Veterans Affairs Commission - Regular Meeting

Recording in progress.

Commissioner Santana? Here. Commissioner Smith. Here. Very

good. We're gonna move on to the adoption of the agenda and approval of the consent calendar. Commissioners, any comments? No. Thank you. See none. Public comment. Public

comment is now being accepted on items on the consent calendar. Comments are limited to three minutes per person. Voluntarily state your name for the record. Participants who would like to make a comment should press the raise hand button. Phone participants, press 9. If you're here in person, please raise your hand. See none on-site and none online.

Very good. We're gonna move forward. We'll now vote on the approval of the agenda and consent calendar.

Commissioner Abram? Commissioner Santiago? Commissioner Clever? Aye. Supervisor Ferrero? Aye. Commissioner Santana? Aye. Aye. Commissioner Smith? Aye. Aye.

Okay. That was the and we're we're approved the agenda and consent calendar. We're gonna move forward with public comments for any items that are not on the agenda.

Public comment on items not on the agenda is now being accepted. Comments are limited to three minutes per person. Please voluntarily state your name for the record. Online participants who would like to make a comment, press the raise hand button. Phone participants, press 9. If you're here in person, please raise your hand. I see none on-site and none online.

Good. So our next item would be the next item on our agenda then is the presentation by Eldorado County Behavioral Health Department staff on substance use disorder prevention services in El Dorado County. Commission to receive, review, and discuss, and take action as appropriate.

Alright. Can everybody hear me?

We can, Sean. Thank you. Okay.

Perfect. Hello, commissioners. I apologize for not being able to be there in person. I had a family matter that I have had to help my parents out with, but I am grateful for the opportunity to do this presentation, virtually. My name is Sean O'Malley.

I am the AOD division manager with substance use disorder services in behavioral health and I really appreciate your time and allowing me to talk to you about our substance use disorder services youth prevention efforts. As I said, I truly appreciate your time because prevention starts with community partnerships and it ends with community partnerships and a shared commitment to supporting our young people. Today we will explore the overview of prevention as well as some specific activities that we're doing and look at the benefits of investing in upstream strategies to strengthen youth well-being and reduce long term risks. Next slide please. Right, so here's what we'll cover today.

We'll begin with federal and state mandates that shape our prevention responsibilities. From there we'll walk through the strategies and frameworks that we use in prevention. Then we'll talk about why youth prevention matters and how it impacts not just individuals but families and communities as a whole. And finally we'll go over very specific, strategies that we use. This is this includes the CSAT six which I'll go into as well as our data collection methods and measures.

I'll outline the county's role and wrap up with some local initiatives that are happening right now in El Dorado County. Next slide. All right, so one of the foundations of prevention work or the primary foundation of prevention work is what is called the Substance Use Prevention Treatment and Recovery Services Block Grant. It was reduced to the Substance Use Block Grant a few years ago and this is a federal prime award that we get that is administered by DHCS and one of the requirements of the Substance Use Block Grant is that at least 20% of the funds that we receive are devoted to primary prevention. That's at least 20% of the funds.

It can of course be more than that, meaning that efforts occur before substance use begins. Next slide. In California of course the Department of Health Care Services administers these funds and ensures county level compliance. While each county can tailor its strategies to local needs, all prevention activities must be evidence based and meet strict state and federal reporting requirements. The state enforces the 20% prevention set aside and ensures that counties plan, implement, and evaluate primary prevention programs consistent statewide.

Next slide please. All right, A couple important frameworks that drive prevention activities and the first one is what is called SAMHSA's, the Substance Abuse Mental Health Services Act Strategic Prevention Framework or SPF. And this strategic pre excuse me. The strategic prevention framework or SPF consists of five focuses. The first is going in and assessing what the problems are. What are the problems in the county? Where is the need? Where should we be focusing efforts? The second is capacity building, is about preparing resources. The third is about planning, choosing effective strategies.

The fourth is about implementation and putting those plans in action, and the fifth is about of course examining outcomes and processes and impact and identify and update our logic model based on the framework, and I'll talk about our logic model later. Next slide please. In addition to the prevention framework in California and the federal requirement for prevention framework, California adds two guiding principles that we must always integrate throughout our prevention work, which is first cultural competence, engaging effectively with diverse communities and second sustainability. We really need to focus on building prevention efforts that last and adapt over principles anchor our prevention activities and tie into our logic model, which as I said before, I'll speak about later in the presentation. Next slide please.

One last model before we kind of talk and get to more specific stuff. So primary prevention also focuses and uses the Institute of Medicine's Continuum of Care and looks at three areas of prevention, which is first of all universal prevention, which is strategies for all youth. But we also have prevention efforts that focus on selective strategies for youth at high risk as well as some indicated strategies for youth also already showing early signs of possible substance use or problem behavior. Matching the right intervention with the right population is of course essential at all times. All right, next slide.

So let's take a break from these models and ask ourselves why does prevention matter? We know that prevention matters because early prevention reduces future treatment needs, it builds youth and family resilience, it improves community health and safety, and of course supports mental health and overall health of systems. Simply put we know that when we support people young and early we set the stage for healthier pathways throughout the rest of their lives. Next slide. All right.

To do this prevention focuses on both risk and protective factors. Risk factors might include peer pressure and low perception of harm. Protective factors include coping skills, supportive relationships, and positive engagement like sports and clubs. Building up these protective factors often has the most powerful long term impact on youth. Next slide.

Can't talk about prevention or youth efforts without talking about ACEs of course. ACEs, adverse childhood experiences, are traumatic and stressful events before the age of 18 that significantly increase the risk of substance use and mental health issues later in life, and of course the opposite and what we focus on is those positive child experiences which help buffer against these challenges. They help build resilience and emotional health amongst use. SAMHSA of course prioritizes trauma informed upstream approaches like mentoring, family engagement, and cross sector collaboration to support all youth environments. Next slide please.

When we're working with youth, Sampson also recommends or requires that we work with youth at all levels also known as the social ecological model where youth behavior is shaped at both the individual level which is traits like impulse control, the relational level which family and peer influence, the community level which looks at neighborhood safety and resources, and of course the societal level which is access to education, healthcare, and larger scale macro events. Each prevention area addresses each layer not just one and they are all interdependent and work together. Next slide please. Just a little bit more on the social drivers of health. When we look at in prevention we're looking at the social drivers of health.

We're looking at education access, community support, economic stability, health care quality, and safe environments. We know that these all play major roles in youth substance use and of course effective prevention accounts for all of these conditions. Alright next we're going to get into the Center for Substance Use Prevention, prevention strategies. These are specifics. So those are more about larger kinda theoretical model based prevention requirements.

When we talk about the the CSAP six, which is the Center for Substance Abuse Prevention Strategies and our logic model. It really helps to inform what we do at the local counties. And so the CSAP six is of course a practical guide work that is prescriptive for how to implement prevention programs. There are six strategies. The first is of course information dissemination.

This is one way communication aimed at raising awareness and knowledge about substance use and related prevention resources. This is stuff like brochures, media campaigns, public service announcements, health fairs, any kind of fairs or speaking engagements. The second is of course prevention education. This education is more interactive, two way, more didactic to enhance life and social skills. It helps enhance decision making, refusal strategies, critical thinking.

These are classroom activities often happening at intermediate level, middle school level, younger or older sometimes at at the high school level and these are really about engaging classes, peer leaders, mentoring different targeted curricula that we use. The third strategy is alternatives. This provides substance free activities to meet community need and reduce attraction to drug use. These are examples like alcohol and drug free social events. These are you know drop in centers, community service projects, leadership opportunities, different kind of mentoring programs.

Number four is problem identification and referral. This focuses on early detection of risky substance use behaviors and directing individuals to necessary education and treatment. These are screening programs that are in schools and workplaces is a good example of these. Number five is community based processes which builds capacity within communities through planning, coordination, and collaboration to support prevention efforts. Examples of these are, like, communities needs assessments, coalition building, multi agency collaboration, volunteer training, strategic planning and technical assistance.

And finally, the sixth strategy is environmental prevention. This involves changing policies, norms and physical environments to reduce substance use across the population. This involves policy creation and enforcement, compliance checks, zoning, pricing strategies, advertising restrictions, law enforcement coordination, and public awareness campaigns. All right next slide please. Just real quick touch on the data.

All prevention data is collected through a DHCS program called Super. They actually changed the program on us and rename it every few years before that was Echo and before that was something else, but data is collect and tracked through these online DHCS programs that we implement this data into. Next slide. All right, so every five years or so a substance use prevention plan is created and implemented to help guide prevention activities. The latest plan is the 2025 plan that goes through 2030.

It focuses on evidence based prevention science, resilience and engagement, improving overall well-being and of course strengthening the prevention workforce. The substance use prevention plan and the CSAT six give us the structure that allows us to map activities and track implementation, evaluate impact and report consistently by ensuring programs are grounded in prevention science. So what we do is we take these prevention plans and the CSAT six and at our local county we develop what is called a logic model. And each county develops a logic model, working with the state to identify what our prevention activities will be over that period of time. And a logic model is you can think of it as essentially a diagram or a cause and effect pathway, essentially a road map for what the prevention activities will be over the five year period.

Know it really helps us identify what our short term, middle term, and long term strategies and change should look like. It helps us develop I'm sorry, next slide please. It's what guides the county in the development of the prevention programs that we do here in El Dorado County. It helps us identify which initiatives we want to fund, which coalitions we want to support, what data we're gonna be collecting and reporting on and any other kind of prevention focused policy really is driven by that logic model which is developed out of the strategic prevention framework and these other models that come to us through SAMHSA and Department of Health Care Services. Alright.

Next slide. Alright. Just a couple more left. Practice components. You know in prevention of the most important things is that we are engaging the appropriate interventions across the individual relational community and societal levels.

We want to make sure that we are always tailoring our local prevention strategies to what our local needs are and that's one of the things that are prioritized in our local logic model through the county. Next slide. And so these are some of the current initiatives that our prevention team is working on and it includes partnership with EDC Animal Services, presentations and peer advocacy classes with the juvenile hall, training local organizations on protective factors and facilitation skills, education on alcohol and drug effects, especially cannabis and also we are seeing kratom becoming a big issue, especially with youth. Mentoring partnerships, student led initiatives, obviously outreach flyers, information dissemination, engagement with others, talking about research establishments selling kratom and working with people to help understand the dangers of kratom. Obviously promote alcohol and drug free community activities, and support of course schools and local schools and organizations with brief intervention and motivational interviewing skills.

Next slide. Okay that was it. I really thank you and thank everyone for you know taking the time to learn a little bit about prevention. I know that by working together we all hope to strengthen and improve our community And with that, I wanna open it up to any questions. Anybody might have any questions or anything?

So commission, anyone have any questions? Go ahead.

Hi, Sean. Deanna Santana from Edco, the Commission for Youth and Families, and also First Five El Dorado. There's just a few initiatives that our commissions are working on that I think might be a good place for us to plug in together. When you referenced the ACEs and mentors, First Five is actually has put addressing ACEs in our zero to five population in their strategic plan for the next five years. And we're doing that through a early it's a book buddy program where we're going to have volunteers going in and reading with TK and Kers and then actually eventually transition into thought upgrades so they have a consistent person showing up in their life with that for that Paces thing.

So I think that that's something that we might wanna talk about. And then on the Commission for Youth and Families side, one of the initiatives we're exploring is one mentor for every child in the county, both formal and informal, and how do we build that network so that we know that all our kids are being touched by someone who understands the role of a mentor and is doing it in the in the right ways to connect them to services. So we'll be having a gathering in the next month and a half of all of our mentoring programs that we're aware of, but we also know there's tons going on that aren't. So we'd love to have you part of that.

Yeah. That sounds great. And and, you know, one thing I just realized I left off the slide when I should have put out there when I was presenting is who our prevention team is. And so, we have an amazing prevention coordinator who is Mel Fisk along with two other staff, CJ Runyon and Jessica Manken, who are our prevention health education coordinators. And I think Mel is on here. Wave, Mel. Say hi. We will definitely make sure our prevention team connects with you and looks for the opportunities that we can to support our youth and the community, of course.

Thank you. Thank

Any other commissioners' questions? I do. Is Shana, it's Greg Ferrero Ferrero.

Are you guys doing anything, I'm assuming you are, but specific to the threats of fentanyl poisoning and, you know, the the fentanyl being illicitly put in drugs that are assumed to be legal.

Just if you

are we doing anything with that since it's such a huge threat to to, you know, and young adults?

So we we are. So we we work we collaborate a lot with COPE and we were actually participated and funded many of the fentanyl high screenings and activities that have been out there to get the awareness out about the dangers of fentanyl because you're right. They are being placed in medications that look real and also just other illegal drugs that they didn't know where there was fentanyl and people are being poisoned. So, yes, our prevention team works directly and is participating in activities to actually get the awareness out there, regarding the dangers of fentanyl.

Thank you. Here.

Yeah. I had a couple questions for, related to you had talked about, kind of the early perfect prevention and identifying students who are potentially at risk. What are the processes for actually identifying those students? Is that happening mostly through the schools, like, the administrators, teachers? Is that happening through, like, family referrals? Where does most of that, like, information come from?

You know, that's a good question. When when we're looking at so there's different levels. There's different levels of identity and risk. Sometimes it happens at prevention where you're we're engaging with youth and mentoring youth that might show some morning behaviors. Sometimes that grows beyond the the prevention side, and it's actually an intervention service where they are actually actively using and they need some kind of brief intervention or lower level of treatment and so that happens, it depends.

Sometimes it happens when, our staff are engaging at at the schools. Sometimes it happens and comes from the schools through many of our mental health providers through the schools. Sometimes it comes through referrals. It just really depends on the situation but pathways there to actually identify those situations. They're not perfect. That's for sure, but but they do exist.

Awesome. Okay. And then my next question would just be, at least from my experience, a lot of substance abuse I've witnessed from within students my age usually started around middle school. So I'm just curious when the, like, when the timeline is of this, like, of the early prevention. Is that starting in middle school, elementary school? Like, how do you work on that timeline?

Mel, are we going into the middle schools right now? Yes. We are. Okay. I'm gonna have Mel share on that because she is our amazing prevention coordinator. She could speak more to us exactly where we're going and what part what the schools we're going into.

So we are networking with any middle school that will coordinate with us. But earlier than that, school would definitely be what we we all as a as a collaboration, all the different community partners. The earlier we engage and educate and interact and go over risk factors and coping skills and protective factors, the better. So I'm sorry. I just

No. That's great. Thank you, Mel. Okay. Yes. So we are. And and we're it's we are engaging with the schools as as much as possible. You know, each has their different frameworks, but we we do work, and we're also open to looking at future collaborations. I know that some of our prevention strategies and focuses have changed over the years from what it was, like, five years ago. So we're also always just open to, like, looking at our logic model and engaging with the community and seeing what works.

Okay. Any other commissioners?

Yeah. When I've when I've looked at various spreadsheets, I've seen this. It looks like there's been a grant or an allocation of funds for opioid opioid use. Does that does

that settlement go to you? Yes and no. Yes and no. So the opioid settlement funds is different than prevention dollars. It's it's it is the contracts are administered by us, but the nuances, think, are are higher than me.

And so, yes, we do. And and how we how we give out those opiate settlement funds is it's part of the board of supervisors had put developed a strategic framework for utilizing those opiate settlement funds. And so we go through an RFQ process with providers, and then if they meet the qualified list, they can get contracts as grantees for those opiate settlement funds. And so yes, SUDS is the I am the contract manager of those contracts, but it's a little different than service contracts that we operate with, our DMC, ODS, and Medi Cal dollars.

Thanks. Thank you. Mhmm. Anyone else? Commissioners? I see none. Public comment?

Comments are limited to three minutes per person. Please voluntarily state your name for the record. Online participants who would like to make a comment should press the raise hand button. Phone participants, press 9. If you're here in person, please raise your hand.

Is it okay to talk? Like

Yes. Sorry. Sorry.

Great. Sean, I was just hoping this is Matt Smith, director of mental health and wellness for Edco. Just hoping that you could talk really briefly about the Narcan distribution and how that impacts and then how we're able to get it to the schools, throughout the county either through our programs or through your programs.

Trying to hit me with a tricky question. So right now I could only speak for HHS and HHS is developed in the process of developing a policy around this. I don't wanna speak on it until the policy is developed and that we actually have a formal policy approved by our director through the requirements to actually have a a formal policy through HHSA. But we are looking at what this looks like for us as HHSA being able to be not just a behavioral but HHS policy. So I can't speak on that right this second exactly what that looks like.

But what we do right now is we partner often with COPE and so individuals that are looking for Narcan, we connect them with our our either Marshall or cope and get them set up. But we are also looking at a policy ourselves with HHSA. We just don't have it finalized yet.

So I will acknowledge we are still holding our public comment, but I do not see any on-site or online. I will also mention that the timer is not displaying on the screen so our staff will notify when we're at thirty minutes and then when three minutes is up.

Okay. We've we've finished your public comment. Alright. Very good. Else from commission? See nothing. Very good. We can move on. Thank you, Sean, for your presentation. This is Jim. And I appreciate you showing up, and and it sounds like a good preventive service intervention is would be a good idea to learn a little more about all those services you provide also. But thank you very much for tonight. Thank you.

Thank you. It was a pleasure to be here.

Okay. Thanks a lot. Alright. So we're gonna move on to the next agenda item, which is presentation by commission chair, would be me, of the twenty five twenty twenty five Behavioral Health Commission annual report were presented to the board of supervisors on 04/07/2025. Commission to receive review and discussion, take action as appropriate.

So you have a copy in your agenda, and I see it's on the screen. Page one just indicates what the report's about. Moving on to page two. It talks about the purpose and the objective of the commission. It states why we exist, the welfare institution codes that we exist under, our bylaws that we exist under, our duties, which is to review and evaluate behavioral health needs services facilities where mental health problems in any facilities and special problems in any facility within the county or jurisdiction where the mental health or substance use disorder evaluation services provided.

Page two, it states our objectives and their pursuant to welfare and institution code fifty six fifty. We are we advise the board of supervisors and El Dorado County behavioral health directors to any aspect of local behavioral health programs. The we're gonna move on to page three. Page three lists our 2025 membership, and it also lists our 2026 membership. Page would be page four.

Page four and five go into list all the meetings the commission had for the year. We had quite a few. Every month, we had some good topics for discussion. Page five. Page six talks about our ad hoc committees that we had during the year.

Mental health service act committee say fiscal year 2526 plan update review, 2026 data and notebook review, and completion ad hoc committee, ad hoc nominating committee for commission officers in 2026. And we had an ad hoc committee to engage in behavioral health service act committee planning process, CCP, and providing updates. Page seven, challenges upcoming challenges for this commission in this year. Staffing vacancies, has been a challenge almost every year. The impact of proposition one behavioral health service act, BHSA, on deliverable mental health substance mental health and substance use disorder services, the need for transitional housing, commission membership filling vacant positions, and commission membership meeting the WIC fifty six zero four requirements.

Page eight is reviews our government documents. Pretty much that was at the start of the start of this PowerPoint presentation, welfare institution code fifty six zero four point two, our bylaws. Our our bylaws were updated in 02/11/2025, approved by the board of supervisors, We're governed by the Ralph Brown Act, and we follow the El Dorado County Board Committee and Commission handbook. Page nine. Our upcoming goals and work plans, hold monthly behavioral health commission meetings, continue to review and evaluate behavioral health and substance use disorder services, hold educational services, presentations of the behavioral health service act updates of required behavioral health division programs and their delivery of services to consumers, and work collaboratively with the behavioral health division in reviewing and evaluating services delivered to consumers.

And that is the PowerPoint presentation. We followed the county's template that was provided, and it will be presented on April 7 to the board of supervisors. I just wanted to see the for the commission to be able to see what will be presented, see it tonight, and get your support in moving it forward. And chair would accept would accept a motion to move forward with this presentation to the board of supervisors.

I move that you move forward with this presentation.

You. You're a second.

Commissioner well, I I Commissioner Abram, we will go through the public comment before taking motions. Okay.

Okay. We need to do public comment. Commissioner comment. None. Public comment.

Comments are limited to three minutes per person. Please voluntarily state your name for the record. Online participants who would like to make a comment should press the raise hand button. Phone participants, press 9. If you're here in person, please raise your hand.

My name is Cheryl Trainer. I'm a NAMI volunteer, family member of someone with a dual diagnosis with mental illness and substance abuse from another county. And I've worked in this county for thirty eight years as an occupational therapist with children and young adults with special needs. And so I'm here, and I'm not sure if this is the right place for the public comment for the second. Mister Abrams, you did a a wonderful job of those data. And there's a second part where you're describing things. Is that a different that's gonna be presented? The rest of the report that talks about a description of the different activities from, like, the wellness center.

Yes. That is the next agenda item.

Okay. Then I'm gonna wait and do my comment then. Thank you. Alright.

Thank you. So any more

I see no others on-site or online.

Thank you. So moving forward with the motion. So moved. And we've been seconded to move this forward. Did I hear a second?

I'll second it.

Okay. Second. Just vote on it.

Commissioner Abram? Yes.

Commissioner Santiago? No. Commissioner Claver? Aye. Supervisor Ferrero? Yes. Commissioner Santana? Yes. Commissioner Smith Smith? Yes.

Very good. Now we can move on to the the behavioral health division's director report report. Commissioners, any comments on the report report? See no questions from any commissioners on the report. None? Okay. I see none. Public comment?

Comments are limited to three minutes per person. Please voluntarily state your name for the record. Online participants who would like to make a comment should press the raise hand button. Phone participants, press 9. If you're here in person, please raise your hand.

Alright. Again, my name is Cheryl Trainer. I think you've got my background that I've had money roles in this county. The most recent is being a NAMI volunteer. And I also mentor therapist still even though I don't work as an OT. And I'm appreciative of the descriptors that you gave mister Abraham about the wellness centers and the different services. But I noticed that there's nothing mentioned about a vendor support and that is the clubhouse. And I recognize that it's not a county program, but it has been funded by the county for the last couple of years, and we appreciate that support that the county has given us. So the reason I think it's important

is because it is part

of the greater plan of what is serving our families and members in our county. We have over 250 members. It is when I worked in special ed as an OT, there was what we call mild to moderate students, and they were often in the general ed classroom were brought in for special services. And then there was children that were more severe, and I worked with all the gamut, and they were in a special day class. So what I see is the wellness center is set up for those severe mental people with severe mental health concerns that need more structure.

And the clubhouse has been set up for those who are ready for another step to maybe get a job. I have someone living in my house right now who is a clubhouse member and is now working full time. So I see it as a necessary part of our county services, and I think my question is really why is it not mentioned in the report that you're presenting to the board of supervisors? Because I think it has been an important part of our overall services to this county. So thank you for your time.

Thank you for your comment.

I see no other oh, I see one more on-site.

Do I press the button? It's supposed to be green. Oh, it's on. Okay. So hi. My name is Diane Rabinowitz. I am president of NAMI, and I'm here to follow-up on Cheryl's comment to emphasize the importance of Clubhouse in our county. I'd like to provide some data, some information and data about the services that Clubhouse provides. We currently serve over 300 we have 300 members, over 300 members, and we see a 120 members per month, 20 to 25 members per day. Some of those services, the supports that our members obtain, they link regularly to services deemed necessary to support their physical and mental health.

The clubhouse helps them identify and meet their goals for education and work, maintain and improve their financial health, maintain and improve their family relationships. In the past year, our members have developed skills in food service, ordering, stocking, meal planning, recipe selection, cooking, menu publishing, developed skills in multimedia production, developed hospitality skills, developed public speaking skills, written better than mine, written 61 resumes, secured 66 jobs, in a 100 interviews, spent five hours a day at the clubhouse with an average daily attendance of 20 to 25, partaken of over 8,000 meals, including breakfast, lunch, and dinner made by them and packaged by them, reducing food insecurity in this county. Linked to community resources for health, mental health, dental health, visual health, and support for chronic ailments, attendant groups for substance use abatement. Here are some quotes by members. I've gained emotional support and help with trying to build a better life.

I love the clubhouse so much. It's my first and only home. I love this place. I'm working on my medical health and looking forward to going back to school. I'm finishing my bachelor's degree soon. I'm thankful for the support of the club. The clubhouse changed my life because it made it possible to make friends who understood my position in life and my mental illness. I don't feel so alone anymore. We invite you to visit the clubhouse and see our act our our clubhouse in action, and we urge you to support the functioning of our clubhouse. Thank you.

Thank you. Thank you.

We have a comment online. Matt, can you please unmute yourself and provide your comment?

Yeah. Again, Matt Smith, Director of Mental Health and Wellness. Just with the definition of wellness center, just again, encouraging, and I've you guys have heard me say this before. Wellness center has become kind of a generic name. And so if we could try to really, differentiate between, like, the wellness center that's in the the document versus the wellness centers at the schools versus clubhouse and other types of wellness centers. There are lot of different types of wellness centers with different purposes and different goals and different structures. It'd be great to be able to differentiate between them. Thank you.

I see no others on-site or online.

Very good. Follow-up from the commission? Good. We can move forward to the final item, which is commissioner's comments. It sends department matters, and we can move on to commissioner comments. Just general closing comments if any commissioners have one.

Well, I got a request, and I Justine isn't here tonight. But I'm really confused, which is kinda normal for me, between, prevention and early intervention. I quite frankly really don't know what they are. I I I I Googled it. I I I've looked up the the parts in the law. And is there any I'd I'd it, but are there any links you could give me or, written materials, let's say, from the state or something like that that that clearly states what the parameters are, what the definitions are so I could, I could better understand it. I'm really in a quandary here.

Thank you. We are in the process of preparing our presentation for next month's, public hearing for the behavioral health integrated plan, and we do have some resources from our Behavioral Health Services Act policy manual that gives as much clarity as we have at this point of the intersect between prevention and early intervention. Sean actually in his presentation tonight shared an infographic that included BHSA early intervention as well as sub g prevention. So that infographic is available. It is part of the publicly available BHSA policy.

And then we also have been using it to help more clearly define where those lines are as far as how we're allowed to use our funding from the state. And so we'll bring more information back in our next

Behavioral Health Services Manual?

Just a light

light light Is the that website? Or

Behavioral health policy services act policy manual is administered by DHCS, and that is our guiding principles to align with s b three twenty six, the behavioral health services act. And so we'll bring some clarity around.

Could you send me a link so I could maybe

We can. It's it's available through the DHS website. I often just Google DHSA policy manual, and it is the first option that pops up.

We can refer to your policy manual in the IP?

We do. The draft IP is is available, and it does

to in that IP.

And one benefit of the template that the state gave us is the integrated plan template that's available on our website does have links directly to the sections that are relevant to the integrated plan. So that's a really nice way

for have the integrated plan.

There's links to this so

I can understand, actually, the integrated plan.

You know? Understood. So, yeah, we'll we'll include more information in our presentation to ensure that at the public hearing, have clarity around where that line is. Isn't in the template we are required to use for the integrated plan. Right.

Right. It it isn't. Yeah. Alright. Okay. Alright. Alright. Okay. And and, Jim, what did you refer to a policy manual? What what was

In the inner the thirty day public comment period, they published the BHSA IP. And in that IP, there's all kinds of hyperlinks. Anything in blue is a hyperlink.

I've seen those.

If you hit on them

I have been.

And the first part of it, I believe, after I read it a couple times, there's a link, and it talks about the relationship with why they did what they did to what the DHCS and their b the BHSA criteria for presenting a the plan in the way it is. That's where it's

Alright.

Clear as mud there, but it's there. So, anyway, I think I don't know what else to tell you there. We just keep there's so many appendixes. It's only 300 pages long that, you know, you gotta pick and choose which ones are the most important practically, but I think one page one through one thirty nine is very important. I was gonna comment on the fact that the plan's out, and we all should be looking at it and reviewing this program and say, look at page one through one thirty nine.

And then on page one thirty nine, there is a hyperlink that takes you to the fund balance and budget charts, and it's a hyperlink. It's called version three. It's one of the hyperlinks and version on page one thirty nine that'll give you the charts we're always looking at for dollars amount, what the balances will be, how it's where the money comes from, and where it's going and everything. So I I missed that. Needs to be looking at all.

I was looking I was looking for those things, and

I Well, it's also it's on January, but then you go up further into, like, $1.52 or something.

No. I've read that.

Then that's all there.

No. I've read that.

But you can hit the hyperlink, and it's very detailed. But, anyway, I was gonna talk about that just say tonight that we all need to look at it because next month on April 15, we are having a public hearing, and this commission will hold the public hearing. And then after the public hearing, we will have a shorter commission meeting than usual. But in that commission meeting, commission meeting portion of April 15, we will be needing to make any substantive recommendations to the plan that the commission is considering. Things would be important.

We all need to look at that and think about what what what is it good as it good as it right now, is it gonna get, or can a few things be changed or improved or make our comments on it? Was my first comment as the chair. The second thing I want in a lighter note is we have an applicant here tonight, a commission applicant here tonight, Avanti Ramaruthi. And she applied back in, I think it was January and missed our February meeting since we didn't have one, but she's here tonight. And we're exciting about having her join the commission.

She's coming from the youth commission. And next month, we'll be she'll be I'm hopefully, she'll I'm sure she'll be attending again. And at that point in time, I will do what I need to do to make a recommendation that she can becomes a full member. We gotta do it as an agenda item, and that will happen in April. Are my two remarks tonight.

You had mentioned when Sean was presenting about the SUDS intervention for youth. I would love to have a future presentation about that, especially around youth, what are the intervention, and then also what are the services, available through the county for our RU?

Yeah. I wrote it down when he was talking. Right. But I I agree. The prevention end that he presented was good, and I think the the intervention parts, the hands on, who's doing what, how are they doing it part would be really important to learn about. So I agree with you there. Any other commissioners' comments? Nothing. I see none. So we're gonna adjourn this meeting. I know it's a short meeting tonight, but we'll make up for it on April 15. I'm sure we'll be here the full two hours, if not more. Anyway, we're gonna adjourn this meeting at 05:48. Thank you all for showing up and all the work you do.