Community Services - Regular Meeting

Come. This is the September fourth County Health Council meeting, and we have some of our members are online. It's a hybrid meeting, and some of them are here in the room. So we're just gonna do a quick roll call. I'm here. Zelda Haven? Here. Leah, are you online? I see your name.

Yes. I'm here.

Thank you. Tyler? He'll probably be calling in shortly, I think. He's here. He's here. Oh.

To unmute.

I'm here. There he is. Oh, thank you, Tyler. Okay. Leticia's out today. Giselle? Yep. Okay. Heather Muck? Not yet. Okay. Chris Pearson is no longer with us. He moved to California. Lucky guy.

Good boy, Barbara. You're here.

Celeste? Sure. You're here. Lorna? Yeah. Thank you for coming. Joyce, are you online?

Joyce can't make it today.

Joyce is not here? Okay. And Leslie just walked in. Perfect timing, Leslie. Thanks.

Okay.

So we have 1234567812. 812. 4? We have okay. So let's, call this meeting to order.

We have a hard stop at 01:30. If the health counselor could please stay online during that time in case we have a vote, we would really appreciate that. Do we have any public comment not related to items on the agenda? If so, if you could state your name and your organization, if applicable, and address me as a chair and limit your discussion to three minutes. And please focus on topics, not people.

Thank you. It's just for the public. Yeah. Not related to the agenda. Anybody online have any public comment? Not related to items on the agenda? Anybody in instead? No? Okay. So I think we're gonna move on to approving the minutes from the last meeting.

Do we have any comments or any changes to the meeting minutes from the last meeting? If not, the minutes from the August 7 meeting are approved unanimously. And I only have two things to discuss as far as my chair report. One of them is the articles for the next coming months and around. I have Celeste on for September to discuss sleep apnea.

What time does that mean? Just toward the end of the month. Okay. No. It's the end of the month. Yeah. Yeah. Just so we can get it in. And then Joyce did Joyce log in or no?

No. I think she's

on vacation. And Giselle? Giselle did log in.

Oh, Giselle is here. Hi, Giselle.

Hi. How are you?

Good. Thank you for joining us. So October is choice for respiratory virus, and then November Leah, we have you down for navigating grief during the holidays. Are you still interested in doing that?

Yes. Absolutely.

Thank you. And then in December, we had Jeremy. I'm just Jeremy's not here. Is Jeremy online? There she is. Hi, Jeremy. We have you down for grandparents and kinship here or what other ever other topic you'd be interested in for December.

I'm still interested in doing that one. Thank you.

Great. That'll that'll complement what Giselle did this month or last month. Thank you. And the only other thing since I anticipate this is gonna be a long meeting, we I'm gonna just talk about the next meeting. In October, we're planning to have Tyler Taylor, doctor Tyler Taylor, from the Interfaith Coalition on Homelessness speak to us as well as Tiffany Holums. She is the director of McCarty Ministries down in Espanola, and also Rob Viehl, who is a social worker at the Espanola Pathway Shelter. And that's all I have. Staff update. Well, welcome, everybody. Hey.

For those that I don't know, which is not that many, I'm Jessica Strong. I'm the social services manager and the staff liaison to the health council. I know I made it here right hello. Right at 11:58 because it was a very busy morning. Today was the county's legislative tour.

I'm hanging out with several other county counselors and heads from other departments and divisions and representative Christine Chandler and her staff and staff from, representative Hermio's office and, Ledger Fernandez's office and a bunch of others and driving all around the county and looking at upcoming projects. And it was a really fun day, and I was really excited to get invited to it. So and then came flying over here. So a couple of updates before we get to the update from councilor Reidy and the bulk of the meeting. Updates from social services.

Today is Thursday. Tuesday, we had Lori Padilla start in the hey, Eli. Come on in. You may get

There's some seats over here.

The Lori Padilla started in our part time casual role that is a mobile homeless outreach. The technical title is health but it's, for those of you that have been here for a while, it is a position that we received a grant for two years ago, to assist with doing active outreach in the community for people who are homeless or at risk of experiencing homelessness. This may include people getting released from jail. This may be people leaving domestic violence situations or people who may be you know, living eight people in a in a housing unit to try to save on costs or living in their cars, whatever it might be. So she started on Tuesday, which is really exciting.

Jeremy, who is here from social services, was in that position before moving into a full time role. And then we also have posted the program specialist position. For health council members, this was one of the recommendations in the comprehensive health plan that we completed in December and then made that recommendation to counsel during budget hearings in April. And grateful to counselor Reidy and the others for approving it. So that position is posted.

It's called program specialist because that's the title, but it is the position that'll do the training and outreach and events. One of the things that we heard over and over and put in that comprehensive health plan was people don't know about social services or they don't know where to get information about Narcan or or any of the services that are provided. And so this person currently, I do some trainings. Denny does some trainings. Jeremy may be logged in from the farmer's market right now because she is there right now.

So it's split between a bunch of people. And you can imagine if Jeremy is at the farmer's market doing outreach, she is not seeing clients. Right? So the idea was move all of that outreach into one dedicated position so that the people who are supposed to be seeing clients can do that important part of their job. So that position is posted.

If you know anyone who is good in front of an audience and loves social service topics that can be really heavy, like suicide prevention, invite them to apply. On the topic of suicide prevention trainings, we health council and social services received a proclamation from county council in August because September is suicide prevention awareness month nationally. We had our first train the trainer event under our launch initiative. And I'm not seeing Brandy here, but Liz is online. She was.

Now it looks like she maybe she fell off. But we had the, train the trainer session here in this room. We I will tell you very honestly, I was hoping for, like, maybe three or four people to be interested in being trainers. And we ended up having 11 join that first session with six more people on the wait list, which I will tell you far exceeded my my hopes. We've also had now a series of regular trainings.

And then hopefully, that group of trained trainers will now start leading trainings throughout the community in in their pockets of connection. So much more to come on that, but that was really exciting. The other big exciting news is that we received word is anybody here from Larso? Stacy, hi. Just like, wait.

I saw you when you came in.

There's this complicated process through the aging and long term services division for capital outlay for capital based projects. That's like a multiyear process. If you want more information, you'll have to take me out for coffee because it's a lot. But a grant we wrote a couple of years ago for capital improvements at the Betty Earhart Senior Center, we received a million dollars in state funds towards the HVAC renovation. Stacy is like, thank gosh.

I can start like, stop wearing tank tops in the winter. The HVAC not working if anyone else goes to the senior center often. I've heard there's, like, melted chocolate on the desks because the HVAC is is wonky. And that'll get merged with money or braided, whatever the right term is, with funding in our existing capital improvements. And so lots to come for LARSO, but it involves, like, the ductwork and the electrical systems, and there's Miguel's folks know way more about that. Somebody just explained to me there's, like, horizontal work, and then there's vertical work. And I was like, sure. Yes. Now we have some money from the state to

do it.

So it was really exciting. And then the last thing I had shared at our last health council meeting, I continue to be involved in these very interesting regional conversations. If you've read in the paper or there's been a lot of press releases, Senate Bill three was passed by the state legislature towards Behavioral Health Reinvestment Act. I think that's the acronym that they're going with. The idea is to create regional collaborations to improve mental health and behavioral health across the state.

Our region mirrors the first judicial district, which is our county, Rio Riva County, Santa Fe County, City Of Santa Fe, City Of Espanola, and several of the tribal nations within, Namba, Tsusuke, Powake, Santa Clara, and Sanae. Yes. Got all five. And so there's a series of ongoing planning sessions. It is like the worst school group project.

Like, we've all been thrown together and we have a deadline to get funding, but it's not clear who's in charge because each county is separate. We've been told numerous times that we're in a really good position because we already work well with Rio Arriba, because we already work well with Santa Fe. We've already attended events at Pauquet and Namba, Pueblos. We have similar software. We're all using the Unite Us software.

So I will continue to keep everyone updated on that. There we have to turn something in by September 30, which feels like not a lot of time. But a lot more to come and hopefully more funding to come to support that. So that's the staff update for today. Thank you, Mike.

So let's go now to the council update. Councilor Riebe?

Okay. Yeah. Thank you. I'll I'll be very brief today. This reminds me of the old health council when there was a lot of people in this exact same room.

Sorry. I'm

I'm to see so many people here like this room. Day. Keep going.

So, yeah, I the proclamation for suicide prevention month, I noted that in my summary for the meeting last week. So that's pretty important. And then the training, appreciate that. And in terms of there weren't a lot of items that were directly relevant, but related to health would be having appropriate amounts of housing. And so we have had some efforts on that.

So we had a web project go to the next step, and then one that was introduced that was on DP Road. And then related also to help with the pedestrian safety, So that's something that we also have the I guess, it was about a year and a half of work on pedestrian master plans that got passed. And so that's a way for people to engage with the county and let us know about issues with certain intersections or speeding and things like that. So, hopefully, that helps with some of the issues we're having. And then I just wanted to highlight something that I had mentioned in my very lengthy written report from last month, and I did watch the meeting afterwards.

And that was in terms of federally, there's this next or the National Association of Counties has something called the state shift. So it's basically the federal budget is being things things that used to paid federally are now being shifted to the states and then sometimes counties and cities. So it's just something to be aware of with what we're looking at in terms of funding. So with that, that's all I had. If there's any questions, be happy to answer them.

Any questions for counselor Reidy? Thank you, counselor Reidy. So now we're gonna move on. It's sort of old business, but then it's the next step as well. So last council meeting, the recommendations of the Community Health Action Center working group were presented to the health council.

There were some questions, some objections, and requests for additional information. So the vote was to table the approval of the recommendations and bring it up at the meeting this month. So here we are. And so Jessica Strong has prepared a lot of information to address I have. These items. Okay. So I'm gonna hand

this to you. It is two pages from that. Okay. Not stapled.

Two pages.

Is this the one

It was attached to everybody. So I have 14 copies, maybe slightly more than 14 people. We could run into CSD and make copies. I know it is really stuffy in here, and usually it's very

I tried to turn the heat. And, also, just one comment, and then I will just let you take over. But I, also, when Jessica sent out the meeting minutes and then also some of our guests in the public may have received the notification for the meeting, which was also in Legisstar. There was a seven page, attachment, which we're passing out as well, which are the recommendations. These are the same recommendations that were in the really long PowerPoint presentation. And these are just recommendations, conclusion, and next steps. So we're passing those around as well.

And if you have extras, there's

oops. Yeah. Let me know if we can borrow the CSD copier. Alright. I'm going to start moving us back to December, and it will generally follow the four page document that doesn't have a blue title at the top.

Thanks for putting color in yours to make it differentiated. Back in December, we completed an almost three year process to draft a comprehensive health plan. Lots and lots of data gathering and research went into that. Part of that document was a table that had a list of action items. Those action items were the recommendations from the health council to county council for adoption.

One of those action items was to create, and I put it in quotes under one a here, to create a colocation hub facility to you did end up coming over to to house multiple service related organizations and the social services division. This recommendation as part of the overall comprehensive health plan was approved by county council at the twelveseventeentwenty four meeting. And both the CHP, the comprehensive health plan, the action items based on both the available social services data based on best practices that are seen around the country, based on recommendations from previous plans. A comprehensive health plan is done, generally speaking, every four to five years ish. I have them going back to 2012 in our office.

We kind of compiled all of that to make our best guess what are going to be the things that address community health in the future. So I just want to reframe it a little bit that the purposes of today are to take the working group's recommendations, what things go into a one stop shop of an action center, not whether or not an action center is needed or required or any of those types of questions. And I I apologize for not reframing it last time in that way because that recommendation has already been made. So for those of you that are new to the health council, you missed three years of work. Happy ducks.

And all of those conversations that took place over those past two to three years that culminated in that action plan. And I I shouldn't say just three years because Bill Gursky recommended a a one stop shop in 2017. And before that, I think Richard Skolnick recommended it in 2014. It it's an it's a really, it's a thing that is proven to be really, really good in many places across the country. And so, it's filtered to here.

So, really, that action plan, same as for many, many divisions and, boards and commissions, that action plan becomes our road map for the next three to four to five years until we do another health plan. And it can't encompass everything. The 2020 comprehensive health plan, like, fun note, was published or presented to council, like, 03/12/2020. And then COVID disrupted the whole world. Right?

Like, COVID was not in that comprehensive health plan because you can't predict everything that is gonna happen. Right? Every time I look at that one, I'm like, oh, you poor sad report that nobody ever looked at again because we were busy dealing with a global pandemic. But this CHP is our road map. So there's a bunch of action items. And and Jill Jill and Celeste and Lisa and Giselle, part of the team that created that. Joyce, right, who's not here. But, like, we put, like, 20 items in there because we were very ambitious. And then we went through and decided what are the short term short term within, like, the next twelve months? Right?

The less idea was that we need a health care directory. People move into town all the time. When you are looking for a health care professional, you may or may not have time to Google. You may or may not have access to Internet or you know? Certainly, at social services, we work with people all the time who have flip phones without access to the Internet. They able to go to the library. They close at eight. You still may need to figure out who you need to for an emergency service. So this idea of an online and paper based directory was one of the short term action items. Everything from that action plan ties back to the comprehensive health plan.

One of the other ones that we heard that I just mentioned, people don't know where to go when they need help. We need to get more education and outreach out there. Not everyone stops by the farmer's market on Thursdays from May to October to meet with us. So let's get a position for that. Right?

So there's a bunch of action items, and some are really big and squishy, like, to counselor Reidy's point, working with the folks in the community development department, CDB, on more affordable housing. None of the health council necessarily is going to build affordable housing, but it's one of our goals because we know it supports the social services population and community health in general. We talked a lot about what can be additional partnerships with educational entities. And part of what came out of that piece was we don't have a lot of connections with the homeschooling community. How do they get information about suicide prevention, RARCAN, etcetera?

And I don't think Heather Muck is here, but we did reach out to try to get health council members who are involved in the homeschool community to start addressing that point too. Right? Hopefully, more concrete things get planned. One of the other squishy ones was related to transportation. Improving transportation because transportation is one of the barriers cited all the time to accessing health care in a timely way regardless of income status.

We know in that report lack of specialists at the medical center. People are traveling to Espanola, Santa Fe, Albuquerque. We also know people who have Medicaid as their health insurance. There are very few providers who accept Medicaid in town, and the blue bus doesn't always run consistently. And so how do they get to their health care needs?

So, for example, one of those action items, we've amended the contract with LARSO, the social services contract with LARSO so that they can begin taking people to medical appointments off the hill. Staffing and vehicles and every good deed requires 72 more steps, but it's it's our road map. Right? Okay. So Can I just add one?

Absolutely. The other piece that was a hard driver for all of us is economic that this is about keeping a vibrant community a vibrant community. It's about workforce development and the reentry moment, and it's about staying ahead of issues. A lot of commute we did a lot of research. Where are communities that don't have all this kind of proactive look into the future moment and waited until they were behind the eight ball as opposed to ahead of the eight ball?

So I think it's it's important to keep in mind through all of this, all these initiatives, because, honestly, we could have a staff of 35 and a board of a 150, and we still need all this stuff done. I think

Councilor Rady, we are not asking for 30 more staff. Yeah. Right.

We could. We could do something on this. So I just it was a it was a big scope Yes. That we took on, and the focus is and will be kind of the I call them the the invisible population up here. But the reality is the invisible population touches every one of us that lives up here. And so, anyway, I'm off my soapbox now. Thank you.

I'm on your soapbox. Off my soapbox. So in in the comprehensive health plan, in our road map, in our action plan, I put some notes in here. So we've already moved forward on some of the action items, which is great because next month, we'll be giving a presentation to county council that there's an annual update from each of the boards and commissions. So good that we've already done some of the things.

The council county council approved that comprehensive health plan, approved those action items, said, yep. You guys have done a tremendous amount of work. We agree to support, you know, these action items as we move forward. The county manager's office and back to the the county side of things also believes in the importance of a one stop shop. Every year, there is a process through which a bunch of different departments get together and go through what we call the ICIP, infrastructure and capital improvements plan.

So I'm on one d. It's just easier to call it ICIP. We go through that list, and that list becomes the priorities for capital projects throughout the county. Both for how we're going to allocate public works and all the other associated how we are going to approach grant funding, state funding, federal funding as it may be, if it's getting shifted to the state, how we're going to allocate capital improvement dollars that just reside within the county. And given the importance of the comprehensive health plan of the people that we are trying to serve, a co located facility was put at number three on the ICIP list.

Like, we're in the top five, so that means county management feels this type of facility is so important that we're in the top five of the 30 items on the list. That means if we have grant writers on staff and we find grants towards this, that's a good priority to be looking for funding. Part of that then was also sorry. Going back up to see, was approving 950,000 in the budget for public works because as this process rolls out, there will be, you know, architectural renderings that will not come from social services given I just figured out there's horizontal and vertical needs. Right?

So money was set aside already in the budget for the artist renderings. Like Mhmm. We're not the only ones that found this so important. Like, lots of people support us in this, which is really great because the people that we serve aren't invisible. Right? I mean, to Jill's point, this is a priority of the county that has only had a social services department for, like, thirteen or fourteen years. Right? That's a huge vote of confidence. Yeah. That the that it is important to take care of people with food needs and utility needs and housing needs. Sure. Jump in. So Which

was in your presentation. Yeah. In addition to that, on page seven of the original presentation, last month was the overall budget, which was $10,000,000. And so that's already in the county budget. The 950,000 that Jessica just mentioned is funding to date. We actually actually have that and are able to spend it. And then for 2027, 2,000,000 additional was was, budgeted for, and then in 2028, another 8,000,000.

Right. But we're hoping to bring in towards

this project. But we also can one of the reasons this was attractive is that we feel like we can also get some matching state funding for this type of possibly. Who knows

what is going on with funding federal funding? State funding? But it was somebody else's. That's Daniel Duran. That's why I was on the legislative tour. So okay. So what was tasked to the health council then? So December, we meet monthly. December, we approved. Health council approved the comprehensive health plan. I presented it to county council mid December, and then then it's approved. And then it's like, well, now you have your action plan. Get going. So the task was figure out how to accomplish all of these action items. Lisa's suggestion was to that there should be a working group, a small group.

We do only meet for an hour and a half. We could not possibly come up with this during our regular meetings in addition to all the other stuff we are doing monthly. So let's make a work group that'll meet every other week for, like, the next six months and figure out what that is. That the the culmination of those six months, Jill was involved in that. Heather, Tyler

George Marston.

George Marston, Richard Skolnick, Lynn Havel, David Israelovitz, community members and the community members that are part of the health council. Right? Public input, important, got together every other week for those six months and worked out a scope, a plan for how to address it. And that included looking at other cities that have one stop shops. What's included?

How did that come about? One of those meetings was a a visit from Corey Styron, head of CSD, because he happened to be at a conference in Arizona and went and visited a colocated facility that was spread out like a broken hub, like a campus with walkways between it. So he shared that experience. We couldn't go visit Glendale, Arizona. We did go do other site visits in Espanola that Lisa went over last time, the McCrudy Ministries, the Casita De Comida, and then a bunch of data from social services because social services is driving this. Right?

And Tyler was also Thank

you, Tyler. Just let you pop up. So so we we have this CHP. We have the action plan as our road map. Next up was creating the working group. And then last month was the presentation of those recommendations. So, I think we're now to, like, number two on the next page. Part of, I think, the the difficulties in the work group and then presenting that here is not everything is within the scope. Right? So number two, just high level reminders.

Like, we are in charge of determining a cost benefit analysis for this type of one stop shop. We've already made the decision that a one stop shop is important, and there will be lots of other financial decisions that come down the pike. Somebody today just asked oh, Erica's not here. Somebody else just asked, like, how do you determine buying a building and renovating it, buying land for new construction? And and that is the public works. I mean, there will be a lot of financial graphs. Right? Cost those kinds of graphs. Am I doing the math right? Is that how you guys do math?

Yeah. Yeah. Just like that? Guys, I took one I took one semester of that a long time ago. And and it's it's based on tariffs and availability and and where does the county have buildings or there's a lot that goes into that, but that wasn't our charge.

Our charge, again, was what would go into that building so we can start we they can start looking for what a site might need to entail. The work group did take it to be like, let it let's put everything in it. I I think one of the comments was, you know, it seems like a Cadillac list of items. Because when we start, we do wanna try to include everything. And if the only location ends up being this and then we have to decide what goes and what stays, there will be more conversations to come on this.

I I don't think this is an end all be all because we don't have a magical four story 10,000 square foot building. Unless you do have one, let me know. But Let Miguel know, but we don't. So so the cost benefit piece isn't really part of this conversation. Figuring out the construction or public works needs or future staffing needs, also not quite a part of it.

We did make our best guess, and I'll get into this in just a minute, because what is the growth of social services look like? It's a shot in the dark. We are currently facing nationally cuts to Medicaid, cuts to SNAP, cuts to lots of the programs that benefit the people we work with. That may mean we come back to council and ask for 30 more staff members. Or it may mean that we have a wait list, or it may mean that we have to send people to other organizations, or it may mean people don't get served in a timely fashion.

But we're making our best guess as to what if if it takes two to three years or five years or however long it takes to build or renovate or move into a new spot, what are the what is that future growth look like, and what would those future needs be? Which is really squishy. Right? So hence, the suggestion to take out specific names of organizations because, right, it could be any intergenerational or family based organization. Who knows what that might be?

It is impossible to say how many nonprofits may pop up between now and some undetermined time in the future that may want to be involved, that we may need multi functional space to accommodate. We know who we currently work with, and we know where we lose people. Even with the best closed loop referral software, we know where we lose people. So the idea is, again, how do we best serve people who are facing a multitude of barriers to not lose them throughout the system? The best way to do it is to colocate as many things as you can so that when they're in your office, you can literally walk them down the hall or across a pathway if you're doing a campus.

But you can literally put them where you need them to go to get the next checklist done for them. I think I think number two, I think that that addresses that piece. So the question that came up is, well, what are the projected future needs of social services and the community partners? So, we did do math. Social services can do math.

I'm being very cheeky. We track number of clients that come in per month, and then we break that down. Number of existing clients, number of new clients, number of clients that are homeless, number of clients that we've met with in jail, number of clients that are 65 and or 60 and 60. So we're we're trying to get a sense of where those patterns are. And in fiscal year twenty five, because conveniently, this meeting last meeting was in August, so we had a full year of data from from then.

We see on average a 110, and this should say, like, client interactions per month because it's on a 110 people. I should have made this clearer in here. It's a 110 people coming and going from our office on average. I would say it varies between 80 and maybe a 130. Some people come in multiple weeks in a row.

Some people come in once. And unfortunately, we never see them again, and people are all in between from there. Four to five, six to seven people per day coming and going from the office in the past year. So before significant cuts to Medicaid or SNAP, we lost our, section eight housing specialist who was coming up from Espanola. She quit coming up at the December.

So we aren't currently helping people with section eight vouchers in our office. They all have to go to Espanola. So there are things that impact that. But without sounding like Debbie Downer, although if you've read the news, you might be aware, we are fully expecting more people to come in. And I've had this conversation with Liz Martino at the Community Foundation, with Lynn at LA Cares, with Diane Smoker at Self Help, with multiple pastors and, faith based leaders, what they're gonna be seeing at churches, we are expecting in the next five years for that number to, I would say, conservatively increase by at least 50 to 75%, and that is probably a wild undercounting.

I mean, we can come back in five years and see where my projection landed. We are increasingly seeing not just an individual coming in, but a whole family coming in with need, a grandparent who is raising a grandkid and trying to get legal custody, but they're also bringing their adult child in for job and education training services so that that kid adult kid can get enrolled in SNAP, which now has employment requirements. Thanks. Words. It is not a one time, one hour appointment.

Right? And we are seeing this increasingly. To corroborate that, I did talk to Diane Smoger at Self Help. And she was laughing because she had just put together a presentation for her board based on 2024 data. And then I'd also you know, I have the numbers from LA Cares there too.

What we don't have a good sense of is because we've all just started using well, self help and and social services have just started using Unite Us in the past nine to twelve months. How many of the 140 people per month that go to self help also come to social services and also go to LA Cares? Right? We don't have a good sense. In conversations with LA Cares, we know that everybody who picks up a food box from LA Cares is not a client of social services.

And we know we refer a lot of people to LA Cares. But if we're seeing a 110 per month and they're seeing a 110 and they're not the same, we both could be seen potentially a 150 or a 180 due to the overlap. Right? People who aren't getting connected to services when they need them. Does that make sense? Great. Okay. So even though I did ask staff, you know, what populate or what what's your estimate? How many people do you tell about LA Cares? How many people express need for food, and do you give an LA Cares brochure to?

And both Jeremy and Denny were like, oh, 100%. And I was like, well, it's probably not a 100%. So I conservatively put on here 80 to 90%. But, again, if 90% of our 110 get the brochure, but they're not all necessarily going there. We are losing people who are not getting the food assistance that they need.

And the same is true for self help. Back to the projections of what we think we're going to see, that would be a huge burden on LA Cares if all nineties started you know, if the the extra overflow all started coming. And same for self help. But there's the idea behind all of us being co located would be that these people would be served much more efficiently by just by virtue of that. Right?

So part of three d then that I I think was in the presentation but may have gotten lost in in it was what are the other top needs of social service clients? We often have people share stories of domestic violence with us. The county has a victim's assistant. She sits at the police station. That is where her office is.

In an ideal world, that would be located right next door to Denny and Jeremy and Jordan. Because, again, somebody shares a story. We mention resources. And once they leave, they may or may not feel comfortable going to the police station. We also have an advocate from Santa Fe, a domestic violence advocate, come up.

She's in our office twice a month, excuse me, from the Esperanza shelter. And she has seen clients almost every time she has been up. Actually, yesterday, she didn't we didn't have any DV clients for her to see. It was, like, a kind of an unusual day. If somebody is considering leaving a violent situation and needs resources to tell them to go to another stop lengthens the amount of time that they may be in danger.

To me, that would that's, like, easy co located amenity. We often get people who have a lot of concerns or questions or needs related to their health care. And I mean that in a very broad. That includes mental health, substance use health. The hospital is close. We work closely with the discharge social worker at the hospital. She tells people to come to social services. We're on Diamond Drive where the Jujitsu building is across from the high school, so it's, like, not that far. She knows people leave the hospital and leave. Right?

We we are close to Las Clinikas and the Department of Health, the Health Commons. We can often get people to, like, walk around our building to get health care there. So keeping some health care closed seems to make sense. Right? Easy vaccinations, easy STD testing.

In an either world, easy access to, MAT, patient assisted treatment. All of that would be ideally located close together. And then the one, like I just mentioned, we are increasingly getting requests for workforce assistance, whether that's help with a resume, help with finding college courses that they may have taken to put on a resume, help navigating an online job application. Again, if you have a flip phone, you can imagine the difficulties of trying to figure out so many applications are only online. So I think when Lisa and the working group put together, you know, some extra office space, right, to meet with a job counselor, to meet with somebody who who could help with that.

So I think that's if we had a department of workforce solutions up here, that would be great. I don't think we do. Some other stats that I I put together, and they're they're just kind of for for everyone's background knowledge. I should point out for months, there's been a suggestion that I share these stats regularly in my staff report, and I just we we just don't have time to do it. But there is a new and improved dashboard coming for the county or new new metrics that we will be sharing.

So hopefully, we'll we'll be able to share that more. So I'm under three e. Approximately 20 percent of our clients are homeless. And that is, to be fair, a broad definition. You they may not be intense under a bridge, but they are couch surfing. They are in cars. They are yeah. They are the invisible people. And that's 2020% of the people we see, right, when I when I did the math. Approximately eighteen percent, almost twenty percent, are 60.

That number has greatly increased in the two years, two and a half years that I have been here. Of that percentage, anecdotally, a lot have never been involved in a government system before. So there is a lot of, helping them learn to navigate different system.

Stacy sent you.

Yes. Oh my right. Partnerships. Mean, Stacy has sent us clients. We have sent people over to to Larso for sure. As we I mean, people self refer. They just walk in. I put a list of who we get clients from. We get calls regularly from the jail and probation staff. When you are released from jail, by definition, you may be homeless.

If you especially if you do not want to return to a place that maybe got you in trouble in the first place, You may not wanna return to a place where people are actively using drugs or engaging in other criminal activities. Or some of our folks here are from other counties but got picked up and put in our jail here. So we connect with them and and provide the resources we can to help get them where they need to go. And then I just put kind of a little clause on here. We have built really good relationships with Manny Pacheco and Kevin Camplain of fire and EMT and with the police department.

And so we are now getting referrals from police and Fire and EMT for hoarding for older adults who are hearing voices or living in unsafe conditions alone. We had a call from a police officer concerned because an older adult was leaving her stove on, and we were unsure if it was for heating costs or mental health reasons. We were getting calls from transportation, concerns about people riding the bus who need additional services. So it's working. Right?

Like, we are getting connected to folks. And I'm not suggesting we collocate with all of those, but it's just to show the scope of referrals come from a lot of different places. And then the next bullet is in all the things not all the things. The summary of some of the things that we help with. Inability to pay housing costs.

So I think in one of the recommendations from the work group, there is the county has a contract with the Santa Fe Housing Trust. They have a couple of programs to help with new homeownership, home repair modification, etcetera. Again, in an ideal world, if we had a client that qualified or was interested in buying a house, is trying to get out of poverty or living in a not great apartment, how great would that be to have, you know, somebody related to housing needs co located? In a real ideal world, we would have somebody from the Santa Fe Civic Housing Authority That is who manages the section 8 in our region. But they are understaffed due to federal cuts, so I don't think we're gonna get that person colocated.

But maybe in the future, which is why it'd be good to have an office available for them. I remain an optimist. Inability to pay utility bills or medical bills, inability to find providers that accept the insurance that the person has, Turquoise Care or whatever it might be. Inability to navigate Medicaid or other websites for assistance. There are multiple steps involved with uploading your documentation, getting getting a six digit security code sent to your phone.

But if you aren't accepting text messages, then it goes to your email. We help people through multiple steps of this. A lot of asking, do you remember your password? And then resetting the password and then writing that password down and asking them to keep it. Like I said, increasingly asking for help with job searches. Get requests for car and house repairs. I promise I'm not being cheeky. Sometimes those are the same. If you were living in your car, then your car repair is your house repair. So, again, connecting with places that have discretionary funding like LA Cares, like self help is really, really helpful.

People need cars to get to work. Say what? Not LA Cares. Not not for the car repairs.

Car repairs.

You're right. Self help. Utilities. Right. That's from the record. You were right. Have we have used self help. But and then the need for for advocacy, whether that is legal pro bono legal work, domestic violence, veterans help, etcetera. We are using technology, right, to to virtually figure out single point of accountability. And especially with Rio Riva County now coming online to unite us, Santa Fe has had unite us for, like, eight years. They're really, really savvy at it. We have been training additional organizations

here

in town. Firstborn, Family Strengths, Larso, both just attended a a community meeting for Unite Us. A virtual single point of accountability is really, really great. There are tons of benefits to that. People don't have to retell their stories. They don't have to keep bringing documentation. Right? It's all in this secure cloud based platform. But even when we send a referral through there, the idea that somebody still has to go someplace else physically can be a challenge. Yes.

Okay. So number four, last piece. The so hopefully that answers the first part of the the questions that came up last time while maintaining, like, you know, what it is that we are here to do. The minimum suggestions, for the record, we had a couple we wanted to present it in both words and a table, but we have both because it whichever is easier for you. And then it's it's really defined in that seven page document with the blue header from from the PowerPoint from last time, the minimum list of suggestions, really, I'm going to hopefully put this out there, was what was suggested last time.

The minimum suggestions were offices or social services and community organizations to be colocated, showers and laundry facilities, and a kind of gathering people place where people can sit and charge their devices, whatever those devices may be, Place for a grocery, grocery store style emergency food distribution. Right? The the emerging best practice for that is a grocery style setup. Inclusion of other supportive services based on what it is that we're seeing. And, if this takes ten years, I'm probably just jinxing this out loud, ten years until there's a facility.

If trends change, domestic violence is magically solved. And what we're seeing instead in ten years is pet care, and we need a pet related nonprofit, then I would hope we would have the flexibility. But the idea that we would need other supportive services because that is the co location model. An idea for an intergenerational space, I think, has to be in there. I don't think that trend is going away anytime soon.

It also really dovetails, and this was not in Lisa's presentation. I I thought about this afterwards. In other parts of the state, they have there's a focus on something called 100% New Mexico that is really focused on intergenerational that you can't solve social service problems in a silo. It requires multigenerational approach. And so that really dovetails with that.

So I put what I could from the presentation, you know, into this table. But after talking to the work group after last month's meeting, like, the the minimum suggestion is what was presented because we wanna start with, I'm gonna suggest, as expansive a list as we can, hand it over to public works. So hopefully, you know, we discuss and come to an agreement about what that is, hand it to public works, and then they have their own timeline for how that then rolls out. This is very similar to lots of other building projects. Right?

If if you follow the Fire station four? Four. Thanks. Right? Based on best practices for fire stations, there should be shower facilities for both genders. There should be, you know, space for sleeping arrangements, training area, technology, whatever equipment they need. Also, I'm not in fire, so I'm making this up. But you can ask for a bunch of stuff. What fits into the space? And is it a renovation or a new build? Where is there opportunity for public comment? Okay. We're gonna decide on this or this, and then here's what fits. So how do we make that work? That is not necessarily our job as health counsel.

Our job is here's what we hope can go into a colocation site. Public works help us figure out how to make that happen. How was that? Is that hopefully a little bit clearer? We probably should have started with that last time. Yes, please.

So as somebody who's been part of this from day one, literally, First and foremost, I think the comments that were made last month were a great help to

you all.

We under we heard things Totally. Because we were we're in it up to our eyeballs on this. We heard things that we went, did we not say that, or did we not make it clear? You know, it was a moment of reflection. So thanks to all of you for your comments last last month.

It is hard to take on a project of this magnitude at at stop, which is where we were. We were at stop, and we were at and go to figure this out. And, oh, by the way, you have four months or whatever it was. And so bottom line, you guys forced us to go back and regroup a little bit. We didn't change anything.

Mhmm. But to say it in a different way that hopefully is a little more Yeah. Because we have so little control over this. We were asked our thoughts. We have given them and more than I'm sure public works wanted to hear, but it's better to give more than too little. And then that turns the engine on. We're not turning the engine on. We have been asked by counsel because we got approved by, you know, our our format of here's here's what we're trying to do. And although there I think there is a layer of, well, the but what's in it for me? And I I mean, I'm gonna be blunt about that.

I have said that myself in these meetings, not so much what's in it for me, but how is this gonna help the community to do this? And the answer has been, if you can't stay ahead of your support systems for the folks that need it the most, you create a tsunami moment that you suddenly can't attract people to move here. You suddenly can't hold on to the people that are here. It's not so much the homeless population. That's certainly an issue, but it's it's it's that none of us feel it.

I go to Santa Fe, and I have to get out of that town as quickly as possible because it makes me nervous to be down there. Let's face it. I've come close to living that life at a point in my history, went through some things. And so for me, this isn't so much the what we're asking for. It's the start the engine, and let's really look at if we can do this. That's the other piece. We don't know. There is a budget. Yes. We have funds.

Yes. But if you go through it, if Public Works is through this and says, the best we can do is what you're in Mhmm. Which could happen. Then as a board, we have to go, well, then what are plan b's behind that? How can we still fulfill what's on this sheet of paper and the recommendations by other methods, but we have to give it a try.

And so that's so that's my long way of saying thank you for forcing us to go back and really rethink this because don't think we didn't hear you. I can promise you there were some very deep conversations that went on after that, but the the specifics haven't changed. It's just the way we've gone through it. And thank you, Jessica, for doing so much and for keeping my chart in because

I

do

love charts. I I agree. Agree.

Short and sweet. Just give me the bottom line.

Thank you, Jill. We appreciate it for the insight. So we have thirty minutes less than thirty minutes. We have about twenty eight minutes. So this is the way the rest of the process, is gonna go according to Robert's rules since we have a hard stop at 01:30. First, we're gonna take questions from health counselors related to the presentation. And if you could try to hold your questions to one minute each so that Jessica can respond. Next, we're gonna take public input for two minutes, and then we're gonna see if we have a motion. There'll be discussion on the motion, and then perhaps we might have a vote.

So one more sorry.

Go ahead.

Sorry. Because you just laid that out so well. One other question that came up was back to that idea of a cost benefit. If it does turn out, the current location is the best location. A question had come up from Barbara. The the county currently pays for social services and the health commons $9,898 per month, $98.98, which is approximately a 110,000 per year. So at some future calculation, if rents go up pardon? 120,000.

Sure. Yeah. So so that's just a facility.

That is just our facility. Yes. So that question had come up, but will be part of some some future but we rent those spaces from a landlord. We pay rent every month as does the the county contractually pays the the health comments piece. So Well, I to include that in the paperwork. Is up. The lease is up June 30.

That means

that I'm gonna go online first so you guys don't feel left out. Are there any health counselors online that would like to ask a question for Jessica or perhaps Miguel? And please limit your questions to a minute if you could. Tyler, Giselle, Leah. Let me put the list or no?

Anybody

have any questions, health counselors? In the room. Do we have any questions questions in the room, Celeste? Jill, Barbara? Counsel. Thank you. You answered both my questions. One was, the number of That was not clear last month to me. And, obviously, in this conversation as well as hearing doc from she's doctor Reidy. No.

House for Reidy, that that's going to obviously increase, as funding changes. And, also, the last comment you just made was a question I had last month in regards to the existing location and the and the lease and as leasing from a commercial property. That money is just you know? And that yeah. So I I appreciated you answering both

of those. Aloysa just texted me because it's recorded and, you know, public July, not June 30. We have an extra month. But thank you.

We can pull

it off. Go ahead, Leslie.

So it's not a question. Just I wanna reiterate what you just said that it was very helpful to have the overview. Sure. And I appreciate the extra effort that you folks all

put in to clarify all our questions. For for everybody, you we have a rolling join date for health council members. And to jump into a process that is multiple years in the making, yeah, we missed giving the the full umbrella to everyone. We just jumped in like, yeah, everyone's on the same page.

Jason, where

Here's the PowerPoint. It would have

been two hours. I tried to go into the history of it a little bit with

the conference. Hard. And Yeah.

And with the presentation and our and our action items and so forth, but it's a lot. Yeah.

So And when you just are doing it all the time, you're swimming in it. So you're like, yeah. This makes take any more Yeah. Sorry. Probably.

Questions. Okay. Any more questions from health counselors, or we're gonna move on? Okay. So now I would like to solicit public input. We're also gonna start with, our guest online, and it's gonna be two minutes. And let me just go ahead and start. Who would like to give public input? Tina. Yeah. Can you state your name and what organization you're with, please?

Hello. Can you hear me? Can you hear me?

Yep. Oh, okay. Hear you.

Oh, okay. Yeah. My name is Tina Dio. I'm also serving on our county's inclusivity task force, and I'm a citizen in this county and also serve as a minister in our community. And so I just wanted to make some comment that I am definitely for this proposal of a community health action center, especially as serving on the inclusivity task force, we look at the underserved and marginalized identity groups and the gaps for those groups in our county, and that's what we've been focusing our work on this year.

And so knowing that this community health action center is gonna be super beneficial to those underserved communities here, including those with, you know, PTSD, substance use disorders, alcoholism, mental and behavioral health problems, accessibility, just, yeah, all of those marginalized identity groups. So knowing, you know, and hearing you guys and all the amazing work you guys have put into this, it just seems like, yeah, a no brainer. Like, hey. Let's do this. Our community desperately needs something like this.

And so I am very much for this, especially serving on the inclusivity task force and in that role. Also, as a citizen, I am very much in favor of this. Our county has a lack of health resources. I go to Santa Fe a lot for mine, and we need this hub in order to inspire more health care coming into our county. And then just, yeah, as a minister, I know that I have been serving in the gap areas and our church and serving different populations of, yeah, homeless and all of that and coming up with trying to come up with solutions ourselves as interfaith leaders here, and that's been a challenge as well.

So this, again, this hub will be a huge benefit for our community in so many ways. So thank you all for the work, and I am very much in favor of this. Thank you.

Thank you, pastor Diem. Is there anybody else online who would like to make public comment? I think mostly we just have our health council and staff. So, okay, well, let's let's go to George in the room, please. And if you could try to limit it to two minutes, but I know that's not always possible.

I'll do my best.

Thank you.

I'm George Martin. I'm the operations interpreter with Family YMTA. And for ten years, I helped to run the team center here in town. So I and was involved with the the previous iteration of the health council. We've been talking about doing something like this for a long time. This goes back. Remember talking with, you know, several service directors ago talking about this. Yeah. Colocating just makes sense. It also it's it's dignity for the people who are looking for this, people who need help.

Like, we we provide everything for those of us who have money, myself included. This is a chance for us to show who we are as a as a people, as a community, our budget. What we spend our money on is a statement of values. This is what our values should be. This is where we should be spending our money as a community to provide for those folks, make it easier. Life has made it really hard for a lot of people. If we can take out that barrier so someone gets the care they need and, you know, oftentimes, it is. That's the person who who gets offered the resource but doesn't go to get it because it's that extra step, and they don't have it that day for the extra step. You can take out that extra step. We must do that as a community.

And, the fact that council has been behind supportive of this, and this is driving, and all this work that's happened with the working group, which I I don't deserve any credit for. I've been on the mailing list, but my mind is for for for lots of kind of reasons that that yeah. I haven't been able to be active, but I've seen all the work going on. We need to do this. This is who we should be as a people, as a community, and I'm so excited that our social services programs are where they are now from from what I was familiar with, you know, five, ten years ago. It's it's very different, and this is who we should be as this community.

Alright. Thank you. And you were with us in spirit. You were our moral support. Elizabeth.

Hi. I'm Elizabeth Leininghainer. I am the current chair of the Inclusivity Task Force. I also served on the racial equity and inclusivity task force, and I'm also on the board of JJAB. A couple of notes. One, as part of the inclusivity task force, we had, someone from the veteran social services come up and talk to us. They currently have offices in the lab. That's fantastic. However, lab employees are the ones that are most likely to be able to go out of town to get the services they need, and the people in town who are not affiliated with the lab don't have access to those services on the lab. Having a social service hub with office space would allow them to meet with clients up here, that are not associated with the lab.

Additionally, personally, I have helped three different people this past year. I've lived in Los Alamos for fifteen years. Three people this last year, I have had to take to the victim advocate to get out of financially abusive situations. All three of those people, the next step of going to self help and going to LA Cares has been too much. It's been six months, and still they haven't gone off to do that.

LA Cares and self help both help people every year. There's a limit for baseline help every year. That's six months to a year where they haven't gotten help. That's a whole cycle that they are missing out on. And that's because that step in a situation that is already hugely overwhelming emotionally, physically, mentally, all of those things is too much.

As well as this past year, we've had multiple people, again, who have had their children moved to institutions for mental health care because they did not get the services they need in town in a timely manner, and it became a crisis. And then they lost control. And most of those families who had that happen to them learned a horrible lesson of I cannot go seek help because then I lose control. If we were to create this situation where everything is in one spot, where you can go to social services, they can refer you to the j job situation down the hall that is now ready to receive mental health service patients that are youth in a very timely, immediate, spun up basis, then this is something that we can change the way this works. I can't imagine removing one of these services that's requested from this because every time you remove a service from this hub, you make a step for a group of people that much harder to impossible to do.

I think the depth and breadth is really where the value comes in in this place. And every time we try to make it smaller and figure out what we can remove is somebody that we are missing wholesale. And then faith erodes, and it stops being as useful.

Thank you, Liz. Jen. You should look someone behind you.

Hi. I'm Jen. I'm the director at the Family Strengths Network. So I get to talk to families every day, and they come to us looking for resources. And I can agree that it is hard when you tell them that there's one more step. Because sometimes when especially when you're a new mom or you're in a mental health crisis or you have four kids that you're trying to get to school and trying to get and you finally work up the courage to ask for help. And then for me to just look at you and say, cool. Here's a pamphlet. Like, that's not super encouraging because the courage it took for them to ask me may not come back for a while. I also just wanted to add on to what Jill said that one of the reasons that I love being in this community is the safety that we feel.

And the safety of a community comes from the people in it not feeling like they have to do something crazy to support their family or to support themselves or to get what they need. So the more that we can provide needs so you guys were saying, what's in it for me? What's in it for me is that if we have a community of people who feel safe where they are, we all get to live in a safe community in a town together. And I just think that's something that overall nationally, we forget that if there isn't poverty, we all live happier. That's what's in it for us.

Thank you, Jen. Do I have Stacy? My name is Stacy.

I am the case manager at the senior center. I see a lot I see our population, I think, over 60, and I think this center will be great. I can come from I have people when they try to go get resources. A lot of them are having health struggles and going to multiple places trying to do that. And when they're not feeling healthy is very hard. Sometimes they only have a couple of good days a week. So having that in one place, I think, is a great idea. Some people even are on oxygen, and they have tanks, and they only last so long. And they can't carry a giant tank, so they're just little tiny ones. So I think this idea is great.

A lot of them, a lot of some of my cases, they don't have transportation. So taking a bus here and a bus there and a bus there is complicated for them. So I think this is a fantastic idea. And I think that we are a great community, and I think this would be a great thing for us.

Thank you, Stacy. Is there anyone who didn't speak? No. No. I know. We're we've got ten minutes left. Is there anybody that didn't speak last time?

Let's go ahead and let her go.

Okay. Maura, please go. Thanks. For anybody

that doesn't know me, I'm Maura Unibel. I have the Los Alamos reporter page. I have been a big supporter of this project since council started talking about it. I've probably been at every meeting that it's been spoken about since they started that. And I just wanna say, I think as a newspaper person, it's time for people in the community to perceive seeking health, help with health or any other, situation that they're in be the norm rather than the the different and to to have people see that, that when they go to look for help help, that they should not have a stigma about doing that.

And so one way that I have looked into that I believe is a very good way to do this is any of you in this room. I bet all of you know somebody who can write a letter to the editor or a column or a a little piece that says, hey. Kudos. This is happening in our community. And and use it.

Anybody who needs help, please use it. This makes people feel that it's easier to come forward and that the help as they get it is gonna be easier than, like, when you talk about oxygen running out or peep some days people just can't do one more thing. Well, if they see that it's that it's easier than they think, it it's gonna help them. So please send me anything that you want. I think I've only ever turned down one, letter to the editor, which was a nasty one. But, and and I would love to receive these. I can space them out. But please, anybody from any of the organizations or individuals or health council members, send me the material, and I'll publish it.

Thank you, Maura. Do we have any other members of the public that have a burning desire to speak right now? Okay. Well, thank you all so much. We really appreciate all the support. So the next thing, would anybody care at this point, we've got ten minutes, to make a motion. Anybody any of the health counselors in

the room or on Can

I can I chime in?

This is Tyler.

Hey. Think we've we've got a pretty good plan ahead of ourselves, and I think we've covered a lot of the bases. I'd like to move that we just adopt the recommendations that we put forward and vote on that. I think it's it's pretty good. I appreciate everybody's hard work in this. You guys did a fantastic job.

Okay. So you're recommending that the health council adopt the recommendations that have been put forward. Do I have a second? Jill's second. Okay. Awesome. Now we have two minutes for health counselors to have any discussion or comments or anything related to this motion.

I just wanna publicly say

Okay. Wait. You got two minutes.

I I think it's only gonna

take thirty seconds. Go ahead.

We don't have all the answers. So this isn't a this is a step. This isn't the end result. If there's things that you love, if there's ideas you crave, if there's concerns, this is a community moment. George. Right? I think this

is something you're talking to me.

This is your community. This is our community, and this is an opportunity to put a very good face on community and wanna get it as close to right, perfect, awesome as we possibly can. So Thank you, Joan. Stayed under my table.

You did awesome. I'm so impressed with you. I've never.

Anybody? Any of the health counselors online? Discussion, comments? Giselle, Leah, Tyler?

Tyler, do you

have your

hand up or is that from before?

Yeah. I just wanted to say I think the important thing is that we just kind of focus on just this one item. I think a lot of the the reasons that some of these projects take so long as we get kind of caught up in a lot of little details, I think that the way this is presented and put forward for what we're actually trying to accomplish, I think you guys did a fantastic job. I think there was a lot of effort put into it. And I think that if we can just, you know, like, eating an elephant one bite at a time, if we could just focus on this bite and get, you know, this piece of the elephant eaten right away, I think we can start focusing on some of the other questions that people brought up. I think that'd be important.

That's my favorite phrase, Tyler.

Have you eaten elephant? Unless you're vegetarian.

Unless you're vegetarian.

Which case. Thank you, Tyler. You are a huge part of this effort as well. We appreciate you being involved in the working group. Heather, Muck also, we're missing her today, but she was involved on the working group as well. Okay. So if speaking now, health counselors or forever hold peace, we are gonna propose a vote.

Go for it.

Okay. So the motion is to adopt the recommendations that have been put forth up to now for the Community Health Action Center. So everybody in favor, please raise your hand.

Okay. And then

123456 in the room. And online, Giselle and Leah? Giselle, yes. That's seven. Giselle is eight.

I can't find the thumbs up,

but mine is yes.

Okay. So it's unanimous. I'll take it. No. I'm done. Thank you guys so much.