GOOD MORNING, EVERYONE AND
WELCOME TO THE JOINT ASSEMBLY,
HEALTH AND HOUSING COMMITTEES
INFORMATIONAL HEARING ON THE
GOVERNOR'S PROPOSAL TO MODERN
AGE MODERNIZED THE BEHAVIORAL
HEALTH SYSTEM IN CALIFORNIA. I
THANK YOU ALL FOR BEING HERE.
I'M GOING TO START THINGS OFF
WITH OPENING COMMENTS FROM
TODAY'S CO CHAIR AND CHAIR OF
THE COMMITTEE ON HOUSING AND
COMMUNITY DEVELOPMENT. SOME
REMEMBER WICKS. THANK YOU. THANK
YOU, DOCTOR WOULD FOR YOUR
PARTNERSHIP ON THIS HEARING. AND
YOUR STAFF WHO HAVE WORKED
TYLER'S TIRELESSLY TO ORGANIZE
THIS HEARING AND ANALYZE THE
COMPLEX POLICIES, UNDERLINING
THIS PROPOSAL. HOMELESSNESS IS
ONE OF OUR GREATEST MORAL
CHALLENGES OF OUR DAY. AND IT'S
PARTICULARLY, UM, CHALLENGING
HERE IN CALIFORNIA, WHERE WE
HAVE ONE OF THE HIGHEST
HOMELESSNESS RATES IN THE
COUNTRY. A KEY CAUSE OF
HOMELESSNESS IS A LACK OF
AFFORDABLE HOUSING. AND FOR MANY
PEOPLE, AN AFFORDABLE HOME IS
THE MEDICINE THAT WOULD SOLVE
HOMELESSNESS. FOR SOME, THOUGH
THE MEDICINE IS MORE COMPLEX,
AND FOR SOME, IT'S INCREDIBLY
MORE COMPLEX. THEY MAY REQUIRE
INTENSE BEHAVIORAL, HEALTH OR
SUBSTANCE ABUSE DISORDER
TREATMENT SERVICES, COUPLED WITH
STABLE HOUSING TO EXIT
HOMELESSNESS. AND CONTINUED
WRAPAROUND SERVICES AND SUPPORT
OF HOUSING ENVIRONMENT TO
MAINTAIN STABILITY, LONG TERM
AND SOME OF THOSE FOLKS NEED
THOSE SERVICES FOR THE REST OF
THEIR LIFE. FOR MANY, WE HAVE
TALKED ABOUT HOUSING AND HEALTH.
AND THE NEED TO COORDINATE MORE
CLOSELY BETWEEN THOSE TWO FIELDS
. THE GOVERNOR'S PROPOSAL
REPRESENTS AN EXCITING
OPPORTUNITY TO CREATE THAT
COORDINATION. TO MAKE THIS
PROPOSAL SUCCESSFUL. WE NEED TO
MAKE SURE IT PROPERLY TARGET IT
IS PROPERLY TARGETED AND
RESOURCED. HE ISSUES I WOULD
LIKE TO EXPORT STATE TO MAKE
SURE WE ARE SUCCESSFUL. OR THE
FOLLOWING. HOW DOES THIS
PROPOSAL FIT INTO THE STATES?
LARGER RESPONSE TO HOMELESSNESS
AND SPECIFICALLY OUR STRATEGY
FOR PROVIDING AFFORDABLE HOUSING
TO THOSE PEOPLE THAT NEED AN
AFFORDABLE PLACE TO STAY. TO
AVOID HOMELESSNESS. ARE THE
HOUSING INTERVENTIONS. COUNTIES
WOULD BE FUNDING IN THIS
PROPOSAL COMPREHENSIVE AND
FLEXIBLE ENOUGH TO GET PEOPLE
HOUSED. DO WE HAVE SUFFICIENT
ONGOING FUNDING? SUPPORTIVE
SERVICES AND OPERATING COSTS FOR
THE UNITS SUPPORTIVE HOUSING
THAT WOULD BE FUNDED BY THE BY
THE BOND. AS WE SHIFT FUNDING
PRIORITIES WITHIN MH ESSAY
TOWARDS HOUSING HOW WELL
EXISTING PRIORITIES BE IMPACTED
. I KNOW THAT'S AN ISSUE THAT'S
BEEN RAISED QUITE A FEW TIMES,
AND I LOOK FORWARD TO EXPLORING
THOSE CONVERSATIONS TODAY. UH
AND WITH THAT, I WILL TURN IT
BACK TO DOCTOR WOULD TO
INTRODUCE THE FIRST PANEL. THANK
YOU BEFORE WE JUMP TO THAT THE
AUTHOR OF ONE OF THE BILLS IN
THIS PROPOSAL ASSEMBLYMEMBER'S
IRWIN IS JOINING US TODAY.
WELCOME MR IRWIN. WOULD YOU LIKE
TO MAKE A BRIEF STATEMENT? YES,
UH THANK YOU. UH, I WANT TO
THANK BOTH CHAIR WOOD AND CHAIR
WIGS FOR CONVENING THIS HEARING
TODAY. THE CONNECTION BETWEEN
HOMELESSNESS AND BEHAVIORAL
HEALTH CHALLENGES IS SIGNIFICANT
AMONG CALIFORNIANS EXPERIENCING
HOMELESSNESS, NEARLY 40,000 HAVE
CHRONIC MENTAL ILLNESS AND OVER
36,000 HAVE CHRONIC SUBSTANCE.
USE DISORDER TO ADDRESS WHAT HAS
TRULY BECOME A BEHAVIORAL HEALTH
CRISIS. GOVERNOR NEWSOM HAS
PROPOSED WHAT WOULD BE THE
LARGEST EXPANSION OF
CALIFORNIA'S BEHAVIORAL HEALTH
CARE SYSTEM. FOR THE PAST SEVEN
YEARS. I'VE AUTHORED LEGISLATION
TO AUTHORIZE THE ISSUANCE OF
BONDS FOR THE VETERAN HOUSING
AND HOMELESS PREVENTION PROGRAM
, KNOWN AS VHP. I'M HAPPY TO
EXPAND THIS EFFORT WITH A B 531,
WHICH WILL PROVIDE HOUSING AND
BEHAVIORAL HEALTH. TREATMENT IN
UNLOCKED COMMUNITY BASED
SETTINGS. UH HUH. AND PROVIDE
HOUSING FOR VETERANS WITH
BEHAVIORAL HEALTH CHALLENGES.
THESE INVESTMENTS WILL GO EVEN
FURTHER WITH THE PROPOSED
REFORMS TO THE MENTAL HEALTH
SERVICES ACT AND SENATOR EDMONDS
SP 3 26. I LOOK FORWARD TO
TODAY'S DISCUSSION ON THIS
PACKAGE, AND I'M COMMITTED TO
WORKING WITH ALL OF YOU. UH TO
ENSURE THAT THE FINAL PRACTICE
PACKAGE WE AGREE ON IS ONE THAT
PRODUCES RESULTS THAT
CALIFORNIANS CAN SEE IN THEIR
COMMUNITIES. THANK YOU. THANK
YOU VERY MUCH. ASSEMBLYMEMBER'S
IRWIN AND THANK YOU, EVERYONE
FOR BEING HERE TODAY AND THANK
YOU ALL TO ALL WHO PARTICIPATED
IN THE COUNT WITH ZOOM CALLS
INDIVIDUAL PHONE CALLS IN PERSON
MEETINGS AND EMAILS THAT HAVE
SURROUNDED THIS. UH THIS
PROPOSAL. UM. SORRY. UM, UM.
YEAH AND SURROUNDED US. EXCUSE
ME. LET ME BACK UP HERE A
SECOND. THANK YOU. EVERYONE UM,
WHO HAVE PARTICIPATED IN THE
COUNTLESS ZOOM CALLS INDIVIDUAL
PHONE CALLS IN PERSON MEETINGS
AND EMAILS THAT HAVE SURROUNDED
THIS PROPOSAL. IN THE PAST NINE
WEEKS. WE HAVE BEEN SINGLE
FOCUSED ON ANALYZING AND
DRAFTING OUR THOUGHTS ON HOW TO
MAKE THIS PROPOSAL, THE BEST IT
CAN BE. AND TO BE WORKING WITH
THE ADMINISTRATION TO ENSURE
THAT WE MEET GOVERNOR NEWSOM
SCHOOL. THE PROPOSAL WE ARE
CONSIDERING TODAY WILL DETERMINE
HOW OUR STATE WILL CARE FOR THE
HOUSING AND BEHAVIORAL HEALTH
NEEDS OF HIS MOST VULNERABLE
POPULATIONS. AND IT REPRESENTS
AN ADJUSTMENT AND A SIGNIFICANT
SHIFT FROM HOW WE THOUGHT ABOUT
IT A DECADE AGO. HOW WE ALIGN
OUR RESOURCES TO THE NEEDS OF
THOSE MOST SEVERELY IMPACTED.
THOSE WHO ARE EXPERIENCING
HOMELESSNESS, SEVERE MENTAL
ILLNESS AND DEBILITATING
SUBSTANCE USE DISORDERS. THIS
PROPOSAL ADDRESSES THE
CHALLENGES OF A CHANGING WORLD
AND ONE THAT WILL CAUSE EACH OF
US TO ADAPT AND RESPOND TO THE
DEVASTATION WE'RE SEEING IN OUR
COMMUNITIES ON A DAILY BASIS. I
WANT TO THANK THE ADMINISTRATION
FOR THE OPPORTUNITY TO ENGAGE IN
A MEANINGFUL WAY ON THIS
PROPOSAL AND TO FACILITATE
CHANGES THAT WE THINK MAKE THE
PROPOSAL BETTER. THERE'S NO
QUESTION THERE WILL BE SOME
CONSEQUENCES TO THE SHIFTS IN
STATEWIDE PRIORITIES. I BELIEVE
THAT OUR TASK IS A LEGISLATURE
IS TO BE SURE THEY ADDRESSED AND
MITIGATED. AT THIS INTERSECTION
OF BEHAVIORAL HEALTH DISORDERS
AND HOMELESSNESS IS PLAYING OUT
EVERY DAY ON OUR STREETS IN OUR
SCHOOLS AND IN THE SMALLEST OF
RURAL COMMUNITIES AND IN OUR
LARGEST CITIES. THE SUBJECT HAS
STIRRED MUCH DEBATE WAS STRONGLY
HELD OPINIONS BY MANY AND
DIVERSE STAKEHOLDERS WHO HAVE
TACKLED THESE CHALLENGES EVERY
DAY TO IMPROVE THE HEALTH AND
LIVING CONDITIONS OF OUR MOST
VULNERABLE. WE HAVE A VERY FULL
AGENDA PLAN FOR TODAY, FOLLOWED
BY A HEALTH COMMITTEE HEARING ON
SENATOR EDMONDS BILL SB 3 26.
WE'LL TAKE A BREAK FOR LUNCH
FROM 12 TO 1. 30 RESUME AGAIN
PROMPTLY AT 1 30. I HAVE
ENCOURAGED MEMBERS FROM THE TWO
COMMITTEES TO ATTEND AND
PARTICIPATE FULLY IN THE
DISCUSSION AND ASK QUESTIONS. UH
TO FACILITATE AND EFFICIENT
MEETING WILL BE BEGIN TO HEARING
AND PROVIDE AN OPPORTUNITY FOR
COMMITTEE MEMBERS ASK QUESTIONS
FOLLOWING EACH PANEL. ALSO HAVE
AN OPPORTUNITY TO MAKE CLOSING
REMARKS AT THE END. OUR
WITNESSES HAVE BEEN GIVEN
SIMILAR TIME CONSTRAINTS AND WE
WILL BE ASKING EVERYONE TO KEEP
THEIR COMMENTS WITHIN THE LIMITS
OF THE COMMENT WILL, AS ALWAYS,
COME AT THE END OF OUR GEMINI
AGENDA AND WILL BE LIMITED TO
ONE MINUTE, ONE MINUTE PER
PERSON. ALSO, ALWAYS AS ALWAYS,
TAKE COMMENTS IN WRITING. THANK
YOU. AND WITH THAT, UH, WE WILL
HAVE OUR FIRST PANEL COME
FORWARD. WELCOME TO DR MARGO
KUSHELL AND K¾T HARDIN. DR
COCHELL IS A PROFESSOR OF
MEDICINE AT THE UNIVERSITY OF
CALIFORNIA, SAN FRANCISCO AND
DIVISION CHIEF AND DIRECTOR OF
THE UCSF CENTER FOR VULNERABLE
POPULATIONS AND DIRECTOR OF THE
UCSF BENNY OFF HOMELESSNESS AND
HOUSING INITIATIVE. AS HERE DARN
IS, UM HE CORN IS ME IS THE
DIRECTOR OF STATE POLICY WITH
THE CALIFORNIA HEALTHCARE
FOUNDATION. WE WILL HEAR FROM
BOTH PRESENTERS AND THEN HAVE
TIME FOR QUESTIONS SO WHENEVER
YOU'RE READY. THANK YOU. THANK
YOU SO MUCH. GOOD MORNING
ASSEMBLY MEMBER WOULD AND
ASSEMBLYMEMBER'S WAX AND MEMBERS
OF THE COMMITTEE. UM I AM MARCO
KUSHELL, UM, PROFESSOR OF
MEDICINE AND A PRACTICING
PHYSICIAN AT UCSF AND SAN
FRANCISCO GENERAL HOSPITAL. I'M
THE PRINCIPAL INVESTIGATOR OF
THE NEWLY RELEASED CALIFORNIA
STATEWIDE STUDY OF PEOPLE
EXPERIENCING HOMELESSNESS. I
THINK WE'VE INCLUDED THE
EXECUTIVE SUMMARY IN YOUR PACKET
AND THANK YOU SO MUCH FOR
INVITING ME TODAY TO DISCUSS THE
BEHAVIORAL HEALTH NEEDS OF THOSE
EXPERIENCING HOMELESSNESS. AND
THE EVIDENCE BASE FOR WHAT IS
NEEDED TO PROVIDE THE SUPPORT
FOR THOSE NEEDS. SO HIS
BACKGROUND AS YOU KNOW,
CALIFORNIA IS HOME TO 12% OF THE
NATION'S POPULATION, BUT 30% OF
THOSE EXPERIENCING HOMELESSNESS
AND 50% OF THOSE EXPERIENCING
AND SHELTERED HOMELESSNESS. AT
ITS CORE IS ASSEMBLYMEMBER'S
QUICK SAID THE HOMELESSNESS
CRISIS IS DUE TO A LACK OF
DEEPLY AFFORDABLE HOUSING. IN
CALIFORNIA. WE HAVE ONLY 24
UNITS OF HOUSING FOR EVERY 100
EXTREMELY LOW INCOME HOUSEHOLDS
, MEANING THAT WERE 1 MILLION
UNITS, SHORT OF WHERE WE NEED TO
BE. EVERY SOLUTION TO
HOMELESSNESS, MISS CENTER THE
NEED FOR HOUSING THAT IS
AFFORDABLE FOR THE LOWEST INCOME
HOUSEHOLDS. WHILE THE UNDERLYING
CAUSES DUE TO THIS DIRE LACK OF
DEEPLY AFFORDABLE HOUSING, IT'S
ALSO CLEAR THAT THOSE WITH
MENTAL HEALTH AND SUBSTANCE USE
PROBLEMS ARE DISPROPORTIONATELY
IMPACTED. IT WILL ALSO MENTIONED
THAT BLACK INDIGENOUS PACIFIC
ISLANDER AND LATIN X
CALIFORNIANS ARE DRAMATICALLY
OVERREPRESENTED IN THE HOMELESS
POPULATION. THIS DISPARITY IS
NOT DUE TO A DESPERATE LEVEL OF
BEHAVIORAL HEALTH PROBLEMS, BUT
RATHER TO THE ONGOING IMPACT OF
STRUCTURAL RACISM. SOLUTIONS TO
HOMELESSNESS THAT FOCUS ON
BEHAVIORAL HEALTH MUST FOCUS ON
RACIAL EQUITY DUE TO THE WELL
DOCUMENTED AND ONGOING RACIAL
DISPARITIES IN ACCESS TO BOTH
MENTAL HEALTH AND SUBSTANCE USE
TREATMENT. HOWEVER DOING SO
ALONE WILL NOT IN AND OF
THEMSELVES. ADDRESS THE
DEMOCRATIC RACIAL INEQUITIES IN
HOMELESSNESS. SO AS I MENTIONED
MY TEAM RECENTLY CONDUCTED THE
LARGEST REPRESENTATIVE STUDY OF
HOMELESSNESS IN DECADES, THE
CALIFORNIA STATEWIDE STUDY OF
PEOPLE EXPERIENCING HOMELESSNESS
TO DO SO WE SURVEYED 3200 ADULTS
EXPERIENCING HOMELESSNESS
SELECTED TO BE REPRESENTATIVE OF
THE STATE AND CONDUCTED 365 IN
DEPTH INTERVIEWS THROUGHOUT
CALIFORNIA. CONSISTENT WITH
OTHER STUDIES. WE FOUND THAT
PEOPLE EXPERIENCING HOMELESSNESS
HAVE HIGHER RATES OF MENTAL
HEALTH CONDITIONS AND SUBSTANCE
USE DISORDER THAN THE GENERAL
POPULATION. MENTAL HEALTH
CONDITIONS AND SUBSTANCE USE CAN
BOTH INCREASE AN INDIVIDUAL'S
RISK FOR HOMELESSNESS AND ALSO
WORSENED DURING HOMELESSNESS.
TWO THIRDS OF THE PARTICIPANTS
IN THE STUDY EXPERIENCE SYMPTOMS
OF A MENTAL HEALTH CONDITION.
ALTHOUGH THESE WERE MOST
COMMONLY SEVERE DEPRESSION AND
ANXIETY. THESE SYMPTOMS RANGED
IN SEVERITY. APPROXIMATELY A
QUARTER OR 27% HAD EXPERIENCED
AN INPATIENT PSYCHIATRIC
HOSPITALIZATION DURING THEIR
LIFETIME, AND APPROXIMATELY 5%
HAD DONE SO IN THE PRIOR SIX
MONTHS. APPROXIMATELY ONE IN
THREE PARTICIPANTS REPORTED
REGULAR SO THREE TIMES A WEEK OR
MORE USE OF ILLICIT SUBSTANCES.
METHAMPHETAMINES BEING BY FAR
AND AWAY THE MOST COMMON 9%
REPORTED HEAVY ALCOHOL USE
MEANING BINGE DRINKING AT LEAST
ONCE A WEEK. SO OVERALL 41%
REPORTED EITHER REGULAR ILLICIT
DRUG USE OR HEAVY ALCOHOL USE
DURING THIS CURRENT EPISODE.
APPROXIMATELY HALF 52% REPORTED
EITHER REGULAR ILLICIT DRUG USE
HEAVY, EPISODIC ALCOHOL USE
HALLUCINATIONS, WHICH WERE
REPORTED BY 12% OF THE
POPULATION OR A RECENT
PSYCHIATRIC HOSPITALIZATION.
MENTAL HEALTH CONDITIONS AND
SUBSIDIES DISORDERS CO OCCUR
WITH LIMITED ACCESS TO MENTAL
HEALTH TREATMENT. MANY
INDIVIDUALS EXPERIENCING
HOMELESSNESS AND THOSE WHO DON'T
SELF MEDICATE WITH ILLICIT DRUGS
OR ALCOHOL AS A RESULT, OR
RELATED TO THEIR MENTAL HEALTH
ISSUES. CONVERSELY SUBSTANCE USE
CAN INCREASE THE LIKELIHOOD OF
DEVELOPING A MENTAL HEALTH
CONDITIONS. THESE CONDITIONS
OVERLAP FREQUENTLY, BUT NOT
ALWAYS MORE THAN HALF OF THOSE
WHO REPORT CURRENT
HALLUCINATIONS OR LIFETIME
HISTORY OF A MENTAL HEALTH
HOSPITALIZATION REPORTED EITHER
REGULAR ILLICIT DRUG USE OR
HEAVY ALCOHOL USE. PEOPLE WITH
SIGNIFICANT MENTAL HEALTH
PROBLEMS. SIGNIFICANT SUBSTANCE
USE PROBLEMS BOTH NEED AND
DESERVE ACCESS TO TREATMENT THAT
WILL ALLOW THEM TO THRIVE FOR
THOSE SERVICES TO BE MEANINGFUL
FOR THOSE EXPERIENCING
HOMELESSNESS. THESE SERVICES
MUST BE PAIRED WITH SUBSIDIZED
HOUSING TO DO ONE WITHOUT THE
OTHER IS NOT GOING TO BE
EFFECTIVE. HOMELESSNESS ITSELF
LIMITS ACCESS TO TREATMENT FOR
MENTAL HEALTH AND SUBSTANCE USE
DISORDERS FOR MANY ADULTS
EXPERIENCING HOMELESSNESS. FOR
INSTANCE, TWO THIRDS OF THE
STATEWIDE STUDY PARTICIPANTS
EXPERIENCED AT LEAST ONE MENTAL
HEALTH CONDITION, BUT ONLY 18%
REPORTED RECEIVING ANY MENTAL
HEALTH TREATMENT OR MEDICATION
IN THE PRIOR 30 DAYS. ONE IN
FIVE INDIVIDUALS WHO REPORTED
CURRENT SUBSTANCE USE EITHER
ILLICIT DRUG USE OR HEAVY
ALCOHOL USE REPORTED THAT THEY
WANTED AND HAD SOUGHT TREATMENT
BUT HAD BEEN UNABLE TO RECEIVE
IT. EVERY PERSON WHO EXPERIENCES
HOMELESSNESS, LEX HOUSING.
THEREFORE HOUSING HAS TO BE AT
THE HEART OF ANY RESPONSE TO
HOMELESSNESS. DESPITE THE HIGH
PREVALENCE OF MENTAL HEALTH AND
SUBSTANCE USE PROBLEMS, MANY WHO
ARE HOMELESS WILL NOT REQUIRE
BEHAVIORAL HEALTH SUPPORT. MANY
WILL REQUIRE HOUSING SUPPORT
ALONE IN THE FORM OF HOUSING,
NAVIGATION AND EITHER SHORT TERM
OR LIKELY LONG TERM RENTAL
SUBSIDIES. IN OUR STUDY THE
MEDIAN HOUSEHOLD INCOME OF
INDIVIDUALS IN THE SIX MONTHS
PRIOR TO HOMELESSNESS WAS ONLY
$960. WHILE PEOPLE WERE HOMELESS
. THAT INCOME DROPPED TO $400 A
MONTH. OVER HALF OF THOSE WHO
ENTERED FROM HOMELESSNESS
ENTERED FROM HOUSING THAT WE
CALLED IN A NON LEASE HOLDING
ENVIRONMENT WHERE THEY WERE
DOUBLED UP OR LIVING WITHOUT
FORMAL LEASES. AMONG THOSE WITH
LEASES THE MEDIAN HOUSING COSTS
FOR $700 A MONTH AN AMOUNT THAT
IS BOTH UNAFFORDABLE FOR
EXTREMELY LOW INCOME HOUSEHOLDS
, AND, FRANKLY DIFFICULT TO FIND
IN CALIFORNIA, WHERE THE MEDIAN
RENT TO $750 A MONTH IN MANY
REGIONS OF THE STATE. IT'S EVEN
HIGHER AND WHEN WE ASKED
PARTICIPANTS ALL PARTICIPANTS
ABOUT THEIR BARRIERS TO EXITING
HOMELESSNESS NINE AND 10
INDICATED THAT HIGH HOUSING
COSTS FOR A MAJOR IMPEDIMENTS
ESSENTIALLY ALL CALIFORNIANS
EXPERIENCING HOMELESSNESS NEED
HOUSING AND INCOME SUPPORTS TO
SUPPORT THEIR TRANSITION BACK TO
PERMANENT HOUSING. BUT THOSE
WITH COMPLEX BEHAVIORAL HEALTH
CONDITIONS WILL REQUIRE MORE
THAN JUST HOUSING. TO END THEIR
HOMELESSNESS AND IMPROVE THEIR
HEALTH. THEY REQUIRE BOTH
ONGOING HOUSING SUPPORT AND
ONGOING BEHAVIORAL HEALTH
SUPPORT, PROVIDING ONE WITHOUT
THE OTHER WILL NOT MEET THEIR
NEEDS. FOR THOSE WHO FACE
BEHAVIORAL HEALTH CHALLENGES. WE
KNOW WHAT WORKS TO END THEIR
HOMELESSNESS FOR THE VAST
MAJORITY OF THOSE WITH
HOMELESSNESS AND SIGNIFICANT
MENTAL HEALTH OR SUBSIDIES,
CHALLENGES. THE SOLUTION IS TO
PROVIDE SUBSIDIZED HOUSING
OFFERED HIM WHAT WE CALL A
HOUSING FIRST BASIS WITH
VOLUNTARY SERVICES THAT MATCH
THE INDIVIDUALS LIKE LEVEL OF
NEED. PERMANENT SUPPORTIVE
HOUSING, SO SUBSIDIZED HOUSING
WITH PAIRED VOLUNTARY SUPPORTIVE
SERVICES. HAS BEEN SHOWN NOT
ONLY TO END HOMELESSNESS BUT
ALSO TO REDUCE CHAOTIC USE OF
HEALTH CARE SERVICES INCREASED
THE UPTAKE OF MENTAL HEALTH AND
SUBSTANCE USE TREATMENT. THE KEY
TO EFFECTIVE, PERMANENT
SUPPORTIVE HOUSING LIES IN
PROVIDING BOTH SUBSIDIZED
HOUSING AND TO EFFICIENT AND
APPROPRIATE SUPPORTIVE SERVICES
AND TO CENTER CLIENT CHOICE.
PERMANENT SUPPORTIVE HOUSING
PROVIDED ON A HOUSING FIRST
BASIS. CREATES A RECOVERY
ORIENTED CULTURE THAT PUTS
CLIENT CHOICE AT THE CORE OF ITS
PROVISIONS OF BOTH HOUSING AND
SERVICES. WHEN HOUSING IS LINKED
TO HIGH QUALITY VOLUNTARY
SERVICES, THE EVIDENCE SHOWS
THAT WERE OF ABLE TO MEET THE
NEEDS OF THE MAJORITY OF THOSE
WITH SIGNIFICANT BABER HEALTH
DISABILITIES, FOR INSTANCE, NEW
YORK CITY'S PATHWAYS TO HOUSING
PROGRAM PROVIDED IMMEDIATE
ACCESS TO HOUSING AND LINKED
HIGH QUALITY SERVICES TO
INDIVIDUALS WITH SEVERE
PSYCHIATRIC DISABILITIES. AFTER
FIVE YEARS 88% OF THESE
INDIVIDUALS WITH SEVERE
BEHAVIORAL HEALTH DISABILITIES
WHO WERE RANDOMLY ASSIGNED TO
THE HOUSING OPTION WITH
VOLUNTARY HIGH QUALITY SERVICES
REMAINED HOUSE. IN CANADA. THE
SHEA SWAP PROJECT PROVIDED
PERMANENT, SUPPORTIVE HOUSING TO
THOUSANDS OF INDIVIDUALS ACROSS
FIVE CITIES. THEY PROVIDED
INDIVIDUALS WITH SEVERE MENTAL
ILLNESS, MANY OF WHOM HAD CO
OCCURRING SUBSTANCES DISORDER
HOUSING WITH ONE OF TWO ROBUST
SERVICE MODELS THAT THEY
ASSIGNED DEPENDING ON THE
CLIENT'S NEED. CHASE WHAT
DEMONSTRATED THAT UPWARDS OF
THREE QUARTERS OF INDIVIDUALS
REMAIN STABLE, HOUSED? AND OUR
OWN RESEARCH IN SANTA CLARA
COUNTY SHOWED THAT PERMANENT
SUPPORTIVE HOUSING WITH
INTENSIVE CASE MANAGEMENT
SUCCESSFULLY HOUSED OVER 90% OF
THE MOST BEHAVIORALLY
COMPLICATED INDIVIDUALS WITH
CHRONICALLY HOMELESS AND KEPT
THEM HOUSED. THOSE WHO WERE
HOUSED REMAINED HOUSED FOR OVER
90% OF THE KNIGHTS FOR MANY
YEARS. THE KEY TO THE SUCCESSFUL
PROGRAMS WAS THE FACT THAT THEY
ADHERE TO THE PRINCIPLES OF
HOUSING FIRST. AND THAT THEY HAD
ROBUST SERVICES DESIGNED TO
MATCH THE NEEDS OF THEIR TENANTS
AND CHASE WA. THEY RISK
STRATIFIED CLIENTS TO ONE OF TWO
MODELS OF CARE, ASSERTIVE
COMMUNITY TREATMENT FOR THOSE
WITH THE HIGHEST LEVEL OF NEED
AND INTENSIVE CASE MANAGEMENT.
FOR THOSE WITH MODERATE NEED.
ASSERTIVE COMMUNITY TREATMENT IS
AN INTENSIVE INTERVENTION. IT
PAIRS TEAMS LED BY PSYCHIATRISTS
AND INCLUDES PEER SUPPORT, CASE
MANAGEMENT AND OTHER TEAM
MEMBERS. WHO HAVE A RELATIVELY
SMALL CASELOAD INTENSIVE CASE
MANAGEMENT WHILE LESS RESOURCE
INTENSIVE INVOLVES MASTERS LEVEL
, BEHAVIORALLY TRAINED
CLINICIANS, SUCH AS SOCIAL
WORKERS, LEADING A TEAM WITH LOW
CASE RATIOS 1 TO 12 12 15 IN OUR
SANTA CLARA STUDY, WE RELIED ON
THIS MODEL. UM WITH A LOW
CASELOAD. HIGH QUALITY HIGH
QUALITY CARE MODELS SUCH AS
ASSERTIVE COMMUNITY TREATMENT
AND INTENSIVE CASE MANAGEMENT,
OR THE GOLD STANDARDS OF CARE
FOR THOSE WITH COMPLEX NEEDS.
HOWEVER IN CALIFORNIA, MANY WHO
CURRENTLY WOULD BENEFIT DO NOT
RECEIVE THIS LEVEL OF SERVICE.
MANY OF THOSE WITH CHRONIC
HOMELESSNESS AND SEVERE
BEHAVIORAL HEALTH NEEDS WHO ARE
PLACED IN PSH DO NOT RECEIVE
THIS LEVEL OF ONGOING BEHAVIORAL
HOUSE SUPPORT THAT THEY REQUIRE
TO THRIVE. AND MANY RECEIVED
NEITHER HOUSING NOR SUPPORTIVE
SERVICES, LEAVING THEM HOMELESS.
OUR TEAM RECENTLY CONDUCTED AN
ANALYSIS OF HEALTHCARE AND
CRIMINAL LEGAL DATA FROM 1700
INDIVIDUALS WITH PSYCHOSIS AND
EVIDENCE OF EITHER 51 50 OR FOUR
MORE URGENT OR EMERGENT VISITS.
FOR INDIVIDUALS WITH SEVERE
MENTAL ILLNESS IN A CALIFORNIA
CITY 70% OF THESE WERE HOMELESS.
AMONG THOSE WHO ARE HOMELESS,
FEWER THAN HALF HAD BEEN
ASSESSED FOR COORDINATED ENTRY
PRIORITY STATUS. AND OF THOSE
WHO ARE ASSESSED ONLY TWO AND
THREE WERE PRIORITIZED FOR
HOUSING, MEANING THAT ONLY ONE
IN THREE OF THESE HIGH NEEDS
HOMELESS INDIVIDUALS WITH
EVIDENCE OF SEVERE MENTAL HEALTH
ILLNESS IN CRISIS OR PRIORITIZED
FOR PSH AMONG THOSE WITH THE
MOST COMPLEX BEHAVIORAL NEEDS
ONLY A QUARTER RECEIVED
INTENSIVE CASE MANAGEMENT.
THERE'S A SPECTRUM OF COMMUNITY
BASED CARE OPTIONS THAT CAN MEET
THE NEEDS OF MOST PEOPLE
EXPERIENCING HOMELESSNESS WITH
SEVERE MENTAL ILLNESS WHEN PSH
IS PAIRED WITH HIGH QUALITY
SUPPORT SERVICES THAT MEET THEIR
NEEDS, THE VAST MAJORITY WILL
THRIVE. A SMALL PROPORTION OF
THOSE WITH THE HIGHEST ACUITY.
BEHAVIORAL HEALTH NEEDS WILL
NEED SUPPORT THAT GOES BEYOND
WHAT CAN BE REASONABLY PROVIDED
IN PSH, EVEN WITH THE MOST
ROBUST MODELS OF SERVICES, THESE
SERVICES SHOULD SHARE MANY OF
THE ATTRIBUTES OF HIGH QUALITY
PERMANENT SUPPORTIVE HOUSING
COMMUNITY BASED WITH CLIENT
CHOICE MODELS, SUCH AS
BEHAVIORAL HEALTH COMMUNITY
RESIDENTIAL CARE FACILITIES MAY
BE ABLE TO PROVIDE THIS
ADDITIONAL SUPPORT. WE HAVE BOTH
THE ABILITY AND THE
RESPONSIBILITY TO DESIGN
RESPONSES THAT ALLOW INDIVIDUALS
TO LIVE IN THE COMMUNITY AND TO
THRIVE. PEOPLE'S NEEDS MAY
CHANGE WITH TIME AND OUR
RESPONSE TO THOSE NEEDS SHOULD
CHANGE AS WELL. BUT OUR FAILURE
TO PROVIDE HOUSING AND
APPROPRIATE SERVICES SHOULD NOT
CONFINE INDIVIDUALS TO EITHER A
LIFE ON THE STREETS OR
INSTITUTIONAL CARE. TO HAVE
SUCCESSFUL OUTCOMES. WE NEED TO
INVEST IN THE SOLUTIONS THAT ARE
MOST SUPPORTED BY EVIDENCE OR
FAILURES TO END HOMELESSNESS AND
A RELIANCE ON INSTITUTIONAL
CYCLING AMONG THOSE WITH SEVERE
MENTAL ILLNESS AND SUBSTANCE USE
DISORDERS AND CHRONIC
HOMELESSNESS ARE DUE TO BOTH A
LACK OF HOUSING AND A FAILURE TO
PROVIDE THE EVIDENCE BASED LEVEL
OF SUPPORTIVE SERVICES TO MEET
THE NEEDS OF THOSE WITH
BEHAVIORAL HEALTH CHALLENGES.
ADDRESSING THIS IS A KEY TO
ACHIEVING A CALIFORNIA WE'RE ALL
CAN THRIVE. THANK YOU. THANK YOU
VERY MUCH. GOOD MORNING CHAIR
WICKS, CHAIR WOOD AND MEMBERS.
SEE. OKAY SLIDES WORK. I'M
KATIE. HI DORN. AND I'M, THE
DIRECTOR OF STATE HEALTH POLICY
FOR THE CALIFORNIA HEALTHCARE
FOUNDATION. THE CALIFORNIA
HEALTHCARE FOUNDATION IS AN
INDEPENDENT, NONPROFIT
PHILANTHROPY BUT WORKS TO
IMPROVE THE HEALTH CARE SYSTEM
SO THAT ALL CALIFORNIANS HAVE
THE CARE THEY NEED. WE FOCUSED
ESPECIALLY ON MAKING SURE THE
SYSTEM WORKS FOR CALIFORNIANS
WITH LOW INCOMES AND FOR
COMMUNITIES WHO HAVE
TRADITIONALLY FACED THE GREATEST
BARRIERS TO CARE. THANK YOU FOR
HAVING ME HERE TODAY, I WILL
PROVIDE A BRIEF OVERVIEW ON THE
INCIDENCE OF MENTAL ILLNESS AND
SUBSTANCE USE DISORDER AND ON
ACCESS TO CARE. THEN I WILL
SUGGEST SOME HIGH LEVEL
QUESTIONS TO GUIDE HOW WE THINK
ABOUT WHAT CALIFORNIA NEEDS
PUBLIC BEHAVIORAL HEALTH
SYSTEMS. FIRST A LANDSCAPE. A
LOT HAS CHANGED SINCE THE PAST
INTO AN IN 2004. FIRST COVERAGE
. THERE'S BEEN A DRAMATIC
EXPANSION OF INSURANCE COVERAGE
, INCLUDING BOTH WHO IS COVERED
AND WHAT IS COVERED LARGELY
BECAUSE OF THE AFFORDABLE CARE
ACT, OTHER MEDICAID EXPANSIONS
AND THE MENTAL HEALTH PARITY.
YES. UH NEXT IS WORKFORCE THE
WORKFORCE IS SHRINKING. PEOPLE
CAN'T FIND A BEHAVIORAL HEALTH
PROVIDER WHO ACCEPTS THEIR
INSURANCE, AND MANY CAN'T FIND A
PROVIDER AT ALL SUBSTANCE USE.
THERE'S BEEN A SIGNIFICANT RISE
IN OVERDOSE DEATHS.
TECHNOLOGICAL ADVANCES IN THE IN
THE LAST NEARLY 20 YEARS,
TECHNOLOGY HAS BROUGHT US NEW
PLATFORMS FOR TREATMENT LIKE
TELEHEALTH, WHICH IS ESPECIALLY
USEFUL IN BEHAVIORAL HEALTH
TREATMENT. AND THE RECENT 988
CRISIS LINE. NEXT THE CRIMINAL
CRIMINALIZATION OF MENTAL
ILLNESS AND SUBSTANCE USE
DISORDER FOR TOO LONG. OUR
APPROACHES TO SERIOUS MENTAL
ILLNESS AND SUBSTANCE USE
DISORDER HAVE BEEN FRAGMENTED
AND TOO OFTEN PUNITIVE. THIS
NEEDS TO CHANGE AND FINALLY
COVID THE SOCIAL ISOLATION AND
ECONOMIC DISRUPTION EXACERBATED
PEOPLE'S MENTAL HEALTH NEEDS AND
SUBSTANCE USE. ON THE PLUS SIDE
, WE SEE RENEWED COMMITMENT
ACROSS THE STATE TO BETTER
ADDRESS BEHAVIORAL HEALTH
ISSUES, AND THAT'S WHY WE'RE ALL
HERE TODAY. NEXT I'LL PROVIDE
SOME STATISTICS ABOUT THE
PREVALENCE OF MENTAL ILLNESS AND
SUBSTANCE USE DISORDER AND
ACCESS TO CARE FOR THOSE
CONDITIONS. MOST OF THIS DATA IS
FROM C. HCFC ALMANAC COLLECTIONS
PUBLISHED UPDATED MENTAL HEALTH
AND SUBSTANCE USE DISORDER, ALL
THE NEXT INTO IN 2022. IT'S A
RELATIVELY RECENTLY OVERALL
PREVALENCE RATES FOR ADULTS AND
CHILDREN HAVE CHANGED VERY
LITTLE OVER THE YEARS. ONE IN
SEVEN ADULTS IN CALIFORNIA
EXPERIENCED ANY MENTAL ILLNESS
IN IN 2019 FURTHER ABOUT 4% OF
ADULTS EXPERIENCED A SERIOUS
MENTAL ILLNESS AND ABOUT 7% OF
CHILDREN HAD A SERIOUS EMOTIONAL
DISTURBANCE. A FEW MORE
STATISTICS NOT PICTURED ON THIS
SLIDE. PEOPLE AT LOWER INCOME
LEVELS ARE MORE LIKELY TO HAVE A
SERIOUS MENTAL ILLNESS OR FOR
CHILDREN. A SERIOUS EMOTIONAL
DISTURBANCE AND BLACK AND
INDIGENOUS AMERICANS EXPERIENCED
THE HIGHEST RATES OF SERIOUS
MENTAL ILLNESS. IT'S LIKE THIS
SLIDE SHOWS SERIOUS
PSYCHOLOGICAL DISTRESS AND THE
TWO SETS OF BARS ON THE LEFT
SHOWS THAT YOUTH ARE SUFFERING
SERIOUS PSYCHOLOGICAL DISTRESS
MORE THAN OLDER AGE GROUPS.
THEIR RATES OF DISTRESS
BASICALLY DOUBLED FROM 2015 TO
2019, AND THERE'S GENERAL
AGREEMENT THAT THIS MEASURE GOT
WORSE DURING THE COVID 19
PANDEMIC IS NOT SHOWN HERE, BUT
THERE ARE PARTICULARLY HIGH
RATES OF SERIOUS PSYCHOLOGICAL
DISTRESS FOR PEOPLE WHO IDENTIFY
AS LGBT QUÊ. IN ADDITION, EVERY
RACIAL AND ETHNIC GROUP REPORTED
AN INCREASE IN SERIOUS
PSYCHOLOGICAL DISTRESS BETWEEN
2015 AND 2019. FOR MULTIRACIAL
THAT RATE MORE THAN DOUBLED.
DATA ON SUBSTANCE USE DISORDER
IS NOT NEARLY AS COMPLETE AS
DATA ON MENTAL ILLNESS OR
PSYCHOLOGICAL DISTRESS. BUT WE
DO KNOW THAT ABOUT 9% OF THE
CALIFORNIA POPULATION OVER AGE
12 HAD HAD SUBSTANCE USE
DISORDERS IN THE PAST YEAR FROM
2019 DATA. ALTHOUGH WE FOCUS A
LOT ON OPIOIDS, ALCOHOL
CONTINUES TO BE THE DRUG THAT
AFFECTS THE MOST PEOPLE OVER 6%
OF CALIFORNIANS HAVE AN ALCOHOL
USE DISORDER OF ALL THE
SUBSTANCES. ALCOHOL IS THE
BIGGEST KILLER. WE ALSO KNOW
THAT SUBSTANCE USE DISORDER AND
MENTAL ILLNESS COOP FREQUENTLY
OCCUR TOGETHER. TURNING TO
TREATMENT. NOT ENOUGH
CALIFORNIANS WITH BEHAVIORAL
HEALTH NEEDS CAN GET TREATMENT.
NEARLY TWO THIRDS OF ADULTS WITH
ANY MENTAL ILLNESS DID NOT
RECEIVE MENTAL HEALTH SERVICES
AND NEARLY 40% OF ADULTS WITH
SERIOUS MENTAL ILLNESS DID NOT
RECEIVE TREATMENT. PLEASE NOTE
THAT THESE ARE WORSE THAN
NATIONAL AVERAGES, AS I
MENTIONED BEFORE CALIFORNIA DATA
ON SUBSTANCE USE DISORDER IS NOT
AS DETAILED AS MENTAL HEALTH.
CALIFORNIA HAS SEEN A MAJOR
EXPANSION IN ITS PUBLIC
SUBSTANCE USE DISORDER PROGRAMS
SINCE 2015 AND WE DO, AND WE DO
KNOW THAT MORE PEOPLE ARE NOW
SELF REFERRING FOR ADDICTION
TREATMENT THAN ARE BEING
MANDATED INTO CARE. THAT'S GOOD.
STILL THE ESTIMATE IS THAT FEWER
THAN ONE IN 10 PEOPLE WITH A
SUBSTANCE USE DISORDER. GET CARE
FOR THAT CONDITION. NOW THAT
WE'VE LOOKED AT THE DATA AND
UNDERSTAND PEOPLE'S BEHAVIORAL
HEALTH NEEDS LIKE TO TALK ABOUT
WHAT TO CONSIDER WHEN RETHINKING
THE STATE'S BEHAVIORAL HEALTH
SYSTEM. THE FIRST QUESTION IS
WHAT KIND OF CARE TO PEOPLE
RECEIVE AND WHERE DO THEY
RECEIVE IT? WE NEED TO FOCUS ON
PEOPLE CENTERED CARE. THE
EFFORTS WE'VE MADE TO EXPAND
ACCESS HAVEN'T CLOSED GAPS FOR
BLACK AND INDIGENOUS
CALIFORNIANS OR OTHER PEOPLE OF
COLOR. WE NEED TO IDENTIFY
EVIDENCE BASED PRACTICES THAT
ARE ALSO CULTURALLY AND
LINGUISTICALLY ACCESSIBLE. WE
NEED TO INTEGRATE MENTAL HEALTH
AND SUBSTANCE USE DISORDER CARE.
FOR EXAMPLE, AS A FIELD, WE NOW
USE THE TERM BEHAVIORAL HEALTH
TO ENCOMPASS BOTH MENTAL HEALTH
AND SUBSTANCE USE DISORDER CARE
MUCH MORE NEEDS TO BE DONE,
INCLUDING AROUND MODERNIZING
PAYMENT. WE NEED TO MEET PEOPLE
WHERE THEY ARE LITERALLY BY
UTILIZING STREET MEDICINE
PROGRAMS AND TELEHEALTH AND
VIRTUAL CARE. FINALLY THERE'S
TREMENDOUS REGIONAL VARIATION IN
ACCESS. WE NEED ACCESS TO BE
EQUAL ACROSS THE STATE. IT'S
DIFFICULT WORK, BUT WE NEED TO
MOVE TOWARDS IT. SECOND QUESTION
IS ABOUT WHO IS PROVIDING THAT
CARE. THIS CHURCH SHOWS THE
RACE, RACE, ETHNICITY, BREAKDOWN
OF BEHAVIORAL HEALTH
PROFESSIONALS. I WANT TO CALL
YOUR ATTENTION TO THE BLUE BARS.
THOSE ARE THE PROFESSIONALS WHO
ARE WHITE. IN MOST CATEGORIES,
WHITE PROFESSIONALS ARE OVER
REPRESENTED RELATIVE TO THE
OVERALL POPULATION, WHILE THERE
ARE VERY FEW LATINO OR ASIAN
BEHAVIORAL HEALTH CLINICIANS
COMPARED TO THE OVERALL
POPULATION. I WILL CALL OUT THAT
SECOND FROM RIGHT IS SUD
COUNSELORS, THE ONLY FIELD IN
WHICH PROVIDERS NEARLY MATCH THE
COMPOSITION OF THE CALIFORNIA
POPULATION AS A WHOLE. THE
SOLUTION IS NOT JUST ABOUT
TRAINING MORE CLINICIANS BUT
ALSO ABOUT HOW WE ALLOCATE
RESOURCES. WE NEED TO USE THE
ENTIRE RANGE OF PROVIDERS MORE
EFFECTIVELY. THROUGH TEAM BASED
MODELS AND CONSULTATION
ARRANGEMENTS AS WELL AS
INVESTING IN OUR COMMUNITY
WORKFORCE, AND THAT THAT MEANS
OUR PEER SUPPORT COUNTS
SPECIALISTS AND OUR COMMUNITY
HEALTH WORKERS. FINALLY, ALL
PROVIDER TYPES NEED TRAINING IN
SUBSTANCE USE DISORDER, PRIMARY
CARE PROVIDERS, MENTAL HEALTH
PRACTITIONERS AND NON CLINICAL
STAFF. OUR THIRD QUESTION IS WHO
IS RESPONSIBLE FOR ORGANIZING
AND PAYING FOR THAT CARE? ONE
THING WE HEAR OVER AND OVER IS
THAT CALIFORNIA HAS A COLLECTION
OF BEHAVIORAL HEALTH PROGRAMS
AND FUNDING SOURCES, BUT NOT A
SYSTEM. REMEDYING THIS
FRAGMENTED SYSTEM IS, OF COURSE,
ONE OF THE REASONS WE'RE HERE
TODAY. COMPLEXITY IS A GIVEN.
BUT THAT DOESN'T MEAN IT HAS TO
BE MEAN CONFUSION. WE NEED TO
ENGAGE PEOPLE WITH LIVED
EXPERIENCE IN THE SYSTEM TO MAKE
SURE THAT WE'RE PLANNING IN
RESPONSE AND IS RESPONSIVE TO
INDIVIDUAL AND COMMUNITY NEEDS,
INCLUDING RELATIONSHIPS WITH
PROGRAMS THAT ADMINISTER HOUSING
, FOOD, SUPPORT, PAROLE AND
PROBATION, AGING EDUCATION AND
OTHERS. IN ADDITION TO KNOWING
WHO IS RESPONSIBLE. WE ALSO NEED
TO MAKE SURE THEY'RE BEING
RESPONSIBLE. WE NEED TO ENSURE
THAT ACCOUNTABLE ENTITIES
INCLUDING PAYERS, PLANS AND
PROVIDERS HAVE CAPACITY
EXPERTISE. AND INFRASTRUCTURE
THAT THEY NEED TO MANAGE THE
CARE FOR WHICH THEY'RE
RESPONSIBLE. FINALLY WE NEED TO
THINK ABOUT HOW WE PAY FOR
BEHAVIORAL HEALTH SERVICES, SO
THAT FINANCIAL INCENTIVES
ALIGNED WITH THE OUTCOMES THAT
WE WANT. THAT MEANS THAT IF WE
WANT TO BEHAVIORAL HEALTH
PROVIDER OR MANAGED CARE PLAN TO
PROVIDE WHOLE PERSON CARE, WE
NEED TO DESIGN PAYMENT SYSTEMS
SO THAT THEY HAVE A REASON TO DO
THAT. AND FINALLY UM, OUR FINAL
QUESTION FOR CONSIDERATION. HOW
DO WE KNOW HOW WE'RE DOING? WE
MEASURE A LOT OF THINGS IN
BEHAVIORAL HEALTH, BUT WE CAN'T
SAY HOW WE'RE DOING. WE NEED TO
INVEST IN DATA CAPACITY AT ALL
LEVELS OF THE SYSTEM TO IMPROVE
QUALITY MEASUREMENT. THIS MHS
REDESIGNED WITH ALIGNED EFFORTS
IN MEDICAL GIVES US A
GENERATIONAL OPPORTUNITY TO
CREATE A COMPREHENSIVE
BEHAVIORAL HEALTH QUALITY
STRATEGY FOR CALIFORNIA. THIS
WOULD INCLUDE MUCH BETTER
MEASUREMENT OF ACCESS TO CARE.
MEASURING PATIENT OUTCOMES, NOT
JUST PROCESSES, AND WE NEED TO
MEASURE THE SAME THINGS ACROSS
ALL OF OUR SYSTEMS, NOT SEPARATE
MEASURES FOR SEPARATE FUNDING
SOURCES. FINALLY WE NEED TO
PRESENT THIS DATA IN WAYS THAT
PEOPLE ALL OF US CAN USE. WITH
THAT. THANK YOU FOR HAVING ME
HERE TODAY. HAPPY TO TAKE ANY
QUESTIONS. THANK YOU VERY MUCH
MOVE ON TO OUR COMMITTEE PEOPLE
WHO HAVE QUESTIONS OR COMMENTS.
MS WALDRON. THANK YOU BOTH FOR
YOUR VERY INFORMATIVE
PRESENTATIONS. I DID, UM, THERE
WAS A LOT SO I JUST WANTED TO
KIND OF TALK A LITTLE BIT MORE
ON THE WORKFORCE BECAUSE THAT'S
ONE OF THE BIG ISSUES. UM ONE OF
THE THINGS YOU MENTIONED WAS HOW
DO WE UP? SKILL. PRIMARY. HERE
PROVIDERS. TO BE ABLE TO GIVE
THE TREATMENT. UM HOW WOULD WE
GO ABOUT DOING SOMETHING LIKE
THAT? IS THAT I MEAN, WE HAVE
THE MEDICAL BOARD THAT KIND OF
DICTATE. YEAH PRIMARY CARE
PROVIDERS DO BUT IT I MEAN,
THEY'RE MEETING PEOPLE ALL THE
TIME, AND IF THEY CAN IDENTIFY
OR AT LEAST YOU KNOW, BE ABLE TO
TALK ABOUT IT WITH THE PERSON IN
FRONT OF THEM AT THE TIME, THAT
WOULD BE VERY HELPFUL. YEAH I'M
THANK YOU, MISS WALDRON. I'M
HAPPY TO TAKE IT FROM SORT OF A
BROAD LEVEL AND THEN HAND IT
OVER TO DR COCHELL. YOU KNOW,
THE STATE HAS INVESTED BILLIONS
OF DOLLARS IN ALL OF OUR
DIFFERENT WORKFORCE CATEGORIES
AND ALSO HAS CREATED SOME
OPPORTUNITIES LIKE, UM,
INVESTING IN TELEHEALTH AND IN
ST MEDICINE AND OUR MEDICAL
PROGRAM TO REALLY MEET PEOPLE
WHERE THEY ARE AS WELL AS
INVESTING IN COMMUNITY HEALTH
WORKERS, SO IT'S REALLY ALL
ABOUT THAT KIND, AS WELL AS
MAJOR INVESTMENTS SPECIFICALLY
IN THE BEHAVIORAL HEALTH
WORKFORCE. THAT WE EXPECT TO
ROLL OUT OVER TIME. AND SO IT'S
REALLY IMPORTANT TO NOT ONLY
HAVE THAT MONEY THERE AND THAT
COMMITMENT WHICH IS ALREADY
THERE, BUT ALSO TO WHAT TO ALSO
HAVE THAT IMPLEMENTED, AND IT
TAKES SOME TIME TO DO THAT. AND
SO I KNOW OUR FOUNDATION IS VERY
ENGAGED IN WATCHING THAT AND
MAKING SURE THAT ALL OF THAT
HAPPENS AND IT'S REALLY
NECESSARY TO HAVE THAT
INVESTMENT UP FRONT. AND AS I
SAID, IT'S REALLY IMPORTANT TO
THINK ABOUT, YOU KNOW TO THINK
ABOUT. THE ENTIRE CONTINUUM, SO
IT'S NOT JUST PRIMARY CARE AND
SPECIALTY CARE. IT'S BEHAVIORAL
HEALTH CARE WORKERS, AND IT'S
ALSO THE PEOPLE WHO ARE GETTING
OUT INTO THE COMMUNITY OR
COMMUNITY. HEALTH WORKERS ARE
PEER SUPPORT COUNSELORS,
ETCETERA, SO IT'S NOT JUST
UPSCALING PEOPLE. IT'S INVESTING
IN THAT ENTIRE CONTINUUM OF
PROVIDERS, DR MICHELLE YES.
THANK YOU. FOR THAT. SUCH AN
IMPORTANT QUESTION. I THINK
THERE ARE A FEW THINGS THAT COME
TO MIND ONCE. IT'S BOTH OUR
PHYSICIAN AND OUR NURSE
PRACTITIONER UM AND PHYSICIAN
ASSISTANT WORKFORCE WHO REALLY
DO A LOT OF THE HEAVY LIFTING
HERE. IT HAS BEEN RELATIVELY
HARD TO GET FUNDING. FOR
INSTANCE. FOR ADDITION,
ADDICTION TREATMENT FELLOWSHIPS
FOR BOTH OF THE PHYSICIAN LEVEL
AND AT THE AT THE NURSE
PRACTITIONER, ADVANCED PRACTICE
PROVIDER LEVEL. THESE PROGRAMS
CAN REALLY PROVIDE
TRANSFORMATIVE. WHAT YOU DO IS
YOU GET A GROUP OF PEOPLE WHO
REALLY BECOME EXPERTS IN THIS
AND LEADERS, AND THEN THEY
BECOME THE TRAINERS TO SUPPORT
SOMEONE LIKE ME WHO DIDN'T GO
THROUGH ONE OF THOSE FELLOWSHIPS
, BUT GET SORT OF TRAINED BY MY
COLLEAGUES WHO DID, AND THEN
THERE'S ALWAYS A LINE FOR ME TO
CALL, SO I THINK THAT'S A REALLY
CONCRETE STEP. I WANT TO JUST
EMPHASIZE THAT THE DISPARITIES
IN SUBSTANCE USE TREATMENT BY
RACE AND ETHNICITY ARE REALLY
GLARING THAT, FOR INSTANCE,
OVERDOSES IN THE BLACK COMMUNITY
OR RISING MUCH FASTER AND SINCE
2019 HAVE SURPASSED OVERDOSE,
WAIT WRITES IN THE WHITE
COMMUNITY, AND THERE HAS BEEN A
VARIETY OF REALLY WELL DONE
STUDIES IN THE LAST FEW YEARS
THAT SHOW THAT ONLY ABOUT 20% OF
PEOPLE WHO QUALIFY GET TREATMENT
TO MEDICATION. OPIOID USE
DISORDER, WHICH IS GOLD STANDARD
LIFE SAVING TREATMENT, SO WE'RE
ONLY GETTING ABOUT ONE IN FIVE
PEOPLE. AND WHEN YOU LOOK AT
THOSE DATA IF YOU ARE BLACK OR
LATIN X, YOU ARE SIGNIFICANTLY
LESS LIKELY, SO THE OTHER THING
IS TO INVEST IN A DIVERSE AND
CULTURALLY APPROPRIATE WORKFORCE
. THINGS LIKE THE PRIME PROGRAM
THROUGHOUT CALIFORNIA THAT
TRAINS PHYSICIANS WHO COMMIT TO
WORKING IN UNDERSERVED AREAS.
OTHER PROGRAMS FOR BOTH THE
NURSE PRACTITIONERS AND
PHYSICIAN WORKFORCE THAT CAN
HELP US DIVERSIFY THAT WORKFORCE
WOULD ALSO BE SO I WOULD SAY
IT'S BOTH INVESTING IN THE
TRAINING PROGRAM. SMALL
INVESTMENTS TO TRAIN A GROUP OF
LEADERS CAN GO A VERY LONG WAY
IN SORT OF FURTHERING. THE
MESSAGE. AND THEN ONCE WE'RE IN
PRIMARY CARE IS SOMEONE WHO
PRACTICES PRIMARY CARE AND DOES
A FAIR AMOUNT OF ADDICTION
TREATMENT IN PRIMARY CARE. IT
DOES TAKE ADDITIONAL RESOURCES.
SO HAVING THOSE PURE CASE
MANAGERS, THIS SOCIAL WORK AND
BEHAVIORAL HEALTH SUPPORTS RIGHT
THERE IN PRIMARY CARE CAN REALLY
HELP US BECAUSE WE'VE OFTEN HAVE
15 MINUTES APPOINTMENTS, WHICH
IS ENOUGH FOR US TO PRESCRIBE
THE LIFESAVING MEDICATION. AND
NOT ENOUGH FOR US, SO WE REALLY
NEED TO WORK HAND IN HAND WITH
OUR BEHAVIORAL HEALTH PROVIDERS
. WHEN THEY'RE CO LOCATED, IT
MAKES ALL THE DIFFERENCE IN THE
WORLD. JUST A QUICK FOLLOW UP IF
I MAY, UM I KNOW IN THE PAST OF
PHYSICIAN NEEDED TO GET SUBOXONE
CERTIFIED, OR WHATEVER, THROUGH
CMS, UM IS THAT STILL REQUIRED
OR HOW WOULD CMS ALSO KIND OF
INTEGRATE WITH EVERYTHING? WE'RE
TRYING TO DO? FANTASTIC QUESTION
THIS IN THE PAST YEAR, THEY X
THE X SO WE NO LONGER HOORAY.
NEED THAT X LICENSE? UM WHICH IS
REALLY TERRIFIC, BUT REALLY,
INTERESTINGLY, THAT HAPPENED AND
WE HAVEN'T SEEN AN UPTICK IN
PRESCRIPTIONS SO TOO. ME THAT
FELT IT NECESSARY BUT NOT
SUFFICIENT AND WHAT IS
SUFFICIENT AS SOMEONE LIKE, WHO
IS A SUBOXONE PROVIDER IS HAVING
THAT CALL A FRIEND LIFELINE, YOU
KNOW, TO INCREASE ALL OF OUR
CONFIDENCE TO DO THIS. I'M SO
GLAD THAT THAT REQUIREMENT WENT
AWAY, BUT WE HAVEN'T ACTUALLY
SEEN IT UNLEASH A LOT OF NEW
SUBSCRIPTION, YOU KNOW,
PRESCRIPTION, SO I THINK IT'S A
MATTER OF INCREASED TRAINING,
WARM LINES AND OTHER SUPPORT AND
THAT CO LOCATION OF SERVICES TO
REALLY MOVE THE NEEDLE. OTHER
QUESTIONS, DR WEBBER. THANK YOU
BOTH. SO MUCH FOR YOUR
PRESENTATIONS TODAY. JUST TWO
BRIEF QUESTIONS. UM YOU KNOW, I
SEE A LOT IN STUDIES WHERE THEY
TALK ABOUT GOING OUT AND DOING
SURVEY OF THOSE WHO ARE HOMELESS
OR IN SHELTERED, AND THEY ASKED
THEM ABOUT LIKE MENTAL HEALTH
CHALLENGES AND THINGS LIKE THAT
IN YOUR STUDY. UH, WAS THERE ANY
DIFFERENTIATION BETWEEN WHETHER
OR NOT THEY ACTUALLY HAD A
MENTAL HEALTH DIAGNOSIS PRIOR?
TO BECOMING HOMELESS. THAT'S
ANOTHER TERRIFIC QUESTION. UM SO
WE ASKED FOLKS, WE DID SORT OF
SYMPTOM SCORES, KNOWING THAT SO
MANY PEOPLE DON'T HAVE ACCESS TO
TREATMENT THAT THEY MIGHT NOT
HAVE EVEN GOTTEN A DIAGNOSIS,
BUT WE TRIED TO ASCERTAIN IT,
AND, FOR INSTANCE, LOOKING AT
THINGS LIKE A PSYCHIATRIC
HOSPITALIZATION, WHICH IS A
DECENT MEASURE OF A PRETTY, YOU
KNOW OF A MORE SEVERE, COMPLEX
PROBLEM OF THOSE WITH THE MENTAL
HEALTH HOSPITALIZATION IN THEIR
LIFE, WHICH IS ABOUT A QUARTER
27. 56% HAD HAD THAT FIRST
HOSPITALIZATION BEFORE THEIR
FIRST EPISODE OF HOMELESSNESS.
SO A LITTLE LESS THAN HALF HAD
HAD THAT FOLLOWING AT LEAST
THEIR FIRST EPISODE OF
HOMELESSNESS. WE ASKED PEOPLE
WITH THEIR SUBSTANCE USE
PROBLEMS HOW IT HAD CHANGED
DURING THIS EPISODE, AND IT WAS
ACTUALLY REALLY INTERESTING. IT
WAS A PRETTY MUCH AN EVEN SPLIT
OVERALL ABOUT A THIRD SAID
DURING THIS PARTICULAR EPISODE
OF HOMELESSNESS, IT GOT
SIGNIFICANTLY WORSE. A THIRD
SAID IT HADN'T CHANGED IN A
THIRD SET. IT GOT BETTER THAT
SPLIT A LITTLE BIT BY WHO THEY
WERE. THE YOUNG ADULTS WHO WERE
HOMELESS WERE MUCH MORE LIKELY
TO SAY THAT THEIR SUBSTANCE USE
HAD GOTTEN SIGNIFICANTLY WORSE.
DURING THIS EPISODE OF
HOMELESSNESS, THE PARENTS AND
HOMELESS FAMILIES WERE MUCH MORE
LIKELY TO SAY IT HAD GOTTEN A
LOT BETTER AND THE SINGLE ADULTS
THE ADULTS, 25 AND OLDER WITHOUT
KIDS WERE MUCH MORE SORT OF LIKE
SOME SAID IT GOT WORSE, SOME
SAID IT GOT BETTER. OKAY. THANK
YOU. SO, UM SO LOOKING AT YOUR
REPORT. WHEN YOU TALK ABOUT THE
MAJORITY, OR 82% SAID SOMETHING
THAT THEY HAD EXPERIENCED SOME
FORM OF, UM MENTAL HEALTH
CHALLENGES. UM, IT'S REALLY. THE
1/4 THAT YOU WERE LOOKING AT,
AND THEN HALF OF THAT? 1/4 HAD
ACTUALLY EXPERIENCED IT PRIOR TO
BECOMING HOMELESS. SO HALF OF
THAT WE TRY TO LOOK AT SORT OF A
MEASURE OF A VERY SEVERE PROBLEM
BECAUSE DEPRESSIVE SYMPTOMS WE
KNOW GET WORSE WITH
HOMELESSNESS. ANXIETY GETS WORSE
, THE AMOUNT OF TRAUMA PEOPLE
EXPERIENCED WHILE THEY WERE
HOMELESS WAS WAS ABSOLUTELY I
HAVE TO SAY, ASTONISHING 10% OF
EVERYONE EXPERIENCING
HOMELESSNESS HAD BEEN SEXUALLY
ASSAULTED. DURING THIS EPISODE
OF HOMELESSNESS ABOUT A THIRD
HAD BEEN PHYSICALLY ASSAULTED.
THOSE NUMBERS ARE REALLY
ACTUALLY MIND BLOWING AMONG
WOMEN OR TRANS AND NON BINARY
FOLKS. IT WAS ACTUALLY MUCH
HIGHER THAN 10% THAT HAD BEEN
SEXUALLY ASSAULTED, NOT A
SURPRISE THAT HOMELESSNESS
ITSELF LEADS TO A DRAMATIC
WORSENING OF MENTAL HEALTH
SYMPTOMS. BUT WE WERE TRYING TO
LOOK AT INDICATORS OF LIKE WHAT
WE MIGHT CALL A SEVERE MENTAL
ILLNESS HARD TO DO, BUT WE'VE
SORT OF COMBINED THE IDEA OF
HAVING SUICIDE ATTEMPTS, WHICH
BY THE WAY, ABOUT ONE IN FOUR
PEOPLE HAD ATTEMPTED SUICIDE IN
THEIR LIFE AGAIN REALLY
ASTONISHING ONE AND FOUR HAD
BEEN HOSPITALIZED ABOUT 14% HAD
EXPERIENCED A TIME WITH
HALLUCINATIONS. THESE WERE SORT
OF OUR MARKERS FOR SEVERITY. AND
IT LOOKED LIKE FOR A LITTLE MORE
THAN HALF OF FOLKS. THOSE SEVERE
SEVERE EVENTS PREDATED THEIR
FIRST EPISODE OF HOMELESSNESS
BUT USUALLY CONTINUED, AND ABOUT
HALF THOSE DEVELOPED AFTER THEY
BECAME HOMELESS. THANK YOU SO
MUCH FOR THAT. I THINK A LOT OF
TIMES THERE'S A QUESTION ABOUT
KIND OF WHICH CAME FIRST. AND,
UM, THERE SEEMS TO BE A LOT OF
THOUGHT THAT THE MENTAL ILLNESS
CAME FIRST. AND THEN THAT'S WHY
THEY ENDED UP. UM, BUT THE
REALITY IS THAT MANY OF THEM
DIDN'T BUT DID DEVELOP SOME
SYMPTOMS ONCE THEY ACTUALLY
BECAME HOMELESS. UM THANK YOU SO
MUCH FOR THAT. AND MY OTHER
QUESTION. UM I KNOW IT'S HARD
BECAUSE WE DON'T REALLY HAVE THE
DATA TO DETERMINE. UM, BUT YOU
KNOW, JUST LISTENING TO SOME OF
THE THINGS THAT YOU POINTED OUT
AND THE FACT THAT YOU KNOW WE
DON'T HAVE PEOPLE THAT ARE
SEEKING TREATMENT AND WORSE THAN
THE NATIONAL AVERAGE, WHICH IS,
UNFORTUNATELY, UNFORTUNATELY
VERY SURPRISING FOR ME HERE IN
CALIFORNIA, UM, WITH THE
RESOURCES THAT WE HAVE NOW, WITH
THE MONEY THAT WE'RE PUTTING
TOWARDS MENTAL HEALTH CARE. UM
DO YOU THINK THAT THAT IS
ENOUGH? I DON'T KNOW THAT
THERE'S EVER ENOUGH, RIGHT? YOU
KNOW, WE WANT THE HIGHEST
QUALITY BEST SYSTEM FOR PEOPLE,
AND I THINK WE'RE A LONG WAY
FROM THAT. AND I THINK THE
INVESTMENTS OF THE LAST SEVERAL
YEARS HAVE MADE GREAT STRIDES IN
THAT. A LOT OF THE DATA THAT I
WAS TALKING ABOUT IS FROM 2019.
SO IT'S RELATIVELY RECENT, BUT
WE KNOW WE HAD THE PANDEMIC, AND
THAT'S JUST CHANGED THE
LANDSCAPE CONSIDERABLY. AND SO I
THINK IN THE NEXT COUPLE OF
YEARS, WE WILL BE ABLE TO NOT
ONLY TRACK THE INVESTMENTS AT
THE STATE LEVEL MAJOR
INVESTMENTS IN BOTH COVERAGE AND
BEHAVIORAL HEALTH. UM BEHAVIORAL
HEALTH INVESTMENTS, BUT ALSO
HAVE BETTER DATA ABOUT TREATMENT
WHO'S ACCESSING TREATMENT AND
SEEKING IT AND BETTER DATA ON
THE WORKFORCE AS WELL. THANK YOU
SO MUCH FOR THAT. I JUST, UH I
WONDER WHEN WE LOOK AT THE
NUMBERS OF THOSE WHO ARE
EXPERIENCING MENTAL HEALTH
CRISIS, WHETHER IT'S SERIOUS OR
EARLY. WE TALK ABOUT
PREVENTATIVE, ESPECIALLY IN OUR
YOUTH. UM YOU KNOW, THE FUNDS
THAT WE HAVE RIGHT NOW IS AND
THE NEW PROPOSAL IS THAT THE
BEST IDEA TO SHIFT SOME OF THOSE
FUNDS AND INTO AWAY THAT'S NOT
SPECIFICALLY GOING INTO
TREATMENT OR PREVENTATIVE CARE,
BUT THANK YOU SO VERY MUCH.
THANK YOU ANYONE ELSE? JUST A
COUPLE OF QUICK QUESTIONS. AND
DR WEBBER GOT ONE OF MINE. SO I
APPRECIATE YOU ASKING THAT
QUESTION. UM DR COCHELL, UM YOUR
RECENT REPORT RECOMMENDED
EMBEDDING RACIAL EQUITY
APPROACHES INTO HOMELESS SYSTEM
SERVICE DELIVERY. UM CAN YOU
TALK A LITTLE BIT MORE ABOUT THE
METHODS TO ACCOMPLISH THAT AND
HOW WE SHOULD MONITOR OUR
EFFORTS TO ENSURE GREATER EQUITY
AND SERVICES? YES. THANK YOU FOR
THAT. I THINK THERE ARE A FEW
POINTS. ONE IS, UM, THAT THE
DISPROPORTIONATE HOMELESSNESS
AMONG BLACK AMERICANS INDIGENOUS
AMERICANS IS NOT ACTUALLY
PROPORTIONAL TO ANY DESPERATE
MENTAL HEALTH OR SUBSTANCE USE
PROBLEMS, SO THERE'S ABOUT A
FOUR FOLD OVER REPRESENTATION OF
THE BLACK POPULATION IN THE HOME
US IN HOMELESSNESS. UM BUT, FOR
INSTANCE, BLACK FOLKS WHO ARE
HOMELESS ARE LESS LIKELY THAN
WHITE FOLKS WHO ARE HOMELESS TO
HAVE SUBSTANCE USE DISORDERS.
BECAUSE REALLY, THE ADDITIONAL
RISK THAT THEY CARRY IS EXPOSURE
TO RACISM AND EXPOSURE TO RACISM
AND HOUSING MARKETS,
INTERGENERATIONAL WEALTH AND
THINGS LIKE THAT. AND SO ONE
THING IS WHEN WE'RE LOOKING AT
HOMELESSNESS RESPONSE AS OPPOSED
TO BEHAVIORAL HEALTH RESPONSE IN
A IN A WAY, IF THE ONLY PEOPLE
WHO GET PRIORITIZED FOR HOUSING
ARE THOSE WITH SEVERE BEHAVIORAL
HEALTH PROBLEMS, YOU RUN THE
RISK. OF UM NOT DOING ANYTHING
ABOUT THAT. YES PRETTY THAT
OVERREPRESENTATION. SO ONE WAY
IS TO MAKE SURE THAT WE ARE
PROVIDING HOUSING RESOURCES AND
RESPONSES THAT ARE BASED ON
WHETHER SOMEONE'S BEEN HOMELESS
, AS OPPOSED TO ONLY BASED ON
THIS AND THESE OTHER PROBLEMS,
AND, AS DR WEBBER SAID, THE
LONGER PEOPLE ARE OUT THERE THAN
THEY DO DEVELOP THOSE PROBLEMS.
UM SO THAT'S ONE THING. SO
MONITORING EXITS FROM
HOMELESSNESS. MONITORING HOW THE
COORDINATED ENTRY SYSTEM IS
WORKING, AND SEEING IF THERE'S
AN ME AND INTENTIONAL. UM
DISPARATE, YOU KNOW, DISPARATE
IMPACT OF WHO GETS THOSE
SERVICES. THE SECOND THING THERE
WAS SOME REALLY GOOD RESEARCH
OUT OF L. A THAT SHOWED, FOR
INSTANCE, THAT BLACK AMERICANS
IN SUPPORTIVE HOUSING WERE MORE
LIKELY TO BE EVICTED THAN WHITE
FOLKS AND SUPPORTIVE HOUSING.
THAT'S A REALLY CONCRETE THING
YOU CAN MEASURE OF, LIKE WHAT'S
GOING ON WITH RETENTION IN
HOUSING ONCE YOU GET FOLKS
HOUSE, SO I THINK YOU WANT TO
MONITOR ENTRANCES INTO
HOMELESSNESS. WE SHOULD BE
SEEING A DECREASE IN THAT
OVERREPRESENTATION IF WHAT WE'RE
DOING IS WORKING. YOU WANT TO
MONITOR EXITS INTO HOUSING AND
MAKE SURE WE'RE NOT ON
INTENTIONALLY SORT OF FAVORING
ONE GROUP OR ANOTHER. AND THEN
FINALLY, YOU WANT TO MEASURE
CONCRETE THINGS LIKE WHO'S
GETTING EVICTED ONCE THEY GET RE
HOUSED, AND THEN FINALLY, YOU
KNOW, WITH THIS REALLY SHOCKING
DISPARITY IN ACCESS TO MENTAL
HEALTH AND SUBSTANCE USE
TREATMENT. YOU DEFINITELY WANT
TO MEASURE THAT YOU ARE ACTUALLY
REACHING THE POPULATION. THAT'S
AT RISK, YOU KNOW, AND YOU AND
YOU'RE NOT. YOU'RE NOT REACHING
ONE GROUP DISPROPORTIONATELY TO
ANOTHER. THANK YOU. AND THEN
JUST BRIEFLY. A QUESTION, MISS
HYDRANT. YOU YOU. YOU MENTIONED
EQUITABLE ACCESS ACROSS STATE
ACROSS THE STATE, AND EVERY
COMMUNITY KNOWS SO WITH SOMEONE
WHO REPRESENTS LARGELY RURAL
DISTRICT, UM, THAT WAS THAT
PIQUES MY INTEREST BECAUSE THAT
IS A HUGE CHALLENGE FOR US IN A
LOT OF OUR RURAL COMMUNITIES, SO
JUST YOUR THOUGHTS ON THIS AND
ALSO REPRESENT A LOT OF NATIVE
AMERICAN COMMUNITIES AS WELL.
AND AS WE JUST HEARD FROM DR
KUSHELL, THEY'RE OVERREPRESENTED
IN IN AND IN THIS, SO JUST JUST
BRIEFLY YOUR THOUGHTS ON THIS.
AND, UM UM WHERE WHERE WE MIGHT
GO BECAUSE OF, YOU KNOW, I HAVE
MY OWN THOUGHTS, AND THEY'RE
PRETTY STRONG. AND SO THERE WE
TRY TO EMBED A LOT OF A LOT OF
THINGS IN THAT AROUND
FLEXIBILITY FOR SMALLER AREAS.
RECOGNIZING THE CHALLENGES THE
TECHNICAL CHALLENGES THE
OUTREACH CHALLENGES AND SO ON,
BUT I'D LOVE TO HEAR YOUR
THOUGHTS. I THINK, DOCTOR, WOULD
YOU JUST NAMED SEVERAL OF THE
ITEMS THAT I WOULD DISCUSS? I
THINK FOR THE INDIGENOUS
COMMUNITIES FOR THE TRIBAL
COMMUNITIES IN PARTICULAR, YOU
KNOW, I MENTIONED AT THE
BEGINNING OF THIS. WE'VE HAD
MANY CHANGES SINCE 2004. ONE OF
THOSE HAS BEEN COVERAGE
EXPANSION AND SO MAKING SURE
THAT PEOPLE THAT PARTICULARLY,
UM PEOPLE WHO IN THE INDIGENOUS
COMMUNITY WHO ARE ELIGIBLE FOR
MEDICAL OR ELIGIBLE FOR COVERAGE
ARE IN COVERAGE THAT THERE'S A
GAP THERE AND SO JUST BASIC
COVERAGE, I THINK IS A REALLY
IMPORTANT PLACE TO START SO THAT
THEY CAN THEN ACCESS HAVE FULL
ACCESS TO THOSE SERVICES. UM AS
I ALSO MENTIONED WORKFORCE IS
KEY. AND AS YOU KNOW, IN THE YOU
KNOW, I REALLY APPRECIATE A LOT
OF THE DATA THAT H CHI COLLECTS
ON UNDER UNDERSERVED AND
UNDERREPRESENTED AREAS IN THE
WORKFORCE. IT'S REALLY IMPORTANT
TO MAKE SURE THAT WE STILL KNOW
WHERE COLLECTING THAT DATA AND
NOWHERE THAT PROVIDERS ARE. UM I
THINK THAT THAT'S REALLY
IMPORTANT TO LOOK AT WHO IS
PROVIDING THESE SERVICES AND
WHO'S AVAILABLE. IN THESE RURAL
COMMUNITIES AND THEN UTILIZING
ALL THOSE, UM, YOU KNOW,
PARTICULARLY TELEHEALTH AND
MAKING SURE THAT PEOPLE HAVE, UM
INTERNET ACCESS SO THAT WE CAN
TO THE EXTENT WE CAN'T YOU KNOW
WHERE THERE IS A SHORTAGE THAT
WE ARE USING ALL OF THE TOOLS
AVAILABLE TO US, UM, YOU KNOW IN
THE INVESTMENT, PARTICULARLY IN
MEDICAL, NOT ONLY COMMERCIAL
INSURANCE BUT NOW IN MEDICAL AND
TELEHEALTH HAS REALLY OPENED
THAT UP, SO MAKING SURE THAT
WE'RE UTILIZING ALL OF THE TOOLS
THAT WE HAVE AT OUR DISPOSAL
WHILE WE'RE MAKING GOOD ON ALL
OF THESE INVESTMENTS AND
INCREASING OUR WORKFORCE, I
THINK IS ALSO VERY IMPORTANT.
GREAT THANK YOU. AND THEN JUST A
FINAL QUESTION AS I CAME TO
MIND, DOCTOR, COCHELL, UM I
DON'T KNOW. NONE OF US WANT TO
REINVENT THE WHEEL BECAUSE IT
ENDED THE DAY IT'S A WHEEL AND
IT'S ALREADY BEEN THERE. SO UM,
YOU MENTIONED, UM NEW YORK HAS
DONE HAS DONE SOME THINGS. ARE
THERE OTHER EXAMPLES OF OTHER
STATES OR OTHER COUNTRIES? YOU
ALSO MENTIONED FRANCE. SO
ANYTHING ELSE OUT THERE THAT WE
SHOULD BE LOOKING AT? UM I THINK
AT THIS POINT THAT YOU KNOW, AS
SOMEONE WHO LOVES TO DO RESEARCH
. WE DON'T NEED TO DO ANY MORE
RESEARCH ON WHAT WORKS FOR THIS
POPULATION. THERE ARE REALLY
GOOD MODELS OF PERMANENT
SUPPORTIVE HOUSING, WHICH IS
HOUSING WITH ROBUST SERVICES. I
THINK ONE OF THE CHALLENGES WE
ENCOUNTER HERE IN CALIFORNIA IS
WE CALL THINGS PERMIT SUPPORTIVE
HOUSING WITHOUT FUNDING, EITHER
THE ONGOING HOUSING NEEDS
BECAUSE THOSE NEEDS ARE ONGOING.
AND THE ONGOING SERVICE NEEDS OR
THE ROBUSTNESS OF THE SERVICE.
THE OTHER THING FROM BOTH FRANCE
, CANADA AND THE US FROM OUR
STUDY IN SANTA CLARA FROM
EXTENSIVE WORK IN NEW YORK AND
FROM CANADA AND FRANCE IS THE
CLOSER. THE PROGRAMS ADHERE TO
THE MODELS IS DESIGNED, UM, THE
BETTER THEY ARE, AND I THINK ONE
OF THE WAYS WE MISS OUR MARK IS
, YOU KNOW, WE AS CLINICIANS
THINK A LOT ABOUT, YOU KNOW,
GIVING PEOPLE THE RIGHT AMOUNT
OF TREATMENT FOR THE SEVERITY OF
THE DISEASE LIKE IF YOU UM, HAVE
CANCER. I'M GOING TO GIVE YOU A
LOT MORE MEDICINE THAN IF YOU
HAVE, YOU KNOW A COLD, BUT BUT
WE DON'T NECESSARILY HAVE THE
RESOURCES OR HAVE BEEN DOING AS
GOOD A JOB AS WE MAYBE SHOULD IN
MATCHING THE SERVICES TO THE
NEEDS OF THE INDIVIDUAL. AND
THEN WE THROW UP OUR HANDS AND
WE SAY OH, THIS PERSON CAN'T BE
HOUSED. THEY NEED TO BE IN AN
INSTITUTION WHEN THAT'S NOT TRUE
AT ALL. THERE. REALLY ARE THESE
MODELS OF WHAT WHAT LEVELS OF
SERVICE PROVISION WORK THAT
CANADA STUDY THE SHAPES WAS
STUDY WAS REALLY IMPRESSIVE
BECAUSE THEY BASICALLY CHOSE
PEOPLE WHO ALL NEEDED A PRETTY
HIGH LEVEL OF SERVICE. THEY THEY
ON INTAKE. JUST IN A BUNCH OF
SIMPLE THINGS TO EVALUATE WHAT
LEVEL THAT THEY NEEDED, AND THEY
PUT SOME PEOPLE IN THIS
ASSERTIVE COMMUNITY TREATMENT,
WHICH IS REALLY THE HIGHEST
LEVEL THE NEXT PEOPLE IN
INTENSIVE CASE MANAGEMENT, WHICH
IS STILL PRETTY INTENSE, BUT BUT
LAST, AND THEN THEY SAW THAT IF
THEY GOT PEOPLE INTO THE RIGHT
GROUPS THEY REALLY WERE ABLE TO
SUCCEED IN KEEPING PEOPLE
HOUSED. AND THEN WHEN PEOPLE
WERE IN THE HIGHEST LEVEL OF
TREATMENT, NEED THE ASSERTIVE
COMMUNITY TREATMENT AND THINGS
STILL DIDN'T GO WELL THEN, AND
ONLY THEN, AND IT WAS A
RELATIVELY SMALL GROUP OF
PEOPLE. DID THEY SAY, OH, LET'S
TRY SOMETHING DIFFERENT LIKE A
RESIDENTIAL CARE FACILITY, SO I
DON'T THINK WE NEED TO REINVENT
THE WHEEL. I THINK CORPORATION
FOR SUPPORTIVE HOUSING, FOR
INSTANCE, HAS A LOT OF DATA AND
TA ON HOW TO DO THIS. WELL I
THINK THIS IS SORT OF KNOWN WHAT
TO DO. I THINK IT'S A SMALL P
POLICY ISSUE. OF JUST
IMPLEMENTING IT BEING SURE THAT
WE ARE MATCHING PEOPLE WITH THE
NEEDS. I THINK YOU YOU'RE
HEARING YOU'LL HEAR AND YOU
PROBABLY HAVE HEARD FROM SOME
SUPPORTIVE HOUSING PROVIDERS
FEELING LIKE THEY'RE OVERWHELMED
BY THE ACUITY OF NEED THAT
THEY'RE BEING PRESENTED WITH.
AND I THINK THAT'S OFTEN BECAUSE
THEY DON'T ACTUALLY HAVE THE
LEVEL OF SERVICES THAT THEY NEED
TO ACTUALLY PROVIDE SERVICES FOR
THE PEOPLE WHO ARE THERE CARING
FOR WELL, THANK YOU, UM, THAT
THAT WILL ACTUALLY CONCLUDE OUR
PANEL JUST WANT TO SAY THANK YOU
TO BOTH OF YOU FOR YOUR WORK AND
YOUR PRESENTATION HERE THIS
MORNING TO KIND OF GIVE US A BIT
OF A BASELINE AS WE AS WE AS WE
GO FURTHER, BUT THANK YOU VERY,
VERY MUCH REALLY APPRECIATE IT.
THANK YOU, DOCTOR, WOULD, UH,
OUR NEXT PANEL PANEL THREE WILL
BE DR GALLEY, MICHELLE BASS AND
MILES WHITE, WHO WILL GIVE AN
OVERVIEW OF THE GOVERNOR'S
BEHAVIORAL HEALTH MODERNIZATION
PROPOSAL. AND YOU ALL HAVE 15
MINUTES. PRESENT AND THEN WE'LL
ALLOW FOR QUESTIONS FROM THE
COMMITTEE MEMBERS. MHM.
OKAY. IF I DIVE IN THANK YOU.
GOOD MORNING. UH, YOUR WORK'S
CHAIR, WOULD ALL THE MEMBERS OF
THE COMMITTEE REALLY A PLEASURE
TO BE HERE. I WANT TO START BY
THANKING THE COMMITTEE. AND THE
CHAIRS FOR THEIR ABILITY AND
TENACITY TO DIG INTO THIS ISSUE.
UH, BEHAVIORAL HEALTH IS AMONG
THE MOST CRITICAL ISSUES OF OUR
DAY. UH, PRE COVID. THE SWELL
WAS REAL POST COVID. THE VIGOR
IS EVEN GREATER, AND WE SEE THAT
IN DATA THAT COMES OUT EVERY
MONTH, EITHER HERE LOCALLY OR
ACROSS THE NATION. WE'RE IN 20
YEARS AGO, BEHAVIORAL HEALTH WAS
HARDLY ON THE RADAR RADAR. TODAY
IT FEELS LIKE THE COMPASS OF SO
MUCH OF OUR HEALTH CARE DELIVERY
SYSTEM. IN CALIFORNIA HAS
RESPONDED AND CLEAR AND DECISIVE
WAYS. SINCE 2019 INVESTMENTS IN
PROGRAMS HAVE BEEN ENORMOUS. UH
LAST WEEK WE HAD THE CHANCE TO
CONTINUE THE ONGOING
CONVERSATION ABOUT THE TAPESTRY
THAT WE'RE CREATING HERE IN
CALIFORNIA. THAT BRINGS A WHOLE
BUNCH OF NEW OPPORTUNITIES
TOGETHER WITH THOSE OLDER
EXISTING OPPORTUNITIES TO GIVE
US A CHANCE TO DO SOMETHING
THAT'S NOT JUST DIFFERENT, BUT I
THINK REALLY MOVES. THE NEEDLE
FOR A NUMBER OF CALIFORNIANS
HAVE HISTORICALLY BEEN
OVERLOOKED. UH, SOME OF THOSE
PROGRAMS JUST TO NAME THEM. UH
KHALIM. THE ASPECTS OF RAPE
PERFORM THAT ARE TAKING PLACE
NOW CHANGES TO MEDICAL NECESSITY
CRITERIA FOR YOUNG PEOPLE IN OUR
CHILD WELFARE SYSTEM, THE
COMMUNITY SUPPORT TRANSITIONAL
RENT, WHICH IS A NEW ASPECT THAT
HELPS US IN IT TOGETHER, THE
HOUSING NEEDS AND THE OTHER
CLINICAL NEEDS OF SO MANY
INDIVIDUALS. AND FIRST IN THE
NATION JUSTICE INITIATIVE THAT
COUNTY IS AND THE DEPARTMENT
UNDER DIRECTOR BOSSES LEADERSHIP
ARE PREPARING TO IMPLEMENT THE
CHILDREN YOUTH BEHAVIORAL HEALTH
INITIATIVE. AH THE ALL KIDS
EVERY KID EVERY DAY, EVERY HOUR,
EVERY MINUTE KIND OF APPROACH TO
THE VIRTUAL PLATFORM, THE OFTEN
OVERLOOKED BUT MIGHTY AND
POWERFUL CONCEPT OF A FEE
SCHEDULE WHEREIN WHERE SERVICES
ARE DELIVERED IN SCHOOLS
DIRECTLY TO YOUNG STUDENTS THAT
THEIR REIMBURSABLE NOT JUST BY
MEDICAID BUT BY COMMERCIAL PLANS
AS WELL. KIND OF CATAPULTING OUR
ABILITY TO NOT JUST HAVE IN
THEORY SERVICES, BUT HOPEFULLY
AT SCALE. UH THE CARE ACT
GETTING READY TO ROLL OUT AND
EIGHT COUNTIES BY THE END OF THE
YEAR. UH TOP OF LOTS OF
DISCUSSION LAST YEAR, CREATING A
PATHWAY. FOR THOSE WITH SOME OF
THE MOST SEVERE NEEDS TO GET THE
FULL COMPLEMENT OF A PLAN THAT
THEY NEED, UH, STRONGER
BENEFICIARY PROTECTIONS UNDER
DMH. SEE THIS LEGISLATURE IN
THIS GOVERNOR HAVE ADVANCED KEY
PIECES OF LEGISLATION THAT LOOK
AT NOT JUST ACCESS BUT TIMELY
ACCESS THE ABILITY OF THAT
DEPARTMENT TO DO ROUTINE SURVEYS
NON ROUTINE SURVEYS TO HOLD
ACCOUNTABLE OUR HEALTH PLANS SO
THAT AVERAGE CALIFORNIANS
WHETHER THEY'RE MEDICAID
BENEFICIARIES OR COMMERCIAL
BENEFICIARIES ARE GETTING WHAT
THEY NEED A LOT OF WORK TO DO
THERE, BUT WE HAVE THE TOOLS TO
REALLY MAKE A DIFFERENCE. STATE
HOSPITALS DEPARTMENT. I'M REALLY
PROUD OF FOR THEIR
TRANSFORMATION OF WHAT THEY'VE
MEN DOING, LOOKING AT COMMUNITY
, UH, OPPORTUNITIES TO RESTORE
AND BE SUPPORTED, NOT JUST STATE
HOSPITAL SOLUTIONS. UH, THE
MODEL MEDICAID MANAGED CARE
CONTRACT THAT IS REALLY GETTING
STARTED IMPLEMENTED STARTING IN
JANUARY THAT DIRECTOR BOSSES
DEPARTMENT IS WORKING HARD WITH
MEDICAID MANAGED CARE PLANS
ACROSS THE STATE TO MAKE SURE
THAT BEHAVIORAL HEALTH ISN'T AN
AFTERTHOUGHT THAT THAT
REQUIREMENT TO FOCUS ON MILD AND
MODERATE SERVICES IS REAL. THAT
WE HOLD THEM TO ACCOUNT AND
THERE'S INVESTMENTS. THE
WORKFORCE PROGRAMS THAT KATIE ON
THE PRIOR PANEL REFERENCED AT H
CHI LOOKING AT NOT JUST HOW DO
WE GET MORE OF WHAT WE ALREADY
KNOW? BUT HOW DO WE BUILD NEW
CLASSIFICATIONS, WHETHER IN
SCHOOLS FOR YOUNG PEOPLE FOR
OLDER CALIFORNIANS AND THE UH,
THE 988 SYSTEM THAT IS ROLLING
OUT AND A NUMBER OF PEOPLE ARE
WORKING ON TO MAKE SURE WE HAVE
A THOUGHTFUL, WELL CONNECTED. NO
ONE FALLS THROUGH THE CRACKS
TYPE OF CRISIS SYSTEM, AND
LASTLY, THE BEHAVIORAL HEALTH
CONNECT PROPOSAL THAT IS BEING
PREPARED BY THE DEPARTMENT OF
HEALTH CARE SERVICES TO GO INTO
CMS LATER. TO PROVIDE MORE LOCAL
FLEXIBILITY AROUND BEHAVIORAL
HEALTH. PUSH THE ENVELOPE ON NOT
JUST FOCUSING ON THOSE
INSTITUTIONS. BUT HOW DO WE
TRANSITION PEOPLE OUT OF THOSE
INSTITUTIONS INTO MEANINGFUL?
COMMUNITY BASED CARE, WHICH IS
FRANKLY, THE OBJECT AND POINT OF
THE CONVERSATION TODAY, WHETHER
YOU LOOK AT THE BOND PART OF
THIS OR THE MENTAL HEALTH
SERVICES ACT REFORM UH, ALSO
WANT TO SAY THAT THE EQUITY
ANCHOR IN THIS AH, PROPOSAL IS
REAL. THERE ISN'T A THOUGHTFUL
DISCUSSION ON BEHAVIORAL HEALTH
THAT DOESN'T END UP CENTERING
AROUND EQUITY. THE
DISPROPORTIONALITY THE REAL
DIFFERENCES IN WHO'S IMPACTED
AND WHO'S GETTING SERVICE AND
ACCESS, I THINK ELEMENTS OF OUR
PLANNING PROCESS THAT ARE
PROPOSED IN THIS, UH, PROPOSED
CHANGED MHS, A TURNING INTO THE
BEHAVIORAL HEALTH SERVICES ACT,
UNDERSCORING ONE OF THE POINTS
THAT THE PRIOR PANEL MADE AS
WELL, THIS BROADER VIEW OF WHAT
MENTAL HEALTH HAS BECOME THAT
IT'S CONNECTED DEEPLY TO
SUBSTANCE USE DISORDERS AND,
FRANKLY, WE TALK ABOUT
INTEGRATION OF THE EVER HEALTH.
AS MENTAL HEALTH AND SUBSTANCE
USE DISORDER. BUT LET'S NOT
FORGET THAT IMPORTANT
INTEGRATION WITH THE REST OF THE
HEALTH CARE DELIVERY SYSTEM, AND
I THINK THIS PROPELS US IN IN
THAT DIRECTION FOR SURE. I THINK
THAT ABILITY TO USE THE EQUITY
LENS NOT JUST TALK ABOUT IT, BUT
TO REQUIRE INVESTMENTS IN
INVESTIGATION AND HOWARD
DELIVERING AND REDUCING
DISPARITIES. WHAT DOES THE DATA
SHOW? NOT JUST CAN WE CAN WE ARE
PRESENTED, BUT HOW DOES THAT
DATA ACTUALLY DRIVE THE PLANS AT
THE LOCAL LEVEL TO MAKE UH,
CHANGES IN THEIR INVESTMENTS TO
ADD DIFFERENT PROGRAMS AND TO
SCALE THOSE THAT WE KNOW WORK.
UH I WANT TO USE A LITTLE BIT OF
MY TIME TO, UH, KIND OF TALK
ABOUT WHAT MIGHT LOOK DIFFERENT
IN THE FUTURE AS A RESULT OF
THIS PROPOSAL. UH, I THINK IT'S
PROBABLY THE MOST
STRAIGHTFORWARD WAY TO ADDRESS
SOME OF THE EXCITEMENT, SOME OF
THE CONCERNS AND, UM SOME OF THE
CRITIQUE AROUND THE PROPOSAL
THAT I KNOW A NUMBER OF YOU GUYS
ON THE PANEL AND YOUR COLLEAGUES
THROUGHOUT THE LEGISLATURE ARE
DIGGING INTO UM, SO TODAY I
THINK IT GOES WITHOUT SAYING WE
HAVE A HARD TIME TRACKING THE
MONEY. UH WHERE ARE MHS A
DOLLAR'S GOING? WHAT ARE THEY
SPENT ON AND HOW MUCH YOU
COUNTIES HAVE SAVED UP? TOMORROW
THIS INFORMATION WILL BE CLEAR,
PRESENTED TRANSPARENTLY TO
LEADERS TO THE PUBLIC AND
IMPORTANTLY TO THOSE WHO STAND
MOST TO BENEFIT FROM THE
SERVICES BENEFICIARIES AND THEIR
FAMILIES. TODAY WE CAN'T REALLY
TELL WHAT WE'RE GETTING FOR
THOSE BILLIONS OF DOLLARS OF
INVESTMENT PER YEAR. UH THROUGH
THE RADICALLY TRANSFORMED
ACCOUNTABILITY REQUIREMENTS. IN
THIS PROPOSAL, WE WILL NOT ONLY
HAVE A SENSE OF WHERE THOSE
FUNDS ARE BEING SPENT. BUT ON
WHAT AND FOR WHOM? FURTHER.
WE'LL HAVE THIS, UH INFORMATION
COLLECTED REGULARLY AND WILL BE
ABLE TO TELL WELL WHAT ACTUALLY
DID THOSE EARLY INTERVENTION
PROGRAMS TO FOR YOUNG PEOPLE
THAT WE TARGETED AND FOCUSED ON
IN THOSE INVESTMENTS? UH DID
THEY REDUCE THE HOSPITALIZATIONS
THAT WE'VE SEEN CONTINUE TO GO
UP AND UP AND UP EACH YEAR HOW
MANY BLACK CALIFORNIANS WITH
SERIOUS BEHAVIORAL HEALTH
CONDITIONS? EXPERIENCING
HOMELESSNESS DID WE GET INTO
PERMANENT SUPPORTIVE HOUSING?
HOW ARE WE DOING ADDRESSING THAT
CLEAR DISPROPORTIONALITY AND THE
DATA BUT WHETHER YOU LOOK AT IT
FROM A HOUSE, HOMELESSNESS LENS
OR FROM A BEHAVIORAL HEALTH
BLENDS, UH, TODAY SUBSTANCE USE
DISORDER PROGRAMS AND SERVICES
CAN ONLY BE FUNDED THROUGH
MENTAL HEALTH SERVICES ACT
DOLLARS. IF THEY'RE CONNECTED TO
A CO ACCORDANCE OR TELE CREATING
DISORDER. TOMORROW COUNTIES WILL
HAVE THE OPPORTUNITY TO SUPPORT
THOSE WITH SUBSTANCE USE
DISORDERS, EVEN IF THEY DON'T
HAVE IT OR YET HAVE A CO
OCCURRING DISORDER. THIS MEANS
YOUNG PEOPLE WHO MIGHT BE
EXPOSED TO OR EARLY IN THEIR
SUBSTANCE MISUSE. UH, CAN
RECEIVE SERVICES IMMEDIATELY. UH
AS A FATHER OF FOUR, A
PEDIATRICIAN WHO IS TAKING CARE
OF LOTS OF YOUNG PEOPLE WITH
THOSE EARLY CONCERNS ISSUES OF
SUBSTANCE MISUSE, KNOWING THAT
THESE FUNDS COULD BE USED TO
SUPPORT THOSE, UH, YOUNG PEOPLE
IN THEIR JOURNEY OF GETTING
SUPPORT AND CARE EARLY, I THINK
IS REALLY IMPORTANT AND JUST
MAKES SENSE. TODAY COUNTY IS
CERTAINLY INVEST SOME OF THEIR
MHS A FUNDING IN HOUSING
INTERVENTIONS. SOME OF THIS
FUNDING IS IN UNIQUE PROGRAMS.
OTHERS ARE ATTACHED PROGRAMS
LIKE THEIR FULL SERVICE
PARTNERSHIP PROGRAM, EVEN IN
COUNTIES WHO STRETCHED
THEMSELVES TO INVEST IN HOUSING
. IT'S NOT ALWAYS AN EXPLICIT
PRIORITY. AND YES, I USE THE
WORD SERVICE WITH HOUSING VERY
DELIBERATELY. I'VE HEARD IN THE
CRITIQUE THAT WE'RE SHIFTING
MONEY FROM SERVICES TO HOUSING.
THE TRUTH IS, IF YOU ENGAGE WITH
THOSE PRACTITIONERS WHO ARE
WORKING WITH PEOPLE WITH SEVERE
BEHAVIORAL HEALTH CONDITIONS
EXPERIENCING HOMELESSNESS. MANY
OF THEM WOULD SAY THE SERVICE
THAT PERSON NEEDS THE MOST IS TO
BE HOUSED. THAT HELPS THEM FIND
STABILITY THAT HELPS THEM. STAY
UH ON THE PLAN AND THE PROGRAM
TO CONTINUE TO HOPEFULLY BEND
THE ARC OF THEIR LIFE TOWARDS
STABILITY AND, UH, COMMUNITY
ENGAGEMENT. I KNOW THAT DR.
CRUCIAL MENTIONED THE DATA THAT
BEFORE THIS STUDY, WE WOULD.
REGULARLY QUOTE THE FIGURE OF
ONE THIRD OF CALIFORNIANS
EXPERIENCING HOMELESSNESS HAD A
SERIOUS BEHAVIORAL HEALTH
CONDITION. I THINK THE STUDY'S
DATA SHOW THAT WE PROBABLY HAD
AN UNDERESTIMATE AND THAT THE
HOUSING INSTABILITY OF THOSE
WITH SERIOUS BEHAVIOR. HEALTH
CONDITIONS IN CALIFORNIA IS EVEN
GREATER THAN WE WANT. ONCE
THOUGHT, UH, FOR FSP. UH THE
FUTURE IS LOOKING DIFFERENT. WE
TODAY HAVE FULL SERVICE
PARTNERSHIP PROGRAMS OF MANY
DIFFERENT VARIETIES. YOU'VE SEEN
ONE COUNTIES PROGRAM. YOU'VE
SEEN ONE COUNTIES PROGRAM. YOU
DO NOT HAVE A STATEWIDE
APPROACHED FULL SERVICE
PARTNERSHIP TOMORROW. AS A PART
OF THIS PROPOSAL, WE WILL HAVE
SIGNIFICANT STANDARDS STATEWIDE
BEGIN TO IN MANY WAYS REQUIRE
CERTAIN COMPONENTS TO FSP THAT
DON'T EXIST TODAY IN
COLLABORATION CREATING DIFFERENT
LEVELS, SO PEOPLE AS DR KUSHELL
MENTIONED CAN SORT OF SCALE UP
AND DOWN ON THE NEEDED LEVEL OF
SERVICE, INCLUDING DIFFERENT
ELEMENTS LIKE ENGAGEMENT AND
OUTREACH, ENSURING THAT SOME OF
THOSE IMPORTANT OUTPATIENT
SERVICES THAT WE'VE ALSO BEEN
TALKING ABOUT ARE BUILT IN TO
THOSE FSP LEVELS LOOK FORWARD TO
CREATING A MORE STANDARD
EXPECTED SET OF PRACTICES AROUND
FSP. UH, AND I WILL END WITH THE
FOCUS ON THE PLANNING PROCESS.
UH SO MUCH OF WHAT GOES INTO THE
PLANNING PROCESS TODAY IS DONE
COUNTY BY COUNTY IN THEIR OWN
IMPORTANT AND UNIQUE WAYS, BUT
THAT PLANNING PROCESS DOESN'T
ALWAYS HAVE THE REPRESENTATIVE
VOICES. THAT I THINK MANY OF US
VALUE, ESPECIALLY FROM AN EQUITY
LENS AT THAT TABLE, THE PLANNING
PROCESS BEING PROPOSED NOT ONLY
FOCUSES ON HOW DO WE HAVE
STANDARD OUTCOME STATEWIDE OR
LOCALLY DRIVEN OUTCOMES BASED ON
THE DATA, OR HOW DO WE HAVE A
THREE YEAR PLAN THAT BUILDS ON
THE PRIOR THREE YEAR PLAN? IT
INVITES A WHOLE SET OF
STAKEHOLDERS TO THE TABLE TO
CONTRIBUTE TO THAT PLAN. AND AS
I HEAR THE FEARS OF THIS PROGRAM
POTENTIALLY BEING CUT OR THAT
PROGRAM BEING CUT. NOTHING IN
THE PROPOSAL REQUIRES A SET OF
PROGRAMS TO BE CUT. BUT TO HAVE
THE DRIVER OF WHAT A LOCAL
COUNTIES BEHAVIORAL HOUSE
SERVICES PLAN LOOKS LIKE HOW IT
ENGAGES AND INTERACTS WITH THE
OTHER PARTS OF THEIR BEHAVIORAL
HEALTH SYSTEM. INCLUDE THE
VOICES OF SO MANY GROUPS THAT
DON'T ALWAYS HAVE THAT SORT OF,
UH, ACCESS AND AH, IF WE BELIEVE
IN THE CONCEPT THAT EQUITY IS
EMPOWERING GROUPS WHO DON'T HAVE
POWER HAVING A SEAT AT THAT
TABLE, AND THAT VOICE I THINK IS
A MANIFESTATION OF THAT EQUITY
PRINCIPLE THAT I KNOW SO MANY OF
US. BELIEVE AND SUPPORT. SO I
ALSO WANT TO JUST SAY THAT A LOT
HAS CHANGED IN 20 YEARS. THAT IF
WE WANT TO SEE THE EFFORTS OF
MANY OF THE IMPORTANT PROGRAMS
IN CALIFORNIA THAT HAVE BEEN
INTRODUCED THAT ARE EITHER
ALREADY IMPLEMENTED OR IN FLIGHT
. WE CAN'T EXPECT TO JUST DO
THINGS THE SAME WAY. TODAY THIS
PROPOSAL THAT YOU ARE
CONSIDERING HELPING US IMPROVE
THROUGH AMENDMENTS AND OTHER
CONSIDERATIONS, I THINK REALLY
HAS A CHANCE TO HELP GUIDE IT
ISN'T THE ONLY THING THAT
MATTERS IN BEHAVIORAL HEALTH MHS
A OFTEN AS REPRESENTED ABOUT ONE
IN THREE, MAYBE ONE IN $4 IN OUR
PUBLIC BEHAVIORAL HEALTH SYSTEM.
BUT IT IS THE GROUT AS I LIKE TO
CALL IT. IT IS THE PIECE THAT
ALLOWS US TO BRAID AND BLENDS SO
MANY OTHER PROGRAMS TOGETHER, SO
RECOGNIZING THE NEW
OPPORTUNITIES ACROSS CALIFORNIA
TO, UH TO ADVANCE OUR LEVERAGE
OF MEDICAID, OUR BLENDING OF
BRAIDING OF OTHER HEALTH AND NON
HEALTH DOLLARS. I THINK THAT
TIME IS NOW. CONSIDER THESE
CHANGES TO CONSIDER HOW WE CAN
CREATE THE KIND OF FLEXIBILITY
THAT COUNTIES HAVE BEEN ASKING
THE KIND OF ACCOUNTABILITY THAT
CALIFORNIANS HAVE BEEN ASKING
FOR IN OUR PURSUIT OF A SYSTEM
THAT I THINK WE CAN ALL BE PROUD
OF ONE THAT NOT ONLY, UH IS
RELIABLE WHO NEED THE SERVICE
TODAY. BUT IT HAS THE CAPACITY
TO MEET THE NEED OF SO MANY
TOMORROW. UH SO WITH THAT WRAP
UP AND JUST THANK YOU FOR YOUR
TIME. THANK YOU, DR GALLEY. WE
HAVE A COUPLE OF MEMBERS. I KNOW
WHO HAVE QUESTIONS. I DO AS
WELL. BUT I'LL SAVE MINE TOWARDS
THE END. I THINK DR ARAMBULA WAS
FIRST. THANK YOU, UM FIRST. IF I
MAY. I WANT TO APPRECIATE THE
ADMINISTRATION FOR THE MENTAL
HEALTH MOVEMENT THAT WE'RE IN
THE MIDST OF WHETHER OR NOT IT'S
THE MENTAL HEALTH STUDENT
SERVICES ACT CHILDREN'S IN THE
YOUTH BEHAVIORAL HEALTH
INITIATIVE. THE B CHIP, THE
BEHAVIORAL HEALTH INFRASTRUCTURE
DOLLARS THAT WE'RE MAKING OR
MANY OF THE 988 AND SCHOOL
DEMONSTRATION PROJECTS. THIS
ADMINISTRATION HAS DONE MORE FOR
MENTAL HEALTH THAN ANY PREVIOUS
ADMINISTRATION. AND SO BEFORE I
BEGIN MY COMMENTS, I JUST WANT
TO ACKNOWLEDGE THE EFFORTS THAT
THIS ADMINISTRATION HAS DONE THE
HISTORIC UM, ATTENTION THAT
YOU'VE PAID TO THE CRISIS THAT'S
BEFORE US. BUT WE SPOKE ABOUT
EQUITY AND WE KNOW THAT THAT
WHICH IS NOT, UM, MEASURED
CANNOT BE IMPROVED, AND
CURRENTLY WE HAVE MANY DATA GAPS
WITHIN THE E C. ARE THE DATA
COLLECTION REPORTING? AS
REPORTED BY MH AS AWAY SEE, A
THIRD OF ALL THE DATA THAT'S
REPORTED DOESN'T HAVE ANY TYPE
OF DEMOGRAPHIC DATA ON RACE, AND
IT MAKES IT AWFULLY DIFFICULT
FOR US TO MAKE IMPROVEMENTS. IF
WE'RE NOT, UM, GETTING THE
IMPORTANT INFORMATION BACK, AND
SO I'M HOPING YOU CAN SPEAK TO
THE COMPREHENSIVE BEHAVIORAL
HEALTH DATA SYSTEMS PROJECT AND
THE OPPORTUNITIES FOR US WITHIN
THAT PROJECT TO BETTER COLLECT
DATA AS WELL AS IF THERE ARE ANY
OUTCOME MEASURES THAT WE'RE
LOOKING TOWARDS TO INCLUDE INTO
THAT PROJECT TO ENSURE THAT WE
ARE COLLECTING ALL OF THE
APPROPRIATE INFORMATION BACK. IF
YOU WANT EXAMPLES OF THOSE
OUTCOME MEASURES HAPPY TO
PROVIDE WITH THE MHS AWAY. SEE
HAS BUT JUST WANT TO MAKE SURE
THIS PROJECT HAS THE CAPABILITY
TO COLLECT THE INFORMATION THAT
WE REQUEST. UH FIRST APPRECIATE
THE ACKNOWLEDGEMENT OF THE
TREMENDOUS EFFORT BY THE
ADMINISTRATION AND THE
LEGISLATURE IN PARTNERSHIP
HEARING THE VOICES OF SO MANY
CALIFORNIANS TO FRANKLY ARE
DEMANDING US TO DO SOMETHING
DIFFERENT THAN WE HAVE DONE
TODAY. UH, AND, UH, I ALSO
APPRECIATE THE QUESTION ABOUT
DATA AND EQUITY IN THAT DATA.
THERE HAVE BEEN, UH, IN THE PLAN
THAT IS BEING REQUIRED. IT IS
REALLY MEANT TO BE DATA DRIVEN.
BUT TO YOUR POINT IF THEY DON'T
HAVE THE DATA, WHAT IS DRIVING
THE PLAN? SO THERE ARE
COMPONENTS HERE THAT REQUIRE US
TO BUILD OUT THE NUANCED DATA
BROKEN DOWN BY RACE AND
ETHNICITY. WE HAVE HEARD FROM
STAKEHOLDERS VERY RECENTLY ABOUT
THE NEED TO DO THAT, IN A FINER,
MORE EXACTING WAY AND APPRECIATE
THE OPPORTUNITY. TO CREATE THAT
PRECISION WITHIN THE LAW THAT
REQUIRES COUNTIES TO LOOK AT AND
COLLECT DATA BASED ON RACE AND
ETHNICITY, SEXUAL ORIENTATION
AND GENDER IDENTITY LANGUAGE. AH
WHETHER IT'S AVAILABLE IN A WIDE
SERVICES ARE AVAILABLE IN A
WIDER RATE ARRAY OF LANGUAGES. I
THINK PART OF WHAT WE PROPOSE
HERE IS ALSO TO SET SOME
STATEWIDE OUTCOME MEASURES. WE
ALSO EXPECT AND HOPE THAT
COUNTIES WELL IN THEIR
INDIVIDUAL WAY COME UP WITH SOME
OUTCOME MEASURES AS WELL THAT
ARE FOCUSED ON EQUITY AND DRIVEN
BY DATA. BUT THE POINT I THINK
THAT YOU MAKE THAT IS NOT JUST
MOST COMPELLING, BUT MOST URGENT
IS WE NEED TO UP OUR GAME IF YOU
WILL, AND THE ABILITY TO COLLECT
THAT DATA. COUNTIES DON'T
NECESSARILY HAVE THE
INFRASTRUCTURE AND THE ABILITY
TO DO IT TODAY. AND FRANKLY
SPEAKING, THE STATE DOESN'T HAVE
THE INFRASTRUCTURE THAT TO
DIGEST THAT DATA, EVEN IF WE
WERE TO RECEIVE IT, SO PART OF
WHAT IS THE UNDERBELLY OF A LOT
OF THIS PROPOSAL IS A COMMITMENT
TO BUILDING THE INFRASTRUCTURE
AT THE LOCAL LEVEL AND AT THE
STATE LEVEL TO DO EXACTLY THAT,
BECAUSE TODAY, FRANKLY, WE DON'T
HAVE THE ABILITY TO DO SOME OF
IT IN THE WAY THAT I THINK IS
EXPECTED AND EMBEDDED IN THIS
PROPOSAL IS THAT CAPABILITY I
APPRECIATE THAT, AND I BELIEVE
IT'S IMPORTANT FOR US TO
DISAGGREGATE MUCH OF THAT DATA.
I OFTENTIMES HAVE TO REMIND
PEOPLE LATINOS ARE NOT
MONOLITHIC AND OFTENTIMES
INCLUDE MANY INDIGENOUS TRIBES
THAT SPEAK DIFFERENT LANGUAGES
AND OUR ABILITY TO DISAGGREGATE
. THAT DATA ALLOWS US TO BETTER
THAN SERVE OUR COMMUNITY. FOLLOW
UP ON DATA IF I CAN WHEN WE LOOK
AT FULL SERVICE PARTNERSHIPS
FROM 2016 TO 2021. WE SEE A
SIGNIFICANT PORTION OF THOSE NEW
FULL SERVICE PARTNERSHIPS ARE
COMING FROM BOTH CHILDREN AND
TRANSITIONAL AGE YOUTH 45% FOR
CHILDREN AND 22% FOR
TRANSITIONAL AGE YOUTH. WITH
THAT KNOWLEDGE OF F SPS. SHOULD
WE BE LOOKING AT A CERTAIN SET
ASIDE A PERCENTAGE FOR F SPS TO
BE SPENT ON CHILDREN AND
TRANSITIONAL AGE USED. SHOULD WE
BE LOOKING AT A SET ASIDE WITHIN
HOUSING OVERALL THAT WE'RE
LOOKING AT FOR TRUE CHILDREN AND
TRANSITIONAL AGE YOUTH? SHOULD
WE BE LOOKING AT A PERCENTAGE
OVERALL OF BHS, A. TO FOCUS OUR
ATTENTION ON GETTING UPSTREAM
AND PROVIDING RESOURCES TO THOSE
WHO NEED THE RESILIENCY. I
SPEAKING TO YOU AS A
PEDIATRICIAN AND FATHER BUT KNOW
THAT IT'S IMPORTANT FOR US AS A
SYSTEM TO BE MAKING THE
INVESTMENTS WHERE THEY COUNT THE
MOST AS WELL. FIRST OFF. I WANT
TO HIGHLIGHT THAT THROUGH THE
LAST MANY WEEKS AND MONTHS,
FRANKLY, AND DEEP ENGAGEMENT
WITH MANY OF YOU YOUR TEAMS AND,
UH VARIOUS STAKEHOLDERS ACROSS
THE STATE. UH, REALLY? FOCUSING
THOSE EARLY INTERVENTION AND
PREVENTION DOLLARS, UH, THAT ARE
SET ASIDE IN THE ACT TO BE SET
ASIDE FOR THOSE 25 AND YOUNGER,
UH, IT MAKES SO MUCH SENSE TO DO
THAT. IT IS THE HISTORY OF WHAT
SO MANY FOLKS HAVE FOUGHT FOR IN
THE EVOLUTION OVER THE LAST 20
YEARS OF THE REFORM. TO MAINTAIN
THAT AND NOT JUST ALLOW IT TO BE
IN REGULATION, BUT TO PUT IT IN
THE LAW HAS BEEN IMPORTANT AS IT
RELATES TO FULL SERVICE
PARTNERSHIPS AND HOUSING
SPECIFICALLY, UH, THERE ARE
NEEDS ACROSS THE STATE. FOR SO
MANY GROUPS. WE OFTEN TALK ABOUT
THE NEEDS OF YOUNG PEOPLE AND
THE ESPECIALLY THOSE L G B T Q
YOUTH, A YOUTH YOUTH
TRANSITIONING OUT OF SYSTEMS
WELL ACCOUNTED FOR THE HOUSING
NEEDS AND REQUIRING THAT IN THE
PLANNING PROCESS BOTH FOR FSP
AND HOUSING THAT WE HAVE AND
ACKNOWLEDGEMENT OF THAT
DISPROPORTIONALITY THAT EXTRA
IMPORTANT NEED AND HOW COUNTIES
ADDRESS IT, WE THINK IS
IMPORTANT. SIMILARLY ON THE
OTHER END OF THE AGE SPECTRUM,
WE KNOW AND DR CASTLES STUDY.
DEMONSTRATES THAT THE FASTEST
GROWING GROUP OF PEOPLE
EXPERIENCING HOMELESSNESS ARE
OLDER CALIFORNIANS OVER THE AGE
OF 50. UM HOW DO WE PAY
ATTENTION TO THAT CLEAR
DEMOGRAPHIC AND ITS INTERSECTION
WITH THE ABRA HEALTH. SO UM, THE
QUESTION ISN'T ONE JUST ABOUT
SET ASIDES AND, UH, APPROACHES
TO MAKING SURE THAT A MINIMUM
DOLLAR AMOUNT GOES TO A SPECIFIC
GROUP. BUT I THINK THIS FOCUS ON
HOW DO WE GET THE NUANCED DATA?
THE DISAGGREGATED DATA TO BE
USED AT THE LOCAL LEVEL TO DRIVE
THE PLAN. AND PAYING ATTENTION
CLEARLY WITH POIGNANT QUESTIONS
EXPECTATIONS IN THAT PLANNING
PROCESS TO CONSIDER SOME OF THE
THINGS OTHERS AS WELL, BUT SOME
OF THE THINGS THAT YOU JUST
MENTIONED, WE BELIEVE IS AN
IMPORTANT, UH BOTH IMPROVEMENT
AND STRENGTHENING OF THE
PROPOSAL, WHILE WE ALSO ALLOW
FOR THE UNIQUE NEEDS COUNTY BY
COUNTY TO DRIVE WITHOUT, YOU
KNOW, A PRESCRIBED SET ASIDE
HERE OR THERE FOR THE MANY
DIFFERENT ENTITIES OR GROUPS
THAT NEEDED. I WILL JUST SAY
THAT THE ABILITY TO USE BOTH CAL
AIM BH CONNECT SO MANY OF THE
OTHER INVESTMENTS AS WELL AS THE
BEHAVIORAL HEALTH SERVICES ACT
FUNDING. TO HELP SOLVE THE
HOUSING AND SERVICE NEEDS OF
YOUNG PEOPLE WHO HAVE SERIOUS
BEHAVIORAL HEALTH, SUBSTANCE USE
DISORDER AND MENTAL HEALTH
CONDITIONS IS REAL, AND IT'S AN
OPPORTUNITY WE EXPECT COUNTIES
TO BUILD IN DEEPLY IN THEIR
PLANS. EARLIER YOU SAID THAT WE
COULD USE THESE FUNDS TO ADDRESS
CHILDREN AND TRANSITIONAL AGE
YOUTH, BUT I'M REALLY TRYING TO
ASK, SHOULD WE MANDATE AND MAKE
IT AN EXPLICIT PRIORITY HEARING
FROM THE STAKEHOLDERS THAT HAVE
PARTICIPATED THIS YEAR WITH VHS
A. SHOULDN'T WE MAKE THAT INTO
THE PLAN AND PRIOR TO ALLOWING
THAT COMMUNITY PROCESS TO BEGIN.
OR. ARE THERE? UM CONSEQUENCES
TO US DOING? THAT IS WHAT I'M
TRYING TO MAKE SURE BECAUSE
OTHERWISE. MY CONCERN IS WE'RE
NOT GOING TO BE PRIORITIZING
WITH THE INTENTIONALITY THAT'S
NEEDED TO FOCUS ON THIS
POPULATION AND THEIR NEEDS AS
WELL. I THINK ONE OF THE DRIVERS
WE WANT TO MAKE SURE WE PRESERVE
HERE IS THE LEVEL OF FLEXIBILITY
THAT IS REALLY COLD FOR AND
NEEDED COUNTY BY COUNTY THAT
SAID, I'M SENSITIVE AND ACUTELY
AWARE OF YOUR POINT. THAT
FLEXIBILITY MEANS THAT YOU MAY
DECIDE NOT TO INVEST. IN ONE
REALLY IMPORTANT AREA OR GROUP
OR PROGRAM. BECAUSE FOR WHATEVER
REASON IN THAT COUNTY, IT WASN'T
FOCUSED ON. UM I THINK OUR
SOLUTION TO THAT IS BUILDING IN
, UM, REALLY POIGNANT AND
REQUIRED QUESTIONS OR COMPONENTS
OF THE PLAN THAT SAY, HOW DID
YOU DISTRACT? UM ADDRESS THIS
DISPROPORTIONALITY IN HOUSING
SERVICES FOR YOUNG PEOPLE OR
OLDER CALIFORNIANS? SO I THINK,
CREATING A TABLE WHERE SPECIFIC
AREAS ARE CLEARLY ADDRESSED,
RESPONDED TO IN THE PLAN
SUBMITTED TO THE STATE FOR HOW
THESE DOLLARS ARE USED,
SAFEGUARD AROUND OVERLOOKING
SOME OF THOSE KEY THINGS WHILE
MAINTAINING THAT FLEXIBILITY. UM
SO APPRECIATE THIS TENSION
OBVIOUSLY HAVE STRUGGLED THROUGH
IT OURSELVES QUITE A BIT. AND
FEEL THAT THE SOLUTION THAT I
JUST SHARED IS ONE THAT HELPS US
ENSURE THAT WE'RE NOT ALLOWING
US TO BLINDLY OVERLOOK A REALLY
IMPORTANT GROUP THAT HAS
HISTORIC DISPROPORTIONALITY
WHILE CREATING THE FLEXIBILITY
THAT COUNTIES FINAL QUESTION IF
I CAN, UM, YOU SPOKE ABOUT THE
INTEGRATED PLAN FOR BEHAVIORAL
HEALTH SERVICES AND OUTCOMES.
THE NEW STAKEHOLDER UM,
ENGAGEMENT THAT'S COMING FORWARD
. ARE THERE OPPORTUNITIES WITHIN
THAT TO BUILD IN THOSE OUTCOMES
THAT YOU WERE JUST SPEAKING
ABOUT? COULD WE UM, REQUIRE. HOW
MUCH THEY SPENT ON CHILDREN AND
YOUTH AS AN EXAMPLE OF THEIR
FUNDING AT THE COUNTY LEVEL AS
ONE OF THE REQUIREMENTS OF THE
PLAN. COULD WE LOOK TOWARDS WHAT
MHS ALWAY SEE, HAS SAID THE
FREQUENCY AND LOCATION OF
SERVICES INCREASED HOUSING,
REDUCED JUSTICE INVOLVEMENT AND
INCREASED SOCIAL CONNECTEDNESS
AS METRICS FOR US TO AGAIN BACON
TO THAT STAKEHOLDER PROCESS TO
ENSURE THAT WE'RE FOCUSED ON THE
RIGHT GOALS AS A SYSTEM. SHORT
ANSWER IS ABSOLUTELY THE INTENT
OF CREATING STATEWIDE MEASURES
AND OUTCOME. MEASURES ARE TO DO
EXACTLY THAT. YOU CAN SIMPLY
SAY, WHAT IS THE OUTCOME? HOW
MUCH OF THIS PLAN WAS SPENT ON 0
TO 25 OR 0 TO 5? HOW MUCH ON
CALIFORNIANS OVER THE AGE OF 50
? WHAT WAS HOW DID THIS CHANGE
THE DATA OVER THREE YEAR PERIOD
AROUND PEOPLE WITH BEHAVIORAL
HEALTH CONDITIONS IN COUNTY. UH
CORRECTIONAL INSTITUTIONS. I
MEAN, WE HAVE THE ABILITY TO
CRAFT EXACTLY WHAT THOSE ARE
WITH STAKEHOLDER IMPORT. SO WE
HAVE SOME STATEWIDE NOUS TO THIS
AND IT'S NOT JUST LOCALLY DRIVEN
, BUT THERE'S ALSO THAT
OPPORTUNITY AT THE LOCAL LEVEL
TO CREATE THOSE IMPORTANT LOCAL
OUTCOMES THAT WE WILL ALSO
EXPECT ACCOUNTABILITY OF IT.
THANK YOU. THANK YOU NEXT, UH,
DOCTOR JACKSON, PLEASE. THANK
YOU VERY MUCH. MADAM CHAIR.
THANK YOU FOR BEING HERE. UM I
WANT TO ASSOCIATE MY WITH THE
REMARKS OF DR ARAMBULA
OBVIOUSLY. UM THE DATA IS CLEAR
THAT YOUTH ARE IN A MENTAL
HEALTH CRISIS THROUGHOUT THIS
NATION. AND I THINK MY FIRST
QUESTION IS THROUGH THIS
PROPOSAL, ESPECIALLY WHEN WE
LOOK AT SET ASIDES. IS THIS THIS
PROPOSAL SET ASIDE MORE MONEY OR
LESS MONEY FOR YOUTH. SO UM,
IT'S A REALLY IMPORTANT QUESTION
AND ONE FRANKLY, IT'S THE RUBBER
MEETS THE ROAD QUESTION FOR
YOUNG PEOPLE. UH IN IF YOU LOOK
AT THE PREVENTION AND EARLY
INTERVENTION DOLLARS IN TODAY'S
CURRENT MHS A, UH ALLOCATION. IT
IS, BY OUR ACCOUNT THE DOLLARS
IN THE PREVENTION BUCKET AND THE
EARLIER INTERVENTION BUCKET WHEN
BROUGHT TOGETHER IS ROUGHLY $700
MILLION DEDICATED TO THOSE
EFFORTS FOR YOUTH WERE IN IN THE
PRIOR MODEL. IT WAS CLOSER TO
630 MILLION. SO IN TOTAL AH,
WITH THE STATEWIDE PREVENTION,
UH, PROPOSAL AND 51% OF THE
BEHAVIORAL HEALTH SERVICES AND
SUPPORTS CATEGORY OF FUNDING AT
THE LOCAL LEVEL BEING DEDICATED
TO EARLY INTERVENTION, AND HALF
OF THAT FOCUSED ON PEOPLE UNDER
THE AGE OF 25. WHEN YOU BRING
THAT TOGETHER, WE SEE IT AS A
HIGHER NOT ONLY WILL INVESTMENT
FOR YOUNG PEOPLE IN THOSE TWO
AREAS, I DON'T WANT TO CONFLATE
THAT IN ANY WAY WITH PROPOSED
SET ASIDES FOR YOUNG PEOPLE OR
OTHER GROUPS WITHIN EITHER
HOUSING INTERVENTION BUCKET,
WHICH IS BRAND NEW AS YOU KNOW,
OR THE FULL SERVICE PARTNERSHIP.
CATEGORY OF FUNDING. BUT IF YOU
STRICTLY LOOK AT WHERE IN
TODAY'S REGULATION, THERE'S A
FOCUS ON YOUNG PEOPLE, THE
INVESTMENT WILL BE GREATER. NOT
JUST BECAUSE OF, UH INCREASED
DOLLAR AVAILABILITY. BUT WHEN
YOU LOOK AT THE PERCENTAGES ON
ANY AMOUNT OF DOLLARS IN ANY
YEAR, WE WOULD SEE MORE INVESTED
IN THOSE TWO AREAS FOR YOUNG
PEOPLE THAN WE DO TODAY. BUT
THANK YOU FOR THAT. UM OBVIOUSLY
, WE KNOW THAT, UM, OUR NATIVE
AMERICAN BROTHERS AND SISTERS
TOPPED THE CHARTS WHEN IT COMES
TO MENTAL HEALTH SUBSTANCE USE
THOSE ISSUES. AND THEN SECOND OR
AFRICAN AMERICANS. AND WHEN WE
TALK ABOUT IN TERMS OF MAKING
SURE THAT THIS IS ANCHORED IN
EQUITY, AND NOT TO MENTION THE L
G B T Q. UH HUH. COMMUNITY AS
WELL. WE KNOW THAT L G B T Q
STUDENTS WERE NEARLY FOUR TIMES
AS LIKELY. UM AS THEIR PEERS TO
ATTEMPT SUICIDE. UM WE KNOW THAT
IN THAT CONTINUES TO CLIMB,
WHERE IN THESE PROPOSALS REALLY
ADDRESS. WHAT WE KNOW ARE THE
UNIQUE NEEDS THAT AGAIN IF WE
CONTINUE TO JUST DO THIS ALL OF
THE ABOVE UNIVERSAL APPROACH
WILL NEVER GET TO EXACTLY WHAT
WE NEED FOR OUR NATIVE AMERICAN
BROTHERS OR SISTERS OR AFRICAN
AMERICANS AND OUR LGBTQ
COMMUNITIES. WHAT ARE WE
SPECIFICALLY DOING IN THIS
REFORM TO MAKING SURE THAT WE DO
NOT MISS OUT ON THE OPPORTUNITY
TO ENSURE THAT WE ARE MEETING
THOSE SPECIFIC NEEDS? I THINK A
FEW THINGS ARE CLEAR AND AGAIN
REFERENCING THE PLANNING PROCESS
REQUIRING COUNTIES IN THEIR
PLANNING PROCESS TO A INCLUDED
DIVERSE RANGE OF STAKEHOLDERS,
INCLUDING MEMBERSHIP FROM MANY
OF THE GROUPS HISTORICALLY
OVERLOOKED THAT YOU MENTIONED
SECONDLY, DRIVEN BY DATA. IF THE
LOCAL DATA AH AS THE LOCAL DATA
BEARS OUT SOME OF THE
DISPARITIES THAT YOU'RE
REFERENCING, MAKING SURE THAT
THE COUNTY PLANS ADDRESS THAT
DATA AND HOW THEY'RE ALLOCATING
AND SPENDING THE DOLLARS AND I'M
WHAT PROGRAMS AND THIRD IN THE
OUTCOMES WE HAVE THE ABILITY TO
MAKE SURE STATEWIDE OUTCOMES
ADDRESS THAT DISPROPORTIONALITY.
THE ONUS ON IS ON US AT THE
STATE LEVEL WITH OUR PARTNERS TO
CREATE WHAT THOSE OUTCOMES ARE,
AND THEN THE ABILITY TO HOLD
COUNTIES AND LOCAL, UM, PARTNERS
ACCOUNTABLE AROUND DELIVERING
THAT THE SECOND AREA OF
OPPORTUNITY HERE IS, UH, THE
INTERACTION BETWEEN THE EARLY
INTERVENTION DOLLARS THAT ARE
FOCUSED IN LARGE PART IN A
MAJORITY PART 51% ON YOUNG
PEOPLE UNDER THE AGE OF 25
MAKING SURE THAT UM, THAT THOSE
DOLLARS ARE INTERACTING WITH THE
OPPORTUNITIES WITH THE CHILDREN
YOUTH BEHAVIORAL HEALTH
INITIATIVE AND USING EVIDENCE
BASED PROGRAMS STIPULATED OR
REQUIRED AS PART OF EARLY
INTERVENTION PROGRAMMING UNDER
BHS S¼. TO ENSURE THAT THEY ARE
BUILT INTO THE FEE SCHEDULE AND
THAT THEY HAVE AN ONGOING
FUNDING SOURCE THROUGH PLAN AND
MEDICAID MEDICAID PAYMENTS IN
THE FUTURE TO ENSURE THAT NOT
ONLY ARE THEY THERE FOR A THREE
YEAR PLANNING CYCLE, BUT THEY
HAVE AN OPPORTUNITY TO CONTINUE
ON ADDRESSING OUR ABILITY TO
MEET THE NEEDS OF THOSE OFTEN
OVERLOOKED OR UM AH, INVISIBLE
GROUPS IN A SCHOOL SETTING WHERE
THEY OFTEN INTERACT AND HAVE
RELATIONSHIPS, SO WE THINK THAT
THERE IS A NUMBER OF PLACES
WHERE THIS PROPOSAL NOT JUST
UNDERSCORES OUR FOCUS ON SOME OF
THAT DISPROPORTIONALITY THAT
YOU'RE MENTIONING, BUT ALSO
ALLOWS THE BHS A DOLLARS TOO.
WORK WELL WITH OTHER PROGRAMS
THAT WE ALREADY HAVE EXISTED.
AND IF I JUST MAY MAY ADD, WE
REALLY HAVE UPLIFTED THE
COMMUNITY DEFINE PRACTICES AS
MODELS THAT WE WANT TO SEE. KIND
OF, YOU KNOW, SCALE IN THE STATE
, SO IN FULL SERVICE
PARTNERSHIPS, REALLY IDENTIFYING
THAT COMMUNITY DEFINED PRACTICES
AS WELL AS EVIDENCE BASED
PRACTICES ARE USED AS PART OF
THE MODEL TODAY F SPS THAT THAT
SPACE GENERALLY ISN'T REALLY
KIND OF FILLED WITH COMMUNITY
DEFINED PRACTICES, SO PROVIDING
REALLY THE OPPORTUNITY TO WHAT
ARE THE KIND OF THE
INTERVENTIONS THAT MIGHT MEET A
PARTICULAR POPULATIONS NEEDS AND
KIND OF WAYS OF ENGAGEMENT
INCLUDE BEING THAT THERE AND
THEN ALSO, YOU KNOW, OVER THE
LAST COUPLE OF DAYS AND WEEKS,
WE'VE BEEN MEETING WITH VARIOUS
CONSUMER ADVOCATES AND WANTING
TO ACTUALLY PUT STRENGTHEN SOME
OF OUR LANGUAGE A LITTLE BIT
MORE WITH REGARD TO COMMUNITY TO
FIND PRACTICES, SO FUTURE
AMENDMENTS ON THAT WILL BE
FORTHCOMING. AH UM, EXCITED TO
HEAR THAT I ACTUALLY WAS A
BEFORE I CAME HERE TO THE
LEGISLATURE. I WAS ACTUALLY AN
ADMINISTRATOR OF THE P E I
PROGRAM THEY ARRIVED FROM
COMMUNITY BEST PRACTICES. THAT
ACTUALLY YIELDS CYSTIC,
STATISTICALLY SIGNIFICANT
OUTCOMES. I KNOW THERE'S ISSUES
AND THAT NOT ALL PROGRAMS
ORIGINATING BY BE ABLE TO YIELD
STATISTICALLY SIGNIFICANT
PROGRAMS. I UNDERSTAND THAT
CONCERN AS WELL, AND WE NEED TO
DO SOMETHING ABOUT THAT. BUT I
WOULD ALSO HOPE THAT WE CONTINUE
TO DOUBLE DOWN TO MAKING SURE
THAT EVEN THOSE STATISTICALLY
SIGNIFICANT PROGRAMS ARE DONE IN
A WAY THAT IS SCALABLE AND
REPLICABLE. RIGHT INSTEAD OF
THESE GEMS. BUT NO ONE ELSE CAN
REPLICATE IT BECAUSE IT'S SO
EXPENSIVE, SO COMPLICATED AND
THOSE THINGS AS WELL. SO I HOPE
THAT WE CAN CONTINUE TO
STRENGTHEN THE LANGUAGE TO
ENSURE THAT WHEN WE DO DO THESE
THINGS THAT WE CAN MAKING SURE
THAT WE CAN ACTUALLY UM, MAKE
THIS SOMETHING THAT CAN BE
EXTEND STATEWIDE OR DEPENDING ON
THE POPULATIONS, UM OF EACH
REGION. MY LAST QUESTION. UM, IS
, UM WELL TWO QUESTIONS. THE
LAST FIRST ONE WAS IN THE
ORIGINAL VERSION. UM IT LIMITED
THE LEGISLATIVE LEGISLATURE'S
ABILITY TO MAKE REVISIONS TO IT.
THERE WEREN'T SIGNIFICANT TAX,
THEY HAVE TO GO TO VOTERS FOR
REVISIONS. UM WAS THAT PROVISION
TAKEN OUT AND THE EVENT LAST
AMENDMENTS? SO THE WAY THAT THE
LANGUAGE IS STRUCTURED TODAY, SO
THIS IS GOING TO GET A LITTLE
TECHNICAL FOR SCIENCE SECTION 81
18 OF EM HSCEI, WHICH IS REALLY
KIND OF THE STATUTE THAT GOVERNS
OR THE LANGUAGE THAT GOVERNS THE
MENTAL HEALTH SERVICES ACT TODAY
, AND THAT STATES, ESSENTIALLY,
UM, CHANGES IN FURTHERANCE OF
THE ACT. IT'S A TWO THIRDS VOTE.
MINOR TECHNICAL CHANGES 50% AND
THEN SUBSTANTIVE CHANGES NEED TO
GO BACK TO THE VOTERS. THAT LAW
REMAINS IN EFFECT. AS PART OF
THIS, UM AND SO WHAT? THIS WHAT
THE NEW LANGUAGES IS REALLY ANY
CHANGES KIND OF THE NEW SECTIONS
THAT ARE ADDED AS PART OF
BEACHES SAY, WOULD REQUIRE A
MAJORITY VOTE OF THE LEGISLATURE
AND ALL OTHER CHANGES WOULD GO
THROUGH. KIND OF THAT LEGAL
ASSESSMENT OF IS THE ACT IN
FURTHERANCE THAN IT REQUIRES A
TWO THIRDS IF IT'S TECHNICAL.
IT'S A 50 MAJORITY VOTE, AND
THEN IF IT'S SUBSTANTIVE, IT
GOES BACK TO THE VOTER. SO IT IS
A LEGAL ASSESSMENT BASED ON WHAT
THE CHANGE MIGHT BE EVERY TIME
IT'S PROPOSED TO BE MODIFIED.
THANK YOU. AND MY LAST QUESTION
IS, UM, WHY DO WE FIND IT
NECESSARY TO, UM, WEEKEND THE
MENTAL HEALTH SERVICES OVERSIGHT
AND ACCOUNTABILITY COMMISSION.
AH! SO. I THINK, IN OUR VIEW,
WE, UH ARE NOT WEAKENING THAT,
UH, AUTHORITY OR THAT ABILITY WE
ACTUALLY IN MAINTAINING ITS
INDEPENDENCE AND ITS ABILITY TO
WORK CLOSELY WITH THE DEPARTMENT
, THE AGENCY AND OTHER
STAKEHOLDERS ON THINGS LIKE
TECHNICAL ASSISTANCE, DATA
ANALYSIS AND REPORTS. OVERSIGHT
IF YOU WILL OF COUNTIES AND
FRANKLY OF OURSELVES THAT THAT,
UH, STRENGTH OF THE CAN BE
DEEPENED AND FURTHERED, AND IN
FACT, I THINK THROUGH THE LAST
MANY WEEKS AND MONTHS OF
CONVERSATION, THE ABILITY FOR,
UH, RENEWED RELATIONSHIP. NOT
ONE THAT SAYS, LET'S DO
EVERYTHING THE SAME AND TOGETHER
BUT ONE THAT IS DONE IN
CONSULTATION AND COLLABORATION
BETWEEN THE DEPARTMENT AND THE
O. A C TO REALLY FURTHER OR
ABILITY, MAYBE TO ROW IN THE
SAME DIRECTION. I THINK IS, UH,
THE UNDERBELLY OF WHERE WE ARE
TODAY WITH THE CA.GOV, WHERE IN
ONGOING CONVERSATIONS ON HOW TO
MAKE SURE THAT THAT'S MANIFEST
IN THE LANGUAGE AND THE LAW. BUT
EVEN MORE THAN BEFORE, I WOULD
SAY THE ABILITY OF US TO ROW IN
THE SAME DIRECTION AND PUSH THE
SYSTEM TOWARDS IMPROVEMENT IS
STRONGER IN THIS PROPOSAL THAN
IT HAS HISTORICALLY BEEN IN
ACTUAL WHERE THE RUBBER MEETS
THE ROAD IN OUR WORK TOGETHER,
SO WE BELIEVE THAT WE'RE IN A
PLACE OF A STRENGTHENED
RELATIONSHIP AND ABILITY TO MOVE
FORWARD AND THAT THE AS A GREAT
DEAL OF ABILITY TO INFLUENCE
WHERE THIS ENTIRE SYSTEM IS. I
WOULD ENCOURAGE US TO CONTINUE
TO WORK ON THIS LANGUAGE.
OBVIOUSLY READING FROM THE L A.
OH, IT SAYS RELATIVE TO HIS
CURRENT ROLE IN AUTHORITY. THE
PROPOSAL STILL SHIFTS THE
MAJORITY. OF THE COMMISSION'S
CURRENT OVERSIGHT, REGULATORY
AND PROGRAM, ERIC AUTHORITY OVER
MHS A FUNDING TO D. H C S SO TO
ME, THAT'S A QUITE A WEAKENING.
I MEAN, WE MAY CALL IT DIFFERENT
, WHATEVER. BUT OBVIOUSLY THERE
IS SOME SIGNIFICANT SHIFTS THAT
ARE HAPPENING. AND SO I WOULD,
UM, ENCOURAGE US TO STRENGTHEN
LATIN LANGUAGE AND ENSURE THAT,
UM, BECAUSE THERE ARE SOME OF US
WHO ACTUALLY ENJOY THE TYPE OF
UM AUTONOMY THAT OVERSIGHT HAS
IN TERMS OF BEING ABLE TO HAVE
MORE FRANK AND HONEST
CONVERSATIONS THAT WE CAN'T HAVE
WITH OTHER FOLKS. UM AND SO, UM
VERY INSTILL VERY CONCERNED
ABOUT THIS, AND I HOPE WE CAN
CONTINUE TO MAKE PROGRESS ON
THIS. THANK YOU VERY MUCH. THANK
YOU. NEXT, ASSEMBLYMEMBER'S
WALDRON. THANK YOU. I WILL TRY
TO BE VERY BRIEF. THANK YOU, DR
CALLIE AND YOUR TEAM FOR BEING
HERE. VERY IMPORTANT ISSUE. AH I
FIRST WANTED TO ADD A LITTLE
BIPARTISAN SUPPORT FOR THE WORK
THAT YOU'VE ALL BEEN DOING IS
REALLY CRITICAL. UM AS YOU KNOW,
I'VE BEEN 11 YEARS IN THE
LEGISLATURE, REALLY FOCUSING ON
MENTAL HEALTH AND SUBSTANCE USE,
ESPECIALLY WITH THE JUSTICE
INVOLVED POPULATION AND, UM, YOU
KNOW, GETTING MORE ACCESS INTO
RURAL COMMUNITIES AS WELL. UM WE
DO APPRECIATE, UM WHAT'S BEEN
DONE, ESPECIALLY WITH THE
INNOVATIVE APPROACHES THAT ARE
KIND OF MORE RELATIVE TO WHAT
WE'RE EXPERIENCING HERE IN OUR
STATE. UM DR ARAMBULA DID TAKE,
UH, A VERY IMPORTANT QUESTION,
WHICH I THINK IS ON ALL OF OUR
MINDS, SO I WON'T ELABORATE ON
THAT, AS YOU'VE ALREADY
ADDRESSED IT PRETTY EXTENSIVELY
ABOUT PRIORITIZING THE FUNDING
AND THE RESOURCES FOR THE YOUTH
, WHICH IS A BIG PART OF
PREVENTION AND WILL SAVE US
MONEY IN THE LONG RUN IF WE CAN
REALLY GET A HANDLE ON IT. JUST
TWO QUICK QUESTIONS. UM
REGARDING THE PROPOSAL. UM HOW
WOULD THIS COMPLIMENT? THE
INITIATIVE THAT THE
LEGISLATURE'S SUPPORTED THE
BEHAVIORAL HEALTH BRIDGE HOUSING
PROGRAM. TO PROVIDE HOUSING
SUPPORT TO HOMELESS INDIVIDUALS
WITH BEHAVIORAL HEALTH
CONDITIONS. HOW WOULD THIS ALL
WORK TOGETHER? OH BEAVER HELPED
BRIDGE HOUSING IS FUNDING GOING
INTO COUNTIES NOW? AND IT IS
REALLY MEANT TO BE A BRIDGE TO
ANOTHER SOLUTION FOR ONGOING
FUNDING TO FOCUS ON THE HOUSING
NEEDS OF THOSE WITH SERIOUS
BEHAVIORAL HEALTH CONDITIONS. SO
IN SOME WAYS, THE BRIDGE TO WHAT
THE BRIDGE TO THIS SO THEY WORK
TOGETHER. THEY ARE MEANT TO BE
SORT OF IN A CONTINUOUS SENSE
SUPPORTING THOSE HOUSING
INTERVENTIONS THAT ARE PROPOSED
IN THIS LEGISLATION BECAUSE WE
NEED THE WRAPAROUND SERVICES. WE
NEED THOSE THINGS AND HAVE THEM
ACCESSIBLE AND, UH, AVAILABLE SO
UM, BUT, YOU KNOW, THEN I HAVE
TO GO TO MY HEART OF THINGS. THE
CRIMINAL JUSTICE SYSTEM, THE
CYCLE OF RECIDIVISM, UM, THAT
WE'RE GETTING. PEOPLE ARE
INCARCERATED THAT REALLY NEED TO
BE IN TREATMENT. UM, EXCITED
ABOUT THE APPROVAL FROM CMS TO
ALLOW INCARCERATED PEOPLE TO
SEGUE INTO THE MEDICAL SYSTEM
PRIOR TO RELEASE UM AND THAT
WILL BE HOPEFULLY VERY
SUCCESSFUL PROGRAM ONCE A WEEK,
FIGURE OUT HOW TO GET IT ALL
WORKING, UM HOW CAN WE BE SURE
THAT THEY DON'T FALL THROUGH THE
CRACKS AS THEY TRANSITION AND GO
ON, UM SOME OF THE BIGGEST
PROBLEMS WE HAVE IS THAT CYCLE
OF GOING BACK ONTO SUBSTANCE
USE. UM ONCE FOLKS ARE OUT AND
HIGH RATE OF OVERDOSE ONCE
THEY'RE OUT UM, HOW CAN WE HAVE
THAT? YOU KNOW ONCE THEY'RE IN
THE PROGRAM THAT WE CAN BE
ACCOUNTABLE FOR THEM ONCE
THEY'RE OUT. WELL, I THINK THE
EASY ANSWER. THERE IS NO EASY
ANSWER TO THIS RIGHT. BUT USING
ANSWER IS TO USE ALL THE TIME
WHILE PEOPLE ARE INCARCERATED TO
MAKE A SOLID, THOUGHTFUL, SORT
OF BELIEVABLE PLAN FOR AN
INDIVIDUAL WHEN THEY COME OUT,
ENSURE TALK ABOUT WARM HANDOFFS
AND, UH, REFERRALS THAT ARE ARE
MEANINGFUL AND REAL TO MAKE SURE
THAT THAT HAPPENS AND THEN TO
MAKE SURE THAT RESOURCES LIKE
THOSE AVAILABLE THROUGH THE
BEAVER ALL SERVICES ACT PROPOSAL
THE MEDICAID SERVICES UNDER CAL
AIM THINGS THAT ARE HAPPENING
BECAUSE OF THE BEHAVIORAL HEALTH
CONNECT PROPOSAL AND SO MANY
OTHER ELEMENTS THAT I'VE
REFERENCED TODAY. THAT THEY'RE
ACTUALLY BLENDED AND BRAIDED
TOGETHER IN THAT PERSON CENTERED
AWAY THAT, UM, YOU KNOW, PEOPLE
HAVE A RELIABLE CONTACT CASE
MANAGER. THEY HAVE A PLACE TO GO
AND SLEEP. THEY HAVE A RELIABLE
PLACE TO GET THEIR CARE AND
SERVICES AND THAT THE BASIC
NEEDS OF INDIVIDUALS DON'T FALL
THROUGH THE CRACKS. AND SO THOSE
OPPORTUNITIES ACROSS CALIFORNIA
ARE MORE AVAILABLE NOW THAN THEY
WERE BEFORE AND WE HAVE TO
DELIVER ON THEM. YES AND I AGREE
. WE CAN SEE A BIG DENT IN THE
PROBLEM. I THINK IF WE COULD GET
A HANDLE ON THE FOLKS THAT ARE
IN THE CRIMINAL JUSTICE SYSTEM
BECAUSE THEN THEIR CHILDREN GET
INTO THE CYCLE, AND IT JUST
CONTINUES THAT SO THANK YOU VERY
MUCH. I'LL JUST ADD ONE LAST
THING BECAUSE IT HIGHLIGHTS THE
NEED AROUND WORKFORCE. WE TALKED
ABOUT IT ON THE PRIOR PANEL. THE
PROPOSAL. THE BHS A PROPOSAL FOR
CONSIDERATION. DEDICATES 3% OF
DOLLARS TO ONGOING BEHAVIORAL
HEALTH WORKFORCE NEEDS BUILDING
UP BOTH THE CULTURAL COMPETENCE
JUST THE BREAD AND BUTTER
POSITIONS THAT WE NEED, BOTH FOR
SUBSTANCE USE DISORDERS AND
BEHAVIORAL MENTAL HEALTH. UM,
NEEDS THAT IT ALLOWS US TO
REALLY BUILD THE TEAM OF FOLKS
THAT ARE GOING TO MAKE WHAT WE
JUST TALKED ABOUT REAL AND
AVAILABLE TO MORE PEOPLE IN
CALIFORNIA BECAUSE TODAY WITHOUT
THE WORKFORCE INVESTMENTS, WE
JUST HAVE REALLY INTERESTING AND
EXCITING PLANS THAT FRANKLY
WON'T DELIVER ON WHAT WE ALL
HOPE THEY WILL BECOME, BECAUSE
YOU DON'T HAVE THE PEOPLE TO DO
THE WORK. THANK YOU. NEXT, WE'LL
HAVE MISS QUIRK-SILVA. OR YOU
WANT ME TO SKIP I THINK DR WOOD
WAS NEXT, ACTUALLY. AND THEN
WE'LL GO TO MS QUIRK-SILVA. OKAY
OKAY. I WASN'T FOLLOWING NEW
YORK. I'M JUST TAKING THE LIST.
YOU KNOW, THERE'S A LONG LIST,
TOO. SO OKAY. UM FIRST OF ALL,
THANK YOU VERY MUCH, DOCTOR
GOLLY, FOR BEING HERE WITH US
THIS MORNING. JUST A COUPLE OF
QUICK THINGS. UM YOU AND I HAVE
BEEN. WE'VE BEEN TALKING A
LITTLE BIT ABOUT UM VOLATILITY
AND THE FUNDING PIECE OF THIS
AND I KNOW THAT'S AN AREA. WE'RE
GOING TO CONTINUE TO WORK ON.
THAT WON'T NECESSARILY BE
COMPLETELY REFLECTED IN IN, UM
IN THE BILL, BUT THAT WE'LL HEAR
LATER TODAY. UM JUST SOME
THOUGHTS ON THAT IF YOU HAVE
ANYTHING, ANYTHING QUICK. YEAH,
FIRST, I WANNA REALLY APPRECIATE
BOTH OUR COUNTY PARTNERS. THE L
A. OH YOU DOCTOR WOULD OTHERS IN
THE LEGISLATURE OF RAISED THIS
AS A REALLY CRITICAL ISSUE?
WE'VE RECOGNIZED IT FOR A WHILE
. WE'VE ALL TALKED ABOUT PRUDENT
RESERVE. FOR YEARS. AND HOW HOW
DOES THAT MAKE SENSE IN THE
BROADER GOAL OF TRYING TO MAKE
SURE AS MANY OF THESE DOLLARS
ARE ACTIVATED OR SERVICES HERE
AND NOW? BECAUSE SO MANY PEOPLE
HAVE NEED AND THERE ARE GAPS,
BUT WITH THAT SORT OF PRINCIPLE
IN MIND, RECOGNIZING THE NEED TO
CREATE SOME REAL RELIABILITY,
THE FUND SOURCES CLEARLY ONE
THAT'S VOLATILE. IT GOES UP.
IT'S GO DOWN IN MY SHORT TIME IN
THIS ROLE. I'VE SEEN ENORMOUS
SWINGS IN THE AMOUNT OF DOLLARS
AVAILABLE IN MH S A IN ONE YEAR
VERSUS ANOTHER, AND IT IS HARD
TO PLAN IN A RELIABLE WAY. SO
WHAT I WILL SAY IS THERE'S A
COMMITMENT TO CONTINUE TO WORK
WITH THE LEGISLATURE OR COUNTY
PARTNERS. UM KEY DEPARTMENTS
WITHIN THE ADMINISTRATION TO
FIGURE OUT WHAT'S THE RIGHT
PATH. AROUND ADDRESSING THOSE
RESERVE NEEDS WHILE ENSURING
THAT WE'RE MAXIMIZING
OPPORTUNITIES TO DELIVER ON
SERVICES TODAY. SO WHAT THAT
EXACTLY LOOKS LIKE I THINK
THERE'S A FEW PROPOSALS AND
IDEAS THAT MANY OF US ARE
KICKING AROUND AND THINKING
THROUGH AND THE EXPECTATION IS
BEFORE THIS BILL IS FINAL AND
CONSIDERED THAT THERE IS A WAY
TO ADDRESS THAT VOLATILITY IN IN
A WAY THAT SETS CALIFORNIA UP
FOR SUCCESS. AND THEN THE FINAL
QUESTION IS AROUND AND I
STRUGGLING TO FIGURE OUT HOW TO
HOW TO PHRASE THIS AND I THINK
YOU'LL GET THE GIST OF WHAT I'M
AFTER HERE, BUT WE HAVE A LOT OF
GREAT COMMUNITY PARTNERS AND
ORGANIZATIONS AND COUNTIES AND
EVERYTHING DOING AMAZING THINGS
IN COMMUNITIES AND FROM MY
PERSPECTIVE. UH UM, IT OFTEN
FEELS LIKE EVERYBODY'S OPERATING
IN SILOS. I THINK PEOPLE HATE
THAT PHRASE. BUT THAT'S HOW I
SEE IT. UM AND SO MY QUESTION IS
. IS THERE GOING TO BE AND IF
THERE IS WHO OR WHAT ENTITY IS
KIND OF AN OVERARCHING, UH,
ENTITY THAT'S GOING TO LOOK AT
THIS AND BE ABLE TO OVERTIME.
SEE ARE WE BEING SUCCESSFUL? UM,
WHAT ARE WE DOING? BECAUSE THE
PUBLIC WILL JUDGE US BY ALL OF
THIS, AND WHAT THEY'RE GOING TO
SEE IS OUR HOMELESS PEOPLE BEING
HOUSED, YOU KNOW? ARE WE SEEING
THE DIMINISHMENT DIMINISHING OF
THAT POPULATION ON THE STREETS?
AND ARE PEOPLE GETTING THE
SERVICES THAT THEY NEED TO BE
SUCCESSFUL? SO IS THERE A WAY TO
USE THIS WORD? IS THERE GOING TO
BE SOME SORT OF A CZAR OR
SOMEBODY OR ANYBODY THAT'S KIND
OF LOOKING AT THE BIG PICTURE.
THAT'S THE FACE OF THIS. IS THAT
YOU? AS UM, IS THAT DIRECTOR
BOSS I MEAN, HELP BECAUSE I
THINK THAT I THINK WE'RE KIND OF
LOOKING TO SEE. IS THIS ALL
BEING COORDINATED? HOW IT'S
BEING COORDINATED? WHAT'S BEEN
SUCCESSFUL? WELL FIRST, I WANT
TO ACKNOWLEDGE AGAIN, THE
LEGISLATURE FOR PUSHING AND, UH
DOCTOR. WHAT DO YOU IN
PARTICULAR FOR, UH, SORT OF SOME
INTERIM REPORTS SOME REAL FOCUS
ON MAKING SURE THAT THE
DIRECTIONALITY IS REAL THAT
WE'RE SEEING THE FRUITS OF THIS
LABOR TODAY MANIFEST IN HOW THE
PLANS ARE COMING TOGETHER COUNTY
BY COUNTY WHAT THOSE OUTCOMES
ARE SO THAT WE DON'T JUST TURN
OUR BACK AND EXPECT THAT
EVERYTHING IS GOING TO TURN OUT
THE WAY WE HOPE TODAY THAT WE
GET THAT OPPORTUNITY TO MAKE
THAT REFINEMENT AND CHANGING
APPROACH. AS DIRECTOR BOSS
MENTIONED THE ABILITY AND THE
FURTHERANCE OF THE ACT TO DO
WHAT THIS BODY IS ASKING US TO
DO. SO THAT'S ONE THING. THE
SECOND PIECE IS, UH, REALLY IN
COLLECTING THOSE COUNTY BY
COUNTY PLANS BEING ABLE WITH A
LOT MORE PRECISION AND
COMPLETENESS THAN WE DO TODAY.
TO BE ABLE TO PULL SOME OF THOSE
MODEL PROGRAMS OUT TO SAY, HEY,
LOOK, THIS IS SOMETHING THAT
THIS COUNTY HAS DONE FOR 123
PLANNING CYCLES. IT'S BEN
EFFECTIVE. IT IS WHAT THEY
ATTRIBUTE TO CHANGING THIS, THIS
SORT OF COUNTY BASED OUTCOME
THAT NEEDS TO BE CONSIDERED BY
OTHER COUNTIES AND TO SORT OF,
SAY THE SHARED RESPONSIBILITY
BETWEEN THE AND THE HCS. TO
CONTINUE TO CALL THROUGH THOSE
LOOKED THROUGH THOSE PLANS CALL
THOSE GEMS OR EVEN THINGS THAT
MAYBE AREN'T TURNING OUT THE WAY
THAT WE WOULD EXPECT THEY ARE
AND SHARE THAT INFORMATION IN
THEIR ANALYSIS, SO I THINK WITH
THIS ROBUST PLANNING TOOL THAT
IS BEING PROPOSED HERE IN THIS
CHANGE, WE HAVE GREAT
OPPORTUNITY TO DO EXACTLY WHAT
YOU SAID. I DON'T WANT TO ANOINT
MYSELF FOR A SIGN MYSELF THAT
ROLE, BUT I WOULD SAY THAT IT IS
GOING TO BE, UH, A WORK BETWEEN
IN THE DEPARTMENT. TO SEE US OUR
AGENCY AT HHS AND OUR
PARTNERSHIP WITH THE TO LOOK AT
THAT JUST QUICKLY SUPPLEMENT THE
SECRETARY'S POINT. THE HOUSING
COMPONENT MIGHT BOSTON SECRETARY
OF THE STATE CONSUMER SERVICE
AND HOUSING AGENCY, ALONG WITH
SECRETARY GALLEY CHAIRED THE, UH
, CALIFORNIA EMERGENCY COUNCIL
AND HOMELESS SYSTEM WE SPEAK TO
A LOT OF THE EFFORTS UNDERWAY
WITH OUR PARTNERS HEALTH, HUMAN
SERVICES, COUNTY REGIONAL
PLANNING WHERE WE'VE REALLY
COMPLEMENTED THAT ON THE HOUSING
SPACE, IT'S ALWAYS THE EDIT OF
EFFORTS ON HOUSING AND
HEALTHCARE, BECAUSE THAT'S
REALLY HOW YOU GET VIABLE. LONG
TERM SOLUTIONS ULTIMATELY IMPAIR
THESE INVESTMENTS TOGETHER AND
STRATEGIC FASHIONS. THANK YOU.
AND WE'LL GO TO, UH, MR YOUR
CURRY AND THEN MISS QUIRK-SILVA.
GREAT THANK YOU. AND THANK YOU
VERY MUCH FOR YOUR
PRESENTATIONS. EVERYONE THAT'S
HERE. APPRECIATE THAT. DOCTOR
KELLY. UM THE ADMINISTRATION
DOESN'T SUPPORT LEGISLATION
WITHOUT A BUDGET ITEM APPROVED
FOR TO FIND IT. DOESN'T THIS
BILL DEPEND UPON THE FUNDING
FROM AN AS YET UNAPPROVED BOND.
WELL JUST TO BE CLEAR THEY THE
BOND AND THE BEHAVIORAL HEALTH
SERVICES ACT OBVIOUSLY HAVE A
LOT OF INTERACTION AND, UM BUILD
TOGETHER THE BOND JUST IN THE
QUICK SUMMARY, I THINK FOCUSES
ON BUILDING SOME OF THESE, UH,
SERVICE SETTINGS TREATMENT
SETTINGS THAT WE'RE LACKING IN
CALIFORNIA, AND WE DON'T HAVE
THE ABILITY TO WE OFTEN TALK
ABOUT THIS CONTINUUM TO MOVE
PEOPLE THROUGH AND THE MENTAL
HEALTH SERVICES. UH CHANGES ACT
CHANGES INTO THE BEHAVIOR HEALTH
SERVICES ACT, I THINK, PROVIDE A
LOT OF HEARD THE WORD WRAP
AROUND OR SUPPORT SERVICES OR
CLINICAL SERVICES THAT ARE
REQUIRED. TO DO MORE THAN JUST
PUT A ROOF OVER SOMEBODY'S HEAD
TO MAKE IT A MEANINGFUL
TREATMENT PROGRAM. SO THEY
ABSOLUTELY WORKED TOGETHER, AND
I DON'T WANT TO DISMISS THAT IN
ANY WAY, BUT THE CHANGES THAT
WE'RE TALKING ABOUT ON THE
BEHAVIOR HEALTH SERVICES ACT, UM
PROPOSAL 3 26 ARE REALLY FOCUSED
ON CHANGING HOW THOSE EXISTING
DOLLARS THAT HAVE BEEN VOTER
APPROVED NEARLY 20 YEARS AGO
UNDER MENTAL HEALTH SERVICES
ACT. YET DEPLOYED IN SOME WAYS
REDEPLOYED IN THE ENVIRONMENT
THAT IS MORE MODERN AND PAYING
ATTENTION TO MANY OF THE THINGS
THAT WE HAVE TODAY. SO IF COURSE
, THE BOND AND BUILDING THOSE
BRICK AND MORTAR SETTINGS THAT
ARE BEING PROPOSED, ARE CRITICAL
TO THIS, BUT THE COMMENTS AND
DISCUSSION WE'VE HAD TODAY. DO
IN SOME WAYS STAND APART FROM
WHAT? WHAT? THAT WHAT THAT BOND
IS REQUIRED. THANK YOU VERY MUCH
. UM THE PROPOSAL. THIS PROPOSAL
CREATES A LOT OF NEW MANDATORY
LOCAL INTEGRATED PLANNING
EFFORTS AND SMALL COUNTIES LIKE
THE ONES THAT I REPRESENT IN THE
DISTRICT HAVE LIMITED MENTAL
HEALTH FUNDING AND STILL HAVE TO
DO THE JOB. HOW DOES THE STATE
PLAN ON PROVIDING SUBSTANTIAL
TECHNICAL ASSISTANCE AND SUPPORT
FROM MY FROM MY COUNTIES? SO TWO
THINGS TO SAY FIRST TO, UH,
START WITH YOUR FOCUS ON
TECHNICAL ASSISTANCE. I THINK WE
BUILD OUR CAPACITY MEANING NOT
JUST HOW HOW DO WE DO IT? BUT
HOW MANY PEOPLE DO WE HAVE
AVAILABLE TO DO IT? DIRECTOR
BOSS ARE ALWAYS PARTNERS, MAKING
SURE THAT WE DEPLOY THE FUNDS WE
HAVE AVAILABLE TO EXECUTE ON
THIS. TO BUILD THOSE TA TEAMS
AND TO BE AVAILABLE COUNTY BY
COUNTY. WE'VE ALREADY HAD SOME
REALLY IMPORTANT CONVERSATIONS
WITH SOME BIGGER SOME SMALLER
COUNTIES ABOUT SOME OF THE
CHALLENGES AND NEEDS THAT THEY
MIGHT HAVE AS A RESULT OF THESE
CHANGES, AND, FRANKLY, TO USE A
WORD THAT I DON'T OFTEN GET TO
USE YOUR EXCITED ABOUT SOME OF
THOSE CHANGES THAT AT THAT COULD
COME, SECONDLY FOR SMALL
COUNTIES, IN PARTICULAR THE
FOCUS OF WHAT WAS ORIGINALLY
PROPOSED AS A 2% ALLOWANCE OF
LOCAL ADMINISTRATIVE DOLLARS TO
FOCUS ON BUILDING UP THOSE
PLANNING EFFORTS WAS INCREASED
FOR SMALLER COUNTIES TO MAKE
SURE TO ADDRESS EXACTLY THE
POINT YOU'RE RAISING THAT THERE
ARE SUFFICIENT DOLLARS.
HOPEFULLY SUFFICIENT, BUT MORE
THAN CURRENTLY PROPOSED TO DO
ALL OF THOSE ALL OF THAT
IMPORTANT PLANNING WORK. AS YOU
CAN IMAGINE. I'VE HAD IN MIND A
LOT OF CONVERSATIONS COMING
THROUGH SEVERAL FEW MORE
REGARDING OUR SMALLER COUNTIES.
GIVEN THE CONCERNS RAISED BY
COUNTIES AND OTHER STAKEHOLDERS
ABOUT THE LOSS OF LOCAL FUNDS TO
SUPPORT MENTAL HEALTH SERVICES.
HOW DOES THE ADMINISTRATION
PROPOSED TO ENSURE THAT
CALIFORNIANS WITH SEVERE MENTAL
ILLNESS, UM DO NOT LOSE THEIR
CORE SERVICES? AND IF I'M NOT
MISTAKEN? AS MUCH AS WE SUPPORT
CAL AIM, IT IS NOT A REPLACEMENT
FOR MENTAL HEALTH, OUTPATIENT
CRISIS AND PEER SERVICES. YEAH.
THAT MUST BE MY LOCAL. MY COUNTY
. WELL IT IT'S YOUR ACCOUNTING
AND MANY OTHER COUNTIES AND THIS
IS FRANKLY BEEN ONE OF THE MOST
IMPORTANT PIECES THAT WE'RE ALL
TALKING THROUGH. GRAPPLING WITH
THE IDEA THAT OUTPATIENT
SERVICES WOULD BE SACRIFICED
BECAUSE OF THE CHANGES THAT ARE
BEING PROPOSED. HERE IS NO ONE'S
INTENT. LET ME JUST STATE THAT
CLEARLY. THAT IN SOME OF THOSE
COUNTY BY COUNTY CONVERSATIONS,
WE HAVE DISCOVERED OPPORTUNITIES
TO SUPPORT OUTPATIENT SERVICES.
MAYBE IN IN WAYS THAT TODAY
AREN'T OFTEN DEPLOYED. WE'VE
TALKED A LOT ABOUT HOW DO YOU
BREAK IT? BLEND IN BRAID
FUNDING. THERE'S OPPORTUNITIES
THAT HAVE BEEN MISSED IN SOME
COUNTIES THAT OTHER COUNTIES ARE
TAKING ADVANTAGE OF.
OPPORTUNITIES TO LEVERAGE
MEDICAID EVEN MORE TO DRAW IN
SOME OF THE OTHER PAYERS FOR
THESE SERVICES TO MAKE SURE THAT
THE FUNDS ARE AUGMENTED AND THEN
IMPORTANTLY, IN RECOGNITION OF
EXACTLY THIS POINT, UH, THERE IS
AN AMENDMENT THAT IS TODAY IN
PRINT THAT WASN'T THERE IN THE
ORIGINAL PROPOSAL THAT CREATES
ADDITIONAL COUNTY FLEXIBILITY.
SO WE'RE IN. THE BUCKETS WERE
FAIRLY PRESCRIBED. YOU HAD TO GO
INTO THEM WITH THOSE EXACT
PERCENTAGES IN OUR FIRST
PLANNING PROCESS. SO IN THE
YEARS 2026 THROUGH 2029 ANY
COUNTY CAN MOVE 7% OUT OF ANYONE
BUCKET. AND NOT 7% OF THAT
BUCKET. THAT'S 7% OF THE TOTAL
LOCAL DOLLARS FROM ONE BUCKET TO
ANOTHER UP TO A TOTAL OF 14% SO
IF THERE'S A CONCERN IN A COUNTY
THAT A SET OF SERVICES WE JUST
CAN'T FIGURE IT OUT. WITH THIS
NEW WORLD ORDER THEY CAN MOVE.
YEAH DOLLARS INTO SUPPORT THAT
IN THE SECOND PLANNING PROCESS
THAT'S REDUCED JUST A LITTLE BIT
DOWN TO 6% OUT OF ANYONE BUCKET
WITH A TOTAL UP TO 12% AND THEN
MOVING FORWARD AFTER THAT SECOND
PLANNING PERIOD. HAVING 5% OF
THE DOLLARS MOVABLE OUT OF
ANYONE. BUCKET UP TO A TOTAL OF
10 CREATES SOME ONGOING
FLEXIBILITY COUNTY BY COUNTY SO
OUR DIRECTION OR COMPASS IS
STILL THE SAME, BUT THAT WE
CREATE SOME RECOGNITION THAT NOT
EVERY COUNTY IS GOING TO BE ABLE
TO DO EXACTLY THE SAME THING AND
THEY'LL NEED SOME FLEXIBILITY.
THIS IS FLEXIBILITY THAT FRANKLY
HASN'T BEEN IN MHS S¼. EVER AND
HAVING THIS OPPORTUNITY, I THINK
IS A REALLY IMPORTANT FEATURE OF
THE PROPOSAL. UM I LOVE TO HEAR
ABOUT FLEXIBILITY BECAUSE THAT'S
ONE OF THE THINGS THAT THEY WERE
OBVIOUSLY QUITE CONCERNED ABOUT.
SO I'LL BE ANXIOUS. I'LL TAKE
SOME TIME AND LOOK AT THEM
AMENDMENT. YOU KNOW, I GO TO THE
COUNTIES AND I'VE MET WITH A LOT
OF MY MENTAL HEALTH
ORGANIZATIONS AND THEY'RE DOING
SUCH A GREAT JOB, MANY OF THEM
BECAUSE THEY'VE HAD TO THINK
OUTSIDE THE BOX FOR SO MANY
YEARS. SO NOW THEY'RE CONCERNED
ABOUT THE DISRUPTION THAT MIGHT
BRING THEM. SO I APPRECIATE YOU
BEING HERE TODAY. APPRECIATE
YOUR ANSWERS, AND, UH, LET'S
LET'S SEE WHAT WE CAN DO. WE
GOTTA WE GOTTA MAKE THIS CHANGE.
SO THANK YOU VERY MUCH. THANK
YOU. THANK YOU, MISS SHARON
QUIRK-SILVA. ON THANK YOU,
DOCTOR MCGAULEY. I'M PLEASED TO
HEAR MANY OF THE PROPOSALS THAT
I AGREE WITH, FOR EXAMPLE,
HAVING STANDARDIZED MEASUREMENTS
THROUGHOUT THE STATE. WE KNOW
COUNTY BY COUNTY. THERE IS VERY
UNIQUE, A LOT OF UNIQUENESS. BUT
WE ALSO KNOW FOR EXAMPLE, IN OUR
PUBLIC SCHOOLS WE HAVE
STANDARDIZED. UH IF YOU WANT TO
SAY ASSESSMENTS, UH, TO MAKE
SURE THAT THROUGHOUT THE STATE
WE HAVE THE SAME GOALS. ONE OF
THE STATEMENTS THAT I HAVE IS
WHEN WE LOOK AT OUR MAJOR
INSTITUTIONS THAT WE AS A STATE
GOVERNMENT ARE RESPONSIBLE FOR
WHETHER IT'S PUBLIC EDUCATION,
PRISONS, PROBATION, HEALTHCARE
EVEN NOW HOUSING WE CONTINUE TO
SEE INEQUITIES. INEQUITIES AS
YOU MENTIONED OF WHO IS NOT ONLY
GETTING THESE SERVICES AND MANY
TIMES AND ALL OF THOSE
INSTITUTIONS WE SEE VERY POOR
OUTCOMES FOR OUR COMMUNITIES OF
COLOR, INCLUDING NATIVE AMERICAN
BLACK LEAD TO, YOU KNOW, UM AND
OUR L G B T Q PLUS COMMUNITIES.
I APPRECIATE THE IDEA THAT YOU
WANT TO BRINGING TOGETHER
STAKEHOLDERS TO NOW MAKE SURE
THEIR THEIR VOICES ARE HEARD.
WHEN THESE DECISIONS ARE MADE,
IT STILL REMAINS THE QUESTION
THAT SOME OF THESE COMMITTEES OR
BOARDS, IN FACT, DEPENDING ON
THE COUNTY, I HAVE ORANGE COUNTY
AND NOW PARTS OF LOS ANGELES.
VERY DIFFERENT GOVERNING BOARDS.
AH AND WHEN I LOOK AT WHO
REPRESENTS, FOR EXAMPLE, ORANGE
COUNTY, THE LARGEST PROVIDER IS
CAL OPTIMA AND I LOOK AT, UH, IN
FACT THAT BOARD TO ME IT WOULD
BE VERY DIFFICULT TO SEE HOW
THESE COMMUNITIES MAY BE
REPRESENTED. SO HOW DO WE AND
HOW DO PEOPLE BECOME BOARD
MEMBERS? SO ALL OF THAT? WHO
GETS APPOINTED YOU? TYPICALLY IT
HAS BEEN DONE BY SUPERVISORS,
DEPENDING ON YOUR SUPERVISORS.
YOU MAY HAVE A VERY DIVERSE
BOARD OR YOU MAY NOT, AND NOW
THAT I RAISE AH, REPRESENT TWO
COUNTIES LOS ANGELES AND ORANGE
COUNTY PRETTY MUCH NIGHT AND DAY
AS FAR AS UM, WHAT TYPE OF
PROGRAMS ARE BEING EXECUTED? SO
MY QUESTION IS, HOW CAN WE
ENSURE THAT THERE WILL BE SOME
EQUITABLE REPRESENTATION? THAT'S
QUESTION ONE. AND THEN THE
SECOND IS EVERYTHING THAT WE DO,
AND THESE INSTITUTIONS, WHETHER
AGAIN IT'S EDUCATION, WHETHER
IT'S PEOPLE COMING OUT OF OUR
PRISON SYSTEMS, WHETHER IT'S
ACCESS TO HEALTHCARE, THE KEY
INGREDIENT, INCLUDING PEOPLE ARE
LIVING ON THE STREETS AND
ENCAMPMENTS IS ABOUT ACCESS.
IT'S ABOUT HOW DO WE GET
SOMEBODY WHO HASN'T ALWAYS HAD,
UH, EXPERIENCE WITH TRADITIONAL
GOVERNMENT INSTITUTIONS, WHETHER
IT'S GOING TO THE SCHOOL SITE,
WHETHER IT'S GOING TO PROBATION
OFFICER WHETHER IT'S GOING INTO
THE HEALTHCARE TO GET QUESTIONS
ANSWERED TO ACTUALLY GET THE
PLAN. AN EXAMPLE IS MY IN LAWS
SPEAK SPANISH. MY HUSBAND MANY
TIMES NEEDS TO GO WITH THEM. TO
GET A PLAN AND SOMETIMES EVEN
WITH HIM THERE, THERE'S A
SOMETIMES JUST NOT THE BEST
OUTCOME, SO THEN IMAGINE LIVING
ON THE STREET. WHAT TYPE OF
INTERACTION THERE. IMAGINE UH,
AS YOU KNOW, UH, EVEN PUBLIC
ENGAGEMENT PEOPLE IF THEY DON'T
SPEAK THE LANGUAGE. SO THE
QUESTION ON ACCESSES? ARE WE
LOOKING AT WHO WE ARE BUILDING A
TEAM WORK AND HOW THEY CAN
ENGAGE WITH PEOPLE THAT ARE IN
VERY VULNERABLE COMMUNITY. SO
TWO QUESTIONS. THANK YOU. SURE
I'LL TRY TO ANSWER THEM BOTH IN
FIRST SAY, UH, THE BOARD
DIFFERENCES BETWEEN ORANGE
COUNTY AND L. A NOTWITHSTANDING
THE STRONG LEADERSHIP IN BOTH,
UH BEHAVIORAL HEALTH DEPARTMENTS
IN THOSE COUNTIES IS EXCITING.
YOU HAVE REALLY TREMENDOUS
LEADERS WHO ARE PUSHING THE
ENVELOPE ON A NUMBER OF
DIFFERENT PROGRAMS IN AREAS AND
I THINK, REALLY DOING SOME VERY
IMPORTANT AND INTERESTING WORK
THAT SHOULD HELP GUIDE THE STATE
. SO, UH, JUST A SHOUT OUT TO
THE WORK THAT THEY DO IN AND DAY
OUT IN TERMS OF SORT OF YOUR
QUESTIONS. I WOULD SAY, UH,
FIRST OFF THE PROPOSED CHANGES,
EXPECT SOMETHING VERY DIFFERENT
. UH EXPECT COUNTIES IN THEIR
PLANNING PROCESS TO INCLUDE
GROUPS THAT TRADITIONALLY MAYBE
THEY WERE THERE. MAYBE THEY
WEREN'T THERE AND I THINK IN OUR
ABILITY TO CONSUME THOSE PLANS
AND REALLY TAKE A LOOK AT WHO'S
AT THE TABLE IN THESE PLANNING
PROCESSES TO MAKE THOSE COMMENTS
. IN SOME WAYS, WE NEED TO HAVE
HIGHER EXPECTATIONS IN DIFFERENT
EXPECTATIONS, BUT WE ALSO HAVE
TO INSPECT WHAT WE'RE GETTING IN
MORE DETAIL AND PART OF THIS
ENTIRE PROPOSAL REALLY PUSHES US
AT THE STATE LEVEL TO INVEST
SOME OF OUR, UH STATE
ADMINISTRATIVE DOLLARS IN
SUPPORTING OUR DEPARTMENT AGENCY
, THE OTHERS TO BE ABLE TO LOOK
AT THESE CRITICALLY, SO THAT
WHEN WE HEAR THE STORY THAT HEY
, THIS COUNTY WAS REALLY GOOD AT
CHOOSING STRONG REPRESENTATIVES
OF SOME OF THESE OFTEN
OVERLOOKED ISSUES TO BE AT THE
TABLE THAT WE CAN ACTUALLY
VERIFY THAT AND POINT TO. THAT
IS THE REASON WHY ONE PROGRAM OR
ANOTHER CONTINUES TO GET FUNDED
. THIS IS NOT, UH, EASY THING TO
DO. WE STILL WANT A LOT OF, UH,
COUNTY AUTONOMY. SO THOSE LOCAL
UNIQUE FEATURES ARE MANIFEST IN
THEIR PLAN, BUT I THINK SETTING
A FLOOR OF EXPECTATIONS IS
EXACTLY WHAT WE'RE DOING IN THIS
PROPOSAL. AND BUILDING THE TEAM
AT THE STATE IN MANY DIFFERENT
AREAS TO BE ABLE TO INSPECT THAT
DOESN'T THAT THOSE EXPECTATIONS
ARE MET IS THE APPROACH THAT WE
HAVE NOW? IS THAT YOUR YOUR GOOD
? OKAY, GREAT. WE'LL GO TO MR
FONG NOW. THANK YOU, MADAM
CHAIR. UM THANK YOU, DR COLLEEN.
YOUR TEAM FOR YOUR HARD WORK
APPRECIATE THE COMPLEXITY OF
THIS ISSUE. I WANTED TO KIND OF
BUILD UPON SOME OF THE QUESTIONS
ASKED BY MY COLLEAGUES IN
NORTHERN CALIFORNIA, AND
SPECIFICALLY THE CONCERNS OF THE
COUNTIES WHERE THEY KNOW YOU'VE
WORKED VERY EXTENSIVELY. WHERE,
UM, YOU KNOW THE ISSUE I'VE SEEN
I REFERENCE, STELIOS, UH,
ANALYSIS, WHICH YOU READ, WHICH
IS, YOU KNOW THIS PROPOSAL
AMONGST MANY THINGS WOULD
REQUIRE COUNTIES TO SPEND MORE
ON CERTAIN PROGRAMS AND LESS
THAN OTHERS. AND I'VE HEARD FROM
FROM MY BEHAVIORAL HEALTH
DIRECTORS THAT THIS BILL DOES
REQUIRE NEW SERVICES WITHOUT THE
POTENTIAL ADDITIONAL FUNDING AND
MY COLLEAGUES AND I WHO SERVED
ON THE BUDGET COMMITTEE. I
CERTAINLY UNDERSTAND THE BUDGET
CONSTRAINTS THERE. SO THE
CONCERN OF DIVERTING FUNDS FROM
FROM REALLY IMPORTANT THINGS. UM
THAT ARE ALREADY OCCURRING AND
TRYING TO MANAGE THE TENSION
THAT EXISTS OF UNPREDICTABLE
SOURCES OF FUNDING, MAINTAINING
PROGRAMS AND THEN ADDING NEW
REQUIREMENTS. UM HOW DO YOU
RESPOND? I GUESS TO THE CONCERNS
OF THE UNINTENTIONAL POTENTIAL
OF PRODUCING THE LEVEL OF
FUNDING THAT'S CURRENTLY SPENT
ON CORE MENTAL HEALTH SERVICES,
PARTICULARLY OUTPATIENT. IN
CRISIS AND RECOVERY SERVICES.
YEAH SO LET ME START BY JUST,
YOU KNOW. REIGNITES COLLEGE NG
THE VOLATILITY ISSUE, WHICH IS
REAL AND ONE THAT WE EXPECT TO
ADDRESS, WHICH I THINK WILL
BRING A LEVEL OF CONSISTENCY AND
SECURITY AT THE COUNTIES TO BE
ABLE TO LOOK AT SOME OF THESE
IMPORTANT PIECES HEARD THAT LOUD
AND CLEAR. SEE THIS AS AN
OPPORTUNITY TO ADDRESS SOMETHING
THAT HAS BEEN A LONG STANDING
ISSUE, AND FRANKLY AS PROBABLY
MOCKED UP OUR ABILITY TO
UNDERSTAND DIFFERENCES BETWEEN
COUNTY APPROACHES. SO WHILE I
JUST SAY THAT AGAIN AS A REALLY
IMPORTANT PART THAT ISN'T IN
TODAY'S AMENDMENTS, BUT IT'S
SOMETHING WE'RE COMMITTED TO
BEFORE. THIS BILL IS FULLY
CONSIDERED TO HAVING IN PLACE,
SO THAT'S NUMBER ONE ON THAT
NOTE, THOUGH, IS THEY'RE LIKE
CAN YOU GIVE US SOME CONCEPTS
THAT YOU'RE BANTERING ABOUT IN
TERMS OF HOW TO HAD TO ADDRESS
THAT. SURE I CAN. I CAN SAY
THERE'S UM OBVIOUSLY, THE ELIO
HAS PREVENTED PRESENTED A FEW
FEW IDEAS. WE'VE CERTAINLY
LOOKED AT. WELL HOW DO YOU LOOK
AT HISTORIC SPENDING OVER THE
LAST PERIOD OF TIME? LOOKING AT
THE LAST THREE YEARS TO INFORM
THE NEXT THREE YEARS LOOKING AT
HOW YOU CONSIDER WAITING CERTAIN
YEARS, POTENTIALLY, BUT ALSO, UH
, PUSHING FORWARD A CONCEPT THAT
MAYBE WE NEED TO TAKE OUR TIME
WITH A NUMBER OF THE RIGHT
PARTNERS AT THE TABLE TO FIGURE
OUT EXACTLY WHAT THE REPLACEMENT
IS OF THE CURRENT PRUDENT
RESERVE APPROACH, SO THAT WE DO
SOMETHING WITH INPUT FROM
COUNTIES WITH THE SUPPORT OF THE
DEPARTMENT OF FINANCE THAT
OBVIOUSLY HAS TO THINK THROUGH
THIS ON A YEAR TO YEAR BASIS TO
MAKE SURE THAT THOSE PIECES ARE
THERE AGAIN WORKING CLOSELY WITH
MEMBERS OF THIS COMMITTEE. AND
MAKING SURE THAT WE GET A BROAD
RANGE OF IDEAS IN PLACE. I THINK
THAT THE CERTAINTY ON WHAT IT IS
LESS TODAY, BUT THE CERTAINTY
THAT THERE WILL BE SOMETHING IS
PRETTY UH AND I GO WAY. I DON'T
WANNA INTERRUPT YOU. BUT I KNOW
THAT WAS ONLY A PORTION OF YOUR
QUESTION THAT MORE NOT MORE
IMPORTANT, BUT THE EQUALLY
IMPORTANT PIECE WAS WELL, OKAY.
WE HAVE CERTAINTY. NOW WE HAVE A
WAY TO PLAN THAT DOESN'T SORT OF
HAVE THE BIG UPS AND DOWNS THAT
I KNOW AS SOMEBODY WHO RAN
COUNTY PROGRAMS FOR AWHILE WOULD
BE VERY DIFFICULT AND FRANKLY
FRUSTRATING TO MEET THE NEEDS
AROUND. WE ALSO KNOW THAT
CERTAIN THINGS OVER THE PAST 20
YEARS ARE IN PLACE TODAY THAT
WEREN'T IN PLACE BEFORE AND AN
OPPORTUNITY TO LEVERAGE CERTAIN
PROGRAMS FUNDING. THAT WE CAN
GET THROUGH THE FEDERAL
GOVERNMENT THROUGH PROGRAMS THAT
DIRECTOR BOSSES DEPARTMENT
REALLY OVERSEAS AND PUTS FORWARD
THAT THERE'S LOTS OF OPPORTUNITY
, FOR EXAMPLE, TO INVITE OTHER
FUNDERS INTO THE MIX AROUND
OUTPATIENT SERVICES TO ENSURE
THAT WE'RE LEVERAGING ALL OF THE
DIFFERENT OPPORTUNITIES WITHIN
OUTPATIENT SERVICES TO DRAW DOWN
FUNDING. TO MAKE SURE THAT
THINGS THAT MAYBE WE SPENT 100%
MHS A FUNDING IN THE PAST THAT
IN THE FUTURE, WE MIGHT HAVE AN
APPROACH THAT ALLOWS US TO BRING
OTHER RESOURCES SO WITHOUT
DIMINISHING THE POTENTIAL, AND
MAYBE EVEN SCALING UP SOME OF
THOSE REALLY IMPORTANT SERVICES
. WE THINK WE CAN SORT OF
BROADEN THE POT IF YOU WILL.
THAT'S AVAILABLE TO FUND ALL OF
THESE SERVICES. I KNOW THAT AS
WE GO COUNTY TO COUNTY AND HAVE
THESE CONVERSATIONS WILL BE LOTS
OF OPPORTUNITIES UNCOVERED,
DISCOVERED THAT WE HAVE SOME
TIME TO BEGIN TO THINK ABOUT HOW
TO IMPLEMENT PROVIDE A SPECIFIC
EXAMPLE TO JUST KIND OF
UNDERSCORE WHAT SECRETARY GALLON
MENTIONED AS IN CONVERSATIONS
WITH COUNTIES, PARTICULARLY
ABOUT OUTPATIENT. REALLY YOU
KNOW, KIND OF HIGHLIGHTING THAT
COME JANUARY 1ST 2024. WE HAVE
UNDOCUMENTED EXPANSION FOR
MEDICAL AND SO SOME OF THE
SERVICES THAT THEY MAY BE
FUNDING TODAY WITH 100% IMAGE
ESSAY DOLLARS FOR OUTPATIENT
SERVICES, FOR EXAMPLE, THERE
WILL BE NEW FUNDING SOURCES FOR
THAT FOR THOSE SERVICES SO,
THEREBY FREEING UP SOME OF THOSE
THOSE MENTAL HEALTH SERVICES
DOLLARS THAT CAN BE USED AGAIN
FOR KIND OF DIFFERENT PURPOSES.
SO THERE SOME SPECIFIC EXAMPLES
AS WE TALKED TO COUNTIES AND TRY
TO UNPACK HOW THEY'RE USING
THEIR DOLLARS TODAY, AND WHAT
THE POTENTIAL CHANGES IN THE
FUTURE MIGHT MEAN FOR HOW THEY
PLAN FOR THE FUTURE. I THINK TO
MEAN TO FOLLOW UP ON MY
COLLEAGUE, UM, YOU KNOW, SENT
LINDBERGH AGUIAR-CURRY MEAN I
THINK THAT THE CHALLENGES IS, AS
YOU INDICATED DIRECTOR BOSSES IS
THAT THERE ARE MULTIPLE COUNTIES
WITH MULTIPLE PROGRAMS THAT THAT
USED THAT THAT BLEND DIFFERENT
FUNDS. UM YOU KNOW, AS AS YOU
KNOW, AS DR GHALI SAID, YOU KNOW
, A LOT OF PROGRAMS, YOU KNOW,
USE BRAIDED FUNDS, YOU KNOW,
THEY USE MEDICAL RESOURCES AS
THE PRIMARY FUNDING AND THEN MHS
A PATCHES WHEREVER IT NEEDS TO
BE AND ACKNOWLEDGING THE NEED
FOR HOUSING AND THEN KNOWLEDGE
IN THE NEED FOR MENTAL HEALTH
SERVICES. AND, OF COURSE
TREATING, YOU KNOW, UH, THREE.
SOME SUBSTANCE USE TREATMENT
SERVICES. ALL OF THOSE THINGS
ENCOMPASS INTO THIS PROPOSAL
CREATES A LOT OF RESOURCES AND
NEEDS AND CAPACITY ISSUES WITHIN
COUNTIES. AND I THINK THAT THAT
CONCERN THAT I'M HEARING IS THAT
YOU KNOW, HOW DO YOU PROVIDE
COUNTIES WITH ESPECIALLY RURAL
COUNTIES WITH THE CERTAINTY AS
YOU ADD IN MORE RESPONSIBILITY,
AND I LOOK FORWARD TO THE
AMENDMENTS, I WILL ASK THE TO
FOLLOW UP SPECIFICALLY IN TERMS
OF THE KEY ELEMENTS OF THIS
PROPOSAL ARE UH, OUR BONDS AND
ASKING THE VOTERS TO DECIDE SO
AND WITH UNCERTAINTY IN THE
BUDGET WEARING MY OTHER HAT,
WHAT HAPPENS IN THAT DYNAMIC IF
. IF THAT SAY THE BOND DOESN'T
PASS OR SOMETHING DOESN'T OCCUR.
WHAT HAPPENS IN THIS SITUATION
AND THAT SITUATION. I THINK, UM
. FIRST OFF AS I AS I MENTIONED
THE WHAT WE'RE CONSIDERING UNDER
SP 3 26 IS REALLY, UH, REFORM.
WE LIKE TO SAY MODERNIZATION OF
THE MENTAL HEALTH SERVICES
ACTIVE TODAY. AND, UH, THE HOPE
AND, YOU KNOW, HOPE, EXPECTATION
THAT THE BOND WILL PASS AND THAT
WE WILL HAVE THE RESOURCES TO
BUILD UP MANY OF THE SETTINGS
THAT WE'VE DESCRIBED IN THAT
POND LANGUAGE. UH IS THERE BUT
NOT WITHSTANDING THAT THESE
CHANGES THAT CAN TAKE PLACE
WITHIN THE BEHAVIOR HEALTH
SERVICES ACT. DO YOU STAND ON
THEIR OWN AND CAN BE CONSIDERED
BY THEMSELVES WITH THE FUNDING
THAT WE GET YEAR OVER YEAR
BECAUSE OF PROP 63 AND 19.5
NEARLY 20 YEARS AGO WHAT THE
VOTERS IN A AND JUST ON THAT
GOING BACK TO SOMETHING SIMILAR,
BUT TIED TOGETHER IN TERMS OF
THE BUCKETS. I MEAN, DO COUNTIES
OR DO YOU ENVISION COUNTIES
HAVING SOME FLEXIBILITY, SAY IF
THEY WANTED TO USE SOME OF THE
LET'S SAY THEY, THERE'S NO
HOUSING CAPACITY AT THAT MOMENT
THAT THEY CAN SHIFT SOME OF
THOSE FUNDS TO OTHER SERVICES.
OR ARE THOSE BUCKETS HARD? AND
RIGID IN TERMS OF THE
PERCENTAGES. HISTORICALLY THEY
HAVE BEEN HARD AND RIGID.
PROPOSED AMENDMENT OVER THE LAST
COUPLE OF WEEKS, IS TO PROVIDE
SOME FLEXIBILITY THAT IN THE
FIRST PLANNING CYCLE, MOVING UP
TO 7% OF THE TOTAL FUNDS AT THE
LOCAL LEVEL OUT OF ONE BUCKET
INTO ANOTHER FOR A TOTAL OF 14%
ACROSS ALL THE BUCKETS AND
ANYONE YOU'RE SO FOR EXAMPLE,
YOU COULD MOVE 7% OF YOUR
HOUSING INTERVENTION. DOLLARS 7%
OF YOUR FSP DOLLARS INTO
BEHAVIOR, HEALTH SERVICES AND
SUPPORTS BECAUSE THERE'S A CLEAR
, GLARING NEED, AND DESPITE
EFFORTS TO FIGURE OUT HOW TO
BLEND IN BRAID DIFFERENTLY,
THERE'S STILL A GAP AND YOU NEED
A LITTLE MORE TRANSITION TIME
THAT THAT IS ALLOWABLE BASED ON
THE AMENDMENTS THAT HAVE, OKAY,
THANK YOU VERY MUCH, AND I THINK
THE READER TO REITERATE WHAT
CHAIR WOULD HAVE SAID. I THINK
THERE'S A LOT OF MOVING PARTS
YOU'VE GOT. CALLUM YOU'VE GOT
HAIR COURT. YOU'VE GOT THIS.
YOU'VE GOT POTENTIAL BOND AND
THE COUNTIES ARE, I THINK JUST
TRYING TO ABSORB ALL OF THIS
THESE CHANGES AND TRYING TO
MEASURE THEM ALL TOGETHER, AND I
THINK THAT COORDINATION IS
SOMETHING THAT'S STILL UM STILL
OUT THERE. IT'S STILL
QUESTIONABLE AND I THINK THAT
THAT THIS LAYERING ON TOP OF IT
CREATES A LITTLE BIT OF UNEASE,
AND I THINK THE POTENTIAL OF OR
THE IMPACT TO THE TO THESE
INDIVIDUALS WHO REALLY NEED
SERVICES. AND IF THEY'RE NOW AT
A PROGRAM IN THE PROGRAM, AND
THAT FUNDING IS NOT NOW
UNSUSTAINABLE OR HAS TO BE
CHANGED, WE'RE CREATING EVEN
MORE UNCERTAINTY FOR A LOT OF
THE MOST VULNERABLE POPULATION.
SO THANK YOU VERY MUCH, DOCTOR
COLLINS. THANK YOU. NEXT WE'LL
HAVE DR WEBBER THAN MR
RODRIGUEZ. AND THEN I BELIEVE
MYSELF. GOOD MORNING, DR GHALI
AND PANEL. THANK YOU ALL SO MUCH
FOR PRESENTING AND COMING HERE
TODAY AND TAKING ALL OF OUR
QUESTIONS. THANK YOU GOT YOU'RE
GONNA GET A QUESTION FROM
EVERYONE ON THIS PANEL, SO THAT
JUST KIND OF DEMONSTRATES, UM,
THE IMPORTANCE OF THIS I FIRST
WANT TO KIND OF GO BACK TO WHAT
ASSEMBLYMEMBER'S, UM JACKSON HAD
SAID BEFORE ABOUT, UM UH, OUR
PEDIATRIC POPULATION. AND FOR
ME, SPECIFICALLY THE ISSUE
AROUND PREVENTION AND YOUR
PEDIATRICIAN PHYSICIAN YOU
UNDERSTAND THE IMPORTANCE
PREVENTION. AND SO I'VE YOU
KNOW, I'VE I'VE HAD SOME
CHILDREN, HOSPITALS. AND OTHER
CHILDREN SERVICES. SPEAK TO ME,
UM, ABOUT THE SHIFT FROM
PREVENTION INTO EARLY
INTERVENTION, WHICH TO ME MEANS
SOMETHING HAS ALREADY HAPPENED.
WE HAVEN'T PREVENTED IT.
SOMETHING HAS HAPPENED. AND NOW
WE'RE JUMPING IN EARLY, UM, TO
TREAT IT AND SO IN OUR ANALYSIS
, IT SAYS THIS BILL. THERE'S
CONCERNS THAT THIS BILL WILL
RESULT IN DRASTIC ONGOING
REDUCTIONS IN FUNDING FOR
PREVENTION POST. FOCUS PROGRAMS.
UM AND I KNOW THAT ARE CURRENTLY
UNDER THE MHS. A THERE ARE
PROJECTS THAT COULD FUND LOCALLY
AND CULTURALLY RESPONSIVE
PROGRAMS LIKE THE SWEET POTATO
PROGRAM AND THE WEST FRESNO
FAMILY RESOURCE CENTER, WHICH
SPECIFICALLY IS USED TO PREVENT
OR REDUCE SCHOOL DROP OUT GANG
INTERVENTION, SUBSTANCE USE
INITIATION. FOR AFRICAN AMERICAN
YOUTH, UM DECREASING
HOMELESSNESS, MENTAL HEALTH
ISSUES ALONG THE LINE. SO WITHIN
THIS PROPOSAL. HOW IT THESE KIND
OF PREVENTION FOCUSED PROGRAMS
BE FUNDED. SO I THINK REALLY
IMPORTANT QUESTION THAT WE HAVE
BEEN SPENDING QUITE A BIT OF
TIME ON, UH, SPECIFICALLY THE
SWEET POTATO PROJECT AND OTHERS
NAME PROJECTS LIKE IT. DIRECTOR
BOSS PEOPLE ON MY TEAM MYSELF
HAVE BEEN DIGGING INTO AND GOOD
CONVERSATION. I THINK A COUPLE
OF THINGS TO SAY FIRST THE WAY
THAT SOME OF THE PROGRAMS HAVE
BEEN FUNDED HISTORICALLY IN THE
BUCKETS, UM, ISN'T THE ONLY WAY
TO FUND THEM. SOME OF THESE
PROGRAMS COULD BE FUNDED UNDER
THE BEHAVIOR. HEALTH SERVICES
AND SUPPORT BUCKET. THAT IS
BEING PROPOSED, AND THERE'S
NOTHING IN THE LEGISLATION THAT
SAYS A PROGRAM LIKE THAT
SHOULDN'T BE FUNDED OR CAN'T BE
FUNDED. SECONDLY THE STATEWIDE
PREVENTION PROGRAM ALLOWS US THE
WAY THAT THE LANGUAGE IS WRITTEN
IS TO FOCUS ON THE YES A
STATEWIDE NOUS BUT ALSO SOME
SPECIFIC PROGRAMS THAT MIGHT BE
IN ONE OR TWO OR THREE OR FOUR
COUNTIES THAT REALLY ADDRESS
SOME OF THE UNIQUE PREVENTION
NEEDS, UM, ALSO MAKE THE
DISTINCTION. BETWEEN AND I
APPRECIATE THE ACKNOWLEDGMENT OF
MY BEING A PEDIATRICIAN OFTEN
SAY PEDIATRICS IS THE ULTIMATE
FORM OF ADULT PREVENTATIVE
MEDICINE BECAUSE WE HAVE A
CHANCE TO ADDRESS THE WHOLE HOST
OF THINGS AT A YOUNG AGE THAT WE
KNOW MORE AND MORE TODAY HAVE
REAL IMPACT ON NOT JUST YOUR
HEALTH, BUT YOUR OPPORTUNITIES
AND TO ADULTHOOD. SO FOCUSING ON
PREVENTION AT A POPULATION BASED
APPROACH AND HAVING THOSE
DOLLARS BE VERY SPECIFIC AND
AVAILABLE. FOR POPULATION BASED
APPROACHES, I THINK WAS REALLY
IMPORTANT AND NOT JUST PUTTING
IN A SINGLE BUCKET PREVENTION
AND EARLY INTERVENTION IN IN IN
MANY PEOPLE'S MINDS, EARLY
INTERVENTION IS TARGETING AN
INDIVIDUAL. IT'S SOMEBODY WHO
FOR A SPECIFIC SET OF REASONS
HAS THE NEED FOR AN EARLY
INTERVENTION THAT'S SPECIFIC TO
THEM OR THEIR FAMILY. UH AND SO
BEING ABLE TO DISTINGUISH THE
TWO WAS AN IMPORTANT FEATURE OF
WHAT WE'RE HAVING PLAY OUT IN
THIS PROPOSAL, SO THREE THINGS.
THE EVERY HEALTH SERVICES AND
SUPPORTS CAN FUND SOME OF THESE
PROGRAMS IN A WAY THAT THEY
HAVEN'T NECESSARILY BEEN
CONSIDERED FOR FUNDING. SECONDLY
WE HAVE STATEWIDE PREVENTION
DOLLARS TO REALLY FOCUS ON THOSE
BROAD POPULATION, MAYBE SCHOOL
BASED PROGRAMS THAT TARGET YOUNG
PEOPLE AT ABOUT 50% OR A LITTLE
BIT MORE. AND THEN IN THE EARLY
INTERVENTION CATEGORY, MAKING
SURE THOUGH THERE'S PERSON
SPECIFIC INTERVENTIONS THAT DO
GET IN THE WAY OF FURTHER SEKULA
AND, UH, CONSEQUENCES, TOO EARLY
SIGNS AND SYMPTOMS THAT WE CAN
INVEST DIRECTLY IN THOSE
PROGRAMS. SO BY OUR ACCOUNT, WE
SEE THIS AS AH NEW SET OF
OPPORTUNITIES TO ADDRESS SOME OF
THOSE EARLY ISSUES THAT I THINK
SO MANY PEOPLE INCLUDING ME, AND
OUR TEAM ARE CONCERNED ABOUT
THANK YOU. THANK YOU. AND, UM
YOU KNOW THERE. THERE'S A LOT OF
, UM IN THIS PROPOSAL, WHICH IS
VERY GOOD AND VERY MUCH NEEDED
AND OVERDUE. UM YOU KNOW THE
ISSUE OF OVERSIGHT
ACCOUNTABILITY USING, UH,
GETTING DATA USING EVIDENCE
BASED INFORMATION TO DIRECT, UM,
HOW WE PROVIDE SERVICES. UM
UNDERSTANDING THAT. WE HAVE TO
FOCUS ON WHAT I TALKED ABOUT A
LOT. THE SOCIAL DETERMINANTS OF
HEALTH TO REALLY CREATE HEALTHY
INDIVIDUALS. WHETHER IT'S
PHYSICAL HEALTH OR MENTAL
HEALTH. YOU HAVE TO ADDRESS
THINGS LIKE HOUSING. YOU HAVE TO
ADDRESS THINGS LIKE RACISM. UM,
OTHERWISE, WE'RE NOT GOING TO BE
ABLE TO DO WHAT WE NEED TO DO.
AND I THINK THAT'S WHY WE HAVE
NOT DONE AS MUCH AS WE COULD DO
HERE IN THE STATE OF CALIFORNIA.
UM YOU KNOW, THE FUNDING ISSUE
IS A CONCERN FOR ME. UM YOU KNOW
, SO I'M VERY MUCH LOOKING
FORWARD TO WHAT THE PROPOSALS
YOU ALL ARE TALKING ABOUT IN
TERMS OF DEALING WITH, UM NOT
ONLY THE EBBS AND FLOWS OF THE
FUNDING STREAM, BUT ALSO TO
HOPEFULLY INCREASE THE AMOUNT OF
FUNDING SCREEN STREAM IN THIS
AREA. AND I THINK THAT'S WHERE,
UM A LOT OF OTHER PEOPLE ARE
CONCERNED ABOUT IF WE HAD A
PROPOSAL THAT INCREASED THE
AMOUNT OF FUNDING THAT WE HAD,
IN ADDITION TO PUTTING IN
HOUSING AND OTHER SERVICES I
DON'T KNOW IF YOU WOULD HAVE AS
MANY QUESTIONS OR CONCERNS
TODAY, BUT THE FACT THAT RIGHT
NOW WE'RE USING THE SAME AMOUNT
OF MONEY. UM, TO TRY TO DO MORE.
MEANS THAT POTENTIALLY. OUR
MENTAL HEALTH ASPECTS ARE GOING
TO GET LESS, AND WE CANNOT
AFFORD TO DO THAT HERE IN
CALIFORNIA. WE HEARD AT THE
BEGINNING THAT WE HAVE, UM YOU
KNOW, AN INCREASE IN, UH, THE
NEED FOR MENTAL HEALTH SERVICES
. WE DON'T HAVE ENOUGH PEOPLE IN
THE STATE ACCESSING WHAT THEY
SHOULD HAVE. OUR YOUTH ARE BEING
. ARE HAVING TO DEAL WITH THIS
AT RATES THAT WE HAVE NOT SEEN
BEFORE. UM AND SO FOR ME, THAT
IS HONESTLY ONE OF MY BIGGEST
CONCERNS. WE NEED TO WE NEED TO
ADDRESS. YES WE NEED TO ADDRESS
HOUSING. BUT DO WE NEED TO DO
THAT AT THE EXPENSE AND TAKING
DOLLARS AWAY FROM OUR MENTAL
HEALTH? I DON'T THINK SO. FACT,
I KNOW WE DON'T AND THAT'S WHY
WE NEED TO. I'M VERY INTERESTED
IN WHAT PROPOSALS YOU'LL COME UP
WITH. BECAUSE RIGHT NOW, THE WAY
THIS IS FUNDED, YOU'VE GOT A
SMALL PROPORTION OF CALIFORNIANS
FUNDING THIS. IT'S NOT ENOUGH
RIGHT NOW. AND SO WE NEED TO
FIGURE OUT HOW WE STABILIZE IT,
BUT ALSO HOW WE GET MORE FUN SO
THAT WE CAN DO ALL OF THESE
AMAZING THINGS THAT WE NEED TO
DO IN YOUR PROPOSING IN THIS IN
THIS BILL. UM, BUT I DO WANT TO
ASK ABOUT AND I DON'T KNOW IF
THERE'S BEEN A NEW AMENDMENT
THAT CHANGES IT. BUT WHAT IS THE
JUSTIFICATION FOR LOWING? THE
COUNTY RESERVES CAPS, ESPECIALLY
WHEN THE L A O CAME OUT AND
SAID, SHOULD ACTUALLY BE
INCREASING IT. BUT THE PROPOSAL
ACTUALLY DECREASES IT. I THINK.
COMING BACK TO THIS STATEMENT
AND THE EXCHANGE WITH DR WOULD
RECOGNITION THAT WE HAVE TO GET
THIS RIGHT THAT THAT SECURITY UH
COUNTY FOR COUNTIES IS REALLY
IMPORTANT AND THAT VOLATILITY AS
YOU REFERENCED IS HARD TO MANAGE
, AND, FRANKLY, HARD TO PLAN
AROUND, AND SO THE COMMITMENT IS
TO HAVE A SOLUTION TO THAT
VOLATILITY THAT YOU KNOW DON'T
HAVE TODAY. BUT AS I SAID
BEFORE, THIS IS OVER. WE PLANNED
EMBED IN THE LEGISLATION TO
ADDRESS THAT, AND I'LL JUST
ACKNOWLEDGE THAT THAT STABILITY
AND REDUCED VOLATILITY IS GOING
TO BE REALLY IMPORTANT, BUT IT
DOESN'T SOLVE ALL OF THE
CONCERNS THAT YOU RAISED. AND WE
LOOK FORWARD TO WORKING ON. UH,
SO MANY OF THE ISSUES YOU
FLAGGED THAT WE SHARE. UH NOT AS
CONCERNS BUT AS OPPORTUNITIES TO
GROW WITH THE RESOURCES THAT WE
HAVE TODAY, UH, THE
OPPORTUNITIES TO USE THEM TO
SERVE THOSE IN GREATEST NEED
ACROSS CALIFORNIA. THANK YOU.
AND FINALLY, I'M VERY HAPPY TO
HEAR ABOUT THE FLEXIBILITY THAT
YOU ALL HAVE BEEN TALKING ABOUT
, UM, AS FAR AS HOW DOLLARS ARE
USED, UM, BECAUSE, YOU KNOW,
CERTAIN COUNTIES DO WELL,
CERTAIN COUNTIES DON'T I COME
FROM A COUNTY THAT IN THE PAST
NOT DO VERY WELL AND WE'VE
CHANGED OUR MAKEUP AND ARE KIND
OF CHANGING OUR COURSE. BUT UM
EVERY COUNTY IS DIFFERENT IN
TERMS OF THEIR NEEDS, UM, IN
TERMS OF THEIR COMMUNITY MEMBERS
AND SOME OF THE PROGRAMS THAT
THEY HAVE TO OFFER THEIR
SPECIFIC COMMUNITY MEMBERS, AND
I JUST WANT TO MAKE SURE THAT AS
WE'RE GOING FORWARD, WE CONTINUE
TO ALLOW FOR THAT FLEXIBILITY,
ESPECIALLY IF THOSE PROGRAMS ARE
SHOWING THAT THEY'RE HELPING.
NOW, IF THEY'RE NOT, THAT'S A
DIFFERENT STORY. UM BUT IF
THEY'RE WORKING, AND THEY'RE
PROVIDING A VITAL RESOURCE TO
THE MEMBERS OF THAT PARTICULAR
COMMUNITY, AND WE SHOULD MAKE
SURE THAT WE ARE CONTINUING TO
FIND AND ALLOW FOR THAT LOCAL
CONTROL, SO THANK YOU VERY MUCH
FOR BEING HERE AND FOR TAKING
ALL OF THIS TIME TO ANSWER OUR
QUESTIONS. PLEASURE THANK YOU.
THANK YOU, DOCTOR. THANK YOU, DR
WEBBER. UH, MR RODRIGUEZ. YEAH
THANK YOU, SECRETARY GALLEY AND
ALL THE MEMBERS WORKING ON THE
VERY IMPORTANT ISSUE NOT TO KIND
OF SHARE THE SAME CONCERNS. SOME
OF MY COLLEAGUES ALREADY TALKED
TO REGARDING THE COUNTIES AND
THE LOSS OF REVENUE RIGHT. ONE
OF THE COMPANIES I REPRESENT
DECEMBER. GIARDINO TELLS ME THAT
BECAUSE OF THIS PROPOSAL, THEY
LOOK TO LOSE OVER $70 MILLION IN
SERVICES BEING PROVIDED SO WITH
THAT SAID, AND I KNOW YOU
PROBABLY ALREADY ANSWERED IN ONE
WAY OR ANOTHER. BUT HOW DOES THE
ADMINISTRATION PLAN TO ENSURE
THAT OUR LOCAL PARTNERS KIND
ACCOMPLISHED WAS BEING REQUESTED
OF THEM UNDER THIS PROPOSAL TO
MAKE SURE THAT THOSE SERVICES
ARE BEING PROVIDED DAY IN AND
DAY OUT. YEAH, I THINK SORT OF
RESTATING A LITTLE BIT OF WHAT,
WHAT WE'VE TALKED THROUGH, BUT I
THINK THERE'S A REAL OPPORTUNITY
AS WE'VE GONE AND SPOKEN TO
COUNTIES ON AN INDIVIDUAL BASIS
, LOOKED ESPECIALLY DIRECTOR
BOSSES TEAM AT WHERE THERE'S
OPPORTUNITIES TO DO DO THE
THINGS PROPOSED IN THE
LEGISLATION AND THE CHANGE IN 3
26. UH WHILE SUPPORTING THOSE
OTHER EFFORTS THAT EXIST TODAY,
MAKING SURE THAT AS DR WEBBER
MENTIONED THAT WE'RE SUPPORTING
THOSE THINGS THAT ARE SUPPORTED
BY EVIDENCE AND MAKING SURE
WE'RE CRITICAL ABOUT THINGS THAT
MAYBE DON'T HAVE THE SAME
EVIDENCE AND MAKING SURE THAT WE
HAVE THOSE SERVICES CONTINUE AND
BE AVAILABLE. THERE IS GOING TO
BE A LOT OF SUPPORT AND
TECHNICAL ASSISTANCE. WE HAVE
NOT TALKED MUCH TODAY OR AT ALL
TODAY ABOUT THE REALITY THAT A
LOT OF OUR MOST IMPORTANT
TRUSTED COMMUNITY BASED
PROVIDERS DON'T YET HAVE THE
CAPACITY TO LEVERAGE MEDICAID TO
REALLY DO ALL OF THE INTRICATE
ADMINISTRATIVE AH, TASKS HOOPS
JUMP THROUGH THEM THAT ARE
REQUIRED TO LEVERAGE THOSE
DOLLARS AND PART OF THE VISION
AND EXPECTATION IS THAT SOME OF
THAT CAPACITY HAS BUILT UP. THAT
WE LOOK AT A WAY TO, UH IN A
MORE RELIABLE AND ENHANCED WAY.
LEVERAGE THE FEDERAL
OPPORTUNITIES TO DRAW DOWN
FUNDING FOR SOME OF THOSE
EXISTING PROGRAMS, SO IT'S GOING
TO BE A LOT OF TECHNICAL
ASSISTANCE. A LOT OF SUPPORT
INVESTING OUR OWN STATE
ADMINISTRATIVE DOLLARS TO BE
ABLE TO PROVIDE THAT SUPPORT,
WHETHER THROUGH THE DEPARTMENT
OR THE MOVING FORWARD. GREAT
OKAY, THANKS, EVERYONE FOR YOUR
PARTICIPATION. UM, I'LL MAKE IT
JUST A COUPLE OF BRIEF COMMENTS
THAT I JUST REALLY TWO QUESTIONS
AND THEN WE'LL ALLOW YOU TO GO
OFF OF THE HOT SEAT HERE. UM SO
ONE YOU KNOW IS HOUSING CHAIR I
HAVE BEEN LIKE HITTING THE DRUM
BEAT ON HOUSING. SINCE THE
SECOND I GOT HERE AND APPRECIATE
THE ADMINISTRATION'S FOCUS ON
THAT AND I, YOU KNOW, I BIG
SUPPORTER OF HOUSING FIRST. I
THINK IT'S A CRITICAL PIECE OF
THE SOLUTION. SO THANK YOU FOR
UM, REALLY BRINGING THAT UP AS
PART OF THE SOLUTION? UM HAVING
SAID ALL THAT OBVIOUSLY, THERE'S
BEEN SOME REALLY IMPORTANT
QUESTIONS THAT HAVE BEEN RAISED,
RIGHT? UM AND SO I JUST WANNA,
YOU KNOW, ALIGN MYSELF WITH SOME
OF THE COMMENTS THAT SOME MY
COLLEAGUES HAVE MADE THIS SORT
OF CONCERN AROUND ROBBING PETER
TO MAKE PAUL AND THINKING
THROUGH HOW WE CAN REALLY WORK
THROUGH THAT BECAUSE WE KIND OF
NEED ALL OF THE THINGS TO FIX
THE PROBLEM. I'M ALSO A BIG
SUPPORTER OF CONTINUED ONGOING
FUNDING FOR HOUSING ACTUALLY
HAVE A BOND. I'M TRYING TO GET
$10 MILLION BOND ON THE BALLOT
NEXT YEAR FOR HOUSING. IN
ADDITION TO THAT WE NEED, I
THINK WITHIN THE GENERAL, UM FUN
BUDGET, MORE FUNDING FOR HOUSING
FOR A SIGNIFICANT PERIOD OF TIME
$100 MILLION INVESTMENT OVER 10
YEARS. UM SO THAT IS, IF ANYONE
WANTS TO WORK WITH ME ON THAT. I
WELCOME THAT, UM SO THAT THAT
THAT BUT THAT IS A REAL ISSUE
THAT WE'VE HEARD FROM OUR
COUNTIES THAT ROBBING PETER TO
MAKE PAUL. THE OTHER ISSUE
THAT'S BEEN RAISED IS THE
VOLATILITY I KNOW WITHIN THE
PAST FIVE YEARS ALONE, REVENUE
IN ANY ONE YEAR HAS SWUNG
BETWEEN AN 88% INCREASE TO A 35%
DECLINE AND PLANNING FOR THAT IS
VERY DIFFICULT AS YOU ALL KNOW,
SO I APPRECIATE YOUR CONTINUED
COMMITMENT TO WANTING TO FIGURE
OUT HOW TO YOU KNOW, FIGURE OUT
THESE TOUGH ISSUES. UM, HAVING
SAID ALL THAT SOME OF THE
QUESTIONS THAT I HAVE ONE YOU
KNOW, THE TURNER CENTER DID A
STUDY RECENTLY, UM, NOTING THAT
SERVICES AND OPERATING, UH,
COSTS ARE CHRONICALLY
UNDERFUNDED. UM, HOW WILL THE
SERVICES AND OPERATING COSTS OF
SUPPORTIVE HOUSING AND
RESIDENTIAL BEDS THAT ARE
CONSTRUCTED THROUGH THE BOND BE
PAID IN AN ONGOING WAY? AND
REALLY MORE SPECIFICALLY, IS
THAT THE INTENT THAT THOSE WOULD
BE FUNDED BY M. H S A HAPPY TO
TAKE THAT QUESTION ON THE
HOUSING FRONT. THANK YOU. SO
REMEMBER, FOR YOUR LEADERSHIP IS
A HOUSING CHAIR AND A LOT OF THE
WORK THAT EMERGENCY AND INTEND
THEM WITH, UH, SECRETARY GALLEY
AND HIS TEAM ON REALLY BREEDING
THIS, UH, FUNDING SOURCES
WHETHER IT'S AT THE STATE LEVEL
BUT ALSO CLEAR EXAMPLES OF THE
WORK WE'VE DONE WITH FEDERAL AND
EVEN LOCAL RESOURCES AND THOSE
EFFORTS. ULTIMATELY THE THEME
WE'RE GOING TO HEAR IS TO REALLY
SCALE OUR EFFORTS RATHER TO
ADDRESS HOMELESSNESS OR HOUSING
PRODUCTION. OVERALL THE
SUSTAINABILITY OF THE PERMIT
SUPPORTIVE HOUSING UNITS THAT'S
ABSOLUTELY CRITICAL. UH JUST
GIVE YOU A QUICK EXAMPLE THE
FIRST TWO ROUNDS AT HOME KEY,
OUR FLAGSHIP PROGRAM FOR THE
STATE ON PROVIDING PERMITS.
SUPPORTIVE HOUSING AT SCALE, BUT
ALSO, UM, MAKING SURE THOSE
CAPITAL DOLLARS THAT THE STATE
INVESTED. WE HAD TWO PROJECTS.
VETERANS UH, HOUSING PROJECTS,
ONE IN MERCED ONE IN SANTA CRUZ.
THOSE UNITS THAT WE PROVIDED THE
CAPITAL DOLLARS FOR WERE ALSO
SUPPORTED BY A VETERAN,
SUPPORTIVE HOUSING VOUCHERS.
FEDERAL ONGOING DOLLARS, SO JUST
TO GIVE YOU A SENSE IN WITH THE
BOND, PARTNERING WITH OUR
COLLEAGUES OVER AT CALVIN, THE
EFFORTS THAT WE'RE DOING WITH
MAKING SURE THAT THESE DOLLARS
ARE STRATEGICALLY LEVERAGED, AND
THAT REALLY EXPANDS TO THE 30%
HOUSING INTERVENTION. COMPONENT
ULTIMATELY, WITH RENTAL
SUBSIDIES, OTHER SUPPORTIVE
SERVICES THAT MAKE THESE
DEVELOPMENTS REALLY VIABLE. YOU
HAVE 55 YEAR AFFORDABILITY
COVENANTS THAT WE UNDERWRITE TO
MAKE SURE THAT THE SUPPORTIVE
HOUSING PLANS SPECIFICALLY
LOCALS ARE INVOLVED TO MAKE SURE
THAT EVERYONE HAS A SHARED
INVESTMENT INTO THE SUCCESS. AND
THAT'S WHERE YOU SEE THE, UH TO
THE FIRST PANELS POINT THE LONG
TERM SUCCESS RATES, MAKING SURE
FOLKS HAVE THAT STABLE, YOU
KNOW, SUPPORTIVE HOUSING.
IMPORTANT THAT WE FEEL IS REALLY
VIABLE HERE AND PROVIDES BEST
LONG TERM SUCCESS. SO AND JUST
TO CLARIFY, SO THAT IS MH A SIG
M SORRY, M H S A GOING TO BE THE
MAIN FUNDER OF THE ONGOING
SERVICES. IT WOULD BE ONE OF
MANY TO BE CLEAR. WE HAVE OTHER
OPERATING SUBSIDIES THAT WE
TYPICALLY PAIR SO AS MENTIONED
FEDERAL VOUCHERS PROJECT BASED
VOUCHERS VASH VERY COMMON, ALSO
THE PERMANENT LOCAL HOUSING
ALLOCATION HALF FUNDING THAT WE
PAIR BUT, UH TO THE SCALE AND
THE ONGOING NATURE OF BEHAVIORAL
OFFICE SERVICE ACT HOUSING
INTERVENTIONS PROVIDED IT DOES
PROVIDE A UNIQUE OPPORTUNITY,
ESPECIALLY WITH A LOT OF THE
WORK THAT LEGISLATURES DONE ON
MAKING THOSE CAPITAL INVESTMENTS
AVAILABLE TO PAIR TO MAKE.
EVERYTHING YOU KNOW, SITUATED
TOGETHER, AND IS THAT GOING TO
BE EXPLICIT IN THE BOND IN TERMS
OF WHAT THE ONGOING FUNDING IS
GOING TO BE, OR IT WOULD BE ONE
OF SEVERAL USES ULTIMATELY INTO
THE SECRETARY'S POINT EARLIER,
THERE'S THE DISCRETION INHERENT
WITH THEIR USE OF THOSE DOLLARS
SO IT COULD BE DEPENDING ON THE
STRATEGIC PRIORITIES.
ULTIMATELY, WITHIN THAT FUNDING
SOURCE. THEY COULD PAIR IT AND
WE'VE SEEN EVEN, UM, YOU KNOW,
FOR A LONG TIME IMAGE TO SAY, UH
, BEING A, YOU KNOW, FUNDING
SOURCE THAT WE'VE SEEN TITLE
UNITS, BUT IT SOUNDS LIKE YOU
KNOW, FROM MY PERSPECTIVE, WE'RE
GOING TO NEED MORE RESOURCES FOR
THIS RIGHT FOR ONGOING FUNDING.
ULTIMATELY THE MORE CAPITAL
THEIR RESOURCES THAT ALLOWS US
TO SCALE SO TO THE YOU KNOW,
PROCEEDING POINT THE ABILITY FOR
US TO HAVE THESE DOLLARS FOR
COUNTIES TO TIE TO OTHER STATE
FEDERAL INVESTMENTS. THAT REALLY
DOES HELP MOVE THE LEVER. BUT
YOU NEED EVERYTHING IS ADDITIVE.
ULTIMATELY I REMEMBER AND EVEN
THE OTHER, UH, YOU KNOW, EVEN
WITH CONSTRAINED BUDGET
ENVIRONMENT THAT WE HAVE OTHER
BIKE SHARE PROGRAMS AT HDD THAT
WE HELPED TO OVERSEE. THOSE ARE
OTHER OPPORTUNITIES THAT ARE
PROVIDED WITH THIS PROPOSAL. AND
ON ON THE HOUSING PIECE IN
PARTICULAR, I'M READY, WILLING
AND ABLE TO WORK WITH ANYONE
AROUND ONGOING FUNDING FOR
HOUSING BECAUSE IT'S VERY
CRITICAL. SO UM, IF THIS OPENS
UP THAT OPPORTUNITY WOULDN'T
WOULD LOVE TO WALK THROUGH THAT
DOOR WITH YOU ALL. UM THE OTHER
QUESTION. I WANTED TO RAISE. UM
IN THE PREVIOUS PANEL, UM DR
KUSHELL RAISED, UM SHE DISCUSSED
. UH AND I WANT TO SORT OF
EXPLORE THIS FURTHER WITH YOU.
UM BLACK FOLKS ARE OVER
REPRESENTED IN THE HOMELESS
POPULATION BUT MAY NOT RECEIVE
BEHAVIORAL HEALTH SERVICES ON
THE SAME LEVEL AS WHITE FOLKS
BECAUSE OF SOME OF THE
STRUCTURAL RACISM THAT EXISTS
WITHIN OUR, UM, HEALTHCARE
PRACTICES. UM. THE BOND FUNDING
FOR SUPPORTIVE HOUSING IS
LIMITED TO PEOPLE WITH
BEHAVIORAL HEALTH CHALLENGES. IS
THAT TOO NARROW OF A DEFINITION
? OR COULD THAT CREATE SOME
LEVEL OF UNINTENDED INEQUITIES
THAT COULD BE EXACERBATED. AND
COULD WE THINK ABOUT MAYBE
LENGTH OF TIME OR SOMETHING
ELSE. JUST BECAUSE THAT DATA WAS
INTERESTING TO ME, AND I WANT TO
CONNECT THAT TO THIS PROPOSAL.
YEAH. SO. UM I THINK WE NEED TO
HAVE A LOT OF IMPORTANT
CONVERSATIONS ABOUT HOW BEST TO
DO THIS. I THINK OUR INTENT IS
TO MAKE SURE THAT SOME OF THOSE
DISPARITIES IN EITHER DIAGNOSES
OR ACCESS TO TREATMENT AND
SERVICES BASED ON RACE OR
ETHNICITY OR ANY OTHER
DISTINGUISHING CHARACTERISTIC
THAT WE REALLY WORK HARD THROUGH
THE PLANNING PROCESS THROUGH OUR
DATA COLLECTION. TO START TO SEE
THOSE ERODE A BIT. AND ENSURE
THAT THE SERVICES THAT ARE
NEEDED ON THE BEHAVIORAL HOUSE
SIDE ARE ACTUALLY GETTING TO
THOSE WHO NEED THEM THE MOST. I
THINK, UH, DR MICHELLE MENTIONED
SPECIFICALLY ALSO SUBSTANCE USE
DISORDER SERVICES AS ANOTHER
AREA WHERE WE HAVE QUITE A BIT
OF WORK TO DO TO MAKE SURE THAT
DISPROPORTIONALITY AS A RACIST.
UH THE IDEA THAT THE PERMANENT
SUPPORTIVE HOUSING, UH, UNITS
SUPPORTED THROUGH THE BOND ARE
AVAILABLE TO PEOPLE WITH
BEHAVIORAL HEALTH. UH CONDITIONS
. SEVERE BEHAVIORAL HEALTH
CONDITIONS. UH IS REALLY
CRITICAL TO MAKE SURE THAT THAT
CONNECTION THEN TO KIND OF
ADDRESS A LITTLE BIT MORE. YOUR
FIRST QUESTION. THOSE ONGOING
SERVICES THAT IMAGINE THAT ONE
OF THESE PSH UNITS IS OCCUPIED
BY SOMEBODY WHO HAS A SERIOUS
BEHAVIORAL HEALTH CONDITION THAT
HOUSING ITSELF IS NOT MAGICAL IN
A WAY, AND DR CRUCIAL MENTIONED
IT. IT NEEDS THE ROBUST SERVICES
THAT ARE EVIDENCE BASED THAT ARE
DONE WITH FIDELITY TO THAT
EVIDENCE BASED MODEL AND MAKING
SURE THAT OUR BHS A FUNDING AND
THE EXPECTATIONS AROUND. FOR
EXAMPLE, FULL SERVICE
PARTNERSHIPS SUPPORT THAT
INDIVIDUAL IN THAT UNIT, SO IN
MANY WAYS, I THINK WE HAVE TO
ADDRESS THE DISPROPORTIONALITY
THROUGH A NUMBER OF DIFFERENT.
UM UH ACCESS POINTS IF YOU WILL
, AND THE PLAN IS GOING TO BE
CRITICAL, BUT I THINK HAVING
THESE UNITS ATTACHED AND SET
ASIDE FOR PEOPLE WITH SERIOUS
BEHAVIORAL HEALTH CONDITIONS
WHERE THERE IS AN ONGOING
FUNDING SOURCE IN THIS PROPOSAL
TO NOT JUST FUND UNITS
THEMSELVES THROUGH RENTAL
SUBSIDIES OR OTHER MEASURES, BUT
ALSO TO MAKE SURE IT'S LINKED TO
THE SERVICES THAT ARE NEEDED.
GIVE US THE BEST CHANCE TO MAKE
SURE INDIVIDUALS DO NOT FALL
THROUGH THE CRACKS. THANK YOU.
UM, WITH THAT. APPRECIATE YOUR
PARTICIPATION TODAY, AND, UH, WE
ARE READY TO MOVE ON TO OUR NEXT
PANEL. THANK YOU FOR ALL OF YOUR
TIME, APPRECIATE A CHANCE TO
ENGAGE ON ALL THESE ISSUES.
GREAT AND SO NEXT, WE WILL BE
HEARING. THIS IS OUR FOURTH
PANEL. THE HOUSING PANEL.
LOURDES MORALES, PRINCIPAL
FISCAL AND POLICY ANALYSTS AND
RYAN MILLER, PRINCIPAL FISCAL
AND POLICY ANALYSTS, LEGISLATIVE
ANALYST'S OFFICE. KEELEY, DEPUTY
COUNTY EXECUTIVE, SANTA CLARA
COUNTY UM SIOBAHN KOTHARI,
DEPUTY COUNTY EXECUTIVE FOR
SOCIAL SERVICES, SACRAMENTO
COUNTY AND DOUG SHOEMAKER,
PRESIDENT MURSI HOUSING
CALIFORNIA AND ALSO WANT TO NOTE
WE WILL BE BREAKING AT NOON. SO
IF WE'RE NOT DONE WITH THIS
PANEL, WE CAN PICK IT BACK UP AT
1 30. BUT YOU MAY BEGIN. GOOD
AFTERNOON. CHAIRS AND MEMBERS
ORTEZ MORALES WITH THE
LEGISLATIVE ANALYST'S OFFICE.
I'VE BEEN ASKED BY STAFF TO
PROVIDE SOME OF THE COMMITTEE
SOME CONTEXTUAL INFORMATION
ABOUT EXISTING STATE HOUSING AND
HOMELESSNESS PROGRAMS FOR
VETERANS AND OTHERS WITH
BEHAVIORAL HEALTH NEEDS. I WILL
ALSO BE PRESENTING OUR
ASSESSMENT OF THE GOVERNOR'S
BEHAVIORAL HEALTH BOND, WHICH IS
CURRENTLY MOVING THROUGH THE
LEGISLATURE IN THE FORM OF A B 5
31. YOU SHOULD HAVE A COPY OF
THE HANDOUT BEFORE YOU THAT I
WILL BE USING DURING MY
TESTIMONY. IT IS ALSO AVAILABLE
AT THE L. A WEBSITE. SO ON THE
1ST AND 2ND PAGE OF THE HANDOUT,
WE BRIEFLY SUMMARIZED THE KEY
TAKEAWAYS FROM OUR ASSESSMENT OF
THE PROPOSED $4.7 BILLION
BEHAVIORAL HEALTH FACILITIES AND
HOUSING FOR VETERANS BOND. WE
FIND THAT THE GOVERNOR'S
PROPOSED BOND APPEARS BROADLY
REASONABLE AS IT USES AN
APPROPRIATE FUNDING MECHANISM TO
ADDRESS A WELL DOCUMENTED NEED
FOR BEHAVIORAL HEALTH FACILITIES
AND HOUSINGS. BUT THE PROPOSAL
ALSO RAISES QUESTIONS FOR
LEGISLATIVE CONSIDERATION.
ULTIMATELY WE DO FIND THAT THE
GOVERNOR'S PROPOSED UM, PROPOSES
A LIMITED ROLE FOR THE
LEGISLATURE IN NOT ONLY
DESIGNING BUT ALSO IMPLEMENTING
THE BOND, AND WE WILL MAKE A
NUMBER OF RECOMMENDATIONS THAT
WOULD ENSURE THAT THE
LEGISLATURE WOULD HAVE AN ACTIVE
AND ONGOING ROLE IN ENSURING THE
BOND SUCCESS. AND SO BEFORE I
GET TO THE UPDATES ON THE
EXISTING STATE PROGRAMS, THERE'S
A BIT OF RELEVANT BACKGROUND I
WANTED TO PROVIDE, BEGINNING ON
PAGE THREE ABOUT PUBLIC
BEHAVIORAL HEALTH SERVICES AND
HOW THEY ARE DELIVERED IN THE
STATE. SO GENERALLY, COUNTIES
PLAY A MAJOR ROLE IN FUNDING AND
DELIVERING PUBLIC BEHAVIORAL
HEALTH SERVICES. AND COMMUNITIES
. UM VERY THESE COUNTIES RELY ON
A VARIETY OF SORT OF MAJOR
DEDICATED AN ONGOING FUNDING
SOURCES TO DELIVER THESE
SERVICES PRIMARILY REALIGNMENT
REVENUE AS WELL AS MHS S¼ FUNDS.
AND, UM, FEDERAL FUNDS THROUGH
THE MEDICAL PROGRAM. THERE WAS A
RECENT STUDY LED BY THE RAND
CORPORATION ESTIMATED A SHORTAGE
OF BEHAVIORAL HEALTH BEDS IN
CALIFORNIA, AS SHOWN IN FIGURE
ONE ON PAGE THREE, THE ESTIMATED
SHORTAGES SIGNIFICANT ABOUT 7800
TOTAL UNITS AND IS PARTICULARLY
SEVERE AT THE COMMUNITY
RESIDENTIAL LEVEL. TURNING TO
PAGE FOUR. ALTHOUGH WE KNOW
HOUSING AFFORDABILITY IS NOT, UM
ALTHOUGH WE KNOW HAS AN
AFFORDABLY IS THE MOST
SIGNIFICANT FACTOR IN THE STATES
HOMELESSNESS CRISIS, THERE IS A
NUMBER OF INDIVIDUALS
EXPERIENCING HOMELESSNESS WHO
ALSO HAVE BEHAVIORAL HEALTH
NEEDS. ESTIMATES VARY ON EXACTLY
HOW MANY INDIVIDUALS
EXPERIENCING HOMELESSNESS ALSO
SUFFER FROM BEHAVIORAL HEALTH
DISORDERS. WE HAD SOME DATA
PRESENTED ON THIS MATTER IN THE
EARLIER PANEL AT THIS HEARING.
HERE WE CITE DATA FROM THE 2022
POINT IN TIME COUNT FROM THE U.
S. DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT. UM, WHICH
NOTES THAT 23% OF PEOPLE
EXPERIENCING HOMELESSNESS IN
CALIFORNIA SUFFERED FROM A
MENTAL HEALTH ILLNESS. 21%
SUFFERED FROM CONVICTS SUBSTANCE
USE DISORDER. WE KNOW THAT
THERE'S LIKELY OVERLAP BETWEEN
THESE POPULATIONS BUT THE DEGREE
TO WHICH IS UNKNOWN. BUT WE ALSO
KNOW THAT SORT OF INDIVIDUALS
WHO BOTH EXPERIENCE HOMELESSNESS
AND HAVE BEHAVIORAL HEALTH NEEDS
COULD PARTICULARLY BENEFIT FOR
MORE COMPREHENSIVE APPROACHES.
TAKE CARE THAT INCLUDES BOTH
HOUSING SUPPORTS PAIRED WITH
BEHAVIORAL HEALTH SERVICES. ON
THE NEXT FEW PAGES OF THE
HANDOUT. WE PROVIDE
IMPLEMENTATION, UPDATES FOR FOUR
KEY STATE HOUSING AND
HOMELESSNESS PROGRAMS. I'LL
START WITH THE DISCUSSION OF THE
BEACH UP PROGRAM, THE BEHAVIORAL
HEALTH CONTINUUM INFRASTRUCTURE
PROGRAM ON PAGE SIX OF THE
HANDOUT. THE $1.7 BILLION IN ONE
TIME FUNDING PROVIDED FOR THIS
PROGRAM MAKES GRANTS AVAILABLE
TO DEVELOP NEW BEHAVIORAL HEALTH
TREATMENT FACILITIES. TO DATE.
FIVE OF THE SIX ROUNDS OF BISHOP
FUNDING TOTALING $1.6 BILLION
HAS BEEN AWARDED. ROUND ONE
REALLY FOCUSED, FOCUSED ON
FUNDING TO CREATE AND EXPAND 109
MOBILE CRISIS TEAMS. ROUND TWO
PROVIDED PLANNING GRANTS TO 50
TRIBES AND COUNTY GRANTEES. AND
ROUND THREE THROUGH FIVE MADE
129 AWARDS THAT ARE EXPECTED TO
ADD 2500 BREADS ACROSS VARIOUS
FACILITY TYPES. TURNING TO HOME
KEY ON PAGE SEVEN AND EIGHT OF
YOUR HAND OUT UM, THE HUNKY
PROGRAM PROVIDES GRANTS TO LOCAL
PUBLIC AGENCIES AND TRIBES IN
ORDER TO ACQUIRE AND
REHABILITATE PROPERTIES LIKE
MOTELS AND HOTELS IN ORDER, UM
TO TRANSFORM THESE PROPERTIES
FOR PERMANENT, PRIMARILY
PERMANENT BUT ALSO SOME INTERIM
HOUSING FOR PEOPLE EXPERIENCING
OR AT RISK OF HOMELESSNESS. $3.7
BILLION HAS BEEN ALLOCATED TO
THIS PROGRAM TO BE USED OVER
THREE YEARS AND 2.8 BILLION OF
THAT FUNDING HAS ALREADY BEEN
AWARDED. UM, THE TABLE ON PAGE
EIGHT PROVIDES AN OVERVIEW OF
THAT NEARLY $2.8 BILLION. AS YOU
CAN SEE, MOST OF THE FUNDING
WENT TO COMMUNITIES IN LOS
ANGELES COUNTY, WHERE OVER 4000
UNITS WILL BE MADE AVAILABLE DUE
TO THAT PROGRAM. OVERALL HOME.
KEY HAS FUNDED 210 PROJECTS
ACROSS THE STATE AS A FEBRUARY
2021, WHICH COLLECTIVELY ARE
EXPECTED TO CREATE 12,800
HOUSING UNITS GOING ONCE THE
MOST OF WHICH ARE PERMANENT, AND
MANY OF THEM ARE ALREADY IN USE
. MOREOVER BECAUSE THESE
PROPERTIES HAVE COVENANTS THAT
ENSURE THEIR AFFORDABILITY OVER
55 YEARS HDD, WHICH ADMINISTERS
THE PROGRAM, ANTICIPATES THAT
THESE UNITS WOULD SUPPORT
212,000 PEOPLE OVER THE LIFETIME
OF THESE UNITS. NEXT IN 2018
VOTERS AUTHORIZED $2 BILLION IN
BOND FUNDING FOR THE NO PLACE
LIKE HOME PROGRAM TO CONSTRUCT
NEW AND REHABILITATE EXISTING
PERMANENT SUPPORTIVE HOUSING FOR
PEOPLE WHO NEED MENTAL HEALTH
SERVICES AND ARE EXPERIENCING OR
AT RISK OF HOMELESSNESS. ALL OF
THIS POND FUNDING HAS ALREADY
BEEN ALLOCATED AS OF AUGUST 2022
AND THE PROGRAM PROVIDED 247
PROJECTS TO NEARLY TWO SUPPORT
NEARLY 8000 HOUSING UNITS. TO
THE FINAL PROGRAM WE WANTED TO
HIGHLIGHT FOR YOU TODAY IS THE
VETERAN HOUSING AND HOMELESSNESS
PROGRAM ON PAGE 10 OF YOUR HAND
OUT. UM THIS PROGRAM IS
SUPPORTED BY $600 MILLION IN
BOND FUNDING FROM 2014. THE
PROGRAM SUPPORTS AFFORDABLE
MULTIFAMILY RENTAL HOUSING FOR
VETERANS AND THEIR FAMILIES. THE
TABLE PROVIDES DETAILS ON AWARDS
TO VARIOUS REGIONS ACROSS THE
STATE. AS OF DECEMBER, 2021. YOU
CAN SEE A TOTAL OF $480 MILLION
HAS BEEN AWARDED OR HAD BEEN
AWARDED. AS OF THAT TIME, AND
ONCE AGAIN, MOST OF IT HAD GONE
TO LAST LOS ANGELES TO SUPPORT
AN OF NEARLY 3000 UNITS. UM
SENSE THE DATA ON THAT TABLE HD
HAS MADE ADDITIONAL AWARDS. AND
SO THEY INDICATE THAT ABOUT $62
MILLION REMAINS AVAILABLE. THERE
IS A CALL FOR AWARDS ON THAT
FUNDING, AND SO FAR APPLICATIONS
HAVE SOUGHT OUT $109 MILLION.
AND SO WE EXPECT THAT ONCE THOSE
AWARDS ARE MADE, THIS FUNDING
SOURCE WILL BE EXHAUSTED. AND SO
, UM, ON THE NEXT PAGE, YOU
PROVIDED JUST A BIT OF CONTEXT
ABOUT BONDS. GENERALLY AS THAT
IS A ISSUE OF CONSIDERATION
BEFORE THE COMMITTEE. AND HERE.
I'LL JUST NOTE THAT AS OF JULY
1ST 2023 THE TOTAL AMOUNT OF
AUTHORIZED GENERAL OBLIGATION
BONDS AND DEBTS THAT REMAIN
OUTSTANDING FOR THE STATE IS $95
BILLION. THAT'S A COMBINATION OF
$71 BILLION FOR BONDS THAT HAVE
ALREADY BEEN ISSUED, BUT NOT
FULLY REPAID, AS WELL AS $25
BILLION IN BONDS THAT HAVE BEEN
AUTHORIZED BY VOTERS BUT HAVE
NOT BEEN SOLD AS OF YET. UM, THE
2023 24 BUDGET PACKAGE REFLECTS
NEARLY $7 BILLION IN DEBT
SERVICE FOR THESE GENERAL
OBLIGATION BONDS, OR ABOUT 3% OF
THE GENERAL FUND REVENUES. UM
THESE DEBT SERVICE COSTS ARE
ABOUT AS LOW AS THEY HAVE BEEN
IN RECENT DECADES AND ARE ABOUT
HALF OF WHAT THEY WERE AT THEIR
RECENT PEAK, WHICH IS ABOUT 6.
IN THE 2010 2011 FISCAL YEAR.
AND SO WITH THAT CONTEXT OF
EXISTING PROGRAMS IN MIND, ALL
OF WHICH ONCE AGAINST ARE EITHER
SORT OF EXHAUSTED OR NEARLY
EXHAUSTED. ON PAGE 12. WE
PROVIDE A BRIEF SUMMARY OF THE
$4.7 BILLION BOND PROPOSED BY
THE GOVERNOR TO CONSTRUCT AND
REHABILITATE, UM UP TO 1000
BEHAVIORAL HEALTH UNITS FOR
RESIDENTIAL SETTINGS AS WELL AS
HOUSING FOR VETERANS. AND OTHER
INDIVIDUALS AT RISK OR
EXPERIENCING HOMELESSNESS. IN
PARTICULAR, THE BOND PROPOSES UP
TO $865 BILLION IN FUNDING FOR
HOUSING. AS THE REMAINDER OF
THAT FUNDING WOULD GO TO BED AND
COMMUNITY BASED TREATMENT
SETTINGS. UM FOR THIS
RESIDENTIAL CARE. AND SO THE
REST OF THE HANDOUT REALLY
PROVIDES OUR ASSESSMENT OF THIS
BOND. ONCE AGAIN, WE DO FIND
THAT THE BOND IS BROADLY
REASONABLE. HOWEVER WE RAISED A
NUMBER OF QUESTIONS FOR
LEGISLATIVE CONSIDERATION. MANY
OF THESE QUESTIONS HAVE ALREADY
BEEN RAISED BY COMMITTED TO THE
ADMINISTRATION. SO FOR EXAMPLE,
HOW WOULD LOCALS FROM THE
ONGOING COSTS TO SUPPORT
PERMANENT HOUSING? UM WE ALSO
HAVE QUESTIONS ABOUT THE
SHORTAGE OF ACUTE PSYCHIATRIC
BEDS BY FOCUSING ON UNLOCKED
VOLUNTARY COMMUNITY BASED
TREATMENT CENTERS. THE
GOVERNOR'S PROPOSAL WOULD NOT
ADDRESS THE NEARLY 2000 ACUTE
BED SHORTAGE IDENTIFIED BY THE
RAND STUDY. AND SO AS THERE ARE
DIFFERENT TYPES OF FUNDS, UM
DIFFERENT TYPES OF BED SHORTAGES
ACROSS THE STATE. UM SOME
COMMUNITIES MIGHT BE MOST
AFFECTED, LIKE THE SUN, HOOKING
VALLEY AND THE NORTH COAST IN
THIS SITUATION. IN THE INTEREST
OF TIME. I WILL JUST SORT OF GET
TO SORT OF OUR OUR BOTTOM LINE,
WHICH IS TO RECOMMEND A NUMBER
OF CHANGES TO ENSURE THAT, UM
THE LEGISLATURE DOES HAVE A MORE
ACTIVE AND ONGOING ROLE. AND SO
WE WOULD SAY THAT WE RECOMMENDED
THE LEGISLATURE CHANGED FROM
DOING IT NOW. CONTINUOUS
APPROPRIATION, WHICH IS WHAT
PROPOSED THIS PROPOSED BY THE
GOVERNOR TO HAVE, UM THE
AUTHORIZATION OF THE FUNDS GO
THROUGH THE ANNUAL BUDGET
PROCESS TO ENSURE THE
LEGISLATURE HAS A MORE ACTIVE
ROLE. UM IN DOING THIS, THE
LEGISLATURE COULD EITHER SORT OF
AMEND THE STATUTE OR DIFFER SOME
DECISIONS TO A SECOND YEAR FOR
SUCH THINGS, AS YOU KNOW THE
METHODOLOGY ABOUT HOW THE BOND
FUNDING WOULD BE ALLOCATED AND
WHO WOULD BE ELIGIBLE FOR THAT
FUND. AND THEN WE ALSO RECOMMEND
THE LEGISLATURE ESTABLISHED
OVERSIGHT AND REPORTING
REQUIREMENTS TO ENSURE YOU CAN
SORT OF GAUGE HOW THE BOND IS
BEING IMPLEMENTED AND THAT THE
GOALS ARE BEING MET OVER TIME.
THANK YOU. UH GOOD MORNING. MY
NAME IS KEELY I'M A DEPUTY
COUNTY EXECUTIVE WITH THE COUNTY
OF SANTA CLARA, WHERE MY PRIMARY
FUNCTIONS ARE TO SUPPORT OUR
EFFORTS TO REDUCE AND PREVENT
HOMELESSNESS AND TO INCREASE AND
IMPROVE BEHAVIORAL HEALTH
SERVICES FOR RESIDENTS WITH OUR
WITH LEAST MEANS. UM ON BEHALF
OF OUR COUNTY EXECUTIVE JAMES
WILLIAMS. HAPPY TO PARTICIPATE
TODAY. THANK YOU VERY MUCH. UM
FIRST, I WANT TO CONVEY OUR
APPRECIATION FOR THE SUBSTANTIAL
INVESTMENTS THAT THE STATE IS
MADE IN, UM, LONG NEEDED
BEHAVIORAL HEALTH TREATMENT
FACILITIES AND AFFORDABLE
HOUSING, RELATIVELY RECENT
CAPITAL PROGRAMS LIKE AND CC
COMBINED WITH OLDER PROGRAMS FOR
THE FIRST TIME, REPRESENT A FULL
CONTINUUM OF HOUSING AND
TREATMENT OPTIONS. I'M FROM
ACUTE INPATIENT SETTINGS TO
TEMPORARY SHELTER TO PURPOSE,
SUPPORTIVE HOUSING AND TO
RESIDENTIAL CARE FACILITIES. WE
BELIEVE THAT THE STATE SHOULD
CONSIDER MAINTAINING AND
EXPANDING THE PORTFOLIO OR FULL
CONTINUUM OF PROGRAMS AND
PROJECTS FUNDED BY THE HOUSING,
BOND OR OTHER SOURCES SHOULD
BUILD ON OR EXPAND ON THE
EXEMPTIONS OFFERED UNDER B SHIP
AND PROJECT HOME KEY. IN SANTA
CLARA COUNTY. WE'VE BEEN WORKING
HARD TO MAXIMIZE EVERY
OPPORTUNITY TO STATE HAS
PROVIDED WITH OUR $950 MILLION
HOUSING BOND. AS A CATALYST, WE
COORDINATED LOCAL FUNDING FROM
CITIES. RESOURCES FROM OUR
HOUSING AUTHORITY AND
PHILANTHROPIC FUNDS FROM META
APPLE AND CISCO THROUGH OUR
PARTNERS DESTINATION HOME TO
MORE THAN DOUBLE OUR SUPPORTIVE
HOUSING CAPACITY IN THE LAST
EIGHT YEARS WITH THE PIPELINE OF
1300 UNITS COUNTYWIDE. WELL,
PERMANENT HOUSING OPTIONS
CONTINUE TO BE A PRIORITY.
SENATE, CLARE COUNTY AND ITS
PARTNERS HAVE ALSO COMMITTED TO
DOUBLING TEMPORARY SHELTER
CAPACITY. UM AND, UH WE HAVE
INCREASED IT BY 66% AND HOPE TO
REACH 100% BY 2025 MORE RECENTLY
WE'VE ACCESSED THE STATE B H C I
P AND C C E FUNDS TO CONSTRUCT
OR START CONSTRUCTION OF A 77
BED, ACUTE CARE PSYCHIATRIC
FACILITY PLAN A SKILLED NURSING
FACILITY. REVIEWING COUNTY OWNED
PROPERTIES FOR MENTAL HEALTH
REHABILITATION CENTERS OPEN TO
28 BED RESIDENTIAL TREATMENT
FACILITY AND WE'RE LOOKING TO
FUND CONSTRUCTION OF NEW
RESIDENTIAL CARE FACILITIES ON
COUNTY OWNED LAND. WE DEFINITELY
BELIEVE THAT MAKE WE HAVE TO
MAKE SURE EVERYONE HAS A HOME.
BUT FROM TIME TO TIME WE HAVE TO
MAKE SURE THAT THEY ARE ABLE TO
ACCESS THE TEMPORARY TREATMENT
SERVICES THAT ARE NECESSARY AND
IF APARTMENTS EVEN WITH
INTENSIVE SERVICES ARE NOT
ADEQUATE. WE NEED TO PROVIDE
OTHER RESIDENTIAL SETTINGS.
WHILE WE ENCOURAGE THE STATE TO
CONTINUE TO EXPAND CAPITAL
FUNDING SOURCES, OUR SECOND
RECOMMENDATION IS THAT THE STATE
AUTHORIZED COUNTIES TO DIRECTLY
ADMINISTER FUNDING ALLOCATIONS.
SIMILAR TO NO PLACE LIKE HOME.
COMMUNITIES WITH SUFFICIENT
EXPERIENCE, INFRASTRUCTURE AND
DEVELOPMENT PIPELINE SHOULD
RECEIVE A DIRECT ALLOCATION OF
FUNDS AND BE GIVEN THE LATITUDE
TO ADMINISTER STATE FUNDS TO
ADDRESS LOCAL NEEDS AND TO
MAXIMIZE LOCAL RESOURCES. FOR
EXAMPLE, ALTHOUGH THE RAND STUDY
INDICATED A SHORTAGE OF
PSYCHIATRIC BEDS AT ALL THREE
LEVELS STATEWIDE, RAND'S REPORT
FOR SANTA CLARE COUNTY SHOWED
THAT THERE WERE NEEDS PRIMARILY
IN THE SUB ACUTE AND COMMUNITY
RESIDENTIAL LEVELS. KEEPING LONG
RANGE PLANNING AND COORDINATION
AT THE LOCAL LEVEL IS ALSO
IMPORTANT BECAUSE CAPITAL
RESOURCES ARE ONLY THE START OF
THE SOLUTION. AS MANY OF YOU
INDICATED. TREATMENT FACILITIES
SHELTER, SUPPORTIVE HOUSING
PROGRAMS REQUIRE ONGOING
FUNDING. DEPENDING ON THE TYPE
OF THE FACILITY OF PROJECT. IT
IS THE COUNTIES OR CITIES THAT
WOULD BEAR SOME OF THE FINANCIAL
RISK. EACH PROJECTS CAPITAL
STACK RELIES ON BRAIDED
OPERATIONAL FUNDING PLAN
DOWNSTREAM OR SANTA CLARA COUNTY
. THAT MEANS THAT THE COUNTY
CITY OF SAN JOSE AND OTHERS ARE
COORDINATING EXPENDITURE PLANS.
FOR HHS ÁP BEHAVIORAL HEALTH,
BRIDGE, HOUSING EMERGENCY
SOLUTIONS AND ONE TIME
INVESTMENTS FROM MEDICAL MANAGED
CARE PLANS. KEEPING RESOURCES
LOCAL CAN ALSO REDUCE THE
UNCERTAINTY AND THUS ALLOWING
CITIES AND COUNTIES TO DEVELOP
AND IMPLEMENT LONG RANGE PLANTS.
UM, IN THAT IN THAT VEIN, OUR
LAST RECOMMENDATION IS RELATED
TO OUTCOMES AND PLANNING. THE
STATE AND COUNTIES AND CITIES
WILL CONTINUE TO RELY ON A MIX
OF FUNDING SOURCES. WE BELIEVE
THAT IN ORDER TO ACHIEVE THE
STATE'S OBJECTIVES, THE STATE
SHOULD FOCUS ON ESTABLISHING AND
SIMPLIFYING. CLEAR OUTCOMES,
ESPECIALLY THOSE OUTCOMES
RELATED TO HOUSING AND
HOMELESSNESS. AND THEN
ENCOURAGING OR REQUIRING CITIES
, COUNTIES AND OTHER ENTITIES
TO, UM, SUBMIT A COORDINATED
EXPENDITURE PLANS. THE STATE HAS
ALREADY TAKEN STEPS IN THIS
DIRECTION WITH SOME OF ITS
PROGRAMS AND SHOULD CONTINUE TO
DO SO. THE MOST IMPORTANT
OUTCOME, OF COURSE, ARE THOSE
RELATED TO THE PRODUCTION OF
BEDS, HOUSING UNITS. AND THE
NUMBER OF PEOPLE WHO ARE HOUSED
INTO THE PERCENTAGE THAT RETAIN
THEIR HOUSING OVER TIME. THANK
YOU. THANK YOU. GOOD MORNING. MY
NAME IS STEPHEN QATARI AND I'M
DEPUTY COUNTY EXECUTIVE IN
SACRAMENTO COUNTY, OVERSEEING
OUR HEALTH AND HUMAN SERVICE
FUNCTIONS, INCLUDING BEHAVIORAL
HEALTH, AS WELL AS HOMELESSNESS
AND HOUSING PROGRAMS. UM, THANK
YOU FOR HAVING ME TODAY.
SACRAMENTO COUNTY REALLY
APPRECIATES THE INTENT BEHIND
THE MODERNIZATION PROPOSAL AND
THE EMPHASIS ON INCREASED
BEHAVIORAL HEALTH SERVICES AND
HOUSING SUPPORTS TOUR AND HOUSED
NEIGHBORS. YEAH, WE ARE
CONCERNED THAT ASKING COUNTIES
TO DO MORE WITH LESS WILL LEAD
TO UNINTENDED CONSEQUENCES,
REDUCING OUR ABILITY TO BE
EFFECTIVE WITH ALL OF THE
POPULATIONS WE SERVE. AS AS DR
KUSHELL POINTED OUT, APTLY
HOMELESS. SORRY, FOLKS COULD, UH
, NOT APPLAUSE DURING COMMITTEE.
THAT'D BE GREAT. THANK YOU. AS
DR KUSHELL APTLY POINTED OUT
HOMELESSNESS RESULTS LARGELY
FROM THE LACK OF AFFORDABLE
HOUSING HOUSING COSTS HAVE
SOARED IN SACRAMENTO COUNTY, AND
WE LACK THE NUMBER OF AFFORDABLE
HOUSING UNITS NECESSARY. AS WE
WORK TO BUILD MORE, WE MUST ALSO
HAVE THE BEHAVIORAL HEALTH
SERVICES TO BOTH STABILIZE AND
PROVIDE ONGOING PERMANENT
SUPPORTS TO KEEP FOLKS
SUCCESSFULLY HOUSED. THE CURRENT
PROPOSAL SHIFTS 30% OF OUR MHS A
FUNDING AWAY FROM OUTPATIENT AND
CRISIS SERVICES TO THE HOUSING
BUCKET, WHILE ALSO ADDING A NEW
GROUP OF CLIENTS EXPERIENCING
SUBSTANCE USE DISORDERS. DUE TO
THE WAY WE LEVERAGE FEDERAL
FUNDING FUNDING IN SACRAMENTO
COUNTY. THIS EQUATES TO ABOUT
$64 MILLION, OR ABOUT 65% OF OUR
OUTPATIENT AND CRISIS SERVICES
ANNUAL BUDGET. SHRINKING THE PIE
REDUCES OUR ABILITY TO KEEP
FOLKS IT'S STABILIZED AND
HOUSED. INDIVIDUALS WITH SERIOUS
MENTAL ILLNESSES HAVE UNIQUE
HOUSING NEEDS, AND MANY REQUIRE
HOUSING WITH A HIGHER LEVEL OF
CARE, SUCH AS BOARD AND CARE
PROGRAMS. SACRAMENTO IS RAPIDLY
LOSING BOARD AND CARE OPERATORS
DUE TO THE GROWING COST OF DOING
BUSINESS. AND WE HAVE USED OUR
FLEXIBLE MHS A FUNDS TO
INCENTIVIZE BOARDING CARE
OPERATORS TO HOUSE OUR
CONSUMERS. COUNTY'S ASKED FOR
CHANGES TO THE HOUSING PORTION
OF THE MODERNIZATION OF PROPOSAL
TO ENSURE THAT THE FUNDS CAN BE
SPENT ON A BROAD ARRAY OF
FLEXIBLE HOUSING OPTIONS. AFTER
RECENT AMENDMENTS, FUNDING IS
STILL NARROWER THAN UNDER
CURRENT LAW AND ADDS RESTRICTED
DEFINITION OF HOUSING SUPPORTS
AND SERVICES. LIKE CAL AIM.
THESE SERVICES ARE GENERALLY
LESS INTENSIVE AND MORE TIME
LIMITED THAN MOST OF OUR CLIENTS
NEED. WHERE CONCERNED THAT
PROVIDERS OF PERMANENT
SUPPORTIVE HOUSING MAY NOT HAVE
THE FLEXIBILITY NEEDED TO FUND
CRITICAL PROJECT BASED
COMPONENTS OF THEIR PROGRAMS,
SUCH AS ON SITE SUPERVISION AND
RELATED SUPPORTS. THOSE WHO NEED
HOUSING WITHIN THE BEHAVIORAL
HEALTH SYSTEM OFTEN DO NOT MEET
THE FEDERAL DEFINITION OF
CHRONICALLY HOMELESS BECAUSE OF
THEIR TIME SPENT AND TREATMENT
FACILITIES OR INSTITUTIONS. WE
APPRECIATE THE INTENT TO
AUTHORIZE DHC S TO REDEFINE
CHRONICALLY HOMELESS TO BE MORE
INCLUSIVE BUT ARE CONCERNED THAT
MANY OF THE HOUSING PROGRAMS
SERVING THIS POPULATION WILL
STILL NEED TO COMPLY WITH THE
FEDERAL HUD REQUIREMENTS, AND WE
ENCOURAGED THE HCS. TO WORK WITH
COUNTIES TO DEVELOP THIS
DEFINITION. WE APPRECIATE THE
LANGUAGE IN THE BILL THAT
REDUCES BARRIERS TO CITING
HOUSING FOR OUR CLIENTS BY
EXPEDITING PERMITTING AND
POTENTIALLY ELIMINATING SECRET
REVIEW. WE ALSO SUPPORT THE
URBAN COUNTIES REQUEST FOR
LANGUAGE TO ENSURE THAT MERELY
ALLOCATING MHS A FUNDING TO
HOUSING PROJECTS DOESN'T TRIGGER
ADDITIONAL SEQUA REVIEW OR
CREATE AN INTENDED BARRIERS FOR
OUR DEVELOPMENT PARTNERS. THE
BOND MEASURE IS GENERALLY A GOOD
IDEA FOR BRINGING MORE TREATMENT
FACILITIES TO OUR COMMUNITIES
AFTER CONDUCTING A LOCAL RAND
STUDY SACRAMENTO COUNTY APPLIED
FOR AND WAS AWARDED BISHOP
FUNDING FOR MENTAL HEALTH
REHABILITATION CENTER, YOUTH
CRISIS FACILITIES AND THE
SUBSTANCE USE RESIDENTIAL
TREATMENT FACILITY. NONETHELESS
WE STILL NEED MORE TREATMENT
FACILITIES AND BEDS TO CLOSE OUR
GAPS AND SUPPORT OUR EFFORTS TO
INCREASE FUNDING FOR THIS
MEASURE. WE ARE CONCERNED BY THE
AMENDMENTS THAT D LINK THE BHS A
FROM THE ACCOMPANYING BOND
MEASURE. IF THE BOND FAILS,
COUNTIES WOULD LOSE SIGNIFICANT
RESOURCES FOR TREATMENT WITHOUT
A CORRESPONDING INCREASE IN NEW
FACILITIES OR HOUSING
PLACEMENTS. PASSAGE OF THE
HOUSING BOND IS ALSO CRITICAL
BECAUSE OF THE LIMITATION ON
CAPITAL FUNDING FOR THE HOUSING
UNDER BHS, A AS WRITTEN AS
WRITTEN ABOUT 7.5% OR 25% OF THE
30% OF THE HOUSING BUCKET CAN BE
USED FOR PHYSICAL HOUSING UNITS
, TRANSLATING TO ABOUT $7
MILLION ANNUALLY FOR SACRAMENTO
COUNTY. WE CURRENTLY INVEST THIS
MUCH OR MORE IN CURRENT MHS A
FUNDING TO LEVERAGE DEVELOPMENT
PROJECTS LOCALLY. MHM S¼ FUNDS
REPRESENT A VERY SMALL PORTION
OF THE FUNDING NEEDED TO BUILD
HOUSING UNITS. SO IN ADDITION TO
THE BOND, WE ASKED THE STATE AND
OUR FEDERAL PARTNERS TO CONTINUE
TO INVEST IN HOUSING DEVELOPMENT
THROUGH LOW INCOME TAX CREDITS,
MORTGAGE REVENUE BONDS AND THE
HCG MULTI FAMILY HOUSING PROGRAM
AMONGST OTHER SOLUTIONS. I WANT
TO JUST APPRECIATE YOUR TIME
TODAY AND IN CLOSING AS MUCH AS
WE APPRECIATE THE INTENT OF THIS
LEGISLATION, THIS WILL SHIFT AND
SHRINK THE OVERALL BUDGET, WHICH
WILL IMPACT TREATMENT AND
SERVICES NECESSARY FOR FOLKS. WE
SERVE TO BE SUCCESSFUL IN
SECURING AND MAINTAINING
OVERTIME. THANK YOU. THANK YOU
AND NEXT, PLEASE. GOOD MORNING.
SURE WOULD SHARE WIGS. THANK YOU
FOR THE OPPORTUNITY COMMITTEE
MEMBERS. I'M DOUG SHOEMAKER. I'M
THE PRESIDENT OF MERCY HOUSE IN
CALIFORNIA. FOR THOSE OF YOU
THAT I'M FAMILIAR WITH US. WE'RE
A NONPROFIT HOUSING PROVIDER. UH
WE WORK WITH SENIORS, VETS,
FAMILIES AND OTHER FOLKS EXITING
HOMELESSNESS WHERE THE LARGEST
NON PRIVATE HOUSING PROVIDER IN
THE COUNTRY AND WE ARE ALSO ONE
OF THE LARGER PERMANENT
SUPPORTIVE HOUSING DEVELOPERS
AND PROVIDERS IN THE STATE OF
CALIFORNIA. UM WE CURRENTLY
MANAGED 2400 PSH UNITS AND ARE
IN THE PROCESS OF DEVELOPING
ANOTHER 1200 IN 10 COUNTIES,
INCLUDING MANY OF THE COUNTIES
REPRESENTED HERE. YOU KNOW,
WE'RE EXCITED TO SEE THIS
PACKAGE MOVING FORWARD FRANKLY,
BECAUSE WE THINK IT HAS THE
OPPORTUNITY TO FILL A TREMENDOUS
GAP IN THE WORK AND ADDRESS SOME
OF THE BIG CHALLENGES THAT
REMAIN IN THIS WORK. UM IN
SUPPORTING THE PACKAGE. THOSE OF
US IN THE HOUSING AND SERVICE
PROVIDER COMMUNITY ARE HOPING
THAT THE LEGISLATURE AND THE
GOVERNOR'S OFFICE RECOGNIZE THAT
CAPITAL THE CAPITAL IN THESE
BONDS, IS AT MOST, A THIRD OF
WHAT'S REALLY REQUIRED TO
ADDRESS A LONG TERM EXITS FROM
HOMELESSNESS. I THINK YOU KNOW
IT WAS. IT WAS ASKED EARLIER BY
CHAIR WICKS IF THERE WAS
SUFFICIENT SERVICES, DOLLARS OR
RENTAL SUBSIDY DOLLARS TO REALLY
SUPPORT THE WORK THAT IS GOING
ON HERE, AND I JUST I'M SAD TO
TELL YOU THAT THERE ISN'T AND
WE'RE ACTIVE IN LOS ANGELES,
SACRAMENTO CONTRA COSTA ALAMEDA,
SACRAMENTO, YOLO. I MEAN, NAME A
COUNTY ORANGE. UM AND IN MOST OF
THOSE COUNTIES, THEY ARE
STRUGGLING WITH BOTH THE RENT
SUBSIDIES AVAILABLE, AS WELL AS
THE SERVICE DOLLARS. AND YOU
KNOW, SO I THINK IT'S VITALLY
IMPORTANT THAT THIS THIS EFFORT
MOVED FORWARD, BUT IT'S ALSO
EQUALLY IMPORTANT THAT THE
LEGISLATURE RECOGNIZE THAT WE
ARE NOT STAFFING. OUR CURRENT
PSH IS APPROPRIATELY AS WE NEED
TO, AND I HEARD EXCELLENT
TESTIMONY EARLIER FROM DR
CRUCIAL AND OTHERS ON THIS. UM
SO IF WE'RE GOING TO EXPAND, WE
REALLY NEED TO THINK THROUGH
EXACTLY HOW WE'RE GONNA SATISFY
THE NEEDS OF THE NEW HOUSING AND
THE AND THE BEDS THAT ARE COMING
ON, AS WELL AS ADDRESS THAT WHAT
I WOULD CONSIDER TO BE A
DANGEROUS DEFICIT IN THE
PERMANENT, SUPPORTIVE HOUSING
SYSTEM THAT WE HAVE TODAY. UM
THERE IS CURRENTLY A BILL IN THE
LEGISLATURE, AS I'M SURE THAT
MANY OF YOUR ARE AWARE THAT
COULD ADDRESS ONE PART OF THAT
BY MAKING PSH CASE MANAGEMENT
BENEFIT UNDER MEDICAL, AND I
THINK THAT WOULD BE AN ENORMOUS
ADVANCE. UM TODAY. PSH PROVIDERS
LIKE MERCY, HOUSING AND MANY
OTHERS. I WOULD SAY WE'RE
EXTREMELY FRAGILE POSITION. AND
I DON'T SAY THAT LIGHTLY. I
THINK SOME OF YOU ARE VERY
FAMILIAR WITH THE RISE AND FALL
OF SKID ROW HOUSING IN LOS
ANGELES, WHICH WAS A REAL
TRAGEDY. THERE ARE LOTS OF OTHER
PROVIDERS, I THINK TEETERING ON
THE EDGE, UM THROUGH A
COMBINATION OF DIFFERENT FACTORS
, UNDERFUNDING UNREALISTIC
EXPECTATIONS, AND I WOULD SAY A
SYSTEM OF KAREN MOST COUNTIES.
THAT DOES NOT HAVE ENOUGH
SERVICE. INTENSE OPTIONS FOR THE
PEOPLE THAT'S TRYING TO SERVE.
AND THAT'S ONE OF THE MAIN
REASONS WHY I'M HERE TODAY IS
BECAUSE I'M I AM EXCITED TO HEAR
YOU ALL TALKING ABOUT A SORT OF
COMMUNITY TREATMENT, BUT ALSO
TALKING ABOUT THE OPPORTUNITY
FOR RESIDENTIAL CARE AND OTHERS
. OTHER OTHER VERSIONS OF
OUTPATIENT CARE. THIS IS NOT
WHAT WE'RE TYPICALLY ABLE TO
PROVIDE HIM PERMANENT,
SUPPORTIVE HOUSING COMMUNITIES.
I THINK WE DO EXCELLENT WORK. I
THINK OUR PARTNERS AND
COLLEAGUES DO EXCELLENT WORK 80
TO 90% OF THE REFERRALS AND
PEOPLE THAT ARE REFERRED INTO
OUR BUILDINGS, AND THOSE OF OUR
COLLEAGUES DO EXTREMELY WELL,
AND THERE'S A SMALL SUBSET THAT
FRANKLY NEED MUCH MORE SUPPORT
THAN WE'RE ABLE TO OFFER IN THE
BUILDINGS THAT WE CURRENTLY HAVE
AND THOSE WHO ARE COLLEAGUES AND
THEY NEED THAT ADDITIONAL LEVEL
OF SUPPORT IF THEY'RE GOING TO
SUCCEED. AND THE IMPACTS ARE NOT
JUST FELT BY THE INDIVIDUALS WHO
DON'T HAVE THAT LEVEL OF
SUPPORT. IT'S ALSO FELT BY
STAFF. AND THE OTHER RESIDENTS
OF THESE BUILDINGS WHEN WE DON'T
HAVE THE APPROPRIATE SUPPORT
NECESSARY TO HELP FOLKS LIVE
INDEPENDENTLY IN COMMUNITY LIKE
THIS, UM YOU CAN SEE THIS IN
TERMS OF SKYROCKETING INSURANCE
RATES FOR PERMANENT SUPPORTIVE
HOUSING. VERY SIGNIFICANT
FINANCIAL LOSSES THAT MANY OF US
ARE ENCOUNTERING, AS WELL AS
INCREDIBLY HIGH STAFF, VACANCY
RATES AND TURNOVER, PARTICULARLY
AMONG MEN, UH, SOCIAL WORK
PROFESSIONALS AND OTHERS THAT
ARE DIRECTLY DEALING WITH
RESIDENTS. UM, SO I DON'T WANT
TO SOUND LIKE I'M NEGATIVE ABOUT
THIS. I'M ACTUALLY QUITE
POSITIVE ABOUT THE ABOUT THE
OPPORTUNITY AND WE'RE VERY
EXCITED ABOUT THE OPTION. I JUST
I JUST WANT TO KNOW THAT THERE
THERE. THIS IS NOT A SINGLE SHOT
SOLUTION, AND I WANT TO
ACKNOWLEDGE THAT SHARE WICKS HAS
BEEN, UM, APPROPRIATELY
ADVOCATING FOR THE FACT THAT WE
ALSO NEED A MORE BROAD APPROACH
TO AFFORDABLE HOUSING. THERE IS
SIMPLY NO WAY YOU CAN SOLVE THE
EPIDEMIC OF HOMELESSNESS IN OUR
IN OUR STATE BY RUSHING TO THE
SCENE OF THE FIRE. UM WE NEED
THE UPSTREAM APPROACHES AND THAT
INCLUDES MORE HOUSING OVERALL
AND MORE AFFORDABLE HOUSING. AND
SO AS AS YOU'RE CONSIDERING THIS
BOND IN THIS MEASURE I WOULD
ALSO JUST COMMEND THE
LEGISLATURE TO CONTINUE TO DO
WHAT IT'S BEEN DOING, WHICH IS
TO PROVIDE THE MUCH NEEDED
CAPITAL FOR BROADER, AFFORDABLE
HOUSING DEVELOPMENT BECAUSE WE
SIMPLY CANNOT JUST FOCUSED ON
PERMANENT, SUPPORTIVE HOUSING
AND EXPECT TO END HOMELESSNESS
AS WE SEE IT HERE IN CALIFORNIA,
SO THANK YOU. THANK YOU. WE WILL
BRING IT BACK TO COMMITTEE, MR
ARAMBULA. THANK YOU, MADAM
CHAIR. I'M GONNA STICK WITH
LOURDES MORALES IF I CAN AND
YOU'LL NOTICE A SIMILAR THEME,
BOTH SPEAKING ABOUT DATA AND
THEN OUR CHILDREN AND YOUTH, SO
I'M GOING TO SPEAK ABOUT THE
RAND STUDY, WHICH YOU MENTIONED
, WHICH SPECIFICALLY LOOKED AT
OUR ADULT POPULATIONS AND
EXCLUDED CHILDREN AND YOUTH. AND
I'M LOOKING TOWARDS WHAT THE L A
O HAD COMMENTED ON AS THAT
RAISES CONCERNS ABOUT WHETHER WE
HAVE INFORMATION REGARDING
CHILDREN AND YOUTH. UM AND THEIR
NEEDS FOR BOTH PSYCHIATRIC BEDS
AND COMMUNITY RESIDENTIAL BEDS
THAT I'D LIKE TO KNOW TO WHAT
EXTENT WE ARE EXPECTING OR
ANTICIPATING THE RESOURCES FROM
THIS BOND TO BE SPENT ON
CHILDREN AND WHETHER OR NOT, UM
THE ADMINISTRATION ANTICIPATES
THAT THE PROCEEDS WILL UM, FUND
AND BE FOCUSED ON SPECIFIC
POPULATIONS LIKE OUR CHILDREN
AND YOUTH, HOPING YOU CAN
COMMENT ON. THANK YOU, MR.
CHAIR, RYAN MILLER FROM THE L A.
OH, YEAH. THE RAND STUDY. UH
ACKNOWLEDGE THAT THE MATTER OF
CHILDREN AND YOUTH NEEDS FOR
BEHAVIORAL HEALTH BEDS WAS
OUTSIDE THE SCOPE OF THEIR WORK
BECAUSE OF THE UNIQUE NEEDS THAT
CHILDREN YOUTH. HAVE WE DID ASK
THE ADMINISTRATION ABOUT THIS,
AND THE ADMINISTRATION DID POINT
OUT THAT THE BOND FUNDS WOULD BE
AVAILABLE TO GO TO CHILDREN AND
YOUTH FACILITIES. UM I THINK
THAT THE REAL REASON THAT WE
WERE POINTING IT OUT AS A ISSUE
FOR LEGISLATIVE CONSIDERATION IS
THAT RELATIVE TO THE TO THE WORK
ON ADULT NEEDS THAT RAN HAD DONE
. UM THERE SEEMS TO BE A LITTLE
BIT LESS. UH THAT'S BEEN DONE ON
THE ON THE ON THE SCOPE OF THAT
ISSUE. AND SO THAT'S SOMETHING
THAT YOU KNOW. WE THINK THE
LEGISLATURE WILL WANT TO
CONTINUE TO HAVE A ROLE IN AS
LORD WAS STRESSING UH, WITH WITH
ONGOING OVERSIGHT AND
IMPLEMENTATION WORK, BRING IT UP
AGAIN. WE CAN SPEND THE MONEY,
BUT WE'RE NOT MANDATING SPENDING
THAT MONEY AND OFTENTIMES WE
STRUGGLE GETTING UPSTREAM WHEN
WE'RE NOT PROVIDING THAT
RESILIENCY EARLY ON IN THEIR
LIFE, AND SO WHEN OUR CHILDREN
AND YOUTH ARE LIVING ON THE
STREETS AND BEING TRAUMATIZED AS
WE HEARD ABOUT EARLIER. IT'S
AWFULLY HARD TO EXPECT DIFFERENT
RESULTS. AND SO I'M WONDERING IF
THIS IS A BLIND SPOT FOR US
SINCE WE DIDN'T STUDY IT WITH
THAT RAND STUDY. HOW DO HOW DO
WE MAKE SURE THAT WE'RE USING
THESE BOND REVENUES
APPROPRIATELY TO ADDRESS THE
CHILDREN IN YOUTH? HE WOULD SORT
OF JUST JUST SAY GENERALLY THAT
WE DO THINK THAT THIS IS SORT OF
AN AREA WHERE THERE IS, UM AN
INTEREST FOR SORT OF MORE
LEGISLATIVE OVERSIGHT FROM OUR
PERSPECTIVE, WHERE YOU COULD
SORT OF TAKE A MORE ACTIVE ROLE
AND NOT ONLY SORT OF ITS DESIGN
BUT ITS IMPLEMENTATION OF THE
RECOMMENDATIONS IN OUR REFLECTED
IN OUR HANDOUT, BUT ALSO IN OUR
LONGER PIECE ONLINE DO SORT OF
IDENTIFY SORT OF QUESTIONS WHERE
THE LEGISLATURE MAY WANT TO
WEIGH IN. SUCH AS TARGET
POPULATIONS THAT MAY BE OF
INTEREST. WHETHER YOU WANT TO DO
SET ASIDE. WHAT IS THE
ALLOCATION METHODOLOGY? AND SO
THOSE ARE ALL SPACES WHERE THE
LEGISLATURE NOT ONLY TAKE AN
ACTIVE ROLE INITIALLY, BUT THEN
ALSO THROUGH ESTABLISHING
OVERSIGHT MECHANISMS ENSURE
THOSE GOALS ARE MET OVER TIME TO
ENSURE THE BOND SUCCESS. THANK
YOU. THANK YOU, MR WOOD. YEAH
AND I'LL BE VERY BRIEF HERE, BUT
I WANT TO GO BACK TO, UM, THE
BENNY OFF. STUDY. DR COCHELL, UM
UM. TALKED ABOUT TODAY AND HER
WORK IN THAT I WOULD SAY, I
FOUND A PAIR OF THERE'S A
PARAGRAPH HERE ON THE THIRD
PAGE. I JUST WANT TO READ THIS
BECAUSE IT'S I THINK IT'S WHAT
WERE. IT'S AN IMPORTANT PIECE
HERE THAT I THAT THAT I HOPE
THAT WE CAN ADDRESS AND IT'S
NOT. I DON'T BELIEVE IS GOING TO
HAPPEN WITH THIS PARTICULAR
BILL, BUT I THINK IT'S SOMETHING
THAT REALLY NEEDS TO BE BROUGHT
BROUGHT OUT. I THINK MR
SCHUMACHER SHOEMAKER HERE
ACTUALLY ALLUDED TO THAT,
ACTUALLY NOT REALLY ALLUDE TO.
YOU TALKED ABOUT IT. AND THIS IS
QUOTE HERE, EVEN IF THE CAUSE OF
HOMELESSNESS WAS MULTIFACTORIAL.
PARTICIPANTS OF THE STUDY, OF
WHICH THERE WERE 365 THAT HAD
WERE DETAILED. UM, UH,
INTERVIEWS. BELIEVE FINANCIAL
SUPPORT COULD HAVE PREVENTED IT.
70% BELIEVE THAT A MONTHLY
RENTAL SUBSIDY OF 300 TO $500
WOULD HAVE PREVENTED THEIR
HOMELESSNESS. FOR SUSTAINED
PERIOD. 82% BELIEVE THAT A ONE
TIME PAYMENT OF 5000 TO 10,000
WOULD HAVE PREVENTED THEIR
HOMELESSNESS. 90% BELIEVE THAT
RECEIVING A HOUSING CHOICE
VOUCHER OR A SIMILAR OPTION
WOULD HAVE DONE SO. AND I POINT
THIS OUT BECAUSE WHAT JUMPED OUT
AT ME IS WE ARE SPENT. WE'RE
GONNA WE'RE SPENDING $189,000.
PER HONKY. UM, UNIT. AND. AND AS
WE SEE A GROWTH IN THE WHOLE,
AND WE'VE SEEN GROWTH IN THE
HOMELESS POPULATION. I WONDER IF
THIS INVESTMENT AND SUBSIDIES
COULD HELP. PREVENT SOME OF
THAT. IT'S NOT GOING TO SOLVE
THE PEOPLE THAT ARE ALREADY
HOMELESS. BUT BUT HOW COULD
COULD WE BE INCORPORATING THAT
SOMEWHAT IN OUR IN OUR HOMELESS
POLICY HOUSING POLICY, ANYWAY?
THAT'S MY COMMENT. THANKS.
GREAT. WELL THANK YOU, MR WOOD.
FOR THAT I WHOLEHEARTEDLY AGREE
. UM AND I JUST APPRECIATE MR
SHOEMAKER YOUR COMMENTS AROUND
THE BROADER NEED FOR MORE
FUNDING FOR RENTAL ASSISTANCE
FOR PRODUCTION. THERE'S A LOT OF
NEEDS HERE WHEN IT COMES TO
HOUSING. UM I WANTED TO ASK, UM
, MR LEE, SINCE YOU HAVE DONE
SOME, UH, SUPPORTIVE HOUSING IN
YOUR COMMUNITY, DO YOU SHARE THE
CONCERNS AROUND THE NEED FOR
ONGOING FUNDING AND YOU SEE IF
THIS MOVES FORWARD AS IS, DO YOU
CURRENTLY HAVE THE RESOURCES YOU
NEED ON THE GROUND? CAN YOU
CONTINUE TO DO AND SUPPORT THE
ONGOING FUNDING THAT YOU NEED TO
SUPPORT THIS COMMUNITY? THANK
YOU FOR THE QUESTION. UM, I
WOULD SAY THAT WE AGREE WITH
SOME OF THE ASSEMBLYMEMBER'S
COMMENTS AND MEMBERS OF THE
PANEL THAT WE SHOULD BE FOCUSED
ON EXPANDING AND INCREASING ONE
TIME OR CAPITAL RESOURCES AND
ADDITIONAL ONGOING RESOURCES TO
PROVIDE FULL RANGE OF TREATMENT,
HOUSING AND SERVICES. THE
ADMINISTRATION'S FOCUS ON
HOUSING AND REDUCING
HOMELESSNESS ARE COMMENDABLE. WE
SUPPORT THAT EXPANSION AND
INCLUSION OF PEOPLE WITH
SUBSTANCE USE DISORDERS ONLY IS
ALSO IMPORTANT. UM BUT
ULTIMATELY WE NEED ADDITIONAL
RESOURCES OR ADDITIONAL
FLEXIBILITY TO MAXIMIZE THE
RESOURCES THAT WE HAVE IN ORDER
TO MEET. UM, CLEAR OUTCOMES FROM
THE STATE. THANK YOU. I THINK
THAT WILL CONCLUDE OUR SESSION.
UH, PANEL NUMBER FOUR WE WILL
ADJOURN FOR LUNCH. WE WOULD BE
BACK AT 1 30, WITH PANEL NUMBER
FIVE AND THE MEETING'S ADJOURNED
FOR NOW. GONNA GAMBLE US.
THIS IS RECESS. NOT NOT NOT
ADJOURNING WERE RECESSING ONLY.
YES, APOLOGIES. WE'LL BE BACK AT
1 30.
GOOD AFTERNOON. WE'D LIKE TO
RECONVENE OUR HEARING. AND THANK
YOU VERY MUCH. UM JUST JUST A
COUPLE OF THINGS BEFORE WE
BEFORE WE BEFORE WE GET STARTED
HERE, UM. WE HAVE TWO MORE
PANELS. UM, AND THEN WE WILL
HAVE OUR AGENDA IS OUR AGENDA
SAYS WE WILL HAVE 30 MINUTES OF
PUBLIC COMMENT. NOW I SEE A LOT
OF PEOPLE HERE. UM AND 30
MINUTES WILL GO BY REALLY,
REALLY FAST. SO UM, THOSE PEOPLE
WHO WERE IF YOU'RE GOING TO
PROVIDE PUBLIC COMMENT, AND YOU
HAVE A POSITION OF AGAINST OR
FOR AND CAN JUST SAY THAT,
RATHER THAN ELABORATING AS TO
WHY THAT WOULD BE HELPFUL TO
THOSE OF YOUR IF YOU'RE
FOLLOWING SOMEBODY ELSE'S
OPINION, IN OTHER WORDS, SO I
WILL ALSO NOTE THAT THE
COMMITTEE DOES ACCEPT AND WILL
CONTINUE TO ACCEPT WRITTEN
COMMENTS TO OUR PORTAL. WE READ
THOSE WE TAKE THOSE INTO
CONSIDERATION. WE DO HAVE SHOULD
THIS BILL PASSED OUT OF
COMMITTEE TODAY WILL BE GOING TO
APPROPRIATIONS. SO THIS IS NOT
THE END OF THE LINE. QUITE QUITE
HONESTLY, THERE'S A WAYS TO GO
HERE, SO JUST UNDERSTAND THAT WE
WILL BE BECAUSE AFTER THIS
INFORMATIONAL HEARING, WE WILL
GO INTO THE BILL HEARING. UM AND
A MORE TRADITIONAL BILL HEARING
ENVIRONMENT THERE, SO JUST KEEP
THAT IN MIND AS YOU PREPARE FOR
YOUR PUBLIC TESTIMONY. UM, I
KNOW THAT ALSO OUR PANELISTS IF
WE COULD ASK THEM TO SPEAK UP
CLEARLY AND DELIBERATELY, IF
POSSIBLE, THAT WOULD BE REALLY
HELPFUL. UM I KNOW EVERYBODY'S
TIMED AND EVERYBODY'S TRYING TO
GET EVERY POSSIBLE WORD IN HERE
. UM BUT IF WE COULD, JUST
SOMETIMES IT'S HARD TO HEAR. AND
WHEN WE'RE LOOKING AT ARE SO FAR
CLOSE CAPTIONING IS HARD FOR
THEM TO KEEP UP. SO IF WE CAN,
UH, KEEP THAT IN MIND AND DURING
YOUR DURING YOUR TESTIMONY, SO,
UM WITH THAT WE'RE GOING TO HAVE
OUR NEXT PANEL ARE BEHAVIORAL
HEALTH PROPOSAL THAT WILL COME
UP. UM WE'VE GOT SEVERAL SEVERAL
FOLKS AND WE WILL ASK THEM. AH
EACH PANELIST WHO SELF INTRODUCE
AS WE GO ALONG, AND THAT'LL SAVE
US INTRODUCING TWICE. AND YOU
ALL KNOW THE ORDERS, SO THAT
SHOULDN'T BE A PROBLEM. SO.
OKAY? WHO HELLO. THANK YOU.
CHAIR AND COMMITTEE FOR HAVING
US MY NAME IS WILL OWNS WITH THE
L A. L HERE WITH MY COLLEAGUE.
AND TODAY WE'RE GOING TO BE
PRESENTING OUR ANALYSIS OF THE
GOVERNOR'S BEHAVIOR. HEALTH
MODERNIZATION PROPOSAL, AS
REPRESENTED SB 3 TO 6. SO WE
RELEASED A NUMBER OF POSTS
EVALUATING THE GOVERNOR'S
PROPOSAL. UM BUT THIS WAS AS OF
THE JULY 13TH VERSION. UH LAST
WEEK. THERE HAS SINCE BEEN A
NUMBER OF AMENDMENTS THAT MADE
SIGNIFICANT CHANGES AND SO
YESTERDAY. OUR OFFICE RELEASED
AN UPDATE POST IDENTIFYING SOME
OF THE KEY ISSUE AREAS THAT WE
BELIEVE HAVE SINCE CHANGED
THANKS TO THE AMENDMENTS. SO
TODAY, I'LL BE FOCUSING ON
MAINLY HOW THE ANALYSIS OUR
ANALYSIS HAS CHANGED. BUT FIRST
I JUST WANT TO TOUCH ON SOME
ISSUES THAT WE RAISED FOR THE
LEGISLATURE THAT WE THINK ARE
ONGOING. SO GENERALLY WE FIND
THE ADMINISTRATION'S ANALYSIS OF
THE PROPOSAL TO BE INCOMPLETE IN
PARTICULAR, WE WAIT RAISED
QUESTIONS REGARDING HOW THE
PROPOSAL WILL, UM, ON THAT
IMPROVED BEHAVIORAL HEALTH
OUTCOMES, GIVING THE SHIFT IN
FUNDING FOCUS. ADDITIONALLY, WE
PROVIDED AN ESTIMATE ON THE
STATEWIDE IMPACTS OF THE SHIFT
IN FUNDING CATEGORIES. HOWEVER
IT'S UNCLEAR ESPECIALLY WHEN IT
DID THE COUNTY BY COUNTY LEVEL
OF WHAT THOSE IMPACTS WOULD BE,
AND WE FOUND THE ANALYSIS FOR
THAT FROM THE ADMINISTRATION
LACKING. SO THAT BEING SAID THE
THREE AREAS THAT WOULD LIKE TO
HIGHLIGHT FROM OUR ORIGINAL POST
THAT WILL WE ARE INCLUDED IN OUR
UPDATE OUR ISSUES ON COUNTY
FLEXIBILITY, CHILDREN YOU
SPENDING AS WELL AS THE ROLE OF
THE MHS ALWAYS SEE OR THE MENTAL
HEALTH SERVICES OVERSIGHT
ACCOUNTABILITY COMMISSION. SO
FIRST ON COUNTY FLEXIBILITY. OUR
PREVIOUS ANALYSIS OF WE FOUND
THAT THE ADMINISTRATION'S
INITIAL PROPOSED FUNDING
CATEGORIES WHICH FOCUSED ON FULL
SERVICE PARTNERSHIPS, HOUSING
INTERVENTIONS AND THEN
BEHAVIORAL HEALTH SERVICES AND
SUPPORTS, UM IT SHIFTED THE
FUNDING TOWARDS F SPS OR FULL
SERVICE PARTNERSHIPS AND HOUSING
INTERVENTIONS. AND GENERALLY,
THE CATEGORIES WERE OVERALL,
MORE PRESCRIPTIVE THAN WHAT IS
UNDER CURRENT STATUTE. UH THIS
REDUCED THE AMOUNT OF
FLEXIBILITY THAT COUNTIES HAD TO
SPEND. ON A NUMBER OF DIFFERENT
SERVICES. AND SO CONSEQUENTLY,
THE LEGISLATURE FACED A TRADE
OFF BETWEEN ENSURING CERTAIN
TYPES OF PROGRAMS, UM, WERE
FUNDED AS WELL AS UTILIZING
LOCAL EXPERTISE. SO UNDER THE
AMENDMENTS ADOPTED LAST WEEK. UM
THE PROPOSAL DOES GIVE NOW SOME
FLEXIBILITY TO COUNTIES IN TERMS
OF HOW FUNDING CAN BE USED IN
PARTICULAR, ALLOWING A CERTAIN
PERCENTAGE OF EACH CATEGORY TO
SHIFT BETWEEN CATEGORIES.
ADDITIONALLY THERE WERE SOME, UH
, PROVISIONS OF THE AMENDMENTS
THAT ALLOWED FOR GREATER
FLEXIBILITY OF SMALL COUNTIES TO
ADJUST HOW MUCH FUNDING IN
GENERAL COULD BE USED FOR
HOUSING INTERVENTIONS
SPECIFICALLY, SO THE AMENDMENTS
ALLOWING COUNTIES TO SHIFT THE
FUNDS BETWEEN THE CATEGORIES MAY
ACTUALLY HELP MITIGATE SOME OF
THE ISSUES IN IN TERMS OF
FUNDING FOR CURRENT SERVICES
THAT WE HIGHLIGHTED ON OUR
ORIGINAL POST. UM PARTICULARLY
COUNTIES CAN MOVE A PORTION OF
FUNDS FROM HOUSING INTERVENTIONS
AND THE FSP CATEGORY TO THE
BEHAVIORAL HEALTH SERVICES
SUPPORTS CATEGORY WHICH, AS WE
NOTED, WE ESTIMATED TO BE OVER
PRESCRIBED BASED ON CURRENT
LEVELS OF FUNDING. HOWEVER THE
NET IMPACT ON CURRENT SPENDING
IS STILL UNCLEAR, GIVEN THAT
ESPECIALLY COUNTIES WILL HAVE
DISCRETION ON WHETHER TO PURSUE
THIS FLEXIBILITY AS WELL AS
THERE'S DISCRETION ON THE PART
OF THE ADMINISTRATION TO APPROVE
THIS SHIFT IN FUNDING. SO WHILE
LIKE I SAID, THERE IS INCREASE
IS A LITTLE UNCLEAR. NEXT LET'S
TALK ABOUT THE CHILDREN YOUTH
SPENDING PORTION, SO UNDER OUR
PREVIOUS ANALYSIS, WE NOTED THAT
WHILE THERE IS A REGULATORY
REQUIREMENT CURRENTLY TO REQUIRE
, UH, PORTION OF PREVENTION,
EARLY INTERVENTION FUNDS TO BE
USED FOR CHILDREN YOUTH UNDER
THE PROPOSAL, THERE WAS NO SUCH
STATUTORY REQUIREMENT INCLUDED.
SO UNDER THE AMENDMENTS, THERE
IS NOW A PROVISION THAT REQUIRES
OVER HALF OF EARLY INTERVENTION
FUNDING AS WELL AS THE
POPULATION BASED PREVENTION
FUNDING TO BE USED FOR CHILDREN,
YOUTH AGED 25 AND YOUNGER I JUST
WANT TO NOTE IN ADDITION THAT WE
HAD RAISED CONCERNS THAT THE
DEFINITION OF CHILDREN YOUTH
UNDER THE PRIOR PROPOSAL DID NOT
INCLUDE TRANSITION AGE YOUTH,
TYPICALLY THOSE 16 TO 25, BUT
THE NEW DEFINITION NOW SEEMS TO
INCLUDE THIS. SO. AS COUNTIES
CURRENTLY USE. UM NOT JUST MAKE
SURE SAY FUNDING UNDER THE P AND
I CATEGORY BUT ALSO IN F SPS TO
TARGET CHILDREN AND YOUTH. IT'S
A LITTLE UNCLEAR TO WHAT DEGREE
THIS. STATUTORY REQUIREMENT
THAT'S NOW INCLUDED COULD
POTENTIALLY INCREASE THE AMOUNT
OF FUNDING FOR CHILDREN YOUTH.
HOWEVER WE DO NOTE THAT IT WILL
ENSURE AT LEAST A MINIMUM LEVEL
OF FUNDING FOR CHILDREN AND
YOUTH SERVICES, PARTICULARLY
THOSE AS I MENTIONED IN EARLY
INTERVENTION AND POPULATION
BASED PREVENTION. FINALLY WE
JUST WANT TO DISCUSS THE ROLE OF
THE UNDER THE PROPOSED
AMENDMENTS. SO THE GOVERNMENT WE
FOUND THAT THE GOVERNMENT'S
INITIAL PROPOSAL WHATEVER MOVED
MOST OF THE COMMISSION'S CURRENT
OVERSIGHT, REGULATORY AND
PROGRAMMATIC AUTHORITY OVER MHS
, A BONDING SO GIVEN THE LACK OF
THE ANALYSIS BY THE
ADMINISTRATION FOR WHY THIS WAS
PRUDENT, WE RECOMMENDED THAT THE
LEGISLATURE REJECT THAT PIECE OF
THE PROPOSAL. AND MAINTAIN THE.
COMMISSION'S OVERSIGHT AND
REGULATORY PRIORITY SETTING ROLE
UNDER THE REVISED PROPOSAL WITH
THE AMENDMENTS. WE DO KNOW THAT
THERE HAS BEEN SOME SHIFT
TOWARDS MORE ROLE AND AUTHORITY
FOR THE A C. HOWEVER MOST OF
THIS IS AS A IN CONSULTATION
ROLE OR PROVIDING TECHNICAL
ASSISTANCE. UM TWO COUNTIES,
HOWEVER, WE FIND GENERALLY,
THAT'S STILL THE PRIORITY
SETTING RULEMAKING AUTHORITY AND
SOME MORE GENERAL OVERSIGHT IS
STILL LACKING. SO BARRING ANY
ADDITIONAL JUSTIFICATION
PROVIDED BY THE ADMINISTRATION,
WE MAINTAIN OUR RECOMMENDATION.
Tð. KEEP THE A C S AUTHORITY AS
IT IS CURRENTLY THANK YOU, RYAN
MILLER. ELIO WE ALSO WANTED TO
COVER THE ISSUE OF REVENUE
VOLATILITY AND THE RESERVES
PROPOSAL BUT ACKNOWLEDGING THE
CONVERSATION THAT'S ALREADY BEEN
HAD THIS MORNING. THE COMMENTS
BY THE ADMINISTRATION AND I
THINK THEIR APPARENT COMMITMENT
TO BE WORKING ON THIS ISSUE. WE
WANTED TO REALLY FOCUS ON MORE
OF A FRAMEWORK FOR THE
LEGISLATURE TO CONSIDER. IN
TERMS OF YOU KNOW HOW TO THINK
ABOUT TACKLING THIS IMPORTANT
CHALLENGE. UM SO I WANTED TO
REALLY FOCUS ON TWO CONCEPTS
FIRST BEING WE WOULD URGE THE
LEGISLATURE TO MATCH THE LEVEL
OF RESERVES TO THE REVENUE
VOLATILITY. THERE'S NOTHING
INHERENTLY PROBLEMATIC ABOUT
WANTING TO REDUCE THE AMOUNT OF
ALLOWABLE RESERVES. BUT REALLY,
THE ISSUE IS THAT IF IT'S
PROPOSED WITHOUT UH, ACCOMPANY
CHANGE IN IN THAT REALLY
ADDRESSES THE SEVERE VOLATILITY
OF THE S ATTACKS THAT REALLY CAN
PUT SOME UNDUE FISCAL RISK ONTO
THE COUNTIES SO WE WOULD URGE
THE LEGISLATURE TO BE TRYING TO
KIND OF MATCH THOSE UP. AND AS
WE HAVE FOUND, IF THERE WASN'T A
CHANGE IN THE TAX, WE ACTUALLY
THINK THAT THE RESERVE SHOULD
PROBABLY BE QUITE A BIT HIGHER
THAN THEY ARE IN CURRENT LAW, SO
WE'VE OFFERED SOME IDEAS IN OUR
ANALYSIS FOR HOW TO ADDRESS THE
VOLATILITY AS WE'VE RECOMMENDED
. SOME OF THEM INVOLVE SWAPPING
OR SAY, SHIFTING THE
MILLIONAIRE'S TAX TO THE STATE
GENERAL FUND. AND THEN TAKING A
PART OF THE STATE'S REVENUE
SYSTEM AND MOVING IT TO THE MHS
A AND SOME OF THE IDEAS THAT
WE'VE OFFERED, WE THINK COULD,
UH, REDUCE THE VOLATILITY BY TWO
THIRDS, UM, STILL MAINTAIN
HEALTHY GROWTH FOR COUNTIES IN
THE LONG RUN, RAISED THE SAME
AMOUNT OF REVENUE OVER THE LONG
RUN AND ALSO REALLY ONLY RESULT
IN A SMALL, MARGINAL INCREASE IN
STATE REVENUE VOLATILE BECAUSE
THE STATE GENERAL FUND IS SO
LARGE AND IT CAN ABSORB THAT
WELL. BUT WE ALSO WANT TO
ACKNOWLEDGE OTHER IDEAS HAVE
BEEN PRESENTED BY THE COUNTIES,
AND I THINK THE SECRETARY EVEN
SPOKE TO THE POSSIBILITY OF LIKE
THE ROLLING AVERAGE NOTION AND
SO YOU KNOW, THOSE IDEAS SEEM TO
BE PROMISING AS WELL. THEN THE I
THINK THE OTHER THING WE WANTED
TO SPEAK TO IS TO TRY TO BE
MINDFUL OF THE WHOLE RESERVES
POLICY TO THERE'S OBVIOUSLY BEEN
A LOT OF FOCUS ON THE ALLOWABLE
CAPS AND THE VOLATILITY ITSELF.
BUT THERE ARE ALSO RULES IN THE
MHS A ABOUT HOW MUCH COUNTIES
CAN DEPOSIT IN A GIVEN YEAR HOW
MUCH THEY CAN WITHDRAW WHEN THEY
CAN WITHDRAW. AND ESPECIALLY IF,
IF THE IF THE REVENUE SOURCE
REMAINS SOMEWHAT OR AS VOLATILE
AS IT IS NOW WE THINK THAT THE
LEGISLATURE MAY WANT TO CONSIDER
MORE FLEXIBILITY FOR COUNTIES
AND WHEN THEY CAN MAKE DEPOSITS
AND WITHDRAWALS, SO WITH THAT, I
WILL LOOK FORWARD TO QUESTIONS
AFTER THE ANALYSTS FINISHED.
THANK YOU. THANK YOU. GOOD
AFTERNOON CHAIR MEMBERS. THANK
YOU FOR JOINING, HAVING ME JOIN
YOU TODAY. I'M KAREN LARSEN. I'M
THE CEO FOR THE STEINBERG
INSTITUTE. UM, AS A THERAPIST, I
SERVED, UH THE UNDERSERVED
POPULATION UNDOCUMENTED ON
HOUSED POPULATION FOR MORE THAN
20 YEARS IN COMMUNITY CLINICS
AND NONPROFIT SETTINGS. AND JUST
PRIOR TO JOINING THIS TIME
INSTITUTE I WAS THE HEALTH AND
HUMAN SERVICES AGENCY DIRECTOR
FOR YOLO COUNTY, WHICH WAS
INTEGRATED AGENCY WITH SOCIAL
SERVICES, PUBLIC HEALTH AND
BEHAVIORAL HEALTH SERVICES, ALL
UNDER ONE AGENCY. STEINBERG
INSTITUTE WAS FOUNDED BY MAYOR
AND CO AUTHOR OF MHS, A DARRELL
STEINBERG AND WHERE NON POP
NONPROFIT PUBLIC POLICY AGENCY
DEDICATED TO TRANSFORMING THE
SYSTEMS OF CARE FOR MENTAL
HEALTH AND SUBSTANCE USE IN
CALIFORNIA. UM AND SINCE OUR
FOUNDING, WE'VE REALLY TRIED TO
SERVE AS STEWARDS OF THE ESSAY
THE MH ESSAY WAS BORN OUT OF TWO
PIECES OF LEGISLATION A B 34 AND
MAYBE 2034. UM UH, THEY WERE
AUTHORED BY THEN
ASSEMBLYMEMBER'S STEINBERG. UM
AND THEY THESE BILLS REALLY
ESTABLISHED THE WHATEVER IT
TAKES APPROACH TO CARE FOR
PEOPLE EXPERIENCING HOMELESSNESS
WITH SIGNIFICANT BEHAVIORAL
HEALTH CONDITIONS, AND THEY HAD
GREAT OUTCOMES. THEY REDUCED
HOMELESSNESS, INCARCERATION AND
HOSPITAL VISITATION
DRAMATICALLY. SO IN 2004. BASED
ON THAT PREMISE, THE VOTERS
OVERWHELMINGLY APPROVED THE MHS
S¼. TO SCALE THIS MODEL
STATEWIDE. AND WITH THE PROMISE
OF ENDING HOMELESSNESS AMONGST
THOSE WITH HEALTH CONDITIONS.
NEARLY 20 YEARS LATER WITHOUT
PROPER STATE OVERSIGHT AND
GUIDANCE. WE'VE STRAYED FROM THE
ESAS ORIGINAL INTENT OF FOCUSING
ON SERIOUS BEHAVIORAL HEALTH
CONDITIONS AND HOMELESSNESS.
CURRENT MHSC RULES REQUIRE THE
MAJORITY OF FUNDS OR SERVICES TO
BE USED FOR THIS, WHATEVER IT
TAKES APPROACH. BUT OUT OF THE
10, CALIFORNIA COUNTIES WITH THE
HIGHEST HOMELESS POPULATION,
ONLY ORANGE COUNTY IS FOLLOWING
THE MHS SUSPENDING STANDARDS
BETWEEN 2019 AND 2022. THIS
ISN'T A COINCIDENCE. OVER THE
LAST DECADE FUNDING AND OUR
BEHAVIORAL HEALTH SYSTEM HAS
MORE THAN DOUBLED. BUT THE RATES
OF FOR THOSE RECEIVING CARE
HAVEN'T IMPROVED. AT THE SAME
TIME, WE'VE SEEN HOMELESSNESS,
INCARCERATION AND
HOSPITALIZATION FOR THOSE LIVING
WITH SIGNIFICANT BEHAVIORAL
HEALTH CONDITIONS SKYROCKET. IN
OUR RECENT ANALYSIS, PUBLISHED
EARLIER THIS MONTH, WE FOUND SP
3 26 TO BE NOT ONLY IN KEEPING
WITH THE ORIGINAL VISION OF THE
ESSAY BUT AN URGENT AND
NECESSARY PLAN TO CARE FOR OUR
MOST VULNERABLE. FIRST SB 3 26
THAT'S CRITICAL CRITICAL
PRIORITIES TO FULFILL THE
INTENTION OF THE MHS. A UNTIL
NOW, CALIFORNIA HAS NOT SET
CLEAR STATEWIDE PRIORITIES FOR
BEHAVIORAL HEALTH. SPENDING IN
GENERAL OR FOR THE MHS S¼. SP 3
26 FOCUSES THE NEARLY $4 BILLION
IN REVENUE TO TARGET THE MOST
INTRACTABLE ISSUE OF OUR TIME
HOMELESSNESS AMONGST THOSE WITH
SERIOUS BEHAVIORAL HEALTH
CONDITIONS. AT THE SAME TIME. SB
3 26 PRESERVES CRITICAL EARLY
INTERVENTION DOLLARS AND SET
ASIDES FOR CHILDREN AND YOUTH.
SECOND THE BILL DOUBLES DOWN ON
OUTCOMES AND ACCOUNTABILITY.
FAILURE TO ESTABLISH STANDARD
METRICS AND PROPERLY TRACK
EVALUATE AND IMPROVE OUTCOMES.
SINCE THE PASSAGE OF THE MHS A
HAS BEEN ONE OF THE BIGGEST
FAILINGS OF THE CURRENT ACT. OUR
SYSTEMS MUST BE ABLE TO ACCOUNT
FOR IMPROVING THE LIVES OF THOSE
LIVING WITH THE MOST SIGNIFICANT
BEHAVIORAL HEALTH CONDITIONS,
ESPECIALLY WHEN IT COMES TO
HOMELESSNESS, INCARCERATION AND
HOSPITALIZATION. THIRD SP 3 26
ADAPT CMH S A TO A NEW FUNDING
LANDSCAPE SCAPE. CALIFORNIA HAS
INVESTED BILLIONS OF DOLLARS IN
A COMPLETE OVERHAUL OF OUR
STATEWIDE BEHAVIORAL HEALTH
NETWORK VIA INVESTMENTS IN YOUTH
MENTAL HEALTH COMMERCIAL
INSURANCE COVERAGE, DESPERATELY
NEEDED MENTAL HEALTH
INFRASTRUCTURE AND THE FIRST IN
THE NATION EXPANSION OF MEDICAL
SP 3 26 ACCOUNTS FOR HOW THESE
NEW INVESTMENTS INTERACT WITH
THEM. I JUST SAY TO ENSURE THAT
WE ARE BEING THE BEST STEWARDS
OF THE PUBLIC DOLLAR AND MEETING
THE NEEDS OF CALIFORNIANS. HMM.
WE HONOR THE HARD WORK AND
DEDICATION OF OUR PARTNERS AT
THE COUNTY AND PROVIDER LEVEL
AND ACKNOWLEDGE THE TREMENDOUS
CHALLENGES THEY ARE FACING IN
TERMS OF WORKFORCE AND COMPETING
PRIORITIES. WE BELIEVE THAT WE
MUST ALL WORK TOGETHER TO FOCUS
RESOURCES AND SERVICES SO THAT
CALIFORNIA CAN ACHIEVE GREATNESS
. WE ARE CAPABLE OF CARING FOR
THOSE LIVING WITH THE MOST
SIGNIFICANT BEHAVIORAL HEALTH
CONDITIONS FACING THE WORST
POSSIBLE OUTCOMES. WE BELIEVE SB
3 26 WILL DO JUST THAT. WE ARE
GRATEFUL FOR THE UNPARALLELED
LEADERSHIP FROM GOVERNOR NEWSOM
AND SENATOR EGGMAN AND ARE PROUD
TO SUPPORT SB 3 26 STEINBERG
INSTITUTE IS COMMITTED TO
WORKING WITH THE LEGISLATURE,
GOVERNOR NEWSOM AND OUR PARTNERS
TO SEE THIS MOMENT AND REALIZE
THE VISION OF THE ESSAY. THANK
YOU. CHAIR WOODEN MEMBERS. THANK
YOU FOR THE OPPORTUNITY TO
TESTIFY TODAY. I'M KENDRA ZOLLER
AND I AM LEGISLATIVE DIRECTOR AT
THE MENTAL HEALTH SERVICES
OVERSIGHT AND ACCOUNTABILITY
COMMISSION. OUR EXECUTIVE
DIRECTOR TOBY EWING, SENDS HIS
APOLOGIES THAT HE IS NOT ABLE TO
BE HERE TODAY. AT THE OUTSET. I
WOULD LIKE TO RECOGNIZE THE
CONSIDERABLE WORK OF THE
COMMITTEE ON THIS LEGISLATION
AND THEIR EFFORTS TO BRING
CLARITY TO WHAT IS A VERY
COMPLICATED AND SIGNIFICANT
BILL. THE COMMITTEE STAFF WENT
OUT OF THEIR WAY TO BE AVAILABLE
TO DISCUSS THE BILL UNDER TIGHT
DEADLINES, AS MANY OF YOU KNOW,
CALIFORNIA'S LANDMARK MENTAL
HEALTH SERVICES ACT WAS PASSED
TO SUPPORT TRANSFORMATIONAL
CHANGE IN OUR PUBLIC MENTAL
HEALTH SYSTEM THAT EMPHASIZES
TAILORED CARE FOR THOSE
STRUGGLING WITH THE GREATEST
MENTAL HEALTH NEEDS. IT CALLS
FOR EARLY INTERVENTIONS THAT WE
MAY MOVE AWAY FROM DECADES OF
RATIONING ACCESS TO CARE. AND IT
REQUIRES A BROAD DEFINITION OF
PREVENTION THAT IS FOCUSED ON
SUPPORTING WELL BEING, INCLUDING
PREVENTING HOMELESSNESS. THERE
HAS LONG BEEN TENSION OVER
WHETHER LIMITED FUNDING SHOULD
FOCUS ON THOSE WITH THE GREATEST
NEEDS OR SUPPORT PREVENTION TO
GET IN FRONT OF THOSE
CHALLENGES. THE GOVERNOR'S
PROPOSAL IS TIMELY AND
HIGHLIGHTS AREAS WHERE WE HAVE
FAILED TO DO ENOUGH HOUSING
ADDICTION PREVENTION, EARLY
INTERVENTION, INCLUDING EARLY
PSYCHOSIS AND LEVERAGING
OPPORTUNITIES TO TAILOR CARE
THROUGH FULL SERVICE
PARTNERSHIPS ON BEHALF OF THE
COMMISSION. I'D LIKE TO THANK
SECRETARY GALLEY AND HIS TEAM
FOR THE TIME WE HAVE SPENT WITH
THE COMMISSION TO UNDERSTAND OUR
CONCERNS. FIRST WE STRONGLY URGE
THE STATE TO NOT TIE ITS OWN
HANDS THROUGH A BALLOT MEASURE
OF A VOTE OF THE PEOPLE IS NOT
NEEDED. THE SCALE OF THESE
CHANGES WILL UNDOUBTEDLY RESULT
AND UNANTICIPATED CHALLENGES.
THE GOVERNOR AND THE LEGISLATURE
MUST BE ABLE TO AMEND AND ADJUST
OVER TIME. SECOND FLEXIBILITY IS
ALWAYS PREFERRED WHEN FEASIBLE.
THE COMMISSION IS CONCERNED THAT
THE FISCAL CATEGORIES FOR STATE
FUNDING MAY NOT BE SUFFICIENTLY
FLEXIBLE OVER TIME. WE WOULD
RECOMMEND THE COMMITTEE EXPLORE
WHETHER FUNDING FOR PREVENTION,
WORKFORCE AND STATE OPERATIONS
CAN BE ALLOCATED THROUGH THE
ANNUAL BUDGET PROCESS WITH THE
GENERAL 10% SET ASIDE OF BHS A
FUNDING RATHER THAN ESTABLISHING
FISCAL SILOS UPFRONT. THAT
FLEXIBILITY WILL ALLOW THE STATE
TO ADJUST FUNDING ALLOCATIONS
OVER TIME BASED ON EVOLVING
NEEDS. THIRD THE COMMISSION IS
CONCERNED ABOUT THE LOSS OF
INNOVATION FUNDING UNDER THE MHS
A. THE STATE AND COUNTIES HAVE
LEVERAGED THE EXISTING 5% SET
ASIDE FOR INNOVATION TO SUPPORT
FUNDAMENTAL IMPROVEMENTS. FOR
EXAMPLE, SOLANO COUNTY USED
INNOVATION FUNDING TO REBUILD
ITS COMMUNITY OUTREACH STRATEGY
, RESULTING IN IMPROVED ACCESS
TO CARE BY MORE THAN 300% FOR
UNDERSERVED COMMUNITIES. TODAY
MORE THAN 40 COUNTIES ARE
EXPLORING OPPORTUNITIES TO
REPLICATE THEIR SUCCESS. THE
COMMISSION IS ALSO WORKING WITH
NEARLY A DOZEN COUNTIES TO
IMPROVE ACCESS TO EARLY
PSYCHOSIS. INTERVENTIONS
UNADDRESSED PSYCHOSIS IS A MAJOR
DRIVER OF HOMELESSNESS,
HOSPITALIZATION AND CRIMINAL
JUSTICE INVOLVEMENT WITH
TREMENDOUS COSTS THAT CAN BE
AVOIDED WITH EVIDENCE BASED CARE
. THIS EFFORT BEGAN AS A COUNTY
INNOVATION PROJECT, AND THE
STATE HAS STEPPED UP TO EXPAND
THE REACH OF THESE FUNDS.
COUNTIES HAVE ALSO USED
INNOVATION, FUNDING TO SUPPORT
CRIMINAL JUSTICE, DIVERSION AND
SUPPORT SCHOOL MENTAL HEALTH.
APPROACHES TO HOUSING MOBILE
CRISIS SERVICES INTEGRATED
ELECTRONIC HEALTH RECORDS ACROSS
COUNTIES, STIGMA REDUCTION,
YOUTH EMPOWERMENT, ER, DIVERSION
AND MORE HAVE BEEN FUNDED WITH
INNOVATION. DOLLARS TO BE CLEAR.
INNOVATION IN MENTAL HEALTH IS
HAPPENING EVERY DAY THROUGH THE
PRIVATE SECTOR. BUT THE BENEFITS
OF THAT WORK DO NOT ALWAYS FIND
THE MOST VULNERABLE
CALIFORNIANS. CALIFORNIA IN OUR
PUBLIC MENTAL HEALTH SYSTEM, THE
MHS SAYS FUNDING SET ASIDE FOR
INNOVATION AND SURE THAT THE
MOST VULNERABLE CALIFORNIANS DO
BENEFIT FROM INNOVATIVE
APPROACHES. WHILE THE BILL
STATES THAT COUNTIES ARE
EXPECTED TO BE INNOVATIVE AND
ALL THAT THEY DO, IT IS UNCLEAR
HOW THAT WILL HAPPEN WITHOUT A
FISCAL MANDATE. FOURTH THE
COMMISSION IS VERY APPRECIATIVE
OF THE WORK THAT HAS BEEN DONE
ON SCHOOL MENTAL HEALTH WITH THE
PASSAGE OF THE MENTAL HEALTH
STUDENT SERVICES ACT AND C Y B H
I, WHILE MANY OF THE FISCAL
REFORMS INCLUDED IN THE C B H, I
WILL CONTINUE AFTER ITS SUNSETS
. CALIFORNIA'S EQUIPMENT TO
SCHOOL MENTAL HEALTH ISN'T NOT
ONE OF THEM. THEREFORE WE SHOULD
ENCOURAGE THE SAME LEADERSHIP ON
SCHOOL MENTAL HEALTH, PERHAPS
FOLLOWING THIS EFFORT. FIFTH WE
ALSO APPRECIATE THE FOCUS
RESTATEMENT OF A COMMITMENT TO
ACCOUNTABILITY. THE STAIN
COUNTIES HAVE NOT YET FULFILLED
THAT COMMITMENT DESPITE THE
STATUTE, AND WE LOOK FORWARD TO
WORKING WITH THE ADMINISTRATION
TO DEVELOP AN IMPLEMENTATION
IMPLEMENTATION PLAN TO ENSURE WE
GET THERE. LASTLY, THE DETAILS
MATTER AND HOW THE STATE AND
COUNTIES IMPLEMENT THESE REFORMS
WILL DETERMINE IF MORE
CALIFORNIANS CAN ACCESS CARE AND
ACHIEVE RECOVERY. FOR ONE, IT
WILL BE IMPORTANT FOR THE
LEGISLATURE AND THE PUBLIC TO BE
ABLE TO MONITOR IMPLEMENTATION
OF THESE REFORMS. OVERTIME
SECOND, IT WILL ALSO BE
IMPORTANT TO ENSURE THAT
IMPLEMENTATION SUFFICIENTLY
ENGAGES THE CLIENTS AND FAMILIES
SERVED BY THE BEHAVIORAL SYSTEM
. ONE EXPLICIT GOAL OF THIS
REFORM SHOULD BE TO ELIMINATE
DISPARITIES AND BEHAVIORAL
HEALTH OUTCOMES. AND THE BEST
WAY TO DO THAT IS TO IMPROVE HOW
WE ENGAGE AND LISTEN TO
CALIFORNIA'S DIVERSE
COMMUNITIES. THE H S A
IMPLEMENTATION SHOULD BE CO
CREATED WITH THE COMMUNITIES
THAT ARE THE MOST UNDERSERVED.
LASTLY AS I MENTIONED BEFORE, IT
WILL BE IMPORTANT TO HAVE LIKE
STABILITY IN STATE LEVEL FUNDING
TO ENSURE WE HAVE THE ABILITY
AND THE FUNDING TO SUPPORT AN
IMPLEMENTATION PLAN THAT MATCHES
THE SCALE OF THIS REFORM. THANK
YOU FOR THE CHANCE TO JOIN YOU
TODAY AND HAPPY TO ANSWER ANY
QUESTIONS. GOOD AFTERNOON CHAIRS
AND MEMBERS. THANKS SO MUCH FOR
HAVING ME HERE TODAY. MY NAME IS
PHOEBE BELL, AND I'M THE
BEHAVIORAL HEALTH DIRECTOR FOR
NEVADA COUNTY AND PAST PRESIDENT
OF C B H D. A AND IT SHOULD SAY,
HAS COMPLETELY TRANSFORMED HOW
WE DELIVER ESPECIALLY MENTAL
HEALTH SERVICES IN CALIFORNIA
OVER THE LAST 20 YEARS FOR THE
BETTER. IT HAS GIVEN US THE
OPPORTUNITY TO MAKE TRUE
INVESTMENTS AND PREVENTION,
EARLY INTERVENTION AND TO BUILD
A MORE ROBUST CONTINUUM ABOUT
PATIENT SERVICES. IN FACT, AN
INDEPENDENT, PEER REVIEWED STUDY
OUT OF USC FOUND THAT THANKS TO
THE MHS A. WE'VE PREVENTED OVER
5500 DEATHS BY SUICIDE IN
CALIFORNIA. TODAY THE IMAGES SAY
, HAS BECOME A CORE SOURCE OF
FUNDING FOR A BROAD RANGE OF
SAFETY NET SERVICES. IT MAKES UP
ONE THIRD OF OUR STATE DEDICATED
FUNDING STREAMS, AND IT'S A
CRUCIAL SOURCE OF LOCAL MATCH
FOR MEDICAL DOLLARS. IT'S ALSO
TRANSFORMED HOW WE DELIVER CARE
BY REQUIRING US TO MORE
MEANINGFULLY ENGAGE OUR LOCAL
COMMUNITIES AND BUILDING OUT
SERVICES, NOT A PENNY CAN BE
SPENT WITHOUT LOCAL INPUT AND
SIGN OFF. AND THESE ARE
APPRECIATIVE. THE AUTHOR AND THE
ADMINISTRATION'S ACKNOWLEDGEMENT
OF THE MANY OUTSTANDING ISSUES
AND CHALLENGES WE FACE AS A
PUBLIC SAFETY NET FOR MENTAL
HEALTH AND SUBSTANCE USE
DISORDERS IN BRINGING FORWARD SP
3 26, INCLUDING AN IMAGE TO SAY
FUNDING STRUCTURE, WHICH IS
OVERLY RESTRICTIVE AT TIMES AND
LIMITS OUR ABILITY TO PAY FOR
STANDALONE SUBSTANCE USE
DISORDER CONDITIONS. EXCUSE ME A
LACK OF ACCESS TO HOUSING FOR
OUR CLIENTS. AND THE OPPORTUNITY
FOR MORE TRANSPARENCY ABOUT OUR
SERVICES AND EXPENDITURES. AND I
WANT TO BE CLEAR COUNTIES ARE
NOT ONLY OPEN INCREASED
TRANSPARENCY AND ACCOUNTABILITY
. WE SPONSORED A BILL AUTHORED
BY ASSEMBLYMEMBER'S ARAMBULA, UM
, THAT WAS PASSED BY THIS
COMMITTEE TO DO JUST THAT. WE'RE
INVESTED IN HELPING OUR STATE
PARTNERS TO BETTER UNDERSTAND
THE GOOD WORK. GOOD WORK WE AND
OUR COMMUNITY PARTNERS DO EVERY
DAY. AS HAS BEEN DESCRIBED A
NUMBER OF TIMES TODAY WE WANTED
TO SHARE THE IMPACT OF ADDING A
NEW REQUIREMENT TO DIVERT A
THIRD OF THE IMAGES SAY FUNDING
THE HOUSING YOU CAN SEE UP HERE
THAT THE PIE GETS SLICED UP
DIFFERENTLY THAN IT WAS BEFORE.
INITIALLY WE WERE LOOKING AT
SOMEWHAT COMPARABLE LEVELS FOR
PREVENTION AND EARLIER
INTERVENTION AND FULL SERVICE
PARTNERSHIPS, BUT WE WERE
CONCERNED ABOUT THE CORE
SERVICES FUNDED THROUGH THE B. H
S S CATEGORY OR THE DARK ORANGE
SLICE HERE. AND ALTHOUGH WE
APPRECIATE THAT THE STATE HAS
ATTEMPTED TO RESPOND TO THOSE
CONCERNS. UM WHAT'S HAPPENED IS
WE'VE LIFTED 4% OF THE FUNDING
OUT TO THE, UM, STATE LEVEL,
WHICH REDUCES THE OVERALL POT.
UM MEANING THAT THERE'S A MODEST
GAIN TO THAT B. H S S CATEGORY
OF 2% AND AN OVERALL DECREASE IN
FUNDS. PREVENTION DOLLARS TODAY
SUPPORT OUR SCHOOL WIDE
PREVENTION ACTIVITIES, INCLUDING
COMMITTEES, STIGMA, REDUCTION
AND OUTREACH EFFORTS,
PARTICULARLY IN OUR BIPAC AND L
G. T. B Q AND IMMIGRANT
COMMUNITIES. FOR THIS VIEW. WE
TRIED TO LOOK AT THE IMPACTS OF
THE FUNDING WHEN WE ADD, UM
SUBSTANCE USE DISORDER SERVICES
AND DIVERT FUNDS TO ADDRESS
THOSE NEEDS. AND I WANT TO
HIGHLIGHT THAT IN 2019, C B H D
AND C SACKED, WORKED ON A JOINT
SET OF IMAGES SAY REFORM
PRINCIPLES, WHICH CALLED FOR
USING IMAGES SAY MORE FLEXIBLY
FOR SUDI ONLY SERVICES. SO WHILE
WE ARE ALIGNED WITH THIS GOAL IS
CURRENTLY DRAFTED. THE BILL
REQUIRES TO DIVERT FUNDING THAT
TODAY SUPPORTS MENTAL HEALTH
SERVICES IN ORDER TO BUILD UP
NEW SUD SERVICES. FOR THIS SLIDE
, SEE BHD AS THE SAMPLE SMALL,
MEDIUM AND LARGE COUNTY TO MODEL
. HOW ARE EXISTING PROGRAMS AND
SERVICES, WHICH TRANSLATES THE
NEW FUNDING CATEGORIES AND MORE
GRANULAR WAY USING CURRENT
EXPENDITURES. UNFORTUNATELY THE
REDUCED FUNDING WE SEE HERE DOES
NOT ACCOUNT FOR THE NEW
REQUIREMENT TO FURTHER DIVERT
FUNDING FOR THE SUD REQUIREMENT.
AND THIS MODELING EXERCISE
REALLY JUST CONFIRMED AT THE
COUNTY LEVEL. WHAT WE SAW AT THE
SYSTEM LEVEL, WHICH IS A
SIGNIFICANT DROP IN THAT DARK
ORANGE GENERAL SERVICES BUCKET
ANYWHERE FROM 50 TO 80% ACROSS
COUNTIES AND AGAIN, THIS IS THE
BUCKET THAT FUNDS, CORE
OUTPATIENT CRISIS AND PEER
SUPPORT SERVICES. AS MANY OF YOU
HAVE ADDRESSED TODAY IN YOUR
COMMENTS THESE SERVICES ARE ALSO
LARGELY MATCHABLE THROUGH
MEDICAL, WHICH WOULD INCREASE
THE IMPACT OF THE LOSSES TO OUR
COMMIES WITH THE RELATED LOSS OF
FEDERAL MATCH DOLLARS TO SAY
THAT ANOTHER WAY TO $100 OF
IMAGES SAY FROM A PROGRAM WE
GENERALLY HAVE TO CUT $200 OF
SERVICES. JUST SIDE IS A DEEPER
DIVE INTO THE IMPACTS ON MY
COUNTY, NEVADA, WHERE IT LOOKS
LIKE I'LL NEED TO MOVE ABOUT
THREE QUARTERS OF A MILLION
DOLLARS OUT OF MY $4.3 MILLION
BREAKFAST P THAT I CURRENTLY
SPEND IN ORDER TO MEET THE
REQUIRED SPENDING IN THE OTHER
CATEGORIES, AND THIS WOULD ALL
BE IF FUNDING WERE ONLY SPENT ON
MENTAL HEALTH SERVICES. WE WOULD
ALSO LIKELY LOSE 1.6 MILLION IN
MEDICAL REVENUES. I WANT TO ADD
A COUPLE OF COMMENTS AS WELL
ABOUT THE HOUSING BUCKET AND
SOME CONCERNS. WE HAVE WE ARE
WORRIED ABOUT FIXING A MUCH
LARGER BROKEN SYSTEM, WHICH IS
THE SUPPLY OF AFFORDABLE AND
ADEQUATE HOUSING IN OUR STATE ON
THE BACKS OF THE BEHAVIORAL
HEALTH SYSTEM. AND TO MAKE THAT
EXPLICIT IN NEVADA COUNTY IN
2022, WE WENT AFTER EVERY DOLLAR
THAT THE STATE GENEROUSLY HAS
PUT FORWARD TO IMPROVE HOUSING
IN OUR STATE, AND WE APPLIED FOR
ALL OF IT. WE ADDED 71 BEDS OF
HOUSING TO OUR COMMUNITY, WHICH
WE'RE REALLY EXCITED ABOUT, AND
IN THAT SAME YEAR, 200 PEOPLE
BECAME HOMELESS FOR THE FIRST
TIME. WE ALSO ARE WORRIED ABOUT
HOW TO SUSTAIN THE HOUSING
THAT'S IN THAT BUCKET. UM WE
CANNOT GET VOUCHERS PERMANENT,
SUPPORTIVE HOUSING VOUCHERS OR
HOUSING CHOICE VOUCHERS, AND I
THINK THAT'S A DISCUSSION
NEEDING MORE ATTENTION. WE ALSO
ARE CONCERNED ABOUT THE SERVICES
, THE NON TREATMENT SERVICES
THAT NEED TO BE FUNDED IN THAT
BUCKET PIECES THAT ALLOW HOUSING
TO BE SUCCESSFUL FOR PEOPLE. WE
REALLY, UM THIS IS A PICTURE
FROM OUR PEER RESPITE PROGRAM
THAT WE OPERATE WITH THEM. HSCEI
DOLLARS. IT'S A BELOVED PROGRAM
AND THE KIND OF PROGRAM WE WORRY
WE MAY LOSE. AND LASTLY, JUST
WANT TO TOUCH ON THE VOLATILITY
ISSUE, WHICH THE LAO FOLKS ALSO
HIGHLIGHTED. UM THERE'S KIND OF
TWO ISSUES TO THE VOLATILITY.
ONE IS IT'S HARD TO PREDICT
FUNDING SOURCE, BUT SECONDLY,
WHEN YOU START HAVING RIGID
FUNDING CATEGORIES, IT'S VERY,
VERY CHALLENGING TO MANAGE YOUR
MONEY AND BE ABLE TO EXPEND IN A
TIMELY WAY. SO FOR EXAMPLE, TWO
YEARS AGO, WE HAD A MILLION
DOLLARS MORE REVENUE THAN WE
PLANNED FOR. WE WANTED TO SPEND
IT ON HOUSING. BUT WE COULDN'T
BECAUSE THEN OUR GSD BUCKET
WOULD BE OUT OF PROPORTION WITH
OUR FSP BUCKET WHICH NEEDED TO
BE 51% AND SO WE'RE STUCK
BECAUSE OF THOSE RIGID
CATEGORIES. UM IN CLOSING. WE
BELIEVE WE HAVE A SHARED
INTEREST WITH THE STATE AND
TRYING TO STABLE AND SUSTAINABLY
FUND OUR SERVICES. UNDERSTANDING
THE POTENTIAL IMPACTS OF THIS
PROPOSAL IS CRITICAL TO AVOIDING
UNINTENDED HARM TO THE SYSTEM.
WE BELIEVE WE HAVE AN
OPPORTUNITY TO ADDRESS SOME OF
THE CHALLENGES OF IMAGES SAY BY
SMOOTHING OUT THE VOLATILITY. WE
BELIEVE THAT IT'S IMPORTANT THAT
FOUNDATIONAL LAWS SUCH AS 91 AND
2011 REALIGNMENT REMAIN
UNTOUCHED THROUGH THIS PROCESS,
AND INSTEAD ARE ADDRESSED
THROUGH THE NORMAL PROCESSES OF
A NEGOTIATION BETWEEN COUNTIES
AND STATES. AND WE CONTINUE TO
ASK FOR SPECIAL CONSIDERATION
FOR RURAL COUNTIES BASED ON THE
UNIQUE CHALLENGES WE FACE. WE
LOOK FORWARD TO CONTINUED
PARTNERSHIP WITH THE LEGISLATURE
AND THE ADMINISTRATION TO ENSURE
THAT AS WE MAKE THESE CHANGES,
WE CAN CONTINUE TO USE FUNDS IN
PARTNERSHIP WITH THE COMMUNITY
IN WAYS THAT BEST MEET THE NEEDS
OF OUR COMMUNITY AND PREVENT
SUFFERING AND EVEN DEATH FOR
THOUSANDS OF CALIFORNIANS. GOOD
AFTERNOON SHERWOOD AND MEMBERS
OF THE COMMITTEE. IT'S AN HONOR
TO BE BACK BEFORE YOU TODAY. MY
NAME IS ZAK FRIEND I'M CHAIR OF
THE SANTA CRUZ COUNTY BOARD OF
SUPERVISORS, AND I'M ALSO HERE
TODAY REPRESENTING ALL OF THE
STATES 58 COUNTIES ON BEHALF OF
THE CALIFORNIA STATE ASSOCIATION
OF COUNTIES, RIGHT SHARE THE
HEALTH AND HUMAN SERVICES
COMMITTEE. AS YOU KNOW, NO
PROGRAM OR NO INITIATIVE, OR NO
BILL CAN SUCCEED WITHOUT THE
IMPLEMENTATION OF COUNTIES. AND
I WISH I WAS HERE TODAY TO TELL
YOU THAT WE FELT THAT THE BILL
THAT'S PROPOSED EVEN WITH THE
AMENDMENTS WENT FAR ENOUGH TO DO
THAT, BUT I DON'T THINK I CAN
QUITE SAY THAT. I THINK OUR
COUNTY, THE 58 COUNTIES HERE
HAVE A SIGNIFICANT NUMBER OF
CONCERNS AS PROPOSED IN ORDER TO
IMPLEMENT THIS SUCCESSFULLY, AND
WE'RE AT A DEFINING MOMENT AS
ALL OF YOU KNOW, YOU'VE HAD
AMAZING LEADERSHIP ON THIS. THE
HOUSING CRISIS IN OUR STATE
BEHAVIORAL HEALTH CRISIS IN OUR
STATE, HOMELESSNESS CRISIS IN
OUR STATE, AND THESE ISSUES
SHOULDN'T BE PUT AT ODDS OR
CONFLICT WITH EACH OTHER. RIGHT
THESE ARE THINGS THAT NEED A
SYMBIOSIS. THEY NEED TO HAVE AN
INTER RELATIONSHIP AND THE
FUNDING MECHANISM SHOULDN'T TAKE
AWAY FROM ONE WHERE THE CAUSE
FOR ANOTHER DOCTOR FOR SO ABLY
SAID IN AN EARLIER PANEL. AS I
THINK ALSO, YOU'RE WELL AWARE
THE EXPANSE OF WHAT'S BEING
ASKED FOR OF THE OF OUR STATES
COUNTIES RIGHT NOW CAN'T BE
OVERSTATED FROM CAL AIM TO CAL
COURTS AND THE TIMELINE TO
IMPLEMENT ALL THESE TAKEN
INDIVIDUALLY. ANY ONE OF THEM
WOULD BE A LOT AND WE WANT THAT
RESPONSIBILITY ON BEHALF OF THE
COUNTIES. BUT YOU CAN'T DO IT
WHILE SIMULTANEOUSLY. TAKING
AWAY RESOURCES FOR ONE AND
ASKING US TO DO MORE AND
REPORTING FOR TWO. I THINK THAT
WHAT WE DO UNDERSTAND THE
LEGISLATURE AND THE GOVERNOR
UNDERSTANDS IS THAT ALL THINGS
BEING EQUAL WERE IN THE SERVICE
DELIVERY BUSINESS, NOT IN THE
REPORTING BUSINESS, BUT THIS HAS
PROPOSED WOULD CREATE MORE
ACCOUNTABILITY IS IT'S CO CALLED
, BUT MORE REALLY REPORTING
REQUIREMENTS UNLESS SERVICE
DELIVERY AVAILABILITY FOR THE
STATE'S COUNTY. SO LET ME SAY
WHAT IT WILL DO BECAUSE I HAD
HEARD ASSEMBLYMEMBER'S FONG
ASKED SOME OF THESE QUESTIONS
EARLIER. IT REQUIRES COUNTIES TO
DO MORE TO SERVE MORE WITH LESS
FUNDING AND LESS FLEXIBILITY AND
DIRECT TO DR WEBBER'S QUESTIONS
EARLIER IT REDUCES FUNDING FOR
CORE MENTAL HEALTH SERVICES. IT
WILL REDUCE OUR ABILITY TO
LEVERAGE FEDERAL FUNDS. IT
DIVERTS FUNDING FROM ONE WORTHY
CAUSE TO ANOTHER. WE NEED
FUNDING FOR ALL THESE CAUSES,
AND I THINK IT CREATES HOLES IN
A SAFETY NET WHERE WE'RE GOING
TO HAVE ADDITIONAL VULNERABLE
PEOPLE FALL THROUGH THOSE HOLES
. WE CAN GET THERE THE
AMENDMENTS AND I APPRECIATE THE
GREAT WORK OF CHAIR WOULD HEAR.
THE AMENDMENTS ARE GETTING US
THERE, BUT WE'RE NOT THERE YET,
AND THE COUNTIES WANT TO MAKE
SURE THAT WE'RE AT THE TABLE TO
ENSURE THAT WE CAN GET THERE
WITH WHAT'S BEING PROPOSED.
SPECIFICALLY THE COUNTY'S
CONCERNS ARE ON THE 30% SET
ASIDE, OBVIOUSLY, THERE NEEDS TO
BE FLEXIBILITY OR ADDITIONAL
DISCUSSION ON THAT, AS A LEO
NOTED, UM THERE NEEDS TO BE SOME
WAY TO ADDRESS THE VOLATILITY
FEELS LIKE THAT'S GETTING
CLOSER, AND I THINK THAT WILL BE
RESOLVED. BUT THAT'S NOT THE
MAJOR ISSUE, RIGHT. I MEAN, THE
MAJOR ISSUE IS THAT MONEY IS
LITERALLY BEING TAKEN OUT OF THE
HANDS OF COUNTIES WHERE WE NEED
TO PROVIDE OTHER SERVICES WITH
THAT, AND LAST IS THAT WE WANTED
THE UNFUNDED MANDATES TO BE
REMOVED FROM THE PROPOSAL. UM, I
THINK THAT WE CAN ALL AGREE THAT
THERE ARE A LOT OF REQUIREMENTS
THAT ARE BEING PUT ON OUR LOCAL
GOVERNMENTS RIGHT NOW TO PROVIDE
SERVICE DELIVERY, AND THESE
THINGS TAKE TIME TO ACTUALLY
EFFECTUATE. THEY TAKE TIME TO
BECOME REAL. AND WE AT THE
COUNTY LEVEL ARE GONNA BE THE
ONES IMPLEMENTING THIS FOR YEARS
TO COME WELL PAST THE TIME THAT
THIS HEARING OCCURS WITH THIS
DECISION IS MADE. WE WANT TO
MAKE SURE THAT WE RECOGNIZE FIVE
YEARS OR 10 YEARS FROM NOW WE'VE
MADE A FUNDAMENTAL DIFFERENCE IN
THESE PEOPLE'S LIVES THAT WE'RE
TALKING ABOUT RIGHT NOW. AND WE
CAN'T DO IT UNDER THE CURRENT
PROPOSAL. THANK YOU, MR CHAIR
FOR THE HONOR OF COMING BACK.
IT'S WONDERFUL TO BE HERE AND BE
PLEASURE TO ANSWER ANY QUESTIONS
YOU MIGHT HAVE. THANK YOU VERY
MUCH. I'M GONNA TURN TO THE
COMMITTEE FOR QUESTIONS. THESE
ARE COMMENTS. DR ARAMBULA. THANK
YOU. I'M GOING TO BEGIN WITH
KAREN LARSON. IF I CAN. I WAS
REALLY DRAWN TO TOWARDS YOUR
COMMENT REGARDING F SPS AND THE
10 LARGEST COUNTIES WITH
HOMELESS POPULATIONS AND NINE
OUT OF 10 OF THEM NOT MEETING
OUR STATE STANDARD REGARDING
FUNDING FOR F SPS THAT I'D LIKE
TO UNDERSTAND HOW WE HAVE
CONFIDENCE THAT ANY OTHER TYPES
OF MANDATES THAT WE ARE
REQUIRING, INSISTING UPON WILL
BE MET IF UM, IF THAT. FSP ONE
IS NOT CURRENTLY BEING MET. I'M
NOT SURE THIS IS A QUESTION THAT
I CAN ANSWER FOR YOU BECAUSE IT
SEEMS LIKE IT'S DEFINITELY IN
THE ADMINISTRATION'S, UH REALM.
AS I UNDERSTAND IT. THERE'S BEEN
A, UH THERE HASN'T BEEN A
MECHANISM FOR HOLDING THE
COUNTY'S ACCOUNTABLE TO THE FSP
REQUIREMENT WITHIN THAT CSS
BUCKET AT THE MOMENT. UM AND
THAT WOULD BE REMEDIED IN THIS
NEW HMM. THE H S A I BRING IT UP
IN LIGHT OF THE COMMENTS THAT
KENDRA HAD STATED REGARDING
FLEXIBILITY IS PREFERRED AS MY
UNDERSTANDING IS, THIS WAS A
TEMPORARY FLEXIBILITY IN 2010
2011 DUE TO BUDGET CIRCUMSTANCES
, AND YET COUNTIES HAVE
CONTINUED TO SPEND LESS THAN
WHAT THEY'RE BEING MANDATED FOR
AT THE STATE LEVEL THAT I
QUESTION WHETHER WERE UTILIZING
THOSE RESOURCES WITH THE
WHATEVER IT TAKES MODEL TO THE
MAXIMUM CAPACITY AND WHAT IS
BEING ASKED OF US THAT I KNOW
YOU PHOEBE BELL. I DON'T LIKE
YOU TO GIVE US SOME THOUGHTS TO
THAT AND HOW WE ENSURE THAT WE
ARE PROVIDING GUIDANCE WHILE
ALLOWING OUR COUNTY PARTNERS TO
BE ABLE TO IMPLEMENT
EFFECTIVELY. YEAH ABSOLUTELY.
AND I THINK WHAT'S IMPORTANT TO
NOTE IS THAT COUNTIES ARE
OPERATING IN ACCORDANCE WITH
EXISTING LAW, WHICH IS THAT YOU
SPEND 51% OF YOUR MONEY ON F SPS
, BUT THAT'S UTILIZING THE
FEDERAL FINANCIAL PARTICIPATION
DOLLARS AS WELL. UM I ALSO WANT
TO ADD THAT IN MY COUNTY WE ARE
SPENDING OVERSPENDING ON FSP.
AND YET WE STILL HAVE A
HOMELESSNESS PROBLEM. JUST THE
ACT OF HAVING FSP DOES NOT SOLVE
THE CORE STRUCTURAL ISSUE OF
INADEQUATE SUPPLY OF HOUSING.
AND WHILE AS WE HEARD EARLIER,
WE NEED THOSE CRITICAL,
SUPPORTIVE SERVICES. ABSOLUTELY
AND WE NEED THEM TO BE FUNDED
ADEQUATELY SO THAT WE CAN IMPACT
AS MANY PEOPLE AS POSSIBLE. IT'S
GOT TO BE ALL OF IT. I'M GONNA
FOLLOW UP WITH YOU, MISS BELL.
IF I CAN. YOU WOULD ALSO MADE A
COMMENT ABOUT CUTTING MHSC
FUNDING AND WHAT THAT WOULD
EQUATE TO WITH COUNTY SPENDING.
IS THERE A WAY TO VALIDATE THAT
NUMBER OR TO VERIFY AS IT WOULD
SEEM THAT THERE'S MULTIPLE
FUNDING STREAMS COMING IN, AND
NOT ALL OF THEM QUALIFY FOR
FEDERAL PARTICIPATION, FINANCIAL
PARTICIPATION THAT I'D LIKE TO
MAKE SURE WE'RE SPEAKING WITH
REAL NUMBERS AND HOPING TO
FOLLOW UP, AND IT CAN BE OFFLINE
ABOUT HOW WE ENSURE WHAT YOU
WERE SPEAKING ABOUT IS ACCURATE.
YEAH 100% HAPPY TO SHARE SOME OF
THE BACKGROUND DOCUMENTS WE USED
TO DEVELOP, UM, SORT OF THE
ANALYSIS AND THE COUNTY BY
COUNTY LEVEL OF WHAT THESE CUTS
WOULD MEAN. AND FINALLY FOR, MR
UM FRIEND. SORRY I WANTED TO YOU
SAID THAT COUNTIES ARE IN THE
BUSINESS OF SERVICE DELIVERY AND
LESS THAN REPORTING HIGHLIGHT
AGAIN EARLIER TODAY WE HEARD
WITH F SPS THAT OUR THIRD AREN'T
GIVING US DEMOGRAPHIC DATA. SO
WHILE I HEAR YOU IN IMPLEMENTING
AND DOING SERVICE DELIVERY. I
ALSO WANT TO MAKE SURE WE'RE
GETTING APPROPRIATE DATA SO THAT
WE CAN ADDRESS SOME OF THE
DISPARITIES THAT WE'VE SEEN
WITHIN OUR SYSTEM. WE'VE WE'VE
HEARD WHAT HAPPENS TO OUR
INDIGENOUS POPULATIONS AND
AFRICAN AMERICANS THAT I'D UM, I
THINK YOU'RE SIMILARLY HAVE A
ROLE HERE TO HELP US WITH
REPORTING OF DATA THAT UM, I
DON'T THINK IT'S AN EITHER, OR I
THINK IT SHOULD BE BOTH. YES DR
. RANDALL, I AGREE WITH YOU
FULLY. LET ME JUST SAY THAT, UH
, WHAT WE'RE DEALING WITH IS A
SITUATION AND YOU WOULD HAVE
KNOWN THIS THROUGH THE MEDICAL
WORK AND BOTH OF YOUR WORK
BEFORE THAT THEY REQUIREMENTS
HAVE GONE UP EXPONENTIALLY.
AVAILABLE STAFFING HAS GONE DOWN
AS WELL. SO WE'RE A THIRD DOWN
IN SANTA CRUZ COUNTY. MOST
COUNTIES HAVE ABOUT 20% LESS
BEHAVIORAL HEALTH STAFF. UM SO A
LOT OF OUR STAFF IS NOW
DEDICATED TO GRANT BASED
REPORTING OR PROGRAMMATIC
REPORTING, REPORTING AND NOT THE
SERVICE DELIVERY. SO WHAT I'M
SAYING? IS THAT WHAT RIGHT NOW I
AGREE. IT'S A HOBSON'S CHOICE,
RIGHT? IT SHOULD BE BOTH. BUT IF
WHAT WE'RE TALKING ABOUT IS A
REDUCTION IN FUNDING, THEN THEN
I THINK ULTIMATELY WE HAVE TO
ASK OURSELVES AS LEGISLATORS,
WHICH I'M AT THE LOCAL LEVEL.
WHAT IS OUR ULTIMATE GOAL? AND I
DON'T THINK OUR ULTIMATE GOAL IS
THE REPORTING SIDE OF THE
SERVICE DELIVERY SIDE OR WE NEED
TO GROW THE PIE SO THAT WE CAN
DO BOTH. BUT THE CHOICE IS
THAT'S WHERE THAT'S WHERE WE'RE
FACED WITH. THANK YOU, MR CHAIR.
ANYONE ELSE? I GUESS IT'S A POST
LUNCH COMA SET IN HERE. UM SO
NO, UM. YOU KNOW, I'M GONNA GO
BACK. UH MISS BELL, OBVIOUSLY,
YOU YOU'RE HERE. YOU REPRESENT A
RURAL COUNTY. UM OR THE FIVE
COUNTIES. I REPRESENT, ACTUALLY
, ALL FIVE OR WE COULD BE
CLASSIFIED AS RURAL. I'M CURIOUS
FROM YOUR PERSPECTIVE. UM, YOU
KNOW WHAT? AH! WHAT KINDS OF
FLEXIBILITIES WHAT DO YOU WHAT
WOULD YOU BE LOOKING? WHAT ARE
YOU LOOKING FOR? TO IMPLEMENT IF
IT IS EXACTLY IF IT ENDS UP
BEING EXACTLY WHAT WE HAVE
BEFORE US. WHAT WHAT? WHAT
CHANGES WOULD YOU LIKE TO SEE? I
THINK AS AMENDED THERE WAS SOME
EXCEPTIONS GIVEN FOR RURAL
COUNTIES, WHICH WAS GREAT TO SEE
WE REALLY APPRECIATED THAT
PROGRESS. UM, BUT AS I
UNDERSTAND IT, IT'S A PROCESS TO
APPLY FOR THAT EXCEPTION. PROVE
YOUR CASE, HAVING GRANTED AND I
THINK OFTEN THAT CAN BE TIME
CONSUMING AND SLOW AND MIGHT NOT
ALLOW US TO BE AS NIMBLE AS WE
NEED TO BE. SO I THINK AUTOMATIC
EXEMPTIONS FOR CERTAIN
CATEGORIES OF THINGS. UM, FOR
EXAMPLE, SOME OF THE PLANNING
EXPECTATIONS. UM, SOME OF THE
PERCENT OF MONEY TO BE SPENT ON
HOUSING. DOESN'T MAKE SENSE IN
SOME OF OUR TINY COMMUNITIES
WHERE THERE ARE POINT IN TIME
COUNT IS LESS THAN 10 PEOPLE,
AND THEY'RE GOING TO SPEND 30%
OF THEIR MONEY ON HOUSING, FOR
EXAMPLE, OR WHERE THERE'S NOT
FIVE LARGE CITIES TO PULL TO THE
TABLE OR SOME OF THOSE KINDS OF
PIECES, SO HAVING JUST A MUCH
MORE SIMPLE PROCESS FOR RURAL
COUNTIES TO, UM USE THESE FUNDS
IN A WAY THAT MAKES SENSE IN
THOSE DIFFERENT SETTINGS. I
APPRECIATE THINGS SIMPLE MAKES A
LOT OF SENSE. AND IF AND BARRING
SIMPLE TECHNICAL ASSISTANCE
BECAUSE WE KNOW NOT NOT THE
SMALLER THE COUNTY, THE LESS
NUMBER OF PEOPLE WHO HAVE THE
EXPERTISE TO ACTUALLY DO THE
WORK. UM UM, AND WHILE
SUPERVISOR FRIEND I APPRECIATE
THE CONCERN ABOUT REPORTING, AND
, UM, YOU KNOW, WE NEED AS DR
WRANGLER SAID, WE NEED THAT
DATA. WE ABSOLUTELY NEED THE
DATA AND, UM UM AND IT BUT BUT,
BUT JUST COLLECTING THE DATA IS
ONLY A PIECE OF IT. IT NEEDS TO
BE ANALYZED AND PROCESSED. AND I
MY IMPRESSION IS THAT THE DATA
THAT HAS BEEN ANALYZED OR
COLLECTED HASN'T REALLY BEEN
ANALYZED AND PROCESSED. AS AS IT
SHOULD BE, WHICH IS PART OF THE
ISSUE THERE AS WELL. BUT WE
ABSOLUTELY NEED THE DATA FROM MY
PERSPECTIVE, SO UM. SURE WOULD
SURE GO AHEAD JUST FOR MENTAL
HEALTH SERVICES ACT REPORTING AS
COUNTIES. WE TURN IN AN
EXTENSIVE AMOUNT OF INFORMATION
TO THE STATE HUNDREDS OF PAGES
OF VERY DETAILED ANALYSIS OF THE
PROGRAMS THAT WE FUNDED, AND I
THINK ONE OF THE CHALLENGES IS
IT'S NOT UNIFORM RIGHT NOW. AND
SO THERE'S NO REAL EASY WAY FOR
THE STATE TO SORT OF ABSORB
THAT, AND DISSEMINATED BACK OUT
TO THE COMMUNITY AT LARGE. BUT
IF YOU GO COUNTY BY COUNTY AND
LOOK AT THEIR ANNUAL PLAN
REPORTS, I THINK YOU'D BE
IMPRESSED BY THE LEVEL OF
ACCOUNTABILITY THAT EXISTS. SO
THE REQUIREMENT THERE IS NO
UNIFORM REQUIREMENT FOR DATA
REPORTING OR IS YOU'RE JUST NOT
IN WAYS THAT YOU COULD LIKE
EASILY SAY 6. MILLION PEOPLE
RESERVED, RECEIVE SERVICE X OR
WHATEVER. YOU HAVE TO SORT OF
BARELY MANUALLY, I THINK, PULL
IT FROM DIFFERENT REPORTS. OH,
THAT'S APPRECIATE THAT
APPRECIATE THAT FEEDBACK, SO UM
UM. LET'S SEE, MISS MISS SOLAR.
UM SO WE'VE HEARD WE HEARD FROM
THE FROM THE L A. OH WE MET WITH
AND WE'VE TALKED WITH WITH YOUR
YOUR FOLKS AS WELL. UM, THE
CHANGES IN THE OVERSIGHT PIECE
OF THIS BY MH MH S O A. C. HOW?
HOW. HARD QUESTION. I MEAN, THIS
IS MOVED FROM WHERE IT WAS AN
INTRODUCTION. UM I WOULD IMAGINE
THE POSITION WOULD BE WE JUST
LIKE IT THE WAY IT IS, UH, NOW,
UM, IS THERE IS THERE SOMETHING
ELSE SHORT OF THAT? IS THERE
SOME OTHER NEW ADDITIONAL MIDDLE
GROUND THAT WE COULD GET TO
BECAUSE I RECOGNIZE ABSOLUTELY
AND RESPECT THE VALUABLE ROLE
YOU PLAY PLAY IN THIS? THEY'RE
OFTEN TIMES WHEN WE NEED
INFORMATION. UM UM AS A
COMMITTEE OR INDIVIDUALS THAT WE
CAN GO TO YOU AND WE CAN GET THE
INFORMATION WHERE IT'S OFTEN
HARDER FOR US TO GET IT FROM
OTHER AGENCIES. SO I APPRECIATE
THE VALUE OF WHAT YOU WHAT YOU
PROVIDE THERE AND DON'T WANT TO
SEE THAT PIECE OF IT DIMINISHED
. SO UM, NOT ASKING YOU TO GET
IN HOT WATER WITH YOUR BOSS OR
ANYTHING BUT BUT YOU KNOW? CAN
YOU LEAN US THAT YOU CAN YOU
PUSH US IN A DIRECTION TO TELL
US, YOU KNOW? IS THERE SOMETHING
THAT'S ABSOLUTELY CRITICAL?
THAT'S MISSING. FROM FROM THE
AMENDMENTS AND WHERE WE ARE NOW.
YEAH THANK YOU FOR THE QUESTION
. UM THE QUESTION DOES NOT HAVE
A FORMAL POSITION. WE ARE GOING
TO BE DISCUSSING THE BILL ON
THURSDAY AT OUR COMMISSION
MEETING, SO I THINK SOME OF THAT
WILL BE DISCUSSED, BUT WE DO
HAVE ONGOING CONVERSATIONS WITH
THE ADMINISTRATION ABOUT OUR
STATUTE AND THE CHANGES THEY'VE
MADE AND THEIR PRODUCTIVE
CONVERSATIONS SPECIFICALLY LIKE
ABOUT THE DATA SHARING, AND SO
THOSE THOSE CONVERSATIONS ARE
ONGOING. APPRECIATE THAT. AND
THEN THIS IS MORE OF A COMMENT
THAN ANYTHING ELSE. I JUST WANT
TO THANK YOU. L A S OFFICE.
YOU'VE BEEN INCREDIBLY
ACCESSIBLE. UM, OBVIOUSLY, SOME
OF THE YOUR CONCERNS WE SHARED
AND YOU'VE SEEN SOME CHANGES AND
THE AMENDMENTS MOVING FORWARD
HERE, AS ALWAYS APPRECIATE YOUR
CANDOR. UM AND YOUR CONSTRUCTIVE
APPROACH TO PROVIDING US WITH
POTENTIAL PATHWAYS. UM WE DO
KNOW THAT WE WILL. OBVIOUSLY
THERE'S STILL WORK GOING ON HOW
WE, YOU KNOW, WE ADDRESS THE
VOLATILITY ISSUE HERE. BUT I
JUST WANT TO THANK YOU AGAIN AND
APPRECIATE THE WORK THAT YOU
PROVIDE. SO OKAY. ALRIGHT UM,
DID YOU YOU JUST WALKED IN. OKAY
WITH THAT. I WANT TO THANK THIS
PANEL AND WE WILL GO AHEAD AND
MOVE ON TO OUR FINAL PANEL.
WE'RE KIND OF IN THE HOME
STRETCH, SORT OF THIS PHASE OF
THE DAY. BUT UM, SO WE'VE GOT A
LARGER PANEL AND THERE MAY NOT
BE ENOUGH SEATS. SO WHEN THE UH
UM MAYBE WHEN THE FIRST SPEAKER
IS DONE. WE CAN CREATE ANOTHER
ANOTHER SPOT FOR SOMEONE. BUT NO
, PLEASE DON'T LEAVE BECAUSE WE
UNDOUBTEDLY WILL HAVE QUESTIONS
SO WHEN ALL THAT YOU YOU ALL
KNOW THE ORDERS. SO I'M GONNA
LET YOU, UM, SELF INTRODUCE. IN
THE INTEREST OF TIME, SO WHEN
THE FIRST PANELIST IS READY TO
GO, PLEASE. OH, GREAT. GOOD
AFTERNOON. MY NAME IS CHERYL
WINTER. I AM A LICENSED CLINICAL
SOCIAL WORKER AND I PROMOTE
HEALTH AND HOMELESSNESS POLICY
SOLUTIONS WITH THE CORPORATION
FOR SUPPORTIVE HOUSING, A
NATIONAL NONPROFIT. IN A PRIOR
POSITION. I PROVIDED ASSERTIVE
COMMUNITY TREATMENT, ALSO CALLED
ACT AND SUPPORTIVE HOUSING TO
PEOPLE EXPERIENCING CHRONIC
HOMELESSNESS, LIVING WITH
SERIOUS MENTAL ILLNESS AND
ACTIVE SUBSTANCE USE DISORDERS.
THE SOLUTION TO HOMELESSNESS
BEGINS WITH HOUSING AND DATA
SUPPORTS THE CONCEPT EMBEDDED IN
SP 3 26 THAT ONGOING FUNDING FOR
HOUSING INTERVENTIONS IS A
HEALTH INTERVENTION. ONCE HOUSED
IN RECEIVING THE RIGHT SERVICES
AND SUPPORTS PEOPLE WITH
BEHAVIORAL HEALTH CONDITIONS CAN
LIVE INDEPENDENTLY RECOVER AND
THRIVE. YET THE FUNDING AND SP 3
26 AND MAYBE 5 31 ALONE ISN'T
SUFFICIENT AND HOMELESSNESS OR
THE BEHAVIORAL HEALTH CHALLENGES
HOMELESSNESS CAUSES. CALIFORNIA
MUST INVEST AN ADDITIONAL $6.9
BILLION, OR ABOUT 2.5% OF OUR
STATE BUDGET EACH YEAR TO SOLVE
HOMELESSNESS. THIS IS WHY
CALIFORNIA MUST ALSO PASS THE
HOUSING BOND SHARE. WICKS HAS
INTRODUCED A B 16 57 AS WELL AS
AN ACT ONGOING FUNDING FOR
HOUSING AND SERVICES FOR ALL
EXPERIENCING HOMELESSNESS.
DECADES OF DATA SHOW THAT
SUPPORTIVE HOUSING WORKS AND HAS
PREVENTED AND ENDED CYCLES OF
HOMELESSNESS AND
INSTITUTIONALIZATION. THOSE
STUDIES RELIED ON EVIDENCE BASED
SERVICE MODELS LIKE ASSERTIVE
COMMUNITY TREATMENT TEAMS OR ACT
TEAMS. ACT AS A
MULTIDISCIPLINARY, TEAM BASED
MODEL THAT PROVIDES INTENSIVE
OUTPATIENT SERVICES FOR PEOPLE
WITH SERIOUS MENTAL ILLNESS AND
CO OCCURRING DISORDERS IN THE
CONTINUUM OF EVIDENCE BASED CARE
ACT OFFERS THE MOST INTENTIONAL
, ONGOING AND COMPREHENSIVE
SUPPORTS. TEAMS ARE AVAILABLE
DAY AND NIGHT EVENINGS AND
WEEKENDS. RIGHT NOW. MOST
CALIFORNIA COMMUNITIES DON'T
HAVE ACT TEAMS. PEOPLE WHO FACE
CHALLENGES LIVING ALONE IN
SUPPORT OF HOUSING WITH CURRENT,
UNDERFUNDED HOUSING CASE
MANAGEMENT ARE THE VERY PEOPLE
THAT ACT WAS DESIGNED TO SERVE.
THIS UNDERFUNDING IN SERVICES
AND PROPERTY MANAGEMENT IS
CAUSING A CRISIS IN OUR SUPPORT
OF HOUSING INDUSTRY IN
CALIFORNIA. ACT AND OTHER
INTENSIVE SERVICE MODELS ARE
EXPENSIVE, BUT THEY ARE FAR
CHEAPER THAN INSTITUTIONAL CARE
. WE RECOMMEND ENSURING
BEHAVIORAL HEALTH REFORM FUNDS
ACT TEAMS IN HOUSING. AND
CALIFORNIA CAN GO A STEP FURTHER
AND USE MEDICAL TO FUND BOTH ACT
AND SUPPORTIVE HOUSING AND A
HOUSING SUPPORT SERVICES
BENEFIT. WE ALSO RECOMMEND
CLARIFYING THAT COUNTIES SHOULD
BE ABLE TO SUPPLEMENT KELLUM
COMMUNITY SUPPORTS WITH BHS A
SERVICES AND THAT HOUSING BASED
KALLEN FUNDED SUPPORTS SHOULDN'T
SUBSTITUTE OR BE THE SOLE SOURCE
OF SUPPORTIVE HOUSING SERVICES
UNLESS THEY ARE FUNDED AND
STRUCTURED TO ALIGN WITH
EVIDENCE BASED MODELS LIKE
ASSERTIVE COMMUNITY TREATMENT.
WE FURTHER RECOMMEND IMPROVING
OTHER PROVISIONS IN SP 3 26 AND
MAYBE 5 31 SPECIFICALLY
EXPANDING ELIGIBILITY FOR
HOUSING INTERVENTIONS TO ANYONE
WITH A BEHAVIORAL HEALTH
CONDITION OR WHO EXHIBITS
SYMPTOMS OF A BEHAVIORAL HEALTH
CONDITION. ADDITIONALLY THE LIST
OF HOUSING INTERVENTIONS IN SP 3
26 SHOULD INCLUDE MASTER LEASING
, MOVING COSTS AND INCENTIVES
FOR LANDLORDS TO TAKE RENTAL
ASSISTANCE. LASTLY WE RECOMMEND
LANGUAGE THAT BUILDS IN MORE
INCLUSIVITY AND RACIAL EQUITY,
SPECIFICALLY, INCLUDING
PROVISIONS THAT TRACK AND REPORT
PROGRESS IN REDUCING RACIAL
DISPARITIES IN HOUSING AND
SERVICE, REFERRALS, SERVICE
DELIVERY AND REFERRALS TO
LICENSED INSTITUTIONAL SETTINGS.
AND INCLUDING PEOPLE WITH LIVED
EXPERIENCE OF HOMELESSNESS IN
PLANNING AND DECISION MAKING,
ADVISORY BOARDS AND COMMISSIONS
REFERENCED IN SP 3 26. THANK YOU
FOR INVITING ME HERE TODAY. GOOD
AFTERNOON CHAIR AND MEMBERS.
ANDREA RIVERA, ASSOCIATE
DIRECTOR OF LEGISLATIVE AFFAIRS
WITH THE CALIFORNIA PEN, ETHNIC
HEALTH NETWORK. DECADES OF
FAILED MENTAL HEALTH AND HOUSING
POLICIES HAVE FORCED COMMUNITIES
OF COLOR TO FACE THE BRUNT OF
UNEQUIPPED SOCIAL SAFETY NET.
IPOD COMMUNITIES HAVE THE
HIGHEST RATES OF UNMET MENTAL
HEALTH NEEDS AND ARE MORE LIKELY
TO EXPERIENCE TRAUMA FROM
DISCRIMINATION DEPENDS SUPPORTS
THE INTENT OF SB 3 26 TO
STRENGTHEN OUR BEHAVIORAL HEALTH
SAFETY NET AND FOCUSED SERVICES
, INCLUDING HOUSING INTERVENTION
SUPPORTS ON THOSE WHO ARE MOST
VULNERABLE. WE AGREE ON THE
IMPORTANCE OF ADDRESSING HOUSING
AND SUBSTANCE, USE TREATMENT AS
EQUITY IMPERATIVES AND
APPRECIATE WHAT KELLY HHS
DESCRIBED AS THE EQUITY ANCHOR.
HOWEVER AS WRITTEN, THE PROPOSAL
LACKS AN EXPLICIT FOCUS ON
IDENTIFYING REDUCING AND
ELIMINATING RACIAL DISPARITIES.
AND MAY, IN FACT, HAVE THE
UNINTENDED IMPACT OF WORSENING
MENTAL HEALTH OUTCOMES FOR
COMMUNITIES OF COLOR. WE HAVE
THREE CONCERNS THAT I'D LIKE TO
SHARE AT THIS TIME. FIRST THE
PROPOSAL ORIGINALLY REQUIRED
COUNTIES TO PROVIDE SUBSTANCE
USE DISORDER SERVICES WITH BHS A
FUNDS AND THIS IS INCREDIBLY
IMPORTANT, GIVEN THE
DISPROPORTIONATE IMPACT THAT
SIDE HAS WITHIN COMMUNITIES OF
COLOR. HOWEVER RECENT AMENDMENTS
NOW REMOVE THIS REQUIREMENT.
WELL COUNTIES MUST REPORT
DOLLARS ALLOCATED FOR MENTAL
HEALTH VERSUS SUBSTANCE USE TO
D. H. C S AND THE DEPARTMENT MAY
ASK FOR ALTERATIONS TO PLANS AND
BUDGETS. THERE IS NO MINIMUM
REQUIREMENT OR DEFINITION TO
DETERMINE WHAT MAY CONSTITUTE
INAPPROPRIATE ALLOCATION.
COMMUNITIES OF COLOR LIVING WITH
SAID, HAVE A HISTORY OF
MISDIAGNOSIS AND INACCESSIBLE
TREATMENT. AND THIS AMBIGUITY
LEAVES SIGNIFICANT POTENTIAL FOR
CONTINUED BIAS AND
DISCRIMINATION. SECOND NOTHING
IN SP 3 26 REQUIRES COUNTIES TO
DEMONSTRATE HOW THE BHS SAY
DOLLARS WILL BE USED TO COMBAT
AND REDUCE RACIAL DISPARITIES IN
COMMUNITIES. WE STRONGLY URGE
THE GOVERNOR AND LEGISLATURE TO
ADD THESE ESSENTIAL PROVISIONS
SO RESOURCES CAN TARGET THE
COMMUNITIES MOST IN NEED. EQUITY
CANNOT BE EXPECTED AS A
BYPRODUCT OF A POLICY THAT DOES
NOT INTENTIONALLY OR EXPLICITLY
SEEK TO UNDO ENTRENCHED SOCIAL
DRIVERS OF RACIALLY INEQUITABLE
OUTCOMES. THIRD AND FINALLY WE
CANNOT MODERNIZE THE ENTIRE
BEHAVIORAL HEALTH SYSTEM BY
ADVANCING A PROPOSAL THAT
CONTINUES TO MINIMIZE THE
OBLIGATION OF HEALTH PLANS TO
PROVIDE BEHAVIORAL HEALTH
SERVICES TO CALIFORNIANS.
MEDICAL MANAGED CARE PLANS AND
COMMERCIAL PLANS HAVE AN
OBLIGATION TO PROVIDE TREATMENT.
AND SP 3 26 REQUIRES THEM TO
PARTICIPATE IN THE INTEGRATED
PLANNING PROCESS, BUT THERE'S NO
REQUIREMENT IN THE PROPOSAL FOR
HEALTH PLANS TO ACTUALLY IMPROVE
ACCESS TO CARE OR OUTCOMES AND
AGAIN NOT TO REDUCE RACIAL
DISPARITIES. COMMUNITIES OF
COLOR NEED TO BEHAVIORAL HEALTH
SYSTEM THAT UTILIZES ALL LOVERS
ACROSS THE CONTINUUM OF CARE TO
MINIMIZE INSTANCES IN WHICH
CALIFORNIANS FALL THROUGH THE
CRACKS OF OUR INSTITUTIONS.
THANK YOU. GOOD AFTERNOON,
HONORABLE CHAIR AND COMMITTEE
MEMBERS. MY NAME IS LESLIE
NAPPER. I'M A PROUD RESIDENT OF
SACRAMENTO COUNTY, A SENIOR
ADVOCATE WITH DISABILITY RIGHTS
, CALIFORNIA BUT ABOVE ALL, I AM
APPEAR SURVIVOR OF THE BATTLES
WAGED AGAINST US LIVING IN THE
REALM OF MENTAL HEALTH
DISABILITY. I AM HERE TO SHARE
MY PIECE PIECE OF MY STORY AND
MY CONCERNS REGARDING SB 3 TO 6.
UM. I REMEMBER. WELL THE ORIGINS
OF THE NHS SAY THAT STARTED WITH
PROP 63 AS A BLACK PERSON AND A
PERSON LIVING WITH SERIOUS
MENTAL ILLNESS. I STAND HERE AS
A TESTAMENT TO THE
TRANSFORMATIONAL POWER OF
CULTURAL REFLECTIVE, RESPONSIVE
, VOLUNTARY, COMMUNITY BASED
MENTAL HEALTH SERVICES. I
VIVIDLY RECALL THE SHADOWS OF
STIGMA SELF STICK. MY MICROPHONE
WENT AWAY. THE STRAIN ON MY
FAMILIES. I LOST MY PLACE. CAN I
GET SOME TIME BACK THEN WE
CALLED THE SHADOWS OF STIGMA,
SELF STIGMA AND THE STRAIN ON MY
FAMILY. THE GLARING ABSENCE OF
CULTURALLY RESPONSIVE COMMUNITY
DEFINED. PRACTICES THAT WERE
GROUNDED. GROOT. EXCUSE ME.
GROUNDED IN CULTURE AND
TRADITION. THEY CAN CULTURAL
CULTURAL AWARENESS IN MENTAL
HEALTH SUPPORT. MY PATH TOWARDS
WELLNESS LIVING WITHIN THE
BIPOLAR SCHIZOAFFECTIVE SPREAD
SPECTRUM BOUGHT ME INTO THE
EMBRACE OF PEER RUN RESPITES
CRISIS CENTERS, WELLNESS CENTERS
AND COMMUNITY BASED VOLUNTARY
OUTPATIENT CARE THAT ARE
CULTURALLY REFLECTIVE AND
POSSIBLE. BY M. H S. A. C S S P
E I AND INNOVATION DOLLARS.
THROUGH THE SERVICE PROVISION. I
LEARNED TO NAVIGATE MY SYMPTOMS
, MANAGE MEDICATION AND BUILD
THE COPING SKILLS THAT SUSTAINED
ME TO THIS DAY. HOWEVER SP 3 TO
6 THREATENS TO DISMANTLE THE
VERY FOUNDATIONS UPON THE LIVES
WITH UPON THE FOUNDATION UPON
WHICH LIVES LIKE MINE HAVE BEEN
REBUILT. THIS BILL IF AND CHANGE
COULD DIVERT ESSENTIAL FUNDS
AWAY FROM CUMIN BASED VOLUNTARY
CULTURAL RESPONSIVE. OUTPATIENT
MENTAL HEALTH SERVICES. THE
LIFELINES THAT MANY OF US DEPEND
ON. CALIFORNIA'S MENTAL HEALTH
CRISIS DEMANDS A MULTIFACETED
APPROACH HOUSING FIRST
INITIATIVES AND ROBUST COMMUNITY
MENTAL HEALTH SERVICES ARE
INTERTWINED AND INTERDEPENDENT,
HOWEVER, ALLOCATING 30% OF MHS
S¼ FUNDS TO THE HOUSING THREATS
TO MENTAL HEALTH SERVICES THAT
ARE THE BACKBONE FOR A SUSTAINED
WELLNESS. THE SACRIFICE WENT FOR
THE OTHER WOULD BE A DISSERVICE
TO OUR COMMUNITIES WELLNESS. AND
PROMOTES DIFFERENTIAL TREATMENT
, ESPECIALLY TOWARDS OUR
COMMUNITIES OF COLOR. I IMPLORE
YOU TO REJECT THE CURRENT FORM
OF SB 3 TO 6 OUR LIVES, OUR
WELLNESS, OUR FAMILIES. OUR
COMMUNITIES ARE AT STAKE.
INSTEAD LET US CONSIDER THE
VOICES OF THOSE OF US THAT ARE
DIRECTLY IMPACTED IN THESE
DECISIONS. LET US FORGE A BILL
THAT STANDS AS A TESTAMENT TO
UNITY. COMPASSION AND GENUINE
CARE FOR THE WELL BEING OF
INDIVIDUALS. LET US USHER IN, UM
THE CHANGES THAT ENHANCES LIVES
AND NURTURES RECOVERY AND DIDN'T
EATING EVERY OF EVERY
INDIVIDUAL. LET US REMEMBER THE
FACES AND STORIES AND JOURNEYS
THAT ARE BEHIND THESE BEHIND
THESE SERVICES. STORIES ARE
RESILIENT STRENGTH AND TRIUMPH
OVER ADVERSITY. I STAND HERE
BEFORE YOU NOT JUST AS LESLIE
NAPPER BUT HAVING EMBODIMENT OF
COUNTLESS VOICES, EACH JOURNEY
FOR THE CHANCE TO RECLAIM OUR
WELLNESS. AS YOU DELIBERATE A
PATH FORWARD. LET US INFUSE
TRANSPARENCY IN EVERY DECISION
AND LET US AMPLIFY THE VOICES OF
THOSE OF US WITH LIVED
EXPERIENCE. SP 3 TO 6 WITH AN
OPPORTUNITY TO DEMONSTRATE OUR
DEDICATION. TO THE WELL BEING OF
OUR COMMUNITY. LET US SEIZE THE
OPPORTUNITY. IN CONCLUSION. I
IMPLORE YOU TO ONE ENSURE YOUR
INVOLVEMENT BY ESTABLISHING A
LIVED EXPERIENCE ADVISORY BOARD
AND REQUIRING THE BOARD TO BE
CONSULTED ON BEHAVIOR HEALTH
POLICY. TO INQUIRE A ROBUST
STAKEHOLDER ENGAGEMENT PROCESS,
NOT JUST THE THREE NOT AS SUCH A
THREE YEAR PLAN BUT ALSO FOR THE
ANNUAL UPDATES, WHICH ARE EVEN
MORE CRITICAL. NOW IF YOU'RE
GONNA BE ABLE TO USE THE
FLEXIBLE UP TO 14% SPENDING FROM
ANOTHER BUCKET. AND THREE
PRESERVED CRITICAL IMAGE OF S¼
FUNDING FOR VOLUNTARY COMMUNITY
BASED CULTURALLY RESPONSIVE SUCH
SERVICES SUCH AS PURE RUN
WELLNESS CENTERS. UM, CRISIS
RESPITES. AND MOBILE CRISIS
UNITS. PLEASE ALWAYS REMEMBER
THAT OUR LIVES ARE HANGING IN
THE BALANCE. LET US WORK
TOGETHER TO PRESERVE THE
ESSENTIAL SERVICES HAVE BEEN
HSCEI PROVIDES AND THAT HAVE
BEEN THE LIFELINE FOR THOUSANDS
OF CALIFORNIANS LIKE ME. THERE
SHOULD BE NOTHING ABOUT US
WITHOUT US. THANK YOU SO MUCH
FOR YOUR TIME. APPRECIATE JUST
WAVING, PLEASE, NO OUTBURST. NO
CLAPPING, PLEASE. IT'S ABOUT
RESPECT OUR PROCESS. THESE
THINGS. UM I'M NOT SURE IF
JESSICA CRUZ IS HERE. NEVER
APPARENTLY SO WE WILL GO AHEAD
AND MOVE ON TO THE SEAN. THANK
YOU. CHAIR AND COMMITTEE MEMBERS
. THANK YOU FOR THE OPPORTUNITY
TO ADDRESS YOU TODAY. MY NAME IS
LASHAWN FRANCIS AND I'M WITH
CHILDREN. NOW CHILDREN NOW IS A
STATEWIDE RESEARCH POLICY AND
ADVOCACY GROUP THAT FOCUSES ON
THE WHOLE CHILD. DESPITE THE
AMENDMENTS LAST WEEK. CHILDREN
NOW IS STILL OPPOSED UNLESS
AMENDED ON SP 3 26. THE BILL AS
IT STANDS STILL LEAVES OUT KEY
POPULATIONS AND CONTINUES TO
IGNORE THE IMPACT THE OVERALL
CHANGES WILL HAVE ON CHILDREN.
TODAY I'M GOING TO SPEND A
LITTLE BIT OF TIME TALKING ABOUT
WHERE WE THINK THE GAPS STILL
ARE IN THE MOST RECENT ROUND OF
AMENDMENTS. UNLIKE THE
PREVENTION AND EARLY
INTERVENTION, CARVE OUT MOST OF
WHAT WE'RE ASKING FOR. IT
DOESN'T EXIST WITHIN THE MM S A
TODAY BUT OUR EXPERIENCE IN THE
LAST 20 YEARS COMBINED WITH THE
NEW PROGRAMMATIC PRESSURES. THIS
BILL PRESENTS HAS PROVEN THAT
GREATER PROTECTIONS FOR KIDS ARE
NEEDED. ONE OF THE THINGS THAT
MANY OF US IN THE CHILDREN'S
SPACE REALLY RECOGNIZE, IS THAT
EVEN WITHIN THE KIDS WORLD WE
TEND TO FORGET ABOUT OUR BOOK
AND POPULATIONS, AND OUR BOOK
AND POPULATIONS ARE BEST
DESCRIBED AS THOSE WHO ARE 0 TO
5 AND OUR TRANSITION AGE YOUTH,
SO OLDER YOUTH AND THAT'S
PRIMARILY BECAUSE THERE'S NO
FORMAL SYSTEM THAT SUPPORTS THEM
LIKE SCHOOL AGED CHILDREN IN
SCHOOLS. SO FOR EXAMPLE, IN OUR
EXPERIENCE WITH THE IMAGES,
SAYING ITS CURRENT FORM IS THAT
THERE'S BEEN A LOT OF WORK TO
ENSURE THAT LITTLE KIDS SO
INFANTS AND TODDLERS ARE THOUGHT
OF ON THE LOCAL LEVEL. THE STATE
VOCALIZING ITS DESIRE TO SUPPORT
SMALL CHILDREN THROUGH A SET
ASIDE IN THE PREVENTION AND
EARLY INTERVENTION BUCKETS COULD
GO A LONG WAY. AND THAT'S
PRIMARILY BECAUSE HE I MODELS
LOOK VERY DIFFERENT FOR INFANTS
AND TODDLERS INVESTING IN R 0 TO
5 POPULATION THAT ONLY HELPS
SMALL KIDS BUT ALSO FAMILIES.
NEXT WE'VE ALWAYS BEEN A BIG FAN
OF THE FULL SERVICE PARTNERSHIP
PROGRAM. HURRIEDLY THE FSP
PROGRAM HAS A POPULATION THAT IS
ABOUT 50% CHILDREN AND YOUTH.
THE ANYTHING GOES APPROACH HAS
WORKED WELL FOR FAMILIES AND
YOUTH. HOWEVER WITH THE
EXPANSION OF THE TARGET
POPULATION TO INCLUDE THOSE WITH
SUD NEEDS, AS WELL AS THE
EXPECTATION FOR S FSP TO SUPPORT
INDIVIDUALS AND CARE COURT
AVAILABLE FUNDING FOR FSP
PROGRAMS FOR YOUTH WILL CLEARLY
BE CROWDED OUT BY THESE
ADDITIONAL DEMANDS ON THE
ALREADY FINITE POOL OF DOLLARS.
THAT IS WHY WE THINK IT'S EVEN
MORE IMPORTANT IN THIS ITERATION
OF THE IMAGE ESSAY FOR YOU TO
GET A SET ASIDE UNDER THE FSP
BUCKET. LASTLY WE ARE REQUESTING
A SET ASIDE FOR THE FOR
UNACCOMPANIED YOUTH. UNDER
HOMELESSNESS. WE'VE HEARD THE
ADMINISTRATION'S DESIRE FOR
FLEXIBILITY. BUT I DO WANT TO
POINT OUT THAT IN THE LATEST
AMENDMENTS, THEY'RE ALREADY SET
ASIDES AND HOMELESSNESS. IT'S
DESCRIBED AS AND I QUOTE 50%
SHALL BE USED FOR HOUSING
INTERVENTIONS FOR PERSONS WHO
ARE CHRONICALLY HOMELESS WITH
THE FOCUS ON THOSE ENCAMPMENTS,
END QUOTE. WE KNOW THAT PEOPLE
IN ENCAMPMENTS TEND TO BE ADULTS
, SO IN ESSENCE, AND WITH
RESPECT TO THE ADMINISTRATION,
IT'S THE AND IT STATED DESIRE
FOR FLEXIBILITY. THERE IS A SET
ASIDE, JUST NOT ONE FOR YOUTH.
WE BELIEVE IT'S CRITICAL TO HAVE
SEPARATE HOUSING SUPPORTS AND
SERVICES DEDICATED TO YOUNG
PEOPLE THAT'S DESIGNED TO MEET
THEIR UNIQUE NEEDS. MANY OF YOU
APPEAR ALREADY KNOW THAT THE
CURRENT SET ASIDES AND CURRENT
STATE PROGRAMS SUCH AS HAPPENED
HOME KEY HAVE BEEN QUITE
SUCCESSFUL. WHILE WE DO WANT TO
THANK THE ADMINISTRATION FOR
BEING WILLING TO WORK WITH US ON
THE PREVENTION AND EARLY
INTERVENTION BUCKET, WE ALSO
WANT TO BE CLEAR THAT WHAT WE'RE
ACTUALLY SAYING IS THAT WHILE
NOTHING IN THE BILL REQUIRES A
CUT TO SERVICES, INTELLECTUAL
HONESTY WOULD HAVE US ADMITTING
THAT BY NOT INCREASING THE 1%
TAX AND ADDING ADDITIONAL
PRESSURES TO COUNTIES, BOTH
POLITICAL AND FISCAL WILL AMOUNT
AND CUTS TO SERVICES. WE'RE
ASKING YOU NOT TO MORTGAGE OUR
FUTURE TO DO SO. GOOD AFTERNOON
, HONORABLE CHAIR AND MEMBERS.
I'M SHERRY DAILY, THE VICE
PRESIDENT OF GOVERNMENTAL
AFFAIRS FOR THE CALIFORNIA
CONSORTIUM OF ADDICTION PROGRAMS
AND PROFESSIONALS WE REPRESENT
OVER 20,000 ADDICTION FOCUSED
PROFESSIONALS MORE THAN 120
TREATMENT PROGRAMS, 350 RECOVERY
RESIDENCES AND THOUSANDS OF
PEOPLE IN RECOVERY THROUGHOUT
THE STATE. WE ALSO CERTIFIED
TRAIN AND REPRESENT SUD PEERS.
THERE IS NOT A SPACE THAT WE
OPERATE IN THAT WON'T BE TOUCHED
BY THE GOVERNOR'S BEHAVIORAL
HEALTH MODERNIZATION PROPOSAL,
AND WE ARE PROUD TO SUPPORT THE
TREMENDOUS SYSTEM IMPROVEMENTS.
WE BELIEVE IT WILL BRING. THE
MOST OBVIOUS IMPROVEMENT IS THE
INCLUSION OF SUBSTANCE USE
DISORDER THROUGHOUT WHEN
PROPOSITION 63 WAS DRAFTED IN
2004 STIGMA TOWARD PEOPLE WITH
ADDICTION WAS RAMPANT. STUDIES
IN 4004 REVEALED THAT PEOPLE
WITH SUBSTANCE USE DISORDERS
WERE GENERALLY CONSIDERED TO BE
MORE RESPONSIBLE FOR THEIR
CONDITIONS THAN PEOPLE WITH
DEPRESSION, SCHIZOPHRENIA OR
OTHER PSYCHIATRIC DISORDERS. AND
THERE WAS A PERSISTENT BELIEF
THAT A SUBSTANCE MISS USERS
ILLNESS WAS A RESULT OF THEIR
OWN BEHAVIOR, THUS IN TURN, AND
THIS INFLUENCED ATTITUDES ABOUT
THE VALUE AND APPROPRIATENESS OF
PUBLICLY FUNDED ALCOHOL AND DRUG
TREATMENT SERVICES. IT DOES NOT
TAKE A TREMENDOUS AMOUNT OF
CONSIDERATION TO COME TO THE
REALIZATION THAT THE EXCLUSION
OF SUBSTANCE USE DISORDERS
SERVICES FROM THE PROPOSITION
WAS BORN FROM STIGMA. WE NOW
HAVE THE OPPORTUNITY TO REMOVE
THE ARTIFICIAL BARRIER TO
RESOURCES THAT WAS PREDETERMINED
BY PROPOSITION 63. WE CAN
REFLECT VOTERS OF TODAY WILL
ASSUREDLY SUPPORT THE TREATMENT
OF THE WHOLE PERSON, REGARDLESS
OF ONE'S PRIMARY CONDITION. THE
MODERATES. MODERNIZATION
PROPOSAL FOCUSES ON THE NEED TO
HOUSE PEOPLE, PARTICULARLY IN
EARLY RECOVERY. RECOVERY HOUSING
HAS BEEN ASSOCIATED WITH
NUMEROUS POSITIVE OUTCOMES,
INCLUDING DECREASED SUBSTANCE
USE REDUCED PROBABILITY OF
RELAPSE. LOWER RATES OF
INCARCERATION, HIGHER INCOME,
INCREASED EMPLOYMENT AND
IMPROVED FAMILY FUNCTIONING
WHOLEHEARTEDLY SUPPORTS THE
EMPHASIS OF THE PROPOSAL PLACES.
ON ENCOURAGING SUPPORTIVE
HOUSING AS A MEANS TO ADDRESS
THE CYCLICAL NATURE OF REMISSION
AND RELAPSE WITHOUT
OPPORTUNITIES TO PUT INTO
PRACTICE RECOVERY SKILLS, ADHERE
TO MEDICATION MANAGEMENT AND
REINTEGRATE TO SOCIETY AND
FAMILY RESOURCES ARE SIMPLY
BEING DIVERTED TO SHORT TERM
SOLUTIONS TO COMPLEX MEDICAL AND
SOCIAL ALES. WITHOUT SUPPORTIVE
HOUSING AND WRAPAROUND SERVICES
. WE WILL CONTINUE TO SEE
RELAPSE AND ADDITIONAL SELF
BLAME. PEOPLE FEEL FOR FAILING
TREATMENT AGAIN. WE LITERALLY
ARE TEACHING MANY PEOPLE THAT
TREATMENT DOESN'T WORK UNDER OUR
CURRENT SYSTEM. IN ADDITION TO
FOCUSING RESOURCES ON HOUSING C
CAP IS ALSO GRATEFUL FOR THE
RECOGNITION. THE PROPOSAL GIVES
TO THE NEED TO INCREASE THE
WORKFORCE. THERE HAVE BEEN
SIGNIFICANT RESOURCES APPLIED TO
MENTAL HEALTH WORK FOR FORCE
NEEDS YET ONLY RECENTLY, HAVE WE
SEEN RESOURCES APPLIED TO THE
SEVENTH USE DISORDER PROFESSION
. THERE ARE TREMENDOUS LONG TERM
NEEDS THAT MUST BE ADDRESSED IF
WE ARE TO EXPAND TREATMENT TO
MEET CURRENT DEMAND AND TO STAFF
THE VARIOUS PROGRAMS PASSED BY
THE LEGISLATURE. TO IMPROVE
ACCESS IN EDUCATION,
INCARCERATION IN HOSPITAL
SETTINGS. CALIFORNIA HAS NO
LICENSE FOR ALCOHOL DRUG
COUNSELORS BECAUSE COLLEGES AND
UNIVERSITIES TEACH TO LICENSES.
THERE ARE VERY FEW BACHELOR'S OR
MASTER'S PROGRAMS OFFERED FOR
THE PROFESSION. THUS THOSE
WISHING TO PROGRESS IN THE
BEHAVIORAL HEALTH FIELD MUST
LEAVE THE PROFESSION TO PURSUE
DEGREES. ALREADY. I THOUGHT WE
HAD FIVE MINUTES. I'M SORRY. UM
AH, WHERE DEGREES ARE OFFERED
STD COUNSELORS ENTRY LEVEL. HAVE
TURNOVER RATES OF 90% AT ONE
YEAR. WE MUST DO BETTER TO
RETAIN OUR CRITICAL WORKFORCE.
WE ALSO MUST COMMEND THE
DRAFTERS OF PROPOSAL FOR
INCLUDING SUD REPRESENTATION,
BOTH BY THOSE WITH LIVED
EXPERIENCE AND BY PROFESSIONALS
AT EVERY PART OF THE PROCESS AND
PLANNING THROUGH TO
IMPLEMENTATION. WE ALSO
APPRECIATE THE DATA TRACKING
IDEAS THAT ARE INVOLVED IN THE
BILL. WE HAVE BEEN ON THE
FOREFRONT OF INNOVATION IN
WHAT'S CALLED RECOVERY CAPITAL
TRACKING WHERE PEOPLE ACTUALLY
INTERACT WITH THE TRACKING
SYSTEM REPORT HOW THEY'RE DOING
, PROVIDE LAUNCH TOODLE DATA TO
SEE HOW OUR TREATMENT PROGRAMS
ARE DOING AND ARE EXCITED ABOUT
THOSE OPPORTUNITIES. WE COMMEND
THE LEGISLATURE AND
ADMINISTRATION FOR WORKING ON
THIS. IT'S A HEAVY LIFT. WE ASK
OUR CLIENTS EVERY DAY TO MAKE
HARD CHOICES AND TO CHANGE WHICH
IS DIFFICULT. AND WE ARE IN FULL
SOLUTION MODE WITH YOU TO MAKE
THIS HAPPEN. THANK YOU. GOOD
AFTERNOON. I'M DR MARIANNE TO
ONE SANTA CLARA COUNTY
SUPERINTENDENT OF SCHOOLS.
REPRESENTING A COALITION OF MORE
THAN A DOZEN EDUCATION, LABOR
AND MANAGEMENT GROUPS, INCLUDING
SEA TO THE CALIFORNIA COUNTY
SUPERINTENDENTS, AXA CFT AND
MANY OTHERS TO SHARE OUR
RECOMMENDATIONS. MY STAFF
EMAILED THE COALITION'S REVISED
JOINT LETTER DESCRIBING ARE
REQUESTED AMENDMENTS TO THE
COMMITTEE LAST NIGHT. WE ARE
GRATEFUL TO THE LEGISLATURE AND
THE ADMINISTRATION FOR RECENT
HISTORIC INVESTMENTS AND POLICY
CHANGES THAT INCREASED SUPPORT
FOR YOUTH BEHAVIORAL HEALTH AND
IS MOVING CALIFORNIA FOR AN
INTEGRATED SYSTEMS APPROACH.
THESE EFFORTS ARE POSITIVE STEPS
TOWARDS ALIGNMENT AND
COORDINATION BETWEEN SCHOOLS AND
HEALTH PROVIDERS. I ALSO WENT TO
SHARE A GRATITUDE TO THE
ASSEMBLY HEALTH COMMITTEE FOR
THE RECENT AMENDMENTS, WHICH
INCLUDED SEVERAL OF OUR
REQUESTED AND RECOMMENDED
AMENDMENTS IN OUR ORIGINAL
LETTER. THANK YOU. FROM THE
EDUCATION PERSPECTIVE,
ADDRESSING THE NEEDS OF THE
WHOLE CHILD IS NECESSARY.
RESEARCH TELLS US THAT WHEN
CHILDREN ARE HUNGRY, EXPERIENCE,
ANXIETY AND STRESS AND HAVE
EMERGING MENTAL HEALTH NEEDS OR
UNTREATED TRAUMA, THEIR BRAINS
CANNOT PROCESS INFORMATION
EFFECTIVELY IN SCHOOLS MUST MEET
THE PHYSICAL AND BEHAVIORAL
NEEDS OF CHILDREN WHILE ALSO
PROVIDING QUALITY. CURRICULUM
AND INSTRUCTION, THE RECENT
HISTORIC INVESTMENTS AND INMATES
S S A AND CHILDREN AND YOUTH
BEHAVIORAL HEALTH INITIATIVE
REFLECT THE FACT THAT CHILDREN
AND YOUTH ARE 21 TIMES MORE
LIKELY TO ACCESS AND BENEFIT
MENTAL HEALTH SERVICES WHEN THEY
ARE PROVIDED ON A SCHOOL CAMPUS.
PROVIDING SERVICES AT SCHOOL
SIGNIFICANTLY REDUCES PRIMARY
BARRIERS TO YOUTH MENTAL HEALTH
ACCESS, INCLUDING TRANSPORTATION
, COST AND COMMUNITY STIGMA. WE
APPRECIATE THAT RECENT
AMENDMENTS TO SENATE BILL 3 26
RESTORE THE PROVISION REQUIRING
51% OF EARLY INTERVENTION FUNDS
BE SPENT ON CHILDREN AND YOUTH.
AND WE NOTE THAT NONE OF THIS
FUNDING IS CURRENTLY PROTECTED
FOR SCHOOL BASED BEHAVIORAL
HEALTH SERVICES, WHICH ARE
NECESSARY PART OF OUR STATE'S
WHOLE CHILD APPROACH. OUR
COALITION IS REQUESTING
ADDITIONAL AMENDMENTS TO ENSURE
THAT PREVENTION BASED DOLLARS
ARE PROTECTED FOR CHILDREN AND
YOUTH EDUCATION REPRESENTATIVES
ARE INCLUDED ON LOCAL MENTAL
HEALTH BOARDS. IN CASE MANAGERS
INCLUDE SCHOOLS AND CARE
COORDINATION. IF YOU HAVE ARGUED
THAT PROP 63 WILL NO LONGER BE
NECESSARY FUNDING SOURCE FOR
SCHOOL BASED BEHAVIORAL HEALTH
PROGRAMS BECAUSE OF NEW ONE TIME
GRANTS AND BILLING OPTIONS. THAT
PERSPECTIVE REFLECTS A
FUNDAMENTAL MISUNDERSTANDING OF
BOTH THE TYPES OF SERVICES THAT
CHILDREN MOST NEED AND THE
LIMITATIONS OF ONE TIME FUNDING
AND BILLING FOR SCHOOL BASED
SERVICES. IT'S NOW WIDELY
ACCEPTED THAT OTHER THAN THE
MOST SEVERE CASES DIAGNOSING
CHILDREN WITH THE MENTAL ILLNESS
IS NOT THE BEST PRACTICE. WELL
ONE IN FIVE CHILDREN. CALIFORNIA
CHILDREN HAVE EXPERIENCED TRAUMA
IN THE LAST THREE YEARS. THE
VAST MAJORITY WOULD NOT MEET THE
MEDICAL NECESSITY REQUIREMENT
FOR BUILDING MANAGED CARE. YEAH
CHILDREN STILL NEED SERVICES TO
MITIGATE THE ONSET OF BEHAVIORAL
HEALTH SYMPTOMS, PROMOTE HEALTHY
SELF REGULATION SKILLS, ADDRESS
ADVERSE CHILDHOOD EXPERIENCES
AND TRAUMA AND SUPPORT THEIR
SCHOOL ATTENDANCE, ENGAGEMENT
AND LEARNING. UNFORTUNATELY
SCHOOLS HAVE LIMITED DIRECT
ACCESS TO ONGOING FUNDS FOR
STUDENT BEHAVIOR, HEALTH AND
ONLY ONE SOURCE OF ONGOING
FUNDING FOR TIER ONE SERVICES,
PERHAPS 63 PREVENTION AND EARLY
INTERVENTION FUNDS. WELL HELPFUL
FOR STARTUP IN ONE TIME EXPENSES
, COMMUNITY SCHOOLS AND THE C Y
B H. I DO NOT PROVIDE ONGOING
FUNDING AND BUILDING OPTIONS DO
NOT FULLY COVER THE COST OF
SERVICES. P E. I IS THEREFORE
CRITICAL TO CREATING A CONTINUUM
OF CARE FOR CHILDREN. SEVERAL
COUNTIES ARE ALREADY
DEMONSTRATING HOW PE I CAN FILL
THE GAPS IN FUNDING FOR STUDENT
MENTAL HEALTH. JUST A COUPLE OF
EXAMPLES. SOLANO COUNTY
CURRENTLY ALLOCATES 8 MILLION TO
FUND 40 STUDENT WELLNESS CENTERS
ON SCHOOL CAMPUSES. AND NOW THEY
COUNTY PROVIDES 10 MILLION TO L
USD FOR TRAUMA AND RESILIENCE
AND FORMED EARLY ENRICHMENT
PROGRAMS AND SANTA CLARA. NEARLY
20 MILLION FOR SCHOOL LINK
SERVICES IS BUDGETED. IF OUR
COALITION'S PROPOSED AMENDMENTS
ARE ADOPTED, THESE PROGRAMS
WOULD BE MAINTAINED AND MODEST
ADDITIONAL FUNDING WOULD BE
AVAILABLE TO GROW SCHOOL BASED
BEHAVIORAL HEALTH PROGRAMS.
THANK YOU. THANK YOU. THANK YOU
VERY MUCH TO EVERYONE. WE'RE
BRINGING BACK TO THE COMMITTEE
QUESTIONS OR COMMENTS FROM THE
COMMITTEE. DR ARAMBULA. THANK
YOU. I'LL BEGIN WITH LOTION.
FRANCIS, IF I CAN UM, I WAS
REALLY MOVED BY YOUR COMMENTS
ABOUT THE SUCCESS WE'VE HAD
WITHIN HAPPENED HOME KEY THAT
I'M HOPING YOU CAN EXPOUND ON
THAT. AS I BELIEVE IT'S
IMPORTANT FOR US TO LOOK AT WHAT
HAPPENS WHEN WE HOUSE OUR
CHILDREN AND TRANSITIONAL AGE.
YOU. THANK YOU AND I WILL ADMIT
THAT I PROBABLY CANNOT SPEAK TO
IT AS WELL AS SOME OF THE
MEMBERS ON THE PANEL. BUT WHAT I
DO KNOW IS THAT ABOUT 10% OF HAP
WAS SET ASIDE FOR YOUTH HOUSING
, AND WE SAW WE SAW A 21%
REDUCTION AND YOUTH HOMELESSNESS
SINCE 2020 AS A RESULT OF THAT,
SO THAT IS SOME SAY WOULD SAY A
REALLY SUCCESSFUL RATE. I THINK
IT WOULD BE A LOGICAL REASON FOR
US TO BE CONSIDERING WHETHER WE
SIMILARLY PUT A SET ASIDE FOR
CHILDREN WITHIN HOUSING AS WELL.
IN LIGHT OF THE FACT THAT F SPS
OVER THE LAST FIVE YEARS HAVE
PREDOMINANTLY BEEN CHILDREN AND
YOUTH. 67% IS THERE ALSO NOT A
LOGICAL ARGUMENT TO BE MADE TO
HAVE A SET ASIDE FOR CHILDREN
AND TRANSITIONAL AGE YOUTH. YEAH
I THINK SO. I MEAN, WE HAVE BEEN
VERY VOCAL ABOUT THAT NEED,
PARTICULARLY AS COUNTIES ARE
GOING TO STRUGGLE WITH FIGURING
OUT HOW TO SERVE FOLKS WITH SUD
NEEDS AS WELL AS YOU KNOW THE
NEW REFERENCE CODES TO THE CARE
COURT POPULATION, SO WE'RE
REALLY CONCERNED THAT YOUNG
PEOPLE WHO TEND TO NOT BE AS
VISIBLE RIGHT, SO THEY TEND NOT
TO BE ON THE STREET. THEY TEND
NOT TO BE LIVING IN ENCAMPMENTS.
UM AND OFTEN TIMES THEY TEND NOT
TO BE SHOWING THE KINDS OF SIGNS
OF MENTAL ILLNESS THAT A LOT OF
ADULTS WILL SHOW AND SO WE'RE
REALLY CONCERNED THAT THEY WILL
GET LEFT OUT OF THIS. OH FINALLY
UPLIFT THE IMPORTANCE OF
FOCUSING ON 0 TO 5 AS A
SUBSECTION. THE HOME VISITING
PROGRAM THAT WE HAVE, AS A STATE
HAS SHOWN TREMENDOUS SUCCESS
WHEN YOU FOCUS WITH
INTENTIONALITY, WHERE PEOPLE
NEED THAT RESILIENCY AND BELIEVE
THAT THAT'S A ANOTHER STRONG
RATIONALE FOR US TO MAKE SURE
THAT WE ARE CONSIDERING FOCUSING
ON THOSE BOOKENDS AS YOU SO
ELOQUENTLY PUT I'LL SHIFT NOW TO
MS RIVERA. IF I CAN I THINK FOR
MANY OF US ON THE DAIS WE WERE
FOLLOWING AND LISTENING TO WHAT
WAS OCCURRING WITH SUBSTANCE USE
DISORDER, BUT THE LACK OF
MANDATE THAT CAME THROUGH THE
RECENT AMENDMENTS UM, WILL
DRAMATICALLY AFFECT THE ABILITY
FOR US TO TREAT COCONUT AND
DISORDERS THAT WE KNOW OCCUR
BETWEEN MENTAL HEALTH AND
SUBSTANCE USE DISORDER THAT I'D
LIKE TO GET YOUR TAKE ON WHAT
YOU THINK THAT WOULD MEAN BY NOT
HAVING A MINIMUM REQUIREMENT FOR
S C D. YEAH AND THANK YOU SO
MUCH FOR THAT QUESTION. ASSEMBLY
MEMBER, YOU KNOW, I THINK FOR
AND IN KIND OF TAKING A BIT OF A
STEP BACK HERE. UM YOU KNOW FOR
US WHEN WE FIRST SAW THIS
PROPOSAL, YOU KNOW, I THINK WE
WERE EXCITED ABOUT THE
OPPORTUNITY TO REALLY TAKE A
LOOK AT HOW WE CAN HOLISTICALLY
, UM ENSURE THAT WE'RE
ENCOMPASSING BEHAVIORAL HEALTH.
UM YOU KNOW, AND I THINK THE
CHALLENGE THAT WE BUMPED INTO
WITH, YOU KNOW THE MORE RECENT
ROUND OF AMENDMENTS THAT NOW
MAKE THE SUBSTANCE USE
PROVISIONS. OPTIONAL IS, YOU
KNOW WE IF WE'RE MAKING
SOMETHING OPTIONAL THEN WE DON'T
ACTUALLY KNOW IF THAT'S GOING TO
HAPPEN, OR IF IT'S GOING TO TAKE
PLACE. AND YOU KNOW, I THINK THE
WHOLE VISION FOR THIS PROPOSAL
IN A WAY THAT IT WAS, YOU KNOW,
SHARED FROM THE VERY BEGINNING
IS THAT WE'RE TAKING A REALLY
DEEP LOOK AT HOW WE CAN ACTUALLY
ENSURE THAT PEOPLE ARE GETTING
ACCESS TO CARE. AND IF WE'RE
MAKING IT ONE OF THE CORE
PROVISIONS RIGHT THE SUBSTANCE
USE PIECE OPTIONAL. WE DON'T
NECESSARILY THINK THAT BRINGS US
CLOSER TO OUR GOAL. BUT I WOULD
JUST SAY WE'RE CHANGING THE
NAME. FROM MENTAL HEALTH TO
BEHAVIORAL HEALTH, WHICH MEANS
WE'RE TO BE INCLUSIVE OF SUD.
AND YET WE'RE NOT MANDATING SUD
TREATMENT FOR EACH COUNTY, AND I
THINK THAT'S PROBLEMATIC AS WE
ARE. SEEING THE OVERDOSE RATES
THAT WE HAVE AS A STATE AND THE
IMPORTANCE FOR US TO BE MAKING
THOSE INVESTMENTS. UM I'LL PAUSE
THERE. I LOOK FORWARD AND
APPRECIATE VERY MUCH. THIS PANEL
. UM FINALLY, JUST IF I CAN
LOOK, I THINK IT'S IMPORTANT TO
CALL OUT LESLIE NAPPER. I THINK
IT'S IMPORTANT WHEN WE HAVE
PEOPLE WITH LIVED EXPERIENCE AND
NOTHING WE DO SHOULD BE DONE
WITHOUT YOU. AND SO I'M GLAD AND
APPRECIATIVE THAT YOU'RE HERE
AND RAISE YOUR PHOTOS AND SPOKE
UP TODAY. THANK YOU, MR CHAIR.
THANK YOU. YOU KNOW, MISS MISS
QUIRK-SILVA. THANK YOU, MR CHAIR
. THANK YOU TO ALL THE PANELISTS
AND EVERYBODY WHO'S BEEN HERE
ALL DAY LISTENING TO THAT. I
KNOW SOME OF YOU ARE ACTUALLY
WORKING IN THE FIELD AND, UH,
WORK IN, UH, TIGHT BUDGET
CONSTRAINTS ALMOST DAILY TO GET
TO WHAT YOU'RE REALLY THERE FOR,
WHICH IS TO SERVE PEOPLE THAT
NEED HELP DESPERATELY. THAT
BEING SAID, I'VE HEARD A LOT
TODAY THAT I AGREE WITH, BUT
THERE ARE SOME THINGS THAT DO
CONCERN ME. UM IF ANY OF YOU
KNOW WHO I AM I'M
ASSEMBLYMEMBER'S SHARON
QUIRK-SILVA, AND I'VE BEEN A
BULLDOG ON HOUSING. BUT WHAT
CONCERNS ME HERE IS OF COURSE, I
SUPPORT HOUSING FOR ALL IN MANY
DIFFERENT LEVELS, SO WHETHER
IT'S OUR, UH, YOUNG PEOPLE
ENTERING THE WORKFORCE, OF
COURSE, WHETHER IT'S KEEPING
PEOPLE HOUSED SO THEY ARE NOT
BEING EVICTED, AND CERTAINLY, UH
, INDIVIDUALS LIVING IN
ENCAMPMENTS. BUT THE CONCERN
HERE AS HAS BEEN MENTIONED A FEW
TIMES, WHICH IS WE'RE SAYING WE
WANT TO NOW ADD HOUSING AS PART
OF THIS MENU WITHOUT NECESSARILY
THE ALLOCATED FUNDS. I'M A
PUBLIC SCHOOL TEACHER FOR MANY
YEARS, AND I'VE SEEN THIS MENU
BEFORE. WHICH IS DO MORE. UH YOU
NOW HAVE ADDITIONAL THINGS TO DO
BUT THE SAME CONSTRAINTS WHETHER
IT'S THAT HOURS IN THE DAY TO
COVER MATERIAL, AND IT'S SIMPLY
ENDS UP NOT WORKING. UH THAT
BEING SAID THERE IS SOME
RESPONSIBILITY ON LOCAL
GOVERNMENTS AND COUNTIES WHEN WE
MENTIONED THE HAT FUNDS, AND
SOME OF THOSE PROGRAMS THAT WE
KNOW HAVE BEEN SUCCESSFUL. HE'S
IN ORANGE COUNTY TOOK ADVANTAGE
OF APPLYING IN ATTAINING THOSE
FUNDS. SO THERE'S CERTAINLY HALF
TO BE MORE EFFORTS FOR THE
RESOURCE IS WE DO HAVE, UM, I'LL
JUST END WITH ON THE SUDS
DISCUSSION. I WAS AN AUTHOR ON A
BILL THAT ACTUALLY, UH, LEAD TO,
UH, ACCEPTING THAT THERE WERE CO
OCCURRING CONDITIONS THAT PEOPLE
ENDURE AND TOO OFTEN. WE HAVE
SYSTEMS THAT ARE MAKING PEOPLE
THAT ARE VERY VULNERABLE
NAVIGATE NOT ONLY MANY DIFFERENT
OFFICES THAT COULD BE DIFFICULT
FOR ANYBODY BUT SOMETIMES
INDIVIDUALS THAT DON'T HAVE
TRANSPORTATION THAT ARE
SUFFERING FROM ANXIETY. MANY
TIMES THEIR UH, INDIVIDUALS THAT
HAVE BEEN RELEASED FROM PRISON
AND NOW THEY'RE WORKING PROVO
FOR WITH PROBATION OFFICERS THAT
ARE SAYING GO HERE, GO THERE. GO
OVER THERE AND YOU ALREADY KNOW.
NO. THE OUTCOMES FOR THAT. IT'S
LIKE HOW I MEAN THAT SAME PARENT
NAVIGATE THREE OFFICES AT A
DISTRICT OFFICE AND MAYBE THEY
DON'T SPEAK THE SAME LANGUAGE
AND IT'S LIKE, GO HERE. GO THERE
. AND WHY ISN'T YOUR KID GOING
TO SCHOOL? I'VE SEEN THIS
FIRSTHAND AND WE HAVE TO DO
BETTER AND WE CAN DO BETTER.
LIKE I SAID, I THINK THERE'S
SOME THINGS TO CHEER HERE. BUT
THERE'S ALSO SOME PLACES THAT WE
NEED MORE MEN DATE MINTS. I'LL
BE PRESENTING, UM, A LETTER FROM
THE ORANGE COUNTY AH, A
SUPERVISORS ABOUT SOME OF THEIR
CONCERNS, AND WE NEED TO TAKE
THOSE CONCERNS AND AMENDMENT.
SERIOUSLY. THANK YOU SO MUCH.
UH, MR MCCARTY. YEAH THANK YOU.
UM I KNOW IT'S BEEN A LONG
MORNING AND AFTERNOON WE
ADDRESSED MANY ISSUES, AND YOU
WANT US TO KIND OF NOT COPY
OTHER ISSUES. AND SO ONE ISSUE I
HADN'T REALLY UM, HEARD MUCH
ABOUT. MAYBE SOMEBODY COULD
DRESS AND THIS IS KIND OF BROAD
. MAYBE I DON'T WANT TO PAINT AN
OVERLY SIMPLISTIC PICTURE HERE.
BUT, UM TO SOME EXTENT, PROP 63
ARE DISCRETIONARY MORE FOR THE
COUNTY'S. IT'S EASIER TO PICK
PROGRAMS. A LOT OF GOVERNMENT
FUNDING SOURCES LIKE MEDICAL.
ARE MORE COMPLICATED TO FIGURE
IT OUT. AND SO I'VE HEARD. SOME
REPORTS SAY THAT THAT, UM THAT,
FOR EXAMPLE, IT'S EASIER TO USE
PROP 63 ON SOME CHILDREN'S
MENTAL HEALTH PROGRAMS THAN
SIGNING THEM UP FOR MEDICAL UM,
BUT WE HAVE MULTIPLE PROBLEMS
WE'RE TRYING TO SOLVE FOR TRYING
TO HELP MENTAL HEALTH SERVICES
FOR ALL HUMAN BEINGS. ADULTS.
ADOLESCENTS SUPER LITTLE KIDS,
TEENS WHAT HAVE YOU AND ALSO
PROVIDE MORE HOUSING SO
EVERYBODY IS FOR MORE HOUSING.
SO IF IT'S JUST THE BOND BY
ITSELF MORE HOUSING FOR PEOPLE
WITH SUBSTANCE ABUSE DISORDERS
OR SEVERE MENTAL HEALTH ISSUES.
WE'RE ALL FOR THAT. BUT THE
ISSUE HERE IS HOW DO WE PAY FOR
IT? AND SO WE'RE MODERNIZING
PROP 63. I GET THAT. I THINK
IT'S TIME TO REEVALUATE THIS
AFTER A DECADE. FOR TWO DECADES.
UM AND, UM, THAT THAT THE GIST
IS THAT YOU KNOW, BY DOING SO,
WE'RE TAKING 63 FLEXIBILITY A
WAY TO DO THINGS LIKE ADOLESCENT
MENTAL HEALTH. I GUESS THE
QUESTION FOR US IS THAT WHAT CAN
WE DO TO MAKE US UTILIZE MEDICAL
MORE EFFICIENTLY. IN OTHER
WORDS, LIKE WHAT ELSE DO WE NEED
TO BE DOING BESIDE? BECAUSE
YOU'RE SAYING DON'T DO THIS,
BECAUSE THIS TAKES AWAY OUR
ABILITY TO USE THAT MONEY OVER
HERE. AND WHY CAN'T WE HAVE OUR
CAKE AND EAT IT TOO. WHY CAN'T
WE DO BOTH? SO WE'RE PICKING AND
CHOOSING SO WHAT DO WE NEED TO
DO TO ACTUALLY MAKE IT SO WE CAN
USE MORE MEDICAL BECAUSE WE
CAN'T USE MEDICAL TO BUILD
HOUSING. WE KNOW THAT THERE'S
SOME PROGRAMS FOR HOUSING, BUT
IT'S NOT NOT THAT EASY. SO WE'RE
TRYING TO FLIP IT HERE. SO HELP
US ANSWER THAT. SO I THINK IT'S
A REALLY GOOD QUESTION, AND I
THINK THIS TENSION BETWEEN 63
AND MEDICAL HAS COME UP OFTEN SO
THERE ARE TWO ISSUES. THE FIRST
ISSUE IS THE ONE THAT YOU
BROUGHT UP THAT THERE ARE THINGS
THAT MEDICAL CAN PAY FOR THAT
WE'RE NOT USING MEDICAL FOR AND
THAT HAS TO BE FIXED. A LOT OF
THAT IS TIED TO THE
ADMINISTRATIVE BURDEN THAT SMALL
ORGANIZATIONS FIND WITH TRYING
TO BUILD MEDICAL AND TRY TO WORK
THROUGH THAT. REALLY QUAGMIRE OF
A SYSTEM. BUT THE SECOND ISSUE
IS SOMETHING YOU ALSO
HIGHLIGHTED AND THAT IS
SOMETHING'S MEDICAL SIMPLY WON'T
PAY FOR SO, FOR EXAMPLE, WHILE
HOUSING IS ONE YOU CAN'T DRAW
DOWN F F P FOR UNDOCUMENTED
YOUTH, FOR EXAMPLE, AND WE KNOW
THAT THE IMAGES S¼ PAYS FOR A
LOT OF SERVICES, MENTAL HEALTH
SERVICES FOR THOSE WHO MIGHT BE
UNDOCUMENTED. SO WE'RE REALLY
LOOKING AT THIS BROADLY. I THINK
THERE ARE TWO CATEGORIES HERE OF
CONVERSATION. WHEN YOU'RE
TALKING ABOUT WHAT MEDICAL WILL
PAY FOR AND WHAT THEY WON'T PAY
FOR. SO WHAT COULD WE DO
DIFFERENTLY? IS THERE ANYTHING
THAT WE CAN DO IN STATE LAW TO
MAKE IT EASIER FOR MEDICAL FOR?
ADOLESCENT MENTAL HEALTH. I'M
SURE THAT THERE IS THIS IS NOT
NECESSARILY MY EXPERTISE. IF I'M
GOING TO BE COMPLETELY HONEST, I
TRY NOT TO MAKE A HABIT TO SPEAK
ON THINGS THAT I DON'T KNOW A
LOT ABOUT. UM BUT WHAT I WILL
SAY IS THE STATE IS TRYING TO DO
SOME THINGS TO LESS THAN THE
ADMINISTRATIVE BURDEN. I THINK
THERE ARE PEOPLE IN THIS ROOM
WHO COULD PROBABLY TALK TO YOU A
BIT MORE ABOUT WHAT THAT LOOKS
LIKE AND HOW WELL THAT'S BEEN
GOING. I GUESS IT'S THE REASON
YOU CAN ANSWER TO THE REASON
IT'S THE ISSUES BECAUSE YOU'RE
SAYING DON'T DO THIS BECAUSE WE
CAN'T USE THAT MONEY HERE. SO
LET'S FIGURE OUT HOW TO USE THAT
MONEY HERE AND THEN WE CAN USE
THIS MONEY FOR A CLEARLY NEEDED
INVESTMENT, WHICH IS 10,000.
PLUS HOUSING UNITS FOR PEOPLE
WHO NEED CARE. YES, SO
ASSEMBLYMEMBER'S I WANT TO ALSO
BE CLEAR. I'M NOT SAYING DON'T
DO THIS. I WILL SAY THAT. I
THINK WHAT THE ADMINISTRATION
HAS PRESENTED TO EVERYONE HERE
IS A FALSE CHOICE AND A FALSE
CHOICES ONE WHERE YOU EITHER DO
X, OR YOU DO Y WHEN THERE ARE
MULTIPLE OPTIONS. OH, YOU COULD
RAISE THE TAX, FOR EXAMPLE, AND
HAVE MORE MONEY IN ORDER TO DO
MORE FOR YOUNG PEOPLE AND FOR
THE HOMELESS AND FOR THE SUD
POPULATION. SO I'M NOT REALLY,
UH, REALLY FORCING THAT
NARRATIVE TO BE FRANK. I THINK
THAT THAT IS A FALSE CHOICE THAT
HAS BEEN PRESENTED BY THE
ADMINISTRATION. THANK YOU.
ANYONE ELSE? UM. I WANT TO SAY
THANK YOU. UM BUT ESPECIALLY TO
THIS PANEL. I THINK THIS IS A
REALLY IMPORTANT PANEL. I
APPRECIATE THAT. I DID HAVE ONE
BRIEF QUESTION, WHICH IT CUT
JUST BECAUSE I GOT MY ATTENTION
. A LOT HAS GOT MY ATTENTION,
BUT THERE'S SOMETHING I EXPECTED
THAT A LOT OF TESTIMONY. BUT
WHERE THERE IS A QUESTION THAT
CAME OUT WHERE SOMETHING CAME UP
BY MISS WINTER. YOU SAID, UM AS
WELL. RIGHT NOW WE'RE TALKING
ABOUT HOUSING THE SERVICE
SUPPORTIVE HOUSING. SO YOU SAID
, WE NEED INCENTIVES FOR
LANDLORDS TO TAKE RENTAL
ASSISTANCE. EXPLAIN THAT TO ME.
I MEAN, IF THE LANDLORD
SHOULDN'T CARE WHAT THE MONEY
LOOKS LIKE IF THEY GET PAID. SO,
TOM, EXPLAIN TO ME WHAT THAT
MEANS, BECAUSE I'M NOT A HOUSING
PERSON. SO, YEAH, SO IN THE SAME
WAY THAT EARLIER PANEL UM MR
SHOEMAKER TALKED ABOUT ONGOING
OPERATING COSTS IN PERMANENT,
SUPPORTIVE HOUSING. IF PEOPLE
DON'T HAVE THE LEVEL OF SUPPORTS
AND SERVICES THAT THEY NEED AT
THE RIGHT INTENSITY, THEN THEY
THERE MAY BE SOME CHALLENGES FOR
THEM REMAINING HOUSED AND
THERE'S GREAT STIGMA ATTACHED.
UM TO HOUSING SOMEONE WHO IS
EXITING HOMELESSNESS. SO FOR
LANDLORDS, THEY HAVE VERY REAL
CONCERNS AROUND PROPERTY DAMAGE
AROUND WHAT OTHER NEIGHBORS
MIGHT THINK AND REALLY JUST THE
COSTS. IF THEY'RE GOING TO
RECEIVE A RENTAL SUBSIDY, SO IT
IS. IT IS, UM, WE FOUND AND THAT
INCENTIVES UM AND EVEN HELP
PAYING, YOU KNOW, FIRST AND LAST
MONTH'S RENT OR HIRE SECURITY
DEPOSIT, OR, UM, IN A SHORT YOU
NO SHORTAGE OF HOUSING A HOLD
UP, YOU KNOW, A FEE TO HOLD THE
UNIT FOR A COUPLE OF DAYS. IF
YOU HAVE TO GO FIND SOMEONE WHO
IT MAY TAKE SOME ASSERTIVE
OUTREACH TO DO THAT, SO THAT
THAT'S WHAT WE'RE TALKING ABOUT.
APPRECIATE. APPRECIATE THAT.
THANK YOU FOR THAT. VERY MUCH
SO. UM OKAY. THANK YOU VERY MUCH
TO THIS PANEL. I APPRECIATE YOUR
TESTIMONY. I WANT TO THANK
EVERYONE FOR BEING HERE TODAY WE
ARE GOING TO BEGIN TAKING PUBLIC
COMMENTS. UM I THINK WE HAVE THE
VERY FIRST ONE IS GOING TO BE MR
HECTOR RAMIREZ WAS BY PRIOR
ARRANGEMENT IS GOING TO GET THE
1ST 1ST PUBLIC COMMENT. I WILL
REMIND YOU WILL BE STARTING THE
CLOCK. IT'S 30 MINUTES OF PUBLIC
PUBLIC COMMENT. SO THE BRIEFER.
YOU ARE THE MORE PEOPLE THAT GET
THE OPPORTUNITY TO SPEAK. YOU
COULD HANG ON A SECOND BEFORE WE
START. SO THE MORE DIRECT AND
BRIEF YOU ARE, THE MORE PEOPLE
WILL GET AN OPPORTUNITY TO
SPEAK. BUT WE DO HAVE A HARD
STOP IN 30 MINUTES AND EACH
PERSON WILL HAVE UP TO ONE
MINUTE AND THEN WE'LL HAVE TO
MOVE ON. OKAY? PLEASE GO AHEAD.
HEY, HANG ON.
OKAY RAMIREZ AND I SAY IT
BECAUSE IT DOESN'T SAY HERE. THE
MEDICAL SERVICES ACT WAS FUNDED
. IT IS FUNDED BY MILLIONAIRES
TAX ON LAND AND NATIVE LANDS.
YET WE HAVE SEEN I AM AM HECTOR
RAMIREZ. I AM AN ACTUAL CONSUMER
OF LOS ANGELES COUNTY DEPARTMENT
OF MENTAL HEALTH FOR THE PAST 23
YEARS. I'M AN ACTUAL PERSON WITH
A LIVED EXPERIENCE. I'M NOT A
PAID LOBBYIST. I'M NOT TO HEAR
WHAT THE ORGANIZATION AND
SPEAKING ON BEHALF OF THE
QUARTER OF A MILLION CONSUMERS
FROM POTENTIAL IS COUNTY. I LEFT
L. A CONDO THIS MORNING EARLY
AFTER HAVING DEALT WITH A
HURRICANE, AN EARTHQUAKE. BUT I
SAY LEFT THIS MORNING, MY
HOMELESS AND ON HOUSE
INDIVIDUALS REACHED OUT TO ME
OFFERING ME THEIR RECYCLE MONEY
OFFERING ME TO DRIVE ME HERE
BECAUSE OF PEOPLE WITH THIS
INDIVIDUALS WITH DISABILITIES
WERE NOT REPRESENTED BY ANY OF
THE EXPERTS YOU HAVE HERE, SO I
REALLY WANT TO REALLY POINT OUT
THAT OUT AND ONE OF THE
RECOMMENDATIONS COMING FROM THE
LARGEST COUNTY IN THE UNITED
STATES WITH THE LARGEST PUBLIC
MENTAL HEALTH SYSTEM IN THE
WORLD. I ASKED THAT, AS SHOULD
DO THIS. THE MENTAL HEALTH
SERVICES ACT HAS FAILED US. IT
HAS FAILED NATIVE AMERICAN
POPULATION. IT HAS FAILED THE
COLOR FOR THE NATIVE POPULATION.
IT HAS FAILED THE LATINO
POPULATION BECAUSE IT HAS NOT
REALLY FOCUSED ON OUR
COMMUNITIES. RIGHT NOW, WITH OUR
OWN HOUSE POPULATION WE SEE AND
WE ASK THAT HAS TO DO THIS. WE
WANT THIS, BUT REALLY, INCLUDING
THERE IS A PRIVATE TYPE
POPULATION ARE NATIVE AMERICANS
ARE TROUBLED COMMUNITIES ARE L G
B T Q. I IS TO COMMUNITIES AND
ARE DISABLED POPULATION, WHICH
IS ALL THE PEOPLE CERTIFIED THE
MENTAL HISTORY SERVICES ACT, BUT
HE HASN'T DONE IT. GO BACK. AND
THANK YOU. THANK YOU. RIGHT?
GOOD AFTERNOON CHAIR AND MEMBERS
. MY NAME IS COURTNEY ARMSTRONG
. I'M HERE ON BEHALF OF THE
FIRST FIVE ASSOCIATION OF
CALIFORNIA AND WE WANT TO ALIGN
OUR COMMENTS WITH THAT EVOLUTION
FRANCIS FROM CHILDREN. NOW WE
REMAIN OTHER. WE APPRECIATE THE
AMENDMENTS AND THE INCLUSION OF
CHILDREN 0 TO 25 IN THE
PREVENTION AND EARLY
INTERVENTION FUNDING. WE, UM,
REMAIN OPPOSED UNLESS AMENDED TO
INCLUDE A SPECIFIC SET ASIDE FOR
YOUNGEST CALIFORNIANS AGES 0 TO
5 OR SPECIFICALLY ASKING FOR 20%
OF THAT 50% BE SET ASIDE OR
DESIGNATED FOR THAT POPULATION
JUST TO ANSWER THE QUESTION THAT
WAS ASKED ON THE MEDICAL
REIMBURSEMENT. WE KNOW THAT FOR
CHILDREN 0 TO 5 ABOUT 95% OF THE
SERVICES THAT ARE CURRENTLY
PROVIDED BY MHSC FUNDING DO NOT
MEET THE CRITERIA FOR MEDICAL
REIMBURSEMENT. UM ARE COUNTIES
CURRENTLY OUR YOUNGEST
CALIFORNIA IS CURRENTLY RELY ON
THAT FUNDING, BUT WE KNOW THERE
NEED IS SO MUCH MORE. UM I ALSO
JUST WANTED TO POINT OUT THAT
EVEN WITH THE P I SET ASIDE
REQUIREMENTS THAT ARE IN PLACE
TODAY FOR 0 TO 25. UM COUNTY
MENTAL HEALTH DEPARTMENTS ARE
NOT REQUIRED TO PRIORITIZE OUR
ADDRESS. THE NEEDS OF CHILDREN'S
AGES. THEY'RE OUT OF FIVE. THANK
YOU. THANK YOU. GOOD AFTERNOON
TARGET NO EASTMAN WITH THE
STEINBERG INSTITUTE AND SUPPORT
AND ALIGN MY COMMENTS WITH THOSE
OF OUR CEO KAREN LARSON. THANK
YOU. GOOD AFTERNOON. JOEL BOUND
DIRECTOR WITH SAFE PASSAGE IS
ONE OF 35 ORGANIZATIONS
COMPRISING THE CALIFORNIA
REDUCING DISPARITIES PROJECT,
WHICH IS A HISTORICAL EFFORT TO
ADDRESS THE DISPARITIES WE FIND
FOR OUR LGBT Q AND BIPAC
COMMUNITIES THE GOVERNOR'S
CURRENT PROPOSAL EXPLICITLY
SEPARATES PREVENTION AND EARLY
INTERVENTION FUNDS IF THIS
ARTIFICIAL SPLIT IS TO REMAIN IT
IS IMPERATIVE THAT SEA DEPTHS
CAN COMMUNITY TO FIND EVIDENCE
PRACTICES SPECIFICALLY MENTIONED
EARLIER BY DIRECTOR BOSS BE
ELIGIBLE FOR FUNDING FROM BOTH
BUCKETS TO REINFORCE THIS IDEA
SO AGAIN CRITICAL THAT SEA
DEPTHS ARE ABLE TO BE FUNDED BY
EITHER ONE OF THOSE P I S, UH,
TO MAKE THAT REALITY ONE. WE
MUST REMOVE THE LANGUAGE THAT
PROHIBITS SERVICES TO
INDIVIDUALS UNDER THE PREVENTION
UMBRELLA. TO WE HAVE TO ENSURE
SEE DEPTHS ARE ABLE TO PROVIDE
EARLY INTERVENTION AND
PREVENTION SERVICES. IF FUNDED
UNDER EARLY INTERVENTION. THREE
WE MUST ASSURE THAT THE EARLY
INTERVENTIONS ARE NOT REQUIRING
A DIAGNOSIS AND FINALLY, EARLY
INTERVENTIONS MUST ALLOW FOREIGN
FUND SERVICES TO INDIVIDUALS WHO
ARE AT RISK, BUT NOT NECESSARILY
SHOWING SIGNS OF MEDICAL MENTAL
ILLNESS. WE ALSO MUST INCLUDE
REPRESENTATION ON THE VARIOUS
BOARDS ASSOCIATED NEXT NEXT
SPEAKER, PLEASE. GOOD AFTERNOON,
ANDY LEAVE IN BALM ON BEHALF OF
LOS ANGELES COUNTY. WE SINCERELY
APPRECIATE YOUR WORK AND THE
WORK OF YOUR STAFF ON ADDRESSING
THIS ISSUE. THE THOUGHTFUL AND
DETAILED ANALYSIS IN ADVANCE OF
THE BILLS HEARING AFTER THIS
HEARING, LIKE MANY HERE, WE'RE
STILL CAREFULLY REVIEWING LAST
WEEK'S AMENDMENTS AND WAITING
AND LOOKING FORWARD TO THE
ADDITIONAL AMENDMENTS THAT MADE
PUBLIC BE PUBLISHED SHORTLY. WE
LOOK FORWARD TO WORKING WITH
THIS COMMITTEE WITH THE SENATE
HEALTH COMMITTEE AND OUR COUNTY
COALITION PARTNERS ON ANY OTHER
NEEDED AMENDMENTS AND NEXT STEPS
. WE APPRECIATE THE WORK THE
ADMINISTRATION HAS DONE SO FAR.
AND WE APPLAUD AND APPRECIATE
YOUR LEADERSHIP DOCTOR WOULD
ANGELES COUNTY WILL REMAIN
ACTIVELY INVOLVED TO GET SB 3 26
TO A PLACE? WHERE WE CAN
SUCCESSFULLY IMPLEMENTED. THANK
YOU. NOTHING. GOOD AFTERNOON,
STACY HERO MOTO WITH RAMCO, THE
RACIAL AND ETHNIC MENTAL HEALTH
DISPARITIES COALITION. I WANT TO
ALIGN MY COMMENTS AND THANK MY
COLLEAGUE JOEL BAUM, SO I WON'T
REPEAT THOSE ABOUT C DIPS OR
COMMUNITY DEFINED EVIDENCE
PRACTICES. THEY MUST BE ABLE TO
BE FUNDED UNDER BOTH PREVENTION
AND EARLY INTERVENTION, AND I
REALLY WANT TO THANK DR
ARAMBULA. AND MEMBERS
QUIRK-SILVA AND WEBER FOR
TALKING ABOUT ISSUES THAT ARE
IMPORTANT TO NOT ONLY REMCO, BUT
THE CALIFORNIA REDUCING
DISPARITIES PROJECT, INCLUDING
REPRESENTATION ON OVERSIGHT AND
ADVISORY BODIES, AND, UM UM,
THAT SPECIFY MEMBERSHIP OF BOTH
L G B T Q AND BIKE PARK
COMMUNITIES BECAUSE WE NEED TO
SEE THAT THE TABLE THANK YOU SO
MUCH. THANK YOU. HELLO I'M
CHRISTOPHER BANEL. I'M
REPRESENTING SIMON KING BRIGHT
CENTER. I AM A SEAT DEPTH THAT
YOU'LL AND STACEY BOTH GO AHEAD
AND BOTH MENTIONED, UM I JUST
WANT TO GO AHEAD AND MAKE SURE
THAT THEIR SENTIMENTS ARE HEARD
AS WELL. THANK YOU. GOOD
AFTERNOON, REBECA GONZALEZ WITH
THE NATIONALIST SOC ATION OF
SOCIAL WORKERS. CALIFORNIA
CHAPTER. WANT TO THANK YOU FOR
THIS THOUGHTFUL DISCUSSION WE'VE
HAD TODAY. UM I DO THINK IT
ILLUSTRATES HOW MUCH WORK STILL
NEEDS TO BE DONE, AND I LOOK
FORWARD TO SEEING ADDITIONAL
AMENDMENTS. I WANT TO ALIGN MY
COMMENTS WITH JOEL FROM SAFE
PATCHES, PASSAGES AND STACY
ARIMOTO WITH RAMCO. THANK YOU.
THANK YOU. GOOD AFTERNOON, SARAH
KAMINSKY WITH THE ASSOCIATION OF
CALIFORNIA SCHOOL, AND
ADMINISTRATORS JUST WANT TO
ALIGN MY COMMENTS WITH MISS
FRANCES FROM CHILDREN NOW AS
WELL AS DR DEWAN. UM JUST WANNA
ALSO REINFORCE THE COMMENT THAT
DR DWAN MADE ABOUT THE
IMPORTANCE OF TIER ONE SUPPORTS
ON SCHOOL CAMPUSES OR
ADMINISTRATORS ARE OBSERVING
STUDENTS COMING TO SCHOOL WITH
ENHANCED NEEDS COMING ON THE
HEELS OF DISTANCE LEARNING. AND
A LONG PERIOD OF REDUCED
SOCIALIZATION WITH PEERS AS SHE
SAID CHILDREN AND YOUTH ARE 21
TIMES MORE LIKELY TO ACCESS AND
BENEFIT FROM MENTAL HEALTH
SERVICES WHEN THEY PROVIDED ON A
SCHOOL CAMPUS, SO IT REALLY IS
CRITICAL THAT THESE, UM SERVICES
ARE PROTECTED WITH THESE FUNDS,
AND WE ALSO WANT TO MAKE SURE
THAT SCHOOLS HAVE REPRESENTATION
ON LOCAL MENTAL HEALTH BOARDS AS
THEY DETERMINE HOW THE COUNTY
WILL ALLOCATE OTHER PROP 63
FUNDS. LASTLY AXEL WANTS TO
CAUTION AGAINST THE RELIANCE OF
C Y B H I. DOLLARS IN LIEU OF
MHSC FUNDS FOR YOUTH. SINCE THAT
IS ONE TIME FUNDING. THANK YOU.
THANK YOU. HI THERE. RACHEL
BHAGWAT WITH A C L U CALIFORNIA
ACTION. I'M HERE TO QUICKLY
COMMENT THAT A TOP GOAL IN
CALIFORNIA'S MENTAL HEALTH
SYSTEM SHOULD BE TO REDUCE MASS
INCARCERATION AND
CRIMINALIZATION OF PEOPLE WITH
MENTAL HEALTH NEEDS. AND SO WE
URGE THE LEGISLATURE TO PROTECT
FUNDING FOR OUTPATIENT TREATMENT
PROGRAMS NEEDED TO IMPLEMENT OUR
2018 MENTAL HEALTH DIVERSION LAW
AND OTHER BILLS SINCE THEN.
COUNTIES ALREADY DON'T HAVE
ENOUGH FUNDING FOR OUTPATIENT
DIVERSION, AND WE'RE WORRIED
THAT THIS REFORM COULD MAKE IT
EVEN HARDER TO DIVERT PEOPLE
INTO THESE PROGRAMS THAT PROVIDE
REHABILITATIVE OPPORTUNITIES FOR
FOLKS WHO ARE INVOLVED IN THE
CRIMINAL SYSTEM FOR MENTAL
HEALTH REASONS. ALSO ANY REFORM
SHOULD EXPLICITLY PROTECT MENTAL
HEALTH CRISIS PROGRAMS THAT
REDUCE POLICE CONTACT DURING
MENTAL HEALTH EMERGENCIES. WE
MUST ALLOW COUNTIES TO SUSTAIN
INVESTMENTS IN MOBILE CRISIS
TEAMS, PEER RESPONDERS AND MORE.
THANK YOU. THANK YOU. GOOD
AFTERNOON, LISA COLEMAN WITH THE
COMMISSION ON AGING. WE URGE
THIS COMMITTEE TO REMEMBER THE
UNIQUE POPULATION OF THE OLDER
ADULTS ALIGNING OURSELVES WITH
THE COMMENTS THAT DR CRUCIAL
SAID THIS MORNING, THE FASTEST
GROWING SEGMENT OF THE HOMELESS
FOR THE FIRST TIME ARE THOSE
OVER THE AGE OF 55. WE URGE YOU
TO CONSIDER WITH THE BEHAVIORAL
HEALTH OVERSIGHT THAT YOU LOOK
TO HAVING TWO POSITIONS, NOT
JUST AN OLDER ADULT AND A
DISABILITY, BUT A UNIQUE VOICE
FOR BOTH, BECAUSE A YOUNG PERSON
WITH DISABILITIES IS GOING TO
HAVE A VERY DIFFERENT
PERSPECTIVE THAN AN OLDER ADULT
WITH DISABILITIES. THANK YOU.
THANK YOU. GOOD AFTERNOON CHAIR
AND COMMITTEE MEMBERS. MY NAME
IS DANNY DEREK ALL WITH THE
CALIFORNIA YOUTH EMPOWERMENT
NETWORK. I WOULD FIRST LIKE TO
SAY THAT WE APPRECIATE THE
AMENDMENTS TO INCLUDE ATTAINED
MEMBER ON THE A C AND ON LOCAL
MENTAL HEALTH BOARDS. HOWEVER
WE, UH, BELIEVE THAT A MINIMUM
REQUIREMENT OF SPENDING FOR
OUTREACH AND CONSISTENT
ENGAGEMENT AT THE LOCAL LEVEL IS
NEEDED TO ENSURE INVOLVEMENT
BROUGHT STAKEHOLDERS TÂM PEERS.
SECONDLY, MANY TAKE CANNOT
ACCESS SERVICES ON CAMPUS. THEY
RELY ON SERVICES OFF CAMPUS. I
MYSELF WAS UNABLE TO ACCESS
SERVICES IN HIGH SCHOOL BECAUSE
THERE WERE NO SERVICES FOR LGBTQ
YOUTH. UM ANY SERVICES THAT WERE
AVAILABLE WEREN'T FOCUSED FOR MY
COMMUNITY, UM, ARE MOST
UNDERSERVED POPULATIONS. LGBT Q
. I A PLUS BY PARK JUSTICE
INVOLVED FOSTER YOUTH. UM ARE AT
RISK OF LOSING SERVICES. AND SO
THAT'S WHY WE OPPOSED THE BILL.
THANK YOU. GOOD AFTERNOON CHAIR
COMMITTEE MEMBERS. KAREN VICKERY
ON BEHALF OF MENTAL HEALTH
AMERICA OF CALIFORNIA. WE ARE
OPPOSED TO THE BILL, BECAUSE, AS
WE HEARD FROM DR KUSHELL
EARLIER, HOMELESSNESS IS AN
AFFORDABLE HOUSING PROBLEM. UM
WE CANNOT DIVERT NECESSARY
MENTAL HEALTH FUNDS AWAY FROM
SERVICES. TOWARDS HOUSING. WE
NEED TO FIND ANOTHER WAY TO FUND
HOUSING. UM AND I WOULD LIKE TO
REALIGN OUR COMMENTS ALSO WITH
LESLIE NAPPER. THANK YOU.
AFTERNOON. AVERY HULA THIS
INTAKE. CALIFORNIA ASSOCIATION
OF MENTAL HEALTH CARE RUN
ORGANIZATIONS, UM WHAT WE'D LIKE
TO ECHO THE COMMENTS OF LESLIE
AND APRA. THE PREVIOUS PANELISTS
FROM DISABILITY RIGHTS
CALIFORNIA WE OPPOSE SB 3 26 THE
INPUT OF THE LEADERS FROM THE
PIER BIPAC AND L G B T Q. I A
PLUS COMMUNITIES WERE INTEGRAL
IN CRAFTING THE MHS SAY IN
SHAPING ITS INTENT AND
STRUCTURE. AND ITS PASSAGE WAS A
WIN FOR US IN BUILDING A MENTAL
HEALTH SYSTEM FOR THE COMMUNITY
AND BY THE COMMUNITY. HOWEVER
THESE LAST FEW MONTHS WE'VE BEEN
FRUSTRATED WITH THESE CONTINUED
ATTEMPTS FROM THE ADMINISTRATION
AND STATE LEGISLATORS TO
DISMANTLE AND RESTRUCTURE THE
MHS A IN THE FORM OF SP 3 26. WE
AGREE MORE INVESTMENTS MUST BE
MADE TO EXPAND SERVICES ACROSS
THE BOARD. BUT DON'T TAKE AWAY
THE INVESTMENTS FROM THE
COMMUNITIES WHO ARE CURRENTLY
BEING SERVED IN AN ALREADY
OVERBURDENED PUBLIC SYSTEM.
DESPITE OUR ADVOCACY EFFORTS, WE
FEEL UNHEARD AND UNSEEN AS THIS
BILL IS CONTINUING TO SHIFT
CHANGE AND MOVE QUICKLY THROUGH
THE LEGISLATIVE PROCESS WITHOUT
OUR VOICES CONSIDERED. THANK
YOU. THANK YOU. GOOD AFTERNOON,
LEAH BARROWS ON BEHALF OF
CALIFORNIA HOSPITAL ASSOCIATION
. WE ARE PLEASED TO SUPPORT THE
IMPORTANT CHANGES PROPOSED TO
MODERNIZE BEHAVIORAL HEALTH
BEHAVIOR, HEALTH EMERGENCIES AND
CHILDREN AND YOUTH IMPACT THE
ENTIRE SPECTRUM OF EMERGENCY
MEDICAL SERVICES. AND BECAUSE OF
THIS, WE SUPPORT EFFORTS FOR A
SET ASIDE TO HELP PRESERVE
EXISTING IMAGE ESSAY FUNDED
PROGRAMS FOR CHILDREN AND YOUTH.
WE WOULD ALSO LIKE TO SEE
CHANGES THAT WOULD ONE CONSIDER
THE NEEDS OF THOSE WHO ARE ON
INVOLUNTARY HOLDS OR CONSERVED
AND TO CLARIFY THAT MHSC FUNDS
AREN'T AVAILABLE SOURCE OF FUNDS
THAT COUNTIES MAY USE FOR ADULTS
WHO ARE RECEIVING SHORT TERM
CRISIS TREATMENT IN THE HOSPITAL
. THANK YOU ALL FOR YOUR HARD
WORK AND DEDICATION ON THIS
IMPORTANT AND TIMELY ISSUE.
THANK YOU. MADAM CHAIR, MR
CHAIRMAN, JOSH PONY, ONE SHORT
AND SMALL THING THAT NEEDS TO BE
DONE IS CONNECTING THIS IN
BETWEEN GROUP. AND I PROPOSED A
GROUP OF AMENDMENTS THAT WOULD
FOCUS OUR ATTENTION ON THE
PROBATE CORD THAT CODE. THE
PROBATE CODE ACTUALLY FOCUSES
DOWN ON A GROUP OF PEOPLE WHO
ARE CAUGHT IN BETWEEN A BIG
GROUP OUT ON THE STREETS RIGHT
NOW, AND THAT PROBATE SECTION
WOULD GIVE THEM A GUARDIAN
ANGEL. RATHER THAN A FULL
FLEDGED CONSERVATOR, SO I WOULD
APPRECIATE YOUR ATTENTION TO
THAT, AND I THINK IT WOULD
BETTER THE BILL SO THAT ONCE YOU
PASS THIS AND THE PEOPLE PASS
IT, THEN THERE'S SOMETHING IN
BETWEEN THE SIDEWALK AND
VOLUNTEERING TO COME IN, AND 51
50 OF THE LPS SO I APPRECIATE
IT. MR CHAIRMAN, MADAM CHAIR.
THANK YOU VERY MUCH. THANK YOU.
PROPOSAL. THANK YOU. GOOD
AFTERNOON CHAIR WOOD AND
COMMITTEE MEMBERS. ADRIAN
SHELTON WITH THE CALIFORNIA
ALLIANCE OF CHILD AND FAMILY
SERVICES. WE REPRESENT NONPROFIT
COMMUNITY BASED ORGANIZATIONS
ACROSS CALIFORNIA THAT ARE
SERVING CHILDREN AND YOUTH AND
FAMILIES AND PUBLIC HUMAN
SERVICES SYSTEMS. WE CAN'T SAY
THIS STRONGLY ENOUGH. OUR YOUTH
ARE IN CRISIS. AND THE NEEDS OF
THE YOUTH AND THE CHILDREN WHO
ARE COMING INTO OUR MEMBER
AGENCY PROGRAMS HAVE ONLY
INCREASED SINCE THE PANDEMIC.
AND THE AUTHORS AND THE
ADMINISTRATION'S RECENT
AMENDMENTS ON THE PREVENTION AND
EARLY INTERVENTION COMPONENT ARE
EXACTLY THE RIGHT DIRECTION AND
WE ARE FURTHER REQUESTING
PRIORITIZATION OF CHILDREN AND
YOUTH WHEN IT COMES TO HOUSING
AND HOUSING SUPPORT. NEARLY ONE
IN FOUR CALIFORNIANS WHO
STRUGGLE WITH HOMELESSNESS ARE
UNACCOMPANIED YOUTH OR FAMILIES
WITH CHILDREN AND ONE AND FOUR
FOSTER YOUTH ARE EXITING THE
FOSTER CARE SYSTEM DIRECTLY INTO
HOMELESSNESS. SO WE BELIEVE THAT
THESE POPULATIONS NEED SUPPORT
TO PREVENT THEM FROM BECOMING
TOMORROW'S HOMELESSNESS.
POPULATION. THANK YOU VERY MUCH
FOR THE THOUGHTFUL HEARING
TODAY. THANK YOU. GOOD AFTERNOON
. COLECCHIA BOZO ALAMEDA COUNTY
. I WANT TO SAY THAT WE'VE
TALKED A LOT ABOUT THE NEED FOR
RACIAL EQUITY AND CHALLENGES
WITH RACIAL DISPARITIES
EXPERIENCED BY OUR BLACK
INDIGENOUS PEOPLE OF COLOR, BUT
THIS ADMINISTRATION HAS A HABIT
OF DOING THINGS AND CLOAKING IT
AND NOT ACTUALLY MAKING AN
EQUITABLE SO BIPOD COMMUNITIES
WERE NOT CONSULTED IN THE
CREATION OF SP 3 TO 6 AND WHITE
SUPREMACY IS CHANGING THE
BEDROCK OF IMAGES SAY WITHOUT
COMMUNITY INPUT WITHOUT LIVED
EXPERIENCE. WHITE SUPREMACY HAS
A DECIDING WHAT WORKS FOR PEOPLE
WITHOUT ASKING US. WHITE
SUPREMACY HAS US CUTTING UP I
OVER AND OVER AGAIN, INSTEAD OF
TALKING ABOUT RAISING THE TAX ON
MILLIONAIRES. WHAT I HEARD TODAY
WAS THAT RENT IS TOO HIGH, AND
IT IS NOT A MENTAL ILLNESS
PROBLEM. I HEARD THAT THE STATE
IS DOING NOTHING ON HOUSING
AFFORDABILITY AND BLAMING THIS
ON MENTAL ILLNESS. WE HAVE TO
ACTUALLY ADDRESS HOUSING
AFFORDABILITY. ALSO 4% IS NOT
ENOUGH TO FUND PREVENTION FOR
OUR BIKE UP BIPOD COMMUNITIES WE
NEED COMMUNITY FIND PRACTICES
FUNDED IN PREVENTION AND EARLY
INTERVENTION. UM THE DATA HAS
BEEN SAYING YES. SO SORRY. SO
THANK YOU. I OPPOSE SB 30 TO 6
AND I ASK YOU TO TAKE IT OFF THE
MARCH BALLOT. THANKS. THANK YOU.
GOOD AFTERNOON. MY NAME IS
JACKIE JOHNSON FROM ALAMEDA
COUNTY. AND I WORK FOR PIERS,
PIERS OF VISIONING ENGAGING AND
RECOVERY SERVICES. WE OFFER
PROGRAMS TO HELP CREATE NON
JUDGMENT SPACES WHERE PEOPLE
COULD COME AND FEEL SAFE,
RECEIVED PEER TO PEER SUPPORT
SKILLS AND TOOLS TO HELP THEM
MAINTAIN WELLNESS RECOVERY,
SUPPORT AND STABILITY, WHICH IS
AT RISK. UM AND BEING CUT
BECAUSE OF SP 3 TO 6. THIS WILL
BE OUR PROGRAMS TO BE CUT. IT
WILL HAVE A NEGATIVE IMPACT ON
OUR PARTICIPANTS AS WELL AS OUR
COMMUNITY S P 36 HAVING TO FORCE
COUNTIES TO CUT EXISTING
VOLUNTARY OUTPATIENT PROGRAMS
AND RECOVERY, OUT ORIENTED
SERVICE THAT HELP PEOPLE STAY
OUT OF HOSPITALS OUT OF JAILS
AND OFF THE STREET. IT ALSO
WOULD ELIMINATE FUNDING FOR PE I
PREVENTION SERVICES, WHICH
INCLUDE PEER SUPPORT SERVICES,
FAMILY EDUCATION SERVICES AND
WELLNESS CENTER. I'M HERE TODAY
TO OPPOSE SB 3 TO 6. THANK YOU.
THANK YOU. WITHOUT THE NEW MY
NAME IS GORDON REED. I'M THE
CHAIRPERSON APPEARS ORGANIZING
COMMUNITY CHANGE AND THE ALAMEDA
COUNTY AS I WAS 1600 MEMBERS,
AND WE SAY NO TO SB 3 26. THANK
YOU. THANK YOU. GOOD AFTERNOON.
MY NAME IS DAMON SUJA JOHNSON.
I'M THE EXECUTIVE DIRECTOR OF
BLACK MEN SPEAK ALAMEDA COUNTY.
UM WE APPEAR SPEAKING
ORGANIZATION WITH THE, UH
IMPOSING OF 3 26. WE TAKE SIDES
WITH THE A C O U CAMPAÑA AND
OTHER ORGANIZATIONS WERE
RETURNING FAMILY MEMBERS AND
WITH THIS THING, IT LEAVES US
OUT OF THE LOOP, ESPECIALLY AS
THE AFRICAN AMERICAN COMMUNITY
AND BLACK MEN COMING HOME FROM
PRISON. IT'S NOT CONSIDERED.
PLEASE PUMP YOUR BRAKES. SLOW
DOWN FOR US. THANK YOU. THANK
YOU. MY NAME IS LATANYA RICHARD
I AM CO FOUNDER AND ASSOCIATE
DIRECTOR OF COMMUNITIES. VOICES
IN MARSEILLE COUNTY, A SMALL
COUNTY, WHICH IS ONLY 3% AFRICAN
AMERICAN. MY QUESTION IS, IF YOU
GUYS CARE ABOUT US AND ONE PIERS
, WHY AREN'T THERE MORE PEERS UP
HERE ON THE PANELS? WEREN'T
THERE MORE BLACK PEOPLE? YOU MR
ARAMBULA ARE FROM FRESNO COUNTY.
CORRECT. I'M IN MERCED COUNTY.
WE BOTH KNOW RURAL COUNTIES.
WHERE IS THE FUNDING CUTTING
FUNDING FOR US? IT'S HORRIBLE
AND WRONG. I'LL SEE A LOT OF YOU
. YOU HAVE A COURAGE, VOTING
SCORE OF F. MANY OF YOU HAVE F
COURAGE, VOTING EXCEPT FOR MR
MCCARTHY. HE HAS AN A REST OF
YOU. AND WHY SHOULD WE BELIEVE
ANY OF YOU WHEN YOU HAVE A
COURAGE VOTING RATE OF F? I
MEAN, I KNOW A C STUDENT CAN
BECOME PRESIDENT. BUT WHY SHOULD
WE CARE ABOUT YOU GUYS WHEN YOU
DON'T OBVIOUSLY CARE ABOUT US?
PLEASE DON'T GET ME STARTED
BECAUSE I AM LIVID. THIS BILL IS
HORRIBLE. PUMP THE BRAKES. WHAT
IS THE RUSH? WHAT'S THE RUSH?
WHY CAN'T YOU WAIT UNTIL
NOVEMBER AND CONSIDER US? THANK
YOU. THANK YOU. PAUL SIMMONS
WITH THE DEPRESSION AND BIPOLAR
SUPPORT ALLIANCE. I'M GOING TO
TRY NOT TO GET INTO THE WEEDS
TOO MUCH. I COULD HEAR A COUPLE
OF POINTS. FIRST WE'VE BEEN
TALKING A LOT ABOUT DATA AND
GETTING THE DATA ANALYZED. AND
THE PEER COMMUNITY HAS ALWAYS
WANTED MORE DATA AND MORE
ANALYSIS, BUT LET'S DO IT
BEFORE. WE REVAMPED THE ENTIRE
SYSTEM. LET'S KNOW WHAT THE HECK
WERE DOING. UM SECOND OVERSIGHT
. IF SOME IF OVERSIGHT IS NOT
INDEPENDENT BY DEFINITION, IT IS
NOT OVERSIGHT. SO DO NOT
HAMSTRING THE MHS O E. C. UM I'D
LIKE TO ADDRESS HOUSING WITH
HOUSING FUNDING AND NOT TAKING
IT AWAY FROM MENTAL HEALTH
RESOURCES ABSOLUTELY SUPPORT THE
INCREASING OF THE FUNDING TO
1.25 OR 1.3% SO THAT WE CAN DO
IT ALL. IT'S NOT HURT OTHER
PEOPLE. I REALLY APPRECIATE THE
WORK THAT'S BEING DONE TO CREATE
MORE HOUSING. UM AND WE TALKED
ABOUT PREVENTION EFFORTS, BUT
KIDS DON'T COME OUT OF THE WOMB.
WITH SCHIZOPHRENIA. WE NEED TO
ADDRESS THOSE SOCIETAL ISSUES
AND THE SOCIAL CONTAGION ISSUES
THAT ARE CAUSING THE
PROLIFERATION OF SOME OF THESE
BEHAVIORAL HEALTH ISSUES. THANK
YOU. THANK YOU. CRYSTAL KUDOS
HERE ON BEHALF OF THE CALIFORNIA
ACADEMY OF CHILD AND ADOLESCENT
PSYCHIATRY. WE JUST WANT TO
ALIGN OUR COMMENTS WITH SHAUN
FRANCIS FROM CHILDREN NOW I WANT
TO THANK THE ADMINISTRATION BUT
STILL HAVE CONCERNS. UM AND WANT
TO ENSURE THAT THEIR YOU KNOW,
THIS MEASURE DOES SET ASIDE A
MINIMUM PERCENTAGE FOR
ADDRESSING HOMELESS YOUTH BUT
ALSO ON BEHALF OF THE BOARD OF
SUPERVISORS OF CURRENT COUNTY
AND NEVADA COUNTY. BOARD OF
SUPERVISORS ALSO EXPRESSING
CONCERNS WITH THIS MEASURE.
THANK YOU. THANK YOU. GOOD
AFTERNOON CHAIR AND MEMBERS.
I'LL KEEP IT SHORT. IS HE
SWINDLER ON BEHALF OF MAYOR
LONDON BREED OF SAN FRANCISCO,
AS WELL AS THE CITY AND COUNTY
OF SAN FRANCISCO? I'M IN SUPPORT
OF THIS MEASURE. THANK YOU.
THANK YOU. GOOD AFTERNOON. SUSAN
GALLAGHER, EXECUTIVE DIRECTOR OF
CAL VOICES FOR THE OLDEST PIER
RUN ADVOCACY ORGANIZATION IN
CALIFORNIA. AND I WANT TO TALK
ABOUT EQUITY BECAUSE EVERYONE
KEEPS USING IT LIKE A BUZZWORD,
BUT NOBODY REALLY YOU DON'T
DEMONSTRATED BECAUSE IF YOU WERE
TO DEMONSTRATE EQUITY CLIENTS
WOULD HAVE BEEN CONSULTED
BEHAVIORAL HEALTH CLIENTS WHO
ARE MOST IMPACTED BY THESE
CHOICES THAT YOU GUYS ARE MAKING
WE HAVE NOT BEEN BROUGHT TO THE
TABLE. I DON'T SEE A PANEL OF US
. SO I ALIGN MY COMMENTS WITH
LESLIE NAPA COLECCHIA. TANIA UM
, WE YOU CAN'T SAY WHAT YOU
THINK IS BEST FOR US. YOU HAVE
TO ASK US WHAT PERSON WITH
SCHIZOPHRENIA HAS BEEN BROUGHT
UP HERE AND SAID WHAT WOULD WORK
FOR THEM? WHAT PERSON WHO'S ON
HOUSED HAS BEEN BROUGHT UP IN
HERE AND SAY, WHAT WOULD WHAT
WOULD WORK FOR YOU TO ENGAGE
WITH SERVICES? YOU GUYS KEEP
MAKING SYSTEMS THAT WE DON'T
ENGAGE IN BECAUSE THEY'RE RACIST
. THEY LACK EQUITY. THEY ARE NOT
CLIENT DRIVEN. AND SO EVERYTHING
THAT WE'RE TALKING ABOUT TODAY
PERPETUATES THIS. I HARDLY THINK
I HAD ENOUGH TIME SO MANY OTHER
PEOPLE, BUT THANK YOU APPRECIATE
YOUR LIFE. TIFFANY ELLIOTT,
PROGRAM MANAGER WITH PAINTED
BRAIN. AYE. REALLY IMPLORE YOU
TO BRING STAKEHOLDERS TO THE
TABLE AND NOT JUST PEOPLE WHO
WILL AGREE WITH YOU PEOPLE WHO
HAVE THE LIVED EXPERIENCE THAT
IS GOING TO BE IMPACTED. BY
THESE MEASURES. PEOPLE WHO ARE
HAVE ALREADY SEEN THERE LIVES
IMPACTED BY THE CONDITIONS THAT
WE'RE DISCUSSING. IT'S
IMPERATIVE NOTHING ABOUT US
WITHOUT US. WE NEED TO HAVE A
VOICE. AND YOU'RE GOING TO FIND
BETTER SOLUTIONS THAT ARE GOING
TO WORK. BETTER WITH THE MONEY
THAT WE HAVE IF YOU INVITE US TO
THE TABLE, PLEASE, PLEASE,
PLEASE DO THAT. AND PLEASE.
THERE'S NO RUSH ON THIS. WE
DON'T NEED TO HAVE ALL THE
ANSWERS TOMORROW. IT'S OKAY TO
TAKE A LITTLE MORE TIME. IF
THAT'S GOING TO MAKE IT BETTER
IF WE IF WE HAVE THIS GO THROUGH
IN NOVEMBER. WE CAN MAKE
SOMETHING BETTER IF WE HAVE ALL
THE PEOPLE WHO ARE GOING TO BE
IMPACTED THIS WAYS AT THE TABLE.
THANK YOU. THANK YOU. HELLO MY
NAME IS RICHARD GALLO. I'M FROM
SANTA CRUZ COUNTY. I OPPOSE SP 3
26. THIS IS A ONE SIDED AND THIS
SHIP IS BASICALLY THE PEER
COMMUNITY WAS NOT INVOLVED WAS
NOT INVITED STATE AGENCIES
SAYING THAT THEY'RE BEING
TRANSFORMATIVE. COLLABORATIVE
BUT THEY ARE NOT. THEY'RE
EXCLUDING US, AND THAT INCLUDES
THE OVERSIGHT COMMISSION. TWO
THINGS THAT YOU OVERSIGHT
COMMISSIONS HAVE FAILED. TO MEET
THE NEEDS OF THE SME COMMUNITY.
THE IN HOUSE COMMUNITY, WHICH I
WAS THE INTENT OF THE ACT TO
HELP OUR COMMUNITIES THROUGHOUT
CALIFORNIA. SECONDLY OBVIOUSLY I
COMMISSION HAVE FAILED TO CREATE
PURE PROGRAMS PEER SERVICES TO
SERVE UP OUR POPULATIONS THAT WE
WORK WITH ALL POPULATIONS
THROUGHOUT CALIFORNIA. THEY TURN
ON DEAF EARS. YES DO YOU
OBVIOUSLY COMMISSION NEEDS TO BE
CHANGED? THANK YOU. SO I POSTED
THE STATE IS TAKING THE WRONG
APPROACH. I WOULD NOTE. WE'RE AT
22 MINUTES. WE'VE GOT EIGHT
MINUTES LEFT SO. WE WERE PRETTY
CLEAR FROM THE BEGINNING SO
WELL, WE HAVE EIGHT MINUTES LEFT
. SO FAITH COX CONSUMER FROM
AMADOR COUNTY, AND I APPROVE. I
OPPOSE. THANK YOU. MY NAME'S
KATRINA. ROGER I AM A PROGRAM
MANAGER FOR CAL VOICES AT A
PROGRAM IN AMATEUR COUNTY. OR
ONE LOCAL WELLNESS CENTER, AND I
OPPOSE SB 3 26. NOTHING ABOUT US
WITHOUT US, YOU NEED TO HAVE
CONSUMERS AND STAKEHOLDERS AT
THE TABLE WHEN YOU HAVE THESE
DISCUSSIONS. THANK YOU. THANK
YOU. MY NAME IS DORIAN COTTERELL
AND I AM A CONSUMER OF THE
WELLNESS CENTERS AND HAVE SAVED
MY LIFE WITHOUT WE WOULD BE
NOTHING. I'M OPPOSED TO SP 3 26.
THANK YOU. GOOD AFTERNOON. I AM
I'M PARTIALLY OF OAKLAND,
CALIFORNIA, ALAMEDA COUNTY. I
WORKED WITH PEERS ENVISIONING
AND ENGAGING AND RECOVERY
SERVICES. I WAS ALSO WANTS A
PARTICIPANT OF THESE PE. I
PROGRAMS ON THESE SERVICES. THEY
HAVE HELPED ME IN MY RECOVERY.
THEY HAVE ALLOWED ME TO KEEP MY
FAMILY TOGETHER. AND I OPPOSE.
THANK YOU. GOOD AFTERNOON. I'M
SARAH MARX. ER FROM ALAMEDA
COUNTY. I OPPOSE SB 3 26. I HAVE
LIVED EXPERIENCE RECEIVING
IMAGES FUNDED SERVICES, AND I
WORK FOR ONE OF THE MANY PURE
RUN RECOVERY ORIENTED PROGRAMS
THAT DO SERVE PEOPLE MOST IN
NEED ALREADY, INCLUDING PEOPLE
WHO HAVE EXPERIENCED MULTIPLE
HOSPITALIZATIONS HAVE
EXPERIENCED HOMELESSNESS AND
HAVING EXPERIENCED INCARCERATION
AND OUR PROGRAMS ARE THREATENED
WITH BEING DEFUNDED UNDER SP 3
26. THANK YOU. THANK YOU. A GOOD
AFTERNOON. MY NAME IS CLAIRE.
I'M UP HERE AND THERE'S MANY
THINGS I COULD SAY. BUT I THINK
THE MOST IMPORTANT THING IS THAT
THE MHS A SAVED MY LIFE. I WAS A
PERSON WHO WAS SICK FOR 10, PLUS
YEARS, NOT IN ANY KIND OF
SERVICE IS NOT SIGNED UP FOR
MEDICAL AND I HAD A PEER SUPPORT
WORKER PROVIDE ME SERVICES FOR
THE THREE MONTHS IT TOOK SIGNED
ME UP FOR MEDICAL. GIVE ME
SERVICES EVERY DAY FOR FIVE
MONTHS AND THAT'S SPECIAL AND
MEDICAL WILL NEVER REPLICATE
THAT THAT IS AN ACTUARY AT AN
INSURANCE COMPANY DECIDING WHAT
I NEED WHEN AND HOW MUCH. UM
THIS WAS A NO BARRIER, NO MONEY.
PERFECT SERVICE FOR ME AND IT
AND IT ABSOLUTELY CHANGED THE
COURSE OF MY LIFE, SO I JUST
WANT TO SAY MAYBE THESE FUNDING
ALLOCATION BUCKETS ARE FUNGIBLE
. BUT PEOPLE ARE NOT FUNGIBLE.
AND WHEN YOU ARE TALKING ABOUT
CUTTING 65% OF OUTPATIENT
SERVICES IN THIS COUNTY THAT IS
CATASTROPHIC. AND YOU KNOW, I'LL
JUST BE REAL BECAUSE THERE'S
BEEN SO MUCH COURAGE BEFORE ME.
NOBODY REALLY WANTS THIS. THE
COUNTIES DON'T WANT IT TO
CLIENTS DON'T WANT IT. THANK
YOU. WHEN I STARTED THIS CRISIS
PORTANTINO TÌM TAMAR TH¤U CAL
VOICES TAMBIÉN PERSONA CON
EXPERIENCIA VIDA. GOOD
AFTERNOON. MY NAME IS SEEN
DURING PHANTOM HERE WITH MY
LIVED EXPERIENCE. I AM A PARENT
OF A CHILD WHO'S RECEIVED IMAGES
SERVICES. I'M ALSO A PROGRAM
MANAGER AT THE CHILDREN'S SYSTEM
OF CARE THROUGH MY AGENCY COW
VOICES WHO RECEIVES OUR FUNDING
STREAMS FROM AMATEUR TO SAY, WHO
HAS BENEFITED NUMEROUS HUNDREDS
AND HUNDREDS AND HUNDREDS OF
FAMILIES YEARLY. WE DO HAVE THE
DATA TO PROVE IT AS WELL. WE
SUPPORT IMMIGRANT CHILDREN,
CHILDREN WHO DO NOT QUALIFY FOR
ANY OTHER SERVICES. FAMILIES
THAT DO NOT QUALIFY FOR MEDICAL
I COMPLETELY AND UTTERLY OPPOSED
THIS BILL. I'M HOPING THAT YOU
GUYS WILL RECONSIDER AND START
FIGURING OUT DIFFERENT WAYS OF
OBTAINING THE FUNDS THAT YOU
NEED FOR HOUSING BECAUSE WE
DEFINITELY NEED THOSE AS WELL,
UM, SIMPLE WAY ESTARÁ QUICKLY
AND A PARLIAMENT. THE UNDER
SERVED THE PEOPLE THAT NOBODY
THINKS ABOUT. AND UM I FORGOT
WHICH ONE OF YOU ASKED ABOUT
LANDLORDS. LANDLORDS DON'T RENT
TO PEOPLE THAT DON'T HAVE, LIKE
RENT RENTAL HISTORY OR ARE OF
LOW INCOME SERVICES. YOU KNOW,
WE HAVE A LOT OF UNDERSERVED
PEOPLE AND ALL OF THESE
COUNTIES. I COME FROM PLASTER
WHERE WE DO HAVE TONS OF
RESOURCES, BUT THERE'S STILL AN
EXTREME HOMELESS. OKAY THANK
YOU. THANK YOU. SORRY DON'T TALK
TO ME THAT WAY. BUT I'M BLIND
WITHOUT MY GLASSES, SO I DIDN'T
SEE THE TIME. I APOLOGIZE. THANK
YOU. RICHARDSON DAVIS FROM THE
CALIFORNIA COMMUNITY COUNCIL OF
BEHAVIORAL HEALTH AGENCIES WANT
TO ALIGN MY COMMENTS WITH DR
LEANDRO CLARK HARVEY AT THE
RECENT SENATE INFORMATIONAL
HEARING, AND WE RECENTLY SAW
SUBMITTED A LETTER WITH OUR
CONCERNS AND LOOK FORWARD TO
WORKING WITH YOU ALL. THANK YOU.
THANK YOU. HELLO MY NAME IS MAX
TAYLOR AND THE EXECUTIVE
DIRECTOR OF PURE VOICES NETWORK
AND CLARA COUNTY 38 YEARS
EXPERIENCE BEING EMOTIONALLY
DISTRESSED, EIGHT YEARS
EXPERIENCE BEING A PURE VOICE
SOMETIMES PAID QUITE OFTEN
UNPAID TWO POINTS FOR YOU ABOUT
WHY I LIVED EXPERIENCE MATTERS
TO YOU ASKED FOR UNIQUE POINTS.
I HAVE POINTS FOR YOU THAT YOU
HAVEN'T HEARD AT ALL TODAY. ONE
RACISM IN THE EVIDENCE BASE
ITSELF. RACISM, SEXISM, AGEISM.
EXAMPLES ONE BLACK KIDS ARE
DIAGNOSED AS OPPOSITIONAL
DEFIANT FIVE TIMES MORE THAN
WHITE PEOPLE ANALYSIS IS THAT A
BLACK KIDS NEED MORE SUPPORT OR
BE Y'ALL ARE RACIST. POINT
NUMBER TWO U. C S F FUNDING. UM
YOUR PANELS WERE HERE. I DIDN'T
SEE A SINGLE BLACK PERSON AND
ANY OF THE PANELS INTO THE LAST
ONE FOR STAKEHOLDER INVOLVEMENT.
TÍNH FUNDING INCLUDES OF FOLKS
THAT HAVE OF ANY H FUNDING THAT
INCLUDES, UM SORRY, I'M TIRED.
I'M RUSHED BECAUSE YOU'RE NOT
GIVING US THE TIME TO SPEAK. SO
PARDON ME FOR BEING A LITTLE
FLUSTERED. HÌNH FUNDING. THESE
ARE STEPS THAT YOU NEED TO HEAR
IT. PLEASE. YOU WANNA HEAR MY
STATS? COME FIND ME. LAST AGAIN
ON BEHALF OF THE GREATER
SEGMENT, URBAN LEAGUE. WE
APPRECIATE THIS THOUGHTFUL
HEARING. WE SUPPORT A B 3 26.
THANK YOU. WE'RE DOWN TO TWO
MINUTES, OKAY? JOHN LEE BEFORE
PROP 13. I WAS AT COUNTY MENTAL
HEALTH ADMINISTRATOR THERE'S A
GREAT DEAL THAT WORKED UNTIL
1978 WENT PROP 13 PASSED. I WANT
TO TALK ABOUT A B 85. WE NEED TO
TALK ABOUT THE SOCIAL
DETERMINANTS HELP. YOU CAN'T
TALK ABOUT MENTAL HEALTH WITHOUT
TALKING ABOUT THIS SUPPORT
SYSTEM. ALL OF THIS SOCIAL
DETERMINES HEALTH OR WHAT YOU
SHOULD BE FOCUSED ON. YOU'RE
ONLY TALKING ABOUT THE VERY
SUPERFICIAL STUFF. YOU NEED TO
HAVE WE PROGRAMMING EVALUATION
AND ARTIST ACCOUNTABILITY.
YOU'RE COLLECTING ALL THESE
NUMBERS AND THEY'RE NOT BASED ON
ANY JUDGMENT AHEAD OF TIME.
YOU'VE GOT TO HAVE PROGRAM
EVALUATION AT THE BEGINNING AT
THE MIDDLE AND AT THE END AT THE
THERAPY LEVEL AND AT THE PROGRAM
LEVEL AND AT THE STATE LEVEL, WE
DON'T HAVE THAT AT ALL. CAL AIM
IS A FAILURE. IT'S ONLY
ADMINISTRATIVE JUNK. THANK YOU.
OKAY, TIME FOR TWO MORE
SPEAKERS. THAT'S IT. CHILDREN'S
PARTNERSHIP IN A SUPPORT IF
AMENDED POSITION. WE'RE
REQUESTING AMENDMENTS IN
COALITION WITH THE OTHER KIDS
GROUPS. THANK YOU. STEPHANIE
RAMOS, FAMILY MEMBER OF THE FSP
CLIENT. I JUST WANNA REALLY JUST
LET YOU GUYS KNOW THAT
OUTPATIENT SERVICES THAT YOU GET
THROUGH YOUR PRIVATE HEALTH
INSURANCE. IT'S EXTREMELY
DIFFERENT THAN THE OUTPATIENT
SERVICES INDIVIDUALS GET THROUGH
PUBLIC BEHAVIOR, HEALTH SYSTEMS
, AND SO I REALLY WANT TO
ENCOURAGE YOU TO LOOK INTO THAT
A LITTLE BIT MORE AND REALIZE
THAT YOU'RE GONNA HAVE A LOT OF
PEOPLE THAT LOSE OUTPATIENT
SERVICES GO TO THEIR PRIMARY
CARE AND END UP BECOMING AN FSP
CLIENT BECAUSE THEY DON'T HAVE
THOSE SUPPORTS AVAILABLE TO
THEM. THANK YOU. THANK YOU. THIS
WILL CLOSE OUR PUBLIC COMMENT AT
THIS TIME, SO BRING IT BACK TO
THE COMMITTEE FOR CLOSING
COMMENTS. ANYBODY. I WANT TO
THANK EVERYBODY FOR BEING HERE
TODAY. I RECOGNIZE THAT THIS IS
A COMPLICATED UM PROCESS, AND
IT'S NOT OBVIOUSLY UNIVERSALLY
SUPPORTED BY EVERYONE. THIS WAS
AN INFORMATIONAL HEARING. THIS
WAS OUR OUR EFFORT TO BRING
THESE ISSUES OUT SO THAT THEY
COULD BE HEARD BY THE PROPONENTS
OF THE BILL. THAT WAS THE
PURPOSE HERE. THIS ISN'T OUR
USUAL PROCESS WITH EVERY BILL.
WE HAVE SPENT. WHAT FIVE HOURS
HERE TODAY ON THIS TOPIC BECAUSE
WE FELT IT WAS REALLY, REALLY
IMPORTANT. OUR TYPICAL PROCESS,
WHICH YOU WILL ACTUALLY GET TO
SEE IF YOU CHOOSE TO SAY. BILL
HEARING IS A VERY DIFFERENT
PROCESS AND THAT WE WILL. WE
WILL DO THAT WHEN WE'RE DONE
HERE. MY STAFF HAS BEEN WORKING
ON THIS ISSUE SINCE WE RECEIVED
IT. WE'VE BEEN WORKING ON THESE
SOME OF THESE ISSUES SUPPORTING
THIS FOR YEARS. SO I UNDERSTAND
AND RECOGNIZE THAT THERE IS
FRUSTRATION AND CONCERN. UM AND
NOT EVERYBODY WILL BE PLEASED BY
CHANGES HERE. UM, BUT WE ARE
LISTENING AND WE ARE WE ARE
MAKING OUR EARNEST EFFORTS TO
MAKE THE POLICIES. BETTER AROUND
HOW WE TAKE CARE OF OUR MENTALLY
HELP. MENTAL HEALTH ARE
BEHAVIORAL HEALTH ISSUES. AND
THE SUPPORTIVE HOUSING THAT WE
NEED TO GO ALONG WITH THAT. SO
WITH THAT WE ARE GOING TO
ADJOURN. ACTUALLY THIS HEARING
AND WE'LL RECONVENE THE HEALTH
COMMITTEE HEARING. IN 10
MINUTES, SO I'M GOING TO ASK THE
HEALTH COMMITTEE MEMBERS TO
PLEASE COME DOWN SO THAT WE CAN
ACTUALLY HEAR THE BILL AND ASKED
THE AD, THE AUTHOR AND THE
SPEAKERS FOR AND AGAINST TO BE
READY TO GO IN 10 MINUTES WHEN
WE RECONVENE, SO THANK YOU VERY
MUCH.