Mar 06, 2024 Public Health Commission

UH, WE'LL MOVE ON TO THE APPROVAL OF MINUTES FOR THE PUBLIC HEALTH COMMISSION MEETING ON FEBRUARY 7TH, 2024.

I'M LARRY FRANKLIN, BLACK LIVES VEGAS, THE NONPROFIT COMMISSIONER FRANKLIN FOOD POLICY COMMISSIONER, FRANKLIN JOINT SUSTAINABILITY, UM, CO-CHAIR OF AUSTIN, TRAVIS COUNTY FOOD PLAN.

SO, UM, WITHIN THOSE TWO ENTITIES OF OPERATING, WE'VE CONCLUDED A RECOMMENDATION THAT'S AROUND $200,000 FOR PRO CLIMATE, PRO CLIMATE, PRO HEALTH FOODS.

AND, UM, THROUGHOUT MY JOURNEY, I LEARNED THAT A RECOMMENDATION NEEDS A HOUSE.

A RECOMMENDATION NEEDS A HOME.

AND I BELIEVE THAT AUSTIN PUBLIC HEALTH HAS THE INFRASTRUCTURE TO SUPPORT THE RECOMMENDATION BEING IMPLEMENTED.

NOW, THIS 200,000 FOR THIS PRO CRIME AND POOR HEALTH IS FOR AN AWARENESS CAMPAIGN.

AFTER SEARCHING THROUGHOUT THE CITY DEPARTMENTS, I'VE SEEN NOTHING THAT RAISES AWARENESS ABOUT HEALTHIER FOOD CHOICES.

AND SO AS WE MOVE FORWARD, I WOULD LIKE, UM, TO HAVE THE OPPORTUNITY TO SHOW YOU ALL THE RECOMMENDATION AND IF POSSIBLE, ALLOW THE RECOMMENDATION TO LIVE WITHIN AUSTIN PUBLIC HEALTH.

THAT'S IT.

I APPRECIATE IT.

I, I KNOW WE CAN'T GIVE ANY PUBLIC COMMENTS, UH, IN REGARDS TO THAT, BUT I WILL, UH, AT LEAST RELAY ACTIONS THAT HAVE ALREADY MOVED FORWARD IN THAT DIRECTION.

UH, I BELIEVE, UH, ONE OF THE LIAISONS HAS ALREADY REACHED OUT TO OUR, UH, OUR LIAISONS TO COORDINATE A FUTURE, UH, PRESENTATION REGARDING THAT.

THANK YOU.

ALRIGHT.

UH, I DON'T BELIEVE WE HAVE ANY OTHER PUBLIC COMMENTS.

[1. Approve the minutes of the Public Health Commission Meeting on February 7, 2024]

UH, DO I HAVE A MOTION ON THE FLOOR? I'LL MOVE THE MOTION.

I SECONDED.

SECOND QUESTIONS.

SHOULD THE MOTION QUESTION? SHOULD THE MOTION, ALL RIGHT.

QUESTION.

I ASSUME YOU'RE TALKING TO ME.

UM, ON THE SECOND PAGE, UNDER PUBLIC COMMUNICATION, IT SAYS, SHANNON JONES IS THE FORMER DIRECTOR OF THE TRAVIS COUNTY HEALTH DEPARTMENT.

THAT IS INCORRECT.

UH, ONLY THE CITY OF AUSTIN HEALTH DEPARTMENT.

AND THEN ALSO, UM, APPROVAL OF MINUTES.

UH, LE UH, COMMISSIONER LEE, SHE'S NAME IS MISSPELLED.

IT'S MISSING AN O.

OTHERWISE, THAT'S ALL I HAVE FOR THE, THOSE MINUTES.

APPRECIATE IT.

ANY ADDITIONAL QUESTIONS TO THE MOTION? , DO I HAVE AN AMENDED MOTION TO APPROVE THE MINUTES? UH, WITH THE RECOMMENDED CHANGES, JUST SAY, I SO MOVE .

I SO MOVE.

SORRY.

YES.

UM, I WAS ACTUALLY PRESENT REMOTELY.

DO YOU HAVE THAT, UM, WRITTEN DOWN, DANIELLA.

I'LL PAUSE FOR ANY OTHER ADDITIONAL CHANGES.

GOING ONCE, GOING TWICE.

I HAVE A MOTION FOR THE APPROVAL OF THE MINUTES OF THE PUBLIC HEALTH COMMISSION SPECIAL CALLED MEETING ON FEBRUARY 26TH, 2024.

WE HAVE A AMENDED MOTION.

DO I HAVE A SECOND? ALL RIGHT.

SECONDED.

ANY QUESTIONS TO THE AMENDED MOTION? GOING ONCE, GOING TWICE APPROVED.

UH, DO

[2. Approve the minutes of the Public Health Commission Special Call Meeting on February 26, 2024]

I MOVE THE MOTION.

SO MOVED.

DO I HAVE A SECOND? IS THAT IN HERE? MM-HMM.

THE 26TH.

ALL RIGHT, MOVING ON TO NUMBER THREE, DISCUSSION PRESENTATION BY LAURA ELMORE WITH THE SOBERING CENTER ON ORGANIZATIONAL STRUCTURE PROGRAMS AND SERVICES PROVIDED.

THE 26TH.

UH, SECONDED AND SECONDED.

DO I HAVE ANY QUESTIONS? SHOULD THE MOTION QUESTIONS? SHOULD THE MOTION QUESTIONS? SHOULD THE MOTION THERE BEING NONE? ALL THOSE IN FAVOR? RAISE YOUR HAND.

NONE OPPOSING MOTION PASSES.

[3. Presentation by Laura Elmore with the Sobering Center on organizational structure, programs and services provided.]

VERY GOOD.

OH, GREEN PROBABLY IS BETTER THAN RED.

GOOD AFTERNOON.

I'M LAURA ELMORE.

I'M THE EXECUTIVE DIRECTOR AT THE SOBERING CENTER.

AND, UM, I WAS INVITED HERE TODAY TO JUST KIND OF GIVE YOU GUYS A BRIEFING ON THE SOBERING CENTER, WHAT IT IS AND WHAT WE DO.

AND I'M HAPPY TO ANSWER ANY QUESTIONS.

SO I'LL JUST GO THROUGH SOME OF THESE SLIDES AND, UM, GIVE YOU A LITTLE ORIENTATION.

YOU HAVE A CLICK IF YOU I DO,

[00:05:01]

YES.

OH, I DO.

SO EVERYBODY'S THERE VOLUNTARILY.

SO THE MISSION OF OUR SOBERING CENTER IS TO ENHANCE PUBLIC HEALTH AND SAFETY.

THIS, THIS WILL COME UP AGAIN AT THE END, I THINK IN CONVERSATION.

UM, THERE'S A LOT OF CONVERSATION RIGHT NOW ABOUT IS THIS A PUBLIC HEALTH ISSUE OR IS IT A PUBLIC SAFETY ISSUE? AND I WOULD ARGUE THAT IT'S BOTH.

AND THAT IS KIND OF HOW OUR MISSION STATEMENT WAS WRITTEN AND, UM, HOW IT WAS DESIGNED BY OUR BOARD OF DIRECTORS.

UM, THE SUBMARINE CENTER IS ABOUT FIVE YEARS OLD.

WE, UM, ARE A SAFE PLACE FOR PEOPLE WHO ARE PUBLICLY INTOXICATED TO SOBER UP AS AN ALTERNATIVE TO THE JAIL OR THE EMERGENCY ROOM.

AND THEN WHEN APPROPRIATE, WE'RE ABLE TO PROVIDE A BRIDGE TO RECOVERY DIRECTLY FROM THE CENTER.

THIS, UM, THIS ACTUALLY WE, I WAS, UM, CHATTING WITH WITH PAUL BACK THERE THAT I DID THIS, THIS SLIDE DECK IN THE FALL, ACTUALLY.

AND, UM, SO THESE NUMBERS HAVE ACTUALLY CHANGED SINCE THEN, BUT THERE, WE HAD SERVED ABOUT ABOUT 8,000 PEOPLE IN, IN THE FALL.

IT'S NOW OVER 10,000 PEOPLE, UM, THAT WE HAVE SERVED THAT, THAT INTAKES THAT WE'VE SERVED SINCE OUR INCEPTION, AND WE OPENED IN THE FALL OF 2018.

SO, AS A REMINDER, THERE IS NO JAIL OR EMERGENCY ROOM WHEN YOU COME INTO THE SOBERING CENTER.

THERE IS ALSO NO FINES, UM, NO MEDICAL BILLS, NO CITATIONS, NO CHARGES.

UM, SO THE, THE PATIENT DIRECTLY IS NOT EXPERIENCING ANY KIND OF LIKE BILLING OR ANY KIND OF COPAYS OR ANYTHING LIKE THAT.

WE'RE OPEN 24 7.

UM, THERE'S NO REAL PAPER TRAIL FROM LIKE A PD FOR EXAMPLE.

IF SOMEONE GETS BROUGHT INTO THE SOBERING CENTER, IT'S NOT AN ARREST.

UM, THAT BEING SAID, WE CANNOT DETAIN ANYBODY.

THEY CAN LEAVE IF THEY WOULD LIKE TO.

UM, IF THEY LEAVE BEFORE THEY'RE SOBER, WE WILL DEFINITELY CALL FOR ASSISTANCE ON THAT.

UM, IF WE THINK THEY'RE NOT GONNA BE SAFE, UM, EITHER TO THEMSELVES OR OTHERS, WE HAVE OTHERWISE COMPLETE CONFIDENTIALITY.

SO WE'RE, UM, A HIPAA PROTECTED FACILITY.

WE ARE NOT ABLE TO NOTIFY ANYBODY OF A CLIENT'S ADMISSION INTO OUR CENTER WITHOUT CONSENT OR A JUDGE SIGNED SUBPOENA.

WE ARE ABLE TO CONNECT DIRECTLY TO COMMUNITY RESOURCES AND OTHER SERVICES, SUCH AS WARM HANDOFFS TO TREATMENT.

WE'VE BEEN GETTING BETTER AND BETTER AT THAT AS THE YEARS GO ON, WHICH IS KIND OF, UM, MOST EXCITING, I THINK ABOUT OUR EVOLUTION AND WE CAN, UM, ASSIST WITH GETTING PEOPLE A SAFE RIDE HOME.

SO OUR ADMISSION CRITERIA, WE DO, UM, SERVE 18 AND UP.

WE, UM, IT, WE CALL IT SUSPECTED ALCOHOL DRUG INTOXICATION.

IT COULD BE ANY DRUGS, ALCOHOL IS A DRUG, BUT ALSO IT COULD BE ANYTHING.

IT COULD BE METH, IT COULD BE CRACK, IT COULD BE MARIJUANA, IT COULD BE ANYTHING THAT ANYONE IS INTOXICATED ON.

OBVIOUSLY WE'RE NOT, I MEAN, THIS MIGHT NOT BE OBVIOUS, BUT WE'RE NOT A LAB, SO WE CAN'T REALLY KNOW WHAT EVERY, WHAT EVERYBODY IS USING.

UM, WE DO HAVE BACS, SO WE CAN TELL YOUR BLOOD ALCOHOL CONTENT IMMEDIATELY, BUT WE WON'T BE ABLE TO TELL WHAT OTHER SUBSTANCES YOU'VE BEEN USING.

SO THAT IS COMING TO US AS SELF-REPORT OR SYMPTOM BASED, LIKE JUST BASED ON KIND OF THEIR BEHAVIORAL, UM, PRESENTATION OR IT'S COMING FROM THE REFERRAL PARTNER.

AND OUR REFERRAL PARTNERS ARE TYPICALLY, UM, OUR BIGGEST REFERRAL PARTNER IS A PD, AND THEN RIGHT BEHIND THAT EMS AND THEN RIGHT BEHIND THAT DELL SETON MEDICAL CENTER.

SO WE'RE TAKING MOST OF OUR REFERRALS FROM, UM, THE POLICE EMS AND THE HOSPITALS.

AND THEN WE HAVE A LIST OF ABOUT 80 OTHER REFERRAL PARTNERS THAT CAN CALL US IF THEY SEE SOMEONE THAT IS PUBLICLY INTOXICATED.

AND THEY WOULD LIKE TO REFER DIRECTLY RATHER THAN TO CALL 9 1 1 OR TO ENGAGE THE FIRST RESPONDERS.

SO WHEN SOMEONE COMES TO US, THE FIRST THING THEY DO IS GET A SCREENED BY A MEDIC.

THAT PERSON IS A PARAMEDIC OR AN EMT THAT WILL LOOK THEM OVER TO MAKE SURE THAT THEY DON'T HAVE LIKE A HEAD INJURY OR UNTREATED LACERATIONS OR HAVE A RECENT SEIZURE OR INTERNAL BLEEDING.

UM, WE DO, WE WILL ADMIT SOMEONE WHO IS TALKING ABOUT SUICIDAL OR HOMICIDAL IDEATION ONLY IF WE WILL CLEAR THEM BY A MENTAL HEALTH PROFESSIONAL.

AND WE DO THAT VIA TELEHEALTH.

SO THIS IS LIKE A FOUR KIND OF A STEP PROCESS.

SO YOU CAN KIND OF SEE FROM THE PATIENT PERSPECTIVE HOW IT WORKS.

THE CLIENT'S REFERRED OR TRANSPORTED TO THE SOBERING CENTER BY LAW ENFORCEMENT EMS OR OTHER REFERRAL PARTNER.

UM, LIKE I SAID, THEY'RE, THEY DON'T GET A PI AS A RESULT OF THIS.

THEY DON'T GET A CITATION OR A FINE.

THE MEDICS DO A SCREENING TO FIGURE OUT IF IT'S SAFE ENOUGH FOR THEM TO SOBER UP WITH US, AND IF NOT, THEN WE'LL SEND THEM TO THE HOSPITAL.

OUR RECOVERY SUPPORT SPECIALISTS, ALSO KNOWN AS SOBERING SUPPORT SPECIALISTS, WILL MONITOR THE PATIENT AND CONTINUE TO ASSESS THEIR NEEDS.

THAT'S DETERMINED BY HOW INTOXICATED THEY ARE.

SO IF THEY'RE LIKE A LEVEL ONE, THEY WILL BE MONITORED EVERY 15 MINUTES BECAUSE ONE, SOMETHING THAT THE PUBLIC ISN'T VERY AWARE OF, I THINK, IS THAT ALCOHOL WITHDRAWAL IS EXTREMELY DANGEROUS.

UM, PEOPLE CAN DIE OR HAVE A SEIZURE PRETTY QUICKLY WITH, UM, WITHDRAWAL FROM ALCOHOL.

SO ALCOHOL IS STILL OUR NUMBER ONE SUBSTANCE.

EVEN IF WE SEE PEOPLE USING OTHER DRUGS, THEY'RE USUALLY ALSO DRINKING WHEN THEY COME IN.

AND SO THE SAFETY FACTOR BECOMES REALLY, REALLY CRITICAL.

SO LEVEL ONE PATIENTS WILL BE MONITORED EVERY 15 MINUTES AND THEN LEVEL TWO EVERY 30 MINUTES AND LEVEL THREE EVERY HOUR UNTIL THEY GET TO LEVEL FOUR.

UM, LEVEL FOUR IS

[00:10:01]

WHEN THEY ARE CONSIDERED SOBER, BUT THEY ARE KIND OF HANGING OUT THERE WAITING TO GO TO TREATMENT IF THEY, UM, WHEN THEY SIT DOWN WITH A COUNSELOR, ONCE THEY'VE SOBERED UP, THEY DO AN ASSESSMENT.

AND THE ASSESSMENT IS TO DETERMINE IS THIS LIKE A BAD NIGHT? IS THIS LIKE A BACHELORETTE PARTY GONE WRONG, OR IS THIS LIKE A CHRONIC ADDICTION, MORE OF LIKE A CHRONIC ILLNESS THAT WE NEED TO, UM, OFFER SOME MORE SIGNIFICANT TREATMENT OPTIONS FOR.

AND AT THAT POINT WE'LL REFER TO APPROPRIATE COMMUNITY RESOURCES FROM THERE.

SO HOW IT STARTED IS THAT WE WERE FOUNDED IN 2018.

WE ARE STRUCTURED THROUGH AN INTERLOCAL AGREEMENT BETWEEN THE CITY AND THE COUNTY.

SO THE CITY'S, UM, AGREEMENT THERE IS TO FUND THE OPERATIONAL EXPENSES FOR THE CENTER.

THE COUNTY'S AGREEMENT IS TO PROVIDE THE BUILDING.

SO WE HAVE A BUILDING AT 12TH AND SABINE, WHICH IS THE FORMER MEDICAL EXAMINER'S OFFICE.

IT WAS RENOVATED BY THE COUNTY.

AND, UM, THEN THE CITY PUTS IN THE OPERATIONAL EXPENSES, AND THAT'S DONE THROUGH A CONTRACT THROUGH, UM, AUSTIN PUBLIC HEALTH.

AT THIS TIME, IT'S ABOUT TO TRANSFER FROM AUSTIN PUBLIC HEALTH OVER TO EMS FOR MANAGEMENT.

UM, THAT ILA EXPIRED IN SEPTEMBER OF 2023.

AND, UM, WE KIND OF RAN OUTTA TIME NEGOTIATING THE NEW ILA.

AND SO THE CURRENT ILA EXTENDED FOR SIX MONTHS.

SO WE'RE CURRENTLY UNDER AN EXTENSION, A SIX MONTH EXTENSION OF A FIVE YEAR CONTRACT THAT EXPIRES MARCH 31ST.

WE'RE JUST AT THE FINAL NEGOTIATIONS WITH THE CITY AND THE COUNTY, UM, AND ALL OF THE ATTORNEYS TO DO A NEW FIVE-YEAR INTERLOCAL AGREEMENT TO CONTINUE THE SOBERING CENTER.

AND THAT SHOULD BE APPROVED BY OUR BOARD AND SIGNED BY ALL PARTIES BY THE END OF MARCH.

DID YOU HAVE A QUESTION? WILL THAT ONE BE WITH EMS? YES.

SO THAT'S WHEN THE CONTRACT WILL TRANSITION FROM AUSTIN PUBLIC HEALTH TO EMS, JUST FOR THE, THE CONTRACT MANAGEMENT PURPOSES.

UM, OKAY.

SO A COUPLE OF BIG CHANGES THAT WE MADE.

UM, WHEN I CAME TO THE SOBERING CENTER, IT WAS JUNE OF 2020, UM, WHICH SHOULD TELL YOU A LOT ABOUT WHAT MY FIRST DAY WAS LIKE.

UM, BUT IT WAS COV, YOU KNOW, UH, LUCKILY IT WAS COVD.

AND SO IT WAS SLOW AT THE SOBERING CENTER BECAUSE ALL THE BARS WERE CLOSED AND EVERYTHING WAS KINDA SHUT DOWN, RIGHT? SO LUCKILY I DIDN'T HAVE TO DRINK FROM THE FIRE HOSE.

I COULD KIND OF TAKE MY TIME LEARNING THE OPERATIONS.

'CAUSE THEY HAD CLOSED THE SOBERING CENTER FOR ABOUT EIGHT WEEKS AND CONSIDERED USING IT FOR HOMELESS TO QUARANTINE AND A BUNCH OF OTHER THINGS.

SO IT WAS KIND OF IN THIS MIDDLE PLACE.

WE VERY QUICKLY REOPENED IT, UM, RIGHT WHEN I STARTED AND, UM, FOR LIMITED HOURS AND THEN OPENED IT AT 24.

BUT A LOT OF DURING THAT TIME, I WOULD SPEND ON THE FLOOR OVERNIGHT WITH PATIENTS OR WITH THE STAFF TRYING TO FIGURE OUT HOW DOES THIS WORK? WHAT, HOW ARE WE, WHAT ARE WE DOING HERE? AND THE MODEL OF THE TIME WAS PEOPLE COME IN, THEY SOBER UP FOR ABOUT SIX TO EIGHT HOURS, THEY GET WATER, THEY GET PRETZELS, AND THEY GO ABOUT THEIR WAY.

THEY BLOW A ZERO, THEY WALK OUT THE DOOR.

UM, MY QUESTION, BECAUSE I HAVE A BACKGROUND IN SOCIAL WORK WAS LIKE, WELL, WHERE ARE THEY GOING FROM HERE, .

AND LIKE, WHAT'S HAPPENING NEXT? RIGHT? AND WE'D SEEN SO MANY FOLKS, ESPECIALLY DURING COVID, THE NUMBERS OF HOMELESSNESS PICKED UP.

THE, THE FOLKS THAT ARE UNHOUSED THAT WERE COMING INTO OUR CENTER WERE PICKING UP.

AND SO, UM, WE STARTED KIND OF LOOKING AT THE MODEL, UM, FROM A COUPLE DIFFERENT WAYS.

ONE WAS, THIS WAS ALSO IN THE MIDDLE OF THE GEORGE FLOYD STUFF.

IT WAS LIKE A NATIONAL KIND OF CALL FOR DEESCALATION AND, YOU KNOW, LOOKING AT RACIAL JUSTICE AND, UM, EQUITY IN A DIFFERENT WAY.

AND SO WE STARTED LOOKING AT WHY IS IT THE ONLY WAY YOU GET TO THE SOBERING CENTER THROUGH A SIREN VEHICLE? IS THERE AN, ARE THERE OTHER PATHS TO THE SOBERING CENTER? 'CAUSE PEOPLE KEPT ASKING ME, WELL, HOW DO I REFER? AND I'M LIKE, WELL, YOU DON'T, YOU HAVE TO CALL 9 1 1 .

AND THEN IT BECAME KIND OF SILLY AT THAT POINT, LIKE, WHY DO YOU HAVE TO CALL 9 1 1? IS IT POSSIBLE THAT THERE ARE TIMES WHEN CALLING 9 1 1 IS THE ONLY OPTION? 'CAUSE YOU DON'T FEEL LIKE THAT PATIENT IS SAFE, RIGHT? FOR YOU TO TRANSPORT THEM OR SOMEONE TO TRANSPORT THEM.

MAYBE THEY NEED, UM, MEDICAL TRANSPORT OR, UM, THEY, THEY'RE AGITATED OR VERY AGGRESSIVE OR SOMETHING LIKE THAT.

BUT THERE'S ALSO A LOT OF TIMES WHERE INDIVIDUALS AT COMMUNITY CENTERS, CLINICS, UM, ON THE BUS, AT THE LIBRARY, ALL THESE DIFFERENT KINDS OF PUBLIC PLACES WHERE SOMEONE MIGHT BE DOING SOMETHING THAT FEELS CONCERNING AND IS PUBLICLY INTOXICATED, THAT THEY CAN CALL US DIRECTLY.

SO THAT WAS THE FIRST BIG CHANGE WE MADE WAS ADDING REFERRAL PARTNERS.

WE STARTED DOING THAT IN 2020.

AND LIKE I SAID, WE HAVE ABOUT 80 DIFFERENT REFERRAL PARTNERS NOW IN ADDITION TO THE SIREN VEHICLES.

UM, THE OTHER BIG CHANGE WE MADE WAS THAT THE PATIENTS, LIKE I SAID, WOULD COME IN SOBER UP AND GO RIGHT.

UM, AND THERE WASN'T REALLY ANY KIND OF WAY TO FOLLOW UP WITH THEM.

AND THERE WASN'T ALSO LIKE ANY KIND OF ACCESS TO TREATMENT, BECAUSE IF YOU HAVE A LOT OF MONEY, IT IS VERY EASY TO GO TO TREATMENT DIRECTLY FROM THE SOBERING CENTER.

IF YOU HAVE INSURANCE, YOU CAN JUST GO RIGHT TO DETOX OR RIGHT TO RESIDENTIAL TREATMENT.

IF YOU DON'T HAVE INSURANCE OR YOU'RE HOMELESS AND IT'S A WEEKEND, THERE'S NO WAY TO DO THAT.

IT TAKES MANY, MANY DAYS.

AND SO WE HAD A PATIENT THAT, UM, WAS PICKED UP BY EMS 75 TIMES IN 135 DAYS IN ONE SUMMER OF 2020, WHICH IF YOU CAN IMAGINE, IS BASICALLY EVERY OTHER DAY FOR THE ENTIRE SUMMER.

UM, ONE GUY,

[00:15:01]

WHICH I, YOU CAN'T EVEN IMAGINE HOW MUCH THIS COSTS, RIGHT? AND HOW MUCH TIME.

UM, BUT ALSO HE WAS NOT GETTING BETTER OVER THAT TIME.

HE PROBABLY CAME TO US A DOZEN TIMES BEFORE HE WOULD EVEN SPEAK TO US.

HE WOULD SOBER UP, WALK OUT, DRINK, COME BACK, SOBER UP, WALK OUT, DRINK.

IT WAS LIKE A PATTERN.

UM, FINALLY AT THE END OF THE SUMMER, WE, HE WAS ABLE TO TALK TO A COUNSELOR AND HE SAID, OKAY, I'M DONE.

I HANG IT UP, RIGHT? I WANNA GO TO DETOX, BUT YOU CAN'T GO TO DETOX ON SUNDAY AT 8:00 AM IF YOU'RE HOMELESS, IT DOES NOT EXIST.

AND SO WE ENDED UP HOLDING HIM FOR FIVE DAYS UNTIL WE COULD GET HIM ON A BUS OUTSIDE OF AUSTIN, BECAUSE THAT WAS THE ONLY OPTION FOR HIM.

UM, HE DID GET SOBER AND, AND CAME BACK 90 DAYS LATER TO KIND OF MAKE AMENDS TO OUR STAFF FOR HOW MUCH TIME HE SPENT THERE, FOR THE SUMMER.

AND WE THOUGHT, WHY AREN'T WE DOING THIS MORE OFTEN? THIS IS WHAT WE SHOULD BE DOING.

BECAUSE IF SOMEBODY IS SOBER AND THEY HAD A BAD NIGHT AND THEY CAN GET UP AND GO HOME AND THEY HAVE A SAFE PLACE TO BE AND THEY DON'T HAVE AN ADDICTION, THEN GREAT.

BUT IF THEY DO AND THEY DON'T HAVE RESOURCES OR A FAMILY OR ANY WAY TO GET TO THE NEXT STAGE, WE NEED TO BE THE PLACE THAT IS REALLY FACILITATING THAT WARM HANDOFF.

AND SO WE STARTED DOING THAT MORE AND MORE, AND THOSE PEOPLE BECAME, WE KIND OF STARTED REFERRING TO 'EM AS HOLDING OVER BECAUSE THEY WERE SOBER, BUT THEY WERE HOLDING THERE WAITING TO GO TO TREATMENT, UM, BY CHOICE, BECAUSE WE ARE OBVIOUSLY NOT KEEPING ANYBODY THERE.

UM, I ALSO REALLY SEE US AT THE SOBERING CENTER AS PUTTY IN THE CRACKS OF A, OF A SYSTEM THAT'S OTHERWISE BROKEN.

UM, LIKE I JUST SAID, THERE IS NO EASY WAY TO GET INTO TREATMENT.

I THINK THAT THE PUBLIC PROBABLY THINKS THAT THERE IS, LIKE WHEN THEY SEE PEOPLE ON THE STREET, THEY THINK, WHY DON'T THOSE PEOPLE JUST GET BETTER AND GO TO TREATMENT OR GO TO, YOU KNOW, A SAFE PLACE? AND THE REALITY IS THAT THERE, WE DON'T HAVE LONG-TERM INFRASTRUCTURE AND CARE FOR THIS CHRONIC ILLNESS.

SO WE TRY TO BE AS FLEXIBLE AS POSSIBLE IN TERMS OF OUR REFERRAL PARTNERS, UM, WHO WILL ADMIT AND ON WHAT KINDS OF SUBSTANCES WITH WHAT KINDS OF MENTAL HEALTH DISORDERS.

UM, WE TRY TO BE THAT SAFE PLACE BECAUSE WE'RE REALLY THE ONLY OPTION THAT'S 24 7 OTHER THAN THE JAIL AND THE HOSPITAL.

UM, AND NOT EVEN PSYCHIATRIC EMERGENCY SERVICES IS OPEN 24 7.

AND SO WE GET A LOT OF REFERRALS FROM THEM.

SO, UM, IF YOU EVER THOUGHT WE WEREN'T DOING MENTAL HEALTH DIVERSION, WE ARE, WE'RE DOING BOTH.

UM, THIS IS A SET OF JUST KIND OF GENERAL DATA FROM, UH, FROM FY 23, I THINK.

UM, SO A FULL YEAR OF DATA.

SO THAT YEAR WE DID 2000, A LITTLE OVER 2000 INTAKE.

WE ADMITTED 93% OF THOSE PEOPLE.

SO THAT MEANS ONLY ABOUT 7% WERE TURNED AWAY AT THE DOOR.

AND THAT'S ALMOST, ALMOST ALL OF THEM WILL BE PROBABLY FOR MEDICAL REASONS, LIKE THEY'RE IN CONGESTIVE HEART FAILURE OR LIVER FAILURE.

UM, THEY'VE HAD A HEAD INJURY WHEN THEY HAVE TO GO TO THE HOSPITAL.

OCCASIONALLY WE DO HAVE BEHAVIORAL ISSUES AT INTAKE WHERE THEY ARE THREATENING PEOPLE OR ASSAULTING PEOPLE AND HAVE TO GO TO JAIL FROM THERE.

UM, SO YOU CAN SEE THAT, UM, IN THAT YEAR WE TRANSFERRED 118 PEOPLE BY AMBULANCE OUT OF THE SOBERING CENTER AFTER THEY WERE ADMITTED.

AND, AND 33 BY PD.

SO THAT'S, THAT'S IF SOMEBODY GETS INTO THE DORM AND STARTS TO SOBER UP AND THEN STARTS TO HAVE LIKE A MEDICAL EMERGENCY OR SOME KIND OF A BEHAVIORAL ISSUE, THAT'S A, A CRIMINAL ACT.

UM, SO WE DID TOTAL DIVERSIONS FROM THE ER AND JAIL ABOUT ALMOST 1800 PEOPLE.

AND, UM, SUCCESSFUL DISCHARGES IN 966, THAT'S ABOUT HALF OF THOSE WHO ADMITTED.

UM, WE KEEP THE SUCCESSFUL DISCHARGE NUMBER PRETTY CONSERVATIVE.

WHAT THAT MEANS IS THAT THEY WENT THROUGH THE ENTIRE PROCESS OF SITTING DOWN WITH A COUNSELOR AND THEY DIDN'T JUST KIND OF SAY, NO THANK YOU AND GO HOME.

UM, NOT ALL OF THOSE PEOPLE ARE INTOXICATED.

MANY OF THEM ARE SOBERED, BUT, UM, BUT THEY'RE READY TO GO HOME AND THEY DON'T WANNA STAY AND TALK TO ANYBODY.

OF THE 144 SEEKING TREATMENT, I JUST MENTIONED THE HOLDOVERS, 96 OF THEM WERE WARM HANDOFF TO A TREATMENT CENTER.

AND THEN 80, WE DID 80 HOLDS FOR REFERRAL PARTNERS.

UM, WHAT THAT LOOKS LIKE IS IF A TREATMENT CENTER OR A SOBER HOUSE IS A REFERRAL PARTNER, THAT MAY BE LIKE, SAY A PATIENT'S GOING THERE FOR TREATMENT FOR 90 DAYS AND THEY GO OUT ON A PASS DURING THEIR STAY AND THEY RELAPSE AND THEY ARE DRINKING OR USING OFFSITE AND THEY COME BACK TO THE HOUSE OR BACK TO THE TREATMENT CENTER.

THAT TREATMENT CENTER OR SOBER HOUSE MAY NOT WANT THEM THERE BECAUSE IT VIOLATES THE RULES OR IT KEEPS THE MILIEU UNSAFE, BUT THEY DON'T NECESSARILY WANNA KICK THEM OUT ONTO THE STREET.

SO WE HAVE SET UP PLACES WHERE THEY CAN BRING TO US AND WE'LL HOLD ONTO THEM FOR 24 TO 48 HOURS AND THEN RETURN THEM BACK TO THE TREATMENT CENTER OR THE SOBER HOUSE SO THEY CAN LIKE REENGAGE IN TREATMENT RATHER THAN KIND OF STARTING OVER FROM THE BEGINNING.

UM, WE DID ENGAGE A PUBLIC HEALTH RESEARCHER IN TO DO SOME COST BENEFIT ANALYSIS WORK FOR US.

AND THIS DATA IS FROM FY 22.

THE DATA I JUST SHOWED YOU.

AND THOSE NUMBERS WERE FROM FY 23, BUT SHE HAD STARTED THIS PROCESS REALLY EARLY.

SO SHE STARTED WITH FY 22 DATA.

IT WAS OUR FIRST REALLY GOOD FULL YEAR OF DATA THAT WE HAD A, A RELIABLE DATABASE TO PULL REPORTS FROM, FROM, AND THIS IS KIND OF

[00:20:01]

A TABLE OF THE COST, SO YOU CAN KIND OF SEE, UM, WHAT THE COSTS ARE WHEN IT SAYS DIRECT COSTS SC THAT'S THE, THE COST, THE MONEY WE'RE SPENDING TO DO THE PROGRAM.

UM, THE REALLY, THE DIRECT COSTS SC ARE REALLY COST TO THE CITY.

THOSE ARE REALLY, THAT'S REALLY THE AUSTIN PUBLIC HEALTH CONTRACT BECAUSE THOUGH WE HAVE LIKE ONE PAYER, UM, THE DIRECT COSTS TO THE COUNTY ARE, UM, THE COSTS OF THE FACILITY.

SO THAT'S KIND OF WHAT THE COUNTY COULD BE COLLECTING ON THAT BUILDING IF WE WEREN'T THERE.

AND THEN DIRECT COSTS TO EMS, UM, EMS DONATES SUPPLIES TO US.

SO THAT'S THE COST OF THE SUPPLIES THAT THEY SEND OVER TO US.

AND THEN DIRECT COSTS A PD ARE JUST FOR TRANSPORT, TRANSPORT TO OUR CENTER AND THEN INDIRECT COSTS.

UM, FOR EMS, THIS IS A BIG DEAL, UM, ACROSS THE COUNTRY.

WE'RE ONE OF THE ONLY SOBERING CENTERS THAT TAKES REFERRALS FROM EMS AT ALL.

AND I GET THAT QUESTION WHEN I TRAVEL CONSTANTLY, IS HOW DID YOU GET EMS TO DROP OFF WITH YOU? AND THE ISSUE IS A REIMBURSEMENT ISSUE.

MOST PLACES AN EMS SYSTEM WILL NOT GET PAID FOR TAKING SOMEONE TO A SOBERING CENTER.

THEY HAVE TO TAKE SOMEONE TO A HOSPITAL.

UM, HERE, OUR EMS SYSTEM HAPPENS TO BE QUITE INNOVATIVE AND COLLABORATIVE, AND THEY DO BRING TO US AND THEY FOREGO THE REIMBURSEMENT.

AND THEY ALSO, WE ALSO SHARE A MEDICAL DIRECTOR WITH EMS AND WE ALSO HAVE A REALLY TIGHT PARTNERSHIP WITH THE COMMUNITY HEALTH PARAMEDICS.

SO OUR EMS PARTNERSHIP IS ACTUALLY NATIONALLY KNOWN.

SO THIS IS JUST TO CAPTURE LIKE WHAT DOES IT COST TO DO THIS WORK? WHAT DOES IT COST TOTAL, AND THEN WHAT DOES IT COST PER DIVERSION SO THAT WE CAN GET A NUMBER THERE.

AND THEN WE CAN LOOK AT THE BENEFITS AND YOU CAN SEE THAT WE'RE, WE CAN, WE'RE HAVE BENEFITS WHEN WE DON DIVERT FROM THE ER.

WE HAVE BENEFITS WHEN WE DIVERT FROM THE JAIL.

AND THEN WE HAVE A NUMBER THAT SHE WORKED OUT THAT IS BASED IN THE LITERATURE ON A REDUCTION IN FUTURE ER UTILIZATION.

SO THAT'S LIKE, IF WE INTERVENE AT THIS POINT AND WE HAVE SOMEBODY SOBER UP WITH US, THEY'RE MORE, THEY'RE LESS LIKELY TO USE THE ER IN THE FUTURE FOR SIMILAR ISSUES.

FROM THERE, YOU CAN CALCULATE A BENEFIT FOR TOTAL BENEFIT AND TOTAL PER DIVERSION BENEFIT.

SO WHAT THAT BASICALLY MEANS IS EVERY SINGLE TIME WE ADMIT SOMEONE TO THE SOBERING CENTER, WE HAVE A 1.4 COST BENEFIT RATIO, WHICH MEANS FOR EVERY DOLLAR THE CITY PUTS IN OR IN THE COUNTY, THEY GET BACK A DOLLAR 40 INTO THE COMMUNITY.

EVERY, IF WE SERVE MORE PEOPLE, THAT NUMBER GOES UP BECAUSE OUR COSTS ARE FIXED, RIGHT? SO WE'RE OPEN 24 7, WE ALWAYS HAVE TO PAY THE LIGHT BILL.

WE ALWAYS HAVE TO PAY THE STAFF, WE ALWAYS HAVE TO DO THE WATER.

IF WE SERVE 2000 PEOPLE IN A YEAR, THIS IS OUR NUMBER.

IF WE SERVE 3000 PEOPLE IN A YEAR, IT GOES UP AND UP AND UP.

AND SO THE GREAT THING ABOUT THIS RESEARCHER IS SHE LEFT US A TOOL THAT WE CAN NOW PLUG NEW NUMBERS INTO EVERY YEAR AND GET A NEW COST BENEFIT RATIO.

AND SO OUR COST BENEFIT RA, I'M ON YOUR PHONE ADRIAN.

OUR, OUR COST BENEFIT RATIO FOR FY 23 WAS 1.65.

UM, THIS IS SHOWING THAT COST BENEFIT ACCRUAL BY THE ACTUAL PARTIES.

AND SO YOU CAN SEE THAT THE SOBERING CENTER IS BEARING MOST OF THE COST.

LIKE I SAID, WHEN YOU SEE SOBERING CENTER, YOU SHOULD REALLY SEE THE CITY BECAUSE THE CITY'S REALLY PAYING THE BILLS THERE.

THE COUNTY HAS A LITTLE BIT OF COST, BUT GETS A LITTLE BIT OF BENEFIT FROM IT.

THEY SEE SOME, SOME, UH, SAVINGS AT THE JAIL.

AND THEN EMS HAS A LITTLE BIT OF COST, BUT REALLY ISN'T SEEING A FINANCIAL BENEFIT.

EMS IS ENGAGING WITH US PURELY FROM A COLLABORATIVE PERSPECTIVE.

UM, AND THEN A PD YOU'LL SEE PUTS VERY LITTLE IN, IN TERMS OF COST, BUT THEY DO GET BENEFIT AS WELL BECAUSE WE'RE SAVING THEM A LOT OF TIME WHEN, AND AN OFFICER BRINGS TO US, IT TAKES ABOUT EIGHT MINUTES TO BOOK INTO THE SOBERING CENTER.

IT TAKES ABOUT TWO HOURS TO BOOK INTO THE JAIL.

UM, THE EXCITING DATA FROM THIS SLIDE, UM, WHICH SO FAR HAS NOT GENERATED A WHOLE BUNCH OF MONEY FOR US, IS THAT LOOK AT THE COST TO THE HOSPITAL, WHICH IS ZERO, BUT THE BENEFITS TO THE HOSPITAL ARE 90%.

BECAUSE IF WE TAKE SOMEONE OUT OF AN ER, THEY CAN FLIP THAT BED AND BILL FOR IT, RIGHT? BUT WE CAN'T AND THEY CAN.

SO WE WOULD LOVE TO MAKE AN ARGUMENT TO THE HOSPITALS THAT THEY OUGHT TO BE PAYERS FOR THIS, RIGHT? UM, AND WE ARE JUST NOW STARTING UP A RELATIONSHIP WITH CENTRAL HEALTH, UM, TO START BILLING FOR PATIENTS WHO ARE THEIR PATIENTS WHO ARE MAP ELIGIBLE.

SO WE'RE KIND OF STARTING DOWN THAT ROAD OF DIVERSI DIVERSIFYING THE REVENUE SO THAT THE ENTIRE COST ISN'T BORN BY THE CITY OF AUSTIN.

UM, HERE'S SOME THINGS THAT ARE, UM, HARD TO CAPTURE IN A RESEARCH STUDY, BUT THINGS THAT ARE OBVIOUSLY BENEFITS.

UM, THE INDIVIDUAL CLIENT IS BENEFITING BY NOT GOING TO THE JAIL OR THE HOSPITAL.

UM, AND THEN THE, THERE'S LONG-TERM BENEFITS TO THE SYSTEM.

SO WE'VE GOT HEALTHCARE SAVINGS, WE'VE GOT REDUCED CRIME, WE'VE ALSO GOT IMPROVED HEALTH AND REDUCED MORTALITY.

I MENTIONED THAT WE HAVE A NATIONAL REPUTATION NOW, UM, SPECIFICALLY FOR OUR RELATIONSHIP WITH EMS AND HOW COLLABORATIVE IT IS.

BUT WE ALSO HAVE A REPUTATION FOR OUR COLLABORATIVE RELATIONSHIP WITH A PD.

UM, THE INTERNATIONAL ASSOCIATION OF CHIEFS OF POLICE INCLUDED US IN A FIVE CITY CASE STUDY ACROSS THE COUNTRY ON OUR RELATIONSHIP WITH CHIEF CHACON SPECIFICALLY.

BUT THE, UM,

[00:25:01]

AUSTIN POLICE DEPARTMENT IN GENERAL, WE WERE INCLUDED IN THEIR TOOLKIT.

UM, THE IACP IS RECOMMENDING THIS AS A BEST PRACTICE ACROSS THE COUNTRY AND PUT OUT A TOOLKIT FOR POLICE DEPARTMENTS TO USE AND HOW TO INTERACT WITH THE SOBERING CENTER OR HOW TO TAKE A LEAD ROLE IN THEIR COMMUNITY.

IN TERMS OF ADVOCATING FOR THE DEVELOPMENT OF ONE, UM, I SERVE ON THE BOARD OF THE NATIONAL SOBERING COLLABORATIVE, WHICH IS, UM, A NONPROFIT THAT IS JUST KIND OF JUST STARTING UP, BUT WE'RE TRYING TO ADVOCATE ACROSS THE COUNTRY FOR THIS TO BE A BILLABLE SERVICE, TO BE CONSIDERED PART OF THE SUBSTANCE USE CONTINUUM OF CARE, AND, UM, TO ADVOCATE FOR BEST PRACTICES AND STANDARDS OF EXCELLENCE ACROSS THE BOARD.

WE ARE KNOWN FOR BEING A MODEL FOR EXCELLENCE.

PEOPLE FLY IN FROM ALL OVER THE COUNTRY TO SEE OUR SOBERING CENTER.

IT'S VERY SMALL BUT MIGHTY.

UM, BUT WE HAVE, WE ARE KNOWN FOR HAVING GOOD OUTCOMES AND GOOD RESEARCH ASSOCIATED WITH IT, AS WELL AS REALLY, REALLY, UM, GREAT PARTNERSHIPS.

THIS, THIS IS A STRATEGIC PLAN SNAPSHOT.

THE WRITING'S A LITTLE BIT SMALL, BUT I CAN ALSO, UM, YOU GOT, JUANITA HAS THE SLIDES AND DANIELLE HAS THE SLIDES.

UM, BUT THIS IS JUST WHAT THE BOARD PUT TOGETHER FOR THE FIVE YEAR PLAN FOR THE NEXT FIVE YEARS, WHICH WILL BE THE NEXT EVOLUTION OF THE SOBERING CENTER.

UM, WE'RE REALLY TRYING TO MAXIMIZE THE USE OF THE CENTER AS A FIRST LINE RESPONSE TO INTOXICATION.

UM, I THINK THERE'S A LOT OF OPPORTUNITIES THERE.

UM, WE'LL SEE KIND OF HOW IT GOES, BUT I THINK, LIKE I SAID, WE ARE KIND OF OFTENTIMES SERVING AS THE ONLY OPTION AND KIND OF PUTTY IN THE CRACKS FOR WHEN THERE ISN'T AN OPTION.

SO PEOPLE CALL US ALL THE TIME FOR THINGS THAT ARE A LITTLE BIT OUTSIDE OF THE NORM AND WE WANNA TRY TO BE CREATIVE AND FLEXIBLE AND INNOVATIVE AND RESPONSIVE TO THOSE COMMUNITY PARTNERS.

UM, WE OBVIOUSLY WANNA SERVE MORE PEOPLE AND DEVELOP CAPACITY.

SO WE ARE, UM, WE JUST GOT APPROVAL FOR SOME FUNDING, FEDERAL FUNDING THROUGH THE COUNTY TO RENOVATE THE BUILDING.

AND WE'RE GONNA BE, UM, CHANGING UP THE WHOLE SECOND FLOOR SO THAT WE CAN USE THAT FOR PEOPLE WAITING TO GO TO TREATMENT.

AND THEN THAT IT WILL ESSENTIALLY DOUBLE OUR CAPACITY BECAUSE WE'LL BE ABLE TO USE THE ENTIRE FIRST FLOOR FOR SOBERING THE ENTIRE SECOND FLOOR FOR PEOPLE WAITING TO GO TO TREATMENT.

UM, WE WANT TO CONTINUE TO BE A, UM, MODEL THAT IS RESPONSIVE IN THAT WAY.

WHEN WE GET FEEDBACK FROM COMMUNITY PARTNERS ON WHAT WE SHOULD BE DOING.

WE WANNA TRY TO, UM, WORK TOWARDS THAT AND THEN CONSIDER CON CONTINUE TO LEAD.

UM, I THINK WE'RE LEADING LOCALLY IN TERMS OF BEING A VOICE AND AN ADVOCATE FOR SUBSTANCE USE AS A PUBLIC HEALTH ISSUE AND A CHRONIC ILLNESS, UM, BUT ALSO NATIONALLY AS A MODEL OF EXCELLENCE.

UM, AND THEN WHERE WE'RE HEADED, WE THIS, LIKE I SAID, THESE SLIDES ARE A LITTLE BIT OUTDATED 'CAUSE WE ALREADY DID SOME OF THIS, BUT, UM, WE STARTED DOING BRIDGE MEDICATIONS AT THE CENTER, WHICH ALL THAT REALLY MEANS IS THAT WHEN WE SEE A PATIENT THAT IS POTENTIALLY GOING TO GO INTO WITHDRAWAL, WE'RE ABLE TO CALL EMS AND THE COMMUNITY HEALTH PARAMEDICS CAN COME OUT AND GET THEM SOME MEDICATION THAT WILL KIND OF KEEP THEM FROM CLIMBING THE WALLS AND KEEP THEM FROM WALKING OUT OF THE CENTER BEFORE WE GET THEM INTO DETOX.

AND THAT'S REALLY THE NEXT STEP.

'CAUSE DETOX ISN'T REALLY A MEDICAL, UM, INTERVENTION THAT IS OFTENTIMES NEEDED FOR ALCOHOL BECAUSE IT IS SO DANGEROUS.

UM, BUT THAT LITTLE BRIDGE RIGHT THERE KEEPS US FROM HAVING TO LET THEM WALK OUT OR NOT GO TO THE NEXT LEVEL OF CARE.

UM, SO THAT'S BEEN REALLY AMAZING.

WE ALSO, UM, THE CHIP MEDICS WILL POTENTIALLY, LIKE IF THEY GO OUT INTO, SAY THE HOMELESS CAMPS AND THERE'S SOMEONE THERE WHO WANTS TO GET OFF OF HEROIN AND ONTO SUBOXONE, THEY CAN BRING SOMEONE TO THE SOBERING CENTER AND WE CAN USE THAT AS A SAFE PLACE TO MONITOR THEM WHILE THEY TRANSITION.

UM, WE ARE INVOLVED IN SOME OF THE CONVERSATIONS AROUND MENTAL HEALTH DIVERSION.

I THINK WE PROBABLY NEED TO BE MORE INVOLVED IN THOSE CONVERSATIONS.

'CAUSE LIKE I SAID, UM, I, I DON'T HAVE A DIRECT A NUMBER, BUT I WOULD SAY EASILY 80% OF THE PEOPLE THAT WE SEE ALSO HAVE A MENTAL HEALTH DIAGNOSIS OR, UM, OR ARE EXHIBITING MENTAL HEALTH SYMPTOMS. AND OFTENTIMES YOU CANNOT TELL THE DIFFERENCE BETWEEN A MENTAL HEALTH CRISIS AND A SUBSTANCE USE CRISIS.

IT'S GONNA TAKE SEVERAL DAYS FOR US TO ASSESS AND TRIAGE THAT EVEN THE DOCTORS, UM, THE PSYCHIATRIST AT DLL SETON HAVE THE SAME ISSUE.

THEY, SOMEBODY COMES IN THERE AND IT'S LIKE, ARE WE DEALING WITH PSYCHOSIS OR ARE WE DEALING WITH METHAMPHETAMINES? WE CAN'T REALLY TELL.

UM, SO WE DO A LOT OF BACK AND FORTH, TWO WAY REFERRALS BETWEEN US AND THE HOSPITAL CALL, YOU KNOW, CONSULTING, CALLING, TRYING TO FIGURE OUT WHAT'S WHAT AND THEN WHERE DOES THIS PERSON GO TO NEXT? SO WE'RE ALREADY DOING A LOT OF MENTAL HEALTH DIVERSION AND LIKE I SAID, WE'RE THE ONLY OPTION 24 7.

SO, UM, I REALLY THINK WE PROBABLY NEED TO BE MORE AT THE TABLE IN THOSE CONVERSATIONS, UM, DOWN THE ROAD.

AND THEN I MENTIONED CENTRAL HEALTH.

WE HAVE A BRAND NEW CONTRACT WITH CENTRAL HEALTH.

UM, WE JUST SIGNED IT AROUND CHRISTMAS AND WE JUST STARTED THE BILLING PROCESS.

SO CENTRAL HEALTH HAS BEEN EXTREMELY FLEXIBLE AND RESPONSIVE TO THIS, UM, ISSUE.

AND UM, WE WILL BE BILLING THEM FOR ANYBODY WHO STAYS THERE OVER 24 HOURS WHO IS INCOME ELIGIBLE AND HAS MAP AND IT'S A REAL SIMPLE PROCESS.

SO THEN THEY'LL BE ABLE TO REIMBURSE US FOR THAT STAY WHILE WE'RE TRYING TO GET SOMEONE INTO

[00:30:01]

CARE.

UM, AND SO MY GRATITUDE DEFINITELY GOES OUT TO, UM, OUR BOARD OF DIRECTORS.

UM, ADRIAN ER SITS ON OUR BOARD AS EXOFFICIO.

LARRY WALLACE IS ON THE BOARD AS A VOTING MEMBER.

UM, WE ARE IN THE PROCESS OF RENEWING OUR ILA.

WE HAVE HAD A TON OF SUPPORT FROM THE TRAVIS COUNTY COMMISSIONERS FOR THE RENOVATION PROJECT AND A TON OF SUPPORT FROM THE COUNCIL FOR OUR BUDGET AS WELL.

AND, UM, THOSE THINGS ARE THE THINGS THAT WE NEED TO KEEP KIND OF MOVING FORWARD.

ALRIGHT, THAT WAS A LOT.

ANY QUESTIONS FROM, UH, THE COMMISSIONERS? YEP, GO AHEAD.

SO, UM, DOES EVERYBODY QUALIFY FOR MAP? AND DO YOU, IF THEY DON'T, HOW ARE YOU COVERING THOSE COSTS? SO CURRENTLY WE HA EVERYBODY WHO COMES IN, IF THEY DON'T HAVE A PLACE TO GO, LIKE IF THEY WANNA GO TO TREATMENT, A LOT OF TIMES THEY CAN JUST GO HOME.

IF THEY HAVE RESOURCES, THEN IT'S GONNA BE EASIER FOR THEM TO GO HOME AND WAIT TO GO TO TREATMENT, OR WE CAN REFER THEM AND GIVE THEM A LIST.

TYPICALLY, OUR HOLDOVERS ARE GOING TO BE MAP ELIGIBLE BECAUSE IF THEY HAD A PLACE TO GO, THEY WOULD'VE ALREADY GONE THERE.

UM, SO MOST OF OUR PATIENTS THAT ARE HOLDOVERS ARE GONNA BE MAP ELIGIBLE.

WE'VE DONE A COUPLE OF TEST RUNS JUST THROUGH THEIR DATABASE AND FOUND THAT MOST OF THEM WILL BE MAP ELIGIBLE, NOT ALL OF THEM.

AND IN THOSE CASES WE JUST WON'T BILL FOR 'EM.

UM, OUR, OUR MAIN OPERATIONS ARE FUNDED BY AUSTIN PUBLIC HEALTH.

SO WHAT WE HAVE DONE, LIKE AUSTIN PUBLIC HEALTH HAS APPROVED OR NOT FUNDED BY AUSTIN PUBLIC HEALTH FUNDED BY THE CITY.

UM, BUT THE CITY HAS APPROVED FOR US TO DO THESE HOLDOVER PROGRAM.

WE'RE JUST TRYING TO FIND ADDITIONAL REVENUE STREAMS TO SUPPORT IT.

SO NOT EVERY SINGLE PATIENT WILL BE CENTRAL HEALTH BUILD, BUT EVERY SINGLE PATIENT THAT'S CENTRAL HEALTH BILLABLE, THAT'S ELIGIBLE WILL BE.

AND THAT'S GONNA BE A PRETTY SIGNIFICANT PORTION OF THAT HOLDOVER POPULATION.

AND DO YOU QUALIFY THEM FOR MAP AT THAT TIME OR? WE, IT'S SO MUCH SIMPLER THAN IT SHOULD BE.

WE RUN THEM THROUGH THE SYSTEM, CHECK IF THEY HAVE MAP, AND IF THEY DO, WE CAN BILL FOR THEM AS LONG AS THEY'VE BEEN THERE 24 HOURS SO FAR.

THE FIRST BATCH WE RAN WAS ONLY A, A HANDFUL OF PEOPLE WHO DIDN'T HAVE MAP.

WE CAN'T CURRENTLY APPLY FOR MAP WITH THEM THERE, BUT WE'RE WORKING ON THAT AS A POTENTIAL NEXT STEP.

WE'RE KIND OF JUST LIKE TRYING THIS OUT.

SO WE JUST SENT OUR FIRST, UM, INVOICE AND WE'RE GONNA KIND OF SEE HOW IT GOES.

UM, BUT CENTRAL HEALTH HAS ALSO SAID IF THIS, YOU KNOW, IF, IF THE VOLUME IS MORE THAN YOU THINK, WE CAN ALWAYS INCREASE THE CONTRACT NEXT YEAR.

SO THEY'VE BEEN JUST EXTREMELY ACCOMMODATING.

BUT WE MIGHT WANNA BE A PORTAL WHERE WE CAN APPLY FOR MAP DIRECTLY THERE IF THEY DON'T HAVE IT, IT, BECAUSE THAT WOULD BE DEFINITELY A WAY TO SERVICE COORDINATE IN A MORE EFFECTIVE WAY.

TRADITIONALLY, WE HAVEN'T HAD CASE MANAGERS AT THE SOBERING CENTER, SO REALLY OUR STAFF ARE LICENSED CHEMICAL DEPENDENCY COUNSELORS AND THE PARAMEDICS AND PEOPLE WITH LIVED EXPERIENCE.

SO WE MIGHT HAVE TO DO SOME TRAINING IF WE'RE GONNA DO MORE CASE MANAGEMENT AND THAT TYPE OF WORK.

UM, BUT RIGHT NOW IT'S MORE JUST FINDING A HANDOFF TO TREATMENT AND THEN HAVING ADDITIONAL PAYERS COME IN AND SUPPORT THE OPERATIONAL EXPENSES.

THANK YOU FOR THAT PRESENTATION.

DO YOU HAVE ANY DEMOGRAPHIC DATA? I'M MORE MOSTLY CURIOUS AS TO WHERE THE PEOPLE ARE COMING FROM.

ARE THEY AWESOME TRAVIS COUNTY RESIDENTS? OR ARE WE SEEING A LOT OF PEOPLE OUTSIDE OF OUR AREA? UM, GIVEN THAT THIS IS SUCH A GREAT SYSTEM, HAVING SOME PEOPLE EVEN OUTSIDE THE STATE COMING HERE SPECIFICALLY FOR THIS SERVICE? YEAH, WE DON'T HAVE PEOPLE LIKE COMING OUTSIDE THE STATE FOR OUR SERVICE, BUT WE DEFINITELY HAVE TOURISTS.

UM, SO WE'LL SEE THAT PICK UP LIKE DURING SOUTH BY AND DURING ACL OR F1, WE'VE SEEN PEOPLE FROM ALL OVER THE WORLD COME THROUGH THE SOBERING CENTER.

UM, BUT MOST OF THEM ARE GONNA BE AUSTIN, TRAVIS COUNTY RESIDENTS.

AND THEN EVEN MORE CONCENTRATED ARE GONNA PROBABLY BE COMING FROM DOWNTOWN OR POTENTIALLY ARE INTOXICATED DOWNTOWN BECAUSE THAT'S WHERE THEY SEE THE MOST VOLUME OF ACTIVITY.

BUT WE DO GET REFERRALS FROM OUTSIDE.

WE GET REFERRALS FROM PFLUGERVILLE THAT'S LIKE IN THE COUNTY, BUT OUTSIDE THE CITY.

UM, AND THEN OBVIOUSLY WE GET REFERRALS FROM ALL KINDS OF PLACES THAT ARE FOLKS ARE VISITING HERE.

AND WE, WE DEFINITELY KIND OF WANT THIS TO BE A PUBLIC SERVICE FOR, FOR ANYONE WHO'S VISITING.

UM, BUT YES, OFF THE TOP OF MY HEAD, I CAN TELL YOU THAT OUR DEMOGRAPHICS, I HAVE DATA ON THIS, BUT WE SERVE, 75% OF OUR PATIENTS ARE MEN, UM, ARE MALE IDENTIFYING.

WE HAVE ABOUT ABOUT 13% ARE AFRICAN AMERICAN, BETWEEN 11 AND 13%.

ABOUT 30 TO 32% ARE LATINO.

UM, AND YEAH, AND SO WE'VE SEEN THOSE NUMBERS PICK UP TOO.

WE ALSO HAVE SEEN THE NUMBERS GO LIKE ABOUT, IT WAS ABOUT 20% HOMELESS WHEN I STARTED.

IT'S PROBABLY ABOUT 30% HOMELESS NOW.

UM, BUT STILL ABOUT 70% OF OUR PATIENTS ARE ONE TIME VISITORS.

, ANY ADDITIONAL QUESTIONS? I HAD A COUPLE.

UM, CAN YOU PULL UP THE SLIDE,

[00:35:02]

THE OPERATIONS CIRCULAR SLIDE? AND THIS IS GONNA BE MORE FOR THE EX OFFICIALS IN, IN THIS ASPECT.

I, I LIKE THE FACT THAT YOU HIGHLIGHTED, UM, THE ONE THAT HAS THE, THE CIRCLE, THE SNAPSHOT ONE.

OH YEAH, YEAH, YEAH.

THAT ONE, THAT ONE RIGHT THERE.

WHERE I LIKE, WHERE I'M GONNA HIGHLIGHT TWO THINGS THAT YOU, YOU DISCUSSED THROUGHOUT THIS WHOLE PRESENTATION THAT I THINK HITS GOAL ONE AND GOAL TWO PERFECTLY.

AND I WOULD LOVE TO BE ABLE TO SEE WHERE, UH, SYNERGY IS AT CURRENTLY WITH THE AGENCIES A PART OF THIS PUBLIC HEALTH COMMISSION AND WHERE THERE CAN BE POTENTIALLY EVEN GREATER, UH, SYNERGY.

UH, I, I LIKE WHERE FOR NUMBER ONE, WHEN YOU'RE TALKING ABOUT MAXIMIZING THE USE OF THE SOBERING CENTER AS A FIRST LINE RESPONSE TO INTOXICATION, THAT YOU'RE ALREADY HIGHLIGHTING STRAIGHTFORWARD, THAT THIS IS INTENTIONALLY SUPPOSED TO BE A JAIL, UH, IN RECORD PREVENTION, UH, EFFORT.

RIGHT? UM, UM, YOU KNOW, SO THEY'RE NOT BEING GO PICKED UP BY THE POLICE AND THEN TAKEN TO THE JAIL DIVERSION.

IT? OR IS IT, OR IS IT CITY OF AUSTIN? CURRENTLY? THE CITY OF AUSTIN.

UM, WHICH DEFINITELY CAN BE A PLACE OF, UH, EQUITY ENHANCEMENT AS WE'RE TALKING WITH.

I DON'T THINK, UH, WELL, WE DO HAVE REPRESENTATION HERE FROM CENTRAL HEALTH WHERE I THINK THAT CAN TIE HEAVILY INTO WHAT THEIR PLAN IS WITH THE HEALTH EQUITY PLAN.

UH, I WOULD LOVE TO BE ABLE TO SEE HOW THIS GOAL ONE AND WHAT YOU'RE DOING WITH THAT PREVENTION ASPECT CAN BE REAL HEAVILY TIED WITHIN THEIR HEALTH EQUITY PLAN AND WHAT THEY HAVE STRUCTURED OVER THE NEXT SEVEN YEARS AS GROWING THE RESOURCES AND THE SUPPORT AND, AND, AND PROCESSES.

UM, I I LIKE THE PIECE THAT YOU SAID THIS IS 24 HOURS, RIGHT? SO IT'S, IT'S OPEN AND REALLY AVAILABLE FOR ANYONE THAT NEEDS IT WITH THE CONTINGENCY OF THE REFERRAL PROCESS, RIGHT? MM-HMM.

AND I THINK WITH THAT LAST PIECE OF THE REFERRAL PROCESS ASKING HERE IS, UM, COMING TOGETHER TO POTENTIALLY CREATE SOME TYPE OF A ASSISTANCE IN MESSAGING BECAUSE OF THE WAY THAT THE, THE SOBERING CENTER IS, IS ESTABLISHED THROUGH THE ILA, HOW IT'S BEING FUNDED.

UM, I, I THINK THERE'S VERY CRITICAL AND CRUCIAL THAT ALMOST EVERY AGENCY IS HELPING TO HIGHLIGHT THE SOBERING CENTER, THE, THE, THESE POINTS THAT ASSOCIATE WITH GOAL ONE, BUT THEN ALSO HIGHLIGHTING EVEN IF IT'S A LINK TO THE REFERRAL PARTNERS AND SAYING REFERRAL, THESE ARE THE DIFFERENT ENTITIES THAT ARE PARTNERED WITH THE SOBERING CENTER TO HELP WITH THAT.

AND ALSO MAYBE ARE THERE OTHER ENTITIES WITHIN THE COUNTY THAT MAY WANT TO PARTNER WITH THE SOBERING CENTER BECAUSE, UM, YOU KNOW, IN SOME OF MY SPACES IT IS NOT KNOWN.

AND I THINK THIS IS A VERY CRUCIAL RESOURCE, RIGHT? GIVEN, ESPECIALLY WHEN YOU'RE TALKING ABOUT IF THE POLICE OFFICER DOESN'T KNOW, OR IF THE EMS DOESN'T KNOW, OR WHOEVER'S ENGAGING WITH THAT INTOXICATED PERSON OR PERSON ON SUBSTANCE ABUSE DOESN'T KNOW, HOW ARE WE MAKING SURE THAT THE COMMUNITY KNOWS AND HELPS THEM ASK FOR THAT FOR, FOR THAT, UH, UH, REFERRAL TO COME TO THE SOBERING CENTER? HOW ARE WE HELPING THE INDIVIDUALS AND NOT, UM, HAVING THE SOBERING CENTER POTENTIALLY OVER RELY ON THE REFERRAL REFERRAL ORGANIZATIONS.

UM, THE OTHER PIECE IS FOR GOAL TWO, WHAT I LIKED YOU SAID, DEVELOP INTO AN ESSENTIAL COMMUNITY HUB FOR A MORE INTEGRATED SYSTEM OF CARE.

AND WHAT I WROTE DOWN HERE, WHICH YOU HIGHLIGHTED, WAS THIS CONNECTIVITY INTO THE, THE SUBSTANCE ABUSE PROGRAMS WHERE A PERSON DOESN'T HAVE TO FEEL AS IF, IF THEY DO FAIL INTO DRINKING OR WHATEVER, THAT THEY ARE HAVING TO START A PROGRAM ALL OVER WHICH NINE TIMES OUTTA 10, THEY PROBABLY HAD TO GO THROUGH A LOT OF EMOTIONAL DISTRESS TO EVEN GO TO THAT, THAT SOBRIETY PLACE.

AND I THINK THAT'S ANOTHER KEY THING TO HIGHLIGHT THERE, BECAUSE I THINK IT HELPS IN THE DISCUSSION PIECE OF BEING ABLE TO SAY FOR THOSE ORGANIZATIONS THAT, HEY, THIS ISN'T A ONE AND DONE, OR YOU HAVE TO GO BACK THROUGH THE VETTING PROCESS, YOU KNOW, UH, HUMANISTICALLY, THERE MAY BE SOME HICCUPS, BUT WE'RE PART PARTNERED WITH THE SOBERING CENTER, SO HOW DO WE HELP MESSAGE AND COMMUNICATE THAT? AND THEN THE LAST TWO PIECES, I THINK YOU ALREADY HIT IT ON, UH, YOUR ONE SLIDE.

WHAT WAS IT? WHERE ARE WE HEADED NOW? UM, YOU HAVE THE TRAUMA CENTER, YOU HAVE THE DIVERSION CENTER, UM, YOU KNOW, I KNOW THOSE CONVERSATIONS ARE COMING UP, UH, AND, AND STILL IN THE FIRST INITIAL YEARS OF THOSE COMING INTO FRUITION.

UM, HOW CAN YOU KNOW FOR YOU OVER AT THE TRAVIS COUNTY HEALTH AND HUMAN SERVICES COMMISSION, MAKE SURE THE SOBERING CENTER IS A PART OF THOSE, UH, DISCUSSIONS REGARDING THE, THE DIVERSION CENTER.

UM, AND, UH, I FORGET IT IS NOT UNDERNEATH YOU ALL TOO FOR THE TRAUMA CENTER, IS

[00:40:01]

FOR THE TRAUMA RECOVERY CENTER.

DIRECTLY INTO THEIR RESPITE.

YEAH.

'CAUSE I WOULD LOVE FOR THEM TO BE A PART OF THAT BECAUSE AGAIN, AS YOU'RE TALKING ABOUT HOW MANY SOBERING CENTERS ARE THERE NATIONALLY AND HOW MANY ARE IN WITHIN TEXAS? OH, THERE'S ONLY, UM, THREE IN TEXAS, BUT THERE'S, THERE'S PROBABLY A COUPLE DOZEN ACROSS THE COUNTRY.

RIGHT.

SO I THINK AGAIN, RIGHT, JUST THE LIMITED AVAILABILITY OF SERVICES AND PROGRAMS LIKE THIS, HOW ARE YOU BEING INTENTIONAL IN MAKING SURE THEY'RE IN THE ROOM? UH, AND, AND A PART OF THE CONVERSATIONS.

AND THEN THE LAST ONE, JUST THE CONNECTED OF SERVICES AS YOU STATED, UM, THAT WHEN A PERSON SOBERS UP, UH, OR WHATEVER ASPECT, I DON'T WANNA PUT WORDS IN YOUR MOUTH IN THIS SENSE, BUT NEEDING MORE CONNECTION TO PRIMARY CARE, BEHAVIORAL HEALTHCARE, AND MAYBE OTHER TYPES OF SOCIAL DETERMINANT SUPPORT.

SO AGAIN, HOW CAN WE POTENTIALLY MAKE SURE WITHIN THE AGENCIES THAT, THAT THAT CONNECTION IS A LITTLE BIT MORE, UH, THERE POTENTIALLY JUST FOOD FOR THOUGHT.

UM, AGAIN, DON'T WANT TO GET INTO THE WEEDS, BUT THINGS THAT COME TO MIND THAT DOWN THE ROAD MAYBE WE CAN LOOK AT AND SEE HOW, FROM A POLICY STANDPOINT, SOME RECOMMENDATIONS OF BETTER CONNECTEDNESS, UM, BETWEEN THE SOBERING CENTER AND DIFFERENT AGENCIES.

UH, ANY THOUGHTS OR REMARKS? GO AHEAD.

UM, THANK YOU FOR THE PRESENTATION.

I WAS DEBATING ON BRINGING THIS QUESTION UP, BUT I FEEL LIKE CHAIR WALLACE OPENED THE DOOR.

SO, UM, WHEN YOU'RE TALKING ABOUT, YOU KNOW, ASSISTANCE WITH COORDINATING AND GETTING THEM HOME AND FOR YOUR WRAPAROUND SERVICES, ARE THERE CONVERSATIONS THAT THE SOBERING CENTER DOES THEN HAVE WITH LIKE THE HOUSING AUTHORITY OR OTHER WAYS TO, UH, WORK ON THAT CONTINUUM OF CARE CONVERSATION SO THAT THAT PERSON IS NOT THEN COMING BACK TO YOU 75 TIMES ONCE IN A SUMMER? UM, IS THAT, IS THAT A CONVERSATION THAT YOU ALL ARE WANTING TO HAVE ALREADY HAVING COULD HAVE? OR IS THAT OUT OF YOUR SCOPE? I THINK IT'S, I THINK THAT'S A GOOD QUESTION.

I DON'T, I THINK THAT'S, WE'RE KIND OF STRADDLING THAT RIGHT NOW.

I THINK WHEN THE SOBERING CENTER OPENED, IT WAS DESIGNED TO BE A VERY SHORT TERM INTERVENTION.

UM, AND, AND SO LIKE WE JUST HAD THIS CONVERSATION AT THE LAST BOARD MEETING AND UM, COUNCIL MEMBER HARPER MADISON WAS ASKING THAT TOO ABOUT, SHE WAS LIKE, OH, THIS SOUNDS A LOT DIFFERENT THAN IT WAS WHEN IT FIRST OPENED.

'CAUSE IT IS BECAUSE WE'VE BEEN RESPONSIVE TO THE NEEDS, BUT WE HAVE, WE DON'T HAVE A STAFF OF CASE MANAGERS AND SOCIAL WORKERS AND WE DON'T HAVE THE PATIENTS WITH US LONG ENOUGH.

NOR DO WE HAVE VERY MUCH SPACE TO REALLY DO LONG-TERM CASE MANAGEMENT.

LIKE THEY'RE NOT COMING BACK FOR RETURN APPOINTMENTS.

YOU KNOW, WE'RE NOT CASE MANAGERS.

SO WE, WHAT WE TRY TO DO IS LINK THEM WITH THAT.

IF THEY ALREADY HAVE A CASE MANAGER SAY THROUGH ANOTHER SYSTEM, UM, WE TRY TO, WE USE OUR, THE HMIS SYSTEM TO TRY TO SEE IF THEY'RE ALREADY CONNECTED OR, OR SOMEONE'S LOOKING FOR THEM TO PUT THEM INTO HOUSING OR SOMETHING LIKE THAT.

WE DO THAT ON A LIMITED BASIS.

BUT I WOULD SAY LIKE, LIKE I SAID, OUR, OUR STAFF ARE TRAINED FOR SPECIFICALLY LIKE MONITORING FOR SAFETY AND, YOU KNOW, KEEPING EVERYBODY ALIVE.

AND THEN IT'S, IT'S, IT WAS SORT OF BUILT TO BE THIS LITTLE BANDAID AND, AND IT, IT, DIVERSION IS AN OUTCOME IN AND OF ITSELF, RIGHT? LIKE THAT'S GREAT.

WE, WE DID THAT, BUT WHERE DO WE DIVERT THEM TO IS A REALLY BIG PROBLEM IN THIS COMMUNITY.

AND LIKE I SAID, WE'RE PUTTING PEOPLE ON BUSES OUT OF TOWN BECAUSE OUR RESOURCES IN TERMS OF TREATMENT LIKE DETOX, RESIDENTIAL IS DISAPPEARING AND WE'RE GOING BACKWARDS IN THAT.

SO WE DON'T REALLY HAVE THAT HERE.

AND SO, YOU KNOW, GETTING SOMEONE INTO HOUSING MIGHT HELP, BUT NOT IF THEY HAVE A CHRONIC, YOU KNOW, ISSUE WHERE THEY'RE GONNA STILL BE USING AND WE MAY SEE THEM AGAIN.

STILL, I'M OKAY WITH US SEEING REPEAT CLIENTS BECAUSE UM, I WOULD RATHER US SEE THEM A DOZEN TIMES AND, AND THEN WE BUILT THAT RAPPORT OVER TIME WHERE THEY ACTUALLY GO AND ACCESS SOME SERVICES.

UM, IT, I DON'T SEE THAT AS A FAILURE, BUT THEY'RE, BECAUSE IF IT'S NOT US, THEN IT'S THE JAIL, RIGHT? THEY'RE GOING TO THE JAIL A DOZEN TIMES OR THE HOSPITAL A DOZEN TIMES.

UM, BUT YES, I AGREE.

IT'S, I THINK WE ARE, WE ULTIMATELY, THIS IS A SHORT TERM INTERVENTION FOR A CHRONIC PROBLEM AND IT'S GONNA TAKE A LOT BIGGER OF A INTERVENTION COMMUNITY-WIDE.

YEAH.

IT'S SO, SO ARE YOU, YOU'RE ALSO SENDING OR GIVING PEOPLE INFORMATION ABOUT, UM, SERVICES AND INDUCTION MEDICINE SERVICES THROUGH INTERVAL CARE? MM-HMM.

OR COMMUNITY? MM-HMM.

AND COMMUNITY CARE IS A GREAT EXAMPLE.

INTEGRAL CARE AND COMMUNITY CARE ARE BOTH REFERRAL PARTNERS SO THEY CAN REFER TO US AND THEN VICE VERSA, WE CAN REFER BACK TO THEM.

AND SO, AND THEY, NEITHER OF THEM HAVE WAIT LISTS.

SO THAT'S, THAT'S DOABLE.

IF THE PERSON DOES WANT TO HAVE THAT SERVICE, IT IS DOABLE.

AND IF THEY'RE ABLE TO FOLLOW UP, LIKE, 'CAUSE MOST OF THAT'S GONNA BE OUTPATIENT.

UM-HUH? YEAH, WE DO HAVE THE BRIDGE TO RECOVERY PROGRAM THROUGH INTEGRAL CARE WHERE WE CAN PUT THEM

[00:45:01]

UM, AND THAT'S MORE RESIDENTIAL, BUT STILL WE DON'T REALLY HAVE A ROBUST SYSTEM OF RESIDENTIAL TREATMENT.

WE DO HAVE OUTPATIENT IF THEY CAN MANAGE THAT BEHAVIORALLY.

RIGHT.

AND I JUST HAD ONE FOLLOW UP WITH THAT.

SO WHEN YOU ARE REFERRING THEM OUT, DO YOU HAVE THAT DATA? DO YOU TRACK, UM, WHAT HAPPENS WITH THEM IN BETWEEN TIME? LIKE SAY FOR INSTANCE YOU DO SEE THEM AGAIN.

DO YOU GET TO SEE KIND OF THEIR JOURNEY IN THAT SPACE? AND I KNOW YOU'RE NOT, YOU'RE NOT DOING CASE MANAGEMENT.

SO YEAH, BECAUSE WE DON'T REALLY HAVE A CASE MANAGEMENT STAFF OR A SYSTEM FOR THAT.

WE DON'T REALLY KNOW WHAT HAPPENED IN BETWEEN EPISODES UNLESS THEY TELL US.

UM, WE DO KNOW A LITTLE BIT ABOUT THAT.

LIKE WE DO KNOW SOME OF THE, THE REPEAT FOLKS.

SO LIKE WE GET TO KNOW THEM OVER TIME AND KNOW WHO THEIR CASE MANAGER IS AND KNOW HOW TO LIKE RECONNECT THEM UP.

WE DON'T ALWAYS KNOW.

I, I LIKEN IT SOMETIMES TO THE EMERGENCY ROOM IN THE SENSE THAT IF THEY HAVE A HEART ATTACK, YOU KNOW, WE OFTENTIMES THEY ARE LIKE, WE LIKE FIX THIS AND SEND THEM HOME, RIGHT? BUT WE DON'T NECESSARILY KNOW IF THEY CONTINUE TO EATING ALL THAT BACON OR NOT , YOU KNOW, WE DON'T KNOW.

BUT, UM, WE TRY TO DO AS MANY LIKE FOLLOW-UPS AS WE CAN.

ESPECIALLY IF WE GET SOMEONE INTO TREATMENT.

IF THEY WILL GIVE US A CONSENT THEN WE CAN TRACK A LITTLE BIT.

BUT WE DON'T REALLY HAVE THE STAFFING FOR THAT BECAUSE IT WASN'T REALLY DESIGNED AS A LONG-TERM MODEL.

SURE.

AND SO YOU'RE NOT LICENSED AS A HEALTHCARE FACILITY, CORRECT? NO.

TO DISCUSSION INTAKE ACTION TO CREATE A BUDGET WORK GROUP FOR PHYSICAL YEAR 2025.

NO, WE'RE NOT.

ANY LAST QUESTIONS GOING ONCE, GOING TWICE.

THANK YOU FOR THE PRESENTATION.

THANK YOU FOR INVITING ME.

ALRIGHT, MOVING ON

[4. Discuss and take action to create budget work group for Fiscal Year 2025.]

UH, I'M DEFER TO YOU .

WELL THAT IS YOUR ACTION ITEM, BUT IN THAT ACTION ITEM, YOU ALSO NEED TO DECIDE WHO WANTS TO SERVE ON THAT COMMISSION.

UM, ON THAT WORK GROUP, YOU'RE ABLE TO PUT THREE UP TO THREE MEMBERS.

AND SINCE YOU DON'T HAVE A FULL COMPLIMENT OF YOUR BOARD, UM, YOU CAN SELECT THANK YOU.

YOU KNOW, I'M GONNA LEAVE THAT UP TO YOU CHAIR WALLACE, BUT THAT IS, UM, YOUR OPTION FOR YOUR, UM, ACTION ITEM TODAY.

DO I HAVE ANY SELF NOMINATIONS OR NOMINATIONS OF OTHERS AT THIS TIME TO SERVE ON THE BUDGET WORK GROUP? GOING ONCE.

CAN I ASK A QUESTION FOR CLARITY? YEP, GO AHEAD.

UM, THE BUDGET WORK GROUP IS SEPARATE FROM THE JOINT COMMISSION CONVERSATION THAT WAS HAVING.

SO THERE'S GONNA BE A BUDGET WORK GROUP THAT SOMEONE MAY NEED TO BE IN AS WELL AS POTENTIALLY ALSO A JOINT YES.

THE BUDGET WORK GROUP WOULD BE FOR US, UH, ANY, ANY PROPOSALS AND THINGS THAT WE WANT TO BE ABLE TO COME UP WITH.

UH, FOR EXAMPLE, WITH THE, UH, THE JIG, THEY HAD SENT AN EMAIL AND BASICALLY SAID, HEY, YOU KNOW, IF YOU'RE GONNA SEND ANYTHING, SIT IT IN VERY QUICKLY.

AND IT HAS TO BE PRETTY MUCH FLESHED OUT FOR THEM TO JUST BE ABLE TO REVIEW AND SAY, YEAH, WE'LL ADD IT TO THEIR LIST OF ENDORSEMENTS.

NO PROBLEM.

SO I SAID I GOT TWO HANDS OR Y'ALL RECOMMENDING OTHER PEOPLE , SO I GOT TWO.

ANYBODY ELSE OVER HERE? NO.

OPPOSING MOTION PASSES FORM FORMALITIES CONCLUDED.

SO WE GOT THREE.

I'LL BE ON IT AND THEM TWO.

UM, I DON'T NEED TO TAKE THIS TO VOTE 'CAUSE Y'ALL SAID NO.

ALRIGHT, I'LL FORMALIZE A VOTE.

UH, DO I HAVE A MOTION ON THE FLOOR TO APPROVE, UH, THE THREE NOMINATIONS FOR THE WORK GROUP? I SO MOVE.

DO I HAVE ANY QUESTIONS TO THE MOTION QUESTIONS? TO THE MOTION? THERE BEING NONE.

ALL THOSE IN FAVOR? RAISE YOUR HAND.

NONE.

UM, I DO WANNA, I DO JUST WANNA MENTION THAT AS YOU'RE CREATING YOUR WORK GROUPS MM-HMM.

THEY HAVE THE ABILITY TO MEET WITHOUT ANY DISCUSSION OR WHATEVER APPROVAL FROM YOU, THEY NEED TO START THAT ASAP LIKE YESTERDAY.

YEP.

UM, WITH THAT BEING SAID, ANY DISCUSSION ON, UH, THE OPPORTUNITY OF HAVING, UM, UH, VOLUNTEERS FROM THE UNIVERSITY HELP, UH, COMMISSIONERS WHEN IT COMES TO RESEARCH IZATION ENGAGING WITH YOU ALL TO KIND OF CONSOLIDATE THIS STUFF IN HELPING WITH THE DRAFTING OF PROPOSALS, NOT JUST FOR HERE, BUT, UH, IN LONG TERM? YEAH, I THINK FOR THE PURPOSES OF THE FISCAL YEAR 25 BUDGET, THAT MIGHT NOT BE FEASIBLE TO WORK OUT.

UM, I KNOW UT HAS A PROCESS.

UM, WE HAVE A PROCESS, SO IF YOU'RE GOING TO EXCHANGE INFORMATION THAT IS BELONGS TO THE CITY OR THE DEPARTMENT, UM, AND SO I, I THINK IT'S SOMETHING WE CAN LOOK INTO.

I DON'T KNOW IF WE CAN GET THAT DONE BEFORE MARCH.

BEFORE MARCH 31ST.

[00:50:01]

UM, I WILL SAY, I, I LISTENED.

THERE WAS A GENTLEMAN WHO HAD A RECOMMENDATION, PERHAPS THE WORK OF THIS FLEDGLING YEAR IS TO LOOK AT THE RECOMMENDATIONS THAT OTHER COMMISSIONS HAVE ALREADY PUT TOGETHER AND SEE WHICH ONES SPEAK TO YOU AND THAT YOU WANT TO ENDORSE.

UM, JUST, JUST FOR THE SAKE OF TIME.

UM, YEAH.

'CAUSE TODAY IS MARCH 6TH.

NO FULLY UNDER, FULLY UNDERSTOOD.

UM, THE, THE ONE THING I DID LIKE ABOUT THE, THE TWO ORGANIZATIONS WERE, THEY, THEY'RE ON LONGEVITY.

SO MOST OF THOSE INDIVIDUALS ARE LIKE FRESHMENS AND SOPHOMORES AND THE UT WALKER, AND I FORGET WHAT THE OTHER AGENCY, THEY, THEY LONG, LONG TERM.

AND SO JUST THE REALITY OF COMMISSIONS IN GROUPS, IT EBBS AND FLOWS AND BANDWIDTH AND ENERGIZED AND SO FORTH.

SO TO BE ABLE TO USE SOME OF THIS YOUNG BLOOD AND, AND, AND, AND ALL THAT TO HELP TO MAKE SURE WE DON'T DROP THE BALL JUST IN GENERAL RIGHT OF, OF RESEARCH AND DIALOGUE COM COMPILING, ANALYZING, AND HELPING US AS COMMISSIONERS MAKE SURE THAT WE ARE STEADILY BRINGING POLICY RECOMMENDATIONS.

HONESTLY, ME, I, I BELIEVE THAT'S A GREAT WAY OF LEVERAGING RESOURCES IN THE INTEREST OF OTHERS LOOKING TO, TO, UM, POTENTIALLY GROW THEIR OWN CAREER IN PUBLIC HEALTH AND HEALTH THEMSELVES.

SO, UH, ANY OTHER THOUGHTS, COMMENTS, RECOMMENDATIONS REGARDING THAT? I'LL DEFINITELY PROVIDE THAT FEEDBACK TO THEM.

UM,

[FUTURE AGENDA ITEMS]

NEXT THING I KNOW IS WE HAVE OUR MEETING TO IRON EVERYTHING OUT THIS SATURDAY, NINE TO ONE.

UM, DO YOU WANNA SPEAK REGARDING THE LINK THAT WAS SENT OUT? SURE.

UM, I DID CREATE A JAMBOARD.

IF YOU ARE TRYING TO ACCESS IT FROM YOUR E YOUR PRIVATE E UM, EMAIL ACCOUNT, IT WILL NOT WORK.

SO YOU HAVE TO BE ON THE CITY'S, UM, BC ACCOUNT IN ORDER TO ACCESS IT.

UM, I GOT A COUPLE EMAILS AND SOME PE SOME PEOPLE ACCESSED IT AND STARTED DELETING STUFF.

I'M LIKE, WAIT, WHAT ARE YOU DOING? BUT DON'T DELETE ANYTHING.

USE STICKY NOTES OR THE COMMENTS TO PUT YOUR FEEDBACK IN THERE.

WE'LL USE THAT TO START PUTTING OUT THE, UM, WORK SESSION ITEMS AS YOU ALL ARE, UM, DISCUSSING THE TOPICS FOR WHAT YOU WANT YOUR WORK GROUP NAMES TO BE.

UM, WHO'S GONNA SERVE ON THOSE WORK GROUPS.

AND SO THOSE ARE SOME LIKE JUST BULLET POINTS ON THAT JAMBOARD FOR YOU TO KIND OF THINK ABOUT AS YOU'RE, YOU KNOW, STARTING TO DO YOUR HOMEWORK, SHORT TIMEFRAME, BUT STILL HOMEWORK.

UM, ALSO SHARED SOME OTHER DOCUMENTS.

THE EXECUTIVE SUMMARY FROM THE CHA CHIP, IF YOU WOULD READ OVER THAT, THAT WOULD HELP KIND OF FORMULATE YOUR IDEAS AROUND YOUR PRIORITIES.

ALSO BRING BACK THE PRIORITIES LIST THAT YOU HAVE WORKED ON BEFORE AROUND WHAT TOPICS.

AND THAT SHOULD ALSO KIND OF HELP FORMULATE WHERE YOU ALL ARE WANTING TO MOVE TO THE NEXT STEP WITH CREATING YOUR WORK GROUPS AND ASSIGNING PEOPLE BASED ON INTERESTS.

AND AS DIRECTOR STIR SAID, YOU KNOW, REVIEWING THOSE BUDGET ITEMS, THOSE THINGS THAT ARE REAL TICKLERS THAT FALL INTO YOUR, UM, GOVERNANCE OF HOW YOU'RE CREATED WILL ALSO HELP STIMULATE THAT COM CONVERSATION.

SO IS THE EMAIL THAT I RECEIVED FROM THE J AND WHAT THEY HAD LISTED OUT, DID THAT GO OUT TO THE OTHER COMMISSIONERS? YES.

IT UH, SEE, I'M ABOUT TO SEND IT TO YOU AGAIN.

ALRIGHT, ANY LAST COMMENTS, REMARKS BEFORE I CALL THIS MEETING ADJOURNED? I HAVE A QUESTION.

YES, DO, IS THERE ROOM FOR CONVERSATION ABOUT WHAT WE WILL BE TALKING ABOUT ON SATURDAY'S LONG MEETING OR ANY PREP WORK AHEAD? OH, I THINK IT'S GONNA BE THE, UH, THAT, UH, JAM BOARD WE'LL HELP AND THEN KIND OF, I THINK AS WE DISCUSSED, BASED OFF OF THE JAMBOARD, THAT WILL REALLY HELP NAVIGATE WHERE THE CONVERSATION GOES FOR THAT DAY TO THEN CREATE THE WORK GROUPS.

VERSUS KIND OF SPENDING A WHOLE BUNCH OF TIME BRAINSTORMING.

LET'S GET THE BRAINSTORMING OUT.

NOW THE TEAM CAN BE ABLE TO CONSOLIDATE, IDENTIFY, UH, SIMILARITIES.

WHAT'S A STRAIGHT OUTLIER? SO THEN WE'RE COMING THERE.

EVERYBODY'S VOICE HAS ALREADY KIND OF BEEN HEARD FIRST.

YES.

WAS THE JAM BOARD SHARED WITH THE EXICUS? NO, PLEASE SEND IT TO ADRIAN.

AND, UM, DR.

WATS, THEY'RE ON THE SAME SYSTEM, BUT YOU ARE NOT, YOU AND, UM, PEARL ARE NOT PART OF THE, THE, UM, BC BOARD.

YOU DON'T HAVE AN EMAIL OR A C EMAIL ADDRESS.