Transcription
adapting the countywide mobile crisis response system to align with anticipated state benefit changes while ensuring sustainability. So translate that for me. What does that mean?
>> Since the inception of trust and and also per was another innovation program, the mobile crisis benefit has been adopted by medical which is a great opportunity for us to sustain programs like trust like like our county operated MCRT. So we are actively have been actively working with our contractors to make sure that we are fully maximizing that benefit. Even as there are contemplated changes at the state level that would net reduce funding, it is still an ongoing funding stream that we can tap into to to maintain our robust system.
One of the many things we are not pleased with in the governor's budget proposal, which is specifically to shift the mobile crisis response benefit from being mandated to optional. What it does is it takes away the state funding associated with that and makes it so that if a county chooses to do it, the county has to cover 100% of the non-federal share. So what it actually is is a proposal by the state to cost shift to counties like ours that they know will be committed to trying to continue the benefit. So that's one very concrete item in the governor's budget that we strongly oppose along with several others and is a piece of our state related budget advocacy.
We would like to know what those programs and services are that are being discontinued, scaled back, that are being added, all of that because I think that allows for us to continue to support the direction that BHSD is making or not making and not to have any surprises, especially the last time that we had a a surprise was with PER. per was never in full development and never really was enacted on the part of the county and so we never even gave it a chance. And these are folks who are interacting with the law enforcement agencies, the local law enforcement agencies that could result in death or severe injury because our law enforcement agency uses different kinds of tools than obviously you all do. And we also had a a death in our jail system of a a gentleman who shouldn't have interacted with our police department in the in that way and shouldn't have been in jail and should have been in a different unit. Should have, should have, should have, but he's not here with us anymore. I keep that in the back of my mind because those are the the the folks who will continue to interact with our police or different law enforcement agencies.
There were some other strategies that your partners mentioned. One of which was um reducing duplicative input of information um simplifying requirements as needed. How are you taking those that feedback and applying it? And Sherry, what is it that you all are doing?
>> We are continuing to work with our contract providers. As Jill mentioned in her part of her presentation, there are many regulatory requirements and directives and obligations that we are required to do with respect to data collection representing the network, the information that we are required to share with the state and you know those do trickle down to the county and then to the providers. So to your question continuing to always look at options for for reducing administrative burden but there you know certainly are c certain circumstances for which we are just required to get information that we need to have as part of those.
>> No there's always improvement if you are not looking to internally improve. What you're missing is a real analysis of your department and where you're doing really well. But there are also areas where there's gaps. This is an opportunity for us to take a look at those gaps and and improve those. And I did not hear that in this in this presentation. So tell me what are you concretely going to do?
>> Supervisor, there's a tremendous amount of work happening on the department as a whole. If you look at bullet number one under cost reduction strategies, restructuring at all levels of the department to prove efficiency of operations and I think you should expect to see coming forward and this department's budget proposals pretty significant reductions associated with the department. We've also raised for some time now the issue of our own clinics. They're the minority of the broader network. We do have county-run behavioral health clinics and the need for those clinics to also be achieving productivity and successful transition to fee for service just like providers do as well. And the board will recall actually in the last budget there were a number of restructurings associated with the behavioral health services department's own clinical operations as well.
>> I'm going to add that to the motion. I want a really I mean thorough breakdown of what that restructuring is going to be and the improved efficiencies of operation because I think it starts in house making sure that you take a look at what your analysis uh that you give us an analysis of the department that we can clearly see what are some of the deficiencies then we can also as policy makers be able to support you or or not or be able to guide with policy a different direction. But if we don't have the information, we're not going to be able to do that.
As you know from the Latino Health Assessment, Latinos represent 58% of the clients served. So, I want to make sure that when you make those cuts or you reduce anything, I I want to understand how that's going to impact the Latino community, how that's going to impact South County specifically. We need to create efficiencies internally so that we can run a better program.
When I looked at the child death review report, we've had between 2021, 2022, and 2023, we had 13 cases of hangings. The youngest of them being a 12year-old. Another one being a 13-year-old. It was a male transgender youth that was being bullied. Another one was another hanging but also um fentinyl toxicity involved. And some of the recommendations that are coming from the committee that reviews all of these deaths are that many of these deaths are preventable.
>> How can we help our children and our youth more directly? In the last eight years for there were two suicides and in these last three years that the death review report was uh reviewed. My gosh I think it was 52. It was very clear that neglect had a lot to do with with um some of the preventable deaths and it is very difficult for us to to see neglect. Um those are our children who are asking for help or transgender youth who is obviously you know in a place where they're in a crisis and for them to have this option to me it means we're failing them.
>> Our children are they're dying >> at their own at their own hands because we are not supporting them and we're not being responsive. And so I'm going to add to the motion on the floor to have a more direct response from the recommendations that were made by the committee by the number of deaths that were committed either through suicide and some preventable um deaths. Uh, I I'd like to see a direct response from you and and maybe later what I'll do is a referral directly on that so we can have something ongoing and structural that behavioral health and DFCs has a response on an annual basis. But for the moment, I'd just like to use this motion um to ask for that.
I'm going to end there. I do have a lot more points I wanted to make, but I'm going to rest there because I think that the children that passed away that are in this report, their statement about how we are doing is stronger than anything else that I can add in terms of comments. Um, so I'll end there.