TESS ALL RIGHT? THANK YOU VERY
MUCH. GOOD EVENING. GOOD EVENING
, EVERYONE. WE ARE GOING TO CALL
THE SELECT COMMITTEE ON
CALIFORNIA'S MENTAL HEALTH
CRISIS. TO ORDER. IT IS INDEED A
PLEASURE TO BE HERE IN THE
BEAUTIFUL CITY OF LOS GATOS. UM
AND WANT TO THANK THE LEADERSHIP
OF MY COLLEAGUE AND DEAR FRIEND
ASSEMBLYMEMBER'S PELLERIN. WHO
ALSO SERVES AS THE VICE CHAIR.
UM, AND ALSO SO EXCITED TO HAVE
THE SENATOR WITH US AS WELL TO
BE ABLE TO PARTICIPATE. THE
SELECT COMMITTEE ON CALIFORNIA'S
MENTAL HEALTH CRISIS WAS MEANT
TO ENSURE THAT WE TALK ABOUT
THIS ISSUE. WITH THE URGENCY
THAT IT DESERVES. AND THAT IS
CALIFORNIA IS IN A MENTAL HEALTH
CRISIS. AND WE MUST TREAT IT AS
SO. BECAUSE WE KNOW WHAT
CALIFORNIA CAN DO WHEN IT
DECLARES SOMETHING A CRISIS.
NOTHING OH, BOY. I DON'T LIKE
HEARING MY OWN VOICE. AH UM,
NOTHING STANDS IN CALIFORNIA'S
WAY WHEN WE HAVE A CRISIS, AND
WE MUST ACT WITH THE SAME AND
INGENUITY AND AGGRESSIVENESS AS
WE HAVE DONE MANY CRISIS BEFORE.
AH WE ARE PLEASED TO BE AT LOS
GATOS TOWN HALL. WE, UM OF
COURSE. I HAVE PEOPLE HERE IN
ATTENDANCE AND THE PUBLIC. BUT
ALSO WE WANT TO MAKE SURE PEOPLE
KNOW THAT THEY CAN ALSO VIEW
THIS ON LIVESTREAM ON THE
ASSEMBLY'S WEBSITE. ASSEMBLY
THAT CA.GOV FORWARD SLASH TODAY
EVENTS. PUBLIC COMMENT WILL
OCCUR AFTER THE CONCLUSION OF
EXPERT PANELISTS TESTIMONY. AND
ALL MEMBERS QUESTIONS TO THE
PANELIST. AFTER ALL MEMBERS,
QUESTIONS TO THE PANELISTS HAVE
CONCLUDED. PUBLIC COMMENTS SHALL
LAST 30 MINUTES AND EACH MEMBER
OF THE PUBLIC SHALL HAVE ONE
MINUTE TO REGISTER THEIR
COMMENTS. LET ME JUST SAY THAT.
THIS SELECT COMMITTEE IS NOT
JUST AN EXERCISE OF ADDRESSING
THE MOMENTS OF THE DAY. BUT TO
MANY OF THE PANELISTS ARE MANY
OF THE MEMBERS OF THIS SELECT
COMMITTEE FOR US IS DEEPLY
PERSONAL. ON MY WAY HERE IN
PREPARATION YESTERDAY ON MY WAY
ON THE FREEWAY. I WAS NOTIFIED
THAT MY BROTHER PASSED. DUE TO
MENTAL ILLNESS AND ADDICTION AND
HOMELESSNESS. AND AS I WAS GOING
THROUGH OUT ON OUR VARIOUS
EVENTS, I WAS PLANNING MY
BROTHER'S FUNERAL. AND SO THIS
IS NOT AN EXERCISE. AH! OH FOR
SOMEONE WHO HAS A MASTER'S
DEGREE AND A DOCTOR'S DEGREE IN
SOCIAL WORK. UM THE SYSTEM STILL
FAILED MY FAMILY. AND SO WE HAVE
GOT TO GET THIS RIGHT. AND
ALTHOUGH WE HAVE DONE A LOT THIS
YEAR WHEN IT COMES TO MENTAL
HEALTH REFORM AND OTHER UH GREAT
THINGS AND OTHER THINGS THAT'S
LEFT FOR THE VOTERS TO DECIDE ON
WHEN IT COMES TO THE MENTAL
HEALTH SERVICES ACT. THE KEY
QUESTION WE WILL ALWAYS ASK.
EVERY TIME IS ARE WE DOING
EVERYTHING THAT WE CAN NOT JUST
ARE WE DOING SOMETHING? BUT ARE
WE DOING EVERYTHING THAT WE CAN
AND WE WILL NOT REST UNTIL WE
CAN SAY YES TO THAT TO THAT
QUESTION. SO I WANT TO HAND IT
OVER FOR A FEW COMMENTS FROM MY
DISTINGUISHED VICE CHAIR,
ASSEMBLYMEMBER'S GAIL PELLERIN.
UM TO SAY A FEW WORDS. THANK
YOU. THANK YOU, TOO. THE DOCTOR
COREY JACKSON, OUR CHAIR OF THIS
COMMITTEE. I'M SO SORRY FOR YOUR
LOSS. IT IS TRULY TRAGIC AND
THANK YOU TO OUR SENATOR DAVE
COURTESY FOR BEING HERE TODAY.
AND THANK ALL OF YOU FOR COMING
HERE TONIGHT TO LISTEN TO THIS
SELECT COMMITTEE ON CALIFORNIA'S
MENTAL HEALTH CRISIS BECAUSE, AS
OUR CHAIR SAID, WE ARE IN A
MENTAL HEALTH CRISIS. I ALSO
WANT TO THANK OUR LEGISLATIVE
AUDIOVISUAL TEAM. I CAN'T
BELIEVE HOW MUCH WORK YOU GUYS
PUT INTO MAKING SURE THAT THIS
HEARING GETS TELEVISED AND I'M
THRILLED TO HAVE YOU HERE IN THE
20TH ASSEMBLY DISTRICT IN LOS
COTTO'S UM I ALSO WANT TO
PERSONALLY THANK THE TOWN
MANAGER LAUREL PAVETTI AND THE
STAFF HERE AT THE TOWN HALL AND
THE LOW SCATTERS TOWN COUNCIL
FOR BEING SO ACCOMMODATING AND
ALLOWING US TO USE THIS
BEAUTIFUL SPACE. I ALSO WANNA
GIVE A SHOUT OUT TO DON'T WALK
AWAY, HANNAH, GIVE A SHOUT OUT
TO HANNAH BARNETT, WHO PUT A LOT
OF WORK AND TIME AND EFFORT INTO
THIS HEARING TODAY. YOU DID
AMAZING. SHE'S OUR FIELD
REPRESENTATIVE OVER IN SAN JOSE.
AND ALSO ASHLEIGH LABARRE IS MY
CHIEF OF STAFF. AND YOU KNOW,
WONG IS HERE. WHO'S A FIELD REP
END LIZETTE JONES. SO HAPPY TO
HAVE TEAM PELLERIN HERE IN THE
ROOM. UM AND AS SOME OF YOU KNOW
, MY FAMILY HAS BEEN PROFOUNDLY
IMPACTED BY MENTAL HEALTH. AND
IT WAS A STRUGGLE FOR YEARS AND,
AS DR JACKSON SAID, AS SOMEBODY
WHO IT IS. HAS RESOURCES AND
ACCESS TO RESOURCES. AND, AS YOU
KNOW, KNOWS WHO TO CALL WHEN
THERE'S A PROBLEM IN A CRISIS,
IT WAS EXTREMELY HARD TO
NAVIGATE OUR MENTAL HEALTH
SYSTEM TO GET THE CARE THE
QUALITY CARE THAT MY FAMILY
NEEDED IN A TIME OF CRISIS. UM
MY HUSBAND OF 25 YEARS DIED BY
SUICIDE FIVE YEARS AGO THIS
NOVEMBER. IT NEVER GETS ANY
EASIER TO TALK ABOUT IT. MM HMM.
BUT HE IS SOMEBODY WHO COULD NOT
ASK FOR HELP. HE, UM. JUST YOU
KNOW, HAD EVERYTHING AVAILABLE
TO HIM, BUT HE JUST REACHED A
PLACE THAT WAS JUST SO HOPELESS
AND HE WAS SO DEPRESSED THAT HE
SAW NO WAY OUT FROM THIS WORLD
BUT TO END HIS LIFE. AND WE HAVE
TO ASK OURSELVES. WHY PEOPLE ARE
MAKING THOSE DECISIONS,
ESPECIALLY WHEN WE TALK ABOUT
OUR 10 TO 18 YEAR OLDS THAT ARE
DYING BY SUICIDE AT ALARMING
RATES. KIDS AS YOUNG AS 23 AND
FOUR SHOWING UP WITH MENTAL
HEALTH CONDITIONS. OUR SENIOR
POPULATION THAT HAVE GONE
THROUGH THIS PANDEMIC WITH ALL
OF US AND CERTAINLY SUFFERED
FROM THAT ISOLATION. AND YOU
KNOW, MENTAL HEALTH IMPACTS,
EVERYBODY. I MEAN, HOW MANY
PEOPLE HERE IN THE ROOM HAVE HAD
SOMEBODY IN THEIR LIVES WITH THE
MENTAL HEALTH? THAT'S WHY WE'RE
HERE. WE'RE HERE TO TALK ABOUT
THIS IMPORTANT ISSUE TO MAKE
SURE THAT WE GET THESE VITAL
SERVICES TO PEOPLE WHO NEED IT
THAT WE BUILD THE WORKFORCE THAT
WE NEED TO DELIVER THESE
SERVICES THAT WE EXPAND UPON OUR
988 EMERGENCY MENTAL HEALTH
HOTLINE. SO WE NOT ONLY HAVE
SOMEONE TO CALL BUT SOMEONE TO
SHOW UP IN SOME PLACE TO GO.
NEARLY ONE IN SEVEN CALIFORNIA
ADULTS EXPERIENCE, A MENTAL
ILLNESS AND ONE IN 26 HAVE A
SERIOUS MENTAL ILLNESS THAT
MAKES IT DIFFICULT TO CARRY OUT
DAILY ACTIVITIES. AND IN 2021,
SANTA CLARA COUNTY, LOST 154
NEIGHBORS TO SUICIDE. SO WE KNOW
THAT MENTAL HEALTH CARE IS A
CRUCIAL STEP TOWARDS HEALING
FROM A MENTAL ILLNESS, BUT
BARRIERS TO ACCESSING THE THIS
CARE AND THE AFFORDABILITY OF
THE CARE IS A HUGE ISSUE THAT WE
NEED TO RESOLVE. SO I WANT TO
THANK OUR PANELISTS WHO ARE HERE
TODAY FOR LENDING THEIR TIME TO
THIS IMPORTANT ISSUE TO EDUCATE
US. WE'RE HERE TO LISTEN AND TO
LEARN AND TO TAKE THIS
INFORMATION AND TO GO BACK TO
SACRAMENTO AND FIGHT LIKE HELL
TO MAKE SURE THAT MENTAL HEALTH
GETS THE RESOURCES IT NEEDS SO
WE CAN HEAL AS A STATE. THANK
YOU. THANK YOU. ASSEMBLYMEMBER'S
UM THIS COMMUNITY IS SO LUCKY TO
HAVE, UM A SENATOR AS SENATOR
CORTEZ E. UM YOU KNOW, THERE'S
100 AND 20 MEMBERS OF THE
LEGISLATURE. AND IT ONLY TAKES
WHEN YOU'RE A NEW MEMBER. YOU
HAVE TO GO THROUGH HALF THE YEAR
TO REALLY BEAT YOUR OTHER
COLLEAGUES ON THE OTHER HOUSE.
AND I STARTED LISTENING TO HIM
IN A HEARING. I SAID, WHO'S THIS
GUY? MAN HE'S TACKLING SOME
GREAT ISSUES. HE SEEMS SO
UNASSUMING SOMETIMES, BUT MAN,
THIS MAN IS REPRESENTING THIS
COMMUNITY. AH THAT IS DEFINITELY
SETTING THE EXAMPLE FOR MANY OF
US KNEW IN THE LEGISLATURE. SO
SENATOR CORTEZ. WOULD YOU LIKE
TO SAY A FEW WORDS? YES THANK
YOU. THANK YOU VERY MUCH FOR
THAT. MR CHAIR AND THE VICE
CHAIR. THANKS FOR THE INVITATION
TO BE HERE. I KNOW MEMBERS OF
OUR CASE YOU'RE WONDERING. A
COUPLE OF PEOPLE RAISE THEIR
EYEBROWS AND SAW ME COMING IN
BECAUSE THEY KNOW ME HERE FROM
SANTA CARLA COUNTY AND MEMBERS
OF THE DELEGATION HERE WITH
CENTOCOR COUNTY WERE INVITED TO
PARTICIPATE IN I DIDN'T WANT TO
MISS THE OPPORTUNITY TO BE HERE
AND SEE WHAT ELSE I CAN LEARN
WHAT WE CAN HERE. UM YOU KNOW, I
SPEAK FOR MYSELF AND EVERYONE
ELSE LISTENING TO MY TWO
COLLEAGUES HERE. THE. YOU KNOW
THE SENSE OF ONGOING GRIEF THAT
THAT WE SHARE WITH YOU AND
ANYONE ELSE WHO HAS BEEN
IMPACTED TO THAT DEGREE BY
MENTAL HEALTH SYMPTOMS THAT.
THERE COULDN'T BE CHECKED OR
TREATED IN THEIR OWN FAMILIES.
IS. YOU KNOW, IT'S PALPABLE.
IT'S VERY REAL TO ALL OF US. AND
YOU KNOW MY CONDOLENCES. OF
COURSE TO YOUR RECENT LOSSES. I
THINK UM ONE THING I WANT TO
SHARE IS AS A MEMBER OF THE
BOARD OF SUPERVISORS. I THINK IT
BECAME FAIRLY APPARENT THAT I
HAVE HAD MY OWN LIVED
EXPERIENCES WITH UM, A LARGE
EXTENDED FAMILY IN TERMS OF, UM
IMPACT AND TRYING TO NAVIGATE
THE SYSTEM AND SO FORTH, AND
OTHER MEMBERS OF THE BOARD OF
SUPERVISORS AGAIN WITHOUT
GETTING SPECIFIC, UM WERE ABLE
TO DRAW ON THEIR OWN EXPERIENCES
IN THAT INFORMS PUBLIC POLICY TO
THE EXTENT THAT YOU CAN, YOU CAN
TAKE THAT AND WHAT YOU'VE SEEN
AND WHAT YOU'VE STRUGGLED WITH
WHAT YOU'VE LEARNED AND THEN
PULL THAT TOGETHER WITH THE
EXPERTISE OF THOSE WHO REALLY
SPEND THEIR LIVES TRYING TO GET
US TO A PLACE WHERE WE CAN
MITIGATE THE IMPACTS OF MENTAL
HEALTH AND WE KNOW WE CAN GET
BETTER AND WE KNOW PEOPLE CAN
GET BETTER. AND WE KNOW THAT
SCIENCE WILL GET BETTER. UM WE
KNOW ALL OF THAT, BUT I THINK
THAT COMBINATION OF LIVED
EXPERIENCE FOR THOSE OF US WHO
WERE I'M HONORED TO BE IN THESE
POLICY POSITIONS AND BLESSED TO
BE THIS POLICY POSITIONS WITH
THE KIND OF EXPERTISE WE'RE
GOING TO HEAR FROM TODAY IS JUST
REALLY IMPORTANT, AND THAT'S WHY
I'M HERE. I'LL NOTE THAT I'M A
MEMBER OF THE SENATE. MENTAL
HEALTH AND ADDICTIONS SO I CAN
BE I'M IN HEALTH AND ADDICTION
WITH SENATOR WIENER CHAIRS. AND
I'VE BEEN A MEMBER FOR THE LAST
COUPLE OF YEARS OF MENTAL
HEALTH. UM OVERSIGHT COMMISSION
FOR THE STATE, SO I'M VERY MUCH
INVESTED IN THE WORK. THANK YOU
AGAIN. THANK YOU VERY MUCH,
SENATOR. WE'RE GOING TO START
OFF WITH OUR FIRST PANEL IN
TERMS OF ADDRESSING GAPS. AND
CARE AND WE'RE SO EXCITED TO BE
ABLE TO HEAR FROM THE BEHAVIORAL
HEALTH CONTRACTORS ASSOCIATION.
THE MATERNAL OUTREACH, MOOD
SERVICES OR MOM'S PROGRAM AT EL
CAMINO HEALTH. AND THE SANTA
CRUZ CHAPTER OF THE CALIFORNIA
ASSOCIATION OF MARRIAGE AND
FAMILY THERAPIST. WE'RE GOING TO
HAVE EACH OF THEM INTRODUCE
THEMSELVES AND WHEN THEY PRESENT
THEIR TESTIMONY AND SERVED FIRST
, WE'LL START OFF WITH THE
BEHAVIOR HEALTH CONTRACTORS
ASSOCIATION. THANK YOU. GOOD
EVENING. LISA COUGH KINS BORG
WITH THE BEHAVIORAL HEALTH
CONTRACTORS ASSOCIATION, A SANTA
CLARA COUNTY WIDE NETWORK OF
COMMUNITY BASED NONPROFIT
ORGANIZATIONS PROVIDING MENTAL
HEALTH SUBSTANCE USE. AND
TRANSITIONAL HOUSING SERVICES TO
CHILDREN, ADULTS AND ADOLESCENTS
. SANTA CLARA COUNTY'S CONTRACT
PROVIDERS REPRESENT 90% OF THE
SAFETY NET SERVICE SYSTEM. THANK
YOU FOR THE OPPORTUNITY TO SPEAK
WITH YOU. I WILL FOCUS MY
REMARKS ON CALLUM. BUT URGED THE
COMMITTEE TO DEVOTE A FUTURE
MEETING TO THE IMPACT OF THE
MODERNIZATION OF MHS. A IT MAY
SHORE UP SOME SERVICES, BUT AT
THE SAME TIME IT CREATES GAPS
AND CARE. CHANGES UNDER CAL AIM
AND THE BEHAVIORAL HEALTH
PAYMENT REFORM REPRESENTS THE
MOST SEISMIC SHIFTS TO SAFETY,
NET BEHAVIORAL HEALTH SYSTEMS
AND OVER HALF A CENTURY.
COUNTIES AROUND THE STATE ARE
DEALING WITH THIS TRANSITION IN
A VARIETY OF WAYS. THE
EXPERIENCE OF PROVIDERS IN SANTA
CLARA COUNTY OFFERS BOTH A
CAUTIONARY TALE AS WELL AS AN
EXAMPLE OF HOW TO STABILIZE THE
SYSTEM ON THE VERGE OF COLLAPSE,
THE SYSTEM THAT SERVES THE MOST
VULNERABLE CHILDREN,
ADOLESCENTS, ADULTS ON MEDICAL
WHO HAVE FACED ENORMOUS BARRIERS
TO ACCESSING CARE, INCLUDING
RACISM. SANTA CLARA COUNTY
ADOPTED SYSTEM WIDE RATES FOR
ALL PROVIDERS IN JULY, 2023. AS
CONTEXT WE WERE PROVIDED AMONG
THE HIGHEST RATES IN THE STATE
OF ANY COUNTY. THE RATES
IMPLEMENTED, REIMBURSE CONTRACT
PROVIDERS BETWEEN 54 TO 72% OF
THE RATES THE COUNTY IS
RECEIVING FOR THE SERVICES
PROVIDED PROGRAMS DEEMED
INTENSIVE WERE PROVIDED AT 10%
RATE DIFFERENTIAL TO ACCOMMODATE
FOR NECESSARY BUT NON
REIMBURSABLE SERVICES. THE
PAYMENT STRUCTURE DOES NOT
DIFFERENTIATE BETWEEN POPULATION
SERVED LEVELS OF CARE. COMMUNITY
BASED CARE REQUIRED OR NON
BILLABLE REQUIRED ACTIVITIES,
TREATS ALL OUTPATIENT AND ALL
INTENSIVE PROGRAMS AS IF THEY
WERE FUNCTIONALLY THE SAME.
WHICH AS I'M SURE YOU ALL KNOW
THEY ARE NOT A PERSON A SERVICE
PROVIDED TO A CLIENT WHO COMES
TO AN OFFICE IS VERY DIFFERENT
THAN THE SAME SERVICE PROVIDED
TO SOMEONE WHO IS ENGAGED IN THE
ENCAMPMENT IN WHICH THEY LIVE.
LOOKING BACK, ONE CAN SEE THE
DEVELOPMENT OF A PERFECT STORM
SINCE JULY. RUSHED
IMPLEMENTATION DUE TO STATE
DELAYS AND CHALLENGES, UPDATING
ELECTRONIC HEALTH RECORDS AND
BILLING SYSTEMS LEAD TO VERY
LIMITED VISIBILITY INTO THE
IMPACT OF PAYMENT REFORM DURING
THE FIRST QUARTER OF THIS YEAR.
BY THE TIME THE DATA BECAME
AVAILABLE IN THE FOURTH MONTH,
IT WAS CLEAR THE SERVICE SYSTEM
WAS IN JEOPARDY. THE MAJORITY OF
AGENCIES ARE FACING SIGNIFICANT
LOSSES AND DESPERATELY SOUGHT
SUPPORT FOR THE COUNTY IN ORDER
TO SURVIVE SURVIVED LONG ENOUGH
TO BUILD A NEW SYSTEM THAT
INCENTIVIZES EFFICIENCY AND
QUALITY CARE. IN SOME CASES, THE
RATES WERE NOT SUFFICIENT TO
COVER THE COSTS. BUT IN ADDITION
THE SHIFT IN BILLING FROM BY THE
MINUTE TO CPT PROCEDURE CODES
RESULTED IN A LOSS OF 10 TO 20%
OF BILLING REVENUE THAT FURTHER
IMPACT LIMITED THE EFFECTIVENESS
OF THE RATES. OUR COUNTY IS
IMPLEMENTING A STRATEGY THAT
COULD SERVE AS A MODEL FOR OTHER
COUNTIES. THE COUNTY JUST ON
TUESDAY PASSED A REPORT OFFERING
OUTPATIENT MENTAL HEALTH
PROVIDERS ADDITIONAL FISCAL
SUPPORT TO COVER ANY OPERATING
LOSSES FOR THE REST OF THE REST
OF THE FISCAL YEAR AND PROVIDING
GRANTS TO AGENCIES THAT
SUCCESSFULLY TRANSITION. THIS
WILL ALLOW US TO STABILIZE THE
SYSTEM AS WE COLLABORATIVELY
SEEK TO DEVELOP A COUNTY PAYMENT
MODEL THAT WILL NOT HAVE
DISASTROUS UNINTENDED
CONSEQUENCES, WHICH A CURRENT,
WHICH ARE BUILT INTO THE CURRENT
COUNTY PAYMENT MODELS ACROSS THE
STATE. SOME PROVIDERS ALSO
EXPERIENCED AN UNINTENDED
CONSEQUENCE OF KELLY. UM,
IMPLEMENTATION A DRAMATIC DROP
IN REFERRALS. UP TO 30% OF THE
YOUTH. UM SENT TO A CALL CENTER
FOR SCREENING WERE REFERRED TO
MANAGED CARE PLANS, WHICH WERE
NOT PREPARED FOR THE SUDDEN
INFLUX. REFERRING PEDIATRICIANS
AND COUNTY STAFF RAISED CONCERNS
THAT THE SCREENING TOOLS LACKED
QUESTIONS ON EATING DISORDERS
AND GENDER DYSPHORIA. DHC S HAS
SINCE ISSUED FURTHER GUIDANCE
THAT ALLOWS A MEDICAL PROVIDER
TO REFER DIRECT DIRECTLY THIS
REPRESENTS THE VARIED
CIRCUMSTANCES, THE TYPE THAT WE
NEED TO BE ALERT TO,
PARTICULARLY AS WE GRAPPLE WITH
THE FINDINGS OF THE RECENT STATE
AUDIT FINDING CHILDREN ENROLLED
IN MEDICAL FACE CHALLENGES
ACCESSING BEHAVIORAL HEALTH
CARE. WHEN WE HAD THIS SHIFT
HAPPENED IN OUR COUNTY, THE
AVAILABLE SPECIALTY MENTAL
HEALTH PROVIDERS WERE NOT ABLE
TO EASILY SHIFT TO SERVING
CLIENTS UNDER MANAGED CARE DUE
TO DRASTICALLY DIFFERENT RATES,
AND I THINK ONE OF THE SPEAKERS
WILL SPEAK MORE TO THAT, UM
LATER IN THE PANEL. WHILE THIS
COMMITTEE IS FOCUSED ON MENTAL
HEALTH, SUBSTANCE USE SERVICES
ARE OFTEN INTERTWINED AND FACE
SIMILAR TRANSITIONS. IN OUR
COUNTY, THE SUBSTANCE USE
TREATMENT SYSTEM WAS DEVELOPED
USING A COST REIMBURSEMENT MODEL
THAT AUGMENTED DRUG MEDICAL THE
SECTOR IS FACING A SHIFT TO FIFA
SERVICE FOR THE FIRST TIME AND
CURRENT RATES THAT ARE NOT
SUFFICIENT TO MAINTAIN SERVICES.
FOR EXAMPLE, OUTREACH AND
PREVENTION SERVICES ARE
IMPORTANT TOOLS, WHICH
PRACTITIONERS USED TO ENGAGE AND
ENROLL CHILDREN. AND. UM BUT ARE
NOT MEDICAL BILLABLE. A MAJOR
CHALLENGE FACING ADULT SERVICE
PROVIDERS IS WHETHER THEY WILL
HAVE SUFFICIENT CLIENT VOLUME
JUST COVER THEIR COSTS BECAUSE
MANY CLIENTS DO NOT ENGAGE IN
SERVICES AND THERE ARE HIGH NO
SHOW RATES FOR APPOINTMENTS.
AGAIN OUR PLAN COULD SERVE AS A
MODEL FOR STABILIZATION. THE
COUNTY IS CONTINUING COST
REIMBURSEMENT THROUGH ALL OF THE
FISCAL YEAR, COUPLED WITH GRANTS
TO FUND CLIENT OUTREACH AND
ENGAGEMENT IS PROVIDERS PREPARED
TO SHIFT TO FEE FOR SERVICE.
THUS FAR I'VE SPOKEN ABOUT SHORT
TERM MEASURES FOR STABILIZATION.
THEY ALLOW US TO FOCUS ON THE
HARD WORK OF DETERMINING
FISCALLY VIABLE RATES THAN
INCENTIVIZED CLIENT DRIVEN
SERVICES WHILE MEETING
OBJECTIVES OF CALLUM AND PAYMENT
REFORM. THE CURRENT METHODOLOGY
OF ONE RATE FOR THE ENTIRE
SYSTEM POSES A LONG TERM DANGER
IS IT COULD PROVIDE DR PROVIDERS
OUT OF THE PROGRAMS WHICH DO NOT
COVER THE COSTS. THE COMMUNITIES
ARE MEMBERS SERVE OFTEN HAVE
GOOD REASON FOR MISTRUST OF
INSTITUTIONS AND LIVE IN
UNDERSERVED AREAS. LACKING
TRANSPORTATION ARE MEMBERS
SUCCEED, WORKING THROUGH TRUSTED
COMMUNITIES AND GOING INTO
STREETS, HOMES AND SCHOOLS WHEN
NEEDED. A PAYMENT REFORM MODEL
BASED ON ONE SIZE FITS ALL.
CLINIC BASED MODELS OF CARE WILL
DRIVE THESE UNIQUE AND
CULTURALLY COMPETENT CBOS OUT OF
BUSINESS, CREATE GAPS IN SERVICE
AND WORSE, THE OUTCOMES WILL
REFLECT THAT. A MORE NUANCED
REIMBURSEMENT STRUCTURE SO THAT
EACH PROGRAM LEVEL OF CARE IS
FISCALLY VIABLE, AND PROVIDERS
CAN DETERMINE THEIR PROGRAM
MIXED BASED ON COMMUNITY AND
SYSTEM RATHER THAN FINANCIAL
DRIVERS IS NEEDED. EARLY
GUIDANCE FROM CALL, MESA
SUGGESTED A TIERED APPROACH AND
WE HOPE TO PARTNER WITH SANTA
CLARA COUNTY TO DEVELOP
SUSTAINABLE RATES AND THAT OUR
COLLEAGUES AND OTHER COUNTIES
WILL BE ABLE TO DO THE SAME
THING. THE SHIFT OF
REIMBURSEMENT RATES BEING TIED
TO THE QUALIFICATIONS OF
CLINICIANS ON A PER UNIT BASIS.
COULD RESULT IN DEMAND
INCREASING FOR FULLY LICENSED
STAFF MEMBERS IN ORDER FOR
PROGRAMS TO SUSTAIN THEIR
OPERATION. THEY WERE SCARCE, PRE
PANDEMIC AND ARE EVEN, UM MORE
SCARCE NOW. OUTPATIENT PROVIDERS
WILL HAVE A HARD TIME SUSTAINING
OPERATIONS, WHICH ARE LARGELY
COMPOSED OF PEERS OR
PARAPROFESSIONALS, THOSE WITHOUT
DEGREES, BUT WITH A GREAT DEAL
OF EXPERIENCE, GIVEN THAT THEIR
REIMBURSEMENT RATES ARE LOWER
THE MOST CRITICAL RESOURCE IN
OUR BEHAVIORAL HEALTH SYSTEM IS
OUR WORKFORCE. THE INTENSITY OF
WORKING IN THE SPECIALTY
BEHAVIORAL HEALTH SYSTEM PUTS
OUR WORKFORCE AT HIGHER RISK OF
BURNOUT. THE PANDEMIC DECIMATED
AND ALREADY DWINDLING WORKFORCE,
FOLLOWED BY KALAM'S AMBITIOUS
PAYMENT REFORM PROPOSAL.
LEARNING NEW BUILDING SYSTEMS.
E. HR MODIFICATIONS, MULTIPLE
CHANGES HAS STRESSED AND ALREADY
STRESSED WORKFORCE. BEHAVIORAL
HEALTH EMPLOYEES HAVE MORE
OPTIONS THAN EVER TO CHOOSE
FROM. CBOS ARE HISTORICALLY AT
THE LOWER END OF SALARIES AND
OTHER ALTERNATIVES HAVE LESS
DOCUMENTATION. WELL KELLY HAS
REDUCED DOCUMENTATION. THE
EXTENT IS NOT CLOSE TO THE
AMOUNT NEEDED. OUR STATE
ASSOCIATIONS ARE WORKING TO
ADDRESS THIS WITH LEGISLATIVE
PROPOSALS AND WORK WITH THE
ADMINISTRATION AS LONG AS
PROVIDERS SPEND MORE TIME DOING
UNNECESSARY PAPERWORK THAN
TREATING CLIENTS IN NEED WILL
HAVE BOTH A WORKFORCE CRISIS AND
A BEHAVIORAL HEALTH CRISIS.
FINALLY IT'S CRITICAL TO KEEP
INVESTING IN WORKFORCE
DEVELOPMENT. THE EXISTING
EFFORTS ARE MAKING A DIFFERENCE,
BUT NEED TO BE BROUGHT TO SCALE
COMMENSURATE WITH THE PROBLEM.
MY COLLEAGUES ARE FINDING GREAT
RESULTS FROM THE MENTORED
INTERNSHIP PROGRAM AND LOCALLY
PALO ALTO UNIVERSITY WAS FUNDED
FOR AN INNOVATIVE CONTRACT THAT
FUNDS 50 CURRENT CALIFORNIA
COUNTY EMPLOYEES. TO EARN THEIR
MENTAL HEALTH COUNSELING DEGREE.
THANK YOU SO MUCH FOR HOLDING
THIS IMPORTANT HEARING AND FOR
YOUR INDIVIDUAL LEADERSHIP ON
THESE CRITICAL ISSUES. I HOPE
THAT YOU WILL CONSIDER ALL
MEMBERS OF THE BEHAVIORAL HEALTH
CONTRACTORS ASSOCIATION AS A
RESOURCE AS WE GRAPPLE WITH THE
ONGOING CHANGES IN THIS SYSTEM
AND PROVIDING CRITICAL SERVICES
TO THOSE WE IN NEED. THANK YOU.
THANK YOU SO MUCH. NEXT, WE'LL
MOVE ON TO THE MATERNAL OUTREACH
MOVES SERVICES PROGRAM AT EL
CAMINO HEALTH. WELCOME THANK YOU
. MY NAME IS NICOLE TO RUI. I'M
A REPRODUCTIVE PSYCHIATRIST AND
THE MEDICAL DIRECTOR OF THE
MATERNAL OUTREACH MOOD SERVICES
PROGRAM AT EL CAMINO HEALTH. UM
CHAIR JACKSON, BEISTER PELLERIN,
SENATOR CORTEZ. THANK YOU SO
MUCH FOR HAVING ME THIS EVENING
AND I ALSO WANTED TO EXPRESS MY
APPRECIATION FOR YOU SHARING
YOUR PERSONAL STORIES ABOUT HOW
MENTAL ILLNESS HAS TOUCHED EACH
OF YOU. I APPRECIATE THE
INVITATION TO SPEAK WITH YOU.
AND I LOOK FORWARD TO ANSWERING
ANY QUESTIONS THAT YOU HAVE.
AFTER MY REMARKS BEFORE I START
TO ADDRESS SOME OF THE GAPS THAT
PATIENTS EXPERIENCE, I'D LIKE TO
BRIEFLY EXPLAIN THE ROLE THAT AL
CAMINO HEALTH PLAYS AS A SERVICE
PROVIDER. SO MEMBERS OF THE
COMMITTEE AND THE PUBLIC HAVE
THIS CONTEXT. WE HAVE SOME
SLIDES TO REFER TO ALSO. AS A
HEALTHCARE DISTRICT HOSPITAL. EL
CAMINO HEALTH HAS MADE A MULTI
DECADE COMMITMENT TO PROVIDING
HIGH QUALITY MENTAL HEALTH AND
ADDICTION SERVICES. WHEN WE
THINK OF PATIENTS, WE FOCUS ON
HIGH QUALITY OUTCOMES,
PERSONALIZED AND SPECIALIZED
TREATMENT THAT IS THE MOST
APPROPRIATE AND OFFERING
SERVICES THAT COVER MUCH OF THE
CONTINUUM OF CARE. AS PART OF
OUR TREATMENT PHILOSOPHY, WE
SEEK TO CARE FOR SIMILAR PATIENT
POPULATIONS TOGETHER AS THIS
SUPPORTS IMPROVED CLINICAL
OUTCOMES. AS AN EXAMPLE OF THIS,
I WORK IN THE INPATIENT WOMEN'S
SPECIALTY UNIT, WHICH OFFERS
TREATMENT FOR WOMEN EXPERIENCING
PERINATAL CONDITIONS. I'M ALSO
THE MEDICAL DIRECTOR OF THE MOMS
PROGRAM AND MOSTLY WORK WITH
PREGNANT AND POSTPARTUM PATIENTS
EXPERIENCING MENTAL HEALTH
CONDITIONS. WE ARE AN OPEN
SYSTEM, AND THIS MEANS THAT WE
WORK WITH A VARIETY OF COMMUNITY
. MENTAL HEALTH CLINICIANS, FULL
TIME AND PART TIME EMPLOYEES AS
FAR AS INDEPENDENT CONTRACTORS.
THESE INDIVIDUALS REPRESENT A
WIDE RANGE OF CLINICAL ROLES
SUCH AS PSYCHIATRISTS,
PSYCHIATRIC NURSES, CLINICAL
THERAPISTS AND OCCUPATIONAL
THERAPISTS. WE ALSO ACCEPT A
WIDE RANGE OF INSURANCE PLANS.
CAMINO HEALTH, MENTAL HEALTH AND
ADDICTION SERVICES. CLINICIANS
PROVIDE SUPPORT FOR OUR TO
EMERGENCY DEPARTMENTS. AND THIS
IS OFTEN THE SETTING WHERE
PATIENTS WITH ACUTE BEHAVIORAL
HEALTH NEEDS ARE IDENTIFIED.
PATIENTS WHO MAY BE IMMINENTLY
SUICIDAL OR EXPERIENCING ACUTE
PSYCHOSIS OR MANIA, WHERE THEY
POSE A SAFETY RISK. UTILIZE
ACUTE HOSPITALIZATION. THESE
HOSPITAL STAYS ARE DESIGNED FOR
STABILIZATION AND SAFETY. STEP
DOWN TO LOWER ACUITY SETTINGS
AND FOLLOW UP CARE IS CRITICAL
TO ENSURE THE BEST OUTCOMES FOR
THE PATIENTS. PARTIAL
HOSPITALIZATION PROGRAMS ARE
TYPICALLY FIVE DAYS OUT OF THE
WEEK. 6 TO 8 HOURS PER DAY AND
COVER GROUP THERAPY, INDIVIDUAL
THERAPY AS WELL AS PSYCHIATRIC
MEDICATION MANAGEMENT. INTENSIVE
OUTPATIENT PROGRAMS ARE
TYPICALLY 3 TO 5 DAYS OF THE
WEEK FOR AT LEAST THREE HOURS
PER DAY. THE FOCUSES ON GROUP
WORK TO HELP PATIENTS DEVELOP
ADDITIONAL SKILLS FOR MANAGING
SYMPTOMS. THE OUTPATIENT LEVEL
OF CARE IS THE LEVEL WHERE A
PATIENT MAY SEE A PSYCHIATRIST
PERIODICALLY FOR MEDICATION
MANAGEMENT OR THERAPY. OR
ANOTHER LICENSED CLINICIAN FOR
THERAPY, DEPENDING ON THEIR
SYMPTOMS. IN THIS SLIDE, YOU CAN
SEE MANY OF THE CONDITIONS AND
PATIENT POPULATIONS THAT EL
CAMINO HEALTH TREATS. BEFORE
DIVING INTO SOME OF THE GAPS
THAT I SEE AS A MEDICAL DIRECTOR
AND PRACTICING PSYCHIATRISTS
LIKE TO UNDERSCORE THE
COMPLEXITY OF THE SYSTEM,
LIMITED FUNDING AND THE
CHALLENGE OF ENACTING CHANGE. I
GREATLY APPRECIATE THE
COMMITTEE'S WORK AND HOLDING
HEARINGS LIKE TODAY'S IN ORDER
TO LEARN MORE ABOUT WHAT WE
EXPERIENCE AS ON THE GROUND
PROVIDERS IN BEHAVIORAL HEALTH.
THE SPIRIT OF MY REMARKS TONIGHT
IS TO SHARE GAPS THAT I AND MY
COLLEAGUES AT EL CAMINO HEALTH
EXPERIENCE AS WELL AS POTENTIAL
POLICY IDEAS THAT COULD MAKE IT
EASIER TO SUSTAINABLY OFFER HIGH
QUALITY SPECIALIST BEHAVIORAL
HEALTH SERVICES FOR ALL
CALIFORNIANS. AS YOU SEE ON THIS
SIDE, A MAIN GAP IS ACCESS TO
THE RIGHT LEVEL OF CARE FOR THE
PATIENT. PATIENTS GET DELAYED
FROM BEING DISCHARGED FROM THE
ACUTE INPATIENT PSYCHIATRIC UNIT
, WHERE THERE IS A SHORTAGE OF
BEDS AT LOWER ACUITY, LEVELS OF
CARE, FOR EXAMPLE, RESIDENTIAL
TREATMENT IS A LEVEL OF CARE FOR
PATIENTS WHO ARE UNABLE TO LIVE
AT HOME WHILE RECEIVING CARE. TO
MAKE THIS POINT MORE CONCRETE,
TYPICALLY ACUTE INPATIENT
PSYCHIATRIC UNITS ARE INTENDED
FOR SHORT STAYS TYPICALLY 7 TO
10 DAYS IN DURATION. IN THE PAST
SEVERAL YEARS WE'VE EXPERIENCED
ONE OUT OF 15 ACUTE INPATIENT
PSYCHIATRIC PATIENTS WITH STAYS
AT OR LONGER THAN 30 DAYS, WHO
WEREN'T ABLE TO BE DISCHARGED
DUE TO CAPACITY SHORTAGES AT
OTHER LEVELS OF CARE. THIS MEANS
THAT THESE OCCUPIED INPATIENT
PSYCHIATRIC BEDS WEREN'T
AVAILABLE FOR THOSE WHO TRULY
NEEDED THEM. ANOTHER GAP IS THAT
PATIENTS GET TO TAKE PATIENTS
GET TAKEN TO THE EMERGENCY
DEPARTMENT FOR PSYCHIATRIC
SERVICES BECAUSE THEY OR THEIR
FAMILIES ARE NOT ABLE TO ACCESS
LOWER INTENSITY SERVICES TO
STABILIZE SYMPTOMS. AND, LASTLY,
PATIENT ACCESS FOR SOME PROGRAMS
CAN BE MORE LIMITED. FOR EXAMPLE
, NOT ALL OUTPATIENT PROGRAMS
EXCEPT MEDICAL DUE TO
REIMBURSEMENT AND ADMINISTRATIVE
CHALLENGES. ANOTHER GAP IS
SCREENING AND LINKING PATIENTS
TO QUALITY OUTPATIENT SERVICES,
WHICH CAN BE PREVENTATIVE.
PATIENTS EXPERIENCED CHALLENGES
BEING SCREENED AND IDENTIFIED
WHEN THEY HAVE MILD OR MODERATE
MENTAL HEALTH SYMPTOMS, AND
PATIENTS CAN FACE INADEQUATE
NETWORKS, WHICH MAKE IT
DIFFICULT TO HAVE TIMELY ACCESS
TO OUTPATIENT CLINICIANS. IN
MANY CASES, PATIENTS WILL RESORT
TO PAYING OUT OF POCKET OR
FOREGOING TREATMENT ALTOGETHER.
AND FOR MANY PATIENTS THIS
AFTERNOON RESULTS IN WORSENING
MENTAL HEALTH SYMPTOMS THAT
REQUIRE STABILIZATION AND HIGHER
LEVELS OF CARE, FOR EXAMPLE, IN
THE EMERGENCY DEPARTMENT OR
INPATIENT SETTING. ANOTHER GAP
IS ADEQUATE REIMBURSEMENT.
HEALTH PLANS DON'T ALWAYS
DIFFERENTIATE REIMBURSEMENT
BASED ON SPECIALIZATION. SO, FOR
EXAMPLE, A SPECIALIZED PROGRAM
LIKE THE MOMS PROGRAM OR MY
SPECIALIZATION AND ADDITIONAL
TRAINING, REPRODUCTIVE
PSYCHIATRY IS OFTEN NOT
REIMBURSED AT A HIGHER RATE THAN
MORE GENERAL PROGRAMS. HEALTH
PLANS DETERMINE USUAL AND
CUSTOMARY REIMBURSEMENT RATES.
THIS METHODOLOGY MAY NOT ALWAYS
INCORPORATE ALL OF THE PROVIDERS
WHO ARE OUT OF NETWORK OR ONLY
ACCEPTING CASH. IF THIS OCCURS
USUAL AND CUSTOMARY,
REIMBURSEMENT RATES MAY BE
DEPRESSED BELOW THE TRUE LEVEL
OF, UM, OPERATING BEHAVIORAL
HEALTH SERVICES. ON THE IN
PATIENT SIDE. MEDICAL RATES
DON'T COVER COSTS AND
REIMBURSEMENT TYPICALLY DROPS TO
AN ADMINISTRATIVE RATE ONCE A
PATIENT HAS DEEMED ELIGIBLE FOR
DISCHARGE TO OUR LOWER INTENSITY
SETTINGS SUCH AS RESIDENTIAL
LEVEL OF CARE, EVEN IF THAT BED
ISN'T AVAILABLE, I'D LIKE TO
FURTHER EXPLAIN THE
ADMINISTRATIVE RATE ISSUE. AND
THE INPATIENT SIDE FOR A PATIENT
MEDICAL ONLY COVERS A PORTION OF
THE HOSPITAL COSTS PER DAY WITH
AN ADMINISTRATIVE RATE MEDICAL
REIMBURSEMENT DROPS MORE THAN
50% WHILE THE HOSPITAL COSTS
REMAIN THE SAME. ANOTHER GAP IS
RECOGNITION OF QUALITY BENEFITS
FROM SPECIALIZED TRAINING AND
CARE. THE SHORTAGE OF MENTAL
HEALTH AND ADDICTION SERVICES AT
ALL LEVELS OF CARE MEANS THAT
PATIENTS CAN END UP IN WHICHEVER
PROGRAM HAS AVAILABILITY RATHER
THAN THE BEST PROGRAM FOR THEM
AS A PATIENT. FOR EXAMPLE, THE
MOMS PROGRAM IS A RARE PROGRAM
THAT FOCUSES ON PERINATAL AND
POSTPARTUM MOMS, AND THERE'S A
LIMITED NUMBER OF PERRY NEEDLE.
PSYCHIATRISTS WERE ONE OUT OF
FIVE PROGRAMS IN THE STATE OF
CALIFORNIA AND THE ONLY ONE IN
THE BAY AREA. INPATIENT
REIMBURSEMENT TYPICALLY IS AT A
SINGLE RATE, WHICH DOESN'T VARY
BASED ON THE ACUITY OF THE
PATIENT. SO, FOR EXAMPLE, IT
WON'T DELINEATE BETWEEN A
PATIENT EXPERIENCING DEPRESSION
OR A POSTPARTUM MOM EXPERIENCING
PSYCHOSIS WHO'S REQUIRING 1 TO 1
ASSISTANCE FOR TREATMENT. THIS
PAYMENT STRUCTURE CAN BE A
DISINCENTIVE FOR OPERATING, MORE
FOCUSED AND SPECIALIZED
PROGRAMS. WHICH COULD ACHIEVE
THE BEST CLINICAL OUTCOMES FOR
PATIENTS. SOME POTENTIAL POLICY
IDEAS. THE FIRST IS TO
INCENTIVIZE AND OFFER GREATER
FINANCIAL SUPPORT FOR FOCUSED
AND SPECIALIZED PROGRAMS WHEN
NEEDED FOR CERTAIN PATIENT
POPULATIONS, FOR EXAMPLE, PERRY
NEEDLES, PSYCHIATRIC CARE AND
ACUTE INPATIENT BEHAVIORAL
HEALTH SERVICES THAT ARE
INTEGRATED WITH OTHER ACUTE
CLERIC CARE, CLINICAL SERVICES.
THE SECOND IS TO MAINTAIN
MEDICAL REIMBURSEMENT FOR
INPATIENT CARE WHEN A PATIENT IS
ELIGIBLE TO BE DISCHARGED, BUT
MUST WAIT DUE TO LIMITED
AVAILABILITY IN OTHER CLINICAL
SETTINGS. AND LASTLY, IS TO HOLD
HEALTH PLANS ACCOUNTABLE TO
ENSURE THAT THE USUAL AND
CUSTOMARY REIMBURSEMENT RATES
ARE STRUCTURED TO REFLECT THE
MARKET AND TRUE COST OF
OPERATING BEHAVIORAL HEALTH
SERVICES. CHAIR JACKSON BEISTER
PELLERIN, SENATOR CORTEZ E.
THANK YOU AGAIN FOR THE
OPPORTUNITY TO ADDRESS YOU AND
FOR HOLDING THIS IMPORTANT FIELD
HEARING, I'D ALSO LIKE TO THANK
AND TO ACKNOWLEDGE THE MANY
DEDICATED BEHAVIORAL HEALTH
PROFESSIONALS IN THE STATE OF
CATTLE, CALIFORNIA IN THE COUNTY
BEHAVIORAL HEALTH DEPARTMENTS AS
WELL AS CLINICIANS WHO DELIVER
THESE CRITICAL HEALTH SERVICES
EVERY DAY. THANK YOU. THANK YOU
VERY MUCH FOR THAT. NOW WE WILL
HAVE THE SENATE CRUZ CHAPTER OF
THE CALIFORNIA ASSOCIATION OF
MARRIAGE AND FAMILY THERAPIST.
WELCOME THANK YOU SO MUCH FOR
HAVING ME AND DR JACKSON. I'M SO
SORRY FOR YOUR LOSS AND
ASSEMBLYMEMBER'S PELLERIN. I'VE
KNOWN FOR AWHILE ABOUT YOUR
HUSBAND AND I REALLY FEEL FOR
YOU AND HOW HARD THAT IS. FOR
HOW LONG THANK YOU. ALSO TO MY
CO PANELISTS. YOU GUYS WERE
AWESOME. THAT WAS REALLY ON
POINT. UM COMMENTS AND THERE'S
SO MUCH OVERLAP, EVEN THOUGH I'M
IN PRIVATE PRACTICE. THERE'S SO
MUCH OVERLAP IN THE CONCERNS
THAT WE ALL DEAL WITH, UM, YOU
PROBABLY HAD MORE INTENSIVE
LEVEL, SO I'M HERE PRIMARILY TO
TALK ABOUT WHAT KEEPS US FROM
TAKING INSURANCE AND MEDICAL UM,
I'VE BEEN A LICENSED CLINICIANS
SINCE 2006. I WAS THE PAST
PRESIDENT OF SANTA CRUZ CAMPED
IN MY AND I'M ON THE LEGISLATIVE
COMMITTEE FOR STATE CAMPED.
WHICH IS THE BIG ORGANIZATION OF
MARRIAGE AND FAMILY THERAPIST IN
CALIFORNIA. UM. THERE ARE SO
MANY ASPECTS OF THIS. IT WAS
KIND OF HARD TO EVEN NAIL.
REDUCE THEM DOWN, AND I PUT OUT
SOME QUERIES TO OTHER MEMBERS OF
THE SANTA CRUZ CAMP AREA TO SEE
WHAT THEY HAD TO SAY ABOUT WHAT
THEIR EXPERIENCES HAVE BEEN
TAKING INSURANCE, NOT TAKING
INSURANCE AND HOW THEY MAKE
THEIR DECISIONS. UM. THERE ARE
THERE'S ONE THING THAT STARTS
SORT OF AT THE BEGINNING. AND I
THINK IT WAS YOUR PROGRAM THAT
ADDRESSED SOME OF THAT WHICH IS
THAT THE COST OF GRADUATE SCHOOL
IS SO PROHIBITIVE THAT WE LOSE
ALMOST ALL PEOPLE OF COLOR. WE
LOSE ALMOST EVERYBODY WHO IS
POOR BECAUSE YOU CANNOT AFFORD
TO DO TO GO AND YOU COME OUT
WITH HUGE STUDENT LOANS, AND WE
HAVE VERY FEW PUBLIC SCHOOL
SETTINGS FOR GAINING THOSE OUT
FOR GAINING THAT TRAINING AND
EDUCATION. UM. THEN ONCE WE DO
THAT, WE THEN HAVE 3000 HOURS OF
COUNTIES LIKE MINE ALMOST ALWAYS
UNPAID LABOR THAT YOU HAVE TO
PUT IN BEFORE YOU CAN GET
LICENSED AND WE LOSE A LOT OF
PEOPLE TO THOSE HOURS AS WELL.
PEOPLE IF I WAS IN TEXT SO I
COULD AFFORD TO KIND OF PUT
MYSELF THROUGH ALL OF THAT. SO
MANY COLLEAGUES CAN'T. THEY ALSO
GET INTERRUPTIONS FOR HAVING
PREGNANCIES FOR HAVING CARING
FOR SICK FAMILY MEMBERS FOR ALL
THE THINGS THAT COME UP IN LIFE?
THEY END UP NOT GETTING LICENSED
, AND THEY ALSO STILL HAVE THE
BURDEN OF THESE BIG STUDENT
LOANS. UM SO WE DO A LOT OF
KETCHUP AFTERWARDS, AND THAT IS
A REALLY BIG FACTOR IN HOW
PEOPLE CAN AND CAN'T ACCEPT
INSURANCE, HOW THEY CAN AND
CAN'T GO INTO PUBLIC PRACTICE.
UM WE, UH ONCE. ONCE YOU HAVE
YOUR LICENSE IN HAND, YOU STILL
HAVE TO WAIT FOR MANY INSURANCE
PLANS FOR TWO YEARS BEFORE YOU
CAN ACCEPT ANY INSURANCE BY THE
TIME YOU'VE DONE THOSE TWO
YEARS, THERE'S A GAP THAT
HAPPENS FOR, UM THAT. IN THOSE
TWO YEARS. YOU YOU DO NOT GET
REIMBURSED, AND WE DO NEED TO
HAVE SOME OF THOSE
REIMBURSEMENTS START AT THE
BEGINNING RIGHT AFTER YOU
EITHER. DURING THE HOURS THAT
YOU'RE GAINING WHILE YOU'RE IN
GRADUATE SCHOOL OR RIGHT
AFTERWARDS. AS SOON AS YOUR
LICENSE THAT YOU START TO BE
ABLE TO BE REIMBURSED IS THAT
THEY WON'T TAKE YOU ON THEIR
PANELS FOR THE FIRST TWO YEARS
IS USUALLY WHAT HAPPENS. UM AND
SO, BY THE TIME YOU GET TO THOSE
TWO YEARS, YOU ALREADY HAVE
HOPEFULLY AN ESTABLISHED
PRACTICE THAT YOU CAN THE
WORKING FROM AND THEN TRYING TO
GET CONTINUITY OF CARE THROUGH
INSURANCE PANELS FOR YOUR
CLIENTS ARE ALREADY EXISTING.
IT'S IN IT'S A NIGHTMARE. IT
JUST TAKES SO MANY HOURS OF WORK
TO TRY TO GET THOSE TO GET ONTO
A PANEL. ONCE YOU'RE ON A PANEL,
YOU HAVE TO AGREE TO ACCEPT ALL
THE CLIENTS THAT THEY NOT
NUMBERS WISE, BUT IF THEY WANT
TO SEE ANY MORE CLIENTS, YOU
HAVE TO AGREE TO ACCEPT THEM.
BUT YOU DON'T NECESSARILY HAVE
THE ROOM TO OR THE ABILITY TO
BECAUSE THE REIMBURSEMENT RATES
ARE SO LOW. UM SO THOSE THINGS
ARE ALL SORT OF THE BACKDROP FOR
WHY PEOPLE HAVE A REALLY HARD
TIME, YOU KNOW, REALLY LOOKING
AT FROM THE BEGINNING OF THEIR
CAREERS, HOW TO ACCEPT INSURANCE
OR NOT. A LOT OF PEOPLE GO INTO
COUNTY WORK AGENCY WORK,
ETCETERA. BUT IF YOU'RE BURDENED
BY A GIGANTIC STUDENT LOAN, YOU
CAN'T AFFORD TO UM, SO YOU ALSO
CAN'T AFFORD THE RATES THAT
MEDICAL PAYS, IN PART, BECAUSE
IF YOUR SOLO PRACTITIONER YOU
HAVE TO HANDLE ALL YOUR BUILDING
YOURSELF OR HIRE A BILLING
SERVICE TO DO THAT, WHEN YOU'RE
DEALING WITH STRAIGHT UP
BUILDING. IT'S NOT THAT BIG OF
AN ISSUE, BUT SO MANY TIMES WE
HAVE CHALLENGES WITH INSURANCE
COMPANIES. WE DON'T GET PAID.
YOU DON'T GET PAID ON TIME. THEY
CHALLENGE ALL KINDS OF DIFFERENT
ASPECTS OF IT. YOU YOU ALWAYS
NEGOTIATING WITH HIM? I
PERSONALLY HAVE A BUILDING
SERVICE THAT I USE SIMPLY. I
COULD DO ON MY OWN BUILDING. I
JUST CANNOT DEAL WITH A NUMBER
OF HOURS IT TAKES TO DEAL WITH
PROBLEMS. IT'S SO EXPENSIVE AND
IT'S PROHIBITIVE TO ME AND ALSO,
I HATE THAT STUFF. AND MANY
THERAPISTS, PARTLY, WE DON'T
TAKE MEDICAL BECAUSE THE
PAPERWORK IS SO BAD. YOU JUST
LIKE I PERSONALLY HAVE OPTED AND
I KNOW A NUMBER OF PEOPLE OPT TO
SEE PEOPLE PRO BONO RATHER THAN
WORK WITH MEDICAL THAT IT IS
LESS EXPENSIVE TO JUST SEE
PEOPLE FOR FREE AND EAT THAT OUR
AND IT IS TOO FIGHT WITH MEDICAL
TO GET THE PAPERWORK TO GO
THROUGH ALL OF THE DIFFERENT
THINGS YOU HAVE TO GO THROUGH TO
GO THROUGH THE AUDITS TO GO
THROUGH EVERY DIFFERENT ASPECT
THAT YOU HAVE TO GO THROUGH.
IT'S NOT WORTH IT TO US. UM AND
MEDICAL REQUIRES MORE PAPERWORK
THAN MOST INSURANCE COMPANIES DO
, AND MANY INSURANCE COMPANIES
STILL REQUIRED QUITE A BIT OF
PAPERWORK. UM WE ALSO HAVE
PROBLEMS AROUND. UH
REIMBURSEMENT RATES IS A BIG ONE
SANTA CRUZ COUNTY I DON'T KNOW
IF IT STILL IS, BUT FOR MANY
YEARS WAS CONSIDERED A RURAL
COUNTY SO REIMBURSED AT RURAL
RATES. WE MIGHT BE PARTLY A
RURAL COUNTY. BUT WE ARE SO
EXPENSIVE. IT IS JUST A TERRIBLY
EXPENSIVE PLACE TO LIVE AND TO
TRY TO SET UP A PRACTICE AND TO
BE REIMBURSED AT A BIG CHUNK
BELOW. WHAT WE WOULD GET IF WE
WORKED IN THE BAY AREA IS, UM
IT'S A REAL CHALLENGE FOR
PEOPLE. UM THE. ONE OF THE
THINGS THAT HAPPENS WITH
INSURANCE COMPANIES IS CLAWBACKS
. UM SO THEY HAVE FOR OBVIOUS
REASONS. YOU KNOW IF YOU BUILD
UNDER FALSE PRETENSES, IF YOU DO
ANYTHING, THEY CAN TAKE THE
MONEY BACK. BUT SO MANY TIMES
THE CLAWBACKS HAPPEN FOR REALLY,
UM MINISCULE REASONS. PAPERWORK
NOT DOING A LITTLE BIT OF
PAPERWORK. UH THERE ARE ALL
KINDS OF SITUATIONS IN WHICH YOU
CAN GET CLAWBACKS AND THAT'S THE
INSURANCE COMPANY TAKING THAT
MONEY OUT OF THE MONEY THAT THEY
WERE GOING TO PAY YOU FOR
SOMETHING ELSE. SO YOU'RE
ALREADY DEALING WITH A LOW RATE
OF REIMBURSEMENT. AND THEN ON
TOP OF THAT, YOU GET THAT MONEY
SUCKED RIGHT BACK OUT OF YOUR
BANK ACCOUNT. UM, THE WORK IT
TAKES TO FIGHT. THIS CLAWBACKS
IS SOMETIMES ALSO PROHIBITIVE.
SOMETIMES IT'S JUST WORTH IT TO
JUST LIKE, OKAY. I'M NOT GOING
TO DEAL WITH THIS ONE. I CAN'T
AFFORD TO NOT WORK THOSE
BILLABLE HOURS IN ORDER TO DEAL
WITH THE PAPERWORK OF THIS ONE.
SO YOU JUST LET THEM GO. UM
THERE. ONE OF THE THINGS THAT WE
ALL WOULD LIKE TO HAVE. ISRAEL
IS COST OF LIVING INCREASES TO
ACTUALLY HAPPENED FOR US.
THERE'S A COMBINATION OF WE
DON'T GET COST OF LIVING
INCREASES. IT'S INCREDIBLY HARD
TO FIND ANYBODY AT THE INSURANCE
COMPANY WHO WILL TALK WITH YOU
AND HELP YOU THROUGH THAT
PROCESS. THERE'S NO TRANSPARENCY
ABOUT IT. THERE'S VERY LITTLE
TRANSPARENCY AT ANY LEVEL ABOUT
WHAT YOU'RE GOING TO BE
REIMBURSED BY INSURANCE
COMPANIES. SO YOU IF YOU WANT TO
BE ON A PANEL, YOU DON'T HAVE
VERY MUCH NEGOTIATING ROOM AND
YOUR SOLO PERSON SO YOU CAN'T
NEGOTIATE AS A GROUP RIGHT? WE
WERE NOT ALLOWED TO FOR
ANTITRUST REASONS. WE HAVE TO
NEGOTIATE ON OUR OWN FOR EACH
DIFFERENT INSURANCE COMPANY THAT
WE WANT TO BE ON. I MYSELF HAVE
NOT HAD AN INCREASE IN RATES. IN
MORE THAN A DECADE. UM BUT MY
COST OF OPERATING HAS GONE UP
CONSIDERABLY OVER A DECADE. AND
WE DON'T THERE'S. THERE'S NO
REALLY GOOD MECHANISMS FOR
GETTING THOSE RATES TO INCREASE.
IT WOULD BE GREAT IF THERE WERE
UM SOME OF THE STUFF THAT HAS
COME UP FOR PEOPLE WHEN I WAS
TALKING WITH THEM, OR UH, THE
REVAMPING REVAMPING OF THE WAYS
THAT INTERNS ARE PAID. UM WHICH
IS A PROBLEM? WE HAVE A LOT OF
INTERNS. WE WHO HAVE BEEN DOING
THIS FOR A WHILE LIKE TO
SUPERVISE INTERNS, AND WE CAN
GET THEM INTO GET THEIR HOURS
THROUGH. BUT THE WAYS THAT WE
HAVE TO WORK. THE INTERNSHIP
HOURS IS IT'S TOO LONG TO
EXPLAIN, AND SOME OF YOU MIGHT
ALREADY KNOW HOW SOME OF THIS
WORKS. IT IS A PAIN IN THE NECK.
AND SO PEOPLE ARE ALL INVENTING
THEIR DIFFERENT WAYS TO MAKE THE
INTERNSHIPS THE INTERNS BE ABLE
TO GET PAID. UM SO REVAMPING
THAT CHANGING THE TENURE
REQUIREMENT IN PUBLIC SCHOOL IN
PUBLIC, UH PRACTICE FOR STUDENT
LOAN FORGIVENESS TO EXPAND IT SO
THAT MORE PEOPLE CAN HAVE THAT
STUDENT LOAN FORGIVENESS FOR
OTHER WORK THAT THEY DO. BESIDES
IN TITLE ONE SCHOOLS BESIDES IN
COUNTY WORK, BESIDES IN, UM THE
REALLY HIGH NEEDS PLACES, SO
MUCH OF WHAT WE DO IS HIGH NEEDS
ALL THE TIME. IT WAS ESPECIALLY
DURING THE PANDEMIC WE HAVE. I
MEAN, I'M SURE YOU GUYS DON'T
WITH THIS, BUT THE INFLUX OF
KIDS JUST THIS YEAR I PROBABLY
TOOK MAYBE 20 CALLS A WEEK. 10
TO 20 CALLS A WEEK. PEOPLE
LOOKING FOR SERVICE AND ALMOST
ALL OF THOSE WERE FOR CHILDREN.
AND WE JUST DON'T HAVE THE
CAPACITY FOR IT. UM I'M ASSUMING
THAT'S MY BILL. THERE. UM SO UH,
IN SOME, THERE ARE SO MANY
BLOCKS TO US TAKING INSURANCE,
AND PEOPLE WOULD BE REALLY
WILLING TO IF WE COULD. IF IT
THIS IS THE SITUATION WAS
SIMPLIFIED IF WE WEREN'T
NEGOTIATING WITH EACH INDIVIDUAL
INSURANCE PANEL IF WE HAD RATES
THAT COULD BE THAT WERE
TRANSPARENT. UM AND YEAH. IF THE
PROCESS OF GOING THROUGH SCHOOL
WERE NOT SO EXPENSIVE THAT IT
PUTS PEOPLE AT A DISADVANTAGE TO
START WITH. THANK YOU VERY MUCH
FOR YOUR TIME. THANK YOU FOR
WORKING ON THIS. THANK YOU.
BOTH. THANK YOU PALACE SO VERY
MUCH COLLEAGUES. ANY QUESTIONS?
AH! SO. ONTO THE YOU KNOW THE
COUNTY BEHAVIORAL HEALTH. GROUP.
UM. WHAT CAN WE DO? I MEAN, YOU
KNOW, THIS SOUNDS LIKE A
HORRIBLE SITUATION YOU'RE FACING
AND, UM WHAT CAN WE DO TO HELP
AND EASE THAT FISCAL CLIFF THAT
I FEEL LIKE YOU'RE ON. UM YOU
KNOW, I THINK IT'S REALLY
FOCUSING ON THE CLIENT AND THE
SERVICES THEY NEED AND
DETERMINING WHAT HOW WE ARE
GOING TO PAY FOR SERVICES BASED
ON WHAT'S NEEDED. AND BUILD THE
FISCAL MODEL THAT WAY SO THAT IF
SOMEONE NEEDS A SERVICE THAT
INVOLVES MORE TIME OR DRIVING
THAT IT CAN BE PROVIDED AND
DOESN'T HAVE TO BE OFFSET WITH,
YOU KNOW, BUILDING A, UM AN
ORGANIZATION THAT HAS PROGRAMS
THAT ARE WINNERS AND THOSE THAT
ARE LOSERS THAT WE REALLY NEED
TO LOOK AT, UM, DIVERSIFYING THE
RATES AND MATCHING THEM TO THE
COST THAT GOES INTO THE
DIFFERENT SPECIFIC SERVICES. UM.
I THINK THE STATE AND THE
COUNTIES AND THE PROVIDERS NEED
TO REALIZE THAT LARGE CHANGES
REQUIRE A LOT OF PARTNERSHIP.
AND THAT THERE'S EXPERTISE UM
AND LEGITIMATE CONCERNS THAT GET
RAISED THAT NEED TO BE HEATED.
YOU KNOW WHAT LOOKS RIGHT ON
PAPER IN TERMS OF RATES OR
PROCESSES AND, YOU KNOW WHAT WE
THINK OF AS OKAY. THIS IS
MANAGED CARE. IT NEEDS TO WORK,
NOT JUST ON PAPER, BUT IT NEEDS
TO WORK WHEN SERVING POPULATIONS
THAT REQUIRE A LOT OF INTENSE
SERVICES. DEFINITELY HAVE A LOT
OF WORK TO DO THERE. THANK YOU,
UM I DIDN'T UNDERSTAND. REALLY?
WHAT CLAWBACKS ARE WHAT? WHAT IS
THAT CLAWBACK IS WHEN, UH, AN
INSURANCE COMPANY HAS PAID YOU
FOR SERVICES AND THEN THEY GO
THROUGH THEIR PROCESS, AND WHEN
THEY'RE ADJUSTING, THEY REALIZED
THAT THERE'S SOME REASON OR
ANOTHER, MANY OF THEM THAT THEY
ARE NOT GOING TO ACCEPT THE
AMOUNT WHAT THEY PAID YOU SO
THEY ALL DENY THE SERVICE
RETROACTIVELY. AND THEN THEY
TAKE THAT MONEY BACK OUT OF YOUR
OUT OF YOUR BANK ACCOUNT AFTER
THEY'VE ALREADY PAID YOU AFTER
THEY'VE ALREADY PAID YOU. YES,
IT'S REALLY FUN. SUPER FUN. WOW
YEAH, AGENCIES AND STUFF CAN GET
MUCH BIGGER CLAWBACKS OR
STEPPING FORWARD THAT YOU HAVE
NO DEDUCTIONS MADE FROM THEIR
MOUTH THAT THEY'RE GONNA PAY
YOU, BUT, UM, YEAH, THAT'S HOW
CLAWBACKS WORK FOR US. AND WHAT
WHEN I DO I'VE BEEN THINKING
ABOUT IS, UM, LIKE YOU WERE
SAYING THAT FOR YOU TO GET
COVERAGE BY AN INSURANCE PLAN.
YOU HAVE TO GO AND APPLY TO THAT
ONE. AND THEN IF YOU WANT A
DIFFERENT ONE, YOU GOT APPLY TO
THAT ONE AND WE'RE ALL FAMILIAR
WITH THE COMMON APP RIGHT FOR
PEOPLE APPLYING FOR UNIVERSITY
ENROLLMENTS. UM WOULD THAT BE
SOMETHING THAT I MEAN? IT SEEMS
LIKE IT WOULD BE HELPFUL TO HAVE
SOMETHING LIKE THAT. AND TO HAVE
SOME TRANSPARENCY AROUND IT. AND
UM AND THEN TO BE ABLE TO SEE
WHAT THE DIFFERENT INSURANCE
COMPANIES ARE WILLING TO PAY
FOR, AND NOT PAY FOR A COMMON
APP WOULD BE IDEAL. OKAY. GOOD
WORK ON THAT. THANK YOU. THANK
YOU. AND I THINK I TOURED YOUR
FACILITY. RIGHT? WHERE'S DR JOHN
COWAN? UM YEAH. YEAH, I DID. I
TURNED THAT RIGHT. IT'S
INCREDIBLE WHAT YOU'RE DOING
THERE FOR MOMS, AND WE JUST
LEARNED TODAY ABOUT HOW
CRITICALLY IMPORTANT IT IS FOR
US TO ADDRESS. THE UM UM, YOU
KNOW, MOM, YOU KNOW NEW MOMS
THAT ARE HAVE DEPRESSION AND ARE
TRYING TO YOU KNOW, GET THEIR
LIVES TOGETHER, AND WE HEARD A
STARTLING STATISTIC TODAY THAT
IT'S LIKE SUICIDES LIKE THE
NUMBER ONE CAUSE OF DEATH FOR
THEM, AND UM YOU HAVE AN AMAZING
FACILITY, THOUGH THAT ALLOWS THE
MOMS TO BE THERE WITH THEIR
THEIR INFANTS AS WELL. SO THANK
YOU FOR EVERYTHING YOU'RE DOING.
UM, JUST IT SEEMS. AND WHAT'S
THE BED FACILITY THAT YOU HAVE?
HOW MANY BEDS DO YOU HAVE THERE?
FOR THE IMPATIENT SIDE, WE
AVERAGE BETWEEN 6 TO 8 BEDS. UM
SO THAT UNIT IS DIRECTLY
CONNECTED TO OUR MOMS PROGRAM.
AND AS YOU CAN IMAGINE, A MOM IN
CRISIS MAY FLUCTUATE OVER TIME,
SO HAVING THAT SEAMLESS CARE
ACTUALLY IS QUITE CRITICAL FOR
MANY OF THESE PATIENTS AND JUST
THE DIFFICULTY AND GETTING THEM
TO MOVE ON TO LOWER ACUITY. CARE
YOU'RE SAYING IS RIGHT, SO THE
UNIQUE THING ABOUT EL CAMINO
HEALTH IS THAT WE HAVE ACCESS TO
THE ONLY INPATIENT PERINATAL
UNIT IN THE WEST COAST. AND THAT
IS PHYSICALLY ON CAMPUS WHERE
OUR MOMS PROGRAM IS LOCATED. SO
WHEN A MOM MAYBE HAVING MORE
ACUTE SYMPTOMS, SHE CAN GO
STRAIGHT INTO INPATIENT FROM OUR
PROGRAM, AND THEN WHEN SHE
STABILIZED DIRECTLY BACK TO US,
SO IT'S COMPLETELY SEAMLESS.
WELL THANK YOU FOR EVERYTHING
YOU'RE DOING THERE. THANK YOU.
SENATOR CORTESI. THANK YOU, MR
CHAIR. UM. I'M WONDERING, I
GUESS, PARTICULARLY FROM HIS
PAGAN ELLIE. WHERE I THINK MAYBE
YOU SEE IT MORE, BUT IT
SHOULDN'T BE OPEN TO HEARING
FROM ANYONE. UM WHAT KIND OF
EXPERIENCE YOU HAVE WITH
UTILIZATION REVIEW ITSELF FROM
FROM THE PRIVATE INSURERS SO
THAT I UNDERSTAND CALLBACK WAS
ALMOST SOUNDS LIKE SORT OF THE.
THE WORST CASE, UM IN SOME WAYS,
BUT WE YOU HEAR CONSTANTLY FROM
CONSTITUENTS HERE IN THE COUNTY
FIND THEIR WAY TO OUR OFFICE.
ESPECIALLY IN AREAS LIKE YOU
SERVE IN AREAS LIKE WE'RE
DEALING WITH TODAY. MENTAL
HEALTH AND ADDICTION THAT
THEY'RE EITHER DENIED RIGHT FROM
THE GET GO AND HAVE TO GO
THROUGH AN APPEALS PROCESS,
WHICH IS CAN LITERALLY BE DEADLY
FOR FOLKS BECAUSE IT'S SUCH A
LENGTHY PROCESS. AH AND OR
THERE. THEY'RE THEY'RE APPROVED
THERE A PROOF TO GO, YOU KNOW,
FROM THE PROVIDER STANDPOINT TO
BEGIN TREATMENT. AND THEN
BASICALLY TOLD AFTER 15 DAYS. UM
YOU SHOULD BE. HE SHOULD BE FINE
NOW. I MEAN, ESSENTIALLY, THAT'S
THE MESSAGE. AND WE'VE HEARD
THAT ON ON THE SENATE SIDE IN
OUR HOUSE AND IN TESTIMONY AS
WELL, NOT JUST FROM, YOU KNOW
FROM PROVIDERS. UM WE ALSO HEAR,
YOU KNOW, PUSH BACK ON THAT, AND
WE THINK THE NUMBERS AND WITH
SOME INSURERS ARE AS HIGH AS 87%
AND DENIAL. THAT'S A REAL NUMBER
THAT WE THAT CAME UP IN
TESTIMONY. WOULDN'T PUT THAT OUT
IF I DIDN'T HAVE THAT ON THE
RECORD IN A IN A PRIOR HEARING.
UM WHAT? LET ME JUST LET YOU
ANSWER, YOU KNOW, MAYBE MAYBE
NOT. EVERYONE IN THIS ROOM HAS,
YOU KNOW UNDERSTANDS WHAT KIND
OF A CHALLENGE THAT IS. I DO
WANT TO SAY SENATOR WIENER A
COUPLE OF YEARS AGO, ACTUALLY,
JUST BEFORE I GOT TO THE SENATE
IN 2019 PASSED THE BILL. I WANT
TO SAY IT'S SENSIBILITY 55 OR
885 APOLOGIZE ON THE NUMBER. UM
THE SO CALLED PARITY BILL,
SAYING YOU CAN'T DO THAT. YOU
DON'T DO THAT, WITH A PHYSICAL
INJURY. YOU CAN'T DO THAT. WITH
THE BEHAVIORAL HEALTH OR MENTAL
HEALTH INJURY. UM BUT THE
RULEMAKING ON ADAM POINTED OUT.
FOUR YEARS LATER. YOU KNOW WE'RE
BACK THERE AT THE TABLE, AND I
SAYING UM, WE DON'T THINK WE'RE
GETTING PARODY, AND I JUST I
JUST WANT TO HEAR WERE RIGHT OR
WRONG ABOUT THAT. YOU DEFINITELY
NOT GETTING PARODY PARODY. FOR
THOSE OF YOU WHO DON'T KNOW WHAT
IT IS, IS TREATING SIGNIFICANT
MENTAL HEALTH ILLNESSES THE SAME
AS YOU WOULD TREAT A PHYSICAL
HEALTH ILLNESS. SO UM, GIVING
COVERAGE, MAKING SURE PEOPLE
HAVE THE CARE THAT THEY NEED.
THROUGHOUT THE TIME THAT THEY
ARE AFFECTED BY THAT, UM, THERE
ON THE U OURS I USED TO BE DO
YOURS AND, UH, BUT I'M OUT OF
TOUCH ABOUT HOW SOME OF THEM
WORK. PART OF WHY I DON'T DO
VERY MUCH INSURANCE WORK IS
ACTUALLY BECAUSE YOURS ARE A
PAIN IN THE NECK. UM AND THEY
AGAIN THEY TAKE SO MANY HOURS
THAT YOU CAN DO OTHER STUFF, BUT
I WILL GO BACK TO CAMP, THEN ASK
THEM THEY'LL HAVE THOSE NUMBERS.
UM, THE STATE WILL TO, UH TO
GIVE MORE INFORMATION ABOUT
THOSE. IT IS REALLY CHALLENGING
TO TRY TO GET PEOPLE THE
SERVICES THAT THEY NEED, UM WHEN
YOU'RE DEALING WITH AN INSURANCE
COMPANY. UM AND THEN MOST PEOPLE
DON'T HAVE THE KIND OF MONEY IT
TAKES TO GET THOSE SERVICES OUT
OF POCKET, SO IT'S A SERIOUS
CHALLENGE. ONE OF THE AND WE
JUST SAY IT'S JUST APPRECIATE
THAT IN ANY, UM YOU KNOW, POST
HEARING INFORMATION YOU CAN GET
TO IT WOULD BE GREAT. UM, I
TALKED TO A LOCAL PROVIDER HERE
IS GETTING REFERRALS FROM THE
COUNTY WHO TOLD ME THAT ONE OF
THE COUNTY WE KNOW THE HEALTH
PLAN IS ACTUALLY ONE OF THE MOST
DIFFICULT TO GET PAST
UTILIZATION REVIEW, WHICH WAS
KIND OF SHOCKING TO ME BECAUSE
OH COUNTY AFFILIATED PLAN, WHICH
IS IN A IN EFFECT, THEN PUSHING
THE INDIGENT, PUSHING THE CASE
HOLD RIGHT BACK TO THE COUNTY TO
THE TAXPAYER. COST RIGHT. SO IT
SHOULD WITH THE SHIFT WILL BE
FROM THE INSURANCE. PLAN UH,
BACK OVER TO THE PUBLIC SIDE. IF
YOU THINK OF IT THAT WAY. UM
LASTLY, YOU KNOW, IT'S STARTING
TO OCCUR TO ME. UM MY
PREDECESSOR'S WORK, SENATOR BILL
SENATOR WEINER'S WORK, AND THEN
WE INTRODUCED A BILL. SENATE
BILL 999 THAT UM TRY TO MODIFY
AND ACCELERATE UTILIZATION
REVIEW AND GET BETTER RESULTS
OUT OF IT WAS FINE IN BOTH
HOUSES GOT VETOED, PROUD TO SAY
ONE OF MY ONLY VETOES, BUT ALSO
DISAPPOINTED IN THAT. UM BUT. I
AM STARTING TO THINK THAT EVEN
THE PARODY SORT OF OFFHAND
DEFINITION THAT WE USE IS NOT
GOOD ENOUGH BECAUSE PEOPLE OFTEN
SAY EVEN IN IN HEARINGS LIKE
THIS YOU WOULDN'T TREAT A BROKEN
LEG LIKE THAT. BUT YOU CAN'T
REALLY COMPARE A BROKEN LEG TO
THE DISEASE THAT PEOPLE ARE
FACING THAT MAY REQUIRE MUCH
MORE INTENSIVE, UM, TREATMENT
FOR MUCH LONGER PERIODS OF TIME
THAN A BROKEN LEG EVERWOOD, SO
IT'S REALLY SOMETHING MORE LIKE
PARODY. PLUS THAT I THINK WE
NEED AND UM, WE'LL TRY TO GET
THERE BUT THANK YOU FOR
RESPONDING AND I WANT TO JUST
ADD SOMETHING FROM THE INPATIENT
SIDE WHERE THIS TYPICALLY COMES
UP WHEN A PATIENT IS
HOSPITALIZED. THERE IS A PROCESS
WHERE, UM, THE INSURANCE IS KIND
OF TAKING A LOOK AT WHAT'S GOING
ON. AND THERE'S AN EXTRAORDINARY
AMOUNT OF PRESSURE TO GET
PATIENTS OUT AS QUICKLY AS
POSSIBLE. AND SOME OF THE ISSUES
AROUND THAT IS THAT THEY'RE NOT.
THERE MAY NOT ACTUALLY BE AN
APPROPRIATE LEVEL OF CARE TO
STEP THAT PATIENT DOWN, AS I WAS
MENTIONING BEFORE IS THAT THERE
MAY NOT BE THAT RESIDENTIAL BED
OR AN OPENING IN A PROGRAM AND
YET WE'RE GETTING PRESSURE FROM
THE INSURANCE COMPANY TO
DISCHARGE THE PATIENT. UM THE
SECOND ISSUE IS THAT WHEN THERE
IS A DENIAL AND SAY, FOR
EXAMPLE, I DO APPEAR TO APPEAR
WITH THE INSURANCE COMPANY AND
THEY DENY MY REQUEST FOR MORE
DAYS. THE HOSPITAL THEN EATS
THAT COST BECAUSE I'M NOT
COMFORTABLE SENDING SOMEBODY OUT
AND PUTTING THEM OUT ON THE
STREET WHEN THEY'RE NOT READY SO
ULTIMATELY THE HOSPITAL AND HAS
TO COMPENSATE FOR THAT. SO THE
SHIFT IS OCCURRING AGAIN,
BASICALLY EXACTLY SOMETHING THAT
WE PEOPLE THINK I'M TALKING
AGAIN ABOUT PRIVATE INSURERS
THAT PREMIUMS ARE BEING PAID
FOR. UM INSTEAD OF GETTING THE
FULL BENEFIT OF THE BARGAIN. UM
PART OF THAT SIGNATURE. PART OF
THE COST IS BEING PICKED UP
EITHER BY PRIVATE HOSPITALS OR
PUBLIC SYSTEMS. EXACTLY. THANK
YOU. THANK YOU, MR CHAIR. THANK
YOU, SENATOR. UM THERE'S BEEN A
LOT OF TALK ABOUT RATES. AND
THEN, OF COURSE, UM I SAID, I
SAID ON ASSEMBLY SUBCOMMITTEE,
ONE HEALTH AND HUMAN SERVICES,
AND WE SPENT A LOT OF TIME ABOUT
THE M C O TAX. ABOUT THE HOPE
THAT THAT WILL BEGIN TO HELP
RAISE THE RATES IN TERMS OF
MEDICAL REIMBURSEMENTS. NUMBER
12 ARE YOUR STATEMENTS TAKING
THAT INTO ACCOUNT OR YOU'RE ARE
YOU SAYING THAT WE SPENT ALL
THAT WORK FOR AN HOUR STILL
BEHIND THE BALL? YOU'RE IN A
SAFE PLACE. THAT'S TRUE. YEAH. I
THINK WE'RE JUST STARTING TO SEE
WHAT THOSE RATES ALL LOOK LIKE,
UM, THE DISPARITY BETWEEN UM
SPECIALTY MENTAL HEALTH RATES
AND THE MANAGED CARE RATES ARE
STILL REALLY GREAT. I THINK EVEN
WHEN THAT'S TAKEN INTO ACCOUNT,
SO YOU DO CONTINUE. UM. TO TWO,
I THINK, MAKE IT MORE DIFFICULT
TO MORE SMOOTHLY SERVE. ALL THE
SERVED CLIENTS THROUGHOUT THE
CONTINUUM OF SERVICES.
PERSONALLY I HAVEN'T SEEN A
CHANGE YET. AND I THINK THAT, UM
THERE HAS ALSO BEEN FREQUENT
DELAYS IN TERMS OF REIMBURSEMENT
. AND SO THERE'S BEEN A PERIOD
OF TIME WHERE THERE WAS LIKE A
SIX MONTH GAP IN WHICH I DIDN'T
SEE ANY REIMBURSEMENTS. AND
THAT'S STILL KIND OF ONGOING, SO
I CAN'T ACTUALLY GIVE YOU A
SPECIFIC ANSWER AS TO IF I'VE
SEEN IMPROVEMENTS BECAUSE OF THE
DELAYS ROOM PAYMENT. I'M NOT
DIRECTLY AFFECTED BY THOSE, BUT
I WILL SAY TO THE DELAYS IN
PAYMENT, ESPECIALLY FROM MEDICAL
AND SOMETIMES FROM INSURANCE.
THIS IS ONE OF THE THINGS THAT
JUST KEPT COMING UP OVER AND
OVER MONTHS AND MONTHS OF NOT
GETTING PAID AND THREE MONTHS
FIRST ONE PERSON SIX MONTHS, BUT
IT WAS REALLY COMMON FEEDBACK
ABOUT THAT. UM AND THE DELAYS IF
YOU'RE IN PRIVATE PRACTICE, YOU
KNOW YOU DON'T HAVE ANY MONEY TO
OPERATE YOUR BUSINESS. YOU KNOW,
WE WE'VE HEARD THAT NUMBER ONE.
WE'VE HEARD CLEARLY THAT WE WILL
WORK ON A HEARING TO TALK ABOUT
THE MENTAL HEALTH SERVICES ACT
REFORM. BUT I THINK ALSO WILL
PROBABLY DO INCLUDE THE CEO TAX
ON THAT. OBVIOUSLY IT HASN'T
TAKEN EFFECT YET. BUT WE ARE WE
KNOW THAT WE SHOULD BE, AND
WE'RE GONNA HAVE TO FIND OUT
EXACTLY THE SCHEDULE OF WHEN
THOSE RATES WILL BE WILL BE
ENACTED. BUT OUR HOPE. AS A
LEGISLATURE IS TÂM IS THAT AH WE
WILL BEGIN TO SEE THOSE RATES
INCREASE BECAUSE WE KNOW HOW
MUCH THOSE RATES HAVE BEEN
NEGLECTFUL OVER THE YEARS,
RIGHT? SO WE LOOK FORWARD TO
CONTINUE TO HEAR HEARING BACK
FROM YOU. ONCE THOSE THINGS
BEGIN TO TAKE EFFECT. OKAY
COLLEAGUES, ANYTHING ELSE BEFORE
WE MOVE ON TO THE NEXT PANEL?
THANK YOU ALL SO VERY MUCH.
REALLY APPRECIATE IT. THANK YOU.
WE WILL MOVE ON TO OUR NEXT
PANEL, WHICH IS DIVERSIFIED
YOUTH MENTAL HEALTH SERVICES.
AND WE ARE SO HAPPY TO HAVE
COUNSELING AND SUPPORT SERVICES
FOR YOUTH. MOMENTUM FOR HEALTH.
AS WELL AS THE SANTA CLARA
COUNTY OFFICE OF EDUCATION. AND
WE'LL ACTUALLY START OFF WITH
OUR, UM COUNTY SUPERINTENDENT.
OF SCHOOLS, UM, FOLLOWED BY
MOMENTUM FOR HEALTH AND THEN
COUNSELING AND SUPPORTIVE
SERVICES FOR YOUTH. WELCOME. SEE
YOU. THERE WE GO. THANK YOU SO
MUCH. DOCTOR JACKSON AND THIS
SIMPLY MEMBER PELLERIN FOR
INVITING ME THIS EVENING TO BE
HERE AND ALSO A LOT OF GRATITUDE
AS SENATOR CORTEZ E AS WELL.
THANK YOU FOR PRIORITIZING THIS
HEARING AND PROVIDING SPACE FOR
US TO TALK ABOUT THE NEEDS OF
OUR YOUNG PEOPLE AND SOME OF THE
OBSERVATIONS WE HAVE HAD,
INCLUDING SOME OF THE SUCCESSES
AND POTENTIALLY SOME OF THE
NEEDS THAT MIGHT LEND THEMSELVES
TO POLICY. SO I WANTED TO START
BY SHARING A LITTLE BIT OF OUR
OBSERVATIONS ABOUT HOW GREAT THE
NIDA'S AMONGST OUR YOUTH. AND AS
MANY AS 75% OF YOUTH HAVE SELF
REPORTED EXPERIENCING DEPRESSION
, ANXIETY OR FEELINGS OF
HOPELESSNESS. WE HAVE ALSO BEEN
HEARING FROM MANY EXPERTS AND
SOME OF OUR OWN OBSERVATIONS
INDICATE THAT IT COULD TAKE MANY
YEARS FOR STUDENTS AND YOUTH. TO
RECOVER FROM SOME OF THE IMPACTS
OF THE COVID 19 PANDEMIC. WE ARE
SEEING INCREASING LEVELS OF
CRISIS NEED AMONGST OUR STUDENTS
. CRISIS LEVEL OF NEED FOR CARE.
INCREASED SUICIDE RATES. CHRONIC
ABSENTEEISM AT THE HIGHEST RATES
WE'VE EVER SEEN AND ADVERSE
CHILDHOOD EXPERIENCES THAT ARE
LEADING TO POST TRAUMATIC STRESS
. UM AND A LOT OF OTHER NEEDS,
SHOWING UP IN THE CLASSROOM AND
IN OUR SCHOOL CAMPUSES. WE'VE
ALSO SEEN SIGNIFICANT
INVESTMENTS THAT HAVE, UM,
REALLY ENABLED US TO EXPAND
SERVICES, AND WE RECOGNIZE THAT
THERE IS AN ESSENTIAL NEED TO
SUSTAIN THESE EFFORTS AS IT WILL
TAKE MANY YEARS FOR OUR YOUNG
PEOPLE TO RECOVER. I WANTED TO
MENTION SOME OF THE STRENGTH OF
OUR PARTNERSHIPS AND SANTA CLARA
COUNTY THAT HAVE ALLOWED US TO
IMPLEMENT SOME MODELS THAT ARE
YIELDING BENEFITS. IN SANTA
CLARA COUNTY, WE ESTABLISHED A
CONSORTIUM OF THE COUNTY OFFICE
OF EDUCATION PLUS R. 31 SCHOOL
DISTRICTS ARE COUNTING
BEHAVIORAL HEALTH SERVICES
DEPARTMENT AND THE NUMBER OF
COMMUNITY BASED ORGANIZATIONS.
THROUGH THIS WORK, WE HAVE BEEN
ABLE TO EXPAND SCHOOL BASED
BEHAVIORAL HEALTH SERVICES
INCREASED ACCESS TO SCHOOL BASED
SERVICES AND IMPLEMENTED A
WELLNESS INTERMODAL. OUR
WELLNESS. INTERMODAL HAS CERTAIN
CORE COMPONENTS, INCLUDING THAT
WE HAVE PERSONNEL THAT STAFF THE
WELLNESS CENTERS, INCLUDING A
SPECIALIST WHO IS LICENSED OR
CREDENTIAL. AND A LIAISON WHO
HAS A BACKGROUND AND WORKING IN
BEHAVIORAL HEALTH. AND HAS AN
ASSOCIATES OR BACHELOR'S LEVEL
DEGREE. WE ARE SUCCESSFULLY
IMPLEMENTING THIS MODEL ON
ELEMENTARY, MIDDLE AND HIGH
SCHOOL CAMPUSES THROUGHOUT THE
COUNTY. IT IS FURTHERING OUR
EFFORTS AT THE STIGMATIZATION,
WHICH WE KNOW MANY OF OUR
CHILDREN AND THEIR FAMILIES SAY
IS INCREDIBLY IMPORTANT. AND THE
WELLNESS CENTERS ARE INCREASING
ACCESS BECAUSE THEY ARE OPEN AND
AVAILABLE TO STUDENTS BEFORE,
DURING AND AFTER SCHOOL. THIS IS
PART OF OUR COUNTY WIDE APPROACH
TO SCHOOL BASED HEALTH AND
WELLNESS, AND I DID WANT TO
START ALSO BY SHARING A DATA
POINT. AND CURRENTLY JUST
LOOKING AT THE WELLNESS CENTERS
OPERATED BY THE COUNTY OFFICE OF
EDUCATION ON SCHOOL DISTRICT
CAMPUSES THROUGHOUT THE COUNTY.
WE STARTED IN OUR FIRST YEAR
WITH FOUR WERE UP TO 19. SINCE
AUGUST OF 2022. WE HAVE HAD
21,713 CENTER VISITS. AGAIN
INDICATING THE HIGH NEED AND
WE'VE SERVED OVER ALMOST 3000
STUDENTS. WHEN WE IDENTIFY HOW
STUDENTS MADE THEIR WAY INTO THE
WELLNESS CENTERS, 82% ARE SELF
REFERRED. SO THE STUDENTS
THEMSELVES AND MAKE THAT
REQUEST. SUSTAINABLE FUNDING IS
KEY TO THIS EFFORT INTO THIS
EXPANSION, AND I WAS ASKED TO
SPEAK ABOUT HOW WE UTILIZE A
VARIETY OF FUNDING SOURCES.
CURRENTLY WE ARE FUNDING THIS
EFFORT THROUGH A VARIETY OF ONE
TIME GRANTS, INCLUDING COMMUNITY
SCHOOL PARTNERSHIP PROGRAM
GRANTS. THE MENTAL HEALTH
SERVICES SCHOOL BASED SERVICES
ACT, THE SP HIP PROGRAM, A
COUPLE OF SMALL FEDERAL GRANTS
AND GRANTS FROM NON PROFITS AND
FOUNDATIONS, AS WELL AS
DONATIONS. SUSTAINABLE FUNDING
IS GOING TO BE KEY TO THE
SUSTAINABILITY AND EXPANSION OF
THE WELLNESS CENTERS, AND WE ARE
WORKING DIRECTLY WITH OUR SCHOOL
DISTRICTS TO CREATE THE
SUSTAINABILITY PLANS LOOKING AT
DIFFERENT LAYERS OF FUNDING, AS
WELL AS ADVOCATING FOR SOME
CHANGES IN THE WAY THAT THAT
CERTAIN FUNDING MECHANISMS ARE
IMPLEMENTED TO MAKE THEM MORE
ACCESSIBLE FOR SCHOOLS. ALSO I
WANTED TO SHARE THAT, UM,
COMMUNITY ENGAGEMENT IS REALLY
IMPORTANT AT THE WELLNESS
CENTERS AND INCLUDING OUR
STUDENTS, SO ONE OF OUR PROGRAMS
IS OUR STUDENT WELLNESS ADVISORY
GROUP THAT HAS STUDENTS
REPRESENTING AGES 14 TO 21. FROM
THROUGHOUT THE COUNTY AND THE
STUDENT WELLNESS ADVISORY GROUP
IS CRITICAL TO THE
IMPLEMENTATION AND THEY PROVIDE
INPUT ON EVERYTHING RELATED TO
THE ONENESS CENTER
IMPLEMENTATION. INCLUDING HOW
THEY HAVE ADVOCATED FOR NON
TRADITIONAL TYPES OF THERAPIES.
UM AND INDICATING THAT, UM, TALK
THERAPY IS NOT ALWAYS THE MOST
EFFECTIVE STRATEGY FOR MANY OF
OUR YOUNG PEOPLE. OUR WELLNESS
CENTERS OF ALSO SERVED A
CRITICAL ROLE. AND HELPING
GETTING EARLY INTERVENTION AND
EVEN PREVENTION ACCESS TO
ADDRESS POTENTIAL EARLY ONSET OR
PRIOR TO ONSET OF MORE SERIOUS
MENTAL HEALTH AND ILLNESS NEEDS.
OUR WELLNESS CENTER APPROACHES
BASED ON EVIDENCE AND RESEARCH,
AND WE KNOW THAT FROM THIS
RESEARCH CHILDREN ARE 21 TIMES
MORE LIKELY TO GET THE
BEHAVIORAL HEALTH SERVICES THEY
NEED WHEN THEY ARE ACCESSIBLE IN
A SCHOOL CAMPUS. RESEARCH ALSO
SHOWS THAT INTEGRATING SOCIAL,
EMOTIONAL LEARNING AND
BEHAVIORAL HEALTH INTO THE
CURRICULUM AND TO THE SCHOOL
CULTURE SIGNIFICANTLY REDUCES
STIGMA AMONGST STUDENTS AND
FAMILIES AS WELL. UM AS
SUPPORTING STAFF AND BETTER
ACCESSING THE SUPPORT FOR YOUNG
PEOPLE. AND SCHOOL BASED MENTAL
HEALTH SERVICES CAN
SIGNIFICANTLY REDUCE SCHOOL
DISCIPLINARY ACTION BY PROVIDING
A MORE THERAPEUTIC AND MORE,
APPROPRIATE SUPPORT SERVICE TO
STUDENTS IN NEED. CAN ALSO REFER
REDUCE REFERRALS INTO THE
CRIMINAL JUSTICE SYSTEM AND
REDUCE SCHOOL DROP OUT RATES.
AND TEACHERS ARE REALLY
ENCOURAGED TO USE WELLNESS
CENTERS AS AN ALTERNATIVE TO
REALLY TRY TO ADDRESS THE SELF
REGULATION NEEDS OF STUDENTS.
AND THROUGH THIS MODEL, WE'RE
ALSO LOOKING AT CURRICULUM,
EARLY INTERVENTION TOOLS THAT
SELF REGULATION ADDRESSING NEEDS
AND IMMEDIATELY WHEN THEY OCCUR,
INCLUDING ADDRESSING YOUNG
PEOPLE WHO MAY HAVE, UM. ANXIETY
DEPRESSION AND SCHOOL AVERSION.
AND WE HAVE FOUND SUCCESS WITH
THIS MODEL. I ALSO WANTED TO
SHARE A LITTLE BIT ABOUT SOME OF
THE DISPARITIES AND SOME OF THE
CONCERNS THAT WE HAVE RELATED TO
OUR CURRENT IMPLEMENTATION. ONE
OF THE INITIAL DISPARITIES THAT
WE NEED TO CONSIDER ARE THE
VARIED RATES OF MEDICAL MEDICAL
ELIGIBLE STUDENTS AMONGST
DISTRICTS AND ACROSS THE COUNTY,
WHERE SOME COMMUNITIES HAVE MUCH
HIGHER RATES OF MEDICAL ELIGIBLE
STUDENTS, OTHERS WITH THE LAST
BUT STILL SIGNIFICANT NEEDS.
THERE ARE ALSO QUITE A FEW
DISPARITIES RELATED TO THE
ABILITY TO HAVE SCHOOL BASED
PERSONNEL AVAILABLE TO MEET THE
NEEDS OF STUDENTS, INCLUDING
VARIATIONS AROUND PERSONNEL TYPE
STAFFING LEVELS AND THE TYPES OF
CREDENTIALS AND OTHER THINGS
THAT DIFFERENT FUNDING SOURCES
REQUIRE IN ORDER FOR THE SCHOOL
TO BE REIMBURSED. WE HAVE GREAT
ANTICIPATION ABOUT THE UNIVERSAL
FACE SCHEDULE AND HOW THAT IS
GOING TO BE VERY ENABLING IN
TERMS OF THE ABILITY FOR SCHOOLS
TO SEEK REIMBURSEMENT FOR
SERVICES THAT ARE PROVIDED.
HOWEVER AND THE UNIVERSAL FEES
SCHEDULE, WHICH IS SLATED TO
START IN JANUARY, WE'LL START
WITH A VERY SMALL COHORT OF
ALLIGATORS ACROSS THE STATE. AND
THERE WILL BE A WIDE VARIATIONS
AND READINESS AND INFRASTRUCTURE
FOR ELIA'S ACROSS THE STATE TO
ACTUALLY UTILIZE THE SCHEDULE.
WE WANT TO MAKE HEAVY
INVESTMENTS IN THIS SPACE
BECAUSE WE DO THINK IT WILL BE
ENABLING, BUT WE NEED TO SUSTAIN
THE ONE TIME FUNDING THAT'S BEEN
BEEN MADE AVAILABLE TO BUILD OUT
THIS INFRASTRUCTURE AND NEED TO
BE AWARE THAT THERE MAY BE
ONGOING NEED AN ADDITIONAL YEAR
OR TWO IN ORDER FOR ALL ELIA'S
TO BE IN A STATE OF READINESS TO
PARTICIPATE? VARIATIONS AND
FUNDING ARE ALSO A BARRIER AND
CREATE THESE DISPARITIES AS MANY
OF THE POSSIBLE FUNDING SOURCES
CURRENTLY AVAILABLE TO SCHOOLS
TO BUILD INFRASTRUCTURE AND TO
EXPAND SERVICES ARE ONE TIME
COMPETITIVE GRANTS AND NOT ALI
A'S HAVE THE INFRASTRUCTURE TO
EVEN PURSUE THOSE GRANTS. LASTLY
I WANTED TO MENTION THE L E. A
BILLING OPTION PROGRAM AND SOME
OF THE ONEROUS AUDIT AND
BUILDING PROCESS REQUIREMENTS
VERY SIMILAR TO WHAT YOU HEARD
ON. THE INITIAL POWER PANEL. AND
VERY FEW SCHOOLS ACTUALLY USED
THIS BUT THIS MECHANISM BECAUSE
OF THE ONEROUS POLICIES AND OUR
STATE IN TERMS OF THE WAY IT'S
IMPLEMENTED. AND HOW EVEN YEARS
AFTER A SCHOOL DISTRICT HAS
RECEIVED FUNDING THAT THEY'RE
REQUIRED TO PAY FUNDS BACK FOR
USUALLY VERY MINOR REASONS.
THANK YOU. THANK YOU. NOW WE
WILL MOVE ON TO MOMENTUM FOR
HEALTH. GOOD EVENING. GOOD
EVENING CHAIR. JACKSON VICE
CHAIR, PILLAR AND SENATOR CORTEZ
E. THANK YOU VERY MUCH FOR THE
OPPORTUNITY TO BE HERE TONIGHT
TO BE ON THIS PANEL. UM AND WITH
MY DISTINGUISHED COLLEAGUES,
IT'S ALWAYS GOOD TO BE WITH
MARIANNE AND MARIKO, UM. BEFORE
I START THE PREPARED TEXT. I
JUST WANT TO SAY, UM, HOW
GRATEFUL I AM. DR JACKSON AND
VICE CHAIR PILLAR AND FOR YOUR
PERSONAL STATEMENTS. AND YOU,
TOO, DAVE. UM I FEEL LIKE. DR
JACKSON. I FEEL LIKE I HAVE TO
ASK YOU YOUR IF IT'S OKAY. YOUR
BROTHER'S NAME. HIS NAME IS
DEREK. THE WORK. WE ALL DO WHAT
WE'RE TALKING ABOUT TONIGHT. UH,
IT FEELS THAT. THAT DEREK IS
CONNECTED TO WHAT WE'RE TALKING
ABOUT TONIGHT DIRECTLY. AND I
WANT TO BE ABLE TO SAY HIS NAME.
AND TO PROVIDE THESE COMMENTS.
SORT OF IN MEMORY OF DEREK. UM.
AGAIN MY NAME IS DAVID VENDETTA.
AND AFTER THE LAST FEW YEARS
I'VE HAD THE PRIVILEGE OF BEING
PRESIDENT AND CEO OF MOMENTUM
FOR HEALTH. BEFORE MOMENTUM I
SERVED FIVE YEARS IN OBAMA.
WHITE HOUSE IS A SENATE
CONFIRMED APPOINTEE IN THE WHITE
HOUSE DRUG POLICY OFFICE. MHM.
IT. BUT MORE IMPORTANTLY, UM.
I'M A CONSUMER OF SERVICES. UM.
AND I WANT TO THANK MY FRIENDS
FROM EL CAMINO HEALTH FOR
HELPING OUR FAMILY WHEN WE
NEEDED IT MOST. AND. IT'S GOOD
TO BE IN THIS ROOM IN THIS
COMMUNITY. UH WELL MEN WAS A
COMPREHENSIVE COMMUNITY BASED
BEHAVIORAL HEALTH. NONPROFIT
AGENCY THAT SERVES YOUTH AND
ADULTS. YOUTH FOR THE NEXT TWO
WEEKS. WE HAVE BOTH MENTAL
HEALTH AND SUBSTANCE DISORDER
SERVICES. WE HAVE OUTPATIENT
RESIDENTIAL AND CRISIS SERVICES
WHERE UNION SHOP REPRESENTED BY
S. C U 5 TO 1. AND WE ALL WORKED
REALLY HARD TO PAY OUR STAFF
WELL AND PROVIDE GOOD BENEFITS.
ALL OF THIS TO STAY ON MISSION
SERVING THE BEHAVIORAL HEALTH
NEEDS OF OUR COMMUNITIES MOST
ACUTE AND COMPLEX BEHAVIORAL
HEALTH CONDITIONS. MOMENTUM IS
BUT ONE COMMUNITY BASED
NONPROFIT AMONG A STRONG NETWORK
OF 30 AGENCIES, NEARLY ALL
MEMBERS OF THE LOCAL BEHAVIORAL
CONTRACTORS ASSOCIATION YOU
HEARD ARE AMAZING, EXECUTIVE
DIRECTOR AT LEAST A COUGH.
GINSBURG ON PANEL ONE, I FEAR
THAT MY COMMENTS I COULD JUST
SAY DITTO TO WHAT AT LEAST A
SAID SHE SAYS IT BETTER THAN ALL
OF US ALL THE TIME. THAT SAID,
I'D ASKED MY BEHAVIORAL HEALTH
BHC COLLEAGUES, MANY OF THEM IN
THE ROOM TO STAND UP. BECAUSE I
WANT TO THANK THEM FOR WHAT THEY
DO EVERY DAY.
UM DATA. WE GO INTO DATA A LOT.
I THINK I'LL SPARE YOU SOME MORE
DATA ISSUES AND DATA, YOU KNOW,
TALKING ABOUT DATA. UM. BUT WE
ARE LIVING IN A TIME OF
UNPRECEDENTED INCREASES DEMAND
FOR BETTER HEALTH SERVICES. BUT
IT'S ALSO A TIME OF EQUALLY
UNPRECEDENTED FOCUSED BY ALL
LEVELS OF GOVERNMENT. FED. STATE
AND LOCAL. IN MY 30 YEARS IN THE
FIELD. I DON'T RECALL A TIME
WHEN MENTAL HEALTH AND SUBSTANCE
USE DISORDER HAS GARNERED SO
MUCH ATTENTION AT THE SAME TIME.
BY ALL THREE LEVELS OF
GOVERNMENT. THE POLICY ATTENTION
IS GREAT, BUT THE POLICIES MUST
BE DEVELOPED IN COORDINATION
WITH THE END USERS AND
PROVIDERS. MEASURABLE CLIENT
IMPROVEMENTS ARE THE ONLY THING
THAT ULTIMATELY MATTERS. IT'S
OUR MISSION IN NORTH STAR. LIKE
TO PROVIDE SEVERAL EXAMPLES FROM
MOMENTUM ZONE EXPERIENCE, AS
WELL AS SOME IDEAS FOR FROM
PROVIDER PARTNERS HERE IN THE
ROOM. KELLY AND KELLY AND
IMPLEMENTATION VARIES ACROSS THE
STATE SINCE JULY. 1ST 2023 WITH
THE IMPLEMENTATION OF CAL AIM
OUR AGENCY HAS EXPERIENCED
SEVERE FINANCIAL DURESS. SO
MUCH, THOUGH, THAT WE MADE THE
DIFFICULT DECISION TO CLOSE
PROGRAMS AND REDUCE OUR SERVICE
OFFERINGS. DURING A COMMUNITY
WIDE BEHAVIORAL HEALTH CRISIS.
I'M A SOCIAL WORKER TO AND THIS
IS ANESTHETIC AELTUS PROFESSION.
WHAT CONCERNS ME IS THAT OUR
PROGRAM CLOSURES WERE
PREVENTABLE. IT REMINDS ME A BIT
OF CALIFORNIA'S
DEINSTITUTIONALIZATION EFFORTS
OF THE 19 SEVENTIES. AS POINTED
OUT BY OUR CHIEF MEDICAL
OFFICER, DR SHEFALI MILLER. WHEN
THE STATE DECIDED FIVE DECADES
AGO TO MOVING CLIENTS FROM STATE
HOSPITALS BACK TO VOLUNTARY
PLACEMENTS IN THEIR COMMUNITY
WAS AN ABSOLUTE LAUDABLE GOAL.
BUT AS WE KNOW NOW, THE EFFORTS
WERE UNDER RESOURCE AND POORLY
IMPLEMENTED. THE SHIFT UNDER
CALLINA PAYMENT REFORM IS ALSO
LAUDABLE AND COULD MOVE
SPECIALTY BEHAVIORAL HEALTH
SERVICES AND A VERY IMPORTANT
DIRECTION. BUT MY WORRY IS THAT
IT TOO. IS UNDER RESOURCED AND
POORLY IMPLEMENTED. THE
CONSEQUENCES OF OUR SYSTEM OF
CARE COULD BE DEVASTATING.
MOMENTUM IS CLOSING SIX PROGRAMS
SERVING OVER 650 CLIENTS. ON THE
DAY THAT WE SAID WE WERE GOING
TO CLOSE THOSE PROGRAMS
AFFECTING 85 STAFF. OVERALL IN A
YEAR. THAT'S 1500 CLIENTS. FOR
PROGRAMS IN THE HIGHER END OF
THE OUTPATIENT SYSTEM SERVING
THE NEEDIEST IN OUR PUBLIC
HEALTH SYSTEM. WHICH IS NOT AN
ACCIDENT. BUT IT'S NOT LIKE THIS
IS HAPPENING IN A COUNTY THAT
DOES NOT PRIORITIZE BEHAVIORAL
HEALTH. SANTA CLARA COUNTY
SUPPORTED BEHAVIORAL HEALTH
BEFORE DECADES BEFORE IT WAS
POPULAR. SENATOR CORTEZ E WAS A
WAS A SUPERVISOR HERE LEADING
THAT CHARGE FOR MANY YEARS. I
BELIEVE SANTA CLARA COUNTY HAS
ONE OF THE STATES BETTER PUBLIC
HEALTH, BEHAVIORAL HEALTH
SYSTEMS. OUR COUNTY BORDER
SUPERVISORS KNOW MORE ABOUT
BEHAVIORAL HEALTH ISSUES AS
INDIVIDUALS AND AS A GROUP. THEN
I WOULD WAGER ANY BOARD IN
CALIFORNIA. OUR NEW COUNTY
ADMINISTRATION IS EXTREMELY
SUPPORTIVE OF BEHAVIORAL HEALTH
AND ALONG WITH THE BAIRRO
LEADERSHIP GROUP LEADERSHIP OF
THE DEPARTMENT. THEY ALL WORK
WELL WITH OUR PROVIDER COMMUNITY
TO CREATE A COMPREHENSIVE AND
STRONG SYSTEM OF CARE. AND YET,
EVEN IN THIS SITUATION, WE ARE
PERILOUSLY CLOSE TO GETTING IT
WRONG. SCORE THIS IS ABOUT AN
INADEQUATE PASS THROUGH RATE.
FORCE SPECIFIC SPECIALTY LEVELS
OF CARE. I SUPPORT PRESIDENT C B
H. A STATEWIDE ASSOCIATION
BEHAVIOR, HEALTH AGENCIES. I
HEAR CALLUM IMPLEMENTATION
ISSUES STATEWIDE. IT SEEMS TO ME
THAT IN COUNTIES THAT HAD A
HIGHER PASS THROUGH RATE
PROVIDERS FOR PROVIDERS, THERE
ARE FEWER SYSTEM WIDE PROBLEMS.
IN SANTA CLARA COUNTY, 16 TO 17
AGENCIES REPORTING RUNNING
DEFICITS. THAT WE CANNOT MAKE UP
IN THIS FISCAL YEAR. REVENUE
LOSS FOR SOME OF THIS IS RUNNING
ABOVE 20. TWO DAYS AGO, ALL TO
THE CREDIT OF THE PARTNERSHIP
BETWEEN THE BOARD OF
SUPERVISORS. COUNTY
ADMINISTRATION AND PROVIDERS
SYSTEM LIFELINE WAS EXTENDED TO
COVER THE INITIAL LOSSES. THAT
WE WERE EXPERIENCING. THIS
LITERALLY SAVED OUR BEHAVIOR
HEALTH SYSTEM. WE NOW HAVE SOME
BREATHING ROOM TO ADDRESS THE
STRUCTURAL ISSUES AROUND THE
COUNTY IN TRANSITION, BUT IT WAS
THE INTERACTION BETWEEN ELECTED
COUNTY ADMINISTRATION OF
PROVIDERS THAT SAVE THAT SYSTEM.
I WOULD SUGGEST THIS CAUTIONARY
TALE THE REST OF THE COUNTY
THROUGHOUT THE STATE. THE
RESULTS WHEN WE DON'T GET IT
RIGHT OR CATASTROPHIC, AS
HIGHLIGHTED BY MY COLLEAGUE, DR
MARTIN MARINA POST WRITTEN
STATEMENT TO THE SELECT
COMMITTEE SUBMITTED ONLINE. MY
COLLEAGUES, DON TAYLOR FROM
CIVIC CLINIC HERE TONIGHT. RYAN
AYE EISENBERG FROM CHILDREN'S
HEALTH COUNCIL HIGHLIGHTED
ACCESS AND EQUITY NEED TO REMAIN
OUR NEED TO REMAIN OUR PRIORITY
THROUGH CALAIS NAME? NO WRONG
DOOR APPROACH AS SIMPLY MOVED
THE DOOR MILD TO MODERATE TO
MANAGE CARE. RECEIVING WHAT USED
TO BE SPECIALTY MENTAL HEALTH
CARE. THERE WERE NEW REFERRAL
FLOWS AND THE CLIENTS ULTIMATELY
MAY NOT ACCESS THOSE SERVICES.
MY COLLEAGUES, CHRIS ROBO FROM
SHELDON'S REBECCA SERVICE
CHILDREN REBECCA'S CHILDREN'S
SERVICES, AND MATT CAME IN FROM
SENECA FAMILY OF AGENCIES
POINTED OUT HOW RATES AND RATE
STRUCTURES LIMIT OF SERVICES IN
VERY REAL WAYS. PROGRAMS ARE
GREAT RISK, LIKE OUR COMMUNITY
BASED SERVICES, THAT MANY OF
THEM THAT WE ARE CLOSING RIGHT
NOW. LITERALLY. WE'RE DOING THIS
NOW. WITH RATES NOW BASED ON
CREDENTIAL. AND HIGHER RATES FOR
FOLKS WITH HIGHER EDUCATION
LEVELS. THERE'S SOME
DISINCENTIVE TO BUILD AND
IMPLEMENT COMMUNITY BASED
PROGRAMS THAT SHOULD BE
UTILIZING PEERS AND
PARAPROFESSIONALS THAT PROVIDE
MUCH OF THE DIRECT SERVICE.
THAT'S CONFLICTS WITH OUR
EFFORTS TO BETTER INTEGRATE
STAFF WITH LIVE EXPERIENCE AND
DIRECT TIES TO OUR COMMUNITIES.
TO PROVIDE CLIENTS WITH
CULTURALLY. RESPONSIVE SERVICES.
IT ALSO HIGHLIGHTS WHAT AT LEAST
I WAS SAYING ABOUT THE WORKFORCE
CRISIS. WE ARE IN IT UP TO OUR
EYEBALLS. THIS IS ABSOLUTELY THE
PERFECT STORM THAT GETS EVER
MORE PERFECT EVERY DAY.
ULTIMATELY MY FAITH IS IN THE
GOOD FOLKS AROUND OUR PROVERBIAL
COMMUNITY TABLE RIGHT NOW. AND
THIS IS EVIDENCED BY OUR WORK OF
THE BOARD OF SUPERVISORS TWO
DAYS AGO. BUT WE ARE NOT OUT OF
THE DANGER YET. WE ARE
IMPLEMENTING MULTIPLE
SIGNIFICANT BEHAVIORAL POLICIES
NEARLY SIMULTANEOUSLY. WE ALL
NEED TO WORK TOGETHER. AND AGAIN
THANK YOU VERY MUCH FOR COMING
TO SANTA CLARE COUNTY AND
LISTENING TO US TONIGHT. THANK
YOU VERY MUCH. NEXT. WE WILL
HAVE. THE COUNSELING AND
SUPPORTIVE SERVICES FOR YOU.
THANK YOU TO SEE YOU. GOOD TO
SEE YOU AGAIN. THANK YOU, DR
JACKSON, ASSEMBLYMEMBER'S
PELLERIN AND SENATOR CORTEZ E
FOR LISTENING TO US TONIGHT.
ANYTHING ALL MY COLLEAGUES IN
THE ROOM THAT ARE SHARING THE
CHALLENGES THAT YOU'VE HEARD? UM
MY NAME IS MARIKA SAYING I AM
THE EXECUTIVE DIRECTOR OF
COUNSELING AND SUPPORT SERVICES
FOR YOUTH. WE ARE A NON PROFIT
THAT BEGAN IN 2009 BECAUSE THREE
STUDENTS DIED AT THE HIGH SCHOOL
ACROSS THE STREET. AND THOSE
FAMILIES AND THAT'S COOL
COMMUNITY DID NOT KNOW WHERE TO
TURN. AND SO MANY OF MY
COLLEAGUES HAVE SHARED THAT MANY
SERVICES THAT ARE AVAILABLE
THROUGH THE COUNTY AND THROUGH
OTHER NONPROFITS. WHAT I HOPE TO
SHARE TO YOU IS WHY SCHOOL BASED
IS SO VITAL BECAUSE THE
PREVENTATIVE WORK THAT IS NEEDED
AND THAT IS BEING PROVIDED
EARLY. THIS IS A CHILD AND THE
FAMILIES FIRST TOUCH TO MENTAL
HEALTH SUPPORT AND IF WE ARE
ABLE TO PROVIDE PROFESSIONAL
QUALIFIED, COMPASSIONATE
THERAPIST, IT OPENED THE DOOR SO
THAT THEY KNOW THERE IS NEVER A
HARM IN ASKING FOR HELP. WHICH
IS WHAT ALL OF US SO DEEPLY
WANT. WE WANTED TO STIGMATIZE
MENTAL HEALTH. WHAT I FEAR IS
THAT IF NONPROFITS SUCH AS OURS
RELY ON MEDICAL RELY ON
INSURANCE THAT PREVENTATIVE WORK
CANNOT GET DONE. AND YOU'VE
ALREADY HEARD WHY. AND SO WHAT
WILL WE LOSE? YOU WILL LEAVE.
YOU WILL LOSE THE ABILITY OF
PLACING THERAPISTS THAT LOVE TO
BE WITH CHILDREN ON CAMPUSES.
THEY'RE NOT THERE TO LOOK FOR
WHAT CAN WE BUILD, BUT THEY'RE
THERE TO LOOK FOR CHILDREN WHO
JUST NEED SOMEONE TO CHECK IN ON
THEM. THAT'S NOT BILLABLE. THEY
ARE LOOKING FOR SUPPORTING
TEACHERS AND THE STAFF THAT ARE
IN CRISIS THEMSELVES. THAT'S NOT
BILLABLE. THE ONE ON ONE
COUNSELING THAT MANY STUDENTS
NEED. SOMETIMES IT TAKES 3 TO 4
SESSIONS BEFORE YOU CAN CREATE A
DIAGNOSIS. THERE'S 3 TO 4
SESSIONS ARE NOT AVAILABLE.
YOU'RE MISSING THE CLASSROOM
PRESENTATIONS. YOU'RE MISSING
THE GROUP COUNSELING. YOU'RE
MISSING THE PARENTS THAT ARE
COMING TO CAMPUSES CRYING
BECAUSE THEY DON'T KNOW WHAT'S
WRONG. THEY DON'T KNOW WHAT
QUESTIONS TO ASK. THEY DON'T
KNOW HOW TO NAVIGATE THE SYSTEM.
AND SO WHEN YOU PLACE SCHOOL
BASED COUNSELORS ON CAMPUS IS
YOU'RE GIVING FAMILIES THE
ABILITY TO ASK FOR HELP BECAUSE
THEY CAN'T NAVIGATE THE SYSTEM,
AND UNFORTUNATELY, WE DON'T HAVE
ENOUGH THERAPISTS THAT CAN HELP
PROVIDE THE SYSTEM OF CARE THAT
WE NEED, SO WE WANT TO DIVERT
THEM FROM GETTING TO THE CLINICS
FROM GETTING TO THE HOSPITALS.
AND THEN IF THEY ARE NECESSARY
TO HAVE THAT CARE, YOU WANT TO
RE ENTRY SO THAT WHEN THEY COME
BACK TO CAMPUS THEY DON'T GO
THROUGH A CYCLE THIS AND
DOWNWARD SPIKE ASPIRE THAT WE'RE
SEEING SO OFTEN AND SO AS A
NONPROFIT OR JUST SHARING THAT
THERE ARE SO MUCH RESOURCES THAT
ARE AVAILABLE. HELP US, UM,
FIGURE OUT HOW TO USE OUR
UTILIZE OUR TALENTS SO THAT WE
CAN CONTINUE TO HELP THE
CHILDREN AND FAMILIES AND NOT
NECESSARILY GET FOCUSED ON THE
BUILDING CYCLES AND THE MEDICAL
PAPERWORK THAT'S OFTEN NECESSARY
JUST TO PROVIDE THAT 15 MINUTES
OF CARE. AND SO YOU'VE HEARD SO
MUCH OF WHAT? THE PREPARED
TESTIMONY I WAS GOING TO SHARE
WITH YOU TODAY ABOUT THE
CHALLENGES AND THE GAPS AND I'M
HOPEFUL THAT TOGETHER WE CAN PUT
OUR HEADS TOGETHER TO REALLY
THINK ABOUT. WELL, WHAT TOOLS DO
WE HAVE? WHAT BARRIERS CAN WE
BREAK? AND ULTIMATELY WHAT CAN
WE DO? SO WE PROVIDE MULTI
LINGUAL, CULTURALLY COMPETENT
THERAPIST INTO THE HANDS OF OUR
FAMILIES INTO THE HANDS OF THE
PEOPLE THAT NEED IT SO THAT WE
CAN TIN YEARS FROM NOW,
HOPEFULLY EVEN SOONER, COME BACK
TO THIS TABLE AND SHOW THE
SUCCESSES WE'VE BEEN ABLE TO
MAKE BY PULLING TOGETHER FOR
YOUR PULLING TOGETHER THIS
HEARING TODAY, AND I THANK YOU
VERY MUCH FOR DOING THAT.
COLLEAGUES QUESTIONS. SENATOR.
HMM. ONE OF I WAS ASKED. BY ONE
OF MY STAFF MEMBERS EARLIER
WHETHER OR NOT THESE KINDS OF
HEARINGS ARE HAVE AN OBJECTIVE
OF. OF INFORMING NEW LEGISLATION
OR. JUST PROVIDING PUBLIC
COMMENT OR YOU KNOW SOME OTHER
PURPOSE. WHAT'S THE REAL?
PURPOSE OR ALL THE ABOVE. UM AND
I THINK IT'S ALL THE ABOVE
PERSONALLY, BUT, UM, YOU KNOW,
WHEN I SEE THESE KINDS OF
HEARINGS, SELECT COMMITTEE
HEARINGS, INFORMATIONAL
HEARINGS, AND WE CAN'T VOTE
TODAY ON A BILL OR ON A BUDGET.
ITEM TODAY. BUT ON THE ON THE
COWL AIM I'VE HEARD BEFORE I GOT
HERE. UM YOU KNOW, WE RECEIVED.
A LOT OF WHAT YOU SAID. YOU
KNOW, THROUGH CORRESPONDENCE AND
COMMUNICATIONS. MR MANETTA. BUT
IF YOU WERE SHAPING LEGISLATION
NOW OR WHAT WE WOULD CALL BUDGET
PLAYER BUDGET. ASKED WHAT WOULD
THAT LOOK LIKE? TODAY IN. UM I
ASKED, REALLY, BECAUSE IT SEEMS
TO ME THE BEST SOLUTION TO THIS
IS, YOU KNOW, ASSUMING WE COULD
GET EVERYONE TO AGREE UP THE
STATE CAPITAL IS TO GET THE
SOLUTION FROM ALL OF YOU. YEAH.
THANK YOU, SENATOR. UM. SO, UH,
ONE I WOULD I JUST WANT TO POINT
OUT A COUPLE OF COLLEAGUES THAT
HAVE BEEN DOING AMAZING WORK FOR
US IN THIS COUNTY AND ERIN, ERIN
O'BRIEN AND RACHEL MONTOYA FROM
COMMUNITY SOLUTIONS. THERE IS A
CEO RACHEL'S THE CFO. UM I'M
TRYING TO CHANNEL BOTH OF THEM
RIGHT NOW. I THINK IT WOULD HAVE
BEEN ONE WOULD HAVE BEEN A
MINIMUM PASS THROUGH RATE IN THE
PAST THROUGH RATE TO THE STATES
TO THE TO THE COUNTIES DOWN THE
PROVIDER. WOULD HAVE BEEN OVER
80. IF NOT 100% PASS THROUGH. IF
THAT HAD PASSED THROUGH AND WHAT
I WOULD TELL WHAT I'VE TOLD OUR
COUNTY ADMINISTRATION. WE
WOULDN'T BE HAVING THIS
CONVERSATION RIGHT NOW ABOUT
CLOSING PROGRAMS. AND IF THE
STATE HAD ACTUALLY MANDATED THAT
THE COUNTIES COUNTIES RIGHT NOW
THAT PASS THROUGH RATE WAS 40.
THEIR AGENCIES IN C B H A.
THEY'RE GOING TO LEAVE THOSE
COUNTIES IF THAT RATE DOESN'T
INCREASE. AND A LOT OF THESE
COUNTIES CAN'T AFFORD TO HAVE A
PROVIDER LEAVE. THEY'RE THE ONLY
PROVIDER. I DON'T KNOW WHAT
HAPPENS AFTER THAT. UM I WOULD
THAT WOULD BE WHERE I WOULD
START. SORT OF EFFECT. THE BRAIN
STRUCTURE JUST NEEDS TO BE
REWORKED. IS THAT THE GUIDANCE?
THE GUIDANCE? YOU KNOW, THE
RATES THAT WAS SET UP? IT SEEMS
LIKE FOR ALL THE DIFFERENT
COUNTIES, I THINK I MEAN, YOU
COULD ARGUE FAIR ENOUGH. IT
SEEMED MOSTLY ADEQUATE. IF IT
100% HAD COME THROUGH 85% AGAIN,
WE WOULDN'T BE HAVING THOSE
CONVERSATIONS. THOSE PROGRAMS
WILL BE OPEN. 50 100 CLIENTS.
THEY WOULDN'T HAVE FELT ANY SEEN
ANY INTERRUPTION IN SERVICE. SO
I THINK THAT AGAIN ON THE
IMPLEMENTATION SIDE. UM THERE
WAS A LOT OF PLANNING AND TALK
GOING INTO THIS. SOMEHOW AGAIN.
WE'RE ON THE VERGE OF LIKE NOT
IMPLEMENTED CORRECTLY, NOT
MAKING THE RIGHT CHOICES, AND IT
HAS SUCH SEVERE CATASTROPHIC.
IMPACT LOCALLY. I CAN'T TELL YOU
HOW MANY. LETTERS WERE GETTING
FROM CLIENTS AND THEIR FAMILIES
RIGHT NOW ABOUT THESE CLOSURES.
THANK YOU. IF I CAN, MR CHAIR, I
JUST WANTED TO ASK EITHER THE
OTHER TWO WITNESSES. YOU KNOW
WHAT THEY THINK IT WOULD TAKE TO
GET YOU KNOW WHAT I THINK WE ALL
BELIEVE, AND I KNOW THERE WAS A
TOUR EARLIER TODAY OF GREAT
WELLNESS CENTER HERE ON A SCHOOL
CAMPUS. WE HAVE THOSE AT THE
MIDDLE SCHOOL LEVEL. UM WE TRY
TO GET LEGISLATION THROUGH.
SOMETIMES IT JUST REQUIRES THE
MOST SIMPLE. OF MENTAL HEALTH
REFERRALS AT EACH AND EVERY
BUSINESS, FOR EXAMPLE, AS FAR AS
THEIR OSHA PLAN. I RAN A BILL
LIKE THAT LAST YEAR. THE BILL
GOT SIGNED, BUT WE HAD TO TAKE
OUT THE PIECE THAT REQUIRED THE
WELLNESS REFERRAL TOO MUCH.
WRITE TOO MUCH BECAME A BECAME A
CALIFORNIA JOB KILLER BILL
BECAUSE OF THE FEAR OF THAT, AS
IF THERE'S SOME EXPENSE RIGHT TO
HAVING. SOMETHING AS SIMPLE AS A
PLAN HAS POSTED, REFERRAL NUMBER
AND UM, WE'VE CERTAINLY SEEN
EFFORTS. ON THE SCHOOL SIDE AT
THE STATE LEVEL TO TRUMP AND I
THINK EVERYBODY HERE IS ALL FOR
IT. UM YOU PROBABLY SEE A WHOLE
RAFT OF I VOTES IN OUR VOTING
HISTORY OVER THE LAST COUPLE OF
YEARS ON EXPANDING MENTAL HEALTH
SERVICES, WELLNESS CENTERS IN
SCHOOLS, BUT WE'RE NOT. PROBABLY
98. DR. TWAN IN TERMS OF, YOU
KNOW, FOLKS WANTING TO KNOW WAIT
A MINUTE. WE DON'T WE DON'T WANT
THE MONEY TO COME OUT OF THAT
BUCKET YOU'VE GOT, YOU KNOW,
FISCAL TAG APPROPRIATIONS
ISSUES. ANY THOUGHTS ON HOW WE
CAN JUST EXPAND. YOU KNOW THE
GREAT WORK HERE. I MEAN,
OBVIOUSLY, I'M DISAPPOINTED. THE
BUSINESS COMMUNITY NOT WANTING
TO DO WITH SEVENTH GRADERS ARE
ABLE TO DO IN SANTA CLARA
COUNTY. UM IT'S JUST THE WORLD
WE LIVE IN SOMETIMES, BUT TO BE
MORE POSITIVE AND HOPEFUL, OKAY?
ESPECIALLY YOU SERVED THE LOCAL
GOVERNMENT. YOU'RE RUNNING A
COUNTY OFFICER. EDUCATION WHAT
DO WE NEED TO DO TO JUST
ACCELERATE GETTING THOSE WALLACE
CENTERS AND THE KIDS TO WHERE
THEY CAN SELF REGULATE? THEY
HAVE A SAFE SPACE AND THEY CAN
DO PURE REFERRAL AND ALL THESE
GREAT THINGS THEY'RE DOING. SO I
THINK THERE ARE A NUMBER OF
OPPORTUNITIES, THINGS THAT WE
CAN DO AT THE STATE LEVEL, AND I
ALLUDED TO A COUPLE OF THEM, UM
SO WE WERE SUCCESSFUL IN GETTING
SOME OF THE IDEAS AROUND
RETOOLING THE L E. A BUILDING
OPTION PROGRAM AND CHANGING THE
ADMINISTRATIVE REGULATIONS
AROUND IMPLEMENTATION. SO I
THINK HAVING SOME ONGOING
OVERSIGHT AND WORKING TO MAKE
SURE THAT THOSE CHANGES ACTUALLY
HAPPEN, AND THEN THAT THERE'S
INFRASTRUCTURE AND SUPPORT TO
HELP SCHOOLS AND ROLL AND TAKE
ADVANTAGE. I ALSO THINK THAT
WE'VE LEARNED A LOT FROM THE S B
HIP. PROGRAM IT WAS A SHORT TERM
IMPLEMENTATION. I'D LIKE TO SEE
SOME POLICY DISCUSSIONS ABOUT
HOW DO WE MAKE THAT MORE OF A
PERMANENT RELATIONSHIP AND HOW
WE TAKE WHAT? UM THAT THE
DIFFERENT LEARNINGS AND HOW WE
WORK WITH THE MANAGED CARE
ORGANIZATIONS AND OTHERS TO
SUSTAIN THOSE EFFORTS OVER TIME
AND BUILD INFRASTRUCTURE AND
CAPACITY. UM WITH THAT EXISTING
MODEL. UM ANOTHER AREA. AS YOU
KNOW, WE KNOW THAT THE
BEHAVIORAL HEALTH SERVICES ACT
WILL BE ON THE BALLOT. UM AND I
THINK AS, UM YOU KNOW, SHOULD
SHOULD THAT PASS AND WE'RE
STARTING TO IMPLEMENT THAT.
THERE WILL ALSO BE A LOT OF NEED
FOR, UM, OVERSIGHT AND
SACRAMENTO. UM THE NO DEVIL IN
THE DETAILS, SO TO SPEAK, AND
THE IMPLEMENTATION WILL TAKE. I
THINK GEARS OF, YOU KNOW,
DEVELOPING REGULATIONS PROVIDING
TRAINING COMMUNICATION,
RETOOLING THE SYSTEM TO MAKE THE
ADJUSTMENTS. AND I THINK ALONG
THE WAY, SOME PRESERVATION FOR
SOME OF THE THINGS THAT WE'VE
BEEN TALKING ABOUT TONIGHT THAT
NOT EVERYTHING IS BILLABLE. NOT
EVERYTHING IS GOING TO BE, UM,
YOU KNOW, CRISIS LEVEL BUT STILL
ABSOLUTELY ESSENTIAL TO MEETING
THE NEEDS OF OUR CHILDREN AND
FAMILIES. SO THE PREVENTION,
EARLY INTERVENTION THINKING
ABOUT INVESTMENTS AND THE WHOLE
CHILD, THE WHOLE FAMILY THAT
THEN MAY ALSO PROVIDE SOME COST
SAVING MEASURES DOWN THE ROAD. I
KNOW THAT'S REALLY HARD FOR YOU
KNOW WHEN WE'RE IN A CURRENT
CYCLE OF THINKING ABOUT EVIDENCE
AND WHAT THE OUTCOMES ARE TO
MAKE DECISIONS THAT YOU KNOW, ON
THE BACKS OF WHAT WE PROBABLY
SAVE MONEY AND SAVE LIVES IN THE
FUTURE, BUT THE EVIDENCE IS VERY
CLEAR. AND WE YOU KNOW, WE HAVE
FIRSTHAND ACCOUNTS AS WELL AS,
UM, JUST IMPLEMENTATION DATA.
THAT SHOWS EARLY INTERVENTION
PREVENTION. THOSE TYPES OF
PROGRAMS ARE REALLY ESSENTIAL.
THE OTHER PIECES AS WE THINK
ABOUT OPPORTUNITIES, EVEN IF
THEY ARE ONE TIME FUNDING COMING
OUT OF SACRAMENTO. THAT WE FIND
A WAY TO NOT MAKE THEM
COMPETITIVE. UM IT CREATES AN
INCREDIBLE AMOUNT OF INEQUITY
AND DISPARITY WHEN A SCHOOL
DISTRICT HAS TO APPLY FOR A
COMPETITIVE GRANT TO DO
SOMETHING THAT WE'VE IDENTIFIED
AS A HIGH PRIORITY NEEDS IN OUR
SCHOOLS AND IN OUR COMMUNITY.
AND I'D REALLY LIKE TO ECHO THAT
NONCOMPETITIVE. WHAT WHAT I
SHARE WITH MY SCHOOL SO IT
ACTUALLY DOESN'T HAVE TO BE THAT
COMPLICATED IF YOU PLACED A
QUALIFIED THERAPISTS, THAT
THERAPIST IS SCHOOLED AND
TRAINED TO WORK WITH CHILDREN
WITH VERY MINIMUM. IT'S AMAZING
WHAT A TRAINED THERAPIST CAN DO
WITH SAND. AND A PLAYGROUND AND
SO SOMETIMES WE DO AS ADULTS
OVERCOMPLICATED WHETHER THEY
JUST NEED A TRAINED THERAPIST TO
BE ON A CAMPUS IN A RELIABLE
FASHION IN A SAFE, COMFORTABLE
ENVIRONMENT, AND SO I ALWAYS
WANT TO ENCOURAGE LIKE WE DON'T
NEED TO OVER COMPLICATE THINGS.
THE OTHER THING I WANT TO COME
MENTIONED IS THERE, UM, TO TALK
ABOUT THE U. THE DISPARITY. WE
WILL CONTINUE TO SEE WELL
RESOURCED SCHOOLS PROVIDE MENTAL
HEALTH THERAPISTS, WHILE OTHER
STOOL SCHOOLS CONTINUE TO
STRUGGLE I HAVE I CAN PLACE FIVE
THERAPISTS AT ONE SCHOOL AND
THEN FIVE MILES AWAY, FIND
SOMEONE FOR PART TIME I HAVE
FIVE SCHOOLS WHERE I AM DOING
100% OF THE FUNDRAISING. AND SO
WE REALLY NEED TO LOOK AT. HOW
CAN WE MAKE SURE THAT EVERY
SCHOOL REGARDLESS OF ZIP CODE
HAS A QUALIFIED THERAPIST THAT
IS AVAILABLE TO ASSIST STUDENTS
AND FAMILIES SO THAT THEY DON'T
ALWAYS HAVE TO NAVIGATE A SYSTEM
THAT IS NOT EASY FOR THEM. AND
SO ANYTHING WE CAN DO TO REMOVE
THAT COMPETITIVENESS AND JUST
PLACE A QUALIFIED THERAPIST ON
THE CAMPUS WILL HELP EASE THE
LONG TERM CHALLENGES AND
PROBLEMS WE WILL SEE IN THE
FUTURE. IF I MAY IF I MAY
THROUGH THE CHAIR JUST SAY IN
SANTA CLARA COUNTY. SOME YEARS
AGO, WE MORE THAN A DOZEN YEARS
AGO, STOOD UP A PROGRAM THAT WE
CALL HERE. SCHOOL LINKS SERVICES
WHERE THE COUNTY ITSELF HAS
DECIDED TO TAKE ITS MHSC MONEY,
AND THIS WAS IN THE DEPTHS OF
THE GREAT RECESSION, SO THERE
WAS NO GENERAL FOR MONEY. I
MEAN, WE WERE TELLING FOLKS WE
COULDN'T EVEN FIND A 1000 OR
GRANT FOR THEM. BUT IT. JUST SAY
MONEY WAS COMING IN. IN A BIG
COUNTY TO THE TUNE WHERE THANKS
TO THE ADMINISTRATION AND THEN
PUSHED BY MYSELF AND OTHER
SUPERVISORS SAID, LET'S LET'S
USE THAT MONEY. UM TO DO EXACTLY
WHAT YOU'RE TALKING ABOUT. THE
VERSION OF THAT COUNTY OFFICE
HAS BEEN INSTRUMENTAL AND, YOU
KNOW, MAKING SURE THAT THAT
ROLLOUT HAS HAPPENED AND
MONITORING IT. UM, IT'S NOT IT'S
NOT VERY IN VERY MANY OTHER
PLACES. THAT MODEL YOU KNOW IN A
LOT OF COUNTIES DON'T USE ALL
THEIR IMAGES SAY MONEY, WHICH I
THINK IS, UM TRIGGERED. YOU
KNOW, SOME OF THE
ADMINISTRATION'S RESPONSE TO YOU
KNOW, WANTING TO PUT IT ON THE
BALLOT AGAIN AND WANTED TO
RESTRUCTURE THINGS THAT ONE OF
THE THINGS THAT ALMOST HAPPENED
IN THE ADMINISTRATION'S FIRST
VERSION WAS IN EFFECT. THE
DRAMATIC CUTTING OF. HER ABILITY
AND FLEXIBILITY AND BEING ABLE
TO USE THAT MHSC MONEY FOR YOUTH
MENTAL HEALTH SERVICES. UM AND I
KNOW. IN THIS COUNTY. THERE WAS
SOME FLEXIBILITY NEGOTIATED IN
WHAT'S GOING TO GO ON THE
BALLOT. BUT UM, THERE ARE
RESOURCES LIKE THAT. UM, BUT HEY
, YOU KNOW HOW HOW TO SCALE THAT
STATEWIDE IS I THINK THE
QUESTION THAT'S THAT'S BEFORE
US. IT'S NOT A QUESTION OF
POLITICAL WILL IN THE
LEGISLATURE. YOU NÓI I'M PLEASED
WITH THE POLITICAL I THINK YOU
HIT UPON IT. DAVID YOU KNOW AT
ALL LEVELS OF GOVERNMENT NOW,
THIS IS NO LONGER ITEM 25 ON THE
LIST OF PRIORITIES. IT'S IN THE
TOP THREE AND YOU NEED TO BE IN
THE TOP THREE. TO GET THE KIND
OF ATTENTION THIS NEEDS. BUT NOW
WE'VE GOT TO FIGURE OUT THE
IMPLEMENTATION SIDE OF IT.
ANYWAY. THANK YOU. THANK YOU
VERY MUCH. ASSEMBLY MEMBER.
WELL, I WANT TO THANK YOU ALL
FOR YOUR TESTIMONY TODAY AND
YOUR STATEMENTS. IT'S REALLY EYE
OPENING, AND I 100% BELIEVE THAT
WE NEED TO MAKE PREVENTION
BILLABLE. YOU KNOW, WE NEED TO
CATCH OUR KIDS WE NEEDED TO BE
DOING SCREENING AT, YOU KNOW,
KINDERGARTEN AND GET THEM INTO A
SYSTEM AND BE ABLE TO PROVIDE
CARE EARLY ON SO IT DOESN'T
BECOME A CRISIS LATER. UM I
WANTED TO SAY I'M GRATEFUL TO
THE SANTA CLARA COUNTY BOARD OF
SUPERVISORS FOR FILLING IN WITH
THE BILLING. THAT'S NOT COMING
IN IN TIME TO KEEP SERVICES
GOING, AND I'M JUST DEVASTATED
TO HEAR ABOUT WHAT'S HAPPENING
WITH MOMENTUM AND LEAVING
FAMILIES WITHOUT THE PROGRAMS
THAT THEY BECOME TO RELY ON.
RIGHT BECAUSE YOU YOU SAID YOU
HAD TO CUT HOW MUCH OH, SIX
PROGRAMS. OKAY AND WHAT'S THE
AMOUNT OF MONEY THAT WOULD BE
NEEDED TO KEEP 10 MILLION HMM.
AND THAT'S BECAUSE OF THE. THE
DELAY IN GETTING THE CALAIS
MONEY, OR IS IT IT'S A BUNCH OF
THINGS BECAUSE IT'S ACROSS
DIFFERENT DIVISIONS. SO IT'S A
IT'S IN THE SUBSTITUTE DISORDER
DIVISION. IT'S IN THE ADULT
OLDER ADULTS AND THE CHILDREN,
YOUTH AND FAMILIES. IT'S IN THE
CRIMINAL JUSTICE AND THEY'RE ALL
SORT OF DIFFERENT REASONS. BUT
I'D SAY THEY'RE ALL RATE RELATED
BECAUSE AGAIN, I THINK IF WE IF
THE IF THE PASTOR HAD BEEN 85%
AGAIN WE WOULDN'T BE HAVING THAT
CONVERSATION. YEAH. ABSOLUTELY
SOCIAL WORKER. I DON'T DO MATH,
BUT I GOT THAT MATH. YEAH YEAH.
NO, I MEAN, IT JUST I MEAN THIS.
LIKE YOU SAID THIS SHOULD BE OUR
NUMBER ONE PRIORITY TO PUT THE
FUNDING INTO MENTAL HEALTH CARE,
ESPECIALLY FOR OUR YOUTH BECAUSE
IT WILL. PROVIDE THEM THE
FOUNDATION. THEY NEED TO LIVE A
HEALTHY LIFE AND WE'LL SAVE
MONEY DOWN THE ROAD, WHICH I
THINK IS THE DIFFICULT THING TO
QUANTIFY. AS YOU WERE SAYING,
YEAH, UM SO LET'S SEE THAT
ANOTHER QUESTION HERE, UM AND
THEN WITH CASSIE. HOW MANY
SCHOOL ARE YOU DISTRICT WIDE OR
NO, WE'RE NOT. WE'RE IN SAN
MATEO AND SANTA CLARA COUNTY.
EVERY SCHOOL? NO NO, WE SERVE
ABOUT 40 SCHOOLS I HAVE ABOUT.
UNFORTUNATELY 10 ON A WAIT LIST
BECAUSE, AS YOU HEARD THERE'S A
WORKFORCE SHORTAGE, TRYING TO
FIND TRAINED THERAPISTS THAT UM,
I KNOW HOW TO WORK WITH YOUTH
AND OUR COGNIZANT OF HOW TO BE
ON THE CAMPUS. IS IT DIFFICULT?
IS THERE A CERTAIN LIKE DEGREE
THAT'S REQUIRED FOR THE PEOPLE
TO BE ON THESE CAMPUSES, OR IS
THERE SOME ROOM FOR SOME CHANGES
THERE TO MAKE IT MAKE IT PERHAPS
LIKE A TWO YEAR DEGREE VERSUS A
FOUR YEAR COLLEGE DEGREE WAS,
YEAH, THERE'S ALWAYS ROOM. UM,
CURRENTLY CASSIE EMPLOYEES
POSTGRADUATE, SO A MASTER'S
LEVEL M F. T S OR SOCIAL WORKERS
. I KNOW THERE'S A LOT OF
EFFORTS TO LOOK AT, UM WHAT WE
COULD DO WITH ASSOCIATE OR
BACHELOR'S LEVEL, AND THAT'S
CERTAINLY SOMETHING THAT WE ARE
LOOKING AT IT AS WELL. AH BUT AT
THIS TIME REALLY TO THE. THE
CASES WE ARE SEEING ARE SO ACUTE
THAT WE REALLY DO NEED TRAINED.
CLINICIANS THAT CAN HANDLE A
CRISIS FROM DAY ONE BECAUSE THEY
WHEN YOU WILL HAVE 1 TO 2
ALREADY READY. SO WE ARE AT A
STAGE AS MANY PEOPLE HAVE SAID
AS A CRISIS. WE'VE GOTTEN HERE
OVER MULTITUDE OF YEARS, AND WE
NEED TO LOOK AT ALL EFFORTS TO
DIVERSIFY WORKFORCE TO MINIMIZE.
UM, THE. THE BARRIERS WERE
CREATING TO PROVIDE CARE AND TO
WORK TOGETHER SO THAT ALL OF US
WHO ARE CONTINUING TO STRUGGLE
TO FIND WORK FORCE. CAN WE
REALLY UTILIZE OUR STRENGTH SO
THAT WE'RE NOT COMPETING, BUT
REALLY UTILIZING EACH OTHER? UM
AND OUR EXPERTISE WHEN NECESSARY
? YEAH I REFER OUT SO OFTEN TOO
MANY OF MY COLLEAGUES HERE. WE
KNOW WHAT WE'RE GOOD AT, AND WE
KNOW WHAT OTHERS ARE GOOD AT.
AND TO LEVERAGE EACH OTHER'S
STRENGTHS REALLY IS ALLOWING US
TO REALLY FOCUS ON MAKING SURE
THAT THOSE STUDENTS AND THOSE
FAMILIES RECEIVED ADEQUATE CARE
THAT THEY NEED TO ABSOLUTELY
THANK YOU. AND I KNOW I'VE BEEN
VERY GRATEFUL TO HAVE THE
OPPORTUNITY TO TOUR THE WELLNESS
CENTER AS WE TOURED THE HIGH
SCHOOL TODAY, AND I'VE TOURED AN
ELEMENTARY SCHOOL NOW AND THE
COURT SCHOOL AND I JUST WISH
THOSE WERE AVAILABLE WHEN MY
KIDS WERE IN SCHOOL BECAUSE IT'S
JUST VITALLY IMPORTANT FOR KIDS
TO HAVE A PLACE TO GO WHEN THEY
NEED A BREAK WHEN THEY NEED TO
TALK TO SOMEBODY WHEN THEY'RE
FEELING THE ANXIETY AND THE
STRESS. SO THANK YOU FOR
EVERYTHING YOU'RE DOING, AND
WILL CONTINUE TO WORK IN
SACRAMENTO TO MAKE SURE WE CAN
ACHIEVE THESE GOALS AND I THINK
THAT COLLABORATION BETWEEN THE
LOCALS STATE AND OUR FEDERAL
GOVERNMENT'S ABSOLUTELY
ESSENTIAL TO GET TO WHERE WE
NEED TO GO. SO THANK YOU. THANK
YOU FOR COMING TO OUR TOURS AND
ALSO TO ALL OF YOU FOR
RECOGNIZING THAT IT IS AND AN
ALL PAYER OPPORTUNITY THAT WE
REALLY CAN'T RELY ON THE FUNDING
THAT IS TARGETED FOR PUBLIC
SCHOOL EDUCATION TO ALSO FUND AN
ENTIRE WHOLE SYSTEM OF MENTAL
HEALTH AND WELLNESS. WE RELY ON
OUR PARTNERS AND COMMUNITY
SCHOOLS CAN'T BE A REPLACEMENT
FOR THE SAFETY NET AND THAT
SYSTEM AND YET, UM, WE KNOW THAT
THERE IS SO MUCH NEED AND SO
MUCH BENEFIT. FROM ENHANCING
THIS CONTINUUM OF CARE, AND WE
DO NEED TO LOOK AT ALL POSSIBLE
PAIRS AS WE'RE BUILDING OUT THE
SYSTEM. THANK YOU VERY MUCH. I'M
JUST TRYING TO DO A LITTLE CHECK
IN. IS THERE ANYONE HERE WHO
PLANS ON DOING ANY PUBLIC
COMMENT? CAN YOU JUST RAISE YOUR
HAND? I JUST WANT TO GET A
LITTLE GREAT. ALRIGHT JUST WANT
TO MAKE SURE WE'RE STAYING ON
TRACK HERE. UM I JUST HAD A FEW
QUESTIONS. MY MYSELF NUMBER ONE.
OF COURSE. WE KNOW WE HAVE
COMMUNITY SCHOOLS, AND YOU'RE
RIGHT. IT'S MORE OF A
COMPETITIVE TYPE. DEAL BUT
UNDERSTANDING THAT THAT IS THE
IF WE'RE GOING TO TRULY MAKE
SURE THAT UM, SCHOOLS ARE
SHIFTING FROM JUST BEING AN
EDUCATION INSTITUTION TO A
WELLNESS INSTITUTION, RIGHT?
THAT WE'RE GOING TO HAVE TO DO
WHATEVER WE NEED TO DO TO MAKE
SURE THAT THAT'S THE TYPE OF
SUPPORT THAT UM, AND THE TYPE OF
FUNDING THAT ALL SCHOOL
DISTRICTS CAN GET IN ORDER TO BE
ABLE TO TRANSFORM THEIR SCHOOLS
INTO WHAT THAT WHAT NEEDS TO
HAPPEN. UM ARE YOU SEEING IT? UM
ARE ANY OF THE DISTRICTS WITHIN
THE COUNTY UTILIZING OR BEING
ABLE TO BE AWARDED? THOSE
COMMUNITY SCHOOL GRANTS? YES WE
HAVE A NUMBER OF SCHOOLS IN
SANTA CLARA COUNTY THAT WERE
ELIGIBLE AND A SMALL SUBSET OF
THOSE THAT WERE ABLE TO APPLY
AND THE FIRST ROUND OF FUNDING.
ONE OF OUR LEARNINGS WAS THAT,
UM, SCHOOLS NEEDED SUPPORT AND
COORDINATION. WITH THEIR
APPLICATIONS, SO A SERVICE THAT
WE PROVIDED OUT OF OUR COUNTY
OFFICE OF EDUCATION WAS TO
CONVENE AND PROVIDE TECHNICAL
ASSISTANCE AND SUPPORT AND
ACTUALLY HELPED DESIGN. UM THE
READINESS STUDIES AND DOING THE
NEEDS ASSESSMENTS AND
COLLABORATION WITH THE SCHOOL SO
THAT THEY COULD ACTUALLY MAKE
THAT APPLICATION AND RECEIVE
FUNDING. SO WE DO HAVE A SMALL
NUMBER OF SCHOOLS THAT ARE
IMPLEMENTING WELLNESS CENTERS AS
PART OF THEIR COMMUNITY SCHOOL
GRANT FUNDING. AND UM, ONE OF
THE BILLS THAT I CARRY THIS YEAR
HAD TO DO WITH UNIVERSAL
SCREENINGS. FOR YOUNG PEOPLE.
AND. FRANKLY I CAN'T BELIEVE HOW
HARD OF A PUSH BACK I GOT FOR
UNIVERSAL SCREENINGS FOR A LOT
OF REASON THAT SOUNDED MORE LIKE
ADULT ISSUES THAN YOUNG PEOPLE
ISSUES. TO PUT IT NICELY.
LUCKILY, WE WERE ABLE TO GET A
STUDIED, UH FIND IT TO BE ABLE
TO FIND BEST PRACTICES. UH OF
HOW SCHOOL DISTRICTS CAN
IMPLEMENT. UNIVERSAL SCREENINGS.
I SAY THAT BECAUSE AH HEALTH
CENTERS ARE GREAT. BUT IT TAKES
A YOUNG PERSON TO SELF IDENTIFY
THEMSELVES IN MANY CASES. AND
THEN HAVE THE COURAGE TO GO IN.
HOPEFULLY, THERE'S NO STIGMA
TIGHT TO THAT. HOPEFULLY THERE'S
NOT AN ADULT, STOPPING THEM TO
GO. WHICH ARE ANOTHER ISSUE. AH
TO BE ABLE TO RECEIVE SERVICES.
OR THEY ARE BECOMING A
DISTRACTION IN THE CLASSROOM
WHERE THINGS LIKE THAT. BUT WHAT
I'M MOST WORRIED ABOUT OR THOSE
STUDENTS WHO KNOW HOW TO
DISAPPEAR IN A CLASSROOM. AND
WHO ARE SUFFERING IN SILENCE.
MANY OF THEM COULD HAVE SUICIDAL
IDEATIONS. MEDIA OF, UM, ARE
DEALING WITH SOME TYPE OF
TRAUMA. BUT THE WAY THEY DEAL
WITH IT IS INTERNAL UNTIL
THERE'S A BLOW UP THAT CANNOT BE
REVERSED. WHAT CAN WE DO? RIGHT
NOW. TO DO A BETTER JOB OF
IDENTIFYING PEOPLE WHO MAY NOT
EXHIBIT EXTERNAL SYMPTOMS. BUT
ARE JUST AS. UH CAPABLE OF
LOSING THEIR LIVES THEMSELVES.
ANYONE. UM. AS I MENTIONED IN
2009. WE WERE CREATED BECAUSE
THREE STUDENTS ACROSS THE STREET
DIED THAT YEAR. WHEN WE LOSE A
STUDENT, AND UNFORTUNATELY IT
HAS HAPPENED AGAIN AND AGAIN, WE
OFTEN CHECK OUR BOOKS. AND WE
CHECKED WAS THAT STUDENT A
CLIENT AND THEN THERE'S ALWAYS
THAT INITIAL RELIEF OF NÓ. OKAY
WE DIDN'T DO ANY WRONG. ANYTHING
WRONG, BUT I ALWAYS THINK ABOUT
ACT ESTABLISHING. YEAH, WE DID,
BECAUSE THIS CHILD DID NOT COME
TO US SO AND SO THAT'S AGAIN
WHERE THE PREVENTATIVE WORK
WHERE? EMBEDDING A THERAPIST IN
THE SCHOOL. SO THAT THEY ARE
PART OF STAFF. THEY'RE WALKING
THE HALLS. THEY ARE CHECKING IN
WITH STUDENTS. THEY ARE WALKING
THROUGH CLASSROOMS, EXPLAINING
WHY MENTAL HEALTH IS SO
IMPORTANT. WHY ASKING FOR HELP?
WHY CHECKING INTO SO HELP
TALKING TO TEACHERS TO SHARE AND
PSYCHO EDUCATE? THOSE ARE THINGS
THAT MEDICAL WILL NEVER PAY FOR
YET ARE SO CRUCIAL TO BUILD A
TEAM. OF SUPPORTERS SO THAT THAT
CHILD KNOWS WHETHER IT'S WHETHER
THEY GO INTO THE WELLNESS CENTER
AND CHECK IN WITH THAT
THERAPIST, OR THEY CHECK IN WITH
A TEACHER OR A COACH OR
CUSTODIAN. THOSE ARE THE PEOPLE
THAT THEY NEED TO KNOW CAN
ULTIMATELY LEAD THEM TO THE
THERAPIST AND THE CLINICIANS
THAT CAN HELP THEM. WHAT WE'RE
SEEING NOW. MIDDLE SCHOOL BOYS.
WHEN YOU REFER THEM WILL NOT
ACCEPT SERVICES. AND SO WE'RE
LOOKING AT INNOVATIVE PROGRAMS
WHERE WE'RE COACHING. WE'RE
WORKING WITH COACHES WERE
WORKING WITH CUSTODIANS SO THAT
THEY COULD DO SOME TYPE OF PLAY
THERAPY TO BUILD THOSE
RELATIONSHIPS TO EASE THOSE
PRESSURES BECAUSE THEY ARE NOT
ACCEPTING SERVICES YET WE KNOW
WE CANNOT LEAVE THEM BEHIND, SO
AND SO, YES, WE NEED TO MAKE
SURE THAT WE CONTINUE TO DO WHAT
WE CAN TO REACH OUT TO EVERY
SINGLE STATE. ADDED ON THAT
CAMPUS REGARDLESS OF WHETHER
THEY'RE SMILING OR CRYING. YOU
KNOW ONE THING I JUST WOULD WANT
TO JUST EMPHASIZE SOMETHING THAT
AMERICA JUST SAID A LOT. THE
SAME WORDS RELATIONSHIPS, SCHOOL
ENVIRONMENTS, OUR TARGET RICH
FOR RELATIONSHIP BUILDING EVERY
DAY, RIGHT? AND. YOU KNOW, TRUE
TO TRUE TO FORM NOT NOT TO
DISPARAGE GOVERNMENT AT ALL. BIG
FAN OF GOVERNMENT. WE CAN DO A
LOT OF GOOD STUFF IN GOVERNMENT.
YEAH, YOU KNOW. THAT'S PART OF
THE FEDERAL GOVERNMENT. WE'RE
HERE TO HELP SO I WAS I LOVE
GOING OUT AND SAYING, YOU KNOW,
FROM THE FEDERAL GOVERNMENT.
WE'RE HERE TO HELP, BUT UM. YOU
KNOW, REINVENTING WHAT WE WHAT
WE KNOW TO BE TRUE. THESE ARE
FACTS AND IT'S YOU KNOW, IT
FEELS LIKE THAT'S THE THING THAT
WE DO CONSTANTLY. TEAR SOMETHING
DOWN. FEW YEARS LATER, SOMEBODY
GETS THE BRIGHT IDEA. HEY, WE
SHOULD DO THIS. THIS WE KNOW. WE
ALREADY KNEW BEFORE WE TRY TO
WORK. YOU KNOW, WE'RE GREAT THAT
AT A AGAIN RELATIONSHIPS IN
SCHOOLS. WHETHER THERE
CUSTODIANS. BUS DRIVERS, WHOEVER
THEY ARE TEACHERS OBVIOUSLY. UM
THAT'S WHO KNOWS THOSE KIDS.
THAT'S WHO KNOWS THOSE QUIET
KIDS, TOO. THE KIDS WHO
DISAPPEAR. IT'S LIKE I KNOW YOU.
I SAW YOU AND WE CAN TRAIN THEM.
TO ACTUALLY DO IT BETTER. AND
AGAIN. I THINK THOSE FUNDS COME
IN, AND, UM, IT'S HOW TO BREAK
THAT TIME OUT IN IN THE
CURRICULUM IS TO TAKE THE STAFF
AND BE ABLE TO DO THAT. UM WE
DID IT BEFORE. THAT'S THE THING.
IF I MIGHT JUST ENDORSE YOUR
IDEA AROUND THE SCREENINGS. UM,
THERE. WE'VE DONE SOME PILOTS
WITH SCREENING AT, LIKE, FIFTH
GRADE AND SIXTH GRADE LEVEL. UM
AND HAVE SOME EXPERIENCE WITH
WHAT WORKED WELL WITH THAT. AND
YOU KNOW, MAYBE WHAT SOME OF THE
EVEN THE BARRIERS TO SERVICE
ONCE YOU IDENTIFY THROUGH A
SCREENER UM, ADDITIONALLY, I
THINK IT'S THERE ALL THESE
OPPORTUNITIES WITH THE ADULTS ON
CAMPUS WITH TRAINING AND
AWARENESS SESSIONS AND WAYS IN
WHICH WE CAN NOTICE AND IDENTIFY
POTENTIAL NEEDS THAT CREATE AN
INVITATION, PERHAPS TO SCREENING
OR TRIAGE. ALSO IN THE WELLNESS
CENTERS. THAT IS A COMPONENT OF
THE WORK THAT WE DO SO WHEN
STUDENTS COME IN, THEY COMPLETE
A REALLY EASY BRIEF SURVEY GIVES
US A HINT OF HOW HOW THEY'RE
SHOWING UP. AND IF NEEDED, THEN
THE LIAISON CAN TRIAGE AND THAT
CAN ALSO LEAD TO A MORE IN DEPTH
ASSESSMENT OF NEEDED. AND THEN I
ALSO THINK THERE'S A LOT OF
OPPORTUNITY AROUND CURRICULUM.
WHAT WE DO IN THE CLASSROOM THE
WAY THAT WE PROMOTE CURRICULUM
ACROSS THE SCHOOL CAMPUS FOCUSED
ON WELLNESS, HELPING YOUNG
PEOPLE EVEN SELF IDENTIFY THE
STIGMATIZING FOCUSING ON OUR
MENTAL HEALTH AND WELLNESS AND
SIMILAR WAYS THAT WE EDUCATE
AROUND PHYSICAL HEALTH AND
WELLNESS. CAN GO A LONG WAY TO
ADDRESSING THE CONCERN THAT YOU
RAISED. THANK YOU ALL VERY MUCH.
I WANT TO THANK THIS PANEL FOR
VERY MUCH FOR. UM, LEARNING
BENDING OUR EAR. UM BECAUSE
THERE'S GOING TO BE SOME VERY
IMPORTANT THINGS. I WANT TO LET
YOU KNOW THAT IT IS NOT TOO
LATE. IF YOU LOOK ON YOUR AGENDA
ON THE AGENDA. THERE IS A E MAIL
ON THE AGENDA, UH, WITH THAT
ALSO SAYS PLANET PLEASE SEND
YOUR WRITTEN TESTIMONY TO LAMONT
GORDON. YEAH I JUST WANT TO LET
YOU KNOW IF YOU GET IN ANY BILL
IDEAS. BY JANUARY. THE ENTIRE
SELECT COMMITTEE WILL BE TAKING
THOSE UP TO SEE WHICH ONES WE
MIGHT BE ABLE TO INTRODUCE NEXT
YEAR AS WELL. SO JUST KNOW WE'RE
TRYING TO PROVIDE EVEN MORE
DIRECT ACCESS FOR YOUR BILLS TO
BE CONSIDERED YOUR IDEAS AS WELL
. SO THAT WE CAN MAKE SURE THAT
WE'RE DOING THINGS IN A TIMELY
WAY. AND ALSO SO YOU KNOW THAT
WE HEAR YOU. AND WE WANT TO MAKE
SURE THAT WE'RE PRESENTING WHAT
IS NECESSARY ON THE GROUND. SO
THANK YOU ALL VERY MUCH FOR
BEING HERE. THANK YOU. YEAH. NOW
WE'RE GONNA DO A PUBLIC COMMENT
AND WE'RE GOING TO DO A. I THINK
WHAT WE'RE GOING TO DO IS WE'RE
GONNA USE THE OH, NEVER MIND.
ALL RIGHT. I WAS GOING TO COME
UP WITH MY OWN IDEAS, SO OKAY.
IMPROVISE I WAS READY. AND SO OF
COURSE WE'RE GOING TO GIVE
EVERYONE A ONE MINUTE TO BRIEFLY
, UH, PROVIDE YOUR COMMENTS, OF
COURSE. UM SO THAT WE CAN MAKE
SURE THAT WE HEAR FROM THOSE
DIRECTLY ON THE GROUND AS WELL
HERE. UM, SO IF YOU CAN BEGIN
LINING UP AND WHAT WE WOULD LIKE
YOU TO DO IS JUST THE STATE YOUR
YOUR NAME. UM YOUR AFFILIATION
IF YOU ARE AFFILIATED WITH AN
ORGANIZATION AND THEN, OF COURSE
, UM, WEST CITY YOU MAY HEAL
FROM ALL RIGHT, PLEASE. GOOD
EVENING. MY NAME IS SARAH RIGLER
AND I AM IN, UM, LIVE IN SANTA
CRUZ COUNTY. SO I'M IN GAIL
PELLERIN 28TH DISTRICT. UM I
KNOW I ONLY HAVE 11 MINUTE I'M A
RETIRED PUBLIC SCHOOL TEACHER
FROM PAJARO VALLEY UNIFIED. I'M
BILINGUAL IN SPANISH AND FROM UM
MY STANDPOINT AS A TEACHER, I
HAD FIRST HAND EXPERIENCE OF
HUNDREDS OF STUDENTS WHO NEEDED
MENTAL HEALTH COUNSELING. AND
REFERRALS AND THE AMOUNT OF
PAPERWORK AND BARRIERS THAT WE
ENCOUNTERED AS TEACHERS TO MAKE
REFERRALS FOR MENTAL HEALTH
COUNSELING WAS JUST ENORMOUS. UM
FOR MY MOST CRITICAL STUDENTS,
AND I WOULD SAY I PROBABLY HAD
ABOUT THREE STUDENTS WHO WOULD
GET IT, UM PER YEAR OR MAYBE
SEMESTER. THEY. OFTEN UM, THE
INTERN WHICH CHANGE EVERY TWO
MONTHS, SO THERE WAS NEVER ANY
CONTINUITY AND THEY WOULD GET TO
SEE SOMEONE FOR ABOUT 15 MINUTES
ONCE EVERY TWO WEEKS OR 15
MINUTES EVERY WEEK. THESE WERE
HIGH RISK STUDENTS. THEY SAW
VIOLENCE IN THE HOME. THEY SAW
SUBSTANCE ABUSE THEY SAW THEY
HAD MALNUTRITION. THERE WERE
ATTENDANCE ISSUES I CAN GO ON
AND ON AND ON ACADEMIC ISSUES.
THE TEACHERS ARE THERE TO SEE IT
IN MY BACKGROUNDS IN PUBLIC
HEALTH. I WAS JUST APPALLED AT
THE LACK OF RESOURCES, UM, AND
THE LITTLE AMOUNT THAT THOSE
INTERNS WERE PAID. SO I'M ALSO
WORKING WITH MIDDLE SCHOOL
STUDENTS NOW AND HIGH SCHOOL
STUDENTS AS A TUTOR. AND I SEE
IT, UM, WITH THE PANDEMIC, SO I
JUST WANTED TO SAY THERE ARE
BARRIERS IN THE SCHOOL SYSTEM
FOR KIDS TO GET, UM, TO GET
HELP. THANK YOU VERY MUCH NEXT.
HI MY NAME IS SHARON MCCORKELL.
I LIVE IN BOULDER CREEK. UM
HAPPY TO BE IN, UH, GIRLS
DISTRICT. AND I AM A RETIRED
SCHOOLTEACHER PUBLIC SCHOOL
TEACHER. I TAUGHT SCIENCE TO
HIGH SCHOOLERS FOR 30 YEARS. THE
LAST 13 YEARS. I WAS IN AN
ALTERNATIVE SCHOOL. THIS WAS IN
DAVIS, THAT WHERE I HAPPEN TO
LIVE AT THE TIME. UM WE HAD WHEN
WE STARTED. WE HAD A LOT OF AT
RISK KIDS, AND WHEN WE STARTED
HAVING HEALTH PROVIDERS, UH ON
CAMPUS MENTAL HEALTH PROVIDERS
ON CAMPUS, IT MADE A WORLD OF
DIFFERENCE. IT REDUCED THE
STIGMA OF, YOU KNOW, SEEING
SOMEBODY UM AND, UH, YOU KNOW
THE THERAPIST, IT WAS INTERNS.
MONEY SAVING. UM SOMETIMES WE
DID HAVE AN ACTUAL THERAPIST AND
HE'D GO OUT AND PLAY BASKETBALL
WITH THE KIDS. AND YOU KNOW, BE
PRESIDENT. YOU KNOW, ASSEMBLIES
AND THINGS LIKE THAT. AND SO,
HAVING THAT PERSON BEING, UH, A
CRITICAL PART OF THE STAFF AND
PART OF THE STUDENTS WORLD IS
VERY IMPORTANT. UM THE OTHER
THING I WANTED TO SAY BEFORE I
RUN OUT OF TIME IS PEOPLE WITH
MENTAL HEALTH PEOPLE DON'T
USUALLY THINK OF CLASS SIZE AS
BEING CRITICAL. BUT UM, UH,
TEACHERS THAT WORK WITH 35 KIDS.
THIS IS SECONDARY SCHOOLS, YOU
KNOW, UH, TURNING OVER FIVE
TIMES A DAY. UM YOU JUST CAN'T
GET TO KNOW YOUR KIDS AND BUILD
KIND OF RELATIONSHIPS THAT YOU
CAN IF YOU COULD EVEN KNOCK FIVE
KIDS OFF OF THAT CLASS. AH IT'S
A HUGE AMOUNT OF MONEY TAKES A
LOT OF RESOURCES, BUT THE MORE
YOU KNOW, TEACHERS AND STUDENTS
HAVE AN OPPORTUNITY TO GET TO
KNOW EACH OTHER. THE MORE THOSE
YOU KNOW THOSE REFERRALS, UH,
CAN CAN BE EFFECTIVE. THANK YOU
NEXT. ALRIGHT THIS IS MENTAL
HEALTH, NOT PHYSICAL HEALTH. AH.
THANK YOU. CHAIR IN JACKSON AND
CONDOLENCES FOR YOUR LOSS. I'M
SORRY TO HEAR THAT. THANK YOU SO
MUCH FOR HOLDING THIS AS THEIR A
BRIDGE WITH THE ASSOCIATION OF
CALIFORNIA HEALTHCARE DISTRICTS
AND GET THE DISTINCT PLEASURE OF
REPRESENTING THE 77 HEALTHCARE
DISTRICTS THROUGHOUT THE STATE.
THANK YOU FOR HAVING AL CAMINO
PARTICIPATE ON THE PANEL. I
THINK IT'S REALLY IMPORTANT TO
HEAR FROM PUBLIC PROVIDERS THAT
AREN'T JUST COUNTY PROVIDERS
WANT TO NOTE THAT WE ARE PROUD
SUPPORTERS OF PROPOSITION ONE,
AND I HOPE TO SEE THAT BE
SUCCESSFUL BECAUSE WE HAVE
SIGNIFICANT CHALLENGE. ACCESSING
THE FUNDING, EVEN THOUGH WE ARE
PUBLIC PROVIDERS ON THE GROUND,
PROVIDING THAT CARE BECAUSE OF
THE COUNTY PASSED THROUGH.
TYPICALLY, THOSE DOLLARS DON'T
FUNNEL DOWN AND WE'RE CARING FOR
THE MOST VULNERABLE POPULATIONS
IN THE STATE. I WANTED ALSO TAKE
THE OPPORTUNITY TO ANSWER YOUR
EMC. OH QUESTION. THE MAKO DEAL
WAS HISTORIC, INCREDIBLY
IMPORTANT AND WILL GO A LONG WAY
IN ADDRESSING SOME OF THE
SYSTEMATIC INEQUITIES THAT WE'VE
TALKED ABOUT TODAY. HOWEVER
WE'RE NOT GOING TO SEE THAT
FUNDING COME DOWN THIS YEAR, WE
WILL SEE IT COME DOWN NEXT YEAR
AND SUBSEQUENT YEARS AND THEN
THERE'S THE BALLOT INITIATIVE
AND CERTAINLY THERE ARE WINNERS
AND LOSERS AND I THINK IT'S
GOING TO BE REALLY IMPORTANT
THAT THE LEGISLATURE MAKE A
COMMITMENT TO FOLLOWING THROUGH
ON HOW THOSE DOLLARS ARE
ALLOCATED. ADDITIONALLY I JUST
NOTE THAT THERE ARE ALL SORTS OF
THINGS THAT WE CAN DO OUTSIDE OF
THE BUDGET PROCESS. I KNOW WE'RE
IN A BUDGET DEFICIT YEAR, BUT
THERE ARE THINGS THAT WE CAN DO
TO UTILIZE OUR EXISTING
WORKFORCE, LEVERAGE FUTURE
WORKFORCES AND ALLEVIATE
ELIMINATE SOME STATUTORY
BARRIERS THAT MAKE IT DIFFICULT
FOR US TO PROVIDE CARE. THANK
YOU SO MUCH LOOK FORWARD TO
WORKING WITH YOU MORE IN
SACRAMENTO. THANK YOU NEXT. UM
GOOD EVENING. THANK YOU FOR
HAVING US. UM MY NAME IS ANDREA
RANKIN FROM SAN JOSE. AND I'M
ALSO A NURSE. UM AND I HAVE
SUFFERED WITH MENTAL ILLNESS FOR
ABOUT 17 YEARS. SO I'VE SEEN
LOTS OF CHANGES HAPPEN. AND LAST
YEAR I WAS HAVING PROBLEMS WITH
MY HEART AND I WENT TO MY
PSYCHIATRIST, AND I TOLD HIM
SOMETHING'S WRONG. AND I ENDED
UP GETTING AN ECHO AND I HAD
LEFT VENTRICULAR HYPERTROPHY OF
THE HEART FROM THE MEDICATION
THAT I WAS TAKING. THE PROVIDER
TOLD ME IF I WAS NOT SUICIDAL OR
MANIC, HE WOULD NOT HELP ME TO
GET OFF OF WORK SO THAT I COULD
USE A BRIDGE MEDICATION TO HELP
ME GET OFF OF THE OTHER ONE, SO
I HAD TO END UP FUNDRAISING
$30,000 TO GO TO A PRIVATE
CLINIC IN FLORIDA TO GET OFF OF
A CERTAIN MEDICATION. AND THAT
WAS A LOT TO TRY TO DO WHAT?
YOU'RE NOT DOING WELL AND, UM,
RECENTLY, I HAD TO BE
HOSPITALIZED AND, UM. MOST PSYCH
WARDS TREAT YOU INHUMANE AND ARE
TRAUMATIC TO BE ON AND I HAD THE
PLEASURE TO BE ON THE UNIT. I
DON'T REALLY WANT TO CALL IT A
PSYCH WARD, THE HOSPITAL UNIT AT
EL CAMINO HOSPITAL SURPASSES ANY
PLACE THAT I'VE EVER SEEN.
THEY'RE PHENOMENAL, THEIR
SEAMLESS THEY'RE EXCELLENT. DR
SINGH, WHO WORKED WITH ME, SHE
SAID. WE DON'T JUST LIKE OUR
PATIENTS. WE LOVE THEM, AND YOU
CAN SEE THAT. AND SO I JUST
WANTED TO SUGGEST THAT AL CAMINO
HOSPITAL BE TRAINING OTHER
HOSPITALS HOW TO TREAT PATIENTS
HUMANELY AND TO DECREASE THE
TRAUMATIC EFFECTS OF BEING IN A
HOSPITAL OR PSYCH WARD. THANK
YOU. THANK YOU NEXT. ASK THEM.
GOOD EVENING. THANK YOU FOR THE
OPPORTUNITY TO SPEAK ON THIS
IMPORTANT TOPIC. MY NAME IS
KATHLEEN WILLEY. I'M A LOCAL LAW
SCATTERS MOM WITH KIDS AND THE
LOCAL SCHOOL DISTRICT. I ALSO
WORKED FOR THE LAST CARESS UNION
SCHOOL DISTRICT. SO I SEE KIDS
IN ELEMENTARY SCHOOL AND MIDDLE
SCHOOL MOST DAYS. SO I HAVE SEEN
THE IMPACT OF THE MENTAL HEALTH
ON THE KIDS FROM BEFORE THE
PANDEMIC AND AFTER THE PANDEMIC,
SO I'VE HEARD A LOT TONIGHT
ABOUT THE INCREASE IN SUICIDE
AND DEPRESSION. AND I THINK IT'S
IMPORTANT TO ACKNOWLEDGE THE
WHY. UM THE LOCKDOWNS WERE
REALLY, REALLY HARD ON OUR
CHILDREN. SO IT'S HARD TO SIT
HERE AS A MOM AND SEE HOW MUCH
YOUR CHILDREN MISSED. WITH NOW,
NOT SOME ACCOUNTABILITY OF WHAT
HAPPENED TO OUR LOCAL, STATE AND
FEDERAL RESPONSE TO COVID WAS
DISASTROUS. IT WAS ALL WRONG AND
IT WAS UNNECESSARY. THE SCHOOL
CLOSURES WERE 100% UNNECESSARY.
YOU LOOK AT SWEDEN, FOR EXAMPLE,
THEY DECIDED TO NOT CLOSE THE
SCHOOLS AND THEY HAD A MUCH
BETTER OUTCOME. WE HAD THE
WORST. COVID DEATHS GLOBALLY,
AND WE HAD SOME OF THE MOST
DRACONIAN LOCKDOWN MEASURES. SO
JUST LIKE TO SAY, I THINK WE
NEED TO ACKNOWLEDGE THE WHY.
THANK YOU. THANK YOU. NEXT GOOD
EVENING, CHRIS MILLER. LET'S GET
PRESIDENT PROUD CONSTITUENT OF
COLOR IN AND CORTEZ I WAS
HONORED TO HAVE ACTUALLY WRITTEN
THE BILL. LANGUAGE FOR SENATE
BILL 2 TO 4, WHICH MANDATED
MENTAL HEALTH INSTRUCTION IN
CALIFORNIA SCHOOLS IN 2021. IT
WAS INTRODUCED BY SENATOR
PORTANTINO. CORTEZ WAS A CO
SPONSOR, WHICH WAS GREAT, AND IT
GOES TO A SUPERINTENDENT'S
TAIWAN'S COMMENT OF
INCORPORATING MENTAL HEALTH
INSTRUCTION IN SCHOOLS. THERE
WAS ACCOMPANYING BILL 509 THAT
UNFORTUNATELY GOT THROUGH THIS
SENATE AND ASSEMBLY WAS VETOED
BY THE GOVERNOR IN OCTOBER. 509
WOULD HAVE BEEN ADDED MENTAL
HEALTH INSTRUCTION MANDATED
MENTAL CONSTRUCTION FOR
ELEMENTARY SCHOOLS. SO AT THIS
POINT IN TIME AT THIS MOMENT IN
TIME, MENTAL HEALTH INSTRUCTION
IS ONLY REQUIRED FOR SCHOOLS
THAT HAVE A HEALTH COURSE. AND
NOT ALL SCHOOLS ACROSS THE STATE
HAVE A HEALTH COURSE, AND IT'S
NOT FOR ELEMENTARY SO I'M HOPING
THAT WE'RE COME THE NEXT
LEGISLATIVE YEAR, PERHAPS THE
SELECT COMMITTEE CAN LOOK TO
HAVE POTENTIAL BILL SUPPORT A
BILL THAT WOULD CONTINUE THE
WORK BUILDING ON SENATE BILL
2224 MANDATED MIDDLE OF
INSTRUCTION. THANK YOU. THANK
YOU. THANK YOU SO MUCH FOR THIS
VITAL CONVERSATION. MY NAME IS
SHEVACK. ARE I AM WITH GAIL. I'M
IN BOULDER CREEK, CALIFORNIA. I
STAND BEFORE YOU RIGHT NOW AS A
CALIFORNIA NONPROFIT AND
CORPORATE EXECUTIVE. CONSULTANT
TO THE HEALTHCARE INDUSTRY TO
PREVENT BURNOUT AND TEACH
CLINICIANS AND OUR V A HOSPITALS
HOW TO TREAT MENTAL HEALTH
ISSUES AND COMPLEX PTSD. FIRST
BUT FOREMOST AND TO PRESENT OUR
WRITTEN TESTIMONY, WHICH WE
EMAILED TO YOU YESTERDAY, MY
STAFF AND I, BUT FOREMOST, I AM
HERE AS A DAUGHTER. A SISTER AND
A WIFE, WHO WOULD HAVE LEFT MY
FAMILY BEREAVED AS THE TWO OF
YOU ARE DO THE SUICIDE HAD IT
NOT BEEN FOR A VERY SIMPLE SELF
REGULATION TECHNIQUE THAT I
LEARNED WHEN OUR MENTAL HEALTH
CARE SYSTEM FAILED ME. THAT WAS
DEVELOPED AT A RESEARCH
INSTITUTE. 45 MINUTES UP THE
ROAD FROM HERE THAT IS NOW
DEPLOYED WORLDWIDE, AND IT'S
TAUGHT TO CHILDREN AROUND THE
WORLD. HAD I LEARNED THAT SKILL
WHEN I WAS SEVEN YEARS OLD WHEN
MY BEST FRIEND WAS KILLED IN GUN
VIOLENCE. I WOULD NOT HAVE
BECOME A BURDEN TO THE MENTAL
HEALTH CARE SYSTEM. EMOTIONAL
LITERACY AND LACK THERE OF IS A
HUGE SOURCE OF OUR MENTAL HEALTH
CARE CRISIS, AND I WANT TO
EXPAND THE CONVERSATION TO SAY
THIS IS NOT A CALIFORNIA MENTAL
HEALTH CARE CRISIS. THIS IS A
GLOBAL HEALTH CARE CRISIS. I
CONSULTED THIS YEAR TO THE G 20
HELPED RATIFY A POLICY. TO LIFT
SOCIAL EMOTIONAL LEARNING IN THE
G 20 COUNTRIES, OF WHICH THE
UNITED STATES IS A MEMBER. ON
PAR WITH LITERACY AND NUMERACY
AS FOUNDATIONAL TO ALL EDUCATION
AND EMPLOYMENT. WE HAVE THE
OPPORTUNITY TO MAKE SIMPLE SELF
REGULATION SKILLS, LIKE THOSE
EVIDENCE BASED DEVELOPED DOWN
THE ROAD AVAILABLE TO CHILDREN,
STARTING AT THE BEGINNING AS
PART OF THEIR READING, WRITING
ARITHMETIC. AND WHEN WE DO THAT
CALIFORNIA WILL BE AN EXAMPLE
WORLDWIDE. FOR HOW TO TRANSFORM
THIS GLOBAL CRISIS. THANK YOU.
THANK YOU. THANK YOU FOR THE
TIME. THANK YOU. PANELISTS DON
TAYLOR PACIFIC CLINICS,
NONPROFIT AND STATEWIDE AND IN
THE AREA AND A COUPLE QUICK
THINGS ON CALLE AIM, JUST NUMBER
ONE TO REEMPHASIZE ACCESS AND
EQUITY IS THE CENTER OF CAL AIM.
AND COMMUNITY BASED WORK IS
CRITICAL FOR SUCCESS. SO I THINK
ABOUT WHERE YOU AND YOUR SEATS
CAN IMPACT THAT. I THINK THERE'S
FOUR AREAS FROM MY PERSPECTIVE.
THE FIRST IS PUSHING FOR
DIVERSITY OF THE SPECIALIZED
RATES BASED ON THE NEED AS YOU
HEARD FROM THE PANEL PANELISTS,
THE SECOND IS INSISTING ON
CONSISTENCY OF RATES ACROSS
COUNTIES AND THE PAST THROUGH
WEIGHTS TO THE PROVIDERS. SIMPLE
EXAMPLE. LOCALLY SANTA CRUZ
COUNTY HAS A MUCH SMALLER RATE
THAN SANTA CLARA COUNTY, SANTA
CRUZ COUNTY, AND, IN TURN, THEIR
PROVIDERS ARE GREATLY STRUGGLING
RIGHT NOW. EVEN MORE SO THAN
SANTA CLARA COUNTY. THIRD AND
FORCING OF THE PARODY LAWS IS
VERY SIGNIFICANT AND THEN FOURTH
IS CONTINUING TO KEEP ADVOCATING
FOR MENTAL HEALTH LIKE YOU ARE,
UM THE CRISIS IS REAL, AND I
APPRECIATE THE TIME. THANK YOU.
MHM. THANK YOU, DR JACKSON CHAIR
. THANK YOU. VICE CHAIR.
PELLERIN AND SENATOR CRITICISM
FOR YOUR PUBLIC SERVICE, EVEN IN
TIMES OF EXTREME AND PERSONAL
LOSSES. MY NAME IS MARINA POST.
I LIVE IN LOS ALTOS. I'M HONORED
TO BE A PSYCHIATRIST WITH THE
MOMENTUM FOR HEALTH, YOUTH
OUTPATIENT PROGRAMS. FOR TWO
MORE WEEKS. WHILE I SAY GOODBYE
TO ALL OF MY PATIENTS, AND THEY
SAID GOODBYE TO ALL OF THEIR
TREATMENT TEAMS. OUT OF THE 650
PLUS CLIENTS AFFECTED BY THE
MOMENTUM CLOSURES OVER 350 FSP
PROGRAMS. SPS PROVIDE LIFESAVING
MENTAL HEALTH CARE ONE OTHER
PROGRAMS CANNOT MANY PATIENTS,
INCLUDING SOME OF MINE. CANNOT
HAVE THIS CARE ANYMORE.
ANYWHERE. THE FRONTLINE STAFF
FOR FS PIECE. ALRIGHT. HARDCORE
SPECIAL FORCES TYPE OF CASE
MANAGER WITH OR WHATEVER IT
TAKES ETHOS. THE STAFF ARE THE
ONES SAVING LIVES BY PHYSICALLY
BEING WITH PATIENTS IN THEIR
COMMUNITIES, RATHER THAN IN A
CLINIC OFFICE. SOON OVER 300.
PEOPLE WITH SEVERE MENTAL HEALTH
STRUGGLES WILL BE LOSING ACCESS
TO THIS LIFE SAVING CARE.
PRIMARY MEDICAL EQUIVALENT WOULD
BE OUR COUNTY LOSING 30% OF OUR
I C BEDS. THANK YOU. THANK YOU.
HI. THANK YOU SO MUCH FOR BEING
HERE. I THINK I'VE BEEN VERY
MOVED BY ALL OF THIS. UM I'M BY
NO MEANS A MENTAL HEALTH
SPECIALIST. ANYTHING. I'M A
CREATIVE PERSON AND I WANT TO
PIGGYBACK ON JERICHO'S COMMENT.
I'M THE EXECUTIVE DIRECTOR OF KK
TV AND RADIO HERE IN LAS CARTAS
WERE ON THE LOVE GODDESS HIGH
SCHOOL CAMPUS. AND AMERICA'S HAD
SOMETHING THAT JUST RESONATED ME
. I WASN'T GOING TO SPEAK OR
ANYTHING, BUT SHE TALKED ABOUT
INNOVATIVE PROGRAMMING AS A I
THINK THE WELLNESS CENTERS ARE
TERRIFIC. I'M GLAD YOU TOURED IT
TODAY. WE OFFER I CONSIDER US
WELLNESS IN A BIG WAY. I'M I'VE
BEEN WITH KK FOR NINE YEARS AND
WE RUN THE SUMMER CAMP MEDIA
PROGRAMS TO TEACH KIDS LIVE TV
AND MOVIES AND OTHER MEDIA
STUFF. AND I'VE NOTICED OVER THE
YEARS, MORE KIDS WITH MENTAL
ISSUES AND THE WORLD OF AUTISM
HAVE BEEN COMING TO OUR CAMPS.
AND. ONE OF OUR BIGGEST
SUCCESSES. IS PODCASTING FOR
KIDS. SO WHEN THOSE KIDS COME,
AND THERE THEY PUT ON THOSE
HEADSETS. AND THEY JUST TALK AND
TALK AND TALK. THEY DON'T EVEN
RECORD CARE IF WE RECORD AND
SOMETIMES I SEND THOSE
RECORDINGS HOME TO MOM AND DAD,
SO THEY'RE AWARE OF ISSUES. IT'S
BEEN SO SUCCESSFUL IN MY LITTLE
OPINION, I THINK I THINK
THINKING INNOVATIVELY, AND
SOMETIMES WE GET TOO INSIDE THE
BOX AND I LIKE TO TAKE IT
OUTSIDE THE BOX. SO MAYBE
INNOVATIVE PROGRAMMING IS A
ANOTHER ROAD OR PATHWAY. THANK
YOU. THANK YOU APPRECIATE IT. HI
BRUCE NEUSTAEDTER. UM MOSTLY, I
WANT TO THANK YOU FOR DOING
THIS. AND THANK ALL THE
COMMUNITY BASED PEOPLE FOR
WORKING THEIR REAR ENDS OFF. UM
ABOUT PROBABLY OVER 35 YEARS
AGO, I WALKED INTO THE CLASSROOM
TO PROVIDE MENTAL HEALTH. AND
THE TEACHER PRINCIPAL IS
PRESENTING ME AND TEACHER ASKED.
WHY DO WE NEED A THERAPIST HERE
ANYWAY? WE'VE MOVED PAST THAT.
AND MY EXPERIENCE IN WORKING AND
COMMUNITY BASED ORGANIZATIONS
AND PRIVATE PRACTICE. THERE'S
ALWAYS AN IMPEDIMENT. AND ALMOST
AN IMPLIED LACK OF TRUST ABOUT
HOW FOUNDED FUNDING PASSES
THROUGH IF SOMEHOW THAT PEACE
CAN BE LIFTED. WHERE THE
COMMUNITY BASED ORGANIZATIONS
GET THE MONEY WHERE WE'RE NOT
SITTING THERE, ARGUING ABOUT HOW
MUCH THE PASS THROUGH IS AND
UNDERSTANDING THAT THESE
CRITICAL SERVICES COST MONEY.
APPRECIATE IT. THANK YOU. THANK
YOU. HI THERE. MY NAME IS CARRIE
DONE. LEE. I LIVE HERE IN LOS
GATOS HAVE THREE GROWN CHILDREN.
AND, UM. AND I DON'T REMEMBER A
LOT OF THIS HAPPENING AS I WAS
GROWING UP, YOU KNOW? SO I THINK
THE LADY THAT LEFT AND SPOKE
EARLIER SAYING WE ACTUALLY NEED
TO LOOK AT WHAT ARE THE CAUSES.
WHAT'S WHAT'S THIS CRISIS COMING
FROM RIGHT INSTEAD OF TRYING TO
PUT. ALL THE SOLUTIONS TO FIXING
. YOU KNOW, I WANT TO TALK TO
YOU. I WANT TO FIGURE OUT WHAT
YOUR PROBLEM IS, BUT I THINK
THERE'S BIGGER PROBLEMS LIKE THE
PANDEMIC. UM I THINK THE KIDS
HAVE MORE POWER IN THE CLASSROOM
THAN THE TEACHERS. DO. I HAVE A
FRIEND WHO'S A TEACHER'S AIDE,
AND THE STORY, SHE TELLS ME ARE
HORRIFIC OF WHAT THE KIDS ARE
ALLOWED TO DO, AND THE TEACHERS
HAVE NO POWER AT ALL. KIDS CAN
SPIT ON HIM. HIT HIM DO WHATEVER
THEY WANT. AND THE TEACHERS ARE
REPRIMANDED. IF THEY REACT TO
THAT. I MEAN, IT'S LIKE IT'S
FLIPPED UPSIDE DOWN, PEOPLE.
KIDS ARE ON THEIR CELL PHONES.
THEY'RE NOT SOCIALIZING
PROPERLY. THERE'S SO MANY
PROBLEMS THAT ARE UNDERLYING
CAUSING THESE MENTAL ILLNESSES.
THEY'RE JUST DISCONNECTED. AND
ANYWAY, I DON'T. I APPRECIATE
YOU BEING HERE, BUT I HOPE YOU
LOOK AT THE DEEPER REASONS WHY
IT'S ALL HAPPENING. THANK YOU
FOR BEING HERE. THANK YOU. THIS
CONCLUDES OUR I FIELD HEARING
JUMPED INTO THE LAST MOMENT
THERE IF YOU DON'T WIN. YOUR
QUICK WHERE'D YOU COME FROM?
IT'S NOT UP ON YOU A LITTLE BIT
THERE. AH THANK YOU ALL VERY
MUCH. APPRECIATE YOU HAVING THIS
CONVERSATION. MY NAME IS KYLE.
I'M FROM OPEN DOORS TO FUTURE
POSSIBILITIES WERE NONPROFIT IN
SAN JOSE. UM WE TALKED A LOT
ABOUT HELPING, LIKE WORKING WITH
KIDS, FAMILIES, MOMS, AND
THERE'S A LOT OF TALK ABOUT LIKE
OVERHAUL AND WORKING WITH RATES
AND INSURANCE AND TRYING TO
FIGURE STUFF OUT WITH MEDICAL
CALAIS. SOMETHING THAT MAYBE WE
DIDN'T TOUCH UPON THAT. I'LL
BRING UP HERE. SO OPEN DOORS,
FUTURE POSSIBILITIES. WE OUR
MAIN GOAL IS TO MAKE MENTAL
HEALTH SERVICES EXPORTABLE
ACCESSIBLE. WE DO THAT $10 AN
HOUR FOR ANYBODY COMING IN,
REGARDLESS OF INSURANCE, SO
THOSE THAT DON'T HAVE INSURANCE
HOW DOES THAT GET BUILD HOUSES
THAT COVERED IN ADDITION TO
VETERANS, BIG FACTOR WITH
VETERANS IS DIAGNOSES HELPED
LIMIT THE PERCENTAGE THAT THEY
GET BACK WHEN THEY GET TALK TO
THE VIA IF THERE'S LIKE THINGS
LIKE THAT, IN TERMS OF THEIR
PERCENTAGE AND RATIO THAT THEY
GET IN RETURN, SO I JUST WANTED
TO SAY THAT THERE'S AN
OPPORTUNITY I THINK TO FILL THAT
GAP WITH ORGANIZATIONS THAT DO
PROVIDE SERVICES THAT KIND OF
COVER THAT SORT OF NICHE AS
WELL. UM JUST WANT TO SAY AGAIN.
THANK YOU FOR YOUR TIME AND
EVERYTHING HERE. THANK YOU.
COLLEAGUES CLOSING COMMENTS. I
JUST WANT TO SAY I TOURED THAT
FACILITY AS WELL. AND THAT'S
INCREDIBLE. UM I MEAN, REALLY,
IT'S JUST GOING TO TAKE A LOT OF
CREATIVITY. A LOT OF
COLLABORATION. UH A LOT OF LOVE
AND CARE FOR OUR FELLOW HUMANS
OUT THERE AND, UM AND TO DO THIS
IMPORTANT WORK TO GET TO WHERE
WE NEED TO GO. AND THERE'S LOTS
OF GAPS AND LOTS OF BARRIERS
THAT HAVE BEEN IDENTIFIED TODAY
AND YOU HAVE MY PROMISE AND THAT
I WILL BE WORKING ON THESE AND
HOPEFULLY COMING UP WITH SOME
SOLUTIONS BECAUSE MENTAL HEALTH
CARE IS SO VITALLY IMPORTANT AND
THANK YOU TO DAVID MANETTA FOR
NAMING DEREK AND I REALLY FEEL
LIKE THIS. HIS SPIRIT IS HERE
AND JUST KIND OF CEMENT ARE
RESOLVED ON HOW IMPORTANT THIS
WORK IS. SO THANK YOU ALL FOR
BEING HERE. SENATOR. AGAIN THANK
YOU BOTH FOR THE INVITATION TO
BE HERE IN THE PARTICIPATE IN.
UM I DO TAKE THE RESPONSIBILITY
NOW OF MAKING SURE THAT THIS
DISCUSSION THIS CONVERSATION, UM
YOU KNOW IS BECOMES FULLY PART
OF THE DISCUSSION AND DEBATE IN
THE SENATE AS WELL. AND THANK
YOU FOR YOUR LEADERSHIP. MR
CHAIRMAN, IMMUNE EMPLOYEE. TO
SAY THE LEAST, THE
UNDERSTATEMENT WOULD BE HE
WOULDN'T FULLY RESPECTED HAD YOU
CALLED OFF THIS HEARING UNDER
THE CIRCUMSTANCES AND INSTEAD,
YOU GAVE US THE OPPORTUNITY TO
DO THE HEARING. UM. DEDICATED TO
YOUR BROTHERS. SO UM, LET'S
CARRY THAT SPIRIT FORWARD AND IN
THE FORM OF LEGISLATION AND IN
BUDGET REQUEST THAT REALLY MAKE
A DIFFERENCE. I KNOW WE CAN ALL
DO THAT TOGETHER. THANK YOU.
THANK YOU. WE WANT TO THANK
EVERYONE, OF COURSE. AH WE WANT
TO MAKE SURE THAT WE THANK ALL
THE STAFF FROM ALL OF OUR
OFFICES WHO DID ALL THE
LOGISTICS. UH, MAKE SURE WE WERE
FED SO WE WEREN'T CRANKY. AH!
MAKE SURE WE GOT TO WHERE WE
NEED TO GO ON TIME AND SO VERY
MUCH. APPRECIATE IT. I WANT TO
THANK THE PANELISTS FOR MAKING
SURE THAT WE FULLY UNDERSTAND
WHAT'S GOING ON ON THE GROUND.
THE RAMIFICATIONS. MAKING SURE
THAT WE CONTINUE TO PUT FACES TO
THESE POLICY DISCUSSIONS AND SO
THAT WE DON'T GET SEPARATED FROM
THESE ARE REAL PEOPLE'S LIVES
HERE. THESE ARE PEOPLE BEING
AFFECTED HERE. AND SO WE REALLY
APPRECIATE THAT AS WELL. WE WANT
TO THANK THE CEO FOR BEING ABLE
TO MAKE SURE THAT UM OTHER
TECHNOLOGY AND EVERYTHING IS
WORKING APPROPRIATELY. AND THEN,
OF COURSE I WANT TO THANK LET
EVERYONE KNOW JUST HOW
APPRECIATE UM, UM APPRECIATE IF
I AM WITH MY COLLEAGUES FOR
BEING HERE. FOR TAKING OUT THE
TIME. UM AND MAKING SURE THAT WE
GIVE THIS THE QUALITY THAT IT
DESERVES. AND MADAM VICE CHAIR.
YOU KNOW HOW MUCH I APPRECIATE
YOU AND PHIL ABOUT YOU, AND ON
THIS WALK THAT WE'VE DONE
TOGETHER THIS YEAR. UM AND, UH,
MAKING SURE THAT TODAY WAS FULL.
HAVE A LOT OF GREAT STUFF. AND I
WANT TO THANK YOU AND YOUR STAFF
FOR MAKING ALL THIS HAPPEN FOR
US SO THAT WE CAN DO THIS HERE
TODAY. I ALSO WANT TO MAKE SURE
THAT YOU KNOW, THROUGHOUT THE
TIME WE ALSO THROUGHOUT OUR DAY
WE WERE ALSO JOINED BY ASSEMBLY
MEMBER REBECCA BARAKEH IN UM AS
WELL AS ASSEMBLY MEMBER MARK
BERMAN AS WELL, UM, AND SO, UM,
AND ALSO ASSEMBLYMEMBER'S ALEX
LEE WOULD HAVE BEEN HERE, BUT
HE'S OUT OF TOWN, AND SO, UM, WE
JUST MISSED EACH OTHER, BUT
THANK YOU ALL VERY MUCH, BUT
KNOW THIS YEAH, WE'VE TAKEN
NOTES. AND HOPEFULLY YOU'VE SEEN
JUST HOW SERIOUS WERE TAKING
THIS. THAT THIS IS NOT AN
EXERCISE FOR US, BUT THIS IS A
MISSION THAT WE'RE ON. TO MAKING
SURE THAT WE GET THIS RIGHT. SO
THANK YOU ALL VERY MUCH FOR
BEING HERE. BE SAFE. WE ARE
ADJOURNED.