THIS WILL BEGIN TODAY SOMEONE
HEARING ON MARK.
FOR TWENTY NINETEEN GOOD
AFTERNOON THIS WILL BEGIN TODAY
SOMEONE HEARING ON MARCH FOURTH.
TWENTY NINETEEN WE WILL BEGIN AS
A SUBCOMMITTEE OF THE
SUBCOMMITTEE UNTIL WE GET A
QUORUM BUT WILL BEGIN WITH ISSUE
.
ONE GOOD AFTERNOON STEPHANIE
CLINTON AN ACTING DIRECTOR FOR
THE DEPARTMENT OF STATE STATE
HOSPITALS.
SO THE CHEN US FOR US TO PROVIDE
AN OVERVIEW OF THE DEPARTMENT AT
THE BUDGET AS WELL AS TO PRESENT --
A COUPLE OF ITEMS --
ISSUE ITEM SO START WITH THE
OVERVIEW OF THE DEPARTMENT.
THE DEPARTMENT OF STATE HIM
HOSPITAL'S MANAGES THE LARGEST
FORENSIC MENTAL HEALTH HOSPITAL
SYSTEM IN THE UNITED STATES WE
PROVIDE DAILY CARE AND MENTAL
HEALTH TREATMENT TO OVER FIVE
THOUSAND EIGHT HUNDRED PATIENTS
DAILY.
SERVING OVER TWELVE THOUSAND
PATIENTS ANNUALLY.
WE HAVE OVER TWELVE THOUSAND
EMPLOYEES AND WE OPERATE FIVE
FREESTANDING HOSPITALS LOCATED
THROUGHOUT THE STATE.
WE SERVE SIX DIFFERENT TYPES OF
COMMITMENTS WE SERVE THE
INCOMPETENT TO STAND TRIAL THE
NOT GUILTY BY REASON OF INSANITY
MENTALLY DISORDERED OFFENDERS.
MENTALLY ILL PRISONERS WHO COME
TO US FROM CDC ARE.
WE HAVE THE SEXUALLY VIOLENT
PREDATORS AND THEN WE ALSO TREAT
INDIVIDUALS WHO ARE CIVILLY
COMMITTED TO US UNDER THE LAND
FROM AND PATRICK SHORT ACT.
LAST YEAR 89% OF THE PATIENTS
THAT WE TREATED CAME TO US AS
FRIENDS A COMMITMENTS.
AND THEY COME TO US FROM EITHER
THE CRIMINAL COURTS OR FROM CDC
ARE 11% OF OUR POPULATION WAS
FROM THE COUNTY IS UNDER THE
WINTER IN PETRA SHORT ACT.
IN ADDITION TO THE TREATMENT
THAT WE PROVIDE IN THE STATE
HOSPITALS WE ALSO OPERATE
COMMUNITY BASED IN JAIL BASED
PROGRAMS.
THROUGH PARTNERSHIPS WITH
VARIOUS ENTITIES FOR WITH
RESPECT TO OUR CONDITIONAL
RELEASE PROGRAMS THESE ARE
DESIGNED PATIENTS HAVE BEEN
COMMITTED TO THE DEPARTMENT
UNDER FRIENDS A COMMITMENTS.
BACK TO THE COMMUNITY WE PROVIDE
COMMUNITY TRICK MENTAL HEALTH
TREATMENT AND SUPERVISION AND
CURRENTLY WE HAVE SIX HUNDRED
AND FIFTY ONE PATIENTS LIVING IN
CALIFORNIA'S COMMUNITIES
THROUGHOUT THE STATE.
WITH WITH THE RESPECT TOWARD
JAIL BASS COMPETENCY TREATMENT
PROGRAMS WE PROVIDE RESTORATION
OF COMPETENCY SERVICES IN THE
JAIL SETTINGS TO INDIVIDUALS WHO
ARE DECLARED INCOMPETENT TO
STAND TRIAL.
THESE ARE DESIGNED TO SERVE
INDIVIDUALS FOR LIKELY TO
RESTORE WITHIN SIXTY TO NINETY
DAYS AND WE CURRENTLY HAVE
CONTRACTS FOR THREE HUNDRED AND
TWENTY FIVE BEDS IN TEN COUNTIES
THROUGHOUT THE STATE.
AND IN THIS YEAR WE ACTIVATED A
NEW PROGRAM WHICH IS THE LOS
ANGELES CAN COUNTY COMMUNITY
BASED PROGRAM THIS IS A PROGRAM
THAT'S IN PARTNERSHIP WITH LOS
ANGELES COUNTY OFFICE OF
DIVERSION AND RE ENTRY.
THIS IS FOR A HUNDRED AND FIFTY
BEDS IN THE COMMUNITY AND WE
CURRENTLY HAVE NINETY TWO BEDS
FILLED OUT SOME THE BEGINNING OF
MARCH.
WITH RESPECT TO THE BUDGET THE
PROPOSED BUDGET IS ONE POINT
EIGHT MILLION DOLLARS WHICH IS
AN INCREASE OF THIRTY SIX POINT
NINE MILLION OVER THE CURRENT
YEAR.
THE TOTAL POSITIONS PROPOSED IN
NINETEEN TWENTY AS TWELVE
MILLION TWELVE MILLION TWELVE
THOUSAND THREE HUNDRED AND
EIGHTY THREE POINT.
SIX AND THIS IS TO SUPPORT A
PROJECTED DAILY CENSUS BY THE
END OF FISCAL YEAR TWO THOUSAND
NINETEEN TWENTY OF SIX THOUSAND
THREE HUNDRED AND TWENTY SEVEN
IN THE STATE HOSPITALS. FOUR
HUNDRED AND THIRTY THREE AND OUR
JOB BASE PROGRAMS SIX HUNDRED
AND EIGHTY NINE IN THE
CONDITIONAL RELEASE PROGRAMS AND
A HUNDRED AND FIFTY AND LOS
ANGELES COUNTY IS COMMUNITY
BASED PROGRAM.
SO THE AGENDA SPECIFICALLY
ASSETS PRESENT ON THREE ISSUE
ITEMS AND THEN ALSO HOUSE FOR US
TO COVER ANY OTHER PROPOSALS
THAT WERE NOT LISTED ELSE FROM
THE AGENDA SO IN ADDITION TO THE
THREE THAT WERE LISTED.
ALSO TOUCH ON THE CONDITIONAL
RELEASE PROGRAM FOR NON SB PEAS --
COMMITMENTS AND THEN OUR
CONDITIONAL RELEASE PROGRAM FOR
SEXUALLY VIOLENT PREDATORS.
SO WITH RESPECT TO THE FIRST
ITEM WHICH IS THE PATIENT DRIVEN
OPERATING EXPENSE AND EQUIPMENT
WERE REQUESTING TEN POINT FIVE
MILLION IN FISCAL YEAR NINETEEN
TWENTY AN ON GOING. TO PROVIDE
FUNDING TO SUPPORT THE OPERATING
COSTS RELATED TO PROVIDING CARE
AND TREATMENT IN OUR FOR OUR
PATIENTS.
SINCE TWO THOUSAND TWELVE
THIRTEEN WE'VE SEEN AN INCREASE
IN OUR STATE HOSPITALS CENTS A
CENSUS AND THAT THREE NINETEEN
TWENTY WE EXPECT THAT IN THAT
INCREASE TO BE FIVE HUNDRED AND
FORTY SEVEN THIS INCREASE IN
SAYS CENSUS RESULTS OF ALL THE
HAD ACROSS THE STATE OF THE PAST
FIVE YEARS. FOR THESE BAD
ACTIVATIONS WITH THE EXCEPTION
OF THE PROPOSALS THAT WE BROUGHT
FOR LAST YEAR FROM METROPOLITAN
STATE HOSPITAL WE ONLY RECEIVE
FUNDING FOR THE STAFFING AND THE
STAFF ASSOCIATED --
ANY BUT WE DID NOT REQUEST ANY
FUNDING FOR THE PATIENT RELATED
OFF -- ANY
EXPENSES THESE ARE THINGS LIKE
LAUNDRY PHARMACEUTICALS LAB
SUPPLIES OUTSIDE MEDICAL COSTS
THE FOOD THE CLOTHING --
EVERYTHING IT TAKES FOR US TO
PROVIDE FOR THE PATIENTS.
THE AVERAGE ANNUAL PATIENT
DRIVEN --
ANY COSTS ACROSS OUR SYSTEM IS
ABOUT NINETEEN THOUSAND FIVE
HUNDRED AND THIRTY FOUR DOLLARS
PER PATIENT WHICH IS IT
REPRESENTS AN 18% INCREASE IN
THIS COSTA CROSS THE PAST SIX
YEARS.
AND THESE INCREASES IN PRICE
HAVE BEEN PRIMARILY DRIVEN BY AN
INCREASE IN COST OF
PHARMACEUTICALS AS WELL AS I'M
OUTSIDE HOSPITALIZATIONS.
THE TEN POINT FIVE MILLION THAT
WE'VE CLASS --
IT JUST FOR THE FUNDING
ASSOCIATED FOR THE INCREASE
CENSUS -- IN
THE IN THE PRINT --
PROJECTED CENSUS IN NINETEEN
TWENTY AND THEN SUB TRACKS OUT
WHAT WE ALREADY RECEIVED --
FOR FOR THE METROPOLITAN --
EXPANSION I LAST YEAR BOARD
BASIS WE DO PLAN TO PROVIDE AN
UPDATE ON A PATIENT REVENUE ANY
EXPENSES AND THAT AND I
GOVERNOR'S BUDGET AND A REVISION
ESTIMATES.
THE SECOND PROPOSAL IS --
FOR THE ENHANCE TREATMENT
PROGRAM AND WE ANTICIPATE A
SAVINGS OF ONE MILLION SEVEN
HUNDRED AND SIXTY FIVE THOUSAND
AND FISCAL YEAR.
NINETEEN TWENTY WITH A REDUCTION
OF TWELVE POINT SEVEN POSITIONS
WITHIN THIS IS ASSOCIATED WITH
THE DELAY AND OUR FOURTH ENHANCE
TREATMENT PROGRAM UNIT.
WHICH WILL BE LOCATED AT PATTON.
I'M JUST AS A BRIEF BACKGROUND
AB THIRTEEN FORTY SO --
STATUTES OF TWO THOUSAND AND
FOURTEEN AUTHORIZES THE
DEPARTMENT TO IMPLEMENT AND
OPERATE IN ENHANCE TREATMENT
PROGRAM FOR A LIMITED PERIOD OF
TIME.
AND THIS WAS TO TREAT PATIENTS
AT HIGH RISK OF THE MOST
DANGEROUS --
BEHAVIOR IN ORDER TO DETERMINE
WHETHER OR MORE INTENSIVE
TREATMENT PROGRAM AND A HIGHER
SECURITY SETTING IS AN EFFECTIVE
WAY TO TREAT THIS PAIN THESE
PATIENTS.
AND RETURN THEM TO THE GENERAL
POPULATION.
IN PREVIOUS BUDGET AX WE'RE
PROOF FOR THE CONSTRUCTION FOR
FOUR UNITS THREE AT ATASCADERO
THEY WERE THIRTEEN BAD UNIT SEND
ONE OUT PATTON WHICH IS A TEN
BED UNIT.
AND THE SEVENTEEN EIGHTEEN
EIGHTEEN NINETEEN BUDGET AX WE
RECEIVED APPROVAL ON FUNDING FOR
THE POSITIONS AND I'M TO BE ABLE
TO BEGIN ACTIVATING THESE ONCE
THE CONSTRUCTION --
IS COMPLETED ON THESE UNITS.
AND THE PROPOSED ADJUSTMENT --
THAT REPRESENTING TODAY REFLECTS
A CHANGE IN THE DATE OF THE
ESTIMATED CONSTRUCTION
COMPLETION FOR THE PATENT ATP
UNIT -- THIS
IS MOVING IT FROM SEPTEMBER TO
JANUARY OF TWENTY TWENTY AND
THIS IS AS A RESULT OF LONGER
THAN ANTICIPATED TIME LINES TIME
TO EVERY SEVE STATE FIRE MARSHAL
PROVE ALL I MOST OF IT TIME.
WE HAD A AND AB WHO IS DUE TO
THE STATE FIRE MARSHAL
RESPONDING TO THAT FIRE
INCIDENTS THIS PAST YEAR AS WELL
AS SOME.
CHALLENGES THAT THE CONTRACTOR
HAD TO RESPONDING AND UPDATING
PLANS AND RESPOND TO SOME OF THE
FIRE MARSHAL COMMONS.
SO THE THAT PLANTS HAVE BEEN
ULTIMATELY APPROVED THEY WERE
APPROVED BY THE STATE FIRE
MARSHAL IN SEPTEMBER OF LAST
YEAR AND THAT PROJECT IS
CURRENTLY OUT TO BED.
THE NEXT ITEM IS THE MANAGEMENT
PETROUS SHORT --
POPULATION SERVICES ADJUSTMENT
AND THIS IS TO INCREASE OUR
REIMBURSEMENT THIRD AT THE
ALREADY BY SIX HUNDRED AND SIX
THOUSAND DOLLARS.
IN NINETEEN TWENTY AN ON GOING
OUR CURRENT APPROVED AUTHORITY
IS A HUNDRED AND FIFTY SIX POINT
SEVEN MILLION DOLLARS.
AND COUNTIES REIMBURSED ON THE
DEPARTMENT A DAILY BED RATE FOR
THEIR OF PATIENTS THAT WE TREAT
UNDER THE LAND FROM IN PETRA
SHORT ACT AS WELL AS ANY --
INDIVIDUALS THAT WE TREAT AS
MISDEMEANOR INCOMPETENT TO STAND
TRIAL PATIENTS.
AND BASED ON OUR ESTIMATED
SENSES AND FOR THE LPS AND AM A
MISDEMEANOR AND I. S. TEENS --
IN NINETEEN TWENTY THAT WE DON'T
WE AT CENTS.
THE NEXT ITEM IS THE CONDITIONAL
RELEASE PROGRAM --
THIS IS A MILLION DOLLARS
HOWEVER THEY WERE REQUESTING IN
NINETEEN TWENTY AN ON GOING AND
THIS IS TO SUPPORT OUR
CONTRACTED CASELOAD OF SIX
HUNDRED AND SIXTY SIX CLIENTS IN
THE CONDITIONAL RELEASE PROGRAM.
THE CONDITIONALLY A CONDITIONAL
RELEASE PROGRAM IS OUR SYSTEM
WIDE SYSTEM OUR SYSTEM WIDE
SYSTEM OF COMMUNITY BASED
SERVICES FOR INDIVIDUALS WHO
HAVE BEEN APPROVED.
BY THE COURT INTO COMMUNITY
OUTPATIENT TREATMENT.
AND THIS A PROGRAM SERVICES THE
NOT GUILTY BY REASON OF INSANITY
PATIENTS MENTALLY DISORDERED
OFFENDERS AN INCOMPETENT TO
STAND TRIAL.
WHEN A COURT --
ORDERS A PATIENT OUT TO
CONDITIONAL RELEASE THERE IS A
COURT APPROVED TREATMENT PLAN
AND THE INDIVIDUALS PROVIDE A
WIDE RATED RIGHT ARRAY OF
SERVICES NEEDED TO SUPPORT THEIR
INTEGRATION INTO THE COMMUNITY.
WHEN A PATIENT IS DISRUPTED
CHARGE INTO CONRAD THE GOAL IS
TO PROVIDE AN INDEPENDENT LIVING
AND MARK OUR ENVIRONMENT IN THE
LEAST RESTRICTIVE OUT POSSIBLE
SETTING?
THE FUNDS THAT WE ARE REQUESTING
TODAY ARE TO SUPPORT INCREASE
HOUSING COSTS FOR OUR
CONDITIONAL RELEASE --
CLIENTS WE PAY UP TO A 100% OF
THE COSTS THAT ARE INCURRED BY
THE CONTENT PROVIDERS TO DELIVER
TREATMENT SUPERVISION AND
HOUSING TO CONRAD.
WELL MOST OF OUR CONRAD CLIENTS
DO QUALIFY FOR BENEFITS --
THAT DO OFFSET THESE COSTS WE
HAVE SEEN A SIGNIFICANT COST --
IN THE INCREASING COST ZING FOR
THESE PATIENTS MOSTLY BECAUSE
THE HOUSING MARKETS IN
CALIFORNIA AND RENTAL MARKETS IN
CALIFORNIA HAVE SIX
SUBSTANTIALLY INCREASED.
OF THE FINAL ITEM IN THIS --
ISSUE IS THE CONDITIONAL RELEASE
PROGRAM FOR SEXUALLY VIOLENT
PREDATORS AND THIS WE ARE --
BECAUSE WE ARE ANTICIPATING
INCREASE OF SEVEN HUNDRED AND
SIXTY EIGHT THOUSAND AND FISCAL
YEAR.
TWO THOUSAND EIGHTEEN NINETEEN
AND THIS IS TO SUPPORT AN
ANTICIPATED INCREASING CASELOAD.
FOR THE FOR FOR FOR SB PEAS IN
THE CURRENT YEAR INCLUDING TWO
TRANSIENT RELEASES AND THIS
WOULD THEN MAKE IT A TOTAL
TWENTY ONE SB PEAS CONDITIONALLY
RELEASED IN THE COMMUNITY BY
JUNE THIRTIETH OF THIS YEAR.
AND THEN WE'RE REQUESTING TWO
POINT ONE MILLION IN NINETEEN
TWENTY AN ON GOING TO SUPPORT AN
ADDITIONAL TWO SB PIECE THAT OUR
SIM TO BE RELEASED NEXT YEAR.
FOR TOTAL CONRAD CASELOAD OF
TWENTY THREE A BY A JUNE
THIRTIETH.
TWENTY TWENTY I'M HAPPY TO TAKE
ANY QUESTIONS ON THOSE ITEMS.
THANK YOU DIRECTOR I MAY START
BY ESTABLISHING FORM
[inaudible]
ARAMBULA.
YOUR FRAZIER.
MATHIS PATTERSON [inaudible]
RAMOS [inaudible]
RUBIO [inaudible]
WHAT?
HELLO DEPARTMENT OF FINANCE.
I WANT TO BURN PLANTS THAT WE
HAVE NO FURTHER COMMENT AT THIS
TIME.
ANY QUESTIONS FROM THE COMMITTEE
[inaudible]
ASSEMBLYMEMBER FRAZIER.
GOOD AFTERNOON.
SO BACK IN THE EIGHTIES HOW MANY --
STATE HOSPITALS DID WE HAVE THAT
TIME -- THAT
PREDATES ME.
ANYBODY IN THE I ANSWER THEM.
I KNOW THAT [inaudible]
SEC.
BY THE RESULT OF EXISTING FIVE
IN THE EIGHTIES.
SO HOW MANY IN THE PSYCH PROGRAM
WERE A DISMISSED.
SO WE HAD AND THREE PSYCHIATRIC
PROGRAMS THAT WE OPERATED FOR
THE CALIFORNIA DEPARTMENT OF
CORRECTIONS AND REHABILITATION
AND THOSE THREE TO ABOUT
PROGRAMS WERE TRANSFERRED AT THE
BEGINNING OF SEVENTEEN SEVENTEEN
EIGHTEEN BACK TO CDC ARE.
AND SO WHEN WE LOOK AT CAPACITY
AND WE LOOK.
PROGRAMMING OUT SOME OF THE LIKE.
TWELVE HUNDRED INDIVIDUALS IT
LOOKS LIKE.
FROM YOUR WE SERVE A TWELVE
THOUSAND PATIENTS ANNUALLY AND
HAVE -- IS A
CENSUS OF ABOUT FIFTY HOSPITALS
DAILY.
SO HOW MUCH OF ITS CONTRACTED
OUT FROM THE STATE HOSPITALS --
THAT CONTRACTED SERVICES ARE
AROUND. TO THAT DATA HERE.
IT IS A LITTLE OVER A THOUSAND
OKAY.
AND SO ONE OF THE THINGS THAT
I'M LOOKING AT IS WE KEEP
DIMINISHING SERVICES BUT WE
CONTRACT OUT MORE.
AND SO.
IT THE EQUITY THAT WE'RE TALKING
ABOUT AS FAR AS TRYING TO BE
ABLE TO PROVIDE A UP.
CONSISTENT AMOUNT OF CARE IS
THIS WHAT I'M CONCERNED ABOUT A
LACY -- THAT
WE DON'T HAVE THE CAPACITY OR
WHAT IS THE DEFAULT TO THE
PRISON SYSTEM.
THAT THAT TWEENER --
GOING FORWARD HE MENTIONED HOW
MUCH PER PATIENT AS YOUR CLASSES.
ANNOUNCES THAT --
NINETEEN THOUSAND DOLLAR FIGURE
WAS THE COSTS ASSOCIATED WITH
JUST THE PATIENT DRIVEN --
ANY THE COST OF YOUR TOTAL
BURDEN THE TOTAL COST AN AVERAGE
IS AROUND TWO HUNDRED AND TWENTY
FIVE GIVE OR TAKE. TWENTY TWENTY
FIVE THOUSAND PER INDIVIDUAL PER
INDIVIDUAL OVER HERE.
SO.
WHAT DO YOU PAY FOR CONTRACTING
OUT?
THE CONTRACTING OUT BERRIES --
THE HOW INDEPENDENT FINANCE FOR
THE GOP ASIAN ON AVERAGE IS
APPROXIMATELY A HUNDRED FIFTY
THOUSAND DOLLARS A YEAR WHICH
MUCH SLOWER.
OKAY.
SO WHAT I'M SEEING IS
[inaudible]
YOUR AND WHAT I'M HEARING IN THE
PUBLIC IS THAT.
THE STAFFING.
AS FAR UNDERSERVED WHERE WE HAVE
TO LOOK AT OUR MANAGING OVERTIME
IN AND SOME OF THE THINGS THAT
ARE GOING ON IN THE PUBLIC.
THIS COMING OUT AND WHEN WE ARE
CONTRACTING UP WE'RE MAKING
STATE EMPLOYEES WORK OVERTIME --
TO MAKE UP THE DIFFERENCE WHEN
WE SHOULD HAVE MORE FULL TIME
EMPLOYEES I THINK THAT'S
SOMETHING THAT NEEDS TO BE
ADDRESSED IN THIS IN THIS COMING
BUDGET --
SPECIALLY WHEN YOU LOOK ABOUT
THE SAFETY OF THE INDIVIDUALS ON
BOTH SIDES [inaudible]
THANK YOU.
THANK YOU ASSEMBLY MEMBER ANY
OTHER QUESTIONS.
SEEING ASSEMBLYMEMBER ROUTE AND
JUST A COMMENT AND THANK YOU --
I WAS LOOKING THROUGH THE
INFORMATION EARLIER AND I
VISITED ACTUALLY VISITED DON
KNAPP THE STATE HOSPITAL LAST
YEAR AND FIRST AND FOREMOST --
SO MANY ISSUES THAT WE HAVE BUT
PRIMARILY I THINK THE SAFETY OF
THE THE PERSONNEL IS MY NUMBER
ONE CONCERN WHEN I WAS THERE IT
WAS JUST --
OVERWHELMING IF YOU WELL TO SEE
WHAT THE EMPLOYEES --
GO TO ON A DAILY BASES
ESPECIALLY WITH THAT THE AMOUNT
OF MONEY THAT --
THAT YOU ALL SURVIVE WITH
BASICALLY AND I WANT TO JUST
LIKE TO KNOW THAT I DO SUPPORT.
THE INCREASE AT MY FEAR IS AGAIN
THAT ON SOME OF YOUR EMPLOYEES
ARE NOT --
BEING TAKEN CARE OF BECAUSE OF
THE LACK OF FUNDING AND SELL I
AGAIN I WANT TO JUST TELL THE IN
THE COMMUNITY THAT --
WHAT YOU GUYS DO IS INCREDIBLE
AND I UNDERSTAND THAT THE
EXPENSES HUGE BITE?
I THINK THAT --
IF.
IN NOT HELPING SOME OF THESE
FOLKS --
ACTUALLY BE REHABILITATED CREEK.
I DON'T SEE A DECREASE AND IN
POPULATION AND SO AGAIN IT'S
JUST A COMMENT I REALLY
APPRECIATE THE VISIT --
LAST YEAR AND I COMPLETELY
UNDERSTAND WHY YOU NEED MORE
FUNDING.
IF YOU NEED ANY HELP OR ANYTHING
IF YOU WOULD LIKE TO TALK TO ME
PLEASE MAKE AN APPOINTMENT AND
SEE.
IF THERE'S ANY WAY THAT I CAN
HELP -- HELP
OUT MORE THAN WHAT WE ARE DOING
TODAY THANK YOU.
THANK YOU SOME REMEMBER.
WITH THAT WE WILL HOLD ISSUE ONE
OPEN I WILL JUST MAKE A COMMENT
THAT -- THE
STATUE THAT WAS PASSED IN TWENTY
FOURTEEN I UNDERSTAND THERE ARE
UNAVOIDABLE DELAYS BUT MANY OF
US WANTED THOSE ATP'S. TO HELP
TO MEET THE NEEDS OF OUR
COMMUNITIES AND WOULD REALLY
LIKE TO MAKE SURE IF THERE'S ANY
FURTHER DELAYS OR PROBLEMS.
THAT YOU NOTIFY THIS COMMITTEE
SO THAT WE CAN FIGURE OUT HOW TO
HELP YOU AND ASSIST YOU TO MAKE
SURE THOSE COME ONLINE.
WITH THAT WE WILL MOVE ON TO
ISSUE.
TO ANY PUBLIC COMMENT ON ISSUE.
ONE MISTER CHAIR MEMBERS KERR
CHILD DISABILITY RIGHTS
CALIFORNIA I JUST WANTED TO
SPEAK TO THE ISSUE ON THE
PATIENT'S RIGHTS ADVOCATES --
THE ADDITION THERE FOR SIX AND A
HALF NEW POSITIONS THAT WOULD BE
INCLUDED FOR THE JAIL BASED --
TREATMENT PROGRAMS --
AS YOU KNOW WE HAVE HISTORICALLY
NOT BEEN SUPPORTIVE OF JAIL
BASED TREATMENT PROGRAMS THAT WE
BELIEVE --
THAT WE NEED TO EXPAND MORE
COMMUNITY BASED TREATMENT
PROGRAMS WHERE SERVICES ARE
BETTER PROVIDED AND AND THE
PROBLEMS THAT WE'VE CERTAINLY IN
THE MULTIPLE --
INVESTIGATIONS WE DO IN COUNTY
JAILS AND THE LITIGATION THAT WE
DO IN COUNTY JAILS ON THE
PRIMARILY AROUND MENTAL HEALTH --
TREATMENT BUT AS YOU KNOW WE
HAVE THE THE PATIENTS RIGHTS --
CONTRACT --
SO WE'RE UNCLEAR ON WHAT MIGHT
BE THE THOUGHT HERE ON AND HOW
OR IF IT'S EXPECTED THAT --
WE WOULD BE INCLUDED WITHIN THE
EXISTING CONTRACT TO INDEED
PERFORM THOSE PATIENTS RIGHT
SERVICES FOR THESE JAIL BASED
TREATMENT PROGRAMS.
AND IF SO --
I THINK THE DOLLARS THAT ARE
BEING PROPOSED HERE --
FOR SIX AND A HALF POSITIONS
WOULD BE WOEFULLY INADEQUATE --
TO PROVIDE THOSE SERVICES SO I'M
NOT SURE IF INDEED THERE'S
ADDITIONAL DOLLARS --
THAT MAY BE SOMEWHERE ELSE THAT --
THE THOUGHT WOULD BE. TO TO USE
FOR THIS CONTRACT OR IF --
THIS WOULD BE THE EXPECTED WE
WOULD PICK UP SIX AND A HALF
ADDITIONAL --
POSITIONS WITH --
WITH THESE FUNDS WE'D BE HAPPY
TO SIT DOWN OF COURSE WITH THE
DEPARTMENT AND TRY AND SORT THAT
PICKED PEACE OUT BUT RIGHT NOW I
THINK WE DON'T QUITE UNDERSTAND
THE DIRECTION THAT THEY'RE GOING.
THANK YOU THANK YOU SIR.
THIS TERM MEMBERS COULD BE
PROVIDED WITH CALIFORNIA
ASSOCIATION OF PSYCHIATRIC
TECHNICIANS FIRST I'D LIKE TO
THINK ASSEMBLYMEMBERS FRAZIER
AND RUBIO FOR THEIR KIND
COMMENTS I KNOW --
ASSEMBLYMEMBER AROMAS AND AND
ASSEMBLYMEMBERS RUBIO AND I
BELIEVE YOU --
TO MISTER CHAIR HAVE TAKEN TOURS
OF THE FACILITIES IN AN ERROR
DISTRICTS AND AND SO WE GREATLY
APPRECIATE.
YOUR SUPPORT AND UNDERSTANDING
OF WHAT IT IS THAT UR STAFF
GOES THROUGH HOME.
I WOULD AGREE WITH
ASSEMBLYMEMBER FRAZIER IN THE
SENSE THAT THE STEEL BASED
PROGRAMS ARE GREAT PROGRAMS BUT
WE DO BELIEVE THAT STATE STAFF
SHOULD BE PROVIDING THOSE
SERVICES --
THESE ARE STATE CONTRADA
CONTRACTED OUT --
BEDS SO THEREFORE WE BELIEVE
IT'S THE STATE EMPLOYEES THAT
SHOULD BE PROVIDING THE SERVICE
I'LL BE CONT COMMENTING MORE ON
OTHER ITEMS IN THE BUDGET LATER.
THANK YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT --
WILL HOLD ISSUE ONE OPEN AND
MOVE ON TO ISSUE.
TOO WHEN YOU'RE READY DIRECTOR.
AGAIN SEVENTY CLENDENIN ACTING
DIRECTOR FOR THE DEPARTMENT I'M
JOINED BY A DEBBIE DIRECTOR
CHRIS EDENS WHO IS THE DIRECTOR
FOR FORENSIC SERVICES --
DIVISION.
BUT I ALSO HAVE BEHIND ME.
CHRISTINE SAKAKI IS OUR CHIEF
COUNSEL ALSO BE STEPPING UP IN A
MOMENT TO SPEAK TO ONE OF THE
ITEMS.
SO FIRST OF ALL JUST A KIND OF
PROVIDE OF YOU OVERVIEW OF WHERE
WE ARE WITH THE I. S. T. --
WAIT LIST AND I HAS BEEN KIND OF
THE EFFORTS THAT WE'VE DONE TO
DATE.
SO IN EARLY TWO THOUSAND AND
THIRTEEN WE BEGAN TO EXPERIENCE
A GROWTH IN OUR WAIT LIST FOR
THE PLACEMENT OF INCOMPETENT TO
STAND TRIALS --
WITHIN A STATE HOSPITAL BED.
ICE TEAS ARE INDIVIDUALS WHO
HAVE COMMITTED A CRIME.
AND HAVE BEEN FOUND BY THE COURT
TO BE TOO MENTALLY ILL TO
UNDERSTAND THE NATURE OF THE
PROCEEDINGS OR TO ACTIVELY A
SISTER COUNCIL IN THEIR DEFENSE.
THE COURT WHEN THEY'RE FOUND
INCOMPETENT.
EXCUSE ME SUSPENDS THEIR
PROCEEDINGS AND WHILE THEY
UNDERGO A COMPETENCY RESTORATION
WITH US.
INDIVIDUALS WHO HAVE COMMITTED
FELONY CRIMES AND OUR FOUNDING
COMMENT TO BE REFER ARE REFERRED
TO THE S. H. --
FOR THE RESTORATION OF CONSTANCY
SERVICES AND THE MAXIMUM
COMMITMENT TIME FOR AN I. S. T.
PRIOR TO JANUARY ONE WAS THREE
YEARS SB ELEVEN EIGHTY SEVEN I'M
CHANGE THAT TIME FRAME TO TWO
YEARS AFFECTED THIS PAST JANUARY.
IN TWO THOUSAND SEVENTEEN
EIGHTEEN WE HAD AN AVERAGE DAILY
CENSUS OF FOURTEEN HUNDRED I IS
TEASE WE SERVE A TOTAL OF FOUR
THOUSAND FIVE HUNDRED AND
SEVENTY EIGHT PATIENT FEISTY
PATIENTS WITHIN OUR SYSTEM AND
THE AVERAGE LENGTH OF STAY WAS A
HUNDRED AND FIFTY THREE DAYS.
IN OUR JOB BASE COMPETENCY
TREATMENT PROGRAM WE SERVED AN
AVERAGE DAILY CENSUS OF TWO
HUNDRED AND TWENTY SEVEN LAST
YEAR.
A TOTAL OF ONE THOUSAND AND
SIXTY TWO PATIENTS WERE SERVED
THROUGH THOSE BEDS.
AND THEY HAD AN AVERAGE LENGTH
OF STAY OF FIFTY SEVEN DAYS WHEN
THEY WERE DISCHARGED FROM THE
JAIL BASS COMPETENCY TREATMENT
PROGRAM.
AND OFTEN --
SOME PATIENTS HAVE.
TO BE TRANSFERRED TO A STATE
HOSPITAL FOR FURTHER SERVICES
AND THOSE PATIENTS HAD EIGHTY AN
AVERAGE LIKE THE STATE OF ABOUT
EIGHTY SEVEN DAYS.
SINCE TWO THOUSAND AND THIRTEEN
WE'VE EXPERIENCED A SIGNIFICANT
GROWTH IN THE I. S. T. IS THAT
BEEN REFERRED TO THE DEPARTMENT.
IN FISCAL YEAR TWO THOUSAND
THIRTEEN FOURTEEN TO GIVE YOU A
SENSE OF THAT GROWTH WE RECEIVED
AN AVERAGE OF TWO HUNDRED AND
THIRTY TWO I S. T. REFERRALS PER
MONTH.
IN IN TWO THOUSAND EIGHTEEN
NINETEEN WE HAVE BEEN AVERAGING
FOUR HUNDRED AND FOURTEEN PER
MONTH THAT'S A 78% GROWTH IN THE
REFERRAL SINCE TWO THOUSAND
THIRTEEN FOURTEEN AND JUST A 10%
GROWTH SINCE TWO THOUSAND AND
SEVENTEEN EIGHTEEN THOUGH.
AND WE'VE TAKEN A LOT OF STEPS
TO TRY TO ADDRESS THE WEIGHTLESS
BUT IT DOES CONTINUE TO GROW --
JUST TO GIVE YOU A LITTLE SENSE
OF THE IT WAS THREE HUNDRED AND
SEVENTY ONE IN JULY OF TWO
THOUSAND AND FOURTEEN IT GREW TO
ITS HIGHEST POINT IN APRIL OF
LAST YEAR AT ONE THOUSAND AND
SIXTEEN BY JULY OF TWENTY
EIGHTEEN WE GAME SOME TRACTION
AND WE BROUGHT.
IT DOWN TO EIGHT HUNDRED THIRTY
SIX AND TODAY WE CURRENTLY HAVE
SEVEN HUNDRED AND SET AT SEVEN
HUNDRED AND SIXTY SEVEN
INDIVIDUALS ON THE WAIT LIST.
THIS GROWTH IN AYE IS TO
REFERRALS IS NOT JUST A
CALIFORNIA TREND IT'S A NATIONAL
TREND.
OUR COLLEAGUES IN STATE
HOSPITALS ACROSS THE COUNTRY ARE
ALSO GRAPPLING WITH THIS WITH
THIS ISSUE.
AND AS A RESULT OF THE RISING
WIRELESS THAT WE'VE BEEN ALL
FACING OFF FACING THERE HAVE
BEEN VARIOUS COURT PROCEEDINGS
BOTH HERE IN CALIFORNIA AND
NATIONALLY --
LOOKING OUT WHAT THE REQUIRED
TIMELINE FOR ADMISSION OF AN
INDIVIDUAL WHO IS FOUND
INCOMPETENT TO STAND TRIAL
SHOULD BE.
NATIONALLY STATES HAVE BEEN
ORDERED TO MET I SEE PATIENTS
WITHIN A SHORT OF SEVEN DAYS
FROM DATE OF REFERRAL IN HERE IN
CALIFORNIA WE'VE BEEN UNDER
VARIOUS COURT ORDERS.
FROM VARIOUS COUNTIES OVER THE
PAST SEVERAL YEARS RANGING FROM
TWO WEEKS TO SIXTY DAYS TO ADMIT
PATIENTS WERE FOUND INCOMPETENT.
WE'VE DONE MANY EFFORTS --
TO TRY TO ADDRESS THIS GROWING
WEIGHTLESS AND THE GROWING
REFERRALS.
FIRST OF ALL CAPACITY HAM BUT
WE'VE ALSO LOOKED AT HIM FOR A
HAS IMPROVING OUR SYSTEMS AS
WELL AS RESEARCHING THE DEMAND
IN RESPONDING TO THE DEMAND.
SO WITH RESPECT TO CAPACITY
WE'VE ADDED OVER FOUR HUNDRED
BED SINCE TWO THOUSAND TWELVE
THIRTEEN IN ORDER TO ATTRACT
GUIDE TO PROVIDE ADDITIONAL
TREATMENT CAPACITY IN OUR HI
STATE HOSPITALS FOR ICED.
WE'VE EXPANDED THE JAIL BASED
PROGRAM I MENTIONED BEFORE WE'RE
CURRENTLY AT THREE HUNDRED AND
TWENTY FIVE BEDS.
IN TEN COUNTIES.
AND WE ALSO HAVE EVERYWHERE
APPROVED IN THE LAST COUPLE
YEARS -- TO
CONSTRUCT A SECURE TREATMENT
AREA AROUND AN EXISTING BUILDING
AT METROPOLITAN STATE HOSPITAL I
WANT TOUCH TOO MUCH ON THAT
BECAUSE THAT'S GOING TO BE
FURTHER IN THE AGENDA.
WE'VE ALSO DONE SYSTEMS
IMPROVEMENTS --
AS A RESULT OF AB FOURTEEN SIXTY
EIGHT WE ESTABLISHED A PATIENT
MANAGEMENT UNIT.
WHOSE --
FOCUSES ON THE CENTRALIZED
RECEIPT AND PROCESSING OF ALL OF
THESE IDEAS T. REFERRALS THEY
MANAGE THE PATIENT MOVEMENT
THROUGHOUT OUR STATE HOSPITAL
SYSTEM.
AND WITH THE JAIL BASED
COMPETENCY AND COORDINATE THAT
WITH THE JOB AT JABAL JOB IS
COMPANIES TREATMENT AND OUR
COMMUNITY PROGRAMS.
AND THEN MAXIMIZE THE
UTILIZATION OF OUR BED CAPACITY.
WE PARTICIPATED IN I. S. T.
WORKGROUP WITH MANY OF OUR
STAKEHOLDERS TRYING TO IDENTIFY
SOLUTIONS AS WELL AND AND EARLY
EFFORTS FROM THATWORK GROUP
RESULTED IN LEGISLATION THAT
ALSO FURTHER STREAMLINED THE I A
STEAMY.
PROCESS.
WITH RESPECT TO DEMAND WE'VE
ALSO BEEN WORKING IN A HARD TO
TRY TO BETTER UNDERSTAND WHY
INDIVIDUALS ARE BE REFERRED TO
THE STATE HOSPITALS AND WHAT
THAT POPULATION LOOKS LIKE SO WE
CAN BETTER SERVE IT.
AS PREVIOUSLY MENTIONED THE
GROWTH IN THE NUMBER OF AYE IS
TO USE AS A NATIONAL TREND AND
MULLIN LOOKING AT NATIONAL DATA
IT DEMONSTRATES A LARGE INCREASE
OVER TIME AND I IS TO I SEE
PATIENTS COMMITTED TO STATE
HOSPITALS THE DATA INDICATES
APPROXIMATE RISE OF 70%.
OVER THE LAST TWENTY YEARS OF
ICE TEAS.
THE EXACT CAUSE AND A RECENT
NATIONAL SEARCH IS DIFFICULT TO
PROVE HOWEVER THERE IS A
CORRELATION BETWEEN THE TIMING
OF THE RECENT NATIONAL SURGE IN
THE RECESSION.
WHEN LOOKING AT COMMON THEMES
WITHIN OUR DS H. DATA AND WITH
LOOKING THROUGH YEARS OF
RESEARCH WE HAD ABOUT A DECADE
OF OF DATA THROUGH RESEARCH THAT
WE'VE CONDUCTED WITH THE UC
DAVIS -- WE
LOOKED OUT THE COMMON TRENDS AND
THE CHARACTERISTICS OF THE
POPULATION THAT WE SERVE AND
THEN WE DID AS A SEVERAL MONTH
STUDY OF NEW ADMISSIONS TO TALK
TO TO COMPARE WHAT OUR NEW
ADMISSIONS A PLANK OF ACROSS
THAT TEN YEAR STUDY.
OVERALL THE DATA DIDN'T REFLECT
ANY MAJOR CHANGES IN THE
CHARACTERISTIC RESTRICTS OF THE
POPULATION WITH THE X. --
EXCEPTION OF THE AND ARRESTED A
FIFTEEN OR MORE HAD FIFTEEN OR
MORE PRIOR REST PRIOR TO THEIR
MISSION HAD SUBSTANTIALLY GROUND
46% OF OUR POPULATION HAD
FIFTEEN OR MORE PRIOR PRIOR
ARRESTS.
WE ALSO AND THE MAJORITY OF I
SEE PATIENTS THAT ARE REFERRED
TO THE S. H. HAVE A MAJOR
PSYCHOTIC OR MOOD DISORDER AND
HAVE HAD.
IT MENTIONED MULTIPLE RESTS
APPROXIMATELY 47% THIS IS
ANOTHER STATISTIC THAT WE GOING
FROM OUR MORE RECENT --
A REVIEW OF THE AYE AYE IS HE
ADMISSIONS IS THAT 47% WERE
COMING INTO US AT IT FROM AN AND
SHELTERED --
HOMELESS STATUS PRIOR TO THEIR
TIME OF THEIR ARREST.
AND THEN --
WE ALSO COMPARED R. I. S. T.
DATA TO MEDICAL DATA AND 2407%
OF THE I GUESS HE'S HAD NOT
ACCESS THE MEDIC HOW
REIMBURSABLE.
A SERVICES --
PRIOR TO THE SIX MONTHS PRIOR TO
THEIR ARREST.
SO AS A RESULT OF THIS RESEARCH
BE UNDERSTOOD THAT MANY OF AYE
AYES TIAS ARE COMING TO US AS A
RESULT OF NON VIOLENT FLONIES
ARISING FROM SYMPTOMS OF THEIR
UNTREATED MENTAL ILLNESS AND
CONDITIONS OF HOMELESSNESS.
AND THIS UNDERSTANDING BECAME
THE BASIS FOR LAST YEAR'S
DIVERSION PROPOSAL --
WHERE WE WERE APPROVED LAST YEAR
FOR HIGH DEVELOP NEW OR
EXPANDING EGGS AN EXISTING
DIVERSION PROGRAMS AND I AM
GOING TO ASK IF YOU DIRECTOR --
EDENS WHO IS A DOCTOR OF OUR
FRIENDS EX SERVICES DIVISION WHO
OR HER TEAM IN PARTNERSHIP WITH
OUR MEDICAL DIRECTOR AND A
MEMBERS OF OUR CLINICAL
OPERATIONS DIVISION.
ARE WORKING TO IMPLEMENT
DIVERSION [inaudible]
THANK YOU.
MISTER CHAIR COMMITTEE MEMBERS
MY NAME IS A CHRIS EATON'S I'M
THE DEPUTY DIRECTOR FOR THE
FRIENDS EX SERVICES DIVISION --
AND AS AS STEPHANIE HAD
MENTIONED THAT --
MY DIVISION IS PARTNERING WITH
OUR CLINICAL OPERATIONS DIVISION
OUR MEDICAL DIRECTOR TO
IMPLEMENT --
THE DIVERSION FUNDING PROGRAM.
SO I'M HAPPY TO PROVIDE YOU WITH
THAT UPDATE TODAY --
SO AS STEPHANIE MENTIONED WE
WERE APPROVED FOR A HUNDRED
MILLION DOLLARS THIS YEAR --
OF THAT TOTAL AMOUNT ON NINETY
ONE AND THE MAJORITY OF THE
FUNDS NINETY ONE MILLION WAS
FOCUSED ON WHAT WE CALL OUR TOP
FIFTEEN COUNTIES.
AND THESE FIFTEEN COUNTY IS --
REALLY REPRESENT OUR HIGHEST
RATE OF REFERRALS AS A FISCAL
YEAR SIXTEEN SEVENTEEN HIGHEST
RATE OF FELONY I S. T. REFERRALS
TO THE DEPARTMENT.
AND THEN --
AN ADDITIONAL EIGHT AND A HALF
MILLION DOLLARS WAS --
AUTHORIZED TO PROVIDE --
FUNDING OPPORTUNITIES TO OTHER
COUNTIES THAT WERE INTERESTED IN --
APPLYING FOR THESE FUNDS SO OUR
OVER ARCHING GOALS FOR THIS
PROGRAM ARE TO REALLY ONE
DEMONSTRATE --
EFFECTIVE STRATEGIES AND
COMMUNITY BASED PROGRAMS THAT
CAN SUPPORT THE DIVERSION OF THE
SPECIFIC POPULATION SO REALLY
WHAT IT WHAT DOES IT TAKE TO
SERVE THIS POPULATION OUT IN THE
COMMUNITY --
TO OBVIOUSLY TO REDUCE THE RATE
OF FELONY ICED TEA REFERRALS
COMING INTO OUR DEPARTMENT --
BASED ON THE RESEARCH THAT WE'VE
BEEN DOING WE DO THINK THAT A
SUBSTANTIAL PORTION OF OUR
REFERRALS COMING IN READ THE
COULD BE BETTER SERVED IN THE
COMMUNITY.
AND SO LASTLY OUR OUR OUR ONE OF
OUR GOALS IS TO INTEGRATE
INDIVIDUALS INTO LONG TERM
COMMUNITY TREATMENT --
WITH THE HOPE OF REVERSING THAT
CYCLE OF OF CRIMINALIZATION AND
AND BACK INTO THE INTO THE JAILS --
AND SO ARE OUR EFFORTS TO DATE
HAVE REALLY BEEN FOCUSED AROUND
SORT OF THREE MAIN DOMAINS.
AND THAT IS THE CONTRACT AND
FUNDING PROCESS.
HOW QUICKLY CAN WE GET THESE
THIS MONEY OUT TO THE COUNTY IS --
AND WHAT WE NEED ELATION WHAT IT
SUPPORTS TO THE COUNTY IS NEEDED
IN ORDER TO IMPLEMENT.
THESE PROGRAMS --
OR WHAT SORT OF SUPPORT TO THE
NEED TO TO PLAN TO JUST GET THE
MONEY OUT THE DOOR.
AND THEN LASTLY TO STRATEGIZE
AROUND THE DATA COLLECTION
EFFORTS --
TO SUPPORT THIS PROGRAM.
ON THE COUNTY IMPLEMENTATION
FRONT --
BECAUSE THE MAJORITY OF OUR
FUNDS WERE TARGET TO THE FIFTEEN
COUNTIES WE PRIORITIZE
PRIORITIZE THAT GROUP --
FIRST -- WE
KICKED OFF THE STAKEHOLDER
ENGAGEMENT IN THE FALL AND THEN
FOLLOWED THAT WITH THE REQUEST
FOR LETTERS OF INTEREST PROCESS --
IN ORDER TO GAUGE --
INTEREST FROM OUR FIFTEEN
COUNTIES ALL FIFTEEN COUNTIES
EXPRESSED INTEREST IN
PARTICIPATING --
AND THEN --
SINCE THEN --
AS OF FEBRUARY WE ACTUALLY ARE
IN ACTIVE NEGOTIATIONS WITH SIX
OF OUR COUNTIES --
LA BEING THE LARGEST COUNTY AND
SO WITH THOSE SIX CONTRACTS WELL
WE DON'T HAVE ACTUAL CONTRACTS
IN PLACE WE DO HAVE PROGRAMS
LIKE LA THAT ARE PRETTY MUCH
READY TO GO --
WE'RE JUST FINALIZING THOSE CON
SO WITH THE SIX COUNTIES THAT
WOULD ACTUALLY REPRESENT SERVING
A PROJECTED POPULATION OF ABOUT
THREE HUNDRED AND FIFTY EITHER I
IS TEASE OR AT RISK OF THAT I.
S. T. --
FINDING --
AND THAT ALSO REPRESENTS ABOUT
47% OF THE FUNDING THAT --
THAT WE WERE AWARDED.
OR THAT WE WERE AUTHORIZED --
IN DECEMBER WE RELEASED OUR
ROUND TO FUNDING OPPORTUNITY FOR
OTHER COUNTIES --
AS OF CASH FEBRUARY WE RECEIVED --
THIRTEEN LETTERS OF INTENT --
FROM VARIOUS COUNTY IS TWO TO
THREE OF THEM REPRESENTS SMALL
COUNTIES.
ON THE APPLICATION PROCESS FOR
THEM -- AND
CLOSES IN APRIL APRIL NINETEENTH --
AND SO WE'RE WORKING TOWARDS --
ESTABLISHING --
A SERIES OF OF TECHNICAL
ASSISTANCE WEBINARS TO ASSIST
THOSE COUNTIES WITH WHAT THEY
NEED TO TO COMPLETE THEIR
APPLICATION PROCESS.
ON THE SECOND FRONT IN TERMS OF
OF SUPPORTING THE COUNTIES IN
THEIR IMPLEMENTATION EFFORTS
WE'VE BEEN REALLY FOCUSED ON
DEVELOPING OUT TRAINING AND
TECHNICAL ASSISTANCE
OPPORTUNITIES --
WE RECEIVE --
A SMALL AMOUNT OF FUNDING --
FOR THE ADMINISTRATION OF THIS
PROGRAM TO POSITIONS --
WE WE OF FILLED BOTH OF THOSE
POSITIONS AS OF OF JANUARY OF
THIS YEAR --
BUT AS PART OF THIS WE'VE REALLY
ESTABLISHED A CROSS
COLLABORATIVE TEAM OR A STEERING
COMMITTEE. TO REALLY FOCUS ON
WHAT CAN WE DO TO SUPPORT
COUNTIES HOW CAN WE LEVERAGE AND
WORK WITH OTHER PARTNERS OUT
THERE IN THE COMMUNITY. TO
PROVIDE AND BE RESPONSIVE TO THE
TRAINING NEEDS OF THE COUNTIES --
AND SO SO WITH THAT WE PARTNER
WITH THE COUNCIL OF CRIMINAL
JUSTICE AND BEHAVIORAL HEALTH.
AND WE ALSO ARE PARTNERING WITH
THE COUNCIL OF STATE GOVERNMENTS
JUSTICE CENTER --
TO SUPPORT THE TECHNICAL
ASSISTANCE NEED SO WORKING WITH
EACH ADDITIONAL COUNSEL --
COUNTY BAKER.
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION --
SEE SACK --
THE MAJOR COUNTY ASSOCIATIONS --
AC AS WELL --
AND SO WE'VE ON THE TECHNICAL
ASSISTANCE FRONT WE'VE SENT ON A
SERIES OF SURVEYS AS WELL AS
CONTACTED EACH ONE OF OUR TOP
FIFTEEN COUNTIES --
TO JUST HAVE.
DISCUSSIONS ON WHERE ARE THEY
OUT WITH THEIR PLANNING PROCESS
WHAT DID THEY NEED HELP WITH --
ALMOST ALL OF THEM KIND OF CAME
BACK WITH A SERIES OF OF
SPECIFIC.
ON THE TOP NEED BEING YOU KNOW
HELP US IDENTIFY WHO COULD BE.
WHO COULD BE ELIGIBLE FOR THIS
FINDING HOW --
HOW CAN WE IDENTIFY THOSE THAT
COULD QUALIFY --
SO WE'VE --
ESTABLISHED AS I SAID A SERIES
OF OF WEAPON OUR TRAININGS ONE
JUST OCCURRED ON ON FRIDAY --
TO TO BROADCAST OUT TOWARD
COUNTIES --
THE HOW TO IDENTIFY THE
ELIGIBILITY OF FOLKS AND HOW --
TO ALSO IDENTIFY THE RISK
ASSESSMENT --
ON THE DATA COLLECTION FRONT --
D. S. H. IS GOING TO JUST BE
WORKING WITH OUR EXISTING FOR
EXISTING RELATIONSHIP WITH THAT
UC DAVIS TO COLLECT AND REPORT
STRUCTURE.
TO STATUTORILY MANDATED DATA
FROM EACH PROGRAM FUNDED THROUGH
IS THAT THROUGH THIS INITIATIVE
WE HAVE --
AN EXISTING CONTRACT WITH UC
DAVIS -- AND
SO THEY'LL BE WORKING DIRECTLY
WITH COUNTIES ON ON THE DATA
COLLECTION FRONT --
I THINK THAT THAT'S ALL I HAVE.
THANK DEPARTMENT OF FINANCE A
LEO ANY COMMENTS ON ISSUE.
TO SEEING NON WILL NOW TAKE
PUBLIC COMMENT AND IF I MAY I
MAY TAKE --
KERR CHILD COMMENT ON THIS YOU
WANT TO APPLY IT TO ISSUED --
TO ANY OTHER PUBLIC COMMENT ON
ISSUE.
TO AFTER HIS RETURN MEMBERS
COURCELLES ALONG BEHALF THE
CALIFORNIA STATE SHERIFFS
ASSOCIATION HERE IN SUPPORT OF
THE PROPOSALS TO FUND THE
EXISTING JBC T. THE JAIL BASS
COMPETENCY TREATMENT PROGRAMS --
AS WELL AS THE CONTINUED FUNDING --
FOR ADDITIONAL CAPACITY AT JAIL
BASED TREATMENT PROGRAMS ALSO IN
SUPPORT OF THE CONTINUED FUNDING
FOR THE EXPANSION OF METRO STATE
HOSPITAL.
THE I. S. T. POPULATION --
CONTINUES TO BE A DIFFICULT
POPULATION FOR JAILS TO DEAL
WITH --
BAKERY CLASSIFICATION IS NOT --
TO TO SPEAK ILL OF THAT
POPULATION BUT IT IT CREATES A
VERY REAL OPERATIONAL ISSUES IN
THE JAILS.
AND SO HAVING --
DEDICATED TREATMENT PROGRAMMING
SPACE AND TREATMENT SPACE THAT --
THOSE PATIENTS CAN BE DEALT WITH
PH BUT THAT CAN BE DEALT
WITH AT THE JAIL THAT AVOIDS
HAVING TO TRANSPORT SOMEONE WAIT
FOR BED TRANSPORT THEM TO A
STATE HOSPITAL BED --
HOPEFULLY BE RESTORED A
COMPETENCY HAVE THEM COME BACK
RUN THE RISK OF THE COMPENSATION
HAVING THAT TREATMENT DONE AT
THE JAILS --
HAS PROVEN TO BE A SUCCESSFUL
PROGRAM WE TYPICALLY SEE SHORTER
LENGTH OF STAYS --
WE SEE CHEAPER --
PROVISIONS WE DO HAVE COUNTY
EMPLOYEES DOING THAT WORK IN
TERMS OF OF SHERIFF STAFF THERE
ARE CONTRACTED MEDICAL
PROFESSIONALS BUT IT'S BEEN A
SUCCESSFUL MODEL.
A AND SO WE WE APPRECIATE --
THE BUDGET INCLUDING THAT
FUNDING --
AND IT REALLY HELPS KEEP THE
LIMITED THE S. H. BED CAPACITY
FOR THE TOUGHEST CASES AND SO WE
THINK IT STRIKES THE RIGHT
BALANCE.
BETWEEN STATE RESPONSIBILITY
FOLKS HELPS THE COUNTIES GET
THROUGH TREATING SOME OF THESE
FOLKS THANK YOU THANK YOU SIR.
CAN KOBE PRESIDED WITH
CALIFORNIA ASSOCIATION OF
PSYCHIATRIC TECHNICIANS WE ALSO
SUPPORT THIS PROPOSAL LAKE
MISTRESS ALSO SAID.
IT DOES DEFINITELY HELP --
WE THINK FLAT LINE THE WAITING
LIST IT DOESN'T DECREASE IN OUR
OPINION OF THE WAITING LIST AS
WE'RE SEEING FOR THE I. S. TEAS --
BUT IT CERTAINLY DOES STOP THE
FLOW FROM GROWING BEYOND CONTROL
AND WE DO BELIEVE THAT THAT IS
SOMETHING THAT WE HAVE TO DO --
ADDITIONALLY WE DO SUPPORT THE
PROPOSAL FOR THE METROPOLITAN
STATE HOSPITAL INCREASE CAPACITY.
SO THANK YOU.
THANK YOU SIR.
HI MY NAME IS MICHAEL BEING I
REPRESENT THE COLEMAN CLASS THE
PATIENTS IN THE C. C. R. TWENTY
SIX EIGHTY FOUR IS ALSO
REPRESENT --
OUR CLASSES IN VARIOUS COUNTY
JAILS MONTEREY.
YUBA -- I AM.
VERY MUCH IN SUPPORT OF THIS
DIVERSION PROGRAM --
I DON'TTHINK THAT WE CAN
CONTROL THE I. S. T. IS.
BY BUILDING MORE BEDS FOR ISSUES
AND JAILS OR THE PRISONS WE HAVE
TO GET THIS POPULATION OUT OF
THE CRIMINAL JUSTICE SYSTEM AND
INTO COMMUNITY MENTAL HEALTH
PROGRAMS --
THIS IS A VERY WISELY SPENT
MONEY I HOPE THE T. S. H. KANG.
MOVIE THROUGH AND YOU CAN SEE
SOME ARE CREATIVE PROCESS SEES
THIS IS EXACTLY THE DIRECTION
SHOULD GO --
IF TOO MANY PEOPLE WITH SERIOUS
MENTAL ILLNESS IN THE PRISON
SYSTEM AND IN THE JAILS THANKS
THANK YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO THE COMMITTEE
FOR ANY QUESTIONS THAT WE MAY
HAVE.
ASSEMBLYMEMBER FRAZIER THANK YOU
SO WHEN YOU TALK ABOUT YOUR
PROGRAM THAT YOU'RE WORKING WITH
THE COUNTIES ON THE ON THE
GRANTS.
ARE YOU MAKING SURE THAT THEY'RE
SPENDING DOWN THERE MAY SOME
MONEY THERE'S A PROP SIXTY THREE
IS WE'RE SEEING A LOT OF THEM.
HOLDING LARGE SUMS OF MONEY.
AND NOT USING IT EFFECTIVELY CAN
ANSWER THAT YEAH SO --
DEFINITE.
DEATH I CAN'T SPEAK TO IN TERMS
OF SPENDING IT DOWN BUT I CAN
SAY THAT THE THE WAY THAT WE
WROTE OUR PROPOSAL AND ARE
ROLLING OUT THE CONTRACT THE
COUNTIES ARE REQUIRED TO
CONTRIBUTE MATCHING FUNDS --
FOR MOST COUNTIES THAT THE 20%
MATCH FOR SMALL COUNTIES IT'S A
10% MATCH AND SO WHAT WE ARE
SEEING IS THAT COUNTIES ARE
GETTING VERY CREATIVE WITH
LEVERAGING --
AVAILABLE FUNDS --
WE ARE SEEING THE MHSAA USED AS
AS PART OF THAT MATCH AND THEN
WHERE --
MEDI CAL APPROPRIATE SERVICES
MAKES SENSE --
THOSE DOLLARS ARE BEING
LEVERAGED AS WELL --
SO DEFINITELY THE COUNTIES ARE
BEING CREATIVE AND ARE UTILIZING
THOSE MHSAA DOLLARS I THINK ONE
OF THE CHALLENGES MIGHT BE MORE
AROUND HAVING THOSE IMAGES STATE
PLANS THAT ARE ALREADY IN PLACE
AND THEN AND GETTING ACCESS TO
THOSE FUNDS --
WHERE THAT PLAN --
HAS ALREADY BEEN IN PLACE BUT
WE'RE WE'RE WE ARE --
HAVING CONVERSATIONS WITH A WE
SEE AROUND THAT --
SO THAT SO THAT WE CAN MAXIMIZE
THE USE OF THOSE IMAGES A
DOLLARS.
HEY PHILIP LEVERAGING BUT WHEN
THEY'RE SITTING ON LARGE AMOUNTS
OF MONEY.
THEY CALL RESERVE FUNDS --
AND THEY'RE NOT BEING EFFECTIVE
IN.
PURPOSING FOR WHAT WE ALL WANT
TO HAPPEN.
ARE THE INTENDED PURPOSE FORM.
I THINK THAT WE NEED TO BE ABLE
TO BE VERY CAREFUL AND MAKE SURE
THEY'RE NOT USING YOUR DOLLARS.
SO THEY CAN HOLD ON TO THEIR
DOLLARS SO SPENDING DOWN THOSE
RESERVES IS VERY VERY IMPORTANT
TILLY'S TO ME.
I'M A BUDGETARY PROCESS THAT
MAKES WAS.
WAS INTENDED TO BE THAT BEING ON
THE SHOW ON YOUR OF FOR YOUR
INDUSTRY HELLO AND SO I'M HOPING
THAT WE CAN LOOK AT HOW.
YOUR PROCESSES ACTUALLY.
MAKES THEM SPEND THE MONEY.
ALSO DOWN TO VERY LOW RESERVES.
I APPRECIATE THAT I ALSO --
EXCUSE -- I
I WILL SAY THAT BECAUSE THIS
HUNDRED MILLION IS ONE TIME
FUNDS -- THE
QUESTION OF OF SUSTAINABILITY
COMING UP AND SO PART OF THE
TECHNICAL ASSISTANCE THAT WE'RE
OFFERING TO THE COUNTY IS
ESPECIALLY THROUGH OUR
PARTNERSHIP WITH.
THE COUNCIL OF STATE GOVERNMENTS
JUSTICE CENTER IS PLANNING
AROUND THAT AND WHILE WHILE WE
CAN'T DO SOURCES TO USE WE CAN
CERTAINLY ENCOURAGE AND HELP
GIVE THEM THE TOOLS THAT THEY
NEED TO TO PLAN AND CONTINUE
THESE PROGRAMS GOING FORWARD.
BECAUSE AS MENTIONED BEFORE.
OF FROM THE DIRECTOR THAT.
EARLY INTERVENTION WOULD HAVE
BEEN A AT A VERY OF USEFUL TOOL
AND KEEPING POPULATION DOWN.
AGAIN SHOT NORMA SUPPOSED TO BE
MESA SO FOR IF YOU NEED
LEGISLATION.
TO HELP YOU.
HELLO YOU CAN ENCOURAGE BUT WE
CAN REQUIRE.
SO YOU KNOW WE NEED TO KNOW
THESE THINGS WHEN YOU'RE GOING
OVER THESE GRANT PROGRAM SO THEY
ARE UTILIZING EVERY DIME FOR
IT'S EXPECTED CHOOSE.
IF I MAY USE ASSEMBLYMEMBER
FRAZIER DANCE YOUR QUESTION
CHRIS COOK DEPARTMENT OF FINANCE --
WITH REGARDS TO PROP SIXTY THREE
FUNDS --
IMAGES OF DOLLARS AND YOUR
CONCERNS --
ON COUNTY SITTING ON RESERVES
THERE HAS BEEN RECENT
LEGISLATION PASSED.
IN THE LAST YEAR TO THAT HAVE --
SET GUIDELINES AND TIME LIMITS
ON COUNTY SPENDING OF THOSE
DOLLARS AND IT'S TAKING STEPS
FORWARD --
TO PROMULGATE REGULATIONS THAT
SPECIFIED THOSE PROCESSES FOR
PERVERSION AND THOSE TIME LINES
I KNOW I'M NOT TALKING BY THE
TIME YOU WANT TO BE RESPECTFUL
OF THE TOPICS THAT WE HAVE.
I KNOW WE'RE GONNA BE TOP IN
TALKING ABOUT THOSE IN MORE
DETAIL ON THAT.
THE COMING WEEK OR SO.
BUT I ALSO KNOW THERE WAS
LEGISLATION EITHER KILLED OR
VETOED --
ALSO PURPOSED AND MAKING SURE
SHORTER TIME LINES.
OF THOSE GLORIA BILL.
THANK YOU ASSEMBLY MEMBER.
I WANTED TO TAKE A MOMENT AND
ACTUALLY JUST THANK YOU DIRECTOR
ACTING DIRECTOR CLINTON --
IT'S IMPORTANT TO INCREASE OUR
THROUGHPUT AND THE DIVERSION
PROGRAM THE HUNDRED MILLION
DOLLARS THAT WE INVESTED SEEMS
TO REALLY BE WORKING ON THREE
PUT AND YOU'RE TO BE
CONGRATULATED FOR THAT FOR A
LONG TIME WE'VE BEEN SEEING
INCREASING NUMBERS OF ICE TEA
PATIENTS AND IT'S IMPORTANT THAT
WE AT A MINIMUM.
TREADING WATER AND IT SEEMS THAT
THE DIVERSION PROGRAM IS IS
DOING THAT.
I'M HOPEFUL THAT THE DATA THAT
COMES OUT OF UC DAVIS WILL ALLOW
US AN OPPORTUNITY TO ADVOCATE.
FOR MORE FUNDING AS NEEDED FOR
THE DIVERSE --
TO YOUR CONTINUED EFFORTS IN
THIS ARENA WITH THAT WE WILL
HOLD ISSUE TO OPEN IN THE BOND
ISSUE
. THREE FOR THIS ISSUE ITEM
I'M JOINED BY A DOCTOR WERE
BURTON WHO IS R. D. S. H.
MEDICAL DIRECTOR AND DEPUTY
OCTOBER CLINICAL OPERATIONS
DIVISION. FOR THIS PROPOSAL WE
THE REQUEST IS FOR A TOTAL OF
NINETY FOUR POINT SIX POSITIONS
AN EIGHTEEN POINT ONE MILLION IN
GENERAL FUND ON GOING.
PHASED IN ACROSS THREE FISCAL
YEARS AND THIS IS TO PROVIDE
RESOURCES NEEDED TO PERFORM.
THE FORENSIC SERVICES WORKLOAD
THAT IS ASSOCIATED WITH COURT
DIRECTED PATIENT TREATMENT
RELATED TO SERVING PATIENTS WHO
ARE COMMITTED AS INCOMPETENT TO
STAND TRIAL NOT GUILTY BY REASON
OF INSANITY MENTALLY DISORDERED
OFFENDERS AND SEXUALLY VIOLENT
PREDATORS.
THIS PROPOSAL WILL PROVIDE THE
RESOURCES THAT ARE NEEDED TO
PERFORM THE WORKLOAD WHICH
INCLUDES FORENSIC EVALUATIONS
REPORTING FOR THE COURT COURT
TESTIMONY.
FRIENDS A CASE MANAGEMENT AND
DATA TRACKING AND NEURO
PSYCHOLOGICAL ASSESSMENTS AND
TREATMENT.
SEVERAL YEARS AGO THE DEPARTMENT
INITIATED A COMPREHENSIVE EFFORT
TO EVALUATE STAFFING AMONG OUR
FIVE STATE HOSPITALS BY
PERFORMING A CLINICAL STAFFING
STUDY WHICH WAS COMPRISED OF
FOUR COMPONENTS.
POSSIBLE FORENSIC DEPARTMENTS
THE TWENTY FOUR HOUR CARE
NURSING SERVICES PROTECTIVE
SERVICES TREATMENT PLANNING AND
DELIVER AN AND TREATMENT
PLANNING AND DELIVERY.
THIS SPECIFIC PROPOSAL IS THE
OUTCOMES OF THE FIRST OF THOSE
COMPONENTS THE HOSPITAL FRIENDS
LIKE DEPARTMENTS.
INCORPORATES ALL THE DATA AND
RESEARCH R. D. S. H. RESEARCH
TEAM.
DURING THE STAFFING STUDY WE
ALSO COLLABORATED WITH THE
DEPARTMENT OF FINANCES RESEARCH
AND ANALYSIS UNIT THROUGH THEIR
MISSION BASED RUBIO.
AND ADDITIONALLY WE CONTRACTED
WITH COOPERATIVE PERSONAL
SERVICES TO CONDUCT AN
INDEPENDENT VALIDATION OF THE
STOPPING STUDY AND METHODOLOGIES.
THERE ARE THREE MAIN COMPONENTS
TO THIS PROPOSAL THE FIRST ONE
IS FIFTY THREE POINT ONE
FORENSIC EVALUATOR POSITIONS FOR
THE HOSPITAL'S FORENSIC
DEPARTMENTS BASED IN ACROSS
THREE YEARS.
THE FORENSIC DEPARTMENT CITIES
HOSPITALS ARE RESPONSIBLE FOR
FORENSIC EVALUATIONS AND COURT
REPORTS THAT ARE ASSOCIATED WITH
OUR FRIENDS AT PATIENTS.
THIS FUNCTION REQUIRES FRIENDS
ECKLEY TRAINED PSYCHOLOGISTS AND
PSYCHIATRISTS THE UNDERSTAND THE
INTERSECTION BETWEEN THE LAW AND
THE PHILOSOPHIES OF THEIR
PRACTICE.
THAT CAN PERFORM A FORENSIC
ASSESSMENT OF A PATIENT WHICH
CAN INCLUDE MENTAL COMPETENCY
EVALUATIONS SOMETHING IS AMISS.
HIS ME LOOKING UP THERE
SOMETIMES DIAGNOSIS PROGRESSION
IN TREATMENT AND VIOLENCE
RESTORED SELF AND OTHERS.
THEY PREPARE REPORTS THE COURT
AND TESTIFY IN COURT TO
COMMUNICATE AN UNBIASED CLINICAL
PERSPECTIVE OF A PATIENT AS IT
RELATES TO THE STATUTORY CREDIT
CRITERIA.
SURROUNDING THAT FOR THEIR
FRIENDS A COMMITMENT.
THIS IS A VERY SIGNIFICANT
FUNCTION FOR OUR DEPARTMENT.
LAST YEAR WE SERVE NINE THOUSAND
EIGHT HUNDRED AND SIXTY FORENSIC
PATIENTS WE MAINTAIN AN AVERAGE
DAILY CENSUS OF FIVE THOUSAND
THREE HUNDRED AND SEVENTY ONE
FORENSIC PATIENT.
AND EACH FRIENDS THAT COMMITMENT
TYPE THERE ARE SUCH A TOTALLY
REQUIRED REPORTS THAT WE MUST AT
SAID SUBMIT TO THE COURT I
PRESCRIBED --
INCREMENTS DURING THE PATIENT'S
DAY LAST YEAR WE FILED A BIRTH
OF ELEVEN THOUSAND REPORTS THE
COURT REGARDING OUR FRIENDS AT
PATIENTS.
WELL IT IS A MAJOR FUNCTION
HISTORICALLY WE HAVE NOT HAD A
STAFFING STANDARD OR METHOD FOR
PROVIDING NECESSARY STAFFING FOR
THIS IS FOR THE SERVICES.
DESPITE OUR GROWING FORENSIC
POPULATION. TO ADDRESS THE THIS
MANDATED FRIENDS LIKE WORKLOAD
THE HOSPITALS HAVE UTILIZED OR
TREATING CLINICIANS OR
REDIRECTED RESOURCES FROM
TREATMENT TEAMS NURSING SERVICES
AND OTHER HOSPITAL FUNCTIONS IN
ORDER TO PERFORM THIS GROWING
WORKLOAD.
THIS PROPOSAL ESTABLISHES A
STAFFING SET A STANDARD
METHODOLOGY ACROSS ALL THE
HOSPITALS BASED ON AN ESTIMATED
NUMBER OF RECORDS OF REPORTS. TO
BE COMPLETED ANNUALLY THE TIME
TO COMPLETE ALL STEPS RELATED TO
THOSE COURT REPORTS AND
EVALUATIONS.
AND THE TESTIMONY AND TRAVELED.
BY ESTABLISHING A DEDICATED
FORENSIC RESOURCE --
THAT ARE SEPARATE FROM OUR
TREATING CLINICIANS IT ADDRESSES
THE CHALLENGE THAT ARISE FROM
THE TREATMENT TEAM CLINICIANS
FULFILLING THE ED A DUAL ROLE OF
BOTH THE TREATMENT FROM PROVIDER
AND THE FRIENDS I CAN BUY A
WAITER.
THE SECOND PORTION OF THIS A
PROPOSAL IS --
SIXTEEN POINT THREE
ADMINISTRATIVE POSITIONS --
FOR FRIENDS THAT CASE MANAGEMENT
AND DATA TRACKING PHASED IN OVER
TWO YEARS.
WITH ALL THE ACTIVITY AND
REPORTS RELATED TO THE FRIENDS
OF PATIENT THERE'S A SECOND
SIGNIFICANT AMOUNT OF DATA AND
TRACKING WHEN REPORTS ARE DUE TO
ENSURE THE REPORT CERTIFIED
FILED TIMELY WITH THE COURTS.
ADDITIONALLY MANY CLINICIANS ARE
SUBPOENAED AND CALLED TO TESTIFY
IN COURT REGARDING THEIR
VALUATIONS WHICH IS ALSO A
FUNCTION THAT REQUIRES
COORDINATION AND TRACKING.
SO THIS PROPOSAL STANDARDIZES
THE ADMINISTRATIVE POSITIONS
NEEDED TO PERFORM THE CASE
MANAGEMENT AND COURT --
TRACKING WORK BASED ON THE
STANDARD CASELOAD OF ONE TO TWO
HUNDRED AND FIFTY AND PROVIDES
ONE POSITION FOR YOU TO THE
HOSPITAL'S TO LEAD THE SUBPOENA
AND TO AND TESTIMONY DATA
TRACKING.
THE THIRD COMPONENT OF THIS
PROPOSAL IS TWENTY FIVE POINT
SEVEN POSITIONS FOR NEURO
PSYCHOLOGICAL NUR
NEUROPSYCHOLOGY ASSESSMENTS AND
COGNITIVE REMEDIATION PILOT.
PHASED IN OVER TWO YEARS AND
THIS RECOGNIZES THE NEED FOR
INCREASED COGNITIVE ASSESSMENT
AND REMEDIATION TREATMENT FOR
PATIENTS.
MANY OF OUR PATIENTS HAVE
SIGNIFICANT COGNITIVE DEFICITS
THAT CONTRIBUTE TO REDUCED
EFFECTIVENESS AND CLINICAL
TREATMENT AGGRESSIVE ACTS AND
LONGER LENGTH OF STAY WITHIN OUR
SYSTEM.
AND CURRENT RESEARCH IDENTIFIES
THAT APPROXIMATELY 50% OF ALL
NEW ADMISSIONS MAY REQUIRE
SECONDARY NEURO PSYCHOLOGICAL
TESTING.
THE RECORD RESOURCES REQUESTED
FOR ICAL ASSESSMENTS AS
CONSERVATIVE AND WILL PROVIDE A
TESTING FOR UP 225% OF OUR
ADMISSIONS.
ADDITIONALLY THE RESOURCES WILL
ALLOW US TO IMPLEMENT A NEURO
PSYCHOLOGICAL COGNITIVE
REMEDIATION TRACK --
TREATMENT PILOT OUR METROPOLITAN
AND NAPA STATE HOSPITALS.
AND THIS IS A FOCUS TREATMENT
PROGRAM --
FOR PATIENTS WHO HAVE BEEN
IDENTIFIED AS HAVING SEVERE
NEUROCOGNITIVE DEFICITS.
HAPPY TO TAKE ANY QUESTIONS ON
THIS ITEM.
DEPARTMENT OF FINANCE HELLO.
SORT OF BORED LEGISLATIVE
ANALYST'S OFFICE --
AS YOU HEARD IN THE DEPARTMENT'S
PRESENTATION ONE OF THE PRIMARY
JUSTIFICATIONS FOR THE DEDICATED
FORENSIC EVALUATOR STAFF.
IS BECAUSE OF THE PRESENCE OF A
CONFLICT OF INTEREST WHEN THESE
CLINICIANS PERFORM THESE DUTIES
WITH RESPECT TO THEIR OWN
PATIENTS.
WELL WE APPRECIATE THAT CONCERN
AND DO AGREE THAT THIS DOES NEED
TO BE RESOLVED WE THINK IT
POTENTIALLY MORE COST EFFECTIVE
APPROACH TO THIS PROBLEM.
COULD BE TO HAVE EXISTING
CLINICIANS PERFORM THESE
RESPONSIBILITIES WITH RESPECT TO
OTHER CLINICIANS PATIENTS.
ARM ACCORDINGLY WE'RE NOT
RECOMMENDING THAT ADDITIONAL
FUNDING FOR A DEDICATED
EVALUATORS BE APPROVED.
INSTEAD WE'RE RECOMMENDING THAT
THE LEGISLATURE DIRECTED THE
DEPARTMENT. TO COME UP WITH A
PLAN TO PILOT THIS PROPOSAL
BECAUSE WE ACKNOWLEDGE THERE'S
SOME UNCERTAINTY OF AS TO
WHETHER IT WOULD BE EFFECTIVE TO
PILOT THIS PROPOSAL.
IN THE BUDGET YEAR AND THAT THE
THIS PLAN BY APRIL.
ONE NOW WITH RESPECT TO THE CASE
MANAGEMENT AND DATA TRACKING
STAFF WE IT THIS THIS PART OF
THE PROPOSAL CAN KIND OF BE
THOUGHT OF IN TWO DIFFERENT
PIECES --
FIRST OF ALL THERE IS A PIECE
WHERE THE DEPARTMENT IS SEEKING
TO AUGMENT THE NUMBER OF STAFF
THAT THEY CURRENTLY USE IN ORDER
TO COMPLETE THIS WORKLOAD.
WE FELT THAT THE DEPARTMENT
DIDN'T PROVIDE ADEQUATE
JUSTIFICATION SHOWING THAT THEIR
EXISTING STAFFING LEVELS ARE
INSUFFICIENT.
SO WE'RE NOT RECOMMENDING
APPROVING THAT SECONDLY THERE
WERE SOME ADMINISTRATIVE STUFF
THAT WERE BEING REQUESTED TO
REFINE THAT THE STAFFING
STANDARDS THAT THEY'RE
ESTABLISHING FOR THE FORENSIC
VALUE WAITERS BECAUSE WE'RE NOT
RECOMMENDING.
APPROVING THOSE POSITIONS WERE
ALSO NOT RECOMMENDING --
APPROVING THESE CORRESPONDING
ADMINISTRATIVE STAFF.
NOW WITH RESPECT TO THE NEURO
PSYCHOLOGICAL EVALUATIONS WE DO
THINK THAT THESE EVALUATIONS
COULD BE AN EFFECTIVE WAY OF
IDENTIFYING PATIENTS THAT ARE AT
RISK OF VIOLENCE.
AND MORE EFFECTIVELY TREATING
OTHER PATIENTS SO WE ARE
RECOMMENDING THAT THOSE
RESOURCES BE APPROVED --
WITH RESPECT TO THE CONDUCT
COGNITIVE REMEDIATION PILOT WE
ALSO THINK THAT THIS IS A
POTENTIALLY PROMISING APPROACH.
THE WE ARE CONCERNED THAT
DESPITE SOURCES ARE OPPOSED.
ACCORDINGLY WERE RECOMMENDING
THAT FUNDING FOR THE PILOT BE
LIMITED TO THREE YEARS AND THAT
THE DEPARTMENT BE REQUIRED TO
REPORT ON THE OUTCOME OF THE
PILOT.
AFTER THE THREE YEARS HAS
EXPIRED TO ALLOW THE LEGISLATURE
DETERMINE WHETHER TO PROVIDE
ONGOING AND OR EXPANDED FUNDING
AT THAT TIME.
THE NO SIR.
BERMAN FUNDS.
I THANK YOU MISTER CHAIR JC
THOMPSON APARTMENT FINANCE I'M.
WE WE DISAGREE WITH THE LA OWES --
RECOMMENDATIONS IN A NUMBER OF
THESE AREAS I AM I JUST TO GIVE
YOU A LITTLE BIT OF BACKGROUND
AND WE WORKED VERY EXTENSIVELY
TIME. FOR OVER GOSH EIGHTEEN
MONTHS --
WITH THE DEPARTMENT THAT
HOSPITALS AS PART OF OUR MISSION
BASED REVIEW PROJECT --
AT THE MISSION BASED REVIEW
PROJECT THE GOAL IS TO REALLY
LOOK AT THE RESOURCES THAT ARE
NECESSARY TO PROVIDE SERVICES
THE GOVERNMENT PROVIDES.
YOU REALLY LOOK AT I'M
INNOVATIVE WAYS OF AND OF
LOOKING AT THINGS FROM A FROM
STANDPOINT --
YOU KNOW TO KIND OF ENSURE THAT
THE THE SERVICES THAT ARE BEING
PROVIDED ARE THE ONES THAT ARE
FUNDAMENTAL TO THE DEPARTMENT'S
MISSION AND THAT ANYTHING THAT.
WOULD BE EXTRANEOUS WOULD BE YOU
KNOW KIND OF LOOKED AT ON A
PRIORITIZE BASIS TO MAKE SURE
WE'RE MAKING USE OF OUR LIMITED
RESOURCES.
AND WE HAVE SPENT QUITE A BIT OF
TIME LOOKING AT THE STUFFING
STUDY --
THAT AT STATE HOSPITALS AND PUT
TOGETHER MANY MANY HOURS I'M
MANY OF THE OF THE QUESTIONS OF
THE LA I WAS ASKING I THINK WE
YOU KNOW WE INITIALLY AUST AS
WELL.
AND BEING NEW TO THIS --
INDUSTRY AND I THINK WE
ABSOLUTELY CAME AWAY FROM THE
PROCESS FEELING LIKE TIME. ONE
OF THE CHALLENGES THAT THE
CLINICAL STAFF EXPERIENCE IT --
RIGHT NOW IS THAT THEY ARE
CALLED AWAY TO TESTIFY IN COURT
SO WHETHER THEY ARE WHETHER THIS
IS FOR THEIR OWN PATIENT OR FOR
PEER -- AS
THE LA WAS PROPOSING IT WOULD
STILL REMOVE THAT CLINICIAN FROM
THE FACILITY WHICH MEANS THAT
THEY'RE NOT SEEING PATIENTS.
THEY'RE NOT THERE ON A DAY TO
DAY BASIS TO OBSERVE WHATEVER I
MIGHT BE GOING ON WITH THE
PATIENTS THAT.
YOU KNOW IF THEY COULD INTERVENE
IN A IN A TIMELY MANNER MAYBE
COULD BE --
MEDIATED NOT THERE AND THEY
DON'T HAVE THAT OPPORTUNITY TO
DO THAT SO.
I'M WHAT ONE OF THE REASONS THAT
WE WERE RECOMMENDING --
AT SEPARATE TO CLINICIAN WAS AND
IN ORDER TO KEEP THE TREATING
CLINICIANS ON THE UNIT AND
PRESENT FOR THE TIME FOR THE
PATIENTS --
IN ADDITION --
WE ARE RECOMMENDING SENIOR
PSYCHOLOGIST --
THE SENIOR PSYCHOLOGIST
SPECIALIST SEES ME WHICH IS A
ENTIRELY DIFFERENT --
DISCIPLINE THEN THAT THE
PSYCHIATRIST THAT ARE CURRENTLY
BEING CALLED AWAY BECAUSE
THEY'RE THE LEAD OF THE
TREATMENT TEAM.
OBVIOUSLY STOP ENOUGH I'M
MISSTATING ANYTHING HERE --
AND SO USING OF THE LA OWES
MODEL WE WE BELIEVE WOULD
ACTUALLY POTENTIALLY RESULT IN
ADDITIONAL COSTS BECAUSE YOU
WOULD NEED TO CONTINUE TO USE
THE PSYCHIATRISTS TO DO.
WORK THAT ACTUALLY THE THE
PSYCHOLOGIST AND IS IS ABLE TO
DO -- A
FINALLY ONE OF ONE OF THE OTHER
COMPELLING REASONS I'M IS THAT
THIS IS THIS --
WE CAME TO UNDERSTAND THAT THE
FORENSIC WORK THE STATE TO BE
DONE IS REALLY MORE OF A NICHE
AREA OF PSYCHOLOGY AND
PSYCHIATRY THIS ROUTE THAT
REQUIRES --
ADDITIONAL TRAINING AND REALLY
OWN THAT LAYS STANDPOINT IT'S
ALMOST LIKE A DIFFERENT
ENGINEERING DISCIPLINES RIGHT
YOU HAVE THE VARIOUS YOU KNOW
ENGINE OR ELECTRICAL STRUCTURAL.
THEY REALLY DO HAVE A SPECIALTY
AREA AND I THINK THAT'S THAT'S
KIND OF A A GOOD LATE --
COMPARISON TO MAKE HERE I WAS
OBVIOUSLY MUCH MORE COMPLEX AND
THEN I COULD GOING TO FOR SURE --
AND SO IT REALLY HAVING THE
RIGHT PERSON TO DO THE JOB --
I THINK IS IS CRITICAL HERE AND
TO MAKE SURE THAT THEY HAVE --
THAT THEY HAVE THE TRAINING AND
EXPERTISE --
AND THAT WERE NOT SIMPLY CROSS
TRAINING A MORE GENERALISED
CLASS TO DO THE WORK OF OF A
SPECIALIST --
AND SO I THAT THAT'S ON THE
ISSUE OF OF THE THE PEER REVIEW --
IN TERMS OF THE CASE MANAGEMENT
STAFF AND WE REALLY --
LOOKED AT THIS ISSUE ALSO --
FOR QUITE A LENGTH OF TIME AND
WERE ABLE TO DETERMINE THAT THAT
EACH FACILITY IS FULLY MANAGING
THEIR DIFFERENCE A CASE
MANAGEMENT DIFFERENTLY AND BY
FOR IN THAT CASE MANAGEMENT WHAT
WE MEAN THAT THEY WERE PLEADED
IN A SIMILAR FASHION IN A TIMELY
FASHION.
THAT THE COURTS GETTING ALL THE
INFORMATION THAT THEY NEED AND
WHEN WE'RE TALKING ABOUT OVER
ELEVEN THOUSAND RIGHT AROUND
ELEVEN THOUSAND REPORTS ANNUALLY
THAT'S A LOT OF OF MANAGEMENT
THE NEEDS TO TAKE PLACE.
AND SO WHAT WE WERE HOPING --
WITH PROVIDING ADDITIONAL
RESOURCES IS IT REALLY THE
ABILITY TO ESTABLISH BEST
PRACTICES --
AMONGST THE FACILITIES AND BE
ABLE TO KIND OF SHARE LESSONS
LEARNED BETWEEN THEM --
AND ADDITIONALLY KIND OF PROVING
THAT LINE OF COMMUNICATION WITH
THE COURT THAT THEY'RE HAVING
CONSISTENT STUFF TO DEAL WITH.
IF THERE ARE CASE MANAGEMENT
STAFF IN PLACE THE WORK STILL
HAS TO GET DONE ITS COURT
MANDATED AND SO IF THERE'S NOT
AN ADMINISTRATIVE STAFF. TO
PERFORM THE WORK AGAIN IT'S BEEN
PERFORMED BY THE CLINICIAN IN
SOME CASES BY PSYCHIATRISTS AND
THAT IS VERY EXPENSIVE --
PAPERWORK.
I'M STILL WE WERE ABLE TO
SUPPORT THE ADDITIONAL --
CASE MANAGEMENT STAFF AND IN
TERMS OF THE DATA TRACKING STOCK
THAT'S ONE OF THE KEYS TO ME OF
THIS PROPOSAL BECAUSE IF WE IF
WE CAN'T.
TRACK.
AND REALLY LOOK AT THE DATA OF
HOW WE'RE UTILIZING OUR STAFF --
THEN WE DON'T REALLY KNOW HOW TO
IMPROVE OR IF IT'S BEING
EFFECTIVE AND IT'S A PRETTY
MINIMAL INVESTMENT OF FIVE
POSITIONS --
TO WRITE REALLY --
ESTABLISH.
A KIND OF A TO LIKE SOME OF THE
QUESTIONS THAT YOU VAST I'M HERE
TODAY I THINK COULD BE THE DATA
COULD BE IMPROVED BY YOU KNOW
ADDITIONAL DATA TRACKING STAFF --
IN TERMS OF THE NEURO PSYCHOLOGY
PROGRAM AND I WE APPRECIATE THE
LA AS RECOGNITION THAT --
THAT THE INTENTIONAL EVALUATIONS --
SEEM APPROPRIATE WE WOULD --
JUST RESTATE THAT --
ARE ESTAMOS VERY CONSERVATIVE
FOR THE CLINICAL RESEARCH IT'S
COMING OUT OF PATTON ACTUALLY
INDICATES THAT IT'S CLOSER 250%.
OF PATIENTS COULD BENEFIT FROM
THAT ADDITIONAL EVALUATION AND
WHAT WE'RE PROPOSING IS --
THAT UP 225% OF PATIENTS WOULD
GET THAT EVALUATION SO WE'RE
REASONABLY CONFIDENT THAT --
THAT REALLY WORK WERE UNDER
SHOOTING HERE BUT AGAIN WILL
GIVE US THE OPPORTUNITY KIND OF
STUDY THAT AND COME BACK --
IF NECESSARY --
AND IN TERMS OF THE COGNITIVE
READING REMEDIAL COGNITIVE AND
ALL IT DOCTOR RIVER TALK ABOUT
THIS THAT SOME MORE BUT THERE
ARE COGNITIVE REMEDIATION --
PROGRAMS IN PLACE AT A COUPLE OF
THE HOSPITALS AND IT RESEARCH
FROM THOSE PROGRAMS HAS SHOWN IT
TO BE EFFECTIVE SO WE'RE
REASONABLY CONFIDENT THAT --
THAT EVEN A WORD FOR PILOTING AT
HOSPITALS THAT DON'T.
HAVE PROGRAMS AT ALL THERE'S
DEFINITELY RESEARCH TO SUPPORT
THE FACT THAT IT'S AN EFFECTIVE --
CONCEPT [inaudible]
THANK YOU.
WITH THE DEPARTMENT LIKE TO
RESPOND DIRECTLY OR SURE I'M
KATE WERE WRITTEN ON THE MEDICAL
DIRECTOR FOR THE DEPARTMENT OF
STATE HOSPITALS.
JUST A GENERAL --
COMMENTS ABOUT FRIENDS
EVALUATIONS THESE ARE VERY
SPECIALIZED --
EVALUATIONS THAT GO INTO THE
REPORT WRITING I DID A
FELLOWSHIP FOUR YEAR FOLLOWING
MY FOUR YEARS OF GENERAL ADULT
PSYCHIATRY RESIDENCY JUST TO
LEARN HOW TO DO THESE KINDS OF
EVALUATIONS AND WRITE A REPORT.
THEY TAKE A DIFFERENT SKILL SETS
YOU KNOW WERE MENTAL HEALTH
CLINICIANS WERE VERY EMPATHIC
AND COMPASSIONATE WHEN YOU'RE
WRITING A FORENSIC REPORT YOU
HAVE TO BE VERY ANALYTICAL.
YOU HAVE TO BE VERY OBJECTIVE
NOT EVERY MENTAL HEALTH
CLINICIAN CAN DO A GOOD FRIENDS
LIKE A VALUATION A RIGHT A GOOD.
A FORENSIC REPORT THE WAY WE'RE
DOING THIS NOW OUT OF NECESSITY
WHICH IS THE WAY WE'VE BEEN
DOING IT AS WE SORT OF EVOLVED
INTO THIS FRIEND SIX SYSTEM ALSO
WRITES THE REPORTS IN MOST CASES
THE PSYCHIATRIST.
DOES ALL THE TESTIFYING TO THE
REPORT IN ADDITION TO TAKING
CARE OF A FULL CASELOAD DOING
ALL THE MEN MANAGEMENT DOING ALL
THE GROUPS IT CETERA.
THIS CREATES A NUMBER OF
PROBLEMS THE PROBLEM THE LA --
SPOKE TO IS VERY REAL THE ISSUE
OF DUAL AGENCY HAVING YOUR TREE --
ALSO BEING YOUR EVALUATOR AND
JUST ABOUT EVERY PROFESSIONAL
ORGANIZATION OUT THERE SAYS THIS
IS AN ETHICAL CONFLICT OF
INTEREST --%
HOWEVER THERE'S ALSO THE ISSUE
WITH A LACK OF TRAINING I
CERTAINLY IF WE HAD A DEDICATED
FRIENDS A GOOD VALUE WAITERS WE
COULD FOCUS ON THE TRAINING GET
PEOPLE WHO HAVEN'T HAD A POST
DOCTORAL FELLOWSHIP IN AREN'T
BOARD CERTIFIED.
UP TO SPEED BUT TRAINING OUR
ENTIRE GENERALIST STAFF APPROVES
CUMBERSOME.
I SPOKE TO THE LACK OF SKILLS
AND ABILITY SOME PEOPLE JUST ARE
NOT CUT OUT TO TESTIFY IN COURT
AS A FORMER FRIENDS IT CHIEF I
CAN TELL YOU.
ABOUT SOME STORIES --
WHERE WITH THAT BECAME CLEAR?
AND THEN THERE ARE JUST
INEFFICIENCIES SO IN IN TERMS OF
THE PROPOSED REVIEW PROCESS IT'S
INEFFICIENT.
YES IT WOULD TAKE CARE OF THE
ISSUE OF DUAL AGENCY. TO SOME
EXTENT --
BUT YOU'D HAVE A CLINICIAN FROM
ANOTHER UNIT WHO WOULD HAVE TO
LEAVE THEIR PATIENTS.
GO AND GET FAMILIAR WITH IN AN
SOME OF THESE PATIENTS HAVE BEEN
IN THE HOSPITAL FOR DECADES
REVIEWING THAT CASE COULD TAKE
DAYS --
PERFORMING THE ASSESSMENTS
WRITING THE REPORT AND THEN CALL
IT GETTING CALLED AWAY TO
TESTIFY SO IF YOU HAVE ANOTHER
CLINICIAN COMING IN TO DO THE
FRIENDS OF THE VALUATIONS.
ACTUALLY ADDING TO OUR WORKLOAD
NOW -- AND
WE WERE BETTER OFF BEFORE THE
PEER REVIEW PROCESS IN ADDITION
IF YOU HAVE A PEER REVIEW
PROCESS YOU HAVE TO HAVE A PEER
REVIEWER SO THIS IS ANOTHER
WORKLOAD ADDITION TO OUR STAFF
THAT WE DON'T CURRENTLY HAVE
UNDER THIS.
PROPOSED MODEL BY THE LA --
ADDITIONALLY THE PEER REVIEW OR
PROCESS WON'T RESOLVE THE ISSUE
OF DUAL AGENCY I THINK YOU HEARD
OUR DIRECTOR TALKING ABOUT THE
PRESSURES ON OUR SYSTEMS TO
ADMIT PEOPLE THAT MEANS A LOT OF
PATIENT MOVEMENT AND THAT MEANS.
WE CAN'T GUARANTEE WHICH
PATIENTS GOING TO BE ON WHOSE
CASELOAD ON A GIVEN DAY
UNFORTUNATELY SO WHILE THIS
PERSON MAY HAVE --
AND EVALUATE OF ROLE TODAY
TOMORROW THAT PERSON TO BE DEAR
DOCTOR AND SO WE STILL ARE BACK
TO THE ISSUE OF DUAL AGENCY IN
THE RISK THAT IT PUTS OUR
CLINICIANS THAT --
WE HAVE HAD VERY VERY BAD
OUTCOMES --
WHEN A PSYCHIATRIST HAVE GONE
INTO COURT FOR EXAMPLE AND SAID
SOMEONE NEEDS INVOLUNTARY
MEDICATIONS --
WE'VE HAD PSYCHIATRIST NOT COME
BACK TO WORK AGAIN AFTER A CASES
LIKE THAT.
SAID THE DO AGENCY ISSUE WON'T
BE RESOLVED ALL THE PEER REVIEW
PROCESS WILL DO IS ADD TO OUR
CURRENT WORKLOAD.
ADDITIONALLY THE PEER REVIEW OUR
PROCESS DOESN'T SOLVE THE ISSUE
OF LACK OF SKILLS AND ABILITIES
THAT WE'RE NOT GOING TO BE ABLE
TO MAKE.
A FRIENDS AGO VALUE WAITERS OUT
OF ALL OF OUR CLINICIANS AND IT
DOESN'T SOLVE THE TRAINING ISSUE
WE ESTIMATE WOULD TAKE DOZENS OF
HOURS TO GET PEOPLE UP TO THE
SPEED OF BEING A GOOD FRIENDS OF
THE VALUE RATE --
THAT'S TIME LEARN HOW TO DO GOOD
CYCLE PHARMACOLOGY GOOD
BEHAVIORAL TREATMENTS TRAUMA
INFORMED CARE THE THINGS THAT WE
NEED TO DO TO TAKE CARE OF OUR
PATIENTS.
AND FOR THESE REASONS ARE WE DO
NOT FEEL THE PEER REVIEW OUR
MODEL WOULD WORK.
HELLO ANY RESPONSE SURE SO ONE
THING I WANT TO EMPHASIZE IS
THAT A LOT OF THE WEAKNESSES
WITH THE PEER REVIEW MODEL ALSO
EXIST IN THE CURRENT.
ONE CURRENTLY --
CLINICIANS ARE BEING CALLED AWAY
FROM THEIR CASE LOAD TO DO THIS
WORK.
THEY WOULD JUST BE BEING CALLED
THE WAY TO DO THIS WORK FOR
DIFFERENT PATIENTS SO THIS ONE
NECESSARILY PUT US IN A
DIFFERENT PLACE THAN WE ARE NOW.
THE OTHER THING WE HAD NOTE IS
WE WERE PROVIDED WITH DATA TO
SUBSTANTIATE THAT THE QUALITY OF
THE REPORTS COMING OUT OF THE
DEPARTMENT RIGHT NOW ARE
INSUFFICIENT.
THERE WERE SOME ANECDOTAL
ACCOUNTS BUT NOTHING
QUANTITATIVE THAT WE COULD
REALLY SINK OUR TEETH INTO.
AND TO THE EXTENT THAT --
TRAINING WE THINK TRAINING COULD
BE AN EFFECTIVE WAY OF
ADDRESSING THIS FOR EXAMPLE WE
KNOW THAT --
IT'S SOMEWHAT TROUBLING.
BUT THE CLINICIANS WERE
ATTEMPTING TO SAY RESTORE
PATIENT TO COMPETENCY AREN'T
FAMILIAR WITH THE LEGAL
REQUIREMENTS SURROUNDING WHAT
JUDGES ARE LOOKING FOR TO CLEAR
PATIENT COMPETENT SO WE THINK
THAT TO THE EXTENT THAT IS A
PROBLEM.
A TRAINING PROGRAM --
IS IN ORDER WITH THREE THE
COGNITIVE REMEDIATION THERAPY
ALREADY HAVING BEEN PUT IN PLACE
AT A COUPLE STATE HOSPITALS --
SPECIFICALLY AT PATTON WEIRD
NOTE THAT THE STAFFING AND THE
APPROACH IS GOING TO BE
DIFFERENT UNDER THE
ADMINISTRATION'S PROPOSAL IN
FRONT OF YOU NOW SO WE DON'T
CONSIDER THAT --
AN EFFECTIVE TEST OF WHETHER OR
NOT THE COGNITIVE REMEDIATION
WOULD BE EFFECTIVE AND WE THINK
A PILOT IS STILL.
IN ORDER --
AND THEN THE THE OTHER THING I
DID WANT TO KNOW IS WE WEREN'T
PROVIDED WITH DATA TO SHOW THAT
THE ADMINISTRATIVE STAFFING THAT
THE CASE MANAGEMENT AND DATA
STAFF.
ARE UNABLE TO DO THERE THE
COMPLETE THEIR WORK LOAD NOW AND
THAT CLINICIANS ARE BEING FORCED
TO DO SO.
THANK YOU SIR.
AT THIS TIME WILL TAKE PUBLIC
COMMENT ON ISSUE.
THREE HEATHER SALIH FROM AS MAY
TWENTY SIX TWENTY WE REPRESENT
THE SENIOR.
PSYCHOLOGIST SPECIALISTS
SPECIALISTS THE PSYCHOLOGIST --
AND WE ARE.
CONCERNED ABOUT THE SUGGESTION
OF THE PEER REVIEW FOR A NUMBER
OF REASONS I THINK IT'S BEEN
WELL DOCUMENTED TODAY AND TALKED
ABOUT THE ISSUE OF TRAINING.
AND THE CLINICAL EXPERTISE WE
HAVE VERY GOOD CLINICIANS WHO
MAY NOT BE GOOD COURT REPORTING.
THE VALUE WAITERS OR WRITERS OR
OR ABLE TO GIVE TESTIMONY --
SO THAT HAS BEEN TALKED ABOUT I
THINK --
PRETTY WELL BUT I I WANTED TO
ADD A COUPLE OF ISSUES.
OF FOR ONE YEAH WE HAVE IS THAT
OUR PATIENTS HAVE TWENTY HOURS
PER WEEK OF GROUPS.
THOSE GROUPS ARE ARE FACILITATED
BY CLINICIANS THROUGHOUT THE
HOSPITAL SO IF YOU COULD HAVE A
PEER REVIEW PERSON WHO IS
ACTUALLY PROVIDING TREATMENT IN
A GROUP JUST BECAUSE THEY'RE NOT%
ON THEIR CASE SO THEY WILL STILL
HAVE THAT.
INTERACTION IN THIS THE CONFLICT
OF INTEREST WILL STILL EXIST FOR
THE IT IN THAT SITUATION --
ADDITIONALLY --
AS AS WAS POINTED OUT WHEN.
WHEN WE HAVE PAPERWORK WE HAVE A
SAYING AS A CLINICIAN I GUESS I
SHOULD SAY I WORK AT CLING TO
STATE HOSPITAL?
AND WE HAVE A SAYING THAT
SOMETIMES WERE TREATING THE
PAPER INSTEAD OF THE PATIENT.
AND SO EVERY MOMENT WE TAKE THAT
WE HAVE TO TREAT THE PAPER.
THE PATIENT IS GOING WITHOUT
TREATMENT AND WHAT HAPPENS THEN
IS THAT THE PATIENT IS THE
STABILIZED.
THE VIOLENCE GOES UP NOT ONLY
GET STAFF BUT AGAINST OTHER
PATIENTS AS WELL.
THEN YOU HAVE --
YOU IT YOU HAVE THE VIOLENCE
GOES UP WE HAVE A HIGHER
TURNOVER RATE WE HAVE TO BRING
MORE PEOPLE INTO TRAIN THEM WE
HAVE A HARD TIME.
RETAINING OUR STAFF AND IN
ADDITION TO THAT THEN --
WE'RE RELYING MORE ON CONTRACTOR
WE HAVE A CONTINUITY OF CARE
WHICH DESTABILIZE THE PATIENT
AND INCREASES THE OF VIOLENCE SO
WE'RE WE'RE NOT IN FAVOR AT ALL
OF THE PEER REVIEW.
THANK YOU MA'AM.
A BILL JOHNSON PRESIDENT OF
ASKED ME LOCAL TWENTY SIX TWENTY
SHE KIND OF SAID EVERYTHING SHE
TOOK ALL MY TALKING POINTS BUT I
JUST WANT TO ADD THAT --
THE WE DISCUSSED PREVIOUSLY WITH
A BROWN ADMINISTRATION ABOUT THE
NEED TO FILL MORE POSITIONS
CHRONICALLY UNDERSTAFFED AND
CONTRACTING OUT IS CONTINUE TO
BE A PROBLEM TWENTY OPPORTUNITY
THAT WE HAVE TO BE ABLE.
TO MAINTAIN POSITIONS --
PROTECTS NOT ONLY THE COMMUNITY
BECAUSE WE'RE TALKING ABOUT
SEXUALLY VIOLENT PREDATORS THAT
ARE BEING EVALUATED AND HOW
EFFECTIVE THAT EVALUATION IS
TWENTY OPPORTUNITY THAT WE CAN
ASSIST.
AND PARTNER WITH THE DEPARTMENT
TO KEEP THE PUBLIC SAFE WHERE
WERE WELCOME TO TAKE THAT
OPPORTUNITY THANK YOU THANK YOU
SIR.
HI ADRIENNE MOM AND WITH THE
UNION OF AMERICAN PHYSICIANS AND
DENTISTS --
OUR COLLEAGUE THAT ASK ME TWENTY
SIX TWENTY I THINK LAID IT OUT
PRETTY CLEARLY SO I'M NOT GONNA
TAKE UP ANY MORE OF YOUR TIME
BUT I WILL SAY THAT WE AGREE
WITH THE IDEA THAT THE PEER
REVIEW PROCESS IS REALLY NOT THE
BEST FIT AND EVEN A COUPLE.
YEARS BACK WE WERE RUNNING A
BILL THAT.
DID EXACTLY WHAT --
THIS BUDGET IS TRYING TO DO
RIGHT CALLING A A SEPARATE --
PANEL SO TO SPEAK FOR THIS TYPE
OF EVALUATION BECAUSE REALLY IT
IS NECESSARY IN AS STATED BEFORE
WE DON'T WANT TO TAKE ALL OF
THIS TIME AND RESOURCE AND
ENERGY.
AWAY FROM OUR PATIENTS AND
TREATMENT WHEN IT CAN BE DONE BY
SOMEONE ELSE RIGHT IT'S A THANK
YOU.
THANK YOU SIR.
CO WITH HIS IDEA WITH CALIFORNIA
ASSOCIATION OF PSYCHIATRIC
TECHNICIANS WE SUPPORT THIS
PROPOSAL AS IT IS AND WE WOULD
ECHO THE COMMENTS A DOCTOR WARM
AND DEPARTMENT AND DR WARBURTON
AND THE DEPARTMENT OF FINANCE --
YOU KNOW TO US YOU KNOW THIS
SEEMS LIKE A IS A PRETTY SIMPLE
IDEA AND WE WERE ONE OF THE
SUPPORTERS OF THE BILL THAT --
YOU A PT AUTHORED WAY BACK WHEN
SO WE WE JUST LIKE TO SEE THIS
PROPOSAL GO FORWARD THANK YOU.
THANK YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO THE DíAS
ASSEMBLYMEMBER MATHIS.
ASSEMBLYMEMBER RUBIO WHITE THANK
YOU I APPRECIATE THAT NO JUST A
COMMENT --
AND I WAS A TEACHER AND SO I
UNDERSTAND THE YOU KNOW I I
WOULD TEACH TO THE PAPER INSTEAD
OF TREATING THE PAPER.
AND IT'S CRITICAL I WAS
FRUSTRATED WITH IF --
WAS THAT WHEN WE WOULD SEND
INFORMATION TO THE DISTRICT
OFFICE FOR EXAMPLE AND I HAD --
EXTRA STUDENTS THEY WOULD SEND
BACK A SOLUTION YOU CAN HAVE
TWENTY POINT FIVE KIDS ARE THIRD
ACTUALLY THIRTY FIVE POINT FIVE
KIDS IN YOUR CLASSROOM AND
THIRTY FIVE POINT FIVE KIDS AND
THE OTHER CLASSROOM --
DEALT WITH SPREAD SHEET WAS
PERFECT EXCEPT WHICH KATE WAS I
COULD NOT CUT OUT. TO SPLIT --
BITE THE ACTUAL PAPER --
AND THE POLICIES WITH ALL DUE
RESPECT OF YOU KNOW FINANCIAL
GURUS IF YOU WELL --
LOOK GREAT ON PAPER BUT THEY
DON'T FUNCTION IN REALITY AND
THAT'S WHAT MY CONCERN IS AND
THAT'S WHY I TOOK THE TIME TO GO
VISIT ONE OF THE HOSPITALS AND I
CAN SEE WHERE.
WHERE THAT --
PROPOSAL THAT THAT YOU HAVE
AVAILABLE IS FOR ME MORE MORE
HELPFUL BECAUSE I YOU WANT TO
PROTECT.
OUR COMMUNITIES AND IF WE DON'T
HAVE PATIENTS ARE BEING TREATED
INSTEAD OF FOCUSING ON THE
PAPERWORK WE'RE GOING TO NOT DO
AN EFFECTIVE JOB OF OF TREATING
THESE PATIENTS --
I APPRECIATE --
YOU KNOW THE WORK THAT'S GONE
INTO IT IN AGAIN WITH ALL DUE
RESPECT YOU KNOW LOOKING AT
SOMETHING ON PAPER IS VERY
DIFFERENT THAN THE PRACTICAL USE
OF WHATEVER.
HI --
INFORMATION YOU'RE PROVIDING
THANK YOU [inaudible]
ASSEMBLYMEMBER MATHIS
[inaudible]
SO.
NO ME START WITH L. LIKE THE
IDEA THE PROPOSAL.
YOU GUYS ON A MILITARY GUY AND
WHEN WE GO AND EVALUATE.
OTHER UNITS YES AND OTHER PEOPLE
AND TO GO OF VALUE WITH THE
UNITS BECAUSE TIONS AND OTHER
THINGS YOU HAVE TO DO.
THEY COME AND THEY TAKE A LOOK.
THEY DO THE RIGHT UP.
TALK TO THE COMMAND AND THEN
MOVE FORWARD ONE IT ENSURES THAT.
THE PEOPLE.
IN THOSE POSITIONS ARE SPENDING
THEIR TIME DOING OTHER THINGS
MORE IN ABOUT OKAY WHAT DO I GET
A TRAINED ALL OF THIS OTHER
THINGS BECAUSE ONE THEY SHOULD
ALREADY KNOW WHAT THEY'RE
SUPPOSED TO BE KNOWING.
BUT TO IT ALSO INSURE SOME
QUALITY CONTROL TO MAKE SURE
THAT THOSE PEOPLE ARE DOING THE
THINGS THAT THEY'RE SUPPOSED TO
BE DOING SO AS AND EVALUATOR
COMES IN. ONE THEIR ENSURING
THAT.
THE PERSON THEY'RE DOING THEIR
JOB CORRECTLY AND WHERE THE
PERSON THAT THEY'RE WORKING WITH
IS SUPPOSED TO BE SO IN THIS
CASE.
WE WOULD BE MAKING SURE THAT.
OUR FRIENDS ARE PSYCHIATRISTS
WOULD BE.
ON POINT IN DOING WHAT THEY'RE
SUPPOSED TO BE DOING CELL ONE
THAT THEIR PROFESSIONAL HOLIDAY.
IN THE QUALITY CONTROL OF THEIR
ACTIONS IS BEING LOOKED AT AS
WELL AS THAT OF THE PATIENT SO
YOU KIND OF GET A TWO FOR IN
THAT.
ON SO I LIKE IT AND IT MAKES
SENSE.
MY BIGGEST CONCERN IS LOOKING AT
THE PROPOSAL.
MAY IF I ADD THIS UP.
WITHIN THREE YEARS WE NEED --
NINETY FOUR POINT SIX ALTHOUGH
HEAD ROUND THAT UP TO A NINETY
FIVE IN THREE YEARS --
BUT ALSO HAVE THAT WITHIN THE US
WE'RE ONLY GETTING ABOUT --
IS ONLY SIXTY SIX WHAT'S A YEAR.
WITH ONLY SIXTEEN FINISHING A
YEAR.
AND SO WITHIN THREE YEARS A
GIVES US FORTY EIGHT US WIDE.
SO WE JUST DON'T HAVE ENOUGH
PEOPLE GET IN LICENSE AT THIS
LEVEL.
IN ORDER TO DO THIS WHICH GOES
INTO THE GREATER PROBLEM THAT WE
HAVE OF NOT ENOUGH DOCTORS NOT
ENOUGH NURSES EVERYTHING ELSE --
HASHTAG WE NEED MORE UC'S AND
THE SOUTH VALLEY --
BOUGHT.
IT'S THAT'S MY BIGGEST CONCERN
HERE IS WE JUST DON'T HAVE.
THE TRAIN BODIES TO DO THIS.
AND AND TELL A FIX THE PROBLEM
OR NOT HAVE IN A FEW CITIES.
AND ENOUGH PROGRAMS INCREASING
THOSE BUDGETS AS WELL --
I DON'T KNOW I DON'T SEE HOW WE
GET THERE IN THAT TIME FRAME --
EVEN THOUGH I WOULD LIKE TO SEE
IT HAPPEN.
IF IF I COULD PERHAPS --
AGAINST YOUR QUESTION I'M.
AT LEAST A LITTLE BIT AND MOST
OF THE POSITIONS PROPOSED OUR
SENIOR PSYCHOLOGIST SPECIALISTS
AND THE THE THE THE SIXTY SIX
LOSSES WERE SINCE THESE AS LIKE.
PSYCHIATRY RESIDENCY IF --
AND A SO IT'S IT'S A SLIGHTLY
DIFFERENT POOL --
AND WE HAVE AN EXPERIENCE THE
SAME DIFFICULTY HIRING --
THE A PSYCHOLOGIST --
DISCIPLINE AS WE HELP WITH THE
PSYCHIATRY DISCIPLINE.
THAT'S A GOOD THING TO HEAR POST --
BACKLOGS SONG.
ANYWAY I LOOK FORWARD TO SEEING.
MORE OF THIS IS A MOVES FORWARD
INTO TALKING WITH THE DIRECTORS
MORE --
LATER ON AS THIS MOVES FORWARD
BUT IT'S AGAIN I LIKE THE
PROPOSAL IT MAKES SENSE AND
ENSURES QUALITY CONTROL AND
PATIENT CARE ON BOTH ENDS SO.
I DO LIKE THOSE ASPECTS.
THANK YOU ASSEMBLYMEMBER.
WITHOUT I'LL JUST HIGHLIGHT THE
TO AGENCY AS WELL KNOWING THAT
IT'S IMPORTANT THAT.
WE DO WHAT WE DO BEST WHICH
OFTENTIMES IS TAKING CARE OF
PATIENTS HANDS THOSE WHO HAVE
THE EXPERTISE TO TESTIFY AND
WORK WITHIN FRIENDS X. --
BOZELL THAT'S BEFORE US AND WITH
THAT WE WILL HOLD ISSUE THREE
OPEN IN THE BOND ISSUE
.
FOR SO FOR THIS ISSUE I'M JOINED
BY JOHN ABOUT --
HAS A CHIEF OF OUR FISCAL IN
PROGRAM RESEARCH UNIT.
SO FOR THIS A PROPOSAL
REQUESTING THREE HUNDRED AND
SEVENTY NINE POINT FIVE NURSING
POSITIONS AND FORTY FIVE MILLION
DOLLARS IN GENERAL FUND PHASED
IN OVER THREE YEARS TO SUPPORT
THE WORKLOAD OF PROVIDING TWENTY
FOUR HOUR NURSING SERVICES AT
OUR FIVE HOSPITALS.
THE REQUEST ALSO INCLUDES TWO
HUNDRED AND FIFTY FOR TEMPORARY
HELP POSITIONS AND FIFTY IT
ADMINISTRATIVE POSITIONS AT THE
POSITIONS NO FUNDING. TO
IMPLEMENT THE STAFFING STANDARDS
THAT WERE IDENTIFIED IN THE
STAFFING STUDY.
AS WITH THE PREVIOUS STAFFING
STUDY THE STAFFING STANDARDS
PROPOSED ARE BASED ON DATA THAT
WAS COLLECTED IN RESEARCH THAT
WAS CONDUCTED BY MISS LOUDER
STEAM.
AND WAS DEVELOPED IN
COLLABORATION WITH THE RESEARCH
THE DEPARTMENT OF FINANCE
RESEARCH ANALYSIS UNIT THROUGH
THEIR MISSION BASED REVIEW
PROCESS.
AS WELL AS WE CONTRACTED WITH
THE UNIVERSITY OF IRVINE TO
PERFORM AN INDEPENDENT
VALIDATION OF THE DATA AND THE
METHODOLOGIES THAT ARE PRESENTED
IN THIS STOPPING STUDY.
CURRENTLY WERE BUDGETED FOR
NURSING STAFFING RATIOS FAR CUTE
IN SKILLED NURSING --
UNITS FOUR AM AND PM SURE SHIFTS
AT ONE TO SIX AND FOR NOXIOUS AT
ONE TO TWELVE AND FOR
INTERMEDIATE UNITS AT ONE TWO
EIGHT FOUR AM AND PM AND ONE TO
TWO SIXTEEN FOR KNOCK.
THESE RATIOS ARE THE MINIMUM
NURSING STAFFING STANDARDS THAT
ARE REQUIRED FOR LICENSING
COMPLIANCE HOWEVER.
DUE TO THE PSYCHIATRIC IN SEE
EACH PATIENTS.
THE PILOT IN THE VIOLENCE RISK
THAT'S ASSOCIATED WITH OUR
PATIENTS ARE ACTUAL NURSING
STAFFING THAT IS DELIVERED TO
THE UNITS AS IT'S HIGHER THAN
THESE RATIOS.
THE STAFFING CITY THROUGH AS
CATEGORIZED OUR HOSPITAL
TREATMENT UNITS INTO LIKE GROUPS
BASED ON VARIABLES THAT DRIVE
THE STAFFING LEVELS --
SUCH AS TREATMENT TYPE AND
COMMITMENT TIGHT.
AND YOU SIX MONTHS OF ACTUAL
STAFF DELIVER DATA. TO CALCULATE
SYSTEM RIGHT STAFF AND PATIENT
RATIOS FOR EACH OF THE GROUPS TO
BE USED IN PLACE OF THESE
CURRENT MINIMUM RATIOS. SEVEN
THERE WAS ALSO TO ADDITIONAL
UNIT BASED STAFFING PROPOSALS
THAT WERE PART OF THIS I'M
STOPPING STUDY THE FIRST IS
THREE HUNDRED AND THIRTY FIVE
PSYCHIATRIC TECHNICIAN POSITIONS
INCLUDING RELIEF TO STAFF.
TWELVE HOUR EXCUSE ME TWELVE OUR
MEDICATION REIMPOSE ON A HUNDRED
AND TWENTY EIGHT UNITS.
IN THIS IS TO BE PHASED IN OVER
THREE YEARS TO PERFORM THE
FUNCTIONS ASSOCIATED WITH OUR
MEDICATION PASS.
MEDICATION PASS OCCURS FOUR
TIMES A DAY ACROSS ALL OF OUR
UNITS IT MAY LAST UP TO TWO
HOURS PER PASS.
THE FUNCTIONS INCLUDE PREPARING
ADMINISTERING DOCUMENTING AND
ULTIMATELY MANAGING THAT
MEDICATION ADMINISTRATION TO THE
PATIENTS.
AND THE MEDICATIONS OR STORE
MANAGED AND ADMINISTERED FROM
EITHER A MEDICATION ROOM ON EACH
UNIT OR BROUGHT TO THE PATIENT --
AT BAY IT BAD SIDE DEPENDING ON
THE MOBILITY AND ACUITY OF THE
PATIENTS IN THE UNIT.
THE MEDICATION PASSED REQUIRES A
LICENSE I COULD A PSYCHIATRIC
TECHNICIAN A REGISTERED NURSE TO
BE FULLY DEDICATED TO THIS
FUNCTION.
IN ADDITION THERE TO THE ONE
DEDICATED STAFF MEMBER DURING
THE ACTUAL MEDICATION PASSED
THERE IS AN ADDITIONAL RESOURCE
THAT IS PULLED FROM THE FLOOR TO
HELP WITH THAT HOUSE.
CURRENTLY OUR PSYCHIATRIC
TECHNICIANS WHO ARE ASSIGNED TO
THE MEDICATION ROOMS ARE
INCLUDED IN THE COUNT OF NURSE
TO PATIENT RATIOS AND DELIVERED
STAFF.
THIS MEANS THAT THEY'RE PART OF
THAT FLOOR RATIO THAT WE
MENTIONED BEFORE.
THE REQUESTED TO PULL THIS
RESOURCE AS A STE SEPARATE
STANDARDS ST STE --
STANDALONE POSITION SINCE THE
MEDICATION ROOM DUTIES ARE
SIGNIFICANT AND AND MAKE THIS
PERSON ON AVAILABLE TO ASSIST
WITH THE POOR CARE DUTIES.
THES NEW MEDICATION ROOM POSTER
PROPOSES TWELVE HOUR SHIFTS AND
WE CONTINUE TO AND WE WILL
CONTINUE TO FOLLOW WE EVALUATE
WHETHER THESE TWELVE OUR POSTS
ARE SUFFICIENT.
THE SECOND PIECE OF THIS I'M
PROPOSAL IS UNIT SUPERVISION AT
OUR HOSPITALS AND IT REALLY IS
FOR FORTY FOUR POINT FIVE
SUPERVISING REGISTERED NURSE
POSITIONS INCLUDING RELIEF. TO
STAFF ADDITIONAL TWELVE OUR
POSTS PROVIDE ON SITE
SUPERVISION FOR THE PM A NOXIOUS
OUR HOSPITALS.
THESE POSITIONS THAT WILL ALSO
BE PHASED IN OVER TWO YEARS.
CURRENTLY THE UNIT SUPERVISORS
AND SUPERVISING REGISTERED
NURSES SERVES AS THE FIRST LINE
SUPERVISORS ON ARE YOU A PATIENT
UNITS WITH ONE ALLOCATED PER
UNIT.
THE SUPERVISORS WORK FIVE DAYS
PER WEEK --
AN EIGHT HOUR SHIFT HOWEVER THEY
ARE RESPONSIBLE FOR THE
CONTINUOUS MANAGEMENT AND STAFF
SUPERVISION OF THEIR UNIT ON A
TWENTY FOUR HOUR BASIS.
SO WELL THEIR SHIFT LEADS THAT
ARE ASSIGNED TO EACH OF OUR
UNITS THE SHIP LEAVES ARE NOT
SUPERVISORY LEVEL POSITIONS IS
OUR POSITIONS ARE USUALLY STAFF
OF SENIOR PSYCH PSYCHIATRIC
TECHNICIANS ARE REGISTERED
NURSES.
SO CURRENTLY TO ENSURE THAT WE
HAVE SUPERVISORY LEVEL POSITION
THAT'S AVAILABLE TO THE HOSPITAL
AT NIGHT.
DURING THE TIMES WHEN THE UNIT
SUPERVISORS ARE NOT ON SITE.
SUCH AS THIS PM AND MARK CHEFS
THE HOSPITAL USES AN OFF SITE ON
CALL PROGRAM OFFICER OF THE DAY
TO PROVIDE THE SUPERVISION AND
COVERAGE.
AND THIS ON BECAUSE TIME IS
ROTATED AMONGST THE VARIOUS
SUPERVISORY LEVEL POSITIONS SUCH
AS UNIT SUPERVISORS PROGRAM
DIRECTORS NURSING COORDINATORS
AND SURPRISING OUR ENDS.
THESE ON CALL MEMBERS ARE CALLED
SEVERAL TIMES THROUGHOUT THE
NIGHT -- TO
TO HANDLE VARIOUS TO THOSE LAWS
TO ADD SEVENTEEN TWELVE HOURS
SUPERVISORY --
POSTS ACROSS THE FIVE HOSPITALS
TO COVER THE PM ANOXIOUS WHICH
WILL EXPAND THE ON SITE
SUPERVISOR COVERAGE FROM EIGHT
HOURS TO TWENTY HOURS PER DAY.
AND THIS WILL THEN PROVIDE A
THREE TO FOUR SUPERVISORS
PERHAPS BOTTLE AT A RATIO OF ONE
TO FORTY STAFF.
AND THIS IS AN INITIAL
CONSERVATIVE NUMBER I'M ESTIMATE
OF THE ERRORS --
SUPERVISORY NEED AS WE BRING
THESE MANAGERS THE SUPERVISORS
ON BOARD WE WILL CONTINUE TO
EVALUATE THAT NEED AND THEIR
WORKLOAD.
IN ADDITION TO THESE TWO
REQUESTS FOR ADDITIONAL UNIFACE
POSITIONS AS RESULT OF THE
STAFFING STUDY THAT TWO HUNDRED
FIFTY FOR TEMPORARY HEALTH
POSITIONS ARE TO INCREASE OUR
TEMP HELP WITH ALREADY TO OUR
TWO THOUSAND SEVENTEEN EIGHTEEN
LEVELS IN ORDER TO MEET THE
DELIVERED STAFFING LEVELS.
AND WE USE THAT PRIMARILY USE
THE TEMPER HELP POSITIONS FOR
OUR NURSING REGISTRY.
AND THEN WE ARE HAVE POSITION
AUTHORITY FOR FIFTY
ADMINISTRATIVE POSITIONS IN THIS
IS WE HAVE A TO FILL FIFTY JOBS
THAT ARE CURRENTLY PERFORMED BY
NURSING CLASSIFICATIONS THAT
WERE FOUND TO BE MORE
APPROPRIATE FOR ADMINISTRATIVE.
POSITIONS.
AND SO IN ORDER TO RE DIRECT
THIS FOR FIFTY NURSING --
POSITIONS BACK TO THE FLOOR WE
ARE REQUESTING THE POSITION SO
THAT WE CAN MEET THAT STAFFING
NEEDS AND THEN USE THOSE NURSES
TO HELP OFFSET OVERTIME --
THE PROPOSAL ALSO --
INCLUDES REALIGNING STAFFING
RESOURCES ACROSS THE HOSPITALS
TO MEET THE STAFFING LEVELS THAT
ARE IDENTIFIED BY THE STUFFING
STUDY.
HAPPY TO TAKE.
DEPARTMENT OF FINANCE A LIVE.
ON THE SO I A WILL WILL TAKE THE
PROPOSAL THERE'S VARIOUS PARTS
FIRST I WANT TO TALK A LITTLE
BIT ABOUT THE STAFFING STANDARDS --
WE THINK THAT THE PROPOSED
STAFFING STANDARDS THE CREATION
OF THE TWO HUNDRED FIFTY FOUR
HOW --
TEMPORARY HELP POSITIONS THE
DEDICATED BUDGET FOR OVERTIME
AND THE FIFTY ADMINISTRATIVE
STAFF WHO WOULD TAKE ON DUTIES
THAT ARE CURRENTLY PERFORMED BY
NURSES REALLY REPRESENTS AN
IMPORTANT STEP FORWARD FOR THE
DEPARTMENT.
WE NOTE THAT THE CREATION OF
SIMILAR TYPE STAFFING STANDARDS
IS SOMETHING OUR OFFICE IS
RECOMMENDED IN THE PAST AND SO
WE THINK THAT THIS IS LIKE A
SAID A REALLY IMPORTANT STEP
FORWARD --
THE ONE THING WE WOULD NOTE
HOWEVER IS THAT IT WOULD PUT IN
PLACE CURRENT PRACTICE LEVEL A
STAFFING STANDARDS AS OPPOSED TO
STAFFING STANDARDS THAT ARE
NECESSARILY OPTIMAL.
WELL THE DEPARTMENT DID WORK
WITH THE UNIVERSITY OF
CALIFORNIA IRVINE. TO VERIFY
THAT THEIR METHODOLOGY ACT --
ACCURATELY DELIVER --
OF STAFF THAT ARE CURRENTLY
BEING USED --
IT DID NOT ASSESS WHETHER OR NOT
THE CURRENT STAFFING LEVELS ARE
ACTUALLY OPTIMAL IN FACT THE
STUDY NOTED THAT IT COULD RESULT
IN SUBOPTIMAL STAFFING AND
RECOMMENDED THAT DEPARTMENT.
REVIEW IT STAFFING STANDARDS IN
THE FUTURE SO WE'RE RECOMMENDING
THAT THE LEGISLATURE APPROVED
THE STAFFING STANDARDS NOW AND
ALL THE ASSOCIATED ADJUSTMENTS
WITH THOSE.
BUT THAT IT DIRECTED THE
DEPARTMENT --
TO ENGAGE WITH AN INDEPENDENT
CONSULTANT FOR A COMPREHENSIVE
CLINICAL STAFFING ANALYSIS.
AND SPECIFICALLY THAT ANALYSIS
WOULD INCLUDE AN EVALUATION OF
THE DEPARTMENT'S CLINICAL
STOPPING BOTH FOR NURSING.
AND NON NURSING STAFF.
NON NURSING CLINICAL STAFF I
SHOULD SAY IT WOULD INCLUDE AN
ASSESSMENT OF THE APPROPRIATE
NUMBER AND TYPE OF CLINICAL
STAFF.
NECESSARY TO PROVIDE TREATMENT
IN EACH OF THE DIFFERENT UNIT
TYPES AN ASSESSMENT OF WHETHER
MORE TASK COULD BE ASSIGNED TO
EITHER LOWER CLASS COST
CLINICIANS OR ADMINISTRATIVE
STAFF.
AND RECOMMENDATIONS TO ENSURE
THAT THE DEPARTMENT IS UTILIZING
IT STAFF AS FOR THE EFFECTIVELY
AS POSSIBLE AND WE ESTIMATE THAT
AN ANALYSIS LIKE THIS COULD COST
IN THE LOW HUNDREDS OF THOUSANDS
OF DOLLARS --
WITH RESPECT TO THE MEDICATION
ROOM STOPPING WE DO THINK IT'S A
PROPOSAL THAT MERITS
CONSIDERATION HOWEVER.
THE DEPARTMENT WASN'T ABLE TO
PROVIDE DATA SHOWING
CONCLUSIVELY THAT THE NEED TO
PULL STAFF FOR MEDICATION PASS
RESULTS AND NEGATIVE PATIENT
OUTCOMES LAKE INCREASES IN
VIOLENCE.
AND GIVEN THE MAGNITUDE OF THE
RESORT I THINK A BETTER APPROACH
WOULD BE TO PILOT --
ADDITIONAL STAFF SPECIFICALLY
WE'D RECOMMEND THAT THE
LEGISLATURE APPROVED SEVEN POINT
ONE MILLION DOLLARS AND SIXTY
THREE STAFF WHICH WOULD BE
ENOUGH TO STAFF TWENTY FOUR
MEDICATION ROOMS FOR A PERIOD OF
THREE YEARS.
AND THAT IT REQUIRE THE
DEPARTMENT TO REPORT ON THE FACT
THAT THESE ADDITIONAL STAFF HAVE
ON PATIENT OUTCOMES AND VIOLENCE.
FINALLY WITH RESPECT TO THE
EVENING AND OVERNIGHT
SUPERVISORS WE THINK IT MAKES
SENSE THAT A SUPERVISOR HAS TO
BE PHYSICALLY PRESENT TO BE
EFFECTIVE.
AND SO WE RECOMMEND APPROVING
THOSE PROPOSALS THAT THOSE
POSITIONS.
THANK YOU SIR.
DEPARTMENT OF FINANCE.
THANK YOU --
WE'D SUPPORT THE PROPOSAL --
THAT'S THAT'S BEFORE YOU I'M.
WE FEEL THAT --
THAT THE VALIDATION BY UC IRVINE --
AND THEN THE SUBSEQUENT OF OUR
MISSION BASED REVIEW --
PROCESS --
HAS TAKEN A DEEPER LOOK THEN
PERHAPS --
IT WOULD DO --
AND WHAT WOULD HAVE OCCURRED AT
WITH THE YOU KNOW WITH JUST THAT
THE DEPARTMENT.
BY ITSELF HOWEVER THE WORK THAT
THE DEPARTMENT IS DONE REALLY
CANNOT BE --
OVERSTATED THEY'VE THEY'VE
WORKED VERY HARD BUT TOGETHER
QUITE A LOT OF DATA.
AND I'M PART OF THE PROPOSAL IS --
THE NEED TO CONNECT YOU KNOW
CONTINUALLY REFINE --
THE WORK THAT'S ALREADY BEEN
DONE AND I THINK THESE RESOURCES
ARE A FIRST STEP AND WOULD PUT --
WHAT PUT REALLY MORE
OPPORTUNITIES IN PLACE TO BE
ABLE TO DO THAT?
AND THEY HAVE A VEHICLE AND TO
REPORT THAT INFORMATIONALREADY
THROUGH THEIR ANNUAL --
FALL ESTIMATE PROCESS AND I AM
SO WE'D.
YOU KNOW WELL WE WE RECOGNIZE
THAT -- IT
ISN'T PERFECT AND WE DO THINK
THAT -- THAT
THERE'S A LOT THAT WE CAN DO
FROM THE STARTING PLACE --
IT FOR THE MEDICATION ROOMS --
THIS WAS SOMETHING AGAIN THAT I
THAT I LEARNED FROM OBSERVATION
WATCHING THE STAFF AND THE
MEDICATION ROOM AND YES THE
MEDICATION PASS ITSELF AS A TWO
HOUR PROCESS POTENTIALLY.
BUT THE AMOUNT OF WORK BEFORE
AND AFTER THAT THE DOCUMENTATION
TRANSPORTATION INVENTORY ALL OF
THOSE TYPES OF ASSOCIATED --
EFFORTS WAS EXTREMELY
SIGNIFICANT --
AND THERE IT OF COURSE THEY THEY
HAVE THE THE MEDICATION ROOM
STAFFERS AND HAS THE KEYS TO THE
MEDICATION ROOM AND SO IF
THEY'RE LEAVING THE MEDICATION
ROOM THEIR PROCESSES THAT HAVE
TO TAKE PLACE.
TO MAKE SURE THAT THE
PHARMACEUTICALS ARE --
ARE SAFE AND AND NOT ACCESSIBLE
TO PATIENTS WHY AND SO IF IT WAS
REALLY SOMETHING THAT THAT --
THAT WE FELT WAS IT WAS VERY
SUPPORTABLE --
IN TERMS OF THIS PARTICULAR
ALLOCATION OF STAFFING AND
REALLY.
YOU COULD POTENTIALLY
CONSERVATIVE AS WELL --
AND AND THAT'S I THINK THAT'LL
HELP ON THANKS THANK YOU.
WILL COMMENT ON ISSUE.
FOR COR SAID TO SAY SOMETHING
BUT THIS COULD BE PRESIDING WITH
CALIFORNIA ASSOCIATION OF
PSYCHIATRIC TECHNICIANS --
YOU KNOW WE'RE ABSOLUTELY A 100%
SUPPORTER OF BEHIND --
THE DEPARTMENTS --
BUT YOUR REQUEST FOR NURSING
STAFF --
THIS IS AN ISSUE THAT I'VE BEEN
COMING TO THE LEGISLATURE ABOUT
FOR YEARS ABSOLUTELY YEARS AND
IT'S MAKES ME FEEL WONDERFUL TO
SEE THAT WE'RE FINALLY GETTING.
OUR REQUEST FOR ADDITIONAL STAFF
APPROVE --
RECOGNIZED IN THE BUDGET --
WE HAVE BEEN DRAMATICALLY
UNDERSTAFFED FOR THE PATIENT
POPULATION THAT HE HAVE SERVED
OR HAVE BEEN SERVING.
YOU KNOW THE PATIENT POPULATION
THAT ARE RATIOS ARE SET UP FOR
WAS FROM A MODEL FROM BACK IN
THE EIGHTIES AND THE PATIENT
POPULATION WAS DRAMATICALLY
DIFFERENT THAN WHAT IT IS NOW
WE'RE NOW SERVING 90% FRIENDS IT
COMMITMENTS --
YOU KNOW.
THIS IS JUST A WHOLLY DIFFERENT
PERSON THAT WE ARE NOW SERVING --
ADDITIONALLY WHEN YOU LOOK AT
WHAT HAPPENS IN THE DEPARTMENTS.
LAST YEAR WE HAD TWENTY SEVEN
HUNDRED ASSAULTS ON STAFF.
THAT'S A BIG NUMBER BUT THAT IS
DOWN FROM FOUR THOUSAND AND
TWENTY TEN THAT IS A HUGE
IMPROVEMENT WE'VE MADE HUGE
STRIDES IN THIS DEPARTMENT WE'VE
INCREASED SLOWLY AND SURELY THE
STAFFING.
A LITTLE BY LITTLE TO GET TO THE
FINALLY WHERE WE ARE NOW --
UNFORTUNATELY THE THE STAFFING
LEVELS ARE.
NOT WHERE THEY NEED TO BE IN --
JUST IN TWENTY SIXTEEN PSYCH TAX
THERE'S THIRTY FIVE HUNDRED SAKE
TAX AT THE DEPARTMENT STATE
HOSPITALS THEY WORKED ONE POINT
FOUR MILLION HOURS OF OVERTIME.
OF WHICH SIX HUNDRED THOUSAND
HOURS WERE INVOLUNTARY OVERTIME.
THIS PROPOSAL RAY HERE WOULD
EFFECTIVELY ELIMINATE.
THE MANDATORY OVER OVER TIME
PORTION.
SO WE WE WANT EVERYBODY TO HAVE
THAT THOUGHT IN THE BACK OF
THEIR MIND.
THE ONE THING.
BUT YOU CAN'T REALLY FATHOM AS
WHEN YOU'RE WE HAVE WORKING AT A
STATE HOSPITAL IN YOUR WORKING
WITH VERY DANGEROUS PEOPLE.
YOU GO TO WORK AT SIX FORTY FIVE
YOU'VE HAD A REALLY ROUGH DAY
YOU'VE BEEN ASSAULTED BY A
PATIENT YOU'RE ABOUT READY TO
WALK OUT THE DOOR.
AND THEN YOU GET TAPPED ON THE
WORK ANOTHER EIGHT HOUR SHIFT.
YOU KNOW YOU MAY NOT OF PACKED
ENOUGH FOOD.
YOU MAY NOT HAVE ARRANGED FOR
CHILD CARE YOU'RE LEFT
SCRAMBLING I KNOW AS A FATHER OF
A SIX YEAR OLD DAUGHTER THAT
WOULD BE INCREDIBLY HARD --
YOU MAY NOT HAVE GOTTEN ENOUGH
SLEEP I MEAN HOW CAN YOU GET
ENOUGH SLEEP TO WORK A SIXTEEN
HOUR SHIFTS BUT STILL YOU MAY
NOT HAVE GOTTEN ENOUGH SLEEP. TO
HANDLE THAT.
SO THEN I WANT TO PUT THE HUMAN
ELEMENT TO THE SIDE OF WHAT THE
LA -- SAYING
AND GET UP KIND OF A PICTURE
THAT THIS IS WHAT HAPPENS THIS
IS A DAILY OCCURRENCE.
AND IT'S NOT JUST ABOUT THE
NUMBERS AND WHEN IT COMES TO THE
MEDICATION ROOM.
A PSYCH TECH IS INSIDE THE
MEDICATION ROOM FOR ROUGHLY
EIGHT HOURS A DAY.
AND WHEN AN ALARM GETS PULLED
[inaudible] TO GO. TO LEAVE THE
MEDICATION ROOM AND GO HELP OUT
YOUR FELLOW SAKE TECH OR YOUR
FELLOW NURSE OR YOUR FOLLOW DR.
IT IS LITERALLY IMPOSSIBLE SO TO
BE INCLUDED IN THE COUNT DOES
NOT SEEM REASONABLE --
SEE IF THERE'S ANYTHING ELSE
THAT I'VE MISSED.
YEAH WE WE WE JUST WANT TO SAY
THANK YOU TO THE DEPARTMENT --
AND THE DEPARTMENT OF FINANCE
FOR FINALLY --
FOR FINALLY KIND OF LIVING UP TO
THE LITTLE HOOVER THE TWENTY
SIXTEEN LITTLE HOOVER'S.
REPORT --
THAT RECOMMENDED AB 50%
REDUCTION IN OVERTIME.
AND ABANDON MANDATORY OVERTIME
ALTOGETHER AND BY THE WAY THAT'S
WHAT IT AB FIVE TWENTY NINE BY
ASSEMBLY MEMBER ALMOST WOULD TOO
SO THANK YOU.
THANK YOU SIR.
THANK YOU COMMITTEE RATHER CHAIR
ON A BILL JOHNSON PRESIDENT OF
LOCAL TWENTY SIX TWENTY WE STAND
IN SUPPORT OF THE DEPARTMENT'S
PROPOSAL.
UNDERSTANDING THAT --
WE ARE MEMBER SERVICE PART OF IT
THE TREATMENT TEAM --
AS ANOTHER MEMBER OF THE LEVEL
OF CARE SO THAT WHEN THEY ARE
UNDERSTAFFED AND IMPACTS OUR
STAFF AS WELL AS WELL AS ME ALSO
STAND IN SUPPORT OF THE
DEPARTMENT OF FINANCE AND
PHARMACY HOSPITALS THANK YOU.
THANK YOU SIR.
ADRIN MOHAMMED WITH THE UNION OF
AMERICAN PHYSICIANS AND DENTISTS
AGAIN JUST TO REITERATE OUR
SUPPORT --
FOR OUR SITE TENGAN NURSE
COLLEAGUES THANK YOU.
THANK YOU SIR.
I'LL BRING IT UP TO THE
COMMITTEE WILL START WITH DOCTOR
WOULD FOLLOWED BY ASSEMBLYMEMBER
RAMOS.
IT'S JUST A QUESTION SO THE
INCREASE IN THE NURSING STAFF
YOU'RE LOOKING FOR THERE'S THESE
ARE THIS IS NOT YOUR NORMAL RANK
AND FILE NURSE.
CORRECT OR IS IT I'M I'M TRY I
UNDERSTAND YOUR YOUR WORKFORCE A
LITTLE BETTER YEAH SO THE THE
THREE HUNDRED AND THIRTY FIVE
POSITIONS IS OUR OUR FIRST LINE
PSYCHIATRIC TECHNICIAN POSITION
SO THESE ARE THE POSITIONS THAT.
ARE ON THE FLOOR THAT DO PROVIDE
AS TO THE PATIENTS [inaudible]
IS THERE.
THE ASSUMING THIS WAS PASSED YOU
KNOW AND AND AND SIGNED INTO LAW.
IS THERE THE WORK FORCE OUT
THERE TO SUPPORT WHAT YOU'RE
ASKING FOR RIGHT NOW
[inaudible]
GOOD QUESTION.
I'M ACTUALLY WE ACTUALLY HAVE A
PROPOSAL FURTHER ON THE AGENDA
THAT WILL HELP US ACHIEVE THESE
NUMBERS AS WELL.
FROM FROM IT I HAD TO INCREASE
OUR TRAINING PROGRAMS IN ORDER
TO PRODUCE MORE I PSYCHIATRIC
CASH TO TECHNICIAN POSITIONS TO
BE ABLE TO MEET THIS NEED.
OKAY I JUST.
WONDER ABOUT WORKFORCE I KNOW
THAT NURSES ARE NOT EASY TO COME
BY AND SO AND THESE ARE
SPECIALIZED IS A SPECIALIZED
CARE.
IS PROBABLY NOT FOR EVERYONE AS
WELL SO ON I WE SEE THIS NUMBER
OF POSITIONS I I WONDER YOU KNOW
IF.
YOUR ABILITY TO TO FILL THEM AND
ALSO RETAIN OVER THE LONG HAUL
SO HOW IS THERE IS ARE DO YOU
HAVE ATTENTION ISSUES.
WELL ACTUALLY IF I CAN TALK A
LITTLE BIT MORE BROADLY ABOUT
THE THREE HUNDRED THIRTY FIVE
POSITIONS IN THE NEED JUST KIND
OF IN RESPONSE TO SOME OF THE
THE ELLIE OWES A IT PROPOSAL AS
WELL AS JUST THIS RETENTION AND
THAT OF OUR STAFF.
AND JUST TO CUTTING FIRST WILL
GIVE A PICTURE OF OUR UNITS --
THE THE PEOPLE HAVEN'T THE
ENVIRONMENTS IN WHICH WE TREAT
PATIENTS FIRST OF ALL BECAUSE WE
SAY WE ARE FRIENDS THAT HOSPITAL
PEOPLE IMMEDIATELY THINK OF
CORRECTIONAL ENVIRONMENT AND
THAT WE HAVE --
THE IN INDIVIDUAL CELLS OR IT
MIGHT HAVE CELLS ARE NOT CELLS
THEY ARE HOSPITAL ENVIRONMENTS
THERE ARE YOU KNOW WHAT THE UNIT
TO THE DOORS LOCKED BUT WHEN YOU
GET INTO THE THE THE UNIT IS
VERY MUCH A HOSPITAL ENVIRONMENT.
WITH -- AND
THEY'RE VERY LARGE UNIT SO WE
HAVE UNITS THAT ARE THAT RUN.
UPWARDS OF FIFTY SIXTY PATIENTS
ON THE UNIT AND WE TREAT
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS AND INDIVIDUALS WHO ARE
VERY DANGEROUS AND HAVE BY HI
VIOLENT RISK AND MANY OF THE
PATIENTS THAT WE SERVE.
COULD NOT BE SAFELY TREATED AT
TWO IN THE COMMUNITY SO WHEN YOU
GET THESE VERY CONCENTRATED --
LEVELS OF OF STAFF OF PATIENTS
ON THESE UNITS WHO HAVE VERY SO --
SIGNIFICANT ACUITY IS IT IS A
VERY DANGEROUS ENVIRONMENT AND I
IN THAT THAT IS NOT TO BE TAKEN
LIGHTLY ARE ARE PSYCHIATRIC
TECHNICIANS EVERY DAY --
PUT PUT THEIR LIVES AT RISKTO
TREAT AND CALIFORNIA'S MOST --
SEVERE POP AS SAY SERIOUSLY
MENTALLY ILL POPULATION --
I WILL JUST SAID IT TO KIND OF
SPEAK TO THE RETENTION OF OUR
STAFF IT'S DIFFICULT THEY DO GET
INJURED YOU HEARD MR PATAKI SITE --
THE THE NUMBERS OF INCIDENTS ON
OUR UNITS --
AROUND TWENTY ENTER IN IT
INCIDENTS AT PACE ON STAFF
ISLAND SIX THREE YEAR BUT HE
DIDN'T EVEN MENTION THE THREE
THOUSAND PATIENT TO PATIENT ACTS
OF VIOLENCE AND OUR NURSES ARE
OFTEN OUR FIRST RESPONDERS TO
THESE INCIDENTS WHEN THEY POINT
SPOKE ABOUT PULLING THE TAGS.
THEY'RE THE ONES THAT RESPOND TO
THE INCIDENT FIRST IF YOU A
SENSE OF THE I AM A FOR
RETENTION PURPOSES WE WE LOSE A
LOT OF STAFF TO INJURY.
THAT'S THE THAT'S ONE OF OUR
BIGGEST CHALLENGES --
THE WORKERS COMPENSATION WE THAT
WE DID A COMPARISON OF OUR
WORKERS COMPENSATION OFF FOR YOU
I AM OFF WORK RATE COMPARED TO
CORRECTIONAL OFFICERS.
AND THE NUMBER OF STAFF --
OFF WORK ON WORKERS COMPENSATION
FOR EVERYONE HUNDRED STAFF FOR
FISCAL YEAR SEVENTEEN EIGHTEEN
BECAUSE HE STAFF AT CDC OUR
INSTITUTIONS AVERAGE RATE OF
THREE POINT ONE EIGHT STAFF OFF
WORK PER.
ONE HUNDRED WELL OUR NURSING
STAFF AVERAGE FOUR POINT ONE SIX
TWO HER FOUR POINT SIX TO HER
ONE HUNDRED SO WE ARE NURSING
STAFF FOR INJURED AT A HIGHER
RATE THAN INDIVIDUALS AND THEN
THAT BECAUSE HE STOP AT
CORRECTIONS.
SO YOU KNOW WE HAVE A CHALLENGE --
IT'S A VERY CHALLENGING
ENVIRONMENT AND YOU KNOW WE THIS
PROPOSAL THESE --
THREE HUNDRED POSITIONS ARE
REALLY TO HELP PROVIDE SOME
ADDITIONAL RESOURCES ON THE UNIT
TO MAKE SURE THAT THERE IS
ENOUGH STAFF TO RESPOND TO THOSE.
TO THOSE NEEDS OF THE PATIENTS
AS WELL AS THE VIOLENCE RISKS
THAT CAN THAT THAT OCCUR ON THE
ON THE FLOORS AS WELL
[inaudible]
ASSEMBLYMEMBER RUNS.
THANK YOU MISTER CHAIR AND YOU
KNOW WE VISITED --
OUR LOCAL --
HOSPITAL PENN STATE --
HOSPITAL THAT WAS THERE AND WE
WALK THE THE FOR THE INITIAL
GATE AND THEN ONCE YOU GET PAST
THAT IS PRETTY MUCH OPEN --
WE WALKED IN IN THE IN THE AREA
WERE ALL PATIENTS WERE AT AND
THERE WAS A A LINE THAT WAS
PAINTED ON THE SIDE OF THE ROAD
THAT SAID YOU KNOW PATIENTS DOWN
THAT SIDE.
AND WE CAN WALK IN BETWEEN
THAT'S HELP CLOSE AND AND SECURE
IT IS FOR FOR THE EMPLOYEES THAT
ARE THERE.
AND WHEN I WHEN I SEEN THE
INTAKE THOSE JUST COMING OUT
FROM -- THE
BUS AND DOING THE INTAKE THERE
WAS NO WALL THERE WAS NO SAFETY
FEATURES IT WAS JUST AS GOOD
EVEN CLOSER THAN YOU AND I ARE
NOW.
SO THE SAFETY OF OF THE THE
TECHNICIANS THAT ARE THERE AND
THEN ALL THE EMPLOYEES THAT ARE
THERE IT'S IT'S A REAL.
DRAMA REAL DILEMMA FOR THEM SO
WHEN I SEE THE THE OVERTIME IN
THE BUDGET FOR THAT TRYING TO
GET A LITTLE BIT MORE
INFORMATION ON THAT BECAUSE AS
FAR AS WHERE THE EMPLOYEES ARE
EVERYONE HAS TO BE PRETTY MUCH.
ON THEIR ON THEIR WITS RIGHT --
TO SEE OF ANY PROBLEMS ARE
COMING ONE WAY OR ANOTHER.
AND WE DID SEE THAT --
THE FIRST LINE OF DEFENSE IS ON
THE SITE TAX EMPLOYEES THAT ARE
THERE.
THEY PUSH A BUTTON AND THEN
EVERYBODY --
DESTABILIZE THE SITUATION IT'S
THEIR ITSELF SO IT TRULY IS A A
SITUATION THAT HAVE SOME HAVEN'T
TOURED ONE IN THE THE HOSPITALS
TO SEE THAT IMPACT IT'S THERE.
SO IT'S GREAT TO SEE THESE
POSITIONS COMING IN BUT YET --
HEARING IT FROM SOME OF THE
SPEAKERS THAT WERE THERE AS FAR
AS MANDATORY OVERTIME VERSUS
VOLUNTARY DOES THAT PUT MORE.
TECHNICIANS OR EMPLOYEES.
AT RISK BECAUSE NOW FOR INJURY
BECAUSE OF THE THE INTERACTION
THAT'S GOING ON THERE WITHIN THE
HOSPITAL'S ITSELF.
AND HOW DO YOU.
BE ABLE TO START TO ADDRESS THAT
AND I KNOW IT AND AND ISSUE FIVE
WE TALK A LITTLE BIT MORE ABOUT
RETENTION AND RECRUITMENT AND
THOSE TYPES OF DEALS.
BUT WE'RE STARTING TO NOW BE
ADDRESSED THE ISSUE THAT'S IN
FRONT OF THE WORK FORCE WITHIN
THE HOSPITALS THAT ARE THERE.
COULD THOSE SIMPLE DISCUSSION
STARTING NOW START TO LOOK AT
THE RETENTION DOWN THE ROAD THAT
WE'RE GOING TO SEE IN THE NEXT
ISSUE AN ISSUE.
FIVE OF HOW WE'RE WE'RE
RETAINING THOSE INDIVIDUALS
THERE.
AND I THINK LOOKING AT THE
DEDICATED MEDICATION ROOMS THOSE
ARE WHEN WE WERE THERE WE WE
SEEN THE MEDICATION ROOM AND I
THINK.
BEING ABLE TO HAVE THAT AS YOUR
FIRST POINT OF CONTACT BE
PROACTIVE KEEPING THOSE MEDS
MOVING THROUGH THE HOSPITAL
SERVES AS A LINE OF DEFENSE BUT
TO THEN COUNT THEM AS RESOURCES
A SERRA CASE SOMETHING HAPPENS.
AND YET AND SOMEONE DOES PUSH
THAT BUTTON AND TO SAY THEY'RE
RESPONDING THEY HAVE TO KEEP AN
EYE ON THAT THAT ROOM THAT'S
THERE.
SO I THINK.
LOOKING AT AND SEEN THE BUDGET
FOR OVERTIME I'D LIKE TO LEARN A
LITTLE BIT MORE ABOUT THAT IT IS
A TRULY --
VOLUNTARY OR INVOLUNTARY
MANDATORY OVERTIME THAT'S COMING
THERE AND IF THAT'S THE CASE
DOES THAT PUT THE INDIVIDUALS --
IN SOME TYPE OF HARM'S WAY
BECAUSE THEIR THEIR WITS AND
THINGS LIKE THAT NEED TO STILL
BE INTACT WHEN YOU'RE DEALING
THAT CLOSE TO A POPULATION.
SO LOOKING AT THE THE THE
OVERTIME THAT'S ASSUMED IN THE
PROPOSAL --
AND CORRECT ME IF I'M WRONG I'M
GOING TO MY MISTAKE THIS --
IT ASSUMES --
ANY AT A 95% VACANCY RATE THAT
THE EACH NURSE WOULD IT'S
THIRTEEN POINT --
EIGHT AVERAGE AN AVERAGE OF
THIRTEEN POINT EIGHT HOURS OF
OVERTIME PER MONTH SO THAT'S TO
SAY YOU KNOW TWO SHIFTS PER OVER
TO PER MONTH HER HER I HAD
NURSES WHAT'S ASSUMED IN THE IN
THE PROPOSAL.
SO WITH THAT ASSUMED IN THE
PROPOSAL IS OUT THOSE HOURS.
THAT NOW ARE ARE MARK TO THAT
POSITION BASED ON MANDATORY
OVERTIME OR VOLUNTARY THIS
SOMETHING'S WORKED OUT AHEAD OF
TIME.
WE HEARD SPEAKERS TALK ABOUT --
EMPLOYEES AT THEN HAVE TO BE
ABLE TO PROVIDE FOR THEIR LUNCH
FOR FOR A FAMILY FOR CERTAIN
THINGS THAT ARE GOING ON SO ARE
THEY ABLE TO PLAN THOSE OUT OR
IS IT SOMETHING.
THAT HAPPENS THE SAME DAY YES
CERTAINLY OUR OUR HOSPITALS PRE
HIGHER FOR OVERTIME BECAUSE OVER
TIME HAPPENS RIGHT SO SOMEBODY
CALLS IN SICK FOR A CHEF WE HAVE --
TO WE HAVE TO PROVIDE THAT
COVERAGE AND SO THE HOSPITALS DO
AND IT CUT A NUMBER OF THINGS TO
TRY TO AVOID MANDATORY OFF.
OVER TIME THE FIRST IS TO PRE
AYE HIGHER WE CAN YOU CAN ASSUME
THAT THERE'S A CERTAIN LEVEL OF
OF SHIPS THAT ARE GOING TO BE
ABLE TO THAT ARE GOING TO NEED
TO BE COVERED IN A DAY.
OR A WEEK BASED ON YOU KNOW THE
AVERAGE RATES OF OF A SICK YOU
KNOW SET CALLS.
AND SAID THEY DO PRE HIGHER OVER
TIME WE ALSO MAINTAIN A
TEMPORARY HELP PULL I'M IN A
REGISTRY STRIVE TO ALSO HELP
FILL THOSE POSITIONS WE'D BETTER.
SO WE DO THE I TRIED WHEN WE GET --
AROUND AREAS OF HOLIDAYS --
OR IF THERE'S A SIGNIFICANT
EVENT GOING ON IN THE COMMUNITY
LIKE THE MID STATE FAIR GIVES US
A LITTLE BIT OF OF CHALLENGE.
OF THOSE TYPES OF TIME FRAMESOF
WE DO FIND OURSELVES OFTEN AND
MANDATORY OVERTIME SITUATIONS --
SO THIS WILL PROPOSAL DOES
PROVIDE ADDITIONAL STAFF AND
WHICH WILL BE ABLE TO YOU KNOW
SPREAD THOSE OVER TIME --
HOURS ACROSS AS WELL SO BE MORE
A A NURSES AVAILABLE TO WORK
OVERTIME SHIFTS THE REASON I
BRING IT UP IT IS BECAUSE ONE I
THINK IT'S A DIFFERENT
ATMOSPHERE --
BEING THERE THAT IT'S A HIGH
RISK HIGH RISK AREA HIGH RISK
JOB THOSE THINGS DO HAPPEN --
WHEN I TOURED --
PENN STATE HOSPITAL I SEE ALL
THESE THINGS THAT WE'RE TALKING
ABOUT AND AND PROBABLY.
SOME MORE BUT WITHIN TWO WEEKS
WHEN I TOURED IT A SITE TECH WAS
ATTACKED.
SO THOSE ARE THE REASONS WHY I'M
SAYING THAT THE SAFETY OF THOSE
EMPLOYEES IS SOMETHING THAT WE
SHOULD TAKE INTO OUR DISCUSSION
WHAT WE'RE TALKING ABOUT OVER
TIME WHETHER IT'S VOLUNTARY OR
MANDATORY.
IS BECAUSE OF THIS THAT WE'VE
SEEN FIRSTHAND THANK YOU.
HELLO THE ONE THE ONE THING I
WANTED -- TO
POINT OUT AND PLEASE CORRECT ME
IF I'M WRONG I THINK IN AND
ITSELF THIS PROPOSAL WANT
NECESSARILY REDUCE MANDATORY
OVERTIME THE ONLY WAY MANDATORY
OVERTIME WOULD BE REDUCED AS IF
THE POSITIONS ARE ACTUALLY
FILLED.
I THINK IT'S A FAIR POINT THAT
BY ADDING POSITIONS YOU MIGHT
SPREAD MANDATORY OVERTIME OVER
MORE PEOPLE BUT I DON'T THINK IN
AND OF ITSELF THE APPROVAL OF
THIS PROPOSAL WOULD HAVE MUCH
FACT THAT.
THE MAIN EFFECT WOULD COME FROM
THE WORK FOR BECAUSE OF THAT WE
MIGHT TALK ABOUT LATER.
THANK YOU THANK YOU FOR THAT
WOULD YOU AGREE THAT IT'S A THE
THE SITUATION THAT NEEDS TO BE
DISCUSSED A LITTLE BIT FURTHER
ON YES THANK YOU [inaudible]
ASSEMBLYMEMBER FRAZIER.
RUSSIA QUESTION HOW MANY TIMES
WERE.
THE FACILITIES AND NOT NOT IN
COMPLIANCE WITH TITLE.
TWENTY TWO DO YOU HAVE REPORTS
ON THE YEAH I I DON'T HAVE ANY
INFORMATION THAT WE HAVE NOT
BEEN IN COMPLIANCE WITH TITLE.
TWENTY TWO IT WHEN WE DO NOT
HAVE A NURSING STAFF WE CAN ALSO
COUNT OTHER CONDITIONS INTO --
OUR ACCOUNT SO WE WILL BRING IN
OUR SUPERVISORS I WILL CALL AND
ME I MANAGEMENT --
LICENSE STAFF AND REALISTIC
REHAB THERAPISTS AS WELL IN
ORDER TO MEET THAT THAT LICENSE.
REQUIREMENTS SO DO THEY HAVE TO
HAVE ANY KIND OF CERTIFICATE.
SOARED OF SUBJECTS.
CERTIFICATE CATION LEVEL TO BE
IN THAT POSITION OR IF YOU'RE
JUST BACK FILLING WITH BODIES ON
WHAT I'M SAYING IS A SAFE
LICENSE.
SO EVERYBODY'S LICENSE IN THIS.
THIS REALM THAT YOU'VE NEVER
BEEN IN TOTAL TWENTY TWO NO
COMPLAINTS NOT THAT I'M AWARE OF
THANK YOU --
HE THE FEW COMMENTS IF I CAN --
I'M HEARING ECHOES OF THE NURSES
WHO I'VE WORKED WITH WHO FELT
UNDER RESOURCE AND OVERBURDENED
AND WHEN I WENT TO COLIN GUY
HEARD MANY OF THE COMPLAINTS
THAT.
WE ARE HEARING TODAY.
I AM --
ECSTATIC ACTUALLY THAT THIS
PROPOSAL IS BEFORE US BECAUSE IT
WILL HELP TO LEAD TOWARDS.
ISSUES WITHIN RETENTION FIFTY
FOR MANY OF THE PEOPLE WHO WORK
WITH IN STATE HOSPITALS AND SO.
AGAIN -- DO
YOU BELIEVE THE LA --
HAS.
SOME MERIT LOOKING TOWARDS
EVALUATION OF THE STAFFING TO
MAKE SURE THAT ADOPTED.
THAT THE DIRECTION THAT THE
DEPARTMENT IS LEADING IS APT THE
RIGHT STAFFING LEVEL AND SO --
I BELIEVE YOU'RE ON THE RIGHT
TRACK BY ADDING PEOPLE
PARTICULARLY I JUST.
HAVING WORKED GRAVEYARDS MY
WHOLE LIFE AND INSENSITIVE TO
THE OVERNIGHT.
STAFFING AND SUPERVISORS THAT
YOU'LL BE ADDING --
AND KNOW THAT --
WITH THAT WE TWO FOUR OKAY
[inaudible] TWO FIVE FOR THIS --
WE'RE REQUESTING EIGHT PERMANENT
FULL TIME POSITIONS AND ONE
POINT EIGHT MILLION IN GENERAL
FUND IN FISCAL YEAR NINETEEN
TWENTY GROWING TO TWO POINT SIX
MILLION IN TWENTY THREE TWENTY
FOUR AN ON GOING.
AND THIS IS TO SUPPORT THE
DEVELOPMENT AND IMPLEMENTATION
OF A PSYCHIATRIC RESIDENCY
EXPAND RESOURCES FOR FOR NURSING
RECRUITMENT AT THREE OF OUR
HOSPITALS.
WE EXPERIENCED RECRUITMENT
CHALLENGES FOR SAY A PSYCHIATRY
AND LEVEL OF KERR STOP WILL ALL
OF OUR CLINICAL STAFF REALLY --
FOR A NUMBER OF REASONS ONE IS
OF WHAT WE JUST SPOKE AROUND
ABOUT OUR HIGH RISK ENVIRONMENTS --
BUT THE CUTIE OF OUR PATIENTS
AND THE PATIENT VIOLENCE TOWARD
STAFF THE CLINICAL AND LEVEL
CARE POSITIONS ARE MENTALLY AND
PHYSICALLY DEMANDING POSITIONS
IN OUR HOSPITALS.
WE ALSO.
HAVE HIGHER OCCUPANCY IN
CASELOADS WITHIN OUR HOSPITALS
AND TO MEET THE DEMAND FOR OUR
SERVICES WE'VE BEEN OPERATING IT
NEARLY MAXIMUM FUNCTIONAL
CAPACITY WHICH IS NOT CONSISTENT
WITH INDUSTRY BEST STANDARDS.
YEAH YOU HEARD ME TALK ABOUT THE
FACT THAT --
WE HAVE -- I
APOLOGIZE I JUST LOST MY TRAIN
OF THOUGHT GET THE GOVERNMENT
HERE -- LET
ME MOVE ON ACCORDING TO EXISTING
RESEARCH --
OCCUPANCY LEVEL IN THE HOSPITALS --
ABOVE 80% LEADS TO STRESSFUL
WORK ENVIRONMENTS AND FURTHER
STUDIES HAVE SHOWN THE OPERATING
ABOVE 85% OCCUPANCY WILL HAVE
DETRIMENTAL IMPACT AT THE
IMPACTS TO HOSPITAL FOR
PERFORMANCE SUCH AS STAFF
DISSATISFACTION.
BURN OUT MEDICATION ERRORS
AGGRESSIVE BEHAVIOR A BY
PATIENTS AMONG OTHER ISSUES.
AND THEN LOOKING AT DATA FROM
THE WESTERN PSYCHIATRIC STATE
HOSPITAL ASSOCIATION WHICH IS
LIKE A COALITION OF STATE
HOSPITALS THAT WE ARE A PART OF
IN THAT REPRESENTS BEEN DOES THE
AVERAGE EVERY SHIFT PSYCHIATRIST
TO PATIENTS --
FOR FOR A PROCESS HOSPITALS WAS
ONE TO TWENTY FIVE MONTHS
MEMBERS AND WE RUN IT I ONE TO
THIRTY FIVE OR IN INTERMEDIATE
CASELOADS.
A THAT WE SPOKE ABOUT NATIONAL --
SHORTAGES OF BOTH PSYCHIATRISTS
AND ON THE NURSES AS WELL THE
NATIONAL INSTITUTE OF MENTAL
HEALTH STATES THAT PSYCHIATRISTS
ARE AGING OUT OF THE WORK FORCE.
70% OF ALL ACTIVE PSYCHIATRISTS
ARE AGE FIFTY OR OLDER AND 39%
OF PSYCHIATRISTS OR SIXTY ONE OR
OLDER.
AND PURSE WERE NURSES ACCORDING
TO THE US DEPARTMENT OF HEALTH
AND HUMAN SERVICES AT THE
CURRENT LEVEL OF HEALTH CARE IS
MAINTAINED CALIFORNIA IS
EXPECTED TO HAVE A DEFICIT OF
FORTY FOUR THOUSAND OVER FORTY
FOUR THOUSAND NURSES BY.
TWENTY THIRTY WE ALSO HAVE A
PAGE CHALLENGES --
IN AND OTHER EMPLOYER
COMPETITION THEIR PAIN AND PAY
AYE INEQUITIES BETWEEN IDEA SAGE --
AND OTHER STATE DEPARTMENTS
NAMELY THE CALIFORNIA DEPARTMENT
OF CORRECTIONS DUE TO A FEDERAL
COURT ORDER SO OUR CLINICAL
STAFF.
DO MAKE 5% LESS THAN --
CDC OUR STAFF.
AS WELL AS HEALTHCARE FACILITIES --
IN THE COMMUNITY PAY MORE THAN
THAT IS THAT A STATE POSITIONS.
TO SO WE PROPOSED TO PARTNER
WITH TORO UNIVERSITY TO DEVELOP
AN EMPLOYER CONSORTIUM COMPRISED
OF OURSELVES TUROW IN AS WELL AS
TO ADDITIONAL COUNTY MENTAL
HEALTH DEPARTMENTS TO CREATE A
NEW PSYCHIATRIC RESIDENCY
PROGRAM --
THIS WOULD INCLUDE HIRING A
PROGRAM DIRECTOR AND A PROGRAM
ASSISTANT TO ESTABLISH THE
RESIDENCY PROGRAM TO COLLABORATE
WITH FURROW --
AND THE ACCREDITATION COUNCIL
FOR GRADUATE MEDICAL EDUCATION
DEVELOP CURRICULUM IN CLINICAL
ROTATIONS AND PROCEED WITH THE
MATCH PROCESS TO PLACE RESIDENTS.
THE GOAL IS TO OPEN THE
RESIDENCY PROGRAM ANYONE TO ITS
FIRST COHORT OF FOR RESIDENTS
AND ADDING AN ADDITIONAL FOUR
RESIDENTS ON GOING FOR EACH YEAR
THE PROGRAM UNTIL THERE ARE
SIXTEEN RESIDENTS IN THE PROGRAM
PERSON ARE PARTICIPATING IN THE
PROGRAM.
WITH FOR COMPLETING THE PROGRAM
EACH YEAR BEGINNING IN.
TWENTY FOUR TWENTY FIVE WELL IN
THE ROTATION AT DSA H. --
NAPA THE RESIDENTS WILL HAVE
THEIR OWN PATIENT CASELOAD AND
WILL BE ACTIVELY TREATING
PATIENTS AT THE DEPARTMENT.
REYES AND CREATING THE RESIDENCY
PROGRAM DAYTON DEDICATED TO
TRAINING PRESS GRADUATES AND
FORENSIC MENTAL HEALTH WILL HELP
DEVELOP A COHORT OF
PSYCHIATRISTS THAT ARE
INTERESTED IN EXPERIENCE IN
WORKING WITH OUR PATIENT
POPULATION.
THIS ONLY --
THE ANNUAL COST OF THE RESIDENTS
WHICH IS 300-990-00600 DOLLARS
PER YEAR BEGINNING IN YEAR TWO
WILL BE LESS THAN THE COST OF
HIRING ONE FULL TIME
PSYCHIATRIST WHICH IS FOUR
HUNDRED AND EIGHTEEN THOUSAND SO
IT'S A VERY COST EFFECTIVE
PROPOSAL FOR US.
WITH RESPECT TO THE NURSING
INSTRUCTORS --
NO TRAINING AND RECRUITMENT WE
WILL FOR INSTITUTION CODE
SECTION FORTY TWO FORTY THREE
TWENTY REQUIRES US TO ESTABLISH
AN EDUCATION AND TRAINING
PROGRAM TO PROVIDE ADEQUATE
SUPPLY OF A PSYCHIATRIC.
TO TECHNICIANS FOR HOSPITALS.
AS WE PARTNER WITH AGITATION
EDUCATIONAL INSTITUTIONS ACROSS
THE STATE FOR TRAINING AND
RECRUITMENT OF OUR OUR INS IN
PT'S.
AND IT'S IN SOME OF THE
PARTNERSHIP AGREEMENT
ARRANGEMENTS --
WE ACTUALLY PROVIDE THE LOCATION
ON OUR FACILITIES FOR THE
TRAINING AS WELL AS NURSING
INSTRUCTORS.
SO WE PROPOSED A HA HIGHER FIVE
NURSE INSTRUCTORS TO PROVIDE
ADDITIONAL INSTRUCTIONAL
RESOURCES TO INCREASE THE NUMBER
OF OUR IN ST PETE TO CANDIDATES
WITHIN THE LOCAL COMMUNITY
COLLEGES. THREE WOULD BE FOR
ATASCADERO WORTH ONE AT THE S.
H. NAPA FOR A PARTNER SAID SHIP
WITH NAPA VALLEY COLLEGE AND ONE
IDEAS THAT EACH COALINGA. FOR
THE PARTNERSHIP WITH WEST HILLS
COLLEGE THE THE NURSES DOCTORS
WILL NOT ONLY BE LIMITED TO THE
CURRICULUM BASED --
WORKLOAD BUT THEY WILL ALSO
SERVE AS LOCAL HOSPITAL OUT
REACH COORDINATORS AS WELL THERE
WERE CARL AVERAGE
COLLABORATIVELY.
WITH OUR RECRUITMENT UNIT
SACRAMENTO TO ASSIST IN
PARTICIPATION ABOUT THE
CANDIDATES OUT REACH --
CAREER FAIRS AND TO BE
AMBASSADORS TO DS H. TO PARTNER
WITH OUR EDUCATIONAL INDUSTRIES
[inaudible]
THE QUESTION.
DEPARTMENT OF FINANCE A LAYOFF.
ARMA SO WITH RESPECT TO THE
PROPOSED FORENSIC PSYCHIATRIC
RESIDENCY PROGRAM BUT WE DO
THINK THAT IT'S A PROMISING
APPROACH BECAUSE IT DOES
RECOGNIZE THAT THERE'S A LACK OF
SLOTS.
HOWEVER WE ARE SOMEWHAT
CONCERNED BECAUSE IT IS ONE
POINT SIX MILLION DOLLARS A YEAR
TO PRODUCE FOR GRADUATES WHO
WANT NECESSARILY BE REQUIRED TO
STAY IN THE STATE HOSPITAL
SYSTEM.
ACCORDINGLY WE'RE RECOMMENDING
THAT IT BE APPROVED ON A SIX
YEAR BASIS THIS WOULD ALLOW ONE
COHORT OF STUDENTS TO GO THROUGH
THE PROGRAM DETERMINE WHETHER OR
NOT THEY'D STAY AND THEN AT THAT
POINT THE LEGISLATURE COULD
DETERMINE.
WHETHER THE RETENTION RATE IS
HIGH ENOUGH IN ORDER TO CONTINUE
THE PROGRAM OR WHETHER ON ONLY
ENOUGH FUNDS TO ALLOW THE
RESIDENTS WERE IN THE PROGRAM --
TO FINISH SHOULD BE APPROVED
WITH RESPECT TO THE PARTNERSHIP
WITH THE COMMUNITY COLLEGES TO
GRADUATE MORE NURSES WE THINK
IT'S A GOOD STEPPED ON A GOOD A
PROVEN WAY. TO REDUCE VACANCIES
WE WOULD KNOW HOWEVER THAT
NORMALLY WHEN THESE CLASS SIZES
INCREASE THE COLLEGE GET SOME
INSTRUCTIONAL FUNDING ASSOCIATED
WITH THAT --
AND WE ARE AWARE THAT THE
DEPARTMENT IS GOING TO PROPOSED
OFFSET A PORTION OF THIS
PROPOSAL WITH SOME OF THAT
COMMUNITY COLLEGE INSTRUCTIONAL
FUNDING AS PART OF THE SPRING
FINANCE LETTER PROCESS.
HOWEVER TWO OF THE INSTRUCTORS
THEY'RE NOT SEEKING TO DO THAT
FOR AND SO WERE WITHHOLDING
RECOMMENDATION JUST PENDING
CLARIFICATION OF WHY IT'S NOT
POSSIBLE TO OFFSET MORE OF THE
COSTS WITH THIS COMMUNITY
COLLEGE INSTRUCTIONAL FUNDING.
BUT WE DON'T HAVE ANY PROBLEMS
IN PRINCIPLE.
THANK YOU THE FROM THE FINANCE I
THINK YOU I'D AS SO IN TERMS OF
THE LIMITING THE THE RESIDENCY
PROGRAM TO LIMITED TERM --
AND TO DETERMINE WHETHER IT'S
EFFECTIVE OR NOT OR NOT --
BUT ONE OF THE THINGS THAT I
WANT TO POINT OUT HERE IS THAT
IT'S ESSENTIALLY IMMEDIATELY
EFFECTIVE BECAUSE YOU'RE FILLING.
POSITIONS THAT MAY OR MAY NOT --
BEAT IT CURRENTLY FILLED WITH
THAT RESIDENTS --
OBVIOUSLY POSITIONS WITH WILL BE
AVAILABLE SHOULD A FULL TIME --
YOU KNOW FULLY JOURNEYED --
CLINICIAN BECOME AVAILABLE I
DON'T MEAN TO SUGGEST THAT IT'S
A IT'S A SUBSTITUTION --
HOWEVER YOU ARE IT EIGHT
IMMEDIATELY --
HAVING THE EFFECT OF PROVIDING
MORE TREATMENT RIGHT AWAY --
IT'S ALSO EXTREMELY COST OF I'M.
A FULL TIME EQUIVALENT POSITIONS
ARE FIVE POINT EIGHT SIX WHEN
THE RESIDENCY FULLY UP AND
RUNNING --
AND THE JUST THAT THAT THE COST
OF THE RESIDENTS THEMSELVES OF
THE THE STIPEND PORTION IS ONE
POINT SIX FOUR MILLION DOLLARS
FOR THOSE FIVE POINT --
EIGHT SIX EQUIVALENT POSITIONS
AND IF YOU WERE TO HAVE FIVE
POINT EIGHT SIX FULL TIME
PSYCHIATRIST IT WOULD BE TWO
POINT FOUR MILLION SO --
YOU DON'T JUST WITH HAVING
STUDENTS PRESENT IT DOES MAKE A
DIFFERENCE IN THE IN THE IN THE
CARE THAT THE PATIENTS ARE
RECEIVING --
AND IN TERMS OF IT WONDERING HOW
HOW EFFECTIVE IT WILL BE AND
WHETHER IT FOLKS DECIDE TO STAY
OR NOT OBVIOUSLY I DON'T HAVE A
CRYSTAL BALL I CAN'T TELL YOU
THAT BUT WHAT I CAN TELL YOU IS
THAT AND I'VE LEARNED THAT --
FORENSICS IS A SPECIALTY WITHIN
PSYCHIATRY THEY'RE ONLY SIXTEEN
SLOTS --
THERE WE WOULD BE ADDING SIXTEEN
SLOTS TO ONLY TWENTY TWO THAT
EXISTING CALIFORNIA SIXTY SIX
NATIONWIDE --
AND DOCTOR WARBURTON'S MUCH MORE --
CAPABLE OF ADDRESSING THIS THAN
I AM BUT I'M FROM MY WHAT I'VE
LEARNED IS THAT THOSE WHO CHIU
THAT'S WHAT THEY WANT TO DO THAT
DAY IF THEY WANT TO WORK IN THAT
ENVIRONMENT.
AND THOSE ENVIRONMENTS ONLY
EXIST AT STATE HOSPITALS AND TO
A CERTAIN EXTENT JAILS AND
CORRECTIONS.
ALL OF WHICH THE STATE HAS A
VESTED INTEREST IN ENSURING THAT
THEY'RE SUFFICIENT STUFF SO IN
TERMS OF WHETHER NOTS EFFECTIVE
I SUPPOSE IT'S POSSIBLE EVERY
SINGLE PERSON EVERY YEAR COULD
MOVE OUT OF STATE BUT THAT'S
UNLIKELY --
AND THAT YOU KNOW THE FACT THAT%
WE WOULD BE IMMEDIATELY
PROVIDING ADDITIONAL CARE --
YOU KNOW WE WE THINK AS IT MAKES
IT MAKES IT WORTHWHILE PROPOSAL.
PUBLIC COMMENT ON PLEASE YES --
IF I MAY ALSO ADD THAT --
TO MAKE IT LIMITED TERM FUNDING
WE REDUCE THE INCENTIVE FOR
OTHER COLLEGES TO PARTICIPATE IN
THIS PROGRAM FOR RESIDENTS TO
APPLY FOR THIS PROGRAM AS WELL.
THANK YOU SIR.
PUBLIC COMMENT ON ISSUE.
FIVE CAN KOBE POSSESS CALIFORNIA
ASSOCIATION OF PSYCHIATRIC
TECHNICIANS --
WE SUPPORT THIS PROPOSAL AND AS
FOR THE RECRUITMENT AND
RETENTION PORTION OF THIS WE
BELIEVE THIS.
THE THE AUTHORIZATION OF
ADDITIONAL --
STAFF TO HOPE THE NURSING
PROFESSIONS WERE CREW AND
DEVELOP --
MORE CANDIDATES COMING OUT OF
THE COLLEGES IS ABSOLUTELY THE
RIGHT WAY TO GO HOWEVER --
WE DO BELIEVE THAT TIONAL
ROADBLOCKS LAKE --
HIGH RENT AREAS IN WHICH SOME OF
THE HOSPITALS ARE LOCATED LIKE
ATASCADERO --
OR THE CENTRAL VALLEY WILDER
PRETTY ISOLATED LIKE KALINGA
THOSE ARE THE PLACES WHERE WE DO
FIND WE HAVE HIGHER VACANCY
RATES -- WE
WILL BE GOING TO THE BARGAINING
TABLE THIS YEAR AND WE WILL BE
ASKING FOR A WERE RECRUITMENT
AND RETENTION STEP IN FOR THOSE
AREAS -- SO
WE DO HOPE THAT THE LEGISLATURE
IS LISTENING AS WE PUTFORWARD
THERE THE REQUEST FOR A AN ARMED
ARE.
THANK YOU THANK YOU SIR.
THANK YOU HAVE BILL JOHNSON
PRESIDENT OF ASKED ME LOCAL
TWENTY SIX TWENTY WE SENT IN
SUPPORT OF THE PROPOSAL --
SPECIFICALLY --
DUE TO THE INCREASE STAFF
ASSAULTS THAT ARE OCCURRING --
ALSO UNDERSTANDING THAT.
NO ONE SPECIFICALLY WERE THOSE
ASSAULTS OCCUR AND ON WHICH
LEVEL OF CARE CLASSIFICATIONS
THEY OCCUR TO IS ALSO IMPORTANCE
TO US -- SB
THREE SIXTY THREE PANS BILL WILL
ADDRESS THAT SO WITH THAT WE
STAND IN SUPPORT OF THE PROPOSAL
THANK YOU.
THANK YOU SIR.
HELLO AGAIN ADRIN MARKET WITH
THE UNION OF AMERICAN PHYSICIANS
AND DENTISTS--
WE ARE DEFINITELY IN SUPPORT OF
THIS PROPOSAL IT'S A WONDERFUL
IDEA AND SOMETHING THAT WE'VE --
BEEN A CONVERSATION WITH THE THE
ADMINISTRATION ABOUT AND SO.
WE WE FULLY SUPPORT AND WE
AGREED THAT IT WOULD BE BECAUSE
THIS IS ATTACKING AN ISSUE THAT
WHAT IS.
IS CURRENTLY BLOSSOMING IT'S
SPREADING IT'S GROWING AND WE
NEED TO DO WHATEVER WE CAN AT
THIS POINT TO START TO SLOW THAT
DOWN AND CHANGE THE TIDE AND A
OF RESIDENCY PROGRAM IS BY FAR
ONE OF THE BEST AND MOST
INNOVATIVE PROPOSALS THAT WE'VE
SEEN IN THIS REGARD AND SO.
WE ARE FULLY BEHIND AND WE
APPRECIATE IT AND HONESTLY WE
THINK IT SHOULD BE EXPANDED WE
UNDERSTAND.
YOU KNOW THE THE CONCERNS OF THE
LA -- BUT
HONESTLY MORE MONEY SHOULD BE
PUT TO PORTS THAT MAYBE WE LOOK
AT SOME TYPE OF LOAN REPAYMENT
PROGRAM FOR THESE RESIDENTS THAT
WAY WE CAN TRY TO HELP INSURE
THAT THEY DO.
STAY HERE AND YOU KNOW MAYBE WE
TO ATTACH SOME TYPE OF WRITER
THAT SAYS HEY.
YOU SAY FIVE YEARS YOU GET THIS
MUCH MONEY TOWARDS LOAN
REPAYMENT OR WHATEVER THAT MIGHT
BE BUT I THINK WE CAN.
LOOK TOWARDS WAYS THAT CAN
IMPROVE --
EFFICACY BEFORE WE LOOK AT ST.
SIX YEARS FROM NOW OKAY WAS THIS
ACTUALLY WORTH IT DID THIS WORK
WE CAN MAKE THAT.
MAKE WE CAN ENSURE THAT WORKS
NOW YOU A PD IS PROUD TO BE WITH
YOU ALL AS WE LOOK TOWARDS.
THE SOLUTION.
ALL RIGHT THANK YOU THANK YOU
SIR.
MICHAEL BEING A REPRESENT A
COMMON CLASS AGAIN I THINK THIS
IS THE RESIDENCY PROGRAM IS A
VERY IMPORTANT POSITIVE STEP --
JUST SOME OTHER INFORMATION YOU
SHOULD CONSIDER BY UNDERSTANDING
IS -- FOR OR
ABOUT TO HAVE THE MATCH PROCESS
FOR PEOPLE COMING OUT OF MEDICAL
SCHOOL.
WAITING FOR THE RESIDENCY
PLACEMENTS --
20% OF THE PEOPLE GRADUATING
FROM MEDICAL SCHOOL IN AMERICA
ARE NOT GOING TO GET ANY
PLACEMENT BECAUSE WE HAVE A
SHORTAGE OF RESIDENCY SLOTS TO
THE PEOPLE GONE THROUGH MEDICAL
SCHOOL THEY HAVE A TREMENDOUS
DEBT.
THEY'RE GONNA HAVE NO PLACE. TO
BE TRAINED.
SO WE NEED MORE RESIDENCY
PROGRAMS.
THANK YOU SIR.
SEEING NO FURTHER PUBLIC COMMENT
ON BRING IT UP TO THE COMMITTEE
FOR ANY COMMENTS ASSEMBLYMEMBER
FRAZIER THANK YOU.
AS A DAD THAT PAID FOR HIS
DAUGHTER'S PSYCHOLOGY.
OF EDUCATION AND HIGHER
EDUCATION.
AND STARTED OUR FORENSIC PATH
AND SO WHAT THE PAY WAS.
AND THEN WENT INTO PRIVATE
BECAUSE OF SHE'S A CLINICAL
PSYCHOLOGIST.
SHORT MEMORIAL HOSPITAL --
IN SAN DIEGO I THINK THAT WE
ALSO HAVE TO LOOK AT THE PAY
DISPARITY BETWEEN PRIDE IN
PUBLIC --
THAT HAS TO BE ADDRESSED.
WHEN WE LOOK IN --
HELP THE PRIVATE SECTOR'S
ADVANCED AND IT'S NOT A FAIR
ASSUMPTION THAT ANYBODY WANTS TO
GO AND MAKE LESS.
IN AN INDUSTRY THAT REALLY DOES
TAKE A DEDICATED INDIVIDUAL --
MAKING A LIFE BASICALLY THAT
THEY'RE GOING TO HELP PEOPLE
WITH THESE INDIVIDUAL PROBLEMS.
YOU KNOW WE KEEP DODGING THE
ELEPHANT IN THE ROOM.
WE DON'T PAY ENOUGH.
WE NEED TO BE ABLE TO ADMIRE
THESE FOLKS TO TAKE THIS THIS
PART OF THE POPULATION.
THE NOBODY WANTS TO HAVE
DEALINGS WITH WHAT I'VE GONE
THROUGH CMF AND BACK OF BILL --
WHICH IS ANOTHER SUBSET OF WHAT
YOU WOULD WHAT WE'RE TALKING
ABOUT THE CRIMINALLY INSANE.
NOBODY WANTS TO BE THERE.
BUT THE FOLKS THAT YOU WORK WITH.
GOD LOVE THEM ARE DOING IT.
WE GOT A KNOWLEDGE IF WE WANNA
TAKE.
YOU'VE TALKED ABOUT THE
POPULATION CENSUS GROWING.
BUT OUR EMPLOYMENT RATE NOBODY
WANTS TO DO IT BECAUSE WE'RE NOT
PAYING ENOUGH HI MY SOMETHING
LIKE A BROKEN RECORD.
BUT IT IS IT IS THE TRUTH --
AND AGAIN MY DAUGHTER IS ONE OF
THE FOREMOST FACTORS SHE JUST
HAS A SOCIETY SHE CAN'T SHE
CAN'T --
PRESCRIBE.
BUT FIVE HUNDRED THOUSAND
DOLLARS IN HER EDUCATION SHE
WENT TO A PRIVATE UNIVERSITY.
OF NOT TORO BUT SHE WENT TO
ALLIANCE.
I THINK WE DON'T NEED TO
ALIENATE ANY PSYCHOLOGY SCHOOL
ALSO WE NEED TO BE ABLE.
TO ALLOW IN.
ANY KIND OF SPECIAL WE CAN GET
OF BECAUSE IT'S NOT A SUBSET OF
THE SCOPE THAT ANYBODY WANTS.
TO JUST JUMP INTO UNLESS THERE'S
SOME PUT OPPORTUNITY TO MAKE
MONEY -- SO
I HOPE WE'VE BECOME MORE
COMPETITIVE.
AND UNDERSTAND THAT --
IT'S EVEN WITH OUR STAFF HERE IN
THE BUILDING.
THEY WORK A FEW YEARS AND THEY
GO OUT OF HER HOUSE.
BECAUSE THEY MAKE MORE MONEY.
YOU KNOW IT'S HARD TO BE
COMPETITIVE.
AND SO I THINK WE NEED TO TAKE
THAT IN AND LOOKING TO HAVE A
STUDY DONE WHAT'S DISPARITY IN
PAY.
AND AND IF THERE IS SOME KIND OF
A COULD WEEK EQUITY WE CAN BUILD
THE WE NEED TO DO THAT.
THE COST MONEY BUT WE'RE ALSO
GONNA HAVE A QUALITY OF CARE
THAT.
WE CAN BE PROUD OF THANK YOU
[inaudible]
SOME.
I HAD MY TWO CENTS AND MAYBE
IT'S BECAUSE I STAYED IN THE
SAME COUNTY WHERE I DID MY
RESIDENCY.
BUT TRAINING PEOPLE OFTEN TIMES
LEADS TOWARDS THEM WANTING TO
STAY.
I THINK HISTORICALLY THE DATA IS
ABOUT 50% DEPENDING ON THE
SPECIALTY.
AND EVEN ATTAINING THAT AMOUNT
OF IMMEDIATE PARTICIPATION OF
THE DEPARTMENT OF FINANCE IS
SAYING WALL THERE RESIDENTS AND
THE OPPORTUNITY TO CAPTURE THEM.
AND HAVE THEM STAY LONG TERM IS
A STRONG REASON TO MAKE THIS
PERMANENT AND NOT ON A LIMITED
TERM -- ONLY
BECAUSE I HAVE CONCERNS THE
ABILITY TO HIRE THE RIGHT
PROGRAM DIRECTOR AND MAKE SURE
THAT THE RESIDENTS ARE WILLING.
TO COMMIT TO A PLACE THAT'S ONLY
ON A LIMITED TERM VERSUS A
LONGER TERM SO.
WITH THAT WE WILL HOLD ISSUE
FIVE OPEN AND MOVE ON TO ISSUE
.
SIX FOR THIS ITEM I'M JOINED BY
A CHRISTINE SAKAKI WHO IS THE S.
H. IS TO THAT CHIEF COUNSEL.
WE'RE REQUESTING ONE PERMANENT
FULL TIME POSITION AND A GENERAL
FUND AUGMENTATION OF THREE POINT
THREE MILLION DOLLARS IN
NINETEEN TWENTY AND THREE POINT.
THREE FOUR ONE ON GOING.
AND APPROVAL OF ASSOCIATED
TRAILER BILL LANGUAGE --
THIS IS TO IMPLEMENT A NEW IN
COMPLIANT WAGE STRUCTURE FOR D.
S. H. AS VOCATIONAL REHAB
PROGRAM THE GOALS OF THIS
REQUEST OR TO STANDARDIZE
PATIENT WAGE OF STRUCTURE ACROSS
ASSOCIATE WITH OUR VOCATIONAL
REHABILITATION PROGRAM ACROSS
OUR STATE HOSPITALS. TO ENSURE
COMPLIANCE WITH FEDERAL AND
STATE LAWS AND TO REDUCE RISK OF
ADVERSE LEGAL ACTIONS ASSOCIATED
WITH THE A CH IS CURRENT AND NON
STANDARDIZED WAGE STRUCTURE.
AS PART OF A PATIENT'S TREATMENT
PLAN AND REHABILITATION PROCESS
WE OFFER OUR PAIN PATIENTS
ACCESS TO A VOCATIONAL
REHABILITATION PROGRAM THIS
PROGRAM SERVES AS A THERAPEUTIC
PROGRAM TO PROVIDE A RANGE OF
OCCASIONAL SKILLS.
AND THERAPEUTIC INTERVENTIONS
FOR THE PATIENTS THE CLINICIANS
WORK CLOSELY WITH THE REHAB
PROGRAM MANAGERS TO INCORPORATE
A TREATMENT PLAN TO ASSIST
PATIENTS AND DEVELOPING SOCIAL
OCCUPATIONAL LIFE AND CAREER
SKILLS.
PREPARING THE PATIENT FOR
DISCHARGE IN OUR TRANSITION TO
THE NEXT LEVEL OF CARE AND
PROVIDING SKILLS FOR FUTURE
EMPLOYMENT AS WELL AS ASSISTING
WITH SUCCESSFUL COMMUNITY
INTEGRATION WHEN RELEASED FROM
OUR CARE.
PATIENTS WORK OPPORTUNITIES I AM
VERY ACROSS THE HOSPITALS THEY
CAN BE --
JOBS SUCH AS CUSTODIAL A KITCHEN
WORKER PRODUCT ASSEMBLY A
LAUNDRY ATTENDANT LANDSCAPER
PAINTER WE HAVE PLUMBERS BARBERS
PARTICLE.
HAVE BOOKS WORKING AND HARPER
HOLDEN HORTICULTURE --
MULTIMEDIA PRODUCTION AND REPAIR
TECHNICIANS.
PATIENTS PARTICIPATING IN THE
VOCATIONAL REHAB PROGRAM ARE
PAID A WAGE FOR THE WORK
PERFORMED AND HISTORICALLY THAT
PAY STRUCTURE FIRE THAT REHAB
PROGRAMS HAS BEEN HAS NOT BEEN
STANDARDISED ACROSS OUR PROGRAMS --
WAGE VARIAS VERY ACROSS THE
STATE HOSPITALS THEY RANGE FROM
A DOLLAR TO TEN DOLLARS AND
FIFTY CENTS PER HOUR AND ARE NOT
CONSISTENT BY THE TYPE OF WORK
PERFORMED.
NORCROSS THE PATIENT COMMITMENT
TYPES.
WHILE EACH HOSPITAL IMPLEMENT
SPRING PROCESSES AND WAGE
STRUCTURES ARE NAPA STATE
HOSPITAL OPERATES THE ONLY
SHELTERED WORKSHOP AS MAGNOLIA
ENTERPRISES --
WERE AUTHORIZED --
TO OPERATE SHELTERED WORKSHOPS
BY WELFARE INSTITUTIONS CODE
FORTY THREE SIXTEEN AND THE
SHELTERED WORKSHOPS ARE DESIGNED
PROVIDE OPPORTUNITIES TO
PATIENTS THAT MIMIC TRADE IN IN
THIS INDUSTRY.
I DIDN'T NAPA'S MAGNOLIA
ENTERPRISES CONTRACTS WITH THIRD
PARTY VENDORS IN THE COMMUNITY
TO PROVIDE OPPORTUNITIES FOR
PATIENTS PERFORM WORK THAT THEY
WOULDN'T BE ABLE TO GET AT THE
HOSPITAL.
SUCH AS A SOW PROPPING BUILDING
NURSERY BOXES --
AND ASSEMBLING SMALL ANIMAL
FEEDERS.
I HAVE FEDERAL LAW REQUIRES THE
SHELTERED WORKSHOPS TO OBTAIN OF
FOURTEEN C. CERTIFICATE SO THAT
IT'S UNNECESSARY TO PAY THE
PATIENT WORKERS THE HIGHER OF
THE FEDERAL OR THE STATE MINIMUM
WAGE.
AND TO PAY SUB STATE MINIMUM
WAGE UNDER THE FOURTEEN C.
CERTIFICATE NAPA IS REQUIRED TO
COMPLETE TIME STUDIES FOR EACH
PATIENT THAT RESULTS IN
COMMENSURATE RANGES.
AS PART OF THE TIME STUDIES THEY
HAVE TO COMPARE THE QUALITY AND
QUANTITY OF WORK PERFORMED BY
EACH PATIENT TO THAT.
OF AN EMPLOYEE IN THE PRIVATE
SECTOR IN ORDER TO DETERMINE THE
APPROPRIATE WAGE FOR THAT EMPLOY
A FOR THAT PATIENT.
I DO WANT TO NOTE THAT IN TWO
THOUSAND AND SIXTEEN DISABILITY
RIGHTS CALIFORNIA DID RAISE
CONCERNS TO US REGARDING OUR
VOCATIONAL REHAB PROGRAM
PARTICULARLY.
ARE THE REYES EQUAL PROTECTION
ARGUMENTS ARE NOTING THAT THE
TYPES OF WORK AS I MENTIONED
BEFORE PERFORMED IN THE WAGES
RECEIVED DIFFERS BY THE PATIENT
TYPE IN ACROSS THE HOSPITALS.
THIS PROPOSAL WOULD A STOP
ASIANS AT SEVEN DOLLARS AND
TWENTY FIVE CENTS PER HOUR WHICH
IS FEDERAL MINIMUM WAGE.
THE PAY WOULD BE APPLIED TO ALL
PATIENTS EXCLUDING ARE MENTALLY
ILL PRISONERS FROM CDC ARE WHO
WILL CONTINUE BE PAID A DOLLAR
PER HOUR.
AND PATIENTS WORKING IN --
NAPA IS --
THE SHELTERED WORKSHOP UNDER
THAT FOURTEEN C. PROGRAM I
PREVIOUSLY MENTIONED --
THIS WOULD PROVIDE ALSO ONE
PERMANENT FULL TIME ASSOCIATE
ACCOUNTING ANALYST POSITION AND
ASSOCIATED --
IN E. RELATED TO THAT POSITION
TO FACILITATE A STANDARDIZED
PAYROLL PROCESS ACROSS THE
HOSPITALS AS WELL.
AND TO IMPLEMENT THE REQUIRED
WITHHOLDINGS IN PAYMENT OF
EMPLOYER SHARE PAYROLL TAXES
THAT WE DON'T CURRENTLY AND TAKE
CARE OF THIS PROPOSAL INCLUDE --
ALSO INCLUDED PROPOSED TRAILER
BILL LANGUAGE WHICH PROPOSES TO
DO TWO THINGS THE FIRST IS TO
CLARIFY THAT PATIENTS WHO ARE
PARTICIPATING IN OUR VOCATIONAL
REHABILITATION PROGRAMS AND
SHELTERED WORKSHOPS ARE NOT
SUBJECT TO STATE MINIMUM WAGE
REQUIREMENTS.
AND THEN ALSO CLARIFIES THE
APPLICABILITY OF WORKERS
COMPENSATION BENEFITS TO OUR
PATIENTS --
THE GENDER DID ASK US TO ANSWER
OF THREE QUESTIONS SO IF I MAY
HOLD FOR C. WITH THOSE.
AS PER THE FIRST ONE WAS FOR
WHAT REASONS DOES I AM DAZED --
THE DEPARTMENT NOT WANT TO PAY
PATIENT WORKERS MINIMUM WAGE
WE'RE ACTUALLY ALREADY
AUTHORIZED TO UNDER THE FEDERAL
AND STATE LAW TO OPERATE THE
SHOT WORK SHELTER BERKSHIRE THAT
I MENTIONED BEFORE.
AND IN THE SHELTERED WORKSHOPS
UNDER THE FOURTEENTH HEY SUB
MINIMUM WAGE --
WE COULD CREATE SHELTERED
WORKSHOPS IN EACH OF THE STATE
HOSPITALS AND I'M USING THE
FOURTEEN C. CERTIFICATES AND
PACE OF MINIMUM AND WAIT A SUB
MINIMUM WAGE.
BUT IT IS A RESOURCE INTENSIVE
AS I MENTIONED IT WOULD REQUIRE
THAT WE DO STUDIES OF FOR EVERY
PATIENT IN ORDER TO DETERMINE
WHAT THAT WAGE WOULD BE.
SO OUR PROPOSAL IS TO PAY
FEDERAL MINIMUM WAGE IT BOUNCES
FACTORS SUCH AS COST AS WELL AS
THE FACT THAT MINIMUM WAGE IS
DESIGNED TO PROVIDE A LIVING
WAGE AND WHILE INDIVIDUALS ARE
WITH US IN OUR CARE WE DO
PROVIDE FOR THE FOOD THE CARE
AND THE HOUSING --
FOR THE PATIENTS --
ITEM ITEMS THAT MINIMUM WAGE IS
DESIGNED TO PAY.
FOR AS THE SECOND --
QUESTION WAS ASKED US TO PLEASE
DO TELL THE COST RECOVERY
STATUTES AND POLICIES FOR
PATIENTS THAT ARE LEAVING THE
STATE HOSPITAL.
AND GET.
MY POLITICS.
BUZZ SO WELFARE INSTITUTIONS
CODE SEVENTY TO EIGHTY ONE DOES
ALLOW US TO ESTABLISH --
BUT THEY CALL AT PATIENT --
A DEPOSIT FUNDS AND WE CALL THE
PATIENT TRUST ACCOUNTS AND
WHENEVER THE SOME DIED AND AND
THAT'S WHERE WE'VE DEPOSITING
MONEY THAT COMES TO THE HOSPITAL
FOR THE PATIENT.
AND WHAT IT DOES --
STATE THAT WHENEVER THE PSALM
BELONGING TO ANY ONE PATIENT --
DEPOSITED INTO THAT FUN EXCEEDS
THE SUM OF FIVE HUNDRED DOLLARS
THE ACCESS MAY BE APPLIED TO THE
PAYMENT OF THE CARE SUPPORT
MAINTENANCE A MEDICAL ATTENTION
OF THE PATIENT --
I DO WANT TO NOTE THAT IN THE
WAKE OF A SATCHEL STATUTORILY
ALTHOUGH ALSO AUTHORIZES THE
DEPARTMENT. TO PROVIDE AID TO
PAVE INDIGNANT INDIGENT PATIENTS
WHO DO NOT RECEIVE ANY FUNDING
INTO THEIR ACCOUNT.
AND AT THAT RATE IS TWELVE FIFTY
PER MONTH.
AS WELFARE INSTITUTIONS CODE --
SEVENTY TWO SEVENTY FIVE ALSO A
PROVIDES THAT THE SPOUSE PARENT
CHILDREN OF A PATIENT THERE IS --
MISSTATES GUARDIANS A
CONSERVATORSHIP ALSO BE LIABLE
FOR THE CARE OF THE PATIENT.
AND UPON DISCHARGE WHEN THE
HOSTILE TRUSTS OFFICERS DO
RECEIVE NOTIFICATION THAT A
PATIENT IS DISH --
TO PENDING DISCHARGE OUR
PRACTICES NOT TO CONTINUE WITH
HOLE OF A SWITCH --
DEDUCTING THE AMOUNTS OVER FIVE
HUNDRED DOLLARS SO THAT THE
PATIENTS DO HAVE THAT AS MUCH
MONEY POSSIBLE WHEN THEY DO
DISCHARGED FROM THE HOSPITAL.
AND THEN THE THIRD --
QUESTION WAS TO PLEASE EXPLAIN
EXPLAIN THE WORKERS COMPENSATION
PROVISIONS THE LAW IS CLEAR --
THAT PATIENTS ARE ALREADY --
EMPLOYEES FOR THE PURPOSES OF
WORKERS COMPENSATION.
THIS REALLY JUST CLARIFY THE
LADIES AND THE PATIENTS BENEFITS
WITH RESPECT --
TO AS THE WORKERS COMPENSATION --
IT MIRRORS ARE PRETTY MUCH THE
EXISTING WORKERS COMPENSATION
LANGUAGE THAT EXIST FOR CDC OUR
PRISONERS.
IT CLARIFIES THAT PATIENTS ARE
ENTITLED TO THE WORKERS
COMPENSATION BENEFITS WHEN THE
INJURY ARISES OUT OF WORK.
THAT'S PERFORMED AS PART OF
OCCASIONAL REHAB OR THE
SHELTERED WORKSHOP PROGRAMS IT
CLARIFIES THAT THEY'RE NOT
PAYABLE WHEN THE INJURY AS A
RESULT OF AN ASSAULT OR AN
INTENTIONAL ACT OF SELF HARM.
AND IT CLARIFIES THAT THE
BENEFITS ARE PAYABLE AFTER
PATIENT IT WAS RELEASED FROM THE
STATE HOSPITAL NOT WHILE THEY'RE
IN OUR CARE AS WE PROVIDE ALL
THE MEDICAL.
TREATMENT FOR THEM.
DELAY --
DEPARTMENT OF FINANCE.
ANY PUBLIC COMMENTS ON ISSUE.
SIX MISTER CHAIR MEMBERS PER
CHILD DISABILITY RIGHTS
CALIFORNIA WE WANT TO THANK THE
DEPARTMENT FOR RECOGNIZING I
THINK WHAT WE SAW SOME
SIGNIFICANT PROBLEMS WITH THE
THE DISPARATE WAGES THAT HAVE
BEEN PAID IN THE PAST AND THE
AMOUNTS OF THAT SO WE THINK THIS
IS A SIGNIFICANT STEP --
IN THE RIGHT DIRECTION WE WOULD
JUST RAISE I THINK THREE
CONCERNS ABOUT THAT --
THAT HAVE BEEN ADDRESSED ONE ONE
IS THAT WE BELIEVE THAT --
THE RACED TO THE MINIMUM WAGE
SHOULD NOT BE THE FEDERAL
MINIMUM WAGE BUT SHOULD BE TO
THE STATEMENT MINIMUM WAGE
RECOGNIZING THE VALUE OF THE
SERVICES.
THAT -- THE
PATIENTS ARE SECOND AS YOU --
AS YOU HEARD THERE IS --
FIVE HUNDRED DOLLAR LIMITATION
NOW THAT THE WAGE ON THE THAT
CAN BE KEPT IN THE ACCOUNT NOW
THAT OF THE WAGES HAVE BEEN
INCREASED.
WE'RE SUGGESTING THAT THAT BE
INCREASED TO AT LEAST A THOUSAND
DOLLARS --
AND THAT SERVES I THINK THE
IMPORTANT PURPOSE THE DEPARTMENT
WAS MENTIONING THAT --
IT EASES RE ENTRY FOR THOSE
PATIENTS THAT'D BE LEAVING AND
HOPEFULLY REDUCING RECIDIVISM --
AS WELL.
AND THE FINALLY THERE THERE ARE
I THINK ABOUT STE NINETY SIX
WORKERS THAT HAVE BEEN GETTING
THE STATE MINIMUM WAGE --
THAT WE THINK THIS PROPOSAL
WOULD ACTUALLY REDUCE THEIR
MINIMUM WAGE TO THE STATE
MINIMUM WAGE AND THAT THOSE
INDIVIDUAL SHOULD BE --
GRANDFATHERED IN --
FOR THE TIME IT THAT THEY'RE
STAYING AND THE FACILITIES THANK
YOU.
THANK YOU SIR.
SEE NO FURTHER PUBLIC COMMENT ON
BRING ITUP TO THE DíAS
ASSEMBLYMEMBER FRAZIER.
SO WHAT IS THE HIM THE MOD. FOR
THE FOR THE AGENCY --
WORKERS COOPERATE. FOR THE HAS
THIS BEEN GOING UP FOR A LONG
TIME [inaudible]
THE THE WORKERS COMPENSATION.
FOR THE PATIENTS WE ACTUALLY
HAVE NEVER HAD A CLAIM THAT
WE'RE AWARE OF THE FROM OUR
PATIENTS WHILE THEY DO QUALIFY
FOR WORKERS COMP WE HAVEN'T HAD
ANY CLAIMS WITH I'M FROM A
PATIENT. TO NATURE.
AND SO.
COULD YOU GIVE ME.
AN APPROXIMATION OR AN AVERAGE
WHEN YOU TALK ABOUT THE
PATIENT'S.
GOING OUT WITH A REHABILITATION
PROGRAM HOW MUCH THE STATE IS
SPENT IN THEIR IN THEIR CARE
COMPARATIVELY --
SO.
AS OF THE GERMAN JUST POINTED
OUT WEEK YOU KNOW WANTING TO
MAKE SURE THAT.
WE'RE GETTING STATE MINIMUM WAGE
BUT HOW MUCH OF THAT HAS THE
STATE PAID FOR THE
REHABILITATION UP TO THAT POINT.
OF FOR THE WAGES. ONE OF THEIR
CARE. FOR THE CARE THE TOTAL
COST OF CARE FOR A PATIENT AND
WITHIN OUR STATE HOSPITALS
AVERAGES ABOUT TWO HUNDRED AND
TWENTY FIVE THOUSAND DOLLARS PER
YEAR AND WHO PAYS FOR THAT --
THIS THE GENERAL FUND
[inaudible]
OKAY SO.
THEY'VE BEEN REHABILITATED TO A
WITH.
TAXPAYER MONEY.
AND THEN PUT WE'RE GONNA PAY
THEM.
MINIMUM WAGE TO CONTINUE THAT
PROCESS.
SO WHAT I'M SAYING IS I MEAN I
THINK THAT THERE'S A POINT IN
TIME THAT WE NEED TO BE ABLE TO
RETURN OUR DOLLAR.
TO AS AN INVESTMENT ON THE
REHABILITATION.
SO HOW DO WE COULD WE I I KNOW
THEY HAVE A VALUE.
AND AND I'M NOT SAYING THAT
THEY'RE NOT WORTH.
IN WAYS BUT BACK SOMEDAY
[inaudible]
THE TAXPAYER.
AS WE KEEP A YEAH I THINK THE
GOAL OF A REHABILITATION
PROGRAMS IS TO ENSURE THAT WHEN
PATIENTS DO LEAVE OUR HOSPITAL
THAT THEY HAVE THE SKILLS TO BE
ABLE TO RAIMES IT IS
SUCCESSFULLY TRANSITION TO THE
COMMUNITY.
AND BE ABLE --
TO OBTAIN GAINFUL EMPLOYMENT --
AND BE ABLE TO MANAGE OR MENTAL
ILLNESS IN THE COMMUNITY SO THAT
THEY DON'T --
COME BACK TO THE STATE HOSPITAL --
AND THE STATE HOSPITAL
[inaudible]
THANK YOU.
THANK YOU BYE.
I MADE ONE THAT THAT --
THEY SEARCH TO FUNCTIONS --
NOT ONLY DOES IT --
IS IS A THERAPEUTIC PROGRAM BUT
ALSO -- AT
THE SAME TIME THEY ARE
PERFORMING NECESSARY FUNCTIONS
WITHIN THE STATE HOSPITALS THAT
STILL NEED TO BE PERFORMED SO
THAT'S PART OF THE PAY BACK AS
YOU WOULD SAY.
I GUESS WE WOULD LOOK AT HOW
MANY YEARS THEY HAD BEEN AT TWO
HUNDRED TWENTY FIVE THOUSAND
DOLLARS HERE --
AND ISSUE SIX IF I CAN JUST.
ALMOST RHETORICALLY SAYING I'M
NOT SURE THE FEDERAL MINIMUM
WAGE IS A LIVING WAGE AND THE
REASON WHY CALIFORNIA'S LEADING
TO HAVE A HIGHER MINIMUM WAGE --
I ALSO WOULD LIKE TO ECHO --
CREEK TRIALS COMMENTS IF I COULD
SPECIFICALLY --
WANTING TO TRY TO INCREASE TWO
THOUSAND I THINK IT FOR
INCREASING THE PAY WE SHOULD
HAVE AN INCREASE CAP --
AND IT DOES SEEM UNFAIR THAT
SOME WILL BE GETTING A PAY
DECREASE DUE TO THE POLICIES
THAT WERE PASSING --
AND JUST WOULD ASK THAT WE MAKE
SURE WE TAKE A HARD LOOK AT THAT.
THE WITH THAT WE WILL HOLD ISSUE
SIX OPEN AND MOVE ON TO ISSUE
.
SEVEN FOR THIS PROPOSAL
REQUESTING TO CONVERT THREE
LIMITED TERM POSITIONS TO
PERMANENT FULL TIME POSITIONS
AND FIVE POINT EIGHT MILLION ON
GOING TO CONTINUE OUR EXPANDED
HOSPITAL POLICE OFFICER ACADEMY.
ARE --
OFFICE OF PROTECTIVE SERVICES IS
A FULL SERVICE LAW ENFORCEMENT
AGENCY WHICH PROVIDE SAFETY AND
SECURITY TO OUR PATIENTS STAFF
AND THE COMMUNITY.
WE HAVE SIX HUNDRED FIFTY SEVEN
HOSPITAL POLICE OFFICER
AUTHORIZED POSITIONS AND THE
MEASURE DISTRIBUTED AMONG OUR
FIVE HOSPITALS.
WHEN AN H. PO IS HIGHER THEY ARE
REQUIRED TO ATTEND --
THE D. S. H. POLICE ACADEMY THIS
IS A FOURTEEN WEEK ECONOMY.
THAT ENSURES THAT ALL CADETS ARE
PROPERLY TRAINED ON THE
REQUIREMENTS AND STATUS AT AND
STANDARDS OF THE H. B. O.
CLASSIFICATION.
HISTORICALLY PRIOR TO THE THREE
LIMITS ARE PUT AT TERM POSITIONS
ACADEMY RAN TWO SESSIONS
ANNUALLY ABOUT TO THIRTY TWO
CADETS AND IN SEVEN AND FISCAL
YEAR SEVENTEEN EIGHTEEN WE WERE
AUTHORIZED TO EXPAND THE COME
OUT CATEGORY TWO THREE ACADEMIES.
OF UP -- TO
FIFTY CAN'T OKAY LOCATION AT THE
S. H. ATASCADERO TO CAMP SAN
LUIS OBISPO.
OBISPO TO ACCOMMODATE THE
INCREASE IN THE CLASS SIZES --
THE HOSPITAL POLICE ACADEMY
WHICH ALSO PROVIDES THE REQUIRED
CONTINUED ADD EDUCATION TRAINING
FOR OFFICERS ON AN ONGOING BASIS.
I AM A CONSISTS OF FOUR FULL
TIME STAFF A CHIEF SERGEANT INTO
EACH PO'S AND THREE WITH LIMITED
TERM SERGEANT POSITIONS.
THE CURRENT ECONOMY STOCK
PROVIDE MOST OF THE INSTRUCTION
THEY PREFER CURRICULUM DESIGN AS
WELL AS TEST EVALUATORS AND AND
COORDINATORS FOR THE ONGOING
TRAINING.
AND THE CONTINUATION OF THE
ECONOMY EXPANDED ACADEMY WILL
ASSIST US IN MEETING THE NEEDS
OF FILLING OUR VACANCIES AS WELL
AS ADDRESSING IT TO PATRICIAN.
AND MEETING THE INCREASE AN
OFFICER NEEDS IT ASSOCIATED WITH
INCREASED BED SECURE AS SECURE
BACK TO PASS THE AT METROPOLITAN
AND THE IN HIS TREATMENT
PROGRAMS AT ATASCADERO AND
COTTON.
LA --
DEPARTMENT FUNDS.
WE AGREE WITH THE DEPARTMENT
THAT THERE IS A NEED TO CONTINUE
THE OPERATION OF THE ACADEMY AT
ITS EXPANDED RATE HOWEVER EVEN
IF THERE IS AN INCREASE IN THE
OFFICER ATTRITION RATE IT'S
POSSIBLE THAT THE ACADEMY DO IT
WOULD START PRODUCING EXCESS
GRADUATES WITHIN THREE YEARS.
SO WHAT WE'RE RECOMMENDING IS
THAT THE LEGISLATURE CONTINUE TO
OPERATE IT AT ITS EXPANDED
CAPACITY FOR THREE YEARS.
AND THAT IT MONITOR THE OFFICER
ATTRITION RATE IN THE MEANTIME
BECAUSE IT OFFERS OR ATTRITION
RATE IS LESS THAN EXPECTED OR
MORE THAN EXPECTED.
THE LEGISLATURE WOULD BE IN A IN
A POSITION TO ADDRESS FUNDING
ACCORDINGLY SO WE'D RECOMMEND
REPORTING REQUIREMENT ON OFFICER
RECRUITMENT AND RETENTION
[inaudible]
IN FRONT.
I'M GONNA FIND IT'S A PRE SHAPE
THAT ALEJO'S --
COMMENTARY ON THE PROPOSAL AND
KIND OF LOOKING FORWARD AND
SIMILAR TO OTHER COMPONENTS OF
THE BUDGET WITH STATE HOSPITALS
BUDGET.
AS WE'VE SEEN --
WE'RE CONTINUOUSLY LOOKING AT
THEM THROUGH THE GOVERNOR'S
BUDGET THE MAYOR VISION AND
MAKING THE NECESSARY ADJUSTMENTS
WHETHER IT UP OR DOWN.
AS NEED AS WE SEE FIT AND SO
SOME BE SOMETHING THAT WE
EVALUATE MOVING FORWARD BASED ON
THE NEEDS OF THAT STATE HOSPITAL
PROGRAM THAT WILL MAKING THE
NECESSARY ADJUSTMENTS TOOK. TO
FOR THOSE NEEDS WHETHER THEY ARE
DOWN OR UP.
THANK YOU.
ANY PUBLIC COMMENT ON THE ISSUE.
SEVEN SING NONO BRING IT UP TO
THE COMMITTEE FOR ANY QUESTIONS --
AT THIS MOMENT WE WILL HOLD
ISSUE SEVEN OPEN.
AND NOW WE ARE WILL.
GO TO THE NON DISCUSSION ITEMS
ISSUES EIGHT NINE AND TEN IF
THERE ARE ANY PUBLIC COMMENTS ON
THOSE ISSUES NOW WOULD BE THE
TIME.
SEEING NONE.
THAT WILL END TODAY'S SOMEONE
HEARING THANK YOU ALL FOR
ATTENDING