[0:00] So I'm I'm usually here taking a lot of
[0:02] you guys time with listening session,
[0:05] right?
[0:08] >> Yeah. But
[0:09] >> I feel like the ramp up's going to
[0:11] happen.
[0:15] » Um there's going to be new reporting
[0:16] requirements they're going to talk about
[0:18] that also impacts me. So it's
[0:21] >> it's all kind of mesh
[0:23] like
[0:26] >> I just posted to the
[0:29] Well, the data notebook just came out
[0:32] and it's on foster care and behavioral
[0:34] health and so
[0:35] >> so just listen to the cow presentation
[0:38] on that and all that
[0:41] work.
[0:43] >> Yes, we have to implement by July 1, but
[0:45] we don't really know what we have to
[0:46] implement. I love it when they do that.
[0:48] >> Yeah. Yeah.
[0:49] >> There's a lot of that going around like oh we know we need to be doing
[0:53] stuff. We just don't know how to do it
[0:54] yet.
[0:54] >> Yeah. They have
[0:56] >> Exactly.
[0:59] » Be in that space,
[1:03] » right?
[1:03] >> You're not going to enjoy yourself.
[1:06] >> They don't know how good you got it.
[1:07] >> My kids have wrapped it up to
[1:09] awful kids.
[1:12] You hold me sing. You're the crowd.
[1:23] I'm sure
[1:30] she
[1:33] was waiting on her and
[1:36] I just
[1:40] could figure out how to do that would be
[1:42] Madison
[1:43] has to leave an hour. I don't know.
[1:45] Michael has to
[1:51] I know they're both loving it
[1:53] complaining a little bit about that.
[1:56] And I think what it is
[1:59] with
[2:02] their own
[2:16] looking forward to next
[2:24] Last
[2:28] week of July
[2:36] 15.
[2:39] Okay.
[2:42] » July.
[2:44] >> It's crazy.
[2:48] » Flash.
[2:49] >> Yeah.
[2:55] when I was
[3:07] » it's interesting you know here like with
[3:10] that kind of love we should buy
[3:13] [laughter]
[3:22] all Sorry. Emmy said she's going to be a
[3:24] few minutes late, but she will. She is
[3:27] coming. She knows how stressed I get if
[3:29] I don't know that she's going to be
[3:31] sitting.
[3:37] The day that I'm not stressed before
[3:40] this meeting, it's the day before the
[3:42] day I quit.
[3:46] I'm out.
[4:02] It's the compass dashboard. It's online.
[4:05] >> Yeah.
[4:17] » Okay. Let's
[4:40] see.
[5:00] learning
[5:02] [laughter]
[5:11] hydrated. Stay hydrated. Stay hydrated.
[5:42] since house cool
[5:53] there
[5:54] and take a to where they're training
[5:59] it right down here on the bank.
[6:06] » It's right next door. They have that
[6:08] twotory building.
[6:10] >> Yeah.
[6:15] Room.
[6:16] >> Very nice.
[6:18] >> Boats there.
[6:20] >> No, no. No, they just
[6:24] >> Yeah, what they did yesterday was they
[6:26] did.
[6:44] » I've been with the five years.
[6:48] >> We have kayaks in there.
[7:00] Well, thank you.
[7:04] Exactly.
[7:13] » River
[7:22] season.
[7:22] >> I feel like it's one of those
[7:27] » and you'll alcohol day. We'll take
[7:29] three.
[7:32] are there.
[7:48] » You guys find it challenging sometimes.
[7:56] » Exactly.
[7:58] that
[8:00] I don't think
[8:00] >> anyways
[8:08] I was some of them more than
[8:12] you were in an
[8:14] of
[8:24] a great example of clients.
[8:37] We were shuttling my uncle, my mom,
[8:48] come back.
[9:01] » Oh my god. Yeah.
[9:06] I think they tried to take that name
[9:07] somewhere else.
[9:14] » I I remember
[9:22] but then there's the other like
[9:25] >> exactly
[9:25] >> around the ocean.
[9:27] >> So great. We were just talking about
[9:31] no matter what
[9:41] » different
[9:56] very very one
[10:01] We like to grow each
[10:18] » I was in the way
[10:22] but I was
[10:25] » going straight down.
[10:27] It's a part
[10:32] very
[10:35] shocked
[10:36] family or a family friend or a neighbor.
[10:53] » Okay.
[11:02] already.
[11:04] >> Well, it sounds like
[11:20] » crazy.
[11:22] This is a huge lesson.
[11:26] grateful to have learned. But I mean I
[11:31] originally from
[11:31] >> I have to take care of I thought about
[11:34] I've got like stairs going up to my
[11:36] house
[11:37] >> just like
[11:50] » I
[11:54] originally
[11:56] I'm from
[12:01] living in the area.
[12:07] » We might
[12:13] just
[12:27] absolutely
[12:35] How are you?
[12:36] >> How you doing?
[12:56] rings back
[13:07] » she was like what she said this year.
[13:13] So, it's so funny having
[13:25] all these
[13:27] women
[13:33] like way back in the day. I go yes,
[13:38] but I was like, "No, you're all good.
[13:46] short. Is there anyone sitting next to
[13:48] you?
[13:54] » Just have you
[14:00] come back in a while.
[14:04] » Whenever I can, I definitely try. I have
[14:07] to go back.
[14:15] » I know. I was like
[14:19] » also
[14:26] makes you question the US
[14:30] >> today.
[14:33] >> Yeah. that has always been a lot
[14:44] » very
[14:54] literally half an hour on my
[14:59] » Yes.
[15:04] and talked about that's happens
[15:22] me right back.
[15:31] We're having a conversation about this
[15:32] because like Yeah, we'll talk. I mean,
[15:43] » how are you
[15:45] doing? All right.
[16:00] It was funny because I saw you come in
[16:03] and it didn't phase me like you go here
[16:05] and then he says, "Oh, Jerseyy's here."
[16:07] And I'm like, "Oh, no. Jeremy's here."
[16:08] [laughter]
[16:15] » It's cold.
[16:16] >> I like that it's cold.
[16:19] Usually I
[16:20] >> my office was so
[16:23] home I had like two going home.
[16:27] >> Yeah. My office of the VH
[16:35] in what used to be an exam room. No
[16:39] windows.
[16:42] I have to have the door open, put the
[16:43] fan on just my office at general the
[16:47] general hospital building
[16:50] and
[16:51] it was all
[16:54] >> Yeah, I think was it used to be a
[16:55] Safeway
[16:57] and our offices are back where
[17:00] >> I think the refrigerator
[17:08] » and
[17:17] Who's doing what?
[17:26] » That's
[17:37] just Never mind.
[17:41] How many
[17:48] of you
[17:53] » heard from
[18:04] that?
[18:06] It's not very burdens.
[18:18] like I walked surgery.
[18:45] » Just take a step out of the way.
[18:56] All right, everyone.
[18:59] >> 12:15.
[19:01] Before we begin, let us take a moment to
[19:03] recognize and appreciate the time,
[19:07] expertise, and commitment each of us
[19:08] brings to this symp.
[19:11] As we gather today, let us be
[19:13] intentional in showing up as
[19:14] traumainformed, compassionate partners
[19:18] grounded in empathy, respect, and
[19:20] collaboration as we work together to
[19:22] strengthen behavioral health outcomes in
[19:24] our community. With that, calling the
[19:26] meeting to order at 12:15. Welcome to
[19:29] the monthly behavioral health board
[19:30] meeting. We are the advisory to the
[19:33] board of supervisors. We hold this
[19:35] meeting on the 4th Thursday of each
[19:37] month and it runs from 12:15 till 2:15.
[19:40] We meet in person at 507 F Street in
[19:42] Eureka. This is a public meeting and
[19:45] everyone is invited to attend. Members
[19:48] of the public may participate remotely.
[19:51] The minutes and the agenda can be found
[19:53] by searching Humble County Behavioral
[19:54] Health Board online. We provide time for
[19:57] public comments early on the agenda.
[20:00] Public comments are limited to three
[20:02] minutes and pertain to matters related
[20:03] to behavioral health. We ask you to make
[20:06] your comment in a respectful manner.
[20:08] Please note this meeting is being
[20:10] recorded and please contact myself or
[20:12] any of the behavioral health board
[20:14] members if you have questions about our
[20:15] work as a board. With that, will you
[20:18] take the role? Sure.
[20:21] Sean Burger here.
[20:32] » Montana
[20:32] >> present.
[20:34] >> Royal
[20:37] Johnson
[20:37] >> here.
[20:44] Peter
[20:47] Joshua
[20:51] here.
[20:56] Okay. Are there any adjustments to the
[20:58] agenda?
[21:08] Now is time for public comments. If
[21:11] anyone has a public comment, we'll start
[21:14] within the room.
[21:16] Any have a public comment in the room
[21:22] online?
[21:29] [laughter]
[21:32] » Oh, there's no public comments.
[21:34] >> Well, let's go to introduction of
[21:37] Stephan.
[21:39] [laughter]
[21:41] » We will start with you now.
[21:44] >> Hi, good afternoon. Emmy Bachelor
[21:46] Rogers. I'm the behal health director.
[21:47] Nice to see you all.
[21:52] » I'm Alex Olivera, BHSA and QI um
[21:58] program manager Q.
[21:59] >> Scott
[22:02] Miller, social worker for Bar Ryan.
[22:08] » Laurel Johnson.
[22:12] Amy Scott manager for Cher Youth
[22:16] >> Jeremy Nelson deputy director for
[22:18] children's behavior health
[22:20] program manager for PHFA
[22:23] Morgan County dependent living
[22:30] go online.
[22:33] >> Good afternoon. My name is Edward
[22:34] Jidome. I'm a QI analyst.
[22:38] Hi, I'm Nancy Stark. I'm the legislative
[22:40] and policy manager for DHS.
[22:48] » Hello, I'm Saul Lopez. I'm a site
[22:50] director with Nation's Finest
[22:58] » and and we can do guests as well. You're
[23:00] a guest online and you want to introduce
[23:03] yourself and we'll come back.
[23:09] Melissa chatted something that I cannot
[23:13] see.
[23:15] That too.
[23:16] >> Hi everyone. I was Melissa Nelson here,
[23:19] patient navigator at Aegis Eureka and
[23:21] now Crescent City as well.
[23:24] >> Thank you.
[23:29] » And back to the room if there's any
[23:31] guests that would like to introduce
[23:32] themselves.
[23:33] >> My name is Austin Barnett. the director
[23:35] of operations and IT for Patrick's
[23:37] Foundation.
[23:40] » Anyone else?
[23:42] >> Was I was a guest. I just kind of came
[23:45] to line there.
[23:45] >> No, you're good.
[23:46] >> All right.
[23:48] Thank you, Sean Burgerer.
[23:51] That's why you're the second VP. I'm
[23:53] fine. Uh,
[23:57] so we do not have a quorum. So, I'm
[24:00] going to say we're gonna uh Josh Ros is
[24:03] on today. of we will perhaps of well we
[24:07] still won't have that so we will put
[24:09] these minutes off to September meeting
[24:13] um just a reminder we have no meetings
[24:15] in August
[24:17] dark in August so we'll be back in
[24:19] September
[24:22] wow and here we are the highlight of our
[24:24] day our QI presentation I'm super
[24:28] excited
[24:30] >> take it away all right good afternoon Um
[24:34] the quality improvement unit today will
[24:35] be presenting to you on some of the high
[24:38] level changes that have been implemented
[24:40] by the state through the department of
[24:41] healthcare services. These changes
[24:43] impact counties due to the number of
[24:45] steps that are involved in these
[24:47] initiatives. The fund the staff time
[24:49] that is necessary to meet requirements.
[24:51] All of these initiatives have added to
[24:53] our daily tasks. Not only us but our
[24:56] other our the other staff that have to
[24:58] deliver services and nothing is being
[25:00] removed from our requirements
[25:02] responsibilities. and we will um
[25:04] hopefully you guys can hold questions to
[25:06] the end so we can get through the
[25:08] content and open it up for questions. So
[25:11] next slide please. [clears throat]
[25:14] So our unit is comprised of myself and
[25:17] um several others but what we're going
[25:19] to do right now is give it yourself give
[25:21] you um a little bit more of an
[25:23] introduction than what we've already
[25:24] done. So I'm Amy Conn again and I'm the
[25:28] quality improvement program manager and
[25:30] I'm also the interim quality improvement
[25:32] coordinator since that is a vacancy. I
[25:35] oversee all the QI activities. I do have
[25:38] 26 of 26 years of experience with the
[25:41] department of health and human services.
[25:43] I've had about four years specifically
[25:45] with behavioral health two as an
[25:47] interimm deputy director of the
[25:49] performance management unit and then I
[25:51] have currently two years in its
[25:52] position. So previously most of my
[25:55] experience was with um quality
[25:57] management services doing quality
[25:59] assurance. I was the BHS compliance and
[26:02] quality assurance administrator and
[26:03] privacy officer for about 14 years. With
[26:06] that I'll hand it over to Alex.
[26:08] >> Hello. My name is Alex Olivera. I'm a
[26:10] BHSA and QI admin analyst. Been with the
[26:13] county now for six plus years. Um for my
[26:17] QI focus uh those things include uh
[26:19] reliance training and compliance
[26:20] monitoring, client satisfaction
[26:22] monitoring, grievance and appeals, uh
[26:25] data monitoring and reporting, cultural
[26:27] responsiveness monitoring, contracts and
[26:28] special projects. With that, I'll pass
[26:30] it over to Scott.
[26:31] >> I'm Scott Barry. I'm a UI analyst too
[26:34] that I've been here at UI for over two
[26:37] years and I focus on timely access
[26:40] providing the provider list and doing
[26:43] other reports that track our components.
[26:47] >> Then Edward is online. Edward, do you
[26:48] want to give your little introduction?
[26:51] >> Absolutely. Thank you. Good afternoon.
[26:52] My name is Edward Dome. I'm a QI analyst
[26:55] with a focus on or provider relations
[26:58] and also doing the um uh county network
[27:01] adequacy. So all of the 274 um which is
[27:04] how DHTS refers to it um uh how they
[27:07] determine our network adequacy.
[27:10] >> All right, next slide please.
[27:13] >> So as we know um there's a lot of
[27:16] acronyms and things terms that the state
[27:20] and government uses. So here's just a
[27:22] snippet of some of the highle ones you
[27:24] may hear today. Um if you're accessing
[27:27] this um presentation online, there are
[27:29] links within it. um many of our um
[27:33] PowerPoint slides, we're not reading the
[27:35] slide. It's mostly there for information
[27:37] for you um to reference. With that, next
[27:40] slide.
[27:43] So, now I'm going to go over just an
[27:45] overview of UI itself. Many of you may
[27:47] have already interacted with quality
[27:49] improvement, the quality improvement
[27:51] supports all of the behavioral health by
[27:53] helping to deliver effective, safe, and
[27:55] client- centered services. Our focus is
[27:57] on improving care and outcomes across
[28:00] the whole system. So what we do is we
[28:02] review data uh client feedback
[28:05] compliance standards and then to
[28:07] understand how services are working
[28:09] through identifies areas where we can be
[28:12] strengthened and support teams and
[28:14] making changes using simple structured
[28:16] me methods like PDSA plan do study act I
[28:19] don't know if you're familiar with those
[28:21] methods um of looking at a system trying
[28:24] things if they don't work going back and
[28:27] you know engaging with new systems and
[28:29] seeing if those work and presenting on
[28:31] those outcomes. So we also have
[28:34] regulatory and compliance that we um are
[28:36] doing which is Qi helping the county
[28:38] meet state federal requirements and
[28:41] managing required performance
[28:42] improvement projects. We also help
[28:44] maintain our quy plan which is on the
[28:48] acronym as the at least miss the quality
[28:52] assessment and performance improvement
[28:54] plan.
[28:56] So uh we do that we also do data
[28:58] reporting. So we analyze trends in
[29:00] access, timeliness, service use,
[29:02] disparities, complaints and outcomes and
[29:06] whole slew of other things but those are
[29:07] more the regulatory ones. We share this
[29:10] information with leadership programs and
[29:13] boards so decisions can be data
[29:15] informed. We support we are support for
[29:19] staff and programs. We work with teams
[29:20] to improve workflows, reduce
[29:23] inefficiencies and enhance the client
[29:25] experience. We offer coaching and tools
[29:27] for problem solving and measurement.
[29:29] This includes of course policy and
[29:31] procedure development and data reports
[29:34] which is we're going to spend a lot of
[29:35] time on those data reports today. So why
[29:38] does this matter? It mattered because QI
[29:40] helps ensure our system is accountable,
[29:42] consistent, and responsive to community
[29:45] needs ultimately supporting better
[29:47] outcomes for clients.
[29:49] >> Happy
[29:53] did I hear something?
[29:55] >> No. Okay, next um Scott's going to go
[29:57] over our org chart in brief.
[29:59] >> Next slide, please.
[30:02] >> So, this is the QI organization chart
[30:06] quality improvement
[30:07] and the closer related training audits
[30:09] and certification sections are overseen
[30:11] by our director Emmy Boxler Andur.
[30:16] There are 16 allocated staff positions
[30:18] for the quality improvement and training
[30:20] and certification sections. three uh
[30:23] full-time analyst positions. Oh,
[30:26] actually three and a half and three
[30:28] review nurse positions are filled with
[30:30] two additional half or eight time nurse
[30:35] review nurse positions. Currently I have
[30:36] five full-time positions making vacant
[30:39] and Amy is uh filling in for the
[30:43] management improve or UIC the quality
[30:47] management improvement coordinator tire.
[30:52] All right. So, how is QI Next slide,
[30:54] please. Um, how is QI helping transform
[30:57] behavioral health? Um, the quality
[31:00] improvement unit has always been
[31:01] responsible for compliance and
[31:03] oversight, but behavioral health systems
[31:06] um have historically been sort of
[31:08] stagnant. So, it's been very set in many
[31:11] ways and slow to change. But in the last
[31:14] five years, it has completely shifted to
[31:17] a very much changing place for
[31:21] especially for all um but in QI it's
[31:23] like every day there's a new thing and
[31:25] so we're going to go over some of these
[31:27] big level changes that have happened in
[31:29] the last five years. We're in it and we
[31:31] have more coming. So even as we give you
[31:34] some information is ever changing and
[31:38] more items are added. So both this shift
[31:41] has mostly been due to state reforms,
[31:43] legis new legislation, new technology
[31:46] and requirements and rising expectations
[31:48] for data driven care. For many years,
[31:51] quality improvement, behavioral health
[31:52] was mostly focused again on that
[31:54] compliance side and doing corrections,
[31:58] much more simple or simple seaming.
[32:01] Still could be complex, but definitely
[32:04] if you compare now to back then, it was
[32:06] much simpler back then. um processes
[32:09] were slow, fragmented, and largely
[32:10] manual. Systems were considered
[32:12] stagnant, did not change much over time.
[32:14] So, we're transitioning from a largely
[32:16] paper driven manual corrective action
[32:19] model to a more modern proactive model
[32:22] with closer to how the medical health
[32:24] field has been operating. Um we've seen
[32:27] even though we had an EHR avatar before
[32:30] we've moved to smart care and even in
[32:33] Avatar we still have a lot of paper
[32:34] charts a lot of paper forms things that
[32:36] we're doing on the side workarounds and
[32:39] now we're really moving to an all
[32:41] inclusive electronic health record of
[32:44] our clients and it's not only going to
[32:45] help them keep and maintain all their
[32:48] information but it helps us assess our
[32:50] systems and look at things in much
[32:52] different ways than we have before. So
[32:55] technology is now central. Our EHR is
[32:57] called SmartCare and we implemented the
[33:00] um program in July of 2023. So we've
[33:03] only had it for about three years now.
[33:05] Um but it updated documentation
[33:07] standards, digital reporting tools,
[33:09] dashboards, and secure data sharing
[33:12] processes that require us to guide staff
[33:15] and contract contracted providers in
[33:17] adopting new workflows. Um data
[33:20] expectations have increased
[33:22] significantly. So QI ensures not just
[33:25] documentation accuracy but data
[33:27] completeness, timeliness and integrity
[33:30] so that county can meet those state
[33:32] requirements, evaluate outcomes and
[33:34] participate in statewide improvement
[33:36] efforts. Analytics analytics analytics
[33:40] are becoming core to how we operate. The
[33:43] unit now helps programs understand the
[33:45] trends, performance indicators,
[33:47] timeliness of service. You're going to
[33:48] hear timeliness a lot because that's way
[33:50] one of the biggest things with DHCS is
[33:53] how timeliness of services are going. Um
[33:56] there's other quality measures and we
[33:58] also are looking for areas for to
[33:59] improve.
[34:01] This aligns behavioral health with
[34:02] broader health care practices. Business
[34:05] practices are evolving as well. also
[34:07] medical reform one of our initiatives
[34:09] calam that we'll be talking more about
[34:11] and also looking at utilizing
[34:13] utilization requirements pushes towards
[34:15] standardized pathways consistent
[34:17] documentation improve billing accuracy
[34:20] and audit readiness UI trains and
[34:22] support staff in processes the medical
[34:26] side alignment means we're operating
[34:27] more like an integrated health system
[34:29] focusing on outcomes value based care
[34:32] principles quality metrics and
[34:34] measurable improvement is the unit
[34:36] driving that change. For contracted
[34:38] providers, the shift means more support,
[34:40] player expectations, consistent with
[34:42] things like using um cans or ANSA. I
[34:46] don't know if you guys know what those
[34:47] are. It's a child um needs assessment
[34:50] and then that helps measure how a child
[34:52] is doing and then of course
[34:54] documentation. If we can be consistent
[34:56] in the training of these kind of things,
[34:58] then staff are doing their processes
[35:01] consistently and thus the data we get
[35:03] from that is consistent better.
[35:06] Um, ultimately QI ensures that these
[35:08] statewide changes that we're undergoing
[35:11] translate into better care, better
[35:13] access, and better outcomes for Humble
[35:15] County clients and the community at
[35:17] large. So, next slide, please. Um we
[35:20] have three of these huge initiatives
[35:23] that we're going to go over today
[35:25] because they're all connected to a mass
[35:27] amount of data. Um the three are CalaN
[35:30] VH connect and VHSA and we'll talk
[35:33] specifically about what we are. So next
[35:36] slide please. We'll go into Cal AIM.
[35:38] This is like one of those slides. I'm
[35:40] not going to read the slides. They're
[35:41] for reference and for you guys to uh
[35:43] engage in if you want. And the links
[35:45] like I said earlier are electronic and
[35:47] workable if you look if you get the
[35:49] electronic version that's on the left.
[35:52] So behavioral health payment reform is
[35:54] really what CalaM was about mostly. I
[35:56] mean there were a lot of elements to it
[35:58] but it was about really shifting um how
[36:02] payment was happening. So, it was
[36:04] implemented in July of 2023, the same
[36:07] time as our new EHR smart care. Um, and
[36:11] it changed the financial foundation for
[36:13] county behavioral health by moving from
[36:15] a crossb costbased system to a fee for
[36:17] service model. The shift means counties
[36:20] are reimbursed based on services
[36:21] delivered rather than overall costs,
[36:23] which increases transparency and
[36:25] predictability. It also brings
[36:27] behavioral health into alignment with
[36:28] other parts of medical and encourages
[36:30] clearer documentation, consistent
[36:32] service delivery, measurable outcomes
[36:35] for Humble County. This has uh required
[36:37] major operational adjustments, including
[36:40] updated workflows, billing practices,
[36:42] and data reporting, and they're still
[36:44] underway. In fact, we were just
[36:46] communicating this morning about um
[36:48] cases that we needed to close out from
[36:50] the transition from Avatar to Smart
[36:52] Care. We um our medical records just
[36:55] finished that project. Thousands of
[36:57] records that when they were transferred
[36:58] from Avatar to smart care didn't
[37:01] automatically close and that shifted our
[37:03] numbers. We found that out um during one
[37:06] of our uh EQRO re um or state audits and
[37:11] then we took action of you know cleaning
[37:14] up the data.
[37:16] [clears throat]
[37:16] Next slide please.
[37:18] So, the next initiative we're going to
[37:20] um look out to review briefly is BH
[37:24] Connect. And BH Connect is a new medical
[37:26] initiative running from 2025 to 2029
[37:31] that expands and coordinates behavioral
[37:33] health services statewide. It increases
[37:36] access to mental health care for people
[37:38] with significant needs, adds short-term
[37:40] inpatient and residential treatment
[37:42] options, and provides up to six months
[37:44] of housing assistance for individuals at
[37:46] risk of losing stability. The program
[37:49] also enhances services for children and
[37:51] units such as multi-ymic therapy, high
[37:54] fidelity, wraparound,
[37:56] and it also expands based and community
[37:59] health work support for supports.
[38:01] Overall, BH Connect strengthens
[38:03] community- based care and fills critical
[38:05] gaps in the behavioral health system.
[38:07] Next, Alex will do the last of our three
[38:10] initiatives because is the panelist for
[38:13] this program.
[38:14] >> All right. Uh, Behavioral Health
[38:17] Services Act or BHSA as we know it. It
[38:19] was enacted in 2024, replacing the
[38:21] mental health services act, MHSA as it
[38:24] was called, uh, and expands behavioral
[38:26] health funding to prioritize individuals
[38:28] with the most significant behavioral
[38:29] needs, health needs. It includes
[38:31] substance use disorder treatment,
[38:33] increases in investment in housing and
[38:35] behavioral health workforce development.
[38:38] It requires counties to plan across the
[38:40] entire behavioral health continuum of
[38:42] care and it strengthens oversight,
[38:45] transparency, accountability, and equity
[38:47] to improve access and reduce
[38:49] disparities. Uh part of Prop One, which
[38:52] is also included uh which also includes
[38:55] um $6.4 4 billion in behavioral health
[38:59] uh bonds to fund treatment meds,
[39:02] supportive housing, community behavioral
[39:04] health facilities, and housing for
[39:06] veterans with behavioral health needs.
[39:08] The BHSA represents a bit a significant
[39:11] shift from MHSA by broadening the focus
[39:14] of mental health uh alone to be
[39:18] from mental health alone to full
[39:21] behavioral health system including
[39:23] substance use treatment, housing and
[39:25] workforce development and improving
[39:27] accountability. Combined with the Prop 1
[39:29] $6.4 or million-dollar bond um billion
[39:32] dollar bond. It provides new
[39:35] opportunities for counties to expand
[39:36] behavioral health infrastructure and
[39:38] services.
[39:40] So
[39:42] data. Next slide, please.
[39:45] Data. Behavioral health is becoming
[39:48] increasingly data driven. DHCS is
[39:51] requiring more reporting than ever
[39:53] before and many of these systems are
[39:55] still evolving with new measures and
[39:57] reporting requirements. This reflects
[39:59] the ongoing transformation of behavioral
[40:02] health under behavioral health
[40:03] transformation, CALINA, MBHSA and all
[40:06] these other initiatives we'll be
[40:07] discussing today. Next slide.
[40:13] Beyond meeting state requirements, we're
[40:14] also use data internally to monitor uh
[40:17] quality, identify opportunities for
[40:19] improvement, and evaluate whether we're
[40:22] providing effective care for our
[40:24] community. This slide shows that none of
[40:26] our data systems stand alone.
[40:28] So some of the primary data sources and
[40:31] reports that we we use include medical
[40:33] connect DHCS's new statewide reporting
[40:36] platform supporting behavioral health
[40:38] payment reform and standardizing
[40:41] reporting the BHAS EIS measures which
[40:44] are national quality measures that track
[40:46] access timeliness and followup and
[40:48] treatment engagement with growing
[40:50] importance which is with with growing
[40:53] importance under calim the voter which
[40:56] we'll discuss these things in further
[40:57] slides
[40:58] a developing DHCS framework focused on
[41:01] behavioral health outcomes,
[41:03] accountability and public transparency.
[41:05] We have monthly reports which we use to
[41:08] monitor our operational performance and
[41:10] including access utilization, weight
[41:12] times, crisis services and workforce
[41:14] trends. We have quarterly reports which
[41:16] provide deeper analysis of the trends
[41:18] and disparities and compliance and
[41:20] quality improvement efforts. And then we
[41:22] have our annual reports which will which
[41:24] summarize the system performance. um
[41:27] [clears throat] outcomes and quality
[41:28] measures, equity and the progress
[41:31] towards improving improvement goals. We
[41:34] also have our quality assurance and
[41:35] performance improvement plan, our quapy
[41:37] activities um which is ongoing quality
[41:40] improvement work including performance improvement projects,
[41:45] process reviews, client feedback,
[41:47] corrective actions.
[41:49] All of this gets put together in our
[41:51] quapy work in our QI work plans. Um
[41:55] using every data source to set
[41:57] priorities, test changes, and monitor
[41:59] improvements over time. Together, these
[42:02] interconnected data systems allow us to
[42:04] meet state expectations, support calain,
[42:07] behavioral health transformation, Prop
[42:09] One, and all these
[42:19] » from Memphis down here.
[42:22] >> Coming from Memphis, Tennessee.
[42:24] >> I'm trying.
[42:26] >> Oh, heck yeah.
[42:27] >> Fine.
[42:28] My mom said of the family grew up down
[42:31] here in this area.
[42:36] » I'm trying
[42:38] things to do.
[42:52] » All right. So, next slide, please.
[42:54] Ember.
[43:00] Um, what is Medical Connect? Medical
[43:03] Connect is THCS's statewide data
[43:05] platform that brings together
[43:07] information from multiple sources to
[43:09] create more complete pictures of the
[43:11] people we serve. Rather than looking at
[43:14] individual services in isolation, it
[43:16] helps us understand population health,
[43:18] identifies gaps in care, and improve
[43:20] coordination across the medical medical
[43:22] system. This supports the goal of calaim
[43:25] by promoting whole person care and
[43:27] better health outcomes for the val for
[43:30] quality improvement unit. Medical
[43:32] connect is becoming one of the most
[43:34] valuable tools because it provides
[43:35] standardized data that helps us monitor
[43:38] performance, identify opportunities for
[43:40] improvement, and make well-informed
[43:42] decisions.
[43:44] Some of the examples of medical data are
[43:46] data dashboards that we have access to
[43:48] now are uh behavioral health quality
[43:50] measures, behavioral health um care
[43:53] management demographics, which I'll
[43:55] share here in some subsequent slides, a
[43:57] behavioral health condition prevalence,
[44:00] uh behavioral health uh equity
[44:03] and behavioral health uh BH BH connect
[44:06] and BHT member tales and we'll be going
[44:10] into these here shortly. Next slide,
[44:11] please. But can I just ask?
[44:13] >> So I think I asked you before you have
[44:16] all this data but only you all can see
[44:20] it right it's not public that
[44:22] >> some of it is public
[44:24] you guys don't have access to this but
[44:26] you have access to other sites that have
[44:27] the same at all.
[44:30] >> Well it would be great for our board to
[44:33] um know where we can access some data.
[44:36] So I can reach out to them.
[44:38] >> Yes.
[44:39] >> Thank you.
[44:41] Um looking at this slide here, this is a high-level overview example on the
[44:45] screen here. It's looks small, but it's
[44:48] a high level overview example of the
[44:50] volume of measures captured within
[44:51] medical connect. If you look in that
[44:53] bottom left corner there, you'll see
[44:54] that there's 213
[44:57] quality measures over eight different
[44:59] category initiatives for both behavioral
[45:02] health plans and managed care plans. So,
[45:05] a ton of data that we're now looking at
[45:07] on the regular.
[45:09] Uh oh, next slide please.
[45:15] » This is uh this is an of our this is an
[45:17] example of our behavioral health
[45:19] accountability set or behas as we know
[45:21] it. Uh these quality measures that track
[45:24] that DHCS tracks for behavioral health
[45:26] plans. These standardized healthc care
[45:29] effectiveness data and information set
[45:31] measures known as HETIS. You'll hear
[45:33] that term to use fetus. Um, evaluates
[45:36] areas like access to care, followup
[45:39] after hospitalization,
[45:41] uh, treatment engagement, and medication
[45:43] adherence.
[45:45] The important takeaways isn't that the
[45:47] indivi isn't the individual numbers.
[45:49] It's that the state is now measuring
[45:51] performance across different quality
[45:54] indicators and comparing counties
[45:56] against an established benchmark. That's
[45:59] this is all new under new or being
[46:02] modified under all these initiatives
[46:04] that we're working through. These
[46:06] measures help us identify where we're
[46:08] performing well and where improvements
[46:10] are needed and ultimately guide our
[46:11] quality improvement efforts.
[46:14] Next slide.
[46:17] This slide is an example of one of the
[46:19] equity and demographic dashboards
[46:21] available through medical connect. It
[46:23] allows us to look beyond overall
[46:24] performance and better understand who we
[46:27] serve by examining data across
[46:29] demographics, in this case, social
[46:31] determin determinance of health. These
[46:34] dashboards help us identify disparities,
[46:36] recognize populations that may be
[46:38] experiencing barriers to care, and use
[46:40] that information to improve health
[46:42] equity and guide improvement.
[46:46] Next slide.
[46:52] So, how does this impact DHHS uh
[46:54] behavioral health quality improvement?
[46:56] Well, DHCS's current initiatives shift
[46:59] the focus from simply providing services
[47:02] to demonstrating improved access quality
[47:05] and outcomes for medical members. While
[47:07] compliance remains important, the
[47:09] emphasis is increasingly on whether
[47:12] people can access services quickly,
[47:14] receive evidence-based care, and achieve
[47:16] better health outcomes. For the quality
[47:19] improvement unit, this means using data
[47:21] not only to monitor compliance, but also
[47:23] to partner with program to improve
[47:25] performance, reduce disparities, and
[47:27] demonstrate the value of our behavioral
[47:29] health system.
[47:31] Next slide.
[47:35] The behavioral health outcomes
[47:37] accountability and transparency report
[47:39] or the voter is one of the largest new
[47:42] reporting requirements under behavioral
[47:44] health services act. Rather than
[47:46] reporting on just one area, counties now
[47:49] provide a comprehensive picture of how
[47:52] behavioral health ser is performing.
[47:55] That includes how funding is spent, who
[47:58] is receiving the services, quality and
[48:00] outcome measures, health disparities,
[48:02] workforce capacity, and overall system
[48:05] performance. The key takeaway here is
[48:09] that DHCS is moving towards greater
[48:11] transparency and accountability.
[48:13] Counties are expected to demonstrate not
[48:15] only where resources are being invested,
[48:18] but how those investments are improving
[48:20] access and qual quality and outcomes for
[48:23] the communities we serve.
[48:26] Next slide.
[48:30] Here are the building blocks of the
[48:32] voter. One thing to keep in mind is that
[48:35] the voter is still under development.
[48:37] And what you're seeing here is DHCS's
[48:39] long-term vision. Additional data
[48:42] sources and reporting requirements will
[48:44] continue to be phased in over the next
[48:46] several years. With that, I will hand it
[48:49] over to Scott. Next slide, please.
[48:52] So, some of the monthly reporting that
[48:55] we do come straight off of our
[48:57] electronic health record called Smart
[48:59] Care. Smart Care is a cloud-based
[49:01] platform designed for behavioral health
[49:03] and human services.
[49:06] enabler staff securely access document
[49:09] and share patient control. It
[49:12] streamlines clinical administrative and
[49:14] billing task with a single system
[49:15] helping teams put into care and maintain
[49:17] clients efficiency. We use this
[49:20] dashboard shown
[49:22] and others like it to help us track how
[49:24] well we're performing and make sure we
[49:25] meet the numerous requirements that
[49:26] apply to us. This uh dashboard was
[49:29] created by an organization we call Cal
[49:31] Mesa.
[49:33] The dashboard allows us to filter out
[49:35] data in various ways to look at smart
[49:37] care timely access data using different
[49:40] levels of detail. Timely access to
[49:42] California means you have the right to
[49:44] behavioral health to to get behavioral
[49:46] health care like therapy or psychiatric
[49:48] help within a set number of days and
[49:51] you're not left waiting too long and
[49:52] needing support. These rules help make
[49:54] sure care is available quickly enough to
[49:56] address your mental health needs before
[49:58] they even worse. Next slide, please.
[50:03] uh users can turn on and off different
[50:05] subsets of the data look using filtered
[50:08] also called slicers which allows us to
[50:10] focus on certain aspects of the data.
[50:13] This picture is showing the data in a
[50:14] different time period than the last one
[50:17] allows to see better detail and focus on
[50:19] the numbers better. We can also explore
[50:20] by other categories such as
[50:24] many other ways. Next slide please.
[50:29] Uh here's a a final uh dashboard from a
[50:33] different part of the same compass
[50:35] website that shows patient demographics
[50:38] in the context of service providation
[50:44] back to Amy so she can work with us.
[50:46] >> Right. Next slide. So that's just some
[50:48] of the
[50:50] most of it is either still under
[50:52] development or brand new. So we're still
[50:54] trying to navigate it and get exposed to
[50:58] it and work with it. But where are we
[51:01] heading? Um that sort of next uh we QI
[51:05] has become more strategic and not just
[51:07] regulatory. Qi helps guide system
[51:09] improvement of language for the
[51:10] company's initiatives
[51:13] connect the HSA and other statewide
[51:15] expectations. QI is increasingly data
[51:18] driven in real time. medical connectis
[51:21] the booger and other reporting cycle
[51:24] provide the data needed for quicker and
[51:25] more informed decisions
[51:28] is the engine for accountability
[51:29] continuous improvement and it ties all
[51:31] the data systems together to show
[51:32] progress identify gaps and improve
[51:35] outcomes for the community the next
[51:37] slide please so in final this is the
[51:40] future so as I said before we have been
[51:43] hit with these initiatives were in
[51:45] various points of their implementation
[51:48] and development
[51:50] But um still more change is coming. So
[51:53] you're going to hear some of what we've
[51:54] already stated because we're still in
[51:55] development and some new things. So what
[51:58] continues to be developed and is
[52:00] upcoming is in limous service expansion.
[52:03] So this is counties will soon be um
[52:06] having expanded alternative supports
[52:08] like respbit and pure services. This
[52:10] will mean new workflows tracking as we
[52:12] prepare for a January 1st 2027 launch.
[52:16] These are services that we may provide
[52:19] and have provided, but we haven't had to
[52:21] do the data um elements to it. So now
[52:23] we're having to do a whole bunch of
[52:24] recoding in our system. Again, new
[52:27] workflows will be developed, policies
[52:29] and procedures.
[52:30] A lot of steps will go into this
[52:32] implementation in a very short period of
[52:34] time. Again, I'll go over the voter um
[52:37] the transparency and outcome reporting
[52:39] because state reporting is increasing
[52:42] with long-term move towards public
[52:43] dashboards. Counties will need to
[52:45] provide more detailed outcomes and
[52:47] disparity data payment reform. You know,
[52:50] CAL was payment reform and we've been in
[52:53] process. So the next step is full
[52:55] implementation. So the fee for service model will require stronger
[52:59] documentation, accurate encounters, and
[53:01] more data drivens. Growing medical
[53:04] connect requirements and more reporting
[53:06] will shift to medical connect. back just
[53:09] this last week, the state was um talking
[53:11] about um not only new things coming in,
[53:14] but some of the stuff that they've
[53:15] already implemented since October um needing corrections. So,
[53:19] they're finding gaps in their own data
[53:21] analysis and making changes with affects
[53:23] us on you know what measures we've seen
[53:26] already and what we were trying to make
[53:27] change to being readjusted over time.
[53:31] So, this will um as it gets better,
[53:33] we'll tighten validation. will have
[53:35] tighter validation rules and additional
[53:37] performance indicators.
[53:39] Petus align performance measures.
[53:41] Counties will see a little focus on
[53:43] femininess and we keep saying that
[53:46] followup after crisis engagement and
[53:48] youth access with expectations to show
[53:50] improvement. The prop one BHS HSA
[53:54] modernization new rules emphasize
[53:56] tracking high acuity compliance
[53:58] coordinating cross crisis housing
[54:00] treatment and clear outcome reporting
[54:02] for state requirements. workforce
[54:04] reporting. We don't do a lot of
[54:07] workforce reporting with the state. So,
[54:08] this is going to be new. They're going
[54:10] to expect us to provide more data than
[54:13] we have around staffing, vacancies,
[54:18] um along with workforce planning, type
[54:19] of service needs. They know we've
[54:22] reported some things, you know, verbally
[54:23] in meetings, but this is going to be
[54:25] more official documented data so uh that
[54:28] they can see it as we can with other
[54:32] dashboards. crisis system
[54:34] transformation. With the federal 988
[54:36] changes, counties will need stronger
[54:38] mobile crisis response, stabilization
[54:40] services, and more crisis related
[54:42] reporting. And then sort of the last
[54:44] area um in the future is equity and
[54:47] disparities reporting. Counties will
[54:49] continue to expand demographic and
[54:51] outcomes by population reporting with
[54:53] expectations to demonstrate reductions
[54:55] in disparity. With that, that is the end
[54:58] of our presentation on the changes that
[55:01] have been happening and what to expect
[55:04] in the future. And does anyone have any
[55:06] questions for us?
[55:09] >> Yes.
[55:11] >> Oh, sorry. I guess I'm being offered a
[55:14] first. Um, do you guys have
[55:19] [laughter]
[55:21] >> Do you guys have um any plans to give
[55:24] more staff for your team for me
[55:26] specifically because there's a lot of
[55:29] how do you guys fit this into the frame?
[55:32] Needless to say, that's why I'm sort of
[55:34] reading the presentation instead of
[55:35] giving one that I was not read because
[55:37] it's like I just need to get it down and
[55:39] go to the next thing because there is so
[55:42] much we need to be working on and we we
[55:46] aren't meeting everything because we
[55:47] don't have enough staffing. I can say um
[55:50] in the last year since I've been here, I
[55:52] have not successfully hired anyone yet.
[55:55] So, we we had only four vacancies when I
[55:58] first started. Now, we have five. I'm
[56:00] still waiting on hiring. I mean this is
[56:04] a lot of data the data centers so
[56:08] >> right not to say that I'm not using some
[56:10] AI to help out with some writing and
[56:12] some
[56:13] >> if it's got to be done it's kind of
[56:14] >> yeah I don't love it but
[56:16] >> we need
[56:22] » I am curious about the um you mentioned
[56:24] the federal 98 aid requirements changing
[56:27] and I am not that familiar with what
[56:29] that entails um and the level crisis
[56:32] component of that. Did you say a little
[56:33] bit more about that or somebody here?
[56:36] >> I actually don't have a lot of
[56:38] information on that as I was compiling.
[56:39] I too was like, "Oh, I'm going to have
[56:41] to look into that a little more." So,
[56:42] >> okay.
[56:43] >> I think it's referencing the changes
[56:46] related to MC mobile crisis benefit,
[56:48] which they're now because they've
[56:50] proposed potential changes to MCB. One
[56:54] of the solutions is linking it to 988 so
[56:57] that um those calls go through there and
[57:00] then some of that funding can be
[57:01] associated with that. But that's still
[57:03] being worked out like that hasn't been
[57:05] um entirely formalized and there could
[57:09] be some problems with that but that's
[57:11] part of what the 988 transition or
[57:13] changes would include. So part of the
[57:16] idea would be someone calls 988 and they
[57:18] think that they're in crisis and we go
[57:19] to that basically
[57:21] >> that that that through 988 the MCB teams
[57:25] get dispatched and it makes it a little
[57:28] tricky because part of what they've
[57:30] talked about is
[57:32] shifting funding for mobile crisis
[57:34] benefit only if you can track from 988
[57:38] only if you can track the calls coming
[57:40] through there and we know that that's
[57:41] not the only way that we get calls. So
[57:43] anyway, there's some elements to work
[57:45] out, but yeah, that's like high level
[57:47] looking at 988 being the the number to
[57:50] call to get mobile crisis benefits is
[57:52] not is
[57:54] >> um so not 911 or local calls.
[57:56] >> Well, I mean, we go through that too,
[57:58] but just if we wanted to use the 988
[58:00] funding that goes with that, then it
[58:03] would go through that.
[58:08] » Yes. Um so
[58:11] a question about A lot of this data
[58:13] seems to come from like smart from like
[58:15] kind of the provider inputs. What are
[58:18] like the measures of getting like um
[58:21] data from like the actual clients
[58:24] services like are there avenues for
[58:26] feedback from them and is that included
[58:28] in
[58:30] >> quite sure question
[58:34] [clears throat]
[58:34] >> I was there are there are mechanisms
[58:36] that we have for client patient feedback
[58:38] that are
[58:39] >> survey I was going to say we have
[58:41] something that's run annually that's
[58:43] >> in smart
[58:44] >> no it's not in smart it's
[58:47] That's where I was missing.
[58:48] >> Yeah.
[58:49] >> Yes.
[58:49] >> Yeah. So, we have the the client
[58:52] perception survey and then on side
[58:54] there's the treatment perception survey
[58:55] which is an annual that provides data um
[58:58] that we distribute to our partners and
[59:00] we review internally. There's also our
[59:02] you know client satisfaction forms and
[59:04] other things that we do internally to
[59:06] gather that feedback. It's not directly
[59:08] through the EHR, but um but we collect
[59:12] that
[59:13] >> and like do we do any like community
[59:15] needs assessments like as part of that
[59:19] how that all folds in? I see like how
[59:21] easy it is to pull data from like the
[59:23] smart systems like like I can't imagine
[59:25] them like getting data outside of that.
[59:28] >> So the public health does a community
[59:31] health assessment and which includes
[59:35] for that. where we, you know, partner
[59:37] with them, they get data, it gets
[59:39] included.
[59:40] >> Okay, cool.
[59:41] >> And also, for instance, um, we mentioned
[59:44] that medical connect and some of these
[59:46] new portals and dashboards that we
[59:47] didn't have. The state is now
[59:49] aggregating that data in places where we
[59:51] can kind of go and we can see, hey,
[59:53] there's we can look at our clients in
[59:55] different ways that we didn't have
[59:56] before and see, okay, there might maybe
[59:59] there's a barrier for this age
[1:00:00] population, for this type of service.
[1:00:02] Uh, that data is really new to us. So,
[1:00:05] it's figuring out how we can build that
[1:00:07] into our flow and evaluate it and then
[1:00:09] use it to to try and improve. There's a
[1:00:12] lot of new new things out there that are
[1:00:14] helping us do that as well.
[1:00:15] >> Like the compass things that we showed,
[1:00:17] we've only been looking at this for two
[1:00:20] months.
[1:00:21] >> So,
[1:00:23] just how new it is and how fast it's all
[1:00:25] coming out.
[1:00:27] >> Cool. You're doing great. [laughter]
[1:00:31] So what I understand is that feel that it's
[1:00:36] scalable that people individuals at some
[1:00:38] point will be able to use the
[1:00:40] information that is available to
[1:00:42] everybody else to see how they compare
[1:00:44] in their community.
[1:00:46] >> They are actually like on medical
[1:00:48] connect we can already compare with
[1:00:49] other counties of the same or similar
[1:00:52] size those measurements that they've
[1:00:54] imposed put in there so far.
[1:00:57] >> So there are those mechanisms. I've seen
[1:00:59] it on other websites. I think back to
[1:01:01] the question um somebody had earlier
[1:01:03] about access to the community to data.
[1:01:06] There are plenty of DHCS websites that
[1:01:08] have elements. Um these ones that we're
[1:01:12] showing are the ones we directly have
[1:01:13] access to because what happens is you
[1:01:15] get into PHI to at some point and we
[1:01:18] can't give the community access to those
[1:01:21] u you know individual level data points.
[1:01:24] So for us to affect change, we need that
[1:01:26] information whereas the community only
[1:01:28] needs the aggregate. So they're on other
[1:01:30] sites.
[1:01:34] » Oh, I'm sorry. Um you had early you
[1:01:36] mentioned a little bit earlier that you
[1:01:37] were measuring uh performance per county
[1:01:40] based on benchmarks but if this is all
[1:01:43] new where are the benchmarks coming from
[1:01:45] and who and where did how are they
[1:01:47] decided or you know is this like a
[1:01:49] federal benchmark which is kind of
[1:01:51] strange because there's no real program
[1:01:53] like medical anywhere else
[1:01:55] >> right well there is medical is called
[1:01:57] Medicaid in other states so it's the
[1:01:59] same program then California takes it
[1:02:01] and likes to scoop it up you know its
[1:02:03] own Right. So, um
[1:02:06] yeah. So,
[1:02:07] >> federal benchmark.
[1:02:09] >> No, not for these. There are in HEATUS,
[1:02:11] the HEADESS ones. Um there are federal
[1:02:13] benchmarks. Um the but the state of
[1:02:17] California also giving us the HEADES
[1:02:19] measures as well and so they're adding
[1:02:22] their components to it um and setting
[1:02:25] benchmarks and then wanting and
[1:02:26] evaluating us on it. I will say that
[1:02:28] even last week in the call when they
[1:02:31] were saying, you know, well, my year 24
[1:02:34] was going to be our benchmark year, but
[1:02:36] you guys, it was a do not report year.
[1:02:39] So now we're looking at 2025. So again,
[1:02:42] they're still trying to really establish
[1:02:44] the foundation
[1:02:45] and causing, you know, us to just keep
[1:02:48] reestablishing, you know, with next
[1:02:51] changes. So,
[1:02:52] >> and that started in 2023 with the what
[1:02:55] they called measurement year 2023. For
[1:02:58] years, the state had a hard time
[1:03:00] comparing counties to counties because
[1:03:01] it really was apples to oranges because
[1:03:03] our services and counties are very
[1:03:05] different. But they started with
[1:03:07] measurement year 2023
[1:03:09] and establishing standards and then
[1:03:11] holding us each all of the counties to
[1:03:13] those and that's what started the
[1:03:15] benchmarks. So now measurement year 2024
[1:03:17] is based off of benchmarks from that and
[1:03:20] that's all we're we're really adapting
[1:03:22] and being counties we're don't
[1:03:23] necessarily adapt as quickly as um you
[1:03:27] know p the private sector does um
[1:03:30] adapting to how quickly we have to start
[1:03:32] measuring new data that we weren't doing
[1:03:34] before and you know keeping to those
[1:03:36] goals at the same time is that it's a
[1:03:39] huge administrative burden but it's not
[1:03:41] what our direct service staff are you
[1:03:43] know they're serving clients. So it's on an administrative level of
[1:03:48] overload for the data component of this.
[1:03:52] >> Thank you.
[1:03:55] » So let me just ask overall how do you
[1:03:59] think our counties do or can you say one
[1:04:02] thing that we're super awesome in this
[1:04:05] [laughter]
[1:04:07] >> like um I don't know all the measures.
[1:04:09] There's no way to know all the measures.
[1:04:10] So I don't overall tell you specifically
[1:04:13] how well we're doing or comparably but
[1:04:15] what I can say is what I have reviewed
[1:04:17] recently and getting a lot of aha
[1:04:19] moments is some of the heat ones which
[1:04:22] we have about four to seven that we're
[1:04:24] being um measured on and we're getting
[1:04:27] again we're doing this roving change
[1:04:30] every you know week it seems but we have
[1:04:33] the heat measures coming out straight
[1:04:34] out of smart care is giving us what they
[1:04:37] have put together with their methodology
[1:04:40] we've got one from our EQRO vendor HSAG
[1:04:43] and then we've got with the state of
[1:04:45] California has given us for DHCS. I
[1:04:47] haven't been able to compare all three
[1:04:48] of them but when I've looked at a couple
[1:04:50] of them for the most part with like FUM
[1:04:53] which is followup after medical care I
[1:04:56] think and then FUA followup after
[1:05:00] hospitalization. Um we're actually doing
[1:05:02] pretty good on those currently. Um so
[1:05:07] and that's from the my 25 measurement
[1:05:09] year 2025 that we just got that report
[1:05:12] from. So we are doing there's obviously
[1:05:15] some areas where we need to do some work
[1:05:17] like mostly I think that's in the SED
[1:05:19] realm which I think is a struggle across
[1:05:21] the board for every county every state
[1:05:25] you know SED is a very complex um
[1:05:29] program so those are areas we need
[1:05:31] improvement and our numbers are super
[1:05:33] small. So one client can change and
[1:05:36] offset the whole measurement you know
[1:05:39] for any measure or one situation you
[1:05:42] know that ex extra thing that happens
[1:05:45] that triggers something that results in
[1:05:47] whatnot it can completely make our
[1:05:51] measures go side scientific some of them
[1:05:53] have a lot of numbers in them but
[1:05:54] they're most not most some of them have
[1:05:57] very small numbers as well in fact one
[1:06:00] of the measurements I just heard the
[1:06:01] state say again her state
[1:06:04] from the same meeting last week um that
[1:06:08] the numbers if they're less than 30 in
[1:06:10] the count they um are going to hold us
[1:06:14] to that and I do know one of the
[1:06:16] measures that I was looking at earlier
[1:06:18] this week had less than 30. I think
[1:06:20] we're still doing okay but it was still
[1:06:22] less than 30 so we wouldn't be held to
[1:06:24] any kind of fines penalties or sanctions
[1:06:27] because of that.
[1:06:30] So I heard we're doing well in followup
[1:06:33] after hospitalization,
[1:06:35] >> right? And what was followup?
[1:06:38] >> It's there's like two components of one
[1:06:40] is like when you go to the ER, there's a
[1:06:43] follow-up and we're doing good there.
[1:06:44] And the other one's um the followup
[1:06:47] after
[1:06:50] >> that M&MD visit. So that one I think
[1:06:53] Ross is still doing. We haven't spent a
[1:06:55] lot of time on the ED ones, so I have
[1:06:56] that one really long in my head.
[1:07:00] These are the ones that are showing up
[1:07:02] on page 15. I think
[1:07:03] >> I was going to say if you look at 15,
[1:07:04] those are
[1:07:05] >> I mean sorry to interfer with this mean
[1:07:08] but yeah.
[1:07:12] I am but this raising questions of
[1:07:15] around so is there a need to push more
[1:07:21] for
[1:07:23] using numbers of clients rather than
[1:07:26] percentages personal accounts and is
[1:07:29] that an area that's like a meaningful
[1:07:32] area for reform or is it kind of too
[1:07:35] soon to say because you're aligning some
[1:07:37] of these systems under new guidelines
[1:07:39] that kind of thing. I think if you're
[1:07:41] trying to do a comparative analysis, it
[1:07:43] you need to stick with the percentages.
[1:07:45] If you're trying to actually affect
[1:07:46] change, we need to know the number. We
[1:07:49] need to say who are those people in the
[1:07:51] ER that we need to follow up on. So,
[1:07:54] which is what some of the work we've
[1:07:55] done in our performance improvement
[1:07:57] projects is to have connections with the
[1:07:59] hospitals. They're giving us a list,
[1:08:01] which is very forward because for years
[1:08:04] we've struggled with sharing
[1:08:06] information. Even though HIPPA says with
[1:08:08] the treating relationship you can share,
[1:08:11] they still nobody wants to share because
[1:08:13] everyone's risk adverse and don't want
[1:08:15] to be the people in trouble. Um so but
[1:08:18] we've made a lot of good partnerships
[1:08:21] and communications and we're getting the
[1:08:23] information. So I think numbers are
[1:08:25] important when you really want to do the
[1:08:28] deep dive. Um I don't know how that sort
[1:08:31] of lays out with legislation and changes
[1:08:34] for that. Um, I know it does when you
[1:08:38] have big numbers and you want something
[1:08:39] done, but I don't know about the small
[1:08:42] numbers.
[1:08:44] >> Thanks.
[1:08:47] » Quick question.
[1:08:49] I'm a little biased about Humble County.
[1:08:50] I think Humble County is great
[1:08:52] >> and I would think that a lot of
[1:08:53] nonprofits are cooperating. I they're
[1:08:56] very involved with the CA, the 998 and
[1:08:58] things like that. What mechanisms are
[1:09:01] there for nonprofits to help if that
[1:09:02] information process that data we sites
[1:09:08] when reports like that are the
[1:09:09] committees and things like that or or
[1:09:11] we're not there yet?
[1:09:13] >> Um
[1:09:15] well we're looking a lot at our own data
[1:09:17] so I'm not really connected to our
[1:09:20] nonprofits
[1:09:22] >> talking about the hospitals providing
[1:09:24] information. They're nonprofits.
[1:09:25] >> That's true. Um
[1:09:28] >> I I think meetings with them.
[1:09:30] >> Yeah. I think another element that I
[1:09:32] would say too is part of these
[1:09:34] initiatives are also integrating us some
[1:09:37] data exchange with other parts of the
[1:09:38] county, right? Like public as an
[1:09:40] example.
[1:09:41] >> So part of like the chimp and chop
[1:09:43] process is going to be integrated in
[1:09:45] some capacity within the integrated plan
[1:09:47] at some point. So if you're doing like
[1:09:48] engagement with public health as an
[1:09:50] example, chances are some of that input
[1:09:52] and feedback will trickle down to our
[1:09:54] planning process as well.
[1:09:57] payment of that data exchange.
[1:09:59] >> And to what Amy was saying earlier, a
[1:10:02] lot of this is spurring conversation and
[1:10:04] increasing health information exchange.
[1:10:07] More people are getting into health
[1:10:09] information exchanges, which is allowing
[1:10:11] us to have access to the data at a level
[1:10:13] we didn't have in the past,
[1:10:15] >> right? Because the state is now saying,
[1:10:16] "Here's your humble county behavioral
[1:10:18] health and then the managed care plans,
[1:10:21] and we want you to play nice and we want
[1:10:23] you to share your information." Yeah,
[1:10:25] that is definitely a heavy lift.
[1:10:34] » Any other questions?
[1:10:37] >> I don't know. There's a lot of letters
[1:10:38] in my brain and a lot of
[1:10:42] soup in there. There's little recipe
[1:10:44] book.
[1:10:44] >> I mean, I probably have other questions
[1:10:47] if that's okay to
[1:10:48] >> absolutely anytime ask.
[1:10:50] >> Yeah. Thank you so so much. really well
[1:10:53] done
[1:10:53] >> and we appreciate all the work you do.
[1:10:56] >> Yeah.
[1:10:57] >> Yes. Thank you.
[1:11:00] >> Well, with that we
[1:11:03] >> Do you guys mind if we hop out so we can
[1:11:05] get back some of that?
[1:11:06] >> Yes.
[1:11:10] » Some of them smell a flower on the web.
[1:11:14] >> I'll go ahead and stop uh the screen
[1:11:16] share if that's okay.
[1:11:20] » Absolutely. Thank you all for your time.
[1:11:22] >> Thank you.
[1:11:29] » At this moment, um, we have a quorum.
[1:11:34] >> So, I would like to bring back the
[1:11:36] action items of approving minutes from
[1:11:38] 618 and 625.
[1:11:42] Anybody want to make a motion? Make a
[1:11:44] motion.
[1:11:45] >> I'll second.
[1:11:46] >> All right. All in favor of approving all
[1:11:49] those minutes.
[1:11:51] >> I opposed.
[1:11:54] >> All right, there we go. We got that
[1:11:56] done. There's no other action items,
[1:11:58] right? That's it.
[1:11:59] >> You're just
[1:12:01] Yes, I know. Thank you so much.
[1:12:04] >> For that,
[1:12:06] >> I only want you here for your vote.
[1:12:10] I'm kidding. Sorry, I'm sassy today.
[1:12:18] All right. So now we will go to
[1:12:20] communications before you leave.
[1:12:23] Supervisor Aoyo, do you have any
[1:12:24] communications?
[1:12:25] >> I um don't at this time. Sorry, this
[1:12:29] very anticlimactic. Um I do I do have to
[1:12:32] depart early. I'm sorry, but
[1:12:37] this is the time when a board members
[1:12:39] can communicate. Hello. Um I don't have
[1:12:42] Well, I guess um I wanted Austin to kind
[1:12:45] of announce um is that okay announce
[1:12:49] >> for you? Sure.
[1:12:51] >> Uh yeah, Patrick's Foundation is uh
[1:12:53] still on course for our sobering center
[1:12:55] and the 3.2 social model detox. Uh we're
[1:12:59] looking for properties currently and um
[1:13:01] we're working on getting the lensure
[1:13:03] figured out as we speak. So we believe
[1:13:05] we've staffed up appropriately. We're
[1:13:07] just kind of uh getting a lot of fine
[1:13:10] tuning done before we're making that
[1:13:12] final step there. And we also will be
[1:13:14] one of the sponsors for International
[1:13:16] Overdose Awareness Day for 2026.
[1:13:20] It worked.
[1:13:35] » So, at this time, uh, just so Eddie,
[1:13:37] Saul, and Allan know, we didn't get on
[1:13:40] the board of soups agenda, but, uh,
[1:13:43] August 10th is what I hear. So,
[1:13:46] >> okay. I think it might be August 11th.
[1:13:49] >> 11
[1:13:52] days. I saw your note.
[1:13:53] >> Oh, August 11th.
[1:13:55] >> 11. Thank you.
[1:13:56] >> And it should be on the consent
[1:13:57] calendar. So, I mean, if you want to
[1:13:59] come, you're welcome to, but um it's
[1:14:02] hard to imagine that it will not pass.
[1:14:05] You never know.
[1:14:06] >> So,
[1:14:07] it would be shocking.
[1:14:09] >> You don't What I'm saying is you don't
[1:14:10] need to be there. Although, if want to,
[1:14:12] for sure.
[1:14:15] >> Thanks.
[1:14:17] John, do you have anything to run out at
[1:14:19] this time? Okay,
[1:14:21] >> Jess.
[1:14:22] >> Yeah, give me just a second to pull up
[1:14:24] the flyer. Oh, well, I believe that Joe
[1:14:26] already sent it out to everybody, but
[1:14:28] the wellness day barbecue that's going
[1:14:30] to be happening from HTC Quark, make
[1:14:33] sure you get over there. We got some
[1:14:35] good chefs. And other than that, the
[1:14:38] popup photography event was a really big
[1:14:41] success. We had lots of people coming in
[1:14:43] and out of that. And yeah, that's pretty
[1:14:45] much all that I have for now.
[1:14:48] >> That's Sean. I know you have something.
[1:14:51] >> I don't think I screw up. I haven't
[1:14:55] >> Okay, save my for
[1:14:59] that. Doesn't matter. I guess
[1:15:00] >> I don't really have anything except for
[1:15:02] I wanted to
[1:15:05] just kind of check back in with Jess
[1:15:07] about any HCTC response to the
[1:15:11] recommendations conversation we had last
[1:15:14] month. Not to put you on the spot.
[1:15:16] >> Well, I guess it's my time to be on
[1:15:18] this. Not yet because I haven't uh I was
[1:15:21] busy during our last meeting, but
[1:15:23] >> that's fine.
[1:15:23] >> I'll make a note to myself.
[1:15:26] I just wanted you to know that at the or
[1:15:28] everybody to know at the last executive
[1:15:30] committee meeting we agreed uh that we
[1:15:33] just want to revisit continuously like
[1:15:35] every six months or so. So we'll
[1:15:38] >> we want and and also not just for
[1:15:40] transition age youth we want to hear
[1:15:42] feedback about how this board is
[1:15:45] accessible and inclusive to all the
[1:15:48] folks in our community. So uh please you
[1:15:51] know keep that in mind when you come to
[1:15:53] these meetings that uh we want to hear
[1:15:56] from folks about how to improve
[1:15:59] uh our accessibility for folks. So
[1:16:04] it
[1:16:06] all right what I have is um
[1:16:11] CIT just
[1:16:14] my gosh CIT will be October 22nd to 26
[1:16:20] um
[1:16:21] >> October 27th.
[1:16:22] >> Yes. The training of the contract 40
[1:16:24] hour training
[1:16:26] to do all of it over time. Just catch
[1:16:28] little bits
[1:16:30] >> and it's going to change.
[1:16:34] » Um
[1:16:34] >> October what?
[1:16:36] >> October 22nd through the 26th. It's a
[1:16:38] 40-hour training for law enforcement and
[1:16:40] social workers.
[1:16:42] >> Thursday through a Monday.
[1:16:45] October.
[1:16:47] >> Or Monday through Thursday.
[1:16:50] All right, y'all.
[1:16:53] >> 26th. I need 26.
[1:16:55] >> Okay.
[1:16:56] >> 26 through 30th.
[1:17:01] » 31st is Halloween.
[1:17:04] >> It's a whole week. Yeah.
[1:17:09] Um, and then also just wanted to let you
[1:17:11] all know that Eureka, the Eureka Police
[1:17:14] Department and the Crisis Alternative
[1:17:16] Response of Eureka Mental Health Team
[1:17:19] and DHS are going out to Huba to present
[1:17:22] on SP 43550s,
[1:17:26] the escalation stuff. And so that's
[1:17:28] becoming quite a nice partnership. We've
[1:17:31] been interacting with Lubo Valley Tribal
[1:17:34] and now out there. So it's been very
[1:17:37] nice
[1:17:39] to share that. What about the CIT
[1:17:42] international conference?
[1:17:44] >> Oh, the CIT international conference is
[1:17:47] in August. The I don't know the second
[1:17:51] Monday, Tuesday, Wednesday, which is in
[1:17:53] Orlando, Florida, which place to be in
[1:17:56] August. Yes,
[1:17:58] >> it was in
[1:18:00] >> what's next to
[1:18:03] in Fort Lauderdale, but
[1:18:06] >> I'm excited to go. Not that far, but
[1:18:09] >> Well, I know there's a Canadian version.
[1:18:11] I I saw that.
[1:18:12] >> I know Canada has their CIT together. I
[1:18:16] bet they Yeah.
[1:18:18] >> Anyway,
[1:18:19] >> yes. Thank you, Kelly.
[1:18:20] >> How many I'm just curious, how many
[1:18:22] people are going? What kind of agencies
[1:18:23] are represented?
[1:18:25] >> Seven people are going. Uh, public
[1:18:27] defender, uh, someone from the district
[1:18:29] attorney's office. Uh, Arcada
[1:18:34] Gman's going. No, supervisors are going.
[1:18:41] Hang on. Uh, sorry.
[1:18:45] >> I know.
[1:18:45] >> I'm just nosy more than anything.
[1:18:48] >> Well, I'm happy to fill you in on
[1:18:49] everyone else who's coming in as soon as
[1:18:51] I can remember who they are, but don't
[1:18:53] do that again.
[1:18:55] Um yes, different agencies are gone.
[1:18:59] Coming back to report to you.
[1:19:03] >> It just the CIT international conference
[1:19:06] is such a good opportunity to learn
[1:19:08] what's happening in other places across
[1:19:11] the country and outside of the country
[1:19:13] around crisis intervention. and our
[1:19:15] county has always done a very good job
[1:19:17] at like bringing folks from all the
[1:19:20] different agencies and it's a great
[1:19:22] opportunity for them to network and
[1:19:24] build better collaborative
[1:19:26] relationships. So I'm it's I'm biased
[1:19:30] obviously but it's a it's a great thing.
[1:19:32] So good job.
[1:19:35] All right. Now we'll go to reports. Uh
[1:19:39] behavioral health direct
[1:19:44] today. Um let's see.
[1:19:48] We're continuing to move forward with a
[1:19:51] new administrator for the DMCO. Yes.
[1:19:53] Which is good. Just regular meetings
[1:19:55] with Hel Mesa,
[1:19:58] BER, CHCS county. So we're kind of in
[1:20:03] the phase where Calme State is working
[1:20:05] with DHCS on the keys the key structure
[1:20:08] and working really hard to create
[1:20:11] something that's reasonable and
[1:20:12] sustainable. So that's good. Um
[1:20:16] we let's see what else we had. Um
[1:20:22] Oliver who was here and left went out
[1:20:25] Tuesday to the groundbreaking for the
[1:20:27] Euro Health and Wellness Center which is
[1:20:29] should be amazing. Um, pretty excited
[1:20:33] about that and just happy that our
[1:20:35] community, Humble County, is really
[1:20:37] building out our health of care in so
[1:20:39] many ways. That's
[1:20:42] Boy, we we are waiting to hear back on a
[1:20:46] community reinvestment application to
[1:20:48] DHCS. I think I talked about this here a
[1:20:51] little bit previously, but um
[1:20:53] Partnership Health in collaboration with
[1:20:56] public health and behavioral health has
[1:20:58] community reinvestment funds that um
[1:21:02] public health and behavioral health need
[1:21:03] to come to an agreement on in terms of
[1:21:07] how we recommend investing that in our
[1:21:10] community. And one of the ways that um
[1:21:12] we talked about here in the whole county
[1:21:14] was using some of those funds for DMCODS
[1:21:16] for um supporting the contract with Cal
[1:21:20] Mesa so that we can you know sure that
[1:21:22] we have resources available for that.
[1:21:24] We're waiting like I said we're waiting
[1:21:26] to hear back from DHCS on that proposal.
[1:21:28] So certainly update this group.
[1:21:31] And then I guess the other thing I'll
[1:21:33] mention is DHS OAC which is Behavioral
[1:21:38] Health Services Oversight and
[1:21:39] Accountability Commission reached out
[1:21:41] and asked if they could come visit. So
[1:21:43] that's great and you know a little
[1:21:46] stressful. So we're we've talked
[1:21:48] internally about creating an opportunity
[1:21:50] for them to come see how things are
[1:21:52] going in Humble County. They would
[1:21:54] certainly talk about some of um the BHSA
[1:21:57] transition and maybe would have
[1:21:59] conversations with some of our um
[1:22:02] community partners and other local
[1:22:03] groups. So possibly behavioral health
[1:22:06] would be a group that could
[1:22:08] share.
[1:22:10] So you know why what well no they just
[1:22:13] said they wanted to come. it they gave
[1:22:15] it as an option and I didn't really feel
[1:22:17] like I should say no but um they are
[1:22:21] just offering to come and see how things
[1:22:23] are going and ta and help us gather
[1:22:26] information so it I mean it sounds
[1:22:29] >> have you seen humble I mean it makes
[1:22:31] sense correct
[1:22:32] >> yeah exactly so anyway I'll keep you
[1:22:35] guys posted on that we're just Oliver
[1:22:37] and I and the deputies have been about
[1:22:40] what how we could actually make it a
[1:22:42] meaningful visit like what are the
[1:22:43] things we might want to talk about or
[1:22:44] get put on and who might we want to
[1:22:46] connect them with. So, we're kind of
[1:22:48] organizing around that and thinking
[1:22:50] about dates.
[1:22:53] >> Are there still any funds coming from
[1:22:56] them for like crisis triage or anything
[1:22:58] like that?
[1:23:00] >> Isn't that the over
[1:23:03] the innovation?
[1:23:05] >> No, the crisis. Oh, this is no
[1:23:09] >> I think all of them.
[1:23:11] I just was curious cuz like we had we
[1:23:13] would go to those meetings and stuff
[1:23:15] with them regularly, but they were I
[1:23:17] mean they were always really
[1:23:19] >> they have been helpful. Yeah. With Yes,
[1:23:21] that's true. That's right. I just was
[1:23:23] curious.
[1:23:26] » Yeah,
[1:23:28] >> Jeremy.
[1:23:30] >> Um yeah, in the children's world, uh
[1:23:33] things don't slow down summer like they
[1:23:35] used to.
[1:23:37] a lot of contracts right now where um
[1:23:40] anytime a youth gets placed in a in a
[1:23:43] short-term residential facility what
[1:23:45] used to be called group homes that
[1:23:46] requires new contracts with those
[1:23:48] facilities. Um we're trying to get new
[1:23:52] contracts in place for some additional
[1:23:53] providers and so just there's a lot of
[1:23:56] activity around that contracting
[1:23:59] certifying our sites. So our humble
[1:24:00] flash site fortune site said are all
[1:24:03] going through medical reertification
[1:24:06] that's a lot of work that are going into
[1:24:08] those things. um all the initiatives
[1:24:10] that Amy talked about in the Cal AIM
[1:24:13] world. Um we're working with uh
[1:24:16] probation as far as solidifying anou
[1:24:20] that outlines a lot of the new
[1:24:22] requirements around pre-release
[1:24:25] services and making sure that that
[1:24:28] on the June slide that youth that are
[1:24:31] getting ready to be discharged from the
[1:24:33] facility are set up with services pri
[1:24:36] prior to being released. and then uh
[1:24:39] looking at all the screening and the
[1:24:40] assessment tools and finalizing that
[1:24:43] probation. So that's part of the cali
[1:24:46] project um under BH connect what Amy
[1:24:50] mentioned a lot of the evidence based
[1:24:51] practices that are now required. So
[1:24:53] we're in the process of um for two
[1:24:57] practices functional family therapy and
[1:24:59] parent child interaction therapy. for
[1:25:03] identifying staff to be trained and
[1:25:04] moving closer to setting up the
[1:25:06] trainings for staff. Um and then once we
[1:25:09] get staff trained then we'll be able to
[1:25:11] roll those specific evidence-based
[1:25:13] practices out to offer those services.
[1:25:16] And then MST multi- systemic therapy is
[1:25:20] a more challenging one because it
[1:25:22] requires 247 247
[1:25:26] crisis availability. that we're looking
[1:25:28] at. It's putting out a request for
[1:25:30] proposals to see if another agency be
[1:25:32] willing to maybe contract with that
[1:25:34] service. Um, so lots of work on BH
[1:25:38] connect stuff um under BHSA which Amy
[1:25:42] also talked about, but the high fidelity
[1:25:45] wraparound is the other really big state
[1:25:47] initiative right now. So there's a kind
[1:25:50] of work both on with behavior health and
[1:25:53] child welfare because child welfare has
[1:25:57] the mandate to offer wrap around to
[1:26:00] section or portions of their youth that
[1:26:03] are identified as immediate needs youth
[1:26:05] or youth coming back from a group home.
[1:26:08] Behavioral health has requirements to
[1:26:09] offer wraparound to our full service
[1:26:12] partnership highle youth. So we're
[1:26:15] trying to organize all of these
[1:26:17] wraparound efforts. So it's essentially
[1:26:20] one wraparound system, one process. So
[1:26:24] it's there's a lot of moving parts right
[1:26:25] now. The state has not finalized the
[1:26:27] pledge of the guidance that we're
[1:26:28] getting on. So right now it's a lot of
[1:26:31] wraparound meetings that are happening,
[1:26:33] but we're getting closer where we have
[1:26:35] two providers in the county that uh both
[1:26:38] been certified by the state to be high
[1:26:41] fidelity wraparound providers. And so
[1:26:43] that's really in many ways we're ahead
[1:26:45] of other counties because we have
[1:26:47] providers. We're just kind of waiting in
[1:26:50] the state for a lot of things to
[1:26:52] finalize things and really be able to
[1:26:53] roll out the services. So lots of things
[1:26:56] going on right now in children. Yeah.
[1:26:58] >> Who are the providers? So, Revenue
[1:27:00] Community Services is they they already
[1:27:03] are doing rapid specifically for child
[1:27:05] welfare youth and so um we'll be
[1:27:08] updating their contract to add
[1:27:11] >> the behavior health portion to that and
[1:27:13] then humble neuro health will be a new
[1:27:16] provider. So, between the two of them
[1:27:19] will have capacities for both child
[1:27:21] welfare and non childare.
[1:27:28] Thanks. Yeah.
[1:27:31] I think people would see Jack, what have
[1:27:35] you got for us?
[1:27:37] >> Hi. Uh, good afternoon everyone. Sorry I
[1:27:40] couldn't make it in person, but nice to
[1:27:42] see everyone. Um, probably not a lot on
[1:27:45] the adult side. Um, you know, we we
[1:27:48] definitely are are uh in the the
[1:27:51] recruitment and hiring phase for for
[1:27:54] some clinicians and uh we've got some
[1:27:57] interviews coming up and that's uh good
[1:28:00] for us. Um but we [clears throat] remain
[1:28:03] pretty pretty busy. We've been working
[1:28:05] on um this transitional rent uh with the
[1:28:10] home program. Uh that's a new
[1:28:13] partnership benefit that uh
[1:28:15] theoretically you're supposed to, you
[1:28:17] know, allow for
[1:28:20] a portion of rent to be paid by uh the
[1:28:23] partnership health plan. And so we're
[1:28:25] kind of working on the the kinks for
[1:28:27] that. But um that's probably the the
[1:28:30] latest initiative that I could recall
[1:28:34] here. Um but yeah, have my updates.
[1:28:40] » Thanks,
[1:28:42] Um, I just wanna I'm gonna just pop it
[1:28:45] in here, Jack, since you just spoke, but
[1:28:47] at the executive committee, we had a a
[1:28:51] wonderful commenation testimonial from a
[1:28:54] man who Jack had helped his family
[1:28:57] member and it was um wonderful to hear
[1:29:01] that. And you know, it's a private
[1:29:04] matter, but good job, Jack. It's
[1:29:08] heartwarming to hear how you helped and
[1:29:10] that's pretty cool that the deputy
[1:29:13] director
[1:29:14] is doing that kind of work. So, good
[1:29:17] job, Jack. You're awesome.
[1:29:18] >> Yeah, I'm I'm out in the field.
[1:29:21] >> I know.
[1:29:22] >> Helping helping the helping the
[1:29:24] community. It's good stuff.
[1:29:26] >> Yeah.
[1:29:28] >> Awesome. All right. Next. Sud committee,
[1:29:32] right? Yes.
[1:29:33] >> SUD committee. So, the last SUD uh
[1:29:37] meeting that we had um we invited Dette
[1:29:40] invited the Good News Rescue Mission to
[1:29:43] come and do a presentation. They are one
[1:29:47] of several new um businesses that have
[1:29:50] come into our community uh specifically
[1:29:52] for ECM services. Um and so we pretty
[1:29:57] much wanted to know, you know, more
[1:30:00] about them quite frankly. um a little
[1:30:03] concerning. Um they uh are coming into
[1:30:06] encampments
[1:30:07] um and other places uh where um most of
[1:30:12] our folks that we serve congregate. Um I think maybe offering them some kind of
[1:30:18] monetary compensation like a gift card
[1:30:20] um signing them up. Um and so we just
[1:30:23] want to make sure that you know they are
[1:30:26] being held accountable. Quite frankly,
[1:30:28] you know, it's my experience and a few
[1:30:29] other navigators um that when we are um
[1:30:33] doing, you know, some kind of
[1:30:34] screenings, you know, a big percentage
[1:30:37] of the folks um you know, will find out
[1:30:40] they they are um signed up for services
[1:30:44] and they have no idea. They don't
[1:30:46] remember signing anything. They don't
[1:30:48] remember having a conversation. And so
[1:30:49] it's a little concerning um you know for
[1:30:53] uh kind of like messes up you know some
[1:30:55] of the services that some of you know us
[1:30:57] folks that are actually kind of want to
[1:30:59] that are here actually doing services
[1:31:01] you know in our community um you know
[1:31:03] when we have someone that's already
[1:31:05] signed up. It's a conflict and you know
[1:31:07] um it just makes it very difficult for
[1:31:10] these people to to get services. So, we
[1:31:13] want to kind of, you know, form like um
[1:31:16] uh more of an accountability uh group.
[1:31:18] Um so, Janette is working on that.
[1:31:21] She'll have more to report um next uh
[1:31:25] meeting. Um she is going to be I guess
[1:31:28] scheduling other um of these groups. Uh
[1:31:31] so, the next um is there going to be an
[1:31:34] August SVG meeting?
[1:31:35] >> No.
[1:31:36] >> Okay. So, that would be the um
[1:31:38] >> in September. So that's the second
[1:31:40] Thursday,
[1:31:42] right?
[1:31:43] >> Yes. Yeah.
[1:31:44] >> Um and so yeah, we will know more about
[1:31:47] that. Uh Laura and uh Kim Burgel joined
[1:31:51] the meeting and they had some questions.
[1:31:53] Um I had some specific questions about
[1:31:56] capacity that I'm still unclear about.
[1:31:58] Uh so we did contact the administration
[1:32:02] of that and we are going to get some
[1:32:04] answers, Laura, and we're going to
[1:32:06] proceed with the meeting I guess. So
[1:32:08] >> yeah, we we met with uh the person uh
[1:32:11] who's the director here locally and our
[1:32:14] chief of police on 17 is we're meeting
[1:32:17] next Thursday with their CEO.
[1:32:20] >> Perfect.
[1:32:21] >> And so yes, we have many questions.
[1:32:24] >> Yes. Awesome. So more will be revealed
[1:32:26] with that.
[1:32:27] >> Um and uh let's see. So yes, um we are
[1:32:32] also um going to be uh so 811 at 9087
[1:32:38] street is the next SCD MAT uh
[1:32:41] collaborative meeting where all uh
[1:32:44] providers SCT
[1:32:46] SD and MAT folks are encouraged to come.
[1:32:49] Um Beth Jansen and Melissa Nelson and I
[1:32:53] are the uh facilitators. We're working
[1:32:56] on
[1:32:58] creating a pool of funds for folks that
[1:33:00] we have a lot of folks that are just
[1:33:02] resistant to going to rehab because they
[1:33:04] have animals. A lot of them are
[1:33:06] houseless. Some of them some some of
[1:33:08] them aren't houseless. They just don't
[1:33:09] have anywhere to put their house their
[1:33:11] animals. So, we're working on a proposal
[1:33:14] to Myrtle Avenue for for boarding
[1:33:16] services and coordination of care,
[1:33:19] getting the animals uh their required
[1:33:22] shots so that they can um there are some
[1:33:25] rehabs that are going to allow the
[1:33:26] animal to go with the patient once they
[1:33:28] complete the detox process, but the
[1:33:31] animals need to have their shots. They
[1:33:33] need to have they just need specific
[1:33:35] things. And so, we're working on that
[1:33:39] for folks that aren't able to do that.
[1:33:41] We're also working on an emergency fund
[1:33:43] for medications. Um I'm having a
[1:33:47] difficult time um finding funding for
[1:33:51] people that don't have money for
[1:33:54] medications and there's like either
[1:33:56] they're not from this area, they don't
[1:33:58] have insurance. Before I was able to
[1:34:00] just have a hospital um on that. I don't
[1:34:03] have access to that anymore. Um, and I'm
[1:34:06] getting shot down when I try to reach
[1:34:09] out to the hospital. So, um, we're
[1:34:12] trying to figure out how the hospital
[1:34:14] can help with that. So I I have a we
[1:34:17] have reached out to um Joy Victorine and
[1:34:20] Martha Shanahan to see if that service
[1:34:22] can still happen because we we are now
[1:34:25] experiencing folks and Melissa Nelson
[1:34:28] and I are trying to put our heads
[1:34:30] together to figure out how people can
[1:34:32] get their suboxone as the alternative is
[1:34:34] them not having it and then them
[1:34:36] >> being hospitalized.
[1:34:37] >> Yes. Exactly. So overutilized in the
[1:34:40] emergency room or sometimes them not
[1:34:41] even going to the emergency room, them
[1:34:43] saying, "Forget it. I'm just going to go
[1:34:45] out there and we don't want that to
[1:34:46] happen. So, um that's what we're working
[1:34:50] on. And uh recovery happens is scheduled
[1:34:53] um for September 19, I believe, right
[1:34:58] Melissa.
[1:34:59] >> Okay. She does her hand up.
[1:35:00] >> Okay. Yeah. Um and uh International
[1:35:03] Overdose Awareness Day um is August
[1:35:06] 31st. However, that falls on a Monday.
[1:35:09] So, a lot of places are having the
[1:35:12] actual event on Saturday the 29th. Uh,
[1:35:16] Humble is having that actual event at
[1:35:18] the Adorn I'm sorry, not the Adorning
[1:35:20] Center, the Gazebo from 12 to 5. Um, and
[1:35:24] so, yes, there's going to be I think I
[1:35:26] don't know we're up to I think in the
[1:35:28] teens with vendors and tables that are
[1:35:30] going to be there. We have speakers
[1:35:33] going to be giving her mayoral
[1:35:35] proclamation. Hatcher and Patrick's
[1:35:38] Foundation are going to be uh sponsors
[1:35:40] along with Crossroads and Eegis um and
[1:35:43] Redwood Recovery Center. So, it's going
[1:35:45] to be a collaboration. Um so, hopefully
[1:35:48] everybody can attend that. Um and then
[1:35:52] there is October 14th through the 18th
[1:35:55] the annual um CAC uh California
[1:35:59] convention on STG consortium is going to
[1:36:01] be in um Universal City and we'll have
[1:36:05] more um information on that. A group of
[1:36:08] us like to go every year. Um and I think
[1:36:12] that is it. Yeah, that's it for me. I
[1:36:16] think Melissa have something to add
[1:36:18] might have something to add.
[1:36:20] Thank you so much. I was typing away and
[1:36:23] I was not doing a good job putting it in
[1:36:25] text. Okay. So um for in regards to
[1:36:29] medication cost if there is an
[1:36:31] individual who is not eligible for
[1:36:34] medical and does how to have an
[1:36:37] out-ofpocket cost for their medications
[1:36:40] and treatment for their Matt treatment
[1:36:42] and if they are seeking buponorphine
[1:36:44] treatment or methodone treatment. We do
[1:36:47] have the state opioid response still a
[1:36:49] grant still at Aegis that can cover the
[1:36:52] cost of treatment, but it is
[1:36:55] monthtomonth until funds are exhausted.
[1:36:57] So, it's not um a long-term solution at
[1:37:01] all, but it is something that can help
[1:37:03] temporarily in regards to medication
[1:37:06] costs. The tricky thing with that with
[1:37:08] BU especially is that we require daily
[1:37:12] medicating for patients that are new to
[1:37:15] our program. So, it's just not a
[1:37:17] realistic option for some if they're not
[1:37:19] able to come to our clinic daily in the
[1:37:21] beginning before establishing stability
[1:37:23] and treatment. But, um, again, if if
[1:37:27] cost is a factor, we do still have those
[1:37:29] grant funds um until they're exhausted.
[1:37:32] And we have the grant until, um,
[1:37:35] September of 2027,
[1:37:37] but we are trying to use those funds
[1:37:39] now. Um,
[1:37:42] so yeah, you can reach out. I'm going to
[1:37:44] put my number in the chat. If you have
[1:37:45] someone that has questions about that or
[1:37:48] is needing um grant assistance for
[1:37:51] treatment costs, please reach out.
[1:37:54] >> Thank you.
[1:37:55] Melissa.
[1:37:59] » All righty. Um adult older adult
[1:38:02] committee update. We did have a meeting.
[1:38:04] Mark Elliot was going to join but then
[1:38:07] he had to somebody had called out so we
[1:38:09] had to take on
[1:38:11] a different role. Um we have another
[1:38:16] remember if we have another meeting but
[1:38:18] that's slow in ramping up however it
[1:38:21] will be with
[1:38:24] as far as other committees uh
[1:38:27] legislative com ad hoc has a meeting on
[1:38:30] the 27th Nancy Stark thank you for
[1:38:33] sending out that invite and uh the
[1:38:39] minutes from your last meeting because
[1:38:40] there's there's a lot in that world and
[1:38:43] I know Vernon wanted to be here today.
[1:38:44] He's not. Do you have anything to say
[1:38:46] about that admark?
[1:38:48] >> No, just that we might delay the meeting
[1:38:51] on Monday uh due to Margarit.
[1:38:55] So,
[1:38:55] >> okay.
[1:38:56] >> We may be delaying the meeting just a
[1:38:57] little bit, but that's okay because the
[1:38:59] behavioral health board is dark in
[1:39:01] August. So, we have time.
[1:39:04] >> Yeah. Awesome. Thanks for that work that
[1:39:07] you're doing there. And then Peter's not
[1:39:10] here, but we do have some people ready
[1:39:13] to go. Jess being one of them that Peter
[1:39:15] stole for the children and family
[1:39:17] committee. And we are waiting for
[1:39:20] September. Maybe we'll have a secretary.
[1:39:23] Yeah.
[1:39:26] Okay. So that's kind of so
[1:39:30] All right. Um do you have anything, Vice
[1:39:34] Chair?
[1:39:37] I just wanted to piggyback on the other
[1:39:40] committees in that we we had our
[1:39:46] behavioral health board retreat a while
[1:39:47] back that we talked about how everybody
[1:39:49] is going to join a committee and so we
[1:39:52] were kind of waiting for our new members
[1:39:54] to become official members to like
[1:39:56] figure that out. So I know there's a
[1:39:59] couple other people that might be
[1:40:01] interested in doing the children and families committee
[1:40:06] >> or adults or um I also have space on the
[1:40:11] membership committee possibly. I know
[1:40:13] supervisor Royal. So I think we can
[1:40:16] revisit that maybe
[1:40:21] September.
[1:40:22] >> Yeah. Okay. Yeah. So I just wanted to
[1:40:25] put that out there. So if you're going
[1:40:28] to be a new member or if you're already
[1:40:30] a member and aren't on a committee,
[1:40:32] we'll be figuring that out. So So think
[1:40:34] about So the the mandated committees are
[1:40:37] the SUD, the adult older adult, the
[1:40:41] children and families and the membership
[1:40:44] committee and the executive committee.
[1:40:46] So uh think about what committees you
[1:40:49] might be most interested in shortly.
[1:40:52] >> Thank you very much.
[1:40:54] >> Thank you. Okay, so I just got the data
[1:40:58] notebook 2026 for California where all
[1:41:00] behavioral health boards, they have a
[1:41:02] subject every time. It was SUD last
[1:41:05] time. This time it's foster youth and uh
[1:41:10] in behavioral health and social
[1:41:13] services. It's 25 questions. Last year,
[1:41:16] I don't know why, if it's just that I'm
[1:41:17] more into like more aware of SUD stuff,
[1:41:20] it was easy. These questions are super
[1:41:23] hard. So, I will be reaching out to
[1:41:27] Peter, Jess, and Jeremy to help answer
[1:41:29] some of these. Um, just a little teaser,
[1:41:34] who provides the child and adolescent
[1:41:36] needs and strengths assessment for
[1:41:37] foster care youth in our county? That's
[1:41:40] can
[1:41:42] be read.
[1:41:43] >> Okay, great.
[1:41:49] » So, there we go. What was that? Well,
[1:41:51] then you just answer these.
[1:41:56] » And then how is your county planning to
[1:41:58] provide high fidelity wraparound
[1:42:00] services?
[1:42:01] >> Planning a lot of planning. [laughter]
[1:42:05] » Well, I like that it says that are
[1:42:07] required starting July 1. And
[1:42:11] >> yeah,
[1:42:11] >> but giving you all a little taste of a
[1:42:15] few of the questions. Um
[1:42:18] yes, but that is due
[1:42:21] >> our houseful policy. So
[1:42:22] >> October 12th
[1:42:25] >> and that will be submitted early. I just
[1:42:28] it's one of those things where in the
[1:42:29] past they were never submitted on time
[1:42:32] and last time I got it in on time and
[1:42:34] the time before that was late. But um
[1:42:37] yes, super excited about that.
[1:42:40] >> And one quick little thing
[1:42:42] >> and one more quick little thing on
[1:42:44] advice.
[1:42:46] Uh Melissa Nelson put her number in the
[1:42:49] chat for grant funds available for
[1:42:50] streaming costs. Um so if anybody would
[1:42:52] like it, get your pen ready. 707
[1:42:57] 5727586.
[1:43:01] Thank you, Melissa.
[1:43:02] >> Thank you, Melissa.
[1:43:04] >> All right.
[1:43:07] >> I'm monitoring the chat. Yeah.
[1:43:10] >> I keep freaking out because I look at
[1:43:11] Saul and I'm like, "No, his eyes are
[1:43:14] >> [laughter]
[1:43:17] » Right on us unfinished business. NAV
[1:43:20] center. [laughter]
[1:43:22] I don't think there's anything new.
[1:43:25] Crisis triage from what I heard in the
[1:43:28] homeless
[1:43:30] leadership work group. Everything is
[1:43:32] progressing uh with those. And then care
[1:43:36] court. Uh we're still killing it. If I
[1:43:38] get out of here on time, I might go see
[1:43:41] if I can pop in because I've been
[1:43:43] invited.
[1:43:49] I think is anybody have any future
[1:43:50] items?
[1:43:53] Seeing hearing none,
[1:43:56] I will
[1:43:57] >> no meeting,
[1:43:58] >> right?
[1:43:59] >> That is correct.
[1:44:00] >> I will adjourn this meeting. Thank you
[1:44:02] all. At 13:40,
[1:44:06] » thank you all. Thank you all. Good to
[1:44:09] see everybody.
[1:44:10] >> We're going to have a full board next
[1:44:12] September when we look back.