Behavioral Health Board - Regular Meeting

very I got some things going um thank you very much I'm at meeting right now so grand grand wonderful to of internationally went to India he went to India mom and dad it is 12:15 um and I'm going to call this meeting of the Humble County Behavioral Health Board two borders my name is Laura Montana welcome everyone we are The Advisory board for

the Board of Supervisors we hold this meeting on the fourth Thursday of each month and it runs from 12:15 to 2:15 you meet here in person at 507 half Street eure this is a public meeting and everyone is invited to attend members of the public May participate remotely the minutes and agenda can be found by searching online for the Humble County Behavioral Health Board we provide time for public comments early on the agenda public comments need to be limited to three minutes and Rain to matters related to behavioral health we ask you to make your comment in a respectful manner we any questions you can reach out to myself or any Behavioral Health Board member and that you take Mar Christi here all righty to go are there any adjustments to the agenda hearing none we will move on to public comments stop yes thank you so much excuse me I have missed introduction of staff and guests so we'll start here in the room start to my

right hi good afternoon Emmy boxler Rogers I'm the behavioral health director nice to see this meeting is being recorded hi Emmy hi pauty director deputy director children sure Alex I transision ni Austin at the transition AR a member of site director Nation finest I'm Peter stall I'm director of prevention intervention Humble County Office of Education do you want to introduce yourself oh okay I'm BR L monang I am a peer participant at the Hope Center then we'll go to online um you can introduce yourself and then popcorn to someone else I'm Eddie Morgan for tricount independent living and I don't see anybody else out there yeah I think that's it all right now any adjustments then we will go to public comment and we can start in the room there any public comment in this

room at this time um online you want to make a comment okay with that we will move on to action items we have the approval of the minutes from 1 12325 meeting does anyone want to make a motion I'll make a motion minutes motion so let's um wait just a second just a second make the motion we second it and then we discuss thanks second Johnson second and are there inrs okay under Communications number eight it says that I said that I've T different SUV facilities that interacted with clients I've T different um different SUV facilities but only once did I interact with clients who came into the room asked to do so and that was at the transitional liit all the other places I've gone to I have a bit around C thank how would you change all right it right there any others I have one it's very minor but on number 10A care court it's says Kelly Johnson reported that a uihs client and instead of uihs client should be your tribal

member yes um just I noted that throughout the minutes the music thank you he sir are you lost yes I am always found I'm found so doing much better sorry I'm late all right so with those three Corrections anything else I will call for the vote all in favor of approving those minutes say I raise your hand I oppos stand aside all right those are approved thank you very much and now the moment you've been waiting for us we have our presentation on chis Services you're that's fast I know early where would you like me to stand I'm not quite sure where the best place is for whever you're most comfortable most comfortable make sure to speak loud right well thanks everybody for being here I'm going to talk a little bit about uh our crisis Continuum of services for c behav h um as I uh introduce myself earlier um I'm one of the deputies and some of my programs are the crisis program programs for the adult side and um I also have a few other projects and programs that I oversee like a Performance Management unit then all of

our forensics uh got us involveed programs to overse so but I have to say you know the the crisis services are are the things that I've been involved with I think most of my career I started on a crisis line and te a runaway Hotline in fact that's where my wife and I met so so you know it's a big part of our lives so anyway um I'm happy to hear to be here to talk about this today this isn't working so the Continuum reallying starts from uh crisis I mean prices calls uh somebody reaching out or somebody um asking for help or somebody asking for help for somebody that they know so uh you know it starts there um typically so crisis calls are a big part of what we do uh we also have uh clinics uh throughout the humo County and uh you know they're a part of our system and our process for crisis as well and we also have mobile teams that go out and respond to crisises so I'll be talking a little bit about those Mo those mobile teams that go out into the community and provide services uh to those that are in crisis and then we have a Subacute programs in our County and we have aute care we're fortunate enough to have aute care uh in our County to those that are go ahead and Advance slide

working maybe aiming over at um aim at Joe not at the to all right a try so yeah like I mentioned you know 911 has been the goto for crisis calls those go into dispatchers uh in counties um and then from there uh law enforcement is better the one that's gone out responded to crisis often times so uh we we've been fortunate enough to have mobile teams that could respond out into the community uh at different times during our existence you but most recently we lifted back up a mobile team back in 2018 I believe or 17 18 uh We've also had other collaborations with uh the city of Eureka the epd uh where we've had teams uh collaborating on on joint responses so um now we have we're more fortunate enough to have 988 uh available to us simple three-digit number like 911 that people that are having an emotional crisis uh or even to Su related prices and substitutes disorder prices could call or text 988 Nationwide so we have uh a number of call centers that 988 Bill calls go into some of our closest ones are the North Bay Area in uh down in the Bay Area we also have one in Sacramento and then throughout the state I believe there's 11 in the state that when I last counted uh in California so California's a lot of uh call centers for 988 I recall there were mobile units in Fortuna and mville is that still the case mobile

units yes uh yeah well our mobile team will spond anywhere in the county so they're but they're they deploy from Eureka so um I just wanted to give you some so we also have a crisis line we crisis lines for um a long time in our County the 7715 number here locally uh Rings right into our 720 Wood Street which is our main hub for crisis services so that's where Seer Von is that's where crisis stabilization is uh so those numbers ring right into uh right into 720 uh and we have staff on the CSU or crisis stabilization unit that end up managing that those calls mostly we also have same day services that manages those calls during regular business hour and those two teams support one another so during regular business hours the uh same day services staff will manage those calls and then after hours uh the CSU manages those calls B did you would you would you like us to wait either way I'm okay either way on these I have maybe 10 slides so hopefully as we call the crisis stabilization unit do you still have an answering service answers and because I do know that there's been times I have used the crisis stabilization and other people have used it that live on the street here in eure they get put on home um from the answering service that's kind of difficult in in in a crisis situation so I didn't know if that has been resolved or if that was still an operation or yeah I would agree with you Vernon that's not the ideal uh we are um we have that service uh in place until June

of this year and then we are uh not uh renewing that contract and we're going to be managing the the calls entirely uh so no answering service for us come July 1 so that'll be our teams that'll be maning maning that I'm gonna just suggest because I think it might be more efficient for our group if you just go through your slides and then we can have like deeper dive conversations on any any of these items because I think there's probably lots of things that this is going to spur in terms of thoughts and reactions and questions all right sounds good so uh so those calls coming in we have an 8888 number that's a to fre number um you call anywhere comes comes right into our our call center um at 720 I just wanted to give you an sense of the call volume that we have we did a a call volume study in 2022 for a six-month period we had 7,876 calls into these two numbers uh that's about 43 calls a day that we receive um 2,929 of those were received after hours so between pm. and 8:00 a.m. those numers so that's about 16 calls a night that we received and interesting enough the busiest call times were 11 a.m. to uh to 1 uh 1 pm on Tuesdays thir uh Wednesdays and Thursdays anyway interesting so just for comparison um epd C Set uh responded to 1100 43 mental health calls in 2022 currently their 911 is is managing about 29,000 calls uh in this year this last year uh thanks to the chief who uh did that presentation to the city just this

last week so I I lifted those numbers from him so uh also I just want to mention that the 988 number when uh if you look on their website for 988 the lifeline societ uh prevention Lifeline number they boast about 98% of their calls they were able to manage uh over the phone without having to deploy uh somebody to do a in-person response thought that was a fairly impressive uh statistic there on their part so uh they do a lot of training with their teams and we do a lot of training with our teams as well so we train our staff uh Tobias Griggs our uh supervising CL on SE irings and who's over this crisis for stabilization unit as well he produced a really nice training that provides a lot of practical skills for the call handlers a lot of U you know evidence-based practices around call handling and managing prices on so he's been uh anybody that answers the vot and interacts with public at 720 W Street um takes those takes that training and is trained in that way and we also provide a lot of backup support with CLS to the crisis line should that be needed so uh like I mentioned we've been expanding services and trying to um get our services out into the communities in in uh in our County so we have uh sites in Fortuna uh the center in McKinleyville now Willow Creek and now in Hoopa we um have site in Garo bille we're really trying to expand our service delivery system to the out in the out areas of our County um but you know crisis Could Happen

anywhere at any time and people go into crisis so uh there's no wrong door really if you come into one of our service centers we're going to help manage that crisis in that moment with that person so even if it is just uh here let me uh let me see what you need and let me get you connected to somebody that can help it's something that easy but really we we take that approach and no wrong door if you're calling and you want something and you happen to call you know older adults will definitely connect you to the right folks to help manage that crisis hopefully we won't put you on V uh we also have a you know a pretty good network of providers we have or organizational providers uh that we contract with that provide services and like in children's we have quite a few or providers that uh provide counseling services and uh well sometimes in schools uh and sometimes at their centers throughout the county so we're fortunate to have some really good long-term relationship with these organizations that provide really good quality care so they're part of our network provider so our mobile response team so right now we have uh we have one adult mobile response team as a clinician and a case manager that's build um positions we also have uh children's clinicians two clinicians that have been taking turns responding to crisis as well as case manager and a parent partner that's then providing prices response on the children's side so we have two mobile response teams we have open positions we're trying to hire more teams so that we can provide more coverage instead of just those individuals and we also have the mobile

um interventions and supports team our M team so we have one team there uh that provides uh mobile response too so the difference between mobile response team and and Mist uh mobile response team goes into the emergency departments to evaluate those that have been placed on hold um 5150 in the uh in the community whether it's by law enforcement uh they come into the emergency departments uh we deploy out to assess those individuals to make sure that you know the hold is U you know it's a good hold it's it's it's uh you know warranted and or if the person can be you know worked with and created a create a safety plan for that individual ual that's sufficient and get them connected to needed services to avoid having to go into a higher level of care unnecessarily so that's what mobile response team does in uh very specific into the emergency departments all the emergency all the four emergency departments in the county that they respond to the m team responds everywhere else so anywhere in the county the Mist will go sometimes they might be down at Shelter Cove and then later in that day they're up in oric so we have a team there and we have positions for a second team to cover seven days a week fully but right now those positions are ven so if you know your friends that have are therapists Feer coaches or case managers that want a job send them over we'd love to hire them so we're trying to expand out our Mist program in coverage there to go 247 right now they're covering seven days a week uh but we're not by covering around the clock for M well we're hoping to get

there soon so I just wanted to give a a few statistics for 2024 for these teams so the Global Response Team uh made contact and assess 571 individuals in last calendar year those were adults so in the children's side they saw 92 individuals in the emergency departments um the Miss team saw 140 people last year out in the community so the total we had 673 individuals that had some contact with one of these mobile last year so that's a total of, [Music] 1582 interactions or contacts that we've had so it's not just one and that's it we don't see you anymore it's it's one with the initial and then several other contacts to make sure that folks are connected to needed services or followup cares we found that when you're having warm handoffs when you're in prices is critically important so that's where our case managers and peer coaches so we have a high number of those contacts post initial contact of individuals um so the other part I wanted to mention to when people come into the emergency departments uh when they're having a crisis hospitals the doctors um have a legal Immunity Clause like counselors do for 5150 um it's it's a code number called 17991 one1 it's a welfare institution code health and safy cod health and safety code so that gives the doctors of the ability to hold somebody in the emergency department if they're worried that they might might be a

danger to themselves or others Orly the same so doctors have been using that and and then notifying us and then we come out and assess those individuals to see if they need to be uh you know brought into higher level of care so uh last year 445 1799 in the county from our emergency department from our doctors we also give our doctors permission uh to to uh to write and resend 5150 PS if they're trained and they get certified by us to do that so there's a number of doctors in emergency department that have done that especially at Province St Joe which um we have really good work in relationship with Dr Hunt and Dr Kramer and a few others have been really wonderful to work with and collaborate with so of those so 445 1799s um we uh had had written cumulatively the doctors and our teams uh 1,33 5150 holds in calendar year 2021 so last year so of that number when we reassessed those individuals uh 520 of those didn't meet criteria for a so for instance if a law enforcement officer uh was interacting with somebody that was having a crisis the law enforcement officer thought that they were maybe a danger to themselves they put them on a hold and brought them to the emergency department our team came out and assessed that individual it determined that they could um safety plan they have good support system and they were um able to be resend that hold and be treated in the least restricted

environment as possible so then that hold would be res so we did 54 20 of those last year that's roughly 51% of the holds that we assessed were able to be rended and treated at a lower level of care really critically important I think to know this because we want to treat people in the least restrictive environment possible we don't want everybody going just right into SV right out of the gate um that's you know we're using beds on SV that maybe we don't need that maybe would be available to somebody else in crisis that's that need that service a little bit more um critically so it's an important part of our of our system of Crisis Care that mobile intervention free um folks go into SV so who can write holds in our County um clinicians nurses psychiat teexs that work for our County our doctors um and then in the community mer Department uh Physicians um and um and there is a provision in there for Community Based psychologist and also swor peace officers so all those individuals uh can write and uh holds anyy is the um holder of that privilege to designate individuals um to uh to be able to have that uh ability to write and resend holds um so it's really uh a delicate um balance between you know somebody's civil liberties and keeping somebody safe you know do I hold somebody against their will and can I do that safely um because we're basically you know taking away some civil rights for a

period of time so that's a critical responsibility that our teams have to to judge and to manage so they do that in collaboration with uh with other liced professionals that are on the team so we also um have our we're trying to expand our our providers that are providing prices response with us so we're in communication with several um entities including our some of our travel Partners uh to to join in with us to be a part part of this team so we could have a a regionally supported quicker response in areas than what we have right now so that's continuing so the next level of care is a Subacute care and the crisis stabilization our for bed crisis stabilization is an example of that so is hyperium our our adult crisis residential program that we just introduced uh with Will Glen this last year so that's a 10 bed uh site so that these are what we would consider Subacute not quite acute but definitely needing some additional intervention for a period of time so our price stabilization unit you could stay on that unit for up 24 hours the state will reimburse us for 20 hours of that not the 24 or anything over that so uh Hyperion you can stay at Hyperion for um several weeks and uh and then there's other types of Sur not quite I would say sub aute but I P them here because they're they're an important part of the process so if somebody maybe needs additional support if care once they leave Hyperion

or the crit stabilization unit maybe they might um be appropriate to have some of that additional support at Lighthouse or maybe they need additional treatment for their s challenges that they're having experienced with Waterfront so there's there's these other entities that are part of our community that we're so fortunate to have that are that are really important for this with folks that are in crisis with with a lot of different needs okay and we have Crestwood Crestwood Pathways is a mental health rehab center so this is a 43b unit here in r so crestwoods are throughout the state there's several many of them throughout the state so they have lots of different types of services they have an adult residential type of service as as well um in in Crestwood Pathways but um and that's a 15 bed unit for Pathways uh but it's a transitional shortterm 18mon program but people stay on site for that but it's not a loss C okay and then finally the most complex and highest uh level of care that we're able to provide in our community is at is happening at sving so that's our 16 bed acute psychiatric hospital that's been around for over 50 50 years so uh we're very fortunate to have Seer virin as part of our crisis Continuum when I was in bu County before I came out here people talked about cir as something was like unique and special not very that that real stand out so that always beat my interest when I heard about supering so was part of the reason why I was really interested in coming coming to

home yeah um okay where am I um so yeah we have we one of two uh County run uh acute psychiatric hospitals run in the St so Santa Barbara is the only other County that is running a 16b acute site like we are but there's a lot of scrutiny like you as you may know already um with having that designation uh we're were're reviewed by the Department of Health Care Services every three years or whatever they want and the center for Medicare Medicaid services um every three years so very stringent just like a another hospital hold to the city um so on SV we had this last year we' served 275 individuals the average length of stay on CER vings for folks that are not um conserved is about 12 days uh for last year for folks that are conserve their average length to St was 94 days so it's I like to separate those out because uh it tells a story about folks that are conserved it doesn't necessarily mean that they're um they have to stay on SV because they're acute for 94 an average of 94 days they could probably stabilize in in eight days but if we can't find them an appropriate Subacute step down they stay on our unit until we're able to find an appropriate level of step down so again talking to the importance of the sub portion of our continu um and Crestwood is the mental health rehab center here in Eureka 43

beds locked facility um they've been around for a long time and been a great partner with us u in providing care for folks in in our community and I would say and I'm finishing up right now but the state has issued um grants over the last five years or so in different rounds to try to build out the infrastructure for for psychiatric um care because there hasn't been investment in the infrastructure for psychiatric care uh forever I mean it just hasn't been there so uh kudos to the state were putting together um a lot of money in different rounds so we're we benefited from some of these rounds round two we've benefited from uh that helped us with our mobile crisis team round 3es helped uh Sor Lea uh start to stand up their um kids at crisis residential um round four uh we've been uh some of our tribal Partners have uh taken advantage of round four round five our Mad River uh Tri crisis Trio Center uh we were awarded some money for that to to create in a stand up so really appreciate the fact that the state has been given money to build out the infrastructure has been so directly needed so on the horizon I'll just say that um we are are looking forward to breaking ground our crisis Tre Center uh up there m River Hospital we're really excited about that because it's Pro it's filling gaps that pattern our system for a while so we don't have a sobering center we're limited in our um substit disorder treatment it's going to provide some of those Services it's going to

also provide um crisis stabilization uh but in a way so we can Flex to treat minors uh and adults at the same time whereas we have a harder time doing that in our existing facility ofvs right now safe uh and for this issue just because of space so that's going to really help us out a lot in our community so Sor Leaf as I mentioned uh V round uh round three uh they're under construction right now and we're excited about about that and working with them uh We've also applied for plans to um for some money to rebuild Seer byrons and uh we got plans for that so we're we're waiting to hear back on that application we should be hearing back anytime now so we're excited about that and the possibility of having a new Seer Rings across the street from the courthouse possibly so keep your fingers crossed um and there's other things on the horizon Senate Bill 43 which expands the criteria for grave disability to include severe St use dis issues so uh we're we're creating a steering committee and a work group to help our community figure out how we're going to navigate that that comes into play in January for us and of course they'll prop one as I mentioned with the dollars for new SE so all of these things that I've talked about we've really expanded and increased our bed capacity so things on um constructed we're going to increase our beds over by over which is enormous increase for us but it's in line with what the state has uh designated as what our need is for

our for our County so we're really looking forward to these other gaps being filled and for infrastructure being built and help us into the future with managing prices so that uh I'll end uh for any questions folks might have you're going first Steve thank you chair um well first of all Paul thank you and to all the staff at DHHS Behavioral Health Partners here I just want to say thank you because these are not easy times seems like we're all more and more in crises I don't know about you but I think we all get up in the morning with Mental Health crisis and try to put One Foot In Front of ourselves and go back out there and do what we can in this world of Ever Changing Times and funding and everything and I just want to applaud you for the hard work that you do it's not easy um funding's getting more difficult and I am so excited about the idea of seer byrn you know as long since I came on the board I it struck me right out of the gate that we own this entire parking lot across from the courthouse this entire block what do we use it for parking and public health great Services there at Public Health but we can have parking still with a another building or separate bys there and things like that and a lot of the problems with seirin are as you said it's 50 years old or older and that's hard on staff it's hard on the clients so that is super super exciting along with the triage Center and Arcada yeah the questions I have is uh I'm still learning things um so is the crisis line really an 8 to5 thing and then after hours it's so it's 247 247 wow that's that's phenomenal and it's uh as you said Veron you know get rid of the answering service because if you're in crisis oh just hold here you know it's like that's a tough one right on every level I'm not trying to throw a

a you know into something that's doing a wonderful job great inut but we definitely need to look at all the aspects yeah because three nights ago I'm sitting with an unhoused person in an Alleyway on the verge of calling the crisis line um this was 11:00 at night so I mean that would be a very sensitive situation for a an answer or an answering service or yeah absolutely well thank you for bringing that up and that's one of many values that you bring to this group so thank you for that burning um anyway that's really all I had was that question about 247 uh again thank you all for your incredible work in this oh um a person calls The Humble County Line versus the 911 and the 988 and they obviously have a substance used disorder crisis what generally is the path that is taken by whoever answers that line well it depends if they're in crisis we're going to work for crisis so we might see them we might bring them in uh to have an we might set an appointment up right then or have them walk in depending on what time it is I mean you can walk up to Chu anytime it's you know we we got we can respond 247 from the CSU um or if you know they uh want to they can we'll connect them to partnership and doing the screening for kind of the their level of care that they do and then get them connected that way so either way it's we try to make

sure that we're just take care of the need right there not not have them you know not push them around to another door but help them get to where they really so there isn't a a direct line with like Waterfront when people um call in that they're not they're not referred by that person to another facility they're talked to by your own staff and if they're you know if they're expressing an immediate need for things we're going to try to work with them as best that we can and but if they're like no I'm good this week you know I I've got things I got things to do today or whatever but I can follow up tomorrow something like that we might um we might connect them um you know give them the number for partnership and have them call or we might do it do it with them so it just really depends Case by case thank you I just carry but the plan is for when the answering service goes away um in terms of like will there be a dedicated staff member answering a crisis line after hours because I know in the past it's been challenging with the rotating staff on the crisis unit and varying levels of skill and um also they're dealing with people in crisis so being taken away from their regular duties to answer the crisis lightness can be a challenge yeah we've shifted to a designated call Handler on the CSU and they're managing the the crisis line um and we're we're talking about what that's going to look like um moving forward does it make sense to add another task for the CSU staff to do that isn't entirely reimbursable for their primary focus work on the CSU then maybe we need to bring in another um uh type of staff to provide that service so

we're have a meeting this afternoon to continue that discussion to see what's what's the best way to approach it the most efficient way to approach it yeah questions on any other questions in here put your hand up I'm sure you all right well I have a um I'm sure do you keep stats on the of the groups of people the place holds how many what percentage are law enforcement percentage Yeah Yeah and yep we keep all those percentages and how many of their holds were actually res sended or upheld so we get pretty detailed statistics on those that's interesting well it's been helping us to be able to train those individuals to about you know what maybe it's how they're writing them maybe that isn't um you know is it working or something so it's it's an opportunity for us to collaborate with our Community Partners and of the holds are those unique people or like are there some people who um yeah there those are Unique Individuals so there could be um repeated holds on that and I I don't a lot of times I get asked a question only have 16 BS why don't they just add some I just want to reiterate that a lot of people don't know to do that yeah it's the it's the licensing type so we're we're licensed as a psychiatric health facility and that limitation is 16 bed so if you go over that you enter into this thing called an IMD uh it's an Institutional Clause that

um you know starts to impact your ability to build so it's a different funding stream and different funding sources and different requirements so uh you know it's really licensing specific plus if you have a child there what plus if you have a child that comes in don't you have to get your BL don't we have to what ask people to leave well currently yeah we we ask them to leave we'll we'll transfer folks if we have somebody on we have to transfer folks over to Seer Rus so we can not have Co mingling between a minor and adult that's one of the reasons why we have limitations with our current building is that we can't Flex like that we have to move actually move people to another unit U so it's you know the the the new design that we have with SV that we've created allows us to exercise the waiver that we have from Department of Healthcare Services to treat both adults and minors at the same time so we can do that in the new facility with separation which is nice right now we can't do that effectively in either unmit so you know youth are going out of County when they could be treated in and I'll I'll just add Paul that the design of the Behavioral Health crisis triage Center also takes that into account so that we can have that flexibility that's right we can go up if we have or down if we don't have a lot and expand the adult side so it's really nice boulder Associates is really been great with the design ideas to help us be flexib um what you connection with calp and their Mental Health Services I was just talking to someone whose son uh needed evaluation uh on calp and I didn't know

they had that kind of services so I'm assuming you're pretty collaborative but can you say we are more yeah we've been having more Communications with them and we're actually trying to arrange for them to do a tour of s or Price stabilization unit um so we've been U going and talking with them and um collaborating with them so uh hopefully you know we'll when there is a crisis like that they can call us and we can assist them in in evaluating Steve has another question and then I have another thank you um it's it's a survey point I guess in the sense that during the pandemic I was getting a lot of calls from the hospitals especially that River about the 5150 I'm not getting those anymore I haven't gotten any for several years from either hospital now that doesn't mean they're not already always still under staffed overworked like our own workers are in DHHS like you pointed out Kelly about how does this work we already have all these duties and then there's this other thing right so none of this is easy but that's a data point I would say that uh whatever has gone on it's an improved system of course Co was a big part of all that um but I think the cooperation between the law enforcement agencies and the hospitals and dhss you know there was things that came up that have been worked on to approve so I would offer that as a data point um the other thing I wanted to say is that I think we all wish there was a whole lot more services on every level right but we only have so much resources to be able to do things and I we just had a Pres ation this week uh from the Department of Behavioral Health from Emy and Paul and others on you know the budget and what the plan is ETC and if I heard you correct there's been a reduction there's efforts to reduce some administrative staff to make more room for Direct Services providers and I

applaud you for that it's not easy but that's one of the things that has been being brought up by staff and others um so if you if you want to blame somebody don't blame ammy and Paul and the especially not the direct service providers blame me and our board because you know um it's really our responsibility in the budget I wish there was a better budget scenario it's horrible it's really looking really Bleak for the next few years and with what's going on currently at the federal level it's not looking better by any means so but we're all in this together and you know we will do our best we're going to survive we're going to make it through and we're going to just continue to do our best with the resources that we have so again I applaud you all because if you want to blame some call me blame me you know take it out on me okay so whatever say thanks what's your number I might be calling the crisis yeah yeah my number is 5725 5725 that's somebody else's number right yeah that's your number had dial [Music] um I have a a question or a comment and it's something I'd like I wish I had more time to drill down on but we have because we have this we have a lot of services here I don't know if you realize it compared to world but Humble County has a lot of services so a lot of people get sent here so is do you track out of County um people who are sent here from out of County they might be sent to a program and then they fail out and they're still here is that something that ever gets looked at um well I mean Paul might be able to respond to that as well just from some of his unit tracking but I will say you

know like there's lots of different categories of when and where people move between counties so for instance Dr medical organized delivery system we have individuals throughout seven counts that intentionally are meant to travel between counties to get with children's we have presumptive transfer and I would venture that we actually send more kids out of coming here um and with adults I'm not quite so sure about that I know we send a high number of individuals out of County or historically we have because we don't have to serviceing locally whether or not we have people coming in I don't know if people are necessarily sent here for services per se but I know that you know certain people show up here or are here for other reasons and then get Services here but I don't know if we have data point on that I mean we check we check know where people's medical every every for everybody that we can in contact with I would say that there sometimes it happens if uh like with uh at Crestwood the mhrc sometimes another County might use send one of their conserved individuals for treatment there and sometimes that doesn't work out and sometimes they blow out and we're in crisis and then we work with that individual and that County because they can't go back to Crest to find a solution so when those things happen like that we do collaborate a lot and and uh and try to work out because that's you know that could be a sticky situation for for everybody involved so we really try to lean into those and prevent that from happening any problem from from that blow out just want to make sure that person's connected with so it doesn't I mean I wouldn't say it's a we don't have a huge influx I

think you know most folks that we're treating are Humble County Medical beneficiaries my in my work I'm seeing a lot of people from out of the air and so I'm getting you know um trying to help them get back to somewhere where they have support so that that is interes if they're being taked out or be given the opportunity to call a c to return to where they're I think I'm not seeing that happen a lot of times I I I see what's happening is people are being told and treatment you're not entitled to so may I respond yeah do you mean like in substance use disorder treatment so and might know this better than I do but my understanding is if partnership is paying for their treatment and the person voluntarily leaves then they're no longer eligible for the transportation benefit a lot of people get stuck here yes is that your understanding as well Providence has paid for you know people to go back to their County because they just have their means and tap takes a while so unfortunately that's that's the case and it does happen you know yeah I've utilized Betty chin for transportation funds but CH will pay for them a few days they have somewhere to go yes and can confirm so tap and be yeah doesn't work for everybody I thought it was odd

people it is an issue that yeah I've come across as well for sure but when I lived in San berardino and I worked for um I did boots on the ground uh Outreach um the girl I worked with used to tell people oh why don't you go to Humble they'll let you stay anywhere so it happens everywhere here I am another question so if a person qualifies for treatment of vir but they're definitely a dual diagnos SD person too does do any Su Services get integrated into the SE environments program yeah or do you kind of defer that and try to destabilize no for sure we we address Al theol all the issues you know we treat the whole person so there's uh I mean primarily they're we're working on the mental health related issue um but you know there a good number of folks that have both things going on sometimes they have pH things going on too that need to be maned as well so we'll do that too as long as we have the capability uh to be able to manage that those conditions we will like we don't do induction of of um any kind of medication assistant treatment on the Su side for instance we could but we have there's other providers that can do that so the some of the um providers of uh Matt come into some vir too oh yeah oh y for sure right y we've had you know other folks that are in other forms of treatment in the community that are also treated on SE environments and we collaborate with those providers um and

because we want those to continue so started sorry I've also um we've also folks on before they thank you well I'm I'm super excited about the all the stuff coming up for use is the more and more I see people in my line of work they've suffered since they were young so I think that's really exciting and super proud as I always say and it will continue to say of our County and the work that we do thank you more and with that we move to Communications this is a time for our Behavioral Health Board to communicate things that they share so we will start on on this side Rael overdoses are continuing to down um we had five accidental overdoses last month um that's that's awesome um but our numbers are still very very high alcohol is still pain and we are still trying to get very creative with um plac for detox managements oh hang on a second Ste did you have anything else no I think I've shared my name is Donette I am uh I have a couple of things I'd like to talk

about um and um first of all uh um as um member of the board I think U it's really important that we talk about um you know we're at the first and Forefront of um Hippa um and I know that people don't really think that this we need to be uh you know following Hippa rules but it start it starts all that stuff starts with us um and so um so I want to talk about what that covers it covers healthc care providers Health Plans it covers patients informations it covers where people live it covers people's names covers all kinds of stuff and I want to share that when we share people's names in the this meeting when we're sharing our reviews or whatever we're sharing and we have community members on that screen we are sharing people's information with the community I'm not trying to be anything but like I just want to make sure that we're being mindful that our our professionalism that we um should be uh role modeling for people that work in our community should start right here um and uh so um you know I people may not like me but um recently you know there's been a few things that I've said that that um uh uh hip is important to I I don't play with it I don't play with people's mental health um when you go into

someone's house and it it affects one person um when you're going in you know you're going in to visit somebody's house and it affects one person cuz they're uncomfortable when when you visit it's one person too many and so um I uh I just um like I have a huge heart for our people whether they be houseless mentally ill TBI um anything um you know uh trauma anything I just have a huge heart for trying to get out of myself and think about how somebody else's feeling and not just think about me and so um like I just want people to start thinking about this isn't about us we're here to learn how to help our community and if we're not thinking about Hippa um we need to role model that um and so uh with that being said I'm going to well I had a couple of epiphanies recently I had a social to work with call me earlier this week um uh working with uh one of my people that's intellectually disabled um she took over about eight months ago and she's like I can't do this and I'm like well why not she told me what's going on that's part of his disability she goes well what's his disability I was like really and so um it made me start thinking about um how you know maybe once a month I have I have some um we could have like an educational day we could you know teach people about intellectual disability and how it affects mental health because we have people in our community that are rcrc as well as mentally ill we have

people that have tbis as well as mentally ill you know you know um maybe have some educational thing on a Saturday or whatever um but we need to start teaching um uh our people in the community because it we're just looking the other way and it's not just about um mental illness and and even at that a lot of people don't even know the symptoms of mental illness and so um I'm hoping that uh somehow we can get together and have some educational for the community on what it what it looks like what it and about it because um that was pretty scary like you don't even know you don't know um and so uh just an epiphany of thought and um and I hope that uh everybody's on the P same page of doing better for our our uh Behavioral Health in this community as well as our substance abuse um I know you all are so sorry if I push too hard thank you thank you Vanette h hi everybody um got a lot of things going on here in the last couple of months I'm the chair of the Native Veterans Coalition and we we are in Rapid progress of developing our own website um to find out you know there a lot of distrust in the native Community with anything that's connected to the government the Veterans Coalition started out as a concern from United Indi Health Service and the VA to bring about a coalition and so the information that what we're

doing with that is we're working on getting a separate in away from ba awesome and so we're uh we got some Talent from our other Coalition Partners who are pres for working on that may run into some funding problems maybe not um but we're we're actively getting some board members and all things that you need to you know work on 3 that's except for manag so the other thing I went up to CES City a couple weeks ago for something called a veterans Cafe they do it about every three months um in collaboration with the Oregon um VA told work City people and what it is is a place that they you know they come together about every three months for three or four hours to the place for veterans and Community to come together they feed us they have a presenter to talk about maybe different benefits or some aspect of and it was AIG than they thought it would be there probably 50 people in the room and um Veterans Coalition here is also looking at the possibility to get that started here so get that moving along and so I got some fly through all these but we have had for a while uh a women's coffee veterans cat course it's once a month I'll leave a fly it starts out over here old Oldtown coffee and chocolates and moves to we have a concert conference room that's been offered to Nation finest at

21 so we need down there and that's a couple hours and now is followed by amends after that I'm I'm offering to do the men's portion and so I have flyers for all that with dat contact information and then and the 11th of March there is a heing drum conference sponsored by UHS in city that that that's awesome awesome good share thanks what's going on Le Johnson I have a handful of announcements so those of you that don't know me I currently work for the neck tribe I am responsible for coordinating the crisis intervention teams in both humble and vort counties and that includes our 40-hour trainings for law enforcement and other crisis responders and so I wanted to report that I worked collaboratively with Leah Nei from Nami we were we applied for a grant and we're funded to send two people to the CIT coordinator course one person to a for a CIT curriculum train the trainer course and two Nomi members to go to the CIT International Conference in August so we're we met yesterday to do our first quarterly report which is identified folks that are going to attend each of those things so that's very exciting we also obtain funding from The Humble County Community Corrections partnership to send 17 individuals from various law enforcement

behavioral he agencies in hul County to go to the CIT International Conference in August in Anaheim so DHHS Laur culture over there is helping to arrange the travel um for all 17 individuals which is a huge heavy lift and so I really appreciate dhs's support with that and um thinking about what Denette was saying about education C is a great opportunity for education so um I will email Joe the registration flyer our train next training is coming up in April April 14th through 18th here in Eureka at the warer building Europe Tribal Police in collaboration with Eureka police are co-hosting that training oh my phone is listening to me that's weird um Alex no I know what's happening um so I just released the registration for that last week I also um released the nomination form for CIT responder of the year which we really like to recognize people that are doing this work that um are doing it well effectively have already received two nominations which is wonderful um so I'll also include that when I emailed Joe with the registration fly and then um lastly other educational things coming up in May people are preparing for me asol matters month I know the city of Eureka is planning an event to kick off the month and um they're working on bringing the presenters together for that and I've already heard from uh the hopes Center folks around the barbecue that will be

happening at the Jefferson Center our CIT group will te me tabling there and then also I encourage everybody to um participate in the walk as well and I'm sure we'll get the calendar once it's released to this group but I just highly encourage those of us that are here to participate in as many of those events as well that's it who's coordinating the Walk The Hope Center the center yeah they've done that oh it's a group there's a committee that's uh is formed by the Hope Center that is putting this together I don't have I'm like Miss Johnson I have a a few a handful of things um March 10th we have um myself arcade house partnership Dr Darlene spor and her executive assistant uh Lawrence at 2 30 we're doing a meeting with Christopher of stand against stigma where he faces out of uh reading he will be coming up here in May to do a stand against stigma PR patience training to teach people uh how to tell their stories in a productive proactive way what we will be doing immediately thereafter is setting forth a community event of a speaker Bureau of trying to reduce stigma and stereotype that comes with with mental health what's disheartened is that no one from County Mental Health and no one from this board has been supported that's well I have given bre

bases you couldn't come to a conclusion of what what I'm talking about uh so you know maybe someone that we can bring up from ready can answer all the questions uh he's the director of bra Aces um he I have worked with him on three other occasions one of those is a a a YouTube thing of I am I was homeless um that has been a very popular is it it is March March 10th at 2:30 p.m. uh that's that's a closed meeting because we're just Dr darling born myself and Florence is getting together how much it's going to cost for this AR house partnership is backing this financially um so just keep us in your hearts and your thoughts and uh that this goes over very well uh yes sir is it called brave brave brave faces uh you can look up stand against stigma and Shasta County will come up in Brave faces comes up underneath stand against stigma they have reached 5,700 individuals since their Inception if we can get half of that reaching the community of half of that we can at least change the tide if not The Narrative of the way mental health is looked at today I say that very passionately because I am a consumer I am a you know a person I saw a hand so what would what would support from the board look like a report from the board will be a letter

of support of something of this nature uh to the Board of Supervisors supporting this uh one person or two people from this board attending uh the brave faces I've offered myself and I'm very interested in participating yes you're definitely going to be there yeah I am too me too okay yeah and in terms of writing the letter to the Board of Supervisors what is it that you're asking for from the Board of Supervisors that's a good question I haven't made it that for you if I if I had someone that ask me those questions legitimately uh I I I would really love to talk about that let's do it because I I I definitely need to form answers to questions it's very overlapped with the work I do as CIT so I'm happy okay to work with you on that let's do this you know how to okay oh yes there there is another U event coming up in May uh that we're proclam mating or hopefully going to have it proclam to recognize our peer support specialist and our coaches yeah because the trenches that they are in uh is a daily work and it is definitely difficult to take time for oneself in those situations uh would like to show some support because uh the State Assembly in September I believe it was resolution 146 of the State Assembly of 2024 2025 session recognized the third week of of May as peer support specialist week in the state of California I have given that Proclamation or resolution to the Board of Supervisors there has been a

board of supervisor and natal a royal the champion this uh we Nat Royal and myself I can't really don't like speaking on her behalf outside of her presence but in the last meeting has brought up support from this board uh to the behavior from the Behavioral Health Board to the Board of Supervisors in support of recognizing this event um third the the other one I have would probably wait until the communications with director it it's about patient rights position um I don't have too much to say uh one thing I was thinking about a lot this month was the fact that um you know I was on the board before a number of years ago and the board um both the committee members and the board has changed a lot and one of the main ways it's changed since I was last on it is that there's fewer community members at large and more people who are actively working in the field and personally I've really like that because then I can get a lot of information since I'm one of the community members at large people who don't work in the field directly anymore but I just wanted to say a word of appreciation about the things that um are sent out about things that are happening in our local community those of us who are community members at large even people I you know was kind of a big wig in the in the alcohol and drug Community when I was working uh really need to know these things and we

need to understand them in the context of this County and which is different than like when I was in Sacramento County tremendously different you know so it's like a different world so um please keep that up uh I really need it and there's a few of us uh Tim and a couple of other people who are you know we're just we're just people we're not working in the county anymore and we're not you know in mental health through alcohol and drug but we're still very involved and interested and we have to find a way to contribute to this board in a different way than the rest of you can you know I can't say that I'm over at providence's er like Raphael is or you know something like that so thank you for doing that and keep it up um I loved that the tape um thing came out about the open house I intend to go there thank you um so I'm sorry I forgot to say one more thing short so on um March 13th is our next sud meeting and our speakers that are coming out our programs that are coming out are new life Discovery projects and agents to come out and share about their program along with a peer from their program and you can uh pick their brains well I don't know if you can pick their brains you can um ask questions and um they will let you know about that and then um um is that the SD committee is part of the board okay can I add some things for the s report for back to

oh I'm sorry it's all right my communication is that May 4th um at the war is the city of Eureka's May's mental health pickup and so um we have our speaker Joseph Reed coming from Michigan he's written a book called broken people uh he was at the CIT conference he is coming with his daughter adult daughter and wife and they are pretty awesome because they have different viewpoints of people with mental health sensing a theme here yeah you guys keep Ving the CIT call that's awesome see people it's great excited so um more details will be coming on that but that is um May 4th which is a Sunday at the war finger it'll be we'll have two panels a lived experience and a professional panel and our main speaker yeah so that's my your Star Wars Fe I know every year okay and with that we will move into reports and I saw that Connie was on there and she's gone so um oh you know what we forgot to put D's director or ores say after me then I can p it to any of the deputies that are here yeah I think they can all they have all right so okay um gosh a lot in this meeting today and I super appreciate all the communication and the sharing and conversations um I had actually thought I would just share a little bit about what supervisor madon already referenced which was that presentation this week to the Board of Supervisors um I just think it's good

information for this this group um this for to also have um we had decided to just bring forward um Paul and Jack and I um had kind of an overview um of Behavioral Health budget and some of the Heavy Hitters like some of the high expend expenditure areas for us um which are really more in the Adult World which is why it was the three of us not soly um but so we did kind of an overview of budget for 2324 we talked a little bit about some of the Heavy Hitters and we also just went through what our core and mandated services are because I think it's important for the community to understand that it's not always real evident I think from the outside and then um just some of the ongoing impacts to our budget as well as our commitment our continued commitment to the community so I'm just going to do a few of the highle talking points from that I think you can probably listen it's public so you can listen back to the reporting if you wanted or you could see the PowerPoint if it's of interest to you but essentially um for 2324 Behavioral Health had about $64 million in expenditures that's our budget and which is you know a pretty substantial number and um we have a variety of ways that we fund our services um through you know realignment that we get Mental Health Services act that you all are familiar with um and then also drawing down billable Services through medical from this from the state from the feds and so um and and then other things like we have a little bit of in fund transfer we have um some grants that we're able to leverage at times we have a small amount of County general fund and just some other things but the bottom line which is what I partly what I wanted to lift to the Board of Supervisors is 2324

which is now last FAL Year we're still about two almost $3 million short and so and that's important for us to talk about because um we continue to be required to provide certain core services like specialty Mental Health Services and we continue to have other mandates roll out some of them you're we've heard about like care court or aot or now s sp43 these other things that we're tasked with um and and much of those initiatives are either under or unfunded so we have to add those to our flight and continue to provide the mandated services without sufficient funding some of what we wanted to present this past week was that our highest Spenders are Seer vibrin who are always in the red on Seer viin um I think for 23 24 we're close to 4 million in the red um and CSU as well which is kind of linked to CER irance and we have substantial placement costs so we're responsible for paying for placement costs for people who are conserved or in need a placement um with no revenue for those so $10 million for 23 24 with no viable Revenue so and I say that because again there are certain things that we're required to do and there are things that we're not required to do but that are important for our community but when we can't make ourselves whole we have to figure out what to prioritize and I I wasn't there on Tuesday nor am I here today saying oh and so we're not going to do these things anymore but what I'm saying is that we're really looking to to to figure out how do we continue to serve the community in all the ways that we need to that we're committed to that we that we want to serve the community and still remain fiscally solvent it's not it's just an

incredibly huge challenge for us and I say know so the $3 million 2.7 million that were short from 23 24 we're still working diligently to draw down every single penny like that number will move there's other funding sources that we're still working to leverage to to make that um to offset that difference and it's not great like it's a challenge and so I just you know I just I'm working really hard to be as transparent as possible because I do feel like it's important for people to recognize and both Board of Supervisors and the behavioral Health Board have been such amazing partners for us when we've had to have difficult conversations and when we've had to communicate with the community about you know where we're falling short or where we're struggling um so I just wanted to leverage that partnership a bit in this conversation and also like I said be real transparent about just kind of the state of of our budget and the state of how we're currently operating within um our requirements and our commitments you know so anyway I just I thought today thank you so you're ping I'm offering for any of the deputies who would like to share to share and no pressure or requirements I don't have anything to share um I'll share that jet de Cruz is retiring which most of you may actually know her she used to come to this board and she filled the role as hospital administrator and many other um Physicians across Behavioral Health F I think we I just saw something that said almost 38 years um so she's retiring on April 1st and we're doing a retirement Proclamation with the board on March 28th um and just making lots of plans to welcome that transition and um wish her well and um it'll be a shift for us we have two senior PMS right now in

children so we we'll be trying to fill her role as quickly we can it's a huge it is a huge L institutional knowledge and she deserves to retire absolutely I think it's March 25th right that's the just so everybody retir sorry March 25th is thank you for that and she's really navigated and done really good work both in adults and in children's again she's kind of sunsetting her career in children's which I'm so grateful for but she has really her knowledge and experience has spanned all all our systems which is she's who hired me I know and sent me to CIT because she didn't want to go and put me in mist and this is how I became I am [Music] today now I want to go Zer I had no interest in working with law enforcement all I was scared of them um all right Madam chair yes I have a question for the director of mental health okay um on our patient right Advocate position um can you let us know about where that may possibly be at in the hiring process the reasoning of asking this question is because the person filling that position is your coach level three and she is the supervisor of Hope Center and the Hope Center is paying the price big big time for that that's the reason why Brenda is here um that's the reason why some other people from The Hop are supposed to be here this

morning um but we would like to know if there's any hiring process on where that may be at um we are recruiting for the pr position yeah we're working hard to recruit for that position do you have any idea about how long I I because I'm gonna let you know we've noticed the times the the Fridays that Betty is out our peer coach level three and when St she's out when hey Veron I'm gonna just pause here because I don't feel like this is this time place can we create a time sure but I don't think this is the place to talk about individual stuff okay well we we need to come to some answers I mean and as a board member I would like to address that because there are a lot of fears at the Hope Center and those fears are legitimate to Bren and others and I'm not going to be afraid to bring that out in any conversation or public meeting yeah I'm just not able to engage in conversation with you about individual staff in you know in a public setting so I'll just say so what would be a good for yeah I mean I you could certainly reach out individually you could reach out I would say to start with with Jack cuz he's the deputy over the Hope Center if you want to reach out and I could have an individual conversation with you I'm happy to do that do great okay yeah sure thank you okay and now sud committee update I just want to say there was just a few minutes ago um the um Michelle sent out the thing for March 13 um I want to say that the last little uh thing that says guidelines for

Community was actually the we were actually working on um a discussion what we want to do about um having a guidelines for going into the community or you know re reviewing communities um treatment programs and stuff like that so um yeah that shouldn't really been in there but those are things that we've been discussing so these are on ongoing discussions in our groups for the past three months um and so uh what the reason why that's even there was we we've been adding and taking away and stuff like that so if anybody wants to show up on the 13 um and listen about New Life Discovery excuse me too much coffee today New Life Discovery and ages and also you know hear about our you know how we're what we're talking about as far as how we're going to handle the these reviews have some input be a part of and also by us having people come to our sud program maybe they'll want to be a part of too so anyways thank you that's it that's all yeah I just wanted to add some uh really exciting updates um North Coast substs Council is going to be expanding 12 more beds um in Henderson Center it was a very exciting um uh we went to the Planning Commission um very exciting to see how the community um responded to that um there was it was mixed and uh but the director for that did a really good job at answering a lot of questions um there's a lot misinformation about the the the project and the the population so um I'm really glad that he was there um so that's

really exciting um something that's not as exciting is um Dr Bayan from uh wrs is retiring um so what that means is that they are now raising the bar a little bit more for folks who are um you know who are cering the fly diagnosed so um and we are experiencing that now um you know it's it's getting it's getting harder to place folks um like I said we're getting very thank God for our partners and other you know surrounding areas um there is a project right now that we're working on and trying to expand Detox Services in Humble County um hopefully by next meeting I'll have more information on that um but yeah uh there's also some things that are happening um we've noticed more nitrous oxide and Crum folks coming through the Ed um and with crum we we treat that just like opioids but with nitrous oxide it gets really really tricky um you know most folks have to uh you know be treated longer there's just really no place um you know so we're having to to uh you know get really creative with that but some of these places that they are getting them at are these local smoke shops and anybody can just go in there and just get as many as they it's not regulated um you know I've had Parents um you know uh some folks that you know did didn't end up in the Ed go actually to these places and threaten you know to to sue them because of what's happening and I mean I certainly don't blame them I mean it's um but this is just a becoming a problem I'm seeing in the community and uh just reports from you know the patients how easy and accessible it is it's very disturbing so just wanted to everybody's brain and

discuss that later so that's all I have um be nice to um celebrate Ruby you know finish she her parties on Monday one at Waterfront she had her Proclamation at the Board of Supervisors this past Tuesday I was just looking to see because did the email about her retirement come to this group I see I'll find it and send it so Jo I want to say she's been up here for a while she's a medical person working with different doctors and she's just dedicated herself you know to this and we a lot of gratitude to so it's going to get tougher than Dr Biden Dr witon is now medical director and he's wonderful um so we're really happy that okay there's no other committees at this time so now as the chair Vice chair reports and I don't have anything you have a vice chair updates about Center we're just coming along was actually excuse except one person it's hard for me to hear so side conversations we about 12 per so far

okay um are there any future items to go on the agenda your chance to so I have education that was a note from DTE um will we know more about you think we'll know more about any Cuts that's happening at the federal level that will be trickling down to affect Services here potentially in the next month or so or do you think it'll be slower than that I I I'm not sure honestly we're just kind of waiting to see as well so certainly anything that I hear or we hear will share yeah thank you for asking it's just kind of unknown right now about yeah well I've heard that bad things about part of the Medicaid Cuts will be mental health Cuts I mean I I've that on TV for the last three days I think that I we're I mean I feel like the information has been hard to quite sort through and a little bit inconsistent and so yes I think there's lots of worry but we're still waiting to like really understand that vac things are bit mus the way you said word you used musky just make just so if there is no other items for future agenda what before two you did it again 1353 want adjourn this meeting and thank you all for being here working for your community thanks than La thank you everyone

everybody Zoom to see everybody