Behavioral Health Board - Regular Meeting

Let's be right to get all grassy. So, there's got to be a trick on this. I should probably sit over that way since

I know I always not at all. But we need to advise. Okay. I don't see it.

How are you doing? You know, under the circumstances about that. Oh, great. I am remar that I'm dedication to mountain more like me. Well, that's good.

Remember me? Yeah. I'm sorry. I never got back to you when you called me after. Oh yeah. It's all good. I'm glad I follow the other hand.

It's a little ray of sunshine sometimes. about Yeah. make the paper this week. Lord,

yeah. Did I make what the papers? I don't know about people always tell me, "Oh, I see this and this." I just put the stuff out there and that's it. doing well. I hope you are. Oh, yeah. I am. Thank you. Laura, do you know anybody that operates Walmart

besides us? You do? She said yes. We do all along the trails. Hey, we went out to the forest, met John last week in North. I actually did this. I walked over to

you office in the A department building up across from Oh, yeah. Yeah. And so when I'm there, I like it cuz lots of places. Yeah. Clinic doesn't have any windows. So it's nice. It's a nicer office.

You're sweet, too. Good work. No, it's far enough to be Well, I read that um I have my dark chocolate. There you go.

Yes, ma'am. That lady. Jen. Was it Jen car? What lady? Sorry, I don't remember. What are we talking about? Maybe it wasn't you. I was thinking Yeah. last week you were saying some uh a program needs volunteers to serve. Maybe it was another Kelly. I think it was me. I could be a little liar. Yeah. I think there's another Well, I can make something up. I always need volunteers for something.

Yeah, I was I have lots of vacation time at the what? Oh, anyways, I'll figure it out. Never mind. Never mind. Never mind. They keep taking my vacation time. So being creative, it's a heart problem or good problem. I don't know. I have like no vacation time because I change.

They keep taking me 167 last time, right?

So, I haven't done already

here. Hello.

Oh, I don't have hair. You're fine.

Yeah, it does. No, I didn't.

All right, everyone. It is 12:15. I would like to call this meeting order. We are the advisory board, the Humble County Board of Supervisors. We meet in person on the fourth Thursday of the month from 12:15 to 2:15 at 507 F Street in Eureka. This is a public meeting and everyone is invited to attend. Members may participate remotely as well as in person. The minutes and agenda may be found by searching online Humble County Behavioral Health Board. We provide time for public comments early in the agenda. Public comments need to be limited to three minutes made in the respectful manner and pertain to matters related to behavioral health. Thank you. This meeting is being recorded. If you have any questions, contact myself, Laura Montana, or any of the members of the behavioral health board. And with that, Joe, you'll do the roll call.

Sean here

excuse here. Grass. Excuse. Johnson here. Here. Price here. Natalie is right. We do have a quorum. Correct. Right. Let's do introduction of staff and guests. You want to start in the room and just go around starting with you.

Okay. My name is Jack Brazil. my name uh playing here. I'm a deputy branch director of

Dana. Oh, I am Dana and I'm very very happy to be here. So, thank you for allowing me to be here.

I'm Chandel Nelson Matthews. I'm an outage specialist with Nation's Finest and I'm glad to be here. Johnson, Department of Health and Human Services, analyst and administration. Paul, deputy director of healthcare. Good afternoon. My name is Xavier Rice. I was invited by Amy. I'm excited to be here to hear the board tonight. Um I'm Scott. I'm a MSW intern with transition. You

we will go to online and we'll we'll start with Suzanne and then if you'll just pop to someone else. Trying to get my camera to come on. Um I'm Suzanne Ryan from North American Mental Health. Um, and I will pass it on to Christine. Sorry, my camera is having issues, too. Christine Messenger, DHHS Communications. I'll pass it on to Oliver.

Hey, good afternoon everybody. I'm Oliver Gonzalez. I'm a behavioral health program manager and I oversee the Behavioral Health Services Act and I'm also our ethnic services manager. And uh as a gentle reminder, I believe our cameras were disabled uh due to uh security purposes if I'm not mistaken. Um and I'll go ahead and popcorn over to Sonia. Hi everyone. Sonia Lovey Boyd. She her. I'm a program manager of a children's behavioral health and I oversee the Humble County Transition Age collaboration at the TA division. I will pass to Jeremy. Hi everyone. Jeremy Nelson. I'm the deputy branch director over children's behavioral health and I'll pass it on to Melissa.

Good afternoon everyone. My name is Melissa Nelson. I'm the patient navigator here at Aegis in Eureka. Happy to be here. And I believe that is all of us. Am I missing someone? Um I can't see if there's anyone else. If not, looks like Nancy and Manuel.

Hi, this is Nancy Stark. I'm the legislative and policy manager for DHS. All right. Thank you. We will move to adjustments to the agenda. Does anyone have an adjustment other than myself? I would like to adjust the agenda because we can't have uh the HCTC members here who were involved with the recommendations. I would like to ask that we uh postpone that to the November meeting. No protocols. If they just I think as the chair you can just post postpone it. Okay.

You're all powerful. All right. So that is the adjustment. We are postponing that to the November meet. Now is the time for public comments. We'll start in the room. Is there anyone from the public who's not on the board who or staff who would like to make a comment?

Yay. Um, I just want to make a comment that I did the just made a deescalation training yesterday um with uh Mander France and um Jacob Rosen and it was incredible and I would love it if like Tay in general could have like I just I think it's something that everyone in the community could use. It was engaging, it was fun, it was informative, and um I felt like it really um is trying to bridge that gap between um somewhat competing forces, social services and police, and um figuring out ways that we can learn to speak each other's language in a really compassionate way. So um I might never do it if I assume everyone has. It was great.

Thanks, Any other comments in the room? Is there anyone online that would like to make a comment? Hearing no one, I'll move to action items. So, we have three items. I'm going to do them one by one. We have minutes to approve. Do I hear a motion? So move. Second. All in favor say I.

Opposed. Thank you. Minutes are approved. Um you were sent the behavioral health board annual report for 22 to 25. Would like a motion if anyone would like to make one. motion to approve the motivation. Second. First and second. Is there any discussion? Really? No. No discussion. You did a wonderful job putting together. Oh boy. No compliments allowed.

They're very helpful. All right. So then to the vote, all in favor of approving the report say I I opposed stand the sides. All right. May I ask a question about that? Yes. Does that mean that um after the now that this is approved there'll be a presentation to our board of activities? Is that the plan? Yes. Okay. Great. Love it.

I was asked about it recently and I think it's we had to approve it first. All right. And the last item, approval of letter to Senator McGuire. I believe everyone got a copy of that first. Discussion. Uh there's none. I'll take the vote. All in favor? I post. All right. So that letter then somehow get to Senator Maguire. Thank you all for your support. Thanks for Are we good?

Okay. So, we will um postpone for a little bit the presentation because our presenter is not quite here yet. We have moved the discussion items to next month. So, communications. Now the time for behavior health board members to talk about any of the things that they would like to talk about. Starting over with Vernon.

Good morning or good afternoon all. My name is Vernon Price board member. I spoke uh with a couple of administrators with behavioral health about Assembly Bill 348. I think last month I I passed out or had for documents for people to have a copy of the Senate Bill 348. I am asking that we take a look at this. This is in involving full service partnership. This is involving pretty some prioritizing people that are coming out of jail out of substance use disorder treatment programs uh into full part full service partnership. I think that in this Senate bill or assembly bill that the county is already doing a lot of these and should be commended for doing that. Um, but there is an option opt out on this bill on counties that are 200,000 and less and that does include Humble County. What my ask is is that the board of supervisors would or county staff in administration not opt out on this and see if we can move forward. This was signed in below on this October 16th. There is a a special opt out. Um I'm asking count to opt out.

Thank you for your time. I just want to acknowledge that we're coming into the holiday season which can be a very difficult time for many people especially people experiencing behavioral health disorders and also just in the current political climate and uh potential Calresh uh benefits being ended this coming month. And I know in the work that I do, a lot of the folks that I work with are really stressed about money and upcoming holidays. So, there are several different uh holiday food programs that are out in the community. I will share with Joe to send out to the group. And I just ask that if anybody else has any food resources to please share in the coming months, we're going to really need them for the folks that we work with

with you. to share with you. Just share with Joe. Send to Joe and then he can send out to the whole behavioral health board. Thank you. Thank you, Margaret.

Um yeah. Um two things. Um um one is a piece of sad news. I don't think it was announced last time because I wasn't here, but um um I think a lot of us know Art Wilson who is um was ran um HA's transitional living here for a long time. He passed away last month. Um evidently he had a several year battle with cancer. Um he and his wife moved to Arkansas when um their place shut down here. and I just heard from his wife like two weeks ago that this had happened. So I said I would share it with everybody here. He was on many boards in our county. He was head of the SUD committee for a while. Um he was uh very instrumental in trying to get more services for transitional living places. I would you know I wish he had lived to see that we actually have done better with transitional living now. So that's one of the things. Um the other thing is that um and I ran this with you already Laura but then at the SUD committee I got some different feedback. um at the SVD committee, last SVD committee, um uh the thought was that we might want to develop a brochure about the behavioral health board that could be handed out at various things like the um um September uh meeting. And uh I had talked to you about it, Laura, and you said, "Well, you know, people are people are doing um it's okay that we duplicate what some of the other county people are handing out." Oh, and

so that where did that come from? That was at last last meeting. We have a card as well as that. Oh, okay. It was part of the TA response, but maybe we could add that to communications. won't have very many cards. Laurel, did you bring any more? Okay, I have a few that I can pass around. Thank you so much for doing that. I'm glad I'm glad that happened. Yes, it was big one and passing.

It was not really very awkward at at recovery happens that we were giving out the same thing as other county things. But I thought it was good to have behavioral health in particular so we can get some more community members on the board, you know, who come to these things.

Just to piggyback on that, these flyers and cards are for anybody to post anywhere in community spaces to encourage people to come as participants um and also to consider potentially joining the behavioral health board. This came out of the recommendations from HCTC, but it's not only specific to transition age youth. It's to our whole community. So, please take the flyers and post them wherever you work or places you go. That might be a good place for people to access them. And they do have a QR code of them, which is

exciting. And thank you Laurel Johnson and DHHS Media for making this happen. And there's the behavioral health board email address now which is handy. It doesn't all um people don't need to remember an individual's name. It's behavioral health board. So uh then it'll get to the executive support. It makes it handy to put on a party. Well, many good things happened with me just being for you. Thank you.

Um, do you have anything? I do. Um, as of October 7th, I was offered and accepted to another position spin. Um, Calvette, CVHI, Cal California Veterans Health Initiative has opened up three different stations across the state and I am your new veteran peer support.

Uh, we have dedicated have a dedicated team member here in the Chandel. is he's the outreach coordinator and as I was talking about previously before uh we now we are driving that mobile unit uh around town if you see us wave at it because uh we're out there and primarily right at this point we got eight counties to cover but primarily what we're doing here is street outreach every day. Um, we're looking for the the the big things about this program is is that we have a clinician on site and we offer mental health services to veterans, family members, wives, widows, not grandchildren. Um, but we have a clinician on site and we also have an MSU. Hopefully the Star Link is going to get hooked up soon so that we go into remote areas, we can do teleconics. Yes. So, we have that and um so we're out there hitting it every day. Uh we do some street outreach. Some days longer than others, but we're on the streets talking to my boss and he says that's always needed to be done and it's never been done right. So, we're going to attempt that. And I'll introduce Chandel here for a minute. let her give her a little introduce herself.

I'm Chandelle. Um I was hired as the outreach navigator, um outreach specialist, whatever you want to call it. Um I go out with Bob and we're really our goal is to bring veterans, their family members, uh wives, children, husbands, whoever it might be in for mental health counseling if that's what they wanted. Um, they can do individual or family counseling. Uh, the veteran can do online counseling with other veterans if they would like. Um, and really it's a great program because the veteran does not have to participate. So, if the spouse or the children want those services, the veteran does not have to participate for them to get those services. Well, the big thing about this program is uh discharge status is a rolling.

Okay. So, uh and the other thing is that I'm starting Monday in a 80hour training with certification. It's a big deal. It is a big deal. So, I'll be a certified veteran. Beautiful.

So, if you know anybody, I'm gonna put this out so it goes out into the community here. So, everybody here knows a veteran, has a neighbor who's a veteran, has a family member who's a veteran, uh, knows somebody who knows a veteran. So, you know, this is a relatively new service here in town. Uh, and the big deal is we have an onsite permission. That's the big deal.

Is it just um, uh, mental health or could it be like hospice? Uh it's primarily mental health services but because I work for nation's finest and know the inner workings under our umbrella we also have cal aim we have SSVF we have transitional housing we have all so one way or another we can get our Yeah. Well, actually,

I don't know. Thanks, Bob. Yeah, if you can change exchange info. Do you have anything? I have. Uh, so my

I'm not in a meeting. Sorry, I am in a meeting, but not for that movie. Um, so I u I have some concerns. Um uh again, we're Porter struggling with getting assessments done from the jail. Um one because there's no jail staff to do to get to answer the phones to get assessments done. Uh two, um medical the medical is um paused. So, programs are not doing assessments for clients that are in the jail. And three, I'm now hearing that programs outside of the jail, even if they get medical reinstated once they get out of the jail, are not going to be um accepting client. Well, one program is telling me this. they're going to have to go to sober living once they get out of jail and get their medical reinstated until their partnership gets reinstated because they're losing money. So, it's it's just becoming a struggle after struggle. So, I just want to talk about that a little bit and see if we can come up with a solution. I mean there's other there's it's not the only program but if it's already starting I just we just I just want to make people aware we need to come up with you know start coming up third for thoughts think outside the boxes um anyways um you know and I keep I've been asking this for quite some time about the medical um how we can you know at least get the assessments done Um, I mean, I think I think outside the box as far as getting the assessments done without the staff at the jail, but um,

when programs will do it without the medical, but um, yeah, we got to be able to figure out how to get the uh, at least a temporary reinstatement of that medical to do the assessments for people to get into treatment or something that's simple. Would you mind elaborating on what like So while people are in jail, uh there is a a pause on their outside medical. They have an inside medical and outside medical. Am I explaining that correctly? Yes.

So there's inside medical and outside medical. Medical on the inside is different. Um and so while they're in custody, the medical that the programs accept on the outsides um does not cover an assessment.

Okay. So you you want to look into it further? Yes. Okay. Are you wanting a report for this board? on how that are you wanting a report for the sport on how that works. I mean, I think a lot of us are sort of

Well, I've been talking about it for a long time, but we it's really getting detrimental and we really need to figure out how how to get this resolved because now we're get I mean, the more um things are getting cut, the more detrimental this is going to get because now we we have short staff in the jail. we don't have people doing um doing the actual job of linking people with assessments. Um and so I'm just concerned. Um

so I'm going to Kelly, do you have some? too. And I it's been a while since I've over seen the jail behavioral health services, so I don't want to speak on behalf of DHS, but uh their oral actually helped us work find some workarounds for this years and years ago around how to get people ACM assessments, which is what's needed to be able to go into residential treatment for substance use disorders. I understand your concern about the staffing. Uh I think we have a presentation coming today about SUDD program. So I wonder if we might be able to table that as a question for the presenter around how we might be able to get substance use disorder assessments done for people in custody to streamline their placement and their residential treatment programs on release. Does that see sound reasonable?

Because they'll be able to hope. Is it Diana that's presenting? Yes. So, she should she's the substance use disorder administrator for the county. So, she should be able to help us talk through that. Yeah. So, you're talking about there's not staff in the jail. Are you are a particular program? So, you're talking about behavioral health staff. So yeah, we have some vacancies in the jail, but we still have clinician and medical staff from psychiatry and nurses that are operating in the jail.

We've been calling to get people to help getting assessments for clients. Um, nobody's outside the box, so we can't get assessments done, which means people are getting stuck in the jail. And I know the jail does have an MAT program too. So that's still in operation and that's still happening. And so which is medication assisted treatment, but how do we get them out of treatment for mental health? Well, what was that question?

That's medication assisted treatment. But how do we get them out of out of custody for mental health diversion for diversion? And we have a diversion team that's separate from the jail team that's fully staffed. So we can, you know, we can certain criteria. Correct. Here's what I'm going to do. Um, so if you have some written specific questions, you could give them to the executive committee who can put things on the agenda, ask for somebody to specifically

address. Yeah. Ad hocs. These are the processes. um to to handle those question. That's okay. Awesome. Thank you, Sean. Do you not want to announce any meeting press conference that you went to? I don't think. Okay. I just need to go back. All right. Well, I guess it's me, you.

So, I was so honored to be invited to a press conference with Senator McGuire and was glad that he had a one sheet so that I could make sure that everything was covered in our thank you letter to him. But that was quite um wonderful and it was great to see all the partners there. And I think that's all all that I have to say. Je

thanks. Thanks for being there. It was great to look out and see some baby program doors there. Um I also had the privilege of being invited to that press conference and um was asked to speak about partnerships in the community and I had some um I probably would have spoken a little more from the heart but I got some scripted notes. That's okay. I did I did a merging of the two. Uh but it was uh lovely to you know being part of that. Um just celebrating the fact that you know Senator Magcguire has been able to bring home some additional funds to the his district around facilities for behavioral health soral leaf and the triage.

Um so filling some gaps there and uh my understanding is that helps the soral leaf project get over their funding finish. Um and the behavioral health facility is still has some needs but it's going to get us closer, right? So, um, and, um, yeah, he just spoke from the heart about why it was important to him and his family. So, that was really, really nice to hear. Um, you know, he's his time as the Senate prom, president of the Senate, and his sun setting in late November or mid November, but I think it's um, outside of the step of our anyway, the timing is perfect for us to send him a letter now and to just really share. So that was really nice and it was uh great to meet uh I had spoken about the soral leaf project folks before but I hadn't met the person in in the kind of driver's seat there. So that's um and meet several of the sorely poor girls services um and healing.

First of its kind in the state.

First of its kind in the state. So really cool um just to be have a little project that's like paving the way for something different for you and I had I got to participate in a conversation last night. It was a workshop held by the Human Rights Commission. Um they've been having a series of community trainings around constructive conversations and I was able to participate in that. um share tips on constructive conversations and most importantly hear tips from other people on holding constructive conversations. So that was really cool. The human rights commission is really trying to make space for people to talk across differences which is super important. Um so that was that was really good. Um I uh obviously we have uh because the box and federal appropriations were coming up against I'm sure everyone has heard um the you know time when um benefits in November will either be delayed or people won't get them um in any timely fashion. So, I think we're going to have a lot of folks that need food and that need community resources, but I do want to kind of remind everyone that we um have invested a lot collectively in having the 211 system in place. And so, I think people maybe it's been around for a while. Like, I I kind of sometimes forget about it and then I'm like, "Oh, wait. All those resources are in one place. you can um call and get access to them or go online and get access to them and it's just a repository for all that information about uh everything from you know food and housing and shelter to mental health resources and more. So please do share

that 211 humble.org or call 211. I'm trying to find folks to get that out there. Um, and I think that's u I mean we've uh I think I'm gonna have more updates at our next meeting, but I appreciate the um uh what you brought up, Vernon, around Assembly Bill 348 and um full service partnerships. And I I do want to just make sure I get more information from Jim Scott about what our engagement was about because there's uh you know at the end of the legislative session that's often kind of a barrage of okay these things were signed and now we we figure out how we are going to implement them or how we're going to adapt and what what we have capacity for. So that'll be good to more information about so I'll follow up with staff members to learn more. So her I heard you Okay. So, thank you. Report. DHS director behavioral health director is not here. I don't believe Connie is on it. Connie is not unable. If Connie is unable to attend today, she sincerely relays that you guys should know she'd much rather be here with you than doing what she's doing, which I don't know. She would much rather be here um with you guys. It was a last minute thing that she got called right to her.

Thanks Laur for um she just wants to thank the board uh for joining um at the press conference and being a part of that. Um that was much appreciated. Um but also uh the participation um of our visit from the California Health and Services uh deputy who came up with some folks from the department of healthcare services to take a look at Humbult and why Humboldt is standing up compared to other counties of size with regards to care and care petitions. So they were really interested uh in what we were doing and it was a good reading I think and it was so good they asked us to be on a panel the following week in Sacramento. So uh that went well too. We were uh on a panel with um Alama County and Stannis County and sharing what's working and what's not working with care court across the state. So that was um really good and good experience and I think helpful for us to see how other counties are doing things. Um and then um she also wanted me to let everybody know that we are interviewing medical director. So, we had uh some we've had two uh interviews with two different um candidates over the last few weeks and one of them was just this last week and we uh I think we're would like to move forward with both of them and so we're starting that process currently. We're having Dr. Simpson and his intern board has been doing a fabulous job,

but she's moving on too, but she's going to hang on long enough for us to get another medical director. So, really excited about this candidate and things come together nicely for us. You

may ask a question. Where do we stand with our patients rights advocate uh position being open or available? Uh is that been available or has someone been, you know, looked at or can you give me an update by any chance about where we stand with the P? Yeah, I believe we have a shortterm uh support in the works. Is that right, Jack? So, yeah, we have a part-time temp position uh that's being filled with a background quiz.

That's right. Cool. And then I believe uh I don't know for certain about the position itself currently if that's open recruitment or not. I don't know. Um, and I also know that we're considering contracting that service out to another entity um that is well known around the state providing that service. Thank you. Jack Deputy Yeah, probably don't have too much going with all those places

in the sense that nothing's going bad. All that's good for stories. There's always stories. All right. I noticed I'm coughing a lot because the air conditioner turned on and it's flying right on. So, I apologize for that. Um STD committee, I think. Do you have one?

We do. Uh so, we met on October 9th. Um we had uh VA which is that ECM program in the area that um that came and shared what they do. Um it's called it's enhanced case management. They provide um gal a uh partnership health plan coverage. Um and they have uh one or two physical people that are in this area. most of their people are across the states. I personally was able to I have a client that lives here, but he got in a motorcycle accident um in uh Santa Cruz and so I was actually able to call and have them meet with him down there. Um anyways, so it's kind of a cool uh uh palative care n care navigation system. Anyway, so they came and shared that showed what they do. Um our next um our next committee meeting is November 13th. Um and we will have a little educational um thing. We'll have Dr. Stockton from public health come and talk about fetal alcohol syndrome which will be kind of exciting. And then um uh we'll have another presenter, Amanda Amanda Steinbeck, which uh used to be an intern at Healthy Moms. She's uh now parent I guess they call it a parent partner. Um there she's going to be talking about ACEs. I think it's important that we educate our community on some of the um residuals from uh fetal alcohol um drinking while pregnant or drink or

anyways the uh residuals from drinking uh or doing drugs while um either pregnant or raising a child. Um, also uh for those and I forgot to ask you where you want to meet next week.

Okay. So, uh, we've been invited um to go and do a walk do a walk through uh to the Hoopa Sober Living. Um, next Thursday I'm hoping to leave hopefully at 8:30 a.m. Um, and we can uh discuss where we're going to meet um to they have a sober living in Hoopa and um I'm kind of excited. They've been asking me to come up there for a little bit. Um, but I thought it would be great for us to come up and um and do and do a walk through. Um, and not only um I believe that it's important for us as a community to embrace our tribal members. Um, we have a lot of people that are that need our support. um as well as DHHS, you know, um needs to to to see what what what's out there, too. So, um I don't know if I said that right, but anyways, uh I never say things quite right and I apologize. Um so, if uh if you want to go, um we'll probably take a couple cars, whatever, um and go up there next Thursday. We'll leave about 8:30 in the morning. Um, and I think that's about it. Any if you have any questions, please let me know.

Thank you. um committees. I think the only thing the executive committee has we do have an application um from a Tay a very interested Tay who I met with personally but would like to meet with the executive committee. So that person is ill this week. So hopefully next week one of the two of you can just so that's exciting. Very excited Tay member. We need all the T we can get. No pressure.

Vice chair. Do you have anything? I know. I feel like it. I've already said it all.

You said it all. Um, how are we looking on our presentation? Our presenter, right? Oh my goodness. Oh. Um, any navigation center, business triage? I I forget that I go to a lot of meetings and it's talked about but I think have to always remember this group only meets once a month and so we there may be other things that oh that we know about care or crisis triage center but I don't know that there's any new updates on navigation.

Nope. Okay. The grading permit was issued. Oh. Oh, by the city of Eureka and there was grading on site. That's good. That's that's something that has so if you go by the site it could look like active. I think it's been confusing to people that they think the project's like accelerating quickly. Still waiting on quite a few things but um but that piece happened which is great. Uh and that would needed to happen before the end of the sort of construction window ideally so that um other things can happen later but now it's just sort of a site that has been graded. So if you go by don't be fooled.

It's still in practice. It's something excited. I got excited. Oh Jette, can I ask you something? Absolutely. Um, have you heard any more about the um the project that uh Raphael is trying to do with the It's being postponed a little uh uh last I heard was of December, possibly a little bit longer. There's some um repairs that need to be uh done that were uh uh beyond their means, financial means. Yeah,

we're working on some I was going to send send them a um potential donor someone I used when I had my silver living. Thank you. So, our presenter is on her way. So, if there are any future items, uh, anybody wants to bring up future items for the agenda? Yes,

I wouldn't do this except we have some time and so my productive vamp is, um, I am getting some more of those flyers printed out right now. I won't be able to do more of those business cards right now, but can I get an indication of how many and who wants them? Maybe what I'll do is I'll pass around a piece of paper um and if people can um uh who want the business cards can write their name and the amount on them and I'll figure out ways to get them to you. I keep offloading mine to other people so all of them.

That's that's I totally understandable and and fine. Um, I just I also can also Does anyone know where I give the little red parks? Red park. Oh, central delto where central delto. Um and then like possibly poss at at Proidence at Providence. Okay.

First humble may also have some time. Thank you. I just think All right, I'm going to career is going to be here short. Let's take a five minute break and then come back on the presenter's here. You can call.

Okay. There she is. You don't have to say good. How about you? Bye. Thanks for g So, I'm the last one. Yes. Well, I'm sure you've been saying the delay. Yeah, Monday to get all that.

He has the answer, but maybe he wants our phone. Okay, good. So, we've been having

unless you guys prefer me to be someplace else. Wherever you're comfortable. earlier.

Yeah.

Whisper twice in one week. How are you doing? does the job.

Yeah. Okay. All right. All right. I need to cancel tickets out.

Thank you.

All right, we're back. We have our presenter, our lovely presenter. Hello everyone. I am so sorry for my voice. My voice um comes and goes as it wants and today it's decided to be this weird. So my apologies for that. If I try and increase my volume, it will go out further. So So I'm going to do my the best I can for this presentation today. Second, I'm also sorry for getting here delayed. Um, as with all things in the mental health field, sometimes our schedules and our days are unpredictable and today was definitely that for me. But the great thing is we're doing the good work that we are all here and that we intend to do. So, with that, we'll start this presentation. So, feel free to ask me questions along the way. Um, I'm going to give a brief overview of the programs that I oversee and then some updates that are coming kind of from the state level and then we'll have a spot for more questions. But if you have something along the way, feel free to interrupt me and we can chat about it. Sound good?

Excellent.

Okay. So, um, Joe's going to be my clicker. So, we're going to go to the family wellness court. The first part that I'm going to tell you guys about is the family wellness court. And I went on to their website and stole their symbols. So family wellness court is has these equal shares of the pie. So we have our tribal partners and the tribe, we have CWS, we have the court system because this came out of tribal court. We have the participants themselves and then we have our behavioral health. So obviously we are part of the behavioral health by piece and that has a clinician and case manager associated with it and those were try and work as transparently as we can and as seamlessly as we can with all of the other individuals. So we have Euro Wellness Court and Hoopa Wellness Court and State Wellness Court. So for individuals who are a part of the Euro tribe, they would participate usually in Euro Wellness Court. For individuals part of Hoopla tribe, they would participate in Huba Wellness Court. For the many, many individuals that we have in our community that don't fall under either of those, they usually participate state wellness court.

Slide, please. So, Family Wellness Clerk was a total collaboration between Tribal for CWS behavioral health and county council and many others. I'm sure that happened well before I was in my current role, but I know that it was totally done at a collaborative level where everybody was um having equal buyin with tribes and our tribal partners and our federal courts. of course uh being one of those leading factors. So in the family and wellness report documents I found this vision and mission statement that was taken from the hooping wellness court guide. So this was created with all of those partners in mind. So the family wellness court vision is children grow up in our community state safe, healthy and culturally grounded families. and the mission. The new court is committed to cultural humility and lifting the cloud of despair and pain of Huba families, empowering them to make healthy decisions and break the cycle of addiction and child abuse and neglect by providing a path to recover, heal, and grow through a coordinated and respectful family wellness team approach, a comprehensive, culturally competent and community involved services, frequent monitoring, and a system of support for family recovery and child well-being. So like I said, I took this one specifically from the hoop. The others are very similar. So I want to make sure that you know that there might be flight, but I didn't include them in the slide. Um as that coordinated effort, we work with families and with the courts through four phases and that is a ton of engagement. The first phase is all about trust. The individual's trust with the

team, the team's trust with the individual, and really establishing a coordinated baseline, which includes being oriented to the program, getting their mental health assessments done, if they need a substance use assessment, getting that done as well, and starting that stabilization process. That usually takes between 30 and 60 days. That's the minimum. I have seen that take a lot longer, but everything is built on that foundation of trust. So if we can't pass that first phase, then we're I'm not going to be as successful in the rest of the phases. So the second phase is belonging and family. And it's returning to healthy connections, education, service planning, belonging and family wellness court, belonging as a part of the tribe. The third phase and the family wellness court um decides as a team. So the courts and our tribal partners and CWSB and behavioral health all decide if the individual working with family wellness court is ready to advance phases. So it's a team approach, team level setting, team knowledge to help support families in a different way through our core systems and being restored with their children if possible with CWS. The third phase is settling up and that's again the language that they came up with collaboratively. And so it's taking responsibility, it's opportunities to start giving back and provide feedback not only for them getting feedback from all of the rest of the partners, but then also providing feedback for what's working well, what can be improved on, what other things are needed. So you can see the minimum duration for that phase as well.

And then they're really trying to get the goals um of clarifying the role that substances have played not only for themselves but in their family and identifying sources of strength in order to move forward with sustained healing. finding anything to add sources of strength to that family connection and that unity and to themselves as a individual will just help them continue to move forward in positive ways that they're hoping to move forward in. And then the fourth goal is that generativity and that's the maintenance and trans transition to lifelong healing. So that is after all of the phases a family wellness court has done. they have met all of their goals for CWS. They have met all of the goals that the tribe has asked of them and they've met all of the goals that the court system has asked for them. And again, then they'll have a great celebration. Family wellness court has a tendency to want to celebrate positives. So they have um I think four times a year is the goal right now where they have shared meals in the evening. They turn cooking, they give back to their community. So that transition and give back piece is also um former participants coming back and walking with people through their cultural activities and on their growth journey. I think we're ready to any questions about family wellness court before I move on to early substance use. it's new or it's

family's honesty has been around for a few years. So, and it's um when I was looking at the literature getting ready for this, they were talking about how Judge Abby was really instrumental in helping create this new way of court systems working for tribal communities and tribal members. So the idea is instead of it them being up where judges normally sit and looking down, they sit around a table or they sit all at eye level to try and remove some of the barriers from they have a tendency to dehumanize and make people feel less than. So it's really a collaborative effort that feels really supportive.

Well, well, I'm sorry, not the Euro Wellness board, but the the one here in Hump, there's a I didn't realize there was a state one, too. there is a state. So all three of those are here assembled.

So we have and the staff for behavioral health are the staff that are involved with all three. So the judges are each involved with their own and one is also involved in state. CWS usually have it divided by who they're involved with. um the courts obviously by location, but our behavioral health team is the one that is that unifying thread through all of the court system that makes it so they're touching all of the families that are in any of those courts. I

I have a question wondering um I'm wondering how the integrations happening or could happen with the new benefit related to traditional healers. Um but is reimburseable you know or is what you outlined with I know there's a lot loaded in this. There is a lot about what those are. I mean, I bet you they're amazing, but is that all managed and handled in like with an internal team or internal to the core um team or is it where they're bringing in traditional healers from the from the tribe to

So, the traditional healing benefit is specific to Fred Medical organized delivery system, right? And that we'll talk about in a little bit and that's if they're part of a substance use disorder treatment program. While this program totally supports and encourages and gets people involved, this is for our behavioral health system which is um doesn't necessarily have that substance use treatment component. Yes, there are. Um I love stats. I love numbers. Are there is there a place to find numbers of who has gone through this?

That a great question. probably I'm not sure where those would live currently. Okay. So, but that is something that I would be interested in finding out as well. And one other thing um since I'm focused on Humble County and how cool we are, where are there other in the state and the war speed? Also, a great question. If my brain wasn't quite so um focused on the situation I've previous just left to come to here, I might be able to pull that information, but right now that is not coming to me. Sacramento. Sacramento and I know a few others do as well. Yes, Kelly.

I just wanted to piggyback on what Paul was asking. It doesn't have anything to do with reimburseable traditional healing, but the tribes wellness court staff are providing a lot of those traditional healing services as part of their component.

Right. So the tribes have their social workers and their case managers and they also have peers that come around and support. CWS has the social workers and they're also trying to get um some peers involved. Behavioral health has our clinician and SCD counselor that are involved with their treatment but clinician and case managers involved. And we also link currently back to tribal healing and the court sometimes suggests that. So one of the beautiful things about family wellness court is if someone on the team says, "Oh, hey, this might be a really cool thing for the individual to participate in. Hey, there's a camp out and they don't have a tent or any equipment." Then the team will problem solve that like who can get them the items needed so they can participate in the cultural activity which is really kind of a beautiful way to approach it. Big fan

wellness court staff from I know I'm seeing you know you're a wellness court because they work there for two years but they will have staff that will take participants like for ceremony and so like they'll help them get the camping gear and accompany them there make sure that they understand protocol and are there in a good way all of that which is really it's really special

and I am super excited right now we've um just hired on a new case manager so currently our clinician and family wellness court is enrolled in one of our local tribes and we have a case manager who is also involved with the tri community and a part of it. So, I think that having our behavioral health team um be able to understand and assist in ways that me as someone who doesn't have a Native American background can is really beneficial and supportive. Okay. So, our substance use disorder treatment programs, there are four county ran treatment programs. Um, there's Humble County Programs for Recovery. I will often refer to that as HCPR. So, if I say that, know that that's the one I'm talking about. Adolescent treatment, which is for individuals who are ages 12 through 18. our healthy moms program which is a perinatal program and then our dual recovery program which is for individuals who are open to county behavioral health and they have the co-occurring diagnosis so it's both mental health and substance use disorders county programs for recovery adolescent treatment of healthy moms the individuals are not often open to county behavioral health that is a service for what we used to call our level two and three clients where door recovery is for our level one clients and all that means is whether they're ser for their any other services would be in the community or through county behavioral health any questions about that all of our programs um that are part of the substance use disorder treatment program for so HCPR and adolescent treatment and healthy

moms they all in order to get services through them. The individual has to have partnership. So they have to have that direct medical benefit. I have medical also listed under healthy mom because healthy moms also sometimes opens people up to behavioral health and then does more of that counseling piece and they also have individuals who work with moms and littles on parent child counseling. All of them provide similar levels of care. So in the substance use disorder world, we have this spectrum of level of care from residential and detox down to recovery services or early interventions. So the outpatient teams or HCPR and adolescent of treatment and healthy moms all provide intensive outpatient which is nine plus hours per week, regular outpatient which is less than nine a week afterare and then recovery services and recovery services can be utilized at any um level of care. I'm sure we're gonna that's going to be redundant here in a minute but we'll still talk about it. I'm ready for the next slide. So the substance use disorder treatment program. So ignore dual recovery for a minute because that is again open to behavioral health. So the programs that aren't open to behavioral health are what we call the wellness and recovery model. It's a regional county model and there's seven counties that are part of the regional model that was created in order to reduce barriers for clients not only in our own county but for other counties to access services. So if I have a client who's part of HCPR and they need to go to detox out of county over in readings, we can now

facilitate that without the individual having to change their county pay county responsible on their medical. So, it increases the ability to quickly get our clients served without additional barriers that if they're not part of the wellness and recovery model that they would still have to face.

Yeah, I I see the county symbols there, but can you just say out loud what the subs are? Sure. It's I had him listed. Well, they're no longer listed alphabetically. I had them initially. I must have changed that at some point. So it's Modoc and Humbult, Dissu, Mendescino, Shasta, Solano, and Lassen. Okay.

If there are individuals who need a program that's not in one of those counties, then we work with the partnership and we do a zero fee agreement with them. It's still they're still able to get services. is just a longer and more convoluted process than if we're able to serve them within that those seven counties. So not Trinity. No ma'am or Delar a lot of our surrounding counties opted out. So Delore opted out which is unfortunate. Yeah, it's a huge

and one of the things that uh we do have that is open to individual or Delor is um it's not my program but I'll tell you guys about it because it's really cool. A stages has just opened up um services in Delnor County. prior to this last I don't know month or so um individuals for Delnar County were coming here for Matt treatment daily and just recently within the last few weeks

um they have now been approved to have a site open in Humbult. So all of their prescriptions come through Humbult and it's still filled through Humbult, but they can get provided their medication from that treatment out of a site in Del North. So we are again doing everything possible to reduce our barriers to clients getting the help they need. So

um the first program I'll talk about is county programs for recovery. Um we kind of briefly hit on it. So it's for any adult who is seeking treatment who doesn't meet the qualifiers for perinatal services or for mental health services are eligible to be seen at Humble County programs for recovery with the goal of empowering people emphasizing their self-awareness and creating meaningful changes in whatever way that they see fit. We are located um at second and D. So it's the address is 2312 street. So it's right across from Royy's right like right out there on the corner right across.

Exactly. Which is really a fantastic location. So most of our adult programs and staff work on the first floor and then we have groups up on the third floor in that building. So the way to access services and we used to send everyone through Carolon partnership if they haven't already is now taking that number back and is putting it back under partnerships um umbrella. So if they haven't done that um they will in the next month or two but it's going to be the same phone number. So I just updated the slide as if it was the same because nothing is going to change versus people who are calling it besides who they say is answering the phone.

So you can still do that. You can still call the program the directly. You can pick up information in person. You can ask us to send it to you and any part of our community partners can refer somebody to for um an assessment and for possible treatment. Joe, do you want to advance for me? So, we are primarily group based. We do provide individuals as needed, but staff right now are providing 15 groups per week and those are divided uh by the type of group or the group name that we've given it. So, our extended outpatient meets four times per week. the rest of them all the way to afterare meet twice a week and their afterare meets once a week. So we are doing everything possible to give people a variety of groups to attend that would fit their schedules their needs and their um ability to participate including an evening recovery group that meets from 5:30 to 7 by per week. So for individuals who are still able to work full-time we also have a group that they can attend. Yes.

I I have a question. Um I keep I keep hearing afterare. Um can you tell me what that may look like?

So afterare is um for individuals who have successfully treated been um through a treatment group in whatever way that makes sense for them. Right? So none of my programs are 100% abstinence only. So I really believe in harm reduction and so that means that people can complete group in ways that abstinate only programs they might not be able to complete the same way. So we ask individuals what's your problematic substance? How can we reduce or stop using your problematic substance? What does that look like for you? And then after they've met their goals and we've walked with them through that process and they're ready, then they're like, "Okay, I want the next step." And the next step for me um is support around relapse prevention, support on how to increase our copy skills beyond what we've already done in group. um maybe how to do a budget, how to re-engage in the community, how to either get the education or reenroll in school or reenroll in something so they can um get the job opportunity that they're hoping to get. So, it's all of that, you know, we have the baseline recovery, which is fantastic, and then it's what's next. And so the afterare for me and what I try and have our staff do is the the what's next part.

Exactly. Okay. Thank you so much. Because in in where where I'm at in the community um I I keep seeing the same faces go back into the same atmosphere uh without the after support, right? Um and and that's what I'm glad to hear. Thank you so much. Right. Very welcome. And we just kind of talked about all of that. So are there more questions about levels of care? Like what's the capacity for the individualized treatments? Like if somebody did wasn't suited to groups for reasons or whatever, like what's your capacity for like having be individually?

So we do that on a rare occasion when individuals need it. So it is really a case byase basis on how that looks or how that's approached. Some individuals come in a couple times a week, some come in once a week, and then some we might be like, "Oh, we can see you every other week or maybe once a month, right?" So, it's very tailored to what is needed. But I will say with that that drug medical services, so this organized system, it's DMCODS, drug medical organized delivery system is what that stands for. And that has some really rigid rules to it. So if somebody hasn't engaged in 30 days, we are required by the federal government to close them to services.

So while we are as flexible as we can be, we also have some really rigid guidelines that we have to adhere to. The behavioral health side is way more flexible and what we're able to accommodate. So, and if somebody's working with us like, "Oh, I can't make it because of X, Y, and Z." We don't consider that that they haven't showed up because they're so untouched. I would say, too, from my experience as a former alcohol and drug administrator in Sacramento, Kathy, that for many, many years, there's only been certain reasons you can see people individually. Yeah,

drug medical is a groupbased process and there are things you can do individually, but they're only for very specific reasons and you're not supposed to go outside those reasons. That is true. Um, Kelly has opened up that a little bit more. So, we are able to have a little bit more flexibility with that, but it is still primarily all group based. Are the groups open or closed? Both. as far as you have to be invited to attend the group. Okay?

So, you can't attend one group like unless it's your plan, right? Like I can't just bounce through around for group to group coming and going from each one as I so desire. But if someone is needing and wants intensive outpatient and wants the nine hours per week, they might do extended outpatient and our moral recognition therapy which is MRT or they might do extended outpatient in our roads group. So they can we can customize it in that way but they're not all groups are not open to all participants.

So I guess what you know groups sometimes have to structure and process so and it's disruptive if people are coming in group midway through the group cycle. Do they all have to start at the same time?

They do not. So and so great question and I know that there are some therapies that do that. We do one it's some helping men recover and helping women recover where there is a two or three week that's really intensive and so for that we may delay someone entry by just two or three weeks just so they're not coming in hearing about everybody's trauma as their first and the people telling about their trauma don't have as somebody in their room that they don't trust but that is really the more rare side of things rather than the dark

what what is the admin process like for someone to call and and receive services. What does that look like? So they call the Empire about services. We will do a brief screening with them. If they appear to meet criteria for the brief screening, we will either have them stop by or we'll mail out a packet via email or by um snail mail. They will fill out the packet and return it to us. We will have them do an assessment. It's an ASAM structured assessment and then they're put into groups pretty immediately after that assessment. So it sounds like maybe like a week or maybe two depending. Okay.

As I was thinking in terms of you know sending people your way about how long that might be. Pretty quick. It's a pretty quick process.

And once their assessment's done, the assessment really is the the the one of the keys, right? And once that's done, they can start groups the next day. Okay, I think we're all done with ACPR. The next one is our adolescent treatment program. Our adolescent treatment program is primarily individual based currently. So, it's working with the youth in our community ages 12 through ages 18. We have the supervisor is a mental health clinician and then we have substance use disorder providers who go out into the community brought to schools go out and meet kids wherever they are in order to provide services. We also have one who's involved at Juvenile Hall who does groups for New Horizons. So they're yeah New Horizons twice per week. So similar goals and for youth they do not have to currently have a substance use disorder. They don't have to meet that threshold or for criteria from the DSM in order to receive services. They can just be concerned of their use or just be using and want to stop using. So it's a preventative base. We also have clients who are actively using hard hard drugs and group also working with us. So it was kind of a a rainbow of who we can treat and how they are also housed at um

I think they're all Yeah, I think we can skip that one. Go to the next one. Um they they have to be eligible for partnerships. said then we'll help them get their vote but then we can go to the next slide Joe also has second and D they do have their own lobby and their own separate from the adults so people can go through the adult side and get we can take them over to the adolescent treatment side but it is it the second part of the floor for the first floor is dedicated to adolescent treatment and it is its own area and I think are There questions about adolescent treatment.

Healthy mom is our per needle substance use disorder treatment program. So for women who are pregnant or who have a child under the age of six years old, healthy moms focuses on helping participants, treating their substance use disorders and supporting them to become healthy, productive women and mothers. We do that for a variety of ways, but that is housed at H Street. So, it's right across the street from severance and that campus. Um, again, we have all of the things we can to support moms, including having a cooperative child care on site. And why I say it like that is the parent has to be on site in order to have their children child for child care. So, we're not able to provide child care for anyone who is not in our building. Moms has its own, you can go ahead and go to the next slide. Child moms has its own criteria for uh how to help individuals and what we're able to do. They do a lot of individual and a lot of groups. While the group at HCPR meets four days a week, they meet for 90 minutes. Healthy moms meets four days a week for three hours per day. So, it's really an intense supportive program. They provide breakfast to the moms and to the children when they arrive. If they arrive early, they may have a whole breakfast program and then they support moms dropping their children off at the child care if needed and then having support throughout that those three hours. They also have an outpatient program and after care. They have mental health counseling as well. So, it's more of a whole person picture program. Can I ask um

someone who's unhoused and don't um I think struggles to be part of that program, there's nothing really helpful. So, they can participate in multiple ways. So yes, that can be. We also have individuals who can provide reputs. So I will say that hesitantly because our parent educator um unfortunately had to resign due to some some other stuff that was going on. So we will be getting a new parent educator so then we'll have more capacity. But um we we try and do our best to give bus tickets or offer support or do the partnership rides. Um we also have um it's kind of like an early recovery group. I don't remember what exactly they call it. So for individuals who are actively using or not ready yet for the intensive 4 day a week program, we also have a group that they are invited to participate in. So um healthy moms also tries to do it's interactive things in the community activity field trips. They have volunteers who come and do quilting and they have potlucks for their stuff. It's for anyone who goes into that. It looks like a house and it feels like this home when you walk in. So, it's really kind of a beautiful program that I feel very lucky to have. They have a little playground outside for the little kiddos. It's just really kind of a cool space. Um, and we have the care coordination education. So, again, the federal guidelines, we

are required to provide parenting education to our population. So, we try and do that. We try and get them established with doctors and services in the area. We try and make sure that the youth are on schedule and seeing their doctors and making all of the things so that little family unit can be as healthy and moving forward the best way possible. Has this um county ever considered um opening a a paranatal residential? I know many people in the county have have inquired about that and have wondered about that. I don't know that the county itself has the capacity to take that on

but I think if an individual in the community would love to do that, I would support you 100%. Isn't the one that they passed the the city last year? So Crossroads is going to allow housing for individuals who are pregnant. Yeah. Yeah, but once that person gives birth, it's not going to be able to have a sustained way of keeping individuals in there. So, it's more of a shorter term housing. And I they they might change that. I think their goal when they presented at council, their goal was at least six months. That is true. I don't know if that

but six months post is still invent and not crawling, right? And so it's that next step for the up to age six I think that we're talking about that would get more of that perinatal program. So we have pat housing that some of our individuals and participants participate in. And so that is one area that they can have children and their family unit. Um and I think that that's we can use a whole bunch more than we have. Yeah. Yeah,

it's nice because I mean that's something that would be paid for. It's a complicated program, but drug medical pays for, you know, um residential parame.

Like I said, I would love to see that in our community. Yeah, it' be great. So, anyone has the gumption of money? Yeah. It's also meaning a lot of money. But it would also probably take a community partner like Oh, definitely. So much so. Yes. And apply for grants and all other things, right? It's all of the work to develop the idea and cost it out and do all the Yeah. the program and project development. That would be great to see.

It would be Next, I'm going to talk about our dual recovery program. So, all of those that I just mentioned again are part of our serving and drug treatment for individuals who are not open to county behavioral health or are not usually open to county behavioral health. I can't say that none of them are because some of them are. But our dual recovery program is specifically for people who have co-occurring disorders, both severe mental illness and a moderate to severe substance use disorder. If someone has a mild substance use disorder, I'm going to send them to outpatient counseling even through the county um as opposed to bring them into group because of the severity of that we're um working with. So, we would much rather have someone um not get new ideas. So, um but we do want to help support people towards recovery. Again, I do a our own side. I won't get ahead of myself. So, it's located also at Second Indep. So, the recovery part. So, it's all all in one building pretty much except for healthy moms and family wellness court. Family wellness support is up in McKinleyville, but the rest of the programs are all a part of the second. So the Joel recovery program has a different address because you enter on a different street, but it is the same building. We are primarily on the third floor. That's where the clinicians are and that's where our groups meet. We are fully integrated with HCPR though. So all of the substance use disorder counselors are participate in the adult recovery groups and our clinicians participate in the groups for Humble County programs for recovery. So while the criteria is different, the staffing is similar, which means if I have someone that comes to me and I'm not sure which group would be best for them,

any of my staff can tease out more appropriate for more appropriate for recovery program. So they do that pretty seamlessly where they're able to navigate that and if they um guess wrong they're also able to help that person find the group that is the most appropriate. So it's a I just love the way we're so integrated. So how to access is to open be up into mental health. We provide case management. We also provide individual services needed. We provide 10 groups per week. So I don't know if you guys remember but the 15 groups and then the 10 groups. So our my staff is providing 25 groups per week. Um we have a women's outpatient and a men's outpatient. We have a community group where both men and women are invited to attend. We have an early recovery group that is for individuals who are actively using substances and don't really want to give up substances. We have our recovery cafe for some individuals to participate in recovery cafe are also part of CCT. Many of them are conserved and recovery cafe happens up on the Brook Street campus. The rest of the groups happen down here at Sacramento. And then we have active care group and after care group is again reimagining what life looks like without substances and we when we have a foundation of health for our mental health and for our substances through recovery. So, it's getting out to the community. Um, it was I don't know my favorite groups. I should probably not admit to, but it's the men's group and the afterare group. But, um, the afterare group, we would sit down with clients and let them brainstorm what they're interested in participating in in the community and then it was our job to try and fit that in and to schedule it and make a calendar of how we were going to help them meet their goals. So

that included going to Avenue of the Giants and going to the visitors bureau where it's all chaotic with 100 people crammed into a little building and walking individuals through their mental health symptoms in real time and then we would go to the river and have a barbecue and kind of decompress after. So it was a way to how to engage in our community for areas that we may have been kicked out of. They may have asked the never time. They may have um never experienced like I'm taking individuals on the medicate. I had people in tears because they said not only had they never done it, but like I would never have had this experience had I not found my life without substances. So it's really kind of this whole comprehensive group where we've had many who have been in early recovery who are have said I never ever want to stop using that ever. That's great. Let's use without dying, right? Like, let's have the AT your baseline then. And then slowly but surely because no one was telling them they had to stop. And many of those people have sustained sobriety and have been free of their problematic substance use. Yes. Well, I someone who is being accepted into dual recovery needs to have an active substance use disorder. That means within the last 12 months they meet their background on criteria for a substance use disorder. Um individuals can continue in dual recovery forever. So you if there's comes a capacity thing then we make sure they're just attending the recovery groups instead of the active treatment groups. But it's it's so they can get as much support as needed because mental health and substance use they never go away, right? It's part of a lifelong community. Yes.

So are all of the programs then um harm reduction based and not like abstinence based. I have a couple of groups that are abstinent based. not for recovery but for um ACPR and healthy moms also has some abstinence because of the perinidal population but harm reduction is what all of my programs

are a part of and we have found that when people have enough freedom decide for themselves they not only give up their hard substances but they're giving up cannabis and they're giving up alcohol and they're giving up tobacco so I have people who are now break free from all of the above just because they finally had the room to make all of those decisions on their own. The two groups that you were talking about, you said that they were your favorites. You you talked about the men's group and the active care group. So the afterare group, is that the group that you were talking about? they go into the community and kind of relive. I just kind of wanted to I also all of our groups can so I can't just say that I've taken all of the groups to the zoo. I've taken all of the groups to the bird sanctuary over by Lolita. I've taken all of the groups on walks around Oldtown and up the trail and over to the bridge and back. So, and we've taken cameras and let them explore photography and taking pictures and then they get their fail back and then they can see what they took pictures of because it's this how do I participate in the world? How do I find joy in a world? How do I what are my next things that I are going to bring the satisfaction maybe not ever that substances did because um of the way it blows out or dopamine but how can I find meaning in my life and purpose in my life? Do you have a pretty seamless way for people to go once they turn 18 from the adolescent treatment groups to the adult programs? Yes.

And some of my adult treatment some of the counselors right now I don't have a female um SED counselor for adolescent treatment. So my adult clinicians for CPR sometimes take on female youth clients. So again, we really try and support each other for throughout all of the programs updates. So these are just updates that affect substance use disorder treatment for individuals who got substance use in my programs um in a general sense. So we have utilized subg funds which is a federal funds. is the substance use to block grant um to provide our recovery residents in in the past few years. The only recovery residents that accepted or that filled out the proposal and that we were able to contract with provided housing to men and so they have recently opened up a women's house. And so we're able to provide um housing for up to 14 individual and four of those are with women. Where is that? for tuna.

Oh, cool.

So, one of the goals of the recovery residence, so when we were doing this contract, so many of our um change over houses, if someone uses, they sometimes get kicked out for three days, sometimes a week, and some they can come back or maybe they can't come back. our animal since relapse is often a part of recovery. Our goal is to have a house that they wouldn't immediately be kicked out of. So, we have a house now where individuals I can't say they can't use, but they're not going to be kicked out immediately upon use. And they will work with the individual to get them back sober and they will work with the individual to make sure that they're connected. And um if that continues to happen, it takes a house vote

to for them to no longer be a part of that house. And the person we work with who manages those houses can override that. So they can't they can Oh. So they can override the house vote. So we can still have an individual stay if it's appropriate. Always. So it's not just about personality, popularity,

right? So, I love the idea that we now have a housing opportunity for individuals who are engaged in groups because that's part of the criteria is they have to be engaged in groups and getting treatment. There's free receive funding, but they do have this fun opportunity available. We also Paul had mentioned that traditional healthcare practice is at the bottom of that slide if you want to go back one. So, as of July 1st of this year, um I think it was actually March when the behavioral health information notice went out, but we have the traditional healthc care practices and are part of the drug medical organized delivery system. That means that individuals who are affiliated with a tribe can now have traditional healing practices and natural helpers paid for by drug medical which is fantastic and about time. So we're using natural supports, natural cultural based healing does not have to be evidence-based because traditional healers and natural helpers don't have that tons of research necessarily behind it. But the fact that we can now pay for what is best and right to do for individuals to get reestablished in their cultural communities is super fantastic. So we have two eligible providers in Humboldt. Currently the UHS is already approved. They are also approved through partnership for DMCOS services. So they are I haven't been able to connect with anyone there and see if they're actually starting to build for that yet. But but that's where we are with that. And then come out Hoopa is in that approval process. So they just resubmitted a

bunch of policies and items that they needed to have their um application continue moving forward. So but you know and when I was talking with Canal, they said you know this is what we do with all of anyway. this is our healthcare and so we're just really excited that for drug medical organized delivery system clients that now they can have what is needed and appropriate paid for through their cultural consciousnesses as well now we're ready to so prop 36 is for individuals who are charged with possession of different control substances and have two or more related key victims and they may be offered a treatment mandate felony instead of incarceration. So instead of being incarcerated, they can choose to do treatment. It is we're still working out some of the science with that just to be really honest. Um but it is something that we are actively trying to figure out and offer it to our community. It is already being offered. We already have individuals who are in our jail who have been offered this and accepted it and are joined to residential treatment. So my hope is that once they leave residential treatment then they'll start to work through the levels of care going back down and getting to outpatient Kelly.

The person who asked this question here earlier isn't here right now but if you receive a referral for somebody in custody how do you get them assessed to get treatment so that they can be released? So that is such a great question. We had an SD counselor in the jail and that counselor expert is no longer with the county but we have clinicians in the jail and clinicians it is a DSM diagnosis and clinicians can assess for that and clinicians can do the ASAM if the county is willing to train the clinicians to be able to do that. So that might be one possibility. You don't have counselors that can go in to the jail and do those assessments? There is currently

okay first of all I'm working at a 60% capacity sure and 50% capacity at healthy moms for my cl for my access so that is not something with doing 25 groups per week that we can add to our case load but we do desire that to happen and we do want to support that we're just not sure what that looks like I know just recently I was asking we do it tellah health Oh, that's a huge jail maybe and we but then that takes staff to hold the that like a whole

and then they're in custody and so with our being a short doily system is that reimburseable because we're not an ECM provider and I don't know that it it's like so there's a whole bunch of nuance which is why I said in my initial statement is it's complicated we're trying to work out some of those complications right now. So, um, we thought we had a plan and then we got thrown for a loop and now we are coming up with blueprints. Okay. Um, how long is the process to get the clinicians that are in there certified to be able to do those?

They're already overburdened though and there's only one clinician and there should be four. So like the the ability for that clinician to also take on substance use disorders responsibilities seems so my goal Yeah. I mean, but it's also people sitting there not sitting there in jail that shouldn't be in there, but there's a lot of folks that have mental health disorders that are Yeah, it's true. And that this is just anecdotal experience from the past. My my transparent goal that I have not shared with the directors or the deputy directors

aspirational. how much of the bus is gonna hit me. But I've seen in other counties where they train all of their clinicians throughout the entire county on how to do regular assessments and how to do as we move towards integration. I think that that would be really beneficial for our county. I think that at every no wrong door

spot where an individual may come see us, we need to be able to assess for what's going on. So my team right now, healthy moms can assess for behavioral health. Dual recovery can assess for behavioral health. If a individual comes through HCPR, they can get a one of a hold of one of the dual recovery clinicians and I'll have them assess for behavioral health needs. Right? So my programs can go both ways and my heart of heart would desire that to be the same and reciprocal for wherever somebody is able to touch our system. So if they come into Wood Street, I would love for them to be able to get an assessment and if the most appropriate assessment is an ASAP, that would be my heart of hearts. I do not know if that goal is shared by anyone other than myself. So I will take that on as my own secret, not so secret now because I'm taking it in this meeting.

But I I do think that that as we we're supposed to be integrated between behavioral health and substance use January 1st of 2027. And so as we move towards integration, I think that that's one of the many many steps that could be beneficial for our and I think that will have this added benefit of reducing stigma. So I see Vernon and then so sorry. Um does anyone have a white Buick out there? Good. Keep going. Sorry. Sorry. A car sustained damage and they would have needed to go out there right away. Oh, thank you. sucks. It does.

So, I think just really being paying attention to how we can merge our county into being able to help all of the individuals who walk through our door at any given time is going to be super helpful. Bernie, I saw your No, I just pointing to back everybody. Okay. Is there any other questions about Prop 36 and the fact that we still have kinks to work on, but it's still a great protocol. Okay, next is SB43 and Senate Bill 43 and I'm sure you guys, many of you have already heard that it is expands 5150 criteria.

Yeah.

To have substance use, severe substance use as one of the qualifying diagnosis for 5150. So most counties have reported they haven't seen a huge increase in their 5150 holds. Um so I will say that kind of anecdotally that most of the individuals who they see still have an underlying memory disorder as well. But we do have some right but I would and severe alcohol use was already part of the 5150 criteria. So now it's just figuring out a way that all of our blocked impatient units or some can treat substance use disorders without um having people suffer the difficulties of withdrawal and um the complications that come from withdrawing. The next one on that slide is the behavior health service act. So the behavior mental health service act. We used to have door recovery as part of our MFA dollars and uh now the state has said instead of having mental health service act funds we're going to have behavioral health service act funds and what does that look like? And you can use part of that money for individuals who have substance use diagnosis as that qualifier as well. And so we are working together with Pmental Health Service Act folks to be able to figure out exactly what that means for our county and how we want to use those funds in our county. Again, that's going to be part of our 2027 integration. Right? So, not only do we need to integrate all of our systems, uh, but we're also integrating some of the funding that's been primarily used for mental health services

without extra funding, I think. with less less do more with less 5% less

so I said up there is expanding funding to to include substance use disorders coincides with um having the integration by 2027 it's promotes the full integration by allowing that coordinated care shared data and streamline referrals and it's trying to increase flexibility now I will say that when you are always you never are like oh no I have all of this money I don't know what to do with it and then they're like please divide it again it creates conflict so um but I also think that it's a really great way to if somebody needs a pair of glasses and they're part of our substance use disorder program to be able to provide a pair of glasses we do that for individuals that are part of our mental health programs right so I think that there is some really great practical things that we can to really the health of all of our clients. And then next slide, it's my last slide almost. So, Narcan, so we're part of the Nlloxxo distribution project. And we have um distributed over 700 boxes of Naria to our community partners to our server living houses to um different tableling events. Um I just saw that we're providing another 144 plus to another department. So we are doing everything possible to get Narcan into the hands and those that need it. My goal is to pass it out like hey you can't be. So um I've been really transparent in that goal. I want everybody to have it. I want it to be a part of your first aid kit. I think that um if we have it and carry it then we can help people not die from use. Um

right now it's often taking more doses of Naran to bring somebody back. So if you're going to have Narcan on you, please make sure you're having are the boxes we distribute. We have two doses. So make sure you're having multiple boxes of Narcan. Yeah. To piggy back off of that, I have personally experienced having to resuscitate someone about a good month ago with about three doses of Narcan back toback. I had to do a five minute about two minute intervals each dose. So just I I would highly recommend all of you if you do have it, keep a lot of it around you. It has taken quite a high dosage to back up. Yeah. So yeah, I have seen that my always call 911 if you're administer like those two things. Yes. Administer narciss.

Um Michelle and I are about to put in another order of narcan because we ordered like 500ish. That's enough that we're about to get rid of a whole bunch more, but we're going to order some more. So we'll again have this supply so we can just be passing it out as people need it. I have it like a giving tree in one of my lobbies where um they can just come and pick as much or 10 as if they want or need. Um I also have baskets in my other lobbies with those baskets. I also have temp test strips. So I think the more we can help people know what they're using, the better it can be. I have had many people who've tested the map and it had fent in it and they decided to not use that map. Wow. So I they've also decided to use smaller doses of that to see how it affected them. Right? So I have both but at least they're not taking their original dose and then overd so we have some really good things that we're doing in the substance use world and I have way too many strokes sitting in the office. So if people need them, please let me know and I will distribute some just really knowing. And then the last thing I just wanted to say is um we have had a contract with Cal Poly Humbult for interns for social work interns for a long time. And for College of the Redwoods, we had a contract, but we never had a contract for our substance use. And prior to me, it was one of those things where we had interns come in and go, but it wasn't really um an official relationship. And then I was asked to get an official relationship in place so we could start accepting College of the Redwood interns again. And now that is in place. So we can now accept interns for College of the Redwood for our substance use disorder program advocates still accept.

Okay, that's it. My next slide is what questions do you have with five minutes left? Our meeting time. I know. Um, thank you so much. Well worth the wait. Joe, I hope you can send the presentation to both. There's a lot on there. Kelly, you have a short question. I do. I have a question. I mean, I can talk about that. Yes.

Just for everybody's knowledge, how long does it take to get trained in ASAM and how are those trainings provided? So ASAM right now I have it's like multiple hours for ASAM I think but it takes a few days exactly is it online or in person? It is an online train. Does it cost the county money to send people to it? Um I have currently yes probably but

I has currently only done it through our DMC ODS services which is brand by partnership because we're in that wellness and recovery model and so right now it does not cost the county because partnership is providing that training to the MCODS treatment staff. Can providers get CEUs through every Yes.

All of that. Yes. We're also um as of January 1st of 25, we were supposed to go to the ASAP 4 in the state of California, the a California decided um rightfully so that we didn't have the infrastructure in place to move to the ASAP 4. It will change all of the levels of care. Every single level of care will be a new number. So between that and all of the other things in place, California decided, hey, let's pause on this. And we said, fantastic. Thank you. So it might have it was supposed to been roll out since July. It did not. And now the state hasn't given us a new time frame for that to roll out. But with my goal of eventually getting our clinicians trained at maybe when that new ASAM rolls out then we will be able to train people in person and have it be a wider accessible thing for staff. And then um we also were just talking about how in a different county they have narcan um vending machines essentially

and we also have those in Humble. Oh yeah. So we have Aegis has done a really good job and I think there's another I don't remember who right now but they have they have some over in the Guro tribe. They have some over at Hoopa. They have one in Willow Creek. the VA. So, we have tried to have um multiple vending machines. Some of those are actual vending machines themselves and some of them are just display cases with the dark tan on that you can take with the vending machines themselves. You're supposed to put them in like your birthday or whatever, but you can say today is your birthday

and and it gives you the thing. It doesn't have to be accurate information. It just has to be information. Um but then you can get nar through a variety of and also a reminder that your emergency room also passes out Nam without asking you questions. Awesome. Okay. So we've been doing our time where I work for our emergency kit. How often does after you replace? Has an expiration date on it. Okay. So the exp what the professionals say is it is good to use up to a year after that expiration date without using any other effective

and also I've been trained that if you have expired narcan and you don't have access to any other it's better to use the and I will also say as a trainer um one of the trainers who came to us while it was an injectable pen not the basil that we're currently using um was showing a demonstration and actually injected herself with live Naran instead of the training pen and nothing happened. Absolutely zero. So don't be afraid of using Narcan, okay, with any ill side effects because there won't be any side effects unless there's opioids in the person's system. Bankro. That's interesting.

All right. Awesome. 1414. One minute early. We will adjourn this meeting now and if you have other questions I'm sure that Diana would answer them for three minutes. So thank you everyone. Thank you Deanna. Thank you so much. and