THE HEARING OF THE ASSEMBLY
BUDGET SUBCOMMITTEE NUMBER ONE
ON HEALTH AND HUMAN SERVICES
COVERING PROPOSALS AND ISSUES
RELATED TO THE ADULT BEHAVIORAL
HEALTH SYSTEM. THIS IS OUR
SECOND HEARING OF THE YEAR ON
BEHAVIORAL HEALTH FOLLOWING LAST
WEEK'S HEARING THAT WAS FOCUSED
ON CHILDREN'S AND YOUTH. BEFORE
WE BEGIN I HAVE BEEN ASKED TO
READ SOME DIRECTIONS REGARDING
PUBLIC PARTICIPATION IN TODAY'S
HEARING TO HELP INSURE THE
SAFETY OF EVERYONE HERE TODAY
WHILE ALSO ALLOWING FULL PUBLIC
ACCESS TO THE DISCUSSION.
TODAY'S HEARING WILL BE ON THE
STATE CAPITOL IN HEARING ROOM
ONE TWENTY SEVEN HOWEVER ALL OF
THE PANELISTS ON THE AGENDA ARE
APPEARING REMOTELY. WE ARE
ACCEPTING PUBLIC COMMENT AT THE
END OF THE HEARING BOTH IN THE
HEARING ROOM AND ON THE PHONE.
THE PHONE NUMBER TO CONNECT IS
ON THE COMMITTEE WEBSITE AND
SHOULD BE ON THE SCREEN IF YOU
ARE WATCHING OVER THE INTERNET.
THE NUMBER IS TOLL FREE.
1-877-692-8957 AND THE PUBLIC
ACCESS CODE IS. ONE THREE ONE
FIVE ONE TWO SEVEN. IF YOU
ENCOUNTER ANY PROBLEMS PLEASE
CONTACT THE ASSEMBLY BUDGET
COMMITTEE AT. 916-319-2090 NINE
AND A STAFF MEMBER WILL ASSIST
YOU. WE WILL BEGIN PUBLIC
COMMENT AFTER ALL MEMBERS HAVE
CONCLUDED THEIR QUESTIONS FOR
ALL OF THE PANEL. THERE WILL BE
NO VOTES TAKEN IN TODAY'S
HEARING AND FINALLY WE WILL ALSO
ACCEPT WRITTEN PUBLIC COMMENTS
IN THE FEEDBACK WILL GO THROUGH
THE SUB ONE EMAIL ACCOUNT. AND
THE ADDRESS IS BUDGET SUB ONE
ACT ASM DOT CA DOT GOV. I WILL
BEGIN WITH SOME INTRODUCTORY
COMMENTS. MENTAL ILLNESSES
PRESENCE AMONG MANY OF US
WHETHER OR NOT IT'S AN IMPACTED
FAMILY MEMBER A FRIEND OR EVEN
OURSELVES. MENTAL ILLNESS IS NOT
A CRIME AND YET MANY EXCUSE ME
AND YET THE LARGEST MENTAL
HEALTH INSTITUTION IN THE STATE
IS THE L. A. COUNTY JAIL. WE
CANNOT ARREST OUR WAY OUT OF
THIS CRISIS BUT WE HAVE FAR TOO
MANY WHO END UP IN OUR JUSTICE
SYSTEM. IT'S TIME TO HAVE A
PARADIGM SHIFT AND TO GET
UPSTREAM BY FOCUSING ON
PREVENTATIVE EFFORTS AND ADDRESS
THE MENTAL AND BEHAVIORAL HEALTH
OF ALL CALIFORNIANS. WE CANNOT
CONTINUE TO PASS WITH THE BLIND
DIED THOSE WHO LIVE ON THE
STREETS. WE AS A STATE MUST HOLD
OURSELVES ACCOUNTABLE TO
DELIVERING REAL RESULTS. WE WILL
NEED PARTNERSHIPS WITH THOSE WHO
HAVE LIVED EXPERIENCES WITH THE
DISABILITY COMMUNITY WITH OUR
COUNTY CIVIC LOCAL AND STATE
PARTNERS AS WELL AS THE
LEGISLATURE. BUT ABOVE ALL WE
WILL NEED TO FOCUS ON THE PEOPLE
WHO WE SERVE. IN TERMS OF
ACCOUNTABILITY THERE IS A STRONG
NEED TO RESPOND IN UNISON. AS AN
EXAMPLE OF THOSE INDIVIDUALS
DETERMINES TO BE INCOMPETENT TO
STAND TRIAL 50% DIDN'T SEE
HEALTH CARE IN THE PAST SIX
MONTHS. WE CANNOT CONTINUE TO
WATCH A SYSTEM THAT CONSISTENTLY
LEADS SO MANY DOWN. WE NEED A
NEW PARADIGM THAT IS CONSISTENT
WITH THE CALIFORNIA VALUES AND
DELIVERS REAL RESULTS. WHY DO WE
HAVE TO WAIT FOR PEOPLE TO BE SO
SICK THE SICKEST OF THE SICK ON
OUR STREETS IN OUR JAILS OR IN
OUR HOSPITALS. WE CAN AND WE
MUST DO BETTER. CARE AND
COMPASSION MUST BE THE
CALIFORNIA WAY. I LOOK FORWARD
TO TODAY'S DISCUSSIONS AND
CREATING A SPACE WHERE WE ALL
FEEL SAFE TO DISCUSS SUCH
WEIGHTY ISSUES. WITH THAT WE
WILL BEGIN OUR FIRST PANEL WHICH
IS ON CRISIS RESPONSE AND NINE
EIGHT EIGHT IMPLEMENTATION. FOR
THOSE WHO ARE PANELISTS AND
PRESENTERS PLEASE PRESENT IN THE
ORDER IN WHICH YOUR NAME APPEARS
IN THE AGENDA WE WILL HOLD ALL
MEMBERS QUESTIONS ON THIS PANEL
UNTIL AFTER ALL OF THE
PRESENTERS HAVE CONCLUDED. WE
WILL HAVE A LEVIN PRESENTERS ON
THIS PANEL INCLUDING SEVERAL
REPRESENTATIVES FROM THE
ADMINISTRATION THE MENTAL HEALTH
SERVICES OVERSIGHT COMMISSION
THE L. A. O. AND SEVERAL
STAKEHOLDERS. LET'S BEGIN WITH
STEPHANIE WELCH DEPUTY SECRETARY
OF THE DEPARTMENT OF BEHAVIORAL
HEALTH AT THE CALIFORNIA HEALTH
AND HUMAN SERVICES AGENCIES
PLEASE BEGIN. AFTER AN HONORABLE
CHAIR DR ROMULUS AND OTHER
MEMBERS THANK YOU SO MUCH FOR
THIS INVITATION TODAY AND- ALSO
THANK YOU VERY MUCH FOR YOUR
WORDS AT THE TOP OF THIS MEETING
I THINK YOU'RE REALLY INCREDIBLY
IMPORTANT AND I THINK THEY'RE-
THAT THEY'RE GOING TO BE
REFLECTED IN MANY OF THE THINGS
THAT WE DISCUSSED TODAY- MY NAME
IS STEPHANIE WELCH ON THE DEPUTY
SECRETARY BEHAVIORAL HEALTH FOR
THE HEALTH AND HUMAN SERVICES
AGENCY AND IN THAT CAPACITY I
SERVED AS A SENIOR ADVISER TO
THE SECRETARY GALLEY. AND OUR
AGENCY TEAM ON BEHAVIORAL HEALTH
ISSUES. ANOTHER ROLE THAT I PLAY
WHICH IS CRITICAL TO OUR
CONVERSATION HERE TODAY ABOUT
THE CRISIS CARE CONTINUE ON. IS
TO SUPPORT OUR DEPARTMENTS AND
FELLOW GOVERNMENTAL BODIES. IN
COORDINATING AND LEVERAGING OUR
EFFORTS TO IMPROVE THE
BEHAVIORAL HEALTH OF ALL
CALIFORNIANS. I WOULD LIKE TO
START TODAY BY EXPRESSING MY
APPRECIATION FOR THE LEADERSHIP
OF THE LEGISLATURE AND THE
SUBCOMMITTEE. FOR PRIORITIZING
INVESTMENTS IN BEHAVIORAL
HEALTH. THAT INCLUDE BUT ARE NOT
LIMITED TO CAL AIMED AT CHILDREN
YOUTH BEHAVIOR HEALTH
INITIATIVE. THE MENTAL HEALTH
STUDENT SERVICES ACT. THE
BEHAVIORAL HEALTH CONTINUE ON
INFRASTRUCTURE PROGRAM AND THE
COMMUNITY CARE EXPANSION PROGRAM
. RIGHT SERVICE IS THAT WILL NOW
BE AVAILABLE AS A BENEFIT IN
MEDIC CAL. OUR NEW OFFICE OF
SUICIDE PREVENTION AND MENTAL
HEALTH PARITY ENFORCEMENT AND
BEHAVIORAL HEALTH FOCUSED
INVESTIGATIONS THAT OUR
DEPARTMENT OF MANAGED
HEALTHCARE. THIS IS BY NO MEANS
AN EXHAUSTIVE LIST IN FACT IT
DOESN'T EVEN COVER SOME OF THIS
YEAR'S CURRENT PROPOSALS. BUT IT
IS A PRIVILEGE AFTER TWENTY PLUS
YEARS IN THIS IN WORKING IN THE
SPACE TO SERVE IN AN
ADMINISTRATION THAT IS WORKING
WITH THE LEGISLATURE. TO BUILD
THE BEHAVIORAL HEALTH CAPACITY
THAT WE HAVE SO DESPERATELY
NEEDED FOR DECADES AND I DON'T
JUST MEAN FOR MENTAL HEALTH CARE
BUT I MEAN FOR SUBSTANCE USE
DISORDER CARE. OUR LACK OF
CAPACITY HAS BEEN DRIVEN BY
DECADES OF STIGMA WHERE
BEHAVIORAL HEALTH FRANKLY WAS
NOT CONSIDERED PART OF THE CORE
HEALTH SYSTEM. CALIFORNIA IS
CHANGING THIS THIS IS NOT THE
WAY THAT CALIFORNIA IS GOING TO
BE- IMPLEMENT HEALTH CARE
ANYMORE. THERE'S A REASON WHY
TAKE YOUR VALUABLE TIME TO
MENTION THESE INVESTMENTS.
BECAUSE ALL OF THE DETAILS THAT
YOU'LL HEAR ON THIS PANEL TODAY
AND ACTUALLY SEVERAL PANELS
TODAY REGARDING CURRENT AND
PLANNED ACTIVITIES IN THE
BEHAVIORAL HEALTH SYSTEMS. AND
IN PARTICULAR CALIFORNIA'S
CRISIS CARE RESPONSE SYSTEM NEED
TO BE COORDINATED. THE GLOBAL
CLIMATE CRISIS MEANS THAT STATES
OF EMERGENCY. WILL BECOME
ENDEMIC NOT EPISODIC AND THAT CO
THAT AS WE'VE BEEN DISCUSSING
FOR THE LAST SEVERAL WEEKS HERE
IN CALIFORNIA. IS ENDEMIC THESE
CHALLENGES WILL INCREASE
ECONOMIC INSTABILITY STRESS
ANXIETY DEPRESSION ISOLATION AND
SUBSTANCE USE AMONG CALIFORNIA'S
PEOPLE. AND THIS IS TRUE ACROSS
THE LIFESPAN AND UNFORTUNATELY
IT WILL DISPROPORTIONATELY
IMPACT UNDERSERVED COMMUNITIES.
ALL OF THIS BEING SAID THERE ARE
INCREDIBLE OPPORTUNITIES FOR
CHANGE E'RE GOING TO TALK ABOUT
SEVERAL OF THEM TODAY- THERE IS
THE IMPLEMENTATION OF THE NINE
EIGHT EIGHT HOTLINE. THERE ARE
THE INFRASTRUCTURE INVESTMENTS
THAT HAVE ALREADY BEEN MADE AND
WILL CONTINUE TO BE MADE SO THAT
WE CAN CREATE A SYSTEM IN WHICH
MOBILE CRISIS SERVICES ARE
AVAILABLE IN MEDIC CAL AND FOR
THE NEXT FIVE YEARS WITH THAT
85% FEDERAL MATCH. WE ARE
LEARNING EVERY DAY THE CAPACITY
THAT WE HAVE TO REACH PEOPLE
WITH OUR CAL HOPE PROGRAM. AND
ABOVE ALL SOMETHING I BELIEVE
DEEPLY AND IS THE CRITICAL
IMPORTANCE OF PEER SUPPORT AND
WHAT ARE THE OTHER THINGS THAT
WE COULD BE DOING IN CALIFORNIA
TO PREVENT CRISIS IN THE FIRST
PLACE. LAST WEEK PRESIDENT BIDEN
ANNOUNCED A STRATEGY TO ADDRESS
THE NATIONAL MENTAL HEALTH
CRISIS AND IT'S AND IT'S PART OF
HIS UNITY AGENDA. SPECIFICALLY
IDENTIFIED THAT THE FEDERAL
BUDGET. WILL PROPOSE SEVEN
HUNDRED MILLION DOLLARS TO HELP
ESTATE STAFF OF OUR CRISIS CALL
CENTERS AND SHORE UP GAPS IN.
OUR NINE EIGHT EIGHT SYSTEM. SO
YOU ASK THE ADMINISTRATION WHAT
ARE OUR PLANS TO IMPLEMENT THESE
OPPORTUNITIES AND I'D LIKE TO
SHARE WITH YOU I'M A LITTLE BIT
ABOUT WHAT WE'LL BE DOING HERE
AT HEALTH AND HUMAN SERVICES AND
I KNOW THAT- OUR DEPARTMENT OF
HEALTH CARE SERVICES HERE. AND
WE'LL TALK ABOUT SOME MORE THESE
COMPONENTS IN SPECIFIC DETAIL.
THIS IS A VERY DYNAMIC SPACE
CERTAINLY IN MY CAREER I'VE
NEVER EXPERIENCED SO MANY THINGS
HAPPENING IN BEHAVIORAL HEALTH
AND THAT IS REALLY EXCITING. BUT
WE WANTED TO BE REALLY
THOUGHTFUL ABOUT THIS AND AS WE
SAW ALL THESE OPPORTUNITIES
COMING OUR WAY QUITE QUICKLY
FRANKLY WE FELT THAT. AT AGENCY
WOULD BE WELL POSITIONED TO WORK
WITH OUR DEPARTMENTS TO WORK
WITH OUR NATIONAL STATE AND
LOCAL GOVERNMENTAL PARTNERS OR
STAKEHOLDERS AND ADVOCATES. TO
PLAN FOR THIS WORK WITHIN THE
CONTEXT OF BOTH CURRENT AND
PROPOSED INVESTMENTS IN
PREVENTING AND RESPONDING TO
CRISIS. SO SPECIFICALLY WE'RE
GOING TO BUILD OFF OF EXISTING
PLANNING EFFORTS THAT HAVE BEEN
UNDER WAY TO BUILD THE CAPACITY
TO REACH THE VISION THAT WAS
INTENDED BY THE FEDERAL
LEGISLATION THAT CREATED NINE
EIGHT EIGHT. AND SO THE
ADMINISTRATION IS GOING TO
LAUNCH INTO A PROCESS OF
DEVELOPING A BLUEPRINT BY THE
END OF THE CALENDAR YEAR SO IT
IS GOING TO BE A SPRINT. THAT
WILL ADDRESS THE FOLLOWING
ISSUES. WE WILL IDENTIFY A
STATEWIDE VISION FOR A SET OF
SERVICES FOR INDIVIDUALS WHO ARE
EXPERIENCING CRISIS. INCLUDING
THE INTERACTION BETWEEN NINE
EIGHT EIGHT AND NINE ONE ONE.
MEDI CAL MOBILECRISIS RESPONSE
CRISIS RECEIVING FACILITIES AND
LONG TERM CRISIS RESIDENTIAL
SERVICES WE WILL ARTICULATE A
STATEWIDE MINIMUM SET OF
STANDARDS. AND IDENTIFY METRICS
TO MEASURE THE STANDARDS. WE
WILL IDENTIFY MODELS MORE
SPECIFICALLY PROTOTYPES OF HOW
STATEWIDE SERVICES COULD BE
IMPLEMENTED LOCALLY I THINK THIS
IS REALLY REALLY IMPORTANT AND
IT'S ALSO COMPLICATED BUT-
SOMETHING THAT I FEEL THAT WE
CAN DO TOGETHER. PARTICULARLY
WITH MANY OF THE STAKEHOLDERS
THAT WILL BE SPEAKING LATER ON
THIS PANEL WE HAVE TO RECOGNIZE
THE DIFFERENT MODELS ARE GOING
TO BE NEEDED IN DIFFERENT
COUNTIES AND COMMUNITIES THAT
SAID IT DOESN'T MEAN THAT WE
CAN'T HAVE A BASIC STATE WIDE
STANDARD- AND THEN WE CAN WORK
TO GET THERE OVER TIME. WE ALSO
WILL PROVIDE A HIGH LEVEL
OVERVIEW OF THE RESOURCES THAT
WILL BE REQUIRED AND OR HOW WE
COULD USE OUR CURRENT AND
PROPOSED INVESTMENTS. TO SUPPORT
THE IMPLEMENTATION OF A ROBUST
CRISIS CARE RESPONSE SYSTEM. WE
WILL OUTLINE A GOVERNANCE MODEL
TO SUPPORT FUTURE IMPLEMENTATION
I THINK THIS IS IMPORTANT AGENCY
WE HAVE TWELVE DEPARTMENTS FIVE
OFFICES. WE LIAISON WITH
CALLAWAY YES IN OTHER
DEPARTMENTS. I THINK IT'S REALLY
IMPORTANT FOR EVERYBODY HAVE A
GOOD UNDERSTANDING OF WHAT THEIR
ROLE AND RESPONSIBILITY IS AND
HAVING A ROBUST CRISIS RESPONSE
SYSTEM. WILL IDENTIFY. AND I
THINK MOST IMPORTANTLY. WE WILL
IDENTIFY MAJOR MILESTONES IT'S
BASICALLY THE HOW TO AND I SAY
THIS BECAUSE- WE ARE. IT'LL TAKE
SEVERAL YEARS TO GET TO WHERE WE
WANT TO GO AND I THINK IT'S
IMPORTANT FOR US TO UNDERSTAND
WHAT NEEDS TO BE DONE THIS YEAR
NEXT YEAR FIVE YEARS TEN YEARS.
SO THAT WE CAN CONTINUE TO ALIGN
OUR OVER ARCHING INVESTMENTS IN
BEHAVIORAL HEALTH SERVICES WITH
OUR OVER OUR OVER ARCHING GOALS
TO HAVE A ROBUST CRISIS CARE
SYSTEM. THAT WORKS FOR ALL
CALIFORNIANS. ABOVE ALL THIS
BLUEPRINT WILL BE COKE CO
CREATED WITH OUR KEY
STAKEHOLDERS MANY OF THEM
ALREADY BEEN THINKING ABOUT
THIS. SIGNIFICANTLY FOR THE LAST
YEAR AND PREPARING FOR THIS AND
I THINK IT'S- IMPERATIVE THAT
THEY BE INVOLVED NOT ONLY ARE
STAKEHOLDERS BUT REALLY OUR
STATE AGENCIES ARE LOCAL
JURISDICTIONS. AND OF COURSE
CONSUMERS CAREGIVERS AND FAMILY
MEMBERS THE INDIVIDUALS WHO
HAVE. FOR BETTER OR FOR WORSE
IMPACTED BY A SYSTEM THAT EITHER
WORKS OR DOESN'T WORK. AND WE
NEED THEIR USER EXPERIENCE TO
HELP US MAKE SOMETHING THAT
WORKS BETTER- IN THE LAST FEW
MONTHS WE'VE BEEN DOING A LOT OF
INTERNAL INFORMATION GATHERING
AND ARE REALLY EXCITED TO LAUNCH
INTO THIS PROCESS THIS SPRING
AND ARE VERY PLEASED TO PARTNER
WITH THE LEGISLATURE SOON AND
OFTEN. IN THIS PROCESS. SHARES
OF WE WERE ALSO ASKED BY THE
COMMITTEE TO SAY A FEW WORDS
ABOUT THE ANNOUNCEMENT THAT WAS
MADE BY THE GOVERNOR ON
THURSDAY. RELATED TO THE CARE
COURT INITIATIVE FRAMEWORK.
TODAY HE IN THE INTEREST OF TIME
I' GOING TO REALLY GET SOME
VERY HIGH VERY HIGH LEVEL
HIGHLIGHTS- YOU HAVE A
TREMENDOUS AGENDAS AGENDA AHEAD
OF YOU AND I WANT TO BE
RESPECTFUL OF TIME- AND WELCOME
ANOTHER OPPORTUNITY TO COME BACK
AND TALK ABOUT THIS IN MORE
DETAIL. SO THE COMMUNITY
ASSISTANCE RECOVERY AND
EMPOWERMENT OR CARE COURT. IS A
PROPOSED FRAMEWORK I THINK THE
TERM FRAMEWORK IS INCREDIBLY.
IMPORTANT TO UNDERSCORE. BECAUSE
THE ADMINISTRATION DEEPLY WANTS
TO DEVELOP THIS FURTHER WITH THE
EXPERTISE AND INSIGHTS OF OUR
STAKEHOLDERS ADVOCATES. AND THE
WORK THAT YOU ALL HAVE BEEN
DOING IN THE LEGISLATURE IN THE
SPACE FOR SEVERAL SEVERAL YEARS-
AGENCY WE ARE DEDICATED TO
SIGNIFICANT ENGAGEMENT EFFORTS.
IN THE COMING WEEKS TO BUILD OUT
THE FRAMEWORK INTO A SET OF
POLICY SOLUTIONS MANY OF WHICH
HAVE DELIBERATED ON. IN THIS.
PARTICULAR BODY I KNOW YOU GUYS
HAD A VERY LARGE HEARING IN THE
IN THE LATE FALL AND EARLY
WINTER. ON THIS VERY TOPIC IN
REALLY DELVED INTO A LOT OF
SOLUTIONS THAT I THINK ARE ARE
WARRANTED TO. LIFT UP AND TO
RECOGNIZE AND TO INVESTIGATE
FURTHER. LET ME TELL YOU A THING
IF YOU THINGS ABOUT I THINK
AIRPORT FROM MY PERSPECTIVE IS
TRYING TO DEAL FIRST SIMILAR AND
REALLY RESONATING WITH THE WORDS
THAT YOU WOULD SHARE IT AT THE
TOP OF THE AGENDA HERE IT IS A
PARODY AND SHIPPED. THIS IS
ABOUT GOING UPSTREAM TO DIVERT
AND PREVENT RESPONSES THAT
RESULT INSTITUTIONALIZATION FOR
PEOPLE WHO ARE SUFFERING FROM
THE DEEPEST OF CONDITIONS. THIS
WILL PREVENT AND AIMS TO PREVENT
CONSERVATORSHIP AND
UNFORTUNATELY INCARCERATION OF
PEOPLE WITH SERIOUS MENTAL
ILLNESS WE BELIEVE THAT WITH THE
RIGHT TOOLS THESE OUTCOMES CAN
BE ELIMINATED FOR MANY PEOPLE.
CARE COURT IS ALSO A PARTNERSHIP
BETWEEN SYSTEMS LIKE BEHAVIORAL
HEALTH CIVIL COURT SOCIAL
WELFARE. AND ALL OF THESE
SYSTEMS WORKING TOGETHER IN
THEIR RESPECTIVE ROLES TO
COORDINATE MENTAL HEALTH AND
SUBSTANCE USE DISORDER SERVICES
HOUSING AND OTHER SOCIAL WELFARE
PROGRAMS. THAT ARE DESIGNED TO
REACH THAT TO MEET THE NEEDS OF
THOSE WHO ARE MOST SEVERELY
IMPAIRED AND ARE UNDER OR
UNTREATED- SO OFTEN LANGUISH.
SUFFERING IN HOMELESSNESS OR
INCARCERATION WITHOUT THE
TREATMENT THAT THEY DESERVE. AND
MOST IMPORTANTLY REPORT IS ABOUT
PEOPLE. FIRST SUPPORTING A PATH
TO RECOVERY AND SELF
DETERMINATION IS CORE TO CARE
FOR WITH THE PUBLIC DEFENDER ANY
NEW SUPPORTER FOR EACH
PARTICIPANT IN ADDITION TO THEIR
FULL CLINICAL TEAM THE ROLE OF
THE SUPPORTER IS TO HELP THE
PARTICIPANTS UNDERSTAND CONSIDER
AND COMMUNICATE THEIR OWN
DECISION GIVING THE PARTICIPANT
TOOLS TO MAKE SELF DIRECTED
CHOICES TO THE GREATEST EXTENT
POSSIBLE. THE SUPPORTER WILL
ALSO HELP WITH THE DEVELOPMENT
OF THE PSYCHIATRIC ADVANCE CARE
DIRECTIVE AND FOR FUTURE
EPISODES AND FOR A GRADUATION
PLAN TO SUPPORT LONG TERM
RECOVERY AND WELLNESS POST CARE
COURT. SUPPORTERS ARE TRAINED IN
SUPPORT OF DECISION MAKING AND
WILL REPRESENT THE DIVERSITY OF
LIFE EXPERIENCES. AND SECOND.
SUPPORTING SYSTEMS TO BE
ACCOUNTABLE. TO DELIVER ROBUST
SERVICES FOR THOSE WHO ARE MOST
IN NEED. MANY OF THE THINGS THAT
WE'VE DESIGNED SO FAR IN THIS
SPACE ONLY FOCUS ON INDIVIDUAL
ACCOUNTABILITY ARE YOU AS THE
CLIENT OR PATIENT. PARTICIPATING
IN TREATMENT TO THE FULLEST
EXTENT THIS IS ALSO ABOUT
ACCOUNTABILITY TO OUR CELLS. ARE
TO US THE PROVIDERS WHO NEED TO
PROVIDE SERVICES TO THOSE WHO
ARE THE PEOPLE WHO ARE IN THE
DEEPEST END OF OUR BEHAVIORAL
HEALTH CONTINUE ON. AND FRANKLY
MANY OF THOSE INDIVIDUALS HAS
EEN HAVE BEEN LOST AND HAVE
BEEN IGNORED. SPECIFICALLY CARE
COURT CONNECTS A PERSON IN
CRISIS. WITH THE APP CONNECTS A
PERSON IN CRISIS WITH THE
SPECIFIC PSYCHIATRIC CONDITION
THAT THEY MUST HAVE IN ORDER TO
MEET THE CRITERIA FOR CARE
COVERAGE IS REALLY IMPORTANT.
THAT PARTICULAR CRITERIA IS
SOMEONE WHO IS LIVING WITH THE
SCHIZOPHRENIA SPECTRUM OR OTHER
PSYCHOTIC DISORDER. THEY ARE
CONNECTED TO CARE AND THEY ARE
CONNECTED TO THE CARE COURT IN
ORDER TO RECEIVE A CLINICAL
ASSESSMENT. AND TO EVENTUALLY
RECEIVE A CARE COURT- COURT
ORDERED PLAN FOR UP TO TWELVE
MONTHS WITH THE POSSIBILITY OF
THE EXTENSION OF AN ADDITIONAL
TWELVE MONTHS. REFERRALS IN THE
QUEUE CARE ACT TO CARE COURT
WILL WILL DIFFER BUT ONE EXAMPLE
COULD BE THAT. IT WOULD BE AN
APPROPRIATE NEXT STEP FOR
SOMEBODY WHO IS EXITING A SHORT
TERM INVOLUNTARY HOSPITAL HOLD.
OF BECAUSE THEYWERE BELIEVED TO
BE ARE FOUND TO BE EXCUSE ME
GRAVELY DISABLED AND OR HARM TO
THEMSELVES OR OTHERS TO
SOMEBODY'S EXENE A FIFTY ONE
FIFTY OR FIFTY TO FIFTY WHICH IS
A FOURTEEN DAY HOLD. THE
FRAMEWORK THAT WE PROVIDED THUS
FAR IS REALLY FOCUSING ON
PROVIDING INDIVIDUALS WITH
CLINICALLY APPROPRIATE COMMUNITY
BASED CARE. THIS IS IMPORTANT
THIS IS NOT CARE ENOUGH IN A
HOSPITAL IN A LOCK SETTING THIS
IS INTENDED TO BE COMMUNITY
BASED CARE. THAT IS CULTURALLY
AND LINGUISTICALLY COMPETENT AND
IT CONTAINS BOTH MENTAL HEALTH
AND IF NEEDED AND NECESSARY
SUBSTANCE USE DISORDERS SERVICES
. THIS INCLUDES SHORT TERM
STABILISATION MEDICATION
WELLNESS AND RECOVERY SUPPORT
AND CONNECTIONS TO SOCIAL
SERVICES AND THAT INCLUDES A
COURT ORDERED. HOUSING PLANS ARE
I'M SORRY THAT THAT INCLUDES A
HOUSING PLAN AS PART OF THE
COURT ORDERED TREATMENT. THE
HOUSING PLAN IS IMPORTANT. IT'S
VERY IMPORTANT BECAUSE FINDING
STABILITY AND STAYING CONNECTED
TO TREATMENT WITHOUT THE PROPER-
EVEN WITH THE PROPER SUPPORTS
FULL SERVICE PARTNERSHIP FOR EGG
SANDRA. IS REALLY NEXT TO
IMPOSSIBLE IF YOU'RE LIVING
OUTDOORS IN A TENT OR IN A
VEHICLE.AND I'M GOING TO END
WITH REALLY EMPHASIZING ONE
IMPORTANT PORT ONE VERY
IMPORTANT POINT AND IT THIS IS
ALSO PARTICULARLY IMPORTANT TO
ME. CANACCORD IS NOT FOR
EVERYONE EXPERIENCING
HOMELESSNESS OR MENTAL ILLNESS.
IT IS VERY FOCUSED ON A GROUP OF
PEOPLE WHO ARE LIVING WITH
SCHIZOPHRENIA SPECTRUM DISORDERS
OR OTHER PSYCHOTIC DISORDERS WHO
LACK MEDICAL DECISION MAKING
CAPACITY BOTH FOR. AND THAT'S
THE GOAL BEFORE THEY GET
ARRESTED BEFORE THEY GET
COMMITTED TO A STATE HOSPITAL OR
BEFORE THEY BECOME SO I'M SO
IMPAIRED THAT THEY END UP IN A
LPS MENTAL HEALTH
CONSERVATORSHIP. HOMELESSNESS
HAS MANY MANY FACES IN
CALIFORNIA BUT I THINK ALL OF US
COULD AGREE I OR AT LEAST MANY
OF US AGREE. THAT AMONG THE MOST
TRAGIC IS THE FACE OF THE OF THE
VERY SICKEST WHO ARE SUFFERING
FROM FRANKLY VERY VERY TREATABLE
MENTAL HEALTH CONDITIONS. AND
THIS PROPOSAL AIMS TO CONNECT
THESE INDIVIDUALS TO EFFECTIVE
TREATMENT AND SUPPORT AND HELP
THEM BE EMPOWERED TO MAP THEIR
OWN PATH TO LONG TERM RECOVERY.
SO WITH THAT BEING SAID I CHAIR
I THINK WE HAVE SOME OF THE
OTHER PEOPLE ON THE PANEL OR KEY
QUESTIONS THANK YOU. VERY MUCH
NEXT WE WILL HEAR FROM G. C.
COOPER WHO IS THE CHIEF DEPUTY
DIRECTOR FOR THE DEPARTMENT OF
HEALTH CARE SERVICES PLEASE
BEGIN. THANK YOU SO MUCH GOOD
AFTERNOON. THE ADMINISTRATION
RECOGNIZES THE DEVASTATING
IMPACT OF THE PANDEMIC OUR
POPULATION. THE TRAUMA FROM
ISOLATION ILLNESS GRIEF AND
FINANCIAL INSTABILITY HAS
AFFECTED THE MENTAL WELL BEING
OF YOUTH AND ADULTS. ALMOST HALF
OF THE YOUTH AND ADULTS REPORT
SYMPTOMS OF ANXIETY. OF
DEPRESSION. IN THE NEED FOR PRE
CLINICAL SERVICES INCLUDING PEER
WARM LINES WEB RESOURCES TAX THE
CHAT SUPPORT AND SELF HELP AS
WELL AS CLINICAL SERVICES. FOR
YOUTH AND ADULTS ARE PRESENTING
IN CRISIS THE SIGNIFICANT
INCREASES IN A CUTIE SEEN IN THE
EMERGENCY ROOM WE CONTINUE TO
SEE INCREASE IN OVERDOSE DEATHS
IN INCREASES IN DEATH BY SUICIDE
FOR PARTICULARLY VULNERABLE
POPULATIONS. AH YES LAUNCH
SEVERAL INITIATIVES TO ADDRESS
THE GROWING ACUITY OF NEED
SERVICES FOR THE BROAD
POPULATION OF PEOPLE WHO NEED
SUPPORT WHEN STRESSED SO THEY
DON'T DEVELOP A MENTAL HEALTH
CONDITION. SERVICES FOR PEOPLE
WITH BEHAVIORAL HEALTH
CONDITIONS IN OPTIONS FOR PEOPLE
IN CRISIS TO PREVENT THE NEED TO
GO TO AN EMERGENCY ROOM OR GET
INVOLVED IN THE JUSTICE SYSTEM.
THE ACS IS LEVERAGING THE UNIQUE
OPPORTUNITY AND CAL AIMS TO
STREAMLINE ACCESS TO BEHAVIORAL
HEALTH SERVICES MAKING IT EASIER
TO GET CARE RELIEVING
UNNECESSARY DOCUMENTATION
BURDENS THAT KEEP PROVIDERS FROM
PATIENT CARE. INCREASING
ACCOUNTABILITY AND OVERSIGHT
OVER THE CARE CONTINUUM. THE
DEPARTMENT IS ALSO RAMPING UP
NETWORK ADEQUACY IN CONTRACT
EXPECTATIONS TO ENSURE EACH
COUNTY BEHAVIORAL HEALTH PLAN
DELIVERS WHAT IS NEEDED. HE IS
THIS IS ALSO PROCESSING ARE IN
THE PROCESS OF ADDING NEW
BEHAVIORAL HEALTH SERVICES WITH
MANY NEW INITIATIVES INCLUDING
DYADIC CARE CONTINGENCY
MANAGEMENT IN THE NEW SERVICES
IN THE CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE.
FINALLY THE DEPARTMENT
RECOGNIZES THE NEED FOR A ROBUST
SYSTEM TO ADDRESS THE NEEDS OF
MEDICARE BENEFICIARIES IN
CRISIS. WE ARE PROPOSING A NEW
BEEFIT IN MEDIC HOW. MOBILE
CRISIS RESPONSE SERVICES I WHICH
KELLY WILL REVIEW IN A MOMENT.
WE ARE INVESTING OVER TWO
BILLION DOLLARS IN BEHAVIOR
HEALTH INFRASTRUCTURE WITH
PLANNING GRANTS IN
IMPLEMENTATION GRANTS TO SUPPORT
NEW AND EXPANDED FACILITIES THE
PEOPLE IN CRISIS HAVE A SAFE
PLACE TO GO IN TO GET THE NEEDED
AIR. AND WE HAVE INVESTED TWENTY
MILLION IN SUPPORT EXPANDING THE
LIFELINE CALL CENTER NETWORK TO
PREPARE FOR THE GO LIVE OF THE
NATIONAL NINE EIGHT EIGHT
HOTLINE. IN DH CS LOOKS FORWARD
TO PARTICIPATING IN AGENCIES
PLANNING PROCESS TO CREATE A
LONG TERM PLAN FOR NINE EIGHT
EIGHT IN THE CRISIS CONTINUUM OF
CARE. NOW I WILL TURN IT OVER TO
YOU I DR KELLY PFEIFER- OUR DOOR
A DEPUTY DIRECTOR OF BEHAVIORAL
HEALTH REVIEW DH CS IS PROPOSED
NEW MOBILE CRISIS BENEFIT AN
UPDATE ON THE MOBILE CRISIS
INVESTMENTS THAT WERE APPROVED
IN LAST YEAR'S BUDGET. AN
OVERVIEW OF HOW HOPE AND AS WELL
AS HAVE THE ACS IS HELPING
SUPPORT NINE EIGHT EIGHT
IMPLEMENTATION. KELLY GREAT
THANK YOU CAN I THINK GOOD
AFTERNOON IT'S AN HONOR TO
PRESENT TODAY. SO WE ARE
REQUESTING A HUNDRED EIGHT POINT
FIVE MILLION TOTAL FUN SIXTEEN
POINT THREE MILLION GENERAL FUND
FOR BUDGET YEAR TO IMPLEMENT THE
MOBILE CRISIS RESPONSE PROGRAM
BY JANUARY FIRST TWENTY TWENTY
THREE. THERE'S NO STATEWIDE
STANDARDIZED MEDICAL BENEFIT
WHICH COVERS MOBILE CRISIS
RESPONSE SERVICES. IN SEVERAL
FACTORS ARE DRIVING THE NEED TO
CHANGE THE DRIVE LETTER EARLIER
IN. THE INCREASED SECURITY THE
EVER HEALTH CRISIS CAUSED BY THE
THOMAS AND MACK. THEY NEED TO
DIVERT PEOPLE EXPERIENCING
MENTAL HEALTH CRISIS FROM LAW
ENFORCEMENT AND HIGHER THAN THE
TREATMENT. PREVENTING
INAPPROPRIATE INVOLVEMENT IN THE
JUSTICE SYSTEM WHICH
DISPROPORTIONATELY AFFECTS
PEOPLE OF COLOR. AND THE NEW
OPPORTUNITY IN AMERICAN RESCUE
PLAN ACTOR CARPA FOR HIS FEDERAL
MATCHING FUNDS FOR THE FIRST
THREE YEARS OF A FIVE YEAR
PERIOD. BEGINNING APRIL TWENTY
TWO TWENTY TWENTY TWO MARCH
TWENTY SEVENTH. SO WHILE CRISIS
INTERVENTIONS ARE CURRENTLY A
LIMITED MEDICAL BENEFIT
ESPECIALLY MENTAL HEALTH DRUG
MEDI CAL AND DRUG MEDICAL EVENT
WHAT THE SYSTEM. THERE'S NO
STATEWIDE REQUIREMENT THAT A
STANDARDIZED SET OF ON CALL TEAM
BASED CRISIS RESPONSE SERVICES
BE AVAILABLE. THROUGH MOBILE
MENTALITY FOR ALL MEDICARE
BENEFICIARIES TWENTY FOUR HOURS
A DAY SEVEN DAYS A WEEK.
TRANSPLANTING GAUGE KEY
STAKEHOLDERS INCLUDING KENNEDY
THE HEALTH AGENCIES PROVIDERS
CONSUMERS ADVOCATES AND OTHER
PARTNERS TO INFORM THE
DEVELOPMENT OF THE MOBILE CRISIS
BENEFIT A MEDIC CAL. INCLUDING
THE COVERED SERVICE COMPONENT
SERVICE CRITERIA THE COMPOSITION
OF THE MOBILE CRISIS. TEAM
ANOTHER PROVIDER QUALIFICATION.
FEDERAL GUIDANCE REGARDING THE
MOBILE CRISIS HAPPENED TO ME
DESCRIBE THE THREAT WORK. FOR
PROVIDER TO LIVE MOBILE SERVICES
AND THIS OF. THANK A REQUIREMENT
THAT THE TEAM INCLUDING LEAVES
ONE BEHAVIOR HEALTH. WHO PROVIDE
QUALIFY TO PROVIDE THE FOR WITH
AMERICA OF PRACTICE. THE FEDERAL
GUY ALSO THAT OTHER TEAM MAY
INCLUDE NOT SOCIAL WORKER TRYING
PEER SUPPORT. ACTUALLY IF YOU
ARE THERE'S A DRAW AND- THE GUY
OFFICE SUCH THE NUMBER REQUIRED
WITH SETS COMPANY. AND
SERVICEABILITY STANDARDS FOR THE
MOBILE CRISIS TEAM. HEARING THAT
PRACTICES IN THE LETTERS. STRONG
EXAMPLE WITHIN CAL HANDED
BECAUSE FROM OTHER STATES GOING
TO KIND OF EXPECT. ADDITIONALLY
THE EXTENT OF THE SEVEN BACK
OPTIONS FOR VERY COMPONENTS OF
THE RAM OF FROM A CRISIS. UNDER
THE CURRENTLY ABOUT ALLERGY DAY
WRITTEN REMEMBER PROVIDE AFTER
WHICH INCLUDE THE CAR INCURRED
PAIN WELL THEY AN ACTOR RENDON
SERVICES. AS PART OF THE HIP HOP
REFORM PROCESS WOULD EFFECTIVE
JULY. ONE TWENTY TWENTY THREE.
FOR THE WILL WHAT. TO FEED
SCHEDULE. THEY'RE DIFFERENT
OPTIONS FOR RANK MODELS FOR
MOBILE CRISIS THAT COULD BE AND
AFTER JULY FIRST TWENTY TWENTY
THREE HOWEVER BEHAVIOR HEALTH
THOSE FORMS. THAT IS PER DIEM
PAYMENTS AUTOMATIC PAYMENTS AS
SMALL INCREMENTAL PAYMENTS SUCH
AS A FIFTEEN MINUTE OUR THE YOU
KNOW. THE GUY LEFT TO THE RIGHT
MODEL THE WEIGHT TRAINING
CLASSES CAN INCORPORATE KEY
FEDERATION CENTURY I'M CALLING
THE ELDERLY FROM MOBILE CRISIS
SERVICES WHICH. CAN INCLUDE
FACTORING IDLE TIME. AVERAGE FOR
MOBILE IN THE IN THAT ACCOUNT
THE PRESENT UNDER THE TREE KEEPS
. FROM ACROSS OF CARE CAN ALONG
WITH I CALLED. AND ADDITION THE. I WANT A LITTLE BIT ABOUT OUR
IN. TODAY AND LOCAL CRY. AGAIN
TWENTY- THE BTS. A STATEWIDE
BEHAVIOR HOW EFFECTS THAT I.
GAPS IN CONTINUE OF CARE HEALTH
AND HOW DID MANAGE. IS PROPOSING
DRESS THEM. WE ADDRESS THE NEEDS
GAPS THROUGH HISTORICAL. IN THE
- CANYON IMPRESSED BECAUSE OFF
OF BEACH. SB FANS NEW AND
EXCITING TO HEAR CONSTRUCTION
RESPECT COUNTY FOCUS ON THE GAP
AND WILL KEPT ONE FOCUSED ON THE
CAPACITY FOR MOBILE GREG BY. AND
TWENTY TWENTY BEACH AWARDED
THIRTY FROM GRAY AND POINT
GRANTS TO CARRY CITY AND TRIBAL
BEING ABOUT AUTHORITY. TO BUILD
EXPAND CRISIS CAN YOU KNOW
PROGRAM FOR CAN THIRTY TRAVEL
IT'S EASY ABOUT THE ALREADY. AND
THE WAR WILL MORE TO ORDER NAY
MOBILE QUITE RESPONSE TEAMS OUT
YEAH. I'M NOT GONNA MOVE ON HOW
. FIRST CAL HOPELINE WITH TO
PUBLIC HEALTH AND- IT'S BEEN
FUNDED X. BY SEN MURDER FUNDING
AND IF AND GROWN FROM OVER LAST
YEAR. HOW WILL SACRAMENTO THE
ABOUT FOUR. WITH THE TRYING TO
HELP PEOPLE NEEDS ARE NOT YET BE
ON AFTER REQUIRE. SERVICES. WHO
MADE ME OF A QUORUM CONNECTION
BY PHONE TAX OR CHAT OR TALK
WEBER. THE CALIFORNIA COULD LEAD
TO BY THE FEDERAL MARK
MANAGEMENT AGENCY AFTER THIRTY
FIVE YEARS AND MENTAL HEALTH IN
THEN- STAND. WITH A HUNDRED
ELEVEN DOLLARS IN FUNDING THAT
CAN. FEDERAL FUNDING EXPIRED
MARCH TENTH HOWEVER WE HAVE FOR
EXPANSION PAYMENT YOU CAN AT THE
CORE THROUGHOUT THE END OF THE
CALL HEALTH OF MY- HELLO.
INCREDIBLE AND CAN TO SCALE
COMMITTEE GROWING DEMAND EVERY
MONTH OVER HER. POUNDS FOR STAND
WITH OVER A THOUSAND SHEKEL.
OVER TWENTY TWENTY FIVE HUNDRED
LINE CALL FIVE THOUSAND
INDIVIDUAL CAL CONFESSION AND
TWELVE THOUSAND GROUP COMPANY
AND ALL ALL RIGHT WHAT. YOU
CAN'T STUDENTS A CORD AFTER AND
SUPPORT FORTY INSTEAD. HE HAD A
RECORD CHILDREN WHO NEEDED TO
HELP. HOW ABOUT THE WEATHER
SERVICE INTO PUT CREDIT CANNOT
HERE TO SPRING FOR WHAT WILL BE
. AND THE CHOI AND YOUTH VEHICLE
HEALTH CONDITION. LAUNCHING IN
TWENTY TWENTY. AFTER TWENTY FOUR
CAL HOPE COULD FILL ON AND
SERVICE TEMPERATURE TO THE HERE
IN ABOUT THE NATIONAL. FOR SERVE
TO CHILDREN. HELLO MEDIA HELPS
KEEP THROUGH. STRESS NORMAL IT'S
A FEW AFTER HOW. CAROL HAS OVER
EIGHT HUNDRED NEW MEDIA MESSAGE
I'M PRESSURES THE MONTH. AND
EXEMPTS TO FOR EVENTS SUCH AS
THE FOOTBALL NOT A QUALITY AND-
SPREADING THE MESSAGE THROUGH
THE MEDIA. HELLO PUTS PEOPLE DO
THAT HAVE A BEARD TO HELP
CONDITION AND WE NEED GROW THREE
FOR THE OF THE- WHO LET ME CRAWL
SERVER OF THE- ME WHILE LATE AND
THAT. TALK WHAT WOULD- TELL THEM
CLINICAL. AND FINALLY- FOR NINE
EIGHT EIGHT IMPLEMENT. DEMCHAK
ANY. SUPPORTED I NEEDED TO.
THREE FOR WE WANTED TO BE HER
TRIP THE LIFELINE CALL NOW A ONE
TIME CHARGE MILLION DOLLARS AND
THE TRUMP FEDERAL HEALTH BLOCK
GRANT BEN. IN THE STANDS THAT IT
TO BUILD NEW TECH AND STAFFING
ATHLETES PREPARE FOR NINETY OF
COMPLICATIONS. D. FOR THE PRICE
FOR. POINT FOUR NO OF. FUNDING
TO SUPPORT NINETY DAYS OPERATE.
TRENDING THE GRANTED NOT COMPARE
IN WE DO EXPECT TO BE UNDER. AND
AGAIN THIS FOCUSED TO STAY HOW
TO SUSTAIN NINETY DATA. AND
FINALLY ALLOCATE FOUR POINT
THREE NINE AND AS A MENTAL
HEALTH THAT SPENDING BE THE
FIRST. THE CAL LIFELINE CALL
CENTER NOW AT THE TWO IS THAT
CORRECT SERVICE. CONTRACT AND
THEN YOU OF OUR IN THAT
CONTRACT. HOW THIS WILL HELP
CONTINUE SUPPORT LIFELINE THANK
NETWORK OPERATE. UNDER IN MY
PREVIOUS AND THANK YOU. THANK
NEXT WE WILL HEAR FROM I RE HAVE
WHO IS A- PEER SUPPORT. AT DAY.
PLEASE BEGIN. HELLO I'M MY NAME
IS THREE HACK- I A YOU'RE SO
FOR. AT THE C. D. EARLY SO
PROGRAM. I WAS ASKED TO TESTIFY
TODAY TO TALK ABOUT MY LIVED
EXPERIENCE IS A CONSUMER MENTAL
HEALTH SERVICES IN MY EXPERIENCE
ACCESSING CRISIS RESOURCES. I'M
I HAVE THE BASE VARIANT OF A
PSYCHOTIC DISORDER AND HAVING
PSYCHOTIC BREAK WHEN I WAS
EIGHTEEN AM POLICE RESPONDED TO
MY HOME. I'M TWICE AND NEITHER
TIMES DID I RECEIVE ANY USEFUL
SERVICES OR WHO WAS
HOSPITALIZED- ON BOTH OCCASIONS
AND THE POLICE RESPONDED TO ASK
VERY FEW QUESTIONS AND LAUGHED
WHEN I SAID. I WAS FINE AND THE
OUTCOME OF THAT WAS I WAS
PSYCHOTIC FOR MUCH LONGER THAN I
NEEDED TO EAT AND THAT THAT'S
REALLY IMPORTANT BECAUSE THE
LONGER SOMEONE IS PSYCHOTIC
WITHOUT TREATMENT THE WORSE YOUR
OUTCOME IS GOING TO BE. I'M AND
I WAS EVENTUALLY HOSPITALIZED
BUT WE HAVE CALLED THE POLICE SO
MANY TIMES BEFORE THAT HAPPENED
I'M AND WHEN PEOPLE CALL THE
POLICE FOR A MENTAL HEALTH
CRISIS REALLY WHAT HAPPENS IS.
YOU ARE HOSPITALIZED OR NOTHING
REALLY HAPPENS I THOSE ARE THE
KIND OF THE TWO OUTCOMES WHEN
THE POLICE RESPOND TO A MENTAL
HEALTH CRISIS- THEY DO NOTHING
OR- YOU YOU GET HOSPITALIZED- SO
ARE YOU REALLY BELIEVE THAT THE
POLICE SHOULD NOT BE INVOLVED IN
RESPONDNG TO MENTAL HEALTH
CRISES- I BELIEVE THAT TRAIN
MENTAL HEALTH PROFESSIONALS.
BOTH WITH LIVED EXPERIENCE-
SHOULD BE RESPONDING TO MENTAL
HEALTH CRISES- AND I ALSO DON'T
FEEL LIKE AND I ALSO FEEL LIKE A
NINE EIGHT EIGHT LINE SURE THAT
HAVE RESOURCES AVAILABLE OTHER
THAN INVOLUNTARY HOSPITALIZATION
OR NOTHING THERE ARE A LOT OF
SERVICES LIKE- OUTPATIENT
PROVIDERS INTENSIVE OUTPATIENT
PROVIDERS PARTIAL
HOSPITALIZATION PROGRAMS
RESIDENTIAL PROGRAMS. AND THAT
THE MENTAL HEALTH SYSTEM IN
CALIFORNIA IS SO COMPLEX I WORK
WITH SO MANY FAMILIES- AND-
PEOPLE THAT DON'T KNOW HOW TO
NAVIGATE THE MENTAL HALTH.
SYSTEM THEY DON'T KNOW WHAT
SERVICES. ARE AVAILABLE TO THEM
SO WE HAD AT THE NINE EIGHT
EIGHT LINE ABLE TO PROVIDE
REFERRALS SHE- SERVICES BACK
FAMILIES AND CLIENTS DON'T KNOW
ABOUT THAT WOULD BE VERY
SIGNIFICANT AND WOULD REDUCE
HOSPITALIZATIONS AND WOULD
REDUCE. AB YOU KNOW THE AMOUNT
OF TIME PEOPLE GO WITHOUT
TREATMENT WHICH IS VERY DRAMATIC
IT'S VERY TRAUMATIC TO BE
PSYCHOTIC OR HOW YOU KNOW MENTAL
HEALTH CRISIS FOR LONGER THAN
YOU NEED TO GO- AND I ALSO
STRONGLY BELIEVE THAT. A NINE
EIGHT SERVICE SHOULD BE
AVAILABLE TO EVERYONE REGARDLESS
OF INSURANCE STATUS- THANK YOU
THOSE ARE MY COMMENTS FOR TODAY
. THANK YOU RINA NEXT WE WILL
HEAR FROM JOHN FRANKLIN SIERRA
SENIOR STAFF ANALYSTS AT THE LOS
ANGELES COUNTY- CHIEF EXECUTIVE
OFFICE PLEASE BEGIN. THANK YOU
HELLO EVERYONE HELLO CHAIR AND
MEMBERS I'M JOHN FRANKLIN ZERO
WITH THE L. A. COUNTY CHIEF
EXECUTIVE OFFICE. FROM THE
ALTERNATIVES TO INCARCERATION
INITIATIVE I'M A HEALTH SYSTEMS
ENGINEER- AND I'M THE PROJECT
MANAGER FOR THE COUNTIES
ALTERNATIVE CRISIS RESPONSE
PROGRAM WHICH IS A PARTNERSHIP
BETWEEN THE CEO. AND THE COUNTY
DEPARTMENT OF MENTAL HEALTH.
WE'RE WORKING HARD TO IMPROVE
BOTH THE CAPACITY AND THE
COORDINATION OF OUR CRISIS CARE
SERVICES COUNTY WIDE IN
PREPARATION FOR THE OFFICIAL
ROLL OUT OF NINETY EIGHT THIS
JULY. WE ENVISION A FUTURE WHERE
ALL INDIVIDUALS IN L. A. COUNTY
WHO EXPERIENCE A BEHAVIORAL
HEALTH CRISIS OR EMERGENCY. HAVE
ACCESS TO RAPID RELIABLE AND
PROFESSIONAL CARE WITHOUT THE
INVOLVEMENT OF LAW ENFORCEMENT
UNLESS NECESSARY. JUST AS OUR
COMMUNITY SHOULD EXPECT FOR ANY
OTHER HEALTH EMERGENCY.
FURTHERMORE WE KNOW THAT GAPS IN
OUR CURRENT SYSTEM
DISPROPORTIONATELY IMPACT
COMMUNITIES OF COLOR AND THE
LGBTQ COMMUNITY. LIKE TO BUY AN
OVER REPRESENTATION OF
INDIVIDUALS WITH MENTAL HEALTH
AND SUBSTANCE USE NEEDS FROM
THESE COMMUNITIES ENDING UP IN
OUR JAILS ON THE STREET AND
REPEATEDLY HOSPITALIZED. WE MUST
BUILD A CRISIS SYSTEM WHICH
ADDRESSES THESE INEQUITIES HEAD
ON. AND SO WE INTEND TO LEVERAGE
NINE EIGHT EIGHT AS THE
PREFERRED NO WRONG DOOR AND
CENTRAL POINT OF ACCESS FOR
CRISIS CARE THROUGHOUT THE
COUNTY. AS YOU CAN SEE THE
SYSTEM WE'RE TRYING TO BUILD AN
L. A. COUNTY IS AMBITIOUS IT
WILL TAKE YEARS TO RECHARGE
VISION. AND THERE ARE NUMEROUS
OBSTACLES TO OVERCOME. WE ARE
GRATEFUL FOR THE ONE TIME FUNDS
WE'VE BEEN ABLE TO SECURE TO
SUPPORT THIS EXPANSION.
INCLUDING THE STATE'S CRISIS
CARE MOBILE UNITS GRANT FROM THE
BEACH THAT PROGRAM WHICH WILL
PROVIDE A SIGNIFICANT BOOST TO
OUR MOBILE CRISIS RESPONSE
INFRASTRUCTURE. HOWEVER WE STILL
NEED TO IDENTIFY AND SECURE ON
GOING FUNDING TO SUPPORT THE
EXPANDED CRISIS SERVICES
CAPACITY THAT WE NEED SYSTEM
WIDE. AS WELL AS TO BETTER
SUPPORT THE CONNECTIONS BETWEEN
PARTS OF THE SYSTEM. THAT WILL
ENSURE IT OPERATES AS A COHESIVE
WHOLE. AND WE KNOW THAT WE ALSO
NEED TO DEVELOP THE WORKFORCE OF
THE FUTURE TO ACTUALLY DELIVER
ON THIS VISION FOR OUR CRISIS
SYSTEM A PROBLEM THAT FUNDING
ALONE CANNOT OVERCOME. BUT STILL
TO REALIZE THIS VISION IN YEARS
INSTEAD OF DECADES DEPENDS ON
WHAT WE DO TODAY. IT REQUIRES AN
URGENCY OF ACTION COMMENSURATE
WITH THE URGENCY OF THE NEED.
SOMETHING OUR COMMUNITIES REMIND
US CONSTANTLY AS THEY BEAR THE
BRUNT OF THE CURRENT SYSTEMS
FAILURES. HERE IN L. A. COUNTY
WE'VE BEEN FORTUNATE TO HAVE
FOUR PLUS YEARS OF COMMUNITY
ENGAGEMENT. THAT IS DIRECTLY
INFORMING OUR VISION AND
PROVIDING A FOUNDATION FOR THIS
WORK. AND ESPECIALLY WITH
CALIFORNIA'S COUNTY BASED
BEHAVIORAL HEALTH CARE DELIVERY
SYSTEMS THAT LOCAL ENGAGEMENT
AND PLANNING. IS CRITICAL TO
BUILDING A SYSTEM THAT
RESPONSIBLY INCLUDES THE
EXISTING NETWORK OF SERVICES AND
IS ALSO ARCHITECTED IN A
HOLISTIC WAY TO ACHIEVE OUR
LOCAL VISION AND PRODUCE THE
BETTER OUTCOMES FOR WHICH OUR
DIVERSE COMMUNITIES ARE RIGHTLY
ASKING. BUT IN ADDITION TO LOCAL
ENGAGEMENT ARCHITECTING AND
PLANNING. WE ALSO NEED STATE
LEADERSHIP AND SUPPORT. FOR
EXAMPLE SINCE THE STATE
MAINTAINS THE INFRASTRUCTURE FOR
THE NINE ONE ONE SYSTEM WE NEED
THE STATE TO HELP ENSURE ROBUST
INTER OPERABILITY BETWEEN NINE
ONE ONE AND NINE EIGHT EIGHT.
THIS WOULD SUPPORT THE RELIABLE
TRANSFER CRISIS CALLS NOT
REQUIRING LAW ENFORCEMENT OR EMS
RESPONSE FROM NINE ONE ONE TWO
NINE EIGHT EIGHT SYSTEM. ALSO
THE FEDERAL CENTERS FOR MEDICARE
AND MEDICAID SERVICES HAVE
ILLUSTRATED SEVERAL AVENUES FOR
ENHANCING MEDICAID FUNDING FOR
CRISIS SERVICES. INCLUDING
BETTER USE OF ADMINISTRATIVE
FUNDING FOR CALL CENTERS AND
TECHNOLOGY. AND WE WOULD NEED
THE SUPPORT OF THE STATE MEDICAL
PROGRAM TO EXPLORE AND
POTENTIALLY IMPLEMENT THESE
MEASURES. AND MORE BROADLY AND
EXPANDED CRISIS SYSTEM PROMISES
TO OFFSET STATE HEALTH CARE
COSTS ELSEWHERE. BY PREVENTING
CRISES FROM ESCALATING INTO MORE
INTENSIVE AND EXPENSIVE HEALTH
NEEDS. INCLUDING FOR EXAMPLE
THOSE NEEDS SO OFTEN FRONT AND
CENTER IN THE FIGHT TO ADDRESS
THE HOMELESSNESS CRISIS. BUT WE
NEED STATE LEADERSHIP AND
SUPPORT TO HELP IDENTIFY AND
CAPTURE THOSE OFFSETS AND ENSURE
THAT THEY ARE ADEQUATELY
REINVESTED IN THE CRISIS
SERVICES THAT HELP TO PRODUCE
THEM. WITH SO MANY DISPARATE AND
SIDELOAD SYSTEMS FOR THE
ORGANIZATION AND FUNDING OF
HEALTH CARE SERVICES IT ISN'T
POSSIBLE TO REALIZE THESE KINDS
OF VALUE BASED RETURNS ON
INVESTMENT WITHOUT GOING ALL THE
WAY UP TO THE STATE LEVEL. WE
KNOW FROM OUR EXPERIENCE IN L.
A. COUNTY THAT IT WILL REQUIRE
HUNDREDS MAYBE THOUSANDS OF
HOURS OF CONVERSATIONS
BRAINSTORMING AND COMMUNITY
ENGAGEMENT FROM THROUGHOUT THE
STATE. TO CLARIFY THE STATE WIDE
VISION FOR CRISIS SERVICES AS
WELL AS THE IDEAL ROLE OF THE
STATE AND SUPPORTING LOCAL
EFFORTS TO ACHIEVE IT. WITH NINE
EIGHT EIGHT ON OUR DOORSTEP THE
BEST TIME TO BEGIN THOSE
CONVERSATIONS WOULD HAVE BEEN
YEARS AGO BUT- SECOND BEST TIME
IS RIGHT NOW. I WE COUNTY LOOKS
FORWARD TO PARTNERING WITH THE
STATE ON BOTH IMPLEMENTING OUR
LOCAL VISION AND ALSO IN
DEVELOPING THE STATE WIDE VISION
THAT WE KNOW WILL HELP ADDRESS
IN THE REST OF THE STATE. MANY
OF THE SAME NEEDS OUR LOCAL
COMMUNITIES ARE EXPERIENCING.
THANK YOU FOR THE OPPORTUNITY TO
PRESENT TODAY. THANK YOU NEXT WE
WILL HEAR FROM DOCTOR LEE LEE
ANDREA CLARK HARVEY CEO. WITH
THE CALIFORNIA COUNCIL OF
COMMUNITY BEHAVIORAL HELP
AGENCIES PLEASE BEGIN. THANK YOU
CHAIR ARAMBULA AND ESTEEMED
COMMITTEE MEMBERS FOR THIS
OPPORTUNITY YOU SHOULD A
PERSPECTIVE OF CVHS MEMBER
ORGANIZATIONS WHO PROVIDE
BEHAVIORAL HEALTH SERVICES TO
OVER EIGHT HUNDRED THOUSAND.
CALIFORNIANS OFFERS COMMENT ON
NINE EIGHT EIGHT AND MY
COLLEAGUE FROM L. A. COUNTY JUST
YOUR MOBILE CAR EXACERBATING THE
IMPENDING JULY IMPLEMENTATION
DEADLINE UP OUR NATIONAL NINE
EIGHT EIGHT HOTLINES ARE
CRITICAL COMPONENTS TO OUR
SYSTEM OF CARE AND THERE'S
DEFINITELY A NEXUS BETWEEN
MOBILE CRISIS IN NINETY EIGHT.
SOME OF CVHS MEMBER AGENCIES RUN
CALL CENTERS AND WE FEED THE
SERVICE OF AN OPPORTUNITY TO
PROVIDE EARLY INTERVENTION THE
CONTINUUM OF CARE OFTEN STARTS
WITH A CALL A TEXT OR CHAT
MESSAGE AND THE MAJORITY OF
THESE ENCOUNTERS STOP THERE
WITHOUT THE NEED FOR REFERRAL OR
ADDITIONAL SERVICES THAT'S HOW
EFFECTIVE THESE CALL CENTER
PROVIDERS RE. PROVIDERS WILL
OBVIOUSLY CONTINUE TO PROVIDE
THIS FRONT AND SERVICE AND WE'RE
GRATEFUL FOR THE FUNDING
ALLOCATED TO ASSIST THEM WITH
YOU'RE NOT A LINE GOING TO LIVE
IN JULY OF TWENTY TWENTY TWO AND
THE DIVISIONAL INVESTMENTS ARE
STILL NEEDED NOW DON'T GET ME
WRONG THOUGH THE CONTINUUM OF
CARE EGINS AND OFTEN ENDS WITH
THESE INITIAL ENCOUNTERS A CALL
CENTERS. THERE IS DEFINITELY A
NEED TO ENSURE THAT EMERGENCY
SERVICES LAW ENFORCEMENT WELL
CRISIS THAT'S AVAILABLE IN A
COUNTY CALL CENTERS EXCEPT TRUMP
WORK COLLABORATIVELY THIS MEANS
THAT INDIVIDUALS WORKING WITH
THEM ALL OF THE SYSTEMS MUST BE
APPROPRIATELY CROSS TRAINED TO
RECOGNIZE THE SIGNS OF A
BEHAVIORAL HEALTH CRISIS AND
WORK WITH THEIR COLLEAGUES TO DE
ESCALATE AND REFER
APPROPRIATELY. THIS MEANS THAT
THE OFFICE OF EMERGENCY SERVICES
AND THE CALL CENTERS HAVE TO
HAVE AN INTEROPERABLE. FORM SO
THAT CALLS CAN BE TRANSFERRED
INTERACT THIS MEANS THAT WOULD
EVER WHETHER. IT'S A MOBILE
CRISIS UNIT OR IF SHE- THAT
FIRST RESPONDERS SOMEONE IN IS
TRAIN TO RESPOND AND REFER TO AN
APPROACH ENVIRONMENT FOR
TREATMENT NO WAY. IN HAS BEEN.
EVERY COUNT AT PER BY IS. EVERY
CALLS IT'S TO BUT WE ALMOST WORK
TOGETHER TO MAKE THE SYSTEM
WORK. WE SEE ALL OF THESE FOLKS-
ANY INVESTMENTS AT THE END OF
MINISTRATION HAS MADE- ALSO AND
CAL HOLDEN APPEAR WARMER. DURING
THE CRISIS TO THE SYSTEM LAST
ALL FAKE WITH ME THAT I WANT TO
APPLAUD THE MENTAL HEALTH
SERVICES. TO THE OVERSIGHT
ACCOUNTABILITY COMMISSION ON THE
PROPOSED REVISIONS TO SB EIGHTY
TWO. NINE CBO TO DIRECTLY APPLY
FOR CONTRACTS WITH THE STRENGTH
OF THIS PROPOSAL AND WE SUPPORT
ANY EFFORT. TO STREAMLINING
FUNDS DIRECTLY TO THE PROVIDERS
WHO ARE SERVING CLIENTS
ESPECIALLY DURING THIS PANDEMIC
MY COLLEAGUE TONY EWING WE'LL
TALK MORE ABOUT THIS IN A FEW
MINUTES OVERALL THANK YOU FOR
THIS FORUM FOR DISCUSSION AND
THE OPPORTUNITY TO. SHARE
PERSPECTIVES. ON BEHALF OF OUR
PROVIDER MEMBERS. THANK YOU NEXT
WE WILL HEAR FROM. VERONICA
CHIEF FOR MENTAL HEALTH AND
RECOVERY SERVICES WITH THE
ORANGE COUNTY HEALTH CARE AGENCY
PLEASE BEGIN. THANK YOU GOOD
AFTERNOON KAREN BLACK AND
MEMBERS MY NAME IS DR RON CALI
BAHAL TRACTOR POINTS COUNTY IN
PREVIOUSLY THE BEHAVIOR HEALTH
DIRECTOR FOR SAN BERNARDINO
COUNTY AND THE PAST PRESIDENT
CAN BE EVER HELD DIRECTORS
ASSOCIATION I'M GOING TESTIFYING
ON BEHALF OF HERE TODAY. COUNTY
BEHAVIORAL HEALTH DIRECTORS LIKE
ALL OF US ARE IN THE MIDST OF
THE MAN'S TRANSFORMATION AND
INFRASTRUCTURE INVESTMENT WHILE
FACING EXTREMELY CHALLENGING
CIRCUMSTANCES ON THE GROUND
THANKFULLY THE LEGISLATURE AND
THE AND THE ADMINISTRATION HAVE
PRIORITIZE BEHAVIORAL HEALTH IN
LAST YEAR'S BUDGET AS WELL AS IN
THIS YEAR'S BUDGET LIKE NEVER
BEFORE. WE'RE ALSO GRATEFUL FOR
THE STATE'S PROPOSED INVESTMENT
IN A STATE WIDE MOBILE CRISIS
BENEFIT WHICH WOULD OCT
CALIFORNIA INTO THE 85% MATCH
AVAILABLE FOR THEIR SERVICES
UNDER OUR BACK FOR A. PERIOD OF
FIVE YEARS STARTING THIS APRIL.
YEAH YEAR WHEN IT. CALLSNINE
DATE. SUPPORT FUNDING PROVIDED
BY THE LEGISLATURE LAST YEAR
WILL ALLOW OUR NATIONAL SUICIDE
PREVENTION LIFELINE CALL
CENTERS. WHICH HAVE BEEN BUILT
WITH FUNDING. FROM THE MENTAL
HEALTH SERVICES ACT. AND COUNTY
BEHAVIORAL HEALTH TO ANSWER THE
CALL WITH TRAINED VOLUNTEERS AND
STAFF. I NEED A CALL CENTER WILL
BE ABLE TO MAKE REFERRALS TO
COUNTY BEHAVIORAL HEALTH FOR
MEDICAL BENEFICIARIES WHO
REQUIRE AND MOBILE CRISIS
RESPONSE. WHERE THOSE SERVICES
EXIST TODAY. I'M SURVIVING
SURVEY LAST YEAR TWO THIRDS OF
COUNTY BEHAVIORAL HEALTH
AGENCIES REPORTED THAT THEY DO
OPERATE A CRISIS MOBILE CRISIS
PROGRAM. AND MANY OF THE MOBILE
CRISIS. CAPACITY WE HAD TODAY
WAS PUT IN PLACE THROUGH OUR
SENATE BILL EIGHTY TWO CRISIS
TRIAGE GRANTS. PREVIOUS
ITERATIONS AND MANY WERE ALSO
STOOD UP WITH AN HSA. AND
DOLLARS. THANKS TO FUNDING
PROVIDED THROUGH BE CHIP BROWN
TO AND LAST YEAR'S BUDGET WE'VE
BEEN ABLE TO BUILD OUT
ADDITIONAL MOBILE CRISIS
INFRASTRUCTURE. BUT AGAIN
THROUGH COMPETITIVE GRANTS THAT
LEAVES PART OF THE STATE WITH
LITTLE OR NO INVESTMENT. IN
ADDITION BECAUSE MOBILE CRISIS
HAS NEVER BANNED A STANDARD
MEDICAL BENEFIT AS DR PEPPER
NOTED. AND WE GET ALMOST NO
REIMBURSEMENT FROM COMMERCIAL
INSURANCE. MOBILE CRISIS TEAM
COVERAGE IS STILL SOMEWHAT
SPOTTY IN CALIFORNIA WITH MANY
COUNTIES LIKE SAN BENITO COUNTY.
HAVING SUCH A SYSTEM IN PLACE
SINCE TWO THOUSAND FIVE WITHOUT
THE ABILITY TO DRIVE DOWN F. P.
TO ALLOW FOR A BROAD EXPANSION.
WE ARE NOT YET A WHERE HAVE THE
EMPTY. OR THE CAT PASS TO
PROVIDE MOBILE CRISIS SERVICES
TWENTY FOUR SEVEN. TO ANY
MEDICAL BENEFITS YOUR NEED LET
ALONE EVERY CALIFORNIAN BECAUSE
I BEHAVIORAL HEALTH CRISIS IS TO
HISTORICALLY HAS NOT BEEN
FUNDED. OR DEVELOPED CHARITY
WITH OUR EMERGENCY MEDICAL
RESPONSE SYSTEM. WE DO SUPPORT
THE RECOMMENDATION OF THE
COMMITTEE TO MORE CLEARLY
COMMUNICATE TO CALIFORNIANS WHAT
NINETY EIGHT EIGHT MEANS FAR
STATE. ON JULY FIRST OUR
NATIONAL SUICIDE PREVENTION MY
PLANS WILL BE MORE ACCESSIBLE
MORE ACCESSIBLE THAN EVER. FOR
EMOTIONAL SUPPORT. WE CONNECTING
ALL CALIFORNIANS INCLUDING THE
70% OF CALIFORNIANS WITH
COMMERCIAL INSURANCE TO MOBILE
CRISIS AND CRISIS SERVICES
THROUGH THE PARTNERSHIP. BETWEEN
NINE EIGHT EIGHT AND COUNTY
BEHAVIORAL HEALTH WILL TAKE EVEN
MORE INVESTMENT. WE ARE ALL IN
FOR THE VISION OF A WELL FUNDED
AND SUPPORTED PUBLIC BEHAVIOR
HEALTH CRISIS SYSTEM. WE ARE
CONCERNED WITH SOME OF THE
RECOMMENDATIONS BEING PUT
FORWARD BY THE L. A. C. FOR
CHANGING OUR SB EIGHTY TWO
GRANTS. AS IT WOULD REPLACE WHAT
HAS BEEN UP UNTIL NOW A CRUCIAL
SOURCE OF FUNDING FOR OUR CRISIS
RESPONSE SYSTEM. THESE CHANGES
TO DIVERT FUNDING TO HOSPITALS-
OR TO SEE VIDEOS WILL ULTIMATELY
NEED TO BE LINKED IN WITH COUNTY
BEHAVIORAL HEALTH DISPATCH
SYSTEMS AND REIMBURSEMENT IS
SHORT SIGHTED. WE WOULD ASK THE
CHANGES INSTEAD ALIGN WITH OUR
RECOMMENDATIONS TO MOVE AWAY
FROM COMPETITIVE GRANTS AND
STAFFING RESTRICTIONS. LAST
YEAR'S BUDGET AND THE PROPOSED
MOBILE CRISIS BENEFIT ALONG WITH
THE ROBUST STATE LEVEL
STAKEHOLDER PROCESS AS OUTLINED
IN THE BUDGET WE BELIEVE
CALIFORNIA WILL BE WELL ON HER
WAY TO ANSWERING. THE CALL EVERY
TIME THANK YOU. THANK YOU NEXT
WE WILL FROM. YOU EXECUTIVE. FOR
THE MENTAL HEALTH. SERVICES
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. THANK YOU MR
CHAIRMAN MEMBERS THIS IS TOBY
YOU IN WITH MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY H. AND I
APPRECIATE THE CHANCE TO JOIN
YOU- THIS AFTERNOON REMOTELY- AS
MUCH AS I ENJOYED THE TIME WITH
YOU LAST MONDAY I THINK IT MAKES
MORE SENSE TO BE REMOTE 70% A
CHANCE TO DO SO. VERY VERY
QUICKLY. YOU KNOW MY COMMENTS
REGARDING THE NINE EIGHT SYSTEM
IN THE SHIFT AT THE STATE OF
CALIFORNIA IS MAKING. REALLY IS
TO- I. RECOGNIZE THAT OUR CRISIS
RESPONSE SYSTEM THAT THE
INVESTMENTS THAT WE'VE MADE IN
THE PAST LARGELY. HAVE BEEN
ABOUT MAKING SURE THAT WE HAVE
THE CAPACITY TO RESPOND WHEN A
CRISIS OCCURS. NINE EIGHT EIGHT
IS RECOGNIZING THAT HE STATE OF
CALIFORNIA NEEDS TO MAKE A SHIFT
TO UPSTREAM KINDS OF. ACTIVITIES
SO THAT WE CAN REDUCE RELIANCE
ON CRISIS SERVICES. WHILE AT THE
SAME TIME MAKING SURE THAT WE
HAVE ROBUST. AFFECTIVE CRISIS
RESPONSE. AT THAT RESOURCES
AVAILABLE IN EVERY COMMUNITY FOR
EVERY CALIFORNIA WHEN WE NEED
THEM. THE IDEA BEHIND THIS FROM
A CHRISTIAN PERSPECTIVE IS THAT
WE CANNOT SIMPLY PAY OUR WAY OUT
OF THE INADEQUACIES OF THE
SYSTEMS THAT WE HAVE STATEWIDE.
WE HAVE TO BE VERY STRATEGIC AND
THINKING ABOUT HOW WE CAN DO
UPSTREAM PREVENTION EARLY
INTERVENTION HOW WE CAN BETTER
UNDERSTAND WHY PEOPLE ARE
NEEDING CRISIS SERVICES THE WAYS
WE CAN FOR THE FIGHT COMMUNITY
SERVICES OF THE CRISES DON'T
HAPPEN IN THE FIRST PLACE. SO
CONSISTENT WITH THE TESTIMONY
THAT I PROVIDED IN THE PAST
AROUND LPS AND OTHER AREAS WE
NEED TO DO THE WORK AND THE DEEP
AND EXCEEDINGLY WELL. BUT WE
ALSO NEED TO BE MAKING THE
INVESTMENTS THAT ARE NECESSARY
TO REDUCE RELIANCE ON THIS
DEFENSE SERVICES. THE COMMISSION
HAS DISCUSSED OPPORTUNITIES TO
MODIFY SB EIGHTY TWO IN A IN A
NUMBER OF WAYS. BUT IT REALLY
STARTS WITH THIS RECOGNITION
THAT IF WE'RE GOING TO BE ABLE
TO ENSURE THAT OUR CRISIS
RESPONSE SYSTEM IS ADEQUATE TO
MEET THE NEEDS OF ALL
CALIFORNIANS WE HAVE TO DO. THE
UPSTREAM PREVENTION EARLY
INTERVENTION WORK THAT IS
NECESSARY TO BUILD OUT THAT PART
OF THE SYSTEM. WHEN EDUCATED TO
WAS FIRST DEVELOPED IT WAS
DESIGNED AS A WAY TO PROVIDE
SUPPLEMENTAL FUNDING. FOR
STAFFING. FOR INFRASTRUCTURE
FUNDING TO- FROM CHAFF- THAT
THAT COMPANY HELPS THAT IS
FINANCING AUTHORITY. WE'VE
LEARNED A LOT OVER THE PAST FEW
YEARS THAT THERE ARE OTHER WAYS
THAT WE NEED TO BE SUPPORTING
OUR COUNTY BEHAVIORAL HEALTH
PARTNERS AND OUR BROADER
COMMUNITY MENTAL HEALTH SYSTEM
TO REDUCE THE NEED FOR CRISIS
RESPONSE AGAIN I DON'T WANT TO
MINIMIZE THE IMPORTANT WORK
AROUND STRENGTHENING CRISIS
RESPONSE WE WANT TO RECOGNIZE
THAT THAT HAS TO B DONE IN
CONCERT WITH STRATEGIES TO
REDUCE THE NEED FOR THAT KIND OF
CARE. CURRENTLY THE WAY S. P.
EIGHTY TWO IS STRUCTURED IT
DOESN'T ALLOW THE COMMISSION TO
MAKE INVESTMENTS IN UPSTREAM
KINDS OF STRATEGIES ITS FOCUS
REALLY IS ON CRISIS RESPONSE.
AND PART OF THAT IS RECOGNIZING
THAT WE HAVE MANY PARTNERS IN
OUR COMMUNITY WHO ARE PART OF AN
INTERVENTION. PREVENTION AND
EARLY INTERVENTION STRATEGY AS
EVIDENCED BY MANY OF THE
PARTNERS WHO ARE PART OF THE
NINE EIGHT EIGHT SYSTEM. SO TO
THE COMMISSION HAS BEEN
DISCUSSING WAYS THAT SB TWO
COULD BE MODIFIED. TO SUPPORT
THOSE UPSTREAM KINDS OF
STRATEGIES TO EMBRACE THE
BROADER SET OF PARTNERS IN
ADDITION TO COUNTY BEHAVIORAL
HEALTH DEPARTMENTS WHO ARE PART
OF THAT STAT STRATEGY. AND
RECOGNIZE THAT INVESTMENTS TO
STRENGTHEN THAT SYSTEM NEED TO
GO BEYOND PERSON NOW SOMETIMES
IT'S RESEARCH SOMETIMES IT'S
TRAINING SOMETIMES IT'S BETTER
UNDERSTANDING THE REASONS THAT
PEOPLE ARE COMING INTO THAT
SYSTEM AND HOW WE CAN PUT IN
PLACE EVIDENCE BASED. OR
COMMUNITY TO FIND PRACTICES THAT
WILL REDUCE RELIANCE ON THIS
CRISIS SERVICES. AND AS PART OF
THAT THERE THERE ARE TWO
ADDITIONAL COMPONENTS OF SPD TO
THAT ARE CONCERNING ONE IS THAT
IF THE COMMISSION WERE ABLE TO
ON BEHALF OF THE STATE INVEST
WITH. SOME NONTRADITIONAL
PARTNERS THAT WE CANNOT REQUIRE
MATCHING FUNDS AND WE THINK THAT
THAT FORGOES OPPORTUNITIES TO
LEVERAGE THE IMPACT THE STATE
DOLLARS. AND LASTLY FOR MANY OF
THESE PARTNERS A COMPETITIVE
PROCUREMENT SYSTEM JUST DOESN'T
WORK PARTICULARLY FOR SMALL AND
VERY SMALL COUNTY PARTNERS BUT
ALSO FOR MANY OF THE COMMUNITY
BASED ORGANIZATIONS THAT CAN BE
KEY. IN SUPPORTING CALIFORNIANS
SO THAT THEY DON'T NEED TO RELY
ON A CRISIS RESPONSE SYSTEM. SO
YOU KNOW CONSISTENT WITH THE
STATE'S INVESTMENT NINE EIGHT
EIGHT THE COMMISSION SEES SB
EIGHTY TWO IS AN OPPORTUNITY TO
REALLY RETHINK HOW WE INVET IN
CREATIVE STRATEGIES INNOVATIVE
APPROACHES TO DO THE UPSTREAM
WORK. SO THAT WE CAN TAKE
PRESSURE OFF OF THE CRISIS
RESPONSE SYSTEM WHILE
SIMULTANEOUSLY MAKING SURE THAT
THE INVESTMENTS WE'RE MAKING ARE
ADEQUATE TO THE ALL CALIFORNIANS
HAVE ACCESS TO THE SERVICES THAT
THEY NEED. TO GET THE CHANCE TO
TALK TODAY HAPPY TO ANSWER ANY
QUESTIONS YOU MIGHT HAVE. THANK
YOU NEXT WE WILL HEAR FROM KIM
PETERSON WHO IS THE SENIOR
ATTORNEY WITH DISABILITY RIGHTS
CALIFORNIA. GOOD AFTERNOON. MY
NAME IS KIM PETERSON AND I AM A
SENIOR ATTORNEY FOCUSING ON
MENTAL HEALTH AT DISABILITY
RIGHTS CALIFORNIA. THANK YOU FOR
INVITING ME TO BE PART OF THIS
HEARING TODAY. I'M TESTIFYING ON
SEVERAL PANELS THIS AFTERNOON.
THE THROUGH LINE OF ALL OF MY
TESTIMONY IS THAT THE STATE MUST
INVEST IN INFRASTRUCTURE
WORKFORCE AND PROGRAM OPERATION
FUNDS THAT WILL SUPPORT
VOLUNTARY. COMMUNITY BASED
UPSTREAM INTERVENTIONS FOR
PEOPLE WITH MENTAL HEALTH
DISABILITIES AND SUBSTANCE USE
DISORDERS. THESE UPSTREAM
INTERVENTIONS CREATE
OPPORTUNITIES TO DIVERT PEOPLE
IN BEHAVIORAL HEALTH CRISIS FROM
HOSPITAL AND JAIL STATUS THAT
ARE COSTLY FOR THE SYSTEM. AND
OFTEN TRAUMATIC FOR THE PEOPLE
IN CRISIS. MOBILE CRISIS TEAMS
ARE ONE OF THESE CRUCIAL
UPSTREAM INTERVENTIONS AND YOUR
SEAT WELCOME DH CS HIS DECISION
TO IMPLEMENT THE SERVICE AS A
MANDATORY MEDICAL BENEFITS. AT
THIS TIME WE HAVE THE FOLLOWING
QUESTIONS AND SUGGESTIONS FOR
THE LEGISLATURE AND DH CS TO
CONSIDER. FIRST WE QUERY HOW THE
MEDICAL MOBILE CRISIS SERVICES
WILL BE INTEGRATED WITH NINE
EIGHT EIGHT NINE ONE ONE AND
OTHER ENTRY POINTS FOR
REQUESTING BEHAVIORAL HEALTH
CRISIS CARE. IT IS CRITICAL THAT
THE XDS PROVIDE COUNTIES WITH
GUIDANCE FOR HOW TO ENSURE
RESPONSES BY MOBILE CRISIS TEAMS
NOT LAW ENFORCEMENT IN ALL
APPROPRIATE SITUATIONS. AND SOME
COUNTIES WERE DRC IS CURRENTLY
WORKING THE DEFAULT RESPONSE FOR
ALL BEHAVIORAL HEALTH CRISIS
CALLS INSTANCES DISPATCH LAW
ENFORCEMENT. IN ADDITION SOME
COUNTIES HAVE ONLY PSYCHIATRIC
EMERGENCY TEAMS WHOSE SOLE
RESPONSIBILITY IS TO CONDUCT
FIFTY ONE FIFTY S. LAST MONTH IN
THE FIELD. NOT PROVIDE A
MEANINGFUL COMMUNITY BASED
CRISIS INTERVENTION SERVICE.
IMPLEMENTING THE MEDIC HOW
MOBILE CRISIS BENEFIT WILL
ENTAIL A MAJOR SHIFT APPROACH
FOR MANY COUNTIES THROUGHOUT THE
STATE. DEAR C. WELCOMES THE
SHIFT OF APPROACH AS OFFERING
TRUE MOBILE CRISIS INTERVENTION
SERVICES IS A BIG STEP TOWARDS
DECRIMINALISING BEHAVIORAL
HEALTH AND CURTAILING
UNNECESSARY INCARCERATION AND
INSTITUTIONALIZATION. SECOND
THROUGHOUT ALL OF THE BUDGET
HEARINGS THAT I PARTICIPATED IN
OR OBSERVED OVER THE LAST MONTH
I HAVE HEARD THE REFRAIN
WORKFORCE WORKFORCE WORKFORCE.
ROLLING OUT THE MOBILE CRISIS
BENEFIT WILL REQUIRE A MAJOR
WORKFORCE EXPANSION. IN BUILDING
OUT THIS WORKFORCE D. R. C. R.
TO THE INCLUSION OF BEHAVIORAL
HEALTH PEERS WITH LIVED
EXPERIENCE AS WELL AS PEOPLE WHO
MATCH THE CULTURAL AND
LINGUISTIC NEEDS OF THE
COMMUNITIES THEY SERVE. LASTLY
DRC REQUEST THAT DHS INVOLVED
ADVOCATES AND PEOPLE WITH LIVED
EXPERIENCE OF MENTAL HEALTH AND
SUBSTANCE USE DISORDERS IN THE
PROCESS OF DEVELOPING THE
POLICIES THAT WILL GOVERN
IMPLEMENTATION OF THE MOBILE
CRISIS BENEFIT. THE STATE'S
IMPLEMENTATION OF THIS CRITICAL
NEW PROGRAMS MUST BE GUIDED BY
THE PEOPLE WHO HAVE EXPERIENCE
BEHAVIORAL HEALTH CRISIS AND
THEIR SUPPORTERS. THANK YOU FOR
THE OPPORTUNITY TO BE HERE TODAY
I AM HAPPY TO ANSWER QUESTIONS
AFTER THE PANEL. THANK YOU NEXT
WE WILL HEAR FROM PETER MURPHY
WHO IS THE OUTREACH MANAGER. AND
CHIEF EXECUTIVE OFFICER FOR THE
MENTAL HEALTH ASSOCIATION OF SAN
FRANCISCO I BELIEVE THEY ARE ON
BEHALF OF MARK SALAZAR PLEASE
BEGIN WHEN YOU ARE READY. THANKS
VERY MUCH GOOD AFTERNOON
HONORABLE MEMBERS- YEAH MY NAME
IS PETER MURPHY AND- I'M THE OUT
REACH MANAGER FOR THE MENTAL
HEALTH ASSOCIATION OF SAN
FRANCISCO. IT'S A GREAT IT'S A
GREAT HONOR TO BE ABLE TO
PRESENT THIS TESTIMONY. TODAY
AND- I'M I'M PRESENTING THIS ON
BEHALF OF MARK SALAZAR WHO'S THE
CHIEF EXECUTIVE OFFICER AND
PRESIDENT OF OUR AGENCY THE
MENTAL HEALTH ASSOCIATION OF SAN
FRANCISCO- AND WE'RE WE'RE HERE
TO TALK ABOUT THE- THE
CALIFORNIA FAIR RUN WARM LIGHT
AND ALSO- THE CAL HOPE. MINE
WHICH WE HAVE BEEN-
ADMINISTERING. SINCE ITS
INCEPTION V. THE CAL HOPELINE
THE- REACHING OUT TODAY BECAUSE-
THE SERVICE THAT WE'VE BEEN
PROVIDING WASN'T INCLUDED IN THE
GOVERNOR'S BUDGET THAT WAS
ANNOUNCED- EARLIER THIS YEAR.
AND THE WARM WIND WE WANTED AS I
WANT TO DESCRIBE THE WARM WINDS
HERE TO- BUT ALSO WANT TO
MENTION THAT- IDENTIFIES HERE.
MYSELF IN IN RECOVERY I HAVE I
HAVE ISSUES WITH SUBSTANCES AND
ALSO- MENTAL HEALTH CHALLENGES
AND- I HAVE. I. CAN PERSONALLY
TESTIFY TO THE AFRICAN THE BE OF
VALUE OF THIS KIND OF- SERVICE
AND I WAS REALLY GRATEFUL TO.
HAVE ARENA I'M HERE EARLIER WHO
IS FROM- UC DAVIS I THINK HAVING
THE VOICES APPEARS AT A HEARING
LIKE THIS IS REALLY WONDERFUL WE
APPRECIATE THAT. SO THE WARM ONE
ISN'T ACCESSIBLE NONEMERGENCY
RESOURCE FOR ANYONE IN
CALIFORNIA SEEKING EMOTIONAL
SUPPORT. SINCE NINETEEN SINCE
TWENTY NINETEEN OUR PEER
COUNSELORS HAVE BEEN OFFERING A
HUMAN CONNECTION EMPATHY AND
HOPE THE CALLERS THROUGHOUT THE
STATE. THROUGH THE PHONE AND
THROUGH PHONE WEB CHAT OR PEER
SUPPORT WARM LINE. HAS UNITS
POWERED PREVENT CRISIS AND BUILD
RESILIENCE. WE'RE SUBMITTING
THIS TESTIMONY TODAY TO REQUEST
REQUEST ME FUNDING AND EXPANDING
THE SERVICES OF THE WARM ONE.
THE FUNDING OF THE OF THE-
CALIFORNIA. WORK BROAD WARM KIND
IS SET TO END AT THE END OF THIS
FISCAL YEAR ON JUNE THIRTIETH.
THAT WOULD MEAN- TRAGICALLY I IT
WOULD TO BE A- OF THIS FREE AND
ACCESSIBLE TWENTY FOUR SEVEN
MENTAL HEALTH SERVICE. A SERVICE
THAT HAS BEEN ACCESSED AND
UTILIZED BY NEARLY FORTY EIGHT
THOUSAND CALIFORNIANS. AND WE
BELIEVE THAT THE THAT THE- THE
CALIFORNIA PERRIN WARMLY AND ARE
COATED NINETEEN FOCUS CAL HOPE
WARM WINE ARE ESSENTIAL ELEMENTS
OF CALIFORNIA'S SYSTEM OF CRISIS
CARE CONTINUUM. ALONG WITH THE
INCOMING NINE EIGHT EIGHT ONE. I
FEEL LIKE WHAT WE'VE HEARD
TODAY- THAT MANY TIMES THAT THE
ENTRYWAY INTO SERVICES THROUGH
ITS THROUGH A PHONE CALL. IT'S
THROUGH A WEB CHAT- WHICH WHICH
WE'RE WE'RE NOW. HOPING TO
PROVIDE THREE NINE EIGHT EIGHT
AND WE SEE THE SERVICE THAT OUR
WARM WIND PROVIDES AS BEING ALSO
IN A GREAT ENTRY WAY FOR FOLKS-
COMING IN THE NOT ALL THAT OUR
HOUSE IS IN A LOOKING FOR CARE.
OUR GOAL IS TO ADDRESS THE ACUTE
MENTAL HEALTH SUBSTANCE USE AND
SUICIDE PREVENTION NEEDS OF THE
COMMUNITY. AND PROVIDE HIGH
QUALITY SERVICE TO PREVENT A
CRISIS FROM ESCALATING TO THE
POINT RATED. NINE EIGHT EIGHT OR
NINE ONE ONE OR NEEDED. ALL
BUREAU MORE MY HAS A 41%
INCREASE IN THE VOLUME OF CALLS.
AND CHATS OVER THE LAST TWO
YEARS. IN TWENTY TWENTY WITH THE
CODE NINETEEN EMERGENCY
DECLARATION. IN MARCH OF TWENTY
TWENTY THE WARMIND RESPONDED TO
NEARLY SEVENTY FIVE THOUSAND
CONTACTS. AND THE CALENDAR YEAR
OF TWENTY TWENTY ONE THE WARM
WIND RECEIVED OVER A HUNDRED
THOUSAND CONTACTS. WE'RE VERY
PROUD TO MEET THE NEEDS OF. THE
STATE IN UNPRECEDENTED NUMBERS
OF CALIFORNIANS EXPERIENCING
MENTAL HEALTH IMPACTS. OF KOBE
NINETEEN. POLITICAL DISCORD
WORLDWIDE WILDFIRES IN ECONOMIC
STRESS AND- PERSONALLY I FEEL
LIKE IT WAS VERY FORTUNATE THAT
THE WARM LINE WAS- IN PLACE.
WHEN THE PANDEMIC- STARTED AND
THAT WE'RE ABLE TO EXPAND
SERVICES- TO MEET THE NEEDS OF
CALIFORNIANS STATEWIDE. BUT
SAYING THAT WE ALSO- WE'RE NOT
ALWAYS ABLE TO GET TO EVERY CALL
THAT WE RECEIVED WHICH IS ONE OF
THE REASONS THAT WE'RE- WE'RE-
WE'RE ASKING FOR- AT NOT ONLY A
REFINING BUT HOPEFULLY AND AN
EXPANSION OF THE FUNDING SO THAT
WE CAN INCREASE OUR SERVICES- WE
EXPECT. WE BELIEVE THAT NOT THAT
THERE'S GOING TO BE AN INCREASE
IN THE NEED OF MENTAL HEALTH
SERVICES AS- AS WE FEEL THE
RESULTS OF- OF THE PANDEMIC. AND
OTHER CRISES THAT THAT OUR STATE
HAS EXPERIENCED OVER THE LAST
SEVERAL YEARS. NOW MORE THAN
EVER THE STATE AND ITS UNIQUE
COMMUNITIES NEED EQUITABLE AND
FAR REACHING STRATEGIES TO
REDUCE MENTAL HEALTH RISKS.
OUTCOMES IN ACCESS TO QUALITY
TREATMENT AND CARE. TAKING NO
ACTION TO ADDRESS THE
FORTHCOMING MENTAL HEALTH NEEDS
OF CALIFORNIANS SHOULD NOT BE AN
OPTION. I'M VERY ENCOURAGED BY
OUR DISCUSSION HERE TODAY AND I
REALLY FEEL LIKE THE- THE WARM
LINE SERVICE THAT WE'RE
DESCRIBING- THAT FITS RIGHT IN I
MEAN I MEAN IT'S- WHAT WE'RE ALL
ABOUT PREVENTION. AND WE BELIEVE
THAT WE SAY. WE CAN SAVE THE
STATE. MILLIONS OF DOLLARS IN
TERMS OF- HELPING FOLKS GET THE
TREATMENT THEY NEED BEFORE THEY
NEED TO. GO TO ANY R. OR END UP
IN A IN A CORRECTIONAL FACILITY-
I MYSELF IT'S LIKE I DIDN'T GET
HERE UNTIL YEAH I WAS IN CRISIS
AND- I. THERE WAS A LOT I FACED
A LOT OF STIGMA AND MY OWN
PERSONAL LIFE AROUND MENTAL
HEALTH AND- IT MEANT THAT IT
WASN'T UNTIL I WAS HAVING AN
EMERGENCY. THAT THAT I WAS ABLE
TO GET THE CARE THAT THEY NEED
IT- IN OUR MOST RECENT FUNDING.
WAS TEN POINT SIX MILLION
DOLLARS WHICH COVERED. OUR
EXPENSES THROUGH THROUGH THE END
OF THIS FISCAL YEAR AVERAGING
THREE POINT SIX MILLION PER
YEAR. AND IN- IN FISCAL YEAR.
TWENTY NINETEEN TO TWENTYTWENTY
WE USED ABOUT 12% OF THAT AROUND
ONE POINT TWO FIVE MILLION FOR
START UP COSTS IN
INFRASTRUCTURE. IN THE FOLLOWING
FISCAL YEAR TWENTY TWENTY TO
TWENTY TWENTY ONE WE IS ONE
POINT NINE MILLION OR EIGHTEEN
PERCENT. TO BUILD CAPACITY AND
MEET THE INITIAL NEEDS OF COVER
NINETEEN. M. THIS CURRENT YEAR
WERE USING SIX BILLION DOLLARS
OR 70% OF THAT. FUNDING TO MEET
THE ACCELERATED DEMANDS BY THE
ONGOING KOBE NINETEEN CAMPUS
PANDEMIC. SO TO CATCH MY BREATH
HERE FOR SEX. TO MEET THE
GROWING NEED FOR CRISIS
PREVENTION SUPPORT AND TO TAKE
ON CALLS DURING FREQUENT STATE
DECLARED EMERGENCIES. NHS STAFF
IS ITS FIRST REQUESTING AN
INCREASE IN OUR FUNDING TO AN
AVERAGE OF NINE MILLION DOLLARS
A YEAR FROM JULY TWENTY TWENTY
JUNE TWENTY TWENTY SEVEN
INCLUDING THE COST OF MORE PEER
COUNSELORS OPERATIONS AND
MARKETING AS WELL AS THE
EXPECTED INCREASE. IN THE COST
OF DOING BUSINESS IN INFLATION
SOME OF THIS IS DIRECTLY RELATED
TO WHAT WAS ALSO- DISCUSSED
EARLIER THAT- THAT. CAL HOPE
FUNDS- CAL HOPE SERVICES ARE.
SCHEDULED TO- TO ADD- LATER THIS
YEAR AND SO WE'RE ANTICIPATING
THAT A LOT OF THE CALLERS- THAT
WERE CALLING CAL HOPE ARE GOING
TO BE- YOUR OR WHO ARE HOPEFULLY
WILL BE ABLE TO CALL. THE
CALIFORNIA BUREAU MORE MONEY
INVESTING CREASING ARE ON NEED
FOR SERVICES EVEN FURTHER I
REALLY REALIZE THAT- THERE WAS
ALSO DISCUSSED TODAY THAT SOME
OF THOSE CALVET SERVICES MAY BE
EXTENDED SO IT'S KIND OF A
DYNAMIC SITUATION. WE'RE ALSO
HOPEFUL AND WE RECOMMEND THAT
THE STATE'S THE DEVELOPMENT AND
ESTABLISHMENT OF THE CALIFORNIA
WARM WHEN COALITION. WHICH WOULD
CREATE THE FIRST COALITION OF
WARM WINDS AROUND THE STATE
COMPLETE WITH TRAINING.
TECHNICAL ASSISTANCE AND SUPPORT
. FOR THOSE WIND WOULD SERVE
SMALLER CAN. PEOPLE OF COLOR
RURAL AREAS NAY OTHER POPULATION
SPECIFIC NEEDS WITH UNIQUE PEER
SUPPORT. THE FUNDS NEEDED TO
ACHIEVE TO ACHIEVE AN ADDITIONAL
GOAL OF ESTABLISHING THIS
COALITION AND EXPANDING QUALITY
WARM WIND SERVICES THROUGHOUT
THE STATE YOUR STANDARDIZED
TRAINING AND TECHNICAL
ASSISTANCE FOR ANY COMMUNITY
WARM LINE CALIFORNIA WILL BE
APPROXIMATELY ELEVEN MILLION
DOLLARS OVER OVER THE PERIOD OF
JULY TWENTY TWENTY TWO. JUNE
TWENTY TWENTY SEVEN- WE'RE ALSO
VERY COMMITTED TO- UP HERE YOUR
RECOVERY WORKFORCE AND USING
PEERS WITHIN THE MENTAL HEALTH
SYSTEM AND BELIEVE THAT THAT
THAT- BEING PART OF THE
WORKFORCE MEANS BEING
COMPENSATED PROPERLY FOR IT FOR
THE SERVICES THAT WE PROVIDE.
WHICH IS A REALLY A KEY
COMPONENT OF THE PROGRAM THAT WE
DEVELOPED- THE STATE OF
CALIFORNIA HAS BEEN HELPING TO
DEVELOP OUR WARM ONE PROGRAM FOR
YEARS AND SUPPORTING THE
DEVELOPMENT AND ANY OTHER COUNTY
AND LOCAL PROGRAMS ACROSS THE
STATE. AS PRESIDENT BIDEN
OFFICIALLY INCLUDED BOTH NINE
EIGHTY EIGHT AND NATIONAL PURE
CERTIFICATION IN HIS STATE OF
THE UNION LAST WEEK I MENTAL
HEALTH STRATEGY FUNDING TO FORM
A CALIFORNIA COALITION OF WARM
WINDS. COULD HELP WAS TO ENSURE
THAT ALL CALIFORNIA'S YOUR ROOM
WARM WINDS ARE BROUGHT TO THE
COALITION FIRMLY SEATED. AT THE
TABLE OF NATIONAL LEADERSHIP. WE
TO BE A SAN CAN TO PRAY TO
PRIORITIZE THESE. AND LOW BARE
MENTAL HEALTH SUPPORT BY FUNDING
AND EXPANDING SERVICES OF THE
CALIFORNIA BUREAU WARMIND FROM
TWENTY TWENTY TO. TWENTY TWENTY
SEVEN. AND MAKING THIS
INVESTMENT IN THE LONG TERM
MENTAL HEALTH OF CALIFORNIANS.
THE INCREASE IN FUNDS- LINKAGES
TO EXISTING RESOURCES AND
SERVICES. TO CREATE THE LARGEST
PEER SUPPORTED MENTAL HEALTH
SAFETY NET IN THE UNITED STATES
. WE CANNOT DESERT THIRTY NINE
POINT FIVE MILLION CALIFORNIANS
AND DEPRIVE THEM OF THE MENTAL
HEALTH SERVICE HAS BECOME
ESSENTIAL ESPECIALLY DURING THE
PANDEMIC AND WHATEVER NEW
CHALLENGES LAND STORE FOR TWENTY
TWENTY TWO NO ONE SHOULD BE
FACING THE- MOTIONAL AND MENTAL
HEALTH CHALLENGES ALONE AND
AGAIN I REALLY WANT TO EMPHASIZE
MY- MY OWN EXPERIENCE I FEEL
LIKE WITH THE WARM WIND- CREATES
IS A COMMUNITY. OF SUPPORT- AND
I FEEL LIKE THAT INCLUDES OUR
COUNSELORS AS WELL AS AS WELL AS
ALL THE CALLERS AT THE COMMITTEE
USER SERVICES- I MEAN I'VE I'VE
BEEN ON THE PHONES MYSELF I
STARTED ON THE WARM WIND AND IN
TWENTY FIFTEEN- I'VE TAKEN OVER
FIVE THOUSAND CALLS MYSELF I
IDENTIFIES SOME WHEN I HAVE- I
HAVE SUBSTANCE USE ISSUES
IDENTIFIES NOT QUALITY IN AN
ATTIC. ALSO SOME WITH THAT
MENTAL HEALTH CHALLENGES AND-
I'VE LEARNED I FEEL LIKE I'VE
LEARNED THE HARD WAY THAT I NEED
TO ADDRESS ALL THOSE THINGS
TOGETHER AND- I'M I'M I'M VERY
PASSIONATE ABOUT THIS AND FEEL
LIKE THAT FEEL THAT THAT THIS IS
A WONDERFUL SERVICE THERE WERE
REALLY ENCOURAGING THE STATE TO
CONTINUE TO SUPPORT AND- ON
BEHALF OF MARK SALAZAR OUR CEO
AND PRESIDENT AND- ALL EVERYONE
OUR AGENCY THE MENTAL HEALTH
ASSOCIATION. SAN FRANCISCO I
WANNA. WHEN I THINK FOR THE
SUBURBS. AND ALL OF BACK THE BUT
YOUR PERSON THANK YOU VERY MUCH
. THANK YOU PETER NEXT WE WILL
HEAR FROM OUR FINAL PRESENTER ON
ISSUE ONE. CORY HAAS CHEETAH
WITH THE LEGISLATIVE ANALYST'S
OFFICE PLEASE BEGIN. THANK YOU
DR ARAMBULA COREY SHEET WITH THE
LEGISLATIVE ANALYST'S OFFICE AND
WE JUST HAVE A FEW COMMENTS TO
RAISE ON THE PROPOSED NEW MEDIC
CAL QUALIFYING COMMUNITY BASED.
MOBILE CRISIS INTERVENTION
BENEFIT- WE ALSO REENTLY
RELEASED A BRIEF ON THE
GOVERNOR'S MAJOR BEHAVIORAL
HEALTH PROPOSALS WHICH PROVIDE
SOME FURTHER DETAIL ON ON THAT
AS WELL. FIRST WE WHICH IS FINE
THAT- ADDING THIS NEW BENEFIT TO
THE MEDICARE PROGRAM DOES HAVE
MERIT AS INAPPROPRIATELY TARGETS
A GAP IN THE BEHAVIOR HEALTH
CRISIS CONTINUE ONE OF WE
UNDERSTAND THAT THERE ARE MANY
COUNTIES THAT EITHER DO NOT
OPERATE ANY MOBILE CRISIS TEAMS
ARE OPERATE JUST A FEW- TEACH
THE US'S BEHAVIORAL HEALTH
ASSESSMENT REPORT ALSO
IDENTIFIES MOBILE CRISIS
SERVICES. AS A KEY AREA TO
ADDRESSING THE BEHAVIOR HEALTH
CRISIS CONTINUE ON- HOWEVER WE
WOULD RECOMMEND THAT THE
LEGISLATURE GATHER ADDITIONAL
INFORMATION BEFORE TAKING ACTION
ON THIS ON THIS PROPOSAL- WE
WOULD KNOW THAT THERE ARE SOME
KEY DETAILS RELATED TO THE
PROPOSED NEW BENEFITS. WHICH ARE
NOT FINALIZED TO FULLY ASSESS
ITS MERITS- THESE DETAILS WOULD
INCLUDE FOR EXAMPLE HOW THE
STATEWIDE STANDARDS FOR THESE.
MOBILE CRISIS INTERVENTION
SERVICES WILL BE DETERMINED- OR
HOW THE PAYMENT RATES FOR THE
SERVICES- WILL BE DEVELOPED OR
HOW THEY WILL ARE AND WHAT THEY
WILL ULTIMATELY END UP BEING-
YOU KNOW ON THE PAYMENT RATES AS
DISCUSSED BY THE ADMINISTRATION
WE UNDERSTAND THAT THESE. THESE
RATES WILL INCLUDE CERTAIN NON
SERVICE COSTS LIKE IDLE TIME.
WHILE MOBILE CRISIS TEAMS ARE ON
CALL. AND THE SORT OF ADDITIONAL
CONSIDERATIONS MAKE THIS A KEY
DETAILS TO HAVE AVAILABLE FOR
THE LEGISLATURE WHEN IT WHEN IT
REVIEWS THIS PROPOSAL- NEXT WE
WOULD NOTE THAT THE DEGREE OF
NEED FOR ADDITIONAL MOBILE
CRISIS RESOURCES LIKELY VARIES
BY COUNTY- ALTHOUGH THEIR
ESTIMATES ARE VERY ROUGH IN THE
DEPARTMENT ACKNOWLEDGES THAT
THESE ESTIMATES MAY NOT SHOW THE
WHOLE PICTURE OF NEED FOR MOBILE
CRISIS RESOURCES- TEACH THE US'S
BEHAVIOR HEALTH ASSESSMENT
REPORT DOES INDICATE THAT THE
LEVEL FULL OP NEED FOR MOBILE
CRISIS. TEAMS RANGES WIDELY
BETWEEN COUNTIES. THESE
DIFFERENCES BY COUNTY MAY RELATE
TO DIFFERENCES IN THE LOCAL
INFRASTRUCTURE TO PROVIDE THESE
SERVICES- FOR EXAMPLE SOME
COUNTIES MAY NOT HAVE ADEQUATE
WORKFORCE TO STAFF THESE TEAMS-
AND THESE DIFFERENCES AND LOCAL
CAPACITY. OF RAISE QUESTIONS
ABOUT HOW VIABLE IT IS FOR
COUNTIES TO MEET THE STATEWIDE
MANDATED REQUIREMENTS UNDER THIS
NEW BENEFIT- FOR EXAMPLE RURAL
COUNTIES MAY HAVE A TOUGHER TIME
MAKING SURE THAT MOBILE CRISIS
TEAMS ARE AVAILABLE TO MEDI CAL
BENEFICIARIES. ON A TWENTY FOUR
SEVEN BASIS WHICH IS ONE OF THE
REQUIREMENTS FOR THIS FOR THIS
NEW BENEFIT. ON THE LEGISLATURE
MAY WISH TO CONSIDER. HOW WE CAN
ENSURE THAT COUNTIES HAVE
SUFFICIENT LOCAL CAPACITY TO
MEET THE REQUIREMENTS OF THIS
NEW. THIS NEW PROPOSED BENEFIT-
FINALLY WE JUST KNOW THAT
FEDERAL GUIDANCE SURROUNDING.
THIS NEW BENEFIT INCLUDES SOME
SUGGESTIONS FOR MOBILE CRISIS
BEST PRICE- TO INCLUDE IN THE
DESIGN OF STATES MOBILE CRISIS-
PROGRAMS- THESE WOULD INCLUDE
FOR EXAMPLE HOW TO REDUCE LAW
ENFORCEMENT INVOLVEMENT SUCH
THAT. INDIVIDUALS EXPERIENCING
CRISIS OUR FIRST MET WITH PEOPLE
HEALTH PROFESSIONALS RATHER
THAN- LAW ENFORCEMENT
PROFESSIONALS. AND ARE
PARTNERING WITH SCHOOL SYSTEMS
TO ENSURE ACCESS TO APPROPRIATE
MOBILE CRISIS SERVICES FOR
CHILDREN AND YOUTH WHICH WE
UNDERSTAND WE HAVE DIFFERENT
NEEDS THAN ADULTS WHEN IT COMES
TO MOBILE CRISIS CARE- ALTHOUGH
THE ADMINISTRATION HAS STATED
THAT IT'S LOOKING INTO THESE-
FOR INCLUSION- THE- GOVERNOR'S
PROPOSAL DOES NOT. INCLUDE A
FINALIZED STRATEGY FOR HOW TO
INCORPORATE THESE BEST PRACTICES
INTO THE DESIGN OF THIS NEW
BENEFIT- IN ADDITION AS
MENTIONED EARLIER THE
ADMINISTRATION IS WORKING AT THE
AGENCY LEVEL TO. DEVELOP A
STATEWIDE STRATEGY FOR THE
ENTIRE BEHAVIOR HEALTH CRISIS
CONTINUING- INCLUDING MOBILE
CRISIS CRISIS- RECEIVING
FACILITIES AND THE NEW NINE
EIGHT CRISIS HOTLINE. THIS
REPRESENTS A POSITIVE STEP
TOWARD TAKING A COMPREHENSIVE
LOOK AT IMPROVING THIS CONTINUUM
OF CARE BUT THE LEGISLATURE MAY.
WANT TO SORT OF MONITOR THE
STATUS OF THE DEVELOPMENT OF
THAT STRATEGY FROM FROM THE
ADMINISTRATION AT THE AGENCY
LEVEL- THOSE ARE ALL OF OUR
COMMENTS AT THIS TIME THANK
THANK YOU VERY MUCH FOR THE-
OPPORTUNITY. THAT IS THE
CONCLUSION OF THE PANELISTS
TESTIMONY WITH THAT I WILL BRING
IT UP TO THE DÍAS TO SEE IF ANY
MEMBERS OF QUESTIONS. I WILL
KEEP IT HERE AT THE CHAIR AND
ASK MY FIRST QUESTION OF THE
DEPARTMENT OF HEALTH CARE
SERVICES. IN THE AGENDA IT
STATES THAT THE FEDERAL AMERICAN
RESCUE PLAN ACT OF TWENTY TWENTY
ONE AUTHORIZES STATE MEDICAID
PROGRAMS TO PROVIDE THOSE
QUALITY. COMMUNITY BASED MOBILE
CRISIS INTERVENTION SERVICES FOR
A PERIOD OF UP TO FIVE YEARS.
THE WINDOW FOR THAT BEGINS ON
APRIL FIRST OF TWENTY TWENTY TWO
AND ENDS ON MARCH THIRTY FIRST.
OF TWENTY TWENTY SEVEN. YET DH
CS DOES NOT PLAN TO IMPLEMENT
THIS BENEFIT UNTIL JANUARY FIRST
OF TWENTY TWENTY THREE. DOES
THIS MEAN THAT CALIFORNIA IS
MISSING OUT ON NINE MONTHS OF
THIS SERVICE AND OF THE ENHANCED
FEDERAL MATCHING FUNDS FOR THE
SERVICE. SO I WILL START OUT AND
THEN KELLY ON AN AD IN ON THE
END ENHANCED FEDERAL MATCH KELLY
CORRECT ME IF I'M WRONG BUT IT'S
ONLY AVAILABLE FOR A CERTAIN
NUMBER OF QUARTERS- FOR THREE
YEARS THANK YOU- AND SO WE WILL
NOT BE MISSING OUT ON ANY OF
THE- ENHANCED FEDERAL FUNDING-
IN REGARDS TO THE PROPOSAL. OUT
REALLY ALSO NEEDED TO MAKE SURE
THAT YOU HAD TIME TO WORK
THROUGH SOME OF THE VERY COMPLEX
ITEMS THAT WERE RAISED ON THIS
EXACT HEARING TO ENSURE THAT WE
BUILT THE BENEFIT CORRECTLY WE
ENGAGE WITH COUNTIES TO MAKE
SURE IT'S GOING TO MEET THE
NEEDS. AS WELL AS ALL OF THE
IMPORTANT LINKAGES THAT WERE
TALKED ABOUT TODAY THIS IS NOT A
WHITE LIFT THIS IS THE HEAVY IN
VERY IMPORTANT LIST WHICH IS WHY
WE PROPOSED THE GO LIVE DATE
THAT WE DID- BUT JUST WANTED TO
ENSURE YOU WE WILL BE DRYING
DOWN IN AND I'M TAKING AN-
ADVANTAGE OF ALL OF THE
ADDITIONAL FEDERAL FUNDS FOR THE
THREE YEARS IS AVAILABLE. EVEN
THOUGH THERE'S FEDERAL AUTHORITY
FOR THE MOBILE CRISIS BENEFIT
FOR THOSE FIVE YEARS IF THAT
HELPS CLARIFY. IT DOES- WE HEARD
FROM A NUMBER OF PANELISTS TODAY
AND- ALL SPECIFICALLY POINTS TO
A DOCTOR VERONICA KELLY THAT WE
CURRENTLY DON'T HAVE THE
INFRASTRUCTURE AND CAPACITY AND
SO I'D LIKE TO ASK THE
DEPARTMENT WHAT. IS OUR PIPELINE
WHAT'S OUR STRATEGY TO ADDRESS
SOME OF THESE WORKFORCE
CONCERNS. SPECIFICALLY RELATED
TO- THE MOBILE. CRISIS
INFRASTRUCTURE GRANTS. SURE SO I
YOU KNOW ONE OF THE BIG PIECES
THAT WAS APPROVED IN THE BUDGET
LAST YEAR'S SPECIFICALLY WAS TO
ENSURE THAT WE WERE GETTING.
PLANNING GRANTS OUT TO COUNTIES
AS WELL AS INFRASTRUCTURE
INVESTMENTS AND- PREVIOUSLY- DR
PIPER WALK THROUGH SOME OF THOSE
BUT DCS HAS AWARDED. THIRTY SIX
IMPLEMENTATION GRANTS AND NINE
PLANNING GRANTS TO COUNTIES
CITIES AND TRIBAL ENTITIES IN
REALLY ON THAT WAS MEANT TO GET
DOLLARS OUT FOR BOTH PLANNING
AND INFRASTRUCTURE TO BE ABLE TO
BE READY FOR. STATEWIDE YOU KNOW
IMPLEMENTATION OF THE MOBILE
CRISIS WE KNOW THIS IS A BIG
CHANGE. I WE KNOW THIS IS A
COMPLICATED POLICY AND THAT WAS
ONE OF THE WAYS IN WHICH WE WERE
TRYING TO ATTEND. A TO BE
PREPARED THAT KELLY BY ALL MEANS
PLEASE FEEL FREE TO ADD IN
REGARDS TO OTHER WAYS THAT WE
ARE PREPARING FOR THAT STATEWIDE
. THANK YOU TAKE CARE THANK YOU
COVERED IT AND WE FELT STRONGLY
THAT WE WANTED TO TAKE ADVANTAGE
OF THAT. FIVE MILLION THAT WE
COULD PUT OUT THE DOOR. I'M TO
SUPPORT THE INFRASTRUCTURE IN
THE BUILDING THE MOBILE CRISIS
EVEN AS WE ARE PLANNING OUT THE
BENEFIT BECAUSE THERE. OF COURSE
WE FEEL THE TENSION OF WANTING
TO START. WITH THE POSSIBLE WE
ALSO NEED TO MAKE SURE THERE'S
ROBUST A QUARTER ENGAGE THEN AND
WE LEARN FROM. OUR COUNTY
COLLEAGUES STANDING AS CORNY AS
SHE THAT ONE SIDE- WE HAVE. VERY
DIVERSE COUNTIES IN OUR SYSTEM
AND WE NEED TO CREATE A BENEFIT
THAT'S WORKABLE. ACROSS THE
STATE. MY NEXT QUESTION CAN BE
FOR JOE FRANKLIN C. HAD SPOKEN.
COOPER AND COORDINATION. AND
THAT HOW- IN YOUR- GRAPH YOU HAD
THE MOBILE CRISIS RESPONSE HELP
TO DETERMINE. WHETHER OR NOT
IT'S CRISIS RECEIVING OR
HOSPITAL THAT'S RECEIVING. AND
HOPING YOU COULD PROVIDE A
LITTLE MORE CLARITY ABOUT. WHO
HELPS TO MAKE THOSE DECISIONS
WHO YOU ENVISION WOULD BE ON
THOSE TEAMS. SO WE CAN BEGIN TO
UNDERSTAND- AND- WHAT THE SHAPE
AND FEEL OF IT IS LIKE. SO FOR
THE CIVILIAN MOBILE CRISIS TEAMS
I THINK WERE YOU KNOW IDEALLY
LOOKING AT A TWO PERSON TEAM- AT
LEAST ONE BEHAVIORAL HEALTH CARE
PROFESSIONAL- CAPABLE OF
ASSESSING AN INDIVIDUAL'S NEEDS
CONSISTENT WITH- CONSISTENT WITH
THE- 85% MATCH HARPER LAW AND
WHAT IT SPELLED OUT THERE AND-
IDEALLY THE OTHER PERSON WOULD
BE A PEER. SUPPORT SPECIALIST-
AND YOU KNOW I THINK THE HOPE IS
THAT MOST OF THE TIME THOSE
TEAMS WOULD BE ABLE TO STABILIZE
SOMEONE IN COMMUNITY WITH NO
NEED TO ESCALATE TO A HIGHER
LEVEL OF CARE AT ALL A LOT OF
OTHER JURISDICTIONS WERE
FAMILIAR WITH. I'VE SEEN RATES
OF 70% OR HIGHER THAT THEY'RE
ABLE TO STABILIZE SOMEONE IN
COMMUNITY AND SAFETY PLAN WITH
THEM AND COMMUNITY SO IF THIS IS
SET UP RIGHT IDEALLY THIS KIND
OF SERVICE REDUCES YOU KNOW
HIGHER LEVEL OF CARE NEEDS FOR
CRISIS FACILITIES CRISIS CARE-
FROM THERE THOUGH. YOU KNOW I
THINK THE HOPE IS THAT MOST OF
THE TIME IF SOMEONE DOES NEED A
HIGHER LEVEL OF CARE YOU CAN GO
TO A CRISIS RECEIVING FACILITY-
LIKE AN L. A. COUNTY WE CALL
THEM TO HEAR AUTHORS AND CARE
CENTERS BUT THEY'RE REALLY.
TWENTY FOUR HOUR. CRISIS
RECEIVING FACILITIES- AND THAT
YOU KNOW THEY'LL HAVE YOU KNOW
THE- IT'S KIND OF CHECKLIST
CRITERIA OF YOU KNOW SIGNS TO
LOOK FOR A MEDICAL EMERGENCY
THAT WOULD REALLY NECESSITATE
GOING TO EMERGENCY ROOM AT THAT
POINT. I THINK THEY'RE IDEALLY
CALLING NINE ONE ONE IN GETTING
EMS INVOLVED SO I THINK THE HOPE
IS MOST OF THE TIME YOU KNOW
UNLESS THERE'S A CLEAR SIGN A
MEDICAL EMERGENCY THAT SHOULD DO
WE WANT THEM TO BE ABLE TO TAKE
SOMEONE TO A PROPER CRISIS
RECEIVING FACILITY IF THEY NEED
A HIGHER LEVEL OF CARE. MAYBE
THAT'S AN APPROPRIATE PLACE TO
THEM FOLLOW UP OFFLINE WITH. THE
DEPARTMENT. TO BE ABLE TO WORK
THROUGH WHO WAS ON THAT TEAM WHO
IS MAKING THOSE. DECISIONS SAID
IT'S ESSENTIALLY A TRIAGE OF
SORTS- DETERMINING WHETHER OR
NOT. YOU BELIEVE THEY HAVE A
PSYCHIATRIC OR MEDICAL EMERGENCY
AND- BELIEVE THERE ARE SOME
COMPLICATIONS TO THIS THAT WILL
NEED TO BE IRONED OUT AS WE'RE
WORKING ON AND WOULD LOVE TO BE
ABLE TO FOLLOW UP AS I'D LIKE TO
MAKE SURE WE'RE SENDING PEOPLE
TO THE RIGHT PLACE AT THE RIGHT
TIME. AND IF THAT MEANS WE CAN
SEND THEM TO A CRISIS
STABILIZATION UNIT OR A CRISIS
RECEIVING- UNIT TO. RATHER THAN
AN EMERGENCY DEPARTMENT WE MAY
MORE APTLY BE ABLE TO ADDRESS
THEIR BEHAVIORAL HEALTH NEEDS
AND CRISIS THAT THEY'RE IN- AND
WOULD LIKE TO FIGURE OUT HOW WE
CAN DEVELOP A SYSTEM THAT KEEPS
BOTH. COMMUNITY SAFE AND SENDS
PEOPLE TO THE RIGHT PLACE- WOULD
LIKE TO FOLLOW UP IF I COULD TO
THE DEPARTMENT- ON PAGE TWELVE
OF OUR AGENDA WITHIN THE THIRD.
PARAGRAPH AND UNDER THE THIRD
BULLET- THERE IS. I'M LOOKING AT
WHETHER OR NOT CRISIS
STABILIZATION UNITS ARE
CONSIDERED TO BE A COMPONENT OF
THE CRISIS RESPONSE CONTINUE ON
. I'M WANTING TO MAKE SURE THAT
WE CAN PROVIDE THE SHORT TERM
SERVICES THAT CAN BE EASILY
ACCESSIBLE AND- RATHER THAN
RELYING ON THE EMERGENCY
DEPARTMENTS OF HOSPITALS THAT I
JUST REFERENCED AND WONDERING IF
WE CAN USE YES USE- IN THAT
CAPACITY. KELLY ARE WOULD YOU
ADDRESS THE QUESTION PLEASE.
SURE EVERY I AM REALLY
HIGHLIGHTED IN OUR BEHAVIORAL
HEALTH ASSESSMENT AS HELPING ALL
OF YOU READ ALL TWO HUNDRED
PAGES BECAUSE THERE'S A LOT OF
RICHNESS AMERICA WE TALK ABOUT
THE FULL CONTINUUM OF CARE WHICH
IS OFTEN DESCRIBED AS A PLACE TO
CALL SOMEONE TO RESPOND AS A
PLACE TO GO CRISIS STABILIZATION
UNITS ARE ABSOLUTELY PART OF THE
CONTINUUM OF CARE. AND THIS IS
REALLY ONE OF OUR KEY GOAL WITH
THE BEHAVIOR HOW CONTINUE
INVESTMENT PROGRAM IS TO HAVE
EACH COUNTY LOOK AT WHAT THAT
FULL CONTINUUM OF CARE IS FOR
THE COUNTY IN WHERE ARE THERE
GAPS AND I'M CERTAINLY WE'VE
SEEN ACROSS THE STATE CRISIS
STABILIZATION UNITS ARE KEY
COMPONENT AS WE CONTINUE ON THAT
NOT EVERY COUNTY HAS AND THOSE
WOULD BE. ELIGIBLE TO RECEIVE-
BEING REJECTED FUNDING. I'M GLAD
YOU BROUGHT THAT UP. I'M EARLY
WE HEARD ABOUT THE AND- OF USE.
PEER COUNSELORS AND I'D LIKE TO.
TALK ABOUT THE CAL HOPE WARM
LINE- WITHIN THE AGENDA- ONE OF
THE- SUBPOPULATIONS THAT WE NEED
TO BE BOTH CULTURALLY. SENSITIVE
FOR EMOTIONAL SUPPORT IS OUR
YOUNG ADULTS. THAT I'D LIKE TO
ASK EXPLICITLY WHETHER OR NOT WE
HIGHER USE PEER COUNSELORS- TO
HELP US WITH THIS POPULATION. SO
WE HAVE JIM COOLER AVAILABLE WHO
IS ARE SIGNIFICANT CALVET
CHAMPION SO JIM I CAN BE PASSED
UP TO YOU TO ANSWER THAT
QUESTION. I'M HAPPY TO DO THAT
THE ON TRACK THROUGH CAL MAYES
OF WAR TWENTY NINE ORGANIZATIONS
TO PROVIDE YEARS WE RELY ON THEM
TO MATCH THE- PEOPLE TO THE
RIGHT AUDIENCES SO- WE DIRECTLY
DO NOT HIRE YOUNG PEOPLE
OURSELVES BUT OUR PARTNERS IN
THE FIELD MAY BE DOING THAT
DEPENDING UPON WHO THEY WERE OUT
REACH TO. WE THEN ARE CAL HOPE
STUDENTS PORT NOT SPECIFICALLY
THE WARM LINE YES WE ARE LOOKING
THROUGH SOCIAL EMOTIONAL
LEARNING EFFORTS THROUGH THE
SACRAMENTO COUNTY OFFICE OF
EDUCATION AND ARE FIFTY EIGHT
COUNTY OFFICES OF EDUCATION THAT
THERE WILL BE A STUDENT
COMPONENT USING STUDENTS AS
PEERS TO SUPPORT OTHER STUDENTS
BUT NOT NECESSARILY SPECIFICALLY
ON A WARM LINE- SO HOPEFULLY
THAT HELPS PROVIDE A LITTLE BIT
OF CONTEXT ON OUR CALVET
PEPPERED. I DO APPRECIATE THAT
AND- WHAT ELEVATES THE COMMENTS
THAT WE HAD IN LAST WEEK SUB ONE
HEARING FROM- OUR YOUTH AND PEER
SPECIALISTS AS I AS I BELIEVE
IT'S- THAT HIDDEN GEM THAT WE
NEED TO LOOK TO GOING FORWARD-
SEEING AS THERE ARE NO OTHER
QUESTIONS I WANT TO THANK THE
ENTIRE PANEL ONE. WE WILL NOW
MOVE ON TO PANEL TO ON SERVING
THE NEEDS OF OUR HIGH NEEDS
INDIVIDUALS FOR THOSE PANELISTS
WHO ARE PRESENTERS PLEASE
PRESENT IN THE ORDER THAT YOUR
NAME APPEARS IN THE AGENDA. WE
WILL HOLD ALL MEMBERS QUESTIONS
ON THIS PANEL UNTIL AFTER ALL OF
THE PRESENTERS HAVE CONCLUDED.
WE WILL HAVE THIRTEEN PRESENTERS
ON THIS PANEL AGAIN INCLUDING
MANY ADMINISTRATION
REPRESENTATIVES THE OVERSIGHT
COMMISSION THE LA- AND SEVERAL
STAKEHOLDERS. UNFORTUNATELY
STEPHANIE REGULAR ASSISTANT
PUBLIC DEFENDER IN CONTRA COSTA
COUNTY WILL NOT BE TESTIFYING
TODAY DUE TO AN URGENT FAMILY
MATTER. LET'S BEGIN WITH J. C.
COOPER STATE MEDICAID DIRECTOR
AND CHIEF DEPUTY DIRECTOR FOR
HEALTH CARE PROGRAMS AT THE
DEPARTMENT OF HEALTH CARE
SERVICES PLEASE BEGIN. THANK YOU
SO MUCH- THE BEHAVIORAL HEALTH
ASSESSMENT HIGHLIGHTED IN A THE
ACUTE NEED FOR SUPPORTIVE
HOUSING OPTIONS THAT PROVIDE
WRAPAROUND BEHAVIORAL HEALTH
SERVICES THE ONE POINT FIVE
BILLION DOLLAR BEHAVIORAL HEALTH
BRIDGE HOUSING PROPOSAL WOULD
FUND CLINICALLY ENHANCED BRIDGE
HOUSING SETTINGS FOR PEOPLE
EXPERIENCING HOMELESSNESS. WHO
HAVE SERIOUS BEHAVIORAL HEALTH
CONDITIONS BOTH MENTAL HEALTH
AND OR SUBSTANCE USE DISORDERS
WELL THE TWENTY TWENTY ONE
BUDGET ACT PROVIDES FIVE POINT
EIGHT BILLION IN INFRASTRUCTURE
FUNDING FOR HOME KEY THE
BEHAVIORAL HEALTH CONTINUUM
INFRASTRUCTURE PROGRAM IN THE
COMMUNITY CARE EXPANSION PROGRAM
TO CREATE NEW UNITS IN. AND
TREATMENT BEDS FOR INDIVIDUALS
EXPERIENCING OR AT RISK OF
HOMELESSNESS THERE IS A NEED FOR
IMMEDIATE BRIDGE SOLUTIONS AS
THESE UNITS COME ONLINE AND NOW
I WILL TURN IT OVER TO YOU DR
PIPER TO PROVIDE MORE. DETAILS
ON OUR BRIDGE HOUSING PROPOSAL.
THANK YOU. VERY GOOD YOURSELF
PHIL FUNDING WOULD BE
ADMINISTERED BY A PRIVATE HEALTH
CARE SERVICES AND BE MADE
AVAILABLE TO COUNTIES AND TRY WE
NEED TO STAND UP AND OPERATE THE
BRIDGE HAS BEEN BETTING. FUNDING
FOR THE HER TO. INSTALL AND
OPERATE TINY HOMES AND FOR
OPERATING COSTS THE STATE'S
HOUSING AND OTHER SETTINGS WHICH
CAN INCLUDE EXISTING RESIDENTIAL
DEVELOPMENTS IN A CASE THAT.
MANY OF THESE EXISTING
FACILITIES ARE WILLING AND ABLE
TO SERVICE OPERATION BUT CANNOT
DO SO WITHOUT OPERATING FUNDING
AND ENHANCE THE PORTS. WHICH THE
FEDERAL PROVIDE. THIS INVESTMENT
IS DESIGNED TO LEVERAGE ABOUT.
PROVIDED BY COUNTY AS WELL
ALIGNED TELLING. MODERNIZE
IMPROVE AND- MY OUT THESE ARE
HEALTH SYSTEM. THE CORRECT TO
THAT NOT HEALTH. PAYMENT OF ARM.
PAIN IN THE- AMERICANS. WILL
ALSO HELP MEDICARE ENROLLEE
PICTURE BETTERIDGE CARE ACROSS
ABOUT HOW BOUT ISSUES BE TREATED
A COMMUNITY SUPPORT. BASED ON
THE TWO TWENTY POINT IN TIME
COUNT. FORTY HE EXPERIENCING
HOMELESS OKAY A NINE MENTAL THAT
IN DESIGNING A- IN. TRAINER PRO
FOR THE TO THE CONNECTIONS FAITH
AND OR- IN THE CROWD PART. THE
REASON RELEASED THX REFERENCE
THAT WE MENTIONED BEFORE
HIGHLIGHTED. THE NEED FOR
HOUSING AND HOUSING SUPPORT
SERVICES ACROSS THE BOARD
INCLUDING SUPPORTED HOUSING
OPTIONS THAT PROVIDE WRAPAROUND
THE HUMOR OUT THERE TO. OPENLY.
HOMELESSNESS AMONG THOSE. OX
FINA HEALTH NEEDS NEEDS TO
ACCOMPLISH BY OF YOU THEIR
TEMPTATION STAYS LONG TERM
RESIDENTIAL THANKS FOR AND-
CRIED FOR. IN THE COLD PANDEMIC
HAD LOTS OF WAITED CAL.
MENTIONED THAT MEN WILL DOUBLE
BE ABLE WITH THEM THE DEDICATED
BECAUSE THEY NEED. TO PROVIDE
HAS SETTING THAT SUPPORT IN THE
TO THE BONTA RECOVERY AND HOW
THE ABILITY. TO FIND WILL BE A
ON THE SENATE AND. FOR ONE
TWENTY- AND GUYS CONCLUDE MY
BROTHER OF POINT THANK YOU VERY
MUCH. THANK YOU WE HEAR FROM THE
STEP COPELAND. DIRECTOR FOR THE
DEPARTMENT OF HOSPITAL PLEASE.
THANK YOU GOOD AFTERNOON SO
CLAIMED THAT AND DIRECTOR THE
PRO OF STATE HIGH AND FOR THIS
ITEM JOIN BY CHRIS EDEN'S OUR
CHIEF DEPUTY DIRECTOR OF PROGRAM
SERVICES. AND WE'VE BEEN ASKED
TO PROVIDE AN OVERVIEW OF THE
INCOMPETENT TO STAND TRIAL
SOLUTIONS PROPOSAL AS WELL AS
SOME ATHLETES AROUND THE
PROPOSALS RELATED TO OUR
EXISTING I. S. T. PROGRAMS SO
I'M GONNA START OFF WITH THAT- I
S. T. SOLUTIONS PROPOSAL. SO THE
PROPOSED BUDGET INCLUDES NINETY
THREE MILLION IN CURRENT YEAR
AND FIVE HUNDRED AND SEVENTY ONE
MILLION GENERAL FUND IN TWENTY
TWENTY TWO AND TWENTY THREE AND
ONGOING AND ASSOCIATED TRAILER
BILL OR D. S. H. TO IMPLEMENT
SEVERAL SOLUTIONS RELATED TO
INCREASING ACCESS IS TO SERVICES
AND EXPANDING THE CONTINUUM OF
CARE FOR INDIVIDUALS FOUND
INCOMPETENT TO STAND TRIAL OR
ICE TEA ON FELONY CHARGES. FOR
MANY YEARS THE DEPARTMENT HAS
EXPERIENCED INCREASING NUMBERS
OF INDIVIDUALS BEING REFERRED BY
THE SUPERIOR COURTS TO THE
DEPARTMENT AS I. S. T. AND THESE
AE INDIVIDUALS WITH SERIOUS
MENTAL ILLNESS WHO HAVE BEEN
ARRESTED ON A FELONY CRIME. AND
DUE TO THEIR MENTAL ILLNESS ARE
UNABLE TO UNDERSTAND THE NATURE
OF THE CHARGES AGAINST THEM OR
ASSIST THEIR COUNCIL IN THEIR
DEFENSE MANY OF THESE
INDIVIDUALS HAVE UNTREATED OR
UNDER TREATED ILLNESSES. AND
HAVE BEEN CYCLING IN AND OUT OF
HOMELESSNESS AND THE CRIMINAL
JUSTICE SYSTEM. OVER THE YEARS
DEPARTMENT HAS AMPLE MANY.
TOWARDS COOPER. INCREASING OF
AND READ THEM TO ME THE NEEDS
THE INCREASE ICE T. REFER.
HOWEVER EFFORTS CAN TO IN IN
THEN APART HAS MADE A WAIT LIST
FOR ADMISSION THIS WEIGHTLESS AS
FURTHER BEEN EXACERBATED BY THE
IMPACTS OF THE KOBE NINETEEN
PANDEMIC AS THE NECESSARY
INFECTION CONTROL MEASURES THAT
WE HAVE HAD TO IMPLEMENT AT THE
STATE HOSPITALS HAS RESULTED IN
SLOWER EMISSIONS. AND REDUCE
CAPACITY FOR THE TREATMENT OF
FELL ON THE ICE TEAS AND YES H.
TODAY THERE ARE OVER NINETEEN
HUNDRED INDIVIDUALS AWAITING
ADMISSION INTO AN I. S. T.
TREATMENT PROGRAM THIS IS T.
SOLUTIONS PROPOSAL WAS. INFORMED
BY THE I. S. T. SOLUTIONS WE'RE
THAT WAS CA. THIS FALL. THE
WORKGROUP WAS. OF
REPRESENTATIVES AND STAKEHOLDERS
FROM MULTIPLE STATE AGENCIES THE
JUDICIAL COUNCIL LOCAL
GOVERNMENT JUSTICE SYSTEM
PARTNERS AND REPRESENTATIVES OF
PATIENTS AND FAMILY MEMBER
ORGANIZATIONS. THE WORKGROUP
IDENTIFIED FORTY ONE STRATEGIES
AND SOLUTIONS AND IT'S AN EXCUSE
ME EIGHTY FIVE POINT ONE
STRATEGIES AND SOLUTIONS AND ITS
REPORT THAT WAS RELEASED ON
NOVEMBER THIRTIETH OF TWENTY
TWENTY ONE. THE WORKING GROUP'S
RECOMMENDATIONS CENTERED ON THE
THEMES OF EARLY STABILIZATION.
INCREASING ACCESS AND TRAINING
OF COURT APPOINTED EVALUATORS
TRAINING AND TECHNICAL
ASSISTANCE NEEDS. INCREASING
ACCESS TO COMMUNITY BASED
TREATMENT AND DIVERSION
INCREASING HOUSING OPPORTUNITIES
FOR CONNIE I ISSUES AND MORE
BROADLY FOR JUSTICE INVOLVED
INDIVIDUALS WITH SERIOUS
BEHAVIORAL HEALTH CONDITIONS.
THAT I IT'S TWO SOLUTIONS
PROPOSAL PRESENTED TODAY
INCLUDES FUNDING FOR SEVERAL
STRATEGIES AND COMPONENTS. THE
PROPOSAL ALSO INCLUDES
IMPLEMENTING A GROWTH CAP ON ICE
TEA REFERRALS FOR ALL COUNTIES
AIMED AT ENCOURAGING THE
EXPANSION OF COMMUNITY CARE. BUT
GUARDING AGAINST ANY UNINTENDED
INCENTIVES THAT MIGHT DRIVE
INCREASED FELONY I GUESS T.
REFER REFERRALS. MANY TOUCH
BRIEFLY ON EACH OF THE
COMPONENTS AND I. S. T. PROPOSAL
THE FIRST IS STABILIZATION AND
EARLY ACCESS TO TREATMENT
FACILITATED IN PARTNERSHIP WITH
COUNTY MENTAL JAIL MENTAL HEALTH
PROVIDERS. THESE ARE SERVICES
DESIGNED TO PROVIDE EARLY ACCESS
TO TREATMENT AT THE EARLIEST
POINT POSSIBLE TO I. S. T.
INDIVIDUALS ON OUR WAIT LIST. TO
PROMOTE STABILIZATION AND
INCREASED ELIGIBILITY
EMPLACEMENT AND DIVERSION OR
OTHER COMMUNITY BASED TREATMENT
PROGRAMS. THAT FUNDS REQUESTED
WILL SUPPORT THE COST OF
PSYCHIATRIC MEDICATIONS
INCLUDING LONG ACTING
MEDICATIONS MEDICATION
ADMINISTRATION SUPPORT. INCREASE
CLINICAL IN PSYCHIATRY
ENGAGEMENT AND COMPETENCY.
EDUCATION AS APPROPRIATE. THE
NEXT COME IS THE CARE. AND WAIT
LIST MANAGEMENT AND AS WE HAVE
I'M CONTINUE TO ADD COMMUNITY
BASED PROGRAMS TO THE MENU OF R.
I. S. T. TREATMENT OPTIONS ARE
PATIENT MANAGEMENT UNITS ROLE AS
THE HUB OF. PATIENT INFORMATION
AND COORDINATION TO FACILITATE
PLACEMENT CONTINUES TO GROW MORE
COMPLEX. SO THE RESOURCES
REQUESTED WILL ALLOW THE
DEPARTMENT TO SCREEN ALL FELONY
EYES TO PATIENTS TO DETERMINE
ELIGIBILITY FOR COMMUNITY BASED
PROGRAMS. PROVIDE ENHANCED
MONITORING OF THE WAIT LIST AND
PROVIDE COMMITMENT TO ADMISSION
CASE MANAGEMENT TO COORDINATE
APPROPRIATE PLACEMENTS AND
MAXIMIZE BED USAGE FRIAS TEASE.
THE LARGEST COMPONENT OF THIS
PROPOSAL EXPANDING FELONY I S.
T. COMMUNITY PROGRAMMING WILL BE
A COMMUNITY BASED RESTORATION
DIVERSION INCLUDES A SIGNIFICANT
EXPANSION OF COMMUNITY PLACEMENT
OPPORTUNITIES FOR FELONY ICED
TEA POPULATION. THROUGH THE
EXPANSION OF COMMUNITY BASED
RESTORATION AND DIVERSION
PROGRAMS THIS INCOMPLETE
INCLUDES BOTH SHORTER. AND
LONGER TERM SOLUTIONS. I WOULD
COMPONENT WE A HOUSING I. FOR
CURRENT CONTRACTS WHERE WE
PROPOSED PROVIDED FUNDING
AUGMENTATION I'M TO OUR CURRENT
VERSION CONTRACTS WITH HOUSE BUT
COUNTIES FOR THE PURPOSES OF
HOUSING AND THIS WILL SUPPORT
INCREASING THE NUMBER OF FELONY
I S. T. INDIVIDUALS WHO ARE
CURRENTLY ON THE DS H. WAITLIST.
TO BE SERVING COUNTY DIVERSION
PROGRAMS ALSO INCLUDED IN THIS
COMPONENT IS A SIGNIFICANT
INSTRUCT INFRASTRUCTURE
INVESTMENT TO DEVELOP OVER A
THREE YEAR PERIOD. DEDICATED
HOUSING TO SUPPORT THE I. S. T.
POPULATIONS SERVED IN COMMUNITY
BASED RESTORATION OR DIVERSION
PROGRAMS. YES H. WOULD PARTNER
WITH COUNTIES AND OUR COMMUNITY-
HOUSING DEVELOPMENT
ORGANIZATIONS TO FUND THE
DEVELOPMENT OF APPROXIMATELY
FIVE THOUSAND COMMUNITY BATS TO
SERVER PROXIMALLY THREE THOUSAND
NEW I. S. T. INDIVIDUALS
ANNUALLY. ASSUMING AN AVERAGE
LENGTH OF STAY OF ABOUT EIGHTEEN
TO TWENTY MONTHS. FINALLY THE
LAST PIECE OF THIS- PROPOSAL IS
PROGRAMMING BENDING TO.
COMPLEMENT THE INVESTMENT IN
DEDICATED HOUSING IDEA STATE
PROPOSES TO PARTNER WITH
COUNTIES TO CREATE OR EXPAND
PERMANENT COMMUNITY BASED
TREATMENT PROGRAMS FOR FELONY I
S. T. INDIVIDUALS. AND WE
PROPOSED TO PROVIDE A HUNDRED
AND TWENTY FIVE THOUSAND PER
CLIENT RATE TO SUPPORT AN
EIGHTEEN MONTH AVERAGE LENGTH OF
STAY IN EITHER A COMMUNITY BASED
RESTORATION OR DIVERSION
PROGRAM. THE SERVICES ARE
ENVISIONED AS AN INTENSIVE
COMMUNITY TREATMENT MODEL OF
CARE WITH INCREASED CLINICAL
ENGAGEMENT IN PSYCHIATRY
SERVICES AS WELL AS WRAPAROUND
SERVICES AND ONGOING HOUSING
SUPPORTS. AND THEN IN ADDITION
TO THE DRUG TREATMENT AND CLIENT
SUPPORT COSTS THE TOTAL
RESOURCES REQUESTED IN THIS
PROPOSAL WOULD ALSO SUPPORT NON
TREATMENT COSTS RELATED TO
PLANNING. COORDINATING AND
MANAGING PROGRAMS TRAINING AND
TECHNICAL ASSISTANCE RESOURCES
FOR THAT SERVICE PROVIDERS.
TRACKING OUTCOMES DATA AND
CONDUCTING AN EVALUATION
PROGRAM. AND THEN WILL ALSO AND
THE LAST AND FINAL COMPONENT OF
THE PROPOSAL IS THE INCREASED
PLACEMENTS TECH. AND TRANSITIONS
AND THIS IS A PROPOSED PILOT OR
A NEW INDEPENDENT. PLACEMENT
DETERMINATION PANEL TO INCREASE
THE NUMBER OF STATE HOSPITAL
PATIENTS SERVED IN THE COMMUNITY
VIA CONRAD. THIS NEW PANEL WILL
REVISE THE COMMUNITY PROGRAM
DIRECTOR ROLE THAT IS PART OF
CONRAD AND IMPROVE THE
ASSESSMENT PROCESS FOR PATIENTS
WHO ARE EITHER NOT GUILTY BY
REASON OF INSANITY OR COMMITTED
TO THE DEPARTMENT AS OFFENDER
WITH MENTAL HEALTH DISORDER. THE
OVERALL INCREASE UTILIZATION OF
CONRAD WILL FREE BEDS IN THE
STATE HOSPITAL ALLOW THE
PLACEMENT OF INDIVIDUALS WHO ARE
TRULY IN NEED OF THE HIGHEST
LEVEL OF KERR INTO OUR BEDS. SO
AT THIS POINT I WOULD LIKE TO
TURN IT OVER TO CHIEF DEPUTY
DIRECTOR EVENS WHO WILL DISCUSS
THE BUDGET PROPOSALS RELATED. TO
OUR EXISTING ISP PROGRAM. THANK
YOU START. I'M CHAIRED ACTUALLY
ITEM INCLUDE IN THIS ISSUE
THAT'LL PROVIDE UPDATES ON-
SOLDIER TO RUN THROUGH THIS VERY
QUICKLY. AS IT RELATES TO THE
INCREASE SECURED BED CAPACITY AT
METROPOLITAN STATE HOSPITAL THE
TWENTY TWENTY ONE BUDGET ACT
PROVIDED FUNDING FOR D. S. H. TO
ACTIVATE THE REMAINING THREE
UNITS OF A FIVE UNIT EXPANSION.
TO PROVIDE ADDITIONAL BED
CAPACITY TO TREAT I. S. T.
INDIVIDUALS COMMITTED TO BE A
STAGE. DO TO COPE IN NINETEEN
AND THE NEED FOR- SKILLED
NURSING FACILITY SWING SPACE YES
AGES EXPERIENCING A TEN MONTH
DELAY IN THE ACTIVATION OF THESE
THREE REMAINING UNITS FOR THIS
PURPOSE. ALL RIGHT SO TO THAT
END CONSTRUCTION IS SCHEDULED TO
RESUME IN JULY TWENTY TWENTY
TWO. RESULTING IN A ONE TIME
SAVINGS OF TWENTY ONE POINT
EIGHT MILLION IN FISCAL YEAR
TWENTY ONE TWENTY TWO.
ASSOCIATED WITH PERSONAL
SERVICES SAVINGS THAT WOULD
STAFF AND THE ADDITIONAL THREE
UNITS UPON ACTIVATION. SPECIFIC
TO THE COMMUNITY BASED
RESTORATION PROGRAM. DSHS
REQUESTING THREE MILLION IN
FISCAL YEAR TWENTY TWO TWENTY
THREE AND THREE POINT TWO
MILLION. ARE ON GOING THIS
ADJUST MINISTER CORRECTED
CALCULATION ERROR AND FUND THE
INCREASE DAILY BAD RATES IN THE
L. A. COUNTY. COMMUNITY BASED
RESTORATION PROGRAM. OF THIS
TOTAL TWO POINT THREE MILLION
WILL FUND THE COST OF THIRTY
FOUR BEDS THAT WERE NOT
INCLUDED. IN OUR ORIGINAL COST
CALCULATION PRESENTED LAST YEAR.
ON IT DIFFERENTLY SIX HUNDRED
AND SEVENTY FIVE THOUSAND IN
TWENTY TWO TWENTY THREE NINE
HUNDRED THOUSAND ONGOING IS
NEEDED TO FUND THE UPDATED DAILY
BAD RATES FOR THE ORIGINAL. ONE
HUNDRED AND FIFTY BEDS THAT WERE
AUTHORIZED FOR THIS PROGRAM- AS
THE RATES HAVE SINCE INCREASED
SINCE THE INITIAL PREPARATION
BACK IN FISCAL YEAR EIGHTEEN
NINETEEN. I'M THE NEXT ITEM IS
AN UPDATE TO THE D. S. H. A.
VERSION PROGRAM NO ADJUSTMENTS
ARE ACTUALLY REQUESTED IN THE
GOVERNOR'S BUDGET- BY WAY OF
BACKGROUND THE TWENTY EIGHTEEN
BUDGET ACT INCLUDED A HUNDRED
MILLION TO PARTNER WITH COUNTIES
TO IMPLEMENT PRE TRIAL FELONY
MENTAL HEALTH DIVERSION
PROGRAMS. SPECIFICALLY AIMED AT
SERVING THE ACCESS TO POPULATION
AS WELL AS THOSE WHO ARE LIKELY
TO BE FOUND I S. T. ON A FELONY
CHARGE. WITH THIS FUNDING PSH
HAS SECURED PARTNERSHIPS WITH
TWENTY FOUR COUNTIES TO DIVERT
AN ESTIMATED EIGHT HUNDRED AND
TWENTY INDIVIDUALS FROM JAIL AND
BACK TO THE COMMUNITY. THROUGH
THIS PROGRAM ALL TWENTY FOUR
COUNTY PROGRAMS HAVE BEEN
ACTIVATED TO DATE AS OF JUNE
THIRTIETH OF LAST YEAR FOUR
HUNDRED AND FIFTY EIGHT ELIGIBLE
AND INDIVIDUALS HAVE BEEN
DIVERTED. UNDER THIS PROGRAM. IN
ADDITION THE TWENTY TWENTY ONE
BUDGET ACT INCLUDED FORTY SIX
POINT FOUR MILLION TO EXPAND- ON
THE EXISTING TWENTY FOUR COUNTY
PROGRAMS TO SERVE ONLY A FELONY
I S. T. DEFENDANTS. AS WELL AS
TO EXPAND THIS PROGRAM TO ALL
OTHER COUNTIES- TO DATE SIXTEEN
OF TWENTY FOUR COUNTIES HAVE
OPTED EXPAND THERE ARE CURRENT
PROGRAMS. AND EDUCATIONAL SIX
NEW COUNTIES HAVE SIGNED UP TO
IMPLEMENT. THE IDEAS EACH
DIVERSION PROGRAM IN THEIR
COMMUNITIES. THE NEXT ITEM IS AN
UPDATE TO THE I AM D. SUB ACUTE
BED CAPACITY PROGRAM. A NOTE
ADJUSTMENTS ARE ARE ALSO
REQUESTED IN THIS GOVERNOR'S
BUDGET AS BACKGROUND IN THE
TWENTY TWENTY ONE BUDGET ACT YES
EACH RECEIVED TWO HUNDRED SIXTY
ONE. POINT I'M SORRY TWO HUNDRED
AND SIXTY SEVEN POINT ONE
MILLION IN TWENTY TWO POSITIONS-
BEGINNING THIS FISCAL YEAR. TO
CONTRACT WITH PRIVATE PROVIDERS
ARE COUNTIES TO DEVELOP NEW OR
RENOVATED EXISTING FACILITIES TO
PROVIDE ALTERNATIVE TREATMENT
OPTIONS TO STATE HOSPITALS. OF
THE FUNDING RECEIVED TWO HUNDRED
AND FIFTY MILLION AS ONE TIME
FUNDING TO SUPPORT
INFRASTRUCTURE COSTS FOR THESE
NEW FACILITIES. IDEAS EACH BEGAN
ENGAGEMENT MEETINGS WITH
MULTIPLE PRIVATE PROVIDERS LAST
SUMMER TO EIGHT IDENTIFY AN
INVENTORY OF POTENTIAL PROJECTS.
ADDITIONALLY DST AGE HAS BEEN
DISCUSSING THIS OPPORTUNITY WITH
TARGETED COUNTY IS AND
STRATEGIZING THE USE OF THESE
FUNDS TO SUPPORT RECOMMENDATIONS
RESULTING FROM I. S. T.
SOLUTIONS WORKGROUP. MOST
RECENTLY NOT REFLECTED N THE
ESTIMATE WE ARE IN THE PROCESS
OF FINALIZING A CONTRACT WITH AN
ACUTE BEHAVIORAL HEALTH HOSPITAL
TO FACILITATE PSYCHIATRIC
STABILIZATION AND SUPPORT A
PATHWAY. FOR MORE I S. T.
INDIVIDUALS TO PARTICIPATE IN
DIVERSION OR OTHER OUTPATIENT
TREATMENT PROGRAMS. THE NEXT
ITEM IS AN UPDATE TOWARD JAIL
BASED COMPETENCY TREATMENT
PROGRAMS IDEAS EACH IS
REFLECTING A ONE TIME SAVINGS OF
APPROXIMATELY SEVEN MILLION. IN
FISCAL YEAR TWENTY ONE TWENTY
TWO TO REFLECT THE DELAYED
ACTIVATION TIMELINE OF PROGRAMS
DO TO COPE IN CHALLENGES
IMPACTING PROCUREMENT AND
RECRUITMENT ACTIVITIES.
ADDITIONALLY DST JUST
REQUESTING- ELEVEN POINT SIX
MILLION IN TWENTY TWO TWENTY
THREE AND ELEVEN POINT EIGHT
MILLION ON GOING TO SUPPORT
SEVERAL ITEMS INCLUDING AN
INCREASE OF NINETY TWO
ADDITIONAL BEDS ACROSS FIVE
EXISTING AND JUNIOR ACCOUNTING
PROGRAMS. A 5% RATE INCREASED AT
TEN OF RGB CG PROGRAMS TO
SUPPORT THE RISING COST OF SAP
STAFF SALARIES AND OPERATING
EXPENDITURES. AND A SERVICE
EXPANSION AT SOME OF OUR G. B.
C. T. LOCATIONS TO PERFORM
STABILIZATION AND EARLY ACCESS
TREATMENT SERVICES FOR ICE TEA
INDIVIDUALS WHO ARE PENDING
ADMISSION TO INDIA'S H. PROGRAM.
THIS LAST COMPONENT IS A
COMPLIMENT TO THE ICE TEA
SOLUTION PROPOSAL BY LEVERAGING
EXISTING G. B. C. T. TREATMENT
PROVIDERS TO EXPAND SERVICES
ALLOWS D. S. H. TO BROADEN ITS
ABILITY TO REACH MORE PEOPLE ON
THE CURRENT. I. S. T. WEEK LAST.
AND THEN LAST BUT NOT LEAST IS
AN UPDATE TO OUR STATE WIDE EYES
T. OFFRAMP. OTHERWISE KNOWN AS
SISTER PROGRAM- WE ARE ACTUALLY
OF REQUESTING TO ELIMINATE THIS
PROGRAM REFLECTING A SAVINGS OF
ONE MILLION IN FISCAL YEAR
TWENTY ONE TWENTY TWO AN
ONGOING. US ENTREATIES EFFORTS
HAVE BEEN SUBSUMED UNDER THE NEW
I. S. T. REEVALUATION SERVICES
PROGRAM WHICH WAS JUST
AUTHORIZED AND- THE CURRENT
FISCAL YEAR TWENTY ONE TWENTY
TWO ON A FOUR YEAR LIMITED TERM
BASIS. THIS NEW PROGRAM ALLOWS
THE A CH TO REEVALUATE FELONY I
S. T. DEFENDANTS WHO HAVE BEEN
WAITING IN JAIL- AND ON THE D.
S. C. H. WAIT LIST FOR SIXTY
DAYS OR MORE PENDING TRANSFER.
TO ONE OF OUR RESTORATION OF
COMPETENCY PROGRAMS. WE HAVE
BEEN ACTIVELY WORKING TO
IMPLEMENT THIS PROGRAM AS OF
LAST WEEK OVER TWO HUNDRED FIFTY
REEVALUATION HAVE BEEN COMPLETED
OF WHICH 38% OF THOSE EVALUATED. HAVE BEEN FOUND COMPETENT.
THAT CONCLUDES MY KIDS HAPPY TO-
MOVE ON TO THE NEXT. PRESENTER
THANK YOUNG NEXT TO HEAR FROM DR
VERONICA KELLY WHO IS THE CHIEF
FOR MENTAL HEALTH AND RECOVERY
SERVICES IN ORDER ORANGE COUNTY
PLEASE BEGIN. THANK YOU VERY
MUCH TALKED ARAMBULA AND-
MEMBERS THE FIRST ONE I THINK
THE OVERSIGHT ACCOUNTABILITY
COMMISSION AND COMMEND THEM FOR
THE QUALITY WORK THEY
FACILITATED ACROSS COUNTIES TO
THEIR VARIOUS INNOVATION
INCUBATOR PROJECTS. EACH OF
THESE HAS REALLY HELPED THE
GROUPS OF PARTICIPATING COUNTIES
TO INVEST IN IMPROVING QUALITY
AND OUTCOMES FOR THE CLIENTS
THAT WE SERVE. LIKE THE JUSTICE
INVOLVED IN COMPUTER HELPING US
THINK OUTSIDE THE BOX THESE
PROJECTS PROVIDE REAL SUPPORT
AND HELP OUR MEMBERS TO INFORM
PROGRAM AND POLICY. I ALSO WANT
TO THANK THE ADMINISTRATION FOR
ITS EMPHASIS ON HOUSING AS A KEY
PREVENTION STRATEGY FOR
INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS AND SUBSTANCE USE
DISORDERS AS REFLECTED IN BOTH
THE BRIDGE HOUSING PROPOSAL AND
THE PROPOSED INVESTMENTS FROM
THE DISH I S. T. WORK GROUP
WHICH HAS A- RAFT. TIME AND TIME
AGAIN COUNTY BEHAVIORAL HEALTH
DIRECTORS HAVE CITED A LACK OF
HOUSING OPTIONS AT THE KEY
SYSTEMIC GAP FOR DRESSING THE
NEEDS OF OUR CLIENTS WHO ARE
OFTEN EXCLUDED FROM OTHER
OPTIONS. WELL ANYONE
EXPERIENCING THE TRAUMA OF
LOSING THEIR HOMES WILL REQUIRE
SOME LEVEL OF EMOTIONAL SUPPORT
FOR MENTAL HEALTH SERVICES THE
POPULATION OF FOCUSED COUNTY
BEHAVIORAL HEALTH- THREE OUT OF
TEN WHO HAVE A SERIOUS MENTAL
ILLNESS AND THE TO OUT OF TOWN
WITH A SUBSTANCE USE DISORDER
WHO ARE DISPROPORTIONATELY
REPRESENTED IN OUR HOMELESS
POPULATION. OUR CLIENTS ARE
LARGELY INDIVIDUALS WITH THE
PAPER HEALTH DISABILITY A
MAJORITY OF WHOM WILL RELY ON
SSI OR SSD I AM PUBLIC
ASSISTANCE INCLUDING HELP
PROVIDED TO COUNTY BEHAVIORAL
HEALTH ACCESS HOUSING. YES BY
THEIR DISABILITY THEY HAVE TO
COMPETE IN THE OPEN MARKET FOR
HOUSING BY TOP TAX HAVING A
CLEAN RECORD BEING IN RECOVERY
FROM ADICTION AND MEETING OTHER
REQUIREMENTS OF LARGE THAT CAN
MAKE SUSTAINABLE. HOUSING
ANALYSTS AT. AND ADDITION COMING
OUT OF A- PROCESS. OR A JAIL OR
PRISON MEANS THAT YOU GET DOWN.
ON YOUR PRIOR. FOR HOUSING YOU
TOO FAULTY. HOUSING CRITERIA AS
YOU LITERALLY LIVED UNDER
SOMEONE ELSE'S ROOF THEREFORE
YOU DON'T QUALIFY AS CHRONICALLY
AT ON HOUSE AND SENATE BACK OF
THE LINE YOU GO. A SYSTEMIC
BARRIERS LIKE MANY OF OUR
CLIENTS TO HEROICALLY CONTINUED
TO WORK THERE RECOVERY WITH US
EVEN WHILE REMAINING ON HOUSE.
ANY OF MY COLLEAGUES AND I
SIMPLY LACKS SUFFICIENT
RESOURCES TO CONNECT OUR CLIENTS
WITH THE HOUSING THEY NEED AND
MY RESOURCES I MEAN THERE ARE NO
AVAILABLE HOUSING OPTIONS NO
APARTMENTS NO ONE CARES NO ROOM
AND BOARD. AND WE KNOW THAT WHEN
OUR CLIENTS AROUND HOUSE THEY'RE
MUCH MORE LIKELY TO BE ENGAGED
BY LAW ENFORCEMENT AND ENTER THE
HARMFUL CYCLE CRIMINALIZATION.
FOR THIS REASON WE APPRECIATE
THE ADMINISTRATION'S FOCUS ON
HOUSING FOR OUR CLIENTS AND
REQUEST THAT IN ORDER TO
EXPEDITE ACCESS TO. TO MEET THIS
AS THE CRISIS IT IS THAT WE NEED
TO ENSURE THAT THE BRIDGE
HOUSING FUNDING FUNCTIONS MORE
LIKE PROJECT HOME KEY. THAN
ANOTHER COMPETITIVE GRANT
PROGRAM. AND WE URGE THE
LEGISLATURE TO CONSIDER MAKING A
MESS AND ONGOING INVESTMENT. OUR
CLIENTS CRIMINAL BACKGROUNDS
INCLUDING SUBSTANCE ABUSE A
SYMPTOMS OF THEIR DISEASE OF
ADDICTION. AND EMPLOYMENT
BARRIERS WILL REQUIRE A LONG
TERM SUSTAINED COMMITMENT TO
HOUSING RELATED SUPPORT SERVICES
BEYOND A FEW YEARS. WE ALSO URGE
THE LEGISLATOR. LEGISLATURE TO
COUPLE HOUSING AND
INFRASTRUCTURE IMPACT
INVESTMENTS APPAREL INVESTMENTS
IN ADDITIONAL SERVICE DOLLARS.
WITH RESPECT TO THE L.
INCOMPETENT TO STAND TRIAL
PROPOSALS WE SUPPORT MUCH OF THE
FREE MRKET THAT HAS BEEN
DEVELOPED BY THE ADMINISTRATION.
AND ARE VERY THANKFUL FOR THE
PARTNERSHIP THAT WE'VE HAD WITH
THEM. WE THINK IT AGAINST ELAINE
APPROPRIATE FRAMEWORK FOR
INVESTMENT IN A BROADER
COMMUNITY BASED FORENSIC
BEHAVIOR HEALTH CONTAINMENT
CARE. THAT BEING SAD. WE
STRONGLY OPPOSE THE NOTION OF A
GROWTH CAP THE WAY TO ADDRESS
GROWTH IN THE FELONY ICED TEA
POPULATION. BECAUSE
UNFORTUNATELY THERE ARE MANY
SYSTEMS THAT IMPACT WHETHER A
PERSON IS ARRESTED. AND CHARGED
WITH A FELONY AND DEEMED I. S.
T. AND NONE OF THE SYSTEMS ARE
COUNTY BEHAVIORAL HEALTH. WELL
WE CAN AND DO WORK TO ENGAGE OUR
CLIENTS INTO TREATMENT SERVICES
WE KNOW THAT 66% OF INDIVIDUALS
OR TEAMS I S. T. CHARGED WITH
FELONIES WERE ON HOUSE AT THE
TIME OF THEIR ARREST. WE BELIEVE
THAT INVESTMENTS IN HOUSING AND
EXPANDED TRADE. JUST LIKE THE
VERSION VERSION ARREST AND PRE
TRIAL DIVERSION. ALONG WITH
IMPROVE COORDINATION BETWEEN LAW
ENFORCEMENT. WITH SERVICE
PROVIDERS. FINANCIAL PENALTIES
LEVEL LEVY ON COUNTY BEHAVIORAL
HEALTH ONLY TRAIN ALREADY SCARCE
RESOURCES FROM TREATMENT PUTTING
BIGGER HOLES IN OUR BEHAVIOR
HEALTH SAFETY NET AND PUT MORE
CLIENTS AT RISK OF HAVING THEIR
NEEDS MET WE ASK THE STATE TO
ANALYZE THOSE REGIONS OF THE
STATE SUCH AS THE BAY AREA WHERE
RATES OF FELONY I S. T. REFERRAL
HAVE BEEN FLAT TO UNDERSTAND WHY
THE REFERRAL RATES HAVE NOT
GROWN AT THE SAME RATE AS OTHER
REGIONS. IN ADDITION IN THE IT
WORKER PROCESS WE HAVE PROPOSED
IDEAS FOR IMPROVING THE
PREVENTION AND TREATMENT A
FELONY ISPS INCLUDING
ESTABLISHING STATEWIDE STANDARDS
FOR ALIENIST AND DEVELOPING A
STATE CERTIFICATION STANDARDS
AND IMPROVING JUST DISCHARGE
PRACTICES TO IMPROVE CONNECTION
TO LOCAL RESOURCES FOR
INDIVIDUALS LEAVING STATE
HOSPITALS AND REDUCE THE RISK
FOR RECIDIVISM I THANK. YOU FOR
THE OPPORTUNITY TO SHARE
PERSPECTIVE TODAY. THANK YOU
NEXT WE WILL HEAR FROM TOBY
EWING EXECUTIVE DIRECTOR FOR THE
MENTAL HEALTH SERVICES.
OVERSIGHT AND ACCOUNTABILITY
COMMISSION PLEASE BEGIN. THANK
YOU MR CHAIRMAN MEMBERS AGAIN
TOBY DEALING WITH MENTAL HEALTH
SERVICES OVERSIGHT
ACCOUNTABILITY COMMISSION I
REALLY APPRECIATE THE ATTENTION
ON THAT AND THE NEEDS OF%
CALIFORNIANS WHO HAVE HIGH END
NEEDS- AND I AND I WANT TO THANK
THE COMMITTEE STAFFER THE
THOROUGHNESS OF THEIR
PRESENTATION ON THIS ISSUE- AS
OUTLINED IN THE PACKET IN TWENTY
SEVENTEEN THE COMMISSION
RECEIVED A FIVE MILLION DOLLAR.
ONE TIME ALLOCATION TO SUPPORT
OPPORTUNITIES FOR COUNTIES TO
WORK TOGETHER TO IDENTIFY
STRATEGIES THAT THEY COULD
ENGAGE TO PREVENT THE NUMBERS OF
FOLKS WHO ARE AT RISK OF
BECOMING INVOLVED WITH THE
CRIMINAL JUSTICE SYSTEM AND AT
RISK OF. NOT COMING BEFORE THE
COURTS WITH AN INCOMPETENT TO
STAND TRIAL DESIGNATION THE
ENTIRE BACKGROUND OF THE
INNOVATION INCUBATOR WAS TO ASK
HOW COULD WE BETTER SUPPORT OUR
COUNTY BEHAVIORAL HEALTH
PARTNERS N. DOING UPSTREAM WORK
TO REDUCE PRESSURE ON THE
DEPARTMENT OF STATE HOSPITALS
AND THIS WAS IN PARALLEL WITH
THE STATE'S INVESTMENT TO
BROADEN COMMUNITY BASED
COMPETENCY RESTORATION
STRATEGIES. THAT THE INNOVATION
INCUBATOR IS REALLY THE THAT
GENESIS OF OUR CONVERSATION
ABOUT MODIFYING SB EIGHTY TWO
HOW CAN WE DO MORE UPSTREAM
WORKS TO PREVENT THE KINDS OF
CRISES THAT ARE. LIKELY TO SEE
THESE NUMBERS GO UP OR OR-
THEY'RE DRIVING THEM UP OVERTHE
PAST FEW YEARS AS OUTLINED IN
THE PACKET WE USE THESE FUNDS TO
PARTNER. WITH GROUPS OF COUNTIES
IN SOME INSTANCES I KNOW IT
DOESN'T COUNTIES AND IN MANY
CASES WE ARE LEVERAGING STATE
FUNDS AGAINST COUNTY INNOVATION
FUNDS OR OTHER COUNTY FUNDS TO
REALLY SUPPORT ENHANCE
STRATEGIES FOR THEM TO LEARN
COLLECTIVELY. ABOUT THE KINDS OF
STRATEGIES THAT CAN REDUCE
PRESSURE ON NOT JUST A CRIMINAL
JUSTICE SYSTEM WRIT LARGE BUT
BUT DOWN THE ROAD THE STATE
HOSPITAL SYSTEM. SO OUR DATA
DRIVEN RECOVERY PROJECT IT'S
ABOUT HELPING COUNTIES BETTER
UNDERSTAND PATTERNS IN THEIR
CRIMINAL JUSTICE AND MENTAL
HEALTH DATA THEY CAN PUT IN
PLACE IMPROVED COUNTY BEHAVIORAL
HEALTH COMMUNITY BEHAVIOR HEALTH
STRATEGIES- THAT TIES IN VERY
NICELY WITH THE NINE EIGHT
DISCUSSION EARLIER TODAY- THAT
CRISIS NOW WORK WAS IN RESPONSE
TO. YELLOW COUNTY THAT WAS
INTERESTED IN THAT MODEL AND
WHAT AND OUR OUR DIRECTION THE
OTHER COUNTY WESTERN BRING IN
OTHER COUNTIES IF THEY WERE
INTERESTED. BECAUSE THAT WAS ONE
OF OUR CRITERIA IS THAT WE WOULD
NOT FIND A COUNTY PROJECT THAT
WE WOULD FIND MULTIPLE COUNTIES
COMING TOGETHER TO LEARN FROM
EACH OTHER. FOR ME TO LEARN FROM
EACH OTHER AND LEVERAGE THEIR
DOLLARS TO STRENGTHEN THESE
PREVENTION OR INTERVENTION
STRATEGIES- I APPRECIATE THE
MENTION AND- DEPUTY SECRETARY
WELCH'S COMMENTS EARLIER ABOUT
TAKE ADVANCE DIRECTIVES. WE HAVE
FIVE COUNTIES THAT ARE EXPLORING
HOW WE COULD BEST LEVERAGE
PSYCHIATRIC ADVANCE DIRECTIVES
TO AGAIN REDUCE RELIANCE ON
ONLINE PORTION BUT IDEALLY.
REDUCE THE DURATION OF A CRISIS
BECAUSE WE SAT DOWN WITH A
MENTAL HEALTH CARE IN ADVANCE TO
TALK ABOUT. HOW WE SHOULD BE
RESPONDING WHEN THAT INDIVIDUAL
EXPERIENCES A CRISIS. THAT THE
PSYCHIATRIC ADVANCE DIRECTIVE
BECOME IS THAT THE INDIVIDUAL
DURING A POINT WHEN THEY'RE NOT
IN CRISIS LAYS OUT A GAME PLAN
FOR HOW BEST TO RESPOND TO THEIR
NEEDS WHEN THEY ARE IN CRISIS.
THIS STRATEGY IS ALL PART OF AN
EFFORT TO RECOGNIZE THAT WE HAVE
A CONTINUE OF SERVICES AND QUITE
OFTEN THE STATE HOSPITALS AT THE
IS IT THE DEEP IN THE FINAL
STEP. OF THAT SYSTEM. AND WE
NEED TO BE THINKING ABOUT EACH
OF THE STEPS PRIOR TO STATE
HOSPITAL INVOLVEMENT AND HOW WE
CAN FORTIFY THAT STRATEGY. SO
VERY QUICKLY THE- BCP IN FRONT
OF YOU TO PROVIDE ADDITIONAL
STAFF AND RESOURCES TO
STRENGTHEN A WORKAROUND FULL
SERVICE PARTNERSHIPS. RECOGNIZES
THAT THE FULL SERVICE
PARTNERSHIP PROGRAM WAS DESIGNED
TO KEEP PEOPLE OFF THE STREETS
OUT OF THE CRIMINAL JUSTICE
SYSTEM. AND OUT OF HOSPITALS-
SOME- FIFTEEN YEARS AGO AND SO
TRY TO THINK ABOUT HOW LONG AGO
THAT WAS. SO WE RECOGNIZE THAT
IF WE HAVE A ROBUST AND WELL
FUNCTIONING. FINANCIALLY STABLE
AND SUSTAINABLE SYSTEM FOR FULL
SERVICE PARTNERSHIPS THAT THAT
SHOULD MEAN THE NUMBERS OF FOLKS
WHO ARE JUSTICE INVOLVED GOES
DOWN AND THAT SHOULD MEAN THE
NUMBER OF FOLKS WHO ARE LANDING
IN STATE HOSPITAL SHOULD GO DOWN
. UPSTREAM FROM THAT IS OUR WORK
ON EARLY PSYCHOSIS RECOGNIZING
THAT NOT ALL BUT MANY OF THE
CALIFORNIANS WHO ARE INVOLVED IN
OUR FULL SERVICE PARTNERSHIPS
WHO ARE ON THE STREETSWHO ARE
JUSTICE INVOLVED. ARE STRUGGLING
WITH PSYCHOSIS AND CAN WE PUT IN
PLACE A STATEWIDE SYSTEM TO
ENSURE THAT EVERY CALIFORNIA HAS
ACCESS TO. AN EFFECTIVE SET OF
SERVICES AND SUPPORTS TO THE
PSYCHOSIS DOESN'T BECOME A
LIFELONG DISABLING CONDITION BUT
A CONDITION THAT CAN BE MANAGED
SO THAT THEY CAN SUSTAIN
RECOVERY AND WELLNESS. TO THE
BEST OF THEIR ABILITY. AN
UPSTREAM FROM THAT AS WE TALKED
LAST WEEK IS ARGUED DROP IN OUR
SCHOOL MENTAL HEALTH WORK AND SO
WE REALLY SEE THIS AS AN
OPPORTUNITY. TO STRENGTHEN THE
UPSTREAM KINDS OF STRATEGIES. IN
TERMS OF THE STATE'S ABILITY TO
WORK COHESIVELY WITH OUR COUNTY
BEHAVIORAL HEALTH AND OTHER
COMMUNITY PARTNERS TO REALLY
TAKE PRESSURE OFF THESE DEFENSE
SYSTEMS. TO DO THE PREVENTION
AND INTERVENTION WORK THAT IS AS
WE BELIEVE THE ONLY WAY THE
STATE IS GOING TO GET ITSELF OUT
OF THE CHALLENGES THAT IS SEEING
IN TERMS OF THE NUMBERS OF FOLKS
WERE LANDING IN OUR STATE
HOSPITALS. THANKS VERY MUCH HAVE
A ANSWERING QUESTIONS. THANK YOU
NEXT WE WILL HEAR FROM COREY HOW
SHE DEALT WITH THE LEGISLATIVE.
ANALYST'S OFFICE. THANK YOU
DOCTOR REGULATORY ISSUE TO WITH
THE LEGISLATIVE ANALYST'S
OFFICE- WE HAVE SOME COMMENTS TO
RAISE ON THE D. ON THE H. THE
US'S BRIDGE HOUSING PROPOSAL AND
DSHS PROPOSED IC SOLUTIONS
PACKAGE- FURTHER COMMENTS ON
THESE ITEMS ARE INCLUDED IN OUR-
RECENTLY RELEASED. REFORM THE
GOVERNOR'S MAJOR FEEDER HEALTH
PROPOSALS AS WELL. REGARDING THE
BRIDGE HOUSING PROPOSAL FIRST WE
WOULD NOTE THAT WE FIND THE
APPROACH TO FOCUS RESOURCES ON
BRIDGE HOUSING FOR PEOPLE WITH.
BEHAVIORAL HEALTH NEEDS HAS
MERIT THIS SPECIFIC POPULATION
FOLKS WHO STRUGGLE WITH BOTH
HOMELESSNESS AND BEHAVIOR
HEALTH- HAS YOU NEED CARE NEEDS
AND WE DO FIND THAT THE PROPOSAL
TARGETS A KEY GAPS. IN THE
CONTINUUM OF CARE BY FUNDING
BRIDGE HOUSING WHICH IS NOT
NECESSARILY A FOCUS OF MUCH OF
THE STATE'S PRIOR SPENDING ON
HOMELESSNESS AND BEHAVIORAL
HEALTH- HOWEVER WE WOULD NOTE
THAT THIS PROPOSAL EXISTS AT A
VERY CONCEPTUAL STAGE RIGHT NOW
WITH. KEY DETAILS OUTSTANDING
RELATED TO HOW THIS PROPOSAL
WOULD WORK IN PRACTICE- SUCH AS
SORT OF HOW THE FUNDS WOULD
ULTIMATELY BE DISTRIBUTED- IN
ADDITION YOU WE UNDERSTAND THAT
THE ADMINISTRATION IS NOT
PLANNING TO HAVE TRAILER BILL
FOR THIS PROPOSAL- THESE TWO
FACTORS TOGETHER MAY LIMIT THE
AMOUNT OF. INPUT THAT THE
LEGISLATURE HAS ON DEVELOPING
THIS PROPOSAL FURTHER- AND WE
WOULD RECOMMEND THAT THE
LEGISLATURE ADOPTS TRAILER BILL
LANGUAGE TO PROVIDE MORE
OPPORTUNITIES FOR OVERSIGHT-
THIS TRAILER BILL COULD SPECIFY
KEEP PROGRAM DETAILS SUCH AS FOR
EXAMPLE TO SPECIFIC.
DISTRIBUTION METHODOLOGY WHETHER
A COMPETITIVE GRANT PROGRAM OR A
MORE FORMULA BASED ALLOCATION-
WHICH MAY RESULT IN FUNDS BEING
DISTRIBUTED TO COUNTIES QUICKER-
IT COULD ALSO SPECIFY YOU KNOW
HOW FUNDING WOULD BE PRIORITIZE
FOR DIFFERENT REGIONS OF THE
STATE- WHAT SHARE OF THOSE FUNDS
SHOULD GO TOWARD THE
CONSTRUCTION OF TINY HOMES
WHICH- ARE RELATIVELY NEW
CONCEPT FOR STATE- HOMELESSNESS
RELIEF WHICH COME WITH TRADE
OFFS- RELATIVE TO FUNDING BEDS
IN EXISTING- SORT OF BRIDGE
HOUSING SETTINGS. AS WELL AS ANY
STATUTORY LANGUAGE NEEDED TO
STREAMLINE THE PROCESS FOR LOCAL
APPROVAL FOR THE CONSTRUCTION OF
TINY HOMES WHICH WE UNDERSTAND
IS OFTEN HELD UP BY BY LOCAL
OPPOSITION- FOR CONCEPTS THAT
WOULD REPRESENT A NEW STATE
APPROACH SUCH AS THE
CONSTRUCTION OF TINY HOMES- WE
WOULD RECOMMEND PROVIDING.
PLANNING FUNDS- WHAT'S THE
PROVIDING FOR TRADITIONAL
APPROACHES SUCH AS SECURING
HOUSING IN EXISTING ASSISTED
LIVING SETTINGS- NEXT WE JUST
KNOW THAT IT'S UNCLEAR WHAT
WOULD HAPPEN TO THESE BRIDGE
HOUSING UNITS PARTICULARLY THE
TINY HOMES. AFTER THE LIMITED
TERM FUNDING FOR THIS PROPOSAL
IS EXHAUSTED. EVEN AFTER THE
LONGER TERM UNITS FUNDED BY A
PRIOR STATE INVESTMENTS COME
ONLINE. IT IS POSSIBLE THAT
THERE WILL STILL NEED THERE WILL
THERE WILL STILL BE SOME NEED
FOR- BRIDGE HOUSING OPTIONS IN
THE COMMUNITY. AND IF COUNTIES
WANT TO SORT OF. CONTINUE
OPERATING THESE BRIDGE HOUSING
FACILITIES AFTER THE FUNDING
RUNS OUT- THEY WOULD NEED TO
COME UP WITH THEIR OWN THEY
WOULD NEED TO SORT OF USE
ALTERNATIVE FUNDING SOURCES TO
DO SO- AND THEIR CAPACITY TO DO
SO IS ULTIMATELY UNCLEAR-
FINALLY THE LEGISLATURE MAY WISH
TO CONSIDER THE TRADE OFFS
BETWEEN THIS PROPOSAL. WHICH
PROVIDES ADDITIONAL FUNDS TO THE
BEHAVIOR HEALTH CONTINUUM
INFRASTRUCTURE PROGRAM AND
POTENTIALLY MODIFYING OR
EXPANDING EXISTING STATE
HOMELESSNESS PROGRAMS TO FOCUS
SPECIFICALLY ON INDIVIDUALS
STRUGGLING WITH BEHAVIORAL
HEALTH NEEDS- WE RAISE THIS
TRADE OFF IS A CONSIDERATION
BECAUSE THOSE EXISTING PROGRAMS
MAY HAVE GREATER CAPACITY TO
DEPLOY BRIDGE HOUSING QUICKLY-
BECAUSE THEY HAVE A TRACK RECORD
OF MAKING HOUSING. AVAILABLE
IMMEDIATELY FOR PEOPLE
EXPERIENCING HOMELESSNESS AND IT
MAY TAKE SOME TIME FOR DH CS TO
ULTIMATELY DISBURSED THESE
PROPOSED FUNDS- FOR DS AGES
PROPOSED HIGHEST HE SOLUTIONS
PACKAGE WE WOULD FIRST NOTE THAT
THERE IS ONE PIECE OF PROPOSED
TRAILER BILL LANGUAGE-
SURROUNDING THE PROPOSED CAP ON
FELONY ICED TEA REFERRALS FROM
COUNTIES- THAT IS NOT YET
AVAILABLE FOR REVIEW. WE WOULD
ALSO NOTE THAT- IMPORTANTLY THE
ADMINISTRATION VIEWS THIS
PROPOSED PACKAGE OF IC
SOLUTIONS. AS A STARTING POINT
FOR DISCUSSIONS ESPECIALLY WITH
VARIOUS STAKEHOLDER GROUPS. AND
THE ADMINISTRATION INTENDS TO
UPDATE THIS PROPOSED PACKAGE AT
ME REVISED TO INCLUDE ANY
CHANGES OR REFINEMENTS OF THE
LEGISLATURE WILL HAVE AN
OPPORTUNITY TO WEIGH IN LATER IN
THE BUDGET PROCESS. ON THE SIDE
M. AS WELL. I'M SPEAKING TO THE
KERR INTERIM THIS PACKAGE THE
SPECIFIC PROPOSALS- INCLUDED
REFLECT THE FUEL OF THE I'D
IDEAS FROM THE ICE TEA WORKGROUP
BUT NOT ALL OF THEM- WE
GENERALLY FIND THESE REASONABLE
PRIORITIES TO FIND THIS YEAR FOR
EXAMPLE THE EARLY STABILIZATION
INVESTMENTS IN PROMISING GIVEN
THAT WE UNDERSTAND THAT LACK OF
EARLY STABILIZATION IS ONE OF
THE MAJOR BARRIERS TO ENSURING
THAT AN INDIVIDUAL CAN
PARTICIPATE IN COMMUNITY OPTIONS
THREE DS H. HOWEVER WE WOULD
NOTE THAT THE IC SOLUTIONS
WORKGROUP REPORT INCLUDED A
VARIETY OF IDEAS- INCLUDING SOME
ATTENDED INTENDED TO ADDRESS
UNDERLYING MENTAL HEALTH ISSUES
THAT MAY LEAD SOMEONE TO BE
FOUND I S. T. IN THE FIRST
PLACE- SUCH AS THROUGH INCREASED
COORDINATION WITH OTHER STATE
AND LOCAL ENTITIES. ALTHOUGH
SOME OF THESE IDEAS ARE VERY
CONCEPTUAL AT THIS POINT THE
LEGISLATURE WE WISH TO MONITOR
PROGRESS IN THE DEVELOPMENT OF-
SOLUTIONS BASED ON THESE OTHER
IDEAS FROM THAT FROM THE ICED
TEA WORKGROUP- REGARDING THAT
PROPOSED CAP ON FELONY ICE TEA
REFERRALS FROM COUNTIES. WE FIND
THAT A CAP MAY MAKE SENSE TO
INCENTIVIZE COUNTIES TO PARTNER
WITH THE S. H. ON THESE
SOLUTIONS PROPOSALS BUT THAT.
COUNTY CAPACITY TO REMAIN UNDER
THESE CAPS IS UNCLEAR-
FURTHERMORE WHILE THE
ADMINISTRATION'S FORTHCOMING
TRAILER BILL LANGUAGE ON THIS
ISSUE MAY PROVIDE SOME
ADDITIONAL INFORMATION. THE
STATE CONSTITUTION GENERALLY
REQUIRES THE STATE TO REIMBURSE
LOCAL GOVERNMENTS FOR MANDATED
HIGHER LEVELS OF SERVICE. GIVEN
THAT ELENI I S. T. TREATMENT IS
A STATE RESPONSIBILITY- WE FIND
THAT THE PROPOSED CAP RAISES
QUESTIONS OF WHETHER THIS WOULD
BE CONSIDERED A STATE
REIMBURSABLE MANDATE. IN
ADDITION THE ADMINISTRATION
CONSIDERS THE BULK OF FUNDING
WITHIN THE PROPOSED IST
SOLUTIONS PACKAGE AS EXCLUDED
FROM THE STATE APPROPRIATIONS
LIMIT AS AN APPROPRIATION
REQUIRED TO COMPLY WITH A COURT
MANDATE- WE FIND THAT THE
REMAINING FUNDING WITHIN THE
PROPOSED PACKAGE AS WELL AS
OTHER FUNDING WITHIN THE S. H.
BUDGET. TO COMMENCE FELONY I
SPEECH FRIEDMAN IN A TIMELY
MANNER MAY ALSO BE ELIGIBLE FOR
EXCLUSION FROM THE STATE
APPROPRIATIONS LIMIT OF FOR
COURT MANDATE REASONS- WE WOULD
RECOMMEND THAT THE LEGISLATURE
DIRECT THE ADMINISTRATION TO
EXPLORE CANNING THIS ADDITIONAL
D. S. H. FUNDING. AS EXCLUDED
FROM THE LIMIT. FINALLY THE
PROPOSED PACKAGEINCLUDES
ONGOING FUNDING TO PILOT AN
INDEPENDENT PANEL TO DETERMINE
FELONY I S. T. PLACEMENT INTO
CONRAD. ONE OF THE S. H. IS
COMMUNITY BASED TREATMENT
PROGRAMS- WE FIND THAT PROVIDING
ONGOING FUNDING FOR THIS PILOT
IS PREMATURE GIVEN THAT ITS
SUCCESS HASN'T BEEN ASSESSED
YET. AND RECOMMENDED THE
LEGISLATURE PROVIDE LIMITED TERM
FUNDING INSTEAD FOR THIS PILOT-
AND THOSE ARE ALL OF OUR
COMMENTS AT THIS TIME WE ARE
HAPPY TO BE OF FURTHER
ASSISTANCE WHERE NEEDED. THANK
YOU NEXT WE'LL HEAR FROM KIM
PETERSON SENIOR ATTORNEY WITH
DISABILITY RIGHTS CALIFORNIA.
AGAIN MY NAME IS COMPUTER SENT
FROM DISABILITY RIGHTS
CALIFORNIA FOR THIS PANEL I HAVE
COMMENTS ON THE BEHAVIORAL
HEALTH BRANCH HOUSING PROPOSAL
AND I. S. T. SOLUTION PACKAGE.
WITH RESPECT TO THE BRIDGE
HOUSING PROPOSAL DSHS
APPRECIATES THE PROPOSED
UNPRECEDENTED INVESTMENT IN
SUPPORT OF HOUSING FOR PEOPLE
LIVING WITH SEVERE BEHAVIOR
HEALTH DISABILITIES. FOR MANY ON
HOUSE PEOPLE HAVING STABLE
HOUSING WILL BE AN IMPORTANT
STEP IN THEIR RECOVERY JOURNEY.
DRC OR JUST ANY HOUSING MADE
AVAILABLE THROUGH THE BRIDGE
HOUSING PROPOSAL. TO BE OFFERED
IN ACCORDING TO HOUSING FIRST
PRINCIPLES. HOUSING FIRST IS AN
EVIDENCE BASED MODEL THAT USES
HOUSING AS A TOOL FOR RECOVERY
RATHER THAN AS A REWARD FOR
MEETING CERTAIN TREATMENT GOALS
. HOUSING FIRST PROVIDERS OFFER
SERVICES ON A VOLUNTARY BASIS
HOUSING IS NOT CONTINGENT UPON
PARTICIPATION AND OR SUCCESS AND
SERVICE. IN ADDITION WE HAVE
QUESTIONS ABOUT WHETHER HOW AND
WHETHER THE BRIDGE HOUSING WILL
CONNECT PEOPLE DEPARTMENT
SUPPORT OF HOUSING. SUPPLY OF
PERMANENT SUPPORTIVE HOUSING IS
CURRENTLY NOT SUFFICIENT TO MEET
DEMANDS AND IT'S UNCLEAR WHETHER
PERMANENT SUPPORTIVE HOUSING
WILL COME ONLINE RAPIDLY ENOUGH
TO ALLOW FOR SMOOTH TRANSITIONS
FROM BRIDGE HOUSING. WE ASK THAT
DH CS ACCOUNT FOR THIS WHEN
DEVELOPING THE POLICIES THAT
WILL GOVERN THE BRANCH HOUSING
PROGRAM. IT WOULD BE A WASTED
OPPORTUNITY IF PEOPLE RETURN TO
HOMELESSNESS BECAUSE THEIR TIME
AND BRIDGE HOUSING ENDS BEFORE
PERMANENT SUPPORTIVE HOUSING
BECOMES AVAILABLE. TURNING TO
THE IC SOLUTIONS PROPOSAL DRC
APPRECIATE SOME DIRECTION
REFLECTED IN THE TRAILER BILL
LANGUAGE IN WHICH THE S. H.
SUGGESTS MOVING TOWARDS A
PRESUMPTION THAT ALL PEOPLE
FOUND INCOMPETENT TO STAND TRIAL
ON FELONY CHARGES. SO FIRST BE
CONSIDERED FOR PLACEMENT IN AN
OUTPATIENT TREATMENT PROGRAM. WE
ASK THAT THE LEGISLATURE CLOSELY
ANALYZED YES AGE AND ITS
PARTNERS ABILITY TO CARRY OUT
THE BOLD GOALS OF CREATING THE
INFRASTRUCTURE AND PROGRAMMING
NECESSARY. TO SUPPORT AN
INCREASE OF FIVE THOUSAND
COMMUNITY BASED RESTORATION AND
DIAPERS AND PAD OVER THE NEXT
TWO FISCAL YEARS. D. R. C. 1100%
SUPPORTS THE EFFORT TO TREAT
FELONY I JUST USE MY COMMUNITY
WHEN I WAS SERVICES AND SET THEM
ON A PATH TOWARDS BREAKING THE
CYCLE OF HOMELESSNESS
DISENGAGEMENT FROM TREATMENT.
AND CANNELLA EAGLE INVOLVEMENT
THAT IS A MAJOR DRIVER OF THE
STATE'S CURRENT HIGHEST YOU
CRISIS. HOWEVER CERTAIN FACTORS
BEYOND YES THEY JUST CONTROL
SUCH AS NIMBYISM HOUSING
SCARCITY AND WORKFORCE SHORTAGES
WILL HAVE TO BE NAVIGATED IN
ORDER TO MAKE THESE CALLS ARE
REALITY. LASTLY IN DRC OPPOSES
THE PROPOSAL TO LIMIT
PARTICIPATION OF DEFEAT S. H.
FUNDED MENTAL HEALTH DIVERSION
TO PEOPLE WHO HAVE ALREADY BEEN
FOUND INCOMPETENT TO STAND TRIAL
ON FELONY CHARGES. ELIMINATING
ELIGIBILITY FOR PEOPLE WHO ARE
AT RISK OF BEING FOUND
INCOMPETENT IS A MISSED
OPPORTUNITY TO STOP THE CYCLE
THAT I PREVIOUSLY MENTIONED THE
IDEA STATES HAS IDENTIFIED AS A
MAJOR DRIVER OF THE CURRENT IC
CRISIS. AGAIN I APPRECIATE THE
OPPORTUNITY TO BE HEARD TODAY
AND I'M HAPPY TO ANSWER
QUESTIONS AFTER THE PANEL.
THANK YOU VERY MUCH- NEXT WE
HAVE A STEPHANIE REGULAR OUR
SYSTEM PUBLIC DEFENDER CONTRA
COSTA COUNTY- SHE'S NOT HERE.
THANK YOU THE WILL HAVE A
MICHAEL RISHER. I'VE OF COUNSEL
ACLU FOUNDATION OF NORTHERN
CALIFORNIA THANK YOU. THANK YOU
. MY NAME IS MICHAEL RICH FROM A
COUNCIL TO THE EAST SO YOU'RE
GOING TO CALIFORNIA AND I WAS
PART OF THE VENUE LITIGATION
THAT WE'VE BEEN TALKING ABOUT
THAT WITH THE STATE AND FEDERAL
CONSTITUTIONS REQUIRE THE STATE
START PROVIDING CONFERENCE THE
TREATMENT. WISE TWO DEFENDANTS
WITHIN THIRTY DAYS OF THE
COMMENCEMENT ORDER. THE- THE
STATE'S APPROACH TO THIS PROBLEM
IS A VERY WELCOME CHANGE OF
DIRECTION FOR DECADES THE STATUS
AFTER FIVE- INCARCERATION
PUTTING PEOPLE IN JAIL BASED
PROGRAMS IN THIS PROBLEM STATE
HOSPITAL AND I WAS FINALLY
REALIZE YOU CANNOT BUILD ITS WAY
OUT OF THIS PROBLEM. AND IS
EMPHASIZING OR PRICKLY DIVERSION
AND COMMUNITY BASED PROGRAMS
THAT'S A FANTASTIC DEVELOPMENTS
. THE BASE TREATMENT IS MUCH
MORE EFFECTIVE FOR THE
INDIVIDUALS MUCH BETTER
MANAGEMENT TOOLS AND MUCH MORE
COST EFFECTIVE A BAD MISTAKE
HOSPITAL CAN COST HUNDREDS OF
THOUSANDS OF DOLLARS A YEAR.
EIGHT COMMUNITY TREATMENT AND
WHAT'S HOUSING COSTS A MERE
FRACTION OF THAT. SO THE OVERALL
APPROACH HIS EXCELLENCY MIDLEVEL
OF COURSE IN THE DETAILS AND
THERE ARE A COUPLE- SIGNIFICANT
ISSUES OR PROBLEMS WITH THE
CURRENT PROPOSAL IN THAT TRAILER
BILL. THE FIRST ONE IS ONE OF
MS. PETERSON'S MENTIONED IN THAT
IT WOULD AMEND THE DIVERGENT
VALUES TO NARROW YOUR GOALIE FOR
DIVERSION AND THAT'S ABSOLUTELY
THE WRONG DIRECTION TO BE GOING
WE SHOULD BE EXPANDING THE
VERSION NOT LIMITING IT. SO
CURRENTLY AND I IS TO DO A BROAD
DEFENDER CAN BE DIVERTED YES I
HEAR SHE IS FOUND R. S. T. OR IF
FROM THE ABSENCE OF THE PERSON
AND- THAT PERSON IS LIKELY TO
BECOME MYERS T. WHAT THAT MEANS
YOU CAN DIVERT SOMEBODY EARLY IN
THE PROCESS WITHOUT WAITING
MONTHS FOR THE EVALUATION OF THE
COURT HEARING. YOU ACTUALLY FIND
THE PERSON I S. T. E. R. THE
PROPOSED AMENDMENT WOULD CHANGE.
AND THAT'S THAT'S A BAD IDEA
FIRST OF ALL BECAUSE IT WOULD
MEAN THAT PEOPLE WHO WERE
DEPORTED AFTER WAIT MONTHS OFF
IN JAIL OFTEN SOLITARY
CONFINEMENT WITH NO TREATMENT
BEFORE THEY CAN BE DEPARTMENT.
THAT'S NOT GOOD FOR ANYBODY AND
ALSO IT WOULD NARROW ELIGIBILITY
PEOPLE WHO ARE WE'RE NOT
INVESTMENT ADVICE YOU WOULDN'T
BE DIVERTED- WHICH- IS A PROBLEM
BECAUSE- THE STATE IS ALL. NOT
USING. ITS TO ENTICE THE STATE I
MEAN. LOCAL COURT TO ARE NOT
USING THE EXISTING DIVERSION
CAPACITY AS MCCARTY EARLIER THAN
SAY A PROGRAM THAT HAS EIGHT
HUNDRED TWENTY BEDS. ARE
PROJECTS OF WHICH ONLY FOUR
HUNDRED FIFTY EIGHT AND ACTUALLY
BEEN USED WE HAVE ACCESS TO
PASSAGE OF PERVERSION WE CAN USE
THAT WE SHOULD NOT BE DO NOT-
NARROWING ELIGIBILITY FOR
DIVERSE- WHICH IS GOING TO LEAD
TO EVEN MORE EXCESS CAPACITY.
THAT'S A BAD IDEA. THE SECOND
ISSUE. IS THAT. THE STATUTE
AMERICANS ELEVEN SEVENTY AGE
QUITE APPROPRIATELY TO TRIED
YOU. ARE INCENTIVIZE OR PROMOTE
DIVERSION A COMMUNITY BASED
TREATMENT. HOWEVER IT DOESN'T GO
FAR ENOUGH TO. OVERCOME YEARS
AND YEARS OF. HABIT OF SENDING
PEOPLE TO LOCK. THE PROPOSAL
WITH THAT IF THE COURT IS ITS
OUT FOR OF BASED. MEANING THAT
CLINICALLY APPROPRIATE. AND IT'S
APPROPRIATE FOR PUBLIC SAFETY
STANDPOINT AND THERE'S NO DOUBLE
BED. THE COURT SHALL FIRST
CONSIDER SPENDING THE PERSON.
WELL THAT'S THAT'S NOT STRONG
ENOUGH TO OVERCOME THIS YEAR'S
OF- AS I SAID NURTURING
TRADITION WE NEED A PARADIGM
SHIFT. THE STATURE CAN SIMPLY
SAY THAT IF SOMEBODY'S ELIGIBLE
FOR DIVERSION OF TREATMENT
EFFECTS ARE CLINICALLY
APPROPRIATE AND APPROPRIATE
TERMS OF PUBLIC SAFETY AND
THERE'S AN OPENING. THEY SHOULD
BE SENT TO THAT'S LOST IN MASS
THERE ARE UNUSUAL CIRCUMSTANCES
THAT THE MILITANT OTHERWISE
OTHERWISE WE'RE SIMPLY GONNA
HAVE UNUSED CAPACITY WHICH
DOESN'T DO ANYBODY ANY GOOD.
REPLACEMENTS AND- WE'VE HEARD
ABOUT A PROPOSED CAP ON OUR
ADMISSIONS AND THAT'S BEEN
CRITICIZED BY THOSE WHO MENTION
AND RIGHTLY SO WE DON'T NEED TO
CAP. THE OUR STATE ITSELF AS WE
DO NEED TO DEAL WITH THE SCIENCE
TO CRISIS TO PROVIDE TREATMENTS
AT THE STATE WANTS ARE FOR
PEOPLE IN THE STATE WANTS TO
PROSECUTE. AND ISSUE THAT
UNIFORMLYTHROUGHOUT CALIFORNIA. SHOULDN'T PUNISH COUNTY.
DOCTORS BEYOND THEIR- PARTICULAR
BECAUSE THAT WAY UP. IRAN G. IN
THE- WERE. BEYOND OUR CONTROL.
THE STATE STREET UNIFORM PROVIDE
FRIEDMAN TO PEOPLE. VATICAN NOT
. AGAINST PARTICULAR COUNTS
THANK YOU. THANK YOU NEXT WE
WILL HEAR FROM SANDRA SEIDENBERG
FAMILY MEMBER OF A NICE T.
PATIENT PLEASE BEGIN. OR GOOD
AFTERNOON YOU HEAR ME. LOUDLY
AND CLEARLY PLEASE CONTINUE OUT
. YES MY NAME IS. BURKE I'M
RETIRED SOCIAL WORKER AND MY
COUSIN'S NAME IS JOHN ON HASHES
I TESTIFIED DURING THE GROUND
BEFORE THE SENATE BUDGET SUB
COMMITTEE AT THAT TIME JOHN HAD
BEEN IN CUSTODY AT THE KERN
COUNTY PRE TRIAL FACILITY FOR
OVER A YEAR WITHOUT TRIAL. HE
WAS APPARENTLY FORGOTTEN BY THE
SYSTEM MY TESTIMONY LED TO THIS
TRANSCRIPT TO A STATE HOSPITAL.
I'M HERE TODAY BECAUSE IT SHOULD
NOT REQUIRE A FAMILY MEMBER WHO
TESTIFIES BEFORE STATE
LEGISLATIVE COMMITTEE TO HAVE
SOMEONE WHO IS DIAGNOSED AS
INCOMPETENT TO STAND TRIAL
TRANSFERRED FROM PROLONGED AND
DAMAGING CONFINEMENT AT THE
COUNTY JAIL. I'M ALSO HERE TODAY
BECAUSE I THINK JOHN AND SO MANY
LIKE HIM SHOULD NOT BE
CIRCULATING. THROUGH THE
CRIMINAL LEGAL SYSTEM TO BEGIN
WITH. THEY NEED TO BE WITH THEIR
FAMILY. AND THEIR COMMUNITIES
AND RECEIVING TREATMENT. MY
COUSIN WAS ARRESTED CHRISTMAS
DAY IN CURRENT COUNTY TWENTY
TWENTY IT WAS CHARGED WITH
MAKING THREATS. TWO VERBAL
CONFRONTATIONS DIRECTLY LINKED
TO HIS MENTAL ILLNESS HE HAD NO
PRIOR CONVICTIONS MY COUSIN HAS
NEVER BEEN VIOLENT. HE USES
WORDS. AND MARCH TWENTY TWENTY
ONE A JUDGE FOUND JOHN TO BE
INCOMPETENT TO STAND TRIAL. IT'S
NOW BEEN ONE YEAR SINCE HIS
COMPETENCY DETERMINATION. HE WAS
JUST TRANSFERRED TO THE STATE
HOSPITAL IN THE MIDDLE OF
FEBRUARY. BEFORE HIS TRANSFER
JOHN WAS LOCKED UP IN A CELL FOR
OVER TWENTY THREE HOURS A DAY.
YOU DID SEE RECEIVE SOME
TREATMENT THROUGH ITALICIZED
HIGH INTEREST ONCE EVERY THREE
MONTHS FOR ABOUT FIFTEEN MINUTES
. AND THEN SOMETIMES HE HAD A
SOCIAL WORKER VISIT HIS CELL
DOOR. FOR THE FORTY FIVE MINUTES
TO HE WAS ALLOWED OUT OF
YOURSELF HE WOULD TAKE A SHOWER
AND EVERYTHING CALLED ME. EVERY
DAY HE'D ASKED ME THE SAME
QUESTION WHY AM I GOING TO GET
OUT. I DIDN'T KNOW WHAT TO TELL
HIM. MY COUSIN AS ARTISTIC. AND
HE'S BEEN DIAGNOSED WITH
SCHIZOAFFECTIVE DISORDER. FROM
THE TIME THAT HE WAS A YOUNG BOY
HE WAS IN AND OUT OF MENTAL
HOSPITALS. JOHN'S MOTHER WAS
JUST ROCK HE WAS VERY PROTECTIVE
OF HER. ONE MONTH AFTER JOHNSON
PARTURITION SHE PASSED AWAY. HE
DIDN'T EVEN GET THE CHANCE TO
SAY GOODBYE TO HIS MOTHER. WHEN
JOHN WAS TAKEN INTO CUSTODY HE
LOST EVERYTHING IS AFFORDABLE
HOUSING. IS SOCIAL SECURITY
BENEFITS. EVERYTHING I AM
GRATEFUL THAT SEAN HAS BEEN
TRANSFERRED TO THE STATE
HOSPITAL BUT IT SHOULD NEVER
HAVE TO BEST AND IT SHOULDN'T
HAVE TAKEN THIS LONG. I STILL
DON'T KNOW WHAT COMES NEXT AND
NEITHER DOES HE- HE DOES CALL ME
HE ASKED. HEY WHAT'S GOING TO
HAPPEN TO ALL. IT MAKES NO SENSE
TO ME THAT HE STILL HAS FELONY
CHARGES PENDING FOR ONCE AGAIN A
NON VIOLENT OF THAT. WHICH IS
CLEARLY RELATED TO HIS MENTAL
ILLNESS ISN'T THAT WHY WE HAVE
MENTAL HEALTH DIVERSION PROGRAMS
SHOULDN'T HE BE A CANDIDATE FOR
MENTAL HEALTH TREATMENT RATHER
THAN GET A CRIMINAL RECORD AND
BE AND LOCK UP. I BELIEVE THAT
IF MY COUSIN HAD BEEN TRACED TO
THE COMMUNITY TREATMENT. HE
WOULD HAVE RESPONDED TO THAT
TREATMENT HE WILLINGLY TAKES HIS
MEDICATIONS NOTHING IS BEING
FORCED ON HIM. AT THE TIME THAT
HE WAS TAKEN INTO CUSTODY WE
WILL MAKE EVERY EFFORT TO FIND
MENTAL HEALTH SUPPORTIVE
SERVICES FOR HIM BUT BECAUSE OF
HOPE THAT THE SERVICES WERE
LACKING THEY WERE NON EXISTENT.
I WOULD LIKE TO SEE HIM COME
HOME AT RECLAIM IS LIVE. I
BELIEVE THAT HE CAN BENEFIT FROM
A ENTAL HEALTH DIVERSION
PROGRAM THIS WOULD ALLOW HIM TO
BE CLOSE TO HOME. HERE HE NEEDS
AND AVOID A CONVICTION ON HIS
RECORD. I ALSO HOPE THAT
CALIFORNIA REFORM SEX CRIMINAL
AND MENTAL HEALTH SYSTEMS. THE
MOBILE HEALTH CRISIS SERVICE
THAT I'M HEARING ABOUT SOUNDS
FABULOUS I WISH IT WOULD HAVE
BEEN AVAILABLE TO MY BECAUSE-
ALL PEOPLE SHOULD HAVE ACCESS TO
THE TREATMENT THEY NEED WITHIN
THEIR COMMUNITY NO MATTER WHERE
THAT UNITY IS. IN JAIL SHOULD
NOT BE A PLACE WHERE PEOPLE WITH
MENTAL ILLNESSES ARE ABANDONED
AND FORGOTTEN. THANK YOU FOR
LISTENING TO ME. THANK YOU
SANDRA FOR THE POWERFUL
TESTIMONY. NEXT WE'LL HEAR FROM
DOCTOR AND RE GAY AND WE DANOS
CEO OF THE COMMUNITY ASED
COORDINATION SOLUTIONS PLEASE
BEGIN. THANK YOU TERRIBLE ON
THANK YOU FOR THE OPPORTUNITY TO
PRESENT I BELIEVE I'M A
EMERGENCY PHYSICIAN BASED IN
SEATTLE WASHINGTON AND I WAS
INVITED TO PRESENT DUE TO MY
FIFTEEN YEARS OF EXPERIENCE
SETTING UP A PROGRAMS OF CARE
COMMUNITY BASED PROGRAMS AND
VARIOUS COMMUNITIES AROUND THE
COUNTRY FOR WHAT WE CALL OUR
HIGH UTILIZES INDIVIDUALS THAT
USE. RESOURCES IN A LARGE
QUANTITY INDIVIDUALS STRUGGLING
WITH ISSUES OF MENTAL HEALTH
SUBSTANCE USE DISORDER AND
HOMELESSNESS I THINK MOST OF US
WHO HAVE BEEN DEALING WITH THIS
PATIENT POPULATION WILL TELL YOU
THAT. OFTENTIMES THE RESOURCES
ARE AVAILABLE IN OUR COMMUNITIES
BUT THEIR SILOS AND THEY'RE NOT
EASILY ACCESSIBLE TO THE
PATIENTS THAT NEED THEM. I'M
GONNA SHARE. A- SHORT POWER
POINT SEQUENCE THAT I HAVE. WE
HAVE FOUND THAT- THERE ARE THREE
BASIC COMPONENTS YOUR DOCTOR
ARAMBULA MENTIONED THE PARADIGM
SHIFT WE'RE GONNA HAVE AN
OPPORTUNITY IN CALIFORNIA
THROUGH THE ENHANCED CARE
MANAGEMENT AND OTHER RESOURCES
TO REALLY CREATE THAT PARADIGM
SHIFT BUT WE FOUND IN OUR WORK
THAT TO DO THAT WELL TO CAKE
CARE COORDINATION EFFORTS WE
NEED TO FOCUS. ON THREE AREAS
NEED TO HAVE ENGAGEMENT. DIRECT
PATIENT ENGAGEMENT HAS TO BE
AVAILABLE TO OUR PATIENTS TWENTY
FOUR SEVEN THREE SIX THREE SIXTY
FIVE. MISTER YOU AND EARLIER
TALKED ABOUT UPSTREAM PREVENTION
AND THAT'S WHAT WE WANT TO DO WE
WANT TO CAPTURE AND HELP
INDIVIDUALS BEFORE CRISIS
OCCURRED WE WANT ADDRESS THEIR
NEEDS IN REAL TIME. AND WE HAVE
TO BE ABLE TO FOLLOW UP WITH
EVERY ENCOUNTER. ITEM NUMBER TWO
IS WE HAVE TO BE ABLE TO CONNECT
WITH THE VARIOUS RESOURCES WE
HAVE SO MANY RESOURCES DOING
GOOD WORK IN OUR COMMUNITIES
ACROSS THE COUNTRY BUT THEIR
SILOS. AND WE HAVE TO BE ABLE TO
HAVE HOSPITAL'S EDIE'S EXISTING
CARE TAKERS GOVERNMENT AGENCIES
SUBSTANCE USE AND BEHAVIORAL
DISORDER AGENCIES WORKING
TOGETHER SO WE'RE NOT
DUPLICATING EFFORTS AND FINALLY
WE WANT TO MAKE SURE THAT OUR
HEALTH INFORMATION EXCHANGES.
AND COMMUNITY INFORMATION
EXCHANGES ARE BEING USED
CORRECTLY. TAKE ADVANTAGE OF THE
TWENTY FOUR SEVEN THREE SIX FIVE
NOTIFICATION SO THAT WE CAN.
ENGAGE WITH CLIENTS DURING MOST
CRISIS AND HELP THE END USERS
SUCH AS EMERGENCY PHYSICIANS.
ADDRESS THEIR CARE AND CONNECT
WITH RESOURCES IN THE COMMUNITY.
CORRECTLY WE'VE USED THOSE THREE
TOOLS TO CREATE THE PARADIGM
SHIFTS IN COMMUNITIES AROUND THE
COUNTRY. IN INNER CITY
WASHINGTON. IN RURAL ALASKA. AND
IN SUBURBAN VIRGINIA AND WHEN WE
DO THAT CONSISTENTLY WITH THOSE
THREE TOOLS WE SEE. 425260%
REDUCTIONS IN UTILISATION STRUM
BATIC REDUCTIONS IN OPIOID
UTILIZATION. AND DRAMATIC
IMPROVEMENTS IN COST AND IT'S
NOT ABOUT THE COST IS ABOUT THE
PATIENT CARE. AND THE RESOURCE
CONNECTIVITY BUT FOR US TO MAKE
SURE OR PROGRAMS OR LONG TERM
AND PERMANENT THEY HAVE TO BE
SUSTAINABLE. SO I TOOK THE
LIBERTY OF JUST TAKING SOME DATA
FROM SONOMA COUNTY DATA FROM THE
CALIFORNIA POLICY LAB TWENTY
EIGHTEEN DATA. THAT IDENTIFIED
SIX THOUSAND SIX HUNDRED HIGH
UTILIZES. AT A COST OF TWENTY
SEVEN THOUSAND DOLLARS PER
INDIVIDUAL JUST FOR MEDICAL AND
SHELTER COST. AND WHEN WE APPLY
THE 40% REDUCTIONS THAT WE
CONSTANTLY SEE WITH THE TOOLS
WE'VE MENTIONED EARLIER WE'RE
TALKING ABOUT ONE POINT SEVEN
MILLION DOLLARS IN COST SAVINGS
FOR EACH TWENTY FIVE TWO HUNDRED
FIFTY AND ROLE IS DEFINITELY. A
SUSTAINABLE CARE MODEL SO I'M
PUTTING MY CONTACT INFORMATION
APPEAR I WELCOME QUESTIONS AND I
APPRECIATE THE OPPORTUNITY TO
PRESENT HER. THANK YOU NEXT WE
WILL HEAR FROM TYLER RINDE
EXECUTIVE DIRECTOR FOR THE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES PLEASE BEGIN. GOOD
AFTERNOON CHEN ARAMBULA LINE
MEMBERS MY NAME IS TYLER INDIAN
I'M THE EXECUTIVE DIRECTOR OF
THE CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES- CAB HE THANK YOU FOR
THE OPPORTUNITY TO ADDRESS THE
SUBCOMMITTEE CATERPIE REPRESENTS
FIFTY SAPS FIFTEEN AT SUBSTANCE
USE DISORDER TREATMENT PROVIDERS
ACROSS CALIFORNIA PROVIDING
SERVICES YOUR TRUCK MEDIC COW.
AND A POPULATIONS WITHIN THE
CRIMINAL JUSTICE SYSTEM. TO DATA
FROM THE CDC'S NATIONAL CENTER
FOR HEALTH STATISTICS SHOW THAT
NATIONALLY THERE WERE OVER A
HUNDRED THOUSAND AMERICANS WHO
DIED BY OVERDOSE FROM MAY TWENTY
TWENTY TWO APRIL TWENTY TWENTY
ONE. MORE THAN SIXTY FOUR
THOUSAND OFTHESE FACTS WERE
RESULT OF SYNTHETIC OPIOIDS OR
PANTS AND ALL CALIFORNIA HAS
EXPERIENCED A 45% INCREASE AS
MORE THAN TEN THOUSAND EIGHT
HUNDRED CALIFORNIANS DIED DURING
THE SAME TIME. THIS IS A CRISIS
AT NEW HEIGHTS AND ONE
PREVENTABLE DEATH IT'S TOO MANY
WE BELIEVE THAT THERE NEEDS TO
BE A FOCUS ON HARM REDUCTION M.
A. T. OVERDOSE PREVENTION AND-REVERSAL HOUSING AND. RECOVERY
SUPPORT SERVICES. WITH A DEGREE
ON HOW AND WE ARE SUPPORT OF
THIS AFTER AND- IN BEHAVIORAL
BRIDGE HOUSING. PROVIDERS SHARE
WITH ME ABOUT A SIGNIFICANT
PORTION OF THEIR CLIENTS EXIT
THE STREETS AND A RESIDENTIAL AT
STUDENT SERVICES. AND ONE OF THE
BARRIERS THAT FINDING HOUSING
FOR INDIVIDUALS AFTER
RESIDENTIAL. FOR EXAMPLE 60% OF
INDIVIDUALS START THEIR SAN
FRANCISCO STRUCK MEDIC HOW
ORGANIZED DELIVERY SYSTEM ARE
EXPERIENCING HOMELESSNESS- IN
THE FISCAL YEAR EIGHTEEN
NINETEEN- NUMBERS. STABLE
HOUSING IS CRITICAL FOR LONG
TERM RECOVERY. OFTENTIMES THESE
INDIVIDUALS ALSO NEED SERVICES
THAT HELP FACILITATE THE
RECOVERY AND THERE'S THIS BAND
HOUSING. IS INCLUDED- HOW TO
HAVE A BANK ACCOUNT WRITING
CHECKS GREEN SPACE JOHN- JOB
SKILLS INCLUDING THE USE OF
COMPUTERS AND OTHER- SKILLS AND-
SERVICES THAT THEY NEED.
ADDITIONALLY WE DO KNOW THAT
THERE'S AN INTERSECTION AND
OVERLAP WITH THE FAMILY AND
COMPETENT TO STAND TRIAL
DISCUSSION THAT'S BEEN HOT I'M
IN THIS PANEL TODAY. A HIGH
NUMBER OF INDIVIDUALS DEEMED
INCOMPETENT TO STAND TRIAL ON
FELONY CHARGES- HOW COOL
OCCURRING SUBSTANCE USE NEEDS
AND WE DO NOT WANT TO SEE BACK
FOR GOTTEN PARTICULARLY WHEN.
INDIVIDUALS ARE ON DIVERSION
PROGRAMS. ADDITION WE IT'S- THAT
THE LEAD. PASSED IN THE
GOVERNOR'S ASK FIFTY. BY SENATOR
WIENER WHICH WOULD AUTHORIZE
LOCAL GOVERNMENTS IN OAKLAND SAN
FRANCISCO AND THE CITY AND IN
THE COUNTY OF LOS ANGELES. TO
ESTABLISH OVERDOSE PREVENTION
PROGRAMS BE SUCCESSFUL EVIDENCE
BASED PROGRAMS HAVE BEEN SET UP
IN CANADA AND EUROPE AND MOST
RECENTLY IN NEW YORK CITY- TO
THE TO NEW YORK CITY PROGRAMS
WHICH WERE ESTABLISHED IN
DECEMBER TWENTY TWENTY ONE I'VE
ALREADY REHEARSED OVER. A
HUNDRED AND SEVENTY DOT SEVENTY
OVERDOSES SINCE OPERATING IT
ALSO REDUCED- SYRINGE LETTER AND
A NEIGHBORING PARK BY OVER
NINETY PERCENT. OVERDOSE
PREVENTION PROGRAMS HAVE BEEN
RESTORED- SHOWN TO REDUCE HEALTH
AND SAFETY PROBLEMS ASSOCIATED
WITH DRUG USE INCLUDING PUBLIC
DRUG USE DISCARDED SYRINGES. HIV
AND HEPATITIS INFECTIONS AND
OVERDOSE DEATHS. PEOPLE WHO USE
SUCH A PROGRAM IN CANADA WERE
MORE LIKELY TO ENTER TREATMENT
AND MORE LIKELY TO STOP USING
DRUGS. WE BELIEVE THAT IT IS
TIMELY TO PASS AN AUTHORIZED
THESE PROGRAMS IN CALIFORNIA.
EDITION ONLY ONE OTHER BEAR THAT
I'D LIKE TO MENTION TODAY. IS
THAT- THERE'S AN OVERDOSE
REVERSAL MEDICATION ON THE
MARKET CLOCKS IT OUT WHICH IS AN
EIGHT MILLIGRAM NALOXONE NASAL
SPRAY. WHICH IS DOUBLE THE
STRENGTH OF THE FOUR MILLIGRAM
NALOXONE NASAL SPRAY IN OUR
CAMP. I'M WITH THE RISE IN THE
SPREAD OFFENSE AND ALL WHICH IS
FIFTY TIMES STRONGER THAN
HEROIN. WEEK TREATMENT PROGRAMS
ARE TELLING ME AND LETTING ME
KNOW ON THE GROUND THAT THEY
HAVE STARTED TO USE TWO DOSES
ARE. ON THE FOUR MILLIGRAMS
SPRAY AS- STANDARD PRACTICE TO
REVERSE AN OVERDOSE BUT HAVE.
THERE'S ALSO BEEN CASES WHERE
THEY'VE HAD TO USE UP TO FIVE TO
SIX OUNCES OF- OR MILLIGRAMS
BRIGHT. WE APPRECIATE BY CLOCKS
AND- WITH NOW ON THE MEDIC
CALIFORNIA MARY BUT BELIEVE THAT
IT IS IMPORTANT THAT IT'S ALSO
COVERED ON THE STATE'S THE MARKS
AND DISTRIBUTION PROJECT UNDER
GATES YES. WELL TREATMENT
PROGRAMS ARE AWARE THAT YOU MAY
NEED TO USE MORE THAN ONE DOES
OUT IN A BOX ON. YOUR THAT THE
LAY INDIVIDUAL IS NOT A WHERE.
AND WITH THE ADVENT OF FAN AND
ALL ITS CRITICALLY IMPORTANT
THAT WE ARE A TO RIVER OVER.
VISION WE WERE LOOK FORWARD TO
HEAR MORE DE ABOUT THE
ADMINISTRATION'S CARE COURT-
I'VE PROPOSAL. AND ITS
IMPLICATIONS AND INTERSECT. WITH
ACTIONS WITH SUBSTANCE USE
DISORDER CARE. I'M CAPPY MEMBERS
STAND READY TO ENGAGE IN THE
DISCUSSION. THANK YOU AGAIN AND
HAPPY TO ANSWER ANY QUESTIONS.
THANK YOU NEXT WE WILL HEAR FROM
CHEN ADDS ANY PARTY IN WHO IS
THE CALIFORNIA STATE DIRECTOR
FOR DPA PLEASE BEGIN. THANK YOU
YOUR NAME IS JACKSON ABOUT DAN
AND I'M A CALIFORNIA STATE
DIRECTOR FOR DRUG POLICY
ALLIANCE TOOK POLICY ALLIANCE IS
A NATIONAL ORGANIZATION
PROMOTING DRUG POLICIES GROUNDED
IN SCIENCE COMPASSION. HEALTH
AND HUMAN RIGHTS- I'D LIKE TO
COMMENT ON THE NEED TO REDIRECT
SERVICES RENDERING INDIVIDUALS
WHO PRESENT HIGH NEED. IN ORDER
TO ALLOW THEM TO ACCESS THE
LIFESAVING AND CRITICAL SERVICES
FOR OF SUBSTANCE USE AND MENTAL
HEALTH NEEDS- MANY OF THE
COLLEAGUES HAVE MADE ALL THE
PLAYS THAT I WANTED TO MAKE IN
MY TESTIMONY SUMMIT I KEEP IT
REALLY BRIEF AND SHORT- I THINK
IT'S REALLY IMPORTANT TO
SUPPORT- PROPOSALS LIKE BRIDGE
HOUSING I THINK IT'S REALLY
IMPORTANT FOR THE LEGISLATURE TO
UNDERSTAND. THAT TREATMENT IS A
CONTINUUM AND MANY TIMES FOLKS
THAT ARE IN TEMPORARY HOUSING OR
THINGS LIKE RIDGE HOUSING WE DO
NEED SUPPORTIVE SERVICES AND YOU
NEED ACCESS TO HARM REDUCTION-
SERVICES AS WELL- WE KNEW THAT
FOR EXAMPLE WITH A J. GREEN KEY.
ESPECIALLY IN PLACES LIKE IN LA
AND SAN FRANCISCO MANY OF THE
PARTICIPANTS IN THE PROGRAM
ALTHOUGH THEY HAD TEMPORARY
HOUSING DID NOT HAVE ACCESS TO
CRITICAL SERVICES INCLUDING
ACCESS TO SYRINGE EXCHANGE
PROGRAM SERVICES HARM REDUCTION
SERVICES. WHICH MADE- MADE IT A
LOT HARDER FOR INDIVIDUALS TO BE
ABLE TO SUSTAIN EVEN THEIR
TEMPORARY HOUSING- UNITS THAT
THAT THEY WERE FORTY DURING THE
PANDEMIC WE ALSO SAW HIGH
NUMBERS OF INDIVIDUALS
UNFORTUNATELY. DIE IN THESE
TEMPORARY HOUSING UNITS ON
BECAUSE THERE WAS NO COORDINATED
DELIVERY OF THE OF ALL THE
SERVICES THAT FOLKS NEED IN
ORDER TO- YOU KNOW IN SHORT THAT
THEY ARE ABLE TO. CONTINUE TO
LIVE HEALTHY LIVES OR MAKE IT
FOR ANOTHER DAY SO THEY COULD AT
LEAST ACCESS TREATMENT WHEN
THEY'RE READY AND SO WE'RE
REALLY WANT TO MAKE SURE THAT ON
THE LEGISLATURE UNDERSTAND THAT
WE NEED TO PROVIDE. WRAPAROUND
SERVICES EVEN FOR THOSE FOLKS
THAT ARE. ABLE TO ACCESS
TEMPORARY HOUSING- THE NEED FOR
THOSE LINKAGES. ARE ARE ARE
PRESENT NOW MORE THAN EVER- AND
LYFT LIKE- ALSO LIKE TO-
RECOMMEND THAT WE- SECURE THAT.
OF SB FIFTY SEVEN ON OVERDOSE
PREVENTION SERVICES THIS WOULD
GO A LONG WAY AND IN THE
TREATMENT OF HIGH NEEDS
INDIVIDUALS. OPC IS NOT ONLY
PROVIDE A CLINICAL BASED SETTING
TO ENSURE THAT NO ONE. DIES
ANOTHER OF AN OVERDOSE THAT MORE
CLEARLY PROVIDES AN OPPORTUNITY
FOR INDIVIDUALS TO BE CONNECTED
TO THOSE SOCIAL SUPPORTS ARE
REALLY IMPORTANT. IN THEIR
RECOVERY AND INCLUDE ACCESS TO
BOTH HEALTH AND- MENTAL HEALTH
AND HOUSING RESOURCES AS WELL AS
FOOD. AND JOB TRAINING- HAVING
OF PC'S WORK IN PARTNERSHIP
WITH. YOUR HEALTHCARE DELIVERY
PLANS WILL PROVIDE A MAJOR
OPPORTUNITY TO PROVIDE SERVICES
TO THE ARD TO SERVE. HARD TO
REACH POPULATIONS IN CALIFORNIA
SIMILAR TO CALIFORNIA'S DRUG
TREATMENT NAVIGATORS WHICH MAKE
THESE LINKAGES FOR THOSE FOLKS
ON THE GROUND. AND ENSURE THAT
FOLKS ARE HAVING A WARM HANDOFF.
ANOTHER CONSIDERATION IS THE
RACIAL EQUITY AND CITIZENSHIP
STATUS OF THE HIGH NEEDS
POPULATION. CALIFORNIA PROVIDING
SERVICES IN A MANNER THAT IS
CULTURALLY APPROPRIATE AND IN
LANGUAGE AND DOES NOT CREATE
MORE BARRIERS FOR THE STATE'S
NONCITIZEN. POPULATION IS KEY
HERE- WE NEED TO ENSURE THAT
INDIVIDUALS REGARDLESS OF
IMMIGRATION STATUS ARE ABLE TO
ACCESS THE SERVICES WITHOUT FEAR
OR STIGMA AND WITHOUT THE HEAVY
HAND OF LAW ENFORCEMENT. OR ICE
ENFORCEMENT TO THE EXTENT
POSSIBLE IS NEEDED-
ADDITIONALLY- WE ALSO- ONE ECHO
OF THE PRIOR PANEL ON THE NEED
FOR. PEER TO PEER MODELS- AND
SUBSTITUENT LIAISONS AND WORKING
WITH COMMUNITY HEALTH WORKERS
ARE FROM WITHOUT US. I'M
BEHAVIORAL HEALTH WILL HELP.
ALLOW THE STATE TO MAKE DEEPER
INROADS ON WITH COMMUNITIES THAT
AGAIN ARE HARD TO SERVE IN HARD
TO REACH. AND THEN FINALLY
SHIFTING AWAY FROM
CRIMINALIZATION AS NOTED
PREVIOUSLY IS REALLY IMPORTANT
TO ENSURE THAT HIGH NEEDS
POPULATIONS ARE ACCESSING THE
SERVICES THEY NEED- EN LA FOR
EXAMPLE. WE RECENTLY HIGHLIGHTED
A PROGRAM. THAT MEANT HEALTH
TEAM WRIST NINE ONE ONE.
RECOGNIZE THE FACT AND THE IN
YOUR INCLUDING INDIVIDUALS THE
FIRE DEPARTMENT OFTEN CAUSE MORE
TRAUMA. TO THOSE IN NEED TO
SERVICES WE COULD GO WE ACTUALLY
WOULD RECOMMEND GOING A STEP
FURTHER AND ENSURING THAT THESE
TEAMS. HAVE STAFF A REDUCTION
ORGANIZATIONS AND INDIVIDUALS
WITH LIVED EXPERIENCE THAT CAN
IMMEDIATELY BUILD TRUST. AND
RELATIONSHIPS WITH PEOPLE ON THE
GROUND AND THOSE ARE ON HOUSING
NEEDS OF CRISIS SERVICES. TO
ENSURE AGAIN THAT THERE IS A
WARM HAND OFF. THE INDIVIDUAL
ALONG WITH A CARE PROVIDER IN
THE BEST POSITION TO MAKE THE
DECISIONS FOR THE CARE. AND
SHOULD NOT BE LEFT TO THE
CRIMINAL JUSTICE SYSTEM OR OR OR
ANY OTHER BARRIER- TO CAUSE MORE
TRAUMA THAN CARE THANK YOU AGAIN
FOR ALLOWING ME THE OPPORTUNITY
TO COMMENT. TODAY THANK YOU VERY
MUCH OF THAT IS THE CONCLUSION
OF OUR PRESENTERS FOR ISSUE TO
ALL. BRING IT UP TO THE DÍAS TO
SEE IF WE HAVE ANY QUESTIONS
SEEING NON I WILL. KEEP IT WITH
THE CHAIR I WILL BEGIN WITH THE
DEPARTMENT OF HEALTH CARE
SERVICES FOR EITHER J. C. COOPER
DR PFEIFFER. I WANTED TO ASK
ABOUT THE BRIDGE HOUSING.
PROPOSAL- WITHIN THE PROPOSAL.
IT STATES THAT DH CS EXPECTS
COUNTY BEHAVIORAL HEALTH
DEPARTMENTS AND MEDICAL MANAGED
CARE PLANS TO IMPROVE
COORDINATION. TO SERVE PEOPLE
WITH ACUTE BEHAVIORAL HEALTH
CHALLENGES. WHAT DOES IT MEAN
THAT YOU EXPECT COUNTY
BEHAVIORAL HEALTH DEPARTMENTS
AND MEDICAL MANAGED CARE PLANS
TO IMPROVE THE COORDINATION TO
SERVE PEOPLE AND WHAT SORT OF
ACCOUNTABILITY WILL WE PUT IN
PLACE TO ENSURE THIS. WOULD YOU
WANT TO GO AHEAD AND TAKE THAT
QUESTION. SURE HE TO THE PEOPLE
WHO ARE SERVED BY THE COUNTY
MANAGED CARE THAT THE BAY COUNTY
BEHAVIORAL HEALTH. HAS THE- MOST
OF THEM PARTICIPATED MEDICARE
MANAGED CARE AND WE ARE
LAUNCHING NEW SERVICES IN
CALLING. BETTER THAN HAND CARE
MANAGEMENT WHICH REQUIRED THE
MANAGED CARE PLANS TO DESIGNATE
A COMMUNITY BASED- COORDINATOR
MANAGER WHO IS ACCOUNTABLE TO
MAKE SURE THAT ALL SERVICES
NEEDED BY A CLIENT WHETHER THOSE
ARE SOCIAL SERVICES MEDICAL
SERVICES BEHAVIORAL HEALTH
SERVICES. ARE COORDINATED IN IN
CALAIS MORE ALSO EXPECTING MATCH
THE BEHAVIOR HEALTH ORGANIZATION
LEAD TO COUNTY MENTAL HEALTH
PLANS ARE EXCHANGING DATA WITH
MANAGED CARE PLANS SPECIFICALLY
TO MAXIMIZE CARE COORDINATION SO
WE SET UP A PROGRAM CALLED THE
VEHICLE QUALITY IMPROVEMENT
PROGRAM WHICH- HAS A SET OF
MILESTONES AND METRICS THAT-
REQUIRED B. PLANS AND PENALIZE
THE MENTAL HEALTH PLANS TO
EXCHANGE DATA AND LIKEWISE ON IS
CARE. WERE HAVING THE SAME SET
OF EXPECTATIONS BECAUSE WE
RECOGNIZE THAT PEOPLE COMING OUT
OF THE WHOLE PACKAGE THEY DON'T
COME AS A- MEDICAL CARE ONE PART
OF THE IRAQ CARE ANOTHER CARD
YET. A LOT OF A CALENDAR DOING
ANY IN OUR EFFORT TO- SUPPORT
WHOLE PERSON CARE HE IS GETTING
THE HEALTH PLANS ON BOTH SIDES
OF THE CAR ABOUT TO STEP UP AND
WORK TOGETHER. KATIE DID I MISS
ANYTHING. NO BUT THAT WAS THANK
YOU. ALONG THE LINES THEN
FOLLOWING WITH WHAT GENET BUT
HAD JUST SAID I IT IS THOSE
WRAPAROUND SERVICES YOU WERE
MENTIONING. THAT WILL BE
IMPORTANT FOR US TO MAKE SURE
THAT THOSE WHO ARE PLACED IN
LONG TERM HOUSING. CAN STAY
SUCCESSFULLY WITHIN THAT LONG
LONG TERM HOUSING THAT I'D LIKE.
TO KNOW SINCE KELLY MS A
PROPOSAL THAT WILL TAKE AWHILE
FOR US TO GET UP AND RUNNING.
HOW WE WILL HAVE THE CONFIDENCE
THAT THE SUPPORTS THAT THEY NEED
WILL BE BOTH PROVIDED AND
ACCESSIBLE. I'M HOPING YOU CAN
TALK ABOUT THE SEQUENCING- OVER
THIS BRIDGE HOUSING PROPOSAL.
THE ALL STAR AND THEN KELLY BY
ALL MEANS YOU CAN ADD ON SO I
THINK YOU'RE ONE OF THE ONE OF
THE BIGGEST TAKE UP THAT WE'VE
HAD OF THE COMMUNITY SUPPORT
OFFERINGS IS THE HOUSING SWEET
SO. ON MAJORITY OF A PLANS
ACROSS THE STATE ARE PICKING UP
THE HOUSING TRANSITION SERVICES
THEY HOUSING DEPOSIT AND THE
HOUSING LIAISON SERVICES ONCE
SOMEBODY IS HOUSE. I'M SO I
THINK THERE IS BROAD
OPPORTUNITIES ALSO AYE WE'RE
SEEING MORE AND MORE TAKE UP
OVER THE YEARS WHICH WE POSTED
THE SCHEDULE ALL COMMUNITY
SUPPORTS AROUND THAT ONLINE.
AROUND RECUPERATIVE KERR IN
RECUPERATIVE CARE CAN BE
PROVIDED FOR INDIVIDUALS WITH
BOTH PHYSICAL HEALTH AND
BEHAVIORAL HEALTH NEEDS I'M TO
MAKE SURE OF BUILDING THAT FULL
CONTINUUM IDENTIFYING
INDIVIDUALS WHO MAY BE GOOD
CANDIDATES FOR THIS TYPE OF
HOUSING. AND THEN WORKING TO YOU
OUT LINK THOSE PIECES ACROSS ARE
YOU MENTION THOUGH. IT IS NOT
STATEWIDE TODAY- THAT WOULD
JUSTIFY THAT THE MAJORITY OF. A
PLANS ARE REALLY PICKING UP THE
HOUSING SUITES SO IT WILL
CONTINUE TO PROVIDE A PATH
FUNDING OPPORTUNITIES FOR
INDIVIDUALS ACROSS THE STATE OF
CALIFORNIA TO PICK UP THOSE
COMMUNITIES SUPPORTS WHERE WE
HAVE NOT SEEN THAT PICKED UP
TODAY- AND WILL CONTINUE TO
PROVIDE THAT OPPORTUNITY WHICH
WOULD INCLUDE FOR OUR COUNTY
PARTNERS COUNTY PARTNERS CAN BE
PROVIDERS OF COMMUNITY SUPPORT.
THEY CAN BE A PROVIDERS OF THE
HOUSING SWEET SERVICES AND
OFTENTIMES COUNTY BEHAVIORAL
HEALTH DEPARTMENTS HAVE BEEN
HUGE LEADERS IN THIS SPACE AND
THAT WE ARE HOPING THAT. THEY
CAN PARTNER WITH THE MANAGED
CARE PLANS TO BE COMMUNITY
SUPPORT PROVIDERS SO THEY HAVE
ALL OF THE TOOLS AT THEIR
FINGERTIPS TO CONNECT ALL OF
THESE RESOURCES. FOR PEOPLE WHO
ARE VERY MUCH IN NEED. I WILL
FOLLOW UP WITH THE SPUR. POINT
YOU HAD BROUGHT UP PASSED THE-
PORTION OF TELLING. I WANTED TO
FOLLOW UP WITH DR VERONICA KELLY
WHO SAID THAT THERE'S NO HOUSING
IF THEY'RE LEAVING. THE JAIL DUE
TO THEM CURRENTLY BEING IN THE
JAIL. THANK YOU COULD ELABORATE
A LITTLE BIT MORE ON HOW WE
COULD REALLY WORK. WITH THIS
POPULATION TO ENSURE. THAT WE
ARE ENCOURAGING HOUSING AFTER
LEAVING INCARCERATION HOPING YOU
COULD COMMENT ON THAT. FOUR SO
ONE OF THE COMPONENTS THAT WE
ARE STILL NEGOTIATING WITH THE
FEDERAL GOVERNMENT IS OUR
JUSTICE PACKAGE WHICH INCLUDES A
NINETY DAY IN REACH WHILE
SOMEONE IS CURRENTLY
INCARCERATED IN PRISONS JAILS
FOR. A JUVENILE FACILITIES ON IN
ONE OF THE MAIN COMPONENTS OF
THAT IS- BERRIES CASE MANAGER
CAN P. M. COMPNENT AND LINKAGES
TO OUR COMMUNITY SUPPORT. SO ONE
OF THE THINGS THAT WE'RE HOPING
TO ACHIEVE NOW THIS WILL TAKE
TIME TO IMPLEMENT WE'RE STILL
NEGOTIATING- AND WE WOULD BE
WILLING ON PHASES IN CALIFORNIA
OF COURSE. BUT THE IDEA IS TO BE
ABLE TO IDENTIFY GOOD CANDIDATES
FOR THESE TYPES OF COMMUNITY
SUPPORT WHILE THEY ARE
INCARCERATED SO WE ARE PROVIDING
THOSE LINKAGES UPON RE ENTRY
BACK INTO THE COMMUNITY. BY THAT
POINT WE'RE HOPING WE'LL HAVE
MORE- PENETRATION OF THESE
SERVICES ACROSS THE STATE OF
CALIFORNIA IF SO THAT IS A HUGE
OPPORTUNITY FOR US WE'RE ALSO
LOOKING ABOUT HOW WE CAN CREATE
WORK- JUSTICE INVOLVED. YOU KNOW
I CONTINUE ON WITH THAT JUSTICE
REENTRY PROPOSAL AS WELL LOOKING
AT HOW WE CAN MAKE SURE THAT
INDIVIDUALS WITH APPEARS WITH
YOUR JUSTICE INVOLVED EXPERIENCE
CAN BE PARTICIPATING IN OUR
DELIVERY SYSTEM. INCLUDING SOME
OF THOSE LINKAGES FOR
INDIVIDUALS LEAVING
INCARCERATION BACK INTO THE
COMMUNITY AND PROVIDING THOSE UP
FRONT CONTINUE ONE ALSO THAT IS
THE LONG TERM GOAL OF WHAT WE'RE
TRYING TO ACHIEVE- AND AS WE
CONTINUE TO NEGOTIATE WITH CMS
WILL BE HAPPY TO KEEP EVERYBODY
APPRISED OF THOSE. DISCUSSIONS A
FINAL QUESTION ON BRIDGE HOUSING
AND- I WANT TO GET A SENSE ABOUT
HOW WE COULD ENSURE EQUITABLE
DISTRIBUTION OF THESE RESOURCES
ACROSS OUR STATE- WAS THERE
GOING TO BE A PRIORITY. TO
STATION- WOULD WE LOOK TOWARDS.
AREA THAT- HAD MANY OF THE JAILS
OR HOW ARE YOU GOING TO BE
LOOKING TO SPEND. THIS BRIDGE
HOUSING FUNDING. JERRY ALL THE
FOR TO YOU IN A TO WHAT OUR
CURRENT THINKING IS ON THE
ALLOCATION OF FUNDS FOR THE
BRIDGE HOUSING. I THINK I THINK
TRYING TO BALANCE THE-
GEOGRAPHIC EQUITY OR WITH THE
NEEDS OF THE INDIVIDUAL COUNTY
IS A BOOKING AT OUR VEHICLE
HEALTH ASSESSMENT TO HELP GUIDE
US THROUGH. I THINK WE ARE
ACTIVELY WORKING ON. HOW TO MAKE
SURE THAT WE'RE USING THE MONEY
EFFECTIVELY ACROSS THE STATE AND
I DON'T HAVE ANY ADDITIONAL
DETAILS AT THIS TIME. WOULD LOVE
TO FOLLOW UP ON THAT I WILL NOW
TRANSITION FOR TO THE DEPARTMENT
OF STATE HOSPITALS. AND FOCUS ON
I. S. T. FOR MY NEXT NUMBER OF
QUESTIONS. SO I WILL I WILL
BEGIN WITH- DIRECTOR CLINTON AND
IF I CAN. I'M TRYING TO. JUST
UNDERSTAND THE SYSTEM AND SO I'D
LIKE TO UNDERSTAND THE INPUT.
MIGHT- SO WHY HAPPENS WHEN A
PUBLIC DEFENDER OR ANOTHER
DEFENSE ATTORNEY BELIEVES THAT
THEIR CLIENT MAY BE INCOMPETENT
TO STAND TRIAL. WHO CURRENTLY
PERFORMS THAT COMPETENCY
EVALUATION. WHAT ARE THEIR
CREDENTIALS AND HOW DO WE ENSURE
THE COMPETENCY OF THESE
PROFESSIONALS. WHAT HAPPENS WHEN
AN INDIVIDUAL- IS ARRESTED ON
AND IS- SUSPECTED OF BEING
INCOMPETENT TO STAND TRIAL IS
THAT AND SOMEONE WHO WOULD RAISE
THE DOUBT THAT DOESN'T
NECESSARILY HAVE TO BE JUST A
PUBLIC DEFENDER BUT- THE AT THE
TECH HAPPENED THAT DOT WOULD BE
REYES AND THEN THE COURT WOULD
APPOINT A COURT APPOINTED AND-
EVALUATOR USUALLY A
PSYCHOLOGISTS- MORE
PSYCHIATRISTS TO OPINE ON THE-
INDIVIDUALS COMPETENCY STATUS-
AND SO THEN AT THAT END OFIT
DOT COMPETENCY REPORT IS
COMPLETED AND SUBMITTED BACK TO
THE COURT- BE. SEVERAL YEARS
AGO- AND I CANNOT REMEMBER THE
STATUE NUMBER OFF THE TOP OF MY
HEAD BUT THERE WAS STATUTES THAT
WHAT DID ASK- AND REQUIRE THE
DEPARTMENT TO PRINT TO PRODUCE-
STANDARDS. FOR COURT APPOINTED
EVALUATORS- AND SO WE DID ISSUE
REGULATIONS AROUND THOSE COURT
APPOINTED EVALUATORS AND THEIR-
THEIR RECOMMENDED TRAINING
LEVELS FOR THOSE INDIVIDUALS AND
EXPERIENCE LEVELS- BE. THAT IT
DOES ALLOW IF THERE IS A
SITUATION WHERE COURT IS UNABLE
TO- I FIND SOMEONE TO MEET THOSE
NEEDS TO STILL BE ABLE TO
APPOINT AN EVALUATOR. SO THERE
BUT THERE ARE EXISTING-
GUIDELINES I GUESS IF YOU WELL
ON WHAT THOSE REQUIREMENTS WOULD
BE AND I DO HAVE- DIRECTOR AND
DR WARBURTON WHO WAS
INSTRUMENTAL IN THE DEVELOPMENT
OF THOSE REGULATIONS- ON THE
LINE FOR QUESTIONS AND THE
ANSWERS THAT SHE MAY BE ABLE TO
SHARE A LITTLE BIT MORE DETAIL
ABOUT WHAT THOSE TRAINING
REQUIREMENTS ARE. DR WARBURTON
ARE YOU AVAILABLE YES I AM I
REQUIREMENTS ARE- SORT OF MULTI
LAYERED ANYTHING FROM REQUIRING-
BOARD CERTIFICATION AND A
FORENSIC SUBSPECIALTY FOR
PSYCHIATRISTS AND PSYCHOLOGISTS
OR A CERTAIN NUMBER OF HOURS OF
TRAINING- IN THE ASSESSMENTS OF
COMPETENCY TO STAND TRIAL SO
THEY WERE REALLY- TRAINING
REQUIREMENTS- THAT WERE
SUGGESTED IN RECOMMENDED. SO I
HAVE A GOOD SENSE NOW OF WHO
HELPED TO DETERMINE THAT BUT
ONCE THE DEFENDANT NOW HAS BEEN
DETERMINED. TO BE INCOMPETENT TO
STAND TRIAL WHO THEN DETERMINES
WHAT TYPE OF COMPETENCY
TREATMENT PROGRAM OR FACILITY TO
WHICH THE DEFENDANT WILL BE
REFERRED IS THAT A COURT
DECISION OR IS THAT SIMILARLY
MADE BY THE PSYCHOLOGIST OR
PSYCHIATRIST. SO AND SO ONCE AN
INDIVIDUAL IS FOUND INCOMPETENT
TO STAND TRIAL THEN THE NEXT
STEP IS THAT IT'S REFER TO THE
COMMUNITY PROGRAM DIRECTOR WHICH
IS A FUNCTION OF OUR
CONDITIONAL. RELEASE ACT GIVE ME
CONDITIONAL RELEASE PROGRAM AND
THAT COMMUNITY PROGRAM DIRECTOR
THAN APPLIANCE ON WHETHER
SOMEBODY AND SHOULD BE
CONSIDERED FOR OUTPATIENT
TREATMENT OR AND IS MORE SHOULD
BE. CONSIDERED FOR A LOCKED
FACILITY SO IT'S REALLY KIND OF
LIKE THE DECISION OF LOCKED OR
UNLOCKED AND THEN THOSE
INDIVIDUALS- ARE THEN THE COURT
WILL MAKE ANY- A RECOMMENDATION
OR EXCUSE ME A COMMITMENT TO THE
DEPARTMENT- OR TO THAT
CONDITIONAL RELEASE PROGRAM IF
THE INDIVIDUAL WAS CHOSEN FOR
THAT CONDITIONAL RELEASE
PROGRAM- ONCE INDIVIDUAL COMES
TO THE DEPARTMENT IS COMMITTED
TO THE DEPARTMENT- INDIVIDUALS
CAN BE DIRECTED BY OUR PATIENT
MANAGEMENT UNIT. INTO OUR STATE
HOSPITALS OR INTO THE JAIL BASED
COMPETENCY TREATMENT PROGRAM AND
THEN- WE ALSO HAVE THE
PARTNERSHIP WITH OUR DIVERSION
PROGRAMS- RELATED TO IN DEMAND
TO OFFER DIVERSION OPPORTUNITIES
AND THOSE INDIVIDUALS.
INDIVIDUALS CAN BEING REVIEWED
BY THOSE PROGRAMS AS WELL TO
MAKE DECISIONS ON WHETHER
SOMEONE MIGHT QUALIFY ù THE
PLACEMENT IN ONE OF THEIR
DIVERSION PROGRAMS AND THEN IF
SOMEONE IS ABLE TO BEING PLACED
IN A DIVERSION PROGRAM- THEN A
PETITION WILL GO BACK TO THE
COURT REQUESTING THAT PLACEMENT
INTO INTO THE VERSION. AND THEN-
SIMILARLY WITH OUR COMMUNITY
BASED PARTNERSHIPS IN- IN LA
THEY ALSO WILL PETITION THE
COURT THEY MAKE THE
DETERMINATION LOCALLY WHETHER
SOMEONE IS ELIGIBLE FOR THEIR
ADS THERE ARE COMMUNITY BASED
PROGRAM AND THEN PETITION THE
COURT FOR THAT CASE MEANT A
PLACEMENT IN THE COMMUNITY IS
REALLY MORE OF A CONDITIONAL
RELEASE IT IS CONSIDERED AN
OUTPATIENT. PROGRAM AND SO YOU
REALLY HAVE TO LOOK I FACTORED-
PUBLIC STATE AND TO THE CLINICAL
AND SO ULTIMATELY THAT THE COURT
AND I AND HERE'S EVERYBODY'S
PERSPECTIVES ON THAT BEFORE THEY
MAKE A DETERMINATION ON WHETHER
SOMEONE CAN BE SAFELY TREATED IN
THE COMMUNITY. I JUST WANNA MAKE
SURE I UNDERSTAND THAT THE
CONRAD. THE PERSON WHO YOU WERE
MENTIONING IS THAT A EMPLOYEE OF
THE STATE OR IS THAT A COUNTY
EMPLOYEE. I'M GONNA ACTUALLY US-
CHANGING W. DIRECTOR EVEN TO
TALK A LITTLE BIT MORE ABOUT
THAT COMMUNITY PROGRAM DIRECTOR
ROLE AND SHE'S USED TO SERVE AS
OUR FORENSIC SERVICES. MORE
INDEFINITELY ABOUT THAT ROLE.
THANK YOU YEAH AS IT RELATES- AT
ONE POINT OF CLARIFICATION- THE
CHAIR IS THAT- WE'RE TALKING
ABOUT THE PROCESS SPECIFIC TO
INDIVIDUALS WHO ARE I. S. T.
FOUND I. S. T. ON A FELONY
CHARGE IF IT'S AN INDIVIDUAL
WHO'S BEING. WHO HAD- BEEN
CHARGED WITH A MISDEMEANOR THAT
IS REALLY THE RESPONSIBILITY OF
THE COUNTIES AND SO THAT WOULD
BE A DIFFERENT PATHWAY IS
INDIVIDUAL HAS THAT FELONY
CHARGE THEN YES- AS AS IT
RELATES TO CPD'S WILL EAT THAT
APARTMENT ST HAN- STATE
HOSPITALS DO CONTRACT WITH
MULTIPLE PRIVATE PROVIDERS AND-
AND WE HAVE SEVEN COUNTY
PROVIDERS SO THERE ARE SEVEN
COUNTIES. ACROSS OUR SYSTEM THAT
DO PROVIDE THAT THAT SERVICE-
BUT THE LAW DOESN'T REQUIRE THE
COUNTY IS TO PERFORM THESE
SERVICES SO THE OTHER COUNTIES
ARE COVERED BY PRIVATE
PROVIDERS. I'M HAPPY TO FOLLOW
UP OFF LINE BUT- REALLY WHAT I'M
TRYING TO GET AT IS THE INPUT TO
IS IT THAT- AS WAS STATED THERE
ARE AN INCREASING NUMBER OF I.
S. T. PATIENTS BEING REFERRED IS
THAT A FUNCTION OF THE- HEALTH
DIRECTOR WHO'S MAKING THAT
DETERMINATION OR IS IT CAPACITY
CONSTRAINTS THAT WE CURRENTLY
HAVE WITHIN THE STATE HOSPITALS
AND SO I WILL. NEXT MOVE ON TO A
COMPARISON THE RESTRAINTS
CONSTRAINTS IF I CAN AS ON THE
TOP OF THE PAGE TWENTY FOUR IT
STATES THAT THAT'S REALLY THE
REASON THAT WE HAVE THESE
ONGOING BACKLOGS OF DEFENDANTS
BOTH IN THE COUNTY JAILS AS WELL
AS IN OUR STATE HOSPITALS THAT
I'D LIKE TO UNDERSTAND ARE THESE
CAPACITY CONSTRAINTS. BEDS. OR
STAFF OR BOTH. EIGHT I WILL TAKE
THAT QUESTION IN SO REALLY WE
HAVE IT- IS. A LITTLE BIT OF
BOTH SO THE FIRST IS BEING IN
THE REFERRALS HAVE BEEN
INCREASING SO THE REFERRALS FROM
THE COURT THIS WOULD BE IN THE
REFERRALS THAT ARE COMING FROM
THE SUPERIOR COURT. THEY DEEM
SOMEBODY INCOMPETENT TO STAND
TRIAL THAT BECOME AN INDIVIDUAL
WHO IS INCOMPETENT TO STAND
TRIAL AS CHIEF DEPUTY DIRECTOR
EVENS POINTED OUT- HE WAS
CHARGED ON FELONY CHARGES. IS
THAT COMMITTED TO THE DEPARTMENT
AND SO THE NUMBER OF REFERRALS
COMING FROM OUR COURTS HAS
CONTINUED TO INCREASE WE HAVE
RESPONDED WITH A LOT OF CAPACITY
INCREASES BUT- BASED ON THE
LEVEL OF CAPACITY THAT WE HAVE
BEEN ADDING. PRIOR TO THE
PANDEMIC WE HAD ADDED OVER A
THOUSAND BEDS TO TREAT THE
INCREASING REFERRALS BUT WE
STILL MAINTAIN THAT WEIGHT ONCE
THOUGHT IT WAS ABOUT- SOMEWHERE
IN THE EIGHT HUNDRED MARK WHEN
WE WENT INTO EIGHT HUNDRED
INDIVIDUALS ON THE WAIT LIST
WHEN WE WENT INTO THE PANDEMIC.
BUT THE PANDEMIC HAS CERTAINLY
EXACERBATED THAT LAST. SO WE
HAVE HAVE. DUE TO LIKE OUR
CAPACITY AT THE STATE HOSPITALS
IS BEEN REDUCED THROUGH THE
PANDEMIC. BECAUSE WE OPERATED
OUT OF BACK OUT THAT'S A 9295%
OCCUPANCY ALL OF OUR BEDS WERE
PRETTY MUCH AN ACTIVATED AN OPEN
ACROSS ALL OF OUR HOSPITALS AND
OVER THE COURSE OF ALL THIS
CAPACITY EFFORTS TO TRY TO
ADDRESS THE I. S. TEASE. AND
ADDS WE HAD TO IMPLEMENT IN
INFECTION CONTROL MEASURES
RELATED TO IT IN RESPONSE TO THE
PANDEMIC WE HAD TO CREATE A
MISSION OBSERVATION UNITS WE
HAVE TO CREATE ISOLATION UNITS
WE CONTACT. GREAT PLACES FOR
TWO. PERSONS WHO ARE UNDER THE
INVESTIGATION FOR KOBE I'M
BECAUSE WE HAVE A VERY LARGE
DORM HOUSING UNITS WHICH IS
VERY- OBVIOUSLY IN THE CONTEXT
OF CODE IT IS VERY. VERY
DIFFICULT TO MANAGE- IN THAT
ENVIRONMENT TO MANAGE THE
TRANSMISSION. SO IT OUR BEST
DEFENSE IS TO TRY TO CAPTURE
INDIVIDUALS AS THEY'RE COMING
INTO OUR SYSTEM TO DETERMINE
WHETHER THEY HAVE COVERED BEFORE
WE MOVE INTO A HOUSING UNITS WE
HAD TO CREATE ALL THAT THESE
THESE UNITS THAT WE DIDN'T. HAVE
A VACANT WE HAD TO CREATE THOSE
SPACES SO OUR CAPACITY HAS BEEN
REDUCED- WITH RESPECT TO THE
TREATMENT OF IDEAS TO USE
BECAUSE THAT IS ONE OF THE- THE
QUICK TURN- PATIENT COMMITMENT
TYPES. THAT YOU KNOW WE JUST
CHARGE PEOPLE QUITE FREQUENTLY
SO AT THE BEGINNING OF THE
PANDEMIC WE WERE ABLE TO WE HAD
TO HALT ADMISSIONS. AND THEN-
CREATE THIS VACANT SPACE TO
CREATE ALL THESE PANDEMIC.
RESPONSE UNITS. MAYBE THEN I'LL
LAST THE QUESTION DIRECT UP IT
SEEMS THAT MOST OF OUR FOCUS HAS
BEEN ON BEDS EVEN THIS YEAR WE
HAVE TO EARN SIXTY SEVEN
MILLION. AUTHORIZED TO HELP US
WITH SOME ACUTE BED CAPACITY IN
THE THOUSAND BEDS THAT YOU
REFERENCED. WHERE ARE WE WITH
STAFFING WAIT WHAT WHAT'S OUR
VACANCY RATE CURRENTLY WITHIN
THE STATE HOSPITALS FOR
PROVIDERS TO HELP TO. PROVIDE
THE NECESSARY ATTENTION TO HELP
US TO TRY TO RESTORE COMPETENCY
ARE WE EFFECTIVELY STAFFING UP
AND HALF THE WORK FORCE- WITHIN
OUR STATE HOSPITALS. TO ADDRESS
THE NUMBER OF ICED. PATIENTS
THAT WE HAVE IN OUR SYSTEM.
THANK YOU AND I APOLOGIZE I
DON'T HAVE A AND B. VACANCY
RATES. WITH ME AT THE MOMENT BUT
WE'RE CERTAINLY HAPPY TO FOLLOW
UP WITH- VACANCY RATES WITH
RESPECT TO OUR KIND OF CLINICAL
AND POSITIONS- BUT GENERALLY-
YOU KNOW OUR SYSTEM HAS ALWAYS
BEEN A HARD TO RECRUIT AND
RETAIN SYSTEM GIVEN THE NATURE
OF THE WORK THAT WE DO IN THE
LOCATIONS OF THAT. THE
GEOGRAPHIC LOCATIONS OF OUR
STATE HOSPITAL SO WE'VE ALREADY
HAD THOSE CHALLENGES- WE
CERTAINLY MAINTAIN- AND BALANCE-
I WOULD HAVE CIVIL SERVANTS BUT
ALSO MAINTAIN REGISTRY CONTRACTS
TO ASSIST US WHEN WE AREN'T ABLE
TO MAKE- TO HIRE- ENOUGH
CLINICIANS INTO CIVIL SERVICE-
BUT WE CERTAINLY- HAVE
CHALLENGES WITH RESPECT IT- TO.
THE CLINICAL POSITIONS ARE
NURSING POSITIONS- CERTAINLY
HAVE BEEN IMPACTED BY THE THAT
PANDEMIC AS MANY- HEALTH- CARE
PROVIDERS HAVE EXPERIENCED AS
RELATED TO THE PANDEMIC. BUT WE
AS A DEPARTMENT HAVE ALWAYS
LOOKED TO BUILD OUR PIPE LINES
INTO THAT INTO THE DEPARTMENT
WITH PARTNERSHIPS WITH MANY
TRAINING INSTITUTIONS ACROSS OUR
PROGRAMS MOST RECENTLY- THANK
YOU TO THE SUPPORT OF THE
LEGISLATURE WE WERE ABLE TO
ESTABLISH. RESIDENCY PROGRAM TO
TRAIN INDIVIDUALS TO- TO TRAINED
PSYCHIATRIST IN WITHIN OUR OWN
INSTITUTION OVER AT NAPA STATE
HOSPITAL AND JUST VERY QUICKLY
WERE ABLE TO GET THAT PROGRAM UP
AND RUNNING AND NOW HAVE OUR
FIRST COHORT- THE- PSYCHIATRIST
I'M IN TRAINING. SO AND WE
CERTAINLY HAVE THESE CHALLENGES
THOSE ARE LONG STANDING
CHALLENGES BUT ALWAYS WORKING TO
EXPAND OUR PIPELINE PROGRAMS IN
OUR RECRUITMENT AND RETENTION
EFFORTS. I WILL- A TO OCCUR. AND
I HAD THIS MORNING SEVERAL OF
THE PROVIDERS REGARDING
VACANCIES THAT ARE AND MANY OF
OUR STATE HOSPITALS ACROSS OUR
STATE. THAT I BELIEVE WE NEED TO
PAY MORE ATTENTION TO ENSURE
THAT. WE ARE INVESTING IN THE
WORK FORCE TO ADDRESS THIS
HIGHEST T. ISSUE THAT HAS BOTH
BEEN. VEXING AND HAVEN'T-
COMPLICATED FOR US AS A STATE
WE'RE GONNA NEED THOSE FRONT
LINE WORKERS TO MAKE SURE WE ARE
DOING THE APPROPRIATE-
RESTORATIONS WHEN. WHEN
APPLICABLE AND FOR US TO REACH
THE TIME LINES AS MANDATED BY
THE ALAMEDA COUNTY SUPERIOR
COURT. AND SO I BELIEVE THAT
THIS WILL BE A NECESSARY
CONVERSATION AND- FINALLY JUST
FOR FINANCE I BELIEVE IT'S
IMPORTANT FOR US TO MAKE SURE
WE'RE PUTTING TO SCALE. THE FACT
THAT WE'RE PUTTING FIVE HUNDRED
MILLION DOLLARS INTO OUR
COMMUNITY BASED TREATMENT
PROGRAMS AND RESIDENTIAL HOUSING
AND TWO HUNDRED SIXTY MILLION
INTO AUTHORIZING SOME OF THESE.
DSHS SUB ACUTE BED CAPACITY THAT
WE NEED TO LOOK AT THEREAL
UNDERLYING ISSUES WITH RETENTION
AND OUR ABILITY TO KEEP MANY OF
THESE PROFESSIONALS WITHIN THE
SYSTEM- BY THE TIME WERE LOOKING
TOWARDS CONTRACTED EMPLOYEES
THERE MAY BE AN UNDERLYING
ISSUE. WITH THE- OUR ABILITY TO
MAKE SURE THEY ARE RESOURCE AND
APPROPRIATELY TAKEN CARE OF FOR
THE WORK THAT THEY'RE DOING
RIGHT NOW. AND KNOW THAT THIS
WILL BE A PART OF THE
CONVERSATION GOING FORWARD TO
ENSURE THAT WE ARE ADDRESSING
THE I. S. T. CONCERNS THAT MANY
OF US HAVE. WITH THAT I HAVE ONE
FINAL QUESTION FOR. REGARDING
FULL SERVICE PARTNERSHIPS AND SO
I WILL START WITH THE DEPARTMENT
OF STATE HOSPITALS AND THEN I
WILL TRANSFER. BIRD TO TOBY
EWING TO GET AN UNDERSTANDING OF
HOW WE ARE MAKING SURE THAT FULL
SERVICE PARTNERSHIPS ARE NOW
BEING FULLY UTILIZED. FOR R. I.
S. T. POPULATION AT LEAST IN THE
COUNTIES THAT ARE PARTICIPATING
IN DIVERSION PROGRAMS ARE THEY
CURRENTLY ALLOWED TO PARTICIPATE
IN FULL SERVICE PARTNERSHIPS.
AND IF NOT WHY NOT. THANK YOU
AND I'M GONNA ASK CHIEF DEPUTY
DIRECTOR EATON'S TO RESPOND TO
THAT QUESTION IS HER AND FORMER
DIVISION WAS RESPONSIBLE AND FOR
IMPLEMENTING DIVERSION ACROSS
pINTIMATELY FOR KIND OF FAMILIAR
WITH THE PROGRAM CLAIMS OF EACH
OF THE DIVERSION PARTNERS. SURE
THANK YOU- DEFINITELY WE DO
ENCOURAGE ACCOUNTING PROGRAMS TO
LOOK TO THE FULL SERVICE
PARTNERSHIP MODEL TO UTILIZE AND
IN SUPPORTING- PAPER VERSION
PROGRAM. AND IN SOME OF OUR
COUNTY PROGRAMS- THOSE- THAT
THAT PROGRAMMING IS BEING- THIS
IS SUPPORTING DIVERSION- BUT THE
WAY THAT WE REALLY APPROACHED IT
IS SORT OF CUSTOMISATION BASED
ON WHERE THE COUNTY IS TRYING TO
MEET THE COUNTY WHERE THEY WHERE
THEY ARE- AND- THE SORT OF THE
RESOURCES AND THE CAPACITY TO
PROVIDE THOSE SERVICES AND SO.
ON IN IN MANY RESPECTS SOME OF
THE PROGRAMS DO LOOK A LOT LIKE
A FULL SERVICE PARTNERSHIP THE
MAY NOT BE CALLED A FULL SERVICE
PARTNERSHIP PROGRAM WHERE AS
OTHER COUNTY PROGRAMS ARE
UTILIZING IT SO IT'S NOT OFF THE
TABLE IT'S NOT- EXCLUDED IT'S I
THINK THAT WE CAN TACKLE- DAY
VERSION AND IMPLEMENT PROGRAMS
IN A VARIETY OF DIFFERENT WAYS
AND SO. IT'S BEEN OUR GOAL TO
REALLY JUST WORK WITH EACH
COUNTY TO. OR WHAT THOSE OPTIONS
ARE WHAT THE GAPS ARE AND THEN
AND THEN TARGET THE FUNDING TO
SUPPORT THAT. I WOULD POINT OUT
AND I WILL NOW TRANSFER TO TOBY
EWING AT THE BOTTOM OF PAGE
TWENTY NINE AND THE AGENDA. IS A
DESCRIPTION OF THE FULL SERVICE
PARTNERSHIPS AND IT DESCRIBES IT
AS THOSE WHO WERE INVOLVED OR AT
RISK OF INVOLVEMENT WITH THE
CRIMINAL JUSTICE SYSTEM. HENCE
WHY I REALLY AM LOOKING TOWARDS
FULL SERVICE PARTNERSHIPS WHICH
DURING THIS LAST YEAR RECEIVED
SIGNIFICANTLY INCREASED
RESOURCES DUE TO OUR TOP EARNERS
DOING WELL THAT I'D LIKE TO
ENSURE THAT OUR FULL SERVICE
PARTNERSHIPS ARE SIMILARLY-
PROVIDING NEEDED RESOURCES FOR I
S. T. POPULATION AS WE HEARD
FROM OUR E. R. DR. THERE ARE
HIGH UTILIZED HERS OR FREQUENT
FLYERS AND- BELIEVE THAT IT'S
IMPORTANT FOR US TO DIRECT THOSE
FULL SERVICE PARTNERSHIP SO I'D
LIKE TO UNDERSTAND. FROM TOBY IF
I CAN. THAT MY UNDERSTANDING IS
THAT ARE A COUNTIES NOW WHO ARE
CURRENTLY EVALUATING AND
REFINING THEIR FULL SERVICE
PARTNERSHIPS. WHAT METRICS ARE
THEY CURRENTLY USING AND WHAT IS
THE TIMING OF THESE EVALUATIONS
AND FINALLY DO COUNTIES
RECOGNIZE THAT FULL SERVICE
PARTNERSHIPS MAY BE A
SIGNIFICANT SOLUTION TO THE I.
S. T. PROBLEM. THANK YOU MISTER
CHAIR TOBY DOING ON BEHALF
MENTAL COMMISSION- I THINK YOU
KNOW YOUR QUESTION RAISES A
NUMBER OF ISSUES SO IT'S A
LITTLE HARD TO ANSWER YOUR
QUESTION WITH A SIMPLE
STRAIGHTFORWARD YES OR NO. FIRST
IT'S IMPORTANT TO REMEMBER THE
ORIGINS OF THE FULL SERVICE
PARTNERSHIP WHICH WAS A PILOT
OUT OF LONG BEACH TO- TO TAKE
PEOPLE OUT OF STATE HOSPITALS
AND SERVE THEM IN THE COMMUNITY.
AND THE MODEL IS CALLED A FULL
SERVICE PARTNERSHIP FIRST
BECAUSE IT'S A PARTNERSHIP
BETWEEN THE PROVIDER AND THE
INDIVIDUAL THE MENTAL HEALTH
HERE. AND IT'S FULL SERVICE
BECAUSE IT IS DESIGNED TO ALLOW
THE PROVIDER TO DO WHATEVER IT
TAKES WITH THE FUNDS THAT ARE
AVAILABLE AND THAT IN THE IN THE
GOALS HISTORICALLY. HAVE BEEN TO
REDUCE HOSPITALIZATION
INCARCERATION AND HOMELESSNESS.
SO THE MODEL IS QUITE ELEGANT
ITS IT'S- COMPREHENSIVE. WE HAVE
WE HAVE A B. C. P. IN FRONT OF
YOU NOW- SO WE HAVE NOT ACTUALLY
BEEN ABLE TO ENGAGE TO REALLY
UNDERSTAND. HOW COUNTIES USING
THE FULL SERVICE PARTNERSHIP
MODEL. THE REASON YOUR QUESTION
IS COMPLICATED ANSWER QUESTIONS
COMPLICATED IS BECAUSE- FOSTERS
PARTNERSHIPS ARE TYPICALLY FIND
WITH AN HSA FUNDS IN THERE RE
PRO HAVE BISSCHEN TIME USING
IMAGES SAY FUNDS. FOR PEOPLE WHO
ARE IN NON VOLUNTARY SCENARIOS
AND SO THERE'S SOME QUESTIONS
AROUND THE NATURE OF DIVERSION
AND SOMEONE WHO MAY BE UNDER A
COURT ORDER- HAVING BEEN DEEMED
INCOMPETENT TO STAND TRIAL. I
THINK THE IMPORTANT LESSON HERE
ISN'T THE SOURCE OF FUNDING. IT
MAY BE THAT THE MENTAL HEALTH
SERVICES ACT FUNDS BECAUSE
THEY'RE SO FLEXIBLE CAN BE USED
WELL BEYOND WHAT CAN BE DONE
WITH MANTA CAL- BUT WHAT'S
REALLY IMPORTANT IS THE MODEL.
HOW CAN WE DESIGN SYSTEMS HOW DO
WE DESIGN THE CAPACITY TO LEARN
FROM THE STRATEGIES TO WORK WITH
INDIVIDUALS IN A WHATEVER IT
TAKES APPROACH. BECAUSE WE
RECOGNIZE THAT IF WE DON'T DO
THAT WORK THERE'S A FAR HIGHER
PERSONAL FAMILY COMMUNITY AND
FISCAL COST. WHEN PEOPLE
ACTUALLY END UP IN THE STATE
HOSPITAL RETURNING TO A STATE
HOSPITAL. FOR EXAMPLE SO I THINK
YOU KNOW WE WANT TO ANSWER THAT
QUESTION AND THAT'S PARTLY WHY
WE COME TO YOU WITH THE BUDGET
CHANGE PROPOSAL. TO REALLY
BETTER UNDERSTAND FULL SERVICE
PARTNERSHIPS THE KINDS OF
METRICS THAT ARE BEING USED THE
DATA THAT ARE BEING COLLECTED-
THE PILOT THAT IS REFERENCED IN
THE ANALYSIS IT WAS A SMALL
PILOT WITH A HANDFUL OF
COUNTIES. REALLY TO STRENGTHEN
THEIR CAPACITY TO BE OUTCOME
FOCUSED IN THEIR CONTRACTING
WITH COMMUNITY PARTNERS. AND SO
WE SEE THE OPPORTUNITY TO EXPAND
THAT WORK TO EXPLORE THE KINDS
OF QUESTIONS YOU'RE ASKING AND
THEN TO SAY. EVEN IF WE MAY NOT
BE ABLE TO USE THEM AND JUST SAY
FUNDS TO SUPPORT THE EXPANSION
OF THIS WHATEVER IT TAKES
APPROACH. HOW CAN THE LESSONS
LEARNED THROUGH THE F. S. P.
COMPONENT AT THE MHSAA REALLY
BEGIN TO DRIVE STREET. DRIVE
STRATEGIES TO PREVENT THE
JUSTICE INVOLVEMENT THE
HOMELESSNESS THAT IS LEADING TO
THE LARGE NUMBERS OF FOLKS
LANDING AT THE DOOR OF THE
DEPARTMENT TATE HOSPITALS. SO
THE BEST I CAN TELL YOU IS WE'RE
STILL WORKING TO FIGURE THAT OUT
WE WANT TO SEPARATE OUT THE
PROGRAMMATIC. SIDE A FULL
SERVICE PARTNERSHIPS FROM THE
FUNDING SIDE SO THAT THE LESSONS
THAT WE LEARNED FROM THE MHSAA
CAN EXPAND INTO FOR EXAMPLE HOW
WE MIGHT USE MEDICARE FUNDING.
HOW WE CAN USE OTHER SOURCES OF
DOLLARS AS WELL AND HOW THE
STATE MIGHT DO. MORE UPSTREAM
WORKS THAT WE CAN REDUCE DEMANDS
ON OUR STATE HOUSE ARE VERY
EXPENSIVE STATE HOSPITAL SYSTEM
. HELP ANSWER. NOW WHAT IT DOES
NOT WE WILL FOLLOW UP MORE IN.
THE FINAL QUESTION MAYBE
RHETORICAL BUT I DO FEEL IT
NEEDS TO BE ASK I WAS REALLY.
MOVED BYSANDRA- CITING BERG'S.
TESTIMONY THAT THAT'D LIKE TO BE
ABLE TO ASK THE ADMINISTRATION
OR STATE HOSPITAL. HOW DO WE
MAKE SURE THAT THAT DOESN'T
HAPPEN AGAIN WHAT HAVE WE DONE
TO PUT IN PLACE TO MAKE SURE
THAT. WHAT HAPPENED A SANDERS
COUSIN DOESN'T HAPPEN AGAIN.
THANK YOU YES AND THE- A COUPLE
OF THINGS TO MENTION WITH
RESPECT TO THAT PROCESS-
OBVIOUSLY I CAN'T- SAYING-
MENTAL HEALTH ORGANIZATION CAN'T
SPEAK SPECIFIC TO ANY SPECIFIC-
SITUATION BUT JUST TALK A LITTLE
BIT MORE ABOUT PROCESS AND SOME
OF THE CHALLENGES THAT WE FACE
AS WELL AS- WHAT WE'RE TRYING TO
DO TO ADDRESS THAT AND IN ORDER
FOR US TO BE ABLE TO ADMIT AND
INDIVIDUAL AS INCOMPETENT TO
STAND TRIAL WE FIRST HAVE TO
KNOW THAT THERE HAS BEEN A
COMMITMENT BY THE COURT. AND
THAT PROCESS STARTS BY- WE HAVE
AN ELECTRONIC PROCESS WHERE THE
COURT UPLOADS A COMMITMENT
PACKET AND THEN THE MINUTE WE
GET THAT COMMITMENT PACKET- NOT
SAME DAY THERE AT THAT
INDIVIDUAL IS THEN ADDED TO OUR
WAIT LIST SO WHATEVER TIME IT
TAKES FOR A COURT TO- SUBMIT A
PACKET TO THE DEPARTMENT THERE
THERE CAN BE DELAYS AND THAT
CAN- DILUTE FURTHER DELAY BEYOND
JUST WHAT TIME IT TAKES FOR MEN
AND BETUL WHO IS COMMITTED TO
THE DEPARTMENT TO WHEN WE HAVE A
BAD THAT IS AVAILABLE FOR THEM-
THAT CAN FURTHER ADD TIME TO
THAT. ADMISSION TIMELINE- THERE
ARE INSTANCES OCCASIONALLY WHERE
WE LEARN THAT TO ANY COURT HAS
NOT SUBMITTED A COMMITMENT
PACKET OFTEN- WHEN NOT WHEN
OFTEN BUT IT DOES HAPPEN IT'S
USUALLY WE ARE NOTIFIED THROUGH
THE COURT FOLLOWING UP ON THE
STATUS OF A MISSION OR THE
PUBLIC DEFENDER HAS- REQUESTED-
AND- ORDER TO SHOW CAUSE AS TO
WHY SOMEBODY HASN'T BEEN
ADMITTED- SO THERE ARE CASES
WHERE AID PACKAGE THE COURT DOES
NOT UPLOAD A PACKET AND THAT'S
HOW WE FIND OUT. AND WE ARE
CURRENTLY IN THE PROCESS OF
DEVELOPING A REPORT ON THAT WE
CAN WORK WITH THE COUNTIES SO
THAT THEY CAN DO A
RECONCILIATION WITH OUR WAIT
LIST- WE'RE CURRENTLY PILOTING
NOT WITH SAN BERNARDINO COUNTY.
AND THEN AS WE WORK OUT THAT IS-
CAN IT'S THAT LITTLE- AT THEY
WILL BE ABLE TO ROLL OUT SO
WIDELY WILL ALLOW THAT COUNTIES
TO BE ABLE TO SEE. WHO'S ON THE
WAY AT LAST AND ENSURE THAT WE
HAVE ALL THE COMMITMENT PACKETS
FOR EVERYBODY THAT THEY ARE
TRACKING AND SHOULD BE ADMITTED
TO THAT DEPARTMENT AND THEN ONE
SECOND WE HAVE A COMMITMENT ALL
OF THE PROPOSALS THAT WERE
WORKING ON TODAY THAT WE
PROPOSED- AND PROVIDED UPDATES
ON TODAY THOSE ARE ALL DESIGNED
TO ENSURE THAT INDIVIDUAL IS
GOING TO GET TREATMENT WITHIN
THE TWENTY EIGHT DAYS I GET
STARTED ON SUBSTANTIVE TREATMENT
WITHIN THE TWENTY DAYS THAT IS
BEEN. REQUIRED BY THE STATE OF
ANY OF THE COURT IN THE CITY OF
ANY CASE. I APPRECIATE THOSE
ANSWERS AND SEEING NO OTHER
QUESTIONS. I WANT TO THANK THE
ENTIRE SECOND PANEL WE WILL NOW
MOVE ON TO PANEL THREE. ON THE
BEHAVIORAL HEALTH CONTINUE ON
INFRASTRUCTURE PROGRAM. FOR THE
PANELISTS WHO ARE SPEAKERS
PLEASE PRESENT IN THE ORDER THAT
YOUR NAME APPEARS ON THE AGENDA.
WE WILL HOLD ALL MEMBERS
QUESTIONS ON THIS PANEL UNTIL
AFTER. THE PRESENTERS HAVE
CONCLUDED. WE HAVE SEVEN
SPEAKERS ON THIS PANEL BEGINNING
WITH THE DEPARTMENT OF HEALTH
CARE SERVICES. DIRECTOR BOSS CAN
YOU PLEASE BEGIN. MISTER CHAIR
AND MEMBERS OF THE COMMITTEE- AS
WE BEGAN FOR PLANNING THE
IMPLEMENTATION OF LAST YEAR'S
SIGNIFICANT BEHAVIORAL HEALTH
INVESTMENTS WE REALLY WERE
EMBARKING ON A JOURNEY AND WE
FELT THAT IT WAS IMPORTANT TO
KNOW WHERE THE STATE IS. UP YOU
KNOW WHERE WE NEED TO GO IN
JANUARY I THINK. PUBLISHED A
COMPREHENSIVE BEHAVIORAL HEALTH
ASSESSMENT UNDERSTAND THE
LANDSCAPE IN CALIFORNIA WHERE WE
HAVE GAPS IN THE CONTINUUM OF
CARE AND PROVIDE GUIDANCE FOR
CURRENT AND FUTURE INITIATIVES
AND OUR RESPONSE TO NEW FEDERAL
FUNDING OPPORTUNITIES. WE WANT
TO CONTINUE ON THAT INCLUDES A
FULL ARRAY OF SERVICES STARTING
FOR PREVENTION AND WELLNESS
OUTPATIENT SERVICES. AND
RECOVERY SERVICES COMMUNITY
SERVICES RESIDENTIAL TREATMENT
CRISIS SERVICES YOUR AGENDA
INCLUDES A VERY COMPREHENSIVE
AND COMPLETE LIST OF THE
FACILITY TYPES THAT WE ARE
CONSIDERING AS PART OF THIS
PROGRAM. REPORT USED AVAILABLE
DATA FOCUS GROUPS AND EXPERT
INTERVIEWS. THE REPORT
SPECIFICALLY SUPPORTS DH YES
IMPLEMENTATION OF THE BEHAVIORAL
HEALTH CONTINUUM INFRASTRUCTURE
PROJECT. THE GUY GRANT MAKING
AND OUR PROPOSED DESIGN OF A
SECTION. ELEVEN FIFTEEN
DEMONSTRATION WAIVER TO STRENGTH
AND MENTAL HEALTH SERVICES FOR
INDIVIDUALS LIVING WITH SERIOUS
MENTAL ILLNESS AND CHILDREN AND
YOUTH LIVING WITH SERIOUS
EMOTIONAL DISTURBANCE. THE
REPORT HIGHLIGHTS THE NEED FOR
DEEP INVESTMENTS AND THREE
POPULATIONS. INDIVIDUALS WHO ARE
JUSTICE INVOLVED- EXPERIENCE
SUBSTANTIALLY HIGHER RATES OF
MENTAL HEALTH CONDITIONS AND
SUBSTANCE USE DISORDERS AND
OFTEN END UP INCARCERATED
BECAUSE OF HOSE CONDITIONS.
CHILDREN AND YOUTH WHO NEED
ACCESS TO THE FULL CONTINUUM
SERVICES FOR PREVENTION CHECK
CRISIS AND NATIVE AMERICAN AND
ALASKAN INDIANS WHO EXPERIENCE
AN EQUITABLE OUTCOMES INCLUDING
HIGH SUICIDE AND OVERDOSE RATES
. THE REPORT REINFORCED THE
ADMINISTRATION'S COMMITMENT TO
ENSURING A COMPREHENSIVE
APPROACH TO CRISIS SERVICES BUT
EMPHASIZES COMMUNITY BASED
TREATMENT AND PREVENTION I
CONNECTS PEOPLE TO ONGOING
SERVICES. COMMUNITY BASED LIVING
OPTIONS FOR PEOPLE LIVING WITH
SERIOUS MENTAL ILLNESS AND OR
SUBSTANCE USE DISORDER.
DESIGNING AND DELIVERING
BEHAVIORAL HEALTH SERVICES TO
ADVANCE EQUITY AND ADDRESS
DISPARITIES. ENSURING EVIDENCE
BASED AND COMMUNITY TO FIND
PRACTICES AND ENSURING HOUSING
AND ECONOMIC AND PHYSICAL HEALTH
ISSUES ARE ADDRESSED FOR PEOPLE
WHO ARE JUSTICE INVOLVED WERE
EXPERIENCING HOMELESSNESS. IN
REGARD TO THE BEER HALL
CONTINUUM INFRASTRUCTURE PROGRAM
OR WHAT WE CALL BE CHIP. CHIP
AIMS TO CONSTRUCT ACQUIRE AND
EXPAND PROPERTIES AND INVESTMENT
IN MOBILE CRISIS INFRASTRUCTURE
RELATED TO BEHAVIORAL HEALTH.
DSDS IS X. IS RELEASING THE
FUNDS THREE SIX GRANT ROUNDS
TARGETING VARIOUS GAPS IN THE
STATE'S BEHAVIORAL HEALTH
FACILITY INFRASTRUCTURE. BROWN
ONE FOCUSED ON MOBILE CRISIS WAS
DISCUSSED EARLIER- AND DCS
AWARDED A HUNDRED FORTY MILLION
TO FORTY FIVE COUNTIES AND
TRIBES IN NOVEMBER TWENTY TWENTY
ONE. BROWN TO FOCUSED ON
PLANNING. GREAT STATE TO
COUNTIES AND TRIBES DHT HAS
AWARDED FIVE POINT THREE MILLION
TO THIRTY SIX HE'S TWENTY FIVE
COUNTIES AND NINE TRIBES IN
JANUARY OF TWENTY TWENTY TWO.
BROWN THREE FOCUSES ON THE
LAUNCH READY PROJECT THOSE ARE
PROJECTS THAT HAVE APPROVALS AND
ARE READY TO BE BUILT AND COULD
PROVIDE SERVICES I'M AS SOON AS
TWENTY TWENTY THREE TWENTY
TWENTY FOUR THERE'S ABOUT FIVE
HUNDRED EIGHTEEN MILLION DOLLARS
THEIR- GIFT YES RELEASED THE
REQUEST FOR PROPOSALS FOR AROUND
THREE IN JANUARY OF TWENTY
TWENTY TWO YOU. PART ONE IS DUE
ON MARCH THIRTY FIRST AND PART
TWO IS DUE. MAY THIRTY FIRST.
BROWN FOUR WILL FOCUS ON
CHILDREN AND YOUTH FOUR HUNDRED
AND EIGHTY MILLION. THE
LISTENING SESSION FURTHER AROUND
FOR IS SCHEDULED FOR MARCH
THIRTY FIRST. IDEA YES WILL STAB
WISH ELIGIBLE FACILITIES AFTER
THE UPCOMING LISTENING SESSION
AND WE ARE COORDINATING THESE
EFFORTS WITH THAT CHILDREN NEED
pBROWN'S FIVE IN SIX REQUEST FOR
APPLICATIONS WILL BE RELEASED IN
THE WINTER OF TWENTY TWENTY TWO
THAT'S ABOUT NINE HUNDRED AND
SIXTY MILLION. THE BEHAVIORAL
HEALTH ASSESSMENT WILL HELP
GUIDE PRIORITIES FOR EACH ROUND
IT WILL BE USED TO HELP SCORE
APPLICATIONS IN BROWN'S THREE
THREE SIX. APPLICANTS ARE
EXPECTED TO USE THE BEHAVIOR
HEALTH NEEDS ASSESSMENT AND
OTHER LOCAL ASSESSMENTS TO
IDENTIFY LOCAL NEEDS WHEN
SUBMITTED APPLICATIONS. AND I
WILL BE I'M CONCLUDING MY
REMARKS WILL BE THE ONLY PERFECT
PRESENTER FOR DH YES. THANK YOU.
THANK YOU NEXT WE WILL HEAR FROM
DR VERONICA KELLY CHIEF OF
MENTAL HEALTH AND RECOVERY
SERVICES ORANGE COUNTY PLEASE
BEGIN. THANK YOU VERY MUCH AGAIN
I THANK YOU- CHAIRMAN AND
ASSEMBLY MEMBER SO CAN BE
RECALLED DIRECTORS ARE GRATEFUL
FOR THE LEGISLATURE'S ALLOCATION
OF TWO POINT TWO BILLION DOLLARS
. IN INFRASTRUCTURE FUNDING LAST
YEAR'S BUDGET AND EXCITED TO
START SPENDING DOWN THESE FUNDS
TO MAKE CRITICAL INVESTMENTS IN
PUBLIC BEHAVIORAL HEALTH
CONTINUE ONE HISTORICALLY
BECAUSE COUNTY BEHAVIORAL HEALTH
REIMBURSEMENT HAS BEEN CAPPED AT
COSTS. WE HAVE NOT HAD THE
ABILITY TO BUILD A RESERVE OR
PROFIT INCREMENTAL INVESTMENT
LIKE OTHER PARTS OF HEALTH CARE
WE'VE HAD A FEW FUNDS EARMARKED
FOR INFRASTRUCTURE SO WE REALLY
HAVE BEEN CHALLENGED TO BUILD UP
ADDITIONAL CAPACITY. IN THE FALL
OF LAST YEAR A COUNTY BEHAVIORAL
HEALTH DIRECTORS COMMISSIONED A
RAND STUDY INPATIENT BED
CAPACITY THROUGHOUT THE STATE
AND WHAT WE FOUND ALIGNS CLOSELY
WITH THE STATE'S GAPS ANALYSIS
BUT PAINS AND MORE NUANCED
PICTURE. FIRST WE NEED TO LOOK
AT THROUGHPUT BECAUSE OF
BOTTLENECKS AT THE SUBACUTE AND
RESIDENTIAL LEVELS CAN CAN
IMPACT A PATH TO THEIR HIGHER
LEVELS SECOND WE HAVE DIFFERENT
NEEDS AND DIFFERENT REGIONS OF
THE STATE WHAT WE FOUND IS THAT
WE HAVE ROUGHLY 65% OF THE
NEEDED CAPACITY ACROSS ALL
LEVELS OF ACUTE CARE FOR ADULTS.
AND ONLY 57% OF NEEDED
RESIDENTIAL LEVELS OF CARE AND
THIS IS SIGNIFICANT BECAUSE WITH
THE EXCEPTION OF INPATIENT UNITS
IN GENERAL ACUTE CARE HOSPITALS.
THE REMAINDER OF THE CUTE AND
RESIDENTIAL CARE LARGELY FALLS
UNDER THE IMD EXCLUSION HAVING
OVER SIXTEEN BADS AND THEREFORE
IS ENTIRELY FUNDED WITH NO
MEDICARE REIMBURSEMENTS OF THE
COUNTY PICKS THAT. ARE MOST
SEVERELY IMPACTED. REGIONS OF
THE STATE AND THE CENTRAL
VALLEY. RETICULAR AND THIS SAN
JOAQUIN VALLEY LACKS A- AND THAT
IS WHY WE ARE SEEING AN
INCREASING NEED. LEAVE THIS
INFRASTRUCTURE INVESTMENT CAN
PAY OFF IF IT IS DONE RIGHT AND
WE URGE THE STATE TO CONSIDER
EXPANDING ON THESE ANALYSES. TO
FURTHER STUDY GAPS IN THE
CHILDREN'S CONTINUUM OF CARE AS
WELL AS FOR SUBSTANCE USE
DISORDER SERVICES. THE STATE MAY
WISH TO CONSIDER DELAYING ITS
FUNDING FOR CHILDREN'S CAPACITY
FOR EXAMPLE UNTIL IT HAS A
SIMILARLY RIGOROUS ANALYSIS OF
REGIONAL NEEDS IN THE CHILDREN'S
SYSTEM OF CARE WHICH IS FAR MORE
COMPLEX. OUR ANALYSIS ALSO FOUND
THAT COUNTY BEHAVIORAL HEALTH
CHALLENGES- ARE UNIQUE TO THE
TYPE OF CLIENTS THAT WE SERVE
WITH FINDING PLACEMENTS IN HE
EXISTING. DELIVERY SYSTEM SO
POPULATIONS SUCH AS PEOPLE WITH
CERTAIN CRIMINAL CONVICTIONS
LIKE OUR CENTER SEX OFFENSES.
AND MEDICAL COMORBIDITIES LIKE
CARPET OR GENETIC BRAIN INJURY
HAVE BEEN PARTICULARLY
CHALLENGING PRESS THE PLACE AND
SALMON DINO COUNTY WE WERE FACED
WITH FINDING PLACEMENT FOR A
SEVENTY FIVE YEAR OLD MAN.
DIAGNOSED WITH SCHIZOPHRENIA
SPECTRUM DISORDER WHO WAS A SEX
OFFENDER AND AN ARSONIST AND WHO
IS NOW EXHIBITING SYMPTOMS OF
DEMENTIA. JUST ONE OF THOSE
COMORBIDITIES AS A CHALLENGE BUT
ALL FOR IN AN ELDER. NEARLY
IMPOSSIBLE TO ATTEND TO BUT WE
DID. WE NEED TO SOLVE NOT ONLY
FOR NUMBERS OF BEDS BUT FOR THE
IN THE NEEDS OF THE PEOPLE IN
THOSE BATS OF PEOPLE WHO ARE NON
AMBULATORY. PEOPLE WHO ARE DEAF.
ANYONE WITH AN ASSAULTIVE
HISTORY. THOSE ARE SOME OF THE
MOST CHALLENGING PEOPLE TO PLACE
AND THEY ARE OFTEN THE MOST IN
NEED OF EFFECTIVE TREATMENT.
CANADA ALREADY APPLYING VIA THE
PROCESS OF FINDING A NEED TO BE
CHECKED IN ORANGE COUNTY WE ARE
POISED TO SUBMIT ONE COUNTY
PROJECT TO ADD CSU. CAPACITY IN
A REGION THAT HAS NOT FOR ADULTS
AND YOUTH PLUS FOUR LEVELS OF S.
U. D. AND RESIDENTIAL. AND WE
HAVE TO CREATE A BASE PRINTER
BASED- PROJECTS TO EXPAND S. U.
D. RESIDENTIAL CONQUERING CARE
AND BOARDING CARE. FOR FORENSIC
POPULATIONS. HOWEVER THESE
DOLLARS ARE NOT STRAIGHTFORWARD
REQUIREMENTS SUCH AS THE
COMPETITIVE GRANT STRUCTURE.
THIRTY YEAR SERVICE COMMITMENT
AND REQUIRE 10% MATCH CASH OR
LAND. ADD UNNECESSARY COMPLEXITY
AND BARRIERS FOR MANY COUNTIES.
MANY OF US HAVE BEEN PREPARING
FOR THIS FOR THE PAST YEAR
HAVING GOOD FOTUNE TO HAVE
RESOURCES LIKE SHOVEL READY
LAND. BUT NOT ALL COUNTIES ARE
IN THIS POSITION ALTHOUGH ALL
COUNTIES NEED THE
INFRASTRUCTURE. IS IMPORTANT TO
NOTE THAT COUNTIES WILL NEED
ADDITIONAL RESOURCES TO EXPAND
OUR CONTINUUM. BEYOND BRICKS AND
MORTAR INVESTMENTS WILL NEED
ADDITIONAL FUNDING TO EXPAND
SERVICES NOT JUST BAD AND TO
RECOUP TO RE RECRUIT AND RETAIN
THE WORKFORCE OF THE FUTURE.
THANK YOU. THANK YOU NEXT WE
WILL HEAR FROM KIM PETERSON
SENIOR ATTORNEY WITH DISABILITY
RIGHTS CALIFORNIA PLEASE BEGIN.
THANK YOU CHAIR AGAIN MY NAME IS
KIM PETERSON FROM DISABILITY
RIGHTS CALIFORNIA MY COMMENTS
RELATED TO BE CHECK FOCUS ON THE
OPPORTUNITIES THAT DH CS HAS TO
FOCUS ON INVESTMENTS IN
COMPREHENSIVE UPSTREAM SERVICES
AND THE ROUNDS OF CRISIS
RESPONSE AND TREATMENTS. FOR
MORE WORK THROUGHOUT THE STATE
DRC HAS SEEN HOW MENTAL HEALTH
CRISIS ALMOST UNIFORMLY RESULTS
AND PLACEMENT OF A FIFTY ONE
FIFTY HOLD WHEN A CALL FOR HELP
IS MADE. THIS IS BECAUSE THE
STATE'S CONTINUUM OF CARE
OVERWHELMINGLY DOES NOT SUPPORT
ALTERNATIVE LESS RESTRICTIVE
OPTIONS. THIS RESULT IN STRAIN
ON EMERGENCY DEPARTMENTS
BACKLOGS OF PEOPLE WAITING FOR
LIMITED INPATIENT BEDS AND
UNTOLD TRAUMA FOR THE PEOPLE WHO
FIND THEMSELVES TAINT. TRAVERSE
THIS TREND WE ENCOURAGE DH CS TO
FOCUS ON THE FOLLOWING TYPES OF
PROJECTS WHEN CHOOSING HOW TO
AWARD ITS SPEECH AT FUNDING.
CURRENTLY EACH OF THESE PARTS OF
THE CONTINUE- ARE NOT OFFERED IN
SUFFICIENT QUANTITIES THROUGHOUT
THE STATE ACCORDING TO THE
RECENT NEEDS ASSESSMENT. IF
EXPANDED THESE SERVICES CAN
PROVIDE MEANINGFUL ALTERNATIVES
TO INVOLUNTARY HOLDS AN ACUTE
HOSPITALIZATIONS. FIRST DH CS
AND INVEST HEAVILY IN
INFRASTRUCTURE PROJECTS THAT
WILL SUPPORT THE EXPANSION OF
VOLUNTARY COMMUNITY BASED CARE
SUPPORT AND SERVICES. SECOND IN
ADDITION TO THE MOBILE CRISIS
SERVICES WE'VE ALREADY DISCUSSED
THE TRIP IS AN OPPORTUNITY FOR
DH CS TO BUILD OUT THE STATE'S
CAPACITY TO PROVIDE A ROBUST
ARAM CRISIS INTERVENTION
SERVICES. THESE ARE SERVICES
THAT ARE BRIEF INTERVENTIONS
DESIGNED TO QUICKLY RESOLVE THE
CRISIS WHEN APPROPRIATE. CRISIS
INTERVENTION SERVICES ARE
PROVIDED IN LOCATIONS LIKE
MENTAL HEALTH URGENT CARE
CENTERS WALK IN CENTRES CARE
RESPITE AND SOBERING CENTERS.
THIRD DH CS SHOULD USE THECHIP
FUNDS TO EXPAND THE STATE'S
CAPACITY FOR CRISIS TREATMENT
OTHERWISE KNOWN AS CRISIS
STABILIZATION SERVICES. THIS
COULD INCLUDE INVESTMENTS IN
INFRASTRUCTURE TO SUPPORT
LICENSE CRISIS STABILIZATION
UNITS AND EXPANSION OF CRISIS
RESIDENTIAL PROGRAMS WHICH CAN
BE USED AS ALTERNATIVES TO
HOSPITALIZATION. LASTLY THE NCS
PRIORITIZE B. EIGHT B. CHIP
INVESTMENT IN COMMUNITIES THAT
HAVE UNDER DEVELOPED BEHAVIORAL
HEALTH INFRASTRUCTURE. IN OUR
WORK THROUGHOUT THE STATE DRC
YOU SEE IS THAT GEOGRAPHIC
ACCESS TO BEHAVIORAL HEALTH
SERVICESIS NOT EQUAL. IN
ADDITION TO YOUR SEATS ARE JUST
BEACH HAPPEN BASS MEANT TO FOCUS
ON PROJECTS THAT WILL SERVE
CALIFORNIA'S DIVERSE CULTURAL
AND LINGUISTIC POPULATIONS AS
WELL SPECIAL POPULATIONS FOR
EXAMPLE PEOPLE INVOLVED IN THE
CRIMINAL LEGAL SYSTEM AND PEOPLE
WITH CO OCCURRING MENTAL HEALTH
AND SUBSTANCE USE DISORDERS.
AGAIN THANK YOU FOR THE
OPPORTUNITY TO PARTICIPATE IN A
PANEL. THANK YOU NEXT WE WILL
HEAR FROM DOCTOR LEE ANDREA
CLARK HARVEY THE CEO OF THE
CALIFORNIA COUNCIL FOR COMMUNITY
BEHAVIORAL HEALTH AGENCIES
PLEASE BEGIN. THANK YOU CHAIR
AND MEMBERS SO MY COLLEAGUES
HAVE PROVIDED SOME EXCELLENT
COMMENTS ALREADY ABOUT THE
OPPORTUNITIES OF THIS PROPOSAL
AND CV HA ALSO APPLAUDS THE
EFFORTS OF THE ADMINISTRATION TO
INCLUDE MANY VOICES IN THEIR
ASSESSMENT AND ALSO CREATE
FUNDING THAT'S AVAILABLE TO
DIVERSE PROVIDERS. TO PROMOTE AN
INTEGRATED SYSTEM THAT FOCUSES
ON PREVENTION AND EARLY
INTERVENTION WHILE ALSO
PROMOTING THE ABILITY FOR
INDIVIDUALS WITH DUAL DIAGNOSES
TO HEAL AND PLACE IN A LEASE FOR
STOCK RESTRICTIVE COMMUNITY
SETTINGS WHENEVER POSSIBLE BUT
I'M GOING TO FOCUS ON CARE
INTEGRATION FOR THE REMAINDER OF
MY REMARKS AND ALL SHARE A QUICK
ILLUSTRATION FROM MY EXPERIENCES
AS A MENTAL HEALTH CLINICIAN.
ABOUT THE IMPACT OF POOR
CLINICAL INTEGRATION WHEN I
PRACTICE THAT I COMMUNITY
BEHAVIORAL HEALTH CENTER IN
ANOTHER STATE SOMETHING THAT
STRUCK ME WAS HOW THEIR
SUBSTANCE USE DISORDER AND
MENTAL HEALTH TREATMENT PROGRAMS
WERE PHYSICALLY LOCATED ON
DIFFERENT FLOORS OF THE
BUILDING. PROVIDERS DID NOT
TRAIN TOGETHER THEY DIDN'T WORK
ON CASE CONCEPTUALIZATION EXCEPT
TRY AND WHY WELL MOSTLY BECAUSE
OF DESPERATE FUNDING SITE
LEVELS. IT WAS HARDLY A WHOLE
PERSON CARE IT WAS SEGMENTED
CARE AND CLIENTS KNEW WHO WAS
GETTING WHAT TYPE OF TREATMENT
JUST BASED ON THE WHICH FLOOR
THEY GOT OFF ON THE ELEVATOR.
YEARS LATER WHEN I STARTED
PRACTICING IN CALIFORNIA AT
CHILDREN'S HOSPITAL LOS ANGELES
WE WERE TRYING TO FOCUS ON AN
INTERDISCIPLINARY MODEL AND
THAT'S WHERE MY BEST CLINICAL
WORK WITH DYING EVERY SPECIALTY
AT THE TABLE COMBINING AND
LEVERAGING EXPERTISE THE GOOD OF
THE INDIVIDUAL CLIENT. SO
INTEGRATING MENTAL HEALTH AND
SUBSTANCE USE DISORDER SHOULD NO
LONGER BE AN OPTIONAL MODEL OR
FRAMEWORK OR HOW TREATMENT
PROGRAMS ARE DESIGNED IT NEEDS
TO BE IMPERATIVE COMMONPLACE AND
CBJ HOPEFUL ABOUT THE FRAMEWORK
OUTLINED BY THE ADMINISTRATION
WILL REALLY HELP US MOVE TOWARDS
INTEGRATION QUICKLY. IT ALL
STARTS WITH BREAKING FUNDING
SILOS. DOWN TO TRULY HAVE A
BEHAVIORAL HEALTH SINCE THAT
WORKS THANK YOU. THANK YOU NEXT
WE WILL HEAR FROM TYLER REALTY
WHO IS THE EXECUTIVE DIRECTOR
FOR THE CALIFORNIA ASSOCIATION
OF ALCOHOL AND DRUG PROGRAM
EXECUTIVES PLEASE BEGIN. GOOD
AFTERNOON CHAIR PAMBULA MEMBERS
TYLER IN THE EXECUTIVE DIRECTOR
OF CASH HE CAN BE AS MEMBERSHIP
IS EXCITED ABOUT THE DEDICATION
OF THE STATE AND TO PAY FOR
HEALTH INFRASTRUCTURE THE LEVEL
OF INVESTMENT BY THE
ADMINISTRATION AND LEGISLATURE
TO SUBSTANCE USE DISORDER AND
FOR STRUCTURE IS UNPRECEDENTED.
HOWEVER SO IS THE LEVEL OF NEED
TODAY I'D LIKE TO SHARE SEVERAL
EXAMPLES OF PROJECTS THAT OUR
MEMBERS ARE SUBMITTED THE STATE
FOR FUNDING AND WE ARE ALSO
GRATEFUL FOR THE OPPORTUNITY TO
APPLY DIRECTLY AS PROVIDERS FOR
THE FUNDING. WE HAVE A PROVIDER
WHO IS PURCHASING AND RENOVATING
A BUILDING FOR RESIDENTIAL
TREATMENT PROGRAM AND SO NOW MY
COUNTY THEY HAD A CURRENT
PROGRAM THAT THE LONG TERM LEASE
EXPIRED AND SO THIS IS EXPAND
ALLOWING THEM TO. GO INTO
ANOTHER FACILITY AND BE ABLE TO
EXPAND ON SERVICE SAYS HAVE A
NEWS SIXTY BAD THAT NEW
CONSTRUCTION RESIDENTIAL PROJECT
IN AN UNDERSERVED AREA OF LOS
ANGELES WITH AN ATTACHED ON
SIXTEEN BADS UPPER COPPERY
BRIDGE HOUSING. AND THAT IT WILL
BE IN AN EXISTING TWENTY BAD
WOMEN AND CHILDREN PROGRAM TO A
NEW BUILDING AND EXPANDING BADS
TO AT LEAST FIFTY AND THEN A
SECOND PROJECT FROM THE SAME
PROVIDER THAT WOULD ALLOW THEM
TO BUILD A SMALL OUTPATIENT
FACILITY TO A LARGER LOCATION.
AND TO BE ABLE TO EXPAND SERVICE
SAYS THESE PROGRAMS AND TYPES OF
PROJECTS WILL SUBSTANTIALLY
INCREASE THE AMOUNT OF SERVICES
AVAILABLE FOR INDIVIDUALS WITH
SUBSTANCE USE DISORDER. I'M
BUILDING OUT INFRASTRUCTURE AND
SERVICES WILL ALSO ALLOW CARE
TRANSITIONS TO BE- TAKE PLACE
MORE SERIOUSLY FOR EXAMPLE AN
INDIVIDUAL THAT'S HOSPITALIZED
FOR AN OVERDOSE MOTIVATED TO
RECEIVE TREATMENT BY THE
EXPERIENCE TRANSITIONING
DIRECTLY INTO RESIDENTIAL CARE
INSTEAD OF HAVING TO CALL HOME
FIRST WHILE THEY WAIT FOR A
PATH. WHERE WE KNOW THAT IN THAT
SITUATION MANY INDIVIDUALS ARE
RISK OF A RELAPSE. I PREVIOUSLY
RAISED THIS WITH THE DEPARTMENT
BUT WE HOPE TO SEE THAT THERE IS
EQUITABLE FUNDING PROJECTS
BETWEEN MENTAL HEALTH AND
SUBSTANCE USE DISORDER
NATIONALLY FORTY ONE MILLION
INDIVIDUALS HAVE. THAT SUBSTANCE
USE DISORDER ACCORDING TO THE
RECENT DATA FROM THE NATIONAL
SURVEY ON DRUG USE AND- HOWEVER
MY THAN 10% OF. EACH YEAR OR
OLDER RECEIVED AN INCREASE FOR
THEIR- USE DISORDER. THERE STILL
EXIST SIGNIFICANT GAPS IN
AVAILABILITY AND- INSPECT MY
PETS AS ASSOCIATED WITH
SUBSTANCE USE DISORDER CARE. I'M
THE BIGGEST BARRIER OUT TO THE
SUCCESS OF THESE PROGRAMS WILL
BE THE RECRUITMENT AND RETENTION
EFFECTIVE WORKFORCE. AND THE
NEED TO FIND ONGOING SERVICES
WITHIN THE INFRASTRUCTURE
PROGRAM. WE ALSO WOULD NOTE THE
CRITICAL ON HOW CRITICAL-
IMPLEMENTATION OF PAYMENT REFORM
AND DOCUMENTATION REFORM UNDER
COUNTY IS TO FULLY UTILIZE DOT
POTENTIAL SERVICES AND-
FACILITIES. THANK YOU AND HAPPY
TO ANSWER ANY QUESTIONS. THANK
YOU- SET THAT IS THE CONCLUSION
OF THE PRESENTERS I WILL BRING
IT UP TO THE DÍAS FOR ANY
QUESTIONS. I WILL KEEP IT HERE
AT THE CHAIR I WILL BEGIN MY
QUESTIONS WITH DH CS. I WANTED
TO TALK A LITTLE BIT I'M I'M
CURIOUS ABOUT THE INFRASTRUCTURE
FUNDING. THAT YOU ARE PROPOSING
WHETHER OR NOT IT IS ABLE TO
HELP TO SUPPORT SOME OF THE WORK
THAT IS CURRENTLY UNDER WAY TO
RESPOND TO BOTH PSYCHOSIS. AS
WELL AS FOR THE ALL CODE YOU'D
DROP IN CENTERS. AS YOU MAY HAVE
HEARD LAST WEEK I ASKED IF- THE
CENTRAL VALLEY WAS A BENEFICIARY
OF THIS FUNDING THAT WAS MADE
AVAILABLE FOR THESE PROGRAMS AND
THE ANSWER WAS NOT YET. IN
TWENTY NINETEEN WE INVESTED
FIFTEEN MILLION TO SUPPORT
ALTHOUGH IF YOU DROP IN CENTERS.
AND TWENTY MILLION TO SUPPORT
THE COORDINATED SPECIALTY CARE.
FOR PSYCHOSIS AND THIS YEAR WE
ARE LOOKING AT ONE POINT FOUR
BILLION THAT IS BEING PROPOSED.
THAT I'D LIKE TO TRY TO GET IN
UNDERSTAND SINCE WE'VE ALREADY
INVESTED IN THESE PROGRAMS. AND
WE HAVE AN OPPORTUNITY TO
FURTHER SUPPORT THAT INVESTMENT
THROUGH THIS. INFRASTRUCTURE
FUNDING CAN YOU CLARIFY IF THESE
PROGRAMS ARE ELIGIBLE. FOR THIS
INFRASTRUCTURE FUNDING AND WHAT
OR NOT THE DEPARTMENT
INCENTIVIZE. THE USE OF THESE
BONDS SO THAT WE CAN FURTHER THE
INVESTMENTS WE HAVE ALREADY MADE
. WELLNESS CENTERS ARE AN
ELIGIBLE- AND ELIGIBLE
RECIPIENTS- FACILITY TYPE FOR
OUR AT OUR BROWN RELATED TO-
CHILDREN ANYTHING EVER HEALTH-
INFRASTRUCTURE DEVELOPMENT AND
SIMILARLY- THE FIRST LYCOS'S
PROGRAMS AND FACILITIES THAT
ADDRESS THOSE THOSE CONCERNS ARE
ALSO ELIGIBLE FOR PARTICIPATION
IN IN THESE GRANT PROGRAMS.
THANK YOU FOR THAT I- WAS
ENCOURAGED BY THE EARLY RESULTS
WE'VE SEEN FROM EARLY PSYCHOSIS
AND THE- PULKOVO DROP IN MODELS
THAT I'D LIKE TO MAKE SURE WERE-
INCREASING- BUILDING THOSE OUT
IF POSSIBLE- I WOULD NOTE OKAY
START. MARCH THIRTY FIRST WE
HAVE OUR FIRST LISTENING SESSION
ON THAT ON THAT ROUND DEFINING
AND SO- JUST. WELCOME THEIR
PARTICIPATION IN NOT LISTENING
SESSION AS WELL. WOULD LIKE TO
FOLLOW UP NOW IT'S A DRAW MIGHT
CONSISTENTLY BEAT BUT HOW DO WE
MAKE SURE THAT THE
INFRASTRUCTURE PROGRAM MONEY IS
BEING EQUITABLY DISTRIBUTED
THROUGHOUT OUR STATE. AND DO
PRIOR ROUNDS OF FUNDING INFORM
FUTURE ROUNDS IN TERMS OF WHO
THE RECIPIENTS HAVE BEEN AND
WHAT STATE GOALS HAVE OR HAVE
NOT BEEN. A REACHED HOPING YOU
COULD COMMENT ON THAT. SURE SO
AT THAT THE PRE ROUND BEEN THREE
GEOGRAPHIC DISTRIBUTION AND I
THINK AS WE LEARNED- WHAT.
PROJECTS HAVE BEEN APPLIED FOR
IN THE EARLIER ROUNDS I THINK
THAT MY TO JUST HOW WE I WORKED
AROUND FIVE AND SIX IN TERMS OF
ADDRESSING THE FURTHER GAPS-%
THAT WE IDENTIFY THINKING WE
WANT TO YOU KNOW WE HAD OUR
FIRST INITIAL KIND OF GIGI
GEOGRAPHIC DISINTEGRATION AND AS
WE MOVE THROUGH IN FUTURE ROUNDS
ADJUSTING BASED ON. YOU KNOW
WHAT PROJECTS ARE AWARDED WHAT
GAPS DO ANYTHING STILL NEED TO
BE FILLED AND REALLY RECOGNIZING
WE WANT THESE DOLLARS TO GO
ACROSS THE STATE TO ADDRESS YOUR
WORLD URBAN AND ALL THE
DIFFERENT A REGIONAL KIND OF
CONSIDERATIONS THAT MIGHT. MIGHT
FACTOR IN AS WELL. EARLIER WE
HEARD ABOUT THE NEEDS ASSESSMENT
AND WAS WONDERING IF IT HAD
IDENTIFIED. A SPECIFIC COST FOR
COVERING ALL OF THE STATE'S
BEHAVIORAL HEALTH.
INFRASTRUCTURE NEEDS. IF SO HOW
MUCH IS IT. AND HOW CLOSELY
ALIGNED IS IT TO THE AMOUNT OF
RESOURCES IN OUR CURRENT BUDGET
. SO IT DID NOT INCLUDE AT TOTAL
COST IN TERMS OFWHAT IT WHAT
AND ASSESSMENT THOUGHT IT WOULD
TAKE I WOULD JUST YOU KNOW THIS
IS ONE PIECE OF THE PUZZLE WE
ALSO HAVE THE WORK THAT WE WILL
BE DOING REGARD OUR TO OUR
ELEVEN FIFTEEN. I AM I AM THE
WAY PERSONAL ALL OF THESE PIECES
TOGETHER I'M REALLY ARE GOING TO
HELP US BUILD OUT THE CONTINUUM.
ACROSS THE STATE. FINAL QUESTION
FOR THIS PANEL I'D LIKE TO
FOLLOW UP ON WHAT TYLER RANDY.
HAD MENTIONED ABOUT ENSURING
EQUITABLE DISTRIBUTION FOR
MENTAL HEALTH AND SUBSTANCE USE
DISORDER. HOPING YOU COULD.
PROVIDE SOME COMMENTS ON ON THE
QUESTION. THAT QUESTION I WILL
TURN IT OVER TO MERRILEES BUT I
WOULD LIKE TO THINK THAT BEING
MISTER READY FOR REALLY JUST
GOING THROUGH SOME OF THOSE
EXAMPLES THAT REALLY KIND OF IT
REALLY THAT THAT IS JUST
CONCRETE EVIDENCE OF WHAT THESE
DOLLARS CAN PROVIDE AND WHAT
SERVICES THEY WILL BE ABLE TO
CONTINUE. TO SUPPORT AND KIND
OF- AND- GROSSO- ARE LEAST CAN
YOU SPEAK TO THAT QUESTION YEAH
DEFINITELY SO- OUTWARD LOOKING
AT MAKING THESE AWARDS AND-
SHELLER DIMENSION BROWN THREE IS
CURRENTLY OUT AND FOR FUTURE
ROUNDS. AS WELL I WILL BE
LOOKING AT. NOT ONLY. AND LIKE
THE- MENTIONED BUT ALSO FOR
SUBSTANCE USE HEALTH ALSO.
INNOVATIVE TO SELL THESE HAT
ARE DOING CO OCCURRING. ON OR
MAYBE SERVING YOU KNOW SPECIAL
POPULATIONS ARE JUST JUST
INVOLVED. I'M SO WE HAVE SET UP
OUR STATE PRIORITIES- AND THIS
IS ONE OF THE AREAS THAT WILL BE
LOOKING AT. SEEING NO OTHER
QUESTIONS I WANT TO THANK THE
ENTIRE THIRD PANEL. WE WILL NOW
MOVE ON TO OUR FOURTH PANEL ON
THE EMERGENCY DEPARTMENT CARE
FOR PSYCHIATRIC PATIENTS. WE
WILL HAVE EIGHT SPEAKERS ON THIS
PANEL WE WILL BEGIN WITH DR SETH
THOMAS AN EMERGENCY PHYSICIAN
AND DIRECTOR OF QUALITY AND
PERFORMANCE. AT FERTILITY PLEASE
BEGIN DR THOMAS.
THANK YOU CHAIRMAN ARAMBULA AND
GOOD EVENING COMMITTEE MEMBERS
THANK YOU VERY MUCH FOR HEARING
MY TESTIMONY I'M DOCTOR SET
THOMAS I AM AN EMERGENCY
PHYSICIAN AND AMID RECTOR
QUALITY PERFORMANCE OF FOUR BY
TWO WEEKS. I WORKED CLINICALLY
AT MERCY SAN JUAN MEDICAL CENTER
IN I'M JOINED THIS EVENING. BY
DR MICHAEL COURT PEEL WHO IS OUR
HOSPITAL CEO AND PRESIDENT WHO
WILL ALSO BE TELLING US A LITTLE
BIT ABOUT OUR EXPERIENCE WITH
THE M. POP BOTTLE. BUT BEFORE I
START TIME WANT TO GIVE YOU A
LITTLE BIT OF BACKGROUND WILL BE
TALKING ABOUT THE GAPS IN CARE
FOR PATIENTS IN CRISIS IN OUR
EMERGENCY DEPARTMENTS AND I
ALWAYS LEARNED EARLY ON. IN MY
LEADERSHIP CAREER WHEN YOU BRING
A PROBLEM TO SOMEBODY TO HELP
THEM SOLVE IT DON'T JUST BRING
THE PROBLEM BUT BRING SOLUTION
AND THAT'S WHAT WE'RE GONNA DO
TODAY. WE'RE GONNA TALK A LITTLE
BIT ABOUT DM HOUSE MODEL OR
EMERGENCY PSYCHIATRIC
ASSESSMENT. AND TREATMENT AND
HEALING MODEL SO AS AN EMERGENCY
PHYSICIAN WHAT'S IMPORTANT TO ME
HIS ACCESS TO CARE MAKING SURE
THAT PATIENTS REGARDLESS OF YOUR
ABILITY TO PAY AND YOUR
BACKGROUND HAVE THE OPPORTUNITY
TO RECEIVE TREATMENT. I ALSO
BELIEVE IN QUALITY COMPASSIONATE
CARE GIVING PATIENTS THE RIGHT
TREATMENT AT THE RIGHT TIME IN
THE RIGHT PLACE DOING WHAT'S
RIGHT FOR THE PATIENT AND DOINGWHAT'S BEST BUT I ALSO REALLY
BELIEVE THAT WHAT'S IMPORTANT IS
MAXIMIZING THROUGHPUT. AND
REDUCING DELAYS FOR THESE
PATIENTS ALSO STEWARDSHIP THE
APPROPRIATE USE OF RESOURCES AND
ELIMINATING UNNECESSARY WASTE AS
AN EMERGENCY PHYSICIAN I SEE
THIS ON A DAY IN AND DAY OUT
BASIS WHERE PATIENTS COME TO US.
IN CRISIS PATIENTS ARE HAVING
MENTAL HEALTH CRISES AND THEY
DON'T HAVE ANYWHERE ELSE TO GO
I'M A BIG BELIEVER THAT PATIENTS
SHOULD COME TO THE EMERGENCY
DEPARTMENT BUT THEY SHOULDN'T
STAY THERE INDEFINITELY AND THEY
SHOULDN'T BE DIFFERENT DAYS ON
END WITHOUT TREATMENT. SO WE
BELIEVE WE HAVE A SOLUTION
SOMETHING THAT WE'VE IMPLEMENTED
AT MERCY ST ONE BECAUSE CENTER.
AND IT IS CALLED THE EMPOWER
MODEL WE HERE TO ADVOCATE FOR
FUNDING OF THAT KIND OF A MODEL.
BEFORE THE END PASSED MODEL. WE
WOULD ASSESS PATIENTS AND THEY
WOULD GO THREE VERY STRINGENT
LINEAR PROCESS OF MEDICAL
EVALUATION BEEN BEING EVALUATED
BY SOCIAL WORKERS ARE CRISIS
WORKERS TO EVENTUALLY GET INTO
INPATIENT UNIT. THAT PROCESS
WOULD TAKE ONE TO TWO DAYS.
AFTER THIS AND HALF MODEL
PROVIDING CRISIS INTERVENTION
CRISIS TREATMENT WE NOW HAVE
CHOICES WE CAN RESTRICT FIVE
PATIENTS INITIATE TREATMENT
QUICKLY AND GET THEM THE CARE
THAT THEY NEED IMMEDIATELY. NOT
EVERY PATIENT NEEDS TO GO TO AN
INPATIENT FACILITY FOR
STABILIZING CARE. YEP HAVE MODEL
IS SOMETHING THAT HAS BEEN
AROUND FOR A LITTLE WHILE AND
ACTUALLY IT'S BEEN EXTERNALLY
VALIDATED CHU. BY IMPLEMENTING
IMPACT MODELS YOU CAN REDUCE THE
E. LANCASTER BY OVER 70% GETTING
PATIENTS THE CARE THAT THEY
TRULY NEED WHEN THEY NEED IT THE
MOST. IT REDUCES INPATIENT
PSYCHIATRIC ADMISSIONS BY OVER
FIFTY PERCENT. REDUCING
RECIDIVISM BY 25% AND BELIEVE IT
OR NOT PATIENTS ARE GETTING
CONNECTED TO THEIR OUTPATIENT
CLINICS AND THE FOLLOW UP
APPOINTMENTS. BY MORE THAN 60%
MORE THAN THEY WOULD HAVE
PREVIOUSLY. AND IT ALSO REDUCES
THE LENGTH OF STAY FOR INPATIENT
HOSPITALS AS WELL. NOW MICHAEL'S
GONNA TALK A LITTLE BIT ABOUT
OUR EXPERIENCE AT MERCY SAN JUAN
MEDICAL CENTER. THANKS DR
THOMAS- WE WERE AWARDED AN
INNOVATION GRANT THROUGH THE
STATE. OUGHT TO OPEN UP OUR-
CRISIS STABILIZATION UNIT AND
THERE'S A PICTURE OF IT ON THE
FAR RIGHT HAND SIDE OF THE PAGE.
YOU CAN SEE IT'S NOT YOUR
EMERGENCY ROOMS TYPE SETTING AND
IT'S SPECIFICALLY DESIGNED FOR.
OUR BEHAVIOR HELP PATIENTS WE
HAVE SEEN THIRTY SEVEN HUNDRED
PATIENTS SINCE ITS INCEPTION. IN
SEPTEMBER OF TWENTY NINETEEN.
OUR AND OUR STATISTICS MERE WHAT
DR THOMAS HAS RECORDED IN THE
PEER REVIEWED ARTICLES 75% ARE
DISCHARGED HOME. 30% REDUCING
RECIDIVISM RATE R. ET BOARDING
TIME. HAS GONE FROM THIRTY TWO
POINT NINE HOURS DOWN TO FOUR
POINT FIVE HOURS THIS FALL. I
AND OUR PATIENT EXPERIENCE
SCORES ARE QUITE HIGH AT THE
EIGHTY SIXTH PERCENTILE. OF
MERCY SAN JUAN HAS DEVELOPED A
TRANSFER AGREEMENTS WITH ALL OF
THE FACILITIES IN. SACRAMENTO TO
HELP ALL PATIENTS THROUGHOUT THE
COUNTY. THIS IS OUR CURRENT-
PAYER MIX AND YOU. CAN SEE VERY
HEAVY META CAL. IN POPULATION
BUT- THAT'S WITH THIS UNIT HAS-
DESIGNED TO- SERVE. AND THEN
FINALLY SUGGESTED NEXT STEPS ARE
CLEAR LICENSING GUIDELINES FOR
ALL COUNTIES AND SEE CDPH TO
FOLLOW. A MEDIC CAL
REIMBURSEMENT RATES THAT MAKE
THE SERVICE FINANCIALLY VIABLE
AND THEN CONTINUED USE OF
INNOVATION DOLLARS TO GET SEE
ISSUES UP AND RUNNING. THANK YOU
VERY MUCH FOR YOUR TIME. THANK
YOU NEXT WE WILL HEAR FROM
DOCTOR AMY MULAN WHO'S AN
EMERGENCY DEPARTMENT BEHAVIORAL
HEALTH DIRECTOR AT UC DAVIS
PLEASE BEGIN. THANK YOU I REALLY
APPRECIATE- THE TIME AND ENERGY
AND CREATIVITY FOR THIS
COMMITTEE HEARING- AND THE
ATTENTION ON OUR PATIENTS WITH
MENTAL ILLNESS. AND I JUST
WANTED TO REITERATE WHAT WE
HEARD FROM DOCTOR THOMAS THAT
OUR CURRENT SYSTEM WE ARE NOT
MEETING THE NEEDS OF OUR
PATIENTS AND WE NEED TO PROVIDE
RESOURCES TO THE PEOPLE WHO MEET
THEM AND DESIGN OUR SYSTEMS TO
MEET PEOPLE WHERE THEY ARE.
RATHER THAN CURRENTLY WHAT WE
HAVE DONE WHICH IS DESIGNED THE
SYSTEM TO DRIVE PEOPLE THROUGH
IT- WE KNOW THAT. THE NEED FOR
MENTAL HEALTH TREATMENT AND
SUBSTANCE USE TREATMENT. IS JUST
INCREASING IN OUR COMMUNITIES
AND WE HAVE CONTINUED TO SEE
INCREASES IN EIGHTY VISITS FOR
MENTAL ILLNESS AND SUBSTANCE
USE. AND WE WERE LIKELY TO
CONTINUE TO SEE AN INCREASE IN
EDIE VISITS. BECAUSE OF OUR
SHARED TRAUMA AND AS WE RECOVER
FROM KOBE NINETEEN. AND I THINK
IT'S A FROM A POLICY PERSPECTIVE
IT'S HARD RATE WE WANT TO THINK
OF AN EASY VISIT IT'S A FAILURE
AND WE WORRY ABOUT WHAT IT SAYS
ABOUT US- AND WE BLAME PEOPLE
FOR GOING TO THE WRONG PLACE AND
NOT UNDERSTANDING THE SYSTEM
THAT WE HAVE DESIGNED. AND
INSTEAD WE SHOULD BEGIN WITH OUR
DUTY TO TAKE CARE OF EACH PERSON
AND FROM WHAT I HEAR ABOUT THIS-
HALF SYSTEM. WHAT THEY'RE TRYING
TO DO IS EXACTLY THIS IS TO
BRING THE RESOURCES TO THE
PATIENT RATHER THAN TAKING THE
PATIENT TO THE RESOURCE. WERE
EVERYWHERE SOMEONE ASKS FOR HELP
WE NEED TO BE THERE AND GIVE
THEM THE HELP THAT TEY NEED.
EVERY HEALTH CARE COME IN
COUNTER EVERY EDIE VISIT IS AN
OPPORTUNITY TO DO BETTER AND
GIVE PEOPLE THE HELP THAT THEY
NEED. AND SO I SWEAR LIKE
THINKING ABOUT HOW TO HELP OUR
OMMUNITY AT A MINIMUM WE SHOULD
THINK ABOUT HOW TO BRING THESE
RESOURCES. SUCH AS PEER SUPPORT
SPECIALIST COUNSELLORS MENTAL
HEALTH WORKERS TO THE PEOPLE WHO
NEED THEM- AND SO THAT IS
EXACTLY THIS THE SYSTEM THAT DR
THOMAS DESCRIBED. AND WE KNOW
WHERE THE PEOPLE ARE THERE OFTEN
IN THE EMERGENCY DEPARTMENT.
WAITING TO BE ABLE TO ACCESS THE
TREATMENT THAT THEY NEED-
BECAUSE WE HAVE SPECIFICALLY
EXCLUDED EMERGENCY DEPARTMENTS.
FROM THESE REIMBURSEMENT AND
BILLING MECHANISMS TO SUPPORT
THE RESOURCES THAT PEOPLE NEED
AND SO I THINK. IF WE ACTUALLY
THINK ABOUT THE PEOPLE THAT WERE
TRYING TO SIR. AND DESIGN THE
SYSTEM FOR THEM RATHER THAN FROM
THEN FOR US WE START TO
UNDERSTAND. THIS IS WHERE WE
NEED TO BE ABLE TO PROVIDE CARE-
BECAUSE IT IS JUST SO EASY FOR
PEOPLE TO GET LOST IN THE SYSTEM
AND SO WE NEED TO HAVE THESE
RESOURCES WHERE. THEY NEED THEM
WHEN THEY NEED THEM. THANK YOU.
THANK YOU DR MULLIN NEXT WE'LL
HEAR FROM RENO HACK A PEER
SUPPORT SPECIALIST. AT UC DAVIS
PLEASE BEGIN OR- HI MY NAME IS
SERENA HOCH UM I MAP YOUR
SUPPORT SPECIALIST AT THE UC
DAVIS EARLY PSYCHOSIS PROGRAM-
I'VE BEEN LIVING WITH- AS A
CHRONIC DISORDER FOR ABOUT A
DECADE- AND I'VE BEEN TO THE
EMERGENCY ROOM- FORD PSYCHIATRIC
EMERGENCIES ARM PROBABLY FOUR OR
FIVE TIMES- I NO LONGER GO TO
THE EMERGENCY ROOM IF I NEED
HELP BECAUSE I FOUND- MERGING.
THE ROOMS TO BE INCREDIBLY
UNHELPFUL. I'M IN GENERAL MY
EXPERIENCE IS BANNED I GO THERE
I WAIT FOR. LIKE BARE MINIMUM
FIVE HOURS I AM IN THE EMERGENCY
ROOM IN DISTRESS I'M
INTELLIGENCE TEAM BY A SOCIAL
WORKER OR PSYCHIATRIST AND THEN
THE TWO OUTCOME BAND EITHER I'M
HOSPITALIZED OR I AM DISCHARGED.
AND WHEN IT GETS CHARGED I AM
GIVING NO RESOURCES MAY. BE A
SHORT TERM PRESCRIPTION. AND
THIS HAS BECAUSE MY MENTAL
HEALTH CRISES TO BE SO MUCH
MORE- PROLONGED THEN THEY NEED
TO BE. BECAUSE YOU KNOW WHEN
YOUR PEOPLE DON'T KNOW HOW TO
NAVIGATE THE MENTAL HEALTH
SYSTEM THEY JUST KNOW- I MEAN
CRISIS I'M GOING TO GO TO THE
EMERGENCY ROOM- THAT. THERE'S
BEEN SO MANY TIMES I WENT TO THE
EMERGENCY ROOM IN CRISIS BUT I
DIDN'T MEET THE GUIDELINES FOR
HOSPITALIZATION. SO FOR SOME
REASON THAT MEANT THAT THEY
COULDN'T HELP ME- THERE'S SO
MANY SERVICES FOR PEOPLE WHO
DON'T MEET THE CRITERIA FOR
HOSPITALIZATION- AND THERE'S
BEEN A LOT OF SERVICES I
BENEFITTED FROM THE HEART OF
HOSPITALIZATION BUT I NEVER KNEW
ABOUT. AND I FEEL LIKE AS LONG
AS THE EMERGENCY ROOM IT IS
DISCONNECTED FROM THE MENTAL
HEALTH SYSTEM AS IT IS. IT'S NOT
DOING ITS JOB AND THE EMERGENCY
ROOM IS GOING TO REMAIN THE
WRONG PLACE FOR PEOPLE IN A
MENTAL HEALTH CRISIS. I THINK
THAT WE REALLY NEED TO SET UP IN
THE EMERGENCY ROOM TO BE
CONNECTED TO OTHER RESOURCES.
BESIDES FOSSILIZATION THERE'S SO
MANY SERVICES THIRD ARTICLE
PUBLICATION PROGRAMS THERE'S AN-
INTENSIVE OUTPATIENT SERVICES
THIRDS RESIDENTIAL SERVICES
OUTPATIENT PROVIDERS. AND PEOPLE
DON'T KNOW HOW TO GET TO THESE
RESOURCES. I AM. EARLY ON IN
THEIR JOURNEY THEY DON'T KNOW
THAT THESE SERVICES EXIST OR HOW
TO GET THERE AND A LOT OF TIMES
THEIR FIRST CONTACT WITH THE
MENTAL HEALTH. SYSTEM IS THE
EMERGENCY ROOM- AND
HOSPITALIZATION THEY'RE VERY
EXPENSIVE LIKE THE PROGRAM I
TALKING. ARE OFTEN A LOT CHEAPER
. BUT INSTEAD OF PEOPLE ARE JUST
DISCHARGED WITH NOTHING AND BAY
CONTINUE ONE BEING A CRISIS
UNTIL A COUPLE MONTHS LATER THEY
MEET CRITERIA FOR
HOSPITALIZATION NOW BECAUSE THEY
HAVEN'T RECEIVED ANY HELP. YOU
KNOW- ALONG THE MENTAL HEALTH
CRISES ARE DRAMATIC OR CONSUMERS
AND FOR EVERYONE WHO CARES ABOUT
THEM SO I REALLY FEEL LIKE
CHANGING THE EMERGENCY ROOM WILL
REDUCE THE TRAUMA RELATED TO
PROLONGED MENTAL HEALTH CRISIS
AND IMPROVE OUTCOMES BECAUSE WE
SHOULD CERTAIN WE SHOULD START
HELPING PEOPLE BEFORE THEY NEED
TO BE HOSPITALIZED- THANK YOU
THAT IS. THAT WILL BE MY
TESTIMONY THANK YOU FOR YOUR
TESTIMONY NEXT WE WILL HEAR FROM
TOBY EWING THE EXECUTIVE
DIRECTOR FOR THE MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION. THANK
YOU AGAIN TOBY HEARING ON BEHALF
OF THE COMMISSION I'LL KEEP MY
COMMENTS BRIEF- BECAUSE I THINK
YOU HEARD TWO VERY IMPORTANT
MESSAGES. FROM MISS HACK AND
INDUCT MULLIN IT'S VERY
IMPORTANT BRING SERVICES TO
PEOPLE. AND THAT ALL PASSED NEED
TO LEAD TO THE RIGHT CARE AT THE
RIGHT TIME. YOU KNOW FOR THE
COMMISSION WHAT WHAT WE'RE
EXCITED ABOUT IS THIS EMPATHIC
MODEL IS AN EXAMPLE OF A VERY
CREATIVE APPROPRIATE- WORK THAT
IS BEING DONE IN. THE CAPACITY
TO SCALE THAT OVER TIME. WHAT
WE'RE CONCERNED ABOUT IS THE
FINANCIAL SUSTAINABILITY AND
WHETHER OR NOT THERE ARE THE
RIGHT KINDS OF FISCAL INCENTIVES
TECHNICAL ASSISTANCE TRAINING IF
WE HAVE BUILT THE INFRASTRUCTURE
THAT IS NECESSARY TO MAKE SURE
THAT WE'RE DEPLOYING THESE
PROGRAMS WITH FIDELITY. TO THE
MODEL WHAT THE EVIDENCE SAYS
THAT THERE ARE EFFECTIVE THAT WE
HAVE THE INFRASTRUCTURE TO LEARN
FROM THESE EXAMPLES. IN TERMS OF
HOW WE CAN BEST SUPPORT PEOPLE
SO WE CAN BRING THOSE TIMES DOWN
EVEN MORE SO THAT WE CAN MAKE
SURE THAT PARTICIPATION IN A
PROGRAM LIKE THIS ACTUALLY LEADS
TO A HIGHER QUALITY OF CARE.
THEY CAN- WE HOPE REDUCE THE
NEED FOR REVISITING THAT THE E.
R. OVERTIME. OF THE COMMISSION
THIS KIND OF THE PROJECT AND
IT'S CONSISTENT WITH MY EARLIER
COMMENTS AROUND THE
MODIFICATIONS TO S. P. TWO. IT
COMES AT AN EXAMPLE OF HOW WE
SHOULD BE THINKING ABOUT
UPSTREAM OPPORTUNITIES TO DO
EARLY ENGAGEMENT PREVENTION
WHERE NECESSARY TO REALLY
INTERVENE QUICKLY IN A CRISIS TO
REDUCE THE SCALE INTENSITY
DURATION. AND IDEALLY THE NUMBER
OF CRISES THAT WE EXPERIENCE AND
SO WE REALLY HOPE THAT WE CAN
WORK WITH OUR PARTNERS IT
DEFEATS THE ASSET SEE BEACH DA
HOSPITALS AND ELSEWHERE TO NOT
JUST SCALE THIS. PROJECT BUT
IDENTIFIED OTHER EXAMPLES OF
VERY EFFECTIVE INTERVENTIONS
THAT ARE BEING. DEPLOYED IN
AMONG OUR PARTNER STATEWIDE
REALLY UNDERSTAND THOSE AND
SCALE THIS OVER TIME SO THAT ALL
CALIFORNIANS HAVE ACCESS TO
HIGHLY EFFECTIVE CARE THAT AGAIN
AS AND I'LL JUST PARAPHRASE.
MINTAK THAT IS AVAILABLE IN THE
RIGHT PLACE AT THE RIGHT TIME TO
THE WERE RESPONSIVE TO NEEDS
THAT WE'RE BRINGING SERVICES TO
PEOPLE RATHER THAN EXPECTING
PEOPLE TO CHANGE THEIR LIVES IN
THEIR REALITIES. TO ACCOMMODATE
A SYSTEM DESIGNED THAT WASN'T
NECESSARILY TAILORED WHAT'S
HAPPENING IN OUR LIVES. THANK
YOU MEDICARE NUMBERS THANK YOU
NEXT WE'LL HEAR FROM JC COOPER
STATE MEDIC K. DIRECTOR THE- OF
HEALTH SERVICES. YOU ARE THE
SUBCOMMITTEE REQUESTED THE ACS
CLARIFY WHAT TYPES OF EMERGENCY
DEPARTMENT MENTAL HEALTH CARE
AND SERVICES ARE REIMBURSABLE BY
MEDICARE ALL ON ALL SERVICES
PROVIDED IN EMERGENCY DEPARTMENT
FOR MEDICARE BENEFICIARIES ARE
COVERED BY THE MEDI CAL MANAGED
CARE PLAN. UP FOR MEMBERS WHO
ARE ENROLLED IN MANAGED CARE AND
FOR MEDIC CAL FEE FOR SERVICE
INDIVIDUALS WOULD BE BILLED TO
MEDICARE FEE FOR SERVICE TO OUR
FISCAL INTERMEDIARY. THESE
SERVICES ARE COVERED BY MANAGED
CARE OR FEE FOR SERVICE
REGARDLESS OF THE DIAGNOSIS MADE
IN A DURING THE EMERGENCY
DEPARTMENT VISITS INCLUDING FOR
MENTAL HEALTH AND SUBSTANCE USE
DISORDER DIAGNOSES I'M THE
REASON FOR THIS IS THAT THERE
COULD BE A IT WOULD BE
IMPOSSIBLE FOR AT MERGING TWO
DEPARTMENTS YOU REALLY SEPARATE
OUT VISITS FOR BEHAVIORAL HEALTH
REASONS- BUT VISITS FOR PHYSICAL
HEALTH REASONS AND BIFURCATING
BE. A RESPONSIBILITY FOR
EMERGENCY DEPARTMENT SAYS IT'S
NOT ADVISED- ADDITIONALLY- WOULD
JUST POINT OUT THOUGH- BASED ON
THE COMMENTS IN THE IN THE
HEARING AROUND CRISIS
STABILIZATION UNITS I'M IT IS
THE RESPONSE WE HAVE THE COUNTY
BEHAVIORAL HEALTH DEPARTMENTS
ARE TO PAY FOR CRISIS
STABILIZATION UNITS OFTEN THESE
CRISIS STABILIZATION UNITS ARE
NEAR OR ADJACENT TO EMERGENCY
DEPARTMENTS AREN'T REQUIRED TO
BE. HE AND I WOULD ALSO INDICATE
THAT I. DEPENDING ON THE OUTCOME
OF THE EMERGENCY DEPARTMENT
VISIT IF THERE IS ADDITIONAL
PLACEMENT NEEDED FOR A
BENEFICIARY OUTSIDE OF THE
EMERGENCY DEPARTMENT DEPENDING
ON THE TYPE OF SERVICES BEING
RECOMMENDED- IT MAY BE THE
RESPONSIBILITY OF THE COUNTY
BEHAVIORAL HEALTH DEPARTMENT TO
COORDINATE THAT TRANSFER AND
SERVICE AND THAT IS WHERE IT
GETS SLIGHTLY COMPLICATED BY THE
MEDICARE MANAGED CARE PLAN IS
RESPONSIBLE FOR PROVIDING. THE
REIMBURSEMENT AND PAYMENT FOR
ALL SERVICES PROVIDED IN
EMERGENCY DEPARTMENT ON THE
SERVICES THAT ARE NEEDED AFTER
OR TRANSFER SERVICES MAY NOT BE
THE MANAGED CARE PLANS
RESPONSIBILITY MAY BE THE COUNTY
BEHAVIORAL HEALTH DEPARTMENT- I
WITH A NOTE I WILL BE THE ONLY
PRESENTER FOR DH CS AND HAPPY TO
ANSWER QUESTIONS WHEN IT IS
TIME. THANK YOU NECK WE'LL HEAR
FROM THE CABRERA. DIRECTOR FOR
THE COUNTY BEHAVIORAL HEALTH
DIRECTORS ASSOCIATION PLEASE
BEGIN. THANK YOU SO MUCH- CHAIR
AND MEMBERS MYSELF HAVE IT I
WOULD SEE THE HTA. TODAY WHEN AN
INDIVIDUAL IS IN A PSYCHIATRIC
EMERGENCY OR HAS A SUBSTANCE USE
DISORDER RELATED EMERGENCY-
CLINICIANS WILL DIRECT THAT
PERSON TO THE EMERGENCY
DEPARTMENT FOR THAT EMERGENCY
AND THAT DIRECTION COMES BECAUSE
HOSPITALS HAVE A RESPONSIBILITY
UNDER AND PAULA TO PROVIDE
EMERGENCY SERVICES FOR ANY
BEHAVIORAL HEALTH CONDITION ON
PAR WITH A MEDICAL CONDITION.
AND AS- NEWS COOPER POINTED OUT
THE- MEDICAL EMERGENCIES
SOMETIME MAY PRESENT AS A
BEHAVIORAL HEALTH EMERGENCY
THERE ARE CERTAIN MEDICAL
CONDITIONS THAT YOU I'M SURE OUR
WHERE I CHAIR SUCH AS A U. TI
WHICH SOMETIMES- MAY APPEAR TO
BE PSYCHOSIS THAT HAS BEEN UNDER
UNDERLYING MEDICAL REASON AND
FOR THOSE REASONS. IT'S VERY
IMPORTANT FOR INDIVIDUALS TO GO
TO EMERGENCY DEPARTMENTS WHEN
THEY'RE HAVING AN EMERGENCY
SITUATION. HOWEVER ALL TOO OFTEN
WHEN INDIVIDUAL SHOW UP AT THE
E. B. HAVE OTHERS HAVE HAVE
POINTED TO- INDIVIDUALS WITH-
PERCEIVED TO BE HERE HEALTH
EMERGENCIES ARE NOT ALWAYS
TREATED WITH THE SAME KIND OF
COMPASSIONATE CARE THAT THEY MAY
RECEIVE IF THEY PRESENTED WITH
THE STROKE OF BROKEN BONES OR
EVEN WITH- SOME SORT OF
TRAUMATIC IJURY. THE KEY
DIFFERENCE IS LONGSTANDING
STIGMA AND BIAS TOWARDS BE
ROCKHOLD CONDITIONS THAT
UNFORTUNATELY PERSISTS TODAY IN
OUR MEDICAL DELIVERY SYSTEM AND
THE RESULTS ARE DEVASTATING FOR
INDIVIDUALS WITH SIGNIFICANT
BEHAVIORAL HEALTH NEEDS- WHO MAY
NOT BE HAVE THEIR ISSUES MATT
TIMELY OR WHO MAY GET
INAPPROPRIATELY DIVERT IT. WE'VE
EVEN SEEN THAT SOMETIMES
HOSPITALS MAY FAIL THE BILL-
THEIR MEDIC HOW. MANAGED CARE
INSURANCE OR OTHER IN SURE IT'S
- WHICH ONLY TO THE DEATH.
SERVICES FOLLOW A NUMBER A- AND
SO ALL OFTHESE ISSUES ARE
REALLY IMPORTANT FOR US TO
ADDRESS MOVING FORWARD.
CURRENTLY TOWNIES HAVE BUILT OUT
THE STATE WIDE NETWORK OF CRISIS
STABILIZATION UNITS WERE CSU
PRIMARILY WITH FUNDING FROM S.
B. EIGHTY TWO I WHICH WAS PASSED
IN TWENTY TWELVE. TODAY WE HAVE
A COUPLE OF DOZEN CSU THROUGHOUT
THE STATE AND ROUGHLY 20% ARE
HOSPITAL BASED TO OUR KNOWLEDGE
FIRST I WANT TO CREDIT ARE-
IMPACT PARTNERS FOR REALLY
RECOGNIZING THAT BEHAVIORAL
HEALTH CRISES OUGHT TO BE
TREATED ON PAR WITH MEDICAL
EMERGENCIES. HOWEVER I MUST
CAUTION BILL ZELIFF APPROACH
AROUND EXPANDING CRISIS
STABILIZATION UNITS- AND THIS IS
BASED ON THE EXPERIENCES OF
COUNTIES IN TRYING TO BUILD OUT
THE A FEW CAPACITY OVER THE LAST
SEVERAL YEARS. FIRST I WANT TO
POINT OUT THAT THERE IS A TWENTY
FOUR HOUR LIMITATION ON WHAT WE
CAN BUILD FOR- AS WHAT IS
CONSIDERED A CSU SERVICE THIS
IS- IN STATE REGULATION. AND
OFTEN TIMES BECAUSE WE ARE
TRYING TO TRANSFER INDIVIDUALS
OR THERE MAY BE- BOTTLENECKS IN
TERMS OF THROUGHPUT INDIVIDUALS
MAY NEED TO STAY OVER TWENTY
FOUR HOURS BUT BECAUSE OF. THE
IF YOU REGULATIONS WERE NOT ABLE
TO BILL FOR THOSE I STAYS OVER
TWENTY FOUR HOURS. IN ADDITION
THE VAST MAJORITY OF OUR CSU
THROUGHOUT THE STATE ARE VERY
SMALL THEIR UNDER SIXTEEN BEDS
SO THAT COUNTIES CAN RECEIVE
MEDICARE REIMBURSEMENT FOR THOSE
SERVICES AS THE ISSUES FALL
UNDER THE I AND B. EXCLUSION.
THIS PART ALSO CURTAILED ARE
LIMITED THE EXPANSION AND THE
SUSTAINABILITY AND VIABILITY OF
THE EXCUSE. IN THE RECENT CALL
THE PANDEMIC WE SAW THAT THOSE
THROUGHPUT ISSUES WERE
SIGNIFICANTLY EXACERBATED AS
MANY OF THE RECEIVING FACILITIES
WHETHER THEY ARE AT HIGHER
LEVELS ARE LOWER LEVELS REQUIRED
KOBE NEGATIVE PASSED OR OTHER
THINGS THAT WERE REALLY
DIFFICULT TO SECURE WITHIN THAT
TWENTY FOUR HOUR PERIOD. WHICH
JUST MADE- SISTEMI SERVICES EVEN
MORE DIFFICULT AND AS YOU HEARD
FROM THE RAND ANALYSIS WHICH- DR
KELLY REFERENCED EARLIER
COUNTIES CURRENTLY HAVE
SIGNIFICANT GAPS DEPENDING ON
REGION- IN EITHER INPATIENT
SUBACUTE OR RESIDENTIAL LEVELS
OF CARE. I ALSO WANT TO
HIGHLIGHT THAT SACRAMENTO COUNTY
BEHAVIORAL HEALTH DEPARTMENT WAS
THE SORT OF- INNOVATOR WHO
BROUGHT FORWARD THE CONCEPT OF
THE HOSPITAL BASED CSU WHICH WAS
FUNDED BY THE OAC- AND THAT
PARTNERSHIP WITH BIRD THROUGH
OUR COUNTY BEHAVIORAL HEALTH
DEPARTMENT. HOWEVER IN ORDER TO
TRY TO REPLICATE- SOMETHING THAT
IS AN INNOVATION PROJECT WE
OFTEN NEED TO MODIFY IT
SIGNIFICANTLY ENOUGH THAT IT IS
CONSIDERED A DIFFERENT
INNOVATION IN THE EYES OF OUR-
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. SO MOVING FORWARD WE
THINK IT'S IMPORTANT THAT WE
LOOK AT POTENTIALLY MAKING
CHANGES TO CSU REIMBURSEMENT- IN
ORDER TO ENSURE THAT WE CAN GET
THE MOST OUT OF THIS LEVEL OF
CAPACITY AND WE ALSO NEED TO
ENCOURAGE EMERGENCY DEPARTMENTS
TO DO THE RIGHT THING. BY
INDIVIDUALS WITH BEHAVIORAL
HEALTH CRISES AND WITHIN
EXISTING MEDICARE REIMBURSEMENT
STRUCTURES- WITH THOSE TWO STEPS
WE THINK THAT WE COULD DO A LOT
MORE TO- ENSURE THAT INDIVIDUALS
DO RECEIVE CARE- ON PAR WITH THE
MEDICAL CARE THAT THEY RECEIVE
AN EMERGENCY DEPARTMENT. THANK
YOU. THANK YOU NEXT WE'LL HEAR
FROM KIM PETERSON SENIOR
ATTORNEY WITH. DISABILITY RIGHTS
CALIFORNIA. HELLO THANK YOU
CHAIR AGAIN MY NAME IS COMPUTER
SAID AND IN. ORDER FOR
DISABILITY RIGHTS CALIFORNIA.
I'LL KEEP MY REMARKS FOR THIS
PANEL SHORT I. ECHO THE
TESTIMONY PROVIDED BY RINA HOCK
AND THANK HER FOR SHARING HER
EXPERIENCE OF GOING TO AN
EMERGENCY DEPARTMENT DURING A
BEHAVIORAL HEALTH CRISIS. IN MY
EXPERIENCE REPRESENTING PEOPLE
LIVING WITH SERIOUS MENTAL
ILLNESS I HAVE SEEN FIRST HAND
HOW HOSPITAL EMERGENCY
DEPARTMENTS ARE POSSIBLY THE
WORST PLACE FOR A PERSON
EXPERIENCING A BEHAVIORAL HEALTH
EMERGENCY. THEY ARE NOT PRIVATE
THEY'RE OFTEN CROWDED LOUD AND
CHAOTIC AND THEY'RE NOT STAFFED
BY BEHAVIORAL HEALTH CLINICIANS
IN MANY PLACES. BECAUSE I'M
OFTEN AN ADEQUATE DISCHARGE
PLANNING RESOURCES COMBINED WITH
A SHORTAGE OF REFERRALS
INTENSIVE COMMUNITY BASED
SERVICES AND A BACKLOG AND
AVAILABILITY OF INPATIENT
TREATMENT BEDS FOR PEOPLE WHO
NEED THEM PEOPLE MAY LANGUISH IN
EMERGENCY DEPARTMENTS FOR DAYS.
NOT ONLY DOES NOT HAVE ACCESS TO
APPROPRIATE TREATMENTS REYES OFF
A CRISIS BUT IT OFTEN LEADS TO
VIOLATIONS IMPORTANT DUE PROCESS
RIGHTS. AS I STATED DURING THE
PREVIOUS PANEL DRC ENCOURAGES
THE STATE TO BUILD OUT THE
INFRASTRUCTURE FOR NON EMERGENCY
DEPARTMENT OPTIONS FOR
BEHAVIORAL HEALTH CRISIS
INTERVENTION AND TREATMENT.
OPTIONS SHOULD STRONGLY FAVOR
VOLUNTARY LOCAL CARE SUPPORTIVE
SERVICES. I DO NOTHAVE ANYTHING
FURTHER TO ADD ON THIS TOPIC BUT
AGAIN I'M HAPPY TO ANSWER ANY
QUESTIONS AFTER THE PANEL. THANK
YOU VERY MUCH THAT CONCLUDES THE
PRESENTERS ON THIS PANEL I WILL
NOW BRING IT UP TO THE DYESS. WE
WILL BEGIN WITH ASSEMBLY MEMBER
RUNS. THANK YOU THANK YOU MISTER
CHAIR JUST A COUPLE OF COMMENTS
AND QUESTIONS I MEAN ONE OF THE
COMMENTS FROM THE- HERE- SUPPORT
SPECIALS FROM UC DAVIS TALKED
ABOUT. HOW ENTERING THE
EMERGENCY ROOM- TURNED INTO A
MINIMUM I THINK FOUR TO FIVE
HOURS. BUT THEN ULTIMATELY WHEN
THEY WERE SEEN THEY WERE THEY
WERE- GIVEN BASICALLY LACK OF
RESOURCES TO MOVE FORWARD. WE
ALSO HEARD ABOUT SOME OF THE
DIFFERENT AREAS OF CRISIS
STABILIZATION UNITS BEING CLOSE
TO. DIFFERENT MEDICAL
FACILITIES- WELL WE'RE ON THE
COUNTY BOARD OF SUPERVISORS WE
WORKED HARD ON CRISIS
STABILIZATION UNITS. I THINK AT
THAT POINT WE HAD ONE OUT AND-
IN JOSHUA TREE OUT IN THE
DESERT- I THINK TWELVE BEDS BUT-
THE LONGEVITY OF THE STAY WAS
ALWAYS SOMETHING THAT WAS- ALSO-
A CONCERN. BECAUSE YOU KNOW THE
LACK OF RESOURCES OVER THERE
WE'RE TALKING ABOUT MOBILE
CRISIS STABILIZATION UNITS IN
CRISIS STABILIZATION UNITS. AS
AN ALTERNATIVE FOR- EMERGENCY
ROOMS AND- AND WE HAVE LAW
ENFORCEMENT FIREFIGHTERS MOVING
YOU KNOW BEING CALLED THE
SITUATION. BUT WE ALSO- WITHIN
WE HEARD A PRESENTATION OF HOW.
IT WAS SUCCESSFUL I FORGET WHICH
PRISONER IT WAS THAT THEY HAVE A
AN AREA NOW WHERE THEY HAVE
SERVICES WITH OTHER HOSPITALS I
GUESS. THAT WOULD THEN- HAVE-PEOPLE HAVE- PATIENTS THERE ARE-
OUR CLIENTS BUT HOW LONG IS THAT
IS THE STATE FOR THOSE
INDIVIDUALS TO BE ABLE TO STAY.
IN THOSE TYPES OF FACILITIES
BECAUSE I THINK ONE OF THE NEXT
STEP- CERTAINLY CRISIS
STABILIZATION UNITS MOBILE
CRISIS STABILIZATION UNITS. BUT
ALSO- THE LONG TERM NINETY DAYS
PLUS TYPE OF TREATMENT I THINK
WE HAVE TO. START AT LEAST THROW
INTO THE DISCUSSION- IF WE'RE
TALKING ABOUT THE INFRASTRUCTURE
BEING BUILT OUT AND I WANT TO
THANK. THOSE IN THE PRESENTERS
FOR ALSO INCLUDING IN PRIOR
PANELS I HAD TO STEP OUT MISTER
CHAIR BUT- ON THE DISCUSSION ON
TRIBAL INCLUSION- WITH THE
INFRASTRUCTURAL BUILD. THAT'S
THERE BUT ALSO- MAKING SURE THAT
THE AGE APPROPRIATION IS THERE
ALSO FOR. OUR YOUTH- OUR OUR
ADOLESCENTS IT IN OUR ADULT
POPULATION THAT WE'RE LOOKING AT
THE PICTURE. IN FULL CIRCLE SO-
COUPLE QUESTIONS AS FAR AS THE
RESOURCES LEAVING- THE EMERGENCY
ROOMS AT THIS POINT. WHAT
RESOURCES- ARE- BEING GIVEN TO-
THOSE INDIVIDUALS NEEDING THAT
AND ALSO IN THOSE- WE HAVE
AVAILABILITY ASIAN AREAS. WHAT
IS THE LONGEVITY OF THE STATE.
I'D BE HAPPY TO ANSWER IT FROM
THE HOSPITAL PERSPECTIVE- WHEN
WE STARTED OUT OUR LENGTH OF
STAY IN THE EMERGENCY ROOM WAS
RIGHT AROUND THIRTY TWO HOURS-
FOR OUR PATIENTS. BEFORE THEY
GOT PLACED IN ANOTHER FACILITY
WITH OUR IMPLEMENTATION OF OUR
C. ISSUE THEY GO THROUGH A
MEDICAL ASSESSMENT. AND RULE OUT
ANY MEDICAL CONDITION THAT THEY
THEY MAY HAVE- MOST RECENTLY IN
THE FALL WE'VE GOT THAT DOWN TO
JUST OVER FOUR HOURS. BUT IN THE
LAST FEW MONTHS WE'VE ACTUALLY
GOT THAT DOWN TO UNDER THREE. ON
AND SO WE'RE GETTING BETTER AT
THIS TOO- MOVE PATIENTS FROM THE
EMERGENCY DEPARTMENT INTO. OUR
CRISIS STABILIZATION UNITS SO
THAT THEY CAN BE TREATED IN THE
RIGHT PLACE AT THE RIGHT TIME
WITH THE RIGHT PROVIDERS. IN THE
LONGEVITY OF STAY AT THE- CSU'S
. SURE RIGHT NOW IT'S TWENTY
HOURS- IT WHEN WE STARTED OUT IT
WAS A LITTLE OVER TWENTY THREE
SOMEONE MADE REFERENCE TO THE
FACT THAT THEY HAVE TO SOME
PATIENTS HAVE TO STAY LONGER
THAN TWENTY THREE HOURS THAT
DOES OCCUR- THAT AND HOW THEY
ARE CORRECT WE CANNOT BILL FOR
ANYTHING OVER. TWENTY THREE
HOURS AND FIFTY NINE MINUTES-
BUT WE WORK VERY HARD TO GET
THAT LIKE TO STAY- INSURANCE WE
CAN. THANK YOU AYE I WANNA BRING
IT UP TO THE CHAIR- I WILL
START- BY IDENTIFYING THE DATA
POINTS THAT BOTH OF THE
PHYSICIANS BROUGHT UP AND- M.
PATH AS A MODEL DECREASING THE
EMERGENCY DEPARTMENT LENGTH OF
STAY BY 70% IS SIGNIFICANT. OUR
ABILITY TO DECREASED IN PATIENTS
LIKE HIGH PSYCHIATRIC
ADMISSIONS. BY 53% IS SIMILARLY
SIGNIFICANT AS WELL AS THE
IMPROVED OUTPATIENT FOLLOW UP.
WILL HELP US WITH TREATMENT
PLANS. THAT I REALLY WOULD AGREE
WITH WHAT TV TOBY EWING SAID
THAT THIS IS BOTH CREATIVE AND
APPROPRIATE. AND THAT WE HAVE
CAPACITY FOR US TO SCALE. I'M
FOCUSED ON SUSTAINABLE ABILITY
BECAUSE WHAT WE HEARD FROM THE
ADMINISTRATION. IS THAT THE
MEDICAL MANAGED CARE PLAN SHOULD
BILL FOR ALL SERVICES WHILE
THEY'RE IN THE- EMERGENCY
DEPARTMENT BUT THAT AS SOON AS
WE TRANSFER- TO A CSU. THAT WE
DON'T HAVE THAT SAME LEVEL OF-
REIMBURSEMENT THAT I'D LIKE TO
BE ABLE TO UNDERSTAND FROM THE
ADMINISTRATION. HOW WE HELP TO
CREATE SUSTAINABILITY WITHIN
THIS MODEL WHILE THE- INNOVATION
DOLLARS MAY HELP US TO CREATE
THE SPACE IT REALLY WILL BE THE
BILLING LONG TERM. THAT CREATES
THE SUSTAINABILITY THAT I'D LIKE
TO UNDERSTAND FROM YOU- WHERE
THERE ARE DIFFICULTIES RIGHT
NOW- WITH THE CSU MODEL IN TERMS
OF CREATING THAT LONG TERM
SUSTAINABILITY. YOUR HAPPY TO
RESPOND TO THAT QUESTION SO YOU
THINK YOU KNOW THE MODELS TALKED
ABOUT TODAY ON THIS HEARING- ARE
ARE REALLY GOOD RIGHT IN REGARDS
TO IDENTIFYING ASSESSING IF IT'S
AN EMERGENCY OR NOT AND IF IT IS
NOT A CURRENT EMERGENCY
TRANSFERRED TO THE APPROPRIATE
LEVEL OF SERVICE LIKE A CRISIS
STABILIZATION UNIT- AND WHAT WAS
STATED. OF PREVIOUSLY IS CORRECT
UNDER FEDERAL LAW SOMEONE IS NOT
ALLOWED TO STAY IN A CRISIS
STABILIZATION UNIT FOR MORE THAN
THAT ARE LESS THAN TWENTY FOUR
HOURS THAT I'D SAY SO TWENTY
THREE HOURS FIFTY. NINE SECONDS
THAT ARE MINUTES AS I MENTIONED
IS CORRECT IT REALLY AT THE END
OF THE DAY- IF YOU HAVE A FULL
CONTINUUM OF CARE- WITH ACCESS
TO OUTPATIENT AND RESIDENTIAL
SERVICES FOR APPROPRIATE
PLACEMENT ACROSS THE STATE OF
CALIFORNIA- IT WOULD BE
REASONABLE TO ASSUME SOMEONE IN
A CRISIS STABILIZATION UNIT.
SHOULD BE ABLE TO BE TRANSFERRED
FOR PLACEMENT- IN VARIOUS OTHER
OUTPATIENT SETTINGS OR
RESIDENTIAL SETTINGS OR
INPATIENT DEPENDING ON WHAT'S
NEEDED BASED ON THE ASSESSMENT-
BY THE CLINICAL STAFF BEING ABLE
TO TRANSFER THOSE INDIVIDUALS
AND THAT'S REALLY WHAT WE'RE
TRYING TO ACHIEVE WITH THAT. CAN
YOU BUILDING OUT IN THE FIRST
AND- ARE THE STATE OF CALIFORNIA
IN ADDITION TO YOU KNOW MORE
CRAZY CRISIS STABILIZATION UNITS
BUT ALSO. MORE OUTPATIENT MORE
RESIDENTIAL MORE IMPATIENT WHEN
NEEDED THAT IS WHERE WE HAVE
CLEAR GAPS ACROSS THE STATE OF
CALIFORNIA. IN REGARDS TO
SPECIALLY RURAL FRONTIER IN
OTHER AREAS OF THE STATE OF
WHERE WE NEED TO HAVE MORE
ACCESS TO THESE TYPES OF
SERVICES THAT ALLOW FOR. BOTH
THAT PREVENTED AND- UPSTREAM AS
A TOBY WAS MENTIONING BUT ALSO
TO ALLOW FOR APPROPRIATE
TRANSITIONS OF CARE WHICH IS
STANDARD IN OTHER PARTS OF
HEALTH CARE. AND REALLY THAT'S
THE INVESTMENTS THAT WE ARE
LOOKING AT TO ALLOW FOR THOSE
INDIVIDUALS TO SMOOTH THE
TRANSITION INTO REALLY BUILD OUT
THE FULL CONTINUUM. OF
BEHAVIORAL HEALTH SERVICES
ACROSS THE STATE OF CALIFORNIA.
WHAT WE HEARD EARLIER- WAS THAT
A SIGNIFICANT PORTION OF THE
PATIENTS IN THE CSU'S ARE FROM
MEDICAID AND SO I'M REALLY
LOOKING TO MEDIC CAL ITSELF TO
SEE IF THERE ARE- ISSUES WITH
ITS CURRENT STATE THAT LEADS
TOWARDS CSU'S NOT BEING
SUSTAINABLE THAT I'M HOPING
EITHER DR THOMAS R. DR MULLIN
MAY BE ABLE TO COMMENT ON WAYS
OUR MANNERS IN WHICH WE COULD
CREATE THAT SUSTAINABILITY. AS
AN EXAMPLE- IS THERE A NEED FOR
US TO LOOK TOWARDS OBSERVATION
STATUS FOR PSYCHIATRIC PATIENTS-
IS THAT CURRENTLY SOMETHING THAT
MEDIC CAL- ALLOWS AND- WAR ARE
MANAGED CARE PLANS AND SHOULD WE
LOOK TOWARDS THE RE PROCUREMENT
PROCESS TO INSURE US GOING
FORWARD THAT WE HAVE THE ABILITY
TO CREATE THAT SUSTAINABILITY
HOPING DR THOMAS R. MULLEN CAN.
STEP IN. DO YOU WANT TO TAKE
THAT. I CAN ANSWER QUESTIONS- SO
CURRENTLY. MEDIC HOW DOES NOT
REIMBURSE FOR OBSERVATION CARE
FOR PSYCHIATRIC ILLNESS I
ACTUALLY DON'T THINK THAT MANY
CAL REIMBURSES FOR EACH
OBSERVATION CARE IN EMERGENCY
DEPARTMENTS AT ALL- AND SO I
THINK SOME OF THE PROBLEMS YOU
KNOW THAT WE'RE HEARING AND
CERTAINLY YOU KNOW. WE ALL WANT
TO DO A BETTER JOB OF PROVIDING.
APPROPRIATE HEALTHCARE IS THAT
THE EDT IS A BAN EXCLUDED FROM A
LOT OF THE MENTAL HEALTH CARE
SYSTEM AND IT MAKES IT VERY
DIFFICULT. FOR PATIENTS IN THE
EMERGENCY DEPARTMENT TO THEN
TRANSITION ACROSS INTO THE
MENTAL HEALTH CARE SYSTEM IT'S
REALLY EASY TO FALL THROUGH THE
CRACKS- STATE MEDICAID DIRECTOR
COOPER CAN I HAVE YOU COMMENT ON
WHAT WE JUST HEARD FROM DOCTOR
MULLIN- I DO BELIEVE IT IS- IT
IS MY UNDERSTANDING THAT WE
DON'T CURRENTLY COVER
OBSERVATION AND MEDIKAL HOWEVER
I'D WANT TO GO BACK IN. A
CONFIRM WITH MY BENEFITS AN
ELIGIBILITY GROUP- HOWEVER I
WOULD NOTE IT'S FOR ALL SERVICES
UNDER PARITY WE WOULD NOT BE
ALLOWED TO JUST DENIED
OBSERVATION PORT MENTAL HEALTH
CONDITION OR BEHAVIORAL HEALTH
CONDITION ALSO THAT POLICY WOULD
BE ACROSS THE BOARD FOR A
OBSERVATION REIMBURSEMENT IF
THAT'S HELPFUL. I LOOK FORWARD
TO FOLLOWING UP ON THAT
CONVERSATION- WITHIN THE
EMERGENCY DEPARTMENT WE'VE-
REALIZE THAT OBSERVATION STATUS
OFTENTIMES- HELPS US TO PREVENT
INPATIENT STAYS AND- MUCH OF THE
DATA THAT IS BEARING OUT FROM M.
PATH IS ALSO SHOWING A DECREASE
IN THOSE ADMISSIONS. AND SO
QUESTION WHETHER OR NOT THERE'S-
AN APPROPRIATE FINANCIAL MODEL
FOR US TO CREATE THE
SUSTAINABILITY NEEDED TO HELP
TO- SCALED THIS PROGRAM TO THE
NEEDS THAT WE HAVE FOR THE
STATE. BUT SEEING AS THERE'S NO
OTHER QUESTIONS I WANT TO THANK
THIS ENTIRE PANEL WE WILL NOW
MOVE ON TO A PANEL FIVE ON
ACCESS TO. BEHAVIORAL HEALTH
SERVICES WE WILL HAVE NINE
SPEAKERS ON THIS PANEL WE WILL
BEGIN WITH THE DEPARTMENT OF
MANAGED HEALTH CARE DIRECTOR
WATANABE CAN YOU PLEASE BEGIN.
FROM. DIRECTOR WATANABE WERE NOT
ABLE TO HEAR YOU ARE YOU ON MUTE. I'M SORRY THIS IS DANCE OTHER
FROM THE DEPARTMENT OF MANAGED
HEALTHCARE JERRY MAILBOX LIKE
OUR DIRECTOR MERRY'S HAVING.
TECHNICAL DIFFICULTIES
DIFFICULTIES ALL JUMP IN TO
PROVIDE THE OVERVIEW OF OUR S.
B. TWO TWO ONE PROPOSAL. SO
UNDER EXISTING LAW THE D. WHICH
USERS ARE ALWAYS HAVE CONSISTENT
ACCESS TO TIMELY MEDICALLY
NECESSARY HEALTH CARE INCLUDING
SCHEDULED APPOINTMENTS AND
REFERRALS TO SPECIALISTS. YOU
STANDARDS INCLUDE WAIT TIMES TO
ACCESS URGENT AND NON URGENT
CARE APPOINTMENTS AS WELL AS THE
AVAILABILITY OF TELEPHONE TRIAGE
OR SCREEN SERVICES DURING AND
AFTER REGULAR BUSINESS HOURS. SB
TWO TO ONE PLACE SOME OF THE
TIME THE ACCESS STANDARDS
ADOPTED A REGULATION. BY THE BBC
INTO HEALTH AND SAFETY. AND
INSURANCE CODES IT ALSO REQUIRES
HEALTH PLANS AS OF JULY ONE
TWENTY TWENTY TWO. TO ENSURE
THAT IS CONTRACTED PROVIDER
NETWORK CAN OFFER NON URGENT
FOLLOW UP APPOINTMENTS WITH A
NON PHYSICIAN MENTAL HEALTH CARE
FOR SUBSTANCE USE DISORDER
WITHIN TEN BUSINESS DAYS OF THE
PRIOR APARTMENT APPOINTMENT. OR
LONGER IT'S A TREATING PROVIDER
THE TERMS A LONGER WAIT TIME
WILL NOT HAVE A DETRIMENTAL
IMPACT. ON THE HEALTH OF THE
ROLE. SB TWO TWO ONE REQUIRES A
DVC TO PROPAGATE IT TIMELY
ACCESS REGULATION TO CLARIFY
REQUIREMENTS AND STANDARDS FOR
FOLLOW UP APPOINTMENTS. WE'RE
NOT POSITION AND HEALTH CARE
SUBSTANCE USE DISORDER PROVIDERS
SET FORTH RAMBLERS AND STANDARDS
FOR ADEQUATE CAPACITY
AVAILABILITY AND SUFFICIENCY OF
THE PROVIDER TYPES SUBJECT IN
TIME THE ACT STANDARDS. REVISED
THE DEMONS HE'S CURRENT
METHODOLOGY FOR HELP IN
REPORTING. DIRECTLY NEW METRIC
DEMONSTRATION OF THE AVERAGE
WEEK TIME FOR EACH CLASS OF
APPOINTMENT. DEVELOP
STANDARDIZED METHODOLOGIES FOR
HELP IN REPORTING THIS TO BE
USED TO HELP ME AS DEMONSTRATE
COMPLIANCE WITH SB TWO TO ONE.
AND FINALLY INVESTIGATE AND TAKE
ENFORCEMENT ACTION OR SESAME
STREET PENALTIES AGAINST
HELPLESS OR NOT. COMPLYING WITH
SB TWO TWO ONE. TO ADDRESS THIS
WERE UNITS YEARS. NINETEEN
POSITIONS AND FUR MILLION TWO
HUNDRED FORTY ONE THOUSAND
EXPENDITURES ALREADY FROM THE
MANAGED CARE. AND THAT CONCLUDES
MY BRIEF OVERVIEW MORE HAPPY TO
ANSWERING QUESTIONS. THANK YOU
NEXT WE WILL HEAR FROM STATE
MEDICAID DIRECTOR JASON COOPER
FROM DH YES PLEASE BEGIN. KELLY
IS GOING TO BE SPEAKING ON
BEHALF OF THE DEPARTMENT FOR
THIS ITEM AND THE REMAINING
THREE BUT OF COURSE I'LL BE
AVAILABLE FOR ANY Q. AND A.'S
FONG. THANK YOU AND I CAN'T- CAN
YOU SEE THE CITY YES REQUEST
EIGHT PERMANENT POSITIONS AND
ONE POINT THREE MILLION
EXPENDITURE AUTHORITY TO
IMPLEMENT. SB ONE. ON HAVE YOU
RECENTLY HEARD FRIDAY MAKES THE
RIVER. SB TWO THREE ONE.
REQUIRES THE DEPARTMENT OF WITH
THE MEDICAL MANAGED CARE PLAN
TIMELY ACCESS. I REQUIREMENTS
FOR FALL OF THE ABOUT SERVICES
THE NEW REQUIREMENTS INCLUDING A
BY THAT TIME STANDARD FOR NOT
APPOINTMENT. MATTER SHOULD
FOLLOW UP APPOINTMENT. TO THE
NON PHYSICIAN MENTAL HEALTH
CARE. QUITE DEFERRALS TO. A
STATE- BY PRIMERICA ANOTHER YOU
SUBJECT TO THE WELL THE TITLE
INTO REQUIRE TO TRUMPETED
SERVICES THE CORNER AND THE- AND
RECORD A NETWORK COVERAGE OF
MEDICAL THAT H. TREE OTHER ALPHA
NOT A NOW WE DO NEED COURSES
STAMP COMMITTEE CRIME. IS ABOUT
COMMUNICATING TO PROVIDE
TECHNICAL ASSISTANCE TO MANAGED
CARE PLAN TO CALIFORNIANS HEALTH
PLANS RELATED TO THE NEW
REQUIREMENTS TO MONITOR
COMPLIANCE AND TO WORK WITH A
CONTRACTOR THE EXTERNAL QUALITY
WOULD BE ORGANIZATIONS. UPDATE
THE TABERNACLE SURVEY. I'M NEXT
IN A MOVE TO THE MEDICATION TO
FIX X. PROGRAM. ON THE V. P. N.
TV L. T. HAS INVESTED ALMOST A
HALF A BILLION DOLLARS IN
FEDERAL STATE WILL BE FUNDING
THE WIND DAMAGE EXPANSION
PROJECT WITH TWENTY SEVEN
PROJECTS RESULTING IN OVER SIXTY
SIX HUNDRED FIFTY NEW ACCESS
POINT ME TREATMENT ACCESS POINT
AND INTEGRATED TREATMENT. FOR
ADDICTION AND HEALTH CARE
DOESN'T THAT. WE INVITE FIGHT.
CAN BE DERIVED FROM ITS OWNER
MEDICAL SORIN OUT OF ACTION. AND
WEBER APPLE. RESPONDED HAS. A
MINUTE SAMPLE CONTRACT
EXPENDITURE GOING AS WELL ASSISTANCE SPANISH
AUTHORITIES OF THE HARD AND ONE
NINE TWO FIND TO CONTINUE TO THE
OUT AND BEATS THE CRAP PROGRAM.
THESE NEW FUNDS FOLKS STAND
DEVELOPMENT DISTRIBUTION PROJECT
WHICH- FOCUSES ON PROVIDING
ORGANIZATIONS ADDRESSING THE
NEEDS OF INDIVIDUALS
EXPERIENCING HOMELESSNESS AND.
PREVENTING OVERDOSE DEATHS
METAPOPULATION. THE COURT A
HUNDRED NEW EIGHTEEN ACCESS
THREE. OKAY ON UNDERSERVED
COMMUNITY EXPAND ANYTHING COUNTY
JAIL AND DRUG COURTS THE GRANT
FUNDING WILL CONTINUE TO SUPPORT
TO THE THIRTY TWO COUNTIES ARE
CURRENTLY DOING AND MAKING IN A
COUNTY JAIL THAT EXPANDED THE
STOCK FARMING. AND INCREASE AND
IT SERVICES WITHIN STATE
LICENSED FACILITIES LIKE
TERRACOTTA TREATMENT PROGRAMS
THE. MEDICATION UNITS. WHAT
STARTED CONGREGATE TRAINING
TECHNICAL ASSISTANCE AND TRUMP
NINETY YOU COULD INVOLVED ABOUT
. TODAY SOME OF THE OUTCOME OF
THE TWO SEVEN. YEAH EXTENSION
PRO INCLUDES A NINE FIVE PAGE
TREATED FOR OPIATE USE DISORDER
OVER SEVENTY PATIENTS TREATED
WITH AREAS ORDER. OVER THIRTY
THOUSAND TACKLE TRAINED ANIME T.
IN THE SIZE OF THE DICTION ON
SIX HUNDRED FIFTY MEALS AND THEY
CAN'T ACCESS POINTS AND OVER
FIFTY THOUSAND OVERDOSE REVERSAL
AND I'M NOT FROM DISTRIBUTION
PROJECT. I WILL BE THE ONLY
DETAILS CONVENTION. ADAM THANK
YOU. THANK YOU NEXT TO FROM
VERONICA CHIEF OF MENTAL AND
RECOVERY SERVICES. IN ORANGE
COUNTY PLEASE BEGIN. THANK YOU
AGAIN CHAIR- CAN BE EVER HEALTH
PLANS SACRAMENTO SPONSOR ABILITY
AS ALL OF YOUR WHERE FOR SERVING
MEDICARE BENEFICIARIES WITH
SPECIALTY. OF MENTAL HEALTH AND
SUBSTANCE USE DISORDERS AND WHAT
THE CHANGES AND SB TWO TWENTY
ONE CALIFORNIA CONTINUES TO
BUILD OUT THE COUNTRY'S MOST
STRINGENT NETWORK ADEQUACY
STANDARDS FOR TIMELY ACCESS TO
CARE. THEY HAVE A HEALTH PLANS
ARE BOTH SUBJECT TO OVERSIGHT
AND MONITORING BY DH CS FOR
MEETING THESE AND OTHER NETWORK
ADEQUACY STANDARDS BUT WE ALSO
SERVE AS AN OUT OF NETWORK
PROVIDER PRIMARILY FOR
CALIFORNIANS WITH COMMERCIAL
INSURANCE. WHO ARE UNSERVED OR
UNDERSERVED BY THEIR INSURANCE
DUE TO INADEQUATE NETWORKS OR
BECAUSE OF A LACK OF
AFFORDABILITY AGED HIGH PREMIUMS
DEDUCTIBLES AND COPAYS. DO THE
CUPBOARD HANDLE MAKING
ASSOCIATED BEHAVIOR HEALTH
IMPACTS WE ARE EXPERIENCING
INCREASED DEMAND FOR SERVICES AT
THE SAME TIME THAT WE ARE ALSO
EXPERIENCING THE WORST WORKFORCE
CRISIS WE HAVE EVER SEE.
TELEHEALTH HAS BEEN BOTH. A
BLESSING AND A CURSE AS IT HAS
ALLOWED US TO MAINTAIN AND
EXPAND SOME SERVICES DURING THE
PANDEMIC WELL IT'S ALSO MADE IT
EASIER FOR OUR STAFF TO BE
RECRUITED TO WORK FROM THE
COMFORT OF THEIR HOMES. SERVING
INDIVIDUALS IN NEED ALL OVER THE
COUNTRY. THAT IS WHY THE
WORKFORCE INVESTMENTS PROPOSED
THIS YEAR WILL BE SELLING
PORTENT. FOR PEOPLE WITH LIVED
EXPERIENCE OUR PEERS FOR
CLINICIANS ALCOHOL AND DRUG
COUNSELORS LICENSE PSYCHIATRIC
TECHNICIANS PSYCH AND PEAS
PSYCHIATRISTS ADDICTION DOCKS WE
NEED ALL OF THEM. BUT I MUST
CAUTION THAT WITHOUT EXPANDED
BASE FUNDING TO BUILD OUT
NETWORKS OVER THE LONG RUN WE
WILL NOT BE IN A POSITION TO
INCREASE DEMAND. CAN BE EVER
HELD FUNDING IS NOT TIED TO
DEMAND AND OUR COUNTIES HAVE
ABSORBED THE COST OF THE
EXPANDED MEDICAL S. U. D.
BENEFIT UNDER. ORGANIZED
DELIVERY SYSTEM BECAUSE IT'S AN
OPTIONAL BENEFIT FOR COUNTIES
BUT IT IS AN ESSENTIAL ONE. AS
WE STARE THE S. U. D. CRISIS IN
THE FACE AND AS A MOTHER OF A
YOUNG WOMAN IN RECOVERY AND THE
SISTER OF THREE SIBLINGS LIVING
IN RECOVERY FROM THEIR
ADDICTIONS AND CO OCCURRING
MENTAL HEALTH ISSUES. WE NEED TO
ENSURE THAT WE BUILD. FROM THIS
INITIAL INVESTMENT BY COUNTIES-
SO WE BUILD OUT THE CAPACITY FOR
A STATEWIDE NETWORK OF
COMPREHENSIVE SUBSTANCE USE
DISORDER SERVICES UNDER
MEDICARE. THIS INCLUDES THE
ESSENTIAL INCLUSION OF EXPANDED
MAPPED. IDEAS NOT CAN'T REVERSE
MY KIDS OVERDOSE IN MY RESIDENCE
BACK THAT I HAD TO FIGHT MY
PHARMACY TO CAT. AND I STAND
BESIDE HER AS SHE ATTEMPTS TO
GET AND KEEP A METHADONE
PROVIDER. THE SAME AS I STAND
WITH DH CS AND ALL CALIFORNIANS
WHO NEED THIS LEVEL OF CARE
THANK YOU. THANK YOU NEXT WE
WILL HEAR FROM COREY HOW SHE
DEALT WITH THE ELIA. YOU DOCTOR
AMBULATORY SHEET WITH THE L. A.
L. L. A. O. HAD COMMENTS FOR AN
ITEM THAT WAS ACTUALLY MOVED
SAID NEXT WEEK'S HEARING AND WE
DON'T HAVE ANY COMMENTS TO RAISE
ON THE OTHER ITEMS INCLUDED IN
THIS ISSUE PANEL TODAY. THANK
YOU. NEXT WE WILL HEAR FROM
DOCTOR LEE ANDREA CLARK HARVEY.
WHO IS THE CEO FOR THE
CALIFORNIA COUNCIL OF COMMUNITY
BEHAVIORAL HEALTH AGENCIES
PLEASE BEGIN. EIGHT THANK YOU DR
RAMBLING COMMITTEE MEMBERS WE
ALSO WANT TO UNLOCK THE EFFORTS
TO DATE TO MAKE IT MAKE. A
TREATMENT- DTS AND DONE SO MUCH
THEY HAVEWAVED AT PROVIDERS
THAT IF FOCUSED ON ACCESS AND
RURAL COMMUNITIES AND LINKAGES
BETWEEN HOSPITALS AND SUBSTANCE
USE DISORDER RIGHT THE EFFORTS
ON BEHALF OF THE ADMINISTRATION
I'VE BEEN INCLUSIVE OF PROVIDERS
AND THE EXPERIENCE. AFTER
AVERAGE JUST NEED TO CONTINUE
PARTICULARLY AS WE EMERGE FROM
THE PANDEMIC AS WE KNOW THAT
DEMAND FOR TREATMENT WILL ONLY
INCREASE. THERE ARE AREAS WHERE
THERE IS MORE WORK TO BE DONE
INCLUDING REACHING THE HEART
ARTERY COPULATION SUCH AS
HOMELESS IN REENTRY POPULATIONS.
REVISING REGULATIONS THAT MAKE
IT DIFFICULT TO GET M. A. T.
THAT THOSE WHO NEED IT. TRAINING
AND RECRUITING FILL BASS AND
EIGHTY PER SECOND PROVIDE
MEDICATIONS IN THE COMMUNITY AND
ALSO EXPANDING THE PARTNERSHIPS
WITH LOCAL PHARMACIES TO GET
THEM ON BOARD WITH STOCKING THE
MEDICATION AND BEING WILLING TO
FILL THE PRESCRIPTIONS.
PARTICULARLY WITH HOMELESS
INDIVIDUALS. AND WE CAN'T
DISCUSS TIMELY ACCESS WITHOUT
OUT THE ISSUE THAT IS HAMPERING
THE ABILITY TO MEET TIMELY
ACCESS REQUIREMENTS WE HAVE ALL.
HEARD THE STATISTICS ON THE
INCREASED MEDICAL AND ROMAN AND
THAT'S. DR KELLY JUST MENTIONED
PROVIDER. ON PROCESS THE- STAFF
IS. SOME OF OUR CBO SAID HAD TO
SHUT DOWN ON BADS IN CLINICS
BASE DUE TO LACK OF STAFFING.
AND ON THE FLIP SIDE WE
PROVIDERS DO YOU HAVE EXTRA
CAPACITY TO DO MORE THE INCREASE
DOLLARS TO MEET THE NEEDS ARE
NOT ALWAYS PROVIDED DUE TO
CONTRACT MAXIMUMS WITH MANY OF
THEIR COUNTIES. ALL EQUATES TO
DENY CARE TO THOSE IN. NEED OUR
PROVIDERS NEAR SIMULTANEOUS AND
IMMEDIATE SOLUTION TO ACCOUNT
FOR CHANGES CHAPMAN I'M A MORE
H. THE DIRE WORKFORCE SHORTAGES
DUE TO THE PANDEMIC. AND ALLOW
FOR MORE COULD WE JUST FOR
RETAINING AND RECRUITING FOR THE
WORK FORCE THANK YOU FOR
INVITING ME ASSURE. THE
PERSPECTIVE OF RCB APARTMENT ON.
THANK YOU NEXT WE'LL HEAR TYLER
RANDY EXECUTIVE DIRECTOR OF THE
CALIFORNIA ASSOCIATION OF
ALCOHOL AND DRUG PROGRAM
EXECUTIVES PLEASE BEGIN. GOOD
EVENING CHEN ARAMBULA AND
MEMBERS HI RANDY EXECUTIVE
DIRECTOR OF CASKEY UNDERSTAND
I'D LIKE TO- ECHO A LOT OF THE
SENTIMENTS OF MY FELLOW
PANELISTS AND THANK YOU TO THE
ADMINISTRATION AND LEGISLATURE
CREDIT APPLICATION I'M
BEHAVIORAL HEALTH- I DO I HAVE
YEAH WHEN I FIRST STARTED OUT
AND FOCUS AND REMIND THE-
SUBCOMMITTEE ON THE IMPORTANCE
OF PAYMENT REFORM AND
DOCUMENTATION REFORM PATTERSON
PROPOSED ACCOUNT NAME. AND IS
NOW IN THE PROCESS OF BEING
IMPLEMENTED AS CALIFORNIA MARKS
UPON PAYMENT REFORM FROM A COST
BASED REIMBURSEMENT THREE
CERTIFIED PUBLIC EXPENDITURE
SYSTEM TO INTERGOVERNMENTAL
TRANSFERS WITH THE FIRST SERVICE
RATES. WE WOULD LIKE TO REMIND
THE LEGISLATURE ADMINISTRATION
OF HOW CRITICALLY IMPORTANT IT
IS TO GET THE RATES RIGHT
INCLUDING CAPTURING ALL EXISTING
COSTS TO PROVIDERS IN THE SYSTEM
AND HOW DEVELOPING RATES THAT
ARE FISCALLY SUSTAINABLE THAT
ALLOW PROVIDERS AND COUNTIES TO
HIRE AND PAY COMPETITIVE AGES.
AND PASSED IN THE SYSTEM
TRANSFORMATION THAT WE WANT TO
SEE AND AT THE END OF THE DAY
ALLOW US TO PROVIDE CULTURALLY
COMPETENT EVIDENCE BASED CARE TO
INDIVIDUALS IN NEED OUT OF PAPER
HEALTH SERVICE SAYS. WE'RE
EQUALLY EXCITED ABOUT THE
STATE'S INVESTMENT IN
CONTINGENCY MANAGEMENT AS A
MATTER HOW BENEFIT A
MOTIVATIONAL INCENTIVE PROGRAM
FOR MEETING SPECIFIED GOALS
FOCUSED ON INDIVIDUALS WITH
STIMULATE USE DISORDERS. THERE'S
NO FORM OF MEDICATION FOR
ADDICTION TREATMENT FOR MATTHEWS
AND SOME CONTINGENCY MANAGEMENT
AS A CRITICAL TOOL IN ADDRESSING
MAP ANOTHER STIMULATE YEARS WE
UNDERSTAND WHY THE STATE IS
STARTING SMALL WITH THE PROJECT
BUT WOULD LIKE TO SEE IN THE
FUTURE AS THE PROJECT IS HOPE WE
SUCCESSFUL. TO EXPAND TO OTHER
SUBSTANCE AS BEYONCE REMAINS AND
TO OTHER REGIONS AND POPULATIONS
OUTSIDE OF THE PILOTS WHILE I
KNOW THAT THIS IS THE FOCUS OF
NEXT WEEK'S HEARING- I THINK
IT'S AN POP IT'S NOT POSSIBLE TO
HAVE A HEARING ON BEHAVIORAL
HEALTH WITHOUT MENTIONING
WORKFORCE IS A LOT OF MY
COLLEAGUES HAVE DONE. I HAD A
RECENTLY A PROVIDER SHARE WITH
ME BACK- YOU KNOW THE NEED.
DURING THE PANDEMIC FOR SERVICES
NEVER STOCKS IN THE ON LIMITING.
IN THEY WORKS. A BEING ABLE TO
SERVICE TO ME THE NEED. WITH THE
ABILITY RECRUIT AND RETAIN AND
IN FACT WORK. OUR HAS PROVIDERS
THAT ARE DOWN 30% STAFF. AND AS
OTHER SECTORS HAVE INVESTED IN
SUBSTANCE USE DISORDER CARE
WHICH WE SUPPORT. IT HAD
INCLUDING CDC OURS EXPANSION OF
THE I. S. U. T. T. PROGRAM AND
HOSPITALS EXPANDING THE BRIDGE
PROGRAM. IT HAS PULLED STAFF
AWAY FROM COMMUNITY PROVIDERS.
WE BELIEVE THAT THESE ARE
WORTHWHILE INVESTMENTS. BUT
ALONG WITH THE PANDEMIC IT MEANS
THAT THERE NEEDS TO BE A
DEDICATED INVESTMENT S. UT CARE
WORKFORCE. SB SIX SIX SIX BY
ASSEMBLYMEMBER QUIRK-SILVA AND
SPONSORED BY MY COLLEAGUE RECIBE
HA AND CAP- THE TAP. IT'S A GOOD
FIRST STEP TO DOCUMENTING THE
WORKFORCE SHORTAGE AND PROVIDING
OPTIONS FOR WORKFORCE FUNDING-
BUT WE NEED TO GO FURTHER THAN
THIS- WE APPRECIATE YOUR
COLLEAGUES FOR YOU KNOW BRINGING
FOR THE SPELL. WE HAVE
INDIVIDUAL PROVIDERS THAT FIND
IT MORE LUCRATIVE TO GO PARK AND
PUBLIC SCHOOL PASSED THE JOINT
OR IN RETAIL THAT IN OUR SYSTEM.
THEY'RE CALTRAIN WE'RE
PARTICULARLY EXCITED ABOUT THE
OPPORTUNITY TO BILL FOR SERVICES
UP TO NINETY DAYS FROM. PRE
RELEASE ON BEING DISCUSSED IN
THE DH CS IS CALLIN JUSTICE
ADVISORY WORKGROUP. INDIVIDUALS
IN THEIR FIRST TWO WEEKS OF
RELEASE- AFTER RELEASE ARE OVER
FORTY TIMES MORE LIKELY TO DIE
BY AN OVERDOSE THAN THE GENERAL
POPULATION. IN UPWARDS OF 80%
AND CDCR INMATES HAVE A
SUBSTANCE USE DISORDER. THEIR
INVESTMENTS THAT CDCR HAS MADE.
THEIR OVER NOW THIRTEEN THOUSAND
INDIVIDUALS ON MATC NCDC ARW.
PRE RELEASE CARE MANAGEMENT AND
MEDICATION COORDINATION ART KERR
ARE CRITICAL TO ENSURE THAT-
SERVICES ARE TRANSITION
SEAMLESSLY. WE ENCOURAGE THE
STATE TO LOOK AT EXISTING MODELS
OF PRE RELEASE COORDINATION
INCLUDING THROUGH THE STOCK
CONTRACTS. WHICH REGIONAL
CONTRACTS THAT PROVIDE SERVICES
CARE COORDINATION TRANSITIONAL
HOUSING. AND SUPPORTS THE
PAROLEES RELEASE SEEN FROM CITY
ARE WE MODERN THE HIGHEST YOU
CAN NEEDS AS A STATE LUCK AT B.
POTENTIAL THE NINE DAY RELEASE.
AS IS YOU KNOW WE ARE SUPPORTED
THE STATE'S AND EIGHTY EXPANSION
PROJECT. AND ARE STILL REVIEW
THE S. AND- BCPL TRAILER
LANGUAGE THANK YOU FOR THE
OPPORTUNITY TO PROVIDE COMMENTS
AND HAPPY TO ANSWER ANY
QUESTION. THANK YOU NEXT WE'LL
HEAR FROM CHEN ADDS ON A BATON
WHO IS THE CALIFORNIA STATE
DIRECTOR. FOR DPA PLEASE BEGIN.
INTERNATIONAL BEING AWARE- HELLO
BUT THE DRUG POLICY ALLIANCE-
YOU KNOW I'M GONNA ECHO THE
COMMENTS THAT MY- FIRE
COLLEAGUES OF ME ON THIS PANEL
I'M DEEPLY IS VERY SUPPORTIVE.
OF ENSURING THAT WE DO HAVE
THINGS LIKE MADDOX EXPANSION
HERE IN THE STATE OF CALIFORNIA
I WOULD LIKE TO KNOW THAT IT'S
REALLY IMPORTANT. TO UNDERSTAND
FROM A RACIAL EQUITY
PERSPECTIVE. THAT UNFORTUNATELY
COMMUNITIES OF COLOR STILL LAG
FAR BEHIND THOSE OF OTHERS. IN
TERMS OF ACT- BEING- NOT ONLY
OFFERED BUT ALSO HAVING ACCESS
TO MATH SERVICES WHICH WE KNOW.
ARE CRITICAL- IN ORDER TO
ADDRESS SUBSTANCE USE AND TO
ADDRESS- THE OVERDOSE CRISIS
HERE IN CALIFORNIA. ON THE ONLY
OTHER THING I WOULD SAY IS YOU
KNOW IT'S REALLY IMPORTANT TO
UNDERSTAND. THAT THE PANDEMIC-
HAS EXACERBATED- THE OVERDOSE
CRISIS SIGNIFICANTLY FOR
COMMUNITIES OF COLOR- PRIOR TO
THE PANDEMIC DPA COMMISSIONED A
STUDY TO LOOK AT THE LEFT. OF
OPIOID OVERDOSE RATE IN
CALIFORNIA NO OTHER STUDY HAS
LOOKED AT A SPECIFIC AND
ETHNICITY. LOOKING AT STATE
LEVEL DATA. AND WHAT WE FOUND
PEOPLE THAT MAC WAS THAT IN FIVE
COUNTIES ON WHICH INCLUDED
NEVADA LASSEN LAKE MENDOCINO IN
SAN FRANCISCO. ON THE OVERDOSE
CRISIS AMONG LATINOS WAS
ACTUALLY REALLY HIGH AND- AND IN
SOME CASES HIGHER THAN THE
NATIONAL AVERAGE. SO REALLY
LOOKING AT INTERVENTIONS AND
WAYS. TO ENSURE THAT-
COMMUNITIES OF COLOR- HAVE
ACCESS TO NOT ONLY SERVICES BUT-
THAT- YOU KNOW. INTERVENTIONS
INCLUDING BACK. UP ARE
CRITICALLY IMPORTANT- IN L. A.
COUNTY FOR EXAMPLE- ACCIDENTAL
DRUG OVERDOSE DEATH RATE PER
HUNDRED THOUSAND- POPULATION.
INCREASE WILL SIGNIFICANTLY
BETWEEN TWENTY NINETEEN TO
TWENTY TWENTY. FOUR AFRICAN
AMERICANS AND ASIANS ACCIDENTAL
DRUG OVERDOSE DEATH RATES
INCREASED BY SEVENTY FIVE POINT
2% AMONG. ASIANS ALONE. AND
SIXTY EIGHT POINT FIVE AMONG
AFTER CAN AMERICAN WITH LATINO-
CHANGE BEHIND BY AN INCREASE OF.
557% IT IN ADDITION TO THESE
NUMBERS- ANOTHER- OF STUDY
RECENTLY EXAMINING THE BEHAVIOR
HEALTH NEEDS OF LATINOS ASIANS
IN CALIFORNIA DEMONSTRATED THAT
MORE INVESTMENT IS NEEDED FOR
THE STATE TO MEET THE NEEDS OF
THE STATE'S TO MOST ETHNICALLY
DIVERSE GROUPS IN SURVEYS. THAT
WERE CONDUCTED 20% OF ADULTS AND
REPORTED THAT THEY HAD SERIOUS
OR MODERATE- PSYCHOLOGICAL
DISTRESS YET ONLY 17% OF LATINOS
AND 14% OF ASIAN AMERICANS
REPORTED THAT THEY BELIEVE THAT
THEY ACTUALLY NEEDED TO SEE A
PROFESSIONAL FOR PROBLEMS WITH
MENTAL. HEALTH MOTIONS AND OR-
AKA HALL AND DRUG USE. OTHER
GROUPS EXPERIENCE THESE
DISPARITIES THAT THE STUDY
REALLY- BUT THE STUDY REALLY-
DID SOMETHING INNOVATIVE AND
REALLY LOOK AT THE SUBGROUPS OF
BOTH LATINOS AND ASIANS IN
CALIFORNIA UNDERSTANDING THAT
THESE COMMUNITIES ARE NOT
MONOLITHS AND INSTEAD LOOKED AT
THE VARIATIONS THAT EXISTED-
WITHIN THESE ETHNIC SUBGROUPS-
TOPLINE- RECOMMENDATIONS FROM.
THIS REPORT- REALLY LOOKS AT
WAYS. FOR ENSURING THAT-
COMMUNITIES OF AND AT THE
COMMUNITY- HAVE ACCESS TO OUR
MENTAL HEALTH LITERACY AND
INCREASING ACCESS TO CULTURALLY
AND LINGUISTICALLY APPROPRIATE
MENTAL HEALTH SERVICES
INCREASING- ETHNIC
REPRESENTATION IN DECISION
MAKING. PROCESS SEES FOR
CULTURALLY COMPETENT PROGRAMS
AND SERVICES AND ALSO THE-
POLICY IS TO COLLECT ANSWER BUT
TO COLLECT DATA ON THAT IS ALSO
DISAGGREGATED FOR I'M NOT ONLY
THE LATINO COMMUNITY BUT FOR THE
APEC COMMUNITY AND OTHER ETHNIC
COMMUNITIES HERE IN CALIFORNIA-
DEMYSTIFYING THESE- THE NEED FOR
MENTAL HEALTH AND SUBSTANCE USE
TREATMENT. FOR THESE COMMUNITIES
WILL GO A LONG WAY AND WE CAN
ENSURE THAT THE COMMUNITIES THAT
NEED THE SERVICES THE MOST ARE
BEING SERVED- BY THE STATE- IN
IN THE NUMBERS THAT THEY
REPRESENT HERE THANK YOU. THANK
YOU VERY MUCH THAT WILL CONCLUDE
THE PRESENTERS FOR THIS PANEL I
WILL BRING IT UP TO THE DÍAS.
FOR ANY QUESTIONS WE WILL BEGIN
WITH ASSEMBLYMEMBER ALMOST THANK
YOU MISTER CHAIR I JUST WANT TO
REITERATE- WHAT DR- RUNNING TO
CALLIE- SPOKE TO AS FAR AS BEING
ABLE TO ACQUIT- THOSE IN OUR
COMMUNITIES ONE- DRUG OVERDOSES
ARE ARE AT A HIGH- PERCENTAGE-
AFFECTING PEOPLE OF COLOR IN OUR
COMMUNITY AS A WHOLE. THAT WE
HAVE TO MAKE REALLY AVAILABLE-
THE USE OF NOR CAN- SO THAT
THOSE COULD BE TRAINED- IN ABLE
TO ADMINISTER THOSE TO LOVED
ONES OR EVEN THOSE THAT ARE
PARTAKING WOULD BE ABLE TO HAVE.
THE READILY AVAILABLE IN TIME OF
NEED WE ALSO WANT TO- BRING TO
ATTENTION- AB BILL SIXTEEN
TWENTY SEVEN THAT WOULD START TO
MOVE FORWARD THE DIALOGUE. AND
THE ADVOCACY OF MAKING SURE THAT
RESOURCES ARE AVAILABLE TO THOSE
THAT THAT THAT NEED TO HAVE
THOSE OF RESOURCES READILY AVAIL
AVAILABLE TO THEM. AND TO START
THE DIALOGUE ON THE I BELIEVE
ANOTHER AND I KNOW THIS IS A-
THE WE HAVE A LOT OF MEDICAL
PROFESSIONS ON BUT I THINK AN
EPIDMIC WHAT WE'RE SEEING WITH
OVERDOSES WITH FENTANYL. AND SO
WE HAVE TO START TO ADDRESS IT
WE HAVE TO START TO MAKE SURE
THAT RESOURCES ARE AVAILABLE.
FOR THOSE IN TIME. AND TIME
SENSITIVE AREAS TO BE ABLE TO
HAVE BEEN A MINISTER NOR CAN AND
THAT MEANS GETTING THAT INTO THE
HANDS OF THOSE THAT WOULD HAVE
THAT ON THEIR POSSESSION. THANK
YOU AND I WILL FOLLOW ALONG WITH
WHAT ASSEMBLY MEMBER RAMOS. SAID
AND IF WE LOOK AT PAGE FORTY
THREE OF THE AGENDA. WE SEE FROM
THE CDC THAT MORE THAN A HUNDRED
THOUSAND PEOPLE DIED. OF DRUG
OVERDOSES IN THE TWELVE MONTH
PERIOD THAT ENDED IN APRIL OF
TWENTY TWENTY ONE SO THE FIRST.
YEAR OF THE PANDEMIC. THAT WAS A
TWENTY EIGHT AND A HALF PERCENT
INCREASE FROM THE SAME PERIOD
ONE YEAR BEFORE. AND IT'S AWFUL
DOUBLING OVER THE PAST FIVE
YEARS. AND WHAT WE SAW FROM THAT
WAS THAT FENTANYL ACCOUNTED 464%
OF ALL OF THOSE DRUG. OVERDOSE
DEATHS DURING THAT TWELVE MONTH
PERIOD SO I WILL ECHO WHAT MY
COLLEAGUES HAVE SAID ABOUT THE
IMPORTANCE. OF MAKING SURE THAT
OUR CAN IS- IN AS MANY HANDS AS
WE CAN TO ENSURE THAT WE CAN-
EXPAND AND- INCREASE ITS REACH.
I WOULD EMPHASIZE THAT- JUST
RECENTLY WE HAD. AN INCIDENT AT
A FRESNO COUNTY JAIL. WHERE
FENTANYL EXPOSURE LED TOWARDS
SEVEN PEOPLE AT THAT JAIL- BEING
EXPOSED AND I BELIEVE THAT THE
ACCESS TO MATCH SIGNIFICANTLY
HELPED. ASSIST THOSE PEOPLE AT
THAT COUNTY JAIL AND WANTED TO
THANK THE ADMINISTRATION. FOR
THAT PROGRAM. BUT I WOULD LIKE
TO ASK TWO QUESTIONS FIRST OF
THE DEPARTMENT OF MANAGED HEALTH
CARE AND THEN. FOLLOWING UP WITH
THE DEPARTMENT OF HEALTH CARE
SERVICES I'M I'M REALLY TRYING
TO. GET A SENSE OF HOW WE MAKE
SURE THAT PLANS ARE COMPLIANCE
WITH THE STANDARDS THAT WE HAVE.
CREATED SO FOR THE DEPARTMENT OF
MANAGED HEALTHCARE. CAN YOU HELP
TO EXPLAIN WHAT. THE CURRENT
BEHAVIORAL HEALTH ACCESS TO CARE
STANDARDS ARE. AND HOW WE
MONITOR OF PLANS COMPLIANCE WITH
THE STANDARDS. ESSENTIALLY WHAT
I'M TRYING TO GET AT IS HOW ARE
THE PLANS DOING RIGHT NOW. THANK
YOU FOR THAT QUESTION SO- THE
DVC MEASURES- BEHAVIOR HEALTH
ACCESS A COPLE OF WAYS ONE. WHO
ARE INITIAL REVIEW OF HEALTH
PLAN NETWORKS WHEN THEY APPLY
FOR A LICENSE. AS WELL AS
ANNUALLY REVIEWING THEIR
NETWORKS TO ENSURE THAT THE
HEALTH PLANS HAVE THE RIGHT
NUMBER OF PROVIDERS TO PROVIDE
CARE TO THEIR GOAL. THE SECOND
COMPONENT IS THE ACTUAL
STANDARDS WHICH IS. FOR A
SPECIALIST POSITION. AT THE
STANDARD IS FIFTEEN BUSINESS
DAYS AND FOR NON PHYSICIAN
MENTAL HEALTH PROVIDERS THE
STANDARD IS TEN BUSINESS DAYS.
AND SO WE ASSESSED HEALTHCARE
COMPLIANCE WITH THAT YOU ARE A
NEW ANNUAL. TIMELY ACCESS
PROCESS WHICH REQUIRES HEALTH
PLANS TO USE. SURVEY A SAMPLE OF
THEIR HEALTH. CARE NETWORK
PROVIDERS TO DETERMINE IF THEY
HAVE AN OF THEIR NEXT AVAILABLE
APPOINTMENT IS WITHIN THOSE
TIMELY ACCESS STANDARDS. AND
THEN THE NOTE THAT INFORMATION
TO US. BY THAT TO THIS ONE NATO
BASES THERE COMPLIANCE
REPORTING. AND THEN WE PUBLISH
ANNUAL IN A PUBLIC REPORT THAT
OUTLINES THE HEALTH PLANS-
RESERVE COMPLIANCE WITH THESE
TIMELY ACCESS SURVEYS. CERTAIN
ANSWER YOUR QUESTION I WOULD
HAVE TO ASSESS IT DIDN'T TAKE
THAT BACK TO SEE EXACTLY HOW
EACH OF OUR HERO HEALTH PLANS
ARE PERFORMING. IN EACH OF THESE
CATEGORIES BUT WE'RE HAPPY TO
FOLLOW UP WITH YOU. I BELIEVE
THAT THAT'S IMPORTANT FOR US TO
DO AGAIN AS WE ARE LOOKING AT
PRE PROCUREMENT I BELIEVE IT'S
AN IMPORTANT DATA POINT FOR US
TO MAKE SURE WE ARE. WORKING
WITH OUR MANAGED CARE PLANS TO
ADDRESS- IN LIGHT OF- WHAT WE'RE
SEEING WITH OVERDOSE DEATHS FOR
OUR STATE- FOR THE DEPARTMENT OF
HEALTH CARE SERVICES I WAS
HOPING. SIMILARLY YOU COULD-
HELP TO EXPLAIN THE EXISTING
TIMELY ACCESS STANDARDS THAT THE
MEDICARE MANAGED CARE PLANS MUST
MEET. AND WHICH METRICS WE ARE
USING TO EVALUATE COMPLIANCE
WITH THOSE STANDARDS AND AGAIN
TO WHAT DEGREE DO WE- BELIEVE
THAT. THE PLANS ARE MEETING
THOSE STANDARDS. THANK YOU FOR
THAT QUESTION AND THE ANSWER IS
ACTUALLY IDENTICAL TO THE
APARTMENT MANAGE HEALTHCARE WE
HOLD OUR MENTAL HEALTH PLANS IN
A DRUG MEDI CAL ORGANIZED
DELIVERY SYSTEM PLANS TO USE THE
SAME TIMELY ACCESS STANDARDS IN
THE SAME NETWORK ADEQUACY
STANDARDS. WE REQUIRE ANNUAL
SUBMISSIONS YES CALLACHAN COUNTY
BE ABOUT PLANS ARE NOT COMPLIANT
WITH THE DEMONIC CORRECTIVE
ACTION PLAN. ONE MINUTE LIKE WHY
THEY DON'T HAVE BE SPECIFIC
ABOUT THE TOP OF MY HEAD ABOUT
HOW MANY PLANS ARE CURRENTLY IN
COMPLIANCE WE DO. TAKE IT VERY
SERIOUSLY AND IF THERE IS A
COUNTY THAT IS NOT IN COMPLIANCE
WE MEET ONCE A MONTH WE WILL BE
READY IN THE DEFICIENCIES AND
CREATE A PLAN TO MAKE SURE THAT. THEY RESOLVE THE DEFICIENCIES
OF THE TRACK. I WOULD LOVE THE-
UP AS I. BELIEVE THAT THE-
DOUBLING IN OVERDOSE DEATHS OVER
THE PAST FIVE YEARS NECESSITATES
US TO MAKE SURE. WE'RE PROVIDING
THE NECESSARY OVERSIGHT AND-
ACCOUNTABILITY TO THE PLANS
WHICH ARE PROVIDING. THE CARE
FOR CALIFORNIANS. SEEING THAT
THERE ARE NO QUESTIONS I WANT TO
THANK VERY MUCH PANEL FIVE AND
NOW MOVE ON TO A PANEL SIX ON
THE STATE OVERSIGHT OF
CALIFORNIA'S BEHAVIORAL HEALTH
SERVICES. WE WILL HAVE FOUR
SPEAKERS ON THIS PANEL AND WE
WILL BEGIN WITH DOCTOR PFEIFFER
DEPUTY DIRECTOR OF BEHAVIORAL
HEALTH FOR THE DEPARTMENT OF
HEALTH CARE SERVICES PLEASE
BEGIN. THANK YU. OVERSEES THE
DELIVERY ESPECIALLY MENTAL
HEALTH- SERVICES RECOUNTED
MINISTER MENTAL HEALTH PLANS AND
OVERSEES THE DELIVERY OF
SUBSTANCE USE DISORDER SERVICES
THROUGH COUNTY ADMINISTERED
PROGRAMS THAT DRUG MEDI CAL.
THIRTY SEVEN FIFTY EIGHT
COUNTIES PARTICIPATE IN DRUG
MEDICAL ORGANIZED DELIVERY
SYSTEMS SUCH A CALL GIVE GET
YES. MENTAL HEALTH FOR IN HERE
PLANS MANAGED CARE PLANS WHERE
REQUIRED TO ADMINISTER ROBUST
ADAMS SESSION ON A HOUSING ISSUE
THE PREVENTION TREATMENT OR
RECOVERY SERVICES FOR MEDICARE
BENEFICIARIES. THE TWENTY ONE
COUNTIES NOT PARTICIPATING IN
THE NCES ACCOUNTABLE FOR A
SMALLER SET OF BENEFITS. EACH
YEAR HOLD MENTAL HEALTH PLANS
AGAIN VIA THE EXPLAINS
ACCOUNTABLE FOR DEMONSTRATING
THAT THEY CONTRACT WITH AN
ADEQUATE NETWORK OF PROVIDERS
AND THEY COMPLY WITH STATE
TIMELY ACCESS TO SERVICES
STANDARDS AS WE JUST DISCUSSED.
ADDED TO THE FACT THAT THE
COUNTY PLAN TO BACK DEMONSTRATE
THAT THEY HAVE MET THE STANDARD
FOR THE KIND OF. PLACE IN A
CORRECTIVE ACTION PLAN OUR CAT.
DETAILS WILL BE WILLING NEW
NETWORK ADEQUATE THANKS PROCESS
CAL YEAR ANY COUNTY AGAIN ON
PROGRESS OTHER CAPTAIN ALIGNMENT
THIS CHANGE THANKS IN COLLEGE.
AND THE CALIFORNIA CARE. IN
ADDITION BEACH VERIFIED IT'S
COUNTIES TO ENSURE COMPLIANCE
WITH THE CONTRACT REQUIREMENTS
AND IMPLEMENT CAPS FOR
DEFICIENCIES AND RECOMMENDS.
OVER THE LAST FEW YEARS YES YES
AND RAMPS UP THE INTENSITY
COUNTY OVERSIGHT AND ANY COUNTY
ON A CAP AS I MENTIONED MEET
MONTHLY WITH ADHD AFFAIRS
HONORABLY WITH UNIX DEFICIENCY
PROBLEM OF PROVIDE TECHNICAL
ASSISTANCE AND ENSURE THAT THAT
COUNTY. HAS A ROBUST ACTION PLAN
TO RESOLVE THE DEFICIENCY. AND
IT'S INTO MORE INTENSIVE
OVERSIGHT AND MONITORING PROCESS
BECAUSE THE DOCTORS. ARE MUCH
STRICTER RESOLUTION OF THE CAP.
I TEACHER. WITH AN EXTRA QUALITY
WITH THE ORGAN. JATAKA ISSUE
WITH THAT THERE STRENGTHENED
THAT THE DEFICIENT IN OVERSEAS
THEIR PERFORMANCE AND FOR THAT-
PROGRAMS. HE ALSO HAS OVERSIGHT
RESPONSIBILITY FOR MENTAL HEALTH
SERVICES EXPAND FUNDING AS WELL
AS OVERSIGHT EXTENDING UP
FEDERAL. FUNDING SOURCES SUCH AS
APPEARED RESPONSE TIMES AND
BLOCK GRANTS. FOR MENTAL HEALTH
AND SUBSTANCE USE DISORDER.
TRINITY SHADY FROM THE RAMP UP
OVER COURT YOU THROUGH COMMUNITY
INCLUDING. THE FOR THAT SHOULD
ANNUAL LEATHERNECKS. REPORTS FOR
MAJOR CHANGE. AND IMPROVING
THEIR REVERSION PROCESS TO
ENSURE ACCOUNTING. SPEND ALL
THEIR IMAGES THEY FIND. WELL IT
IS HUNDRED CAN VARY MUCH 20%
FROM ACTUAL AVAILABLE FUNDS YEAR
TO YEAR DHS HOLD COUNTIES
ACCOUNTABLE TO ENSURE THAT
THEY'RE FOLLOWING A MAJOR STATE
REGULATIONS AND SPENDING THE
CLAN BUT PROBABLY THEY CAN
CLEARLY WITH AND THAT'S WHAT I
KIND FRANK. DECEMBER THIRD OF
TRADE IN THE RECENT YEARS
RESULTING IN LESS THAN 1% OF
THEM MAKE IT THEY FIND THAT
BETTER REGARDED DID
UNDERSTANDING. AND OVER 80% OF
ANY JUST. WANTED TO SAY
SANDESTIN WITHIN THE FIRST TWO
YEARS OF THEIR ALLOCATION. ON
THAT YOU KNOW KIND OF THREE TO
FIVE YEARS. WHEN THE FUNDS ARE
GOING ON INSIDE. DETAILS ABOUT
THE TIDE THAT OVERSIGHT OF
COUNTIES AMOUNT HOW CONNECTS BE
BLACK GRANTS AND- HARD PERCENT
OF FEDERAL OF THIS. AND FOUNDER.
AS PARAGRAPH. FINALLY OFFERINGS
BY. FOR OVERSIGHT- FOR LIFE. IS
OF A THIRD MARK BECAUSE- IN OUR
YOU DO. SO BY THE TREE FOR SO.
AS WELL THE EXACT. COMPLAINT IN
IN THE LAST YEAR DHS HAS
STREAMLINED THE APPLICATION
PROCESS FOR LICENSING AND
CERTIFICATION. AND HAS. FUTURE
PLANS FOR STREAMLINED CURRENT AS
WELL AS WEB BASED APPLICATION
FOR MULTIPLE APPLICATIONS TO
IMPROVE EFFICIENCY GRAPPLE JOBS
THAT COULD BE JACKSON. IN
ADDITION NEEDS TRANSCEND
EMPLOYMENT A NEW TRACKING. AND
MONITORING PROCESSES TO. TO
PROCESS COMPLAINTS AGAINST
FACILITIES CUTTING RESOLUTION.
TIME AND HALF IN THE LAST YEAR.
I'M NOT GOING TO COVER THE IN.
OF THE LA THAT EIGHT- IS
COMPLIANT OVERSIGHT OF INSURANCE
POLICIES FOR LICENSED ALCOHOL
AND DRUG ABUSE RECOVERY A
TREATMENT FACILITY. THE TEACHERS
HERE IS REQUESTING FOR PERMANENT
POSITIONS AND I'M GOING FUNDING
TO MONITOR THE COMPLIANCE OF
INSURANCE POLICIES FOR LICENSE
ALCOHOL AND OTHER. DRUG RECOVERY
ANTI OR TREATMENT FACILITY AND
ACCOMMODATION REGULATIONS ENABLE
THE ENFORCEMENT OF AB ELEVEN
FIFTY EIGHT. AB UNTHINKING
REQUIRED. TO ESTABLISH POLICIES
PROCEDURES AND REGULATIONS TO
COMBAT COMPLIANCE REVIEWS
AVAILITY RECOVERY TREATMENT
FACILITIES I DID MANAGE YOUR
PENALTY IS A DISCIPLINARY ACTION
FOR NON COMPLIANCE WITH
SPECIFIED MINIMUM INSURANCE
LEVELS. ADDITIONALLY THE
PROPOSAL INCLUDES A FEE INCREASE
FOR RESIDENTIAL AND OUTPATIENT
RECOVERY TREATMENT PROGRAMS
EFFECTIVE JULY ONE TWENTY TWENTY
TWO. THE. I THANK LICENSE AND
CERTIFICATION FEES FOR
RESIDENTIAL AND OUTPATIENT
PROGRAMS ARE INSUFFICIENT TO
COVER COSTS. WITH THESE FOR. THE
FULL OF THE BLACK INCREASE IN
TWO THOUSAND FOURTEEN- WOULD
HAVE NO. INCREASES SINCE THAT
DATE NEVERTHELESS SINCE TWO
THOUSAND FOURTEEN WE HAD NINE
NEW LAW PASSED WHICH REQUIRED
ADDITION BUT THIRTY ONE
POSITIONS TO OVERSEE AND SHE'S
ONE OF. THOSE LAWS ABOUT AN
INCREASE IN THE- IN ADDITION THE
DEAD WAS. BY PRO CLOSE AND WE'RE
FOR MORTGAGE FEE WAIVER GIVEN
BECAUSE NINETEEN- WHICH RESULTED
IN THERE SO- THIS NEW REQUEST
THIS YEAR INCREASED WEEDS.
BECAUSE THE FUNDS CANNELLA
DISAPPOINT EXISTING STAFF
RESOURCES ABOUT A FEW WEEKS. I
WILL BE THE ONLY BE FASTER THAN
OUR FOR THEIR TIGHTENING MY
PRISON TATIAN. THANK YOU. THANK
YOU NEXT WE WILL WE WILL HEAR
FROM ELLEN FOXMAN THE DEPUTY
DIRECTOR WITH THE. DEPARTMENT OF
STATE HOSPITALS PLEASE BEGIN.
THE NATURE ARAMBULA AND MA'AM
ELLEN BACHMAN TO. DEPARTMENT OF
STATE HOSPITALS STATE WIDE
QUALITY IMPROVEMENT DIVISION.
THE DEPARTMENT OF STATE
HOSPITALS PROPOSES ONE POINT SIX
MILLION GENERAL FUND AND ELEVEN
POSITIONS IN FISCAL YEAR TWENTY
TWO TWENTY THREE AND I'M GOING
TO SUPPORT STANDARDS COMPLIANCE
AND QUALITY IMPROVEMENT
OPERATIONS AND TO PROVIDE THE
OFFICE OF AUDITS WITH NECESSARY
RESOURCES TO CONDUCT INDEPENDENT
FINANCIAL OPERATIONAL COMPLIANCE
AND PERFORMANCE AUDITS. THE
STATE WIDE QUALITY IMPROVEMENT
DIVISION GUIDES AND MONITORS
POLICY FORMULATION AND
INTEGRATION OF OUR QUALITY
IMPROVEMENT PROGRAM FOR THE FIVE
STATE HOSPITALS. THE DIVISION
HAS FOUR UNITS THE STATE WATER
QUALITY IMPROVEMENT PROGRAM UNIT
PROVIDES OVERALL DIRECTION FOR
THE DIVISION AND TECHNICAL
SUPPORT FOR THE DEPARTMENTS
GOVERNING BODY THE STANDARDS
COMPLIANCE AND QUALITY
IMPROVEMENT UNITS PROVIDE
CENTRALIZED OVERSIGHT OF
HOSPITAL COMPLIANCE WITH FEDERAL
AND STATE LAWS REGULATIONS AND
POLICIES. THE OFFICE OF AUDITS
CONDUCTS AUDITS OF THE
DEPARTMENT'S PROGRAM
ADMINISTRATIVE AND ACCOUNTING
CONTROLS. AND ENTERPRISE HEALTH
AND SAFETY COORDINATESTHE
DEPARTMENT'S OCCUPATIONAL SUCH
SAFETY AND HEALTH PROGRAMS CAL
OSHA COMPLIANCE. AND EMERGENCY
PREPAREDNESS. THE RESOURCES
REQUESTED WILL ALLOW THE
DEPARTMENT TO DEVELOP AND
MAINTAIN POLICIES THAT ARE
CRITICAL TO COMPLIANCE WITH
REGULATORY REQUIREMENTS. TO
MONITOR CDPH LICENSING AND JOINT
COMMISSION SURVEY FINDINGS
INCIDENTS CITATIONS AND
DEFICIENCIES. TO ENSURE
COMPLETION OF STATEWIDE CLINICAL
COMPLIANCE AUDITS AND A WIDE
RANGE OF PERFORMANCE IMPROVEMENT
ACTIVITIES. MS TO MENTOR AND
CONSULT WITH STATE HOSPITAL
STAFF TO ENSURE STATEWIDE
CONSISTENCY IN IMPLEMENTING NEW
REGULATIONS POLICIES PRACTICE
STANDARDS AND REPORTING
REQUIREMENTS. WITH REGARD TO THE
OFFICE OF AUDITS THE MAJORITY OF
YOUR FOCUS IN RECENT YEARS HAS
BEEN CONDUCTING AUDITS IN
RESPONSE TO WHISTLEBLOWER
COMPLAINTS AND SERVING AS THE
LIAISON AND COORDINATOR TO
EXTERNAL ORGANIZATIONS THAT
PERFORM AUDITS OF D. S. H.
FUNCTIONS. DUE TO THE UNABATED.
WORKLOAD IN THESE AREAS AND
OFFICE ABOUT ITS LIMITED
STAFFING DSHS UNABLE TO PERFORM
INTERNAL FINANCIAL OPERATIONAL
PERFORMANCE AND COMPLIANCE
AUDITS TO HELP US MITIGATE RISK
IN THESE AREAS AND REQUIRES
ADDITIONAL RESOURCES TO SUPPORT
THIS ESSENTIAL FUNCTION. A B. C.
P. FOR THESE RESOURCES WAS
INCLUDED IN THE TWENTY TWENTY
TWENTY ONE GOVERNOR'S BUDGET BUT
WAS WITHDRAWN IN THE MAY
REVISION BECAUSE OF THE ECONOMIC
CHALLENGES AND PROJECTED GENERAL
FUND DEFICIT THAT CALIFORNIA WAS
FACING DUE TO THE GLOBAL
PANDEMIC. THE STATE WATER
QUALITY IMPROVEMENT DIVISION
SUBSEQUENTLY PRIORITIZED MISSION
CRITICAL ACTIVITIES WITHIN
EXISTING RESOURCES PRIMARILY IN
SUPPORT OF THE DEPARTMENT'S CODE
NINETEEN PANDEMIC RESPONSE.
HOWEVER THE CRITICAL NEED TO
ENHANCE OUR STANDARDS COMPLIANCE
QUALITY IMPROVEMENT AND-
AUDITING CAPABILITIES STILL
REMAINS. I'M HAPPY TO TAKE ANY
QUESTIONS ON THIS PROPOSAL.
THANK YOU NEXT WE WILL HEAR FROM
TOBY EWING THE EXECUTIVE
DIRECTOR FOR THE MENTAL HEALTH
SERVICES OVERSIGHT AND
ACCOUNTABILITY COMMISSION PLEASE
BEGIN. THANK YOU MR CHAIRMAN
MEMBERS GOOD EVENING WELL- THANK
YOU FOR HAVING ME BACK. VERY
QUICKLY. AS OUTLINED BY DEPUTY
DIRECTOR KELLY THE DEPARTMENT OF
HEALTH CARE SERVICES IS THE KEY
OVERSIGHT AGENCY FOR MENTAL
HEALTH SERVICES IN THE STATE OF
CALIFORNIA- THE COMMISSION
DOESN'T HAVE AUDITORS WE DON'T
DO WE DON'T DO COMPLIANCE
REVIEWS. THE COMMISSION HAS AN
OVERSIGHT ROLE THAT IS MORE AKIN
TO A GRAND JURY A SPECIALIZED
GRAND JURY ON MENTAL HEALTH.
PROVIDER TO THE GOVERNOR AND
LEGISLATURE- AND THE STATUTE
STIPULATES THAT IN THE EVENT
THAT THE COMMISSION IDENTIFIES A
CHALLENGE IN OUR BEHAVIOR HEALTH
SYSTEM. WE REPORT THAT TO THE
DEPARTMENT OF HEALTH CARE
SERVICES AS THEY HAVE THE A MUCH
BROADER ARRAY OF TOOLS. TO
ADDRESS THOSE KINDS OF
CHALLENGES. IN CONTRAST. OUR
FOCUS IS REALLY AROUND
UNDERSTAND WHAT'S WORKING AND
WHAT'S NOT WORKING IN THE MENTAL
HEALTH SYSTEM- ADVISING THE
GOVERNOR AND THE LEGISLATURE ON
POLICY OR PRACTICE CHANGE.
DEVELOPING STRATEGIES AND TOOLS
TO REALLY DRIVE WHAT WE REFER TO
AS TRANSFORMATIONAL CHANGE THE
CONVERSATION EARLIER TONIGHT
AROUND THE M. PATH MODEL AS AN
EXAMPLE OF A PRACTICE THAT HAS
LOTS OF SUPPORT. BEHIND IT BUT
IS NOT SCALING ON ITS OWN AND SO
THE COMMISSION USES ITS
AUTHORITIES TO DRAW ATTENTION TO
THESE ISSUES TO IDENTIFY THESE
ISSUES I CAN SAY IN THE DRAW
ATTENTION TO THEM. AND THEN
REALLY WORK WITH POLICY MAKERS
ADMINISTRATION AND OTHER
PARTNERS TO SEE IF WE CAN-
SUPPORT THE SCANNING OF THOSE
KINDS OF STRATEGIES. PART OF OUR
WORK ONE OF OUR SAID DEFINITION
OF OVERSIGHT AND ACCOUNTABILITY
IS REALLY ABOUT MAKING SURE THAT
THE PUBLIC- BUT INCLUDING POLICY
MAKERS PRACTITIONERS. ARE
AWARE OF WHAT'S WORKING IN OUR
SYSTEM IN AREAS THAT AREN'T
WORKING AS WELL. AND REALLY
BRINGING PEOPLE TOGETHER TO
FACILITATE SHIPS IN OUR STRATEGY
SO THAT WE GET BETTER OUTCOMES
BETTER BANG FOR THE BUCK SO TO
SPEAK. IN OUR MENTAL HEALTH
SYSTEM. THE IMAGES SAY VERY
CLEARLY CALLS FOR A COMMUNITY
ENGAGEMENT PROCESS AT THE COUNTY
LEVEL AS WELL AS COMMUNITY
ENGAGEMENT THE LEVEL OF THE
COMMISSION. AND THE LANGUAGE
STIPULATES THAT THAT IN PLANNING
FOR HOW TO SPEND IMAGES SAY
DOLLARS FOR THINKING MORE
BROADLY ABOUT HOW TO ACHIEVE THE
GOALS OF MENTAL HEALTH SERVICES
ACT. THAT WE HAVE TO ENGAGE
COMMUNITIES THAT ARE PART OF
THAT SYSTEM. MENTAL HEALTH PEERS
AND CLIENTS FAMILY MEMBERS
PROVIDERS AND OTHERS TO REALLY
BE PART OF THE- THE WAY IN WHICH
THE SYSTEM IS DESIGNED WITHIN
FORWARD. THE COMMISSION'S WORK
IS REALLY DESIGNED TO PROVIDE
WHAT WE MIGHT CALL INFORMED
CONSENT OF THAT PROCESS THE
COMMISSION HAS BEEN WORKING IN
THREE PRIMARY AREAS THE FIRST IS
FINANCING. THE LAW REQUIRES
COUNTIES TO ENGAGE MENTAL
HEALTH. THE MENTAL HEALTH
COMMUNITY AROUND HOW TO SPEND
FUNDING AND SO WE BELIEVE IT'S
IMPORTANT TO KNOW HOW MUCH MONEY
IS AVAILABLE SO THAT THOSE THOSE
DECISIONS CAN BE INFORMED. BY
THAT INFORMATION SECOND WE THINK
IT'S IMPORTANT FOR THE COMMUNITY
TO UNDERSTAND THE KINDS OF
PROGRAMS THAT ARE IN PLACE
AROUND THE STATE THAT'S VERY
DIFFICULT BECAUSE OF THE
DIVERSITY OF STRATEGIES IN PLACE
ACROSS THE COUNTIES. ALL OF THAT
WERE TAKES EXAMPLE THE EMPATHIC
MODEL IS UNDERSTANDING THAT IF
WE HAVE AN EFFECTIVE
INTERVENTION WHERE IS IT IN
PLACE SOMEWHERE ISN'T IT IN
PLACE. AND HOW MIGHT WE ENGAGE
THE COMMUNITY TO WORK WITH THE
COUNTY PARTNERS AND OTHERS WHO
ARE INVOLVED IN COMMUNITY MENTAL
HEALTH SYSTEM. TO REALLY PUT IN
PLACE THE PROGRAMS THAT WILL BE
RESPONSIVE TO NEEDS. AND THE
THIRD ISSUE IS THE MOST
IMPORTANT ISSUE IS OUTCOMES AND
SO WE WORK WITH THE H. YES TO
WORK THERE CAN BE FOR HEALTH.
PARTNERS BUT ALSO OTHER STATE
DEPARTMENTS THE DEPARTMENT OF
JUSTICE THE DEPARTMENT OF
EDUCATION EMPLOYMENT DEVELOPMENT
DEPARTMENT TO TELL WELFARE
DEPARTMENT- THE PUBLIC PUBLIC
HEALTH. TO SEE IF WE CAN
IDENTIFY CORE METRICS THAT CAN
INFORM THESE DECISIONS OVER
TIME. THE GOAL IS REALLY TO A
QUICK POLICYMAKERS AND THE
PUBLIC TO UNDERSTAND THE MENTAL
HEALTH SYSTEM THEY HAVE TODAY.
TO MAKE GOOD EVALUATED DECISIONS
IF THEY'RE HAPPY WITH THE KINDS
OF OUTCOMES THAT WE'RE GETTING
FOR THE FUNDING AND THE EFFORT
THEY WERE PUTTING FORTH. AND IF
WE'RE NOT HOW CAN WE ROLL UP OUR
SLEEVES AND REALLY DRIVE
TRANSFORMATIONAL CHANGE AND PART
OF THAT IS BEING HONEST ABOUT
WHAT WE CAN DO WITH THE FUNDING
WE HAVE. WHERE WE MAY NEED
ADDITIONAL RESOURCES HOW WE CAN
DESIGN STRATEGIES TO STRENGTHEN
PROGRAMS ACROSS THE STATE
RECOGNIZING THE DIVERSITY OF
ISSUES FROM IMPERIAL TO DOWNARD.
THAT THE DEMOGRAPHIC AND
GEOGRAPHIC DIFFERENCES IN THESE
COMMUNITIES. BUT FOR THE END
GOAL OF MAKING SURE THAT ALL
CALIFORNIANS HAVE ACCESS TO THE
CARE THEY NEED. IN WAYS THAT ARE
TIMELY RESPONSIVE LINGUISTICALLY
AND CULTURALLY APPROPRIATE SO
THAT WE CAN ACTUALLY ACHIEVE
THAT BEHAVIORAL HEALTH OUTCOMES
OF THE IMAGES THAT CALLS FOR.
WHICH IS YOU KNOW VERY BROADLY
SPEAKING REALLY ABOUT WELLNESS
MAKING SURE THAT PEOPLE HAVE
HOUSING THEY'RE NOT CRIMINAL
JUSTICE INVOLVED. THERE THAT
FAMILIES ARE INTACT AND NOT
INVOLVED IN THE CHILD WELFARE
SYSTEM. STUDENTS ARE SUCCEEDING
IN SCHOOL. ADULTS ARE SUCCEEDING
AND IN THE WORK FORCE IF
APPROPRIATE AND THAT THEIR ARRAY
OF STRATEGIES TO MAKE SURE THAT
WE ARE WORKING UPSTREAM TO
ENSURE THAT PEOPLE ARE HEALTHY
HAPPY. AND WELL TAKEN CARE OF.
THANK YOU VERY MUCH FOR THE
OPPORTUNITY AND HAPPY TO ANSWER
ANY QUESTIONS YOU MIGHT HAVE.
THANK YOU DOCTOR YOU NEXT WE
WILL HEAR FROM DR VERONICA
KELLY. CHIEF OF MENTAL HEALTH
AND RECOVERY SERVICES IN ORANGE
COUNTY PLEASE BEGIN. THANK YOU
VERY MUCH TALKED ARAMBULA AB
ALTHOUGH COUNTIES ARE AWARE OF
CONCERNS ABOUT AND SPENT AN HSA
FUNDING IN THE PAST. MHSAA HAS
BEEN A VITALLY IMPORTANT SOURCE
OF COUNTY FUNDING FOR BEHAVIORAL
HEALTH SERVICES AND I JUST SAID
FUNDS ARE OUR LARGEST SOURCE OF
STATE FUNDING. AND WITH IT WE
LEVERAGE WELL OVER ONE BILLION
DOLLARS IN MANTA CAL IT FUNDS
THE CRISIS SYSTEM THAT WE
DISCUSSED EARLIER HOUSING FOR
OUR CLIENTS. FULL SERVICE
PARTNERSHIP SHIP SERVICES
COMMUNITY DEFINED PRACTICES
PREVENTION AND SO MUCH MORE. IN
FACT THERE'S VERY LITTLE THAT
ARE AN HSA FUNDS DO NOT TOUCH.
OVER THE LAST SEVERAL YEARS LESS
THAN 1% OF IMAGES THAT BONDS
HAVE BEEN REVERTED AND RE
DISTRIBUTED DUE TO LACK OF
EXPENDITURE. CHALLENGES
ASSOCIATED WITH SPENDING ARE
TYPICAL- AND WERE USUALLY FOUND
WITHIN THE INNOVATIONS COMPONENT
WHICH IS THE ONLY FUNDING
CATEGORY THAT REQUIRES STATE
LEVEL APPROVAL. COUNTIES MUST
SPEND BONDS WITH INPUT FROM OUR
COMMUNITIES ON THREE YEAR CYCLES
FOR LARGE COUNTIES AND FIVE YEAR
SPENDING CYCLES FOR SMALLER
COUNTIES. MAJESTIC PINES ARE
MOST VOLATILE FUNDING SOURCE
WHEN FUNDING DIPPED
SIGNIFICANTLY BELOW BUDGET
AMOUNTS AS WAS IN THE CASE IN
TWENTY TWENTY ONE TAXES WERE
DEFERRED OR WHEN THEY INCREASE
SIGNIFICANTLY SUCH AS IN THIS
YEAR WE MUST GO BACK TO OUR
LOCAL STAKEHOLDERS TO UPDATE OUR
PLANNED ACCORDING TO LOCAL NEED.
STAKEHOLDER PROCESS AS REQUIRED
ASPECT OF THE MENTAL HEALTH
SERVICES ACT AND THERE'S A LOT
OF WAYS DOWN IN OUR DIVERSE
COMMUNITIES COMMITTEE AND PUT
THAT MAY NOT EXIST ELSEWHERE TO
ADDRESS EQUITY CIVILIAN VALUE
THIS REQUIREMENT AS A CORE WAY
OF DEVELOPING OUR EXPENDITURE
PLANS. WE UNDERSTANDTHAT THE
ALWAYS HE HAS EXPRESSED SOME
CONCERN WITH FUND BALANCES FROM
YEAR TO YEAR HOWEVER IS THE
STATE HAS REPORTED. ON AVERAGE
COUNTIES TYPICALLY SPEND DOWN
MOST IF NOT ALL OF OUR IMAGES A
FUNDS BY YEAR TWO OF OUR THREE
YEAR FUNDING CYCLE. THE FACT
THAT FUNDS ARE NOT SPENT DOWN
CHARLIE IN YOUR WINE IS A
FEATURE. NOT A BUG OF THIS
UNIQUE PROCESS FOR COMMUNITY
INPUT AND ENGAGEMENT IN OUR
PLANNING PROCESS WHICH WE VALUE
SO MUCH. ADJUSTMENTS ALSO NEED
TO BE MADE TO DEAL WITH THE
VOLATILITY OF THE FUNDING. THE
ULTIMATE MEASURE FOR US IS AND
THE DEGREE TO WHICH COUNTY SPEND
DOWN THESE BONDS TO MEET
PREVENTION INTERVENTION AND
TREATMENT NEEDS OF OUR TO OUR.
DIVERSE COMMUNITIES AND WHICH TO
DATE AS CONSISTENT. THANK YOU.
THANK YOU VERY MUCH THAT THE
PRESENTERS ON PANEL SIX I WILL
NOW BRING IT UP TO THE DÍAS I'D
LIKE TO END WITH THAT LAST
COMMENT IF I COULD REGARDING-
THE- COUNTIES AND- THE
COMMISSION'S ASSESSMENT. ON
WHETHER OR NOT- THEY HAVE LARGE
RESERVES AND I WOULD LIKE TO
FOLLOW UP WITH WHAT TO TOBY HAD
SAID THAT IT REALLY IS THE
DEPARTMENT OF HEALTH CARE
SERVICES THAT HAS THE- TOOLS
NEEDED THAT. WHAT WE HAVE ON THE
AGENDA IS THE FISCAL
TRANSPARENCY TOOL THAT COUNTIES
ARE CURRENTLY NOT- SUBMITTING
THE FISCAL DATA FOR THAT I'D
LIKE TO ASK THE DEPARTMENT
WHAT'S A REASONABLE EXPECTATION.
FOR US TO BE ABLE TO RECEIVE
THAT INFORMATION SO WE CAN HAVE
THAT FISCAL TRANSPARENCY.
I BELIEVE THE QUESTION IS FOR
DOCTOR PFEIFFER. I'M SORRY I
JUST HAD A TECHNICAL GLITCH I
FELT TERRIBLY CAN YOU CAN YOU
REPEAT THE QUESTION BECAUSE I
DIDN'T HEAR. WHAT YOU WHAT YOU
NEED FOR CONSTRUCTION PLENTY OF
COUNTIES ARE NOT REPORTING THE
INFORMATION SO THAT WE CAN USE
THIS FISCAL TANSPARENCY TOOL
WHAT IS THE APPROPRIATE
EXPECTATION. WHEN WILL WE BE
ABLE TO HAVE THIS FISCAL
TRANSPARENCY. I THINK I MAY NOT
BE UNDERSTANDING THE QUESTION
BECAUSE COUNTIES ARE REPORTING
I'M ALL OF THE INFORMATION THEY
ARE SUPPOSED TO BE REPORTING ON
THEIR- ANNUAL REVENUE AND
EXPENSE. REPORT WHICH WOULDN'T
BELIEVE THAT EVERY WEEK SAID
MEANT TOO- B. L. A. C. WHO THEN
REPORT ON THE TRANSPARENCY TO
ALSO AND I MAY NOT AND BE
UNDERSTANDING EXACTLY WHAT IT IS
I THINK I MADE A MISTAKE COUNTY
DOESN'T WITH. A MAIL OUT TO BE
YOU INTO STEP IN IF. PLEASE IF I
MAY MISTER CHAIR SO WHEN WE WORK
IN COMMUNICATION WITH THE
COMMITTEE STAFF WE REPORTED THAT
WE HAD. A VERY SMALL NUMBER OF
COUNTY REPORT SO THE DATA COME
TO THE DEPARTMENT OF HEALTH CARE
SERVICES THE DEPARTMENT
HEALTHCARE SERVICES PREPARES A
FILE AND THEN IT COMES TO US. WE
HAVE BEEN GETTING QUESTIONS FROM
THE LEGISLATURE AND OTHERS ABOUT
THE FUND BALANCES THAT COUNTIES
RECEIVE. ON OUR WEBSITE WE
INCLUDE INFORMATION FROM THE
COMPTROLLER'S OFFICE ON
DISTRIBUTIONS OF IMAGES SAY
FINDING IT SAID IT'S A REAL TIME
MONTH TO MONTH REPORT ON THE
REVENUES THAT ARE COMING IN. AND
WHAT WE'RE SEEING IS THAT
REVENUES THIS YEAR I SHOULD SAY
LAST YEAR EXCEEDED THE PRIOR
YEAR AND THIS YEAR THEY'RE
EXCEEDING LAST YEAR. AND THAT
THE VAST BULK OF THOSE FUNDS
COME IN AT THE BEGINNING OF THE
FISCAL YEAR. ENDED AT THE SAME
TIME WE'VE BEEN HEARING FROM
PROVIDERS AND COMMUNITY MEMBERS
OF CONCERNS THAT IS THEY WORK
WITH THEIR COUNTY BEHAVIORAL
HEALTH PARTNERS TO TRY TO ACCESS
THESE ADDITIONAL FUNDS TO EXPAND
ACCESS TO CARE BECAUSE OF THE
KINDS OF CHALLENGES THAT WE'RE
SEEING STATEWIDE. THEY'RE OFTEN
HEARING THAT THAT- BUDGETS ARE
TIGHT- SO TO SPEAK AND SO WE
REACHED OUT TO THE DEPARTMENT
HEALTHCARE SERVICES TO TRULY
REALLY TRYING TO UNDERSTAND WHAT
HAPPENED LAST YEAR AND HOW CAN
WE UPDATE THE FISCAL
TRANSPARENCY TOOL. AT THE TIME
WE SPOKE WITH THE COMMITTEE
STAFF WE HAD ONLY RECEIVED ABOUT
TEN COUNTY REPORTS SUBSEQUENT TO
THAT WHICH. WAS A COUPLE OF
WEEKS AGO THE DEPARTMENT HEALTH
SERVICES HAS- HAS SENT US A- OUR
THIRTY NINE. COUNTY BEHAVIORAL
HEALTH REPORTS SO MUCH I THINK
YOU KNOW BOTH REALITIES ARE TRUE
IN THAT WE DID AT THE TIME THAT
WE WORK WITH YOUR STAFF. FOR
THIS COMMITTEE THERE WERE SOME
DELAYS. AND ES DE PRODUCTOR 5%
AS THE COUNTIES HAVE IMPROVE THE
REPORTING H. U. S. HAS HAS
REALLY TRIED TO STREAMLINE THIS
PROCESS WE'RE IN PRIOR YEARS WE
SAW- DELAYS THAT MIGHT HAVE
LASTED A YEAR OR LONGER WE'RE
SEEING. A MUCH QUICKER
TURNAROUND. HOWEVER TO THIS AS
OF TODAY AND WE DO NOT HAVE A
CLEAR UNDERSTANDING OF WHAT FUND
BALANCES ARE. AT THE END OF LAST
YEAR. THE COMMISSION WILL EARN
GENEROUS. OKAY THANK COMMISSION
WILL HOLD A HEARING ON THIS
ISSUE ON AS PART OF OUR MARCH
TWENTY FOURTH. PUBLIC HEARING
THE COMMISSION WILL WILL RECEIVE
A PRESENTATION FROM ME ON THE
FISCAL TRANSPARENCY TOOL IN ITS
STATUS- THERE IS SOME
DISAGREEMENT BETWEEN THE
COMMISSION AT THIS POINT AND C.
B. H. D. A. AND SO THAT THAT'S
THOSE ARE THE ISSUES THAT WE
WANT TO ERROR DURING THAT
MEETING ON THE TWENTY FOURTH.
AND IT REALLY GETS THAT- KNOW
HOW TO MOST APPROPRIATELY
COMMUNICATE WITH THE PUBLIC
ABOUT THE FUND BALANCES THE
COUNTIES MAINTAIN WE DON'T
DISPUTE THE COMMENTS OF DH
YASSER CVH TA THAT MOST COUNTIES
DO SPEND THEIR FUNDS WITHIN THE
THREE OR THE FIVE YEAR TIME
FRAME. THAT'S NOT IN DISPUTE
WHAT WE'RE SEEING IS WIDE
VARIATION IN HOW QUICKLY COUNTY
SPEND THOSE DOLLARS AND CONCERNS
IN THE COMMUNITY THAT COUNTIES
THAT ARE RETAINING LARGE FUND
BALANCES COULD USE THOSE FUNDS
TO RESPOND TO THE VERY URGENT
NEEDS IN THE COMMUNITY THAT
THAT. THAT THE PEOPLE ARE
CONCERNED ABOUT TODAY IS I THINK
THE ISSUE OVER ACCESS TO DATA IS
GETTING DRAMATICALLY BETTER AND
WE MAY HAVE CAUGHT UP- I HAVEN'T
CHECKED IN WITH MY STAFF TODAY
BUT I KNOW DHS HAS BEEN WORKING
TO MAKE SURE THAT WE HAVE THE
MOST UPDATED INFORMATION- BUT
THERE ARE DISAGREEMENTS OVER.
THE EXTENT THAT THE COMMISSION
SHOULD BE RELEASING INFORMATION
ON AND FENCE FUND FUND BALANCES
AS IT COULD BE MISINTERPRETED BY
THE PUBLIC THAT THOSE FUNDS ARE
NOT. PLANNED FOR FUTURE
EXPENDITURES AGAIN OUR CONCERN
IS THE TENSION BETWEEN PLANNING
FOR FUTURE EXPENDITURES AND
ADDRESSING THE VERY URGENT
CRISES THAT. WE'RE SEEING ACROSS
OUR COMMUNITIES AT THE MOMENT.
THANK YOU THANK YOU AND IF I
COULD HAVE THE OPPORTUNITY TO
RESPOND NOW THAT I BETTER
UNDERSTAND THE ISSUE I THINK THE
REASON I WAS CONFUSED BECAUSE
THE VAST MAJORITY OF COUNTIES
HAD TURNED. THEIR EXPENSES WE
PASSED THE MON DAMAGES SAYING
I'M TO THE L. A. C. WE WORK
TOGETHER REGULARLY ON THE
TRANSPARENCY TOOL THAT.
DIFFERENCES BETWEEN THE YES IN
THE L. A. P. ON THE TRANSPARENCY
TO ALL I THINK ARE QUITE MINOR
AND AT THIS POINT TECHNICAL I
THINK THE ONE ISSUE THAT SHALL
BE RAISED AS WE- ARGUE ONE OF
FLAG IS THAT- WE ARE. COMMITTED
TO MAKING SURE THAT THE ALLIES
FOLLOWED IN THE COUNTY G. USING
THE FUNDS AND APPROPRIATELY
WHICH MEANS THAT MANY OF THESE
BONDS ARE LOCKED INTO. PLANNING-PROCESSES THAT CAN TAKE A YEAR
TO DO AND THAT WE- AND THAT WE
ARE NOT AT LIBERTY TO TELL
COUNTIES HOW TO USE THAT FUNDING
OUTSIDE OF LOCAL PLANNING
PROCESS AND SO WILD. AND I'M
SPEND FUND BALANCE COULD LOOK
ALARMING IN REALITY ALL OF THAT
FUNDING COULD BE ALLOCATED
CONTRACTED ENCUMBERED AND USED
FOR PRIORITIES THAT HAVE
INDETERMINATE LOCALLY. AND COULD
BE SPENT AB ACCORDING TO THE NHS
A PRIORITIES AS I MENTIONED
BEFORE WITHIN THREE YEARS THE
LARGER COUNTIES IN FIVE YEARS
FOR THE FOLLOWING COUNTIES. AND
WE HAVE SEEN- WHEN WE LOOK AT
THE DATA THAT THE VAST MAJORITY
OF AN HSA FUNDS IS BEING SPENT
VERY EARLY ON. AND WE ARE SEEING. THAT KIND OF PROBLEMS WE DID
SEVERAL YEARS AGO. WHAT A PLEASE
THE ARE. TO THE FOLLOW AND FOR
THE- AS WELL TO HAVE THE-
TURNED. AS WE FOR ALL DAY ABOUT
THE NEED FOR US TO MAKE
APPROPRIATE INVESTMENTS AND- IF
COUNTIES ARE SITTING ON LARGE
RESERVES. I BELIEVE MANY OF US
WOULD LIKE TO ASK. TO SEE IF WE
CAN WORK ON FASTER TIMELINES TO
ADDRESS THE CRISES. THAT WE HAVE
BEFORE US. THAT I'D LIKE TO TURN
TO A QUESTION AND BE ABLE TO
ASK- DR KELLY IF I COULD. IT IT
SEEMS FROM WHAT YOU WERE SAYING
YOU MADE A VERY COMPELLING
ARGUMENT TO. FOCUS ON KEEPING IT
LOCAL SO WE COULD WORK WITH
EQUITY. THAT I'D LIKE TO
UNDERSTAND IF YOU BELIEVE- BASED
ON WHAT YOUR TESTIMONY IS TODAY
WHETHER OR NOT THOSE ARE THERE
ARE THOSE LARGE RESERVES AND- IN
LIGHT OF THE FACT THAT WE JUST
WENT THROUGH A PANDEMIC OR
ANECDOTALLY WE'RE HEARING. ABOUT
SPENDING DECLINING DURING THIS
CURRENT FISCAL YEAR AND THE
LIGHT OF. US HAVING INCREASED
REVENUES. ARE ALL FUNDS
CURRENTLY ENCUMBERED OR WILL
THERE BE A SIGNIFICANT AMOUNT.
FOR US TO HAVE DISCUSSIONS WITH
TO HELP TO DETERMINE HOW TO
SPEND THAT WOULD LOVE TO HAVE
YOUR OPINION ON THAT. THANK YOU-
DOCTOR ON BLACK. AND SO. THAT
THE DIFFICULTY IN ANSWERING THAT
IS THAT I KNOW THAT MY BUDGET I
KNOW HOW IT IS BUDGETED I KNOW
HOW IT'S ALLOCATED I KNOW HOW
THAT WE WILL ENCUMBER AT ALL
THAT IT WILL GO FORWARD. I CAN'T
SPEAK TO EVERY COUNTY AND EVERY-COUNTIES PROCESS AS YOU KNOW IS
A LITTLE BIT DIFFERENT THE THING
THAT MAKES IT HARDER FOR US IS
THAT DURING THE PANDEMIC WE HAD
THE FUNDING OUT FOR OUR
PROVIDERS BUT- WE WEREN'T ABLE
TO DO ALL OF THE SERVICES WE
NEEDED TO DO WE SHIFT INTO DOING
TELEHEALTH WE WEREN'T DOING THE
FULL ARRAY OF SERVICES BECAUSE
WE WERE ON LOCKDOWN. AND THAT'S
STILL SORT OF REMAINS SO THERE'S
THAT IN ADDITION TO OUR WORK
FORCE AND I'M NOT SAYING THIS TO
BE FLIPPANT I AM SAYING IT
BECAUSE IT'S TRUE THAT- OUR WORK
FORCE NOT ONLY HAS IT SHIFTED
BACK SOME OF OUR WORK FORCE
DIED. AND SO THAT CHANGES THINGS
THAT CHANGES THE WAY WE- GET
SERVICES OUT ON THE STREETS AND
WHEN I WAS AND- SIMPLY NOT
COUNTY FOR ABOUT. THREE MONTHS I
COULDN'T DO ANYTHING WITH MY
CONTRACTS BECAUSE EVERYONE OF MY
CONTRACT STAFF WERE OUT IN A
ROTATING BASIS MANY ARE AND
THEN. I ON ON VENTILATORS
BECAUSE OF BECAUSE OF IT SO I
WOULD LIKE FOR US JUST TO THINK
ABOUT THAT WE ARE NOT JUST THE
PROVIDERS OF SERVICE ALL OF US
BUT WE ARE ALSO PEOPLE WHO BEEN
EXPERIENCING THE VERY SAME THING
THAT ALL OF US HAVE BEEN
EXPERIENCING. AND SO THAT HAS
SLOWED DOWN THINGS DO I THINK
WILL BE UP AND RUNNING
ABSOLUTELY DO I THINK THAT OUR
FUNDS WILL BE ENCUMBERED
ABSOLUTELY I THINK THAT THERE
ARE ALSO TO BE REAL- COUNTIES
THAT DON'T HAVE THE WORKFORCE
THEY SIMPLY DON'T HAVE THEM. I
KNOW THAT YOU KNOW I HAD LASTING
SAMBAR DINO COUNTY FIVE
EMPLOYEES WHO DIED OF KOBE. AND
I DON'T KNOW IF I WERE IN
SISKIYOU FIVE EMPLOYEES WOULD BE
EVERYBODY. SO I THINK THAT'S
REALLY IMPORTANT TO KEEP IT IN
THE CONTEXT OUR GOAL IS TO GET
SERVICES OUT ON THE STREET. WE
DO EVERYTHING WE CAN TO TRY
THREE PEOPLE AND UNFORTUNATELY.
WE ARE HAND BY A BUREAUCRATIC
SYSTEMS. HEY I CAN SAY THAT I
THINK KNOWING THAT EVERYONE HAS
A BOARD OF SUPERVISORS TO
APPROVE OR DON'TAPPROVE. OUR
CONTRACTS AND HOW THEY MOVE. AND
SO THAT IS DIFFICULT FOR US TO
MANAGE BUT WE ARE ALL TRYING
AGAIN WE ALL WANT. TO HEAR OUR
STAKEHOLDERS AND GET THE FUNDS
OUT THE DOOR TO THEM. KNOWING
THAT WE HAVE THIS HUGE CHALLENGE
OF HOW WE DO BUSINESS AS A
COUNTY AS A GOVERNMENTAL ENTITY.
AND THAT'S NOT REAL. FLEXIBLE
FOR COMMUNITY PROVIDERS AND SO
WE WENT WE MAKE VERY GOOD USE OF
AN HSA DOLLARS SO THAT WE CAN
GET IT OUT IN A WAY THAT'S VERY
DIFFERENT THAN OUR MEDICAL SIDE
OF THE HOUSE. BUT MY OPINION IS
YES I DON'T THINK WE ARE SITTING
ON A BIG DOLLARS. I WHAT I DO
THINK IS THAT IT IS HARD TO
UNDERSTAND OUR SYSTEM IT'S HARD
FOR US TO UNDERSTAND OUR SYSTEM
SO. TO DIRECTOR EWING'S POINT
AND THAT THE TRANSPARENCY
DASHBOARD WHICH WHICH WE ARE
VERY MUCH IN FAVOR UP AS LONG AS
IT'S PUT IN CONTACTS SO THAT
PEOPLE UNDERSTAND WHAT IT MEANS
TO. ALLOCATE TO ENCUMBER WHAT
THAT THE FACT THAT WE FLY WE
HAVE THREE YEARS TO SPEND DOWN
THE DOLLARS ON WHY WE WOULDN'T
SPEND EVERY PENNY IN ONE YEAR. I
THINK THOSE ARE IMPORTANT THINGS
THAT WE HAVE TO ALL REMEMBER
WITH THIS. THE DR KELLY IN A
POWERFUL REMINDER OF THOSE WHO
ARE ON THE FRONT LINES DOING THE
HARD WORK THANK YOU FOR THAT.
SEEING AS THERE ARE NO OTHER
QUESTIONS I WOULD LIKE TO THANK
THE PANEL SIX AND WE WILL NOW
MOVE ON TO OUR FINAL PANEL.
PANEL SEVEN ON THE BEHAVIORAL
HEALTH THE STATE OPERATION
NEEDS. WE WILL HAVE FOUR
PRESENTERS ON THIS PANEL WE WILL
BEGIN WITH DOCTOR FIGHT FOR.
THANK YOU FOR THE OPPORTUNITY TO
PRESENT I DID WANT TO ADD ONE
THING THAT I ACCIDENTALLY
OMITTED IN MY LAST SEASON
ASIANET THAT IN RESPONSE TO.
RISING OVERDOSE DEATHS FROM
OPIOIDS. WE HAVE PROPOSED
TRAILER BILL LANGUAGE AS PART OF
OUR INMATES SHE- PROPOSAL AS
PART OF THE OF THE EXTENT OF THE
PROPOSAL WHICH WOULD REQUIRE
OPPORTUNITIES TO SORT OF
PROVIDERS REGARDLESS OF THEIR
SOURCE. TO THEY'RE OFFERING THE
T. ON SITE OR HAVE AFFECTED
REFERRAL MECHANISMS ON SIDE WE
THINK THIS IS REALLY IMPORTANT
AND THE TRANSFORMATION. OF THEIR
TO DO TREATMENT CONCLUDED MAKING
IT ALL COME TOGETHER SO. HOW
DOES THAT I DIDN'T MENTION THAT-
GLASS TOP PANEL. GOING INTO-
DEATH PANEL WHAT I'M GONNA BE
TALKING ABOUT OUR BEHAVIORAL
HEALTH WORKLOAD- BUDGET PROPOSAL
WE ARE REQUESTING TWENTY ONE
POINT TWO MILLION IN TWENTY TWO
TWENTY THREE. FOUR THIRTY THREE
NEW COMMENTED AND- THE
CONVERSION OF ONE LIMITED TERM
RESOURCE SO PROMINENTLY SARS.
FIVE THREE YEAR LIMITED TERM
CORPORATION'S CONTRACT FUNDING
TO BUILD OUR CAPACITY TO HOLD
COUNTIES ACCOUNTABLE FOR NEW
STANDARDS EXPECTATIONS AND
TRAVIS SAYS. AND THAT'S REQUEST
INCLUDES AN ADDITIONAL EXECUTIVE
POSITION THAT SECONDS E HAVE A
HEALTH ASSISTANT DEPUTY
DIRECTOR. TO LEAD DIRECTOR
MONITOR THE DEPARTMENT'S EFFORTS
TO EXPAND THAT CRISIS CONTINUE
OF CARE LEAD THEM TO- EFFORTS TO
IMPROVE. BEHAVIOR HEALTH
SERVICES FOR CHILDREN AND YOUTH.
THX FOR QUITE. RESOURCES AND
FROM OVER SEVEN CREDIT BEHAVIOR
FIVE AND CAL. INCLUDING ME NEW
BEHAVIORAL HEALTH GRANT AFTER.
FOR TRYING TO CAN TO GO- WHAT
LARGE AMOUNT OF BETTER FUNDING
IN. ESPECIALLY BASED ON THE
PRODUCT. DRIVE ON THIS NEW AND-
OF FEDERAL FUNDS MEANS FIESTA
ARE A- COMMUTER TO DIVISION
INTEREST. FOR ADMINISTERING
ALMOST TWO BILLION DOLLARS- IN
ONE YEAR IS 66% INCREASE IN
FUNDING WHICH DRAMATICALLY
INCREASES THE WORKLOAD FOR THE
STAFF TO MAKE SURE THAT FUNDING
IS SPENT EFFECTIVELY. WE ARE
COMPLAINING THE MOBILE CRISIS
SERVICES WERE INTENSIFYING OR
OVERSIGHT OF COMMUNITY COUNTY
BEING RUN HEALTH SYSTEM AS I
MENTIONED BEFORE. I'M OUR
SUPPORT OF THE CHILDREN CRISIS
CONTINUE ON PILOTS. AND SUPPORT
OF THE FAMILY FIRST PREVENTION
SERVICES ACT AND NOT BECAUSE-
WHY WE NEED THOSE REQUESTED ME
SERGEANTS. THANK YOU FOR
LISTENING AND I AM. THE ONLY BCS
PROVENCHER. THANK YOU NEXT WE
WILL FROM BROWN HAUSER. CHIEF
DEPUTY DIRECTOR OF. WITH THE OF
HOUSE. PLEASE BEGIN. I MEAN SURE
MEMBERS OF THE COMMITTEE BRETT
HAUSER CHIEF DEPUTY DIRECTOR OF
THE DEPARTMENT OF STATE
HOSPITALS THIRTY DEPARTMENTS
THEY HOSPITAL'S PROPOSALS UNDER
ISSUE NUMBER SEVEN I'LL BE
COVERING THE FIRST THE
ADMINISTRATIVE SERVICES WORKLOAD
PROPOSAL AND PASS IT OVER TO MY
COLLEAGUE. J. C. THOMPSON DEPUTY
DIRECTOR FOR A BRIEF OVERVIEW OF
THE REGULATIONS RESOURCES
PROPOSAL. SPECIFIC TO THE
ADMINISTRATIVE SERVICES PROPOSAL
THE DEPARTMENT STATE HOSPITALS
REQUEST ONE POINT SEVEN MILLION
GENERAL FUND IN TWENTY TWO
TWENTY THREE AND TWELVE
POSITIONS. PERMANENT ONGOING TO
PROVIDE STAFFING RESOURCES TO
ADDRESS AN INCREASE AND
ADMINISTRATIVE OPERATIONS
WORKLOAD ASSOCIATED WITH
STAFFING GROUP OF. GROWTH OVER
THE LAST SEVERAL YEARS. THEIR
NUMBER PROPOSALS THAT HAVE ADDED
AND WILL CONTINUE TO PHASE IN
POSITIONS IN THE PAST AND THE
FUTURE. ISTHE S. H. GROWS IN
THE PROGRAMMATIC AREAS THE
SUPPORT NEEDED TO PROVIDE THOSE
EMPLOYEES IN THE DEPARTMENT ALSO
GROWS IN SPECIFIC ADMINISTRATIVE
FUNCTIONS. ACROSS HUMAN
RESOURCES EQUAL EMPLOYMENT
OPPORTUNITY BUDGET MANAGEMENT
AND RESEARCH. THE GROWTH
INCREASES THE DEMAND THIS OKAY
WITH HUMAN RESOURCES FUNCTIONS
INCLUDING RECRUITMENT HIRING ON
BOARDING UP EMPLOYEES ENSURING
ADEQUATE PAYROLL BENEFITS
PROCESSING INCLUDING IMPORTANTLY
BENEFITS ARE PROVIDED TO OUR
EMPLOYEES. ADDITIONAL POSITIONS
ALSO DRIVE INCREASE PERFORMANCE
MANAGEMENT NEEDS EQUAL
EMPLOYMENT OPPORTUNITY
INVESTIGATIONS AND REASONABLE
ACCOMMODATIONS. IN ADDITION
POSITION GROWTH DRIVES THE NEEDS
FOR THE BUDGET MANAGEMENT
BRANSON RESEARCH TO SUPPORT
FISCAL OVERSIGHT ACCOUNTABILITY
AND INCREASE PROJECTION ALICE'S
FOR POPULATION WAIT LIST AND
STAFFING METHODOLOGIES. THE
NATIONAL RESOURCES WILL ENABLE
THE DEPARTMENT TO KEEP UP IN THE
DEMAND FOR ADMINISTRATIVE
SERVICES AND SUPPORT MISSION
CRITICAL AREAS AT THIS TIME I'LL
PASS IT OVER TO MY COLLEAGUE
TRACY THOMPSON FOR AN UPDATE ON
THE REGULATIONS RESOURCES
PROPOSAL AND THAT HAPPY TO TAKE
ANY QUESTIONS AT THE END. THANK
YOU. GOOD EVENING J. C. THOMPSON
DEPARTMENT OF STATE HOSPITALS
DEPUTY DIRECTOR FOR HOSPITAL
STRATEGIC PLANNING AND
IMPLEMENTATION. THE DEPARTMENT
PROPOSING FIVE HUNDRED AND TEN
THOUSAND GENERAL FUND AND THREE
POSITIONS BEGINNING IN FISCAL
YEAR TWENTY TWENTY TO TWENTY
THREE AND GOING TO SUPPORT
THE RESOURCES FOR THE
REGULATIONS AND POLICY UNIT AND
LEGAL DIVISION. TO MEET THE
DEPARTMENT'S INCREASING DEMANDTO PROMULGATE REGULATIONS. THE
REGULATIONS ON POLICY UNIT WAS
INITIALLY STAFF TO COORDINATE A
MINIMAL NUMBER REGULATIONS
HOWEVER IS THE DEPARTMENT MOVES
TOWARD OPERATING AS AN
INTEGRATED. HEALTH SYSTEM. THE
DEPARTMENT MUST CONTINUALLY
PROMULGATE SYSTEM WIDE
REGULATIONS ACROSS ALL STATE
HOSPITALS IN ACCORDANCE WITH THE
ADMINISTRATIVE PROCEDURES ACT.
AND REGULATIONS ADOPTED BY THE
OFFICE OF ADMINISTRATIVE LAW.
DEDUCTION OF REGULATION IS A
COMPLEX TIME INTENSIVE PROCESS
WHICH REQUIRES SUBSTANTIAL
ATTENTION TO DETAIL AND ALSO
DEVELOPMENT AND THOROUGH REVIEW
OF FACTUAL AND LEGAL
INFORMATION. AS WELL AS
COORDINATION WITH OUTSIDE
STAKEHOLDERS AND THE
FACILITATION OF WORKERS. I'M
HAPPY TO TAKE ANY QUESTIONS.
NEXT WE WILL HEAR FROM TOBY
EWING EXECUTIVE DIRECTOR OF THE
MENTAL HEALTH SERVICES OVERSIGHT
AND ACCOUNTABILITY COMMISSION
PLEASE BEGIN. THANK YOU MR
CHAIRMAN MEMBERS- FIRST I JUST
WANT TO POINT OUT THAT- WE ARE
HAVING CONVERSATIONS WITH THE
DEPARTMENT OF FINANCE AROUND
THESE PROPOSALS WE HAVE NOT
FORMALLY REVIEW THESE PROPOSALS
WITH THE DEPARTMENT OF FINANCE.
THESE ARE- TOPICS THAT HAVE COME
UP VERY QUICKLY WITHIN THE
COMMISSION BUT WE WANTED TO MAKE
SURE THAT WE HAD A CHANCE TO
SHARE THEM WITH THE BUDGET SUB
COMMITTEE- DURING THIS PHASE OF
YOUR WORK- SO AS OUTLINED IN THE
IN THE WRITER FOR THE HEARING-
THE COMMISSION IS LOOKING AT%
FOR. AREAS FOR IN NEW INVESTMENT
THAT THE FIRST IS TO ESTABLISH
AN OUTCOMES FELLOWSHIP WE'VE
BEEN WORKING WITH SOME ACADEMIC
PARTNERS AND COUNTY BEHAVIOR
HEALTH PARTNERS TO RECOGNIZE
THAT IF WE WANT THE SYSTEM THIS
THIS BROAD MIDDLE HEALTH SYSTEM
TO BE ABLE TO MOVE TOWARDS.
OUTCOMES DATA ANALYTICS AND A
STRONGER APPROACH TO EVALUATION
WE NEED TO SUPPORT OUR TEAM
MEMBERS AT THE COUNTY LEVEL AND
THE STATE LEVEL TO REALLY
UNDERSTAND HOW TO MAKE MOST
EFFECTIVE USE. OF DATA HOW TO
MAKE MOST EFFECTIVE USE OF
EVALUATION INFORMATION AND HOW
TO DESIGN STRATEGIES INCLUDING
FISCAL INCENTIVES TO REALLY BE
OUTCOME FOCUSED AND SO WE WILL
COME BACK TO YOU AT A LATER DATE
WITH SPECIFIC. A SPECIFIC
REQUEST FOR FUNDING TO ACTUALLY
BUILD OUT A PERFORMANCE SPACE OR
OUTCOME FELLOWSHIP IN THE
BEHAVIORAL HEALTH FIELD THAT
REALLY WOULD TARGET THAT OUR
COMMUNITY MENTAL HEALTH PARTNERS
AND OUR STATE PARTNERS THE
PROPOSAL WE'RE ENVISIONING IS A
PROPOSAL THAT WOULD LEVERAGE A
SMALL AMOUNT OF STATE FUNDING
WITH PRIVATE SECTOR FUNDING. TO
LAUNCH A FELLOWSHIP THE COULD BE
SUSTAINED OVER TIME. ARE VERY
EXCITED ABOUT THAT PROPOSAL AND
WE THINK IT WAS VERY TIMELY
GIVEN ALL OF THE ATTENTION THAT
WERE HAVE THAT THAT YOU'VE BEEN
SPENDING AND WE HAVE BEEN
SPENDING AROUND UNDERSTANDING
THE SYSTEMS THAT ARE WORKING AND
THOSE THAT ARE WORKING AND HOW
WE CAN REALLY SCALE EFFECTIVE
PRACTICES OVER TIME. THIS ISSUE
THAT THE COMMISSION HAS
UNDERSTOOD THIS QUESTION IS THE
ROLE OF TEARS- WITH THE WORK
THAT THE LEGISLATURE HAS DONE
OVER THE LAST FEW YEARS IN
SUPPORT FROM THE GOVERNOR IN IN
ADOPTING CARE CERTIFICATION IN
CALIFORNIA. WE RECOGNIZE THAT
OUR COMMUNITY PARTNERS ARE
COUNTY BEHAVIORAL HEALTH
DEPARTMENTS AND IN SOME
INSTANCES THE FEDERAL GOVERNMENT
HAS REALLY RECOGNIZE THE ROLE OF
PEERS. IN OUR COMMUNITY MENTAL
HEALTH SYSTEM. BUT WE'RE STILL
LEFT WITH RECOGNITION THAT STATE
GOVERNMENT HAS NOT EMBRACED THE
ROLE OF PEERS AS PART OF OUR
STATE WORKFORCE. AND SO- WE'RE
WHERE PEOPLE COME TO YOU WITH A
SPECIFIC PROPOSAL AT A LATER
DATE AGAIN WE NEED TO WORK AT
THE DEPARTMENT OF FINANCE ON
THIS. BUT THE COMMISSION IS
REALLY RECOGNIZING THAT F THE
STATE IS GOING TO EMBRACE A ROLE
FOR PAYERS THEN WE NEED TO MAKE
SURE THAT OUR STATE WORKFORCE
ALSO EMBRACES THE ROLE FOR
PEERS. PARTICULARLY IN
LEADERSHIP POSITIONS ACROSS
STATE GOVERNMENT SO THAT WE CAN
BEST UNDERSTAND THE APPROPRIATE
ROLE FOR PEERS AND I'M FINE I
WOULD COMMENTS ONE OF THE
QUESTIONS EARLIER THAT YOU
RAISED. AROUND THE ROLE FOR
YOUNG PEOPLE AS PEERS HOW CAN WE
BRING PEERS IN THE STATE
WORKFORCE WE CAN REALLY DESIGN
THE SYSTEMS AND STRATEGIES. TO
EMBRACE APPEAR ROLE THROUGHOUT
OUR BEHAVIOR HEALTH SYSTEM. AND
THEN THE THIRD PIECE. IS I WANT
TO WRITE WORK WE'RE GOING TO
SEEK TO NEW POSITIONS ONE FOR
LEGISLATIVE LIAISON FOR THE
COMMISSION OUR WORKLOAD IN
SUPPORTING THE LEGISLATURE. IN
TERMS OF MENTAL HEALTH POLICY
BILLS HAS INCREASED DRAMATICALLY
AS YOU ARE AWARE THERE'S MUCH
MORE ATTENTION AROUND BEHAVIOR
HEALTH NEEDS. AND SO WE WILL BE
SEEKING A LEGISLATIVE LIAISON
POSITION AND A CHIEF DEPUTY
DIRECTOR TO REALLY STRENGTHEN
OUR ABILITY TO DO THE KINDS OF
THINGS. THAT YOU HAVE SUPPORTED
US IN DOING OVER THE YEARS AS
OUR WORKLOAD HAS INCREASED. I
APOLOGIZE THAT I DON'T HAVE
FORMAL PROPOSALS ON THIS THESE
ARE CONVERSATIONS WE'VE HAD WITH
THE COMMISSION ONLY RECENTLY.
AND SO I WILL HAVE TO COME BACK
TO YOU AT THROUGHOUT THE BUDGET
PROCESS WITH SPECIFICS ON OF
PROPOSALS. ADVANCE ANY QUESTIONS
YOU MIGHTHAVE. THANK YOU VERY
MUCH THAT WILL CONCLUDE THE
PRESENTATIONS ON PANEL SEVEN I
WILL ASK. THE DEPARTMENT'S DR
PFEIFFER. TO RESPOND ABOUT THE
ROLE FOR PEERS WITHIN T. H. C.
S. OR OTHER STATE AGENCIES. CAN
YOU PROVIDE SOME INITIAL
THOUGHTS OR INSIGHTS INTO- THAT
PROPOSAL FROM THE MHS. O. S. O.
AC. WE ARE WE ARE OVERWHELMINGLY
SUPPORT CARES AND ARE VERY PROUD
OF OUR IMPLEMENTATION OF THE
SPEED OF THREE WHICH IS OFFERING
PEER SUPPORT SERVICES THAT.
BENEFIT AND- COUNTY USUALLY
IMPRESSION MENTAL HEALTH AND
DRUG BETTER CALTRANS LEVERAGES
THURMOND DRUG MEDI CAL WELL ON
THE DASH MAJORITY OF CHINESE HAS
INDICATED THAT THEY WANT TO
PARTICIPATE IN THIS NEW BENEFIT
AND WE'VE BEEN. WORKING WITH
STAKEHOLDERS FOR THE LAST YEAR
WITH THE PROBABLY MOST ROBUST
STAKEHOLDER PROCESS I NEVER BEEN
A PART OF WITH HUNDREDS AND
HUNDREDS OF COMMENTS TO DEVELOP
A CERTIFICATION PROCESS- WE
THINK THAT WE'RE GONNA BE PRETTY
CLOSE TO. HAVING THE MEASURE THE
I DON'T HAVE THE EXACT NUMBER OF
THE TOP MANAGER THE VAST
MAJORITY OF MEDICARE
BENEFICIARIES LIVING. IN
COUNTIES APPEARS ARE ENCOURAGED
. MAYBE OF UP TO MAKE SURE- TO
BRIDES AND IN MY UNDERSTANDING
IS. THE PEERS ARE TO HELP WITH
THE MENTAL HEALTH RELATED
DEPARTMENTS THAT CURRENTLY OUR
FEDERAL GOVERNMENT HAS. AN
INFRASTRUCTURE TO SUPPORT PEERS
AS TO SOME OF OUR COUNTY. MENTAL
HEALTH DEPARTMENTS AND I'M
WONDERING WHETHER OUR- STATE
DEPARTMENTS ARE SIMILARLY
LOOKING TO INCLUDE PEERS. HAPPY
TO FOLLOW UP IF THE JACK IN THAT
SENSE. YEAH I AM I WONDER IF
FROM MY DIRECTOR WANTS TO SPEAK
TO THAT BECAUSE WE HAVE. IN
TERMS OF INCLUDING THE VOICE OF
THAT. THAT THE CLIENT IN THE
CONSUMER IN POLICY IS THAT WHAT
THE QUESTION. IT IS. SO I'M NOT
SUR OF THE DIRECTOR BOSSES THE
LAWN SO I'D BE MORE THAN HAPPY
TO RESPOND TO THE ITEM THAT AT
THIS POINT- WE WOULDN'T TAKE
BACK IN REGARDS TO FULLY IN
INTEGRATING PEERS BECAUSE THEY
THINK IT'S A GREAT QUESTION I
JUST WANT TO BE ABLE TO
RESPONSIVE TO THAT IN REGARDS TO
A CONSUMER ADVOCATE ADVOCACY
GROUP WE ARE WORKING TO BRING UP
BY THE END OF THIS YEAR TWENTY
TWENTY TWO OF EIGHTY I. KNOW
BENEFICIARY OR CONSUMER ADVISORY
GROUP FOR THE DEPARTMENT ON THAT
WOULD BE ABLE TO WE WOULD USE TO
BE ABLE TO THAT POLICY ON
IMPLEMENTATION ITEMS FEEDBACK ON
MATERIALS THAT WE USE WITH THE
MEDI CAL BULLYING OUR
BENEFICIARIES- BOTH CHILDREN
YOUTH AND FAMILIES-
BENEFICIARIES THE BILL'S ACROSS
THE FULL CONTINUUM VARIOUS
POPULATIONS- AND TO ENGAGE IN
THOSE CONVERSATIONS SO MORE TO
COME IN REGARDS TO WORK AT YOU
KNOW CONSUMER ADVISORY COMMITTEE
THAT THE ACS IS STANDING UP
DIRECTOR BOSSES BEEN LEADING
THAT INITIATIVE AND I KNOW SHE
WILL BE HAPPY TO PROVIDE
ADDITIONAL INFORMATION. TO YOU
ALL ABOUT THAT INITIATIVE. THANK
YOU FOR THAT WAS. AND I WOULD
LIKE TO THANK ALL OF OUR
PANELISTS TODAY. WE WILL NOW
BEGIN PUBLIC COMMENT. WE DO HAVE
A SUBSTANTIAL NUMBER OF PEOPLE
WHO WOULD LIKE TO PROVIDE PUBLIC
COMMENT AND- THEREFORE I WOULD
LIKE TO URGE YOU TO KEEP YOUR
COMMENTS BRIEF SO THAT WE CAN
HEAR FROM EVERYONE. WE WILL
START WITH ANY IN PERSON.
COMMENTS IN THERE ARE NONE WE
WILL NOW GO TO THE PHONE LINE
FOR PUBLIC COMMENT. AS A
REMINDER THE PHONE NUMBER TO
CONNECT IS ON THE COMMITTEE
WEBSITE AND SHOULD BE ON THE
SCREEN IF YOU ARE WATCHING OVER
THE INTERNET. THAT NUMBER IS
TOLL FREE. 877-692-8957 THE
PUBLIC ACCESS CODE IS ONE THREE
ONE. FIVE ONE TWO SEVEN. IF YOU
ENCOUNTER ANY PROBLEMS PLEASE
CONTACT THE ASSEMBLY BUDGET
COMMITTEE AT 916-319-2090 NINE
AND A STAFF MEMBER WILL ASSIST
YOU. OPERATOR WE ARE READY TO
BEGIN PUBLIC COMMENT. THANK YOU
MISTER CHAIR AND LADIES AND
GENTLEMAN YOU MAY PRESS ONE AND
THEN ZERO AT THIS TIME. AN
OPERATOR WILL PROVIDE YOUR LINE
NUMBER. AND CURRENTLY YOU TO
SHOW. BUT WE HAVE TEN IN THE
COMING Q. AND- MINUS THIRTY SIX
YOUR LINE IS OPEN. PLEASE GO
AHEAD. GOOD EVENING SHARE THIS
THE TARGET BY ETHAN CALLING TO
PROVIDE COMMENT ON IT IF YOU
WANT ON BEHALF ABOUT THE
STEINBERG INSTITUTE AND THE
KENNEDY FORUM AT THOSE SPONSORS
OF EIGHTY NINE EIGHTY AND
RELATED BUDGET REQUEST TO
IMPLEMENT NINETY DAY IN
CALIFORNIA WE'RE INCREDIBLY
GRATEFUL FOR STATE ACTION ON THE
ON GOING LEADERSHIP OF THE
LEGISLATURE ANY ADMINISTRATION
IN SETTING UP THE SYSTEM. WE
WOULD ALSO LIKE TO HIGHLIGHT THE
NEED FOR ADDITIONAL SHORT TERM
FUNDING FOR CALL CENTERS AND FOR
ONGOING COORDINATED BUILT OUT OF
HOW NINETY DAY WILL FIT WITHIN A
BROADER HEALTH REFORMS. AND
INVESTMENTS THAT THE STATE HAS
ALREADY MADE WE ARE INCREDIBLY
HARD TO SEE THE AGENCIES ROBUST
PLANNING EFFORT IS GETTING
UNDERWAY. AND WILL ALSO
UNDERSCORE THE NECESSARY URGENCY
FOR THIS WORK NOT ONLY IS THE
NINETY DATELINE GOING LIVE THIS
JULY. BUT I'VE DISCUSSED TODAY
SIGNIFICANT INVESTMENTS ACROSS
THE CONTINUUM ARE CURRENTLY
BEING ROLLED OUT WITHOUT A CLEAR
VISION FOR HOW TO INTEGRATE
THESE DIFFERENT COMPONENTS. THE
VENUE MAKE DEMANDS LEFT ACTION
FINALLY WE WOULD ADDITIONALLY
URGED THE LEGISLATURE TO PASS A
SMALL FEE ON PHONE LINES TO
SUSTAINABLY FIND GAPS IN OUR
NINETY DAY TO STAND. AS
AUTHORIZED UNDER THE NATIONAL
SUICIDE HOTLINE AND DESIGNATION
ACT THANK YOU SO MUCH. THANK
YOU. OPERATOR NEXT CALLER PLEASE
. ONE THIRTY. YOUR LINE IS OPEN
PLEASE GO AHEAD. GOOD EVENING
TURN MEMBERS MRS COLLINS WORSE
WITH THE CALIFORNIA
PSYCHOLOGICAL ASSOCIATION.
RICKLY ON TWO ITEMS OF SUPPORT
WE DO SUPPORT- FUNDING DIRECTED
TOWARDS THREE NINE EIGHT EIGHT
ADULT CRISIS LINE AS MISS
CAMPBELL HOUSTON JUST POINTED
OUT WE ALSO SO- SUPPORT THE
MONEY GOING TO THE MHC IN
SUPPORT OF SB TWO TO ONE FOR
WHICH WE WERE STRONG. SUPPORT
I'D ALSO LIKE TO FLAG FOR THE
COMMITTEE SOMETHING THAT WAS A
THROUGH LINE ON ALL OF THESE
CONVERSATIONS TODAY WAS THE NEED
FOR WORKFORCE SPECIFICALLY
LICENSED- WELL TRAINED WELL
PREPARED- HEALTH PROFESSIONALS
WE WOULD POINT OUT THAT WE HAVE
SUBMITTED A FIVE HUNDRED MILLION
DOLLAR ASK. BETWEEN OURSELVES
EMERGING FAMILY THERAPIST THE
SOCIAL WORKERS NOT LICENSED
PROFESSIONAL CLINICAL COUNSELORS
TO CREATE A STRONG PUBLIC MENTAL
HEALTH TYPE ONE FOR THESE
PROVIDERS I WE DO THINK THAT
TRANSITIONING FOLKS FROM CRISIS
SERVICES BEYOND PSYCHIATRIC
CAÑADA HOSPITALS BE AT COMMUNITY
SETTINGS ALL REQUIRE A STRONG
AND WELL PREPARED LICENSE.
WORKFORCE THANK YOU. THANK YOU.
OUR NEXT PLEASE. NINE SIX SIX
YOUR LONG IS OPEN PLEASE GO
AHEAD. GOOD EVENING JOSH DUGGAR
REPRESENTING THE URBAN COUNTY TO
CALIFORNIA WE APPRECIATE THE
GOVERNORS CONTINUED INVESTMENT
IN BEHAVIORAL HEALTH AND WE
SUPPORT THE BEHAVIORAL HEALTH
BRIDGE HOUSING PROPOSAL UNDER
ISSUE TWO AND THE MEDICATION
ASSISTED TREATMENT EXPANSION AND
NATION FIVE. ADDITIONALLY UCC
REPORTS MAKING COMEDIC MOBILE
CRISIS A MEDIC CAL BENEFIT AND
WITHOUT THAT THE FEDERAL TIME
AND DISTANCE CRITERIA WILL TAKE
WORK IN LIGHT OF SPARSELY
POPULATED REGIONS INCLUDING
THOSE WITHIN URBAN COUNTY AND WE
ARE BEHAVIORAL HEALTH WORKFORCE
SHORTAGES LASTLY WE ARE
ENCOURAGED BY SOME OF THE
ELEMENTS IN THE INCOMPETENT TO
STAND TRIAL PACKAGE UNDER ISSUE
TWO. ESPECIALLY THE INVESTMENTS
IN RESIDENTIAL INFRASTRUCTURE
AND ADDITIONAL HOUSING SUPPORT
FUNDING FOR DIVERSION COUNTY
CONTRACTS HOWEVER THE NEW COUNTY
CAP INCLUDED IN THE PROPOSAL
CONCERNING ESPECIALLY ALONGSIDE
LPS MECHANISMS INCLUDED IN LAST
YEAR'S BUDGET AND CONSIDERING
THE COMPLEX FACTORS LEADING TO
ADMISSIONS. THAT DISCUSSED TODAY
THANK YOU. THANK YOU OPERATOR
CALLER PLEASE. NINE SEVENTY SIX
YOUR LINE IS OPEN PLEASE GO
AHEAD. GOOD EVENING MISTER CHAIR
AND MEMBERS RONALD COLEMAN HERE
ON BEHALF OF THE CALIFORNIA PAN
AT THE KELP IT WORKS THE PLAN WE
GENERALLY SUPPORT THE PROPOSAL
ON MOBILE CRISIS RESPONSE AS
PART OF ISSUE ONE BUT WE SEEK
MODIFICATIONS TO ENSURE RACIALLY
RACIALLY JUST IMPLEMENTATION OF
THE MOBILE CRISIS BENEFIT
RESPONSE FOR FAR TOO LONG OUR
BEHAVIORAL HEALTH SYSTEM IS
SEPARATE FROM THE UNDERPAINTING.
FROM SUFFERED FROM UNDERFUNDING
COMPLEX SEGMENTATION AND THE
COUNTIES TO FOLLOW EVERYONE
ESPECIALLY PEOPLE OF COLOR IS
ARE LOOKING FOR ALTERNATIVES TO
A POLICE RESPONSE WHICH TOO
OFTEN RESULTS IN HARM CHARM AND
SOMETIMES DEATH WHEN CALLING IN
A MENTAL HEALTH CRISIS WE MUST
ENSURE COMMUNITY PEERS AND
COMMUNITY HEALTH WORKERS ARE THE
RESPOND THERE'S ENSURE WORKERS
HAVE CULTURALLY ENGLISH
LINGUISTICALLY INFORM TRAININGS.
ADDITIONALLY WE BELIEVE WE MUST
CREATE A REPRESENTATIVE
STAKEHOLDER WORK GROUP FOR
FEEDBACK AND MAKE SURE COUNTIES
OF A STANDARD APPROACH AS
OPPOSED TO THE CURRENT PATCHWORK
SYSTEM I WANT TO URGE THIS
COMMITTEE TO WORK WITH
HEALTHEQUITY STAKEHOLDERS TO
ENSURE THAT THE TRAILER BILL
IMPLEMENTATION CAPTURE THESE
CRITICAL RACIAL JUSTICE ISSUES
ADDITIONALLY AS REFORMS TO
IMPROVE SB EIGHTY TWO ARE
CONSIDERED. CHEAP AND BELIEVES
THAT ANY CHANGE TO THE ACT
SHOULD REDEFINE ITS FOCUS ON
RACIAL EQUITY AND MENTAL HEALTH
CARE CRISIS WE PROPOSE THAT SB
EIGHTY TO PRIORITIZE FUNDING FOR
COUNTIES OR OTHER ENTITIES THAT
COMMIT TO DEVELOPING CULTURALLY
AND LINGUISTICALLY RELEVANT
COMMUNITY BASED NON LAW
ENFORCEMENT ALTERNATIVE RESPONSE
MODELS REQUIRE COLLECTION OF
DATA THAT ALLOWS FOR MEANINGFUL
ANALYSIS OF RACIAL DISPARITIES
IN BOTH WHO WAS SERVED. AND THE
OUTCOMES OF THIS SERVICE AND
REQUIRE THE PROFESSIONAL
COMPUTERS TO STAFF RESPONSE
TEAMS RESPONDED- REPRESENT THEIR
COMMUNITIES RACIAL LINGUISTIC
DIVERSITY AND ALSO REQUIRE THAT
SERVICE PROVIDERS GO THROUGH
IMPLICIT BIAS TRAINING THANK
YOU. THANK YOU. OPERATOR NEXT
CALLER PLEASE. IN SIX THREE YOUR
IS OPEN GO AHEAD. GOOD EVENING-
MISTER CHAIR AND- MEMBERS MANY
OUT ROBERT HARRIS I'M THE
HAPPIEST S. CI YOU CALIFORNIA
FIRST OF ALL WE WILL EXPRESS OUR
SUPPORT FOR THE BILL LINE A NEED
TO CALL CRIME LINE. YEAH AND
MAKING SURE THAT THERE'S
ADEQUATE FUNDING PATCH DID. THAT
BE. PROVIDE SERVICE AFTER IT
GOES AWAY AND AFTER THE- ISIS
FINE MONEY GOES AWAY. ARCSECOND
BALL- WE SUPPORT THE PEERS I
JUST I'M CONCERNED THAT. DURING
THE DISCUSSION APPEARS WE DON'T
DISCUSS THAT THEY GET REIMBURSED
BELUM REASONABLE RATE. SO THAT
WE DON'T JUST TRY AND DUMMY DOWN
THE WORKFORCE BUT WE ACTUALLY
SEE THEIR VALUE ON PAPER ABOUT
VALUE IN THE WAR. IN THE- STREAM
OF MONEY AND THEN ALSO WE WANT
EXPRESSED SUPPORT FOR EXPANSION
OF THE BAT PROGRAM. AND LOOK
FORWARD TO HAVING MORE COMMUNE.
GET YOU A YEAR PARTICIPATE IN
THE SYSTEM BECAUSE THEY ARE THEY
ARE THEY ARE THE PEOPLE WHO WORK
FOR THE POOREST OF THE POOR. AND
BASED THEY ARE ACCESS TO THE
COMMUNITY FOR PEOPLE WHO NEED
THAT SO THANK YOU VERY MUCH AND
HAVE A GETTING TO. THANK YOU
OPERATOR NEXT CALLER PLEASE. IN
SEVENTY ONE YOUR LINE IS OPEN
PLEASE GO AHEAD. MR CHAIRMAN
MEMBERS ROB LANE WITH THE
CALIFORNIA COUNCIL- COMMUNITY
BEHAVIORAL HEALTH AGENCIES WE
APPRECIATE YOU INCLUDING OUR
VOICE INTO A TERRAIN AND THE
VARIOUS PROPOSALS PRESENTED
TODAY AND PARTICULARLY IN
PARTICULARLY WHEN I SUPPORT-
INITIATIVES AROUND SB EIGHTY
TWO. BEHAVIOR HEALTH CONTINUING
INFRASTRUCTURE PROGRAM
ADDITIONAL AND ADEQUATE NINE
EIGHT EIGHT FINDING PROMOTING
MEDICATION ASSISTED TREATMENT
AND ADDITIONAL CHANGES TO TIMELY
ACCESS TO ALLOW PROVIDERS TO
MEET THE CURRENT NEEDS. WE ALSO
AGREED WITH THE COMMENTS- DR
KELLY EXECUTIVE WITH OUR
BUREAUCRATIC SYSTEM AND WE WANT
TO UNDERSCORE THAT WE MUST ALL
WORK TOGETHER TO CHANGE IT'S NOT
AND NOT JUST TO COME TO IT. IN
CLOSING I WANT TO EMPHASIZE THAT
PROVIDERS ARE SUFFERING DUE TO
WORK OR SHORTAGE AS WE SIMPLY
CANNOT PROVIDE SERVICES WITHOUT. ARE ESSENTIAL STAFF AND- THANK
YOU. OPERATE NEXT CALLER PLEASE
. NINE THIRTY EIGHT YOUR LINE IS
OPEN PLEASE GO AHEAD. GOOD
EVENING I AM HIGHLY STRUNG CEO
OF MENTAL HEALTH AMERICA OF
CALIFORNIA AND HAZ THANK YOU FOR
TODAY FIRST WE SUPPORT ISSUE ONE
MOBILE CRISIS INFRASTRUCTURE
TWENTY TWENTY ONE INVESTMENT. WE
URGE THE LEGISLATURE
ADMINISTRATION TO CONSIDER
PLANNING FOR THE NINE EIGHT
EIGHT CRISIS CONTINUE WENT
BEYOND A ONE TIME LIMITED TERM
ESTABLISHMENT OF A STATE WIDE
PLANNING PROCESS. TO ENSURE THAT
THE COMPONENTS OF THESE CRISIS
SYSTEMS ARE BUILT AND FUNDED IN
AS CORNY AS A MATTER OF SECONDS
EMERGENCY SUPPORT IF YOU WIND
CAL HOKA ONE LINE THE ADVOCATE
THE CALVET FUNDING BE EXTENDED
BEYOND WHAT MIGHT BE TECHNICALLY
TO FIND AT THE END OF THE
pPANDEMIC. AS A PANDEMIC AND
REPERCUSSIONS OF THE PANDEMIC
WELL IMPACT INDIVIDUALS NEARING
TO BE ON THE COMPLAINT AND THEN
THE PANDEMIC. WE ALSO SUPPORT
THE PROPOSED CAL HOPE
COLLABORATIVE WE ENCOURAGE AT
NINE EIGHT AM CAL HOPE NOT BE
APPROACHED AS A YEAR OR MORE BUT
INSTEAD WE REQUEST BOTH BE
FUNDED AT SYSTEMS TO SUPPORT
INDIVIDUALS ACROSS OUR STATE.
AND LAST ACROSS THE SCOPE OF
BEHAVIORAL HEALTH CONVERSATION
WE WERE QUITE. THE CONVERSATION
STEP. YOU ME CHEF FROM MORE
NEEDING MORE IN HOT BED. TO
INSTEAD OF SHIFTING THE PRIOR
INCOME. TO INCREASING COMMUNITY
INSTEAD FOCUSING ON PREVENTION
AND MITIGATION OF CRISIS THANK
YOU SO MUCH THANK YOU. OPERATOR
NEXT CALLER PLEASE. I AM
THIRTEEN YOUR LINE IS OPEN
PLEASE GO AHEAD. HELLO I'M REYES
I LIVE IN DISTRICT FIVE AND USE
RESOURCES AND DISTRICT THREE I
AM A CLIENT WITH LARKIN STREET
YOUTH SERVICES. HAVING APPROVED
WITH MENTAL HEALTH CYCLES FOR
NEARLY MY ENTIRE LIFE I CAN
EXPECT FROM PERSONAL EXPERIENCE
HELLO HERE YOU CAN BE TO BE ABLE
TO HAVE TALK TO SOMEONE WHO GOES
THROUGH SOME OF THE SAME
EXPERIENCES. EMOTIONAL BLOCKS
AND SWINGS COPING STRATEGIES AND
EVEN BETTER TO RECEIVE NEW
STRATEGIES AND RESOURCES FROM
SOMEONE WHO HAS EXPERIENCED
THOSE COPING PLANS WORK OUT.
MANY HOTLINES HIGHER AT THE JOB
NOT AS A POSITION TO HELP THOSE
WHO DESIRE GOING. THROUGH MENTAL
HEALTH CRISIS IS. PLEASE PROVIDE
MONEY FOR. ORGANIZATIONS THAT
HAVE USED THEM FOR YEARS WITH
THE LIVED EXPERIENCES. PROVIDE
MONEY TO. HEALTH SERVICES. AND
FACILITIES- LEGAL FACILITIES HE
- AND INCARCERATED PROSTRATION-
TO PROVIDE FOR PREVENTIVE
SERVICES THANK YOU. THANK YOU
OPERATOR NEXT CALLER PLEASE.
NINE SEVENTY EIGHT YOUR LINE IS
OPEN PLEASE GO AHEAD. GOOD
EVENING THIS IS JENNIFER ALLEY
WITH THE CALIFORNIA ASSOCIATION
AMERICAN FAMILY CARE BEST THINGS
LIKE THAT THANK THE COMMITTEE
FOR THE OPPORTUNITY TO TESTIFY
FOR THAT. FULL OF ROBUST
CONVERSATIONS ABOUT HOW TO
TRANSFORM THE BEAVER HEALTH
SYSTEM IN THE STATE I'M CAMPUS
SUPPORT THAT NINE EIGHT EIGHT
BUT HE NEVER LIKED THE BAND
PROGRAM HAVE. STABILIZED AT IN
THE OUTER YEARS THEN WE ALSO
WOULD LIKE TO ECHO THE COMMENTS
MADE EARLIER BY MY COLLEAGUES-
WHAT THE PSYCHOLOGICAL
ASSOCIATION. OUT NEEDING TO HAVE
SOME FUN AND FROM MISTER. THAT-
PROFESSIONAL BEHAVIOR FORCED- IS
AVAILABLE TO PUT TO PARTICIPATE
IN THE STAFFORD- WE REQUESTED A
FIVE HUNDRED MILLION DOLLAR
PACKAGE PACKAGE THAT WE CALL TWO
TWO ONE WITH TWO HUNDRED
MILLION. FOR STIPENDS. FOR OUR
PRE LICENSED INDIVIDUALS WORKING
FIVE TOWARDS THEIR HOURS
REQUIRED FOR THEIR CLINICAL
EXAMS- TWO HUNDRED MILLION- IN
STUDENT LOAN FORGIVENESS AND A
HUNDRED MILLION FOR SCHOLARSHIPS
FOR THE FUTURE WORKFORCE. I
THANK YOU FOR YOUR TIME AND HAVE
A GOOD REST OF YOUR DAY. THANK
YOU. OPERATOR NEXT CALLER PLEASE
. NINE SEVENTY FOUR YOUR LINE IS
OPEN PLEASE GO AHEAD. HI THANK
YOU- THIS IS JANE AND I'M NOT
SURE AND- SANTA CLARA COUNTY AND
- HUNDREDS I'M GRATEFUL TO ALL
OF YOU. FOR ALL OF HE HARD WORK
THAT YOU'RE DOING AND I JUST.
FOR SURE NOW YOU'RE ALL IN MY
PRAYERS AND- I- WHEN HER PER OUT
REACH AND NOT THE FALL JUST
BEFORE- THE NATIONAL PER DAY FOR
NOW HELLO NO RECOVERING
UNDERSTANDING. WE DO NOT
RESTRICT YOU WANT CHURCHES EVEN
AN INNOVATION GRANT WITH MATT
AND- FAMILY WE'VE MAPPED OUT
WHERE ALL ARE LOCKED FACILITIES
WERE IN OUR CHAIRS AND YOU KNOW
WE HAVE A HUNDRED YEAR KRAFT
CERTAINLY HAD NO. THIRTY HERE IT
COULD SOUND. FROM THE CHURCH'S
NEAR THE FACILITIES WERE INVITED
DOWN TO HOLDER LET THEM KNOW
THAT THEY HAVE WE HAVE FOLKS IN
LOCKED FACILITIES IN THE
NEIGHBORHOOD. AND BY THEIR
HERMAN STREET TO JOIN WITH US.
AND PRAYER FOR OUR PEERS. AND
I'M JUST WONDER HOW. WE COULD
COLLABORATE WITH CHURCHES. AND-
YOUR MINISTERS MATRIX LEADERS TO
HELP BIRDS ARE TO UNDERSTAND THE
TRANSPORTATION ARE NOT NEEDED.
PUBLIC BECAUSE WE NEED NERVOUS
SYSTEM EDUCATION FOR DOCTORS WE
NEED TO- AND WE NEED TO BE SEEN
AS EQUALS WITH WERE FOR OUR
THERAPISTS ARE PROVIDERS BECAUSE
BECAUSE WE HEAL TOGETHER AND YOU
KNOW THE FUTURE SUPPORT. IT IS
NOT YEAH IT'S WITH OUR OUR OUR
OUR OUR DOCTORS AND OUR
COUNSELORS I MEAN WE NEED TO
RECOVER OR SHARING THE AS AS- OF
THE PEOPLE AND WITH EACH OTHER
AND ARE EMPTY AND- I THINK- DEAL
WAKING BRAIN IS- A REFERENCE
FIFTY MCALMONT TOLD ME ABOUT
NINE. LITERATURE. ON AUDIBLE
AND- YOU KNOW THERE'S A- YOU
KNOW WE TURN- FOR MORE ABOUT
THAT BUT- BUT- BUT BUT HERS IS A
POWERFUL ANYWAY BUT A DEVOTIONAL
I'M HOLDING YOU ALL IN MY
PRAYERS AND- AND HOW CAN WE-
IMPROVE THE EDUCATION AND
ENGAGING. FOR MEDICAL- EDUCATION
BECAUSE OF NERVOUS SYSTEM
RECOVERY THAT DOES USUALLY
BLOCKED WITH ROCKEFELLER YEAH
BACK IN LATE TWO ZERO NOT GONNA
KNOW OF IF YOU'RE GOING TO
WAITING AND- VERY LONG. SESSION
I'D APRECIATE ALL OF YOU BUT
BUT- LET'S NOT LET FORMER
CONTINUES TO DRIVE OUR
LEGISLATION IN OUR SOCIAL
MARKETING LET'S PUT KIDS YOU
KNOW THEY DON'T HAVE BRAIN
DISEASE. THEY CAN RECOVER BUT
STOP GIVING PERMANENT DIAGNOSTIC
LABELS I MEAN LET'S BUT I MEAN
IS A LOT OF ITS COMPLEX
POSTTRAUMATIC STRESS. IN WE CAN
RECOVER AND BUT FROM HOW IMPROVE
AND LET'S NOT MAKE IT CRIMINAL.
RICHARD WHEN WE NEED YOU KNOW
WORK SHARING IN THE ASSEMBLY WE
NEED WE NEED HER REST BUT- WE
NEED THAT WARM LINE WITH MHSAA
AND LIKE I AGREE WITH PARTY
STRUCK YOU KNOW WHEN YOU CANNOT
BE OUR CULTURE SHORT NINE EIGHT
EIGHT BUT WE HAVE HARD TO
SUCCESSFUL PURE WARM LINE FOR A
LONG TIME. AND THERE IS A LOSS
COUPLE YEARS AND SO BUT- YOU
KNOW TO THAT THANK YOU FOR
ORANGE CONVENER ADVISORY COUNCIL
FOR WITH CAL NOW DOCTOR KELLY
AND- ANYWAY SO WE'LL HOPE WE
CAN- JUST JOIN WITH YOU AND
SOMEHOW. YOU KNOW. EIGHT ARABS
WE COULD DO A SAFETY NET GRANT I
MEAN WE DID A FACING A INVASION
GRANT WE DO A RECIPROCAL
CHURCHES HOW CAN WE- BRING OUT
YOUR OTHER. HOW CAN WE YOU KNOW
- JUST JUST. THAT DURING A PER.
HAVE A UNDER PRESSURE AFTER FOR
MOVEMENT. THANK YOU. THANK YOU.
OPERATOR NEXT CALLER PLEASE.
NINE SEVENTY NINE YOUR LINE IS
OPEN PLEASE GO AHEAD. GOOD
EVENING- SHARE ARTICLE KIANA
SPEAKING ON BEHALF OF EVERY TOWN
FOR GUN SAFETY AND SUPPORT MANY
OF THE ITEMS RELATED TO FUNDING
AND PLANNING OF THE STATE CA
NINETY EIGHT EIGHT. I SHOULD
STATE THAT WE ALSO FEEL IT'S
IMPERATIVE THE LEGISLATURE ADOPT
A PERMANENT FISHING HUNTING
BIRTH DEFECTS THAT WE IMPLEMENT
NINE EIGHT EIGHT THANK YOU.
THANK YOU. OPERATOR NEXT CALLER
PLEASE. NINE EIGHTY FOUR YOUR
LINE IS OPEN PLEASE GO AHEAD. HI
GOOD EVENING THANK YOU AGAIN SO
MUCH- FOR THIS OPPORTUNITY THIS
IS DOCTOR BATH JONES AND I AM
THE FRONTLINE STAFF PSYCHIATRIST
AT PATTON STATE HOSPITAL WE'RE
THE LARGEST FORENSIC HOSPITAL IN
THIS COUNTRY AND IT'S NOT THIS
WORLD WE WONDERFUL WE HAVE
FIFTEEN HUNDRED PATIENTS- WE
HOUSES THE MOST. CRITICALLY ILL
THANK YOU EXPECTATIONS- ONE WITH
YOU KNOW REFRACTORY SYMPTOMS
THAT NO AMOUNT OF MEDICATION AND
CAN HELP OFTEN AND I'M SO
GRATEFUL FOR THIS OPPORTUNITY
BECAUSE- WE ARE SUFFERING. YOU
KNOW THIS REAL PLATES AND ANYONE
WHO WILL LISTEN WE'RE WE'RE
GOING TO TRY TO SCREAM I'M
PREPPING FOR THE THANK YOU FOR
THE STAFF LIKE HIGH INTEREST
THERE ARE GIGGLE ON THE PHONE
BUT IT IS LIKE FIVE HOURS AND
SO. EVERYONE HAD COMMITMENT
NIGHT BUT- THANK YOU SO MUCH
BECAUSE I DO WANT TO SAY WE ARE
NOW AT A 55% VACANCY RATE.
WITHIN THE HOSPITAL AND IT'S
ONLY GROWING WORSE WE'VE BEEN
TRYING TO SOUND THE ALARM. YOU
KNOW THE SPECIAL MASTER WHO- WHO
IS IN CHARGE OF THE PRISONS HAS
RECOMMENDED TO- THAT. SACRAMENTO
BUT THE INCREASE OUR SALARIES.
THEY WOULDN'T TALK ABOUT IT THEN
THEY WOULDN'T TALK ABOUT IT IN
NEGOTIATIONS WE CANNOT COMPETE
WITH THE SALARY WERE NOT GETTING
PAID FOR MARKET VALUE WE WE'RE-
THERE'S NOBODY APPLYING TO
THESE. TO THESE POSITIONS THERE
WERE ONLY ASKING I MEAN WE'RE
WE'RE AT A JOB THAT SO DANGEROUS
THAT WE CAN GET CHOKED OUT FROM
BEHIND WILL HAVE SECURITY WE CAN
GET PUNCHED IN THE FACE I MEAN
THAT HAPPENS. CONSTANTLY AND SO
HOW ARE WE GOING TO COMPETE WITH
OTHER JOBS THAT ARE OFFERING
LIKE HOLY WORK AND THE SAFETY OF
YOU KNOW BEING IN A CLINIC AND
NOT HAVING TO BE WITH. YOU KNOW
PEOPLE WHO HAVE BEEN CONVICTED
OF ARE FOUND GUILTY BUT NOT
GUILTY BY REASON OF INSANITY OF
MURDER OR RAPE I MEAN THOSE ARE
OUR PATIENTS WITHIN THE HOSPITAL
THOSE ARE THE PEOPLE WE TREAT.
SO I I'M CREATING THAT YOU KNOW
YOU KNOW WITH THE FINANCE
COMMITTEE THAT YOU CAN PLEASE
LOOK AT THIS WE NEED TO BE PAID.
WHAT WE'RE WORTH AND AT A
COMPETITIVE SALARY BECAUSE
PATIENT CARE IS ULTIMATELY
SUFFERING WITH THE 55% AND
GROWING VACANCY RATE. AND THAT'S
ALL I HAVE TO SAY THANK YOU SO
MUCH. DR GERM. OPERATOR NEXT
CALLER PLEASE. NINE FIFTY NINE
YOUR LINE IS OPEN PLEASE GO
AHEAD. THANK YOU MISTER MEMBERS
WITH THE KOBE STUDY WITH THE
CALIFORNIA ASSOCIATION OF
PSYCHIATRIC TECHNICIAN- I WOULD
SIMPLY LIKE THAT YOU KNOW ECHO
SOME OF THE COMMENTS FROM THE
PREVIOUS SPEAKER ABOUT- THE
VACANCY RATE AND THE DANGERS. OF
THE JOBS- THANK TECH DO YOU
PROVIDE THEY'RE THE LARGEST
DIRECT LEVEL OF CARE PROVIDERS-
IN THE STATE HOSPITAL COULDN'T
GET THEM. AND IT'S IMPORTANT
THAT WE POINT OUT THAT GREAT
QUESTION THAT YOU OUT- MISTER
CARE ABOUT. IS THE WAIT LOOK
BEING IMPACTED BY FACILITIES OR
STAFF AND THEY ANSWER THAT
QUESTION AND YEAH THE BOTH- FOR
THE FACILITIES THAT WE USE TODAY
WERE NEVER DESIGNED A HOUSE
SYSTEM. THAT HAS NINETY PERCENT-
FRIENDLY POPULATION NAPA STATE
HOSPITAL OPENED IN EIGHTEEN
SEVENTY FIVE PATENT IN EIGHTEEN
NINETY THREE METRO IN NINETEEN
SIXTEEN- ATASCADERO WITH THE
MOST MODERN IN NINETEEN FIFTY
FOUR. UNTIL. C
TWO THOUSAND FIVE. I YOU KNOW
WE HAVE THAT COMPLETE A PROBLEM
OF OUR FACILITY IS BEING
OUTDATED- WHICH WHEN TO A SAFETY
ISSUE AND I THINK THE CONCERN
BUT THEN IT ALSO WENT TO A
CAPACITY PROBLEM AND WHEN THE
DEPARTMENT HAS THE CAPACITY
PROBLEM LIKE THAT WE'VE GOT WHAT
ARE YOU DOING TO. YOU KNOW.
INCREASE CAPACITY AND WE'VE GOT
THE QUESTION OVER THE LAST
FIFTEEN YEARS WELL EVERYTHING IS
BEEN MOVED TOWARD EITHER KILL
BIG- DIVERSION. OR A COMMUNITY
BASED TREATMENT PROGRAM AND-
GOOD FOR YOU A NEW PATIENT
POPULATION THAT IS USUALLY
HARDER TO TREAT AND MORE.
VIOLENT GOING TO THE HOSPITAL
AND SO OUR CONCERN IS THAT- WITH
. VACANCIES BEING FILLED HI- AT
EVERY SINGLE- HOSPITAL MINUS
ONE- WE HAVE OVER A HUNDRED AND
TWENTY VACANCY I THANK THAT- SO
. REALLY CONCERNED ABOUT. WHAT
KIND OF TREATMENT WE CAN PROVIDE
HELP THEY ARE WE ABLE TO PROVIDE
IT TO THE PATIENT FEEL FREE
ENOUGH TO ASK FOR HELP AND ARE
THEY ABLE TO- COMFORTABLE ENOUGH
TO RECEIVETHAT TREATMENT- SO.
THE PROBLEM THAT WE'RE FINDING
IS THAT NOT ONLY IS THE LARGE
VACANCY RATE YOU KNOW. CREATING
AN ISSUE WITH THE PATIENT
TREATMENT IT ALSO CREEK CREATING
MASSIVE AMOUNTS OF OVERTIME- I
KEPT ARE AVERAGING THREE HUNDRED
THOUSAND HOURS OF OVERTIME PER
QUARTER. AND THAT'S WORKED BY
ONLY THIRTY FIVE HUNDRED- THANK
TECH. EXPECT THEM BACK TECHNICAL
- OVERTIME DUE TO STAFF BEING
OUTLOOK QUOTED AND. AND OTHER-
QUARANTINE ISSUES- THE VACANCIES
HAVE EVEN GOTTEN LARGER SO THIS
IS EXACERBATING THE ISSUE AND
CREATING- A BIG CROP PRO
PROBLEM- UNFORTUNATELY. YOU KNOW
THE DEPARTMENT HAS KIND OF MOVED
TO FILL- SOME OF THESE POSITIONS
WITH- WITH A CONTRACT REGISTRY
BETTER RECEIVING ANYWHERE FROM
10215% HIGHER SALARIES. THAN THE
THAN THE STATE AFTER MAKING-
THIS IS A DIFFERENT KIND OF
HIRING NEW STAFF IN STATE
SERVICE SO I JUST WANTED TO
POINT THAT OUT AND SAY THANK YOU
FOR YOUR EXCELLENT QUESTION
CHAIR ARAMBULA- YOU KNOW WE HOPE
THAT IN THE FUTURE WE NOTICED
THE IN THE BUDGET- THERE WAS NO
BUDGET CHANGE PROPOSAL ON THE-
ON A RECRUITMENT RETENTION
STATEMENT THAT CAP THIS PROPOSAL
APARTMENT- WE HAD HOPED THAT
THAT WOULD BE IN THERE- ANDWE
HOPE THAT THIS- THIS COMMITTEE
CAN. PRESS FORWARD AND AFT YOU
KNOW THE QUESTIONS OF WHAT IS.
THE DEPARTMENT. YOU KNOW. PLAN
ADDRESS THE STAFFING ADDITION
WHAT IS DEPARTMENT THE LONG TERM
PLAN. TO ADDRESS AGING
FACILITIES PROBLEMS SO WITH THAT
I WOULD LIKE TO THANK YOU AND
THANK YOU FOR STAYING LATE
TONIGHT AND- TAKE CARE. THANK
YOU OPERATOR NEXT CALLER PLEASE. THERE ARE NO FURTHER COMMENTS
IN QUEUE AT THIS TIME. THANK YOU
OPERATOR I WILL TAKE THAT AS THE
CONCLUSION OF PUBLIC COMMENT FOR
TODAY IT WILL TAKE A MOMENT TO
THANK ALL OF THE ADMINISTRATION
AND ALL OF OUR PANELISTS. TO THE
- STAFF WHO HELPED TO WRITE AN
EXCELLENT AGENDA I JUST WANT TO
ALSO SHARE AN APPRECIATION- AND
THEN FINALLY I WANTED TO THANK
ALL OF THE PUBLIC FOR
PARTICIPATING IN TODAY'S
HEARING. WITH THAT WE ARE JOINED
FOR THE NIGHT HAVE A GOOD NIGHT.