Community Services - Regular Meeting

They go, the team can pop in there and it gives them little tidbits and little videos that they can look at to help them navigate. And then at the end of that, it gives them additional resources. So we want to make sure that that is out there because, you know, that 13 to 18 year age, which, you know, I think we can all agree is a very difficult time in our lives. It's been a while since I've been there, but nonetheless, It hasn't changed. That's a very difficult time, especially for kids that might not feel like they belong to a group or have that ability to talk to someone. If they're going to use an app, I would rather that they use something that's been vetted. And these actually have evidence-based practices associated with them, which means that they've been tried, tested, and fixed. It's not chat GPT. It's not Dr. Google. This is an actual thing that's related to science. And we're going to be rolling this out across the state. And so far, what we've seen is really good results from this because we're meeting teens where they're at, when they want it. And we're making sure that if it's a crisis, that they know that there's resources available to them. The app is free. The crisis resources are free. We need to kind of get the word out. Right now, it's available on their website. It's awaiting release onto the Apple Store and the Google Play Store. I have an Apple, so I don't know what it's called on Google. Forgive me. But we're going to make sure that it's available. It's Google Play. That's it. All right. Probably have that in my notes, but who reads those things? But the biggest thing that we see is that there continues to be this disconnect. So some of the other things that we're working on is we've launched what's known as CCBHCs, which are Certified Community Behavioral Health Clinics. And if you're familiar with an FQHC, which is the physical health side version of this, which is a federally qualified health clinic, a CCBHC doesn't turn anyone away. They have to meet very rigorous standards in nine categories, which is that they, and I'm not going to go over all nine because we're short on time, but some of the things that they do is they have to treat the entire lifespan so they can do family services. They also treat, have to have services for veterans. They have to have services for treatment and make sure that some of those things are available. But one thing that they also have to do is they have to have a mobile crisis team. Now, the CCBHC that's closest to Los Alamos is actually located in Espanola. Okay. And that's run by Presbyterian Medical Services. But those crisis services are available 24-7. And when someone calls 988, they will then triage them. And if they need to send out a mobile crisis team, they will. which is staffed by behavioral health professionals. Why that's important is because we know that when we engage law enforcement or EMS, sometimes they don't end up in the right spot. And we know that our law enforcement, number one, are overworked and overtaxed. But more importantly, they don't get a lot of training in behavioral health. So having someone respond that's trained, whether that's as a social worker, a peer support worker, They can be clinicians. Helps deescalate the situation and get them to the right resource, which usually is not an emergency room where they'll get stuck in a hallway and hopefully they get seen soon, but there's no guarantee on that. So those are some of what crisis services are. I did want to kind of also just mention a couple of other things. You know, we've reached out before, and I'm always happy to have this conversation. We offer a lot of free programs that we have offered to Los Alamos, and I would want to extend the offer again. For example, the PACS Good Behavior trainings for kids. It's to train students as to how they can kind of engage and teach kids the right way to cope with situations. We have something known as the Yellow Ribbon Campaign. where we train adults that if a kid comes to them and they hand them their yellow card, that kid is then put into a safe space while someone then goes and assesses them. But the use of the yellow card is to try and make it as non-judgmental of having to ask for something, to raise your hand, use secret code words and we've had very good success across the state the other thing and I you know I want to note is that we've offered mental health first aid training for the school district for free we're willing to do that all of those programs I just mentioned right now are free to train staff and if you feel that there's others that are in contact with kids after school sports programs forth we are I will pay for it not personally but the state will pay for it I don't know if I mentioned that cracked windshield on my Subaru so these are resources that are available to you all and I offer them up again how can we do that the other thing I want to just note because it's been in the news quite a bit is the overdose rates in New Mexico. And I'm not going to spend a lot of time on this because I want to leave questions for you all. But we offer free naloxone. You can also pick it up at the public health office on Trinity, right across from the school, by the way. All you have to do is just give them your zip code because we need to have that tracking number to report back to the feds. That's it. We don't ask for an ID, no thumbprints. It's free. It's available. We also have folks that can train groups. The training is real simple. It's very simple. Depending on where you go, our training is 15 minutes long. That's it. And then you can ask as many questions as you want, and when you're done, We give you two kits to walk away with it. Each kit has two doses. If you feel that you don't need it, give it to a neighbor. Give it to somebody you think might need it. The instructions are on there, so if you forget, you can just follow along. It's really simple. In the past year and a half, per capita, we've had the lowest uptake of people wanting free Narcan and training. In the last year and a half, we have trained 107 people in the county of Los Alamos in a year and a half. In Rio Arriba, we've trained over 8,000 in the same timeframe. In Rio Arriba, we've given away free, I want to add, thousands of doses. In that same timeframe in Los Alamos, 617 doses. So what I'm asking you is how can we work together to break the stigma of asking for help because when kids have a behavioral health or mental health issue that goes untreated, frequently they're turning to areas to then hopefully take away the pain. But we all know that this is not taking away the pain. This is compounding the issue. I'm standing here asking you all, help me help you. You want free training, I'll give it to you all. You need Narcan, we'll get it to you. I've got trainers that are ready to go. They're on contract. It starts though with breaking the stigma. So I know I'm not the one that's supposed to do the challenging, but I'm going to give you another challenge. Take that stuff. And by the way, all of that stuff is on our website. You can download for free. Print it out yourself. You don't need me to do that. I'm happy to come up and get another coffee. I've got to stay car with gas. But the reality is that we've got plenty of this stuff that we're happy to share. So how can we get some of this to go across? And I'll leave you with just a couple of other numbers real quick. Okay. So when we look at like attempted suicide for youth, you know, 10th grade, 6.8% in Los Alamos County have said that they've thought about it or have attempted it. Now, again, this is self-reported. The state average, 8.4%. So it's not that far behind. I would rather we get to zero everywhere so that no child feels like they don't have a place to go and no parent ever has to think about what did I miss. With that, Madam Chair, I'll stand for questions from you.

Thank you, Mr. Bukas. We really appreciate all the information, and we appreciate your dedication. I have just a quick question, and then I'm going to turn it over to our health counselors to ask. The youth risk and resiliency report where you're quoting statistics, I think probably most all of us in the room are very familiar with that. Which year was that report? Do you know offhand? And if not, that's okay.

It's the most recent report, which I believe they're still working on 2025, so that would be 2024. Okay.

Fairly, okay. So 2024 is the end of the year. Thank you. Do I have questions from health counselors in the room? Okay. Counselor Rydell.

I think it's on.

Just pull it up closer and press the button.

So my question is around when we're having behavioral health issues that have to do with, like, you know, dependence on substances, and the person really is at a point where they need a bed. They need a place in an inpatient area. And I deal with it a lot with adults. I haven't seen what it is for the children, but I know how hard of a time we have finding available beds, where to take them. you know, it's an emergency level where it needs to happen now and it can't happen now. Where are the resources for kids? Are there beds available for them if they're reaching that point?

So, the closest here is Haven Behavioral Health in Espanola. I don't have their contact information off the top of my head. that that's something that is easily found. But they have youth services and they can kind of triage whether they need a day program or an actual bed inpatient stay. One thing that I would say also is in utilizing 988, they can kind of put you in touch with the closest and then work through the system as to where do we have available beds immediately. ONE THING THAT WE ARE WORKING ON AT THE STATE, AND WE'RE GOING TO BE RELEASING AN RFP, A REQUEST FOR PROPOSALS SHORTLY, IS AN IMPROVED CLOSED-LOOP REFERRAL SYSTEM AND HAVE BETTER REAL-TIME DATA FOR PROVIDERS TO KIND OF LOOK AND SAY, HERE'S WHERE I NEED TO GO. IT WILL LINK ALSO TO THE YESNM.GOV WEBSITE, SO IF YOU ARE you know, not a clinician and you're at home and you're like, I need a service, not necessarily a bed, you can go in by zip code and say this is the type of service I need. Perhaps it's counseling. Perhaps it's drug treatment. And you can hit those check boxes and they can tell you what's available based on the search radius that you put in.

Thank you. Any other health counselors in the room? Counselor Williams.

Thank you. My question is in regards to our LGBTQIA population, especially with the youth. What facilities do you know accommodate these folks, especially trans kids who need special personal items things like that, and how is that addressed?

Certainly. So I'll start by saying we're happy to share those resources with you. I don't know all of them off the top of my head. Forgive me. But we can make a note and we can get it over to Lisa and she can share with the committee and whoever else wants it. Thank you. Number one, for our 988 call centers, they must go through training for LGBTQI individuals. period, end of story, it's mandatory. That's in our contract. We made sure of that, that that population is not left unserved. The other part to answer that, so there are services I know that are available in Taos, in Santa Fe, and in Albuquerque. I think Albuquerque has some of the more available resources. than those other counties, but I don't want to swear to that. But, you know, one of the things that we really do try to work with our providers as they become enrolled with Medicaid, which then we oversee them, is we ask them how are they being culturally competent, not only for LGBTQI individuals, but also culturally competent or culturally aware for like our Native American populations and other cultures. So across the board, they're not sending folks away uninformed. Thank you.

Does anybody else? Councillor Granville?

It's on. Thank you. So my question has to do with housing, affordable housing. And how does that look in a community like ours where things are very expensive? And, you know, we want to incorporate transitional housing for folks that need that help. And, yeah, that's what I'd like to know.

Certainly. Good question. So at the health care authority in our division, behavioral health services division, We provide services for those folks that are currently in treatment or getting into treatment, as I mentioned, that are precariously unhoused or actually unhoused. And they go through a provider that identifies, you know, what those needs are and which programs they qualify for. So it might be what the program is called Fresh Start Rental Assistance. There's also another one called linkages. All told, we have about 75 different scopes of work that work on housing. And some of them seem like they might overlap, but I won't get into the bureaucracies behind that. The more important thing is that we try to identify which program they qualify for. So, like, for example, if they are in Fresh Start, we can pay up to nine months of rent. Or if they, depending on what the rent is, I forget the exact number, the total cap on that. We also give them some basic assistance for basic necessities like pots and pans. pillow for their bed or something like that if they need a crib for their kid the biggest problem that we face with these programs is that honestly we don't have enough units because we work with the landlords and so if we don't have landlords that are enrolling in the program we tend to run out of space The Department of Workforce Solutions just last legislative session did get a housing and homelessness office. And one of the things that they're looking at is across the board, housing affordability and how do we entice builders to do low-cost housing in all communities so that people aren't fighting for that one unit that might not meet their needs. So we're happy to kind of work with folks in developments and so forth to try and identify additional folks. I will say when we talk about, like, reversions and so forth, this is one of those programs we never send money back. And I will give props to our team that they work very hard. So if they know that one county is not going to use all of their vouchers, they reroute it to another county that is using it. And we have had very, very few reversions on that because we know that housing is a huge problem. So when we look at, like, linkages, fresh start, a lot of that might be tied to their participation in recovery. But it might also be other things that they're meeting, whether it's their income threshold. It might also include things like, you know, kids or that they've had – an eviction that in all likelihood was not their fault. It might have just been that somebody came and said, I'll give you double what you're getting in rent, and they boot somebody out. So we really try to work with the populations to see what program they fit into. But these are not really long-term programs. This is to kind of get them someplace where they can then have permanent homing. And it's one of the programs that I'm most proud of.

That's very exciting. Let me get the folks online, and then I can come back to you. And I did see that Counselor Han had a question. Are there any health counselors online that have questions? Okay. Counselor Williams, one more question, and then Counselor Han, do we have time for two? Sure. Mr. Bukas, thank you.

Really easy questions, though. I'm kidding.

Thank you. My one question was in relation to what you were just talking about, about with affordable housing and behavioral health, would domestic violence fall into that category or is there a different service that they can reach out to?

So the short answer is yes, and there are different categories. There are some things that are available as well through CYFD, but we do have some programs that do address that. Yes. Thank you.

Excellent. So we have our county council liaison online, Councillor Hand. Do you have a question for us?

Yes. Thank you, Chair. I am happy to be a part of the public discussion. you know, for my comments. So if you want to put it out to the public, then I, I'm happy to ask my question.

I think we'll just stick with, um, Mr. Lucas right now, but, um, go ahead and no, you're up. So ask your question.

Okay. All right. Um, so, um, I thank you very much for your presentation. I was wondering, because when you asked the question, what are we missing? The first thing that came to mind, and it may be just because I have lived here for so many decades, but it almost seemed like a rhetorical question to me because the reasons that I think it is popped into my head right away. And I was just wondering if you have ever had the opportunity to talk to the Department of Energy and the Security Clearance Program. Basically, they work with the FBI to investigate people and families and friends, et cetera, of anybody who wants to work for the laboratory.

So I'm going to be as politically correct as possible in saying this. That's a tough hurdle. There are different federal guidelines that dictate that. I know that there are services available at the lab. I will say that I have friends that work at the lab, and I know that it can be very difficult sometimes to be open about what services you might need. When we talk about it being a rhetorical question, I think that it's not really rhetorical. I think it's a matter of us actually having a discussion, that's the gap. If we're afraid to talk about what this is and engaging folks outside of their security clearance and those types of areas, I think we could have a very fruitful discussion with a path forward very quickly. I will say this, though. I'm sorry to cut you off, but I'll say this. The easiest way to start to change these numbers is let's get into the schools and do the mental health first aid training, which we'll pay for. You want to do the PACS good behavior to teach kids empathy? I will pay for. The yellow ribbon? I'll pay for. I will give you all the 988 stuff. The easiest way that we can start with prevention is to start with our kids. And it has to be a dedicated and a true commitment. So if a teacher leaves, we're training that next teacher that's coming in, and they're not taking all the institutional knowledge with them. So if I seem a little animated about that, forgive me. But this is really the easiest way that we can start to turn the tide is to teach kids empathy towards their colleagues and to ask for help. and that it's not a problem. And whether they're asking their coach, their teacher, their counselor, their parent, we can't assume that there's only going to be one person that they're going to talk to. So train them all.

Thank you, Mr. Bucas. I'm going to stop Councilor Hand and see. We have several people from the schools here in the room and just see if we have any questions at this point. Ms. Deal, would you like to come up to the podium and ask your question and introduce yourself too?

Thank you so much for your presentation. My name is Sylvia Diehl. I work in prevention for Los Alamos Public Schools. I just wanted to say thank you for your investment. We are bringing Tech's Good Behavior Game to the community tomorrow thanks to your funding. And we are hoping if funding becomes available to bring it to the teachers as well. There were still some funding questions there. So we are really thankful for that. My big question is I agree we have to work that everyone recognizes science. and reaches out, is there, and knows what to do if someone reaches out for them and says, I need help. Like, I'm struggling. What we see a lot is we have youth that actually struggle. They are released from the ER, and then they can't access health care, mental health care. So how could we get that behavioral health clinic up here in Los Alamos?

Thank you. That's a great question. I think one of the things is We need to kind of engage providers and, like, for example, at the medical center here and say, what can you help us support? Is it space? And that's why you're not coming here? Do you feel like there might be other barriers? We're always trying to get providers to look at places where they're not going and ask why. So it would be wonderful to have one of these CCBHCs in every county. I think the biggest thing is do they feel like it's going to be sustainable for them, and what's that hurdle to do that? So, for example, in Española, they know that they have a big population that they're going to be able to meet and need, and they kind of put it strategically so they can get folks coming from the north as well as the folks that are coming into surrounding areas. How do we kind of entice folks to say, here's what it is, here's the numbers? If these numbers are underreported, then they're going to say, there's not a population for me to be there. So from a business standpoint, they're just not going to be able to do that. It is still that they have to be able to pay salaries and rent and so forth. So I think that that's a really good question to engage with like the Chamber of Commerce and say, how do we kind of do this to make this attractive so that they can kind of do that? And how do we get these numbers to reflect what reality is? and not just that small population. So, I do apologize. I am going to have to run.

We appreciate your time. Thank you for coming up, and we will definitely get you up here again. Okay. Thank you so much, Mr. Bukas. Thank you for having me.

Thank you for the coffee.

Thank you, Catherine. Okay, moving along on the agenda here. We actually are ahead of schedule, which absolutely never happens in this meeting. So we're going to go ahead and do a staff report. So we have Jessica Strung, who is our staff liaison, and she's going to tell you a little bit about what's going on with staff. You can come up to the podium.

Hello and good afternoon. It's fascinating seeing the health counselors up here instead of sitting around our U-shaped table. I usually see the county councils up there. A couple of things. Evelyn wasn't able to make it, and I know we have her also on the agenda, so we're going to table. her report on what she has been working on. She has been our summer intern through the county's internship program. She's been at social services since June. And the good news is, well, I mean, while it's sad she isn't able to be here to present the project she was working on, we're able to keep her through the school year. So she'll be able to come to a future health council meeting and present her work. So We'll table that and have her in September or October, depending on what her schedule allows. A couple of things to highlight for the staff report. I know, clapping. Thank you, Crystal. We are so excited. We have, I'm going to have you wave, Eileen Bobadia here. She is the social services newest case coordinator. She started three weeks ago, give or take. I think she's in her third week. She comes to us from El Centro Medical Center in Española. She is trained in trauma-informed practices, SBIRT screening, brief intervention, and referral to treatment. She is trained as a community health worker. She is fluent in Spanish. We feel so, so lucky to have her join us at Social Services. So wanted to make sure to introduce her. She's already been thrown into several different cases and different things. Welcome to her. I saw Jamie Allback, our program specialist, is online. I know, Jamie, you had a question, but I did want to point out she is putting together, just to reference what Director Bukas was saying, putting together a series of trainings. She has been trained in the opioid overdose She's happy to give trainings on that for anybody who wants it if he or the head trainer isn't able to come up. Also able to get folks Narcan. We do maintain a map of where Narcan is available in the county, not just at the public health office, but we also have it at both libraries, both visitor centers, at the transportation, at the schools. because we have trained our prevention specialists who have gone out and trained others. So by all means, send me a note and I will get you connected. She is also working on what trainings will be coming out in this fall. September is Suicide Prevention Awareness. October is Mental Health Awareness Month. So more to come on once we get the logistics, rooms, and times right. for those jamie i'm not sure that's why you had your hand raised but i thought i would put a plug in for you otherwise um and also has been trained in um same as me with the nature and forest guided therapy um so i just love that that nick was here talking about like the spectrum of prevention and it aligns so much with what social services is doing what the schools are doing um I believe also what LRSO is doing, like we're all kind of aligned across these different initiatives. For future health council meetings, we will also have speakers on domestic violence and also addressing food insecurity in Los Alamos. That will take us kind of through the end of the year. And then in December, since we have a couple of new folks here, December we will be working on our annual work plan. and getting an update on our comprehensive health plan and action items. So lots more to come on that. Two other updates. Social Services has been working with the courts on criminal justice work, people who need reentry into the community. I know Judge Elizabeth Allen is here. She and I will be in Chicago in two weeks presenting what happens in a small town where you don't have all the resources available. The answer is you creatively brainstorm and creatively come up with ways to solve them, right? If we don't have enough providers open 9 to 5 to give out Narcan, then we look for places that are open after 5 to have Narcan, et cetera. So we will be presenting on that in two weeks in Chicago. And then I think also it's so funny that Nick brought it up, we could not have planned this coordination better, but we just had the first kickoff meeting related to the regional, we're in region one, the behavioral health regional investment, the regional behavioral health services that we're all working on with us, Rear Reba County, Santa Fe. We also sometimes call it Senate Bill 3 for shorthand. Our first meeting related to building out transportation needs, figuring out how we get people to those CCBHCs, how we maybe pick somebody up who's leaving a detention center and needs to get to a mental health facility, but that facility is in Santa Fe, et cetera. As you can imagine, figuring out the times places are open, the existing... blue bus or other transportation that exists, what costs money and what's free. You know, it was a very, very beginning meeting, but really, really good to have all of the main players at the table. So hopefully I will have more updates on that as we start problem solving this exact thing. Can we get a CCBHC in Los Alamos? Maybe, but in the meantime, it already exists there. How do we get our folks there? Right. So, um, working on lots of initiatives. And with that, I'm happy to stand for questions. It feels so formal, but yes, happy to answer questions.

Thank you. I think we're good. I'll give a few updates.

I've stunned you all and answered all of your fantastic. Thank you. Thank you.

Thank you. I think I would like to just add a few things from the health council perspective. And then since we have a little time, we actually have four new members I would just like to go around and introduce them as well, or have them introduce themselves. As Jessica mentioned, we have a really good plan for the second half of the year, which we've collaborated with you all on. So we're looking at September as Suicide Prevention Month. As Jessica mentioned, we have some programs and Jamie has some special ideas and training and so forth with social services. We were also looking at getting one of the ABC prevention trainers from the state to come talk to us, either Clary Miller or Marvel Harrison, so we have questions out to them. We'd love for Christine and Sylvia to be involved with that as well with the prevention. programs in October. We're looking at domestic violence awareness. And so we are going to have a speaker from Esperanza Shelter in Santa Fe talk to us. And we're also going to have a couple of articles Stacy has offered to write an article on the problems of elder abuse, and Susan was going to talk to us about interpersonal abuse. So we can do two articles that month if you guys feel like it. That's pretty exciting. And then in November, in addition to kind of food insecurities and talking about a food drive, Tyler, who's online, does a toy drive as well. And he's offered to write an article in addition to that about healthy activities for children. and dealing with cell phones and social media and that sort of thing because it sort of ramps up a lot during the holidays. Kids have a lot more time. And then in December, as Jessica mentioned, it will be kind of a working meeting, but we might also focus on grief and loss during the holidays. And that's really all I have. I'd like for our new health council members to kind of introduce themselves. If they would, we'll start with Councillor McCleary and then just kind of go around.

Hello, everybody. My name is Matthew McCleary. Short of it is I grew up in Los Alamos. I'm interested particularly in affordable housing issues. And I wanted to serve on the council as a way of kind of giving back. I feel like Los Alamos County has given a lot to me over the last three decades. It's good to be here.

My name is Joe Granville, and affordable housing is important to me as it relates to many things in our community. I think it's a common issue for many of the things that we're facing, mental health and behavioral health issues, and how we're helping our next generation navigate these things.

I'm Susan Williams and trying to learn technology. Apparently I am with the first born program here in Los Alamos. I have, I born and raised here in Los Alamos, married my husband who was born and raised here, raised both our children. And this is again, another way of giving back to the community. My interests lie in, With early childhood in the youth as well as elderly, I have special interest in domestic violence, interpersonal violence, and mental behavior health, and lots of things. Babies. And babies, yes. I deal with lots of babies and mental – PARANATAL MENTAL HEALTH AND WORKING ON THAT AS WELL. SO.

THANK YOU. COUNSELOR, I DON'T THINK YOU'VE INTRODUCED YOURSELF IN A WHILE, TOO. AND I'M SKIPPING VICE CHAIR RIDAL BECAUSE SHE AND I HAVE BEEN HERE A WHILE. IF YOU'D LIKE TO TALK, VICE CHAIR, I DON'T KNOW IF YOU WANT TO. WE MIGHT AS WELL SINCE WE DO HAVE NEW MEMBERS.

so I'm Marna Riedel and I have been on the council about a year and I work at Christa St. Vincent and in starting to work there I started to realize a lot of the gaps that we have in getting care to our patients and especially the elderly population and getting them you know that you can give them a referral to go to a specialist but if they don't have a way to get there they can't get seen And so it's really started, got on the council because I wanted to be able to figure out ways to fill the gaps or to get them the resources they need or get the information out there.

And she's a big connection to Christa St. Vincent, so we love that.

Hi, it's great to see some new faces around the table. Elizabeth I currently work for the laboratory, but I'm not here in any capacity representing the lab. My particular interest in serving on the council are mental health, particularly mental health for first responders. I also have a background in transition services and life skills training for folks who are transitioning from time incarcerated back to their communities. So those are some issues that I've been thinking about working through with the council.

Thank you.

Hi, everybody. My name is . I work for the .

Thank you.

Hi, I'm Stacey Frayers. I'm new to the council. I've been here now for five years. We moved from Houston, Texas. And one of my interests is the older adult population. It is the population that I've worked with for probably the last 13 years. I wanted to join the council so I could be more connected to the community and its services and also the health services of this community. We're a small town and We are always striving to have more doctors and nurses and, you know, those things like that. So I wanted to be a part of that.

Thank you, everybody. I would like to ask Joyce, Counselor Richens, also to tell some of the new folks about herself, if you could, please.

Yeah, can you?

If I can get this.

Hello. I'm Joyce Richens. I was raised in Los Alamos and then came back 30 plus years ago with our family. I initially worked as a nurse at the hospital in labor and delivery. So I had a lot of experience with babies as well in firstborn and way back when. Since then, I am now the infection prevention nurse and employee health nurse at the hospital. So, yeah, happy to be here.

Thank you. And did Counselor Jones have to jump off?

Yeah.

Okay. Well, I think we're going to set a new precedent and go ahead and adjourn early and give you guys your 30 minutes back unless anyone.