MORNING- WELCOME TO THE JOINT
HEALTH AND JUDICIARY COMMITTEE
INFORMATIONAL HEARING ON THE
LAND LETTERMAN PETROUS SHORT ACT
HOW CAN IT BE IMPROVED. WE ARE
ARE REQUIRING MASS THAT MUST BE
WORN AT ALL TIMES OF BY ALL
MEMBERS OF THE PUBLIC TESTIFYING
IF YOU DO NOT HAVE A MASS WE CAN
PROVIDE ONE FOR YOU FOR MEMBERS
OF THE PUBLIC CALLING IN WE WILL
BE USING A MODERATED TELEPHONE
SERVICE THROUGH WHICH ANY MEMBER
OF THE PUBLIC CAN PROVIDE
COMMENTARY WHEN WE GET TO THAT
APPOINTMENT AT THAT POINT IN THE
AGENDA. ANALYSTS HAVE BEEN
PROVIDED TO CALL IN NUMBER PRIOR
TO THIS HEARING THE CALL IN
NUMBER FOR PUBLIC COMMENT FOR
THIS HEARING IS. 877-692-8957
AND THE ACCESS CODE IS. ONE
THREE ONE FIVE FOUR TWO ZERO TWO
READ THAT AGAIN. 877-692-8957
AND THE ACCESS CODE IS. ONE
THREE ONE FIVE FOUR TWO ZERO
TWO. YOU CAN ALSO FIND THIS
NUMBER ON THE ASSEMBLY HEALTH
AND- ASSEMBLY JUDICIARY
COMMITTEE'S WEBSITE AS WELL AS
ON YOUR TV SCREEN. THE OPERATOR
ON THE LINE WILL GIVE YOU
INSTRUCTIONS ON HOW TO BE PLACED
IN THE QUEUE- TO RIDE YOUR
PUBLIC COMMENTS. IF YOU WERE
CALLING IN PLEASE ELIMINATE ALL
BACKGROUND NOISE THIS INCLUDES
MUTING YOUR LIVESTREAM
BROADCAST. AND YOUR SMART
DEVICES TO REDUCE THE SOUND
DISTORTION ONCE YOU'RE PLACED IN
THE QUEUE YOU'LL NEED TO SPEAK
YOU'LL NEED TO MEET YOURSELF
UNTIL YOU'RE CALLED UPON TO
SPEAK. IF YOU HAVE ANY PROBLEMS
WITH THE MODERATE IT'S TO A
PHONE SERVICE YOU CAN CALL THE
HEALTH COMMITTEE AT NINE ONE
SIX. THREE ONE NINE TWO ZERO
NINE SEVEN AND MY STAFF WILL BE
THERE TO TRY TO HELP. I ALSO
WANT TO NOTE THAT WE ARE
ACCEPTING WRITTEN PUBLIC COMMENT
THROUGH THE HEALTH COMMITTEES
PUBLIC EMAIL. WHICH IS A H. E.
A. DOT COMMITTEE. AT ASSEMBLY
DOT CA DOT G. O. V. WHICH CAN
ALSO BE FOUND ON OUR WEBSITE. WE
MAYBE NEED TO LIMIT HOW LONG
EACH PERSON HAS TO PROVIDE
PUBLIC COMMENT AT THE END OF THE
HEARING AND WE APOLOGIZE FOR
THAT IN ADVANCE. WE THANK YOU
FOR YOUR PATIENCE WE HAVE A
VERY- AMBITIOUS AGENDA TODAY- AS
YOU CAN SEE WE HAVE A VERY. FULL
DAY OF EXPLORING THE L. P. S.
ACT AS IT RELATES TO INVOLUNTARY
DETAINMENT AND TREATMENT OF
INDIVIDUALS FOUND TO BE EITHER A
DANGER TO THEMSELVES OR OTHERS.
OR WHO ARE GRAVELY DISABLED. I
WANT TO BEGIN BY THANKING MY CO
CHAIR MR STONE AND HIS STAFF FOR
ALL THE WORKERS GONE INTO
PREPARING FOR THIS HEARING. I
ALSO LIKE TO THANK IN ADVANCE
ALL THE PARTICIPANTS WHO AGREED
TO SHARE THEIR TIME AND
EXPERTISE TODAY. AS COMMITTEE
MEMBERS I THINK IT'S OUR JOB
TODAY TO LISTEN AND LEARN. I
REMINDED OF THE PRINCIPLE OF
SEEK FIRST TO UNDERSTAND AND
THEN TO BE UNDERSTOOD. I DON'T
THINK ANYONE IS I WANT TO
BELIEVE C. O. P. S. ACTORS
OPERATING AT MAXIMUM
EFFECTIVENESS. IN SUPPORTING
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS THROUGHOUT CALIFORNIA.
THE SYSTEM IS QUITE COMPLEX AND
NUANCED IF WE'RE GOING TO SEEK
WAYS TO IMPROVE THE L. P. S.
SYSTEM TO BETTER SERVE THE
INDIVIDUALS IT IS INTENDED TO
SERVE. WE NEED TO BETTER
UNDERSTAND THE SYSTEM AND THE
DIFFICULTIES BEING ENCOUNTERED
NOT ONLY BY THOSE WHO
EXPERIENCING AN LPS HOLD OR
CONSERVATORSHIP. BY THOSE WHO
WERE OR BUT BY THOSE- ARE
INVOLVED IN THE IMPLEMENTATION
OF THE SYSTEM AS WELL. THE
QUESTION BEFORE US AS A BEST
POLICYMAKERS IS HOW DO WE- THE
DALLAS THE OBVIOUS NEED FOR
BEHAVIORAL AND OFTENTIMES
PHYSICAL HEALTH CARE TREATMENT
AND TREATMENT WITH ENSURING
CIVIL LIBERTIES AND THE RIGHTS
OF INDIVIDUALS ARE NOT
ENCROACHED UPON. I HOPE AS WE
WORK THROUGH TODAY'S AGENDA WE
WILL CONSISTENTLY ASK OURSELVES
HOW ARE THE INTERESTS OF THE L.
P. S. CONCERT INDIVIDUAL AND
THEIR FAMILIES BEST SERVED IN
THE LONG RUN. AT THE EPICENTER
ALL OVER THOUGHT SHOULD BE THE
CARE AND CONCERN OF SOME OF OUR
MOST VULNERABLE CITIZENS- MR
STONE DO YOU HAVE ANY OPENING
REMARKS. HE WAS. VERY HAPPY TO
BE HERE AND- THAT. YES STATUTE
WORKS THE SOME OF THE
COMPLICATING ISSUES THOUGH ARE
FROM THE STATE OF CALIFORNIA
STANDPOINT REAL LACK OF
APPROPRIATE SERVICES AT THE
LOCAL LEVEL. TO BE ABLE TO
PROVIDE SERVICES FOR PEOPLE AS
NEEDED AND I THINK THERE'S A LOT
OF INCONSISTENCY COUNTY THE
COUNTY NOT NECESSARILY THEIR
FAULT BUT A LOT OF INCONSISTENCY
IN. THE STATE'S IMPLEMENTATION
IN SUPPORT OF COUNTIES SO ONE OF
THE CHALLENGES IS THAT IF WE ARE
. INDEED GOING TO BE EXPANDING
DEFINITIONS FOR FINDING OTHER
WAYS FOR PEOPLE TO BE CONSERVE
THEN I THINK FIRST WE NEED TO
MAKE SURE THAT WE HAVE. THE
APPROPRIATE INFRASTRUCTURE AND
THE APPROPRIATE PLACEMENTS FOR
PEOPLE TO GO. I THINK THIS WILL
BE A BIT OF A DEEP DIVE IT IS
GOING TO BE A LONG A LONG DAY SO
WE DEFINITELY APPRECIATE
EVERYONE KEEPING TO THEIR TIME
SO THAT WE CAN GET TO EVERYBODY
BOTH IN THE MORNING AND THE
AFTERNOON SESSIONS THAT. THAT
WILL BE VERY IMPORTANT SO THAT
WE CAN COLLECT INFORMATION AND
THEN FROM THIS LOOK AT POLICY
NEXT YEAR POLICY THAT'S LEFT
OVER FROM LAST YEAR. AND TRY IN
IN SHAPE THE BEST POLICY THAT WE
POSSIBLY CAN FOR CALIFORNIA.
BEING MINDFUL OF THE NEEDS OF
THE INDIVIDUALS BEING CONSERVE
THE NEEDS OF THE FAMILY NEEDS OF
THE COMMUNITY OR ARE OFTEN
CONFLICTING AND NOT EASY TO SORT
OUT FOR THAT IS OUR CHALLENGE
TODAY. TO LISTEN TO GAIN
PERSPECTIVE AND THEN ULTIMATELY
FIGURE OUT NEXT STEPS. THANK
THANK YOU VERY MUCH MR STONE I
WILL NOTE THAT WE DO HAVE WILL
HAVE COMMITTEE MEMBERS ARRIVING
THROUGH THE DAY. INCLUDING
SENATOR EGGMAN WHO'S NOT A
MEMBER OF OUR COMMITTEE OUR
HOUSE BUT SHE'S- SHE'S WELCOME
HERE AND- WHEN SHE ARRIVES WE'LL
ASK HER IF SHE'D LIKE TO JOIN US
UPON THE DIET SO- DO YOU HAVE
ANY BRIEF COMMENTS DR. OKAY VERY
GOOD OKAY THANK YOU SO- WITH
THAT WE'D LIKE TO GO AHEAD AND
KIND OF JUMP INTO OUR FIRST
PANEL RECOGNIZING THAT KEEPING.
KEEPING EVERYTHING. ON OUR
SCHEDULE WILL BE TIGHT WILL
LEFT. TAKE OFFENSE THE FACT THAT
WE'RE LIKE THREE MINUTES AHEAD
BECAUSE I WON'T LAST SO- SO
FIRST OUR FIRST PANEL- WILL BE.
AN OVERVIEW OF THE- LET AND
LETTERMAN PETROUS SHORT AFTER
WAS CALLED LPS ACT PLEASE IF
THAT'S WHAT IF THAT'S OKAY. THIS
WILL BE KIM LEWIS MANAGING
ATTORNEY A NATIONAL HEALTH LAW
PROGRAM. KOREA SHE TO THE FISCAL
AND POLICY ANALYST WITH THE
OHIO- GENET GIONALE ITO ORAL
DIVISION. CHIEF LICENSING AND
CERTIFICATION. BERMAN OF HEALTH
CARE SIR. TO GET THAT RIGHT. A
GOOD OKAY. MERRILEES PEREZ
DIVISION CHIEF COMMUNITY
SERVICES DIVISION DEPARTMENT OF
HEALTH CARE SERVICES SO WE HAVE
A VARIETY OF WAYS PEOPLE WILL
APPEAR BEFORE US TODAY- COREY IS
PRESENT IN IN IN THE IN THE ROOM
AND THE OTHERS WILL APPEAR ON
OUR SCREENS OVER HERE. SO WITH
THIS- PLEASE WHENEVER YOU'RE
READY- MISS LEWIS. THANK YOU
VERY MUCH- I THINK I HAVE SOME
SLIDES I'M HOPING WILL BE POSTED
. SO AS THAT'S BEEN DONE ON THE
SE- GOOD MORNING CHAIRS WOODEN
STONE AND MEMBERS OF THE
COMMITTEE MY NAME'S KEN LEWIS
AND THE MANAGING ATTORNEY OF THE
CALIFORNIA OFFICE. THE NATIONAL
HEALTH LAW PROGRAM- WE ARE A I'M
NONPROFIT LAW OFFICE THAT WORKS
TO ADVANCE LOW INCOME
HEALTHCARE. ISSUES IN
CALIFORNIA. AND IN THE REST OF
THE UNITED STATES. I'M GOING TO
PROVIDE AN OVERVIEW OF THE LPS
FACT HOPEFULLY. YOU CAN SEE THAT
FIRST LINE AND- I'LL ASK PEOPLE
TO ADVANCE THE SLIDES BY SAYING
NEXT FIGHTS LET'S. WORK SO
HERE'S A LITTLE BIT OF A ROAD
MAP OF WHAT I'M GOING TO COVER.
WE TALK ABOUT THE- KEY FEDERAL
AND STATE RIGHTS THAT ARE
IMPLICATED BY THE CIVIL
COMMITMENT LAWS PROVIDE A VERY
BRIEF. HISTORY OF THE CIVIL
COMMITMENT. LEADING UP TO THE
LPS ACT AND THEN GO THROUGH. YEP
YES THAT COMPONENTS WHICH
INCLUDE CIVIL COMMITMENT
CONSERVATORSHIP- OF ASSISTED
OUTPATIENT TREATMENT FINALLY
PROVIDER JUST BRIEF- COVERAGE OF
SOME RECENT LEGISLATION THAT
HAS. BEEN IN- IN. INTRODUCED IN
THE LAST NUMBER OF YEARS TO
EXPAND THE LPS AT. EXLINE SO-
JUST WANTED TO START WITH THE
CONTEXT OF DISABILITY RIGHTS
LAWS AND YOU KNOW WHAT'S AT
STAKE SO. YOU KNOW THE AMERICANS
WITH DISABILITIES ACT TITLE TO
REQUIRES- THAT SERVICES PROGRAMS
AND ACTIVITIES BE ADMINISTERED
IT MUST INTEGRATE APPROPRIATE
SETTING. TO THE NEEDS OF PEOPLE
WITH DISABILITIES THIS IS
COMMONLY REFERRED TO AS THE
INTEGRATION MANDATE. THE MOST
INTEGRATED SETTING IS WHERE
PEOPLE WITH DISABILITIES AND
WITHOUT DISABILITIES ARE
INTEGRATED TOGETHER. IN SECTION
FIVE OH FOR THE REHAB ACT WAS
REALLY FOR CIVIL RIGHTS LAW
DESIGNED TO PROTECT INDIVIDUALS.
WITH DISABILITIES FROM
DISCRIMINATION BASED ON THEIR
DISABILITY STATUS. A LAW
PROHIBITS DISCRIMINATION AGAINST
PEOPLE WITH DISABILITIES IN ALL
PROGRAMS THAT ARE RECEIVING
FEDERAL FINANCIAL ASSISTANCE.
AND THEN AND THEN THERE'S A
LANDMARK CASE OF COURSE OF ALL
STATE RESOURCES L. C. OR THE
UNITED STATES SUPREME COURT HELD
THAT AND- NECESSARY SEGREGATION
INSTITUTIONALIZATION OF PEOPLE
WITH DISABILITIES. HIGHLIGHTS
THE AMERICANS WITH DISABILITIES
ACT AND THAT STATES HAVE AN
AFFIRMATIVE OBLIGATION. TO
ENSURE INDIVIDUALS WITH
DISABILITIES. I LIVE IN THE MOST
INTEGRATED SETTING POSSIBLE. WAS
RESULT OF HOMESTEAD. OUR STATES
DEVELOPED ON STEP PLANTS IN
ORDER TO INCREASE THE
AVAILABILITY OF HOME AND
COMMUNITY BASED SERVICES. IN
CALIFORNIA HAS SUCH A PLAN AS
WELL. EXLINE SO WHAT'S AT STAKE
OUR CONSTITUTIONAL RIGHTS. WELL
WE KNOW THAT A CIVIL COMMITMENT
LPS CONSERVATORSHIP. INFRINGE ON
A HOST OF FUNDAMENTAL RIGHTS
NAMELY THE RIGHT TO LIBERTY. AND
DUE PROCESS CLAUSE OF THE
FOURTEENTH AMENDMENT STATES THAT
NO PERSON SHALL BE DEPRIVED OF
LIBERTY WITHOUT UE PROCESS.
FOURTEENTH AMENDMENT ALSO
PROMISES THAT ALL PERSONS IN THE
UNITED STATES. SHOP CHOI EQUAL
PROTECTION OF THE LAWS. IN
ARTICLE ONE OF CALIFORNIA
CONSTITUTION ALSO GUARANTEES DUE
PROCESS AND EQUAL PROTECTION.
THE SUPREME COURT IN- ADDINGTON
VERSUS TEXAS FOUND THE CIVIL
COMMITMENT FOR ANY PURPOSE
CONSTITUTES A SIGNIFICANT
DEPRIVATION OF LIBERTY THAT
REQUIRES TO PROCESS PROTECTIONS.
A NUMBER OF. US SUPREME COURT
CASES SINCE THAT AND SOME OTHER
ARE LISTED HERE HAVE REINFORCED
THE ACCORD LIBERTIES AT RISK AND
THE REQUIREMENTS OF G. OF DUE
PROCESS UNDER THE DUE PROCESS
CLAUSE- THOSE CASES INVOLVED
PEOPLE WITH MENTAL ILLNESS AND
SOME OF THEM WERE INVOLVING ALSO
PEOPLE WHO HAD- EITHER SEXUALLY
DANGEROUS. INDIVIDUALS OR PEOPLE
ARE COMMITTING CRIMES. SO THEIR
NUMBER OF THE STATE- COURT CASES
THAT ARE ALSO ADDRESSED
INVOLUNTARY CONFINEMENT AND DUE
PROCESS UNDER THE STATE
CONSTITUTION PARTICULARLY. ARCH
RELATION TO LPS CONSERVATORSHIP
AND BECAUSE THESE FUNDAMENTAL
RIGHTS ARE INFRINGED ON THERE'S
AN INHERENT RIGHT TO JUDICIAL
REVIEW AND RIGHTS COUNCIL THE
LEGAL STANDARDS FOR REVIEW CAN
VERY. FINALLY IT'S IMPORTANT
UNDERSTAND RACIAL DISPARITIES AS
ONE NEW YORK OUTPATIENT
TREATMENT PROGRAM FOUND AFRICAN
AMERICANS ARE MORE LIKELY THAN
WHITE PEOPLE TO BE INVOLUNTARILY
COMMITTED FOR OUTPATIENT
PSYCHIATRIC CARE. HOWEVER THE
CANDIDATES FOR THE OUTPATIENT
COMMITMENT WERE LARGELY DRAWN
FROM A POPULATION IN WHICH CASE
SINCE PATIENTS WERE BLACK WERE
OVER REPRESENTED PSYCHIATRIC
PATIENTS WITH MULTIPLE
INVOLUNTARY HOSPITALIZATIONS AND
PUBLIC FACILITIES. NEXT TIME. SO
WHY THE LPS ACT AFTER A LONG
HISTORY OF INSTITUTIONAL THEY
COULD INSTITUTIONALIZATION OF
SEGREGATION OF PEOPLE IT WITH
DISABILITIES IN STATE HOSPITALS
AND FOLLOWING WIDESPREAD NEWS
REPORTS OF ABUSE AND DEATH THE
STATE PSYCHIATRIC HOSPITALS WERE
LARGELY CLOSED IN THE SIXTIES
AND SEVENTIES AND NOW THEY
MOSTLY HOUSE PEOPLE WERE DEEMED
CRIMINALLY INCOMPETENT TO STAND
TRIAL OR THOSE WERE FOUND NOT
GUILTY BY REASON OF INSANITY. BY
THE COURTS YET THE MONEY DIDN'T
FOLLOW THE PEOPLE INTO THE
COMMUNITY SO SERVICES WERE
LARGELY NOT AVAILABLE THERE AND
THERE IS NO FUNDING DEDICATED TO
DEVELOP THOSE COMMUNITY
SERVICES. THANKS A LOT. SO THIS
IS THE ARE THE INTENT OF THE LPS
ACT WHICH WAS SUBSTANTIALLY
ALSO- AMENDED IN TWENTY FOURTEEN
BY SB THREE SIXTY FOUR- AND
THESE ARE TWO FUNDAMENTAL
PRINCIPLES I JUST WANT TO
HIGHLIGHT FROM THIS LIST. ONE IS
THAT YOU AND THE INAPPROPRIATE
INDEFINITE INVOLUNTARY
COMMITMENT OF PEOPLE WITH MENTAL
HEALTH DISORDERS DEVELOPMENTAL
DISABILITIES AND CHRONIC
ALCOHOLISM. AND TO LIMIT LEGAL
DISABILITIES. AND SECONDLY TO
PROVIDE SERVICES IN THE LEAST
RESTRICTIVE SETTING APPROPRIATE
TO THE NEEDS OF EACH PERSON. ARE
RECEIVING THOSE SERVICES. LEE
THAT'S CONSISTENT WITH THE ADA'S
EMBLEM- INTEGRATION MANDATE
WHICH REQUIRES MORE REALLY
ACCESS TO VOLUNTARY MENTAL
HEALTH SERVICES AND COMMUNITY
SERVICES AND SUPPORTS THAT ALLOW
THOSE INDIVIDUALS TO RESIDE IN
THE COMMUNITY. EXLINE. SO
TALKING ABOUT INVOLUNTARY
COMMITMENTS- ALTHOUGH THE AS HE
SAID THE ACT WAS ENACTED IN
NINETEEN SIXTY SEVEN IT WAS
UPDATED IN TWENTY FOURTEEN THIS
WAS THE FIRST SIGNIFICANT
MODERNIZATION OF THE INVOLUNTARY
DETENTION PROCEDURES OF THE FACT
AND THE CHANGES THAT TOOK EFFECT
INCLUDED AMONG OTHERS EXPANDING
THE TYPES OF FACILITIES THAT CAN
BE UTILIZED AS LPS DESIGNATED
FACILITIES TO- SUCH AS TWENTY
THREE ARE CRISIS FACILITIES.
CRISIS STABILIZATION UNITS
CRISIS- PSYCHIATRIC HEALTH
FACILITIES IT ALSO AUTHORIZED
EVALUATION BY TELEHEALTH AND
ALLOWED COUNTIES TO DESIGNATE-
PROFESSIONALS TO BE OF DETAINING
INDIVIDUALS UNDER THE LPS ACT
UNDER SECTION FIFTY ONE FIFTY SO
IT EXPANDED REALLY WHO WAS
ALLOWED TO DO THOSE COMMITMENTS
. NEXT LIFE'S. SO GOING A LITTLE
BIT INTO THE LPS ACCESSIBLE
COMMITMENTS OF WHAT A FIFTY ONE
FIFTY HOLDS THE LPS ACT PROVIDES
THAT IF THERE'S PROBABLE CAUSE
TO BELIEVE A PERSON IS GRAVELY
DISABLED OR DANGER TO THEMSELVES
OR SOMEONE ELSE AS A RESULT OF A
MENTAL DISORDER THEN A PEACE
OFFICER DESIGNATED TREATMENT
FACILITIES STAFF OR MOBILE
CRISIS TEAM RATHER PROFESSIONAL
PERSON AS DESIGNATED BY THE
COUNTY CAN TAKE THEM INTO
CUSTODY FOR A PERIOD OF SEVEN
TWO HOURS FOR ASSESSMENT
EVALUATION. PRICES INTERVENTION
OR PLACEMENT AND TREATMENT AND
IT APPEARS DESIGNATED FACILITY.
PROBABLE CAUSE MEANS THE FACTS
WOULD LEAD A PERSON OF ORDINARY
CARE AND PRUDENCE TO BELIEVE. OR
SUSPECT THAT THE PERSON MEETS
THAT CRITERIA. BEEN REALLY
DISABLED MEANS A PERSON IS NOT
ABLE TO PROVIDE FOR THEIR OWN
FOOD CLOTHING AND SHELTER
BECAUSE OF MENTAL DISORDER. SO
BEING HOMELESS FOR EXAMPLE BY
ITSELF WOULD NOT MEET THOSE
GREAT DISABILITY STANDARDS
HOWEVER SOMEONE WHO CAN'T TAKE.
UP ISN'T ABLE OR WILLING TO TAKE
FOOD OR SHELTER AS A DIRECT
RESULT OF A MENTAL DISORDER
WOULD LIKELY BE CONSIDERED
GRADED DISABLE- THE FIFTY ONE
FIFTY IS AN APPLICATION FOR
INVOLUNTARY TREATMENT ON
ADMISSION FORM. SO GUESS
INDIVIDUAL TO THE FRONT DOOR
WHERE PROFESSIONAL STAFF THEN
DETERMINE THE APPROPRIATENESS OF
THE DETENTION ITSELF. ONCE
ADMITTED TO A FACILITY ON A
SEVENTY TWO HOUR HOLD. PERSON
HAS- CAN BE DETAINED FOR UP TO
FOURTEEN DAYS FOR INTENSIVE
TREATMENT IF THE PERSON
CONTINUES TO POSE A DANGER TO
SELF OR OTHERS OR BE GREAT THE
DISABLED- THEY HAVE TO BE ALSO
BE UNWILLING TO ACCEPT TREATMENT
ON A VOLUNTARY BASIS. AND ONCE
THEY'RE ON THAT FOURTEEN DOUBLE.
IF A RIGHT TO CERTIFICATION
REVIEW HEARING THIS HEARING MUST
BE HELD WITHIN FOUR DAYS OF
BEING PLACED ON FOURTEEN DAY
HOLD. ON THE STANDARD THE
HEARING IS PROBABLY BECAUSE-
THIS IS ENTITLED TO WRITTEN
NOTICE OF THEM BEING HELD ON THE
REASONS ARE BEING HELD. AND
THEY'RE ENTITLED TO ASSISTANCE
FROM A PATIENTS RIGHTS ADVOCATE
AT THE HEARING WHO HELPS THEM
UNDERSTAND THE RIGHTS. AND
ADVOCATE FOR THEIR INTERESTS.
ONCE ON A FOURTEEN DAY HOLD
PERSON HAS THE RIGHT TO FILE A-
WRIT WITH BILL RITTER HABEAS
CORPUS WITH OF SPIRIT COURT-
THEY CAN FILE THIS IF THEY'RE
NOT RELEASED AT THE
CERTIFICATION REVIEW HEARING.
THANKS FOR THE READ THE COURT
MUST. HOLD AN EVIDENTIARY
HEARING HELD WITHIN TO JUDICIAL
DAYS AFTER THE PETITIONS FILED.
IN THE COUNTY BEARS THE BURDEN
OF PROVIDING. A LAWFULNESS OF
THE DETENTION BY PREPONDERANCE
OF THE EVIDENCE. FIFTY ONE
FIFTEEN OR FOURTEEN DAY HOLD
DOES NOT ALLOW A PERSON TO BE
INVOLUNTARILY. MEDICATED ABSENT
AN EMERGENCY. A SEPARATE
COMPETENCY HEARING FOR THAT
PURPOSE IS REQUIRED. THESE ARE
OFTEN CALLED REESE HEARINGS OR
BASED ON THE NINETEEN EIGHTY
NINE CALIFORNIA SUPREME COURT
CASE OF RESOURCES ST MARY'S
HOSPITAL. NECKLINE. EXTENDED
VOLUNTARY HOLDS- ESSENTIALLY THE
LAW ALLOWS FOR PERSON WHO HAS
BEEN DETAINED FOR FOURTEEN DAYS
OF INTENSIVE TREATMENT TO BE
DETAINED FOR AN ADDITIONAL
THIRTY DAYS OF INTENSIVE
TREATMENT IF THEY REMAIN GRAVELY
DISABLED AND ARE UNWILLING TO
ACCEPT TREATMENT ON A VOLUNTARY
BASIS NOT ALL COUNTIES HAVE
THESE THIRTY DAY HOLDS IN FACT
IN SOME CIRCUMSTANCES AFTER
BEING PLACED ON HOLD
CONSERVATORSHIP PAPERS MAY BE
FILED IN THIS CASE TEMPORARY
CONSERVATORSHIP WOULD RUN
CONCURRENTLY WITH THAT. THIRTY
DAY HOLD. WE'LL BE GOING THE
CONSERVATORSHIP AFTER THIS. I'M
AT THE EXPIRATION OF THE
FOURTEEN DAY HOLD PERSON WHO AS
A RESULT OF A MENTAL DISORDER OR
CHRONIC ALCOHOLISM REMAINS A
DANGER TO SELF. PERSON CAN BE
DETAINED RENDITION OF FOURTEEN
DAYS TO QUALIFY FOR THIS PERSON
MUST HAVE THREATENED OR
ATTEMPTED TO TAKE THEIR OWN LIFE
OR WERE DETAINED- FOR VALUATION
TREATMENT BECAUSE YOU'RE SHE
ATTEMPTED TO TAKE HIS OUR HOME
LIFE AND CONTINUES TO BE AN
IMMINENT THREAT. TAKING HIS ARE
ONLY. SUPERIOR COURT CAN ALSO
ORDER INTIMATELY DANGEROUS
PERSON TO OTHERS TO BE CONFINED.
OR FURTHER ON INTENSIVE
TREATMENT FOR UP TO AN
ADDITIONAL HUNDRED EIGHTY DAYS.
IF THE PERSON IS DEMONSTRATED
DANGER OF UPLIFTING SUBSTANTIAL
PHYSICAL HARM ON OTHERS. RISEN
UPON ORDERED DETAINED UNDER THIS
AUTHORITY HAS A RIGHT TO AN
ATTORNEY AND A MANAGER A TRIAL.
IT CAN ALSO CONTINUE ON AN
OUTPATIENT OUTPATIENT BASIS
WHERE THAT CAN STATUS CAN BE
REVOKED IF THEY ON THE BECOME
DANGEROUS AGAIN. EXLINE. SO
THERE ARE SOME SPECIAL RULES FOR
MINORS- AS THERE'S A CIVIL
COMMITMENT- CHILDREN'S OF A
COMMITMENT MENTAL HEALTH
TREATMENT ACT IS PART OF THE LPS
ACT SO THE MINERS RESULTS OF-
BEING A MENTAL DISORDER IS A
DANGER TO SELF OR OTHERS ARE
GRAVELY DISABLED AND THE-
THERE'S NO ADULTS OR PARENT TO
VOLUNTARILY COMMIT OR OR PLACE
THE CHILD INTO THE FACILITY THEN
THEY CAN BE PUT ON A SEVENTY TWO
HOUR HOLD THE FACILITY HAS TO
MAKE EVERY EFFORT TO NOTIFY THE
MINOR'S PARENT OR LEGAL GUARDIAN
AS SOON AS POSSIBLE AFTER THEIR
TO CHANGE. AND A GREAT THE
DISABLED MINOR IS ONE WHO AS A
RESULT OF THE MENTAL DISORDERS
UNABLE TO USE THE ELEMENTS OF
LIFE THAT ARE ESSENTIAL TO
HEALTH SAFETY DEVELOPMENT
INCLUDING FOOD CLOTHING AND
SHELTER EVEN THOUGH PROVIDED TO
THE MINOR BY OTHERS MINORS ARE
REQUIRED TO PROVIDE THAT FOR
THEMSELVES. SO ELECT
DISABILITIES ACT APPLE OR OTHER
DEVELOPMENTAL DISABILITIES.
ALCOHOLISM OR DRUG ABUSE OR
REPEATED ANTI SOCIAL BEHAVIORS
ARE NOT IN THEMSELVES CONSTITUTE
A MENTAL DISORDER. AND THE MINOR
MUST RECEIVE A CLINICAL
EVALUATION CONSISTING OF A MULTI
DISCIPLINARY ANALYSIS OF THEIR
MEDICAL OF PSYCHOLOGICAL
DEVELOPMENTAL EDUCATIONAL SOCIAL
FINANCIAL AND LEGAL CONDITIONS.
AND THE EVALUATION HAS TO
INCLUDE- FAMILY EVALUATION AND
LEARNING ENVIRONMENT AS WELL.
AND THEN FINALLY THERE ARE SOME
SPECIAL RULES FOR DEPENDENTS ON
WORDS OF THE JUVENILE COURT THEY
MUST FOLLOW THE LPS ACT AS THE
CHILD WELFARE AGENCY OR SOCIAL
WORK OR THE JUVENILE COURT CAN'T
AUTHORIZE HOSPITALIZATION. BUT A
MINOR CAN BE HELP- CAN SEEK
VOLUNTARY TREATMENT ON THE
ADVICE OF COUNSEL EITHER
INPATIENT OR OUTPATIENT UNDER
PROVISIONS OF THE INDIAN WELFARE
INSTITUTIONS CO. NEXT SLIDE.
WHEN I QUICKLY GO INTO
CONSERVATORSHIP SEN WE KNOW
LEGAL LPS CONSERVATORSHIP FOR A
MECHANISM IN WHICH THE COURT
APPOINTS ANOTHER PERSON TO MAKE
CERTAIN CERTAIN LEGAL DECISIONS
A CONSERVATIVE- BASED ON
FINDINGS THAT THE PERSON'S GRAVE
DISABLED AS A RESULT OF A MENTAL
DISORDER- THE PURPOSE OF THE
CONSERVATORSHIP IS TO PROVIDE
INDIVIDUALIZED TREATMENT. OF
SUPERVISION AND PLACEMENT SO.
I'M LET'S GO ON TO THE NEXT
SLIDE. TEMPORARY CONSERVATORSHIP
IS A PERSON WHO IS DETAINED
ESSENTIALLY ON A FOURTEEN DAY
HOLD OF WE'RE JUST TALKING ABOUT
AT THE END OF THE HOLD MAY BE
PLACED ON A TEMPORARY
CONSERVATORSHIP FOR THIRTY DAYS
- IT'S A MENTAL HEALTH
PROFESSIONAL. A DETERMINES THAT
THEY ARE BOTH GRAVELY DISABLED
AND UNWILLING TO ACCEPT
TREATMENT VOLUNTARILY. SO THAT-
CARE PROVIDER MAKE
RECOMMENDATION TO THE PUBLIC
GUARDIAN'S OFFICE TO STARTED
INSERTION COMBUSTED CATION. AND
INVESTIGATOR WILL DECIDE WHETHER
OR NOT TO REQUEST THE COURT TO
STARTED CONSERVATIVE SHIP- IN
ALL POSSIBLE OF TURN
ALTERNATIVES TO CONSORTIUM. ARE
SUPPOSED TO BE EXAMINED ONLY
RECOMMENDING CONSERVATORSHIP BUT
THERE AREN'T A SUITABLE
ALTERNATIVES. IF THE
INVESTIGATION RECOMMENDS
CONSERVATORSHIP THEN- THE PERSON
MOST SUITABLE TO SERVE AS A
CONSERVATIVE IS APPOINTED IT CAN
BE A FRIEND OR FAMILY MEMBER BUT
ULTIMATELY IT'S UP TO THE JUDGE
TO DECIDE WHO IS THE MOST
SUITABLE PERSON OR AGENCY TO BE
APPOINTED. IF THE COURT GRANTS
THE PETITION IN ORDER THE TERM
TEMPORARY CONSERVATORSHIP. VINES
NO PERSON IS WILLING TO BE A
CONSERVE OUR THAT IT WILL
APPOINT THE PUBLIC PARTY- PEOPLE
FOR PERSONS WHO ARE HELD ON A T.
CONNOR TEMPORARY CONSERVATORSHIP
HAVE A RIGHT TO A RICH. IN THE
SPIRIT COURT. AND THE BURDEN OF
PROOF IS ON THE COUNTY BY
PREPONDERANCE OF THE EVIDENCE
THAT THE PERSON MEETS THE
CRITERIA FOR DETENTION. THANKS
LIVE. SO AFTER THAT THIRTY DAY
TEMPORARY CONSERVATORSHIP THEY
MUST BE RELEASED UNLESS THE
COURT CONDUCTS A HEARING ON THE
ISSUE OF WHETHER THEY'RE OPPOSE
CONSERVATIVE STILL GRAVELY
DISABLED HEARING HAS TO BE HELD
ON ALL PETITIONS WITHIN THIRTY
DAYS OF THE DATE OF THE POSITION
. THE COURT MUST APPOINT A
PUBLIC DEFENDER OR ATTORNEY FOR
THE CONSERVATIVE E. WITHIN FIVE
DAYS OF THE DATE OF PETITIONS.
SO THE CONSERVATIVES ARE RIGHT
TO DEMAND A JURY TRIAL OR COURT
TRIAL ON THE ISSUE OF WHETHER
THEY'RE GREAT THE DISABLED. THE
COURT CAN EXTEND THE TEMPORARY
CONSERVATORSHIP UNTIL THE DATA
ABOUT DISPOSITION OF THE COURT.
FOR JURY TRIAL PROVIDED THAT
IT'S NO LONGER THAN SIX MONTHS
EXTENSION THE PERSON MUST MAKE A
REQUEST FOR JURY TRIAL WITHIN
FIVE DAYS THE HEARING ON THE
CONSERVATORSHIP PETITION. IF
THEY HAVE A JURY TRIAL JURY MUST
BE UNANIMOUS AND THE PERSON WHO.
IS- DETERMINED TO MEET THE
EVIDENCE PRESENTED AS BEYOND A
REASONABLE DOUBT. A TRIAL SHOULD
OCCUR WITHIN TEN DAYS OF THE
REQUEST OF THE COURT CAN. EXTEND
UP TO FIFTEEN DAYS. OKAY NEXT
SLIDE SO WHAT ARE THE POWERS OF
THE CONSERVATIVE- SERVER IS
USED- USUALLY HAS THE POWER TO
DECIDE PLACEMENT SO THAT'S WHERE
THE PERSON LIVES THE PERSON-
CONSERVATIVES THE GREASE ABOUT
PLACEMENT AND THE CONSERVATIVE
YOU CAN GO BACK TO COURT AND
CHALLENGE THAT APPROPRIATE
PLACEMENTS IS CALLED THE
PLACEMENT REVIEW HEARING- IF THE
CONSERVANCY IS UNSUCCESSFUL AT
THAT HEARING THEY HAVE TO WAIT
ANOTHER SIX MONTHS BEFORE THEY
CAN CHALLENGE THAT PLACEMENT.
CONSERVER CAN OPERATE IS
AUTHORIZED BY THE COURT TO MAKE
DECISIONS- THOSE ARE INDIVIDUAL
DECISIONS THAT ARE DETERMINED BY
THE COURT ORDER. SUCH AS WHETHER
THEY CAN START OR STOP
PSYCHIATRIC MEDICATIONS. OR MAKE
OTHER MEDICAL TREATMENT
DECISIONS. ADDITIONALLY
CONSERVATIVE IN MANAGING THEIR
FINANCES. OTHER RIGHTS THE COURT
CAN REMOVE ARE THE PERSON'S
RIGHT TO VOTE TO ENTER INTO
CONTRACTS. ALONE TO DRIVE HAVE A
DRIVER'S LICENSE OR TO OWN A
FIREARM. LPS CONSERVATORSHIP
LAST FOR A MAXIMUM OF ONE YEAR
BUT CAN BE RENEWED AT THE END OF
THAT YEAR. THE CONSERVANCY CAN
PETITION FOR REHEARING TO SEE
WHETHER THEY SHOULD BE ON
CONSERVATORSHIP EVERY SIX MONTHS
. THERE ISN'T A RIGHT TO A JURY
TRIAL AND NOT. NEXT SLIDE SO I
WANT TO TALK ABOUT THE EXPANDED
CONSERVATORSHIP PILOTS- S. B.
TEN FORTY FIVE WHICH WAS ENACTED
IN TWENTY EIGHTEEN CREATED A
WHAT'S CALLED A HOUSING
CONSERVATORSHIP PILOT PROVIDED
AND PROVIDE A LEGAL BASIS FOR
BROADER CONSERVATORSHIP CRITERIA
AND SAN FRANCISCO LOS ANGELES
AND SAN DIEGO COUNTIES- BASED ON
THE BOARD OF SUPERVISORS
AUTHORIZATION OF ITS USE. IT
ALLOWED FOR APPOINTMENT OF A
CONSERVATIVE A PERSON WHO'S
INCAPABLE OF CARING FOR THEIR
OWN HEALTH AND WELL BEING DUE TO
A SERIOUS MENTAL ILLNESS AND
SUBSTANCE USE DISORDER AS
EVIDENCED BY FREQUENT DETENTION.
OR VALUATION TREATMENT OR
SEVENTY TWO HOUR HOLD.
ESSENTIALLY MEANS EIGHT OR MORE
FIFTY ONE FIFTIES IN THE LAST
TWELVE MONTHS. IT REQUIRES A
BOARD OF SUPERVISORS FIND THE
SPECIFIC SERVICES INCLUDING
SUPPORTED COMMUNITY HOUSING AND
WRAPAROUND SERVICES PUBLIC
CONSERVATORS. NOW HOW SERVICES
SUBSTANCE USE DISORDER SERVICES
AND SERVICE PLANNING AND
DELIVERY SERVICES ARE AVAILABLE
IN SUFFICIENT QUANTITY.
RESOURCES AND FUNDING. LEVELS TO
SERVE THE IDENTIFIED POPULATION.
IT ALSO REQUIRES A COUNTY
ESTABLISHES STAKEHOLDER WORK
GROUP TO CONDUCT AN EVALUATION
OF ITS EFFECTIVENESS. AND ON THE
IMPLEMENTATION OF THAT IN THE
DRESSING THE NEEDS OF THESE
FOLKS WITH SERIOUS MENTAL
ILLNESS AND SUBSTANCE USE
DISORDERS. AND SUBMIT A
PRELIMINARY REPORT TO THE
LEGISLATURE THE FIRST ONE WAS NO
LATER THAN JANUARY ONE TWENTY
TWENTY ONE AND A FINAL REPORT IS
DUE TO LEGISLATURE- IT BY
JANUARY ONE TWENTY TWENTY THREE.
A LOT OF SUNSETS ON ON JANUARY
ONE TWENTY TWENTY FOUR. AND THEN
LATER SB FORTY WAS AN ACCIDENT
TWENTY NINETEEN TO FURTHER
EXPAND THIS CONSERVATORSHIP
AUTHORITY BY SIMPLY REQUIRING
THAT ASSISTED OUTPATIENT
TREATMENT WOULD BE INSUFFICIENT
SO IT'S NO LONGER. REQUIRED TO
BE EITHER UNSUCCESSFUL OR HAVE
BEEN DENIED IT ALSO SHORTEN THE
CONSERVATIVE SHIPS TO SIX MONTHS
BUT THEY ARE RENEWABLE. NEXT
TIME SO I WANT TO TALK JUST
ABOUT THE OUTPATIENT ASSISTED
TREATMENT PROGRAM WHICH IS-
KNOWN AS LAURA'S LAW THIS IS
ESSENTIALLY ALLOWING OUTPATIENT
TREATMENT UNDER CIVIL COMMITMENT
ORDER OR INVOLUNTARILY THANKS
LIKE. SOLARZ LAW WAS ENACTED IN
TWO THOUSAND TWO- AN ESTABLISHED
ASSISTED OUTPATIENT TREATMENT
THROUGH THIS LEGISLATION-
AFTERNOON THIS IS ESSENTIALLY
NAMED AFTER A MAN WITH A MENTAL
HEALTH CONDITION FATALLY SHOT
LAURA WILCOX IN NINETEEN WILL
VOLUNTEERED IN NEVADA COUNTY
MENTAL HEALTH CLINIC AND IT WAS
MODELED AFTER NEW YORK'S
OUTPATIENT. GRAHAM HAD CALLED
KENDRA'S LAW. LEGISLATION ALLOWS
EACH COUNTY IN THE STATE TO
DECIDE WHETHER OR NOT TO ADOPT
THE ASSISTED OUTPATIENT
TREATMENT PROGRAM AND THERE'S NO
FUNDING ATTACHED THIS
LEGISLATION. IMPORTANT TO NOTE
THOUGH THAT- WILD IMPEDES- THE
IMPETUS IS LEGISLATION WAS THIS
TRAGIC EVENT- I WANT TO MAKE
SURE YOU KNOW THAT MOST PEOPLE
WITH MENTAL CONDITIONS ARE NOT
DANGEROUS. I SAW. SO WHAT ARE
THE KEY FEATURES OF THIS
ASSISTED OUTPATIENT TREATMENT OR
A. O. T. REALLY ANY PERSON OVER
EIGHTEEN THAT LIVES WITH
INDIVIDUAL A PARENT SPOUSE
SIBLING- A PEACE OFFICER PAROLE
OFFICER PROBATION OFFICER.
PUBLIC AGENCY MENTAL HEALTH
PROVIDER JUDGES NOW ESSENTIALLY
CAN REFER A PERSON FOR THIS
PROGRAM. IT'S A FAIRLY BROAD-
OPPORTUNITY FOR REFERENCE SHARE
REFERRAL. A LICENSED MENTAL
HEALTH TREATMENT PROVIDER HAS TO
PERSONALLY EXAMINE THE PERSON
WHO IS THE SUBJECT OF THAT
PETITION. NO MORE THAN TEN DAYS
PRIOR TO SUBMISSION OF THE
PETITION. AND ATTEMPT TO GET
AGREEMENT TOO BIG OR ATTEMPT TO
HELP GET THEIR AGREEMENT TO BE
EXAMINED. THE PROVIDER WHO
BELIEVES A PERSON MEETS THE
CRITERIA FOR ASSISTED OUTPATIENT
TREATMENT MUST BE WILLING ABLE
TO EXAMINE THE PERSON TESTIFIED.
AT THE HEARING ON THE PETITIONS
THE NEXT SLIDE. TO QUALIFY. FOR
OUTPATIENT TREATMENT THIS A. O.
T. PROGRAM AN INDIVIDUAL MUST
HAVE A SERIOUS MENTAL DISORDER
THAT RESULTS IN A PSYCHIATRIC
HOSPITALIZATION OR INCARCERATION
TWICE IN THE PREVIOUS THREE
YEARS. TREATED IN JAIL OR
PRISON. TWO TIMES IN THE LAST
THIRTY SIX MONTHS OR RESULT IN A
VIOLENT BEHAVIOR WITHIN THE LAST
FORTY EIGHT MONTHS. SO VOLUNTARY
TREATMENT ALSO HAS TO BE OFFERED
AND REFUSED. COURT BASED ON THE
PETITION TO OBTAIN ASSISTED
OUTPATIENT TREATMENT MAKES
VARIOUS FINDINGS INCLUDING AMONG
OTHERS THAT THERE'S BEEN A
CLINICAL DETERMINATION THAT THE
PERSON IS UNLIKELY TO SURVIVE
SAFELY IN THE COMMUNITY WITHOUT
SUPERVISION. PERSON'S CONDITION
IS SUBSTANTIALLY DETERIORATING
AND IN VIEW OF THE PERSON'S
TREATMENT HISTORY AND CURRENT
BEHAVIOR THAT THEY ARE IN NEED
OF ASSISTED OUTPATIENT TREATMENT
ORDER REVENT A LIVE RELAPSE. OR
DETERIORATION THAT WOULD LIKELY
RESULT IN GRAVE DISABILITY OR
SERIOUS HARM TO THEMSELVES OR
OTHERS- GOING TO THE NEXT SLIDE
. SO THE RIGHTS OF INDIVIDUALS
AND ASSISTED OUTPATIENT
TREATMENT LIKE WITH OTHER CIVIL
COMMITMENTS OR DUE PROCESS
RIGHTS RIGHT TO NOTICE COPY OF
EVALUATION RIGHT TO COUNSEL. OF
THE PUBLIC DEFENDER'S ALWAYS
APPOINTED IF THERE IS NOT A
COUNCIL THAT THE PERSON CAN-
OBTAIN ON THEIR OWN. RIGHT TO A
HEARING TO PRESENT EVIDENCE AND
CROSS EXAMINE WITNESSES THE
RIGHT TO APPEAL. RIGHT TO SEEK A
WRIT OF HABEAS CORPUS IN FRONT
OF SUPERIOR COURT. NEXT TIME. SO
AFTER THE HEARING ON ALL RIGHT
WELL OF AN EVIDENCE THE COURT
CAN'T FIND BY CLEAR AND
CONVINCING EVIDENCE THAT THE
PERSON MEETS THE CRITERIA FOR A.
O. T. AND THAT THERE IS NO
APPROPRIATE. AND FEASIBLE LESS
RESTRICTIVE ALTERNATIVE. ALL IT
DOES NOT EXCEED- THE COURT
ORDER. THE PERSON TO IN A PERIOD
NOT TO EXCEED SIX MONTHS. JUST
ASSISTANCE MUST INCLUDE MENTAL
HEALTH TREATMENT TEAM TEAM
PLANNING ARRAY OF SERVICES THAT
ARE GENDER AND CULTURALLY
APPROPRIATE- THE COURT IS
REQUIRED TO CONSIDER DANCE
HEALTHCARE DIRECTIVES A PERSON
HAS IN DETERMINING THE TREATMENT
PLAN. AND EVERY SIXTY DAYS- THE
DIRECTOR OF THE OUTPATIENT
TREATMENT PROGRAM MUST FILE AN
AFFIDAVIT WITH THE COURT THAT
ORDERED THE OUTPATIENT TREATMENT
PROGRAM AND AFFIRMING THE PERSON
CONTINUES TO MEET THE CRITERIA.
AT THESE TIMES A PERSON HAS A
RIGHT TO A HEARING ON WHETHER OR
NOT THEY STILL MEET THE CRITERIA
IF THEY DISAGREE M. OF BURDEN OF
PROOF IS ON THE DIRECTOR TO
SHOW- THAT THEY MADE IT. PERSON
CAN FILE A WRIT OF HABEAS CORPUS
AGAIN REQUIRING OF THAT THERE'D
BE A HEARING ON THAT TO REVIEW
THE DETERMINATION OF THE MEET
THE CRITERIA. NEXT SLIDE SO
THERE HAVE BEEN SOME CHANGES TO
THE A. R. T. PROGRAM SB FIVE
EIGHTY FIVE BUYS IN CENTER
STAMBERG IN TWENTY EIGHT
THIRTEEN WHICH ENABLE PROP SIXTY
THREE FUNDS TO BE SPENT ON THE
MIDDLE PORTION OF THE A. O. T.
PROGRAM WAS ONE OF THEM THERE'S
A FEW OTHER MORE SUBSTANTIVE
CHANGES AND I'M GOING TO QUICKLY
GO OVER. EXCITED. A PATIENT
TREATMENT- LARA'S LOG ON
SEPTEMBER TWENTY FIFTH TWENTY
TWENTY AB NINETEEN SEVENTY THREE
SIX WAS CHOPPERED INTO LAW
AMENDING THE CURRENT A. O. G.
OUR EFFECTIVE JULY ONE TWENTY
TWENTY ONE SO THAT ALL
REQUIRED TO OFFER A O. T. OR
THEY MUST OPT OUT. MOUNTIES MAY
OFFER SERVICES INDEPENDENTLY OR
PARTNER WITH NEIGHBORING
COUNTIES. DISSIPATING COUNTIES
ARE NOT REQUIRED TO BECOME FULLY
OPERATIONAL. THEY CAN CHOOSE TO
DELAY THE PROGRAM EFFECTIVE DATE
THEY HAVE TO HAVE AN
IMPLEMENTATION PLAN IN PLACE.
CAN YOU TO OPT OUT FROM
PARTICIPATING MUST PASS A
RESOLUTION BY THE COUNTY BOARD
OF SUPERVISORS WHICH STATES THE
REASON. AND THE FACTS OR
CIRCUMSTANCES USED TO MAKING
THAT DECISION. IT ALSO REVEALED
THE SUNSET DATE OF THIS LAW SO
THERE IS NO SUNSET DATE THEREBY
EXTENDING THE PROGRAM
INDEFINITELY. AND PROHIBITS THE
COUNTY FROM REDUCING EXISTING
VOLUNTARY MENTAL HEALTH PROGRAMS
AS A RESULT OF IMPLEMENTING THE
A. O. T. SERVICES. ADDITIONALLY
ALLOWS THE SUPERIOR COURT JUDGE
TO PETITION FOR THE L. T. AS
WELL. NEXT SLIDE SO THE RECENT
EXPANSIONS OF A. O. G. M. IN
SEPTEMBER TWENTY TWENTY ONE
THROUGH SB. FIVE OH SEVEN- THE
LEGISLATION BROADENED A. R. T.
CRITERIA BY ALLOWING THE COURT
TO FIND SYSTEM OUT PATIENT
TREATMENT TO BE BASED ON A
CLINICAL DETERMINATION THE
PERSON IS UNLIKELY TO SURVIVE IN
THE COMMUNITY WITHOUT
SUPERVISION THE PERSON'S
CONDITION IS EITHER
SUBSTANTIALLY DETERIORATING OR
THAT THE ASSISTED OUTPATIENT
TREATMENT IS NEEDED TO PREVENT A
RELAPSE. OR- OF DETERIORATION
THAT WOULD LIKELY RESULT IN
GREAT DISABILITY OR SERIOUS HARM
TO SOMEONE ELSE- THEMSELVES SO
THAT ESSENTIALLY NO LONGER
REQUIRES THAT THEY'RE CURRENTLY
SUBSTANTIALLY DETERIORATING.
SECONDLY REQUIRES THAT A
MEDICATION COMPETENCY HEARING BE
INCLUDED IN THE A. O. T.
PETITIONS SO NOW THIS IS NO
LONGER A SEPARATE DETERMINATION
ABOUT THEIR CAPACITY TO REFUSE
AND I SACCADIC MEDICATION. THIRD
IT DOES AUTHORIZES OF THE FILING
OF A PETITION BE ATTAINED FOR
OUTPATIENT TREATMENT UNDER THE
EXISTING PROCEDURES FOR A PERSON
WHO'S ELIGIBLE FOR
CONSERVATORSHIP BUT SEEKING TO
END THEIR CONSERVATIVE SHIP SO.
ESSENTIALLY CAN TRY TO UTILIZE
A. O. T. WHEN- IF THE
CONSERVATORSHIP IS EITHER
ENDURANCE AND SUCCESSFUL. NEXT
SLIDE. SO IT'S JUST REALLY IS
NOT MY LASTS FOR A POINT IS
FINALLY UNDERSTANDING THAT
BRIEFLY MENTIONING RECENT
LEGISLATIVE EFFORTS AND
ADDITIONAL ONES I'VE GONE OVER A
DATA ACTUALLY NOW IN LAW. ARE
THOSE- ON THE NEXT SLIDE WE'LL
GO TO THE LAST POINT. SO OVER
THELAST COUPLE OF YEARS O
LEGAL THIS IS JUST THE LAST TWO
LEGISLATIVE SESSIONS IS A NUMBER
OF BILLS THAT HAVE BEEN
INTRODUCED. TO TRY TO EXPAND
CIVIL COMMITMENT LAWS EITHER
EXPANDING THE DEFINITION OF
GRAVE DISABILITY. OR BROADENING
THE CIVIL COMMITMENT CRITERIA OR
CHANGING CONSERVATIVE SHIP
CRITERIA- AND THOSE ARE ALL
CONTINUING TO BE INTRODUCED
TODAY. OF THE STATE AUDITOR ALL
ALSO WHY NO GOING TO BE SPEAKING
LATERON FOUND IN A JULY TWENTY
TWENTY REVIEW OF LPS THAT THERE
WAS NOT EVIDENCE TO JUSTIFY
EXPANDING. CREATURES I'M HAPPY
DAVID STEPS TAKE ANY QUESTIONS
THANK YOU. THANK YOU VERY MUCH
MISS LEWIS WE IF IT'S OKAY WE
LIKE TO TAKE QUESTIONS AT THE
END OF THIS PANEL SO IF YOU
DON'T MIND STICKING WITH US WE'D
WE'D LOVE TO HAVE TO THAT THAT.
IS THAT OKAY. YES OKAY GREAT
THANK YOU VERY MUCH. I DO WANNA
KNOW WE'VE HAD THE ARRIVAL OF
SOME OTHER MEMBERS HERE. I MISS
EGGMAN- WELCOME SENATOR EGGMAN
TO THOSE TYUS- ASSEMBLY MEMBER-
RADIUS EXCUSE ME. GOOD TO SEE
YOU MISTER KALRA ALSO AND THEN
ASSEMBLY MEMBER- GALLAGHER AS
WELL SO WE'VE GOT OTHERS
ARRIVING SO WELL BUT THANK YOU
THANK YOU VERY MUCH FOR BEING
HERE FOR THIS VERY IMPORTANT
DISCUSSION. WE WILL GO AHEAD AND
MOVE ON TO OUR NEXT PANELIST
WHICH IS- KOREA SHE TO WITH THE
L. A. O.'S OFFICE WHENEVER
YOU'RE READY SIR. A GOOD MORNING
TO THE COMMITTEES- MY NAME IS
COREY SHEET OF THE LEGISLATIVE
ANALYST'S OFFICE- THERE SHOULD
BE A HAND OUT IN YOUR PACKETS
WHICH WILL FORM THE BASIS OF
ELLY ELLS REMARKS TODAY- JUST
WANT TO NOTE THAT THIS HAND OUT
IS. PUBLICLY AVAILABLE ON OUR
WEBSITE SHOULD ANYONE TUNING
INTO THIS HEARING WANT TO ACCESS
IT- OUR OFFICE WAS ASKED TO
PROVIDE AN- OVERVIEW OF WHAT
FUNDING IS AVAILABLE FOR
IMPLEMENTATION OF THE LPS ACT-
AS I'LL GET INTO IN A LITTLE
BIT- DETERMINING SPECIFIC
FUNDING FOR THE LPS ACT. IS A
VERY COMPLEX EXERCISE AND IT'S
QUITE DIFFICULT- THAT SAID WE DO
KNOW OF BROADER FUND SOURCES
THAT. CAN BE USED TO SUPPORT THE
ACT- AND THE MAJOR TOUCH POINTS
AT WHICH THE ACT IS IMPLEMENTED
AND WE WILL BE MAKING NOTE OF
THESE IN THE PRESENTATION- SO
TURNING BRIEFLY TO PAGE ONE. OF
OUR HAND OUT I'LL PROVIDE A
SHORT ROAD MAP FOR OUR
PRESENTATION TODAY- AS I
MENTIONED EARLIER YOU KNOW
FUNDING FOR IMPLEMENTATION OF
THE LPS ACT IS DIFFICULT TO
ASSESS- FUNDING FOR THE ACT. IS
SPREAD. ACROSS THE SYSTEM OF
CARE CONSISTING OF A VARIETY OF
ACTIVITIES AND FUND SOURCES. AND
GIVEN THE SUBSTANTIAL COMPLEXITY
ALL FIRST START THE PRESENTATION
BY. PROVIDING SOME KEY TAKEAWAYS
ABOUT FUNDING FOR THE L. P. S.
ACTIVE SYSTEM OF CARE. AFTER
THAT I'LL PROVIDE A BRIEF
RUNDOWN OF MAJOR TOUCH POINTS
WE'VE IDENTIFIED- AT WHICH
IMPLEMENTATION OF THE LPS ACT
OCCURS. AND WHAT WE KNOW ABOUT
AVAILABLE FUNDING AT EACH OF
THESE TOUCH POINTS. BOB SO
TURNING TWO PAGES TWO AND THREE
OF OUR HAND OUT- ALL NOW GET
INTO- ARE KEY TAKE AWAYS ABOUT
FUNDING FOR THE LPS ACTS SYSTEM
OF CARE. THE FIRST KEY TAKE AWAY
IS THAT ASSESSING FUNDING FOR
THE LPS ACT IS COMPLEX AND
DIFFICULT THE LPS ACTED IN ENACT
A SPECIFIC PROGRAM TO BE FUNDED
IT RATHER CREATED A SYSTEM FOR
INVOLUNTARY MENTAL HEALTH
TREATMENT STATEWIDE-
IMPLEMENTATION IMPLEMENTATION OF
THE ACT OCCURS ACROSS MULTIPLE
SYSTEMS INCLUDING OUTSIDE OF THE
HEALTH SYSTEM- AND THERE ARE
MULTIPLE ENTITIES INCLUDING
LOCAL GOVERNMENTS. THAT CAN
CONDUCT ACTIVITIES RELATED TO
IMPLEMENTATION OF THE ACT. IN
ADDITION EACH OF THESE ENTITIES
HAS DISTINCT FUND SOURCES AT
THEIR DISPOSAL- THAT THEY CAN
USE FOR LPS ACT RELATED PURPOSES
- ADDING TO THE COMPLEXITY OF
ASSESSING FUNDING FOR THE ACT.
IS THE FACT THAT THERE ARE NO
DEDICATED FUNDING STREAMS TO
SPECIFICALLY TO IMPLEMENT THE
LPS ACT- SPENDING ON
IMPLEMENTATION OF THE ACT
GENERALLY COMES FROM BROADER
FUND SOURCES THAT CAN ALSO BE
USED FOR OTHER PURPOSES- ONE
NOTABLE EXAMPLE HERE ARE THE
VARIOUS POTS OF- FUNDING THAT
COUNTIES HAVE AT THEIR DISPOSAL
TO FUND THEIR MENTAL HEALTH
SERVICES- FURTHERMORE WHEN
SPENDING DOES OCCUR. FROM THESE
BROADER POTS OF FUNDING IT IS-
GENERALLY NOT TRACKED AS
DIRECTLY FOR LPS ACT
IMPLEMENTATION- AND SO THIS
MAKES IT ULTIMATELY UNCLEAR WHAT
SPECIFIC SHARE OF THESE BROADER
FUND SOURCES ARE ULTIMATELY
SPENT ON LPS ACT RELATED
ACTIVITIES SPECIFICALLY- OUR
NEXT KEY TAKE AWAY. IS THAT
IMPLEMENTATION OF THE LPS ACT
INVOLVES A WIDE VARIETY OF
ACTIVITIES TYPICALLY THE MOST
PROMINENT EXAMPLE THAT COMES TO
MIND WHEN THINKING ABOUT
IMPLEMENTATION OF THE ACT- ARE
DIRECT MENTAL HEALTH SERVICES
FOR INDIVIDUALS ON LPS HOLD OR
CONSERVATORSHIP- BUT THIS IS
JUST ONE PART OF THE WHOLE
PICTURE AS- THEIR ALSO FOR
EXAMPLE- MENTAL HEALTH. OUTREACH
ACTIVITIES TO TRY TO CONNECT
FOLKS WITH- MENTAL HEALTH
SERVICES BEFORE THE POINT WHERE
THEY EVER REACH THE NEED TO BE
PLACED ON AN LPS HOLD OR
CONSERVATORSHIP- THERE ARE OTHER
SUPPORTIVE SERVICES LIKE HOUSING
THAT- CAN SUPPORT SORT OF THE
ADDITIONAL NEEDS OF FOLKS THAT
ARE UNDER AN LPS
CONSERVATORSHIP- AND THEY'RE
ALSO ADMINISTRATIVE CASE
MANAGEMENT ACTIVITIES- FOR
INDIVIDUALS THAT ARE ON AN LPS
CONSERVATORSHIP- WHICH ARE
TYPICALLY PROVIDED BY COUNTY
PUBLIC GUARDIANS. OF WHICH I'LL
DISCUSS LATER IN THE
PRESENTATION AS WELL- AND
FINALLY OUR LAST KEY TAKE AWAY
IS THAT THERE ARE SEVERAL TOUCH
POINTS AT WHICH- IMPLEMENTATION
OF THE LPS ACT OCCURS- EACH OF
THESE TOUCH POINTS MAY INVOLVE
THE- A DIFFERENT ENTITY WITH ITS
OWN. YOU KNOW SPECIFIC FUND
SOURCES THAT IT CAN DRAW ON FOR
LPS RELATED ACTIVITIES- AND
AGAIN THESE BROAD THESE FUNDS
SOURCES ARE BROAD IN NATURE YOU
KNOW THERE IS NO SPECIFIC
FUNDING. THAT IS SPECIFICALLY
EARMARKED FOR IMPLEMENTATION OF
THE ACT- FOR THE NEXT PART OF
OUR PRESENTATION ALL PROVIDE
BRIEF DESCRIPTIONS OF MAJOR
TOUCH POINTS- WE'VE IDENTIFIED
WHERE THE LPS ACT IS
IMPLEMENTED. AND ALSO DESCRIBE
WHAT WE KNOW ABOUT FUNDING FOR
EACH OF THOSE TOUCH POINTS- SO
TURNING TO PAGE FOUR OF OUR HAND
OUT- THE FIRST LPS ACT TOUCH
POINT I'LL DISCUSS OUR THE
PREVENTATIVE OUTREACH AND
ENGAGEMENT. ACTIVITIES CONDUCTED
BY- COUNTY BEHAVIOR HEALTH
DEPARTMENTS- THESE INCLUDE
OUTREACH EFFORTS TO LINK
INDIVIDUALS WITH SEVERE MENTAL
ILLNESS WITH PROGRAMS- ON A
VOLUNTARY BASIS. IN ESSENCE
THESE OUTREACH ACTIVITIES ARE
INTENDED TO HELP CONNECT PEOPLE
WHO MAY BE AT RISK OF. BEING
PLACED ON LPS HOLD WITH SERVICES
TO HELP PREVENT THIS FROM
OCCURRING- NOTABLE EXAMPLES OF
PROGRAMS THAT THESE OTREACH
ACTIVITIES- CAN RAISE AWARENESS
ABOUT INCLUDE YOU KNOW ASSISTED
OUTPATIENT TREATMENT WHICH WAS
JUST- DISCUSSED BY THE- ANALYST
IMMEDIATELY PRIOR TO ME. OR
MENTAL HEALTH SERVICES ACT FULL
SERVICE PARTNERSHIPS- AND BOTH
OF THESE PROGRAMS ARE GENERALLY
INTENDED TO PROVIDE- INTENSIVE
MENTAL HEALTH SERVICES TO
INDIVIDUALS WITH SEVERE MENTAL
HEALTH NEEDS WHO MAY BE AT RISK
OF BEING PLACED ON LPS HOLD. IN
TERMS OF FUNDINGFOR THESE
OUTREACH ACTIVITIES YOUR
COUNTIES MAKE USE OF SEVERAL OF
THEIR BROADER POTS OF FUNDING
FOR MENTAL HEALTH OUTREACH YOU
KNOW THESE INCLUDE NINETEEN
NINETEEN NINETY ONE REALIGNMENT
DOLLARS- MENTAL HEALTH SERVICES
ACT FUNDS- FEDERAL GRANTS FOR
MENTAL HEALTH SERVICES- AND AS
AVAILABLE YOU KNOW SORT OF THEIR
OWN. RESOURCES GENERALLY THESE
OUTREACH TYPE ACTIVITIES ARE NOT
MEDICAID REIMBURSABLE AND SO-
FED FUNDS OBTAINED THE MEDICARE
PROGRAM TYPICALLY DON'T SUPPORT
THESE THESE OUTREACH ACTIVITIES
- TURNING TO PAGE FIVE OF OUR
HAND OUT- THE NEXT MAJOR TOUCH
POINT- DISCUSS ARE THE DIRECT
MENTAL HEALTH SERVICES THAT-
COUNTY BEHAVIORAL HEALTH
DEPARTMENTS PROVIDE. TO PEOPLE
ON LPS HOLDER ON A
CONSERVATORSHIP- THESE CAN
INCLUDE THINGS LIKE MENTAL
HEALTH EVALUATIONS OR
THERAPEUTIC COUNSELLING- NOTABLY
SOME PATIENTS- SOME LPS PATIENTS
RECEIVE TREATMENT IN THE
DEPARTMENT OF STATE HOSPITALS-
AND IN THESE CASES THE COUNTIES
ACTUALLY REIMBURSE THE
DEPARTMENT OF STATE HOSPITAL FOR
THE COST OF CARE. FOR THOSE
PATIENTS- IN TERMS OF FINDING
YOU KNOW AGAIN COUNTY BEHAVIORAL
HEALTH DEPARTMENTS DON'T RECEIVE
SPECIFIC FUNDING FOR THE L. P.
S. ACT- AS WITH THE OUTREACH
ACTIVITIES THAT I DESCRIBED
EARLIER- THEY DRAWN BROADER FUND
SOURCES INCLUDING THEIR
REALIGNMENT DOLLARS MENTAL
HEALTH SERVICES ACT AHLERS-
FEDERAL FUNDS OBTAINED THROUGH
MEDIC CAL FOR DIRECT SERVICES-
AND ADDITIONAL FEDERAL GRANTS
FOR- MENTAL HEALTH SERVICES
BROADLY- WHEN IT COMES TO LPS
SPECIFICALLY COUNTY BEHAVIORAL
HEALTH CAN DRAW. ON OF THESE
BROADER FUND SOURCES FOR DIRECT
MENTAL HEALTH SERVICES- WITH ONE
NOTABLE EXCEPTION WHICH IS THAT-
TYPICALLY M. HSA DOLLARS ARE NOT
ARE NOT USED FOR SORT OF
INVOLUNTARY TREATMENT- OF THE
FUND SOURCES AVAILABLE TO THEM
YOU KNOW WE HAVE HEARD THAT
COUNTY'S PREDOMINANTLY USE THEIR
NINETEEN NINETY ONE REALIGNMENT
DOLLARS TO FIND DIRECT MENTAL
HEALTH SERVICES FOR PEOPLE ON
MLPS HOLD OR ON A
CONSERVATORSHIP- BUT AGAIN THIS
FUNDING IS NOT EXPLICITLY
TRACKED AS FOR LPS- FOLKS ON LPS
HOLDER UNDER A CONSERVATORSHIP-
THIS IS JUST- ONE SLICE OF THE
OVERALL PICTURE BUT WE DO HAVE A
SENSE OF HOW MUCH COUNTY SPEND-
ON LPS PATIENTS RECEIVING CARE
IN THE DEPARTMENT OF STATE
HOSPITALS- IN TWENTY TWENTY
TWENTY ONE ROUGHLY A HUNDRED AND
EIGHTY MILLION DOLLARS IN COUNTY
REIMBURSEMENTS- FUNDED LPS
TREATMENT IN STATE HOSPITAL
FACILITIES- NOTABLY THIS AMOUNT
HAS GROWN CONSIDERABLY OVER
TIME- WITH COUNTY REIMBURSEMENTS
PROVIDED IN TWENTY TWENTY TWENTY
ONE- REFLECTING ROUGHLY A 50%
INCREASE OVER THE TWENTY TWELVE
THIRTEEN LEVEL- I SHOULD ALSO
JUST MAKE MENTION THAT THERE
WERE- A COUPLE OF MAJOR.
INVESTMENTS THAT WERE INCLUDED
IN THIS YEAR'S BUDGET ACT WHICH-
HAVE SOME INTERACTION WITH SORT
OF THE L. P. S. POPULATION-
SPECIFICALLY YOU KNOW THE TWENTY
TWENTY ONE TWENTY TWO BUDGET
PROVIDED TWO HUNDRED AND SIXTY
SEVEN- ARE ROUGHLY TWO HUNDRED
SIXTY SEVEN MILLION DOLLARS TO
THE DEPARTMENT OF STATE
HOSPITALS TO- CONTRACT. OUT FOR
ADDITIONAL BEDS IN THE COMMUNITY
SETTING- AND- THE TWENTY TWENTY
ONE TWENTY TWO BUDGET ALSO
INCLUDED- ROUGHLY SEVEN HUNDRED
FIFTY MILLION DOLLARS IN TWENTY
TWENTY ONE TWENTY TWO. AND
ROUGHLY ONE POINT FOUR BILLION
IN TWENTY TWENTY TO TWENTY THREE
TO EXPAND- IN IN THE FORM OF
GRANT FUNDING FOR LOCALS TO SORT
OF EXPAND- BED CAPACITY IN IN
COMMUNITY SETTINGS- I SHOULD
JUST MAKE NOTE THAT. YOU KNOW
THESE INVESTMENTS THAT WERE
INCLUDED IN THE BUDGET CAN SORT
OF IMPACT FOLKS THAT ARE ON AN
LPS HOLDER A CONSERVATORSHIP
BUT- FUNDING IN THOSE- PROGRAMS
THAT WERE ENACTED IN THIS YEAR'S
BUDGET ISN'T SPECIFICALLY
EARMARKED FOR THE LPS
POPULATION- BUT REGARDLESS- YOU
KNOW ADDITIONAL BED CAPACITY IN
THE COMMUNITY CAN SORT OF
PROVIDE OPTIONS FOR TREATMENT
FOR THESE INDIVIDUALS- SO
TURNING TO PAGE SIX. OF OUR HAND
OUT. OF THE NEXT MAJOR TOUCH
POINT ALL DISCUSS- OUR
ACTIVITIES CONDUCTED BY- COUNTY
PUBLIC GUARDIANS AND PUBLIC
CONSERVATORS- WHILE THERE IS
SOME VARIATION BY COUNTY- COUNTY
PUBLIC GUARDIANS AND PUBLIC
CONSERVATIVES. ARE GENERALLY
RESPONSIBLE FOR ADMINISTRATING
IS ADMINISTRATIVELY MANAGING-
AND ARRANGING FOR THE SERVICE
NEEDS OF. INDIVIDUALS THAT ARE
ON LPS CONSERVATORSHIP SO- IN
TERMS OF FUNDING- THERE IS NO
DEDICATED STATE FUNDING PROVIDED
TO SUPPORT COUNTY PUBLIC
GUARDIANS AND PUBLIC
CONSERVATORS- AS A RESULT THE
ADMINISTRATIVE ACTIVITIES AT
THIS TOUCH POINT ARE 1100%
COUNTY FUNDED- HOWEVER THE
SERVICES THAT PUBLIC GUARDIANS
HELPED. ARRANGE FOR THEIR
CLIENTS CAN BE PAID FOR BY A
VARIETY OF FUN SOURCES- THESE
INCLUDE FOR EXAMPLE- FUNDING FOR
BOARDING CARE HOUSING THAT-
COUNTY BEHAVIORAL HEALTH MAY
HAVE ACCESS TO- OR EVEN HEALTH
INSURANCE INCLUDING- WITHIN THE
MEDICARE PROGRAM. FOR DIRECT-
FOR DIRECT TREATMENT SERVICES-
FOR EXAMPLE WE'VE HEARD THAT-
MEDIC CAL BILLING FOR TARGETED
CASE MANAGEMENT SERVICES IN THE
MEDICARE PROGRAM- IS FACILITATED
BY BY COUNTY PUBLIC GUARDIAN'S-
HOWEVER WE DO UNDERSTAND THAT
MOST OF THE CLIENTS SERVED BY
THE PUBLIC GUARDIANS DO NOT HAVE
HEALTH COVERAGE- ONE THING TO
NOTE- HERE ON THE SORT OF
ADDITIONAL SUPPORT OF SERVICES.
IS THAT PEOPLE ON LPS HOLDS
CONSERVATORSHIP I DO NOT HAVE
GUARANTEED SPOTS IN PROGRAMS
SUCH AS SUPPORTIVE HOUSING- THAT
CAN HELP SORT OF PAY FOR THEIR
SERVICE NEEDS IF THERE IS
ALTERNATELY DIFFICULTY WITH
GETTING AN INDIVIDUAL ON. A
CONSERVATORSHIP PLACED- IN AN
APPROPRIATE SUPPORTIVE PROGRAM-
AND THEN- IN SOME CASES AN
INDIVIDUAL'S OWN INCOME OR THEIR
FAMILY'S INCOME MAY HAVE TO SORT
OF HELP SUPPORT THEIR NEEDS
INCLUDING THEIR HOUSING NEEDS-
YEAH WE HAVE HEARD ANECDOTALLY
THAT- CLIENTS OF COUNTY PUBLIC
GUARDIANS YOU KNOW MANY OF THEM
ARE ON SSI AND SORT OF RELY ON.
THAT INCOME TO HELP MEET THEIR
NEEDS. FINALLY ARE TURNING TO
PAGE SEVEN OF OUR HAND OUT I'LL
BRIEFLY DISCUSS OUR FINAL MAJOR
TOUCH POINT THE COURT SYSTEM. AS
WELL AS SOME OTHER TOUCH POINTS
AT WHICH YOU KNOW FUNDING MAY
IMPACT PEOPLE- ON LPS HOLDER
UNDER A CONSERVATORSHIP- FOR
LPS. INDIVIDUALS TYPICALLY
ENGAGE WITH THE COURT SYSTEM
AFTER AN INITIAL SEVENTY TWO
HOUR SHORT TERM HOLD WHILE IT'S
BEING DETERMINED THAT- WHETHER
THEY MEET THE CRITERIA FOR AN
EXTENDED HOLD OR OR
CONSERVATORSHIP- AS AS WAS
DISCUSSED ON. BY THE PREVIOUS
SPEAKER ON THIS ON THIS PANEL-
THE COURTS ARE VARIETY OF FUNDED
BY A VARIETY OF FUN SOURCES THAT
ARE NOTED IN OUR HAND OUT- BUT
AGAIN SIMILAR TO SORT OF THE
OTHER FUND SOURCES THAT I'VE
NOTED EARLIER THIS PRESENTATION-
SPECIFIC COURT COSTS FOR LPS.
RELATED ACTIVITIES SPECIFICALLY
IS NOT IS NOT SPECIFICALLY
TRACKED AS AS SO. OTHER TOUCH
POINTS THAT SORT OF IMPACT THE
LPS SYSTEM OF CARE INCLUDE- LAW
ENFORCEMENT- PARTICULARLY FOR-
INITIAL SEVENTY TWO HOUR LPS
HOLDS- PUBLIC DEFENDER'S
OFFICES- AND EVEN HOSPITALS
WHERE- INDIVIDUAL STAY WHILE
THEY'RE SORT OF ON AN INITIAL
SEVENTY TWO HOUR HOLD. ON EACH
OF THESE ENTITIES COMES YOU KNOW
WITH ITS OWN SORT OF FIND
SOURCES- AND SIMILARLY YOU KNOW
THEY'D THEY'D SORT OF DO NOT
TRACK- FUNDING FOR LPS RELATED
ACTIVITIES SPECIFICALLY- SO JUST
TO SUM UP AND CIRCLE BACK ON OUR
ARE A KEY TAKE AWAYS. ASSESSING
FUNDING FOR THE LPS ACT IS VERY
COMPLEX AND- VERY COMPLEX GIVEN
SORT OF THE WIDE VARIETY OF
TOUCH POINTS AT WHICH
IMPLEMENTATION OF THE ACT OCCURS
THE WIDE VARIETY AND THE WIDE
VARIETY OF FUND SOURCES THAT-
DATA CAN BE USED TO SORT OF
COME. SUPPORT VARIOUS COMPONENTS
OF THE ACT- AND YOU KNOW
GENERALLY ADDING TO THIS
COMPLEXITY AND DIFFICULTY IN
DETERMINING SPECIFIC FUNDING
AMOUNTS IS THE FACT THAT FUNDING
TO SUPPORT THE ACT. TYPICALLY
COMES FROM BROADER POTS OF
FUNDING THAT I CAN BE USED FOR
OTHER THINGS AS WELL AS THERE
ARE NO DEDICATED FUNDING STREAMS
TO SUPPORT THE AXE THE
CIVICALLY- AND WITH THAT I WILL
CONCLUDE OUR PRESENTATION AND AT
THE END OF THIS PANEL BE HAPPY
TO TAKE. ANY QUESTIONS THAT YOU
HAVE ABOUT THIS MATERIAL. THANK
YOU VERY MUCH REALLY APPRECIATE
THAT- WE WILL NOW MOVE ON TO OUR
THIRD PANELIST- JANELLE E. TWO
OR L. DIVISION CHIEF BLOCKS
INCIDENTS CERTIFICATION FOR
DEPARTMENT HEALTHCARE SERVICES-
APPEARING. ON THE SCREEN TO YOUR
LEFT MEMBERS. THANK YOU GOOD
MORNING SHARON MEMBERS MY NAME
IS JANELLE EACH OVERALL AND I AM. OKAY CAN YOU HEAR ME THEM YES
THANK YOU. OKAY GREAT. SO AGAIN
GOOD MORNING MY NAME IS JANELLE
ITO ROLE AND I AM THE DIVISION
CHIEF OF LICENSING AND
CERTIFICATION- FOR THE
DEPARTMENT OF HEALTH CARE
SERVICES. THANK YOU FOR THE
OPPORTUNITY TO BE HERE TODAY AND
PROVIDE AN OVERVIEW OF WHAT
DHS'S ROLE IS IN IN OVERSEEING
THE LPS. DO YOU SEE AS
RECOGNIZES THE IMPORTANCE OF
PROVIDING SUPPORT PROTECTIONS TO
INDIVIDUALS WHO NEED INVOLUNTARY
MENTAL HEALTH TREATMENT. BUT IT
MENTAL ILLNESS MAY POSE A RISK
OF HARM TO THEMSELVES OR OTHERS
. HUNDRED LPS ACT IN WELFARE AND
INSTITUTIONS CODE SECTIONS FIVE
THOUSAND THROUGH FIVE THOUSAND
FIVE HUNDRED AND FIFTY SIX. HSS
THE AUTHORITY TO APPROVE COUNTY
DESIGNATED OPS FACILITIES AND
WORKS WITH JOHNNY'S TO ENSURE
THAT THESE FACILITIES ARE IN
COMPLIANCE. WITH STATUTORY
REQUIREMENTS OF THE WELFARE AND
INSTITUTIONS CODE. SOME OF THE
H. RESPONSIBILITIES INCLUDE THE
APPROVAL A FIFTY ONE FIFTY LBS
FACILITIES THAT HAVE BEEN
DESIGNATED BY THE COUNTIES
THROUGHOUT THE STATE OF
CALIFORNIA. SPECIFICALLY THIS IS
FOR THE PURPOSE OF SENDING TO
OUR TREATMENT AND EVALUATION
HUNDRED LPS ACT AND THE
CHILDREN'S CIVIL COMMITMENT AND
MENTAL HEALTH TREATMENT. THE
BRIDGE WAS WITH THE MENTAL
HEALTH CONDITION. THE EXISTING
STATUTE AUTHORIZES DHS TO
ESTABLISH REGULATIONS RELATED TO
BE APPROVED FOR A FIFTY ONE
FIFTY LBS FACILITIES. DESIGNATED
BY COUNTY. DHS CLUB STATISTICAL
DATA AND MAKES THE DATA PUBLICLY
AVAILABLE TO MEDICAL LEGAL AND
OTHER PROFESSIONAL GROUPS
REGARDING THE NUMBER OF PERSONS
INVOLUNTARILY DETAINED FOR AN
EVALUATION AND TREATMENT AND
CONSERVATORSHIP. AND WHILE WE
ALSO COLLECT THE SPECIFIED
INFORMATION REGARDING THE NUMBER
OF PERSONS WHO ADMINISTERED.
THEM ALSO TREATMENTS OR
PSYCHOSURGERY THIS PARTICULAR
INFORMATION IS NOT PUBLISHED AND
CAN ONLY BE SHARED IN A MANNER
THAT PROTECTS THE PATIENT'S
CONFIDENTIALITY AND PRIVACY.
ANOTHER COMPONENT OF DHS'S
RESPONSIBILITIES INCLUDE
MONITORING CONTRACT WITH
DISABILITY RIGHTS CALIFORNIA FOR
PATIENTS RIGHTS ADVOCACY TO
CONDUCT INVESTIGATIONS AND
RESULT PATIENT'S RIGHTS
COMPLAINTS AND MENTAL HEALTH
FACILITIES SLASH COUNTY
DESIGNATED LPS FACILITIES. IT IS
RESPONSIBILITIES ALSO INCLUDE
FACILITATING THE RESOLUTION OF
COMPLAINTS GRIEVANCES AND
APPEALS CONDUCTED BY DISABILITY
RIGHTS CALIFORNIA. DHS MONITORS
MENTAL HEALTH FACILITIES ARE
COUNTY DESIGNATED APPEARS TO
STILL AT EASE CHANGE YOUR THAT
THEY HAVE DISPLAYED PATIENCE
RIGHTS HANDBOOKS AND POSTERS AND
PROVIDE THAT HANDBOOKS TO
PATIENTS UP ON- WHEN THEY'RE
RECEIVING TREATMENT IN THESE
FACILITIES. YES YES I'M SURE
THAT THE POSTERS ARE VISIBLE
AND- ARE CHECKING FOR THESE
WHILE WE ARE CONDUCTING
COMPLAINTS VISITS WALKERS-
ENSURING THAT THEY'RE AVAILABLE
AND ALSO REVIEWING THE
FACILITY'S ADMISSIONS CRITERIA
AS TO ENSURE THAT THE PATIENTS
ARE BEING GIVEN A HANDBOOK. YES
THIS IS ALSO RESPONSIBLE
RESPONSIBLE FOR THE PROPAGATION
OF REGULATIONS TO ENSURE LPS
FACILITIES ARE IN COMPLIANCE
WITH ALL STATUTORY REQUIREMENTS
OF LPS ACT. WELL THERE'S NO
SPECIFIC LPS LICENSE IN ORDER TO
BE AN LPS DESIGNATED FACILITY
AND MUST BEING ONE OF THE
FOLLOWING. A CDPH ARE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH
LICENSED ACUTE PSYCHIATRIC
HOSPITAL A GENERAL ACUTE CARE
PSYCHIATRIC HOSPITAL OR SKILLED
NURSING NURSING FACILITY WAS
SPECIAL TREATMENT. AND THOSE ALL
FACILITIES ARE LICENSED BY THE
CALIFORNIA DEPARTMENT PUBLIC
HEALTH. THE OTHER OPTION IS TO
BE- A DH CS LICENSE PSYCHIATRIC
HEALTH FACILITY MENTAL HEALTH
REHABILITATION CENTER. OR A DH
CS OR COUNTY CERTIFIED CRISIS
STABILIZATION UNITS. CURRENTLY
THE COUNTIES ARE REQUIRED FOR
THE EXISTING STATUTES REPORT
DATA TO DH CS ON A QUARTERLY
BASIS EACH LOCAL MENTAL HEALTH
DIRECTOR AND EACH FACILITY
PROVIDING SERVICES TO PERSONS
UNDER THE LPS ACT MUST PROVIDE
ANY INFORMATION RECORDS AND
REPORTS WHICH DH CS DEEMS
NECESSARY. FOR THE PURPOSES OF
OVERSIGHT OF THE LPS OCT.
HOWEVER DH CS DOES NOT HAVE
ACCESS TO ANY PATIENT
IDENTIFIERS. THE INDIVIDUAL
FACILITY IS REQUIRED TO REPORT
TO THEIR LOCAL MENTAL HEALTH
DIRECTOR THE NUMBER OF PERSONS
WHOSE RIGHTS WERE DENIED AND THE
RIGHTS OR RIGHTS WHICH WERE
DENIED. THIS INFORMATION IS THEN
PROVIDED TO DH CS QUARTERLY THE
CONTENT OF THE REPORTS FROM THE
SAUDIS ENABLE THE LOCAL MENTAL
HEALTH DIRECTOR AND DH CS TO
IDENTIFY INDIVIDUAL TREATMENT
RECORDS IF NECESSARY FOR FURTHER
ANALYSIS AND INVESTIGATION.
THESE INVESTIGATIONS ARE NOT
PUBLISHED OUR PUBLIC SINCE THIS
WOULD BE IN RELATION TO APOSTLE
PATIENTS RIGHTS VIOLATION. I'M
IT IS A COMPLETE INVESTIGATION
AND THE REPORTS AND DATA THAT
ARE PART OF THE RIVER- GIVE ME
THAT. THESE INVESTIGATIONS AND
THIS INFORMATION IS NOT- A PART
OF THE REQUIREMENTS OF
REPORTING- INFORMATION UNDER THE
LPS OCT. SIMILAR TO THE
REPORTING REQUIREMENTS AS JUST
STATED THERE ARE ADDITIONAL
REQUIREMENTS FOR REPORTING
INFORMATION SPECIFIC TO
CONVULSIVE TREATMENT OR
PSYCHOSURGERY. DATA AND
INFORMATION THAT IS SUBMITTED BY
DOCTOR FACILITY TO THE LOCAL
MENTAL HEALTH DIRECTOR IS
REQUIRED TO BE SENT TO DH CS.
THE SPECIFIC INFORMATION AND
DATA INCLUDES THE NUMBER OF
PERSON TO RECEIVE TREATMENTS
WHICH OF THE FOLLOWING
CATEGORIES. INVOLUNTARY PATIENTS
WHO GAVE INFORMED CONSENT.
INVOLUNTARY PATIENTS ÓRDENES
AND CAPABLE OF GIVING INFORMED
CONSENT AND RECEIVE COMPULSIVE
TREATMENTS AGAINST HER WILL.
BUDGET PATIENTS WHO GAVE
INFORMED CONSENT. INVOLUNTARY
PATIENTS DEEMED INCAPABLE OF
GIVING CONSENT. ADDITIONALLY THE
DEPARTMENT OF STATE HOSPITALS
REPORT TO DHS THE NUMBER OF
PERSONS WHO RECEIVED TREATMENTS
WHATEVER ADMINISTERED IN THE
SAME FOUR CATEGORIES. ONCE THE
INFORMATION AND DATA IS RECEIVED
DHS WILL FORWARD TO THE MEDICAL
BOARD OF CALIFORNIA ANY RECORDS
OR INFORMATION RECEIVED FROM
THESE REPORTS THAT MAY INDICATE
A VIOLATION BY PHYSICIAN- IN.
VIOLATION OF THE LPS ACT A LAW
OR REGULATION. FOR FACILITIES
AND PHYSICIANS ADMINISTER
PERFORM CONVULSIVE TREATMENT
INSULIN COMA TREATMENT OR
PREFRONTAL SONIC TREATMENT
INVOLVING CALLING DIRECT
STIMULATION OF CELLS OR TISSUE
THE FOLLOWING INFORMATION AND
DATA IS REQUIRED TO BE REPORTED
. STILL THESE I HAVE PERFORM
THESE TREATMENTS DURING THE
PRIOR QUARTER OR WHICH CANCERS
SUCH TREATMENT THAT'S A PART OF
THE FACILITIES PROGRAM REPORT
THIS INFORMATION TO THE LOCAL
MENTAL HEALTH DIRECTOR. THESE
REPORTS ARE REQUIRED EVEN IF
THESE TREATMENT METHODS WERE NOT
USED DURING THE QUARTER.
ADDITIONALLY ANY PHYSICIAN
CONSIDERS ANY OF THESE METHODS A
SERVICE THAT THEY PROVIDE AND
HIS USE OF THE PREVIOUSLY
MENTIONED TREATMENT METHODS IS
NOT INCLUDED IN ANY FACILITIES
REPORT MUST ADMIT ACCORDING TO
REPORTS OF LOCAL MENTAL HEALTH
DIRECTOR. THESE REPORTS ARE
REQUIRED EVEN IF THESE
TREATMENTS WERE NOT ADMINISTERED
DURING THAT. THAT PARTICULAR
QUARTER. THESE REPORTS CAN BE
PROVIDED IF REQUESTED BY THE
PUBLIC HOWEVER THIS IS NOT THE
SAME DATA THAT IS REQUIRED TO BE
PUBLISHED IN ACCORDANCE WITH
WELFARE AND INSTITUTIONS CODE.
SECTION FIFTY FOUR OH TWO.
ADDITIONAL QUARTERLY DATA
REPORTING REQUIREMENTS ALSO
EXIST FOR FACILITIES AND
PHYSICIANS THAT PERFORM
PSYCHOSURGERY. PREFRONTAL SONIC
TREATMENT INVOLVING DESTRUCTION
OF CELLS OR TISSUE. VISIBILITIES
AND PHYSICIANS MUST SUBMIT TO
THE LOCAL MENTAL HEALTH DIRECTOR
A REPORT OF ALL SUCH PROCEDURES
ACTUALLY PERFORMED DURING THE
PRECEDING QUARTER CONTAINING THE
FOLLOWING INFORMATION.
PSYCHIATRIC DIAGNOSIS TYPE OF
PSYCHOSURGERY PERFORMED. DAY
SURGERY PERFORMED AND
COMPLICATIONS THAT AROSE DURING
OR AFTER COMPLETING
PSYCHOSURGERY IF APPLICABLE. THE
LOCAL MENTAL HEALTH DIRECTOR
TRANSMITS COPIES OF ALL
QUARTERLY REPORTS TO DH CS BY
THE LAST DAY OF THE MONTH
FOLLOWING THE END OF THE QUARTER
. AND WHETHER NO STATUTORY
CONSEQUENCES FOR NOT REPORTING
LPS DATA. DIGEST IS WORKING TO
CONTACT COUNTIES TO PROVIDE
TECHNICAL ASSISTANCE AND REMIND
THEM OF THE REQUIREMENT TO
REPORT IN AN EFFORT TO PRODUCE
CONSISTENT DATA. ULTIMATELY DHS
IS COMMITTED TO COLLABORATING
WITH COUNTIES IN THE OVERSIGHT
OF THE LPS ACT AND SERVING THOSE
INDIVIDUALS WHO ARE IN NEED OF
INVOLUNTARY MENTAL HEALTH
TREATMENT. I THANK YOU FOR YOUR
TIME TODAY AND HERE WITH ME TO
ANSWER ANY QUESTIONS IS. RESCUE
IS THE DIVISION CHIEF OF OUR
COMMUNITY SERVICES DIVISION.
THANK YOU. GREAT THANK YOU VERY
MUCH- WE WILL GO AHEAD AND MOVE
ON TO QUESTIONS FROM OUR MEMBERS
AT THIS POINT. WHO WOULD LIKE TO
START. ANYBODY ANY QUESTIONS. GO
AHEAD. THANK YOU THANK YOU O
MUCH FOR YOUR COMMENTS LIKE I
DID WANT TO ASK AND THIS IS OF
CHIEF- ITO OR REAL. PAGE TEN AND
YOU'VE BEEN TALKING ABOUT THIS
IT TALKS ABOUT THE REPORTS AND
THE FACT THAT. MORE THAN 50% OF
THE COUNTIES. DO NOT PROVIDE
ACCURATE. INFORMATION ABOUT
THEIR LPS DETENTIONS AND IT GOES
ON TO DESCRIBE HOW SOME OF THE
PROVIDE NO INFORMATION SOME OF
IT IS INACCURATE INCOMPLETE. THE
MOST IMPORTANT PART OF THAT
PARAGRAPH ON PAGE TEN IS IT SAID
THAT THERE ARE NO CONSEQUENCES
TO COUNTIES WHO FAIL TO EITHER
REPORT DATA OR PROVIDE
INCOMPLETE DATA. WHAT DO WE DO
TO CORRECT THIS. HUESO CURRENTLY
LIKE I SAID BECAUSE THERE IS NO
EXISTING CONSEQUENCE- BUT THERE
IS A REQUIREMENT FOR COUNTIES TO
REPORT SO REALLY WHAT WE'RE AT
DH CS LOOKING TO DO IS TO BUILD
BETTER COMMUNICATION
COLLABORATION WITH THE COUNTIES
WE ARE GOING BACK AND WE ARE
LOOKING AT THE INFORMATION WE
ALSO ARE LOOKING AT INTERNALLY
ARE WE HAVING ANY ISSUES WITH
OUR REPORTING MECHANISMS. MAKING
SURE THAT THERE IS AN F. YOU
KNOW SOMETHING OCCURRING
INTERNALLY WITH THE REPORTING
SYSTEM SO WE ALSO WANT TO LOOK
AT THAT. THEIR- ARE A LOT OF
THINGS GOING FORWARD THAT WE
WANT TO IMPROVE ON AND MAKE SURE
THAT WE ARE NOT. USING THE SAME
DATA WE WANT TO GET BETTER
ACCURATE MORE DATA SO AGAIN
WE'RE LOOKING AT MULTIPLE WAYS
TO IMPROVE THE SYSTEM RIGHT NOW.
SO I. I'M SURE THAT YOU
UNDERSTAND THAT IT WOULD BE VERY
DIFFICULT FOR POLICYMAKERS AND
TO DETERMINE WHAT OUR
COMMUNITIES NEED. AND WHETHER
OUR EFFORTS TO ADDRESS THESE
NEEDS ARE ACTUALLY WORKING. SO
IF THERE ARE NO CONSEQUENCES AND
FOR YEARS YOU ALL HAVE TRIED TO
. I THINK YOU SAID TO REMIND
THEM OF THEIR RESPONSIBILITY TO
REPORT I THINK IS. WHAT YOU HAD
SAID AND IF THAT DOESN'T WORK
THEN PERHAPS NOW THERE NEEDS TO
BE CONSEQUENCES FOR NOT
REPORTING. AND THAT WOULD BE
SOMETHING THAT IS POLICYMAKERS
WE THEN CAN INCLUDE. WOULD YOU
AGREE THAT THAT IS A ONE OF
THOSE POSSIBILITIES. I WOULD
WHAT I WANT TO JUMP INTO I'M
JUST TO. RESTATE THAT WE DON'T
HAVE ANY AUTHORITY AT DH THE
PAST FOR ANY CONSEQUENCES- SO
LIKE CHEN I WAS STATING WORDS
WERE USING ALL THE TOOLS THAT WE
CAN. TO ASSIST COUNTY SWEAT
TECHNICAL ASSISTANCE ON BUT
UNLESS WE HAVE SOME SORT OF A
BROADER AUTHORITY FOR
CONSEQUENCES AND THEN JUST ALSO
TO AND RELATE BACK THAT THERE IS
NO. FUNDING TIED TO LPS COUNTIES
ARE USING DIFFERENT FUNDING
SOURCES BUT THE STATE DOESN'T
HAVE. A PARTICULAR FUNDING
SOURCE FOR LPS AND SO THEY'RE
YOU KNOW OUTSIDE OF OUR
REQUIREMENTS EACH YES TO COLLECT
THIS DATA LIKE CHANNEL. HAS BEEN
REFERENCING ONCE AGAIN WE DON'T
HAVE A IN FORTY DID YOU HAVE ANY
OTHER KIND OF CONSEQUENCES FOR
DATA. THAT IS NOT PROVIDED TO
THE DEPARTMENT. BUT YOU WOULD
AGREE THAT THE DAY COLLECTION IS
EXTREME IMPORTANT ORCHARD IN
ORDER TO DETERMINE WHAT TO DO
NEXT. WEEK WE CAN'T EVALUATE IN
LESS WE KNOW WHAT'S WORKING
WHAT'S NOT WORKING. AND IT TO
HELP YOU HELP CALIFORNIANS WITH
MENTAL ISSUES. WE DO NEED TO
COLLECT THE DATA. YEAH SO WE
DEFINITELY AGREE THAT YOU KNOW
HAVING THE MOST ACCURATE DATA
FOR ANY SORT OF PROGRAM FOR
BEHAVIORAL HEALTH IS IMPORTANT I
AM I DO JUST WANT TO ALSO
MENTION THE DEPARTMENT HAS. BEEN
UNDERTAKING A VERY LARGE A
PROJECT TO. INCREASE OUR DATA
COLLECTION INEFFICIENCY CALLED
OUR PAPER HEALTH DATA
MODERNIZATION- THIS IS ONE
COMPONENT OF THAT- SO I JUST
ALSO WANTED TO SAY WERE DOING
SHORT TERM EFFORTS LIKE CHEN I
WAS MENTIONING THAT WE ALSO DO
HAVE A LONG RANGE PLAN- FOR ALL
OF OUR PAPER HEALTH. THANK YOU.
THIS SEGMENT. THANK YOU VERY
MUCH AND THANK YOU FOR THE
PRESENTATION TODAY IF I HAVEN'T
SAID IT YET BUT THANK YOU TO
BOTH CHEERS FOR HOLDING THIS
HEARING TODAY AS WELL AS FOR
ALLOWING ME TO ATTEND- I'M GLAD
WE'RE HAVING THIS HEARING TODAY
AND I AND I THINK I WOULD GO
EVEN FURTHER AND THEN JUST
MENTION THAT THE CRISIS THAT I
THINK THAT WE'RE WE'VE ALL BEEN
GRAPPLING WITH FOR AS LONG AS
MOST OF US HAVE BEEN SITTING ON
THIS DIET CONTINUES TO- TO
INVOLVE. AND WILL THIS HEARING
IS IMPORTANT I WOULD SUGGEST
THAT WE EVEN CONSIDER SOMETHING
LIKE A SPECIAL SESSION TO DEAL
SPECIFICALLY WITH THIS NOT JUST
LPS BUT THE OVERALL- OUR STATE
OF MENTAL HEALTH IN CALIFORNIA
THIS MIGHT BE A GOOD TIME I
THINK WE I THINK BY WHAT IS VERY
EVIDENT STE- AND WE'VE ALL
TALKED ABOUT A LOT OF RESOURCES
BEEN GOING INTO THE SYSTEM
ESPECIALLY THIS LAST COUPLE
YEARS EVEN THOUGH WE KNOW WE'VE
BEEN HISTORICALLY OVER FUNDED. I
THINK IT IS NOW THE TIME THAT
THERE HAS BEEN SO MUCH OUT AND
YOU KNOW REPORTED FRAUD ND IN
OTHER AGENCIES NOT NOT ANY OF
THESE BUT THAT IS A GOOD TIME
JUST TO REALLY MONITOR ALL OF
THAT FUNDING THAT'S GOING OUT
AND TO REALLY BE ABLE TO SIFT
THROUGH- OUR CURRENT STATE OF
AFFAIRS AND HOW WE MOST
EFFECTIVELY GO FORWARD AND
SOMETIMES THAT'S HARDER TO DO
I'M JUST IN A REGULAR SESSION
WHEN EVERYTHING ELSE IS GOING ON
WE ALL HAVE A DIFFERENT BILLS
WE'RE TALKING ABOUT SOLAR WE
TALK ABOUT OTHER THINGS ALL THE
SAME TIME. SO THAT SAID- JUST
HISTORICALLY SO WE FACED OUT THE
DEPARTMENT OF MENTAL HEALTH AND
HELP ME REMEMBER BUT I IT WAS
BEFORE I ARRIVED SO I THINK THAT
WAS LIKE IN TWO THOUSAND TWELVE
WHEN WE FACED OUT GOING TO THIS
NEW SYSTEM AT THE BROWN NOT NOT
THE SAME TIME- THAT LPS AND
EVERYTHING WAS ESTABLISHED BUT
THE INSTITUTIONALIZATION
OCCURRED WE'RE MOVING TOWARDS
COMMUNITY RESOURCE AS WE PHASE
OUT THE DEPARTMENT OF MENTAL
HEALTH NOW WE HAVE THE
DEPARTMENT OF HEALTH CARE
SERVICES WHO HAVE TAKEN OVER
KIND. OF SOME OF THAT OVERALL
MONITORING. OF THE FIRST. AND A
THE SAME TIME WE KNOW WE HAVE
THE- OF PUBLIC HEALTH- THAT IS
DOING THE LICENSING A LOT OF
THOSE FACILITIES. AND SO FOR ME
I MEAN RIGHT THERE THERE THERE
BECOMES A GAP RIGHT BECAUSE I
CAN TALK TO FACILITIES ABOUT.
AND WE NEED MORE RIGHT WE NEED.
I THINK WHAT HAS BECOME VERY
CLEAR- AND WHAT I THINK WE ALL
UNDERSTAND AS WE DO NOT HAVE THE
INFRASTRUCTURE YET. IN PLACE. TO
BE ABLE TO HANDLE PEOPLE IN THE
COMMUNITY- IN LOCKED FACILITIES
AND IN ANY KIND OF CONTINUE.
CARE AS THEY COME IN AND OUT. OF
THAT WE NEED TO AFFECT THAT THAT
. WE NEED TO MORE CLEARLY
UNDERSTAND THAT. BUT BUT CAN YOU
TALK A LITTLE BIT ABOUT THE
COMMUNICATION BETWEEN BECAUSE I
I'VE TALKED WITH PEOPLE RECENTLY
ABOUT THEIR WAITING A YEAR FOR
SOMETHING TO GET LICENSED AT THE
SAME TIME YOU'RE DOING THE
OVERSIGHT OF THINGS AFTER THEIR
LICENSE SO WHAT IS THE WHAT IS
THE COMMUNICATION PROCESS
BETWEEN YOUR DEPARTMENT AND THE
DEPARTMENT OF PUBLIC HEALTH WHEN
IT COMES TO LICENSING- BOTH
LOCKED AND RESIDENTIAL
FACILITIES- IN THE SUBJECT. CAN
YOU JUST HELP ME UNDERSTAND THAT
PART AND THEN JUST HISTORICALLY
. AS YOU'VE AS YOU'VE EMBRACED
ALL OF THIS EXTRA RESPONSIBILITY
THAT HAS COME WITH THE
DISINTEGRATION OF THE DEPARTMENT
OF MENTAL HEALTH FOR THE STATE
OF CALIFORNIA. IT IT DID YOU SEE
ALL THIS COMMON. THANK YOU FOR
THOSE COMMENTS I AM YES AGAIN SO
WE DO HAVE DIFFERENT TYPES OF
FACILITIES THAT ARE LICENSED BY
OUR DEPARTMENTS SO SPECIFICALLY
AGAIN THE HOPE REALLY THE
HOSPITALS TYPE SETTINGS ARE
LICENSED BY DEPARTMENT OF PUBLIC
HEALTH. AND WITHIN THOSE
FACILITIES THEY ARE ABLE TO
OBTAIN A MENTAL HEALTH
CERTIFICATION FROM OUR
DEPARTMENT OR MENTAL HEALTH
PROGRAM APPROVAL AND THEY DO
SEEK THAT SO THERE IS SOME
OVERSIGHT BY BOTH OF OUR
DEPARTMENTS AND- WE BOTH KIND
OF. COLLABORATIVE COLLABORATIVE
WORK TOGETHER SO DHS IS
RESPONSIBLE FOR LICENSING TO
OTHER TYPES OF FACILITIES WHICH
AGAIN ARE THE PSYCHIATRIC HEALTH
FACILITIES AND THE MENTAL HEALTH
REHABILITATION CENTERS AND SO
WITH THAT THEN THEY'RE ALSO KIND
OF THE DESIGNATIONS THAT COME
WITH THAT LIKE THE OPS
DESIGNATIONS WHICH DH CS DOES DO
THOSE- THERE IS ALSO THAT CRISIS
STABILIZATION UNITS. AT DH CS-
WILL PROVIDE SOME ASSISTANCE IN
AND- AND WITH THOSE FACILITIES
AS WELL SO THERE ARE THERE'S
MULTIPLE DEPARTMENTS THAT ARE
INVOLVED WITH KIND OF THE
OVERSIGHT OF THE WHOLE SPECTRUM
OF SERVICES THAT ARE PROVIDED. I
MEAN IN THE MENTAL HEALTH FIELD
. SO I GUESS I WOULD JUST MAKE
AN OBSERVATION THAT THAT WHAT
YOU DESCRIBE SEEMS A LITTLE BIT
FRAGMENTED. I JUST WANT TO ADD
IN TO YOUR QUESTION ABOUT DID WE
SEE THIS COMING AND YOU'RE
CORRECT AND THE DEPARTMENT OF
MENTAL HEALTH AND A FORMER
DEPARTMENT OF ALCOHOL AND DRUG
PROGRAMS MERGED INTO THE
DEPARTMENT OF HEALTH CARE
SERVICES. AND THAT WAS DONE TO
FOSTER. INTEGRATION OF SERVICES%
AND CARE ON FOR INDIVIDUALS
ESPECIALLY A LOT OF INDIVIDUALS
THAT SUFFER WITH A MENTAL HEALTH
CONDITION ALSO HAVE A SUBSTANCE
USE DISORDER. AND SO SINCE NOT
MERGING INTO THE DEPARTMENT OF
HEALTH CARE SERVICES IT PUTS THE
MAJORITY OF RESPONSIBILITY FOR.
ALL SERVICES UNDER ONE AUTHORITY
AND SELL THAT HOUSE MAJORITY DH
CS NOW BECAUSE THE MAJORITY OF
AUTHORITY. FOR LICENSING
BEHAVIORAL HEALTH FACILITIES
ALSO AS THE SINGLE STATE AGENCY
AROUND MEDICAID AND IT ALSO IS
THE SINGLE STATE AGENCY. OR
FEDERAL SUBSTANCE ABUSE AND
MENTAL HEALTH SERVICES
ADMINISTRATION FUNDS. AND SO THE
INTEGRATION HAS REALLY BEEN
LOOKING FORWARD TO PROVIDE
BETTER CARE SERVICES I'M FOR
INDIVIDUALS AT THE LOCAL LEVEL-
FOR LPS INDIVIDUALS AS WELL. IN
ADDITION TO OTHER. FOLKS THAT
ARE SERVED ACROSS CALIFORNIA. HE
OKAY. THANK YOU I'VE GOT ABOUT A
LINE HERE SAID HANG ON TO SECOND
MR SANTIAGO. BUT WE WILL. YOU
HAD YOUR HAND UP FIRST. MISTER
MISTER STONE THANK. I THINK
THAT'S THE INTERPRETATION FOR
THE APARTMENT. WHAT IS SINCE
WE'VE EXPANDED THE LEGISLATURE
IS EXPANDED THE NUMBER OF
FACILITIES AND THE TYPES OF
FACILITIES THAT COULD BE BROUGHT
TO BEAR. FOUR IN THE AREA THAT
WE'RE TALKING ABOUT WHAT'S THE
BACKGROUND WITH A LICENSING
BACKLOG. BY CATEGORY OR BY JUST
IN AGGREGATE FOR WHAT THE
REQUESTS ARE FROM THE COUNTIES
TO. BE ABLE TO GET LICENSED AND
WHAT'S THAT THE AVERAGE TIMELINE
FOR COUNTIES TO BE ABLE TO GET
FACILITIES LICENSE. OKAY SO
CURRENTLY WE DON'T HAVE A
BACKLOG WITHIN OUR MENTAL HEALTH
LICENSING SECTION FOR ANY
FACILITIES RE SPEAKING AS
PSYCHIATRIC HEALTH FACILITY
LICENSE OR MENTAL HEALTH
REHABILITATION- CENTER LICENSE.
SO ONCE WE DO RECEIVING
APPLICATIONS FOR THOSE WE ARE
VERY RESPONSIVE AND DON'T CARRY
A BACKLOG FOR THOSE FACILITIES.
DO YOU KNOW IF THAT'S THE SAME
FOR PUBLIC HEALTH. I KNOW I
PERSONALLY I'M NOT AWARE. HE'S
HE SAID- I WAS GONNA JUMP IN
HERE BECAUSE I WANT AS COME A
FOLLOW UP TO THAT YOU SAID THAT
THE PARTY HEALTHCARE SERVICES IS
RESPONSIBLE FOR THE OR OR-
MERRILEES MAY HAVE SAID THAT-
FOR THE BULK OF THE LICENSING
WHAT. WHAT IS THE BALK MAIN 75%
EIGHTY PERCENT- CAN YOU GIVE US
A ROUGH IDEA WHAT THAT MEANS. SO
AGAIN WE FOR SPECIFICALLY FOR
MENTAL HEALTH AND REHABILITATION
CENTERS AND ARE PSYCHIATRIC HELP
FACILITIES- WE ARE THE SOLE
AUTHORITY FOR LICENSING THOSE
TYPES OF FACILITIES AND THEN
AGAIN ON OUR AS OUR SUBSTANCE
USE DISORDER SIDE WE ARE THE
SOLE AUTHORITY FOR LICENSING IN
THE RESIDENTIAL AND OUTPATIENT
FACILITIES. OKAY THANK YOU
THAT'S HELPFUL FOR **** MR
SANTIAGO YEAH. I AM TAKING THIS
CHAIR- AND I GUESS I GUESS I'M
STRUGGLING BECAUSE- AND I KNOW
YOU WANT TO TRY TO IMPROVE THIS
SO. YOU KNOW WE DID NOT A COUPLE
YEARS AGO OF THE L. A. COUNTY
AND SOME OF HIS PROGRAMS WE
FOUND SOME SOME GAPS- IN TERMS
OF WHEN SOMEBODY IS BROUGHT IN
FOR HELP AT THE HELP WASN'T
THERE IN SOME CASES. AND THERE
WAS MONEY LEFT OVER CAN I
REALIZE THAT YOU IT'S NOT APPLES
TO ORANGES BUT I GUESS I
STRUGGLE FOR. HADA IN ANOTHER
THIS IS WHAT THIS HEARING IS
ABOUT BUT- AND YOU MENTIONED THE
DATA COLLECTION THAT IS IN PART.
BY STRUGGLE IN ALL THIS HOW TO
MAKE SENSE OF THE DIFFERENT
FILTER HOLDEN ON BEING VETERAN
OKAY UP ONE FIFTY ONE AM IT WILL
FLOORS LA WE HAVE. LETTERMAN ACT
IN ALL IS TO PHASE TO BRING THAT
PERSON AND TRY TO HELP THEM AND
YOU'RE RIGHT ABOUT THE IN ABOUT
THE- CONSERVATORSHIP. THERE'S NO
FUNDS FOR CONSERVATORSHIP- ORAL
PS AND WE STRUGGLE WITH THAT.
BUT IT SEEMS LIKE WHEN YOU HAVE
LAYERS AND LAYERS OF THINGS
WE'RE TALKING ABOUT IN AND I'M
NOT PLACING BLAME ANYWHERE IT'S
JUST THE WAY THE SYSTEM IS ONCE
IT'S BEEN CREATED. THAT LOOK
IT'S LOSS OF THAT INDIVIDUAL WHO
REALLY DESPERATELY. NEEDS HELP.
A. N. N. AND THAT'S KIND OF WHAT
I STRUGGLE WITH. TRYING TO PUSH
MAYBE A LITTLE BIT ON THIS
CONVERSATION ABOUT WHAT WHAT IT
WOULD TAKE. TO REALLY. I ONCE A
SIMPLIFIED RIGHT BUT MAYBE
MAYBE. CRAIG A MORE DIRECT WAY
OF HELPING. THIS INDIVIDUAL-
GOOD EVEN IF WE HAD THE DATA
THAT'S GOING TO TELL US THAT
IT'S PROBABLY NOT WORKING THE
WAY SHOULD BE- EVEN IF WE HAD
THE ENFORCEMENT. WE WEEK WE CAN
ENFORCE. DIFFERENT PARTS OF THE
LARGER PART SERVICES. THERE'S
OT TO BE SOMETHING THAT THAT
THAT AND I'M STRUGGLING FOR TO
HELP I'LL PUSH IT THAT THAT
HELPED CREATE THAT SERVICE FOR
PEOPLE LIKE AN ALLEY CAT IT WILL
BE FOUND AT THIS A COUPLE YEARS
OLD INFORMATION SO IT'S NOT.
IT'S NOT RECENT INFORMATION BUT
WHEN WE DID. THE AUDIT. WE FOUND
OUT THAT IT WAS HOLDING ON TO. A
LITTLE OVER NINE HUNDRED
MILLION. DOLLARS A AND M. FHA
DOLLARS RIGHT NOT THAT THOSE
COULD BE VERY CRITICAL TO
HELPING PEOPLE- WHAT WHAT WHEN
WONDER HELD EITHER ON THE
LETTERMAN ACT LAURA LAURA'S LAW
OR ONE FIFTY ONE OR WHAT HAVE
YOU KNOW ONE OF THE TALK A
LITTLE BIT MORE ABOUT THAT THAT
ONCE A PERSON IS THERE AND THEY
NEED HELP. WHAT WHAT IS THERE
FOR THEM RIGHT NOW I'M I'M
INTERESTED IN SORT OF. YOUR
PERSPECTIVE TO ON WHAT WE KNOW
ABOUT THE SUCCESS OF THE PROJECT
I THINK THERE HAS TO BE
SOMETHING BECAUSE AND I'M
TALKING FROM THE PERSPECTIVE OF
THE AIRLINE GROUP REPRESENTS
COULD ROLL. WHERE DO THESE
CONVERSATIONS BECOME VERY
EMOTIONAL FOR PEOPLE. BECAUSE OF
THE AUTOMATIC THING THAT THEY
THINK ABOUT IS WE'RE GONNA GO
TAKE AWAY SOMEBODY CIVIL RIGHTS
NOT THAT'S NOT REALLY WHAT WAS
COMING FROM THIS IS COMING FROM.
WALKING THE STREETS AND SEEING
SOMEBODY WHO DESPERATELY NEEDS
HELP BANG IN THEIR HEAD UP
AGAINST THE WALL OVER AND OVER
AND OVER UNTIL THEY PASS OUT. A.
N. WHERE THAT. WHERE THE- INTENT
IS TO HELP THEM NOT. DEPRIVE
THEM OF THEIR LIBERTY THAT THEY
NEED BECAUSE IT'S DESPERATE. AND
WE SEE THIS. IT DAY IN DAY OUT.
NO PEOPLE NO T. THIRTY YEARS A
BLEEDING LEGS ARE THIS BIG. AND
IT'S PAINFUL TO SEE THEIRS BUT
WE DON'T HAVE THE TOOLS. TO HELP
THAT PERSON. AND I DON'T I DON'T
A LOT OUT THERE BUT- BUT I
WONDER IF YOU CAN COMMENT TO
THAT NIGHT AND I REALLY THAT
THAT THAT'S A BIG QUESTION- FOR
VERY SMALL SEGMENT OF WHAT WE'RE
DOING RIGHT NOW BUT- BUT I'M
STRUGGLING WITH THAT PARTICULAR
PIECE. ABOUT THAT ACTUAL SERVICE
FOR PEOPLE. A MOMENT BOOM WHAT
NEED TO CHANGE. CAN START WITH
THE RESPONSE AND THEN IF ANY
OTHER PANEL MEMBERS WANT TO JUMP
AND I'M JUST AND TO YOUR
QUESTION AROUND WHAT KIND OF
SUCCESS IS EVERYTHING SO WITH
THE SYSTEM OUTPATIENT TREATMENT
PROGRAM. I WE TO PUBLISHED
REPORTS FOR THE LEGISLATURE
ANNUALLY AND FOR ON 200-018-2000
NINETEEN THE REPORT ON THERE
WERE TWO HUNDRED AND EIGHTEEN
COURT INVOLVED INDIVIDUALS THAT
WERE CERTAIN TWELVE COUNTIES-
AND THERE WAS A LOT OF SIX
THAT'S FOUND IN REDUCING
HOMELESSNESS HOSPITALIZATIONS
INCARCERATIONS- ENTER YOUR
POINTS OUT INTO. SOME OF THE
OTHER TESTIFIED AT THE FINE
FOLKS TODAY- THE FUNDS THAT WERE
USED FOR THAT ARE PRIMARILY THE
IMAGES THEY DLLARS ON THOSE
FUNDS ARE ALLOWED TO BE UTILIZED
FOR PROGRAMS LIKE ASSISTED
OUTPATIENT TREATMENT. ON IN
THOSE INDIVIDUALS THERE ARE
FOLKS- YOU KNOW WITH LPS THAT
ARE OBVIOUSLY CAN START AN EMPTY
SPOT THERE ARE- SOME SUCCESSES
THERE SO I DO JUST WANT TO POINT
OUT THAT- AND THEN ALSO JUST
WHEN I TURN IT OVER CHAT ON THE
OTHER PANEL MEMBERS. IF THEY
WANT TO COMMENT. YEAH THIS IS
KIM THE NASH FLOOD AND TO MAKE A
- ON THAT I THINK CHECK
KNOWLEDGE. HONEST MEMBER. THE
POINT THAT THERE'S A VERY
FRAGMENTED BEER HALL SYSTEM IN
CALIFORNIA- WE DO HAVE DIFFERENT
PAPERS LIKE MEDICAID AND- EVEN
THEIR BEHAVIORAL HEALTH SERVICES
ARE CARVED OUT. FROM MANAGEMENT
FROM THE REST OF THE HEALTHCARE
DELIVERY SYSTEM IN A WAY THAT
ALSO MAKES THAT. TRANSITION MORE
ON CHALLENGING AND THEN VARIOUS-
THERE SHOULDN'T BE A LOT OF
UNINSURED PEOPLE LEFT IN IN THIS
WORLD WITH THE ACA HAVING
EXPANDED MEDICAID. AND SO A LOT
OF I THINK THESE INDIVIDUALS ARE
ELIGIBLE FOR MEDICAID IF THEY'RE
OVER INCOMES AND- CERTAINLY
THEY'RE MORE CHALLENGES GETTING
IN THERE AND SHOULD PRIVATE
INSURANCE TO PAY FOR- SOME OF
THESE SERVICES BUT- I DO BELIEVE
THE REAL SOLUTION. AS WE TALK
ABOUT IT IS BALLS TWO THINGS ONE
IS- TO EXPAND ON I THINK WHAT
THE IMAGES THEY PROMISED IN ITS-
INITIAL- SORT OF PROPAGANDA
AROUND DEVELOPING THEM- MENTAL
HEALTH SERVICES ACT WHICH IS
THAT. THERE ARE SUPPORT OF
HOUSING PROGRAMS LIKE AB THIRTY
AB TWENTY THIRTY FOUR THAT WERE
REALLY THE MODEL FOR IT IT'S
ACIDS. AND THOSE WERE ABOUT.
HANNAH PROVIDING THAT REALLY
REALLY SPECIFIC SUPPORTIVE MODEL
OF GETTING PEOPLE BURST INTO
HOUSING AND KEEPING THEIR
HOUSING THROUGH A SUPPORT OF
INTEGRATED PROGRAM. SO I THINK
THOSE ARE MATURE THOSE WERE
THERE WAS. ALSO DATA AND
LEGISLATIVE RECORD THAT SHOWED
HOW EFFECTIVE THAT WAS. IN
REDUCING HOSPITALIZATION
REDUCING CAR SERRATION ALL OF
THOSE THINGS THAT WE ARE TRYING
TO DO AND SO I THINK THAT IS A
REALLY CRITICAL. HE SAID WE NEED
TO GET BACK TO ADEQUATELY FUND
ADEQUATELY HAVE AVAILABLE
STATEWIDE THAT'S A HUGE
CHALLENGE FOR SURE. AND THEN THE
SERVICE DELIVERY SYSTEM REALLY
NEEDS TO BE ENHANCED AND
EXPANDED THERE IS A CHALLENGE
GETTING ACCESS TO MENTAL HEALTH.
AND SUBSTANCE USE SERVICES.
ACROSS THE STATE SO TO SAY
THERE'S DIRT THERE ISN'T ENOUGH
SERVICES AND WE ALL KNOW THAT IS
TO BE TRUE AND IT'S. WORSE NOW
WITH THE PANDEMIC. SO HOW ARE WE
GOING TO THROUGH. GIVE PEOPLE
MORE INVOLVED JUVENILE THEY
CAN'T SERVICE WHEN THEY NEED
THEM A ONE THEM SO I THINK WE
REALLY TO ACT PASS CITY BUILD.
BEFORE WE LOOK AT SORT OF GOING
BACK TO THE APPROACH OF TRYING
TO EXPAND THE WAY TO GET PEOPLE
IN THE SYSTEM THAT DON'T.
CURRENTLY A QUOTE WANNABE IN
BECAUSE THEY HAVE BEEN ENGAGED
IN THE RIGHT PLACE. THANK YOU MR
MCCARTY AND THEN DOCTOR REGULAR
. YES THANK YOU- I WANTED TO ASK
THE FIRST PANELISTS I BELIEVE
MISS MISS LEWIS- ABOUT YOUR
PRESENTATION ON THAT THE POLICY
THAT WE PASSED IN TWENTY
EIGHTEEN ON THE CONSERVATORSHIP
AND THIS THREE COUNTIES BUT BUT
BEFORE I GET THERE I CAN CARE
THIS IS AN EXTREMELY IMPORTANT
ISSUE THAT'S WHY WE HAVE AND
ECONOMIC HEARING SEVEN RIGHT
MEMBERS HERE- IT'S- IT'S- YEAH
THE INTERSECTION THESE ISSUES WE
HEAR ON OUR COMMUNITIES LIKE MR
SANTIAGO SAID ON A REGULAR
BASIS. WITH MENTAL HEALTH AND
HOMELESSNESS AND ADDICTION AND
NOT ALL THOSE PEOPLE HAVE THE
SAME. BUT THERE'S A REAL.
INTERSECTION NETWORKS THAT WERE
SAYING AND- YEAH I DON'T THINK
IT'S A BAD IDEA TO HAVE A
SPECIAL SESSION ADDRESSING ALL
THOSE ISSUES. AS OUR SENATOR
SAID- AND I ALSO NOTE THAT THAT
NOT I THANK EVERY SHOULD THE
SECOND SPEAKER SAID THAT NOT
ALL. ON MENTAL AND LARA'S LAW
NOT ALL PEOPLE WITH MENTAL
ILLNESS ARE VIOLENT- IN NOT ALL
PEOPLE THAT ARE HOMELESS NEED.
ON CONFINEMENT ATTACK TAKE CARE
OF OURSELVES BUT- AS MY
COLLEAGUE REPRESENTS SKID ROW
SAYS HE WALKED ON OUR
COMMUNITIES ALL THOUGHT ALL.
TAKE YOU CAN TALK TO OUR NEW
POLICE CHIEF HERE WHO'S THE
CAPTAIN DOWNTOWN. AND WALKED
THROUGH CASE THREE AND TEN POINT
OUT INDIVIDUALS WHO THEY'RE FREE
THEY HAVE A RIGHT TO LIVE THEIR
LIVES. BUT IT'S NOT WORKING FOR
THEM THEIR FAMILIES THE
COMMUNITY NORTHERN BUSINESSES
SO. THE STATUS QUO HAS TO CHANGE
THIS THIS IS UNACCEPTABLE SO I
APPRECIATE THIS HEARING. I DON'T
WANT TO JUST DIG IN ON THAT BILL
THAT WE PASSED IN TWENTY.
EIGHTEEN AND I WATCHED IT I
PROCEED I WASN'T ON EITHER THE
COMMITTEES WERE WENT THROUGH. I
THINK I SAID IN ONE DAY SO I DID
HEAR THE DEBATE AND I THINK THE
FINAL- CONCLUSION WAS IN THOSE
THREE COUNTIES. INDIVIDUAL HAD
TO BE- CONFINED. NOT CONFINED
HAD TO BE. BROUGHT IN BY THE
LOCAL LAW ENFORCEMENT EIGHT
TIMES OVER A TWELVE MONTH.
PERIOD FOR IT TO TRIGGER- I
THINK AT THE TIME THAT SOUNDED
LIKE A HIGH NUMBER. HI IT IS IT
WORKING I'VE HEARD ANECDOTAL
REPORTS THAT FOR EXAMPLE IN SAN
FRANCISCO. ONLY LIKE TWO OR
THREE PEOPLE THAT IT'S ACTUALLY-
WORKED WITH AND I DON'T KNOW IF
THAT'S THE TYPE OF THE
APPROPRIATE. AMOUNT WHAT WE ARE
LOOKING FOR CAN YOU GIVE US YOUR
ANALYSIS ON. THE BILL THREE FOUR
YEARS LATER- HOW. POLICY IS
WORKING AND IS IT EACH THE GOAL
THAT WE OUT FOR- I THINK IT'S A
VERY GOOD QUESTION IN TERMS OF
HOW IT'S WORKING- YOU KNOW THE-
PURPOSE OF THOSE CONSERVATIVE
SHIPS AS THEY AS I UNDERSTAND
THEM WERE A- HOUSING.
CONSERVATIVE PILOT SO- I THINK
CRITICALLY THE VERY FIRST
QUESTION WOULD BE HOW IS THE
HOUSING COMPONENT OF THAT. IN
OTHER WORDS HOW SUCCESSFUL ARE
BECAUSE IT'S A BROADER LPS
CRITERIA THAT ALLOWS THAT COUNTY
CHIU INTERVENING AND DETERMINES
UPGRADE TO DISABLE INPUT ON A
CONSERVATORSHIP- IN A BROADER
WITH A BROADER GREAT DISABILITY
STANDARD. ON EVEN THOUGH AS YOU
SAY YOU HAVE TO BE FIFTY ONE
FIFTY EIGHT TIMES STOP BY LAW
ENFORCEMENT COULD REALLY BE BY
ANYONE WE HAVE A VERY EXPENSIVE
L. FIFTY ONE FIFTY THIRTY. THAT
THE COUNTY CAN AUTHORIZE TECH
TEAM PSYCHIATRIC EMERGENCY
RESPONSE TEAMS A LOT OF
DIFFERENT FOLKS COULD BRING
SOMEBODY IN TO THE SYSTEM SO. I
THINK IT'S IT ISN'T JUST POLICE
INVOLVEMENT THERE AS WELL BUT
THERE WAS A- IT LEGISLATIVE
FINDING RECOMMENDATION WAS
SUPPOSED TO BE DONE BY JANUARY
ONE TWENTY TWENTY ONE WHICH I
HAVE NOT. BEEN ABLE TO FIND BUT
I THINK LOOKING AT THAT AND WHAT
THE WRIT OF PRELIMINARY FINDINGS
WERE IS VERY IMPORTANT. AND HOW
SUCCESSFUL WAS AND WHAT WAS THE
REASON IT WASN'T SUCCESSFUL IF
IT WASN'T AND THEN SECONDLY YOU
KNOW THAT. THERE IS ALSO A
LEGISLATIVE. RESPONSE TO IN
JANUARY OF TWENTY TWENTY THREE
TO MAKE A DETERMINATION ON THAT
SPECIFIC PROGRAM IN THOSE PILOTS
SO. VERY IMPORTANT QUESTION
ABOUT. IF THEY WERE SUCCESSFUL
Y. AND IF THEY WERE NOT
SUCCESSFUL WHY NOT I THINK THAT
ISTHE REAL KEY QUESTION AND I
THINK IT IS ONE THAT STILL OUT
THERE- BUT I KNOW THERE WILL BE
OTHER PANELIST SPEAKING TO SOME
OF THE LIMITATIONS. IN SOME OF
THOSE VERY COUNTIES WHERE- WE
KNOW THAT ACCESS IS BEING VERY
DIFFICULT AND EVEN WITH THESE
EXPANDED AUTHORITIES TO
INVOLUNTARILY TREAT PEOPLE IT
HASN'T BEEN IN ITSELF THE
SOLUTION YOU HAVE TO HAVE
SOMETHING TO. OFFER ON THE OTHER
SIDE OF THAT. YES I OF A FALL UP
QUESTION. IS YOUR RIGHT SO IT'S
NOT USING THE TOOL WHAT'S
HAPPENING SOMETHING AT THE BACK
END BUT MY UNDERSTANDING THEY
WOULDN'T UTILIZE THE TOOL OF
INVOLUNTARY- A POLICY UNLESS
THERE'S SOMEONE TO TAKE THE
INDIVIDUAL. CELLS ASSUMING THAT
IS ACCURATE NEEDS THREE COUNTIES
AND THEY DO UTILIZE THIS
OPPORTUNITY. DO YOU. DO YOU HAVE
ANY INFORMATION ON ON HIS THAT
NUMBER IS THAT THE RIGHT IS THAT
NUMBER TOO HIGH ART ARE THESE.
ANECDOTAL STORIES ABOUT SAN
FRANCISCO AND LESS THAN FIVE
PEOPLE HAVING IT TRIGGERED IS
THAT ACCURATE AND DOES THAT TELL
US ANYTHING ABOUT. WHETHER OR
NOT THE NUMBER EIGHT. IS THAT
THE WRONG NUMBER.
THE PROCESS TO
GET PEOPLE INTO THAT SAME PLACE
AND ACCEPT THOSE SAME SERVICES
AND ALSO BE HOUSE. IS A REALLY
IMPORTANT AND SUCCESSFUL MODEL
AND WE DO KNOW THAT THIS IS
ABOUT PATIENT TREATMENT FOR
EXAMPLE EVEN AS A NATIONAL-
BEING STILL BEING STUDIED THERE
ARE NOT THERE'S NOT EVIDENCE TO
SUPPORT THAT IT ACTUALLY HAS AN
IMPACT AND THEN THE INVOLUNTARY
COMPONENT OF IT. IS THE
SUCCESSFUL PART THERE ARE OTHER
EVIDENCE BASED PRACTICE LIKE
ASSISTANT- I'M COMMUNITY
TREATMENT MODELS THAT DO THAT
TENDENCY SUPPORT AND HOUSING
SUPPORT THAT. HAVE BEEN SHOWN TO
BE EFFECTIVE NATIONALLY SO I
THINK IT'S REALLY DOUBLING DOWN
ON WHAT IS OF EVIDENCE BASED
PRACTICE ON WHAT IS A FACTOR
PRACTICE AND WHY DON'T WE DO
MORE. THANK YOU THANK YOU MISTER
CHAIR- DOCTOR REGULATE I'VE I
JUST I JUST KNOW WE WERE WE HAD
A THREE MINUTE HEAD START AND WE
ARE NOW FIFTEEN MINUTES BEHIND
SO- BUT ANYWAY I THINK I'M NOT
TRYING TO DETER YOU IN ANYWAY.
JUST TO. BREVITY OR- DIRECT. I
WILL- THANK YOU MISTER CHAIR I
WILL START WITH THE FRAMING
COMMENT IF I CAN ABOUT LPS I.
THINK IT'S IMPORTANT FOR US TO.
ACKNOWLEDGE THAT THIS IS NOT A
DISCUSSION THAT IS PENDING YOUR
ABILITY TO ACCESS HEALTH CARE OR
MENTALHEALTH CARE VERSUS. SELF
DETERMINATION. IT'S INSTEAD
REALLY EVALUATING THE SYSTEMS OF
CARE. AND WHETHER OR NOT THOSE
WHO ARE IN CRISIS ARE LOCKED UP.
OR WHETHER OR NOT THEY'RE ABLE
TO ACCESS THE APPROPRIATE MENTAL
HEALTH AND PHYSICAL CARE THAT
THEY- SHOULD BE GIVEN. AND SO
I'D LIKE TO FOLLOW UP ON THE
CAPACITY QUESTION AS I. DO THINK
IT'S THE IMPORTANT QUESTION FOR
US TO ADDRESS. AS A STATE AND
LOOKING TOWARDS OUR COUNTY
PARTNERS. WHETHER OR NOT THE
INVESTMENTS WE'VE MADE IN THE
LAST FISCAL YEAR FOR STATE
HOSPITALS FOR GRANT FUNDING FOR.
BEDS OUT IN COMMUNITY OR WHETHER
OR NOT IT'S- US LOOKING TOWARD
SUPPORT OF HOUSING VERSES
PROJECT HOME KEEP. FOR THE
INVESTMENTS THAT WE MADE AS THE
STATE INTO OUR BEHAVIORAL HEALTH
WORKFORCE LPS BY ITSELF. CANNOT
CONNECT PEOPLE TO ONGOING CARE.
IF THAT CARE DOES NOT EXIST
WITHIN THE COMMUNITY. AND SO MY
QUESTION REALLY IS ABOUT SCOPE
AND TRYING TO UNDERSTAND. WHAT
THESE INVESTMENTS WILL MEAN FOR
US AS A STATE AND- WHETHER OR
NOT THEY WILL ADDRESS THIS
CRISIS HEAD ON OR IF THERE ARE
ADDITIONAL FUNDS THAT WE NEED TO
BE TALKING ABOUT THIS UPCOMING
YEAR. AND WAS HOPING THE
ADMINISTRATION COULD COMMENT
REGARDING. BOTH THE STATE
HOSPITALS THE CONTINUUM OF CARE
THE SUPPORT OF HOUSING AND THE
BEHAVIORAL HEALTH WORKFORCE.
WHETHER OR NOT THOSE FUNDING
STREAMS WERE APPROPRIATE
SUFFICIENT TO WORK. ANY PLANS. I
CAN TAKE THE FIRST PART OF YOUR
QUESTION. AND I CAN STATE THAT-
THE ADMINISTRATION MADE A- SPOT
THREE BILLION DOLLAR INVESTMENTS
IN. HEBER HEALTH CONTINUED TO
THE BEHAVIORAL HEALTH CONTINUED
INFRASTRUCTURE PROGRAM AND THE
COMMUNITY CARE INSURANCE- AND
SO. ARE THE PAYER HEALTH
CONTINUE- WE RECEIVED TWO POINT
TWO BILLION AND THEN. BURKE
MEDICARE EXPANSION EIGHT HUNDRED
MILLION AND- DEPARTMENT
HEALTHCARE SERVICES HAS BEEN
WORKING CLOSELY WITH OUR
DEPARTMENT OF SOCIAL SERVICES TO
A LOT. ABOUT FUNDING WE'RE
ACTUALLY REALLY SAYING. I
REQUEST REPLICATION IN JANUARY.
FOR ON THE FIRST LARGE PORTION
OF THAT- AND SO RECOGNIZING
THAT. AS MISS LEWIS STATED WE DO
NEED- FURTHER CAPACITY I THINK
EVERYBODY UNDERSTANDS SPOT. ON
FOR BEHAVIORAL HEALTH SO WE ARE
PUTTING THOSE FUNDS TO GOOD USE
AND IT REALLY DOES NOT RAPIDLY-
I CANNOT SPEAK TO THAT. I'M
STATE HOSPITALS BUT I DO JUST
WANT TO TOUCH ON THE BEHAVIOR
HEALTH WORKFORCE- AND WHILE
WE'VE ALREADY HAD STRAINS. TO
THE BEHAVIOR HEALTH WORKFORCE
PRIOR TO THE PANDEMIC- JUST WITH
THE INCREASING COMPLETED
SUICIDES. ON THE RISING OVERDOSE
RATES AND ALSO JUST WITH
INCREASED. MENTAL HEALTH
CONDITIONS WE'RE SEEING MORE
STRAINS ON NOT JUST CAPACITY BUT
WORKFORCE. IN RECOGNIZING THAT
THERE'S- A NATIONWIDE WORKFORCE
ISSUE. BUT WE ARE SEEING THE
IMPACTS OF THOUGHT AND
BEHAVIORAL HEALTH- THAT AND
WE'RE HEARING A LOT FROM OUR
LOCALS- OUR PROVIDERS ARE
COUNTIES ON THAT THEY'RE REALLY
STRUGGLING- WITH. WORKFORCE AND
IN BEING ABLE TO HAVE SUFFICIENT
WORKERS- WE WILL- THIS WILL BE A
QUESTION A FOLLOW UP QUESTION
FOR THE AUDITOR BUT WITHIN THE
HAND OUT. RAND CORP HAS
IDENTIFIED AND I JUST WANT TO
REMIND US. THAT THE MOST
EXPENSIVE WAY FOR US TO TREAT
OUR LPS POPULATION IS WITHIN
JAILS AND EMERGENCY ROOMS. AND
FOR US TO FOCUS ON MAKING SURE
THAT WE HAVE THOSE COMMUNITY
SUPPORT. I POINT. US BACK TO THE
AUDITORS FINDINGS WHICH SHOW
THAT- ONLY NINE PER. OF THOSE
WHO NEEDED ON SO. FOR A TO BE.
TO THOSE SIR. SO MY QUESTION IS
WHY WILL THIS LAST YEAR'S BUDGET
INVESTMENTS ALLOW US TO START TO
MAKE A DIFFERENCE WITHIN THAT
SPECIFIC METRIC. AS I THINK
THOSE WHO WE HAVE IDENTIFIED AS
NEEDING- RESOURCES SHOULD THEN
BE CONNECTED TO THOSE RESOURCES
FOR US TO START MAKING A
DIFFERENCE WITH THIS POPULATION.
THANK YOU MISTER CHAIR AB. THANK
YOU VERY MUCH I HAVE A COUPLE OF
BRIEF QUESTIONS AND THEN A
COUPLE OF COMMENTS- FIRST OF
ALL- MISS IT OR OF. YOU GUYS-
YOU MENTIONED THERE'S A LOT OF
DATA COLLECTION- WE ALSO KNOW
THAT COUNTIES ARE NOT DOING THAT
ANYWAY FOR NOT PROVIDING DATA TO
YOU- WHAT ARE YOU USING THE DATA
FOR. BECAUSE SOME OF IT ISN'T
PUBLISHED- BEYOND WAS PUBLISHED
ON THE WEBSITE WHAT DO YOU USING
THE DATA THAT'S COLLECTED FOR-
IS IT ARE YOU JUST COLLECTING
THE BECAUSE YOU'RE MANDATED
COLLECTED OR IS THERE A VALUE TO
IT. THAT ISN'T APPARENT TO US OR
ME ANYWAY- BECAUSE I HAVEN'T I
HAVEN'T SEEN IT. WE DO AND THE
DATA COLLECTION THAT IS REQUIRED
TO BE PUBLISHED IN PUMP AND WITH
THE POSTED SO THAT IS ONE ASPECT
OF IT THE OTHER ONE IS THAT WE
DO COLLECT INFORMATION TO ALSO
REVIEW IF THERE IS ANY NEED FOR
US TO OPEN UP ANY TYPE OF
INVESTIGATIONS- BASED OFF OF ANY
DATA RECEIVED THAT THERE MIGHT
BE ANY PATIENTS RIGHTS
VIOLATIONS AS WELL. SO THAT'S
INTERNALLY LOOK THAT AGAIN THE
INFORMATION THAT IS COLLECTED-
IS FOR THAT PURPOSE I'M IS NOT
REQUIRED TO BE PUBLISHED BY WE
CAN PROVIDE. INFORMATION OR THAT
DATA PUBLICLY IF IT'S REQUESTED
BUT IT HAS TO JUST MAKE SURE WE
ARE MEETING ALL THAT
CONFIDENTIALITY AND PRIVACY.
LAWS UT YOU DON'T BUT COUNTIES
ARE NOT SUBMITTING THE DATA SO
YOU DON'T KNOW THERE MAY BE
PROBLEMS AND SOME OF THESE
COUNTIES YOU JUST DON'T KNOW
ABOUT THEM BECAUSE ARE NOT
SUBMITTING DATA AND THEY'RE NOT
BEING IN ANY WAY FOR NOT
SUBMITTING THE DATA. TWO DATA
SETS INCOMPLETE. REYES SO WE ARE
FINDING THAT THERE ARE SOME
DEFICIENCIES ARE THAT WE NEED TO
IMPROVE THAT SO WE CAN HAVE.
BETTER DATA COLLECTION AND A
MORE ROBUST UNDERSTANDING OF
WHAT'S GOING ON. SO THAT IS PART
OF WHAT WE REALLY ARE ARE
LOOKING AT DOING KIND OF GOING
FORWARD AND- IMPROVING OUR DATA
COLLECTION TRYING TO IMPROVE
OUR- OUR COMMUNICATIONS WITH THE
COUNTIES TO. REALLY HAVE A
BETTER DOT AND- OKAY- MR- THANK
YOU FOR YOUR COMMENTS- IT SOUNDS
LIKE FUNDING FOR ELSE L. P. S.
IS A MESS IT'S COMING FROM ALL
OVER THE PLACE PEOPLE CAN DRAW
DOWN FOR LPS ACTIVITIES FROM A
VARIETY OF DIFFERENT PLACES-
FROM THE L. A. O. PERSPECTIVE-
SHOULD THERE NOT BE SOMEONE SOME
ENTITY THAT OVERSEES ALL OF THE
L. P. S. FUNDING ACTIVITIES- TO
AN END SO THAT WE CAN ACTUALLY
YOU KNOW COORDINATE- YOU KNOW
FOR THE DOLLARS IN THE PROGRAM
SO THAT SO THAT THE IT WENT WHEN
SHE COULD COORDINATE THEN YOU
POTENTIALLY HAVE. ACCOUNTABILITY
FOR THIS BUT IT FEELS LIKE
THERE'S A LOT OF PEOPLE COMPOSED
MONEY AWAY AND NOBODY KNOWS WHAT
THE HELL'S GOING ON IS THAT A
FAIR CHARACTERIZATION OR IT
MIGHT IT DIDN'T HAVE ENOUGH
COFFEE THIS MORNING. AT THANK
THANK YOU DOCTOR WOULD- WHAT
WHAT I WOULD SAY IS THAT YOU
KNOW WE HAVEN'T DONE SORT OF A-
A COMPREHENSIVE ANALYSIS OF THE
LPS ACT YOU KNOW- AND SO WE
DON'T SORT OF HAVE SPECIFIC
RECOMMENDATIONS ARE FINDING TO
SORT OF PROVIDE ON SORT OF WHAT
CHANGES TO THE OVERALL
STRUCTURE- WOULD BE- WARRANTED
OR IF THEY THEY ARE SORT OF
NECESSARY AND- IN. INTO TO
IMPLEMENT- WHAT I WILL SAY IS
THAT- PART OF THE REASON WHY A
SORT OF THERE ARE ALL THESE
DIFFERENT ENTITIES THAT DRAWDOWN
DIFFERENT FUND SOURCES FOR TO
SORT OF SUPPORT THE ACTORS
BECAUSE- THERE ARE A VARIETY OF
DIFFERENT ACTIVITIES THAT. YOU
KNOW ARE. REQUIRED TO SORT OF
IMPLEMENT THE ACT AND SO- THE
COURT SORT OF HAVE THEIR
RESPONSIBILITIES ARE COUNTY EVER
HEALTH HAS THEIR RESPONSIBILITY
AND SO IT ALL SORT OF GETS-
MODELED IN LARGE PART BECAUSE-
YOU KNOW THERE ARE DIFFERENT
SORT OF ACTIVITIES AT DIFFERENT
ENTITIES HAVE. RESPONSIBILITIES
FOR- WHAT WILL SAY IS THAT-
CONSISTENT WITH SORT OF LIKE-
OTHER OVERARCHING COMMENTS THAT
WE MADE ABOUT THE BEHAVIORAL
SYSTEM AS A WHOLE. IT DOES SORT
OF MAKE SENSE TO HAVE SORT OF AN
OVERARCHING FRAMEWORK TO SORT OF
LOOK AT. BEHAVIOR HEALTH ISSUES
BROADLY INCLUDING YOU KNOW
ISSUES RELATED TO THE LPS ACT.
SORT OF- HAVING A SORT OF-
UNIFIED FRAMEWORK THROUGH WHICH
YOU CAN SORT OF LOOK AT AN ISSUE
OR EVALUATE SORT OF A PROBLEM IS
YOU KNOW- OUR OFFICE HAS SORT OF
COMMENTED ON THOSE TYPES OF
ISSUES IN THE PAST AND- WE HAVE
SORT OF FOUND THAT THERE THERE
IS SOME BENEFIT TO SORT OF
HAVING. A MORE UNIFIED AND
COMPREHENSIVE APPROACH AT
LOOKING AT AN ISSUE. WHAT WHAT
ABOUT THAT THANK YOU FOR THAT I
GUESS. I GUESS WHAT I'M
STRUGGLING WITH- AND THIS WILL
BE A THEME THROUGHOUT THE DAY
AND I DON'T WANT TO BELABOR
THIS. THIS EARLY BUT- BUT IT- I
GUESS I'M STRUGGLING WITH IS WHO
HAS ULTIMATE RESPONSIBILITY FOR
THE L. P. S. ACT- WE'VE GOT
PEOPLE TO DRAW FUNDING FROM ALL
OVER THE PLACE- IT JUST DOESN'T
FEEL LIKE THERE'S KIDS. THAT
THINGS ARE COORDINATED AND NOW
WE'VE AND WE'RE INVESTING MORE
AND MORE MONEY. IN A SYSTEM THAT
AS ISN'T. DOESN'T FEEL TERRIBLY
COORDINATED. EXPECTING YOU KNOW
DIFFERENT OUTCOMES I GUESS I
THINK. AND THERE'S SOME GREAT
PROGRAMS PLEASE I UNDERSTAND
THAT THIS IS NOT TO. IN ANY WAY
TO DISPARAGE OR DOING ANY OF THE
GREAT PROGRAMS THAT ARE
HAPPENING OUT THERE. BUT I DON'T
THINK A LOT OF THESE PROGRAMS WE
KNOW WHAT EVERYBODY ELSE IS
DOING UP THERE. AND THAT'S AND I
THINK THAT'S- PROP THE PROBLEM
SO I GUESS MY QUESTION FOR- FOR
YOU. MISS IT ORAL IS. WHO IS
RESPONSIBILITY WHO IS ULTIMATELY
RESPONSIBLE FOR THE- FOR THE L.
P. S. ACT OR IS THERE ANYBODY.
GREAT SITE I THINK THERE IS A
COORDINATION THAT IS REQUIRED
BECAUSE THERE IS RESPONSIBILITY
BETWEEN BOTH A DH YES WITH THE
OVERSIGHT AND THE COUNTIES. SO
PART OF IT IS INCREASING THE
COORDINATION BETWEEN OUR TWO-
ENTITIES- FOR REALLY. TO HAVE A
BETTER UNDERSTANDING AND BETTER
OVERSIGHT. SO ARE YOU SAYING
THAT. THAT DEPARTMENT HEALTH
CARE SERVICES AS WELL TIMIDLY
RESPONSIBLE FOR OVERSEEING THE
LPS ACT. YES WE ARE AND THEN
DESIGNATING AND GIVING THE
APPROVAL SO THEY COUNTIES ALSO
GO IN AND REVIEW AND- PROVIDE
THEIR APPROVALS ARE
RECOMMENDATIONS FOR DEBT
FACILITIES TO BE DESIGNATED AS
AN LPS FACILITY AND DHS
ULTIMATELY HAS A RESPONSIBLE
RESPONSIBILITY TO APPROVE THAT-
SO WHO'S WHO IS STRATEGIZING AND
PLANNING AND COORDINATING THESE
THANK. YOU HAVE RESPONSIBILITY
BUT WHO WITHIN DH C. S. IS
ACTUALLY COORDINATING AND MAKING
SURE THAT THE FUNDING AS IS
APPROPRIATE A WE HAVE AN ACT
THAT HAS NO DEDICATED FUNDING.
SO WE GOT SOME IS PERPETUALLY
FUELED- A SHIP THAT'S GIVEN FUEL
IT'S FLOATING AROUND OUT THERE-
NOW NOW YOU SAID THAT YOU KNOW
T. ACS IS ULTIMATELY RESPONSIBLE
FOR- THE ACT. BUT HOW ARE WE GET
WE HAVE INCOMPLETE DATA AND
PARTS OF THIS SO HOW DO WE KNOW
THIS SHIP IS EVEN GOING ANYWHERE
OTHER THAN AND CIRCLE- SKIN
REFUEL CONSTANTLY BUT HOW DO WE
KNOW. AND WE KNOW WHERE THINGS
ARE GOING IT DOESN'T. IT IT JUST
FEELS REALLY REALLY
UNCOORDINATED. RIGHT SO I MEAN I
THINK I AGREE THAT PART OF WHAT
WE NEED TO DO IS INCREASE OUR
DATA WE DO WORK INTERNALLY WITH
OUR OTHER DIVISIONS AS WELL I'M
TO REALLY KIND OF UNDERSTAND ALL
OF THIS BUT I. WILL OVERLY AGREE
THAT WE NEED TO AND OUR
RESPONSIBILITY IS TO REALLY
IMPROVE OUR DATA COLLECTION SO
THAT WE CAN PROVIDE A BETTER
PICTURE UNDERSTANDING OF THIS OP
YES PROGRAM SO I GUESS IF YOU
COLLECT BETTER DATA- WHO. IS
GOING TO USE THAT DATA THAT'S
WHAT I'M GETTING AT I DON'T
YOU'RE GING TO COLLECT DATA
WITH MORE INFORMATION WE'VE GOT
WE'RE GETTING INFORMATION HERE
TODAY. ULTIMATELY WHO'S GOING TO
BE IN CHARGE OF MAKING CHANGES.
IS THERE AN ENTITY OR IS IT JUST
IS IT. THE ENTIRE DEPARTMENT OF
HEALTH CARE SERVICES AS AN
UMBRELLA. I'M JUST STRUGGLING
TO. COULD THERE BE SOMEBODY IN
CHARGE. I MEAN THAT'S REALLY
WHAT I'M ASKING. SOMEBODY. I
JUST WANT TO JUMP IN AND STATE
WITH WHAT CHANNELS TALKING
ABOUT- WITH WHAT THE DEPARTMENTS
RESPONSIBLE AROUND THAT DATA
PIECE OF THE FACILITY TYPES SO
THERE'S DIFFERENT PARTS OF THIS
LIKE YOU MENTIONED- THERE'S THE
FACILITY WHERE THE HEALTHCARE
SERVICES A CURRENT OF DIFFERENT
FACILITIES- THERE'S ALSO LIKE
YOU MENTIONED THAT THERE ISN'T
AN OUTCAST FUNDING SOURCE AND I
THINK THAT THAT IS WHERE THERE'S
SOME OF THIS FRAGMENTATION I'M
THAT YOU'RE YOU'RE TALKING
ABOUT- YOU CAN USE AN HSA
DOLLARS BUT THERE'S CERTAIN
THINGS AND WHICH I MAY JUST SAY
DOLLARS CAN'T BE USED FOR MEDIC
HOW CAN COVER SOME OF IT. BUT
NOT ALL OF IT AND THEN YOU ALSO
LIKE YOU MENTIONED ON YOUR HAVE
THE ARM IF THE COURT FOUND THAT
IS WORKING YOU KNOW I'M PART OF
LPS AS WELL- SO I WOULD JUST
STATE THAT THERE ARE DIFFERENT
ENTITIES RESPONSIBLE FOR
DIFFERENT PIECES AND THEN OF
COURSE THE COUNTY'S TOP.
RESPONSIBILITIES AS WELL. I
WOULD JUST GUESS OF JUST AND I
ASKED AT THIS- OF JUST I GUESS
MY PER. IS THAT. THAT YOU'VE GOT
A LOT OF MONEY BE DRAWN DOWN
FOR. DIFFERENT LPS ACTIVITIES.
YOU'RE COLLECTING DATA FROM
COUNTIES AND THEN YOU KNOW I'VE
GOT COUNTY DON'T HAVE BEDS TO BE
ABLE TO DO ANY OF THIS RIGHT YOU
GOT COUNTIES ARE REPORTING TO
YOU AT ALL. SO WE GOT ALL THIS
MONEY BEING SPENT. AND WE DON'T
REALLY HAVE A COORDINATED. WAY
TO UNDERSTAND WHAT THE IMPACT IS
. HOW ARE PEOPLE GETTING
SERVICES I MEAN WE WOULDN'T BE
HERE AT THIS HEARING TODAY IF
THIS THING WAS RUNNING LIKE A
CLOCK. WE WOULDN'T. IT'S CLEARLY
CLEARLY SOME SOME SERIOUS
SERIOUS CHALLENGES. AND SO I'M
WHAT I'M BEGGING FOR AT SOME
POINT IS THAT CAN THERE BE SOME
. IT OPENS HER ST OR ENTITY
WITHIN YOUR AGENCY. TO
COORDINATE GATHER THIS DATA AND
REALLY ASSESS WHERE THE HECK ARE
WE AND WHERE ARE WE GOING.
CONSIDERING THE MASSIVE AMOUNTS
OF RESOURCES THAT ARE COMING IN
TO THESE PROGRAMS THE WORST
THING WE CAN DO IS CONTINUE TO
PUT MONEY INTO A SYSTEM. THAT
ISN'T BEING EFFECTIVE. WITHOUT
TRYING TO CHANGE CHANGE AND
IMPROVE THE SYSTEM AND THAT'S
KIND OF WHY WE'RE HERE TODAY. IS
THAT WE HEAR FROM OUR
CONSTITUENTS CONSTANTLY THIS
ISN'T WORKING. AND AND YET I
HEAR WILL COME TO COLLECT MORE
DATA. BUT I DON'T HEAR WHERE
WHO'S GONNA WHO'S GONNA EVALUATE
THE DATA WORDS THE OUTCOMES CAN
BE WORSE ACCOUNTABILITY GOING TO
BE AND HOW WE GONNA BE AND JUST
HOW DO WE ENSURE THAT PEOPLE ARE
GOING TO GET THE SERVICES THEY
NEED AT THE END OF THE DAY. IT'S
ABOUT SERVING THE NEEDS OF THE
PEOPLE WHO NEED THESE SERVICES.
AND THAT'S WHAT WAS NOT
HAPPENING. IN MY OPINION. OKAY I
WOULD AND I WOULD JUST LIKE TO
STATE THAT- THAT'S WE'VE YOU
KNOW TALKED ABOUT TODAY DH CS IS
COMMITTED TO MAKING IMPROVEMENTS
IN THE AREAS THAT WE HAVE
AUTHORITY OVER. I THINK YOU'RE
GOING TO HEAR THROUGHOUT THE
REST OF THE DAY. ON FOR VARIOUS
COMPONENTS OF LPS LIKE YOU
ALREADY MENTIONED THERE ARE.
THERE ARE GAPS AND THERE ARE
AREAS. I'M THAT DH YES DOES NOT
HAVE THE ABILITY TO OVERSEE AS
WELL MORE. OR WE SHOULD MAYBE
LIKE OVER THE COURT SYSTEM WE
DON'T HAVE ANY AUTHORITY OVER
THOSE. YOU KNOW THOSE
COMPONENTS- BUT THAT WE ARE
ALSO. YOU KNOW REALLY LOOKING TO
SEE- AND ARE VERY CONCERNED.
ABOUT INDIVIDUALS WE WANT TO
ENSURE. THAT THEY CAN GET THE
CARE THAT THEY NEED. I HAVE TO
SAY. THE NEW. OF MEMBERS HERE.
IN DECEMBER FOR AN INTERIM
HEARING- ON THIS SUBJECT. SHOULD
BE A CLUE THAT THAT THIS IS A
BIG DEAL TO US AND WE STAND
READY. AS A LEGISLATURE TO WORK.
TO COORDINATE TO TRY TO MAKE
SOME POSITIVE IMPACT HERE. BUT
WE GOT TO WORK AS A TEAM. SO IF
YOU GOT IDEAS AS AND AS AS AN
AGENCY. WE'RE OPEN TO HEARING
THOSE. WE ABSOLUTELY ARE.
SOMETHING WENT THANK YOU WE
APPRECIATE VERY MUCH THE PANEL
AND PART I TEND TO GET
OVERWHELMED UP SOMETIMES I GUESS
I GOT A MAYBE I HAD MORE COFFEE
THAN I THOUGHT- BUT ANYWAY I'M
GONNA MOVE ON WE'RE GOING TO
HAVE MOVE ON ONCE AGAIN THANK
YOU VERY MUCH TO ALL OUR
PANELISTS AND VERY MUCH
APPRECIATE YOUR INPUT AND- JUST
UNDERSTAND THAT I DO THIS AND-
NOT YEAH I'M TRYING TO WE'RE
TRYING TO- MOVE THE BALL HERE
AND- AND- HOPE TO MAKE THINGS
BETTER FOR EVERYONE SO. WITHOUT
GOING TO TURN THIS OVER TO MY CO
CHAIR- MR STONE WHO ENTERS OUR
NEXT PANEL. THANK YOU MISTER
WHAT'S THE- PANEL. IS A PANEL OF
. PERSONAL X. AND WE HAVE TO
MEMBERS CHOLESKY. TO BOZO AND
CARIS MERRICK BOTH OF. WHOM ARE
WITH US REMOTELY. SO THANK YOU
BOTH THE BUZZER. ARE YOU WITH US
. YES CAN YOU HEAR ME YEAH.
WONDERFUL THANK YOU
REPRESENTATIVES OF WHAT IN STONE
FOR THE OPPORTUNITY TO ADDRESS
AT LEAST. IMAGINE FOR A MOMENT.
WITHIN THE LAST YEAR MAYBE. CAN
YOU HEAR ME YES. OKAY. ARE YOUR
FEET IS VERY SLOW YOU MAY NEED
TO TURN OFF YOUR VIDEO. CAN YOU
ALL HEAR ME YES WE CAN HEAR YOU
NOW. I'M SORRY ABOUT THAT OKAY.
RIGHT IMAGINE YOUR LIFE
TRAJECTORY BEING JUDGED YOUR
LOWEST POINT MAYBE IT IS A DAY
WEEKS MONTHS OR LONGER. FOR ME
IT WOULD HAVE BEEN THE DAY I
TRIED TO KILL MYSELF FOLLOWING A
SEXUAL ASSAULT. WHEN I WAS
INVOLUNTARILY COMMITTED I WAS
TREATED LIKE A BURDEN AND I WAS
TOLD. NOT TO LET MYSELF GET
RAPED AGAIN. AS A BLACK WOMAN I
ALWAYS HAVE TO CONSIDER THE ROLE
THE HISTORICAL RACISM PLAYS AND
MY TREATMENT AND CARE. AT THE
HOSPITAL I EXPERIENCED CHEMICAL
RESTRAINTS AND VERBAL ABUSE AND
THE TREATMENT MODALITY. IT WAS
COLORING AND WATCHING SILENCE OF
THE LAMBS THERE IS NO THERAPY NO%
DIGNITY AND CERTAINLY NO CURE
SUPPORT. WE WERE TOLD WHEN TO
WAKE UP WHAT TO EAT WHAT
MEDICATION TO TAKE. THERE IS NO
CHOICE. I'VE BEEN TOLD THAT I
HAD A MENTAL ILLNESS I WOULD
NEVER WORK IN A RELATIONSHIP OR
HAVE A FILLING LIFE. AND I KNOW
THIS IS NOT WHAT MY MOTHER
ENVISIONED FOR ME WHEN SHE WAS
TRYING TO GET ME HELP. MY STORY
IS NOT RARE IT IS NOT UNIQUE. A
LOT OF PEOPLE DON'T UNDERSTAND
WHAT IT'S LIKE TO HAVE SOMEONE
MAKE LL OF YOUR DECISIONS FOR
YOU TAKE AWAY YOUR AGENCY AND
LOOK AT YOU LIKE YOU WERE BROKEN
CHILD. THIS IS WHAT IT'S LIKE TO
BE SENT AWAY. THE SPACE TO HEAL
WASN'T HEALING IT WAS
OVERCROWDED AND CHAOTIC AND THEN
I WAS RELEASED NO FOLLOW UP NO
AFTER CARE NO SUPPORT OF
LINKAGES TO COMMUNITY BASED
PROGRAMS. SO THE CURRENT
TREATMENT IS TRAUMATIC WHY WOULD
WE EXPAND WHAT TRAUMA RECEIVED
FROM INVOLUNTARY TREATMENT TAKES
TIME TO RECOVER FROM AND I TRULY
BELIEVE OUR COLLECTIVE INTENTION
IS NOT TO SUBJECT PEOPLE TO
TRAUMA BY OVER TAX SYSTEMS.
PEOPLE DESERVE AND NEED
VOLUNTARY OPTIONS WAS ACTUALLY
HELPFUL PURE SUPPORT. VOLUNTARY
TRAUMA INFORMED THERAPY AND A
SUPPORTIVE COMMUNITY THAT
BELIEVES THAT PEOPLE CAN AND DO
RECOVER. EVERYONE DESERVES
ACCESS TO THESE TYPES OF ROBUST
EVIDENCE BASED SERVICES AND
CULTURE RESPONSIVE PROGRAMMING
IN THEIR COMMUNITIES THAT STAY
CONNECTED WITH THEM AND JUST
FOLLOW UP. IN THE STATE BECAUSE
THOSE LONG PSYCHE. HOSPITALS WE
WERE. MENTAL HEALTH SUPPORT IN
THE COMMUNITY AND THAT IS A
PROMISE THAT HAS NOT BEEN BUILT.
WE CANNOT LOOK AT LPS
CONSERVATORSHIP WITHOUT LOOKING
AT THE LARGER MENTAL HEALTH
SYSTEM. EXERCISING THAT MUCH
CONTROL OVER SOMEONE'S EMOTIONAL
AND BODILY AUTONOMY IS REALLY
JUST A WAY NOT TO LOOK AT.
CONTEXT IN A SIDE STEP SOLVING
THE PROBLEMS THAT CREATE
SYSTEMIC OPPRESSION AND TRAUMA.
I THINK WE TEND TO WANT TO
EXERCISE CONTROL OVER PEOPLE
LABELED THEM AS THE PROBLEMS
WHEN WE FEEL LIKE WE CAN'T
CONTROL BIGGER SOCIETAL
PROBLEMS. LIKE HOMELESSNESS. WE
SHOULD BE MOVING INTO THE
DIRECTION OF ALTERNATIVES THAT
ARE HUMAN RIGHTS SPACE AND
CENTERS THE VOICES OF PEOPLE
WITH LIVED EXPERIENCE. AND
EXPANDING CONSERVATORSHIP IS
CERTAINLY A MOVE IN THE OPPOSITE
DIRECTION. I SUPPORT VOLUNTARY
CHOICES AND THE DIGNITY OF
PEOPLE LIVING WITH MENTAL HEALTH
CONDITIONS ABILITY TO MAKE
DECISIONS ABOUT SERVICES
MEDICATIONS AND SUPPORTS. NOT
ONLY IS CORPORATION A CIVIL
RIGHTS ISSUE IT'S ULTIMATELY
INEFFECTIVE. TRYING TO HELP
SOMEONE WHO IS LIVING WITH
MENTAL HEALTH ISSUES BY TAKING
AWAY THEIR RIGHTS. EXACERBATES
THE PROBLEM AND RESEARCHERS HAVE
FOUND THAT FORCE TREATMENT
CONTRIBUTES TO. QUOTE UNQUOTE ON
NON COMPLIANCE. IT UNDERMINES
THE THERAPEUTIC RELATIONSHIP
BETWEEN CLIENT AND THERAPIST IT
MAGNIFIES POWER DIFFERENTIALS
AND DIMINISHES THE SENSE OF
PERSONAL DIGNITY. AND. SELF
ADVOCACY THAT IS IMPORTANT TO
RECOVER. INTO TWENTY WE ALREADY
RECEIVED A ONE HUNDRED TWENTY
PAGE LPS AUDIT THAT FOUND NO
EVIDENCE TO JUSTIFY MAKING ANY
CHANGES TO OUTKAST CRITERIA.
MUCH LESS EXPANDING IT. THE
REPORT UNDERSCORED SIGNIFICANT
ISSUES WITH HOW CALIFORNIANS
WITH SERIOUS MENTAL ILLNESSES
WERE CARED FOR INCLUDING HAVING
LIMITED TREATMENT OPTIONS
EXPLAINED THAT MANY PEOPLE ON
INVOLUNTARY HOLDS. I'M NOT BEEN
CONSISTENTLY ENROLLED IN CARE TO
HELP THEM SAFELY RETURN TO THEIR
COMMUNITIES. ALREADY TALKED
ABOUT WHAT HAPPENS WHEN PEOPLE
ARE PUT AWAY AND AN INVOLUNTARY
TREATMENT IS THE PRECURSOR TO
CONSERVATORSHIP. INSTEAD CAN WE
MOVE PEER CERTIFICATION FROM AN
OPTIONALCOUNTY PROCESS TO A
ROBUST WIDE MEDI CAL BENEFITS I
DIDN'T NEW FUNDING TO EXPAND
CULTURALLY RESPONSIVE VOLUNTARY
PROGRAMS. LIKE THE CALIFORNIA
REDUCING DISPARITY PROJECTS CAN
WE INVEST MORE SERVICES IT IS
STOCK TO OFFER DROP IN MEDICAL
SERVICES AND MENTAL HEALTH
SERVICES WITHOUT COERCION. CAN
WE START TO UNTANGLE THE MASSIVE
RED TAPE THAT BLOCKS THE
COUNTY'S ABILITY TO PROCURE
BUILDINGS AND BUILD YOUR RESPITE
RATHER THAN EXPANDING HOSPITAL
BEDS. WE CAN'T SAY VOLUNTARY
PROGRAMS DON'T WORK IF WE'VE
NEVER FULLY FUNDED THEM OR
IMPLEMENTED THEM AND IF IT TOOK
A MEGA SUPERSTAR WITH HUGE FAN
BASE EXPENSIVE LAWYERS I
SPENDING HASHTAG A PASSION FREE
BRITNEY. THIRTEEN YEARS TO BE
RELEASED FROM HER
CONSERVATORSHIP WHAT IS THE
TRAJECTORY FOR BLACK INDIGENOUS
PEOPLE OF COLOR FOR WHITE FOLKS
WITH NO RESOURCES. WHAT O YOU
COMMUNICATING ABOUT PEOPLE'S
ABILITY TO. RECOVER IF YOU SWEEP
THEM AWAY AND CONTROL THEM WE
WANT OUR LOVED ONES AND OUR
COMMUNITY SO HE'LL RIGHT SO WHY
WOULD WE MEDICALLY INCARCERATE
THEM AND THINK IT'S IN THEIR
BEST INTEREST IT'S NOT.
EXPANDING LKS LAW IS A VIOLATION
OF OUR CIVIL RIGHTS AND
HISTORICALLY WITH MOST LAWS THAT
ARE INEQUITABLE ARE BY POCK
TRANS QUEER PEOPLE EXPERIENCING
. WILL MOST LIKELY GET THE BRUNT
OF THIS ON BEHALF OF PEOPLE
WHOSE HARD THIS TIME DOES NOT
AND DID NOT TO FIND. URGE YOU
NOT TO EXPAND THIS LAW AND TO
SPEND TIME FUNDING HARM
REDUCTION YOUR SUPPORT.
INVOLUNTARY MENTAL HEALTH
PROGRAMS. THANK SO MUCH I'M
SORRY I COULDN'T BE ON CAMERA.
THANK YOU THANK YOU FOR BEING
WILLING TO TESTIFY AND NOW WITH
THE PERSONAL EXPERIENCE THAT
THAT CAN BE VERY VERY DIFFICULT
SO WE APPRECIATE YOU BEING WITH
US. SO OUR NEXT IS CHARISMATIC.
MICHAEL THERE WILL YES WE CAN.
OKAY HI I'M CHARISMATIC AND ON
WITH THE NATIONAL ASSOCIATION
APPEAR SUPPORTERS A PERSON WITH
LIVED EXPERIENCE THANK YOU
ASSEMBLY MEMBERS ARMY OR HANDOUT
CHAIRS FOR THE OPPORTUNITY TO
ADDRESS THE GLOBAL. CHERRY RED
FOURTEEN SIXTY ONE DOC MARTIN
OXFORDS I WANTED ISSUES FOR EVER
I SAVED UP MY POCKET CHANGE
UNTIL I COULD FINALLY AFFORD
THEM BUT NEW OUTFITS TO MATCH
THAN WHERE THE MORALLY EVERYDAY
AND SURVIVED A LIFE ALTERING.
EXPERIENCE AND THAT. MY FIRST
ENCOUNTER WITH THE MENTAL HEALTH
SYSTEM DURING A CRISIS AT BURKE-
WHEN I WAS IN MY LATE THIRTIES
AND LOS ANGELES. THE VOICE IS
ONLY I COULD HEAR WERE
RELENTLESS CALLING ME DEROGATORY
NAMES TELLING ME I WAS STUPID
ORACLE'S UGLY. AND USELESS.
WHENEVER THIS HAPPENS I WITHDRAW
I STOPPED EATING I CAN'T WORK I
STOPPED PAYING MY RENT I BECOME
HOMELESS AND BASICALLY I GIVE UP
ON LIFE. PERHAPS THE VOICES ALL
RIGHT. THAT TERRIBLE NIGHT THE
VOICES WOULD NOT RELENT.
TERRIFIED INTO EMBARRASSED TO
CALL MY MOTHER I REACH OUT TO MY
DOCTOR SURELY EVEN NEUTRAL
RESOURCE I HAVE TO TRUST THAT
YOU COULD GET ME OUT OF THIS
UNINTENDED UNTENABLE SITUATION.
I WAS IN TROUBLE AND NEEDED HELP
MY DOCTOR QUICKLY RESPONDED
SAYING YOU HAVE TO CALL NINE ONE
ONE. I WAS FULLY DRESSED WEARING
MY NEW MY NOW VERY WELL BROKEN
IN CHERRY RED DOC MARTENS. DID I
SAY SOMETHING TO SUGGEST THAT
THE ONLY OTHER WAY TO END THIS
ONSLAUGHT OF THE NOISE WAS TO
WAKE UP CAD. MISINTERPRETED MY
RAMBLINGS ME I WAS CERTIFIED.
BEING ALSO DEEMED GREATLY
DISABLE CLOSER TO MYSELF I WAS
HAND CUFFED AND TAKEN TO THE
POLICE STATION. RIGHT WITHIN
HAND PUMP TO A CHAIR AND
ULTIMATELY TRANSFERRED TO A
HOSPITAL FIFTY ONE FIFTY. NO ONE
INTRODUCED THEMSELVES WELL
EXPLAINED WHAT WAS HAPPENING AND
A NON IDENTIFIED NURSE ASKED ME
WHAT SEEMED TO BE A BARRAGE OF
RANDOM QUESTIONS. I WAS AN
INCONVENIENCE NOT WORTH THE
BOTHER TO ENGAGE- AND ADDS A
RESPONSE I WAS DECLINING EVERY
REQUEST INCLUDING HAVING MY
TEMPERATURE TAKEN. AT WHICH TIME
I HEARD THE WORD CODE. THE
POLICE AND HOSPITAL STAFF
WRESTLED ME TO THE GROUND AND I
KEPT TRYING TO GET FREE. TAKE
OUR SHOES OFF THEIR WEAPONS
YELLED ONE OF THE OFFICERS. MY
WELL WORLD WARN. YOU BROKE. A
LEG. RED FOURTEEN SIXTY ONE
STOCK MARKET OFFERED WERE RIPPED
FROM MY FEET. I FOUND OUT THAT
NIGHT WITH THE MENTAL HEALTH
CARE WAS ALL ABOUT. ASKING FOR
HELP FULL STACK GETTING HAND
CUFFED RIGHT TAKEN AWAY AND
BEING HARMED PHYSICALLY. AND
EMOTIONALLY. THE IN FOR- SITE-
AS A RESULT IN FOR ME YEARS I ON
WILL TO SEE THE CARE I NEED A
WHEN I. IT MY CHERRY RED MARTENS
WERE WERE. TO THE BACK OF CLOSET
COLLECTOR DUST. THEY WERE THE A
BODY OF THE- OF THE FIRST. THE
FOURTEENTH SUBSEQUENT
INVOLUNTARY HOSPITALIZATIONS
THAT WOULD FOLLOW IN CALIFORNIA.
I COULDN'T BEAR TO WEAR THEM I
COULDN'T EVEN LOOK AT ALL YOUR
REMINDER THAT I WAS SO BROKEN
AND SO BLACK IN AMERICA. THAT
SOMEHOW THE TREATMENT I RECEIVED
MUST'VE BEEN DESERVED EVEN ON
ONE IS SAID TO HAVE ON THE
SIGNALS YEAH. THERE'S A LOOK
WHAT CODE IS. THAT FORCE NO
MATTER HOW BUSY BEGETS
RESISTANCE. PERHAPS IT IS OUR
SYSTEMS NOT JUST ONE BUT MANY
SYSTEMS THAT HAS AND HAS IGNORED
THE ARE A LACK OF INSIGHT ABOUT
OUR NEEDS AND THEIR
RESPONSIBILITY. TO THE MOST
VULNERABLE OF CALIFORNIANS WHOSE
MENTAL HEALTH IS SERIOUSLY
IMPACTED IN THE COLLECTED. WHEN
SYSTEMS FAIL PEOPLE WE CAN HELP
THE PEOPLE TO BROKEN SYSTEMS
RATHER WE SHOULD BE COMPELLING
SUPPORTING SYSTEMS TO MEET THE
NEEDS OF ALL PEOPLE IN THE LEAST
RESTRICTIVE WAY POSSIBLE. FORCE
NO MATTER HOW YOU FEEL EVEN IN
POLICY READ REGULATIONS. WELL
THAT WAS INSTALLED. WHAT DO WE
NEED TO DO. NUMBER IT MAY NOT BE
OUT. EXPANSION BUT RATHER IT MAY
BE OTHER THINGS THAT ARE RELATED
TO CREATE A VOLUNTARY ACCESS IS
ACCESS TO SERVICES THAT MEET OUR
NEEDS WHEN WHERE AND HOW WE NEED
THEM. YOU ACTUALLY HAVE ACCESS
TO SERVICES THAT ARE RECOVERY
AND RESILIENCY DRIVEN CULTURALLY
AND LINGUISTICALLY ALIGNED
PERSON CENTERED AND ACTIVE. ANY
CONSIDERATION OF IMPROVING LCS
HELP YES THAT INCLUDES
INCREASING THE PREPARATION OF
THE RIGHTS. ARE NEEDS TO BE DATA
DRIVEN. CURRENTLY WE DON'T KNOW
WHAT'S HAPPENED TO LPS
DESIGNATED FOLKS WE DON'T HAVE
THE BATTLE. AT THE BOTTOM
INDIGENOUS PERSON I'M APPALLED
WE HAVE NO IDEA ABOUT THE
DEMOGRAPHICS- SORRY BUT WE HAVE
NO IDEA OF THE DEMOGRAPHICS AND
THAT THE LITTLE THAT WE DO HAVE.
CLEARLY AND KEEP INDICATES.
DISPARITIES FOR BLACK FOLKS. WHY
WITH THAT KNOWLEDGE IS ANY. OF
EXPE THE PROGRAM. I DON'T JUST
WANT THE DATA AS A CALIFORNIANS
I WANTED AS A BLACK CALIFORNIA
AND I DID MANDATE FOR BY POCKETS
ABLED AND LGBTQ TWO OUTSIDE
BROTHERS SISTERS AND THEIR
FAMILIES. AS COLLECTION STATED
WE NEED TO MAKE YOUR SUPPORT OF
MEDICAID BENEFITS THAT THAT THE
STATE COULD NOT DEAL CITED COST
AS A RATIONALE. WELL IN THE
TWENTY ONE EIGHTEEN BUDGET AND
COMMUNITY HEALTH WORKER BENEFIT
- WITHIN THE MEDICAL PROGRAM BUT
WE DON'T HAVE THAT PEOPLE
BENEFIT FOR CERTIFIED PEER
SUPPORT SPECIALIST. WE KNOW
ENGAGEMENT IN MEETING PEOPLE
WHERE THEY ARE- IS A HURDLE TO
OVERCONFIDENCE WITH MOST NEEDS
IF THE STATE WOEFULLY AND BEST A
WORKFORCE THAT IS RUBEN. HELP
PEOPLE ENGAGE IN TREATMENT AND
RESOURCES. THE CHASM WIDENS AND
THE PEOPLE WHO FALL IN OUR
BLAMES CALLED NOT COMPLAINT AND
FORCED TO BE VERY TREATMENT-
PERHAPS THAT THEY WOULD HAVE
THOUGHT ESPECIALLY IF SUPPORTED
BY SOMEONE WHO LOOKS LIKE THEM.
IT'S FROM THE SAME CULTURE
SPEAKS THE SAME LANGUAGE AND
HELP THEM THROUGH THE VERY SAME
WHAT THE HELL STRUGGLE. SEVENTY
CHAU PEER SUPPORT SERVICES IN
PRISONS AND GAUGE WHAT
ACTIVATION FORTY. ENTRY AS WELL
AS WE DO HEALTH. AND TENURE
COMMUNITY. SO CLOSE THAT. MAKE
YOUR SUPPORT IN MY BETTER FOR
ALL POLL MEDIC OF THIS YEAR WE
ARE IT IS AND FOR OTHER STATES.
FORTY ONE STATES. THAT COLLECTED
ON ALL HELP THAT'S- BITTERMANN
YOU. OF THE ART NOT JUST REDUCE
HOMELESS USE THAT WE ARE AND HOW
. BUT TO RESTORE PEOPLE'S RATES
AND IMPROVE HELP OUT AND WE- OF
. MEASURES OF HOW ALL PURPOSES
EIGHTY AND WE- THIS OF. THE DATA
NEED TO DRAW WILL. RATHER THAN
STRUCTURE WAS OTHER. POLITICAL.
OVERSIGHT AN ACCOUNT. THERE YOU
THE CURRENT TO OR COMMISSION
FROM OF. AFTER BUT YOU CAN'T
TELL HOW DEPARTMENT WE HAVE G.
FOR. AT CHAMPION TO LIVE
EXPERIENCE OF FAMILY. GIVE
CAREGIVERS FOR MULTIPLE AND THIS
IS MAKING. DID YOU. WITH OF
PROCESS AND- ON THE STOCK OF OUR
- THERE'S A IN ORDER MAKE THIS.
THAT ARE BASED ON A- DATA AND
EVIDENCE INFORM. ANY NEEDED AND
- NOT JUST OF LPS INSTEAD WE DO
BUT MADE OUT. SO THAT COUNTIES
CAN WE WILL OF THE ROAD
VULNERABLE. THAT PREEMPTS NEED
LPS WENT ABRUPT. I JUST OVER.
THAT THE SHOES THAT I HAD WANTED
FOR ALBERTA'S JERRY RIGHT
FOURTEEN SIXTY ONE STOP MARTINS
ARE A WEAPON. DAY FOR ME ARE THE
WEAPON OF POWER PRIDE AND
PERSISTENCE I WILL CONTINUE TO
BE PART OF THE SOLUTION I THANK
YOU FOR THIS OPPORTUNITY TO
SPEAK. I URGE THE COMMITTEE TO
TAKE THESE RECOMMENDATIONS TO
HEART IN ORDER TO SOLVE THE
RIGHT PROBLEM WITH THE RIGHT
SOLUTIONS THAT SUPPORT OUR MOST
VULNERABLE. CALIFORNIANS THANK
YOU. THANK DEPENDING HAVE
QUESTIONS FOR EITHER OF THESE
WITH THE- DRESS I JUST WANT TO
THANK YOU BOTH FOR PROVIDING
YOUR PERSONAL EXPERIENCES IT'S
VERY HELPFUL WHEN WE ARE TRYING
TO LOOK AT POLICY TRIED TO DO
OVERSIGHT WHATEVER IT IS WE'RE
TRYING TO DO IS POLICY MAKERS
IT'S IMPORTANT TO HEAR FROM
THOSE WHO HAVE EXPERIENCED OUR
SYSTEM AND CAN GIVE US INSIGHT
TO THAT OTHERS COULD NOT SO I
WANT TO THANK YOU BOTH FOR
PROVIDING THAT. OTHER QUESTIONS
SIGNAL AND I ALSO WOULD LIKE TO
THANK YOU IT IS. WE REALIZE THAT
IT IS OFTEN VERY DIFFICULT FOR
PEOPLE WITH LIVED EXPERIENCE TO
BE. TESTIFYING IN BODIES LIKE
THIS WE GREATLY APPRECIATE YOUR
ABILITY OR WILLINGNESS TO BE
WITH US AND PRESENT YOUR
PERSONAL STORIES. THOUGH THANK
YOU BOTH VERY VERY MUCH. ALL
RIGHT WE WILL THEN MOVE ON TO
OUR FOURTH PANEL. WHICH IS A
REVIEW OF THE L. P. S. AUDIT BY
OUR STATE AUDITOR AND WE HAVE TO
MEMBERS BOTH WITH US IN PERSON
ELAINE HOWELL WHO IS OUR STATE
AUDITOR. AND BOB HARRIS WITH THE
STATE AUDITOR'S OFFICE.
GOOD
MORNING WELCOME PLEASE GOOD
MORNING. GERMAN WORD CHAIRMAN
STONE MEMBERS OF THE OF THE OUR
RESPECTIVE COMMITTEES- SENATOR
EGGMAN- FOR THE RECORD MY NAME'S
ELAINE HOWELL I AM CURRENTLY THE
CALIFORNIA STATE AUDITOR- WITH
ME IS BOB HARRIS HE WAS THE
AUDIT MANAGER ON THIS PARTICULAR
PROJECT I'M GOING TO AT A VERY
HIGH LEVEL IN THE INTEREST OF
TIME. COVER SOME OF THE KEY
ISSUES THAT WE IDENTIFIED IN AN
AUDIT WE ISSUED IN JULY OF
TWENTY TWENTY- AND TALK ABOUT
SOME OF THE RECOMMENDATIONS
PRIMARILY RECOMMENDATIONS WE
MADE FOR LEGISLATIVE ACTION I WE
MADE SOME RECOMMENDATIONS TO THE
THREE COUNTIES THAT WE VISITED
WE VISITED LOS ANGELES. SHASTA
COUNTY AND SAN FRANCISCO AND
LOOKED AT SOME OF THEIR-
PROCESSES BUT BUT REALLY WANT TO
TALK TODAY ABOUT HIGH LEVEL KEY
ISSUES AND SOME LEGISLATIVE
RECOMMENDATIONS THAT WE MADE
THAT- SOME OF WHICH HAVE
ACTUALLY BEEN TAKEN UP AND AS
YOU HEARD FROM A PREVIOUS A
PANELIST- LEGISLATION WAS
CHAPTER THAT THAT REALLY HAS
IMPROVED- THE PROGRAM FOR A
GREAT STEP IN. THE RIGHT
DIRECTION SO LET ME FIRST START
WITH THE FIRST KEY ISSUE MEMBERS
WHEN THE REQUESTERS **** TO
CONDUCT THIS AUDIT ONE OF THE
CONCERNS WAS IS THE CRITERIA
WITHIN THE LANHAM AND PETROUS
ACT BEING USED INCONSISTENTLY
ARE PEOPLE BEING TREATED AND
CONSISTENTLY ACROSS THE STATE.
SO THE FIRST ISSUE WE REALLY
WANT TO LOOK AT WAS THE
ASSESSMENT OF AN INDIVIDUAL'S
CONDITION IN THE DETERMINATION
WHETHER OR NOT THAT PERSON
NEEDED TO BE PLACED ON AN
INVOLUNTARY HOLDS. SO WE LOOKED
AT- SHORT TERM HOLDS DECISIONS
MADE RELATED TO SHORT TERM HOLD
ON SOME CONSERVATORSHIP
DECISIONS MADE- WITH RESPECT TO
THOSE. AND THEN WE ALSO LOOKED
AT CASES WHERE THE DETERMINATION
WAS THIS INDIVIDUAL DOES NOT
NEED TO BE PLACED ON A HOLD WE
WANT TO LOOK AT ALL DIFFERENT
ASPECTS. AND AS HAS BEEN
DISCUSSED. PREVIOUSLY BY SOME OF
THE OTHER PANELISTS WHEN WE LOOK
AT THE CRITERIA WE DIDN'T SEE
SIGNIFICANT KINDS
INCONSISTENCIES. IN THE
INDIVIDUALS WHO ARE MAKING THESE
DETERMINATIONS AT EACH OF THE
COUNTIES SOME HAD- SHASTA COUNTY
PARTICULAR HAD MORE SPECIFIC
GUIDANCE FOR THEIR INDIVIDUALS.
WHO ARE MAKING THESE DECISIONS
BUT WE REALLY DIDN'T SEE A LOT
OF INCONSISTENCY SO WE DID REACH
THE CONCLUSION THAT. WE DIDN'T
FEEL THAT THERE NEEDED TO BE ANY
REVISIONS TO THE CRITERIA. IN
THE LETTERMAN PETROUS ACT WITH
RESPECT INVOLUNTARY HOLDS SO WE
REACH THAT CONCLUSION WE DID NOT
HAVE ANY RECOMMENDATIONS WITH
RESPECT TO THAT. SO MOVING ON TO
IF YOU MAKE A DETERMINATION
SOMEONE NEEDS TO BE PLACED IN AN
INVOLUNTARY HOLDS. LOOKING AT
CAPACITY BOTH AT THE STATE LEVEL
AND THE LOCAL LEVEL THE THREE
COUNTIES I MENTIONED. AS TO THE
ABILITY FOR THE STATE OF
CALIFORNIA THROUGH OUR STATE
HOSPITALS. TO PROVIDE BED SPACE
FOR INDIVIDUALS WHO NEED
INTENSIVE INPATIENT TREATMENT.
AND WHAT WE FOUND IS IN LOOKING
AT STATE HOSPITALS BECAUSE THOSE
STATE HOSPITALS ARE REALLY HAVE
A LEGAL OBLIGATION. TO PROVIDE
BEDS TO INDIVIDUALS WHO HAVE
BEEN DETERMINED AND COMPETENT TO
STAND TRIAL. MAJORITY OF THE BED
SPACE IN OUR STATE HOSPITALS. IS
TAKEN UP BY THESE INDIVIDUALS
WHEN WE CONDUCTED THE AUDIT.
WE'RE LOOKING AT FISCAL YEAR
181985% OF THE BEDS. IN THE
STATE HOSPITAL WERE WERE.
OCCUPIED BY INDIVIDUALS WHO ARE
INCOMPETENT TO STAND TRIAL SO
UNFORTUNATELY WHAT THAT MEANS IS
INDIVIDUALS- DETERMINED THAT
NEED THAT ASSISTANCE FROM THE
STATE HOSPITAL. BECAUSE OF
LETTERMAN ACT. ARE WAITING FOR A
LONG TIME TO GET ACCESS TO THOSE
BEDS. ON AVERAGE WE DETERMINED
THERE WAITING AT LEAST A YEAR ON
AVERAGE TO GET A BET. ON IN SOME
CASES IT WAS LONGER THAN THAT
SOME OF THE EXAMPLES WE LOOKED
AT. SO ONE OF THESE INDIVIDUALS
WHAT ARE THEY FACED WITH WEALTH
WHICH WE TRY TO PROVIDE AS A
STATE. AT THE LOCAL LEVEL DO WE
HAVE BED SPACE AT THE LOCAL
LEVEL. AND THEN LOOKING AT LOS
ANGELES AGAIN SAN FRANCISCO IN
SHASTA WE ASK THEM WHAT KIND OF
CAPACITY DO YOU HAVE. AND
CONSISTENTLY THEY'RE SAYING WE
DON'T HAVE ENOUGH CAPACITY TO
PROVIDE SERVICES TO THESE
INDIVIDUALS. WHEN WE ASKED EACH
OF THE THREE COUNTIES. DO YOU DO
AN ANALYSIS OF. HOW MUCH YOU
KNOW THE NEED FOR BED SPACE. LOS
ANGELES HAD A VERY ROBUST
PROCESS WE DESCRIBED IN THE
REPORT. AND THEY ACTUALLY HAD
DONE AN ANALYSIS IN OCTOBER OF
TWENTY NINETEEN. INDICATING THAT
THEY NEEDED APPROXIMATELY
FIFTEEN HUNDRED ADDITIONAL BEDS.
TO BE ABLE TO PROVIDE THE
SERVICES INPATIENT SERVICES. FOR
INDIVIDUALS WHO NEED HELP. ON
SEPARATIST GO HAD NOT DONE THAT
TYPE OF ANALYSIS SHASTA WAS VERY
SMALL SO ON A MONTHLY BASIS THEY
WOULD COMMUNICATE- WITHIN THEIR
COMMUNITY AND WOULD UNDERSTAND
HOW HOW IF THERE WERE
INDIVIDUALS WAITING FOR A BED-
BUT A SMALL COUNTY WE REALLY
WANT TO LOOK AT A SMALL COUNTY
BUT LOS ANGELES HAD A VERY
ROBUST PROCESS SO THAT COULD BE
CERTAINLY BE USED AS A MODEL FOR
OTHER COUNTIES. TO DETERMINE HOW
MANY. BEDS ARE REALLY NEEDED FOR
THESE INDIVIDUALS. SO ONE OF THE
RECOMMENDATIONS WE HAD IS TO
REQUIRE STATE HOSPITALS TO
REPORT. AND WAS BY APRIL OF
TWENTY TWENTY ONE WE SHOULD JUST
REPORT IN JULY AND AS YOU KNOW
MEMBERS. IN OUR REPORTS NOW WE
SPECIFIED TIME FRAME- TO.
AGENCIES TO YOU NEED TO
ACCOMPLISH THIS BY THIS DATE AND
AT THAT POINT IN TIME WE SAID
APRIL OF TWENTY TWENTY ONE TO
IDENTIFY. HOW MUCH IT WOULD COST
THE STATE OF CALIFORNIA TO
EITHER IDENTIFY ADDITIONAL.
FACILITIES THAT COULD BE USED AS
STATE HOSPITALS TO PROVIDE EDS
FOR. YOU KNOW THE INCOMPETENT TO
STANDTRIAL BUT CERTAINLY THE
LPS INDIVIDUALS WHO ARE NEEDING
THAT INTENSIVE AN INPATIENT
TREATMENT. SO THAT WAS ONE OF
THE KEY RECOMMENDATIONS TO THE
STATE. WE ALSO SUGGESTED THAT
THE COUNTIES. DEVELOP WAYS TO-
DECIDE OR DETERMINE HOW MANY
BEDS THEY ACTUALLY NEED NOT ONLY
CURRENTLY BUT IN THE FUTURE TRY
TO ASSESS TRY TO PROJECT YOUR
NEEDS AND AGAIN LOS ANGELES
COUNTY I HAVE TO SAY. AND
BREEDING REPORT AGAIN THIS
WEEKEND REALLY DID HAVE A READ
ROBUST PROCESS TO DO THAT
ANALYSIS. SO WE THINK THAT NEEDS
TO HAPPEN. SO NOW IF SOMEONE
DOESN'T HAVE ACCESS TO A- BED AT
THE STATE LEVEL DOESN'T HAVE
ACCESS TO A BED AT THE LOCAL
LEVEL FOR INTENSIVE CARE. WHAT
HAPPENS TO THAT INDIVIDUAL. AND
ONE OF THE THINGS THAT WE
IDENTIFIED WHEN WE WERE
CONDUCTING THE WORK IS. PEOPLE
AS YOU I'M SURE HAVE HEARD OUR
CYCLING THEIR CYCLING IN CRISIS
THEY'RE IN A IN A SEVENTY TWO
HOUR HOLD THEIR RELEASED.
THERE'S NO BED SPACE AVAILABLE
FOR THEM PERHAPS WE CAN HAVE
THEM IN AN ASSISTED OUTPATIENT
TREATMENT I'LL TALK ABOUT THAT
IN A MINUTE. BUT WHAT WE WERE
SEEING IS A LOT OF. INDIVIDUALS
CONSISTENTLY CYCLING BECAUSE
THEY'RE NOT GETTING THE
TREATMENT THEY NEED EITHER AN
INPATIENT. A SITUATION OR
SCENARIO. OR THROUGH ASSISTED
OUTPATIENT TREATMENT. SOMEONE
TALKING TO THE COUNTIES WHAT WHY
AREN'T YOU ABLE TO NOT JUST THE
BED SPACE BUT WHY AREN'T YOU
ABLE TO PROVIDE SERVICES TO
THESE DIFFERENT INDIVIDUALS. AND
THERE ARE A VARIETY OF GAPS THAT
WERE IDENTIFIED MANY OF THE
COUNTIES INDICATED TO US. WE
DON'T EVEN KNOW ALL OF THE
INDIVIDUALS WHO ARE CYCLING
THROUGH EITHER SEVENTY TWO HOUR
HOLD. OR PERHAPS A FOURTEEN DAY
HOLD. SO WHAT WE DID IS WE DID
AN ANALYSIS WE HAD ACCESS TO
DATA. THE HEALTHCARE SERVICES
DOESN'T HAVE ACCESS TO WHICH IS
DEPARTMENT OF JUSTICE. WE'VE
DONE A LOT OF SAYS YOU KNOW OF
ARMED PROHIBITED PERSONS IN FACT
MR HARRIS WAS THE MANAGER ON
THAT PARTICULAR PROJECT. WHERE
MENTAL HEALTH FACILITIES ARE
REQUIRED TO REPORT TO JUSTICE AN
INDIVIDUAL WHO IS PLACED ON A-
FIFTY ONE FIFTY. THIS PERSON
SHOULD NOT HAVE THE RIGHT TO.
HAVING A WEAPON BECAUSE THEY ARE
DANGER TO HIMSELF OR OTHERS. SO
WHEN USING THE DEPARTMENT OF
JUSTICE DATA. WE IDENTIFIED FOR
SOME OF THESE COUNTIES YOU HAVE.
SEVENTY FOUR HUNDRED PEOPLE WERE
PLACED ON AT LEAST. FIVE OR MORE
HOLD OVER A TWO OR THREE YEAR
WINDOW THIS IS FOR LOS ANGELES
COUNTY. SO WE SAID HOW MANY OF
THOSE INDIVIDUALS THEY COULDN'T
GET A BED. HOW MANY OF THOSE
INDIVIDUALS ACTUALLY GOT ACCESS
TO. ASSISTED OUTPATIENT
TREATMENT A REALLY GOOD TYPE OF
TREATMENT. IT WAS TWO TWO OUT OF
TWENTY SOURCE ABOUT TEN PERCENT.
OF THOSE INDIVIDUALS WERE
GETTING THAT KIND OF CARE SO
AGAIN THOSE THOSE PEOPLE WHO ARE
NOT GETTING THAT KIND OF CARE.
AGAIN ARE GOING FROM. CRISIS
MODE TO CRISIS MODE TO PRICES
MOTHER NOT GETTING THE TREATMENT
THEY NEED. WE LOOK TO SAN
FRANCISCO IT WAS EVEN WORSE IT
WAS ONE OUT OF TWENTY
INDIVIDUALS. SO WHAT WE
DETERMINED IS A THIS IS
INFORMATION THAT THE COUNTY
NEEDS THE COUNTY NEEDS THIS TYPE
OF INFORMATION SO WE DID MAKE
SOME RECOMMENDATIONS. TO THE
LEGISLATURE. THAT WOULD REQUIRE
THE DEPARTMENT OF JUSTICE TO
PROVIDE THIS INFORMATION. TO THE
DEPARTMENT HEALTH CARE SERVICES
SO HEALTHCARE SERVICES WOULD
HAVE THE INFORMATION THAT IS.
ALREADY STATUTORILY REQUIRED TO
BE REPORTED TO JUSTICE SO GET
THAT INFORMATION TO HEALTH CARE
SERVICES SO HEALTHCARE SERVICES
CAN LOOK AT. THAT INFORMATION
AND SHARE IT WITH THE COUNTIES
AND SAY THESE ARE INDIVIDUALS.
WHO ARE PLACED ON A FIFTY ONE
FIFTY WERE REPORTED TO US THEY
CANNOT. HAVE A WEAPON BECAUSE
THEY ARE A DANGER TO THEMSELVES
AND OTHERS BUT WE NEED TO REACH
OUT TO THESE FOLKS TO TRY TO GET
THEM THE CARE AND TREATMENT THEY
NEED- SO WE SO WE MADE THAT
RECOMMENDATION. THAT JUSTICE BE
ABLE TO PROVIDE INFORMATION
HEALTHCARE SERVICES. HEALTHCARE
SERVICES USE THAT INFORMATION
AND WORK WITH THE LOCALS. THE
COUNTIES- DEPARTMENT SO THAT
THEY UNDERSTAND YOU THE
RESIDENTS IN THEIR COMMUNITIES
THAT NEED THIS KIND OF CARE SO
THAT THEY HOPEFULLY CAN. WORK
WITH THOSE INDIVIDUALS AND GET
THEM TO THE ASSISTED OUTPATIENT
TREATMENT. OR TO THE FULL
SERVICE PARTNERSHIPS GET THEM
THE CARE THEY NEED SO THEY STOP
CYCLING. SO SOME KEY
RECOMMENDATIONS THERE SO THEN WE
SAID OKAY WELL LET'S LOOK AT
ASSISTED OUTPATIENT TREATMENT
HOW EFFECTIVE IS THAT WHAT'S
BEEN PROVEN TO BE VERY EFFECTIVE
I'M SURE YOU'RE ALL AWARE OF
THAT. WHEN WE CONDUCTED THE
AUDIT WHAT WE DETERMINED IS AS
YOU KNOW THAT ASSISTED
OUTPATIENT TREATMENT IS A
VOLUNTARY COUNTIES CAN
VOLUNTARILY PARTICIPATE IN THAT
AT THE TIME WE CONDUCTED THE
AUDIT AND AT THAT TIME YOU'RE
ONLY NINETEEN OUT OF FIFTY EIGHT
COUNTIES THAT WERE USING
ASSISTED OUTPATIENT TREATMENT
THAT REALLY EMBRACED IT. WE ALSO
IDENTIFIED THAT THERE ARE
ELIGIBILITY REQUIREMENTS- WITHIN
THE LETERMAN ACT. THAT LIMITED
PEOPLE AND THIS IS WHAT MAKES-
IS EGGMAN'S BILL CORRECTED. IS
THAT AND WE FOUND THAT
INDIVIDUALS COMING OFF OF
CONSERVATORSHIP. THEY'RE DOING
BETTER THEY DIDN'T EVEN QUALIFY
FOR ASSISTED OUTPATIENT
TREATMENT BECAUSE YOU HAD TO
HAVE. YOU KNOW YOUR CONDITION
HAD TO BE DEGRADING. HER
LEGISLATION FIX THAT SO I THINK
THAT'S SIGNIFICANT IMPROVEMENT.
IN THE ABILITY TO PROVIDE THIS
ASSISTANT OUTPATIENT TREATMENT.
TO INDIVIDUALS WHO ARE COMING
OFF OF CONSERVATORSHIP BECAUSE
WHAT WE FOUND IS OF SIXTY
CONSERVATORSHIP. EIGHTEEN OF
THOSE INDIVIDUALS ENDED UP
COMING OFF OF CONSERVATORSHIP.
COULDN'T GET THAT ASSISTED
OUTPATIENT TREATMENT AT SYSTEM
CONTINUOUS CARE. WENT BACK INTO
CRISIS MODE WENT BACK INTO
CONSERVATORSHIP. A LONGER CYCLE
BUT STILL CYCLING- SO WE BELIEVE
THAT THAT LEGISLATION CERTAINLY
HAS HAS MADE AN IMPROVEMENT.
ANOTHER AREA RELATED TO CRITERIA
UNDER THE LANHAM AND PEPPERS-
SHORT ACT IS THE COURT ORDERED
MEDICATION- THIS IS ANOTHER
RECOMMENDATION THAT WE MADE IS
TO YOU KNOW PROVIDE EXPRESS A
STORY TO INCLUDE MEDICATION
REQUIREMENTS IN COURT ORDERED.
ASSISTED OUTPATIENT TREATMENT
PLANTS THIS IS SOMETHING THAT
HAS. IS AUTHORIZED IN OTHER
STATES I THINK WE IDENTIFIED
ABOUT TWELVE OTHER STATES THAT
ACTUALLY ALLOW FOR THIS AND IT
REALLY DOES HELP BECAUSE IT IT
REALLY ENCOURAGES AND IT'S A WAY
TO GET PEOPLE TO. THEIR
PARTICIPATING IN ASSISTED
OUTPATIENT TREATMENT IT'S A
LEAST LESS RESTRICTIVE
ENVIRONMENT THAN INPATIENT. IT'S
GOING TO HELP THOSE INDIVIDUAL
STAY ON THEIR MEDICATION AS WE
DISCUSSED IN THE AUDIT REPORT
MANY PEOPLE WHO RIVER RIVER
TENANTS BAD WORD BUT CYCLE BACK
IT'S BECAUSE THEY NO LONGER TAKE
THEIR TO THEIR MEDICATION. OR
THEY THEIR ILLNESSES SUCH THAT
THEY DON'T REALIZE THAT THAT
MEDICATION IS IMPORTANT FOR THEM
TO AVOID ENDING UP ON A- SEVENTY
TWO HOUR HOLD ENDING UP IN IN
PATIENT- TREATMENT SO. WE MADE
SOME RECOMMENDATIONS RELATED TO
THAT- AS FAR AS THE YOU KNOW
NINETEEN OUT OF FIFTY EIGHT
COUNTY'S AGAIN. MS EGGMAN'S BILL
AS FAR AS- OF REQUIRING COUNTIES
TO YOU KNOW BASICALLY PUBLICLY
OPT OUT OF USING ASSISTED
OUTPATIENT TREATMENT. PUT SOME
PRESSURE ON SOME COUNTIES QUITE
FRANKLY AND NOW INSTEAD OF
NINETEEN COUNTIES WE HAVE THIRTY
COUNTIES IN CALIFORNIA. THAT ARE
USING ASSISTED OUTPATIENT
TREATMENT AND THAT'S BASED ON
YOU KNOW RESEARCHERS EXPERTS NOT
AUDITORS THIS IS A VERY
EFFECTIVE TYPE OF TREATMENT NOW
IF WE CAN GO AHEAD AND GET THE-
THE OTHER. THE RECOMMENDATION WE
MADE TO PROVIDE EXPRESSIVE
SORTIE TO INCLUDE MEDICATION
REQUIREMENTS AND COURT ORDERED
TO A TREATMENT PLANT THAT'S WHAT
I THINK GOING TO MAKE THOSE
PROGRAMS EVEN MORE EFFECTIVE SO
THAT'S A RECOMMENDATION THAT WE
CONTINUE. TO EMBRACE AND SUGGEST
TO THE LEGISLATURE. SO THOSE ARE
THE KEY ISSUES RELATED TO
ASSISTED OUTPATIENT TREATMENT.
AND THE LAST THING AND THIS A
DOCTOR WHAT I THINK WILL TIE
INTO SOME OF THE QUESTIONS YOU
HAD FOR PREVIOUS YOUR SOME OF
YOUR FRUSTRATIONS. OR AUDITORS
WE WANT TO KNOW. THERE'S A LOT
OF FUNDING HERE'S WHEN WE
CONDUCTED THE AUDIT THERE WAS
ABOUT CLOSE TO EIGHT BILLION
DOLLARS BEING INVESTED. AND
MENTAL HEALTH SERVICES IN
CALIFORNIA EITHER THROUGH
REALIGNMENT MONEY. MEDI CAL
MONEY M. HSA MONEY BUT THERE
REALLY ISN'T A COMPREHENSIVE
FRAMEWORK IT'S VERY DISJOINTED
AS WE SAY IN THE REPORT. THERE
ARE DIFFERENT TOOLS DIFFERENT
REPORTING MECHANISMS BUT THERE
ISN'T AN OVER ARCHING.
COMPREHENSIVE CLEAR VIEW OF THE
INVESTMENT CALIFORNIA MAKES IN
MENTAL HEALTH SERVICES NOW
CERTAINLY THE MENTAL HEALTH
SERVICES ACT IS TERRIFIC FOR
CALIFORNIA THERE ARE CATEGORIES
THAT ARE COUNTIES HER MENTAL
HEALTH OFFICIALS AT THE LOCAL
LEVEL REQUIRED TO REPORT UP TO
THE OVERSIGHT COMMISSION IN
CALIFORNIA MY WHOLE SERVICES
ACCOUNTABILITY OVERSIGHT
COMMISSION HAS THOSE CATEGORIES
OF COMMUNITY SUPPORT PREVENTION
EARLY INTERVENTION INNOVATION AT
CETERA ETCETERAAND WE'VE DONE A
LOT OF TIME THAT AND AS MR
SANTIAGO MENTIONED EARLIER WE'VE
IDENTIFIED ON SPENT MONEY WE
TALK ABOUT IT IN THIS AUDIT
REPORT LOS ANGELES COUNTY
JUSTIN. PREVENTION AND EARLY
INTERVENTION COMMUNITY SUPPORT
AT THE END OF FISCAL YEAR
EIGHTEEN NINETEEN HAD CLOSE TO
EIGHT HUNDRED MILLION DOLLARS
UNSPENT FUNDS AND THAT'S
SEPARATE FROM THE RESERVE THAT
THEY'RE ALLOWED TO HOLD ON TO SO
THERE IS MONEY AVAILABLE OUT
THERE SO WHAT WE DID IS WHEN WE
LOOKED AT HOW DO WE HOW DO WE
COME UP WITH A COMPREHENSIVE
FRAMEWORK AND WHO SHOULD BE
RESPONSIBLE FOR. WE FELT THAT IT
NEEDED TO BE THE OVERSIGHT
COMMISSION AND THE REASON FOR
THAT IS THEY ALREADY HAVE SOME
RESPONSIBILITY FOR AN HSA MONEY.
THOSE CATEGORIES THEY'RE A BIT
TOO BROAD FOR CALIFORNIA TO
REALLY UNDERSTAND. THE
INVESTMENT IN MENTAL HEALTH
SERVICES. SO OUR RECOMMENDATIONS
WERE TO ASSIGN THIS PRIMARY
RESPONSIBILITY TO THIS OVERSIGHT
COMMISSION. REQUIRE THAT
COMMISSION TO WORK WITH STATE
AND LOCAL. EXPERTS MENTAL HEALTH
OFFICIALS- TO REALLY DENTIFY
THE MAJOR FUNDING SOURCES- WHAT
PROGRAMS THOSE FUNDING SOURCES
SUPPORT. WHAT OUTCOMES ARE WE
LOOKING FOR WHAT TYPES OF THINGS
SHOULD WE BE ASSESSING. AND
COLLECTING SO JUST I'M GOING TO
VERY QUICKLY GO THROUGH THE
RECOMMENDATION SO ASSIGNEE
OVERSIGHT COMMISSION THAT
RESPONSIBILITY. DEVELOP
CATEGORIES OF MENTAL HEALTH
PROGRAMS AND SERVICES FOR
EXAMPLE. IN PATIENT CARE VERSUS
INTENSIVE OUTPATIENT HOW MUCH
ARE WE SPENDING ON INPATIENT
CARE VERSUS OUTPATIENT THEN
IDENTIFYING SOME INDICATORS SOME
THAT WERE MENTIONED EARLIER THE
PERCENTAGE OF INDIVIDUALS HAVE
BEEN INCARCERATED DUE TO A
MENTAL ILLNESS OR SOMETHING THEY
ARE CRIME THEY COMMITTED DUE.
DUE TO MENTAL ILLNESS HOW MANY
REPEAT HOLDS HAS AN INDIVIDUAL
BEEN THROUGH. THE RATES OF
SUICIDE AMONG INDIVIDUALS
RECEIVING TREATMENT SOME
DIFFERENT INDICATORS TO BE ABLE
TO ASSESS HOW SUCCESSFUL
CALIFORNIA'S IN PROVIDING
SERVICES. TO THE MENTALLY ILL IN
OUR STATE. SO THAT WAS ANOTHER
RECOMMENDATION TO DIRECTLY
OVERSIGHT COMMISSION TO DEVELOP
THE STATE WIDE MEASURES AGAIN
WORKING WITH STATE AND LOCAL
OFFICIALS TO REALLY AND EXPERTS
TO UNDERSTAND WHAT CAN WE
MEASURE. AND WORK WHEN WE
DETERMINE WHAT WE WANT TO
MEASURE THAT TELLS YOU WHAT YOU
NEED TO COLLECT TO BE ABLE TO US
TO USE THAT MEASUREMENT. TO
ASSESS HOW SUCCESSFUL CALIFORNIA
IS. AND THEN TWO OTHER
RECOMMENDATIONS RELATED TO M. M.
HSA. AND ONE IS TO AMEND STATE
LAW TO SPECIFICALLY TARGET.
INDIVIDUALS WHO HAVE LEFT LPS
ACT HOLDS TO BE ABLE TO RECEIVE
SERVICES THROUGH AN HSA. SO
THOSE AT THAT WOULD REALLY TIE
INTO THIS ASSISTED OUTPATIENT
TREATMENT YOU CAN USE PREVENTION
AND INTERVENTION SERVICES OR
COMMUNITY SUPPORT SERVICES
FUNDS- FOR THESE INDIVIDUALS TO
BE ABLE TO PROVIDE THESE TYPES
OF SERVICES. TO INDIVIDUALS WHO
ARE COMING OFF OF THESE HOLD
BECAUSE THE INTENT OF THE ACT
AND I THINK. THE DESIRE FOR ALL
CALIFORNIANS IS FOR PEOPLE WHO
HAVE THESE ILLNESSES AND ON FOR
ARE PLACED ON A HOLD FOR THEIR
OWN PERSONAL SAFETY. TO GET THEM
THE HELP THEY NEED TO BE
SUCCESSFUL AND TO HAVE A VERY
ACCEPT SUCCESSFUL COMFORTABLE
LIFE IN CALIFORNIA SO. SO THAT
WAS ANOTHER RECOMMENDATION THAT
WE HAD AND THEN. FINALLY
ESTABLISH A GOAL AND MENTAL
HEALTH SERVICES ACT FOR
CONNECTING ALL INDIVIDUALS TO
COMMUNITY BASED PROGRAMS SO
WE'VE GOT THE FUNDING TO BE ABLE
TO PROVIDE IT. LET'S DETERMINE
THE INDICATORS HOWARD WHAT
OUTCOMES WE WANT TO WE WANT TO
ACHIEVE. AND THEN WHAT TYPE OF
DAY WE NEED TO COLLECT BUT MAKE
IT ABUNDANTLY CLEAR AND THAT
MENTAL HEALTH SERVICES ACT THAT.
THESE INDIVIDUALS ARE SPECIFIC
INDIVIDUALS THAT WE WANT THESE
FUNDS TO BE USED FOR AND TO
SUPPORT. SO WITHOUT MEMBERS. I
WILL ALLOW ABOUT TO ANSWER ALL
YOUR DIFFICULT QUESTIONS. THANK
YOU VERY MUCH. THANK YOU
HUNDREDS OF COUPLE QUESTIONS ON.
DID YOU GET A SENSE IS IT. YOU
WERE TALKING TO THE COUNTIES. HE
SAID THAT THERE ARE NINETEEN
COUNTIES THAT HEAD OFFICE IS
THAT A PATIENT TREATMENT AND THE
OTHERS HAD AND NOW THAT IT'S
INCREASED. WHAT WERE SOME OF THE
REASONS WHY DID YOU GET. A SENSE
OF THAT. BUT HARRIS FOR THE
STATE AUDITOR'S OFFICE SIR. BUT
THE THREE COUNTIES WE AUDITED
HAD ALREADY EITHER IMPLEMENTED
A. O. T. OR A PILOT VERSION OF
IT. SO WHAT WE DID TO TAKE A
LOOK AT WHY SOME COUNTIES MAY
NOT BE IMPLEMENTING A O. T. AT
THE TIME AS WE LOOK AT THREE
OTHERS THAT- HAD NOT YET AT
LEAST YOU COUNTY WAS ONE OF
THEM- AND I'M- NOT REMEMBERING
THE OTHER TWO OFF THE TOP OF MY
HEAD BUT WE DID TAKE A LOOK AT
THEIR- PUBLIC DISCUSSIONS ABOUT
WHETHER TO ADOPT A T. AT THE
TIME THE CONCERNS ESSENTIALLY
BOIL DOWN TO TWO FACTORS ONE WAS
COST. AND THE OTHER WAS SOME
CONCERN THAT THIS WOULD BE A
DUPLICATION OF SERVICES SO THOSE
ARE THE CENTRAL REASONS WE
DETERMINED. THERE MIGHT BE
RESISTANCE TO ADOPTING ANTI.
OKAY AND THEN THEN THAT MAKES
SENSE- JUST WONDERING ABOUT THAT
YOU TALK ABOUT THE FRACTURE THE
MENTAL HEALTH SYSTEM I THINK
THAT'S SOMETHING THAT. WE'VE
BEEN REALLY STRUGGLING WITH OVER
THE LAST NUMBER OF YEARS AT
LEAST THOSE OF US IN THE
LEGISLATURE AND- GOES BACK
DECADES. AS THE SYSTEM HAD BEEN
DISMANTLED ESPECIALLY
DISMANTLING THE STATE HOSPITALS.
THERE WAS NOTHING BUILT BACK UP
I THINK THERE WAS SUPPOSED TO
BE. A INCREASING CAPACITY AT THE
LOCAL LEVEL TO PROVIDE EXACTLY
THE BEDS AND THINGS THAT YOU'RE
THAT YOU'RE TALKING ABOUT THAT'S
REALLY NEVER HAPPENED AND SO
WE'VE ENDED UP WITH A FRACTURED
SYSTEM. AND I THINK WE'LL
DISCONNECT BETWEEN STATE AND
LOCAL AUTHORITIES. AND ABILITIES
. MARULA LACK OF SO. OF COUNTIES
THEY'VE BEEN. WITH THIS BECAUSE
AND IT'S INTERESTING YOU LOOKED
AT SOME LARGE COUNTIES AND YOU
LOOK AT SOME SMALL COUNTIES. I
THINK THEY'RE FROM VERY
DIFFERENT IMPLEMENTATION
QUESTIONS LARGE COUNTIES TO
SMALL COUNTIES. AND THEIR
ABILITY TO MANAGE THE POPULATION
THAT THEY'RE SUPPOSED TO SO IN
IN YOUR SENSE WITH THE COUNTIES
YOU DID TALK TO THAT AYE IT
ASKED THE AGENCY EARLIER ABOUT
ABOUT A BACKLOG THEY SAID THERE
IS NO BACKLOG ALTHOUGH IN AS I'M
DEALING WITH AND TALKING TO TWO
COUNTIES THEY'RE VERY FRUSTRATED
WITH THE LICENSING PROCESS SO
FROM YOUR SENSE IN THE DATA THAT
YOU LOOKED AT AND TEN PART OF
HIS HEARING HAS REALLY REVEALED.
SOME SIGNIFICANT DATA
DISCREPANCIES WHICH ARE
CHALLENGING AND YOU WERE ABLE TO
GO INTO DEPARTMENT OF JUSTICE
AND GET INFORMATION THAT DACA'S
DID NOT HAVE AND WE DO SO MUCH
IN THE STATE IN SILOS IS REALLY
FRUSTRATING N. IN IN HIS OR THE
ABILITY OF THE RIGHT INFORMATION
GETTING TO THE RIGHT. DECISION
MAKERS AT THE RIGHT TIME IN
ORDER TO EFFECTUATE THIS AND
SOME OF THE REASONS ARE GOOD A
LOT OF THE REASONS OR JUST
BECAUSE OF HOW WE'VE ALL DONE IT. OR BUREAUCRACIES OR OR
WHATEVER. BUT IF YOU'RE DEALING
WITH THE COUNTY THAT LEAST THE
SUBSET THAT YOU LOOKED AT ARE
THEY GETTING. THE ARE THEY ABLE
TO GET THE FACILITIES THEY FEEL
THAT THEY NEED LICENSE AND UP TO
SPEED TO BE ABLE TO PROVIDE
THESE SERVICES. SO WHAT WOULD
THERE'S- THERE'S A BIT OF A
DISCONNECTED I'M NOT SURE I
QUITE UNDERSTAND. RIGHT SO WE
DIDN'T LOOK AT THE LICENSING
COMPONENT- IN TERMS OF THE
DEPARTMENT PUBLIC HEALTH THIRD.
HEALTHCARE SERVICE NICE I THINK
NUMBERS OF FACILITIES THAT
CORRECTIVE REALLY DIFFERENT
FACILITIES ONLINE AS NEEDED.
RIGHT SO WE DID LOOK AT THE
HEALTH CARE SERVICES PROCESS FOR
APPROVING DESIGNATED FACILITIES
CONDUCTING INSPECTIONS OF
DESIGNATED SO AS WE DON'T HAVE
ANY CONCERNS THAT WE FOUND IN
THAT AREA EVERYTHING SEEMED OKAY
TO US IN THAT AREA SO. I DON'T
THINK WE HAVE ANY OBSERVATIONS
RELATED TO A BACKLOG OR PENDING
DEMAND FOR FACILITY DESIGNATION
THERE ARE CERTAINLY THOUGH THE
CONCERNS WE NOTED ABOUT BED
CAPACITY GENERALLY- ONE OF THE
WAYS YOU COULD ADDRESS THAT IS
BY BRINGING MORE FACILITIES
ONLINE BUT WE DIDN'T SEE. A LOG
JAM OR A PROBLEM WITH GETTING
THOSE FACILITIES APPROVED. OKAY
SO YES I'M STILL KIND OF SCRATCH
MY HEAD ABOUT WHAT WHAT. WHERE
THE DISCONNECT IS. IS OUR
COUNTIES. NOT ASKING FOR THE
RIGHT FACILITIES DO WE NOT HAVE
THE RIGHT MIX OF FACILITIES- AND
SOME OF IT'S GOING TO BE FUNDING
RELATED AND OTHERS AND I DON'T
KNOW THAT YOU CAN NECESSARILY
ANSWER THAT BUT THAT'S THAT IS A
COMPONENT HERE THAT THAT I THINK
NEEDS TO REALLY BE THE LOOKED AT
AND ADDRESSED AND FROM WHAT YOU
FOUND ME ONE OF THE UNDERLYING
REASONS THAT WE'RE HAVING THIS
HEARING IS SOME REQUESTS TO
EXPAND. DEFINITION OF GRAVELY
DISABLED SO FOR EXPANDING. THE
DEFINITIONS TO BRING MORE PEOPLE
INTO THE L. P. S. KIND OF
AUTHORITY. JUDGING BY WHAT YOU
HAD SEEN WHAT WHAT WOULD BE THE
IMPACT ON THE SYSTEM FOR DOING.
THAT BUT THE WHAT WE'VE SEEN IS
THE SYSTEM'S ALREADY. STRAINED
TO COMPLETELY UNABLE IN SOME
CASES THEY HANDLE THE- DEMAND IF
YOU WILL OR THE NEED FOR BEDS-
SO. THE LOGICAL CONCLUSION IS
WIDENING THE POOL OF PEOPLE WHO
WOULD NEED THOSE BEDS ARE NEED
THOSE SERVICES WOULD PUT FURTHER
STRAIN ON THE SYSTEM. EVERYTHING
FROM YOUR RECORD THAT. YOU'RE
CLEARLY POINTING OUT SOME OF THE
WEAKNESS IS THE SYSTEM THAT
WOULD PROBABLY E BETTER SERVED
TO BOLSTER AND SUPPORT AND
WHETHER OR NOT THAT'S FUNDING
FOR KIND OF SETTING BETTER
FRAMEWORKS BEFORE WE REALLY
EXPANDS. ELIGIBILITY BECAUSE
THAT RIGHT THERE REALLY BEGS THE
QUESTION OF WHERE WITH THOSE
FOLKS GO AND HOW ARE THEY
ULTIMATELY GOING TO BE SERVED SO. AND THEN AFTER I MET THANK YOU
TO OUR SON I'D LIKE TO FOLLOW UP
ON- THE PERMITTING IF IT'S NOT
LICENSING HERE AT THE STATE IS
THERE ANYTHING HAPPENING AT THE
LOCAL LEVEL THAT MAY BE
PROHIBITING AN APPROVAL PROCESS
SUCH AS NIMBYISM REGARDING
HAVING- THESE FACILITIES. IN THE
COMMUNITY. SO AND FORCE I DON'T
THINK WE HAVE AN ANSWER FOR THAT
WE DIDN'T LOOK SPECIFICALLY AT
THE COUNTY PROCESSES FOR
DESIGNATING FACILITIES AND
WHETHER THERE IS. OBSTACLES IN
THAT AREA. I WILL HIGHLIGHT FOR
MY COLLEAGUES THAT ON PAGE
TWENTY THREE OF THE HAND OUT
THERE IS SOME INFORMATION
REGARDING. THE CONCERN ABOUT
NIMBYISM- AND- THE NEED FOR US
TO HELP TO REMOVE SOME OF THE
RED TAPE AND SO I HOPE TO FOLLOW
UP WITH MANY OF US TO FIGURE
OUT. HOW WE CAN HAVE THESE
CONTINUE ONCE BUILT OUT. I THINK
IT'S IMPORTANT IF WE HAVE
INVESTED BILLIONS OF DOLLARS TO
MAKE SURE THAT THESE FACILITIES
ARE GOING TO THE VERY
COMMUNITIES THAT. NEED THEM THE
MOST. I'M WOULD LIKE TO FOLLOW
UP ALSO ON THE SEILING OF
INFORMATION I THINK IT WAS A
POWERFUL STATEMENT REGARDING
THAT DOJ HAD THE INFORMATION BUT
THE IT'S THE US DID NOT. AND SO
I'M WONDERING IF THERE'S
ANYTHING WE CAN DO TO. ENCOURAGE
THE PARTNERSHIP BETWEEN THE
DEPARTMENT OF HEALTH CARE
SERVICES AND ARE CUNTY PARTNERS
TO. MAKE SURE THAT THOSE WHO ARE
LEAVING THE L. P. S. ACT HOLDS
ARE ABLE TO RECEIVE THOSE
RESOURCES THAT ARE NEEDED- ARE
THERE SPECIFIC RECOMMENDATIONS
HE WOULD HAVE FOR US TO FOLLOW
UP ON. YEAH THERE ARE SO OUR
RECOMMENDATIONS SPECIFICALLY WAS
THAT THE INFORMATION SHARING IS
ALREADY REQUIRED TO OCCUR AND IS
OCCURRING BETWEEN THE DESIGNATED
FACILITIES IN THE DEPARTMENT OF
JUSTICE. UNDER TWO OF THE THREE
HOLD CRITERIA THAT'S DANGER TO
SELF IMAGE DANGER TO OTHERS.
THAT INFORMATION ALREADY FLOWS
UP TO THE STATE LEVEL OUR
RECOMMENDATION IS THE STATE
DEPARTMENT OF JUSTICE AND THE
STATE DEPARTMENT HEALTHCARE
SERVICES SHARE THAT INFORMATION
SPECIFICALLY JUSTICE SHARES WITH
HEALTHCARE SERVICES. AND THAT
HEALTHCARE SERVICESTHAN IN PART
PARTNERING WITH THE COUNTY
SHARES IT DOWN TO THE COUNTY
LEVEL. THAT WOULD GET YOU THAT
THE INDIVIDUALS HELD ON THE
FIRST TWO CRITERIA. THERE WOULD
NEED TO BE A CHANGE TO STATE LAW
ALSO TO REQUIRE THE FACILITIES
TO REPORT DIRECTLY TO HEALTH
CARE SERVICES ABOUT. INDIVIDUALS
HELD UNDER THE GRAVELY DISABLED
CRITERION. WHICH THEY COULD THEN
REPORT BACK DOWN TO THE
COUNTIES- THERE WOULD ALSO NEED
TO BE CHANGES TO STATE LAW WITH
RESPECT TO WHAT HEALTHCARE
SERVICES ALLOWED TO POSSESS
BECAUSE THEY ARE CURRENTLY
PROHIBITED FROM POSSESSING
PERSONALLY IDENTIFYING
INFORMATION. WHICH THIS WOULD
CERTAINLY INCLUDE BUT IT WOULD
IT IT WOULD BE IN SERVICE OF
GETTING THAT INFORMATION TO THE
COUNTIES TO AS YOU. INDICATED
ALLOW THOSE COUNTIES TO CONTACT
THOSE INDIVIDUALS KNOW THAT THEY
WERE EVEN HELD RIGHT NOW
COUNTIES DON'T EVEN KNOW THE
FULL SOME OF INDIVIDUALS HELD.
SO THAT THEY COULD TRY AND
CONNECT THEM MORE EFFECTIVELY
WITH SERVICES POST HOLD. AND IT
SEEMS THAT PART OF YOUR
RECOMMENDATION WAS REGARDING AS
WELL THE MHSAA FUNDS AND I'M
WONDERING IF THERE'S ADDITIONAL
FLEXIBILITIES THAT. WE MAY NEED
TO. PROVIDE SO THAT COUNTIES CAN
USE THESE FUNDS FOR. THOSE AFTER
THE L. P. S. ACTON HOPING.
PROVIDING MORE. CONTRITE SO
WE'RE WE'RE RECOMMENDING THAT
THE INDIVIDUALS WHO ARE LEAVING
LPS HOLDS BE IDENTIFIED AS A
PRIORITY TARGET POPULATION UNDER
THE MHA SAY AND THAT THE GOAL BE
TO CONNECT THEM ALL WITH. POST
HOLDS TREATMENT- THERE IS SORT
OF A BRIGHT LINE IN THE IMAGE TO
SAY RIGHT NOW ABOUT PAYMENT FOR
INVOLUNTARY CARE WE'RE NOT
RECOMMENDING A CHANGE TO THAT
BUT WE DO THINK THAT THE POST
HOLD CARE NEEDS TO BE A PRIORITY
UNDER THE AMBITIOUS I- SINCE WE-
KERN. ARE RECEIVING ANYWHERE
FROM ONE TO TWO OUT OF TWENTY
WHO ARE RECEIVING RESOURCES POST
LPS ACT OLD. IS THERE A GOAL WE
SHOULD FOCUS ON AS A STATE AND
WHAT TYPE OF TIME FRAME DO YOU
THINK WE SHOULD LOOK TOWARDS. WE
DON'T HAVE A SPECIFIC GOAL- WE
DID LOOK AT AS YOU SAID TO SORT
OF RATE AT WHICH PEOPLE ARE
CONNECTED TO POST HOLD CARE. WE
LOOK AT THE WAY THAT- AND
THE STATISTICS THAT YOU'RE
CITING WE ALSO LOOKED AT JUST IN
GENERAL NOT IN THE GLOBAL
POPULATION BUT ALSO IMPROVE BUT
SPECIFICALLY IN THE- SAMPLE THAT
WE TOOK FIVE INDIVIDUAL CASE
FILES REVIEW. WERE INDIVIDUALS
AFTER THEIR HOLD IN THE TWO
WEEKS FOLLOWING THEIR HOLD
OFFERED ANY SERVICES AT ALL NOT
JUST THE FULL SERVICE
PARTNERSHIPS OR THE ASSISTED
OUTPATIENT TREATMENT WHICH ARE
THE MORE INTENSIVESERVICES BUT
ANY KIND OF. CONTACT WITH THE
COUNTY FOR ADDITIONAL SERVICES
AND FOUND SORT. POOR RATES OF
CONTACT POST HOLD JUST FOR EVEN
ANY OFFER OF SERVICES SO WE
DON'T HAVE A GOAL SPECIFICALLY
BUT CERTAINLY WHAT'S HAPPENING
RIGHT NOW DOESN'T APPEAR
SUFFICIENT. I WILL IN MY
QUESTIONS IF I CAN JUST BY
COMMENTING THAT THIS DOES NOT
APPEAR TO BE AN ISSUE WITH THE
LPS AFTER ALL. OF THIS IS A
SYSTEMS ISSUE THAT WE NEED TO
ADDRESS TO ENSURE THAT PEOPLE
ARE. RECEIVING THE RESOURCES
BETTER COORDINATION AMONG SO
MANY PARTNERS AND- THANK YOU-
STATE AUDITOR ELAINE HOWLE FOR
YOUR SERVICE TO OUR STATE AND WE
ARE GOING TO MISS YOU. THANK YOU
. THANK YOU PROTECT EGGMAN.
THANK AND I'D ALSO LIKE TO ECHO
DR AMBULANCE THANKS TO OUR STATE
AUDITOR- AND YOU MAY NOT KNOW
THIS BUT- MANY PEOPLE THINK OF
YOU AS MY DOPPELGANGER- ME AS
YOURS AND WE HAVE BEEN MISTAKEN
FOR EACH OTHER UPON UPON MANY
OCCASION BY EVEN BY SOME OF MY
PEERS AND I'M ALWAYS HONORED
WHEN THEY WHEN THEY WHEN THEY
SAY I WAS GREAT AT A HEARING
THAT I KNOW THEY'RE NOT TALKING
TO ME- SO THANK YOU SO THANK YOU
FOR YOUR WORK IN THE STATE OF
CALIFORNIA WILL CERTAINLY MISS
YOUR SERVICES- AND I THINK YOU
KNOW AS WELL AS WERE AS WE'RE
TALKING ABOUT THIS AND I AND I-
AND I HEAR MR. MIGHT BE PURE
MISTER STONES QUESTIONS- AND I
DON'T THINK ANYBODY IN THIS ROOM
IS LOOKING TO YOU KNOW HOLD MORE
PEOPLE AGAINST THEIR WILL I
THINK EVERYBODY IN THIS ROOM IS
LOOKING TO HELP AS MANY PEOPLE
AS WE POSSIBLY CAN IN OUR IS
DISTRESSED AS THE PUBLIC BY WHAT
WE SEE EVERY SINGLE DAY IN THE
STREETS- I WOULD I WOULD SAY
WITHOUT EXCEPTION THAT IS
EVERYBODY'S GOAL- AND IN THE
MORE OF COURSE WE TALK ABOUT IT
AND THE MORE. YOU KNOW BECOMES
QUITE APPARENT THAT WE HAVE A
HUGE BREAKDOWN OF OUR ENTIRE
SYSTEM I THINK YOU KNOW TWO
THINGS CAN BE TRUE RIGHT AT THE
COUNTIES DON'T HAVE ENOUGH
FUNDING TO DO IT- AND WE'VE
GIVEN THE CAN IS A TON OF MONEY
TO DO IT I MEAN BOTH OF BOTH
THOSE THINGS ARE TRUE AND SO
CLEARLY THERE'S A DISCONNECT AND
A BREAK DOWN AT SOME LEVEL- THE
LACK OF AVAILABILITY OF- OF STEP
DOWN CARE OF STEP DOWN FUNDING
OF STEPPED OUT HOUSING- WE HEARD
FROM PEOPLE WHO WHO HAVE
EXPERIENCED- THE WHOLE.
THEMSELVES AND I'M SURE WE'VE
ALL TALKED TO MOTHERS. WHO ARE
MOTHERS OF. FORTY FIFTY YEAR OLD
OF CHILDREN WHO ARE STUPID CAT
OFFSPRING WHO ARE STILL.
STRUGGLING TO FIND SAFE PLACES
TO LIVE DESPITE BEING ON OUR
SYSTEM. FOR THE ENTIRETY OF
THEIR ADULT LIVES AND THAT AND
THAT'S NOT GOOD FOR ANYBODY- SO
I THINK I THINK WHAT WE WERE ALL
JUST COMING DEEPER AND DEEPER TO
REALIZE IS. IS A WELL L. PS MAY
NOT BE THE SPECIFIC PROBLEM IT
HAS SERVED AS A SOLUTION FOR
SOME. IN A TEMPORARY FASHION BUT
IT IS ONLY. FOR A TEMPORARY
PERIOD OF TIME AND UNLESS WE
HAVE THE COMMUNITY SUPPORTS. AS
I WOULD LIKE TO I THINK WE HAVE
AS A AS A SOCIETY AS A STATE WE
HAVE FAILED. ON TO BE ABLE TO
PROVIDE THAT STEP DOWN CARE THAT
IS SO NEEDED. I THINK WE MUST DO
A BETTER JOB BECAUSE WE'RE ON
THE COMMUNITY. THE COUNTIES ARE
TELLING US THEY CAN'T GET THINGS
LICENSE THEY CAN'T GET THAT
PERMIT FROM THE STAFF AT THE
STATE THEY CAN'T. ALL THESE
BARRIERS THEY'RE EXPERIENCING
FROM THE STAFF FROM THE STATE.
STATE TELLING US THERE THERE'S
NO BACKLOG THERE'S NO. WE DON'T
UNDERSTAND- SO IT'S POLICYMAKERS
WE SET UP HERE AND SCRATCH YOUR
HEAD. BECAUSE WE'RE ALL LOOKING
TO KICK DOWN BARRIERS IF WE
POSSIBLY CAN. TO MAKE THINGS
BETTER. AND SO I CAN THINK WE
KEEP COMING BACK TO THE SAME
POINT LIKE WHAT IS IT THAT. THEN
THAT WE SHOULD BE DOING BESIDES
. AND I AM SAY IT. LIKE AGAIN AT
THE I DON'T KNOW WE NEED TO
DECISION ON THE GOVERNOR THE-
STATE OF DEPARTMENT HEALTH AT
LEAST THERE WAS SOME KIND OF
BACKSTOP- AND I'M NOT ABOVE LIKE
SUGGESTING THAT MAYBE. FOR
TEMPORARY TIME WE GO BACK AND BE
ABLE TO JUST. I MEAN. WE NEED TO
BE ABLE TO TREAT THESE PEOPLE
WHO ARE NOT. IN EVERYBODY'S
COUNTY IT IS IT IS. WE SHOULD
NOT. HAVE TO GO TO THE
DEPARTMENT OF JUSTICE. BECAUSE
THAT WHEN PEOPLE ARE. IT FOR THE
DEPARTMENT OF JUSTICE OR OR
BEING HELD AGAINST HER WILL
THAT'S ALREADY FAR DOWN THE
LINE. THAT IS ALREADY FAR DOWN
THE LINE. IF WE DON'T EVEN KNOW
HOW MANY PEOPLE THOSE ARE
IMAGINE HOW MANY PEOPLE WE DON'T
KNOW ON THE FRONT END.
ESPECIALLY AS WE KNOW THE CRISIS
COMING UP RIGHT NOW IN OUR
SCHOOLS AND- AND WITH OUR KIDS
SO. I GUESS NOW I'M REALLY NOT
BE LANE HOME BECAUSE I'M NOT
BEING DIRECT AT ALL- BUT JUST TO
SAY. I THINK ALL OF US ARE
DEDICATED AND CERTAINLY
INVESTED- NOT JUST TO EXPAND LPS
THAT IS NOT ANYBODY'S GOAL JUST
TO EXPAND THE- AMOUNT OF PEOPLE
WERE HOLDING AGAINST THEIR WILL.
OUR GOAL. IS TO HELP AS MANY
PEOPLE AS WE POSSIBLY CAN NOT
REACH THAT LEVEL. AND TO BE ABLE
TO LEAD A GOOD EFFECTIVE LIVE SO
I THINK ALL OF US WILL CONTINUE
TO LOOK AT LEGISLATION AND
OVERSIGHT OVERSIGHT OVERSIGHT- I
THINK I THINK THE COUNTIES AND I
ARE GOING TO. WE'RE GOING TO SEE
EACH OTHER A WHOLE LOT THIS THIS
COMING YEAR. ABOUT HOW THIS
MONEY IS BEING SPENT. I THINK
THE IDEA I HAVE BEING- PERHAPS
IMAGES A AND TOTALING AND THAT
OVERSIGHT COMMITTEE LOOK AT ALL
THOSE STEP DOWNS AND- I DID A
PIECE OF LEGISLATION LAST YEAR
FOR SIXTY FIVE THAT WHAT WE
REALLY LOOK. AT AND WHERE ALL OF
THAT BUT BUDGET MONEY IS GOING-
BECAUSE WE ARE AT AN INFLECTION
POINT I THINK IN OUR SOCIETY- IN
OUR- IN OUR CARE OF PEOPLE IN
OUR POLITICS AND- EVERYTHING AND
IT'S- I THINK. INCUMBENT UPON US
TO REALLY GET THIS RIGHT. AGAIN
IT WE'RE GONNA HAVE A HISTORIC
AMOUNT OF MONEY LET US ALL
PLEASE USE IT TO THE BEST OF OUR
ABILITY TO HELP AS. MANY PEOPLE.
AS POSSIBLE. THANK YOU. ALL
RIGHT BACK TO THE KIDS GREAT
WELL THANK YOU AND I WANT TO SAY
YOU TO- FOR YOUR SERVICE- MUCH
APPRECIATE YOU ARE ACTUALLY- YOU
TWO WERE- ACTUALLY-
MISIDENTIFIED EARLIER TODAY BY
SOMEBODY SO IT CONTINUES RIGHT
UP TO THE RIGHT UP TO THE MOMENT
HERE I HAVE TO SANTA CLARA SO
BUT- JUST APPRECIATE APPRECIATE
VERY MUCH THE APPROACH THIS
AUDIT HAS LED TO LEGISLATION
WHICH I BELIEVE HAS HAS IS HAS
AND IS. AND WILL MAKE
IMPROVEMENTS TO THE SYSTEM BUT-
OBVIOUSLY. OBVIOUSLY WE HEAR IT
FROM OUR CONSTITUENTS THE
CHALLENGES THAT WE FACE AND-
AND- AND IT IT AND SOME OF THESE
PROBLEMS SEEM TO BE MORE SAY SEE
THEY FEEL MORE INTRACTABLE- AND
PART OF IT FROM I'LL KEEP COMING
BACK TO THIS IS THE SORT OF. THE
FEELING OF A LACK OF
COORDINATION- THROUGH THIS AND-
SOMEBODY I DON'T CARE WHO AND
WHY DO CARE OF ACTUALLY ABOUT.
SOMEBODY NEEDS TO BE IN YOU KNOW
OR SOME ENTITY WHETHER IT'S A
COMMISSION OR WHATEVER NEEDS TO
BE- MORE ACTIVELY- ENGAGED IN A
LEADERSHIP LEVEL- TO. TO HELP
SOLVE SOME OF THESE INTRACTABLE
PROBLEMS. FOR THE BENEFIT OF THE
PEOPLE WHO ARE SUFFERING THAT'S
THE BOTTOM LINE THANK YOU AGAIN.
TO MY COLLEAGUES FOR RE
EMPHASIZING THAT SO THANK YOU.
WITH THAT WE WILL MOVE ON TO OUR
NEXT PANEL AND WE'RE GOING TO
TRY TO MEMBERS IT'S BEEN AN
HONOR. OKAY OKAY- WE'RE GONNA
MOVE ON INTERNET PANEL AND-
OBVIOUSLY THIS IS GENERATE A LOT
OF INTEREST AMONG MEMBERS AND I
AND I. AND I APPRECIATE ALL THE
QUESTIONS AND I'VE BEEN
RESPONSIBLE FOR SEVERAL AS WELL.
SO WE'RE GONNA MAKE THIS NEXT
ROUND A LITTLE BIT MORE LIKE A
LIGHTNING ROUND- FOR THE FOLKS
THERE. AND SO- IS- IS ALEX IN
THE RIVER YEAH COME ON UP TO THE
COME ON UP HERE. SO WHAT WE
WOULD LIKE THIS PANEL TO FOCUS
ON IN THEIR AND THEIR FIVE
MINUTE REMARKS SO. IS WHAT ARE
THE OBSTACLES- TO IMPLEMENTATION
OF THE LPS AND WHAT ARE THE PAIN
POINTS WHERE WHERE ARE YOU
FINDING THAT THIS IS THAT THE
VEHICLES WHICH WHICH MAY BE
RELATED BUT IT MAY NOT- SO WHERE
IS AND WE'RE AND WE'RE GONNA-
ACTUALLY YOU'RE NOT GOING TO BE
FIRST THOUGH. YOUR TALISMAN
APPRECIATE THAT YOU'RE HERE. WE
GOT ONE WE'RE GOING TO STAY
THERE STAY THERE DON'T ME. WE
HAVE SOMEBODY WHO'S OUT OF THE
SOMEONE WHO WANTS TO IS GOING TO
SPEAK SO WE'RE GONNA MOVE JULIA
WALLACE UP TO THE TOP OF THE
LIST. FOR FIVE MINUTES AND THEN-
SO- WHENEVER YOU'RE READY I MISS
WALLACE. HELLO ALL RIGHT. SORRY
I'M LIKE TRYING TO FIGURE OUT.
HOW TO. START THE VIDEO AS WELL
OKAY GREAT- YES MY NAME IS.
JULIA WALLACE I'M A COMMUNITY
HEALTH WORKER AND I'M SPEAKING
AS A MEMBER OF SEIU LOCAL SEVEN
TWENTY ONE. I REALLY WANT TO
THANK. BOTH OF THOSE SPEAKERS OF
RELATED EXPERIENCE- THANK YOU SO
MUCH FOR SHARING THAT IT WAS
VERY BELL HOOKS AND APPRECIATE
IT- SO I WANTED TO SPEAK AS A
WORKER I'VE WORKED AT HAVE OVER
FIFTEEN YEARS OF EXPERIENCE
WORKING WITH PEOPLE- WITH
BEHAVIORAL HEALTH CHALLENGES AND
SOME OF THEM WITH SEVERE MENTAL
HEALTH DISABILITIES I ALSO
ASSISTED. PEOPLE WHO BEEN- WHO
HAVE BEEN PUT ON HOLD ONE OF
THEM IN PARTICULAR THAT I'M
THINKING OF- THE AUDITORY
HALLUCINATIONS CAUSED THEM TO.
COMMIT ASSAULTIVE AND VIOLENT
BEHAVIORS- BUT MOST OF THE
PEOPLE THAT I'VE WORKED WITH.
EVEN THOSE WITH SEVERE MENTAL
HEALTH DISABILITIES WHO WERE NOT
NECESSARILY MED COMPLIANT I
WOULD NOT RECOMMEND
CONSERVATORSHIP FOR THOSE FOLKS
ARE WOULDN'T THINKING
CONSERVATORSHIP WAS APPROPRIATE.
THERE'S SO MANY REASONS WHY
PEOPLE ARE REPEAT- USING
HOSPITALS- AND REPEAT
HOSPITALIZATIONS SOME OF THEM
ARE BECAUSE WHEN THE FOLKS ARE
PUT ON A FIFTY ONE FIFTY SEVENTY
TWO HOUR HOLD. OFTENTIMES THAT.
BIG BABY FEEL BETTER THAN THEY
DID WHEN THEY WERE PUT ON HOLD
BUT IT REALLY WASN'T EFFECTIVE
IN TERMS OF THE UNDERLYING
ISSUES AND SOME OTHER
PARTICIPANTS HAVE SPOKEN ABOUT
THAT- WHAT A LARGER ISSUE I
THINK IS. IN THE IDEA OF
EXPANDING L. P. S. WHERE IS THE
INFRASTRUCTURE WHERE IS THE
STAFFING. PEOPLE HAVE MANY KINDS
OF IDEAS A POLICY BUT FRANKLY
WE'RE FACING THE GREAT
RESIGNATION WITH IN MENTAL
HEALTH SERVICES- ARE LEAVING
MENTAL HEALTH SERVICES BECAUSE
IT NOT ONLY ARE THEY NOT BEING
PAID ENOUGH BUT BECAUSE THEY'RE
FACING THEIR OLD MENTAL HEALTH
CHALLENGES AND THEY'RE DEALING
WITH A VERY STRESSFUL JOB.
INCREASING CASELOADS AND SO
THERE ISN'T EVEN THE PROCESS IN
TERMS OF WORKERS TO BE ABLE TO
SERVE MANY OF THESE POPULATIONS
I WORK IN SERVICE AREA FOR I
HAD- WHICH IS WHERE IN LOS
ANGELES- WHICH IS SKIDROW CREEK
TOWN NEED CITY- DOWNTOWN. AND
YOU KNOW MY TEAM WAS ELEVEN
PEOPLE AND NOW IT'S ONE THAT'S
ME. SO HOW THEN ARE THOSE FOLKS
ARE WE SUPPOSED TO BE DOING
THESE THINGS THAT PEOPLE ARE
WANTING TO ROLL OUT IT'S NOT
POSSIBLE I DON'T. I THINK THAT
THERE NEEDS TO BE A COMMITTEE OF
WORKERS OF COMMUNITY MEMBERS OR
REALLY MAKING THESE DECISIONS O
REALLY AS MANY PEOPLE HAVE SAID
HAVE SOMETHING BE EFFECTIVE TO
HELP PEOPLE NOT JUST HOUSING
THEM OUR WAREHOUSING THEM- WHICH
I FEAR IS SOME OF. NOT NECESSARY
PEOPLE HERE BUT MY FEAR IS THAT
IT'S LIKE WELL THERE'S A
HOMELESS PROBLEM SOME OF THOSE
PROBLEMS ARE MENTAL HEALTH SO
WE'LL JUST. PUT PEOPLE SOMEWHERE
AND REALLY WE WANT TO HEAL
PEOPLE WE DON'T WANT TO JUST PUT
THEM SOMEWHERE WE DON'T JUST
MAKE IT EASIER TO PUT PEOPLE
SOMEWHERE WE WANT TO TAKE CARE
OF THOSE PEOPLE SO THAT THEY ARE
HEALING SO THAT THEY AREN'T JUST
IN A CYCLE BUT THEY'RE GETTING
BETTER AND THAT MEANS. HAVING
MORE WORKERS THAT MEANS THAT
HAVING MORE STAFF THAT MEANS
HAVING WORKERS WHO ARE
CULTURALLY COMPETENT. AND IN ALL
LEVELS NOT JUST OUTREACH WORKERS
BUT THE PEOPLE THAT ARE IN THESE
HOSPITALS. AND FURTHERMORE A LOT
OF TIMES PEOPLE ARE IN MY
EXPERIENCE JUST CHARGED- SOON
BECAUSE THEY'RE LOW INCOME THEIR
MEDIC CAL SO. FIRST SOME PRIVATE
PLACES THEY WOULD RATHER JUST.
DISCHARGED THEM- AND THEN THEY
JUST COME BACK THEY COME BACK IN
A FEW DAYS AND AGAIN SOME OF
THESE PEOPLE THERE ARE PEOPLE
WHO HAVE USED HOSPITALS FIVE.
TEN TIMES IN A YEAR MAYBE MORE-
BUT THEY DON'T NECESSARILY NEED
CONSERVATORSHIP THEY NEED A MORE
ROBUST AND HOLISTIC APPROACH
WHICH MEANS MORE WORKERS WHICH
MEANS. LESS CASELOADS WHICH
MEANS THAT PEOPLE ARE REALLY
ABLE TO GIVE THE CARE AND
COMPASSION THAT THEY HAVE. THE
COWORKERS THAT I'VE WORKED WITH
ARE INCREDIBLY CONTENT AND
UNDERSTANDING AND GO THE EXTRA
MILE FOR OUR CLIENTS BECAUSE
THEY CARE. BUT THEY'RE PUSHED
OUT BECAUSE THEY'RE EXHAUSTED.
AND IT PUSHED OUT BECAUSE THERE
ISN'T ENOUGH CAPACITY AND PLACES
THAT EXIST THAT NEED TO REALLY.
SERVE THE NEEDS OF THOSE
COMMUNITIES- AND SERVE THE NEEDS
OF THE PEOPLE WHO WORK IN THOSE
COMMUNITIES. CONSERVATORSHIP
IT'S NOT A NOT A CATCH ALL. OF
ME AND TO CONSERVE PEOPLE REALLY
HAVE TO MEAN THAT THOSE PEOPLE
ARE A DANGER TO THEMSELVES AND
INCREDIBLY- GREGIS WAY- THAT
THEY COULD POSSIBLY LOSE THEIR
LIVES AND IF. THEY'RE GOING TO
BE PUT IN THE FACILITY IT NEEDS
TO BE A FACILITY THAT'S CARING
AND COMPASSIONATE AND THAT MEANS
PEOPLE WHO ARE OVERWORKED THAT
MEANS PEOPLE WHO ARE PAID OFF
THAT MEANS PEOPLE WHO ARE ALSO
TAKING CARE. AND UNDERSTAND THE
NEEDS OF THE COMMUNITY SO I
WANTED TO ADVOCATE FOR THAT I
APPRECIATE A LOT OF THE THINGS
PEOPLE SAID MANY OF THOSE I.
WHOLEHEARTEDLY AGREE WITH- JUST
LASTLY THE ISSUE OF PEOPLE NOT
HAVING HOMES- HOME BECAUSE
SOMETIMES WHEN PEOPLE USE THE
TERM HOMELESS IT CAN SEEM.
INHUMANE JUST LIKE THIS IS A
PROBLEM RATHER THAN THESE ARE
INDIVIDUALS WHO HAVE ISSUES THAT
NEED TO BE TAKEN CARE OF AND
ADDRESSED. ALL RIGHT THE OTHER
ISSUE REALLY IS HOUSING AND
HOUSING P. AND PEOPLE HAVING
HOUSING AND BEING ABLE TO AFFORD
WHERE THEY LIVE. IF THAT ISN'T
ADDRESS THEN THERE WILL BE MORE
THESE ISSUES BECAUSE WHEN PEOPLE
BECOME HOMELESS THEY TEND TO
HAVE MORE MENTAL ILLNESSES
BECAUSE THE FACT OF BECOMING
HOMELESS IS ITSELF TRAUMATIZING.
SO- PLEASE TAKE THESE INTO
CONSIDERATION I THINK IT
COMMITTEE NEEDS TO BE FORMED
ESPECIALLY WITH THE WORKERS WHO
ARE DOING THIS WORK BECAUSE WE
UNDERSTAND SO MUCH MORE WHAT'S
HAPPENING ON THE GROUND- ALONG
WITH PATIENTS AND COMMUNITY TO
REALLY DO WHAT I THINK A LOT OF
PEOPLE ARE REALLY WANTING TO DO
WHICH IS TO TAKE CARE OF PEOPLE
WHO ARE MOST IN NEED. AND TO
HELP THEM BE WHOLE THANK YOU SO
MUCH FOR YOUR TIME I APPRECIATE
YOU ALLOWING ME TO SPEAK. THANK
YOU VERY MUCH APPRECIATE THAT
WE'LL GO. AHEAD MOVED ON TO- THE
STRAFFORD. THANK YOU GOOD
MORNING COMMITTEE. CHAIRS OUT
HAWTHORN CALIFORNIA HOSPITALS.
THE STATEWIDE ASSOCIATION
REPRESENTING OVER FOUR HUNDRED
HOSPITALS THROUGHOUT THE STATE.
HOSPITALS ARE ON THE FRONTLINES
CARING FOR CALIFORNIANS
EXPERIENCING BEHAVIORAL HEALTH
AND SUBSTANCE USE DISORDERS.
THIS INCLUDES THIRTY THREE
FREESTANDING PSYCHIATRIC
HOSPITALS AND HUNDRED TWENTY
NINE DEDICATED PSYCHIATRIC UNITS
INSIDE OF GENERAL ACUTE CARE
HOSPITALS THIS IS A TOTAL OF
OVER A THOUSAND INPATIENT
PSYCHIATRIC BEDS. IMPORTANTLY IT
ALSO INCLUDES OVER THREE HUNDRED
EMERGENCY DEPARTMENTS WHICH ACT
AS A SAFETY NET PROVIDERS FOR
THOSE IN CRISIS OR WITH SIMPLY
NOWHERE ELSE TO GO. STATEWIDE
IT'S ESTIMATED THAT
APPROXIMATELY ONE THOUSAND
PEOPLE ON ANY GIVEN DAY ARE
ADMITTED TO AN EMERGENCY
DEPARTMENT ON A FIFTY ONE FIFTY
HOLD. ALL TOLD CALIFORNIA
HOSPITALS SEE MORE THAN ONE
MILLION INDIVIDUALS WITH THE
PAPER HEALTH DIAGNOSIS IN THEIR
EMERGENCY DEPARTMENTS EVERY YEAR
. COVERT NINETEEN HAS
EXACERBATED THESE CHALLENGES FOR
OUR PATIENTS AND THE COMMUNITIES
ARE HOSPITAL SIR. ANXIETY AND
DEPRESSION AMONG ADULTS NEARLY
QUADRUPLED BETWEEN MID TWO
THOUSAND NINETEEN AND JANUARY
TWENTY TWENTY ONE. MORE THAN 41%
OF AMERICAN ADULTS REPORTED
SYMPTOMS ASSOCIATED WITH ANXIETY
AND WE'RE DEPRESSIVE DISORDERS
AND EVEN MORE CONCERNING AS
YOU'VE ALL BEEN READING IN THE
NEWSOVERDOSE DEATHS ARE AT AN
ALL TIME HIGH. YOU SUICIDE RISK
HAS RISEN TO ALARMING LEVELS ARE
EMERGENCY DEPARTMENT VISITS FOR
SUSPECTED SUICIDE ATTEMPTS AMONG
YOUTH JUST AGES TWELVE TO
SEVENTEEN. OR MORE THAN 31%
HIGHER. N TWENTY TWENTY TO
TWENTY NINETEEN. WHEN YOU PAIR
THIS WITH THE FACT THAT STAFF IN
OUR EMERGENCY DEPARTMENTS NURSES
DOCTORS TAX AND OTHERS HAVE BEEN
WORKING AROUND THE CLOCK FOR TWO
YEARS TO STAVE OFF THE PANDEMIC
THE NEED FOR RELIEF IS GOING
DESPERATE. SO IT'S WITH THESE
CHALLENGES AS A BACKDROP THAT
THE INTENTION OF THE L. P. S.
ACT WE BELIEVE IS JUST AS
RELEVANT AND IMPORTANT AS WHEN
IT WAS SIGNED FIFTY FOUR YEARS
AGO. TO INAPPROPRIATE INDEFINITE
AND INVOLUNTARY COMMITMENTS. TO
PROVIDE PROMPT EVALUATION AND
TREATMENT TO PROTECT PUBLIC
SAFETY AND PROTECT THOSE WITH
BEHAVIORAL HEALTH DISORDERS.
PROVIDE INDIVIDUALIZED CARE
WHILE SAFEGUARDING CIVIL RIGHTS.
AND TO PROVIDE CONSISTENT
STANDARDS FOR PROTECTING RIGHTS
AND PROVIDING CARE.
UNFORTUNATELY THE LACK OF
STATEWIDE STANDARDS FOR
PROTECTING RIGHTS AND PROVIDING
CARE IS AT THE ROOT OF MANY OF
THE PROBLEMS WE SEE IN
IMPLEMENTING THE LPS ACT. THERE
ARE A NUMBER OF AREAS IN
CARRYING OUT THE FIFTY ONE FIFTY
PROCESS THAT COUNTIES LAW
ENFORCEMENT HOSPITALS AND JUDGES
HAVE TO INTERPRET ON THEIR OWN.
THESE INCONSISTENCIES CREATE
SIGNIFICANT BARRIERS AND MEAN
THAT DEPENDING ON WHAT ZIP CODE
YOU LIVE IN. THE TREATMENT OF
PROCESS SEES WILL DIFFER HERE
SOME EXAMPLES. THE PROCESS FOR
FACILITIES AND INDIVIDUAL
PROVIDERS TO BECOME LPS
DESIGNATED WITH INVOLUNTARY
HOLDEN ASSESSMENT POWERS VARIES
FROM COUNTY TO COUNTY. IN SOME
COUNTIES PSYCHIATRIST AND
EMERGENCY ROOM PHYSICIANS. ARE
DESIGNATED TO WRITE AND RELEASE
FIFTY ONE FIFTY HOLTZ AND OTHERS
THEY ARE NOT. IN SOME CASES THE
PROCESS TO DESIGNATE A FACILITY
OR INDIVIDUAL PROVIDER CAN BE
EXPEDIENT AND OTHERS IT CAN
LINGER ON FOR YEARS. IN SOME
CASES THE SEVENTY TWO HOUR CLOCK
ON A FIFTY ONE FIFTY HOLD BEGINS
WHEN THE PERSON IS INITIALLY
DETAINED AND OTHERS IT BEGINS
WHEN THEY ARRIVE TO DESIGNATED
FACILITY AND THE BACKGROUNDER
THE COMMITTEE DID DID AN
EXCELLENT JOB OUTLINING THAT
ISSUE. FINALLY IN SOME CASES A
PERSON'S PHYSICAL HEALTH
CONDITION CAN BE CONSIDERED BY A
COURT WHEN MAKING A
DETERMINATION FOR LONGER
INVOLUNTARY HOLDS. OTHER PLACES
IT CANNOT AND WE THANK CENTER
EGGMAN FOR EFFORTS IN THAT SPACE
. THESE DIFFICULTIES AND
INCONSISTENCIES CREATE BACKLOGS
FOR ALREADY CROWDED EMERGENCY
DEPARTMENTS. AS AN EXAMPLE MORE
THAN 75% OF ALL FIFTY ONE FIFTY
HOLDS CAN BE SAFELY RELEASED
WITHIN TWENTY THREE HOURS. AND
LESS THAN 25% RESULT AND
ADMISSION TO AN INPATIENT
PSYCHIATRIC SETTING. BUT THE
BOTTLENECKS CREATED BY
INCONSISTENT STANDARDS TOO OFTEN
LEAVE THESE PATIENTS LANGUISHING
IN EMERGENCY DEPARTMENTS WAITING
ON DESIGNATED INDIVIDUALS FROM
OUTSIDE THE HOSPITAL TO COME AND
ASSESS THEM. ONLY TO BE RELEASED
LONG AFTER THE ORIGINAL THE
TENSION. SURE WOULD YOU HIT THE
NAIL ON THE HEAD MANY OF THESE
ISSUES COULD BE RESOLVED THROUGH
OVERSIGHT AND ACCOUNTABILITY.
CURRENTLY THERE IS NO ACTIVE- NO
ONE ACTIVELY OVERSEEING
IMPLEMENTATION OF THE LPS ACT.
STRONG CONSISTENT LEADERSHIP IS
NECESSARY TO BETTER PROTECT THE
CIVIL RIGHTS OF INDIVIDUALS. AND
IMPROVE THE STATEWIDE
INTERPRETATION AND APPLICATION
OF THE LAW TO TRACK DATA.
PROCESS TO RESOLVE COMPLAINTS
AND ADVISE THE COURTS THAT'S WHY
WE WERE PROUD TO CO SPONSOR AB
THIRTEEN THIRTY ONE THIS YEAR
WITH THE EMMY CALIFORNIA
AUTHORED BY ASSEMBLYMEMBER
IRWIN. THAT WOULD HAVE
ESTABLISHED DEDICATED LEADERSHIP
POSITION WITHIN DH CS TO PERFORM
SOME OF THESE FUNCTIONS
UNFORTUNATELY THAT BILL WAS
VETOED- ALTHOUGH WE'VE
HIGHLIGHTED SOME OF THE CURRENT
CHALLENGES WE ARE OPTIMISTIC
THAT WE AND OTHER STAKEHOLDERS
CAN HELP THE LEGISLATURE. MAKE
THE CHANGES NECESSARY TO DELIVER
A BETTER SYSTEM FOR BEHAVIORAL
HEALTH CARE AND LOOK FORWARD TO
SHARING SOME OF THE SUGGESTIONS
AFTERNOON. THANK YOU VERY MUCH
MISTER HOPPER VERY MUCH
APPRECIATE THAT- WILL MOVE ON TO
A VERONICA KELLY DIRECTOR SAN
BENITO COUNTY DEPARTMENT OF
BEHAVIORAL HEALTH- WITH THE
COUNTY COUNTY OF COUNTY
BEHAVIORAL HEALTH RECORDS
ASSOCIATION SO- MISS KELLY. I
THANK YOU I THANK YOU CHAIRS AND
MEMBERS AND- GOOD MORNING
AFTERNOON MY NAME IS DR RON
KELLY I AM THE DIRECTOR OF SAN
BENITO COUNTY DEPARTMENT OF
HEALTH AND IN THE PAST PRESIDENT
OF THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION. MY
COMMENTS TODAY YOU'RE REALLY
GONNA BE CENTERED ON THE
CHALLENGES THAT OUR PUBLIC
SAFETY NET FACES AND SERVING.
PEOPLE THE MOST VULNERABLE
PEOPLE THOSE WHO AT SOME POINT
IN THEIR RECOVERY JOURNEY MAY BE
INVOLUNTARILY HELD INVOLUNTARILY
TREATED OUT AND OUR CONCERT AND
SO FIRST THING I WANT TO LET ALL
OF YOU KNOW IS THAT RECOVERY IS
POSSIBLE. I SAY THIS AS A
CLINICIAN AND AS A FORMER
CONSERVATOR. FOR A FAMILY MEMBER
. BUT WHEN IT COMES TO PROGRAMS
THAT HAVE BEEN DISCUSSED YEAR
LAKE ASSISTED OUTPATIENT
TREATMENT A. O. T. THE SECRET
TECH COUNTY SUCCESS IS FAR LESS.
OFTEN IN THE COMPULSORY AREA OF
IT SO NOT JUST THE BLACK ROBE
FACT BUT MORE OFTEN IT'S IN THE
RELENTLESS ENGAGEMENT. PEOPLE
EIGHT LACK INSIGHT INTO THEIR
MENTAL ILLNESS OR HAVE A
MISTRUST OF INSTITUTIONS WHETHER
IT'S A MEDICAL INSTITUTION OR
ITS GOVERNMENT. ASSEMBLY DINO
COUNTY WE FOUND OUR NHS EIGHT
INNOVATIONS PROJECT CALLED OF
RECOVERY BASED ENGAGEMENT
SUPPORT TEAMS. OUR BEST WHICH IS
OUR LARA'S LA TO QUIBBLE MEANT
THAT IT TAKES AN AVERAGE OF
FORTY FOUR ZERO FACE TO FACE
VISITS WITH SOMEONE WHO ISN'T
INTERESTED IN SERVICES ALTHOUGH
THEY PROBABLY NEED THEM ALTHOUGH
THEY DEFINITELY NEED THEM. TO
GET THEM TO VOLUNTARILY ACTIVATE
INTO TREATMENT WE HAVE A 90%
ACTIVATION ONCE WE ARE ENGAGING
AND TALKING TO PEOPLE AND WHAT
THAT DOES IS IT REDUCES THE
DRAMATIC ENTRY INTO OUR SYSTEM
OF CARE IT REDUCES THE IDEA OF
TAKING AWAY ALL SIMILAR. WE NEED
IN MY COUNTY. WE CAN WE DO THIS
WORK EVERY DAY. WE KNOW WHAT
WORKS AND WE KNOW THAT THERE ARE
CERTAIN PERCENTAGE OF OUR THE
INDIVIDUALS WE CONTACT WHO ARE
NOT SUCCESSFUL IN ENGAGING INTO
SERVICES. TOO OFTEN INDIVIDUALS
PEOPLE FALL THROUGH THE CRACKS
CYCLING BETWEEN OUR JUSTICE
PARTNERS HOMELESSNESS AND
HOSPITAL EMERGENCY DEPARTMENTS
THAT'S TRAUMA UPON TRAUMA UPON
TRAUMA. WE HAVE A COLLECTIVE
FAILURE AND IT'S NOT ONE
ENTITIES PROBLEM IT'S ALL OF OUR
PROBLEMS. THIS GOES ACROSS
SYSTEMS. OUR SYSTEMS THAT DON'T
COMMUNICATE WHILE WE DON'T
COORDINATE EFFECTIVELY ENOUGH
WITH ONE ANOTHER WE OFTEN MISSED
CRUCIAL OPPORTUNITIES TO TREAT
PEOPLE WITH THE URGENCY AND
COMPASSION THAT THEY DESERVE AND
THAT THEY NEED FOR EXAMPLE.
TODAY KIND OF A HERO HEALTH MAY
NOT KNOW THAT SOMEONE WE ARE
WORKING WITH IT'S IN A HOSPITAL
EMERGENCY DEPARTMENT OR- IS
BEING IS EXPERIENCING A
PSYCHIATRIC EMERGENCY BECAUSE WE
AND OUR OTHER HEALTH PLANS ARE
OTHER PARTNERS ARE OFTEN NOT
NOTIFY. BY THE HOSPITAL OR BY
THE PATIENT THE PATIENT MIGHT
NOT NOT BE ABLE TO TELL THE
HOSPITAL THAT THEY ARE ONE OF
OUR CLIENTS I'M PROBABLY
CHALLENGES OUR HOUSING
AFFORDABILITY CRISIS. HAS
DECIMATED OUR ABILITY TO KEEP
OUR CLIENTS SAFELY HOUSE AND
CREATING MARK IT'S CREATED MORE
HEALTH AND JUSTICE INVOLVEMENT
RISK FOR OUR CLIENTS. THIRTY
YEARS AGO WHEN I STARTED IN THIS
FIELD AS A SOCIAL WORKER AND I
MANAGED INDIVIDUALS. WHO WERE IN
THE CONDITIONAL RELEASE PROGRAM
WHO HAD VARIOUS LEVELS OF
CRIMINAL GENIC RESTAURANT ELEMIS
. WE WERE ABLE TO RELY ON
COMMUNITY BASED OR IN CARE. TO
HELP US SUPPORT PEOPLE WHO ARE
CONCERT. IN COMMUNITY. WHILE WE
PROVIDED THE TARGETED BEHAVIORAL
TREATMENT. AS HOUSING AND REAL
ESTATE PRICES HAVE ESCALATED. WE
STARTED TO LOSE THAT WE DON'T
HAVE THOSE RESOURCES NOT
COMMUNITY ANYMORE IN RESPONSE
COUNTIES HAVE USED EVERYTHING
WE- ARE MENTAL HEALTH SERVICES
ACT FUNDING OUR BLOCK GRANT
FUNDING R. NINETY ONE
REALIGNMENT TO TRY TO BUILD AND
BY HOUSING FOR CLIENTS SOMETIMES
THAT MEANS WE DIVERT FUNDING
FROM DESPERATELY NEEDED
EXPANSION OF SERVICES SUCH AS
OUR FULL SERVICE PARTNERSHIPS.
OR THAT WE ARE PAYING OUR
PROVIDERS AS WELL BECAUSE WE ARE
BUILDING HOUSES. ALL OF THIS
BECAUSE WE KNOW THAT HOUSING
HELPS PEOPLE HEAL IT KEEPS OUR
CLIENTS SAFE AND OUT OF THAT
CYCLE THAT EVERYONE'S TALKING
ABOUT HERE THIS MORNING OF
CRIMINALIZATION THAT CAN
TRAUMATIZE AND INTERRUPT THEIR
RECOVERY. DESPITE THESE
INVESTMENTS WE STILL LACK
SUFFICIENT INVESTMENT AND
RESOURCES TO SAFELY HOUSE ALL OF
OUR CLIENTS I WANT TO BE CLEAR
IT'S NOT ABOUT MORE MONEY IT'S
ABOUT MORE RESOURCE. THERE'S A
DIFFERENCE. WE ARE TRYING TO
SAVE THE HOUSE OUR CLIENTS WE
ARE TRYING AND WE KNOW THAT
DISCRIMINATION **** BEEN SPOKEN
ABOUT ALREADY KNOW HOW MORE
ABOUT IN ACCESSING IN BUILDING
HOUSING- AND TREATMENT
FACILITIES ALL TOO REAL TO
DOCTOR RECKLESS POINT A LEVEL OF
NIMBYISM. IN OUR COUNTIES. THAT
WE EXPERIENCED IT SHAMEFUL. WHEN
SEEKING TREATMENT COUNTY
BEHAVIORAL HEALTH CLIENTS ARE
FREQUENTLY REJECTED FROM
TREATMENT FACILITIES FROM
TREATMENT FACILITIES. BECAUSE OF
SOME. EARNERS ON HOSPITAL SAY
THAT THE CLIENTS PASSED CRIMINAL
BACKGROUND AND TAX ABILITY TO BE
TREATED IN THE AND THE FACILITY
THEY CAN'T HAVE A FELONY. THAT
THEY HAVE PAST AGGRESSIONS AND
THAT THEY'RE TOO DANGEROUS TO BE
TREATED. THIS MAKES THEM
UNSUITABLE FOR SOME OF OUR
PARTNERS FOR OPEN BEDS UNSTABLE
FOR THE TREATMENT THEY NEED AND
THE TREATMENT THEY WANT AND
WHILE WE ARE WORKING WITH OUR
PARTNERS AT CALIFORNIA HOSPITAL
ASSOCIATIONSHE JUST HEARD ON
THIS WE HAVE A LONG ROAD AHEAD
OF US. OUR RESOURCES ARE FURTHER
STRETCH BY FEDERAL LAW WHICH
DOES NOT ALLOW FUNDING OF
RESIDENTIAL AND ACUTE
PSYCHIATRIC SERVICES.
IMPOSSIBILITIES THE HUB OVER
SIXTEEN BEDS. IT'S I AM D.
EXCLUSION AND THAT MEANS THAT WE
PAY THE FULL COST OF TREATMENT
AND WE USE WHATEVER FUNDING WE
CAN USE FOR THAT EVER HEALTH
SAFETY NET FUNDING FOR SERVICES
HAS SIMPLY NOT KEPT PACE WITH
CLIFORNIA'S GROWING POPULATION
AND ARE INCREASED MEDIC HOW
ENTITLEMENTS. IT DOESN'T KEEP UP
WITH CASELOAD GROWTH IMPACT
FUNDING FOR THE HIGHEST LEVEL OF
NEED HAS DIMINISHED
SIGNIFICANTLY OVER TIME WE OFTEN
REALIZE THEY SAID ON NINETEEN
NINETY ONE REALIGNMENT TO FIND
LPS ACTIVITIES AS IT'S ALMOST
FLEXIBLE FUNDING SOURCE ANDTHERE IS SCANT DEDICATED FUNDING
FOR LPS SERVICES IN. TWENTY
TWENTY WE USED OUR NINETY ONE
REALIGNMENT. AT IT WAS LOWER IN
NINETY AND I. TWENTY TWENTY THAT
ONCE IN TWO THOUSAND AND FOUR
TWO THOUSAND AND FIVE IN ACTUAL
DOLLARS. WE HAVE SOME COUNTIES
THAT SPEND ALL OF THEIR NINETY
ONE REALIGNMENT. ON ON INPATIENT
TREATMENT AND I LIKE HOW OTHER
SOCIAL SERVICES PROGRAMS ARE
FUNDED IN REALIGNMENT THERE IS
NO DIRECT LINK FROM MENTAL
HEALTH BETWEEN FUNDING AND
ACTUAL SERVICE COST THAT MEANS
THE MONEY WE GET IS NOT BASED ON
WHAT IT ACTUALLY. COSTS TO
DELIVER AT SERVICE INSTEAD
FINDING IS BASED ON HOW MUCH
COUNTY SPENT ON MENTAL HEALTH
RESPONSIBILITIES IN THE EARLY
NINETEEN NINETIES. I MEAN
COLBERT HAS TAUGHT US A WHOLE
LOT OF THINGS BUT IT IS
ABSOLUTELY TAUGHT US THE
IMPORTANCE OF BEHAVIORAL HEALTH
AND RECOVERY SO WE MUST ACT NOW
TO CHANGE THAT. CAN BE HERE
HEALTH DIRECTORS ASSOCIATION
FIFTY EIGHT COUNTIES AND TO CITY
MUNICIPALITIES ARE GRATEFUL TO
THE LEGISLATURE. FOR CONSIDERING
THIS TOPIC OF LPS REFORM. FROM
THE PERSPECTIVE OF COUNTY
BEHAVIORAL HEALTH AT THE ROOT OF
THE CHALLENGE WE FACE- ARE IN A
CHRONIC DECADES LONG UNDER
FUNDING A LACK OF HOUSING FOR
OUR CLIENTS AND A LACK OF STATE
LEVEL DATA AND TRANSPARENCY
ABOUT THE WORK DETAIL. A
BROADENING OF INVOLUNTARY.
COMMITMENT WILL NOT TOUCH THIS.
WHAT WE DO TO IS TO X. WARNING
CARE. WITH OUT THAT. BEING BASED
ON COMPETITIVE GRANTS. WE WOULD
LOVE HOUSING THAT THERE IS A
STATEWIDE PURE BENEFIT AS YOU'VE
HEARD PEOPLE WITH LIVED
EXPERIENCE EXPRESSED YOU HERE
TODAY. AUGMENTED TREATMENT
SERVICE DOLLARS THOSE ARE FAR
MORE EFFECTIVE AND EFFICIENT
INVESTMENTS THAT EXPAND THE LONG
TERM SUCCESS OF OUR OUR STATE
YOU KNOW I FEEL- INDUCTOR
RAMBLING HEARD ME SAY THIS A FEW
TIMES WHAT WE ARE ALL SITTING IN
DIFFERENT WINGS OF THIS
WINCHESTER MYSTERY HOUSE THAT
COUNTIES ARE SITTING ON. IN
DOWNSTAIRS AND THE DOWNSTAIRS
PARLOR AND CALIFORNIA
HOSPITALIZATION ASSOCIATION IS
ON THE FRONT PORCH LAW
ENFORCEMENT IS AN UPSTAIRS BACK
BEDROOM AND THEN YOU HAVE THE
DEPARTMENT HEALTHCARE SERVICES
THAT SITS IN THE HALLWAY WITH NO
ENTRANCES OR EXITS. MAYBE PART
OF WHAT WE NEED TO LOOK AT IS
TEARING DOWN THIS. SO THAT WE'VE
- AND REBUILDING. ROME BY ROME
IN A WAY THAT MAKES SENSE THANK
YOU VERY MUCH. THANK YOU VERY
MUCH VERY MUCH APPRECIATE THAT
AND WE'RE GOING TO MOVE ON TO
OUR NEXT OUR NEXT PANELIST AND I
WOULD JUST WE ARE DARK TIMES A
LITTLE TIGHTER SO PLEASE- FIVE
MINUTES AND I DO APOLOGIZE FOR
THAT BUT- BUT PLEASE GO AHEAD-
DR- JUST ON THIS TOPIC IS
INSTANT. SYSTEM HEAR AN ECHO. OF
ARE A CLINICAL PROFESSOR FROM.
OF MEDICINE DOCTOR AND SEE
WHATEVER READY. ALL THE UC DAVIS
HEALTH SYSTEM AND MEDICAL
DIRECTOR OF SACRAMENTO
BEHAVIORAL HEALTH CARE HOSPITAL
. PREVIOUSLY I WAS CHILDREN'S
MEDICAL DIRECTOR FOR SACRAMENTO
CHILDREN'S MENTAL HEALTH. I
WOULD BOOK IN AN EMERGENCY
DEPARTMENT ASSESSING INDIVIDUALS
IN MENTAL HEALTH WHEN I MENTAL
HEALTH CRISIS THEY ALSO WORK IN
AN ACUTE CARE PSYCHIATRIC
HOSPITAL. I EVALUATE AND TREAT
INDIVIDUALS WITH MENTAL ILLNESS
ON A DAILY BASIS AND MY PURPOSE
HERE TODAY IS TO HOPEFULLY SHOW
YOU WHAT I SEE ON A DAY TO DAY
BASIS. IN MY WORK ASSESSING AND
TREATING PATIENTS WITH MENTAL
ILLNESS AND HOPEFULLY INFORM YOU
ON GAPS RELATED TO TREATMENT AS
THEY RELATE TO LPS. OUR
UNDERSTANDING FOR MENTAL ILLNESS
AND ITS TREATMENT HAS ADVANCED
DRAMATICALLY SINCE THE LPS
BECAME OPERATIVE. WE HAVE
LEARNED THAT MENTAL ILLNESSES
LIKE SCHIZOPHRENIA AND BIPOLAR
DISORDER. OR ILLNESSES OF THE
BRAIN. AND IN THAT RESPECT THERE
ARE NO DIFFERENT FROM MEDICAL
DISORDERS AFFECTING OTHER ORGAN
SYSTEMS. HOWEVER WHAT EVIDENCE
BASED TREATMENTS HAVE ADVANCED
SIGNIFICANTLY PSYCHOSIS AS
EXPERIENCED BY PEOPLE WITH
MENTAL ILLNESS IS STILL VERY
PAINFUL AND FRIGHTENING. IMAGINE
TRYING TO FUNCTION IN DOING YOUR
WORK IF YOU BELIEVE PEOPLE ARE
CONSTANTLY TRYING TO KILL YOU.
IMAGINE BEING SO HUNGRY BECAUSE
YOU HAVEN'T EATEN DAIS. BUT YOU
DON'T TRUST THE FOOD IN FRONT OF
YOU BECAUSE YOU THINK IT MIGHT
BE POISONED. IMAGINE HEARING
VOICES SO LOUD THAT YOU CANNOT
SLEEP. IT'S NOT PLEASANT AND
IT'S VERY DISTRESSING. THERE'S
ANOTHER DIMENSION OF PSYCHOSIS
THAT DIFFERS FROM OTHER MEDICAL
DISORDERS MENTAL CAPACITY MENTAL
ILLNESS ROB SAYS ABOUT OUR
ECONOMY AND ABILITY TO KNOW REAL
FROM NOT REAL. HEART DISEASE BY
CONTRAST DOESN'T ROUTINELY
AFFECT ONE'S ABILITY TO MAKE
INFORMED DECISIONS A HEART
ATTACK IS VERY APPARENT YOU WANT
HELPING YOU WANT NOW NO ONE
DOUBTS OR QUESTIONS YOU NEED FOR
TREATMENT AND NO ONE BRINGS INTO
AN NSF TO DECISION MAKER OR
NEEDS A COURT ORDER. IN MENTAL
ILLNESS HOWEVER THE PERSON'S
ABILITY TO EXERCISE INSIGHT IS
IMPAIRED THE ABILITY TO
RECOGNIZE THAT YOUR MIND IS
CONTROLLED BY DELUSIONS OR
HALLUCINATIONS IS LACKING IN THE
IMPULSE TO SEEK OUT HELP IS
DIMINISHED. OR ALTOGETHER ABSENT
THE INDIVIDUAL OFTEN BELIEVE
THAT NOTHING IS WRONG WITH THEM
. THEY DISTRUST OTHERS THEY END
UP DISTRUSTING MEDICATIONS NOT
ONLY PSYCHIATRIC MEDICATION BUT
LIFESAVING ONES THE ONES THAT
THEY NEED TO TREAT A COLD DURING
OUR CONDITION OR DIABETES. THESE
INDIVIDUALS ARE GRAVELY
DISABLED. AND THAT'S TRAGIC. LPS
OPENS THE DOOR TO EVALUATE. AND
DIAGNOSE PATIENTS LPS ALLOWS
PATIENTS WITH MENTAL ILLNESS AN
OPPORTUNITY PER TREATMENT. BUT
WHEN THE OPPORTUNITY SLACKING
THERE IS A SERIOUS RISK OF HARM
TO THE PATIENT. WHEN THE
CAPACITY TO MAKE INFORMED
DECISIONS IS IMPAIR THE LPS
PROVIDES A FRAMEWORK OF
COLLABORATION BETWEEN THE
MEDICAL PROVIDER AND THE COURT
IN ORDER TO ASSURE THAT INFORMED
DECISION ON BEHALF OF THE
PATIENT'S WELFARE IS MADE.
HOWEVER THERE ARE PROBLEMS WITH
THIS BECAUSE TREATMENT ON A
ROUTINE BASIS. IS DELAYED OR
WORSE THE NIGHT. DATA SUGGESTS
THAT THAT IF WE TREAT PSYCHOSIS
EARLY ON. WE CAN DRAMATICALLY
SHORTEN ACUTE EPISODES. WHEN
TREATMENTS PROVIDED CONSISTENTLY
OVER TIME WE OPTIMIZED EVENTUAL
OUTCOME. UNFORTUNATELY THAT TIME
THAT ELAPSED BETWEEN A FIFTY ONE
FIFTY THE TENSION IN THE
COMMUNITY IN BEING ABLE TO
PROVIDE TREATMENT IN AN
INPATIENT PSYCHIATRIC FACILITY.
CAN ON AVERAGE BE SEVEN DAYS OR
LONGER FOR A PATIENT REFUSING
TREATMENT. WE ARE EFFECTIVELY
DETAINING PATIENTS BUT NOT
TREATING THEM. FOR PATIENTS
REFUSING TREATMENT LPS PROVIDES
A COURT PROCEDURE CALLED HERE
REACHED HEARING. A RESPECT ISSUE
IF THE COURT PROCEDURE TO
EVALUATE THE PATIENT'S CAPACITY
TO UNDERSTAND HER ILLNESS AND
THEIR CAPACITY TO CONSENT TO
TREATMENT. IN THEORY THIS IS
FINE THERE IS A BALANCING ACT
BETWEEN LEGAL AND TREATMENT
NEEDS. AND SECOND PSYCHIATRIST
UNDERSTAND AND ACCEPT THIS VERY
WELL BUT IN PRACTICE IS THE
PROCESS IS COMPLICATED AND IN
SOME SENSE SOMETIMES BAD THINGS
HAPPEN. RECENT POSITIONS ARE
LINKED TO LPS TO PAYMENT SO THAT
SOMEONE IS CURRENTLY ON. ONCE
THE COURT APPROVED THE
INVOLUNTARY TREATMENT
INVOLUNTARY TREATMENT ONLY LAST
UNTIL THE END OF THAT WHOLE.
ONCE THE CURRENT HOLD EXPIRES
AND IF THE PATIENT IS STILL ILL.
ANOTHER CAPACITY HEARINGS
REQUIRED IN THE MEANTIME UNTIL
THAT CAPACITY HEARING IS ONCE
AGAIN HURT. THE TREATMENT THAT
WAS APPROVED INITIALLY BY THE
COURT IS UNABLE TO CONTINUE. AND
RISKS ACUTE DECOMPENSATION OF
THE PATIENT. THIS IS A REAL
PROBLEM. LET'S GO BACK THE
INITIAL ONE WEEK DELAY PRIOR TO
TREATMENT CAN BE VERY COSTLY.
NOT ONLY FROM A FINANCIAL
STANDPOINT AS THE PATIENT IS IN
THE HOSPITAL LONGER THAN THEY
OTHERWISE MIGHT NEED TO BE. BUT
MORE IMPORTANTLY IT'S COSTLY
FROM A PATIENT'S FUNCTIONALITY
STANDPOINT. DURING THAT ONE
WEEK. I'VE SEEN PATIENTS END UP
HURTING THEMSELVES BECAUSE THE
VOICES ARE TELLING THEM TO KILL
THEMSELVES. THREE THAT ONE WEEK
I'VE SEEN PATIENTS HURT OTHERS
BECAUSE OF THEIR PARANOIA.
BECAUSE OF THE DELAY IT TAKES A
MUCH LONGER TO GET BACK TO THE
BASELINE. DATA TELLS US THAT THE
LONGER THAN THREE MINUTES THE
LATE THE LONGER IT TAKES TO GET
BACK TO THE WAY YOU WERE BEFORE
YOU GOT SICK. SO THE PATIENT
LOSES MORE TIME OFF FROM WORK.
EMPLOYER IS AFFECTED BY THE LOSS
OF THEIR WORKERS. THE PATIENT
AND THEIR FAMILY ARE DRASTICALLY
AFFECTED. THE LPS ACT MADE US
AWARE THAT PSYCHOTIC DISORDERS
ARE DEVASTATING HIS ORDERS THAT
REQUIRE TREATMENT. IN A SYSTEM
THAT PROTECTS BOTH AND
INDIVIDUALS RIGHTS AND ALSO THE
RIGHT TO BE TREATED. WELL TAKING
INTO ACCOUNT THEIR ABILITY TO
PROVIDE INFORMED CONSENT. THIS
STANDARD THE STANDARD CARE WITH
ANY OTHER MEDICAL ILLNESSES TO
TREAT DURING THE ACUTE STAGE OF
THAT THIS ORDER ONCE THE
DIAGNOSIS IS MADE. TREATMENT OF
PSYCHOTIC DISORDERS AND OTHER
MENTAL DISEASES SHOULD ALIGN
WITH THIS OR SHOULD AT MOST BE
WITHIN TWENTY FOUR HOURS A
DIAGNOSIS. HOW WE MIGHT DELIVER
EARLY INTERVENTIONS IN THESE
ILLNESSES IS A CRITICAL MATTER
WORTH DISCUSSING. THANK YOU.
THANK YOU VERY MUCH DOCTOR
SYSTEM- WE WILL NOW GO AHEAD AND
MOVE ON TO THE FINAL PANELIST IN
THIS IN THIS PANEL- FRANK RYAN
TO SAN JOSE FIRE DEPARTMENT IN
THE CALIFORNIA PROFESSIONAL
FIREFIGHTERS WHENEVER YOU'RE
READY. SIR. THANK YOU ALL HEAR
ME I I'M NOT GONNA VIDEO SOME TO
PROBABLY SPEAKING. OKAY GREAT.
ARE YOU CHAIR COMMITTEE MEMBERS
THANK YOU APPRECIATE THE INVITE.
TO GIVE MY PERSPECTIVE AS A-
BILL NUMBER OF TAKING CARE OF
MENTAL PATIENTS OUT THERE. AGAIN
MY NAME'S FRANK RYAN I WORK THIS
SOUNDS A FIRE DEPARTMENT FOR
JUST OVER TWENTY FIVE YEARS- IN
THAT ASPECT I'VE BEEN A
PARAMEDIC- SINCE NINETEEN NINETY
THREE- WE RUN ABOUT A HUNDRED
THOUSAND CALLS HERE IN SAN JOSE-
6265% OF THAT. IS MEDICAL CALLS
AND YOU CAN IMAGINE I DON'T KNOW
THE EXACT BREAKDOWN BUT SO MANY
OF MENTAL ILLNESS- WE HAVE IN
THE CITY AND WE DEAL WITH ON A
DAILY BASIS- OVER THE COURSE OF
A YEAR I. HAVE ABOUT TWO HUNDRED
THOUSAND HOURS OF FIELD
EXPERIENCE- I'VE CHOSEN TO STAY
IN THE FIELD WORK IN THE FIELD
NOT TAKE DESK JOBS AND THINGS
THAT- QUITE FRANKLY DON'T
INTEREST ME. AND SO I HAVE THE
ABILITY TO STAY- INVOLVED IN
I'VE WATCHED A LOT OF CHANGES
THROUGHOUT THE YEARS- QUICK
BACKGROUND AS WELL I'VE WORKED
IN MULTIPLE COUNTIES SO BETWEEN
RIVERSIDE COUNTY L. A. COUNTY
AND NOW SANTA CLARA COUNTY IN
SAN JOSE- I CAN ATTEST THAT.
EACH COUNTY HAS THEIR OWN WAYS
OF DOING THINGS- SOME GOOD SOME
BAD- I DON'T KNOW IF COUNTIES
ARE COLLABORATING WITH THEIR
SUCCESSES AND FAILURES- BUT IF
THAT'S NOT HAPPENING I. I WOULD
CERTAINLY HOPE- THROUGH THIS
COMMITTEE THEN THEY WE WOULD
FIND A WAY TO BETTER THAT
COMMUNICATION- AS WELL AS A LOT
OF THE OTHER THINGS HAVE BEEN
SPOKEN ABOUT- SO FAR TODAY-
BEFORE I TALK ABOUT EXACT
EXPERIENCES- I LIKE TO SAY THAT-
ALLOWED MEMBERS AND SPOKE AS
SPECIAL JULIA WALLACE. NEVER MET
HER BUT I WAS IMPRESSED BY- HER
INSIGHTS AND SHE MADE A LOT OF
BALLOT IN THE- GREAT POINTS- SO
BEFORE I GET INTO THAT I WOULD
HOPE THAT. PEOPLE UNDERSTAND
THAT WHEN NINE ONE ONE IS CALLED
WE- THE SYSTEM IS OBVIOUSLY
FAILED THESE INDIVIDUALS. THAT
ARE A CRISIS. LONG BEFORE WE
SHOW UP AND SO. THAT IS SYSTEMS
NEED TO BE REVAMPED EVERY LOOK
THAT- EVERYTHING SHOULD BE BUILT
I THINK BACK UP FROM THE BOTTOM-
BECAUSE- WE'RE BEING CALLED OUT
TO THESE CALLS. YEAH LIKE I SAID
THAT THE CRISIS IS WAY BEYOND-
WHAT THE SYSTEM HAS PROVIDED.
THEM AND LIKE I SAID WAIT WHAT
WHETHER IT'S FUNDING OR- WHETHER
IT'S ENOUGH STAFFING IS UP FOR
YOU GUYS TO DETERMINE ON
EVERYBODY HAS AN OPINION ON THAT
- I WILL GIVE YOU AN EXAMPLE OF
THAT I'VE BEEN IN. FOUR EIGHT
EIGHT INDIVIDUAL THAT. OBVIOUSLY
IS SYSTEM HASN'T- ALLOW THEM TO
SUCCEED IS WE WOULD WE RESPONDED
TO A CALL TWO EIGHT MIDDLE AGED
LADY WHO WAS. ARE FOUND IN A
DUMPSTER AND SHE'S BASICALLY
LIVING HER DAYS IN A DUMPSTER
AND HOW MANY DAYS SHE WAS THERE
IS UNKNOWN BUT WE'RE CALLED OUT
TO THIS AND TO RESPOND TO THAT.
SHE DOESN'T NECESSARILY MEET AN
INJURY. THAT WE GENERALLY SEE
FROM- A TRAFFIC ACCIDENT OR A
HEART ATTACK IS AS WAS SAID
EARLIER. AND SO DEALING WITH AN
INDIVIDUAL LIKE THAT. IS A
SENSITIVE MATTER- THE MATTER HOW
YOU LOOK AT IT BUT GETTING AN
INDIVIDUAL OUT OF A DUMPSTER WHO
IS HAVING A CRISIS AND TRYING TO
NAVIGATE THAT WITH THE GENERAL
PUBLIC. ALL WATCHING WITH CELL
PHONES AND HAVING THEIR OPINIONS
AND- HOW TO DO THAT IS A IT'S A
DELICATE MATTER AND HOW SHE GOT
THERE IS THE TRAGIC PART OF ALL
OF IT- AND THE SYSTEM IS
OBVIOUSLY FAILED HER. AS WE
REMOVE HER FROM THE DUMPSTER-
AND- WHAT HE OUR SYSTEM IS WE
ARE NOT A TRANSPORTING AGENCY
HERE IN SAN JOSE SO WE TRANSFER
THE CARE TO AN AMBULANCE. AND
UPON ARRIVAL OF AN AMBULANCE WE
EXPLAIN WHAT'S GOING ON IF SHE
DOESN'T HAVE ANY OBVIOUS
INJURIES AND SHE CAN ANSWER THE
FOUR QUESTIONS. THAT WE ASK.
THAT SOMETIMES. A FIFTY ONE
FIFTY HOLD. IS WHAT WE HAVE TO
DO IN THIS MOMENT BUT I I'D LIKE
TO ECHO SOME OF THE THINGS THAT
OTHER PEOPLE SAID THAT IS NOT
NECESSARILY- THE NEED AND- SO WE
TRANSPORT THEM TO THE AMBULANCE
THE AMBULANCE THEN BRING HIM TO
THE EMERGENCY ROOM AND AGAIN AND
AGAIN THIS HAPPENS OVER AND OVER
IN EVERY CITY EVERY COUNTY AND
THE STATE CALIFORNIA AND ER'S
BECOME. OVER BURDENED WITH WITH
PEOPLE HAVING MENTAL ILLNESS
CRISIS IS AN ISIS SEEMS THAT'S
THE SYSTEM THAT'S IN PLACE AND
THAT'S THE SYSTEM WE USE DOESN'T
SEEM VERY EFFECTIVE AND TO GO
FULL CIRCLE IT WAS PROBABLY
TWENTY SIX TWENTY SEVEN HOURS
AFTER- WE WERE ABLE TO. GET THE
PATIENT TO GO IN THE M. S. ONE
SHE WAS RIGHT BACK OUT ON THE
STREET- AND SO- SOMEBODY IN THE
HOSPITAL'S DETERMINED YOU KNOW
WE ARE ON THE FIRE DEPARTMENT
SIDE OF IT AREN'T. REALLY
TRIBUTE TO THE PROCESS ONCE WE
TRANSFER THE CARE. BUT WE SEE
THIS TIME AND TIME AGAIN WITH
THE SAME. PEOPLE HAVING THE SAME
TYPE CRISIS IS AND THEN IT. IT
USUALLY PROGRESSES TO THE WORST
CASE SCENARIO WHERE THE PATIENT
IS NO LONGER HAVING A CRISIS
THEY ARM THEMSELVES IN A WAY
THAT. THEY DON'T COME BACK FROM-
BUT I ALSO LIKE TO TALK ABOUT
MEDIA- D. A. A CALL WHERE THE
SYSTEM. DIDN'T WORK AND THE
FIFTY ONE FIFTY HOLD WAS PUT ON
THEM. FOR THEIR FOR THEIR NEEDS-
FOR HAVING ANXIETY ISSUES AND WE
DID GET SOME FOLLOW UP IF THE
SYSTEM DOES WORK AT TIMES- IT'S
NOT ALL. DOOM AND GLOOM- BUT
THERE IS A LOT OF. TRAGEDY AND
THINGS THAT ARE BEING MISSED OUT
HERE ON A DAILY BASIS- AND LIKE
I SAID THAT WE EVERY HEALTH A
HEALTH CARE WORKER HAS A STORY
EVERY PARAMEDIC HAS THE STORY-
IT IN THE STORIES JUST JUST.
SEEM TO BE GETTING WORSE AND
GREATER IN NUMBER- SO. I WANT TO
TAKE UP TOO MUCH OF YOUR TIME
BUT I DO I WOULD LIKE TO FINISH
. THE BY STATING OF. AMONG OUR
OWN RATES IN THE FIRE DEPARTMENT
WE HAVE YOU KNOW A GREATER
NUMBER OF MENTAL ILLNESS- AND WE
OURSELVES ARE ABLE TO SERVE OUR
AYE I ALSO WORK IN OUR UNION
BOARD AND WE- ARE DIRECTLY IN IN
CARE OF ARE INDIVIDUALS WHO ARE
HAVING. ISSUES OVERALL I THINK
OUR SYSTEM IS BROKEN AT TIMES
BECAUSE WE DON'T. WHAT WERE WE
ON THE NINE ONE ONE SYSTEM
AREN'T PUTTING THEM INTO THE
FACILITY OR DIRECTING THEM TO
THE FACILITY- INSTEAD WE ARE
JUST TRANSFERRED TO AN AMBULANCE
AN AMBULANCE TO AN EMERGENCY
ROOM AND THEN WE HOPE FOR THE
BEST FOR THESE INDIVIDUALS. AND
I WOULD HOPE THAT WE COULD FIND
UP REVAMP NOT ONLY THEY- THE
HEALTHCARE SYSTEMS BUT THE NINE
ONE ONE SYSTEM AND HOW WE SHOULD
BETTER SERVE THE INDIVIDUALS IN
CRISIS OTHER THAN. TRANSFERRING
THEM TO- AN EMERGENCY ROOM AND-
OVERWHELMING THOSE SYSTEMS SO
HAVING A ROBUST MENTAL HEALTH
SYSTEM- THAT SUPPORTS PATIENTS
LONG. LONG BEFORE WE GET CALLED
OUT THERE IS HOPEFULLY EIGHT
EIGHT LARGE FOCUS AND THAT WE
CAN BUILD A BETTER SYSTEM-
BECAUSE- GETTING SOMEBODY THAT
HELP THE PERMANENT SIDE. IT AND
USING A FIFTY ONE FIFTY HOLD IT
SOMETIMES BECOMES EIGHT A GOTCHA
SYSTEM WHERE INDIVIDUALS NOT
REALLY TELLING US THEY WANT TO
HARM THEMSELVES THEY'RE NOT
REALLY- NO THEY DON'T HAVE A
WEAPON AND WE'RE NOT. BUT THEY
NEED HELP AND THEY NEED THE
INTERVENTION AND AT TIMES WE
FIND OURSELVES WELL THE ONLY WAY
WE CAN REALLY GET THIS
INDIVIDUAL IN THIS AMBIENCE
LEGALLY OR AND HELP THEM AS-
WELL. I WATCHED PEOPLE TRY TO
CONVINCE THEM TO IT SHOULD HAVE
PEOPLE SAY THAT THEY WANT TO
HARM THEMSELVES. AND IT'S REALLY
A- AND ASSIST AT TIMES THAT
THAT- CAN BE BETTER SERVED I
THINK IF WE HAD A DIFFERENT WAY
TO RESPOND- IN THE FIRE
DEPARTMENT WE HAVE RAPID
INTERVENTION TEAMS. YOU KNOW
WHAT WE'RE IN A FIRE IN THE
BUILDING COLLAPSES. WE HAVE A
TEAM THAT COMES IMMEDIATELY TO
SPECIALIZE IN HOW TO GET THE
INDIVIDUALS. THAT WERE TRAPPED-
IF WE HAD A SYSTEM. THAT COULD
UP THAT WE COULD CALL IF WE'RE
GOING TO A MENTAL HEALTH CRISIS
THAT WE DON'T DO THAT THEY NEED
TO AN EMERGENCY ROOM. WHO CAN WE
CALL THEY'VE CALLED US TO HELP
THEM BUT HOW HOW CAN WE GET THEM
THE BEST HELP THE BEST FACILITY-
FIRE DEPARTMENTS ALL ACROSS THE
STATE OF CALIFORNIA HAVE THE
BEST ACCESS TO ALL THESE
INDIVIDUALS WHEN THEY'RE IN
CRISIS WE MEET THEM FIRST. WHEN
THEY'RE HAVING THIS CRISIS BUT
WE DON'T SEEM TO BE GETTING ON
TO THE BEST FACILITY TO THE BEST
PEOPLE. THAT HARM- THE ABILITY
TO. TO HELP THEM IN THEIR MOMENT
OF CRISIS. SO WITH ALL THE FIRE
DEPARTMENTS WE HAVE IN EVERY
CITY AND ALL OUR FIRE ENGINES
THAT GO TO THESE AND HAVE
CONTACTS. IT SEEMS THAT IF WE
GETTING THEM. THE RIGHT HELP WE
CAN ELIMINATE THE CYCLE OF. AB
MEMBERS AND SEE ROOMS. A FEW
DAYS A COUNSELING IT BACK ON
STREET- IT JUST SEEMS THAT CAN.
STREAMLINE THIS BETTER TO BETTER
SERVE- THE INDIVIDUALS THAT ARE
HAVING THESE- MOMENT CRISIS.
THAT ULTIMATELY WE SEE IT EVERY%
DAY. THAT IF NOT TREATED IF NOT.
ANYTHING ELSE YES- USUALLY GOES
TO A- NOT A GOOD OUTCOME FOR
THESE INDIVIDUALS NOT LONG TERM.
SO ON IF YOU HAVE ANY QUESTIONS
I'M HERE TO ANSWER BUT- I DO
THANK YOU FOR YOUR TIME AND
ALLOWING ME TO SPEAK GREAT WELL
THANK YOU THANK YOU VERY MUCH
AND- ANY QUICK QUESTIONS FROM
THE PANELISTS BEFORE WE- MOVE ON
TO OUR NEXT PANEL. SO I WANT TO
SAY THANK YOU I JUST I JUST KIND
OF KIND OF SUMMARIZE WHAT WHAT
WHAT WHAT I HEARD THERE.
OBVIOUSLY WE HAVE TO CHALLENGES
WITH ONE MORE SESSION WE CAN
EXACERBATED BY COVE IT
EXACERBATES. WE HAVE BEEN
INCONSISTENT- INTERPRETATION OF
THE STATUTE- THAT WE SEE. THAT A
COUNTY BY COUNTY LEVEL SO WHICH
MAKES IT COMPLICATED FOR
HOSPITALS WHO ARE DOING A LOT OF
INTAKE HERE- WITH A LACK OF
FACILITIES. FOR PEOPLE WHO DO TO
GET CARE. THEY ALSO HEARD
THERE'S A LACK OF MONEY ALTHOUGH
WE PUT A BUNCH OF MONEY INTO THE
SYSTEM NOW- SO WE NEED TO KNOW
HOW THAT MONEY IS GOING TO BE
SPENT WHERE IT'S GOING TO BE
SPENT. AND WE ALSO HEARD THAT
YOU KNOW WHAT FIFTY ONE FIFTY
CAN BE A VALUABLE TOOL FOR THE
RIGHT PEOPLE. IT'S NOT ALWAYS
THE RIGHT TOOL AND THAT THERE
NEEDS TO BE SOME OTHER
ALTERNATIVES FOR PEOPLE THIS
TOOL BEING USED PROBABLY IN.
SOM CASES OUT OF DESPERATION
BECAUSE WE DON'T HAVE ANY OTHER
TOOLS IN THE TOOLBOX SO. SIZE
ONE I THINK THIS PANEL FOR- FOR
PARTICIPATING TODAY. AND WITH
THAT WE WILL GO AHEAD AND MOVE
ON TO OUR NEXT PANEL AND- MR
STONE IS GOING TO TAKE THE NEXT
COUPLE PANELS SENATORS PEOPLE.
THANK YOU SO CONTINUE IN WITH
STAKEHOLDER. INPUT WILL NOW MOVE
TO. WE HAVE. FOUR MEMBERS. CHIEF
ABDUL PRIDGEN WHO IS WITH US
REMOTELY. JOSEPH QUINN IN
PERSON. SCARLET HUES IN PERSON
AND TIFFANY MALES ARE NOT IN.
PERCENT OF THOSE IN PERSON WOULD
COME UP TO THE- TABLES IF
THERE'S ROOM MAYBE A COUPLE AT A
TIME. AND SO THE FIRST ONE IS
REMOTE CHIEF PRIDGEN ARE YOU
WITH US. I WAS TOLD HE MIGHT NOT
BE ABLE TO MAKE THE MORNING
SESSION. CHIEF PRIDGEN. OKAY IS
THAT ALLIANCE I THINK HE WILL BE
JOINING US THIS AFTERNOON. SO
WILL THAT MOVE TO JOSEPH QUINN
SUPERVISING. PROBATE JUDGE
SERVICES BECAUSE THE COURT. YOU
KNOW LIKE. WE HAVE TO. OKAY NOW
WE DO WE DO NEED YOU TO THE
MICROPHONE OTHERWISE WE DON'T
GET A RECORDING. THANK YOU- GOOD
AFTERNOON- CHAIRS WOOD AND STONE
AND MEMBERS OF THE COMMITTEES
AND SENATOR EGGMAN- THANK YOU
FOR- EXTENDING AN INVITATION FOR
TESTIMONY- TO THE JUDICIAL
COUNCIL- I AM A MEMBER OF THE-
PROBATE IN MENTAL HEATH
ADVISORY COMMITTEE FOR THE
JUDICIAL CUNCIL- AND-
VOLUNTEERED. TO PROVIDE THE
TESTIMONY- MY NAME IS JOE QUINN
I AM AT- A JUDGE OF THE SENSES
GOOD SECURE COURT AND- THE
SUPERVISING JUDGE. OF THE
PROBATE MENTAL HEALTH DIVISION
OF THE COURT. SO FIRST I JUST.
TALK A LITTLE BIT ABOUT WHAT THE
COURT'S ROLE- KIND OF ON A ON A
STREET LEVEL- IS IN THE L. P. S.
ACT- SO YOU KNOW LPS
CONSERVATORSHIP SO OFTEN START
WITH A FIFTY ONE FIFTY HOLD. AND
THE COURTS GENERALLY DON'T HAVE
ANY INVOLVEMENT- IN IN THAT
STEP- THOSE HOLDS CAN- YOU CAN
BE EXTENDED- AND THE COURT CAN
HAVE A ROLE IN HOLDING A HEARING
ON A CERTIFICATION. OR MEDICAL
POWERS- OR OTHER REQUESTS THOSE-
HEARINGS ARE HELD- WE HOLD THOSE
HEARINGS- AND I CAN ONLY SPEAK
OF COURSE TO. OUR EXPERIENCE
REALLY IN SAM CISCO WE HELD
THOSE HEARINGS AT TWELVE
DIFFERENT HOSPITALS IN THE
COMMUNITY- SO WE GO TO WHERE THE
PATIENTS ARE- AND THOSE HEARING
IT AT THOSE HEARINGS THE
PATIENTS ARE REPRESENTED- AND BY
THE PUBLIC DEFENDER. AND AND WE
DO TO KATE THE REQUEST- AND THEN
WOULD COME THE TEMPORARY
CONSERVATORSHIP IF- THE MATTER
ADVANCES TO THAT LEVEL AND
THOSE. ARE ADDRESSED- AS THEY
COME IN IT KIND OF THE EVERYDAY
OF THE WEEK- AND- THERE ARE-
RESULT ON THE ON THE PAPERS ON
THE MEDICAL INFORMATION
SUBMITTED AND- THE PETITION
SUBMITTED BY THE PUBLIC
CONSERVATORY. THEN THE COURT
CONDUCTS THE HEARINGS ON
PETITIONS FOR A CAN-
CONSERVATORSHIP- AND- ALSO COULD
BE A HEARING ON MEDICAL- POWER
IS. ON MEDICATION POWER IS- OR
YOU KNOW A NUMBER OF OTHER
RELATED REQUESTS AND PETITIONS-
SO AT THOSE HEARINGS- THE
PUBLICAN SERVITOR THE CITY
ATTORNEY THE DISTRICT ATTORNEY.
AND THE PUBLIC DEFENDER- I
SHOULD SAY BEFORE THOSE
HEARINGS- ALL THOSE PARTIES
COLLABORATE- TO PUT TOGETHER THE
CASES- AND TO ASSEMBLE THE-
CALENDAR. THE OUR CLERK'S OFFICE
DEDICATES- SUBSTANTIAL RESOURCES
TO PREPARING THE CALENDARS- AND
THEN- THE WE HOLD THE CALENDARS-
THE ORGANIZATION OF THE
CALENDARS IS SEVERAL MATTERS ARE
SUBMITTED ON THE PAPERS- AND IN
THE PAPERS BEING YOU KNOW THE
PETITION AND THE MEDICAL
TESTIMONY- AND THE LIKE- AND
THOSE ARE ARE ADDRESSED. FIRST
THEN WE HEAR IT IN THE A. O. T.
MATTERS- AND THE- IN THE C. I.
P. P. PROGRAM- MATTERS THE I. P.
P. IS ANOTHER. KIND OF-
OUTPATIENT- PROGRAM IS EVERY RUN
IN SAM CISCO- AND THEN WE HEAR
THE CONTESTED MATTERS- SO THOSE
ARE THE ONES WITH THE
EVIDENTIARY HEARINGS- AND- THERE
ARE. TYPICALLY A NUMBER OF
THOSE- IT BUT. THE KEY TO I
THINK THE WAY- THE- THE
CALENDARS ARE HANDLED- SEEMS. IS
THIS- RESOURCES THAT ARE PUT
INTO YOU KNOW ORGANIZING THEM
THE FRONT LOADED RESOURCES AND
THE RESOURCES PUT INTO THEM- IT
FOR HEARING- AND THE COOPERATION
OF A LOT OF PARTIES- ME AND I
MEAN YOU KNOW COURTS ARE- YOU
YOU KNOW YOU CAN. IN THE UNITED
STATES AN ADVERSARIAL- PROCESS-
BUT THERE IS A LOT OF
COOPERATION- AND THERE'S
AGREEMENT WHERE THERE CAN BE
AGREEMENT- AND- THERE'S A LOT OF
WORK THAT GOES INTO THAT. WE
CERTAINLY APPRECIATE THE HEMP
AND ARE VERY MINDFUL OF EVERYONE
INVOLVED IN THE SYSTEM IN THEIR
CISCO- IS MINDFUL OF THE
IMPORTANT LIBERTY INTERESTS- AND
THE IMPORTANCE OF SILENT DRESS-
AND- IT AND WE TRY TO KEEP TO
KEEP TRACK OF THAT- ON EVERY
CASE. FOR EVERY MATTER- IT'S
ALSO IMPORTANT TO NOTE THAT YOU
KNOW THE COURTS ARE RESPONSIVE-
WE RESPOND TO PETITIONS WE
RESPONDED TO REQUESTS AND WE-
RESOLVE THEM- LARGELY ON THE ON
THE RULES THEY HAVE- PROVIDED BY
THE LEGISLATURE. AND ON THE
EVIDENCE- THAT IT'S PRESENTED IN
pISSUES THAT WE SEE AND I'LL BE
BRIEF AND WE'LL TALK ABOUT THIS
MORE IN THE AFTERNOON BUT- YOU
FOR A LOT OF PLACEMENT PLACEMENT
IS AN ISSUE WE SEE ALL THE TIME.
THAT'S PROBABLY THE MOST
DIFFICULT PORTION OF THE OF ANY-
LPS GALLAGHER. IN ADDITION
TREATMENTS- AND THEN LEGAL
ISSUES ABOU. TIME LINES- THAT
ARE YOU KNOW BUILT INTO THE L.
P. S. ACT AND HOW PRACTICAL THEY
ARE AND HOW WORKABLE THEY ARE.
APPRECIATING THAT IT'S ALWAYS A
BALANCE THANK YOU. THANK YOU.
ALL RIGHT SO SCARLET HUE. NINE
FIFTY CENT.
AND JUST PUSH THE
RED BUTTON NEXT TO THE
MICROPHONE THAT TO TURN IT OFF.
THERE YOU GO OKAY THANK YOU VERY
MUCH. I'M SCARLET HUES I'M THE
EXECUTIVE DIRECTOR FOR THE
CALIFORNIA STATE ASSOCIATION OF
PUBLIC ADMINISTRATORS PUBLIC
GARDENS AND PUBLIC SERVICE. OUR
MEMBERS ARE THE COUNTY OFFICIAL
APPOINTED. TO REPRESENT PEOPLE
WHO HAVE SEVERE MENTAL ILLNESS
FOUR POINT THE CONSERVATIVE.
BECOME RESPONSIBLE FOR ALL OF
THEIR CARE THEIR DECISION
MAKING- THEIR PROPERTY. AND
DESPITE THE VARIOUS MANDATES PUT
FORWARD IN STATE LAW OUR MEMBERS
RECEIVE NO STATE FUNDING NO
DEDICATED STATE FUNDING IN FACT
AS NEAR AS WE CAN TELL. EXCUSE
ME. WE'RE THE ONLY MAJOR HEALTH
AND HUMAN SERVICES PROGRAM THAT
RECEIVES NO STATE FUNDING. AND
AS THE ONLY MAJOR CALIFORNIA
COUNTY SOCIAL SERVICE SAFETY NET
PROGRAM WHICH DOESN'T RECEIVE
STATE FUNDING OUR PROGRAMS ARE
STRUGGLING TO MEET THE DEMAND.
OUR POPULATIONS ARE GROWING BY
LEAPS AND BOUNDS. IN PART
BECAUSE OF NUMEROUS. LAWS THAT
HAVE BEEN PASSED OVER THE LAST
SIX TWENTY THIRTY YEARS SINCE
REALIGNMENT- OUR CASELOADS HAVE
. MORE THAN DOUBLED. WE HAVE
ABOUT 50% OF THE STUFF THAT WE
NEED TO MEET THE NEED CURRENTLY. AND SO WE SUBMIT RESPECTFULLY
THE FOLLOWING SUGGESTIONS. OR I
SHOULD SAY. IDENTIFIED THE
FOLLOWING OBSTACLES AND
DIFFICULTIES THAT OUR MEMBERS
ARE FACING. OUR MEMBERS ARE SO
SHORT STAFFED. THAT WE CANNOT
PROVIDE THE CARE THAT OUR
CLIENTS DESERVE. TO THE LEVEL
THAT THEY DESERVE IT. AN EVER
GROWING NUMBER OF INDIVIDUALS
WITH SERIOUS AND PERSISTENT
MENTAL ILLNESS EXISTING EXITING
THE JAILS. THE PRISONS AND ACUTE
HOSPITALS. HAS INTENSIFIED AND
WE ARE GETTING THOSE REFERRALS
BECAUSE OF THE- DIVERSION FROM
THE MIDDLE OF THE PRISON SYSTEM
FROM THE JUVENILE JUSTICE SYSTEM
NOT TOO LITTLE I'M SORRY. FROM
THE JUSTICE SYSTEM. BECAUSE
INDIVIDUALS ARE COMING TO
CONSERVATORSHIP. THAT HAS BECOME
THE NORM THROUGHOUT THE STATE.
JUSTICE REFORM HAS REALLY
RESULTED IN AND OUT
CONSERVATORSHIP AS THE
ALTERNATIVE TO INCARCERATION.
AND THAT IS NOT. AND I'M NOT
SAYING THAT BECAUSE THAT'S THE
WRONG THING THAT'S JUST THE
REALITY AND THOSE INDIVIDUALS DO
DESERVE TREATMENT AND OFTENTIMES
NEED CONSERVATORSHIP THE PROBLEM
IS. THERE'S ONLY SO MANY STUFF
IN A GIVEN OFFICE AND WE SIMPLY
DON'T HAVE THE CAPACITY TO
ABSORB THOSE INDIVIDUALS ANY
LONGER. IN ADDITION THE
INCOMPETENT TO STAND TRIAL
CRISIS THAT WE'RE SEEING IN OUR
STATE IS ALSO IMPACTING OUR
MEMBERS. THESE ARE INDIVIDUALS
WHO HAVE BEEN CHARGED WITH A
CRIME. AND THEY HAVE BEEN
DETERMINED TO BE INCOMPETENT TO
STAND TRIAL THEY DON'T HAVE THE
CAPACITY TO PARTICIPATE IN THEIR
OWN DEFENSE SO AS A RESULT.
THOSE INDIVIDUALS GO FOR
TREATMENT TO BE RESTORED
OFTENTIMES THEY'RE NOT RESTORED
AND SO THEY COME TO
CONSERVATORSHIP AS A RESULT.
THREE THERE'S A LOT THAT GOES
INTO EFFECT THE FIRST OF JANUARY
WHICH IS GOING TO DOUBLE THAT
NUMBER THAT WE'RE GETTING NOW.
BECAUSE OF THE MISDEMEANOR
INCOMPETENCE STAND TRIAL CASES
WILL ALL BE COMING OUR WAY NOT
ALL OF THEM THAT'S NOT ACCURATE.
BUT WE WILL BE SEEING AN
INCREASE IN THOSE CASES BECAUSE
THEY NO LONGER WILL BE GOING FOR
COMPETENCY TRAINING. THEY WILL
BE COMING MOSTLY THE
CONSERVATORSHIP. THE HIGH BURDEN
OF PROOF. IN THE LPS ACT. AND
MANY CASE LAW PRECEDENTS HAVE
NARROWED THE DEFINITION OF GREAT
DISABILITY. IT HAS ALSO LED TO
THE UNREALISTIC EXPECTATION THE
PUBLIC GUARDIAN CONSERVATORS ARE
THE ANSWER TO THE SOCIETAL
PROBLEMS THAT FORCED WERE
CHALLENGED WITH AT THE MOMENT.
MOSTLY THE HOMELESS AND
UNSHELTERED THERE IS A BELIEF IN
SOME SOME AREAS THAT
CONSERVATORSHIP CAN SOLVE THAT
PROBLEM I'M HERE TO TELL YOU CAN
NOT. WE DO NOT HAVE THE CAPACITY
NOR DO A LOT OF THOSE
INDIVIDUALS NEED THAT LEVEL OF
CARE. HOWEVER BECAUSE OF THE
CRISIS THAT WE'RE SEEING. THERE
IS A LOT OF THERE'S AN INCREASE
IN LOOKING TO CONSERVATORSHIP TO
SOLVE THAT PROBLEM. WE ALSO
DON'T HAVE ANY PARTNERSHIP WITH
A STATE AGENCY. WITHOUT A STATE
PARTNERSHIP WE CAN'T MEET THE
GROWING NEEDS OR COLLECT THE
DATA. THAT WE NEED TO MEASURE
THE QUALITY OF THE SERVICES THAT
WE'RE PROVIDING. AND CERTAINLY
CAN'T DEVELOP THE INFORMATION WE
NEED TO GUIDE FUTURE POLICY
DECISION MAKING. OUR PUBLIC
GUARDIAN CONSERVATORS. ARE ALSO
TAX WITH THE FACT THAT THERE'S
NO PLACEMENTS YOU'VE HEARD THAT
EARLIER SO I WILL BLAKE- GO OVER
THAT AGAIN. AND WE ALSO HAVE A
SEVERE LACK OF PSYCHIATRISTS AT
THE COUNTY LEVEL TO HELP WITH
THE- INDIGENT POPULATION WHICH
IS THE BUT MOST OF WHAT OUR
MEMBER SERVICE. AND WITH THAT MY
TIME IS OVER AND I'M READY FOR
ANY QUESTIONS IF YOU HAVE ANY.
THANK YOU TO MOVE HER LAST
SPEAKER OF THIS PANEL TIFFANY
LEÓN SENATE. YES. CAN YOU HEAR
ME YES. THANK YOU SO MUCH FOR
THE HONOR OF BEING HERE TODAY I
AM A PUBLIC DEFENDER I'VE BEEN A
PUBLIC DEFENDER FOR TWENTY YEARS
NEXT SPECIALIZING
CONSERVATORSHIP FOR THE LAST
FIFTEEN YEARS PUBLIC DEFENDERS
OFFICES HAVE A UNIQUE LENS
BECAUSE WE'RE NOT ONLY SEEING
INDIVIDUALS IN THE CRIMINAL
JUSTICE SYSTEM WITH MENTAL
HEALTH BUT WE ALSO REPRESENT
INDIVIDUALS AT THE PSYCHIATRIC
HOLD AND WHEN THEY LATER GO ON
TO. RID OF HABEAS CORPUS FOR
THOSE APPEALS OF THOSE
PSYCHIATRIC HOLES AND THEN LATER
ON IN LPS CONSERVATORSHIP AND
START WITH SOME DATA OVER THE
LAST NINE MONTHS- OUR PUBLIC
DEFENDER'S OFFICE CREATED A PRE
TRIAL SUPPORT PROGRAM WHERE WE
GO WHEN WE INTERVIEW PEOPLE IN
CUSTODY PRIOR TO ARRAIGNMENT TO
FIGURE OUT WHAT THEIR NEEDS ARE
WE DO EVIDENCE BASED TOOLS TO
ASSESS. ONE OF THOSE TOOLS IS
THE BRIEF MENTAL HEALTH
SCREENING TOOL I CAN TELL YOU IN
THE LAST NINE MONTHS WE SAW ONE
THOUSAND TWO HUNDRED AND
SEVENTEEN INDIVIDUALS. OF THOSE
52% HAD MENTAL HEALTH ISSUES.
89% NEEDED SOCIAL WORKER FOLLOW
UP SUPPORT 48% NEEDED HOUSING.
AND FORTY FOUR HAD A SUBSTANCE
USE. DISORDER THAT NEEDED
TREATMENT. SO OUR JOB IS THEN TO
SAY WHERE WE PUT THESE
INDIVIDUALS ARE THEY GOING TO GO
TO THE CRIME REPORT ARE THEY
GOING TO GO TO DIVERSION. OR DO
THEY GO THROUGH A
CONSERVATORSHIP TRACK. WE LETTER
IN THE PSYCHIATRIC FACILITIES WE
HAVE EIGHT PSYCHIATRIC
FACILITIES IN SACRAMENTO COUNTY
. OF THOSE EIGHT EVERYBODY THAT
COMES IN ON A FIFTY ONE FIFTY
HOLD HAVE A RIGHT TO
CERTIFICATION HEARING WITH
PATIENTS RIGHT THEY DIDN'T HAVE
A RIGHT TO APPEAL THAT HEARING.
THEY CAN BE HELD IN A
PSYCHIATRIC FACILITY ON HOLD FOR
FORTY SEVEN DAYS BEFORE BEING
PUT ON A TEMPORARY
CONSERVATORSHIP. HOW MANY PEOPLE
ARE WE TALKING WELL IN THREE
MONTHS AT EIGHT PSYCHIATRIC
FACILITIES. THERE IS ONE
THOUSAND NINE HUNDRED AND SIXTY
THREE HOLES. OF THOSE SCHOOLS.
ONE THOUSAND FIVE HUNDRED AND
NINETY AND IT UP AND HEARINGS.
THE PUBLIC DEFENDER'S OFFICE
TOOK THREE HUNDRED APPEALS OFF
OF THOSE SIXTEEN HUNDRED
HEARINGS. AND WHAT WE TRACK IS
HOW MANY ARE FROM OUR COUNTY AND
HOW MANY ARE FROM OTHER
COUNTIES. BECAUSE SACRAMENTO
COUNTY IS FORTUNATE TO HAVE A
LOT OF ACUTE PSYCHIATRIC
FACILITY WE GET A LOT OF
COUNTIES BRINGING THEIR CLIENTS
TO OUR COUNTY BECAUSE THEY DON'T
HAVE THOSE RESOURCES. SO OF
THOSE NINETEEN HUNDRED PEOPLE
25% WE'RE NOT SACRAMENTO COUNTY. IN TOTAL RIGHT NOW WE HAVE
ROUGHLY TWO HUNDRED FIFTY PEOPLE
AND LPS CONSERVATORSHIP THAT'S
DOWN FROM TWO THOUSAND AND EIGHT
WHEN WE HAD ABOUT FIVE HUNDRED.
SO LET ME TELL YOU JUST THROUGH
MY LENS WHERE I SEE THE FIVE
OBSTACLES THAT WERE REALLY
FACING NUMBER ONE LACK OF
PLACEMENT IN HOUSING WE'VE HEARD
THAT OVER AND OVER AGAIN.
CONSERVATIVES ARE USUALLY PLACED
IN BOARDING CARE LOT PLACEMENT
OR THROUGH THE STATE HOSPITALS
THOSE ARE USUALLY YOUR THREE
AVENUES. BOARDING CARE THERE IS
A LICENSING ISSUE AND I'LL TELL
YOU WHAT IT IS. ROMAN BOARDS
DON'T REQUIRE A STATE LICENSE.
SO GUESS WHAT HAPPENING THOSE
BOARDING CARES ARE SHUTTING DOWN
AND BEING CALLED ROMAN BOARDS
IT'S A WHOLE LOT EASIER THERE'S
NO OVERSIGHT FROM THE STATE.
RIGHT AND THEY CAN CHARGE WHAT
THEY WANT. AND THERE'S NOBODY
AUDITING OF THERE'S NO ONE
COMING IN SO WE'RE SEEING AN
INCREASE IN ALL THESE REMEMBER
IT'S POPPING UP EVERYWHERE BUT
WE CAN'T PLACE PEOPLE IN
CONSERVATIVE AND REMEMBER THAT'S
NOT LICENSED BY THE STATE. THE
OTHER THING WE'RE SEEING. IS THE
STATE SET DOWN OR DEVELOPMENTAL
DELAYS CENTER. AND WHERE DID
THOSE INDIVIDUALS GO THEY WENT
TO BOARDING CARES AND GUESS WHAT
BOARDING HERE'S GOT MORE MONEY
FOR AN INDIVIDUAL WITH THE
DEVELOPMENTAL DELAY ISSUE THEN
WITH A MENTAL HEALTH ISSUE. SO
WHAT YOU HAD IN YOUR BOARDING
CARDS ACROSS THE STATE BECOME
DEVELOPMENTAL DELAYS BOARDING
CARES WHERE THOSE PARTY CARES
MADE MORE MONEY LEAVING THE
MENTAL HEALTH FORTY CARES
CHECKED OUT. I'M LOCKED
PLACEMENTS WE HAVE LONG WAIT
LISTS TO GET INTO A QUEUE
FACILITIES- DEPARTMENT OF STATE
HOSPITALS WE HAVE THAT WAIT LIST
RIGHT NOW- ALL THIS IMPACTS THE
ENTIRE SYSTEMS. I TALKED TO UC
DAVIS AND THE LAST TWO AND A
HALF YEARS THEY HAD FOURTEEN
PATIENTS PENDING CONSERVATORSHIP
POLLS. THOSE FOURTEEN PATIENTS
MADE UP FIVE THOUSAND THREE
HUNDRED AND NINE DAYS MONEY.
WELL AN AVERAGE OF FIFTY THREE
HUNDRED DOLLARS A DAY THAT'S
TWENTY EIGHT MILLION DOLLARS FOR
THOSE FOURTEEN PATIENTS SITTING
IN A UC DAVIS. HOSPITAL WHEN
THEY COULD HAVE BEEN SOMEWHERE
ELSE- I HAVE PATIENTS I HAVE
CLIENTS IN JAIL WAITING TWO
YEARS FOR LPS PLACEMENT WE HAVE
AN ACUTE PSYCHIATRIC FACILITY
BUT AS FIFTY BEDS BUT FORTY
SEVEN OF THEM ARE LPS
CONSERVATORSHIP THEY CAN'T MOVE
INTO BETTER PLACEMENT. THAT'S
NOT THE APPROPRIATE PLACE I'M
REAL QUICK BECAUSE I'M RUNNING
OUT OF TIME. BACK OF CORONATION
WITH THE SYSTEM WE'RE TRYING TO
COORDINATE PRIVATE SECTORS
HOSPITALS JAILS MENTAL HEALTH
FACILITIES. WE HAVE LACK OF
COORDINATION WITH STATES WE
RIGHT NOW HAVE- STATES AND
COUNTIES NOT HAVING RESOURCES SO
THEY DUMPED INTO OTHER COUNTIES.
AND THE OTHER BIG ISSUE IS
FINDING WE HAVE A GREAT STATE
FUNDING THEY'RE NOT. ALLOCATING
MONEY JUST FOR LPS THERE ONE
TIME FUNDING. I'M IN THERE NOT
CARVED OUT. THIS RECYCLED THIS
CAUSES RECYCLES OF HOLES THIS
CAUSES PROBLEMS IN PLACEMENTS-
WE HAVE BLOODY DISCHARGE
HAPPENING WE HAVE INCREASED IN
THIRTEEN SIXTY EIGHT ISSUES
HAPPENING WE'RE NOT ADDRESS THE
NEEDS OF FRIENDS. THANK YOU SO
MUCH. THANK YOU THANK YOU
INTERESTING PANEL AND MEMBERS
ARE ALSO NOTED THAT THIS PANEL
WILL BE BACK IN THE AFTERNOON
TALKING ABOUT POTENTIAL
SOLUTIONS AND TEN BEST PRACTICES
OF THIS IS LAYING THE FRAMEWORK
FOR THE CHALLENGES AHEAD OF US
OR THEIR QUESTIONS FOR THIS
PANEL AT THIS POINT. I WOULD
JUST HAVE ONE QUICK ONE QUESTION
AND I WANT AND I WANT TO THANK
YOU ALL FOR YOUR WORKING FOR
YOUR PASSION AND FOR. TAKING THE
TIME OUT TO COME TODAY INTENT
AND HELP US UNDERSTAND ALL OF
THESE MORE OF THESE PROBLEMS.
BUT JUST BROUGH AND I'M SURE
THAT THESE NUMBERS ARE HERE
SOMEWHERE BUT THAT THE HOW MANY
PEOPLE WHO ARE IN PUBLIC
GUARDIANSHIP I MEAN IT WASN'T.
THE PERCENTAGE OF PEOPLE WHO ARE
ON UNDER CONTROL WORKING SERVED
WHO HAVE A PRIVATE GUARDIAN OR
PUBLIC GUARDIAN DO WE KNOW THAT
NUMBER. NOBODY KNOWS THAT NUMBER
I CAN TELL YOU ROUGHLY WHAT THE
PUBLIC DEFENDER JUST BECAUSE WE
REPRESENT ALL OKAY- WE HAVE TWO
HUNDRED FIFTY AND PUBLICLY.
RIGHT NOW WE HAVE ABOUT THIRTY
EIGHT PRIVATE. OKAY AND OKAY AND
WE DON'T KNOW THAT STATEWIDE BUT
WE COULDN'T WE COULDN'T. RIGHT
WE COULD STRUGGLING WITH
POTENTIALLY OKAY IT'S REALLY
HARD FOR FAMILIES TO TAKE A YES
ABSOLUTELY ABSOLUTELY ABSOLUTELY
ESPECIALLY WHEN IT. WHEN IT WHEN
IT'S BEEN GOING ON FOR YEARS AND
YEARS AND YEARS OF THE TIME
JUSTICE OKAY THANK YOU VERY
MUCH. AND I AND I AM IN THE HIVE
. I WASN'T AWARE THAT THE OF THE
NAME SWITCH THE BOARDING CARE TO
THE TO THE CARE MORE TO THAT'S
THAT'S CRAFTY. DESCRIBED BUT AND
CERTAINLY THE IDEA DE POPULATION
I MEAN THEY'RE NOT MAKING
MILLIONS EITHER RIGHT EVERY SO
THAT FOR IT RIGHT BUT IT TELLS
US. IT HELPS US I THINK-
UNDERSTAND THE PROBLEM THAT THE
EVEN DEEPER LEVEL ABOUT HOW. HOW
WE THINK WE CREATE A SYSTEM IN
THOSE WORK AROUNDS. THANK YOU
THANK. THANK YOU OTHER FOR THE
QUESTIONS THAT'S RIGHT I ALSO
WANT TO THANK YOU ON THE
STATISTICS- SHOWING US HOW MANY
HELP THE MENTAL HEALTH OF THAT
THE THOUSANDS OF JUDAH
INTERVIEWED- THE HOUSING WORKS
HOUSING IS THE ISSUE OR
SUBSTANCE ABUSE KNOWING THAT
THAT INFORMATION ALSO IS VERY
HELPFUL AND I'M LOOKING FORWARD
TO THIS AFTERNOON WHEN YOU
PROVIDE SOME INSIGHT ON WHAT IT
IS WE NEED TO DO TO FIX THAT
THANK YOU WE OFTEN TIMES FORGET
TO LOOK AT NEEDS AND I'M TRYING
TO GET AWAY FROM THAT SILO.
WE'RE TRYING TO FIT PEOPLE AS
JUST MENTALLY ILL AND THEY'RE
NOT THEY'RE VERY COMPLEX WHICH
IS WHY WE'RE ALL HAVING THE
CHALLENGES THAT THE STATE. OKAY
ON THE QUESTION RIGHT THANK YOU
PANEL SEE YOU BEING HERE AND FOR
YOUR SERVICE DESK TODAY THIS
MORNING AND IN THE AFTERNOON
ALTHOUGH I GUESS WE ARE OFTEN
TECHNICIANS RIGHT NOW WILL MOVE
ON TO THAT ADVOCATES THEN AGAIN
WE'RE GOING TO BE SEEING. EACH
OF THESE PANELS THIS MORNING TO
THE DELAY OF THE PROBLEM IN IN
THE AFTERNOON TO LAY OUT SOME
SOLUTIONS AND WITH US WE HAVE
MOST OR IN PERSON KAREN SAVAGE.
THREE SEPARATE SCREENING
JENNIFER FREED BY. ANY CHANCE
MORE EATEN FOR IS WITH US
REMOTELY. SO SORRY WE'RE WE'RE
TRYING TO STAGE. BASED A LITTLE
BIT YEAH BUT ALSO PROVIDE FOR.
BUT PEOPLE TO COME TO THE PANEL. SO THANK YOU SO. PLEASE GO
AHEAD GREAT- SO- GOOD MORNING I
THINK IT'S STILL MORNING ADD
SHARES AND COMMITTEE MEMBERS MY
NAME IS KAREN SAVAGE THAT ONE
AND THAT DECADE RECTOR OF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK OR C. PEN WE'RE
STATEWIDE MULTI CULTURAL HEALTH
ADVOCACY ORGANIZATION AND I
FIRST REALLY WHEN I THINK
KERRISON CLUTCH YOU SHARE THEIR
PERSONAL STORIES EARLIER FOR
ABOUT THEIR BRAVERY AND THEIR
GENEROSITY. I KNOW THIS IS A
DIFFICULT EMOTIONAL TOPIC FOR
MANY OF US WHO ARE INVOLVED
BECAUSE OF OUR PERSONAL
EXPERIENCE I ALSO WENT WITH
KNOWLEDGE THAT I WAS ASKED TO
ADDRESS RACIAL DISPARITIES AND
RACIAL JUSTICE CONSIDERATIONS
FOR THIS CONVERSATION AND I PLAN
TO ADDRESS THIS IN THREE AREAS
WHAT WE KNOW WHAT WE DON'T KNOW
HOW AND WHERE WE GO FROM HERE.
SO FIRST WHAT WE KNOW. WHAT WE
KNOW IS THAT THERE IS A LONG
HISTORY. OF BIAS AND
DISCRIMINATION BASED ON RACE IN
MENTAL HEALTH DIAGNOSIS. AND
TREATMENT IN THE UNITED STATES.
BUT IT WOULD BE A MISTAKE TO
ASSUME THAT THIS IS A THING OF
THE PAST. RESEARCH SHOWS THAT
EVEN PRESENTLY BLACK AMERICANS
ARE OVER DIAGNOSED WITH
SCHIZOPHRENIA AND UNDER
DIAGNOSED WITH DEPRESSION. EVEN
WHEN COMPARING SIMILAR
SYMPTOMATIC PRESENTATIONS IN
BLACK AND WHITE PATIENTS. AS A
RESULT THE AMERICAN PSYCHIATRIC
ASSOCIATION. ISSUED A STATEMENT
EARLIER THIS YEAR APOLOGIZING.
TO BLACK INDIGENOUS AND PEOPLE
OF COLOR. FOR THE ROLE OF
PSYCHIATRY IN PERPETUATING
RACISM IN THE PAST AND TODAY.
PEOPLE OF COLOR OFTEN EXPERIENCE
A TRAJECTORY OF MENTAL ILLNESS
THAT PUTS THEM IN A POSITION OF
BEING SUBJECT TO ITS COERCIVE
TREATMENT AS A RESULT OF THEIR
MENTAL HEALTH SYMPTOMS. THIS
TAKES THE FORM OF BOTH
INVOLUNTARY MENTAL HEALTH
COMMITMENT AND CRIMINAL JUSTICE
INVOLVEMENT. THIS IS BASED ON A
LACK OF ACCESS TO EVIDENCE BASED
AFFORDABLE AND COMMUNITY MENTAL
HEALTH SUPPORTS. AS WELL AS WELL
AS THE PERVASIVE IMPLICIT BIAS
THAT LEADS TO THE STIGMATIZING
BELIEF THAT PEOPLE OF COLOR
EXPERIENCING MENTAL ILLNESS ARE
DANGEROUS. PEOPLE OF COLOR ARE
LESS LIKELY TO BE ABLE TO ACCESS
EXISTING MENTAL HEALTH SERVICES
THAN THEIR WHITE PEERS AND MOST
LIKELY TO REPORT AN UNMET NEED
FOR MENTAL HEALTH SERVICES. OF
THOSE WHO DO MAKE IT THROUGH THE
DOOR AND WHO DO ACCESS SERVICES.
PEOPLE OF COLOR OFTEN EXPERIENCE
LOWER QUALITY OR LESS EFFECTIVE
TREATMENT. WHAT COLOR ARE MORE
LIKELY TO BE SEEN IN EMERGENCY
DEPARTMENTS FOR PSYCHIATRIC
TREATMENT. WHICH IS OFTEN A
GATEWAY TO SHORT AND LONG TERM
INVOLUNTARY COMMITMENTS. AS A
RESULT PEOPLE OF COLOR
DISPROPORTIONATELY REPRESENTED
IN BOTH INPATIENT AND OUTPATIENT
INVOLUNTARY TREATMENT- SETTINGS
. A STUDY OF NEW YORK STATE'S
KENDRA'S LAW FOR ASSISTED
OUTPATIENT TREATMENT. SHOW THAT
PER TWENTY YEAR PERIOD 35% OF
THOSE WITH AN INVOLUNTARY
OUTPATIENT COMMITMENT ORDER WERE
BLACK COMPARED TO JUST 17% OF
THE STATE POPULATION. DATA
UNDERSERVED BY CALIFORNIA
SPECIALTY MENTAL HEALTH SYSTEM
SHOWS THAT BLACK CLIENTS ARE
NEARLY TWICE AS LIKELY TO
EXPERIENCE A PSYCHIATRIC
HOSPITALIZATION AS WHITE
CLIENTS. MOREOVER BLACK KAIET
SOMETIMES HAVE LONGER
HOSPITALIZATIONS AND ARE EVEN
LESS LIKELY TO RECEIVE FOLLOW UP
WITH DISCHARGED. THEN THERE'S
WHAT WE DON'T KNOW AND THE GAPS
IN DATA HAVE BEEN ROBUSTLY
DISCUSSED TODAY. BUT I WILL ADD
TO THAT THAT WE DON'T KEEP
STATEWIDE AND- FULL DATA ON
THEIR RACE OR ETHNICITY OF THOSE
SUBJECTS LPS HOLDEN
CONSERVATORSHIP. THAT'S NOT PART
OF THE DATA THAT COUNTIES REPORT
TO THE DEPARTMENT OF HEALTH CARE
SERVICES. AND AS A RESULT WE'RE
UNABLE AT THE STATE AND YOU ARE
UNABLE TO ASSESS PATTERNS OF
BIAS AND DISCRIMINATION THAT MAY
NEED TO BE ADDRESSED. SO WHERE
DO WE GO FROM HERE. IF THE
DANCING RACIAL EQUITY IS A GOAL
OF REFORMING ANY PART OF THE
MENTAL HEALTH SYSTEM IN
CALIFORNIA. WE MUST CONSIDER THE
FOLLOWING. WE MUST HAVE A FULL
PICTURE OF HOW PEOPLE ACCESS OR
FAIL TO ACCESS ALL COMPONENTS OF
THE MENTAL HEALTH SYSTEM. WITH
SPECIFIC CONSIDERATION OF
MARGINALIZED COMMUNITIES AND WE
MUST UTILIZE THIS INFORMATION TO
MAKE DATA DRIVEN DECISIONS.
SECOND WE MUST FIND AND BUILD A
FULL CONTINUUM OF CULTURALLY
APPROPRIATE PERSON CENTERED
MENTAL HEALTH TREATMENT. I MUST
ENGAGE IN RIGOROUS PURSUIT OF
EVIDENCE TO UNDERSTAND WHICH
SERVICES ARE EFFECTIVE OR NOT.
THIRD WE MUST STOP LETTING
MARGINALIZED CALIFORNIANS FALL
THROUGH THE CRACKS BY ENSURING
THAT EVERY CALIFORNIAN HAVE HAS
ACCESS TO A BEHAVIORAL HEALTH
HOME. AND FOURTH WE MUST
HONESTLY AND INTENTIONALLY
ADDRESS ROOT CAUSES. A SOCIETAL
CRISES INCLUDING MASS
INCARCERATION. AND UNSHELTERED
HOMELESSNESS. IN CLOSING I'D
LIKE TO SHARE MY BRIEF PERSONAL
EXPERIENCE. TWO YEARS AGO I GAVE
BIRTH TO MY DAUGHTER AT KAISER
HOSPITAL IN THE SACRAMENTO AREA.
THE BIRTH WAS UNEXPECTEDLY
COMPLICATED AND THE NEXT
MORNING. WELL IN THE RECOVERY
UNIT I REALIZED THAT I WAS NOT
OKAY. I WAS EXPERIENCING A
RESPONSE TO A TRAUMA. THAT I HAD
UNDERGONE AND I NEEDED HELP. MY
AMAZING NURSES RECOGNIZE THAT I
DID NEED SUPPORT AND THEY TAPPED
EVERY RESOURCE THEY HAD TO TRY
TO GET MENTAL HEALTH SUPPORT FOR
ME. HOWEVER I WAS ULTIMATELY
GIVEN TWO OPTIONS. I COULD GO
HOME AND TRY TO FIND RESOURCES
ON MY OWN. OR THE HOSPITAL COULD
PLACE ME ON A FIFTY ONE FIFTY
HOLD SEPARATING ME FROM MY
NEWBORN BABY. I DON'T THINK
THAT'S THE CHOICE THAT ANY NEW
MOM ASKING FOR HELP SHOULD BE
GIVEN. I HOPE THAT AS THIS
CONVERSATION CONTINUES YOU WILL
ENSURE THAT WE DO NOT USE THE
LPS ACT TO PLUG THE SUBSTANTIAL
GAPS IN OUR COMMUNITY MENTAL
HEALTH SYSTEM. INSTEAD WE CAN
ACT WITH EQUITY AND INCLUSION AS
OUR CORE VALUES. AND SUPPORT THE
MENTAL HEALTH AND WELL BEING OF
ALL CALIFORNIANS THANK YOU.
THANK YOU PRESS THREE SERVICE
CLAIMS. HI THANK YOU SO MUCH-
CHAIR CHAIR STONE- I I'M I'M
GOING TO TRY TO REDUCE MY
COMMENT SO I KNOW WE'RE OUT OF
TIME HERE- I DO HOPE TODAY TO
HEAR THE VOICES OF MANY FAMILIES
LIKE MINE- I AND I'M GRATEFUL TO
NAOMI CALIFORNIA FOR GIVING ME
THIS OPPORTUNITY MY NAME IS
TERESA PASQUINI AND I AM A
CALIFORNIA MOM ON A MISSION. TO
SAVE MY SON'S LIFE AND POSSIBLY
OUR STATE AND NATIONAL SOUL I AM
A LOCAL STATE NATIONAL ADVOCATE
FOR THOSE WHO LIVE HE WROTE KLAY
WITH A SERIOUS MENTAL ILLNESS
WHICH ARE BRAINLESS IS NOT
BEHAVIORAL CHOICES. MY BELOVED
SON DANNY HAD HIS FIRST FIFTY
ONE FIFTY AT THE AGE OF SIXTEEN
AND A SUICIDE BY COP TYPE OF IT.
WITH THE HELP OF THE
PEDIATRICIAN AND CLINICIAN HE
WAS DIAGNOSED EARLY RECEIVED
INTENSIVE THERAPIES HAD A JOB
AND GRADUATED FROM HIGH SCHOOL
WE THOUGHT WE HAD MANAGED HIS
CARE. BUT ON HIS EIGHTEENTH
BIRTHDAY HE WAS FIFTY ONE FIFTY
FOR THE SECOND TIME AND FELL
INTO WHAT I CALL THE BLACK HOLE
OF THE CALIFORNIA DON'T MENTAL
HEALTH SYSTEM. HE WAS PLACED ON
AN LPS CONSERVATORSHIP AT THE
AGE OF NINETEEN DURING HIS THIRD
INVOLUNTARY HOSPITALIZATION THAT
YEAR. WE RECEIVED LPS
CONSERVATORSHIP PAPERS FROM THE
CONTRAPOSITIVE COUNTY PUBLIC
GUARDIAN'S OFFICE. I CALLED THE
OFFICE TO FIND OUT WHAT THIS
MEANT AND THE PUBLIC
CONSERVATIVE SAID TO ME. WHY DO
YOU KEEP BRINGING HIM HOME HE IS
VERY SICK. AT THE SAME TIME HIS
INPATIENT PSYCHIATRIST TOLD US
THAT WE WOULD BE LUCKY. IF WE
COULD GET OUR SON INTO THE
CRIMINAL JUSTICE SYSTEM HE SAID
IT CASUALLY AS THOUGH WE WERE
BEING. AS THOUGH HE WERE BEING
ACCEPTED TO CAL OR STANFORD. I
WAS INFURIATED I REALIZED THAT
HE WAS GIVING US FAIR WARNING
THAT THE CRIMINAL JUSTICE IS
WHERE WE HOUSE PEOPLE. WITH SMI
IN CALIFORNIA. AS MY FRIEND AND
FELLOW NOMINEE MEMBER MARC GAIL
SAYS THIS IS BECAUSE QUOTE JAIL
IS THE BAD THAT NEVER SAY NO. I
LEARNED THEN THAT THE SYSTEM
REQUIRED ME TO MAKE MY SON
HOMELESS AND GRAVELY DISABLED IN
ORDER TO GET HIM THE MEDICALLY
NECESSARY TREATMENT. I LEARNED
EVERY NUANCE OF EVERY STATUTES
POLICY AND REGULATION I BECAME
AN EXPERT ON NAVIGATING A BROKEN
SYSTEM THAT DEMANDS IT DANGEROUS
NOUS COMPLETE DETERIORATION
BEFORE ONE CAN ACCESS THE LEVEL
OF CARE. THAT MY SON NEEDED BUT
I ASKED EVERYONE HERE TODAY
ISN'T IT TIME THAT WE ALL
UNBREAK THE SYSTEM TOGETHER.
DURING THE TWENTY YEARS OF MY
SON'S CONSERVATORSHIP HE WAS
FIFTY ONE FIFTY OVER FORTY
TIMES. PLACED IN MULTIPLE LOCKED
FACILITIES IN NINE COUNTIES
ARRESTED AS A PATIENT AND PUT IN
SOLITARY WELL UNDER AND I. S. T.
HOLD. SHUFFLE BETWEEN TWO STATE
HOSPITALS AND WAS MIRACULOUSLY
STAYED FROM PRISON WHEN DIVERTED
TO AN I. N. D. IN MERCED COUNTY
WHERE HE WAS STABILIZED PROPERLY
TREATED AND HAD ALL CRIMINAL
CHARGES DROPPED. RECEIVING THE
APPROPRIATE LEVEL OF CARE IN A
LOCKED I AM DEEP ALLOWED HIM TO
SUCCESSFULLY TRANSITION TO
SYNERGIES NO WAVE OF VISTA
CAMPUS IN SANTA CLARA COUNTY.
FINALLY HE WAS IN THE NINE
O'CLOCK HOUSING THAT HEELS
FACILITY HE HAS BEEN LIVING
STABLY SAFELY AND SOBER IN THE
COMMUNITY FOR OVER TWO YEARS HIS
TWENTY YEAR LPS CONSERVATORSHIP
WAS RENEWED THIS MONTH AND I AM
SO GRATEFUL THAT HE NOW HAS THE
CAPACITY. TO KNOW HE NEEDS IT.
THERE HAS BEEN NOTHING CIVIL OR
RIGHT ABOUT MY SON'S CARE IN
CALIFORNIA. WE MUST STOP SAYING
THAT WE ARE PROGRESSIVE
PROTECTORS OF HUMAN CIVIL AND
DISABILITY RIGHTS WHILE WE ARE
FORCING THE MOST VULNERABLE
POPULATION. INTO EARLY GRAVES
SOLITARY JAIL CELLS ARE HOMELESS
ENCAMPMENTS IN THE NAME OF
FREEDOM OF CHOICE. THERE IS NO
CHOICE NO DIGNITY NO FREEDOM
UNDER THE CURRENT LPS SYSTEM.
SELF DETERMINATION WITHOUT
REGARD TO HOW HIGH A PRICE MUST
BE PAID FOR THAT PRIVILEGE IS
TOO HIGH A PRICE EMPLACEMENT IN
JAILS PRISONS STATE HOSPITALS
ARE HOMELESSNESS AND
VICTIMIZATION. ARE NOT EVIDENCE
OF FREEDOM. TELL ME HOW CAN ONE
PARTICIPATE IN INFORMED CONSENT
IF ONE SUFFERS FROM MANTA SAID
NOKIA THE LACK OF INSIGHT THAT
ONE IS STILL. THE LPS LAW DOES
NOT WORK THE DEFINITION OF GREAT
DISABILITY IS VAGUE AND NARROW
AND IT IS JUST LUCK AND AEROBICS
THAT OUR SON IS STILL ALIVE. MY
SON'S LIFE IS NOT A GAME OF
RISK. POLICY MAKING MUST BECOME
HUMANITY BASED REALITY BASED
DATA BASED ON EQUITY BASE WITH A
LASER FOCUS ON THE FORGOTTEN SMI
POPULATION. THE WAY THAT WE
TREAT THE SERIOUSLY MENTALLY ILL
POPULATION IN OUR STATE IS
SHAMEFUL AND IT'S UNACCEPTABLE.
IN TWENTY TWENTY I CO WROTE A
PAPER WITH LORNA TELANGANA
CALLED HOUSING THAT HEALS AND IN
THAT PAPER WE DETAIL OUR LIVED
EXPERIENCE WITH CALIFORNIA'S
BROKEN SYSTEM OF CARE. IT
DESCRIBES HOW MY SON AND FAMILY
EXPERIENCE EVERY JAGGED EDGE OF
EVERY BROKEN PIECE THAT THE
CALIFORNIA MENTAL HEALTH SYSTEM.
BOTH PUBLIC AND PRIVATE. AND IN
SPITE OF ALL OF OUR EFFORTS AND
RESOURCES MY SON ENDED UP IN
NAPA STATE HOSPITAL ON THE CIVIL
NOT A CRIMINAL COMMITMENT AND
WAS THEN ARRESTED AS A PATIENT
AND PLACED IN THE I. S. T. HUMAN
LOG JAM. THAT EXPERIENCE ALMOST
BROKE MY SON AND OUR FAMILY BUT
WE SURVIVED TO TELL OUR STORY
AND I REFUSED TO LEAVE THAT DAY
OUT OF THE SOUL OUT OF ANY HELP
OR JUSTICE REFORM CONVERSATION.
NO FAMILY MEMBER WANTS TO COMPEL
THEIR LOVED ONE TO RECIEVE
TREATMENT OVER OBJECTION. UNLESS
THEY LACK THE CAPACITY OF MAKING
A VOLUNTARY DECISION TO SEEK
TREATMENT ON THEIR OWN. IT IS A
GUT WRENCHING DECISION THAT
TEARS UP THE HEART AND SOUL OF
THE FAMILY. WE HEAR ABOUT THE
RIGHTS OF THE LARGER DISABLED
COMMUNITY BUT THERE IS SILENCE
ABOUT THE RIGHTS OF THE US OF MY
POPULATION WHO ARE GRAVELY
DISABLED. FAMILIES LIKE MINE ARE
SHATTERING THE SILENCE AND WE
ARE ASKING THAT OUR LOVED ONES
HAVE ACCESS TO WHATEVER IT TAKES
TO BECOME A GRAVELY DISABLED.
HELP US. HELP THEM LEARN LOVE
WORK LIVE FREE. FROM FREEDOM
FROM CODIFIED FISCAL
DISCRIMINATION IN THE LEGAL
TORTURE OF LPS. THIS IS NOT A
CIVIL LIBERTIES BATTLE AS LONG
AS WE CONTINUE TO USE JAILS OF
HEALTH FACILITIES AND SPEND
MILLIONS ON JAIL FACE LIVES TO
MAKE SUFFERING LOOK BETTER THIS
IS NOT A BATTLE OF CHOICE WHEN
THERE IS NO CHOICE FOR FAMILIES
EXCEPT TO WAIT FOR DANGER OR
REFUSED TO HOUSE OUR LOVED ONES
IN ORDER TO GET THEM HELP.
BEFORE HARM YOU ASK HOW CAN HELP
YES BE IMPROVED. PLEASE STOP
FORCING OUR LOVED ONES TO
DETERIORATE TO A LEVEL OF
DANGEROUSNESS AND AN INABILITY
TO SURVIVE SAFELY IN OUR
COMMUNITIES BEFORE THEY ARE
ELIGIBLE. FOR THE HELP THEY
NEED. TREATMENT IS NOT A BAD
WORD. MY SON NEED TO TREAT THAT
PERSON NOT HOUSING FIRST HE HAD
A HOME. HE ALSO HAD A BRAIN
DISORDER THOUGHT DISORDERS BUT
STILL IT'S CAPACITY TO THINK
CLEARLY ABOUT HIS CHOICES AND
SELF DETERMINATION. HIS NOBLE
BRAIN ILLNESS REQUIRED THE LPS
LAWS TO PROTECT HIM NOT TO MAKE
HIM FEEL OVER AND OVER AND OVER
AGAIN. AND THERE IS NO DIGNITY
IN CONTINUOUS FAILURE. WE MUST
MOVE ON LOCK. ENTEROTOXIN
CALIFORNIA IF WE ARE GOING TO
PROVIDE A WHOLE PERSON CARE THEN
WE NEED A WHOLE CONTINUUM OF
CARE. AND THAT IS WHAT THE
HOUSING THAT HILLS VISION
ATTEMPTS TO ACHIEVE. TO
DEMONSTRATE THAT THERE ARE
SOLUTIONS AND ALTERNATIVES TO
STATE HOSPITALS JAILS PRISONS
HOMELESSNESS FOR FAMILIES LIKE
MINE. WE MUST ALL LAY DOWN OUR
IDEOLOGICAL WEAPONS AND UNITE
OUR HUMANITY IN SUPPORT OF LOS
AT WORK IN THE REAL WORLD TO
FACILITATE TREATMENT SO PEOPLE
HAVE A RIGHT TO TREATMENT BEFORE
TRAGEDY AND CAN LIVE IN DIGNITY.
I'VE SEEN IT HAPPEN I KNOW IT'S
POSSIBLE AND IT SHOULD NOT HAVE
TAKEN TWENTY YEARS OF BEING
SHUNNED SHAMED FAILED IN JAIL.
THANK YOU. THANK YOU I'M SORRY
PLEASE WE'RE NOT GOING TO TAKE
OUT. THOSE WHO CONSIDERED
OUTBURST IF YOU WANT TO SUPPORT
SOMEONE YOU CAN DO IT SILENTLY
THAT IS APPRECIATED. WELL NOW
MOVE ON TO JENNIFER FREED BACK
WHO'S WITH US REMOTELY. I THANK
YOU STILL SORRY THERESA- TO LONG
I. THE WAY OF INTRODUCING MYSELF
I'M JENNIFER FREEDOM BOUGHT A
DIRECTOR OF THE COALITION ON
HOMELESSNESS IN SAN FRANCISCO-
WE ORGANIZE ON HEALTH FOLKS TO
CREATE PERMANENT SOLUTIONS TO
HOMELESSNESS- I'VE BEEN INVOLVED
ON AND OFF WORKING TO TRANSFORM
THE MENTAL HEALTH SYSTEM IN SAN
FRANCISCO FOR THE PAST TWENTY
SEVEN YEARS. GATHERING INPUT
DIRECTLY FROM FOLKS WHO ARE
HOMELESS AND HAVE MENTAL HEALTH
STRUGGLES AND THEN AMPLE FIND
THE COMMON EXPERIENCES OF SYSTEM
FAILURES AND CHANGES NEEDED.
WELL SAN FRANCISCO IS SEEN AS
HAVING A ROBUST- MENTAL HEALTH
SYSTEM IT IS IN FACT NOWHERE
NEAR MEETING THE NEED. IN TRUTH
OUR BEHAVIORAL HEALTH SYSTEM IS
A MESS- DUE TO SEVERE FUNDING
CUTS OVER THE LAST FORTY YEARS-
RESULTING IN A BYZANTINE ACCESS
SYSTEM THAT SERVES TO DISQUALIFY
PEOPLE RATHER THAN ENGAGE THEM
IN. SINCE WE DON'T HAVE ADEQUATE
QUICK CARE FOR FOLKS IN THE
COMMUNITY ARE SYSTEM IN SAN
FRANCISCO IS OVERLY RELIANT ON
THE HIGH END OF CARE. MANY FOLKS
OKAY KAREN TELL THEIR CRISES AND
BROUGHT IT ON TO YOUR COLD. THIS
EXPERIENCE LAYERS ADDITIONAL
TRAUMA MAKING RECOVERY MORE
DIFFICULT. SAN FRANCISCO HAS THE
HIGHEST RATE BY FAR OF PERMANENT
CONSERVATORSHIP IN THE STATE AND
LAST YEAR ABOUT NINE THOUSAND
TIMES AN INDIVIDUAL WAS FIFTY
ONE FIFTY DID SAN FRANCISCO
ALONE. IN A LEGISLATIVE ANALYST
REPORTS ON A TWO THOUSAND AND
EIGHTEEN OF FOUR THOUSAND SIX
HUNDRED SIXTY SIX ON HOUSE
INDIVIDUALS WERE BROUGHT INTO
SAN FRANCISCO GENERAL PSYCH
EMERGENCY FOR A FIFTY ONE FIFTY.
B. TWENTY NINE LANDED IN A
RESIDENTIAL TREATMENT PROGRAM
WHILE ALMOST EIGHTEEN HUNDRED-
WE'RE JUST CHARGE OF THE STREET
WITH NOT EVEN A. REFERRAL TO ANY
TYPE OF HELP AT ALL. I FOR THOSE
WHO WERE HELD AS- TO BEAT THE
CRITERIA. ARE WEIGHTLESS FOR
APPROPRIATE PLACEMENT LET. A
CUTE STAYS BEYOND WHAT WAS
MEDICALLY NECESSARY OR IN SOME
CASES LONG WAITS IN JAIL UNTIL
APPROPRIATE THAT'S RUBBISH ALL
FOR THOSE WHO GOT INTO THE
COMMUNITY RESIDENTIAL TREATMENT
UPON COMPLETION WE FOUND ONLY 9%
LIMITED IN STABLE HOUSING.
PSYCHIATRY HAS A DEEPLY RACIST
LEGACY FROM THE CREATION OF
MENTAL HEALTH DISORDERS TO
EXPLAIN SLAVE TENDENCIES TO RUN
AWAY AND AVOID HARD WORK IN THE
EIGHTEEN HUNDREDS. TO THE
JUSTIFICATION OF DISCRIMINATION
AND SEGREGATION CLAIMING
BIOLOGICAL DIFFERENCES NO WE'RE
RACES PRACTICES MORE HARMFUL
THAN IN LOCKED FACILITIES
LOOKING AT THESE ISSUE TODAY
TAKEN SEPARATE CISCO AS AN
EXAMPLE IF YOU LOOK AT WHO GETS
FIFTY ONE FIFTY. A SYSTEM THAT
IS MOSTLY LAW ENFORCEMENT LED
YOU SEE IT'S AFRICAN AMERICANS
ARE MORE LIKELY TO GET PUT INTO
A LOCKED FACILITIES. SAN
FRANCISCO OF THE ONE THOUSAND
FORTY EIGHT UNIQUE INDIVIDUALS
FROM THAT- DATABASE WERE BROUGHT
INTO SAN FRANCISCO SECOND.
AFRICAN AMERICANS WERE
SIGNIFICANTLY OVER REPRESENTED
BY SIX FULL MAKING UP 31% OF THE
INDIVIDUALS COMPARED TO OVERALL
THE FLOCCULATION SF AT 5% OKAY
DEEPER INTO WHO IT'S BROUGHT IN
ON FIFTY ONE FIFTIES AND HOW THE
SYSTEM HAS FAILED THEM. AND YES
WHEN WE FIFTY ONE FIFTIES
SOMEONE MOST OFTEN THAT'S DUE TO
A MENTAL HEALTH SYSTEM FAILURE.
THAT SAME DATABASE SHOWS THAT
ONLY 13% OF ALL INDIVIDUALS HAD
AN ASSIGNED. INTENSIVE CASE
MANAGER 13% FOR EVERY ONE PERSON
WITH A SEVERE MENTAL ILLNESS YOU
QUALIFIES HIM ON TO RECEIVE A
FULL SERVICE PARTNERSHIP- OR
INTENSIVE CASE MANAGEMENT TO
PEOPLE ARE UNABLE AND SAN
FRANCISCO TO GET IT BECAUSE THE
SLOTS ARE FIT. ARE FULL SAN
FRANCISCO'S LOST OVER TWENTY
THREE HUNDRED BEDS IMPORTING
CARE FACILITIES OVER THE LAST
FEW DECADES WE HAVE SEVERAL
THOUSAND PEOPLE ON OUR STREETS
YOU NEED MENTAL HEALTH CARE. AND
ARE NOT GETTING IT FOR UNDER
PASADENA LITERALLY EVERY LEVEL
OF CARE RESIDENTIAL TREATMENT
COMMITTEE CRISIS PART OF
HOUSING. IN SAN FRANCISCO YOU
TYPICALLY HAVE TO BE HOMELESS
FOR MORE THAN A DECADE BEFORE
YOU CAN GET SUPPORTIVE HOUSING.
OUR EXPERIENCE IS THAT FOLKS
WANT HERE IT'S NOT THE SYSTEM
REALLY HAS THE FORM OF CARE THAT
MEETS THEIR NEEDS. I WOULD LIKE
TO POINT OUT THAT FOR EVERYONE
OF THE HORROR STORIES YOU'RE
HERE TODAY OF PEOPLE WHO ARE
STUCK OUT ON THE STREETS A GREAT
HARM TO THEMSELVES OR OTHERS.
THOSE ARE FOLKS WHO ALREADY
QUALIFY FOR CONSERVATORSHIP THE
NUMBER OF PEOPLE CONSERVING
CALIFORNIA YES IS FALLEN- BUT
IT'S NOT THAT THE
CONSERVATORSHIP STANDARD IS TOO
STRICT FOR THE JUDGES ARE
APPLYING THE STANDARD TO NEARLY.
RATHER CONSERVATORSHIP FACES THE
SAME PROBLEM AS EVERYTHING ELSE
IN OUR SYSTEM INSUFFICIENT FUNDS
AND CAPACITY. IF THEY DON'T GET
CONCERNED IT'S A FAILURE OF THE
SYSTEM OF CARE. THIS ISSUE HAS
BEEN ROUTED INTO A VERY FALSE
CHOICE THE CHOICE BETWEEN
KEEPING PEOPLE ON THE STREETS
THE COMPENSATOR DIE. OR
EXPERIENCE YES TO MAKE IT EASIER
TO FOR STREET BUT THERE'S A
WHOLE OCEAN. OF AFFECTED POLICY
AND SYSTEM CHOICES BETWEEN THOSE
TWO. IT SOME WE DON'T GIVE
PEOPLE THE CARE THEY NEED. WAIT
UNTIL THEY'RE IN CRISIS TO GET
CARE ALL THEM AND SPENT ABOUT
LIKELY MOST LIKELY WORSE OFF
THAN BEFORE. MOST PEOPLE'S FIRST
INTERACTION WITH THE MENTAL
HEALTH SYSTEM IS IN HANDCUFFS IN
THE BACK OF A POLICE CAR. IF YOU
LOOK AT THE EXPANSIONS OF
CONSERVATORSHIP THE EVIDENCE
THAT MAKES THE DIFFERENCE WAS
NOT THE FORCING OF TREATMENT BUT
THE AVAILABILITY. OF TREATMENT
THAT MEETS THE INDIVIDUAL'S
NEEDS. THAT WAS NEVER AVAILABLE
BEFORE. FOR ME THIS IS NOT AN-
AND- IT'S A QUESTION OF WHAT IS
THEMOST EFFECTIVE INTERVENTION.
WHAT ARE THE SOLUTIONS THAT
WORK. ON HOUSE PEOPLE WITH
MENTAL HEALTH CHALLENGES CAN
TELL YOU WHAT THEY ARE. THEY
WILL TELL YOU FROM THEIR
PERSPECTIVE THAT OCCASIONALLY
THEY NEED TO BE LOCKED UP. BUT
MORE OFTEN AND WHAT IS THE VERY
COMMON THING. IS THAT THEY NEED
TO STOP BEING LOCKED OUT. I AM
GOING TO END UP. AND THIS WITH
THE CLOSING OF A QUESTION. WHY
IS THE STATE LEGISLATURE FOCUS
ON EXPANDING THE MOST
DISCRIMINATORY LEAST AFFECTED
MOST RESTRICTIVE AND MOST COSTLY
ELEMENT OF THE SYSTEM. IS THE
STATE LEGISLATURE INTERESTED IN
SOLVING THE ISSUE. AND IF SO.
YOU SERIOUSLY MISDIAGNOSED THE
PROBLEM THANK YOU. THANK YOU AND
OUR FINAL SPEAKER CHEN FLOORING.
HE WAS ALSO WITH US REMOTELY.
GOOD MORNING I'M JENNIFER LORI
WITH THE WESTERN CENTER ON LAW
AND POVERTY CALIFORNIA'S OLDEST
LEGAL SERVICES SUPPORT CENTER
SHE OFTEN WHEN ISSUED
CONSERVATORSHIP COME UP IN THIS
BUILDING WHAT'S REALLY ON
PEOPLE'S MIND IF PEOPLE LIVING
ON THE STREETS SHOWING SIGNS OF
SEVERE DISTRESS WHETHER
PROCESSES USED ACROSS SEVERE
MENTAL ILLNESS OR A COMBINATION
. HOWEVER THE FOCUS ON THE LPS
ACT MOVED TO FOCUS FROM WHERE IT
SHOULD BE. DESPITE THE RECENT
STATE BUDGET WINDFALL AN
INCREASE IN STATE SPENDING WE
STILL DO NOT HAVE THE SERVICES
NECESSARY TO IMMEDIATELY HELP
SOMEONE IN CRISIS OR BETTER YET
BEFORE THEY'RE IN CRISIS WITH
VOLUNTARY INTENSIVE AND
THERAPEUTIC MENTAL HEALTH
SERVICES. FURTHERMORE WE LIVE IN
A STATE WHERE THE COST OF
HOUSING IS SKYROCKETED IT'S NO
COINCIDENCE THAT LOS ANGELES AN
AREA THAT SEE MORE OF ITS FAIR
SHARE OF PEOPLE LIVING WITHOUT
HOUSING THE AVERAGE APARTMENT
RENT INCREASED BY 65% IN THE
LAST DECADE. YOU HOUSEHOLDS
COULD WHETHER 65% INCREASE IN
RENT MUCH LESS INDIVIDUALS
STRUGGLING WITH MENTAL ILLNESS.
THE ANSWER TO THIS CRISIS IS NOT
TO MAKE IT EASIER TO CONSERVE
PEOPLE THE ANSWER IS TO ADDRESS
THE COST OF HOUSING AND PROVIDE
THE MENTAL HEALTH SERVICES THAT
PEOPLE STRUGGLING NEAT. FAILING
TO SOLVE THE HOUSING CRISIS
MEANS THAT MORE AND MORE PEOPLE
WILL UNDERGO THE TRAUMA OF
HAVING NO HOMES AND MORE AND
MORE PEOPLE WILL NEED INTENSIVE
SERVICES AS A RESULT. THIS
POSITIONAL STRESS ON A MENTAL
HEALTH SYSTEM THAT ALREADY DOES
NOT SERVE THE NEEDS OF
CALIFORNIANS. WESTERN CENTER AS
LONG ADVOCATED FOR THE. LONG
ADVOCATED FOR INCREASED SERVICES
TO PEOPLE WITH SEVERE MENTAL
ILLNESS AS WELL AS FOR INCREASED
HOUSING SUPPORT TIME AND TIME
AGAIN VOTERS IN THE STATE HAVE
AUTHORIZED INCREASES IN FUNDING
FOR MENTAL HEALTH SERVICES ARE
HOUSING ONLY TO SEE OTHER
SERVICES REAL BACK OR DELAYED IN
BUILDING AND OTHER DELAYS IN
IMPLEMENTATION. WHAT WE NEED IS
NOT NECESSARILY BRAND NEW
SOLUTIONS BUT FOR THOSE
SOLUTIONS THAT HAVE DEMONSTRATED
SUCCESS TO BE FULLY IMPLEMENTED
AT THE LEGISLATURE IN THE VOTERS
INTENT. FOR EXAMPLE WHEN PROP
SIXTY THREE THE MENTAL HEALTH
SERVICES ACT WITH PASSED IT WAS
BUILT ON THE CHASSIS OF AB
THIRTY FOUR IN AB TWENTY THIRTY
FOUR PROGRAMS PROGRAMS THAT HAD
DOCUMENTED THEIR SUCCESS IN
PREVENTING JAIL TIME AND
HOSPITAL TIME FOR PEOPLE WITH
SEVERE MENTAL ILLNESS LIVING ON
THE STREET. BOB SIXTY THREE EVEN
CONTAIN SUPPLEMENT NOT SUPPLANT
LANGUAGE SAID THAT EARLIER FUNDS
WERE ELIMINATED AND COURTS
FAILED TO UPHOLD THE CLEAR
INTENT OF THE VOTERS WESTERN
CENTER REPRESENTED PLAINTIFFS
INVOLVED IN TRYING TO ENFORCE
THIS PROVISION PLAINTIFFS THAT
INCLUDED. PROVIDERS AND
INDIVIDUALS. READ BENEFITTED THE
EIGHTY FOUR AND EIGHTY THIRTY
FOUR PROGRAMS. BUT MANY
ALTERNATELY LOST ACCESS WHEN
THOSE PROGRAMS WERE DEFUNDED.
AND HAVING WORKED WITH SOME OF
THE INDIVIDUALS INVOLVED IN THIS
CASE I WILL JUST SAY THAT SOME
OF THESE INDIVIDUALS ARE THE
VERY INDIVIDUAL FUTURE DESCRIBES
NOW PEOPLE WHO ARE HEARING
VOICES IN THEIR HEAD. PEOPLE WHO
ARE TALKING TO THEMSELVES AND TO
SEE WHAT A DIFFERENCE A
VOLUNTARY BUT SLOWLY WHATEVER IT
TAKES MODEL. CAN HAVE ON AN
INDIVIDUAL IS TRULY TRANSFORMING
. MORE RECENTLY THE MEDICARE
PROGRAM HAS HAD PILOT PROGRAMS
TO HELP PEOPLE WHO ARE HIGH
UTILIZED AS OF HEALTHCARE AND
EXPERIENCING HOMELESSNESS ACCESS
TO DIFFERENT ADDITIONAL
SERVICES. THROUGH THE WHOLE
PERSON CARE PILOT AND THE HEALTH
HOME PILOT. HELICOPTER MEDICAID
BENEFICIARIES EXPERIENCING
CHRONIC HOMELESSNESS AVERAGES
OVER THIRTY FOUR THOUSAND
DOLLARS A YEAR AND EASILY
EXCEEDS A HUNDRED THOUSAND FOR
THOSE WHO ARE FREQUENT HOSPITAL
USERS. INTERNET RECENT
EVALUATION OF THE WHOLE PERSON
CAR PILOT BY UCLA INSUFFICIENT
HOUSING TO REFER PEOPLE TO WAS
IDENTIFIED AS THE NUMBER ONE
BARRIER SIX TO THE SUCCESS OF
THE PROGRAM. NOW THOSE PILOTS
ARE ENDING AND SIMILAR SERVICES
ARE TO BE PROVIDED BY MANAGED
CARE PLAN THROUGH THE MEDICARE-
CAL AIM INITIATIVE. BUT THESE
SERVICES ARE AT THE OPTION OF
THE PLANS AND ARE NOT COUPLED
WITH ADDITIONAL HOUSING BUT IN
COORDINATION WITH THE SAME SCARE
HOUSING RESOURCES. EVEN WHEN WE
COME UP WITH INNOVATIVE
SOLUTIONS WERE NOT ADDRESSING
THOSE LESSONS LEARNED. WE KNOW
THAT HOUSING FIRST MODELS WORK
PARTICULARLY WHEN COUPLED WITH
ALL OF THE SUPPORTIVE SERVICES
THAT PEOPLE NEED TO STABILIZE
OFTEN IN A WHATEVER IT TAKES
MODEL. WE RECOGNIZE THAT THIS
CAN REQUIRE MANY HOURS AT THE
START OF OUR REGION TRUST
BUILDING TO IT ENSURE THAT AN
INDIVIDUAL IN NEED OF SERVICES.
CAN FEEL. COMFORTABLE RECEIVING
THEM. IN THE IN WHICH SOMEONE
CAN BE CONSERVED WITHOUT
CORRESPONDING NEEDED SERVICES
DURING AND AFTER THE
CONSERVATORSHIP IS DOOMED TO
FAIL. CONSERVING INDIVIDUALS IN
LOCKED FACILITIES WITHOUT
APPROPRIATE TREATMENT IS JAIL.
RELEASING PEOPLE FROM
CONSERVATORSHIP WITHOUT ADEQUATE
HOUSING AND CORRESPONDING
SERVICES IS A RECIPE FOR
RELAPSE. THE LPS ACT WAS BUILT
ON A PROMISE THAT A
CONSERVATORSHIP WITH A LAST
RESORT. AND WHEN WE DO NOT HAVE
APPROPRIATE VOLUNTARY MENTAL
HEALTH SERVICES THAT PEOPLE CAN
ACCESS AS EARLY AS POSSIBLE
PEOPLE FALL THROUGH THE CRACKS.
OUR CONCERNS ABOUT EXPANDING THE
USE OF CONSERVATORSHIP IS NOT
WITH THE PHILOSOPHICAL
DISAGREEMENT ABOUT THE AUTONOMY
OF THE INDIVIDUAL BUT IT'S ALSO
BASED IN THE REAL HARM THAT
TAKING AWAY AN INDIVIDUAL'S
RIGHTS AND RIGHTS AND FOURTEEN
TREATMENT ON AND THAT.
PARTICULARLY FOR PEOPLE WHO ARE
ON HOW THEY'RE ALREADY SUBJECT
TO INCREASE DISCRIMINATION
HARASSMENT PHYSICAL VIOLENCE
TARGETING OF UNFAIR LAWS
INCREASING COUNTERS WITH THE
POLICE CRIMINALIZATION OF BASIC
HUMAN NEEDS SUCH A SWEEPING OR
RECEIVING FOOD. HAVING THEIR
POSSESSIONS TAKEN FROM THEM
INCLUDING THE VERY MEDICATIONS
THAT THEY NEED AND HAVING THE
VEHICLE THEY ARE LIVING IN AND
POUND IT LEAVING THEM LESS STATE
AND FURTHER FROM STABILITY.
HOMELESSNESS ITSELF IS AN
ONGOING TRAUMA LIVING WITH SUCH
STRESSORS WOULD CHALLENGE THE
MOST MENTALLY FIT AMONG US BUT
IT'S EVEN HARDER FOR INDIVIDUALS
TO HAVE SEVERE MENTAL ILLNESS
SUBSTANCE ABUSE DISORDER AND WHO
ARE RECOVERING FROM OTHER
TRAUMAS. HAVING SOMEONE OF THE
RIGHT AND FOURTEEN TREAT IS YET
ANOTHER TRAUMA THAT CAN MAKE
STABILIZATION EVEN HARDER TO
CHANGE DUE TO THE PERSON
INCREASING DISTRUST OF THE
SERVICES BEING OFFERED. ON THE
OTHER HAND EVERY SERVICE
PROVIDER THAT WE WORK WITH THAT
SERVE INDIVIDUALS OR ON HOW TO
REPORT LONG DELAYS IN BEING ABLE
TO GET PEOPLE THE SERVICES THEY
NEED IF THEY'RE ABLE TO AT ALL.
ALL TOO OFTEN PEOPLE WORKING IN
THIS SPACE HAVE NOTHING TO OFFER
SOMEONE IN A CRISIS. EVEN IF THE
DEFINITION OF GRAVELY DISABLED
AS PART OF THE LPS ACT WERE
EXPANDED SO THAT MORE PEOPLE
WORKING SEARCH WE HAVE NO
GUARANTEE THAT PEOPLE WILL
RECEIVE THE TREATMENT THEY NEED
TO STABILIZE OR THOSE WHO ARE
CONCERNED WILL HAVE A PLACE TO
STAY. CHANGING THE LEGAL
DEFINITION OF GRADES- GRAVELY
DISABLED TO ADDRESS THE LACK OF
MENTAL HEALTH SERVICES IS AKIN
TO ADDRESSING THE HOUSING CRISIS
BY CHANGING THE DEFINITION OF
HOMELESSNESS. SHOULD ANY CHANGES
THE CONTEMPLATED FOR LPS WE
SHOULD CONSIDER ADDING
GUARANTEED OFFERS A VOLUNTARY
SERVICES PRIOR TO CONSERVING
SOMEONE GUARANTEED APPROPRIATE
LEVEL OF SERVICE WHILE SOMEONE
IS CONCERT AND A GUARANTEE OF
APPROPRIATE HOUSING AND MENTAL
HEALTH SERVICES WHEN THE
CONSERVATORSHIP AND- IN CLOSING.
WE APPRECIATE THE EVERYONE
PARTICIPATING IN THIS HEARING
REALLY DOES WANT TO ALLEVIATE
THE SUFFERING WE WENT IT'S WHEN
PEOPLE WITH SEVERE MENTAL
ILLNESS OR SUBSTANCE ABUSE
DISORDER ARE LIVING ON THE
STREETS WITH NO ACCESS TO
SERVICES. BEYOND THAT FIRST
RESPONDERS WERE CALLED IN WHEN
THERE APPEARS TO BE A DANGER OR
THE SHORT TERM HOSPITALIZATION
AND COMPANIES THE PSYCHIATRIC
HOLD. HOWEVER RATHER THAN
FOCUSING ON WHETHER THE ACTIVE
ALLOWING ENOUGH PEOPLE TO BE
CONSERVED WE ASSET SERVICES SUCH
AS INTENSIVE MENTAL HEALTH
SERVICES ASSERTIVE OUTREACH
SUPPORT OF HOUSING AND PEER
SUPPORT PROGRAMS BE EXPANDED. WE
ASK THAT YOU LISTEN TO THOSE WHO
HAVE TRIED AND FAILED TO GET
ADEQUATE MENTAL HEALTH SERVICES
OR THOSE WHO HAVE TRIED AND
FAILED TO FIND SECURE HOUSING.
THANK YOU. I THANK YOU. I DO
MEMBERS HAVE QUESTIONS FOR THIS
PANEL. RIGHT THREAT. THANK YOU
FOR THE INFORMATION YOU PROVIDED
MODE LIST ESPECIALLY THANK YOU
FOR SHARING YOUR PERSONAL STORY
I THINK IT MAKES IT CLEAR THAT
WE'RE NOT TALKING ABOUT
SOMETHING IS HAPPENING SOMEBODY
ELSE HAPPENING IN OURFAMILIES
AND YOUR SON IS VERY HAPPY VERY
LUCKY TO HAVE YOU IS HIS
ADVOCATE BECAUSE THAT ADVOCACY
CLEARLY X. EXPANDS BEYOND JUST
YOUR SON. YOUR YOUR- CAUSING A
CHANGE EVEN WITH SO MANY OTHERS
THANK YOU SO MUCH. THANK YOU.
THANK YOU VERY MUCH. THANK YOU
WILL NOW MOVE ON TO OUR NEXT
PANEL TURNED BACK TO THE THREE
THANK YOU VERY MUCH- WE HAVE ONE
MORE PANEL AND THEN WE WILL TAKE
A SHORT LUNCH IT WON'T BE IT
WON'T BE VERY LONG SO BUT- BUT
WE WILL DO THAT WILL TAKE A
SHORT BREAK SO. I'M MOVING ON
TO- LOCAL OUR LOCAL GOVERNMENT
PARTNERS- PERO IT MAKE IT MAKE
DATING THE SENIOR LEGISLATIVE
REPRESENTATIVE FOR CALIFORNIA
STATE ASSOCIATION OF COUNTIES
AND JOHN SHARON AND THE DIRECTOR
OF THE LOS ANGELES- COUNTY
DEPARTMENT OF MENTAL HEALTH SO.
LEAVE THAT- HAVE FAIR IS HERE IN
PERSONAND THEN- DR SHARON IS
GOING TO JOIN US- YEAH. VIDEO SO
YOU'RE READY. THANK YOU MISTER
CHAIR AND MEMBERS AS WELL AS A
CO CHAIR STONE FOR THIS SAYS-
AMAZING ENOUGH INFORMATION
FILLED DAY. I'M FOR MAY DAY
TAKING REPRESENTING THE
CALIFORNIA STATE ASSOCIATION OF
COUNTIES WE REPRESENT ALL FIFTY
EIGHT COUNTY BOARD OF
SUPERVISORS THROUGHOUT
CALIFORNIA- I WAS ASKED TO SPEAK
AS EVERYBODY ELSE WAS THIS
MORNING ABOUT THE CHALLENGES AND
OBSTACLES. AND I THINK EVERY
SPEAKER HAS TOUCHED UPON THE
SAME POINTS THAT I INTENDED TO
MAKE UP TO KEEP IT SHORT-
BETWEEN YOU IN LUNCH- I WANT TO
SAY THAT. WE UNDERSTAND- BOTH ON
A PERSONAL LEVEL OF MYSELF AND-
THE ASSOCIATION ITSELF THE LPS
CONSERVATORSHIP FOR ONE OF THOSE
ISSUES THAT TOUCH EVERYBODY'S
LIFE. IF YOU DON'T HAVE A FAMILY
MEMBER OR COLLEAGUE OR FRIEND
WHO IS STRUGGLING IN LIVING WITH
MENTAL HEALTH YOU MAY EXPERIENCE
THAT ON THE STREETS. YOU MAY
EXPERIENCE IT IN OTHER AREAS OF
YOUR LIFE AND SO NO ONE IS
UNTOUCHED BY THIS- HAVE USE
HEARD TODAY. THE COUNTY PUBLIC
GUARDIANS AND CONSERVATORS TAKE
CARE THE MOST VULNERABLE AMONG
US- MANY OF THEM I WOULD SAY THE
VAST MAJORITY BECAUSE A
CONSERVATORSHIP IS REALLY THE
LAST RESORT- DON'T HAVE THE
BENEFIT OF A FIERCE MAMA BEAR
LIKE MISS PLUS GREANEY WHO I SO
COMPELLING- THERE AT THE REALLY
THE ONLY PERSON. THAT IS TASKED
WITH THEIR CARE IS THE LOCAL
PUBLIC GUARDIAN AND PUBLIC
GUARDIANS DO THIS. WITHOUT ANY
STATE SUPPORT IT'S A 100% COUNTY
FUNDED ON THE PUBLIC GUARDIAN
PIECE AS- MISMATCHED MISTER SHE
THAT WITH ELLIE- MADE CLEAR
THERE'S A BUNCH OF OTHER FUNDING
STREAMS THAT OFFER SERVICES TO
THE CONSERVATIVES MUCH NEEDED
BUT THE WHAT BUT THE CASE
MANAGEMENT THAT THE PUBLIC
GUARDIANS DUE IS A 100% COUNTY
FUNDED. MANY OTHER COUNTY
DEPARTMENTS ALSO COME INTO PLAY
AS YOU'RE WELL AWARE I WON'T
LIST THEM ALL BUT IT RANGES FROM
LAW ENFORCEMENT OR HUMAN
SERVICES PROGRAMS- HOUSING
AUTHORITY ARE HOMELESS
ASSISTANCE TEAMS AND OTHERS- BUT
OUT OF ALL THOSE ENTITIES. ONLY
PUBLIC GUARDIANS ARE THE ONLY
ONES WHO RECEIVE NO STATE
SUPPORT. IT'S NOT A REAL LINE
PROGRAM. IT RECEIVES NO OTHER
FUNDING FROM ANY OTHER SOURCE
FEDERAL STATE- AND OF COURSE YOU
DON'T WHILE THESE PUBLIC
GUARDIANS ARE STRUGGLING WITH
THE LARGE CASELOADS COMPLEX
REQUIREMENTS. ARE THEY ALSO
STRUGGLE WITH WHAT ANOTHER ISSUE
THAT'S BEEN RAISED HERE TO
ISSUES ACTUALLY EQUITY AND A
LACK OF TRANSPARENCY. ONLY NOT
ONLY INTO THEIR OWN SYSTEM BUT
THE SYSTEM AS A WHOLE STATEWIDE
. BECAUSE OF THIS. COUNTIES ARE
EAGER FOR HELP I WOULD LIKE TO
INSURE STEP DOWN CARE
COORDINATION AND TRACK OUTCOMES
FOR CLIENTS WOULD LIKE TOGETHER
SHARE DATA I WOULD LIKE TO
COLLABORATE MORE TO BETTER SERVE
CONSERVANCIES BUT THE LINCHPINS
OF THE SYSTEM THE PUBLIC
GUARDIANS. ARE AT THE BREAKING
POINT. THUS THE SINGLE LARGEST
CHALLENGER MARC PERSPECTIVE IS
THE NEED FOR NEW STATE RESOURCES
TO TACKLE THIS ISSUE TOGETHER.
IT'S SIMILAR TO THE HOMELESSNESS
ISSUE IN THE LAST FIVE YEARS
BEFORE THAT IT WAS CONSIDERED A
LOCAL PROBLEM. CITIES AND
COUNTIES GET YOUR ACT TOGETHER
AND SOLVE HOMELESSNESS. AFTER
MANY YEARS OF ADVOCACY AND LOTS
AND LOTS OF DISCUSSION- THE-
BROWN ADMINISTRATION IN THE
NOOSA MINISTRATION IN A HUGE
WAY. HAVE STEPPED FORWARD TO
HELP LOCALITIES WITH THIS ISSUE-
AND WHAT PROGRESS HAS BEEN SLOW
. MANY ARE NOT SEEING THE
PROGRESS THAT'S BEEN MADE BUT
IT'S BEING MADE- IT'S BECAUSE
THE STATE AND LOCALITIES ARE NOW
ROWING IN THE SAME DIRECTION.
THAT'S REALLY IS WHAT IT IS AND
SO I WANNA MAKE THAT ANALOGY FOR
THE PUBLIC GUARDIANS IF WE CAN
PARTNER- WE CAN- HAVE RESOURCES
THAT WORK FOR US WE CAN INCREASE
THE DATA PER TRANSPARENCY WE CAN
INCREASE THE LEVEL OF SERVICE.
AND WE CAN BETTER TAKE CARE OF
ALL CONSERVATIVES- I'M SURE THIS
TEAM DOCTOR SHERIN WHO SPEAKS
AFTER ME HAS A FEW MORE
IMPORTANT WANTS TO ELIMINATE-
BUT ALL OF THE- GAPS IN HURDLES
WE'VE HEARD TODAY. I THINK
RESOURCES IS ONE OF THE MAJOR
ONES AND WE LOOK FORWARD TO
PARTNERING WITH THE STATE TO
WORK ON THIS FURTHER. THANK YOU
. THANK YOU VERY MUCH- WHO HAD
TO MOVE ON TO DOCTOR SHEERAN.
THANK YOU VERY MUCH SURE WOULD
AND THANKS TO THE COMMITTEE. I'M
JOHN SURE NUMBER- THE DIRECTOR
FOR THE LOS ANGELES COUNTY
CRIMINAL HOW THE MUSCLE STICK
HIGH INTEREST AND I DO MY
CLINICAL WORK ALTHOUGH NOT VERY
OFTEN- IN THE STREETS IN SKID
ROW IN HOLLYWOOD- TED HELP THE
POPULATION THAT WERE-
DISTRACTING ABOUT RIGHT NOW- AND
I DO WANT TO RECOGNIZE FIRST OFF
THAT. THE POINTS ARE BEING MADE
BY EVERYBODY ARE YOU ARE
ENTIRELY VALID AND A LOT OF THIS
DOES TRACE BACK TO. THE D.
INSTITUTIONALIZATION MOVEMENT
WHICH JFK TRIED TO LAUNCH AND IN
SOME PARTS OF THE WORLD IS DONE
PROPERLY ONE OF THEM WHICH IS
PROBABLY BEST KNOWN AS- IN
TRIESTE ITALY BUT IT DIDN'T
HAPPEN. WELL IN THE UNITED
STATES AND CERTAINLY NOT. IN
CALIFORNIA BECAUSE WE DIDN'T
BUILD UP OUR COMMUNITY RESOURCES
MIGHT BE TREATMENT OPPORTUNITIES
BUT I MEAN ALSO SHOT SOCIAL
DETERMINANTS. AND OUR GOAL IS TO
CREATE MORE OF A SYSTEM WHERE
PEOPLE CAN GET THE SERVICES THEY
NEED. WHEN THEY NEED THEM WHERE
THEY NEED AND HOW THEY YOU KNOW
FROM WHOM THEY NEED THAT WHICH
OCCURS MYRICK PRODUCT I BELIEVE
IN A REALLY LOVELY WAY. AND THAT
THOSE SERVICES NEED TO BE
DIGNIFIED AND WELCOMING. I WITH
THAT BEING THE CASE IN L. A.
COUNTY AND I'M SPEAKING ON
BEHALF OF L. A. COUNTY NOT ALL
COUNTIES ACROSS THE STATE. I'M
IN ROCKY HILL DID A WONDERFUL
JOB OF REPRESENTING CVH YET. WE
CLEARLY HAVE A HUMANITARIAN
CRISIS AND I'M NOT SAYING WE'VE
GOT TO WITH THE ONLY ONES. AND.
IS HEALTH ISSUES AND AGAIN THE
SOCIAL DETERMINANTS. CONSPIRE IN
MANY CASES FOR PEOPLE TO NOT BE
ABLE TO LIVE SAFELY IN THE
COMMUNITY. ABOUT HOW MANY PEOPLE
IS THAT THAT WE'RE ACTUALLY
TRYING TO STUDY THAT NUMBER IT'S
NOT A BIG NUMBER BUT IT'S A
SIGNIFICANT NUMBER. AND YOU KNOW
WHAT WHAT WE TALK ABOUT YOUR L.
A. COUNTY IS THAT. THERE ARE
MANY PEOPLE WHO ARE GRAVELY
DISABLED OR GRAVELY DISABLED
CHASING HER ACTUALLY NOT.
GETTING CARE AND THE PROBLEM IN
TERMS OF THE STANDARD OF GREAT
DISABILITY. ISN'T NECESSARILY
ABOUT THIS ABOUT THE SCOPE IT'S
ABOUT ITS- IMPLEMENTATION. OF
FOOD CLOTHING AND SHELTER
INTERPRETED BY FRONTLINE WORKERS
BY COURTS- BY PEOPLE
DIFFERENTLY- AND THERE ARE
CHALLENGES AND MANY OF THEM ARE
BROUGHT UP BY THE AUDIT. AND
FIFTY ONE FIFTIES AS A PART OF-
LPS LAW IS USED- IN A WAY THAT-
CONSENSUALLY TAXES ARE A CUTE.
RESOURCES IN PARTICULAR ARE OUR
HOSPITALS AND WHAT WE'RE TALKING
ABOUT RIGHT NOW IS NOT KEEP
SITUATION SO I'LL TALK ABOUT IT
LATER I HOPE THIS AFTERNOON BUT
NOT ACUTE- SITUATIONS DO NOT
REQUIRE A CUTE RESOURCES THEY
REQUIRE I RESOURCES THAT ADDRESS
A CHRONIC. CONDITION WE NEED TO
DEVELOP A STANDARD THAT IS
UNIFORMITY ACCOUNTABLE WHERE WE
HAD INDICATORS THAT ARE ACTUALLY
MUCH CLEARER THAN FOOD CLOTHING
AND SHELTER IN MY OPINION- IN
TERMS OF- CHAIRMAN WHAT'S
COMMENT ABOUT IT'S ABOUT
SERVICES. AND WE ALL AGREE IT'S
ABOUT SERVICES IT'S ABOUT
OPPORTUNITIES IT'S ABOUT
RESOURCES BUT THE ISSUE AND
WHETHER IT'S A O. T. R. LPS. WE
HAVE A GREAT DIFFICULTY ENGAGING
CERTAIN PEOPLE. AND IN FACT THE
BEHAVIORAL HEALTH FIELD IS
DEEPLY CHALLENGED BY ENGAGEMENT
GETTING PEOPLE TO ACCEPT CARE A
LOT OF THAT HAS TO DO WITH THE
TYPE OF CARE AND THE CARE THAT'S
AVAILABLE AND IS DEEPLY BROKEN
SYSTEM AND I APPRECIATE.
COLLETTI'S COMMENTS ABOUT SB
EIGHT OH THREE WHICH DIDN'T
QUITE GO AS FAR AS WE WANTED BUT
IS KEY TO THE WHOLE ENGAGEMENT
CHALLENGE. I'M ONE OF THE THINGS
THAT WILL ALSO RECOGNIZE ABOUT
THE STATE IS CALLIN CALLIN IS
ACTUALLY INCORPORATING
ENGAGEMENT AND THE ENGAGEMENT
CAPACITY AS A PART OF WHAT'S
NEEDED. IN THE BEHAVIORAL HEALTH
FIELD AND IS ROCKY KELLY SAID AN
AVERAGE OF FORTY VISITS TO
ENGAGE SOMEBODY. THAT TYPE OF
WORK HASN'T REALLY BEEN FUNDED
PROPERLY AND IT NEEDS TO BE I
THINK KILLINGS MOVING US IN THAT
DIRECTION AND ON THE TOPIC OF
THE GAUGE MEANT. I WOULD ARGUE
THAT WE NEED A CONTINUUM OF
TOOLS WITH A CONSERVATORSHIP
TYPE. ENGAGEMENT TOOL AS THE
VERY LAST RESORT BUT IF WE CAN
HAVE A CONTINUE UNDER DEVELOPED
THE TOOLS OF ENGAGEMENT WHEN
IT'S NOT POSSIBLE TO ENGAGE
DESPITE RELENTLESS EFFORTS WITH
GUARANTEED RESOURCES. THAT I
THINK WOULD BE HELPFUL SHARE
DECISION MAKING PSYCHIATRIC
ADVANCE DIRECTIVES S. T.
TEMPORARY CONSERVATORSHIP CAN
SCAN SERVER TO SHIP THOSE TO BE
EXAMPLES OF THE CONTINUUM. I'M
ENGAGEMENT TOOLS. IN TERMS OF
FINDING WE NEED FUNDING THAT IS
DEDICATED AND COMMITTED TO THOSE
WHO IN L. A. RIVER KERR NOT
LIVING SAFELY IN THE COMMUNITY
AND THOSE RESOURCES ARE
GUARANTEED UP FRONT WHEN WE DO
RELENTLESS ENGAGEMENT FOR PEOPLE
WHO FIT THAT DESCRIPTION.
CURRENTLY THE FUNDING IS
INADEQUATE IN TERMS OF IT BEING
I'M GOING AND WE APPRECIATE THE
STATE'S EFFORT TO EXPAND ALL
INFRASTRUCTURE BUT WE NEED ON
GOING FUNDING. ITS SUPER
COMPLICATED TO ADMINISTER IT'S
NOT AN ENTITLEMENT. IF WE DECIDE
THAT THIS IS A PRIORITY THIS
POPULATION WE HAVE TO REALIZE
THAT THAT WILL DE PRIORITIZE
OTHER POPULATIONS IN A ZERO SUM
GAME. WE ALSO HAVE TO REALIZE
THAT AS A PART OF IT BEING
COMPLICATED. WE NEED MORE
FLEXIBILITY AND I WOULD POINT TO
AN HSA IS A CLASSIC EXAMPLE.
IMAGES A FUNDING IT'S FENCED.
THERE ARE A LOTS OF PROCESS
REQUIREMENTS. WE NEED
FLEXIBILITY TO USE IT TO GO
AFTER. THE PRIORITIES OF THE
STATE AND WE NEED TO BE HELD
ACCOUNTABLE TO OUTCOMES NOT TO
REPORTS AND YOUR PROCESSES. IN
TERMS OF- ENGAGEMENT WE NEVER
EVER OUGHT TO BE USING ANY TYPE
OF ENGAGEMENT TOOL. WITHOUT UP
FRONT GUARANTEED RESOURCES
STARTING WITH SHARED DECISION
MAKING. SO IN SUMMARY. I BELIEVE
THE STANDARDS NEED TO BE
REVISITED TO BECOME CLEARER AND
EASIER I THINK IT'S A PROBLEM I
ALSO THINK IT'S AN OPPORTUNITY
WE DO NOT HAVE A CONTINUUM OF
ENGAGEMENT TOOLS. THAT'S A
PROBLEM IT'S ALSO AN OPPORTUNITY
AND WE NEED FUNDING THAT IS
DEDICATED GUARANTEED I WOULD SAY
THROUGH ENTITLEMENT. AND WE NEED
TO LOOK AT THIRTY SB EIGHT FIFTY
FIVE AND HOW WE HOLD OTHER
PLANS. ACCOUNTABLE AGAIN IT'S A
PROBLEM AND IT'S AN OPPORTUNITY
THE LAST THING I'LL SAY IS YES
WE DO NEED BETTER OVERSIGHT. BUT
THAT OVERSIGHT NEEDS TO BE OF
OUTCOMES. AND WE NEED TO BE A
POWER TO ACHIEVE THEM. WITH
INCREASED FLEXIBILITY THANK YOU
VERY MUCH. THANK YOU THANK YOU
VERY MUCH VERY MUCH APPRECIATE
THAT QUESTIONS- DOCTOR I. THINK
YOU JUST AND THANK YOU ALL FOR
YOUR YOUR YOUR TESTIMONY AND
YOUR WORK- IF YOU ARE NOT THE
FIRST PERSON WHO SAID TODAY THAT
WE THAT THE- PUBLIC GUARDIANS
ARE THE ONLY PEOPLE WHO ARE.
STATE FUNDED. THOSE ARE THERE'S
A COUNTY EMPLOYEES THAT WHEN YOU
SAY THEY'RE NOT STATE FUNDED DO
YOU MEAN- THE DUBBED THE
POPULATION THAT THEY'RE SERVING
PRESIDENT AT THE POPULATIONS ARE
SERVING OFTENTIMES COMES WITH A
FUNDING STREAM. THAT THEN THE
PUBLIC GUARDIAN'S USE OR OR WHAT
IS IT THAT YOU'RE REFERRING TO
THAT WOULD BE HELPFUL TO COUNTY
EMPLOYEES HERE SAYING YOU KNOW
GET. STATE MONEY OR THE WHOLE
PROGRAM IS NOT FUNDED AND THEN
HOW DO YOU HOW DO YOU DETERMINE.
WHAT THE STATE WOULD FUND.
THAT'S ASIDE FROM WHAT THE CLAIM
IS ALREADY RECEIVING. THANK YOU
SENATOR I APPRECIATE THE
QUESTION AND THE OPPORTUNITY TO
CLARIFY IT'S A GREAT QUESTION.
ABOUT SOMETHING WE WALK THROUGH
ALL THE TIME- WHEN I MEAN IT'S
NOT STATE FUNDED THE CLIENTS
THAT WE SERVE. DO ACCESS STATE
FUNDED SERVICES RIGHT IT'S THE
PUBLIC GUARDIANS AND THEIR
WORKLOAD AND CASELOAD. WHICH IS-
DOESN'T RECEIVE ANY STATE OR
OTHER FEDERAL FUNDING. SO THEY
ARE COUNTY WORKERS- AND THEY
THEY THEY HAVE NO CONTROL OVER
THE CASE LAW THAT THEY RECEIVE-
BECAUSE IT'S- ONE THING YOU HAVE
TO RESPOND IN INVESTIGATE EVERY
REFERRAL. AND THEN OF COURSE THE
JUDGE DECIDES WHETHER TO- HAVE
SOMEONE PUT INTO
CONSERVATORSHIP. AND SO WHAT
WAIT WHEN WE'RE TALKING ABOUT NO
STATE FUNDING. WE'RE TALKING
ABOUT THE ACTUAL ADMINISTRATIVE
DUTIES THAT THOSE FOLKS DO- THEY
DO RECEIVE SOME TARGETED CASE
MANAGEMENT FUNDING THROUGH MEDIC
CAL. BUT IT'S A SMALL PORTION OF
WHAT WE'RE ABLE TO- COUNT
TOWARDS RECEIVING FEDERAL
REIMBURSEMENT- AND SO THAT'S-
REALLY. WHAT I'M TALKING ABOUT
WHEN IT'S SAYING OF THE PUBLIC
GUARDIANS AND CONSERVATIVE
PROGRAMS. WERE NOT A REAL LINE
TO PROGRAM SO THEY DON'T HAVE
ACCESS THOSE WORKERS. TO THE
REALIGNMENT FUNDING. DEPENDING
ON WHERE THEY ARE MANY COUNTIES
AUGMENT SIGNIFICANTLY- FIND
EFFICIENCIES. SOME PUBLIC
GUARDIANS CONSERVATORS OF L. A.
COUNTY IS A GREAT EXAMPLE. ARE
WITHIN THE DEPARTMENT OF MENTAL
HEALTH- AND THEY CAN. ACCESS THE
EFFICIENCIES AND THE FUNDING
THAT IT COMES WITH BEING PART OF
THE DEPARTMENT OF MENTAL HEALTH-
BUT THE CONSERVE GUARDIANS AND
CONSERVATORS THOSE STYLES.ARE
TYPICALLY. 100% COUNTY FUNDED.
THIS THAT. CLARIFY IT HELPS AND
I AND I GO IT'S JUST A THE
QUESTION POPPED IN MY MIND THEN
AS WE'RE TALKING ABOUT CALLING
HIM. CAN THEN CAN AND GUARDIANS
BECOME A CONTRACT SERVICE- CAL
LAME AS ANOTHER WAYS OF
RECEIVING ANYWAY SO STUFF THAT'S
FOR DOCTOR EVEN WHEN I THINK
ABOUT NEXT YEAR. DR INDIA THANK
YOU AND- I WOULDN'T MISS A
CHANCE TO ACTUALLY THANK
CHOLESKY KERIS KIERAN AND
THERESA FOR THEIR ADVOCACY AND-
REALLY ALLOWING US TO EMBRACE
THE WHOLE PERSON WHO WERE TRYING
TO HELP- THERESA SAID IT BEST
WHEN SHE SAID THAT THE WHOLE
PERSON CARES DOESN'T. WORK IF
YOU DON'T HAVE A WHOLE
CONTINUUM. OF CARE. EARLIER WHEN
WE HEARD FROM OUR AUDITOR SHE
SAID THAT THERE WAS A NEEDS
ASSESSMENT WHICH WAS TO BE
COMPLETED IN APRIL OF TWENTY
ONE. AND I'M WONDERING IF THE
COUNTIES HAVE PLAYED A ROLE HAVE
PARTICIPATED ARE ABLE TO SHARE
SOME OF THE NEEDS THAT WE HAVE
SO THAT WE IS THE STATE CAN
START TO PARTNER WITH OUR COUNTY
PARTNERS. THANK YOU DR ARAMBULA
I AM NOT AWARE SPECIFICALLY OF
CANDY PARTICIPATION IN THE NEEDS
ASSESSMENT- PERHAPS THE BEACH
DAY MAY HAVE MORE INFORMATION ON
THAT. BUT THE STATE DID
UNDERTAKEN NEEDS ASSESSMENT
BASED ON LEGISLATION AND ALSO IN
PREPARATION FOR LAUNCHING CAL
AIMS- SO- I AGAIN I DON'T HAVE
SPECIFICS ABOUT THAT I DO NOT
KNOW COUNTIES WERE. SURVEYED AND
HAD SOME INPUT I DO NOT I RECALL
SEEING THE FINAL PRODUCT-
EARLIER WE HEARD FROM DR SHARON
AS WELL ABOUT THE FACT THAT THIS
IS A CHRONIC UNDERFUNDING OF OUR
SYSTEM AND- WHILE MANY OF THE
INVESTMENTS LAST YEAR WERE ONE
TIME IN NATURE I BELIEVE THAT
THAT NEEDS ASSESSMENT WILL HELP
TO DRAW. A MAP FOR US A ROAD MAP
OVER THE NEXT FEW YEARS FOR
INVESTMENTS THAT WE NEED AND
LOOK FORWARD TO BEING ABLE TO
GET MORE SPECIFICS ON. AND
DOCTOR AND IF I'VE MADE CHAIR OF
RESPOND THE NEED FOR DATA AND
TRANSPARENCY IS. BEYOND CLEAR
FOR ALL OF US AND WE WELCOME.
THOSE EFFORTS I THINK THE NEEDS
ASSESSMENT IS A GREAT FIRST
STEP- BUT CLEARLY WE NEED UP TO
DATE. QUALITY DATA. SHERIFF I
MIGHT. JUST REALLY QUICK I- YOU
KNOW WHAT ONE OF THE ONE OF THE
CHALLENGES THAT THAT WE HAVE IS-
NOT HAVING ACCESS TO FEDERAL
FUNDING FOR. BOB WHAT ARE CALLED
I AM D. AND THIS IS SOMETHING
THAT THE STATE AND WE'VE SPOKEN
IN THE STATE NUMBER OF TIMES HAS
THE OPPORTUNITY TO APPLY FOR A-
THREE SPEND MASS A WAIVER FOR
THE I AM DEEP. NOW THE IDEA WITH
I AM THE EXCLUSION WOULD
NECESSARILY BE TO EXPAND ALL THE
BEDS AND TREATMENT BEDS ARE
LOCKED ON TO BE BUDGET WOULD BE
DISPLACED SOME OF THE MONEY THAT
WE'RE- PUTTING INTO- TREATMENT
BEDS WHICH IS ESSENTIALLY. THE
TWENTY THE NINETEEN NINETY ONE
REALIGNMENT WHICH IS AS YOU
HEARD EARLIER FLEXIBLE IF WE GET
A LOT MORE ABOUT FLEXIBLE
FUNDING TO CARE FOR PEOPLE IN
THE COMMUNITY IN DROUGHT ON
FEDERAL MONEY. TO TAKE CARE OF
SOME OF THE FACILITY BASED CARE
THAT WOULD BE A MASSIVE. BOB
THAT WOULD THAT WOULD REALLY
HELP US WITH OUR FUNDING STREAMS
AND OUR FLEXIBILITY. PRETTY GOOD
WELL THANK YOU THANK YOU VERY
MUCH AND THANK YOU TO BOTH OF
YOU FOR YOUR YOUR CLEAR MESSAGES
TO US- AND- I VERY MUCH OF A
VERY MUCH APPRECIATE THAT. I
JUST WANNA SAY FOR THE RECORD
LOOK- I DON'T THINK ANYBODY
ANYBODY UP HERE WANTS TO CREATE
YOU KNOW IT WHEN I LOOK AT
OVERSIGHT I'M NOT LOOKING AT THE
IDEA OF CREATING MORE PAPERWORK
AND MORE OF A BURDEN FOR YOU.
FOR U. S. CLINICIANS OR WORK OR
AND COUNTIES WHAT YOU KNOW I AM
ALL ABOUT FLEXIBILITY I'M ALL
ABOUT RESULTS- AND WE OUGHT TO
BE LOOKING FOR WAYS TO
STREAMLINE SOME OF THOSE
PROCESSES QUITE FRANKLY- IT DOES
TROUBLE ME THATWHEN I HER FROM
THE HOSPITAL ASSOCIATION THAT.
WE HAD ISSUES DIFFERENT COUNTIES
INTERPRETS THE STATUTE
DIFFERENTLY WHICH MAKES IT
REALLY DIFFICULT. TO OFFER
SERVICES YOU KNOW FROM ONE
COUNTY TO THE NEXT YOU KNOW AND
AROUND THAT AND HAVE SOME
CONSISTENCY THERE I BELIEVE- SO
THEY WERE ALL THAT WERE ON THE
SAME PAGE AND THAT'S THAT THAT
IS DIFFICULT IN THE STATE IS
DIVERSE IS THIS QUITE YOU KNOW
QUITE FRANKLY. SO SO I'D VERY
MUCH APPRECIATE YOUR YOUR YOUR
INPUT AND YOUR YOUR THOUGHTS ON
THIS AND TRUST WERE TAKEN WE'RE
TAKING NOTES- AND- WITH THAT I
THINK WE'LL GO AHEAD AND- IN
THIS IN THIS PARTICULAR PANEL
WILL TAKE ABOUT. WE'LL TRY TO
RECONVENE. AROUND ONE FORTY FIVE
IF THAT'S OKAY. I KNOW IT'S A
VERY SHORT LUNCH- SO FOR THE
NEXT SPEAKERS JUST EVERYTHING'S
GONNA MOVE DOWN ABOUT FIFTEEN
MINUTES AND- WE'LL KEEP GOING
THANK YOU VERY MUCH.
YEAH WELL
NOW. YEAH OKAY. OKAY. I DON'T.
ONE NINE HOURS. OKAY RIGHT.
RIGHT. I'VE LEARNED A LOT.
YEAH. GONZALEZ. OKAY I WOULD LIKE TO
SEE IF WE CAN GO AHEAD AND
RECONVENE ARE HEARING HERE I
RECOGNIZE THAT MY COLLEAGUES ARE
STILL OUT IN ABOUT- BUT BUT LIKE
TO GO AHEAD AND GET STARTED WITH
OUR NEXT PANEL OUR NEXT PANEL
IS- BEST PRACTICES IN NATIONAL
STANDARDS OF CARE- JOINING US ON
THIS PANEL WILL BE. SCOTT
ZELLER- DOCTOR SELLER- PLEASE
COME ON UP THE ISIS IT SAID NOW
THIS YEAR HERE- ROBERT. I'M
SORRY ROBERT TED DINER STINA BE
JOINING US BY PHONE OR OF OR A-
WHATEVER THAT. THAT IS ZERO OUR
VERSION OF ZOOM HERE AND THEN-
TOBY YOU IN. OUR EXACT ADDRESS
FOR- TÌM MENTAL HEALTH SERVICES
OVERSIGHT ACCOUNTABILITY
COMMISSION. SO WE'LL GO AHEAD
AND GET STARTED AND- GOT YOU
GUYS THAT WE HAVE YOU VALUE YOUR
GENTLEMAN H. AT THAT TO AT ABOUT
TEN MINUTES OF A PRESENTATION SO
- TO GET CHANGED NO SIR TWENTY
I'M SORRY I CAN'T COUNTY YES
YES. SO WE COULD TRY TO KEEP IT
WITHIN TWENTY WE'RE HI HOW ARE
YOU PRETTY MUCH TRY TO MAKE IT
SO WE'LL GET IN TWENTY MINUTES
ON THE BATHROOM. IRAN THEN
PLEASE OKAY GREAT WELL THANK YOU
THANK YOU VERY MUCH. SIR AND- SO
MY NAME'S COUNSELOR I'M
EMERGENCY PSYCHIATRIST WITH
ABOUT THIRTY FIVE YEARS OF
EMERGENCY PSYCHIATRY. ACTICIN
CALIFORNIA OVER NINETY THOUSAND
EMERGENCY PSYCHIATRIC PATIENTS
DURING THAT TIME AND I'VE BEEN
ABLE TO- YOU KNOW- IF VALUE WAIT
AND SEEA LOT OF WHAT'S BEEN
GOING ON THAT A LOT OF RESEARCH
PUBLISHED A LOT IN THE- OF
EVIDENCE BASED- INTERESTING
MATERIAL IN THAT TIME. AND I AM
ABLE TO TALK TO YOU ABOUT SOME
REALLY EXCITING- SOLUTIONS THAT
MIGHT BE A LITTLE BIT DIFFERENT
THAN WHAT YOU'RE USED TO HEARING
ABOUT BECAUSE INSTEAD OF ASKING
YOU FOR MORE MONEY. ARE YOU
GOING TO TELL YOU ABOUT WAYS
THAT WE CAN ACTUALLY DELIVER
INFINITELY BETTER CARE AND SAVE
YOU MILLIONS OF DOLLARS A YEAR
IN THE MENTAL HEALTH SYSTEM. AND
IN THE FIFTY ONE FIFTY SYSTEM.
SO IF I COULD START GOING TO THE
NEXT SLIDE PLEASE. SO IS EVER
SINCE WE'VE HAD LINEMEN PETROUS
SHORT. WE PRETTY MUCH HAD A LOT
OF THE OPTIONS BEING IF YOU WERE
IN A CRISIS ARE YOU AN EMERGENCY
PSYCHIATRIC SITUATION. YOU WOULD
BE TOLD TO CALL NINE ONE ONE OR
YOUR YOUR YOUR NEAREST EMERGENCY
DEPARTMENT. JUST FOR
CLARIFICATION AND A LOT OF
PEOPLE SAY E. R. EMERGENCY ROOM.
WE'LL GO WITH EMERGENCY
DEPARTMENT OR EDT FOR THAT
TODAY. SO EVEN IF YOU DO CALL
NINE ONE ONE A LOT OF TIMES
YOU'RE GONNA END UP ON A FIFTY
ONE FIFTY HOLD AND THAT'S GOING
TO END UP BRING YOU TO THAT SAME
HOSPITAL EMERGENCY DEPARTMENT.
FOR A MEDICAL EVALUATION AND
MAYBE FURTHER PSYCHIATRIC
EVALUATION. AND THERE'S
HISTORICALLY BEEN KIND OF AN
ASSUMPTION THAT IF YOU END UP ON
A FIFTY ONE FIFTEEN YOU GO T
THE ER. THAT YOU'RE MOST LIKELY
THAT I'M GOING TO GET A MEDICAL
CLEARANCE TO BE TRANSFERRED TO A
PSYCHIATRIC HOSPITAL FOR.
SEVENTY TWO HOURS OR LONGER FOR
A PSYCHIATRIC STATE NEXT SLIDE
PLEASE. SO WHAT WE'VE BEEN
TRYING TO DO IN THE PAST DECADE
WE'VE BEEN FOCUSING A LOT OF OUR
EFFORTS ON. THAT DVD IS NOT A
GREAT PLACE FOR SOMEBODY TO GO
WHEN THEY'RE IN THE PSYCHIATRIC
CRISIS AND I DON'T THINK THERE'S
ANY DISAGREEMENT ON THAT THE
STANDARD EMERGENCY DEPARTMENT
ITSELF IS NOT REALLY WELL SET UP
FOR A PSYCHIATRIC EMERGENCY. AND
ACTUALLY CAN MAKE PEOPLE
SYMPTOMS WORSE. HOWEVER WE'VE
BEEN ABLE TO CREATE THESE
WONDERFUL PROGRAMS BE THEY'D
DROP IN CRISIS COUNSELING
PROGRAMS MOBILE CRISIS TEAMS-
ALTERNATIVE CRISIS STABILIZATION
COMMUNITY PROGRAMS. AND IS
WONDERFUL AS THE PROGRAMS HAVE
BEEN AND HAVE PROVIDED SOLUTIONS
FOR A LOT OF DIFFERENT- FOLKS-
THE NUMBER OF PEOPLE COMING IN
ON FIFTY ONE FIFTIES INCOMING
FOR PSYCHIATRIC EMERGENCIES TO
HOSPITAL ER'S. HAS ONLY
INCREASED DURING THAT SAME
DECADE. AND SO WHICH NOW ABOUT
ONE IN EVERY SEVEN PATIENTS IN A
HOSPITAL E. ARE IN CALIFORNIA
AND INDEED ACROSS THE UNITED
STATES IS THERE FOR A BEHAVIORAL
HEALTH EMERGENCY. THAT'S MORE
THAN PEOPLE ARE COMING IN FOR
CHEST PAIN OR SHORTNESS OF
BREATH OR CAR ACCIDENTS IT'S ONE
OF THE MOST COMMON REASONS
PEOPLE ARE IN E. OURS NOW. AND
SO INSTEAD OF FOCUSING ALL OF
HER TIME AND EFFORTS AND SAYING
THE ER IS NOT THE RIGHT PLACE TO
GO. THERE THERE NO MATTER WHAT
WE'RE GOING TO SAY ABOUT IT
ANYWAY AND IT MAY BE TIME TO
SAY. HEY WHY DON'T WE START
SEEING WHAT WE CAN DO AT THAT
EMERGENCY LEVEL OF CARE AND THE
GOOD THING I COULD TELL YOU
ABOUT HAVING WORK WITH A NUMBER
OF HOSPITALS ACROSS THE STATE
AND THIS. IS HOSPITALS ARE NOW
SAYING. YOU KNOW WHAT THESE ARE
OUR PATIENTS TO. IT'S TIME FOR
US TO START SAYING YOU KNOW IF
WE HAD A TRIPLE THE NUMBER OF.
HEART ATTACKS COMING IN. WE
WOULD MAKE EFFORTS TO BETTER
TREAT HEART ATTACK PATIENTS.
WE'RE SEEING LOTS AND LOTS MORE
EMERGENCY PSYCHIATRIC PATIENTS.
WERE RECOGNIZING NOW THAT THESE
ARE OUR PATIENTS AND WE'RE GOING
TO MAKE EFFORTS TO. REALLY
IMPROVE THE WAY WE HELP THESE
FOLKS NEXT SLIDE. AND THE REASON
THAT WE'RE SEEING SO MANY MORE
FOLKS AND THAT'S THE WE'RE JUST
NOT ABLE TO DIVERT THEM TO
COMMUNITY PROGRAMS AND THE
REASON IS THAT THERE'S A LOT OF.
PSYCHIATRIC EMERGENCIES THAT ARE
JUST TOO ACUTE FOR COMMUNITY
PROGRAMS MAYBE THAT'S PEOPLE WHO
ARE ON FIFTY ONE FIFTY HOLDS.
MAYBE IT'S BECAUSE THEY'VE TAKEN
AN OVERDOSE OR HAVE COAL MORBID
INTOXICATION. OR OTHER MEDICAL
PROBLEMS OR THEY'RE SO
AGGRESSIVE OR AGITATED. THAT
THEY'RE JUST TOO ACUTE FOR A
COMMUNITY DROP IN A VOLUNTARY
PROGRAM. DOESN'T MEAN WE SHOULD
BE DENYING THEM HELP. ONCE THEY
GET INTO THE E. ARE. TOO LONG
WE'VE BEEN SAYING ONCE YOU GET
TO THE E. ARE ALL OUR EFFORTS A
CRISIS STABILIZATION AND
COMMUNITY STOP. AND NOW ALL
YOU'RE BASICALLY GOING TO BE
ABLE TO DO IS GET EVALUATED TO
SEE IF YOU NEED TO GO TO A
HOSPITAL OR NOT. BUT WHAT WE'VE
ABLE BEEN ABLE TO SEE IS IF WE
ACTUALLY INITIATE. CRISIS
STABILIZATION AT THAT EMERGENCY
LEVEL OF CARE. IN THE HOSPITAL
SETTING WE'RE GOING TO HAVE
INCREDIBLE POSITIVE RESULTS. HEY
GO TO THE NEXT SLIDE PLEASE. SO
WHAT WE HAVE CURRENTLY IN A LOT
OF HOSPITALS IN THE COUNTRY IN
THE CALIFORNIA AND NATIONWIDE IS
SOMETHING CALLED BOARDING. AND
THAT IS A FIFTY ONE FIFTY
PATIENT COMES IN. THE HOSPITAL
DOES A MEDICAL CLEARANCE EXAMINE
THE E. D. AND THEN THE PATIENT
SITS AND WAITS. AND THEY'RE
WAITING SOMETIMES FOR AN
EVALUATION BY A COUNTY PERSON TO
COME BY AND SEE WHETHER OR NOT
THERE. I DETERMINE THAT THEY
NEED INPATIENT STABILIZATION
ORDER ONE STATES EVEN BEEN
DETERMINED. THEY'D HAVE TO STILL
WAIT A LONG LONG TIME. FOR AN
INPATIENT BED BECOME AVAILABLE.
AND OFTEN THEY'RE NOT BEING
HELPED AT ALL THERE'S NO
TREATMENT EXCEPT MAYBE
OCCASIONALLY SOME SEDATION.
THEY'RE USUALLY STUCK WITH A
SITTER OR SECURITY GUARD.
SOMETIMES THEY'RE STRAPPED TO A
GURNEY AND PUT IN A HALLWAY. AND
AS WE'VE SAID BEFORE THE
EMERGENCY DEPARTMENT ITSELF CAN
BE. A BAD ENVIRONMENT FOR FOLKS
AND ACTUALLY MAKE THEIR SYMPTOMS
WORSE DURING THAT TIME. AND WHEN
THEY'RE BOARDING THAT'S EVEN
THAT MUCH WORSE AND SO SOMETIMES
THIS CAN LAST. FOR HOURS AND
SOMETIMES FOR DAYS IN FACT. I
CAN'T TELL YOU HOW MANY PLACE I
TALKED TO WHERE THE AVERAGE
LENGTH OF BOARDING IS OVER
THIRTY HOURS. SO IMAGINE COME TO
THE ER. IN THIS HORRIBLE
HORRIBLE STATE. AND IT'S THE
WORST DAY OF YOUR LIFE AND YOU
JUST GET STRAPPED TO A GURNEY
AND THEY'LL SAY WELL WE'LL SEE
IN A- COUPLE OF DAYS. HOPEFULLY
WE'LL HAVE SOME TREATMENT FOR
YOU AT THAT TIME. OKAY COMPARED
TO IF YOU CAME NTO THE
EMERGENCY DEPARTMENT AND YOUR
SHORT OF BREATH. AND YOUR HAVING
AN ASTHMA ATTACK YOU. PLEASE
HELP ME CAN YOU HELP. AND THEY
WERE SAYING LIKE YES YES PLEASE
COME WITH ME WE'RE GOING TO HAVE
A SEAT FOR YOU IN THE BCK.
WE'RE GONNA CALL AROUND TRYING
TO FIND AN ASTHMA HOSPITAL AND
TRANSFER YOU TO. WE SHOULD HAVE
AN ASTHMA HOSPITAL FOR YOU IN
ABOUT THIRTY HOURS. SIT TIGHT.
TRY TO RELAX. THAT'S WHAT WE'RE
DOING WITH PEOPLE ARE HAVING
PSYCHIATRIC EMERGENCIES. AND
WHAT'S ON REALLY UNFORTUNATE
ABOUT IT IS ACTUALLY IF WE HAD
INITIATE TREATMENT. WE COULD
ACTUALLY HAVE THOSE PEOPLE IN
MUCH BETTER SHAPE AND GOING
HOME. IN LESS TIME THAT RIGHT
NOW THEY'RE SITTING THERE WITH
NOTHING ELSE GOING ON. NEXT
SLIDE PLEASE. SO ONE THING TO
KNOW ABOUT EMERGENCY DEPARTMENTS
FEDERAL LAW. I SURE MOST OF YOU
KNOW THIS BUT JUST TO REITERATE.
EMTALA IS THE FEDERAL LAW THAT
ANYBODY COMES TO E. R. MUST BE
SEEN. THEY MUST BE EVALUATED SEE
IF THERE'S AN EMERGENCY MEDICAL
CONDITION AND IF SO THEY NEED TO
HAVE THAT CONDITION STABILIZED
OR THE NEED TO BE ADMITTED TO A
HOSPITAL. FEDERAL LAW THE INTEL
LAW SAYS THAT PSYCHIATRIC
EMERGENCIES ARE MEDICAL
EMERGENCIES. AND SO. THEY NEED
TO BE EVALUATED AND ATTEMPTED TO
STABILIZE IN THAT SAME WAY WERE
ADMITTED TRADITIONALLY THEY'VE
JUST BEEN TRYING TO ADMIT THOSE
FOLKS. BUT WHAT WE KNOW IS THAT
WE CAN ACTUALLY STABILIZE HIM IN
THE E. R. AS WELL. AND IF WE
LOOK AT THEM AS MEDICAL
EMERGENCIES WHICH THE FEDERAL
GOVERNMENT SAYS THEY ARE. THEN
WE STOP THINKING LIKE YOU KNOW
THE STIGMATIZING IDEAS LIKE WHAT
ARE YOU DOING HERE YOU DON'T
BELONG HERE. YOU SHOULD BE
SOMEWHERE ELSE. DISEASES THE
BRAIN DON'T BELONG HERE. THERE'S
BEEN SEVERAL OTHER SPEAKERS
TODAY WHO HAVE MENTIONED THAT.
THESE ARE SERIOUS SERIOUS
ILLNESSES THAT PEOPLE ARE
SUFFERING FROM. THAT ARE NOT
CHOICES THEY'RE NOT JUST THINGS
THAT THAT THE- PICKED THE WRONG.
DAY OR SOMETHING LIKE THAT. NO
THESE ARE ACTUALLY DISEASES OF
THE BRAIN TISSUE. AND IF WE LOOK
AT THEM AS MEDICAL ISSUES AND
REALIZE THAT THESE ARE PEOPLE
WHO REALLY NEED OUR HELP AT THE
ER. MAKES IT MUCH EASIER TO
UNDERSTAND. WHY IT'S APPROPRIATE
FOR SERIOUS SERIOUS LEVEL
ILLNESSES TO BE IN THE EMERGENCY
DEPARTMENT. NEXT SLIDE PLEASE.
SO WELL ONE OF THE THINGS WE'VE
WE HEARD ABOUT IT HISTORICALLY
IS WHEN PEOPLE ARE BACKING UP IN
THE E. OURS. WHY DON'T WE BUILD
MORE INPATIENT BEDS AND WE CAN
TRANSFER THEM TO AND THAT WILL
CLEAR OUT THE E. OURS BUT THAT
PERPETUATES THAT SAME SYSTEM
LIKE I WAS SAYING WITH THE
ASTHMA ATTACK WHERE. LET'S JUST
HAVE YOU SIT AND WAIT UNTIL WE
FIND SOMETHING ELSEWHERE AND WE
DON'T DO THAT FOR ANY OTHER KIND
OF MEDICAL EMERGENCY. THAT WE
SEE IN THE EMERGENCY DEPARTMENT.
IN FACT IF WE COMPARED IT TO
CHEST PAIN. IF YOU CAME INTO THE
R. WITH CHEST PAIN YOU THINK YOU
MIGHT BE HAVING A HEART ATTACK.
ONLY 10220% OF THOSE FOLKS END
UP GETTING HOSPITALIZED. AND IN
FACT IF WE ACTUALLY INITIATE
THAT SAME KIND OF STABILIZING
EVALUATION AND TREATMENT. AT
THAT EMERGENCY LEVEL CARE WE
FIND THAT WE CAN DO THE SAME
KIND OF STABILIZING CARE. AND
GET FOLKS HOME IN LESS THAN
TWENTY FOUR HOURS WE PSYCHIATRIC
EMERGENCIES THE SAME WAY WE CAN
WITH MEDICAL EMERGENCIES. NEXT
SLIDE PLEASE. SO THE KEY ABOUT
THIS IS THAT WE NEED TO REALIZE
THERE'S A SPECTRUM OF KERR AND
I'VE HEARD PEOPLE TALK ABOUT
THIS TODAY. THAT WE NEED TO HAVE
APPROPRIATE LEVELS OF CARE IN
THE COMMUNITY FOR. MILD TO
MODERATE EMERGENCY CONDITIONS
WHERE PEOPLE CAN ACCESS CARE
VOLUNTARILY. THAT'S ALWAYS OUR
FIRST CHOICE WE DON'T WANT
ANYBODY TO BE ON A FIFTY ONE
FIFTY IF THEY DON'T HAVE TO BE.
BUT SOMETIMES PEOPLE ARE TO VERY
SEVERE LEVEL OF CARE YOU
WOULDN'T EXPECT THAT IF YOU'RE
IN A CAR ACCIDENT. THAT WOULD
THEY WOULD TAKE YOU TO THE- THE
DROP IN. URGENT CARE NEXT TO THE
WALGREENS. YOU'D WANT TO GO TO
THE TRAUMA CENTER WHERE THE
TRAUMA SURGEON CAN HELP YOU OUT
CORRECT. IT'S THE SAME KIND OF
THING WITH SEVERE SEVERE. MENTAL
ILLNESS WE NEED DIFFERENT LEVELS
OF CURE ACUITY AND SOMETIMES
THAT HOSPITAL ER IS INDEED THE
RIGHT PLACE. NEXT SLIDE. SO WHAT
HAVE WE HAD TRADITIONALLY THAT'S
AVAILABLE AT THAT HOSPITAL
EMERGENCY DEPARTMENT. BEST CASE
SCENARIO IS THAT THERE MIGHT BE
SOMEBODY STATIONED THERE WHO CAN
HELP YOU OUT A MENTAL HEALTH
PROFESSIONAL WHO CAN DO AN
EVALUATION THERE MAY EVEN BE A
MENTAL HEALTH NURSE PRACTITIONER
PSYCHIATRIST THERE. DID THE
UNFORTUNATE THING IS THAT MOSTLY
AND EVEN SOMETIMES THEY'LL HAVE
THE COUNTY WILL HAVE SOMEBODY
WILL COME AND HELP FOLKS OUT
THERE. THE UNFORTUNATE THING IS
THAT REALLY THEY AREN'T DOING
MUCH BEYOND DECIDING WHETHER OR
NOT YOU'RE APPROPRIATE TO BE
TRANSFERRED TO AN INPATIENT
FACILITY. THEY MIGHT HELP SAY
YOU'RE DOING OKAY WE CAN GET YOU
BACK HOME LET'S PLUG YOU INTO
COMMUNITY SERVICES. MORE LIKELY
THEY'RE GONNA SAY IT LOOKS LIKE
YOU'RE HAVING SEVERE ILLNESS
LET'S START TRYING TO FIND AN
APPROPRIATE. INPATIENT HOSPITAL
TO TRANSFER YOU TO AND WE'RE
GOING TO AUTHORIZES. THE MISSING
PIECE THE BIG HUGE DONUT HOLE IN
THIS WHOLE SYSTEM WHEN WE'RE
DOING IT THAT WAY AS- WHAT ABOUT
INITIATING TREATMENT WHAT ABOUT
ACTUALLY. STARTING CARE WHILE
THEY'RE IN THAT EMERGENCY LEVEL.
AND WHAT WE'RE GOING TO GET THE
BIGGEST BANG FOR THE BUCK AND
OUR MENTAL HEALTH SYSTEM AND ITS
THE BIGGEST MISSING PIECE IN OUR
MENTAL HEALTH SYSTEM. IS WHY
AREN'T WE INITIATING CARE WHEN
SOMEBODY'S IN THAT EMERGENCY YOU
LEVEL AND REALLY REALLY NEEDS
HELP. NEXT SLIDE PLEASE. SO
INITIATE THAT EMERGENCY CARE WE
DO WE IF WE FOLLOW WHAT ARE
KNOWN AMONG US AND EMERGENCY
PSYCHIATRY'S THE SIX GOALS ARE
RUMORED TO SEE PSYCHIATRIC CARE.
AND REAL QUICKLY IT'S GOING TO
GO THROUGH THESE BECAUSE THIS IS
THE BASIS FOR THE WHOLE NEXT
PART AND MAKE IT ALL MUCH MAKE
MUCH MORE SENSE. FIRST OF ALL
YOU NEED TO EXCLUDE MEDICALLY
THE ALLERGIES AND SURE MEDICAL
STABILITY WHEN SOMEBODY'S HAVING
A SEVERE MEDICAL EMERGENCY- THE
MEDICAL PSYCHIATRIC EMERGENCY
MAYBE IT'S HALLUCINATIONS MAYBE
SEVERE SUICIDALITY. SEVERE
ANXIETY YOU NEED TO MAKE SURE
THAT THE FIRST OFF THAT THIS IS
NOT. DUE TO A MEDICAL CONDITION
WISE THAT. BASED ON WHICH STUDY
LOOK AT ANYWHERE FROM 10225% OF
PSYCHIATRIC EMERGENCIES. ARE
EITHER MEDICAL CONDITIONS THAT
ARE MIMICKING WHAT APPEAR TO BE
PSYCHIATRIC CONDITIONS FOR. A
PSYCHIATRIC TO GET CONDITION IS
BEING EXACERBATED BY A MEDICAL
CONDITION. AND THOSE ARE
SOMETIMES LIFE THREATENING
SOMETIMES HEAD TRAUMA WITH IT
BREATHE BLEEDING INSIDE THE
BRAIN CAN LOOK LIKE- SOMEBODY IS
JUST CONFUSED OR DISORIENTED.
SOMETIMES SOMEBODY MIGHT HAVE.
ABNORMALITIES IN THEIR THYROID
GLAND OR THEY MAY HAVE A TIME TO
TALK TO DRUM THEY'VE INGESTED
POISON. THERE'S ALL KINDS OF
DIFFERENT THINGS THAT CAN LOOK
LIKE PSYCHIATRIC CONDITIONS. AND
I THERE'S TOO MANY STORIES OF
PEOPLE SAYING OH THIS IS JUST
LIKE SEND THEM FOR COUNSELLING.
AND IT TURNED OUT IT WAS A VERY
VERY SEVERE MEDICAL CONDITION
AND BAD BAD OUTCOMES. SO WE WANT
TO MAKE SURE THAT WE- DON'T JUST
ASSUME THAT SOMEBODY NEEDS
COUNSELING AS I HEARD SOMEBODY
MENTIONED BEFORE BUT THAT THESE
ARE SERIOUS PSYCHIATRIC MEDICAL.
CONDITIONS AND WE GIVE SOMEBODY
A GOOD MEDICAL EVALUATION ONCE
WE ARE INSURE THAT THIS IS
INDEED. APPEAR PSYCHIATRIC
EMERGENCY AND THAT WE'VE RULED
OUT ALL THE NON. NON PSYCHIATRIC
MEDICAL CONDITIONS WE WANT TO
RAPIDLY STABILIZE THE ACUTE
CRISIS THE ACUTE PSYCHIATRIC
EMERGENCY CONDITION. AND I THINK
THAT IT TOO OFTEN HISTORICALLY
EMERGENCY DEPARTMENTS HAVE KIND
OF PUT PSYCH PATIENTS ON THE
BACK BURNER. MAKES SENSE OF
SOMEBODY'S COMING IN WITH A
HEART ATTACK OR CAR ACCIDENT.
BUT I DON'T THINK THERE'S BEEN A
RECOGNITION ABOUT HOW SERIOUS I
AFTER CONDITIONS CAN BE. BECAUSE
FOR ALL OF US WHO ARE LISTENING
RIGHT NOW CAN WE POSSIBLY
IMAGINE WHAT IT MUST BE LIKE TO
BE SO SUICIDAL. THAT YOU DON'T
WANT TO TAKE ANOTHER BREATH. AND
YOU JUST WANT TO DIE YOU JUST
WANT YOUR LIFE TO BE OVER WHAT
CAN I FEEL LIKE I HOPE NONE OF
US EVER HAVE TO EXPERIENCE THAT
FEELING. OR HOW ABOUT HEARING
VOICES IN YOUR HEAD THAT ARE
TELLING YOU. TO KILL YOUR FAMILY
MEMBERS. AND WHAT WHAT MUST THAT
BE LIKE THAT MUST BE LIKE THE
MOST AWFUL THING YOU COULD
POSSIBLY IMAGINE. AND THOSE ARE
REAL VOICES THEY'RE HEARING IF
YOU DID A BRAIN SCAN. OF
SOMEBODY WHO'S WITH
SCHIZOPHRENIC WHO'S HEARING
VOICES. THE SAME PART OF THEIR
BRAIN THAT WOULD LIGHT UP YOU
HEARING ME TALK RIGHT NOW.
LIGHTS UP WITH THEM THEY'RE
LITERALLY HEARING VOICES. AND
THEY DON'T WANT TO ACT ON THOSE
VOICES. BUT IT MUST BE SO.
DIFFICULT AND IS THAT AS BAD. AS
AS BEING YOU KNOW HAVING A
BROKEN ARM. MAYBE THEY NEED TO
BE PRIORITIZED. AND SO YOU KNOW
I HAD COLLEAGUES SAY TO ME. YOU
KNOW SCOTT THE ONE THING ABOUT
PSYCHIATRIC EMERGENCIES WE DON'T
HAVE A BLOOD TEST THAT PROVES
THAT SOMEBODY'S HAVING PSYCH
EMERGENCY WE DON'T HAVE AN- X.
RAY THAT PROVES THERE'S PSYCH
EMERGENCY. AND I SAID YEAH. BUT
YOU KNOW WHAT WE DON'T HAVE. A
BLOOD TEST OR AN X. RAY TO PROVE
EITHER. PAIN WE ALL KNOW WHAT
PAIN FEELS LIKE. SO MAYBE. I'VE
WE ALL KNOW WHAT PAIN IS. SO
THINK OF YOUR JUST GOING OH MY
GOD MY HEAD SPLITTING I REALLY
NEED HELP PLEASE HELP ME NOW AND
IMAGINE SOMEBODY SAYING. WELL
PLEASE COME IN HAVE A SEAT WILL.
GET SOMEBODY TO SEE YOU IN A FEW
HOURS TO BE NO PLEASE HELP ME
NOW I REALLY NEED HELP. AND
THAT'S WHERE WE NEED TO THINK
ABOUT PSYCHIATRIC EMERGENCIES
BECAUSE THAT'S OUR PATIENTS ARE
FEELING. AND WHEN WE DO HELP
THEM WE WANT TO AVOID COERCION
TO MUCH OF. HISTORIC PSYCHIATRIC
EMERGENCY CARE HAS BEEN ABOUT.
I'M THE DOCTOR YOU'RE THE
PATIENT SHUT UP WE'RE GOING TO
TIE YOU DOWN WE'RE GONNA GIVE
YOU A SHOT. WE WANT TO GET RID
OF THAT. INSTEAD FORMA
THERAPEUTICS ALLIANCE WHERE IT'S
ALL ABOUT COLLABORATION NOT
COERCION. YOU'RE GOING THROUGH A
TOUGH TIME LET'S GET YOU THROUGH
THIS. YOU'RE GONNA BE OKAY. AND
THAT MEANS TREAT IN THE LEAST
RESTRICTIVE SETTING. AND SO MUCH
OF OUR HISTORIC APPROACH HAS
BEEN THE BEST THING WE CAN DO
FOR YOU IS FIND YOU AN INPATIENT
PSYCH BED. BUT IN ALL
SERIOUSNESS WHO WOULD REALLY
WANT TO BE LOCKED INTO A
PSYCHIATRIC HOSPITAL FOR SEVERAL
DAYS. AGAINST YOUR WILL. UNLESS
YOU REALLY REALLY NEEDED IT. IF
THERE'S AN ALTERNATIVE WE WANT
TO GO IN THE OTHER DIRECTION
WHERE THE LEAST RESTRICTIVE
SETTING WHERE WE'RE BEING LOCKED
INTO RESTRAINTS IS PROBABLY THE
MOST RESTRICTIVE SETTING. NEXT
MOST RESTRICTED BE JUST LOCKED
INSIDE OF A HOSPITAL. LET'S KEEP
MOVING TOWARDS THE LEAST
RESTRICTIVE SETTING WHICH IS ME
BEING HOME ABLE TO COME AND GO
AS YOU PLEASE MAKE YOUR OWN
DECISIONS FEELING SAFE. THAT'S
THE DIRECTION WE WANT TO GO AND
SO. THE IDEA THAT THE SOLUTION
IS ALWAYS IMPATIENT. IS ACTUALLY
THE OPPOSITE OF THAT I THINK THE
BEST WAY WE CAN HELP SOMEBODY.
AND WHEN WE ARE ABLE TO DO ALL
THESE THINGS. WE WANT TO GET
SOMEBODY BACK HOME BACK TO THE
COMMUNITY. AND IN DOING SO WE
WANT TO HAVE A REALLY GOOD WARM
HAND OFF TO COMMUNITY SERVICES
AND ENSURE THAT WE'RE GETTING
PEOPLE CONNECTED. AND NOT JUST
OPENING THE DOOR TO THE ER AND
SAYING HERE'S A PAMPHLET. BUT
ACTUALLY CONNECTING THEM TO
SERVICES AND MAKING SURE THAT.
THE PEOPLE GET OUT AND- DON'T
HAVE TO COME BACK AGAIN MY GOAL
AS AN EMERGENCY PSYCHIATRIST HAS
ALWAYS BEEN TO PUT MYSELF OUT OF
WORK. BY DOING SUCH A GREAT JOB.
THAT PEOPLE DON'T HAVE AN
EMERGENCY SITUATION OR CRISIS
AGAIN NEXT SLIDE. SO THE MODEL
THAT HAS BEEN DEVELOPED THAT
REALLY REFLECTS. ALL OF THESE
CONCEPTS IS CALLED THE M. PATH
MODEL AND M. PATTERSON ACRONYM
STANDS FOR EMERGENCY
PSYCHIATRIC. ASSESSMENT
TREATMENT AND HEALING. FACILITY
AND THESE ARE LIKE ICY USE
ADJACENT TO EMERGENCY
DEPARTMENTS. THAT PEOPLE CAN BE
SWIFTLY MOVED OUT OF THE E. R.
RIGHT INTO A MORE APPROPRIATE.
YOU KNOW THERAPEUTIC SETTING.
THAT STILL THAT SAME LEVEL OF
CARE THAT STEAM EMERGENCY
HOSPITAL DEPARTMENT. LEVEL OF
CARE. BUT IT'S DESIGNED REALLY
FOR. THE KIND OF EMERGENCIES
THAT PEOPLE ARE HAVING A PSYCHE
AFTER MONTHS YOU'RE GOING
THROUGH. AND WHAT WE FIND IS
THAT IF WE GET PEOPLE INTO A
SETTING LIKE THIS. THAT OF THE
PEOPLE WHO WE WOULD HAVE HELD TO
GO TO AN INPATIENT FACILITY
BEFORE. 75280% OF THEM WE CAN
GET BETTER AND STABLE. AND GET
BACK HOME IN LESS THAN TWENTY
FOUR HOURS. IT'S JUST AN AMAZING
AMAZING TURNAROUND. IT'S AND IF
YOU SAY LIKE WHAT AT THIS
DOESN'T MAKE SENSE HOW WOULD
SOMEBODY BE AN E. R. AND WE MOVE
THEM SOMEWHERE THAT'S THAT'S
MORE APPROPRIATE WE DON'T DO
THAT WITH ANYTHING ELSE BUT I
SAY. IF YOU CAME INTO THE ER
BECAUSE IT'S THE ONLY DOOR IN
THE HOSPITAL AT THREE IN THE
MORNING. AND YOU'RE ABOUT TO
HAVE A BABY THE ER DOC WOULD SEE
YOU AND SAY LIKE YOU'RE ABOUT TO
HAVE A BABY. YOU'RE NOT GOING TO
HAVE IT HERE IN THE YEAR LET'S
GET YOU OVER TO LABOR AND
DELIVERY. IT'S EXACT SAME KIND
OF THING WE'RE GONNA GET YOU
OVER TO THE PSYCHIATRIC
EMERGENCY UNIT WHICH IS CALLED
THE M. PATH UNIT. AND WHAT MAKES
IT DIFFERENT WE GET EVERYBODY
THERE AS QUICKLY AS POSSIBLE GET
THEM OUT OF THE E. R. WHICH WE
KNOW IS NOT A GOOD SETTING.
WHERE WE HAVE NO EXCLUSIONS WE
TRY TO FIND ALL THE- PATIENTS WE
THE WE WERE JUST NOT GOING TO
FIND REASONS TO NOT HAVE THEM
COME OVER WE WANT TO HAVE MORE
REASON TO HAVE THEM COME OVER.
BECAUSE WE KNOW WE'RE A BETTER
ENVIRONMENT. WE'RE GONNA HAVE
EVERYBODY SEE A PSYCHIATRIST OR
A PSYCHIATRIC NURSE
PRACTITIONER. IN LESS THAN AN
HOUR AFTER ARRIVAL SO MANY TIMES
WE FIND OF REASON PATIENTS HAVE
A TOUGH TIME IN PSYCHIATRIC
EMERGENCIES OF THEY'LL BE LIKE
I'VE BEEN HERE FIVE HOURS I
HAVEN'T EVEN SEEN A DOCTOR YET.
LET'S GET THAT DOCTOR OR THAT
PSYCHIATRIC PROVIDER THE VERY
FRONT OF THE LINE IF MEDICATIONS
ARE INDICATED THAT ARE GOING TO
RELIEVE THAT ANXIETY THAT
STRESSED THAT PSYCHOSIS. LET'S
GET STARTED RIGHT AWAY AND LET'S
HAVE THIS ENVIRONMENT BE A MUCH
MORE THERAPEUTIC SPACIOUS RELAX
HOME LIKE COMFORTABLE
ENVIRONMENT. THAT IS COMPLETELY
DISTINCT FROM THE MEDICAL YOUR
NEXT NEXT SLIDE. AND THAT DESIGN
IS. ABOUT BEING SPACIOUS IT'S A
LARGE OPEN SPACE WHICH WE CALL A
MILIEU WHERE PATIENTS CAN ALL BE
TOGETHER IN THE SAME ROOM. IT
MIGHT SEEM COUNTER AND
INTUITIVE. BUT ACTUALLY HUMAN
CONTACT IN THOSE FIRST FEW HOURS
OF A CRISIS. ARE AMAZING FOR
PEOPLE. WHEN YOU WERE SUICIDAL
YOU THOUGHT EVERYBODY IN THE
WORLD HATED YOU IF YOU GET
LOCKED IN A ROOM BY YOURSELF
WHAT'S CHANGED. BUT MAYBE YOU'RE
IN A ROOM THERE'S OTHER FOLKS
THERE. YOU MAKE A NEW FRIEND.
LIFE SEEMS A LITTLE BIT BETTER.
MAYBE IF YOU'RE PARANOID
PSYCHOSIS YOU GET LOCKED IN A
ROOM YOU THINK THE PEOPLE
OUTSIDE THE DOOR OF PLOTTING
AGAINST YOU ARE LAUGHING AT YOU.
IF EVERYBODY'S THERE AROUND YOU
YOU CAN SEE THEM. AND THINGS
SEEM A LOT LIKE BETTER. WE HAVE
THE NURSING STAFF INTERSPERSED
AS OPPOSED TO BEING. LOCKED
BEHIND A BULLETPROOF FISH BOWL
THAT ARE SEPARATED FROM THE
PATIENTS. WE'VE DONE A LOT OF
RESEARCH. THE OPEN SPACE AND THE
IMMEDIATE ACCESS TO NURSING
STAFF. REDUCES A LOT OF THE
ANXIETY. THE ANGER THE
FRUSTRATION THAT CAUSES
AGGRESSION. AND VIOLENCE AND
AGITATION. IT'S ME IT'S JUST THE
WHOLE EXPERIENCE IS COMPLETELY
DIFFERENT AND WE WANT TO HAVE
EVERYBODY HAVE ENOUGH SPACE.
BECAUSE PEOPLE DON'T FEEL
PARANOID. A LOT OF OUR PATIENTS.
NEED TO PACE AROUND FOR EXAMPLE
TO HELP THEM WORK OFF THEIR-
AGITATION OR THE ANXIETY. YOU
CAN'T DO THAT ON A REGULAR E. R.
SOMEBODY WOULD YELL YOU GET BACK
IN YOUR ROOM I'M CALLING
SECURITY. HERE WE GIVE YOU THE
SPACE TO WALK AROUND. THERE'S
PLENTY OF ROOM. TO MOVE ABOUT.
INSTEAD OF BEING IN A SYMBOL AND
A SMALL- YOU KNOW OBSERVATION
BAD OR SOMETHING LIKE THAT.
YOU'RE IN THIS BIG ROOM YOU PICK
YOUR OWN RECLINER. YOU'RE ABLE
TO GO THERE AND CHOOSE THE
RECLINER. YOU CAN SIT IN IT. AND
YOU CAN ENGAGE IN ONE TO ONE OR
SMALL GROUP THERAPY YOU CAN PLAY
A GAME YOU CAN WATCH TV YOU CAN
READ A BOOK. OR YOU CAN FOLD IT
FLAT YOU CAN GRAB YOURSELF A
PILLOW AND BLANKET. TAKE A NAP.
YOU CAN ALSO GO OUT GRAB
YOURSELF A SNACK. OR BEVERAGE
NOBODY'S GOING TO MAKE YOU HAVE
TO. BEG FOR ANYTHING YOU'RE
NEVER GOING TO HAVE SAY. PLEASE
NURSING STAFF CAN I HAVE A GLASS
OF WATER. YOU JUST GO UP AND GET
IT YOURSELF. IF YOU WANT TO WALK
AROUND PACE. EVERYBODY'S GONNA
GO THIS IS GREAT. IT SAYS SPACE
IS ABOUT EIGHTY SQUARE FOOT PER
PATIENT. AND THIS IS WELL
DESIGNED NOW THAT THIS IS THE
NATIONAL STANDARD. THE FACILITY
GUIDELINES INSTITUTE GUIDELINES
NOW HAVE THIS. NATION WIDE
EIGHTY SQUARE FEET PER PATIENT
IN A UNIT LIKE THIS. AND IF
SOMEBODY IS HAVING A TOUGH TIME
THE NURSING STAFF CAN QUICKLY
RECOGNIZE IT. GO AND HELP THEM
WITH DE ESCALATION CALMING
TECHNIQUES. AND IF IT'S STILL A
TOUGHER TIME. THEY CAN BRING
THEM TO AN UNLOCKED ROOM AROUND
THE PERIMETER CALL THE CALMING
ROOM. WHERE INSTEAD OF PUTTING
SOMEBODY IN LOCKS INCLUDED. OR
FORCIBLE RESTRAINTS THEY CAN GO
IN THERE AND DECOMPRESS. AND
FEEL A LITTLE BETTER AND GET OUT
OF THERE QUICKLY NEXT SLIDE
PLEASE. SO HERE'S SOME- PHOTOS
YOU CAN SEE OF WHAT SOME OF
THESE UNITS LOOK LIKE. WHAT'S
AMAZING ABOUT THEM AS YOU CAN
ACTUALLY USE UNDER UTILIZED
SPACE AND FOR A LITTLE BIT OF
PAINT- BECAUSE YOU DON'T NEED
WALLS THESE ARE JUST OPEN ROOMS.
LITTLE BIT OF PAIN AND SOME NEW
FURNITURE. YOU CERTAINLY HAVE AN
IMPACT UNIT. AND IT'S SO
DIFFERENT WHEN WHAT THE E. R.
WAS AND YOU CAN JUST SEE FROM
SOME OF THESE PHOTOS WHERE. YOU
CAN MOVE ABOUT YOU CAN HAVE THE
BIG COMFY RECLINERS. AND THE
BANG FOR THE BUCK IS JUST
INCREDIBLE NEXT SLIDE PLEASE. SO
WE HAVE ALL KINDS OF WONDERFUL
STAFF THAT WORK IN IT INCLUDING
PEER SUPPORT SPECIALIST WHICH
ARE WORTH TEN TIMES THEIR WEIGHT
IN GOLD. IF SOMEBODY COMES IN
AND A CRISIS AND THEY'RE THERE
AS PART OF OUR STAFF AND SAY HEY
YOU'RE GOING THROUGH TOUGH
TIMES. I'VE BEEN THERE TOO WE'RE
GOING TO GET YOU THROUGH THIS
TOGETHER. AND THEY REALLY REALLY
HELP US. WORK TOWARDS OUR GOAL
OF THAT LEAST RESTRICTIVE
ALTERNATIVE NEXT SLIDE PLEASE.
SO FOR THE PATIENT BENEFITS IT'S
THIS WONDERFUL TROM INFORMED
UNIT WERE OF WAITING ALL THE
KIND OF THINGS THAT MIGHT
TRIGGER- BAD OUTCOMES BUT
INSTEAD IS A VERY CALMING
ENVIRONMENT. WHERE THE OTHER BIG
KEY PART IS THAT. AFTER THAT
INITIAL EVALUATION BY A
PSYCHIATRIST. WE'RE GOING TO.
INSTEAD OF SAYING YOU NEED TO GO
TO INPATIENT OR WHATEVER'S GOING
TO HAPPEN WE'RE GONNA START A
TREATMENT PLAN WE'RE GONNA SEE
HOW SOMEBODY DOES FOR A FEW
HOURS. IN THIS COMFORTABLE
THERAPEUTIC ENVIRONMENT. MAYBE
THEY'RE GONNA GO SIT AND PLAY A
BOARD GAME AND JUST KIND OF GET
DISTRACTED A BIT. AND ALLOW
THEMSELVES TO RELAX AND THEN
WE'RE GONNA SEE THEY'RE DOING
BETTER WE'RE NOT GOING TO TRY TO
DECIDE TOO QUICKLY BUT WAIT. SIX
EIGHT TEN HOURS. AND IF WE DO
THAT WE'RE GONNA BE ABLE TO SEE
THAT. SOMEBODY'S ON A TO A
COURSE TOWARDS GETTING BETTER
RATHER THAN TRYING TO DECIDE
ONLY THAT FIRST HOUR WHEN
THEY'RE AT THEIR WORST. WHAT THE
DISPOSITION TWENTY FOUR HOURS
FROM NOW SHOULD BE. WE'RE GOING
TO CONTINUALLY RE OBSERVE
REEVALUATE AND OBSERVE. AND AS
WE DO THAT PEOPLE ARE GOING TO
CONTINUE TO GET BETTER. AND WE
GET SOME REAL BANG FOR THE BUCK
WHERE IS THE LONGER WE WORK WITH
THEM. THE MORE LIKELY IT IS
THEY'RE GOING TO BE GETTING
BETTER WE CAN START WORKING ON A
PLAN TO GET THEM BACK HOME. AND
PLUGGED INTO COMMUNITY PROGRAMS.
BECAUSE OF THIS WHOLE DESIGN IS
ALL SET UP TO MAKE IT MORE
CALMING AND- RELAXED.
THERAPEUTIC WE HAVE ALMOST
ELIMINATED THE NEED FOR PHYSICAL
RESTRAINTS WITH THIS POPULATION.
WHICH THIS IS A POPULATION THAT.
THERE THE FIFTY ONE FIFTIES THAT
WOULD HAVE BEEN IN THE- IS.
TYPICALLY ABOUT 30% OF THEM
WOULD HAVE BEEN IN PHYSICAL
RESTRAINTS. THE AVERAGE EMPAT
UNIT ACROSS THE NATION. IS
AVERAGING ABOUT ONE OUT OF EVERY
ONE THOUSAND OF THOSE SAME FOLKS
GOES IN RESTRAINTS. SO INSTEAD
OF THREE HUNDRED OUT OF A
THOUSAND IT'S ONE OUT OF A
THOUSAND. NEXT SLIDE PLEASE. ONE
EVIDENCE BASED INFORMATION THE
MOST PRESTIGIOUS EMERGENCY
MEDICINE JOURNAL CALLED ACADEMIC
EMERGENCY MEDICINE DID A STUDY
OF THEIR EMPAT UNIT. AT THE
UNIVERSITY OF IOWA. HERE'S SOME
OF THE GREAT METRICS THEY CAME
OUT WITH. THEY REDUCE THE EASY
THE OVERALL LENGTH OF STAY OF
PATIENTS IN THE ER. FROM SIXTEEN
HOURS TO JUST OVER FOUR HOURS.
AND THAT'S INCLUDING ALL THE
TIME IT TOOK THEM TO LIKE. DETOX
THEM FROM AN OVERDOSE OR OR GET
THEM THROUGH A WITHDRAWAL OR
THINGS LIKE THAT SO. THERE'S
GOING TO BE SOMETIME IN THE E.
ARE NO MATTER WHAT BUT THEY
DROPPED ALL THAT BOARDING TIME
TO ALMOST ZERO. THEY REDUCE THE
INPATIENT PSYCHIATRIC ADMISSIONS
BY OVER FIFTY PERCENT. BUT
HERE'S SOMETHING THAT MAYBE
WOULDN'T EVEN BEEN OBVIOUS FROM
THE FIRST POINT. THE FOLLOW UP
OF THESE FOLKS WANT TO DISCHARGE
HIM THEY DO SUCH A BETTER JOB OF
GETTING THEM CONNECTED TO THE
COMMUNITY THAN EVEN HAD THEY
BEEN AN IMPATIENT. AND MAYBE
IT'S ABOUT BEING THERAPEUTIC
RATHER THAN COERCIVE. BUT THE
HAD A 60% IMPROVEMENT IN PEOPLE
FOLLOWING UP WITH THEIR
OUTPATIENT PLANS. GOING TO THEIR
OUTPATIENT APPOINTMENTS THEY
ACTUALLY WERE DOING BETTER.
AFTERWARDS BECAUSE THEY HAD A
BETTER EXPERIENCE IN THEIR
CRISIS. AND FOR PEOPLE SAY LIKE
OH IF YOU BUILD SOMETHING LIKE
THIS THEY WILL COME. AND YOU'RE
JUST GONNA GET RECIDIVISM AND
MAYBE YOUR COVER NOT HOLDING
THEM LONG ENOUGH AND THEY'LL
JUST HAVE TO COME BACK. ACTUALLY
WE'VE SEEN JUST THE OPPOSITE AT
ALL THESE PROGRAMS AROUND THE
COUNTRY. AND IN THIS PEER
REVIEWED EVIDENCE BASED JOURNAL.
THEY SHOWED THAT THE THIRTY DAY
RETURN OF THESE PATIENTS TO THE
EMERGENCY DEPARTMENT. ACTUALLY
DROPPED BY TWENTY FIVE PERCENT.
THIS IS HAVING THIS PROGRAM OPEN
FOR YEAR COMPARED TO THE YEAR
BEFORE THEY OPEN. AND ALL THESE
THINGS HAPPENED THAT CHANGED
THESE DYNAMICS AND JUST AMAZING.
INCLUDING REALLY REDUCING THE
RECIDIVISM WHICH IS SOMETHING I
THINK WE ALL LIKE TO SEE HAPPEN
NEXT SLIDE. UNIVERSITY OF
MINNESOTA- JUST OPEN ONE UP THIS
YEAR. IT WITHIN SIX MONTHS THEY
HAD A FIFTY EIGHT READ 8%
REDUCTION IN THEIR HOSPITAL
ADMISSION JUST SEVENTEEN
PERCENT. OF THE PATIENTS THEY
ARE SEEING THAT USED TO GO TO
IMPATIENT. NOW GETTING ADMITTED
YOU CAN SEE A NICE PICTURE OF
THEIR UNIT AS WELL NEXT SLIDE.
SO WHAT ABOUT CALIFORNIA WE DO
HAVE THEM WITHIN CALIFORNIA. AT
THE PROVIDENCE LITTLE COMPANY OF
MARY HOSPITAL WHICH IS IN LOS
ANGELES IN THE SAMPEDRO AREA
THEY HAVE A TWELVE CHAIR UNIT
WHICH OPENED UP FOUR YEARS AGO.
AND THEY'RE HAVING THE SAME KIND
OF METRICS 81% OF THE FOLKS
COMING THERE AND FIFTY ONE
FIFTIES GET DISCHARGED HOME. OR
TO COMMUNITY PROGRAMS AVERAGE
LENGTH OF STAY IS ABOUT SIXTEEN
HOURS WHICH IS WHAT'S GREAT IN
THESE UNITS. YOU DON'T WANT TO
BE TOO SHORT GOING TO GET THE
BENEFIT OF THAT UNIT. YOU WANT
TO BE IF YOU'RE IF YOU'RE
KEEPING THEM TO SHORT AMOUNT OF
TIME YOU'RE PROBABLY SENDING TOO
MANY OF INDIAN PATIENTS WANT TO
BE THERE LONG ENOUGH SETTING
STABILIZE. GET BACK HOME GET
BACK TO THE COMMUNITY. AND AGAIN
YOU SEE. ONE OR TWO OUT OF EVERY
ONE THOUSAND PATIENTS GOING IN
RESTRAINTS INSTEAD OF THREE
HUNDRED NEXT FIVE. NOT FAR FROM
HERE IN SACRAMENTO COUNTY
THERE'S A GREAT PROGRAM WHICH IS
A COMMUNITY PROGRAM PUT TOGETHER
BY SACRAMENTO COUNTY MENTAL
HELTH. AND THE DIGNITY HOSPITAL
THERE THEY'VE DONE SOME AMAZING
THINGS TO THIS WAS A HOSPITAL
THAT WAS AVERAGING IN LENGTH OF
STAY OF OVER THIRTY TWO HOURS
FOR THE AVERAGE FIFTY ONE FIFTY
PATIENTS. WITHIN THE FIRST MONTH
OF OPENING UP THEIR EMPAT UNIT
THEY DROP THAT ALMOST BY HALF.
TWO MONTHS LATER IT WAS DROPPED
BY THREE QUARTERS A 77%
REDUCTION. NOW THEIR AVERAGE
LENGTH OF TIME FROM THE ONCE
THEY'RE DECLARED MEDICALLY CLEAR
EMERGENCY DEPARTMENT TO MOVING
TO. THE EMPAT UNIT IS AN HOUR.
80% OF FOLKS ARE DISCHARGED BACK
TO THE COMMUNITY AND IF YOU
WANTED OF PATIENTS ARE THINKING
THIS IS A GOOD EXPERIENCE EIGHTY
FIVE PERCENT. SAY THEY WERE VERY
HAPPY WITH THE EXPERIENCE WHICH
IS AMAZING CONSIDERING THAT SO
MANY OF THEM ARE BROUGHT IN
INVOLUNTARILY AND EVEN THEY SAY
THIS IS A WONDERFUL EXPERIENCE.
NEXT SLIDE PLEASE. IS NOW
RECOGNIZED NATIONWIDE THE
NATIONAL COUNCIL FOR MENTAL
WELLNESS USED TO BE THE NATIONAL
COUNCIL BEAVER HEALTH CAME UP
WITH THE SOMETHING CALLED THE
ROADMAP TO AN IDEAL CRISIS
SYSTEM. EARLIER THIS YEAR AND
THEY SAID THAT EMPAT UNITS ARE
COMPLETELY NECESSARY. BECAUSE
THERE'S JUST SOME PATIENTS WHO
ARE GOING TO END UP COMING HE
OURS AND WE GOT TO DO SOMETHING
FOR THEM THERE. AND THEY SAY
THERE SHOULD BE ONE IN EVERY
MENTAL HEALTH SYSTEM. AND ONE
LAST SLIDE PLEASE. AND THIS IS
THE PART I MENTIONED AT THE
OPENING ABOUT SAVING MONEY
AFFORD A YEAR OLD AND THE
AVERAGE PERSON GOING. ON A FIFTY
ONE FIFTY IF THEY END UP IN AN
INPATIENT FACILITY IN THEIR A
MEDIC CAL PATIENT. THAT AFTER
AVERAGE LENGTH OF STAY. AND AN
AVERAGE BUILDING IS USUALLY
COSTING THAT COUNTY MEDIC CAL
ABOUT TWELVE THOUSAND DOLLARS
PER PATIENT. THE AVERAGE DAY IN
AND EMAT UNIT. IS ABOUT TWO
THOUSAND DOLLARS AND WE'RE
AVOIDING. 75280% OF THE FIFTY
ONE FIFTIES WHO WOULD BE GOING
TO INPATIENT. IF THERE WASN'T AN
EMPAT UNIT I MEAN THERE'S NO
ALTERNATIVE IF YOU'RE ON A FIFTY
ONE FIFTY GOT TO GO SOMEWHERE.
IF WE'RE ABLE TO TAP THE MINUTE
EMPAT UNIT STABILIZE AND GET
BACK HOME DROPPED A FIFTY ONE
FIFTY. IT COST TWO THOUSAND
DOLLARS INSTEAD OF TWELVE
THOUSAND DOLLARS. THREE OUT OF
FOUR TIMES FOUR OUT OF FIVE
TIMES. IF WE'RE JUST TALKING
ABOUT IT THREE OUT OF FOUR
TIMES. THAT MEANS FOR EVERY
EIGHTY THOUSAND DOLLARS A COUNTY
MENTAL HEALTH MEDIC CAL PAYS FOR
HIM BACK HERE. THE AVOID THIRTY
SIX THOUSAND DOLLARS. THINK HOW
QUICKLY THAT GETS INTO THE
MILLIONS. SO THE KEY THING AND
ONE THING I WANT TO MAKE SURE
THAT YOU KNOW ABOUT. YOU'VE
HEARD A LOT OF PEOPLE TESTIFYING
TODAY THAT. DIFFERENT COUNTIES
DO THINGS DIFFERENT WAYS THAT WE
HAVE THIS DISJOINTED SYSTEM
ESPECIALLY WITH THE WAY THAT
MEDIC CAL WORKS. SOME COUNTIES.
HAVE DECLINED TO PAY FOR IMPACT
UNITS THERE'S A WILL WAS A GREAT
EMPAT UNIT THAT HAD TO CLOSE
AFTER THE COUNTY MENTAL HEALTH
DEPARTMENT SAID. YOU DIDN'T ASK
US PERMISSION TO OPEN THIS UP SO
YOU'RE NEVER GOING TO GET ANY
MONEY FROM US FOR. SO THEY HAD
TO THEY HAD TO GO OUT OF
BUSINESS THERE'S OTHER THAT WILL
ACTUALLY PAY FOR IT. LET'S SAY
THAT THEY'LL PUT A CAP. BECAUSE
AGAIN. IT WASN'T PART OF THEIR
PLAN. AND YOU KNOW IT IS THERE'S
NO OTHER AREA OF MEDICAID OR
MEDICARE ALL THAT. ACTUALLY DOES
THINGS THIS WAY WHICH IS VERY
VERY STRANGE IF YOU'RE GOING TO
OPEN UP. A NEW WAY TO TREAT
HEART ATTACKS IN YOUR HOSPITAL
YOU DON'T HAVE TO GET PERMISSION
OF THE COUNTY. HEART ASSOCIATION
TO DO SO THE COUNTY HEART
ASSOCIATION DOESN'T HAVE TO
PROVE EVERY TIME. PATIENT HAS A
HEART ATTACK THAT YOU GET
REIMBURSED. THESE ARE MEDICAL
CONDITIONS THAT HAVE EMERGENCY
REQUIREMENTS THAT BY FEDERAL
LAWSUIT THAT THEIR MEDICAL
EMERGENCY CONDITIONS. AND YET.
SOME COUNTIES HAVE CHOSEN THAT
THEY WOULD PREFER NOT TO PAY FOR
THIS LEVEL OF CARE. AND I WOULD
HOPE THAT AS PART OF THE HEARING
TODAY WILL TAKE A GOOD LOOK AT.
WHEN SOMETHING GETS THAT POINT
WERE. IT'S AT THAT HOSPITAL
LEVEL OF CARE. THERE SHOULD BE A
STANDARD STATEWIDE WHERE IT'S
REIMBURSED. THERE'S OTHER STATES
THAT DO THIS WHERE THEY JUST SAY
YOU KNOW WHAT THIS IS THE SAME
AS HEART ATTACKS. CAR ACCIDENTS
ASTHMA ATTACKS. IT SHOULD BE
REIMBURSED THE SAME WAY RE
REIMBURSE MEDICAL CARE. AND
THERE SHOULDN'T BE A DIFFERENT
THING DEPENDING ON WHAT COUNTY
YOU'RE IN. AND IF YOU BREAK YOUR
LEG IN. SAN JOSE AND YOU HAVE
YOU KNOW. LOS ANGELES COUNTY
MEDICARE ALL YOU'RE STILL GOING
TO BE ABLE TO GET YOURSELF TAKEN
CARE OF. THAT'S NOT THE WAY IT
WORKS WITH THE MENTAL HEALTH
SYSTEM. THEY MIGHT JUST SAY
WE'RE NOT GOING TO COVER BECAUSE
YOU'RE NOT THE RIGHT COUNTY AT
THE RIGHT TIME. WE NEED TO
CHANGE THAT AND MAKE SURE THAT
PEOPLE GET THAT EMERGENCY
SOOTHING. HEALING THERAPEUTIC
CARE. WHERE THEY ARE IF THEY'RE
MEDIC CAL. THEY DESERVE THAT
LEVEL OF CARE JUST LIKE THEY
DESERVE FOR ANY OTHER. MEDICAL
EMERGENCY. AND I REALLY
APPRECIATE LAST SLIDE- YOUR TIME
AND THANK YOU FOR LISTENING.
THANK YOU VERY MUCH VERY MUCH
APPRECIATE THAT- I WANT TO OUR
NEXT PANELIST- MISSED YOUR-
DINER STEEN- I THINK YOU ARE. UP
THERE SOMEWHERE THE CAN YOU CAN
YOU HEAR ME YES WE CAN OKAY
TERRIFIC THANK YOU. SO YES SAID
MEMBERS OF THE HEALTH OF
JUDICIARY COMMITTEE MEMBERS AND
STAFF MY NAME IS ROBERT
INTERESTING I'M A PROFESSOR OF
LAW AND DIRECTOR F THE
DISABILITY RIGHTS CLINIC AT
AMERICAN UNIVERSITY WASHINGTON
COLLEGE OF LAW IN WASHINGTON DC.
NINE ADDRESSING TODAY FROM
OUTSIDE WASHINGTON DC FROM HOME
THANK YOU FOR PROVIDING ME WITH
AN OPPORTUNITY TO ADDRESS YOU ON
THIS IMPORTANT ISSUE OF THE
APPROPRIATE ROLE FOR MENTAL
HEALTH LEGISLATION IN CALIFORNIA
. THERE'S NO CREASING FOCUSED ON
THE NEEDS OF PEOPLE WITH MENTAL
HEALTH DISORDERS SOCIETIES
APPROPRIATE RESPONSE TO THAT.
THERE ARE MANY SOURCES FOR THIS
CONCERN AMONG OTHERS AMONG SOME
OF THEM. THE PERSISTENT ALMOST
POPULATION MANY OF WHOM HAVE
MENTAL HEALTH AND SUBSTANCE
ABUSE ISSUES. CONFRONTATIONS
BETWEEN POLICE AND PEOPLE WITH
MENTAL ILLNESS THAT HAVE LED TO
SERIOUS INJURY OR DEATH.
ESPECIALLY FOR PEOPLE OF COLOR.
HIGH PROFILE IF EXCEEDINGLY RARE
INCIDENTS IN WHICH ALLEGEDLY
MENTALLY ILL PEOPLE HAVE CAUSED
MASS INJURY OR DEATH. ACTUALLY
IT'S EASIER TO ADDRESS THE
MENTAL HEALTH NEEDS. I GET IN
THE SYSTEM. FOR EXAMPLE DEALING
WITH GUN VIOLENCE. OKAY
INCREASING CONCERN WITH THE
NUMBER OF PEOPLE IN JAILS OR
PRISONS WEB MENTAL DISORDERS.
WHICH ARE OFTEN I'M I'M SEATED
OR UNDER TREATED. I OF COURSE
COVERED NINETEEN PANDEMIC WHICH
HAS INCREASED THE LEVEL OF
ANXIETY AND OTHER MENTAL HEALTH
CONDITIONS ESPECIALLY FOR PEOPLE
OF COLOR. FIRST RESPONDERS
PEOPLE AT THE ECONOMIC MARGINS
AND OTHER. THE BALANCE BETWEEN
THE INDIVIDUAL LIBERTY AND
AUTONOMY INTEREST ON THE ONE.
SIDE IS LEGITIMATE AND IN FACT
SOLITARY INTEREST IN MAKING CARE
AVAILABLE AND PROTECTING THE
PUBLIC ON THE OTHER. IT'S NOT
IT'S NOT EASY TO RESULT. WE MUST
BE SKEPTICAL OF EASY FIXES
INCREASING THE SIZE OF
PSYCHIATRIC INSTITUTIONS MAKING
IT EASIER TO SIMPLY CONNECT
PEOPLE ARE OR INVOLUNTARILY
TREAT THEM. WELL TAKING THE
PROBLEM AND ITS ASSOCIATED
CONFLICTS SERIOUSLY. AND WHERE
WE HAVE PERCENT PUBLIC POLICY TO
A FAILED OR AT LEAST NOT FULLY
SUCCEEDED. WE SHOULD BE MINDFUL
OF THE REASONS FOR THOSE LESS
THAN OPTIMAL OUTCOMES AVOIDING
SUPERFICIALLY APPEALING.
CALIFORNIA'S COMMITTEES ARE TO
BE COMMENDED FOR HOLDING THIS
JOINT HEARING TODAY TO ADDRESS
THESE THORNY QUESTIONS. WE MUST
RECOGNIZE THAT COERCIVE FORMS OF
TREATMENT INVOLUNTARY COMMITMENT
FORCED MEDICATION ANOTHER
MODERN. ARE LIKELY TO WORK IN
THE LONG RUN I NOTED THAT THE-
PRIOR SPEAKER SPOKE ABOUT THE
IMPORTANCE OF NON CORE. AVOIDING
COLLISION PROVISION OF SERVICES.
WHICH I AGREE. WHAT DO WE KNOW
IT WAS THE TREATMENT NOT JUST
FOR MENTAL HEALTH DISORDERS IS
MORE EFFECTIVE THE PERSON
ACCEPTS IT WILL. BE FRUSTRATING
FOR LOVED ONES AND OTHERS TO
WATCH A FAMILY MEMBER IN NEED
ASSISTANCE REFUSING TO TAKE-ADVANTAGE WILL BE ABLE SERVICES.
THINK HOW FASTER IT IS FOR MANY
PEOPLE VACCINATED AGAINST COVER
NINETEEN THAT THERE ARE A LARGE
NUMBER OF PEOPLE WHO REFUSE TO
BE ACCIDENT. BUT IN A FREE
SOCIETY THAT VALUES LIBERTY
SHOULD BE LEERY OF FORCING
PEOPLE INTO TREATMENT AGAINST
THAT WELL RATHER WE NEED TO WORK
HARDER TO MAKE THE SERVICES WE
PROVIDE A HIGHER QUALITY. MORE
AVAILABLE AND MORE ACCESSIBLETO
THE PEOPLE WE SEEK TO SIR SO THE
QUESTION. BECOMES LESS MISTER.
BACKGROUND OF COURSE- WE ARE
DEALING WITH. INSURANCE THAT
REALLY HAS BEEN A- OVER THE-
ALMOST SEVENTY. I WOULD SAY THAT
SIXTIES YEARS. I'M BEGINNING IN
NINETEEN FIFTY FOUR WHICH WAS
THE HIGH POINT OF.
INSTITUTIONALIZATION OF PEOPLE
IN PSYCHIATRIC FACILITIES. AND
THE COMBINATION OF THE
INTRODUCTION OF PSYCHOTROPIC
MEDICATION IN THAT YEAR- JOHN F.
KENNEDY'S MESSAGE TO CONGRESS IN
NINETEEN SIXTY THREE. ABOUT A
BOLD NEW APPROACH TO MENTAL
HEALTH CARE. AND THESE COMMUNITY
HEALTH CENTERS ACT OF NINETEEN
SIXTY THREE. JUMPSTARTED AN
APPROACH. THAT TALKED ABOUT THE
VALUE AND- REFERENCE UP TO BE
BASED. ALTHOUGH IT SHOULD BE
SAID. EARLY EFFORTS TO CLEAN THE
COMMUNITY HEALTH CENTERS ACT-
WE'RE- PROMISED MORE THAN THEY
WERE ABLE TO DELIVER SOMETHING
CONTINUE TO LIVE WITH. DO YOU.
ARE WHICH GAO AND NINETEEN
SEVENTY SEVEN. AS BOTH GETTING
PEOPLE OUT OF INSTITUTIONS AND
GETTING AND KEEPING PEOPLE FROM
GETTING IN THERE. IN FIRST PLACE
. WE REDUCE THE SIZE STATES.
HOSPITALS AT THE SAME TIME IS
COMMUNITY BASED CARE. HOW
SERVICE IS SUPPORTED HOUSING
SUPPORTED EMPLOYMENT YOUR
SUPPORT AND OTHERS HAS
PROLIFERATED. BUT IT'S JUST A
RESOURCES FROM THE INSTITUTION
OF THE COMMUNITY ONCE AGAIN HAS
NOT RESULTED IN ADEQUATE FUNDING
OF COMMUNITY BASED MENTAL
HEALTH. SERVICES THE SAME TIME
STARTING IN THE LATE NINETEEN
SIXTIES AND SEVENTIES ADVOCATES
BEGAN TO FOCUS ON THE LEGAL
STANDARD FOR COMBAT. ALLEGEDLY
MENTALLY ILL PEOPLE TO CONCRETE
INSTITUTIONS IN A SERIES OF
CASES MOST OF THE FEDERAL
DISTRICT COURT. ADVOCATES
SUCCESSFULLY CHARM CIVIL
COMMITMENT STATUTES THE
PERMITTED COMMITMENT ON THE
BASIS OF THE ALLEGEDLY MENTALLY
ILL PERSONS NEED FOR CARE AND
TREATMENT. DIDN'T MATTER SUCH
CARE WAS INADEQUATE AND THE
TREATMENT LIMITED OR NONEXISTENT
BUT THIS LOW BARS OF THAT AND
MANY PEOPLE BEING
INSTITUTIONALIZED WHO DID NOT
NEED TO BE. IN THIS AND OTHER
PERIODS THERE WERE MANY PEOPLE
WITH INTELLECTUAL DISABILITY OR
OTHER DEVELOPMENTAL DISABILITIES
OLDER PERSONS. ALL RIGHT NO
BUSINESS BEING INSTITUTIONALIZED
IN STATE PSYCHIATRIC FACILITIES.
WHERE HOUSING WAS THE ORDER OF
THE DAY. THE NEW STEP THAT THE
ALLEGEDLY MENTALLY ILL PERSON
NEEDED TO BE CHANGED TO SUFFER
OTHERS GOT A SUBSTANTIAL BOOST
FROM THE U. S. SUPREME COURT IN
NINETEEN SEVENTY FIVE DECISION
OF ALL. KIND OF RESPONSE. WHICH
I THE STATE COULD NOT COME TO
THIS TO. UNDER PERSON TO SURVIVE
THE COMMUNITY WITH THE HELP OF
FAMILY FRIENDS. THAT'S GOOD TO
DODSON STATES TO THE STANDARDS
STAND. STANDARD ADDING ANOTHER
PRO OF JUST WHICH COUNTY.
ALTHOUGH JUST OF THIS LAST
PHRASE OF THE AND VERY THEY KEEP
ASPECT THE TO READ TO BE WHO
MIGHT NOT BE FOR DAY TO SELL
PARK. BUT AT RISK OF SIX HARM TO
THEM SO BECAUSE OF AN TO PROVIDE
FOR THEIR BASIC CARE. IS REVISED
STATUTES SOME PROCEEDING
DONALDSON AND OTHERS IN RESPONSE
TO WHAT ALSO CORPORATE AT THE
CONCEPT AS WE HEARD AT THE LEAST
RESTRICTIVE ALTERNATIVE. THAT IS
BECAUSE COMMITMENT TO
INSTITUTIONAL BONTA MASSIVELY
TRAVEL OF LIBERTY STATE HAVE TO
SHOW THAT THEY WERE NOT
AVAILABLE METHODS OF TREATMENT.
PAGE LESS ON A PERSON'S LIBERTY
OR AUTONOMY SPRING COURT ALSO
HELD IN A CASE CALLED ANGELES
TEXAS IN NINETEEN SEVENTY NINE
THAT THE STATE MUST DEMONSTRATE
BY CLEAR AND CONVINCING EVIDENCE
THE INDIVIDUAL IN QUESTION MAKES
THE COMMITMENT STANDARD I NEED
TO MAKE A STAND. OTHER FORMS
SUCH AS TIME LIMITED COMMITMENTS
PERIODIC REVIEW MORE ROBUST
DEFINITIONS OF DANGEROUSNESS
WHICH FOCUSED ON IMMINENT DANGER
MISSION OVER ACTS IMPORTANT
BECAUSE OF THE DIFFICULTY OF
PREDICTING DANGERS. ALSO CAME
INTO PLAY. THESE DEVELOPMENTS
PERCENT THE IN THE OF STATUTE
SUCH AS THE CIVIL RIGHTS OF ITS
TO. FOR ACT. G. EIGHTY EIGHTY
EIGHT I DO AS THE SPREE COURT A
EIGHT JUST IN NINETY NINE POSTED
FIRST L. C. WHICH FOUND THAT.
WAS A FORMER DISCRIMINATION AND
REQUIRE THIS TO PEOPLE WITH
DISABILITIES BE PROVIDED AT
LEAST IN THE MOST INTEGRATED
SETTING IS. ANOTHER IMPORTANT
ABOUT OF COURSE IS BEEN THE
CONCEPT OF ASSISTED OUTPATIENT
TREATMENT LTT WHICH I KNOW YOU
HAVE A CALIFORNIA FOR LAWRENCE
LAW. STATE SECTIONS VERY
REGARDING THE STANDARDS THAT IN
SOME STATES SUCH AS NORTH
CAROLINA FOR EXAMPLE PROVIDING
OUTPATIENT COMMITMENT FOR PEOPLE
WHO ARE DEEMED MENTALLY ILL AND
IN DANGER OF SEVERE TO
GENERATION. EVEN IF THEY WOULD
NOT BE A DANGEROUSNESS TO SUFFER
EITHER STANDARD OR GREAT
DISABILITY. CALIFORNIA'S
BANNERMAN PETROUS SHORT ACTOR
LPS WHICH WAS PASSED IN NINETEEN
SIXTY SEVEN WAS VERY MUCH A PART
OF THIS TREND. ONE OF THE
EARLIEST OF THE COMMITMENTS TO
ACTIONS TO CORPORATE
DANGEROUSNESS AND GREAT
DISABILITY INTO ITS COMMITMENT
STANDARD. I THANK THE LPS ACT
ACCORDING TO SAM'S FEDERAL LEVEL
SERVICE A MODEL FOR OTHER STATES
CONSIDERING REFORM OF COMMITMENT
LOS. EFFORTS TO WATER DOWN THE
COMMITMENT STANDARD OR OTHERWISE
MAKE IT EASIER TO IMPOSE
TREATMENT AGAINST A PERSON'S
WILL SHOULD BE RECESSED.
YESTERDAY'S LA TIMES EDITORIAL
DON'T TAKE SELF DETERMINATION
FOR THE MENTALLY ILL THANKS
NUMBER OF COACHING POINTS IN
THIS REGARD. MY UNDERSTANDING IS
THE STATE AUDITOR CONCLUDED NOT
LONG AGO THAT THE LPS ACT
CRITERIA. WHERE APPROPRIATE
SHOULD BE EXPANDED WHEN DOING SO
WOULD ENDANGER CIVIL LIBERTIES.
WITH THAT SAID ONE OF
ALTERNATIVES TO ENHANCING ARE
MAKING IT EASIER. GOAL AGAINST
THEIR WILL WELL ONE VERY
IMPORTANT ONE I WANT TO START
WITH IS ASSERTIVE COMMUNITY
TREATMENT CALLED ACTS UP AGAIN I
SHOULD SAY IF YOU WORK IN THIS
FIELD AT ALL SURE YOU'RE QUITE
AWARE YOU HAVE TO DO NOTHING BUT
IF YOU DID NOTHING BUT MEMORIZED
ACRONYMS YOU WOULD BE. QUITE
THIS ITEM THAT DID ACT IS
ESPECIALLY IMPORTANT ESPECIALLY
APPROPRIATE FOR PEOPLE WITH
SEVERE MENTAL ILLNESS.
COMORBIDITY WITH SUBSTANCE
ABUSE- ASSERTIVE COMMUNITY
TREATMENT HIGH SPECIALIZED
PERSONALIZED CARE TO THE CLIENT.
OFFICIALS WITH BACKROADS. HERE
PSYCHOLOGY DRUG ABUSE RECOVERY
ITS MANAGEMENT ARE AVAILABLE
TWENTY FOUR SEVEN TO ASSIST
PEOPLE IN ASPECTS OF THEIR LIVES
AND HERE I'M QUOTING FROM DUAL
DIAGNOSIS DOT ORG WHICH IS
PROVIDED THAT THAT DEFINITION.
THE STUDY SHOWED EXCELLENT
OUTCOMES WITH ACT- AND IN BOTH
THE DOCTOR DIAGNOSED START DOT
ORG OTHER SOURCES REPORT THIS AS
A RESULT OF MAKING- TAKING
ADVANTAGE OF ACT. I ONE SEES
THAT PEOPLE SPEND THREE DAYS IN
JAIL- THE NUMBER OF INPATIENT
HOSPITAL DAYS ARE REDUCED THE
REDUCTION IN JAIL BOOKINGS AND
ARRESTS AND REDUCTION ALCOHOL
USE. MORE IMPORTANT OR AS
IMPORTANT PATIENTS FEEL HAPPIER.
AND ARE AT AND IT WAS SECURE
LIVING CONDITIONS WERE LIKELY TO
WORK WERE LIKELY TO TAKE
MEDICATION HE AND MORE LIKELY TO
LIVE INDEPENDENTLY- AGAIN THIS
CAN BE A PART OF THE- ASSISTED
OPERATION TREATMENT BUT IT'S-
DIFFERENT IN THE SENSE THAT IT'S
NOT COURSE IF YOU'RE NOT
COMMITTED TO SUCH A PROGRAM. I
IS SIMPLY ONE OF PROGRAMS IT'S
AVAILABLE TO YOU THE REAL CHEAP
PARTY I THINK IT IS
INTERDISCIPLINARY ARTIST LEVEL
SERVICES. AND COORDINATION AND
AVAILABLE ALL THOSE. ARE REALLY
CRITICAL ASPECTS. ELEMENT OF
WHAT BE THE OF AS PROBABLY SET
COMMITTEES SUPPORT IS THAT
SUPPORT HOUSING. IT'S A HOUSING
- IS AGAIN MULTI DISCIPLINARY.
ALLOWING PEOPLE TO LIVE IN THEIR
OWN COMMUNITIES AND RECEIVE
SERVICES THERE. SHOULD SAY THAT
THE THEORY OF
INSTITUTIONALIZATION STARKLY
GOING BACK INTO THE NINETEENTH
CENTURY. WAS THAT PEOPLE NEEDED
TO SORT OF A RESPITE IF YOU WILL
THE SILENCE TO GET OUT OF THEIR
CIRCUMSTANCES. TO BE ABLE TO
RECOVER TERM USED WAS THAT THAT
MORAL TREATMENT- IT CLEARLY OR
QUICKLY DID. AND FOUGHT FOR
SENATE BILL EVOLVED INTO. A
STUDY LOOKING AT BEST. BUT I
THINK WE LEARNED IS AS EARLY AS
THE LATE SIXTIES EARLY SEVENTIES
WAS IF YOU WANT PEOPLE TO ADJUST
TO THEIR HOME COMMUNITIES. YOU
NEED TO BE A NETWORK BECAUSE
ADJUSTING TO AN INSTITUTIONAL
SETTING AB EVEN IF YOU'RE ABLE
TO DO IT MANY. PEOPLE THAT
CHALLENGES AND- WE NOT
NECESSARILY. AT GIVE ANY
INDICATION I JUST TOOK HIM SOME
THE DIFFERENCE OF NORMS
DIFFERENT SENSE OF IT SAID
ABSOLUTELY OF THAT ALLOWED TO
LIVE IN THE OWN IS THE PLACE
WHERE THEY WILL IF THEY'RE GONNA
BETTER WERE YEAH. SERVICE AND
SUPPORT HOUSING INCLUDING STEPS. EXTRA IN IN THE LIVING SO.
MEDICATION MANAGEMENTSUBSTANCE
JUST TREATMENT. HELP IS THE
EMPLOYMENT AND MAINTAINING
HOUSING HOME HEALTH IS. SO THERE
MANY I THINK THE IDEA IS THAT AS
THEY SAY IT TAKES A VILLAGE IN
THE VILLAGE HERE ARE THE
DIFFERENT PROFESSIONAL. SUPPORTS
THAT UP EVERY PROVIDE. ANOTHER
IMPORTANT ELEMENT HERE IS THAT
OF- PROVIDING MOBILE CRISIS
SERVICES WHICH AGAIN. IS NOT
ONLY ALTERNATIVE TO
INSTITUTIONAL CARE AT THE
PSYCHIATRIC LEVEL BUT
IMPORTANTLY CAN BE. MULTITUDE OF
TWO POLICE AND CRIMINALS- A LOT
PARLIAMENT. OKAY THAT'S
RIDICULOUS YOU I THINK I'M GONNA
FIGHT FOR PEOPLE WITH TOM YOUNG
PEOPLE TO GET PEOPLE OF COLOR I
MANY OF THEM WIND UP. GETTING
INTO TROUBLE IN TERMS OF THEIR
INTERACTIONS WITH THE POLICE AND
IN SITUATIONS WHERE THEY COULD
BE TREATED THROUGH THE MOBILE
TEAM. I RATHER THAN THREE BY
POLICE OFFICERS WHO ARE NOT
REALLY TRAINED RECALLING TO DEAL
WITH THIS POPULATION APPROPRIATE
WAY. IMPORTANT ASPECT OF THIS.
SERVICE IS THAT IT BE PROVIDED
BY A TWENTY FOUR SEVEN
ILLEGALITY. OF THAT INCLUDES A
PEER SPECIALIST IF YOUR SUPPORT
PERSON AS WE HEARD OF THE
PREVIOUS. WITNESS HERE'S A
CONFERENCE SITUATE COULD BE VERY
. HELPFUL IN TERMS OF. PEOPLE
THE NEED FOR OR AT SPLIT SPLIT
GOING THROUGH SAY THAT. THEY'VE
WITH EXTREMIST- AND- I'M NOT. AT
IS ALSO AT MOBILE MOBILE SIR FOR
OFF SLOW AND- AVAILABILITY OF
WHAT IT CALLED- COMMUNITY CRISIS
APARTMENTS SOMETHING YOU. TO BE
IN THE COMMUNITY IF NOT IN THEIR
OWN HOME- IN ORDER TO. BE PART
OF THEIR GETTING GETTING BETTER
PROCESS. AND MOBILE UNITS I
THINK I'VE BEEN SHOWN IN STUDIES
TO REDUCE INCARCERATION AND THE
NEED TO CALL FIRST RESPOND. WELL
IF YOU'VE GOT YOUR HASN'T TAKEN
CARE OF AND YOU'VE GOT YOUR
MENTAL HEALTH ISSUES TAKE CARE
OF. YOU ALSO NEED YOUR
EMPLOYMENT AND SO SUPPORTED
EMPLOYMENT IS ANOTHER ELEMENT.
OF A ROBUST SYSTEM. ARE IT'S A
PACKAGE OF SERVICES AIMED AT
HELPING PEOPLE WITH SERIOUS
MENTAL ILLNESS. GETTING S.
ALLOWING THEM TO GET AND KEEP A
JOB IN THE IN THE WORK FORCE
IT'S NOT NECESSARILY TIME
LIMITED. AND IS FOCUSED ON THE
PERSON'S UNEMPLOYMENT DOES NOT
GOALS THAT ARE. DETERMINED
EXTERNALLY TO THE- ONE THAT ONE
ASPECT OF SUPPORT EMPLOYMENTS
COME SOMETHING CALLED INDIVIDUAL
PLACEMENTS SUPPORTER I GUESS.
IT'S ONE OF THE MOST SUCCESSFUL
MODELS I'M SUPPORT ON IT. AND TO
GO TO SOURCE IT USES A RAPID JOB
SEARCH APPROACH TO HELP
INDIVIDUALS ACHIEVE JOBS RATHER
THAN FOCUSING ON THE LENGTHY
ASSESSMENTS. TRAINING CAMPS AND
IS IT PUTS YOU INTO THE POSITION
OF THE EMPLOYMENT POSITIONS WHAT
I RATHER THAN THE KIND OF STEPS
YOU MIGHT HAVE TO GO THROUGH. TO
GET TO THAT. AND ONE SUPPORT
EMPLOYMENT. I. P. S. AS SHOWN-
60% OF PLANNING RATE WHICH IS.
HIGH THE TO OTHER P. WITH
ILLNESS. JUST MARCH. I AM ALSO
OVER INCREASE USED MENTAL HEALTH
SERVICE. LASTLY I WANT TO MAKE.
A PEER SUPPORT WHICH AGAIN WE
WE'VE ABOUT- FROM- FIRST. I
THESE ARE TRAINS. NOT JUST
PEOPLE WHO HAVE THAT EXPERIENCE
BUT INCLUDING PEOPLE WITH LIVED
EXPERIENCE. THEY CAN HELP THE
PERSON IN DECISION MAKING AND
PROBLEM SOLVING. IN ESTABLISHING
OR MAINTAINING SOCIAL
RELATIONSHIPS AGAIN THIS IS JOE
TO REDUCE HOSPITALIZATIONS. FOR
ALL THESE. ARE ADEQUATE FUNDING
AND SMART COORDINATION EXISTING
FUNDING IS AMOUNTS. OVER TIME
FUNDING MUST BE SPENT ON
SUPPORTING PEOPLE IN NEED WITH
APPROPRIATE SPORTS. WE PROBABLY
SUPPORTS AND THAT WILL BE MONEY
WELL SPENT BOTH IN THE SHORT
TERM AGAIN WE HEARD THE PRIOR
SPEAKER SOME OF THOSE SAVINGS
THAT COULD COME FROM. A MORE
ROBUST. APPROACH IN THE PROGRAM.
BUT ALSO REDUCING FUTURE COSTS
AND IN FACT LET IT ALLOWING
PEOPLE TO GREATER OPPORTUNITY
PRODUCTIVE CITIZENS FUTURE. NOT
ONLY SCRATCHED THE SURFACE OF
THE KINDS OF ALTERNATIVES THAT
ARE AVAILABLE TO MEET THE NEEDS
OF PEOPLE WITH MENTAL HEALTH
DISORDERS. HE'S NOT TRYING TO
SCUTTLE TORNADOES BUT ARE ONES
THAT ARE SHOWING INCREASING
PROMISE WITH A GROWING BODY OF
RESEARCH IN SUPPORT. AND
PRACTICE SUPPORT. THE KEY IS
COORDINATION AND PROVISION AND
EXPANSION OF NON COURSE OF
SERVICES FOR THE POPULATION.
HERE AGAIN AB FIVE. THINKING
ABOUT THE PRIOR SPEAKER NOT.
AGREE WITH THIS. WE HAVE TO I
THINK GET AWAY FROM THE SENSE OF
MENTAL HEALTH SERVICES AS BEING
SOMEHOW WILDLY DISTINCT FROM
DIVERGING FROM OTHER KINDS OF.
SOCIAL SERVICES OR MEDICAL AND
OTHER KINDS OF SERVICES THAT IT
SHOULD BE SOMETHING THAT YOU
EXPERIENCE AS PART OF IT RATHER
THAN THE KIND OF SEPARATION. AND
WE HAVE TO I THINK IN THE END IF
WE CAN'T GET THERE TODAY WE HAVE
TO MOVE OVER TIME TO A SITUATION
WHERE WOULD REDUCE THE NEED FOR.
A COURSE OF SERVICES SO IT'S
VERY EXCITED TO HEAR ABOUT
REDUCTION IN SUCH. FORMS OF
INTERVENTION INSTANCE GO STRAINS
INCLUSION. OTHER ISOLATION OTHER
KINDS OF WAYS- BECAUSE THOSE ARE
CAN HAVE SHORT TERM SUCCESS BUT
NOT LEAD TO LONG TERM SUCCESS.
AND THAT'S REALLY WHAT WE SHOULD
BE LOOKING- RETCHING THE
CRITERIA FOR CIVIL. MAKING IT
EASIER. TO INVOLVE. CONFINED
PEOPLE ON HOLD FOR LONGER TERM.
BASIS IS NOT GOING TO IN THE AND
STOP THE PROBLEM. EITHER AND NOR
OF COURSE ISN'T AN APPROACH THAT
WOULD RESPECT THE AUTONOMY OF
LIBERTY. THANK YOU FOR YOUR KIND
ATTENTION AND FOR AGAIN FOR.
REPORT IN WHICH- THANK YOU VERY
MUCH MR DENNISTON HOPE YOU CAN
STICK AROUND WE'LL HAVE WE'RE
GONNA ASK QUESTIONS SAID WE'RE
DONE YEAH. OKAY GREAT THANK YOU
SO MUCH. AND NOW MISTER MISTER
EWING WE- FOR A FAMILIAR FACE
GOOD TO SEE YOU THANKS VERY MUCH
MISTER CHAIR PROJECT HAVE TO BE
HERE AND THAT TO JEFF STONE AS
WELL FOR THE CHANCE TO SPEAK TO
THE COMMITTEES ON THIS TOPIC FOR
THE RECORD MY NAME IS TOBY DOING
I'M THE EXECUTIVE DIRECTOR OF
THE STATE'S NOT HEALTH SERVICES
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. AND I REALLY
APPRECIATE THE ATTENTION OF THE
COMMITTEES ARE ARE UP DIRECTING
TOWARDS THE CHALLENGES FACING
CALIFORNIA'S LPS STATUTES AND US
AND THE SERVICES THAT SURROUND
THEM AND YOU'VE HAD A LONG DAY
ALREADY AND I'M SURE THERE'S A
QUEUE FOR PUBLIC COMMENTS WILL
TRY TO BE VERY BRIEF AND JUST TO
REITERATE A COUPLE OF THE POINTS
THAT THAT I THINK YOU'VE HEARD
REPEATEDLY HERE BECAUSE I THINK
THERE- THE RIGHT AREA FOCUS. YOU
KNOW FIRST I WANT TO SAY THAT
THE STATE HAS FOCUSED
CONSIDERABLE TIME AND ENERGY ON
THE CONDITION AND THE CONDITIONS
UNDER WHICH WE INVOLUNTARILY
SERVE PEOPLE AND BUT WE HAVEN'T
NECESSARILY DEDICATED THE
COMMENSURATE LEVEL OF TIME AND
ATTENTION ON HOW THOSE SERVICES
ARE WORKING AND SO YOU HEARD
SOME OF THE TESTIMONY THIS
MORNING AROUND DATA CHALLENGES.
I'M YOU KNOW CONSISTENT WITH THE
COMMENTS FROM THAT THAT THE
PEERS THE FOLKS OF LIVED
EXPERIENCE. I HAVE HOSTED-
PANELS. STATE LEVEL PANEL WITH.
WHO SAID THAT HOSPITALIZATION
INVOLUNTARY HOSPITALIZATION. WAS
THE- THE WORST EXPERIENCE OF
THEIR LIFE- BUT IT ALSO SAVE
THEIR LIFE. AND OTHERS HAVE SAID
THAT IT HAS BEEN SO TRAUMATIC
THAT THAT THEY WOULD NEVER ALLOW
THEMSELVES TO BE HOSPITALIZED
UNDER THOSE CONDITIONS AGAIN AND
SO CLEARLY WE NEED TO SPEND SOME
TIME TALKING ABOUT QUALITY OF
CARE AND WHAT THE COP WHAT THAT
REMOTE RESPONSE LOOKS LIKE AND I
THINK DOCTORS ELDER LAID OUT. A
MODEL THAT THE COMMISSION
TOMORROW IN FACT IS DOING A SITE
VISIT FOR THE PROGRAM DOWN IN
LOS ANGELES AND WE'RE HOPING TO
VISIT. THE SITE HERE IN TOWN-
PROBABLY THE VERY BEGINNING OF
JANUARY. SO YOU KNOW I WOULD
SUGGEST THAT YOU KNOW FIRST WE
REALLY NEED TO FOCUS ON WHAT IS
THAT EXPERIENCE OF INVOLUNTARY
CARE AND HOW CAN WE BEGIN TO
UNDERSTAND FROM THAT FROM THAT
HUMAN CENTERED PERSPECTIVE HOW
WE CAN IMPROVE QUALITY. AND
UNDERSTAND HOW WE MIGHT BE ABLE
TO PUT STANDARDS AND STRATEGIES
IN PLACE THAT NGUYEN INVOLUNTARY
CARE IS PROVIDED IT IS THE MOST.
EFFECTIVE OUTCOME FOCUSED CARE
POSSIBLE WE DO THAT IN OTHER
AREAS OF HEALTH CARE ROUTINELY.
AND WE HAVE NOT SPENT AS MUCH
TIME AND ATTENTION ON ENSURING
THAT THAT'S A STRATEGY THAT WE
CAN DEPLOY IN ADDRESSING THE
NEED FOR INVOLUNTARY CARE. THE
GOVERNOR IN HIS HISTORIC
CHILDREN NEED BEHAVIOR HEALTH
INITIATIVE HAD INCLUDE
SUBSTANTIAL FUNDING TO EXPLORE
AND SCALE EVIDENCE BASED
PRACTICES I THINK THIS IS AN
AREA WHERE. WE MIGHT WANT TO
CONSIDER SOMETHING VERY SIMILAR
TO UNDERSTAND ARE THERE EVIDENCE
BASED PRACTICES AND HOW MIGHT
THE STATE INCENTIVIZE. THE
ADOPTION OF EFFECTIVE
INTERVENTIONS THAT WILL ADDRESS
THE ISSUE OF QUALITY AND
OUTCOMES ASSOCIATED WITH
INVOLUNTARY CARE WHEN IT IS
UNNECESSARY INTERVENTION. BUT AS
AS OUTLINED. BY OTHERS- IT'S
ALSO REALLY IMPORTANT TO LOOK
AT. THE IMPORTANCE OF REDUCING
RELIANCE ON INVOLUNTARY CARE IT
NEEDS TO BE AN EXCEPTIONAL
INTERVENTION AS YOU'VE HEARD
THROUGHOUT THE DAY TODAY. SO IN
ADDITION TO REALLY ENGAGING
PEOPLE WITH LIVED EXPERIENCE TO
THINK ABOUT HOW WE COULD
REDESIGN AND REINVENT HOW WE
RESPOND WHEN PEOPLE ARE A DANGER
TO THEMSELVES OR OTHERS. REALLY
THINKING SYSTEMATICALLY ABOUT
HOW CAN WE REDUCE THAT RELIANCE
. CALIFORNIA HAS THE OPPORTUNITY
TO SET CLEAR GOALS COMPELLING
GOALS FOR THE USE OF INVOLUNTARY
CARE TO MAKE IT RARE BUT ALSO AT
THE SAME TIME TO MAKE IT
EXCLLENT I THINK YOU'VE HEARD
FROM FAMILY MEMBERS AND I HAVE
FAMILY MEMBERS MYSELF. WHO WHO
HAVE NEEDED THAT LEVEL OF
INTERVENTION AND HAVE CALLED
INTO QUESTION THE ADEQUACY AND
THE QUALITY OF THAT CARE SO IT
NEEDS TO BE EXCELLENT. AND IT
NEEDS TO BE EXCEPTIONAL AND RARE
IN THAT IN THAT INSTANCE. THIS
MEANS- AGGRESSIVELY FOCUS ON HOW
WE CAN RESPOND MUCH EARLIER. TO
THE NEEDS OF OUR COMMUNITY. WHO
ARE AT POTENTIAL RISK FOR
NEEDING INVOLUNTARY CARE. WE
HAVE SOME UNIQUE OPPORTUNITIES
IN THE DESIGN OF OUR SYSTEM SO.
THE AUDITOR IN HER PRESENTATION
MENTION FULL SERVICE
PARTNERSHIPS. THIS IS A
CALIFORNIA INVENTION COMING OUT
OF WORK DONE IN IN LONG BEACH.
YEARS AGO AND THAT IDENTIFIED A-
SYSTEMATIC APPROACH TO WORKING
WITH INDIVIDUALS WITH MENTAL
HEALTH NEEDS. TO SERVE THEM IN
COMMUNITIES WHO OTHERWISE WOULD
HAVE BEEN SERVED IN THE
HOSPITAL'S. FULL SERVICE
PARTNERSHIPS ARE DESIGNED TO
REDUCE CRIMINAL JUSTICE
INVOLVEMENT HOMELESSNESS AND
HOSPITALIZATION. UNDER THE
STATE'S FUNDING RULES WE REQUIRE
COUNTIES TO SPEND JUST UNDER A
BILLION DOLLARS A YEAR TO
SUPPORT FULL SERVICE
PARTNERSHIPS. WE NEED TO MAKE
SURE THAT THAT INVESTMENT IS
HAVING THE IMPACT THAT IT IS
SUPPOSED TO HAVE. AND THAT CAN
BECOME AN INTERVENTION THAT CAN
REDUCE. THE NEED FOR INVOLUNTARY
SERVICES OVER TIME. I WANT TO
RECOGNIZE. THAT THE WORK OF
SENATOR EGGMAN WHO WAS HERE THIS
MORNING SHE PASSED S. B. SHE
AUTHORED SB. SIX FOUR SIX FIVE
TO THE GOVERNOR SIGNED TO BEGIN
THE PROCESS TO LOOKING MORE
INTENSIVELY WHAT'S HAPPENING IN
THE FULL SERVICE PARTNERSHIP.
PROGRAMS AROUND THE STATE- THAT
LEGISLATION REQUIRES THE
COMMISSION TO ENGAGE TO LOOK AT
THE DATA AND TO TRY TO SUPPORT
THE KINDS OF QUESTIONS THAT
YOU'RE ASKING TODAY. THAT'S ONE
TO RECOGNIZE DR JOHN SHARON L.
A. COUNTY HE ACTUALLY STARTED
THAT WORK. REALLY TRYING TO
UNDERSTAND THE IMPACT THAT FULL
SERVICE PARTNERSHIP FOR HAVING
IN LA. AND WITH SOME COMMISSION
SUPPORT WE'VE BEEN ABLE TO
ENGAGE EIGHT COUNTIES. TO
REPLICATE THE KIND OF WORK THAT
DR SHARON HAS DONE IN LA. TO TRY
TO UNDERSTAND HOW THEY CAN GET
BIG BIGGER BANG FOR THE BUCK.
FOR FULL SERVICE PARTNERSHIPS.
THE COMMISSION IS DOING A NUMBER
OF OTHER THINGS WITH A SMALL
AMOUNT OF FUNDING THAT THE STATE
HAS PROVIDED A FEW YEARS AGO
INCLUDING. TRYING TO EXPAND THE
UTILIZATION OF PSYCHIATRIC
ADVANCE DIRECTIVES ADVANCE
DIRECTIVES ARE WELL KNOWN IN THE
HEALTHCARE FIELD. THEY'RE NOT
REGULARLY USED IN THE AREA OF
PSYCHIATRY AND SAW THOUGH
THEY'RE AUTHORIZED OR LEGALLY
RECOGNIZED WE DON'T HAVE.
STANDARDS OF PRACTICE AND
IMPLEMENTATION TO BETTER
UNDERSTAND HOW WE CAN DEPLOY
PSYCHIATRIC VENTS DIRECTIVES
WERE WORKING WITH ABOUT EIGHT
COUNTIES. TO DEPLOY THIS
STRATEGY AS A AS AN INNOVATION
TO SEE IF THIS APPROACH ACTUALLY
COULD REDUCE THE NEED FOR
INVOLUNTARY CARE. AND THE IDEA
REALLY IS TO WORK WITH SOMEONE
WHEN THEY'RE NOT IN CRISIS. TO
DESTRESS AND ENGAGE SO THAT WHEN
THEY ARE IN CRISIS WE HAVE A
GAME PLAN THAT THEY THEMSELVES
HAVE DEVELOPED. SO IT'S LESS
ABOUT IMPOSING A MEDICAL
INTERVENTION AGAINST SOMEONE'S
WILL AT A TIME OF CRISIS INSTEAD
WORKING WITH THEM WHEN THEY
DON'T NEED THAT INTERVENTION TO
UNDERSTAND WHAT WILL WORK BEST.
SIMILAR TO THE KIND OF LANGUAGE
YOU SAW IN THE PRESENTATION FROM
DOCTORS DOLLAR ABOUT ENGAGING
FROM THIS VERY HUMAN CENTERED
APPROACH. ANOTHER AREA WORTH
CONSIDERING IS TO RECOGNIZE.
THAT ALTHOUGH WE DON'T HAVE THE
DATA OF THE INSTANCES IN WHICH
PEOPLE ARE BEING PUT INTO
INVOLUNTARY. TREATMENT TO
RECOGNIZE THAT WE ANTICIPATE
THERE'S A HIGH LEVEL OF
PSYCHOSIS ASSOCIATED WITH. THESE
CONSUMERS WHO ARE FIFTY ONE
FIFTY EIGHT. THE STATE HAS MADE
SOME INVESTMENTS IN EARLY
PSYCHOSIS CARE BUT WE DO NOT YET
HAVE A SYSTEM IN PLACE IN
CALIFORNIA WHERE EVERY
CALIFORNIAN HAS ACCESS TO. AN
EVIDENCE BASED EARLY RESPONSE TO
PSYCHOSIS. RESEARCH OUT OF THE
FEDERAL GOVERNMENT SUGGEST THAT
EARLYINTERVENTIONS CAN HAVE
PROFOUND IMPACTS. TO ALLOW
PEOPLE TO LIVE WITH INDEPENDENT
RESPONSIBLE PRODUCTIVE LIVES. IN
REDUCE THE RELIANCE ON CRISIS
CARE OVER TIME. BUT IT IS THE
EXCEPTION IN CALIFORNIA. WE'RE
WORKING WITH A NUMBER OF COUNTY
PARTNERS TO REALLY EXPAND THAT.
I MENTIONED THE SECOND TWO
EVENTS DIRECTIVES WORKED EARLY
PSYCHOSIS WORK- THE CONVERSATION
THAT WE'RE HAVING ON EMPATHIC.
IS WE'RE TRYING TO IDENTIFY WAYS
THAT WE CAN BUILD UPON THE
CAPACITY OF OUR COUTY PARTNERS.
REALLY UNDERSTAND WHAT THEIR
NEEDS ARE ENGAGE THE VOICE OF
CONSUMERS AND FAMILY MEMBERS
IDENTIFY MODELS THAT HAVE BEEN
ADOPTED IN OTHER COUNTRIES AND
OTHER STATES OR EVEN HERE IN
CALIFORNIA WHICH IS OFTEN THE
CASE. AND BEGIN TO SCALE THE
STRATEGIES IN WAYS THEY CAN
SUPPORT THEIR EFFECTIVE
IMPLEMENTATION STATEWIDE. I
THINK- WE KNOW THAT THAT WE'VE
BEEN ABLE TO TAP INTO THE
EXPERTISE OF UC DAVIS UCSF
STANFORD USC. OTHER ACADEMIC
PARTNERS- ALL OF THIS REALLY
STARTS WITH LISTENING TO THE
CUSTOMER THAT WE'RE TRYING TO
SERVE. CALIFORNIA HAS A VERY
ACTIVE. AND EMPOWERED PEER
MOVEMENT. AND CLEARLY AVAILABLE
TO TALK ABOUT WHAT THEY'RE
LOOKING FOR WHAT WORKS AND WHAT
DOESN'T WORK WE HAVE A VERY
EMPOWERED IN VOCAL FAMILY
MOVEMENT. VERY IMPORTANT TO
REALLY ENGAGE BOTH PEERS AND
FAMILY MEMBERS TO STEP BACK A
LITTLE BIT AND SAY WHAT WE
TRYING TO GET DONE. AND THEN TO
TRY TO DESIGN THESE SYSTEMS SO
THAT ONCE WE IDENTIFY I'M A BEST
PRACTICE IN A MODEL WE YOU CAN
ACTUALLY IMPLEMENT A SCALE THEM.
IN A IN A RELATIVELY EASY WAY
PART OF THE CHALLENGE WE HAVE.
IS WE CAN DEVELOP EVIDENCE BASED
OR EFFECTIVE PROGRAMS BUT
SCALING THEM IS OFTEN VERY VERY
DIFFICULT BECAUSE OF THE WAY
THAT WE DESIGNED OUR SYSTEM IN
CALIFORNIA. SO I WOULD I WOULD
SAY- AS YOU'VE HEARD TODAY THE
FOCUS REALLY SHOULD BE ON
EXCELLENCE IN THE RESPONSE WHEN
A FIFTY ONE FIFTY IS NEEDED. AND
FIGURE OUT WHAT THAT LOOKS LIKE
BUT REALLY INVESTING IN
STRATEGIES TO PREVENT THE NEED
TO USE THAT TOOL- SO IT IS IT IS
AN EXCEPTIONAL EXPERIENCE. AND
THAT MEANS AS YOU DISCUSSED
BUILDING OUT THE DATA SYSTEMS
BUILDING UP THE CAPACITY FOR THE
STATE TO BERESPONSIBLE FOR THAT
OPPORTUNITY AND TO BE ABLE TO
DRIVE TOWARDS THAT GOAL OVER
TIME. THANK YOU FOR THE CHANCE
TO BE HERE TODAY HAPPY TO ANSWER
ANY QUESTIONS YOU MIGHT HAVE.
GREAT THANK YOU VERY MUCH MISTER
EWING- MOVE TO OUR- OUR PANEL
HERE ARE. MY COLLEAGUES- MISTER
KALRA. THANK YOU MR. I HAVE A-
THIS IS COME UP AND NATURALLY-
ON MORE THAN ONE OCCASION SO FAR
IT IS A BUT NOT TO COMING IN AND
OUT BUT- IN TERMS OF- URGENCY
THAT IF SOMEONE'S IN CRISIS AND
ALL CRISIS. THE URGENCY OF-
DEALING WITH IT RIGHT AWAY.
CERTAINLY OTHERWISE IT ACTUALLY
WILL EXACERBATE- IF UNTREATED IN
AND BECOME. A FARM WORSE FOR
THEM AS AN INDIVIDUAL FARMER
COSTLY AS ON- THEN OVER THE LAST
COUPLE YEARS ON A COUPLE
OCCASIONS I'VE I WENT TO THE
LOCAL. COMMUNITY CLINICS THAT-
OFFER MEDICAL SERVICES. AND
THEY'VE INDICATED THAT- IF
SOMEONE IS GOING TO THE CLINIC
FOR. SOME KIND OF PHYSICAL
ELEMENT OR OR WHAT HAVE YOU THAT
THEY CANNOT. IMMEDIATELY BE
REFERRED FOR MENTAL HEALTH
TREATMENT AT THE SAME TIME AND
GET THAT MEDICAL REIMBURSEMENT
IS- BUT I IMAGINE A KNOWN. ISSUE
THAT'S BEEN GOING ON FOR SOME
TIME CORRECT. YEAH AND I JUST
WANT THAT UP TO NOT SOMETHING
THAT. EVERY SINGLE ONE OF US
HAVE HEARD. OF IT GOING TO OUR
LOCAL CLINICS THAT THEY HAVE
TODAY AND INSTEAD SEND THEM AWAY
SET UP AN APPOINTMENT FORTY
EIGHT HOURS SEVENTY TWO HOURS
WHO KNOWS WHEN. AT SOME LATER
DATE EVEN THOUGH THERE'S A
MENTAL HEALTH PROFESSIONAL RIGHT
DOWN THE HALL. AND SO I JUST MAY
MAKE AS A COMIC ENERGY
REITERATING THE NEED IN ALL
SETTINGS TO HAVE THAT URGENCY OF
CARE ESPECIALLY IF THE RESOURCES
RIGHT THERE AND IF IT'S A MATTER
OF. CALLED THINGS ARE PAID OR
REIMBURSED ON HAVE YOU THOSE ARE
THINGS THAT WE CAN CERTAINLY
MORE CONFIDENCE LEVEL BUT I
APPRECIATE- AB THE PRESENTATION
IN TERMS OF MAKING IT VERY CLEAR
THAT THE MOST IMPORTANT THING IS
GETTING TREATMENT. ALL RIGHT
AWAY YOU POSSIBLE. IF I MISTER.
A SO PART OF THAT ISSUE IS
AROUND FEDERAL RULES ABOUT
REIMBURSEMENT RIGHT THAT PART OF
THAT ISSUE IS THAT OUR SYSTEM
REALLY ISN'T AN ON DEMAND KIND
OF SYSTEM. RIGHT IF I WALK INTO
IF I TRY TO SEE MY PRIMARY CARE
PROVIDER AND I HAVE A SORE KNEE
AND THE GOAL IS THAT AN
ANTIBIOTIC OR- PAIN MEDICATION
THAT'S USUALLY AVAILABLE BEFORE
THE AFTERNOON. IF THE ANSWER IS
SOMETHING- THAT INVOLVES MENTAL
HEALTH INVOLVEMENT IT'S A
DIFFERENT PAYMENT SYSTEM IT'S A
DIFFERENT STRATEGY CAN TAKE
MONTHS. SO I THINK THE ISSUE OF
TWO VISITS DURING A SINGLE DAY
IS ONE ISSUE BUT IT'S MUCH MORE
BROADER THAN THAT. AND PART OF
IT IS THAT WE DESIGNED THE
SYSTEM. OFTEN OFTEN TO SORT OF
EXCLUDE CERTAIN PEOPLE BASED ON
WHO PAYS WHO'S YOUR INSURANCE-
THIS THE STATE HAS INVESTED SOME
FUNDING IN A USED DROP IN
CENTER. THAT IS DESIGNED TO BE
ALL COMERS. THAT STARTS WITH ITS
ITS TARGETING YOUNG PEOPLE THAT
THEY CAN WALK IN WITHOUT AN
APPOINTMENT TO BE SEEN SAME DAY.
AND THE LESSON THERE THE
RESEARCH IN ITS ITS
INTERNATIONAL IS THAT IF YOU
WANT PEOPLE TO ACCESS CARE. YOU
NEED O REMOVE AS MANY BARRIERS
AS POSSIBLE PARTICULARLY PEOPLE
WHO. ARE FACING DISABILITIES OR
CHALLENGES ARE WHO ARE STRIVING.
AND THAT'S WHAT IT'S GOING TO
TAKE OVER GOING TO BE ABLE TO
PUSH MORE PEOPLE INTO UPSTREAM
KINDA SERVICES. TO AVOID THE
NEED. FOR THAT YOU KNOW CRISIS
RESPONSE. THANK YOU SEE THAT
WITH THE VA FOR EXAMPLE THERE'S
A NEWER FACILITY THAT WAS- THAT
OPENED UP IN IN MY AREA WHERE
IT'S A ONE STOP SHOP. FOR THEY
HAVE WHATEVER YOUR NEEDS OVER
THERE HOUSING PHYSICAL HEALTH
MENTAL HEALTH. YOU NAME IT THEY
THEY DON'T. YOU'RE NOT ASKING.
OF THE PERSON IN NEED TO GO
THROUGH ALL THE HOOPS AND TO
TRAVEL AROUND AND WAIT FOR A
DAILY FOR FIVE DAYS AND- I THINK
THIS ALSO SPEAKS TO THIS IS ALSO
BEEN REITERATED BY. BY MANY
INCLUDING HER COLLEAGUES OF
MINE. THAT WE JUST TREATMENT
HELP DIFFERENTLY- AND I FIGURED
THAT THAT CREATES A- A TOTALLY
DIFFERENT. SYSTEM MIND IF THERE
WAS A COORDINATION AND A SENSE
THAT- OF TREATING THEM. AS AS
EQUAL ELEMENTS- AND PHYSICAL
AILMENT VERSES A MENTAL HEALTH
AILMENT- THAT YOU COULDN'T OF
DONE THAT HOMES TO ALLOW FOR THE
COORDINATION MORE EASILY TOO
BECAUSE YOU JUST. REMOVE SOME OF
THOSE. BOTH ABOUT INSTITUTIONAL
BARRIERS BUT ALSO JUST THE
MENTALITY OF IT AND THE THOUGHT
PROCESS OF HOW YOU ACTUALLY SEE.
THE DIFFERENT. TYPES OF ISSUES
THAT INDIVIDUALS MIGHT BE FACING
. THANK YOU SIR CALL. OF DR
RAMYA. THANK YOU- FIRST I WANT
TO THANK PANEL WAS LOOKING. TO
HEARING SOME SOLUTIONS AND IDEAS
THAT- WE COULD WORK ON IN THIS
UPCOMING YEAR AND WANTED TO.
FIRST START WITH ONSITE VISIT
THEY WERE TALKING ABOUT AT THE
BEGINNING OF JANUARY- TOBY IF
YOU WANT TO COORDINATE WITH Y
OFFICE AND SEE IF I CAN HELP
SHARE THAT. WITH SOME OF OUR
COLLEAGUES I'D LOVE FOR. US TO
GO SEE FIRSTHAND WHAT'S CURRENT
WHAT'S- IN A BETA AND WHAT'S
WORKING. WITHIN OUR COMMUNITIES.
I WILL JUST SHARE THAT I SAW
FIRST HAND WHAT OCCURRED WITH
TOMMY WHO'S ONE OF OUR PEER
SUPPORT SPECIALIST. AND TO THE
ORIGIN FOR WHY WE AND CALIFORNIA
HAVE REALLY LEANED INTO
SUPPORTING. THOSE PEER SUPPORT
SPECIALIST A COUPLE YEARS AGO.
THAT I'D LOVE TO FIGURE OUT AND
I AGREE WITH YOU THAT IT IS PEER
SUPPORT SPECIALISTS WHO ARE
WORTH THEIR WEIGHT IN GOLD. BUT
I SAW THAT ACTUALLY OUT ON A
SITE VISIT SEEING FIRST HAND
HEARING FROM PEOPLE. AND HOPE
THAT THIS UPCOMING YEAR MANY OF
MY COLLEAGUES WILL WANT TO.
PARTICIPATE IN THAT SITE
PRESIDENCY IF THIS M. PATH IS.
PART OF THE SOLUTION FOR US. BUT
I DON'T WANT TO MISS AN
OPPORTUNITY TO MAKE SURE I
PUSHED HARD AS WELL ON EARLY
PSYCHOSIS CARE. AS WE KNOW THE
EVIDENCE HAS SHOWN US. THAT
THOSE EARLY INTERVENTIONS HELP
US AS A SYSTEM LONG TERM HELPING
TO PREVENT. THE DOWNSTREAM
CONTACT CONSEQUENCES AND REALLY
WANT TO MAKE SURE THAT WE'RE
MAKING THE APPROPRIATE
INVESTMENTS AS A STATE TO- HELP
THOSE WHEN WE CAN HELP THEM THE
MOST. SO BELIEVE THAT THE EARLY
PSYCHOSIS CARE IS RIGHT FOR US
AS A STATE TO CONTINUE TO INVEST
IN AND- WE LOOK FORWARD TO THAT.
CALIFORNIA'S SHIP WE CAN. THANK
IT WILL REACH TO YOU ON THE SIDE
WITH AS WELL AS THE OF THE OTHER
SIDE. WHERE PRESENTED THANK YOU
THANK YOU. ANYONE ELSE I HAVE A
COUPLE QUESTIONS- THAN TO
CLOSEST CLOSEST PANEL OUT HERE
PERSONAL- PERSONAL VERY
INTERESTING PANEL THANK YOU VERY
MUCH- VERY MUCH APPRECIATE
LEARNING ABOUT AND PASSED WITH.
WE HAD BEEN TALKING ABOUT THAT
BUT YOUR YOUR EXPLANATION OF AND
ILLUSTRATIONS PHOTOGRAPHS- KINDA
HELP TO CLOSE THE LOOP ON THAT
ON THAT FOR US AND SO I GUESS.
OBVIOUSLY THE FAIRLY NEW YOU'RE
YOU YOU CITED SOME SOME STUDIES
THAT ARE OR SOME SOME RESULTS
THAT ARE COMING OUT- WHICH WHICH
SHOW SHOW TREMENDOUS PROMISE- IN
GENERAL HOW ARE THESE FUNDED.
HAVE HOW ARE IN PASS FUNDED- IS
ARE THEY ASSUME THEIR DESIGNATED
FACILITIES BY THE COUNTY OR OR I
SHOULD ASSME ANYTHING BUT HOW
HOW. GOOD BECAUSE WE ARE YOUR
TOES BUT WHEN THAT DIDN'T WORK
BECAUSE THEY DON'T GET
PERMISSION OF THE COUNTY SO
THERE'S GOING TO BE AN ISSUE
THERE SO IN GENERAL HOW ARE THEY
HOW ARE THEY FUNDED. WHAT DO YOU
TO THE AMAZING THING ABOUT HIM
HAS BEEN THAT THE HOSPITALS
HAVE. KIND OF TAKEN IT ON TO
CREATE THEM THEMSELVES AND
HAVEN'T SEEN STOCK. GRANT
FUNDING OR WHAT HAVE YOU THERE
ARE SOME THAT HAVE GOTTEN. SB
EIGHTY TWO FUNDS- THE- THE ONE
THAT'S IN CARMICHAEL HERE IN
SACRAMENTO COUNTY WAS ABLE TO.
ACCESS SOME OF THAT. BUT EVEN
ALSO SOME HAVE BEEN. DOING IT
THROUGH PHILANTHROPY THERE'S AN
ENORMOUS INTEREST IN THE FLAT
FOR. PHILANTHROPIC COMMUNITY IN
SUPPORTING THESE BECAUSE
THERE'S- EVERYBODY KNOWS THERE'S
A NATION WIDE MENTAL HEALTH
CRISIS GOINGON. IT'S A REALLY
GOOD INVESTMENT WHERE MAYBE NOT
AS MUCH AS YOU MIGHT. HAVE TO
DONATE TO GET YOUR NAME ON
SOMETHING. ELSE WHERE YOU CAN
REALLY MAKE A DIFFERENCE- AND AS
I SAID YOU IS SOMETIMES THESE
HOSPITALS HAVE UNDER UTILIZED.
LARGE EMPTY ROOM THAT THEY CAN
JUST. FIX UP AND MAKE INTO AN
IMPACT UNIT THAT'S DOWN THE HALL
FROM. FROM THEIR ER AND
SUDDENLY. YOU KNOW. A FEW
HUNDRED THOUSAND DOLLARS LATER
YOU'VE GOT THIS WONDERFUL
PROGRAM. IN TERMS OF THE
REIMBURSEMENT- THERE'S A
DIFFERENCE IN THE WAY THAT THAT
MEDICARE AND PRIVATE INSURANCE
WILL ACTUALLY. REIMBURSE THIS
UNDER A RUBRIC OF. EMERGENCY
OBSERVATION CARE WHICH WOULD BE
THE SAME THING AS IF YOU WERE IN
THERE FOR. A SMALL BALL OF
STRUCTURE IN OR UNDER CHILUBA
TREE FOR A HEART ATTACK. THEY IT
WILL REIMBURSE AND THAT BOTH
UNDER PRIVATE INSURANCE AND
MEDICARE AND MANY OTHER STATES
MEDICAID WILL PAY FOR IT THAT
WAY. CALIFORNIA DOES NOT
RECOGNIZE OBSERVATION CARE UNDER
MEDICAID. SO INSTEAD THE COUNTY-
MENTAL HEALTH DEPARTMENT THEN
HAS TO REIMBURSE UNDER CRISIS
STABILIZATION. FUNDING WHICH
USUALLY IS USED- THOUGHT OF IS
FOR COMMUNITY BASED. CRISIS
STABILIZATION PROGRAMS. IT'S THE
SAME REIMBURSEMENT STRATEGY-
THAT'S USE THAN FOR THE MEDIC
HAL IN THE HOSPITAL- IMPACT
UNITS- BUT IT NEEDS TO BE
APPROVED BY THE COUNTY MENTAL
HEALTH DEPARTMENT. THEY NEED TO
BE A CONTRACT AND THEN THEY WILL
ONLY REIMBURSE FOR THE- MENTAL
HEALTH- PATIENTS WHO HAVE
MEDICAID MEDIC CAL FOR THAT
SPECIFIC COUNTY. THEY WOULD HAVE
TO GET ONE WITH ALL OTHER FIFTY
SEVEN COUNTIES AS WELL IF
THEY'RE GOING TO SEE PEOPLE FROM
OTHER COUNTIES. SO DOES MAKE IT
DIFFICULT AND IT ALSO PUTS THEM
KIND OF AT. THE MERCY OF EACH
COUNTY- IF THEY'RE GOING TO
PROVIDE THIS SERVICE AS OPPOSED
TO. ANY OTHER SERVICE THAT THAT
HOSPITAL ER IS PROVIDING. THEY
DON'T HAVE TO GO TO THE COUNTY
TO GET AN OK TO DO SO I GUESS
SOME. OF I'M SITTING HERE
THINKING- THIS. SO MANY
ENTITIES- REIMBURSEMENT AS A FOR
SERVICES AS A BIG COMPONENT
OBVIOUSLY OF PROVIDING SERVICES
FOR PEOPLE SO I JUST I HOPE THAT
WE'RE NOT GOING WE'RE NOT GOING
TO SEE THE EVOLUTION OF M.
PASSED SLOW DOWN BY THE
POSSIBILITY THAT THOSE CAN BE
DIFFICULT TO GET REIMBURSED SO-
THAT. YOU'RE TALKING ABOUT
SOMETHING IS SHOWING GREAT
PROMISE. WEST DOLLARS BUT MOST
IMPORTANTLY A MUCH BETTER
IMPACT. AND OUTCOME FOR THE
PATIENT NOW. OUR SYSTEM START
ARE ARE ALWAYS SET UP TO
ACCOMMODATE FOR THOSE KINDS OF
THINGS TO SAY. DANGER ROGERS YOU
KNOW SO I THINK WHAT THE HECK
YOU KNOW. YOU WERE GOING TO PAY
LESS AND WE'RE GOING TO GET A
BETTER OUTCOME- I DON'T KNOW
ABOUT THAT. SO SO I I'M NOT AN
EXPERT ON THIS- AND I AND I
DON'T EVER WANT TO BE AN EXPERT
ON THIS BUT THIS IS FEELS LIKE.
AN OPPORTUNITY FOR- A WAIVER- IN
INNOVATION WAIVER SOMETHING WITH
THE FEDS TO BE ABLE TO DRAW DOWN
RESOURCES TO EXPAND UPON THIS
KIND OF A PROGRAM THINKING IN
CALIFORNIA- I PROBABLY SHOULDN'T
HAVE SAID THAT BUT- BUT- I DID-
BUT- YOU KNOW. THIS ISN'T JUST
HAPPENING IN CALIFORNIA THESE
IMPACT UNITS YOU SHOW TO OTHERS
AND OTHER PARTS OF THE COUNTRY
THAT THAT OR MAKE A DIFFERENCE.
IN CLEARLY. WHAT'S GOING ON IN
HOSPITAL ER'S ISN'T. IS IT WE'RE
DOING THE SAME THING OVER AND
OVER AND OVER AGAIN AND NOT
GETTING THE DESIRED RESULTS SO.
I THANK YOU FOR YOUR
PRESENTATION- I'M HOW DID YOU
WANT TO A DOCTOR ARAMBULA. I
JUST WANTED TO FOLLOW UP ON THE. IS THAT CALIFORNIA'S ONLY OR
ARE THERE STATES. THAT DO PAY
FOR OBSERVATION YEAH SO
OBSERVATION IS AGNOSTIC TO
DIAGNOSIS AS I SAID IT'S WHETHER
IT'S MEDICAL OR PSYCHIATRIC IT'S
ALL OF RUMORED AND SHE CARE.
THINK THEY'RE SOMETHING LIKE
THIRTY FIVE STATES WHICH
MEDICAID PAYS OBSERVATION
EMERGENCY CARE BUT CALIFORNIA
DOES NOT. THAT'S SOMETHING I'D
LIKE TO FOLLOW UP AND SEE IF WE
CAN MAKE A FISCAL ARGUMENT FOR
WHY IT WOULD BE ADVANTAGEOUS FOR
CALIFORNIA TO MAKE THAT TYPE OF
INVESTMENT AND WOULD LOVE
DETAILS IF YOU CAN. LOVE TO TALK
TO MORE ABOUT IT THANK YOU THANK
YOU THANK YOU DR ABELA- MR
DINNER STEEN- GIVEN EXISTING
CASE LAW- FROM YOUR PERSPECTIVE
DO YOU THINK IT'S POSSIBLE THAT
CHANGE CALIFORNIA STATE LAW IN A
WAY THAT WILL IMPROVE THE
LIKELIHOOD A PERSON. WILL BE
BETTER ABLE TO RECEIVE THE
MENTAL OR- PHYSICAL HEALTH CARE
THEY NEED WITHOUT. LIMITING
THEIR CONSTITUTIONAL RIGHTS AND
IF SO HOW WOULD WE ACCOMPLISH
THAT. HOW MUCH TIME DO YOU- WHAT
I DO WANT TO SAY I WANT TO PICK
UP ON SOMETHING THAT THE DOCTOR
YOU IN TESTIFIED BACK AS WE
ACTUALLY HAD SOME EXPERIENCE
WITH THIS IN OUR DISABILITY
RIGHTS CLINIC HERE IN WASHINGTON
AND THAT IS. THE USE OF ADVANCED
A DIRECTOR FOR PSYCHIATRIC CARE-
AND AB WE'VE WORKED WITH OUR
LOCAL PROTECTION ADVOCACY
ORGANIZATION DISABILITY RIGHTS
DO YOU SEEN EACH YEAR WITH THE
PROJECT WE GO SEE PEOPLE WHO ARE
EITHER IN COMMUNITY BASED
PROGRAMS OR ARE ABOUT TO BE.
DISCHARGED FROM OUT AND WORK
WITH THEM TO SEE WHETHER OR NOT
AND THEY EXPRESSED SOME INTEREST
IN- EXECUTING AN ADVANCE
DIRECTIVE WHICH BOTH CAN
INDICATE. WHAT KINDS OF SERVICES
THEY WANT IF THEY COME TO A
POINT WHERE THEY'RE NOT ABLE TO
ARTICULATE BETTER COMMUNICATE
THAT AT A LATER TIME WHEN I KEY
EXPERIENCING PSYCHOSIS AND ALSO
WHO MIGHT BE A PERSON THEY TRUST
YOU CAN MAKE SOME SOME JUDGMENTS
BECAUSE I DO THINK ONE OF THE
CHALLENGES HERE. IS WHAT LEVEL
OF ASSESSMENT OF YOUR OF YOUR
INTEREST LET'S SAY ARE YOU ABLE
TO ENGAGE AND WHEN YOU'RE IN THE
PRESENCE OF THIS CHALLENGE. SO
THAT IS A WAY TO BASICALLY IN AT
A TIME WHEN YOU'RE FEELING
PRETTY GOOD AND ABLE TO MAKE
THESE KIND OF CHOICES TO SORT
OF. PROTECT YOURSELF IN THE
FUTURE ABOUT WHAT WOULD HAPPEN
IF I GET TO A POINT WHERE I
CAN'T NOW THERE ARE ISSUES ABOUT
WHETHER THAT THAT TRIGGERS. THE
DOCTORS OTHERWISE HAVE TO FOLLOW
ITS LEAD DIRECTED BUT IT CAN
LEAST AT MINIMUM INDICATE WHAT
THE PREFERENCES AND I GUESS STEP
YOU KNOW ANOTHER YOUR QUESTION I
THINK IS SOMETHING WHICH I THINK
IS VERY DIFFICULT. FOR LAW TO
ADDRESS MANY IS THE CONTINUING
STIGMA THAT IS ASSOCIATED WITH
MENTAL ILLNESS. AND WITH THE
TREATMENT OF. THE WAY WHICH I
THINK ON THE PANEL. ABOUT THE-
HISTORICAL THAT'S A OF THE
SEARCH. ARE STEP OR DID. WHEN
YOU REALLY KNOW PRETTY REASON
WHY OUT HOW TO BE THE CASE. SO I
MEAN LAW DON'T USE THE TERM KNOW
FIRST NO HARM DR BUT I ACTUALLY
THINK THAT'S IMPORTANT
PERSPECTIVE FOR US. TO HAVE AS
WELL SO THAT IN THINKING ABOUT
WHAT STATUTES CAN AND CANNOT DO-
I THINK THAT TO SOME EXTENT WE
HAVE TO I. BELIEVE HAVE TO MOVE
AWAY. FROM THAT KIND OF TENDENCY
TO JUST. MAKE IT- WELL. HE IS A
YEAR OR TWO TO DESCRIBE THE
PROBLEM IS ONE WHERE THE
PROBLEMS WERE NOT ABLE TO
CONNECT PEOPLE FOR LONGER TERMS.
SO WE CAN MAKE IT EASIER TO DO
THAT AND I WAS. ENCOURAGED BY
YOU KNOW BY THE- L. PANEL
MEMBERS I THINK EVERYBODY. MR
THIS PANEL WAS KIND OF THE SAME
MIND WHICH IS. NOT NO WE DON'T
WANT TO GET AWAY FROM COURSE OF
TREATMENT WANT TO GET AWAY FROM
LONG TERM TREATMENT. WE WANT TO
TURN PEOPLE AROUND AS QUICKLY AS
WE CAN SO I THINK LAW HAS TO. BE
CONSISTENT WITH THAT AND I WILL
SAY THAT OVER TIME LOOKING AT
THIS. AND CALIFORNIA BUT MORE
GENERALLY. TOO OFTEN WE'VE HAD
POLICIES THAT WORK ACROSS
PURPOSES WE HAVE. FUNDING
STATUTES WHICH WILL IN ONE
DIRECTION INCONSISTENT WITH THE
CONSTITUTIONAL. PROTECTIONS WE
MIGHT HAVE BUT- LAST THING I
GUESS I'LL SAY IS. I THINK YOU
YOU. HAVE HEARD WILL HEAR FROM
PEOPLE WHO ARE MOST AFFECTED.
LIKE ANYTHING ELSE IN PUBLIC
POLICY- YOU CAN SIT IN YOUR
IVORY TOWER TRYING TO IDENTIFY
WHAT. THE RIGHT INTEREST MIGHT
BE BUT IT'S REALLY IMPORTANT
HERE FOR PEOPLE WHO ARE MOST
AFFECTED. WHAT WOULD THEY FIND
TO BE. SOMETHING THAT WOULD BE
HELPFUL TO THEM. RATHER THAN
SOMETHING THAT THEY WANT TO BE
FORCED TO AND THAT'S- NOT ONLY
THE INDIVIDUALS BUT FAMILY
MEMBERS. OTHER STAKEHOLDERS
RIGHT HAVE A- WHAT PERSPECTIVE.
THANK YOU THANK YOU VERY MUCH
APPRECIATE THAT AND THEN JUST A
FINAL QUESTION ON THAT SAID TO
MISTER EWING- IT'S FAIR TO SAY
YOU SPEND A GREAT DEAL IF YOU
WERE A PROFESSIONAL LIFE
ADVOCATING FOR MORE INTEGRATED-
COHESIVE MENTAL HEALTH SYSTEM IN
CALIFORNIA AND WE ARE ETERNALLY
GRATEFUL FOR YOUR EFFORTS- SO.
SOMEBODY GIVE YOU AN EASY
QUESTION- CAREFUL IN THE IN THE
LPS ARENA HOW HE MAKES SUCCESS
EASIER AND FAILURE MORE
DIFFICULT. VISIT THE EASY
QUESTIONS MISTER CHAIR IT- YOU
KNOW OUR OUR MENTAL HEALTH
SYSTEM IS DESIGNED AROUND SORT
OF YOU KNOW WE SET RULES ABOUT
WHAT WHAT WE WILL DO WHAT WE CAN
PAY FOR RIGHT AND THERE'S WE
ALSO HAVE RULES ABOUT WHAT MUST
BE PAID FOR SO THE EXAMPLE OF
FULL SERVICE PARTNERSHIPS RIGHT
EVEN WITHIN THE REALIGNMENT
RELATIONSHIP WITH COUNTIES. AND
THEN AS SOME PEOPLE TALKED ABOUT
THEN THERE'S THINGS THAT THE
STATE JUST PAYS FOR. IS THE
REASON THIS IS HARD IS. A
VARIETY OF THINGS ONE WE DON'T
HAVE CLEAR MODELS. AND SO
THERE'S WIDE VARIATION ACROSS
COUNTIES AND SO YOU THAT YOU'RE
SEEING SOME EXAMPLES HERE THE
CONVERSATIONS THAT ARE HAPPENING
AROUND PSYCHIATRIC EVENTS
DIRECTORS IN WASHINGTON YOU IT
IS VERY DIFFICULT WHAT WHAT
COUNTIES OFTEN STRUGGLE WITH
WHAT THEY SHARE WITH US. IS
UNDERSTANDING WHAT A BEST
PRACTICES AND WHAT THEY SHOULD
BE IMPLEMENTING IT CAN BE VERY
DIFFICULT THERE OFTEN SORT OF ON
THEIR OWN TO FIGURE THAT OUT AND
THAT AND THAT CAN BE VERY
IMPORTANT WHEN IT'S YOUR
DISTRICT AND IT'S TAILORED TO. A
RURAL COASTAL COMMUNITY WHICH IS
VERY DIFFERENT FROM LOS ANGELES
OR- IN YOU KNOW OR IMPERIAL
COUNTY. BUT IT ALSO CAN MEAN-
THAT THEY'LL STRUGGLE TO S. C.
THEIR SYSTEMS EVOLVE IN WAYS
THAT RESULT IN. HAD THE
EFFECTIVE EFFICIENT CARE THAT
LEADS TO THE RIGHT KINDS OF
OUTCOMES. SO IF YOU KNOW THE
STATE IS IN A POSITION
PARTICULARLY IN PARTNERSHIP WITH
OUR ACADEMIC PARTNERS AND
OTHERS. TO REALLY IDENTIFY WITH
THESE MODELS ARE AND TO
INCENTIVIZE AND JUST TO CLARIFY
THE SACRAMENTO COUNTY EXAMPLE IS
ACTUALLY FINE WITH IMAGE THE
INNOVATION FUNDS. IN THE
QUESTIONS EXPLORING THE IDEA OF
USING SOME OF OUR SB EIGHTY TO
TRIAGE FUNDS TO INCENTIVIZE
COUNTIES. TO WORK WITH THEIR
COMMUNITY HOSPITAL PARTNERS. TO
ADOPT SOME OF THE SAMPATH MODELS
SO. YOU KNOW IT IT'S ABOUT
MAKING IT EASIER FOR OUR
COMMUNITY PARTNERS TO BE
SUCCESSFUL. IT FROM A KNOWLEDGE
BASIS PROVIDING THE TECHNICAL
ASSISTANCE AND TRAINING THAT IS
NECESSARY BECAUSE IT CAN BE VERY
DIFFICULT. FROM COUNTY
BEHAVIORAL HEALTH PERSPECTIVE TO
UNDERSTAND. YOU KNOW WHAT THE
KNOWLEDGE BASIS THAT'S SPECIALLY
FOR SMALLER COUNTIES THAT DON'T
HAVE THE STAFF TO GO LOOKING AND
LEARNING FROM. AS FAR AWAY AS DC
AROUND THE KINDS OF PROJECTS
THAT MIGHT BE DEPLOYED OR EVEN
OUT OF STATE. SO IDENTIFYING
MODELS DEVELOPING TECHNICAL
ASSISTANCE AND TRAINING CREATING
CLEAR FINANCING PATHS. IF THIS
ISN'T AS EASY TO FIND IT'S MORE
LIKELY TO BE EASY TO IMPLEMENT
OF IT'S A VERY DIFFICULT TO
FIND. IT IS GOING TO BE A
HEAVIER LEFT YOU'RE GOING TO SEE
TYPICALLY ONLY THE MOST ARDENT
CHAMPIONS. CLIMB UP THAT THE
FINANCIAL HILDA FIGURE OUT HOW-TO IMPLEMENT. THEM THAT IS
WORKING AGAINST STREAM. IT IN
THE SAME THING IS TRUE AROUND
STAFFING IF THERE'S CLEAR
STAFFING STRATEGIES PARTICULARLY
AROUND GUIDANCE TO IT TO
FIDELITY TO THESE MODELS SUCH AS
THE ROLE APPEARS THAT'S VERY
HELPFUL. AND LAST THING I WOULD
SAY. DOING THE DATE IN THE
ANALYTICS SO THAT THE POLICY.
POLITICAL AND COMMUNITY
INCENTIVES. TRY ATTENTION TO THE
NEED TO ACTUALLY GET BETTER AT
THIS OVER TIME SO IF SOME
COMMUNITIES ARE ADOPTING
PROGRAMS WHERE THEY'RE SEEING.
THEIR INVOLUNTARY RATES GO DOWN
ANOTHER COMMUNITIES ARE NOT HOW
DO WE MAKE IT EASIER FOR PEOPLE
WHO ARE IN THOSE PLACES WHERE
THEY'RE NOT GOING DOWN TO
UNDERSTAND WHAT THE STRATEGIES
ARE. AND HOW DO WE CREATE THAT
SUPPORT AT HOME. SO THEY CAN BE
SUCCESSFUL. THANK YOU FOR THE
EASY QUESTION. THANK YOU FOR-
MUCH APPRECIATED SO- I WOULD
JUST I GUESS IT WAS CLOSE BY
SAYING. FROM MY PERSPECTIVE.
HERE ONE OF THE THINGS THAT I
THINK WOULD BE- MAKE THINGS
EASIER WOULD BE A RELIABLE
CONTINUOUS BUT- THE BEST SHOT
THEY'RE THEY'RE GETTING THE
UPDATE HERE ON THIS FABULOUS
THAT IS YOUR MOTHER WILL
TRANSFORM. RIGHT I'M SORRY THIS
TRANSFORMATIVE THANKS- HOWEVER-
FOR US TO BE SUCCESSFUL IN THE
LONG TERM I THINK WE'RE GONNA
NEED CONTINUOUS FUNDING FOR A
LOT OF A LOT OF PROGRAMS GOING
FORWARD- THE INTEREST IN THE
SUBJECT MATTER HERE TODAY IN THE
MIDDLE OF DECEMBER- YEAH I KNOW
THERE'S OTHERS THAT WOULD LIKE
TO BEEN HERE TODAY I THINK
SHOULD BE SHOULD BE. SHOULD BE
NOTICED- WE'RE WE'RE PRETTY
SERIOUS ABOUT THIS BECAUSE WE
HEAR ABOUT OF OUR CONSTITUENTS
ON A REGULAR BASIS EVERYWHERE I
GO IN THE COMMUNITY. AND SO- AND
I KNOW THAT MY COLLEAGUES HAVE
THE SAME HAVE THE SAME
EXPERIENCE SO THANK YOU THANK
YOU VOTE I THANK YOU OUT THERE
FROM WASHINGTON DC MISTER
DYNASTY DISTINCT THANK YOU. OKAY
ALL RIGHT WE'LL GO AHEAD AND
MOVE ON TO AN EXTENT. THANK YOU
FOR THE OPPORTUNITY THANK YOU.
AND THIS IS GOING TO BE- ANOTHER
ANOTHER ONE OF OUR HOPEFULLY-
HOPEFULLY RAPID FIRE- WHEN WE
CALL THEM- BOB RAPID FIRE
SESSION HERE WE HAVE GOT FOUR
PANELISTS AND WE'D LOVE TO GET
ABOUT FIVE MINUTES EACH. SO- AND
SHE'S TIMING YOU HERE SO JUST
BECAUSE- BUT TO APPRECIATE
APPRECIATE THAT- IT LOOKS LIKE-
WE'VE GOT TO HAVE THREE OF OUR
PART THREE OF OUR PANELISTS IN
PERSON THANK YOU THAT'S
WONDERFUL- CERTAINLY WITH MR
HAWTHORNE- WITH THE CALIFORNIA
HOSPITAL ASSOCIATION. PLEASE GO
AHEAD THANK YOU AGAIN CHAIR
COMMITTEE MEMBERS ALEX HAWTHORN
WITH CALIFORNIA'S BILL SITUATION
AND THANK YOU FOR THE
OPPORTUNITY TO PROVIDE SOME
IDEAS AND RECOMMENDATIONS THE
LEGISLATURE ON HOW WE CAN
IMPROVE OUTCOMES FOR PATIENTS.
ADDRESSING OUR BEHAVIOR HEALTH
CRISIS IS A TOP PRIORITY FOR CJR
HOSPITALS. TO THAT END WE'RE
PROUD TO HAVE PARTNERED WITH
NAVY CALIFORNIA AND MANY OF THE
ORGANIZATIONS HERE TODAY. TO
FORM THE BEHAVIORAL HEALTH
ACTION COALITION OR PJ FOR
SHORT. THIS SET REPRESENTS OVER
FIFTY ORGANIZATIONS WITH A
SHARED GOAL TO ENGAGE
CALIFORNIA'S LEADERS TO
PRIORITIZE BEHAVIORAL HEALTH AND
RIVER STIGMAS ASSOCIATED WITH
THE MANY FORMS OF THIS DISEASE.
AND MAY OF THIS YEAR THE B. H.
A. COALITION RELEASED A
BLUEPRINT FOR BEHAVIORAL HEALTH
WHICH CALLS TO PRIORITIZE
PREVENTION AND EARLY
INTERVENTION. THE FULL DETAILS
OF THIS PLAN CAN BE FOUND ON THE
BEACH A WEBSITE AND WE HAVE
SHARED THESE MATERIALS WITH
COMMITTEE STAFF. TODAY HOSPITALS
PROVIDE CRISIS CARE THROUGH
INPATIENT HOSPITALIZATION AND
EMERGENCY DEPARTMENTS. BUT THIS
IS A SAFETY NET SYSTEM AND THESE
ARE NOT OPTIMAL SETTINGS FOR
PATIENTS EXPERIENCING MENTAL
HEALTH AND SUBSTANCE USE
DISORDER CONDITIONS. TO RECEIVE
THE CARE THEY NEED AND DESERVE.
RATHER CALIFORNIA SHOULD INVEST
IN PREVENTION EARLY INTERVENTION
AND A CONTINUUM OF SERVICES IN
EVERY COMMUNITY SO THE
CALIFORNIANS WITH BEHAVIORAL
HEALTH NEEDS. CAN AVOID
UNNECESSARY ACUTE CARE
HOSPITALIZATION INCARCERATION
AND CONSERVATORSHIP IS. THE
BLUEPRINT IDENTIFIES SPECIFIC
CRISIS STABILIZATION COMMUNITY
BASED RESIDENTIAL CARE AND
MOBILE CRISIS SERVICES THAT CAN
DIVERT INDIVIDUALS FROM
AVOIDABLE HOSPITALIZATIONS AND
ENSURE THE LEAST RESTRICTIVE
TREATMENT OPTIONS. HOWEVER
ALTHOUGH SO CRITICAL THESE ARE
NOT CONSISTENTLY AVAILABLE ON A
STATEWIDE BASIS. THE BLUEPRINT
CALLS ON INFRASTRUCTURE TO BE
EXPANDED EXPANDED BY BOTH
GOVERNMENT FUNDED PROGRAMS AS
WELL AS COMMERCIAL HEALTH PLANS
IT SADLY DO NOT TYPICALLY COVER
THE SERVICES TODAY. SPECIFIC TO
THE LPS ACT HOWEVER AND ALTHOUGH
THE INTENTION OF THE LAW REMAINS
SOUND IMPROVEMENTS CAN BE MADE.
FIRST UNDER THE OPS ACT PUBLIC
CONSERVATIVES BECOME LGAL
DECISION MAKERS FOR INDIVIDUALS
WITH SERIOUS MENTAL ILLNESSES
UNABLE TO PROVIDE FOR THEIR OWN
BASIC NEEDS. WHEN THEY DO NOT
HAVE A LOVED ONE WHO COULD DO SO
FOR THEM. AS YOU HEARD EARLIER
TODAY COUNTY PUBLIC
CONSERVATIVES ARE CURRENTLY
FUNDED SOLELY WITH LOCAL FUNDS-
WE SUPPORT THE COUNTY'S REQUEST
FOR STATE GENERAL FUND SUPPORT
FOR THIS REALLY CRITICAL SERVICE
STEMMING FROM THE LPS ACT.
SECOND AND WE DISCUSSED THIS A
LITTLE BIT EARLIER DEDICATED
STATE LEVEL LEADERSHIP ON LPS
ACT- INVOLUNTARY DETENTION AND
TREATMENT IS ALSO NEEDED TO
PROVIDE CONSISTENT
INTERPRETATION. TECHNICAL
ASSISTANCE IN APPLICATION OF THE
LAW. TO ATTRACT DATA WE HEARD
SOME OF THE ISSUES WITH THAT
TODAY PROCESS TO RESOLVE
COMPLAINTS AND ADVISE AND
EDUCATE FAMILIES. INDIVIDUALS
DETAINED OUR EDUCATIONAL
INSTITUTIONS THE JUDICIAL SYSTEM
INCLUDING LAW ENFORCEMENT
OFFICERS IN THE COURTS. SO
SPECIFICALLY THIS LEADERSHIP
COULD DO SOME OF THE FOLLOWING.
FIRST ENABLE REVIEW OF EXISTING
DOJ DATA AND REFORM REPORTING
REQUIREMENTS SO THAT POLICY
MAKERS CAN ACCURATELY EVALUATE
LPS TRANSALPINE AND THE ADEQUACY
OF EXISTING RESOURCES. AS AN
EXAMPLE THE AUDIT FOUND THAT
MANY INDIVIDUALS WERE NOT
CONNECTED TO ADEQUATE SERVICES
FOLLOWING LPS HOLD. A STATE
ENTITY COULD CLARIFY THE
EXPECTATIONS FOR FOLLOW UP CARE
AND IDENTIFY WAYS TO IMPROVE THE
EXPERIENCE OF PEOPLE PLACE ON
INVOLUNTARY HOLDS. SECOND IT
COULD PROMULGATE REGULATIONS
ADMINISTRATIVE DIRECTIVES. TO
CLARIFY AREAS WHERE THE L. P. S.
ACT IS OPEN TO INTERPRETATION.
FOR EXAMPLE A STATE ENTITY COULD
HELP CLARIFY WHEN THE CLOCK ON
LPS HOLD BEGINS. THIRD IT COULD
SHARE BEST PRACTICES AND DEVELOP
TRAINING FOR THE COURTS LAW
ENFORCEMENT PROVIDERS AND
HOSPITALS INVOLVED IN LPS ACT
IMPLEMENTATION FOR QUALITY
IMPROVEMENT. AND FINALLY IT
COULD ENSURE THE INVOLVEMENT OF
MENTAL HEALTH CONSUMERS AND
FAMILY MEMBERS IN OVERSIGHT AND
POLICY DEVELOPMENT RELATED TO
THE LPS ACT. FINALLY SEE TWO
SUPPORTS MODERNIZING THE OPS ACT
THROUGH LEGISLATION WHICH WILL
REQUIRE CHANGES TO STANDARDIZE
AND IMPROVE THE EVER EVOLVING
BEHAVIORAL HEALTH CARE DELIVERY
SYSTEM. WE MUST STREAMLINE THE
EVALUATION ASSESSMENTS AND
RELEASE PROCESS FOR INDIVIDUALS
DETAINED BY LAW ENFORCEMENT AND
BROUGHT TO HOSPITALS ON AN
INVOLUNTARY HOLDS. WE MUST
BETTER DEFINE THE VARIOUS STEPS
OF THE FIFTY ONE FIFTY DETENTION
PROCESS CLEARLY ARTICULATE WANNA
HOLD BEGINS IN SOURIS
DISCONTINUED I WHO MAY PERFORM
THESE DECISION MAKING FUNCTIONS
TO ENSURE CONSISTENT STATEWIDE
APPLICATION SO THAT PEOPLE
RECEIVE THE MOST APPROPRIATE
CARE IN THE LEAST RESTRICTIVE
ENVIRONMENT. WHEN THERE'S
CONSISTENT IMPLEMENTATION OF OUR
LPS LAWS AND A ROBUST CONTINUUM
OF OUTPATIENT CRISIS SERVICES
EVERYWHERE IN OUR STATE WE CAN
BETTER ACHIEVE THE L. P. S. ACTS
GOALS. THE PROVIDING PROMPT
TREATMENT AND COMMUNITY SETTINGS
WHILE ENSURING CIVIL LIBERTY
PROTECTIONS THANK YOU. VERY MUCH
NEXT IS THE MICHELLE CABRERA
EXECUTIVE DIRECTOR THE COUNT
COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION THANK YOU
THANK YOU SO MUCH FOR THE
INVITATION TO BE HERE- CHAIR
WOULD CHAIR STONE AND MEMBERS MY
NAME IS MICHELLE COVERED IT UP
AND THE EXECUTIVE DIRECTOR OF
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION AND TODAY
WE HEARD FROM AN ARRAY OF
STAKEHOLDERS WHO EACH WITH THEIR
OWN UNIQUE PERSPECTIVE LAID OUT
AN ARRAY OF CONCERNS ABOUT THE
STATE. OF OUR LPS SYSTEM. OUR
MEMBERS HAVE CONSISTENTLY
AFFIRMED WHAT MANY TODAY HAVE
SPOKEN TO. OUR BEST CHANCE AT
HEALING COMES THROUGH VOLUNTARY
ENGAGEMENT INTO SERVICES. AND
THESE APPROACHES ARE ALMOST
ALWAYS SUCCESSFUL. CONSISTENT
WITH THE OLMSTED ACT AND TIED TO
IMPROVED CLINICAL OUTCOMES. WHEN
WE ASKED OUR MEMBERS WHAT
CHANGES WERE NEEDED THEY WERE
CLEAR WE DON'T NEED MORE STICKS
WE NEED MORE CARROTS. SO THE
FIRST RECOMMENDATION THAT WE
HAVE FOR YOU TO CONSIDER TODAY
IS THIS WE NEED TO RIGHT SIZE
OUR BEHAVIORAL HEALTH SAFETY NET
FUNDING. IN RECESSION YEARS
REALIGNMENT SERVED AS A BUFFER
TO PROTECT THESE FUNDING FOR
CRUCIAL MENTAL HEALTH PROGRAMS.
BUT TODAY WE'RE STUCK IN THAT
BASEMENT THE DOCTOR KELLY
REFERENCED EARLIER. SINCE
NINETEEN NINETY ONE WHEN
REALIGNMENT WAS NEGOTIATED
CALIFORNIA'S POPULATION HAS
GROWN BY THIRTY FOUR POINT 5% OR
TEN MILLION CALIFORNIANS AND OUR
FUNDING HAS REMAINED STEADY BUT
STOPPED. IT WAS NEVER TIED TO
CASELOAD. IT WAS TIED TO A
CONCEPT OF COMMUNITY MENTAL
HEALTH THAT UNLIKE THE LAND
TERMAN ACT FOR PEOPLE WITH
INTELLECTUAL AND DEVELOPMENTAL
DISABILITIES. WHICH IS AN
ENTITLEMENT WAS A DOT DOT DOT TO
THE EXTENT RESOURCES ARE
AVAILABLE. IT STARTED OUT AS A
NICE TO HAVE NOT A MUST HAVE.
AND WHILE WE ARE GRATEFUL FOR
THE STATE'S PURSUIT OF AN I AM
THE WAIVER FOR MENTAL HEALTH
FUNDING. AND THE INFRASTRUCTURE
INVESTMENT IN THIS YEAR'S BUDGET
IT WILL NOT BE ENOUGH TO GET THE
JOB DONE. WE NEED FUNDING TO PAY
FOR THE ONGOING SERVICES AND
SALARIES IN THIS COMPETITIVE JOB
MARKET. WE WILL NEED TO KEEP
THAT INFRASTRUCTURE CAPACITY
GOING FOR THIRTY YEARS OR
BEYOND. WE GOT A CAR WITH NO GAS
. STRENGTHENING THE SAFETY NET
MEANS IMPROVED FLEXIBLE FUNDING
FOR MENTAL HEALTH SERVICES
TREATMENT BUT ALSO FOR THE
EXPANSION OF MENTAL HEALTH
SUBSTANCE USE DISORDERS- SORRY
MEDIC HEALTH SUBSTANCE USE
DISORDER TREATMENT. WITH
ADDITIONAL FUNDING FOR SUBSTANCE
USE DISORDER SERVICES ESPECIALLY
IN OUR RURAL COMMUNITIES WE
COULD REALLY MAKE A DIFFERENCE
IN TURNING THE TIDE ON THE
PUBLIC HEALTH EMERGENCY
PRESENTED TO US IN INCREASED
FENTANYL RELATED DEATHS
METHAMPHETAMINE RELATED
PSYCHOSIS AND ALARMING LEVELS OF
ALCOHOL ABUSE FUELED IN THIS
PANDEMIC. NUMBER TWO WE NEED TO
PRIORITIZE HOUSING FOR COUNTY
BEHAVIORAL HEALTH CLIENTS IF
COUNTY BEHAVIORAL HEALTH CLIENTS
CAN BE PRIORITIZE WITH OUR
HOUSING EFFORTS WE CAN
FUNDAMENTALLY ALTER THE NATURE
OF THE PROBLEM WE'RE TRYING TO
SOLVE FOR MEANING THAT WHEN WE
PROVIDE A SAFE STABLE LIVING
ENVIRONMENT FOR INDIVIDUALS WITH
SERIOUS MENTAL ILLNESS WE
INTERRUPT CYCLES OF
CRIMINALIZATION AND THE SEVERE
DETERIORATION OF PHYSICAL HEALTH
CONDITIONS. WE START TO CALL FOR
RECOVERY RATHER THAN FAILURE. DR
KELLY SPOKE IN THE MORNING ABOUT
A FEW OF OUR HOUSING RELATED
CHALLENGES BUT WE ALSO HAVE
CONCRETE SOLUTIONS TO PROPOSE.
FIRST WELL MENTAL HEALTH
SERVICES ACT FUNDING HAS BEEN
ESSENTIAL IN OUR ABILITY TO PAY
FOR HOUSING IT'S NOT ENOUGH AND
IT PULLS FUNDING AWAY FROM
SERVICES. IN THE IMMEDIATE WE
PROPOSE THE STATE COMMITTED TO
FUNDING HOUSING FOR ANY AND ALL
FULL SERVICE PARTNERSHIP OR LPS
CLIENTS AND THAT ANY CLIENT
ACTIVELY ENGAGED IN TREATMENT.
IN THIS WAY SHOULD BE GUARANTEED
HOUSING. WE SHOULD BE PROVIDED
WITH THOSE RESOURCES. WE ALSO
NEED TO PROVIDE COUNTY
BEHAVIORAL HEALTH CLIENTS- WITH
A BROADER- STATE LEVEL HOUSING
INVESTMENT SO. THAT SUPPORTIVE
HOUSING IS ONE USEFUL APPROACH
HOWEVER OUR CLIENTS- OFTENTIMES
HAVE WIDER NEEDS AND THEY NEED A
WIDER ARRAY OF HOUSING OPTIONS
INCLUDING. RATES FOR BOARDING
CARE FACILITIES AGAIN NOT JUST
THE BRICKS AND MORTAR CAPITAL
INVESTMENTS OFTEN FEDERAL
DEFINITIONS OF HOMELESS EXCLUDE
INDIVIDUALS WHO MAY BE
TRANSITIONING FROM INCARCERATION
OR FROM RESIDENTIAL OR INPATIENT
TREATMENT SERVICES DESPITE THEIR
VULNERABILITY. WE NEED TO TIP
THE SCALE WITH STATE POLICY AND
INVESTMENTS THAT FOCUS ON OUR
MOST IMPORTANT SUBSET WITHIN THE
BROADER BROADER POPULATIONS.
WITH EXPANDING SERVICES FOR
FUNDING PARTICULARLY NINETY ONE
REALIGNMENT S. U. D. FUNDING AND
HOUSING WE CAN ALTER THE COURSE
OF THIS CRISIS. BECAUSE BUILDING
OUR WORKFORCE SERVICES AND
INFRASTRUCTURE INCLUDING HOUSING
WILL TAKE TIME WE WOULD ALSO ASK
THAT THE LEGISLATURE CONSIDERING
EXPANSION OF OUR PEER MEDICAL
BENEFIT FROM AN OPTIONAL BENEFIT
WHICH MUCH MUST BE TODAY
ENTIRELY COUNTY FUNDED WITHIN
EXISTING RESOURCES. TO A ROBUST
FULLY FUNDED STATE MEDICAL
BENEFIT WITH THE COMMUNITY
HEALTH WORKER BENEFIT FOR
MANAGED CARE THE OPTIONAL AND
UNFUNDED NATURE OF PEERS IN
BEHAVIORAL HEALTH CREATES A LACK
OF EQUITY. AND IT IS TIME FOR
CALIFORNIA TO FULLY COMMIT TO
PIERCE. FINALLY IT IS ALSO TIME
THAT WE INVEST IN BUILDING OUR
STATE'S MORAL CRISIS SYSTEM WITH
INFRASTRUCTURE NEEDED TO SUPPORT
A COUNTY BEHAVIORAL HEALTH
DISPATCH PAYMENT IN COORDINATION
FOR ALL CALIFORNIANS WITH CRISIS
MEANS. THIS TOO IS A MATTER OF
POLICY AND PARITY WE MUST FULLY
FUND WE I'M SORRY WE ALREADY
FULLY FUND MEDICAL EMERGENCY IN
CRISIS. BUT WE NEED TO DO THAT
AS WELL FOR BEHAVIORAL HEALTH
EMERGENCY SYSTEMS ESPECIALLY IF
WE WANT ALTERNATIVES TO NINE ONE
ONE AND POLICE. REGARDING OUR%
PUBLIC GUARDIANS WE SUPPORT
IMPROVE STATE FUNDING FOR PUBLIC
GUARDIAN SO THAT WE CAN
ADEQUATELY RESOURCE THAT AWESOME
RESPONSIBILITY. AND FINALLY WE
URGE YOU TO MOVE BEYOND PARITY
TO ENSURE THAT INDIVIDUALS WITH
COMMERCIAL COVERAGE CAN GET
SPECIALTY CARE AND HELP COUNTY
BEHAVIORAL HEALTH ALL TOO OFTEN
IS SHOULDERING THE
RESPONSIBILITY AS WELL AS THE
BLAME FOR INDIVIDUALS WHO WERE
ALLOWED TO BECOME DISABLED BY
VIRTUE OF THEIR- UNTREATED
BEHAVIORAL HEALTH CONDITIONS AND
PHYSICAL CONDITIONS WE NEED TO
UNDERSTAND THAT THESE ISSUES AND
CONCERNS CANNOT BE ADDRESSED BY
OUR PUBLIC SAFETY NET. ALONE ON
TRANSPARENCY AND ACCOUNTABILITY
WE WELCOME INCREASE STATE LEVEL
TRANSPARENCY AND ACCOUNTABILITY
FOR SERVICES I WANT TO THANK DR
ADAM LAFFER OFFERING AND
CARRYING AB SIX EIGHTY SIX.
WHICH WE INTRODUCED THIS YEAR
AND WHICH WOULD LET- BUILD UPON
SUCCESSFUL OVERSIGHT STRUCTURES
AND CAL WORKS IN CHILD WELFARE.
TO HOLD US ACCOUNTABLE OUR
MEMBERS WANT TO BE HELD
ACCOUNTABLE FOR SERVICES FOR
OUTCOMES FOR FUNDING. AND WE
INCLUDED EQUITY AND DISPARITIES
IN THIS BILL. OUR FOLKS ARE
SERIOUS ABOUT THIS BECAUSE WE
THINK THAT WE HAVE A GOOD STORY
TO TELL AT THE STATE ACTUALLY.
THIS BILL IS CURRENTLY IN THE
ASSEMBLY HEALTH COMMITTEE. AND
THEN WE HAVE AB EIGHT SIX EIGHTY
ONE BY ASSEMBLY MEMBER BREWING
X. HU H. WITH IS OFTEN THIS
COMMITTEE AND SEEKS TO LEVERAGE
THE DOJ DATA. AS RECOMMENDED IN
THE AUDIT WE WELCOME EFFORTS TO
IMPROVE ARE ALREADY REQUIRED
STATE LEVEL REPORTING. AND
IMPROVE UPON IT AND SLOWS TO
LEVERAGE OPPORTUNITIES FOR DATA
SHARING. BY OUR PUBLIC HOSPITAL
AND PUBLIC SAFETY PARTNERS
THROUGH THE STATE WIDE. HEALTH
AND HUMAN SERVICES DATA EXCHANGE
INITIATIVE THANK YOU SO MUCH FOR
YOUR TIME. THANK YOU- WE'LL GO
AHEAD AND MOVE ON TO A MISTER
HAGER SO. AND PLEASE- I ASKED IF
WE COULD TRY TO STAY CLOSE TO
THE FIVE MINUTES I WOULD REALLY
APPRECIATE IT AND THEN WE'LL GO
TO CHEAP JOHNSON AFTER MR AKERS%
COULD BE ON. JOIN US FOR MONTHLY
SO THANK YOU. I JUST A REMINDER
WHAT WE'RE ACCEPTING ANYTHING IN
WRITING AS WELL TOO SO THIS IS
NOT YOUR ONLY OPPORTUNITY TO.
INFLUENCE OUR OUR THOUGHTS HERE
SO YOU'RE OUT THERE MR HAGER. I
AM AND RADIOHEAD PLEASE GO AHEAD. OKAY THANK YOU THANKS
COMMITTEE- VERY PLEASED TO BE
ABLE TO CONTRIBUTE TODAY TO THIS
VERY IMPORTANT HEARING I AM
RANDALL HAGER I REPRESENT THE
CALIFORNIA PHYSICIANS-
PSYCHIATRIC PHYSICIANS ALLIANCE
OF CALIFORNIA- AND AS SUCH YOU
KNOW WE ARE THE AUTHOR SPONSORS
EXCUSE ME OF SOME IMPORTANT BUT
LOOK LEGISLATION THAT I THINK IS
REALLY RELEVANT TODAY SO JUST
VERY QUICKLY YOU KNOW THE OTHER
WAS REFERENCED BY TOBY OF AB
FOUR SIXTY FIVE WHICH COLLECTS
DATA AND MAKES REPORTING
POSSIBLE. UNTIL SERVICE
PARTNERSHIPS- THAT IS ONE OF OUR
BILLS WITH SENATOR EGGMAN WOW WE
ALSO WHEN SPONSORED THE- THE US
IS NOT PATIENT TREATMENT-
AMENDMENTS AND S. B. FIVE OH
SEVEN I THINK IT IS FIVE ONE
SEVEN I'M SORRY- AND- WE ARE-
ALSO THE SPONSORS OF THE PENDING
BAIL IN THIS COMMITTEE SB- FIVE
SEVENTEEN WHICH ALLOWS- HEALTH
TO BE CONSIDERED IN IN TREATMENT
DECISIONS FOR GREAT DISABILITY
SO WE'VE BEEN VERY ACTIVE IN
THIS SPACE AND A LOT OF PEOPLE
ACTUALLY MADE SOME OF THE POINTS
THAT- WE WANT TO MAKE AND SO
WE'LL JUST SORT OF. HONOR THEM
KIND OF IN THE BREACH IF YOU
WILL- DOCTOR WOULD HAVE YOUR
WRIST YOUR COMMENTS ABOUT IT
NEEDING A SINGLE POINT OF
RESPONSIBILITY IN STATE
GOVERNMENT WE COMPLETELY AGREE
AND WE'RE GONNA RECOMMENDED THAT
INDEPENDENTLY IN ANY CASE- WE
ALSO- DO APPRECIATE THE REMARKS
IT'S GARLAND TERRA MADE ABOUT
RESOURCES FOR CONSERVATIVES AS
ABSOLUTELY CRITICAL. IN A WELL
FUNDED SYSTEM- DOCTOR SHARON'S
REMARKS ABOUT- CLARIFICATION OF
LPS CRITERIA OBVIOUSLY WERE
ACTIVE IN THAT SPACE WE BELIEVE
THAT HE IS ABSOLUTELY CORRECT
THAT GOING FORWARD WE DO NEED
SOME CLARIFICATION AND THEN THE
IMPORTANCE OF THE STATE- SEEKING
IN ADOPTING. MY AND YOU WAIT
FOR- TO DRIVE DOWN PAGE AND
SAMPLES FOR CARE. IN THE END-
WOULD HELP WITH MORGAN IN I AM
DE ASK WHICH THINK IS A- MEASURE
GOING FOR. SO WHAT SMOKE ON SOME
ISSUES HERE- AND I AND I WOULD
REMISS IF I DID. HONOR THE
TESTIMONY A JURY PASSED WE NEED
EARLIER THIS IS NOTHING SHORT OF
. INNER ECHOES- TO PSYCHIATRISTS
VERY STRONGLY. SO YOU KNOW I
THINK I'M ONE OF THE THINGS I
WANT ONE POINT YOU WANTED TO
MAKE WAS THAT IT YOU KNOW OUR
OUR OUR LPS SYSTEMS CRISIS
DRIVEN. AND TREATMENT SCHEELE OR
DRIVEN AND I THINK THAT'S NOT
TOO UNSURPRISING GIVEN THE
NATURE OF THE SYSTEM. I
PROVIDING EMERGENCY CARE UNDER
SITUATIONS OR PEOPLE ARE
DANGEROUS OR GRAVELY DISABLED
BUT- WHEN WE MAKE IS THAT- THAT
DEPENDS ON WAITING FOR DANGER I
THINK SOMETIMES FOR SOME
PATIENTS. WAITING FOR THAT THE
INTEREST TOO LATE- IT MAKES
OUTCOMES WORSE FOR PATIENTS.
YEAH IT DOESN'T HELP FAMILIES-
IT MAKES HAS NOT PROCESS SAID IN
A PSYCHIATRIST WAIT FOR ORDERS
TO TREAT WHILE WEEKS CAN GO BY
AND HOSPITALS. BEFORE TREATMENT
CAN ACTUALLY BE APPLIED THERE
ARE THERE A LOT OF DOWNSIDES TO
THAT SYSTEM WE UNDERSTAND THAT
THE NEEDS FOR. THE INVOLUNTARY
TREATMENT STANDARDS IN THE
PROTECTION OF INDIVIDUAL
LIBERTIES AND CIVIL RIGHTS. BUT
IT ACTUALLY EXAMINE THE ARK OF
INDIVIDUALS IN FRANCE AND SEND
UP IN STATE HOSPITALS- AND
THAT'S AN END POINT FOR MANY AND
THAT MEANS THAT IT'S EITHER A
LOW POINT- THE LOWEST POINT IN
THEIR PERSONAL HISTORIES. WHERE
THEY BURNED THROUGH RESOURCES IN
THE COMMUNITY THAT WERE ABLE TO
HELP THEM- AND IF YOU LOOK AT
THAT DATA ARC- YOU KNOW THROUGH
NO FAULT OF THEIR OWN AND IF YOU
LOOK AT THAT ARGUE CAN PROBABLY
IDENTIFY MANY MISSED.
OPPORTUNITIES FOR INTERVENTIONS
AND TREATMENT. AND IT THAT KIND
OF ALLOWS US TO THE HOLES. OF
ENTER- YOU KNOW THIS DIDN'T
REALLY. UP HERE. YOU KNOW
STRICTLY IN THE L. P. AND SPELL
THE INTRODUCTION OF THE ORIGINAL
A OF JESUS IS NOT PATIENT
TREATMENT OR LARA'S LAW STATUTE
IN TWO THOUSAND AND TWO. AND I
THINK THERE IS A PARADIGM THAT
WE COULD LOOK AT THAT MIGHT HAVE
WIDER APPLE APPLICABILITY. YOU
THINK ABOUT THE PARADIGM- IT'S
ABOUT- LOOKING AT A PERSON'S
HISTORY- AS THE BEST PREDICTOR
OF FUTURE CONSEQUENCES- SO
SOMEBODY HAS AS A- AIR T. ****
THE REQUIRED. TO INCIDENTS OF-
HOSPITALIZATION TO REST- WITHIN
A CERTAIN TIME OR ACTS OR
THREATS OF VIOLENCE. YOU CAN
PRETTY WELL YOU KNOW- ANTICIPATE
THAT IF THOSE KINDS OF THINGS
ARE GONNA HAPPEN AGAIN THEY'RE
GOING TO HAPPEN BECAUSE OF
PERSONS IN THE COMMUNITY THEY'RE
DETERIORATING THEY'RE NOT
RECEIVING AN ADEQUATE LEVEL
SERVICES AND THEY WILL HAPPEN
AGAIN. SO THAT'S AN EXAMPLE OF
HISTORY BEING ABLE TO ELL US
THAT THERE NEEDS TO BE CERTAIN
THRESHOLDS AFTER WHICH-
AUTHORIZATION IS- IS PROVIDED
FOR TREATMENT- AND ENDS SB FIVE
OH SEVEN- AND THANK YOU TO THE
CHAIR MEMBERS OF THE COMMITTEE
FOR PASSING THAT OUT THIS YEAR.
WE'VE IMPROVE THE ORIGINAL
STATUTES AND OUR THRESHOLD IS
BECOME AN INTERVENTION TO
PREVENT- A RELAPSE OR
DETERIORATION THAT WOULD LIKELY
RESULT IN GREAT DISABILITY OR
SERIOUS HARM TO OTHERS IS REALLY
IMPORTANT WE CAPITALIST TOOLS
THAT WE CAN GET UPSTREAM. WE CAN
MAKE THE INNOVATION INNOVATION-
OF EARLY INTERVENTION HAPPENED
WITHIN THE CONTEXT OF THE L. P.
S. I. THINK IT'S STILL VERY
VALID CONCERT. AND SO. LIKE TO
MOVE ON- TO THE WHOLE IDEA OF
ORDERED. THERE ARE A LOT TESTING
THIS LAST YEAR PARTICULARLY IN
BUDGET PROCESSES WHERE. WE
REALIZE THAT I DIDN'T ACTUALLY
PERSONALLY REALIZE THIS UNTIL
MUCH LATER THAT WE ACTUALLY HAVE
A LOT OF STATUTES ON THE BOOKS
THAT HELP INDIVIDUALS TWO BLACK
CAPACITY TO MAKE DECISIONS.
ABOUT MEDICATIONS THERE ARE
PROCEDURES AND STATUTES. THAT
HAVE BEEN ON THE BOOKS FOR A
WHILE THAT ALLOW MEDICATION TO
BE ORDERED FOR THOSE INDIVIDUALS
EVEN OVER THEIR OBJECTIONS AND
THAT'S IN AID OF A STABILIZING
THEM AND HELPING THEM- WILL
ALONG TO THE ROAD TO RECOVERY-
AND THOSE ARE NOT BEING USED IN
IN IN A COUPLE OF CNTEXT DOCTOR
CYSTS AND- MENTIONED THAT IN IN
PATIENT SETTINGS- WE HAVE
SOMETHING CALLED THE RESEARCHER.
AND THAT'S WHERE COURT CAST
CATASTROPHE- TO ACTUALLY MAKE
DECISIONS PARTICULARLY DECISION
TO REFUSE. MEDICATION AND- THERE
ARE I MEAN DID. THE THAT HE A-
IN HIS TESTIMONY AS WERE YOU
KNOW BASICALLY PSYCHIATRISTS AND
OTHER TREATMENT PEOPLE ARE
SITTING ON THEIR HANDS WAITING
FOR TREATMENT AND THAT WHEN A
PROLONGED STAYS IN IN PATIENT
SETTINGS IT PROLONGS THE
SUFFERING OF THE INDIVIDUAL IT'S
COST MORE FOR THE ARE
JURISDICTIONS ARE HAVING TO PAY
FOR THAT CARE. AND YOU KNOW
THERE AE WAYS THAT WE CAN THINK
ABOUT HOW TO REDUCE THE TRYING
TO GET AND A DETERMINATION ABOUT
WHO HAS CAPACITY DOESN'T AND ONE
OF ONE OF THE SUGGESTIONS OF THE
LPS REFORM TASK FORCE- ADDITION
TO REPORT- IN TWO THOUSAND
ELEVEN WAS TO TELESCOPE. THE
WHOLE IDEA OF A PROBABLE CAUSE
HEARING ALONG WITH THE CAPACITY
DETERMINATION SO THAT YOU YOU
INITIATE THESE THINGS BUT THEN
HOURS OF AN INDIVIDUAL- BEING-
BROUGHT TO A FACILITY- WORK WHEN
THEY'RE IN THE PROCESS OF BEING
EVALUATED FOR ADMISSIONS ON A
FIFTY ONE FIFTY YOU ALSO DO IT
CAPACITY PASS AND YOU CAN START
A PROCESS THERE MUCH EARLIER TO
GET NEEDED NECESSARY APPROPRIATE
MEDICATIONS. TO AN INDIVIDUAL
APPROPRIATELY SO THAT YOU CAN
ALLEVIATE SUFFERING YOU CAN
REDUCES DAY YOU CAN HAVE MORE
THROUGH PET- HAVE MORE
EFFICIENCY IN THE USE OF THE
BEDS YOU HAVE BY SERVING MORE
PEOPLE. SO IT'S SOMETHING TO
KEEP IN MIND- THEY THE NEEDS I'M
GONNA MOVE ON HERE TO ANOTHER
POINT THE OVER. AND SINGLE POINT
OF RESPONSE- TO CHAIRMAN LLOYD-
IS REALLY CRITICAL- I THINK WE
LOST SOME OF THAT WILL BE LOST
THE OLD DEPARTMENT AND HEALTH.
AND I'M AND I'M NOT SURE SURE
THAT WE SHOULDN'T BE REVISITING
THAT ISSUE DO WE NEED WHAT ARE
THE RESPECT TO ARE VERY CAPABLE
AND DEDICATED- STAFFING
DEPARTMENT HEALTH CARE SERVICES.
YOU KNOW WE REALLY NEED AGENCIES
THAT CAN PROVIDE- WHAT IS IN MY
VIEW NT BEING PROVIDED NOW TO
GIVE YOU AN EXAMPLE- WORKING
WITH- THEN ASSEMBLY WOMAN EGGMAN
IN TWO THOUSAND FIFTEEN WE
PASSED AB ELEVEN FOUR. AND THAT
CHANGED A LITTLE BIT NINE IT WAS
A CLARIFICATION OF WHAT DANGER.
IN THE LPS. AND WE SAID
BASICALLY IT DOESN'T IT'S NOT
CONFINED IT WAS NEVER INTENDED
TO BE CONFINED. TO THE CONCEPT
OF IMMINENT DANGER NEW YORK WE
NEED TO TAKE INTO ACCOUNT
HISTORY. HISTORY WILL TELL YOU
WHETHER OR NOT YOU HAVE SMEBODY
IN FRONT OF YOU WHO MAY BE ON
THE EDGE OF BEING DANGEROUS EVEN
THOUGH THEY'RE NOT READY TO
THROW A BRICK THROUGH. THE
WINDOW THEY DON'T. HAVE A
BASEBALL BAT OR THEY'RE NOT
SPREE AND- IN CHESTER AGAIN LAW
. OKAY SO WE HAVE THIS. ON THE
BAR. AND IT TURNS OUT THAT THIS
IS ONE OF THE BEST KEPT SECRETS
IN STATE I GET. ONE FORSMAN
AGENCY TRAINING OFFICERS COME UP
TO ME AND SAY CAN YOU EXPLAIN TO
ME WHAT THE STATUTE MEANS HOW DO
I TRAIN TO THIS. SO IT RAISES
THE QUESTION THE LARGER
QUESTION. OF WHO PROVIDES THE
GUIDANCE THAT IS NEEDED OUT
THERE FOR IN THIS INSTANCE.
THOSE AGENCIES WHAT DOES THAT
MEAN POWER THAT YOU IMPLEMENT
LAW. AND WE HAVE TO RECOGNIZE
THAT NO MATTER HOW MANY
STATUTORY TWEAKS THAT WE MAY. TO
THE L. P. S. THE IMPLEMENTATION
IS NINE TENTHS OF BIG. I'M AND
IN MY VIEW THE VIEW OF SKY WE
NEED A SINGLE OR A POINT OF
AUTHORITY. WITHIN STATE
GOVERNMENT TO ENSURE THAT
THERE'S A CONSISTENT APPLICATION
OF THE LAW. AND WE SEE THAT AS A
PROBLEM FROM COUNTY TO COUNTY AS
WELL AS WITHIN COUNTIES- NEEDS
TO BE SOMEONE TO PROVIDE
INFORMED GUIDANCE TO LOCAL
AUTHORITIES TECHNICAL ASSISTANCE
TO COUNTIES- SURE FUNDING AS
WELL SPENT AND ANALYSES. OF DATA
ON HOW CAN BE BETTER SPENT- TO
DO THAT WILL BE CRITICAL AND
NECESSARY DATA COLLECTION. SO
LET ME END ON THIS FINAL POINT
BECAUSE ADULTS IT TAKES THAT
POINT A BIT FURTHER- WE'RE VERY
I WAS VERY GRATEFUL THAT
ASSEMBLY WOMAN- REYES PRODUCT.
THE DATA ISSUE AND IT'S ACTUALLY
SOMETHING WE WORK WITH SENATOR
EGGMAN ON IT AS YOU YOU KNOW
WHEN SB. FOUR SIXTY FIVE. SO IN
ADDITION TO THE CAN. AND QUALITY
OF REPORTS. THAT COUNTY SANTA
THE STATE I THINK WE ALSO NEED
TO COLLECT THESE SORTS OF DATA-
THERE'S ALSO BEEN COMMENTS ABOUT
HOW YOU KNOW WE NEED. TO
INSTITUTE SOME SORT OF SYSTEM
WORD THERE IS INFORMATION
SHARING. BETWEEN SYSTEMS FOR
INSTANCE THE H. C. S. AND- DOJ
BUT SOME SOMETIMES- YOU KNOW I
KEEP WISHING THAT THERE WAS
ANOTHER SOURCE OF DATA ALL
TOGETHER. AND YOU CAN LOOK AT IT
THIS WAY THIS DATA THAT'S NOW
REQUIRED SIMPLY PROVIDES AS A
LEASE- FOR- THE DATE I'M
THINKING ABOUT THAT COUNTY
SUPPLIED TO DH. INTERESTS
SUPPLIES SIMPLE AGGREGATE A RAW
NUMBERS FOR THE NUMBERS OF
INDIVIDUALS WHO ARE ON HOLDS.
CHAO'S SACRAMENTO COUNTY MAY
HAVE ON THE ANNUAL RATE OF
PUTTING. EIGHT HUNDRED PEOPLE ON
CONSERVATORSHIP MA'AM DONE TEN
THOUSAND FIFTY ONE FIFTIES. AND
YOU KNOW THAT'S INTERESTING BUT
WHAT DOES IT REALLY TELL YOU. I
THINK DATE BETTER DATA WOULD
TELL US AT THE FRONT END. YOU
KNOW HOW MANY FIFTY ONE FIFTIES
WERE ACTUALLY WRITTEN SO THAT
THERE IS A DETENTION. AND
TRANSPORT AND THEN ARE
ULTIMATELY HELD WHEN THEY WERE
PRESENTED AND FACILITY. AND THE
FACILITY SAYS WE AGREE WITH YOU
THEY MAKE GREAT TERRY I. WOULD
LIKE TO IN- WAR THE CONVERSE HOW
MANY- ARE NOT- BACK BE A-
IMPORTANT SAID FOR PAUL INDOOR.
AND ALL. BETTER TO THE SERVICE
JUNIOR- CONSUMERS AND THAT. SO I
THINK WE DO NEED- MORE DATA TO
TELL US MORE ABOUT QUALITY I'M
IN THE FIELD- YOU COULD DO THE
SAME THING ON THE BACK AND YOU
KNOW YOU CAN TALK ABOUT
CONSERVATORSHIP RIGHT NOW. YOU
KNOW WHEN PEOPLE ARE RELEASED
FROM INSURGENTS LET YOU NOW IS
THAT THAT'S A REDUCTION OF ONE
PERSON. AND YOU ASSUME THAT%
THEY'RE NOT GREAT DISABLED IT
MORE BECAUSE THAT'S THE CRITERIA
THAT'S LAW DEMANDS FOR RELEASE
BUT WHAT ELSE DO YOU KNOW ABOUT
THAT AND WHAT ELSE DO YOU KNOW
ABOUT THAT PERSON- M. AND THEN
THE ANSWER IS NOT NOTHING AND SO
HOW DO WE BEST SERVE THAT
INDIVIDUAL. THERE'S A LINKAGE IS
THERE THAT ARE REALLY MESSED UP
AND WILL HELP US ONSELEN. SO
THANK THANK YOU WE NEED TO WE TO
MOVE HERE. OKAY I APOLOGIZE YOUR
FIVE MINUTES WANTED TO TWELVE SO
I. OKAY COLLEGES THANK YOU SO
MUCH FOR YOUR FOR YOUR FOR YOUR
TESTIMONY WEEK AND THERE IS AN
URGENCY HERE WE WE'VE GOT WHEN I
HEAR FROM OUR CHIEF AND THEN WE
DO HAVE. TO REARRANGE OUR
GENERATOR HIMSELF SO PLEASE
CHIEF COURT GO AHEAD AND THANK
YOU VERY MUCH. THIS TTK JOHNSON
THE CHIEF THE LODI. OF FIRE
DEPARTMENT CALVET AND ALSO
ACCOUNT FOR CALIFORNIA
PROFESSIONAL FIREFIGHTERS THANK
YOU SIR THANK YOU FOR HAVING ME
TODAY I APPRECIATE THIS
OPPORTUNITY SPEECH YOU GUYS ON
BEHALF OF THE FIRE SERVICE AND
THE CALIFORNIA FIRE SERVICE. A
LISTENING TO MANY OF THE
PRISONERS TODAY AYE AYE WE TOOK
SOME NOTES DOWN SOME OF THINGS
THAT I WAS LISTENING TO AND IT
WAS EDUCATION FOR ME. AND UN
UNFORTUNATELY FROM THE FIRE
SERVICE PERSPECTIVE AND WE'RE
NOT SEEING AN IMPROVEMENT WHEN
IT COMES TO DEALING WITH THOSE
WHO HAVE MENTAL HEALTH ISSUES OR
OR SITUATIONS OR CRISIS. IN FACT
RECEIVED THE COMPLETE OPPOSITE
WE'RE SEEING AN INCREASE IN WHO
ARE RESPONDING TO. AND IF WE
HAVE TO USE NINE ONE ONE AS THE
INITIAL ACCESS TO HEALTH CARE OF
MENTAL HEALTH CARE. WERE ALREADY
FAILING. OUR FOLKS RT QUIPPED OR
TRAINED TO HANDLE THESE
SITUATIONS DE ESCALATION IS
SOMETHING THAT'S NEW TO THE FIRE
SERVICE AND UNDERSTANDING IT.
AND IF WE WANNA GET TO HAVE THIS
PROBLEM WE'RE AT THE START RIGHT
THERE. YOU SEE CALIFORNIA
ALREADY HAS A BUSY EMS SYSTEM.
ABALONES WAIT TIMES ARE ON THE
RISE THIS IS IN PART TO WHAT WE
CALL A POT TIMES AND THOSE
PATIENT OFTENTIMES AT THE
HOSPITALS WHERE PATIENTS
LITERALLY ARE WAITING FOR A BED-
BECAUSE ALL THE OTHER BEDS ARE
FULL. AND WHAT THAT MEANS IS
THAT PATIENT WHO CAME TO THE
HOSPITAL AN AMBULANCE. IS NOW
WAITING ON AMBULANCE GURNEY AND
THAT AND BILLS ITSELF IS NOW
STUCK AT THE HOSPITAL UNTIL
CLEARED. WHAT PEOPLE ARE
REALIZING IS NINE ONE ONE STILL
CONTINUES ON THE BACKSIDE. OTHER
PEOPLE ARE CALLING NINE ONE ONE
FOR CARDIAC ARRESTS AND STROKES
AND ASTHMA TYPE CALLS. AND WHAT
WE SEE IS THAT THOSE PATIENTS
ARE GETTING TREATED QUICKLY
BECAUSE WE DON'T HAVE THE
AMBULANCE TO BE TRANSPORTED
TRANSPORTED THAT- THOSE THAT.
THOSE SICK AND INJURED A
HOSPITAL. SO THAT I DON'T THINK
IT DOES IDENTIFY OFTEN. IS WHEN
WE SAID FIREFIGHTERS TO THESE
THESE TYPES OF CALLS. WHICH
SHOULD BE SEEN BY A CLINICIAN OR
SOME OUTPATIENT THERAPY. WE
START TO ERODE AT THE
FIREFIGHTERS OF MENTAL WELL
BEING FOR DELIVERING THE
SERVICES YOU SEE THEY GET THERE
THEY RESPOND THEY PROVIDE THE
BASIC OF NEEDS BASIC LIFE
SUPPORT ADVANCED LIFE SUPPORT.
THE TAKE THE PATIENT TO THE
HOSPITAL AND THE VERY NEXT DAY
THEY SEE THE SAME PATIENT. AND
THEN THE NEXT DAY THEY SEE THE
SAME PATIENT AGAIN MORE TIMES
THAN NOT WHEN PEOPLE ARE IN
CRISIS THE USED THE NINE ONE ONE
AS THE DIRECT ACCESS TO HEALTH
CARE. WE SEE THAT ROUTINELY. AND
WHAT I'VE BEEN LISTENING TO THE
GROUP FOR AS FAR AS WE'RE
LOOKING FOR SOME SOLUTIONS WHAT
CAN WE DO TO MAKE THINGS BETTER.
WELL I WROTE DOWN TO SOME SIMPLE
THOUGHTS. THE CALIFORNIA MERCY
MEDICAL SERVICES AUTHORITY MSA.
REGULATES THEIR REGULATORY
AUTHORITY THROUGH THEIR LENSES
AND LOCAL IMMERSION MEDICAL
SERVICES THIRTY. LENSES OFTEN
TIME RESTRICT FIRE DEPARTMENTS
PROVIDING BASIC LEVELS OF
SERVICES BASED UPON THEIR THORNY
SPEAKING SPECIFICALLY TO AB
FIFTEEN FORTY FOR THE COMMUNITY
PARAMEDICINE BILL. WHERE IT ALSO
HAS PART OF IT AND ALTERNATIVE
DESTINATION. THE FIRE SERVICE
MORE TIMES THAN NOT IN
CLIFORNIA IS THE TIP OF THE
SPEAR FOR HEALTH CARE. WE ARE
GOOD AT TRIAGE AND WHAT TRIAGE
MEANS IS TO SORT WE DO IT RIGHT
NOW FOR TRAUMA PATIENTS ARE
BURNED PATIENTS ARE PEDIATRIC
PATIENTS. THIS IS ANOTHER
ELEMENT OF OUR DEPLOYMENT. THE
FIRE SERVICE OFTENTIMES PIVOTS
BASED UPON THE COMMUNITY NEED
WELL THIS I'M TELLING YOU TODAY
IS THE COMMUNITY THERE IS A
MASSIVE MENTAL HEALTH CRISIS. WE
SEE IT ALL THE TIME. WHAT WE'RE
DOING IS NOT WORKING. WE NEED TO
MAKE A CHANGE I THINK WE COULD
LEVERAGE THAT COMMUNITY
PARAMEDICINE BILL AND ALLOW FIRE
DEPARTMENTS. TO PROVIDE THAT
TRIAGE. TO HELP SOLVE THESE
PROBLEMS AND TAKING THOSE
PATIENTS OUT OF THE EMERGENCY
ROOM. ADDITIONS THAT I THINK WE
NEED TO BRING TRAINING FROM THE
STATE LEVEL DOWN FOR DE
ESCALATION AND UNDERSTANDING
MENTAL HEALTH CRISIS. FUNDING IS
GOING TO BECOME KEY BECAUSE
THESE PROGRAMS ARE RUN ARE GONNA
REQUIRE SOME TYPE OF FUNDING
MECHANISM TO MAKE THEM HAPPEN.
AND THEN ALSO ASK. THERE'S A
SAFETY COMPONENT TO THIS AS WELL
. WHEN FIRST RESPONDERS POLICE
FIRE IBM IS COMPANIES RESPOND ON
THESE TYPES OF CALLS OFTENTIMES
THERE'S A WEAPON INVOLVED
THERE'S A FIRE THERE'S OTHER
EXTENUATING CIRCUMSTANCES THAT
NEEDS TO BE PART OF THIS
CONVERSATION SO THAT WE
UNDERSTAND THE TOTALITY OF THE
MENTAL HEALTH CRISIS HERE IN
CALIFORNIA. SO I THINK YOU FOR
THE OPPORTUNITY TO SPEAK AND
ANSWER ANY QUESTIONS YOU GUYS
MIGHT HAVE. THANK YOU VERY MUCH
CHIEF APPRECIATE APPRECIATE YOUR
THOUGHTS- ANY QUESTIONS OR
COMMENTS AND- I'M GONNA- FROM
SHELTER BETTER YOU HAD MENTIONED
THE MOBILE CRISIS FOR
PSYCHIATRIC AND BEHAVIORAL
HEALTH AND THE NEED FOR US TO
HAVE PARITY. I WAS HOPING YOU
COULD PROVIDE ANOTHER LEVEL OF
DETAIL AS WELL AS- NOTICED THAT
OUR STATE IS GOING TO BE
IMPLEMENTING A NEW NINE EIGHT
EIGHT SYSTEM BY JUNE OF NEXT
YEAR AND WHAT ROLE THAT NINE
EIGHT EIGHT SYSTEM COULD
POTENTIALLY HAVE WITH THE MOBILE
CRISIS UNIT. THANK YOU FOR THE
QUESTION- ASSEMBLY MEMBER ADAM
BLAST SO I WILL TAKE THIS- IN
TWO PARTS FIRST- EFFECTIVE JULY
ONE OF NEXT YEAR- PHONE USERS
WILL BE ABLE TO DIAL OF AN EASY
THREE DIGIT NUMBER NINE EIGHT
EIGHT TO ACCESS TE NATIONAL
SUICIDE PREVENTION LINE. AND
THAT IS THE CHANGE THAT'S BEING
USHERED IN- PURSUANT TO FEDERAL
LAW NEXT YEAR- I THINK IT'S
IMPORTANT TO KNOW THE STATE OF
CALIFORNIA WENT ABOVE AND BEYOND
AND HAS PROVIDED TWENTY MILLION
IN FUNDING FOR THOSE NINE EIGHTY
CALL CENTERS. WE HAVE THIRTEEN
OF THEM ACROSS THE STATE TWO OF
THEM ARE RUN BY A COUNTY
BEHAVIORAL HEALTH DEPARTMENT AND
THEY ARE PROVIDING EMOTIONAL
SUPPORT TO PEOPLE WHO HAVE MAY
HAVE SUICIDAL IDEATION I
OFTENTIMES THEY ARE STAFFED BY
VOLUNTEERS AND THAT SORT OF
THING SO. IT'S A VERY IMPORTANT
SERVICE IT'S ONE THAT COUNTY
BEHAVIORAL HEALTH FUNDS- EVEN
WHEN WE'RE NOT RUNNING THIS CALL
CENTERS- AND IT'LL REALLY HELP I
THINK FOR PEOPLE WHO ARE IN A
TIME OF CRISIS TO HAVE AN EASY
TO REMEMBER NUMBER TO DIAL. I
THINK WHAT'S CHALLENGING IS THAT
OFTENTIMES THAT CONVERSATION IS
CONFLATED WITH AN EXPECTATION OR
HOPE THAT WE ARE GOING TO
SOMEHOW ALSO MAGICALLY MANIFEST
A BRAND NEW. PARALLEL TO EMS AND
LAW ENFORCEMENT SYSTEM OF
BEHAVIORAL HEALTH MOBILE CRISIS
RESPONSE WHICH I WILL JUST SAY
WE HAVEN'T DONE THAT YET WE HAVE
NOT CREATED THE INFRASTRUCTURE
THE STRUCTURES LIKE THE PARALLEL
LIMB SO IF THAT'S WHAT YOU WANT
TO CREATE. OR THE MOBILE CRISIS
INFRASTRUCTURE IN A CONSISTENT
WAY THROUGHOUT THE STATE AND
THIS GOES BACK TO SOME OF WHAT I
WAS TALKING ABOUT WITH THE EARLY
COMMUNITY MENTAL HEALTH FUNDING
STRUCTURE. COUNTY SOME COUNTIES
HAVE BEEN DOING MOBILE CRISIS
FOR DECADES NOW THEY'RE VERY
EXPERIENCED BUT THERE IS NO WAY
FOR US TO CONSISTENTLY FUNDS
THOSE MOBILE CRISIS SERVICES
BECAUSE THERE'S NOT A DEDICATED
FUNDING STREAM IT'S NOT A-
SPECIFIC BENEFIT FOR EITHER
MEDICAL OR- COMMERCIALLY INSURED
INDIVIDUALS. AND SO KIND OF
PATCH WORKING IT TOGETHER AND
THEN OTHER STAKEHOLDERS GET VERY
FRUSTRATED BECAUSE THEY SAY WELL
THERE'S ALL THIS VARIATION
COUNTY EXCESSIVE THE COUNTY WHY
DOESN'T AND THAT'S WHAT HAPPENS
WHEN YOU. GRANT AN ENTIRE SYSTEM
WHEN YOU MAKE IT BASED ON
COMPETITIVE GRANTS. OR VERY
LIMITED FUNDING AND SO IF WE
WANT TO CREATE THAT MOBILE
CRISIS SYSTEM IN CALIFORNIA AND
ESPECIALLY IF WE WANT IT
AVAILABLE TO ALL CALIFORNIANS
REGARDLESS OF THEIR INSURANCE.
WE HAVE A LONG WAY TO GO BUT WE
CAN GET THERE IF THAT'S WHAT WE
CHOOSE TO DO FROM A POLICY
PERSPECTIVE AND I THINK THAT THE
DEMAND. ADD TO THE CHIEFS
POINTS. IS REALLY THERE FOR
SOMETHING MORE IN THAT SPACE-
YOUR STATEMENT REGARDING PARITY
IS SOMETHING WE AS A STATE
THOUGH SHOULD NOT FORGET THAT
THERE IS NO DIFFERENCE BETWEEN A
MEDICAL OR PSYCHIATRIC
EMERGENCY. AND THE NEED FOR US
TO PROVIDE THOSE CRISIS SERVICES
IN THOSE TIMES OF NEED IS
IMPERATIVE PROCESS THE STATE SO.
I LOOK FORWARD TO FOLLOW UP
CONVERSATIONS AND ANY DATA YOU
MAY HAVE FROM THOSE COUNTIES
WHICH HAVE HAD PROGRAMS. UP AND
RUNNING FOR A WALK THANK YOU.
THANK YOU VERY. DESERVES COMMENT
ON A COMPLETELY AGREED THAT WE
HAVE AN OPPORTUNITY TO REALLY
RETHINK THAT SYSTEM AND SHIFT
THE RESPONSIBILITY FROM. LAW
ENFORCEMENT IN THE FIRE SERVICE
TO EIGHT A BETTER RESPONSE BUT
IF YOU LOOK AT THE HEARINGS ON
THE BILL AS IT WENT THROUGH LAST
YEAR I THINK THERE'S A LOT OF
CONFUSION ABOUT WHAT IT
REPRESENTED. BUT IN REALITY FOR
COUNTIES OF LOCAL PROVIDERS IT'S
A LOT CHEAPER TO FIND
APPROPRIATE RESPONSES INSTEAD OF
JUST PUTTING EVERYBODY
FORTUNATELY THE SAME. BRACKET
WHERE WE HAVE NOT PROVIDED
ADEQUATE RESPOND TO CROSS THE
BOARD FOR MENTAL HEALTH SERVICES
SO IT IT'S IT WAS A LITTLE
FRUSTRATING WATCHING
CALIFORNIA'S RESPONSE AND
UNFORTUNATELY WE'RE GOING TO END
UP WHERE DIFFERENT COUNTIES ARE
GOING TO HAVE DIFFERENT
RESPONSES UNLESS A STATE STEPS
IN AND IMPROVISES STANDARD.
FUNDING IN IN THE SENSE OF WHAT
THOSE RESOURCES ARE SO WE HAVE
AN OPPORTUNITY IN FRONT OF US
AND THERE WILL BE BUILDING GOING
THROUGH THIS YEAR TO TRY AND
EXPAND THE AMOUNT OF MONEY
BECAUSE THAT AMOUNT OF MONEY
THAT IS PUT ON THE TABLE TO
REALLY PALTRY COMPARED TO WHAT
THAT INVESTMENT COULD BE. AND
THE BENEFIT IF I MAY UM CHAIR
STONE I MEAN I THINK ONE THING I
DO WANT TO CALL OUT BECAUSE IT
IS A LEGAL ISSUE IS THAT- YOU
KNOW WE ARE REQUIRED IN TERMS
OF- HOSPITALS AND EMERGENCY
DEPARTMENTS DOCTORS SELLERS
SPOKE TO THIS HOSPITALS ARE
REQUIRED TO TAKE PSYCHIATRIC
EMERGENCIES THERE IS UNDER THE
LAW FEDERALLY AND STATE LAW NO
DISTINCTION DR ARAMBULA JUST
MENTION THAT. AND SO I DO THINK
THAT WE NEED TO BE CAREFUL
BECAUSE CERTAIN PHYSICAL HEALTH
CONDITIONS AND THE PHYSICIANS IN
THE ROOM CAN SPEAK TO THIS
BETTER THAN I CAN ME UP HERE
INITIALLY TO BE A PSYCHIATRIC
EMERGENCY OR OR SITUATION BUT
THEY MAY ACTUALLY BE A PHYSICAL
HEALTH NEED THAT THAT HAS TO BE
REVIEWED BY A AND M. D. AND
THAT'S WHY OUR EMERGENCY
DEPARTMENTS ARE ACTUALLY A
REALLY IMPORTANT BACKSTOP AND WE
CANNOT. ENTIRELY DIVORCE WHAT IS
WHAT IS OUR PHYSICAL HEALTH
SYSTEM SO TO SPEAK AND OUR
BEHAVIORAL HEALTH SYSTEM WE NEED
MORE SPECIALTY CARE ACCESS WE
NEED MORE SPECIALIZATION IN
BEHAVIORAL HEALTH INSIDE OUR
HOSPITALS INSIDE OF OUR EMS
SYSTEMS INSIDE OF OUR STATE
FRANKLY BUT WE ALSO. DO NEED TO
BUILD OUT MORE SPECIALIZATION
BOTH WITHIN OUR PUBLIC DELIVERY
SYSTEM FROM MEDICAL MANAGED CARE
THROUGH TO MOVE FAR MORE
SERVICES AND OUR SPECIAL TEAMS
SAFETYNET AND THEN IN THE
COMMERCIAL SIDE AS WELL SO I
THINK THAT THE BIGGEST MESSAGE
HERE IS EVERYBODY NEEDS TO HAVE
A PART OF THIS AND EVERYBODY'S
GOING TO HAVE TO GO THROUGH THAT
KIND OF EDUCATION THAT THE-
CHIEF WAS TALKING ABOUT. CORRECT
AND I WAS REALLY TALKING TO THE
INITIAL CONTACT BECAUSE WE DON'T
HAVE WITH SOMEBODY'S IN CRISIS
AND THEY CALL THE POLICE SO THEY
CALLEDTHE FIRE DEPARTMENT WHO
ARE MORE USED TO DEALING WITH
PHYSICAL. ALMONDS THE IN THE
HOSPITAL SHOULD NOT BE
DISTINGUISHING AND SHOULD BE
ADEQUATELY TRAINED FOR BOTH
PHYSICAL MENTAL THERE SHOULD BE
THAT THE DIFFERENCES THAT WE
HAVE. BUT IF WE HAD. A BETTER
WAY FOR SOMEONE WHO IS IN. AN
EMOTIONAL OR MENTAL CRISIS. TO
THEN GET INTO THAT SYSTEM THAT'S
REALLY WHAT I WAS TALKING ABOUT
THAT THAT THAT ENTRY SO THAT
THERE ARE. LIKE FIREFIGHTERS WHO
WERE TRAINED.FOR FIRES IN FOR
CERTAIN TYPES OF MEDICAL
EMERGENCIES HAVING AN
APPROPRIATE PERSON ON THE OTHER
END OF THAT LINE TO FIGURE OUT
WHAT THAT INDIVIDUAL NEEDS AND
THE DISPATCH APPROPRIATE AND
APPROPRIATE RESPONSE. IS ONE
PIECE THAT WE'RE MISSING. THANK
YOU THANK YOU VERY MUCH AND
THANK YOU AGAIN TO THE PANEL
MUCH APPRECIATE YOUR YOUR
EXPERTISE AND YOUR TIME WITH US
HERE TODAY SO THANK YOU. WE'RE
GOING TO GO OUT ORDER A LITTLE
BIT OF A TO TURN THIS OVER TO
MY- MY- CO CHAIR HERE. WE'RE
GOING TO ACTUALLY MOVE DOWN TO-
PANEL C. JUST FOR ONE WITNESS
AND THAT IS- MAYOR MAYOR DARRELL
STEINBERG SO I'LL LET YOU TAKE
SO YES OKAY SO THE NEXT LEGAL
PANEL IF YOU JUST HOLD ON A
MINUTE WE WILL TRY AND- TAKE.
THEIR STEINBERG OUT OF ORDER HE
HAS THE SITUATION AND HE'S
DEALING WITH AND- I THINK THIS
WILL BE MORE EXPEDITIOUS SO IS.
THERE A TIME BERMAN A LOT. YEAH
I AM MISTER CHAIRMAN CAN YOU
HEAR ME WE CAN YOU HAVE FIVE
MINUTES ARE UP. I GOT FIVE
MINUTES VERY GOOD THANK YOU FOR.
YOUR FLEXIBILITY IN
ACCOMMODATING ME I HAVE THE- OF
THE SITUATION AND DEAL WITH BUT
I DID NOT WANT TO MISS THIS
TODAY I WANT TO THANK. THE
CHAIRMAN STONE IN SHERMAN WOULD
NOT ONLY ARE THEY TEARING BUT
FOR THE SEVERAL CONVERSATIONS.
THAT WE HAVE HAD ON THIS
SUBJECT. I'LL GET RIGHT INTO IT-
I SPEAK I SUPPOSE IS THE MAYOR
OF SACRAMENTO IS THE- FORMER
STATE SENATE LEADER AND THE
AUTHOR OF BOTH THE MENTAL HEALTH
SERVICES ACT WE NEED AUTHORS
WELL AS S. B. EIGHTY TWO WHICH
WAS- THE LARGE INVESTMENT IN
CRISIS- INTERVENTION. IN
CALIFORNIA IN TWO THOUSAND AND
THIRTEEN- IT'S PROBABLY NO
SURPRISE TO HEAR ME SAY THAT
WHILE CONVENTIONAL WISDOM. SAYS
THAT ONLY INCREMENTAL CHANGES
POSSIBLE. IN THE LEGISLATURE.
THAT THE BROKEN NATURE OF THE
MENTAL HEALTH SYSTEM THE
FRAGMENTATION OF THE MENTAL
HEALTH SYSTEM. E. INABILITY OF
PEOPLE TO ACCESS TIMELY CARE.
THE AMOUNT OF SUFFERING MAKES
BOLD AND FUNDAMENTAL CHANGE THE
ONLY REAL CHOICE I CAUGHT THE
END OF THE LAST PANEL WE'RE
TALKING ABOUT NINE EIGHT EIGHT
AND CRISIS CARE AND HEARD FROM-
MICHELLE COMBAT AS WELL AS- THE
FIRE CHIEF NINE EIGHT IS REALLY
IMPORTANT ISSUE. AND YET IT IS
ONE PIECE. OF THE FIFTH IT
NEEDED FOR OUR MENTAL HEALTH
SYSTEM. HOLDEN FUNDAMENTAL
CHANGE IS THE ONLY CHOICE AND I
BELIEVE THE TIME FOR THAT IS NOW
BOTH. YOU JUST GO OUT JUST THAT
WHEN WE GET PROPOSITIONS
DIRECTED TWO THOUSAND AND FOUR
WELL WE WON THE ELECTION- MENTAL
HEALTH NEVER PLACED AT THE TOP
OF THE PUBLIC CONCERNS NOW
MENTAL HEALTH HOMELESSNESS OUR
TOP ANY AND EVERY SINGLE PUBLIC
OPINION POLL THAT IS DONE IN
CALIFORNIA IN ANY OF OUR MAJOR
SIT. IN TERMS WHAT THE PUBLIC IS
CONCERNED ABOUT TODAY'S TOPIC I
KNOW IS LPS. AND THE BULK OF THE
DISCUSSION I SUPPOSE WILL BE ON
WHETHER AND HOW TO TREAT
INVOLUNTARY COMMITMENT STANDARDS
IT'S AN IMPORTANT AND LEGITIMATE
DISCUSSION OF COURSE. I DON'T
BELIEVE THAT THE LEGISLATURE
SHOULD UPDATE THE DEFINITION OF
RAPE THE BILL YOU TO CONFORM. TO
BOTH THE REALITIES AND THE
EXTENT OF THE HOMELESS CRISIS.
AND TO CONFORM TO JUST PLAIN
COMMON SENSE I KNOW YOU WILL
HEAR IF YOU HAVEN'T ALREADY FOR
DOC. SHARE IN THE L. A. COUNTY
MENTAL HEALTH DIRECTOR WHO I
THINK IS- DOES A VERY IMPORTANT
THINKING. ON REDEFINING GRAVE
DISABILITY TO ENSURE THAT IT
FIND NOT JUST IN A MOMENT'S TIME
WHEN AN INDIVIDUAL WHO MAY BE
SUFFERING FROM STE YOUR MENTAL
HEALTH AND PHYSICAL HEALTH
ISSUES CAN PRESENT THEMSELVES IN
A WAY TO SAY THAT THEY'RE
GREATLY DISABLED IT NEEDS TO BE
A DEFINITION THAT ACTUALLY
CONFORMS TO. I SITUATION OF
THEIR LIVING OUTDOORS SIX
BASICALLY AND MENTALLY AND IT'S
BEEN OUT THERE FOR A LONG TIME.
THE DEFINITION OF GREAT
DISABILITY SHOULD ALLOW ABOUT US
AS A SOCIETY BE ABLE TO HELP
THEM VOLUNTARILY YES FIRST BUT
IT'S NOT TO SAY EVERY UP. IN
WHAT WAY BECAUSE LIVING ON THE
STREETS IS PLAYING AN ACCEPTABLE
IN THE CURRENT DEFINITION. AND
AT LEAST ITS INTERPRETATION DOES
NOT CONFORM TO THE REALITY IN MY
VIEW OF THE SUFFERING OUT THERE
BUT I WOULD USE THE REMAINDER OF
MY TIME IF I'VE GOT TWO OR THREE
MINUTES LEFT. THE FLIP THE
CONVERSATION ON ITS HEAD. AS YOU
KNOW- A LEGAL RIGHT TO HOUSING.
BECAUSE I BELIEVE THAT A LEGAL
RIGHT TO HOUSING. WOULD FORCE
PUBLIC AND PRIVATE STAKEHOLDERS.
TO BUILD MORE TO PRODUCE MORE
SHELTER TO PRODUCE MORE HOUSE.
IN A WAY THAT WOULD BETTER MEET
THE NEEDS THE LAW CURRENTLY SAYS
THAT NO CITY NO COUNTY. NOR THE
STATE DESPITE THE LEADERSHIP THE
GOVERNOR AND THE LEGISLATURE PUT
MORE MONEY THAN EVER AN EASY
ISSUES WE ARE NOT REQUIRED. HE
SAID. AND ALL OF THE OBSTACLES
WHETHER IT BE ISM EXCESSIVE
LOCAL CONTROL OVER REGULATION.
EXCESSIVE COST LACK OF HOUSING
INNOVATION ALL ARE MORE POWERFUL
. THEN THE MORAL OBLIGATION TO
BUILD MORE BECAUSE THERE'S NO
LEGAL OBLIGATION THAT CAN HELP.
THOSE OBSTACLES SOME CRITICS
MADE THAT FOR MANY OUT ON THE
STREET. L. ELLIS HOUSING ISN'T
HE ISSUE MENTAL HEALTH IS ALL
RIGHT- THE CITY MAYOR HOUSING IS
THE BEST PROXY I HAVE FOR
HELPING PEOPLE WITH MENTAL
HEALTH THAT'S YOUR MENTAL HEALTH
ISSUES ARE OUT ON THE STREET
BECAUSE- CITIES DON'T. PROVIDE
MENTAL HEALTH CARE. IT'S A THIS
IS THE MAIN POINT I WANT TO MAKE
TO YOU AND THEN I WILL. TURN IT
BACK OVER. WHILE MUCH ATTENTION
IS BEING PAID TO THE INVOLUNTARY
TREATMENT SIDE OF THE L. P. S.
ACT. LITTLE ATTENTION HAS BEEN
PAID TO THE ORIGINAL STATE.
DECISION MADE BY THE LEGISLATURE
WHEN IT PASSED THE L. P. S. ACT
IN NINETEEN SIXTY SEVEN. AND
THEN THE LANHAM ACT TEN YEARS
LATER IN NINETEEN SEVENTY SEVEN
THE LETTERMAN ACT OF COURSE
DEALT WITH DEVELOP PEOPLE WITH
DEVELOPMENTAL DISABILITIES. AND
WHAT WAS THE FATEFUL DECISION A
DISTINCTION. FOR PEOPLE TO. THE
ABILITIES THE LEGISLATURE SAID
THAT PEOPLE WITH DEVELOPMENTAL
DISABILITIES HAVE A RIGHT TO
TREAT WITH. AB RIGHT TO
TREATMENT AND ABILITY H. DIRKSEN
SUPPORTS IN THE LEAST
RESTRICTIVE ENVIRONMENT THE
LETTERMAN PETROUS SHORT ACT HAS
NO RIGHT TO MENTAL HEALTH
TREATMENT NO ONE TITLE. IT DID
NOT DIG DEEP THE SYSTEM IS FAR
FROM PERFECT BUT AT LEAST WE
HAVE A GUARANTEE IN THE LAW THAT
PEOPLE ARE CARED FOR. THE EXACT
OPPOSITE FOR PEOPLE LIVING WITH
SEVERE MENTAL ILLNESS. WHAT ARE
THE DIFFERENT YOU SHOULD. WELL
THERE'S A LOT OF HISTORY BUT I
CAN TELL YOU AT LEAST IN THE
PRESENT CONTEXT WHY THERE'S A
DIFFERENCE NATION. BECAUSE
PEOPLE LIVING WITH SEVERE AND
SERIOUS MENTAL ILLNESS ARE SEEN
AS LESSER THAN BY OUR SOCIETY
INSIDIOUS DISCRIMINATION WHEN WE
TALK ABOUT THE HOMELESS WHEN WE
TALK ABOUT THESE PEOPLE HOW
WOULD BROAD BRUSH THEM AS AS AS
LESS THAN WORTHY OF OUR CARE AND
TREATMENT. IN MY VIEW IS BENEATH
US AS LEADERS IN. CIVIL SOCIETY.
AND SO MY PLEA TO YOU TODAY. IS
TO CONSIDER GOAL MAY. BUT MENTAL
HEALTH AT LEAST FOR THE MOST
SEVERELY MENTALLY ILL ON PAR.
DEVELOPMENTAL DISABILITIES MAKE
MENTAL HEALTH AT LEAST FOR THOSE
WITH THE MOST SERIOUS AND
PERSISTENT THIS IS A RIGHT OR AN
ENTITLEMENT. WILL PUT L.
EIGHTEEN DEAR BEIJING GREAT
INITIATIVE BY GOVERNOR NEWSOM ON
STEROIDS IN A POSITIVE WAY. THIS
SYSTEM IS TERRIBLY FRAGMENTED
YOU'VE GOT PRIVATE PAY YOU'VE
GOT MEDICAID YOU'VE GOT THE
PUBLIC SYSTEM YOU'VE GOT JAIL
INCREASE CARE YOU'VE GOT TO. BE
CAREFUL AND YOU KNOW THAT IT IS
FOR PEOPLE OF MEANS FOR PEOPLE
TO KNOW HOW PEOPLE WHO- NO I TO
NAVIGATE SYSTEMS. IT IS
INCORRECT WE HARD TO GET HELP
RESOURCES FOR YOUR LOVED ONE. A
LEGAL RIGHT TO MENTAL HEALTH
CARE ESPECIALLY THE PEOPLE WHO
ARE MOST SEVERELY AND
PERSISTENTLY L. WOULD FORCE
THOSE SYSTEMS JUST LIKE WITH THE
RIGHT TO HOUSING TECH BEHAVE AND
ACT DIFFERENTLY. TO INTEGRATE
INSTEAD OF FRAGMENT AND SO- I
APPRECIATE YOUR TIME. I
APPRECIATE- ARE YOUR WILLINGNESS
TO TAKE ON THESE TOUGH ISSUES
BUT- THE PUBLIC HOLD BACK ANY
BOLD IDEA THAT WILL MAKE IT
EASIER FOR PEOPLE TO GET HELP
AND I KNOW WHAT THE ARGUMENT IS
AGAINST MY RIGHT THINKING AND
RIGHT. NOW THERE. WE'RE ALREADY
ABOUT FOUR MINUTES OVER SO IF
YOU COULD YOU ARE COMMENTING.
THANK YOU COST COST IS TOO
EXPENSIVE SOME WILL SAY WHATEVER
THE PRICE TAG IS LET'S JUST MAKE
SURE WE SUBTRACT WHAT WE ARE
SPENDING NOW IN HUMAN AND
FINANCIAL TERMS FOR THE TRAGEDY
THAT WE HAVE GOING ON NOT JUST
OUT ON OUR STREETS BUT IN MANY
BACK BEDROOMS THROUGHOUT
CALIFORNIA YOU GUYS HAVE AN
OPPORTUNITY TO BE THE NEXT.
LETTERMAN'S YEAH IN THIS STATE
AND TO MAKE FUNDAMENTAL AND BOLD
CHANGE AND I'M HERE TO HELP YOU
THANK YOU IN ANY WAY. I CAN
THANK YOU. THANK YOU. OKAY SO
NOW WE'RE GOING TO GO BACK UP TO
POWER IN THE STAKEHOLDER INPUT
THE LEGAL WE HAVE HOW DO PRIDGEN
CHIEF OF POLICE CITY OF SAN
LEANDRO. JUDGE QUINN AGAIN
SCARLET HUES AGAIN TIFFANY LEON
SENATE AGAIN- THE LAST THREE OR-
I BELIEVE HERE SO YOU HAVE COME
UP AND IS CHIEF PRIDGEN ONLINE.
YES MISTER CHAIRMAN I ASK OUR
TEETH NICE TO SEE HEAR FROM YOU
AGAIN PLEASE GO AHEAD. THANK YOU
GERMAN- REALLY APPRECIATE THE
OPPORTUNITY OF THE SURE CHECKED
IT FROM CALIFORNIA POLICE CHIEFS
ASSOCIATION WITH YOU AND UP
REALLY THANKFUL FOR THIS
INVITATION. SO AGAIN MY NAME IS
ABDUL PRIDGEN I'M CURRENTLY THE
POLICE CHIEF IN SAN DIEGO I'M
ALSO PRESIDENT OF THE CALIFORNIA
POLICE CHIEFS ASSOCIATION. WHICH
REPRESENTS THREE HUNDRED THIRTY
THREE MYSTICALLY SHE'S IN
CALIFORNIA. THE TOPIC OF TODAY'S
DISCUSSION IS ONE OF INCREDIBLE
IMPORTANCE S. POLICIES IMPACT
THOUSANDS OF LIVES EACH YEAR.
ALL AGREE TOPICS ARE NOT NEW.
YEARS WE HAVE ALL STRUGGLED WITH
THE CHALLENGES TO THE OPS ACT OF
FIFTY ONE FIFTY FOUR PROCEDURES
AND MENTAL HEALTH RESPONSE
SERVICES. REALITY IS THAT EACH
OF THESE. ABOUT ARE INCREDIBLY
COMPLEX THE SYSTEM FOR
RESPONDING TO THESE SITUATIONS
IT'S EQUALLY AS INTRICATE. AS
REPRESENT REPRESENTATIVE FOR
CALIFORNIA POLICE ASSOCIATION
I'M HERE TO PROVIDE THE LAW
ENFORCEMENT PERSPECTIVE ON THE
SYSTEM ENSURE THOUGHTS AND
OPINIONS FROM MY COLLEAGUES-
BEFORE TODAY'S HEARING C. PCA
CONDUCTED A SURVEY. OF OUR
MEMBERS REGARDING THE LOOK AT
PROCEDURAL PROBLEMS AND
STATUTORY LIMITATIONS OF YEP YES
ACT AS WELL AS IDEAS ABOUT HOW
TO IMPROVE THE SYSTEM WE HAVE IN
PLACE TODAY. CONSISTENT THEMES
EMERGE FROM THE RESPONSES WE
COLLECTED I LIKE TO SHARE THOSE
WITH YOU RIGHT NOW FIRST THERE'S
A PROBLEM WITH THE LIMITED
RESOURCES DEDICATED TO MENTAL
HEALTH. THERE ARE INSUFFICIENT
HOSPITAL BEDS TO PROVIDE SPACE
FOR THOSE IN NEED WHICH IS
SIGNIFICANT BECAUSE THE E. R. IS
THE ONLY APPROVED DESTINATION
FOR FIFTY ONE FIFTY HOLES. EACH
OF US. LIMITED BEDS CREATE
DELAYS AND TRANSPORTABLE LAW
ENFORCEMENT ANY MESS. WHICH IS
WHY WE ARE SEEING INCREASINGLY
HIGH PATIENT AWFUL TIME TO CROSS
THE STATE. WE'RE ALSO INADEQUATE
DETOX AND TREATMENT FACILITIES
WHICH ARE CRITICAL BECAUSE MOST
HOSPITALS WILL NOT TAKE PATIENTS
WERE CURRENTLY UNDER THE
INFLUENCE OF NARCOTICS. IT MORE
MENTAL HEALTH SPECIALISTS AND
SOCIAL WORKERS WILL PLAY A
CRITICAL ROLE DURING THE INITIAL
RESPONSE. WE NEED MLTI
DISCIPLINARY TEAMS IN THE FIELD
TO MAKE SURE WE'RE DOING THE
BEST WE CAN AND TO CONNECT THOSE
WERE SUFFERING TO SERVICES.
SECOND THERE ARE PROCEDURAL
PROBLEMS AGREED CHALLENGES IN
THE FIELD. CURRENTLY LAW
ENFORCEMENT ARE THE ONLY ONES
LEFT RIGHT FIFTY ONE FIFTY
HOLES. IN SOME JURISDICTIONS LAW
ENFORCEMENT CANNOT WRITE FIFTY
ONE FIFTY HOLDS. EVEN LAW
ENFORCEMENT PLACES A FIFTY ONE
FIFTY HOLD ON INDIVIDUAL.
OFTENTIMES END UP RIGHT BACK IN
THE SAME SITUATION. FINALLY
THERE ARE LEGAL ISSUES THAT
PRESENT MANY DIFFICULT THINGS.
INFORMATION ONE CAN SHARE WITH
LAW ENFORCEMENT IS LIMITED BY
THE PROTECTIONS. RESTRICT
RESCUES ME RESTRICTING WHAT WE
KNOW CONFINES OUR ABILITY TO
MAKE OPTIMAL DECISIONS. THERE IS
NO CENTRAL DATABASE OF AVAILABLE
RESOURCES ASIAN HISTORY. OR
MECHANISM TO TRACK THE SAME
INDIVIDUALS RECURRING THAT'S-
THERE ARE EXAMPLES OF INSTANCES
WHERE INSURANCE COVERAGE. HAS
NOT BEEN- EXCUSE ME HAS IMPEDED
SERVICE. OUR DEFINITIONS FOR
GRAVELY DISABLED DANGER TO SELF
DANGER TO OTHERS DO NOT
ENCOMPASS THE VARIED
CIRCUMSTANCES OFFICERS ENCOUNTER
FOR RICKY CHASES OCCURRING OVER
TIME. FINALLY THE FOURTH
AMENDMENT PROHIBITS LAW
ENFORCEMENT FROM ENTERING THE
HOUSE OR PRIVATE FACILITY IF THE
INDIVIDUAL IS THE ONLY A THREAT
TO THEMSELVES WHICH CAUSES
ISSUES WHEN FAMILY MEMBERS ALL
THE POLICE AND EXPECT OUR
OFFICERS TO ENSURE THE WHOLE.
MANY OF THE SOLUTIONS TO THESE
PROBLEMS ARE. PLEX WHICH IS WHY
WE CONTINUE TO HAVE THESE
DISCUSSIONS YOUR YEAR HOWEVER WE
DO HAVE SOME RECOMMENDATIONS
REGARDING ACTIONS THAT CAN BE
TAKEN TO ABBREVIATE SOME OF
THESE PROBLEMS THAT ARE RECENTLY
IDENTIFIED. FIRST OF ALL
PROVIDING MORE RESOURCES FOR
MENTAL HEALTH RESPONSE UNITS
CBCA SUPPORTS CO DEPLOYMENT
TEAMS COMPRISED OF LAW
ENFORCEMENT AND MENTAL HEALTH
PROFESSIONALS. INCLUDING HEALTH
PROFESSIONALS ALLOWS US TO
BETTER NAVIGATE SOME OF THE
LIMITATIONS IN THE FIELD SINCE
HEALTHCARE PROFESSIONALS WILL
HAVE ACCESS TO PATIENT
INFORMATION. ESTABLISHED MORE
DETOX AND SUBSTANCE ABUSE
FACILITIES ALLOW ALTERNATIVE
DESTINATIONS FOR THOSE PATIENTS
OUTSIDE EMERGENCY ROOMS. ALLOW
FIRE EMS AND MENTAL HEALTH
PROFESSIONALS TO WRITE FIFTY ONE
FIFTY GOALS WORKFORCE CITY LAW
ENFORCEMENT SHOULD NOT BE THE
ONLY ENTITY. WITH THIS
AUTHORITY. EXPAND THE DEFINITION
OF BREAKING BRAVELY DISABLED-
POSSIBLY TO INCLUDE MORE THAN
ONE FIFTY ONE SHOULD BE MORE
THAN THREE FIFTY ONE FIFTY HOLES
PLACED HONEST. PERSON A CERTAIN
TIME FRAME. A CREATE A STATEWIDE
SYSTEM TO SHARE INFORMATION
ABOUT RESOURCES. BASS BASS AND
PATIENT HISTORY. IF NARCOTICS
ARE PRESENT DURING A MENTAL
HEALTH HOLD SERVICE PROVIDER
SHOULD BE PERMITTED TO EXPAND HE
MAKES THEM TO HOLD UNTIL THE
DRUG SYMPTOMS SUBSIDE. STUDIES
SHOW THAT TIME FRAME IS ROUGHLY
TEN DAYS FOR STIMULATE COST
PSYCHOSIS AT A FIFTY ONE FIFTY
HOLDS ONLY SEVENTY TWO HOURS.
ALL THESE RECOMMENDATIONS
REQUIRED INPUT AND COLLABORATION
WITH THE VARIOUS. BOB PEOPLE
WERE IMPACTED SUCH AS FIRE
HOSPITAL'S EMS ASIAN ADVOCATES
COMMUNITY MEMBERS AND MORE. SOME
OF THE SAME GROUPS THAT ARE HERE
TODAY AND REPRESENTED ON THIS
DISCUSSION. AGAIN THANK YOU FOR
THE OPPORTUNITY TO HAVE AN
AUDIENCE WITH YOU AND HAPPY
HOLIDAYS. THANK YOU TO. GREG
WILL NOW MOVE TO. THAT'S QUITE
ALRIGHT THANK YOU I'M PLEASED TO
BE BACK THIS IS ON RIGHT YEAH
ALL RIGHT SO- I'LL TRY TO BE
VERY BRIEF- SOME ISSUES I KIND
OF PREVIEWED IN MY MORNING
COMMENTS- REMAIN THE SAME YOU
KNOW THAT WE FIND PLACEMENT TO
BE A PRETTY CONTENTIOUS ISSUE AT
TIMES AND OF COURSE IT'S A LEGAL
OBLIGATION TO PLACE IN THE LEAST
RESTRICTIVE- SETTING- AND OFTEN
TIMES THE APPROPRIATE TO- YOU
KNOW SETTING ISN'T AVAILABLE SO.
BE GREAT IF WE HAD MORE BEDS-
BASICALLY OUTSIDE THE LOCKED YOU
KNOW SUB ACUTE FACILITY LEVEL-
IT WOULD BE GREAT IF WE HAD MORE
BEDS FOR SPECIALIZED CARE- OFTEN
TIMES THAT'S- THE MOST BUT THAT
YOU KNOW THE MOST APPROPRIATE
SPECIALIZED CARE IS AT THE STATE
HOSPITAL AND AS WE HEARD- BEFORE
YOU KNOW THE STATE HOSPITAL BEDS
ARE TAKEN UP- BY- CRIMINAL
JUSTICE INVOLVED FOLKS- AND SO
AREN'T SO AVAILABLE TO TOO MANY
LPS- PATIENTS. AND PLACEMENTS
FOR MINORS- I THINK MY
UNDERSTANDING IS THERE'S
BASICALLY MAYBE TWO MAYBE ONE-
FACILITIES- WHERE MINORS CAN BE
PLACED IN THE BOTH IN SOUTHERN
CALIFORNIA SO- PLACEMENT FOR
MINORS THAT IS- CLOSE TO WHERE
THE FAMILY IS. I ANOTHER ISSUE
THAT I- MENTIONED IN THE MORNING
WAS TRANSITIONAL SERVICES YOU
KNOW WE'VE HEARD ABOUT CYCLING-
PEOPLE COMING IN AND OUT OF THE
L. P. S. SYSTEM. AND YOU KNOW AS
WE AS I SIT THERE AND GET THE
JUDGES OVER THESE- PROCEEDINGS.
AND SEE SOMEONE IMPROVE IMPROVE
TO THE POINT WHERE THEY NO
LONGER GRAVELY DISABLED- AND
THEN THEY COME BACK SIX MONTHS
LATER. IN MUCH WORSE SHAPE- THE
MAYBE WITHIN THE START OF IT
CERTAINLY WHEN THE-
CONSERVATORSHIP WAS TERMINATED.
AND RIGHT NOW IT'S MOSTLY IT'S-
LPS CONSERVATORSHIP EXISTS OR
DOESN'T EXIST AND THERE'S NOT A
LOT. THAT I SEE- HOW THEIR AT-
TO TRANSITION FOLKS- AND FIVE OH
SEVEN IS ABSOLUTELY A GREAT
GREAT- START AND ONCE
IMPLEMENTED MAYBE WILL BE- A
SIGNIFICANT- HERE- BUT I THINK
THAT THAT REMAINS TO BE SEEN
NOT. NOT SUGGESTING ANY- ANY-
ANYTHING ABOUT WHETHER IT WOULD
WORK OR NOT I HOPE IT DOES- AND
THEN YOU KNOW WE DO HAVE YOU.
I'M HERE AS A JUDGE YOU KNOW
THROUGH THE JUDICIAL COUNCIL SO
YOU KNOW AS FAR AS CHANGES TO
THE ACT REALLY ARE COMMENTS WILL
BE LIMITED TO- ADMINISTRATIVE.
ADMINISTRATION OF JUSTICE
MATTERS- WHICH AREN'T REALLY THE
FOCUS OF TODAY'S PROCEEDINGS AND
IN SO TO SAVE TIME- WE WILL
SUBMIT ANY SUGGESTIONS ALONG
THOSE LINES IN RIGHT- BUT- ONE
THING I WOULD SAY IS I TALKED
ABOUT HOW WE PROCEED AND SAM
JUST GO. I THINK OUR JUDICIAL
PROCESS WORKS FAIRLY WELL- I
KNOW OTHER COURTS DO IT
DIFFERENTLY AND- SO OVERALL I
WOULD ENCOURAGE- TO MAINTAIN AS
MUCH FLEXIBILITY FOR HOW THESE
PROCEEDINGS ARE DONE- BECAUSE
EVERY COMMUNITY IS DIFFERENT AND
EVERY COMMUNITY AND WHAT WORKS
IN. ONE COMMUNITY MAY NOT WORK
IN ANOTHER COMMUNITY. THE YOU.
THANK YOU ALL RIGHT THIS IS GOOD
AFTERNOON EXCUSE ME ASSEMBLY
STONE AND SANTIAGO I'M SCARLET
HUES AND THE EXECUTIVE DIRECTOR
FOR THE CALIFORNIA STATE
ASSOCIATION OF PUBLIC
ADMINISTRATORS PUBLIC GUARDIAN
SOME PUBLIC CONSERVATORS AND OUR
MEMBERS- BIRDS STATE FINANCIAL
INVESTMENT IN PUBLIC
CONSERVATORSHIP GUARDIANSHIP
SERVICES. THE COUNTIES MADE THE
STATE'S FINANCIAL AND
ADMINISTRATIVE SUPPORT TO ENSURE
PARITY OF SERVICES FROM COUNTY
TO COUNTY. THE SHOESTRING NATURE
OF FUNDING HAMPERS OUR ABILITY
TO MANAGE OUR CASES BUT ALSO
PRECLUDES SPENDING ANY TIME ON
DATA GATHERING AND OUTCOME
MEASURES. ADDITIONAL FUNDING
WOULD ALSO INCREASE TRANSPARENCY
. WE RECOMMEND NEW INVOLVEMENT
IN PARTNERSHIP WITH THE STATE
AGENCY AND THE CREATION OF
DEDICATED STATE FUNDING FOR
PUBLIC GUARDIAN CONSERVATORS TO
ENSURE ENSURE SERVICE QUALITY%
AND DELIVERY AND THE CREATION OF
DEDICATED STATE FUNDING TO
SUPPORT TRAINING AND TECHNICAL
ASSISTANCE FOR PUBLIC GUARDIAN
CONSERVATORS CURRENTLY THERE IS
NO STATEWIDE DATA COLLECTION
SYSTEM. TO ANALYZE PUBLIC
GUARDIAN CONSERVATOR ACTIVITIES
NO CLEAR UNDERSTANDING OF THE
STATE WIDE NEED FOR
CONSERVATORSHIP SERVICES AND NO
VISION FOR HOW PUBLIC GUARDING
CONSERVATORSHIP SERVICES COULD
BE DELIVERED MORE EFFECTIVELY.
PUBLIC GUARDIAN CONSERVATORS
ADMINISTER THEIR PROGRAMS
WITHOUT THE BENEFIT OF ANY STATE
BY DATA OR TECHNICAL ASSISTANCE%
AND APPROPRIATE STATE AGENCY
COULD ASSURE PURELY STATISTICAL
DATA COLLECTION AND REPORTING TO
THE LEGISLATURE. STANDARDIZED
SERVICE DELIVERY REQUIREMENTS
AND DRIVE THE OPPORTUNITY TO
MAKE CONTINUOUS IMPROVEMENTS IN
THE SERVICES WE PROVIDE. WE
RECOMMEND PROVIDING STATE
FUNDING FOR SUCH RESEARCH
RELATED TO CONSERVATORSHIP
PRACTICES WE WELCOME PARTNERING
WITH THE STATE AND ACADEMIC
PARTNERS AND RESEARCHERS. OVER
THE PAST YEAR. CONSERVATORSHIP
HAVE BEEN THE FOCUS OF PUBLIC
SCRUTINY. PUBLIC GUARDIAN
CONSERVATORS ARE SIMULTANEOUSLY
ACCUSED OF USING OUR POWERS AND
AUTHORITY AND APPROPRIATELY I
CONSERVING THOSE WHO DO NOT NEED
THAT LEVEL OF INTERVENTION WHILE
ALSO AT THE SAME TIME BEING
BLAMED FOR NOT USING OUR
AUTHORITY FOR THOSE WHO ARE THE
MOST VULNERABLE AND WHO ARE
HOMELESS UNSHELTERED INDIVIDUALS
AND TRAGIC CONDITIONS. WE
WELCOME ALL EFFORTS TO BECOME
MORE TRANSPARENT TO POLICYMAKERS
AND COMMUNITY MEMBERS. AS POLITE
AS WELL AS TO ENHANCE OUR
PRACTICES. HOWEVER WITHOUT
FUNDING. WE CANNOT SUPPORT ANY
LEGISLATIVE CHANGES. THAT
INCREASE AUTHORITY FOR OUR
RESPONSIBILITIES WE SIMPLY DON'T
HAVE THE BANDWIDTH TO DO THAT
ANY LONGER. IN CLOSING ON BEHALF
OF OUR MEMBERS THANK YOU VERY
MUCH FOR PROVIDING US THE
OPPORTUNITY TO DISCUSS
OPPORTUNITIES TO STRENGTHEN
IMPROVE LPS CONSERVATORSHIP
PROGRAMS. AS WE LOOK TOWARD THE
BUDGET CYCLE NEXT YEAR WE
ANTICIPATE PURSUING A TWO
HUNDRED MILLION DOLLAR I'M GOING
BUDGET REQUEST AND URGE THE
COMMITTEE MEMBERS TO JOIN US IN
SUPPORT. WE LOOK FORWARD TO
WORKING CLOSELY WITH YOU AND THE
GOVERNOR TO INFORM THE POLICY
DECISIONS AND DISCUSSIONS AND
SURE THIS THAT ENSURES THIS
CRUCIAL SAFETY NET PROGRAM HAS
THE RESOURCES NEEDED TO SERVE
THE CALIFORNIANS IN OUR
COMMUNITY THANK YOU VERY MUCH
FOR YOUR TIME. THANK YOU.
CORRECT THIS BEYONCE. INSTEAD OF
EXPANDING EIGHT CONSERVATORSHIP
AND GUARDIANSHIP. HAPPY MOTHER'S
AB THE BUTTON NEXT TO THE
MICROPHONE RECORDS ON THANK YOU
OKAY. INSTEAD OF EXPANDING A
CONSERVATORSHIP UNIT THAT IS
ALREADY X. IMPACTED I'M HERE TO
OFFER YOU SOME MORE SOLUTIONS.
FOCUSED ON PRE TRIAL THE STATE
HAS OFFERED PRE TRIAL FUNDING
FOR LAW ENFORCEMENT AND
PROBATION OFFICERS TO DO
SURVEILLANCE AND MONITORING. BUT
THE STATE ALSO HAS AN
OPPORTUNITY DURING PRE TRIAL TO.
ENGAGE INDIVIDUALS THAT ARE
RECENTLY ARRESTED IDENTIFY THEM
WITH MENTAL HEALTH NEEDS AND
LINK UP TO SUPPORTIVE SERVICES
IN CASE MANAGEMENT TO GET OUT OF
JAIL. PUBLIC DEFENDER'S OFFICE
IN SACRAMENTO COUNTY PARTNERED
WITH THEIR DEPARTMENT BEAVER
HEALTH DEPARTMENT OF HUMAN
ASSISTANCE AND WE DID JUST THAT.
THE LAST NINE MONTHS WE HAVE
CONTACTED ONE THOUSAND TWO
HUNDRED AND SEVENTEEN PEOPLE IN
JAIL AND HAVE DONE NEEDS
ASSESSMENTS USING FOR EVIDENCE
BASED TOOLS. OF THOSE THREE
HUNDRED AND FORTY FIVE ARE
LINKED TO MENTAL HEALTH. ONE
HUNDRED AND SEVENTY ONE FOR
LINKED TO SUBSTANCE USE
PREVENTION TREATMENT PROGRAMS.
AND A HUNDRED AND NINETY THREE
WERE HOUSED. THAT IS THE RESULT
OF DEPARTMENTS GETTING OUT OF
THEIR SILOS AND WORKING
TOGETHER. AND IT WORKS WE HAVE
HAD LESS THAN A 3% RECIDIVISM
RATE. BECAUSE WHEN YOU USE
SOCIAL WORKERS AND THE PUBLIC
DEFENDER'S OFFICE TO HELP
COORDINATE SYSTEM SERVICES. AND
THEN YOU HAVE THEM CASE MANAGE
INDIVIDUALS WHEN THEY'RE
RELEASED. THEN YOU CAN WORK WITH
YOUR PROBATION LAW ENFORCEMENT
DEPARTMENT E EVER HEALTH YOU
CAN GUARANTEE THEY COME BACK TO
COURT WE CAN ALSO OFFER THEM
TREATMENT. THE OTHER SOLUTION I
WOULD SAY IS TO CONTINUE TO
SUPPORT YOUR DIVERSION PROGRAM.
WE USE DEPARTMENT A STATE
HOSPITAL GRANTS WE BUILT A
FORENSIC CONTENT CONTINUUM OF
CARE WITH INTER COUNTY FOR THE
FIRST TIME. AND WE HAVE ALREADY
SEEN RESULTS WITHIN SIX MONTHS
WE WERE ABLE TO GET THIRTY THREE
PEOPLE GRANTED FELONY MENTAL
HEALTH DIVERSION. WE WERE ABLE
WE NOW HAVE A HUNDRED AND SIXTY
ONE PEOPLE PENDING THE WAIT LIST
TO GET IN. THAT PROGRAM WORKS
BECAUSE IT OFFERS CLIENTS AN
ALTERNATIVE PLEADING GUILTY TO
GET MENTAL HEALTH THEY CAN HAVE
THEIR- CASE- DIVERTED WITHOUT
SAYING THAT THEY'RE GUILTY. IT
ALSO ENCOURAGE YOU TO LOOK AT
ONE STOP SHOP FUNDING WE JUST
CREATED ONE WE'VE HEARD THAT
TESTIMONYBEFORE REMOVE THE
BARRIERS OF PEOPLE HAVING TO GO
ALL OVER THE COUNTY TO GET
SERVICES BRING THEM ALL UNDER
ONE ROOF SO THEY CAN MEET WITH
THE PUBLIC DEFENDER T. HA
DEPARTMENT BE EVER HEALTH SEPT
D. SO THEY CAN GET ASSESSED IN
LENGTH AND CAN GET EVERYBODY
WORKING TOGETHER. AND ALSO
ENCOURAGE THAT WE LOOK AT THE
LPS LAW. ONE OF THE THING
SACRAMENTO COUNTY IS DOING WHICH
IS REALLY UNIQUE IS WE DO
BASICALLY C. F. CFT IS
INDEPENDENT THE SYSTEM CHILD
FAMILY THERAPY. THOSE ARE
MEETINGS THAT YOU CALL WHERE THE
KID SITS IN THE CENTER OF THE
ROOM AND EVERYBODY SURROUNDS THE
KID AND- PUT THEIR HEADS
TOGETHER ABOUT WHAT THEY NEED TO
DO TO SUPPORT. THAT YOU. WERE
DOING THAT AN LPS WE HAVE OUR
LPS CLIENT COME TO THE TABLE
WHERE THE PUBLIC DEFENDER COUNTY
COUNCIL PUBLIC GUARDIAN. WE GET
TOGETHER WITH THE PROVIDERS AND
SAY WHAT WE NEED TO DO. TO MAKE
YOU SUCCESSFUL TO ENGAGE AND
TREATMENTS. I ALSO HAVE THE
COURT OR THE STATE LOOK AT OUR
FIFTY ONE FIFTY HOLES IN OUR
SEARCH AND HOW WE'RE DOING THOSE
HEARINGS. THERE IS NO FORMAL
HEARING ON THAT FIFTY ONE FIFTY
WE'RE LOSING THE OPPORTUNITY. TO
MEET WITH CLIENTS TO ENGAGE TO
LINK TO MAKE SURE CORONATION OF
KERR IS HAPPENING. SO THAT WE
DON'T JUST HAVE TO LEAVE THE
HOSPITAL TO COME RIGHT BACK IN
ANOTHER FIFTY ONE FIFTY OR LEAVE
THE HOSPITAL INGLEWOOD FOR JAIL.
WE NEED TO LOOK AT OUR- ACT IN
AND OF ITSELF. I'D ALSO
ENCOURAGE US TO GIVE LAW
ENFORCEMENT ALTERNATIVE TO THE
EMERGENCY ROOM. AND THE JAIL.
WITH ZERO BAIL WHAT HAPPENS IS
INDIVIDUALS GET CITED ON A
MISDEMEANOR AND THEY MAY NOT
COME TO COURT FOR THREE MONTHS
SACRAMENTO COUNTY IS WORKING ON
THAT WE'RE WORKING WITH OUR LAW
ENFORCEMENT TO ACTUALLY CONTACT
THE PUBLIC DEFENDER'S OFFICE.
WE'VE CONTACTED SOMEBODY. AND
THE STREETS AND YOU DECIDED I'M
OUT LET'S GET HIM TO MENTAL
HEALTH DIVERSION SOONER THAN
LATER LET'S TAKE OPPORTUNITY. TO
TAKE ADVANTAGE OF THAT CRITICAL
TIME WHERE PEOPLE ARE IN CRISIS.
AND ENGAGE THEM BECAUSE IF WE
WAIT THREE MONTHS TO ENGAGE. YOU
DON'T HAVE THE SAME LEVEL OF
DESIRE TO PARTICIPATE THEN YOU
DO AT THE TIME OF CRISIS. THE
OTHER THING I WOULD DO IS ECHO
WHAT THE CHIEF SAID WE NEED DATA
SHARING THE ONLY WAY WE GET DATA
SHARING RIGHT NOW IS A RELASE
OF INFORMATION FOR THE PUBLIC
DEFENDER'S OFFICE. SO THERE'S
ALL OF THE SYSTEMS OUT THERE
THAT HAVE ALL THIS INFORMATION
IF WE HAD ACCESS TO THAT
INFORMATION WE COULD COORDINATE
CARE. AND ENCOURAGE THIS STATE
TO CONTINUE DOING RECORD
MODIFICATION WORK RECORD
MODIFICATION MAKES A DIFFERENCE
WE HELPED CLEAR THREE HUNDRED
PEOPLES- THAT WERE HOMELESS WITH
THEIR RECORDS. THOSE THREE
HUNDRED PEOPLE NEEDED FIFTEEN
HUNDRED TOUCHES. BUT WE STILL
HAVE BARRIERS BUT THAT WE STILL
ARE CHARGING PEOPLE A HUNDRED
TWENTY DOLLARS TO HAVE AN
EXPUNGEMENT FILING FEE PEOPLE
DON'T HAVE THE MONEY TO DO THAT.
WE HAVE TO REMOVE THOSE BARRIERS
- THE LAST IT WOULD END IS
PUBLIC DEFENDER ALSO NEEDS
FUNDING JUST LIKE THE PUBLIC
GUARDIAN'S OFFICE THAT IS NOT
STATE FUNDED YET ITS MANDATE IN
THE STATURE THAT THE PUBLIC
GUARDIAN OR THE PUBLIC DEFENDER
REPRESENT PEOPLE. AT THESE RED
OF HABEAS CORPUS IS AT THE LPS-
BUT WE'RE NOT FUNDED TO DO THAT
EITHER SO WE HAVE TO COMPETE FOR
THOSE GENERAL FUND DOLLARS. FOR
THAT REPRESENTATION OF SERVICES
. I'M JUST LIKE THE PUBLIC
GUARDIAN'S OFFICE HAS TO. WE
NEED SYSTEM COORDINATION AND
CARE WE NEED DOCTORS AVAILABLE
TO WRITE DECLARATIONS WE NEED-
FOR THEIR SUPPORT AND SYSTEM
CORONATION. THANK YOU FOR THE
OPPORTUNITY TO BE HEARD TODAY.
THANK YOU. CORRECT ANY QUESTIONS
FOR THIS PANEL. SANTIAGO THANK.
THANK YOU VERY MUCH AND THANK
YOU FOR WORKING WITH US WHEN
WE'VETRIED- THESE ENDEAVORS AS
WELL AND I DO UNDERSTAND THAT
THE PIECE ABOUT- MORE REVENUE IN
ORDER TO MAKE THESE PROGRAMS-
WORK. AND I UNDERSTAND CAPACITY
ISSUES AND- A LOT OF THAT IS
THANKS TO YOU BECAUSE YOU'VE
TALKED TO ME IN THE PAST ABOUT
THIS AND I'VE COME TO CONCLUSION
I GUESS YOU DO. AND I'D LIKE TO
WORK WITH YOU. ON THE PANEL BUT
IT'S BUT- HAVING SAID THAT
THOUGH- I STILL STRUGGLE WITH
WITH TRYING TO IMPROVE THE
PROGRAM- AND- THAT'S RIGHT.
THAT'S RIGHT REALLY STRUGGLING
WITH IT WILL LIKE HELP GIVE.
BECAUSE I THINK SOMETIMES IN YOU
AND I HAVE- WE'VE DISCUSSED THIS
BEFORE THERE. ISN'T AN ATTACK
TO. THE SHOULD BE ABLE OUR
EFFORTS NOT BE PERCEIVED. AS
SOMETHING TO LIMIT SOMEBODY'S.
CIVIL LIBERTIES THAT THAT'S
REALLY NOT WHAT IT'S ABOUT. YOU
KNOW IN AND I WOULD BE THE FIRST
ONE TO STAND WITH ALL ADVOCATES
THE STATE. LET'S NOT DO THAT.
BUT ARE THOSE INSTANCES AND-
WHERE. INDIVIDUALS DO NEED THAT
HELP. AND EVERY COMMUNITY IS
DIFFERENT AND I AND I KNOWLEDGE
THAT IN MY KNOWLEDGE IT IS
ALWAYS BETTER TO BE PREVENTIVE.
AND IN A RECOGNIZABLE TRYING TO
DO GOOD WORK HERE. BUT BUT IN
SOME COMMUNITIES YOU NOW HAVE A
SITUATION WHERE THE WHERE THE
PROBLEMS- HAVE GOTTEN SO BIG
LIKE THE DISTRICT THAT I HAVE
THE HONOR OF REPRESENTING. THAT
HISTORICALLY HAS HAD
POPULATIONS- WHO HAVE BEEN LEFT
BEHIND. IN THE POLLS RIGHT TO
THE PLACE. THERE ARE SEVERE
MENTAL HEALTH CARE ISSUES WHERE
THERE ARE- SUBSTANCE ABUSE
ISSUES WERE. TRAUMA ISSUES AND
JUST LAYERS AND LAYERS COMPILED
IT BUT WE'VE I WOULD STILL ARGUE
THAT THERE ARE CHANGES THAT NEED
TO HAPPEN- SO THAT WE ARE
BRINGING THOSE PEOPLE BECAUSE
IT'S MORE HUMANE TO HELP PEOPLE
WHO ARE AT THAT STAGE. THEN TO
ALLOW THEM. GEN DO NOT GIVE THEM
THE ACCESS TO THIS TO THE HELP
THAT THEY NEED AND DESERVE AS
HUMAN BEINGS. AND THAT'S WHY
STRUGGLE IN IT I DON'T DISAGREE
ON A LOT OF THE COMMENTS THAT IT
THAT YOU ARE SAYING AND I AND I.
AM GRATEFUL TO THE CONVERSATION
OVER THE YEARS. ON THESE ISSUES
AND SPECIALLY PURPLE CHAIRS FOR
PUTTING THIS TOGETHER AND IT IS
AN EMOTIONAL ISSUE. AND I'M
SECURE I'M GOING A LITTLE BIT
LONG ON THIS BUT I. BUT I STILL
STRUGGLE AND PUSH GENTLY TO ASK
BUT WHAT WOULD WE DO IF WE
REALLY WANTED TO IMPROVE IT
BECAUSE WE'VE GOT. A LOT OF
FOLKS. FOR HER ON THE STREET.
WHO MAY NOT BE IN THE SITUATION
WHERE THEY CAN ASK FOR HELP
THEMSELVES AT THAT MOMENT BUT WE
KNOW IF THEY'RE IN GRAVE. IN
DESPERATE NEED OF IT AND THAT'S
WHY STRUGGLE IN LET. THIRTY
PEOPLE TWO HUNDRED PEOPLE YEAH
IT'S A VERY SMALL POPULATION I
WOULD ARGUE COMPARED TO WHAT WE
SEE. IS THAT NEED OUT THERE AND
A LITTLE SKID ROW FOR EXAMPLE
AND NOT ALL POPULATIONS WILL FIT
IN THAT PARTICULAR- DISAPPEARED
ON DESCRIBING THAT PARTICULAR
PERSON. AND I USE ROUNDED NUMBER
SO FOR THOSE WHO FACT CHECK ALL
THAT WE SAY WE'RE USING RANDOM
NUMBERS. BUT YOU GOT A LITTLE
SHY OF FIVE THOUSAND PEOPLE IN A
FEW SQUARE BLOCKS AND IF YOU
WERE TO TRAVEL JUST LATER RIGHT
THERE. YES I WOULD ALMOST DETER
SOMEBODY TO ARGUE THAT IS MORE
HUMANE TO LEAVE SOMEBODY ON THE
STREET AND IT WOULD BE TO BRING
A MAN TO GET THEM THE HELP THAT
THEY NEED. AND DESERVE AS HUMAN
BEINGS. AND THAT'S WHY I
CHALLENGE YOU TO CHALLENGE ME AS
WELL. AND I'M HOPING THAT WE
COULD WORK TOGETHER ON THIS TO.
TRY TO CHANGE SME OF THESE.
LAWS FOR THE SAKE. OF HELPING.
HUMAN BEINGS. WHO DESERVES THAT
SORT OF DIGNITY. AND I ASK YOU
WHAT IS IT THAT WE NEED TO
CHANGE IT BECAUSE OUR PEOPLE NO
MATTER WHO ARGUES WITH ME THAT
WE DO NEED- TO HELP OF LIFT OFF
THE STREETS. IN INTO A MENTAL
HEALTH CARE SERVICES IN INTO
SUBSTANCE ABUSE IN THE SYSTEM
CAN'T WAIT FOR THEM ANYMORE.
THIRTY PEOPLE A HUNDRED AND
SIXTY PEOPLE IN LINE PROBABLY
GOT TENS OF THOUSANDS OF PEOPLE
OUT THERE IN CALIFORNIA WHO
COULD USE THE HELP IMMEDIATELY.
IMMEDIATELY IN LOS ANGELES YOU
HAVE A- I'M UNITEDROUNDED
NUMBERS AGAIN SIZE SIXTY FIVE
THOUSAND PEOPLE WORKING HOMELESS
SEAT OF LOS ANGELES- MODEL FORTY
TWO FORTY THREE. THOUSAND PEOPLE
USE ROUND NUMBERS WHO ARE
HOMELESS. I CAN'T IMAGINE- THAT
WE CAN FIND LARGE PERCENTAGES OF
PEOPLE WITHIN THOSE CATEGORIES
WITHIN THAT POPULATION THERE'S-
THAT DESERVE. A HUMANE APPROACH
TO THAT IN LEAVING AND I'M ON
THE STREETS FOR THE SAKE OF
PROTECTING A STAT A STATUS QUO
OR A SET OF STATUS QUO LAWS IT
IS SIMPLY HUMANE I WANT TO BE
GOOD MAYBE HE'LL TELL ME WHAT
YOU THINK IN TERMS OF WHAT WENEED TO CHANGE TO ACTUALLY DO
THAT OR TO HELP PEOPLE- IF WE
HAD TO CHANGE THINGS- WITHIN
OUR- LITTLE LETTERMAN ACTIVE
LPO. I MEAN WE GOT LAYERS AND
LAYERS OF THINGS. YOU KNOW THE
IN LAURA'S LAW WE- WILL BE GONE
FOREVER ON THE DIFFERENT LAYERS
A LAW THAT ARE MEANT TO. AND
PROGRAMS ARE MEANT TO HELP
PEOPLE BUT- I DON'T THINK THAT
ANYBODY WOULD ARGUE THAT PEOPLE
AREN'T. GOING AND GOING BY THE
LARGEST NUMBERS ON THE STREET
AND THEY NEED DESPERATE HELP. I
KNOW THAT L. A. COUNTY HAS. SIX
ASSET WITH WORKING WITH PEOPLE
THAT ARE ON THE STREETS AND
LOOKING AT THEM- AT CONSERVING
THEM BUT STRAIGHT FROM THE
STREET BECAUSE THEN IT HAS BEEN
TOO DIFFICULT TO TRY TO GET THEM
INTO A TREATMENT CENTER BECAUSE
OF. THEIR UNWILLING TO GO TO
THAT LENGTH TO GET THEIR
TREATMENT AND THEY'RE REFUSING
TREATMENT SO THEY START WITH
THEM ON THE STREET AND THEY'VE
BEEN VERY SUCCESSFUL. THAT
PROGRAM ALTHOUGH VERY SUCCESSFUL
IS EXTREMELY EXPENSIVE BECAUSE
YOU'RE TALKING ABOUT A TEAM
APPROACH THEY'VE GOT A
PSYCHIATRIST A SOCIAL WORKER A
PUBLIC GUARDIAN CONSERVATOR
DEPUTY AND I THINK ONE OTHER
MAYBE A NURSE OF SOME KIND THAT
TEAM GOES OUT. TO SEE THOSE
INDIVIDUALS ON THE STREETS AND
THAT'S VERY HELPFUL IT'S A WHOLE
PERSON APPROACH. BUT IT'S A VERY
EXPENSIVE PROGRAM AND THERE THE
ONLY COUNTY THAT HAS HAD THE
RESOURCE NINETY TWO AND NINETY.
YEAH YES IT IN SO. THOSE KINDS
OF WHOLE PERSON APPROACHES HAVE
THE EVIDENCE SHOWS THAT THEY'RE
VERY SUCCESSFUL IF YOU'RE
WILLING TO SUPPORT THEM BUT
THERE ARE TO DO THAT STATE WHY
WOULD BE- I CAN'T EVEN CALCULATE
I CAN'T EVEN BEGIN TO CALCULATE
THE COST OF THAT TO DO THAT ST
WORK FOR SOMEONE TO GET
CONCERNED BECAUSE IT'S SO. IT
DOES TAKE A TEAM APPROACH AND
IT'S GOING TO BE A LONG PROCESS
TO GET THAT KIND OF SYSTEM IN
PLACE. BUT I DO KNOW THAT THAT'S
ONE ONE PROCESS THAT IS
CURRENTLY VERY SUCCESSFUL. ALL
THE OTHER COUNTIES. I HAVE TO BE
HONEST WITH YOU THEY ARE
STRUGGLING JUST TO DEAL WITH
WHAT THAT WHAT THEY'VE GOT ON
THEIR PLATE BECAUSE WE DON'T
CONTROL THE FRONT DOOR WE DON'T
CONTROL- AND BECAUSE THERE ISN'T
ANY DEDICATED STATE FUNDING
THERE'S ONLY THE COUNTY GENERAL
FUND AND WHAT LITTLE BIT OF
MONEY THE COUNTIES CAN COLLECT
IN FEES BUT BECAUSE WE DEAL WITH
THE INDIGENT POPULATION. EVEN
THOUGH THE COURT AWARDS ARE FEES
WE CAN'T COLLECT THEM 90% OF THE
TIME AS A PUBLIC GARDENING
CONSERVATOR AND SO MAKING COUNTY
I HAD MILLIONS OF DOLLARS ON THE
ACCOUNTS PAYABLE BOOKS I WAS
NEVER GOING TO SEE BECAUSE I
COULDN'T COLLECT THOSE FEES SO
MOST OF OUR MEMBERS DON'T HAVE
THE DON'T HAVE THE- BILITY. TO
DO THOSE THOSE INTENSIVE
PROGRAMS THAT ARE NEEDED TO
BRING THOSE INDIVIDUALS OFFICE
DIRECTLY OFF THE STREET. MISTER
CHAIRMAN MANIFOLD MMHM. A. N.
YOU DON'T HAVE A MORE
COMPETITION WITH YOU SORRY MY
MASCOT SUBCOMMITTEE. BUT WHAT
WOULD YOU STREAMLINED EXAMINE I
AGREE THAT- THAT SOME OF THOSE
PROGRAMS ARE SUCCESSFUL AND I
SEEN THEM- YOU TAKE A LONG TIME.
AND IN PARTNERSHIP WOULD YOU SAY
WHAT WE NEED TO STREAMLINED
BECAUSE IT WITH MY PERSPECTIVE
AND I KNOW YOU PLACE SURE THIS
AS WELL IT'S IN HUMANE BELIEVE
SOMEBODY OUT THERE FOR THAT LONG
FOR THE SAKE OF. FOR THE SAKE OF
CONTINUE TO TRIAL BE MIL. THEY
GIVE YOU SEE. HELP REGULATE IN
TO TALK ABOUT THINGS THAT WE
HAVE SOME INNOVATIVE PROGRAMS-
WE ARE CELEBRATING FOR LACK OF
BETTER WORDS I FORGET. AT THE
CALDER SUBRING HOMES WERE ONCE
SOMEBODY. HAS USED ENOUGH DRUGS
IN THE PASS OUT IN. THEIR ON THE
VERGE. THEY BRING THEM INTO
THESE- THESE A NURSING
FACILITIES AND WE HAVE SOME ON
SKID ROW IN. IT AND IF YOU WERE
IF AN EPIDEMIC MY COLLEAGUES
I'VE EVER SEEN MONEY IT'S A REAL
TO SEE. ANYWHERE ON THE PLANET
LET ALONE. IN THE FIFTH LARGEST
ECONOMY IN THE WORLD. SOMEBODY
BEING BROUGHT INTO THESE THINGS
WITH SYRINGES ON THEM BECAUSE-
MOMENTS AWAY FROM POSSIBLY NOT
BEING THERE AND IT COULD'VE BEEN
PREVENTED IF WE JUST. BROUGHT
THE PERSON AND EARLY AND GAVE ON
THAT HELP- AND THAT'S WHAT I'M
STRUGGLING FOR RIGHT NOW IT'S
WHAT WOULD YOU DO IF YOU. HOW TO
MAGIC WAND MONEY TO RADICALLY
HANGE THE SYSTEM TO MOVE
QUICKER TO HELP PEOPLE AND
ADDRESS IT LIKE THE EMERGENCY
THAT IS. THE CHALLENGING PART
ABOUT IT ALL DAY LONG IS THE
BALANCE BETWEEN THE CIVIL
LIBERTIES OF THE INDIVIDUAL AND
THE- THE NEED TO PROVIDE THAT
REALLY CRITICAL- SERVICE
STREAMLINING IT. YOU RUN THE
RISK OF VIOLATING THAT
INDIVIDUAL CIVIL RIGHTS AND THE
PROTECTION OF THE LPS ACT WAS
PUT INTO PLACE FOR ALL OF OUR
PROTECTION TO MAKE SURE THAT
NONE OF US ARE. TAKEN IN PUT
INTO A LOCKED FACILITY AGAINST
OUR WILL WITHOUT DUE PROCESS. SO
I DON'T KNOW HOW YOU STREAMLINED
DUE PROCESS WITHOUT VIOLATING
THAT INDIVIDUAL'S RIGHTS. UNLESS
YOU'RE GOING TO PROVIDE THAT
INTENSIVE THERAPY- THAT
INTENSIVE SERVICE UP FRONT AND
MAKE SURE THAT THEY GET ALL THE
PIECES THAT THEY NEED TO SUPPORT
THEM. YOU MIGHT BE ABLE BUT YOU
HEARD IT THIS MORNING
STREAMLINING. WORKING WITH
INDIVIDUALS TO GET THEM TO
ENGAGE IN SERVICES WITH YOU
TAKES FORTY VISITS TAKES FORTY
CUMBERLAND I RECOGNIZE. I'VE
I'VE GONE TO ENOUGH TENNYSON
AGAIN PLEASE RESPECT TO YOUR
QUESTION YOUR QUESTION IS THE
FUNDAMENTAL QUESTION THAT THIS
WHOLE HEARINGS ABOUT. AND WE'VE
BEEN ADDED FOUR EIGHT HALF HOURS
NOW. SO I DON'T KNOW THAT IT'S
FAIR TO ASK THEM THAT QUESTION
WHEN THERE'S BEEN A LOT OF
INFORMATION THAT IS GOING ON
HERE AND IT'S NOT AN EASY
QUESTION. TO ANSWER GIVEN THAT
THE TIME CONSTRAINTS THAT WE'VE
THAT WE'VE BUILT AROUND HERE SO
AND I THINK THERE A LOT OF
QUESTIONS AND CONVERSATIONS THAT
ARE GOING TO HAPPEN. OUT SIDE OF
THIS HEARING BASED ON THE
INFORMATION THAT'S HERE AND FOR
THOSE WHO HAVE NOT SEEN THE
WHOLE HEARING. I RECOMMEND
SEEING HEARING. BECAUSE THERE'S
BEEN A LOT OF INFORMATION THAT'S
BEEN PUT ON THE TABLE HAS BEEN
DISCUSSED IN A LOT OF. A LOT OF
THESE PERSPECTIVES OF. IT HAS
BEEN A PART OF WHAT WE'VE BEEN
DISCUSSING. OKAY THAT. GOOD OKAY
TO THIS PANEL THANK YOU. THANK
YOU. AND THAT WE WILL MOVE TO
THE- ADVOCATES PART WE HAD THE
MAYOR STEINBERG HAD A REQUEST
FROM JENNIFER FREE BACK. TO
BONTA THE TOP THE LIST SO I'M
GOING TO DO THAT NOW SHE'S STILL
ON THE LINE. YES I AM OKAY AND
THEN WE WILL ALSO THAT WE HAVE
ANDREW IMPARATO SUSAN CHOI GOOD
MEN. HERE IN PERSON AND THEN
ALSO CAN LOWEST REMOTELY ONLINE.
SERVICE THREE BUT- THANK YOU-
GOOD AFTERNOON AND THANKS FOR
HAVING ME. WHAT I'VE SEEN ON THE
STREET LEVEL IN MY TWENTY SEVEN
YEARS IS A VICTORY STATE YET
ALARMING EROSION OF THE HOUSE
COMMUNITY MEMBERS MENTAL HEALTH
. WELL SYSTEM EXPERIENCED LARGE
SCALE LOSSES AND REDUCTIONS
WHILE SIMULTANEOUSLY
SIMULTANEOUSLY BEARING WITNESS
TO INCREASE SECURITY INCREASE
PREVENTABLE AND FAR TOO EARLY
DEATHS AS PEOPLE SEE DOOR AFTER
DOOR SLAMMED INSTINCTS. LAST
YEAR WE HAD THE COALITION-
RELEASED A REPORT ENTITLED
REVOLVING DOOR WHERE WE
INTERVIEWED ABOUT SIX HUNDRED ON
HEALTH PEOPLE ASK THEM TWO
HUNDRED QUESTIONS TO TWENTY FIVE
FOCUS GROUPS IN COLLABORATION
WITH FOREIGN UNIVERSITIES. ABOUT
HALF FOR SIMPLE INCLUDE
INDIVIDUALS WHO STRUGGLED WITH
THEIR MENTAL HEALTH AND THEN WE
DUG DEEP INTO THEIR EXPERIENCES
WITH THE MENTAL HEALTH SYSTEM.
NOTABLY 60% REPORTED
EXPERIENCING IN UP MENTAL HEALTH
CRISES IN THE PAST FIVE YEARS
AND SAN FRANCISCO BUT ALMOST
HALF NEVER GOT THE CARE THEY
NEEDED AT THE TIME. HERE'S A
QUOTE FROM ONE YOUNG HOMELESS
MOM WHO WAS ONE OF THE MANY
SURVEY RESPONDENTS SEEKING CARE
. THE MENTAL HEALTH SYSTEM IS
REALLY BACKED UP RIGHT NOW I'M
ON THE WAITLIST FOR MENTAL
HEALTH SERVICES AND THEY HAVE A
LONG WAIT LIST I ALSO WENT
SOMEWHERE ELSE TO GET HELP AND
THEY ALL HAVE WAIT LISTS. I'M
JUST TRYING TO GET IN SOMEWHERE.
WHEN SURVEY RESPONDENTS WERE
ABLE TO ACCESS TREATMENT 72%
NOTED IMPROVEMENTS IN THEIR
MENTAL HEALTH HOWEVER FAR TOO
OFTEN AFTER COMPLETING TREATMENT
THERE WAS NO PLACEMENTS AND
STABLE HOUSING AFTER LEAVING
RESIDENTIAL TREATMENT ONLY 99%
OF OUR SURVEY PARTICIPANTS
LANDED IN STABLE HOUSING. YET
92% INDICATED STABLE HOUSING
AFTER TREATMENT WOULD BE VERY
IMPORTANT FOR TREATMENT TO BE
SUCCESSFUL. HERE'S A QUOTE FROM
HOMELESS AFRICAN AMERICAN WOMAN
IN HER FIFTIES WHEN I FIRST
TRIED TO GET HELP I WENT TO SANFRANCISCO GENERAL ON AT THIS
TIME I STAYED ON THE SIXTH FLOOR
IN THE MENTAL WARD A TOTAL OF
TWO WEEKS. AND THEN THEY
RELEASED ME BACK INTO THE PUBLIC
SO THAT WAS MY FIRST ENTRY OF
HELP. WHILE ANOTHER PARTICIPANT
STATED. THINGS GOT MUCH BETTER
FOR ME ONCE I GOT ESTABLISHED IN
THE COOP I STARTED GOING TO THE
DAY TREATMENT CENTER USING THE
SUPPORT GROUP THAT HELPS ME
CLEAR MY MIND.I STILL FIND THAT
AFTER FIVE YEARS I FEEL BETTER
USING THE SUPPORT GROUPS TO DO
SOMETHING FOR MY MENTAL
ATTITUDE. COOPS ARE AN EXAMPLE
OF AN INNOVATIVE SOLUTION
CONCERT FLATS OR APARTMENTS ARE
RENTED OR PURCHASED AND SHARE
CASE MANAGEMENT AT SCATTERED
SITES. IDEALLY INDIVIDUALS
LEAVING RESIDENTIAL CARE ONCE
STABILIZED MOVE INTO THEM
ENSURING CONTINUITY OF CARE THE
STATE COULD FIND NEEDS ENSURING
STABILITY FOR Q. CLIENTS. OTHERS
MAY NEED EVEN A HIGHER LEVEL OF
CARE AND THAT INCLUDES
PREPARATION HILLS SUCH AS
QUALITY BOARDING CARE WE CAN
ALSO REIMAGINE BOARDING CARES A
SHARED SUPPORTIVE HOUSING SPACES
THAT BUILD COMMUNITY. BUT WHAT
LESS BUREAUCRACY AND MORE
FUNDING. ALSO IN HIGH DEMAND OR
SUPPORT OF HOUSING YOU. FOR
OTHERS YOU CAN'T LIVE IN PRIVATE
SPACES INDEPENDENTLY GOTTA HAVE
STOPPED BEYOND SUPPORTIVE
HOUSING. FOR FOLKS WHO CAN'T
LIVE IN PRIVATE SPACES
INDEPENDENTLY THIS MARKET
SUCCESSFUL FOR- FOR ADULTS OF
THE TOTAL THREE THOUSAND TWO
HUNDRED TWENTY NINE UNDUPLICATED
SAN FRANCISCO CLIENTS RECORDED
IN THE AVATAR. I WAS RECEIVING
pTWO THIRDS HAD CO OCCURRING
MENTAL HEALTH AND SUBSTANCE USE
DISORDER DIAGNOSES HOWEVER
DESPITE MANY EFFORTS FUTURE
PROGRAMS ARE TRULY AN EQUAL THE
DUAL DIAGNOSIS COMPANIES.
LEAVING INSTEAD IN ONE DIRECTION
OR THE OTHER- FOR PHILLY NIGHT
TREATMENT GOAL EFFECTIVELY.
RECOMMENDATION IS TO EXPAND HIGH
DEMAND. DUAL DIAGNOSIS
RESIDENTIAL TREATMENT. SO THAT'S
WHAT MENTAL TREATMENT IS OFTEN
IN TEN WAYS THE CULTURE. A
LANGUAGE WITHOUT GROUND.
ESSENTIAL TRUCK STEP TO CRAFT
IT'S CRITICAL THAT OUR SYSTEM IS
DIVERSE ENOUGH TO MEET THE
COMPLEXITY OF HUMANITY. A FIFTY
THREE YEAR OLD TRANS WOMAN
RECALLS HER STRUGGLE WITH
FINDING A THERAPIST TO FIT
BETTER NEEDS. ACCESS TO CARE IS
IMPOSSIBLE I CANNOT SEE TO MAKE
THEIR PETS MY BIGGEST BARRIERS
FEELING SAFE AND FINDING AN
APPROPRIATE PROVIDER. IN MANY OF
OUR MUNICIPALITIES WE HAVE
STAFFING SHORTAGES MEANWHILE WE
HAVE POOLS OF PEOPLE WITH LIVED
EXPERIENCE AND NATURAL SKILL.
YOUR SUPPORT SERVICES ARE OFTEN
MORE EFFECTIVE THAN POLITICAL
PEERS DEVELOP TRUST INSPIRE HOPE
BUILD COMMUNITY AND PROVIDE
COUNSELING. GIVEN THE LACK OF
PREVENTIVE AND COMMUNITY BASED
MENTAL HEALTH CARE THERE ARE
THOUSANDS OF PEOPLE WHO
EXPERIENCE LIKE AT YOUR CRISES
EACH YEAR IT'S SF.
OVERWHELMINGLY THE RESPONSE TO
THE CRISIS IS A POLICE OFFICER.
WILL BE SHOULD NOT FUNCTION AS
FIRST RESPONDERS IN PSYCHIATRIC
CRISES NORTH FIREMEN. ABSENT A
THREAT TO PUBLIC SAFETY THIS IS
BOTH INEFFECTIVE AND COSTLY AT
LEAST HARM UPON PEOPLE WITH
DISABILITIES AND INJURIES ON THE
PART OF THE OFFICERS. SAN
FRANCISCO HAS AN OVER RELIANCE
ON HIGH AND CARE. WITH THOUSANDS
OF PEOPLE EACH YEAR NEVER
GETTING THE HELP THEY NEED UNTIL
THEY'RE IN CRISIS THAT'S THE
POINT. WE'RE AVOIDING FIFTY ONE
FIFTIES WE HAVE A DECENT SYSTEM
THEY END UP IN A REVOLVING DOOR
OF EMERGENCY HOSPITAL BASED CARE
AND BACK TO THE STREETS. OR
OTHERS WHO ARE HOLDEN EXPENSIVE
BEDS BECAUSE LOWER LEVEL OF
KERR'S ARE NOT AVAILABLE. IN
DEVELOPING POLICY AT THE STATE
LEGISLATURE WE HAVE TO LISTEN TO
FOLKS WHO ARE LIVING IN THIS.
EXPANDED OUR SYSTEMOF COMMUNITY
CARE INSURANCE STABLE HOUSING
POST TREATMENT. YOU'RE NOT
CONTROVERSIAL HEADLINE GRABBERS
THEY'RE NOT SILVER BULLETS BUT
THEY WORK INSTEAD THE STATE
LEGISLATURE HAS FOCUSED ON
MENTAL HEALTH WORK ALMOST
EXCLUSIVELY ON ATTEMPTS TO WHITE
IN THE DOOR OF A LOCK SYSTEM.
THAT HAS NO PLACEMENTS FOR
PEOPLE ONLY TO HAVE THOSE
INDIVIDUAL STEP THROUGH SORRY
I'M ALMOST DONE. THIS CREATES A
TROUBLE TURNING IN ORDER FOR
OUR- HEALTH SYSTEM TO BE
SUCCESSFUL WE MUST EMBRACE THE
POWER OF THE MANAGED TO
TRANSFORM EVEN WHEN INVOLVED. IN
OVERWHELMING DESPAIR THIS
TRANSFORMATION HAPPENS WHEN
AGENCY. SELF DETERMINATION AND
THE OPPORTUNITY TO THRIVE. EXIST
THANK YOU SO MUCH. THANK YOU.
ALL RIGHT ANDREW IMPARATO. YEAH
THANK YOU SERVICE STARK AIR
AMERICA. YES THANK YOU SIR WERE
THE STAFF MY NAME IS ANDY FOR
HONORABLY THAT IS- THIS IS YOUR
LIFE CALIFORNIA I STARTED MY JOB
LONG BEFORE THE PANDEMIC OF THIS
MY FIRST TIME TRYING TO FIGURE
BEFORE THE LEGISLATURE I'VE
POINT THERE'S A LOT OF MOVIES
THERE BEFORE COMING BACK TO MY
HOME STATE AND I WAS. THERE ARE
GETTING TO THE VOTER OFFICE
DIRECTOR THE U. S. SENATE ON
HEALTH IF LABOR. THANK YOU FOR
THE UNITED STATES SENATE NOT BE
VERY THIS LAW SO I RECOMMEND YOU
SPEND. SHE WAS ABOUT FOR SO- I'M
ALSO. WITH NEXT WITH POLAR
DISORDER WHICH I'VE BEEN OPEN
ABOUT THROW OUT MY CAREER AND
I'M GONNA. A LITTLE BIT ABOUT.
IN MY ROOM THAT FOR I JUST TO.
ASSIST MYSELF WITH WHAT YOU'RE
HEARD GENERAL I THINK SHOULD
VERY L. MADE THE CASE FOR A- AND
FOR SELF THE L. EIGHT. YESTERDAY
ADDED TO. ABOUT THE IMPORTANCE
OF SELF DETERMINATION. AND AS A
DISABILITY CIVIL RIGHTS LAWYER I
CAN TELL YOU THERE'S NOTHING
MORE IMPORTANT THAN SELF
DETERMINATION. IF YOU REALLY
WANT TO HAVE A LONG TERM
STRATEGY. THAT'S GOING TO HAVE
TO HELP PEOPLE WITH LIVED
EXPERIENCE. BILL THE KIND OF
LIVES THAT THEY DESERVE- WE HAD
FOUR KEY POINTS THAT I MAKE
BRIEFLY A AND R. LETTER WHICH
YOU ALL HAVE A COPY OF. FIRST
JUST RESPECT THE DIVERSITY OF
FOLKS WITH MENTAL ILLNESS AT
SOME OF THE WITNESSES TODAY HAVE
TALKED ABOUT. PEOPLE WITH MENTAL
ILLNESS WITH A BROAD. BRUSH IT'S
A VERY DIVERSE COMMUNITIES JUST
TAKE MY DIAGNOSIS OF BIPOLAR
DISORDER. YOU HAVE PEOPLE LIKE
DOLLY PARTON AND TED TURNER. AND
YOU HAVE PEOPLE WHO ARE HOMELESS
ON THE STREET. IT'S A DIAGNOSIS
THAT IS VERY COMMON BUT NOT
EVERYBODY WHO HAS THE DIAGNOSIS
IS OPEN ABOUT IT. AND I JUST
THINK- JUST TO RECOGNIZE THAT.
PEOPLE CAN END UP IN A FIFTY ONE
FIFTIES SITUATION. WHEN YOU LOOK
AT THEM YOU WOULD THINK THAT
THERE'S NOTHING WRONG WITH THEM.
SO IT'S JUST A IT'S A BIG
POPULATION IT'S A DIVERSE
POPULATION. AND IF THE ONLY
PEOPLE YOU THINK ABOUT ANYTHING
ABOUT MENTAL ILLNESS OR PEOPLE
LIVING ON THE STREET. YOU'RE NOT
SEEING HIM AT ALL THE. THE FULL
SPECTRUM OF THE POPULATION-
ANOTHER POINTWE MADE IN OUR
TEST. IS THE PURPOSE OF THE
LETTERMAN PATRIS SHORT ACT. IS
N. THE INAPPROPRIATE INDEFINITE
AN INVOLUNTARY COMMITMENT OF
PERSONS WITH MENTAL HEALTH
DISORDERS THAT'S THE PURPOSE.
WE'RE NOT DOING THAT CERTAIN TO
MAKE IT EASIER TO TAKE AWAY
PEOPLE'S RIGHTS IS NOT GOING TO
ACHIEVE THAT PURPOSE WE SHOULD
MAKE IT HARDER TO TAKE AWAY
PEOPLE'S RIGHTS AND LET ME JUST
GIVE YOU AN EXAMPLE IN THIS
STATE RIGHT NOW. PEOPLE GO TO AN
EMERGENCY ROOM VOLUNTARILY
BECAUSE THEY'RE IN CRISIS AND
THEY'RE TRYING TO GET HELP. AND
THEY GET PUT ON A FIFTY ONE
FIFTY EVEN THOUGH THEY'RE ASKING
FOR HELP WHY ARE WE TAKING AWAY
THEIR LIBERTY WHEN ALL THEY NEED
IS GOOD CARE. SO I THINK IF
YOU'RE GONNA LOOK AT LPS REFORM
DON'T START WITH THE IDEA THAT
WE NEED MORE POWER TO TAKE AWAY
RIGHTS START WITH THE IDEA THAT
THIS EXISTS TO PROTECT PEOPLE
FROM HAVING THEIR RIGHTS TAKEN
AWAY- THE NEXT ONE I WANTED TO
MAKE. IS WE NEED TO IMPROVE
TRUTH I THINK THERE'S A LOT OF
CONSISTENCY ON THIS ACROSS ALL
YOUR WITNESSES. WE NEED TO
IMPROVE TREATMENT FOR ALL PEOPLE
WHO ARE DETAINED ON LPS HOLDS
AND CONSERVATORSHIP. THE FACT
THAT YOU'RE GETTING DETAINED
DOESN'T MEAN THAT YOU'RE GETTING
GOOD MENTL HEALTH TREATMENT-
AND IT AND IT'S ESPECIALLY
IMPORTANT TO EXPRESSLY REQUIRE.
EFFECTIVE TRANSITION PLANNING
FOR PEOPLE WHO ARE RELEASED FROM
BOTH SHORT TERM LPS SOLD. AND
LONG TERM LPS CONSERVATORSHIP.
WE'RE NOT DOING THAT RIGHT NOW
AND IF WE MAKE THIS TREATMENT
DURING THE TRANSITION. VOLUNTARY
PERSON CENTERED AND CULTURALLY
AND LINGUISTICALLY APPROPRIATE.
WE'RE GONNA SET SOMEBODY UP FOR
SUCCESS OVER THE LONG TERM. THE
THIRD POINT WHAT YOU'VE HEARD
FROM MANY WITNESSES TODAY AS WE
NEED BETTER DATA AND WE NEED THE
DATA TO BE DISAGGREGATED BY
RACE. ETHNICITY AND OTHER
DEMOGRAPHIC CHARACTERISTICS SO
WE KNOW WHAT'S ACTUALLY
HAPPENING. SO FINALLY JUST IN
TERMS OF MY STORY- THIRTY TWO
YEARS OF AGO I WAS A STUDENT AT
HARVARD LAW SCHOOL. AND I WENT
VERY QUICKLY FROM BEING HAPPY
TALKING A LOT IN CLASS I HAD
RECENTLY GOTTEN MARRIED. TO
HAVING NO ENERGY NO SELF
CONFIDENCE HAVING TROUBLE
GETTING OUT OF BED VERY
DIFFICULT FIGURE OUT THAT I
COULD HAVE A CAREER AS A LAWYER.
AND IT WAS THE SCARIEST THING
I'VE EVER BEEN THROUGH IN MY
LIFE. I GOT MARRIED THE SUMMER
BEFORE MY WIFE HELPED ME STAY ON
THE CONVEYOR BELT THAT I WAS ON
I STAYED IN SCHOOL I GRADUATED I
WORK FOR LEGAL SERVICES THAT
SUMMER. AND ENDED UP CLERKING
FOR A FEDERAL JUDGE JUDGE AND I
GOT MY LIFE TOGETHER AND I WAS
ABLE TO HAVE A CAREER. AS A
DISABILITY RIGHTS LAWYER A VERY
SUCCESSFUL CAREER. MY WIFE AND I
RAISED TWO CHILDREN YOU KNOW
WE'VE WE'VE HAD GOOD LIVES
TOGETHER. THE MOST IMPORTANT
THING FOR ME WAS STAYING ON THE
CONVEYOR BELT AND IF I HAD GONE
TO AN EMERGENCY ROOM. AND THEY
PUT ON A FIFTY ONE FIFTY AND
MAYBE TOLD BY HARVARD LAW SCHOOL
WANTED TO TAKE CARE OF YOUR
MENTAL ILLNESS AND THEN COME
BACK TO US WHEN YOU'RE FEELING
BETTER. I MIGHT HAVE BEEN
KNOCKED OFF THE CONVEYOR BELT
AND NEVER GOT BACK ON SO I JUST
ENCOURAGE YOU WHEN YOU THINK
ABOUT THE SYSTEM. DO EVERYTHING
YOU CAN TO KEEP PEOPLE
CONNECTED. TO THE HEALTHY THINGS
IN THEIR LIVES THEY'RE GOING TO
HELP THEM REBUILD THEIR LIVES.
KEEP THEM CONNECTED TO THEIR
SPOUSE OF THEIR MARRIAGE. KEEP
THEM CONNECTED TO THEIR JOB IF
THEY'RE WORKING. KEEP THEM
CONNECTED TO THEIR SCHOOLING. IF
THEY'RE PURSUING AN ADVANCED
DEGREE OR A COLLEGE DEGREE. AND
I THINK OUR SYSTEM SOMETIMES
SAYS WE'RE GONNA KNOCK YOU OFF
OF THAT. AND LET YOU DEAL WITH
YOUR ILLNESS AND THEN YOU CAN
COME BACK. KNOCKING PEOPLE OFF
THE CONVEYOR BELT CAN BE THE
WORST THING YOU CAN DO TO THEM.
AND THEN FINALLY I JUST WANT TO
QUOTE. THE EDITORIAL FROM THE L.
A. TIMES YESTERDAY. THIS WAS THE
STATEMENT THAT WAS MOST POWERFUL
TO ME THEY SAID A SOCIETY THAT
PROVIDES PHYSICAL AND MENTAL
HEALTH CARE. IS NOT AT ODDS WITH
ONE THAT RECOGNIZES THE PERSON'S
AUTHORITY OVER THEIR LIFE AND
BODY. NOR IS HUMAN DIGNITY
OPPOSED TO SELF DETERMINATION.
IN FACT THOSE PRINCIPLES ARE
DEEPLY. INTERTWINED SO AGAIN I
JUST REALLY ENCOURAGE YOU. AS
YOU THINK ABOUT REFORM.
RECOGNIZE THE CORE PURPOSE OF
THE OF THE LAND FROM PATRICK
SHORT ACT. WHICH IS TO PROTECT
PEOPLE AGAINST HAVING THEIR
LIBERTIES TAKEN AWAY. THANK YOU
VERY MUCH. THANK YOU. AND THEN
SUSAN CHUCKLED. HELLO THANK YOU
OFFICES AND GOOD MEN. AND I'M
HERE TODAY OF. FIRST TOOK OFF IN
THE BACK NAY FOR THEM OR THE
THINGS- I'M REMINDED OF
PARAPHRASE A BEATLES SONG I AM
YOU AND YOU ARE ME. I USED TO
SET UP THEIR NEXT TO MY BOSS WHO
WAS THE CHAIRMAN OF PUBLIC
SAFETY COMMITTEE. AND- WE NEVER
TALK TO MENTAL HEALTH AT THAT
TIME. BUT ANYWAY I GRADUATED
COLLEGE I BECAME A TEACHER GOT A
LITTLE BIT FRUSTRATED WENT TO
LAW SCHOOL AND THEN STARTED
WORKING I WAS THE DEPUTY DA IN
LA I WAS THE DEPUTY DA CHIEF
DEPUTY AND YOU'LL KILL ME AND
THEN A DEPUTY DA HERE IN
SACRAMENTO. NOTHING IN ALL THOSE
YEARS PREPAREDME TO BE THE
PARENT OF A CHILD WITH A SERIOUS
MENTAL ILLNESS NOTHING. OF SO
AFTER HAVING TWO KIDS I STOPPED
WORKING HERE AT THE TIME MY
ULTIMATE BUS WAS WILLIE BROWN
AND HE SAID YOU CAN NOT WORK
HERE IF YOU WANT TO COMMUTE FROM
HOME YOU WORK HERE TIMES HAVE
CHANGED- I STILL STATE
INTERESTED IN LOCAL POLITICS RAN
FOR MY LOCAL SCHOOL BOARD ANDWAS ON THE FULL SUPPORT OF THE
SCHOOL BOARD FOR FOUR YEARS.
ALSO WAS A PRESIDENT OF NAMI AND
DID SOME OF CRISIS INTERVENTION
TRAINING FOR POLICE OVER THE
LAST FEW YEARS. SO I JUST
MENTION ALL THIS BECAUSE THIS IS
LIKE I SAID THERE'S NOTHING IN
ALL THAT EXPERIENCE. THAT
PREPARED ME TO TRY TO BE THE
BEST MOTHER I COULD TO MY SON.
MY SON IS NOW THIRTY THREE. AND%
OVER TWENTY YEARS AGO HE STARTED
SHOWING SOME STRANGE BEHAVIORS
SOME DESTRUCTIVE BEHAVIORS
TALKING IN SOME STRANGE. THE
LANGUAGE. AND IT TOOK SEVERAL
YEARS TO GET HIM TO SEE A
PSYCHIATRIST WHEN HE FINALLY DID
HE WAS DIAGNOSED WITH PARANOID
SCHIZOPHRENIA DEPRESSION AND
SEVERAL MOOD DISORDERS. DURING
THE TIME THAT HE- BEFORE THAT
LET ME PUT IT THAT WAY. HE WAS
SOMEONE WITH A SERIOUS MENTAL
ILLNESS WHO DENIED HIS ILLNESS I
THINK IT'S PRONOUNCED AT AND
THOSE WITH NO SHIP. AND HE WENT
FOUR YEARS WITH NOTHING WRONG
WITH HIM HE DIDN'T NEED
TREATMENT DURING ALL OF THAT
TIME HE WAS EITHER LIVING ON THE
STREETS. OCCASIONALLY IN MY
BACKYARD IN JAIL FOR SEVERAL
FIFTY ONE FIFTY THE HOLDS THAT
BECAME A LITTLE LONGER THAT WAS
A LIFE HE LIVED IN MY I CANNOT
STRESS TO YOU ENOUGH THAT LPS
HAVE TO CONSIDER THOSE PEOPLE
WITH A SERIOUS MENTAL ILLNESS
WHO DENIED THEIR ILLNESS WHO
DON'T HAVE INSIGHT. THEY'RE
COMPLETELY ALMOST COMPLETELY
OVERLOOKED IN OUR SYSTEM AND I
UNDERSTAND IT GETS POLITICAL
BECAUSE WE TALK ABOUT CIVIL
RIGHTS AND CHOICE BUT THERE'S
ROOM. FOR BOTH IN L. P. S. BUT
THE OTHER THING THAT THAT I WILL
TO MENTION OF. BESIDES THAT WAS
ONE OF MY ALL TIME FAVORITE
WORDS WHICH IS CARE GIVER. AND I
HAVEN'T HEARD A THING TODAY
ABOUT CARE GIVERS. I KNOW MORE
ABOUT MY SON THAN ANYONE ELSE
I'VE GIVEN HIM MORE TREATMENT
THAN ANYONE ELSE I'VE BEEN
AROUND HIM ALL HIS LIFE I DON'T
COUNT. HIPPLE PREVENTS PEOPLE
FROM TALKING TO ME ATTITUDE
PREVENTS PEOPLE FROM TALKING TO
ME THE POLICE WON'T TALK TO ME
THE POLICE HAVE BEEN TO MY HOUSE
NUMEROUS TIMES AND THE ONLY
ADVICE THEY GAVE ME BELIEVE IT
OR NOT WAS WHY DON'T YOU PACK UP
YOUR STUFF AND MOVE AWAY AND
DON'T TELL THEM WHERE YOU ARE.
SO YOU'VE GOT TO TAKE CARE
GIVERS INTO ACCOUNT. YOU'VE GOT
TO UNDERSTAND OCEAN SANDERS SAID
YOU'VE GOT TO GIVE SOME ROOM FOR
DISCUSSION ABOUT DUAL DIAGNOSIS
YOU'LL BE HARD PRESSED TO FIND A
SCHIZOPHRENIC WHO HASN'T TRIED
METHAMPHETAMINE AT LEAST ONCE IN
HIS OR HER LIFE. AND YOU'VE GOT
TO CONSIDER THE ROLE. THAT CARE
GIVERS COULD HAVE IF THEY WERE
INCLUDED IN THIS ENTIRE PROCESS.
SO WITH THAT I SAY THANK YOU.
THANK YOU HE CHRISSY YOUR
TESTIMONY. AND A FINAL PANELIST
FOR THIS SECTION KIM LEWIS.
WHO'S WITH US REMOTELY. THANK
YOU VERY MUCH GOOD AFTERNOON
CHAIRS WOOD AND STONE MEMBERS OF
THE COMMITTEE MY NAME'S KIM
LEWIS AND THE MANAGING ATTORNEY
OF THE CALIFORNIA OFFICE OF THE
NATIONAL HEALTH LAW PROGRAM.
IT'S MY PRIVILEGE TO BE HERE ON-
TO TALK ON THIS PANEL ABOUT THIS
VERY CRITICAL TOPIC. VERY
FAMILIAR WITH THE LPS ACT AS
I'VE WORKED FOR TEN YEARS AS
LEGAL DIRECTOR. SORRY JUSTIN MY
CAMERA- THE PATIENT'S RIGHTS
PROGRAM IN SAN DIEGO COUNTY
WHERE I WAS DIRECTLY RESPONSIBLE
FOR ADDRESSING THE RIGHTS OF
CHILDREN AND ADULTS IN THE
MENTAL HEALTH SYSTEM IN
PARTICULAR OF LPS FACILITIES IN
THE COUNTY. I REPRESENTED
HUNDREDS OF CHILDREN AND ADULTS
WE'RE COMMITTED TO PSYCHIATRIC
HOSPITALS IN THE COUNTY JAILS
ARE PLACED ON LPS
CONSERVATORSHIP. SO I WANT TO
MAKE THREE POINTS TO THE
COMMITTEE AND LEGISLATURE.
AREN'T AT FOR CONSIDERATION IN
DETERMINING WHETHER ANY FURTHER
CHANGES ARE NEEDED FOR THE LPS
ACT. AND WHICH POINTS DO NOT
SUPPORT FURTHER BROADENING
INVOLUNTARY TREATMENT. TIMES
MOST RECENTLY IN TWENTY TWENTY
ONE. AND THOSE LAWS NEED TO BE
DEMONSTRATE. HOW BENEFICIAL
OUTCOMES. SOME HAVE NOT EVEN
BEEN IMPLEMENTED FOR EXAMPLE
CONSIDERATION PILOTS ALLOWED
INSURANCE DISCO IN LOS ANGELES
AND SAN DIEGO COUNTY THAT WERE
CREATED BY S. B. TEN FORTY FIVE
AND FURTHER BROADENED. THROUGH
AB FORTY IN TWENTY NINETEEN NEED
TO BE EVALUATED. WHERE IS THE
EVIDENCE THAT THESE ARE
EFFECTIVE AND MUST BE FOR THE
BROAD. IN FACT THE FINAL REPORT
ON THESE VERY QUESTIONS IS NT
DUE TO THE LEGISLATURE UNTIL
JANUARY ONE TWENTY TWENTY THREE
. SIMILARLY AS I STATED THIS
MORNING ASSISTED OUTPATIENT
TREATMENT HAS BEEN EXPANDED
MULTIPLE TIMES. FIRST IN TWENTY
THIRTEEN AGAIN IN TWENTY TWENTY.
AND THEN A TWENTY TWENTY ONE.
THE MOST RECENT CHANGES HAVE NOT
EVEN TAKEN EFFECT YET. AND STILL
MORE BILLS ARE CONTINUING TO BE
INTRODUCED TO BRIBE FURTHER
BROADEN THE CIVIL COMMITMENT
LAWS. WHERE IS THE JUSTIFICATION
OF BRIGHTON A. O. T. WITHOUT
DEMONSTRATING THE BENEFITS OR
VALUE WAITING OUTCOMES OF THESE
CHANGES THE LEGISLATURE AND THE
GOVERNOR HAVE ALREADY MADE.
DESPITE HEARING SOME EVIDENCE TO
THAT A. O. T. WORKS. AS I SAID
EVERY RANDOMIZED CONTROLLED
STUDY OF B. O. T. HAS
DEMONSTRATED THAT THERE'S NO
EVIDENCE THAT MANDATING
OUTPATIENT TREATMENT THROUGH A
COURT ORDER IS EFFECTIVE. AND AS
PROFESSOR DINNERS TEEN DISCUSSED
EARLIER THERE ARE EFFECTIVE
VOLUNTARY COMMUNITY BASED
SERVICES THAT ARE EVIDENCE BASED
AND NOT SHOULD BE THE FOCUS OF
STATE POLICY SOLUTIONS SUCH AS A
SEARCH ASSISTIVE. ASSERTIVE
COMMUNITY TREATMENT WHICH IS
HIGHLY INDIVIDUALIZED TEAM TO.
SERVICE DESIGNED TO SUPPORT
ADULTS WITH THE MOST INTENSIVE
MENTAL HEALTH NEEDS. AND A CITY
IS ENDORSED AND SUPPORTED BY SAM
SO THERE'S FOUR DECADES OF
INTERNATIONAL RESEARCH ON THAT
PARTICULAR SERVICE SECOND. I'M
MORE SUPPORTIVE HOUSING MODELS
MUST BE EXPANDED AS JENNIFER I
THINK EL ELOQUENTLY TALKED ABOUT
EARLIER ON THIS PANEL. THERE CAN
BE NO QUESTION THAT ONE OF THE
FUNDAMENTAL NEEDS OF PEOPLE WITH
MENTAL HEALTH. CONDITIONS AND
SUBSTANCE USE DISORDERS WHO ARE
UN HOUSED IS THAT INDIVIDUAL
HOUSING THAT IS NOT AVAILABLE.
SO INDIVIDUAL HOUSING TRANSITION
TENANCY SUPPORT SERVICES TO
SUPPORT TRANSITION CHIU AND
MAINTENANCE OF HOUSING IS
CRITICAL. SUCH SERVICES
INCLUDING ASSESSMENT TO IDENTIFY
PREFERENCES AND BARRIERS TO
HOUSING DEVELOPING A HOUSING
SUPPORT PLAN WITH GOALS
DEVELOPING A HOUSING CRISIS PLAN
TO PREVENT DISRUPTION OF
HOUSING. EARLIER IDENTIFICATION
AND INTERVENTION FOR BEHAVIORS
THAT MAY JEOPARDIZE HOUSING
EDUCATION AND TRAINING ABOUT HOW
TO MAINTAIN HOUSING. AND THE
ROLES OF LANDLORDS AND TENANTS
AND ASSISTANCE IN RESOLVING
DISPUTES AND LINKAGES TO OTHER
COMMUNITY RESOURCES TO PREVENT
INFECTION. AS I STATED THIS
MORNING PROP SIXTY THREE AND
THEN THE MENTAL HEALTH SERVICES
ACT WAS SPECIFICALLY INTENDED TO
EXPAND. VOLUNTARY SERVICES
THROUGH AB THIRTY FOUR AND
TWENTY THIRTY FOUR THAT WERE
ENACTED IN NINETEEN NINETY NINE
AND TWO THOUSAND TO STAB WISH
THE INTEGRATED SERVICE MODEL OF
SUPPORTING HOUSING FOR ADULTS IN
CALIFORNIA WHO HAVE SERIOUS
MENTAL ILLNESSES AND ARE AT RISK
OF BECOMING HOMELESS. THOSE
SERVICES INCLUDE OUTREACH
MEDICAL CARE SHORT TERM HOUSING.
PRESCRIPTION DRUGS OCCASIONAL
TRAINING AND SELF HELP AND
SOCIAL REHABILITATION. TWENTY
TWENTY TWO THOUSAND THREE REPORT
TO THE LEGISLATURE FOUND THE
SERVICE TO BE HIGHLY SUCCESSFUL
AT REDUCING. PARTICIPANTS
HOSPITALIZATIONS INCARCERATIONS
AND HOMELESSNESS. WELL
INCREASING THEIR EMPLOYMENT. IN
FACT THIS PROGRAM WAS SEEN AS A
NATIONAL MODEL FOR ADDRESSING
THE ISSUE OF HOMELESSNESS AND
MENTAL ILLNESS. YET TO DATE BE
SUPPORTED HOUSING PROGRAMS HAVE
NOT RECEIVED ADEQUATE INVESTMENT
ABROAD TO SCALE STATEWIDE
DESPITE EVIDENCE FROM AT LEAST
ONE LARGE STUDY BY YOU SEE A
PASSED THE PHONE PEOPLE WILL
ACCEPT SUPPORT OF HOUSING IF
IT'S OFFERED TO THEM. INSTEAD M.
HSA FUNDS ARE BEING ALLOWED TO
BE USED FOR INVOLUNTARY
OUTPATIENT. SYSTEM TREATMENT.
AND AS A FISCAL MATCH FOR
MEDICAL COVER BEHAVIORAL HEALTH
SERVICES. STATE MUST INCREASE
INVESTMENT INCLUDING AN HSA
FUNDS TO GROW EVIDENCE BASED
SUPPORT OF HOUSING MODELS. AND
BEHAVIORAL HEALTH CRISIS.
MEDICARE COVERED SERVICES
INSTEAD OF. INCREASING RELIANCE
ON A. O. T. OR BRIGHTENING LPS
CONSERVATORSHIP. AND FULL
SERVICE PARTNERSHIPS WHICH HAVE
BEEN TALKED ABOUT MAYBE
EFFECTIVE. BUT THERE AREN'T
CONSISTENT PROGRAMS AND THERE
AREN'T A STATE WIDE OUTCOMES FOR
THIS. SO THIRD MY FINAL POINT
MORE RECESSED SOURCES ARE NEEDED
TO IMPROVE ACCOUNTABILITY AND
BUILD CAPACITY IN CALIFORNIA'S
BEHAVIORAL HEALTH SYSTEM WE
TALKED A LOT ABOUT THAT TODAY.
MEDICALS THE LARGEST PAYER OF BE
HERE HOLD SERVICES OVER THIRTEEN
AND A HALF MILLION LOW INCOME
CALIFORNIANS RELYING ON IT FOR
COVERAGE. MANY PEOPLE SUBJECT
LPS ARE MEDICARE ELIGIBLE. THE
STATE IS ALSO IN THE MIDST OF
UNDERTAKING A MAJOR OVERHAUL OF
MEDICO CALLIE. EFFORT OR
INITIATIVE INCLUDING EXPANSION
OF ELIGIBILITY FOR SPECIALTY
MENTAL HEALTH SERVICES AND
SUBSTANCE USE SERVICES AND
COVERAGE OF NEW TYPES OF
SERVICES SUCH AS PEER SUPPORT
SPECIALIST SERVICES THAT WE'VE
TALKED ABOUT TODAY. YET ACCESS
REMAINS A MAJOR CONCERN IN THE
PUBLIC BEHAVIORAL SYSTEM CANNOT
MEET THE CURRENT DEMAND FOR
SERVICE. THE DEPARTMENT OF
HEALTH CARE SERVICES MOST RECENT
REPORT. ON PROVIDER NETWORKS FOR
MEDICAL SPECIALTY MEDICAL
SERVICES FOUND THAT LESS THAN A
QUARTER OF THE FIFTY SIX COUNTY
MENTAL HEALTH PLANS IN
CALIFORNIA RECEIVED A PASSING
NETWORK ADEQUACY RATING.
SEPTEMBER CALIFORNIA HEALTH CARE
FOUNDATION REPORT THAT EXAMINED
BEHAVIOR HEALTH NEEDS AND ASSESS
CHALLENGES RELATED TO ACCESS. TO
BEHAVIORAL HEALTH SERVICES FOR
MEDICARE ENROLLEES FROM THE
DEMAND EXCEEDS SUPPLY. THE
FACTORS CONTRIBUTING TO THESE
ACCESS ISSUES INCLUDE CHRONIC
WORD SUREST RICHARD WORKFORCE
SHORTAGES. THE COMPLEXITY OF THE
MEDICAL BEHAVIORAL HEALTH SYSTEM
IN LACK OF INTEGRATED BEHAVIORAL
AND PHYSICAL HEALTH CARE. AND
THE CAPACITY IN SERVICE GAPS
THAT EXIST WITH THE DIFFERENT
LEVELS OF CARE SUCH AS MOBILE
CRISIS SERVICES THAT ARE MISSING
AND THE NUMBER OF CANS. RATHER
THAN EXPANDING INVOLUNTARY
TREATMENT ADDING HOSPITAL BEDS
OR I. M. D. AT A HIGHER COST
WHICH WILL ONLY MAKE MATTERS
WORSE. CALIFORNIA NEEDS TO
ADDRESS THE CURRENT VOLUNTARY
SERVICE ACCESS CRISIS THAT HAS
BEEN FURTHER EXACERBATED BY THE
ONGOING PUBLIC HEALTH EMERGENCY.
TO THAT END WE URGE YOU TO HAVE
FOCUSED ANY LEGISLATIVE
PROPOSALS ON ENSURING AND
EXPANDING THE AVAILABILITY OF
COMMUNITY BASED MENTAL HEALTH
SERVICES IN SUPPORT OF HOUSING.
THANKS FOR THE OPPORTUNITY TO
TESTIFY ON THIS IMPORTANT TOPIC
AND I'M HAPPY TO ANSWER
QUESTIONS. THANK YOU WRITER
CONCLUDES THE PANEL OTHER
QUESTIONS FROM THAT. RIGHT
SINGER THANK YOU ALL FOR THE
INFORMATION AND YOUR CAR'S. I'VE
WORKED THERE. FOR- I'LL GIVE
YOU. JUST A FEW SECONDS REAL
QUICK IS HOPEFULLY VERY QUICK.
TO GO BACK. MMHM YOUR
MICROPHONE'S NOT ON. I JUST WANT
TO GO BACK TO WHAT THE MAYOR
SAID THAT THERE'S AN OPPORTUNITY
TO DO SOMETHING BOLD I AGREE
WITH THE MAYOR AND I JUST
ENCOURAGE YOU TO JUSTIFYING BOLD
BROADLY DON'T LIMIT IT TO LPS
REFORMATORY BROADLY WHAT CAN WE
DO THAT'S REALLY GOING TO MAKE A
DIFFERENCE TO IMPROVE THE LIVES
OF PEOPLE WITH LONG TERM MENTAL
ILLNESS OPS REFORM IS A SMALL
PIECE OF A MUCH BIGGER
CONVERSATION. THANK YOU AND I
THINK WE'RE ALL HUNGRY HUMANS.
HAVE OKAY. SO GOOD I APPRECIATE
THAT AND I'LL TURN IT BACK. TO
YOU DOCTOR. GREAT WELL THANK YOU
VERY MUCH AND ONCE AGAIN THANK
YOU TO OUR WITNESSES ON THIS ON
THE PANEL VERY MUCH APPRECIATED
MOVE ON TO OUR FINAL PANEL OF
THE DAY- FAIR MAKE DATING'S
GOING TO JOIN US HERE. IN PERSON
AND THEN- ALSO- DOCTORS DOCTORS
HERE AND I'M ON THE- ON THE-
REMOTE REMOTE PART OF THIS SO
ONCE AGAIN WE'VE GOT TO JUST
ABOUT FIVE MINUTES EACH IF YOU
COULD THAT BE GREAT. THANK YOU.
GOOD AFTERNOON MISTER CHAIRS AND
MEMBERS I'D FOR ADVOCATING WITH
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES GOOD TO SEE YOU
AGAIN- I WANT TO THANK THE
SERGEANTS AND STAFF FOR MAKING
THIS A CLEAN SAFE ENVIRONMENT.
AND OF THE STAFF OF BOTH
COMMITTEES WHO PRODUCED A
BACKGROUND PAPER. THAT IS
UNPARALLELED- FORTY FIVE FISH
PAGES WITH A LOT OF REALLY GOOD
BACKGROUND IT IT I THINK ANYBODY
WHO'S- BEEN A PART OF THIS
HEARING OR IS WATCHING IT FROM
AFAR WOULD BENEFIT FROM READING
IT- MY COMMENTS WERE TALKING
ABOUT. CHANGES AND IMPROVEMENTS
IN IN THE MORNING I'D SHARE THE
KEY CHALLENGE FOR COUNTIES.
WHICH WAS A VARIETY OF THINGS
BUT FUNDING SPECIFICALLY FOR
PUBLIC GUARDIANS- YOU DON'T. I
HAVE THREE SUGGESTIONS FOR
CHANGES AND IMPROVEMENTS UP ONCE
SHORT TERM WANT TO MEDIUM TERM
ONCE A LONG TERM WHAT I WANT TO
KNOW FIRST IS THAT MANY OF THE
PROGRAMS WE'VE TALKED ABOUT
TODAY THAT ARE INNOVATIVE THAT
HELP PEOPLE MEET THEM WHERE THEY
ARE OUR PILOT PROGRAMS ARE GRANT
FUNDED PROGRAMS- ARE. OFTEN OR
VOLUNTARY PROGRAMS IN FACT EVEN
THE EXPANSION OF LAURA'S LAW- BY
SENATOR EGGMAN REALLY HAS
EXPANDED THOSE SERVICES IN
CALIFORNIA AND I THINK THAT'S TO
THE GOOD OF ALL CALIFORNIANS-
WAS DONE WITHOUT ANY FUNDING FOR
COUNTY IS WILLING TO OPT IN. AND
SO I CAN LIST TEN PROGRAMS THE
PEER SUPPORT SERVICES- THE IT'S
S. B. EIGHTY TWO MOBILE CRISIS
TEAMS LARA ALL OF THESE GOOD
INNOVATIONS HAVE OCCURRED
WITHOUT ADDITIONAL STATE FUNDING
AND SO I JUST WANT TO NOTE THAT
THAT- IF WE WANT TO MAKE BIG
CHANGES WHO TRULY WANT TO HELP
WE NEED THE STATE'S HELP WITH
THAT- IT'S A CRITICAL PIECE. MY
SHORT TERM. SUGGESTION IS IT OF
COURSE COUNTIES ARE IN ANY IN
NEED OF ADDITIONAL FUNDING FOR
CASE LOOKS THAT THE PUBLIC
GUARDIANS ARE STRUGGLING WITH
CURRENTLY BEFORE ANY OTHER
POLICY CHANGES ARE MADE- THEY'VE
NOTED THE INCREASE IN FORENSIC
REFERRALS THOSE FROM THE JAILS
AND THE CRIMINAL JUSTICE SYSTEM
AS WELL AS- JUST GENERALLY MORE
AN INCREASE IN POPULATION AND
MORE FOLKS THAT ARE REFERRED FOR
AT LEAST INVESTIGATION FOR THIS
SO THE SHORT TERM SOLUTION. THAT
COULD BE ADDRESSED IN TWENTY
TWENTY TO EARLY TWENTY TWENTY
TWO COULD BE SOMETHING TARGETED
FUNDING TO HELP PUBLIC GUARDIANS
DEAL WITH THOSE RISING CASELOADS
AND IMPROVE CARE. THE MEDIUM
TERM AND THAT'S WHAT'S REALLY
IMPORTANT IS AS WE'VE ALL TALKED
ABOUT TODAY THE DATA AND
TRANSPARENCY EFFORTS. IT'S NOT
SOMETHING THAT NEEDS TO BE
ADDRESSED IMMEDIATELY- THE
INEQUITIES THAT BEEN MENTIONED
HERE TODAY- THE FACT THAT WE
DON'T HVE THE STATISTICS. THE
FACT THAT VERY FEW PEOPLE OF
COLOR ARE EVEN INVOLVED IN THIS
HEARING- BELIES THE NEED THAT WE
NEED TO UNDERSTAND WHO WERE
TREATING. HOW WE'RE TREATING
THEM OF COURSE- MEASURE AND
DETERMINE OUTCOMES SO THE DEMAND
TRANSPARENCY I CLASSIFY AS A
MEDIUM TERM. GOAL IN THAT- IF WE
HAD SOME FUNDING AND SOME CLEAR-
STANDARDS AND- DATA REQUIRED AND
OUTCOMES THAT WE WANT TO MEASURE
SET FORTH. THEN WE CAN BEGIN
MEASURING THAT SO I CLASSIFIED
AS MEDIUM TERM. THE LAST PIECE
IS A LONG TERM PEACE AND IT'S
THE MOST CRITICAL PIECES- THAT
WE'VE ALL HEARD TODAY BY EVERY
SINGLE PERSON REGARDLESS OF.
WHERE THEY STAND ON LPS ISSUES
WHICH IS THE NEED FOR HOUSING.
OF COURSE THE GOVERNOR AND THIS
LEGISLATURE IS INVESTMENT IN THE
BEHAVIORAL HEALTH CONTINUUM
INFRASTRUCTURE PROGRAM AS WELL
AS- FUNDING FOR SOME MOBILE
CRISIS TEAMS AS WELL AS FUNDING
FOR OTHER- KINDS OF BETS LIKE
BOARDING CARE A LITTLE BIT OF
FUN IN THERE- THIS IS A LONG
TERM. IT'S GOING TO TAKE MORE
THAN A YEAR. IF NOT TWO OR THREE
OR FOUR BEFORE WE REALLY START
REAPING. THE REWARDS OF THOSE
INVESTMENTS- WITH MORE BAD SAFE
PLACES TO PUT THE PEOPLE WE ALL
SERVE. WITH THAT IN IN THE
INTEREST OF TIME. I COULD. THANK
THANK YOU VERY MUCH MUCH
APPRECIATED WE WILL GO AHEAD AND
MOVE ON TO DOCTOR SHARON.
REMOTELY THANK YOU VERY MUCH-
CHAIRS STONE AND WOOD AND TO ALL
THE MEMBERS- I DO WANT TO
COMMEND YOU FOR YOUR LEADERSHIP
AND PULLING THIS LARGE GROUP
TOGETHER YOUNG SUCH A BROAD. SET
OF INFORMATION- I ALSO WOULD
LIKE TO RECOGNIZE GERALD
STEINBERG AND HIS- YOU KNOW.
REQUESTED OR SUGGESTED THAT BOLD
ACTION- IS NEEDED I THINK IT'S
DEMANDED BY THE SITUATION- I
WANT TO JUST FOLLOW UP ON SOME
OF THE- BILL IS SOME SOLUTIONS
TO PROBLEMS THAT I DISCUSSED
THIS MORNING- THE STANDARD-
WHICH- REALLY FOR ME IS A IS A
DISCUSSION ABOUT GRADE
DISABILITY. THE NEED FOR TOOLS
OF ENGAGEMENT AND THEN- THAT THE
REQUIREMENT THAT WE HAVE
RESOURCES TO DELIVER TO OF
ANYONE THAT'S GOING TO RECEIVE.
ANY TYPE OF- COMPELLED
ENGAGEMENT- THE FIRST THING IS
REALLY WHEN YOU LOOK AT- LPS LAW
THE ORIGINAL. LANGUAGE REALLY
REFLECTED NOT SO MUCH GOOD
DISABILITY- SAY BUT A LARGER
PLATFORM OF THE INABILITY TO
LIVE SAFELY IN THE COMMUNITY DUE
TO A SERIOUS. MENTAL ILLNESS AND
AN UNWILLINGNESS TO ACCEPT CARE-
I BELIEVE THAT THAT WORKS IN THE
ACUTE OR EMINENT SENSE IN TERMS
OF SOMEONE BEING HOMICIDAL OR
SUICIDAL. DEMOCRATIC SENSE IT
DOES NOT WORK THAT'S ABOUT WHAT
I BELIEVE IS REALLY AT THE CORE
TOPIC. OF CONVERSATION TODAY AND
THEIR NUMBER REASONS FOR THAT-
INTERPRETATION OF THE INDICATORS
OF GREAT DISABILITY OTHER WHICH
YOU SEE SHOWS UP IN VARIABLE
IMPLEMENTATION. THINGS LIKE DATA
BEING LIMITED FOR THE COURTS AND
FOR THE JUDGES I'M AND THE
JURIES- THE YOUR LACK OF INPUT
FROM CARE GIVERS WHICH WE JUST
HEARD ABOUT I WHICH IS A
PROBLEM. AND REALLY WHAT WE END
UP SEEING IS- IT. FIFTY ONE
FIFTIES WHICH LEAD TO MULTIPLE
ADMISSIONS FOR INPATIENT CARE
WHICH IS ACTUALLY FOR ACUTE
SERVICES AND- GREAT DISABILITY
OR NOT LIVING SAFELY IN THE
COMMUNITY ARE CHRONIC. EARNS AND
THE FACT OF THE MATTER IS WHEN
YOU PUT SOMEONE INTO THE
HOSPITAL THAT CAN BE TOXIC
EXPERIENCE A TRAUMATIZING
EXPERIENCE ALSO WE HAVE A
LIMITED NUMBER OF BEDS OR BEDS
ARE ALL JAMS AND NOT AVAILABLE
FOR FOLKS THAT THE ACUTE
SERVICES. AND WE SPENT A LOT OF
MONEY AND FRANKLY THE HOSPITAL
SYSTEMS CAN'T DRAW DOWN MONEY
FOR INDIVIDUALS WHO ARE IN WITH
CHRONIC. CONDITIONS IN FACT THIS
MAY BE A CONTROVERSIAL THING TO
SAY BUT IF IT WERE UP TO ME I
WOULD CONSIDER STRIKING GREAT
DISABILITY FROM THE FIFTY ONE
FIFTY BECAUSE GREAT DISABILITY
DOES NOT INDICATE AN IMMINENT-
CUTE. SCENARIO SO I'M- ARGUING
FOR A REVISITING XIN OF WHAT
LIVING SAFELY MEANS. THESE ARE
THREE INDICATORS I BELIEVE THAT
THERE ARE MORE. AND THAT WHEN WE
IDENTIFY INDIVIDUALS WHO ARE NOT
LIVING SAFE IN THE COMMUNITY.
FOR REASONS- RELATED TO THEIR
MENTAL ILLNESS AND AYE AYE AND
WILLINGNESS TO ACCEPT CARE. WE
NEED A PROPER SET OF TOOLS
THAT'S BROADER. THAN JUST A
CONSERVATORSHIP AND GUARANTEED
RESOURCES IN TERMS OF THE TOOLS
OF ENGAGED I MENTION OF THEM
THIS MORNING. SHARE DECISION
MAKING PSYCHIATRIC ADVANCE
DIRECTIVES THE L. T. PROGRAM I
WANT TO SALUTE CENTER EGGMAN FOR
IMPROVEMENTS AND THE TEMPORARY
AND A FULL CONSERVATORSHIP- ONE
OF THE THINGS THAT WE HAVE SEEN
WITH A- FIFTY ONE FIFTIES AND IS
THAT THERE'S NO LINKAGE AFTER. A
FIFTY ONE FIFTIES BECAUSE WE
DON'T HAVE OTHER TOOLS. AND IT
CAN'T BE ALL OR NOTHING. AND I
WOULD SAY TO YOU THAT A BODY OF
LAW IS NEEDED TO CAN'T BE
ENGINEERED AS ONE OFFS- THAT'S
AN IMPORTANT THING FOR I WOULD
SUGGEST THE LAWMAKERS TO THINK
ABOUT. IN TERMS OF GUARANTEED
RESOURCES UP FRONT- CIVIL
LIBERTIES COMPEL US TO GUARANTEE
RESOURCES BEFORE WE MESS WITH
ANYBODY'S- CIVIL LIBERTIES. AND
WHEN I TALK ABOUT RESEARCH THAT
I'M TALKING ABOUT HOUSING OF ALL
TYPES NOT JUST PERMANENT
SUPPORTIVE HOUSING. BUT ALSO
CONGREGATE HOUSING BOARDING
CHAIRS FOR EXAMPLE AND THERE'S A
HUGE PROBABLY BOARDING HAS WHICH
ARE DISAPPEARING OFF THE FACE OF
A CALIFORNIA FOREVER IDEA
REASONS THEY'RE NO LONGER
AFFORDABLE. FULL SERVICE
PARTNERSHIPS THAT ARE ACTUALLY
REAL ACCOUNTABLE AND WE'RE IN
THE PROCESS OF. RE ENGINEERING-
ARE FULL SERVICE PARTNERSHIP
APPROACH- AND WE'VE DONE THAT IN
PART- COLLABORATING WITH- THE
OVERSIGHT ACCOUNTABILITY
COMMISSION- RESIDENTIAL
TREATMENT. A PARTIAL
HOSPITALIZATION AND INTENSIVE
OUTPATIENT CARE ANY CONSERVATIVE
WHO I'D LIKE TO THINK IT WAS
RECOVERY FACILITATOR BECAUSE OUR
GOAL. WITH AN ENGAGEMENT TOOLS
IS TO GET PEOPLE ON IT RECOVERY
PATHWAY SO THAT THEY DON'T NEED
ANY ENGAGEMENT TOOLS IN THAT
THEY'RE WILLINGLY ACCEPTING
KERR. AND I WOULD ALSO ADD
APPEARS SOMEONE WHO. PROVIDES
KINSHIP TO INDIVIDUALS WHO OFTEN
ISOLATED IN ON THAT BUT ON THE
ISSUE OF CONSERVATORSHIP I FULLY
AGREE WITH GETTING MORE FUNDING.
I APPRECIATE- SCARLET HUES OF
THE BIG FAN I WILL SAY HOWEVER
I'D LIKE TO MENTION THE WHOLE
PILOT WHICH WE'RE DOING WHICH
SAVES MONEY. OUR OWN PILOT IS
BASED ON GUARANTEED RESOURCES
AND RELENTLESS ENGAGEMENT WE
HEARD THAT SOMEONE NEEDS TO BE
ENGAGED FORTY TIMES BEFORE
THEY'LL ACCEPT HERE THAT'S
ACTUALLY A PRETTY ACCURATE-
ESTIMATE IN MY OPINION. BUT
AFTER AND RELENTLESS ENGAGEMENT
FAILS WITH GUARANTEED RESOURCES. THE LIST OF WHICH I JUST WENT
THROUGH WE DON'T HAVE THINK
ABOUT STEP INTO. THE USE OF TO.
WHEN THEY'RE NEEDED IN REAL
TIME- I CAN HEAR THAT I'VE
EXPIRED JUST GIVE ME ONE MORE
SECOND IF YOU DON'T MIND.
DISTRICT REALITY OF SOMEONE WHO
IS REFUSING CARE AND HAS
SUFFERED IS SUFFERING FROM
SEVERE PERSISTENT ELEMENTS.
NEEDS TO BE VISIBLE TO THE COURT
AND TO THE JUDGE AND WITH OUR
HOME PILOT. WE ARE DOING THIS
WORK IN THE STREET THAT'S THE
CLINICAL WORK THAT I DO VERY
VERY RARELY BUT WE'RE PRESENTING
CASES TO THE COURTS. BASED ON
SOMEONE LIVING ON THE STREET AND
NOT ACCEPTING KERR AS OPPOSED TO
BEING PUT INTO A HOSPITAL FOR
MONTHS AT A TIME. MEDICATED
ETCETERA AND THEN RELEASED WORK
CONCERNED AT GREAT COST TO OUR
SYSTEM OUR TAXPAYERS AND IN MY
OPINION TO INDIVIDUALS. IN TERMS
OF GENERAL OUTCOMES ARE THE- THE
THINGS THAT WE NEED TO LOOK AT-
TO BE SUCCESSFUL AND WE NEED TO
BE FUNDED FLEXIBLY TO GO AFTER
THOSE. OUTCOMES AND THERE ARE
MANY DIFFERENT WAYS TO THINK
ABOUT HOW FUNDING COULD BE USED
I'VE MENTIONED MHSAA WHICH IN MY
OPINION NEEDS TO BE REFRESHED.
AND ALLOW WE NEED TO BE ALLOWED
TO USE IT MUCH MORE FLEXIBLY TO
ACHIEVE GOALS AT THE STATE THE
FINES. AND WE COULD DEFINE THIS
POPULATION AS OUR TOP PRIORITY
AND USE THAT MONEY TO GO AFTER
IT WITH OR WITHOUT ENGAGEMENT
TOOLS THANK YOU. THANK YOU VERY
MUCH- BRING IT BACK TO THE
COMMITTEE QUESTIONS OR COMMENTS
. NO MR SOME. IN THE CLIP OKAY
WELL THANK YOU VERY MUCH M. BOTH
OF YOU AGAIN- COMMENTS MUCH
APPRECIATED- HAS PUT ALL OF OUR
WITNESSES TODAY. I THINK THAT
WILL CONCLUDE OUR- OUR WITNESSES
AND OUR PANELS AND SO I THINK
YOU THANK YOU AGAIN FOR YOUR
ASSISTANCE IN THIS- REALLY. SO
IT LINK THE BUT BUT FASCINATING
HEARING FROM MY PERSPECTIVE SO
THANK YOU THANK YOU VERY MUCH.
AT THIS POINT- WILL GO AHEAD AND
MOVE ON TO- AND TAKE PUBLIC
COMMENT FOR ABOUT TWENTY MINUTES
AND- PUT TO. MY CO CHAIR IN
CHARGE OF THAT NANA. SIT HERE
AND WATCH AND LISTEN THANK YOU
RIGHT SO NOW WE'LL MOVE TO
PUBLIC COMMENT WILL THOSE WHO.
ARE IN THE ROOM WILL START IN
THE ROOM. AND ASKED THAT
EVERYONE LIMIT THEMSELVES TO IT
THE MINUTE EACH WE WILL ALSO
THEN BE GOING TO PUBLIC WHO MAY
BE ON THE LINE. IF YOU WANT TO
CALL IN I'LL REITERATE THE
INSTRUCTIONS CALL IN AT.
877-692-8957 THE ACCESS CODE IS. ONE THREE ONE FIVE FOUR TWO-
TO. YOU CAN ALSO FIND US ON THE
WEB SITES FOR BOTH THE HEALTH
AND THESE THE JUDICIARY
COMMITTEES FOR THE ASSEMBLY SO
WE'LL START WITH PUBLIC COMMENT
IN THE ROOM PLEASE. HE NO IT'S
NOT ON. TESTING CARIA THANK YOU
COMMITTEE- MY NAME IS LINDA MIMS
I'M FROM SAN DIEGO COUNTY AND
I'M A BOARD MEMBER OF THE
SCHIZOPHRENIA AND PSYCHOSIS
ACTION ALLIANCE AND MY COMMENT
IS THAT SERIOUS MENTAL ILLNESSES
ARE REALLY SERIOUS NEURO
DEVELOPMENTAL BRAIN DISEASES AND
FIFTY FOUR YEARS AGO WHEN LPS
WAS ENACTED WE DIDN'T KNOW THE
BIOLOGICAL NEUROLOGICAL NATURE
OF THESE ORGAN BASED DISEASES.
TODAY WE KNOW THAT PSYCHOSIS
LIKE STROKE NEEDS IMMEDIATE
MENTAL MEDICAL INTERVENTION TO
STOP WHITE BRAIN MATTER
DETERIORATION- IT'S LIKE A BRAIN
ATTACK. LPS PREVENTS THIS
INTERVENTION FOR OUR SICKEST WHO
ARE UNABLE THEY'RE NOT IN DENIAL
THEY ACTUALLY PHYSICALLY CANNOT
DO TO COGNITIVE CHANGES SEEK
HELP VOLUNTARILY. THIS HAS LED
TO THE TERRIBLE SUFFERING OF
THOSE AFFLICTED THEIR FAMILIES
IN OUR SOCIETY MILLIONS HAVE
DIED NEEDLESSLY JUST BECAUSE
THEY CAME INTO THE WORLD WITH
TREATABLE NO FAULT BRAIN
DISEASES THAT WE HAVE ALLOWED TO
GO UNTREATED. IN THE NAME OF
PROTECTING PERSONAL RIGHT TO DIE
A TERRIBLE DEATH JUST QUICKLY
LPS WAS BUILT ON A FAULTY
FOUNDATION RIDDLED WITH NON
MEDICAL CRITERIA FOR THE RIGHT
TO TREATMENT BEFORE TRAGEDY WE
MUST REBUILD THE LEGISLATION
WITH A STRONG FOUNDATION BASED
ON THE MEDICAL TREATMENT THE
MEDICAL NEED FOR TREATMENT. OUR
SICKEST AND MOST VULNERABLE ARE
COUNTING ON US THANK YOU. CAN I
PLEASE ASK EVERYONE TO KEEP TWO
MINUTES SO WE CAN MAKE SURE WE
HEAR EVERYONE. RYAN BRECHT NEED
FROM ANTIOCH CALIFORNIA. BEEN
INVOLVED IN- PATIENTS RIGHT BEEN
INVOLVED WITH THE- AND I'M SORRY
SIR YOU NEED TO BE WEARING A
MASK THANK YOU I KNOW THAT MY- I
WAS INVOLVED IN A- ADVOCACY IN
FOR MENTAL HEALTH CONSUMERS
SINCE EIGHTY FIVE A- ACTUALLY
SINCE. L. IKE A GIRLFRIEND OF
MINE WAS PUT ON CONSERVATORSHIP
AND IT WAS PAINFUL BUT THIS HAS
TO BE AN ALTERNATIVE FIRST OFF.
I DID SEE AN ALT FIRST OFF SHE'S
WRONG THE ONLY PARTLY RIGHT WE
KNOW THERE'S A BIOLOGICAL
COMPONENT TO IT BUT WE KNOW BUT
ALSO THERE ARE. AS IN EVERY
ILLNESS- CERTAIN FACTORS IN
PARTICULARLY ENVIRONMENTAL
FACTORS I SAW A- WELL I'M NOT
GOING TO GET INTO IT I COULD
MAIL IT TO YOU BECAUSE THE STATE
LIBRARY UNFORTUNATELY HIS. DID
NOT EMAIL ME IN THE BIG TEN THE
EVENING OUTLOOK ABOUT THE ROLE
THAT FAITH COMMUNITIES HAVEN'T.
MENTAL HEALTH NAMELY CONTRAST
THING A PERSON WITH PILLS WITH.
WITH THE VALUE. THAT THAT WAS
WHEN THE EARLY SIXTIES WHEN WE
HAD WHEN WE HAD A STRONGER.
THING I THINK WHAT WE NEED TO DO
IS RESTORED WITH SOCIAL CAPITAL-
WHEN LPS PASSED WE HAD. WE HAD
OF FAITH COMMUNITIES VETERANS
GROUPS SOCIAL CLUBS AND SO ON
WERE. GOT LOADS OF PEOPLE AS
ROBERT PUTNAM HAS POINTED OUT IN
HIS BOOK. BOY LET BOWLING ALONE
VETS DISAPPEARED I THINK STRONG
SOCIAL CAPITAL COULD HELP.
PEOPLE WE PEOPLE THAT YOU CAN
FIND. ARTICLES IN POPULAR
MAGAZINES WE NEED TO. I THINK
THERE WAS AN ARTICLE THAT ED HAD
A GOOD POINT. WHICH WE HAD
STRONG SOCIAL CAPITAL AND WE
NEED TO RESTORE IT AND WE NEED
ALSO TO. THANK YOU YOUR STORY
THANK YOU. AND IF YOU HAVE
LONGER STATEMENTS YOU'RE VERY
VERY WELCOME TO SUBMIT ANYTHING
IN WRITING TO US AND WE'LL MAKE
IT. A PART OF THE RECORD. TALK
TO IN THE SERGEANTS IN THE HOPE
YOU. NEXT PLEASE. HELLO M. HI
I'M AVERY WHO ARE DESCENTE AND
I'M ADVOCACY COORDINATOR FOR
CAMPOREALE I'M ALSO A CONSUMER
WHO UNDERSTANDS THE CHALLENGES
IN NAVIGATING CALIFORNIA'S
BEHAVIORAL HEALTH SYSTEM. AS
MENTIONED BY MULTIPLE PANELISTS
TODAY THE CURRENT SYSTEM FAILS
IN WAYS THAT CAUSES INDIVIDUALS
TO CYCLE IN AND OUT OF THE
SERVICES BECAUSE THE SPACES ARE
NOT DESIGNED FOR HEALING TO
BEGIN WITH. VOLUNTARY INTENSIVE
SERVICES ARE THE ANSWER TO
MENTAL SUFFERING NOT THE
EXPANSION OF COURSE TREATMENT. I
MENTIONED I'M A CONSUMER AND I'M
FULLY AWARE OF MY OWN NEEDS WHEN
I AM EXPECT EXPERIENCING A
MENTAL HEALTH CRISIS. I KNOW HOW
PEOPLE LIKE ME ARE TREATED WHEN
THEY ARE SEEKING HELP AND
SUPPORT FROM THE TRADITIONAL
CRISIS INTERVENTION ENTITIES AND
I WOULD MUCH RATHER KEEP QUIET
THROUGH MY MENTAL HEALTH
SUFFERING. THEN RE LIVE THE
FIFTY ONE FIFTY EXPERIENCE.
INVEST IN ACCOUNTABILITY COLLECT
AND AGGREGATE THE DATA TO
IDENTIFY THE GAPS IN SERVICES
AND ADDRESS THEM WITH
SUSTAINABLE INNOVATION AND
INTENTION. INVEST IN SPACES THAT
PROMOTE HEALING INVEST IN
INNOVATION THAT HAS PROVEN TO
PRODUCE POSITIVE INCOMES.
INVESTED I AM HAPPY UNITS AND
MOBILE CRISIS TEAMS S MENTIONED
EARLIER. HERE ON PROGRAMS HIGHER
PEER SUPPORT SPECIALISTS AND
INVESTED PRS BITS THANK YOU
THANK YOU. CARPER'S HELLO
COMMITTEE MEMBERS THEN THANK YOU
FOR THIS OPPORTUNITY TO SPEAK TO
TODAY MY NAME IS ANDREA WAGNER
AND I LIVE IN BUTTE COUNTY BUT
CURRENTLY I'M A PROGRAM MANAGER
FOR THE LIVED EXPERIENCE
ADVOCACY AND DIVERSITY PROGRAM
OF CAMPRO THE CALIFORNIA
ASSOCIATION OF MENTAL HEALTH
CARE RUN ORGANIZATIONS AND MY
PROGRAM IS THE ADULT CONSUMERS
STAKEHOLDER GROUP THAT ADVOCATES
THAT DOES ADVOCACY OUR REGION
EDUCATION FOR THE MENTAL HEALTH
SERVICES OVERSIGHT
ACCOUNTABILITY COMMISSION. AND
THIS LAST YEAR WE SPOKE TO- OVER
THREE HUNDRED CONSUMERS ACROSS
THE STATE GATHERED OVER TWELVE
HUNDRED COMMENTS AND ONLY ONCE
IN THAT WHOLE TIME DID ANYONE
MENTION THAT WE NEED MORE AT A
COURSE OF TREATMENT AND THAT WAS
ONLY BECAUSE THAT PERSON DID NOT
WHEN I HAVE TO TRAVEL OUT OF
THEIR COUNTY TO VISIT A LOVED
ONE IN THE HOSPITAL. I'M I'M A
TRAUMA SURVIVOR MYSELF I BUT I
HAVE ALSO. BEEN ON A FIFTY ONE
FIFTY AND I'VE ALSO BEEN ABLE TO
WRITE FIFTY ONE FIFTIES FOR MY
COUNTY. I'VE WORKED AT A LOSS AS
A HOSPITALIZATION COORDINATOR.
AND IT I CAN TELL YOU FIRSTHAND
THAT AT YOUR SUPPORT AND
COMMUNITY FOR GROUPS IN SUPPORT
WAS THE CHANGE. MAKER THAT SAVED
MY LIFE AND GAVE ME THE SKILLS
TO BE WHERE I AM TODAY AS A FULL
TIME. EMPLOYEE AT A GRADUATE
STUDENT AND MOST LONGEST PERIOD
OF STABLE WELLNESS THAT I'VE HAD
IN MY LIFE. TODAY IN
REPRESENTING CAMPER- I WANT TO
RECOGNIZE MY- BUT- EXECUTIVE
DIRECTOR MY OUTGOING DIRECTOR
SALLY'S DEMAND HAS BEEN WORKING
AS AN ADVOCATE. FOR FORTY FIVE
YEARS AGAINST FORCE TREATMENT.
AS SHE ASKED US TO IMAGINE AND
STRIVE FOR A SYSTEM WITHOUT
COURSE OF TREATMENT AND THAT IS
SOMETHING THAT IS HAS INSPIRED
ME SINCE I STARTED WORKING AS A
PEER SUPPORTER THANK YOU. I'M
ENCOURAGED AND HOPEFUL HEARING
TODAY THAT YOU'RE NOT LOOKING TO
EXPAND CRITERIA FOR LPS HOLDS
NECESSARILY RIGHT EXCITED. THAT
YOU HAVE ALL HEARD FROM THE
FRONT LINE WORKERS AND OTHERS-
AND I JUST WANTED TO SAY THAT
COERCIVE HOSPITALIZATION THANK
YOU. SORRY CAN I JUST SAY ONE
MORE THING. WE DO WE DO MAKE
NEED TO MOVE ALL RIGHT. OKAY
ANYONE ELSE IN THE HEARING ROOM. ALL RIGHT THING THEN WE'LL GO
TO THE PHONES THAT. OPERATOR TO
HAVE ANYONE ONLINE UNDERSTAND WE
HAVE QUITE A FEW. THANK YOU IF
YOU WISH TO MAKE A COMMENT
PLEASE PRESS ONE THAT THEM ZERO
AT THIS TIME. WHAT WHAT TO LINE
FIFTY EIGHT PLEASE GO AHEAD. HI
AM I LINE FIFTY EIGHT CAN I BE
HEARD IN COMMITTEE. INSTEAD OF-
MENTAL HEALTH HEARING ABOUT
FIFTY ONE FIFTY I HAD A LITTLE
PROBLEM RINGING THROW YES WE'RE
WELL WE'RE LOOKING AT THE-
LANTERN MEN T. THREE SHORT ACT.
YEAH I'M IN THE RIGHT PLACE
BECAUSE A LOT OF TIME WHEN I
DEAL WITH YOU PEOPLE I FEEL LIKE
I'M ON THE BACKSIDE OF THE MOON
AND I JUST HAVE TO SAY I THINK
IT'S REALLY SHAMEFUL THAT PEOPLE
THOUGHT THERE ALL DAY FOR EIGHT
HOURS LISTENING TO YOUR SUPPOSED
THAT ACTS BURKE. AND YOUR
CUTTING PEOPLE OFF YOUR RINGING
A BELL ON THEM LIKE THAT ARE
WHAT CAO THAN TO SHOOT WHAT
HAPPENS TO PEOPLE IN GOVERNMENT
WELL YOU CRIMINAL LEGISLATORS
SET UP THERE INCREASE YOUR PALM.
WITH BLOOD MONEY WELL
CALIFORNIA'S FALLING. THE STATE
YOU KNOW WE ABOUT. ALL LIKE
THERE CALVINISTS YOU. I'M SORRY
MOVE ON TO THE NEXT ONE PLEASE
WE ARE WE ARE NOT GOING TO TAKE
A VIEWS WE ARE NOT GOING TO TAKE
COMMENTS THAT ARE NOT ON POINT
HERE IF YOU WANT TO JUST YELL AT
US THAT IS INAPPROPRIATE FOR
THIS PARTICULAR HEARING SO
ANYTHING HAVING TO DO WITH THE
HEARING. WE WERE HAPPY TO HEAR
YOUR REMARKS NEXT WHEN IS PLEASE. THANK YOU I'M FORTY ONE PLEASE
GO AHEAD- JUST BELOW ITS
INCOMING TEACHERS MY NAME IS
EXCELLENT MUNIS- HILLS ACTUALLY
COUNTY WHERE YOU ARE MORE LIKELY
YOU ARE MORE LIKELY TO GET SHOT
BY LAW ENFORCEMENT IF YOU ARE.
CLEARED THE TABLE BLACK
INDIGENOUS PERSON OF COLOR
TRYING TO GET COUNTY MENTAL
HEALTH SERVICES MY NAME IF THEY
CALL ME THAT TIME SHE GOT A
PASSION MEXICAN AND LIVE IN L.
A. COUNTY. AND I'M GOING TO SEE
A PERSON WHO IS HARD OF HEARING
AND I HAVE A CHAPTER DISABILITY
I HAVE BEEN FORMALLY I
INVOLUNTARILY COMMITTED ONLY
HOMELESS CRTAIN IMPACT AND HAVE
A GREAT WEEK DISABLED SEVERE
PERSISTENT. MENTAL ILLNESS
DIAGNOSIS- OVER TWENTY YEARS I
HAVE BEEN A COMPUTER CONSUMER
SERVICES WITH THE LOS ANGELES
COUNTY DEPARTMENT OF MENTAL
HEALTH WOODLOTS YOU'RE PROVIDED
SERVICES TO AT LAST TWO HUNDRED
AND THIRTY SEVEN THOUSAND THREE
HUNDRED AND FIFTY ONE OF PEOPLE
LIKE MYSELF. WITH ONLY UNTIL
BUDGET OF ALMOST THREE BILLION
DOLLARS MOSTLY STATE FUNDED
SOURCES LIKE THE REALIGNMENT AND
THE EMERSON OF SOURCES THAT WE
TALKED ABOUT. PLEASE KNOW THAT
ALL CURRENT AND FORMER
DISCUSSIONS ABOUT INVOLUNTARY
TREATMENT MUST DO A BETTER JOB
INCLUDING AUTHENTIC STAKEHOLDER
PRESENTATION FROM ACTUAL CLIENTS
LIKE MYSELF FROM WITHIN THE
PUBLIC MENTAL HEALTH SYSTEM IN
MY COUNTY AND I WAS STRUCK THE
STATE THE LACK OF EQUITY PERSON
CENTERED SERVICES ACCOMMODATIONS
STATE SERVICE OF. PATIENTS
RIGHTS AND STATE LAW AND THE
LACK OF OVERSIGHT ACCOUNTABILITY
AROUND FUNDING LIKE THE IMAGE
SHOULD SAY OUR OLDER PRIMARY
REASONS BUT THE OVER
REPRESENTATION OF OUR QUEER
DISABLED LIKE CONDITION THAT
PEOPLE OF COLOR PURITY PRISONS
JAILS. I'VE BEEN LOOKING FOR A
HOUSE SPECIALTIES ON THE STREETS
PARK AND BY THE BUSINESSES WHICH
ARE ALL REPRESENTING AND OF
COURSE THE PUBLIC SPECIFIED
PUBLIC SPACE AT. A TIME WHEN WHO
HAS BEEN INVOLUNTARY COMMITTED
AND I SOMEONE WHO WEBER GIPSON
HELPED COMMITTED INDIVIDUALS AND
THEIR FAMILIES IN THE STATE OF
CALIFORNIA I KNOW FIRST HAND
THAT LPS CONSERVATORSHIP YOUR
CHEATIN ON THE COMPLETE PROGRAM.
HAVEN'T REALLY WORKED ESPECIALLY
FOR CALIFORNIA'S DIVERSE ETHNIC. AND CULTURAL POPULATIONS WHICH
MAKEUP COMMITTEE. OF THE STATE'S
FRED. THE RETURN OF. FOR THE
PEOPLE OF CALIFORNIA AND THINGS
THE EMISSION SAY RELY. HOBSON
REALLY HARD YOU KNOW A PRETTY
PAYOUT WITH OVERSIGHT AND IMPORT
OF CURRENT LAW. AND REQUIREMENTS
THERE IS NO I TO STAY JUST. THAT
HE WOULD THAT IS GOING TO GET
ANY BETTER WHICH IS ADD MORE
DUTIES TO. YOU THAT HAPPENED
BEEN ABLE OR WILLING TO THE WORK
NO TO CONTINUE TO USE THE
PUBLIC'S HARD EARNED MONEY. TO
SUPPORT A SYSTEM THAT HAS
FAILED. THERE ARE SOLUTIONS BUT
IN ORDER FOR ALL OF YOU TO HEAR
THEM YOU NEED TO HAVE PEOPLE
LIKE ME AT THE TABLE- THERE WERE
A LOT OF PEOPLE HERE INCLUDING
MY DIRECTOR WHO DIDN'T BOTHER TO
TELL US. THAT HE WAS SPEAKING
HERE THAT WE COULD HAVE AN
OPPORTUNITY TO SPEAK. YOU KNOW
IF YOU REALLY WANT OUR BODIES
LUCIOUS TALK TO THOSE OF US WHO
HAVE GONE THROUGH IT AND ARE NOT
THRIVING. YOU KNOW ROLE OF THE
PEOPLE WHO ARE JUST LOOKING FOR
MORE MONEY BUT THINGS THAT DON'T
WORK. AND REMEMBER NOTHING ABOUT
US WITHOUT US THAT'S A SOLUTION.
THANK YOU VERY MUCH THANK YOU
MISTER MEMBERS WE ALSO HAVE YOUR
WRITTEN TESTIMONY. WHICH WILL BE
WE WILL MAKE PART OF THE RECORD
. OKAY LEVINE FORTY THREE PLEASE
GO AHEAD. HI THERE MY NAME IS
ELIZABETH ASHER BEING IN ALL OF
THIS WITHIN A INTERNET BETTER
THAN YOUNGER BE IF ANYONE LOOKS
ME UP I AM LOOKING INTO
ADVOCATING FOR PEOPLE IN
SITUATIONS LIKE THAT I'VE BEEN.
PROFILE THAT I'VE BEEN
INDIVIDUALS THAT ALTHOUGH
ETHNICALLY NOT PRESENTS AS WHITE
AND EVEN IN SITUATIONS WHERE I
HAVE HAD NO FAULT OF MY OWN I'VE
BEEN APPROACHED BY LAW
ENFORCEMENT JUST FOR LOOKING
SUSPICIOUS THE CARD ANIKA TAX.
AND THEN LEFT ME THERE I DON'T
THINK THAT'S THE APPROACH I ALSO
WANT TO ADD ON TO THAT THAT THE
LANGUAGE IT REALLY WAS. HURTFUL
AND HARMFUL TO HEAR. SOMEONE IN
THE FIRED COMMUNITY SAID THEY
HAVE TO DEAL WITH PEOPLE. WITH
MENTAL HEALTH CONDITIONS. THE
LANGUAGE SHOULD BE THAT WE- ARE
GOING TO ASSIST THEM BUT THEY
ARE AN EXTENSION OF OURSELVES. I
HAVE NEVER BEEN FIFTY ONE
FIFTIES BECAUSE I KNEW THE
TRAUMA THAT IT CAN CAUSE AND HOW
MUCH WORK THEY COULD MAKE THE
TRAUMA HEALING BUT I HAD BEEN
THROUGH. I AM VERY GRATEFUL THAT
I'M ALIVE DESPITE THE SITUATION
BUT I'VE BEEN TRUE. AND I WANT
TO KNOW WHAT WE CAN DO AND WHO
WE CAN TURN JAIL IN THE MEANTIME
AND TELL THE EIGHT THAT NUMBER
GOES LIVE. IN THE MIDDLE OF NEXT
YEAR I THINK THE DENTON
GENTLEMEN AT THE BEGINNING OF
THE TOP THIS MORNING THAT THAT
MAYBE HE HAD TOO MUCH COFFEE I
DON'T THINK YOU DID I THINK HE
WAS ON THE RIGHT PATH I BELIEVE
THAT WITH THE DOCTOR. AND I
THINK THAT THE FACT THAT HE WAS
THAT LARGELY ABOUT THE TOPIC AND
WANTED TO KNOW WHAT TO DO WITH
THE DATA RATHER THAN JUST
SITTING ON A AND IMPACTING IT
AROUND TRACKING THE BUCK I MEAN
THAT'S WHAT HAPPENS WHEN I GO TO
MY DOCTOR'S APPOINTMENT. THANK
YOU KNOW THANK YOU. YEAH.
OPERATOR THANK YOU I'M FORTY
FOUR PLEASE GO AHEAD. SHE MISTER
CHAIR NUMBERS DROP LANE WHAT THE
CALIFORNIA COUNCIL OF COMMUNITY
WITH THE HELP AGENCIES. A. J.
THAT THEY ALSO AT THE ASIAN
COMMUNITY BASED MENTAL HEALTH
AND SB ORGANIZATIONS THAT
PROVIDE CRITICAL BEHAVIOR HEALTH
SERVICES MORE THAN SEVEN HUNDRED
TWENTY FIVE THOUSAND
CALIFORNIANS WITH A DEEP
CONNECTION TO THE MHSAA AS RUSTY
FELIX CVHS CONNOR COOPER POP
SIXTY THREE WITH LANDOWNERS
LAMBERG IT IN THE NAME REMAIN
COMMITTED TO ADVOCATING FOR THE
APPROPRIATE USE OF THE FUNDS AND
SERVICES. TO INDIVIDUALS UNDER
THE LPS ACT ADDITIONALLY WE WANT
TO REMIND THE COMMITTEE THAT
COMMUNITY PROVIDER SIR EVERYONE
IN THE COMMUNITY INCLUDING THOSE
WITH A CRIMINAL BACKGROUND WE
DON'T DISCRIMINATE WE'RE IN THE
BUSINESS OF SUPPORTING EVERYONE
THAT NEEDS OUR HELP. GDA ALSO
PREDATES CHAIR WAS REMARKS
RELATED TO DIFFERENCES AND
SERVICES AMONG COUNTY THE
STRUCTURAL ISSUES OFTENTIMES
LEGALIZING CARE HIGH QUALITY AND
TIMELY CARE WE AGREE THAT WHOLE
PERSON CARE DOESN'T WORK UNLESS
THERE IS A WHOLE CONTINUUM OF
CARE. WE ARE ALSO COMMITTING
MORE SUBSTANTIAL- COMMENTS TO
THE COMMITTEE THANK YOU THANK
YOU. THANK YOU RAIMES FIVE WE'VE
AHEAD AND THE WORRIED ABOUT
RIGHT WAIT. HELLO YES XP FIVE
THREE FOUR THANK YOU THANK YOU
SO MUCH MY NAME IS KENOSHA AND-
I WILL NOT TAKE UP TOO MUCH OF
YOUR TIME I DO WANT TO TELL
ASSEMBLY MEMBER WORDS AND A
FAMILY MEMBER- THE A MEMBER LED
TO- YEAH THE COMMUNITY SERVICE
AND SERVED. TWO OF YOUR
COUNTIES- PROVIDING MENTAL
HEALTH SERVICES ACROSS THE
SPECTRUM AND THAT THERE'S BEEN
THE MOST. IMPORTANT HEARING I
HAVE HEARD. AND IN SO MUCH TIME
AND I DON'T WANNA YOU HAD
SOMEBODY EXPERTS THAT WERE
AMAZING. I'M NOT GONNA- RESTATE
WHAT THEY'VE ALREADY SAID FIRST
AND FOREMOST DATA YOU DO NOT
HAVE NEAR ENOUGH NEVER ENOUGH OF
WHAT THE DOLLARS. AND CENTS
SACRIFICES IN THE WORK GOING ON
TO TRY AND SUPPORT OUR MOST
VULNERABLE MOST ACUTELY
SUFFERING CLIENTS. FUNDING NO
FUNDING NO FUNDING FOR THE FOR
THE PUBLIC GUARDIAN DID NOT
FUNDING FOR THE KIND OF HIGH END
SERVICES THAT NEED TO BE TAKEN
CARE OF BECAUSE BY THE TIME THEY
GET THERE. WITH ALL COUNTY
DOLLARS AND YOU'RE DOING
ANYTHING YOU CAN JUST TO GET
THEM A SAFE PLACE TO BE. HONEST
TO BE WITHOUT TREATMENT AND
WITHOUT ACKNOWLEDGING THAT AT
THE END OF THE DAY SUBSTANCE
ABUSE I HAVE TO BE A PART OF THE
PICTURE. WHEN YOU LOOK AT THE
YOU CANNOT. H. SIMILARLY MIDDLE
ILL. AT THE MOVIES KERN DISORDER
. BY THE TIME WE TO PLAY FOR
HUMAN HAVE TO BE. IN THE OF
SITUATIONS THEY ARE IN. LAST I
JUST WANT TO. AND HOW MULTIFAITH
. THE WORDS OF THE RADHIKA KELLY
TODAY- SHE SHE IF YOU LISTEN TO
HER. AND CHAPA PERERA AROUND
WHAT COULD HAPPEN AND WHAT WE
NEED TO HAVE. DONE AND YOU'VE
GOT A RIGHT THERE JUST WE LISTEN
TO RESTART. ONE EIGHT FROM THE
NATIONAL ALLIANCE. MY HEART GOES
OUT TO YOU. BREAKS MY HEART THAT
YOUR SON HAD TO GO THROUGH THAT
YOU WERE NOT WE WORK. VERY
CLOSELY AND VERY THANK YOU DALY
WITH THE PEOPLE AND WE CARE VERY
MUCH AND I'M SORRY FOR YOUR
PAIN. AND- IT IS THE LAST WEEK.
I'M SORRY. WE NEED. TO MOVE ON.
THANK YOU OPERATOR NEXT. THANK
YOU SEVENTY THREE PLEASE GO
AHEAD. GOOD AFTERNOON MISTER
CHAIR AND MEMBERS PAULA VAZQUEZ
ON BEHALF OF THE COUNTY WELFARE
DIRECTORS ASSOCIATION
REPRESENTING HUMAN SERVICES
TRACTORS FROM EACH OF
CALIFORNIA'S FIFTY EIGHT
COUNTIES. ENTER THE CHAIRS OF
THE ASSEMBLY HELP AND JUDICIARY
COMMITTEE. FOR FACILITATING THIS
IMPORTANT HEARING AND FOR YOUR
ONGOING COMMITMENT TO PROTECTING
OUR MOST VULNERABLE NEIGHBORS
ENTER COMMITTEE STAFFER THE
THOROUGH BACKGROUND MATERIALS.
ARE ADULT PROTECTIVE SERVICE
PROGRAMS OFTEN PART AWAY AND
RELY UPON THE SERVICES OF THE
LOCAL PUBLIC GUARDIANS
CONSERVATORS TO PROTECT OLDER
ADULTS AND PERSONS WITH
DISABILITIES WHO ARE VICTIMS OF
ABUSE. NEGLECT AND EXPLOITATION
WHEN VICTIMS LACK CAPACITY TO
MAKE DECISIONS ON THEIR OWN.
I'VE DISCUSSED COUNTY PUBLIC
GUARDIAN CONSERVATIVE PROGRAMS
ARE SERVING A HIGHER NUMBER OF
INDIVIDUALS WITH INCREASINGLY
COMPLEX MEET. FOR THIS REASON C.
W. D. ECHO THE CALLS FOR
SIGNIFICANT STATE INVESTMENT
COUNTY PUBLIC ADMINISTRATORS
PUBLIC GUARDIAN AND PUBLIC
CONSERVATIVE PROGRAM THANK YOU
THANK YOU. THANK YOU RYAN FIFTY
THREE PLEASE GO AHEAD. HELLO MY
NAME IS TIFFANY LEN I'M WHEN
LONG BEACH AND I'M THE PROGRAM
MANAGER FOR THE PURE IMPAIRMENT
PARTNERSHIP WITH CAMPRO I HAVE
MY BACHELOR'S IN MY MASTER'S AND
I'VE BEEN GAINFULLY EMPLOYED FOR
THE PAST FIFTEEN YEARS I WANTED
TO BRING THAT UP BECAUSE I WAS
TOLD MULTIPLE TIMES BY ALL THE
MENTAL HEALTH PROFESSIONALS IN
MY LIFE. I WOULD NEVER BE ABLE
TO CHEAT THOSE OLDER PEOPLE JOB
LONG TERM. I DID TRY TO COME
MYSELF FIVE TIMES BEFORE THEY
TOLD ME THAT AND EVERY TIME
WHILE I WAS ON MEDICATION- VERY
ALSO IMPACTED ME VERY NEGATIVELY
IN MY HEALTH. I HAD- A METABOLIC
SYNDROME AND HAD REALLY HORRIBLE
HELP IMPACT BECAUSE OF THAT-
PLEASE I WANT TO JUST ON BAG
THAT YOU GUYS. THINK ABOUT WHAT
KIND OF IMPACT THE EXPANSION OF
THE GREAT DISABILITY DEFINITION
AND ASSISTED OUTPATIENT
TREATMENT WOULD HAVE ON PEOPLE
LIKE ME. BECAUSE I WOULD BE DEAD
RIGHT NOW IF I HAD REMAINED ON
THOSE MEDICATIONS ASK MY MEDICAL
MENTAL HEALTH PROVIDERS WANTED
ME TO IT WAS A DECISION THAT
SAVED MY LIFE FIFTEEN YEARS AGO
. AND I DID GO OFF OF MY
MEDICATIONS AGAINST MEDICAL
ADVICE. I WAS TOLD THAT PEOPLE
LIKE ME DO NOT. MAINTAIN OUR
OUR- EMPLOYMENT WE DO NOT FIND
OUR ADVANCED DEGREES IN OUR PATH
AND ALL OF THE THINGS TURNED OUT
TO BE FALSE FOR ME PLEASE DO
CONSIDER THESE KINDS OF STORIES
WHEN YOU'RE THINKING ABOUT WHAT
TO DO NEXT BECAUSE I AM VERY
HAPPY. IN MY LIFE AND I FOUND SO
MUCH SUCCESS AND I WOULD HAVE
FOUND THAT WITHOUT THIS THANK
YOU SO MUCH FOR YOUR TIME THANK
YOU. THANK YOU OF I AM SIXTY
EIGHT PLEASE GO AHEAD. HI GOOD
EVENING THIS IS CAROL BUT I'M ON
THE BOARD OF MENTAL HEALTH
AMERICA OF CALIFORNIA AND I'M
SPEAKING ON THEIR BEHALF. WE
AGREE WITH THE STATE AUDITOR'S
BUT CHANGES TO THE LPS ACT ARE
NOT NEEDED. RATHER WHAT IS
NEEDED IS ACCESS TO EFFECTIVE
TIMELY AND INTENSIVE SERVICES.
UNTIL WE HAVE SERVICES THAT CAN
BE ACCESSED ON A VOLUNTARY BASIS
WE SHOULD NOT EXPAND INVOLUNTARY
CARE. AND ACCESS WE NEED.
ADDITIONAL TRAINED WORK FORCE
SUFFICIENT INFRASTRUCTURE AND
ACCOUNTABILITY BASED ON OUTCOMES
THANK YOU THANK YOU. THANK YOU
I'M FORTY SIX PLEASE GO AHEAD.
HELLO YES PLEASE GO AHEAD. RIGHT
CAN YOU HEAR ME OK YEAH. YEAH
OKAY- HI MY NAME IS DANIEL
CURTIS MY SON HAS A JUDGMENT ON-THE SLIP AND TECHNAVIO AND
ACTIVISTS. IS UNDER CONSERVATIVE
YEARS TO GET BACK EVEN
VICTIMIZED JAILED ALMOST DOUBLED
HOME STARVING AND COLD AND AS AN
ADVOCATE I COME BEFORE YOU AND
BAG THAT YOU HEAR ME I'VE BEEN
TRAVIS IS SOME OF CARE AND HAVE
MULTIPLE SUGGESTIONS ON HOW TO
FIX THE SYSTEM BUT ONLY ONE
MINUTE TO TELL THEM TO YOU. I'M
NOT AT HIS ADVOCATE OR CARE
GIVER ABLE TO PROVIDE TESTIMONY
AND MY SON'S IPS HEARING I CAN'T
HEAR MORE NO CARE CAN ADVOCATE
OR PETITION THE COURT FOR HELP.
WE NEED TO CHANGE THAT WE LACK
DATA AS PARENTS- OR COOPERATION
WITH ADVOCATES THOSE WITH LIVED
EXPERIENCE LACK THE ABILITY TO
HAVE ANY INFORMATION PROVIDED TO
YOU OTHER THAN THINGS LIKE THAT-
WE COULD START A DATABASE
THROUGH THE- STATE OF CALIFORNIA
THAT- HERE'S THE CURES DATABASE
THAT WE USE FOR NARCOTICS
PRESCRIPTIONS SHE AND IF WE DID
THAT WE CAN TRACK ADMISSIONS
PROVIDERS TO BE ABLE TO SEE THE
SEVERITY OF ILLNESS. I THINK
IT'S THE HOW. MANY TIMES THE
PATIENT WAS ADMITTED- WE HAVE
ENOUGH MONEY RESOURCES ARE
CHINESE LONG FOR. OF FOR LAWYERS
AND IN THE MENTAL HEALTH. WE CAN
MANDATE THAT FOR HAVE CARE
WORKERS AND WE SHOULD BE DOING
SO. WE NEED TO WRITE INTO LAW
THAT. WHO HAS AN ALTERATION OF
CONSCIOUSNESS TO A MENTAL SHE BE
TREATED IN THE SAME IMPLIED
COMMITTEE CANDOR. THAT OTHER
PATIENTS ARE TREATED WHEN I A MY
REASON TO HAVE AN ALL THREE OF
CONSCIOUSNESS BUT WE DON'T DO
THAT- WE SHOULD ALSO REGULATE
ABOUT THAT IT IS IT SHOULD BE A
CRIME IF YOU ABANDON NEGLECT OR
HURT SOMEONE. WHO'S CLOSE
HOMELESS OR HAD INSURANCE MENTAL
ILLNESS BUT BUT THEY OFTEN DON'T
GET THAT PROTECTION UNDER THE
LAW WE COULD COMBINE MENTAL
HEALTH SERVICE ACT AND
HOMELESSNESS FUNDS AND I'M NOT
GOING TO BE USED FOR INPATIENT
RESOURCES ENGAGEMENT BUT WE
DON'T. I'M SPEND NEXT TIME YOU
SEE A HOME PERSON ASK YOURSELF
WHEN YOU SEE THEM. AFTER
SOMETHING ABOUT MY SON. AND
AFTER THAT WAS YOUR SON WHAT
WOULD YOU DO THE SAME KIND OF
HER WHEN I WHERE WOULD YOU SEEK
HELP. WOULD YOU DEPEND ON THANK
YOU. SIX THANK YOU RYAN SIXTY
TWO PLEASE GO AHEAD. GOOD
EVENING MISTER CHAIR MEMBERS
OBLIGATED JOHN VAN OVER OTHER
THAN LOS ANGELES AND I'M THE
LEGISLATURE PRETTY BE AT THE
CALIFORNIA DEPRESSION BIPOLAR
SUPPORT ALLIANCE. I HAVE BIPOLAR
ONE AND EIGHT YEARS AGO I HAD A
MANIC EPISODE THAT LED TO A
PSYCHOTIC BREAK. I WOULD PUT ON
A SEVENTY TWO HOUR HOLD INTENT
TO OFFICIALLY END THE ALL
HUMBER. UPON MY RELEASE I WAS
PLACED IN A VAN WITH THREE OTHER
MEN AND WE WERE ALL DROPPED OFF
AT UNION STATION IN DOWNTOWN. IT
WAS ANYTHING BUT A WARM HAND
OFF. AND A WEEK LATER I WAS
DIRECTED MOST OPEN SPENT
THIRTEEN DAYS IN THE COUNTY JAIL
STILL INCREDIBLY SICK. THE
PROBLEM IS THE LACK OF FORCE
TREATMENT OPTIONS BUT RATHER A
LACK OF ANY OTHER OPTION BESIDES
FOR STREET RIGHT. MIDDLE HELP
SYSTEM SHOULD PROVIDE MORE
EFFECTIVE ACCEPTABLE INVOLUNTARY
SERVITUDE THAT WOULD
SIGNIFICANTLY REDUCE THE NEED
FOR STRICTER. AND EARLY IN
INTERVENTION APPROACH LEAD TO
BETTER OUTCOMS FOR THE PUBLIC
AND THE STATE. POLICE PUT MORE
RESOURCES INTO EARLY
INTERVENTION AND LYFT SINGAPORE
ST. AND THEN FINALLY I WOULD
LIKE TO SAY THAT IS NOT THE
BIOLOGICAL EXPERIENCE OF A
MENTAL HEALTH EPISODE THE CAUSES
DESTRUCTIVE PROBLEM. THERE THE
REACTION FROM SOCIETY UP ALONG
WITH THE WHOLE ORDER BEING
LOCKEDUP AND TREATED AS A
CRIMINAL WHEN ONE IS MOST TAKEN
VULNERABLE THAT LEAVES TRAUMA
AND PTSD. THANK YOU FOR YOUR
TIME. THANK YOU. THANK YOU I'M
FIFTY PLEASE GLAD. THE HARDWARE. TRADEMARK AND COUNTY L. A.
COUNTY DEPARTMENT MENTAL HEALTH
YOU KNOW JUSTICE PROBE AND
PROPERTY. THE DAMAGE THE
SOUTHERN HOW THANK AFTER TO AS
THE CHAIR THE ALTERNATE CRACKED
RESPONSE COMMITTEE. AND RIDLEY
IT A PATH TRAGEDY INDIVIDUALS
AND FAMILIES WITH BIGGER MENTAL
IN A- AND BLACK IN. IF NEEDED OF
COLOR ARE FEW FEARFUL OF RIGHT
ON TO THEIR NEEDS. FOR THESE
REASONS AND OTHERS LIKE SUPPORT
HAS THE BALL FOR NOT LINE RISK.
TO BEHAVIOR MENTAL CRISES PROP
THE COUNTRY AND IN CALIFORNIA.
BUT THE BADLY MANDATED NINETY
DIALING NUMBER TAKING EFFECT IN
JULY TWENTY TWENTY TWO
CALIFORNIA HAS STARTED TO
INVESTIGATE WAYS TO MEET THE
NEED FOR MENTAL HEALTH CRISES
RESPOND. AND BILL AB. NINE EIGHT
EIGHT ON THE HORIZON. THE
CURRENT MENTAL HEALTH PRACTICES
AND HEALTH RELY BY D. ON LAW
ENFORCEMENT RESPONSE TO MENTAL
HEALTH EMERGENCIES. BOTH TO AN
ADEQUATE ON ARMS NON LAW
ENFORCEMENT CRISIS RESPONSE
SERVICES. AND R. LPS LAW WHICH
GIVES LAW ENFORCEMENT OR PEACE
OFFICERS AT A LOT THREATEN.
NATIONAL PRIVILEGES IN
TRANSPORTING AND TRANSFERRING
PROPERTY OF PERSONS REQUIRING
MENTAL HEALTH ASSESSMENT.
BRIEFLY WHILE CURRENT LPS
MODIFYING EMERGENCY CRISIS
RESPONSE. AT THE CLINICALLY
BASED ACTIVITY AND ALLOW THE
PARTIES TO DESIGNATE THANK YOU
AND HAVE THE AUTHORITY. AND
ALTHOUGH THE PHYSICALLY OPERATED
LAW ENFORCEMENT TO TRANSPORT
INDIVIDUALS TO A PRICE RANGE OF
FACILITIES WHICH IS NOT ALLOWED
TO OTHER. MENTAL HEALTH
EMERGENCY RESPONDERS. IN THIS
WAY I CATCH TWENTY WITH THE SET
UP LAW ENFORCEMENT ALL A
POWERFUL BOMB INTO HOSPITAL THAT
. EVEN THOUGH LINE FOR PRESS AT
MANTA HOW CRISES IT'S. OPS
BLEIBERG STANDS MAY BE A VERY TO
THE STATE COUNTY LIVING. WITH
DEVELOPING A COMP. RESPONSE
BURKE BUT PEOPLE GOVERNMENT HELP
. BECAUSE CALIFORNIA THANK YOU
DECIDING BURKE. OKAY LOOK AT
OUTKICK OUT OF THEIR OPERATOR
ACCORDING AND WHETHER HE TO BE A
- HE THANK YOU. THANK YOU RIGHT
FIFTEEN CLEAR GO AHEAD. HELLO
THANK YOU LETTING ME MY AND ALL
OF OUR ON FROM COSTA COUNTY AND
I WORKED AND BEEN A CLIENT THE
SYSTEM FOR OVER TWENTY FIVE
YEARS. PLEASE BE WARY OF THOSE
WHO GIVE YOU A SIMPLE SOLUTIONS
TO COMPLICATED PROBLEMS SUCH AS
BLOOD THEM UP AND IT WILL SOLVE
ALL YOUR PROBLEMS. THAT'S WHAT
HITLER AND MUSSOLINI DID THEY
MADE IT SOUND REALLY SIMPLE AND
REALLY QUICK PLEASE DO NOT GO
BACK TO THE OLD MEDICAL MODEL
METHOD YOUR SCARING EDITORIAL
PEOPLE FROM ACCEPTING SERVICES
PLEASE STOP IF YOU DON'T PEOPLE
WILL CONTINUE TO DIE I MENTAL
HEALTH CHALLENGE IS NOT AN
ILLNESS OF THE BRAIN THE THOUGHT
MENTIONED HERE IT IS ALSO A
PROBLEM OF THE HEART. AND AN
ILLNESS OF THE STIGMA AND DESIRE
FOR THE QUICK FIX IN OUR SOCIETY
PLEASE REMEMBER IF SOMETHING
DIDN'T WORK FORCING IT WILL NOT
MAKE IT WORK I WANT TO ASK MAYOR
FINE WHY. HE FEELS IT IS
NECESSARY TO EQUATE THE LEGAL
RIGHT TO SERVICES BUT COURSE
TREATMENT WHY DO WE HAVE TO HAVE
THE RIGHT TO ONLY FOR TREATMENT
YOUR TRYING TO CREATE A NEW ONE
SIZE FITS ALL AND FOURTH. IT'S
ALL ON ALL OF US I THE PERSON
WITH LIVED EXPERIENCE THEY I
DON'T WANT THIS RIGHT I NEAR IT
NEARLY KILLED ME THIS IS NOT
WHAT I SIGNED UP FOR WHEN I
SUPPORTED YOU IN CREATING AND
PASSING AN HSA IN TWO THOUSAND
AND FOUR. IF YOU WANT TO HELP
NEED TO SHARE YOUR POWER NOT
EXERTED IT IS COUNTER INTUITIVE
I KNOW BUT THIS IS THE ONLY WAY
HOW IT CAN HELP LET MOTHER WHICH
WORK TOGETHER WE NEED MORE
VOLUNTARY SERVICES THAT DOES NOT
HARM BUT ACTUALLY HELP DID YOU
NOTICE THAT. YOU'RE NOT A SINGLE
PAYER RUN PROGRAM TODAY- REPORT
IT. PREVENTING ON PANEL. THEY
DID NOT A LOT. DID NOT HAVE
CHANCE TO YOU. THEIR IN S. OF.
FUNDING WE NEED YOUR SUPPORT
SERVICES AND YOUR- THAT. AND THE
FOUNDER OF NOT AN- WELL IT IS
AVAILABLE ALL THANK YOU THANK.
THANK YOU FIFTY FIVE PLEASE GO.
HI MY NAME IS DAN TONIGHT-
WONDERFUL FORM YOU I LOST MY
DAUGHTER. LAST OCTOBER A STRONG
HAND WHILE SHE WAS IN CARE. I
HAVE SPENT. I THOUSAND HOURS A
YEAR FOR. FOUR YEARS TRYING TO
HELP RELATIONS- AT ENACT THEIR
PLANS. SEVERAL HUNDRED THOUSAND
DOLLARS WERE SPENT ON HER SHE
DIED. IN CARE AT A TIME WHEN SHE
WAS BEGGING FOR HELP. FOURTEEN
HOSPITALIZATIONS. LIKE A CHEST
COMPLETE REVOLVING DOOR ON THE
HARD NEEDED IN THIS FORUM. THESE
ISSUES ARE ARE ONE WONDERSTRUCK
IN REMARKS IN THIS FORM
WONDERFUL IDEAS ABOUT KEEPING
PEOPLE ON THEIR- ON THEIR
CURRENT LIFE PLANS ABOUT BEING
FLEXIBLE- IN IN IN HOW ARE.
PLANTS ARE CONSIDERED I WOULD
JUST URGE YOU TO CONSIDER THAT
THIS IS. AN EPIDEMIC PROBLEM AND
MEETING OTHER PARENTS WHO ALSO
LOST THEIR CHILDREN I KNOW THAT
AS WE'RE SPEAKING NOW YOUR
CHILDREN ARE BEING LOST. AND I
WOULD ENCOURAGE YOU TO TAKE
COULD NOT A MONOLITHIC APPROACH
. BY ALL I DIDN'T MAKE APPROACH.
THAT THEY DO NOT USE THE
EPIDEMIC NATURE MUCH LIKE WE
WOULD NOT- HELD A STATIC
APPROACH TO A PANDEMIC OR
INTEREST WAKE- WE WOULD WE WOULD
ADOPT WE WOULD GET MULTIPLE.
ACTIONS TOGETHER I WOULD
ENCOURAGE YOU TO SEEK OUR WONDER
MARCHES ABOUT THINGS THAT DON'T
COST MONEY LOOK AT WHEN PROGRAM
IN SACRAMENTO IT'S WONDERFUL
LOOK AT STATE PROCESS IN ORANGE
COUNTY IT'S WONDERFUL. TAKE THE
BEST AND- FIGURE OUT HOW TO USE
THEM FOR THE PEOPLE WHO NEED
HELP YES I WAS TOLD. FOR YEARS
PRIOR TO REJECT BY A DOCTOR THAT
YOUR CHANCES OF DEATH RIGHT WHAT
WE'RE 10% WERE CONSIDERABLY
HIGHER. AND ALL THESE WAYS THAT
WERE DISCUSSED. OF SPRING BROKE
TO DO YOU TO. HOW CAN WE WATCHED
HAPPEN TO MORE CHILDREN. THANK
YOU THANK YOU VERY SORRY TO HEAR
OF YOUR LOSS. THANK YOU I'M
SIXTY NINE PLEASE GO AHEAD. YES
HELLO THANK YOU MY NAME IS JILL
NIELSEN AND I. AND DEPUTY
DIRECTOR OF SAN FRANCISCO
DEPARTMENT OF DISABILITY AND
AGING SERVICES ARE ALSO SERVES
AS THE CITY'S PUBLIC GUARDIAN
AND PUBLIC CONCERN ABOUT OUR-
CALIFORNIA'S MOST VULNERABLE
CITIZENS DESPERATELY NEED THE
STATE TO TAKE A LEADERSHIP ROLE
WITH LPS CONSERVATORSHIP. SAN
FRANCISCO HAS BEEN A LEAD
ADVOCATE AN ATTEMPT TO REFORM
THE CONSERVATORSHIP PROCESS. BUT
WE HAVE ENCOUNTERED CHALLENGES
WITH THE IMPLEMENTATION OF BILL
LEGISLATIVE BY SACRAMENTO AND
THEY NEED TO CARRY OUT THE
WOBBLE COORDINATION DUE TO THE
LACK. OF RELIABLE DATA AND NEED
FOR TECHNICAL ASSISTANCE FROM
OUR STATE PARTNERS. WERE
OPTIMISTIC THAT PROCESS
IMPROVEMENT CAN BE MADE BUT ONLY
WITH FINANCIAL SUPPORT FROM THE
STATE DIRECTED TOWARD OPERATIONS
THE COUNTY LEVEL PUBLIC GUARDIAN
AND CONSERVATOR PROGRAM. SO THAT
WE CAN INCREASE CAPACITY. PUBLIC
GUARDIAN AND CONSERVATOR
PROGRAMS ARE CRITICAL
STAKEHOLDERS WITHIN THE LARGER
LPS CONTINUE ON AND WE WANT TO
BE PART. OF THE STATE SOLUTION
TO THE MENTAL HEALTH CRISIS THAT
IS GROWING ON OUR STREETS. TO
ACCOMPLISH THAT THE CITY AND
COUNTY OF SAN FRANCISCO REMAINS
READY TO PARTNER WITH YOU ON
THIS WORK LAURIE FORWARD. BOTH
IN THE BUDGET AND THE
LEGISLATIVE. PROCESS THANK YOU
THANK YOU. THANK YOU I'M THIRTY
THREE PLEASE GO AHEAD. HELLO CAN
YOU HEAR ME YEAH YES PEOPLE HAVE
. YES HELLO THIS IS RICHARD
GALLO FROM SANTA CRUZ CALIFORNIA
I'M CALLING TO SAY TO NOT EXPAND
L. P. S. THE SYSTEM IS BROKEN WE
NEED YOUR SUPPORT SERVICES AND
RESPITE SERVICES AS AN
ALTERNATIVE TO TREATMENT. LIVES
THEY MAINTAIN THEIR INDEPENDENCE
THE DATA REPORTING MUST BE.
STANDARDIZED ACROSS THE BOARD
WITH ALL PROGRAMS AND SERVICES
RELATING TO OUR VERITABLE
POPULATION THAT WE SERVE IN OUR
COMMUNITIES THROUGHOUT
CALIFORNIA AND THAT INCLUDES THE
MENTAL HEALTH SERVICES ACT BINDI
WHICH HAS TWO POINT FIVE BILLION
DOLLARS CITIES AND COULDN'T
RESERVE FUND. AND TELL ME DON'T
ANY INTEREST ON THIS THEY CAN.
BE USED AND UTILIZED. EARLY IN.
AND PREVENTION SERVICES THIS
PAST THE STOP IT'S SHAMEFUL THAT
FAMILIES ARE STRUGGLING WITH
THEIR LOVED ONES NOT GETTING
ADEQUATE TREATMENT AND SERVICES
THAT THEY NEED ALSO DOES
INDIVIDUALS ARE CONSERVE OUR
PICKING UP FARES IN A
PSYCHIATRIC. HELP FACILITIES
KNOWN AS PUFF. FOR ALL THE
OTHERS ARE BEING SENT OUT A
COUNTY FOR THE TREATMENT THAT IS
WRONG IT IS NOT FAIR TO THE
FAMILIES. WE NEED TO CHANGE THE
SYSTEM- BOLT IT WOULD BE HALF OF
THE MENTAL HEALTH COMMUNITY
BANKS. THANK YOU I'M SEVENTY TWO
PLEASE GO AHEAD. MY NAME IS DR
KAREN MCCARTHY AND I'M A MENTAL
HEALTH OCCUPATIONAL THERAPIST.
AFTER CO FOUNDER OF THE
COMPASSION NOT COMPETITION AND
CHAIR OF THE PSYCHIATRIC OKEY
ACTION COALITION AND AN
OPERATIONAL THERAPY OUR CODE OF
ETHICS THAT YOU NO HARM AT THE
MODOC COUNTY I THINK IT'S
IMPERATIVE THAT WOULD PROVIDE
SERVICES TO THEIR CLIENTS CENTER
AND BE QUIET THERE PEOPLE NEED
TO HAVE CHOICE ABOUT HOW TO
MEETING FIND THEIR OWN. PATH
RECOVERY. IF YOU WANT FIFTY
COULD BE A TREND EXPERIENCE.
OFTEN THEIR CHAMBER THE BIBLE
AND WE NEED TO RE. RECONOCIDA OF
THE FRANKLIN. OFTENTIMES
INVOLVED. AND THERE'S NO
EVIDENCE BASED PROGRAMS WHICH IS
THE COURT YOU'RE RIGHT. CHART IN
WHAT IS THE- AND I MANY PATHWAYS
THE WELL OUT OF PORT MEDICAL. IT
WILL DEGRADE THE HAVE A LACK OF
INSIGHT THAT LACK OF LISTENERS
AND ANY TO BE LOOKED INTO AND
PART OF POLICY MAKING. NOTHING
ABOUT US WITHOUT US AND I WOULD
NOT REQUIRE RUNNING OUT YES
THAT. HELP YES AND I WOULD COURT
CALL WHO DID MANAGE BUT OUR-
AGENCY AND REMOVED POLICE THAT'S
ALREADY I HOPE THAT THE ASSEMBLY
STEPPED UP TO THE HARD WORK AN
HOUR LATE AND EMPOWER OTHERS.
THANK YOU SO MUCH THANK YOU.
THANK YOU I'M FOR TWO GO AHEAD.
HELLO MY NAME IS MARIE OTCHKISS
. AND I JUST LOST MY DAUGHTER.
AFTER IN SEPTEMBER AFTER A
FOURTEEN MONTH CRISIS WHERE WE
CAME IN CONTACT WITH MOST OF.
WHAT YOU HAVE ALL BEEN SPEAKING
OF TODAY THEN EVERYTHING. WAS A
DISASTER- WE HAVE KAISER HEALTH
INSURANCE KAISER WAS BEYOND
COULD TASK CAT CATASTROPHIC FOR
MY DAUGHTER. SHE FIRST-
EXPERIENCED A PSYCHOTIC BREAK
AFTER BEING PUT ON A ANTI
DEPRESSANT- SHE VOLUNTARILY WENT
TO THE HOSPITAL BUT THEN I WAS
ADVISED BY A SOCIAL WORKER TO
ASK FOR A FIFTY ONE FIFTY WHICH
I DIDN'T REALLY UNDERSTAND BUT I
WENT ALONG WITH IT. MY DAUGHTER
BECAUSE KAISER DOES NOT HAVE
ADEQUATE PSYCHIATRIC INPATIENT
FACILITIES OF THEIR OWN THEY
COULDN'T TELL ME WHERE SHE WAS
GOING TO GO AND THIS IS ALSO
NEWS TO ME- SHE WOULD SPEND THE
NEXT DAY- TAKE INTO. A FACILITY
WHERE SHE WAS KEPT FOR A WEEK
AND PUT ON MEDICATION SHE WAS
RELEASED SHE WAS NOT STABLE SHE
WAS- REALLY QUITE MANIC AND-
FANTASTICAL- OVER THIS YEAR SHE
WAS HOSPITALIZED THREE TIMES
TOTAL WITH THAT STEP DOWN
PROGRAM EACH PLACE TRY TO PUT
HER IN A DEEP EIGHT A DIFFERENT
PLACE EACH TIME SO THERE WAS NO
CONTINUITY OF CARE THE
PSYCHIATRIC TEAM IN EACH
FACILITY WAS IN CHARGE OF
DECIDING EVERYTHING ABOUT IT SHE
CAME OUT OF EACH. FACILITY WITH
A DIFFERENT MEDICATION. SHE
DEVELOPED YOU KNOW IT IT THE
CARE WAS IMPOSSIBLE THERE WAS NO
. CARE IN THESE HOSPITALIZATIONS
AND SHE DEVELOPED NO TRUST OF
MEDICATION OR HELP. THE
HOSPITALS WE ALSO- AFTER HER
SECOND HOSPITALIZATION I HAD TO
CALL NINE ONE ONE. WITH AN
INCIDENCE SHE WAS. EATING OUT OF
CONTROL THE POLICE CAME THEY DID
NOT TAKE HER TO THE HOSPITAL
THEY TOOK HER TO JAIL AND SHE
SPENT THE NIGHT IN JAIL DESPITE
NOBODY IN THE HOUSEHOLD WANTING
TO PRESS CHARGES AGAINST HER SHE
WAS. VERY TRAUMATIZED. I TRIED
TO ACCESS LAURA'S LAW. THAT WAS
A COMPLETE BLAST- I TOTALLY
BELIEVE AFTER. WORKING THROUGH
EVERYTHING THAT HAS HAPPENED TO
US THAT IF SHE HAD RECEIVED
PROPER CARE IN HER VERY FIRST
HOSPITALIZATION IN HER FIRST
CRISES IN THE PSYCHOSIS THAT SHE
HAD RECEIVED EARLY INTERVENTION
IN PSYCHOSIS. CARE SHE WOULD BE
ALIVE. THANK YOU THINK I'M DEAD
. YOUR PARENTS WERE VERY SORRY
TO HEAR OF YOUR RECENT LOSS TO
THANK YOU. THANK YOU ARRIVE
SEVENTY PLEASE GO AHEAD. HI CAN
YOU HEAR ME YEAH KALRA YES. OKAY
MY NAME'S MATTHEW DEATH I'M THE
ASSISTANT PROGRAM MANAGER OF THE
CALIFORNIA YOUTH EMPOWERMENT
NETWORK OR PROGRAM THE MENTAL
HEALTH AMERICA CALIFORNIA THAT
LED BY TRANSITION AGE YOUTH
THOSE BETWEEN FIFTEEN TO TWENTY
SIX YEARS OLD WE UP LET THE
VOICE OF THE PAVE HAWK IT A
CALIFORNIA TO BRING THEIR LIVED
EXPERIENCE AND EXPERTISE. INTO
BEHAVIORAL HEALTH DECISION
MAKING SPACES SO THAT THE
SUPPORTS AND SERVICES DESIGNED
FOR K. ARE REFLECTIVE OF THEIR
NEEDS AND EXPERIENCES BY TWENTY
TWENTY EIGHT OF THE COMMUNITY
REQUIRE IDENTIFIED MANY
STATEWIDE GAP IN PROVIDING
APPROPRIATE SUPPORT
CONSERVATIVES BURKE HEY
INCLUDING BUT NOT LIMITED TO
CULTURALLY COMPETENT BEHAVIORAL
HEALTH SERVICES AND- SUPPORTS
FOR ON HEALTHCARE. AND HAVING
ACCESS TO A VARIETY OF UPSTREAM
PREVENTATIVE AND EARLY
INTERVENTION SERVICES YOU CAN
REFERENCE THIS REPORT AT HE A
HYPE AND WHITE E. N. .ORG. THE
GAP THAT WE'VE OUTLINED IN THE
REPORT REPRESENTS OPPORTUNITY
FOR SUPPORTING THE BASIC NEED TO
PAY AND ALL INDIVIDUALS ACROSS
CALIFORNIA THAT CAN HELP PREVENT
THE NEED FOR SUCH
CONSERVATORSHIP THAT LIMIT
PEOPLE'S RIGHT. CALIFORNIA'S
FOCUS ON PROACTIVE SUPPORT
SERVICES INSTEAD OF THINKING
ABOUT THE EXPANSION OF
CONSERVATORSHIP INSTEAD OF
THINKING ABOUT THE EXPANSION OF
CONSERVATORSHIP WILL RESULT
THESE CHALLENGES. I THANK YOU
FOR THE TIME. THANK YOU. THANK
YOU I'M SEVENTY NINE PLEASE
AHEAD. HI THIS IS JACK BECAUSE
DECADE RECORD CALIFORNIA
ASSOCIATION OF SOCIAL
REHABILITATION AGENCIES OUR
STATEWIDE ASSOCIATION
ORGANIZATIONS THAT PROVIDE
ALTERNATIVES TO GET USUAL THE
PATIENT CARE- WE'RE IN FULL
AGREEMENT WITH THE STATE
AUDITOR'S REPORT THAT TO HELP US
ROUTE YOUR IT IS NOT EACH BE
EXPANDED- BUT REALLY WHAT IT
COMES DOWN TO IS THAT IF YOU
EVER ALSO SEND ME A STOP
BLAMING. THE CUSTOMER FOR OUR
INABILITY TO MAKE THE SALE YOU
GET SALES PERSON WILL TELL YOU
THAT SALESPEOPLE IS IT PART OF
PRODUCT LINE A GOOD SALES PITCH
AND SOMETIMES THEY HAVE TO DO
WITH YOUR SALES FORCE- WITH A
VERY LARGE INVESTMENTS ARE
COMING OR THANKS THE
MINISTRATION AND THE
LEGISLATURE- WITH-
INFRASTRUCTURE YOU MAY ACTUALLY
GET THE PRODUCT LINE THE IT
NEEDED FOR A LONG TIME. WITH THE
ADVANCEMENTS COMING THROUGH
CALTRAIN WE MIGHT ACTUALLY BE
ABLE TO CHANGE OUR SALES PITCH
AND WITH THAT PURE PROVIDERS
COMING ONLINE WE MIGHT ACTUALLY
GET THE BILL'S FORCE THAT WE
NEED- WE'VE ALSO. READ COMMENTS
THANK YOU. THANK YOU. THANK YOU
SEVEN SEVEN GO OUT. HELLO CAN
YOU HEAR ME YES WE CAN YES
PLEASE GO AHEAD. HELLO MY NAME
IS ANDREA CURRENTLY NINE TO
DIRECTOR OF ADVOCACY FOR COWBOYS
SIR THE OLDEST CARE RUN
ORGANIZATION IN CALIFORNIA THAT
PACIFIC LEE REPRESENTS
INDIVIDUALS WITH MENTAL HEALTH
WHAT EXPERIENCE. I TOO AM A
SURVIVOR AND BEING PLACED ON AN
INVOLUNTARY HOLDS AND I CAN
ASSURE YOU THAT THERE WAS
NOTHING WE HAVE ILLUSTRATED.
THAT CAME FROM MY EXPERIENCE.
YEAH CAL VOICE BELIEVE THAT
EFFECTIVE PROTECTION OF HUMAN
RECOVERY FROM MENTAL ILLNESS
COMES FROM ACCESS TO VOLUNTARY
MENTAL HEALTH TREATMENT. AND
SERVICES THAT ARE COMPREHENSIVE.
COMMUNITY BASED RECOVERY
ORIENTED AND CULTURALLY AND
LINGUISTICALLY COMPETENT. IT IS
ESSENTIAL THAT THE RIGHTS OF
PERSONS WITH MENTAL HEALTH
CONDITIONS TO MAKE DECISIONS.
CONCERNING THEIR TREATMENT E
RESPECTED. PUBLICIST URGES YOU
TO ADOPT LAWS THAT REFLECT THE
PARAMOUNT VALUE AND MAXIMIZING
THE DIGNITY A TANAMI AND SELF
DETERMINATION OF PERSONS
AFFECTED BY MENTAL HEALTH
CONDITIONS. THANK YOU FOR THE
OPPORTUNITY TO PROVIDE COMMENT
AND IN THE FUTURE WE HOPE THAT
YOU ALLOW ONE ORGANIZATIONS AS
CAL PLACES TO HAVE AN
OPPORTUNITY TO SHARE SOLUTIONS
AND MEANING CORRECTIVE
RECOMMENDATION. AGAIN THANK YOU
FOR YOUR TIME THANK YOU. THANK
YOU I NINETY TWO PLEASE GO AHEAD. NINE NINETY TWO LET ME ASK
REQUIRED. IT TAKES UNTIL
MIDNIGHT TO HEAR THE VOICES OF
THE PEOPLE YOU NEED TO STAY
THERE UNTIL MIDNIGHT BECAUSE
PEOPLE AND I DON'T KNOW WHY YOU
CARE HOW LONG WE TALK ANYWAY YOU
NEVER LOOK UP FROM YOUR- THANK
YOU. THANK YOU I HAVE NO FURTHER
COMMENT THANK YOU AT THIS TIME.
OKAY THEN HELLO I THANK EVERYONE
FOR HANGING WITH US FOR A VERY
INTERESTING HEARING SOMETHING
THAT IS BEN AFFLECK ABOUT QUITE
A BIT IN THE LEGISLATURE OVER
THE YEARS. DEALING WITH
CONSERVATORSHIP AND WE WILL
CONTINUE TO SEE SOME POLICIES SO
FROM THIS IS A VERY GOOD
COLLABORATION BETWEEN THE TWO
COMMITTEES AND IS A LOT OF GOOD
INFORMATION ON THE TABLE. AND WE
WILL CERTAINLY BE TAKING THAT
WITH US INTO THE NEXT
LEGISLATIVE SESSION. THIS WAS A
THANK YOU TO OUR CO CHAIR- STONE
HERE- WORKING WITH THIS ON THIS
AND- AND THIS OUR STAFFS FOR
PUTTING. PUTTING THE BACKGROUND
PAPER TOGETHER AND BEING HERE
WITH US TODAY THIS WAS A- I
LEARNED A LOT. I RECENTLY AND
THE SEA DID WAS I WENT A LOT
MORE THAN I. THAN I EVER
ANTICIPATED- AND- WE DO HAVE A
LOT OF INFORMATION AVAILABLE FOR
US NOW AND I JUST WANNA THANK
ALL THE WITNESSES AND PEOPLE.
WHO TESTIFIED PEOPLE CALLED IN I
THINK IT WAS- AND MANY TIMES
VERY MOVING- TO HEAR HEAR THESE
VOICES AND SO. I WILL TAKE THIS
INTO CONSIERATION OBVIOUSLY WE
HAVE COLLEAGUES THAT ARE LOOKING
AT LEGISLATION BUT- ANYBODY WHO
STEP PLANNING LEGISLATION I'M
GOING TO ASK THEM TO WATCH THIS
HEARING. IF THEY HAVEN'T IF THEY
WEREN'T PARTICIPATING IF WITH
THAT. WITH US TODAY SO. SO THANK
YOU AGAIN- AND JUST AS I WOULD
TURN IT THIS MAY BE THE VERY
LAST HEARING IN THIS ROOM. OR IT
MAY NOT WHO KNOWS. BUT IT'S
LIKELY OUR LAST HEARING IN THIS
ROOM SO ANYWAY SO- ARAMBULA- TO-
FORTY TWO OH TWO SO THANK YOU
VERY MUCH AND WE WILL GO AHEAD
THE JOURNAL HEARING TODAY THANK
YOU