Behavioral Health Board - Regular Meeting

I'm usually here taking a lot of you guys' time with listening sessions. I care about what's going on. Yeah, but I feel like the ramp up is going to happen. There's going to be new reporting requirements they're going to talk about that also impacts me. So it's all kind of meshing. I just listened to the...

Well, the data just came out, and it's on foster care, behavioral health, and so just listen to the county presentation on that. Yes, we have to implement by July 1st, but we don't really know what we need to implement. I love it when they do that.

Yeah, yeah. There's a lot of that going around. Like, oh, we know we need to be doing stuff. We just don't know how to do it yet.

Yeah, because they have to. Exactly.

Speaking of that space. Right? You're not going to enjoy yourself.

You don't know how good you got it. My kids have wrapped it up, too. Oh, awful kids. You know what I'm saying? You're the problem, Lisa. I'm sure it's not going to be Michael. So Madison had a surgery. She was waiting on the street for her. And I said, I'm either.

I just. If you can figure out how to do that would be Madison. And then Natalie has to leave in an hour.

And then Michael has to leave in an hour.

Yeah, you know, because they're both loving it. I'm playing a little bit like that. Yeah. And I think what it is, is I also found some small problems with that. Whereas one thing if they're left their own devices, it's just going to be somebody said, both of them. This is very good. I'm looking forward to

Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah.

I'm a crime and flash.

Yeah, my sense of purpose.

When I was. Yeah. Yeah. My heart.

It's interesting.

Are you good? Like, well, that kind of love. Yeah.

All right. Emmy said she's going to be a few minutes late, but she will. She is coming. She knows how stressed I get if I don't know that she's going to be sitting down. The day that I'm not stressed before this meeting is the day before the day I quit. I'm out. It's the compass dashboard. It's online. Yes, it is. But it's only available to people who have license. Yeah, to help those things.

Oh, OK.

Both are.

Is he.

Stay. In.

Actually, from the field house and lots of cool.

Very little on there.

Take a minute to put to them there for their training. Right down here on that thing. So you know, we're doing some

It's right next door. They have that history of the kayaks. Yeah. And you follow the other side upstairs office room. It's very nice. So nice to be there. Oh, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no.

So he's on just. Their dad has kind of. So part of the rest of fire. I didn't with the gammies like years old. It's great because we have kind of accident. I'll tell you how long you're going to have to get so I really need dollars. For Ellen great fine, and they are building your. Well, thank you. That's the best. We went through that season. I feel like it's one of those.

And, you know, I'm tired.

I'm tired. I'm tired. I'm tired. I'm tired. I'm tired. I'm tired. I'm tired. I'm tired. I don't think any are 20 something year old to grab me grab me. Those rivers are. More than. Jackson and you were in an area with the same friend. He.

I have really good chemistry upstairs. I used to work on such a patient where he was doing this. He was doing this constantly.

I used to put a couple of kinds of answers which would be there.

We were shuttling in and out. My uncle, my mom, I mean, my father, my uncle, my uncle, my uncle, my uncle, my uncle, my uncle, Oh my God, yeah. I think it's trying to take that name somewhere else.

I remember that too. I do. But then there's the other. Exactly. So great then.

We were just talking about how you need to respect your boss, no matter what. And there was two different names.

That was a little light reading. It's very, very popular.

Thank God, one guy was so insomniac. We like to go to each city. As a small community. We do. We do. We do. We do. We do. We do. We do. We do.

We do. We do. We do. We do. We do. We do. We do. We do. We do. We do. We do. We do. We do. We do. We do. We do.

We do. We do. We do. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm sorry.

I'm sorry. This is a huge lesson. I'm grateful to have learned. But I mean, I have to take care of myself. I thought about it. I've got, like, stairs all the way up to my house.

It just, like, I don't think you should know.

Hi. How are you? Yeah, I'm good. I forgot you were on the phone. Yeah. Yeah, I'm going to come home very soon. I'm from . Yeah, I've been living in the area for a long time.

We migrated here when I was 30. Yeah, that's a good year goal.

How are you? How are you? Well, that's very nice. I know them. Yeah. I'll bring back memory. Yeah. Be careful. No, no, no. She's mine. She's mine. So, yeah, that's what I use. What which is a big issue, but it's not a big issue, but it's a big issue, but it's a big issue, but it's a big issue, but it's a big issue.

My way back in the day, I guess. Yes, I think probably so. But I was like, Oh, sorry. Short. Sitting next to you.

And we can actually just chat with you. I'm back in a while. Should I go over things?

Whenever I can, I definitely try. I have to actually go back to my mother.

I know I was like, I know it's a good dollar. Also, Vincent, thanks for calling. Absolutely. Makes you question the US system. I'm sorry. Today. Here. Yeah, it's a lot. It's a lot. It's a lot. It's a lot.

It's a lot. It's a lot. It's a lot. It's a lot. It's a lot. It's a lot.

And talk about that. That's what's like, yeah, I messaged him to me right now. We're having a conversation about this because

I mean, yeah, we'll talk. I mean, I'll tell you about it. Perfect party. How are you? Doing all right. Awesome.

It was funny because inside you come in and it didn't even faze me that you go in here and then he says, oh, Dorothy's here. And I'm like, oh no, Jeremy's here, here. It's cold.

I like that it's cold. Usually I... My office was so cold.

I had to like go home.

I had to like, it's too hot here.

I'm going home.

Yeah, my office of the VH and it just...

They have three of us crammed in what used to be an exam room.

There's no windows for vigilations. I've got the door open, put the fan on. We were in my office at the general hospital building. It was all open. It used to be a safe way to get in, and our offices are back where... Oh, yeah, no.

It's going to be. But yeah, it's just never mind. We've got a whole lot of money.

Yeah.

Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. But I'm sure it's not. This morning from. Out there. It's not very good. No. After this event. Yes. Right. The one and the three. Same thing is about here. You're not much time in the agency. Right.

I like I walked into my car coach.

Oh, I'll run around. Why are you just like it's all right. It's just to take a step out of the way.

All right, everyone. Before we begin, let us take a moment to recognize and appreciate the time, expertise, and commitment each of us brings to the symposium.

As we gather today, let us be intentional in showing up as trauma-informed compassionate partners, grounded in empathy, respect, and collaboration as we work together to strengthen behavioral health outcomes in our community. With that, calling the meeting to order at 1215. Welcome to the monthly Behavioral Health Board meeting. We are the advisory to the Board of Supervisors. We hold this meeting on the fourth Thursday of each month and it runs from 1215 till 215. We meet in person at 507 F Street in Eureka. This is a public meeting and everyone is invited to attend. Members of the public may participate remotely. The minutes and the agenda can be found by searching Humboldt County Behavioral Health Board online. We provide time for public comments early on the agenda. Public comments are limited to three minutes and pertain to matters related to behavioral health. We ask you to make your comment in a respectful manner. Please note this meeting is being recorded. Will you please contact myself or any of the Behavioral Health Board members if you have questions about our work as a board. With that, will you take the roll, Judge?

John Berger? Here. Marguerite Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Soren-Bacon? Are you sure? Yeah.

Okay. Are there any adjustments to the agenda? Now is Time for public comments, if anyone has a public comment. We'll start within the room.

Does anybody have a public comment in the room? No?

Online? Thank you. Oh, there's no public comments. Well, let's go to introduction of staff. Say it louder, Shawn.

We will start with you, ma'am. Hi. Good afternoon. I'm Amy Boxler-Rogers. I'm the VB For All Health Director. Nice to see you all.

I'm Alex Oliveira, VHSA and QI .

program manager, QI.

Scott Berry, I'm an employee . I'm Alex Oliveira, a social worker for .

Laurel Johnson, I'm an analyst with VHSA.

Amy Scott, Program Manager for Transition Asia.

Jeremy Nelson, Deputy Director for Children's Behavioral Health.

Oliver Newfellas, Program Manager for PHFA. Teddy Morgan, Project Counselor at Fenton Living.

So we'll go online.

Good afternoon. My name is Edward Yudome. I'm a QI analyst.

Hi, I'm Nancy Stark. I'm the legislative and policy manager for DHHS.

Hello, I'm Saul Lopez. I'm the site director with Nation's Finest.

And we can do guests as well. You're a guest online and you want to introduce yourself and we'll come back. Oh, Melissa chatted something that I cannot see.

Hi, everyone. I'm Melissa Nelson here, patient navigator at Aegis Eureka, and now Crescent City as well.

Thank you. And back to the room, if there's any guests that would like to introduce themselves.

My name is Austin Barnett. I'm the director of operations and IT for Patrick's Foundation.

Anyone else?

I was a guest. I just kind of hang the line there.

No, you're good.

All right.

All right. Thank you, Sean Berger. That's why you're the second VP. So we do not have a quorum. So I'm going to say we're going to, Josh is on today. We will perhaps, well, we still won't have him. So we will put these minutes off to September meeting. Just a reminder, we have no meeting in August, dark in August, so we'll be back in September. Wow, and here we are, the highlight of our day, our QI presentation. I'm super excited. Thank you. Take it away.

All right. Good afternoon. The Quality and Dremate Unit today will be presenting to you on some of the high-level changes that have been implemented by the state through the Department of Healthcare Services. These changes impact counties due to the number of steps that are involved in these initiatives, the funding, the staff time that is necessary to meet requirements. All of these initiatives have been added to our daily tasks. Not only us, but the other staff that have to deliver services. And nothing is being removed from our requirements and responsibilities. And we will hopefully, you guys can hold the questions to the end so we can get through the content and then we'll open it up for questions. So next slide, please. So our unit is comprised of myself and several others, but what we're going to do right now is give you a little bit more of an introduction than what we've already done. So I'm Amy Cohn again, and I'm the Quality Improvement Program Manager, and I'm also the Interim Quality Improvement Coordinator. Since that is a vacancy, I oversee all of the QI activities. I do have 26 years of experience with the Department of Health and Human Services. I've had about four years specifically with behavioral health, too, as an interim deputy director of the performance management unit. And then I have currently two years in this position. So previously, most of my experience was with quality management services, doing quality assurance. VHHS compliance and quality assurance administrator and privacy officer for about 14 years. With that, I'll hand it over to Alex.

Hello, my name is Alex Oliveira. I'm a VHHS QI admin analyst. I've been with the county now for six plus years. For my QI focus, those things include reliance training and compliance monitoring, client satisfaction monitoring, grievance and appeals monitoring, at data monitoring and reporting, cultural responses and monitoring contracts and special projects. With that, I'll pass it over to Scott.

I'm Scott Berry. I'm a UI analyst too. I've been here at UI for over two years. I focus on timely access, providing the provider list, and doing other reports that track our components.

And Edward is online. Edward, do you want to give your little introduction?

Absolutely. Thank you. Good afternoon. My name is Edward Dudome. I'm a QI analyst with a focus on org provider relations and also doing the county network adequacy. So all of the 274, which is how DHCS refers to it, how they determine our network adequacy.

All right. Next slide, please. So as we know, there's a lot of acronyms and things. terms that the state and government uses. So here's just a snippet of some of the high-level ones you may hear today. If you're accessing this presentation online, there are links within it. Many of our PowerPoint slides, we're not reading the slide. It's mostly there for information for you to reference. With that, next slide. So now I'm going to go over just an overview of QI itself. Many of you may have already interacted with quality improvement. The quality improvement supports all of the behavioral health by helping to deliver effective, safe, and client-centered services. Our focus is on improving care and outcomes across the whole system. So what we do is we review data, client feedback, and client standards to understand how services are working. QI identifies areas where we can be Strengthened and support teams and making changes using simple structured methods like pdsa plan do study act. I don't know if you're familiar with those methods of looking at a system trying things that they don't work going back and you know engaging with new systems and seeing if those work and presenting on those outputs. So we also have regulatory and compliance that we are doing which is QI helping the county meet state federal requirements. and managing required performance improvement projects. We also help maintain our coffee plan, which is on the acronym list as the, at least in this, this will have the quality assessment and performance improvement plan. So we do that. We also do data reporting. So we analyze trends in access, timeliness, service use, disparities, complaints, and outcomes, and a whole slew of other things, but those are more the regulatory ones. We share this information with leadership, programs, and boards so decisions can be data-informed. We are support for staff and programs. We work with teams to improve workflows, reduce inefficiencies, and enhance the client experience. We offer coaching and tools for problem-solving and measurement. This includes course policy and procedure development and data reports. We're going to spend a lot of time on those data reports today. So why does this matter? It matters because QI helps ensure our system is accountable, consistent, and responsive to community needs, ultimately supporting better outcomes for clients. I'm sorry. Did I hear something? No? OK. Next, Scott's going to go over our work chart in brief.

Next slide, please. So this is the QI organization chart. Quality improvement. And the closer related training audits and certification sections are overseen by our director, Emmie Boxler-Rogers. There are 16 allocated staff positions for the quality improvement and training audits and certification sections. Three full-time analyst positions, or actually three and a half, and three review nurse positions are filled with two additional half or 0.8 time There's three nurse positions. Currently, I have five full-time positions vacant. And Amy is filling in for the Quality Management Improvement, or QIC, the Quality Management Improvement Coordinator.

All right. So how is QI, next slide, please. How is QI helping transform behavioral health? The quality improvement unit has always been responsible for compliance and oversight, but behavioral health systems have historically been sort of stagnant. So it's been very set in many ways and slow to change. But in the last five years, it has completely shifted to a very much changing place, especially for all. But in QI, it's like every day there's a new thing. And so we're going to go over some of these big level changes that have happened in the last five years. We're in it and we have more coming. So even as we give you some information, it's ever-changing and more items are added. So this shift has mostly been due to state reforms, new legislation, new technology requirements, and rising expectations for data-driven care. For many years, quality improvement and behavioral health was mostly focused, again, on that compliance side and doing documentation corrections, much more simple or simple-seeming. So it could be complex, but definitely, if you compare now to back then, it was much simpler back then. Processes were slow, fragmented, and largely manual. Systems were considered stagnant, did not change much over time. So we're transitioning from a largely paper driven manual corrective action model to a more modern proactive model with closer to have a medical health field and has been operating. We've seen, even though we had an EHR Avatar before, we've moved to SmartCare. And even in Avatar, we still have a lot of paper charts, a lot of paper forms, things that we're doing on the side, workarounds. And now we're really moving to an all-inclusive electronic health record at our clients. And it's not only going to help them We maintain all their information, but it helps us assess our systems and look at things in much different ways than we have before. So technology is now central. Our EHR is called SmartCare. And we implemented the program in July of 2023. So we've only had it for about three years now. But it updated documentation standards, digital reporting tools, dashboards, and secure data sharing processes that require us to guide staff and contractors contracted providers in adopting new workloads. Data expectations have increased significantly. So QI ensures not just documentation accuracy, but data completeness, timeliness, and integrity so that county can meet those state requirements, evaluate outcomes, and participate in statewide improvement efforts. Analytics are becoming core to how we operate. The unit now helps programs understand the trends, Performance indicators, timeliness of service. You're going to hear timeliness a lot because that's one of the biggest things with DHCS is how timeliness of services are going. There's other quality measures, and we also are looking for areas to improve. This aligns behavioral health with broader health care practices. Business practices are evolving as well. So Medi-Cal reform, one of our initiatives, CalAIM, that we'll be talking more about. And also, utilization requirements pushes towards standardized pathways, consistent documentation if you're billing accuracy and audit readiness. QI trains and supports staff in processes. The medical side alignment means we're operating more like an integrated health system, focusing on outcomes, value-based care principles, quality metrics, and measurable improvement. QI is the unit driving that change. For contracted providers, the shift means more support, player expectations, consistent with things like using CANs or ANSA. I don't know if you guys know what those are. It's a child needs assessment, and that helps measure how a child is doing. And then, of course, documentation. If we can be consistent in the training of these kind of things, then staff are doing their processes consistently, and that's the data we get from that if you want to assist it better. Ultimately, QI ensures that these statewide changes that we're undergoing translate into better care, better access, and better outcomes for Humboldt County clients and the community at large. So, next slide, please. We have three of these huge initiatives that we're going to go over today because they're all connected to a mass amount of data. The three are CalAIM, BH Connect, and BHSA, and we'll talk specifically about what each of these are. So next slide, please. We'll go into CalAIM. It's like one of those slides. I'm not going to read the slides there for reference and for you guys to engage in it if you want. And the links, like I said earlier, are electronic and workable if you get the electronic version that's on the web. So behavioral health payment reform is really what CalAIM was about mostly. I mean, there's a lot of elements to it, but it was about really shifting how payment was happening. So it was implemented in July of 2023, the same time as our new EHR SmartCare, and it changed the financial foundation for county behavioral health by moving from a cost-based system to a fee-for-service model. This shift means counties are reimbursed based on services delivered rather than overall costs, which increases transparency and predictability. It also brings behavioral health into alignment with other parts of Medi-Cal and encourages clearer documentation, consistent service delivery, miserable outcomes. For Humboldt County, this has required major operational adjustments, including updated workflows, billing practices, and data reporting, and they're still underway. In fact, we were just communicating this morning about cases that we needed to close out from the transition from Avatar to SmartCare. Our medical records just finished that project, thousands of records that when they were transferred from Avatar to SmartCare didn't automatically close. And that shifted our numbers. We found that out during one of our EQRO state audits. And then we took action in cleaning up the data. Next slide, please. So the next initiative we're going to look out to review briefly is BH Connect. And BH Connect is a new Medi-Cal initiative running from 2025 to 2029. that expands and coordinates behavioral health services statewide. It increases access to mental health care for people with significant needs, adds short-term inpatient and residential treatment options, and provides up to six months of housing assistance for individuals at risk of losing stability. The program also enhances services for children in units such as multisystemic therapy, high-fidelity wraparound, and it also expands space and community health worker supports. Overall, BHConnect strengthens community-based care and fills critical gaps in the behavioral health system. Next, Alex will do the last of our three initiatives and is the panelist for this program.

All right. Behavioral Health Services Act, or BHSA as we know it, was enacted in 2024, replacing the Mental Health Services Act, MHSA as it was called. and expands behavioral health funding to prioritize individuals with the most significant behavioral health needs. It includes substance use disorder treatment, increases investment in housing and behavioral health workforce development. It requires counties to plan across the entire behavioral health continuum of care, and it strengthens oversight, transparency, accountability, and equity to improve access and reduce disparities. Part of Prop 1, which is also included which also includes $6.4 billion in behavioral health bonds to fund treatment meds, supportive housing, community behavioral health facilities, and housing for veterans with behavioral health needs. The BHSA represents a significant shift from MHSA by broadening the focus of mental health from mental health alone to full behavioral health system. including substance use treatment, housing, and workforce development, and improving accountability. Combined with the Prop 1 $6.4 million bond, billion dollar bond, it provides new opportunities for counties to expand behavioral health infrastructure and services. So data. Next slide, please. Data. Behavioral health is becoming increasingly data-driven. DHCS is requiring more reporting than ever before, and many of these systems are still evolving with new measures and reporting requirements. This reflects the ongoing transformation of behavioral health under Behavioral Health Transformation, CalAIM, MVHSA, and all these other initiatives we'll be discussing today. Next slide. Beyond meeting state requirements, we'll also use data internally to monitor quality, identify opportunities for improvement, and evaluate whether we're providing effective care for our community. This slide shows that none of our data systems stand alone. So, some of the primary data sources and reports that we use include Medi-Cal Connect, DHCS's new statewide reporting platform, supporting behavioral health payment reform and standardizing. So, PHAS measures, which are national quality measures that track access, timeliness, and follow-up and treatment engagement With growing importance, which is with growing importance under CalAIM, the voter, which we'll discuss these things in further slides, developing DHCS framework focused on behavioral health outcomes, accountability, and public transparency. We have monthly reports, which we use to monitor our operational performance, including access, utilization, wait times, crisis services, and workforce trends. We have quarterly reports. which provide deeper analysis of the trends and disparities in compliance and quality improvement efforts. And then we have our annual reports, which summarize the system performance, outcomes and quality measures, equity and the progress towards improvement goals. We also have our quality assurance and performance improvement plan, our QAPI activities, which is ongoing quality improvement work, including performance improvement projects, process reviews, client feedback, corrective actions. All of this gets put together in our QI work plans, using every data source to set priorities, test changes, and monitor improvements over time. Together, these interconnected data systems allow us to meet state expectations, support CalAIM, behavioral health transformation, Prop 1, and all these other- No.

I'm coming from Memphis down here.

I'm coming from Memphis, Tennessee. I'm trying. Oh, heck yeah.

Fine. My mom's side of the family grew up down here in this area.

Yeah.

Jeanette. I'm trying. All right, so next slide, please, Ever.

What is Medi-Cal Connect?

Medi-Cal Connect is THCS's statewide data platform that brings together information from multiple sources to create more complete pictures of the people we serve. Rather than looking at individual services in isolation, it helps us understand population health, identifies gaps in care, and improve coordination across the Medi-Cal system. This supports the goal of CalAIM by promoting whole person care and better health outcomes. For quality improvement unit, Medi-Cal Connect is becoming one of the most valuable tools because it provides standardized data that helps us monitor performance, identify opportunities for improvement, and make well-informed decisions. Some of the examples of Medi-Cal data, our data dashboards that we have access to now are behavioral health quality measures, behavioral health care management demographics, which I'll share here in some subsequent slides, behavioral health condition prevalence, behavioral health equity, and behavioral health, BH Connect, and BHT member tails. And we'll be going into these here shortly. Next slide, please.

Can I just ask? Yes. I think I asked you before. You have all this data, but only you all can see it, right? It's not public. I'm sorry, it is public. It's not public.

You guys don't have access to this, but you have access to other sites that have the same data.

Well, it would be great for our board to know where we can access some data. So, okay, I can reach out to you. Yes. Thank you.

Looking at this slide group, this is a high-level overview example. On the screen here, it looks small. But it's a high-level overview example of the volume of measures captured within Medi-Cal Connect. If you look in that bottom left corner there, you'll see that there's 213 quality measures over eight different category initiatives for both behavioral health plans and managed care plans. So a ton of data that we're now looking at on the regular. Next slide, please. This is an example of our behavioral health accountability set, or BHAS as we know it. These quality measures that DHCS tracks for behavioral health plans. These standardized healthcare effectiveness data and information set measures, known as HEDIS, we'll hear that term used, HEDIS, evaluates areas like access to care, follow-up after hospitalization, treatment engagement, and medication adherence. The important takeaways isn't the individual numbers, it's that the state is now measuring performance across different quality indicators and comparing counties against an established benchmark. This is all new or being modified under all these initiatives that we're working through. These measures help us identify where we're performing well and where improvements are needed and ultimately guide our quality improvement efforts. Next slide. This slide is an example of one of the equity and demographic dashboards available through Medi-Cal Connect. It allows us to look beyond overall performance and better understand who we serve by examining data across demographics, in this case, social determinants of health. These dashboards help us identify disparities, recognize populations that may be experiencing barriers to care, and use that information to improve health equity and guide improvement. Next slide. So how does this impact DHHS behavioral health quality improvement? Well, DHCS's current initiatives shift the focus from simply providing services to demonstrating improved access, quality, and outcomes for Medi-Cal members. While compliance remains important, the emphasis is increasingly on whether people can access services quickly, receive evidence-based care, and achieve better health outcomes. For the Quality Improvement Unit, this means using data not only to monitor compliance, but also to partner with program to improve performance, reduce disparities, and demonstrate the value of our behavioral health system. Next slide. The Behavioral Health Outcomes Accountability and Transparency Report, or the BOADER, is one of the largest new reporting requirements under Behavioral Health Services Act. Rather than reporting on just one area, counties now provide a comprehensive picture of how behavioral health system is performing. That includes how funding is spent, who is receiving the services, quality and outcome measures, health disparities, workforce capacity, and overall system performance. The key takeaway here is that DHCS is moving towards greater transparency and accountability. Counties are expected to demonstrate not only where resources are being invested, but how those investments are improving access and quality and outcomes for the communities we serve. Next slide. Here are the building blocks of the voter. One thing to keep in mind is that the voter is still under development, and what you're seeing here is DHCS's long-term vision. Additional data sources and reporting requirements will continue to be phased in over the next several years. With that, I will hand it over to Scott.

Next slide, please. So some of the monthly reporting that we do comes straight off of our electronic health record called SmartCare. SmartCare is a cloud-based platform designed for behavioral health and human services. And then we have staff securely access documents and share patients. It streamlines clinical, administrative, and billing tasks from a single system, helping teams to build new care and maintain compliance efficiency. We use this dashboard shown and others like it to help us track how well we're performing and make sure we meet the numerous requirements that apply to us. This dashboard was created by an organization called CalMesa. The dashboard allows us to filter out data in various ways to look at smart care timely access data. using different levels of detail. Time of access to California means you have the right to behavioral health, to get behavioral health care like therapy or psychiatric health in a set number of days, and you're not left waiting too long in need of support. These rules help make sure care is available quickly enough to address your mental health needs before they get worse. Next slide, please. Users can turn on and off different subsets of the data using filters, also called slicers. which allows us to focus on some aspects of the data. This picture is showing the data in different time periods than the last one. It allows us to see better detail and focus on the numbers better. And we can also split it by other categories, such as hologram, but many of them . Next slide, please. Here's a final dashboard from a different part of the same Compass website that shows patient demographics in the context of services performed at the area. We'll now pass the presentation back to Amy so she can work with us.

Right, next slide. So that's just some of the most of it is either still under development or brand new. So we're still trying to navigate it and get exposed to it and work with it. But where are we heading? That's sort of next. QI has become more strategic and not just regulatory. QI helps guide system improvement aligned with the CAHPS Initiative, Skylane, EHConnect, VHSA, and some other statewide expectations. QI is increasingly data-driven in real time. Medi-Cal Connect, Conquistis, the VUGR, and other reporting cycles provide the data needed for quicker and more informed decisions. QI is the engine for account building community improvement, and it ties all the data systems together to show progress identify gaps and improve outcomes for the community. The next slide, please. So in final, this is the future. So as I said before, we have been hit with these initiatives. We're in various points of their implementation and development, but still more change is coming. So you're going to hear some of what we've already stated because we're still in development and some new things. So what continues to be developed and is upcoming is service expansion. So this is, counties will soon be having expanded alternative supports like respite and peer services. This will mean new workflows tracking as we prepare for a January 1st, 2027 launch. These are services that we may provide and have provided, but we haven't had to do the data elements to it. So now we're having to do a whole bunch of recoding in our system. Again, new workflows will be developed, policies and procedures. A lot of steps will go into this implementation in a very short period of time. Again, I'll go over the voter, the transparency and outcome reporting because state reporting is increasing with long-term move towards public dashboards. Counties will need to provide more detailed outcomes and disparity data. Payment reform, CalAIM was paying them reform and we've been in process. So the next step is full implementation. So the fee-for-service model will require stronger documentation and accurate encounters and more data-driven topics. Growing Medi-Cal Connect requirements and more reporting will shift into Medi-Cal Connect. Back just this last week, the state was talking about not only new things coming in, but some of the stuff that they've already implemented since October, needing corrections. So they're finding gaps in their own data analysis and making changes which affects us. on you know what measures we've seen already what we were trying to make change to being readjusted over time so this will um as it gets better we'll tighten validation we'll have tighter validation rules and additional performance indicators fetus aligned performance measures counties will see more focus on effectiveness and we can keep saying that follow-up after crisis engagement and youth access with expectations to show improvement The Prop 1, VHSA modernization new rules emphasize tracking high-acuity clients for meetings across crisis, housing, treatment, and clear outcome reporting for state requirements. Workforce reporting. We don't do a lot of workforce reporting with the state, so this is going to be new. They're going to expect us to provide more data than we have around staffing, vacancies, along with workforce planning, type of service needs. They know we've reported some things verbally in meetings, but this is going to be more official, documented data so that they can see it as we can with other dashboards. Crisis system transformation. With the federal 988 changes, counties will need stronger mobile crisis response, stabilization services, and more crisis-related reporting. And then the last area in the future is equity and disparities reporting. and to continue to expand demographic and outcomes by population reporting with expectations to demonstrate reductions in disparity. With that, that is the end of our presentation on the changes that have been happening and what to expect from the future. And does anyone have any questions for us? Yes. I'm sorry.

I guess I'm being offered a first. Do you guys have? Do you guys have any plans to get more staff for your team, specifically? Because there's a lot of data, and how do you guys fit this in your brain?

It was to say that's why I'm sort of reading the presentation instead of giving one that I would not read, because I just need to get it down and go to the next thing, because there is so much we need to be working on. we aren't meeting everything because we don't have enough staffing. I can say in the last year since I've been here, I have not successfully hired anyone yet. So we had only four vacancies when I first started, now we have five and I'm still waiting on hiring.

I mean, this is a lot of data and we're building data centers, so.

I'm not to say that I'm not using some AI to help out with some writing and some things.

It's got to be done.

It's got to be done.

Yeah, I don't love it, but.

We need a neuro.

I am curious about the, you mentioned the federal 98 requirements changing, and I am not that familiar with what that entails and the level of crisis component of that. Did you say a little bit more about that or somebody here?

I actually don't have a lot of information on that because I was compiling. I too was like, oh, I'm going to have to look into that a little more.

I think it's referencing the changes related to MC Mobile Crisis Benefit, which they're now, because they've proposed potential changes to MCB, one of the solutions is linking it to 988 so that those calls go through there and then some of that funding can be associated with that. But that's still being worked out. That hasn't been entirely formalized, and there could be some problems with that, but that's part of what the 988 transition or changes would include. So part of the idea would be someone calls 988 and begins that they're in crisis, and we go to them, basically? That through 988, the MCB teams get dispatched, and it makes it a little tricky because part of what they've talked about is shifting funding for mobile crisis benefit only if you can track from 988, only if you can track the calls coming through there. And we know that that's not the only way that we can call. So anyway, there's some elements to work out, but yeah, that's like high level looking at 988 being the number to call to get mobile crisis benefits as much. So not 911 or local calls? Well, I mean, we go through that too, but just if we wanted to use the 988 funding that goes with that, then it would go through that number. Interesting.

Yes. So I have a question about a lot of this data seems to come from the provider inputs. What are the measures of getting data from the actual clients and services? Are there avenues for feedback from them? And is that ?

I'm not quite sure. I didn't receive any questions.

There are mechanisms that we have for client-patient feedback.

CPS survey.

I was going to say, we have something that's run annually. It's not in SMART. No, it's not in SMART.

It's a part of our work. That's where I was missing. Yeah.

Yes. Yeah. So we have the client perception survey. And then on that, as we said, there's the treatment perception survey, which is an annual that provides data. that we distribute to our partners and we review internally. There's also our, you know, client satisfaction forms and other things that we do internally to gather that feedback. It's not directly through the EHR, but we collect that.

And, like, do we do any, like, community needs assessments, like, as part of that, how that all folds in? I see, like, how easy it is to pull data from, like, the smart persistence. Like, I can't imagine then, like, getting data outside of that.

So the public health does a community health assessment and which includes, you know, getting there for that. Yeah, that's where we, you know, partner with them and get data that gets included. Okay, cool.

And also, for instance, We mentioned that medical connect and some of these new portals and dashboards that we didn't have the state is now aggregating that data. in places where we can kind of go and we can see, hey, we can look at our clients in different ways that we didn't have before. And let's see, okay, maybe there's a barrier for this age population for this type of service. That data is really new to us. So it's figuring out how we can build that into workflow and evaluate it and then use it to try to improve. There's a lot of new things out there that are helping us do that.

Like the Compass things that we showed, we've only been looking at this for two months. So that's how new it is and how fast it's all going down. Cool. You're doing great.

So what I understand is that the field is scalable, that people, individuals at some point will be able to use the information that is available to everybody else to see how they compare in their community.

They are actually like on Medi-Cal Connect, we can already compare with other counties of the same or similar size of those measurements that they've imposed put in there so far. So there are those mechanisms. I've seen it on other websites. I think back to the question somebody had earlier about access to the community to data. There are plenty of DHCS websites that have elements. These ones that we're showing are the ones we directly have access to because what happens is you get into PHI to at some point and we can't give the community access to those, you know, individual level data points. So for us to affect change, we need that information, whereas the community only needs the aggregate. So they're on other sites.

Oh, I'm sorry. You mentioned a little bit earlier that you were measuring performance per county based on benchmarks. But if this is all new, where are the benchmarks coming from and who and where did, How are they decided? Or, you know, is this like a federal benchmark? Which is kind of strange because there's no real program like Medi-Cal anywhere else. Right, right.

Well, there is. Medi-Cal is called Medicaid in other states. So it's the same program. Then California takes it and likes to scoop it up, you know, its own race. So, yeah.

So there are federal benchmarks?

No, not for these. There are in the HEDIS, the HEDIS ones. There are federal benchmarks. But the state of California is also giving us the HEDIS measures as well. And so they're adding their components to it and setting benchmarks and evaluating us on it. I will say that even last week in the call when they were saying, well, my year 24 was going to be our benchmark year, but you guys, it was a do not report year. So now we're looking at 2025. So again, they're still trying to really establish the foundation and causing us to just keep reestablishing what's next and changes.

And that started in 2023 with what they called Measurement Year 2023. For years, the state had a hard time comparing counties to counties because it really was apples to oranges because our services and counties are very different. But they started with Measurement Year 2023 and establishing standards and then holding us each all of the counties to those. And that's what started the benchmarks. So now measurement year 2024 is based off of benchmarks from that. And that's all we're really adapting and being counties where we don't necessarily adapt as quickly as the private sector does adapting to how quickly we have to start measuring new data that we weren't doing before. And keeping to those goals at the same time, Is that it's a huge administrative burden, but it's not what our direct service staff or you know they're serving clients so it's it's on an administrative level of overload for the data component of this.

So let me just ask overall, how do you think our counties to or can you say one thing that but.

We're super awesome in this. I don't know all the measures. There's no way to know all the measures. So I don't overall tell you specifically how well we're doing or comparatively. But what I can say is what I have reviewed recently and getting a lot of aha moments is some of the heatest ones, which we have about four to seven that we're being measured on. And we're getting, again, we're doing this roving change every week, it seems. But we have the HEDIS measures coming out straight out of SmartCare. CalMASE is giving us what they have put together with their methodology. We've got one from our EQRO vendor, HSTAG. And then we've got what the state of California has given us from DHCS. I haven't been able to compare all three of them, but when I've looked at a couple of them, for the most part, with like FOOM, which is follow-up after medical care, I think, and then FUA follow-up after hospitalization. We're actually doing pretty good on those currently. So that's from the my 25 measurement year 2025 that we just got that report from. So we are doing, there's obviously some areas where we need to do some work, like mostly I think that's in the SUD realm, which I think is a struggle across the board for every county at every state. SUD is a very complex program. So those are areas we need improvement. And our numbers are super small. So one client can change and offset the whole measurement, you know, for any measure. For one situation, you know, that extra thing that happens that triggers something that results in whatnot, it can completely make our measures go sideways. Some of them have a lot of numbers in them, but they're most, some of them have very small numbers as well. In fact, one of the measurements, I just heard the state say again, or state this from the same meeting last week, that the numbers, if they're less than 30 in the count, they are going to hold us to that. And I do know one of the measures that I was looking at earlier this week had less than 30. I think we're still doing okay, but it was still less than 30. So we wouldn't be held to kind of say fines, penalties, or sanctions because of that.

So I heard we're doing well in follow-up after hospitalization, right? And what was follow-up?

There's like two components. One is like when you go to the ER, there's a follow-up, and we're doing good there. And the other one's the follow-up after that M&MD visit. So that one, I think Ross is still doing well. We've been spending a lot of time on the ED one, so I have that one really well-ground in my head.

You're the ones that are showing up on page 15, I think.

I was going to say, if you look at page 15, those are there.

I mean, it's hard to interpret what they're saying, but yeah, you can explain that.

I am, but this raises questions around, so is there a need to push more for using numbers of clients rather than percentages for small companies? And is that area that's like a meaningful area for reform? Or is it kind of too soon to say because you're aligning some of these systems under new guidelines, that kind of thing?

I think we've tried to do a comparative analysis if you need to stick with the percentages. If you're trying to actually affect change, we need to know the number. We need to say, who are those people in the ER that we need to follow up on? So which is what some of the work we've done in our performance improvement projects is to have connections with the hospitals. They're giving us a list which is very forward because for years we've struggled with sharing information, even though HIPAA says with the treating relationship you can share, they still, nobody wants to share because everyone's risk averse and don't want to be the people in trouble. So, but we've made a lot of good partnerships and communications and we're getting the information. So I think numbers are important when you really want to do the deep dive I don't know how that sort of lays out with legislation and changes for that. I know it does when you have big numbers and you want something done, but I don't know about the small numbers. Thanks.

A quick question. I'm a little biased about Humboldt County. I think Humboldt County is great. And I would think that a lot of nonprofits are cooperating. They're very involved with the CalAIM, the 998, and things like that. What mechanisms are there for nonprofits to help with that information process, that data besides doing the reports and things like that? Are there committees and things like that, or we're not there yet?

Well, we're looking a lot at our own data, so I'm not really connected to our nonprofits.

It depends on the hospital providing information. They're nonprofits.

That's true. We have meetings with them.

Yeah, I think another element that I would say too is part of these initiatives are also integrating some data exchange with other parts of the county, right? Like public health was an example. So part of like the chip and chop process, it's going to be integrated in some capacity within the integrated plan at some point. So if you're doing like engagement with public health as an example, chances are some of that input and feedback will trickle down to our planning process as well. Same with that data exchange.

And to what Amy was saying earlier, a lot of this is spurring conversation and increasing health information exchange. More people are getting into health information exchanges, which is allowing us to have access to the data at a level we didn't have in the past. Because the state is now saying, here's your Humboldt County behavioral health and then the managed care plans. And we want you to play nice and we want you to share your information.

That is definitely a heavy lift.

Any other questions? I don't know. There's a lot of letters in my brain and a lot of soup in there. There's a little recipe book. I mean, I probably have other questions if it's okay to ask. Absolutely. Thank you so, so much. Really well done. And we appreciate all the work you do. Yeah. Yeah. Thank you. Well,

With that, we... Do you guys mind if we hop out so we can get back to some of that?

Yes.

I'll go ahead and stop the screen share if that's okay. Absolutely. Thank you all for your time.

Thank you. At this moment, we have a quorum. So I would like to bring back the action items of approving minutes from SIPs 18 and SIPs 25. Anybody want to make a motion? I'll second. All right. All in favor of approving all those minutes? Aye. Opposed? All right. There we go. We got that done. There's no other option, I'm sorry. You're just here to approve. Yes, I know. Thank you so much for that.

I only want you here for your vote.

Sorry, I'm sassy today.

All right. So now we will go to communications before you leave. Supervisor Arroyo, do you have any communications? I'm sorry, this is very anticlimactic. I do have to depart early, I'm sorry. This is the time when board members can communicate roughly well.

I don't have, well, I guess I wanted Austin to kind of announce, is that okay? Sure.

uh yeah patrick's foundation is uh still on course for our sobering center and the 3.2 social model detox uh we're looking for properties currently and um we're working on getting the licensure figured out as we speak so we believe we've staffed up appropriately we're just kind of uh getting a lot of fine-tuning done before we're making that final step there and we also will be one of the sponsors for international overdose where to stay very funny crazy it works

So at this time, just so Eddie saw and Alan know we didn't get on the board of suits agenda, but August 10 is what I hear so

I think it might be August 11th.

And it should be on the consent calendar.

So, I mean, if you want to come, you're welcome to, but it's hard to imagine that it will not pass. It would be shocking.

What I'm saying is you don't need to be there, although if you want to, of course you're welcome.

Thanks. I'll listen to you. Jeff, do you have any bullshit shot in front of us at this time of day?

Yes. Yeah, give me just a second to pull up the flyer. Oh, I believe that Joe already sent it out to everybody, but the wellness day barbecue that's going to be happening from HHAC at Sequoia Park. Make sure you get over there. We got some good chefs. And other than that, the pop-up photography event was a really big success. We had lots of people coming in and out of that. And yeah, that's pretty much all that I have for now.

Sean I know you have something.

I don't really have anything except for I wanted to.

just kind of check back in with Jess about any HCTC response to the recommendations conversation we had last month, not to put you on the spot.

Well, I guess it's my time to be honest. Not yet, because I haven't, I was busy during our last meeting, but I'll make it up to myself on

I just wanted you to know that at the, or everybody to know, at the last executive committee meeting, we agreed that we just want to revisit continuously like every six months or so. So we'll, we want, and also not just for transitioning students, we want to hear feedback about how this board is accessible and inclusive to all the folks in our community. And so please, you know, keep that in mind when you, come to these meetings that we want to hear from folks about how to improve our accessibility for folks.

All right. What I have is CIT. My gosh. CIT will be October 22nd to 26th. October 22nd?

Yes. The training on the contract.

The 40-hour training.

I was trying to do all of it over time, just catch little bits.

And it's going to change. October what? October 22nd through the 26th, it's a 40-hour training for law enforcement and social workers. Are you talking Thursday through a Monday?

Thursday through a Monday.

October?

Or a Monday through a Thursday. All right, y'all.

26th. I need 26th.

Okay. 26th. 26th through 30th. Ooh, Halloween.

31st is Halloween. It's a whole week. And then also just wanted to let you all know that the Eureka Police Department and the Crisis Alternative Response of Eureka mental health team And DHHS are going out to Upa to present on SB 43 51 50s, the escalation stuff. And so that's becoming quite a nice partnership. We've been interacting with Upa Valley Tribal and now out there. So it's been very nice to share that. What about the CIT International Conference? Oh, the CIT International Conference is in August. I don't know when. The second one, Monday, Tuesday, Wednesday, which is in Orlando, Florida, which is kind of a place to be in August.

Yes.

What's next to Miami? Fort Lauderdale, one time. I'm excited to go. Not that far. Well, and that was a Canadian version. I saw that. I know. Canada has their CIT together. I thought they did. Yeah. Anyway. Yes, thank you, Kelly. How many people are going? What kind of agencies are represented? Seven people are going. Public defender, someone from the district attorney's office. Arcata, Grossman's going. No supervisors are going. Hang on. Sorry. I know. I'm just nosy more than anything. Well, I'm happy to fill you in and everyone else who's coming in as soon as I can remember who they are. Don't do that again. Yes, different agencies are gone. Coming back to report to you.

It's just the CIT International Conference is such a good opportunity to learn what's happening in other places across the country and outside of the country around crisis intervention. And our county has always done a very good job at like, bringing folks from all the different agencies. And it's a great opportunity for them to network and build better collaborative relationships. So it's biased, obviously, but it's a it's a great thing.

So good job. All right, I'll go to reports. Hey, grandpa.

We're continuing to move forward with a new administrator for the TMCOES, which is good. Just regular meetings with Cal Mesa, Fiders, THCS, County. So we're kind of in the phase where Cal Mesa is working with the HCS on mobile. piece the key structure and working really hard to create something that's reasonable and sustainable so that's good um we let's see what else we had um oliver who was here and left went out tuesday to the groundbreaking for the york health and wellness center which is should be amazing um I'm excited about that and just happy that our community, Humboldt County, is really building out our care in so many ways. We are waiting to hear back on a community reinvestment application to DHCS. I think I talked about this here a little bit previously, but Partnership Health in collaboration with Public Health and Behavioral Health has community reinvestment funds that public health and behavioral health need to come to an agreement on in terms of how we recommend investing that in our community. And one of the ways that we talked about here in Humboldt County was using some of those funds for DMCODS for supporting the contract with CalMESA so that we can, you know, make sure that we have resources available for that. We're waiting, like I said, we're waiting to hear back from DHCS on that proposal. So certainly update this group. And then I guess the other thing I'll mention is BHS OAC, which is Behavioral Health Services Oversight and Accountability Commission reached out and asked if they could come visit. So that's great and, you know, a little stressful. So we've talked internally about creating an opportunity for them to come, see how things are going. In Humboldt County, they would certainly talk about some of the BHS transition and maybe would have conversations with some of our community partners and other local groups. So possibly behavioral health would be a group that can share. So you know why? Well, no, they just said they wanted to, they gave it as an option. And I didn't really feel like I should say no.

They are offering to come and see how things are going and help us gather information.

So it I mean, it sounds

I mean, have you seen Humble? I mean, it makes sense.

Yeah, exactly. So anyway, I'll keep you guys posted on that. We're just, Oliver and I and the deputies have been talking about how we could actually make it a meaningful visit, like what are the things we might want to talk about or get put on and who might we want to connect them with. So we're kind of organizing around that and thinking about dates.

Are there still any funds coming from them for like crisis triage or anything like that?

I mean, the innovation? No. The crisis. No, this is, no.

I think all of them, right?

This does, okay, exactly.

I was just curious because we had, we would go to those meetings and stuff with them regularly, but they were, I mean, they were always really, they have been helpful. Yeah. Yes, that's true. That's right. I just was curious.

Thank you. Jeremy?

Do you have that? Yeah, in the children's world, things don't slow down all summer like they used to. A lot of contracts right now, anytime a youth gets placed in a short-term residential facility, what used to be called group homes, that requires new contracts with those facilities. We're trying to get new contracts in place for some additional providers. And so just there's a lot of activity on contracting. certifying our sites, our Homoplaza site, Fortune site, those that are all going through medical recertification. That's a lot of work that are going into those things. All the initiatives that Amy talked about in the CalAIM world, we're working with probation as far as solidifying an MOU that outlines a lot of the new requirements around pre-release services and making sure that by that youth that are getting ready to be discharged from the facility are set up with services prior to being released and then looking at all the screening and assessment tools and finalizing that information so that's part of the colleague project um under bh connect what amy mentioned a lot of the evidence practices that are now required so what are functional family therapy and parent-child interaction therapy. We're identifying staff to be trained and moving closer to setting up the trainings for staff. And then once we get the staff trained, then we'll be able to roll those specific evidence-based practices out to offer those services. And then MSD, multisystemic therapy, is a more challenging one because it requires some learning course efforts. that service. So lots of work on the BH Connect stuff, under BHSA, which Amy also talked about, the high fidelity wraparound is kind of the other really big state initiative right now. And so there's a ton of work, both with Neighbor Health and Child Welfare because Child Welfare has the mandate to offer wraparound behavioral health has requirements to offer wraparound to our full service partnership, high level youth. So we're trying to organize all of these wraparound efforts. So it's essentially one wraparound system, one process. So there's a lot of moving parts right now and the state has not finalized a bunch of the guidance that we've been on. So right now it's a lot of wraparound meetings that are happening, but we're getting closer where we have two providers in the county that both been certified by the state to be high fidelity wraparound providers and so that's really in many ways we're ahead of other counties because we have providers we're just kind of waiting on the state for a lot of things to finalize things and really be able to pull out the services so lots of things going on right now in children's

Who are the providers?

So Redwood Community Services, they already are doing RAPID specifically for child welfare youth. And so we'll be updating their contract and some of the behavioral health portion to that. And then Humboldt NeuroHealth will be a new provider. So between the two of them, we'll have the passages for both child welfare

Thanks.

What have you got for us?

Hi. Good afternoon, everyone. Sorry, I couldn't make it in person, but nice to see everyone. Probably not a lot on the adult side. You know, we definitely are in the recruitment and hiring phase for some clinicians. And we've got some interviews coming up. And that's good for us. But we remain pretty busy. We've been working on this transitional rent with the home program. Uh, that's a new partnership benefit that, uh, theoretically you're supposed to, you know, allow for a portion of rent to be paid by, uh, the partnership health plan. And so we're kind of working on that. The kinks for that, but, um, that's probably the latest initiative that I could recall here. Um, Oh yeah. On my updates.

Thanks. I just want to, I'm going to just pop it in here, Jack, since you just spoke, but at the executive committee, we had a wonderful commendation testimonial from a man whose Jack had helped his family member. And it was wonderful to hear that. And, you know, it's a private matter, but good job, Jack. It's heartwarming to hear how you helped. And that's pretty cool. that the deputy director is doing that kind of work.

So good job, Jack.

You're awesome.

Yeah, I'm out in the field.

I know.

Helping the community. It's good stuff. Yeah.

Awesome. All right. Next. SUD committee.

SUD committee. So the last SUD meeting that we've had, we invited, Danette invited the Good News Rescue Mission to come and do a presentation. They are one of several new businesses that have come into our community specifically for ECM services. And so we pretty much wanted to know, you know, more about them, quite frankly. A little concerning, they are coming into encampments and other places where most of our folks that we serve congregate. I think maybe offering them some kind of monetary compensation, like a gift card, signing them up. And so we just want to make sure that they are being held accountable, quite frankly. It's my experience and a few other Navigators that when we are doing some kind of screenings, about a big percentage of the folks you know, we'll find out they are signed up for services and they have no idea. They don't remember signing anything. They don't remember having a conversation. So it's a little concerning, you know, for kind of like messes up, you know, some of the services that some of us, you know, us folks that are actually kind of, that are here actually doing services, you know, in our community, you know, when we have someone that's already signed up, it's a conflict and, you know, It just makes it very difficult for these people to get services. So we want to kind of, you know, more like more of an accountability group. So Jeanette is working on that. She'll have more to report next meeting. She is going to be, I guess, scheduling other of these groups. So the next, is there going to be an August STD meeting? No. Okay, so that would be the, in September. So that's the second Thursday, 30th and 33rd, right? Yes, yeah. And so, yeah, we will know more about that. Laura and Kim Bergell joined the meeting and they had some questions. I had some specific questions about capacity that I'm still unclear about. So we did contact the administration of that and we are gonna get some answers, Laura, and we're going to proceed with the meeting, I guess.

Yeah, we met with the person who's the director here locally and our chief of police on seven. We're meeting next Thursday with their CEO. Perfect. And so, yes, we have many questions.

Yes, awesome. So more will be revealed with that. And let's see. So, yes, we are also... going to be, so 811 at 9087th Street is the next SCDMAT collaborative meeting where all providers, SCDMAT folks are encouraged to come. Beth Jansen and Melissa Nelson and I are the facilitators. We're working on creating a pool of funds for folks that We have a lot of folks that are just resistant to going to rehab because they have animals. A lot of them are houseless. Some of them aren't houseless. They just don't have anywhere to put their house or animals. So we're working on a proposal to Myrtle Avenue for boarding services and coordination of care, getting the animals their required shots so that they can. There are some rehabs that are going to allow the animal to go with the patient once they complete the detox. process but the animals need to have their shots they need to have they just need specific things and so we're working on that for folks that aren't able to do that we're also working on an emergency fund for medications um i'm having a difficult time um finding funding for people that don't have money for medications and there's like either they're not from this area, they don't have insurance. Before I was able to just have a hospital fund that, I don't have access to that anymore. And I'm getting shot down when I try to reach out to the hospital. So we're trying to figure out how the hospital can help with that. So we have reached out to um joy victorine and martha shanahan to see if that service can still happen because we we are now experiencing folks and melissa nelson and i are trying to put our heads together to figure out how people can get first the box zone because the alternative is not having it and then them being hospitalized yes exactly so over utilizing the emergency room or sometimes i'm not even going to the emergency room them saying forget it i'm just going to go out there we don't want that to happen so um That's what we're working on. And Recovery Happens is scheduled for September 19th, I believe. Right, Melissa? Okay.

She has her hand up.

Okay, yeah. And International Overdose Awareness Day is August 31st. However, that falls on a Monday. So a lot of places are having the actual event on Saturday the 29th. Humble is having that actual event at the Adorni, I'm sorry, not the Adorni Center, the Gazebo from 12 to 5. And so, yes, there's going to be, I think, I don't know, we're up to, I think, 15 vendors and tables that are going to be there. We have speakers. Kate Ruggel is going to be giving her mayoral proclamation. Hatcher and Patrick's Foundation are going to be sponsors along with Crossroads and Aegis. and Redwood Recovery Center. So it's gonna be an elaboration. So hopefully everybody can attend that. And then there is October 14th through the 18th, the annual CAC, California Convention on Esthetic Consortium is gonna be in Universal City. And we'll have more information on that. A group of us like to go every year. I think that is it. Yeah, that's it for me. Melissa, do you have something to add?

I might have something to add.

Thank you so much. I was typing away and I was not doing a good job putting it in text. Okay, so in regards to medication cost, If there is an individual who is not eligible for Medi-Cal and does have an out-of-pocket cost for their medications and treatment, for their MAT treatment, and if they are seeking buprenorphine treatment or methadone treatment, we do have the state opioid response grant still at AGES. that can cover the cost of treatment, but it is month to month until funds are exhausted. So it's not a long-term solution at all, but it is something that can help temporarily in regards to medication costs. The tricky thing with that, with Bupe especially, is that we require daily medicating. for patients that are new to our program. So it's just not a realistic option for some if they're not able to come to our clinic daily in the beginning before establishing stability and treatment. But again, if cost is a factor, we do still have those grant funds until they're exhausted. And we have the grant until September of 2027, but we are trying to use those funds now. So, yeah, you can reach out. I'm going to put my number in the chat if you have someone that has questions about that or is needing grant assistance for treatment costs, please reach out.

Thank you. Thank you, Melissa.

All righty. Adult holder, adult committee update. We did have a meeting. Mark Elliott was going to join, but then he had to do, somebody had called out, so he had to take the phone. a different role. We have another, I can't remember if we have another meeting, but that's slow in ramping up. However, it will be. As far as other committees, legislative ad hoc has a meeting on the 27th. Nancy Stark, thank you for sending out that invite and

the minutes from your last meeting because there's there's a lot in that world and i know vernon wanted to be here today he's not do you have anything to say about that ad hoc no just that we might delay the meeting on monday uh due to marguerite's knee so we may be delaying the meeting just a little bit but that's okay because the behavioral health board is dark in august so we have time yeah awesome thanks for that work that you do in there

And then Peter's not here, but we do have some people ready to go, just being one of them that Peter stole for the Children and Family Committee. And we are waiting for September. Maybe we'll have a secretary. Yeah.

Okay. So that's kind of so... All right.

Do you have anything, Vice Chair?

I just wanted to... thinking back on the other committees in that we we had our behavioral health board retreat a while back that we talked about how everybody is going to join a committee and so we were kind of waiting for our new members to become official members to like figure that out so i know there's a couple other people that might be interested in bringing the children children and families committee or belts or I also have space on the membership committee possibly I know supervisor Royals interest, so I think we can revisit that maybe. So fine those number yeah yeah so I just wanted to put that out there, so if you're. going to be a new member, or if you're already a member and aren't on a committee, we'll be figuring that out. So think about, so the mandated committees are the SUD, the adult, older adult, the children and families, and the membership committee and the executive committee. So think about what committees you might be most interested in.

Thank you very much. Thank you.

Okay, so I just got the data notebook, 2026 for Californians, where all behavioral health boards, they have a subject every time. It was SUD last time. This time it's foster youth and behavioral health and social services. It's 25 questions. Last year, I don't know why, if it's just that I'm more into, like more aware of SUD stuff, it was easy. These questions are super hard. So I will be reaching out to Peter, Jess, and Jeremy to help answer some of these. Just a little teaser. Who provides the Child and Adolescent Needs and Strengths Assessment for Foster Care Use in our county? That's CANDS. Okay, great. So there we go.

What is that?

Well, then you just answer these.

Yeah.

And then how is your county planning to provide high fidelity wraparound services?

I know a lot of planning.

Well, I like that it says that are required starting July 1st and giving you all a little taste of a few of the questions. Yes, but that is due October 12th. And that will be submitted early. I just, it's one of those things where in the past they were never submitted on time. And last time I got it in on time and the time before that I was late, but yes, super excited about that.

And one more quick little thing on advice.

uh melissa nelson put her number in the chat for grant funds available for streaming costs um so if anybody would like it get your pen ready 707-572-7586 thank you melissa thank you melissa all right i'm monitoring the chat yeah i keep freaking out because i look at saul and i'm like no his eyes

unfinished business, nav center. I don't think there's anything new. Crisis triage. From what I heard in the homeless leadership work group, everything is progressing with those. And then care court, we're still killing it. If I get out of here on time, I might go see if I can pop in because I've been invited. I think is anybody have any future items? Seeing here, none. I will. No meeting next time. That is correct. I will adjourn this meeting. Thank you all at 1341. Thank you all. Thank you all.

We're going to have a full floor next September. We'll meet in the back.