Health & Human Needs Committee - Regular Meeting

Okay, I call the meeting to order. First, order of business is roll call.

Yes, ma'am.

Peacock. Here.

Hamble. Hamble here. Nowitzki. Palio. Here. Mullery. Middleton. Here. Warwick. Hosein is excused. Zahler? Here. Cron? Here. Triggs?

He's muted, but he said here.

Mattson? Your Honor, we have quorum.

Okay. All right, so going to the agenda for today. First order of business is minutes from last meeting. One change that I had to those minutes is deleting a reference to chapters 54 and 55. For work group one, that work group is only really dealing with chapter 51 and criminal competency proceedings. So I propose to delete references to 54 and 55 from the meetings from the May 12 meeting from the meeting minutes. With that amendment, do I have a second for that amendment?

Second. All right.

Any issues with that amendment? Let's go on to the actual minutes themselves then with that amended. Do I have a motion as to the minutes?

Motion.

Do I have a second?

Second.

All right. The minutes are approved. All right. The next order of business is a potential motion. And that and it says to direct staff to distribute Corporation Council ethics training and track committee member compliance. What do we have somebody just provided more of a background and that potential motion for me?

Yes, ma'am. The Corporation Council has instituted an ethical training And as a result of that, they would like for each of the committees of the CJC to take that training. A couple of individuals on this committee are on other committees as well. So they're not required to take that training multiple times. But each member of this committee who has not taken the training should do so. And then they should notify me so that I can send that information to the Corporation Council that they have done so.

And what is that ethics training?

It is a video, approximately 20 minutes, that the individual will watch to ensure that they are in compliance with Dane County ethical standards.

And for that, is there a link somewhere? How does that get to the committee members?

That link will be provided to each of the committee members from the Office of Justice Reform as soon as the motion is adopted.

Okay. Right. So who is making that motion regarding the committee members taking the ethics training video?

I'll make that motion.

Second.

Second.

All in favor? All opposed? Motion passes. Okay, presentations and reports to the committee. There are continued reports on the work groups. So first, we will go to work group number one, criminal competency in chapter 51 proceedings. With regard to that, we are continuing to meet, I think our next work group number one meeting is when?

I believe it is in August, ma'am. I'll get that information for you now.

And for one action item that has been completed was that I drafted a... a order template that the judges can use in criminal competency proceedings when the evaluator has found that a criminal defendant is not competent and not likely to regain competency, the court must hold a hearing And one of the things the court must determine is whether to hold that person for potential 51 commitment. And as judges, we often don't know if the county is going to pursue the 51. So as a work group, we talked about some procedures that might be beneficial to make that procedure itself more efficient. And so I have drafted an order in the cases where we do receive a report that someone is not competent and not likely to regain. There is an order that goes out when the notice of hearing goes out that asks corporation counsel to notify the court as to whether they intend to pursue Chapter 51 proceedings or to appear at the hearing to let the court know the county's position. This does two things. It gets the county involved earlier so that they can make those Chapter 51 and they can initiate them if that's what they decide to do. they'll just have more lead time in doing so and looking at the issue. And two, if there are many times situations where there is no intent to initiate Chapter 51, so a judge ordering the person to be held for those extra hours in order for that evaluation to take place is holding somebody unnecessarily because the judge uh county isn't going to pursue it but the judges need that knowledge that the county is not going to pursue it in order for um to make a more informed decision as to whether the person should be held for potential 51 commitment So now we have a procedure whereby the judge, at least most judges, it's not required to use, but I think all criminal judges and frankly all civil judges, because they deal with competency as well, if it's brought up at certain steps in the process, To the extent that they do have these, I think most judges, if not all, are going to be using this order to bring Corporation Counsel into the process earlier. And then Corporation Counsel will, again, notify the court in writing or appear at the hearing. Attorney Khalil, anything on that?

Nothing something to add, Your Honor. I really appreciate you speaking with your colleagues and initiating this process of drafting this process. I've been in contact with at least one clerk who's reached out about this after you initiated this process. I actually have a question about something related to this. Okay, now's a good time. Thank you. I did see this morning that officially the case assignments for the Dane County Circuit Court will change in a year, August 1st, 2027, will be effective at that time. There's a lot of lead time. And I'm just wondering if, in your opinion, you know your colleagues better than I, of course, If there is anything that any one of us here can do to make sure that everybody that's now going to be in the criminal rotation is ready for this and understands the benefit of this, so it's not just on you to try to speak to your colleagues in private or at judges' meetings.

Yeah, so I spoke with everybody at the judges meeting. I think everybody is going to intend to use it because we all, whether we're civil or criminal, do run into criminal competency proceedings, especially if they're brought up early in the case. If they're brought up before preliminary hearings, then whoever is assigned to the preliminary hearing shepherds that case through the competency process. whether that person is criminal or civil. It is a duty week issue if it comes up earlier in the cases. So everybody should know about it. And frankly, if the judges aren't as familiar, if they forget because they don't see it a whole lot, their clerks will know about it because the clerk's office is in contact with the judge's clerks to let them know of this new order that's a resource for both corporation counsel to be informed earlier and for judges to make more informed decisions on those.

Thank you. Okay.

All right. Anything else that anybody wants to report out as to work group one? And work group one's next meeting is?

Work Group 1 is August 10th, Work Group 3 is July 27th, and Work Group 2, 4, and 5 is August 31st.

Okay, great. All right, so all the work groups will be meeting before our next Behavioral Health Subcommittee meeting, which is in... September. So at that point, we will have updates for work groups as well. With regard to work group three, we did have a meeting after the last Behavioral Health Subcommittee meeting where we continue to work on some of those issues. There are some action items that people are working on and we are continuing to think through some of the medication continuity issues and improving those processes. and developing some recommendations and putting things in place earlier rather than later, especially if there are little easy fixes that we can do along the way as we try to make broader systemic changes. We are trying to do that in both work groups. For example, that order, there was no reason to wait until the work of the committee group or the work group was completely done to start initiating those changes. So to the extent that we can have small changes along the way, we have been doing that with both work group one and work group three. Anybody else from work group three want to say anything? Okay. I'm going to go to if there are any reports from Workgroup 2, 4, or 5. We do.

All right. Time to go. Thank you, Judd.

Turn it over to Peter.

Yep. So we'll break this down into objectives, and we'll start with objective two. And as a reminder, two is develop a comprehensive plan documenting current behavioral health practices and service delivery system. So where is our progress? Conduct system mapping of the jail behavioral health services. We've talked quite a bit about the resource desk and their operations and reviewing services. uh behavioral health provider inventory has been initiated we're working on Well, we'll continue on talking about that as we go. But initially created a frost block of providers that can be getting services or are getting services within the jail. But an idea came yesterday in the meeting that some of these lists already exist. So let's find the rate list cross reference and make that part of that. So there'll be more initial steps coming with that later. And then resource tracking spreadsheets have been introduced. What have been some of the findings? We've talked to, again, people at WellPath, people within the behavioral health teams in the jail, and talking about the resource desk being staffed by volunteers from Just Dane and Operation Fresh Start. There's no centralized verification of service delivery. need to distinguish contracts, their MOUs, and volunteer services. So where is all that? Well, it is still in progress, but that's what the subgroup is for. So next step is to expand the service inventory, and that is really cross-referencing what has already been laid out to making sure that that is a system still providing those services, verifying organizations can still provide those services and those needs. Is that still part of their contracts? With objective four, that is strengthen coordination between behavioral health providers and justice partners. Where are we in the progress? discussing a generic release of information. And that does sound like a really big discussion point, but there are other partners that use this in our system. So being able to see if this is something that Some of our community partners can use, and there's lots of questions that come with that, lots of approvals that are needed for that. And other private partners, too, like, well, Pat, I would have to look at this. Is this an option as well? But it's also really important to have these conversations because we do know that they work when they are available. Explore standardized intake forms. Kind of the same thing. We have... multiple providers that ask multiple of the same questions. And that can be a very lengthy process. It can be very frustrated for the individuals being asked the questions. And it just seems like there's a better way where that data could be collected. And if we were able to talk to that individual, even just making it a yes, no, this is what the responses were last time. Is that still the case? Is this still current? Could be a better option. So being able to just Talk that out a little more and then talk to community partners. Is this something that people would be on board with? If so, then the other bigger questions. Who houses it? Who approves it? Corporate counsel, do you like it? You know, all of those questions. But we're not there yet. That's part of the discovery. Where am I? Looking at, like, the kiosk implementation in the jail lobby, because there is a desk that does get staffed. Again, we just mentioned Justine and, did I say Fresh Start? But they have their volunteers that are already there. However, it can't be... Station 24 hours a day. They try to get it on the more like the Tuesdays where there are going to be people released, but there still is another option for a kiosk where it'd be run through 211 and the resources right there. And it's driven by that person being released. They can choose to go to it or they can choose not. But we know that there's another net for that person to find a resource. Originally, there was an approval for the conversation to see if it can be approved within the lobby. And at that time, we did have a product, a product being the actual like laptop, kiosk, tablet, whatever it may be. However, that is being put on hold now till probably October. Once that does become available, then those conversations will resume. Is this something that will work within the lobby? So then troubleshooting, this is still a situation. We want to be able to have people independently make choices if they can't have that table there. So conversations of are there QR codes that can be put on any discharge paperwork where, again, if a person is released, they then can choose to follow up with providers. part of this is to hope to have like the system know this person has been connected and we won't get that um if the person does the qr code unless if they provide that information and there's another agreement that that partner then says we got this information but more importantly right now we're just making sure that people have that opportunity to get connected So planning is resumed. We're going to keep having continued conversations about what coordination means and what coordination is needed between these systems. Key findings. We all know we're here because there's some fragmented conversations, there's some fragmented connections, and that's the hope to smooth this out. These are some proposed ways. Duplicative intake processes, if we know that it's being duplicated, we should try to find a solution for that to save everybody the time and frustration. And then technology, it is there, and we just need to find out how we can use it correctly. Next steps, resuming the Ferris style community, I'm sorry, Ferris style meetings. Invent a community organization to discuss intake processes and then continue the ROI discussions. Going to objective five, identifying improvements that strengthen behavioral health outcomes and continuity care. Very similar to work group three, the medication continuity, sorry about this, continuity identified as a priority. uh reviewing well path operations we've discussed discharge planning and lived experience and began evaluating accountability for contracted providers that started with the conversation of a thought that uh community partners had built in their contracts that they would staff that desk. And we have learned that it is voluntary. So there are no actual contracts that say that somebody has to be there. That's not what we're suggesting right now. It's just that was part of the progress and learning. Being able to look at medications continually remains that significant gap. There's no mechanism exists to verify post-release follow-up through. So, like, if that prescription is given, we don't know if that person got to that pharmacy to pick it up. And then that also leads to the question, how do we get the resource for that person to pick up the medication as well? And then provider capacity remains a challenge. So once we have the verified sources of providers within the jail being able to find out what their capacity is and maybe what's that next step program that they have within their own projects that they might be able to step into. so what's in progress now everything that's our status uh so continue the the conversations about the continuity of medications we do have a couple overlapping partners from this group and work group three so being able to share that information in-house and i think if if it ever got bigger we probably could ask um how that could be done or maybe a one-time meeting with joint thought partners could work. Develop recommendations regarding provider accountability and invite individual with lived experience to present. And ultimately, when we're looking at all of our providers within our system, and we're not hearing the voice or even a single voice of somebody that we're hoping to help, that's not doing anybody a favor. That's us making decisions for people based off of what we think. And so being able to hear lived experience from a member, can I say the group, from the Phoenix group that was already verified and had the conversation, feels comfortable sharing their story and within the group being supported by that team to be the representative. Again, I think and I hope that this is something that we can look at more and more as we step through this process. Let's talk about some major accomplishments. I mean, there's been a lot of meetings. There's been five meetings. Our next meeting is August 31st. So the resource desk presentation, we've improved understanding of our current jail-based services and reentry planning, behavioral health resource tracking spreadsheet. Though we are going to be looking at different ways to verify, that conversation has already started, and it's not... level zero anymore we're on like the third step and we keep proving on that kiosk initiative it's been a little bit of a high low high low situation but i think it's a very hopeful uh project and and can have some real results and that's physical and tangible that we can see and you probably can track how many times it's been used so you can actually get data from that um anything with tech you can get the data typically um The QR code discussion. I'm loving this project. I'm gonna try to see if any 211, any community providers already do have QR codes and that would be something that if it is, then we can bring it back to the jail. Is this something that you can, willing, able, see value in? Again, sometimes it's just presenting options. You don't have to invent it. Here's a product that we know you can use if you choose. Um, and then everything that, that we'd be looking at, I wouldn't want there to be like a cost. Like we feel like we could get like the QR code, like voluntarily, uh, provided. And if not, then there's other conversations. Um, but it is a value to that, uh, that place too, like two on one, what's their mission to connect people. So it would fit their own mission too. Cross-system collaboration. The Office of Justice Reform will coordinate the new, I'm sorry, the renewed Ferris Center-styled meetings. Generic ROI and intake forms. These are initial discussions, recognizing that they are big. uh discussions but there aren't changes unless if there are conversations started so i think just creating a couple mock-up ones again presenting it to the group i'll be doing that what do you think about this and then talking to other partners starting within the jail i know sharon's going to be collecting some intake forms and other forms that other rois to see what they look like already We might find that they are completely different and absolutely they need to be separate, but we also might find that there's the same 10 questions on all of them. Um, current action items, uh, captain splinter, uh, we'll be following up with well paths, Tricia moon for goody. I'm sorry, Mooney for goody. I'm saying her name wrong. Sorry, Tricia, uh, regarding medication continued tea, uh, Lieutenant Kyle Keller's coordinating with Ed wall regarding the kiosk inflammation and explore generic ROI options. Um, and Ed wall is through two one one. Um, and then hi how are you my name is pete uh develop uh provide cross-reference tools um and then uh the roi and the intake form what that could look like uh and then tron the ferris center meetings inviting safe communities just dane other individuals with lived experience and then gathering those intake forms thank you Emerging system themes, again, medication, I'm going to say it again, continued T, individuals remain vulnerable during the transition from jail to the community.

And you're just looking at that in terms of the release, after release, and that work group three then should then focus on the medications, making sure that people have them while they're in jail itself, right?

That's how I am understanding it. Yeah. Verify contracted services, limited ability to verify that contract services are delivered as intended. Again, we originally thought these were part of contracts. They are not. Maybe they're part of MOUs. Maybe they're not. But just being able to Note that it is a theme, and again, presenting all of that information as we would with anybody. Here's what we're seeing. Standardized intake ROI, again, theme that we are seeing, technology, kiosks, QR codes, tablets offer promising tools for improving access to resources, especially like there's internet right there. I mean, that can be its own challenge. Cross-system collaboration, again, having these conversations naturally does start the collaboration process and being able to present items that they might be able to easily incorporate also should help the collaboration. Service verification, limited ability to verify that contracted services are delivered as intended. uh and then lived experience we need direct input from individuals who have navigated the system because we will get to hear what their struggles what their successes are and the ideas of what would be helpful And then emerging recommendations, not to repeat myself so many times, but looking at the medications at release, verifying behavioral health services, standardized intake and release information. Again, these are things that are done in other systems that could possibly be done here. Expand technology solutions, strengthen cross-system collaboration, service verification, and then including lived experience. That's any, anybody from groups two, four, and five that want to add anything. I thank you for the time.

Thank you. All right, and then work group six is Todd Campbell as to the triage center update report. Really, it's more the educational piece of what the triage center, the current status of it is. Getting the triage center off the ground is something that is not part of this committee's work, but one of the areas we identified was... having a central location for updates so that community partners can know where we are in the process of getting that center. So I'm going to turn it over to Todd Campbell.

Right. Thank you. And this is on the department essentially to come up with that public facing website. Unfortunately, budget priorities and the departure of our communications manager have interfered with our ability to stand that up. So I expect that within the next month, we should be able to continue. stand up a public-facing website that will be able to give those updates. As far as the update, there really is no progress from what was reported during the May meeting. We are still waiting on Joint Finance Committee approval of the grant opportunity that the state has ready to go. administrative rule has been approved there's a there's a licensing lane but funding is the key feature here and that's currently held up okay thank you all right um does anybody have any uh future agenda items that they would like to put on for next meeting

Okay, I think the work groups will continue their work in the separate meetings between the Behavioral Health Subcommittee meeting and it sounds like I think all of those work groups are going to meet at least once before the September 8th, 2026 Behavioral Health Subcommittee meeting. So we will again receive updates on what the work groups have been doing and if there have been any changes. Any public comment for items not on the agenda? Or any other business? Hearing none, do I have a motion to adjourn? Motion. All right. Pete makes a motion. Do I have a second?

Second.

All in favor? All opposed? Motion passes. Alright, we are adjourned.