOOL THAT'S
ACTUALLY MANDATE COUNTIES ARE
REQUIRED TO DEVELOP PROPOSALS
TO STRENGTHEN THEIR MENTAL
HEALTH SYSTEMS USING THESE
INNOVATION DOLLARS. SO I WANT
TO I WANT TO PUT THAT OUT THERE
IN THAT THE VALUE OF THE M.
HSA. INCLUDES THE FUNDS BUT
IT'S THE APPROACH TO DELIVERING
CARE THAT REALLY IS THE CRUX OF
THE ACT FOCUSED ON RECOVERY.
AND WITHIN THE P. E. I.
COMPONENT IT OUTLINES SEVEN KEY
OUTCOMES THAT WE REALLY NEED TO
BE THINKING ABOUT IN TERMS OF
HEALTH AND WELL BEING NOT
ILLNESS RESPONSE AND THAT
INCLUDES HOUSING AND EMPLOYMENT
AVOIDING JAIL INVOLVEMENT.
AVOIDING THE CHILD WELFARE
SYSTEM MEANING KEEPING FAMILIES
INTACT. AND SO IT IT IT IT ALSO
INCLUDES REDUCING SCHOOL
FAILURE WOULD LIKE TO SAY
SUPPORTING EDUCATIONAL SUCCESS
I THINK INCREASINGLY WHILE.
THEY CHALLENGE OF HOMELESS
MENTALLY ILL FOLKS IS THE FACE
OF OUR MENTAL HEALTH SYSTEM FOR
ADULTS PLUS OUR CRIMINAL
JUSTICE INVOLVEMENT WHEN IT
COMES TO CHILDREN AND YOUTH. I
CANNOT SET FOOT ON A SCHOOL
WITHOUT A TEACHER OR PRINCIPAL
THEIR PARENTS TALKING TO ME
ABOUT THE MENTAL HEALTH. MENTAL
HEALTH NEEDS OF CHILDREN IN OUR
EDUCATIONAL SYSTEM THANK YOU
VERY MUCH FOR RECOGNIZING THAT
THIS YEAR AND PASSING THEM IN
THE HOUSE DIDN'T SERVICES ACT
WITH FUNDING TO INCENTIVIZE
THESE COUNTY SCHOOL PARTNERSHIP
THIS IS PHENOMENAL. SIDE I'M I
WANT TO SORT OF GO INTO THIS
CONVERSATION PARTICULARLY FOR
THE SECOND PANEL TALKING ABOUT
THE OPPORTUNITY THAT THE MENTAL
HEALTH SERVICES THAT CREATES.
WHAT THE COMMISSION HAS BEEN
DOING IN TERMS OF OVERSIGHT AND
ACCOUNTABILITY IT'S REALLY BEEN
TRYING TO CREATE THE CONDITIONS
FOR PUBLIC ACCOUNTABILITY THREE
TRANSPARENCY AND SO IF YOU'VE
BEEN TO OUR WEBSITE RECENTLY
GAVE YOU SOME HANDOUTS. WHEN WE
FIRST SAW THE CHALLENGES OF ON
A LACK OF REPORTING IN UNSPENT
FUNDS WE BASICALLY DIGITIZED
THE STATE'S REVENUE AND
EXPENDITURE REPORTS AND PUT
THEM ONLINE AN EASY POINT AND
CLICK MANNER AND WHAT WHAT
FIRST HAPPENED WAS THERE WAS
RECOGNITION. THAT COUNTIES HAD
NOT BEEN SUBMITTING THEIR
FINANCIAL REPORTS THE SECOND
ISSUE THAT CAME UP WERE THE
LARGE UNSPENT FUND BALANCES.
PUTTING THE DATA OUT THERE I
WOULD ARGUE MORE SO THAN THE
REVERSION POLICY HAS WHAT IS
GENERATED THE CONVERSATIONS IN
FACT I RECEIVED A CALL. FROM
THE THEN CHAIR OF THE ORANGE
COUNTY BOARD OF SUPERVISORS
ASKING ME TO CALM AND EXPLAIN
THE DATA BECAUSE THE BOARDS HAD
BEEN TO THE LEARNED IT TO THIS
AM PROBABLY HALF A DOZEN OTHER.
COUNTY SUPERVISORS ACROSS THE
STATE CALLED IN AND ASKED US
FOR SOME GUIDANCE ON THIS. WE
HAVE BEEN WORKING TO MAKE
READILY AVAILABLE KEY
INFORMATION ON REVENUES
EXPENDITURES AND UNSPENT FUNDS.
AS A AS A COMPONENT TO THAT
WE'RE ALSO MAKING AVAILABLE
INFORMATION ON THE PROGRAMS
THAT ARE BEING FUNDED. INCLUDED
IN THAT IS INFORMATION WHO IS
ACTUALLY BEING SERVED WITHIN
THE REGULATORY LIMITATIONS OF
THE COMMISSION'S AUTHORITY
WHICH IS FOCUSED ON INNOVATION
MP I ONLY. WE ARE ASKING THE
COUNTIES TO ACTUALLY GIVE US
DETAILED INFORMATION ON WHO IS
SERVED BY RACE ETHNICITY
LANGUAGE SPOKEN SEXUAL
ORIENTATION GENDER IDENTITY
VETERAN STATUS DISABILITY
STATUS WHAT WE WANT IS THE
PUBLIC TO UNDERSTAND HOW
COUNTIES ARE PRIORITIZING USES
OF THESE FUNDS. OUR INTENT IS
NOT TO TELL COUNTIES WHAT THEIR
PRIORITIES ARE OUR INTENT IS TO
SUPPORT THE COMMUNITY PLANNING
PROCESS THAT IS REQUIRED UNDER
THE LAW. WHICH SAYS GO OUT AND
ENGAGE THE PUBLIC TO SHAPE
DESIGN AND TAILOR YOUR MENTAL
HEALTH SYSTEM TO YOUR NEEDS.
THE COULD THE COMMISSION SEES
THAT STRATEGY HAS PUBLIC
ACCOUNTABILITY RATHER THAN THE
SIXTEEN COMMISSIONERS DECIDING
WHICH COUNTIES ARE DOING IT
RIGHT WHICH KIND OF TO DOING IT
WRONG THE IDEA IS TO EMPOWER
THE PUBLIC TO ACTUALLY ENGAGE.
WE HAVE IN OUR SYSTEM
INFORMATION ON FUNDING ON
SERVICES AND THE THIRD PIECEIS
THE OUTCOMES ACHIEVED. WHEN I
TALK TO THE PUBLIC ABOUT WHAT
THEY'RE LOOKING FOR FROM
GOVERNMENT THEY WANT SYSTEMS
THAT WORK. AND WHAT THEY WANT
TO KNOW IS ARE WE MAKING SMART
DECISIONS WITH HOW WE SPEND
MONEY. ARE WE MAKING SMART
DECISIONS WITH WHAT WE'RE
BUYING THE SERVICES WERE PAYING
FOR. AND DO THOSE SERVICES
RESULT IN YOUR PEOPLE GOING TO
JAIL YOUR PEOPLE HOMELESS
LIVING ON THE STREETS MORE
PARENTS CAPABLE OF. KEEPING
THEIR CHILDREN IN THEIR
HOUSEHOLD IN AVOIDING THE CHILD
WELFARE SYSTEM X. AT OUR
CENTER. WHAT WE'VE SEEN SINCE
THEN IS A TREMENDOUS RESPONSE
FROM THE DEPARTMENT OF HEALTH
CARE SERVICES AND THE COUNTIES
TO STRENGTHEN FISCAL
TRANSPARENCY WHEN WE STARTED.
THERE WERE ZERO COUNTIES WERE
SUBMITTING THEIR FINANCIAL
REPORTS ON TIME SOME COUNTIES
HAD SUBMITTED REPORTS IN FIVE
TO SEVEN YEARS LOTS OF REASONS
FOR THAT. SOME UNDERSTANDABLE
MANY OF THEM NOT TODAY I THINK
WE'RE AT A 100% REPORTING.
RIGHT WE SAW VERY LARGE FUND
BALANCES AND LITTLE ATTENTION
IN TERMS OF THESE DOLLARS THAT
WERE SITTING IN THE BANK
ACCOUNTS. I CANNOT GIVE YOU AN
UPDATE TODAY ON UNSPENT FUNDS
AND I CAN EXPLAIN THAT BUT I
CAN TELL YOU ANECDOTALLY THAT.
COUNTY AFTER COUNTY IS WORKING
HARD TO STREAMLINED HOW THEY
SPEND THESE DOLLARS TO PUT MORE
PROGRAMS IN PLACE. TO SUPPORT
THAT AND I'LL TALK ABOUT THIS
MORE ON THE SECOND PANEL. WE
HAVE BEEN FACILITATING CROSS
COUNTY LEARNING COLLABORATIVE'S
WE HAVE BEEN INCENTIVIZING
PARTNERSHIPS WE HAVE BEEN SORT
OF RAISING THE FLAG AND SAYING
HEY WHO'S INTERESTED. AND THE
COUNTIES ARE BEING VERY
RESPONSIVE BOTH IN TERMS OF
THEIR USE OF THEIR OWN DATA.
TRYING TO STRENGTHEN THEIR
UNDERSTANDING OF THEIR OWN DATA
TRYING TO STREAMLINE THAT
PROCESS GET MORE MONEY OUT. THE
TRANSPARENCY HAS HAD THE IMPACT
THAT WE HAD HOPED IT WOULD HAVE
WHICH WAS MORE CONVERSATION
MORE UNDERSTANDING. AND MORE
OPENNESS AND WILLINGNESS TO
ROLL UP OUR SLEEVES AND TRY
THINGS WE HAVEN'T TRIED BEFORE.
TERMS OF THE SPECIFIC ISSUES
THAT THE AUDIT REYES RELATIVE
TO THE COMMISSION AROUND
STATEWIDE STANDARDS FOR THE
TRIAGE PROGRAM AND
CLARIFICATION ON INNOVATIONS WE
HAVE A DASHBOARD IN FRONT OF
YOU THAT SHOWS THE APPROVAL
RATES FOR INNOVATIONS THOSE
RATES. AND HAVE ALWAYS BEEN
HIGH I THINK IT WAS A LOT OF
MISCOMMUNICATION WITH THE
COUNTY IS ABOUT. WHAT
INNOVATION MEANS. SOME OF THAT
WAS A LACK OF CLARITY ON THE
COMMISSION'S PART SOME OF IT
WAS JUST THE DIFFICULTY OF
GETTING THIS INFORMATION OUT TO
LOTS AND LOTS OF DIVERSE
COUNTIES. SO I THINK WE'VE
ADDRESSED THAT ISSUE QUITE.
COMPREHENSIVELY ON THE TRIAGE
PIECE. WHAT THE AUDITOR WAS
SAYING IS WHEN WE FIRST ISSUED
TRIAGE FUNDS EACH COUNTY WAS
RESPONSIBLE FOR THEIR OWN
INTERNAL EVALUATION. AND SO
THERE WAS NOT A STATE WIDE
PICTURE OF THE DOLLARS BECAUSE
THE PICTURE WAS INDIVIDUAL
COUNTIES. AND WE HAVE MOVED
TOWARDS A STATE LEVEL
EVALUATION SO WE CAN TELL A
MORE BROAD PICTURE WE LOSE THE
NUANCE OF WHAT HAPPENED IN AN
INDIVIDUAL COUNTY BUT WE GAIN A
BROADER PERSPECTIVE AND- WE
HAVE A CONTRACT IN PLACE WITH
UCLA AND UC DAVIS. TO SUPPORT A
STATEWIDE EVALUATION FOR THE
TRIAGE DOLLARS SO WHAT WE
ALTHOUGH THERE ARE SOME
CHALLENGES WITH THAT BECAUSE
THERE'S SUCH DIVERSITY AND HOW
THOSE FUNDS HAVE BEEN
DISTRIBUTED. IT'S GOING TO BE
DIFFICULT FOR US TO COME UP
WITH A SINGLE PICTURE OF HOW
THAT IT'S BEEN IMPLEMENTED BUT
THAT'S THAT'S MY IN AND THERE'S
A REPORT IN YOUR PACKET THAT IS
THAT REPORT ON THE TRIAGE FUNDS
AND- I THINK WE'VE SATISFIED
THE AUDITOR THAT. WE'VE MOVED
IN THAT DIRECTION. HAPPY TO
ANSWER ANY QUESTIONS AND GET
INTO THE DETAIL OF WHY WE CAN'T
TELL YOU THE UPDATE. IN TERMS
OF WHAT THE RESERVE BALANCES
ARE IT BUT I'M ALSO WOULD JUST
LIKE TO ANSWER ANY QUESTIONS
YOU MIGHT HAVE. AT THE I WOULD
LIKE AN UPDATE ON THAT BEFORE
WE DIVE INTO THAT. AS YOU SAID
PEOPLE KNOW THE PEOPLE OF
CALIFORNIA. WHEN I WHEN I
BELIEVE THEY WANT TO THINK THAT
WE ARE SPENDING THIS MONEY.
SMARTLY I'M PROGRAMS THAT ARE
WORKING SO WELL MAKING SURE THE
MONEY IS ACTUALLY GETTING SPENT
CURLY ENTER IMPORTANT FIRST
STEP. RIGHT ARE YOU SPENDING
THE MONEY IS NOT THE HARD PART.
IT'S GETTING RESULTS SO WHAT
ARE WE DOING EITHER YOUR
OVERSIGHT COMMITTEE OR OR SOME
OTHER BODY. HOW ARE WE TRACKING
OUTCOMES AND HOW ARE WE
IDENTIFYING BEST PRACTICES
RIGHT ONE OF THE QUESTION. LET
ME ADD ONE LITTLE PIECE ON THE
MONEY AND I DON'T HAVE THE
CALCULATION EXACTLY BUT- IF YOU
COMPARE THE FUNDS THAT SAT IN
THE BANK ACCOUNTS. STATEWIDE AT
THAT POINT IN TIME WITH THE
FUNDS THAT WERE GENERATED BY
THE ACTS. IT'S A VERY IT'S A
LOT OF MONEY BUT IT'S A VERY
SMALL PERCENTAGE THE VAST
MAJORITY OF AN HSA DOLLARS ARE
GETTING OUT THERE BEING SPENT
THERE BEING SPENT QUICKLY. I
THINK YOU'RE ASKING THE MORE
PERTINENT QUESTION NOT IS ARE
WE ACTUALLY GETTING THE JOB
DONE BECAUSE WHAT WE SEE
EVERYDAY IS MORE MORE PEOPLE ON
THE STREET. MORE MORE PEOPLE IN
OUR JAILS MORE AND MORE
CHILDREN STRUGGLING THE SUICIDE
RATES THAT YOU THAT YOU
HIGHLIGHTED IN YOUR OPENING
COMMENTS. HERE'S A WE'RE TRYING
TO DO. CLICK THE CAN I AND I
PRESENTED IN. MANY BUDGET
COMMITTEES IN THE IN THE BUDGET
PROCESS THAT JUST CLOSED
RECENTLY WE REALLY HAVE THIS
FOUR PRONG STRATEGY THE FIRST
IS ABOUT DATA. SO ON OUR
WEBSITE WE HAVE ONE INDICATOR
OF OUTCOMES ASSOCIATE WITH FULL
SERVICE PARTNERSHIPS AND WHAT
WE'RE TRYING TO DO IS ANALYZE
THE DATA THAT THE STATE HAS
AVAILABLE WE'RE WE'RE NOT
INVESTING IN YOU KNOW ALL NEW
DATA SYSTEMS HAS A VERY
EXPENSIVE WE'RE REALLY TRYING
TO DO IS TAKE EXISTING
ADMINISTRATIVE DATA AND LINK IT
SO WE HAVE LINKED. DATA FROM
THE DEPARTMENT HEALTHCARE
SERVICES WITH DATA FROM THE
DEPARTMENT OF JUSTICE TO LOOK
AT CRIMINAL JUSTICE RATES AND
WE'RE NOW WORKING TO UNDERSTAND
THE SERVICE DELIVERY SO IT'S
NOT CHEST WHO'S IN THIS YOU
KNOW WHO IS IN A COMMITMENT A
WHOLE SYSTEM NOW WHO'S IN JAIL
WE WANT TO UNDERSTAND WHAT
HAPPENED IN THE COMMUNITY
MENTAL HEALTH SYSTEM AND WHICH
OF THOSE INTERVENTIONS HAD AN
OUTCOME. OF AVOIDING JAIL RIGHT
WE'RE NOT THERE YET. I I'LL
SHARE WITH YOU THAT THIS IS NOT
COMMON PRACTICE IN CALIFORNIA
IN TWO THOUSAND AND- SIMPLY TWO
THOUSAND AND TWO. I WAS
INVOLVED WITH THE DRAFTING THE
LEGISLATION TO CREATE
CALIFORNIA'S COUNSELING MILLION
OFFENDERS WHICH IS NOW THE
COUNSEL IN CRIMINAL JUSTICE AND
BEHAVIORAL HEALTH. AND WE AND
LIST I WAS OF LITTLE WHO WERE
AT THE TIME WE ENLISTED UC
BERKELEY TO DO THAT DATALINK.
AND IN TWO THOUSAND SEVEN WE
PUBLISHED THAT IT IS FEASIBLE
TO ACTUALLY LOOK AT YOUR MENTAL
HEALTH DATA. IN OUR CRIMINAL
JUSTICE DATA AND UNDERSTAND
WHAT KINDS OF SERVICES DIVERT
PEOPLE TO PREVENT. TYPICALLY RE
INVOLVEMENT BECAUSE WE'RE
WORKING WITH THE POPULATION
THAT IS IN THE CRIMINAL JUSTICE
SYSTEM INITIALLY. TEN YEARS
LATER THE COMMISSION IS NOW
DOING THIS AGAIN TRYING TO
STAND THAT UP. WE ARE WORKING
TO LINK MENTAL HEALTH DATA TO
EMPLOYMENT DATA. THE
LEGISLATURE GAVE US THE
AUTHORITY TO WORK WITH EDT TO
ACCESS EMPLOYMENT DATA BECAUSE
REDUCING UNEMPLOYMENT AS ONE OF
THE GOALS OF THE PREVENTION AND
EARLY INTERVENTION LANGUAGE OF
THE ACT. WE ARE SITTING DOWN
WITH THE DEPARTMENT OF
EDUCATION TO TALK ABOUT HOW WE
CAN BETTER UNDERSTAND THE
INTERSECTION OF COMMUNITY
MENTAL HEALTH AND OUR SCHOOLS
AND DESIGN PARTNERSHIPS. TO
MAKE THAT HAPPEN BUT ALSO LOOK
AT THE DATA ACROSS THE SYSTEM'S
VERY DIFFICULT BECAUSE THEIR
DATA IS PROTECTED UNDER CERTAIN
FEDERAL RULES THE MEN HOT THAT
AFFECTS UNDER SEPARATE FEDERAL
RULES THAT THEY'RE THEY'RE
THEY'RE OPEN THEIR WORKING WITH
US WERE ROLLING UP OUR SLEEVES
WE WANT TO DO THE SAME THING
WITH CHILD WELFARE INVOLVEMENT.
HOMELESSNESS IS MORE DIFFICULT
WE DON'T HAVE A GOOD
ADMINISTRATIVE DATABASE THAT
HAS IDENTIFIERS THAT YOU CAN
LINK. BUT DURING THE DAY TO
WORK IS JUST THE FIRST PIECE IT
MEANS WE ARE GOING TO IDENTIFY
CHALLENGES. AND IN NEW YOU TAKE
OFF THE CHALLENGES WE WANT TO
GET MUCH MORE GRANULAR INTO
WHAT THOSE CHALLENGES ARE AT
THE COMMUNITY LEVEL. WE THEN
WANT TO BE ABLE TO COME ALONG
AND SUPPORT IMPROVEMENT SAID
THAT WE'RE ACTUALLY. MOVING
COUNTIES TOWARDS BEST PRACTICES
AND FOR US THAT MEANS THE STATE
NEEDS TO PUT IN PLACE A
TECHNICAL ASSISTANCE STRATEGY
WHICH S NOT AS ROBUST AS IT
COULD BE TODAY. WHICH MEANS THE
STATE NEEDS TO DEVELOP
OPPORTUNITIES TO INCENTIVIZE
COUNTIES. LAST YEAR WE RECEIVED
FIVE MILLION DOLLARS O SUPPORT
WHAT WE'RE CALLING IN
INNOVATION INCUBATOR. RATHER
THAN IN ESSENCE SIGN THE CHECK
FOR A PLAN THAT THE COUNTY
WROTE WHAT WE WANT TO DO IS
WORK WITH THE COUNTY TO
STRENGTHEN THE INNOVATION
COMPONENT WE WANT TO USE THE
DATA TO IDENTIFY KEY
OPPORTUNITIES THAT NEED TO BE
IMPROVED. AND THEN BRING PEOPLE
TOGETHER TO TALK ABOUT HOW WE
COULD USE INNOVATION DOLLARS TO
STRENGTHEN CORE PROGRAMMING TO
MEET THOSE GOALS THE INTENT IS
NOT FOR THE COMMISSION TO TELL
THE COUNTIES WHAT TO FUND THE
INTENT IS TO SUPPORT BRINGING
COUNTIES TOGETHER WHO HAVE
SHARED CHALLENGES WHERE
WEAKENED SUBSIDIZE THAT CROSS
COUNTY CONVERSATION. THAT IS
MUCH EASIER THAN HALF ASKING
EACH COUNTY TO WRITE A CHECK
FOR FIVE HUNDRED DOLLARS SO YOU
CAN GET PEOPLE IN A ROOM. THEY
CAN'T SUBSIDIZE EACH OTHER. WE
WERE ABLE TO TAKE TWO AND A
HALF MILLION DOLLARS. IN OUR
BUDGET LAST YEAR TO LAUNCH
THREE COLLABORATIVE INNOVATION
PROJECTS. ONE IS FOCUSING ON
STRENGTHENING FULL SERVICE
PARTNERSHIPS WHICH ARE THE
HIGHEST LEVEL OF COMMUNITY
BASED CARE. AND OUR DATA
SHOWING THAT ABOUT 40% OF
PEOPLE COMING OUT OF THIS
PROGRAMS ARE NOT MEETING GOALS.
THE COUNTIES ARE CO INVESTING
WITH US THEY'VE RACED
PHILANTHROPY PHILANTHROPIC
DOLLARS AS WELL WE HAVE
EIGHTEEN COUNTIES COMING
TOGETHER TO LEARN. HOW TO
BETTER ANALYZE THEIR OWN DATA
HOW TO STRENGTHEN THEIR
CONTRACTING WITH THEIR
COMMUNITY PROVIDERS AND HOW TO
PROVIDE TECHNICAL ASSISTANCE TO
STRENGTH THAT TO ACHIEVE THE
OUTCOMES OF THAT LAW. WE HAVE A
GROUP OF FIVE COUNTIES WORKING
TO ANALYZE THEIR OWN CRIMINAL
JUSTICE AND MENTAL HEALTH DATA
ALONG. THE LINES OF WHAT WE
HAVE DONE THEY HAVE MUCH MORE
DETAILED DATA. AND WE HAVE A
MULTI COUNTY PROJECT TO USE
PSYCHIATRIC ADVANCE DIRECTIVES
AS A WAY TO AVOID THE NEED FOR
LAW ENFORCEMENT BASED CRISIS
CARE. WE HAVE AN ADDITIONAL TWO
AND A HALF MILLION DOLLARS THIS
YEAR WILL ENGAGE THE COUNTIES.
THE FIVE MILLION DOLLARS WE
RECEIVED IN LAST YEAR'S BUDGET
REALLY THAT WAS FOR. WE ARE
REQUIRED TO FOCUS ON CRIMINAL
JUSTICE INVOLVEMENT. WE SEE
THIS AS AN OPPORTUNITY FOR THE
STATE TO FACILITATE HOW
COUNTIES CAN LEARN TOGETHER AND
IMPROVE THEIR SYSTEMS WITHOUT
ACTUALLY DIRECTING THEM SAID
BEYOND THAT THAT THE LOCAL
PRIORITIES THAT ARE THAT. THE
VISION OF REALIGNMENT THE THIRD
PIECE IS INCENTIVES AND SO MANY
OF THE FUNDS THAT YOU PROVIDED
US THIS YEAR ON THE SCHOOL
MENTAL THESE DIDN'T KNOW HOW
SERVICES ACT EARLY PSYCHOSIS
FUNDS AND YOUTH DROP IN CENTERS
PLUS THE DATA ARE WHAT WE VIEW
AS INCENTIVES TO ENCOURAGE
COUNTIES TO ROLL UP THEIR
SLEEVES IN MY EARLIER COMMENTS
ABOUT HOW RESPONSIVE THE
COUNTIES HAVE BEEN. WE'VE HAD A
TREMENDOUS RESPONSE FROM
COUNTIES UP AND DOWN THE STATE
WHO HAVE BEEN VERY APPRECIATIVE
THAT WE BOTH RECOGNIZE HOW
DIFFICULT IT IS FOR THEM TO
ACHIEVE THE GOALS THAT WE ALL
EXPECT OF THEM. AND THAT THE
KIND OF PARTNERSHIP THAT WERE
ENVISIONING WITH STATE IS VERY
WELCOME IN PART BECAUSE ALL ALL
QUOTE THE NORTH COUNTIES THAT
SAID THAT THEY DON'T HAVE THE
CONSULTANTS THEY DON'T HAVE THE
BAND WITH OR THE TIME OF THE
STAFF. TO ROLL UP THEIR SLEEVES
ANALYZE THE DATA. EXPLORE THE
WORLD TO LOOK FOR BEST
PRACTICES AND THEN TO FIND THE
FOLKS WHO CAN HELP THEM
IMPLEMENT THEM. AND IF WE CAN
OPEN SOME OF THOSE DOORS FOR
THEM OR SUPPORT THEIR PEER
COUNTIES TO DO THAT THEN THEY
CAN BENEFIT AND OTHER COUNTIES
LIKE THAT CAN BENEFIT. SO IN
THAT'S OUR YOU KNOW OUR OUR
BROAD STRATEGY REALLY IS THE
DATA AND THEN SUPPORT SUPPORT
SUPPORT SUPPORT. I THINK WE'VE
GOT SOME OTHER QUESTIONS AT
CHAIRMAN. THANK YOU MADAM CHAIR
AND THANK YOU FOR FIRM TO THE
LA AND YOU AS WELL FOR SOME
REALLY GOOD INFORMATION. COUPLE
QUESTIONS TONIGHT. I'M I'M
GONNA I'M- THIS IS BY SAYING
YOU KINDA ANSWERED THIS BUT IT
IS I THEY OBVIOUSLY WERE
LACKING DATA AND THAT IS A HUGE
HUGE CHALLAN SO FOR ME. IN THE
FIVE COUNTIES I REPRESENT RURAL
COUNTIES. WE GET IN TWO
THOUSAND SIXTEEN SEVENTEEN WE
ABOUT THIRTY SIX MILLION
DOLLARS TOTAL. FROM ONE POINT
SEVEN MILLION DOLLARS FOR
TRINITY COUNTY TO TWENTY
MILLION TWENTY ONE MILLION FOR
CINEMA COUNTY. CURRENTLY
DOESN'T SOUND LIKE THERE'S ANY
WAY TO DETERMINE. HOW THIS
MONEY WAS SPENT ON THE PROGRAM
ON INDIVIDUAL PROGRAMS IF THERE
IS THEN I'D LOVE TO KNOW HOW WE
CAN DO TO DO THAT HOW MUCH
MONEY WAS SPENT ON INNOVATION
HOW MUCH MONEY WAS SPENT ON P.
E. I HOW MUCH MONEY WAS SPENT
ON WET. AND SO WE CAN SEE THAT
I'M REALLY HAPPY TO HEAR ABOUT
THE OPPORTUNITIES FOR TECHNICAL
ASSISTANCE BECAUSE I CAN TELL
YOU THAT IN AT LEAST FOR THE
COUNTIES I HAVE ROLLING UP
THEIR SLEEVES AND TRYING TO
FIGURE THIS OUT IS ALMOST
IMPOSSIBLE SO. ONE QUESTION IS
HAVE YOU CONSIDERED SORT OF
REGIONAL COLLABORATIVE'S WARS
WERE SMALLER GROUPS A COUNTIES
COULD ACTUALLY WORK TOGETHER TO
FIGURE FIGURE SOME OF THIS OUT
BECAUSE. YOU KNOW CLEARLY
TRINITY COUNTY IN A TRAINING
COUNTY IS NOT LA. NOT EVEN
CLOSE THE MAIN AND SO THE
CHALLENGES ARE DIFFERENT AND SO
THE ONE A ONE SIZE FITS ALL
APPROACH IS ARE JUST A DISASTER
FOR SMALLER COUNTIES SO HAVE
YOU CONSIDERED ANY SORT OF
REGIONAL REGIONAL
COLLABORATIVE'S WERE YOU CAN
BRING COUNTIES TOGETHER. THAT
CAN LEARN NOT LEARN TOGETHER
LEARN FROM THAT ABSOLUTELY AND
LET ME ANSWER THE ENEMY CAN
COMMENT ON YOUR FIRST QUESTION
ABOUT BEING ABLE TO FIND WHAT'S
BEEN THE ANTENNA BUT RIGHT. SO.
ON THE FISCAL TRANSPARENCY TOLD
WE HAVE ONLINE RIGHT NOW YOU
CANCLICK ON FIVE FISCAL YEARS.
ALL OF THE COUNTIES AND THE
INDIVIDUAL COMPONENTS THE WET
FUNDS ARE NOT BROKEN OUT BUT
THE S. S. P. E. I'D INVASION
ARE BROKEN OUT AND YOU COULD
SEE. HOW MUCH MONEY THEY
RECEIVED WHAT THEY SPENT AND
WHAT THEY HAD LEFT IN THAT
ACCOUNT AT THE END OF THE
FISCAL YEAR AND THERE'S A
CUMULATIVE TOTAL OKAY SO WEIRD.
SOYES WE WANT TO GET THERE
THAT IS PART OF THE CHALLENGE
OF UPDATING THAT THAT THE RULES
AROUND HOW COUNTIES REPORT
THOSE DOLLARS THAT WHOLE
PROCESS HAVE CHANGED FROM LAST
YEAR TO THIS YEAR. AND SO
ALTHOUGH SEVENTEEN EIGHTEEN
FIGURES ARE AVAILABLE THEY WERE
CáC THAT UNDER A DIFFERENT
METHODOLOGY. AND SO THE
HISTORICAL BASE TO CALCULATE
THE SEVENTEEN EIGHTEEN FUND HAS
CHANGED. AND SO WE ARE WE HAVE
NOT. PUT THAT INFORMATION
ONLINE BECAUSE WE SORT OF DONE
APPLES FOR TEN YEARS AND
THERE'S AN ORANGE NOW. AND WE
WANT TO IN AND WE'RE CONCERNED
THAT THE RELIABILITY AND
VALIDITY OF THAT. WE'RE JUST
NOT THERE YET. IN ADDITION TO
THAT OF THE PROGRAM REPORTING
TOOL AND THERE'S A HAND OUT IN
HERE ON YOUR WEBSITE ON OUR
WEBSITE. IT ACTUALLY ALLOWS YOU
TO DO A SEARCH OF THIS IS BASED
ON THE COUNTY THREE YEAR PLANS.
THERE ARE. A COUPLE THOUSAND
PROGRAMS IN THERE AND IT IS A
PLAN IT'S NOT WHAT THEY DID IT
SORT OF HOW THEY'RE MOVING
FORWARD MANY THOSE PROGRAMS ARE
HISTORICAL PROGRAMS OVER TIME.
THIS WILL BE. EXPANDED ITS
COUNTIES GIVE US MORE
INFORMATION THERE IS IN HERE.
SPACE AT LEAST AND WHILE THE
DATA COMES IN FOR A DESCRIPTION
OF THE PROGRAM IN THE BUDGET
FOR THE PROGRAM. AND THAT'S
WHERE REPORTING ON WHO YOU'VE
SERVE WOULD BE ADDED AND SO THE
IDEA IS IF YOU WANT TO KNOW
WHICH PROGRAMS SERVE VETERANS
IN YOUR COUNTY YOU CAN CLICK
ON. YOUR COUNTY TYPE IN
VETERANS IT'LL TELL YOU YOUR
BILL TO TELL HOW MUCH FUNDS
WENT TO A PROGRAM YOU KNOW
VETERANS AN INDIVIDUAL PROGRAMS
BUT THERE WAS A PROGRAM THAT
WAS TARGETED. TOWARDS VETERANS
YOU COULD FIND IT SO WE
ABSOLUTELY ARE WORKING TO
INCLUDE THE BUDGET INFORMATION.
I WILL ADD THAT AS THE LA SO
ELOQUENTLY POINTED ME TO SAY IS
2225% HAVE A COUNTY SPENDING.
WE KNOW NOTHING ABOUT THE OTHER
7580% OF THE DOLLARS. OUR HOPE
IS THAT IN PARTNERSHIP WITH THE
COUNTY SENATE ARMED HEALTHCARE
SERVICES THAT WE COULD ACTUALLY
GIVE YOU A VERY CLEAR VALID
RELIABLE ASSESSMENT OF ALL OF
THE DOLLARS ALL OF THE SERVICES
AND THEN A FULLER AND OUTCOMES.
TO GET THERE ON THE OUTCOMES
PACE WE ABSOLUTELY ARE
ENCOURAGING REGIONAL
APPROACHES. IN SOME TYPICALLY
WHAT WE DO IS WE SAY HEY WHO'S
INTERESTED SOMETIMES THOSE
COUNTIES ARE CO LOCATED AND IT
IS A REGIONAL IN THE
TRADITIONAL SENSE THAT I THINK
YOU INTENDED. SOMETIMES IT'S
SISKIYOU IN LA AND SAN DIEGO IN
TRINITY. AND SO WE ARE WE DON'T
PICK PARTICIPANTS WHAT WE SAY
IS WHO'S INTERESTED AND WE
REALLY TRY TO WORK WHERE THERE
IS INTEREST. IN BE RESPONSIVE
AND TYPICALLY WHAT WE SAY IS
WELL WHAT ARE YOU INTERESTED IN
DOING AND HOW CAN WE HELP YOU
RATHER THAN SAYING THIS IS WHAT
WE WANT DONE. YOU KNOW USE
THESE DOLLARS TO GO DO IT OUR
WAY AND SO IT IS A ACROSS
COUNTY COLLABORATIVE BUT
BECAUSE WE'RE NOT HAND PICKING.
WE ARE HAVING FOLKS STEP UP
IT'S NOT ALWAYS IN THE
TRADITIONAL GEOGRAPHIC. AT TERM
I THINK OF WHAT YOU MEN OF
REGIONAL. THE REASON WE WANT
CROSS COUNTY ENGAGEMENT. AS WE
WANT TO AVOID WHAT I MIGHT CALL
THE MENDOCINO MIRACLE. OF
MENDOCINO DOING SOMETHING
PHENOMENAL AND NO ONE ELSE
TRIES BECAUSE IT'S THE WATER OR
THE CLEAN AIR OR YOU KNOW SORT
OF THE NATURE OF THE COMMUNITY.
AND THAT BEST PRACTICE NEVER
EXTENDS BEYOND THE COUNTY
BORDER. WE ASK THAT THERE BE AT
LEAST TWO OR THREE IDEALLY FIVE
TO EIGHT COUNTY THAT ARE
PARTICIPATING IN THESE
COLLABORATIVE'S THE IDEA IS
THAT IF IT WORKS. IT'S EASIER
TO GET TO THAT TIPPING POINT OF
EVERYBODY PICKING IT UP BECAUSE
IT WAS DONE IN LA AND INFINITY.
THE OTHER REASON WE DO IT IS WE
WANT THE STATE TO BE RESPONSIVE
WHAT THE COUNTIES ARE TELLING
US IS THAT INNOVATION ISN'T
JUST ABOUT COUNTIES CHANGING
THEIR BEHAVIOR IT ALSO MUST
INCLUDE THE STATE CHANGING ITS
BEHAVIOR. AND SO IF WE CAN HAVE
A CRITICAL MASS OF COUNTIES. WE
BELIEVE IF THEY'RE COMING TO
THE STATE ASKING FOR REFINEMENT
OF A REGULATION OR RULE OR A
STATUTE THAT THE STATE WILL BE
MORE RESPONSIVE TO THAT REQUEST
IF IT'S EIGHT COUNTIES THEN IF
IT'S TRINITY ALONE. AND SO VERY
MUCH CHAIRMAN WOULD WE ARE
WORKING TO CREATE THOSE
COLLABORATIVE'S. THANK YOU. CUT
ONE FINAL QUESTION. SO TWO
POINT SEVEN BILLION DOLLARS
REALIGNMENT MONEY. IS THIS
WORKING. I MEAN THAT'S A TOUGH
QUESTION FOR YOU GUYS BUT. HOW
MUCH DID WE SEE THAT A SPEND.
AS A STATE BEFORE. IS THE MONEY
IS AT COMPARABLE. AND DO
COUNTIES HAVE. THE TOOLS. F. AT
THE BILL'S LIKE INDIVIDUAL
COUNTIES DON'T HAVE THE TOOLS
THAT THE STATE HAD BEFORE
REALIGNMENT. SO. I HEAR ALL THE
TIME REALIGNMENTS KILLING US
WHERE IT'S NOT WORKING YOU KNOW
AND IT'S A VARIETY OF
DIFFERENT. THINGS RIGHT. IT'S A
TOUGH QUESTION. IS IT WORKING
TWO POINT SEVEN BILLION DOLLARS
A LOT OF MONEY. I APPRECIATE
YOU SAVING THE EASY QUESTION
FOR THE LA OUT. HER I'M OF THE
ANYBODY WANTS IT TO CRACK IT
YOU KNOW SO I I'LL SAY A COUPLE
OF THINGS. I'M YES AND NOW
RIGHT I MEAN YOU KNOW THE NO
ANSWER DO YOU OPENED RIGHT. AT
THE SAME TIME WE SEE INCREDIBLE
STRENGTH IN WHAT COUNTIES HAVE
BEEN ABLE TO DO WITH THE
FLEXIBILITY IN THE STRUCTURE
REALIGNMENT I THINK OUR
ARGUMENT IS THAT WITHIN THE
DESIGN OF REALIGNMENT THIS
SYSTEM CAN WORK MUCH MUCH
BETTER THAN IS WORKING TODAY
WHAT'S MISSING IS THE STRATEGY
TO ACTUALLY GO FROM HERE'S THE
DOLLARS GO DO GOOD WORK TO WHAT
WE ACTUALLY TRYING TO GET DONE
WE DON'T HAVE CLARITY ON THAT.
YOU KNOW IN MY OUT REACH AND
SPEAKING I OFTEN WILL COMMENT
THAT I WAS THE LOOK TO WHAT'S
HAPPENING WITH MEASLES BECAUSE
IT IS A CURRENT ISSUE IN
CALIFORNIA IN THAT WE HAVE A
VERY CLEAR SENSE OF WHAT WE ARE
TRYING TO GET DONE IN TERMS OF
IMMUNIZATIONS AGAINST MEASLES
WE KNOW WHERE THE GAPS ARE. AND
WE KNOW THE STRATEGIES USED TO
FILL THOSE GAPS. AND IN THE
MEASLES CONVERSATION. OUR
PUBLIC HEALTH OFFICIALS DON'T
SAY MY JOB IS TO GET MEASLES
SHOT FOR PEOPLE ON MEDICARE AL.
THEY SAY IF WE'RE GOING TO BE
SUCCESSFUL. MY JOB IS TO MAKE
SURE THAT EVERY CHILD EVERY
ADULT WHO CAN RECEIVE THE
VACCINE RECEIVE THE VACCINE
BECAUSE THAT'S HOW WE'RE GOING
TO ACHIEVE OUR GOALS. WE DON'T
HAVE COMPARABLE GOALS IN MENTAL
HEALTH WE DON'T HAVE AGREEMENT
ON WHAT IT IS WE ARE TRYING TO
GET DONE MY EARLIER COMMENTS
ABOUT PREVENTION. THERE'S ABOUT
FOUR HUNDRED MILLION DOLLARS A
YEAR DEDICATED TO PREVENTION
EARLY INTERVENTION WE DON'T YET
HAVE AGREEMENT ON WHAT THAT
MEANS IN TERMS OF MENTAL HEALTH
I WAS TALKING TODAY YESTERDAY.
WITH WE HAVE A FORENSIC
PSYCHIATRIST WHO IS ACTUALLY IN
THE ROOM BACK HERE HIS SPENDING
SOME TIME WITH US AS A POLICY
FELLOW. AND WE WERE TALKING
ABOUT THE TRAINING THAT IS
AVAILABLE FOR THE FOLKS WHO ARE
IN THAT FIELD AROUND PREVENTION
MENTAL IN IN TERMS OF
PREVENTING MENTAL HEALTH NEEDS.
AND IT'S THAT'S RIGHT THERE YOU
GO RIGHT. IT'S NOT HAPPENING
SO. I THINK. THE PROBLEM ISN'T.
REALIGNMENT I MEAN I THINK IF
THE LEGISLATURE WANTS TO
REVISIT THAT ABSOLUTELY THERE
ARE WAYS THAT WE COULD PROBABLY
STRENGTH AND THAT. FROM OUR
PERSPECTIVE. WITHIN THE CONTEXT
HOW TO CONSTRUCT OF REALIGNMENT
WE HAVE NOT REALLY ESTABLISHED
AGREED GOALS FOR MENTAL HEALTH
MENTAL HEALTH CARE. WE AREN'T
LEVERAGING THE DATA WE HAVE IT
IS VERY DIFFICULT IT TAKES US
SOMETIMES TWO TO THREE YEARS TO
NEGOTIATE A DATA USE AGREEMENT
WITH THE DEPARTMENT IN ORDER TO
LOOK AT THEIR DATA. AND THEN
WHEN WE DO LOOK AT THEIR DATA
AND WE FIND THESE CHALLENGES WE
THAN WE THAN SAY OR THE
COUNTIES SAY. NOW WHAT. AND THE
TOOLS WE HAVE ARE VERY LIMITED.
AND I WOULD ARGUE THAT WHAT WE-
REALLY NEED TO FOCUS ON IS
STRENGTH IN THIS STRENGTHENING
THOSE RELATIONSHIPS THOSE TOOLS
AND THE STRATEGIES SO THAT SO
THAT COUNTIES HAVE A CLEAR
SENSE. OF HOW TO GET TO THE
GOALS THAT ARE AGREED UPON.
ANOTHER QUESTION THE LA ONCE A
CRACK ABOUT. DID YOU HAVE
ANYTHING TO ADD. NOT NOT NOT
ALLOWED TO ADD A I THINK IT'S
IMPORTANT TO NOTE THAT LOCAL
FLEXIBILITY AND ADAPTATION IN
THE ABILITY TO COORDINATE
ACROSS PROGRAMS THAT ARE
OPERATE AT THE LOCAL LEVEL ARE
IMPORTANT FEATURES A
REALIGNMENT GIVEN THE SIZE AND
VARIETY OF CIRCUMSTANCES THAT
EXIST IN THE STATE. SO THERE
DEFINITELY ARE BENEFITS THAT
ARE THAT ARE IN THAT SYSTEM AT
THE SAME TIME AS IT'S BEEN
NOTED ON A COUPLE OF PLACES SO
FAR TODAY AND THERE IS A NEED
FOR TECHNICAL ASSISTANCE AND
PROVIDING THAT GUIDANCE. AND
ADDITIONALLY ONE ASPECT A
REALIGNMENT THAT PERHAPS HASN'T
BEEN FULLY REALIZED IS LOOKING
AT OUTCOMES AND THAT OBVIOUSLY
IS AN EXTREMELY DIFFICULT THING
TO DO BUT A LOT COULD BE DONE
TO INCREASE THE REPORTING OF
INFORMATION UP TO THE STATE
LEVEL TO REALLY ASSESS. WHETHER
IT'S WORKING OR NOT. AND I AND
I WOULD THAT LOOK AT THAT THE
IDEA OF THE QUESTION WAS NOT.
THIS IS HER TO THROW A BOMB YOU
ANSWERED. WHAT I WAS LOOKING
FOR AND I APPRECIATE THAT BOTH
OF YOU ANSWER WEB LOOKING FOR.
LIKE A LOT OF COUNTIES HAVE
FELT. OVERWHELMED BY THE
RESPONSIBILITY THEY NOW HAVE
AND SO. THE TECHNICAL
ASSISTANCE PART OF THAT BECOMES
A REAL CHALLENGE ESPECIALLY FOR
SMALLER CAN EVEN THE LARGER
COUNTIES BECAUSE- NOW. YOU HAVE
THE RESOURCES AND NOW YOU HAVE
THE RESPONSIBILITY. AND I THINK
IT'S PRETTY OVERWHELMING AND
ABSOLUTELY WHEN YOU ADD ALL THE
OTHER THINGS IN THEIR LACK OF
WORK FORCE AND ALL THESE OTHER
FACTORS. IT'S A HUGE AMOUNT OF
CRIME AND WE'RE REALLY
STRUGGLING. THANK YOU I
APPRECIATE THAT. BEING A LITTLE
TALKIE TODAY BUT THIS IS THE
JUST SUCH A HUGE ISSUE THAT I
THINK INCOME VINCE'S MUCH MORE
AREAS THAN WE REALLY BELIEVE IT
DOES SO ALWAYS GLAD TO HEAR YOU
TALK ABOUT THE STUDENT
SERVICES. BUT I MY HOPE IS WITH
THE STUDENT SERVICES DISCUSSION
IS THAT WE ENROLLED THE SCHOOL
DISTRICTS PARTICULARLY IS
SUPERINTENDENTS AND PRINCIPALS.
TO REALLY START TO UNDERSTAND
THESE ISSUES FROM A VERY YOUNG
AGE. MUCH MORE THAN THEY DO AND
AS WE SAY THAT WE HAVE ONE
INSTITUTION TALKING TO EACH
OTHER AND THEN OTHER STUFF THAT
DURING TALKS OF CRIMINAL.
JUSTICE TALKS TO CRIMINAL
JUSTICE YOU OF EDUCATORS
TALKING EDUCATORS MENTAL HEALTH
TALKING AND WE DON'T HAVE THAT
CROSS DIALOGUE BUT THERE'S
THINGS THAT HAPPEN AND VERY
VERY YOUNG AGE FOR. CHILDREN
AND FAMILIES THAT AS YOU SAID
ARE JUST NOT EVEN AND DRESSED
IN THE SCHOOLS AND MANY TIMES
SCHOOLS ARE WE'RE HERE FOR
EDUCATION ACADEMICS. NOT
REALIZING THAT IF YOU CAN WORK
ON THE MENTAL HEALTH ISSUES
YOU'RE GOING TO HAVE MUCH MORE
OPPORTUNITY FOR SUCCESS
ACADEMICALLY AND AS A TEACHER
FOR ALMOST THIRTY YEARS ALWAYS
I JUST DISTINCTIVELY REMEMBER
LOOKING AT. WELL FIRST GREATER
LOOKING UP AT ME AND HE HAD A
BIG ABSCESS IN HIS TOOTH SO
THAT'S ACTUALLY A HEALTH ISSUE
BUT IF YOU CAN GET THAT TAKEN
CARE OF. THAT'S GOING TO GO A
LONG WAY TO. ADDRESS OTHER
ISSUES WHETHER IT BE EYE
GLASSES AND ALL OF THESE TYPE
OF THINGS BUT ONE OF THE THINGS
THAT. WE HAVE A VERY PUNISHING.
KIND OF SOCIETY WHEN IT COMES
TO BEHAVIOR BY CHILDREN AND WE
JUST HAD A BILL YESTERDAY. I
BELIEVE ON THE FLOOR A FEW DAYS
AGO. ABOUT NOT EXPELLING OR
SUSPENDING KIDS UNDER FIVE I
THINK IT WAS AND- YOU KNOW THAT
WE EVEN GO THERE IN THE FIRST
PLACE FOR KID THAT ARE FOUR
AND FIVE. IT JUST SEEMS
OUTRAGEOUS I REACH FOR MY OWN
KIDS AND YOU KNOW ALONG WITH
ALL THE STUDENTS THAT I'VE HAD
AND YES YOU CAN GET FRUSTRATED
ALL BUT THERE'S SO MANY THINGS
YOU CAN DO. BUT AGAIN I'D BE
HAPPY TO WORK AT SOME POINT
BECAUSE I MEAN KIDS GET BUT YOU
KNOW WHETHER IT'S SUSPENDED OR
THEY GO TO DETENTION ALL THESE
THINGS WE HEARD DECADES AGO
THEY'RE STILL DOING SO IF YOU.
IF YOU PUT A STUDENT AND
DETENTION AND THEY'RE SITTING
THERE FOR AN HOUR OR WHATEVER
AMOUNT OF TIME. AND THEY'RE NOT
DOING ANYTHING HOW IS THAT
PRODUCTIVE SO ARE THERE WAYS TO
BRING IN UP. INNOVATIVE
PRACTICES WHETHER THEY BE YOGA
OR OR VARIOUS TYPE OF
ACTIVITIES THAT YES THERE
REMOVED. BUT THEY'RE NOT PUNISH
WHERE IT JUST BECOMES WELL WHY
DO I EVEN CARE I WORKED IN A-
JUNIOR HIGH WHERE I WAS DOING A
LUNCH PROGRAM AND IT WAS KIND
OF DETENTION STUFF BUT I
THOUGHT I'M NOT GOING TO DO
THAT. I'M GONNA CREATE LIKE WE
CALLED IT A LUNCH BUNCH IN AND
BROUGHT IN SPEAKERS AND THINGS
LIKE THAT. AND I ASKED THE KIDS
WHO KINDA REPEATEDLY CAME.
WHICH THEY'RE USUALLY THE SAME
KIDS AND THE KIDS FROM
KINDERGARTEN AND THEY SAID I
DON'T CARE. YOU KNOW I SO WILL
YOU KNOW SOMETHING ABOUT THAT.
BUT I DON'T CARE WHY SHOULD
EVEN BE HERE BECAUSE THEY
ALREADY HAD. IN THEIR MINDS OF
FELT THAT THEY WERE JUST NOT
CONNECTED NOT ENGAGED SO WITH
THAT I WOULD LOVE TO SEE AND I
SAY SUPERINTENDENTS AND
PRINCIPALS. BECAUSE YES YOU CAN
TALK TO THE TEACHERS BUT THE
PRINCIPALS AND SUPERINTENDENTS
ARE THE ONES THAT IMPLEMENT THE
POLICY. AND MAKE IT A PRIORITY
SO IF SOMEBODY WANTS TO COME TO
CAMPUS AND TALK ABOUT SOME NEW
INNOVATION IF THEY CAN'T EVEN
GET IN THE DOOR. THERE IT IS
IT'S GOING TO GO NO WHERE AND
SO THOSE ARE SOME PARTNERSHIPS
THAT I THINK THAT COULD BE
REALLY HUGE TELEHEALTH I HAD A
BILL LAST YEAR. TO START TO SET
THE STAGE FOR TELEHEALTH IN
PUBLIC SCHOOLS NOW I GOT SIGNED
BUT I DON'T KNOW IF IT'S-
ANYTHING IS HAPPENING SO THAT'S
ANOTHER. QUESTION BUT BECAUSE
OF ALL THE ACTIVE SHOOTING ALL
THESE TYPE OF THINGS STUDENTS A
LOT OF TIMES CAMPUSES WILL SAY
WELL WE'RE BRINGING
PROFESSIONALS ON THE CAMPUS
LIKE. THE DAY AFTER THE WEEK
AFTER AND YOU KNOW YOU MAY HAVE
TEN STUDENTS THAT GO MAYBE OF A
HUNDRED BUT IT'S IMMEDIATELY
AFTER. AND WE KNOW THAT A LOT
OF THESE ISSUES THAT KIND OF
SUSTAIN FROM DRAMATIC EVENTS.
CAN SHOW UP SIX MONTHS LATER A
YEAR LATER SO THAT AYE
TELEHEALTH. THEY COULD IF THEY
FOR FEELING ANXIETY COULD GO
LOG IN AT SCHOOL. HAVE SOME
TYPE OF ADMINISTRATOR BUT THAT
YOU HAVE A TELE HEALTH PERSN
RIGHT THERE. SO I APPRECIATE
THAT. LAST YEAR AT TWO YEARS
AGO THE COMMISSION. IT SHOULD
AN RFP TO SEE THAT USING SB
EIGHTY TO TRIAGE FUNDS SAYING
THAT COUNTY WOULD BE ELIGIBLE
TO THE FOR THESE FUNDS BUT YOU
HAVE TO HAVE A SCHOOL PARTNER.
AND ABOUT 30% ABOUT A THIRD OF
THE COUNTIES RESPONDED I MEAN
MANY CALLED AND SAID THAT LOVE
TO DO THIS BUT I DON'T HAVE THE
CAPACITY. I THINK THERE IS
TREMENDOUS RECOGNITION ON THE
PART OF THE COUNTIES IN THE
SCHOOLS THAT WE NEED TO DO
THIS. THE CHALLENGE AND THINK
THIS GETS BACK TO THE QUESTION
THAT THAT WITH RAISED EARLIER
THERE ARE BEST PRACTICES ALL
AROUND THE STATE OF CALIFORNIA.
BUT THEY'RE IN POCKETS. RIGHT
THERE ARE COUNTIES THAT HAVE
BEEN PARTNERING WITH THEIR
SCHOOLS ALAMEDA COUNTY FOR
YEARS. THEY THROUGH PREVENTION
AND INTERVENTION STRATEGIES I
HAVE YET TO TALK TO A COUNTY
HIS RAISED AN ISSUE WHERE WE
HAVEN'T BEEN ABLE TO FIND
SOMEONE WHO HAS THOUGHT ABOUT
THAT SAME ISSUE OVER TIME AND
IS AND IS EITHER DOING
SOMETHING NOW THAT THEY FIND TO
BE VERY EFFECTIVE OR IS TRYING
SOMETHING NOW. SO WE SEE THIS
TREMENDOUS WILLINGNESS IT'S
JUST VERY DIFFICULT TO GET
THOSE PRACTICES OUT OF THE YOU
KNOW THE BOUTIQUE BOX RIGHT
THAT THE MENDOCINO MIRACLE AND
SPREAD THEM AND IT'S VERY
DIFFICULT TO DO THAT SORT OF
INDEPENDENT THIRD PARTY
ANALYSIS OF IS IT ACTUALLY
WORKING AND WHY DOES IT WORK.
AND TO DO THAT IN A WAY. THAT
WITHIN SHAPE THE OTHER COUNTIES
BUT WE'RE VERY OPTIMISTIC
BECAUSE THERE'S- A RICHNESS OF.
LEADERSHIP AT THE COUNTY LEVEL
AND IN OUR STATE AGENCIES
THERE'S A RICHNESS OF RESOURCES
AS YOU TALKED ABOUT IN TERMS OF
THE M. HSA. AND TODAY MORE THAN
EVER BEFORE THERE'S A RENEWED
COMMITMENT TO TACKLE SOME OF
THESE CHALLENGES. IT'S NOT EASY
IT'S ACTUALLY VERY VERY
DIFFICULT MOSTLY FOR
LONGSTANDING CULTURAL ISSUES OF
WE DON'T TO DO THIS AND THEN
THESE OTHER ISSUES LIKE
INADEQUATE WORK FORCE BARRIERS
TO ACCESSING DATA. NO DOLLARS
FOR TA OR VERY LIMITED TO I
SHOULD SAY VERY LIMITED DOLLARS
FOR TECHNICAL ASSISTANCE BUT I
THINK CALIFORNIA HAS THE
OPPORTUNITY TO ADDRESS ALL OF
THOSE ISSUES. THANK YOU AND I
THINK BEFORE WE SELECTED FOR A
MOVE ON TO OUR SECOND PANEL
WILL TAKE ONE MORE QUESTION
FROM MS CREA. THANK YOU MADAM
CHAIR MISTER CHAIR FOR
CONVENING THIS HEARING. I ALONG
SIDE SENATOR BELL ARE ACTUALLY
THE LEGISLATIVE. MEMBERS THAT
SIT ON THE MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION AND I
WANT TO THANK MISTER HEALING.
FOR ALL THE WORK THAT HE AND
HIS TEAM DUE TO ENSURE THAT WE
ARE MOVING FORWARD IN OUR
MENTAL HEALTH. ABILITIES TO
SERVICE THE STATE AND FOR YOUR
SPONSORSHIP FOR A. B. FORTY SIX
WHICH AIMS THAT WHICH WAS
SIGNED BY THE GOVERNOR JUST
RECENTLY IT'S A BILL THAT I
AUTHORED. THAT AIMS TO CHANGE
THE LANGUAGE THAT WE USE
TOWARDS MENTAL HEALTH THAT PUTS
THE INDIVIDUAL FIRST VERSES.
THE MENTAL ISSUE OR MENTAL
DISABILITY THAT THEY MAY BE
FACING. I WANT TO SHARE JUST AN
EXPERIENCE THAT I'VE HAD AT THE
LOCAL LEVEL. THE CITY OF LOS
ANGELES FIRE DEPARTMENT
CONVENED A SERIES OF OPEN
HOUSES IN THE DISTRICT THAT
MYSELF AND OUR CHIEF OF STAFF.
ATTENDED WE WENT TO SEVERAL
FIRE HOUSES AND ASSEMBLY
DISTRICT FIFTY ONE. AND THE
NUMBER ONE ISSUE THAT CAME UP
FOR FIRST RESPONDERS WAS THEIR
ABILITY TO MANAGE. A CRISIS IN
OUR CITY WHEN IT COMES TO
HOMELESSNESS WHEN IT COMES TO
ISSUES OF MENTAL HEALTH. WHEN
IT COMES TO THEIR ABILITY TO.
DO THE WORK THAT THEY HAVE BEEN
TRAINED. AND WANT TO DO VERSUS
THE WORK OF. MENTAL HEALTH
CAPACITY ON THE GROUND AND SO
THE NUMBER ONE THING THAT CAME
UP IN ALL OF THESE DIFFERENT
FIRE HOUSES THAT WE VISITED WAS
THE LACK OF RESOURCES WE NEED
TO THE POINT OF HOW DOES THE
COUNTY AND AGENCIES AND
DEPARTMENTS WORK TOGETHER. TO
ENSURE THAT THE FOLKS THAT ARE
ON THE GROUND THAT ARE THE
FIRST ONES TO DO THE ONE ON ONE
CONTACT HAVE THE RESOURCES THAT
THEY NEED TO BE ABLE TO DO
THEIR JOB EFFECTIVELY. THAT WAS
VERY EYE OPENING FOR ME BECAUSE
FIRST RESPONDERS PARAMEDICS
FIREFIGHTERS ARE ARE TRAINED TO
DO A VERY SPECIFIC JOB. AND
WHAT THE PRICES THAT WERE
FACING ONTHE GROUND. IT'S HARD
FOR THEM TO DO SO. SO WHILE AND
I SAY THIS SPECIFICALLY TO THE
CITY OF LOS ANGELES SKID ROW IN
PARTICULAR WHICH IS JUST
ADJACENT TO MY DISTRICT. THE
INCREASE OF PEOPLE THAT ARE
COMING INTO THE STATE OF
CALIFORNIA WHO ARE NON
CALIFORNIANS WHO ARE SEEKING
SERVICES HERE IN OUR STATE. AND
THIS WAS REPEATED TO ME OVER
AND OVER. TAKE A BUS OR HAVE A
ONE WAY TICKET FROM THE STATE'S
AT THEIR FROM. TO COME TO
CALIFORNIA OFTENTIMES LANDING
IN DOWNTOWN LOS ANGELES. WHERE
THE WE HAVE FORTUNATELY IN THE
COUNTY A GREAT PROGRAMS TO
ASSIST PEOPLE BUT BE INFLOW IN
THE AMOUNT OF FOLKS THAT ARE
COMING IN. OUT WE DON'T HAVE
THE RESOURCES TO MANAGE THAT
AND IT'S CREATED. A CRISIS
THAT'S MORE THAN JUST ABOUT THE
PEOPLE THAT ARE IN THE CITY OF
LOS ANGELES AND I WOULD EXPECT
ACROSS THE STATE OF CALIFORNIA.
THAT IT'S ABOUT PEOPLE ALSO
COMING INTO OUR STATE FOR
SERVICES AND SO IT'S A MUCH
BROADER CONVERSATION ABOUT
WHERE THE FUNDING IS GOING AND
HOW THE COUNTY IS MANAGING IT.
HOW THEY'RE WORKING WITH
AGENCIES AND DEPARTMENTS ACROSS
DIFFERENT REGIONS TO MAKE SURE
THAT THE FOLKS THAT ARE
ACTUALLY DOING THE WORK
FIRSTHAND HAVE THE RESOURCES
NECESSARY AND I PUT THAT. OUT
THERE BECAUSE I WOULD ENCOURAGE
EVERY MEMBER OF THE LEGISLATURE
TO MEET WITH FIRST RESPONDERS
TO ME WITH THEIR LOS ANGELES
THEIR FIRE DEPARTMENTS AS WELL
AS THEIR POLICE DEPARTMENTS TO
MAKE SURE THAT. THEY'RE HEARING
FROM PEOPLE THAT ACTUALLY DO
THE WORK ON THE GROUND THAT'S
BEYOND THE DEPARTMENTS BUT
REALLY THE FOLKS THAT ARE
TRYING TO MANAGE THIS CRISIS.
THANK YOU. IN TOKYO. AND WITH
THAT THANK YOU AGAIN TO OUR
PANELISTS WILL GO AHEAD IN OUR
WORK NOT THE PARTICIPANTS FOR
OUR SECOND PANEL. WHICH WILL
FOCUS ON. THE STATE AND COUNTY
OVERSIGHT ACCOUNTABILITY AND
FUTURE DIRECTION AS MUCH AS AN
HSA FUNDING. VIEWING IS GOING
TO CONTINUE TO JOIN US AND THAT
WE COULD GO AHEAD AND HAVE OUR
OTHER PANELISTS HE'S GOT AN
INCREASED INTRODUCE YOURSELVES
THANKS. GOOD MORNING JENNIFER
CAN DIRECTOR FOR THE DEPARTMENT
OF HEALTH CARE SERVICES. THE
MORNING BRENDA GRAY ALICIA
ASSISTANT DEPUTY FOR BEHAVIOR
HEALTH BEACH YES GOOD MORNING
DOCTOR ANNIKA KELLY BEHAVIOR
HEALTH DIRECTOR SAN BERNARDINO
COUNTY. GOOD MORNING MICHELLE
COVERED AT EXECUTIVE DIRECTOR
FOR THE COUNTY BEHAVIORAL
HEALTH DIRECTORS ASSOCIATION OF
CALIFORNIA. THANK YOU FOR
JOINING US THIS MORNING THEY
WILL GO AHEAD AND KICK OFF WITH
DH CS THANKS. SO I THINK I IN
RESPONSE TO THE STAFF QUESTIONS
AN OVERALL AGENDA WANTED TO
PROVIDE A LITTLE BIT MORE
DETAIL TO WHAT THE LA RD
REFERENCED IN TERMS OF THE
AUDIT AND SOME OF THE WORK THAT
WE HAVE DONE AS A DEPARTMENT TO
IMPROVE BOTH THE OVERSIGHT AS
WELL AS THE ACCOUNTABILITY. AT
THE MHSAA FUNDS. FIRST WANTED
TO JUST ALSO STRESS THAT YOU
KNOW TO THE- QUESTIONS THAT
WERE ASKED IN THE PREVIOUS
PANEL AROUND. YOU KNOW IS AN
HSA EITHER WORKING OR IS IT IS
IT WORKING WELL I THINK WHAT WE
WOULD SAY AND WHAT WE STRONGLY
BELIEVE IS THAT IT. UNLIKE
OTHER STATES IS ONE OF THE MOST
UNIQUE. PARTS ABOUT CALIFORNIA
FROM THE STANDPOINT THAT WHEN
EITHER. HOLES ARE PROBLEMS ARE
IDENTIFIED I THINK WE TYPICALLY
AS A STATE STEP IN WITH A
UNIQUE SET OF SOLUTIONS. I
THINK THERE IS NO OTHER STATE
THAT HAS SEPARATE AND UNIQUE
AND CERTAINLY NOT AS A
SUBSTANTIAL A FUNDING SOURCE AS
WHAT THEY MAY JUST SAY IS AND
SO. YOU KNOW TO THE EXTENT THAT
IT DID NOT EXIST I THINK WE
WOULD BE IN AN EVEN WORSE
POSITION AS A STATE IN TERMS
OF. THE VITAL SERVICES AN
ADDITIONAL REVENUE THAT IT
BRINGS TO THE OVERALL SAFETY
NET. SO REALLY WANTED TO JUST
KIND OF LAY THAT OUT IN TERMS
OF HOW WE VIEW THE FUND AND ITS
OVERALL CONTRIBUTION TO THE
PUBLIC HEALTH. SYSTEM THAT WE
SUPPORT AS A DEPARTMENT OVERALL
NOT JUST MENTAL HEALTH SERVICES
BUT ALSO THE OVERALL SAFETY NET
THAT IS. COMPRISED IN OF THIS
FUNDS. SO WITH THE AUDIT THERE
WERE SEVERAL RECOMMENDATIONS
THE FIRST ONE WAS THAT WE
NEEDED TO DEVELOP A FORMAL AN
HSA FISCAL REVERSION PROCESS.
WE DEVELOP THIS THROUGH A
COUPLE OF INFORMATION NOTICES.
AND THEN SUBSEQUENTLY HAVE
SUBMITTED FISCAL REGULATIONS TO
THE OFFICE OF ADMINISTRATIVE
LAW. BUT THAT REVERSION PROCESS
AS WAS TALKED ABOUT IN THE
FIRST PANEL. WE RE OUT REVERTED
AND REALLOCATED APPROXIMATELY
FOUR HUNDRED AND ONE MILLION
DOLLARS TO THE COUNTIES. AS
REQUIRED UNDER AB ONE FOURTEEN.
THE BIGGEST OF. COMPLIMENTS OF
THAT REVERSION REALLOCATION
WERE IN THE P. E. I. FUNDS AND
THE INNOVATION FUNDS AT SUPPORT
AT THE CSS FUND IS THE ONE THAT
IS THE BULK OF THE IMAGE IS A
FUNDS THAT GO TO THE COUNTY IS.
DIRECTLY FOR SERVICES AND THOSE
ARE THE FUNDS THAT WE
CONSISTENTLY SEE USED
SUBSTANTIVELY AND NOT NOT A LOT
IS SUBJECT TO REVISION IN THAT
AREA AND SO JUST WANTING TO
ALSO STRESS. THAT THE FOR THE
FUNDS THEMSELVES ARE BEING USED
FOR SERVICES WITHIN THE TIME
FRAME THAT THE COUNTIES HAVE TO
SPEND THOSE FUNDS AND SO WANTED
TO MAKE SURE THAT YOU
UNDERSTOOD THAT AS IT PERTAINS
TO BOTH REVERSION AND
REALLOCATION. AFTER TWENTY
FIFTEEN AND TWENTY SIXTEEN WE
HAVE STARTED REVERTING FUNDS
THAT WERE NOT SPENT OR DID NOT
HAVE A PLAN BY THE COUNTIES TO
SPEND THOSE BY JULY FIRST. DATE
THIS HAS TOTALED. EIGHT MILLION
DOLLARS AND REFLECT UNSPENT. IN
TWO AND FIVE AND TWENTY
FOURTEEN FIFTEEN SO AGAIN EIGHT
MILLION DOLLARS OVER MULTIPLE
YEARS WITH FUNDS THAT HAVE
RANGE YOU KNOW IN TERMS OF THE
TOTAL OVERALL. ALLOCATION OF
THE ACT IN THE YOU KNOW IT ANY
THINK THE LOWEST IN THE ROAD
AND THE RECESSION WAS SOMEWHERE
IN THE SEVEN TO EIGHT HUNDRED
MILLION DOLLARS. AND THEN NOW
YOU AS WE NOTED WERE UP OVER
TWO BILLION DOLLARS IN
REVENUES. WE HAVE ALSO ISSUED
REVERSION NOTICES TO THE
COUNTIES THAT'S APPROXIMATELY
EIGHT POINT SIX MILLION DOLLARS
FOR COUNTIES WITH A POPULATION
OF TWO HUNDRED THOUSAND PEOPLE
OR MORE THAT HAVEN'T SPENT THE
MONEY AND THEY'RE SUBJECT TO
REVERSION AND SO. YOU KNOW
AGAIN THE LARGEST AMOUNT THAT
HAS BEEN BOTH REPORTED IN
REALLOCATED TO THE COUNTIES IS
FOUR HUNDRED MILLION SOME OF
THEM HAVE OBVIOUSLY SUBMITTED
PLANS TO THE AWAY SEE FOR USING
THOSE INNOVATION FUNDS. AND
THEN VERY VERY SMALL AMOUNTS
BOTH REMITTED AND OR REVERTED
BACK TO THE COUNTIES AND THOSE
ARE EIGHT MILLION AN EIGHT
POINT SIX MILLION SO JUST WANT
TO. I WANT TO JUST NOTE THAT IN
TERMS OF I THINK THAT'S A
FAIRLY GOOD INDICATOR OF HOW
THIS HOW THE FUNDS ARE BEING
USE. THE AUDIT HAD ALSO ASKED
THAT WE CLARIFY THAT THE
INTEREST EARNED ON AND SPENT AN
HSA FUNDS WAS SUBJECT TO
REVERSION AND SO WE DID THAT
THROUGH BOTH AN INFORMATION
NOTICE AND INCLUDED IT. IN THE
FISCAL REGULATIONS PACKAGE SO
THAT HAS BEEN DONE. THE THIRD
RECOMMENDATION THAT WE NEEDED
TO ESTABLISH AND ENFORCE
UPROOTED RESERVE LEVEL. AND SO
WE HAVE DONE THAT WE INITIALLY
SET THAT AS THROUGH AN
INFORMATION NOTICING THAT IT
WAS SET AT THIRTY THREE
PERCENT. OF THE LARGEST
DISTRIBUTION TO THE COUNTY FROM
THE IMAGE AS A FUND IN THE
FISCAL YEAR. AND THEN
SUBSEQUENTLY YOU THE
LEGISLATURE I CHANGE THAT W.
NIGHT CODE TO SAY THAT. THE
PRUDENT RESERVE COULD NOT
EXCEED 33% OF THE AVERAGE CSS
REVENUE RECEIVED IN THE PRIOR
FIVE YEARS AND SO WE CHANGE
THAT THROUGH A SEPARATE
SUBSEQUENT INFORMATION NOTICE.
AND THEN WE HAVE ALSO ADDRESS
THAT AND THE REGULATIONS THAT
WERE FILED WITH THE A. L. THE
AUDITOR HAD NOTED. A TWO
HUNDRED AND TWENTY FIVE MILLION
DOLLAR FUND BALANCE AND THE
MHSAA FUND AS PART OF THE AUDIT
THAT FROM A STATE FISCAL
PERSPECTIVE IS ALMOST LIKE
SAYING YOU HAVE AN OPEN LINE OF
CREDIT BUT WITH NO CREDIT
CHARGED TO THE ACCOUNT AND SO
WE WORKED WITH THE DEPARTMENT
OF FINANCE AND THE
COMPTROLLER'S OFFICE TO MAKE
SURE THAT THAT ACCOUNT WAS A
DIDN'T HAVE ANY CASH IN IT AND
THEN BE HAS SUBSEQUENTLY BEEN
CLOSED AND I THINK THAT WAS
ALSO. SOME OF THE- AFTER
EFFECTS OF MOVING THE
DEPARTMENT OF MENTAL HEALTH THE
COMMUNITY PORTION OF THE
DEPARTMENT OF MENTAL HEALTH
INTO THE DEPARTMENT OF HEALTH
CARE SERVICES. SO THERE WAS
PROBABLY SOME HISTORICAL CLEAN
UP THAT JUST HADN'T BEEN
ACCOUNTED FOR SO WE APPRECIATED
THE AUDITOR. BRINGING THAT TO
OUR ATTENTION. AS NOTED AS- WE
WERE. ASKED TO SUBMIT YOU KNOW
FISCAL REGULATIONS AND
IMPLEMENT A WITH WHOLE PROCESS
FOR COUNTIES THAT WERE OUT OF
COMPLIANCE WITH SUBMITTING
REPORTS. SO JUST RECALL
COUNTIES HAVE TO SUBMIT ANNUAL
REVENUE AND EXPENDITURE REPORTS
TO US AND SOME. OF THOSE HAD
NOT BEEN DONE EITHER IN QUITE
SOME TIME OR WERE QUITE
DELAYED. WE IMPLEMENTED A WITH
WHOLE PROCESS BACK IN SEPTEMBER
OF TWENTY EIGHTEEN. SO FOR ANY
COUNTY THAT DOES NOT SUBMIT
THEIR ARI ARE ON TIME WE
WITHHOLD TWENTY FIVE PERCENT.
OF THEIR MHSAA ALLOCATION UNTIL
SUCH TIME AS THOSE ARI OURS ARE
SUBMITTED TO US. WE DON'T HAVE
A 100% COMPLIANCE BUT WE ARE
AND WE HAVE SEEN. EXTRAORDINARY
AMOUNT OF RESPONSE FROM THE
COUNTIES AND SO THERE ARE VERY
FEW COUNTIES THAT ARE STILL ON
A WITH HOLD FOR. FAILURE TO
SUBMIT ARI OURS AND WE HAVE
BEEN IN COMMUNICATION WITH. THE
COUNTIES AS WELL AS THE
ASSOCIATION TO TRY TO ENSURE
THAT THAT COUNTIES ARE
COMPLYING WITH THAT AND THEN
ONCE THEY DO FILED ARI OURS WE
RELEASE THOSE FUNDS AND SO. ONE
COUNTY FILED MULTIPLE YEARS AND
WE FINALLY REVERTED THOSE FUNDS
LAST MONTH. WE WERE ASKED TO
ESTABLISH A PROCESS FOR
CONDUCTING COMPREHENSIVE
PROGRAM REVIEWS AND STARTING
THOSE REVIEWS ON THIS IS A
PLACE AND TIME OF THE AGENDA
THAT WE WOULD NOTE THAT WE CAME
TO THE LEGISLATURE ASTRA
RESOURCES TO DO THAT WORK AND
YOU RESPONDED YOU GAVE US
THIRTEEN POSITIONS TO DO BOTH
FISCAL AND PROGRAMMATIC
OVERSIGHT AND SO THOSE PROGRAM
REVIEWS HAVE STARTED WE DID THE
FIRST ROUND OF THOSE WE DID FOR
COUNTIES IN THE SUMMER AND FALL
OF TWENTY EIGHTEEN AND THEN WE
ARE ON TRACK TO DO
COMPREHENSIVE PROGRAM REVIEWS
FOR UP TO TWENTY IN THE FISCAL
YEAR. SO BECAUSE THERE'S FIFTY
EIGHT COUNTIES WERE NOT ABLE TO
GET TO THEM EVERY STEP ALL OF
THEM AT THE SAME TIME AND SO WE
PUT THEM THROUGH A ROTATING
BASIS FROM JANUARY OF TWENTY
NINETEEN THROUGH JUNE OF THIS
THIS JUST TWO MONTHS AGO WE DID
COMPREHENSIVE PROGRAM REVIEWS
FOR NAPA SAN LUIS OBISPO MAYOR
OPPOSE A LOS ANGELES IMPERIAL
GLENN KERN ALPINE SKIER
RIVERSIDE AND SISKIYOU SOME OF
THOSE COUNTIES RECEIVED
FINDINGS SO WHEN WE DO THESE
COMPREHENSIVE PROGRAM REVIEWS
WERE LOOKING AT A SERIES OF
EITHER PROGRAM AREAS ARE POLICY
AREAS AND SIMILAR TO HOW WE
WOULD DO AN AUDIT AND MEDI CAL
WE WILL ISSUE LIKE AN AUDIT
FINDING AND SAY THERE'S A
CORRECTIVE ACTION PLAN THAT'S
NEEDED AND SO. WE HAVE DONE
THAT WITH SOME OF THESE
COUNTIES AND SO WE WILL BE
POSTING BOTH THE PROGRAM REVIEW
AS WELL AS ANY OF ROTH THE
RESPONSES FROM THE COUNTIES BUT
I THINK OVERALL AND WE HAVE NOT
NOTED ANY SIGNIFICANT FINDINGS.
WHEN WE TALK ABOUT SOME OF THE
THINGS THAT HAVE CONTINUE TO
CHALLENGE THE COUNTIES ARE THE
THINGS THAT WERE SEEN
CONSISTENTLY IN THE PROGRAM
VIEWS AND I THINK THIS ALSO
HELPS DETERMINE. THE AREAS IN
WHICH WE TRY TO PROVIDE
ADDITIONAL TECHNICAL ASSISTANCE.
SOME OF THE NARRATIVE AROUND
WHAT THE COUNTIES ARE DOING IN
TERMS OF YOU KNOW I WOULD AND I
SHOULD STEP BACK AND JUST
REMIND. THE COMMITTEE THE
COUNTIES THEMSELVES WHEN THEY
SET OUT EITHER PROGRAMS OR
INITIATIVES THAT THEY WANT TO
FUND WITH THEIR IMAGES TO SEE
AN HSA FUNDS. THEY HAVE TO GO
THROUGH A LOCAL PLANNING
PROCESS AND OBVIOUSLY GOING
THROUGH LOCAL PLANNING PROCESS
IF SOME OF YOU HAVE BEEN EITHER
BOARDS OF SUPERVISORS OR CITY
COUNCIL YOU CAN APPRECIATE THAT
SOMETIMES THAT IS A LITTLE BIT
LONGER. AND SO THE LOCAL
PLANNING PROCESS I THINK IT HAS
DEFINITELY BEEN NOTED AS
SOMETHING THAT IS SUCCESSFUL
THE BOARDS OF SUPERVISORS ALL
COMPLY WITH THE WAY IN WHICH
THOSE FUNDS ARE. EITHER
DEVELOPS DETERMINED OR PROGRAMS
AT A LOCAL LEVEL BUT WHAT WE
HAVE NOTED ISSOMETIMES THE
NARRATIVE AROUND WHAT IS
REPORTED TO US IS NOT ALWAYS AS
FULLY. ENCOMPASSING AS WE WOULD
LIKE IT TO BE JUST BECAUSE IT'S
HARD TO SEE WHAT HAS BEEN
EITHER APPROVED OR INCLUDED IN
IN THE LOCAL PLAN AND SO SOME
OF THOSE HAVE COME UP IN IN THE
COUNTRY. COMPREHENSIVE PROGRAM
REVIEWS. I WOULD SAY ALSO THAT.
THERE HAVE BEEN AS LACK OF
CONSISTENCY AND HOW THEY BOTH A
DOCUMENT THEIR PROGRAMS AND
WHAT THEY NAMED THEM SO WHEN
YOU TRY TO MATCH UP A LOCALLY
APPROVED PLAN AND THEN YOU TRY
TO MATCH IT UP TO ITS ANNUAL
EXPENDITURE REPORT SOMETIMES
THEY DON'T MATCH AND SO WE'VE
HAD TO GO BACK AND WORK WITH
THE COUNTY IS JUST TO MAKE SURE
THAT WHEN THEY ARE DOING THOSE
TWO DOCUMENTS THAT WE CAN LINK
THEM UP AND THINK THAT'S NOT
NECESSARILY. A BIG THING IT'S
JUST YOU KNOW THEIR THREE YEAR
PLANS AND SO IF STAFF CHANGES
OR SOMETHING HAPPENS THOSE TEND
TO BE A LITTLE BIT MORE
DIFFICULT TO TRACK AND THEN
LASTLY SOME OF THE ISSUES THAT
WE NOTED IN SMALLER COUNTIES IS
THAT YOU HAVE TO EXPAND 51%
MORE THAN 51% OF YOUR P. I.
FUNDS TO INDIVIDUALS TWENTY
FIVE OR YEARS OR YOUNGER. IN
SOME COUNTIES NOT LOS ANGELES
BUT PERHAPS IN SOME OF A DOCTOR
WOODS COUNTIES THERE'S ACTUALLY
NOT THAT BIG OF A POPULATION
UNDER THE AGE OF TWENTY FIVE IN
ORDER FOR YOU TO DO SOMETHING
THAT AREA AND SO THAT'S BEEN
SOME OF THE FEEDBACK THAT WE'VE
HEARD FROM THE RURAL COUNTIES.
THE SUCCESS AS I NOTED IN THE
PROGRAM REVIEWS IS THAT
COUNTIES HAVE BEEN CIRCULATING
THEIR THREE YEAR PLAN AN ANNUAL
UPDATE FOR PUBLIC REVIEW AND
COMMENT. ON THE BOARDS OF
SUPERVISORS ARE ACTIVELY
ENGAGED IN APPROVING THOSE
PLANS. IN FULL SERVICE
PARTNERSHIPS COUNTIES HAVE BEEN
DESIGNATING A PERSONAL SERVICE
COORDINATOR CASE MANAGER FOR
EVERY SINGLE CLIENT AS
REQUIRED. SO THAT IS SOMETHING
THAT IS OBVIOUSLY BOTH
IMPORTANT CRITICAL TO THE
SUCCESS OF THAT. MOST COUNTIES
ARE PROVIDING FULL SERVICE
PARTNERSHIP SERVICES TO ALL AGE
GROUPS. AND WHAT WE ARE NOTING
IS THAT THEY'VE BEEN VERY FEW
TREATMENT PLAN ISSUES
IDENTIFIED WHEN WE GO IN AND
LOOK AT THE TREATMENT PLANS
THAT HAVE BEEN DEVELOPED. IN
MEANING THAT THE CLIENT IS
PARTICIPATING IN THE OVERALL
DEVELOPMENT OF THEIR- PLAN AS
WELL AS ARTICULATING GOALS AND
THEIR DOCUMENTING. HOW THE
CLAIM IS PROGRESSING IN THOSE
GOALS AND THE RESILIENCY IN
PERSONAL SERVICE COORDINATOR IS
OBVIOUSLY SHOWN TO BE WORKING
WITH THAT CLIENT. AND THEN
OBVIOUSLY ONE OF THE OTHER
SUCCESSES THAT WE ARE HEARTENED
BY IS THAT SOME. NOT NOT ALL
BUT SOME COUNTIES ARE OFFERING
HOUSING SUPPORT IN SOME FORM.
YOU KNOW OUTSIDE OF AN HSA. WE
AT THE- STATE DEPARTMENT OF
HEALTH CARE SERVICES IN THE
MEDICAL PROGRAM THROUGH A WHOLE
PERSON CARE. HAVE BEEN
PROVIDING HOUSING SUPPORT. TO
MEDI CAL BENEFICIARIES I THINK
THAT IS HELP TO AUGMENT SOME OF
THE WORK AND THE FUNDING THAT
HAS BEEN. DONE AND PERFORM
THROUGH EMIT AN HSA AND SO I
THINK YOU KNOW WHEN YOU STEP
BACK AND LOOK AT ALL THE
DIFFERENT FUND SOURCES. AND
WHAT IS BEEN DRIVEN DOWN AT THE
COUNTY LEVEL IN TERMS OF
RESPONSIBILITY AND
ACCOUNTABILITY. YOU KNOW TO A
DOCTOR WOODS EARLIER COMMENT
AROUND IT'S BEEN A LOT AND THE
RESPONSIBILITY IS SIGNIFICANT.
I THINK WE ARE COMMITTED TO
WORKING CLOSELY WITH THE
COUNTIES AND HOW THEY ACHIEVE.
ALL OF THOSE DIFFERENT BOTH
COMPLIANCE ISSUES AS WELL AS-
OVERALL GOALS TOWARDS CERTAIN
INDIVIDUALS WITH BOTH. MENTAL
HEALTH AND SUBSTANCE USE
DISORDER SO. I'M HAPPY TO. STOP
THERE AND TAKE QUESTIONS BUT
CERTAINLY WANTED TO APPRECIATE
THE OPPORTUNITY TO COME AND
TALK TO YOU ABOUT WHAT WE'VE
DONE IT WHAT WE FEEL IS BEEN.
YOU KNOW A PRETTY GOOD RESPONSE
TO THE AUDITOR'S REPORT WE
CERTAINLY ACKNOWLEDGE THE
IMPORTANT WORK OF THE AUDITOR
TO. CALL THOSE ISSUES OUT FOR
US TO. THE THANK YOU AND AS YOU
SAID AS THE LA HAD HAD NEEDED
AS WELL SOUNDS LIKE YOU'VE MADE
YOUR- HUGE STRIDES IN
TREMENDOUS PROGRESS IN
ADDRESSING THE- LARGELY KIND OF
ADMINISTRATIVE ISSUES AS
IDENTIFIED BY THE AUDIT. THAT
DOESN'T IN THAT IS A REALLY
GOOD AT THE HEART AS- IS THIS
STUFF WORKING. IS THE MONEY
HAVING IMPACTED WANTED TO HAVE
AND I GUESS MY QUESTION IS WHO
EITHER ON YOUR TEAM ELSEWHERE.
WAKES UP EVERY MORNING AND GO
TO BED BED EVERY NIGHT THINKING
ABOUT THAT. WELL I WOULD SAY
THAT THERE'S A NUMBER OF
INDIVIDUALS IN THE DEPARTMENT
THAT PROBABLY GO TO SLEEP
THINKING ABOUT IT AND PROBABLY
WAKE UP IN THE MIDDLE OF THE
NIGHT I'M LOOKING AT. A LOT SHE
SENDS ME EMAILS IN THE MIDDLE
OF THE NIGHT. I THINK THAT. IT
HAS BEEN A REALLY LONG ROAD
FROM. I CAN RECALL. YOU KNOW
I'VE I'VE DONE HEALTH CARE FOR
A NUMBER OF YEARS AND THE TIMES
IN WHICH MENTAL HEALTH OR
SUBSTANCE USE DISORDER WAS
BROUGHT UP. WHEN I FIRST
STARTED WORKING IN THIS AREA
WAS HARDLY EVER AND EVEN WITH
THE PASSAGE OF THE AFFORDABLE
CARE ACT IT WAS KIND OF NOTED
AS THERE'S THIS. THERE'S THIS
ITEM ON THE TENNIS INTO HEALTH
BENEFITS THAT SOMEHOW INDICATES
THAT WE SHOULD BE THINKING
ABOUT THIS BUT- REALLY THE
OPPORTUNITY FOR US TO REDESIGN.
OUR SYSTEM AND WE THINK AND
SYSTEMS RIGHT. MOST IMPORTANTLY
IS HOW DO WE SUPPORT. COUNTIES
BROADLY RATE WITH FINANCING
DIRECTION AND TECHNICAL
ASSISTANCE BUT UNDERLYING ALL
OF THOSE BIG SYSTEM THOUGHTS
ARE A DEEP ABIDING PASSION FOR
THE INDIVIDUAL PEOPLE THAT ARE
STRUGGLING IN THOSE COUNTIES
AND COMMUNITIES AND I KNOW SO
AS DR. MISS QUIRK SILVA
INDICATED ALL OF US HAVE FAMILY
MEMBERS THAT HAVE OF FAMILY
FRIENDS OURSELVES HAVE ISSUES
WITH MENTAL ILLNESS AND I THINK
THAT'S WHAT DRIVES A LOT OF
PEOPLE IN OUR DEPARTMENT. I'M
NOT JUST IN THE DIVISIONS THAT
ARE PRIMARILY RESPONSIBLE FOR
MENTAL HEALTH BUT ACROSS THE-
THE DIFFERENT AREAS. WE HAVE A
NEW DEPUTY DIRECTOR FOR
BEHAVIORAL HEALTH THAT I
STARTED AS I THINK WE'RE ON
WEEK THREE SHE'S ACTUALLY DONE
THAT OUR STD CONFERENCE. RIGHT
NOW AND SO WE LOOK FORWARD TO
INTRODUCING YOU TO DR KELLY
PFEIFFER AND SHE'LL BE WORKING
WITH BRENDA MOST DIRECTLY ON A
LOT OF THE ISSUES AROUND
BEHAVIORAL HEALTH. PROBABLY
READ IT WE HAVE. WE HAVE
REORGANIZED OUR DEPARTMENT AND
TAKEN AWAY ANY KIND OF MENTAL
HEALTH VERSUS SUBSTANCE USE
DIVISION REFERENCE AND WE HAVE
COMBINED THEM INTO BEHAVIORAL
HEALTH. DIVISION BUT I THINK
THAT IS ALSO. WE SIGNIFICANT
IMPORTANT FOR US AS A
DEPARTMENTS TO INDICATE THAT A
LOT OF INDIVIDUALS THAT ARE
HAVING A SUBSTANCE USE.
DISORDER PROBLEM ALSO HAVE A
MENTAL HEALTH PROBLEM OR FOR SO
AND THE IMPORTANCE IN THE LAW
WHICH OF THE TWO. SPECIAL LOOK
AT LARGER SOCIETAL ISSUES SUCH
AS LISTENERS. SO. IT'S ONE
THING TO SAY WORKING AS A TO
SAY IT GETTING BETTER AND I
WOULD SAY THAT IT'S BOTH. IT IS
WORKING FROM THE STANDPOINT
THAT WE KNOW THAT THE FUNDING
IS A CRITICAL COMPONENT TO WHAT
THE COUNTIES ARE DOING. WE ARE
IN THE PROCESS OF BOTH CREATING
THE SYSTEMS THAT ACCOUNT FOR
THOSE OUTCOMES THERE HAVE NOT
TRADITIONALLY BEEN A LOT OF
MEASUREMENT. PIECES THAT YOU
COULD ACTUALLY SAVE IS SOMEONE
BETTER OFF TODAY THAN THEY WERE
TWO OR THREE YEARS AGO AND IF
YOU'RE USING JUST VERY. BASIC
DATA IT MAY NOT TELL YOU THE
FULL ACCOUNTING OF IT AND YOU
KNOW A CLASSIC EXAMPLE WHEN I
FIRST STARTED THE DEPARTMENT
THERE IS A LOT OF ATTENTION
AROUND. CHILDREN IN FOSTER CARE
THAT WERE RECEIVING
PSYCHOTROPIC MEDICATIONS AND
MORE IMPORTANTLY THAT WERE
RECEIVING ONE OR MORE ANTI
PSYCHOTICS. AND THE LARGE
QUESTION FOR US IS THE
DEPARTMENT ALONG WITH SOCIAL
SERVICES AND THE COURTS. AND
THE COUNTY CHILD WELFARE
AGENCIES WAS. ARE THESE
CHILDREN BEING MEDICATED
APPROPRIATELY AND ALL OF US HAD
TO LOOK AT EACH OTHER AND SAY
WELL WE'RE NOT QUITE SURE. AND
THERE WAS A REALLY SIGNIFICANT
EFFORT AROUND DATA MATCHING AND
SHARING OF INFORMATION. AND
WHEN WE WERE ABLE TO PUT THOSE
PIECES TOGETHER AND THEN LOOK
AT MEASURES AROUND THE
APPROPRIATE USE OF AND
MANAGEMENT OF THOSE
MEDICATIONS. WHAT WE WERE ABLE
TO SEE FROM THE DATA IS THAT
CHILDREN IN FOSTER CARE
ACTUALLY WERE HAVING BOTH
BETTER OUTCOMES. AND HAVING
BETTER MANAGEMENT OF THOSE
DRUGS THAN CHILDREN LARGER MORE
LARGELY TREATED IN THE MEDICAL
PROGRAM. SO IT'S YOU KNOW IT'S
BOTH AN INTERESTING DATA
EXERCISE BUT IT'S ALSO
IMPORTANT TOOLS FOR US TO
UNDERSTAND WHAT HAPPENED IN OUR
LARGER PROGRAM. SO TO YOU FOR
YOUR QUESTION SAYING DOES THIS
WORK IT'S ONE OF THOSE THINGS
WHERE IT'S LIKE WILL. WE HAVE
TO KIND OF DECIDE YOU KNOW WHAT
IS IT THAT WE WANT TO MEASURE
WHAT DO WE CONSIDER TO BE
SUCCESS AND ARE WE ON A PATH TO
GET IN THERE AND I THINK THE
ANSWER IS STILL YET TO BE
FULLY. BOTH DETERMINED ANSWERED.
SO WE ARE IN THE PROCESS AS. I
IS BUILDING A FRAMEWORK TO
EVALUATE THE EFFICACY OF OUR
INVESTMENTS IS THAT I WOULD SAY
THE SOPHISTICATION AROUND THE
DATA THE SOPHISTICATION AROUND
THE USE OF. EVIDENCE BASED
PROGRAMS THAT HAVE BEEN SHOWN
TO WORK ALL OF THAT IS EVOLVING
THE FIELD ITSELF I THINK IS
ALSO EVOLVING THERE'S
INCREASING SOPHISTICATION
AROUND. THE USE OF DIFFERENT
TYPES OF PROFESSIONALS TO HELP
MANAGE POPULATIONS I KNOW THAT
THERE'S BEEN A LOT OF
CONVERSATION IN THE LEGISLATURE
THIS YEAR ROUND PEER COUNSELORS
SO SIMILAR TO PROMOTE TORTOISE
AND THE MANAGED THE MET AT
MEDICAL SIDE OF HELPING YOU
KNOW SPECIFIC POPULATIONS I
THINK THAT THERE'S A LOT OF
OPPORTUNITIES FOR US TO DO A
LOT OF REALLY GOOD WORK AND THE
BEHAVIORAL HEALTH OF SPACE. AND
WE ARE BOTH ENGAGED IN THAT
WORK BUT ALSO UNDERSTANDING
THAT'S A LONG IT'S A LONG AND
EVOLUTION AND IT TAKES A NUMBER
OF CONSISTENT YEARS OF BOTH
FUNDING AN EFFORT TO GET TO GET
FURTHER DOWN THE LINE. THANK
YOU I'M THE MAN IN THE INTEREST
OF TIME WILL LOOK AT IT AND
UPDATING FROM OUR COUNTY FOLKS
AND THEN COME BACK TO A- DH CS.
GREAT THANK YOU SO MUCH GOOD
MORNING CHAIRS AND MEMBERS
MICHELLE CABINET WITH THE
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION OF
CALIFORNIA. I JUST WANT TO
START OFF BY THINKING BOTH THE
LEGISLATURE'S WELL AS DH CS AND
THE OAC FOR ALL OF THE PROGRESS
THAT WE BELIEVE WE'VE MADE A
SINCE THE AUDIT IN HELPING TO
REMEDY. BUT SOME OF THE ISSUES
THAT WERE FLAGGED BY THAT THE
AUDIT I'M HERE TODAY ON BEHALF
OF OUR FIGHT FIFTY NINE COUNTY
AND LOCAL MENTAL HEALTH
AGENCIES RESPONSIBLE FOR THE
LOCAL DISTRIBUTION OF THE
MENTAL HEALTH SERVICES ACT
FUNDING AND I'M JOINED. ON
TODAY'S PANEL BY DR VERONICA
KELLY ARE SAMBAR NAY DINO OF
BEHAVIORAL HEALTH DIRECTOR WHO
WILL SPEAK MUCH MUCH MORE.
ELOQUENTLY AND FROM THE GROUND
ON HOW HOW THE EXPERIENCES OF
MANAGING AN HSA FUNDS MY
COMMENTS TODAY ARE CENTERED
AROUND THE VOLATILITY OF THE
IMAGES SAY AS A REVENUE SOURCE
FOR LOCAL MENTAL HEALTH PLANS.
AND HOW THIS IMPACTS OUR LEVELS
OF UNSPENT FUNDS IMPROVEMENTS
AS WELL AS ON GOING CHALLENGES
ASSOCIATED WITH OUR INNOVATION
FUND EXPENDITURES. AND THEN THE
OVERSIGHT OF THE IMAGE TO SAY
FROM THE COUNTY PERSPECTIVE
SINCE LAST YEAR'S AUDIT. AND I
WILL HAVE A FEW SUGGESTIONS ON
HOW WE CAN STRENGTHEN BOTH A
RELATIONSHIP WITH OUR TO
REGULATORS AS WELL AS- PROGRAM
OVERSIGHT. SO ON THAT THEY
HISTORY IN THE VOLATILITY I
THINK IT'S HELPFUL FOR US TO
LOOK BACK A BIT AND RECALL
THAT. THE VOTER APPROVED
MILLIONAIRES TAX TO FUND
BEHAVIOR OF PROGRAMS OR MENTAL
HEALTH PROGRAMS CAME JUST AT
THE RIGHT TIME. WE GOT OUR
FIRST DISBURSEMENTS IN TWO
THOUSAND FIVE SIX WHICH WAS.
JUST OVER A YEAR YEAR AND A
HALF BEFORE THE GREAT RECESSION
HIT CALIFORNIA AT THE END OF
TWO THOUSAND SEVEN. AND THAT
POINT MHSAA RESERVE REVENUES
ARE MUCH LOWER THAN THEY ARE
TODAY. I THINK WE WERE STARTED
OUT OR TWO AND- THEN AND THEY
WERE ALSO THE FIRST FIVE YEARS.
OF ANY SIGNIFICANT ME. WHICH IN
THOSE YEARS TO USE THE M. HSA
TO HELP US ABSORB THE IMPACTS
OF THE BUDGET RECESSION. AND IN
ADDITION IT SWEPT UP CLOSE TO A
BILLION DOLLARS AN HSA REVENUES
INTO THE GENERAL FUND TO HELP
WITH OVERALL BUDGET STABILITY.
THESE ARE SORT OF HISTORIC
ACTIONS BUT I THINK THEY ALSO
SPEAK TO KIND OF WHAT WE WERE
EXPERIENCING. IN THOSE EARLY
YEARS OF LIFTING UP THE MHSAA
AND WHY IT IS THAT THE IMAGES
SAY LOOKS THE WAY IT DOES
TODAY. IN THE ROLE THAT IT
PLAYS IN OUR OVERALL BEHAVIORAL
HEALTH SAFETY NET AND DELIVERY
SYSTEM FOR US OVERALL IT. YOU
KNOW THE IMAGES SAYS ABOUT 20%
OF THE OF THE STATE'S
INVESTMENTS IN PUBLIC
BEHAVIORAL HEALTH SERVICES FOR
COUNTIES IT'S ABOUT A QUARTER.
A TWO DAY OF WHAT WE SPEND AND
I THINK IT'S IMPORTANT TO NOTE
TO THAT. ONE OF THE REASONS WHY
I THINK FOLKS CONSIDER COUNTY
BEHAVIORAL HEALTH CONFUSING OR
COMPLICATED. IS BECAUSE WE ARE
NOT. JUST SERVING ONE
POPULATION SO YOU KNOW UNLIKE
MEDI CAL WORDS THAT YOU KNOW
MEDI CAL THE BENEFICIARIES
UNDER CERTAIN YOU KNOW. INCOME
THRESHOLD COUNTIES RECEIVE
REALIGNMENT DOLLARS AS WELL AS
GRANTS AND ME TO SAY FUNDS TO
SERVE A VARIETY OF POP
POPULATIONS DEPENDING ON THE
FUNDING STREAM SO WE HAVE
RESPONSIBILITY YES FOR THE
MEDIC HOW POPPY. XIN THAT HAS A
SERIOUS MENTAL ILLNESS AND
SUBSTANCE USE DISORDERS. BUT WE
ALSO HAVE RESPONSIBILITY FOR
INDIVIDUALS WHO ARE IN CRISS
REGARDLESS OF THEIR PAY YOUR
SOURCE RIGHT SO YOU COULD HAVE
BE A PRIVATELY INSURED
INDIVIDUAL. WHO GETS ON A FIFTY
ONE FIFTY HOLDER NEEDS
CONSERVATORSHIP AND WE ARE
SUPPORT SERVICES. IF YOU'RE IN
SALES WE ARE SUPPORTING THIS
SERVICES AND. SO IT'S EIGHT IT
GETS A LITTLE CONFUSED. SO IT'S
IT IT'S COMPLICATED IN THAT WAY
I THINK OTHERWISE YOU KNOW OF
THE QUARTER THE BULK OF OUR
FUNDING OBVIOUSLY COMES THROUGH
MEDI CAL AND THAT IS OUR CORE
POPULATION. NEAR ME TO SAY IS
CRITICAL BOTH TO OUR MEDIC
HEALTH SERVICES IT BRINGS IN
CLOSE TO. A BILLION DOLLARS IN
FEDERAL FINANCIAL PARTICIPATION
IT'S ALSO CRITICAL TO BE
INFRASTRUCTURE FOR ARE CRISIS
CONTINUE HIMSELF IT'S REALLY AT
AND DR KELLY WILL SPEAK MORE TO
THAT. SO AS WE TURN THE CORNER
AND START TO COME OUT OF THE
GREAT RECESSION IN CALIFORNIA
COUNTIES EXPERIENCED OTHER
SIGNIFICANT CHANGES THAT I
THINK ARE IMPORTANT AND IMPACT
THE MHSAA EVOLUTION THE FIRST
ONE IS TWENTY ELEVEN
REALIGNMENT WHERE WE BRING WITH
IT. OUR RESPONSIBILITY FOR ALL
CHILDREN AND PUTTING UP THE OF
NON FEDERAL SHARE FOR OUR
CHILDREN IN MEDI CAL THROUGH
EPS D. T. THE NEXT ONE IS THE
IMPLEMENTATION OF THE
AFFORDABLE CARE ACT WHICH
OTHERS HAVE NOTED TODAY. THIS
BOTH INCREASES THE NUMBER OF
MEDI CAL ELIGIBLES IN OUR
SYSTEM AND ALSO THE NON FEDERAL
SHARE AND YOU'LL SEE FROM THE
LA OWES GRAPH THAT THE NOT THE
FEDERAL. PORTION OF FUNDING
THAT COMES INTO OUR SYSTEM HAS
INCREASED SIGNIFICANTLY AND WE
WOULD SAY THAT THAT'S A GOOD
THING WE ALSO EXPERIENCED TO
THE CONSOLIDATION A MENTAL
HEALTH UNDER THE DEPARTMENT OF
HEALTH CARE SERVICES IN THE
ELIMINATION OF WHAT USED TO BE
THE DEPARTMENT OF MENTAL
HEALTH. ON TOP WITH THESE
CHANGES SINCE THE GREAT
RECESSION IN CALIFORNIA ARE AN
HSA REVENUES ALONE HAVE MORE
THAN DOUBLED SO. DH CS HAS AND
ALONG WITH THE LEGISLATURE
IMPLEMENTED IN IN THIS PAST
YEAR A 33% CAP ON OUR PRUDENT
RESERVES IN TERMS OF ALL THAT
THE NEW MONEY THAT WE'RE
GETTING IN. AND YOU KNOW WE
WANT TO NOTE THAT IN ADDITION
TO THAT 33% TOP THE DEPARTMENT
HAS ALSO PROPOSED THROUGH THE
REGULATIONS THAT ARE IN PROCESS
RIGHT NOW A MINIMUM RESERVE
LEVEL OF TWENTY THREE PERCENT.
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION ACTUALLY
COMMENTED TO THE DEPARTMENT
THAT WE DO NOT THINK THAT
HAVING THE MINIMUMS 23% IS A
GOOD IDEA ALONG WITH THE
MAXIMUM 33% AND THE REASON IS
WITH THE VOLATILITY OF THIS
REVENUE SOURCE THE UPS AND THE
DOWNS. IT'S GOING TO BE REALLY
HARD. THE FISCAL MANAGEMENT
STANDPOINT TO FIGURE OUT THAT
10% SWEET SPOT FROM HERE TO
HERE AND SORT OF MAINTAIN
WITHIN THAT AND THEN ON TOP OF
THAT WHEN WE DO HIT THE NEXT
RECESSION WE ARE CONCERNED
ABOUT OUR ABILITY. TO REACH
INTO THOSE RESERVES TO SUSTAIN
PROGRAMS ON AN ONGOING BASIS IF
WE'RE REQUIRED AT THAT POINT TO
MAINTAIN THAT 23% LOWER AMOUNT
AS WELL. SO THAT'S ONE THING I
WANTED TO KNOW IN TERMS OF SOME
OF THE NEW WAYS THAT THE STATE
HAS BEEN TRYING TO ADDRESS THE
AUDIT FINDINGS. WE HAVE NOT YET
TESTED THE THIRTY 3% MAXIMUM
RESERVE LEVEL AND WE WILL FIND
OUT IN OUR NEXT ECONOMIC
DOWNTURN HOW THAT WORKS FOR US
BUT I CAN SAY THAT YOU KNOW WE
HAVE CONCERNS ABOUT OUR ABILITY
TO AGAIN. MAINTAIN CORE
PROGRAMS WHEN WE WHEN WE GET
INTO A RECESSION AND YOU KNOW
THE CHALLENGE FOR US AS OTHERS
HAVE NOTED IS WE MUST ENGAGE
OUR LOCAL STAKEHOLDERS WE THINK
THAT THAT'S A REALLY VALUABLE
AND IMPORTANT PART OF THE WAY
THAT WE RUN OUR PROGRAMS. AND
SO YOU KNOW WE WANT TO MAKE
SURE THAT EVERYBODY'S ON BOARD
WITH WITH HOW WE'RE GOING TO
SEE IF SEE THROUGHT OUT MORE
CHALLENGING TIMES AND TODAY. IN
ADDITION TO THE PROPOSED
REGULATIONS FROM THE STATE THIS
YEAR COUNTIES AS DCS NOTED HAVE
BEEN RECEIVING ADDITIONAL
INFORMATIONAL NOTICES TO
PROVIDE CLARIFICATION AND
GUIDANCE. OUR MEMBERS HAVE ALSO
REPORTED TO US ABOUT THE AUDITS
THAT ARE BEING DONE IN SEVERAL
COUNTIES STARTING AT THE END OF
LAST YEAR ONE OF THE THINGS
THAT WE WOULD KNOWN IS THAT
FROM OUR PERSPECTIVE THESE
AUDITS ARE ABOUT COMPLIANCE
WITH OUR SPENDING RULES AND
THAT. YOU KNOW. WE HAVE THE
STATE AUDITOR FOUND THAT WHEN
THEY LOOKED AT THE THREE
COUNTIES IN THE AUDIT COUNTIES
WERE GENERALLY DOING A GOOD JOB
OF MONITORING AND OVERSIGHT OF
THEIR EXPENDITURES. ARE MEMBERS
WOULD LIKE TO SEE MORE
COLLABORATION BETWEEN THE TWO
REGULATORS AS WELL AS COUNTIES
TO HELP US FIGURE OUT WHICH
PROGRAMS ARE MOST EFFECTIVE AND
THAT REALLY GETS TO A LOT OF
WHAT WE'VE HEARD TODAY BOTH
FROM DH CS AS WELL AS THE AC. I
THINK IT SEEMS LIKE WE'RE ALL
ON THE SAME PAGE ABOUT WANTING
TO SEE MORE OF THAT ANALYSIS ON
WHAT'S WORKING AND WHAT'S NOT
AND WHAT WHAT COULD WE CONSIDER
COUNTY COUNTY TO COUNTY TO
SCALE UP. ONE OF THE THINGS
THAT I WANT AND NOTICE AND SORT
OF RECOGNIZE THE OAC FOR IS
THEIR NEW WORK ON SOME OF THIS
THESE DATA. MASH UPS THAT TOBY
WAS DESCRIBING IN PARTICULAR WE
REALLY LOVE TO THE DEPARTMENT
OF JUSTICE. FULL SERVICE
PARTNERSHIP DATA ANALYSIS IT
WAS ASTONISHING FOR US TO SEE
THAT FOR PEOPLE WITH HIGH
NUMBERS OF ARRESTS GOING
THROUGH FULL SERVICE
PARTNERSHIPS WHILE THEY WERE IN
THE FS P. THEIR ARREST RATE
WENT DOWN BY 69% AND FOLLOWING
EXIT. EXITING THE OFFICE P.
EITHER RACE PRESS RATES WENT
DOWN BY 64% I MEAN THAT IS IT A
TREMENDOUS RETURN ON IT YES MEN
AND I THINK WE'RE LOOKING AT
BEHAVIORAL HEALTH SYSTEMS WRIT
LARGE YOU KNOW OUR
COLLABORATIONS OUR PARTNERS AND
OUR INTEGRATION REALLY IS
ACROSS SO MANY DIFFERENT
SYSTEMS. OTHERS NOTED AGAIN
KELLY WILL SPEAK TO THAT. WITH
A LOT MORE GRANULAR PRETTY WELL.
THE STATE'S GUIDANCE ON PRUDENT
RESERVES HAS BEEN VIEWED AS
VERY HELPFUL TO WORK COUNTIES
THEY ALSO FELT THAT THEY WOULD
BENEFIT FROM CHITONS ON
OPERATIONAL RESERVES SO THIS IS
AN AREA. NOT RAISED BY THE
AUDITOR OR OR BY OTHERS TODAY
BUT THIS IS SOMETHING THAT THE
COUNTY IS BROUGHT TO US THAT
THEY THOUGHT WOULD BE REALLY
HELPFUL FOR US. THEY ALSO WOULD
LIKE TO ASK THAT OUR REGULATORS
CONSULT WITH US MORE IN
PROVIDING SOME OF THIS
GUIDANCE. AGAIN RIGHT NOW OUR
PRUDENT RESERVES CAN ONLY BE
USED IN A MAJOR STATEWIDE
ECONOMIC DOWNTURN AND SOME OF
OUR COUNTIES NOTED THAT WHEN WE
HAVE LOCAL EMERGENCIES OR
DISASTERS OR EVEN A LOCAL
ECONOMIC DOWNTURN THAT ISN'T
FELT THROUGHOUT THE STATE. THAT
THOSE ARE INSTANCES WHERE WE
SHOULD WE THINK BE ABLE TO
REACH AND TREVOR SERVICE AND
USE THOSE. ONE OF THE AREAS
WHERE SPENDING HAS BEEN MOST
DIFFICULT FOR US AS HAS BEEN
NOTED IS IN OUR INNOVATIONS
PROGRAMS. AND FROM OUR
PERSPECTIVE YOU KNOW THE
REASONS FOR THIS ARE MULTI FOLD
FIRST IT IT'S OBVIOUSLY MORE
CHALLENGING OVER TIME TO COME
UP WITH THE NEXT NEW INNOVATIVE
THING. YOU KNOW WITH THE AT THE
FURTHER WE GET ALONG AN MA TO
SAY THE MORE WE CAN LOOK BACK
AND SAY WELL SOMEBODY ALREADY
DID THAT OR THEY DID IT IN THIS
WAY OR THAT. SO THAT'S ONE
CHALLENGE AS HAS BEEN MENTIONED
SMALLER COUNTIES HAVE LACKEY
ADMINISTRATIVE OR STAFF
RESOURCES TO COME UP WITH SOME
OF THESE INNOVATION PROJECTS.
AND THEN TYPICALLY OVER THE
OVER THE PAST WE'D HAVE HAD
FIVE THREE TO FIVE YEAR
PLANNING CYCLES PLANNING
THROUGH IMPLEMENTATION CYCLES
AND IT YOU KNOW FOR ANYONE
WHO'S WORKED IN THE PRIVATE
SECTOR DONE RESEARCH AND- AND
DEVELOPMENT OR START UPS YOU
COULD UNDERSTAND THAT THREE TO
FIVE YEAR WINDOW TO GO FROM.
YOU KNOW START TO END IS REALLY
AGGRESSIVE AND YOU KNOW IT'S
NOT IT'S REALLY NOT IN LA ME
WITH WHAT THE PRIVATE SECTOR
WOULD DO SO WE ARE VERY
APPRECIATIVE TO OUR TO THE
LEGISLATURE TO THE AC AND OTHER
STAKEHOLDERS WHO WORKED WITH US
TO. WITHIN THE INNOVATIONS
PROJECTS ALLOW US TO A LITTLE
BIT MORE FLEXIBILITY ON
TIMELINE WE THINK THAT THIS IS
GOING TO DO A LOT TO HELP US
SEE THROUGH EVEN MORE AMBITIOUS
INNOVATION PROJECTS WHICH-
WHICH IS REALLY THE POINT
THERE. WE HAVE TRADITIONALLY
ALSO STRUGGLED WITH REALLY
SIMPLE. THINGS LIKE GETTING ON
THE CALENDAR IT THE OAC. SO YOU
KNOW IF ACCOUNTING SORT OF LEE
IN IN GIVING THE AC THE HEADS
UP THAT THEY WANT TO APPLY FOR
AN INNOVATION GRANT OR IF THEY
HAVEN'T GOTTEN ON THE CALENDAR
THEY COULD BE WAITING IN THE
QUEUE AND MISS THEIR
OPPORTUNITY AND THEY NEED TO
KIND OF GO RIGHT BACK TO THE
BEGINNING. WE WOULD LIKE TO
RECOGNIZE THAT THE OAC HAS BEEN
TREMENDOUS IN TRYING TO CORRECT
FOR SOME OF THOSE SIMPLE
ADMINISTRATIVE ISSUES. AND SO
YOU KNOW AS WE STREAMLINED THIS
WE HOPE TO SEE THOSE INNOVATION
FUNDS MOVING OUT OF THE DOOR
AND DOING SO IN A WAY THAT WE
WOULD ALL LIKE TO SEE. OUR
MEDIC HEALTH. YOU KNOW
LEVERAGING THROUGH THE AN HSA
IS INCREDIBLE YOU KNOW WE THINK
THAT IT'S COR TO ALL OF OUR
PROGRAMS AND YOU KNOW I'LL JUST
SORT OF JUMP PAST ALL THE
THINGS I WAS GOING TO SAY ABOUT
WHAT THE IMMEDIACY DOES TODAY
BECAUSE I THINK DR KELLY WILL
SPEAK TO THAT BETTER BUT YOU
KNOW WE DO THINK THAT WE NEED
TO BALANCE WHAT WE DO MOVING
FORWARD IN TERMS OF OUR
COMMUNITY VOICES THAT'S REALLY
THE CORE OF THE AN HSA IS SORT
OF BEING LOCALLY DRIVEN AND
COMMUNITY DRIVEN. WITH OUR OUR
FISCAL RESPONSIBILITY FOR
PUBLIC DOLLARS AND A REASONABLE
EXPECTATION THAT WE WILL SPEND
TO THESE FUNDS TIMELY AND IN A
WAY THAT REALLY HAS AN IMPACT
ON OUR COMMUNITIES AT THE SAME
TIME WE DO NEED TO RECOGNIZE A
THINK AS A BODY THAT THERE'S A
TON OF VOLATILITY IN THESE
REVENUE STREAMS THE UPS AND
DOWNS ARE REALLY HARD TO MANAGE
AROUND AND PREDICT AND SO WHEN
YOU START ONE THREE YEAR
PLANNING CYCLE YOU MIGHT
ACTUALLY END UP GETTING A LOT
MORE OR A LOT LESS THAN YOU
THINK YOU'RE GOING TO AS YOU GO
THROUGH THAT PERIOD. AND THAT'S
MADE PLANNING AROUND SOME OF
THESE THINGS FOR GOLD FOR SOME
OF OUR LARGER COUNTIES ARE
SMALLER COUNTIES DON'T SEEM TO
HAVE A PROBLEM WITH SPENDING
DOWN THERE HAVE YOU TO SAY
DOLLARS IT BY AND LARGE THEY'RE
THEY'RE THEY'RE SPENT BUT FOR
SOME OF OUR LARGER COUNTIES
THING AT MY CHURCH TO RECEIVE
AN HAVE HAD SIGNIFICANT SPENT
FUNDS ONE OF THE STRATEGY
THAT'S BEING LLOYD I THINK.
MAYBE MUCH TO THE CHAGRIN OF
COUNTY BOARDS SUPERVISING. THEY
ARE OVER SPENT RIGHT NOW. THERE
PROJECTS AND THEIR PLANS ARE
OVER WHAT THEY BELIEVE THEY'RE
GOING TO GET IN JUST SO THAT
THEY CAN TRY TO LEVEL OUT SOME
OF THOSE DIFFERENCES AND SO
THAT SPEAKS TO SOME OF THE
QUESTIONS EARLIER ABOUT HOW
WE'RE MANAGING WITH THE UNSPENT
FUNDS GREAT THANKYOU AND I WAS
ABLE TO SAY WE ARE AT NOON
WHICH IS AT THE OFFICIAL AND
FOR HEARING SO IF IT'S NUMBERS
TO NEED TO STEP OUT. COMPLETELY
UNDERSTAND BUT I WOULD LOVE TO
STAY AND LISTEN TO ADD DR KELLY
THANK YOU. THANK YOU SO A GOOD
AFTERNOON CHAIRS PETRIE-NORRIS
AND WOOD AND MEMBERS OF THE
COMMITTEE. I'M BONTA KELLY AND
THEY HAVE A HEALTH DIRECTOR FOR
SAN BERNARDINO COUNTY AND I
REALLY AM HERE TO BE THE LOCAL
COUNTY VOICE AS- SOMEONE WHO'S
ACTUALLY BEEN ON THE GROUND
PROVIDING THE SERVICES AND THEN
CONTINUES TO MONITOR THEM. I
ALSO WANT TO SPEAK TO OUR
PARTNERSHIP WITH THE DEPARTMENT
HEALTH CARE SERVICES IN THE
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. AS WELL AS THE
CHANGES THAT WE MAKE. ON A
DAILY BASIS THE LIVES OF THOSE
PEOPLE THAT WE SERVE. SO FIRST
RD MOUNT OUR PARTNERSHIP
COUNTIES CONSIDER OURSELVES TO
BE ACTIVE INVESTED PARTNERS
WITH DH CS AND THE AC. WE LOOK
FORWARD TO MORE PRODUCTIVE
COLLABORATIONS NOTICED NOTING
OF CHALLENGES EXT EXPERIENCE BY
OUR PARTNERS. AND THERE'S A LOT
OF TALK ABOUT THE ANNUAL
REVENUE EXPENDITURE REPORT THE
ARE ARE. AND PART OF THAT WE'VE
WORKED VERY HARD WITH OUR
PARTNERS AT DH CS. BECAUSE IN
ORDER TO COMPLETE THAT FORM YOU
HAVE TO COMPLETE YOUR COST
REPORT FORM THEY'RE BOTH DO THE
SAME DATE. SO YOU NEED TO HAVE
COMPLETED ONE FOLLOWING FISCAL
YEAR TO COMPLETE THE OTHER. AND
IN THE LAST FEW YEARS THERE HAS
BEEN SOME DIFFICULTY WITH THE
TEMPLATE ITSELF WHICH IS JUST A
VERY LOGISTICAL ISSUE BUT
IMPACTS EVERYBODY. AND SO WRONG
FORMULAS ON ON BOTH OF THOSE
FORMS BANK CONTRIBUTED TO US
NOT BEING ABLE TO MEET THE DATE
REQUIREMENTS. BUT WE WERE ABLE
TO WORK WITH DH CS. SO THAT WE
COULD COME A COMPLETE
ADJUSTMENTS IF WE NEED TO DO
THAT. THE DIFFICULTY IN THAT IS
THAT THEY ARE OUR DATA IS
PULLED FROM THE OAC PUT ON
THEIR DASHBOARD AND THOSE THAT
INFORMATION MIGHT NOT BE.
INCLUSIVE OF THE ADJUSTMENTS
BEING MADE AFTER THE MENTAL
HEALTH SERVICES ACT COST REPORT.
BUT WE DO APPRECIATE THE
RECENTLY ISSUED GUIDANCE AND
PROGRAMMING AND THE
RESPONSIVENESS I AM THE ABILITY
TO PROVIDE TECHNICAL ASSISTANCE
BY THE DEPARTMENT TO COUNTIES.
ARE COUNTY SAN BERNADINO JUST
WENT THROUGH OUR IMAGE AS A
REVIEW WE FOUND THE OUGHT THE
REVIEWERS TO BE VERY
KNOWLEDGEABLE AND VERY OPEN WE
JUST COMPLETED THAT'LL LAST
MONTH. WE ALSO IS COUNTIES
APPRECIATE OUR COLLABORATIVE
RELATIONSHIP WITH THE OVERSIGHT
ACCOUNTABILITY COMMISSION THEY
HAVE BEEN VERY OPEN AND
RECEIVING FEEDBACK REGARDING
THE INNOVATIONS PROCESS WE
APPRECIATE THE INTRODUCTION OF
THE CONSENT CALENDAR AS WELL AS
STAFF APPROVAL FOR FUNDS.
PROJECTS THAT ARE UNDER THE ONE
MILLION DOLLAR AMOUNT. FOR
IMPLEMENTATION OF THE MENTAL
HEALTH SERVICES ACT IN TWO
THOUSAND AND FIVE I WAS CHARGED
WITH THE COMMUNITY PLANNING
PROCESS AN ORANGE COUNTY. AND I
AT THAT POINT WE REALLY NOTICE
THAT THIS WAS A BRILLIANT PART
OF THE LEGISLATION. TO BEGIN TO
ENGAGE STAKEHOLDERS IN A
PROCESS WHERE WE ACTUALLY
TALKED OUT LOUD ABOUT MENTAL
HEALTH AND MENTAL ILLNESS
REALLY HELPED INCLUDE INCREASE
OUR EDUCATION. OF OUR
COMMUNITIES OURSELVES AND ALSO.
HELPED A DIS DECREASE STIGMA.
WE'VE BEEN DOING STAKEHOLDER
PROCESS SEES EVERY YEAR SOME OF
OUR COUNTIES TO IT MORE OFTEN
WE DO IT EVERY MONTH. FOR
FIFTEEN YEARS AND SO WHAT THAT
HAS AFFORDED US IS THE ABILITY
TO CREATE LONG TERM
RELATIONSHIPS THAT ALLOWS US TO
LEVERAGE THOSE RELATIONSHIPS
AND AS AS AS IMPORTANT FUNDING
FROM OUR PARTNERS AND
COMMUNITY. THAT INCLUDES OUR
SCHOOL DISTRICTS THAT INCLUDES
OUR LAW ENFORCEMENT PARTNERS
BOTH SHERIFF AND LOCAL. OTHER
FIRST RESPONDERS OUR HOSPITAL
SYSTEM OF CARE OUR FAITH BASED
ORGANIZATIONS ARE COMMUNITY
BASED ORGANIZATIONS. COUNTIES
WE REALLY DO SEE AN HSA LIKE
THE REBAR. THAT IS BENEATH THE
BRICKS WHEN YOU'RE BUILDING A
STRUCTURE IT HAS NOW BECOME THE
ACTUAL STRUCTURE ITSELF THAT
REALLY ONLY STRENGTHENS THE
MENTAL HEALTH SERVICES WE CAN
PROVIDE. AND SO JUST TO MOVE ON
TO HOW AN HSA IS WORKING. LET
ME JUST ALSO SAY THAT PRIOR TO
IN TWO THOUSAND NINE WE GO BACK
TEN YEARS IN MY COUNTY WE
SERVED THIRTY EIGHT THOUSAND ON
DUPLICATED CLIENTS A YEAR TODAY
WE SERVE OVER SIXTY THOUSAND ON
DUPLICATED CLIENTS A YEAR.
CERTAINLY THAT WAS WITH THE
ADVENT OF THE AFFORDABLE CARE
ACT BUT ALSO AN HSA AND ALSO
OUR CHANGING WORLD. AM I JUST A
HAS ALLOWED US TO EXPAND OUR
PUBLIC SERVICES HAVE TO RESPOND
TO VERY COMPLEX NEEDS. OF A
VERY DIVERSE POPULATION AND I'M
NOT JUST SPEAKING TO ETHNICITY
OR LANGUAGE ABOUT DIVERSITY I
MEAN. COUNTIES WHERE WE HAVE
RURAL URBAN AND FRONTIER AREAS
FROM THE LARGEST COUNTY IN THE
CONTIGUOUS UNITED STATES WITH
OVER TWENTY ONE THOUSAND SQUARE
MILES. I AM RESPONSIBLE FOR
FRONTIER AREAS. AS WELL AS VERY
POPULATED URBAN AREAS. I MIGHT
JUST SAY ALLOWS US TO GO BEYOND
OUR CURRENT BENEFIT STRUCTURE
ON BOTH THE PRIVATE AND THE
PUBLIC SIDE WHICH IS AN AMAZING
THING IT ADDS FLEXIBILITY FOR
SERVICE DELIVERY. IT ALLOWS
CREATIVITY AND INNOVATION THAT
ALLOWS US TO PROVIDE SERVICES
THAT RESEARCH TELLS US ARE
ESSENTIAL TO CHANGE THE
TRAJECTORY OF MENTAL ILLNESS.
BUT. SIMPLY ONE INDIVIDUAL
SESSION OR BY A PRESCRIPTION
PAD. THAT EXTRA THE IMAGE AS A
BRINGS ALLOWS US TO ATTEND TO
THE WHOLE PERSON AND NOT JUST
ONE PSYCHIATRIC EPISODE. FOR
EXAMPLE. YOLO COUNTY MATCHES
THEIR FIRST FIVE DOLLARS WITH
MHSAA AS NEEDED TO PROVIDE
DEVELOPMENTAL SCREENS TO
CHILDREN ZERO TO FIVE AND THE
FOLLOW UP SERVICES AS NEEDED IF
THE CHILDREN DON'T HAVE
INSURANCE OR IT'S NOT
CONSIDERED MEDICALLY NECESSARY.
IN NEVADA COUNTY THEY ALSO
LEVERAGE ARMATURE SAY WITH
THEIR SCHOOL PARTNERS TO
PROVIDE THERAPIST IN THE
SCHOOLS LEVERAGING MHSAA EPS D.
T. WHICH IS FULL SCOPE
CHILDREN'S MEDIC HOW THEY DRAW
DOWN FEDERAL FINANCIAL
PARTICIPATION. AND THEY GET THE
SCHOOL DISTRICT TO ANTE UP THAT
IS AN AMAZING COLLABORATIVE
THAT IS NOT POSSIBLE WITH OUR
REGULAR SYSTEM OF CARE. MON
COUNTY WHICH IS OF ANOTHER
SMALL COUNTY THIRTEEN THOUSAND
NINE HUNDRED FOLKS IN THIRTY
ONE HUNDRED SQUARE MILES. AND
THEY HAD AN ISSUE WITH ACCESS
TO SERVICES SO THEY UTILIZE
THEIR IMAGES A DOLLARS AND A C.
SACK ORDERED PROJECT. TO WORK
WITH THE BATON PAY YOU. NATIVE
TRIBE AND THEY HAVE A PRO
PROGRAM CALLED DINNER AND A
MOVIE BUT IT DOES INVOLVE
DINNER OR MOVIES SO AND JUST
ONE MAKE SURE THAT'S CLEAR.
WHERE IT REALLY IS ABOUT
OPENING COMMUNITY DIALOGUE AND
NOW THE TRIBAL ELDERS ARE THE
ONES WHO AND NEW SHAPE THE
DIALOGUE WITH NON NATIVE PEOPLE
AS WELL AS OUR OWN USE AND WHAT
THEY HAVE SEEN AS AN 85%
INCREASE. IN TREATMENT SEEKING
BY THIS POPULATION WHICH IS
AMAZING. KERN COUNTY AND LIKE
MANY OF OUR COUNTY IS HOW'S
THAT FOR A FULL SERVICE
PARTNERSHIP DEDICATED
SPECIFICALLY O OUR SENIOR
POPULATION CALLED WISE WELLNESS
INDEPENDENT SENIOR IN RICHMOND.
OUR SENIOR POPULATION CONTINUES
TO GROW AND WE CONTINUE TO
IGNORE IT AS A NATION THIS
ABILITY FOR THEM TO UTILIZE
IMAGE AS A DOLLARS TO LEVERAGE
MEDI CAL AND MEDICARE. IS.
IMPACTING THAT POPULATION IN A
VERY POSITIVE MANNER. AND THEN
OF COURSE THERE SAN BERNADINO
COUNTY WE'VE BUILT AN ENTIRE
CRISIS SYSTEM OF CARE UTILIZING
AN HSA DOLLARS WE STARTED IN
TWO THOUSAND AND SIX. CREATING
COMMUNITY CRISIS RESPONSE TEAMS
THAT INCLUDE CLINICIANS FOR
ADULTS CHILDREN ALCOHOL DRUG
COUNSELORS AND PEER NAVIGATORS
ALL FUNDED THROUGH AN HSA. THEY
GO OUT TO COMMUNITY AND RESPOND
TO ANY CRISIS AND I WILL TELL
YOU WE ARE AMAZING AT IT WHICH
IS HIGHLY UNFORTUNATE. WE HAD A
TEAM AND AN INFRASTRUCTURE IN
PLACE PRIOR TO OUR DECEMBER
SECOND TERRORIST ATTACK OUR C.
C. R. T. CRISIS RESPONSE TEAM
WAS WHO WAS INITIATED WHO WE
DEPLOYED. WHO FOR THE FIRST
FORTY EIGHT HOURS OF THAT EVENT
WE WERE ABLE TO THEN GET THREE
HUNDRED CLINICAL BOOTS ON THE
GROUND. IN PART BECAUSE OF THE
M. HSA WE THEN WERE UTILIZING
THAT KNOWLEDGE TO ASSIST WITH
THE LAS VEGAS SHOOTING IN WHICH
OUR COUNTY HAD SIX PEOPLE WHO
WERE SHOT AND ONE PERSON WHO
WAS MURDERED. TO PROVIDE CRISIS
INTERVENTION TWO FAMILIES TO
OUR COMMUNITIES. ANY FOLKS
WOULD ATTENDED THAT EVENT WE
WOULD NEVER HAVE BEEN ABLE TO
DO THAT WE WOULD NEVER HAVE
BEEN ABLE TO. IMPACT THE
TRAJECTORY OF CRISIS WITHOUT
MHSAA AND THEN MOST RECENTLY TO
A RIDGE CREST TRONA EARTHQUAKE
OF SIX POINT NINE AND SEVEN
POINT ONE. OUR CRISIS RESPONSE
TEAMS WERE THE FIRST OUT. AND
THEY WERE OUT THERE FOR FOUR
WEEKS. I IN A TOWN THAT HAD NO
WATER. AND ALL OF OUR BUILDINGS
EXCEPT OUR ONE COUNTY BUILDING
WAS RED TAGGED. WE HAVE THE
EXPERIENCE IN THAT BASED ON THE
MHS A BEING ABLE TO FUND THOSE
SERVICES. AND WE ADDED TO OUR
CRISIS SYSTEM OF CARE WE
LEVERAGE THE CHAFF A GRAND THE
CALIFORNIA HEALTH FACILITIES
AND FINANCING ASSOCIATION
FUNDS. FOR MENTAL HEALTH
WELLNESS UNDER SPD TWO. VIA THE
CALIFORNIA TREASURER'S OFFICE.
CAL SAMBAR YOU KNOW COUNTY WAS
AWARDED TWENTY TWO POINT TWO
MILLION DOLLARS WE LEVERAGE
TWENTY FOUR POINT FIVE MILLION
DOLLARS OF MHSAA. TO BUILD
FACILITIES PSYCHIATRIC
FACILITIES. FROM THE MOST
NORTHERN PART OF OUR COUNTY IN
THE TOWN OF NEEDLES WHICH WOULD
BE LAUGHLIN. THE ARIZONA NEVADA
CALIFORNIA BORDER IF YOU WERE
UP THERE HAVING A NICE SUMMER
VACATION WITH YOUR FAMILY AND
YOUR CHILD HAD A PSYCHIATRIC
BREAK OR YOU I'LL RAN OUT OF
YOUR MEDICATION AND HAD A
PSYCHIATRIC CRISIS. YOU WILL
DRIVE FIVE HOURS TO GET TO THE
FIRST LIKE BAD. OUR COUNTY IS
ABOUT LARGE AND WE HAVE NO
PSYCHIATRIC. HOSPITAL SERVICES
FROM THE TOWN OF VICTORVILLE ON
UP TO THE CALIFORNIA NEVADA
ARIZONA BORDER. SO WE WORKING
WITH OUR COMMUNITIES AND OUR
STAKEHOLDER PROCESS. BUILT SIX
FACILITIES FOR CRISIS A
RESIDENTIAL TREATMENT
FACILITIES AND TO CRISIS
STABILIZATION UNITS. WE HAVE
DONE THAT WAS IN THE HIGH
DESERT AND THE LOW DESERT AND
IN OUR CENTRAL PART OF OUR
COUNTY EACH CRISIS RESIDENTIAL
HAS SIXTEEN BEDS. WE ARE AT 98%
CAPACITY ALL THE TIME OUR C. S.
USE OUR CRISIS STABILIZATION
UNITS ARE LIKE AN URGENT CARE
WHERE YOU CAN GO AND RECEIVE
CARE FOR TWENTY THREE HOURS UP
TO TWENTY THREE HOURS WE HAVE
TWENTY BEDS IN EACH OF THOSE
FACILITIES. FOR DESIGNATED FOR
CHILDREN AND YOUTH IN EACH OF
THOSE FACILITIES. AND IN THE
SEVENTEEN MONTHS WE'VE BEEN
OPEN FOR ONE FACILITY I CAN
TELL YOU WE'VE DRAWN DOWN FOUR
MILLION DOLLARS AND FFE. IN ONE
FACILITY. WE HAVE ALSO AS AM
DIRECTOR EWING POINTS OUT WE
ARE REALLY INVESTED IN TELLING
OUR STORY AND I WILL BE THE
FIRST TO SAY COUNTIES DON'T DO
IT VERY WELL BECAUSE OUR BUSY.
THAT'S TRULY THE REASON BUT IF
WE'RE LOOKING AT OUR C. C. R.
T. R. I. I'M SORRY AT OUR
CRISIS RESIDENTIAL NOT CRISIS
STABILIZATION UNITS IN THE PAST
YEAR. WITH THOSE OF SIX
BASILIDES WE'VE REDUCED
HOSPITAL AT AM. M. ET
ADMISSIONS AND INPATIENT PSYCH
USE BY 52% WE HAVE DECREASED
LAW ENFORCEMENT INVOLVEMENT HI
TOUCH LOW TOUCH BY 33% WE'VE
INCREASED CLIENT PARTICIPATION
AND OUTPATIENT SERVICES AFTER
THE CRISIS AFTER DISCHARGE FROM
OUR PROGRAM BY 40% AND HAVE A
98% CLIENT AND FAMILY
SATISFACTION RATE. WE HAVE
LEVERAGE PREVENTION AND EARLY
INTERVENTION AND HAVE DONE SO
AS MANY COUNTIES HAVE FOR YEARS
BEFORE AN HSA P. E. I. IN
PARTICULAR ALLOWS US TO
INTERVENE EARLY. P. I. SPECIFIC
YOU CAN'T HAVE A DIAGNOSIS TO
USE P. E. I. FINDS AN EARLY
INTERVENTION MEANS THAT YOU'RE
INTERACTING WITH SOMEONE WHO
MIGHT HAVE A DIAGNOSIS IN THE
FIRST FIVE YEARS SO WE'VE BEEN
VERY FLEXIBLE AND CREATIVE WITH
THAT. WE WORK WITH OUR SCHOOL
SIMILAR TO YELLOW. IN DOING A
SCREENING ASSESSMENT AND
REFERRAL TO TREATMENT PROGRAM
AS WELL AS AN EARLY
IDENTIFICATION AND INTENSIVE
SERVICES PROGRAM. FOUR ZERO TO
FIVE FOLKS WE LEVERAGE FIRST
FIVE LOCAL MATCH P. E. I. LOCAL
MATCH FUNDING FROM A LOCAL
SALPA. DESERT MOUNTAIN SPECIAL
EDUCATION LOCAL PLANNING AREA
THEY USE THEIR ELLIE EIGHT
DOLLARS WE USE THE IP PST TEA
AND WE DRIVE DOWN A FIFTY SO WE
CAN MAKE THAT WORK NONE OF
THOSE SERVICES WOULD BE A
BILLABLE TO MEDIC COW. NOR
WOULD THEY BE TO COMMERCIAL
SERVICE TO COMMERCIAL
INSURANCE. AND IN THOSE
PROGRAMS WE SCREEN ALL OF OUR
KIDS USING THE ADVERSE
CHILDHOOD EVENTS SCREENING
TOOL. WHAT WE FOUND IS THAT 48%
OF THE CHILDREN WHO ARE
REFERRED FROM OUR PARTNER IN
THE SCHOOL. HAVING A SCORE OF
FOUR. THAT'S HIGH TWO IS HIGH.
THESE ARE FOR. AND ALTHOUGH WE
CANNOT CHANGE TRAUMA THAT'S
ALREADY OCCURRED WE DO USE THE
CHILD ADOLESCENT NEEDS SURVEY
TOOL TO MONITOR WE DO THAT AND
SIX MONTH INTERVALS AND POST
DISCHARGE FROM PROGRAM. AND WE
SAW THE RESILIENCY SCORES OF
THOSE CHILDREN INCREASED BY 78%
WE HAVE A LEVERAGE MHSAA TO
ASSIST IN OUR HOMELESS ISSUE
AN OUR COUNTY WE HAVE AN A
SYSTEM OF CARE THAT INCLUDES
OUR SHERIFF'S DEPARTMENT WHO DO
HOMELESS POLICING THEY DO IT IN
CONJUNCTION WITH OUR MENTAL
HEALTH SERVICES ACT FUNDED
STAFF WE RIDE ALONG TOGETHER.
INTO ENCAMPMENTS OUT INTO THE
MIDDLE OF THE MOJAVE DESERT
UNDERNEATH BRIDGES AND
OVERPASSES WE LEVERAGE ALL OF
OUR PARTNERS IN ORDER TO ATTEND
TO BEING ABLE TO SUPPORT
SOMEONE AND HOUSING IT IS NOT
ENOUGH I'M A SOCIAL WORKER BY
TRAINING IT'S NOT ENOUGH TO
GIVE SOMEONE A HOME. WE ARE
FOLKS NEED TO KNOW HOW TO STAY
IN THAT HOME THEY NEED SUPPORT
OF SERVICES TO DO SO WE ALSO
FIND ARE COORDINATED ENTRY
SYSTEM FOR THE HOMELESS THIS
ARE HOMELESS. PARTNERS THROUGH
AN HSA. LIKE MANY COUNTIES WE
ALSO FIND CRISIS INTERVENTION
TREATMENT WHICH IS EDUCATION TO
FIRST RESPONDERS AND LAW
ENFORCEMENT ON WHAT MENTAL
ILLNESS LOOKS LIKE AND HOW TO
INTERVENE IF THEY COME IN
CONTACT WITH SOMEONE WHO IS
EXPERIENCING A MENTAL ILLNESS.
IT IS A REQUIREMENT OF OUR
SHERIFF'S ACADEMY THE EVERYONE
WHO GOES THROUGH RECEIVES
THIRTY HOURS OF THAT ALL FUNDED
THROUGH AN HSA. WE OFFER THAT
COURSE AGAIN TO OUR FIRE TO C.
H. P. TO PROBATION. AND WE ALSO
FIND STRIKE TEAMS TO WORK WITH
OUR SHERIFF IN CUSTODY SO THAT
THEY CAN DO A WARM HAND OFF OF
FOLKS OR EXPERIENCE A SERIOUS
MENTAL ILLNESS AS THEY LEAVE.
THE JAIL SYSTEM SO THAT THEY
CAN THEN BE ENGAGED IN
OUTPATIENT SERVICES. AND NONE
OF THESE SERVICES WOULD BE
POSSIBLE WITHOUT THE MENTAL
HEALTH SERVICES ACT. AT LEAST
TO THE BREADTH AND DEPTH IN
WHICH WE WERE ABLE TO USE THEM
NOW. AS WELL AS THE ABILITY TO
LEVERAGE OUR RELATIONSHIPS
OTHER FUNDING SOURCES ARE
COUNTIES EXPERIENCE OUR
EXPERTISE AND OUR OUR PARTNER'S
RELATIONSHIPS. THIS MHSAA HAS
ALLOWED US AS A SYSTEM TO
INTERRUPT A TRAJECTORY OF A
PERSON'S MENTAL ILLNESS AND
THAT IS INVALUABLE. THANK YOU
VERY MUCH FOR YOUR ATTENTION.
THANK YOU INDICATE ALL OF OUR
PANELISTS AND I JUST OPEN IT UP
FOR ANY COMMENTS OR QUESTIONS
FROM COMMITTEE MEMBERS. MISS
SMITH. THANK YOU FOR THAT
REALLY THOROUGH AND IMPRESSIVE
TESTIMONY IT HELPS INFORM
PARTICULARLY AND MEMBERS LIKE
MYSELF WHO ARE NEW AND TO HOW
THESE RESOURCES ARE USE AND
VERY VERY INFORMATIVE BUT IN
PARTICULAR MISS CABRERA MISS
KAY KELLY YOU SPOKE ABOUT
CAPACITY IN BAND WITH WHEN IT
COMES TO CRISIS RESPONSE AND IN
ANOTHER COMMITTEE THAT I'M A
PART OF IT SOMETHING WE'VE
EXAMINED I'M SURE ARE ARE THERE
CHAIRMAN DOCTOR WOULD COULD
SPEAK TO WHAT HIS COMMUNITY
EXPERIENCED AND REALLY WANTING
TO BE MINDFUL OF THE NEED TO
RESPOND RAPIDLY TO EXPAND
RESOURCES TO MOBILIZE RESOURCES
BUT I THINK THE FACT THAT YOU
POINTED OUT THAT THE PRUDENT
RESERVE FUNDS ARE NOT
ACCESSIBLE FOR THAT. SO IF YOU
COULD SPEAK TO THAT MAYBE A
LITTLE BIT MORE ABOUT INCIDENTS
WHERE YOU KNOW OR COUNTIES THAT
MAYBE HAVE EXPERIENCED THIS AND
WHAT YOU. WOULD RECOMMEND THE
LEGISLATURE DO IN RESPONSE.
THANK YOU YEAH THE WAY THAT THE
ACT IS WRITTEN CURRENTLY WE CAN
REACH INTO THOSE PARDON
RESERVES FOR STATEWIDE EAT
ECONOMIC DOWNTURNS BUT OUR
COUNTY SO POINTED OUT THAT. IT
WOULD BE REALLY HELPFUL IF WE
COULD ALSO REACH AND FOR LOCAL
DISASTERS AND EMERGENCIES AND-
UP YOU KNOW JUST AN EXAMPLE OF
THIS IN AGAIN IN SOME OF OUR
SMALLER COUNTIES THEY DON'T
HAVE A PROBLEM OF UNSPENT M. H.
C. THEY ARE USING IT ALL. AND
SO IT YOU KNOW WHEN A LOCAL
DISASTER STRIKES ARE ONE OF THE
SMALLER COUNTIES THE ABILITY TO
USE WHAT IS NOW BEING SET UP
WHICH IS THE PRUDENT RESERVE
UNDER THERE CURRENTLY LEGAL
STRUCTURE WOULD BE REALLY
HELPFUL AND I DON'T KNOW IF YOU
WANTED TO AND I WOULD JUST SAY
THAT. WE ARE USING AN HSA FOR
THAT BUT IT'S OTHER COUNTIES
MHSAA SO THAT OUR COUNTY HAS
RESPONDED TO. CINEMA TO NOW BUT
TO BE YOU WE'VE GONE OUT WHEN
THE FIRES HAVE HAPPENED WE'VE
GONE TO OTHER STATES UTILIZING.
THE FUNDING HERE AND IT IS
OFTEN TIMES THERE IS ARE THERE
A FEDERAL AVENUES TO DO THIS
AND- THOSE ARE TIMELY THE FEDS
DON'T KNOW WHAT. THE CINEMA
COUNTY LOOKS LIKE THEY DON'T
KNOW WHAT PARADISE IS AND SO
THE ABILITY FOR US AS
BEHAVIORAL HEALTH DIRECTORS WE
REACH OUT ACTUALLY THAT'S HOW
WE DO IT WE THERE IS A
FORMALIZED PROCESS AND
UNFORTUNATELY SOMETIMES. THAT
TAKES TOO LONG SO WE'VE JUST
REACHED OUT CELLPHONE THE CELL
PHONE TO SAY CAN YOU DEPLOY A
TEAM HERE BECAUSE OFTEN TIMES
THE CRISIS IS IMPACTING THE
VERY PEOPLE WHO ARE SUPPOSED TO
BE PROVIDING CRISIS RESPONSE.
THANK YOU MADAM CHAIR THANK YOU
FOR THE GREAT DIALOGUE THAT
WE'RE HAVING AND- TO ATTEST TO
THE- HOW. THE PROCESS IS
WORKING THE RETURN ON THE MONEY
THIS COMING THROUGH THE STATE.
WAS ELOQUENTLY OF SPOKEN AS FAR
AS- THE DIFFERENT CRISIS
RESIDENTIAL AREAS IN CRISIS
STABILIZATION UNITS THAT ARE
THERE. AND JUST TO ADD TO THE
IMPORTANCE. OF LOCAL CRISIS
WHEN COUNTIES ARE ASKED TO.
BUILD THESE RESERVES BUT ONLY
BE ABLE TO USE THEM ON
STATEWIDE ECONOMIC FACTORS.
LOCAL ISSUES HAPPEN WE WERE ON
THE COUNTY BOARD OF SUPERVISORS
CHAIRMAN DURING DECEMBER
SECOND. AND THAT ALLOWED THE
CRISIS TEAM TO GET THERE
QUICKLY TO START TO GIVE THAT
NECESSARY. TREATMENT THAT
NEEDED TO BE DONE BUT IT ALSO
SHOWED. OTHER PARTS OF THE
STATE AND THE WILLING OF
RESOURCES TO BE SHARED WITHIN
SEMINAL COUNTY TO MAKE SURE
THAT. THOSE PROCESSES WERE
TAKING CARE OF AND YOU KNOW
THROUGHOUT THE STATE THE
DIFFERENT COUNTIES BEHAVIORAL
HEALTH DEPARTMENTS IT CAME TO
THAT AID SHOWS THE NETWORKING
AND HOW THE STATE CAN RESPOND
TO THOSE AREAS. ONE OF THE
THINGS YOU KNOW THE CRISIS
RESIDENTIAL AREAS WE TALK ABOUT
SAM YOU KNOW COUNTY HAS ALL THE
RURAL THE SUBURBAN AND URBAN
COMPONENTS OF SALMON YOU KNOW
COUNTY. AND TALKING ABOUT
NEEDLES AND HOW FAR YOU WOULD
HAVE TO DRIVE TO GET FIRST THE
FIRST TREATMENT IS SOMETHING
THAT WE CAN'T OVER LOOK WE HAVE
TO CONTINUE TO LOOK AT THOSE
THINGS. CRISIS RESIDENTIAL I
pBELIEVE ON THE COUNTY BOARD OF
SUPERVISORS WERE THERE AND IN
THIS POSITION HERE WE SPEAK UP
ON THOSE ISSUES I THINK CRISIS
STABILIZATION. HAVE A COMPONENT
THAT CONTINUES TO BE MAY BE
OVERLOOKED AS SOMETHING THAT
COULD BE THE FIRST LINE OF
DEFENSE BEFORE WE GET TO WHERE
WE'RE AT IN A CRISIS SITUATION
CRISIS SITUATION OF EMERGENCY
ROOMS CRISIS SITUATIONS OF LAW
ENFORCEMENT HAVING TO TAKE
PEOPLE INTO JAILS WHICH IS ONE
OF THE- PRIORITIES RIGHT
LOOKING AT. HOW WE'RE WE'RE
WE'RE NOT HAVING MENTAL HEALTH
INDIVIDUALS NOW HAVING TO GO
THROUGH THAT CYCLE OF JAIL OR
AT THE EMERGENCY ROOM THEY THEY
SERVE A PURPOSE WE DID ADVOCATE
AND SUCCESSFULLY GOT A CRISIS
STABILIZATION UNIT OUT IN
JOSHUA TREE ON OUR LINE AREA
RULE PART OF THE COMMUNITY
SAMBIA COUNTY HAS SERVED. THE
PURPOSE IT WAS THERE IN SHORT
THE MERITS OF THOSE AS FAR AS
52% 33% THOSE STATISTICS AND
DATA THAT IS BEING SHOWN HERE
SHOWS THAT THERE IS
ACCOUNTABILITY THERE IS
ACCOUNTABILITY AT THE LOCAL
LEVEL. BUT THE STORY OF THAT
ACCOUNTABILITY GETTING TO THE
LEGISLATURE IS WHERE WE NEED TO
MAKE SURE THAT THAT MESSAGE IS
BEING HEARD HOWEVER AT THE
COUNTY LEVEL YOU'RE WORKING
VERY HARD TO MAKE SURE YOUR
LEVERAGING THE DOLLARS MAKING
SURE THAT YOU'RE GOING AFTER.
THESE DIFFERENT AREAS AND IN
THE COMMUNITY ITSELF SO. IT'S
GOOD THAT YOU YOU. BRING THAT
OVER I THINK THAT ONE OF THE
THINGS THAT. WE CONTINUE TO
LOOK AT IT. THE LOCAL
ATMOSPHERE THE LOCAL
COMMUNITIES OF ALL FIFTY EIGHT
DIFFERENT COUNTIES. IT CHANGES
THROUGHOUT THE AREAS AS
CHAIRMAN WOULD ALLUDED TO HIS
REPRESENTS WORLD COMMUNITIES SO
WHAT'S THE NEED THERE RIGHT IS
THERE TRULY. UP A ONE PIECE
FITS ALL TYPE OF APPROACH TO
THIS AND THE ANSWER. IS NOW BUT
THE NEED IS THERE SO HOW DO YOU
ADJUST THE NEED. TO THE ACTUAL
COUNTIES THAT ARE THERE ITSELF.
I'M A BIG PROPONENT OF CRISIS
STABILIZATION UNITS AND I SAY
STIPE STABILIZATION YEARS
BECAUSE THAT'S THE FIRST.
IMPACT THE FIRST THE LINE OF
DEFENSE BEFORE YOU GET TO THE
CRISIS RESIDENTIAL BEFORE YOU
GET TO THE INCARCERATION BEFORE
YOU GET TO THE SITUATION WHAT
WE SEE SO MANY RATHER ITS ROLE
OR OR LARGE. COUNTIES THAT ARE
THERE YOU SEE THAT THE HOMELESS
POPULATION. BUT WITHIN THAT
HOMELESS POPULATION THERE'S A
SUB POPULATION OF THOSE THAT
HAVE MENTAL HEALTH ISSUES. IF
WE COULD FOCUS ON AND WE DID
THIS AT THE COUNTY FOCUSED ON
SUB POPULATIONS ARE BRINGING
RESOURCES TO THEM. THERE WERE
GOING TO BE ABLE TO HAVE AN
EFFECT IN A MEASUREMENT BASED
ON THE SUB POPULATION THAT'S
THEIR- MENTAL HEALTH. CONTINUES
TO BE ONE OF THE- BIGGEST
CHALLENGES THAT WE FACE AS A
LECTOR LEADERS AT THE LOCAL
LEVEL AND NOW AT THE STATE WIDE
AREA OR ELSE YOU WOULDN'T BE
HAVING THIS JOINT HEARING
DISCUSSING THESE TOPICS THAT
ARE FACING. THE POPULATION ALL
FIFTY EIGHT COUNTIES IN THE
STATE OF CALIFORNIA. AND IT'S
NOT JUST TALKING ABOUT CRISIS
STABILIZATION CRISIS
RESIDENTIAL. WE'VE BEEN IN IN
SITUATIONS WHERE WE ACTUALLY
SEE IT WORK. WE SEEN LAW
ENFORCEMENT FROM FAR OUT THERE
IN THE DESERT FROM JOSHUA TREE
WHO HAD TO TAKE. AN INDIVIDUAL
INTO IT A COUNTY HEALTH
FACILITY OR THE COUNTY JAIL TWO
HOURS TRAVELING. TAKE SOME OFF
OF THE LAW ENFORCEMENT
CAPABILITIES ARE THERE CRISIS
STABILIZATION UNIT DEPENDING ON
THE SEVERITY. YOU'RE ABLE TO
GET THEM TO THE CRISIS
STABILIZATION UNIT AND
STABILIZE INDIVIDUAL GETTING
THOSE RESOURCES BACK OUT NOT
CLOGGING THE EMERGENCY ROOMS
AND NOT CLOGGING UP COUNTY
JAILS OF THOSE THAT ARE
SUFFERING. FROM RIGHT FROM FROM
THIS EPISODE IMAGES. ESCALATE
THE SITUATION ITSELF. SO THAT
THERE IS A BIG A NEED FOR THAT
AND WE CONTINUE TO ADVOCATE FOR
THOSE AREAS IN THERE IS TRUE
MEASUREMENT. TO SEE THAT MOVE
FORWARD. AND THAT'S DEALING
WITH IN THE FIFTY EIGHT
COUNTIES AND HOW WE MOVE THAT
FORWARD. AND I WANT TO BRING
FOR AND I THANK YOU FOR
BRINGING UP ON THAT THE TRIBAL
COMMUNITIES OF BATON IN
PARTICULAR. WE KNOW THAT WITHIN
THE FIFTY EIGHT COUNTIES THERE
IS A TRIBAL COMMUNITIES ARE
THERE AND WHEN YOU LOOK AT THE
STATISTICS THAT WE SEE IT IN
THE STATE OF CALIFORNIA. THE
STATISTICS OF NATIVE AMERICANS
IS HIGHER THAN THE AVERAGE WITH
IN THOSE AREAS RIGHT SO MAKING
SURE THAT WE'RE REACHING OUT
WHEN I TALK ABOUT. CRISIS
STABILIZATION CRISIS
RESIDENTIAL WE'RE TALKING
ACROSS THE BOARD IN THE WHOLE
STATE OF CALIFORNIA IN ALL
FIFTY EIGHT COUNTIES AND THAT
DOES INCLUDE THE TRIBAL
COMMUNITIES. SO WE HEARD OUT
REACH THOSE DONE AT THE BATON I
BELIEVE. BUT WE DIDN'T HEAR. IN
AN IN DEPTH IN IN SOME OF THE
OTHER DIALOGUE AND I WOUD
ENCOURAGE. THAT WE CONTINUE TO
ADVOCATE. BECAUSE IF WE'RE
TRULY TALKING ABOUT. LORRAINE
AND ADDRESSING THOSE ISSUES.
HOW CAN WE OVERLOOK A
POPULATION THAT HAS A HIGHER
DATA STATISTIC THAN ANY OTHER
GROUP IN THE STATE OF
CALIFORNIA. SO I WOULD LOOK
FORWARD TO HEARING MORE ABOUT
THAT. AND TO UNDERSTAND WHAT
MORE WE CAN DO. AS A
LEGISLATIVE BODY. TO CONTINUE
TO GIVE YOU THE CAPABILITIES TO
CONTINUE TO WORK ON THOSE
AREAS. BUT ALSO. COMING FROM
THE LOCAL LEVEL WE DO SEE. THE
DATA AND THE STATISTICS AND THE
OUTCOMES THAT WERE THERE I
THINK THAT STORY. NEEDS TO
TRANSLATE INTO THE DIFFERENT
BRIEFINGS WE GET THE SUCCESSFUL
MODELS WE'VE BEEN ENGAGED AT
THE COUNTY WE SEEN A SUCCESSFUL
MODEL WITH A HOMELESS VETERAN
POPULATION ARE HOMELESS WOMEN
ON THE STREETS RIGHT AND ARE
HOMELESS YOUTH AND IN SEMINOLE
COUNTY. BUT IT'S BY TACKLING
THOSE SUB POPULATIONS AND I
THINK NOW GETTING THE SYNERGY
AND IN THE ATMOSPHERE AROUND
OUR MENTAL HEALTH COMPONENT IN
TACKLING THAT. TO SHOW. THE
RESULTS OF THAT WORK IS
SOMETHING THAT I WOULD
ENCOURAGE YOU CONTINUE TO PUT
INTO THE BRIEFINGS BECAUSE I
KNOW COUNTIES ARE WORKING HARD.
COUNTIES ARE WORKING HARD TO
ADDRESS THESE ISSUES BUT YET
THOSE SUCCESS STORIES. ARE FAR
IN BETWEEN OF GETTING TO THE
LEVEL OF THE BRIEFINGS WERE AT
NOT TODAY UMMER THANK YOU FOR
THAT AND REALLY ENCOURAGE. MORE
OF THOSE A CRISIS STABILIZATION
PRICES RESIDENTIAL BUT MORE
DIALOGUE TO WITH THE NATIVE
AMERICAN POPULATION BECAUSE IF
THOSE STATISTICS CONTINUE TO
CLIMB. THEN WHAT WE TRULY DOING
TO CURB THE WHOLE ELEMENT HERE
IN THE STATE OF CALIFORNIA.
THANK YOU VENTURE THANK YOU I
SENT A MEMBER AROMAS I BEFORE
WE CLOSE DOCTOR WOULD ANY OTHER
ANY FURTHER QUESTIONS OR
COMMENTS. JUST JUST WITH
REGARDS TO DISASTERS I'M KIND
OF CURIOUS ABOUT HIM AND
OBVIOUSLY COUNTY MENTAL HEALTH
IN. THERE THERE WEREN'T AND IF
I'M WRONG PLEASE SOMEONE
CORRECT ME BUT- IN THE IN THE
MAJOR FIRES THAT KEPT THE
PHYSICAL INFRASTRUCTURE FOR
CATAMOUNT MET MENTAL HEALTH
SERVICES BUT THAT WASN'T
DESTROYED. IN THE FIRES HOWEVER
CLINICS THAT PROVIDED SERVICES
THROUGH MEDICARE MANAGED CARE
PLANS OR OR ACTUALLY OR
FEDERALLY QUALIFIED HEALTH
CENTERS EXCUSE ME. WORD
DESTROYED AND SO IT BECAME
PROBLEMATIC. FOR THEM TO
PROVIDE SERVICES OUTSIDE THEIR
EXISTING FOUR WALLS BECAUSE I'M
SORRY THAT'S A FRASER PRYCE
SHOULD USE THEIR MEN. OUTSIDE
THEIR BUILDINGS BECAUSE THAT
WASN'T THE LICENSE FACILITIES
SO AND THAT YOU KNOW THAT MEANT
THAT A LOT OF PEOPLE WHO WERE
GETTING MENTAL HEALTH SERVICES
AND THESE FACILITIES WERE NET
WORTH ETS EASILY ABLE TO ACCESS
THEM AS QUICKLY AS THEY SHOULD
SO. ANYBODY HAVE THOUGHTS ON
THAT ONE BECAUSE THAT WAS I
I'LL GIVE THE EXAMPLE. VISTA
CLINIC IN IN SANTA ROSA AT HOME
TO TWENTY FOUR THOUSAND
PATIENTS. BUT DESTROYED AND
THAT'S MORE OR LESS DESTROYED
BUT THEY WERE REALLY STRUGGLING
WITH GETTING REIMBURSEMENT FOR
SERVICES. YES COUPLE THINGS WE
UNFORTUNATELY ARE WELL
PRACTICED NOW AT HELPING THE
COUNTIES WHEN THERE IS A
DISASTER IN TERMS OF RECEIVING
WHEN THERE'S A FIFTH OF. A
DECLARED DISASTER AND APPROVED
BY THE FEDERAL GOVERNMENT THERE
ARE CRISIS OF FUNDS THAT ARE
AVAILABLE TO THE COUNTIES FOR
MENTAL HEALTH SERVICES AND LIKE
I SAID UNFORTUNATELY WE HAVE
BECOME. ACTUALLY PRETTY GOOD AT
HELPING THE COUNTIES GET THOSE
FUNDS IN A TIMELY WAY AND THEY
HAVE A VIEW I BELIEVE A YEAR OR
SO ONCE THAT I DID. ONCE THEY
CAN EXPEND THE FUNDS FOR UP TO
A YEAR AFTER THE DISASTER HAS
BEEN DECLARED. AND THEN
OBVIOUSLY IF THERE ARE
CONTINUING NEED WE HAVE I THINK
WORKED WITH ONE PARTICULAR
COUNTY IN IT PROBABLY WAS AFTER
THE CINEMA FIRES WHERE THE
FUNDS WERE CONTINUED AFTER THAT
ONE YEAR PERIOD. THERE ARE ALSO
OPPORTUNITIES UNDER. FEDERALLY
APPROVED DISASTERS IN WHICH WE
CAN APPLY FOR WAIVERS IN WHICH
SERVICES CAN BE PROVIDED AN
ALTERNATE SETTINGS. THAT WAS
ALSO NOTED IN THE CINEMA FIRE
WHERE SKILLED NURSING FACILITY
RESIDENTS FOR HAVING TO BE
RELOCATED TO EITHER SHELTERS
SOMEWHERE IN LIBRARIES. OR
OTHER ALTERNATE SITES AND TO
THE EXTENT THAT THE FACILITY
STAFF CONTINUE TO FOLLOW THOSE
INDIVIDUALS AND CONTINUE TO
DELIVER CARE WE WERE ABLE TO
GET FUNDING FOR THAT. WE ARE I
THINK PURSUING A CHANGE TO OUR
STATE PLAN THAT WOULD ALLOW FOR
SERVICES AND DECLARED DISASTERS
TO BE PROVIDED OUTSIDE OF THE
CLINIC SHOULD THE CLINIC BE
TAKEN OFFLINE AND SO. I THINK.
THE HISTORY OF CALIFORNIA BEING
WHAT IT IS AND THE FUTURE BEING
WHAT IT MOST LIKELY WILL
CONTINUE TO BE IS THAT WE'RE
CONTINUING TO KIND OF MAKE
STEPS AND REFINEMENTS. TO ALLOW
FOR THOSE PROCESSES TO OCCUR
WHEN A DISASTER UNFORTUNATELY
TAKES PLACE IN SO I THINK.
WE'RE HOPING NOT TO USE IT BUT
WE ARE WE'RE TAKING THE
APPROPRIATE STEPS TO ADDRESS IT.
CAN I JUST HAVE ONE FINAL
QUESTION FOR DEPUTY DIRECTOR I.
CABRERA PART SORRY GREEN LUSH
DEPUTY DIRECTOR AGREE LASH ATSU
BASED ON THE GOVERNOR'S VISION
GOVERNOR NUISANCE VISION FOR
IMPROVING CALIFORNIA'S
BEHAVIORAL HEALTH SYSTEM I TWO
QUESTIONS FIRST KNOW WHAT YOUR
VISION FOR THE DH CS BEHAVIORAL
HEALTH UNIT AND WHAT ROLE DO
YOU ENVISION AND THAT CHECK AN
HSA PLANE. AS PART OF THAT
TRANSFORMATION SO ONE POINT OF
CLARIFICATION ASSISTANT DEPUTY
SO I'VE BEEN ASKING FOR A YEAR
AND A HALF RIGHT I WAS A
DIRECTOR CAN'T JUST MENTIONED
DR KELLY PFEIFFER IS NOW OUR AD
DIFFUSE DIRECTOR SO
UNFORTUNATELY SHE COULDN'T BE
HERE WITH US TODAY SHE'S
PROBABLY LISTENING TO US RIGHT
NOW. OPTIONS THAT ARE SUBSTANCE
USE DISORDER CONFERENCE BUT I
THINK YOU KNOW IN TERMS OF OUR
DEPARTMENT'S VISION YOU KNOW
THERE'S A LOT OF EXCITEMENT I
THINK WITH OUR RE
ORGANIZATIONAL STRUCTURE THAT
WE'VE JUST RECENTLY IMPLEMENTED
IT KIND OF SPREADS OUT
THROUGHOUT THE DEPARTMENT
HEALTH CARE SERVICES WE ARE
GOING TO BE MORE STREAMLINED
AND BE MORE EFFICIENT. WE WERE
VERY TOP HEAVY AND I WAS LIKE
VERY DEEP DOWN IN TERMS OF THE
WAY OUR STRUCTURE I WAS WITH
MEDI CAL AND NON MEDICAL WE
PULLED OUT A PART AND SO DOCTOR
PFEIFFER WILL BE OVER THAT
MENTAL HEALTH SERVICES ACT AREA
AND SO AND THEN WITH ALL OF THE
RECENT RESOURCES THAT WE'VE
JUST RECEIVED A THIRTEEN
PETITION THAT DIRECTOR CANNOT
JUST MENTIONING. I'M WE'VE GOT
AN AMAZING OPPORTUNITY TO BUILD
OUT OUR OVERSIGHT SH SURE AND
TO REALLY FOCUS ON THINKING YOU
KNOW ABOUT OUR POLICIES AND
SPEND TIME WITH THE COUNTIES
WITH THE OVERSIGHT AND
ACCOUNTABILITY COMMISSION OR
OTHER STAKEHOLDERS SO I THINK
THAT YOU KNOW IT'S A- GREAT
OPPORTUNITY TO THINK BROADLY
AND WITH OUR OTHER PARTNERS AND
OTHER SYSTEMS BECAUSE THAT'S
ANOTHER AREA WHERE I THINK
WE'RE I'M REALLY EXCITED TO BE
ABLE TO WORK WITH. OUR CONTINUE
WORKING WITH SOCIAL SERVICES
OUR CRIMINAL JUSTICE PARTNERS
TO REALLY STRENGTHEN OUR COUNTY
SYSTEMS AND REALLY. LOOKING AT
HOW MEDICARE ON NON MEDICARE
ALL THE. FULL PICTURE CAN
SUPPORT COUNTY IS IN THE
IMPLEMENTATION OF YOU KNOW THE
SERVICES THAT CAN. ARE REALLY
IMPROVE THE LIVES OF PEOPLE
WERE MOST IMPACTED AND NOT JUST
FOR MENTAL HEALTH AND MENTAL
HEALTH AND SUBSTANCE USE
DISORDER SERVICES BECAUSE WE'RE
REALLY THINKING BROADLY. JUST
BE ON MENTAL HEALTH AND REALLY
LOOKING AT THE WHOLE PERSON AND
AN ACTUAL PHYSICAL HEALTH CARE
AS WELL SO. SO TAKING WHAT
WE'VE BEEN THAT INFRASTRUCTURE
THAT WE'VE HAD GOING FOR YOU
FOR THE LAST SEVERAL YEARS AND
JUST CONTINUING TO GROW IT AND
EVOLVE OVER THE YEARS SO. THANK
YOU. I KNOW I'M SURE BUT ALONG
WITH THE OTHER MEMBERS OF THE
PANEL I HAVE IN FOR THE HOURS
OF OTHER QUESTIONS FOR.
WE'LL SAVE THAT. FOR ANOTHER
DAY I DID WANT TO THOUGH OPEN
IT UP FOR PUBLIC COMMENTS I.
IT'S ANOTHER SOME FOLKS THAT
HAVE BEEN BEEN HERE. AND WHAT
WILL GO AHEAD AND DO IS IF YOU
CAN JUST LIMIT YOUR PUBLIC. YOU
TWO MINUTES. THANK YOU SO MUCH.
THANK YOU ONCE AGAIN TO ALL OF
OUR PANELISTS IT'S BEEN
INCREDIBLY INFORMATIVE. THANK
YOU SERGEANT. GOOD AFTERNOON
OUT OF MADAM CHAIR AND MEMBERS
AND MISTER CHAIR FOR BOTH
COMMITTEES I'M FAIR MCDADE TANG
I AM THE LEGISLATIVE
REPRESENTATIVE FOR HEALTH AND
BEHAVIOR HEALTH FOR THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES LONG LONG WORDS
REPRESENTING ALL FIFTY EIGHT
COUNTY BOARDS OF SUPERVISORS IN
THIS IS AN ISSUE VERY CLOSE TO
HOME FOR US AND WE APPRECIATE
THE PANELISTS AND AS NEWS
CABRERA MENTIONED THAT YOU KNOW
THE INCREASE COORDINATION AND
HELP FROM THE DEPARTMENT HEALTH
CARE SERVICES AND AC OF VERY
MUCH WELCOME AND WE REALLY
APPRECIATE THAT. THE AC IS A
SPECIALLY DONE A LOT OF LEG
WORK ON THE DATA PIECE WHICH
YOU HEARD AND WE THINK THAT
THAT GOES A LONG WAY TOWARD
SHOWING ALL THE GREAT THINGS
THAT OUR COUNTIES ARE DOING AS
VERONICA MENTIONED TO SO WE'RE
REALLY LOOKING FORWARD TO
INCREASING THOSE THE CORONATION
AND THE RELATIONSHIP AND FOR
IMAGES SAY WE'RE USING IT FOR A
LOT OF GREAT THINGS BUT OF
COURSE THERE ARE OTHER NEEDS
THAT WE CAN SEE AND ONE THING
THAT WE CAN'T USE IMAGES SAY
HONEST SUBSTANCE USE DISORDER
SERVICES. IT'S FOR MENTAL
HEALTH ONLY AND WHILE THAT'S
VERY VERY IMPORTANT SOME OF
THOSE FOLKS ABILITIES AND
THINKING OF NEW WAYS TO BE
FLEXIBLE THE WAY THE SYSTEM OF
THE HAS CHANGED IN THE LAST
FIFTEEN YEARS WORKING WITH OUR
PARTNERS DH CS AND OTHERS ON
HOW TO FIGURE OUT THE BEST WAY
TO USE THOSE FUNDS WE KNOW WE
ARE REALLY PROUD THAT COUNTIES%
ARE COMPLYING WITH THE
REPORTING REQUIREMENTS WE
FIGURED OUT THE SPREADSHEET
ERRORS IT'S A WORKING NOW AND
WE CONTINUE TO SUPPORT THAT WE
THINK THAT'S REALLY IMPORTANT
FOR COUNTIES TO MEET THOSE.
GOALS AND HAVE THAT
ACCOUNTABILITY SO AGAIN I WANT
TO THANK YOU FOR HOLDING THIS.
HEARING TODAY AND YOU KNOW WILL
BE. CONTINUING TO WORK WITH OUR
PARTNERS ON THESE ISSUES AND
AGAIN. DHS ESPECIALLY HAS BEEN
HELPFUL IN THE LAST YEAR OR SO
AS WELL. THANK YOU THANK YOU.
GOOD AFTERNOON MADAM CHAIR
MISTER CHAIRMAN ADRIAN CHILTON
FROM THE STEINBERG INSTITUTE WE
FIRST LIKE TO THANK THE
COMMITTEE IS FOR YOUR
LEADERSHIP AN ONGOING ATTENTION
TO THESE ISSUES AND ALL THE
COMMITTEE MEMBERS THAT WERE
HERE TODAY WE LIKE TO SAY THAT
THE MENTAL HEALTH SERVICES ACT
IS REALLY THE CRITICAL
INFRASTRUCTURE NEEDED TO
TRANSFORM THE PUBLIC MENTAL
HEALTH SYSTEM IN CALIFORNIA
THIS IS A MONUMENTAL ACT
THERE'S NOTHING LIKE IT ACROSS
THE NATION. AND IT HAS DONE
AMAZING THINGS IN THE SAME
TRANSFORM THOUSANDS OF LIVES
FOR THE BETTER BUT JUST LIKE
ANY MAJOR INITIATIVE THEY'RE
ALWAYS WAYS TO STRENGTHEN AND
IMPROVE IT IMPROVE IT AND WON
AREA OF FOCUS FOR US THAT WE'VE
BEEN IT'S VERY IMPORTANT TO US
IS AROUND. OUTCOMES AND THE
GOALS OF THE ACTOR VERY CLEAR
AND THIS IS WHAT WE CAMPAIGNED
ON. TO FOCUS AND DO WHATEVER WE
COULD FOR HOMELESS INDIVIDUALS
LIVING WITH A MENTAL ILLNESS.
AND YET FOURTEEN YEARS LATER
THERE REALLY IS STILL NOT A
SHARED UNDERSTANDING OF WHAT
THE STATE WIDE OUTCOME SHOULD
BE ACROSS ALL OF THE IMAGE TO
SAY COMPONENTS SO WE CONTINUE
TO FOCUS ON THAT. ANOTHER AREA
OF PARTICULAR IMPORTANCE TO US
IS THE PREVENTION AND EARLY
INTERVENTION COMPONENT THE 20%
OF THE I MEAN TO SAY THE FIVE
HUNDRED MILLION DOLLARS IT IS
OUR OPPORTUNITY TO INTERVENE
EARLIER IN THE COURSE OF
SOMEBODY'S ILLNESS. SO WE THINK
THAT WE CAN BE MUCH MORE
FOCUSED AND SCALE UP YOU KNOW
IT MORE EFFECTIVE PRACTICES SO
THAT WE'RE MAKING A LARGER
IMPACT BECAUSE THIS IS THE
OPPORTUNITY TO TURN THE TIDE IN
CALIFORNIA. SO THANK YOU SO
MUCH FOR YOUR ATTENTION. THANK
YOU. TURN MEMBERS WANT TO ECHO
THE COMMENTS OF MY COLLEAGUES
AND THANK YOU FOR THIS HEARING
IT'S BEEN VERY INFORMATIVE AND
I STILL. SORT OF GOOD TO HEAR
WHERE THINGS HAVE COME SINCE
THE AUDIT. KATHY MOSSBERG FIRST
FIVE ASSOCIATION OF CALIFORNIA.
I THINK I WANT TO TELL TALE
SORT OF ON WHAT MICHELLE'S AND
HAD SAID. IN REGARDS TO THE 20%
THE EARLY INTERVENTION DOLLARS.
AND CERTAINLY SOME OF THE
PIECES THAT THE COUNTY.
REPRESENTATIVES HAVE RAISED
CURRENTLY MORE THAN A DOZEN
FIRST FIVE IN COUNTY BEHAVIORAL
AGENCIES ARE WORKING TOGETHER
TO PREVENT. CHILDHOOD TRAUMA
AND INTERVENE EARLY TO GET
THESE ISSUES BEFORE THEY
SNOWBALLED LATER INTO. INTO
FUTURE YEARS AND BECOME BIGGER
ISSUES WERE EAGER TO SEE THESE
PARTNERSHIPS RAMP UP WE'RE
HOPEFUL THAT NOW THAT ALL THESE
THINGS HAVE BEEN. SORT OF
CLEARED UP THAT WE WILL START
TO SEE THAT AND WORK MORE WITH
OUR COUNTIES ON THIS. WE WOULD
REALLY LIKE TO SEE THE AC
PRIORITIZE EARLY CHILDHOOD
TRAUMA PREVENTION INTEGRATOR
WAY. KNOWING THAT THE
STRATEGIES WILL SPAN ALL AGES
AND CERTAINLY SERVICE INTO THE
FUTURE. SO THANK YOU FOR THE
HEARING. THANK YOU SO MUCH.
THANK YOU FOR TODAY'S HEARING
MY NAME'S ELIZABETH OF SECURE
AND I'M WITH THE CALIFORNIA
PRIMARY CARE ASSOCIATION WE
WERE WE REPRESENT MORE THAN
THIRTEEN HUNDRED HEALTH
CENTERS. AND ABOUT SIX POINT
NINE MILLION PATIENTS
THROUGHOUT THE STATES. ABOUT
85% OF OUR HEALTH CENTERS
PROVIDE. COLOCATED PRIMARY CARE
BEHAVIOR HEALTH SERVICES.
HEALTH CENTERS TAKEN APPROACH
TO CARE THAT LOOKS AT THE NEEDS
OF THE WHOLE PERSON AND TRY. TO
APPROACH THAT CARE AND THAT
WAY. CPC IS A PROUD CO SPONSOR
OF SB SIXTY SIX AND THIS WOULD
ALLOW WE ENFORCEMENT FOR SAME
DAY VISITS FOR BEHAVIOR HEALTH
AND PRIMARY CARE. INSTEAD OF
FORCING PATIENTS TO COME BACK
FOR. ANOTHER DAY TO RECEIVE THE
BEHAVIOR HEALTH VISITS IF THE
HOUSE AND I CAN'T AFFORD TO
PROVIDE A ON THE SAME DAY
WITHOUT REIMBURSEMENTS. A
SAFETY NET PROVIDERS WE PROVIDE
CARE TO DIVERSE POPULATIONS WE
HAVE OVER TWO HUNDRED THOUSAND
HOMELESS POP YOU. HOMELESS
PATIENTS AND AT LEAST THIRTY
FIVE PATIENTS THAT HAVE
IDENTIFIED ANOTHER ENGLISH AND
OTHER LANGUAGE OTHER THAN
ENGLISH AS THEIR PRIMARY
LANGUAGE. SO HOWEVER WE ARE
VERY CONCERNED THAT ONLY ABOUT
NINE COUNTIES HAVE ACCEPTED IT
TO PARTNER WITH HEALTH CENTERS
TO PROVIDE HERE WERE HEALTH
SERVICES TO COMMUNITY MEMBERS.
AND IT WE WOULD LOVE TO SEE AN
OPPORTUNITY TO EXPAND THIS ON
WE WANT TO MAKE SURE THAT WE
ARE SERVING COMMUNITY MEMBERS
IN THE BEST WAY POSSIBLE AND
BELIEVE THAT HEALTH CENTERS
COULD BE A LEVERAGE POINT FOUR
COUNTIES TO MAKE SURE THAT
SERVICES ARE REACHING. LL
POPULATIONS AND ALSO TELEHEALTH
WAS BROUGHT UP EARLIER TODAY
AND WANTED TO MENTION THAT IN
OUR RURAL COMMUNITIES WITH
TELEHEALTH IS SOMETHING THAT WE
DEFINITELY USED TO EXPAND
SERVICES AND WOULD WELCOME ANY
CONVERSATIONS AROUND EXPANDING
THAT. THANK YOU. THANK YOU.
GOOD AFTERNOON MEMBERS ALEX
TAURUS WITH THE CALIFORNIA
ASSOCIATION OF VETERAN SERVICE
AGENCIES I JUST WANT TO ECHO
THE THANK YOU BY THE OTHER
STAKEHOLDERS FOR CONVENING THIS
IMPORTANT HEARING CABS HELD OUR
INAUGURAL VETERANS MENTAL
HEALTH SUMMIT LAST WEEK IN A
LOT OF THE CONVERSATION THAT WE
HEARD IN THE HEARING TODAY
ABOUT CHALLENGES AS WELL AS
IMPROVEMENTS SPECIFICALLY ON
THE DATA PIECE. WE HEARD IN OUR
MENTAL HEALTH SUMMIT WE
CONTINUE TO LOOK TO FOR
OPPORTUNITIES TO WORK WITH
OTHER STAKEHOLDERS AS WELL AS
MEMBERS OF THE RESPECTIVE
COMMITTEE. LOOK FORWARD TO
IMPROVING PARTNERSHIPS AND
CONNECTING ON DIFFERENT WAYS
THAT WE CAN SOLVE A LOT OF THE
MENTAL HEALTH ISSUES FACING
PATTERNS THANK YOU. THANK YOU.
MADAM CHAIR MISTER CHAIR
MARKETS CUSTOMER THE CALIFORNIA
PENTA THINK HEALTH NETWORK A
STATEWIDE MULTICULTURAL HEALTH
ADVOCACY ORGANIZATION COMMUTES
THE COLOR AND LIMITED ENGLISH
PROFICIENT COMMUNITIES CONTINUE
TO FACE BARRIERS ACCESSING
MENTAL HEALTH CARE AND STILL
FACE SIGNIFICANT DISPARITIES IN
MENTAL HEALTH OUTCOMES MHSAA
PROVIDES AN IMPORTANT
OPPORTUNITY TO FOCUS ON THE
ISSUES TO ADVANCE HEALTH EQUITY
IN OUR PUBLIC MENTAL HEALTH
SYSTEM FOR EXAMPLE OFFICE OF
HEALTH EQUITY IS CURRENTLY
ADMINISTERING A SIXTY MILLION
DOLLAR PROGRAM THE CALIFORNIA
REDUCING DISPARITIES PROJECT
WAS THE RDP. WHICH IS FUNDED BY
THE M. HSA THE CRT P. IS OF ITS
FUNDING AND TESTING NEW
STRATEGIES TO SERVE TO ME AS A
COLOR AND THE LGBT COMMUNITY
HOWEVER THERE IS CURRENTLY NO
PLAN TO SUSTAIN THIS. WORK AND
INTEGRATE THE SUCCESSFUL
STRATEGIES THAT THERE HAVE.
HAVE HAVE COME FROM THAT
PROJECT INTO THE BROADER MENTAL
HEALTH SYSTEM ONCE THE FUNDING
RUNS OUT. SO WE URGE THE
LEGISLATURE TO PRIORITIZE IN
THE ISSUE OF RACIAL AND ETHNIC
DISPARITIES WHEN YOU THINK
ABOUT IMPROVING THE IMAGE TO
SAY THANK YOU. THANK YOU. CHAIR
WITH DO YOU HAVE ANY CLOSING
REMARKS YOU'D LIKE TO SHARE
YEAH FOR FIRST OF ALL JUST
THANK YOU TO EVERYONE FOR THEIR
PARTICIPATION TODAY OBVIOUSLY
THIS IS A PRETTY COMPLICATED
ISSUE THE ISSUES SURROUNDING
THE DELIVERY OF MENTAL HEALTH
SERVICES ARE NOT EASY TO SOLVE
THAT'S PRETTY OBVIOUS BUT I
BELIEVE IT'S TIME FOR A
DIFFERENT MINDSET AROUND MENTAL
HEALTH AND THE ACCOMPANYING
ISSUES. OF INCARCERATION AND
STIGMA SUBSTANCE ABUSE AND
HOMELESSNESS. IT IT IT FEELS TO
ME LIKE WE'VE GOT THESE SILOS
WHEN I HEARD YOU SAY. DOCTOR
THAT WE YOU WE CAN'T USE THEM
AS A M. AT MHS MUCH A MONEY
WITH FOR PEOPLE WHO S. ON
SUBSTANCE ABUSE ISSUES OKAY I
UNDERSTAND THAT THE MONEY ASIDE
IS NOT MEANT FOR THAT BUT IT
ALSO BEGS THE QUESTION YOU KNOW
HOW DO WE HOW DO WE REALLY
BRING TOGETHER ALL OF THESE
ISSUES WHICH WHICH IN MANY
CASES IT IN MANY INDIVIDUALS
ARE TIED TOGETHER. I THINK OF
THIS IS WILL PROBABLY A STRANGE
ANALOGY BUT I THINK OF YOU KNOW
WHEN I WAS ON THE CITY COUNCIL
WE HAD CONTRACTORS COME
TOGETHER TO BUILD A PROJECT WE
HAD THE FIRE DEPARTMENT YOU HAD
THE POLICE DEPARTMENT HAD THE
ELECTRIC UTILITY AND THEY ALL
TOOK THEY ALL THEY ALL TOOK
THEIR BITE AT THE APPLE UNTIL
WE FIGURED OUT A WAY TO BRING
THEM ALL TO THE TABLE. TO LOOK
AT THE PROBLEM MORE
HOLISTICALLY LIKE WHAT I HEAR
ABOUT WITH THE COUNTY WITH THE
COMMUNITY HEALTH CENTERS AND
FEDERALLY QUALIFIED HEALTH
CENTERS. AND SO I YOU KNOW WE
HE WE TALK WE HAVE SO MUCH TALK
ABOUT HOMELESSNESS AND- AND BUT
THERE'S SO MANY ISSUES THAT
THAT LEAD TO THAT. I'D I LONG
FOR THE DAY WHEN WE COULD HAVE
ALL THE PLAYERS AT THE TABLE TO
REALLY LOOK AT THIS
HOLISTICALLY AND IF I'M MISSING
IF THERE'S THAT IF THAT'S OUT
THERE HAPPENING NOW I'D LOVE.
TO KNOW ABOUT IT. BUT I HAVEN'T
SEEN IT AND I THINK WE'RE
MISSING A HUGE OPPORTUNITY. SO
YEAH BETWEEN THE HEARINGS SO
WE'VE HAD THIS YEAR TODAY'S
HEARING I THINK WE HAVE LAID
THE FOUNDATION FOR. MANY MORE
HEARINGS QUITE FRANKLY. BUT I
AND I HOPE THE DYNAMICS THAT
SURROUND THESE ISSUES YOU KNOW
BEGIN TO SHIFT. THE WAY WE
APPROACH THEM AND I LOOK
FORWARD TO FUTURE HEARINGS AS
WE DELVE DEEPER INTO THESE
ISSUES AND- AND HOW DO WE
BETTER SERVE. THE MENTAL HEALTH
NEEDS OF OUR- PEOPLE OF OUR
STATE. THANK YOU MADAM
SECRETARY. THANK YOU MR MUST.
MENTION THANK YOU MISTER
CHAIRMAN FOR BRINGING THAT UP
ONE OF THE THINGS THAT WAS DONE
AND IN SAN MARINO COUNTY WAS
BRINGING THE FULL ARSENAL OF
THE FAMILY OF THE COUNTY
HOUSING AUTHORITY LAWN FOR SOME
BEHAVIORAL HEALTH. EVERYONE
TOGETHER TO START TO FOCUS ON A
ON A COMMON GOAL. BECAUSE THE
SILOS DID EXIST AND CURRENTLY
DO EXIST BUT THERE IS MODELS
TAKING PLACE WITHIN THE COUNTY
SPECIFICALLY WITHIN. THE COUNTY
OF SANTA DINO MAY WE GET YOU
MORE INFORMATION OF HOW THAT
WORKS. AND. AND HOW IT LED UP
TO EVERYBODY COMING TOGETHER
FOR A COMMON CAUSE. THANK YOU.
GET ECHO SOME OF WHAT WHICH
HERE WOULD SAID IT'S ACTUALLY
HARD TO THINK OF AN AREA OF
PUBLIC POLICY THAT'S NOT. TOUCH
MY MENTAL HEALTH. AND I WANT TO
THANK ALL OF YOU FOR. THAT THE
PASSION. THAT YOU BRING TO THE
US FOR THE HARD WORK THAT
YOU'RE POURING INTO DRESSING.
IS REALLY TOUGH AND REALLY
IMPORTANT CHALLENGE FOR THE
STATE OF CALIFORNIA. BUT YOU
KNOW I THINK IN EVERY AREA AND
I'M PASSIONATE ABOUT INSURING
THAT WE ARE DEVELOPING DATA
DRIVEN. POLICY AN EVIDENCE
BASED POLICY AND I THINK HERE.
IN PARTICULAR THAT'S IMPORTANT
SO. HI I LOOK FORWARD TO THE
OPPORTUNITY TO CONTINUING TO
WORK WITH OUR PARTNERS IN IN
CALIFORNIA STATE AGENCIES. IN
THE COUNTY AND DOING GROUPS ALL
ACROSS THE STATE SO THAT WE CAN.
HELP PEOPLE AND WE CAN HELP TO
HEAL OUR COMMUNITIES AS WELL SO
THANK YOU AGAIN FOR BEING HERE
THANK YOU EVERYONE FOR YOUR
COMMITMENT AND TAX. LOOK
FORWARD TO CONTINUING THIS
CONVERSATION. WE ARE TURNED