[00:00:03] GOOD MORNING. TODAY IS A SPECIAL MEETING OF THE SHASTA COUNTY BOARD OF SUPERVISORS. [CALL TO ORDER] IT IS TUESDAY, OCTOBER 24TH AND THE TIME IS 9 A.M.. WE HAVE ALL BOARD MEMBERS PRESENT ALONG WITH CEO DAVE RICKERT COUNTY COUNCIL JOE LARMER, AND FROM THE CLERK OF THE BOARD, STEPHANIE BLANKENSHIP, MARCY WINSTEAD. AND IN THE FOYER, MIRANDA ANGEL. WE ENCOURAGE THOSE WISHING TO PARTICIPATE IN PUBLIC COMMENT. FILL OUT A SPEAKER REQUEST CARD AND SUBMIT IT TO THE CLERK IN THE FOYER. SPEAKER REQUEST CARDS MUST BE SUBMITTED TO THE CLERK BEFORE PUBLIC COMMENT FOR EACH ITEM BEGINS. WITH THAT, I'LL TURN THINGS OVER TO MISS BLANKENSHIP. THANK YOU. THROUGH THE CHAIR, I WOULD LIKE TO REMIND EVERYONE IN ATTENDANCE TODAY OF THE BOARDROOM RULES OF ORDER AS OUTLINED IN ADMINISTRATIVE POLICY 1-1 HUNDRED ONE. THOSE CAN BE FOUND THROUGH THE CLERK OF THE BOARD'S WEBSITE. THIS POLICY INCLUDES SIGNAGE RESTRICTIONS, ATTENDEE SEATING AND OVERALL CONDUCT TO ENSURE BUSINESS IS DONE IN AN ORDERLY FASHION AND THAT ALL HAVE AN EQUAL OPPORTUNITY TO BOTH OBSERVE AND PARTICIPATE UNLESS ADDRESSING THE BOARD, ALL THOSE IN THE AUDIENCE SHALL REMAIN SEATED IN THE CHAIRS PROVIDED. STANDING ALONG THE BACK WALL OF THE BOARDROOM IS ACCEPTABLE, SO LONG AS NO PERSON BLOCKS THE INGRESS OR EGRESS. MEMBERS OF THE MEDIA WHO WANT TO OBSERVE, RECORD OR OTHERWISE DOCUMENT A BOARD OF SUPERVISORS MEETING ARE REQUESTED TO SET UP EQUIPMENT FROM THE DESIGNATED AREA ALONG THE SOUTH WINDOWS. SHASTA COUNTY REMAINS COMMITTED TO CONDUCTING BUSINESS IN A PROFESSIONAL AND ACCESSIBLE ENVIRONMENT. FOR ANYONE WISHING TO PARTICIPATE, ATTEND OR OTHERWISE ENGAGE WITH THE SHASTA COUNTY BOARD OF SUPERVISORS. WE KINDLY ASK THAT ALL ATTENDEES ADHERE TO THESE RULES. WITH THAT CHAIR, I'LL TURN THINGS BACK OVER TO YOU. THANK YOU SO MUCH, MISS BLANKENSHIP. AT THIS TIME, I'D ASK YOU TO PLEASE STAND FOR THE PLEDGE LED BY SUPERVISOR HARMON. PLEASE JOIN ME. I PLEDGE OF ALLEGIANCE TO THE FLAG OF THE UNITED STATES OF AMERICA. AND TO THE REPUBLIC FOR WHICH IT STANDS. ONE NATION UNDER GOD, INDIVISIBLE, WITH LIBERTY AND JUSTICE FOR ALL. THANK YOU, SUPERVISOR HARMON. AGAIN, THIS IS A SPECIAL MEETING, SO THERE IS NO INVOCATION. A COUPLE HOUSEKEEPING THINGS BEFORE WE JUMP TO OUR ONE. THERE ARE POSSIBLY PEOPLE HERE FOR THE VERY FIRST TIME. SO THE SPEAKER REQUEST CARD ON THE TABLE IS OUT THERE. I MENTIONED THAT EARLIER, BUT I JUST REITERATE THAT OUR ONE IS A NO VOTE ITEM. SO IF YOU WANT TO SPEAK R2 IS GOING TO BE WHERE YOUR COMMENT CARDS WILL GO. AND I'D ASK MISS BLANKENSHIP TO MAKE SURE MIRANDA IN THE FOYER IS ABLE TO HELP PEOPLE THROUGH THAT PROCESS BECAUSE I WANT TO MAKE SURE EVERYBODY HAS AN OPPORTUNITY TO SPEAK THAT WANTS TO SPEAK THAT CAME OUT TODAY. WITH THAT, [R1 Receive a presentation from the Health and Human Services Agency regarding the Behavioral Health Director's opposition to the True North Behavioral Health Campus application proposed by Arch Collaborative, Signature Health, and the Shasta Health Assessment and Redesign Collaborative, to secure BHCIP Round 2 funds.] WE'RE GOING TO MOVE TO R1, RECEIVE A PRESENTATION FROM THE HEALTH AND HUMAN SERVICES AGENCY REGARDING THE BEHAVIORAL HEALTH DIRECTOR'S OPPOSITION TO THE TRUE NORTH BEHAVIORAL HEALTH CAMPUS APPLICATION PROPOSED BY ARCH COLLABORATIVE, SIGNATURE HEALTH AND THE SHASTA HEALTH ASSESSMENT AND REDESIGN COLLABORATIVE TO SECURE BHCIP. ALSO KNOWN AS B CHIP ROUND TWO FUNDS. MISS COLEMAN. I WANT TO WAIT FOR THE PRESENTATION TO COME UP REAL QUICK. STEPHANIE, STOP THE CLOCK FOR ME UNTIL IT UNTIL IT COMES UP. AND MATT, WE'RE USING THIS. THESE ARE DOWN. MARCY, CAN WE GET AN X ONE FOR SUPERVISOR PLUMMER. SINCE OUR SCREENS ARE OKAY? CORKY DOESN'T HAVE ONE EITHER. NO, NO, IT'S THIS ONE. YOU HAVE IT. IT'S THIS ONE. YEAH, YEAH, YEAH. I'M SORRY. THIS IS MY NOTES. YOU DON'T HAVE A COPY OF MY NOTES? I HAVE ONE, YES. MR. COLEMAN. OKAY. GOOD MORNING, CHAIRMAN CRYE. MEMBERS OF THE BOARD, I'M CHRISTIE COLEMAN, HRSA AGENCY DIRECTOR. HERE WITH ME TODAY IS CINDY LANE, BRANCH DIRECTOR FOR BHS LEE, WHO IS OUR DEPUTY DIRECTOR OF OUR CLINICAL TEAM. AND S AARON WANTZ, WHO'S OUR DIRECTOR BRANCH DIRECTOR OF ADMINISTRATION. AND KATIE CASSIDY, WHO IS OUR BRANCH DIRECTOR IN PUBLIC HEALTH. I WAS ASKED TO SHARE SOME INFORMATION ON THE B CHIP FUNDING, AS WELL AS WHY HRSA CANNOT SUPPORT A LETTER OF SUPPORT FOR THE TRUE NORTH PROJECT AT THIS TIME. BEFORE I GET STARTED, I DO WANT TO THANK THE PUBLIC FOR COMING TO HEAR THIS INFORMATION. IT WILL SHARE A LOT ABOUT THE COUNTY'S PERSPECTIVE ON THIS PROJECT. SO I WANT TO START WITH GOING OVER KIND OF WHAT THE B CHIP FUNDING IS. SO WHAT IS B CHIP FUNDING? THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES LAUNCHED THE BEHAVIORAL HEALTH CONTINUUM OF INFRASTRUCTURE PROGRAM TO ADDRESS HISTORIC GAPS IN BEHAVIORAL HEALTH CARE CONTINUUM AND MEET THE GROWING DEMANDS FOR SERVICES AND SUPPORT ACROSS THE LIFESPAN [00:05:01] OF VULNERABLE INDIVIDUALS IN NEED. ACROSS THE STATE, THERE IS ABOUT $800 MILLION AVAILABLE FOR ROUND TWO OF THIS FUNDING. IT CAN BE USED TO EXPAND OR CREATE NEW CAPACITY FOR FOR A VARIETY OF BEDS. DHS RELEASED THE REQUEST FOR APPLICATION FOR ROUND TWO ON MAY 30TH OF THIS YEAR, AND THE APPLICATION IS DUE OCTOBER 28TH OF THIS YEAR, WITH AWARD ANNOUNCEMENTS COMING IN SPRING OF 26. ELIGIBLE APPLICATION CRITERIA PROJECTS MUST COMMIT TO SERVE MEDI-CAL MEMBERS AWARDED. APPLICANTS ARE EXPECTED TO WORK WITH THEIR COUNTY BEHAVIORAL HEALTH MENTAL HEALTH ADMINISTRATORS, OR DHCS FOR MEDI-CAL REIMBURSEMENTS. APPLICANTS MUST DESCRIBE THEIR PAYER MIX, WHICH. THIS IS THE PERCENTAGE OF INDIVIDUALS THAT THEY WILL SERVE THAT ARE THEIR MEDI-CAL BENEFICIARIES, AS WELL AS PRIVATE PAY, INSURANCE AND SUSTAINED BEHAVIORAL HEALTH SERVICES. SOME OF THE THRESHOLD REQUIREMENTS INCLUDE A SUSTAINABLE BUSINESS PLAN, CONCEPTUAL SITE PLAN, STAKEHOLDER SUPPORT, AND FOR NONPROFIT AND FOR PROFIT ENTITIES. THIS WOULD BE A LETTER OF SUPPORT FROM THEIR COUNTY BEHAVIORAL HEALTH AGENCY DIRECTOR. DEMONSTRATION OF COUNTY AND MEDICAL MEDI-CAL INVESTMENTS TO SUPPORT ONGOING SUSTAINABILITY AS WELL AS SITE CONTROL. AND LISTED THERE ON THE SCREEN IS A VARIETY OF. HOUSE SITE CONTROL CAN BE MEET THE REQUIREMENTS. WE'RE GOING TO GET INTO THE CONCERNS THAT HHS HAS AT THIS CURRENT MOMENT. SO I'M GOING TO START WITH THE FACILITY BED TYPES. THE PROPOSED FACILITY BED TYPES BREAK DOWN TO BE A SOCIAL REHAB CRISIS STABILIZATION UNIT, PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY, AND A PSYCHIATRIC HEALTH FACILITY. THE WE'RE GOING TO START WITH THE SOCIAL REHAB FACILITY. SO CURRENTLY HERE LOCALLY, WE HAVE TWO SOCIAL REHAB FACILITIES. THE COUNTY HAS ONE, WHICH IS ALSO KNOWN AS THE CRC OR THE CRICK. AND THERE IS ANOTHER ONE IN THE LOCAL COMMUNITY AS WELL. CRISIS STABILIZATION UNIT. THE COUNTY HAD A CRISIS STABILIZATION UNIT. IT WAS VERY UNDERUTILIZED AND WE ACTUALLY CLOSED IT BECAUSE OF THE UTILIZATION. THERE IS A LOCAL HOSPITAL THAT WILL BE OPENING A CSU, AND ANOTHER ENTITY HERE LOCALLY IS WILLING TO OPEN AND HAVE CONVERSATIONS ON OPENING A CSU. IF THE COUNTY CAN DEMONSTRATE THAT THERE ACTUALLY IS A NEED FOR CSU. THE CONCERN WITH THE CSU, AS THIS PROJECT PROJECT IS PROPOSED TO BE A REGIONAL MODEL, IS THAT CSU IS A 23 HOUR STAY, WHICH MEANS THAT COUNTIES FROM DOWN SOUTH WILL HAVE A BIG COST BURDEN TO COME BACK UP AND PICK UP THEIR CLIENTS WITHIN 23 HOURS OF DROPPING THEM OFF. PLUS, WITH THE CSU, THERE HAS TO BE A MEDICAL CLEARANCE OBTAINED BEFORE GOING INTO THE CSU, AND AT THIS TIME, IT IS STILL UNCLEAR HOW THAT MEDICAL CLEARANCE WILL BE OBTAINED. AND SO WE DO NOT KNOW IF THAT WILL RELEASE THE BURDEN OF THE IMPACT ON THE ERS OR IF IT WILL STILL HAVE THE IMPACT, AS IT CURRENTLY HAS NOW, OR EVEN MORE PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES, ALSO KNOWN AS A PRTF. THIS IS NOT SOMETHING WE CURRENTLY UTILIZE. WE CURRENTLY UTILIZE A MODEL CALLED AN STP, AND THE CONCERN WITH THE PRTF IS THAT WE DON'T HAVE A NEED FOR 16 BEDS HERE IN SHASTA COUNTY. WE POTENTIALLY HAVE MAYBE A NEED FOR 1 OR 2 THROUGHOUT AN ENTIRE YEAR. AND THE COST IS ALSO A HUGE BARRIER TO THE COUNTY. THIS WOULD HIT OUR SOCIAL SERVICES BUDGET, AND THE COST FOR PRTF PLACEMENT IS ABOUT $113,000 PER BED PER MONTH. CURRENTLY, FOR AN STP, WE PAY ABOUT $17,000 PER BED PER MONTH. THAT'S A HUGE INCREASE TO THE COUNTY COST. PSYCHIATRIC HEALTH FACILITY, ALSO KNOWN AS A PUFF. SO THE NEED FOR PUFF BEDS CONTINUES TO BE FOR OUR HIGH ACUITY CLIENTS AND OUR HIGH ACUITY CLIENTS WITH AN SUD COMPONENT, AS THAT WILL SERVE THE SB 43 POPULATION COMING UP IN JANUARY. THERE ARE TWO LOCAL FACILITIES HERE THAT HAVE CAPACITY, AND THEY ASK US FOR REFERRALS CONTINUALLY, BUT WE ARE NOT ABLE TO PROVIDE THEM MORE REFERRALS BECAUSE WE DON'T HAVE MORE CLIENTS TO SEND THEM. THE CLIENTS THAT WE DO SEND OUT OF COUNTY FOR PUFFS ARE ABOUT 176 PER YEAR, WHICH DOES NOT EQUATE TO 316 BED FACILITIES COMING IN TO SUPPORT THAT. ANOTHER CONCERN IS THAT THE PROJECT DOES NOT HAVE AN IMD EXCLUSION. IF THE FACILITY DOES NOT RECEIVE AN IMD EXCLUSION, THE COST FOR THE PUFF BEDS WILL BE 100% COUNTY COST AS IT WILL NOT BE ELIGIBLE FOR REIMBURSEMENT FROM THE STATE. HRSA HAS NOT BEEN INVOLVED IN THE DATA FOR THE GRANT APPLICATION. OPERATING EXPENDITURES OR PRO FORMA FOR THE PROJECT. AT THIS TIME, THE COUNTY IS UNABLE TO DO A COST ANALYSIS TO DETERMINE IF HHC CAN SUSTAIN THE PROJECT FOR 1 TO 30 YEARS. THERE IS ALSO PAST CONTRACTUAL CONCERNS WITH THE ARCH COLLABORATIVE AS WELL AS WITH SIGNATURE HEALTHCARE, WHICH IS THE OPERATOR THAT'S ON THIS [00:10:01] FACILITY. CURRENTLY, WE HAVE CONTRACTS WITH SIGNATURE HEALTHCARE, AND RIGHT NOW IN ONE OF THE FACILITIES, WE ARE HAVING TO DO BIWEEKLY REPORTING TO THE STATE BECAUSE OF THE ISSUES WITH CARE FOR THE CLIENTS IN THAT FACILITY. WE ALSO RECENTLY FOUND OUT THAT THERE WAS A SIGNATURE HEALTH CARE FACILITY DOWN SOUTH, WHERE THE LPS DESIGNATION WAS ACTUALLY REMOVED BY THE COUNTY BECAUSE OF THE CONTINUED CONCERNS IN THAT FACILITY. WE ALSO HAVE ANOTHER CONTRACT WITH SIGNATURE WHERE THEY ARE NOT ACCEPTING OUR HIGH ACUITY CLIENTS, WHICH LEAVES US IN THE SAME POSITION THAT WE'RE AT TODAY. STAFFING IS ANOTHER BIG CONCERN IN THAT THIS FACILITY WILL REQUIRE A LOT OF STAFFING FOR THE BED TYPES AND THE AMOUNT OF BEDS. MY CONCERN IS THE AMOUNT THAT IT WILL DRAW FROM THE COUNTY STAFF, AS WELL AS LOCAL FACILITIES HERE, AND HOW THEY WILL MAINTAIN DOING THEIR MANDATED PROGRAMS GOING FORWARD. PART OF THE COMMUNITY ENGAGEMENT FOR THE APPLICATION SHOULD INCLUDE VOICES FROM COUNTY BEHAVIORAL HEALTH DEPARTMENTS. SHASTA COUNTY BEHAVIORAL HEALTH DEPARTMENT HAS NOT BEEN REPRESENTED IN THIS APPLICATION, AS FAR AS I KNOW, BECAUSE I HAVE NOT SEEN WHAT THE APPLICATION ACTUALLY SAYS AND THE CONCERNS THAT HAVE BEEN RAISED DURING MEETINGS THAT WE HAVE BEEN INVOLVED IN ARE NOT REPRESENTED IN THE BED TYPE OR THE PROJECT PROPOSAL. AS WE SEE IT TODAY, HAVING A FACILITY OF THIS SIZE COME INTO THE COMMUNITY WILL REQUIRE HRSA TO GROW TEAMS REGARDLESS OF A CONTRACT SUCH AS BILLING, TEAM UTILIZATION, TEAM QUALITY MANAGEMENT TEAM, AND OUR PATIENTS RIGHTS TEAM. HHS WILL BE THE ENTITY DOING THE MEDI-CAL CERTIFICATION FOR THE FACILITY FOR THE FACILITY, PATIENT'S RIGHTS WILL HAVE TO ASSESS ALL HOLDS TO ENSURE THE RIGHTS OF CLIENTS ARE NOT BEING VIOLATED. AND ACTUALLY, AT THIS TIME, I'M GOING TO INVITE KATIE CASSIDY UP TO TALK MORE ABOUT THE THE UNINTENDED, UNINTENDED CONSEQUENCES OF HHS AYE FOR THIS FACILITY. GOOD MORNING. THANK YOU, KATIE CASSIDY, PUBLIC HEALTH. AS WE WERE KIND OF EXPLORING WHAT THIS MIGHT LOOK LIKE IN TERMS OF IMPACT TO OUR STAFFING, NOT ONLY TO PATIENTS RIGHTS, TO OUR QUALITY MANAGEMENT AND MEDI-CAL BILLING, PATIENTS RIGHTS INTERFACES WITH OUR OTHER COUNTY TEAMS IN TERMS OF LEGAL AND OUR COURT SYSTEMS AS WELL. AND WE WOULDN'T KNOW WHAT THE IMPACT WOULD BE TO THEM. AND THEN FROM A PURELY PUBLIC HEALTH STANDPOINT, SHOULD WE HAVE TO EVACUATE THIS FACILITY, WE WOULD HAVE TO MOVE ALL OF THESE INDIVIDUALS TO COMPARABLE PLACES. AND WE DON'T WE HAVEN'T HAD THE CHANCE TO EXPLORE EVEN WHERE THAT MIGHT BE, LIKE WHAT DISTANCES PEOPLE WOULD HAVE TO TRAVEL AND HOW WE WOULD TRANSPORT PEOPLE. THIS FACILITY IS ALSO PROPOSING TO BE A REGIONAL MODEL. THE UNINTENDED CONSEQUENCES OF A REGIONAL MODEL IS THAT IT PUTS THE BURDEN ON SHASTA COUNTY HEALTH AND HUMAN SERVICES BUDGETS WITH A TRUE REGIONAL MODEL. IT'S A COUNTY TO COUNTY PERSPECTIVE AND COUNTY TO COUNTY. CONTRACTUAL OBLIGATIONS THAT COME INTO PLAY. THIS IS NOT HAPPENING WITH THIS FACILITY, AS SHASTA COUNTY HAS NOT BEEN IN CONTACT WITH OTHER COUNTIES TO SEE WHAT THEIR TRUE INVOLVEMENT WILL BE AND WHAT THEY ACTUALLY WILL BE CONTRACTING FOR. THE APPLICATION GUIDELINES FOR FUNDING DO STATE THAT A LETTER OF SUPPORT IS REQUIRED FROM THE DIRECTOR OF COUNTY BEHAVIORAL HEALTH, WHERE THE PROJECT IS LOCATED, WHICH WOULD BE THE SHASTA COUNTY BEHAVIORAL HEALTH DIRECTOR, WHICH IS ME. ROUND ONE OF FUNDING DID INCLUDE A BUNCH OF ADDITIONAL PUFF BEDS, AS WELL AS SOCIAL REHAB BEDS AND PRTF BEDS THAT ARE GOING TO BE COMING IN UP AND DOWN THE STATE. WE ARE STILL UNCLEAR OF WHAT THE ANALYSIS HAS SHOWN THAT THIS PROJECT TEAM HAS COME UP WITH FOR THE NEED FOR OUR COUNTY. AS WE HAVE NOT BEEN INVOLVED IN THAT. SO MOVING FORWARD ON THE AGENDA TODAY IS A LETTER OF OPPOSITION FOR THE PROJECT. I'M NOT SAYING THAT THERE ISN'T A NEED FOR MENTAL HEALTH BEDS IN OUR COMMUNITY. WHAT I'M SAYING IS THAT THIS PROJECT DOESN'T REPRESENT THE NEEDS OF THE SHASTA COUNTY MENTAL HEALTH CLIENTS, AND THE OPERATOR HAS A CONCERNING HISTORY THAT HAS NOT BEEN ADDRESSED. I HAVE SHARED THAT I WOULD MAKE TIME TO SHARE ANYTHING THAT IS NEEDED ME TO TALK ABOUT THE NEEDS TO COLLABORATE FOR THE DEVELOPMENT OF THE PROJECT. MY LEVEL OF INVOLVEMENT FOR THIS PROJECT HAS BEEN MINIMAL AT BEST. I HAVE PROVIDED THE DATA THAT HAS BEEN REQUESTED, BUT THE TRUE VOICE OF SHASTA COUNTY BEHAVIORAL HEALTH HAS NOT BEEN HEARD. THE GRANT APPLICATION FOR THIS PROPOSAL IS DUE ON TUESDAY. A LETTER OF SUPPORT IS A REQUIREMENT FOR THE APPLICATION GRANT. APPLICATION INFORMATION STATES THAT THE PROJECTS MUST MAKE A COMMITMENT TO SERVE MEDI-CAL MEMBERS, AND THAT THE AWARDED APPLICANT ARE EXPECTED TO WORK WITH THE COUNTY BEHAVIORAL HEALTH MENTAL HEALTH ADMINISTRATOR, OR DHCS, FOR MEDI-CAL REIMBURSEMENTS. WITHOUT A CLEAR UNDERSTANDING OF THE FISCAL IMPACTS TO HSA FOR THE NEXT 30 YEARS. A TRUE UNDERSTANDING OF THE PERCENTAGE OF MEDI-CAL MEMBERS THAT WILL BE SERVED. HOW MANY COUNTIES. LETTERS OF SUPPORT ACTUALLY SAY THEY WILL CONTRACT TO USE THIS FACILITY. HSA IS UNABLE TO DETERMINE IF THEY CAN SUPPORT THE PROJECT FOR 1 TO 30 YEARS. [00:15:02] THE NEED REMAINS THE SAME. WE NEED BEDS FOR HIGH ACUITY CLIENTS. WE ARE CURRENTLY HAVING ISSUES WITH SIGNATURES SERVING OUR HIGH ACUITY CLIENTS. WHAT IS THE PLAN TO ENSURE HIGH ACUITY CLIENTS WILL BE SERVED AT THIS FACILITY, AND THE CONTRACTUAL CONCERNS NEED TO BE WORKED THROUGH. INFORMATION NEEDS TO BE SHARED, AND THOSE THAT ARE SUPPOSED TO BE SUPPORTING THIS PROJECT FOR THE NEXT 30 YEARS NEED TO BE INVOLVED. REGARDLESS OF THERE BEING A CONTRACT IN PLACE FOR BED USE, THE COUNTY HAS RESPONSIBILITY TO PROVIDE SERVICES TO THE FACILITY. I REMAIN AVAILABLE TO COLLABORATE AND WORK TOGETHER TO SERVE THE NEEDS OF SHASTA COUNTY MENTAL HEALTH CLIENTS. AND AGAIN, I'M NOT SAYING THERE ISN'T A NEED. I'M SAYING WE DON'T HAVE THE INFORMATION NEEDED IN ORDER TO MAKE A DECISION ON IF WE CAN SUPPORT THE PROJECT FOR ANY AMOUNT OF TIME. THANK YOU. AND I'M AVAILABLE FOR QUESTIONS. ALL RIGHT. THANK YOU, MISS COLEMAN. THAT'S A PRESENTATION. NO VOTE. WE'RE GOING TO MOVE ON TO R TWO. [R2 Approve a letter which supports the Shasta County Health and Human Services Agency, Behavioral Health Director’s opposition to the True North Behavioral Health Campus application proposed by Arch Collaborative, Signature Health, and the Shasta Health Assessment and Redesign Collaborative, to secure BHCIP Round 2 funds (Sponsored by Supervisor Crye).] SOMEBODY UP IN BOARD DISCUSSION FOR R TWO THAT WE'LL TALK A LITTLE BIT ABOUT. AND THAT'S OUR DEPUTY CEO STUART BOUTELLE WHO WAS ON THE PHONE WITH NOEL DE SHORT OUR AUDITOR CONTROLLER THIS MORNING ABOUT THE SEVERE RISK AND COST TO SHASTA COUNTY. SHOULD THIS FACILITY COME. NOW, THAT DOESN'T EVEN INCLUDE THE ASPECT FOR ME. I DON'T WANT OTHER COUNTY'S PROBLEMS BEING SENT TO SHASTA COUNTY. I'M 100% TAKING CARE OF SHASTA COUNTY. I AM VERY SHASTA COUNTY FIRST. I AM NOT FOR OTHER 57 COUNTIES SENDING THEIR MENTALLY UNSTABLE INDIVIDUALS TO RUN RAMPANT IN OUR CITY AND OUR COUNTY. AND I FEEL PRETTY STRONGLY ABOUT THAT. SO WHAT WE'RE GOING TO DO HERE IS I'M GOING TO MAKE A MOTION THAT WE APPROVE R-2. AND THEN SO I MAKE A MOTION THAT WE APPROVE R-2 AND SEND THE LETTER. I'LL SECOND FOR DISCUSSION. DO WE HAVE A SECOND BY SUPERVISOR KELSTROM. WE WILL OPEN TO PUBLIC COMMENT AND THEN WE WILL TAKE SOME BOARD DISCUSSION. WITH THAT MISS, AND LET ME ASK MY FELLOW BOARD MEMBERS, WOULD YOU GUYS LIKE TO HAVE ANY DISCUSSION FIRST, BECAUSE WE ABSOLUTELY CAN HAVE SOME DISCUSSION. FIRST, I'M OPEN TO THE PROCEDURE. SUPERVISOR LONG OKAY. THANK YOU SIR. SUPERVISOR. HARMON. PERFECT. ALL RIGHT. SO WE'LL GO AHEAD AND TAKE PUBLIC COMMENT. MISS BLANKENSHIP, HOW MANY SPEAKERS DO WE HAVE? CHAIR, AT THIS TIME WE HAVE 33 SPEAKERS. OKAY. SO IT'S TWO MINUTES OF. SPEAKER. MISS BLANKENSHIP IS GOING TO CALL YOU UP. I'D ASK YOU TO BE IN QUEUE BEHIND THAT SIGN TO MY LEFT. YOUR RIGHT. SO LET'S GIVE US THE FIRST FIVE. FREDERIK HOLST, BRIAN FULTON, SARAH PIRIE, AND STEVE CONN. IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. GOOD MORNING EVERYBODY. MY NAME IS DOCTOR FREDERICK HOLST, DIRECTOR OF INNOVATIVE RESEARCH, ARCH COLLABORATIVE. THANK YOU VERY MUCH, BOARD OF SUPERVISORS. I APPRECIATE THE OPPORTUNITY TO SPEAK BRIEFLY ON THE MACRO DATA THAT I'VE EXAMINED SO FAR ON THE BEHAVIORAL HEALTH NEEDS THAT WE FACE IN SHASTA COUNTY AND NEIGHBORING COUNTIES AS WELL. FIRST, SHASTA ISN'T AN OUTLIER. IT'S THE EPICENTER OF NORTHERN CALIFORNIA'S BEHAVIORAL HEALTH GAPS. DESPITE EXISTING FACILITIES, THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT SHOWS PERSISTENT SHORTAGES. OVER 9000 UNHOUSED MEDICAL MEMBERS WITHOUT INTEGRATED CARE, ONE OF THE HIGHEST OVERDOSE AND AGED SCORES IN CALIFORNIA. ADVERSE CHILDHOOD EXPERIENCES AND PROVIDER SHORTAGES THAT KEEP SHASTA ON THE FEDERAL HEALTH PROFESSIONAL SHORTAGE AREA LIST IN CHILD WELFARE. OUR MALTREATMENT RATE IS 8% VERSUS THE STATE'S 5%, AND ABOUT 340 FOSTER YOUTH IN SHASTA ALONE NEED BEHAVIORAL HEALTH TREATMENT AND LOCAL PROGRAMS, WHICH LOCAL PROGRAMS CANNOT YET PROVIDE. THE HUD POINT IN TIME COUNT FIVE FOUND 2400 PEOPLE EXPERIENCING HOMELESSNESS, NEARLY TWO THIRDS OF WHICH LIVE WITH A BEHAVIORAL HEALTH OR SUBSTANCE USE DISORDER. THESE INDIVIDUALS EXIST BENEATH THE SURFACE OF OUR EVERYDAY LIFE IN AIR SHELTERS AND JAILS, CYCLING THROUGH SYSTEMS NEVER BUILT TO HEAL THEM. THEY ARE NOT DUPLICATE NEEDS. THEY ARE UNMET NEEDS. THE PROPOSAL IS DESIGNED TO SLIGHTLY CONTRIBUTE A BIT TO CLOSE THOSE GAPS, NOT TO COMPETE WITH EXISTING PROVIDERS. WE SEEK A COLLABORATIVE, INFRASTRUCTURE FOCUSED SOLUTION, NOT A FISCAL BURDEN. OUR GOAL IS TO STRENGTHEN, NOT TO SUPPLANT. SHASTA CONTINUUM OF CARE. THE PROJECT AND THE DATA IT IS BASED ON IS NOT TRULY RADICAL. THANK YOU. BRIANNE FULTON FOLLOWED BY SARAH PERRY. STEVE KHAN, THEN CHRISTIAN GARDNER. HI, MY NAME IS BRIANNE FULTON. I'M A LICENSED PROFESSIONAL CLINICAL COUNSELOR AND THE BEHAVIORAL HEALTH DIRECTOR AT HILL COUNTRY COMMUNITY CLINIC. [00:20:01] PRIOR TO MY CURRENT JOB, I WORKED AT THE JUVENILE REHABILITATION FACILITY. I WAS PART OF THE SHASTA COUNTY CRISIS TEAM, ASSESSING INDIVIDUALS IN THE ERS FOR 5150 HOLDS. AND JUST PRIOR TO THAT, I WAS THE SUPERVISOR AT TEHAMA COUNTY'S CRISIS STABILIZATION UNIT. MUCH LIKE THE ONE IN THE PROPOSAL, I NOW OFTEN WORK AS A MENTAL HEALTH CLINICIAN FOR BOTH OUR MOBILE CRISIS TEAMS AND IN OUR CARE CENTER. BOTH OF WHOM HAVE SEEN THEIR NUMBER OF CONTACTS DOUBLE IN THE LAST YEAR, SO I MIGHT KNOW A THING OR TWO ABOUT CRISIS SERVICES AND THE MENTAL HEALTH NEEDS AND SERVICES AND LACK THEREOF IN OUR COMMUNITY. CURRENTLY, IF YOU'RE IN AN ACTIVE MENTAL HEALTH CRISIS, YOU REALLY ONLY HAVE TWO CHOICES. YOU GET AN ASSESSMENT OR CRISIS THERAPY FROM SHASTA COUNTY OR THE CARE CENTER, OR YOU WILL BE VOLUNTARILY HOSPITALIZED, INVOLUNTARILY HOSPITALIZED ON A 5150 HOLD WHERE YOUR RIGHTS ARE TAKEN AWAY AND YOU WAIT IN AN EMERGENCY ROOM UNTIL YOU CAN HOPEFULLY BE PLACED IN A PSYCHIATRIC FACILITY. THERE IS NO IN-BETWEEN AND NO SAFE PLACE EVEN REMOTELY CLOSE TO SHASTA COUNTY, WHERE YOU CAN GET VOLUNTARY CRISIS STABILIZATION SERVICES. THE OPPOSING LETTER IMPLIES THAT THIS PROPOSAL INCLUDES DUPLICATE SERVICES THAT ALREADY EXIST, DESPITE 400 PEOPLE BEING SENT OUTSIDE OF OUR COMMUNITY, THOSE OF WHICH WERE REFERRED TO AS OFTEN VERY VIOLENT OFFENDERS. THIS IS SIMPLY NOT TRUE. A LARGE PORTION OF OUR CHILDREN, WITH WHOM OUR FACILITIES IN THE LOCAL AREA WILL NOT ACCEPT, AND INDIVIDUALS ARE SENT TO SACRAMENTO, SANTA ROSA AND OTHER FACILITIES ALL THE TIME FOR NOTHING TO DO WITH BEING VIOLENT. I'VE BEEN PART OF THESE TEAMS THAT FACILITATE TRANSFERS TO PSYCHIATRIC FACILITIES. SO I HAVE A WORKING KNOWLEDGE OF WHY PEOPLE WERE SENT OUT OF COUNTY AND TO WHERE WE DO NOT NEED TO USE FEAR MONGERING AND INACCURATE STATEMENTS TO SCARE A COMMUNITY INTO BELIEVING THAT THE MENTALLY ILL DON'T BELONG HERE. THEY ARE YOUR NEIGHBORS AND YOUR FAMILY MEMBERS AND WHAT THEY NEED IS HELP, NOT SHAME AND STIGMA. THEY ARE SENT ELSEWHERE BECAUSE WE DON'T HAVE THE CAPACITY. OR MAYBE WE ARE UNWILLING OR UNPREPARED TO HELP THE RESIDENTS OF SHASTA COUNTY. IF THIS TRUE NORTH PROJECT ISN'T THE ANSWER, THEN WHAT IS? WHAT ARE WE DOING TO SARAH PERRY, STEVE KHAN, CHRISTIAN GARDNER, THEN MIKE FREEMAN? IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. THANK YOU, CHAIR AND MEMBERS OF THE BOARD. MY NAME IS SARAH PERRY, AND I'VE SERVED THIS COMMUNITY FOR OVER 13 YEARS AS A SOCIAL WORKER, WALKING ALONGSIDE FOSTER YOUTH, SURVIVORS OF VIOLENCE AND FAMILIES IN CRISIS. IN THAT TIME, I'VE SEEN FAR TOO MANY PEOPLE FALL THROUGH THE CRACKS OF A SYSTEM THAT CANNOT MEET THE GROWING NEED FOR MENTAL HEALTH CARE. I'VE SEEN PEOPLE SENT HOURS AWAY FOR PSYCHIATRIC TREATMENT, ONLY TO RETURN WITHIN DAYS TO NO COORDINATED PLAN OR TO A SYSTEM SO STRAINED IT CANNOT MEET THEIR NEEDS. I'VE WATCHED PARENTS, FAMILIES, SURVIVORS AND PROFESSIONALS BURNED OUT AND HEARTBROKEN. ADVOCATING FOR THOSE THEY LOVE WHILE NAVIGATING A SYSTEM THAT OFFERS TOO LITTLE, TOO LATE. AS A MOTHER TO AN ADOPTIVE DAUGHTER WHO MAY 1ST DAY NEED THESE SERVICES, THIS IS NOT ABSTRACT. I'VE DRIVEN I-5 MORE TIMES THAN I CAN COUNT. HOURS EACH WAY FOR FOSTER YOUTH AND MY OWN CHILDREN TO REACH CARE THAT SHOULD HAVE BEEN AVAILABLE HERE. EVERY MILE REPRESENTS SEPARATION, EXHAUSTION, AND ANOTHER REMINDER OF HOW DEEPLY WE ARE FAILING THE PEOPLE WHO CALL SHASTA COUNTY HOME. AS AN EMPLOYEE OF ARTS COLLABORATIVE, I'VE WITNESSED OUR COMMUNITY COME TOGETHER IN AN UNPRECEDENTED WAY. HOSPITALS, COUNTY GOVERNMENTS, LAW ENFORCEMENT, AND NONPROFITS UNITED BEHIND THIS TRUE NORTH BEHAVIORAL HEALTH CAMPUS. THIS PROJECT SHOWS WHAT TRUE COLLABORATION LOOKS LIKE A SHARED COMMITMENT TO BUILD SOLUTIONS THAT KEEP CARE LOCAL AND RESTORE DIGNITY TO THOSE WHO SEEK IT. THE ONLY BARRIER HAS BEEN OUR LOCAL GOVERNMENT, WHO ARE MEANT TO PROTECT AND SUPPORT THIS COMMUNITY. YOUR FAILURE TO LEAD, COMMUNICATE AND COLLABORATE HAS LEFT CHILDREN WAITING, ADULTS STRUGGLING, AND PROVIDERS DEMORALIZED. YOU ARE THE LEADERS OF THIS COUNTY. LEADERSHIP IS NOT ABOUT POWER. IT'S ABOUT PURPOSE. IT'S ABOUT THE MORAL COURAGE TO DO WHAT IS RIGHT. IT'S NOT ABOUT ONE PERSON OR ORGANIZATION. IT'S ABOUT A COMMUNITY THAT HAS STOOD TOGETHER TO SAY WHAT EXISTS NOW IS NOT ENOUGH, AND WE CAN NO LONGER ACCEPT IT. LEAD WITH INTEGRITY, EMPATHY, AND CONVICTION. STAND FOR THOSE WHO NEED HELP BUT CANNOT BE HERE. THE YOUTH, THE SURVIVORS, FAMILIES AND CAREGIVERS AND EVERYONE STILL WAITING. HISTORY WON'T REMEMBER THE NOISE. ONLY WHETHER YOU LED WITH HUMANITY WHEN IT MATTERED. OUR COMMUNITY DESERVES BETTER. AND WHAT YOU DECIDE TODAY WILL SHOW IF YOU BELIEVE THAT. THANK YOU. STEVE KHAN FOLLOWED BY CHRISTIAN GARDNER, MIKE FREEMAN, JEFF GORDON, AND DOLORES LUCERO. GOOD MORNING CRYE. I THINK YOU'VE MADE IT CLEAR THAT BEING VINDICTIVE IS MUCH MORE IMPORTANT THAN DOING SOMETHING CLEARLY NEEDED IN OUR COMMUNITY. AND CHRISTIE COLEMAN, IT SEEMS YOU HAVE GREAT CONTROL OVER HER, TOO. I'M AFRAID YOU'VE TAKEN CONTROL OF HEALTH AND HUMAN SERVICES, PERIOD. NOW. HER GREATEST COMPLAINT WAS THAT. THAT SHE'S WORRIED ABOUT A HEALTH BENEFIT TAKING EMPLOYEES FROM THE COUNTY. DOES THAT MEAN THAT WE DON'T INCREASE ANY MECHANISM AT ALL THAT WOULD PROVIDE HEALTH CARE, BECAUSE WE'RE WORRIED ABOUT THEM TAKING AWAY FROM OUR EMPLOYEES FROM THE COUNTY? NO. WE NEED MEDICAL FACILITIES AND WE WILL END UP FINDING EMPLOYEES, ESPECIALLY IF THEY FEEL LIKE THEY HAVE JOB SECURITY AND ARE PAID PROPERLY. SO IT'S A VERY POOR ARGUMENT BEING HER MAJOR ARGUMENT. I THINK YOU'VE CREATED THIS SITUATION CALLING A SPECIAL MEETING LESS THAN 48 HOURS BEFORE A [00:25:01] DECISION HAS TO BE MADE IS SIMPLY YOU PLAYING THE GAME AND TO IMPLEMENT YOUR WILL. I BELIEVE THIS IS AN EXAMPLE, A CLEAR EXAMPLE TO A LOT OF PEOPLE ABOUT HOW WHAT YOUR LEADERSHIP IS. WE NEED THE $200 MILLION INFRASTRUCTURE INPUT INTO OUR COMMUNITY. WE NEED THE 200 EMPLOYEES. AND IF ANYBODY THINKS THAT WE DON'T HAVE A NEED IN MENTAL HEALTH, DRIVE AROUND TOWN AND TALK TO SO MANY PEOPLE, TALK TO SO MANY PEOPLE THAT HAVE DEALT WITH THE MENTAL HEALTH SITUATION AND NOT HAD THE ADEQUATE COVERAGE FOR THEIR CHILD, THEIR HUSBAND, THEIR SPOUSE, WHOEVER. SO ANYWAY, IT JUST SEEMS TO ME LIKE YOU ARE UNDERMINING THIS BECAUSE IT ISN'T YOUR MEDICAL SCHOOL AND BECAUSE IT WASN'T YOUR IDEA. AND THAT'S SAD. CHRISTIAN GARDNER, FOLLOWED BY MIKE FREEMAN, JEFF GORDON, DOLORES LUCERO, THEN THOMAS H. TRUE NORTH IS NOT ASKING FOR A HANDOUT. TRUE NORTH IS ASKING FOR A LETTER, NOT FINANCIAL CONTRIBUTION. TRUE NORTH WILL PROVIDE BADLY NEEDED 24 OVER SEVEN INPATIENT MENTAL HEALTH TREATMENT FUNDED BY THE STATE AND FUNDED BY SIGNAL SIGNATURE HEALTH, WHICH WILL OWN THE CAMPUS AND CREATE UP TO 300 JOBS IN OUR COMMUNITY. LAST YEAR, OVER 1700 PEOPLE WERE SEEN AT MERCY ALONE. 300 PATIENTS HAD TO BE SENT TO OTHER PLACES IN CALIFORNIA BECAUSE THERE JUST WEREN'T ENOUGH BEDS. AND THERE ARE NO INPATIENT BEDS FOR KIDS OR ADOLESCENTS IN SHASTA COUNTY. PERIOD. FORCING KIDS TO BE SENT FAR FROM THEIR HOMES AND SUPPORT SYSTEMS. TRUE NORTH HAS THE FULL SUPPORT OF MEDICAL AND LAW ENFORCEMENT AGENCIES, HELPING DIVERT PSYCHIATRIC CRISES FROM OUR EMERGENCY ROOMS, FROM OUR ERS, FROM OUR JAILS, WHO ARE ALL OVERWHELMED WITH BED SHORTAGES AND BUDGET CUTS. YET THEY SERVE AS DEFAULT HOLDING CELLS FOR PEOPLE IN PSYCHIATRIC CRISES. THAT'S WHY SHERIFF JOHNSON SUPPORTS TRUENORTH BECAUSE IT WILL CUT TIME. DEPUTIES SPEND ON MENTAL HEALTH TREATMENT AND CUT TIME. EMT'S HAVE TO SPEND ON ON THIS CONDITION. SO, CRYE, WHY DID YOU PERSUADE COLEMAN TO CHANGE HER MIND? WELL, IT'S BECAUSE IT'S NOT YOUR PROJECT. IT'S NOT THE PROJECT OF YOUR CRONY, MR. CHRIS STREET. IT'S NOT THE UNREALISTIC PIPE DREAMS OF BECOMING MEDICAL CZARS FOR SHASTA COUNTY. HOW PATHETIC. MIKE FREEMAN, JEFF GORDON, DOLORES LUCERO, THOMAS H. THEN DAVID HALLIGAN, IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. GOOD MORNING, BOARD OF SUPERVISORS. MY NAME IS MIKE FREEMAN. I'M A SHASTA COUNTY SUPERINTENDENT OF SCHOOLS. I'M A PROUD ARTS COLLABORATIVE BOARD MEMBER. PROUD MEMBER OF SHARK. I'VE COME INTO THIS SPACE WITH CURIOSITY AND WITH 18 ALWAYS ON MY MIND. GAPS ARE REAL. THEY'RE VISUALLY EVIDENT EVERYWHERE AND THEY'RE GROWING. THE STATUS QUO IS NOT WORKING. AND THIS IS A CATALYST FOR CHANGE. I'M NOT A HEALTH CARE EXPERT. I'M NOT A MENTAL HEALTH EXPERT. BUT I HAVE, OVER THE LAST TEN MONTHS, SAT WITH MENTAL HEALTH AND HEALTH CARE EXPERTS IN A TRUE COLLABORATION. I DON'T I DON'T HAVE ANY TIME. SO I WANT TO START BY, I WANT TO I WANT TO END, I WANT TO START WITH THE END IN MIND AND THANK KIMBERLY JOHNSON FOR THE WORK THAT SHE'S DONE ON THE PROPOSAL AND HER TEAM. I THINK I, I WENT TO STATE OF THE CITY AND I HEARD MICHELLE NYSTROM AND SHE TALKED ABOUT MAN IN THE ARENA. AND I WALKED AWAY INSPIRED BY THAT. THAT'S A QUOTE. THAT'S A LOT OF A LOT OF YOU MIGHT EVEN HAVE IN YOUR OFFICE. THIS IS STRIVING VALIANTLY. THIS IS DARING GREATLY. I WANT TO BE A PART OF HISTORY. ANY TIME I HAVE AN OPPORTUNITY TO BE A PART OF HISTORY, I SAY YES. THIS IS A HISTORIC MOMENT FOR OUR COUNTY. IT GIVES ME INCREDIBLE SATISFACTION FOR THE RECORD, TO SHOW THAT MIKE FREEMAN, SHASTA COUNTY SUPERINTENDENT OF SCHOOLS, IS IN FAVOR OF THE PROPOSAL THAT'S IN FRONT OF YOU. JEFF GORDON, FOLLOWED BY DOLORES LUCERO, THOMAS H. DAVID HALLIGAN, THEN MARY WILLIAMS. IF I CALL YOUR NAME, PLEASE GET IN QUEUE. SHAME ON YOU. KEVIN CRYE. YOUR ATTEMPT TO SABOTAGE THIS PROJECT BECAUSE OF YOUR PETTY VINDICTIVENESS RATHER THAN MERIT IS DESPICABLE. THIS PROJECT HAS BEEN GOING ON FOR ALMOST A YEAR. YOUR CLAIM THAT IT'S BEEN A SECRET IS AN ABSOLUTE FALSEHOOD. THIS HAS BEEN REPORTED ON FOR A YEAR BY VARIOUS MEMBERS OF THE MEDIA. THE COUNTY HAS BEEN INVOLVED. HHS AYE HAS BEEN INVOLVED. I SUSPECT THAT CHRISTIE COLEMAN'S REPUTATION IN THE MEDICAL COMMUNITY HAS TAKEN AN [00:30:06] IRREVOCABLE HIT AS A RESULT OF HER PRESENTATION HERE THIS MORNING. DOCTOR MU SUPPORTS THE PROJECT HAS BEEN INVOLVED. SHERIFF JOHNSON, WHO SUPPORTS THE PROJECT, HAS BEEN INVOLVED. EVERY LOCAL MEDICAL PROVIDER AND LAW ENFORCEMENT AGENCY IN THE NORTH STATE HAS BEEN INVOLVED. ALMOST EVERY COUNTY BEHAVIORAL HEALTH DEPARTMENT IN THE NORTH STATE HAS BEEN INVOLVED. THEY ALL SUPPORT THE PROJECT. JUST TWO MONTHS AGO, ON SEPTEMBER 22ND, HHS DIRECTOR COLEMAN WAS QUOTED AS SAYING, QUOTE, THIS EFFORT BRINGS TOGETHER THE STRENGTHS OF HEALTH CARE, NONPROFIT AND GOVERNMENT PARTNERS TO ADDRESS BEHAVIORAL HEALTH INFRASTRUCTURE NEEDS IN SHASTA COUNTY. THANK YOU TO ALL THE ENTITIES COLLABORATING TO BRING MEANINGFUL, COMMUNITY DRIVEN BEHAVIORAL HEALTH SOLUTIONS TO OUR COMMUNITY. THAT WAS TWO MONTHS AGO. WHAT'S HAPPENED? WHAT'S HAPPENED SINCE THEN? THE PROJECT HASN'T CHANGED. WHY AT THE 11TH HOUR ARE WHAT APPEAR TO BE BOGUS OBJECTIONS TO THIS PROJECT BEING RAISED WITHOUT AN OPPORTUNITY FOR THE PROPONENTS TO ADDRESS THEM. YOU KNOW, CORKY CHRIS, YOU'VE GOT YOU'VE GOT TO TAKE A LOOK AT THIS. OKAY. I MEAN, WHY ARE WE NOT SUPPORTING THIS PROJECT? AND WHY IS IT EVEN CONSIDERED TO SEND A LETTER OF OPPOSITION? IT'S IT'S ABSURD. AND IT'S ALL DUE TO CRYE VINDICTIVENESS. THANK YOU. DOLORES LUCERO, THOMAS H. DAVID HALLIGAN IN THE. IN THE INTEREST OF JUST LETTING PEOPLE KNOW, I WOULD ENCOURAGE YOU TO REACH OUT BECAUSE I'M GETTING MESSAGES ABOUT PEOPLE ROLLING THEIR LETTERS BACK. SO KEEP THEM COMING. GO AHEAD. THIS IS PUBLIC COMMENT. WHEN PEOPLE COME UP HERE, YOU'RE NOT SUPPOSED TO RESPOND. LEARN YOUR RULES. YOUR OWN RULES. THIS IS LET'S LOOK AT THIS PICTURE. WHY ARE WE HERE? AND WHY IS MR. KEVIN CRYE IS OPPOSING IT. I'LL TELL YOU WHY. THE BIGGER PICTURE. BECAUSE HE DOESN'T WANT INTERFERENCE FOR HIS MEDICAL SCHOOL THAT HE'S PUSHING. THAT'S WHY IT'S GOING TO INTERFERE HIS AGENDA. THAT'S THE ONLY REASON HE'S GOING TO OPPOSE IT, ESPECIALLY WHEN WE NEED IT. YOU TALK ABOUT HAVING MENTAL ILLNESS, PEOPLE OUT THERE, AND YET WE HAVE AN OPPORTUNITY, BUT YET WE'RE GOING TO GO AHEAD AND OPPOSE IT. TO WHAT? FOR WHAT REASON? BECAUSE KEVIN CRYE HAS A GOAL. HIS MISSION IS TO MAKE SURE THE MEDICAL SCHOOL PASSES, BECAUSE HE WANTS TO USE THAT AS THE PLATFORM TO BE ABLE TO SAY, OH, LOOK WHAT I DID. SO DOWN THE ROAD, HE COULD USE IT AS WHEN HE RUNS AND SAY, LOOK, THE CHANGES I MADE, MAKE SURE YOU VOTE FOR ME. THAT'S ALL IT IS. KEVIN CRYE LITTLE AGENDA. BUT THE REASON ALSO MRS. CHRISTY COLE COLEMAN ACTUALLY CHANGED YOUR MIND? AS I WAS DRIVING HERE, I HEARD ON THE RADIO THAT SHE WAS FOR IT IN THE PAST, BUT NOW SHE'S NOT THE REASON WHY? BECAUSE KEVIN CRYE IS A DICTATOR AND MANIPULATOR, AND IF SHE'S WILLING TO BACK DOWN TO HIM, THAT I FEEL SORRY FOR HER BECAUSE SHE NEEDS TO STAND UP. SHE SHOULDN'T BE AFRAID TO BE FIRED IN CASE THAT'S IN THE BACK OF HER MIND, BECAUSE KEVIN CRYE IS GOING TO PUSH BUTTONS AND INTIMIDATE PEOPLE, AND ESPECIALLY AGAINST WOMEN. IF HE CAN'T HAVE THE WOMEN, HE WILL INTIMIDATE THEM AND, AND GO AFTER THEM TO MAKE SURE THAT THEY FOLLOW HIS AGENDA. OR ELSE YOU'LL YOU'LL SEE YOURSELF OUT THE DOOR. THAT'S KEVIN. HE DOESN'T CARE. WHERE'S YOUR GODLY NOW, MAN? THANK YOU. THOMAS H. FOLLOWED BY DAVID HALLIGAN, MARY WILLIAMS, PATRICK MORIARTY. THOMAS H. AFTER HEARING SOME SPEAKERS, WE. WE MIGHT NEED MORE ROOM FOR FACILITIES. BUT I THINK I THINK PRIVATE ENTERPRISE CAN HANDLE IT. YOU GET GOVERNMENT INVOLVED. WHAT DO YOU GOT? WE DON'T HAVE ENOUGH MONEY. IT'S LIKE, YOU KNOW, WE PAVED THE STREETS. NOW WE CAN'T KEEP THEM. KEEP THEM GOING BECAUSE WE DON'T HAVE ENOUGH MONEY. I WOULD IF THIS WAS A VALID, GREAT THING. ASHLAND, OREGON WOULD ALREADY HAVE IT. YOU WOULDN'T HAVE TO FIGHT FOR IT. THEY'D HAVE IT. I DON'T SEE IT BEING AN ADVANTAGE TO SHASTA COUNTY. THAT'S WHO WE GOT TO LOOK OUT FOR. YOU THINK YOU HAVE BUSSES COMING IN NOW? YOU'LL HAVE BUSSES COMING IN IF YOU PASS THIS THING. AND THEN YOU'LL HAVE MORE BUSSES, THEN YOU'LL HAVE TO SAY. THEN WE'LL SAY, WE DON'T HAVE NOBODY. WE'RE NOT PAYING ENOUGH. IT'S ALL A GOVERNMENT COMPLAINT. YOU EVER HEARD OF SOCIALISM? MOST OF THESE GUYS SPEAKING ARE FROM A SOCIALISTIC GOVERNMENT. [00:35:02] THEY HAVEN'T BEEN OUT THERE WORKING. DAVID HALLIGAN, FOLLOWED BY MARY WILLIAMS, PATRICK MORIARTY, KIMBERLY JOHNSON AND ADRIAN. ADRIAN CUSHMAN. GOOD MORNING BOARD BIGGEST CROWD OF THE YEAR. KEVIN, I WONDER WHY. WELCOME TO THE KEVIN CRYE EMERGENCY SPECIAL MEETING HOUR WHERE CHAIR CRIES EMERGENCY IS EVERYONE ELSE'S EMERGENCY. MISS COLEMAN, YOU'VE BEEN INVOLVED WITH THIS PROCESS ALL ALONG THE WAY FOR MONTHS AND MONTHS, AND YOU HAVE BEEN SUPPORTIVE OF, UNTIL NOW, THE LAST MINUTE TURNAROUND, ALL CAUSED BY WHAT WE BELIEVE IS COMING AT YOU FROM CHAIR CRYE. MISS COLEMAN, YOU'VE TREMENDOUSLY HURT YOUR CREDIBILITY AND REPUTATION HERE EARLY IN YOUR CAREER AS A DIRECTOR. YOUR SUDDEN OPPOSITION FEELS LIKE A BETRAYAL, ESPECIALLY AFTER A LONG PERIOD OF APPARENT SUPPORT. THE TRUE NORTH BEHAVIORAL HEALTH CAMPUS TEAM QUESTIONS YOUR MOTIVES AND WONDERS IF YOUR SUPPORT WAS EVER GENUINE, BUT NOT ANYMORE. YOUR SUPPORT AND LOYALTY IS TO KEVIN CRYE AND NOT THE GREATER GOOD OF THE COUNTY AND THE MEDICAL NEEDS OF OUR COMMUNITY. YOU SOLD OUT HERE, MISS COLEMAN. YOU SOLD OUT. I'VE SEEN A LIST OF OVER 40 PROMINENT COMMUNITY ORGANIZATIONS, BUSINESSES, HIGH LEVEL PROFESSIONALS, LAW ENFORCEMENT MEMBERS, AND GOVERNMENT LEADERS THAT ALL SUPPORT. YES, SUPPORT THIS GRANT PROPOSAL FOR OUR COMMUNITY. I'VE SEEN NAMES LIKE DOCTOR MOO SUPERVISOR, MATT PLUMMER, DOCTOR DHENUKA, SHERIFF JOHNSON, CHIEF BARNER, ALONG WITH SENATOR MEGAN DOLLY AND MANY, MANY MORE INDIVIDUALS AND ORGANIZATIONS IN THE NORTH STATE. AND NOW I'M CURIOUS, MR.. CRYE. MR.. GO WITH YOUR GUT. WHERE IS YOUR LIST OF OPPOSITION? PLEASE SHARE WITH US YOUR LIST OF MEDICAL PROFESSIONALS, LAW ENFORCEMENT, GOVERNMENT LEADERS IN OPPOSITION OF THIS GRANT REQUEST. PLEASE SHARE. MR. CRYE CHAIR. CRYE WOULD NOT CALL A SPECIAL MEETING TODAY UNLESS HE THOUGHT HE HAD THE SUPPORT OF MR. KELSTROM. MR. HARMON SO WHICH ONE OF YOU GENTLEMEN ARE GOING TO STEP UP TODAY? BOTH OF YOU STEP UP FOR THE COMMUNITY AND THE COUNTY TO FURTHER SUPPORT WHAT WOULD BE ENHANCED MEDICAL TREATMENTS AND IMPROVED OUTCOMES FOR THE CITIZENS AND FAMILIES OF SHASTA COUNTY. REMEMBER A $200 MILLION PROJECT AND 200 NEW MEDICAL JOBS. AND CHAIR CRYE WANTS TO OPPOSE IT. MARY WILLIAMS, PATRICK. MORIARTY, KIMBERLY. JOHNSON, ADRIAN. CUSHMAN, THEN. ROBERT. GOOD MORNING. MARY WILLIAMS, DIRECTOR OF REGIONAL INITIATIVES AT ARCH COLLABORATIVE. REGARDING MISS COLEMAN'S STATEMENTS TODAY ABOUT A LACK OF INVOLVEMENT FROM HERSELF OR HER TEAM IN THIS PROPOSAL, I WOULD LIKE AN OPPORTUNITY TO PROVIDE SOME CLARITY. ARCH COLLABORATIVE FIRST APPROACHED SHASTA COUNTY H H AYE OVER A YEAR AGO TO ASK ABOUT THE OPPORTUNITY AND TO ASK FOR SOME COLLABORATION IN A PROPOSAL. AT THAT TIME, HHS INDICATED THAT THEY WOULD NOT INTEND TO APPLY FOR FUNDING THEMSELVES, BUT WOULD ENCOURAGE COMMUNITY PROVIDERS TO COME TOGETHER AND SUBMIT APPLICATIONS FOR SHASTA COUNTY. SO WE APPROACHED SHASTA HEALTH ASSESSMENT AND REDESIGN COLLABORATIVE SHARK AND ASKED THEM IF THEY WOULD LIKE TO PARTNER WITH US IN DOING JUST THAT. AND THEY DID. I'D LIKE TO POINT OUT THAT MISS COLEMAN IS A VOTING MEMBER OF SHARK, WHICH IS THE BODY THAT OVERSAW THIS PROCESS. ADDITIONALLY, SHARK THEN MOVED TO CREATE AN AD HOC COMMITTEE OF THEIR BODY TO GUIDE THIS APPLICATION PROCESS AND TO INFORM ITS DEVELOPMENT. MISS COLEMAN'S DEPUTY DIRECTOR, MISS BAILEY COGGER, THEN SAT ON THAT COMMITTEE, WHICH MET MONTHLY TO OVERSEE THE APPLICATION DEVELOPMENT. THAT PROCESS INVOLVED OVER 100 COMMUNITY ENGAGEMENT MEETINGS AND STAKEHOLDER MEETINGS WITH HHS. AYE INPUT INTENDED TO DESIGN A PROPOSAL BROUGHT FORWARD FROM THIS COMMUNITY AND FOR THIS COMMUNITY TO FILL THE MOST CRITICAL GAPS IN OUR BEHAVIORAL HEALTH CONTINUUM OF CARE. WE ATTENDED 16 MEETINGS RELATED TO THE PROJECT, SIX MEETINGS BETWEEN ARCH AND HHS AYE SEVEN MEETINGS AT AD HOC MEETINGS INVOLVING HHS LEADERSHIP PARTICIPATION. 19 EMAILS SHARING SPECIFIC INFORMATION ABOUT OUR PROJECT. EIGHT WHICH RECEIVED NO RESPONSE, AND TWO EMAILS TO CEO RICKERT WITH NO RESPONSE. WE WOULD LOVE AN OPPORTUNITY TO SPEAK TO THESE ISSUES, WHICH COULD HAVE BEEN PRESENTED OVER THE LAST YEAR, BUT WE RECEIVED NOW THE MORNING OF THIS MEETING, WITHOUT EVEN NOTIFICATION THAT THIS MEETING HAD BEEN SCHEDULED TO DISCUSS OUR PROJECT. I WOULD ENCOURAGE THIS BOARD NOT TO SET A PRECEDENT OF TAKING A POSITION ON A PROJECT WITHOUT AT LEAST AFFORDING THE APPLICANT AN OPPORTUNITY TO COME PRESENT TO YOU WHAT THE PROJECT IS TRULY ABOUT. PATRICK MORIARTY. KIMBERLY JOHNSON. ADRIAN CUSHMAN, FOLLOWED BY ROBERT. GOOD MORNING. MY NAME IS PATRICK MORIARTY, A 45 YEAR RESIDENT OF SHASTA COUNTY AND A PERSISTENT ADVOCATE FOR PEOPLE WITH MENTAL ILLNESS, LIVING WITH MENTAL ILLNESS AND THEIR FAMILIES. I CONTRACTED WITH CHESTER COUNTY IN THE 80S AND 90S TO PROVIDE A RANGE OF SERVICES SOCIAL, EDUCATIONAL, EMPLOYMENT AND RESIDENTIAL SERVICES TO PEOPLE LIVING WITH MENTAL ILLNESS. IT'S A SAD STATE OF AFFAIRS THAT WE'RE HERE TODAY. WE DON'T NEED TO BE. HAVING SAID THAT, HERE ARE MY THOUGHTS. I APPRECIATED SOME OF CHRISTIE'S PRESENTATION. SHE'S IN A TOUGH SITUATION. IT'S A LITTLE DISINGENUOUS, TO BE HONEST, TO SAY THAT SHE WAS NOT INCLUDED IN THE PROCESS. [00:40:02] THAT THAT BEARS EXAMINATION. I AGREE THAT THERE IS A NEED FOR BEDS FOR HIGH ACUITY PATIENTS. THIS IS TRUE NOT JUST IN SHASTA COUNTY, BUT AROUND THE STATE. THERE'S A REASON THOSE BEDS ARE NOT BEING DEVELOPED AROUND THE STATE. IT'S CALLED MONEY, A RETURN ON INVESTMENT. THIS PROPOSAL ACTUALLY INCREASES COMPETITION IN A WAY THAT PUTS MORE PRESSURE ON PROVIDERS TO ACCEPT HIGH ACUITY PATIENTS EARLIER, AND MORE EFFECTIVE INTERVENTIONS CAN MAKE A DIFFERENCE HERE. ALSO, THE COMPONENT OF THIS PROPOSAL ADDRESSING THE NEEDS OF YOUTH LIVING WITH MENTAL ILLNESS ON ITS OWN SHOULD DESERVE THE SUPPORT OF THIS BOARD. THIS PROPOSAL WOULD BRING ANOTHER REPUTABLE AND EXPERIENCED MENTAL HEALTH PROVIDER TO OUR COMMUNITY. AND I HAVE TO SAY THIS IF HE INDEED FEELS THAT THE BEDS FOR HIGH ACUITY CLIENTS IS THE PRIORITY, HOW COME FROM THE BEGINNING OF THIS PROCESS, DIDN'T THEY BRING THAT MESSAGE TO THE COMMUNITY AND LOOK FOR PARTNERS INSIDE AND OUTSIDE THE COMMUNITY TO ADDRESS THAT NEED? THANK YOU FOR YOUR TIME. THANK YOU. KIMBERLY JOHNSON, FOLLOWED BY ADRIAN CUSHMAN, ROBERT ELIZABETH SCHROEDER, THEN ALAN EAKES. GOOD MORNING. I'D LIKE TO BEGIN BY SAYING THAT I CHECKED MY EMAIL JUST BEFORE I CAME UP HERE, AND NOT A SINGLE LETTER HAS BEEN PULLED BACK. AND IN FACT, THREE MORE HAVE COME IN THIS WEEK ALONE TO THE MORE THAN 200 PEOPLE WHO HAVE POURED YOUR HEARTS INTO THIS PROJECT. THANK YOU. YOU'VE SHOWN UP MEETING AFTER MEETING BECAUSE YOU SEE THE TRUTH. FAMILIES ARE IN CRISIS, PARENTS BREAKING UNDER THE WEIGHT OF SYSTEMS THAT KEEP FAILING THEM. CHILDREN WAITING MONTHS FOR CARE THAT NEVER COMES. PEOPLE TRYING TO HOLD ON TO HOPE WHEN EVERYTHING AROUND THEM TELLS THEM TO GIVE UP. HOW DARE ANYONE LOOK A STRUGGLING FAMILY IN THE EYE AND SAY YOU'RE FINE. HOW DARE YOU CHOOSE COMFORT OVER COURAGE, SILENCE OVER ACTION AND CALL THAT GOVERNANCE. THIS DID NOT HAPPEN OVERNIGHT AND IT DID NOT BEGIN LAST WEEK WITH GLENN COUNTY'S BOARD CHAIR CALLING YOU. IT HAPPENED. IT WAS SHAPED. BUT IT HAS BEEN SHAPED BY ONE VOICE, A VOICE THAT IS BULLIED, MISLED AND MANIPULATED THE TRUTH FOR MONTHS. CHAIRMAN CRYE HAS CHOSEN CONTROL AND CONFLICT OVER COLLABORATION, AND THE RESULT IS THAT PEOPLE WHO NEED THE MOST HELP THE MOST ARE THE ONES THAT ARE PAYING THE PRICE. TO THE REST OF THE BOARD, I AM ASKING YOU THAT YOU DRAW A LINE IN THE SAND. DEMAND THAT WE DEMAND THAT WE LEAD IN THE LIGHT, WHERE THE PUBLIC CAN SEE WHERE DECISIONS ARE ABOUT THE HEALTH OF OUR COMMUNITY ARE BEING MADE WITH TRANSPARENCY AND TRUTH. OVER THE PAST TEN MONTHS, THIS PROJECT HAS BEEN BUILT BY HOSPITALS, LAW ENFORCEMENT, SCHOOLS, BEHAVIORAL HEALTH EXPERTS AND FAMILIES ALL UNITED AROUND A SHARED GOAL TO STOP WATCHING THE CYCLICAL CRISIS OF PEOPLE FALLING THROUGH THE CRACKS. AFTER MONTHS OF MEETINGS AND MORE THAN 20 EMAILS, REPEATED EFFORTS TO ENGAGE WITH HHS ON THIS BOARD, WE'RE STILL READING BRAND NEW CONCERNS FOR THE VERY FIRST TIME TODAY. THAT'S NOT LEADERSHIP. IT'S AVOIDANCE DISGUISED AS CAUTION TO SIGNATURE HEALTHCARE. THANK YOU FOR SHOWING UP, LISTENING AND STILL CONSISTENT. CONSIDERING A $50 MILLION CASH INVESTMENT IN ACCOUNTING WHOSE LEADERSHIP CAN'T DECIDE WHETHER IT WANTS TO HELP ITS OWN PEOPLE OR TO CONTINUE SENDING FUNDS SOUTH OF SACRAMENTO, INCLUDING THE 68 REFERRALS INTO YOUR SANTA ROSA HOSPITAL ALONE. THIS FIGHT IS FOR THE FAMILIES, THE ONES WHO ARE THE ONES WHO ARE HURTING AND HOPING THAT SOMEBODY WILL FINALLY CHOOSE TO DO WHAT'S RIGHT TO THIS COMMUNITY THAT I LOVE. EVEN IF MISINFORMATION WINS TODAY, THE TRUTH WILL OUTLAST IT. BECAUSE COMFORT NEVER SAVED A CHILD. CAUTION NEVER BUILT A BED, AND COMPLACENCY NEVER CHANGED. THANK YOU. ADRIENNE. ADRIENNE CUSHMAN. ROBERT ELIZABETH SCHROEDER, THEN ALEX ALLEN X GOOD MORNING CHAIR CRYE AND MEMBERS OF THE BOARD. MY NAME IS ADRIAN CUSHMAN AND I SERVE AS CHIEF PROGRAM OFFICER AT ARCH COLLABORATIVE. I'M HERE TODAY NOT ONLY IN THAT ROLE, BUT AS A RESIDENT OF DISTRICT ONE AND A MOTHER WHO DEEPLY CARES ABOUT THIS COUNTY THAT WE CALL HOME FOR NEARLY 15 YEARS, MY WORK IN CHILD WELFARE, CHILD MALTREATMENT AND VICTIM SERVICES SUPPORTING CHILDREN, YOUTH AND ADULTS IMPACTED BY TRAUMA HAS GIVEN ME AN IN-DEPTH UNDERSTANDING OF THE URGENT AND COMPLEX NEEDS IN OUR COMMUNITY. I SIT IN MULTIDISCIPLINARY TEAM MEETINGS EACH WEEK WITH LAW ENFORCEMENT, SOCIAL WORKERS, ADVOCATES, MENTAL HEALTH CLINICIANS AND HEALTHCARE PROFESSIONALS, INDIVIDUALS WITH DEEP EXPERTISE AND EVEN DEEPER COMMITMENT. YET TOGETHER, WE FACE THE SAME BARRIERS AGAIN AND AGAIN. THE LACK OF ACCESSIBLE BEHAVIORAL HEALTH AND SUBSTANCE USE SERVICES FOR INDIVIDUALS AND FAMILIES WE SERVE. RECENTLY, I SAT ACROSS FROM A MOTHER WHO'S DONE EVERYTHING RIGHT, WHO SPENT HOURS ON THE PHONE ADVOCATING AND SEARCHING FOR PROGRAMS FOR HER CHILD, ONLY TO LEARN THAT WHAT IS NEEDED SIMPLY DOESN'T EXIST HERE, THAT HER CHILD WILL HAVE TO LEAVE HOME, THEIR SCHOOL, AND THEIR COMMUNITY JUST TO ACCESS CARE. THIS IS NOT A FAILURE OF FAMILIES. THIS IS A FAILURE OF SYSTEMS. AND IT'S EXACTLY WHAT THE PROJECT WAS BUILT TO CHANGE. CHAIR CRYE. AS MY ELECTED REPRESENTATIVE, YOU HAVE SPOKEN OFTEN ABOUT PROTECTING CHILDREN, REDUCING ACES, ADDRESSING THE OPIOID CRISIS AND STRAIN ON OUR JAILS AND HOSPITALS. BUT WORDS WITHOUT ALIGNMENT RING HOLLOW. YOU CANNOT CREDIBLY ADVOCATE FOR THOSE CAUSES WHILE ACTIVELY UNDERMINING THE VERY PROJECT THAT DIRECTLY ADDRESSES THEM. YOU CANNOT CRITICIZE THE IMPACT OF CHILD ABUSE AND ADDICTION, AND THEN OPPOSE THE INFRASTRUCTURE DESIGNED TO RESPOND AND HEAL. THE PROJECT REPRESENTS WHAT THIS COUNTY HAS BEEN MISSING FOR DECADES A UNIFIED SYSTEMS [00:45:04] LEVEL RESPONSE THAT CONNECTS BEHAVIORAL HEALTH, HEALTH CARE AND PREVENTION. THIS IS NOT ABOUT POLITICS. IT'S ABOUT FINALLY BUILDING WHAT COUNTLESS PROFESSIONALS AND FAMILIES WHO'VE LIVED. THE CONSEQUENCES OF OUR SYSTEM'S GAPS KNOW WE NEED. SO I'M ASKING YOU TO STAND ON THE SIDE OF COLLABORATION, HUMANITY, INTEGRITY, AND PROGRESS. BECAUSE THE POWER YOU HOLD IN THIS ROOM CARRIES THE WEIGHT OF EVERY CHILD, EVERY FAMILY, AND EVERY LIFE WAITING FOR A PLACE TO TURN. THANK YOU. ROBERT. FOLLOWED BY ELIZABETH SCHROEDER, ALAN EAKES, JOE CAMPBELL, THEN KURT EDGAR. GOOD MORNING. BOARD. I'D LIKE TO URGE THE BOARD TO VOTE AGAINST OUR TWO. THIS OPPORTUNITY FOR FUNDING FOR THE MENTALLY ILL WILL FILL A VOID. WE CANNOT POSSIBLY FILL OURSELVES. THERE IS NO IDEOLOGY OR POLITICS HERE. I CHECKED, BASING A DECISION OUT OF IDEOLOGY OR FEAR OF REPRISALS FROM A SUBJECT MATTER. EXPERT WISE, IN HIS OWN EYES, IN EVERYTHING IS JUST OUR BOARD CHAIR. I DON'T BLAME CHRISTIE. SHE'S JUST A MOUTHPIECE FOR KEVIN THE CRICK. REALLY? THAT'S LAUGHABLE. THERE ARE NO BEDS FOR MENTAL HEALTH CLIENTS. MERCY ER AND SHASTA REGIONAL ER ARE FULL. LET'S CALL THIS FOR WHAT IT IS A PERSONAL POLITICAL VENDETTA AGAINST KIMBERLY JOHNSON AND ARCH COLLABORATIVE. WHY HASN'T KEVIN ALLOWED ARCH TO PRESENT THEIR SIDE INSTEAD OF THE DISRESPECT OF PLACING THEM ON THE TWO MINUTE GANTLET? CHRISTIE HAS BEEN INVOLVED, AND THERE ARE MULTIPLE EMAILS SAYING HOW SUPPORTIVE HHS WAS UNTIL LAST WEEK. TO CHRIS AND CORKY. I SAY, PLEASE DO THE RIGHT THING. DON'T, DON'T DON'T FEAR KEVIN. JUST BE A MAN OF INTEGRITY AND DO THE RIGHT THING, PLEASE. ELIZABETH SCHROEDER, ALAN. EAKES, JOE CAMPBELL. KURT EDGAR. GOOD MORNING, I'M ELIZABETH SCHROEDER. I WANTED TO READ THIS LIST. THE TRUE NORTH INITIATIVE ALREADY RECEIVED 49 FORMAL LETTERS OF SUPPORT, REFLECTING A BROAD CONSENSUS THAT URGENT BEHAVIORAL HEALTH INVESTMENT IS LONG OVERDUE. THIS LIST INCLUDES THE SHASTA COUNTY SHERIFF, SHASTA COUNTY SUPERVISOR MATT PLUMMER, SHASTA COUNTY PUBLIC HEALTH OFFICER DOCTOR JAMES MOO, SHASTA COUNTY DISTRICT ATTORNEY STEPHANIE BRIDGETT, SHASTA COUNTY SUPERINTENDENT OF SCHOOLS MIKE FREEMAN, REDDING POLICE CHIEF BRIAN BARNER ANDERSON, POLICE CHIEF OLIVER COLLINS, PLYMOUTH COUNTY BEHAVIORAL HEALTH DIRECTOR, COLUSA COUNTY BEHAVIORAL HEALTH DIRECTOR, SISKIYOU COUNTY BEHAVIORAL HEALTH DIRECTOR, SISKIYOU COUNTY SUPERVISOR, DISTRICT TWO ED VALENZUELA, HUMBOLDT COUNTY BEHAVIORAL HEALTH DIRECTOR, MODOC COUNTY BEHAVIORAL HEALTH DIRECTOR, MODOC BOARD OF SUPERVISOR, MODOC COUNTY SHERIFF. TEHAMA COUNTY BEHAVIORAL HEALTH DIRECTOR, TRINITY COUNTY BEHAVIORAL HEALTH DIRECTOR, BUTTE COUNTY BEHAVIORAL HEALTH DIRECTOR, BUTTE COUNTY SHERIFF, LASSEN COUNTY SHERIFF, GLENN COUNTY SHERIFF DEL NORTE COUNTY BEHAVIORAL HEALTH DIRECTOR AND BOARD OF SUPERVISORS PARTNERSHIP HEALTH PLAN CEO, SIERRA SACRAMENTO VALLEY EMS, JOINT POWERS AUTHORITY, SHASTA HEALTH ASSESSMENT AND REDESIGN COLLABORATIVE, RURAL COUNTY REPRESENTATIVES OF CALIFORNIA, OUR CRC CEO, CALIFORNIA HEALTH CARE FOUNDATION, NORTH VALLEY MEDICAL ASSOCIATION. DOCTOR. PAUL DHANUKA. MERCY MEDICAL CENTER REDDING CEO, SHASTA REGIONAL MEDICAL CENTER CEO, SHASTA COMMUNITY HEALTH CENTER CEO, MOUNTAIN VALLEY HEALTH CENTER CEO, WELL SPACE HEALTH CEO, SHASTA SUBSTANCE USE COALITION, GOOD NEWS, RESCUE MISSION CEO, RENEWED LIFE MEDICAL GROUP, MERCEDES DOCTOR. MERCEDES PETTY DOCTOR. MICHELLE SAGER, PSYCHIATRIST, SIMPSON UNIVERSITY, SHASTA COLLEGE FOUNDATION SENATOR. MEGAN DOLLY, ASSEMBLY MEMBER. HEATHER HARDWICK, OTHER PARTNERS AND ADVISORS INCLUDE DOCTOR, I'M SORRY, DONALD EWERT, FORMER SHASTA COUNTY HSA DIRECTOR. PATRICK MORIARTY, MENTAL HEALTH ADVOCATE AND SHARK BOARD MEMBER. THIS IS AN EXTENSIVE LIST OF SUPPORTERS. ALAN EAKES, FOLLOWED BY JOE CAMPBELL, KURT EDGAR, THEN JUDY SALTER. IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. HELLO, I'M ALAN EAKES, I'M THE CHIEF OPERATING OFFICER FOR SIGNATURE HEALTH CARE, AND I DO WANT TO RECOGNIZE I REALLY DON'T HAVE A STANDING IN THIS COMMUNITY. WE'RE HERE. AND BECAUSE WE WERE ASKED TO BE A PARTICIPANT AND THE PRIMARY APPLICANT, THE ONLY APPLICANT IN THIS GRANT AND OUR MOTIVATION AND HAS BEEN OUR MOTIVATION SINCE THE COMPANY WAS FOUNDED BY OUR FOUNDER, DOCTOR KIM, WAS TO CREATE ACCESS TO CARE, PURELY PURE AND SIMPLE. AND WE HAVE KNOWN FOR A VERY LONG TIME. THE NORTHERN PORTION OF THE STATE OF CALIFORNIA IS IN GREAT NEED FOR MORE ACCESS TO CARE. SO THIS PROJECT, ALONG WITH THE IMMENSE AMOUNT OF SUPPORT WITH STAKEHOLDERS IN THE COMMUNITY AND SURROUNDING COUNTIES, WAS ONE THAT WE THOUGHT WAS VERY VIABLE. BEING VIABLE ON ITS OWN WITHOUT THIS GRANT IS NOT POSSIBLE. IT DOESN'T PENCIL OUT. SO AS A PRIVATE COMPANY, WE HAVE TO LOOK AT THE, [00:50:02] THE, THE REAL ASPECTS OF THIS, NOT ONLY WHETHER WE HAVE THE SUPPORT IN THE COMMUNITY TO PROVIDE CARE, BUT SECONDLY, IF IF WE CAN IF IT IS A SUSTAINABLE MODEL AND WE ARE ABLE TO CREATE A SUSTAINABLE MODEL BECAUSE OF THE THE FUNDING THAT THE B CHIP OFFERS AND CREATES A REGIONAL APPROACH TO CARE SO THAT FOLKS CAN ACCESS CARE WITHOUT GOING TO ONE OF OUR FACILITIES, EITHER IN SANTA ROSA AND SACRAMENTO OR EVEN PATIENTS COME TO L.A. COUNTY. SO I GUESS WHAT I'D LIKE TO SAY IS THAT WE ARE HERE. WE ARE ABLE TO EXECUTE A PROJECT OF THIS NATURE. WE HAVE NINE HOSPITALS IN THE STATE THAT WE'VE OPENED, AND WE ARE HERE TO ASSIST AND AID THE COUNTY IN THIS ENDEAVOR AND HOPEFULLY PREVAIL IN GAINING FUNDS FOR THE COUNTY AS WELL AS THE NORTHERN NORTHERN FRONTIER PART OF THE STATE. THANK YOU. MR.. MR.. MR.. I WOULD LIKE TO ASK YOU A FOLLOW UP QUESTION, BECAUSE I THINK IT'S IMPORTANT. WE ARE HEARING JUST ONE PERSPECTIVE TODAY. THE PRESENTERS WE'RE NOT HEARING FROM MARCH. WE'RE NOT HEARING FROM YOUR ORGANIZATION. SO I WANT TO ASK YOU PUBLICLY HERE YOU ARE. YOUR UNDERSTANDING IS YOU WILL BE THE SOLE APPLICANT ON THIS PROJECT. IT WILL NOT BE A PARTNERSHIP WITH THE COUNTY. IT WILL NOT BE A PARTNERSHIP WITH ARCH SHARK IS NOT INVOLVED IS YOUR ORGANIZATION, AND YOU WOULD BE PUTTING UP THE $50 MILLION TO BE MATCHED BY CHIP FUNDS, WHICH WOULD BE ANOTHER $150 FOR A $200 MILLION PROJECT. IS THAT YOUR UNDERSTANDING? YES. WE'RE THE SOLE APPLICANT AND FULLY RESPONSIBLE FOR THE APPLICATION AND THE FINANCIAL RESPONSIBILITY THAT COMES BEHIND IT. THANK YOU, THANK YOU. I HAVE A QUESTION. IS EXCITED AND FACT CHECKS THIS. DID YOU GUYS LOSE YOUR DESIGNATION? I BELIEVE IT WAS IN ORANGE COUNTY. WE DID LOSE OUR DESIGNATION. OKAY. THANK YOU. AND THEN MY NEXT QUESTION IS ARE YOU GUYS ARE YOU GUYS STILL ARE YOU GUYS? HEY, LISTEN, I'VE SAT AND LISTENED TO YOU FOREVER. HERE'S MY NEXT QUESTION. ARE YOU GUYS STILL A FOR PROFIT COMPANY? YES WE ARE. THANK YOU. THANK YOU. NEXT SPEAKER PLEASE. JOE CAMPBELL. KURT EDGAR, JUDY SALTER, THEN STACEY WATSON. IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. GOOD MORNING. MY NAME IS JOE CAMPBELL AND I'M THE CEO OF HILL COUNTRY COMMUNITY CLINIC. I WANT TO EXPRESS MY CONCERN AND DISAPPOINTMENT WITH THE DECISION NOT TO SUPPORT THE TRUE NORTH BEHAVIORAL HEALTH CAMPUS. THIS PROJECT REPRESENTS A RARE AND TRANSFORMATIVE OPPORTUNITY FOR OUR COMMUNITY TO BUILD DESPERATELY NEEDED BEHAVIORAL HEALTH INFRASTRUCTURE. EVERY DAY, OUR TEAMS AT HILL COUNTRY SEEK THE CRACKS IN OUR SYSTEM. THE THREE TENETS OF CRISIS RESPONSE ARE A SAFE PERSON TO CALL, A SAFE PERSON TO RESPOND, AND A SAFE PLACE TO GO. THEY MUST ALL EXIST FOR THE SYSTEM TO WORK. WE'VE MADE GREAT PROGRESS IN BUILDING THE FIRST TWO, BUT WITHOUT A SAFE PLACE TO GO, THOSE EFFORTS REMAIN INCOMPLETE. THAT'S THE CRITICAL GAP THIS PROJECT WOULD FILL. THE HHS LETTER CITES CONCERNS ABOUT BUDGET IMPACTS AND EXISTING BED CAPACITY, BUT FROM OUR EXPERIENCE ON THE FRONT LINES. THOSE ARGUMENTS DON'T REFLECT THE DAILY REALITY FOR THE PEOPLE IN CRISIS IN SHASTA COUNTY. OUR MOBILE CRISIS TEAMS, EMERGENCY DEPARTMENTS, AND LAW ENFORCEMENT PARTNERS ARE STRETCHED TO THE BREAKING POINT, TRYING TO RESPOND TO INDIVIDUALS WITH SERIOUS MENTAL ILLNESS AND SUBSTANCE USE DISORDERS, OFTEN WITH NOWHERE APPROPRIATE TO TAKE THEM. WE SEE FIRSTHAND OUR COMMUNITY LACKS ADEQUATE PLACEMENTS AND TRANSITIONAL OPTIONS. THIS PROJECT WOULD CREATE A CONTINUUM OF CARE THAT COMPLEMENTS, NOT COMPETES, WITH EXISTING LOCAL SERVICES. IT WOULD BRING STATE INVESTMENT, EXPAND TREATMENT ACCESS AND STRENGTHEN PARTNERSHIPS ACROSS COUNTIES. REJECTING IT OUTRIGHT RISKS LEAVING OUR COMMUNITY UNDERSERVED, WHILE THE URBAN CENTERS IN OUR STATE USE OUR TAX DOLLARS TO MOVE FORWARD IN BUILDING THEIR BEHAVIORAL HEALTH INFRASTRUCTURE. I URGE HHS TO RECONSIDER ITS POSITION. HILL COUNTRY STANDS READY TO WORK WITH HHS, A SIGNATURE HEALTH AND THE REST OF OUR COMMUNITY PARTNERS TO MAKE SURE THIS PROJECT MEETS OUR SHARED GOALS, BECAUSE OUR COMMUNITY DESERVES A FULL CRISIS SYSTEM BUILT ON ALL THREE PILLARS. A SAFE PERSON TO CALL, A SAFE PERSON TO RESPOND, AND EDGAR, FOLLOWED BY JUDY SALTER, STACY WATSON, AND BENJAMIN WAYNE. GOOD MORNING. MY NAME IS KURT EDGAR. I AM THE CEO OF BREAST PAD INCORPORATED AS WELL AS REST PAD HEALTH CORPORATION. AND I DON'T KNOW KEVIN CRYE. I'VE NEVER MET HIM. I CAN TELL YOU THAT I HAVE QUITE A, QUITE A FEW YEARS OF EXPERIENCE IN THE MENTAL HEALTH BUSINESS. [00:55:04] AND WE HAVE CURRENTLY A FACILITY LOCATED IN READING AT 16 BEDS AS WELL AS ONE IN RED BLUFF. IT TAKES BOTH YOUTH AND ADULTS ALSO 16 BEDS. TODAY I'D LIKE TO SHARE SOME PERSPECTIVE AND MAYBE WRITE SOME MISCONCEPTIONS AND ERRONEOUS REPORTING IN THE MEDIA. IN REALITY, AS I SAID EARLIER, OUR FACILITIES CAN TREAT UP TO 16 PATIENTS AT A TIME. THE PROBLEM IS, AS MRS. COLEMAN SAID, THERE AREN'T ENOUGH PSYCHIATRIC PLACEMENTS IN THIS COUNTY TO KEEP OUR BEDS FULL. ESSER MC ALSO HAS 18 BEDS, SO IF YOU ADD THAT UP, DO THE MATH. THAT IS 50 INPATIENT BEDS BETWEEN THE THREE FACILITIES SERVING A COMMUNITY OF ABOUT 200, MAYBE 250,000 PEOPLE. THEY CANNOT KEEP THE BEDS FULL. LET ME GIVE YOU SOME REASONS WHY THERE'S PEOPLE STILL IN THE ER, AND THIS IS SOMETHING YOU DON'T HEAR IN THE MEDIA. AND QUITE FRANKLY, YOU HAVEN'T HEARD HERE TODAY. THERE IS GOOD REASON WHY PEOPLE ARE IN THE ER. NUMBER ONE IS THE LAW REQUIRES THAT ALL PEOPLE ARE MEDICALLY CLEARED BEFORE THEY'RE PLACED IN PSYCHIATRIC FACILITIES. NUMBER TWO, OUR FACILITY GETS BOGGED DOWN BECAUSE WE DON'T HAVE ENOUGH LONG TERM BEDS IN CALIFORNIA, ESPECIALLY IN THE NORTH STATE. WHAT WE NEED HERE IS NOT ANOTHER PUFF. WHAT WE NEED HERE IS LONG TERM BEDS, AN EYE MD OR AN MHR THAT CAN SERVE THIS COMMUNITY AND GET THOSE CLIENTS OUT OF SOUTHERN CALIFORNIA BACK WHERE THEY BELONG. JUDY SALTER. I HAVE A QUICK. I HAVE A QUICK FOLLOW UP. YOU SAID YOU'RE FROM RUSS. RUSS TURNED HIS MIC ON. OKAY. SO YOU'RE FROM REST PAD. SO YOU HAVE. AND KRISTY, THIS IS ONE OF THE PLACES THAT WE CAN'T KEEP FULL CURRENTLY. AND THIS IS THE DUPLICATION. THIS IS THE THIS IS THE PERSON. OKAY. YEAH. THANK YOU. SIT IN THE FRONT ROW. I'M SURE SOMEBODY UP HERE WILL HAVE QUESTIONS FOR YOU. JUDY SALTER, FOLLOWED BY STACY WATSON. BENJAMIN WANE, FOLLOWED BY DOUG MCLELLAN, MD. PLEASE DON'T SIT IN THE FRONT ROW, SIR. THAT'S NOT THAT'S NOT YOUR. SECURITY. WILL YOU PLEASE? THANK YOU. I'M SPEAKING HERE TODAY AS A MOM AND, FRANKLY, A HEARTBROKEN MOM. MY DAUGHTER IS MENTALLY ILL. SHE WAS DIAGNOSED WITH BORDERLINE PERSONALITY DISORDER. A CRUEL DIAGNOSIS WITH NO PHARMACEUTICAL SOLUTION. AFTER YEARS OF STRUGGLES AND NUMEROUS BREAKDOWNS, SHE FINALLY AGREED TO SEEK HELP. BUT THERE WERE NO BEDS OR FACILITIES OR OR FACILITIES FOR TREATMENT OF YOUTH HERE. PUBLIC HEALTH SAID THEY COULD NOT HOUSE HER WITH ADULT PATIENTS BECAUSE IT WOULD NOT BE SAFE. FINALLY, IN A DESPERATE ATTEMPT TO HELP HER, THEY PUT HER ON A SUICIDE WATCH SO SHE COULD BE TRANSFERRED BY AMBULANCE TO A LOCKED FACILITY IN SACRAMENTO. IT WAS UNBELIEVABLY HARD ON HER. SHE FELT ABANDONED AND ALONE. I COULD NOT BE THERE ON A DAILY BASIS DUE TO THE DISTANCE AND THE FACT THAT AT THAT TIME I WAS A SINGLE WORKING MOM. I HAVE LEARNED TRAGICALLY OVER THE SUBSEQUENT YEARS HOW TRAUMATIC IT WAS FOR HER TO NOT HAVE ACCESS TO ME DURING THE TREATMENT. OUR KIDS NEED TO BE TREATED HERE WITH THEIR FAMILIES INVOLVED. MENTAL HEALTH AND DRUG ABUSE PLAGUE OUR KIDS. PLEASE SUPPORT THIS MUCH NEEDED FACILITY. THE LIST OF SUPPORTERS IS HUGE AND IT CROSSES A WIDE SPECTRUM. PLEASE, PLEASE PUT OUR KIDS FIRST. THANK YOU. STACEY WATSON, FOLLOWED BY BENJAMIN DUANE, DOUG MCCLELLAN, MD, AND R FERNANDO. GOOD MORNING, CHAIR CRYE AND MEMBERS OF THE BOARD OF SUPERVISORS. THANK YOU FOR GIVING ME THE OPPORTUNITY TO SPEAK TODAY. I'M ACTUALLY READING THIS LETTER ON BEHALF OF RENEE BRACEY. HERE ARE HER WORDS. I'M WRITING TO EXPRESS STRONG SUPPORT FOR THE APPLICATION FOR THE TRUE NORTH CAMPUS INITIATIVE TO ADDRESS THE GROWING UNMET MENTAL HEALTH AND SUBSTANCE USE NEEDS IN OUR COUNTY. MY NAME IS RENEE. I'M A CLINICAL SOCIAL WORKER AND WORKED IN BEHAVIORAL HEALTH FOR OVER 20 YEARS. I'M ALSO THE PROJECT DIRECTOR OF OUR CERTIFIED BEHAVIORAL HEALTH CLINIC AT HILL COUNTRY COMMUNITY CLINIC, DESIGNATED BY SAMHSA IN 2023. I PARTICIPATED AND COAUTHORED THE CCBC COMMUNITY NEEDS ASSESSMENT REPORT. [01:00:04] THE SURVEY RESULTS ARE A DATA ANALYSIS WITH RESPONSES FROM COMMUNITY MEMBERS, SERVICE PROVIDERS, CONSUMERS AND FAMILIES. THE RESULTS INDICATE SIGNIFICANT DISPARITIES FOR MENTAL HEALTH, SUBSTANCE USE, AND SUICIDE RISK. OUR COMMUNITY CONTINUES TO EXPERIENCE INCREASING RATES OF MENTAL HEALTH CRISIS, SUBSTANCE USE AND CO-OCCURRING CHALLENGES THAT OVERWHELM THE EXISTING SYSTEMS OF CARE. BISHOPS AIM IS TO SUPPORT RURAL AREAS FACING INSUFFICIENT BEHAVIORAL HEALTH INFRASTRUCTURE AND UNMET BEHAVIORAL HEALTH NEEDS. THE TRUE NORTH INITIATIVE IS A COMMUNITY COLLABORATIVE DRIVEN PROJECT WITH STRONG SUPPORT FROM STAKEHOLDERS LOCALLY AND ACROSS THE NORTH STATE. THIS DEMONSTRATES THE URGENCY TO INVEST IN THE WELLNESS OF OUR COMMUNITY BY APPLYING FOR THE BEACH FUNDING. THE TRUE NORTH INITIATIVE WILL EXPAND THE CRITICAL TREATMENT CAPACITY AND OFFER CONTINUUM OF CARE THAT FOSTERS LONG TERM STABILITY AND RECOVERY. BY INVESTING IN THIS PROJECT, WE WILL BE TAKING PROACTIVE STEPS TOWARDS IMPROVING PUBLIC HEALTH, REDUCING EMERGENCY SERVICE UTILIZATION AND STRENGTHENING THE WELL-BEING AND RESILIENCE OF THE RESIDENTS. THIS IS A DIRECT RESPONSE TO THE SERVICE GAPS IDENTIFIED IN THE NEEDS ASSESSMENT. THIS IS BENJAMIN WAINE FOLLOWED BY DOUG MCCULLEN, MDR FERNANDO, THEN MARJORIE ECHO BONGAARTS. ALL RIGHT, SO I, I REALLY WANTED TO BE WRONG ABOUT THIS ONE. I ACTUALLY GOT ON A GROUP CHAT LAST NIGHT AND TALKED A BUNCH OF PEOPLE DOWN ACTUALLY SAYING LIKE, NO, NO, YOU KNOW, I KNOW CRYE CALLED THIS, I KNOW IT'S 48 HOURS PRIOR, BUT THERE, THERE HAS TO BE SOMETHING HERE. THERE'S GOT TO BE SOMETHING THERE. BECAUSE WHY WOULD AN ELECTED OFFICIAL CALL A MEETING OF THIS IMPORTANCE, A SPECIAL MEETING, AN EMERGENCY? WHAT IT WOULD SEEM. BUT UNFORTUNATELY, THE NEXT MORNING, AS I READ INTO IT, IT ALL BECAME APPARENT. IT'S THE SAME NAMES ON YOUR VINDICATION LIST. INDIVIDUALS LIKE KIMBERLY JOHNSON, MARY WILLIAMS, PEOPLE THAT YOU HAVE A VENDETTA AGAINST THAT YOU JUST FEEL LIKE FOR SOME REASON YOU NEED TO USE WHATEVER LEGAL LEVERS AND JUST BUTTONS THAT YOU HAVE IN ORDER TO DENIGRATE THEM IN ORDER TO, YOU KNOW, TAKE THEM OUT OF, OF THEIR, THEIR ABILITY TO SERVE THEIR COMMUNITIES. I MEAN, I'VE WATCHED YOU DO THIS TO A NUMBER OF PEOPLE NOW. AND IT IS IT'S IT'S INCREDIBLY DISINGENUOUS FOR YOU TO SIT UP THERE AND SAY THAT YOU ARE FOR CHILDREN WHEN YOU I MEAN, THIS IS THIS IS SOMETHING THAT'S GOING TO HURT KIDS. TO BE PERFECTLY HONEST WITH YOU, MY KID, MY KID HAD TO GO TO ONE OF THESE FACILITIES 5 OR 6 YEARS AGO, AND IT WAS 4 OR 5 HOURS AWAY. I COULDN'T SEE MY KID. IT'S THE SAME THING. LIKE I, I, I JUST I DON'T UNDERSTAND YOUR LOGIC. YOU'RE TRYING TO LIKE APPLY THIS BULLSHIT LOGIC TO THIS. SO THE LAST THING I WANTED TO SAY IS I WAS SO PLEASED WITH YOUR DECISION THAT YOU MADE LAST WEEK. BECAUSE WE NEED THAT KIND OF LEADERSHIP. WE NEED PEOPLE THAT ARE GOING TO NOT GIVE IN TO PRESSURE AND THAT ARE GOING TO MAKE THE RIGHT DECISIONS. THAT'S IT. DOUG MCLELLAN R FERNANDO. MARJORIE. ECHO. BONGAARTS THEN. JUSTIN WONDRA. SO GOOD MORNING. I DON'T COME HERE A LOT. I SHOULD COME MORE OFTEN, I GUESS, BUT THIS ONE RINGS A BELL. I'VE BEEN A PHYSICIAN IN THE IN THE TOWN FOR OVER 30 YEARS. I'VE WORKED WITH THE MENTAL HEALTH FACILITIES THAT ARE AVAILABLE. I APPRECIATE THE STATEMENTS OF WHAT'S AVAILABLE. I CANNOT GET ANYBODY INTO REST PAD. I CANNOT GET ANYBODY INTO SHASTA. I CANNOT GET ANYBODY INTO THE CURRICULUM. 30 YEARS WHEN I CALL, IT SENDS SEND THEM TO THE ER. AND SO I, I REALLY HAVE A, I REALLY HAVE A PROBLEM WITH THIS. AND THIS IS A GRAND OPPORTUNITY FOR US. IF YOU'RE GOING TO HAVE A MED SCHOOL, YOU'VE GOT TO HAVE TRAINING, YOU'RE GOING TO NEED A PSYCHIATRIC FACILITY FOR THEM TO GO TRAIN IN. SO I THINK THIS MELDS PRETTY WELL WITH THAT, ACTUALLY. I'VE BEEN AN EDUCATOR FOR PHYSICIANS FOR OVER 15 YEARS. I REALLY WANT US TO NOT BE PARALYZED BY, OH, THIS COULD HAPPEN, THIS COULD HAPPEN. WE SHOULDN'T WORRY THAT PEOPLE ARE GOING TO PARACHUTE IN IF WE TRY TO HELP OUR OWN PEOPLE. RIGHT NOW, WE HAVE MENTAL HEALTH ON THE STREETS. WE HAVE PEOPLE WHO ARE NOT BEING HELD. IF I GET SOMEBODY IN MY PRACTICE THAT NEEDS REALLY MENTAL HEALTH, I'M GOING I'M GOING TO CALL SACRAMENTO. IT'S JUST THAT SIMPLE BECAUSE IT'S NOT BEEN ABLE TO HAPPEN HERE FOR MEDICAL CLEARANCE IN THE ER. THAT'S BECAUSE YOU DON'T CONTRACT WITH A PHYSICIAN. IF YOU HAD A PHYSICIAN THAT CAME TO YOUR FACILITY TO DO MEDICAL CLEARANCE, PROBLEM SOLVED. I DO THAT AT REQUEST ALL THE TIME. SO THERE'S SOME THERE'S SOME ISSUES THAT AREN'T QUITE FITTING TOGETHER HERE. AND I THINK YOU HAVE A GREAT OPPORTUNITY TO HELP US ADVANCE AHEAD IN THIS. THIS IS LIKE SUPERINTENDENT SAID, A GREAT OPPORTUNITY FOR US TO TO MOVE AHEAD [01:05:03] AND TO DEVELOP SOMETHING FOR OUR PEOPLE RIGHT NOW. I THINK IF YOU VOTE AGAINST THIS, YOU'RE REALLY VOTING AGAINST. YOU'RE REALLY VOTING. YOU KNOW, YOU HAVE TO TELL THE PUBLIC, WHY IS IT OKAY TO GO SIT IN THE ER WITH A PSYCHOTIC PATIENT? WHY IS IT OKAY TO OCCUPY THAT BED WHEN THERE'S A CAR ACCIDENT COMING IN? WHY IS IT. WHY IS IT OKAY TO TELL THE SHERIFF YOU HAVE TO RELEASE A FELON FROM JAIL INTO THE COMMUNITY SO THAT YOU CAN ADMIT THIS PSYCHIATRIC CASE INTO THE JAIL? THAT'S JUST. WE NEED TO THINK AHEAD ON THAT. OUR FERNANDO, FOLLOWED BY MARJORIE ECHO BAUMGARDT, JUSTIN WONDRA, AND DANA SILBERSTEIN. HI, MY NAME IS MARCY FERNANDEZ AND I'M HERE TO SPEAK ON THIS ISSUE. I TAKE ISSUE WITH CHRISTIE COLEMAN'S NUMBERS. THERE ARE MANY PEOPLE THAT CAN'T GET HELP HERE. I'VE TRIED FOR 25 YEARS TO GET HELP WITH MY DAUGHTER. SHE'S BEEN AT 12 DIFFERENT FACILITIES OUT OF TOWN. I THERE BECAUSE THERE'S NO ROOM AT REST PAD. WHAT BURDEN IS THE HOMELESS TO THIS COMMUNITY THAT THE MONEY THAT'S SPENT ON POLICING AND HOSPITALS? AND I WANTED TO SAY THAT THERE ARE NO FACILITIES HERE THAT CAN SUPPORT MENTAL ACUITY PATIENTS. AND I DON'T UNDERSTAND WHY. ALMOST TWO YEARS LATER, NO ONE IS PREPARED TO GO FORWARD WITH SOMETHING. KEVIN CRYE, I ONLY MENTION THIS BECAUSE YOU MENTIONED IN PUBLIC MEETING THAT YOUR BROTHER HAD PROBLEMS WITH MENTAL HEALTH, AND I FEEL SORRY. THAT'S INCORRECT. DRUGS, DRUGS AND MENTAL HEALTH GO TOGETHER. IT MIGHT BE SELF-MEDICATING. IT MIGHT JUST SIMPLY BE DRUGS THAT CHANGE YOUR BRAIN. BUT THAT'S ALL MENTAL HEALTH. AND I KNOW YOU'RE BITTER ABOUT IT. YOU FEEL PAIN FROM WHAT I'VE HEARD AND FROM YOU, BUT YOU'VE BUILT UP THIS WALL AGAINST MENTALLY ILL PEOPLE AND THEY ARE OUT THERE. THEY ARE COMMUNITY MEMBERS. THEY ARE NOT SIMPLY NUMBERS. YOU MIGHT SAY THAT WE NEED TO BE RESPONSIBLE WITH THE MONEY WE SPEND, BUT WE'RE ALSO RESPONSIBLE FOR THE MONEY WE DON'T SPEND. WE NEED THIS FACILITY HERE. WE'RE RESPONSIBLE FOR THE LIVES OF THE PEOPLE THAT WE'RE TESTING AND HELPING THESE PEOPLE. THANK YOU. THANK YOU. MARJORIE ECHO BONGAARTS FOLLOWED BY JUSTIN, ANDREW, DANA SILBERSTEIN, THEN JON LUOMA. YEAH. AND JUST FOR THE RECORD, NO, I'M NOT BITTER AT ALL. AND NO, AND NO PARENT SHOULD HAVE TO BURY THEIR CHILD. WATCHING MY PARENTS WALK THROUGH THAT WAS BRUTAL. BUT AT THE SAME TIME, HE HAD EVERY RESOURCE, EVERY OPPORTUNITY TO GET CLEAN AND DIDN'T TAKE IT. COME ON UP. THANK YOU. THANK YOU, SUPERVISORS FOR FOR CALLING THIS MEETING TODAY. THANK YOU FOR YOUR SUPPORT OF CHRISTIE COLEMAN'S LETTER OF OPPOSITION. I AND THANK YOU, CHRISTIE, FOR YOUR YOUR PRESENTATION TODAY. THAT WAS VERY INFORMATIVE. I PRAISE GOD FOR THIS BREAKTHROUGH. WHAT WHAT WE'RE TALKING ABOUT HERE, FOLKS, IS A REGIONAL PROJECT. IT'S NOT JUST TO TREAT SHASTA COUNTY RESIDENTS AS WE HERE WE HAVE BEDS AVAILABLE FOR SHASTA COUNTY RESIDENTS. I'D LIKE TO SEE STAFF MAKE SURE THOSE BEDS ARE FULL. BECAUSE WE CERTAINLY HAVE THE, THE, THE PATIENTS HERE IN SHASTA COUNTY. BUT THE, THE BIG CONCERN HERE IS REGIONAL YOU GUYS. WE DON'T NEED TO BE BRINGING IN OTHER COUNTIES PROBLEMS. WE CAN BARELY HANDLE OUR OWN AND THE, THE, THE BURDEN THAT IT WOULD PLACE ON THIS COUNTY AND OUR STAFF IS, IS PHENOMENAL THAT NO ONE'S THINKING ABOUT. AND WE'RE ACTUALLY HERE TODAY, LAST MINUTE BECAUSE OF KIM JOHNSON AND THIS PROJECT'S LACK OF TRANSPARENCY AND ACCOUNTABILITY TO THE COMMUNITY. THE COMMUNITY NEEDS TO BE INVOLVED IN THESE DECISIONS. BUT WHAT IS MOST CONCERNING IS THIS B CHIP FUNDING WAS NOT EVEN ANNOUNCED TO THE PUBLIC THAT WE CAN BE BRINGING PROJECTS FORWARD, THAT WE CAN BE WORKING TOGETHER TO CREATE PROJECTS THAT IS BENEFICIAL TO OUR COMMUNITY. INSTEAD, THIS PROJECT WAS KEPT SECRET UNTIL LAST MINUTE WHEN I CALLED IT OUT AT THE MENTAL HEALTH, DRUG AND ALCOHOL ADVISORY BOARD MEETING, WHEN MATT PLUMMER WAS SECRETLY TRYING TO PUSH A LETTER OF SUPPORT THROUGH THE MENTAL HEALTH, DRUG AND ALCOHOL ADVISORY BOARD WITHOUT FOLLOWING POLICY OR LAWS. STAKEHOLDER INVOLVEMENT MENTAL HEALTH SERVICES ACT FUNDING MUST INCLUDE STAKEHOLDER [01:10:04] INVOLVEMENT AND THAT'S WHAT THIS PROJECT LACKS. THANK YOU. JUSTIN. FOLLOWED BY DANA SILVERSTEIN, JOHN LUOMA, TIM GARMAN, THEN CHRIS STREET. SUPERVISORS. I'M HERE TO READ STATEMENT ON BEHALF OF JONATHAN ANDERSON, WHO IS OUT OF TOWN TODAY. OVER THE PAST 11 YEARS, THE MISSION HAS SERVED MORE THAN 18000 PEOPLE RIGHT HERE IN SHASTA COUNTY. DURING THAT TIME, WE'VE WATCHED OUR COMMUNITY CHANGE DRAMATICALLY. WHAT WERE ONCE SMALL HOMELESS ENCAMPMENTS HAVE BECOME OPEN AIR DRUG SCENES. WE NOW SEE MORE PEOPLE STRUGGLING WITH MENTAL INSTABILITY AND ADDICTION THAN EVER BEFORE. THAT'S WHY WE'RE BUILDING A PROP ONE ROUND, ONE FUNDED, 75 BED, MEDICALLY SUPERVISED ADDICTION TREATMENT PROGRAM, A CRITICAL STEP FOR THOSE BATTLING ADDICTION. A CAMPUS THE MISSION ASSUMES RESPONSIBILITY TO FUND AND OPERATE. BUT 75 BEDS BARELY, BARELY BEGINS TO MEET THE GROWING NEED FOR JUST ADDICTION RECOVERY SERVICES. SB 43 REQUIRES COUNTIES TO TAKE RESPONSIBILITY FOR SEVERELY MENTALLY ILL INDIVIDUALS. WHILE PROPOSITION ONE PROVIDES THE FUNDING TO BUILD THE FACILITIES NEEDED TO MEET THAT MANDATE, SHASTA COUNTY NOW HAS AN OPPORTUNITY TO BUILD A STATE FUNDED BEHAVIORAL HEALTH CAMPUS THAT WILL EXPAND TREATMENT, CREATE HUNDREDS OF NEW HEALTH CARE JOBS, AND DO SO WITHOUT USING COUNTY TAX DOLLARS. WITHOUT IT, WE'LL CONTINUE CYCLING PEOPLE THROUGH EMERGENCY ROOM JAILS AND THE STREETS AT A FAR GREATER COST TO BOTH TAXPAYERS AND HUMAN LIVES. I WANT TO PERSONALLY COMMEND KIMBERLY JOHNSON FOR HER LEADERSHIP, PERSEVERANCE AND GRACE UNDER PRESSURE. SHE HAS EARNED THE TRUST AND ENDORSEMENT OF AN EXTRAORDINARY RANGE OF RESPECTED LEADERS ACROSS LAW ENFORCEMENT, HEALTH CARE, PUBLIC EDUCATION, AND OUR STATE REPRESENTATIVES. THE CALIBER OF PEOPLE WHO STAND BEHIND HER SPEAKS VOLUMES ABOUT HER INTEGRITY AND VISION. OUR COMMUNITY CAN TRUST HER LEADERSHIP BECAUSE SHE IS A PROVEN RECORD OF BUILDING STRONG, SUCCESSFUL ORGANIZATIONS. THIS IS A ONCE IN A GENERATION OPPORTUNITY TO MAKE A LASTING DIFFERENCE FOR SHASTA COUNTY. THE CHOICE IS SIMPLE. WE CAN SUPPORT A STATE FUNDED PRIVATE INITIATIVE TO BUILD THIS LIFE SAVING CAMPUS, OR WE CAN PREPARE TO RAISE LOCAL TAXES TO FUND THE ALTERNATIVE. LET'S CHOOSE HEALING OVER HESITATION. LET'S CHOOSE THIS OPPORTUNITY. DANA SILVERSTEIN. JON LUOMA. TIM GARMAN. CHRIS STREET. THEN NICK GARDNER. IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. GOOD MORNING. FIRST OF ALL, THE POLLING OF THE DESIGNATION OF SIGNATURE IN ORANGE COUNTY WAS TEMPORARY. IT WAS ONE POSITION. IT WAS CAUGHT. IT WAS DEALT WITH. IT'S BEEN HANDLED. AND THEIR DESIGNATION HAS BEEN RESTORED. THAT'S THE OTHER HALF OF THAT STORY. WHEN DID WE STOP CARING ABOUT OUR NEIGHBORS? WHEN? WHEN DID WE DECIDE THAT? BUTTE. TEHAMA. GLENN. YUBA, TRINITY, MODOC SHOULD JUST BE IGNORED. THEIR ISSUE SHOULD BE IGNORED. WE CAN DO BETTER THAN THAT. I'M ALSO CONCERNED ABOUT GOVERNANCE HERE. SO WE HAVE A CHAIR OF OUR BOARD WHO HAD NO IDEA THAT THIS 16 PAGE LIST OF SUPPORTERS HAD ALL COME TOGETHER TO DEAL WITH THIS FOR NEARLY A YEAR, INCLUDING OUR DIRECTOR OF HHS. AYE. AND HE DIDN'T KNOW UNTIL HE GOT A PHONE CALL FROM GLENN COUNTY. THAT, TO ME, IS SOME OF THE WORST GOVERNING WE COULD EVER ASK FOR. SO PLEASE. SO MUCH WORK, SO MUCH HEART, SO MUCH EXPERTISE, SO MUCH TIME HAS GONE INTO THIS. THE NEED IS TREMENDOUS. ADDRESS IT. JON LUOMA, TIM GARMIN, CHRIS DRAKE, NICK GARDNER, THEN BRANDON THORNOCK. GOOD MORNING SUPERVISORS. MY NAME IS JOHN LUOMA. I'M A LICENSED CLINICAL SOCIAL WORKER. OH, SORRY. I'M A LICENSED CLINICAL SOCIAL WORKER AND I CURRENTLY MANAGE THE HILL COUNTRY MOBILE CRISIS OUTREACH TEAM. I'VE SPENT 14 YEARS IN THE HUMAN SERVICES FIELD, THE MAJORITY OF THE LAST DECADE ON THE FRONT LINES DOING CRISIS WORK. I WANT TO TELL A STORY THAT PLAYS OUT EVERY WEEK RIGHT HERE IN SHASTA COUNTY, WITH FOLKS THAT ARE ALREADY HAVING ONE OF THE WORST DAYS OF THEIR LIVES. IT'S 9:30 P.M., AND A FAMILY CALLS FOR HELP FOR THEIR 13 YEAR OLD DAUGHTER STRUGGLING WITH CRIPPLING ANXIETY, SELF-HARM AND NOW THOUGHTS OF SUICIDE. THE CRISIS PROFESSIONALS WHO ARRIVE DO THEIR BEST TO WORK WITH THE FAMILY AND THE YOUTH TO DEVELOP A SAFETY PLAN, BUT CAN'T. SHE CAN'T STAY HOME SAFELY FOR THE NIGHT AND ABSENCE OF A VOLUNTARY CRISIS STABILIZATION UNIT. SHE'S PLACED ON A 5150 HOLD AND TAKEN TO THE MERCY EDDY. ONCE THERE, THE BEDS ARE FULL, THE LOBBY IS OVERFLOWING AND SO THEY WAIT FOR HOURS. THEY FINALLY GET A BED. A NURSE LEADS THE YOUNG GIRL BACK TO THE ED, WHERE SHE SITS ON A GURNEY IN THE HALLWAY. [01:15:04] SHE DOES HER BEST TO SLEEP UNDER FLUORESCENT LIGHTS AND ALONE, LISTENING TO SCREAMS, WATCHING TRAUMA PATIENTS ROLL BY HER IN THE MORNING. SHE'S REEVALUATED AND IS DETERMINED THAT SHE DOES NEED INPATIENT CARE. THE NEAREST BED IS IT A PUFF IN SANTA ROSA? SHE'S TRANSPORTED THERE, AND THE FAMILY NOW FACES A SIX HOUR ROUND TRIP JUST TO VISIT THEIR DAUGHTER. THIS STORY IS HYPOTHETICAL, BUT IT COMBINES PARTS OF SO MANY REAL CASES TODAY. YOU'RE CONSIDERING WHETHER TO OPPOSE THE ONLY CONCRETE PROJECT CURRENTLY ON THE TABLE, FULLY FUNDED WITH STATE DOLLARS. IF NOT THIS, THEN WHAT? WE WANT THIS PARTNERSHIP TO WORK. WE'RE HERE BECAUSE WE CARE DEEPLY ABOUT OUTCOMES. WE'RE NOT HERE TO TAKE SIDES. WE'RE HERE TO STAND WITH THE GIRL AND THE GURNEY. TIM GARMAN, FOLLOWED BY CHRIS STREET, NICK GARDNER, BRANDON THORNOCK, AND LISA CONN. GOOD MORNING EVERYONE. FIRST AND FOREMOST, A LETTER OF SUPPORT. IT'S NOT GOING TO COMMIT THIS COUNTY TO SPENDING A DIME. SO TODAY A LETTER OF SUPPORT WOULD BE RECOMMENDED, I WOULD THINK, TO GET A CHANCE TO LEARN MORE ABOUT THIS WHOLE PACKAGE. AGAIN, YOU'RE NOT COMMITTING YOURSELF TO A DIME. WITH THAT SAID, I TALKED TO CEO RICKERT WHEN I WAS STILL A SUPERVISOR ABOUT PROP ONE FUNDING. THE COUNTY WANTED NOTHING TO DO WITH IT. A LOT OF SCARE TACTICS HERE TODAY. CHRISTIE COLEMAN, KEVIN CRYE BOTH SAID THEY DIDN'T KNOW MUCH ABOUT THIS PROJECT. CHRISTIE COLEMAN CLIENTS FROM DOWN SOUTH CRYE MENTIONED 57 OTHER COUNTIES. THIS PROJECT IS A RURAL, REGIONAL, RURAL REGIONAL CENTER, WITH THE SOUTHERNMOST COUNTY BEING GLEN. THEY'RE NOT GOING TO SHIP PEOPLE IN FROM ALL THE WAY FROM LA. SO I THINK YOU GUYS NEED TO GET YOUR FACTS STRAIGHT. THIS IS A RUSHED ITEM, OBVIOUSLY. CHRIS, YOU SAID A LETTER OF SUPPORT IS A REQUIREMENT. THAT'S SIMPLY NOT TRUE. HAD YOU READ THE APPLICATIONS YOU GUYS WOULD UNDERSTAND ALL THESE DETAILS. YOU GUYS HAVEN'T DONE YOUR WORK. HHA HASN'T DONE THEIR WORK. WE NEED A MENTAL HEALTH FACILITY IN THIS COMMUNITY VERY, VERY BADLY. WE ALL RAN AND TRIED TO CLEAN UP OUR STREETS AND MAKING THIS A SAFER COMMUNITY. THIS IS AN OPPORTUNITY TO DO SO. MR. HARMON. MR. KELSTROM, PLEASE CONSIDER THIS. IN FACT, MR. KELSTROM, YOU COULD DO ME A FAVOR BY WRITING, NOT WRITING A LETTER OF SUPPORT. BUT I DON'T WANT YOU TO DO THAT. IT'S NOT ABOUT ME. IT'S NOT ABOUT YOU. IT'S ABOUT OUR COMMUNITY. DO WHAT'S RIGHT BY THEM. AND IF YOU WIN THE SEAT NEXT YEAR BECAUSE YOU DO, RIGHT. I'M HAPPY BECAUSE OUR COMMUNITY WINS. THAT'S WHAT WE'RE ALL LOOKING FOR. BUT WE'RE HERE TODAY BECAUSE SUPERVISOR CRYE HAS AN ISSUE WITH PEOPLE. HE HAS AN ISSUE WITH WOMEN WHO DO NOT COWER TO HIM. OKAY. AND THIS IS THIS IS THE TRUTH OF WHAT WE'RE HERE FOR. AND AGAIN, THE LETTER OF SUPPORT DOESN'T COMMIT THIS COMMUNITY TO A DIME. THANK YOU TOM. THANK YOU. NICK GARDNER, BRANDON THORNOCK, FOLLOWED BY LISA KHAN. IF I CALLED YOUR NAME, PLEASE GET IN QUEUE. HELLO, MY NAME IS CHRIS STREET AND I'M VERY CONCERNED ABOUT THIS PROJECT. MY UNDERSTANDING IS THE STAFF OPPOSES THIS PROJECT. I HAPPEN TO HAVE EXPERIENCE IN THIS AREA. I WAS A CEO OF COMPREHENSIVE CARE CORPORATION. WE HAD FIVE HAD THE MENTAL HEALTH AND PSYCH CARVE OUT CONTRACTS FOR MEDICAID IN FIVE STATES AND PUERTO RICO, AND WE OPERATED 28 PSYCH HOSPITALS, VERY SIMILAR IN SOME OF THOSE PSYCH HOSPITALS TO WHAT'S BEING PUT FORWARD HERE. I WANT TO SAY THAT ANY KIND OF ENTRY INTO THIS KIND OF RELATIONSHIP IS VERY, VERY CHALLENGING. THAT THESE ARE THIS FACILITY WOULD BE BRINGING IN CLEARLY WOULD BE IMPORTING PATIENTS FROM OTHER COUNTIES, CONCENTRATING THEM HERE. THIS IS A MANAGEMENT ISSUE. AND ANYBODY TO THINK THAT THAT THE COUNTY STAFF AND HHS WOULD NOT BE PART OF THIS OR PART OF THE BLOWBACK IF IT GOES WRONG, DO NOT UNDERSTAND HOW SERIOUS THIS ISSUE IS. IF YOU EVER WERE TO DO THIS, YOU WOULD HAVE TO HAVE 100% SUPPORT FROM THE BOARD BECAUSE YOU'RE GOING TO OWN THIS, NOT YOU. YOU'LL LEAVE OFFICE EVENTUALLY, AND THE COMMUNITY WILL OWN THIS. SO IF YOU'RE NOT 100% IN, I THINK IT'S A CHALLENGE. YOU ALSO NEED TO LOOK AT ANY KIND OF CONFLICTS OF INTEREST, ANY KIND OF CONSULTING CONTRACTS, WHATEVER TOOK PLACE HERE THAT MAY, YOU KNOW, COULD BE DOWNSTREAM, SOMETHING THAT PEOPLE LOOK BACK AND SAY, YOU KNOW, WAS THAT A CONFLICT? I JUST THINK THAT WITHOUT STAFF SUPPORT IN SOMETHING THIS SERIOUS THAT YOU'RE PUTTING [01:20:01] THE COMMUNITY AT HIGH RISK, YOU KNOW, THE IDEA THAT, YOU KNOW, SOMEHOW, MISS COLEMAN, YOU KNOW, AS A WOMAN, SHOULDN'T STAND UP HERE AND SPEAK. YOU KNOW WHAT SHE REALLY FEELS IN HER HEART, I THINK THAT'S. NICK GARDNER FOLLOWED BY BRANDON THORNOCK. THEN LISA CONN. HI, CHRIS. HOW ARE YOU? WELL, I WANT TO START OFF BY THANKING KEVIN CRYE FOR LOOKING OUT FOR OUR COUNTY FUNDS. YOU KNOW, THESE PEOPLE WENT ALONG WITH EVERYTHING THEY WANTED TO DO IN THE CITY OF REDDING AND IT'S BROKE. YOU SEE WHAT A MESS THEY ARE. THEY DIDN'T HAVE A CITY COUNCIL MEMBER TO STAND UP TO THEM. YOU KNOW, THE REGIONAL FACILITY IS WHAT GETS ME. WE'VE GOT A REGIONAL HOMELESS FACILITY CALLED THE GOOD NEWS RESCUE MISSION. THEY'VE SERVED 18,000 PEOPLE. A LOT OF THOSE PEOPLE ARE FROM OUT OF TOWN, AND THEY HAVEN'T BEEN AN ASSET TO OUR COMMUNITY. AND THEN WE'RE DUMPING GROUNDS FOR PAROLEES. WE HAVEN'T CURED THAT PROBLEM EXCEPT, YOU KNOW, MAYBE STICKING THEM IN MOTEL ROOMS AND PEDOPHILES. WHERE DID ALL THESE PEDOPHILES COME FROM? THEY COME FROM THEY COME FROM OUT OF THE AREA. MOST OF THESE MENTALLY ILL PEOPLE, IN MY OPINION, IT'S DRUG INDUCED MENTALLY ILL. AND, YOU KNOW, I LOOK AT THE GENERATIONS THAT HAVE GONE ON WITH DRUG ABUSE AND THEY PROBABLY, IN MY OPINION, LEARNED IT FROM THEIR PARENTS. SO WE'RE GOING TO HAVE A FACILITY WHERE WE'RE GOING TO BRING REGIONAL FROM OUT OF THE AREA. MENTALLY ILL HERE AND THERE GOING TO THE PARENTS ARE GOING TO FOLLOW THEIR KIDS, AND I DON'T BELIEVE THAT'S GOING TO BE AN ASSET TO OUR COMMUNITY. A GOOD COMPARISON WOULD BE SUSANVILLE. WHEN THEY BUILT THE PRISONS IN SUSANVILLE, THE QUALITY OF LIFE WENT DOWNHILL BECAUSE THE PARENTS FOLLOWED THEIR KIDS THERE, INCARCERATED KIDS UP THERE, AND THE COUNTY FUNDS WENT TO HELL BECAUSE THEY'RE ALL ON WELFARE. SO, YOU KNOW, JUST KEEP IN MIND THAT THEY HAVEN'T GOT A PROGRAM YET THAT WORKS. AND I DON'T THINK WE'RE THE GOLDEN GOOSE. IT'S IT'S MY OPINION THAT WE DON'T NEED A REGIONAL FACILITY. WE NEED A LOCAL FACILITY. BRANDON THORNOCK, FOLLOWED BY LISA CONN. GOOD MORNING, BOARD OF SUPERVISORS. MY NAME IS BRANDON THORNOCK. I'M THE CURRENT SERVING CHAIR OF THE SHASTA HEALTH AREA REDESIGN COLLABORATIVE. OTHERWISE KNOWN AS SHAK AS WELL AS. I'M THE CEO OF SHASTA COMMUNITY HEALTH CENTER. YOU KNOW, I DON'T THINK I'M GOING TO BE ABLE TO PROVIDE ANY ADDITIONAL DATA POINTS THAT YOU HAVEN'T HEARD OR SEEN AT THIS POINT THAT'S GOING TO HELP CHANGE ANYONE'S MIND. SO WHAT I WANT TO DO IS I WANT TO APPROACH THIS FROM MY PERSONAL LIFE. SOME OF THE THINGS THAT I DO WHERE I VOLUNTEER, MY TIME FOR MY CHURCH SERVING VULNERABLE FOLKS, PEOPLE WHO STRUGGLE WITH MENTAL HEALTH ISSUES, DRUG ADDICTIONS, THAT KIND OF THING. SPECIFICALLY, A WOMAN WHO I GOT TO KNOW ABOUT TWO YEARS AGO WHO WHEN I CONNECTED WITH HER, SHE WOULD CALL ME MULTIPLE TIMES PER DAY IN CRISIS SAYING, BRANDON, I NEED THIS, I NEED THAT. SHE HAD A STEADY JOB AT THE TIME, BUT THEN SHE LOST HER HER WORK. BUT THEN SHE KEPT PRESENTING AT HER WORKPLACE. THEY ENDED UP HAVING TO TELL HER SHE WAS GOING TO BE THROWN IN JAIL IF SHE DIDN'T STOP PRESENTING. SHE CAN'T CONTINUE TO DO THAT. THE THE POLICE GOT INVOLVED. SHE WAS ADMITTED TO THE ERSI WOULD VISIT HER WHILE SHE WAS IN THE ER. NO SOLUTIONS FOR HER. THIS HAPPENED OVER AND OVER AND OVER AGAIN. AND YOU KNOW, THE THING IS, IS THAT EVEN THOUGH THIS IS JUST ONE STORY OF ONE PERSON, WHAT I'M DESCRIBING IS THE SITUATION OF MANY, MANY INDIVIDUALS IN OUR COMMUNITY. OUR SYSTEM IS BROKEN. THERE ARE MANY, MANY CHALLENGES AND HURDLES THAT THESE FOLKS FACE EVERY SINGLE DAY AND IS VERY DIFFICULT FOR THEM TO OVERCOME THOSE THINGS. WE HAVE A WONDERFUL OPPORTUNITY NOW TO BRING SOME INVESTMENT INTO OUR COMMUNITY TO ENHANCE THE LEVEL OF SERVICES THAT WE PROVIDE. AND IF THE COMMUNITY CAN COME TOGETHER, THE COUNTY ARTS COLLABORATIVE AND DO WHAT WE NEED TO DO, I'M CONFIDENT WE CAN MAKE A DIFFERENCE. THANK YOU. LISA KHAN. GO AHEAD. GOOD MORNING. THANK YOU FOR LETTING ME SPEAK. MY NAME IS LISA CULLEN AND I AM THE NEWLY APPOINTED PRESIDENT FOR SHASTA COUNTY NATIONAL ALLIANCE ON MENTAL ILLNESS. AND I WANTED TO TALK A LITTLE BIT ABOUT WHAT THE COUNTY HAD SAID ABOUT NOT HAVING ENOUGH BEDS. THERE'S A LOT OF PEOPLE THAT ARE SUFFERING FROM MENTAL HEALTH ISSUES THAT LACK INSIGHT, WHICH MEANS THAT THEY DON'T UNDERSTAND THAT THEY'RE ILL. THEY'RE NOT ENGAGED IN TREATMENT. THEY'RE ACTUALLY LIVING. MOST OF THEM ARE LIVING ON THE [01:25:01] STREETS AND EVERYBODY WANTS TO COMPLAIN, BUT NOBODY WANTS TO TAKE ANY ACTION. I DO THINK THAT THIS IS A A CHANCE FOR SHASTA COUNTY TO WORK TOGETHER AND CLEAN UP THE STREETS. MY OWN SON WAS IS A PATIENT AT SHASTA COUNTY MENTAL HEALTH. I HAD TO TRAVEL TO SACRAMENTO, YUBA CITY, RED BLUFF. HE HAD TO BE 51, 50/12 TIMES IN ONE YEAR FOR HIM TO BE ABLE TO GET TREATMENT. THE ANSWER THAT WE WERE TOLD WAS TO TURN OUR BACKS AND WALK AWAY. AND ON OUR LOVED ONES AND TO PICK UP THE PIECES AFTER EVERYTHING WAS DONE. I WAS ALSO RECENTLY INFORMED THAT A 1799 HOLD IS ONLY ALLOWED BY SPECIFIC PEOPLE. IT IS NOT ALLOWED BY THE EMERGENCY ROOM DOCTORS TO BE ABLE TO PUT A PATIENT THAT THEY SEE AS IN NEED ON A, ON A HOLD FOR THEIR OWN GOOD. I JUST REALLY WANT YOU GUYS TO CONSIDER THIS. I DON'T WANT YOU TO THIS MEETING WAS CALLED ON SHORT NOTICE. WE DIDN'T KNOW WHAT WAS HAPPENING, SO I DON'T REALLY HAVE ANY NUMBERS TO SHARE WITH YOU, BUT I CAN TELL YOU FROM MY PERSPECTIVE, THERE ARE A LOT OF PEOPLE THAT ARE NOT ENGAGED IN TREATMENT AT THIS TIME. SO I BELIEVE THE COUNTY'S NUMBERS MIGHT BE A LITTLE BIT OFF. MAYBE HAVING SOME NUMBERS FROM THE EMERGENCY ROOMS MIGHT SERVE BETTER. SO PLEASE CONSIDER IT. THANK YOU FOR YOUR TIME. THANK YOU SIR. THAT'S OUR LAST SPEAKER. ALL RIGHT. SO WE'RE GOING TO BRING IT BACK FOR BOARD DISCUSSION. THE PUBLIC HAS GOT A CHANCE TO WEIGH IN. THE BOARD IS GOING TO SPEAK AT THIS POINT. REMEMBER, THIS ISN'T A ROCK CONCERT OR A BASEBALL OR FOOTBALL GAME. WHAT WE'RE GOING TO DO IS WE'RE GOING TO HAVE SOME DISCUSSION. YOU MAY AGREE WITH SOME OF IT. YOU MAY NOT AGREE WITH OTHER PARTS OF IT. WE'RE JUST ASKING FOR RESPECT AS WE SPEAK. WHO WANTS TO KICK US OFF? DO YOU WANT US WITH SUPERVISOR LONG OR SUPERVISOR REQUEST FORM TO TALK? YEAH. HEY, THIS I UNDERSTAND THIS IS. THIS IS YOUR FIRST WARNING. THIS IS YOUR. THANK YOU. THANK YOU. OKAY, THIS IS YOUR FIRST. THIS IS YOUR FIRST WARNING. THANK YOU. ALL RIGHT. ALL RIGHT. KEVIN. THANK YOU. ALL RIGHT. SUPERVISOR LONG SUPERVISOR PLUMMER SUPERVISOR HARMON. SUPERVISOR. KELSTROM. SUPERVISOR PLUMMER. SURE. I'LL KICK IT OFF. THANK YOU ALL FOR BEING HERE TODAY. I WANT TO START BY JUST REFLECTING ON THIS PROCESS A LITTLE BIT AND THEN RUN THROUGH A NUMBER OF THINGS. THIS MIGHT TAKE A LITTLE BIT OF TIME, SO HOPEFULLY YOU'RE OKAY WITH THAT. THE THE FIRST THING IS, HONESTLY, I WOULD SAY THAT I'M EMBARRASSED FOR SHASTA COUNTY FOR DOING IT IN THIS WAY. AND THIS IS, AS HAS BEEN MENTIONED BY OTHERS, THREE DAYS BEFORE THIS APPLICATION IS DUE AS A RUSH SPECIAL MEETING, WHICH NO, YOU KNOW, ADVANCE NOTICE WAS GIVEN. IN FACT, I DON'T THINK ANYONE FROM THE COUNTY REACHED OUT TO THE APPLICANTS. WE DIDN'T GIVE THEM A CHANCE TO PRESENT. AND THE IDEA THAT THAT HAD TO BE THE CASE IS COMPLETELY WRONG. I MEAN, KEVIN, YOU AND I WERE AT A BEHAVIORAL HEALTH CONVENING WHEN WE HEARD ABOUT THIS PROJECT IN JULY. AND SO I THINK THIS IS AND HOPEFULLY. IS THAT A QUESTION? NO, THAT WASN'T A QUESTION. OKAY. IT WAS A STATEMENT. AND THE YOU KNOW, I'M HOPEFUL THAT OTHER ORGANIZATIONS AND COMPANIES THAT ARE INTERESTED IN INVESTING IN SHASTA COUNTY, AS SIGNATURE HEALTHCARE HAS INDICATED, ARE NOT SCARED AWAY BY THIS, INCLUDING, FOR EXAMPLE, DOUG BOND FROM AMITY FOUNDATION, WHO SIGNED A LETTER OF SUPPORT FOR THIS PROJECT AS WELL. BECAUSE TO PULL THE RUG OUT ON SOMETHING IN THE FINAL HOUR WITHOUT GIVING THEM A TRUE PUBLIC HEARING IS JUST NOT RIGHT, AND TO NOT EVEN NOTIFY THEM THAT THIS WAS HAPPENING. SO THAT'S NUMBER ONE. THIS SHOULDN'T BE HAPPENING IN THIS WAY. AND, AND THAT'S, YOU KNOW, THAT'S A STARTING POINT. THE SECOND THING AS WE GO INTO NEED AND, AND I THINK AS WE GO INTO THE NEED, THERE CAN BE A LOT OF DEBATE ON THIS. AND, YOU KNOW, WHETHER OR NOT THE EXACT NUMBER OF BEDS, TYPE OF LICENSE, I THINK THAT'S, YOU KNOW, WE CAN HAVE A ROBUST DEBATE ABOUT IT. CHRISTY AND I HAVE TALKED ABOUT THAT AT LENGTH. OBVIOUSLY, A NUMBER OF FOLKS IN THE COMMUNITY HAVE A PERSPECTIVE ON IT. AND SO, YOU KNOW, THAT IS SOMETHING THAT CAN BE DEBATED. I DO WANT TO RUN THROUGH A NUMBER OF THINGS, THOUGH, BECAUSE I THINK IT'S IMPORTANT THAT WE PUT THIS IN THE BROADER CONTEXT. AND FIRST OF ALL, THIS WILL NOT BE ONLY SERVING COUNTY PATIENTS, RIGHT? THIS WILL SERVE THE BROADER COMMUNITY. AND SO THIS IS MEANT TO REFLECT AND SERVE BOTH THE BROADER COMMUNITY AS WELL AS COUNTY PATIENTS. SO I DO WANT TO JUST START BY IN TERMS OF THE NEED FOR THIS SERVICES, LOOKING AT A FEW OF OUR STAFF REPORTS, BECAUSE IF YOU LOOK OVER, SINCE I'VE BEEN ON THE BOARD, WE'VE APPROVED OVER $50 MILLION IN MENTAL [01:30:01] HEALTH RELATED SERVICES IN ABOUT 22 DIFFERENT CONTRACTS. OKAY. AND SO I'M GOING TO READ A FEW. SO ONE IS FOR YOUTH RESIDENTIAL SPECIALTY MENTAL HEALTH SERVICES. THIS WAS FROM FOR OPEN LINE. THIS WAS FROM AUGUST. WE JUST DOUBLED THE MAXIMUM COMPENSATION IN AUGUST BECAUSE THE CURRENT SERVICES ALREADY PROVIDED HAD EXCEEDED THE ORIGINAL MAXIMUM COMPENSATION. THE. WE ON THAT. ON JUNE 24TH, WHEN WE'RE TALKING ABOUT SENDING PEOPLE FOR WHO ARE IN HOLDS, WE SAY THIS NUMBER GROWS EACH YEAR IN AND PROBATION. WE APPROVED A CONTRACT FOR THEM TO SERVE OFFENDERS. AND WE SAY IN THE PAST FEW MONTHS, THERE HAS BEEN AN INCREASE IN OFFENDERS NEEDING AND PARTICIPATING IN RESIDENTIAL SERVICES. IN FACT, IN IN MARCH OF THIS PAST YEAR, WE SAID THAT IF WE WERE NOT TO SIGN A CONTRACT FOR YOUTH SPECIALTY MENTAL HEALTH SERVICES, THAT AND THIS IS I'M READING FROM THE STAFF REPORT. IT SAYS THE CURRENT YOUTH PLACED AT THIS FACILITY WOULD NO LONGER HAVE PLACEMENT THERE, WHICH WOULD MEAN THE YOUTH WOULD HAVE TO BE MOVED TO AN UNLICENSED FACILITY SUCH AS THE CHILD WELFARE OFFICE. SO THOSE ARE SOME OF THE THINGS THAT WE'RE INDICATING ON A REGULAR BASIS THAT ARE COMING BEFORE THIS BOARD AND THAT WE'RE APPROVING AND WE'RE SENDING FOLKS OUT OF THE COMMUNITY. AND I DO WANT TO INVITE SIR, FROM PAD UP BECAUSE I DO HAVE A FEW QUESTIONS THERE. AND THIS IS THE THING THAT WHERE YOU PLEASE COME UP THE, WHERE THERE'S SOME COMPLEXITY. SO THAT DOESN'T COMPLETELY SQUARE FOR ME. SO, AND PART OF IT'S NOT RELATED TO REST PAD, BUT THE FIRST, COULD YOU JUST REMIND US HOW MANY BEDS DO YOU HAVE? WE HAVE 16 IN REDDING AND 16 IN RED BLUFF. AND WHAT WAS YOUR AVERAGE CENSUS LAST YEAR IN TERMS OF PATIENT CENSUS FOR THOSE BEDS IN REDDING? JUST UNDER 15. OKAY. SO ALMOST FULL. RIGHT. AND THEN WHAT ABOUT SO FAR THIS YEAR IT'S RUNNING ABOUT THE SAME. OKAY. SO YOU'RE BASICALLY FULL. I MEAN, IT WOULDN'T BE REASONABLE TO EXPECT A FACILITY OF YOUR TYPE TO BE AT 16 AT YOUR MAX CAPACITY 100% OF THE TIME. IT'S IMPOSSIBLE. OKAY. THANK YOU. CAN I MAKE A POINT TO THAT REAL QUICK, THOUGH? SO THE REASON WHY WE DO, WE STAY FULL AND I KNOW THIS IS NOT GOING TO BE POPULAR, BUT WE ARE FORCED TO CONTRACT WITH SOME OUTSIDE COUNTIES TO KEEP OUR BEDS FULL. OKAY, CAN I SAY I'M GONNA INTERRUPT YOU FOR A SECOND? YEAH. ACTUALLY, IT DOESN'T MATTER. YOU SAY THE TRUTH, AND THAT'S ALL THAT MATTERS. IT DOESN'T MATTER IF IT'S. IF IT'S NOT POPULAR IN THIS ROOM, IT MIGHT BE POPULAR OUTSIDE OF IT. WELL, I THINK WHAT HE'S SAYING IS NOT POPULAR IS THE FACT THAT EVERY FACILITY THAT SERVES THESE POPULATION, AND FEEL FREE TO DISAGREE WITH ME IS BY DEFINITION, A REGIONAL FACILITY BECAUSE THE MODEL DOESN'T WORK. HOW MANY CONTRACTS DO YOU HAVE WITH OTHER COUNTIES? 14. 14. RIGHT. SO IN READING RIGHT NOW, AND I'M NOT UPSET WITH THAT, BUT I'M SAYING IF WE'RE GOING TO BE AGAINST A REGIONAL FACILITY, THEN WE HAVE TO BE AGAINST ALL OF THEM BECAUSE THEY ARE ALL REGIONAL FACILITIES. ABSOLUTELY. SO AND, THE OTHER THING. SO AND THIS YOU'RE WELCOME TO TO SIT. THANK YOU. UNLESS YOU WANT TO ADD ANOTHER COMMENT. YEAH. IT'S IT'S THERE AGAIN, THERE'S A LOT OF MISUNDERSTANDING AND MISCONCEPTION AS FAR AS TO, YOU KNOW, WHAT THE NEEDS ARE, ETCETERA, AND, AND WHAT, HOW PSYCHIATRIC FACILITIES OPERATE IN REALITY. YES, WE DO TAKE CLIENTS FROM OTHER COUNTIES. IN OUR PARTICULAR CASE, WE WRITE INTO OUR CONTRACTS THAT THE CLIENT MUST GO BACK TO THEIR HOME COUNTY. WE DO NOT LET PEOPLE GO IN SHASTA COUNTY, PERIOD. FULL STOP. SO YEAH, SO THAT'S NOT THAT'S NOT SOMETHING THAT WE DO. I WOULD PREFER TO HAVE MY BEDS COMPLETELY FULL WITH SHASTA COUNTY PATIENTS, AND WE STRIVE TO DO SO. IN FACT, ESPECIALLY WITH YOUTH, WE TAKE ALMOST 100% OF THE YOUTH AT SHASTA COUNTY GIVES US IN RED BLUFF. SO WE, WE DO WANT TO STAY FULL SHASTA COUNTY. THERE JUST ISN'T ENOUGH REFERRALS. PART OF THAT IS BECAUSE CBH OPENED AND YOU KNOW, WE'RE COMPETING WITH THEM AS WELL. SO CBH WAS ORIGINALLY SUPPOSED TO BE A MEDICAL SLASH PSYCH FACILITY THAT COULD TREAT PEOPLE WITH BOTH ISSUES. IT HAS NOT QUITE PANNED OUT THAT WAY. AND SO THEY GET THERE AGAIN, THOSE ARE INDIVIDUALS THAT OFTEN GET STUCK IN THE ER BECAUSE THEY CANNOT BE PLACED IN A PUFF LIKE OURS. IT'S AGAINST REGULATION TO DO SO. SO WE THAT'S AGAIN, THERE'S A LOT OF REASONS WHY THERE'S PEOPLE STUCK IN THE ER, YOU READ WHAT THE NUMBERS IN THE MEDIA AND IT SOUNDS LIKE WE HAVE NO SERVICES IN NORTHERN CALIFORNIA. IN FACT WE DO. IF I COULD GIVE YOU A QUICK NUMBER SINCE WE OPENED OUR FACILITY IN REDDING IN 2013, WE HAVE SERVED 4909 CLIENTS SINCE WE OPENED OUR FACILITY IN RED BLUFF. WE HAVE SERVED 2417 ADULTS AND 1458 YOUTH. [01:35:07] SO WE DO TAKE A LOT OF CLIENTS AND THERE IS A PRETTY ROBUST INPATIENT PSYCH OFFERING HERE IN THIS COUNTY. WHAT WE'RE MISSING ARE A COUPLE OF PIECES. IT'S LONG TERM CARE AND IT'S MEDICAL PSYCH. I YEAH, I'LL LEAVE YOU FOR YOUR COMMENTS. YEAH. APPRECIATE IT. AND WHILE HE'S UP HERE, I JUST HAVE A. YOU SAID 16 BEDS, RIGHT. IS THERE IS THERE A REASON 16 BEDS LIKE THE OTHER. THE APPLICANT FOR THIS OTHER ONE HAS THREE FACILITIES AT 16 BEDS. IS THAT JUST A COINCIDENCE OR IT'S A MAGIC NUMBER? WHY? BECAUSE ANYTHING OVER THAT HAS TO BE DESIGNATED AS AN IMD, WHICH STANDS FOR INSTITUTE FOR THE MENTALLY DISEASED. QUITE FRANKLY, IT'S A MONEY THING. WHAT DO YOU MEAN? IT'S A MONEY THING? WELL, IF I WAS TO OPEN A OR A PSYCHIATRIC FACILITY AND I WANTED TO MAKE THE MOST MONEY, TO BE FRANK WITH YOU, I WOULD OPEN A PUFF. AND THE REASON WHY IS IT'S EASIER TO DO. THERE'S LESS INVESTMENT IN THE LONG RUN, AND THEY'RE ULTIMATELY MORE MONEY. MHCSRA. ECONOMIES OF SCALE, AS ARE IMDS. YOU HAVE TO HAVE A LOT OF BEDS TO BE ABLE TO MAKE A PROFIT OUT OF IT. AND SO I APPRECIATE, YOU KNOW, WHAT MRS. JOHNSON HAS DONE AND HER PASSION AND HOW MUCH WORK HAS GONE INTO THIS. I JUST WISH THAT THEY HAD CONSULTED WITH SOMEONE IN THE MENTAL HEALTH COMMUNITY THAT RUN FACILITIES ALREADY EARLIER ON, SO THAT WE COULD HAVE MAYBE GUIDED THIS PROCESS A LITTLE BIT BETTER. INSTEAD, THEY HAVE GONE TO A LARGE PSYCHIATRIC COMPANY OUT OF SOUTHERN CALIFORNIA. AS HAS BEEN ALREADY POINTED OUT, THAT HAS A HISTORY OF POOR PATIENT CARE. AND WE DO NOT WANT THAT, FOLKS. WE NEED MORE SERVICES. WE NEED MORE FACILITIES HERE, BUT THAT'S NOT HOW WE WANT TO GO ABOUT IT. AND WE WILL. AND JUST ONE OTHER THING. SO YOU HAD MENTIONED IN THERE THAT OFTENTIMES THE FACILITIES COME UP AND START THIS WAY AND PIVOT. CAN YOU HELP ME UNDERSTAND WHAT YOU MEANT BY THAT? AND THEN I'M GOING TO YIELD BACK TO SUPERVISOR PLUMMER. I JUST DIDN'T WANT TO MAKE IT COME UP TWICE. NO. THAT'S OKAY. COULD YOU GIVE ME. I'M NOT QUITE CLEAR WHAT YOU'RE ASKING THERE. YOU WOULD YOU WOULD MENTION THAT SOMETIMES THE DESIGNATION OR I THOUGHT I WAS IF I WAS UNDERSTANDING IT RIGHT, THAT YOU WERE THERE DOING THIS. AND THEN THEY DECIDE THEY'RE NOT GOING TO DO THIS NOW THEY'RE GOING TO DO THAT. RIGHT. SO SO AGAIN, I THINK HAD THERE BEEN AND I KNOW THEY'VE TALKED TO, YOU KNOW, THE ERS, THE HOSPITALS, A LOT OF INDIVIDUALS IN THE COMMUNITY. AND AGAIN, EVERYBODY HAS A DIFFERENT PERSPECTIVE. GRANTED. BUT I THINK WELL, I'LL GIVE YOU AN EXAMPLE. I HAVE TALKED TO THE ADMINISTRATORS OR THE DIRECTORS OF SEVERAL OVER THE YEARS OF SHASTA COUNTY MENTAL HEALTH, OTHER COUNTIES AS WELL. AND I WOULD SAY ALMOST TO THE PERSON WHEN I ASK THEM, WHAT IS THE GREATEST NEED IN SHASTA COUNTY? AND THEY WILL SAY AN MHR, AN MHR IS A REHABILITATION MODEL. IT IS NOT A JUST A HOUSING MODEL. SO THERE ARE SERVICES THAT GO INTO THAT TO HELP PEOPLE THAT COME IN, TO ACTUALLY BE ABLE TO REHABILITATE AND GO BACK OUT INTO THE COMMUNITY AND HOPEFULLY DON'T HAVE TO GO BACK INTO A PSYCHIATRIC HOSPITAL. THAT IS WHAT IS NEEDED HERE, NOT JUST MORE CRISIS BEDS, WHERE WE LOCK PEOPLE UP FOR 72 HOURS, AND THEN WE ULTIMATELY LET THEM BACK OUT INTO THE COMMUNITY AT SOME POINT. THAT IS NOT A REHABILITATION MODEL AND THERE IS NO MONEY CHANGES HANDS BACK TO SUPERVISOR PLUMMER. WELL, AND JUST TO TO CLARIFY ON THE IMD PIECE, MY UNDERSTANDING IS THAT MEDICAID WON'T FUND THAT. AND SO THAT'S WHEN WE TALK ABOUT MAKING MONEY. IT ACTUALLY IS IMPORTANT FOR THE LOCAL COMMUNITY THAT YOU DON'T EXCEED IMD BECAUSE THEN YOU DON'T HAVE MEDICAID FUNDS, WHICH ARE FEDERAL DOLLARS TO FUND THAT. AND SO THEN IT HAS TO PULL ON OTHER RESOURCES. AND SO IT'S ACTUALLY BENEFICIAL TO THE COMMUNITY TO STAY UNDER THAT 16 BED IN ORDER TO BRAID THE FUNDING TOGETHER AND MAKE IT SOMETHING THAT IS A SUSTAINABLE MODEL. THE OTHER THING, AND THIS IS WHERE IT GETS INTERESTING, IS THAT THE, YOU KNOW, IN SEPTEMBER, ON SEPTEMBER 9TH AND YOU'RE WELCOME TO SIT DOWN. THANK YOU FOR YOUR COMMENTS. THE ON SEPTEMBER 9TH, WE SIGNED A CONTRACT AMENDMENT WITH SAINT HELENA HOSPITAL FOR PSYCHIATRIC INPATIENT HOSPITALIZATION. AND WE INCREASED THAT CONTRACT TO FROM 180,000 TO 550,000. AND SO ON ONE HAND, WE ARE SAYING, OKAY, WE'RE STRUGGLING TO. EVEN THOUGH RUST IS FULL, AS HE AS HE INDICATED, BASICALLY FULL WE'RE STRUGGLING TO PLACE PEOPLE THERE, BUT THEN WE'RE INCREASING THE AMOUNT OF CONTRACTS THAT WE'RE SENDING OUT OF THE COUNTY. AND THERE MIGHT BE GOOD REASONS FOR IT. AND THERE'S COMPLEXITY IN TERMS OF WHO CAN TAKE WHAT FACILITY CAN WE ASK SOMEBODY, WHOEVER YOU WANT. LIKE I'D BE CURIOUS TO KNOW. THAT'S A GREAT QUESTION BECAUSE YEAH, WHOEVER SURE CAN, WHOEVER CAN ANSWER THAT. [01:40:02] I MEAN, EXPLAIN THE CONTRACT. BUT I THINK THAT QUESTION NEEDS TO BE ANSWERED. ARE YOU A HIGH LEVEL OVERVIEW? BUT I DO HAVE MY CLINICAL DEPUTY DIRECTOR HERE WHO CAN GIVE YOU THE DETAILS ON THAT. AND SO PART OF THE REASON THAT WE ACTUALLY HAVE TO HAVE CONTRACTS WITH DIFFERENT FACILITIES IS BECAUSE THEY HAVE EXCLUSION CLAUSES THAT THEY WON'T TAKE OUR HIGH NEEDS CLIENTS. AND SO DIFFERENT HIGH NEEDS CLIENTS HAVE DIFFERENT NEEDS. THEY CAN BE VIOLENT. THEY COULD WANT TO SET FIRES. THEY COULD HAVE HAD A HISTORY IN THE FACILITY AND THOSE FACILITIES WON'T TAKE THEM ANYMORE. AND SO WE'RE CONSTANTLY HAVING TO FIND NEW FACILITIES. WHO WILL TAKE THEM. AND THAT'S CURRENTLY ONE OF THE PROBLEMS WE HAVE WITH SIGNATURE IS THEY WON'T TAKE OUR HIGH NEEDS CLIENTS. AND THAT'S A CURRENT PROBLEM WE ARE HAVING. AND IF YOU HAVE MORE DETAILED QUESTIONS, LEAH, WHO IS OUR DEPUTY DIRECTOR FOR CLINICAL SERVICES, CAN ACTUALLY GIVE YOU MORE DETAILS. WELL, LET ME ASK A CLARIFICATION ON THAT. SO JUST TO MAKE SURE I'M UNDERSTANDING, WHAT I THINK YOU'RE IMPLYING IS THAT OUR LOCAL FACILITIES ARE NOT WILLING OR ABLE TO TAKE A NUMBER OF OUR HIGH NEED CLIENTS. THAT'S CORRECT. THERE'S EXCLUSION CLAUSES AND SOME OF THE FACILITIES UP AND DOWN THE STATE THAT SAY, YOU KNOW, IF SOMEBODY HAS HAD A HISTORY OF VIOLENCE IN THE ED IN THE PAST, IN THE FACILITY IN THE PAST, THEY WON'T TAKE THE CLIENTS DUE TO THE COMPLEXITY OF INSURANCE AND LIABILITY THAT IT HAS FOR THE FACILITY. GREAT. THANK YOU. AND ACTUALLY, SO, SO I KNOW THAT THE THIS IDEA THAT SIGNATURE WILL NOT TAKE THE HIGH NEED CLIENTS IS SOMETHING THAT WAS MENTIONED IN THE STAFF REPORT. I'D ACTUALLY LIKE TO INVITE ALAN UP FROM SIGNATURE AND WOULD LOVE TO HEAR BOTH SOME CONTEXT ON WHAT TYPE OF CLIENTS DO YOU TYPICALLY SERVE AND WHAT TYPE OF CLIENTS WOULD YOU BE WILLING TO SERVE AND ARE PLANNING TO SERVE IN THE CONTEXT OF THIS FACILITY? WELL, I'D LIKE TO FIRST SAY THIS IS THE FIRST TIME I'VE HEARD THIS. THAT SIGNATURE IS NOT ABLE TO TAKE HIGH NEED PATIENTS. THAT IS OUR BUSINESS MODEL. WE SERVE PATIENTS AT THE HIGHEST LEVEL OF CARE FROM AN INPATIENT LEVEL. THERE ARE TIMES WHEN THERE MIGHT BE A PRESENTATION OF A PATIENT THAT WOULDN'T BE. WE WOULD NOT BE ABLE TO TAKE FOR A VARIETY OF REASONS, WHETHER IT'S AGE, WHETHER IT'S WHETHER IT'S CLINICAL PRESENTATION AS IT REGARDS WITH REGARD TO VIOLENCE, WE, WE LOOK AT EVERY CASE. WE DON'T HAVE EXCLUSION CLAUSES IN OUR CONTRACTS. WE LOOK AT EVERY CASE INDIVIDUALLY, WHETHER WE CAN SERVE THAT PATIENT OR NOT. WE CAN'T SERVE EVERYONE. THERE ARE PATIENTS LIKE MURPHY CONSERVATORSHIPS. WE'RE NOT A FORENSIC UNIT. WE CANNOT HANDLE A PATIENT WHO'S NOT GOING TO GET BETTER AND WHO HAS A VIOLENT HISTORY BECAUSE WE HAVE PATIENTS AND WITH THE COMMUNITY. YOUR MOTHER, YOUR DAUGHTER. WE'RE NOT GOING TO BE MIXING PATIENTS THAT HAVE PUT OTHER PATIENTS AT RISK. BUT TO SAY THAT WE DON'T PROVIDE SERVICES FOR HIGH NEED PATIENTS IS INCORRECT AND IT HAS NOT BEEN PRESENTED TO ME OR MY CEO AT SANTA ROSA THAT WE HAVE A PROBLEM IN THAT REGARD, AND I WOULD BE HAPPY TO HAVE THAT DISCUSSION. AND MY UNDERSTANDING IS THAT IN TERMS OF THE BROAD EXPERIENCE OF SIGNATURE HEALTHCARE, WHICH I KNOW YOU HAVE A NUMBER OF FACILITIES THAT YOU ACTUALLY PROBABLY MORE SO THAN THAN MANY OTHER PROVIDERS AROUND THE COUNTRY HAVE EXPERIENCE, FOR EXAMPLE, SERVING THOSE WHO ARE IN THE INCOMPETENT TO STAND TRIAL, WHICH ARE PROBABLY SOME OF THE HARDEST TO SERVE. AND SO THIS IS ACTUALLY TO YOUR POINT YOU KNOW, THE POPULATIONS THAT YOU, YOU MORE THAN PROBABLY MOST PROVIDERS HAVE EXPERIENCE SERVING, RIGHT? WE HAVE THREE HOSPITALS THAT PROVIDE SERVICES TO PATIENTS WHO OTHERWISE WOULD BE IN JAIL BECAUSE THEY'RE INCOMPETENT TO STAND TRIAL. SO WE HAVE A CONTRACT WITH THE STATE THAT THE CALIFORNIA DEPARTMENT OF STATE HOSPITALS TO TAKE PATIENTS WHO THEY DEEM TO BE A PATIENT THAT COULD BE STABILIZED AND STAND TRIAL. THESE ARE PATIENTS THAT TYPICALLY ARE NOT VIOLENT OFFENDERS. THEY'RE BASICALLY INCARCERATED BECAUSE THEY'RE MENTALLY ILL. THEY'VE DONE SOMETHING ON THE STREET THAT BREAKS THE LAW. THEY'VE BEEN DISRUPTIVE. THAT KIND OF THING. SO WE DO TAKE THOSE HIGH NEED PATIENTS, BUT WE TREAT THEM IN A SPECIALIZED PROGRAM. WE DON'T MIX THEM WITH THE GENERAL POPULATION. SO IN THOSE THREE HOSPITALS I'M TALKING ABOUT, WE HAVE A SPECIALIZED SECURE UNIT FOR THAT PATIENT POPULATION. WE TREAT THEM AND ACTUALLY THEY'RE VERY MOTIVATED PATIENTS AND THEY DO WELL AND THEY GET BETTER. AND WE'VE HAD A VERY OVER 90% SUCCESS RATE IN RESTORING THEM TO COMPETENCY AND WELL-BEING. SO AND I JUST WANT TO MAKE ONE COMMENT. THE WAY WE TREAT PATIENTS IS NOT STABILIZATION AND SEND THEM OUT TO THE COMMUNITY. WE TREAT PATIENTS TO STABILIZE THEM, TO LOOK FOR A COURSE OF TREATMENT FOR ONGOING RECOVERY AND STABILIZATION. AND THEY GO BACK TO THEIR COMMUNITY, NOT NECESSARILY THE COMMUNITY WHERE THEY'RE [01:45:04] BEING TREATED, SO THAT THEY CAN HAVE A HIGH LIKELIHOOD OF SUCCESS, SO THAT THEY DON'T HAVE A KIND OF A ROTATING DOOR SCENARIO. DO WE HAVE PATIENTS THAT WE SEE OFTEN? YES. THERE ARE PATIENTS WHO REALLY HAVE A HARD TIME STAYING STABILIZED, BUT OUR GOAL IS TO STABILIZE AND SUSTAIN THAT RECOVERY IN THE TREATMENT AND TREATMENT IN THE COMMUNITY WHERE THEY CAME FROM. ALL RIGHT. SO I HAVE A SO I HAVE A QUESTION. I HAVE A FOLLOW UP QUESTION. SURE. SO AND I APPRECIATE THAT SOME OF THAT CLARIFICATION. BUT, YOU KNOW, YOU SAID YOU'RE IN THE BUSINESS OF THE HIGH NEEDS. THAT WAS YOUR FIRST THING. AND THEN YOU SPENT A COUPLE MINUTES TALKING ABOUT ALL THE BUT, BUT, BUT OR SOMETIMES, SOMETIMES SOMETIMES. SO THERE WAS A LOT OF DISCLAIMERS EVEN HERE, HOW YOU JUST SAID, WE TREAT THEM. WE DO ALL THIS, HOWEVER. AND THEN YOU SAID, WE DO SEE PEOPLE. SO A LOT OF THE STATEMENTS YOU WOULD SAY YOU FOLLOWED UP WITH THE EXACT OPPOSITE OF WHAT YOU WERE JUST SAYING YOU DID. SO HERE'S MY NEXT QUESTION. NO, I DID NOT. I DID NOT. YEAH. BUT YOU SAID IT'S OFTEN IT'S OFTEN THAT THEY COME BACK. YOU SAID IT'S OFTEN THAT THEY COME. IS THAT CORRECT? NO, I SAID IT IS NOT. IT'S NOT IT'S NOT UNCOMMON FOR THEM TO COMMON THAT SOME PATIENTS WILL COME BACK TO SEE US FAIRLY OFTEN. OKAY. SO HERE'S HERE'S ANOTHER QUESTION I HAVE. IF THIS CAMPUS MOVES FORWARD, WHAT IS THE PROPOSED STAFFING RATIO AND HOW WILL THEY HOW ARE YOU GOING TO MAINTAIN THAT 24 HOUR FACILITY WHEN. CURRENTLY RIGHT NOW IN SHASTA COUNTY, THERE IS A. EXTREME PROVIDER SHORTAGE. SO IF YOU'RE SUPPOSED TO PROVIDE 24 HOUR CARE FOR 16 BEDS OVER ACROSS THREE FACILITIES, 48 AND WE'RE HAVING HUGE ISSUES DOING IT. NOW, HOW DOES THAT WORK? I MEAN. WELL, NUMBER ONE, WE'LL HAVE TIME. THIS IS THIS IS AN APPLICATION PROCESS. THE IN TERMS OF EXECUTING SUCH A FACILITY WILL BE 2 TO 3 YEARS OUT. DURING THAT PERIOD OF PLANNING, WE PLAN TO HAVE WORKFORCE DEVELOPMENT PROJECTS HERE IN THE COMMUNITY TO DEVELOP A WORKFORCE. BUT WHAT HAPPENS? LET'S JUST SAY, BECAUSE I LIKE TO ALWAYS HOPE FOR THE BEST, BUT PLAN FOR THE WORST. SO WHAT HAPPENS IF THAT DOESN'T HAPPEN? WHAT HAPPENS IF THERE IS A WORKFORCE SHORTAGE? WHAT IF MORE PEOPLE DON'T COME? WHAT ARE WHAT ARE YOUR STAFFING RATIOS? BECAUSE THAT'S WHAT SOME OF THE PROBLEMS IN OUR LOCAL PLACES HAVE BEEN. THEY'VE BEEN HIGHLY SKILLED STAFF WHO HAVE ACTUALLY CHOKED OUT PEOPLE AND ESCAPED, AND FACILITIES HAVE BEEN SHUT DOWN. WE'VE JUST BEEN THROUGH A PERIOD WHERE WE HAD TO DEAL WITH THAT PROBLEM DURING COVID. AND WE, WE HAVE HAD TO DOWNSCALE SOME OF OUR, SOME OF OUR UNITS IN ORDER TO HAVE ADEQUATE STAFFING RATIOS. AND WE COMPLY WITH STAFFING RATIOS THAT ARE REQUIRED BY THE STATE THEY ARE WRITTEN, THEY ARE REQUIRED AND WE COMPLY WITH THEM. SO WHAT I'M UNDERSTANDING IS YOU COULD HAVE TO POSSIBLY OPEN THESE AND THEN IMMEDIATELY DOWNSIZE. THAT'S A POSSIBILITY. IT'S ALWAYS POSSIBLE IN ANY HOSPITAL WHERE YOU'VE GOT A WORKFORCE CHALLENGE, WHETHER IT'S COVID OR SOMETHING ELSE. BUT WE ARE VERY ADEPT AT. WORKING WITH THOSE ISSUES AND DEVELOPING PLANS TO MITIGATE THEM. AND I CAN APPRECIATE THAT. AND MY BIGGEST CONCERN IS SHASTA COUNTY FOR 30 YEARS HAS TO OPEN UP THE CHECKBOOK AND IS ON THE HOOK FOR THAT. HOPING FOR THE BEST. SUPERVISOR LONG. THANK. ALAN. UNDERSTAND THE CHECKBOOK PART? WELL, NO, BUT BUT SHASTA BECAUSE I'M GOING TO ASK THE SAME QUESTION. WELL, BECAUSE WHAT THIS I THINK HE'S ASKING ME TO FOLLOW UP. WHAT I'M JUST SAYING IS SHASTA COUNTY FINANCIALLY IS ON THE HOOK FOR THIS. AFTER. THIS IS BUILT FOR 30 YEARS IN TERMS OF CONTRACTING BEDS. AND THAT'S WHERE I BELIEVE SHASTA COUNTY WILL BANKRUPT ITSELF QUICKLY. BUT WE'LL TALK ABOUT THAT WHEN IT'S MY TIME. SUPERVISOR LONG. WELL, I WOULD BE INTERESTED IN YOUR PERSPECTIVE ON THAT BECAUSE I WAS GOING TO ASK THAT SAME THING AS WELL. THIS IS A SOLE APPLICATION FROM A PRIVATE FOR PROFIT VENDOR. CORRECT. CORRECT. AND CAN YOU TELL US YOUR PERSPECTIVE ON THE COUNTY WILL BE IN MARRIED TO THIS PROJECT FOR THE NEXT 30 YEARS AND HAVE TO TAKE OVER ALL THAT KIND OF STUFF. OUR CONTRACTS WITH COUNTIES ARE ABOUT FEE FOR SERVICE, PROVISION OF SERVICES. IN OTHER WORDS, IF YOU REFER US A PATIENT UNDER CONTRACT, YOU PAY FOR THE SERVICES PER DAY THAT WE PROVIDE FOR THAT PATIENT. THAT'S THE ONLY FINANCIAL BURDEN RELATIONSHIP WITH THE COUNTY. THE. WHETHER THIS PROJECT IS SUCCESSFUL OR NOT IS THE FINANCIAL RISK IS ON THE COMPANY WHO RECEIVED THE FUNDS AND WHO EXECUTED THE PROJECT AND SPENT THE MONEY. CORRECT. AND AND THE CONTRACT ITSELF WITH THE COUNTY TO PROVIDE CLIENTS TO YOUR YOUR ORGANIZATION. THAT IS SOMETHING THAT CAN BE ADDRESSED LATER. [01:50:03] WE DON'T HAVE TO ACCEPT THIS CONTRACT. THAT'S CORRECT. OKAY. I THINK THAT'S A VERY IMPORTANT DISTINCTION. THIS WILL BE UPON PROPER ANALYSIS FROM THE COUNTY, DECIDING WHETHER YOUR FACILITY OFFERS A COST WORTHY PROJECT OR WHETHER WE WANT TO CONTINUE TO SHIP PEOPLE EVERYWHERE. THAT'S CORRECT. OKAY. AND YOU KEYED ON ONE OTHER THING, WHICH I THINK I THINK NEEDS TO BE MENTIONED. I THINK WHEN YOU WERE TALKING ABOUT THE MENTALLY INCOMPETENT, UNABLE TO STAND TRIAL FOLKS, YOU'RE TALKING ABOUT THE MURPHY COMMITMENTS. NO I'M NOT. NO. OKAY. WHAT? NOT MURPHY NOT THOSE ARE NOT MURPHY CONSERVATORSHIP. OKAY. PATIENTS WHO HAVE NOT BEEN PUT UNDER A CONSERVATORSHIP AT THIS POINT, BUT ARE DEEMED TO BE INCOMPETENT TO STAND TRIAL, WHICH IS THE MAJORITY OF WHICH IS THE MAJORITY OF MENTALLY ILL FOLKS IN THE STATE. OKAY. AND THAT WILL FREE UP WHAT WOULD HAVE BEEN HELD IN THE JAIL FOR PEOPLE THAT ARE INCOMPETENT. BECAUSE I'VE WORKED WITH OUR SHERIFF AND I UNDERSTAND THAT PROCESS ABOUT NOT COMPETENT TO STAND TRIAL. I WANT TO BE CLEAR, WE'RE NOT GOING TO PROVIDE THAT SERVICE HERE BECAUSE THE STATE ISN'T GOING TO FUND IT HERE FOR NOW. BUT IT YOU KNOW, IN THE FUTURE, IT'S POSSIBLE. BUT THAT IS NOT IN OUR PLAN FOR THE INCOMPETENT TO STAND TRIAL LEVEL OF CARE. OKAY. THANK YOU. I APPRECIATE YOUR RESPONSES. SUPERVISOR. KELSTROM. OH, I'M SORRY. SUPERVISOR. I'M SORRY. DID YOU DID DID YOU TAKE HIM OUT? OKAY. I DIDN'T. OH. JUST DISAPPEARED. I FIGURED IT WAS TAKEN OUT BECAUSE I STARTED TO TALK ABOUT. YOU'RE GOOD TO ALAN. OKAY. I DO HAVE SOME BOARD COMMENT ON THIS. I WOULD SAY $200 MILLION, $200 MILLION COMING INTO OUR COMMUNITY. $200 MILLION. WE WERE TALKING ABOUT A JAIL FACILITY THAT WAS GOING TO BE ABOUT 130 TO 150. WE COULD NEVER AFFORD THAT. WE NEVER GOT THAT BUILT. WE'RE STILL WORKING ON ALTERNATIVES TO WORK TOWARD THAT GOAL EVENTUALLY. $200 MILLION IS AVAILABLE THROUGH PROPOSITION ONE B CHIP FUNDING TO BUILD THIS FACILITY. OKAY. I WANT TO CLARIFY THAT. THIS IS AN APPLICATION FROM. I'LL GO BACK JUST A MINUTE. AND THIS IS THE WAY I SEE IT. AND I APPRECIATE SUPERVISOR PLUMMER QUESTIONS BECAUSE I WAS FORCED. YESTERDAY I WAS ON THE PHONE IN MEETINGS LITERALLY ALL DAY, TRYING TO COME UP TO SPEED ON THIS SO THAT I HAD SOME KNOWLEDGE ABOUT WHAT WE WERE TALKING ABOUT HERE. AND THAT WAS A HERCULEAN TASK, I WILL TELL YOU. AND THE REASON I SAY THAT IS BECAUSE THIS IS SUCH A SIGNIFICANT VOTE HERE TODAY. AND I LOOK AT THIS. THIS IS A BACK UP JUST A BIT. SO WE AS A COUNTY, WHEN THE PROP ONE FUNDS B CHIP FUNDS WERE ANNOUNCED, WE WERE TOLD, AND I SAT IN SOME OF THOSE MEETINGS THAT THIS IS NOT GOING TO BE A COUNTY LED PROJECT. WE ARE NOT GOING TO BE THE PRIMARY APPLICANT TO GET ANY OF THIS FUNDING. WE ENCOURAGE AND WE WILL SUPPORT PRIVATE SECTOR FOLKS THAT ARE WILLING TO STEP UP. AND SO I THINK THAT'S WHAT WE'VE GOT HERE. THIS IS WHAT WE SAID. WE ARE NOT GOING TO AVAIL OURSELVES OF THE PROP ONE FUNDING DIRECTLY AS A COUNTY. SO WE ENCOURAGED FOLKS TO DO THIS. THEY WORKED ON A PROJECT. IT IS HERE NOW WAITING FOR US. THIS IS NOT OUR PROJECT. THIS IS A PROJECT TO HELP OUR COMMUNITY AND THIS IS THE APPLICATION PROCESS ONLY. THIS IS THE APPLICATION PROCESS. $200 MILLION. I CAN'T SAY THAT ENOUGH BECAUSE THE IMPACT OF WHAT WE'RE TALKING ABOUT HERE IS TRYING TO DEFEAT A PROJECT BEFORE IT'S EVEN BEEN AWARDED. THIS IS THE APPLICATION ONLY. AND IF IF WE WERE ABLE TO ISSUE A LETTER TO HELP THIS APPLICATION GO FORWARD, THAT GIVES US, UNLIKE THE DAY I HAD TO GET READY FOR THIS MEETING, THAT GIVES US 8 OR 9 MONTHS. WE JUST HEARD THAT IT WAS. THE AWARD WILL BE IN THE SPRING OF 26. OKAY, FIRST OF ALL, WHY WOULD WE TURN DOWN $200 MILLION IN POSSIBILITY? I ENDED UP TALKING YESTERDAY TO FOLKS AT THE STATE LEVEL, AND THEY SAID, YOU'RE PROBABLY NOT GOING TO GET ANOTHER BITE AT THIS APPLE GIVEN STATE FINANCES AND THE WAY THIS PROPOSITION MONEY IS GOING, YOU BETTER BE VERY CAREFUL RIGHT NOW AS TO WHETHER YOU TURN THIS DOWN. [01:55:06] APPLICATION ONLY WE KEEP THE PROCESS ALIVE. WE KEEP THE $200 MILLION IN THE PROCESS HERE, AND WE CAN THEN WAIT UNTIL SPRING OF 26 TO DECIDE IF IT'S GOING TO AFFECT OUR COUNTY ADVERSELY. I IN A DAY, I DON'T HAVE ENOUGH TIME TO KNOW EXACTLY WHAT ALL THE IMPLICATIONS ARE. WHAT I DO KNOW IS WE NEED TO KEEP THIS MONEY ALIVE. AND WE CAN WE CAN HELP SUPPORT THE APPLICATION AND THEN WE. THAT DOESN'T BIND US IN ANY FASHION TO THIS PROJECT. FIRST OF ALL, WE ARE NOT AN APPLICANT. THEY ARE THE PRIMARY APPLICANT. THERE ARE NO CO-APPLICANTS AND WE WILL GET ALL THE WAY TILL SPRING. I WILL HAVE FIVE SIX MONTHS TO RESEARCH THIS IN GREAT DETAIL AND SEE IF THIS IS, IS IS GREAT FOR OUR COUNTY. AND IT'S NOT IT'S NOT A PROJECT THAT WE'RE EVEN RESPONSIBLE FOR AND IN CHARGE OF, BUT IT WILL GIVE US SIX MONTHS, $200 MILLION. I DON'T WANT TO TURN THAT DOWN TODAY. AND I DON'T WANT TO STOP WITH THE CONSIDERATION THAT WE HAVE A TREMENDOUS NEED IN THIS COUNTY FOR MENTAL HEALTH, FOR BEHAVIORAL HEALTH, AND THIS COULD GO TOWARD PROJECTING AND PROTECTING THOSE FOLKS IN OUR COMMUNITY THAT ARE UNDERSERVED AND ARE BEING FORCED TO BE SENT TO SACRAMENTO, SANTA ROSA. ALL THE CONTRACTS THAT SUPERVISOR PLUMMER JUST TALKED ABOUT. SO I THINK WE HAVE TO REALLY WEIGH THIS AS A BOARD. THIS IS THIS LETTER OF SUPPORT OR OPPOSITION. IT'S NOT BINDING US IN ANY FASHION. IT SIMPLY KEEPS $200 MILLION THE CONVERSATION ALIVE, THAT WE CAN THEN FIGURE ALL THIS OUT OVER A LONGER PERIOD OF TIME. I HAD A DAY TO GET UP TO SPEED ON THIS, AND I'M AMAZED AT THE PEOPLE THAT I WAS ABLE TO CONTACT TO GET A LOT OF IN THE WEEDS DEFINITIONS AND COME TO THIS. BUT I THOUGHT ABOUT IT. AND I JUST SAID, WHAT'S THE RUSH? WHAT'S THE HURRY TO TURN DOWN $200 MILLION? WHAT IS THE URGENCY? WE'RE NOT THE APPLICANT. WE CAN WRITE A LETTER OF SUPPORT. WE KEEP THE PROPOSAL, THE B CHIP FUNDING THAT PROBABLY WILL DISAPPEAR IF WE EVER TRY TO GO BACK FOR IT. I THINK OF TEN YEARS AGO, WE WENT WE TURNED DOWN STATE MONEY TO BUILD OUR JAIL. AND IT'S A DIFFERENT SITUATION. I'M NOT GOING TO GO INTO ALL THAT, BUT WE STILL DON'T HAVE A JAIL. THAT'S WE'RE FIGHTING. TEN YEARS LATER, TO TRY TO GET THAT $200 MILLION IS SITTING AT THE READY, POTENTIALLY. AND KEEP IN MIND, THIS IS AN APPLICATION ONLY. THIS IS NOT AN AWARD. THIS IS AN APPLICATION. IF WE KEEP 200 MILLION ON THE TABLE, IT WILL GIVE US 6 TO 8 MONTHS UNTIL SPRING OF 26. TO FIGURE THIS OUT AND TO ASK ALL THE APPROPRIATE QUESTIONS AND FIGURE ALL THE MINUTIA AND THE IN THE WEEDS. BUT WE KEEP THE MONEY ALIVE. AND THIS ISN'T OUR PROJECT, BUT WE WILL BE ABLE TO ASK ALL THE QUESTIONS AND THE IMPACT ON THE COUNTY WE WILL BE ABLE TO ASK THE QUESTIONS ABOUT, IS THIS SOMETHING WE WANT TO BE PART OF? DO WE WANT TO ENDORSE IT? ALL THOSE KINDS OF QUESTIONS. WE ARE NOT BOUND BY WRITING A LETTER OF SUPPORT AND WE CERTAINLY ARE NOT LOCKED INTO A CONTRACT. AND IF WE IF IT EVER LOOKED LIKE WE WOULD, THEN WE CAN DECLINE AT THAT TIME. JUST BECAUSE A CONTRACT IS AWARDED FOR A B CHIP FUNDING, PROP ONE DOES NOT OBLIGATE THE RECIPIENT. WE TURNED DOWN $50 MILLION, 30 TO $50 MILLION TWO DIFFERENT TIMES TO BUILD A JAIL. WE CAN AND WE'RE NOT EVEN THE APPLICANT. THOSE MONIES CAN BE TURNED DOWN. AN AWARD DOES NOT MANDATE THAT YOU GO FORWARD. SO I WOULD SAY TO OUR BOARD, PLEASE, PLEASE, PLEASE KEEP THE $200 MILLION ALIVE AND SUPPORT THE APPLICATION FOR THIS. AND WE CAN FIGURE THIS OUT WHEN WE HAVE ENOUGH TIME TO GET THE ANALYSIS DONE. AND THAT'S WHERE I THAT'S MY OPINION. THANK YOU. JUST SO WE'RE SENDING OUT A DOLLAR, I MEAN, 2.8 BILLION. I WON'T REPEAT IT TEN TIMES. BUT 2.8 BILLION HAS BEEN SPENT ON HOMELESS IN SAN FRANCISCO. ALL RIGHT. SUPERVISOR. KELSTROM. ALL RIGHT. SO I MET WITH KIMBERLY A FEW WEEKS AGO, AND. SUPERVISOR PLUMMER AND DOCTOR MARK MONTGOMERY TO DISCUSS THIS THING. AND AND AT THE END OF THAT, MY THOUGHTS WERE PRETTY MUCH EXACTLY LIKE YOURS. ALAN. IN FACT YOU KNOW, SORRY. [02:00:01] KIMBERLY ACTUALLY HAD A LETTER OF SUPPORT WRITTEN AND BUT THEN I GOT SOME CALLS FROM SOME STAFF THAT WITH SOME CONCERNS. SO I DIDN'T SEND OFF THAT LETTER AND I APOLOGIZE. I PROBABLY SHOULD HAVE TOLD YOU THAT, BUT SO I STILL HAVE A LOT OF QUESTIONS WITH STAFF. I MEAN, IT SOUNDS LIKE A GREAT PROJECT. IT SOUNDS LIKE, YOU KNOW, WE GET A WHOLE BUNCH OF EXTRA BEDS, BUT THESE LIABILITIES THAT KEEP GETTING POINTED OUT, I NEED THOSE CLARIFIED FOR ME. SO STUART, I KNOW YOU'RE ON YOUR PHONE AND I DON'T MEAN TO PUT YOU ON THE SPOT, BUT AARON'S NOT HERE RIGHT NOW, AND CHRISTY AND I'LL PROBABLY HAVE SOME QUESTIONS FOR YOU TOO, BECAUSE THE ONE, THE ONE THAT STANDS OUT TO ME IS THE PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY. AND THE COST PER BEDS WILL BE 133,000 OR 113,000 COMPARED TO 17,000. CAN YOU EXPLAIN THAT AT ALL? OR, YOU KNOW, THANK YOU. SUPERVISOR KELSTROM BEUTEL, DEPUTY COUNTY EXECUTIVE OFFICER STANDING IN FOR MY MUCH BETTER AND MORE INTELLIGENT HALF, AARON BURTON. I CANNOT SPEAK TO THAT DISCREPANCY OTHER THAN WHAT WE CONTRACT FOR PSYCHIATRIC HEALTH FACILITIES. AND THOSE COSTS ARE WILDLY EXPENSIVE COMPARED TO OTHER PLACEMENTS IN OTHER COUNTIES AND OTHER FACILITIES. SO AND WHO ON THE STAFF FOR SUPERVISOR KELSTROM QUESTION WHO? WHO WOULD ANSWER THAT? IS THAT BAILEY OR IS THAT AARON? WILL YOU BE ABLE TO ANSWER THAT OR. AARON. WHAT'S. CHRISTY. CHRISTY. SO THE RATES ARE SET BY THE STATE. OKAY. AND SO, SO EXPLAIN TO ME HOW WE GO. YOU KNOW, HOW WOULD WE POSSIBLY GO TO 113,000 FROM 17,000? SO IT'S A DIFFERENT TYPE OF FACILITY. SO THE STP IS A DIFFERENT TYPE OF FACILITY THAN THE PRTF. OKAY. SO THIS HAS A HIGHER RATE THAN THE STP. OKAY. AND THEN THIS IS PROBABLY WHERE I'LL REFER YOU. I THINK THAT ANSWERED THAT THIS IS SO IF IT'S OVER 16 BEDS, IT'S NO LONGER A PUFF. IS THAT THE DIFFERENCE HERE. YEAH. THERE'S THAT THE IMD EXCLUSION. AND SO IF IT GOES OVER A CERTAIN AMOUNT WHICH THEY DON'T HAVE THE EXCLUSION YET FOR THIS, THIS PROJECT PROPOSAL, WHICH IS ANOTHER CONCERNING FACTOR, IS WE DON'T KNOW IF THEY'RE GOING TO GET THAT EXCLUSION. OKAY. GOING TO GO INTO DETAIL ABOUT THAT JUST SO WE'RE ALL CLEAR. SO IF THEY DON'T GET THE EXCLUSION FOR THE IMD, THEN IT WOULD BE 100% COST FOR THE COUNTY. IT WOULD NOT BE REIMBURSABLE. SO WE COULD NOT GO TO THE STATE TO BE REIMBURSED FOR ANY PLACEMENTS IN THE FACILITY. SO THAT MEANS NO ALTERNATIVE CUSTODY PROGRAM. THAT MEANS CUTTING LAW ENFORCEMENT IF IT GOES BAD. THAT'S WHAT THAT MEANS. AND WHAT IS THE LIABILITY ON THE COUNTY? I MEAN, BECAUSE AGAIN, YOU KNOW, WHEN I MET A FEW WEEKS AGO, IT WAS KIND OF LIKE, WELL, HEY, THIS IS, YOU KNOW, THIS IS A SIGNATURE. HEALTH IS TAKING THE RISK. AND, YOU KNOW, THE COUNTY'S REALLY NOT INVOLVED AND IT'S THEIR PROJECT. AND SO WHERE DOES THE LIABILITY FOR THE COUNTY COME IN? THE LIABILITY COMES IN THAT WE WILL HAVE TO GROW OUR TEAMS, REGARDLESS OF THE CONTRACT SIZE THAT WE HAVE WITH THIS FACILITY, BECAUSE WE ARE THE MEDI-CAL ADMINISTRATOR FOR THE COUNTY. AND SO ANY ENTITY SERVING MEDI-CAL RECIPIENTS, WE WILL HAVE TO CERTIFY OUR PATIENTS RIGHTS TEAMS WILL HAVE TO GO INTO THE FACILITY TO MAKE SURE PATIENTS RIGHTS ARE NOT BEING VIOLATED IN THE FACILITY. AND THE CSU CANNOT BE A REGIONAL MODEL. AND SO IF SHASTA COUNTY DOES NOT CONTRACT FOR THAT, I DON'T KNOW WHAT COUNTY WOULD BECAUSE IT'S A 23 HOUR PLACEMENT, A SOCIAL REHAB FACILITY. WE HAVE A SOCIAL REHAB FACILITY, SO WE SHOULDN'T BE CONTRACTING FOR A THIRD FACILITY WHEN WE HAVE A SECOND ONE HERE IN THE COUNTY THAT IS NOT FULL AS WELL. AND IF THE FACILITY WAS BUILT AND THE POSITIONS WERE NOT FULLY, YOU KNOW, FILLED IN THAT, WOULD THAT BE A LIABILITY? THE COUNTY ALSO. I IT COULD BE FROM WHAT I READ WITH THE LETTERS OF SUPPORT. SO WHEN WE PROVIDE A LETTER OF SUPPORT, WE ARE STATING THAT THE COUNTY WILL ENSURE THAT THERE ARE MEDI-CAL SERVICES PROVIDED IN THIS FACILITY FOR 30 YEARS. THAT IS PART OF THE STIPULATIONS OF RECEIVING THE THE B CHIP FUNDING FOR THE GRANTEE. AND SO WE ARE THE MEDI-CAL ADMINISTRATOR FOR OUR COUNTY. AND SO THAT WOULD FALL ON US AS A RESPONSIBILITY. AND THEN ONE OTHER THING I NEED TO EXPLAIN AND IS SO WE'RE NOT SENDING A LETTER OF SUPPORT. AND I PULLED BACK MY LETTER OF SUPPORT AND BUT WHY DO WE NEED TO SEND A LETTER OF OPPOSITION? WHY CANNOT WE JUST REMAIN NEUTRAL? SO AS PART OF THE APPLICATION GUIDELINES AND EVERYTHING ELSE RELATED TO FUNDING, A LETTER OF SUPPORT IS A REQUIREMENT. IT'S A THRESHOLD REQUIREMENT FOR THIS APPLICATION. AND SO REGARDLESS IF WE DON'T SEND A LETTER OF SUPPORT OR WE SEND A LETTER OF OPPOSITION, THE WAY I READ THIS IS IF THEY DON'T HAVE A LETTER OF SUPPORT FROM THE COUNTY BEHAVIORAL HEALTH DIRECTOR OF THE COUNTY OF ORIGIN, WHICH IS SHASTA COUNTY, BECAUSE THAT'S WHERE THE PROJECT WILL BE BUILT. THERE IS NO PROJECT. OKAY, SO REMAINING NEUTRAL WOULD WOULD BASICALLY THE PROJECT WOULD NOT GO FORWARD. SO WHAT'S THE NEED FOR A LETTER OF OPPOSITION? I AM CAN TAKE A RECOMMENDATION TO NOT SEND A LETTER OF OPPOSITION. I CAN SPEAK TO THAT IF YOU IF YOU IF YOU WANT TO KNOW WHY I DEFINITELY. NO NO NO. CHRISTY. CHRISTY. IF YOU WANT. BUT YOUR SUPERVISOR OR CEO RECORD RECORD. I MEAN, I WROTE IT. I MEAN, I'LL TELL YOU WHY, BUT IF YOU WANT. BECAUSE IF YOU ASK WHY THE LETTER, I'LL EXPLAIN IT. IT'S THE SAME EXACT THING. HOW ABOUT THIS? YOU'RE A BASKETBALL STAR. WERE. IT'S A LAYUP VERSUS A DUNK, RIGHT? A LAYUP IS TWO POINTS A DUNKS TWO POINTS. I WANT NO CHANCE THAT THE STATE BY ANY MANEUVERING JOCKEYING DEALINGS, [02:05:05] THINKS THAT WE'RE IN ANY WAY PART OF THIS OR WANT ANY PART OF THIS. AND I DON'T KNOW IF I HAVE I HAVE ONE VOTE, BUT I DON'T KNOW IF I HAVE TWO, THREE, FOUR DOESN'T MATTER TO ME. I WANT TO MAKE SURE I GO ON BIG TIME RECORD. THAT'S WHY A DUNK VERSUS A LAYUP. I WANT TO LEAVE NO DOUBT AND MAKE SURE THE STATE UNDERSTANDS THAT. I STAND BEHIND THE HHS DIRECTOR AND THE MENTAL HEALTH DESIGNEE FOR SHASTA COUNTY, THAT THIS IS A BOONDOGGLE AND A BAD THING. THAT'S WHY. SO HOPE THAT ANSWERS IT. OKAY, A FEW MORE QUESTIONS FOR STUART, PLEASE. SO HELP ME WITH THE WITH THE MONEY ASPECT. WHERE ARE LIABILITIES AT. SO I MEAN, WITHOUT BEING ABLE TO REVIEW THE FULL APPLICATION, I CAN ONLY SPEAK TO WHAT I WHERE I THINK THE LIABILITIES MAY BE. OBVIOUSLY ANY SUPPORT SERVICES THAT WE'RE PROVIDING TO THAT FACILITY, AS DIRECTOR COLEMAN MENTIONED THERE'S POTENTIAL TO, TO HAVE TO INSERT EMPLOYEES INTO THAT SPACE TO ADVOCATE FOR PATIENTS TO PROVIDE SERVICES. AS SUPERVISOR CRYE MENTIONED, OVER THE COURSE OF THE NEXT 30 YEARS, THERE'S LIABILITY THERE. THERE'S LIABILITY FROM THE STANDPOINT OF, YOU KNOW, IF THERE'S A STAFFING RATIO SHORTAGE, WE WOULD THEN POTENTIALLY BE RESPONSIBLE FOR PLACING THOSE CLIENTS IN OTHER FACILITIES UNDER. I'LL JUST SAY UNDER DURESS. AND THAT COULD RESULT IN PLACING THEM IN FACILITIES OUT OF COUNTY, IN COUNTY. IT JUST DEPENDS ON WHERE THERE'S BED SPACE. SO OFF, OFF THE TOP, THAT'S JUST A HIGH LEVEL. THERE'S POTENTIAL PROBLEMS. WHAT'S THE LIABILITY? I'LL LET YOU ASK. HEY, DON'T. NOT FROM THE CROWD. GO AHEAD. ALL RIGHT. I'LL. I'LL. I'LL PROBABLY HAVE MORE QUESTIONS. DO YOU WANT TO ARTICULATE ANYTHING FROM THE PHONE CALL FOR SUPERVISOR KELSTROM WITH NOEL DE SHORT, OUR AUDITOR CONTROLLER AND WHAT SHE ARTICULATED. SO I THINK WHAT AUDITOR CONTROLLER SHORT MENTIONED ON THAT PHONE CALL. AND I'LL REITERATE WHAT AARON BURTON LIKES TO SAY, WHICH IS THAT WE HAVE NO MONEY. AND DESPITE HAVING CONTRACTS WITH VARIOUS FACILITIES AND WHATNOT EXPANDING THOSE SERVICES AND PROVIDING FUNDING WOULD POTENTIALLY TAKE AWAY FROM THE ACP, FROM OTHER PRIORITIES THIS BOARD HAS INDICATED ARE A PRIORITY. SO I WOULD JUST SEND UP A FLAG OF CAUTION IN THAT REGARD. NOLA IS TRYING TO RATCHET BACK MONEY IN HHA BECAUSE IT'S RUNNING OUT AND WE HAVE TO PARSE IT OUT AS BEST WE CAN. THIS DOES THE EXACT OPPOSITE. THEY'RE TRYING TO PUT THE FIRE OUT OR TAMPING IT DOWN. THIS POURS GAS ON IT, SO I'LL SPEAK TO THAT TO SOME DEGREE TOO. THANK YOU SUPERVISOR CRYE FOR THE REMINDER. SO THE IN THAT CONVERSATION WITH NOEL DE SHORT. AND AS THIS BOARD MAY RECALL AT VARIOUS POINTS, DIRECTOR COLEMAN, AS WELL AS BRANCH DIRECTOR WATTS, HAVE MENTIONED THAT THE SOCIAL SERVICES FUND IS CURRENTLY RECEIVING GENERAL FUND MONIES TO SUPPORT THEIR CASH FLOW, AND THEY'RE IN THE PROCESS OF DETERMINING WHAT IS NECESSARY TO BRING THAT BACK UNDER CONTROL SO THAT IT'S NO LONGER NECESSARY. CORRECT. SUPERVISOR. PLUMMER. SINCE YOU'RE HERE AND I APOLOGIZE IF I'M OKAY TO ASK A QUESTION. SO IN YOUR OPINION, WHAT IS THE DANGER OF LETTING THE APPLICATION GO THROUGH? IT'S NOT OUR OUR APPLICATION. AND THEN BEFORE THE AWARD GETS. WE CAN FIGURE ALL THESE QUESTIONS OUT, AND IT'LL GIVE ME FIVE MONTHS TO DEEP DIVE INTO THIS AND FIGURE OUT TO MY SATISFACTION WHETHER WE'RE GOING TO HAVE TO STAFF THIS FACILITY, WHETHER SOCIAL SERVICES BUDGETS CAN BE IMPACTED. THERE'S THERE'S MORE TIME. WE CAN KEEP THE MONEY ALIVE. AND WHAT, WHAT IS THE DOWNSIDE TO THAT? SO I WOULD SAY THE DOWNSIDE IS BASED ON ROUND TWO APPLICATION GUIDELINES, IS THAT WE ARE OBLIGATED IN SUPPORTING THIS APPLICATION TO PROVIDING MEDI-CAL BEHAVIORAL HEALTH SERVICES SHOULD THIS FACILITY MOVE FORWARD. AND ACTUALLY, AND I WANT TO SPEAK TO THIS BECAUSE THIS THIS HAS BEEN A POINT OF CONTENTION. AND CHRISTIE AND I HAVE TALKED A LOT ABOUT THIS AND YES IN FACT YOU KNOW, I HAVE REACHED OUT TO THE STATE MULTIPLE TIMES ON THIS. I KNOW THE PROJECT TEAM HAS REACHED OUT TO THE STATE. WE HAD A CONVERSATION WITH MARK FAWCETT FROM ADVOCATES FOR HUMAN POTENTIAL, WHO IS OVERSEEING THE STATE'S LETTER OF SUPPORT EFFORT. HE INDICATED ON THAT CALL THAT THERE WAS NOT THE NEED TO CONTRACT. THERE'S NO OBLIGATION TO CONTRACT WITH THE APPLICANT BY WRITING A LETTER OF SUPPORT, AND WE'RE NOT EVEN TALKING ABOUT WRITING A LETTER OF SUPPORT. WE'RE JUST TALKING ABOUT NOT WRITING A LETTER OF OPPOSITION. SO THAT'S THAT'S NUMBER ONE. AND, YOU KNOW, BUT A CALL, YOU KNOW, IT CAN BE INTERPRETED DIFFERENT WAYS. SO I ASKED HIM AGAIN, CAN YOU GIVE ME A WRITTEN STATEMENT OF THAT? CAN YOU SHARE SOMETHING WITH ME? AND WHAT HE DID IS HE SHARED, AND I WANT TO READ THIS HE SHARED, HE SAID, HERE'S A LETTER OF SUPPORT THAT HAS BEEN SUBMITTED BY ANOTHER COUNTY FOR ANOTHER APPLICANT. AND HE SAID, YOU CAN'T SHARE THE NAMES PUBLICLY, BUT YOU CAN READ THAT. AND SO I'M GOING TO READ A SECTION OF IT. THIS IS THE LANGUAGE THAT THEY PUT IN THEIR LETTER OF SUPPORT. IF THE APPLICANT DOES NOT CURRENTLY HAVE A CONTRACT WITH THE COUNTY, THIS LETTER OF SUPPORT DOES NOT GUARANTEE A [02:10:03] FUTURE CONTRACT. WHILE THE APPLICANT INDICATED IT WILL SERVE A PERCENTAGE OF MEDI-CAL CLIENTS THE APPLICANT MUST SECURE A MEDI-CAL CONTRACT WITH THE MENTAL HEALTH PLAN OR DRUG MEDI-CAL ORGANIZED DELIVERY SYSTEM PLAN IN ORDER TO SERVE MEDI-CAL POPULATION. THE TERMS INCLUDING, BUT NOT LIMITED TO, THE SCOPE OF SERVICES, PRICING AND TERM AND AWARDING OF MEDI-CAL CONTRACT WITH THE MENTAL HEALTH PLAN OR THE DRUG MEDI-CAL. ODS IS MANAGED VIA THE COUNTY'S COMPETITIVE SOLICITATION PROCESS AND NOT THROUGH THIS LETTER OF SUPPORT. THIS LETTER OF SUPPORT IS NOT A GUARANTEE OF FUTURE FUNDING. SO THERE'S AN EXAMPLE OF A COUNTY WRITING A LETTER OF SUPPORT THAT IS EXPLICITLY NOT GUARANTEEING ANY FUTURE CONTRACT AND INDICATING TO THE APPLICANT THAT, LIKE ANYONE ELSE IN THE COUNTY WHO WOULD WANT TO PROVIDE MEDI-CAL SERVICES, THEY WILL HAVE TO GO THROUGH THAT PROCESS. AND THEN THE COUNTY AT THAT TIME CAN DETERMINE WHETHER OR NOT THEY WILL CHOOSE THEM AS A PROVIDER OF MEDI-CAL SERVICES. THAT LIABILITY IS ON THE APPLICANT. AND ULTIMATELY, IF AFTER A 5 OR 6 MONTH PERIOD WHEN THESE AWARDS ARE ANNOUNCED. IF THE COUNTY AT THAT POINT SAYS, WE'RE NOT GOING TO CONTRACT WITH YOU, MAYBE AND THEY ARE AWARDED THE CONTRACT SIGNATURE MIGHT SAY, OKAY, WELL, MAYBE WE WON'T DO THIS, AND THAT WILL BE UP TO THEIR PREROGATIVE TO FIGURE OUT. BUT THE APPLICANT, WHICH IS SIGNATURE, IS THE ONE THAT IS BOUND FOR 30 YEARS TO PROVIDE THE SERVICES. CAN I ASK YOU A QUESTION AS A PLUMMER? SO IN THE EVENT, AND JUST BECAUSE I KNOW YOU'RE A CONSULTANT AND I RESPECT YOUR OPINION, IF YOU'RE A FOR PROFIT COMPANY AND YOU CAN PUT A AND YOU CAN PUT SOMETHING IN AND SOMEBODY ELSE DOES HAVE TO PAY FOR IT, ARE YOU GOING TO SAY NO, IF THE MONEY, YOU KNOW, IF YOU BUILD IT, THE COUNTY'S CONTRACTUALLY HAS TO FOOT THAT BILL. ARE YOU GOING TO SAY, WELL, YOU KNOW, WE'RE JUST NOT GOING TO BUILD IT. THEY'RE FOR PROFIT. THEY HAVE SHAREHOLDERS. THEY'RE GOING TO BUILD THAT AND THEY'RE GOING TO SAY COUNTY. IT'S LIKE, YOU GOT TO PAY FOR IT, RIGHT? THEY WILL HAVE NO OBLIGATION. BUT THAT'S THE RISK. THAT'S THE RISK. SO THEY ARE OBLIGATED TO PROVIDE THE SERVICES. THEY CAN'T DICTATE TO THE COUNTY TO MAKE THE COUNTY PAY THEM WITHOUT A CONTRACT. I MEAN THE COUNTY, BUT THE STATE CAN. THE STATE CAN. THE STATE CAN DICTATE TO THE COUNTY THAT THEY HAVE TO PROVIDE SERVICES TO THIS APPLICANT. THAT'S WHAT YOU'RE SUGGESTING WOULD HAPPEN. NOT SUGGESTING. HAS THAT HAPPENED BEFORE? WE'RE GOING TO FIND OUT IN EIGHT MONTHS OR TWO YEARS. EIGHT MONTHS. AND THAT'S THE I MEAN THAT'S KIND OF A WILD SCENARIO. AND WITHOUT ANY PRECEDENT, WITHOUT ANY PRECEDENT, YOU'RE BASICALLY SAYING THAT THE STATE IS GOING TO STEP IN AND OVERRIDE THE COUNTY'S MEDI-CAL DETERMINATION ABILITY. AND, I MEAN, WE COULD HYPOTHESIZE A MILLION DIFFERENT THINGS THAT COULD BLOW THIS UP AND CAUSE ALL KINDS OF PROBLEMS. BUT WE HAVE TO LOOK AT WHAT'S MOST LIKELY AND WHAT IS ACTUALLY CONTAINED IN THE APPLICATION PROCESS TO DATE. AND THAT'S THE WHOLE THE BIGGEST QUESTION FOR ME IS YOU LOOK AT WHERE THE CITY OF REDDING'S BUDGET IS VERSUS THE COUNTY AND THE STEPS WE'VE TAKEN AND THE FIDUCIARY WORK THAT NOLDE IS SHORT. AARON BURTON, STUART BEUTEL, DAVE RICKERT HAVE DONE, AND THE HISTORY AND WHY IT HAS US HERE WHERE WE'RE TALKING ABOUT ALTERNATIVE CUSTODY. WE'RE TALKING ABOUT NOT LAYING PEOPLE OFF. AND THESE ARE THE MOMENTS THAT BURY A COUNTY, MUCH LIKE HOW IT'S BURIED THE CITY OF REDDING. SO I WOULD DISAGREE ACTUALLY, BECAUSE AND HERE'S WHY. BECAUSE THE WHEN WE HAD OUR PUBLIC SAFETY MEETINGS, EVERY AGENCY GOT UP HERE AND SAID THAT THEY WERE UNDERSTAFFED AND UNDER-RESOURCED. AND YOU KNOW AS WELL AS I DO THAT WE DO NOT HAVE THE ABILITY TO CHANGE THAT SIGNIFICANTLY IN THE FORESEEABLE FUTURE. THE ONLY WAY TO CHANGE THAT IS TO ACTUALLY REDUCE THE BURDEN ON THE SYSTEM. AND WE KNOW THAT 67% OF THE PEOPLE IN OUR JAIL ARE ON PSYCHOTROPIC MEDICATIONS. AND SO IF WE DON'T PREVENT THAT AND GET THEM OUT OF THE JAIL, WHICH IS A DIRECT DRAW ON OUR GENERAL FUND, UNLIKE THE SOCIAL SERVICES FUND AND THE MENTAL HEALTH FUND, THEN WE'RE GOING TO INCREASE THE BURDEN ON THERE BECAUSE WE'RE SENDING MORE MENTALLY ILL PEOPLE INTO OUR JAILS. BUT IF WE CAN PREVENT THAT, WE'LL ACTUALLY REDUCE THE BURDEN ON OUR JAILS AND ON OUR OVERALL CRIMINAL, THOSE PEOPLE AND THOSE BEDS. BUT AGAIN, THOSE BEDS, THOSE BEDS AREN'T GOING TO BE FULL. AND THAT'S WHAT WE'RE TRYING TO SAY. THEY DON'T HAVE THE DISTINCTION. THERE IS NO GUARANTEE THAT THOSE BEDS WILL BE FULL WITH THOSE INDIVIDUALS. AND THAT'S THE POINT. IT'S LIKE CIRCULAR. ALL RIGHT. KEEP GOING. I THINK I THINK IN ADDING TO THIS, WE ALL KNOW WHAT A CONTRACT IS. A CONTRACT INVOLVES AN AGREEMENT WITH SOME SERVICE PRODUCT, WHATEVER. AND THERE HAS TO BE COMPENSATION. THAT'S WHAT CONSISTS OF A CONTRACT IS MADE OUT OF. WE WILL HAVE THE OPTION WHETHER TO CONTRACT FOR THESE SERVICES ONCE WE FIND OUT IF THE AWARD IS EVEN GIVEN AND A LETTER OF SUPPORT. I DON'T BELIEVE AT THIS POINT FROM EVERYBODY I'VE TALKED TO. [02:15:03] IT DOES NOT COMMIT US OR BIND US TO ANYTHING. IT IS JUST A MEANS TO KEEP THE MONEY ALIVE AND KEEP THE PROJECT AS A POTENTIAL. WE DON'T EVEN KNOW IF IT'LL IT'LL PASS THE STATE'S PROCESS AND IT WILL BE AWARDED. THAT'S A BIG HURDLE. NEXT HURDLE IS IF IT IS AWARDED, THEN WE GET TO HAVE HAD SIX MONTHS TO FIGURE THIS OUT, TO FIGURE OUT. BUT A SIMPLE LETTER OF SUPPORT DOES NOT BIND US TO ANYTHING THAT IS NOT A CONTRACT, AND WE GET TO DECIDE THE CONTRACT PORTION OF IT AT A LATER TIME. SUPERVISOR PLUMMER. YEAH, I WANT TO ADDRESS THREE OTHER THINGS THAT HAVE COME UP THAT ARE A LITTLE BIT IN THE WEEDS, BUT I THINK IS HELPFUL SINCE WE'VE WE'VE MENTIONED THEM. ONE IS AND STORED THIS THAT WON'T BE FOR YOU. THANK YOU. THE THE ONE IS THE MEDICAL CLEARANCE PIECE, WHICH IS THE IDEA. AND I'M RELATIVELY NEW TO THIS TOO. BUT JUST SO EVERYBODY UNDERSTANDS WHAT WE'RE TALKING ABOUT IS THAT, YOU KNOW IF YOU DON'T HAVE MEDICAL CLEARANCE, THEY WOULD STILL HAVE TO TAKE FOLKS TO THE HOSPITAL AND THEN GET MEDICAL CLEARANCE AND THEN TAKE THEM THERE, WHICH WOULD BE PROBLEMATIC. AND I DO WANT TO POINT OUT THAT AND THIS ISN'T A CRITICISM OF MERCY, BUT IF YOU LOOK AT OUR AMBULANCE OFFLOAD TIMES, OUR OUR STATE STANDARD IS 30 MINUTES AND WE'RE CURRENTLY AT 45 MINUTES. AND PART OF IT IS BECAUSE OF THIS AND BECAUSE OF THE NUMBER OF PEOPLE CYCLING IN THERE THAT THEY'RE, YOU KNOW, NOT CAPABLE OF, OF, OR SET UP TO ADDRESS. SO MEDICAL CLEARANCE WOULD REQUIRE THAT INSTEAD OF GOING TO THE HOSPITAL FIRST, YOU WOULD BE ABLE TO GO DIRECTLY TO THIS FACILITY, WHICH WOULD BE A DRAMATIC IMPROVEMENT. AND FORTUNATELY, ONE MEMBER OF OUR BOARD IS ON THE SIERRA SACRAMENTO VALLEY EMS EMERGENCY SERVICES BOARD. THAT HAPPENS TO BE ME IN THIS CASE. AND SO WE'VE ACTUALLY HAD CONVERSATIONS WITH THEM BECAUSE THEY ARE THE ONES WHO CAN GET MEDICAL CLEARANCE. AND THERE WAS LEGISLATION PASSED IN THE LAST 2 OR 3 YEARS, I FORGET EXACTLY. THAT ALLOWS YOU TO GET MEDICAL CLEARANCE THROUGH THAT ROUTE. AND WE ACTUALLY HAVE A LETTER OF SUPPORT FROM JOHN POLAND, WHO'S THE DIRECTOR OF THAT EMS AGENCY, SAYING THAT THEY WOULD INTEND AND COMMIT TO GO THROUGH THAT PROCESS TO SECURE MEDICAL CLEARANCE. SO THAT IS SOMETHING THAT IS ALREADY IN THE PROCESS OF BEING RESOLVED AND WOULD MAKE A HUGE DIFFERENCE FOR OUR EMERGENCY ROOMS. THE NEXT TWO THINGS THAT I DID WANT TO COMMENT ON, AND THIS I'LL I'LL INVITE EITHER ALAN OR KIMBERLY UP BECAUSE THEY'LL BE ABLE TO SPEAK TO IT MORE. SO. BUT ONE IS THE IMD EXCLUSION. AND I KNOW THERE'S BEEN. BECAUSE THIS WOULD BE A HUGE RISK TO THE TO THE APPLICANT. I KNOW THERE'S BEEN CONVERSATIONS WITH THE STATE ABOUT THAT. AND SO I'D LOVE TO INVITE ALAN OR KIMBERLY UP TO, TO SPEAK TO THAT. AND THEN THE OTHER THING IS, IS THIS IDEA OF THE PRF VERSUS THE STR, WHICH IS A LOT OF ACRONYMS THAT YOU PROBABLY DON'T KNOW WHAT THAT IS. I DON'T EVEN KNOW WHAT THOSE STAND FOR EXACTLY. BUT BUT BUT BASICALLY THE DIFFERENCE IS A PRF IS A LOCKED FACILITY VERSUS AN STR. TP IS NOT. AND THE REASON THAT THAT'S MORE EXPENSIVE, AS YOU CAN IMAGINE, IS IT REQUIRES A LOT MORE STAFFING AND INFRASTRUCTURE. AND HERE'S WHY THAT IS IMPORTANT. YOU KNOW, THERE'S BEEN MENTION OF CONCERNS WITH WHAT WE CALL STR TPS IN THE PAST. AND IN FACT, BASED ON DATA, I WAS JUST PROVIDED BY COUNTY STAFF IN THE LAST WEEK, ONE OF OUR LOCAL STR TPS, WHICH IS TAKING PEOPLE FROM OUT OF THE COUNTY LIKE THEY ALL DO. EVERY ONE IS A REGIONAL ONE THAT IN THE LAST FISCAL YEAR, 15 PEOPLE FROM OUT OF THE COUNTY HAD TO BE TAKEN FROM THAT FACILITY AND THEN PUT INTO OUR JUVENILE REHABILITATION FACILITY. AND SO THAT IS THE POTENTIAL NEED FOR GOING TO A HIGHER LEVEL OF CARE SO THAT WE'RE NOT SPENDING THE MONEY THEN IN OUR JUVENILE REHABILITATION FACILITY SERVING THOSE FOLKS. BUT THE OTHER THING THAT'S IMPORTANT. THIS IS WHERE I WANT TO HAVE ALAN OR KIMBERLY SPEAK TO IT, IS THAT THERE WAS ALSO CONVERSATIONS WITH THE STATE THAT WOULD ALLOW FLEXIBILITY AS WE GET FURTHER ALONG TO CHANGE THAT LICENSE TYPE, IF THAT IF THAT IS NECESSARY OR DEEMED TO BE YOU KNOW, MORE SUITABLE FOR THE COMMUNITY. SO COULD ONE OF YOU COME UP? OR BOTH, IF YOU PREFER. SO, ALAN, COULD YOU FIRST SPEAK TO THE IMD EXCLUSION AND YOUR CONVERSATIONS WITH THE STATE ON THAT FRONT? WE DON'T HAVE ANY CONCERN ABOUT THE IMD EXCLUSION GETTING PAST THE STATE. TYPICALLY IT'S JUST THROUGH THE APPLICATION PROCESS. THERE ISN'T THERE'S THERE'S A CRITERIA THAT YOU HAVE TO MEET. AND IT'S VERY BASIC CRITERIA, AND MOST OF IT HAS TO DO WITH BED SIZE. SO, YOU KNOW, THE REASON THAT THE PUFF TYPE OF IMD EXCLUSION TYPE OF UNITS ARE SET UP IN [02:20:02] THE STATE IS SO THAT COUNTIES SUCH AS SHASTA COUNTY AND OTHER SMALLER COUNTIES CAN HAVE THAT MEDI-CAL FUNDING STREAM SO THAT THEY'RE NOT PAYING FOR AN IMD EXCLUSION TYPE OF FACILITY WHERE ALL THE FUNDING HAS TO COME THROUGH THE COUNTY. SO THAT'S THE THAT WAS THE THE PURPOSEFUL DESIGN OF THE 16 BED PUFFS WAS TO BE ABLE TO DRAW UPON MEDI-CAL FUNDING. AND YOU HAD. MY UNDERSTANDING IS THAT YOU ACTUALLY HAD A CONVERSATION WITH THE STATE ABOUT THIS PARTICULAR PROJECT AND LAST WEEK. YES. AND CAN YOU SHARE ANY KIND OF RECAP FROM THAT? I PERSONALLY WASN'T ON THE CALL. BUT MY COLLEAGUE ERIC KIM WAS ON THE CALL AND THEY WERE VERY, THEY FELT THAT THE PROJECT WAS VERY DOABLE. THERE WAS, THERE'S ANOTHER PUFF IN SAN MATEO THAT HAS 3 TO 4 DIFFERENT 16 BED PUFFS, VERY SIMILAR TO IT. AND THEY'RE VERY THEY SAID IT WAS A, THE, THE PATH HAS ALREADY BEEN FORGED AND THAT THEY FELT COMFORTABLE WITH, WITH WORKING WITH US ON THE PROJECT. THANK YOU. AND THEN AS FAR AS IT RELATES TO THE PRTF, MY UNDERSTANDING IS THAT THE STATE ACTUALLY PUT IN WRITING TO YOU ALL THAT YOU WOULD HAVE SOME FLEXIBILITY TO EVOLVE THAT AS IS NEEDED. YOU KNOW, IF AS WE GET FURTHER ALONG, BECAUSE NOT ONLY IS THERE THE APPLICATION WINDOW, BUT THEN THERE WOULD BE A CONSTRUCTION WINDOW BEFORE THIS WOULD BE OPERATIONAL THAT, YOU KNOW, THINGS WOULD EVOLVE. AND ONE THING I DO WANT TO COME BACK TO IS THE EVOLVING NEEDS THROUGH SENATE BILL 43, WHICH WE'LL GET TO IN A MINUTE. BUT COULD WE SPEAK TO THAT? I THINK KIM IS MORE EQUIPPED TO ANSWER THAT QUESTION. YEAH. SO THE Q AND A PROCESS WITHIN THE APPLICATION, YOU ACTUALLY HAVE TO SUBMIT A TICKET IN ORDER TO THEN GET A RESPONSE. AND SO ACTUALLY AFTER OUR MEETING THAT WE HAD WITH PAT AND YOU AND YOUR TEAM. WE SUBMITTED THIS VERY QUESTION, AND WE AND I'M HAPPY TO PROVIDE THAT LANGUAGE TO YOU OR ANY OF THE OTHER BOARD MEMBERS, ESSENTIALLY ASKING IF BY THE TIME WE GET TO A PLACE WHERE SIGNATURE IS LOOKING AT BEGINNING THE APPLICATION PROCESS WITH WITH ACTUAL LICENSURE, IF THE NEEDS EVOLVE, WHETHER IT'S AT A RESULT OF SB 43 OR OUR UNDERSTANDING OF LICENSURE TYPES, IF THERE'S AN EVOLUTION OF THAT, IS THAT GOING TO POTENTIALLY DISRUPT THE AWARD? AND WE GOT A FORMALIZED RESPONSE FROM FROM AHP AND DHS AND THEY SAID, NO, THERE'S FLEXIBILITY THERE. SO I DON'T WANT TO EXACTLY QUOTE THEM. I THINK IT'S REALLY IMPORTANT TO SHARE EXACT INFORMATION. SO I'M HAPPY TO PROVIDE THE EXACT LANGUAGE THAT WE ASK THE STATE. AND THEN THE RESPONSE THAT WE GOT, AND IT WAS IT WAS DESIGNED INTENTIONALLY FOR THIS PURPOSE SO WE COULD ENGAGE IN THOUGHTFUL DIALOG AND CONVERSATION. THANK YOU. AND THEN ONE KIND OF A DIFFERENT QUESTION. THIS IDEA OF THE LETTER OF SUPPORT, MY UNDERSTANDING IS THAT THERE WAS AN APPLICANT IN THE BAY AREA THAT ACTUALLY DID NOT GET A LETTER OF SUPPORT FROM THEIR COUNTY OF RESIDENCE, I'LL CALL IT, WHERE THE PROJECT WOULD BE LOCATED. AND THEN THAT, YOU KNOW, THAT'S IT'S NOT NECESSARY A REQUIREMENT THAT THERE'S ACTUALLY PRECEDENT FOR THAT NOT HAPPENING. AND SO IF WE CHOSE TO SAY, FOR EXAMPLE, OR IF CHRISTIE CHOSE, FOR EXAMPLE, TO NOT WRITE A LETTER OF SUPPORT THAT DOESN'T YOU KNOW, NECESSARILY, YOU KNOW, WE COULD REMAIN NEUTRAL AND THAT DOESN'T NECESSARILY DISQUALIFY THE PROJECT. YEAH. THAT'S CORRECT. BUT BECAUSE OF THE WAY THAT THE LANGUAGE IS WRITTEN WITHIN THE RFA, WE ACTUALLY REACHED OUT TO THE STATE TO TRY TO CLARIFY THIS FURTHER AS WELL. AND SO THERE WAS A PROJECT THAT WAS IN THE BAY AREA THAT DID NOT RECEIVE A LETTER OF SUPPORT FROM THEIR COUNTRY OF ORIGIN, BUT DID FROM THE SURROUNDING COUNTIES. NOW, I WANT TO MENTION ON THAT THAT WAS ACTUALLY WITHIN THE FIRST FIVE ROUNDS OF FUNDS THAT WERE SEPARATE FROM PROP ONE. SO I THINK THAT THAT, AGAIN, DESIGNATION MATTERS WITHIN THIS ONE IN PARTICULAR, IT WAS IT WAS THE THE FACT THAT WE HAVE SO MANY BEHAVIORAL HEALTH DIRECTORS, LETTERS OF SUPPORT IS CERTAINLY COUNTERBALANCING THE FACT THAT WE DO NOT HAVE OUR OWN. THAT BEING SAID, THE STATE LANGUAGE DOES REQUIRE THAT IF WE HAVE REQUESTED A LETTER OF SUPPORT AND WE DO NOT RECEIVE IT, THAT WE HAVE TO SUBMIT CORRESPONDENCE WITH THE THE IN THIS CASE, WITH DIRECTOR, WITH HHS DIRECTOR COLEMAN, AND ANY SORT OF CORRESPONDENCE THAT HAS HAPPENED OVER THE COURSE OF THE PROPOSAL PROCESS. SO WHEN WE GO TO SUBMIT ALL OF OUR LETTERS OF SUPPORT, WHICH I THINK RIGHT NOW WE'RE SOMEWHERE SITTING AROUND 50, SPECIFICALLY WITH HHS AYE DIRECTOR COLEMAN, WHAT WE ARE GOING TO BE REQUIRED TO DO IS SUBMIT ALL OF THE CORRESPONDENCE UP TO MOST RECENTLY OCTOBER 7TH, WHEN WE HAD AN EMAIL FROM HER SAYING THAT SHE WAS WORKING ON THE LETTER OF SUPPORT. SO WE WILL BE SUBMITTING ALL OF THAT DOCUMENTATION TO THE STATE. THANK YOU. CAN WE BRING CHRISTIE UP TO I WANT TO I WANT TO VERIFY THAT BECAUSE IF THAT'S TRUE, I WANT TO HEAR THAT. YEAH. WE CAN. I HAVE IT IN WRITING, BUT ABSOLUTELY. CHRISTIE, COME ON UP. SO YES, I DID EMAIL HER AND I SAID I WAS WORKING ON IT. HOWEVER, THE LETTER OF SUPPORT WAS NOT GOING TO BE A FULL LETTER OF SUPPORT. IT WAS GOING TO HAVE THE LANGUAGE IN THERE THAT WE DID NOT KNOW IF WE COULD CONTRACT WITH THIS ENTITY. AND I CHANGED A LOT OF LANGUAGE IN THE DRAFT THAT WAS SENT TO ME, SAYING THAT WE WERE NOT IN FULL SUPPORT OF THIS. OKAY. YEAH. SO, SO WALK ME BACK BECAUSE I KNOW IT'S BEEN PUT OUT THERE THAT THAT YOU [02:25:04] SUPPORTED IT IN APRIL AND IT WAS USED AGAIN IN SEPTEMBER BECAUSE I CALLED YOU WHEN I SAW THAT, AND THEN YOU GOT A LETTER OF APOLOGY, RIGHT? THAT THEY WEREN'T SUPPOSED TO USE THAT IN SEPTEMBER APPROVAL BEFORE THEY DID THAT PRESS RELEASE. TO ACTUALLY USE MY QUOTE. AGAIN, I GAVE MY QUOTE BACK IN APRIL ON THE INITIAL LIKE, HEY, THIS IS COMING. LIKE WE'RE ALL GOING TO WORK TOGETHER. AND UNFORTUNATELY, THE WORKING TOGETHER PART IS SOMETHING THAT HAS LACKED. AND SINCE THAT HAS LACKED AND THE LACK OF INFORMATION THAT HAS BEEN SHARED WITH HHS TO DETERMINE ANYTHING GOING FORWARD, THAT'S WHERE WE'RE HERE TODAY. ALL RIGHT. SO, MISS, MISS KIMBERLY JOHNSON COULD. SO IS THAT TRUE? DID YOU USE A QUOTE? AND THEN YOU SAID YOU'RE SORRY YOU WEREN'T SUPPOSED TO USE THAT. IS THAT CORRECT? YEAH. CHRISTIE GAVE A QUOTE. AND ARE YOU GOING TO LET ME CAN I FINISH THE SENTENCE? IS THAT OKAY? GREAT. SO CHRISTIE GAVE A QUOTE IN APRIL, AND I REACHED OUT TO HER VIA TEXT AND SAID, HEY, YOU KNOW, WE'RE GOING TO BE UPDATING THIS PRESS RELEASE. I NEED TO I JUST WANT TO RECONFIRM YOUR QUOTE. SO IT WAS VIA TEXT. AND THEN BEYOND THAT, WE HAVE IT IS MY UNDERSTANDING. WE HAVE A SEPTEMBER 15TH EMAIL FROM HER THAT WAS A VERIFICATION OF IT. THAT BEING SAID, I ABSOLUTELY HOLD ON. WHAT DO YOU MEAN UNDERSTANDING? LIKE HELP ME ON THAT. OKAY, SO WE'VE HAD WE'VE HAD 40 HOURS TO PREP FOR TODAY, INCLUSIVE OF TRYING TO REVIEW 30 PLUS EMAILS BACK AND FORTH TO THE COUNTY. AND SO I'M, I'M NOT GOING TO GET CAUGHT IN A POTENTIAL QUESTION. WHAT I WILL DO IS I WILL MAKE ALL EMAILS AVAILABLE TO ALL OF YOU AND TO THE PUBLIC. DID I ABSOLUTELY OWN THE FACT THAT WE REUSED A QUOTE OR WE USED A QUOTE THAT SHE HAD APPROVED IN A PRESS RELEASE? ABSOLUTELY. BECAUSE I'M GOING TO I'M GOING TO OWN IF THERE'S ANY POINT IN TIME WHERE I DO SOMETHING WHERE I FEEL LIKE IS NOT COMPLETELY ABOVE BOARD, THERE'S GOING TO BE OWNERSHIP OF THAT. AND SO I THINK THE ENTIRETY OF THE CORRESPONDENCE VERSUS LIKE A SMALL SNAPSHOT IS REALLY IMPORTANT. AND SO THAT'S THAT'S THE ANSWER TO THAT QUESTION. I APPRECIATE THAT. DOCTOR MU, COULD YOU COME UP PLEASE, SINCE I DON'T SEE AS MANY PEOPLE HERE WITH THE LETTER OF SUPPORT AND YOU KNOW. THAT'S NOT ACTUALLY TRUE. I DON'T KNOW IF YOU RECOGNIZE MANY OF THEM OUT THERE, BUT THEY ARE. NO I'M SORRY. YEAH. NO. ABSOLUTELY. ARE WE GOING? AFTER YOU AFTER YOU TALK WITH DOCTOR MU. I'D LIKE TO. I HAVE ANOTHER KIND OF LINE OF QUESTIONING BUT THAT'S FINE. HE'S ALREADY UP. YEAH. SURE. YEAH. WELL BECAUSE WE'RE TALKING ABOUT LETTERS OF SUPPORT. SO I'D LIKE TO JUST LINE THEM UP AND JUST KNOCK THEM DOWN AS WE TALK ABOUT IT. DOCTOR MU THANK YOU. WELCOME. AS OF LAST NIGHT I WAS SUPPORTING FOR THIS PROJECT UNDER TWO CONTINGENCIES. NUMBER ONE IS THAT OUR SPECIAL MENTAL HEALTH CLIENTS, INCLUDING THOSE WITH HIGH AND COMPLEX NEEDS, ARE BEING SERVED. AND NUMBER TWO, THAT THIS PROJECT WOULD COMPLEMENT WHAT'S CURRENTLY EXISTING, FILLING THE GAP AND MEETING UNMET NEEDS. AND AS OF THIS MORNING, I'M KIND OF SWAYING. AND WITH DIRECTOR COLEMAN'S CERTAIN OPPOSITION OR CONCERNS AND SHE'S VERY GOOD AT WITH HER JOB, AND I'M BEGINNING TO WONDER, WHAT AM I MISSING? SO AS OF NOW, I AM SUSPENDING MY SUPPORT AND TRY TO FIGURE OUT MORE INFORMATION. I WOULD LOVE TO TALK MORE WITH THE GENTLEMAN FROM WESTPORT. CHRISTY AND ALAN AND KIMBERLY. I'D LIKE TO TALK TO YOU SOME MORE. SO AGAIN, I'M NOT OPPOSING IT. I'M JUST SUSPENDING IT, FINDING OUT MORE INFORMATION. THANK YOU FOR BLESSING WITH THAT. THANK YOU. SUPERVISOR. PLUMMER. YOU DOCTOR MU. OBVIOUSLY YOU HAVE THE ABILITY TO DO WHAT YOU WANT. AND I THINK THAT'S SOMEWHAT DISAPPOINTING SINCE THAT YOU'VE BEEN INVOLVED THROUGHOUT THE PROCESS AND THE SHARK MEETINGS WHERE WE'VE GOTTEN MONTHLY UPDATES AND INCLUDING ALAN CUMMING SPEAK TO THAT. AND IT WOULD HAVE BEEN YOU KNOW IT WOULD HAVE BEEN GREAT IF YOU HAD SOUGHT OUT THOSE ADDITIONAL QUESTIONS THAT YOU MIGHT HAVE HAD IN ADVANCE RATHER THAN, YOU KNOW, DOING IT IN THIS CONTEXT AND ASKING FOR MORE TIME. BUT I DON'T, I DON'T HAVE ANY FURTHER QUESTIONS FOR YOU. I'D ACTUALLY LIKE TO BRING UP EITHER KRISTY OR SOMEONE FROM YOUR TEAM TO SPEAK TO SB 43. THANK YOU DOCTOR. OKAY. THANK YOU. I'M GOING TO BRING UP A VARIETY OF PEOPLE AS IT TOUCHES MANY ASPECTS. BASED ON YOUR QUESTION. WE'LL FIGURE OUT WHO'S GOING TO ANSWER THEM. GREAT. THANK YOU. SO I GUESS MAYBE FOR FOR THE PUBLIC FIRST TO JUST OFFER KIND OF A BRIEF EXPLANATION OF SB 43, WHAT IT IS AND WHAT WHAT IT CHANGES. AND THEN WHEN IS THE COUNTY RESPONSIBLE FOR HAVING TO IMPLEMENT THAT AND MAKE THAT CHANGE? SO SB 43 CHANGES THE DEFINITION OF GRAVELY DISABLED. WE ARE GOING INTO EFFECT JANUARY 1ST. WE HELD OUR FIRST SB 43 CONVENING MEETING ON MONDAY OF THIS WEEK. [02:30:03] IT'S HARD TO BELIEVE THAT WAS JUST ONLY A MONDAY. SO MONDAY OF THIS WEEK TO KIND OF HEAR FROM COMMUNITY STAKEHOLDERS OF KIND OF LIKE, YOU KNOW, THE THOUGHTS THAT WE PUT INTO THIS AND WHAT ARE WE MISSING? AND THE BIG THING THAT WE'RE MISSING IS SEED TREATMENT SPACE. AND THAT CONTINUES TO BE, YOU KNOW, A CONTINUED NEED THAT WE HAVE. AND THAT WAS EXPRESSED DURING THAT MEETING TO FROM MULTIPLE STAKEHOLDERS THAT, YOU KNOW, ARE PART OF SOME OF THE ENTITIES THAT ARE IN THIS ROOM TODAY. AND SO THAT IS A NEED FOR SB 43 BECAUSE IT DOES ADD THE COMPONENT TO THE GRAVELY DISABLED AND PART OF THE SB 432. THAT IS, IS A HIGH THING THAT'S UNKNOWN IS WHEN SOMEBODY COMES IN AND IS HELD ON THE SUD HOLD. ONCE THEY CLEAN UP IN THAT 72 HOURS, THEY PROBABLY WON'T MEET THE DEFINITION OF GRAVELY DISABLED ANYMORE. AND SO THEY WON'T HAVE A NEED TO STAY IN A LONG TERM FACILITY OR EVEN A SHORT TERM FACILITY. AND SO IT'S KIND OF A BIG UNKNOWN. AND EVEN TALKING TO COUNTIES THAT HAVE IMPLEMENTED THIS ALREADY, THEY HAVEN'T SEEN A HIGH GROWTH IN THEIR, IN THEIR REFERRALS THAT HAVE COME IN BEYOND, BEYOND THAT 72 HOURS BEYOND THAT. RIGHT. AND DO WE HAVE PROJECTIONS ON WHAT THE INCREASE IN OUR 72 HOUR HOLDS WILL BE? WE DON'T. OKAY. BECAUSE THIS WAS SOMETHING THAT I WAS TRYING TO FIND TO, YOU KNOW, AS WE'VE AS WE'VE BEEN TALKING ABOUT IT, BECAUSE BASICALLY IT WILL ALLOW US TO CONSERVE OR PUT A PLACE, A HOLD, A 72 HOUR HOLD ON A BROADER PORTION OF THE POPULATION AND SAN DIEGO COUNTY, WHICH MY UNDERSTANDING IS THAT THEY ARE ONE OF THE FIRST TWO COUNTIES TO IMPLEMENT THIS, THEY PROJECTED THAT IT WOULD INCREASE THEIR 72 HOUR HOLDS BY 1500 PEOPLE, WHICH IS A 12% INCREASE AND WHICH WOULD AMOUNT TO IN SHASTA COUNTY. BASED ON WHAT I SAW IN SOME PAST DATA, ABOUT 45 TO 50 ADDITIONAL 72 HOUR HOLDS. AND SO THAT'S, YOU KNOW, ANOTHER COMPONENT TO THIS THAT WILL WILL HAVE TO BE AS A COMMUNITY ADDRESSING AS EARLY AS JANUARY 1ST. OBVIOUSLY, YOU KNOW, IT WON'T CHANGE OVERNIGHT, BUT THAT WILL BE SOMETHING THAT WE ARE GOING TO QUICKLY BE UP AGAINST. AND CAN I SAY SOMETHING TO THAT TOO? SO WHAT'S STILL UNKNOWN, THERE'S LIKE A LOT OF UNKNOWNS TO US ABOUT THIS PROJECT. AND I UNDERSTAND LIKE A LOT OF PEOPLE IN THIS ROOM HAVE BEEN INVOLVED IN MEETINGS, BUT I HAVE NOT BECAUSE WHEN THOSE MEETINGS HAPPEN TO GIVE UPDATES, I'M IN SACRAMENTO AT STATEWIDE MEETINGS. AND SO I HAVE NOT BEEN ABLE TO ATTEND THE MEETINGS, AS WE TALKED ABOUT, BECAUSE I HAVE AN OBLIGATION TO BE IN SACRAMENTO FOR A STATE DIRECTOR'S MEETING, AND THEY FALL ON THE SAME DAY. SO I UNFORTUNATELY HAVE NOT BEEN ABLE TO ATTEND THE MEETINGS, NOR HAVE I BEEN KEPT UP TO DATE, OTHER THAN JUST RECEIVING AN EMAIL ABOUT THE DOCUMENT THAT WAS PRESENTED AT THE MEETINGS, NOT UNDERSTANDING WHAT WAS TALKED ABOUT VERBALLY, ANY OTHER PRESENTATIONS OR ANYTHING THAT GO BEHIND THAT. AND SO ONE OF THE THINGS THAT'S UNKNOWN IS EVEN IF THIS FACILITY WILL HAVE THE PUFF STUDY COMPONENT TO IT. AND SO THAT'S A BIG UNKNOWN THAT WE DON'T KNOW. AND SO YES, WE HAVE A NEED FOR STUDY BED SPACE AND POTENTIALLY PUFF STUDY BED SPACE. BUT AS WE HEARD FROM PAT ON MONDAY IN OUR SB 43 CONVENING, IT'S A HIGHER LEVEL OF ACTUAL TREATMENT THAT HAS TO BE PROVIDED. AND SO NOT KNOWING IF THIS IS GOING TO DO THAT, WE STILL ARE GOING TO HAVE TO LOOK FOR OTHER FACILITIES THAT WILL SERVE THAT POPULATION. SORRY, I DON'T THINK WE CAN. YEAH, WE CAN'T, WE CAN'T. WE CAN'T CALL OUT. WE CAN'T CALL OUT FROM THE FLOOR. PLEASE. THE IN TERMS OF ENGAGEMENT AND I YOU KNOW, I'M ON SHARK AS WELL. SO I KNOW THAT YOU HAVE THAT CONFLICT AND SCHEDULE AND YOU'RE ONLY ABLE TO MAKE THAT AUGUST 1ST, BUT I THINK IT'S A LITTLE YOU KNOW DISINGENUOUS TO SAY THAT YOU AS HHS WEREN'T INVOLVED BECAUSE BAILEY WAS PART OF THE SUBCOMMITTEE. AND MY UNDERSTANDING IS THAT YOU WERE ACTUALLY INVITED TO BE PART OF THAT SUBCOMMITTEE AND DELEGATED THAT TO BAILEY INITIALLY TO PARTICIPATE. IS THAT FAIR? THAT'S CORRECT. BAILEY IS PART OF THE AD HOC COMMITTEE, AND SHE HAS RAISED CONCERNS OF THIS PROJECT COMING IN. SHE HAS TOLD THEM WHAT THE NEEDS OF THE COUNTY ARE, AND IT IS NOT REFLECTED IN THE PROJECT PROPOSAL THAT WE SEE TODAY. YEAH. AND SO THOSE THOSE I WOULD SAY ARE TWO SEPARATE ISSUES, RIGHT? THERE'S ONE OF LIKE, WE WEREN'T INVOLVED, WHICH I'M I'M SUGGESTING THAT WELL, YOU HAD SOMEONE WHO ATTENDED, I THINK IT WAS 10 OR 11 MEETINGS OVER THE LAST, YOU KNOW, TEN MONTHS. AND, YOU KNOW, IN PARTICULAR, FROM MY UNDERSTANDING OF THE THE MINUTES FROM THOSE MEETINGS IS THAT THERE WAS ACCESS TO YOU KNOW, PRO FORMA DOCUMENTS. THERE WAS AN OFFER TO SHARE THOSE WITH ANYONE IN, IN THAT AD HOC. AND SO YOU KNOW, I'M TOTALLY FINE WITH THE COUNTY TAKING MORE TIME TO FIGURE THIS OUT. BUT ALSO, YOU KNOW, KIND OF, AS I SUGGESTED TO DOCTOR MU, GIVEN THAT THERE WAS PARTICIPATION IN THAT, WHERE THERE WAS BOTH AN INVITATION AND ACCESS TO THOSE FILES, IT WOULD HAVE BEEN GREAT AT THAT TIME. AND FOR THAT INFORMATION TO FLOW UP TO YOU IF THAT WASN'T HAPPENING FROM YOUR TEAM. SO NOW THE BUDGET DOCUMENTS ARE SOMETHING THAT I CONTINUE TO NOT BE, YOU KNOW, I DON'T KNOW ANYTHING ABOUT THE BUDGET. AND SO WITH THE PAYER MIX OF KNOWING, NOT KNOWING HOW MANY MEDI-CAL BENEFICIARIES THEY'RE GOING TO SERVE, THAT'S WHERE OUR COST ANALYSIS CAN'T BE DONE. [02:35:01] YOU KNOW, WITHOUT KNOWING THAT MIX AND KIND OF WHAT THEY'RE SAYING THEIR OPERATING BUDGET IS GOING TO BE. AND THAT'S PART OF THE APPLICATION THAT THEY'RE SUBMITTING ON TUESDAY. ARE THOSE BUDGET DOCUMENTS THAT SAY THEIR PAYER MIX AND HOW MUCH THEY'RE GOING TO SUPPORT WITH THE MEDI-CAL PARTICIPANTS IN OUR COMMUNITY. AND WE DID HAVE THAT CALL. THAT IS A BIG THING THAT GOES INTO A LETTER OF SUPPORT TO, AND A HIGH THING THAT WILL BE CONSIDERED WHEN THE APPLICATION IS PUT FORWARD IS THE MEDI-CAL PAYER MIX AND HOW THAT'S GOING TO ACTUALLY BE CONTRACTED OUT, RIGHT? ABSOLUTELY. YES. ALL RIGHT. THANKS, CHRISTY. I THINK, YOU KNOW, I KNOW WE COULD PROBABLY TALK ABOUT THIS FOR A LOT LONGER. WE'RE ALMOST HEADED TOWARDS LUNCHTIME, BUT AT THIS POINT, WHAT I WOULD LIKE TO DO IS I WOULD MAKE A MOTION THAT BOTH WE DO NOT SEND A LETTER OF OPPOSITION AND THAT WE ASK OUR DIRECTOR OF BEHAVIORAL HEALTH SERVICES TO REMAIN NEUTRAL ON THIS AND NOT SUBMIT A LETTER AND THEN ANY ADDITIONAL YOU KNOW, THE APPLICANT WILL HAVE TO EXPLAIN WHY THERE ISN'T A LETTER OF SUPPORT SINCE THAT WAS REQUESTED AND THAT CAN BE DONE, BUT THAT WE BASICALLY, AS A BOARD AND AS A COUNTY, WE REMAIN COMPLETELY NEUTRAL ON THIS TIME. AND WE GIVE OURSELVES THE NEXT ENSUING MONTHS TO DETERMINE YOU KNOW, WHAT THE COUNTY'S FORMAL POSITION ON THIS SHOULD BE. MATT, COULD I, COULD I PUSH BACK ON THAT JUST A BIT AND JUST HAVE YOU CONSIDER THAT THAT MOTION. I THINK WE'VE HAD IT DESCRIBED THAT THE LETTER OF SUPPORT FROM THE BOARD FROM BEHAVIORAL HEALTH CHRISTIE'S OFFICE IS ARGUABLY VITAL TO THIS PROCESS GOING FORWARD. SO I DON'T, I'M NOT REALLY SEEKING JUST A LETTER OF NEUTRALITY. I THINK THAT WE CAN GO FORWARD WITH A MEASURE OF SUPPORT AS THE BOARD. AND I KNOW I DON'T KNOW WHERE THIS IS GOING TO GO, BUT THE MEASURE OF SUPPORT WOULD WOULD NOT FORCE THE APPLICANT TO GO THROUGH ALL THE CORRESPONDENCE AS WE WERE DESCRIBING THEIR INTERPRETATION OF THIS. IF YOU LISTEN TO CHRISTIE COLEMAN'S INTERPRETATION, IT'S AN ABSOLUTE PROJECT KILLER. IF YOU LISTEN TO ARCH COLLABORATIVE'S VERSION OF THIS, THE LETTER OF SUPPORT CAN BE WORKED AROUND IF THEY DON'T GET IT, BUT IT'S GOT A LOT OF THEY'LL HAVE TO SUBMIT CORRESPONDENCE AND ALL KINDS OF DIFFERENT EMAILS AND THINGS LIKE THAT. SO I WOULD ACTUALLY REQUEST THAT YOU CONSIDER MAKING A MOTION OF SUPPORT FOR THIS PROJECT. AND ARE YOU FROM THE BOARD OF SUPERVISORS? CORRECT. I MEAN, I WOULD BE HAPPY TO DO THAT. OBVIOUSLY, I'VE SENT MY OWN LETTER OF SUPPORT FOR THIS PROJECT. AND SO YOU KNOW, I WOULD BE, I WOULD BE HAPPY TO YOU KNOW, IF YOU WANT TO MAKE THAT MOTION, I'D BE HAPPY TO SECOND IT. OKAY. SO I WILL MAKE A SUBSTITUTE MOTION TO THE ORIGINAL MOTION TO ACTUALLY CREATE A LETTER OF SUPPORT FOR THIS PROJECT GOING FORWARD, RECOGNIZING THAT IT DOES NOT IN ANY WAY OBLIGATE US, BUT IT KEEPS THIS PROJECT POSSIBILITY ALIVE. I'LL SECOND THAT. ALL RIGHT. COUNSEL LARMER. MR. CHAIRMAN, I JUST WANTED TO CONFIRM WITH THAT MOTION. THAT WOULD BE A LETTER FROM THE BOARD AND NOT FROM THE BEHAVIORAL HEALTH DEPARTMENT. CORRECT. IT'S FROM THE BOARD. AND THAT WOULD HAVE TO COME BACK BECAUSE WE DON'T HAVE ONE WRITTEN. AND THAT WAS YOUR INTENT? SUPERVISOR I'M GUESSING. WELL, ACTUALLY IF IF THE REQUIREMENT IS THAT IT COME FROM BEHAVIORAL HEALTH, I THINK THE BOARD COULD DIRECT BY, BY APPROVAL TO HAVE THEM WRITE THAT LETTER. IS THAT NOT RIGHT? NO. SO BEHAVIORAL HEALTH DIRECTOR IS A POSITION THAT IS STATE APPROVED. AND ULTIMATELY SHE WOULD SHE WOULD HAVE HER OWN FREE REIGN THERE. THE BOARD COULD SEND THEIR OWN LETTER OF RECOMMENDATION OF APPROVAL, THOUGH, OR THEY COULD HAVE WRITTEN THEIR OWN LETTER OF OPPOSITION. CORRECT. SO BUT THIS WAS BROUGHT TO THE BOARD FOR, FOR DISCUSSION AND FOR ACTION. AND WHAT'S BEFORE WHAT WAS PUT ON THE AGENDA IS FOR FOR THE BOARD TO DRAFT A LETTER. OKAY. OKAY. SO SO SO IF THERE'S THREE VOTES TO DO THAT, A STAFF AND PERFECT, PERFECT. LET'S LET'S LET'S TAKE THE VOTE. THE LETTER WOULD BE FROM THE BOARD. YEAH. ALL RIGHT. SO WE HAVE A FIRST AND A SECOND. THAT'S A SUBSTITUTE MOTION. WE WILL TAKE THAT IN A BIT. SUPERVISOR. HARMON. WELL AND I THERE WAS NO SECOND I BELIEVE ON MY MOTION. SO I DON'T THINK IT'S A. WELL NO NO HE. THAT'S CORRECT. BUT WE ALSO HAD A MOTION WHEN THIS ITEM FIRST BEGAN. SO IT WOULD STILL BE CONSIDERED A SUBSTITUTE MOTION. CORRECT. LOOK AT THAT STAFF. RIGHT. GOT IT. ALL RIGHT. HARMON. SO I WOULD JUST LIKE SOME MORE CLARITY BECAUSE I WHAT'S THE DIFFERENCE. NO, NO. WHAT IS WHAT IS THE ORIGINAL MOTION. ORIGINAL MOTION IS TO IS TO APPROVE THE LETTER THAT'S IN THE STAFF REPORT. [02:40:01] SUPERVISOR LONG'S SUBSTITUTE MOTION IS TO SEND A LETTER OF SUPPORT FOR THE PROJECT, NOT A LETTER OF SUPPORTING CHRISTIE COLEMAN AGAINST THE PROJECT. OKAY, SO I'M GOING TO I'M GOING TO GO AHEAD AND TAKE MY TIME AT THIS POINT. MISS COLEMAN, CAN YOU COME UP, PLEASE? THERE'S BEEN A THERE'S BEEN A LOT OF THINGS SAID A LOT. AND, AND I GOT TO TELL YOU THE GENTLEMAN, WHICH I DON'T KNOW WHAT FIRST NAME. KURT. KURT. KURT FROM WESTPORT. I APPRECIATE YOU COMING, BECAUSE WHEN PEOPLE. I MEAN, I'VE GOT SO MANY NOTES HERE, BUT PEOPLE TALK ABOUT COURAGE AND ALL THAT STUFF. COURAGE IS STEPPING INTO A ROOM THAT, YOU KNOW, IS GOING TO BE HOSTILE, AND YOU GET UP AND SPEAK TRUTH. SO I APPRECIATE THAT. MISS COLEMAN, IS THERE ANYTHING THAT YOU WANT TO REFUTE? BECAUSE EVEN THE SUBSTITUTE MOTION WE HAVE, I MEAN, ONCE THE HAT, ONCE THAT BARN DOOR FLIES OPEN AND THE HORSE IS OUT, THAT'S IT. IT'S OUT, IT'S OVER. AND SO EVEN JUST THAT SUBSTITUTE MOTION SCARES ME BECAUSE THERE ARE TOO MANY. THERE ARE TOO MANY UNKNOWNS STILL. SO IS THERE ANYTHING YOU'D LIKE TO REFUTE OF ALL THE THINGS THAT WERE SAID THAT YOU FEEL WERE THE MOST IMPORTANT? THERE'S ACTUALLY A LOT. AND SO I SAT HERE AND I TOOK A LOT OF NOTES AND LISTENED TO WHAT EVERYBODY HAD TO SAY, INCLUDING ALL THE BOARD. AND SO I WANT TO START BY SAYING, WE'RE NOT SAYING WE DON'T HAVE A NEED. THAT'S THE VERY FIRST THING I WANT TO SAY, BECAUSE A LOT OF PEOPLE SAID, WE ARE COMING UP HERE SAYING, WE DON'T HAVE A NEED, WE HAVE A NEED. WHAT I'M SAYING IS THIS IS NOT THE NEED WE HAVE, AND A FACILITY LIKE THIS WILL IMPACT OUR TEAMS INTERNALLY. IT WILL IMPACT OUR UMCA TEAM, IT WILL IMPACT OUR PATIENTS RIGHTS TEAMS. AND THOSE ARE JUST TWO OF OUR TEAMS THAT ARE TINY TEAMS THAT WILL HAVE TO GROW BECAUSE WE ARE THE MEDICAL ADMINISTRATOR FOR THE COUNTY. WE HAVE REQUIREMENTS AND OBLIGATIONS TO ANYBODY SERVING MEDI-CAL PATIENTS TO ACTUALLY MAKE SURE THEIR RIGHTS ARE NOT BEING VIOLATED. AND SO REGARDLESS OF WE HAVE A CONTRACT WITH THIS ENTITY, HRSA TEAMS WILL STILL HAVE TO GROW BECAUSE OF OUR ADMINISTRATIVE RIGHTS FOR THE MEDI-CAL PROGRAM HERE IN OUR COUNTY. ANOTHER THING THAT I WANT TO SHARE IS, LIKE I SAID, I HAVE NOT ATTENDED THE MEETINGS. BAILEY HAS SHARED A LOT OF CONCERNS AND NEEDS. AND ONE THING THAT SHE HAS SHARED IS THAT IT DOESN'T THEY DON'T LISTEN TO WHAT WE ACTUALLY SAY. AND SO WE'VE TRIED TO SAY A LOT OF THINGS IN THESE MEETINGS AND NOTHING HAS BEEN HEARD. AND UNFORTUNATELY, YOU KNOW, WE'RE HERE TODAY. EMPLOYEES ARE NOT MY ONLY CONCERN. MY CONCERN IS MY EMPLOYEES AND GROWING OUR TEAMS AND ACTUALLY HOW THAT'S GOING TO IMPACT OUR BUDGETS. MY JOB IS TO MAKE SURE I'M BEING FINANCIALLY RESPONSIBLE FOR OUR BUDGETS AND MAINTAINING AND WORKING IN THE REVENUE THAT WE RECEIVE, AND GROWING OUR TEAMS FOR A FACILITY THAT WE DON'T HAVE A NEED FOR AND POTENTIALLY CAN'T PLACE CLIENTS HERE IS A BIG CONCERN FOR ME. AND SO I WOULD ASK THE BOARD TO, ARE YOU GOING TO SUPPORT THOSE POSITIONS WITH GENERAL FUND AND GOING ON? I WOULD SAY THAT, YOU KNOW, THE ENTITIES THAT WERE LISTED THAT WERE INVOLVED IN THE DEVELOPMENT OF THIS PROJECT DIDN'T INCLUDE HRSA. HRSA WAS NOT MENTIONED WHEN THEY CAME UP AND SAID THE ENTITIES THAT WERE INVOLVED IN THE DEVELOPMENT OF THIS. SO WE WERE NOT INVOLVED IN OUR AND WHAT OUR NEEDS ARE AND WHAT OUR VOICES ARE FOR THIS PROJECT. COUNTIES, THE LETTER OF SUPPORT DOES STATE, YOU KNOW, THAT WE HAVE TO HAVE THAT LETTER OF SUPPORT FOR THIS PROJECT TO GO FORWARD. RASPAD. YOU KNOW, DID SAY THAT THEY HAVE BEDS AND THEY ARE CONTRACTED BY OTHER COUNTIES, AND THAT IS A THING. AND THAT WILL HAPPEN HERE WITH THIS FACILITY AS WELL. AND EVEN THOUGH, YOU KNOW, THERE ISN'T A GUARANTEE THAT THEY WILL GO BACK TO THEIR OTHER COUNTIES IF THEY DON'T GO BACK TO THEIR OTHER COUNTIES, THEY CAN'T JUST BE HELD WHEN THE HOLD IS UP. AND SO THEY DO HAVE THE OPPORTUNITY TO, TO WALK OUT THE DOOR AND NOT WAIT FOR THEIR COUNTY TO COME PICK THEM UP. WE WOULD HOPE THAT THEY DO. BUT THERE IS THAT THAT OPTION THAT THEY DON'T, THEY CAN WALK OUT. THE UNINTENDED CONSEQUENCES, YOU KNOW, OF CLIENTS COMING FROM OTHER COUNTIES WILL IMPACT MULTIPLE AREAS. IT WILL IMPACT OUR SOCIAL SERVICES BUDGET, WHICH IS, WHICH IS A HIGH CONCERN RIGHT NOW FOR THE BOARD. WE'VE BEEN HERE MULTIPLE TIMES TO TALK ABOUT THAT BUDGET AS WELL, AS WELL AS OUR MENTAL HEALTH BUDGET, BECAUSE IF THEY BECOME OUR MENTAL HEALTH CLIENTS HERE FOR THE COUNTY, WE THEN ARE REQUIRED TO SERVE THEM WITH OUR INTERNAL STAFF AS WELL AS OUR BUDGET FOR THE COUNTY. THIS FACILITY WILL COMPETE WITH OUR CURRENT FACILITIES THAT WE HAVE HERE. AND SO, YOU KNOW, HEARING THAT THIS WON'T WON'T AFFECT THE CURRENT FACILITIES THAT ABSOLUTELY WILL AFFECT THE CURRENT FACILITIES. AS WE HEARD FROM RASPAD TODAY THIS FACILITY WILL NOT SERVE EVERY NEED. AND SO WE HEAR ALL THE TIME THAT THERE'S THIS GREAT COMMUNITY NEED. AND ONE THING THAT I ADVOCATE FOR AND MAKE SURE I EDUCATE EVERYONE WHERE I GO IS THAT THE COUNTY DOESN'T SERVE EVERY SINGLE COMMUNITY MEMBER FOR MENTAL HEALTH SERVICES. WE SERVE THE MODERATE TO SEVERE POPULATION. WE DON'T SERVE THE MILD TO MODERATE. AND SO A LOT OF THE TIMES WHERE YOU SEE PEOPLE OUT ON THE STREET, THOSE ARE NOT THE CLIENTS THAT WE WOULD BE SERVING. AND SO IT WON'T HAVE THAT CONSEQUENCE OF CLEANING UP OUR STREETS LIKE WE HEARD TODAY. NOT EVERY CLIENT WILL FILL THESE BEDS, BECAUSE THERE'S ONLY PARTICULAR CLIENTS THAT WILL QUALIFY TO GO INTO THIS BED SPACE. SO YOU'RE SAYING IT'S NOT A QUALITY OF LIFE ISSUE? NO, NO, THERE'S A LOT OF THERE'S A LOT OF THINGS THAT GO INTO WHY SOMEBODY IS EITHER HOMELESS OR, OR HAVING, YOU KNOW, AN ISSUE THERE, A SUD OR THEY HAVE MENTAL [02:45:02] HEALTH THINGS GOING ON. THERE'S A LOT OF THINGS THAT GO INTO IT. AND IF YOU TALK TO OUR CLINICAL TEAM, THEY'LL TELL YOU MORE ON THAT AND THEY'LL HAVE THE DETAILS. OUR CLINICAL TEAM WAS NOT TALKED TO ABOUT THIS FACILITY AT ALL. AND SO THAT'S ANOTHER CONCERN TOO. I TALKED TO THEM ABOUT THE FACILITY BECAUSE OF COURSE, I TALKED TO ALL OF MY STAFF AND GET INFORMATION AND BUY IN AND COMMUNICATE AND MAKE SURE THAT I'M ASKING THE RIGHT QUESTIONS AND ASKING THE RIGHT TEAMS THAT THIS WILL IMPACT US. AS FAR AS LIKE THE, THE LEVEL OF NEED FOR CLIENTS WHEN THEY ARE PLACED. LIKE, YES, WE DO PLACE CLIENTS IN FACILITIES AND YES, THINGS DO HAPPEN, BUT WE CANNOT PLACE THEM IN A HIGHER LEVEL OF CARE IF THEY DON'T NEED THAT, IF THEY DON'T MEET THAT CRITERIA. AND SO, YOU KNOW, WE CAN'T JUST SAY YOU CAN'T GO INTO AN STP BECAUSE WE THINK SOMETHING WILL HAPPEN. THEY ACTUALLY HAVE TO MEET THE CRITERIA TO GO INTO THAT HIGHER LEVEL OF CARE. AND SO THERE'S NO GUARANTEE THAT THE CLIENTS THAT END UP IN OUR JEFF ACTUALLY WOULD HAVE QUALIFIED FOR THAT HIGHER LEVEL OF CARE. THERE'S NO WAY TO GUARANTEE THAT IT'S A CASE BY CASE BASIS. AND HANG ON ONE SECOND. THIS, YOU KNOW, AS FAR AS LIKE THE APPLICATION GOES WITH THE PAYER MIX, WE HAVE TO BE ABLE TO HAVE MEANINGFUL CONVERSATIONS TO SEE WHAT THE BUDGET DETAIL IS FOR THIS PROGRAM. I HAVE NOT SEEN THAT BUDGET MIX TO KNOW WHAT THE MEDI-CAL PAYER MIX WILL BE FOR THAT. AND THAT'S THE BIG CONCERN THAT I HAVE. HAVE YOU ASKED FOR IT? I HAVE ASKED FOR IT AND I HAVE. I DON'T HAVE IT. I'VE ASKED THE OTHER ENTITIES THAT ASKED FOR A LETTER OF SUPPORT, AND I HAVE THEIR GRANT INFORMATION AS WELL AS THEIR BUDGET INFORMATION. I DON'T HAVE THIS FOR THIS FACILITY. AND THIS FACILITY IS BIG. IT'S MASSIVE. AND THE, YOU KNOW, THE ENTITIES THAT RECEIVE THAT WANT SUPPORT FROM THE COUNTY, THEY REALLY SHOULD GET THE COUNTY INVOLVED. AND SO IF THEY WANT A LETTER OF SUPPORT FROM THE COUNTY AT THE END, THEY NEED TO INVOLVE THE PARTIES THAT ARE GOING TO BE RESPONSIBLE FOR WRITING THAT LETTER OF SUPPORT. ALL RIGHT. WELL, I THINK I MEAN, YOU'VE I MEAN, I'VE GIVEN YOU QUITE A BIT OF TIME TO REFUTE ANYTHING YOU WANT. YOU KNOW, ONE OF THE THINGS FOR ME OF MANY OF THESE YOU YOU LOOK AT FOR ME, I KNOW SUPERVISOR PLUMMER YOU HAD MENTIONED ABOUT THE $50 MILLION THAT WE'VE REALLOCATED OR PULLED TO COVER DIFFERENT FUNDS AS WE VOTE ON THESE TYPES OF THINGS WHERE IT'S A RETROACTIVE AGREEMENT TO COVER SOME SHORTFALL THAT WE HAVE TO DO BECAUSE THEY HAVE YOU KNOW THERE WAS AN OVERAGE. THE THING AND I AGREE WITH THAT. AND THAT MAKES ME WINCE. AND, YOU KNOW THE, THE WORD RETROACTIVE JUST MAKES ME GRIT MY TEETH AND CRINGE EVERY TIME BECAUSE I WANT TO BE PROACTIVE AND GET AHEAD OF IT. THE ONE THING, AND THIS IS WHAT REALLY DRIVES IT HOME WITH ME, WITH NOELLE DE SHORT AND STEWART BEUTEL AND DAVE RICKERT AARON BURTON IS THAT WHEN WE MOVE THAT MONEY WITH THE STAFF REPORT, THEY SEE A LOT OF THOSE THINGS COMING SIX, 12, 18, 24 MONTHS OUT. SO THEY'RE READY FOR IT. THEY CAN ADJUST IT. THERE'S AN AUDIBLE TO BE CALLED, BUT THAT WAS GAME PLANNED WEEKS, IF NOT MONTHS IN ADVANCE. WHAT THIS IS, IS THIS IS SHOWING UP AND WE HAVE NO ABILITY TO PLAN FOR THIS. SO FOR ME, IF WE WERE TO SUPPORT THIS, I WOULD PULL ALL SUPPORT FROM THE ALTERNATIVE CUSTODY PROGRAM BECAUSE I BELIEVE THIS IS A BATTEN DOWN THE HATCHES BECAUSE WE DON'T KNOW WE DON'T KNOW WHAT THE FUTURE HOLDS. AND I'M NOT GOING TO PUT US IN A SITUATION THAT THE CITY OF REDDING IS IN RIGHT NOW WITH THEIR BUDGET SHORTFALL AND WHAT'S ON THE BALLOT. AND THAT'S WHAT THIS COMES DOWN TO, BECAUSE I THINK YOU MADE A GREAT POINT ABOUT THE $50 MILLION. AND I, I GET THAT, BUT I KNOW YOU'VE POURED OVER THOSE STAFF REPORTS AND YOU UNDERSTAND WHERE THE MONEY COMES FROM. AND EVERY SINGLE TIME WE USUALLY THROUGH CONVERSATION, WE ALL AGREE THAT, YEAH, IT HAS TO BE DONE. IT SUCKS, BUT IT IS WHAT IT IS. THIS BOARD SUPPORTED MISS COLEMAN'S APPOINTMENT FIVE ZERO. AND IF I REMEMBER RIGHT, AND I DON'T I DIDN'T GO BACK AND WATCH THE VIDEO, BUT WHAT WE DID WAS WE ALL GAVE MISS COLEMAN AN OPPORTUNITY. I THINK IT WAS I DON'T KNOW IF IT WAS THREE MONTHS OR SIX MONTHS, BUT WE SAID, LET'S LET HER BE THE INTERIM. LET'S SEE WHAT SHE DOES. LET'S SEE WHAT QUESTIONS SHE ANSWERS. LET'S SEE HOW FIDUCIARY SHE IS, THE CUTS SHE MAKES, HOW SHE STREAMLINES THE DEPARTMENTS. AND SHE DID THAT WONDERFULLY. AND ALL FIVE OF US AGREED THAT HER LEADERSHIP WAS EXACTLY WHAT WAS NEEDED WHEN IT WAS NEEDED. AND NOW, BECAUSE THERE'S POLITICAL PRESSURE TO MAYBE GO A DIFFERENT ROUTE. AND THEN WE TALK ABOUT THE $200 MILLION. I AGREE SUPERVISOR LONG IT IS SO TOUGH. BUT ONE THING I'VE LEARNED IN NEARLY THREE YEARS OF SITTING HERE. IF THEY SAY IT AIN'T FREE IT COSTS TWICE AS MUCH AS WE THINK AND ASK. CAN I ASK YOU A QUESTION ON THAT? ABSOLUTELY, SIR. SO WHY ARE YOU THREATENED BY ALLOWING THIS PROCESS TO GO UNTIL THE SPRING AND SEE? JUST JUST LET ME FINISH THE QUESTION. OKAY. TO GO UNTIL THE SPRING AND SEE IF IF THE AWARD IS EVEN GIVEN. AND THAT GIVES US SUFFICIENT TIME, NOT THE RUSHED. [02:50:01] ONE DAY THAT WE GOT HERE TO THINK ABOUT ALL THE IMPLICATIONS ON THIS, AND TO ADDRESS EVERY IMPLICATION, AND TO DECIDE WHETHER WE WANT TO SUPPORT THIS ENDEAVOR OR WHETHER WE WANT TO SUPPORT A CONTRACT WITH THEM IF WE DON'T CONTRACT WITH THEM. THAT'S A GREAT QUESTION. THEY WILL BE PROBABLY NOT GOING FORWARD WITH THE PROJECT IF THE COUNTY TEAMS. BUT WHY WOULD WE THROW AWAY? CAN I ANSWER THE QUESTION YOU'VE ASKED? IT'S A IT'S A LONG QUESTION. WHY WOULD WE THROW AWAY $200 MILLION AND NOT JUST BY OURSELVES? BY OURSELVES? A LITTLE EXTRA TIME, I'LL SAY EXACTLY WHY. AND THAT'S A THAT'S A GREAT QUESTION. AND I AND I APPRECIATE YOU ASKING IT. SO HERE'S THE THING. SOME OF YOU GUYS, IF YOU COULD NOT GROAN, I'D APPRECIATE IT, BECAUSE THE GENTLEMAN, MR. LONG OR SUPERVISOR LONG ASKED ME. SO I'M GOING TO ANSWER IT LIKE THIS. AND WE. I TALK ABOUT MY GUT, THE BOOK. THERE'S A THERE'S A GUY IN THE BIBLE NAMED JOSHUA AND HE WAS PURSUING. OKAY, HERE WE GO. THE MOANERS. SO THERE'S A STORY WHERE THERE WAS THREE KINGS THAT WERE BEING PURSUED, AND THEY HID IN A CAVE, AND THEY BROUGHT THE THREE KINGS OUT. AND THEY WENT TO JOSHUA AND SAID, WHAT SHOULD WE DO WITH THEM? AND HE TOOK OUT HIS SWORD, AND HE RAN IT THROUGH THE BACK OF THEIR HEAD. AND HERE'S WHAT THAT SYMBOLIZES. YOU DON'T ENTERTAIN WHAT IS EVIL, WHAT IS WRONG, WHAT IS NOT THE RIGHT PATH. AND HERE'S HOW THIS RELATES TO ME. WHEN I'VE BEEN LETTING THIS GO, I KNEW THIS WAS COMING. I MEAN, WE'VE TALKED ABOUT THE LETTER. I WASN'T I WASN'T UNAWARE LIKE SUPERVISOR PLUMMER MENTIONED. I MEAN, I'VE BEEN TO WORKSHOPS. I'VE HAD PEOPLE TALK TO ME A LITTLE BIT ABOUT IT AND WHAT I KNEW. I SAID, YEAH, I'M NOT SUPPORTING ANYTHING THAT AYE IS GOING TO POSSIBLY COST THE COUNTY UNTOLD MONEY. AND B, I'M NOT INTERESTED IN TAKING OTHER PEOPLE'S INDIVIDUALS HERE BECAUSE YOU DID HEAR, RIGHT, SOME OF THE SPEAKERS CAME UP AND SAID, DON'T WE CARE ABOUT OUR NEIGHBORS IN BUTTE AND GLENN AND TRINITY? I DO, BUT YOU KNOW WHO I CARE ABOUT MORE. I CARE ABOUT SUSAN AND HER NEIGHBORS IN DISTRICT ONE, IN DISTRICT TWO, THREE, FOUR, AND FIVE. I CARE ABOUT SHASTA COUNTY FIRST. SO HERE'S THE POINT OF WHY I SAID WE GOT TO DO THIS LETTER BECAUSE I DON'T WANT ANY CHANCE OF ANY SHELL GAME IN ANY WAY AT THE STATE LEVEL. SOMETHING HAPPENING AT THE LAST MINUTE WHERE THE THE APPLICATION, WHAT IS NEEDED FOR APPROVAL ALL OF A SUDDEN BECOMES A BAIT AND SWITCH. YOU SAW THE ARCH COLLABORATIVE REPRESENTATIVE, MISS JOHNSON AND SUPERVISOR PLUMMER ACTUALLY DISAGREEING A LITTLE BIT ON THAT COMPONENT. AND THAT IN OF ITSELF SCARES ME. SO IF THERE'S ANY WAY, SHAPE OR FORM, ANY GLIMMER THAT WE CAN KILL THIS NOW, I DON'T WANT TO ENTERTAIN IT. I WANT TO PUT IT DOWN. I WANT TO PUT IT DOWN SO IT NEVER INFECTS OUR COUNTY. THAT'S HOW I FEEL. OKAY, THAT'S YOUR FIRST WARNING. OKAY, I APPRECIATE I APPRECIATE THAT ANSWER. AND I WOULD LIKE TO CALL CHRISTIE BACK UP. NOW, WHAT WE'RE TALKING IN THIS PROPOSAL, WHICH THE COUNTY IS NOT THE APPLICANT, THE THAT'S ANOTHER APPLICANT THEY'RE TALKING ABOUT. YOU WERE TALKING ABOUT QUALITY OF LIFE ISSUES AND SOME OF THESE SITUATIONS THAT OCCUR. SO YOU'RE AWARE IN THAT IN THEIR PROPOSAL, THEY'RE TALKING ABOUT CSU BEDS. CORRECT. CORRECT. AND AND THAT WOULD BE 12, I THINK, SPLIT BETWEEN ADULTS AND JUVENILES. I THINK THAT NUMBER IS CORRECT. I THINK IT WAS EIGHT AND FOUR. RIGHT? YEAH. IT CHANGES. OKAY. AND THEN THERE'S A POSSIBILITY IF SOMEBODY NEEDS MORE THAN THE 23 HOURS OF CARE, THEY GO TO THE THREE DAY FACILITY, WHICH IS THE 72 HOURS AND THEN GET STABILIZED. AND IT'S A CRISIS STABILIZATION UNIT. AND I WAS, YOU KNOW, I WAS I WAS POLICE MYSELF, RIGHT. AND I JUST KNOW WHAT WE DEALT WITH WITH 51 50S AND SOME OF THOSE PEOPLE THAT ARE IN THAT CRISIS STABILIZATION MODE AND TO HAVE A FACILITY TO DROP THEM OFF AND, AND TO NOT DROP THEM AT AN E.R. WHERE THEY SIT FOR SOMETIMES THEY CAN BE DAYS THERE, AND THEN THEY GET SHIPPED TO SOMEWHERE ELSE. WE CAN ACTUALLY GET THEM THE STABILIZATION TREATMENT RIGHT NOW. AND SO I THINK THAT IS A QUALITY OF LIFE ISSUE. AND THOSE ARE SOME OF THE THINGS. AND THE OTHER THING I WAS GOING TO DO YOU WANT TO RESPOND TO THAT AT ALL? YEAH. WITH THE, WITH THE CSU. SO WE HAVE ONE COMING ONLINE HERE LOCALLY. AND SO WHAT I WOULD ASK IS WHAT KIND OF NEEDS ASSESSMENT WAS DONE TO MAKE SURE WE ACTUALLY NEED THREE CSU'S COMING ONLINE IN OUR COMMUNITY BECAUSE 23 HOURS IS NOT LONG ENOUGH REALLY FOR A COUNTY DOWN SOUTH TO COME IN, GET THE CLIENT MEDICALLY CLEARED, DROP THEM OFF FOR 23 HOURS, GO HOME, AND THEN COME PICK THEM BACK UP. THE REGIONAL MODEL DOES NOT WORK FOR CSU, AND I KNOW WE HAVE A DIFFERENCE OF OPINION AS TO ALLOWING THIS PROJECT TO GO AND THEN SEE IF IT EVEN GETS AWARDED, AND THEN WE CAN MAKE ALL THESE OVER THE NEXT SIX MONTHS CALCULATIONS. AND THEN, YEAH, SO WHAT I WOULD SAY IS WHEN I'M AGREEING TO SOMETHING FOR 30 YEARS, LIKE I WANT TO KNOW THAT I KNOW WHAT I'M SIGNING MY NAME TO. I KNOW IT'S IN THE BUDGET. I KNOW WHAT I'M COMMITTING TO RIGHT NOW. I DON'T KNOW WHAT I'M COMMITTING TO. AND SO IF YOU WANT A LETTER OF SUPPORT FROM BEHAVIORAL HEALTH, I WOULD SAY THAT THE BOARD NEEDS TO HAVE SOME SORT OF DIRECTION AS TO WHY YOU GUYS ARE [02:55:01] GOING TO SUPPORT THE PROJECT FOR 30 YEARS. SO I FEEL COMFORTABLE KNOWING THAT IT WON'T FALL ON HRSA BUDGETS FOR 30 YEARS. AND THERE WILL BE SOME LEVEL OF COMMITMENT FROM THE GENERAL FUND TO MAKE SURE THAT THE GENERAL FUND CAN FILL IN, BECAUSE HRSA BUDGETS WILL NOT BE ABLE TO. RIGHT, RIGHT. AND WE'RE WE'RE STARTING TO BEAT THE DEAD HORSE HERE. SO SO MY LAST MY LAST STATEMENT WAS IF THIS COMES FROM BEHAVIORAL HEALTH AND THE BOARD LETTER ITSELF, WHICH WE'RE GOING TO TAKE A VOTE ON SHORTLY, IS NOT THE LETTER THAT IS NEEDED FOR THIS PROJECT. WHY ARE WE HERE? WHY, WHY ARE WE GOING THROUGH ALL THIS? IF THE BOARD BUY IN WAS NOT SIGNIFICANT FOR THE LETTER, I, I DIDN'T UNDERSTAND THAT. I THOUGHT IT WAS GOING TO BE A BOARD LETTER OF SUPPORT, BUT IT HAS TO COME FROM BEHAVIORAL HEALTH. IT HAS TO COME FROM BEHAVIORAL HEALTH. SO. SO I'M NOT SURE WHY WE'VE HAD THIS TWO HOUR DISCUSSION ABOUT A PROJECT. TAKE THE VOTE. THE BOARD DOESN'T EVEN WEIGH IN. SO I MEAN, UNLESS UNLESS WHAT YOU'RE SEEKING IS DIRECTION FROM OUR BOARD MAJORITY TO SAY GO FORWARD. BUT THAT SOUNDS LIKE WE ACCORDING TO COUNTY COUNCIL, WE'RE NOT ALLOWED TO DO WE CANNOT TAKE A VOTE AND TELL YOU WHAT TO DO. YOU MAKE THAT DECISION ON YOUR OWN. AND SO I'M NOT SURE WHY WE'RE HERE. ALL RIGHT. SO WE'RE GOING TO GO AHEAD AND TAKE THE VOTE AT THIS TIME. I JUST WANT TO MAKE ONE FINAL COMMENT. CHRISTY. IT'S NOT A QUESTION FOR YOU. SO THAT'S THANK YOU. YOU'RE GOOD TO SIT DOWN. SORRY. YEAH. I GUESS MY MY CLOSING COMMENT WOULD BE AND I'LL KEEP THIS BRIEF IS THAT YOU KNOW, THE NEED FOR THESE TYPES OF SERVICES IS CLEAR, BOTH FROM WHAT WE'VE HEARD TODAY FROM EVERY NEEDS ASSESSMENT FROM THE, YOU KNOW, COUNTLESS CONVERSATIONS THAT HAVE HAPPENED OVER THE LAST TEN MONTHS. IF YOU JUST LOOK AT THE PSYCHIATRIC BEDS PER POPULATION BASIS, THERE'S A CLEAR NEED FOR IT. AND WHAT I WORRY ABOUT, AND THIS WOULD BE THE CLOSING ANALOGY THAT I WOULD POINT TO IS YOU KNOW, AND SUPERVISOR MENTIONED THIS EARLIER THAT, YOU KNOW, A NUMBER OF YEARS AGO, WE HAD AN OPPORTUNITY TO GET FUNDING FROM THE STATE TO, TO BUILD A NEW JAIL. AND WE DIDN'T HAVE ALL THE QUESTIONS ANSWERED. AND SO WE SAID, NO, WE'RE GOING TO GIVE IT BACK. WE'RE NOT GOING TO EVEN TRY TO FIGURE THIS OUT. AND NOW WE'RE IN A WORSE POSITION BECAUSE OF IT. AND IF WE DON'T AT LEAST GIVE OURSELVES A CHANCE ON THIS FUNDING, BECAUSE WE HAVEN'T, THERE'S BEEN THERE'S BEEN SIX ROUNDS OF THIS ALREADY, AND WE HAVEN'T GIVEN OURSELVES A CHANCE. IF WE DON'T GIVE OURSELVES A CHANCE IN FIVE AND TEN YEARS, WE'LL TURN AROUND AND WE'LL LOOK BACK AT THE LEADERSHIP WHO WAS THERE AT THE TIME AND SAID THEY DIDN'T HAVE THE FORESIGHT, THEY DIDN'T HAVE THE VISION. THEY DIDN'T HAVE THE COURAGE TO TAKE A RISK AND TO BE WILLING TO FIGURE IT OUT AS THEY GO TO IMPROVE THE COMMUNITY. ALL RIGHT. SO WHAT I'M GOING TO WHAT I WOULD SAY. SUPERVISOR. PLUMMER. SO I'M GOING TO MAKE I'M GOING TO MAKE MY I'M GOING TO MAKE MY CLOSING STATEMENT ON THAT. IT'S WHEN YOU TALK ABOUT THE RISK, TWO PARTS RISK YOUR OWN MONEY. I'M NOT RISKING THEIR MONEY BECAUSE IT'S TAXPAYERS MONEY. THE SECOND PART IS THE REASON, HEY, THAT'S ENOUGH. THAT'S YOUR SECOND WARNING. THE REASON WE DIDN'T BUILD THE JAIL. AND THIS IS THE HORROR. THIS IS THE THE THE WORST PART ABOUT IT IS IT WAS POLITICS. IT WAS BECAUSE ONE SUPERVISOR DIDN'T GET ALONG WITH A SHERIFF. THAT'S WHAT YOU'RE DOING RIGHT NOW. NO, IT'S THE EXACT OPPOSITE. WE'RE GOING TO TAKE THE VOTE. WE HAVE THE WE HAVE THE SUBSTITUTE MOTION BY SUPERVISOR LONG TO SEND A LETTER OF SUPPORT SUPPORTING THE ARCH COLLABORATIVE PROJECT. AND THEN WE'LL TAKE THE SUBSTITUTE MOTION, WHICH WAS THE LETTER SUPPORTING OUR HHS DIRECTOR AS RELATED IN THE STAFF REPORT. SO WE'LL START TO MY LEFT WITH SUPERVISOR. MISS BLANKENSHIP, WILL YOU CALL THE ROLL CALL VOTE TO MY LEFT? SUPERVISOR LONG? YES. SUPERVISOR KELSTROM. I CAN'T VOTE AGAINST STAFF. NO, NO. OOPS, SORRY. SUPERVISOR. CRYE. NO. SUPERVISOR. HARMON. NO. AND. SUPERVISOR. PLUMMER. YES. ALL RIGHT. WE'RE GOING TO TAKE THE ORIGINAL MOTION, WHICH IS TO SEND THE LETTER OF SUPPORT OF OUR HHS DIRECTOR OPPOSING THIS PROJECT. WE'LL START TO MY LEFT WITH SUPERVISOR. LONG SUPERVISOR. LONG. NO. SUPERVISOR. KELSTROM. YES. SUPERVISOR. CRYE. YES. SUPERVISOR. HARMON. YES. AND SUPERVISOR. PLUMMER. NO PASSES THREE TWO. ALL RIGHT. MISS BLANKENSHIP, IS THAT ALL? YES. AND THAT AND THAT IS ALL WE HAVE. THIS MEETING IS ADJOURNED. * This transcript was compiled from uncorrected Closed Captioning.