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We have.

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Welcome to the AUGUST 26th

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meeting of the Regional Policy

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Committee. To manage today

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s

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meeting, I

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d like to ask the

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only committee members and the

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scheduled presenters join us on

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the zoom platform. I asked the

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other staff and interested

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community members follow the

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meeting on King County tv

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channel 22 or stream online.

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This time. I

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d like to begin by

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asking the clerk to call the

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roll.

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Thank you. Chair. Council

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member Arnaud.

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Here.

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MAY your packets. MAY your

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backs. You

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re muted. Okay. MAY.

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Council member. Robertson. MAY

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your wrath. MAY your brethren.

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Council member. Juarez. Council

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member. Len. Council member.

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Faster. Council member. Drink.

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Councilmember Baron. Here.

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Councilmember. Perry.

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Sherburne.

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Reichbauer here. Well, we

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ll go

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back and do a roll. Again, I

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know that the Sound City

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Association has had a meeting

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going on, and that they are

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concluding at this time, and

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we

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re trying to accommodate

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their schedule. Uh, I want to

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thank everyone for attending

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today

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s Regional Policy

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Committee meeting. We have two

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briefings on today

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s agenda,

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both related to the county

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sales tax funded Mid initiative

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that provides behavioral health

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programs and services to King

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County residents, which has

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been renewed to continue

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through 2034, 2030. For. The

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first briefing will cover the

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mid annual report for calendar

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year 2025. The second briefing

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will be the committee

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s first

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opportunity to hear about the

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executive

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s proposed 2028 2030

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four implementation plans for

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this initiative, which is

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proposed through a companion

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legislation to be renamed

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Behavioral Health Bridge. At

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this time, I would like to

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bring forth, um, I believe

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Isabel Jones, the acting

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director, as well as Robin

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Buren, the special project

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manager, to talk about, um, our

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item number four, 2026 0088.

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MISTER Chair, this is Miranda.

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Would you like for Sam Porter

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to provide a brief introductory

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remarks before our presenters

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begin?

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Sure.

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Absolutely. Report.

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Miranda. Thank you.

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Thank you. Chair von Reichbauer

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Sam Porter, Council central

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staff. The documents for this

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staff report begin in the

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packet on page nine of the pdf.

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I will just provide a very

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brief overview of the

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requirements of the mid annual

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report before handing it over

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to Robin Bowman. From dhs to to

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present on the materials. So

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the 2025 mid annual report does

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appear to meet the requirements

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of King County Code. Um, the

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services and programs funded by

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the Mid are evaluated by staff

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in King County

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s Department of

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Community and Human Services,

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based on data submitted by

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providers. King County Code

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requires that the Annual

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Summary Evaluation report shall

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include, at minimum, the

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following performance

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measurement statistics, program

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utilization statistics.

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Requests for proposals and

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expenditure status updates.

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Progress reports on evaluation.

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Implementation. Geographic

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distribution of the sales tax

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expenditures across the county,

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including collection of

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residential zip code data for

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individuals served by the

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programs and strategies.

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Updated performance measurement

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targets for the the following

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year of Mid initiatives,

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programs and services.

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Recommendations on either

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program changes or process

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changes, or both, and then

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summary cumulative calendar

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year data on page 11 of the

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packet. There is a table one

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that provides an overview of

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the different sections of the

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2025 mid Annual Report, and

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includes the page numbers that

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are associated, and I will

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leave the rest of it to our

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folks at dhs. That concludes my

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remarks. Thank you.

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Thank you very much. I want the

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record to also recognize that

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Mayor Backus, Mayor Pavone, and

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mayor. Mayor Ralph Roll here

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present as well. Um, at this

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time, uh, we

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ll go to our

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friends at, um, Isabel or

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Robin, who

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s going to start off.

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Hi. Thank you so much. Uh,

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chair and, uh, committee

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members. Um, thank you for

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having us. Uh, I will start us

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off, and I will go ahead and

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share my screen with our

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slides. Uh, one moment. Okay.

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Um, are you seeing the screen

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now?

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We are. They just popped up.

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Okay. I

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m going to start the

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slides from the beginning. Um,

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okay. Um, thank you so much.

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And I will introduce myself.

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For the record, my name is

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Isabel Jones. I

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m the acting

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director of the Behavioral

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Health and Recovery Division

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here at the Department of

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Community and Human Services.

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And I

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ll pass it to my

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colleague Robin to introduce

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herself.

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Sure. My name is Robin Forman.

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I

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m typically the mid

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coordinator. You

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ve seen me

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here before for the last

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several years. I

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m serving in a

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special duty role right now.

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And the proviso report that you

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will all receive later. Um, in

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JANUARY of 2027. But here to

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share the report this today.

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Thank you. And I will kick us

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off. I am just going to put the

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2025 mid annual report in

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context for our next

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presentation on the renewal of

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the Mid and the bridge

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implementation plan. Um, as a

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reminder in context, the Mid is

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a one tenth of 1% sales tax

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that generates just under about

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$100 million per year in

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revenue for the county. In

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support of behavioral health

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services in our community. Um,

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in 2008, the Mid was launched

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to counter chronic state and

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federal underinvestment in

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behavioral health programming,

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providing a more stable local

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resource that strengthens our

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provider capacity and our

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behavioral health delivery

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system. The mid one and mid two

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implementation plans, which

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were the first two nine year

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cycles of the mid uh, which has

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stood for mental illness and

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drug dependency. Um, those

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investment and implementation

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plans historically focused on

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prevention, early intervention,

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diversion, recovery and reentry

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system improvement, crisis

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services and therapeutic

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courts. Um, in SEPTEMBER 2025,

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the King County Council voted

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to extend the mid sales tax.

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The collection of the sales tax

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for an additional nine years

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through 2034. Um, and since

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that time we have been working

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on an implementation plan for,

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uh, sort of the next iteration

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of the mid, uh, which we are

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now calling the bridge, which

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we transmitted in JULY of 2026

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and is under consideration by

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the council at this time. Um,

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so our following presentation,

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uh, will provide additional,

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uh, context related to the

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bridge implementation plan. But

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today

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s presentation, um, with

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Robin is focused on 2025 and

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the mid investments of 2025 and

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some of the accomplishments of

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the mid, um, in the last year,

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2025. Um, with that, I

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m going

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to turn it to Robin.

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Great. Thank you for that

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introduction. So. I will just

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be starting on this slide. Um,

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wanted to share the outcomes.

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The 2025 mid accomplishments.

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You can see on this. These are

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signature measures um for Mid

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initiatives for which jail

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bookings, emergency department

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admissions and inpatient

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psychiatric hospital admissions

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are assessed. Outcome data

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demonstrated a consistent

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impact in reducing the use of

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these system among mid

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participants over the long

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term. Um, three years after

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initiating initiating Mid

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services, we can see that the

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63% of participants had fewer

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recorded crisis episodes, 29%

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had fewer emergency department

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admissions. Jail bookings were

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down 33% in psychiatric

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hospital admissions were down

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41% over the long term, and 89%

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of youth in related programs

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had no new juvenile legal

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system. Charges filed after

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enrolling in mid services. Next

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slide. Let

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s go. In 2025. Mid

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serve just over 30,000 people

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across 52 initiatives. Um this

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slide displays the demographic

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information of people served by

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Mid initiatives. Last year. And

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we

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ve included the percent of

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the population living below the

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federal poverty level, which we

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use often as a proxy for need

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to provide the additional

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context. Next slide. These maps

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show the geographic

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00:09:54,565 --> 00:09:56,433
distribution of individuals

295
00:09:56,433 --> 00:09:58,735
served by Mid. Also, compared

296
00:09:58,735 --> 00:10:00,437
to the federal poverty level.

297
00:10:00,437 --> 00:10:02,406
And while Mid serve residents

298
00:10:02,406 --> 00:10:04,400
across all of King County,

299
00:10:04,400 --> 00:10:06,440
service recipients were more

300
00:10:06,543 --> 00:10:08,120
often rated in zip codes with a

301
00:10:08,120 --> 00:10:10,412
higher percentage of families

302
00:10:11,114 --> 00:10:12,483
living below the poverty line

303
00:10:12,483 --> 00:10:14,618
aligning with Mid School to

304
00:10:14,618 --> 00:10:18,218
serve those most in need. Next

305
00:10:21,158 --> 00:10:21,825
slide. And last year

306
00:10:21,825 --> 00:10:23,593
s

307
00:10:23,593 --> 00:10:25,495
financial report reflects a

308
00:10:25,495 --> 00:10:27,931
single year budget. You are

309
00:10:27,931 --> 00:10:31,201
very well aware of that. We

310
00:10:31,201 --> 00:10:34,801
adjusted to a new biennium um,

311
00:10:37,507 --> 00:10:39,507
in 2025 mid expended 115.8

312
00:10:44,514 --> 00:10:46,914
million of its budgeted $128.2

313
00:10:47,184 --> 00:10:49,486
million, or 90% of our planned

314
00:10:49,486 --> 00:10:50,787
expenditures. And as you are

315
00:10:50,787 --> 00:10:52,550
also likely where mid to

316
00:10:52,550 --> 00:10:54,550
funding obligations are

317
00:10:54,157 --> 00:10:55,893
starting to outpace projected

318
00:10:55,893 --> 00:10:57,494
revenues. The behavioral health

319
00:10:57,494 --> 00:10:59,620
Bridge Implementation Plan

320
00:10:59,620 --> 00:11:00,664
presents the opportunity to

321
00:11:00,664 --> 00:11:02,766
realign programming and planned

322
00:11:02,766 --> 00:11:04,766
expenditures to anticipated

323
00:11:06,403 --> 00:11:08,471
revenue beginning in 2028, and

324
00:11:08,471 --> 00:11:10,400
lastly, I just encourage you

325
00:11:10,400 --> 00:11:11,700
all to visit the data

326
00:11:11,700 --> 00:11:11,975
dashboard. It

327
00:11:11,975 --> 00:11:13,900
s truly worth

328
00:11:13,900 --> 00:11:14,444
diving into if you want to

329
00:11:14,444 --> 00:11:16,480
learn more about mid to

330
00:11:16,480 --> 00:11:17,948
programming. The hyperlink is

331
00:11:17,948 --> 00:11:19,516
included on the slide and is

332
00:11:19,516 --> 00:11:21,584
embedded throughout the online

333
00:11:21,584 --> 00:11:21,750
version of the report. And now

334
00:11:21,750 --> 00:11:22,920
I

335
00:11:22,920 --> 00:11:24,721
ll turn it back to Isbell for

336
00:11:24,721 --> 00:11:25,556
some concluding remarks. Thank

337
00:11:25,556 --> 00:11:27,556
you.

338
00:11:28,920 --> 00:11:29,159
Thank you. Um, so the

339
00:11:29,159 --> 00:11:30,994
behavioral Health Bridge is

340
00:11:30,994 --> 00:11:32,529
very much building on the

341
00:11:32,529 --> 00:11:34,929
learnings, the investments, the

342
00:11:35,980 --> 00:11:37,200
community engagement, um, that

343
00:11:37,200 --> 00:11:38,735
has occurred over the life of

344
00:11:38,735 --> 00:11:40,838
really both mid one and mid

345
00:11:40,838 --> 00:11:43,907
two. Um, there are a couple,

346
00:11:43,907 --> 00:11:45,442
uh, kind of key points that we

347
00:11:45,442 --> 00:11:46,976
are bringing from mid over to

348
00:11:46,976 --> 00:11:48,445
the bridge, which is to

349
00:11:48,445 --> 00:11:50,480
strengthen our data reporting

350
00:11:50,480 --> 00:11:52,382
and accountability. Um, by

351
00:11:52,382 --> 00:11:53,817
having performance expectations

352
00:11:53,817 --> 00:11:56,190
within each of the five new

353
00:11:56,190 --> 00:11:57,287
strategy areas, including

354
00:11:57,287 --> 00:11:58,888
performance measurement and

355
00:11:58,888 --> 00:12:00,524
accountability that we apply to

356
00:12:00,524 --> 00:12:03,524
some of the programming. About

357
00:12:04,194 --> 00:12:05,963
25% of the mid programming that

358
00:12:05,963 --> 00:12:08,363
is actually administered by

359
00:12:08,365 --> 00:12:08,799
county agencies. Um, we

360
00:12:08,799 --> 00:12:10,330
re also

361
00:12:10,330 --> 00:12:11,869
emphasizing alignment and

362
00:12:11,869 --> 00:12:13,700
integration across service

363
00:12:13,700 --> 00:12:14,637
areas and increasing

364
00:12:14,637 --> 00:12:16,306
coordination and cross system

365
00:12:16,306 --> 00:12:17,808
connectivity. Um, one of the

366
00:12:17,808 --> 00:12:20,110
ways that we intend to do that

367
00:12:20,110 --> 00:12:22,413
is by managing the mid, um, the

368
00:12:22,413 --> 00:12:24,814
goal level rather than a more

369
00:12:24,814 --> 00:12:26,814
narrow individual initiative

370
00:12:27,350 --> 00:12:29,319
level as we did in mid one and

371
00:12:29,319 --> 00:12:31,722
two, which we found kind of

372
00:12:31,722 --> 00:12:33,590
created, um, more silos and

373
00:12:33,590 --> 00:12:35,492
challenged our ability to have

374
00:12:35,492 --> 00:12:37,492
integration across programming.

375
00:12:37,594 --> 00:12:39,620
Um, and then continuing to

376
00:12:39,620 --> 00:12:40,497
invest where needs are

377
00:12:40,497 --> 00:12:42,199
greatest. According to data,

378
00:12:42,199 --> 00:12:44,199
community engagement and

379
00:12:45,168 --> 00:12:46,169
subject matter input. Um, and

380
00:12:46,169 --> 00:12:48,538
with that, that actually

381
00:12:48,538 --> 00:12:50,938
concludes our mid 2025 annual

382
00:12:50,974 --> 00:12:52,542
report presentation. Uh,

383
00:12:52,542 --> 00:12:54,111
however, our next presentation

384
00:12:54,111 --> 00:12:55,713
will continue on this topic as

385
00:12:55,713 --> 00:12:57,347
we transition to the bridge

386
00:12:57,347 --> 00:12:59,347
implementation plan.

387
00:13:09,960 --> 00:13:11,494
All right.

388
00:13:11,494 --> 00:13:14,297
And I think I will turn it back

389
00:13:14,297 --> 00:13:15,264
to you, chair, perhaps to Sam.

390
00:13:15,264 --> 00:13:17,934
Thank you. I thought you were

391
00:13:17,934 --> 00:13:19,703
going to continue. Although my

392
00:13:19,703 --> 00:13:22,103
colleagues. Any questions? I

393
00:13:22,673 --> 00:13:24,474
know. Um, this has been a

394
00:13:24,474 --> 00:13:25,509
beginning process for many of

395
00:13:25,509 --> 00:13:26,977
us. I

396
00:13:26,977 --> 00:13:28,745
m checking any raised

397
00:13:28,745 --> 00:13:32,945
hands. I feel free to speak up

398
00:13:33,383 --> 00:13:36,619
if I MISS You on the zoom

399
00:13:36,619 --> 00:13:39,255
outline. You know, it looks

400
00:13:39,255 --> 00:13:41,524
like we have no questions for

401
00:13:41,524 --> 00:13:43,426
my colleagues. Isabelle, where

402
00:13:43,426 --> 00:13:45,995
do you want to go from here?

403
00:13:45,995 --> 00:13:47,631
Um, I believe I will pass it to

404
00:13:47,631 --> 00:13:50,334
Sam Porter, who is going to do

405
00:13:50,334 --> 00:13:51,568
a staff briefing on the bridge

406
00:13:51,568 --> 00:13:53,203
implementation plan.

407
00:13:53,203 --> 00:13:55,372
Excellent. Sam, can you proceed

408
00:13:55,372 --> 00:13:57,173
with the, um, executive

409
00:13:57,173 --> 00:13:59,109
transmitted behavioral health

410
00:13:59,109 --> 00:14:00,744
Bridge implementation program

411
00:14:00,744 --> 00:14:02,110
and companion legislation?

412
00:14:02,110 --> 00:14:03,580
Yes, certainly. Thank you.

413
00:14:03,580 --> 00:14:05,381
Chair. Von Reichbauer Sam

414
00:14:05,381 --> 00:14:06,216
Porter, Council central staff.

415
00:14:06,216 --> 00:14:06,616
Um, so if you don

416
00:14:06,616 --> 00:14:06,808
t mind, I

417
00:14:06,808 --> 00:14:08,318
m

418
00:14:08,318 --> 00:14:10,120
going to begin with the mid

419
00:14:10,120 --> 00:14:11,821
renaming ordinance and then go

420
00:14:11,821 --> 00:14:13,490
into the implementation plan.

421
00:14:13,490 --> 00:14:15,859
The mid renaming ordinance is

422
00:14:15,859 --> 00:14:17,327
fairly brief and leads into the

423
00:14:17,327 --> 00:14:17,504
implementation plan because

424
00:14:17,504 --> 00:14:19,295
it

425
00:14:19,295 --> 00:14:20,664
s renaming the Mid. So the

426
00:14:20,664 --> 00:14:23,320
materials for this ordinance

427
00:14:23,320 --> 00:14:25,902
begin on page 65 of the packet.

428
00:14:25,902 --> 00:14:27,270
Proposed ordinance 2026 0174

429
00:14:27,270 --> 00:14:28,271
would rename and revise the

430
00:14:28,271 --> 00:14:30,173
mental illness and drug

431
00:14:30,173 --> 00:14:31,475
dependency for Mid Fund and

432
00:14:31,475 --> 00:14:32,909
Advisory Committee to the

433
00:14:32,909 --> 00:14:34,111
Behavioral Health Bridge Fund

434
00:14:34,111 --> 00:14:35,779
and Advisory Committee, and

435
00:14:35,779 --> 00:14:37,481
make additional changes to the

436
00:14:37,481 --> 00:14:39,416
Advisory Committee. This

437
00:14:39,416 --> 00:14:41,840
legislation is a mandatory dual

438
00:14:41,840 --> 00:14:42,519
referral to this committee and

439
00:14:42,519 --> 00:14:44,488
the health, Housing and Human

440
00:14:44,488 --> 00:14:46,123
Services Committee. The term

441
00:14:46,123 --> 00:14:47,557
behavioral health encompasses

442
00:14:47,557 --> 00:14:49,459
both mental illness and drug

443
00:14:49,459 --> 00:14:51,628
dependency, also referred to as

444
00:14:51,628 --> 00:14:52,863
substance use disorders. The

445
00:14:52,863 --> 00:14:54,698
transmittal states that the

446
00:14:54,698 --> 00:14:56,660
proposed name change is because

447
00:14:56,660 --> 00:14:57,334
the terms mental illness and

448
00:14:57,334 --> 00:14:58,869
drug dependency no longer

449
00:14:58,869 --> 00:15:00,103
reflect the values and

450
00:15:00,103 --> 00:15:01,304
priorities that guide

451
00:15:01,304 --> 00:15:02,506
behavioral health work today,

452
00:15:02,506 --> 00:15:04,307
and that the terms contribute

453
00:15:04,307 --> 00:15:05,675
to stigma. Executive staff

454
00:15:05,675 --> 00:15:06,977
indicate that the new name is

455
00:15:06,977 --> 00:15:08,977
responsive to community

456
00:15:09,512 --> 00:15:10,747
feedback. Section one of the

457
00:15:10,747 --> 00:15:11,949
proposed ordinance makes

458
00:15:11,949 --> 00:15:13,983
changes to the advisory

459
00:15:13,983 --> 00:15:15,252
committee and updates reference

460
00:15:15,252 --> 00:15:17,200
to expired portions of King

461
00:15:17,200 --> 00:15:18,355
County Code and references to

462
00:15:18,355 --> 00:15:20,323
groups that no longer exist,

463
00:15:20,323 --> 00:15:22,325
including all home and regional

464
00:15:22,325 --> 00:15:24,661
Human Services Levy, Citizen

465
00:15:24,661 --> 00:15:26,396
Oversight board. The proposed

466
00:15:26,396 --> 00:15:27,730
ordinance. Um, one of the key

467
00:15:27,730 --> 00:15:29,232
issues identified in the staff

468
00:15:29,232 --> 00:15:30,267
report is that the proposed

469
00:15:30,267 --> 00:15:31,435
ordinance changes the

470
00:15:31,435 --> 00:15:33,435
activities. The advisory

471
00:15:33,670 --> 00:15:35,271
committee, um, conducts from

472
00:15:35,271 --> 00:15:37,400
reviewing and reporting to the

473
00:15:37,400 --> 00:15:38,542
Executive and Council to review

474
00:15:38,542 --> 00:15:39,576
and provide guidance on

475
00:15:39,576 --> 00:15:41,576
behavioral health. Bridge

476
00:15:42,246 --> 00:15:43,347
annual reports. Executive staff

477
00:15:43,347 --> 00:15:44,681
state that this change is

478
00:15:44,681 --> 00:15:45,882
intended to better reflect the

479
00:15:45,882 --> 00:15:47,350
advisory committees current

480
00:15:47,350 --> 00:15:49,653
role and engagement. Regarding

481
00:15:49,653 --> 00:15:51,121
the annual report process. The

482
00:15:51,121 --> 00:15:52,689
proposed change in Advisory

483
00:15:52,689 --> 00:15:54,524
Committee duties reflects a

484
00:15:54,524 --> 00:15:56,930
policy choice. Um.

485
00:15:56,930 --> 00:15:57,794
Additionally, section one also

486
00:15:57,794 --> 00:15:58,828
replaces two positions for an

487
00:15:58,828 --> 00:16:00,296
individual representing

488
00:16:00,296 --> 00:16:02,296
behavioral health, consumer

489
00:16:02,299 --> 00:16:03,466
interests and an individual

490
00:16:03,466 --> 00:16:04,768
representing community

491
00:16:04,768 --> 00:16:06,736
interests from the mid

492
00:16:06,736 --> 00:16:08,739
consumers and communities. Ad

493
00:16:08,739 --> 00:16:10,240
Hoc workgroup with two

494
00:16:10,240 --> 00:16:11,341
positions that would represent

495
00:16:11,341 --> 00:16:12,476
behavioral health. Consumer

496
00:16:12,476 --> 00:16:14,770
interests who have lived

497
00:16:14,770 --> 00:16:16,120
experience with behavioral

498
00:16:16,120 --> 00:16:17,180
health conditions. Executive

499
00:16:17,180 --> 00:16:18,515
staff state that during the

500
00:16:18,515 --> 00:16:20,650
renewal process, the Mid

501
00:16:20,650 --> 00:16:22,219
Advisory Committee advised

502
00:16:22,219 --> 00:16:24,421
adding additional members with

503
00:16:24,421 --> 00:16:26,900
lived experience. This proposed

504
00:16:26,900 --> 00:16:28,240
change to the membership

505
00:16:28,240 --> 00:16:30,260
reflects a policy choice.

506
00:16:30,260 --> 00:16:31,695
Sections two, three and five in

507
00:16:31,695 --> 00:16:33,960
the proposed ordinance are all

508
00:16:33,960 --> 00:16:34,364
technical changes. Those are

509
00:16:34,364 --> 00:16:37,267
outlined in the staff report.

510
00:16:37,267 --> 00:16:37,427
But just to keep things moving,

511
00:16:37,427 --> 00:16:38,901
I

512
00:16:38,901 --> 00:16:40,336
ll move on to section four,

513
00:16:40,336 --> 00:16:41,938
which would update the name of

514
00:16:41,938 --> 00:16:44,307
the mid fund to the Behavioral

515
00:16:44,307 --> 00:16:46,707
Health Bridge Fund. This

516
00:16:46,709 --> 00:16:48,678
section also has a key issue

517
00:16:48,678 --> 00:16:50,414
identified that would remove

518
00:16:50,414 --> 00:16:52,115
the new strategy Reserve fund

519
00:16:52,115 --> 00:16:53,516
from King County Code.

520
00:16:53,516 --> 00:16:55,916
According to executive staff,

521
00:16:56,452 --> 00:16:57,754
the Mid to initiative 65, which

522
00:16:57,754 --> 00:16:59,422
is emerging issues and

523
00:16:59,422 --> 00:17:01,822
Behavioral health, was launched

524
00:17:02,250 --> 00:17:03,930
in the 2324 biennium through a

525
00:17:03,930 --> 00:17:05,493
partnership with the Mid

526
00:17:05,862 --> 00:17:07,363
Advisory Committee. This fund

527
00:17:07,363 --> 00:17:09,999
served the purpose of the new

528
00:17:09,999 --> 00:17:11,100
strategy Reserve Fund executive

529
00:17:11,100 --> 00:17:12,803
staff state that during the

530
00:17:12,803 --> 00:17:14,804
biennium, this strategy, funded

531
00:17:14,804 --> 00:17:17,700
for time limited projects

532
00:17:17,700 --> 00:17:18,475
including including Seattle

533
00:17:18,475 --> 00:17:20,376
Public Schools, creation of

534
00:17:20,376 --> 00:17:22,120
substance Use Reduction work

535
00:17:22,120 --> 00:17:24,214
Group and virtual parent

536
00:17:24,214 --> 00:17:26,249
education sessions, among other

537
00:17:26,249 --> 00:17:28,118
programs. The removal of this

538
00:17:28,118 --> 00:17:29,786
new strategy Reserve Fund is

539
00:17:29,786 --> 00:17:31,540
proposed by the executive

540
00:17:31,540 --> 00:17:32,822
because the strategy is no

541
00:17:32,822 --> 00:17:34,958
longer funded and executive

542
00:17:34,958 --> 00:17:36,293
staff states that it has

543
00:17:36,293 --> 00:17:38,195
historically been challenging

544
00:17:38,195 --> 00:17:39,830
to administer under short

545
00:17:39,830 --> 00:17:41,898
timelines and in response to

546
00:17:41,898 --> 00:17:43,534
new and emerging trends.

547
00:17:43,534 --> 00:17:44,935
Removing this new strategy

548
00:17:44,935 --> 00:17:47,571
Reserve Fund from King County

549
00:17:47,571 --> 00:17:48,905
Code is a policy choice. There

550
00:17:48,905 --> 00:17:50,600
is no fiscal impact of the

551
00:17:50,600 --> 00:17:51,341
proposed ordinance. According

552
00:17:51,341 --> 00:17:51,574
to the Fiscal Note, and

553
00:17:51,574 --> 00:17:52,609
council

554
00:17:52,609 --> 00:17:54,440
s legal counsel has

555
00:17:54,440 --> 00:17:56,440
reviewed the proposed

556
00:17:56,779 --> 00:17:58,581
ordinance. So I will move on to

557
00:17:58,581 --> 00:18:00,550
the implementation plan.

558
00:18:00,550 --> 00:18:02,950
Proposed ordinance, which is

559
00:18:04,620 --> 00:18:06,422
2026 0177. I am on page 89 of

560
00:18:06,422 --> 00:18:08,124
the packet. This ordinance

561
00:18:08,124 --> 00:18:09,593
would adopt the implementation

562
00:18:09,593 --> 00:18:11,194
plan for the renamed Behavioral

563
00:18:11,194 --> 00:18:14,194
Health Bridge or Bridge Sales

564
00:18:14,397 --> 00:18:16,797
tax funded services from 2028

565
00:18:17,734 --> 00:18:19,102
through 2034, starting in 2028.

566
00:18:19,102 --> 00:18:21,104
This implementation plan would

567
00:18:21,104 --> 00:18:22,406
govern the administration and

568
00:18:22,406 --> 00:18:23,639
implementation plan of the

569
00:18:23,639 --> 00:18:25,809
Behavioral Health Bridge sales

570
00:18:25,809 --> 00:18:27,244
tax revenue. The existing mid

571
00:18:27,244 --> 00:18:28,445
to Service Improvement Plan,

572
00:18:28,445 --> 00:18:30,146
implementation plan and

573
00:18:30,146 --> 00:18:32,348
evaluation plan will continue

574
00:18:32,348 --> 00:18:34,317
to govern investments for this

575
00:18:34,317 --> 00:18:35,953
fund through 2027, in

576
00:18:35,953 --> 00:18:36,953
accordance with an expenditure

577
00:18:36,953 --> 00:18:37,287
restriction in the county

578
00:18:37,287 --> 00:18:39,287
s

579
00:18:40,824 --> 00:18:42,592
2627 biennial budget. This

580
00:18:42,592 --> 00:18:44,561
legislation also is a mandatory

581
00:18:44,561 --> 00:18:47,663
dual referral to both rpc and

582
00:18:47,663 --> 00:18:49,232
three hs. The implementation

583
00:18:49,232 --> 00:18:50,801
plan is organized around a

584
00:18:50,801 --> 00:18:52,468
primary purpose and five

585
00:18:52,468 --> 00:18:54,538
updated strategy areas, which

586
00:18:54,538 --> 00:18:57,538
are identified in table two,

587
00:18:57,674 --> 00:18:59,709
which is on page 94 of your

588
00:18:59,709 --> 00:19:01,110
packet. Programs that receive

589
00:19:01,110 --> 00:19:02,546
bridge funding according to the

590
00:19:02,546 --> 00:19:04,981
plan will advance the primary

591
00:19:04,981 --> 00:19:07,483
strategy areas and will be tied

592
00:19:07,483 --> 00:19:09,385
to performance measures and

593
00:19:09,385 --> 00:19:11,785
outcomes that achieve the 13

594
00:19:11,822 --> 00:19:14,822
strategy areas as identified in

595
00:19:15,725 --> 00:19:16,492
table two. Table two the the

596
00:19:16,492 --> 00:19:17,940
primary. I

597
00:19:17,940 --> 00:19:18,828
ll just read the

598
00:19:18,828 --> 00:19:21,331
primary purpose. And then again

599
00:19:21,331 --> 00:19:22,599
that table two is on page 94.

600
00:19:22,599 --> 00:19:24,167
The primary purpose of the

601
00:19:24,167 --> 00:19:25,501
bridge is to invest in the long

602
00:19:25,501 --> 00:19:27,300
term availability,

603
00:19:27,300 --> 00:19:28,338
accessibility, effectiveness

604
00:19:28,338 --> 00:19:28,605
and equity of the county

605
00:19:28,605 --> 00:19:29,773
s

606
00:19:29,773 --> 00:19:31,400
behavioral health system,

607
00:19:31,400 --> 00:19:32,141
especially where people are

608
00:19:32,141 --> 00:19:35,141
falling through the cracks of

609
00:19:36,312 --> 00:19:37,800
existing systems. The strategy

610
00:19:37,800 --> 00:19:38,214
areas I

611
00:19:38,214 --> 00:19:39,449
ll just briefly read

612
00:19:39,449 --> 00:19:41,251
through those. The first one is

613
00:19:41,251 --> 00:19:43,220
care transitions and Diversion

614
00:19:43,220 --> 00:19:44,220
Services strategy. Area two is

615
00:19:44,220 --> 00:19:45,388
substance use disorder

616
00:19:45,388 --> 00:19:47,388
prevention, treatment and

617
00:19:47,523 --> 00:19:48,991
recovery. Strategy three is

618
00:19:48,991 --> 00:19:50,794
equitable access to behavioral

619
00:19:50,794 --> 00:19:51,961
health care. Strategy four is

620
00:19:51,961 --> 00:19:53,229
children, youth, and young

621
00:19:53,229 --> 00:19:54,565
adult mental well-being. And

622
00:19:54,565 --> 00:19:56,965
strategy five is behavioral

623
00:19:57,234 --> 00:19:58,835
health workforce development.

624
00:19:58,835 --> 00:20:02,435
Um. It is important to note

625
00:20:03,206 --> 00:20:04,608
that the transmitted 28 to 2034

626
00:20:04,608 --> 00:20:06,109
plan, unlike the Mid two

627
00:20:06,109 --> 00:20:07,811
implementation plan, does not

628
00:20:07,811 --> 00:20:09,646
identify specific programs that

629
00:20:09,646 --> 00:20:11,348
will receive bridge funding as

630
00:20:11,348 --> 00:20:12,649
allowed under state law. The

631
00:20:12,649 --> 00:20:13,750
plan further indicates that

632
00:20:13,750 --> 00:20:15,180
this structure allows the

633
00:20:15,180 --> 00:20:16,853
Behavioral Health and Recovery

634
00:20:16,853 --> 00:20:18,688
Division to make programmatic

635
00:20:18,688 --> 00:20:20,560
decisions through procurement.

636
00:20:20,560 --> 00:20:21,391
The phased competitive

637
00:20:21,391 --> 00:20:23,393
procurement and based Budget

638
00:20:23,393 --> 00:20:24,861
analysis section. Later in the

639
00:20:24,861 --> 00:20:27,261
staff report provides more

640
00:20:28,565 --> 00:20:30,660
detail. Um, on that process and

641
00:20:30,660 --> 00:20:32,369
attachment five to the staff

642
00:20:32,369 --> 00:20:34,270
report contains a crosswalk

643
00:20:34,270 --> 00:20:35,405
provided by executive staff

644
00:20:35,405 --> 00:20:37,805
that illustrates the Mid

645
00:20:38,241 --> 00:20:40,210
programs that currently are

646
00:20:40,210 --> 00:20:41,678
operating and the corresponding

647
00:20:41,678 --> 00:20:42,979
anticipated bridge activity

648
00:20:42,979 --> 00:20:45,979
under which programs MAY be

649
00:20:46,216 --> 00:20:46,382
eligible for funding. Um, I

650
00:20:46,382 --> 00:20:47,584
m

651
00:20:47,584 --> 00:20:48,585
going to move past the

652
00:20:48,585 --> 00:20:49,486
community engagement and

653
00:20:49,486 --> 00:20:50,520
subject matter expert

654
00:20:50,520 --> 00:20:51,755
components, as I believe

655
00:20:51,755 --> 00:20:53,657
executive staff are touching on

656
00:20:53,657 --> 00:20:56,657
that in their presentation. So

657
00:20:56,960 --> 00:20:58,929
I am now on page 96 of the

658
00:20:58,929 --> 00:21:00,196
packet. Um, the phased

659
00:21:00,196 --> 00:21:02,196
competitive Procurement and

660
00:21:02,666 --> 00:21:04,670
Based budget analysis. So the

661
00:21:04,670 --> 00:21:05,401
transmitted plan states that

662
00:21:05,401 --> 00:21:06,936
the executive intends to

663
00:21:06,936 --> 00:21:08,771
implement phased competitive

664
00:21:08,771 --> 00:21:10,573
procurements beginning in 2028

665
00:21:10,573 --> 00:21:12,750
for nearly all bridge funded

666
00:21:12,750 --> 00:21:14,750
programs administered by

667
00:21:14,377 --> 00:21:15,812
contracted providers. The plan

668
00:21:15,812 --> 00:21:17,180
states that the phase timeline

669
00:21:17,180 --> 00:21:19,916
will allow for careful design

670
00:21:19,916 --> 00:21:21,851
of the procurement process, and

671
00:21:21,851 --> 00:21:23,587
page 138, which is in the

672
00:21:23,587 --> 00:21:24,888
implementation plan, not in the

673
00:21:24,888 --> 00:21:26,623
staff report, shows the

674
00:21:26,623 --> 00:21:27,758
complete list of components

675
00:21:27,758 --> 00:21:29,692
that are expected to be

676
00:21:29,692 --> 00:21:32,920
included in the procurement

677
00:21:32,529 --> 00:21:33,530
process. Design. Executive

678
00:21:33,530 --> 00:21:35,232
staff indicate that the

679
00:21:35,232 --> 00:21:37,267
procurement process will follow

680
00:21:37,267 --> 00:21:38,869
standard departmental um

681
00:21:38,869 --> 00:21:40,403
procedures, including new

682
00:21:40,403 --> 00:21:41,872
safeguards that dhs is

683
00:21:41,872 --> 00:21:44,872
implementing to respond to the

684
00:21:45,642 --> 00:21:46,909
results of the 2025 um audit.

685
00:21:46,909 --> 00:21:48,278
Additionally, procurements will

686
00:21:48,278 --> 00:21:49,679
be guided by the anticipated

687
00:21:49,679 --> 00:21:51,548
activities that appear with the

688
00:21:51,548 --> 00:21:52,915
logic models that are described

689
00:21:52,915 --> 00:21:54,284
in more detail in the

690
00:21:54,284 --> 00:21:56,284
Performance Measurement section

691
00:21:56,520 --> 00:21:58,254
of the staff report. Those um

692
00:21:58,254 --> 00:21:59,221
logic models are also in the

693
00:21:59,221 --> 00:22:01,221
appendices to the

694
00:22:02,125 --> 00:22:03,726
implementation plan. The

695
00:22:03,726 --> 00:22:05,228
transmitted plan states that

696
00:22:05,228 --> 00:22:06,830
all bridge funded programs that

697
00:22:06,830 --> 00:22:07,897
are managed or administered by

698
00:22:07,897 --> 00:22:10,660
King County departments and

699
00:22:10,660 --> 00:22:11,501
agencies outside of dhs,

700
00:22:11,501 --> 00:22:13,690
including those operated by the

701
00:22:13,690 --> 00:22:15,338
courts and public health, will

702
00:22:15,338 --> 00:22:17,730
receive a base budget analysis

703
00:22:17,730 --> 00:22:18,275
instead of being procured.

704
00:22:18,275 --> 00:22:20,143
Because those programs are

705
00:22:20,143 --> 00:22:21,578
operated by King County.

706
00:22:21,578 --> 00:22:24,347
Details about what this base

707
00:22:24,347 --> 00:22:26,316
budget analysis, um, are not

708
00:22:26,316 --> 00:22:28,840
included in the plan, but the

709
00:22:28,840 --> 00:22:29,519
plan states that the executive

710
00:22:29,519 --> 00:22:30,988
anticipates that the initial

711
00:22:30,988 --> 00:22:33,388
analysis would be completed

712
00:22:35,325 --> 00:22:36,759
ahead of the 2829 budget. Um,

713
00:22:36,759 --> 00:22:38,280
due to the scale of planning

714
00:22:38,280 --> 00:22:39,295
and staffing, the plan states

715
00:22:39,295 --> 00:22:41,164
that the procurement and base

716
00:22:41,164 --> 00:22:42,799
budget analysis cannot occur

717
00:22:42,799 --> 00:22:44,835
all at once and will be done in

718
00:22:44,835 --> 00:22:46,737
a phased manner, as described

719
00:22:46,737 --> 00:22:48,104
in table three, which is on

720
00:22:48,104 --> 00:22:50,104
page 97 of today

721
00:22:50,407 --> 00:22:52,276
s packet. The

722
00:22:52,276 --> 00:22:53,509
plan states that the phased

723
00:22:53,509 --> 00:22:55,440
procurement approach will

724
00:22:55,440 --> 00:22:56,980
provide an opportunity to

725
00:22:56,980 --> 00:22:58,140
coordinate the children, youth

726
00:22:58,140 --> 00:22:59,382
and young adult mental

727
00:22:59,382 --> 00:23:00,783
well-being strategy with the

728
00:23:00,783 --> 00:23:02,753
Best starts for kids renewal,

729
00:23:02,753 --> 00:23:04,870
which is anticipated next year.

730
00:23:04,870 --> 00:23:05,521
Um, to ensure that funding

731
00:23:05,521 --> 00:23:07,658
streams complement rather than

732
00:23:07,658 --> 00:23:09,658
duplicate one another,

733
00:23:10,193 --> 00:23:12,593
executive staff provided table

734
00:23:12,896 --> 00:23:14,765
four, which is on page 98 that

735
00:23:14,765 --> 00:23:16,699
shows an estimated timeline for

736
00:23:16,699 --> 00:23:18,135
the phased procurements and non

737
00:23:18,135 --> 00:23:19,536
funded program ramp down

738
00:23:19,536 --> 00:23:20,236
periods. That would be for

739
00:23:20,236 --> 00:23:20,870
programs that don

740
00:23:20,870 --> 00:23:22,739
t receive

741
00:23:22,739 --> 00:23:25,108
bridge funding but currently

742
00:23:25,108 --> 00:23:28,511
receive mid to funding. So that

743
00:23:28,511 --> 00:23:30,470
table is on page 98. The

744
00:23:30,470 --> 00:23:31,314
transmitted plan states that

745
00:23:31,314 --> 00:23:32,615
the process to develop and

746
00:23:32,615 --> 00:23:34,615
implement procurements is

747
00:23:34,818 --> 00:23:36,486
expected to include notifying

748
00:23:36,486 --> 00:23:37,854
the council. Um, additional

749
00:23:37,854 --> 00:23:39,890
details are not included in the

750
00:23:39,890 --> 00:23:40,524
plan, but in response to

751
00:23:40,524 --> 00:23:41,891
council staff questions,

752
00:23:41,891 --> 00:23:43,326
executive staff stated that the

753
00:23:43,326 --> 00:23:45,726
bridge will continue the

754
00:23:46,897 --> 00:23:48,331
standard practice that dhhs

755
00:23:48,331 --> 00:23:49,967
uses to notify Council of

756
00:23:49,967 --> 00:23:51,100
Procurements and invite council

757
00:23:51,100 --> 00:23:53,637
members and their staff to

758
00:23:53,637 --> 00:23:55,710
attend panel deliberations. Um.

759
00:23:55,710 --> 00:23:56,839
The members MAY wish to include

760
00:23:56,839 --> 00:23:58,441
additional detail in the plan

761
00:23:58,441 --> 00:24:00,744
to ensure that this practice

762
00:24:00,744 --> 00:24:02,579
occurs, and I will hand things

763
00:24:02,579 --> 00:24:03,814
over to my colleague, Miranda

764
00:24:03,814 --> 00:24:05,615
Leskinen, to go over the

765
00:24:05,615 --> 00:24:07,615
measurement and evaluation

766
00:24:08,518 --> 00:24:09,919
portion of the staff report.

767
00:24:09,919 --> 00:24:11,354
Okay.

768
00:24:11,354 --> 00:24:14,954
MR. Chair, would you like to

769
00:24:15,250 --> 00:24:15,291
pause or MAY I proceed?

770
00:24:15,291 --> 00:24:16,225
Why don

771
00:24:16,225 --> 00:24:16,392
t you proceed? Then

772
00:24:16,392 --> 00:24:17,227
we

773
00:24:17,227 --> 00:24:18,928
ll open up for questions

774
00:24:18,928 --> 00:24:20,830
afterwards. Thanks, Brenda.

775
00:24:20,830 --> 00:24:21,164
Thank you so much. So as Sam

776
00:24:21,164 --> 00:24:21,965
mentioned, I

777
00:24:21,965 --> 00:24:23,300
m going to pick up

778
00:24:23,300 --> 00:24:24,340
with measurement and

779
00:24:24,340 --> 00:24:24,668
evaluation. I

780
00:24:24,668 --> 00:24:26,870
m at the very

781
00:24:26,870 --> 00:24:29,720
bottom of page 98 of your

782
00:24:29,720 --> 00:24:30,506
packets. Um, so provisions for

783
00:24:30,506 --> 00:24:31,775
measurement and evaluation of

784
00:24:31,775 --> 00:24:33,343
bridge investments are

785
00:24:33,343 --> 00:24:35,279
addressed in the plan in its

786
00:24:35,279 --> 00:24:36,613
section seven, which starts on

787
00:24:36,613 --> 00:24:36,779
page 154 of your packets, if

788
00:24:36,779 --> 00:24:38,649
you

789
00:24:38,649 --> 00:24:39,716
re curious, um, the plan

790
00:24:39,716 --> 00:24:40,917
states that measurement and

791
00:24:40,917 --> 00:24:41,985
evaluation for the bridge,

792
00:24:41,985 --> 00:24:43,985
consistent with current

793
00:24:44,154 --> 00:24:46,389
practice under mid two, will

794
00:24:46,389 --> 00:24:48,191
utilize the results based

795
00:24:48,191 --> 00:24:49,826
accountability or rpa

796
00:24:49,826 --> 00:24:50,961
framework. Uh committee members

797
00:24:50,961 --> 00:24:52,595
will be familiar with this

798
00:24:52,595 --> 00:24:54,831
framework for evaluation, as it

799
00:24:54,831 --> 00:24:56,666
is also used for other human

800
00:24:56,666 --> 00:24:58,268
service initiatives like Best

801
00:24:58,268 --> 00:24:59,536
starts for kids and as a

802
00:24:59,536 --> 00:25:00,837
framework includes, uh,

803
00:25:00,837 --> 00:25:02,305
performance measures,

804
00:25:02,305 --> 00:25:04,240
population indicators, and

805
00:25:04,240 --> 00:25:05,641
in-depth evaluation regarding

806
00:25:05,641 --> 00:25:06,943
performance measures for the

807
00:25:06,943 --> 00:25:08,644
bridge. Per the transmitted

808
00:25:08,644 --> 00:25:10,580
plan, measures MAY be

809
00:25:10,580 --> 00:25:12,582
qualitative and or quantitative

810
00:25:12,582 --> 00:25:14,216
and will vary across programs

811
00:25:14,216 --> 00:25:15,885
and strategy areas depending on

812
00:25:15,885 --> 00:25:17,420
factors like the population

813
00:25:17,420 --> 00:25:18,689
served, types of services

814
00:25:18,689 --> 00:25:20,689
provided, and intended

815
00:25:21,191 --> 00:25:23,894
outcomes. Per the plan, request

816
00:25:23,894 --> 00:25:26,596
for proposals, RFPs for for

817
00:25:26,596 --> 00:25:27,998
competitive procurements will

818
00:25:27,998 --> 00:25:29,866
include that strategies,

819
00:25:29,866 --> 00:25:31,401
intended goals, and system wide

820
00:25:31,401 --> 00:25:33,401
outcomes and associated

821
00:25:33,403 --> 00:25:34,804
performance measures. Um, a

822
00:25:34,804 --> 00:25:35,906
couple of examples of

823
00:25:35,906 --> 00:25:37,240
performance measures are

824
00:25:37,240 --> 00:25:37,707
provided in the plan. In it

825
00:25:37,707 --> 00:25:39,707
s

826
00:25:40,577 --> 00:25:43,380
figure 22, which is located on

827
00:25:43,380 --> 00:25:45,715
page 157 of your packets. Um,

828
00:25:45,715 --> 00:25:47,317
also per the plan, uh, dhs

829
00:25:47,317 --> 00:25:48,351
staff will work with service

830
00:25:48,351 --> 00:25:50,351
providers during their

831
00:25:50,720 --> 00:25:52,221
contracting process to finalize

832
00:25:52,221 --> 00:25:52,522
a performance measurement plan,

833
00:25:52,522 --> 00:25:54,900
which I

834
00:25:54,900 --> 00:25:55,458
ll speak to a bit more

835
00:25:55,458 --> 00:25:57,160
shortly. Uh, for county

836
00:25:57,160 --> 00:25:59,160
administered programs, agencies

837
00:25:59,362 --> 00:26:00,931
will collaborate with dhs to

838
00:26:00,931 --> 00:26:02,632
develop their program

839
00:26:02,632 --> 00:26:02,789
performance measurement plan.

840
00:26:02,789 --> 00:26:04,789
I

841
00:26:04,801 --> 00:26:05,568
m going to pivot to logic

842
00:26:05,568 --> 00:26:06,937
models. I

843
00:26:06,937 --> 00:26:08,839
m on page 99 of your

844
00:26:08,839 --> 00:26:10,873
packets. As Sam noted. Um,

845
00:26:10,873 --> 00:26:13,376
appendices f through j of the

846
00:26:13,376 --> 00:26:15,244
transmitted plan. Identify a

847
00:26:15,244 --> 00:26:17,580
logic model for each of the

848
00:26:17,580 --> 00:26:20,283
five bridge strategy areas. Um,

849
00:26:20,283 --> 00:26:21,718
each strategy areas logic model

850
00:26:21,718 --> 00:26:23,886
highlights the types of

851
00:26:23,886 --> 00:26:25,886
programs or activities

852
00:26:25,922 --> 00:26:27,256
anticipated for funding, and

853
00:26:27,256 --> 00:26:28,324
illustrates the envisioned

854
00:26:28,324 --> 00:26:29,726
relationship between

855
00:26:29,726 --> 00:26:31,561
investments, measures, and

856
00:26:31,561 --> 00:26:32,696
outcomes. Tables five through

857
00:26:32,696 --> 00:26:34,197
nine of the staff report

858
00:26:34,197 --> 00:26:35,965
provide a very high level

859
00:26:35,965 --> 00:26:37,467
summary of those anticipated

860
00:26:37,467 --> 00:26:39,369
activities that are identified

861
00:26:39,369 --> 00:26:41,204
in each strategy. Areas. Logic

862
00:26:41,204 --> 00:26:43,390
model. Additionally, a Sam

863
00:26:43,390 --> 00:26:45,208
noted attachment five to the

864
00:26:45,208 --> 00:26:46,742
staff report on page 241 of

865
00:26:46,742 --> 00:26:48,244
your packets that was provided

866
00:26:48,244 --> 00:26:49,846
by executive staff provides

867
00:26:49,846 --> 00:26:52,246
that high level comparative

868
00:26:53,150 --> 00:26:55,252
crosswalk overview of Mid two

869
00:26:55,252 --> 00:26:57,520
programs and the anticipated

870
00:26:57,520 --> 00:26:58,955
bridge activities. Um, moving

871
00:26:58,955 --> 00:26:59,356
next to data collection. I

872
00:26:59,356 --> 00:27:01,356
m on

873
00:27:01,858 --> 00:27:04,270
page 102 of your packets. The

874
00:27:04,270 --> 00:27:05,695
transmitted plan indicates that

875
00:27:05,695 --> 00:27:07,397
data collection practices for

876
00:27:07,397 --> 00:27:09,198
the bridge will be outcomes

877
00:27:09,198 --> 00:27:10,567
driven and reflect system level

878
00:27:10,567 --> 00:27:12,969
objectives for each of those

879
00:27:12,969 --> 00:27:14,271
strategy areas, as described in

880
00:27:14,271 --> 00:27:16,390
the aforementioned logic

881
00:27:16,390 --> 00:27:17,473
models. Um, earlier in my

882
00:27:17,473 --> 00:27:18,874
remarks, I had referenced

883
00:27:18,874 --> 00:27:20,874
provider performance

884
00:27:21,277 --> 00:27:22,879
measurement plans. These plans

885
00:27:22,879 --> 00:27:24,714
will include key performance

886
00:27:24,714 --> 00:27:26,583
measures, types of data

887
00:27:26,583 --> 00:27:28,384
collection, reporting cycles,

888
00:27:28,384 --> 00:27:30,860
and activities to review data

889
00:27:30,860 --> 00:27:32,880
and use data to inform

890
00:27:32,880 --> 00:27:33,990
continuous improvements.

891
00:27:33,990 --> 00:27:35,424
Service providers will submit

892
00:27:35,424 --> 00:27:37,127
data and relevant information

893
00:27:37,127 --> 00:27:38,394
to the county as required by

894
00:27:38,394 --> 00:27:40,296
their contract and or

895
00:27:40,296 --> 00:27:42,131
documented in their performance

896
00:27:42,131 --> 00:27:43,700
measurement plans. The

897
00:27:43,700 --> 00:27:45,700
Transmitted Implementation Plan

898
00:27:46,360 --> 00:27:47,470
further notes that dhs intends

899
00:27:47,470 --> 00:27:49,205
to measure and assess long term

900
00:27:49,205 --> 00:27:50,640
data and outcomes at the

901
00:27:50,640 --> 00:27:52,442
participant level, as well as

902
00:27:52,442 --> 00:27:54,810
collect system level data as

903
00:27:54,810 --> 00:27:56,379
appropriate, and monitor key

904
00:27:56,379 --> 00:27:58,115
level behavioral health

905
00:27:58,115 --> 00:27:58,304
indicators. The last thing I

906
00:27:58,304 --> 00:27:59,382
ll

907
00:27:59,382 --> 00:28:00,883
touch on before handing things

908
00:28:00,883 --> 00:28:02,785
back over to Sam relates to

909
00:28:02,785 --> 00:28:04,520
in-depth evaluation. Uh, the

910
00:28:04,520 --> 00:28:06,550
transmitted implementation plan

911
00:28:06,550 --> 00:28:07,791
indicates that the ability to

912
00:28:07,791 --> 00:28:09,559
conduct in-depth evaluations

913
00:28:09,559 --> 00:28:11,161
will be different for each

914
00:28:11,161 --> 00:28:13,561
program and strategy, and

915
00:28:14,164 --> 00:28:16,199
identifies in the plan criteria

916
00:28:16,199 --> 00:28:18,340
to help guide the evaluation

917
00:28:18,340 --> 00:28:19,769
team in prioritizing projects

918
00:28:19,769 --> 00:28:22,169
for that more in-depth

919
00:28:22,372 --> 00:28:23,740
evaluation. Um, if if I MAY, I

920
00:28:23,740 --> 00:28:25,208
will hand things back over to

921
00:28:25,208 --> 00:28:27,177
Sam to continue with the staff

922
00:28:27,177 --> 00:28:28,110
report. Um, regarding

923
00:28:28,110 --> 00:28:30,110
reporting.

924
00:28:30,680 --> 00:28:32,480
Thank you. Miranda and I will

925
00:28:32,480 --> 00:28:33,483
go through these quickly so

926
00:28:33,483 --> 00:28:35,284
that members can begin

927
00:28:35,284 --> 00:28:36,452
discussing. But I am on page

928
00:28:36,452 --> 00:28:38,421
102 of today

929
00:28:38,421 --> 00:28:39,656
s packet. Um,

930
00:28:39,656 --> 00:28:41,910
going into the reporting

931
00:28:41,910 --> 00:28:42,959
section. So the transmitted

932
00:28:42,959 --> 00:28:44,994
plan states that dhs will offer

933
00:28:44,994 --> 00:28:46,429
an annual briefing to council,

934
00:28:46,429 --> 00:28:49,429
coinciding with the release of

935
00:28:50,330 --> 00:28:53,330
the annual data dashboard. Um,

936
00:28:53,302 --> 00:28:54,604
and the the plan proposes that

937
00:28:54,604 --> 00:28:56,139
the executive transmit a

938
00:28:56,139 --> 00:28:58,207
biennial report to council

939
00:28:58,207 --> 00:28:59,809
instead of an annual report.

940
00:28:59,809 --> 00:29:01,544
Um, that would detail, continue

941
00:29:01,544 --> 00:29:04,447
to detail programs and services

942
00:29:04,447 --> 00:29:06,549
funded by the bridge. Um, this

943
00:29:06,549 --> 00:29:08,184
plan, uh, or the annual

944
00:29:08,184 --> 00:29:09,819
biennial report would be

945
00:29:09,819 --> 00:29:11,755
transmitted no later than

946
00:29:11,755 --> 00:29:14,755
AUGUST 31st every other year,

947
00:29:14,824 --> 00:29:16,726
beginning in 2030. This is a

948
00:29:16,726 --> 00:29:18,761
changed from the annual report

949
00:29:18,761 --> 00:29:20,263
cadence, a list of the contents

950
00:29:20,263 --> 00:29:22,431
of the proposed biennial report

951
00:29:22,431 --> 00:29:24,233
appears on page 103 of the

952
00:29:24,233 --> 00:29:26,302
packet today. Um, the

953
00:29:26,302 --> 00:29:26,602
transition to biennial reports

954
00:29:26,602 --> 00:29:27,537
and what

955
00:29:27,537 --> 00:29:29,905
s included in the

956
00:29:29,905 --> 00:29:32,305
report represent policy choices

957
00:29:33,209 --> 00:29:35,110
to the Council to to members.

958
00:29:35,110 --> 00:29:38,514
So moving on to the financial

959
00:29:38,514 --> 00:29:40,160
plan or financial policies, the

960
00:29:40,160 --> 00:29:41,484
transmitted plan includes a

961
00:29:41,484 --> 00:29:43,219
financial plan with estimated

962
00:29:43,219 --> 00:29:45,219
collections and expenditures.

963
00:29:47,757 --> 00:29:49,580
Table ten on page um 104. Uh,

964
00:29:49,580 --> 00:29:52,580
shows a summary of the

965
00:29:52,361 --> 00:29:54,761
estimated annual revenue from

966
00:29:55,398 --> 00:29:57,798
2028 to 2034, based on the

967
00:30:00,169 --> 00:30:02,238
2026, uh, for forecast. This,

968
00:30:02,238 --> 00:30:05,107
uh, has been updated from the

969
00:30:05,107 --> 00:30:07,376
the MARCH for forecast. Um,

970
00:30:07,376 --> 00:30:09,776
that was originally published

971
00:30:09,880 --> 00:30:11,748
in the 3/8 staff report, and it

972
00:30:11,748 --> 00:30:14,148
projects the JULY weather

973
00:30:14,417 --> 00:30:17,417
forecast. Uh shows a decrease

974
00:30:18,254 --> 00:30:20,890
in approximately $26 million

975
00:30:20,890 --> 00:30:21,791
less in overall revenue during

976
00:30:21,791 --> 00:30:24,160
the plan period from the MARCH

977
00:30:24,160 --> 00:30:25,728
forecast. Table 11 shows the

978
00:30:25,728 --> 00:30:28,128
estimated expenditures for each

979
00:30:28,331 --> 00:30:29,932
strategy, area, and staff

980
00:30:29,932 --> 00:30:32,202
analysis is ongoing regarding

981
00:30:32,202 --> 00:30:33,670
the impact of the JULY for

982
00:30:33,670 --> 00:30:35,672
forecast on the financial plan

983
00:30:35,672 --> 00:30:38,720
and estimated expenditures for

984
00:30:39,108 --> 00:30:41,645
the bridge. Moving on to the

985
00:30:41,645 --> 00:30:42,745
other financial policies before

986
00:30:42,745 --> 00:30:44,460
moving into the potential

987
00:30:44,460 --> 00:30:44,881
policy issues. So I

988
00:30:44,881 --> 00:30:46,881
m on page

989
00:30:47,383 --> 00:30:49,218
105 of the packet. Uh, the

990
00:30:49,218 --> 00:30:50,353
transmitted plan indicates that

991
00:30:50,353 --> 00:30:52,455
the behavioral health bridge

992
00:30:52,455 --> 00:30:53,590
will set aside a half a percent

993
00:30:53,590 --> 00:30:54,823
of revenue for technical

994
00:30:54,823 --> 00:30:56,359
assistance and capacity

995
00:30:56,359 --> 00:30:57,894
building to support the

996
00:30:57,894 --> 00:30:59,894
implementation of the

997
00:31:00,620 --> 00:31:01,831
identified goals. Um, for

998
00:31:01,831 --> 00:31:03,831
administration and compliance.

999
00:31:03,833 --> 00:31:05,435
In response to the 2025 audit,

1000
00:31:05,435 --> 00:31:06,636
the transmitted plan states

1001
00:31:06,636 --> 00:31:08,270
that the bridge will increase

1002
00:31:08,270 --> 00:31:09,539
the proportion of funds

1003
00:31:09,539 --> 00:31:11,539
supporting administrative

1004
00:31:13,643 --> 00:31:15,378
functions in 2028 to 2034 to

1005
00:31:15,378 --> 00:31:17,460
enhance fiscal controls and

1006
00:31:17,460 --> 00:31:18,581
contract management. Um

1007
00:31:18,581 --> 00:31:20,160
executive staff indicate that

1008
00:31:20,160 --> 00:31:21,500
additional staff will be needed

1009
00:31:21,500 --> 00:31:22,585
to support procurement

1010
00:31:22,585 --> 00:31:24,190
evaluation, program management,

1011
00:31:24,190 --> 00:31:26,190
compliance, financial

1012
00:31:26,288 --> 00:31:28,458
management and reporting. Um

1013
00:31:28,458 --> 00:31:29,292
for the reserves consistent

1014
00:31:29,292 --> 00:31:30,593
with the county

1015
00:31:30,593 --> 00:31:32,495
s comprehensive

1016
00:31:32,495 --> 00:31:34,230
financial management policies,

1017
00:31:34,230 --> 00:31:35,998
the bridge will maintain a fund

1018
00:31:35,998 --> 00:31:37,266
reserve equivalent to 60 days

1019
00:31:37,266 --> 00:31:39,402
of budgeted spending in the

1020
00:31:39,402 --> 00:31:40,737
current, adopted or projected

1021
00:31:40,737 --> 00:31:42,538
biennial budget. Under this

1022
00:31:42,538 --> 00:31:44,340
plan. Additionally, the fund

1023
00:31:44,340 --> 00:31:46,740
will maintain a sustainability

1024
00:31:46,976 --> 00:31:48,578
reserve starting in 2028 to

1025
00:31:48,578 --> 00:31:50,113
maintain program commitments

1026
00:31:50,113 --> 00:31:51,347
despite the projected decrease

1027
00:31:51,347 --> 00:31:53,747
in sales tax revenue

1028
00:31:53,983 --> 00:31:56,383
anticipated in 2029 due to

1029
00:31:56,453 --> 00:31:58,254
2026. Changes in state law

1030
00:31:58,254 --> 00:31:59,522
pertaining to products and

1031
00:31:59,522 --> 00:32:01,557
services that will be exempt

1032
00:32:01,557 --> 00:32:03,726
from sales tax beginning in

1033
00:32:03,726 --> 00:32:05,610
2029. The sustainability

1034
00:32:05,610 --> 00:32:07,330
Reserve is anticipated to be

1035
00:32:07,330 --> 00:32:08,899
spent down by 2031. The

1036
00:32:08,899 --> 00:32:10,767
transmitted plan also would

1037
00:32:10,767 --> 00:32:12,235
formalize the continuation of a

1038
00:32:12,235 --> 00:32:13,569
transfer of mid revenue to the

1039
00:32:13,569 --> 00:32:16,539
Behavioral Health Fund that has

1040
00:32:16,539 --> 00:32:17,974
occurred since 2021, and

1041
00:32:17,974 --> 00:32:19,842
consistent with the health

1042
00:32:19,842 --> 00:32:22,242
through housing Crisis Care

1043
00:32:22,478 --> 00:32:23,913
centers and bsk levy. If a

1044
00:32:23,913 --> 00:32:25,682
substantial adjustment to the

1045
00:32:25,682 --> 00:32:26,549
financial plan were planned by

1046
00:32:26,549 --> 00:32:28,500
the executive, then the

1047
00:32:28,500 --> 00:32:29,452
executive would transmit a

1048
00:32:29,452 --> 00:32:30,787
notification letter to Council

1049
00:32:30,787 --> 00:32:32,322
explaining the rationale and

1050
00:32:32,322 --> 00:32:33,590
scope of the plan change upon

1051
00:32:33,590 --> 00:32:35,157
which time the council would

1052
00:32:35,157 --> 00:32:37,590
have 30 days to pass a motion

1053
00:32:37,590 --> 00:32:38,628
rejecting the change. Otherwise

1054
00:32:38,628 --> 00:32:41,628
the change would proceed after

1055
00:32:42,598 --> 00:32:44,768
30 days. Uh, I am now on page

1056
00:32:44,768 --> 00:32:47,168
106 of the packet. The

1057
00:32:47,203 --> 00:32:49,272
priorities for allocating the

1058
00:32:49,272 --> 00:32:50,473
undesignated fund balance, the

1059
00:32:50,473 --> 00:32:52,740
transmitted plan would

1060
00:32:52,740 --> 00:32:53,509
establish priorities for

1061
00:32:53,509 --> 00:32:55,411
allocating any undesignated

1062
00:32:55,411 --> 00:32:57,280
fund balance, which is new for

1063
00:32:57,280 --> 00:32:58,347
this revenue stream. The plan

1064
00:32:58,347 --> 00:32:59,783
states that the executive

1065
00:32:59,783 --> 00:33:01,584
intends to apply the following

1066
00:33:01,584 --> 00:33:03,419
three priorities to allocate

1067
00:33:03,419 --> 00:33:04,887
any undesignated fund balance.

1068
00:33:04,887 --> 00:33:05,789
When the executive determines

1069
00:33:05,789 --> 00:33:07,757
that it represents an

1070
00:33:07,757 --> 00:33:10,757
opportunity for long term or

1071
00:33:10,894 --> 00:33:12,362
sustainable investment. In any

1072
00:33:12,362 --> 00:33:13,563
year where inflation rates have

1073
00:33:13,563 --> 00:33:15,698
been reduced due to limited

1074
00:33:15,698 --> 00:33:17,567
funding availability, the

1075
00:33:17,567 --> 00:33:18,901
undesignated fund balance would

1076
00:33:18,901 --> 00:33:20,402
provide inflationary

1077
00:33:20,402 --> 00:33:22,172
adjustments to contracted

1078
00:33:22,172 --> 00:33:24,707
providers up to the amount of

1079
00:33:24,707 --> 00:33:27,107
cpu. Seattle inflation rates.

1080
00:33:27,576 --> 00:33:29,245
The second, um, type of use for

1081
00:33:29,245 --> 00:33:30,814
undesignated fund balance under

1082
00:33:30,814 --> 00:33:33,616
a long term investment would be

1083
00:33:33,616 --> 00:33:35,151
to augment existing investments

1084
00:33:35,151 --> 00:33:36,218
to mitigate losses of Medicaid

1085
00:33:36,218 --> 00:33:38,387
coverage to the degree

1086
00:33:38,387 --> 00:33:40,787
necessary and feasible within

1087
00:33:40,890 --> 00:33:42,491
allowable funds. And the third

1088
00:33:42,491 --> 00:33:43,292
use of undesignated fund

1089
00:33:43,292 --> 00:33:44,260
balance. If it

1090
00:33:44,260 --> 00:33:46,260
s determined to

1091
00:33:46,829 --> 00:33:48,298
be a long term investment, is

1092
00:33:48,298 --> 00:33:49,732
to scale high performing or

1093
00:33:49,732 --> 00:33:51,467
innovative behavioral health

1094
00:33:51,467 --> 00:33:54,237
bridge investments to address a

1095
00:33:54,237 --> 00:33:55,271
net unmet need. The plan states

1096
00:33:55,271 --> 00:33:56,372
that when the executive

1097
00:33:56,372 --> 00:33:58,410
determines that fund

1098
00:33:58,410 --> 00:33:59,909
availability is one time in

1099
00:33:59,909 --> 00:34:01,944
nature and cannot reasonably

1100
00:34:01,944 --> 00:34:03,112
support sustained programming,

1101
00:34:03,112 --> 00:34:04,547
the executive intends to

1102
00:34:04,547 --> 00:34:06,382
consider using these funds for

1103
00:34:06,382 --> 00:34:07,616
one time investments, including

1104
00:34:07,616 --> 00:34:09,418
capital projects such as

1105
00:34:09,418 --> 00:34:10,386
behavioral health facilities or

1106
00:34:10,386 --> 00:34:11,554
housing for people with

1107
00:34:11,554 --> 00:34:13,389
behavioral health conditions,

1108
00:34:13,389 --> 00:34:14,557
or in pilot programs that can

1109
00:34:14,557 --> 00:34:16,259
later transition to other

1110
00:34:16,259 --> 00:34:18,659
funding sources, such as

1111
00:34:18,961 --> 00:34:20,863
Medicaid. The transmitted plan

1112
00:34:20,863 --> 00:34:23,263
also includes a proviso

1113
00:34:24,900 --> 00:34:27,503
response, um, that uh responds

1114
00:34:27,503 --> 00:34:29,806
to an analysis requested for

1115
00:34:29,806 --> 00:34:31,907
about the dhs inflation rate

1116
00:34:31,907 --> 00:34:32,108
adjustment policy that is in.

1117
00:34:32,108 --> 00:34:33,776
There

1118
00:34:33,776 --> 00:34:34,644
s an overview of that in

1119
00:34:34,644 --> 00:34:34,977
the staff report. I won

1120
00:34:34,977 --> 00:34:36,813
t go

1121
00:34:36,813 --> 00:34:37,880
into it now. Um, but just

1122
00:34:37,880 --> 00:34:38,810
flagging that for you that

1123
00:34:38,810 --> 00:34:39,215
that

1124
00:34:39,215 --> 00:34:41,615
s present in the

1125
00:34:41,617 --> 00:34:43,753
transmitted plan, um, moving on

1126
00:34:43,753 --> 00:34:45,721
to the potential policy issues.

1127
00:34:45,721 --> 00:34:47,157
So staff have identified nine

1128
00:34:47,157 --> 00:34:49,557
potential policy issues that

1129
00:34:50,693 --> 00:34:53,396
are summarized on pages 109 to

1130
00:34:53,396 --> 00:34:54,864
110 of your packet. Um, I will

1131
00:34:54,864 --> 00:34:56,990
only highlight a few here

1132
00:34:56,990 --> 00:34:58,701
before handing things over to

1133
00:34:58,701 --> 00:35:00,360
executive staff. Um, but the

1134
00:35:00,360 --> 00:35:01,237
the first that I will highlight

1135
00:35:01,237 --> 00:35:02,571
is that the priorities for

1136
00:35:02,571 --> 00:35:03,840
allocating the undesignated

1137
00:35:03,840 --> 00:35:05,175
fund balance that I just spoke

1138
00:35:05,175 --> 00:35:06,442
about, those are policy

1139
00:35:06,442 --> 00:35:08,444
choices, since that is a new

1140
00:35:08,444 --> 00:35:10,213
policy. Um, members could

1141
00:35:10,213 --> 00:35:12,613
consider changing those or

1142
00:35:12,681 --> 00:35:14,583
amending those in some way.

1143
00:35:14,583 --> 00:35:16,190
Another policy issue is that

1144
00:35:16,190 --> 00:35:17,787
the transmitted plan uses

1145
00:35:17,787 --> 00:35:19,787
permissive language throughout,

1146
00:35:20,256 --> 00:35:21,991
such as intends, plans and

1147
00:35:21,991 --> 00:35:23,326
anticipates with respect to

1148
00:35:23,326 --> 00:35:24,594
various components of the plan

1149
00:35:24,594 --> 00:35:26,496
that the executive MAY

1150
00:35:26,496 --> 00:35:28,300
implement. Using these terms

1151
00:35:28,300 --> 00:35:29,766
allows the executive the option

1152
00:35:29,766 --> 00:35:31,500
to not implement components,

1153
00:35:31,500 --> 00:35:32,502
whereas terms such as shell or

1154
00:35:32,502 --> 00:35:34,671
will would require the

1155
00:35:34,671 --> 00:35:36,873
executive to follow through.

1156
00:35:36,873 --> 00:35:38,240
Um. The transmitted plan, as

1157
00:35:38,240 --> 00:35:39,475
mentioned, changes the

1158
00:35:39,475 --> 00:35:41,510
recording cadence from an

1159
00:35:41,510 --> 00:35:43,713
annual report to a biennial

1160
00:35:43,713 --> 00:35:46,883
report. Um, that is a policy

1161
00:35:46,883 --> 00:35:49,418
choice to make that change. Um,

1162
00:35:49,418 --> 00:35:51,540
the implementation plan also is

1163
00:35:51,540 --> 00:35:52,488
drafted, uh, from the

1164
00:35:52,488 --> 00:35:52,989
perspective of the executive.

1165
00:35:52,989 --> 00:35:54,457
So that

1166
00:35:54,457 --> 00:35:56,659
s a language choice.

1167
00:35:56,659 --> 00:35:58,895
That is a policy choice. Um, it

1168
00:35:58,895 --> 00:35:59,662
refers to things, uh, as in

1169
00:35:59,662 --> 00:36:00,262
keeping with the executive

1170
00:36:00,262 --> 00:36:02,262
s

1171
00:36:03,990 --> 00:36:05,499
priorities, instead of, uh,

1172
00:36:05,501 --> 00:36:07,503
having it be a from the county

1173
00:36:07,503 --> 00:36:07,703
as a perspective of the plan.

1174
00:36:07,703 --> 00:36:08,871
So it

1175
00:36:08,871 --> 00:36:10,640
s a policy choice whether

1176
00:36:10,640 --> 00:36:13,420
or not to edit these statements

1177
00:36:13,420 --> 00:36:14,760
so that the implementation plan

1178
00:36:14,760 --> 00:36:15,211
reflects that it is a King

1179
00:36:15,211 --> 00:36:16,812
County plan, and not just that

1180
00:36:16,812 --> 00:36:18,981
of the executive. Um, and then

1181
00:36:18,981 --> 00:36:19,749
the last policy flag that I

1182
00:36:19,749 --> 00:36:20,350
will make is that there

1183
00:36:20,350 --> 00:36:22,350
s just

1184
00:36:22,619 --> 00:36:24,821
a lack of specificity in the

1185
00:36:24,821 --> 00:36:26,923
plan around what specific

1186
00:36:26,923 --> 00:36:28,324
programs will receive funding

1187
00:36:28,324 --> 00:36:30,590
based on communication with the

1188
00:36:30,590 --> 00:36:30,960
executive staff. It appears

1189
00:36:30,960 --> 00:36:32,261
that they MAY not have

1190
00:36:32,261 --> 00:36:33,696
additional detail to share

1191
00:36:33,696 --> 00:36:35,696
about this. Regarding

1192
00:36:36,332 --> 00:36:38,332
programmatic investments. Um,

1193
00:36:38,467 --> 00:36:39,736
at this time. So if members

1194
00:36:39,736 --> 00:36:41,271
wanted additional information

1195
00:36:41,271 --> 00:36:44,173
about these topics prior to

1196
00:36:44,173 --> 00:36:46,800
2028, uh, the council would uh,

1197
00:36:46,800 --> 00:36:47,843
could add a new section to the

1198
00:36:47,843 --> 00:36:49,145
proposed ordinance and amend

1199
00:36:49,145 --> 00:36:51,545
the implementation plan to

1200
00:36:51,714 --> 00:36:54,116
reflect that as well. So the,

1201
00:36:54,116 --> 00:36:56,620
um, last two things that I will

1202
00:36:56,620 --> 00:36:59,421
note are the updated, um,

1203
00:36:59,421 --> 00:37:03,210
schedule for the the plan that

1204
00:37:03,693 --> 00:37:06,529
is on page 111 of the packet.

1205
00:37:06,529 --> 00:37:08,764
Um, this update was, uh,

1206
00:37:08,764 --> 00:37:10,660
distributed to rpc members. So

1207
00:37:10,660 --> 00:37:12,350
you should have that updated

1208
00:37:12,350 --> 00:37:14,403
schedule in your inbox. The

1209
00:37:14,403 --> 00:37:16,205
main changes are that it

1210
00:37:16,205 --> 00:37:17,674
anticipates three, uh,

1211
00:37:17,674 --> 00:37:18,730
contemplates three touches for

1212
00:37:18,730 --> 00:37:19,442
each committee

1213
00:37:19,442 --> 00:37:20,943
s, uh, with

1214
00:37:20,943 --> 00:37:22,645
amendments being considered in

1215
00:37:22,645 --> 00:37:24,714
three hours in OCTOBER. Now,

1216
00:37:24,714 --> 00:37:26,480
instead of in SEPTEMBER. Um and

1217
00:37:26,480 --> 00:37:27,751
an option for amendments to

1218
00:37:27,751 --> 00:37:29,552
also be taken up in rpc during

1219
00:37:29,552 --> 00:37:32,540
a special meeting that is to be

1220
00:37:32,540 --> 00:37:34,457
scheduled the week of NOVEMBER

1221
00:37:34,457 --> 00:37:35,491
2nd. Um, lastly, before handing

1222
00:37:35,491 --> 00:37:36,592
things over, I will orient

1223
00:37:36,592 --> 00:37:37,660
members to the attachment of

1224
00:37:37,660 --> 00:37:38,861
the staff report. We have

1225
00:37:38,861 --> 00:37:40,960
mentioned the Behavioral Health

1226
00:37:40,960 --> 00:37:41,764
Bridge and Mid strategy

1227
00:37:41,764 --> 00:37:44,100
crosswalk. That is attachment

1228
00:37:44,100 --> 00:37:47,100
five that provides the overview

1229
00:37:47,136 --> 00:37:49,305
of existing uh programs and

1230
00:37:49,305 --> 00:37:50,573
what bridge, uh, they MAY be

1231
00:37:50,573 --> 00:37:52,750
eligible for, what bridge

1232
00:37:52,750 --> 00:37:53,977
strategy they MAY be eligible

1233
00:37:53,977 --> 00:37:55,578
for under um and then

1234
00:37:55,578 --> 00:37:57,647
attachment six is the question

1235
00:37:57,647 --> 00:37:59,615
and response question and

1236
00:37:59,615 --> 00:38:02,385
answer um document. That was in

1237
00:38:02,385 --> 00:38:04,860
response to the JULY 23rd, uh,

1238
00:38:04,860 --> 00:38:05,522
three hours committee meeting.

1239
00:38:05,522 --> 00:38:06,789
Attachment seven is the

1240
00:38:06,789 --> 00:38:08,240
behavioral health bridge and

1241
00:38:08,240 --> 00:38:10,240
mid strategy financial

1242
00:38:10,926 --> 00:38:13,926
crosswalk, which shows, uh, the

1243
00:38:14,797 --> 00:38:16,932
Mid strategies, uh, and what uh

1244
00:38:16,932 --> 00:38:19,680
amount those programs were

1245
00:38:19,680 --> 00:38:21,170
funded, sort of rolled up into

1246
00:38:21,170 --> 00:38:22,838
the bridge strategies. Um,

1247
00:38:22,838 --> 00:38:24,574
attachment eight is sort of a

1248
00:38:24,574 --> 00:38:26,709
reference document for that.

1249
00:38:26,709 --> 00:38:29,278
Attachment seven that gives the

1250
00:38:29,278 --> 00:38:30,746
um the actual names of the

1251
00:38:30,746 --> 00:38:32,548
strategies that attachment

1252
00:38:32,548 --> 00:38:34,684
seven only shows the sort of

1253
00:38:34,684 --> 00:38:36,152
Sio five, the abbreviation. So

1254
00:38:36,152 --> 00:38:37,486
attachment eight helps provide

1255
00:38:37,486 --> 00:38:39,355
a little bit more information

1256
00:38:39,355 --> 00:38:40,923
about that. And then the last

1257
00:38:40,923 --> 00:38:43,323
attachment is the executive

1258
00:38:43,326 --> 00:38:44,794
staff PowerPoint presentation.

1259
00:38:44,794 --> 00:38:45,728
Um, Councilmember von

1260
00:38:45,728 --> 00:38:46,629
Reichbauer, would you like me

1261
00:38:46,629 --> 00:38:48,231
to hand things over to

1262
00:38:48,231 --> 00:38:49,733
executive staff now for for

1263
00:38:49,733 --> 00:38:50,400
their presentation?

1264
00:38:50,400 --> 00:38:50,867
Let me see if there

1265
00:38:50,867 --> 00:38:52,835
s any

1266
00:38:52,835 --> 00:38:53,360
questions today. Thank you. I

1267
00:38:53,360 --> 00:38:55,360
m

1268
00:38:55,437 --> 00:38:57,106
just checking for hands and

1269
00:38:57,106 --> 00:38:59,843
feel free colleagues to speak

1270
00:38:59,843 --> 00:39:00,543
out if I MISS You.

1271
00:39:00,543 --> 00:39:01,100
Okay.

1272
00:39:01,100 --> 00:39:02,412
So let

1273
00:39:02,412 --> 00:39:04,113
s go ahead now to the

1274
00:39:04,113 --> 00:39:05,281
executive staff.

1275
00:39:05,281 --> 00:39:08,217
Sounds good. So we have

1276
00:39:08,217 --> 00:39:10,320
Isabelle Jones. Um, also Laura

1277
00:39:10,320 --> 00:39:13,189
Smith, Susan McLaughlin and Liz

1278
00:39:13,189 --> 00:39:16,392
Arjun. Um, to present on this

1279
00:39:16,392 --> 00:39:18,193
item.

1280
00:39:18,193 --> 00:39:20,797
Thank you so much, Sam, and

1281
00:39:20,797 --> 00:39:21,431
good afternoon, everybody. MR.

1282
00:39:21,431 --> 00:39:22,798
Chair, members of the

1283
00:39:22,798 --> 00:39:24,367
committee, thanks for having us

1284
00:39:24,367 --> 00:39:25,835
this afternoon. My name is

1285
00:39:25,835 --> 00:39:27,269
Susan McLaughlin. I am the

1286
00:39:27,269 --> 00:39:29,138
director of the Department of

1287
00:39:29,138 --> 00:39:31,538
Community and Human Services

1288
00:39:31,540 --> 00:39:33,776
over here at King County. And I

1289
00:39:33,776 --> 00:39:35,440
am going to kick us off. So,

1290
00:39:35,440 --> 00:39:35,311
um, uh, just to say, I

1291
00:39:35,311 --> 00:39:35,510
m sure

1292
00:39:35,510 --> 00:39:36,612
you

1293
00:39:36,612 --> 00:39:36,846
re aware at this moment

1294
00:39:36,846 --> 00:39:37,780
that we

1295
00:39:37,780 --> 00:39:39,482
re here to brief you on

1296
00:39:39,482 --> 00:39:41,882
the behavioral health Bridge

1297
00:39:42,850 --> 00:39:43,419
implementation plan. Um, the

1298
00:39:43,419 --> 00:39:44,620
county council passed the

1299
00:39:44,620 --> 00:39:46,322
continuation of the collection

1300
00:39:46,322 --> 00:39:49,922
of the one tenth of 1% sales

1301
00:39:50,159 --> 00:39:51,940
tax at the end of 2025. And

1302
00:39:51,940 --> 00:39:52,495
with the promise of an

1303
00:39:52,495 --> 00:39:54,495
implementation plan being

1304
00:39:54,496 --> 00:39:56,432
transmitted mid-year. So, um,

1305
00:39:56,432 --> 00:39:58,300
this updated implementation

1306
00:39:58,300 --> 00:39:59,368
plan has been noted, covers

1307
00:39:59,368 --> 00:40:01,768
behavioral health sales tax

1308
00:40:03,539 --> 00:40:05,539
investments from 2028 to 20 20

1309
00:40:05,741 --> 00:40:07,343
or sorry, 2034. Um, the

1310
00:40:07,343 --> 00:40:09,343
implementation plan and

1311
00:40:09,511 --> 00:40:10,713
financial plan for the bridge

1312
00:40:10,713 --> 00:40:11,847
just is a little background

1313
00:40:11,847 --> 00:40:13,847
context. Take into

1314
00:40:13,917 --> 00:40:15,917
consideration three things.

1315
00:40:16,486 --> 00:40:18,354
First is that we want to ensure

1316
00:40:18,354 --> 00:40:20,422
that the the bridge and the use

1317
00:40:20,422 --> 00:40:22,458
of this precious sales tax is

1318
00:40:22,458 --> 00:40:23,893
more focused on investments in

1319
00:40:23,893 --> 00:40:25,495
areas within the behavioral

1320
00:40:25,495 --> 00:40:27,960
health system that have the

1321
00:40:27,960 --> 00:40:27,930
greatest need, and also

1322
00:40:27,930 --> 00:40:28,798
ensuring that there

1323
00:40:28,798 --> 00:40:30,400
s greater

1324
00:40:30,400 --> 00:40:31,534
accountability to achieve the

1325
00:40:31,534 --> 00:40:33,970
goals that are laid out in the

1326
00:40:33,970 --> 00:40:35,638
plan. The second is to mitigate

1327
00:40:35,638 --> 00:40:38,380
current and projected financial

1328
00:40:38,941 --> 00:40:40,743
pressures that are plaguing the

1329
00:40:40,743 --> 00:40:41,978
sales tax and the bridge. And

1330
00:40:41,978 --> 00:40:43,513
so one of the things that we

1331
00:40:43,513 --> 00:40:45,548
need to do is bring bridge

1332
00:40:45,548 --> 00:40:47,548
expenditures into alignment

1333
00:40:48,150 --> 00:40:49,918
with the projected revenue. And

1334
00:40:49,918 --> 00:40:51,654
then finally, we want to make

1335
00:40:51,654 --> 00:40:53,389
sure that we support a smooth

1336
00:40:53,389 --> 00:40:55,758
transition to new investment

1337
00:40:55,758 --> 00:40:57,927
areas and new outcome. Um, and

1338
00:40:57,927 --> 00:40:59,927
goal expectations while

1339
00:41:00,263 --> 00:41:01,931
mitigating any disruption in

1340
00:41:01,931 --> 00:41:03,700
services wherever possible for

1341
00:41:03,700 --> 00:41:03,933
providers. So at the end of the

1342
00:41:03,933 --> 00:41:05,101
day, we

1343
00:41:05,101 --> 00:41:06,302
re looking to make sure

1344
00:41:06,302 --> 00:41:08,437
that we are using these

1345
00:41:08,437 --> 00:41:10,837
precious and shrinking dollars

1346
00:41:11,374 --> 00:41:14,343
in the most strategic way. Um,

1347
00:41:14,343 --> 00:41:15,645
next slide. Our agenda for

1348
00:41:15,645 --> 00:41:16,845
today, um, we

1349
00:41:16,845 --> 00:41:18,614
re gonna cover

1350
00:41:18,614 --> 00:41:21,183
how the implementation plan was

1351
00:41:21,183 --> 00:41:22,484
developed, including the, um,

1352
00:41:22,484 --> 00:41:24,453
the depth of community

1353
00:41:24,453 --> 00:41:24,692
engagement that was done. Uh,

1354
00:41:24,692 --> 00:41:25,388
we

1355
00:41:25,388 --> 00:41:25,688
ll also talk about what

1356
00:41:25,688 --> 00:41:27,220
s

1357
00:41:27,220 --> 00:41:29,580
different with regard to the

1358
00:41:29,580 --> 00:41:30,793
bridge implementation plan and

1359
00:41:30,793 --> 00:41:31,827
how we plan to implement the

1360
00:41:31,827 --> 00:41:33,827
transition through our

1361
00:41:33,997 --> 00:41:34,997
procurement process. And then,

1362
00:41:34,997 --> 00:41:35,398
as Sam noted, there

1363
00:41:35,398 --> 00:41:37,398
s an

1364
00:41:37,600 --> 00:41:40,202
analysis that will, um, talk

1365
00:41:40,202 --> 00:41:42,400
about about the impact of dcs

1366
00:41:42,400 --> 00:41:43,439
inflationary adjustment policy

1367
00:41:43,439 --> 00:41:44,707
on the behavioral health bridge

1368
00:41:44,707 --> 00:41:47,107
and its implementation and

1369
00:41:47,676 --> 00:41:49,445
financial planning. So kicking

1370
00:41:49,445 --> 00:41:50,880
us off is just, uh, gives the

1371
00:41:50,880 --> 00:41:52,749
highest level, um, all that

1372
00:41:52,749 --> 00:41:54,683
went into the development of

1373
00:41:54,683 --> 00:41:57,830
this implementation plan, it

1374
00:41:58,354 --> 00:41:59,922
started in late 2023 and 2024,

1375
00:41:59,922 --> 00:42:01,591
when we were doing an

1376
00:42:01,591 --> 00:42:03,593
assessment of the behavioral

1377
00:42:03,593 --> 00:42:05,961
health landscape. Um, you know,

1378
00:42:05,961 --> 00:42:09,561
the last mid renewal was back

1379
00:42:10,365 --> 00:42:11,701
in 20 2016, 2017. And a lot has

1380
00:42:11,701 --> 00:42:12,969
changed with regard to

1381
00:42:12,969 --> 00:42:14,969
behavioral health services,

1382
00:42:15,171 --> 00:42:15,371
including both all of state.

1383
00:42:15,371 --> 00:42:16,405
There

1384
00:42:16,405 --> 00:42:18,805
s been federal changes

1385
00:42:18,908 --> 00:42:21,110
and also local changes to both

1386
00:42:21,110 --> 00:42:23,279
policy and funding. Um,

1387
00:42:23,279 --> 00:42:25,447
including the introduction of

1388
00:42:25,447 --> 00:42:26,716
new local resources like the

1389
00:42:26,716 --> 00:42:26,916
crisis care center levy that

1390
00:42:26,916 --> 00:42:28,916
didn

1391
00:42:29,752 --> 00:42:31,954
t exist when the last uh,

1392
00:42:31,954 --> 00:42:34,220
mid version was implemented. We

1393
00:42:34,220 --> 00:42:36,920
then combined that landscape

1394
00:42:36,920 --> 00:42:38,160
analysis data with our

1395
00:42:38,160 --> 00:42:38,394
community engagement feedback.

1396
00:42:38,394 --> 00:42:38,995
And I

1397
00:42:38,995 --> 00:42:40,396
m going to talk a little

1398
00:42:40,396 --> 00:42:42,465
bit about what that looked

1399
00:42:42,465 --> 00:42:43,966
like. Um, in a minute and who

1400
00:42:43,966 --> 00:42:45,802
we talked to. But to develop

1401
00:42:45,802 --> 00:42:47,703
the five new strategy areas

1402
00:42:47,703 --> 00:42:51,700
that are part of this renewal

1403
00:42:51,700 --> 00:42:53,407
implementation plan, um, we

1404
00:42:54,100 --> 00:42:56,100
engaged over 2200 diverse

1405
00:42:56,178 --> 00:42:57,346
county residents to understand

1406
00:42:57,346 --> 00:42:58,915
from their perspective, the

1407
00:42:58,915 --> 00:43:01,315
behavioral health system needs

1408
00:43:01,417 --> 00:43:03,520
gaps and opportunities. Um,

1409
00:43:03,520 --> 00:43:05,540
once we had all of that data

1410
00:43:05,540 --> 00:43:07,454
collected and brought together,

1411
00:43:08,900 --> 00:43:10,493
we engaged a cross-sector, um,

1412
00:43:10,493 --> 00:43:11,728
table of subject matter

1413
00:43:11,728 --> 00:43:14,728
experts, and this was done

1414
00:43:14,897 --> 00:43:16,399
between APRIL and JULY of 2025.

1415
00:43:16,399 --> 00:43:18,799
We convened five different

1416
00:43:19,350 --> 00:43:21,804
tables, one around each of the

1417
00:43:21,804 --> 00:43:23,405
prioritized strategy areas that

1418
00:43:23,405 --> 00:43:25,208
are in the implementation plan.

1419
00:43:25,208 --> 00:43:27,643
Those work groups of subject

1420
00:43:27,643 --> 00:43:29,440
matter experts included um

1421
00:43:29,440 --> 00:43:30,479
providers and included

1422
00:43:30,479 --> 00:43:32,879
researchers in that particular

1423
00:43:33,182 --> 00:43:34,583
area. Advocates, peers, county

1424
00:43:34,583 --> 00:43:36,518
staff, people with lived

1425
00:43:36,518 --> 00:43:37,887
experience. And through that

1426
00:43:37,887 --> 00:43:39,922
process, that group really

1427
00:43:39,922 --> 00:43:42,910
developed a set of ideas and

1428
00:43:42,910 --> 00:43:43,225
recommendations, um, that could

1429
00:43:43,225 --> 00:43:45,894
be used to leverage the

1430
00:43:45,894 --> 00:43:47,463
foundation of what Mid had been

1431
00:43:47,463 --> 00:43:49,499
doing and to and to build

1432
00:43:49,499 --> 00:43:51,267
forward in the best future.

1433
00:43:51,267 --> 00:43:53,636
Invest um investment of these

1434
00:43:53,636 --> 00:43:56,205
funds. We then did an internal

1435
00:43:56,205 --> 00:43:57,506
analysis of that information in

1436
00:43:57,506 --> 00:43:59,175
AUGUST through DECEMBER,

1437
00:43:59,175 --> 00:44:01,543
leveraging the data and

1438
00:44:01,543 --> 00:44:03,746
knowledge and looking at some

1439
00:44:03,746 --> 00:44:03,979
of those ideas through the lens

1440
00:44:03,979 --> 00:44:05,681
of what

1441
00:44:05,681 --> 00:44:07,116
s feasible, equitable,

1442
00:44:07,116 --> 00:44:10,152
how does it align with existing

1443
00:44:10,152 --> 00:44:12,221
programs and services, and also

1444
00:44:12,221 --> 00:44:13,956
prioritizing what the greatest

1445
00:44:13,956 --> 00:44:15,591
need was. And then, of course,

1446
00:44:15,591 --> 00:44:17,991
we had our executive

1447
00:44:18,527 --> 00:44:21,797
transition. Um, uh, late at the

1448
00:44:21,797 --> 00:44:23,166
end of 2025 into 2026. And so,

1449
00:44:23,166 --> 00:44:24,967
um, we were able to then work

1450
00:44:24,967 --> 00:44:27,536
with our new executive, Zahilay

1451
00:44:27,536 --> 00:44:29,172
to understand priorities of

1452
00:44:29,172 --> 00:44:30,806
this administration and how we

1453
00:44:30,806 --> 00:44:32,475
fit that together into this mid

1454
00:44:32,475 --> 00:44:33,342
implementation plan. So, um,

1455
00:44:33,342 --> 00:44:33,676
quite a process that

1456
00:44:33,676 --> 00:44:35,210
s been

1457
00:44:35,210 --> 00:44:36,779
going on for a while, but it

1458
00:44:36,779 --> 00:44:37,980
really helped to shape and

1459
00:44:37,980 --> 00:44:39,315
inform where we think the

1460
00:44:39,315 --> 00:44:40,416
behavioral health system needs

1461
00:44:40,416 --> 00:44:40,816
to go. So now I

1462
00:44:40,816 --> 00:44:42,919
m going to talk

1463
00:44:42,919 --> 00:44:44,720
a little bit about the ways

1464
00:44:44,720 --> 00:44:47,120
that we engage community

1465
00:44:47,323 --> 00:44:49,325
members, providers and others

1466
00:44:49,325 --> 00:44:52,280
in this process. As I

1467
00:44:52,280 --> 00:44:53,796
mentioned, over 2200 people

1468
00:44:53,796 --> 00:44:55,931
were engaged over an 18 month

1469
00:44:55,931 --> 00:44:57,767
period. Uh, we used a

1470
00:44:57,767 --> 00:44:59,767
combination of listening

1471
00:44:59,836 --> 00:45:01,971
sessions, both virtual and

1472
00:45:01,971 --> 00:45:03,539
in-person sessions across King

1473
00:45:03,539 --> 00:45:05,540
County, including at least one

1474
00:45:05,540 --> 00:45:08,440
in every council district. We

1475
00:45:08,440 --> 00:45:11,440
held community events and we

1476
00:45:11,470 --> 00:45:13,282
can, um, conducted an online

1477
00:45:13,282 --> 00:45:15,985
survey that was translated into

1478
00:45:15,985 --> 00:45:17,920
21 different languages and had

1479
00:45:17,920 --> 00:45:19,655
our teams out in a variety of

1480
00:45:19,655 --> 00:45:21,323
different community settings

1481
00:45:21,323 --> 00:45:22,692
and events with qr codes where

1482
00:45:22,692 --> 00:45:24,260
people could just, like, log on

1483
00:45:24,260 --> 00:45:25,394
with their phone and answer

1484
00:45:25,394 --> 00:45:27,129
that survey right then and

1485
00:45:27,129 --> 00:45:29,898
there. Um, we had a very

1486
00:45:29,898 --> 00:45:31,634
diverse set of respondents to

1487
00:45:31,634 --> 00:45:33,402
all of that participated, and

1488
00:45:33,402 --> 00:45:35,405
all of those different, um,

1489
00:45:35,405 --> 00:45:37,307
venues and avenues, including

1490
00:45:37,307 --> 00:45:40,420
half of the people engaged, um,

1491
00:45:40,420 --> 00:45:41,411
were self-identified as being

1492
00:45:41,411 --> 00:45:42,678
black, indigenous or other

1493
00:45:42,678 --> 00:45:45,780
people. People of color,

1494
00:45:46,150 --> 00:45:47,549
including our Latinx, uh, Asian

1495
00:45:47,549 --> 00:45:49,518
American, Pacific Islander,

1496
00:45:49,518 --> 00:45:52,518
Middle Eastern, and so forth.

1497
00:45:52,755 --> 00:45:55,291
Um, and then there was quite a

1498
00:45:55,291 --> 00:45:57,426
variety also of different, um,

1499
00:45:57,426 --> 00:46:00,195
lived experience and ages. So

1500
00:46:00,195 --> 00:46:02,464
we did hear, um, specifically

1501
00:46:02,464 --> 00:46:05,464
from youth, uh, between the

1502
00:46:06,680 --> 00:46:08,468
ages of 2025, about 209 were

1503
00:46:08,705 --> 00:46:11,540
engaged, um, seniors. We had a

1504
00:46:11,540 --> 00:46:15,440
sample of folks from the lgbtq

1505
00:46:15,440 --> 00:46:16,545
ia plus population, individuals

1506
00:46:16,545 --> 00:46:17,813
that I self-identify as having

1507
00:46:17,813 --> 00:46:19,748
lived experience with, mental

1508
00:46:19,748 --> 00:46:21,818
health and substance use needs,

1509
00:46:21,818 --> 00:46:24,253
um, about 356 people there. We

1510
00:46:24,253 --> 00:46:26,488
also did some, um, focused, um,

1511
00:46:26,488 --> 00:46:28,290
listening sessions in our King

1512
00:46:28,290 --> 00:46:29,892
County jail to hear directly

1513
00:46:29,892 --> 00:46:32,270
from people who have behavioral

1514
00:46:32,270 --> 00:46:33,830
health conditions, who are were

1515
00:46:33,830 --> 00:46:35,998
incarcerated. So, again, a

1516
00:46:35,998 --> 00:46:37,934
very, um, very wide range of

1517
00:46:37,934 --> 00:46:39,201
people that we heard from and

1518
00:46:39,201 --> 00:46:41,300
the nature of those

1519
00:46:41,300 --> 00:46:43,305
conversations were really about

1520
00:46:43,305 --> 00:46:44,540
what, um, what are the gaps in

1521
00:46:44,540 --> 00:46:45,441
the behavioral health system?

1522
00:46:45,441 --> 00:46:46,943
What are your highest

1523
00:46:46,943 --> 00:46:48,443
priorities? Where do you think

1524
00:46:48,443 --> 00:46:49,812
we need to make changes or need

1525
00:46:49,812 --> 00:46:50,450
more investment and so forth?

1526
00:46:50,450 --> 00:46:51,414
So that

1527
00:46:51,414 --> 00:46:52,882
s what helped inform

1528
00:46:52,882 --> 00:46:55,183
this. Um, I also mentioned our

1529
00:46:55,183 --> 00:46:57,320
subject matter expert groups.

1530
00:46:57,320 --> 00:46:58,788
Uh, you can see here we had

1531
00:46:58,788 --> 00:47:01,657
again one work group for each

1532
00:47:01,657 --> 00:47:03,459
of the five strategy areas. Um,

1533
00:47:03,459 --> 00:47:05,127
they it was a very diverse

1534
00:47:05,127 --> 00:47:06,962
group of people. Um,

1535
00:47:06,962 --> 00:47:08,962
participants included clinical

1536
00:47:09,865 --> 00:47:10,966
providers, licensed peers, um,

1537
00:47:10,966 --> 00:47:13,136
individuals from the criminal

1538
00:47:13,136 --> 00:47:15,136
legal system, researchers,

1539
00:47:15,571 --> 00:47:17,571
educators, outreach workers,

1540
00:47:17,739 --> 00:47:19,308
nonprofit leaders. We also had,

1541
00:47:19,308 --> 00:47:21,610
um, substantial engagement with

1542
00:47:21,610 --> 00:47:24,100
our mid advisory committee

1543
00:47:24,580 --> 00:47:26,381
throughout this process as well.

1544
00:47:26,381 --> 00:47:27,850
Um, the goals again of the and

1545
00:47:27,850 --> 00:47:30,385
from the same work group formed

1546
00:47:30,385 --> 00:47:31,654
the basis of the goals that are

1547
00:47:31,654 --> 00:47:31,920
identified. So each there

1548
00:47:31,920 --> 00:47:33,920
s the

1549
00:47:34,323 --> 00:47:36,325
five strategy areas. And um

1550
00:47:36,325 --> 00:47:36,525
specific goals within each. And

1551
00:47:36,525 --> 00:47:37,590
that

1552
00:47:37,590 --> 00:47:37,660
s what you

1553
00:47:37,660 --> 00:47:39,828
ll hear in a

1554
00:47:39,828 --> 00:47:41,300
minute from Liz about um, one

1555
00:47:41,300 --> 00:47:42,699
of the big changes is getting

1556
00:47:42,699 --> 00:47:44,733
much more focused on impact and

1557
00:47:44,733 --> 00:47:46,235
outcomes and detailing out what

1558
00:47:46,235 --> 00:47:46,433
when we do procurements, what

1559
00:47:46,433 --> 00:47:47,403
we

1560
00:47:47,403 --> 00:47:49,338
re trying to achieve to

1561
00:47:49,338 --> 00:47:49,550
ensure that the strategies that

1562
00:47:49,550 --> 00:47:50,305
we

1563
00:47:50,305 --> 00:47:51,173
re investing in are

1564
00:47:51,173 --> 00:47:51,389
achieving the goals that we

1565
00:47:51,389 --> 00:47:53,176
re

1566
00:47:53,176 --> 00:47:53,442
trying to accomplish. So with

1567
00:47:53,442 --> 00:47:54,342
that, I

1568
00:47:54,342 --> 00:47:55,844
m going to turn it over

1569
00:47:55,844 --> 00:47:57,580
to Liz, who will introduce

1570
00:47:57,580 --> 00:47:59,615
herself and, um, sort of put

1571
00:47:59,615 --> 00:48:01,884
the frame of the executive new

1572
00:48:01,884 --> 00:48:03,884
executive administration on,

1573
00:48:04,119 --> 00:48:06,880
um, priorities. Liz.

1574
00:48:06,880 --> 00:48:07,122
Thanks, Susan. Good afternoon

1575
00:48:07,122 --> 00:48:08,124
everyone. For the record, my

1576
00:48:08,124 --> 00:48:08,324
name is Liz Arjun. I

1577
00:48:08,324 --> 00:48:09,525
m the

1578
00:48:09,525 --> 00:48:10,760
behavioral health and public

1579
00:48:10,760 --> 00:48:12,161
health policy advisor for

1580
00:48:12,161 --> 00:48:12,795
Executive Zahilay. I

1581
00:48:12,795 --> 00:48:14,330
m pleased

1582
00:48:14,330 --> 00:48:16,798
to be here in partnership with

1583
00:48:16,798 --> 00:48:18,568
colleagues from dhs, be heard.

1584
00:48:18,568 --> 00:48:18,801
And for those whom I don

1585
00:48:18,801 --> 00:48:20,360
t

1586
00:48:20,360 --> 00:48:22,171
know, just a little bit, a bit

1587
00:48:22,171 --> 00:48:23,639
about my background, um, I

1588
00:48:23,639 --> 00:48:26,375
return to the county and public

1589
00:48:26,375 --> 00:48:29,375
service in, uh, MARCH this

1590
00:48:29,378 --> 00:48:32,378
year. Um, after working, um,

1591
00:48:32,981 --> 00:48:35,217
here at King County from 2014

1592
00:48:35,217 --> 00:48:36,519
to 2017, when I was here at the

1593
00:48:36,519 --> 00:48:38,654
county before I was a joint

1594
00:48:38,654 --> 00:48:39,621
employee of dhs and Public

1595
00:48:39,621 --> 00:48:41,123
Health, where I had the

1596
00:48:41,123 --> 00:48:43,425
opportunity to work on project

1597
00:48:43,425 --> 00:48:44,393
projects that were focused on

1598
00:48:44,393 --> 00:48:45,895
bringing our departments

1599
00:48:45,895 --> 00:48:47,950
together and working together

1600
00:48:47,950 --> 00:48:49,165
on behalf of the shared

1601
00:48:49,165 --> 00:48:50,966
populations that are so often

1602
00:48:50,966 --> 00:48:52,340
the focus of the two agencies.

1603
00:48:52,340 --> 00:48:53,202
But where coordination and

1604
00:48:53,202 --> 00:48:55,300
alignment were not the standard

1605
00:48:55,300 --> 00:48:56,500
approach, and these projects

1606
00:48:56,500 --> 00:48:57,639
were a catalyst to start

1607
00:48:57,639 --> 00:48:59,308
working that way. When I came

1608
00:48:59,308 --> 00:49:01,110
back to the county earlier this

1609
00:49:01,110 --> 00:49:03,278
year, I was really pleased to

1610
00:49:03,278 --> 00:49:04,346
see the path that the bird team

1611
00:49:04,346 --> 00:49:06,615
and the executive team were

1612
00:49:06,615 --> 00:49:07,617
already on with regard to how

1613
00:49:07,617 --> 00:49:09,618
we were, how we were

1614
00:49:09,618 --> 00:49:11,820
approaching the mid renewal and

1615
00:49:11,820 --> 00:49:14,220
the implementation plan. And

1616
00:49:14,323 --> 00:49:17,393
just to say that this really is

1617
00:49:17,393 --> 00:49:17,559
a one one county approach where

1618
00:49:17,559 --> 00:49:18,461
we

1619
00:49:18,461 --> 00:49:19,929
re looking to funding

1620
00:49:19,929 --> 00:49:22,310
activities that will support a

1621
00:49:22,310 --> 00:49:23,765
system of robust behavioral

1622
00:49:23,765 --> 00:49:25,501
health continuum from

1623
00:49:25,501 --> 00:49:26,569
prevention activities that

1624
00:49:26,569 --> 00:49:28,437
could be happening in public

1625
00:49:28,437 --> 00:49:30,673
health to the therapeutic court

1626
00:49:30,673 --> 00:49:32,174
interventions, um, to, you

1627
00:49:32,174 --> 00:49:32,379
know, the the crisis system

1628
00:49:32,379 --> 00:49:34,379
that

1629
00:49:34,777 --> 00:49:36,412
s being established. And,

1630
00:49:36,412 --> 00:49:38,800
um, this is something that I,

1631
00:49:38,800 --> 00:49:40,282
Susan, is going to share more

1632
00:49:40,282 --> 00:49:41,383
about, but was very strongly

1633
00:49:41,383 --> 00:49:41,553
heard in the community. But

1634
00:49:41,553 --> 00:49:43,553
it

1635
00:49:44,153 --> 00:49:46,550
s also what makes sense, um,

1636
00:49:46,550 --> 00:49:47,422
the people that we serve are

1637
00:49:47,422 --> 00:49:47,823
not uh, they don

1638
00:49:47,823 --> 00:49:48,230
t they don

1639
00:49:48,230 --> 00:49:50,230
t

1640
00:49:50,159 --> 00:49:51,193
care what what agency is

1641
00:49:51,193 --> 00:49:52,929
serving them. They just want to

1642
00:49:52,929 --> 00:49:54,363
have their needs met. And so I

1643
00:49:54,363 --> 00:49:56,865
was really pleased to see that

1644
00:49:56,865 --> 00:49:59,865
approach. We really viewed this

1645
00:50:00,200 --> 00:50:01,470
happening in an approach that

1646
00:50:01,470 --> 00:50:03,305
promotes overall accountability

1647
00:50:03,305 --> 00:50:04,840
across the county, investments

1648
00:50:04,840 --> 00:50:06,108
that the Mid brings to the

1649
00:50:06,108 --> 00:50:08,611
table or that the bridge brings

1650
00:50:08,611 --> 00:50:10,779
to the table. Um, we envision

1651
00:50:10,779 --> 00:50:13,179
doing this through establishing

1652
00:50:13,548 --> 00:50:15,217
with our partners at dhs and

1653
00:50:15,217 --> 00:50:17,217
other relevant agencies,

1654
00:50:17,386 --> 00:50:19,786
establishing a shared framework

1655
00:50:20,288 --> 00:50:23,288
about metrics for metrics and

1656
00:50:23,559 --> 00:50:24,526
accountability. Um, again, just

1657
00:50:24,526 --> 00:50:25,327
to reiterate, it doesn

1658
00:50:25,327 --> 00:50:26,795
t matter

1659
00:50:26,795 --> 00:50:28,795
which department is

1660
00:50:28,864 --> 00:50:31,264
administering the services. We

1661
00:50:31,266 --> 00:50:32,468
want to have a an overarching

1662
00:50:32,468 --> 00:50:34,468
framework for accountability

1663
00:50:34,570 --> 00:50:36,400
that crosses those agencies.

1664
00:50:36,400 --> 00:50:38,875
Um, we want to be able to look

1665
00:50:38,875 --> 00:50:39,770
and see over time as we

1666
00:50:39,770 --> 00:50:40,275
re

1667
00:50:40,275 --> 00:50:41,911
making an investment in one

1668
00:50:41,911 --> 00:50:43,412
part of the continuum, how it

1669
00:50:43,412 --> 00:50:46,548
MAY or MAY not be showing up in

1670
00:50:46,548 --> 00:50:48,984
other parts. Um, and we

1671
00:50:48,984 --> 00:50:50,385
anticipate that this approach

1672
00:50:50,385 --> 00:50:52,487
will give us the opportunity to

1673
00:50:52,487 --> 00:50:54,290
make stronger, data driven

1674
00:50:54,290 --> 00:50:55,958
decisions in real time that

1675
00:50:55,958 --> 00:50:57,560
have performance goals that we

1676
00:50:57,560 --> 00:50:59,562
can see and make adjustments

1677
00:50:59,562 --> 00:50:59,929
along the way. So I

1678
00:50:59,929 --> 00:51:01,431
m really

1679
00:51:01,431 --> 00:51:04,333
pleased to be here with my

1680
00:51:04,333 --> 00:51:05,901
colleagues from dhs and be back

1681
00:51:05,901 --> 00:51:06,690
with many of you who whom I

1682
00:51:06,690 --> 00:51:06,969
ve

1683
00:51:06,969 --> 00:51:08,337
had the chance to meet in the

1684
00:51:08,337 --> 00:51:09,605
past and look forward to

1685
00:51:09,605 --> 00:51:10,272
talking with you more in the

1686
00:51:10,272 --> 00:51:10,873
future. I

1687
00:51:10,873 --> 00:51:13,873
m going to pass it

1688
00:51:16,450 --> 00:51:17,780
back over to Susan.

1689
00:51:17,780 --> 00:51:18,514
Um, I think this is about is

1690
00:51:18,514 --> 00:51:20,349
this going to you or do you

1691
00:51:20,349 --> 00:51:21,817
want me to take these? Okay.

1692
00:51:21,817 --> 00:51:23,652
Yeah, I can take this. Um,

1693
00:51:23,652 --> 00:51:25,688
thank you so much. Uh, thank

1694
00:51:25,688 --> 00:51:25,891
you. And for the record, I

1695
00:51:25,891 --> 00:51:27,256
d

1696
00:51:27,256 --> 00:51:28,958
like to introduce myself. My

1697
00:51:28,958 --> 00:51:30,493
name is Isabel Jones. She her

1698
00:51:30,493 --> 00:51:32,194
pronouns. And I am the acting

1699
00:51:32,194 --> 00:51:33,529
director for the Division of

1700
00:51:33,529 --> 00:51:35,865
Behavioral Health and Recovery

1701
00:51:35,865 --> 00:51:37,132
here in dc. Hs. Um, and I am

1702
00:51:37,132 --> 00:51:39,680
going to talk us through some

1703
00:51:39,680 --> 00:51:41,300
of what is new in the bridge

1704
00:51:41,300 --> 00:51:43,710
implementation plan as compared

1705
00:51:43,710 --> 00:51:46,700
to the prior Mid implementation

1706
00:51:46,700 --> 00:51:48,110
plan. Um, so first start the

1707
00:51:48,110 --> 00:51:50,120
bridge investment

1708
00:51:50,120 --> 00:51:52,120
considerations. Um, the

1709
00:51:52,147 --> 00:51:53,416
investments as outlined in the

1710
00:51:53,416 --> 00:51:55,416
Mid implementation plan

1711
00:51:55,651 --> 00:51:57,319
financial model are designed to

1712
00:51:57,319 --> 00:51:58,587
respond to changing financial

1713
00:51:58,587 --> 00:52:00,587
projections throughout the

1714
00:52:00,656 --> 00:52:02,656
implementation plan 2028

1715
00:52:03,526 --> 00:52:05,926
through 2034. Um, for context,

1716
00:52:06,962 --> 00:52:08,897
the mid as of 2026 is actually

1717
00:52:08,897 --> 00:52:11,897
currently in a minor reserve

1718
00:52:11,900 --> 00:52:13,900
shortfall of approximately $4

1719
00:52:14,403 --> 00:52:16,639
million. Um, and should

1720
00:52:16,639 --> 00:52:18,639
expenditures and economic

1721
00:52:18,707 --> 00:52:20,710
adjustments for all existing

1722
00:52:20,710 --> 00:52:23,120
programs within the current Mid

1723
00:52:23,120 --> 00:52:24,713
continue. Um, you know, sort of

1724
00:52:24,713 --> 00:52:26,114
as status quo and giving

1725
00:52:26,114 --> 00:52:28,114
inflationary adjustments each

1726
00:52:28,350 --> 00:52:30,319
year. Um, the revenue source

1727
00:52:30,319 --> 00:52:31,687
would be in a significant

1728
00:52:31,687 --> 00:52:33,687
reserve shortfall of

1729
00:52:34,957 --> 00:52:36,957
approximately 29. Yeah, 29

1730
00:52:38,760 --> 00:52:41,290
million by 2029. Um, so the

1731
00:52:41,290 --> 00:52:43,165
bridge implementation plan, uh,

1732
00:52:43,165 --> 00:52:46,680
is designed to address that

1733
00:52:46,680 --> 00:52:47,870
over, um, the first several

1734
00:52:47,870 --> 00:52:49,671
years of the implementation

1735
00:52:49,671 --> 00:52:51,841
plan, in particular, um,

1736
00:52:51,841 --> 00:52:53,841
primarily by conducting

1737
00:52:53,976 --> 00:52:55,976
procurements for new

1738
00:52:56,512 --> 00:52:59,470
programming or to select, uh,

1739
00:52:59,470 --> 00:53:01,851
new providers to do similar

1740
00:53:01,851 --> 00:53:04,120
programming to the current mid,

1741
00:53:04,120 --> 00:53:05,787
um, and to assure that as we

1742
00:53:05,787 --> 00:53:08,490
proceed into the mid, the

1743
00:53:08,490 --> 00:53:10,890
bridge implementation plan, um,

1744
00:53:11,393 --> 00:53:13,162
that the programming is, uh,

1745
00:53:13,162 --> 00:53:15,197
sort of operating within the

1746
00:53:15,197 --> 00:53:17,733
revenue that is available from

1747
00:53:17,733 --> 00:53:19,268
the funding source. Um,

1748
00:53:19,268 --> 00:53:21,268
additionally, we have

1749
00:53:21,270 --> 00:53:23,270
introduced through learnings

1750
00:53:23,305 --> 00:53:24,873
during the last prior mid

1751
00:53:24,873 --> 00:53:25,740
implementation plan, um, we

1752
00:53:25,740 --> 00:53:26,942
ve

1753
00:53:26,942 --> 00:53:29,245
introduced a reserve that

1754
00:53:29,245 --> 00:53:31,113
creates more flexibility during

1755
00:53:31,113 --> 00:53:33,349
anticipated periods of sales

1756
00:53:33,349 --> 00:53:36,285
tax volatility. For example, we

1757
00:53:36,285 --> 00:53:37,887
know that in 2029 there will be

1758
00:53:37,887 --> 00:53:40,220
a kind of a revenue, uh,

1759
00:53:40,220 --> 00:53:41,723
reduction in terms of sales tax

1760
00:53:41,723 --> 00:53:43,625
due to some of the state

1761
00:53:43,625 --> 00:53:44,226
changes to the, um, related to

1762
00:53:44,226 --> 00:53:45,961
the millionaire

1763
00:53:45,961 --> 00:53:48,361
s tax. Um, and

1764
00:53:48,564 --> 00:53:49,998
so the implementation plan

1765
00:53:49,998 --> 00:53:50,900
already contemplates that that

1766
00:53:50,900 --> 00:53:52,534
would be a year where there

1767
00:53:52,534 --> 00:53:55,534
would be a lower inflationary

1768
00:53:55,838 --> 00:53:58,340
adjustment proposed. Um, but it

1769
00:53:58,340 --> 00:54:01,940
also creates a reserve, as Sam

1770
00:54:02,578 --> 00:54:03,679
mentioned, through 2031, so

1771
00:54:03,679 --> 00:54:05,614
that we are sort of smoothing

1772
00:54:05,614 --> 00:54:07,783
out the known sales tax

1773
00:54:07,783 --> 00:54:09,151
volatility, um, and planning

1774
00:54:09,151 --> 00:54:10,653
for it so that we can plan

1775
00:54:10,653 --> 00:54:12,421
ahead to provide economic

1776
00:54:12,421 --> 00:54:14,421
adjustments for existing

1777
00:54:15,390 --> 00:54:17,225
contractors. Um, uh, when

1778
00:54:17,225 --> 00:54:18,360
revenue is available. Um, and

1779
00:54:18,360 --> 00:54:19,494
this is something that is part

1780
00:54:19,494 --> 00:54:21,830
of the bridge implementation

1781
00:54:21,830 --> 00:54:23,732
plan as a learning from the

1782
00:54:23,732 --> 00:54:25,300
prior mid period. Um, and then

1783
00:54:25,300 --> 00:54:26,601
we are also proposing to

1784
00:54:26,601 --> 00:54:28,704
strengthen our monitoring and

1785
00:54:28,704 --> 00:54:29,839
compliance work by rightsizing

1786
00:54:29,839 --> 00:54:32,239
staffing to support the

1787
00:54:33,576 --> 00:54:35,976
investment of $100 million per

1788
00:54:36,110 --> 00:54:37,747
year. We do have over 312

1789
00:54:37,747 --> 00:54:40,147
contracts currently within the

1790
00:54:40,182 --> 00:54:42,351
mid. Um, and so we are seeking

1791
00:54:42,351 --> 00:54:43,852
a modest increase in staffing

1792
00:54:43,852 --> 00:54:45,821
to support our ability to do

1793
00:54:45,821 --> 00:54:48,221
compliance work, do monitoring

1794
00:54:48,591 --> 00:54:50,259
work, and to implement the

1795
00:54:50,259 --> 00:54:52,595
various levels up policies and

1796
00:54:52,595 --> 00:54:54,995
procedures that the department,

1797
00:54:55,631 --> 00:54:57,433
um, uh, has been, um,

1798
00:54:57,433 --> 00:54:59,833
implementing. And next slide,

1799
00:55:04,540 --> 00:55:06,909
please. Um, so another primary,

1800
00:55:06,909 --> 00:55:09,879
uh, change in the bridge as

1801
00:55:09,879 --> 00:55:12,549
compared to Mid. Is that the

1802
00:55:12,549 --> 00:55:15,484
bridge is organized into five

1803
00:55:15,484 --> 00:55:17,884
primary strategy areas, um,

1804
00:55:19,588 --> 00:55:21,957
with 2 to 3 concrete goals. Uh,

1805
00:55:21,957 --> 00:55:25,557
in each of these five strategy

1806
00:55:26,261 --> 00:55:27,696
areas for a total of 13 goals

1807
00:55:27,696 --> 00:55:30,666
and funding in the financial

1808
00:55:30,666 --> 00:55:33,469
plan is at that goal level. Um,

1809
00:55:33,469 --> 00:55:35,571
and this is a shift from mid

1810
00:55:35,571 --> 00:55:37,907
where the Mid implementation

1811
00:55:37,907 --> 00:55:40,907
plan was organized under about

1812
00:55:41,420 --> 00:55:43,420
55 distinct initiatives. Um,

1813
00:55:43,780 --> 00:55:45,314
those 55 initiatives did roll

1814
00:55:45,314 --> 00:55:47,683
up to five goals. Also in the

1815
00:55:47,683 --> 00:55:50,830
Mid implementation plan. Um,

1816
00:55:50,386 --> 00:55:52,521
but we are seeking to move away

1817
00:55:52,521 --> 00:55:54,521
from uh 55 distinct

1818
00:55:54,523 --> 00:55:56,158
initiatives, which in some

1819
00:55:56,158 --> 00:55:58,558
cases were quite narrowly

1820
00:55:59,270 --> 00:56:00,830
defined and kind of, uh,

1821
00:56:00,830 --> 00:56:02,830
resulted in somewhat

1822
00:56:03,498 --> 00:56:05,500
constraining how, uh, programs

1823
00:56:05,500 --> 00:56:07,669
could be implemented within a

1824
00:56:07,669 --> 00:56:09,972
given initiative if it was

1825
00:56:09,972 --> 00:56:11,206
narrowly defined to moving

1826
00:56:11,206 --> 00:56:14,142
towards kind of a little bit of

1827
00:56:14,142 --> 00:56:15,577
a higher level investment and,

1828
00:56:15,577 --> 00:56:17,712
um, having more flexibility

1829
00:56:17,712 --> 00:56:20,282
within the bridge to be able to

1830
00:56:20,282 --> 00:56:21,717
make broader, deeper

1831
00:56:21,717 --> 00:56:23,717
investments, meaningful,

1832
00:56:24,219 --> 00:56:25,888
impactful investments. Um,

1833
00:56:25,888 --> 00:56:27,822
investments that are scalable

1834
00:56:27,822 --> 00:56:29,858
across our community and

1835
00:56:29,858 --> 00:56:32,161
operating at that goal level

1836
00:56:32,161 --> 00:56:34,463
rather than at the, um, the

1837
00:56:34,463 --> 00:56:36,464
initiative level. Um, so the

1838
00:56:36,464 --> 00:56:38,267
five strategy areas are care,

1839
00:56:38,267 --> 00:56:40,136
transitions and diversion

1840
00:56:40,136 --> 00:56:41,170
services, substance use

1841
00:56:41,170 --> 00:56:43,170
disorder, treatment and

1842
00:56:43,305 --> 00:56:44,873
recovery, equitable access to

1843
00:56:44,873 --> 00:56:46,750
behavioral health care, child

1844
00:56:46,750 --> 00:56:47,309
youth and young adult mental

1845
00:56:47,309 --> 00:56:49,309
well-being and behavioral

1846
00:56:49,411 --> 00:56:51,411
health. Workforce development.

1847
00:56:51,880 --> 00:56:53,749
I will note that, um, well,

1848
00:56:53,749 --> 00:56:55,951
this is a change in structure

1849
00:56:55,951 --> 00:56:58,870
and sort of organization of

1850
00:56:58,870 --> 00:56:59,955
work in the bridge. The

1851
00:56:59,955 --> 00:57:01,955
existing programs and

1852
00:57:02,124 --> 00:57:04,930
initiatives and contracts, um,

1853
00:57:04,930 --> 00:57:06,629
do crosswalk to these five

1854
00:57:06,629 --> 00:57:08,497
strategy areas and 13 goals.

1855
00:57:08,497 --> 00:57:10,632
And in many ways, you know,

1856
00:57:10,632 --> 00:57:10,813
align with the direction that

1857
00:57:10,813 --> 00:57:12,534
we

1858
00:57:12,534 --> 00:57:12,958
re moving in the bridge. So

1859
00:57:12,958 --> 00:57:13,869
it

1860
00:57:13,869 --> 00:57:14,269
s not a, um, it

1861
00:57:14,269 --> 00:57:16,204
s not a

1862
00:57:16,204 --> 00:57:18,240
dramatic departure from, uh,

1863
00:57:18,240 --> 00:57:20,776
much of which much of what the

1864
00:57:20,776 --> 00:57:23,278
Mid has been investing in over

1865
00:57:23,278 --> 00:57:24,980
the last few years. Um, but in

1866
00:57:24,980 --> 00:57:27,583
particular, I think a different

1867
00:57:27,583 --> 00:57:30,583
way of organizing the work.

1868
00:57:30,653 --> 00:57:32,287
And, you know, uh, highlighting

1869
00:57:32,287 --> 00:57:34,222
these really as the five

1870
00:57:34,222 --> 00:57:36,258
strategy areas in particular

1871
00:57:36,258 --> 00:57:37,327
that we see as being priorities

1872
00:57:37,327 --> 00:57:39,394
for the community Behavioral

1873
00:57:39,394 --> 00:57:40,729
Health System based on, as

1874
00:57:40,729 --> 00:57:41,997
Susan mentioned, uh,

1875
00:57:41,997 --> 00:57:43,798
significant community

1876
00:57:43,798 --> 00:57:45,801
engagement as well as data

1877
00:57:45,801 --> 00:57:47,690
analysis and a lot of work with

1878
00:57:47,690 --> 00:57:50,690
subject matter experts in our

1879
00:57:55,110 --> 00:57:56,678
system. Uh, next slide. Um, the

1880
00:57:56,678 --> 00:57:57,880
bridge implementation plan is

1881
00:57:57,880 --> 00:57:59,648
also bringing a county wide

1882
00:57:59,648 --> 00:58:01,583
approach to accountable

1883
00:58:01,583 --> 00:58:02,884
accountability and outcomes.

1884
00:58:02,884 --> 00:58:03,252
Um, uh, as the executive

1885
00:58:03,252 --> 00:58:05,252
s

1886
00:58:05,721 --> 00:58:06,956
office has mentioned, um, there

1887
00:58:06,956 --> 00:58:08,257
is an intent to measure,

1888
00:58:08,257 --> 00:58:09,791
monitor and support

1889
00:58:09,791 --> 00:58:11,791
accountability across county

1890
00:58:11,794 --> 00:58:13,794
administered programming in

1891
00:58:13,795 --> 00:58:15,970
addition to our programming

1892
00:58:15,970 --> 00:58:17,433
that we contract out to

1893
00:58:17,433 --> 00:58:18,834
providers. Um, currently under

1894
00:58:18,834 --> 00:58:19,670
the Mid right now, there

1895
00:58:19,670 --> 00:58:21,670
s

1896
00:58:22,204 --> 00:58:23,739
about 75% of the funds that are

1897
00:58:23,739 --> 00:58:24,973
administered through contracts

1898
00:58:24,973 --> 00:58:27,900
with provider organizations in

1899
00:58:27,900 --> 00:58:29,244
the community. And then about

1900
00:58:29,244 --> 00:58:31,547
25% of the programming is

1901
00:58:31,547 --> 00:58:33,820
actually administered by the

1902
00:58:33,820 --> 00:58:34,917
county itself, whether that be

1903
00:58:34,917 --> 00:58:36,718
through public health or, um,

1904
00:58:36,718 --> 00:58:37,286
jail health or even some

1905
00:58:37,286 --> 00:58:38,200
programming that

1906
00:58:38,200 --> 00:58:38,387
s administered

1907
00:58:38,387 --> 00:58:39,187
in the sheriff

1908
00:58:39,187 --> 00:58:41,187
s office. For

1909
00:58:42,557 --> 00:58:43,492
example. Um, uh, we will also

1910
00:58:43,492 --> 00:58:45,492
be doing competitive

1911
00:58:46,428 --> 00:58:47,763
procurement for dhs programs.

1912
00:58:47,763 --> 00:58:50,265
Uh, this is something that we

1913
00:58:50,265 --> 00:58:52,467
are proposing to do. Uh, in all

1914
00:58:52,467 --> 00:58:55,271
five strategy areas and under

1915
00:58:55,271 --> 00:58:55,737
all of the sort of 13 goals,

1916
00:58:55,737 --> 00:58:57,172
um, that doesn

1917
00:58:57,172 --> 00:58:59,172
t necessarily

1918
00:58:59,841 --> 00:59:01,443
mean that some or much of the

1919
00:59:01,443 --> 00:59:03,443
current programming that

1920
00:59:03,445 --> 00:59:05,281
happens now in the mid, um,

1921
00:59:05,281 --> 00:59:06,548
might not be something that,

1922
00:59:06,548 --> 00:59:07,883
uh, either something that is

1923
00:59:07,883 --> 00:59:09,318
procured in the future or

1924
00:59:09,318 --> 00:59:11,687
something very similar could be

1925
00:59:11,687 --> 00:59:13,856
procured in the future. But we

1926
00:59:13,856 --> 00:59:16,324
are proposing to do procurement

1927
00:59:16,324 --> 00:59:18,940
processes for, uh, contracted

1928
00:59:18,940 --> 00:59:20,629
programming. We think this is

1929
00:59:20,629 --> 00:59:22,764
very important. Um, just to,

1930
00:59:22,764 --> 00:59:24,366
uh, give, for example, new

1931
00:59:24,366 --> 00:59:26,335
organizations and entrants in

1932
00:59:26,335 --> 00:59:27,736
our community an opportunity to

1933
00:59:27,736 --> 00:59:29,638
compete, an opportunity to

1934
00:59:29,638 --> 00:59:31,730
bring forward the best possible

1935
00:59:31,730 --> 00:59:33,508
proposals for how they can

1936
00:59:33,508 --> 00:59:35,811
serve our community. Um, so

1937
00:59:35,811 --> 00:59:35,978
that is, um, a change that

1938
00:59:35,978 --> 00:59:37,880
we

1939
00:59:37,880 --> 00:59:39,948
re proposing in this bridge

1940
00:59:39,948 --> 00:59:41,450
implementation plan. Um, that

1941
00:59:41,450 --> 00:59:43,180
is something that we seek to do

1942
00:59:43,180 --> 00:59:44,786
and we think is very important

1943
00:59:44,786 --> 00:59:46,655
to do at this point for the

1944
00:59:46,655 --> 00:59:49,580
funding source. Um, because in

1945
00:59:49,580 --> 00:59:51,560
many cases, it has been many

1946
00:59:51,560 --> 00:59:52,627
years, uh, since some of our

1947
00:59:52,627 --> 00:59:53,629
programming through this

1948
00:59:53,629 --> 00:59:55,764
funding source has actually

1949
00:59:55,764 --> 00:59:58,400
been open up for a competitive

1950
00:59:58,400 --> 01:00:01,400
process in the community. Uh,

1951
01:00:03,710 --> 01:00:05,507
next slide, please. Um, in

1952
01:00:05,507 --> 01:00:08,507
terms of the anticipated steps

1953
01:00:08,510 --> 01:00:08,672
to the procurement, uh, so, um,

1954
01:00:08,672 --> 01:00:09,578
I

1955
01:00:09,578 --> 01:00:12,547
ll just kind of walk us

1956
01:00:12,547 --> 01:00:14,716
through how we at the division.

1957
01:00:14,716 --> 01:00:16,151
Um, uh, do our procurements and

1958
01:00:16,151 --> 01:00:17,219
what those various steps are,

1959
01:00:17,219 --> 01:00:17,415
as well as my next slide. We

1960
01:00:17,415 --> 01:00:19,415
ll

1961
01:00:19,722 --> 01:00:21,323
talk about the timeline. Um,

1962
01:00:21,323 --> 01:00:23,725
but we start by analyzing the

1963
01:00:23,725 --> 01:00:25,660
current financial projections,

1964
01:00:25,660 --> 01:00:27,362
how much revenue is going to be

1965
01:00:27,362 --> 01:00:29,164
available to, you know, put out

1966
01:00:29,164 --> 01:00:30,765
for a given procurement, the

1967
01:00:30,765 --> 01:00:32,734
behavioral health landscape,

1968
01:00:32,734 --> 01:00:34,135
performance data and potential

1969
01:00:34,135 --> 01:00:35,838
funding sources for each

1970
01:00:35,838 --> 01:00:36,190
strategy area? Um, what we

1971
01:00:36,190 --> 01:00:38,190
re

1972
01:00:38,440 --> 01:00:41,243
referencing with that is, um,

1973
01:00:41,243 --> 01:00:42,978
uh, continuing to evaluate, uh,

1974
01:00:42,978 --> 01:00:44,746
if there is a funding source

1975
01:00:44,746 --> 01:00:47,146
that has perhaps become

1976
01:00:47,149 --> 01:00:48,284
available to the county, um, in

1977
01:00:48,284 --> 01:00:49,752
recent years, such as the

1978
01:00:49,752 --> 01:00:51,486
crisis care center levy, that

1979
01:00:51,486 --> 01:00:52,487
might have a stronger alignment

1980
01:00:52,487 --> 01:00:54,523
with something that we were

1981
01:00:54,523 --> 01:00:57,125
previously doing under the mid.

1982
01:00:57,125 --> 01:00:59,328
Um, we would seek to evaluate

1983
01:00:59,328 --> 01:01:00,829
whether that programming might

1984
01:01:00,829 --> 01:01:02,964
actually be more appropriate

1985
01:01:02,964 --> 01:01:05,367
for a different funding source

1986
01:01:05,367 --> 01:01:06,735
and evaluate the programs

1987
01:01:06,735 --> 01:01:08,236
Where we have braided multiple

1988
01:01:08,236 --> 01:01:09,337
funding sources together to

1989
01:01:09,337 --> 01:01:10,710
determine if there might be an

1990
01:01:10,710 --> 01:01:12,273
opportunity to kind of

1991
01:01:12,273 --> 01:01:14,643
streamline and fund something

1992
01:01:14,643 --> 01:01:17,430
through 1 or 2 funding sources,

1993
01:01:17,790 --> 01:01:19,648
as opposed to at times, 4 to 5

1994
01:01:19,648 --> 01:01:19,915
funding sources. Um, the

1995
01:01:19,915 --> 01:01:21,490
executive

1996
01:01:21,490 --> 01:01:22,784
s office intends to

1997
01:01:22,784 --> 01:01:24,186
conduct a base budget analysis

1998
01:01:24,186 --> 01:01:26,755
of programs that are directly

1999
01:01:26,755 --> 01:01:29,755
operated by county agencies as

2000
01:01:29,792 --> 01:01:31,393
part of the 2829 budget

2001
01:01:31,393 --> 01:01:33,295
process. Um, then we would

2002
01:01:33,295 --> 01:01:35,695
crosswalk existing programs to

2003
01:01:35,764 --> 01:01:37,990
strategy areas, identify

2004
01:01:37,990 --> 01:01:38,867
alternative funding sources

2005
01:01:38,867 --> 01:01:41,267
where applicable, and right

2006
01:01:41,403 --> 01:01:43,405
size rfp budgets to align

2007
01:01:43,405 --> 01:01:45,700
procurements with other county

2008
01:01:45,700 --> 01:01:46,775
funding streams. Again, as

2009
01:01:46,775 --> 01:01:48,977
available, um, draft our

2010
01:01:48,977 --> 01:01:51,212
procurement materials for the

2011
01:01:51,212 --> 01:01:53,212
anticipated activities, goals,

2012
01:01:53,215 --> 01:01:54,830
preliminary outcome measures in

2013
01:01:54,830 --> 01:01:54,349
partnership with the

2014
01:01:54,349 --> 01:01:56,840
executive

2015
01:01:56,840 --> 01:01:57,719
s office. Also likely

2016
01:01:57,719 --> 01:01:59,288
doing more community engagement

2017
01:01:59,288 --> 01:02:01,790
in that process. More subject

2018
01:02:01,790 --> 01:02:03,224
matter expert engagement and

2019
01:02:03,224 --> 01:02:05,460
using the logic models that are

2020
01:02:05,460 --> 01:02:07,362
in the implementation plan as a

2021
01:02:07,362 --> 01:02:09,131
starting point. Um, the

2022
01:02:09,131 --> 01:02:10,933
implementation plan itself does

2023
01:02:10,933 --> 01:02:13,468
include for each of the 13

2024
01:02:13,468 --> 01:02:16,338
goals, a list of what we refer

2025
01:02:16,338 --> 01:02:18,738
to as anticipated activities.

2026
01:02:19,541 --> 01:02:22,377
Um, so this is a strong kind of

2027
01:02:22,377 --> 01:02:24,346
roadmap or example that, uh,

2028
01:02:24,346 --> 01:02:26,381
you and stakeholders could look

2029
01:02:26,381 --> 01:02:27,683
at to have a sense of what are

2030
01:02:27,683 --> 01:02:29,518
some of the things that we

2031
01:02:29,518 --> 01:02:30,719
think would be applicable or

2032
01:02:30,719 --> 01:02:33,550
would be kind of appropriate

2033
01:02:33,550 --> 01:02:36,224
under each goal to be the focus

2034
01:02:36,224 --> 01:02:37,225
point for a future procurement?

2035
01:02:37,225 --> 01:02:38,794
Um, then we would launch

2036
01:02:38,794 --> 01:02:40,794
competitive procurements with

2037
01:02:40,796 --> 01:02:42,431
community outreach information

2038
01:02:42,431 --> 01:02:44,431
sessions and technical

2039
01:02:44,733 --> 01:02:46,902
assistance, recruit and train

2040
01:02:46,902 --> 01:02:48,902
panelists, conduct equitable

2041
01:02:49,370 --> 01:02:50,806
applications, scoring select

2042
01:02:50,806 --> 01:02:53,575
awardees, and complete all of

2043
01:02:53,575 --> 01:02:55,544
our due diligence processes.

2044
01:02:55,544 --> 01:02:57,546
Um, this is also where we would

2045
01:02:57,546 --> 01:02:59,114
notify Council and we, as part

2046
01:02:59,114 --> 01:03:00,982
of our standard procurement

2047
01:03:00,982 --> 01:03:03,885
process. For example, we invite

2048
01:03:03,885 --> 01:03:06,885
council, um, to participate in

2049
01:03:07,422 --> 01:03:10,422
the scoring panels. Uh, next

2050
01:03:12,494 --> 01:03:14,129
slide. Um, in terms of the

2051
01:03:14,129 --> 01:03:16,365
estimated timeline for the

2052
01:03:16,365 --> 01:03:18,765
phased procurement, uh, the

2053
01:03:19,468 --> 01:03:21,536
implementation plan proposes to

2054
01:03:21,536 --> 01:03:23,936
phase the procurements over

2055
01:03:24,306 --> 01:03:25,474
approximately two years. Um,

2056
01:03:25,474 --> 01:03:28,110
this is for a number of

2057
01:03:28,110 --> 01:03:30,450
reasons. Uh, for one thing, um,

2058
01:03:30,450 --> 01:03:31,880
just capacity and resources,

2059
01:03:31,880 --> 01:03:34,416
both at the department level

2060
01:03:34,416 --> 01:03:36,918
and in the community to develop

2061
01:03:36,918 --> 01:03:38,387
procurements. Um, and to for

2062
01:03:38,387 --> 01:03:39,888
community members to respond to

2063
01:03:39,888 --> 01:03:42,288
procurements is something that

2064
01:03:42,390 --> 01:03:44,193
we think necessitates a phased

2065
01:03:44,193 --> 01:03:46,361
approach. Um, we want to be

2066
01:03:46,361 --> 01:03:48,197
able to, uh, certainly take

2067
01:03:48,197 --> 01:03:49,464
time and again, do additional

2068
01:03:49,464 --> 01:03:51,320
stakeholder engagement as we

2069
01:03:51,320 --> 01:03:52,934
are developing these

2070
01:03:52,934 --> 01:03:54,136
procurements. Um, from the time

2071
01:03:54,136 --> 01:03:56,671
when our procurement would be

2072
01:03:56,671 --> 01:03:57,973
announced to when a new program

2073
01:03:57,973 --> 01:04:00,708
would launch would actually be

2074
01:04:00,708 --> 01:04:02,277
a little bit over a year. Um,

2075
01:04:02,277 --> 01:04:03,612
because of just the time it

2076
01:04:03,612 --> 01:04:04,946
takes to put out the

2077
01:04:04,946 --> 01:04:06,515
procurements, allow the

2078
01:04:06,515 --> 01:04:08,417
provider community to respond

2079
01:04:08,417 --> 01:04:09,985
to procurements, and then go

2080
01:04:09,985 --> 01:04:11,787
through the selection process,

2081
01:04:11,787 --> 01:04:13,955
and then also do readiness

2082
01:04:13,955 --> 01:04:16,258
review due notification to any

2083
01:04:16,258 --> 01:04:17,726
existing programs that you know,

2084
01:04:17,726 --> 01:04:19,962
might need a transition period

2085
01:04:19,962 --> 01:04:21,930
and kind of a ramp down period.

2086
01:04:21,930 --> 01:04:24,660
Um, so there would be a, a

2087
01:04:24,660 --> 01:04:25,500
pretty significant timeline of

2088
01:04:25,500 --> 01:04:27,569
about a year. Um, in

2089
01:04:27,569 --> 01:04:29,371
particular, for any program

2090
01:04:29,371 --> 01:04:30,873
that was not proposing to be

2091
01:04:30,873 --> 01:04:31,840
renewed or really is not going

2092
01:04:31,840 --> 01:04:33,708
to be the focus of a

2093
01:04:33,708 --> 01:04:35,977
procurement in the future. That

2094
01:04:35,977 --> 01:04:38,613
program would have over a year

2095
01:04:38,613 --> 01:04:39,982
notice. Um, on that timeline.

2096
01:04:39,982 --> 01:04:41,950
Um, and then, you know, we also

2097
01:04:41,950 --> 01:04:43,384
have some, uh, things that we

2098
01:04:43,384 --> 01:04:45,253
would just note in terms of the

2099
01:04:45,253 --> 01:04:47,790
child, youth and young adult,

2100
01:04:47,790 --> 01:04:50,190
uh, mental wellbeing strategy

2101
01:04:50,392 --> 01:04:51,827
being the last strategy on the

2102
01:04:51,827 --> 01:04:53,827
phased procurement timeline.

2103
01:04:53,895 --> 01:04:56,231
That is intentional. Um, so

2104
01:04:56,231 --> 01:04:57,533
that, uh, there is more clarity

2105
01:04:57,533 --> 01:04:59,501
and uncertainty around best

2106
01:04:59,501 --> 01:05:00,536
starts for kids and we would be

2107
01:05:00,536 --> 01:05:03,672
able to sort of align that

2108
01:05:03,672 --> 01:05:06,241
procurement with, uh, with Best

2109
01:05:06,241 --> 01:05:09,344
starts for kids at that time.

2110
01:05:09,344 --> 01:05:11,747
Next slide please. Um, I wanted

2111
01:05:11,747 --> 01:05:14,583
to touch on, uh, just upcoming

2112
01:05:14,583 --> 01:05:17,583
reports and briefings. Um, so

2113
01:05:18,870 --> 01:05:19,955
the 2025 mid retrospective, uh,

2114
01:05:19,955 --> 01:05:22,457
we just did prior to this

2115
01:05:22,457 --> 01:05:24,459
presentation, then we have two

2116
01:05:24,459 --> 01:05:25,494
progress reports. Um, well, we

2117
01:05:25,494 --> 01:05:26,928
have a progress report and then

2118
01:05:26,928 --> 01:05:28,931
a transmittal that will go to

2119
01:05:28,931 --> 01:05:30,699
county Council related to our

2120
01:05:30,699 --> 01:05:32,634
strategic planning work. This

2121
01:05:32,634 --> 01:05:34,870
was a proviso that was in the

2122
01:05:34,870 --> 01:05:37,272
prior budget that has, um,

2123
01:05:37,272 --> 01:05:39,740
required us to bring forward a

2124
01:05:39,740 --> 01:05:40,876
very comprehensive report

2125
01:05:40,876 --> 01:05:42,944
around our programming and our

2126
01:05:42,944 --> 01:05:45,130
strategic planning. So we have

2127
01:05:45,130 --> 01:05:46,810
an upcoming SEPTEMBER briefing

2128
01:05:46,810 --> 01:05:47,616
on that. And then we will

2129
01:05:47,616 --> 01:05:49,718
transmitting the report in

2130
01:05:49,718 --> 01:05:52,420
JANUARY. Um, and then following

2131
01:05:52,420 --> 01:05:54,456
that at both our pc as well as

2132
01:05:54,456 --> 01:05:55,891
council each summer, we would

2133
01:05:55,891 --> 01:05:58,460
be coming back with bridge

2134
01:05:58,460 --> 01:06:01,329
transition updates. Um, and we

2135
01:06:01,329 --> 01:06:03,565
will also have the data

2136
01:06:03,565 --> 01:06:05,400
dashboard. Um, that, you know,

2137
01:06:05,400 --> 01:06:06,335
is available and has data

2138
01:06:06,335 --> 01:06:07,903
related to all of the

2139
01:06:07,903 --> 01:06:09,638
programming. And then the first

2140
01:06:09,638 --> 01:06:12,380
biennial report would actually

2141
01:06:12,708 --> 01:06:14,509
be in AUGUST 2030. Um, that

2142
01:06:14,509 --> 01:06:16,812
would look back on the first

2143
01:06:16,812 --> 01:06:19,714
two full years of the bridge

2144
01:06:19,714 --> 01:06:20,582
implementation plan. Next slide

2145
01:06:20,582 --> 01:06:21,316
please. Um, I

2146
01:06:21,316 --> 01:06:22,917
m gonna also

2147
01:06:22,917 --> 01:06:25,317
touch on the inflation

2148
01:06:26,540 --> 01:06:28,923
analysis. Um, uh, which was a

2149
01:06:28,923 --> 01:06:31,259
budget proviso. That is part of

2150
01:06:31,259 --> 01:06:33,659
the implementation plan. Um,

2151
01:06:33,662 --> 01:06:35,964
the budget proviso, uh, sought

2152
01:06:35,964 --> 01:06:37,532
for the department to talk

2153
01:06:37,532 --> 01:06:39,501
about how inflation rate

2154
01:06:39,501 --> 01:06:41,901
adjustments are made and

2155
01:06:42,370 --> 01:06:44,439
determined to be, um, sort of

2156
01:06:44,439 --> 01:06:45,840
viable and something that can

2157
01:06:45,840 --> 01:06:47,542
happen within a given revenue

2158
01:06:47,542 --> 01:06:48,843
source. Um, we do seek to

2159
01:06:48,843 --> 01:06:50,278
integrate provider inflation

2160
01:06:50,278 --> 01:06:52,278
rate adjustments into

2161
01:06:52,781 --> 01:06:54,950
implementation plans and budget

2162
01:06:54,950 --> 01:06:57,118
proposals for our local funding

2163
01:06:57,118 --> 01:06:59,287
sources whenever the revenue

2164
01:06:59,287 --> 01:07:01,222
support source supports our

2165
01:07:01,222 --> 01:07:02,457
ability to do that. That is so

2166
01:07:02,457 --> 01:07:04,159
that we can support human

2167
01:07:04,159 --> 01:07:05,827
service providers to maintain

2168
01:07:05,827 --> 01:07:07,896
their service levels and retain

2169
01:07:07,896 --> 01:07:09,598
their workers in the face of

2170
01:07:09,598 --> 01:07:11,660
inflationary costs that they

2171
01:07:11,660 --> 01:07:13,466
experience at the provider

2172
01:07:13,702 --> 01:07:15,637
level. Um, however, there are

2173
01:07:15,637 --> 01:07:18,370
times when expenditure growth

2174
01:07:18,173 --> 01:07:20,241
is predicted to outpace revenue

2175
01:07:20,241 --> 01:07:21,443
growth. Um, and so, you know,

2176
01:07:21,443 --> 01:07:22,510
therefore and we see this

2177
01:07:22,510 --> 01:07:23,913
happening in the mid and the

2178
01:07:23,913 --> 01:07:26,482
bridge. Um, there are times

2179
01:07:26,482 --> 01:07:27,883
when we know that the economic

2180
01:07:27,883 --> 01:07:29,885
adjustment that we would seek

2181
01:07:29,885 --> 01:07:31,286
to give to contracted providers

2182
01:07:31,286 --> 01:07:32,521
is actually larger than the

2183
01:07:32,521 --> 01:07:34,289
additional revenue that will

2184
01:07:34,289 --> 01:07:36,491
come in during that time

2185
01:07:36,491 --> 01:07:39,228
period. Um, and so again, in

2186
01:07:39,228 --> 01:07:40,610
the implementation plan, we did

2187
01:07:40,610 --> 01:07:42,330
build in that kind of

2188
01:07:42,330 --> 01:07:44,633
volatility reserve to account

2189
01:07:44,633 --> 01:07:46,468
for that. And uh, inflationary

2190
01:07:46,468 --> 01:07:48,300
adjustments are always subject

2191
01:07:48,300 --> 01:07:50,372
to council approval and go

2192
01:07:50,372 --> 01:07:52,772
through that, uh, budget

2193
01:07:52,975 --> 01:07:54,709
process. Um, and at times we

2194
01:07:54,709 --> 01:07:56,177
have to propose a lower

2195
01:07:56,177 --> 01:07:57,979
inflationary adjustment or

2196
01:07:57,979 --> 01:07:59,480
perhaps even know inflationary

2197
01:07:59,480 --> 01:08:00,615
inflationary adjustment if the

2198
01:08:00,615 --> 01:08:01,917
revenue source can

2199
01:08:01,917 --> 01:08:03,917
t support

2200
01:08:05,520 --> 01:08:07,556
it. Um, we can go to the next

2201
01:08:07,556 --> 01:08:08,156
slide. Um, I

2202
01:08:08,156 --> 01:08:09,458
m just going to

2203
01:08:09,458 --> 01:08:11,459
touch on some a couple of

2204
01:08:11,459 --> 01:08:12,694
frequently asked questions that

2205
01:08:12,694 --> 01:08:14,462
we have gotten over the last

2206
01:08:14,462 --> 01:08:15,964
couple of weeks, and then we

2207
01:08:15,964 --> 01:08:17,766
can open it up for additional

2208
01:08:17,766 --> 01:08:19,670
questions. Um, one of the

2209
01:08:19,670 --> 01:08:20,369
questions has been whether the

2210
01:08:20,369 --> 01:08:22,710
bridge will invest equitably

2211
01:08:22,710 --> 01:08:23,538
across the county. Um, and we

2212
01:08:23,538 --> 01:08:25,730
do expect to maintain or

2213
01:08:25,730 --> 01:08:27,473
improve our behavioral health

2214
01:08:27,776 --> 01:08:29,177
service availability across the

2215
01:08:29,177 --> 01:08:30,445
full county through countywide

2216
01:08:30,445 --> 01:08:32,445
services and targeted

2217
01:08:32,447 --> 01:08:34,349
investments in both rural and

2218
01:08:34,349 --> 01:08:36,180
urban areas. Um, another

2219
01:08:36,180 --> 01:08:37,352
question we have got is why

2220
01:08:37,352 --> 01:08:39,755
there is a proposed shift from

2221
01:08:39,755 --> 01:08:41,923
annual to bi annual narrative

2222
01:08:41,923 --> 01:08:43,125
reports. Um, the proposed

2223
01:08:43,125 --> 01:08:44,693
implementation plan does

2224
01:08:44,693 --> 01:08:46,228
continue. An annual dashboard

2225
01:08:46,228 --> 01:08:48,463
update accompanied by council

2226
01:08:48,463 --> 01:08:50,198
briefings. Each year. The

2227
01:08:50,198 --> 01:08:52,167
proposed transition to bi

2228
01:08:52,167 --> 01:08:53,669
annual narrative reports is

2229
01:08:53,669 --> 01:08:56,690
intended to redirect executive

2230
01:08:56,271 --> 01:08:58,671
branch resources to continuous

2231
01:08:59,740 --> 01:09:01,710
improvement. Um, and with that,

2232
01:09:01,710 --> 01:09:03,544
that brings me to the end of

2233
01:09:03,544 --> 01:09:05,747
the slides. And I think we can

2234
01:09:05,747 --> 01:09:09,217
open for questions. Um, or I

2235
01:09:09,217 --> 01:09:09,392
can turn it back to you. Chair.

2236
01:09:09,392 --> 01:09:11,180
I

2237
01:09:11,180 --> 01:09:12,120
m going to open up for

2238
01:09:12,120 --> 01:09:13,210
questions at this time. Thank

2239
01:09:13,210 --> 01:09:13,588
you very much. I

2240
01:09:13,588 --> 01:09:15,557
m looking at

2241
01:09:15,557 --> 01:09:15,724
my colleagues. I know we

2242
01:09:15,724 --> 01:09:16,792
re

2243
01:09:16,792 --> 01:09:18,826
kind of overwhelmed with all

2244
01:09:18,826 --> 01:09:21,229
the data that we have received.

2245
01:09:21,229 --> 01:09:22,297
Not only today, but in advance.

2246
01:09:22,297 --> 01:09:23,665
But I want to make sure my

2247
01:09:23,665 --> 01:09:25,199
colleagues, if they had any

2248
01:09:25,199 --> 01:09:27,235
questions, this would be a good

2249
01:09:27,235 --> 01:09:28,970
time. If not, we have a

2250
01:09:28,970 --> 01:09:29,143
scheduled process that I

2251
01:09:29,143 --> 01:09:30,838
ve

2252
01:09:30,838 --> 01:09:33,800
worked out with, uh, vice

2253
01:09:33,800 --> 01:09:35,244
chair, Mayor of Backus to

2254
01:09:35,244 --> 01:09:37,212
hopefully accommodate the

2255
01:09:37,212 --> 01:09:38,446
Scelsi Association, the city of

2256
01:09:38,446 --> 01:09:41,446
Seattle, and my colleagues on

2257
01:09:42,884 --> 01:09:45,253
the county council. Um, chair,

2258
01:09:45,253 --> 01:09:47,210
mayor, mayor. Baca. Okay.

2259
01:09:47,210 --> 01:09:48,890
Councilmember Baron.

2260
01:09:48,890 --> 01:09:49,958
Thank you. Chair. Uh, you know,

2261
01:09:49,958 --> 01:09:50,826
and I definitely want to defer

2262
01:09:50,826 --> 01:09:52,600
if other colleagues have

2263
01:09:52,600 --> 01:09:53,996
questions because I have I have

2264
01:09:53,996 --> 01:09:56,765
the, uh, the the good fortune

2265
01:09:56,765 --> 01:09:58,166
of serving both on hhs, on the

2266
01:09:58,166 --> 01:10:00,401
council side. And so I get to

2267
01:10:00,401 --> 01:10:02,801
hear these presentations twice.

2268
01:10:03,370 --> 01:10:04,706
Um, uh, I first want to say

2269
01:10:04,706 --> 01:10:07,208
share that. I really appreciate

2270
01:10:07,208 --> 01:10:08,309
your, um, uh, working with

2271
01:10:08,309 --> 01:10:09,444
Councilmember Mosqueda to

2272
01:10:09,444 --> 01:10:11,120
adjust the schedule, to give us

2273
01:10:11,120 --> 01:10:12,614
a little bit more time to this

2274
01:10:12,614 --> 01:10:14,116
is a very important decision

2275
01:10:14,116 --> 01:10:15,150
involving, you know, hundreds

2276
01:10:15,150 --> 01:10:16,217
of millions of dollars of

2277
01:10:16,217 --> 01:10:17,452
investments over the next

2278
01:10:17,452 --> 01:10:19,954
several years. And so I

2279
01:10:19,954 --> 01:10:21,422
appreciate the, um, allowing us

2280
01:10:21,422 --> 01:10:22,557
a little bit more opportunity

2281
01:10:22,557 --> 01:10:23,910
to to consider this because I

2282
01:10:23,910 --> 01:10:24,426
think there are some

2283
01:10:24,426 --> 01:10:26,394
significant questions, policy

2284
01:10:26,394 --> 01:10:28,496
questions here. Uh, one thing I

2285
01:10:28,496 --> 01:10:30,632
wanted to highlight for, um,

2286
01:10:30,632 --> 01:10:32,434
our colleagues, uh, on the, on

2287
01:10:32,434 --> 01:10:35,434
the committee, uh, I would

2288
01:10:35,670 --> 01:10:37,539
encourage you to, as Sam

2289
01:10:37,539 --> 01:10:39,539
mentioned, attachment seven,

2290
01:10:39,841 --> 01:10:41,276
which is on page 259 of the

2291
01:10:41,276 --> 01:10:42,477
packet. As the chair mentioned,

2292
01:10:42,477 --> 01:10:44,279
we have a lot of information

2293
01:10:44,279 --> 01:10:45,881
here, but I think the reason

2294
01:10:45,881 --> 01:10:47,148
that I point to 59 is because

2295
01:10:47,148 --> 01:10:49,517
there are some significant

2296
01:10:49,517 --> 01:10:50,952
shifts in funding allocations

2297
01:10:50,952 --> 01:10:53,455
that are being proposed among

2298
01:10:53,455 --> 01:10:53,888
the different strategy areas.

2299
01:10:53,888 --> 01:10:54,489
And I think it

2300
01:10:54,489 --> 01:10:55,857
s important for

2301
01:10:55,857 --> 01:10:57,926
us to understand those

2302
01:10:57,926 --> 01:10:59,728
decisions as we as we consider

2303
01:10:59,728 --> 01:11:00,862
this. Um, and it kind of leads

2304
01:11:00,862 --> 01:11:02,263
me to one of the questions that

2305
01:11:02,263 --> 01:11:03,998
I had, and I appreciate that

2306
01:11:03,998 --> 01:11:04,266
this team is, uh, we

2307
01:11:04,266 --> 01:11:05,467
re going

2308
01:11:05,467 --> 01:11:06,401
to have a separate meeting to

2309
01:11:06,401 --> 01:11:07,402
kind of focus a little bit on

2310
01:11:07,402 --> 01:11:09,337
this, but I wanted to highlight

2311
01:11:09,337 --> 01:11:10,138
this issue for everybody here

2312
01:11:10,138 --> 01:11:11,206
and to allow them an

2313
01:11:11,206 --> 01:11:12,941
opportunity to share a little

2314
01:11:12,941 --> 01:11:15,210
bit of a perspective on, on on

2315
01:11:15,210 --> 01:11:16,440
the proposal, because one of

2316
01:11:16,440 --> 01:11:17,450
the areas that I

2317
01:11:17,450 --> 01:11:19,450
m concerned

2318
01:11:19,514 --> 01:11:20,148
about is, um, the there

2319
01:11:20,148 --> 01:11:21,884
s some

2320
01:11:21,884 --> 01:11:23,985
aspect of the current program

2321
01:11:23,985 --> 01:11:25,753
that supports behavioral health

2322
01:11:25,753 --> 01:11:27,989
for low income people who are

2323
01:11:27,989 --> 01:11:30,325
ineligible for Medicaid. Um,

2324
01:11:30,325 --> 01:11:31,627
and that program is, uh, you

2325
01:11:31,627 --> 01:11:31,793
know, as was mentioned, we

2326
01:11:31,793 --> 01:11:33,950
re

2327
01:11:33,950 --> 01:11:34,729
going to continue funding these

2328
01:11:34,729 --> 01:11:36,865
services. But what I noted, if

2329
01:11:36,865 --> 01:11:38,000
you look at that, that chart in

2330
01:11:38,000 --> 01:11:38,967
259, there

2331
01:11:38,967 --> 01:11:40,340
s a significant

2332
01:11:40,340 --> 01:11:41,236
decrease in the amount of

2333
01:11:41,236 --> 01:11:42,570
funding that is going to that

2334
01:11:42,570 --> 01:11:44,472
is going to be cut by about a

2335
01:11:44,472 --> 01:11:46,541
quarter, uh, of funding as

2336
01:11:46,541 --> 01:11:48,941
proposed currently in future

2337
01:11:49,770 --> 01:11:50,845
years. Um, and that strikes me

2338
01:11:50,845 --> 01:11:53,215
as a little bit concerning,

2339
01:11:53,215 --> 01:11:53,448
given that we have a, you know,

2340
01:11:53,448 --> 01:11:55,448
uh, we

2341
01:11:56,284 --> 01:11:57,285
re expecting, uh, a drop

2342
01:11:57,285 --> 01:11:58,386
in the number of people who are

2343
01:11:58,386 --> 01:12:00,389
eligible for Medicaid who are

2344
01:12:00,389 --> 01:12:02,658
about to lose coverage for

2345
01:12:02,658 --> 01:12:04,292
about 4000 residents, uh,

2346
01:12:04,292 --> 01:12:05,760
because of immigration status

2347
01:12:05,760 --> 01:12:07,563
issues. These are folks who are

2348
01:12:07,563 --> 01:12:09,130
here on legal status, but who

2349
01:12:09,130 --> 01:12:10,698
are being made ineligible

2350
01:12:10,698 --> 01:12:12,801
because of the of the bill last

2351
01:12:12,801 --> 01:12:13,802
year from Congress. And then,

2352
01:12:13,802 --> 01:12:14,769
of course, the work

2353
01:12:14,769 --> 01:12:16,337
requirements that are going to

2354
01:12:16,337 --> 01:12:17,405
be imposed next year. Um, the

2355
01:12:17,405 --> 01:12:18,606
estimates I think that we heard

2356
01:12:18,606 --> 01:12:21,600
from public health recently

2357
01:12:21,676 --> 01:12:23,111
were about 72,000 residents are

2358
01:12:23,111 --> 01:12:25,511
expected to potentially lose

2359
01:12:25,814 --> 01:12:27,816
Medicaid next year. And so I, I

2360
01:12:27,816 --> 01:12:29,500
would love to hear from dhs

2361
01:12:29,500 --> 01:12:30,752
staff on how we

2362
01:12:30,752 --> 01:12:31,986
re accounting

2363
01:12:31,986 --> 01:12:32,621
for that at a time when we

2364
01:12:32,621 --> 01:12:34,222
re

2365
01:12:34,222 --> 01:12:35,957
expecting the population that

2366
01:12:35,957 --> 01:12:38,527
is not eligible for Medicaid to

2367
01:12:38,527 --> 01:12:41,263
increase over the next several

2368
01:12:41,263 --> 01:12:42,530
years. Um, why the decision was

2369
01:12:42,530 --> 01:12:43,432
made to actually reduce the

2370
01:12:43,432 --> 01:12:45,600
amount of funding to that

2371
01:12:45,600 --> 01:12:46,635
program. That is ensuring that,

2372
01:12:46,635 --> 01:12:49,371
uh, or, you know, attempting to

2373
01:12:49,371 --> 01:12:50,671
at least mitigate, uh, and

2374
01:12:50,671 --> 01:12:52,640
provide coverage for people who

2375
01:12:52,640 --> 01:12:53,842
are not eligible for Medicaid,

2376
01:12:53,842 --> 01:12:57,442
uh, to, to have access to

2377
01:12:58,146 --> 01:13:00,146
behavioral health.

2378
01:13:04,319 --> 01:13:04,602
Who wants to take that on?

2379
01:13:04,602 --> 01:13:06,602
Don

2380
01:13:07,188 --> 01:13:10,124
t you? Yeah. Go ahead.

2381
01:13:10,124 --> 01:13:13,161
Um, yeah. So we are we, as you

2382
01:13:13,161 --> 01:13:16,197
know, have, um, a program now

2383
01:13:16,197 --> 01:13:17,298
that provides, uh, services to

2384
01:13:17,298 --> 01:13:18,700
individuals who are not

2385
01:13:18,700 --> 01:13:21,603
eligible to Medicaid and who

2386
01:13:21,603 --> 01:13:22,637
are otherwise uninsured. Um,

2387
01:13:22,637 --> 01:13:24,539
this is actually the single

2388
01:13:24,539 --> 01:13:27,750
largest, uh, initiative in the

2389
01:13:27,750 --> 01:13:28,444
current mid. Um, we have been

2390
01:13:28,444 --> 01:13:30,844
working with the provider

2391
01:13:31,546 --> 01:13:32,848
community this year due to some

2392
01:13:32,848 --> 01:13:35,248
challenges that we identified

2393
01:13:35,750 --> 01:13:37,419
with that program in 2025. Um,

2394
01:13:37,419 --> 01:13:39,187
the program actually ended up

2395
01:13:39,187 --> 01:13:42,187
being overspent by its budget

2396
01:13:42,624 --> 01:13:45,240
in 2025 by about $1.5 million.

2397
01:13:45,260 --> 01:13:46,762
And so we did a very broad

2398
01:13:46,762 --> 01:13:47,996
listening session with all of

2399
01:13:47,996 --> 01:13:49,331
the providers who participate

2400
01:13:49,331 --> 01:13:51,466
in that program and have been

2401
01:13:51,466 --> 01:13:53,335
doing quite a bit of evaluation

2402
01:13:53,335 --> 01:13:54,335
as to how, at the provider

2403
01:13:54,335 --> 01:13:55,971
level, they determine

2404
01:13:55,971 --> 01:13:57,338
eligibility, for example, and

2405
01:13:57,338 --> 01:13:58,373
screening for individuals who

2406
01:13:58,373 --> 01:14:00,410
are able to access that

2407
01:14:00,410 --> 01:14:01,509
benefit. Um, and then also

2408
01:14:01,509 --> 01:14:03,909
around our payment methodology

2409
01:14:04,412 --> 01:14:06,347
of how we pay for the services.

2410
01:14:06,347 --> 01:14:08,350
Um, right now, the program

2411
01:14:08,350 --> 01:14:10,652
serves a little under 4000

2412
01:14:10,652 --> 01:14:12,353
people per year. Um, you know,

2413
01:14:12,353 --> 01:14:15,457
some of the analysis that we

2414
01:14:15,457 --> 01:14:16,692
have done has, um, uh, led us

2415
01:14:16,692 --> 01:14:18,692
to implement process

2416
01:14:18,760 --> 01:14:20,762
improvements in the program in

2417
01:14:20,762 --> 01:14:23,264
terms of more clear eligibility

2418
01:14:23,264 --> 01:14:24,399
and screening processes so that

2419
01:14:24,399 --> 01:14:26,468
we can validate that

2420
01:14:26,468 --> 01:14:28,670
individuals who are on the

2421
01:14:28,670 --> 01:14:30,805
benefit absolutely do not have

2422
01:14:30,805 --> 01:14:31,973
any eligibility for Medicaid

2423
01:14:31,973 --> 01:14:34,943
that could be leveraged for

2424
01:14:34,943 --> 01:14:36,744
their services. Um, and we are

2425
01:14:36,744 --> 01:14:38,446
also implementing some, uh,

2426
01:14:38,446 --> 01:14:41,490
changes so that we are going to

2427
01:14:41,490 --> 01:14:42,751
be reporting spend down when we

2428
01:14:42,751 --> 01:14:44,619
at the county use local funds

2429
01:14:44,619 --> 01:14:46,121
to pay for these services.

2430
01:14:46,121 --> 01:14:47,880
Previously that was not being

2431
01:14:47,880 --> 01:14:47,822
reported in the state

2432
01:14:47,822 --> 01:14:49,791
s spend

2433
01:14:49,791 --> 01:14:52,930
down process. Um, which we have

2434
01:14:52,930 --> 01:14:53,861
learned could allow individuals

2435
01:14:53,861 --> 01:14:56,130
to probably within a matter of

2436
01:14:56,130 --> 01:14:58,200
months, qualify for Medicaid by

2437
01:14:58,200 --> 01:14:59,801
meeting their spend down. Um,

2438
01:14:59,801 --> 01:15:01,690
and then transition over to

2439
01:15:01,690 --> 01:15:03,469
Medicaid as their funding

2440
01:15:04,380 --> 01:15:06,438
source. Um, additionally, we

2441
01:15:08,877 --> 01:15:11,790
also have done a kind of, um, a

2442
01:15:11,790 --> 01:15:12,647
cost modeling, I guess I would

2443
01:15:12,647 --> 01:15:14,115
say in terms of looking at how

2444
01:15:14,115 --> 01:15:15,417
we pay for services, which

2445
01:15:15,417 --> 01:15:18,219
right now when someone comes

2446
01:15:18,219 --> 01:15:20,956
on, we pay for about 12 months

2447
01:15:20,956 --> 01:15:23,191
of benefits. If we transitioned

2448
01:15:23,191 --> 01:15:25,727
to, um, kind of a fee based

2449
01:15:25,727 --> 01:15:27,629
payment methodology. Um, which

2450
01:15:27,629 --> 01:15:29,598
would be a significant change

2451
01:15:29,598 --> 01:15:31,599
in this program, but it would

2452
01:15:31,599 --> 01:15:33,968
be a fee based methodology

2453
01:15:33,968 --> 01:15:35,770
where the county was paying for

2454
01:15:35,770 --> 01:15:38,106
each service that is provided

2455
01:15:38,106 --> 01:15:39,408
to an individual. Um, our

2456
01:15:39,408 --> 01:15:42,877
modeling shows that we would be

2457
01:15:42,877 --> 01:15:45,470
able we would, um, uh, expend

2458
01:15:45,470 --> 01:15:47,415
about one quarter of the funds

2459
01:15:47,415 --> 01:15:49,417
on the same amount of people

2460
01:15:49,417 --> 01:15:51,386
and services being provided as

2461
01:15:51,386 --> 01:15:52,654
they are now. So there are a

2462
01:15:52,654 --> 01:15:55,540
number of process improvements

2463
01:15:55,123 --> 01:15:57,250
that we already have under way

2464
01:15:57,250 --> 01:15:58,259
on this program that we think

2465
01:15:58,259 --> 01:15:59,727
will allow the program to

2466
01:15:59,727 --> 01:16:01,727
actually serve additional

2467
01:16:02,631 --> 01:16:05,631
clients within the same budget.

2468
01:16:05,700 --> 01:16:08,203
Um, and other opportunities for

2469
01:16:08,203 --> 01:16:09,638
kind of optimization and

2470
01:16:09,638 --> 01:16:11,500
potentially changing the

2471
01:16:11,500 --> 01:16:12,708
payment model in such a way

2472
01:16:12,708 --> 01:16:15,176
that we could serve additional

2473
01:16:15,176 --> 01:16:18,176
individuals. Um, so that is

2474
01:16:18,379 --> 01:16:18,546
some of the, um, the work that

2475
01:16:18,546 --> 01:16:19,481
we

2476
01:16:19,481 --> 01:16:22,317
ve been doing related to

2477
01:16:22,317 --> 01:16:23,284
that question. Um, oh, the

2478
01:16:23,284 --> 01:16:24,786
other thing that I would note

2479
01:16:24,786 --> 01:16:26,354
is there is a section of the

2480
01:16:26,354 --> 01:16:28,423
implementation plan that also

2481
01:16:28,423 --> 01:16:30,823
outlines the priorities for

2482
01:16:30,959 --> 01:16:32,727
investment. Should, um, revenue

2483
01:16:32,727 --> 01:16:34,529
be available and revenue can

2484
01:16:34,529 --> 01:16:36,970
become available both through

2485
01:16:36,970 --> 01:16:37,498
just, you know, additional

2486
01:16:37,498 --> 01:16:39,901
revenue, more revenue coming in

2487
01:16:39,901 --> 01:16:42,837
than expected or also through

2488
01:16:42,837 --> 01:16:43,972
underspend of initiatives. If

2489
01:16:43,972 --> 01:16:45,907
it takes longer for something

2490
01:16:45,907 --> 01:16:46,107
to get off the ground. Or

2491
01:16:46,107 --> 01:16:47,420
there

2492
01:16:47,420 --> 01:16:48,776
s a variety of reasons

2493
01:16:48,776 --> 01:16:50,879
why underspend occurs. Um, and

2494
01:16:50,879 --> 01:16:52,580
after providing full and

2495
01:16:52,580 --> 01:16:54,516
economic adjustments to

2496
01:16:54,516 --> 01:16:56,317
existing program, the very next

2497
01:16:56,317 --> 01:16:59,287
priority that we are proposing

2498
01:16:59,287 --> 01:17:02,256
is to add additional funding

2499
01:17:02,256 --> 01:17:03,625
to, um, uh, this program or

2500
01:17:03,625 --> 01:17:05,827
potentially other programs, if

2501
01:17:05,827 --> 01:17:08,227
they primarily serve non

2502
01:17:08,497 --> 01:17:10,897
Medicaid people. Um, to

2503
01:17:10,898 --> 01:17:12,433
mitigate the harm of H.R. One,

2504
01:17:12,433 --> 01:17:14,436
so, um, that is another thing

2505
01:17:14,436 --> 01:17:16,871
that I would sort of direct you

2506
01:17:16,871 --> 01:17:19,874
to is something we have, um,

2507
01:17:19,874 --> 01:17:21,709
put in as really the next

2508
01:17:21,709 --> 01:17:24,546
priority for funding. If we

2509
01:17:24,546 --> 01:17:26,614
identify that there is more

2510
01:17:26,614 --> 01:17:28,490
needed in order to mitigate

2511
01:17:28,490 --> 01:17:29,183
harms of H.R. One.

2512
01:17:29,183 --> 01:17:31,183
Thank you.

2513
01:17:31,419 --> 01:17:32,220
Uh, any other follow up

2514
01:17:32,220 --> 01:17:34,210
questions?

2515
01:17:34,210 --> 01:17:35,223
No, chair. I appreciate it. I

2516
01:17:35,223 --> 01:17:36,558
appreciate the response. Look

2517
01:17:36,558 --> 01:17:39,260
forward to digging in more with

2518
01:17:39,260 --> 01:17:40,428
the the on this. But I think

2519
01:17:40,428 --> 01:17:41,496
this continues to be an area of

2520
01:17:41,496 --> 01:17:42,564
concern for me. But I

2521
01:17:42,564 --> 01:17:44,320
appreciate the response and

2522
01:17:44,320 --> 01:17:44,966
look forward to continuing

2523
01:17:44,966 --> 01:17:46,367
conversations.

2524
01:17:46,367 --> 01:17:47,602
Thank you to any other

2525
01:17:47,602 --> 01:17:50,720
colleagues at this time. Have a

2526
01:17:50,720 --> 01:17:52,907
question? If not, I want you to

2527
01:17:52,907 --> 01:17:54,776
feel free to, um, send

2528
01:17:54,776 --> 01:17:57,211
questions to Sam, who will then

2529
01:17:57,211 --> 01:17:59,514
work with the, um executive

2530
01:17:59,514 --> 01:18:01,820
staff on answering them. Uh,

2531
01:18:01,820 --> 01:18:02,884
Sam, thank you very much for

2532
01:18:02,884 --> 01:18:04,252
you and your staff. Susan,

2533
01:18:04,252 --> 01:18:06,688
thank you for your staff work

2534
01:18:06,688 --> 01:18:07,210
as well. And your team. And

2535
01:18:07,210 --> 01:18:07,822
again, it

2536
01:18:07,822 --> 01:18:09,230
s going to be a team

2537
01:18:09,230 --> 01:18:11,260
effort to resolve some of the

2538
01:18:11,260 --> 01:18:13,940
issues that have come up and

2539
01:18:13,940 --> 01:18:14,996
hopefully resolve some of the,

2540
01:18:14,996 --> 01:18:16,300
um, concerns that have been

2541
01:18:16,300 --> 01:18:16,664
raised. If there

2542
01:18:16,664 --> 01:18:17,865
s no other

2543
01:18:17,865 --> 01:18:19,267
issue to come before it.

2544
01:18:19,267 --> 01:18:19,700
Would you like to do the the

2545
01:18:19,700 --> 01:18:20,902
minutes?

2546
01:18:20,902 --> 01:18:21,936
No, no.

2547
01:18:21,936 --> 01:18:22,504
No, I think we

2548
01:18:22,504 --> 01:18:23,871
ll do that

2549
01:18:23,871 --> 01:18:25,871
another time.

2550
01:18:26,107 --> 01:18:26,441
Thank you. Thank you.

2551
01:18:26,441 --> 01:18:27,742
If there

2552
01:18:27,742 --> 01:18:30,780
s no other issues,

2553
01:18:30,780 --> 01:18:30,779
come before us. We are

2554
01:18:30,779 --> 01:18:31,000
adjourned.