[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.

Humboldt County Behavioral Health Board regular meeting July 23, 2026

Agenda

Transcript