Jun 04, 2025 Public Health Committee

AND IF WE CAN GET SOMEONE FROM CTM OR IT TO THE DIOCESE, WE'RE HAVING ISSUES WITH OUR COMPUTERS UP HERE.

COLLEAGUES WILL NOW MOVE ON TO APPROVAL OF THE PREVIOUS MEETING MINUTES.

UH,

[Approval of Minutes]

CAN I GET A MOTION FOR ITEM NUMBER ONE? WE HAVE COUNCIL MEMBER VELASQUEZ APPROVES AND SECONDED BY VICE CHAIR UCHIN.

THIS IS FOR MAY 7TH, 2025.

ANY OBJECTION TO APPROVING THE MEETING MINUTES?

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WONDERFUL.

THOSE MEETING MINUTES FROM MAY STAND APPROVED.

NOW WE'LL MOVE

[2. Briefing from Austin Travis County Mental Health Mental Retardation Center d/b/a Integral Care regarding mental health services, crisis response, and housing programs. [Dawn R. Handley, M.Ed., LPC, Vice President and Chief Operations Officer; Elizabeth Marrero, MSSW, Provider Network & Authority Officer; Marlene Buchanan, LPC, Director of Systems of Care - Integral Care].]

ON TO ITEM NUMBER TWO.

THIS IS A BRIEFING FROM AUSTIN, TRAVIS COUNTY, UH, MENTAL HEALTH CENTER, THE INTEGRAL CARE REGARDING MENTAL HEALTH SERVICES, CRISIS RESPONSE AND HOUSING PROGRAMS. I'D LIKE TO WELCOME DAWN R HENLEY, VICE PRESIDENT AND CHIEF OPERATIONS OFFICER ELIZABETH MORERO, PROVIDER NETWORK AND AUTHORITY OFFICER, AND MARLENE BUCHANAN, DIRECTOR OF SYSTEMS OF CARE WITH INTERVAL CARE.

THANK YOU SO MUCH, AND I APOLOGIZE IF I BUTCHERED YOUR NAMES ABOUT, BUT THANK Y'ALL FOR BEING HERE.

THERE WE GO.

THANK YOU FOR THE INVITATION.

HAPPY TO BE HERE.

DON HANLEY.

UM, I AM THE CHIEF OPERATIONS OFFICER AND VICE PRESIDENT FOR INTERVAL CARE.

UM, AND WE'RE HAPPY TO, UH, MEET WITH YOU TODAY TO TALK A LITTLE BIT ABOUT, UM, WHO WE ARE AND WHAT WE DO AS AN ORGANIZATION.

UM, APOLOGIES FOR NOT BEING ABLE TO MAKE THE MAY UH, VISIT, UM, BUT WE'RE HAPPY TO BE HERE TODAY NONETHELESS.

SO, INTEGRAL CARE IS THE LOCAL MENTAL HEALTH AUTHORITY FOR AUSTIN AND TRAVIS COUNTY.

WE'VE BEEN PROVIDING THESE SERVICES, UM, TO OUR COMMUNITY FOR MORE THAN JUST ABOUT 60 YEARS.

UH, WE'RE COMING UP ON THAT, UH, 60 YEAR MARK HERE SHORTLY.

WE PROVIDE SERVICES TO ADULTS AND, UM, FAMILY AND, AND, UH, CHILDREN AND WHO ARE EXPERIENCING A MENTAL, UH, ILLNESS NEED OR BEHAVIORAL HEALTH NEED THROUGH SUBSTANCE USE AND INTELLECTUAL AND DEVELOPMENTAL DISABILITY.

WE WERE THE FIRST COMMUNITY CENTER, UH, ACTUALLY IN CENTRAL TEXAS TO BE FORMED AND BEGIN PROVIDING THESE SERVICES.

AND WE ARE GOVERNED BY A BOARD OF TRUSTEES THAT'S APPOINTED BY CENTRAL HEALTH, UH, YOU THE CITY OF AUSTIN, UM, AND TRAVIS COUNTY AS WELL.

WE HAVE A PROVIDER AND AN AUTHORITY, UH, FUNCTION AS THE LOCAL MENTAL HEALTH AUTHORITY.

UM, I'LL START, WE'LL START OFF BY TALKING MORE ABOUT OUR PROVIDER SERVICES, AND THEN WE'LL BRING OUR NETWORK AND AUTHORITY OFFICER UP TO TALK A LITTLE BIT ABOUT THE SYSTEM OF CARE, WHICH, UM, INVOLVES OUR NETWORK PROVIDER ARM.

AND, UM, PART OF THAT AUTHORITY ROLE ALSO INVOLVES, UH, PLANNING AND WORKING WITH STAKEHOLDERS IN THE COMMUNITY TO IDENTIFY NEEDS AND GAPS RELATED TO BEHAVIORAL HEALTH AND INTELLECTUAL AND DEVELOPMENTAL DISABILITY NEEDS.

UM, LASTLY, WE ARE ONE OF 39 CENTERS IN THE STATE OF TEXAS, UH, THAT SERVE AS THE LOCAL MENTAL HEALTH AUTHORITY.

ONE THING THAT'S, UH, UNIQUE ABOUT US AND NOW ALL 39, UH, LOCAL MENTAL HEALTH AUTHORITIES, IS THAT WE ARE A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC.

THAT'S ANALOGOUS TO WHAT YOU PROBABLY ARE MORE FAMILIAR WITH AS AN FQHC.

UM, WE HAVE SEVERAL HERE IN TOWN, LONE STAR COMMUNITY CARE PEOPLE'S CLINIC.

SO THIS IS THAT BEHAVIORAL HEALTH.

LOOK AT THAT, UH, SIMILAR, UH, DESIGNATION.

SO THERE ARE CERTAIN CRITERIA THAT WE HAVE TO MEET.

IT'S A EVIDENCE-BASED MODEL.

IT PROVIDES COMPREHENSIVE INTEGRATED CARE, UM, WHICH INCLUDES SUBSTANCE USE, MENTAL HEALTH, UM, AND PRIMARY CARE SERVICES.

UM, THIS ALLOWS US TO LEVERAGE, UH, DIFFERENT FINANCING MECHANISMS, UM, IN ORDER TO PULL DOWN SOME FEDERAL FUNDS, UH, IN ADDITION TO, UH, UTILIZING SOME OF OUR STATE FUNDS AS MATCH.

ON THIS NEXT SLIDE, YOU WILL SEE JUST AN OVERALL LOOK AT WHAT OUR, UH, TOTAL FUNDING IS AS AN ORGANIZATION.

UM, WE'LL CONCENTRATE SPECIFICALLY ON THE CITY OF AUSTIN'S.

UM, WE HAVE 24, UH, CONTRACTS WITH THE CITY, SO ONE INTERLOCAL AND THEN 23 OTHER, UH, CONTRACTS THAT, UH, CONSIST OF THAT $18,000,781, UH, IN FUNDING, WHICH WE ARE GRATEFUL TO HAVE.

THAT INVOLVES SOME OF OUR, UH, OUTPATIENT SERVICES.

THAT INCLUDES THE HOUSING, THAT INCLUDES, UM, OUR CRISIS SERVICES OF WHAT AS WELL, OF WHICH WE'LL TALK A LITTLE BIT MORE AS WE MOVE INTO THE PRESENTATION.

THIS IS A SNAPSHOT OF OUR JUST KIND OF SYSTEM OF CARE, WHAT, WHAT THAT LOOKS LIKE AND WHAT'S, WHAT'S INVOLVED WITH THAT.

WE HAVE EMERGENCY SERVICES.

WE HAVE OUR HOTLINE AND 9 8, 8 SERVICES.

UH, WE ARE EMBEDDED INTO THE 9 1 1, UH, CRISIS, UH, SYSTEM SERVICE HERE IN AUSTIN, TRAVIS COUNTY.

WE HAVE OUTPATIENT, UH, CLINIC SERVICES AS WELL, UM, WHERE INDIVIDUALS ARE SERVED THROUGH CHILDREN AND ADULT SERVICES, AS WELL AS INTELLECTUAL AND DEVELOPMENTAL DISABILITIES.

WITHIN THAT ARRAY IS ALSO SUBSTANCE USE.

UM, SO WE HAVE AN IOP.

WE HAVE A METHADONE CLINIC AS PART OF THAT WORK, UM, WE HAVE JUSTICE INVOLVED SERVICES, WHICH YOU'RE, UH, FAMILIAR WITH THROUGH OUR, UH, DIVERSION.

UH, WE WORK WITH PROBATION AND PAROLE AS WELL IN HELPING DEFLECT AND DIVERT INDIVIDUALS FROM THE JUSTICE SYSTEM.

AND THEN A LARGE PART OF OUR WORK, UH, ALSO INVOLVES THAT, UH, HOUSING COMPONENT.

SO IF YOU, IF YOU THINK ABOUT THE SERVICES THAT WE PROVIDE ACROSS THE BOARD, THERE'S THAT PREVENTION FRONT DOOR SERVICE, AND THEN THERE'S THE INTERVENTION, AND THEN WE LINK AND REFER, UM, AS THE STEP THROUGH SERVICE.

THIS SLIDE GIVES YOU A LOOK AT HOW MANY INDIVIDUALS THAT WE'VE SERVED, UM, JUST UNDER

[00:10:01]

30,000 INDIVIDUALS AND FY 24.

THAT'S, UH, 426,000, UH, UNIQUE SERVICES.

UM, WE ARE STAFFED WITH ABOUT A THOUSAND EMPLOYEES, ACTUALLY A LITTLE BIT MORE.

AND WE HAVE OVER 30, UH, PROGRAMS AND SERVICES THAT WE OFFER BY WAY OF LIKE 120 PLUS, UH, CONTRACTS.

SO IT'S A PRETTY COMPLEX FUNDING, UH, ARRANGEMENT THAT WE HAVE, BUT THAT ALLOWS US TO KIND OF BRAID THAT FUNDING TOGETHER, UM, AND LEVERAGE, UH, OTHER RESOURCES TO DRAW DOWN FEDERAL AND STATE DOLLARS TO SERVE OUR COMMUNITY.

UM, NEXT SLIDE HERE JUST GIVES YOU A SNAPSHOT OF, UH, WHAT THESE CLIENTS, UH, GENERALLY LOOK LIKE.

UM, THE DE TOP DIAGNOSIS IS A DEPRESSIVE DISORDER.

THAT'S THE MAJORITY OF THE FOLKS THAT WE'RE SERVING.

ALMOST 40% OF THEM HAVE AN ACTIVE, UH, SUBSTANCE USE CO-OCCURRING DIAGNOSIS.

UM, OVER HALF OF THOSE INDIVIDUALS ARE CHILD AND FRAN WITH, UH, CHILD AND FAMILY SERVICES.

THOSE KIDDOS ARE EXPERIENCING, UH, A LOT OF TRAUMA.

40%, UM, OF THE FOLKS WE'RE SERVING HAVE CHRONIC MEDICAL NEED, AS WELL AS 20% OF THOSE WITH, UH, CO-OCCURRING IDD.

SO THAT'S A BEHAVIORAL HEALTH DIAGNOSIS AND IDD DIAGNOSIS.

THIS GIVES YOU A LOOK, A HEAT MAP OF WHERE THE CLIENTS ARE THAT WE'RE SERVING IN THE BLUE.

THAT'S WHERE THEY'RE LOCATED IN THE, UH, WHITE ICON, WHICH IS OUR, OUR LOGO ARE THE LOCATIONS WHERE WE ARE, WHERE FOLKS CAN ACCESS, UM, OUR CARE.

ONE NOTE IS THAT AS A LOCAL MENTAL HEALTH AUTHORITY, OUR MAIN FOCUS IS LEAST RESTRICTIVE CARE.

SO COMMUNITY BASED.

WHENEVER WE CAN, UH, SERVE FOLKS IN A COMMUNITY IN THAT LEAST, UH, RESTRICTIVE ENVIRONMENT, WE WANT TO FOCUS TO DO SO.

SO THIS MAY BE WHERE WE HAVE CLINICS OR HOUSING LOCATIONS, UM, OR CRISIS RESIDENTIAL LOCATIONS, BUT WE'RE ALSO MEETING THOSE PEOPLE IN THE BLUE AREAS WHERE THEY LIVE.

THERE ARE SOME INDIVIDUALS WE GO TO THEIR HOMES AS WELL.

AND THE NEXT SLIDE WILL BE THE SYSTEM OF CARE.

AND WE'LL HAVE OUR CHIEF, UM, SYSTEMS NETWORK OFFICER, UH, ELIZABETH PRESENT ON THIS ITEM.

HI, GOOD MORNING.

UM, I'M ELIZABETH MORERO.

AND, UM, I'M HERE TO TODAY TO TALK TO HIGHLIGHT HOW THE CITY OF BOSTON'S INVESTMENTS IN INTER CARE SYSTEM OF CARE ARE HELPING US MEET URGENT NEEDS ACROSS OUR COMMUNITY AND DOING SO WITH IMPACT COORDINATION AND ACCOUNTABILITY.

UH, THE CITY OF AUSTIN IS PROJECTED TO INVEST OVER 24.6 MILLION INTO THE SYSTEM OF CARE AND FY 25 WITH THE LARGEST ALLOCATIONS FOCUSED ON HOUSING AND HOMELESS SERVICES AT 10.3 MILLION CRISIS SERVICES, SYSTEM OF CARE AND SMALLER CONTRACTS WITHIN THAT AND SUBSTANCE USE DISORDER AT 1.35 MILLION.

AND CHILD AND FAMILY SERVICES, THESE INVESTMENTS REFLECT AN INTEGRATED STRATEGY TO REVIEW REDUCE FRAGMENT FRAGMENTATION ACROSS SERVICES.

IT'S ALIGN, ALIGNING HOUSING, CRISIS PREVENTION, AND LONG-TERM BEHAVIORAL HEALTH NEEDS.

I WANNA EMPHASIZE THAT THESE AREN'T JUST PROGRAM LINES.

THIS IS A MODEL THAT ENSURES THAT SERVICES ARE CONNECTED AND NOT SILOED.

IT MEANS THAT THE SAME PERSON EXPERIENCING HOMELESSNESS OR MENTAL HEALTH CRISIS AND SUBSTANCE ABUSE, UH, USE, CAN USE, UH, ONE SYSTEM AND NOT BE BOUND ACROSS MULTIPLE ONES.

UH, CITY FUND CITY FUNDING ALSO HELPS US BRING SERVICES CLOSER TO WHERE THEY'RE NEEDED.

UM, AS, UH, DON SHOWED WITH THE HEAT MAP, FOR EXAMPLE, PROGRAMS LIKE THE CRISIS INTERVENTION, WHICH WHICH YOU'LL HEAR MORE ABOUT IS CO-FUNDED BY THE CITY AND HELP HELPS US DECRIMINALIZE MENTAL ILLNESS.

AND WE'RE SEEING MUCH BETTER RESULTS BECAUSE OF THAT AND THE INVOLVEMENT.

UM, I'D LIKE TO CLOSE WITH THIS.

THE SYSTEM OF CARE IS NOT AN ABSTRACT IDEA.

WE'VE SERVED OVER 28,000 INDIVIDUALS, UH, IN INTEGRAL CARE ACROSS ALL PROGRAMS THIS YEAR.

AND THE SYSTEM OF CARE ENSURES THAT AUSTIN'S MOST VULNERABLE RECEIVE INTEGRATED AND EFFECTIVE SERVICES.

UH, WE'RE CONTINUING TO LOOK TO EXPAND OUR PROVIDER NETWORK AND LOOKING TO FILL THOSE GAPS AND INCREASE ACCESS TO SERVICES THAT ARE NOT BEING MET CURRENTLY.

AND YOUR CONTINUED INVESTMENT IS WHAT ALLOWS US TO MEET PEOPLE WHERE THEY ARE AND KEEP THEM HOUSED AND ENSURE THAT THEY DON'T FALL THROUGH THE CRACKS.

AROUND CRISIS, RESIDENTIAL OR INTENSIVE SERVICES.

THANKS.

AS YOU NOTICED ON THE PREVIOUS SLIDE, UM, THE LARGEST AMOUNT OF FUNDS THAT THE CITY IS SUPPORTING OUR WORK IN FALL IN THE HOUSING BUCKET AND THE CRISIS BUCKET.

SO WE'LL ROLL INTO, UM, A SNAPSHOT OF WHAT, WHAT SOME OF THAT CRISIS WORK LOOKS LIKE.

SO INTEGRAL CARE DELIVERS, UM, A COMPREHENSIVE RESPONSIVE CONTINUUM OF CRISIS SERVICES THAT ARE DESIGNED TO MEET INDIVIDUALS WHERE THEY ARE, UH, RANGING FROM THAT EARLY INTERVENTION TO COMMUNITY-BASED PROGRAM.

SO THAT LEAST RESTRICTIVE, UH, CARE THAT I SPOKE ABOUT EARLIER.

UM, AND, UH, MOST OF OUR SERVICES ARE, UH,

[00:15:01]

WE ALSO HAVE INVOLUNTARY SERVICES THAT WE CAN PROVIDE AT THE JUDGE, GE HERMAN AT OUR EX, UM, UH, EOU, WHICH IS OUR EXTENDED OBSERVATION UNIT.

UM, THOSE, UH, INDIVIDUALS CAN BE BROUGHT IN, UH, BY, UH, LOCAL LAW ENFORCEMENT IF THEY'RE ON A-P-O-E-D OR AN INVOLUNTARY HOLD, WE CAN TAKE SOME OF THOSE CLIENTS AT THE HERMAN CENTER AND TRANSITION THEM THROUGH OUR SYSTEM OF CARE.

AT THAT POINT.

WE ALSO PROVIDE A 24 7 CRISIS HOTLINE, UM, WHICH SERVES, UH, PRIMARILY AUSTIN AND TRAVIS COUNTY.

BUT AS PART OF OUR WORK, WE'RE ALSO, UM, A 9 8 8 PROVIDER.

SO THAT'S MORE OF A REGIONALLY BASED, UM, RESPONSE ON TAKING CRISIS CALLS.

AND THAT INCLUDES 76 OF THE CURRENT, UM, SURROUNDING COUNTIES.

THESE, UH, CALLS CAN BE ROUTED THROUGH 9 8 9 8 8 BASED ON, UH, WHAT YOUR, UH, UH, NOT ZIP CODE.

HELLO.

WHAT'S THE FIRST THREE NUMBERS? AREA CODE, THERE YOU GO, .

AND THEN THEY'LL ROUTE.

SO IF IT'S AN AUSTIN AREA CODE, YOU, NO MATTER WHERE YOU ARE, THAT WILL COME THROUGH OUR NINE EIGHT EIGHT, UH, CALL SYSTEM.

ADDITIONALLY, CRITICAL COMPONENTS OF THE CRI OF OUR CRISIS SYSTEM OF CARE ARE PSYCHIATRIC EMERGENCY SERVICES, WHICH IS A WALK-IN URGENT CARE CLINIC FOR IMMEDIATE MENTAL HEALTH NEEDS.

UM, WE ALSO HAVE A CRISIS RESIDENTIAL AND RESPITES, WHICH ARE LESS INTENSE LEVEL OF CARE, BUT THOSE SERVE AS EITHER DIVERSION TO INPATIENT OR STEP DOWN FROM INPATIENT.

IT ALSO CAN SERVE AS DIVERSION, UH, TO JAIL AS WELL, WHICH YOU'LL HEAR ABOUT IN ANOTHER PRESENTATION, UH, FOLLOWING OURS.

UM, ON THE WORK THAT WE'RE DOING, UH, THROUGH A COLLABORATION WITH THE CITY OF THE COUNTY, UM, AND OURSELVES, UH, THESE FACILITIES OFFER SHORT TERM, UH, STABILIZATION AND TREATMENT, UM, AND HELP IMPROVE, UH, OUTCOMES FOR INDIVIDUALS BY THAT LEAST RESTRICTIVE RESPONSE.

AND ALSO REDUCE THE STRAIN ON THE EMERGENCY SYSTEMS, UH, USING LAW ENFORCEMENT EMS OR, UH, EMERGENCY DEPARTMENTS.

THE CITY OF AUSTIN, UH, INVESTED IN THE THERAPEUTIC DIVERSION PROGRAM.

I'M NOT GONNA GO INTO GREAT DETAIL HERE BECAUSE YOU'RE GETTING A FULL PRESENTATION ON THIS WORK SHORTLY.

UM, THIS IS A 25 BED, UH, SPECIALTY SHELTER FOCUSED TO PROVIDE, UM, ALTERNATIVE TO INCARCERATION.

THESE SERVICES INCLUDE CASE MANAGEMENT, UH, COUNSELING, GROUP THERAPY, PEER SUPPORT, NURSING MEDICATION EVALUATION, UM, AND MEDICAL SERVICES, WHICH WE PARTNER WITH CENTRAL HEALTH ON, UH, THROUGH THEIR BRIDGE WORK.

SO THEY'LL COME OUT AND, UH, ANYONE WITH THOSE CO-OCCURRING, UH, PRIMARY CARE NEEDS, UH, WILL BE ADDRESSED THROUGH, THROUGH THAT MOBILE PROGRAM.

THE FACILITY FOLLOWS THE CRISIS, UH, RESPITE STANDARDS OF CARE.

UM, SO IT'S YOUR, UH, MOST STABLE, LEAST RESTRICTIVE AND IS VOLUNTARY.

AND THIS PARTICULAR, UH, RESPITE PROGRAM, UH, JUST TO EMPHASIZE, HAS BEEN DESIGNATED AS A SHELTER.

SO WE'RE WORKING AS PART OF THE SHELTER SYSTEM, TRYING NOT TO DISCHARGE PEOPLE INTO HOMELESSNESS.

IF WE CAN HANG ONTO 'EM A LITTLE LONGER THROUGH THIS PROGRAM AND HOPEFULLY MOVE THEM, UH, CONNECT THEM TO A HOUSING PROVIDER AND HELP LOCATE THAT, THAT HOUSING.

UH, IN ADDITION, UH, THE CITY OF AUSTIN HAS, UH, INVESTED QUITE A BIT OF FUNDS IN OUR CRISIS RESPONSE THROUGH OUR EXPANDED MOBILE CRISIS TEAM, OUR EM COT.

UM, IT'S A CRITICAL COMPONENT OF THE CITY'S BEHAVIORAL HEALTH SYSTEM.

THE EM COT PROGRAM OPERATES TWO SPECIALIZED TEAMS. ONE'S EMBEDDED INTO THE NINE ONE ONE CALL CENTER, AND THEN THE OTHER ONE PROVIDES A FIELD RESPONSE.

SO WE DO TAKE CALLS FROM THE CALL CENTER STAFF, UH, WHICH IS STAFFED BY A PD.

SO IF YOU CALL, UH, 9 1 1 IN AUSTIN AND YOU ASK FOR, UH, THEY'LL ASK YOU IF YOU NEED FIRE, UM, EMS, LAW ENFORCEMENT OR MENTAL HEALTH, IF YOU ASK FOR MENTAL HEALTH, THAT CALL WILL BE DIRECTED TOWARDS OUR, UH, CRISIS CLINICIANS ON THE FLOOR AT THE NINE ONE ONE CALL CENTER.

UM, WE ALSO CORRESPOND WITH, UH, OUR EMS PARTNERS, UM, AND A PD WITH OUR FIELD RESPONSE.

AND THIS TEAM CAN PROVIDE CRISIS SCREENING, ASSESSMENT, SAFETY PLANNING, AND TIMELY LINKAGE TO THE APPROPRIATE LEVEL OF CARE.

SO IF YOU NEED A HIGHER LEVEL OF CARE OF INPATIENT, WE CAN HELP, UH, FACILITATE THAT.

IF NOT, WE CAN MOVE YOU THROUGH OUR, UH, LESS RESTRICTIVE SERVICES UTILIZING PES OR OUR CRISIS RESIDENTIAL PROGRAMS. AND THE LA THE LAST NOTE ON THE MOBILE TEAM IS, UM, THAT I JUST WANNA TAKE A MINUTE TO REALLY, UH, EXPRESS MY GRATITUDE TO THE CITY FOR YOUR SUPPORT IN HELPING US DESIGN AND IMPLEMENT THAT PROGRAM.

IT ACTUALLY STANDS AS A NATIONAL EXAMPLE.

UM, THERE ARE MANY OTHER CITY OFFICIALS FROM VARIOUS STATES THROUGHOUT THE NATION THAT ACTUALLY CALL AND ASK FOR CONSULTATION, UH, FROM OUR TEAM TO HELP THEM BUILD A SIMILAR MODEL.

UM, WE'VE ALSO, UH, BEEN ABLE TO GET A STUDY THROUGH, UH, UT'S LBJ SCHOOL OF PUBLIC AFFAIRS AND CORNELL UNIVERSITY TO, UH, TAKE A LOOK AT THIS PROGRAM AND SHOW, UM,

[00:20:01]

THE EFFECTIVENESS OF THIS PROGRAM.

AND IT IS, UH, SHOWING AMAZING RESULTS.

AS YOU CAN SEE ON THE SLIDE, IT'S REDUCED, UM, UH, THOSE INVOLUNTARY, THE NEED FOR INVOLUNTARY HOLDS BY LAW ENFORCEMENT.

WE ARE REDUCING ARREST, WE ARE REDUCING USE OF FORCE INCIDENTS.

UM, WE ARE REDUCING THE AMOUNT OF TIME AN OFFICER HAS TO SPEND, UM, ON THE SCENE IF THEY ARE DISPATCHED.

AND THE COST SAVINGS ACROSS OUR SYSTEM OF CARE, UM, ARE PHENOMENAL AS WELL AS A RESULT OF THAT.

SO WE'RE REALLY, THIS IS REALLY SOMETHING TO BE PROUD OF ON WHAT WE'VE BUILT HERE.

AND FOCUSING ON, UH, SCALING IT TO THE NEED OF OUR CITY, I THINK IS VERY IMPORTANT.

UM, WE HAVE BUILT THIS PROGRAM OVER TIME TO KIND OF START IT AS, UM, FRONT DOOR.

YOU KNOW, A LOT OF PEOPLE THAT ARE ENTERING, UH, MENTAL HEALTH CARE ACTUALLY FOR THE FIRST TIME DO SO THROUGH A CRISIS SERVICE.

SO HAVING THAT CONNECTION WITH US UP FRONT WHEN THAT FIRST OCCURS, AND THEN MOVING THROUGH OUR SYSTEM OF CARE REALLY HELPS DIVERT, UM, AND THE OVERUSE OF THE EMERGENCY DEPARTMENT.

IT HELPS, UH, INDIVIDUALS RECOVER QUICKER BECAUSE THEY HAVE BETTER OUTCOMES.

UM, AND, AND IT ALLOWS FOR, UM, OUR CITY, UH, AND OUR CONSTITUENTS TO RECEIVE, UH, AN EXPERT IN THE FIELD WHEN YOU'RE HAVING A MENTAL HEALTH CRISIS, JUST AS YOU'RE HAVING A MEDICAL CRISIS AND YOU GET A MEDICAL EXPERT THROUGH EMS TO RESPOND TO YOUR CARE.

SO THIS IS REALLY IMPORTANT IF YOU LOOK AT RECOVERY AND RESILIENCY, UM, IS HAVING THAT RIGHT, UH, SCOPE AND THAT RIGHT PROVIDER, UH, PROVIDING THAT CARE AT THE RIGHT TIME WHEN OUR FOLKS, UH, NEED THAT HELP.

JUST WANNA TAKE A MOMENT TO REALLY APPRECIATE THESE FINDINGS.

IT'S PRETTY INCREDIBLE.

THE ONE ON THE LEFT IS TERRACE AT OAK SPRINGS.

AND I'M GONNA CLOSE THIS OUT BY TALKING ABOUT OUR SUBSTANCE USE AND HIV SERVICES, OUR HOUSING AND HOMELESS SERVICES, AND OUR CHILD AND FAMILY SERVICES.

SO AT INTERVAL CARE, WE PROVIDE A FULL RANGE OF SUBSTANCE USE SERVICES.

WE HAVE PREVENTION ALL THE WAY TO TREATMENT AND EVERYTHING IN BETWEEN.

UM, SO ON THE PREVENTION FRONT, WE HAVE SCREENING, UM, AND THEN AS WE MOVE INTO TREATMENT, WE OFFER MEDICA MEDICATION ASSISTED TREATMENT.

WE HAVE THE METHADONE CLINIC, WE ALSO HAVE HIV SERVICES AND OVERDOSE EDUCATION AND PREVENTION.

SO HERE YOU CAN SEE THE CITY'S INVESTMENT IN SUBSTANCE USE AND HIV SERVICES.

A LOT OF THIS IS THROUGH OUR CARE PROGRAM, WHICH IS OUR HIV OUTREACH AND PREVENTION TEAM.

UM, THE CARE PROGRAM IS OUT ON THE STREETS EVERY DAY, PROVIDING NARCAN, PROVIDING HIV SERVICES, UM, AND PROVIDING, UM, YOU KNOW, LIFESAVING SKILLS FOR FOLKS THAT ARE LIVING ON THE STREET WITH HIV OR PERHAPS COULD AT ONE POINT HAVE HIV.

UM, WE ALSO, THE CITY ALSO INVESTS IN ROAD TO RECOVERY AND PROJECT RECOVERY.

PROJECT RECOVERY IS A BRIDGE BETWEEN THE SOBERING CENTER AND INTEGRAL CARE.

SO A GREAT PARTNERSHIP THAT WE HAVE WHERE, UM, FOLKS AT THE SOBERING CENTER ARE THEN LINKED TO INTEGRAL CARE.

UM, NOW I'M GONNA TALK ABOUT A VERY LARGE INVESTMENT THAT WE'RE VERY MUCH APPRECIATIVE OF IS OUR HOUSING AND HOMELESS SERVICES.

SO AS YOU CAN SEE, THE CITY INVESTS A LOT, UM, OVER $10 MILLION IN HOUSING AND HOMELESS SERVICES.

SOME EXAMPLES OF THESE RANGE FROM, UH, HOMELESS OUTREACH STREET TEAMS ALL THE WAY.

SO, UM, THAT'S ON THE HOMELESS SPECTRUM ALL THE WAY TO PSH SITES, PERMANENT SUPPORTIVE HOUSING SITES, WHICH IS ON THE HOUSING SPECTRUM.

AND SO I LISTED THESE IN ORDER OF, UM, FROM HOMELESS TO HOUSED IN, IN THE INTERVENTIONS THAT ARE THAT FALL BETWEEN HOMELESS AND HOUSED.

AND SO WE HAVE OUR HOST TEAM, OUR ASSERTIVE COMMUNITY TREATMENT TEAM, WHICH, UM, IS THE HIGHEST LEVEL OF CARE FOR INDIVIDUALS EXPERIENCING HOMELESSNESS THAT ARE OUTPATIENT.

UM, WE ALSO HAVE OUR PATH TEAM, OUR TENANT-BASED PSH TEAM.

WE HAVE RENTAL HOUSING DEVELOPMENT ASSISTANCE, WHICH IS FUNDS THAT WE CAN USE DIRECTLY TO SUPPORT CLIENTS FOR RENT PAYMENTS, MOVE IN COSTS, UM, FURNITURE, THAT KIND OF THING.

WHEN YOU'RE MOVING FROM HOMELESS TO HOUSE AND YOU HAVE NOTHING, YOU KNOW, WE NEED THOSE SUPPORTS TO BE ABLE TO MAKE SOMEONE'S PLACE COMFORTABLE AND LIVABLE.

UM, AND THEN WE ALSO HAVE OUR PROJECT BASED PSH SITES.

SO, UM, TERRACE, OAK SPRINGS, WHICH JUST CELEBRATED THEIR FIVE YEAR ANNIVERSARY.

WE ALSO HAVE BUNGALOWS AT CENTURY PARK, WHICH OPENED WITH MANY OF Y'ALL WERE THERE LAST YEAR.

UM, AND THEN SEABROOK SQUARE IS OUR NEWEST PSH SITE, WHICH IS BEING BUILT IN THE MUELLER NEIGHBORHOOD.

UM, AND SO WITH ALL OF THESE, WE PROVIDE THE, THE SERVICES AND WE IN THE PSH SITES, WE ALSO DO THE OPERATIONS PARTNERING WITH VOLUNTEERS OF AMERICA TO DO THE PROPERTY MANAGEMENT.

THIS IS A LITTLE SMALL, BUT THIS IS A RETURN ON INVESTMENT REPORT THAT, UM, WE DID INTERNALLY FOR TWO OF OUR HOUSING AND HOMELESS TEAMS. THE ONE ON THE LEFT IS TERRACE AT OAK SPRINGS.

UM, THESE ROIS ARE RETURN ON INVESTMENTS, LOOKED AT UTILIZATION ONE YEAR PRIOR TO SERVICES, AND THEN ONE YEAR POST RECEIVING SERVICES ON THAT TEAM.

[00:25:01]

IT SHOWS A ONE YEAR COST SAVINGS OF CLOSE TO $600,000 FOR THE RESIDENTS AT TERRACE AT OAK SPRINGS.

AND THAT IS THROUGH THE REDUCTION OF ARRESTS, UM, STATE HOSPITAL BED DAYS, PRIVATE INPATIENT, PSYCHIATRIC BED DAYS, ER VISITS, UM, AND INPATIENT MEDICAL BED DAYS.

THE ONE ON THE RIGHT, WHICH IS OUR HIGHEST LEVEL OF CARE ON OUR HOMELESS SIDE, IS OUR CITY ACT TEAM.

UM, THE CITY ACT TEAM PROVIDES INTERVENTIONS SEVERAL DAYS A WEEK.

THEY'RE TWENTY FOUR SEVEN ON CALL CRISIS.

UM, THEY SOMETIMES SEE PEOPLE EVERY SINGLE DAY, UH, OF THE WEEK AND MORE IF NEEDED.

UM, AND THIS COST SAVINGS IS, UH, ON A SLIGHTLY MORE INTENSIVE TEAM, IS ALMOST $1 MILLION PER YEAR OF COST AVOIDANCE IN THESE SAME SYSTEMS. SO DEFINITELY WORTH THE INVESTMENT THAT YOU ALL GIVE US.

UM, AND THEN THE LAST INVESTMENT IS CHILD AND FAMILY SERVICES.

WHILE THIS INVESTMENT IS ON THE SMALLER SIDE FROM THE CITY, THERE IS A LARGER CHUNK OF CHILDHOOD AND FAMILY SERVICES THROUGHOUT THE SYSTEM OF CARE THAT YOU ALL PROVIDE IN OUR INNER LOCAL CONTRACT.

UM, SO THIS CHILD, THIS INVESTMENT IS, UM, JUST CLOSE TO A HUNDRED THOUSAND DOLLARS AND IT JUST FUNDS ONE STAFF AT IDEA RUNDBERG, WHICH IS A CHARTER SCHOOL, UM, IN, IN THE CITY OF AUSTIN.

LASTLY, I'M GONNA TALK ABOUT WHAT FUNDING IS AT RISK.

SO WHILE WE ARE VERY APPRECIATIVE AND GRATEFUL FOR ALL THE FUNDING WE HAVE, WE DO HAVE A FEW, UM, THINGS THAT ARE AT RISK OF ENDING THIS YEAR.

UM, ONE OF THOSE IS OUR HOMELESS HEALTH AND WELLNESS TEAM.

THIS PROGRAM PROVIDES INTENSIVE COORDINATION, UM, FOR THOSE THAT ARE THE HIGHEST VULNERABILITY WITHIN D'S WAIT LIST FOR INTENSIVE CASE MANAGEMENT.

UM, THIS CONTRACT IS ENDING AT THE END OF THIS YEAR, AND WE'RE WORKING CLOSELY WITH DAC, UM, TO, YOU KNOW, UTILIZE THE FUNDS WE HAVE NOW AND FIGURE OUT WHAT'S NEXT.

BUT THE FUNDING AMOUNT FOR THIS THAT'S AT RISK IS $541,714.

UM, THE OTHER TWO THAT ARE AT RISK ARE THE THERAPEUTIC DIVERSION PROGRAM.

YOU ALL INVESTED IN THAT, AND YOU'RE GONNA TALK MORE ABOUT THAT NEXT.

UM, BUT THAT CONTRACT RIGHT NOW ENDS ON 9 30, 20 25, AND THAT FUNDING AMOUNT IS 2 MILLION.

AND THEN THE EM CO, UH, WHICH DON SPOKE AT LENGTH ABOUT, UM, WHICH WAS A GREAT PARTNERSHIP AND REALLY BUILT FROM THE GROUND UP WITH YOU ALL, UM, THAT EXPANDS THE SERVICES TO INCLUDE 24 7 AVAILABILITY, WHICH, UH, WE HAVEN'T ALWAYS HAD 24 7.

AND SO THAT WAS A HUGE INVESTMENT AND A HUGE NEED IN OUR COMMUNITY.

UM, THAT CONTRACT ENDS 9 30, 20 25, AND THAT FUNDING AMOUNT IS ONE POINT CLOSE TO 1.5 MILLION.

JUST TO ADD, JUST TO ADD TO THAT, THAT'S JUST THE EXPANDED DOLLAR AMOUNT, NOT THE FULL TEAM.

SO IN THIS CONTRACT HERE, WE WERE PARTIALLY FUNDED FOR PART OF THE YEAR TO TAKE THE MO THE FIELD RESPONSE TEAM 24 7.

SO 9 1 1 HAS BEEN 24 7.

IT IS NOT SCALED TO TAKE ALL THE MENTAL HEALTH CALLS THAT COME THROUGH THE NINE ONE ONE CALL CENTER.

UM, AND SO THIS WOULD ADD A COUPLE OF POSITIONS THERE TO HELP US TAKE MORE CALLS AT 9 1 1, BUT IT'S PREDOMINANTLY FOCUSED ON BUILDING OUR FIELD RESPONSE TEAM SO THAT IT CAN GO 24 7 AND BE AVAILABLE TO DISPATCH OUR OWN MOBILE TEAM.

UH, MUCH LIKE, UH, EMS, UH, DISPATCHES, IT'S CHIP PROVIDERS AND, AND AMBULANCE.

AND JUST A QUICK QUESTION ON THIS PART, WHEN, BECAUSE THIS IS ABOUT 4 MILLION OF FUNDING AT RISK, AND WHEN YOU SAY AT RISK, YOU MEAN THESE ARE CITY DOLLARS THAT ARE SUBJECT TO RENEWAL, CORRECT? THAT THERE'S NOT A FEDERAL FUNDING COMPONENT TO IT, CORRECT? THAT'S CORRECT.

SO JUST WANNA HIGHLIGHT THIS FOR MY COLLEAGUES, ABOUT $4 MILLION WORTH OF CITY INVESTMENTS WITH INTEGRAL CARE THAT ARE, UM, SUBJECT TO OUR CONSIDERATION, THIS BUDGET CYCLE.

AND I BELIEVE THAT IS ALL WE HAVE FOR YOU ALL TODAY.

WE'RE OPEN TO ANY QUESTIONS OR FEEDBACK OR COMMENTS.

THANK YOU COLLEAGUES.

COUNCILOR VELASQUEZ, THANK YOU SO MUCH FOR THE PRESENTATION.

UM, AND, AND, UH, JUST AMAZING WORK.

I I WANTED TO ASK ABOUT THE, UH, RESEARCH STUDY FINDINGS FOR THE NINE ONE ONE CALL CENTER.

DO YOU, IS THERE A, AND I APOLOGIZE IF I MISSED IT.

IS THERE A DOLLAR AMOUNT ATTACHED TO THESE IMPROVEMENTS BETWEEN EITHER BETWEEN Y'ALL OR A PD? THERE ARE, IT'S A LITTLE, UM, THE, THE COST SAVINGS IS A LITTLE MORE THAN FOUR, $4 MILLION, UM, IS WHAT WE'RE SAVING ACROSS, UH, FIRST, FIRST RESPONDERS IN LOOKING AT EMERGENCY DEPARTMENT USE.

UM, BUT WE CAN PROVIDE YOU WITH A FULL REPORT PLEASE AS WELL, JUST SO YOU CAN SEE THE DETAIL.

IT'S PRETTY, IT'S PRETTY NEAT, UM, UH, BECAUSE THIS IS SOMETHING WE BUILT HERE TOGETHER WITH THE CITY, UM, AND WITH OUR FIRST RESPONDER PARTNERS, AND IT'S, UH, REALLY SHOWING SOME VALUE, UH, THROUGH, BECAUSE IT'S A SIGNIFICANT, SIGNIFICANT INVESTMENT BY THE CITY.

SO WE REALLY WANTED TO GET IT EVALUATED, UM, TO, TO SHOW IS IT WORKING, IS IT NOT WORKING? DO WE NEED TO SHIFT AND CHANGE? AND IT, IT'S, UH, LOOKS VERY PROMISING.

AND ALSO THESE NUMBERS ARE PHENOMENAL.

I MEAN, JUST THE 44 TO 62 EMERGENCY DETECTIVES THAT ARE NO LONGER THERE, IT'S, THAT'S INCREDIBLE.

IT, IT

[00:30:01]

IS INCREDIBLE.

AND, AND THE, THE ARREST.

SO YEAH, IF Y'ALL, IF Y'ALL HAVE MORE NUMBERS AROUND THAT OR, AND SOME, UH, SOME DOLLARS ATTACHED TO IT, I'D LOVE TO BET LOVE TO KNOW WHAT THAT LOOKS LIKE.

YEAH, WE'LL GET YOU, GET YOU THAT REPORT.

AND JUST OUTSIDE OF JUST THE COST SAVINGS, JUST THINK ABOUT THE INDIVIDUAL, THE NUMBER OF FOLKS WHO WERE NOT BEING DETAINED, YOU KNOW, INVOLUNTARILY AROUND WHEN THEY WERE HAVING AT THEIR MOST VULNERABLE TIME.

RIGHT.

UM, AND ALLOWING US TO KIND OF COME IN WITH AT LEAST RESTRICTIVE RESPONSE AND HELP STABILIZE THEM THROUGH OUR SYSTEM OF CARE IS JUST OUTSTANDING.

AND THANK Y'ALL FOR THAT.

WE WOULDN'T HAVE BEEN ABLE TO DO THAT WITHOUT THE HELP FROM THE CITY.

NO, THANK YOU FOR YOUR SERVICE.

I, I'VE BEEN A LONG TIME A MENTAL HEALTH ADVOCATE, AND SO JUST, JUST SEEING THIS IS, IS, IS, IS INSPIRING.

SO THANK YOU FOR YOUR SERVICE TO THE CITY ALSO.

YOU BET.

CAN YOU SHARE A LITTLE BIT ABOUT ANY FEDERAL FUNDING THAT Y'ALL HAVE AT RISK, UM, AND ARPA DOLLARS THAT HAVE COME TO AN IN OR ABOUT TO BE CLOSED OUT? CAN YOU PROVIDE SOME CONTEXT ON THAT? YEAH, SO WE'RE LOOKING AT, SO THAT'S STILL COMING IN, SO WE DON'T HAVE THE FULL PICTURE.

JUST BEFORE I CAME IN TODAY, WE JUST RECEIVED ANOTHER NOTE.

WE'RE LOSING SOME FEDERAL FUNDING AROUND SOME TOBACCO CESSATION WORK THAT WE'RE DOING.

BUT TO DATE, UH, WE HAVE, UH, TAKEN ABOUT, UH, $7 MILLION HAIRCUT.

SO THAT'S ARPA DOLLAR REDUCTIONS.

UM, ANY SLRF FUNDS THAT ARE COMING, UH, TO AN END.

UM, AND SOME OF THAT IS, IS, IS PASSED THROUGH, RIGHT? SO IT'S NOT DIRECT FUNDING BUT US IN, IN THE FEDERAL GOVERNMENT, BUT THEY FUND THE STATE OR THE, JUST LIKE, THEY'LL, UM, OFFER FUNDS THROUGH THE CITY AND THE COUNTY AND THEN THEY PASS THAT THROUGH TO PROVIDERS.

AND SO THAT'S WHAT WE'RE SEEING THROUGH THE STATE RIGHT NOW.

THERE'S BEEN SOME REDUCTION ON, UH, HR 1 33.

UH, THOSE WERE SERVICES THAT, UH, WE PROVIDE TO HELP INDIVIDUALS CONNECT, UM, AND GET MEDICAID.

UM, WE HELPED, UH, PROVIDE, UH, OUTPATIENT, UH, SERVICES TO SOME OF THESE INDIVIDUALS THAT HELPS EXPAND OUR CAPACITY THERE.

SO THAT'S, UH, THAT IN AND OF ITSELF WAS ABOUT $4 MILLION.

SO TOTAL WE'RE AT THAT 7 MILLION MARK RIGHT NOW.

COUNCIL OR VICE CHAIR? UCHIN.

THANK YOU MAYOR TIM, OR CHAIR? UH, I'VE BEEN TRYING TO WORK WITH DIRECTOR STIR UP FOR THE LAST COUPLE OF DAYS OR WEEK OR SO, AND I'M HOPEFULLY GONNA GET MORE UNDERSTANDING LATER THIS WEEK.

YOU KNOW, WE WERE BRIEFED, UH, THAT THERE WOULD BE MAYBE ORIGINALLY BACK IN APRIL ABOUT MAYBE UPWARDS OF $40 MILLION OF AUSTIN PUBLIC HEALTH DOLLARS THAT MAYBE AT RISK OF BEING NON-RENEWED, UH, LATER THIS YEAR, THE NEXT FISCAL YEAR.

I'M, I'M LOOKING AT THE STUFF THAT SHE JUST SENT ME, UH, I THINK ON FRIDAY.

THE GRANTS THAT SHE'S LISTED OUT.

ARE Y'ALL WORKING WITH THEM TO HELP COMPEL, I REALIZE THIS STUFF IS CHANGING EVERY DAY.

AND THE SORT OF LANDSCAPE SHIFTING AS YOU GUYS ARE GETTING NEW INFORMATION.

UM, I'M WONDERING THOUGH WHETHER THE $4 MILLION YOU JUST LAID OUT IS PART OF, IT'S NOT.

SO REALLY I THINK THE BEST QUESTION I OUGHT TO BE ASKING IS WHAT IS THE BEST WAY TO COORDINATE WITH US, THE, THE CITY DIRECTOR, STIR WHOEVER TO MAKE SURE WE'VE GOT AS CLEAR AND ACCURATE PICTURE AND REALLY UP TO DATE AS PICTURE ABOUT WHERE WE ARE AS FAR AS THE GAPS WE MIGHT BE HAVING TO THINK THROUGH AS WE GET INTO THE BUDGET PROCESS ABOUT FEDERAL DOLLARS THAT MAY BE AT RISK OF BEING NON-RENEWED OR THINKING ABOUT EITHER, IF NOT THAT THEN HOW TO PRIORITIZE WHAT PROGRAMS WE NEED TO BE INVESTING IN OVER THE NEXT FOUR MONTHS.

YEAH, I THINK THAT'S AN EXCELLENT QUESTION.

I, WHAT WE CAN DO IS I'LL GET, UH, DIRECTLY WITH, UM, UH, THE CITY STAFF AND GIVE THEM AN OUTLINE.

WE'RE DOING THE SAME WITH, UH, CENTRAL HEALTH AS WELL, TRYING TO KIND OF LOOK AT WHAT THINGS ARE AT RISK, HOW CAN WE, UH, FIND OTHER RESOURCES TO HELP COVER SOME OF THE, THE LOSS, AND THEN WHAT CAN WE NOT RECOVER FROM, RIGHT.

KIND OF WHERE IS THE, A TRUE SHORTFALL AND UH, WE'LL BE ABLE TO PROVIDE THAT, UH, TO YOUR TEAM.

THAT'D BE GREAT BECAUSE EVEN PART OF WHAT I'M STRUGGLING WITH IS JUST FIGURING OUT WHICH OF THE PROGRAMS THAT ARE SCHEDULED TO EXPIRE AUTOMATICALLY THAT HAVE CONCLUDED VERSUS THOSE THAT WE MAY WANT TO RENEW OR MAY BE PART OF A COMPETITIVE PROCESS TO RENEW THAT MAY HAVE A RISK FACTOR FOR NOT BEING RENEWED.

SO, UH, IT'D BE INCREDIBLY VALUABLE IF WE CAN GET AN UPDATE ON THAT GOING FORWARD.

ABSOLUTELY.

WHERE WE STILL CONTINUE TO STRUGGLE JUST AS AN ORGANIZATION ARE REALLY IN THESE SPECIALTY AREAS.

HAPPY TO DO SO COUNCIL MEMBER ALTER COUPLE QUESTIONS STARTING WITH THE MOT.

HOW ARE WE DOING ON STAFFING UP TO GET 24 7 COVERAGE? WE'RE DOING PRETTY WELL.

I KNEW YOU WERE GONNA ASK THAT.

AND I TRIED TO GRAB THAT NUMBER BEFORE I GOT HERE AND I UNFORTUNATELY DON'T HAVE THE ACTUAL NUMBER, BUT I KNEW YOU WERE GONNA ASK IT, SO THAT COUNTS FOR SOMETHING.

ALRIGHT.

UM, BUT WE'RE, WE ACTUALLY ARE DOING REALLY WELL.

UH, SO WE, JUST TO ADD SOME CONTEXT, YOU KNOW, WE MADE SOME CHANGES TO THAT SHIFT IF, RIGHT.

SO WE ADDED TO OUR SECOND AND THIRD SHIFT, WHICH HAS BEEN PART OF THE STRUGGLE, YOU KNOW, AND THAT'S NOT UNIQUE TO INTERVAL CARE ANYONE PROVIDING 24 7.

OFTEN IT'S THOSE OVERNIGHT AND WEEKEND TYPE SHIFTS THAT ARE DIFFICULT TO FILL.

SO ADDING THAT INCREASES, UH, HELPED US

[00:35:01]

SO OUR LICENSED PROFESSIONAL COUNSELORS, OUR LHAS, WHICH ARE CRITICAL BECAUSE WE NEED THEM TO DO THE ASSESSMENT, THE DIAGNOSTIC COMPONENT, THE BILLING PIECE, UM, OF THE WORK THAT WE'RE DOING, THAT'S A KEY PIECE.

UM, THAT'S OFTEN OUR LEADERSHIP.

IT'S OUR CLINICAL LEAD CLINICAL LEADERSHIP WHO IS OVERSEEING OUR Q-Q-M-H-P.

SO YOUR BACHELOR'S LEVEL AND YOUR MASTER'S LEVEL, UM, INDIVIDUAL.

SO, BUT AS FAR AS THE QMH PIECE, WE'RE DOING A GREAT JOB.

THOSE ARE MOST OF THE DIRECT CARE STAFF.

UM, WE'RE DOING REALLY WELL IN THAT AREA.

SO, UM, SO DO WE HAVE TEAMS GOING OUT ON THAT THIRD SHIFT NOW? WE DO HAVE TEAMS GOING OUT.

GREAT.

UH, IT'S A, IT'S A LITTLE DICEY AT THE MOMENT, SO IT'S NOT FULLY STAFFED, BUT WE'RE ON A SHORT SIX MONTH.

RIGHT, RIGHT.

AND SO MOST OF THIS TIME IT'S BEEN REALLY TRYING TO ONBOARD AND THEN TRAIN WHO WE HAVE.

AND SO RIGHT NOW THEY'RE NOT INDEPENDENT, BUT THEY'RE GOING WITH, WITH SOME OF THE EXISTING TEAMS. OKAY.

I I ALSO WANNA ASK ABOUT YOUR SUBSTANCE USE PROGRAMS. I KNOW THAT IS ALWAYS SEEMS TO BE SOMETHING THAT IS THE, THE DEMAND IS MUCH GREATER THAN THE SUPPLY OF, OF SERVICES.

AND SO I'M CURIOUS, HAVE Y'ALL DONE ANY KIND OF ANALYSIS OR JUST HOW MUCH MORE SUBSTANCE USE TREATMENT DO WE REALLY NEED OUT IN THE COMMUNITY THAT WE'RE NOT PROVIDING? SO RIGHT NOW, AND I'LL LET, UH, MARLENE TALK ABOUT THAT SINCE THAT'S IN HER AREA, BUT I BELIEVE THAT THERE IS A A, A C COMMUNITY GROUP FORMED RIGHT NOW, UM, UH, TO LOOK AT THAT VERY THING, KIND OF DO THAT GAP ANALYSIS AND SO WE'LL BE INVOLVED IN THAT WORK.

BUT WE, YOU KNOW, AS YOU SAW EARLIER ON SOME OF OUR SLIDES, THAT 40% OF CO-OCCURRING, UM, ARE OUR CLIENTS ARE EXPERIENCING, UH, SUBSTANCE USE NEEDS.

AND, AND IN OUR COMMUNITY, THE REASON WE HAVE SUCH A SHORTFALL IS JUST BECAUSE AS AN INDIVIDUAL PROVIDER, YOU CAN'T, THE, UM, REIMBURSEMENT RATE IS SO LOW FOR THOSE SERVICES YOU CANNOT REALLY OPERATE, UM, AND PROVIDE WHAT'S NEEDED.

UH, YEAH, DON'S EXACTLY CORRECT.

THERE IS A COUNTY LED INITIATIVE TO LOOK KIND OF AT THAT GAP.

UM, I, I KNOW LAURA AND COURTNEY ARE BACK THERE AND THEY HAVE BEEN, UM, WORKING WITH COMMUNITIES FOR RECOVERY TO LOOK AT THAT GAP.

UM, THIS LAST YEAR WE DID EXPAND OUR SUBSTANCE USE LICENSE TO ADD A HUNDRED NEW SLOTS AT OUR NARCOTIC TREATMENT PROGRAM, WHICH IS OUR METHADONE CLINIC.

UM, SO WE HAVE NO WAIT LIST AT OUR METHADONE CLINIC.

UM, YEARS PAST WE HAVE OPERATED ON A WAIT LIST BECAUSE OUR LICENSE DIDN'T ALLOW FOR THE CAPACITY THAT WE NEEDED.

UM, BUT THIS YEAR WE WERE FORTUNATE ENOUGH TO BE ABLE TO EXPAND OUR LICENSURE.

WE ALSO HAVE MEDICATION ASSISTED TREATMENT PROGRAM THROUGH CENTRAL HEALTH, UM, WHICH WE EXPANDED THIS LAST YEAR AS WELL.

WE DOUBLED IT.

UM, IT WAS, IT WAS $300,000 OF INVESTMENT AND NOW IT'S $600,000 OF INVESTMENT.

SO WE'RE ABLE TO TAKE STATE FUNDED FOLKS, UM, AND THEN ALSO FOLKS THAT HAVE MAPPED NOW AND, UH, NO INSURANCE AND THEN PRIVATE INSURANCE AS WELL.

SO, UM, WHILE THERE IS A GAP, WE ARE, WE HAVE EXPANDED WITH THE GAP AND RIGHT NOW WE'RE OPERATING ON NO WAIT LIST.

GREAT.

AND I THINK THAT'S AN IMPORTANT QUESTION AND THEN KIND OF HOW THAT WORK, UM, CONNECTS TO THE SOBERING CENTER AND THE WORK THAT THEY'RE DOING AND UM, AND, AND IN GETTING THAT CARE AND, AND, AND WHY THEY'RE NEEDING SOME ADDITIONAL FUNDING.

UM, TRYING TO HOLD ONTO PEOPLE UNTIL WE CAN GET THEM INTO, UH, THOSE, UH, TREATMENT BEDS, UH, FOR THE, FOR THOSE TYPE OF NEEDS.

AND I ALSO BELIEVE THAT THERE'S SOME CONGRATULATIONS IN ORDER HERE FOR THE SOFTBALL GAME.

, SO, WHICH BENEFITS THE CITY.

SECURITY PROPERTY MANAGEMENT 24 7.

SO CONGRATULATIONS ON YOUR PHENOMENAL WIN .

APPRECIATE YOUR SUPPORT OF THE SOBERING CENTER 'CAUSE WE WERE SO WELL COACHED.

, I WAS MOVING ON TO YOUR HOUSING PROGRAM.

ONE OF THE THINGS THAT WE ARE DISCUSSING AS UH, A POTENTIAL POLICY SHIFT MOVING FORWARD IS TO DO MORE TENANT BASED PSH OR SCATTER SITE PSH.

Y'ALL DO BOTH, SOME SCATTER, RAN SOME PROJECT BASED.

WHAT HAS BEEN YOUR EXPERIENCE BOTH IN TERMS OF OUTCOMES AS WELL AS JUST ADMINIST ABILITY OF THOSE TWO DIFFERENT PROGRAMS? SURE, I CAN ANSWER THAT.

UM, I THINK BOTH ARE VERY MUCH NEEDED AND ONE DOESN'T, YOU KNOW, CANCEL OUT THE OTHER.

SO TENANT BASED IS, UH, WE HAVE FOLKS GOING TO THEIR HOME TO PROVIDE SERVICES, UM, BUT THEY'RE ALSO TRAVELING.

AND SO THE SERVICES AREN'T AS INTENSE.

I HAVE ONE CASE MANAGER GOING TO 15 DIFFERENT APARTMENT COMPLEXES, YOU KNOW, MAYBE ALL ACROSS TOWN.

UM, 'CAUSE IT'S A ONE TO 15 STAFF TO CLIENT RATIO.

UM, SO THAT IS PROBABLY FOR A POPULATION THAT IS A LITTLE BIT LESS ACUTE, STILL NEEDS THAT PSH LEVEL OF SERVICES BUT IS NOT AS ACUTE AS THE PROJECT BASED.

SO PROJECT BASED, I HAVE A STAFF OF 10 ON SITE ALL THE TIME.

UM, SO THERE'S A LOT MORE CONTROL.

WE ALSO DO A, UM, SINGLE ACCESS, SINGLE POINT OF ENTRY.

UM, AND SO WE KNOW WHO'S IN THE BUILDING, WHO'S

[00:40:01]

OUT OF THE BUILDING, WE KNOW REALLY CAN CONTROL WHAT'S GOING ON IN THE BUILDING.

UM, AND SO THAT IS FOR OUR MORE ACUTE FOLKS I WOULD SAY.

UM, SO YES, THERE'S A NEED FOR TENANT-BASED.

YES, THERE'S A NEED FOR PROJECT-BASED.

UM, I THINK THEY'RE BOTH VERY IMPORTANT AND THAT'S WHY WE DO BOTH.

UM, WE CAN'T DO ONE WITHOUT THE OTHER.

THE GOAL REALLY WOULD BE TO MOVE SOMEONE, YOU KNOW, HAVE SOMEONE COME INTO PROJECT-BASED STABILIZED, DO REALLY WELL, AND THEN WHAT WE CALL MOVE UP OR MOVE ON TO UM, TENANT BASED SERVICES.

UM, MOVE TO A LOWER LEVEL OF CARE.

AND THEN FROM THERE WE HAVE HU EIGHT 11 PROPERTIES.

SO YOU WOULD MOVE FROM MM-HMM .

YOU KNOW, THAT PSH LEVEL OF CARE TO LOWER LEVEL.

SO I THINK THE FULL SPECTRUM IS IMPORTANT.

UM, AND YOU KNOW, THE COST DIFFERENCE IS A LITTLE BIT LESS FOR TENTATIVE BASE, BUT NOT THAT MUCH LESS FOR THE AMOUNT OF SERVICES YOU'RE GETTING IN PSH.

AND SITE BASED PSH.

ANY FURTHER QUESTIONS? WONDERFUL.

THANK YOU VERY MUCH, COLLEAGUES.

ALRIGHT, WE'LL BE MOVING ON TO OUR NEXT ITEM, WHICH IS ITEM NUMBER THREE, AN UPDATE ON CRISIS CARE DIVERSION.

THANK Y'ALL FOR THE GREAT INFORMATION.

WE APPRECIATE THE WORK THAT Y'ALL DO.

[3. Update on the Crisis Care Diversion (Mental Health Diversion) Pilot Program to provide alternatives for persons experiencing a mental health crisis. [Courtney Lucas, Assistant Director of HPP Division, Health and Human Services; Laura Peveto, Division Director of OCS, Health and Human Services; Robert Kingham, Court Administrator, Downtown Austin Community Court; JP Eichmiller, Vice President of Strategy - Central Health; Dawn R. Handley, M.Ed., LPC, Chief Operations Officer].]

THIS IS THE MENTAL HEALTH DIVERSION PILOT PROGRAM TO PROVIDE ALTERNATIVES FOR PEOPLE EXPERIENCING A MENTAL HEALTH CRISIS.

COLLEAGUES, PLEASE HELP ME IN WELCOMING COURTNEY LUCAS, ASSISTANT DIRECTOR OF HPP DIVISION, HEALTH AND HUMAN SERVICES.

LAURA PATO, DIRECTOR, DIVISION DIRECTOR OF OCS HEALTH AND HUMAN SERVICES.

ROBERT KING, COURT ADMINISTRATOR DOWNTOWN AUSTIN COMMUNITY COURT.

JP ECK MILLER, VICE PRESIDENT OF STRATEGY WITH CENTRAL HEALTH.

I'M SAYING A LOT OF NAMES THAT AT LEAST TO PEOPLE .

UM, SO I WILL JUST TOSS IT OVER TO YOU ALL.

WELCOME.

THERE WE GO.

ALRIGHT, THANK YOU SO MUCH.

GOOD MORNING.

THANK YOU FOR THE OPPORTUNITY TO PRESENT ON THE CRISIS CARE DIVERSION PILOT ALSO REFERRED, UH, TO AS THE MENTAL HEALTH DIVERSION PILOT.

SO THE NAMES ARE INTERCHANGEABLE, BUT WE'RE TALKING ABOUT THE SAME THING.

THIS WILL BE A SHARED PRESENTATION BY TRAVIS COUNTY, CITY OF AUSTIN, DOWNTOWN AUSTIN COMMUNITY COURT, CENTRAL HEALTH AND INTEGRAL CARE.

SO THE COUNTY'S GONNA KICK IT OFF WITH THE FIRST FEW SLIDES, THEN WE'LL TRADE SEATS AND HAVE OTHER PRESENTERS COME.

WE'RE ASKING THE EXPERTS IN THEIR AREAS TO PROVIDE THE MOST, UH, UPTODATE INFORMATION FROM THE SLIDES.

SO WE FIGURED IT'D BE BETTER TO HEAR DIRECTLY FROM THEM THAN TO HEAR FROM US.

UM, UH, YOU'VE ALREADY INTRODUCED ME, SO THANK YOU FOR THAT.

SO WE'LL MOVE RIGHT ON TO THE NEXT SLIDE.

ALRIGHT.

TRAVIS COUNTY IS DEDICATED TO DEVELOPING A COMPREHENSIVE DIVERSION SYSTEM FOR THE COMMUNITY IN COLLABORATION WITH KEY STAKEHOLDERS THAT BUILDS ON EXISTING RESOURCES AND PARTNERSHIPS.

AS PART OF THIS SYSTEM, A DIVERSION PILOT WAS DEVELOPED THROUGH COMMUNITY AND STAKEHOLDER COLLABORATION AND WITH DIRECT PARTNERSHIP FROM TRAVIS COUNTY, CITY OF AUSTIN, CENTRAL HEALTH AND INTEGRAL CARE TO BEGIN ADDRESSING SOME OF THE COMMUNITY'S DEFLECTION AND DIVERSION NEEDS AS IDENTIFIED IN THE TRAVIS COUNTY FORENSIC MENTAL HEALTH PROJECT REPORT.

SO I'LL JUST PAUSE HERE TO SAY THAT THE IDEA BEHIND THE CRISIS CARE DIVERSION PILOT IS THE CONCEPT OF WE NEEDED TO GET STARTED SOMEWHERE NOW THAT WE SAW THE ISSUES AND THE CONCERNS THAT WERE IMPACTING OUR COMMUNITY.

AND WE WANTED TO MOVE TOGETHER IN, UH, COLLABORATION WITH OUR PARTNERS TO PILOT SOMETHING TO SEE IF WE COULD MAKE AN IMPACT, A CHANGE, BE ABLE TO DO, UH, IMPORTANT WORK IN THE SPACE OF DIVERSION DEFLECTION.

THERE IS ALSO ONGOING WORK AT THE COUNTY FOR A LARGER DIVERSION ECOSYSTEM.

THE, THE CONCEPT OF WHETHER WE'LL HAVE A DIVERSION CENTER, UH, NEW JAIL BOOKING, ALL OF THAT WORK IS ONGOING AT A DIFFERENT SHOP WITHIN, UH, THE HEALTH AND, UH, WITHIN, UH, TRAVIS COUNTY.

BUT THE WORK IS, WORK IS HAPPENING PARALLEL, BUT IN CONCERT.

SO WE'RE OVERLAPPING WORK, MAKING SURE THERE'S COMMUNICATION AS WE GO FORWARD.

SO THIS IS A SMALL PILOT TO BE ABLE TO LOOK AT THE WORK, UNDERSTAND THE CHALLENGES AND THE WINS WITHIN DIVERSION AND DEFLECTION, HOW WE CAN BEST SERVE THE INDIVIDUALS MOST IMPACTED HOW WE CAN, UH, WORK THROUGH THAT CYCLING THAT WE'RE ALL SEEING, RIGHT? CYCLING THROUGH THE JAIL, CYCLING THROUGH THE EMERGENCY DEPARTMENT, CYCLING THROUGH A STATE OF HOMELESSNESS.

HOW DO WE INTERVENE AND PROVIDE THE RIGHT SUPPORTS AT THE RIGHT TIME TO PULL PEOPLE UP FROM THAT.

THANK YOU COURTNEY.

ALRIGHT, SO WITH THAT WE'RE GONNA FOCUS THE FOCUS AND GOALS OF THE PILOT.

SO, UM, THE PILOT HAS SEVERAL GOALS, INCLUDING LEVERAGING AND REALIGNING COMMUNITY RESOURCES TO IMMEDIATELY START, AS I SAID, ADDRESSING NEEDS ASSOCIATED WITH DEFLECTION AND DIVERSION.

FURTHER DEVELOPING THE SERVICES, PARTNERSHIPS, REFERRAL PATHWAYS, UH, AND DATA INFRASTRUCTURE THAT WILL BE NEEDED TO DELIVER EFFECTIVE RESULTS AT SCALE.

SO WE FEEL LIKE WE HAVE SOME OF THE RESOURCES ALREADY AVAILABLE IN OUR COMMUNITY, BUT WE MAY NOT BE ALIGNED EXACTLY.

WE MAY NOT HAVE THE RIGHT WAYS OF ACCESSING THOSE SERVICES.

THE STRENGTHS MAY NOT BE THERE, THE RELATIONSHIPS NEED

[00:45:01]

TO BE BUILT.

UM, ADDITIONALLY WE'LL LOOK AT LEVERAGING LEARNINGS FROM THE PILOT, OUR PARTNERS AND STAKEHOLDERS TO AGAIN, BUILD OUT THAT LARGER COMMUNITY DIVERSION SYSTEM THAT I REFERENCED EARLIER.

AND THEN IMPROVING PUBLIC SAFETY AND THE OUTCOMES FOR INDIVIDUALS WHO INTERSECT WITH THE MENTAL HEALTH AND CRIMINAL LEGAL SYSTEM AND OFTEN THE HOMELESS RESPONSE SYSTEM.

AND FINALLY, INCREASING ACCESS TO MENTAL HEALTH SERVICES, THEREBY DECREASING THE NUMBER OF INDIVIDUALS WHO ARE ARRESTED AND ARE INCARCERATED DUE TO UNMET MENTAL HEALTH NEEDS.

OKAY, I WOULD LIKE TO REVIEW THE BUDGET WITH YOU.

SO THE FIRST TABLE IS TALKING THROUGH THE PROJECTED COSTS OF THE PILOT OVER THIS FY 24 THROUGH 25, 26, AND 27, BOTH FOR THE THERAPEUTIC DIVERSION PROGRAM OR TDP AS WELL AS PSYCHIATRIC EMERGENCY SERVICES OR PES.

AND SO YOU CAN SEE THE TDP IS ESTIMATED, UH, PROJECTED AGAIN TO BE, UH, ABOUT $11.4 MILLION OVER THE LIFE OF THE PILOT WHILE PES IS, UH, NEARLY 15 MILLION, UM, OVER THE LIFE OF THE PILOT PILOT.

THIS IS, AGAIN, THOSE ARE PROJECTED COSTS, UH, BUT THIS IS THE, THE WHERE WE THINK WE ARE RIGHT NOW.

AND SO THEN THE SECOND TABLE IS TALKING THROUGH THE PILOT FUNDING BY SOURCE.

SO TRAVIS COUNTY, UM, HAS CONTRIBUTED $6 MILLION.

WE ALSO HAVE, UM, A ROW TO SHOW THAT THE, THERE'S A MILLION DOLLARS OF THE CITY'S FUNDING THAT IS IN THE COUNTY CONTRACT BECAUSE OF THE FUNDING SWAP THAT WE DID WITH THE TRAUMA RECOVERY CENTER.

AND SO THAT'S, THAT IS THAT LINE.

UM, AND THEN THE CITY, THE OTHER MILLION DOLLARS OF THE CITY IS IN A CONTRACT.

WE ALSO WANNA ACKNOWLEDGE THAT THERE IS A $300,000 IN KIND CONTRIBUTION BY THE CITY FOR THE 15TH STREET PROPERTY, UM, ANNUALLY.

AND THEN YOU'LL ALSO NOTICE THAT IN THE THIRD COLUMN OR FOURTH COLUMN, THE, THERE'S A FUNDING REQUEST FOR A TOTAL OF $4 MILLION OR 2 MILLION PER YEAR FOR THE SECOND AND THIRD PILOT YEARS.

SO FY 26 AND 27 MOVING FROM CENTRAL HEALTH, THEY HAVE COMMITTED $4.5 MILLION, UM, IN CONTRACTS THUS FAR AND ARE PROJECTED TO, UH, CON CO CONTRIBUTE, SORRY, CONTRIBUTE FUNDING, UH, FOR ANOTHER $3 MILLION PER YEAR, UM, IN FY 26 AND 27 INTEGRAL CARE RECEIVED AN HHSC GRANT THAT WAS $5.1 MILLION.

AND THEY ARE ALSO PROJECTED TO COMMIT ANOTHER $3 MILLION OF FUNDING TOWARDS THE PILOT.

JUST, UM, QUICK QUESTION, 'CAUSE I REMEMBER CUSTOMER CADRE, YOU HAD A BUDGET AMENDMENT FOR THE MENTAL HEALTH DIVERSION PROGRAM AND I THOUGHT IT WAS FOR 3 MILLION, WAS IT NOT? DO Y'ALL REMEMBER THAT? IT WAS, IT WAS FOR THREE YEARS.

$2 MILLION A YEAR.

2 MILLION A YEAR.

BUT THIS SAYS HERE THAT IT'S A REQUEST FOR 4 MILLION FOR NEXT FISCAL YEAR.

IS THAT RIGHT? MAKE SURE I DON'T, I DON'T MISS NEXT TWO FISCAL YEARS.

THE NEXT TWO, OKAY.

YEAH, 2 MILLION PER, SO 2 MILLION IN 26, 2,000,027.

WHAT I REMEMBER WAS IS 300,000 FOR THIS, THIS FISCAL YEAR WITH THE INTENT TO DO THEN THE 2 MILLION, 2 MILLION TO GET US TO THAT.

CORRECT.

ALMOST 6 MILLION.

OKAY, GOTCHA.

SO THE 4 MILLION OVER THOSE TWO YEARS, SO IT'S STILL THE, YOUR ITEM, CORRECT.

2 MILLION A YEAR? CORRECT.

ALRIGHT, I'M GONNA GIVE YOU A REAL BRIEF PROJECT OVERVIEW FOR THE CRISIS CARE DIVERSION PROGRAM.

AND, AND JUST TO CLARIFY, ROBERT KINGHAM, ADMINISTRATOR OF THE COMMUNITY COURT, UM, THE, THE PROPOSED BUDGET AMENDMENT, UM, FOR AN ADDITIONAL 300,000 WAS TO EXTEND THE CONTRACT, UM, AN ADDITIONAL THREE MONTHS TO GET US THROUGH THIS CURRENT FISCAL YEAR.

AND THERE'S AN ITEM ON THURSDAY'S COUNCIL MEETING AGENDA TO DO THAT.

AND SO REALLY WHAT, WHAT WE WERE LIKE TO HIGHLIGHT HERE IN THIS BUDGET IS JUST THAT EVERY FUNDING PARTNER IS REALLY, UM, THEIR CONTRIBUTION'S CRITICAL TO SUSTAIN THE PILOT OVER THIS THREE YEAR PILOT PERIOD.

AND SO IT'S ALL BRAIDING TOGETHER TO BE VERY IMPACTFUL IN SUPPORTING BOTH OF THE PILOT COMPONENTS.

AND THEN FOR TRAVIS COUNTY SPECIFICALLY, WE, UM, HAVE A SEPARATELY NEGOTIATED CONTRACT WITH INTEGRAL CARE AND OUR FUNDING IS UTILIZING OUR ARPA LFRF FUNDS.

AND OUR CONTRACT SUPPORTS BOTH SERVICES AT PES AS WELL AS SERVICES AT TDP.

BUT BECAUSE THESE ARE OUR VANILLA RF FUNDS, ALL FUNDS MUST BE FULLY EXPENDED BY DECEMBER OF 2026.

SO THAT IS ANOTHER, UM, LAYER OF COMPLEXITY ON THE, THE FUNDING FOR THE PILOT.

AND I WILL TURN THIS OVER TO JP IKE MILLER TO COVER CENTRAL

[00:50:06]

GOOD MORNING.

SO AS IT WAS MENTIONED EARLIER, YES, UH, CENTRAL HEALTH CONTRACTS WITH INTERVAL CARE FOR SERVICES AT THE PSYCHIATRIC EMERGENCY SERVICES.

UH, I KNOW INTERVAL CARE WILL BE GOING INTO MORE DETAIL ABOUT THIS, SO I, UM, WILL DEFER THAT.

BUT THAT'S, THIS IS SOME OF THE SERVICES WE ARE SUPPORTING.

UH, OUR FUNDING IS BASED ON THE LEVEL OF SERVICES PROVIDED TO ELIGIBLE PATIENTS AND WE WILL BE REVIEWING AND THEN RENEWING THOSE CONTRACTS ANNUALLY.

THIS FUNDING IS ALSO EXCLUSIVE TO THE PES.

THAT BEING SAID, HOWEVER, WE ALSO ARE PROVIDING IN KIND SERVICES AT THE THERAPEUTIC DIVERSION CENTER.

UM, THIS IS, UH, TO ADDRESS CO-OCCURRING PRIMARY CARE NEEDS FOR THE PATIENTS WHO ARE RESIDING THERE.

UM, WE IDENTIFIED OUR RELATIVELY NEW BRIDGE CLINIC PROGRAM AS A, UH, IDEAL UH, SUPPORT SERVICE FOR THIS LOCATION.

UH, OUR BRIDGE LAUNCHED LAST YEAR AND IT IS ESSENTIALLY A STOP GAP FOR PATIENTS WHO EITHER NOT YET ENROLLED OR WAITING, UM, TO RECEIVE PRIMARY CARE SERVICES.

UH, PHASE ONE WAS A BRICK AND MORTAR LOCATION AT THE CAPITOL PLAZA.

PHASE TWO LAUNCHED LAST YEAR AND THAT WAS A, UH, A DIVERSION PROGRAM WITH AUSTIN TRAVIS COUNTY EMS, WHERE THEY, UM, DIVERT PATIENTS FROM, UH, 9 1 1 CALLS FROM GOING TO THE EMERGENCY ROOM AND THEY BRING 'EM TO OUR BRIDGE CLINIC.

AND THEN PHASE THREE WAS LAUNCHED EARLIER THIS YEAR.

AND THAT IS A MOBILE TEAM.

AND WE ARE CURRENTLY GOING TO FIVE LOCATIONS, UM, INCLUDING, UH, PERMANENT, UH, PERMANENT SUPPORTIVE HOUSING LOCATION, UH, THE BUNGALOWS RUN BY A**L CARE AS WELL AS THE, UH, THERAPEUTIC DIVERSION CENTER.

WE GO THERE ON MONDAYS FROM NINE TO 2:00 PM UM, AS OF MAY 19TH, WE'VE SERVED A TOTAL OF 65 ENCOUNTERS AND 35 PATIENTS.

UM, MAJORITY OF THESE DO NOT HAVE ANY SORT OF PRIMARY CARE PROVIDER ESTABLISHED, SO WE ARE HELPING THEM MAKE THAT CONNECTION.

AND WE ARE CURRENTLY SUPPORTING PATIENTS WITH, UH, ENROLLING IN OUR MAP PROGRAM, UM, CONNECTING FOOD AND HYGIENE, UH, VISION VOUCHERS, WHICH ALLOWS THEM TO GET A EYE EXAM AND GLASSES AT TEXAS STATE OPTICAL.

AND AGAIN, UH, HOOKING 'EM UP WITH PRIMARY CARE PROVIDERS TO OUR NETWORKS, UM, WHICH INCLUDES COMMUNITY CARE PEOPLES AND LONE STAR.

THANKS JP.

AND NOW WE WILL PASS THAT BACK OVER TO ROBERT.

MORNING AGAIN.

UH, ROBERT KINGDOM ADMINISTRATOR FOR THE COMMUNITY COURT.

SO THIS SLIDE REALLY WALKS THROUGH THE CITY'S CONTRIBUTIONS FOR THIS DIVERSION PILOT.

THE CITY HAS A CONTRACT SPECIFICALLY WITH INTEGRAL CARE FOR SERVICES AT THE THERAPEUTIC DIVERSION PROGRAM THAT'S MANAGED AT THE COMMUNITY COURT.

THE REASON THE CONTRACT IS SPECIFIC TO THOSE SERVICES IS BECAUSE IT ALIGNS WITH THE CITY'S IN INVESTMENTS, UH, UH, HISTORICAL INVESTMENTS.

AND SO YOU HEARD EARLIER IN THE, IN THE PRIOR PRESENTATION THAT THIS, UH, THERAPEUTIC DIVERSION PROGRAM IS CONSIDERED A PART OF A SHELTERED SYSTEM.

AND SO THE CITY HAS, UH, OTHER INVESTMENTS IN SHELTER ACTIVITIES AND UH, IT ALIGNS WITH OUR INVESTMENT STRATEGIES.

YOU ALSO, UH, SAW EARLIER IN THE BUDGET OVERVIEW THAT THERE IS A TOTAL INVESTMENT, UH, ON THE CITY'S BEHALF OF $2 MILLION, 1 MILLION, SPECIFICALLY IN CONTRACT WITH INTEGRAL CARE AND ANOTHER MILLION DOLLARS.

THE COUNTY HAS INCREASED THEIR INVESTMENT ON BEHALF OF THE CITY, UH, AS THAT FUNDING SWAP FOR THE TRAUMA RECOVERY CENTER BECAUSE THE CITY HAD AN EXISTING CONTRACT WITH THAT PROVIDER THERE.

UM, AS I MENTIONED A FEW MINUTES AGO, THE COMMUNITY COURT IS BRINGING FORWARD A COUNCIL ITEM ON THURSDAY'S AGENDA TO EXTEND THE CONTRACT TERM THROUGH SEPTEMBER OF THIS YEAR, UM, AND PROVIDE AN ADDITIONAL $300,000, UH, TO THIS, THIS PROGRAM TO GET US, UH, ALL THE WAY THROUGH THE, THE CURRENT FISCAL YEAR.

AND WHEN WE'RE LOOKING FORWARD TO THE FUTURE FOR FY 26 AND 27, THE COMMUNITY COURT ADVISORY BOARD DID PUT FORWARD A BUDGET RECOMMENDATION THAT SUPPORTS A $2 MILLION INVESTMENT, UH, FROM THE CITY FOR EACH OF THOSE FISCAL YEARS.

AND NOW I'M GONNA TURN IT BACK OVER TO OUR PARTNERS AT TRAVIS COUNTY.

THANKS YOU, ROBERT.

OKAY, I'LL GET THIS TO LAURA .

[00:55:02]

AND AGAIN, INTEGRAL CARE IS GONNA GO INTO A MORE DETAILED REVIEW OF THE PROGRAM ITSELF.

UM, BUT THE PILOT INITIATES A COLLABORATIVE VERSION PROGRAM BY LEVERAGING EXISTING PROGRAMS AND FACILITIES TO EXPAND COMMUNITY RESOURCES TO IMMEDIATELY ADDRESS UNMET COMMUNITY NEEDS.

THE PILOT WAS LAUNCHED, UM, IN SEPTEMBER, 2024, SO THAT WAS THE PSYCHIATRIC EMERGENCY, UH, SERVICES.

AND THEN WE HAVE AN OCTOBER OF 2024, THE THERAPEUTIC DIVERSION PROGRAM, WHICH WAS LOCATED, UH, AT THE REPURPOSE 15TH STREET LOCATION.

UM, AS YOU PROBABLY HAVE ASCERTAINED, THE PILOT HAS TWO COMPONENTS.

ONE IS EXPANDING INTEGRAL CARE PSYCHIATRIC EMERGENCY SERVICES TO 24 7, WHICH IS A CRITICAL COMPONENT SO THAT YOU HAVE, UH, DROP OFF CAPACITY ANYTIME, SEVEN DAYS A WEEK, ANYTIME THE, UH, NEED ARISES.

AND THEN ESTABLISHING THE THERAPEUTIC DIVERSION PROGRAM, WHICH IS THAT SPECIALTY SHELTER PROVIDING THERAPEUTIC WRAPAROUND SERVICES.

SO THE IDEA THAT INDIVIDUALS HAVE TIME TO HEAL, UM, TIME TO, UH, ACCESS RESOURCES TO GO SEEK HOUSING OPPORTUNITIES AND TO TRANSITION, UH, BACK INTO THE COMMUNITY.

AND WE DIDN'T SEPARATELY INTRODUCE OURSELVES, SO I APOLOGIZE.

I'M LAURA PITO WITH, UH, UH, TRAVIS COUNTY HEALTH AND HUMAN SERVICES.

NOW I TURN IT MY COLLEAGUE COURTNEY LUCAS.

HELLO.

AGAIN, THERE'S ENHANCEMENTS, THERE'S ITERATIVE IMPROVEMENTS.

AND SO THIS, THIS IS A PILOT.

WE WANT TO LEARN.

THAT'S, THAT IS WHY WE'RE DOING THIS.

WE WANT THIS TO INFORM ALL OF THE EFFORTS MOVING FORWARD.

AND TO THAT END, THE COUNTY HAS A ROBUST SET OF PERFORMANCE MEASURES INCLUDED IN OUR CONTRACT THAT COVERS, AGAIN, BOTH PES AND TDP.

AND THE CITY IS USING THE SAME MEASURES, UH, FOR TDP UNDER THEIR CONTRACT.

SO WE DO HAVE ALIGNMENT.

INTEGRAL CARE IS REPORTING PERFORMANCE TO ALL OF US QUARTERLY.

THEY ALSO HOST QUARTERLY STAKEHOLDER MEETINGS TO REPORT OUT ON THEIR PERFORMANCE AND TO ENGAGE THE COMMUNITY TO ANSWER QUESTIONS, GATHER FEEDBACK.

SO THAT'S A, A REALLY IMPORTANT IN ONGOING ENGAGEMENT.

WE HAVE PILOT TASK GROUPS THAT ARE, UM, INTENDED TO ADDRESS BARRIERS AND CHALLENGES AS WE IMPLEMENT A PILOT.

WE ARE LEARNING AS WE GO.

UM, SO THESE TASK GROUPS INCLUDE A MANAGEMENT TASK GROUP, A DIVERSION, A DEFLECTION, A DATA, AND MEASURABLES IN A CLINICAL INTERVENTIONS AND COMMUNITY RESOURCES TASK GROUP.

SO A LOT OF ENGAGEMENT AND INVOLVEMENT ACROSS A BROAD SWATH OF STAKEHOLDERS.

AND SO THAT MEMBERSHIP INCLUDES THOSE STAKEHOLDERS, COMMUNITY MEMBERS, FOLKS WORKING IN THE FIELD, UH, AGAIN, SO THAT WE CAN HAVE, HAVE A SMALL TEAM TO, TO HELP PROBLEM SOLVE, UM, AS WE BUMP INTO IMPLEMENTATION CHALLENGES OR, OR WHERE WE FIND THAT WE NEED TO MAKE IMPROVEMENTS.

AND SO FINALLY THE COUNTY HAS CONTRACTED WITH DELL MEDICAL SCHOOL TO CONDUCT AN EVALUATION OF THE PILOT.

SO WE WILL ALSO HAVE THAT LEVEL OF LEARNING, UM, FROM FROM DELL MED AS THEY, AS THEY MOVE FORWARD THERE, WHICH IS EXCITING.

AND SO NOW THE COUNTY IS GOING TO TURN IT BACK OVER TO DAWN, UM, TO GO THROUGH OUR INTEGRAL THE INTEGRAL CARE, UH, SLIDES AND YOU'LL STAY.

HI, DAWN HANLEY, CHIEF OPERATIONS OFFICER, VICE PRESIDENT INTEGRAL CARE.

NICE TO SEE YOU AGAIN, .

SO, I'M GONNA GO INTO A LITTLE BIT MORE DEPTH ABOUT, UM, KIND OF WHAT THE SERVICES THAT WE'RE PROVIDING, UM, IN, AT THIS, UH, PILOT LOCATION.

SO, AS THE LOCAL MENTAL HEALTH AUTHORITY, UM, OUR MISSION IS TO IMPROVE THE LIVES OF PEOPLE AFFECTED BY BEHAVIORAL HEALTH AND DEVELOPMENTAL, UH, AND INTELLECTUAL CHALLENGES.

AS THE LMHA, OUR SPECIALTY LIES IN SERVING THOSE WITH SEVERE AND PERSISTENT MENTAL ILLNESS, UH, SUBSTANCE USE, UH, THOSE INDIVIDUALS EXPERIENCE HOMELESSNESS AND THOSE THAT ARE INVOLVED IN THE JUSTICE SYSTEM.

BY LEVERAGING OUR CURRENT, UH, CRISIS CONTINUUM OF CARE AND OUR EXISTING FACILITIES, WHICH YOU HEARD ABOUT IN THE PREVIOUS, UH, PRESENTATION, WE'VE BEEN ABLE TO ESTABLISH THIS DIVERSION PILOT AND PROVIDE SERVICES, UM, THAT OUR COMMUNITY NEEDS.

NEXT SLIDE.

THE GOALS OF THIS PROGRAM INCLUDES STABILIZATION, UH, STABILIZING BEHAVIORAL HEALTH CONDITIONS THROUGH EVIDENCE-BASED, UH, MENTAL HEALTH CO-OCCURRING INTERVENTIONS, ASSISTING INDIVIDUALS WITH COMPLEX NEEDS BY REMOVING THOSE BARRIERS TO TREATMENT AND SERVICES.

WE'RE HOPING TO REDUCE, UH, CRISIS UTILIZATION AND JAIL RECIDIVISM BY LINKING INDIVIDUALS TO ONGOING SUPPORT AND SERVICES, AND ENHANCING OUR COMMUNITY PARTNERSHIPS TO WORK TOGETHER, UM, AND COLLABORATE ON THAT JAIL DEFLECTION AND DIVERSION STRATEGIES.

PART OF THIS, UH, DIVERSION PILOT IS, UM, THE WORK IS, IS IN MORE THAN ONE LOCATION, UM, BECAUSE IT IS A PILOT WE'RE USING, UM, AND LEVERAGING

[01:00:01]

EXISTING SERVICES WITHIN THE INTEGRAL CARE SYSTEM OF CARE.

UH, WE USE OUR PSYCHIATRIC EMERGENCY, UH, SERVICES WALK-IN CLINIC AS THAT TRIAGE POINT.

SO THAT'S THE WAY YOU ENTER INTO THIS DIVERSION PILOT WORK.

UM, WE'VE BEEN, UH, PROVIDING THIS WALK-IN SERVICE FOR OUR COMMUNITY, UH, SINCE WE'VE, UH, ESTABLISHED, UM, AS, AS A-L-M-H-A, UM, THIS, UH, CLINIC WILL SERVE INDIVIDUALS WHO ARE EXPERIENCING A MENTAL HEALTH CRISIS.

SO ANYONE IN THE COMMUNITY CAN ALSO USE THIS.

THIS IS NOT JUST A SERVICE THAT IS, UH, DEDICATED SOLELY FOR THE PURPOSES OF DIVERSION.

UH, WHAT'S IMPORTANT IS WHAT YOU HEARD ABOUT US BEING ABLE TO GO 24 7.

UH, THAT'S THE INVESTMENT, UH, FROM THE CITY AND THE COUNTY IN, IN CENTRAL HEALTH THAT ALLOW US TO OPEN THAT, UH, UH, ACCESS, UH, TO 24 7.

AND IN THIS LOCATION, WE'LL PROVIDE ASSESSMENT, UH, MENTAL HEALTH ASSESSMENTS, NURSING SERVICES, UH, WE CONNECT FOLKS TO PEER SUPPORT SERVICES.

UM, WE HAVE A PSYCHIATRIST 24 7 AS WELL.

SO YOU HAVE ACCESS TO A DOC.

UM, AND IF THERE'S ANY NEED FOR MEDICATION, WE CAN PROVIDE THAT AT THAT TIME.

THROUGH THE PILOT, WE'VE ENHANCED THESE SERVICES, UM, THROUGH ADDING A 23 HOUR OBSERVATION BEDS, UM, WHICH ALLOWS US TO KIND OF HOLD ONTO AN INDIVIDUAL FOR THAT TIME PERIOD AND MAKE A DETERMINATION.

DO THEY NEED A HIGHER LEVEL OF CARE WHERE WE CAN COORDINATE INPATIENT OR DO COULD THEY USE A LITTLE BIT MORE TIME TO STABILIZE, WHICH IS OFTEN THE CASE, UH, THROUGH ANY OF OUR CRISIS PSYCHIATRIC SERVICES.

SO THE IN HERMAN CENTER, UM, WHERE THEY CAN STAY, UM, UP TO FIVE TO SEVEN DAYS.

AND AT THAT POINT, UM, ONCE THEY'RE STABILIZED, WE CAN MOVE THEM OVER TO TDP, WHICH IS THE ACTUAL LOCATION, UM, OF THE DIVERSION CENTER.

UM, THE FOLLOWING SLIDE HERE SHOWS DATA FROM THE FIRST TWO QUARTERS, UH, UP THROUGH THE END OF MARCH OF 2025.

SO WE'RE CURRENTLY IN QUARTER THREE, AND THAT'LL END, UH, INTO JUNE.

THE NUMBER OF INDIVIDUALS, UH, SERVED SO FAR IN THIS DATASET, UH, ONLY INCLUDE INDIVIDUALS THAT WERE SERVED AT PES, REFERRED FROM, UH, EMERGENCY DEPARTMENTS, THE SOBERING CENTER, AND, UH, FIRST RESPONDERS.

THE OUTCOMES HERE REFLECT RATES, UH, FOLLOWING THE 30 DAYS AFTER DISCHARGE FROM PES.

THE FOLLOWING SLIDE HERE SHOWS THE AVERAGE WAIT TIME FOR INDIVIDUALS.

SO I'D LIKE TO HIGHLIGHT THAT AVERAGE, UM, FIVE MINUTES.

THE LAST BULLET BULLET THAT YOU SEE, UM, TIME IT TAKES FOR THE FIRST RESPONDER TO DROP OFF AN INDIVIDUAL.

SO DURING THE DROP OFF TIME, UH, A FIRST RESPONDER WILL COMPLETE A FORM, UH, WHEN THEY COME, UH, TO PES, TO PROVIDE SOME CRITICAL INFORMATION ON THAT INDIVIDUAL AND WHY THEY'RE BRINGING THEM, UH, FOR SERVICES.

THIS, UH, INFORMATION IS IMPORTANT SINCE IT IS A PILOT, WE'RE TRYING TO, UH, GRAB AS MUCH DATA AS WE CAN.

WHO ARE THEY BRINGING, UM, WHAT CHARGES MAY LOOK LIKE THAT THEY'VE DEFLECTED FROM SO THAT WE'RE KEEPING FOLKS OUTTA JAIL.

UM, SO OUR GOAL HERE IS TO ENSURE THAT PROCESS IS EFFICIENT, UM, AS POSSIBLE SO THAT WE CAN RELEASE THOSE FIRST RESPONDERS BACK INTO THE FIELD AND, UM, GET THAT SERVICE STARTED, UH, QUICKLY AND PROVIDE ANY KIND OF, UH, UH, MEDICAL EMERGENCY SERVICES IF NEEDED TO THAT HIGHER LEVEL OF CARE.

JUST TO JUMP IN THE PERFORMANCE DATA, THAT IS FOR THE FIRST SIX MONTHS? CORRECT.

SO YOU'VE SERVED 324 INDIVIDUALS IN THE FIRST SIX MONTHS.

MM.

UNDUPLICATED, YES.

SO AT LEAST ONE INDIVIDUAL IS GETTING HELP EVERY SINGLE DAY, CORRECT.

IN THIS COMMUNITY.

OKAY, THANK YOU.

IMPORTANT TO DESIGNATE TDP, UM, ALSO AS A, A SHELTER, BECAUSE INDIVIDUALS CAN STAY HERE LONGER.

HERE, THIS SLIDE SHOWS THE OUTCOMES OF INDIVIDUALS FOLLOWING THE COMPLETION OF A CRISIS ASSESSMENT, WHICH IS THE FIRST PART.

UM, SO FIRST RESPONDERS WILL BRING THEM IN OR INDIVIDUALS WALK IN.

WHAT THE FIRST THING THAT HAPPENS IS WE DO A THOROUGH, UH, CRISIS ASSESSMENT TO KIND OF LEARN WHAT'S GOING ON, SIGNS AND SYSTEMS. SO DO WE NEED A HIGHER LEVEL OF CARE? CAN WE TRANSITION TO THE OTHER, UH, PROGRAMS? UM, OF THE 42% THAT WENT TO A HIGHER LEVEL OF OF CARE, UH, 40% OF THEM WENT TO AN INTEGRAL CARE CRISIS RESIDENTIAL FACILITY.

SO THAT'S LIKE THE N UM, OR THE HERMAN CENTER.

UM, AND TDP ALSO COUNTS AS A CRISIS RESPITE CENTER.

UM, BUT THIS IS JUST THOSE TWO, UH, VOLUNTARY TYPE PROGRAMS. WE'VE NOT HAD ANY DIRECT TRANSFERS OVER TO THE THERAPEUTIC, UH, DIVERSION PROGRAM AS OF YET.

UM, BECAUSE THAT PART WASN'T QUITE AVAILABLE IN THE FIRST TWO QUARTERS.

SO WE'RE JUST THIS NEXT ROUND OF DATA, WE SHOULD BE ABLE TO CAPTURE WHAT THAT LOOKS LIKE.

UM, SO PRIMARILY RIGHT NOW, WHO'S MOVING IN THROUGH TDP ARE, UH, DIRECT ADMISSIONS FROM THE JAIL.

THIS SLIDE WILL SHOW YOU THE DEMOGRAPHICS OF THOSE THAT ARE SERVED AT PES.

AND OF NOTE, MORE THAN HALF OF THESE FOLKS, UM, ARE EXPERIENCING HOMELESSNESS.

UM, SO THIS IS, UH, SOME OF THE DATA THAT WE'RE TRYING TO COLLECT AND WHY WE THOUGHT IT WAS

[01:05:01]

IF THEY STAY LONGER, THEY MIGHT LOSE THEIR UNHOUSED STATUS, WHICH WILL, UH, YOU KNOW, HAVE A NEGATIVE CONSEQUENCE OF IMPACTING THEIR ABILITY TO GET TIMELY HOUSING.

WAIT A MINUTE, CAN YOU SAY THAT AGAIN? SO, IF YOU STAY LONG BEING, IF YOU'RE NOT IN A SHELTER, SO IF YOU'RE IN CRISIS RESIDENTIAL, FOR INSTANCE, AND YOU STAY FOR MORE THAN 30 DAYS, YOU'RE NOT CONSIDERED UNHOUSED.

SO YOU'RE TELLING ME IF SOMEONE DECIDES TO GET HELP FOR MORE THAN 30 DAYS, CORRECT.

THEY'RE DISINCENTIVIZE FROM DOING THAT FROM HOUSING, THE, IT'LL IMPACT THEIR HOMELESS, HOMELESS STATUS.

SO THAT'S WHY WE WANTED TO MAKE SURE WE WERE NOT DOING THAT HERE.

WE WANTED TO HOLD ONTO PEOPLE LONGER SO WE COULD DO ALL THE THINGS, GET THE BENEFITS, UM, MAKE SURE IF THEY'RE ELIGIBLE FOR MEDICAID, WE WANNA GET THE MEDICAID AND THOSE THINGS TAKE TIME, UH, TO SET ALL THOSE KIND OF SYSTEMS UP.

AND, UH, BY DESIGNATING OURSELF, UH, AS A SHELTER, IT DOESN'T NEGATIVELY IMPACT THAT.

AND THEN IF WE CAN GRAB HOLD OF ANY, UH, VOUCHERS FOR HOUSING, UM, THEN WE CAN MOVE PEOPLE RIGHT, RIGHT INTO THOSE HOUSING SERVICES.

SOME EARLY, UH, LESSONS LEARNED.

UM, AND SUCCESSES INCLUDE THE VALUE OF THE ROUND, THE CLOCK ACCESS FOR FIRST RESPONDERS THAT REDUCE THE STRAIN ON EMERGENCY DEPARTMENTS AND JAILS, UM, BY ALLOWING US TO PROVIDE A SPECIALIZED ALTERNATIVE DESTINATION.

EFFICIENCY IS KEY AND STREAMLINE DROP OFF PROCESSES, INCREASE FIRST RESPONDER BUY-IN, AND CONTINUED UTILIZATION.

WE'VE SEEN THIS WORK AS IT TRENDS, UH, HAS BEEN TRENDING UP CONSISTENTLY SINCE WE'VE, UH, BEGAN THIS SERVICE.

IT WAS A LITTLE SLOW WHEN YOU START, BUT EVERYTHING IS SLOW WHEN YOU START.

UM, WE'RE TALKING ABOUT MOVING SOME BIG SYSTEMS, AND SO NOW WE'RE SEEING THAT UPTICK, UM, IN THE USE, UH, FROM OUR FIRST RESPONDERS, DROPPING OFF INDIVIDUALS, UM, WHICH IS WHAT WE WANT TO SEE.

THE 23 HOUR OBSERVATION BEDS PROVIDE A CRITICAL WINDOW FOR ASSESSMENT AND STABILIZATION THAT WE DID NOT HAVE IN OUR SYSTEM OF CARE PREVIOUSLY.

UM, AND THAT'S, UH, PROVING TO BE BENEFICIAL.

SOME FOLKS ARE ABLE TO STABILIZE, WHICH IS, YOU KNOW, THE DATA WILL SHOW THAT MOST PEOPLE'S, UH, CRISIS WILL RESOLVE WITHIN THAT, UH, 23 TO 48 HOUR WINDOW, AND THEN YOU CAN MOVE THEM INTO THESE LEAST RESTRICTIVE LEVEL OF CARE.

SO, SO HAVING THIS, UH, STABILIZATION BIDS HAVE REALLY HELPED US IN THAT SENSE.

UM, IT'S ALSO REDUCED THE UNNECESSARY USE OF HOSPITALIZATION AND INCARCERATION.

PART OF OUR PROJECT, UM, WAS WE WERE INTENTIONAL ABOUT ADDING PEER SERVICES TO PROVIDE THAT REAL LIFE PERSPECTIVE AND HOPE THAT INCREASES THE LIKELIHOOD THAT INDIVIDUALS WILL STAY ENGAGED WITH THE SERVICES AND TO KIND OF HELP THEM NAVIGATE WHAT IT, WHAT IT LOOKED LIKE.

HAVING THAT LIVED EXPERIENCE AND HAVING THEM, UH, BUILD THAT TRUST HELPS THEM TRUST IN THE SERVICE DELIVERY AND WHERE WE WILL SEE BETTER OUTCOMES FOR THAT INDIVIDUAL.

THE SMALL NUMBER OF INDIVIDUALS THAT HAVE LEFT WITHOUT BEING SEEN WERE ATTRIBUTED TO, UM, AN ENGAGEMENT, UM, WITH THE PEERS, MEANING THAT WE, THEY'RE NOT LEAVING AS OFTEN PRIOR TO THE PROJECT.

YOU MAY HAVE USED UTILIZED PES SERVICES, BUT WE DIDN'T HAVE THAT PEER CONNECTED TO 'EM, SO THEY WOULD NOT WAIT, AND THEY WOULD LEAVE BEFORE THEY REACHED THE PROVIDER.

THIS ALLOWS THEM TO, TO CONNECT WITH SOMEBODY THERE, GO THROUGH THE PROCESS WITH THE ASSESSMENT, WITH THE NURSE, THE COUNSELOR, AND THE PSYCHIATRIST.

FINALLY, UH, CROSS-AGENCY COLLABORATION IS ESSENTIAL AND COMPLEX.

THIS PILOT, UM, IS STRUCTURED WITH TASK GROUPS THAT ALLOW FOR THAT REAL-TIME PROBLEM SOLVING TRANSPARENT DISCUSSION OF CHALLENGES, AND IT ENCOURAGES TRUST AND INNOVATION AMONG PARTNERS.

THERE ARE MANY VOICES IN THE ROOM WITH THIS PROJECT, AND WE WELCOME THEM ALL.

OH, BACK ONE.

THERE YOU GO.

SO THIS IS JUST A, A PICTURE OF WHAT THE BUILDING LOOKS LIKE.

IT'S ACROSS THE STREET FROM, UH, DELL MEDICAL, SO RIGHT OFF OF 15TH, UM, INTEGRAL CARE'S, UH, THERAPEUTIC DIVERSION PROGRAM OR TDP.

IT'S A 25 BED, UH, SPECIALLY SHELTER FOCUSED ON PROVIDING ALTERNATIVES TO INCARCERATION SERVICES INCLUDE INTENSIVE CASE MANAGEMENT, INDIVIDUAL AND GROUP THERAPY, PEER SUPPORT, NURSING MEDICATION EVALUATION, MEDICAL SERVICES BY CENTRAL HEALTH.

THE FACILITY, UH, FOLLOWS THE CRISIS RESPITE FACILITY STANDARDS AND PROVIDES A LEVEL OF CARE FOR INDIVIDUALS THAT ARE AT LOW RISK OF HARM IN SELF OR OTHERS.

THIS IS AN IMPORTANT, UH, PIECE BECAUSE IT'S, UH, UNDER THE HHS STANDARDS OF CARE FOR A RESPITE FACILITY.

SO WE'RE FOLLOWING AN EVIDENCE-BASED MODEL AROUND, UH, CARE FOR INDIVIDUALS WITH, UH, COMPLEX MENTAL HEALTH NEEDS.

THE LENGTH OF STAY IS UP TO 90 DAYS TO PROVIDE THAT EXTENDED TIME FOR THAT STABILIZATION AND OPPORTUNITY TO LINK INDIVIDUALS TO SERVICES PRIOR TO DISCHARGE.

THIS PROGRAM OPENED FOR SERVICES ON OCTOBER 7TH, 2024.

SINCE OPENING, UH, TDP HAS SERVED, UH, 83 UNIQUE

[01:10:01]

INDIVIDUALS, AS MENTIONED PREVIOUSLY, ALL REFERRALS TODAY HAVE BEEN REFERRED, UH, TO DTDP BY THE DEFENSE ATTORNEYS, UH, FOR INDIVIDUALS THAT ARE CURRENTLY INCARCERATED.

SO THESE ARE PRIMARILY INDIVIDUALS THAT ARE COMING FROM JAIL.

SO THEY'RE ALREADY IN THE CARCERAL SYSTEM.

UM, SO IT IS TRUE DIVERSION.

SOME OF THE OTHER WORK THAT WE'RE TRYING TO TRACK IS THE DEFLECTION THROUGH THE DROP OFF AT PES WHERE THEY'RE DIVERTING, UH, THE CHARGES ALTOGETHER, AS MOST INDIVIDUALS SERVED AT TDP ARE EXPERIENCING HOMELESSNESS, UM, COMPLETION OF THE COORDINATED ASSESSMENT AND CONNECTION TO BENEFITS IS CRITICAL FOR THEIR STABILIZATION.

ALL OF THOSE ACTIVITIES HAPPEN DURING THEIR STAY.

THE FOLLOWING SHOWS THE PERCENTAGE OF THOSE THAT HAVE COMPLETED, UM, FOUR INDIVIDUALS SERVED AT TDP.

SO HERE YOU CAN SEE HOW MANY COORDINATED ASSESSMENTS, UH, THE MAP AND PAP BENEFITS, AS WELL AS SOAR, WHICH IS THE CONNECTION TO YOUR MEDICAID, UH, TYPE SERVICES.

UM, ALL INDIVIDUALS WHO NEED COORDINATED ASSESSMENT MAP OR, OR MAP OR PAP BENEFITS ARE CONNECTED WHILE, WHILE THEY'RE STAYING AT TDP.

UH, THERE'D BE SOME EXEMPTIONS TO THAT.

SOME PEOPLE LEAVE, UM, THEY'RE RELEASED FROM JAIL, THEY STAY A FEW DAYS AND THEY DECIDE, UH, TO LEAVE.

AND SO WE AREN'T ABLE TO KIND OF FINISH ALL OF THESE COORDINATED ASSESSMENTS, BUT THE MAJORITY, UM, A LARGE PORTION OF THEM ARE STAYING GETTING CONNECTED TO THESE BENEFITS.

THIS SLIDE SHOWS THAT SERVICES AND TREATMENT, UH, HOURS PROVIDED TO INDIVIDUALS WHILE THEY'RE AT TDP.

UH, FOUR HOURS OF PROGRAMMING IS DEDICATED EACH DAY FOR INDIVIDUALS THAT ATTEND GROUP SESSIONS, UM, ALONG WITH INTENSIVE CASE MANAGEMENT SERVICES AND PEER SUPPORT SERVICES.

TO DATE, THE AVERAGE LENGTH OF STAY, UH, FOR INDIVIDUALS IS 41 DAYS, WHICH IS PRETTY GOOD CONSIDERING THEY'RE COMING FROM AN, UH, CARCERAL SITUATION.

OUTCOME DATA FOR THE FIRST TWO QUARTERS, SINCE OPENING SHOWS THE POSITIVE OUTCOMES, UH, FOR THOSE THAT ENGAGED IN SERVICES.

OVER 80% OF THE INDIVIDUALS ARE CONNECTED TO ONGOING CARE.

THEY DO NOT HAVE AN EMERGENCY DEPARTMENT ADMISSION FOR MEDICAL OR A PSYCHIATRIC REASON, AND THEY DO NOT ACCESS THE CRISIS SERVICES THROUGH INTEGRAL CARE'S 30 DAY POST-DISCHARGE, WHICH IS PRETTY IMPRESSIVE.

THIS SLIDE WILL SHOW YOU THE DEMOGRAPHICS FOR THE INDIVIDUALS SERVED AT TDP IN QUARTER TWO.

UM, OF NOTE, THE MAJORITY OF THOSE SERVED ARE BLACK AND AFRICAN AMERICAN, WHICH ALIGNS WITH THE DEMOGRAPHICS, UM, DATA THAT SHOWS THAT THESE, THIS POPULATION OF INDIVIDUALS ARE DISPROPORTIONATELY REPRESENTED IN THE CARCERAL SYSTEM.

TO ENSURE CONTINUITY OF CARE AND PREVENT REENTRY INTO CRISIS OR PREVENT INCARCERATION, THERE MUST BE SIGNIFICANT THROUGHPUT RESOURCES.

AND THOSE RESOURCES INCLUDE PERMANENT SUPPORTED HOUSING UNITS, UH, CASE MANAGEMENT, UM, ACCESS TO TRANSITIONAL HOUSING OPTIONS.

UH, FOR INSTANCE, MANY INDIVIDUALS EXITING PROGRAMS LIKE TDP OR LIVING WITH SEVERE PERSISTENT, UH, MENTAL ILLNESS CONGREGATE, SHE SHELTERS ARE OFTEN, UH, NOT APPROPRIATE FOR PEOPLE, UH, WITH BEHAVIORAL HEALTH CHALLENGES, THEY, THEY'RE LOUD, YOU HAVE A LARGE NUMBER OF PEOPLE, UM, AND IT CAN EXACERBATE, UH, SYMPTOM ONTOLOGY.

SO HAVING A DEDICATED SYSTEM THAT'S MORE TREATMENT FOCUSED FOR INDIVIDUALS WITH, UH, MENTAL HEALTH NEEDS, UM, LIKE TDP, UH, MAKES SENSE AND PRODUCES BETTER OUTCOMES.

UM, WE ALSO ARE CONNECTING INDIVIDUALS TO EXISTING COMMUNITY RESOURCES, AND WE CAN'T THANK THE CITY ENOUGH, UH, AS WELL AS THE COUNTY AND CENTRAL HEALTH FOR THEIR INVESTMENTS.

UM, IN THE CITY'S INVESTMENT IN, IN HOMELESS SERVICES IS REALLY CRITICAL TO THE SUCCESS OF THIS PILOT, UH, PROJECT SO THAT WE'RE NOT DISCHARGING, UH, FOLKS INTO HOMELESSNESS.

AN IMPORTANT LESSONS LEARNED IN THE FIRST SIX MONTHS OF OPENING AND INCLUDE HAVING A WIDE RANGE OF COORDINATED SERVICES, INCLUDING ASSESSMENTS, THE SOAR ASSISTANCE, THE MENTAL HEALTH CARE, THE MEDICAL SERVICES PROVIDED BY CENTRAL HEALTH, THE LIFE SKILLS TRAINING THAT THEY GET IN THE GROUP, THEY'RE ALL CONVENIENTLY PROVIDED AT A SINGLE LOCATION.

REDUCING BARRIERS FOR INDIVIDUALS NOT HAVING TO TRAVEL CATCH BUSES, UM, AND PUTTING THE ONUS ON THEM TO GET TO THAT CARE.

WE HAVE IT ALL IN ONE STOP SHOP, UH, IN ONE LOCATION.

ADDITIONALLY, BEING, UH, DESIGNATED AS AN EMERGENCY SHELTER ALLOWS, UM, IN, IN HMIS, UM, ALLOWS US TO NOT NEGATIVELY IMPACT THEIR, UH, HOUSING STATUS OR HOMELESS STATUS.

UH, SOME CHALLENGES INCLUDE NO CURRENT ESTABLISHED PATHWAYS TO THESE NON CONGREGATE SHELTERS, HOWEVER, WORK IN THE TASK GROUPS CONTINUE TO FOCUS IN THIS AREA.

FINALLY, THE PROGRAM IS OPERATING WITH AN INTEREST LIST.

WE'RE AVERAGING ABOUT FOUR WEEKS TO ADMIT TO TDP, UH, AND THESE ARE JUST JAIL REFERRALS, UH, WITHOUT EVEN OPENING, UH, THAT OPPORTUNITY AND LOOKING AT WHAT IT'S, WHAT IT

[01:15:01]

IS THROUGH PES.

SO THE, THERE IS A WAIT LIST FROM JAIL AT THIS TIME TRYING TO GET FOLKS INTO TDP.

JUST TO REMIND YOU, IT IS ONLY A 25 BED FACILITY.

I WAS GONNA ASK WHEN, RIGHT NOW IT IS FOCUSED ON OUR JAIL POPULATION, BUT EVENTUALLY WE ARE GOING TO ALLOW CORRECT INDIVIDUALS EXPERIENCING HOMELESSNESS TO ALSO, THEY CAN, THEY CAN, WE CAN TRANSFER, IF WE HAVE BEDS OPEN, WE CAN TRANSFER THEM IN THERE FROM IN FOR EITHER PES OR ANY OF OUR CRISIS RESIDENTIAL PROGRAMS, WHICH IS PART OF THE SYSTEM OF CARE.

UM, AND WE INTENTIONALLY SET IT UP THAT WAY BECAUSE INDIVIDUALS HAVE TO BE AT A CERTAIN LEVEL OF INDEPENDENCE, RIGHT? BEING ABLE TO SELF TAKE YOUR MEDICATION INDEPENDENTLY.

AND WE'RE REALLY PREPARING YOU TO BE INDEPENDENT IN THE COMMUNITY.

SO IF YOU'RE EITHER, UM, IN SOME, THIS COULD BE FOLKS EVEN RELEASED FROM JAIL, IF THEY'RE NOT QUITE STABLE WITH THEIR PSYCHIATRIC SYMPTOMS, WE WANT TO GET 'EM THROUGH THE CRISIS SYSTEM AND STABILIZE 'EM BEFORE GOING TO TDP, SO THEY'LL HAVE BETTER OUTCOMES.

SO AS WE MOVE FORWARD THROUGH THE FIRST YEAR OF IMPLEMENTATION WITH THE PROJECT, UM, WE CONTINUOUSLY WILL MONITOR THE REFERRAL PATHWAYS, STRENGTHEN COMMUNITY PARTNERSHIPS TO ENSURE ACCESS TO MEDICAL AND BEHAVIORAL HEALTH AND HOUSING SERVICES FOR INDIVIDUALS, AND EVALUATE THE SERVICES PROVIDED TO IDENTIFY ANY UNMET NEEDS.

UM, AND NOW I'LL HAND IT BACK TO LAURA SO SHE CAN CLOSE OUT THE PRESENTATION, UH, BEFORE WE OPEN IT UP TO ANY QUESTIONS YOU MAY HAVE.

THANK YOU, DAWN.

ALRIGHT, THIS IS OUR LAST SLIDE, AND THEN WE'LL HAVE, UH, QUESTIONS AND ANY OF THESE SPEAKERS WILL BE AVAILABLE TO ANSWER THOSE QUESTIONS.

SO YOU MAY SEE IT A LITTLE SHUFFLING AS CHAIRS.

UM, SO CONCLUSION AND WRAP UP.

UM, ENSURING UNINTERRUPTED SERVICES TO VULNERABLE COMMUNITY MEMBERS, THOSE WITH SEVERE AND PER PERSISTENT MENTAL ILLNESS WITH CRIMINAL LEGAL INVOLVEMENT, OFTEN UNHOUSED AND CYCLE THROUGH OUR EMERGENCY SERVICES SYSTEMS. THAT IS WHAT WE ARE WORKING TO DO WITHIN THIS PILOT, SO THAT WE BUILD THE SKILLS, THE MEMORIES, THE PATHWAYS, THE UNDERSTANDING SO THAT WE CAN BROADEN THAT, UH, BROADEN THE SCOPE, GO TO SCALE IN OUR COMMUNITY.

UH, THE PILOT IS GIVING US THOSE CRITICAL LEARNINGS TO ALLOW US TO UNDERSTAND WHERE WE NEED TO MAKE SHIFTS AND CHANGES, UH, IN OUR WORK AND HOW WE COLLABORATE TOGETHER, UM, SO THAT WE CAN BETTER SERVE THESE INDIVIDUALS WITH THE GOAL OF DECREASING THOSE THAT ARE EXPERIENCING HOMELESSNESS, DECREASING THOSE THAT ARE, UH, IN JAIL SETTINGS WITH, UH, UNMET MENTAL HEALTH NEEDS SO THAT INDIVIDUALS IN OUR COMMUNITY ARE GETTING THE RIGHT LEVEL OF CARE, THE RIGHT LEVEL OF SERVICE AT THE RIGHT TIME, AND NOT THROUGH THESE LARGER SYSTEMS. WE WANT IT TO BE A VIABLE RESOURCE, UH, FOR FIRST RESPONDERS TO DEFLECT, RIGHT? SO WE WANT THOSE FIRST RESPONDERS FROM OUR LAW ENFORCEMENT TO OUR EMS TO BE ABLE TO HAVE A SAFE PLACE, A QUICK PLACE TO BRING INDIVIDUALS THAT THEY ASCERTAIN ARE HAVING A MENTAL HEALTH CRISIS TO PES, TO BE ABLE TO DROP OFF QUICKLY AS DON INDICATED, AND TO RECEIVE THEM THOSE MENTAL HEALTH SERVICES AND MOVE INTO SOME STABILIZATION SUPPORTS FROM THERE.

UM, AND WITH THAT 24 7, UM, THAT WORK IS GROWING AND DEVELOPING, AND WE'RE SEEING REAL PROGRESS IN THAT AREA, WE WANNA, UH, SERVING TO INFORM AND ENHANCE THE BROADER DIVERSION EFFORTS, RIGHT? SO AGAIN, SMALL PILOT, JUST STARTING THE WORK, GETTING TO KNOW WHAT WE NEED TO DO, AND THEN USING THAT TO INFLUENCE AND GUIDE, UM, OUR FU OUR FUTURE WORK IN THAT DIVERSION ECOSYSTEM.

AND THEN OF COURSE, THE COLLABORATION FUNDING BY ALL THREE PARTNERS REMAINS ESSENTIAL TO THE ONGOING SUCCESS OF THE PILOT WITH THE CITY'S CONTRIBUTION BEING OF COURSE A CRITICAL COMPONENT.

SO ALL THE MAJOR FUNDERS COMING TOGETHER TO, UH, WRAP AROUND THIS PROGRAM.

UM, AND THIS PILOT HAS BEEN INCREDIBLY, UM, MEANINGFUL, UH, TO THE COMMUNITY AND IS ESSENTIAL FOR US TO CONTINUE, UH, TO COMPLETION FOR THE PILOT.

SO THAT IS THE WRAP UP, AND THEN WE'LL LEAVE IT OPEN TO QUESTIONS AND THEN OUR PARTNERS WILL COME IN, UM, BASED ON THE QUESTIONS.

COLLEAGUES, VICE CHAIR, DECHEN.

WE REALLY APPRECIATE THIS VERY COMPREHENSIVE UPDATE.

AS YOU CAN TELL, THERE'S A LOT OF INTEREST FROM OUR COUNCIL IN SUPPORTING MENTAL HEALTH DIVERSION SERVICES IN, IN OUR COMMUNITY.

AND SO JUST HAVING THIS UPDATE COMPREHENSIVELY, ROBUSTLY ON THE FIRST, UH, SIX MONTHS OF THE PILOT PROGRAM HAS BEEN EXTREMELY HELPFUL.

SURE.

THANK YOU CHAIR.

UH, THANK YOU FOR THIS VERY ROBUST PRESENTATION.

I HAD A COUPLE OF QUESTIONS, UM, AND I UNDERSTAND SOME OF MY COLLEAGUES MIGHT BE A BIT AHEAD OF ME, GIVEN THAT THEY PROBABLY HAD A HAND IN STARTING THIS PROGRAM.

UH, SO I WANTED TO START WITH, YOU MENTIONED BOTH IN THE LESSONS LEARNED AND CHALLENGES FOR BOTH PES AND TDP, THE IDEA THAT IT WAS HELPFUL TO HAVE PEERS ON SITE FOR ENGAGEMENT RETENTION.

CAN YOU EXPAND ON WHAT THAT MEANS? SO WHEN WE LOOK AT PEERS, WE'RE LOOKING AT INDIVIDUALS WITH LIVED

[01:20:01]

EXPERIENCE THEY HAVE EXPERIENCED AND WALKED THE ROAD THAT THE INDIVIDUAL THEY'RE WORKING WITH.

UM, AND SO THEY HAVE A, AN ABILITY TO CONNECT AND LINK WITH THEM IN A WAY THAT OTHERS MAY NOT.

PROFESSIONALS IN THE FIELD MAY NOT.

AND SO THE PEERS ARE THERE TO PROVIDE EMOTIONAL SUPPORT, HELP THEM CONNECT, HELP THEM UNDERSTAND RECOVERY AS POSSIBLE, UM, TO HELP WAIT WITH THEM, UH, HELP THEM PROCESS THE EXPERIENCE, HELP THEM UNDERSTAND HOW THEY'RE GONNA NAVIGATE THROUGH THE NEXT STEPS, UH, IN LANGUAGE, UM, AND INTERACTION THAT IS REALLY WELCOMING AND RECEIVING IN A WAY THAT THEY CAN, THEY CAN TAKE IT IN.

UM, AND IT MAKES THAT INDIVIDUAL THEN MORE TRUSTING OF THE NEXT STEPS IN THAT SERVICE PROVISION MAKES THEM MORE OPEN TO IT.

UM, SO IT'S LIKE A WARM HELPING HAND KEEPING THEM SAFE AND COMFORTABLE IN THE SETTING WHILE THEY THEN MOVE THROUGH THE PROCESS TO ENGAGE IN THE MORE PROFESSIONAL SERVICES.

AND ARE THESE FOLKS VOLUNTEERS? ARE THEY, THEY'RE PAID.

SO THESE ARE PAID, UM, STAFF.

THEY'RE PAID STAFF AND THEY'RE ALSO CERTIFIED, RIGHT? AND SO THROUGH THE STATE OF TEXAS, PEERS CAN BE GO THROUGH A CERTAIN CERTIFICATION PROCESS TO THEN BE CERTIFIED PEER PROVIDERS IN BOTH THE AREAS OF RECOVERY AND IN MENTAL HEALTH.

SO IT SOUNDS LIKE, UH, THE PROCESS IS FINDING PEOPLE THAT HAVE GONE THROUGH THIS EXPERIENCE THEMSELVES, TRAINING THEM, HIRING THEM, STAFFING THEM AT THESE DIFFERENT FACILITIES TO HELP WITH THE NAVIGATION AND PROCESS OF FOLKS THAT ARE THEN COMING IN TO BE SERVED THERE.

IS THAT IT, IT ABSOLUTELY, WE'VE FOUND IN LOTS OF DIFFERENT SETTINGS THAT THAT ENGAGEMENT AND BEING ABLE TO RETAIN THEM LONG ENOUGH TO BE ABLE TO PROVIDE THE CRITICAL SERVICES THAT, THAT THE PEER BRIDGES THAT CREATES THAT BRIDGE TO THAT SERVICE IN A WAY THAT IS INCREDIBLY MEANINGFUL AND THEN HELPS THEM CONTINUE ENGAGING IN THAT SERVICE PROVISION.

SO THE PEERS ARE WALKING HAND IN HAND SIDE BY SIDE WITH THE INDIVIDUALS.

UM, AND WE HAVE LEARNED AS, UM, PROFESSIONALS IN THE FIELD THAT WHAT THEY BRING IS AS VALUABLE TO AS WE BRING.

RIGHT.

AND SO IT'S A WORKING IN CONCERT AND COLLABORATION.

LIKE WHAT A POPULATION OF INDIVIDUAL WOULD DO BETTER AND WHAT TYPE OF A SETTING.

WELL THAT'S GONNA HELP ME LEAD INTO MY NEXT QUESTION THEN, WHICH IS YOU MENTIONED, UH, NOT EVERYBODY IS STAYING AT THESE FACILITIES.

THEY COME THROUGH THERE.

WHAT DO WE KNOW ABOUT THE FOLKS THAT ARE NOT STAYING? SO I MIGHT HAVE TO TURN TO DAWN TO SEE IF YOU WANNA PROVIDE MORE DETAILS WITH THAT DAWN.

UM, BUT I THINK EVERYBODY'S COMING TO THOSE SETTINGS WITH DIFFERENT EXPERIENCES, UM, DIFFERENT NEEDS.

AND SO EVEN IF THEY ARE LEAVING, THEY'RE GETTING SOMETHING TO BEGIN WITH THAT'S STARTING THEIR PATH TO RECOVERY.

THEY JUST MAY NOT BE READY AT THAT MOMENT TO FULLY ENGAGE.

BUT DON, WHAT WOULD YOU SAY? THAT'S AN EXCELLENT QUESTION.

SINCE EARLIER IN THE PRESENTATION I TALKED ABOUT THE MAJORITY OF THE FOLKS THAT ARE COMING TO, UH, TDP TO THE 25 BED FACILITY MAY NOT BE STAYING, UM, THAT ON AVERAGE 41 DAYS, RIGHT? UM, AND THAT'S BECAUSE THEY'VE BEEN IN A, IN JAIL FOR A SUBSTANTIAL AMOUNT OF TIME.

SO A LOT OF THEM JUST WANT TO BE INDEPENDENT AND GO AND DO AND CONNECT TO THEIR, UH, SUPPORT SYSTEMS OUTSIDE.

DOESN'T MEAN THEY'RE NOT GONNA COME BACK FOR ONGOING SERVICES, IT JUST MEANS THEY'RE, UH, READY TO BE MORE INDEPENDENT IN THE COMMUNITY.

UM, WE ARE STILL GATHERING DATA ON THAT SO THAT WE CAN HAVE MORE OF A SNAPSHOT OF WHAT THAT LOOKS LIKE AND WHAT THOSE NEEDS ARE.

SOME PEOPLE AREN'T STAYING AND THEN THEY'RE COME BACK SO WE CAN RE UH, ADMIT THEM INTO THE PROGRAM, WHICH MAKES SENSE.

YOU KNOW, IF YOU'RE IN A, IN JAIL FOR A SIGNIFICANT AMOUNT OF TIME, YOU'VE GOT PEOPLE TELLING YOU WHAT AND HOW AND WHEN TO DO THINGS.

AND SO TRANSITIONING OUT TO A LEAST RESTRICTIVE LEVEL OF CARE, IT WOULD MAKE SENSE THAT THERE'D BE SOME INDIVIDUALS THAT HAVE HAD ENOUGH OF THAT .

SO I FIRST OF ALL, APPRECIATE THAT ANSWER.

I STARTED TO TRY AND GET CLARITY ON, ON THAT, AND I'M NOT SURE THE BEST WAY TO ASK THIS, BUT I'M TRYING TO FIGURE OUT IS THERE ANY CIRCUMSTANCE IN WHICH, FOR PUBLIC SAFETY OR OTHER REASONS WHERE JAIL IS ACTUALLY SEEN AS THE BETTER OPTION BETWEEN THESE PROGRAMS? OR DO PEOPLE COME HERE, LET'S SAY WE'RE TRANSITIONING OUT OF JAIL TO THESE PROGRAMS, IS IT EVER THE DETERMINATION THAT NO, THIS PERSON BECAUSE OF DIFFERENT RISK FACTORS, IS ACTUALLY BETTER SERVED IN A DIFFERENT ENVIRONMENT? I THINK THAT'S AN EXCELLENT, UH, QUESTION.

AS A CLINICIAN, AS A LICENSED CLINICIAN AND HAVING MORE THAN 30 YEARS EXPERIENCE, UH, WORKING IN THIS FIELD, UH, I WOULD NEVER SAY THAT JAIL IS A BETTER OPTION FOR ANYBODY, UM, NEEDING MENTAL HEALTH SERVICES OR A MENTAL HEALTH NEED.

HOWEVER, THE JAIL, UM, AND THE CARCERAL SYSTEM OR THE JUSTICE SYSTEM DOES SERVE A PURPOSE IN THE CONTINUUM OF CARE, DEPENDING ON KIND OF WHAT THE CHARGE WAS, WHAT WERE THE SYMPTOMS, WHAT WAS THE CHARGE, YOU KNOW, IF YOU HAVE MORE, UH, VIOLENT HISTORY, UH, TYPE OF SITUATIONS, WHICH ARE NOT THE MAJORITY OF THE INDIVIDUALS, BUT THERE IS A SUBSET THAT MIGHT MAKE MORE SENSE.

UM, AND I, THERE'S A, AN EVIDENCE-BASED TOOL THAT LOOKS AROUND KIND OF DIFFERENT LEVELS,

[01:25:01]

UM, AND SO THERE IS A SUBSET OF INDIVIDUALS WHERE, UM, DOESN'T MATTER WHAT KIND OF SERVICES YOU WRAP AROUND THEM, THERE'S GONNA BE A MINIMAL CHANGE.

SO THOSE PEOPLE MAY, WOULD NOT BE OR HAVE THE MOST SUCCESS IN A PROGRAM, UH, LIKE THIS, BUT WE'RE NOT NECESSARILY LOOKING AT THAT POPULATION OF INDIVIDUALS.

WE'RE TRYING TO KIND OF FOCUS ON THOSE FOLKS THAT HAVE A LOW, UH, RISK FACTOR AROUND JUSTICE SORT OF CONCERNS AND A HIGH NEED FOR MENTAL HEALTH SERVICES.

NO, THAT MAKES PERFECT SENSE.

UM, LAST QUESTION IS ON THE LESSONS LEARNING CHALLENGES SLIDE FOR PES SPECIFICALLY, YOU TOUCHED ON SOME BARRIERS THAT ARE BEING DISCUSSED BY THE TASK GROUPS.

CAN YOU EXPAND AT ALL AT THIS POINT ON WHAT SOME OF THOSE BARRIERS YOU'RE DISCOVERING ARE? SURE.

SO, SO ONE OF THE, THE BIGGEST ONES IS THE DATA, RIGHT? THE DATA COL COLLECTION, BECAUSE IT'S NOT JUST INTEGRAL CARE DATA THAT WE'RE COLLECTING, RIGHT? WE NEED GEL DATA.

SO THERE ARE OTHER SYSTEMS THAT ARE INVOLVED.

AND SO THERE IS A GROUP THAT'S SPECIFICALLY LOOKING AT THAT WE'RE WORKING ON, UH, BAAS AND DIFFERENT AGREEMENTS THAT WE CAN HAVE TO KIND OF GA TO GATHER THAT DATA.

SO THAT IS, UH, PROBABLY THE PRIMARY, UH, BARRIER, UH, THAT WE'RE TRYING TO ADDRESS, UM, THE COMPLEXITY, UM, OF IMPLEMENTING THE DEFLECTION AND DIVERSION REFERRAL PATHWAYS ACROSS MULTIPLE, UH, COMMUNITY SYSTEMS AND ORGANIZATIONS.

SO HOW WE GET PEOPLE INTO HOUSING AND WHAT THE RULES LIKE, UH, THE CONVERSATION WE HAD WITH COUNCIL MEMBER ALTER ON, UH, THE, IF THEY STAY A CERTAIN AMOUNT OF TIME THEY LOSE THEIR HOUSING STATUS.

THOSE KIND OF THINGS ARE COMPLICATING FACTORS WORKING ON THAT PATHWAY TOO.

IF WE DON'T, DON'T HAVE, UM, A VOUCHER THERE ISN'T HOUSING AVAILABLE, CAN WE CONNECT THEM TO ONE OF THE SHELTERS, UM, IN THE COMMUNITY AND THEN CONTINUE TO ENGAGE THERE.

SO KIND OF WHAT THAT PATHWAY LOOKS LIKE IS STILL UNDER DEVELOPMENT.

I APPRECIATE YOU EXPLAINING THAT.

SURE.

YOU'VE TOUCHED ON THIS A LITTLE BIT, BUT I WAS HOPING TO JUST GET SOME BETTER CLARITY ON THE P-E-S-T-D-P.

IF I'M A, IF I'M AN OFFICER AND THERE'S A CALL FOR AN INDIVIDUAL SUFFERING A MENTAL HEALTH CRISIS AND THEY GO AND HELP THAT PERSON, BUT WANTING TO BRING THEM SOMEWHERE, THAT PLACE IS THROUGH THE PES PROGRAM, NOT CORRECT.

TDP.

CORRECT.

AND THEN WHERE, WHERE DOES TDPI? IS THAT JUST A THEN FROM PES, WE HAVE TO DECIDE WHERE THE NEXT STOP IS, AND TDP MIGHT BE ONE OF THOSE NEXT STOPS? CORRECT.

TDP DOES, IF SOMEONE GOES TO THE DIVERSION CENTER, IF THEY'RE THERE FOR MORE THAN 30 DAYS, DO THEY LOSE THEIR SPOT ON THE LIST SO THEY CAN NO, BECAUSE WE'RE DESIGNATED AS A SHELTER.

IS IT EVER ENVISIONED THAT THE OFFICER WOULD GO STRAIGHT TO TDP OR IS IT, UH, PES ALWAYS THE FRONT DOOR? WELL, IN THIS PARTICULAR PILOT, THE, BECAUSE WE DON'T HAVE ALL OF THE SERVICES IN ONE PLACE, SO TDP WASN'T SET UP IN ORDER TO TAKE, UM, UH, TO DO THE WORK AROUND THE TRIAGE, RIGHT? IT DIDN'T HAVE THE SPACE FOR WHAT WE WOULD NEED.

ON THE OBSERVATION BEDS, THERE'S NOT A GOOD CLINICAL SPACE FOR TRIAGE AND FOR NURSING DOCTOR, UM, AND MEDICAL SERVICES.

SO WE'RE HAVING TO UTILIZE EXISTING SERVICES AND PES IS IN A, IN A DIFFERENT FACILITY.

IT'S NOT FAR, UM, FROM 15TH STREET.

UM, AND THEN LOOKING AT GETTING THAT STABILIZATION THERE, BECAUSE TDP, UM, IS TAKING A SPECIFIC LEVEL OF CARE, RIGHT? SO YOUR, UH, SYMPTOMS ARE MORE CONTROLLED.

YOU'RE MED, UH, ABLE TO TAKE YOUR MEDICATION ON YOUR OWN, THOSE KIND OF THINGS.

INSTEAD OF SOMEONE WHO MIGHT BE, UH, IN A FULL CRISIS IN THE COMMUNITY AND NOT TAKE, NOT ON MEDICATION, THEY LOST THEIR MEDICATIONS OR SYMPTOMS EXACERBATE.

SO WE WANNA BE ABLE TO PROVIDE SOME OF THAT CARE IN ANOTHER LOCATION TO HELP STABILIZE AND THEN MOVE THEM TO TDB FROM THERE ONCE THEY'RE STABILIZED.

SO ALL THE THINGS CAN HAPPEN, BUT EVEN IF IT WERE ALL IN ONE PLACE, IT WOULD BE A DIFFERENT FLOOR OR A DIFFERENT WING OR A DIFFERENT AREA JUST BASED ON WHAT YOU NEED TO DELIVER THAT SERVICE.

AND THEN KIND OF LOOKING AT FROM A TRAUMA INFORMED LENS, WHAT DOES IT NEED TO LOOK LIKE AROUND, UH, SAFETY TO DELIVER THAT CARE? AND THERE WAS SOME DISCUSSION LOOKING AT THE EXPANSION QUESTIONS, SOME DISCUSSION THIS PAST LEGISLATIVE SESSION AROUND ASH AND THAT SITE, WHATEVER, WHAT CAME OF THOSE IDEAS AND THOUGHTS, THEY DID NOT SURVIVE OKAY.

THE LEGISLATIVE SESSION.

CORRECT.

BUT IF YOU THINK OF, IF YOU LOOK AT A PA STANDARDS OR BEST PRACTICE OR ANY OF THE EVIDENCE BASED MODELS, YOU KNOW, HAVING ALL OF THE THINGS IN CLOSE PROXIMITY, UM, DOES HAVE VALUE.

SO WHETHER IT'S ONE BUILDING OR ONE CAMPUS, IT REALLY OPENS UP ACCESS AND IS A NICE THROUGHPUT FOR THAT TRANSITION OF CARE FOR WHATEVER HIGHER LEVEL OR LOWER LEVEL OF CARE.

HOW DOES THE 30 DAY ISSUE THAT WE TALKED ABOUT FACTOR IN WITH

[01:30:01]

SO THAT WAS THE KEY TO TO, TO THAT COMPONENT.

HAD IT NOT BEEN, UM, WE DIDN'T, IF WE HADN'T HAD THAT DESIGNATION, IT WOULD NEGATIVELY IMPACT US.

SO WE WERE, UM, INTENTIONAL ABOUT THAT CHANGE.

UM, I'M TRYING TO REMEMBER, I, ON THE TIP OF MY MIND THAT I HAD ANOTHER QUESTION.

THAT'S THE STANDARD, BY THE WAY.

THAT'S NOT AN INTEGRAL CARE STANDARD.

ALL RIGHT.

WELL, I THINK THAT HELPS UNDERSTAND, I'M, I'M INTERESTED TO SEE KIND OF HOW, WHAT THAT, THAT UNMET NEED QUESTION BECAUSE IT, IT COMES UP ALL THE TIME IN THE AREA I REPRESENT, RIGHT? LIKE, SOMEONE'S HAVING A MENTAL HEALTH CRISIS, WHAT DO WE DO? YOU KNOW, WHO DO I CALL AND WHAT'S GONNA HAPPEN WITH THIS INDIVIDUAL? I GUESS THE LAST QUESTION I WOULD ASK, IT'S IN THAT VEIN, THE QUESTION COMES UP FREQUENTLY ABOUT INVOLUNTARY HOLDS.

WHERE CAN YOU, YOU HAVEN'T TALKED ABOUT THAT, BUT CAN YOU, WHAT IS THE STANDARD AND, AND WHERE ARE WE ON THAT IDEA OF INCREASING OUR ABILITY TO HAVE INVOLUNTARY HOLDS? RIGHT.

SO THERE WAS ANOTHER BILL THAT WAS TRYING TO MOVE THROUGH THE LEGISLATIVE SESSION TO KIND OF EXPAND THE PROVIDERS THAT COULD, UH, DO, UH, GIVE AN INVOLUNTARY WHOLE OR A-P-O-E-D, WHICH WAS INVOLVING, UH, EMS. SO, UM, EXPANDING THAT CAPACITY RIGHT NOW, BECAUSE THE, THE LAWS IN TEXAS, ONLY LAW ENFORCEMENT HAS THE ABILITY TO DECIDE WHETHER AN INDIVIDUAL CAN BE PLACED ON AN INVOLUNTARY HOLD OR NOT.

WE REALLY WANT TO MAYBE THIS NEXT LEGISLATIVE SESSION COME AT IT AGAIN WITH OUR EMS PARTNERS AND EXPAND THAT, NOT NOT JUST LOOKING AT PARAMEDICS, BUT LOOKING AT LICENSED CLINICIANS, UH, BEING ABLE TO DO THAT IN THE WORK.

SO RIGHT NOW WE HAVE TO PARTNER, UM, WITH A PD AND HAVE THOSE DISCUSSIONS AND THEY HAVE A CERTAIN THRESHOLD THAT HAS TO BE MET, BUT WE'LL HAVE INPUT ON IT.

SOMETIMES WE ALIGN, SOMETIMES WE DON'T ALIGN.

UM, BUT THEN THE PLACES FOR WHERE PEOPLE GO ONCE THEY'RE PLACED ON AN INVOLUNTARY HOLD, WE CAN TAKE, UH, SOME OF THOSE, ADD OUR HERMAN CENTER BECAUSE WE HAVE FOUR, UH, UM, OBSERVATION BEDS THERE THAT WE CAN TAKE INVOLUNTARY HOLDS ON.

THERE'S A SPECIFIC STANDARD AROUND THAT AND HOW YOUR FACILITY HAS TO LOOK.

UM, OR WE CAN GO THROUGH OUR NETWORK PROVIDER SERVICES, CONNECT THEM TO INPATIENT SERVICES THROUGH ANY OF THE PRIVATE PSYCHIATRIC HOSPITALS, UM, OR COORDINATE THROUGH ASH IF THERE'S CAPACITY.

RIGHT NOW, THERE'S NOT CAPACITY AT ASH.

RIGHT.

ALRIGHT, I APPRECIATE IT.

ALRIGHT.

THANK YOU SO MUCH FOR BEING WITH US TODAY.

THIS IS GREAT.

WE REALLY APPRECIATE Y'ALL SERVICES AND WORK.

THANK YOU SO MUCH.

VERY GOOD.

THANK YOU COLLEAGUES.

WE'RE NOW GONNA MOVE ON TO ITEM NUMBER FOUR.

THIS IS, WAIT, THAT WAS ITEM NUMBER FOUR.

WE'RE MOVING ON TO ITEM NUMBER

[5. Briefing from Undue Medical Debt on the impact of medical debt in Austin and opportunities for relief. [Courtney Werpy Story, Vice President of Government Initiatives- Undue Medical Debt].]

FIVE.

UH, THIS IS A BRIEFING FROM UNDUE MEDICAL DEBT ON THE IMPACT OF MEDICAL DEBT IN AUSTIN AND OPPORTUNITIES FOR RELIEF.

I WANNA WELCOME COURTNEY WARPY STORY, VICE PRESIDENT OF GOVERNMENT INITIATIVES WITH UNDUE MEDICAL DEBT FOR BRIEFING.

WELCOME, COURTNEY.

GOOD MORNING.

THANK YOU GUYS SO MUCH FOR HAVING US HERE.

MY NAME IS COURTNEY STORY, I'M THE VICE PRESIDENT OF GOVERNMENT INITIATIVES AT UNDUE MEDICAL DEBT.

WE ARE A NATIONAL NONPROFIT, UM, BASED ALL OVER THE COUNTRY AND I'M REALLY EXCITED TO INTRODUCE MY COLLEAGUE LINDSAY, WHO IS ACTUALLY A RESIDENT OF AUSTIN.

SO SHE HAS JOINED US TODAY, SO I'LL LET HER SHARE A LITTLE BIT ABOUT HERSELF.

I MEAN, THAT'S PRETTY MUCH IT.

, I'M, I'M THE POLICY ANALYST HERE AT UND MEDICAL DEBT AND I LIVE IN AUSTIN, SO LOVELY TO BE HERE.

UM, I DON'T SEEM TO BE ABLE TO CLICK.

OVER $472.5 MILLION IN MEDICAL DEBT IN CLEVELAND.

UM, SO HERE AT UNDUE MEDICAL DEBT, WE ARE A NATIONAL NONPROFIT THAT PURCHASES MEDICAL DEBT AT SCALE AND RELIEVES DEBT, NO STRINGS ATTACHED FOR INDIVIDUALS.

WE DO THAT THROUGH TWO MAIN EFFORTS, BOTH PHILANTHROPIC DONATIONS AS WELL AS GOVERNMENT PARTNERSHIPS.

WE CURRENTLY WORK WITH OVER 25 GOVERNMENTS ACROSS THE COUNTRY, BOTH CITIES, STATES, AND COUNTIES TO DO THIS WORK.

OUR GOVERNMENT WORK ALONE HAS ABOLISHED ALMOST $4.5 BILLION IN DEBT FOR OVER 3.5 MILLION INDIVIDUALS.

AND WE ARE VERY PROUD OF THAT WORK.

UH, WE STARTED OUR GOVERNMENT PARTNERSHIPS WITH COOK COUNTY IN 2022, AND THIS MAP JUST KIND OF SHOWS WHERE WE ARE CURRENTLY ACTIVELY WORKING.

THE DARKER BLUE, UM, STATES ARE STATE CONTRACTS AND THEN THE YELLOW DOTS ARE OUR CITY OR COUNTY CONTRACTS.

AS YOU CAN SEE, WE RECENTLY JUST PARTNERED IN TEXAS WITH SAN ANTONIO AND WE WERE ABLE TO DO SOME DEBT RELIEF THERE.

UM, THAT WAS OUR FIRST PARTNERSHIP IN THE STATE OF TEXAS.

JUST SOME, UH, AN OVERVIEW OF SOME OF THE THINGS THAT OUR GOVERNMENT WORK HAS BEEN DOING IN THE NEWS LATELY.

UM, IN ORANGE COUNTY, FLORIDA, WE ABOLISHED

[01:35:01]

WE WERE ABLE TO ABOLISH OVER $165 MILLION IN MEDICAL DEBT IN SAN ANTONIO.

60 MILLION FOR OVER 45,000 RESIDENTS, UM, IN RHODE ISLAND.

7 MILLION FOR OVER 3000 RESIDENTS AND 245 MILLION, UM, FOR 170,000 RESIDENTS IN ILLINOIS.

AND THIS IS JUST A SNAPSHOT OF RECENT ABOLISHMENTS THAT WE HAVE DONE.

SO WE ARE REALLY DOING WORK ALL OVER THE COUNTRY AND WE'RE REALLY EXCITED.

LOOKING A LITTLE BIT MORE AT TEXAS.

UM, WE KNOW THAT TEXAS HAS MORE MEDICAL DEBT ON AVERAGE THAN ANYWHERE ELSE IN THE NATION.

UM, ON AVERAGE, 10.7% OF ADULTS, WHICH IS ABOUT 2.3 MILLION PEOPLE IN TEXAS REPORT HAVING MEDICAL DEBT IN A GIVEN YEAR.

LOOKING MORE, UM, MYOPICALLY AT TRAVIS COUNTY, WE KNOW THAT, UM, ABOUT A HUNDRED, OR I'M SORRY, $1,350 IS THE AVERAGE MEDICAL DEBT THAT A RESIDENT OF TRAVIS COUNTY HAS.

WE KNOW THAT MEDICAL DEBT IMPACTS COMMUNITIES OF COLOR MORE, MORE DEEPLY THAN IT DOES, UM, WHITE COMMUNITIES.

AND WE KNOW THAT THIS IS NOT THE FULL PICTURE.

WE KNOW THAT THE REALITY IS PROBABLY MUCH STARKER THAN WHAT THE DATA REPORTS BECAUSE WE KNOW THAT THERE ARE NOT STRONG DATA REPORTING LAWS AROUND DEBT IN COLLECTIONS.

DID YOU WANNA ADD ANYTHING, LINDSAY? THIS IS REALLY LINDSAY'S BREAD AND BUTTER IN DOMAINS.

SO YEAH, I WOULD JUST SAY THAT.

SO WITHOUT GETTING LIKE DOWN A RABBIT HOLE, THE DEBT IN COLLECTIONS IS JUST PART OF THE PICTURE.

MOST PEOPLE WHO HAVE MEDICAL DEBT, IT'S NOT IN COLLECTIONS, SO THE BURDEN IS GREATER.

UM, AND SO THIS IS JUST AN ESTIMATE OF MAYBE THE JUST ONE, IT'S JUST ONE SLICE.

SO I WOULD SAY YOU COULD PROBABLY EVEN DOUBLE IT AND THAT'S CLOSER TO REALITY.

YEP.

UM, SO JUST A LITTLE BIT MORE ABOUT UNDUE AND WHAT, HOW OUR MODEL OPERATES.

SO IF WE WERE TO ENTER INTO A PARTNERSHIP WITH THE CITY OF AUSTIN, WE WOULD THEN, UM, USE THAT FUNDING TO START PURCHASING DEBT THROUGH HOSPITAL SYSTEMS THAT HOLD DEBT FOR RESIDENTS OF AUSTIN.

SO WE WOULD START BUILDING RELATIONSHIPS WITH HOSPITALS.

WE WOULD ASSESS HOW MUCH DEBT WE THINK THAT THEY HAVE THAT QUALIFIES FOR OUR PROGRAM.

WE WOULD PURCHASE THAT DEBT FROM THEM, WE WOULD PROCESS IT THROUGH OUR INTERNAL SYSTEMS, AND THEN WE WOULD SEND OUT LETTERS TO RESIDENTS NOTIFYING THEM THAT THEIR DEBT HAS BEEN ABOLISHED.

THIS PROCESS CAN TAKE ANYWHERE FROM TWO MONTHS TO OVER A YEAR.

IT REALLY JUST DEPENDS ON THE RELATIONSHIPS THAT WE HAVE WITH THE HOSPITALS AND HOW QUICKLY THEY'RE ABLE TO ENGAGE WITH US AND SORT OF USE THEIR RESOURCES TO HELP US ACCOMPLISH THIS TASK.

WE KNOW THAT HOSPITALS ARE VERY OVERWHELMED RIGHT NOW, ESPECIALLY WITH ALL OF THE CHANGES THAT ARE COMING THROUGH IN THE FEDERAL GOVERNMENT.

SO WE TRY TO BE VERY SUPPORTIVE AND MAKE THIS PROCESS AS EASY AS WE CAN FOR THEM AND REALLY, WE REALLY DO VIEW THEM AS PARTNERS IN THIS WORK.

AND THIS, WE, I, WE DON'T HAVE TO GO INTO THIS, THIS UNLESS YOU GUYS, UM, ARE INTERESTED, BUT WE JUST WANTED TO GIVE YOU AN IDEA OF THE COST OF DEBT ABOLISHMENT.

WE OFTEN SAY THAT $1 IN GOVERNMENT FUNDING CAN ABOLISH MORE THAN A HUNDRED DOLLARS IN MEDICAL DEBT.

AND WE'VE ACTUALLY SEEN A HIGHER ROI RIGHT NOW OUR GOVERNMENT FUNDING $1 IS ABOLISHING ABOUT $167 OF MEDICAL DEBT.

SO WE'RE DEFINITELY HITTING THAT MARK, BUT WE JUST WANNA MAKE SURE THAT FOLKS UNDERSTAND THAT THERE IS MORE THAN JUST THE PURCHASE PRICE OF THE DEBT THAT GOES INTO THE COST OF ABOLISHING IT.

IN ADDITION TO PURCHASING IT, WE HAVE TO QUALIFY IT.

SO WE HAVE TO MAKE SURE THAT THE FOLKS THAT HOLD THAT DEBT ARE EITHER 400% OR BELOW FPL OR THAT THAT MEDICAL DEBT EXCEEDS 5% OF THEIR INCOME OR MORE.

WE ALSO, IF WE'RE WORKING WITH A GOVERNMENT PARTNER, HAVE TO MAKE SURE THAT THEY LIVE WITHIN A ZIP CODE THAT IS APPLICABLE TO THE GOVERNMENT SPENDING.

IN ADDITION, WE HAVE TO PRINT THE LETTERS, MAIL THE LETTERS, OUR STAFF TIME AND ALL OF THAT.

THAT GOES INTO SOURCING AND PURCHASING AND QUALIFYING THE DEBT.

UM, AS WELL AS OUR IT NEEDS, WE HAVE OUR OWN PROPRIETARY DEBT ENGINE AND THERE ARE A LOT OF COSTS WITH MAINTAINING THAT TECHNOLOGICALLY SAFE ENVIRONMENT SO WE CAN MAKE SURE THAT WE ARE MAINTAINING CYBERSECURITY, MAINTAINING PATIENT PRIVACY AND COMPLYING WITH ALL HIPAA AND DATA REPORTING LAWS.

SO THAT'S JUST SORT OF LIKE JUST A LITTLE BIT OF AN OVERVIEW ON THE TOTAL COST.

UM, THE NEXT SLIDE GIVES, I BELIEVE AN AN EXAMPLE BUDGET.

SO IF YOU HAD A MILLION DOLLARS, IT WOULD BE ABOUT 869,000 GOING TO DIRECT DEBT ABOLISHMENT.

AND THEN OUR INDIRECT COST IS AT A 15% INDIRECT COST RATE AND THAT IS ACROSS OUR CONTRACTS NATIONWIDE.

SO JUST GIVE SOME OPTIONS.

UM, AND THAT WOULD SORT OF BE THE NEXT STEPS.

IF YOU GUYS WANTED TO WORK WITH US, WE WOULD LOOK AT WHAT BUDGET YOU HAVE AVAILABLE, WHAT DEBT WE THINK WE COULD ACCESS IN AUSTIN, AND COME UP WITH AN ESTIMATE THAT WE THINK WOULD BE REASONABLE FOR US TO EXECUTE OVER THE COURSE OF A TWO TO THREE YEAR CONTRACT.

UH, AND THESE ARE JUST SOME, YOU KNOW, GUIDELINES ABOUT MORE FOR, FOR YOU ALL AND HOW TO WORK WITH US.

UM, OUR PROGRAM QUALIFICATIONS

[01:40:01]

ARE SET.

THEY CANNOT BE ADJUSTED.

WE CANNOT TARGET SPECIFIC CRITERIA, WE CANNOT LOOK AT IMMIGRATION STATUS.

WE CANNOT TARGET SPECIFIC ILLNESSES.

THAT'S JUST NOT SOMETHING THAT WE'RE CAPABLE OF DOING.

WE ALSO DO NOT SHARE HOSPITAL OR PROVIDER NAMES WITHOUT THEIR PERMISSION.

SO IF WE WERE TO WORK WITH A HOSPITAL, IT WOULD BE UP TO THEM IF THEY WANTED TO GO PUBLIC OR NOT.

AND WE DO TAKE THAT VERY SERIOUSLY AND AGAIN, TYPICALLY WE RE WE REQUIRE ABOUT THREE YEARS AS A MINIMUM CONTRACT JUST TO MAKE SURE THAT WE HAVE ENOUGH TIME TO COMPLETE THAT CYCLE FROM START TO FINISH.

UM, WE ARE A SOLE SOURCE PROVIDER, WHICH I KNOW IS CAN BE INTERESTING WITH GOVERNMENT, BUT WE ARE THE ONLY ONES DOING THIS WORK IN THE COUNTRY AT SCALE.

UM, WE TALKED A LITTLE BIT ABOUT OUR ADMIN, UM, INDIRECT RATES AND AGAIN, JUST ENGAGING WITH HOSPITAL PARTNERS EARLY WITH SUPPORT FROM GOVERNMENT PARTNERS JUST MAKES THIS PROCESS GO SO MUCH SMOOTHER AND FASTER.

SO WE JUST LIKE TO BRING THAT TO THE TABLE EARLY AS WELL.

AND I DON'T KNOW WHY WE STOPPED WORKING.

THAT MUST, THAT MUST BE THE END.

SO YEAH, HAPPY TO ANSWER ANY QUESTIONS THAT YOU GUYS HAVE, PROVIDE ANY MORE INFORMATION THAT WE CAN.

TO PREVENT THE ACCRUAL OF MEDICAL DEBT AND WORKING WITH A GOVERNMENT PARTNER TENDS TO HELP STREAMLINE THOSE CONVERSATIONS WITH HOSPITALS OR OTHER PROVIDERS OR LOOK AT LEGISLATION TO SEE WHAT WE CAN DO TO PREVENT THIS PROBLEM IN THE FIRST PLACE.

I APPRECIATE YOUR BREVITY.

THAT WAS GREAT.

YOU RAN THROUGH A LOT OF GOOD STUFF THERE.

UH, COUNCILMAN UCHIN, I KNOW YOU REQUESTED THIS, SO I WILL START WITH YOU FIRST.

YEAH, THANK YOU SO MUCH FIRST OF ALL FOR MAKING TIME TO COME DOWN HERE AND SHARE THIS WITH US.

I HAVE A COUPLE OF QUESTIONS I WANTED TO RUN BY Y'ALL.

UM, JUAN IS, CAN YOU HELP THE COMMITTEE UNDERSTAND KINDA WHAT IS THE PRACTICAL IMPLICATION OF A PERSON THAT'S CARRYING THIS DEBT? I KNOW I'VE TALKED TO A COUPLE OF MY COLLEAGUES ABOUT THIS ALREADY, SOME THAT AREN'T PART OF THIS COMMITTEE AND THEY SAID, WELL, THIS DEBT IS KIND OF WORTHLESS ANYWAY.

SO, UM, CAN YOU HELP US UNDERSTAND WHAT'S REALLY HAPPENING WHEN PEOPLE ARE CARRYING THIS DEBT AND WHAT IT MEANS FOR THEM TO BE RELIEVED OF THIS DEBT? ABSOLUTELY.

I THINK THE BIGGEST THING IS THE PSYCHOLOGICAL BURDEN.

EVEN IF YOU CAN'T PAY IT, YOU KNOW THAT THAT DEBT IS OWED AND IT IS WEIGHING ON YOU.

IT'S ALSO AFFECTING YOUR ABILITY TO CONTINUE TO CHOOSE TO GET CARE.

YOU MAY DELAY CARE BECAUSE YOU'RE AFRAID TO GO BACK TO THAT HOSPITAL OR DOCTOR BECAUSE YOU'RE AFRAID THAT THEY MAKE YOU MAY MAKE YOU PAY THAT BILL THAT YOU MAY NOT GO TO RECEIVE CARE BECAUSE YOU'RE AFRAID YOU'LL GET ADDITIONAL BILLS.

SO WE REALLY, THAT IS THE BIGGEST BENEFIT THAT I THINK WE SEE AS BOTH THE PSYCHOLOGICAL BURDEN BEING REMOVED AND THEN ALSO INDIVIDUALS RETURNING TO CARE.

AND HOSPITALS HAVE CONFIRMED THAT, THAT HAVE WORKED WITH US AND GONE THROUGH OUR PROGRAM THAT THEY ARE SEEING MORE FOLKS COME BACK AND RE-ACCESS CARE THAT HAD NOT ENGAGED BEFORE.

AND THEN I WOULD JUST HIGHLIGHT, SINCE WE HEARD A LOT ABOUT MENTAL HEALTH TODAY, I THINK IT WAS JOHNS HOPKINS JUST RELEASED SOME RESEARCH SHOWING THAT, UH, PEOPLE WITH MEDICAL DEBT AND COMORBID MENTAL HEALTH ISSUES OR SOMETHING LIKE FIVE TIMES LESS LIKELY TO CONTINUE OR PURSUE TREATMENT.

SO THERE'S, THERE'S A RELATIONSHIP THERE THAT'S, THAT'S REALLY CRITICAL.

SO I THINK LIFTING SOME OF THAT BURDEN CAN HELP PEOPLE FEEL SAFER TO RETURN TO CARE.

ABSOLUTELY.

NO, I APPRECIATE THAT ANSWER.

AND I THINK THAT WOULD KIND OF DOVETAILS REALLY NICELY INTO WHERE I WAS GOING WITH THIS, WHICH WAS, YOU KNOW, WE'RE IN A TIME OF, UH, I WOULD SAY A LOT OF FINANCIAL CONSTRAINT TO THE CITY.

IT'S GONNA BE A TOUGH BUDGET SEASON.

I'LL SKIP ALL THE DETAILS.

YOU PROBABLY KNOW A LOT OF IT ALREADY.

SO IN MY MIND, PART OF THE CHALLENGE WOULD BE JUST LIKE WE HEARD WITH, UH, THE PROGRAMS THAT, UM, WERE JUST SHARED WITH US SORT OF RUNNING A ROI CALCULATION ON HOW WE'RE ACTUALLY HELPING, UH, THE CITY OR CONSTITUENTS OR PEOPLE THAT ARE CARRYING DEBT OR ALL OF US, UM, WITH, YOU KNOW, YOU MENTIONED DELAYING CARE.

WHAT DOES THAT COST TO INDIVIDUALS? WHAT DOES THAT COST TO THE HEALTHCARE SYSTEM? WHAT DOES THAT, WHAT ARE THE EXTERNALITIES OF THAT COST TO OTHER PLACES? DO YOU HAVE ANY DATA THAT YOU CAN HELP SHARE WITH US, IF NOT NOW AT SOME POINT SOON, THAT CAN HELP US UNDERSTAND WHAT THE BENEFIT OF, UH, RETIRING OR ABOLISHING THE DEBT IS FROM A HEALTHCARE SYSTEM PERSPECTIVE OR A DIFFERENT PERSPECTIVE BEYOND JUST THE RAW NUMBER OF, HEY, WE'RE RETIRING X AMOUNT OF DOLLARS OF DEBT? YEAH, I, I MEAN IT'S A CHALLENGING QUESTION, RIGHT? BECAUSE THERE ARE, LIKE YOU SAID, SO MANY EXTERNALITIES.

THERE ARE OTHER FACTORS, AND THIS IS A ONE TIME ABOLISHMENT, BUT A A LOT OF WHAT WE HEAR LIKE ON THE CONSTITUENT SIDE IS JUST SO HARD TO QUANTIFY IN TERMS OF DOLLARS.

BUT THE, THE MENTAL HEALTH BENEFITS, I MEAN, WE GET STORIES LIKE I WAS ABLE TO SIGN MY DAUGHTER UP FOR SOFTBALL AND THAT'S SOMETHING THAT'S REALLY, YOU KNOW, THAT RE DOWNS ACROSS THE LIFESPAN, SO IT'S HARD TO PUT A DOLLAR NUMBER ON IT.

UM, AND THAT ALSO IS JUST ONGOING RESEARCH, RIGHT? THAT'S, THAT'S SOMETHING WE'VE BEEN LOOKING INTO AND AND ALSO WANNA KNOW MORE ABOUT.

AND THEN THE OTHER THING I WOULD HIGHLIGHT, ANOTHER BENEFIT IS THAT THESE, PARTICULARLY THESE GOVERNMENT ABOLISHMENTS OPEN UP THE DOOR TO HAVE CONVERSATIONS ABOUT, OKAY, ABOLISHMENT IS NOT A SOLUTION, IT'S SORT OF LIKE A TREATMENT.

WHAT ARE THE SOLUTIONS WE CAN TAKE ON UPSTREAM

[01:45:01]

YEAH, I THINK THAT'S RIGHT AND WE ARE LOOKING TO DO SOME OF OUR OWN IN-HOUSE RESEARCH AND PARTNERING WITH UNIVERSITIES AROUND THE COUNTRY.

BUT I THINK THIS WORK IS VERY NEW, ESPECIALLY AT THIS SCALE THAT WE ARE DOING AT DOING IT AT GUESS WE STARTED WITH COOK COUNTY IN 2022, BUT THE FIRST ABOLISHMENT FOR COOK COUNTY DIDN'T COME UNTIL ALMOST A YEAR LATER.

SO WE ARE STILL PRETTY NASCENT IN THIS WORK AND AS LINDSAY POINTED OUT, THERE ARE A LOT OF COMPLICA, NOT COMPLICATIONS, BUT A LOT OF THINGS THAT MAKE IT A LITTLE BIT HARDER TO BE AS DIRECT, I THINK, AS WE WANT TO BE.

SO WE'RE STILL KIND OF SORTING OUT HOW TO BEST MAKE, MAKE SURE THAT THE BENEFITS OF THE WORK THAT WE'RE DOING ARE KNOWN.

YEAH, I THINK THAT WOULD BE SUPER VALUABLE GOING FORWARD.

YEAH, TO GET UPDATES OR ADDITIONAL DATA AS YOU'RE DISCOVERING IT FOR HELPING US UNDERSTAND, HEY, IT'S NOT JUST SORT OF WORTHLESS DEBT THAT'S BEING RETIRED, BUT IT ACTUALLY HAS AN IMPACT ON THE, ON HEALTHCARE RESULTS.

IT ACTUALLY HAS AN IMPACT IN THESE OTHER WAYS THAT PEOPLE ARE PRIORITIZING SPENDING MONEY.

OR PSYCHOLOGY OR WHATEVER THOSE THINGS ARE.

UM, I DID WANNA TOUCH ON ONE OTHER THING YOU MENTIONED, WHICH WAS YOU MENTIONED THAT IT REALLY FOCUSES ON ZIP CODES IN CERTAIN AREAS.

CAN YOU EXPAND ON WHAT THAT MEANS? THAT'S REALLY FOR OUR GOVERNMENT PARTNERS, UM, BECAUSE YOU ALL TYPICALLY ARE MORE RESTRICTIVE ON YOUR FUNDING.

SO IF YOU ARE THE CITY OF AUSTIN, YOUR FUNDING CAN ONLY BENEFIT ZIP CODES THAT ARE WITHIN THE CITY OF AUSTIN.

SO IT JUST DEPENDS ON, UM, WHERE, WHERE THAT, HOW, WHERE THE FUNDING IS COMING FROM TO ABOLISH THAT PARTICULAR PIECE OF DEBT.

AND I'M SURE AS YOU ALL CAN IMAGINE, PEOPLE DON'T ALWAYS SEEK CARE OUT WHERE THEY LIVE.

SO WE MAY END UP PURCHASING, UM, SOME DEBT IF WE WERE TO DO A CONTRACT WITH YOU GUYS, GUYS FOR FOLKS THAT DON'T LIVE IN AUSTIN, YOUR FUNDING WOULD NOT BE USED FOR THAT.

WE WOULD GO BACK AND PRIVATELY FUNDRAISE ON THE BACKEND TO TRY TO ABOLISH THAT DEBT FOR THOSE INDIVIDUALS.

AND WHAT'S SORT OF A MIX OF FUNDRAISING VERSUS SAY IN THIS CASE POTENTIALLY CITY OR COUNTY POLICY? YEAH, IT REALLY DEPENDS ON THE LOCATION, THE HEALTH SYSTEMS KIND OF, IT'S, IT'S REALLY HARD TO SAY BECAUSE IT, THERE COULD BE A HOSPITAL LIKE FOR EXAMPLE IN NEW YORK CITY THAT SERVES FOLKS FROM A TRI-STATE AREA.

SO IT JUST KIND OF DEPENDS ON EACH FILE THAT WE GET AND WHAT THE MIX IS AND THAT SORT, WE DO THAT CALCULATION BEFORE WE EVER PURCHASE THE FILE FROM THE PROVIDER SO WE KNOW WHAT WE'RE GETTING INTO BEFORE WE COMMIT TO, TO PURCHASING THE FILE.

IS THERE A WAY FOR Y'ALL TO SHARE WITH US WHAT SOME DIFFERENT MODELS OR EXAMPLES THAT YOU'VE WORKED WITH IN DIFFERENT PLACES IN SAN ANTONIO OR COOK COUNTY, WHEREVER ELSE? SO WE CAN SAY, OKAY, WELL WE'RE LOOKING AT SHARING THIS WITH THE COUNTY OR SHARING THIS WITH PHILANTHROPIC SUPPORT AS SO THE CITY ISN'T JUST SORT OF SIGNING UP TO GO IT A LOAN.

YEAH, WE DON'T, WE DON'T, IT DOESN'T WORK LIKE KIND OF IN THAT WAY WHERE WE HAVE A NAMED PUBLIC-PRIVATE PARTNERSHIP.

IT JUST KIND OF, UM, WE HAVE A LOT OF PRIVATE FUNDRAISING.

WE'VE RECEIVED FUNDING FROM, FOR EXAMPLE, MACKENZIE SCOTT SEVERAL TIMES.

SO WE, IT KIND OF, WE LOOK AT OUR PORTFOLIO, WHAT DONORS WE HAVE IN THE AREA.

WE'LL OFTEN RUN A CAMPAIGN SO WE'LL PURCHASE A FILE AND KNOW THAT WE HAVE A LITTLE BIT OF DEBT WE NEED TO FORGIVE, SO WE'LL, WE'LL DO A PRIVATE CAMPAIGN.

SO IT'S NOT REALLY MORE OF A FORMAL RELATIONSHIP, BUT IT JUST KIND OF HAPPENS AS WE PURCHASE FILES AND AS WE MAKE THOSE CALCULATIONS AS AN ORGANIZATION.

UH, LAST QUESTION.

YOU MENTIONED A RECENT DEAL WITH SAN ANTONIO.

CAN YOU JUST DESCRIBE THE GENESIS OF THAT AND UH, HOW YOU ARRIVED AT THE DOLLAR VALUE AND, AND SORT OF HOW THAT DEAL WORKED OUT? YEAH, SO THE CITY COUNCIL IN SAN ANTONIO HAD SOME DISCRETIONARY FUNDING THAT THEY WANTED TO, UM, PUT TOWARDS THIS WORK.

AND WE HAD ACTUALLY, AS PART OF A LARGER NATIONAL DEAL THAT WE DID, WE PURCHASED A VERY LARGE AMOUNT OF MONEY FROM THE SECONDARY MARKET AND WE HAD THAT BUNDLE OF DEBT AVAILABLE FOR SAN ANTONIO.

SO THEY WERE ABLE TO, WE WERE ABLE TO KIND OF MATCH THE DOLLAR AMOUNT THAT THEY HAD WITH THE DEBT THAT WE HAD AVAILABLE AND WE WERE VERY ABLE TO QUICKLY ABOLISH THAT, UM, WITH THAT CONTRACT.

I APPRECIATE THAT.

I HOPE MY COLLEAGUES HAVE SOME CURIOSITY ABOUT THIS ALSO.