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YOU'RE WATCHING A MEETING OF THE AUSTIN CITY COUNCIL WITH MAYOR KIRK WATSON, MAYOR PRO TIM CHITOVELA, COUNCIL MEMBERS NATASHA HARPER MADISON, VANESSA FUENTES, JOSE VELAZQUEZ, RYAN ALTER, KRISTA LANE, MIKE SIEGEL, PAIGE ELLIS, ZO KADRI, MARK DUCHEN, CITY ATTORNEY DEBORAH THOMAS, CITY CLERK ERICA BRADY, AND CITY MANAGER TC BROADNAX.
UH, WE WILL START AS SOON AS WE HAVE QUORUM.
WHAT DO YOU KNOW, CHAIR? YOU GOT YOURSELF A QUORUM.
UH, WE, A QUORUM IS PRESENT AND I WILL CALL THE MEETING TO ORDER, THE WORK SESSION MEETING TO ORDER AT, UH, 9:00.
UH, IT IS, UH, TUESDAY, OCTOBER 6TH.
UH, AND WE WILL TURN TO THE CLERK TO CALL THE SPEAKERS.
AND BY THE WAY, I WILL BE CHAIRING THE MEETING TODAY.
THE MAYOR IS, UH, OUT OF TOWN, UH, IS AWAY ON IMPORTANT CITY BUSINESS.
ON ITEM B1, SPEAKING REMOTELY, ME- MELISSA SHEARER.
UM, THIS IS MELISSA SCHEER AND I AM SPEAKING ON BEHALF OF MYSELF, NOT ON TRAVIS COUNTY.
UM, BUT MY ROLE IS I AM THE MENTAL HEALTH PUBLIC DEFENDER, AND I AM CALLING TODAY BECAUSE I WANTED TO UPDATE THE COUNCIL ON WHAT'S BEEN HAPPENING WITH NO WRONG DOOR FROM OUR PERSPECTIVE.
I, I, AS I SAID MANY TIMES TO APD, CARRIE ROGERS, EVERYONE THAT'S DOING NO WRONG DOOR, WE ARE SUPPORTIVE OF GETTING OUR CLIENTS THE SERVICES THAT THEY NEED AND GETTING THEM INTO LONG-TERM STABILITY.
OUR OFFICE HAS BEEN OPEN FOR 19 YEARS AND WE HAVE LAWYERS AND SOCIAL WORKERS AND CASE WORKERS.
WE'RE TWO TO ONE, UM, SOCIAL, SOCIAL SERVICE STAFF TO LAWYERS.
AND SO WE HAVE DEEP, LONG, INTENSIVE CASE MANAGEMENT RELATIONSHIPS WITH THESE CLIENTS.
AND MY BIGGEST CONCERN IS THAT THE NO WRONG DOOR PROGRAM HAS DECLINED TO ALLOW THE DEFENSE TO BE INCLUDED IN THE STAFFING THAT THEY ARE DOING WITH ALL OF THE OTHER PROVIDERS AND THE PROSECUTION.
UM, ANOTHER HUGE CONCERN FOR ME IS THAT I'M AWARE THAT THE, THE SOPS WERE CHANGED, THAT WERE SUPPOSED TO, UM, ADDRESS SOME OF OUR CONCERNS, BUT THEY ACTUALLY DON'T.
I SPECIFICALLY SAID THAT WE DID NOT WANT OUR CLIENTS MIRANDIZED WHEN THEY ARE SEEN BY POLICE.
IF THIS IS SUPPOSED TO BE SOMETHING THAT IS A CASE MANAGEMENT ROLE AND NOT A LAW ENFORCEMENT ROLE, THEN OUR CLIENTS SHOULD NOT BE PLACED IN THAT KIND OF A POSITION, UM, WHERE EVIDENCE COULD BE USED AGAINST THEM IN THE FUTURE IF THEY MAKE ANY STATEMENTS, UM, THAT ARE INCRIMINATING.
WE WANT TO WORK WITH NO WRONGDOOR.
WE PROVIDED SAFEGUARDS THAT WE THINK ARE APPROPRIATE.
ALSO SPEAKING REMOTELY ON ITEM B1, SNEHA PATEL.
GOOD MORNING, MAYOR AND COUNCIL MEMBERS.
I'M AN INTERNAL MEDICINE PHYSICIAN WHO WORKS IN THE PUBLIC HEALTH SAFETY NET SYSTEM HERE.
UM, I AND MY TEAM CARE FOR PEOPLE WITH SEVERE MENTAL ILLNESS, SUBSTANCE USE DISORDERS, AND COMPLEX MEDICAL AND SOCIAL CONDITIONS THAT REQUIRE APPROPRIATE MEDICAL CARE AND CARE COORDINATION.
I FULLY SUPPORT THE GOAL OF CONNECTING PEOPLE WITH COMPLEX MEDICAL AND BEHAVIORAL, UH, HEALTH NEEDS TO SERVICES, BUT ENGAGEMENT WITH CARE MUST NEVER COVER, COME AT THE COST OF PRIVACY, LIBERTY, AUTONOMY, OR DUE PROCESS.
THE RECORD FOR NO WRONGDOER THUS FAR SHOWS TROUBLING PRACTICES.
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OFFICERS REPEATEDLY APPROACHING PEOPLE IN JAIL WITHOUT COUNSEL, SEEKING RELEASES THAT PERMIT SHARING PSYCHIATRIC AND MEDICAL RECORDS WITH POLICE AND PROSECUTORS AND MAKING BOND RECOMMENDATIONS TIED TO NO, NO WRONGFUL CONTACTS.THE PRO - THE PROGRAM USES EIGHT OR MORE ARRESTS AS A PRIMARY SELECTION CRITERIA.
ARRESTS MEASURE POLICE CONTACT, NOT CLINICAL NEED.
BUILDING OUTREACH TEAMS, UH, BUILDING OUTREACH AROUND ARREST HISTORY WILL BOTH DETER CARE AND DEEPEN HARMS IN ALREADY OVER POLICE COMMUNITIES.
AS A PHYSICIAN, I SWORE AN OATH TO DO NO HARM.
MEDICAL PROVIDERS CANNOT BE PLACED IN AN ETHICAL QUANDARY WHERE CLINICAL CARE BECOMES A PATHWAY TO SURVEILLANCE OR ENFORCEMENT.
I FEEL FULLY SUPPORT FUNDING TREATMENT AND CARE COORDINATION, BUT NOT FUNDING CARCERAL RESPONSE TO MEDICAL AND MENTAL HEALTH NEEDS.
AND WE MUST PROTECT PRIVACY AND HIPAA STANDARDS.
UM, ONE OF THE THINGS I, I, I WOULD RECOMMEND AN INDEPENDENT COMMUNITY INCLUS- INCLUSIVE OVERSIGHT, UH, OF THIS PROGRAM WITH REAL ENFORCEMENT, UH, POWER.
I DO THINK THAT WE CAN IMPROVE CARE AND CARE COORDINATION FOR AUSTINITES, CARE THAT REALLY TRULY WILL SAVE LIVES AND IMPROVE HEALTH, BUT WE MUST PROTECT RIGHTS, UM, AND, AND WE NEED TO PRIORITIZE TREATMENT, EQUITY AND CIVIL LIBERTIES, UH, IN, THROUGH THIS PROCESS.
SPEAKING ON ITEM B1 REMOTELY, COLE WEAVER.
HELLO, CAN Y'ALL HEAR ME? YES, WE CAN HEAR YOU.
UM, I, I AM A U - A MEMBER OF UNITED WORKERS OF PETAL CARE, BUT I'M NOT REALLY SPEAKING ON BEHALF OF THEM TODAY.
I'M SPEAKING SPECIFICALLY AS A PEER SUPPORT SPECIALIST THAT HAS LIVED EXPERIENCE WITH, UH, PSYCHIATRIC, UH, HOSPITALIZATION AND WHAT THEY HAVE REPRESENTED TO ME AND RE - AND WHY I AM WEAR - VERY, VERY WEARY OF THE NO ONE DOORS PROGRAM AT, IN ITS CURRENT FORM, BECAUSE CARCERAL CARE IN ANY WAY, SHAPE OR FORM HAS NEVER HELPED ME AND I KNOW SEVERAL OF MY PEERS/CLIENTS AT THAT IT NEVER HELPED THEM EITHER, UM, BECAUSE, AND IT DOESN'T HA - IT DOESN'T MATTER IF IT'S LAW ENFORCEMENT OR IF IT'S, YOU KNOW, INVOLUNTARY COMMITMENT.
I'M, UH, I'M AGAINST EXPANDING THAT.
I'M AGAINST, YOU KNOW, MAKING IT TO WHERE THE COMMUNITY MEMBERS ARE INCREASINGLY PREVAILED AND NOW THERE'S THE POSSIBILITY OF DETENTIONS BEING WARRANTLESS AT THAT POINT.
UM, I KNOW THAT THERE ARE OTHER EXPERTS IN, IN THIS MEETING THAT ARE GONNA BE SPEAKING MORE ABOUT WHAT IS ACTUALLY THE, THE CORE ISSUES WITH, CORE CONCERNS WITH NO WRONG DOOR, BUT I JUST WANNA STATE MY POSITION THAT MENTAL HEALTHCARE NEEDS TO BE COLLABOR- COLLABORATORS, COLLABORATIVE, IT NEEDS TO BE PERSON-CENTERED BECAUSE WHEN IT'S NOT AND WHEN IT'S INVOLUNTARY AND WHEN RIGHTS ARE VI - UH, WHEN THE AUTONOMY IS VIOLATED BECAUSE OF WHATEVER RE - F - UH, FOR A VARIETY OF UNJUST REASONS, I AM GOING TO BE AGAINST THAT.
AND I - WE'LL NOW MOVE TO IN-PERSON SPEAKERS ON ITEM B1, BRADLEY HARGIS, BILL BRYCE, LISA HUGMAN, RYAN POPPE.
PLEASE STATE YOUR NAME AND BEGIN SPEAKING.
GOOD MORNING, MAYOR PRO TEM AND COUNCIL MEMBERS.
I'M BRADLEY HARGIS WITH THE CAPITAL AREA PRIVATE DEFENDER SERVICE.
OUR ATTORNEYS REPRESENT MORE THAN 18,000 PEOPLE WHO CANNOT AFFORD COUNSEL LAST YEAR.
WE PROTECT THEIR RIGHTS, PROVIDE AN INDEPENDENT VOICE AND UNDERSTAND THE LEGAL CONSEQUENCES OF DECISIONS ABOUT TREATMENT AND SERVICES.
NO WRONG DOOR SITS AT THE INTERSECTION OF CRIMINAL JUSTICE AND HEALTHCARE, AS VULNERABLE CLIENTS NEED SUPPORT AND RESPECTS BOTH.
THE PROGRAM IS WELL INTENDED, BUT IMPLEMENTATION WITHOUT ADEQUATE SAFEGUARDS IS CAUSING HARM.
WE HAVE DOCUMENTED OFFICERS SEEKING BOND CONDITIONS OUTSIDE THE ORDINARY LEGAL PROCESS AND ATTEMPTS TO HAVE CLIENTS RELEASED DIRECTLY TO OFFICERS AGAINST THEIR WISHES.
THIS PROGRAM HAS DISRUPTED ONGOING CASEWORK WITHOUT A, WITHOUT ADEQUATELY ADDRESSING THE RISK AND INTERACTIONS BETWEEN POLICE AND CLIENTS FACING CHARGES.
CLIENTS' LIBERTY, AUTONOMY AND DEFENSE ARE AT STAKE.
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GOOD INTENTIONS CANNOT SUBSTITUTE FOR ACCESS TO COUNSEL AND ENFORCEABLE PROTECTIONS.WE ASK COUNSEL TO REQUIRE THREE THINGS.
FIRST, INCLUDE DEFENSE PROVIDERS IN THE MEMORANDUM OF UNDERSTANDING AND REVISE IT TO ADDRESS THE REASONABLE CONCERNS THAT WE HAVE EXPRESSED.
SECOND, INCLUDE DEFENSE ORGANIZATIONS IN EVERY STAFFING CONCERNING THEIR CLIENTS BEFORE DECISIONS ARE MADE.
OUR EX- EXPERTISE, OUR EXPERIENCE, AND OUR KNOWLEDGE OF THEIR LEGAL CIRCUMSTANCES ARE ESSENTIAL TO MEANINGFUL INTERVENTIONS.
THIRD, ESTABLISH WRITTEN SAFEGUARDS ADDRESSING COUNCIL'S ACCESS BEFORE INTERVIEWS OR RELEASE OF INFORMATION, INFORMED AND VOLUNTARY CONSENT, CONFIDENTIALITY, THE USE OF STATEMENTS IN CRIMINAL CASES, AND APPROPRIATE LIMITS ON COMMUNICATION WITH COURTS AND PROSECUTORS.
NO WRONGDOOR CANNOT RESPONSIBLY MOVE FORWARD WITHOUT RESPECTING THE RIGHTS THE ATTORNEYS PROTECT.
OUR CLIENTS SHOULD NOT HAVE TO RISK THEIR DEFENSE TO RECEIVE CARE.
PLEASE MAKE DEFENSE PARTICIPATION IN ENFORCEABLE SAFEGUARDS A CONDITION OF MOVING FORWARD.
MR. BRYCE? GOOD MORNING, COUNCIL MEMBERS AND CITY MANAGER.
I'M BILL BRYCE WITH THE DOWNTOWN AUSTIN ALLIANCE SPEAKING IN SUPPORT OF NO WRONG DOOR.
I REPRESENT THE DOWNTOWN ALLIANCE ON THE NO WRONG DOOR COALITION AND THE SIGNIFICANCE OF THIS COLLABORATION TO IDENTIFY AND PROVIDE CARE FOR PEOPLE WHO CYCLE THROUGH OUR CRIMINAL JUSTICE, HEALTHCARE AND HOMELESS SYSTEMS CANNOT BE OVERSTATED.
THESE ARE PEOPLE WITH SEVERE BEHAVIORAL HEALTH ISSUES WHO ARE UNABLE TO MAKE DECISIONS IN THEIR OWN BEST INTEREST AND DUE TO INSUFFICIENT RESOURCES AND COORDINATION LANGUISH ON OUR STREETS AND IN OUR JAIL.
THROUGH NO WRONG DOOR, LOCAL LAW ENFORCEMENT AND CRIMINAL JUSTICE, HEALTHCARE, CITY AND COUNTY OFFICIALS AND HOMELESS SERVICE AGENCIES ARE COLLABORATING TO IDENTIFY AND PROVIDE CRISIS CARE AND STEP-DOWN SERVICES FOR THIS POPULATION NO MATTER WHERE THEY ENTER THESE SYSTEMS. NO WRONG DOOR HAS IDENTIFIED 950 HIGH UTILIZERS WHOSE UNTREATED ILLNESS AND HOMELESS COST TAXPAYERS AN ESTIMATED 137 MILLION A YEAR WITHOUT SOLVING THE PROBLEM.
AND WE SEE MANY OF THESE PEOPLE LIVING ON THE STREETS DOWNTOWN DAY AFTER DAY NOT GETTING THE HELP THEY NEED.
THEY CYCLE THROUGH JAIL, COURTS, HOSPITALS, PSYCH FACILITIES, AND SOCIAL SERVICES AND ARE OFTEN RELEASED AFTER A QUICK FIX ONLY TO CYCLE THROUGH THE SYSTEMS AGAIN AND AGAIN.
THROUGH NO WRONG DOOR, LOCAL PARTNERS ARE WORKING TO PROPERLY TREAT AND RESTORE PEOPLE WHO LANGUISH ON OUR STREETS AND IN OUR JAILS, BUT THIS PROBLEM'S NOT UNIQUE TO AUSTIN.
AT RECENT TEXAS HOUSE AND SENATE HEARINGS, URBAN AND RURAL POLICE DEPARTMENTS, SHERIFF'S ASSOCIATIONS, DISTRICT AND COUNTY ATTORNEYS, LOCAL MENTAL HEALTH AUTHORITIES AND SOCIAL SERVICE PROVIDERS FROM ACROSS THE STATE TESTIFIED ON HOW THIS PROBLEM AFFECTS HEALTH AND SAFETY AND EXCEEDS RESOURCES IN THEIR COMMUNITIES AT COSTS THEY CAN'T AFFORD.
THE DOWNTOWN ALLIANCE APPLAUDS NO WRONG DOOR AS WE STRIVE TO RALLY STAKEHOLDERS AND ENCOURAGE LEGISLATORS TO FILL CRITICAL CRISIS SERVICE GAPS, AND WE ENCOURAGE YOU TO PUT THE FULL WEIGHT OF THE CITY OF AUSTIN BEHIND IT.
GOOD MORNING, CITY MANAGER AND COUNCIL MEMBERS.
I'M THE FOUNDER OF FAMILY BRIDGE, A PRIVATELY FUNDED NONPROFIT THAT PROVIDES TEMPORARY HOTEL RESPITE FOR FAMILIES WITH CHILDREN WHO ARE CAR CAMPING.
I ALSO SERVED ON THE PARKS AND REC BOARD WHERE I STARTED A HOMELESSNESS WORKING GROUP AND HAVE SPENT SEVERAL YEARS STUDYING HOMELESSNESS SOLUTIONS AROUND THE COUNTRY.
I WANNA START BY RECOUNTING A CONVERSATION I HAD WITH AN APD OFFICER WHO'S PART OF THE NO WRONG DOOR TEAM.
HE TOLD ME A STORY ABOUT A SPECIFIC ENCOUNTER WITH A HIGH UTILIZER WOMAN HE CLEARLY CARED FOR AND WAS CONCERNED FOR HER WELLBEING.
HE HAD THE KNOWLEDGE AND THE DEC- DECISION MAKING TO KNOW WHAT STEP TO TAKE NEXT.
I WAS STRUCK BY HIS COMPASSION AND DEDICATION AND THAT HE CHOSE TO BE PART OF THE NO WRONG DOOR TEAM.
BUT I'M HERE TODAY BECAUSE I BELIEVE NO WRONG DOOR REPRESENTS SOMETHING OUR COMMUNITY DESPERATELY NEEDS, COORDINATED CARE FOR THE HIGH UTILIZER POPULATION WHO SUFFERS SEVER- SEVERE MENTAL ILLNESS AND HAVE COMPLEX NEEDS.
PRIOR TO NO WRONG DOOR, THE ONLY ACCESS TO CARE FOR HIGH UTILIZERS WAS FRAGMENTED.
WE COULD STABILIZE SOMEONE IN A PSYCHOTIC STATE, BUT WITHOUT A CONTINUUM OF CARE, WE WOULD SEND THAT PERSON BACK TO THE STREET.
THE CITY BEGAN ASKING THE RIGHT QUESTIONS, "HOW DO WE HELP PEOPLE WHO ARE CYCLING THROUGH ERS, JAILS, STREETS, AND OUR MENTAL HEALTH SYSTEM WITHOUT EVER REACHING STABILITY?" I'M SPEAKING ABOUT WHAT I'M SEEING HAVING WORKED IN THIS SPACE FOR SEVERAL YEARS.
THE CITY IS NOW LEADING THE EFFORT IN REDEFINING THE MULTIPLE AGENCY RELATIONSHIPS THAT ALLOW COORDINATED CARE AND NO WRONG DOOR TO HAPPEN.
ALL THE PARTNERS ARE WORKING TOGETHER IN A UNIFIED EFFORT.
WHEN ONE OF OUR HIGH UTILIZERS IS HAVING A CRISIS, THE FIRST STEP IS STABILIZATION IF NECESSARY, AND THEN THEY ARE GIVEN THE OPTION TO CONSENT TO FURTHER TREATMENT.
I UNDERSTAND THE CONCERN ABOUT CIVIL RIGHTS.
I ALSO UNDERSTAND THE STATE OF TEXAS HAS PROTECTIONS IN PLACE FOR THOSE WHO VOLUNTARILY COMMIT
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TO TREATMENT AND A PERSON CAN OPT OUT ANY TIME.MY NAME IS RYAN POPPE AND I AM HERE ON BEHALF OF CWA LOCAL 6154 AND THE UNITED WORKERS OF INTEGRAL CARE.
OUR MEMBERS WORK EVERY DAY WITH PEOPLE EXPERIENCING SERIOUS MENTAL ILLNESS, SUBSTANCE USE DISORDERS, AND OTHER COMPLEX BEHAVIORAL HEALTH NEEDS.
OUR POSITION TODAY IS FAIRLY STRAIGHTFORWARD.
WE SUPPORT THE GOAL OF NO WRONG DOOR, BUT THE PROGRAM CANNOT SUCCESSFULLY CONNECT PEOPLE TO CARE IF THE VERY MECHANISMS IT USES DESTROYS THE TRUST REQUIRED TO PROVIDE THAT CARE.
OUR MISSION ISN'T ONLY TO ADVOCATE FOR OUR MEMBERS, IT'S ALSO TO SPEAK UP FOR THE PEOPLE AND THE COMMUNITIES THEY SERVE EVERY DAY.
WE AGREE THE CURRENT CRI - CYCLE OF CRISIS, ARREST, STABILIZATION AND RELEASE IS NOT WORKING, AND WE AGREE THAT THE INDIVIDUAL SHOULD BE AT THE CENTER OF THE RESPONSE, BUT THE PRINCIPLE MUST EXTEND TO HOW THE PROGRAM OPERATES.
WE'RE HERE TO HELP YOU WHILE CREATING PATHWAYS FOR DETENTION THAT UNDERMINE THAT TRUST.
YOU CANNOT EARN SOMEONE'S TRUST AND THEN ASK THEM WHILE IN CRISIS JAILED AND WITHOUT AN ATTORNEY PRESENT TO DISCLOSE DEEPLY PERSONAL MEDICAL AND PSYCHIATRIC INFORMATION.
AND YOU CANNOT CALL THIS A PATHWAY TO TREATMENT WHILE POLICE OFFICERS ARE MAKING RECOMMENDATIONS TO COURTS ABOUT SOMEONE'S BOND.
FOR BEHAVIORAL HEALTH PROFESSIONALS, TRUST IS PART OF THE TREATMENT.
UWIC ISN'T ASKING COUNCIL TO THROW THE BABY OUT WITH A BATH WATER.
NO WRONG DOOR ADDRESSES A REAL PROBLEM AND CONNECTING PEOPLE TO SUSTAIN CARE RATHER THAN CYCLING THEM THROUGH EMERGENCY ROOMS, JAILS, AND CRISIS SERVICES IS THE RIGHT GOAL, BUT STREAMLINE THE SERVICES, NOT THE CIVIL LIBERTIES.
WE ASK COUNCIL TO ESTABLISH CLEAR SAFEGUARDS AROUND LAW ENFORCEMENT'S INVOLVEMENT, MEDICAL PRIVACY, LEGAL REPRESENTATION AND DUE PROCESS.
NEXT, SPEAKING ON ITEM B1, ELIZABETH BAKER, KAY GRAZIANI, NICK HUDSON, LILY HUGHES.
I'M THE EXECUTIVE DIRECTOR OF THE OTHER ONES FOUNDATION, AND I'M HERE TODAY TO SUPPORT THE NOOR WRONG DOOR INITIATIVE.
PRIOR TO JOINING THE OTHER ONES FOUNDATION, UH, BETWEEN THE YEARS OF 2015 AND 2021, I DEVELOPED AND OVERSAW ASSERTIVE COMMUNITY TREATMENT TEAMS AT INTEGRAL CARE.
MOST OF THE PEOPLE SERVED BY THESE TEAMS HAD FREQUENT INTERACTIONS WITH APD, EMS, ERS, AND JAILS, AND OUR ACT TEAMS, SORRY, MY ACT TEAMS AT THE TIME WOULD NOT HAVE BEEN ABLE TO DO THEIR JOBS WITHOUT THEIR SUPPORT.
THE MOST SUCCESSFUL INTERVENTIONS WERE WHEN THE TEAMS COLLABORATED WITH FIRST RESPONDER TEAMS TO DEVELOP AN ONGOING CARE PLAN.
WHEN THIS HAPPENED, THE INTERVENTIONS WEREN'T JUST BUILT AROUND A SINGLE CRISIS, THEY WERE BUILT AROUND A PERSON'S NEEDS.
AUSTIN HAS A LONG HISTORY OF MULTIDISCIPLINARY RESPONSES AND UTILIZATION OF BY NAME LISTS FOR THE MOST VULNERABLE PEOPLE IN OUR COMMUNITY.
WE SAW IT THROUGH THE 100,000 HOMES CAMPAIGN IN 2012.
WE SAW IT THROUGH THE DOWNTOWN AUSTIN COMMUNITY COURT HIGH UTILIZER LISTS IN 2015, AND WE SAW IT THROUGH HOST AND MULTIPLE COLLABORATIVE STREET OUTREACH EFFORTS.
IN EACH OF THESE INITIATIVES, THE MOST MEANINGFUL PROGRESS OCCURRED WHEN AGENCIES SHARED INFORMATION, BUILT RELATIONSHIPS, AND ACCEPTED COLLECTIVE RESPONSIBILITY FOR A SMALL GROUP OF PEOPLE WITH HIGH NEEDS, AND THAT WAS OCCURRING IN BOTH ROUTINE CARE AND IN CRISIS CARE.
AT ESPERANZA, WE SEE THAT PEOPLE WHO ACHIEVE STABILITY ARE ALMOST ALWAYS THE ONES SUPPORTED BY A COORDINATED NETWORK THAT REMAINS ENGAGED LONG ENOUGH TO EARN TRUST AND CREATE A PATHWAY FORWARD.
AND I BELIEVE THAT THE NO WRONG DOOR MODEL RECOGNIZES THIS IMPORTANT TRUTH, THAT NO SINGLE SYSTEM CAN SOLVE THESE CHALLENGES IN A SILO AND THAT RELATIONSHIPS MATTER.
WITH CAREFUL ATTENTION TO EFFECTIVE USE OF DATA SYSTEMS AND ROLES FOR EACH TEAM MEMBER, THIS CAN BE A REALLY IMPACTFUL PROJECT.
I ENCOURAGE COUNCIL TO CONTINUE SUPPORTING THIS EFFORT, AND THANK YOU FOR YOUR TIME.
GOOD MORNING, COUNCIL, CITY MANAGER.
I'M ONE OF THE CO-DIRECTORS OF VOCAL TEXAS, AND I'M A RESIDENT OF DISTRICT FOUR.
UM, I'M HERE TO JOIN THE VOICES CALLING FOR MORE TRANSPARENCY AND ACCOUNTABILITY ON THE NO WRONG DOOR PROGRAM, PAIRED WITH THE CITY'S NEW SWEEPS ENHANCEMENT PLAN, UM, WHICH ALSO IS APD-LED.
UH, WE HAVE SOME SERIOUS CONCERNS ABOUT THE NO WRONG DOOR INITIATIVE, ANOTHER INITIATIVE DEVELOPED BEHIND CLOSED DOORS
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AND WITHOUT THE COMMUNITY EXPERTS THAT NEED TO BE PART OF CREATING REAL SOLUTIONS THAT WORK FOR OUR UNHOUSED COMMUNITY.NOW, WE FULLY SUPPORT EXPANDING MENTAL HEALTH CARE AND HOUSING OPTIONS FOR PEOPLE WHO NEED IT.
WE'VE BEEN CALLING FOR THAT FOR, FOR YEARS.
UM, BUT PART OF OUR CONCERNS ABOUT THIS PROGRAM IN PARTICULAR IS THAT, UM, THE FIRST I HEARD ABOUT A NO WRONG DOOR TYPE PROGRAM WAS ACTUALLY DURING TESTIMONY AT THE CAPITOL OVER THE SUMMER.
UM, THE TEXAS PUBLIC POLICY FOUNDATION AND THE CICERO INSTITUTE WERE TESTIFYING ON BEHALF OF PROGRAMS THAT USE POST ADJUDICATION TO FORCE TREATMENT FOR PEOPLE WHO ARE UNHOUSED AND IN CRISIS, UM, CALLING FOR A DATA SHARING AT THE INDIVIDUAL LEVEL.
UM, THEN I SAW THE NO WRONG DOOR MEMO HERE FOR OUR PROGRAM LOCALLY, AND IT SOUNDED EERILY SIMILAR TO WHAT THEY WERE ADVOCATING FOR AT THE CAPITOL.
AND SO I KNOW YOU ALL KNOW THIS, BUT TPPF AND THE CICERO INSTITUTE ARE, ARE TRUMP ALIGNED THINK TANKS.
UM, THEY ARE MOST CONCERNED WITH DISMANTLING HOUSING FIRST PROGRAMS. THEY'RE NOT CONCERNED WITH KEEPING OUR COMMUNITY SAFE AND HOUSED.
UM, THE CICERO INSTITUTE WAS FOUNDED BY A TECH BILLIONAIRE, JOE LONSDALE, AND WE KNOW THAT THESE PROGRAMS ARE MORE POLITICAL THAN THEY ARE ABOUT HELPING PEOPLE.
UM, SO WHILE THE CITY HAS REFUSED TO WORK WITH EXPERTS LIKE OUR PUBLIC, OUR MENTAL HEALTH PUBLIC DEFENDER'S OFFICE, THEY'RE CALLING ON TRUMP ALIGNED THINK TANKS TO HELP DEVELOP PROGRAMMING, AND THAT IS DEEPLY, DEEPLY CONCERNING.
I'M A DISTRICT FIVE RESIDENT, A SOCIAL WORKER, AND THE CAPACITY BUILDING MANAGER AT TEXAS HARM REDUCTION ALLIANCE.
I'M HERE TO ASK FOR A PAUSE IN IMPLEMENTING THE NO WRONG DOOR PROGRAM.
IT'S INCREDIBLY FRUSTRATING TO SEE MEMOS WITH PROMISES OF REFERRING PEOPLE TO PROGRAMS THAT OFFER LONG-TERM STABILITY.
WHAT PROGRAMS ARE THOSE? IS THAT REFERRING TO THE HOUSING AGENCIES WITH WRAPAROUND SERVICES THAT ARE ALREADY UNABLE TO KEEP UP WITH DEMAND, THE SAME HOUSING AGENCIES AND SOCIAL SERVICES THAT WERE FACING DRASTIC BUDGET CUTS IN THE PROPOSED BUDGET? IS THERE SOME SECRET UTOPIA OF SERVICES THAT ONLY APD KNOWS ABOUT? DOES A SINGLE PERSON IN THIS PLANNING PROCESS HAVE ANY IDEA WHAT THE SUBSTANCE USE TREATMENT LANDSCAPE CURRENTLY LOOKS LIKE IN TEXAS? HAVE ANY OF YOU DESPERATELY CALLED ON BEHALF OF A CLIENT WHO WAS BEGGING TO GET A BED IN A TREATMENT CENTER ONLY TO BE REPEATEDLY DENIED? HAVE YOU HAD A CLIENT WA- WATCHED A CLIENT DETERIORATE IN A MENTAL HEALTH CRISIS WHILE FRANTICALLY CALLING INPATIENT PSYCHIATRIC SERVICES OR RESPITE CARE? I'VE LOST COUNT OF HOW MANY TIMES I'VE SAT BEFORE THIS DIAS AND TALKED ABOUT THE PEOPLE I LOVE DYING IN THE STREET BECAUSE THE CARE THEY NEED DOES NOT EXIST.
AND I CAN ASSURE YOU, I FOUGHT FOR EVERY SINGLE ONE OF THOSE PEOPLE.
I FOUGHT AGAINST THE UNDERFUNDED AND OVERBURDENED SYSTEM OF CARE THAT NO WRONG DOOR CLAIMS TO BE CAPABLE OF REFERRING ITS PARTICIPANTS TO.
EVERY SINGLE DOCUMENT AND PRESS STATEMENT ACTS AS IF THIS PROGRAM IS ALREADY SUCCESSFUL, ALL WHILE PROMISING TO DEVELOP THE SYSTEM IT NEEDS TO BE SUCCESSFUL.
HOW CAN BOTH BE TRUE? WHY DO THE ARCHITECTS OF THIS PROGRAM NEED TO LIE ABOUT HAVING THE SUPPORT OF COMMUNITY STAKEHOLDERS? WHY IS NO WRONG DOOR BEING EXPANDED SO RAPIDLY? WHY CAN'T WE PAUSE AND ACTUALLY PLAN OUT A COORDINATED COMMUNITY SYSTEM OF CARE? THE ONLY REASON I CAN THINK OF IS BECAUSE THE GOAL OF THIS PROGRAM IS NOT TO PROVIDE CARE.
IT IS TO INSTITUTIONALIZE, INCARCERATE, AND PUNISH PEOPLE WHO USE DRUGS, PEOPLE WITH MENTAL ILLNESS, AND PEOPLE EXPERIENCING HOMELESSNESS.
BUT WHAT DO I KNOW? I'M JUST A SOCIAL WORKER THAT WORKS WITH THE POPULATION THIS PROGRAM IS TARGETING.
I'M JUST A PERSON WITH LIVED EXPERIENCE IN SUBSTANCE USE AND RECOVERY.
I'M JUST A GRIEVING COMMUNITY MEMBER WHO HAS BUILT THE RELATIONSHIPS WITH THE PEOPLE BILLIONAIRES WANT TO SWEEP AWAY.
THIS WILL BE THE LAST SPEAKER, MATTHEW MALIKA.
GOOD MORNING, COUNCIL MEMBERS.
MATTHEW MALIKA, EXECUTIVE DIRECTOR ENDING COMMUNITY HOMELESSNESS COALITION.
I'M SPEAKING THIS MORNING IN SUPPORT OF THE NO WRONG DOOR INITIATIVE.
ECHO HAS BEEN A COLLABORATOR IN THE WORK TO BRING THIS INITIATIVE TO THIS POINT.
WE SHARE MANY OF THE RESERVATIONS OF OUR PARTNERS IN THE HOMELESSNESS RESPONSE SYSTEM, SO I WANT TO SHARE WHY WE'RE IN SUPPORT.
THE NO WRONG DOOR INITIATIVE NEEDS TO BE VIEWED IN THE CONTEXT OF OUR CURRENT SYSTEM, RIGHT NOW TO SUPPORT PEOPLE EXPERIENCING SIGNIFICANT MENTAL HEALTH AND SUBSTANCE USE EPISODES IN OUR STREETS.
CURRENTLY, PEOPLE IN CRISIS ARE ENGAGED MAINLY BY LAW ENFORCEMENT WITHOUT THE SUPPORT OF LICENSED CLINICAL PROFESSIONALS.
THEY ARE FORCED INTO A CARCERAL SYSTEM THAT IS NOT FOCUSED ON TREATMENT AND SUPPORT, RATHER WAREHOUSING AND BEHAVIOR MANAGEMENT.
THEN THEY ARE SENT RIGHT BACK TO THE STREET WHERE THE CYCLE CONTINUES.
DISRUPTING THAT CYCLE TAKES COLLABORATION AND OUTSIDE THE BOX RELATIONSHIPS THAT PROMOTE CARE COORDINATION AND HAVE THE SAME END GAME IN MIND, SUPPORTIVE HOUSING WITH ACCESS TO PERSON-CENTERED TREATMENT AND CREATING A SENSE OF BELONGING AND COMMUNITY.
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THE NO WRONG DOOR INITIATIVE IS NOT CURRENTLY AND CAN'T BECOME ABOUT THE PERCEPTION OF CREATING SAFETY THROUGH THE RELOCATION OF PEOPLE TO OTHER PARTS OF THE CITY WHERE THEIR MENTAL HEALTH AND SUBSTANCE USE CONTINUES TO GO UNTREATED AND IGNORED.THE NO WRONG DOOR INITIATIVE IS NOT CURRENTLY AND CAN'T BECOME ABOUT CREATING DETENTION CAMPS FULL OF PEOPLE WHO HAVE BEEN CONSISTENTLY MARGINALIZED AND IGNORED FOR THE SAKE OF PUBLIC SAFETY.
COUNCIL MEMBERS, THE NO WRONG DOOR INITIATIVE IS NOT PERFECT, BUT IT'S PROGRESS.
THERE IS NOW MUCH MORE COMMUNITY OVERSIGHT AROUND PEOPLE AND A SIGNIFICANT MENTAL HEALTH OR SUBSTANCE USE EPISODE ARE TREATED AND WHERE THEY END UP.
THROUGH A 17-PARTY DATA SHARING AGREEMENT, WE'RE BETTER EQUIPPED TO COORDINATE CARE AND ENSURE PLACEMENT TO THE BEST POSSIBLE ENVIRONMENT THAT TAKES INTO ACCOUNT THE LEVEL OF SERVICE NEED AND THE WILL OF THE PARTICIPANT RECEIVING SERVICES.
MAYOR AND COUNCIL MEMBERS, I'VE SPENT MY ENTIRE CAREER ADVOCATING AGAINST THE CRIMINALIZATION OF HOMELESSNESS, AGAINST THE INSTITUTIONALIZATION OF PEOPLE AS A FIRST RESORT FOR CARE, AND AGAINST THE PUNITIVE RESPONSE TO STREET HOMELESSNESS IN THE NAME OF SO-CALLED PUBLIC SAFETY.
AS A BOARD MEMBER FOR THE NATIONAL COALITION FOR THE HOMELESS AND A GOVERNING MEMBER OF THE NATIONAL HEALTHCARE FOR THE HOMELESS COUNCIL, I'VE CONTRIBUTED TO REPORTS ABOUT HATE CRIMES AGAINST HOMELESS PEOPLE AND ANTI-HOMELESS ARCHITECTURE THAT MAKE OUR STREETS AND PARKS - FOR PEOPLE WHO HAVE NOWHERE ELSE.
THANK- THANK YOU VERY MUCH, MR. MALIKA.
AND WITH, UH, ALL SPEAKERS CALLED, THEN WE'LL GO AHEAD
[B1. Briefing on the No Wrong Door initiative, a coordinated crisis response program connecting high-utilizer individuals with permanent supportive services, including housing, health care, behavioral health, and substance use treatment, to reduce arrests, emergency room visits, and homelessness. [Robert Luckritz, Chief - Austin Travis County Emergency Medical Services; David Gray, Director - Homeless Strategies and Operations; Robert Kingham, Court Administrator - Community Court; Maris Herold, Chief of Strategic Initiatives - Police; Marisa Malik, Director of Crisis Services and Justice Initiatives - Integral Care; Perla Cavazos, Chief Governance and Government Affairs Officer - Central Health].]
AND MOVE ON TO OUR, UH, AGENDA ITEM B1, AND LET ME GO AHEAD AND, UH, HAVE STAFF COME ON DOWN AND GIVE THE PRESENTATION.UM, AS THE TEAM, UH, GETS PREPARED TO PRESENT, UH, I WANNA FIRST THANK YOU, UH, FOR, UH, REQUESTING THIS BRIEFING.
UH, STAFF WILL BE, UH, HERE TO PRESENT AN OVERVIEW OF THE NO WRONG DOOR PROGRAM.
NO WRONG DOOR IS A CITY AND PARTNER-LED COORDINATED CRISIS CARE PROGRAM ACROSS 17 ORGANIZATIONS HERE IN AUSTIN, TRAVIS COUNTY.
WHILE THE PROGRAM REMAINS IN DEVELOPMENT, THE MOST SIGNIFICANT ACHIEVEMENTS TO DATE IS THE ENHANCED RELATIONSHIP AND COMMUNICATION ACROSS SO MANY PARTNERS WORKING IN THIS PARTICULAR SPACE.
I KNOW WE HAVE MANY OF THOSE PARTNERS WITH US TODAY, AND I THANK THEM, UH, IN ADVANCE FOR BEING HERE.
WITH THAT, I WILL TURN IT OVER TO MR. ROBERT KINGHAM, UH, TO BEGIN THE PRESENTATION.
GOOD MORNING, MAYOR PRO TIM AND COUNCIL.
I'M ROBERT KINGHAM, ADMINISTRATOR OF THE AUSTIN COMMUNITY COURT, AND, UH, THANK YOU FOR THE OPPORTUNITY TO PROVIDE AN UPDATE REGARDING NO WRONG DOOR AND OUR WORK AROUND COORDINATED CRISIS CARE THIS MORNING.
I'M EXCITED TO BE JOINED BY OUR COLLEAGUES ACROSS THE COMMUNITY WHO ARE HELPING LEAD THIS WORK.
UH, JULIE WE - UH, WHEELER FROM TRAVIS COUNTY, DAVID GRAY WITH AUSTIN HOMELESSNESS STRATEGIES AND OPERATIONS, JEFF RICHARDSON WITH INTEGRAL CARE, CHIEF LUKERITZ WITH AUSTIN TRAVIS COUNTY EMS, ASSISTANT CHIEF HAROLD WITH AUSTIN POLICE DEPARTMENT, AND DR.
LEE AND SYDNEY HARRIS OF CENTRAL HEALTH.
I APPRECIATE EVERYONE BEING HERE TODAY TO SHARE THEIR PERSPECTIVE ON OUR COORDINATED RESPONSE FOR NO WRONG DOOR.
SO NO WRONG DOOR IS REALLY ABOUT A CHALLENGE THAT YOU'VE HEARD THAT CUTS ACROSS SEVERAL OF OUR SYSTEMS. WE HAVE INDIVIDUALS IN OUR COMMUNITY WITH EXTREMELY COMPLEX NEEDS WHO INTERACT REPEATEDLY WITH HOMELESS SERVICES, BEHAVIORAL HEALTH, LAW ENFORCEMENT, EMERGENCY MEDICAL, THE COURTS, AND OTHER PARTS OF OUR SAFETY NET SYSTEM.
EACH OF THOSE SYSTEMS ARE DOING IMPORTANT WORK, BUT THE QUESTION WE ARE TRYING TO ADDRESS THROUGH NO WRONG DOOR IS HOW DO WE MOVE FROM MULTIPLE SYSTEMS RESPONDING TO THE SAME PERSON IN CRISIS OFTEN AND THOSE SYSTEMS WORKING AROUND THAT PERSON? THAT'S THE FOCUS OF TODAY'S BRIEFING.
SO WE'LL BEGIN THE BRIEFING GROUND, UH, BY GROUNDING THE DISCUSSION AND WHERE WE ARE TODAY, THE CURRENT STATE OF OUR HOMELESSNESS RESPONSE SYSTEM, OUR BEHAVIORAL HEALTH AND CRISIS RESPONSE SYSTEMS, AND WE'LL TALK ABOUT THE SPECIFIC ISSUES NO WRONG DOOR IS INTENDED TO ADDRESS, AND THEN FINALLY, WHAT A MORE COORDINATED FUTURE STATE WOULD LOOK LIKE FOR OUR COMMUNITY.
AS WE GO THROUGH THE PRESENTATION, I THINK YOU'LL SEE THAT THIS ISN'T ABOUT CREATING ANOTHER STANDALONE PROGRAM, IT'S ABOUT BETTER CONNECTING AND LEVERAGING THE SIGNIFICANT RESOURCES AND EXPERTISE THAT ALREADY EXIST IN OUR COMMUNITY TODAY.
SO BEFORE TALKING SPECIFICALLY ABOUT NO WRONG DOOR, I THINK IT'S IMPORTANT TO RECOGNIZE THAT THIS WORK DID NOT BEGIN IN A VACUUM.
IT BUILDS DIRECTLY ON PRIORITIES THAT COUNCIL HAS ESTABLISHED OVER A NUMBER OF YEARS.
THROUGH MULTIPLE RE- RESOLUTIONS, COUNCIL HAS ASKED US TO STRENGTHEN OUR RESPONSE SYSTEM AT THE INTERSECTIONS OF HOMELESSNESS, MENTAL HEALTH, HEALTHCARE, AND THE CRIMINAL...
[00:30:01]
COUNCIL HAS ALSO CONSISTENTLY EMPHASIZED BETTER COORDINATION, WHETHER THAT'S THROUGH OUTREACH, CRISIS RESPONSE, CONNECTIONS TO CARE, HOUSING, OR INITIATIVES LIKE HEAL.NO WRONGDOOR BRINGS THOSE PRIORITIES AROUND A PARTICULAR CHALLENGING POPULATION, THE PEOPLE WITH COMPLEX NEEDS WHO REPEATEDLY INTERS - INTERACT WITH ALL OF THESE SYSTEMS. SO IN MANY RESPECTS, THE WORK IS ABOUT TAKING THE DIRECTION COUNCIL HAS ALREADY PROVIDED AND ASKING HOW CAN WE BETTER ORGANIZE OUR COLLECTIVE RESPONSE AROUND THE INDIVIDUAL RATHER THAN INDIVIDUAL SYSTEMS? SO TO UNDERSTAND WHERE NO WRONGDOOR IS HEADED, WE FIRST NEED TO UNDERSTAND THE SYSTEMS WE'RE BUILDING FROM.
AND I WANT TO START BY EMPHASIZING SOMETHING INCREDIBLY IMPORTANT FOR THIS CONVERSATION.
ALSTON IS NOT STARTING FROM SCRATCH.
WE HAVE ALREADY MADE SIGNIFICANT INVESTMENT AND BUILT SOME VERY STRONG MODELS FOR RESPONDING TO HOMELESSNESS, BEHAVIORAL HEALTH NEEDS, AND MENTAL HEALTH CRISIS.
AND ALSTON HAS BEEN A LEADER IN DEVELOPING ALTERNATIVES TO CRIMINAL EMERGENCY RESPONSE MODELS.
ALSTON WAS THE FIRST COMMUNITY IN THE COUNTRY TO ADD A MENTAL HEALTH OPTION TO 911.
ALSTON CARES BRINGS TOGETHER APD, EMS, AND INTEGRAL CARE TO COORDINATE CARE FOR PEOPLE WHO FREQUENTLY ARRI - UH, RELY ON ALL THREE OF THESE SYSTEMS. INTEGRAL CARE'S EMCOT TEAM RESPONDS TO MENTAL HEALTH CRISIS CALLS IN COLLABORATION WITH LAW ENFORCEMENT AND EMS COMMUNITY HEALTH PARAMEDICS.
AND INTEGRAL CARE CLINICIANS ARE INTEGRATED IN CTEC TO SUPPORT CALLS AS THEY COME IN FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH CRISIS.
AND HOST IS ANOTHER EXAMPLE MANY OF US KNOW VERY WELL.
IT BRINGS TOGETHER HOMELESS STRATEGIES AND OPERATIONS, APD, EMS, INTEGRAL CARE, AND THE COMMUNITY CARE TO ENGAGE PEOPLE EXPERIENCING HOMELESSNESS AND CONNECT THEM TO HOUSING, CASE MANAGEMENT, HEALTHCARE, BEHAVIORAL HEALTH SERVICES, AND SUBSTANCE USE SERVICES AS WELL.
THESE ARE SIGNIFICANT ASSETS AND THEY DEMONSTRATE THAT WE ALREADY KNOW HOW TO COLLABORATE ACROSS ORGANIZATIONAL BOUNDARIES.
SO THE CHALLENGE ISN'T THAT ALSTON HAS NO RESPONSE.
IN MANY WAYS, WE HAVE A VERY ROBUST RESPONSE.
THE CHALLENGE IS WHAT HAPPENS WHEN AN INDIVIDUAL'S NEEDS ARE SO COMPLEX THAT THEY REPEATEDLY TOUCH SEVERAL OF THESE SYSTEMS AT THE SAME TIME.
AND THAT'S REALLY WHERE THE NO WRONG DOOR CONVERSATION BEGINS.
AND NOW I'LL TURN IT OVER TO JULIE WILL - WHEELER WITH TRAVIS COUNTY.
GOOD MORNING, UM, MEMBERS AND CITY MANAGER BROADNEXT.
I'M JULIE WHEELER, THE INTERGOVERNMENTAL RELATIONS OFFICER FOR THE COUNTY.
UM, MY COMMISSIONER'S COURT UNFORTUNATELY WAS NOT ABLE TO BE HERE TODAY BECAUSE THEY'RE ACTUALLY CONDUCTING THEIR OWN MEETING RIGHT NOW.
UM, THANK YOU SO MUCH FOR THE OPPORTUNITY TO BE HERE THOUGH AND SHARE WITH YOU SOME OF THE FOUNDATIONAL WORK OF TRAVIS COUNTY AND OUR PARTNERS AT INTEGRAL CARE AND CENTRAL HEALTH IN THIS SPACE.
UM, FOR A NUMBER OF YEARS NOW, THE COUNTY HAS BEEN EXPLORING HOW TO BUILD OUT THE MENTAL HEALTH CRISIS CARE CONTINUUM SO THAT INDIVIDUALS IN CRISIS CAN ACCESS CARE WITHOUT FIRST ENGAGING WITH THE CRIMINAL JUSTICE SYSTEM, WHICH IS UNFORTUNATELY THE CATALYST FOR MOST INTERVENTIONS.
WE KNOW THAT THE JAIL HAS BECOME THE LARGEST PROVIDER OF MENTAL HEALTH CARE, NOT JUST IN TRAVIS COUNTY, BUT ALSO ACROSS THE ENTIRE COUNTRY.
AND THOUGH WE AREN'T UNIQUE, THE COURT WANTED TO FIND SOLUTIONS TO BREAK THE CYCLE OF PEOPLE ENTERING THE COUNTY JAIL DUE TO PRO- PROBLEMATIC NONVIOLENT BEHAVIORS THAT WERE MOSTLY THE RESULTS OF UNTREATED MENTAL HEALTH DISORDERS AND SUBSTANCE USE DISORDERS.
IN MAY 2022, THE COURT EMPLOYED THE DELL MEDICAL SCHOOL TO STUDY WAYS TO IMPROVE OUTCA - OUTCOMES FOR RESIDENTS IN CRISIS, PULLING DATA FROM A MULTI-YEAR LOOK BACK LOOKING AT THE COUNTY'S HIGHEST REPEAT UTILIZERS OF THE SYSTEM.
THE DELL STUDY CONVENED A STEERING COMMITTEE WITH A MAJOR LIST OF STAKEHOLDERS, INCLUDING APD INVOLVEMENT, ECHO, UM, REPRESENTATIVES FROM OUR PROBATE COURT AND OTHER LEGAL DIVISIONS, AS WELL AS A NUMBER OF COMMUNITY ORGANIZATIONS.
THEY THEN CONVENED EIGHT DIFFERENT WORKING GROUPS TO ADDRESS SPECIFIC GAPS WITHIN THE INTERSECTION OF THE CRIMINAL, LEGAL, AND MENTAL HEALTH SYSTEMS. THEY LOOKED AT LAW ENFORCEMENT INTERACTION AND ARREST, CENTRAL BOOKING, MENTAL HEALTH EVALUATIONS, LEGAL REPRESENTATION, ADJUDICATION, IN JAIL INTERVENTIONS, ALTERNATIVES TO COMPETENCY RESTORATION AND SUCCESSFUL REENTRY.
WITH THESE, WITH THIS WORK, THERE WERE FIVE RECOMMENDATIONS THAT CAME OUT OF IT, WHICH YOU SEE ON THE SLIDE UNDERNEATH YOU OF FIVE THINGS THAT WE COULD IMMEDIATELY START TO TRY TO IMPLEMENT.
THESE RECOMMENDATIONS FILL SEVERAL CRITICAL GAPS AND REMOVE EXISTING BARRIERS TO OPTIMAL OUTCOMES THAT ONCE IMPLEMENTED COULD LEAD TO A DRAMATIC SHIFT IN
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HOW INDIVIDUALS MEN- MENTAL HEALTH DISORDERS WHO INTERSECT THE CRIMINAL LEGAL SYSTEM ARE TREATED WHILE CONCURRENTLY ENSURING THE SAFETY OF BOTH THE PERSON AND THE COMMUNITY.I DID WANNA FLAG THAT THE COURT HAS ALREADY STARTED WORKING ON ALL OF THESE INITIATIVES.
UM, ONE OF THE ONES I REALLY WANTED TO HIGHLIGHT WAS IMPLEMENTATION OF COUNSEL AT FIRST APPEARANCE, WHICH GIVES INDIVIDUALS LEGAL COUNSEL FROM THE VER- VERY BEGINNING OF ENGAGING WITH THE CRIMINAL JUSTICE SYSTEM.
A NUMBER OF THESE ARE ALSO UNDERWAY, UM, AND ARE UNDERWAY IN COLLABORATION WITH OUR PARTNERS.
THE MENTAL HEALTH FORENSIC REPORT GAVE US A ROADMAP OF THE ELEMENTS NECESSARY TO BUILDING OUT A BETTER PATHWAY FOR INDIVIDUALS IN CRISIS.
HOWEVER, I DO WANNA HIGHLIGHT THAT AMONG THOSE FIVE RECOMMENDATIONS, THE MOST NEEDED SOLUTION IS ALSO THE MOST CHALLENGING TO IMPLEMENT.
IN TRAVIS COUNTY, THERE ARE LIMITED OPTIONS FOR INDIVIDUALS IN CRISIS TO RECEIVE ADEQUATE SUPPORT OR COMPLEX HIGH ACUITY HEALTH NEEDS OR POLICE DROP-OFF LOCATIONS WHEN THERE ARE INTERACTIONS WITH LAW ENFORCEMENT.
OUR COMMUNITY IS IN DIRE NEED OF A MENTAL HEALTH CRISIS CENTER.
BUILDING OFF OF THE RECOMMENDATIONS OF THE MENTAL HEALTH FORENSIC REPORT, TRAVIS COUNTY INITIATED A COLLABORATIVE CRISIS DIVERSION PROGRAM IN APRIL OF 2023.
NOT WANTING TO WAIT FOR THE MENTAL HEALTH CRISIS CENTER, THE INITIATIVE WAS INTENDED TO LEVERAGE EXISTING PROGRAMS AND FACILITIES TO EXPAND COMMUNITY SERVICES TO IMMEDIATELY DRESS, ADDRESS JAIL DIVERSION NEEDS THROUGH BOTH DEFLECTION AND DIVERSION.
THE PILOT PROGRAM WAS DESIGNED AND FUNDED THROUGH A $7 MILLION SUB-AWARD TO INTEGRAL CARE OVER A THREE-YEAR-YEAR PERIOD TO INITIATE A COLLABORATIVE CRISIS DIVERSION PROGRAM, INCLUDING THE EXPANSION OF INTEGRAL CARE PSYCHIATRIC EMERGENCY SERVICES, OTHERWISE KNOWN AS PES, AND THE CREATION OF THE THERAPEUTIC DIVERSION PROGRAM.
ON THE SLIDE IN FRONT OF YOU, YOU'VE GOT A LITTLE SNAPSHOT OF BOTH OF THOSE PROGRAMS. JUST FOR THE PUBLIC TO BE AWARE OF, PES IS A WALK-IN MENTAL HEALTH URGENT CARE CLINIC FOR INDIVIDUALS HAVING A BEHAVIORAL HEALTH CRISIS AND SERVES AS A DEFLECTION AND DIVERSION FROM THE CRIMINAL LEGAL SYSTEM.
ADULTS EXPERIENCING A MENTAL HEALTH CRISIS IN TRAVIS COUNTY CAN RECEIVE VOLUNTARY CARE SERVICES THERE REGARDLESS OF THEIR ABILITY TO PAY.
SINCE JANUARY 6TH OF 2025, THE PES HAS BEEN AVAILABLE FOR DROP OFF BY LAW ENFORCEMENT FOR T - WITH TWENTY FOUR SEVEN ACCESS.
THE THERAPEUTIC DIVERSION PROGRAM IS A 25-BED FACILITY THAT OFFERS EXTENDED THERAPEUTIC RESPITE CARE WITH WRAPAROUND SERVICES FOR ADULTS WITH MENTAL HEALTH, SUBSTANCE USE DISORDER, OR INTELLECTUAL AND DEV- DEVELOPMENTAL DISABILITIES WHO NEED ONGOING BEHAVIORAL HEALTH.
THE EFFORT IS DESIGNED SO THAT PEOPLE CAN STAY UP TO 90 DAYS TO STABILIZE AND TRANSITION INTO HOUSING.
AS OF MAY, UM, TWO - 219 PEOPLE HAVE GONE THROUGH TDP AND DID WANNA FLAG THAT WHILE TDP HAS RECEIVED OVER 600 REFERRALS FOR THIS TREATMENT, THERE ARE ONLY 25 BEDS AVAILABLE HIGHLIGHTING THE URGENT NEED THAT, FOR EXPANSION OF THIS TYPE OF SERVICE.
WITH THESE PILOTS, THE COUNTY IS GETTING REAL LIFE DATA TO HELP INFORM NECESSARY DEV - DESIGN ELEMENTS FOR THE EVENTUAL MENTAL HEALTH CRISIS CENTER.
AT THE SAME TIME, THESE PILOTS ARE ALLOWING THE COMMUNITY TO ACCESS SERVICES THAT WOULD OTHERWISE NOT BE AVAILABLE.
ALONG WITH FUNDING TO CONTINUE BOTH PES AND TDP, THE COUNTY HAS MADE SIGNIFICANT INVESTMENTS IN MENTAL HEALTH SERVICES, INCLUDING $91 MILLION OF DEDICATED ONE-TIME FUNDS FOR THE CONSTRUCTION OF A MENTAL HEALTH CRISIS CENTER AND $15 MILLION IN ONGOING FUNDS FOR DEFLECTION AND DIVERSION PROGRAMS TO CONNECT RESIDENTS WITH APPROPRIATE SERVICES AND ALTERNATIVES TO INCARCERATION.
THERE ARE A NUMBER OF OTHER INVESTMENTS THAT THE COUNTY MADE IN ITS MOST RECENT BUDGET, INCLUDING MONEY FOR ASSISTED OUTPATIENT TREATMENT, MONEY FOR TRAVIS COUNTY TRANSFORMATION PROJECT TO SUPPORT RESTORATIVE JUSTICE PRACTICES FOR YOUTH, AND $1.5 MILLION TO CONTINUE THE ASSERTIVE COMMUNITY TREATMENT TEAM.
WHEN THE COUNTY WAS INVITED TO PARTICIPATE WITH THE CITY ON, AS THEY WORKED TOWARDS NO WRONG DOOR, WE WERE EXCITED TO SEE HOW THEIR HYPER-FOCUS ON THEIR OWN IDENTIFIED HIGH UTILIZER LIST WILL COMPLIMENT OUR BROADER EFFORTS TO PROVIDE BETTER OUTCOMES FOR INDIVIDUALS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS.
COLLABORATION ACROSS ALL PARTNERS AND ENTITIES IS VITAL FOR SUCCESSFULLY BUILDING OUT A ROBUST MENTAL HEALTHCARE SYSTEM.
WITH THE ALIGNMENT BETWEEN THE COUNTY, CITY, CENTRAL HEALTH AND INTEGRAL CARE, WE'RE MUCH CLOSER TO ESTABLISHING A MENTAL HEALTH CRISIS CENTER, WHICH YOU WILL HEAR MORE ABOUT IN LATER SLIDES.
AND NOW WE WILL TRANSITION OVER TO DAVID GRAY, DIRECTOR OF HOME - AUSTIN HOMELESSNESS, UH, STRATEGIES AND OPERATIONS.
UH, GOOD MORNING, MAYOR PRO TEM, MEMBERS OF THE COUNCIL AND CITY MANAGER BRATNAX.
UM, DAVID GRAY, THE DIRECTOR FOR AUSTIN HOMELESS STRATEGIES AND OPERATIONS.
AND I JUST WANNA TALK TO YOU A LITTLE BIT TODAY ABOUT THE CURRENT STATE OF OUR HOMELESS RESPONSE SYSTEM AND HOW THIS HIGH UTILIZER POPULATION FITS OR I GUESS CURRENTLY DOESN'T REALLY FIT WITHIN THE INVESTMENTS THAT WE'VE BEEN ABLE TO MAKE AS A COMMUNITY.
UH, IN TERMS OF THE CURRENT STATE, OUR HOMELESS RESPONSE SYSTEM OVERALL IS BECOMING MUCH MORE EFFICIENT, UH, AND MUCH MORE EFFECTIVE AT HELPING PEOPLE STAY HOUSED OR QUICKLY GET REHOUSED.
UH, ACCORDING TO THE MOST RECENTLY PUBLISHED
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STATE OF THE SYSTEM REPORT FROM THE INDIAN COMMUNITY HOMELESS COALITION, OUR ECHO, UH, WHAT WE'RE SEEING IS THAT OUR INVESTMENTS ACROSS THE CONTINUUM OF CARE ARE DELIVERING REAL RESULTS FOR OUR COMMUNITY.UH, WHAT WE'VE SEEN IS A DECLINE IN FIRST TIME HOMELESSNESS BY 5%, WHICH REPRESENTS THE FIRST TIME DECLINE IN FIRST TIME HOMELESSNESS, UH, SINCE 2020.
WE ALSO SEE THAT MORE PEOPLE ARE MOVING INTO HOUSING OR REMAINING HOUSED THAN EVER BEFORE WITH OVER 3,000 PEOPLE HOUSED THROUGH NOT JUST CITY RESOURCES, BUT RESOURCES PROVIDED THROUGHOUT THE ENTIRE CONTINUUM.
AND NEARLY 70% OF THOSE MOVE-INS OCCURRED WITH MINIMAL HOUSING ASSISTANCE.
WE'VE ALSO SEEN A SIGNIFICANT DECREASE IN THE WAIT TIME FOR HOUSING FOR PEOPLE WHO ARE ON THE WAIT LIST, UH, WHETHER THAT'S COORDINATED ASSESSMENTS AND, AND COORDINATED ENTRY LIST OR OTHER LISTS.
AND, AND I THINK WHAT THIS GOES TO DEMONSTRATE IS REALLY THE RESULTS OF THE INVESTMENTS MADE BY THE CITY, BY PHILANTHROPY AND OTHER PARTNERS IN BUILDING OUT OUR HOMELESS RESPONSE SYSTEM.
UH, AND SO ON, ON BEHALF OF OUR OFFICE AND OUR COMMUNITY OF HOMELESS RESPONSE PARTNERS, WE REALLY WANNA THANK COUNCIL FOR YOUR SUPPORT.
UH, THE INVESTMENTS THAT WE'VE MADE FROM PREVENTION ALL THE WAY TO PERMANENT SUPPORTIVE HOUSING ARE DELIVERING REAL RESULTS, UH, AND WE'RE, WE'RE PROUD OF THAT.
WE KNOW WE STILL HAVE MORE WORK TO DO, BUT WE ARE PROUD OF THE DIRECTION THAT WE'RE HEADING.
THAT BEING SAID, UH, THERE IS THIS HIGH UTILIZER POPULATION THAT WE'RE HERE TALKING ABOUT TODAY THAT THE NO WRONG DOOR INITIATIVE AIMS TO SOLVE FOR.
UH, WITHIN THE HOMELESS RESPONSE SYSTEM, THESE HIGH UTILIZERS ARE TYPICALLY FOLKS WHO EXPERIENCE CHRONIC HOMELESSNESS AND HAVE SOME HIGH DEGREE OF, UH, BEHAVIORAL OR PHYSICAL OR MENTAL HEALTH NEED.
UH, AND WHEN WE TALK ABOUT CHRONIC HOMELESSNESS, WE'RE TALKING ABOUT INDIVIDUALS WHO HAVE LIVED UNSHELTERED HOMELESS FOR MORE THAN 12 MONTHS, UH, OR HAVE EXPERIENCED MULTIPLE STINTS OF HOMELESSNESS THAT TOTAL TWO 12 MONTHS OVER THE COURSE OF ABOUT A THREE-YEAR PERIOD.
WHEN WE LOOK AT OUR HOMELESS RESPONSE SYSTEM, PARTICULARLY OUR HOMELESS SHELTERS, WHICH OFTENTIMES ARE THE FRONT DOORS INTO OTHER SERVICES, IN ORDER TO LIVE AND, AND BE SUCCESSFUL IN A HOMELESS SHELTER, INDIVIDUALS HAVE TO BE ABLE TO PERFORM THEIR ACTIVITIES OF DAILY LIVING.
THIS MEANS THEY HAVE TO BE ABLE TO BATHE THEMSELVES, DRESS THEMSELVES, TOILET THEMSELVES, FEED THEMSELVES.
UH, WE DO NOT HAVE THE LICENSED STAFF WITHIN OUR SHELTERS TO PROVIDE THESE TYPES OF SERVICES TO CLIENTS.
OFTENTIMES, OUR HIGH UTILIZER POPULATION ARE NA - NOT ABLE TO DO THESE ACTIVITIES, AND THEREFORE WE'RE NOT ABLE TO SERVE THEM.
THE CLIENTS WHO CANNOT PERFORM THESE ACTIVITIES THAT THEY'RE LIVING REQUIRE A HIGHER LEVEL OF CARE THAN WHAT WE'RE ABLE TO PROVIDE.
OFTENTIMES, THAT HIGHER LEVEL OF CARE NEEDS TO OCCUR WITHIN A LICENSED HEALTH CENTER, SUCH AS, UH, A STATE HOSPITAL, AN ACUTE CARE HOSPITAL, OR A STATE SUPPORTING LIVING CENTER, OR A SIMILAR TYPE OF, OF FACILITY.
THE LACK OF SUITABLE BEDS FOR THESE INDIVIDUALS MEANS THAT THESE FOLKS OFTENTIMES WILL CYCLE IN AND OUT OF OUR HOSPITALS, UH, IN AND OUT OF OUR JAILS, UH, AND THEY RETURN TO THE STREETS.
AND YOU SEE THESE INDIVIDUALS IN YOUR DISTRICTS.
I KNOW MY STAFF SEE THESE INDIVIDUALS EVERY DAY THROUGH OUR STREET OUTREACH AND OUR PUBLIC SPACE MANAGEMENT WORK.
AND I PERSONALLY HEAR ABOUT THESE INDIVIDUALS ALL THE TIME BECAUSE I'M THE ONE WHO GETS THE CALLS FROM OUR RESIDENTS AND FROM OUR CONSTITUENTS WHEN THESE INDIVIDUALS NEED HELP.
AND PRIOR TO NO WRONG DOOR, THE TRUTH OF THE MATTER IS THAT WE HAD VERY LITTLE COORDINATION AND ABILITY TO SERVE THESE FOLKS.
WE ARE VERY GRATEFUL AS A DEPARTMENT TO HAVE OUR COLLEAGUES AT CENTRAL HEALTH AND INTEGRAL CARE DEDICATING REAL RESOURCES THAT YOU'LL HEAR ABOUT IN JUST A MOMENT, UH, AND THOSE RESOURCES WILL EXPAND BEDS AND SERVICES FOR THESE FOLKS.
RICHARDSON TO MY LEFT AND MY RIGHT, UH, FOR THE INVESTMENTS THAT YOU'RE MAKING.
THAT BEING SAID, WE'RE ALSO MINDFUL OF THE FACT THAT MORE REGIONAL THAN STATE INVESTMENTS WILL BE NECESSARY TO MEET THE DEMAND.
UH, BUT BEFORE WE TALK ABOUT WHAT THOSE INVESTMENTS MIGHT LOOK LIKE, UH, I'D ACTUALLY LIKE TO HAND THE PRESENTATION OFF TO DR.
RICHARDSON, UH, TO MY LEFT TO TALK ABOUT THE CURRENT STATE OF THE WORK THAT INTEGRAL CARE IS DOING TO SERVE THIS POPULATION, UH, AND TO SERVE OUR COMMUNITY.
UM, REALLY, AS, AS MUCH OF IT WOULD BE FUN FOR ME TO READ THESE SLIDES TO YOU GUYS IN DETAIL, I'M GONNA TALK A LITTLE BIT ABOUT THEM SPECIFICALLY.
UM, BUT FIRST OFF, LET YOU KNOW MY BACKGROUND.
I'VE BEEN A SOCIAL WORKER FOR 41 YEARS.
UM, I'VE BEEN THE CEO AT INTEGRAL CARE FOR ALMOST THREE YEARS, UM, AND I'VE DONE WORK IN THIS SPACE MY ENTIRE CAREER IN TERMS OF DEVELOPING COMMUNITY-BASED SYSTEMS. AND I'M ALSO A FATHER OF A 30-YEAR-OLD SON WITH MENTAL ILLNESS.
SO I KNOW WHAT IT'S LIKE TO BE ON ALL SIDES OF THIS, AND I REALLY WANNA APPRECIATE, UM, ALL THE, ALL THE SENTIMENTS
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THAT YOU'VE HEARD TODAY.IT IS A COMPLEX, CHALLENGING SYSTEM, AND THIS NO WRONG DOOR INITIATIVE IS REALLY INCREDIBLE IN TERMS OF ITS ABILITY TO COORDINATE AND INTEGRATE ALL OF THESE DIFFERENT PARTNERS.
AND I THINK THAT'S SOMETHING THAT EVER SINCE I'VE BEEN HERE IN AUSTIN, I'VE SEEN THAT'S CRITICAL THAT YOU DON'T SEE EVERYWHERE, IS THIS LEVEL OF COLLABORATION FROM THE CITY, THE COUNTY, AND LOCAL PARTNERS TO MAKE THIS WORK.
UM, THE, THE FOLKS THAT WE'RE TALKING ABOUT WITH THIS INITIATIVE ARE SOME OF THE MOST CHALLENGING FOLKS THAT OUR SYSTEM HAS NOT SERVED WELL.
AND SO IT'S UP TO US TO COME UP WITH CREATIVE SOLUTIONS TO MAKE SURE WE MAINTAIN THAT ENGAGEMENT IN A CRISIS, BUT MORE IMPORTANTLY, AFTER THE CRISIS, HELPING PEOPLE GET ON THE PATHWAY TO RECOVERY.
AND I'M HERE TO TELL YOU THAT PEOPLE DO RECOVER FROM MENTAL ILLNESS.
PEOPLE LIVE SUCCESSFUL, MEANINGFUL LIFE IF WE'RE ABLE TO PROVIDE THE RIGHT INGREDIENTS OF SERVICES AT THE RIGHT TIME.
INTEGRAL CARE DOES HAVE A FULL CONTINUUM OF SERVICES, AND I'LL T- TOUCH ON THAT IN A MOMENT, BUT IT'S NOT COMPLETE.
UM, WE, THIS COMMUNITY CONTINUES TO GROW AND EVOLVE, AND OUR SYSTEMS NEED TO GROW AND EVOLVE AND EXPAND TO MEET THEM.
THERE'S SIGNIFICANT GAPS IN SERVICE.
YOU'VE HEARD SOME FOLKS ALREADY TALK ABOUT THAT, AND THAT'S WHY THIS INITIATIVE BECOMES SO IMPORTANT FOR US TO ALIGN AND, AND MAXIMIZE THE EXISTING RESOURCES THAT WE HAVE AND USE THOSE IN THE MOST SUCCESSFUL WAY POSSIBLE.
SO JUST TO TOUCH ON, UH, OUR CONTINUUM OF SERVICES, BECAUSE I REALLY THINK THIS IS IMPORTANT WHEN WE TALK ABOUT WHAT MATTERS HERE.
UM, THESE SER - THE NO WRONG DOOR INITIATIVE IS, IS ONE AS, AS THIS, THE TITLE SAYS, IT'S NO WRONG DOOR.
BUT ONCE WE'RE ABLE TO GET PEOPLE SU - THE SUPPORT THAT THEY NEED, IT'S BUILDING THE TRUST, BUILDING THE TREATMENT, AND BUILDING THE ENGAGEMENT TO HELP PEOPLE STAY IN CARE, NOT GOING FROM ONE CRISIS TO THE NEXT.
SO OUR, OUR SERVICES INCLUDE TRADITIONAL OUTPATIENT, UH, COMMUNITY-BASED CRISIS DIVERSION.
UM, YOU HEARD JULIE TALK ABOUT THIS A MOMENT AGO WITH SOME OF THE SERVICES THAT WE'RE DOING WITH THE COUNTY.
UH, MANY CRISIS DIVERSION PROGRAMS, OUR 988 PROGRAM, OUR 911 PARTNERSHIP, UM, OUR MOBILE OUTREACH SERVICES, AND MOST RECENTLY OVER THE PAST COUPLE OF YEARS, THE EXPANSION OF OUR PES SERVICE WHERE BOTH SOMEONE FROM THE COMMUNITY, EMS, POLICE, AND OTHERS CAN DROP BY AND BE EVALUATED, UM, TWENTY FOUR SEVEN, UM, FOR A RANGE OF OPTIONS THAT, THAT MAY BE AVAILABLE TO THAT INDIVIDUAL.
UM, THE L - THE LAST THING THAT'S NOT ON THIS LIST THAT I JUST SHOULD TALK ABOUT IS THAT WE ALSO HAVE A PARTNERSHIP TO ACTUALLY PURCHASE BEDS IN INPATIENT FACILITIES IN AND AROUND TOWN, BUT THE, THE SCALE AND THE NEED IS FAR GREATER THAN OUR RESOURCES TO DO IT RIGHT NOW.
WE HAVE MORE WORK TO DO IN THIS SPACE.
BUT OUR ROLE ALSO AS THE LOCAL MENTAL HEALTH AUTHORITY IS ALSO CONTRACTING AND PARTNERING AND BUILDING A NETWORK OF PARTNERS THAT HELP MEET THESE GOALS.
THIS ISN'T, AGAIN, SOMETHING THAT WE DO ALONE.
WE DO IT WITH ALL THESE FOLKS AT THIS TABLE AND ALL, ALL OF OUR COMMUNITY ADVOCATES AND ALL OF OUR PARTNERS TO MAKE THIS WORK.
SO JUST TO TOUCH ON WHAT ROBERT SAID EARLIER, THAT WE HAVE MADE, WE HAVE BEEN DOING WORK IN THIS SPACE.
UH, AUSTIN HAS BEEN DOING THIS WORK, TRAVIS COUNTY HAS BEEN DOING THIS WORK.
ALL OF US HAVE BEEN WORKING TOGETHER ON A NUMBER OF INITIATIVES THAT ARE LISTED ON HERE, AND SOME OF THESE HAVE BEEN GOING ON FOR A LONG TIME.
SO WE DO HAVE EXPERIENCE WORKING ACROSS THESE DOMAINS.
THIS PARTICULAR INITIATIVE IS REALLY FOCUSING ON SOME OF THE MOST CHALLENGING FOLKS, AND I'LL TALK IN A MINUTE ABOUT SOME OF THE CLINICAL NEEDS THAT THESE FOLKS PRESENT.
BUT OUR COMMUNITY HAS EXPERIENCE WORKING ACROSS THE TRADITIONAL BOUNDARIES TO GET THIS, THIS WORK DONE.
AND AS YOU CAN SEE ON THIS LIST, THE, THE, THE INVESTMENTS FROM THE COUNTY, THE CITY, UM, CENTRAL HEALTH, THE STATE, AND MANY OTHERS TO MAKE THIS HAPPEN ARE CRITICAL.
INTEGRAL CARE IS NOT A TAXING AUTHORITY.
WE ARE DEPENDENT ON THE SUPPORT FROM ALL OF OUR PARTNERS AND TO WORK TOGETHER TO MAKE ALL OF THIS HAPPEN.
UM, SO WE HAVE A, A LIST OF PROGRAMS ON HERE, AND YOU MAY BE SAYING, "OH, THIS IS GREAT.
WE GOT THIS LIST, SO WHY DO WE NEED THIS OTHER PROGRAM?" THIS PROGRAM IS REALLY TARGETING A VERY HIGH TOUCH, HIGH NEED GROUP OF FOLKS THAT NEED VERY, VERY FOCUSED COORDINATION.
I KEEP TELLING SOMEONE TO SWITCH THE SLIDES, AND THAT'S ME.
SO LET'S TALK ABOUT THIS FOR A SECOND, WHICH IS ONE, ONE OF THE THINGS THAT WE HAVE BEEN DOING AS PART OF THE NO WRONG DOOR DISCUSSION IS TO SORT OF LOOK AT DATA, TO TALK ABOUT PROFILING THE, SOME OF THE FOLKS THAT NEED THESE SERVICES MOST CRITICALLY.
AND AGAIN, FROM A CLINICAL AND A HEALTHCARE PERSPECTIVE, THESE FOLKS ARE FOLKS WHO HAVE, MAY HAVE A CHRONIC AND PERSISTENT ILLNESS LIKE SCHIZOPHRENIA THAT MAY BE A LIFELONG CONDITION.
THERE'S NOT YET A CURE FOR SCHIZOPHRENIA, BUT THERE'S PLENTY OF TREATMENTS THAT ALLOW PEOPLE TO LIVE SUCCESSFUL, MEANINGFUL LIVES, IF THOSE SUPPORTS IN THE RIGHT PLACE AT THE RIGHT TIME AND ARE AVAILABLE TO PEOPLE, UH, WHEN AND HOW THEY
[00:50:01]
NEED THEM.AND SO TO TOUCH ON SOME OF THIS DATA, OF THE 2% OF, OF THE FOLKS THAT WERE ARRESTED DURING THIS PERIOD OF TIME, UM, NEARLY 2% OF THOSE, UH, OF THOSE INDIVIDUALS ACCOUNTED FOR 17% OF ALL ARRESTS.
85% EXPERIENCE HOMELESSNESS, UH, AND 55 EX - PERCENT EXPERIENCE SOME RANGE OF BEHAVIORAL HEALTH ISSUES.
AND AGAIN, NOT EVERY PERSON IS DIFFERENT.
WHAT, WHAT THEY COME WI- WI- WITH AND PRESENT THEMSELVES WITH IS NOT JUST A MENTAL ILLNESS, IT MAY BE ADDICTIONS, IT MAY BE, UM, BEING UNHOUSED, IT MAY BE DEALING WITH A TRAUMATIC CRISIS.
MUCH OF THE WORK THAT WE DO NOW WITH KIDS AND CHILDREN IS ALSO LOOKING AT, UM, ADVERSE CHILDHOOD EXPERIENCES AND TRAUMA WITH MANY OF THE FOLKS THAT ARE IN THIS GROUP HAVE EXPERIENCED A, A RANGE OF TRAUMAS THAT HAVE FURTHER COMPLICATED THEIR WILLINGNESS AND IN, UH, ABOUT ENGAGING ANYONE IN CARE.
SO IT IS A VERY CHALLENGED, UH, GROUP OF FOLKS.
50% OF THIS POPULATION HAVE BEEN REARRESTED WITHIN 10 WEEKS.
UM, AT ONE POINT OR ANOTHER, SOMEONE MAY HAVE HAD A TOUCH POINT WITH THE INTEGRAL CARE SYSTEM, BUT AGAIN, AS YOU SAW EARLIER, THERE'S A LOT OF WAYS THAT PEOPLE CAN ENGAGE OUR SYSTEM, AND IF THEY'RE NOT ENGAGED IN A LONG-TERM WAY, UM, THAT'S NOT GONNA BE HELPFUL TO THEM, AND WE HAVEN'T DONE OUR JOB.
UH, 15%, UM, HAVE AT LEAST ONE PSYCH HOSPITAL INPATIENT.
AND FRANKLY, THAT NUMBER TO ME IS SHOCKINGLY LOW.
TO ME, THAT SHOWS ANOTHER EVIDENCE OF SOME OF THE THINGS THAT WE NEED TO WORK ON OUR COMMUNITY AROUND ACCESS FOR INPATIENT AND, AND PSYCHIATRIC INPATIENT CAPACITY.
UH, 8% HAVE BEEN IN RESIDENTIAL CRI - PROGRAMS. AGAIN, AN AREA OF CONCERN THAT I HAVE ABOUT MAKING SURE THAT WE CAN SCALE THAT OUT FURTHER.
AND AT LEAST 43% HAVE HAD AT LEAST ONE PSYCH INPATIENT HOSPITALIZATION IN 12 MONTHS.
AND AGAIN, THE AVERAGE LENGTH OF STAY IN AN INPATIENT FACILITY IS VERY SHORT.
UM, PEOPLE SPEND ANYWHERE FROM THREE TO SEVEN DAYS, NOT A LONG TIME TO BE ABLE TO GET SOME OF THE ISSUES RESOLVED THAT MAY HAVE GOT YOU THERE IN THE FIRST PLACE, ALONG WITH ALL THE MEDICAL COMPLICATIONS THAT SOMEONE MAY EXPERIENCE.
UM, AND AGAIN, FOR US, THE, THE, THE, THIS IS A, THIS IS A POPULATION OF FOLKS THAT WE ALL ARE COMMITTED TO AND PASSIONATE ABOUT CARING FOR, AND THAT'S WHY THIS INITIATIVE MATTERS SO MUCH.
AND THEN THE LAST THING I'M JUST GONNA TOUCH ON BEFORE I HAND IT BACK TO ROBERT, UM, ONE IS, IS THAT WHEN WE LOOK AT, UM, HAVING A GOOD CONTINUUM OR HAVING SERVICES, THAT'S NOT SUFFICIENT.
WE NEED TO BE ABLE TO FURTHER SCALE OUT AND MEET THE NEEDS OF FOLKS BOTH IN PREVENTATIVE CARE, BUT ALSO IN HIGH NEED, HIGH TOUCH SERVICES.
AND SOME AREAS THAT WE REALLY NEED TO KEEP FOCUSING IN ON, ONE IS, UM, UH, PROFESSIONALS, CONTINUING TO DRAW IN AND RECRUIT AND RETAIN, UH, PSYCHIATRISTS, PHYSICIANS, THERAPISTS, OTHERS WHO WANNA DO THIS WORK AND ARE PASSIONATE ABOUT THIS CRITICAL WORK IN OUR COMMUNITY.
UM, INPATIENT CAPACITY, PARTICULARLY AT AUSTIN STATE HOSPITAL, A BEAUTIFUL NEW FACILITY, UH, BUT IT'S AT 100% CAPACITY.
OUR, OUR ABILITY TO TAKE ADVANTAGE OF THAT AS A RESOURCE IS LIMITED.
UM, AND IN THE, IN OUR COMMUNITY AND AS A WHOLE IN THE METRO AREA, WE'VE SEEN A DECLINE IN INPATIENT PSYCHIATRIC BEDS, AND THIS NUMBER IS EVEN SMALLER WHEN YOU START LOOKING AT TRAVIS COUNTY SPECIFICALLY.
AND, AND WHEN YOU START LOOKING AT INPATIENT BEDS, THEY'RE NOT ALL THE SAME.
UM, CHILDREN NEED A SPECIFIC SET OF INTERVENTIONS, FOLKS WHO ARE STRUGGLING WITH MENTAL HEALTH AND ADDICTION NEEDS NEED A, A UNIQUE SET OF INTERVENTIONS.
AND SO SIMPLY HAVING A BED IS NOT SUFFICIENT.
BEING ABLE TO PROVIDE THE CLINICAL CARE THAT THAT PERSON NEEDS IS KEY.
AND THE REASON THAT'S KEY IS THAT BREAKS THIS CYCLE THAT WE'VE BEEN TALKING ABOUT.
IF PEOPLE ARE ACTUALLY ABLE TO GET THE TREATMENT AND THE SUPPORT, IT BREAKS THIS CYCLE.
IF NOT, WE CONTINUE TO SEE WHAT WE'RE SEEING NOW, WHICH IS PEOPLE MOVING FROM ONE CRISIS TO THE NEXT.
UM, WE OPERATE 85 INTERMEDIATE STEP-DOWN AND, UH, TRANSITIONAL BEDS.
AS YOU HEARD DAVID SAY EARLIER, YOU KNOW, HAVING HOUSING IS, IS A CRITICAL PIECE OF THIS, BUT NOT HA, NOT, NOT HAVING SUFFICIENT SUPPORTS IN PLACE, PEOPLE WILL NOT BE ABLE TO SUCCEED.
AND SO HAVING THAT SUPPORT TO HELP PEOPLE MAINTAIN THEIR SUCCESS IN THEIR HOUSING, GETTING MEDICATION SUPPORT, BEING ABLE TO BE SUPPORTIVE FOR ANY OF THEIR MEDICAL COMORBID MEDICAL CONDITIONS, UH, AND THIS IS THE SAME FOR THE SOBERING CENTER.
THE SOBERING CENTER HAS BEEN A CRITICAL RESOURCE, BUT AGAIN, ALONE, IT'S NOT SUCCESSFUL.
IT HAS TO BE TIED TO EVERYTHING THAT WE DO.
SO WE HAVE MADE TREMENDOUS PROGRESS IN THIS COMMUNITY, AND I CAN TELL YOU, HAVING WORKED IN OTHER PLACES AND DONE CONSULTING ALL OVER THE COUNTRY, WHAT WE ARE DOING HERE IN AUSTIN IS PRETTY FANTASTIC.
WE JUST NEED TO SCALE IT OUT AND START HAVING EVERYONE WORK TOGETHER.
ROBERT? THANKS, JEFF, AND, AND JULIE AND DAVID FOR THAT, THAT INFORMATION.
[00:55:01]
UM, SO WE'VE HEARD ABOUT THE GROWING DEMAND FOR SERVICES AND THE LIMITS THAT EXIST IN OUR COMMUNITY.UM, THIS SLIDE SHOWS WHAT IT LOOKS LIKE WITH PEOPLE THAT WE'RE TALKING ABOUT REGARDING NO WRONG DOOR ARE REPEATEDLY CYCLING THROUGH THE EMERGENCY RESPONSE HOSPITALS AND JUSTICE SYSTEMS. THE MEADOWS MENTAL HEALTH POLICY INSTITUTE ESTIMATES THAT ARO - ABOUT 950 PEOPLE IN TRAVIS COUNTY HAVE BOTH HIGH NEEDS AND HIGH RISK OF JUSTICE INVOLVEMENT.
THE ESTIMATED ANNUAL COST ACROSS THE SYSTEMS SERVING THIS POPULATION IS APPROXIMATELY $144,000 PER YEAR, AND THAT TOTALS $137 MILLION ANNUALLY.
STATEWIDE, THE ESTIMATE IS ROUGHLY 3.2 BILLION EACH YEAR TO SERVE THIS POPULATION IN OUR CURRENT SYSTEMS. THE EXAMPLES AT THE BOTTOM OF THE SLIDE MAKE THE PATTERN MORE TANGIBLE.
ONE PERSON GENERATED AN EMS INCIDENT ABOUT EVERY FOUR DAYS, ANOTHER GENERATED A FIRE RESPONSE ABOUT EVERY SEVEN DAYS, AND A THIRD GENERATED A POLICE INCIDENT ABOUT EVERY FOUR DAYS.
THESE ARE SEPARATE EXAMPLES FROM EACH DEPARTMENT.
THE FIGURES INCLUDE EMS CHARGES AND SELECTED WAGE COSTS, AND THIS JUST GIVES US A PARTIAL VIEW OF THE RESOURCES INVOLVED IN REPEATED RESPONSES.
EACH RESPONSE MEETS AN IMMEDIATE NEED.
THE CONCERN IS WHAT HAPPENS BETWEEN THOSE RESPONSES, WHETHER THE PERSON IS CONNECTED TO SUSTAINED TREATMENT, FOLLOW UP, AND SUPPORT THAT CAN HELP PREVENT THE NEXT CRISIS.
AS NO WRONGDOOR DEVELOPS, WE ARE BROADENING HOW WE IDENTIFY HIGH SYSTEM USE TO INCLUDE OTHER SYSTEMS BEYOND PUBLIC SAFETY.
OUR FOCUS IS ON PATTERNS OF REPEATED CONTEXT AND COMPLEX NEEDS.
MENTAL ILLNESS AND HOMELESSNESS ARE NOT CRIMES, AND IDENTIFYING SOMEONE FOR COORDINATED CARE REQUIRES MORE THAN DIAGNOSIS OR HOUSING STATUS.
THE COMMUNITY COURT'S EXPERTISE PROVIDES ANOTHER EXAMPLE OF WHY SUSTAINED COORDINATION MATTERS.
AT THE COMMUNITY COURT, WE SEE THE SAME PATTERN OF REPEATED CONTACT OVER TIME.
THIS SLIDE LOOKS AT 25 OF OUR MOST FREQUENT COURT UTILIZERS OVER THE PAST TWO YEARS.
THOSE 25 INDIVIDUALS ACCOUNTED FOR 1,043 CASES AND AN AVERAGE OF ALMOST 42 CASES PER PERSON IN THAT TWO YEAR TIME PERIOD.
SO THAT MEANS WITHIN THIS GROUP, CONTACT RANGE FROM APPROXIMATELY EVERY 10 DAYS TO EVERY 23 DAYS FOR THESE 20, 25 INDIVIDUALS.
EACH CASE INVOLVES WORK BY STAFF AND OTHER INTERACTIONS WITH THE JUSTICE SYSTEM FOR THIS INDIVIDUAL.
THE FREQUENCY OF INTERACTIONS OFTEN SHOW HOW OFTEN WE'RE COMING BACK IN CONTACT WITH THE SAME PEOPLE.
IT ALSO CREATES AN OPPORTUNITY.
OUR REPEATED CONTACT CAN HELP US UNDERSTAND THE PERSON'S NEEDS.
IT SIGNIFICANTLY HELPS IN BUILDING A RELATIONSHIP AND TO CONNECT COURT INVOLVEMENT WITH CASE MANAGEMENT SERVICES.
SO NO WRONG DOOR CAN STRENGTHEN THAT WORK BY HELPING, HELPING THE ORGANIZATION SERVING THAT PERSON ACT ON A SHARED PLAN AND MAINTAIN CONTINUITY BETWEEN THESE ENCOUNTERS.
SO THE GOAL IS TO USE THESE POINTS OF CONTACT TO SUPPORT A COORDINATED INTERVENTION THAT ADDRESSES THE NEEDS CONTRIBUTING TO REPEATED INVOLVEMENT.
WE WANT TO SEE MORE STABILITY FOR THE INDIVIDUAL AND FEWER RECURRING CRISIS ACROSS THE SYSTEM SERVING THEM.
SO WITH THAT CONTEXT, I'LL TURN IT OVER TO CHIEF LUKERITZ TO WALK US THROUGH THE FUTURE STATE WE ARE WORKING TOWARDS.
ROB LUKRITZ, CHIEF OF AUSTIN TRAVIS COUNTY EMS. AGAIN, THANK YOU FOR THE OPPORTUNITY TO BE HERE TODAY.
SO WE'VE TALKED EXTENSIVELY, UM, ABOUT THE PROBLEM STATEMENT.
WE'VE, WE'VE ALL RECOGNIZED, AND I THINK EVERYONE HERE UNDERSTANDS THE CHALLENGES THAT WE FACE HERE IN THE CITY OF AUSTIN, WHICH ARE SIMILAR TO WHAT WE SEE ACROSS THE COUNTRY.
WE'VE ALSO TALKED ABOUT THE VARIOUS SERVICES AND THE GREAT INITIATIVES THAT WE HAVE HERE IN THE CITY OF AUSTIN, UM, AND THE, THE LEAPS AND BOUNDS THAT WE'VE MADE IN PROGRESS, UM, TOWARDS ADDRESSING SOME OF THESE ISSUES.
BUT WHEN WE THINK ABOUT HOW IT IS THAT EACH OF THE INDIVIDUALS THAT ARE UP HERE ON STAGE AND MANY OF THE FOLKS THAT ARE IN THE AUDIENCE APPROACH THESE, WHAT WE DO FIND IS THAT VERY OFTEN WE'RE OPERATING INSIDE...
[01:00:01]
AND THAT WE'RE MAKING GREAT PROGRESS INDIVIDUALLY AND WE'RE ADDRESSING THOSE INDIVIDUALS THAT PRESENT TO US INDIVIDUALLY.BUT SOMETIMES THE PLACE WHERE SOMEONE PRESENTS IS NOT THE BEST SOLUTION FOR THAT INDIVIDUAL.
AND SO FROM A HIGH LEVEL, AS WE THINK ABOUT WHAT NO WRONG DOORS IS, IT'S FIRST AND FOREMOST THE ABILITY TO ELIMINATE THOSE SILOS, TO EXPAND OUR ABILITY FOR ALL OF THE RESOURCES ADDRESSING MENTAL HEALTH, HOMELESSNESS, SUBSTANCE ABUSE AND OTHERS ACROSS THE CONTINUUM AND IDENTIFY HOW IT IS THAT WE CAN BETTER COORDINATE.
FIRST AND FOREMOST, HOW WE CAN COORDINATE THE CRISIS CARE FOR THOSE THAT ARE ENCOUNTERING AN ACUTE ISSUE.
HOW CAN WE RESPOND TO THE IMMEDIATE NEEDS OF THOSE INDIVIDUALS SO THAT WE CAN THEN MOVE FORWARD WITH BUILDING INDIVIDUALIZED SERVICE PLANS THAT UTILIZES THOSE RESOURCES APPROPRIATELY? NO WRONG DOORS IS CALLED NO WRONG DOORS BECAUSE THERE IS NO WRONG DOOR FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH CRISIS OR WITH LONG-TERM MENTAL HEALTH NEEDS.
REGARDLESS OF WHO IT IS THAT THEY CONTACT, THEY SHOULD BE ABLE TO GET THE SERVICES THAT ARE NECESSARY FOR THEM.
NOW, WHEN WE THINK ABOUT HOW IT IS THAT WE OPERATIONALIZE THIS CONCEPT OF NO WRONG DOORS, THE FIRST THING THAT WE NEED TO DO IS TO MEET THEM WHERE THEY ARE.
SO MANY OF THESE INDIVIDUALS IN, ARE OUT IN THE COMMUNITY AND WE HAVE TO IDENTIFY WHO THEY ARE.
AND EACH OF US HAVE DIFFERENT WAYS OF IDENTIFYING WHO THOSE INDIVIDUALS MIGHT BE.
WE NEED TO BUILD A RELATIONSHIP.
AND FOR EACH INDIVIDUAL, THAT LOOKS A LITTLE BIT DIFFERENT AS TO WHO THEY TRUST AND HOW THEY TRUST THEM.
BUT REGARDLESS OF WHO IT IS THAT THEY ARE INTERACTING WITH, WE NEED TO UNDERSTAND WHAT THE CIRCUMSTANCES ARE AND WHAT NEEDS IT IS THAT THEY HAVE.
AND WE NEED TO CONNECT THEM WITH OPTIONS FOR SERVICE THAT ALIGN TO WHAT THEIR IMMEDIATE NEEDS ARE IN THAT MOMENT AND PERFORM WARM HANDOFFS TO WHOEVER IT IS THAT CAN BEST PROVIDE THOSE SERVICES.
THEN, AS WE MOVE FORWARD, FOR THOSE INDIVIDUALS THAT VOLUNTARILY AGREE TO BECOME PART OF THIS PROGRAM, THE KEY IS HOW IT IS THAT WE BUILD THAT CONNECTIVE TISSUE.
HOW DO WE BUILD A COORDINATED RESPONSE? HOW DO WE BRING ALL OF US TOGETHER FOR A COLLABORATIVE LONG-TERM SOLUTION FOR THESE INDIVIDUALS? HOW DO WE COORDINATE SOMETHING THAT IS SPECIFIC TO THAT INDIVIDUAL, INDIVIDUALIZED CARE? HOW IS IT THAT WE CAN COLLECTIVELY CONNECT THOSE ACUTE UTILIZERS TO THE MOST APPROPRIATE SERVICES? AND THAT'S WHAT WE'RE DOING WHEN WE COME TOGETHER IN NO WRONG DOORS.
WE ARE TRYING TO IDENTIFY WHAT ARE THE INDIVIDUAL NEEDS, HOW DO WE BREAK THE SILOS DOWN, RIGHT? ONCE WE, ONCE WE COME TOGETHER AS A TEAM, HOW DO WE PROVIDE COORDINATION? HOW DO WE SHARE? BECAUSE SOMETIMES IT MAY NOT BE AS SIMPLE AS JUST TAKING THAT INDIVIDUAL AND PLUGGING THEM IN SOMEWHERE ELSE BECAUSE THESE INDIVIDUALS HAVE COMPLEX NEED THAT CROSS DISCIPLINES.
THEY MAY NEED MULTIPLE SERVICES AND WE CAN ONLY COORDINATE THOSE IF WE'RE ALL WORKING TOGETHER.
BECAUSE SOMETIMES WHILE SOMEONE MAY HAVE A LONG-TERM NEED THAT MAY BE ABLE TO BE PROVIDED BY ONE INDIVIDUAL OR ONE PROVIDER HERE SITTING DOWN HERE, IT CAN ONLY BE ACHIEVED AFTER SOMETHING IS ACCOMPLISHED BY ANOTHER PROVIDER.
AND SO WE HAVE TO OPERATE TOGETHER IN ORDER US TO BE, IN ORDER FOR US TO BE SUCCESSFUL.
AND IT ALLOWS US TO PROVIDE DIRECT CONNECTIONS TO THOSE CLINICAL INTERVENTIONS PROVIDED BY INTEGRAL CARE AND OTHERS THAT ARE SO ESSENTIAL TO THE LONG-TERM STABILITY OF THESE INDIVIDUALS.
BY IMPLEMENTING NO WRONG DOORS, WE'RE BUILDING SOMETHING THAT IS INTEGRATED AND RESPONSIVE, SOMETHING THAT MEETS THE INDIVIDUALS AS THEY ARE TODAY, BUT ALSO BUILDS AN INFRASTRUCTURE AND PATHWAYS FOR US TO COME TOGETHER AS A TEAM TO SUPPORT THESE INDIVIDUALS IN THE FUTURE AND TO RESPOND TO THE NEEDS OF THE OVERALL COMMUNITY.
THIS IS A, THIS IS NOT A SINGLE GROUP.
THIS IS NOT JUST THE CITY OF AUSTIN, THIS IS NOT JUST PUBLIC SAFETY.
THIS IS A COORDINATION OF 17 INDIVIDUAL ORGANIZATIONS THAT HAVE SIGNED MEMORANDUMS OF UNDERSTANDING TO BECOME A PART OF THIS TEAM, INCLUDING THE CITY OF AUSTIN, TRAVIS COUNTY, OUR HEALTHCARE PARTNERS THAT ARE SO ESSENTIAL, ASCENSION, ST.
DAVID'S ARE OF COURSE OUR INTEGRAL CARE PARTNERS AND ON, RIGHT? THIS IS NOT JUST A CITY OF AUSTIN ISSUE AND WE CAN'T SOLVE IT JUST AS THE CITY OF AUSTIN AND TRAVIS COUNTY.
THIS IS NOT SOMETHING THAT CAN BE SOLVED JUST WITH GOVERNMENT.
IT'S A PARTNERSHIP BETWEEN GOVERNMENT, BETWEEN PUBLIC SAFETY, BETWEEN HEALTHCARE, BETWEEN BEHAVIORAL HEALTH PROVIDERS AND OTHERS.
AND OF COURSE, ALL OF OUR COMMUNITY STAKEHOLDERS THAT HAVE ENGAGED WITH US TO HELP US BECAUSE THEY'RE THE BOOTS ON THE GROUND.
THEY'RE THE ONES THAT SEE THIS FIRSTHAND
[01:05:01]
ALONGSIDE OUR PUBLIC SAFETY INDIVIDUALS AND OUR HEALTHCARE PROVIDERS, RIGHT? THOSE COMMUNITY PARTNERS THAT ARE EXPERIENCING THIS CAN HELP US AS WE MOVE FORWARD WITH THE SOLUTION.NOW, WHO IS IT THAT WE'RE SERVING? ALL OF THIS COMES BACK TO ONE THING THAT AT LEAST I KNOW I'VE SPOKEN HERE MANY TIMES ABOUT THE SOCIAL DETERMINANTS OF HEALTH.
THOSE INDIVIDUALS EXPERIENCING CHALLENGES LIKE SERIOUS MENTAL ILLNESS, SUBSTANCE ABUSE, CHRONIC MEDICAL CONDITIONS, HOMELESSNESS AND TRAUMA.
THESE ARE THE INDIVIDUALS THAT WE ARE TARGETING AND THOSE INDIVIDUALS THAT FALL WITHIN THE ONE, TOP 1% OF OUR HIGH UTILIZERS FOR BEHAVIORAL HEALTH EMUS - EMERGENCIES, SUBSTANCE USE RELATED EMERGENCIES AND ARRESTS.
AND WITH THAT, I'LL TURN IT OVER TO CHIEF, UH, HERALD FROM APD.
UH, GOOD MORNING, MAYOR PROTEM.
GOOD MORNING, COUNCIL, AND GOOD MORNING, MR. CITY MANAGER BROADNEXT.
I'M THE CHIEF OF STRATEGIC INITIATIVES FOR THE AUSTIN POLICE DEPARTMENT.
TODAY, I JUST WANNA TALK TO A, TO YOU FOR A FEW MINUTES, UM, FROM A POLICING PERSPECTIVE OF WHAT WE ARE SEEING EVERY DAY.
WE ARE ALL HERE DISCUSSING THE INTERSECTION OF CHRONIC H - CHRONIC HOMELESSNESS, BEING CHRONICALLY MENTALLY ILL, AND/OR SUFFERING FROM A SEVERE ADDICTION.
AND IN ADDITION TO THAT, WHEN YOU TAKE A CLOSER EVALUATION OF WHAT'S GOING ON WITH THIS VERY SMALL SUBSET OF THE UNHOUSED COMMUNITY, WHAT YOU ARE SEEING IS A VICIOUS CYCLE EVERY DAY OCCURRING IN AUSTIN WHERE SOMEBODY IN THIS VERY SMALL, VULNERABLE POPULATION IS BEING ARRESTED FOR A LOW LEVEL CRIME, BEING TAKEN TO JAIL, INTO A HOSPITAL SITTING, BACK TO THE STREETS, AND THIS CYCLE CONTINUES ON A DAILY BASIS ON THE STREETS OF AUSTIN.
IT IS OCCURRING RIGHT NOW AS WE SPEAK.
BUT AS A POLICE LEADER, TO STOP THIS VICIOUS CYCLE FROM OCCURRING, YOU HAVE TO GO DEEPER INTO THE ANALYSIS OF THIS SMALL GROUP OF PEOPLE THAT WE'RE ALL HERE TODAY CONCERNED ABOUT, AND YOU START TO SEE ALARMING PATTERNS JUMP OUT AT YOU.
ONE, WE KNOW THIS POPULATION IS DISPROPORTIONATELY IMPACTED BY CRIME.
IN ADDITION, WE KNOW THERE'S EVIDENCE OF VICTIM OFFENDER OVERLAP IN THIS POPULATION, BUT WHEN YOU LOOK AT THIS IN GREATER DETAIL, WHAT YOU WILL FIND IS REALLY ALARMING, THAT IF YOU'RE SIMPLY UNHOUSED IN THE CITY OF AUSTIN, YOU ARE TWO TIMES MORE LIKELY TO BE A VICTIM OF SEXUAL ASSAULT.
IF YOU ARE UNHOUSED AND EXPERIENCING A MENTAL HEALTH CHALLENGE, YOU ARE FOUR TIMES LIKELY TO BECOME A VICTIM OF SEXUAL ASSAULT.
IF YOU ARE UNHOUSED AND EXPERIENCING MENTAL HEALTH CHALLENGES AND YOU ARE A WOMAN, YOU ARE 20 TIMES MORE LIKELY TO BECOME A VICTIM OF A SEXUAL ASSAULT.
AS A POLICE LEADER AND FORMAL S - FORMER SOCIAL WORKER, I FIND THIS COMPLETELY UNACCEPTABLE.
SO WHAT, WHAT ARE WE DOING AS A PUBLIC SAFETY INFRASTRUCTURE, UH, TO MEASURE THESE OUTCOMES, TO KNOW IF WE'RE IMPACTING THIS VULNERABLE GROUP IN A POSITIVE WAY? I CAN TELL YOU PRELIMINARILY, PUBLIC SAFETY INTERACTIONS ARE GOING DOWN, SPECIFICALLY POLICE INTERACTIONS ARE GOING DOWN WITH THIS SMALL POPULATION.
AND WHY IS THAT IMPORTANT? BECAUSE THE MORE WHAT WE ENGAGE AND THE MORE THAT YOU SEE POLICE INTERACTIONS GOING DOWN WITH THIS VULNERABLE GROUP OF PEOPLE, THE LESS LIKELY THAT CYCLE IS TO HAPPEN OVER AND OVER AND OVER AGAIN.
WE ARE ALREADY STABILIZING, UM, OUR MOST VULNERABLE ON THIS TOP 100 LIST, UM, AND WE ARE PROVIDING BASIC STABILIZATION, WHETHER THAT'S BASIC IDENTIFICATION, MAYBE THAT'S SHELTER BEDS, MAYBE THAT'S RECONNECTION BACK TO, UH, SOCIAL SERVICES, MAYBE THAT'S CONNECTING BACK, UH, WITH FAMILY MEMBERS.
WE ARE ALSO SEEING, UH, A DRAMATIC INCREASE IN SOCIAL SERVICE OUTCOMES, INCLUDING HOUSING OPTIONS FOR THIS VULNERABLE GROUP OF PEOPLE AS WELL.
BUT THE IMPORTANT THING IS, IS TO STOP THAT CYCLE THAT I TALKED ABOUT BEFORE, AND PRELIMINARILY, THAT IS EXACTLY WHAT WE'RE SEEING.
I THINK THIS IS PROBABLY ONE OF THE MOST POWERFUL SLIDES AS A POLICE LEADER I HAVE SEEN.
UM, THIS IS, UH, APPROXIMATELY OVER THE COURSE OF THE LAST 90 DAYS.
AND WHAT WE ARE SEEING IS BEFORE NO WRONG DOOR STARTED, ONE OF THESE TOP 99, UH, HIGH UTILIZERS WAS HAVING A CRISIS CONTACT IN OUR COMMUNITY BY EITHER THE POLICE OR EMS EVERY 11 DAYS.
[01:10:01]
EVERY 16 DAYS.TO PUT THAT INTO FURTHER CONTEXT, THAT'S 10 FEWER CONTACTS PER PERSON PER YEAR WITH A 30%, 31% REDUCTION IN POLICE CONTACTS.
IF YOU BREAK THAT DOWN FURTHER, IF YOU TAKE THE TOP 28, THAT IT MEANS THE MOST COMPLEX, THE MOST VULNERABLE, SUFFERING FROM COMPLEX ISSUES.
BEFORE NO WRONG DOOR, THIS SMALL GROUP OF PEOPLE WAS HAVING A CRISIS CARE CONTACT EVERY SIX DAYS IN OUR COMMUNITY.
NOW, AFTER NO WRONG DOOR, THAT EXTENDS OUT TO 14 DAYS.
WHEN YOU EXTRAPOLATE THAT OVER THE YEAR, THAT'S 35 FEWER CONTACTS PER PERSON PER YEAR WITH A 57% REDUCTION IN POLICE CONTACTS.
SO, SO FAR, WE HAVE 300 PLUS FEWER POLICE CONTACTS WITH APD OFFICERS, AND YOU START TO SEE THAT OTHER SOCIAL SERVICE AGENCIES ARE INCREASING.
THEY ARE GOING UP AT THE SAME TIME POLICE CONTACTS ARE GOING DOWN.
SO I WANNA TALK ABOUT A COUPLE REAL LIFE EXAMPLES FROM OUR DATA SETS.
UM, WE WILL CALL THIS, UH, GENTLEMAN OSCAR.
UM, BEFORE NO WRONG DOOR, OSCAR WAS BEING CONTACTED BY THE POLICE DEPARTMENT 10 TIMES A MONTH.
IN ADDITION, OSCAR WAS BEING CONTACTED BY EMS ALMOST 11 TIMES A MONTH.
AFTER NO WRONG DOOR, OSCAR DROPPED DOWN TO 2.8 TIMES, UH, TO BE SEEN BY A POLICE OFFICER AND 3.5 TIMES, UH, SEEN BY EMS. COLLECTIVELY, THAT'S A 74% REDUCTION IN POLICE CONTACT AND A 66, UH, PERCENT REDUCTION IN EMS CALLS.
HE HAS BEEN REUNITED WITH HIS FAMILY AND THAT HE IS ENGAGED IN THE NO WRONG DOOR PROCESS, AND WE ARE SEEKING LONG-TERM HOUSING FOR OSCAR AS WE SPEAK.
ON THE OTHER HAND, WHEN WE LOOK AT EVE, AND I WILL SAY THIS, UH, I'M VERY PROUD OF THE WORK THAT DR.
ED ANDERSON, WE ARE LUCKY TO HAVE HIM ON OUR POLICE, UH, STAFF BECAUSE HE IS DOING SOME REALLY INNOVATIVE WORK, UH, WITH THE NO WRONG DOOR PROJECT.
UH, ED ANDERSON, RETIRED PROFESSOR AT THE UNIVERSITY OF TENNESSEE AND NOW WORKING FOR US, HE'S REALLY STARTING TO PINPOINT WHEN WE SEE ONE OF THESE HIGH UTILIZERS GO INTO ACUTE CRISIS ON OUR STREETS.
AND SO WITH EVE, FROM JUNE OF 2025 TO MARCH OF 2026, YOU WILL SEE THAT SHE HAD FIVE, OVER FIVE, UH, MONTHLY CONTACTS WITH EMS. IN APRIL TO AUGUST OF 2026, YOU SEE THAT ESCALATE TO 8.3 TIMES.
EMERGENCY DETENTIONS, WHICH I THINK THAT ALL OF THE CLINICIANS UP HERE ARE PROBABLY THE MOST TRAUMATIC, UH, SYSTEM TO PUT, UH, ONE OF THESE HIGH UTILIZERS IN.
IT IS A VERY TRAUMATIC EXPERIENCE TO BE TAKEN TO AN EMERGENCY ROOM, UM, AND BE EVALUATED.
SO, UH, BE- BETWEEN THE TIMES OF DECEMBER 24TH, UH, TO SEPTEMBER 26TH, EVE WAS SEEN IN EMERGENCY DETENTION OVER ONE TIMES PER MONTH.
BUT AS WE SEE EVE ESCALATING FROM FEBRUARY TO JUNE OF 2026, YOU SEE THAT SKYROCKET TO FOUR POINT TIME, 4.5 TIMES.
UM, AND WHAT WE SAW WITH EVE IS THAT HER ESCALATION WAS GETTING SERIOUS.
AND I CAN TELL YOU FROM EXPERIENCE THAT WITHOUT INTERVENTION WITH EVE, SHE WOULD EITHER END UP COMMITTING A SERIOUS FELONY REQUIRING A JAIL, A LONG DURATION OF JAIL TIME, OR UNFORTUNATELY WORSE.
AND WHAT WE SEE IS SOMETIMES PEOPLE LIKE EVE DIE IN OUR STREETS BECAUSE INTERVENTION DOESN'T COME QUICK ENOUGH.
RIGHT NOW, BECAUSE OF NO WRONGDOOR AND A TEAM EFFORT BY EVERYBODY AT THIS TABLE, EVE IS NOW, UM, AT THE ASH STATE HOSPITAL RECEIVING INTENSIVE CARE, UM, AND THE TREATMENT THAT SHE DESERVES AND THE TREATMENT, UH, THAT WILL GET HER INTO A LONG T- TERM STABILIZATION, UM, AREA.
AND THEN FINALLY, FROM A POLICE LEADER'S PERSPECTIVE, THIS ISN'T JUST AUSTIN, THIS IS OCCURRING IN EVERY CITY ACROSS AMERICA, WHETHER YOU'RE A LARGE CITY, A RURAL AREA, UM, THIS IS A REAL TRAGEDY, UH, IN THIS COUNTRY, AND I'VE SEEN IT FOR FAR TOO LONG, DECADES.
WHAT WE'RE TRYING TO DO, UM, IS REALLY CLOSE THESE SERVICE GAPS DOWN, UH, WITH OUR PARTNERS, AND WE'RE TRYING TO REDUCE POLICE CONTACTS BECAUSE WE KNOW THAT IF WE REDUCE POLICE CONTACTS, THEN WE'VE STOPPED THAT CYCLE AND PEOPLE ARE ACTUALLY GETTING THE HELP THAT THEY NEED.
WE REALLY ARE TRYING TO EMPHASIZE,
[01:15:01]
UH, CONTACTS WITH THE SERVICE-BASED INDU - ENT- ENTITIES INCREASING, AND THAT IS WHAT WE'RE SEEING RIGHT NOW.WE ARE SEEING EMS CONTACTS INCREASING, WE ARE SEEING OTHER SOCIAL SERVICES, INTEGRAL CARE, CENTRAL HEALTH, ALL OF THESE OTHER NETWORKS, SAFETY NETWORKS FOR THIS VULNERABLE GROUP OF PEOPLE INCREASE, AND THAT IS WHAT WE WANT.
AND I THINK MOST EXCITINGLY IS WE'RE SEEING A HIGH RATE OF PROGRAM PARTICIPATAT - PARTICIPATION.
I THINK ONE OF THE COOLEST THINGS THAT I'VE SEEN IS RIGHT NOW OUT OF THOSE 99 HIGH UTILIZERS, 40% OF THEM HAVE SIGNED INDIVIDUAL CONSENT, UH, AGREEMENTS WITH NO WRONG DOOR.
THAT MEANS THAT THEY UNDERSTAND THAT THERE'S HELP, THAT THEY CAN ACTUALLY GET HELP, THE HELP THAT THEY NEED, AND THEY WANNA BE ENGAGED WITH, UH, ALL OF THE PEOPLE UP HERE IN FRONT OF YOU TODAY TO MAKE THEIR LIVES BETTER.
AND I'M GONNA TURN IT OVER TO DR.
THANK YOU, GOOD MORNING, MAYOR PROTEMBELLA, COUNCIL MEMBERS, CITY MANAGER BRAD NEXT, PAT LEE, PRESIDENT AND CEO OF CENTRAL HEALTH.
I WANNA SPEND A FEW MINUTES TALKING ABOUT CENTRAL HEALTH'S ROLE IN THIS WORK AND THE HEALTHCARE INFRASTRUCTURE WE ARE BUILDING TO EARN THE TRUST OF OUR COMMUNITY AND SUPPORT PEOPLE BEFORE, DURING, AND AFTER A CRISIS.
JUST A FEW WEEKS AGO, OUR BOARD OF MANAGERS IN THE TRAVIS COUNTY COMMISSIONER'S QUARTER APPROVED OUR FISCAL YEAR 2027 BUDGET, WHICH INCLUDES SIGNIFICANT INVESTMENTS IN CRISIS AND RECOVERY CARE SERVICES THAT ARE CLOSELY ALIGNED WITH THE GOALS OF NO WRONG DOOR.
WE'VE BEEN USING THIS ICEBERG VISUAL TO ILLUSTRATE HOW WE THINK ABOUT THAT WORK.
SO AT THE TIP OF THE ICEBERG ARE THE PEOPLE AND THE CRISES WE SEE MOST VISIBLY, PERHAPS AROUND 950 INDIVIDUALS WITH COMPLEX MENTAL HEALTH NEEDS, SUBSTANCE USE NEEDS, PHYSICAL HEALTH AND HOUSING NEEDS WHO REPEATEDLY CYCLE AMONG EMERGENCY DEPARTMENTS, HOSPITALS, THE JAIL AND THE STREET.
AS A PRIMARY CARE PHYSICIAN, I THINK OF THOSE 950 PEOPLE AS THE MOST VISIBLE SYMPTOM OF A DEEPER UNDERLYING PROBLEM, AND CENTRAL HEALTH'S ROLE IS TO HELP ADDRESS THE ROOT CAUSES OF THE UNDERLYING PROBLEM BY BUILDING THE CARE INFRASTRUCTURE BENEATH THE WATERLINE, SERVICES THAT PREVENT CRISES WHERE POSSIBLE, RESPOND APPROPRIATELY WHEN THEY OCCUR, AND HELP PEOPLE STAY CONNECTED TO CARE AFTERWARD.
AND THAT INCLUDES $73.5 MILLION IN EXISTING CRISIS AND RECOVERY CARE INVESTMENTS THAT CENTRAL HEALTH MAKES ACROSS MENTAL HEALTH, ADDICTION TREATMENT, HOMELESSNESS, AND CARE FOR PEOPLE INVOLVED IN THE JUSTICE SYSTEM.
MUCH OF THAT WORK HAS BEEN BUILT OVER YEARS ALONGSIDE MANY OF THE PARTNERS HERE TODAY, INCLUDING INTEGRAL CARE, EMS, THE CITY, THE COUNTY, THE SOBERING CENTER, TEXAS HARM REDUCTION ALLIANCE, OUR HOUSING PARTNERS, AND OUR COMMUNITY ORGANIZATIONS.
ONE RELEVANT EXAMPLE IS OUR EXISTING PARTNERSHIP WITH EMS THROUGH OUR BRIDGE CLINIC AND STREET AND MOBILE MEDICINE TEAMS, WHICH SERVE UNHOUSED INDIVIDUALS WITH COMPLEX NEEDS IN OUR COMMUNITY.
THROUGH EMS'S COLLABORATIVE CARE COMMUNICATION CENTER, OR C4, PARAMEDICS CAN IDENTIFY THE BRIDGE CLINIC AS AN ALTERNATIVE TO TAKING THAT PATIENT TO THE EMERGENCY DEPARTMENT AND BRING ELIGIBLE PATIENTS WITH LOWER ACUITY NEEDS DIRECTLY TO OUR CLINICAL TEAM AT BRIDGE.
WE ALSO WORK WITH EMS'S COMMUNITY HEALTH PARAMEDICS WHO JOIN OUR TEAMS IN THE FIELD TO HELP COORDINATE CARE AND FOLLOW UP WITH HIGH RISK PATIENTS.
TO DO THIS WORK, EMS AND CENTRAL HEALTH CURRENTLY SHARE LIMITED CLINICAL INFORMATION AND DATA NEEDED FOR CARE COORDINATION THROUGH A SECURE HIPAA-COMPLIANT PLATFORM CALLED PULSARA, NOTABLY THAT INFORMATION IS NOT SHARED WITH LAW ENFORCEMENT.
WE ARE WORKING TOGETHER WITH OUR EMS PARTNERS TO DETERMINE HOW WE CAN DEVELOP PROCESSES LEGALLY AND RESPONSIBLY TO ENSURE WE CAN PROTECT PATIENT PRIVACY AND DIGNITY WHILE CONNECTING PEOPLE TO THE HEALTHCARE SERVICES THEY NEED.
OUR BRIDGE CLINIC AND STREET TEAMS ARE JUST ONE EXAMPLE OF THE CRISIS AND RECOVERY CARE INFRASTRUCTURE THAT WE'RE CONTINUING TO FUND AND EXPAND IN FY27.
WE ARE ALSO CONTINUING TO INVEST IN BEHAVIORAL HEALTH CRISIS CARE, INCLUDING INPATIENT PSYCHIATRIC SERVICES, COUNSELING, AND CASE MANAGER SERVICE PROVIDED MEDICAL CARE, AS WELL AS A NEW CRISIS CARE TEAM WITH TWO PSYCHIATRISTS, TWO CASE MANAGERS, AND A COUNSELOR FOCUSED ON MORE COMPLEX NEEDS.
WE'RE INVESTING IN SERVICES TO HELP PEOPLE STABILIZE AND STAY CONNECTED TO CARE AND HOUSING AFTER A CRISIS, INCLUDING OUR MEDICAL RESPITE PROGRAM, ACQUISITIONS OF CARE PROGRAM, OUR SKILLED NURSING FACILITY AND JUSTICE INVOLVED TEAMS, AND PROGRAMS THAT WORK TO GET PEOPLE CONNECTED WITH PERMANENT SUPPORTIVE HOUSING.
AND WE'RE GROWING OUR INVESTMENTS IN ADDICTION TREATMENT AND RECOVERY CARE, INCLUDING BY PROVIDING FUNDING FOR SOBERING CENTER OPERATIONS, FOR MEDICATION ASSISTED TREATMENT AND LONG-ACTING INJECTABLES AT THE TRAVIS COUNTY JAIL AND
[01:20:01]
THROUG OUR NALOXONE DISTRIBUTION PROGRAM.WE SEE NO WRONG DOOR AS AN OPPORTUNITY TO BUILD ON THESE KINDS OF COORDINATED RELATIONSHIPS AND MAKE THEM WORK TOGETHER MORE EFFECTIVELY.
ALTOGETHER, CENTRAL HEALTH IS INVESTING 127.5 MILLION IN CRISIS AND RECOVERY CARE IN FY27, ALIGNING OUR CLINICAL AND CARE COORDINATION SERVICES WITH BOTH NO WRONG DOOR AND THE COUNTY'S BROADER DIVERSION AND DEFLECTION WORK.
THIS ISSUE IS LARGER THAN ANY ONE OF US.
WITH THE CITY, THE COUNTY, AND OTHER PARTNERS COMING TOGETHER WITH THEIR OWN RESOURCES AND CAPABILITIES ALONGSIDE OURS, WE CAN DO EVEN MORE TO HELP PEOPLE AVOID REPEATED CRISES AND STAY CONNECTED TO CARE.
AT THE TOP OF THAT ICEBERG, WE, UH, NOTED 54 MILLION IN NEW MENTAL HEALTH INVESTMENTS THAT WE'RE MAKING IN THEIR TWO MAJOR AREAS WE'RE INVESTING THE MOST.
THE LARGEST COMMITMENT IS 33.1 MILLION FOR PSYCHIATRIC EMERGENCY AND INPATIENT CAPACITY, INCLUDING 10 PSYCHIATRIC EMERGENCY DEPARTMENT BAYS AND 22 INPATIENT PSYCHIATRIC BEDS.
TRAVIS COUNTY DOES NOT CURRENTLY HAVE A DEDICATED PSYCHIATRIC EMERGENCY DEPARTMENT, SO WORKING TO CLOSE THAT GAP.
WE'VE ALSO DESIGNATED 16 MILLION TOWARD ESTABLISHING A MENTAL HEALTH CRISIS CENTER WITH THE CITY, THE COUNTY, AND OTHER PARTNERS, WHICH WE HEAR ABOUT IN A MOMENT.
AND THE REMAINING INVESTMENTS HERE STRENGTHEN THE REST OF THAT SYSTEM THROUGH ADDITIONAL CRISIS CARE CAPACITY, PRIMARY CARE OF PEOPLE INVOLVED IN THE JUSTICE SYSTEM, MEDICATION ASSISTED TREATMENT, LONG-ACTING INJECTABLES, AND FUNDING FOR ADDITIONAL PSYCHIATRIC EMERGENCY SERVICES WITH OUR PARTNERS AT INTEGRAL CARE.
AND TOGETHER, ALL THESE INVESTORS ARE ABOUT CREATING MORE APPROPRIATE PLACES FOR PEOPLE TO GET CARE, MAKING IT EASIER FOR THEM TO CONNECT TO THE RIGHT CARE BEFORE A CRISIS BECOMES AN EMERGENCY.
AND WITH THAT, I'LL TURN IT OVER TO SYDNEY HARRIS, OUR SENIOR CONSULTANT FOR BEHAVIORAL HEALTH, BEHAVIORAL HEALTH, TO WALK THROUGH WHAT THAT MENTAL HEALTH CRISIS CARE SYSTEM CAN LOOK LIKE AND PRACTICE FROM THE HEALTHCARE PERSPECTIVE.
THANK YOU, MAYOR PRO TEM VELA, CITY MANAGER BRODNEX, AND COUNCIL MEMBERS APPRECIATE YOUR TIME THIS MORNING.
I'M HERE TO SHARE WHAT WE'VE BEEN WORKING WITH, WITH OUR PARTNERS FROM INTEGRAL CARE, DELL MEDICAL SCHOOL, TRAVIS COUNTY, AND MEMBERS OF THE CITY.
WE HAVE AN, AN ACCELERATED EXPANSION, UM, DR.
UH, WE'RE LOOKING TO INCREASE THE PSYCHIATRIC EMERGENCY TO 10 BEDS AND PSYCHIATRIC INPATIENT TO 22 BEDS.
UM, AND OUR PARTNERS AT INTEGRAL CARE ARE LOOKING AT WHAT THEY CAN DO AT THE HERMANN CENTER TO INCREASE TO 16 INPATIENT BEDS.
THIS IS AN ACCELERATED EXPANSION BECAUSE THE INFRASTRUCTURE OF THE CITY OF AUSTIN IS VERY MUCH NEEDED TO CREATE THE CAPACITY FOR THE MENTAL HEALTH CONTINUUM.
I THINK WE'VE HEARD OVER TIME AND TIME AGAIN THIS MORNING THAT WE NEED TO SCALE TO THE NEED OF OUR POPULATION.
UM, SO AS EVERYONE IS WORKING ON THE CURRENT SERVICES THAT ARE AVAILABLE AND EXPANDING THOSE SERVICES, WE ALSO NEED TO INCREASE THE INFRASTRUCTURE FOR THE MENTAL HEALTH AND BEHAVIORAL HEALTHCARE SYSTEM.
IN PHASE TWO, UM, YOU'VE HEARD HIGHLIGHTS OF A MENTAL HEALTH CRISIS CENTER.
THIS STEMS FROM THE WORK TRAVIS COUNTY HAS BEEN DOING SINCE 2023 ON THE ORIGINAL DIVERSION, BUT AS RESEARCH HAS INDICATED, A MENTAL HEALTH CRISIS CENTER IS, UM, WHAT WE WOULD LIKE TO SEE IN TRAVIS COUNTY, AUSTIN.
AND AS YOU CAN SEE, IT INCREASES THE PSYCH TRIAGE.
THIS IS IN ADDITION TO WHAT PHASE ONE HAS, UM, 40 ADULT BEDS, SIX YOUTH, EXTENDED OBSERVATION.
SO ONCE YOU GO INTO A FACILITY FOR TRIAGE, SOMETIMES YOU NEED TO STAY A LITTLE BIT LONGER FOR PEOPLE SUFFERING WITH MENTAL ILLNESS AND BEHAVIORAL HEALTH ISSUES.
SO WE WOULD LIKE TO SEE EXTENDED OBSERVATION, OF COURSE, SOBERING AND WITHDRAWAL, 40 RECLINERS IN 20 SINGLE ROOMS FOR DETOX, AND AN INCREASE IN OUR PSYCHIATRIC INPATIENT TO 48 BEDS FOR ADULTS AND 12 YOUTH, AND THEN CRISIS RESIDENTIAL.
SO THE MENTAL HEALTH SYSTEM, BEHAVIORAL HEALTH SYSTEM NEEDS A VERY LONG, LONG, UM, EXCUSE ME, A LONGER RUNWAY FOR INDIVIDUALS TO, UH, RETURN TO THE RECOVERY, SO THAT'S WHY YOU CAN SEE A STAGED APPROACH WITHIN A SINGLE BUILDING.
OUR PARTNERS AT TRAVIS COUNTY ARE ALSO LOOKING AT HOW DO WE CREATE A JUSTICE ANNEX THAT COULD BE POSSIBLY TIED TO THE CENTRAL BOOKING OR THE WORK THAT THEY'RE DOING, UM, WITH THE SHERIFF'S OFFICE, BECAUSE A LOT OF INDIVIDUALS DO GO INTO THE CRIMINAL JUSTICE SYSTEM WHO ARE LIVING WITH A MENTAL ILLNESS.
SO WE NEED TO MAKE SURE WE'RE PROVIDING CARE AS THEY ARE ENTERING INTO THE JUSTICE SYSTEM AND HOPEFULLY EXITING QUICKLY AFTERWARDS AND CAN BE SEEN AT THE MENTAL HEALTH CRISIS CENTER.
AND THEN PHASE THREE, AGAIN, THE RUNWAY IS LONG.
UM, SO ONCE AN INDIVIDUAL MAY LEAVE THE CRISIS CENTER OR THE JUSTICE ANNEX, WE HOPE TO SEE IN THE FUTURE A STEP DOWN WHICH CAN INCLUDE CRISIS RESIDENTIAL AND CRISIS RESPITE, AND THEN HOPEFULLY THAT INDIVIDUAL CAN RETURN TO THEIR COMMUNITY, THEIR LOVED ONES, AND RECEIVE CARE AT OUTPATIENT FOR MENTAL HEALTH, HEALTHCARE,
[01:25:01]
AND SUBSTANCE USE.UM, THIS IS, AGAIN, THE PROPOSED MENTAL HEALTH CONTINUUM FOR AUSTIN AND TRAVIS COUNTY.
IT'S A VERY HIGH LEVEL, AND I HOPE TO BE ABLE TO COME BACK AND SHARE MORE INSIGHTS ON THE WORK THAT WE'VE BEEN DOING WITH OUR PARTNERS IN THE NEAR FUTURE.
THANK YOU TO ALL THE PRESENTERS AND COMMUNITY PARTNERS HERE TODAY, UM, OUTLINING THE WORK THAT IS BEING DONE UNDER THIS NO WRONGDOER INITIATIVE AND BROADER, UM, FOR OUR CRISIS CARE ECOSYSTEM IN OUR COMMUNITY.
SO LOOKING AHEAD FOR NEXT STEPS, OUR NEXT STEPS IS TO PUT THIS INTEGRATED APPROACH INTO PRACTICE.
THIS SLIDE OUTLINES FOUR SPECIFIC WORK AREAS.
FIRST, CONTINUE CRISIS CARE INTERVENTION, FOLLOW UP AND CASE MANAGEMENT.
OUR PARTNERS WILL CONTINUE RESPONDING TO IMMEDIATE NEEDS WHILE STRENGTHENING THE CONNECTIONS THAT HELP PEOPLE REMAIN ENGAGED IN CRISIS CARE, OR IN CARE AND AFTER CRISIS.
FOLLOW UP AND CONTINUITY WILL BE ESSENTIAL TO MAKING THIS APPROACH WORK.
SECOND, MEASURE OUTCOMES AND REFINE OUR METRICS.
WE NEED TO UNDERSTAND WH- WHETHER PEOPLE ARE CONNECTING TO CARE, MAINTAINING STABILITY, AND EXPERIENCING FEWER REPEAT CRISIS AND SYSTEM CONTACTS.
AS WE LEARN MORE, WE CAN REFINE THE MEASURES TO BETTER CAPTURE BOTH INDIVIDUAL PROGRESS AND THE EFFECT ON THE SYSTEM SERVING THEM.
THIRD, ADDRESSES FUNDING AND LEGISLATION.
WE WILL IDENTIFY THE RESOURCES AND ANY LEGISLATIVE CHANGES NEEDED TO SUPPORT THE CARE CONTINUUM AND BRING THOSE NEEDS FORWARD THROUGH THE APPROPRIATE CHANNELS.
THAT INCLUDES UNDERSTANDING THE CAPACITY REQUIRED TO SUSTAIN THIS WORK.
FOURTH IS TO REPORT AND RECALIBRATE.
WE'LL USE THE RESULTS AND THE EXPERIENCE OF OUR PARTNERS TO ASSESS WHAT IS WORKING, IDENTIFY GAPS, AND ADJUST THE APPROACH.
THOSE FINDINGS WILL ALSO HELP INFORM FUTURE UPDATES TO COUNCIL.
THE DIRECTION IS TO ORGANIZE OUR COLLECTIVE RESPONSE AROUND THE INDIVIDUAL WITH CLEAR COORDINATION AND CONTINUITY FROM CRISIS RESPONSE THROUGH ONGOING CARE.
THAT IS HOW WE CAN HELP PEOPLE ACHIEVE GREATER STABILITY WHILE REDUCING REPEATED DEMANDS ACROSS OUR SYSTEMS. SO I APPRECIATE ALL OF YOUR TIME AND ATTENTION.
I KNOW THIS WAS A LOT OF INFORMATION PROVIDED, AND I WANNA THANK YOU FOR YOUR CONTINUED ATTENTION TO THIS WORK, AND WE WELCOME YOUR QUESTIONS.
THANK YOU, UH, VERY MUCH TO, UH, MR. KINGHAM AND TO ALL OF THE, UH, PRESENTERS.
IT IS A LOT OF, UH, INFORMATION TO, UH, DIGEST, UH, TO THROW A LITTLE MORE INFORMATION ON THERE.
I JUST ALSO WANTED TO MENTION THAT, UH, THE STAFF PUT OUT A MEMO ON, UH, NO WRONG DOOR JUST A FEW DAYS AGO, I THINK, UH, OCTOBER 1ST, THAT HAS ADDITIONAL, UH, BACKGROUND FOR, FOR THOSE THAT ARE, UH, LISTENING AND, AND WATCHING AND FOLLOWING.
UM, AND THEN FINALLY, I JUST WANTED TO THANK, UH, DR.
LEE AND CENTRAL HEALTH IN PARTICULAR BECAUSE THEY'VE MADE A VERY BOLD, UH, INVESTMENT, UH, IN MENTAL HEALTH SERVICES IN, UH, SUBSTANCE ABUSE, UH, AND I, I REALLY, UH, APPRECIATE THAT, THE LEADERSHIP FROM, FROM YOURSELF, FROM YOUR BOARD, FROM, UH, YOUR TEAM, UH, UH, IT'S, UH, IT'S GREAT, AND WE WANNA PARTNER WITH YOU TO, TO ADDRESS, UH, THESE ISSUES.
AND AGAIN, BUSINESS AS USUAL, IT'S, IT'S JUST NOT GONNA, THAT'S NOT GONNA WORK.
THE STATUS QUO IS, IS NOT, UH, SUSTAINABLE.
AND WITH THAT, I'LL, I'LL, UH, UH, COUNCIL MEMBER CAUDRY.
UH, THANK YOU, UH, MAYOR PROTEM.
UM, I, I WANNA THANK, I WANNA KINDA KICK THIS, KICK THIS OFF BY, BY THANKING THE PRESENTERS THAT APPRECIATE Y'ALL AND THE PRESENTATION AND EVERYTHING THAT Y'ALL DO.
UH, I ALSO WANNA THANK A LOT OF THE OTHER SPEAKERS FROM, FROM OTHER AGENCIES WHO DO A LOT OF WORK ON THE GROUND, UH, HELPING OUR UNHOUSED COMMUNITY.
YOU KNOW, ONE OF THE REASONS I DECIDED TO GET INTO THIS SPACE TO BEGIN WITH WAS TO MAKE A, A VISIBLE DIFFERENCE, A REAL DIFFERENCE IN, IN HELPING OUR, OUR UN-HOUSE COMMUNITY.
UH, SO THAT'S SOMETHING THAT'S REALLY NEAR AND DEAR TO ME.
WHEN, WHEN THE NO WRONG DOOR, I GUESS, CONCEPT CAME TO BE, I WAS REALLY EXCITED ABOUT IT.
UM, YOU KNOW, I BELIEVE WHAT IT COULD DO, WHAT IT CAN BE, UH, BUT, BUT I WANTED TO ASK SOME QUESTIONS ON SOME OF THE COMMENTS THAT HAVE BEEN MADE BY SOME OF THE SPEAKERS TODAY, UM, AND THEN I KNOW MANY OF US, IF NOT ALL OF US ON THE COUNCIL HAD GOTTEN, UH, A LETTER FROM THE ACLU OF TEXAS, UM, AND IT WAS SI- SIGNED ON BY OTHER AGENCIES, SO I WANTED TO ALSO ASK QUESTIONS ABOUT, ABOUT THAT AS WELL.
UH, BUT TO KIND OF KICK IT OFF, I, I WANTED TO ASK, IT WAS, I THINK IT WAS MENTIONED BY A SPEAKER TODAY, WHAT IS THE INVOLVEMENT OF THE CICERO INSTITUTE AND, AND NO WRONG DOOR? SO THERE, THERE IS NO INVOLVEMENT WITH THAT INSTITUTE WITH NO WRONGDOOR.
SO THERE'S, THERE'S NO, THERE'S NO COLLABORATION, THERE'S NO MEETINGS THAT TAKE PLACE, NOTHING OF THAT SORT? THE, THEY, THEY ARE NOT IN THE ORGANIZATION AND
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DESIGNING PROCESS FOR NO WRONG DOOR, THE SERVICES THAT ARE BEING PROVIDED.I THINK WE HAVE COMMENT BY DIRECTOR GRAY.
COUNCILMEMBER DAVID GRAY, UH, GOOD TO SEE YOU.
UM, MAYBE LET ME, MAYBE CLARIFY.
I THINK AS DIRECTOR KINGHAM MENTIONED, CICERO INSTITUTE HAS NOT BEEN INVOLVED IN NO WRONG DOOR.
I THINK WHERE LINES ARE GETTING CROSSED IS OUR OFFICE HAS MADE IT, UH, AN INTENTIONAL EFFORT TO ENGAGE WITH MULTIPLE FOLKS FROM MULTIPLE ORGANIZATIONS TO TALK ABOUT OUR HOMELESS STRATEGY AND WORK THAT WE'RE DOING AS A CITY AND AS A COMMUNITY TO ADDRESS UNSHELTERED HOMELESSNESS.
AS WE THINK ABOUT THE CONTEXT THAT WE'RE IN, BEING IN THE STATE OF TEXAS AND KNOWING THAT WE HAVE AN UPCOMING LEGISLATIVE SESSION, WE KNOW IT'S IMPORTANT TO DEMONSTRATE TO OUR STATE LAWMAKERS AND THEIR STAFF THAT THE CITY OF AUSTIN IS HAVING AN, A POSITIVE IMPACT IN HELPING PEOPLE GET OFF THE STREET AND INTO HOMELESSNESS.
SO AS PART OF OUR OFFICE'S WORK, WE DO MEET WITH ORGANIZATIONS LIKE CICERO AND TPPF, JUST LIKE WE MEET WITH ORGANIZATIONS LIKE VOCAL TEXAS AND THRA.
WE DO NOT DISCOUNT PEOPLE BECAUSE OF THEIR POLITICAL IDEOLOGIES OR AFFILIATIONS.
WE BELIEVE IT IS OUR JOB TO MEET WITH ANYBODY AND EVERYBODY WHO WANTS TO DO THIS WORK, UH, AND DO THIS WORK IN GOOD FAITH.
AND SO I, I APPRECIATE THE QUESTION, BUT I ALSO JUST WANNA BE VERY CLEAR THAT NO WRONG DOOR HAS BEEN CHAMPIONED BY MY COLLEAGUES SITTING O- ON THIS DAIS WITH ME AND THE ORGANIZATIONS WHO YOU SAW REPRESENTED, UH, ON THE, THE SLIDE WITH ALL OF OUR PARTNERS.
UH, AS FOR ANY MEETINGS WITH CICERO AND TPPF THAT OUR AGENCY IS HAVING, THOSE ARE AN OPPORTUNITY FOR US TO EDUCATE THEM ON THE WORK THAT WE'RE DOING SO THAT THEY COULD HELP BE CHAMPIONS, UH, FOR SOME OF THE CAUSES THAT WE, WE ARE WORKING UP TOWARDS, UH, BUT ALSO AN OPPORTUNITY FOR US TO LISTEN AND UNDERSTAND THEIR PERSPECTIVE.
AND WHERE THERE ARE OPPORTUNITIES FOR US TO DO WORK TOGETHER, WE WILL DO THAT WORK TOGETHER JUST LIKE WE DO WITH ANY OTHER ORGANIZATION THAT WE MEET WITH.
AND THEN WHAT I WAS GONNA ASK NEXT IS GROUPS LIKE VOCAL TX, UH, TEXAS HARM REDUCTION ALLIANCE, UM, ACLU OF TEXAS, THIS GROUP IS COMMITTED TO, TO MEETING WITH THOSE GROUPS AS WELL.
UM, AND, AND THEN I WANTED TO ASK A FEW QUESTIONS THAT ARE RELATED TO THE, THE LETTER THAT WE GOT FROM THE ACLU, ACLU OF TEXAS.
UM, THERE ARE SEVERAL BULLET POINTS.
I, I, I DON'T WANNA GO THROUGH ALL OF THEM.
I THINK MY COLLEAGUES MIGHT, MIGHT HAVE FURTHER QUESTIONS ON THAT.
BUT THERE WAS, UH, THREE, THREE POINTS THAT I, THAT I KINDA WANTED TO, TO DIVE INTO AND, AND GET CLAR- CLARITY ON.
UH, AND ONE OF THEM IT SAYS NO WRONGDOOR SELECTS PEOPLE BY THEIR ARREST RECORDS, UM, WHICH MEASURE CONTACT WITH POLICE RATHER THAN THEIR HEALTH NEEDS.
UM, COULD, COULD SOMEONE COMMENT ON THAT? YOU WANT ME TO TAKE THAT ONE ALSO PLEASE? SURE.
SO I CAN, I, I'LL START WITH THAT ONE.
UH, AND SO WH- WHEN WE, AS A, AS A GROUP OF, OF COLLABORATORS PUT TOGETHER THE INITIAL HIGH UTILIZER LIST, WHAT WE ENDEAVORED TO DO WAS LOOK AT INDIVIDUALS WHO HAVE THE MOST FREQUENT POINTS OF CONTACT WITH THE CRIMINAL JUSTICE SYSTEM, THE HEALTHCARE SYSTEM, AND THE HOMELESS RESPONSE SYSTEM.
SO IT IS TRUE THAT WE WORKED WITH THE AUSTIN POLICE DEPARTMENT AND THEIR DATA ANALYSTS TO UNDERSTAND WHO ARE THE INDIVIDUALS IN OUR COMMUNITY THAT ARE HAVING MULTIPLE REPEATED CONTACTS WITH APD.
IN SOME INSTANCES, FOLKS WHO'VE RECEIVED UPWARDS OF A DOZEN POLICE OFFICER EMERGENCY DETENTIONS IN LESS THAN A 48-HOUR PERIOD, SO SUPER HIGH UTILIZERS.
WE ALSO WENT THROUGH A SIMILAR EXERCISE WITH OUR HEALTHCARE PARTNERS OVER AT AUSTIN TRAVIS COUNTY EMS, AS WELL AS THE FIRE DEPARTMENT.
YOU SAW SOME EXAMPLES OF THAT DATA REPRESENTED TODAY.
AND THEN WHEN WE ACQUIRED THAT INFORMATION FROM OUR PUBLIC SAFETY PARTNERS, WE THEN WORKED WITH ECHO TO CROSS-REFERENCE THAT LIST WITH INDIVIDUALS WHO ARE IN OUR HOMELESS RESPONSE SYSTEM IN OUR HMIS DATABASE TO COME UP WITH THE LIST OF FOLKS WHO WE CAN S - CAN AFFIRMATIVELY SAY THROUGH REAL DATA ARE ACTUALLY CYCLING THROUGH THE PUBLIC SAFETY SYSTEM, THE HEALTHCARE SYSTEM, AND THE HOMELESS RESPONSE SYSTEM.
SO THE BOTTOM LINE IS THAT THE, THE LIST IS A CONSTELLATION OF DIFFERENT LISTS.
ONE OF THE CHALLENGES THAT HAS MADE THAT EXERCISE SO DIFFICULT IS THAT HISTORICALLY OUR AGENCIES DO NOT SHARE DATA AND INFORMATION.
UH, THERE'S SOME LEGAL REASONS WHY WE CAN'T AND, AND HAVE NOT BEEN ABLE TO DO THAT.
THERE'S ALSO CLIENT PRIVACY REASONS.
UH, AND SO A BIG PART OF THE WORK HAS BEEN FIGURING OUT HOW CAN WE SHARE DATA ABOUT CLIENTS WHO WE ARE SEEING CYCLE THROUGH OUR SYSTEM WITH THE SOLE PURPOSE OF FIGURING OUT HOW WE BREAK THE CLIENTS OUT OF THOSE CYCLES.
SO THE BOTTOM LINE, SIR, IS, IS THAT YES, APD DATA IS USED, BUT SO
[01:35:01]
IS HEALTHCARE DATA AND HOMELESS RESPONSE DATA.UM, UH, ANO- ANOTHER POINT THAT WAS MADE WAS THAT NO WRONGDOOR SH- SHARES SENSITIVE INFORMATION WITH POLICE AND PROSECUTORS WITH NO ASSURANCE THAT IT'LL STAY OUT OF CRIMINAL PROCEEDINGS.
I AM NOT AWARE OF US SHARING SENSITIVE DATA WITH, UH, PROSECUTORS OR ANYONE ELSE.
WE'VE BEEN VERY GOOD, UM, ENSURING THAT WE ARE ALL IN COMPLIANCE WITH THE CGICS ARE, UH, LAWS THAT, UH, GOVERN, UH, THE DATA THAT COMES OUT OF THE POLICE DEPARTMENT.
UM, BUT I CAN GUARANTEE YOU THAT THE, THE TOP 99 ON THAT LIST HAVE A STRONG OVERLAP WITH MANY OF THE PEOPLE THAT YOU SEE UP IN FRONT OF YOU, UH, RIGHT NOW.
AND THEN, AND THEN MY LAST POINT OF CLARIFICATION FROM THE LETTER, UH, IT, IT TALKED ABOUT HOW APD APPROACHES PEOPLE IN JAIL WITHOUT NOTIFYING THEIR LAWYERS AND ASKING THEM TO SIGN DOCUMENTS THAT AFFECT, UM, THEIR LEGAL INVOLVEMENT.
AUSTIN POLICE OFFICERS DO MEET PEOPLE IN JAIL.
UM, WE MEET PEOPLE IN JAIL, ESPECIALLY WITH THE NO WRONGDOOR, BECAUSE THIS IS A, UH, MAYBE THE ONLY OPPORTUNITY THAT WE GET, UM, TO PROVIDE SERVICES BEFORE THEY GO BACK INTO THAT VICIOUS CYCLE THAT WE ALL TALKED ABOUT.
AND THE OFFICERS, UM, ARE TRYING TO MEET THEM EITHER WHEN THEY ARE EXITING THE JAIL SYSTEM OR WHILE THEY'RE THERE TO OFFER SERVICES, UH, HOUSING, UH, SUBSTANCE ABUSE, WHAT, WHATEVER THEY NEED.
AND THE ONLY, UM, THE MAJORITY OF THE INDIVIDUAL CONSENT, UH, UH, P - UH, UH, REPORTS, THAT IS THE PAPERWORK THAT WE'RE TRYING TO SEEK SIGNATURE ON, UH, JUST SO THEY CAN GET THE SERVICES THEY NEED.
BUT POLICE, WE ARE M- MEETING PEOPLE IN THE JAIL SYSTEM TO TRY TO PROVIDE SERVICES FOR THIS HIGH UTILIZER GROUP.
SO THE ONLY DOCUMENTS THEY SIGN ARE, ARE DOCUMENTS ABOUT, ABOUT CONSENT? IS THAT WHAT YOU'RE, IS THAT WHAT YOU'RE ANSWERING? CORRECT.
AND, AND ARE, ARE, ARE LAWYERS PRESENT FOR, FOR THEM WHILE THEY'RE DOING THIS PROCESS? WE HAVE PUT GUARDRAILS ON THAT PROCESS.
UM, OUR OFFICERS, UH, HAVE JUST CHANGED THEIR STANDING OPERATING PROCEDURES TO MAKE EVERY EFFORT TO NOTIFY, UH, ATTORNEYS THROUGH, UH, THROUGH, UH, PHONE, THROUGH EMAIL.
BUT WE TRY OUR, OUR DARNEDEST TO GET, UH, AN ATTORNEY INVOLVED, UH, WITH THIS BECAUSE I KNOW THAT THEY OFFER A LOT OF SERVICES, UH, THAT ARE VERY BENEFICIAL TO THE NO WRONG DOOR PROGRAM.
WELL - COUNCIL MEMBER CONCHIE, IF I COULD JUST ADD SOMETHING TO THAT REALLY QUICKLY, SORRY.
UM, THE COUNTY'S SENSITIVE TO THESE ISSUES AND WE LOOK FORWARD TO THE REFINEMENT OF NO WOR - NO WRONGDOOR PROCESSES TO ENSURE THAT PEOPLE ARE NOT UNINTENTIONALLY HARMED BY THE, THE GOODWILL OF THIS PROGRAM, UM, AND THAT CIVIL LIBERTIES ARE NOT UNINTENTIONALLY VIOLATED.
SO COUNTY HAS RESPONSIBILITY TO PROSECUTE, DEFEND, WE RUN THE JAIL, WE RUN THE COURTS.
UM, IT'S REALLY IMPORTANT TO GET THIS RIGHT.
AND SO WE DO APPRECIATE THE COMMENTS FROM ACLU AS, AS WELL AS SOME OF THE PUBLIC DEFENDERS THAT TESTIFIED EARLIER.
UM, AND WE WELCOME ANY WAY TO ENSURE THAT THERE ARE THOSE PROTECTIONS AND THAT WE DON'T HAVE TO HAVE ONGOING CONCERNS ABOUT PROGRAM DESIGN.
YEAH, AND I, I APPRECIATE THOSE COMMENTS.
WE, WE WANNA MAKE SURE WE GET THIS RIGHT, THAT WE'RE ABLE TO HAVE, YOU KNOW, WHATEVER REFINEMENTS LOOK LIKE AND MAKE SURE WE HAVE THE GUARDRAILS WHERE IT'S DOING ITS JOB, BUT WE'RE NOT, WE'RE ALSO PROTECTING PEOPLE AND WE'RE, WE'RE TAKING CARE OF PEOPLE AND WE'RE NOT GIVING UP OUR VALUES.
UM, SO, UH, THANK YOU FOR, FOR TAKING MY TIME.
UM, CAN Y'ALL OUTLINE SOME OF THE SPECIALIZED TRAINING THAT OUR OFFICERS, UH, GO THROUGH THAT ARE, UH, AS PART OF NO WRONG DOOR? ABSOLUTELY.
I WOULD SAY THIS IS, UH, AN ELITE GROUP OF NO WRONG DOOR OFFICERS, UH, SPECIFICALLY TRAINED IN CRISIS INTERVENTION AND SPECIFICALLY TRAINED BY INTEGRAL CARE.
I, I WOULD PUT THIS GROUP OF OFFICERS UP IN FRONT OF ANYBODY IN THE CITY DOING THIS WORK.
UH, THEY UNDERSTAND THE DYNAMICS AT PLAY.
THEY UNDERSTAND THE COMPLEXITY OF THE WORK.
THEY RECEIVE 40 HOURS OF CRISIS INTERVENTION TRAINING.
BUT IMAGINE THIS, THESE ARE, THESE ARE THE SAME OFFICERS THAT ARE DOING THE HOST PROGRAM.
SO THEY'RE BEING TRAINED IN, UH, WITH DAVID GRAY'S GROUP.
UH, THEY ARE WORKING WITH THE CARE UNIT AS WELL.
THIS IS A GROUP OF OFFICERS THAT HAVE VOLUNTEERED TO DO THIS TYPE OF WORK.
UH, SOME OF THEM ARE CLINICIANS THEMSELVES THAT HAVE A LONG HISTORY OF WORKING IN THIS AREA.
UM, SO I WOULD SAY THEY'RE THE, THE, THE BEST OF THE BEST AS IT RELATES TO WORKING WITH THIS VULNERABLE AND COMPLEX POPULATION THAT WE'RE ALL DISCUSSING TODAY.
AND COUNCIL MEMBER VELASQUEZ, I WOULD, UH, POINT OUT, THERE ARE ADDITIONAL SLIDES THAT ARE AVAILABLE, UM, TO THE PRESENTATION THAT OUTLINE THE SPECIFIC TRAININGS FOR, UH, UM, A, A LOT OF THE PARTNERS
[01:40:01]
FOR NO WRONG DOOR, INCLUDING OUR PUBLIC SAFETY PARTNERS.UM, WHAT OTHER CITIES, COUNTIES, OR ORGANIZATIONS HAS THE CITY REACHED OUT TO SEEKING ADVICE OR SUPPORT ON THE NO WRONG DOOR INITIATIVE AND WHAT ARE THE S - THE KEY TAKEAWAYS FROM THOSE ENGAGEMENTS? DAVID, UH, UH, DIRECTOR GRAY, IF YOU COULD TAKE THAT, PLEASE.
UH, COUNCIL MEMBER, NO WRONG DOOR IS A, IS A NEW CONCEPT TO THE CITY OF AUSTIN, BUT FORTUNATELY THERE ARE PEER CITIES THAT HAVE SIMILAR MODELS, UH, THAT THEY DELIVER.
UH, FOR EXAMPLE, I KNOW THAT THERE WAS A COALITION OF FOLKS C - FROM, UH, TRAVIS COUNTY, CITY OF AUSTIN, INCLUDING APD, UH, AND A FEW OTHERS WHO HAD THE PRIVILEGE OF TRAVELING TO SALT LAKE CITY, UH, AND SEEING HOW THEIR CITY OPERATES A MODEL SIMILAR TO NO WRONG DOOR, AS WELL AS A CRISIS CARE CENTER SIMILAR TO THE ONE THAT, UH, CENTRAL HEALTH AND OTHER PARTNERS ARE PROPOSING FOR, FOR HERE IN THIS COMMUNITY.
UH, AND SO WE, WE'VE DONE A, A LOT OF RESEARCH, BOTH SITE VISITS AS WELL AS SOME KIND OF ACADEMIC RESEARCH, LITERATURE REVIEWS ON WHAT'S GOING ON IN OTHER COMMUNITIES.
UH, OBVIOUSLY EVERY COMMUNITY IS DIFFERENT.
AND SO OUR GOAL, WHETHER WE'RE TALKING ABOUT THIS PROGRAM OR ANY OTHER PROGRAM THAT WE DO IN THIS SPACE, IS TO FIGURE OUT HOW WE TAKE THE LESSONS AND THE PRACTICES FROM THOSE OTHER COMMUNITIES AND HYPER-LOCALIZE IT TO AUSTIN'S SPECIFIC CONTEXT.
AND THAT, THAT'S EXACTLY THE WORK THAT WE'VE DONE, UH, WITH THIS PROGRAM.
AND, AND I WOULD ALSO ASK ASSISTANT CHIEF HAROLD TO PROVIDE CONTEXT ABOUT HER WORK IN BOULDER, WHICH I- INCLUDES A LOT OF ELEMENTS AND SIMILAR- SIMILARITIES WITH NO WRONG DOOR.
UH, WE DID, WE DID HAVE A VERY SIMILAR PROGRAM IN BOULDER, COLORADO.
I WAS THE CHIEF THERE, UM, AND, UH, WAS VERY SIMILAR.
AND I, I WILL SAY THE HARDEST THING AT THAT TIME, WE'RE ALMOST AT FIVE YEARS AGO, UH, SINCE I WAS A CHIEF, WAS GETTING A DISPARATE GROUP OF MULTIDISCIPLINARY TEAMS TO SIGN THE MOU, WHICH WE DID IN BOULDER.
AND I THINK I'M PROUD OF THAT WORK BECAUSE I THINK WE WERE ONE OF THE FIRST CITIES IN THE COUNTRY TO ACCOMPLISH THAT.
UM, AND SO OUR, OUR PROGRAM STILL LIVES TODAY IN BOULDER.
UM, THEY HAVE S- SINCE I LEFT, GOTTEN THROUGH THEIR S - 60 HIGHEST UTILIZERS AND FOUND LONG-TERM SOLUTIONS FOR EACH OF THOSE CLIENTS.
UM, AND I RECENTLY CALLED BACK AND VISITED BOULDER, UH, JUST TO SEE THE IMPACT OF THEIR PROGRAM, UM, IN BOULDER.
AND I CAN TELL YOU WITH THE, WITH THE PROGRAM SIMILAR TO WHAT WE'RE DOING IN AUSTIN, PLUS THEY HAVE A TWENTY FOUR SEVEN CRISIS CARE CENTER NOW FOR THEIR UNHOUSED, WHICH HAS PROVED TO BE, UH, SO POSITIVE.
UM, AND I'M PROUD OF THE WORK THAT WE DID HERE.
AND THERE'S LITTLE DOUBT IN MY MIND THAT WITH THE PLAYERS THAT WE HAVE, WE'LL HAVE THE SAME SUCCESS BOULDER, COLORADO HAD, ESPECIALLY IF WE KEEP THE VISION AS, UM, GETTING A TWENTY FOUR SEVEN, UM, CRISIS CENTER, UH, THAT WE CAN ALL UTILIZE FOR SOME OF THESE HARDEST TO REACH, UH, COMMUNITY MEMBERS.
UM, UH, A YEAR AGO, WE, THE CITY LAUNCHED, UH, THE AUSTIN FIRST PILOT, A PARTNERSHIP BETWEEN APD, EMS, INTEGRAL CARE, AND THE OFFICE OF THE CHIEF MEDICAL OFFICER TO SUPPORT OUR, UH, HIGH ACUITY MENTAL HEALTH INCIDENTS.
WHAT HAVE WE LEARNED FROM THAT PILOT AND HOW IS THAT BEING INCORPORATED INTO NO WRONG DOOR? CHIEF LUKRITZ, CAN YOU PLEASE RESPOND? THE ELEMENTS OF AUSTIN FIRST, UM, AS WE WENT THROUGH THAT PILOT, YOU KNOW, WE'VE IDENTIFIED THAT, UH, THAT THERE WERE SUCCESSES IN THAT PROGRAM.
UM, IT, IT IS A SEPARATE PROGRAM FROM WHAT WE DO HERE WITH NO WRONG DOORS.
UM, YOU KNOW, THERE IS A LOT OF OVERLAP BETWEEN, UH, THE INDIVIDUALS THAT ARE INVOLVED.
AND SO WE'RE STILL KIND OF EXPLORING WHAT THAT'S GONNA LOOK LIKE FOR US, UM, IN ORDER TO MAXIMIZE THE, UM, THE TIME, UH, A- AND, AND STAFFING UTILIZATION ACROSS APD, ACROSS THE EMS, AND ACROSS INTEGRAL CARE.
SO I THINK THERE'S STILL PROBABLY MORE ANALYSIS TO BE DONE AND MORE TO, MORE TO COME BACK TO YOU WITH ON THAT.
UH, AND, UH, ONE OF THE SLIDES THAT TOUCHED ON LEGISLATION THAT WE'LL BE PUTTING, I GUESS, BEFORE THE, THE, UH, THE STATE.
OUR PARTNERSHIPS WITH THE STATE ARE CRITICAL FOR THIS INITIATIVE, AND I WAS CURIOUS HOW MANY PIECES OF LEGISLATION WE'RE CURRENTLY WORKING ON AND HOW MUCH, UH, INPUT WILL THE COUNCIL HAVE ON THAT.
OUR, OUR DIR - OUR LEGISLATIVE DIRECTOR IS COMING UP.
THANK YOU, COUNCIL MEMBER CARRIE ROGERS.
FOR THE RECORD, LEGISLATIVE DIRECTOR.
TANGLED UP IN A BAG DOWN HERE.
UM, YES, THERE ARE, IN THE APPENDIX, THERE'S A SLIDE THAT REFERS TO A, A NUMBER OF THE LEGISLATIVE INITIATIVES THAT WE'VE BEEN TALKING ABOUT WITH OUR PARTNERS.
[01:45:01]
TO THE VERY BEGINNING OF, UM, THE WORK AND TRYING TO IDENTIFY OUR HIGHEST UTILIZERS AND HOW WE COULD HELP THEM, THE GOVERNMENT RELATIONS OFFICE HAS SORT OF BEEN SHADOWING THAT PROCESS TO IDENTIFY, UM, WHAT WERE THE GAPS, WERE THERE LEGISLATIVE REMEDIES THAT MIGHT BE NEEDED TO ADDRESS SOME OF THESE NEEDS? AND THEN OF COURSE, WORKING WITH OUR PARTNERS AT INTEGRAL CARE AND CENTRAL HEALTH AND THE COUNTY ON WHAT THEIR INTERESTS WERE IN PURSUING, UM, DURING THE NEXT LEGISLATIVE SESSION.UM, WE ALL, WHAT I'VE SEEN IS WE ALL HAVE HAD A VERY STRONG INTEREST IN SUPPORTING OUR, UM, MENTAL HEALTH POPULATION.
UM, I THINK THERE WAS SOMETHING MENTIONED FROM MAYOR PRO TEM, UH, VELA OVERNIGHT REGARDING A BILL THAT REPRESENTATIVE HOWARD WAS PLANNING TO BRING FORWARD IN THE NEXT SESSION.
SO, SO WHAT YOU SEE ON THAT SLIDE, AND I THINK IF, AND I DON'T KNOW IF THEY HAVE IT UP, UM, UM, IF IT'S SOMEWHERE IN THE SLIDE DECK THAT THEY CAN PULL UP, BUT ON THE TOP OF THAT SLIDE ARE ITEMS THAT WE'VE TALKED WITH OUR PARTNERS, WE AGREE, "HEY, THESE ARE THINGS WE WANNA MOVE FORWARD WITH." UM, THEY COULD BE IN STANDALONE BILLS, IT COULD BE IN ONE LUMP BILL, WE'RE STILL NAVIGATING THAT.
UM, AS YOU ALL KNOW, IT'S A VERY DYNAMIC PROCESS, UM, UH, ON BILLS.
AND THEN THE LOWER PART ARE ADDITIONAL CONSIDERATIONS THAT WE'RE STILL TALKING THROUGH WITH OUR PARTNERS.
I THINK ONE OF THEM IS PURSUING FUNDING FOR THE 988 SUICIDE HOTLINE.
UM, 988 FOR THE SUICIDE HOTLINE, UM, UH, SUPPORTING, UH, REGIONAL PSYCH BED, UM, AVAILABILITY, UM, FOR THOSE PARTNERS HERE WHO ARE CALLING AROUND AND TRYING TO FIND PROPER PLACEMENT FOR HIGH ACUITY FOLKS AS OPPOSED TO THOSE MANUAL CALL TREES THAT THEY'RE DOING RIGHT NOW.
UM, AND THEN ALSO SUPPORTING, UH, FUNDING, UM, AND EXPANSION OF OUR STATE SUPPORTED LIVING CENTERS, WHICH ARE REALLY TARGETED AT, UM, ADULTS WHO WERE DIAGNOSED WITH IDD, OR EXCUSE ME, UH, INTELLECTUAL DEVELOPMENT, UH, DISEASE BEFORE THEY WERE 18, THAT THEY'RE ALWAYS GOING TO NEED CARE.
SO IT'S REALLY A CONTINUUM, KIND OF A MENU OF THINGS THAT WE'RE WORKING THROUGH RIGHT NOW, AND NOTHING IS, IS FINAL AT THIS POINT.
THANK Y'ALL, AND THANK Y'ALL FOR THIS.
UM, THAT'S IT, UH, MAYOR PRO TEM.
THANK YOU, MAYOR PRO TEM AND, AND EVERYONE FOR YOUR PRESENTATION.
UM, I'M GONNA HAVE SOME QUESTIONS.
I WANNA ASK, UH, MR. BRADLEY HARGIS TO COME BACK UP, UH, FROM CAPITAL AREA PUBLIC DEFENDER SERVICE, IF ONE OF Y'ALL CAN MAKE ROOM.
UH, DIRECTOR ROGERS, IF YOU WOULDN'T MIND STAYING, UH, AND, UH, ASSISTANT DIRECTOR HAROLD, I HAVE QUESTIONS FOR YOU AS WELL.
AND SO, UM, MR. ROGERS, THANK YOU SO MUCH FOR BEING HERE TODAY.
I WAS OFF THE DAIS WHEN YOU PRESENTED EARLIER, BUT, UM, REALLY APPRECIATE YOUR TESTIMONY AND HAD A FEW FOLLOW-UP QUESTIONS.
UM, CAN YOU SAY MORE ABOUT THIS STATEMENT THAT YOU MADE THAT THERE HAVE BEEN QUOTE, ATTEMPTS TO RELEASE CLIENTS DIRECTLY TO OFFICERS AGAINST THEIR WISHES? UH, YEAH.
I MEAN, WE HAVE SEVERAL EXAMPLES.
I'LL MENTION AS DETAILED THE MOST RECENT ONE, WHICH WAS ON THURSDAY.
UH, WE INTERCEPTED AT THE COURT PROCESS A REQUEST, UH, COMING FROM A NO WRONG DOORS OFFICER TO HAVE A BOND CONDITION PLACED ON A CLIENT TO, UM, BE RELEASED ONLY TO THE NO WRONG DOORS OFFICER.
SO IT WOULD MAKE IT A CONDITION OF, OF THE BOND FOR THE PERSON BEING RELEASED TO JAIL, THAT THEY GO WITH THE NO WRONG DOORS OFFICER, UM, TO WHATEVER PLACE THAT OFFICER WAS WORKING TO TRY TO FIND A LOCATION FOR THEM.
THAT PARTICULAR CLIENT, OUR CASE WORKERS ACTUALLY MET WITH AND KNEW WE HAD AN EXISTING RELATIONSHIP.
THAT, UM, CLIENT WOULD NOT HAVE AGREED TO GO WITH THAT OFFICER.
IT WOULD NOT HAVE BEEN A GOOD, UH, EXPERIENCE FOR EITHER THE OFFICER OR THE CLIENT.
SHE WAS ADAMANT SHE WOULD NOT GO.
THE COURT, UM, FOUND THAT TO BE A TOTALLY INAPPROPRIATE REQUEST AND DIDN'T GRANT IT.
WE HAVE SINCE WORKED OUT, UM, A TREATMENT BED FOR HER, AND SHE HAS AGREED TO GO VOLUNTARILY.
AND OUR TREATMENT TEAM, OUR, OUR, UM, OUR CASE MANAGEMENT TEAM THAT HAS A RELATIONSHIP WITH HER IS TRANSPORTING HER.
UM, YOU KNOW, THAT WAS JUST THE MOST RECENT EXAMPLE.
WE'VE GOT OTHERS OF BOND CONDITION REQUESTS WHERE THE, THE OFFICERS HAVE CONTACTED THE COURTS DIRECTLY TRYING TO HAVE BOND CONDITIONS IMPOSED ON CLIENTS.
AND I, I COULD GO ON, BUT I WANNA RESPECT THE COUNCIL'S TIME.
WELL, UH, COULD YOU SHARE A LITTLE BIT MORE ABOUT HOW CAPITAL AREA PUBLIC DEFENDER SERVICE AND MAYBE THE PUBLIC DEFENDER'S OFFICE HAVE BEEN INVOLVED IN RO WRONGDOOR? THAT'S ACTUALLY BEEN THE MOST FRUSTRATING PART FOR US.
UM, WE FIRST LEARNED OF THE PROGRAM IN APRIL, UM, WHEN WE WERE ALERTED BY THE COURT OF AN OUTREACH, UM, FROM OFFICERS REQUESTING BOND CONDITIONS.
UM, YOU KNOW, WE ENGAGED, UH, WITH THE PROGRAM TO TRY TO FIND OUT MORE ABOUT IT.
I'M SURE THAT THEY WILL HAVE SOME ANSWERS FOR YOU IN A MOMENT AS WELL.
UM, FROM OUR PERSPECTIVE, WE'VE, WE'VE WORKED HARD TO TRY TO GET, UM, OUR CONCERNS ADDRESSED, TO BE INVITED TO JOIN THE MOU, TO BE ABLE TO PARTICIPATE
[01:50:01]
FULLY TO HAVE OUR CONCERNS ADDRESSED.UM, SO FAR TO THIS TIME, MOST RECENTLY IN THE LAST FEW DAYS, WE'VE BEEN TOLD THAT SINCE WE ARE NOT A SIGNATORY ON THE MOU, UM, AND THE DATA SHARING AGREEMENT WILL NO LONGER BE ALLOWED AT STAFFINGS OF OUR CLIENTS.
UM, AND SO I THINK THERE'S A REAL CHALLENGE TO US BEING INVOLVED.
IT'S BEEN VERY DIFFICULT TO GET CLEAR ANSWERS.
ONE OF OUR FIRST REQUESTS WAS JUST A ONE-PAGER ABOUT WHAT THIS PROGRAM WAS TO GIVE TO OUR ATTORNEYS, OUR ATTORNEYS RECEIVING QUESTIONS FROM CLIENTS ABOUT WHAT THIS PROGRAM WAS.
WE COULDN'T EVEN EXPLAIN WHAT THE PROGRAM WAS.
I, I HEARD AN, AN HOUR PRESENTATION TODAY ABOUT A MENTAL HEALTH CRISIS IN TRAVIS COUNTY, WHICH IS WITHOUT A DOUBT TRUE, AND I HEARD SOME AMAZING RESOURCES THAT A LOT OF ORGANIZATIONS ARE DOING, BUT THERE STILL WAS VERY LITTLE INFORMATION ABOUT WHAT NO WRONG DOORS ACTUALLY DOES AT THAT INTERSECTION.
AND THAT'S BEEN ONE OF THE MOST DIFFICULT PIECES IS TO N - TRY TO NAVIGATE BECAUSE WE ARE THE PEOPLE HELPING OUR CLIENTS NAVIGATE THIS SYSTEM WHEN IT COMES INTO THE CRIMINAL JUSTICE SYSTEM BECAUSE ALL OF THESE CLIENTS, UH, THAT WE'RE TALKING ABOUT WHEN THEY TALK ABOUT DOZENS OF ARRESTS, THOSE ARE OUR CLIENTS, RIGHT? WE ARE THE ONES THAT ARE HANDLING THE LEGAL CONSEQUENCES OF THOSE CASES.
AND IF WE CANNOT BE INVOLVED IN THIS AND A STAKEHOLDER IN, IN THIS, THEN IT'S NOT GONNA BE SUCCESSFUL.
IT, IT CAN'T BE IF THE PEOPLE THAT ARE RESPONSIBLE FOR PROTECTING THEIR LEGAL RIGHTS ARE NOT FORMALLY INCLUDED.
SINCE THE, UH, KIND OF FIRST PUBLIC MEMO IN AUGUST, I GUESS IT WAS AUGUST 3RD WAS ISSUED, HAVE YOU SEEN ANY CHANGES IN HOW THE PROGRAM IS ADMINISTERED? UH, I DON'T KNOW IF I WOULD SAY THERE ARE CHANGES IN THE WAY THE PROGRAM IS ADMINISTERED INTO THE EXTENT THAT I'M NOT CLEAR ON THE WAY THE PROGRAM IS ADMINISTERED.
UH, I THINK IT'S STILL A STARTUP AND IN DEVELOPMENT PHASE AND THERE'S NOT A LOT OF MATURE PROCEEDINGS.
UM, YOU KNOW, ONE AREA THAT WE DID ASK TO HAVE ADDRESSED, AND I THINK THERE WAS AN ATTEMPT TO ADDRESS IT WAS AROUND SOME TRANSPARENCY WITH OFFICERS VISITING CLIENTS WHILE THEY HAVE CRIMINAL CU - UH, CRIMINAL CASES PENDING.
OBVIOUSLY, THAT PUTS YOU IN A VERY DIFFERENT FOOTING THAN MANY OF THE PROGRAMS, UM, THAT ARE TRULY DIVERSIONARY ACROSS THE COUNTRY THAT HAVE BEEN ANALYZED, WHERE PEOPLE ARE BEING DIVERTED AWAY FROM THE JUSTICE SYSTEM WITHOUT CHARGES.
WE'RE ENGAGING OR THE NO WRONGDOORS IS ENGAGING WITH PEOPLE WHO HAVE ACTIVE CRIMINAL CASES.
UM, YOU KNOW, WE'VE HAD OFFICERS QUESTION PEOPLE ABOUT THEIR PENDING CRIMINAL CASES.
UM, THAT WAS OBVIOUSLY ALARMING TO US.
SO ONE OF THE THINGS WE DID SEE WAS A MEMO THAT CAME OUT.
I KNOW MELISSA SHEARER, UM, ADDRESSED THE NEW POLICIES THE POLICE OFFICER, OFFICERS OR, OR THE POLICE DEPARTMENT ADOPTED.
UM, WE ACTUALLY WENT THE WRONG DIRECTION.
WE WERE ASKING FOR INFORMED CONSENT AND TRANSPARENCY.
IT WENT MORE WITH MIRANDA RIGHTS AND, UH, RECORDED STATEMENTS, WHICH ACTUALLY MAKES THOSE STATEMENTS MORE LIKELY TO BE USED IN COURT AND NOT LESS.
SO I THINK THERE'S ROOM FOR IMPROVEMENT AND FOR REAL WORK HERE, BUT WE HAVE TO HAVE A FOUNDATION FROM THE BEGINNING THAT RESPECTS THE, THE FULL LEGAL PROCESS AND NOT JUST THE, THE CLINICAL NEEDS OF THESE CLIENTS, BECAUSE WE ARE SUBJECTING THEM TO LEGAL CONSEQUENCES TO JAIL AND TO PRISON.
AND IT, IT'S VERY IMPORTANT THAT THIS PROCESS RESPECT THAT AND IT HASN'T YET GOTTEN THERE.
UM, EARLIER ASSISTANT DIRECTOR, UH, HAROLD SHARED THAT MAYBE 40% OF THE PEOPLE THAT ARE BEING TARGETED BY NO WRONG DOOR HAVE SIGNED, UH, RELEASES OF SOME SORT.
ARE YOU AWARE OF ATTORNEYS CONSENTING OR BEING PRESENT TO THOSE RELEASES BEING SIGNED? UH, I'M NOT AWARE WE'VE ALMOST EVER BEEN PRESENT WHEN THEY WERE SIGNED.
WE'VE BEEN REQUESTED, UH, HERE OF LATE, INCLUDING TODAY, TO TRY TO GET A CLIENT TO RECEIVE, RELEASE, SIGN THEM.
WE ARE UNCLEAR ON WHICH ONE OF OUR CLIENTS HAVE ACTUALLY SIGNED RELEASES.
WE NO LONGER HAVE ACCESS TO THE NO WRONG DOORS LIST, AND SO WE CAN'T EVEN SAY WHICH OF OUR CLIENTS ARE ON THE NO WRONG DOORS LIST AT THE MOMENT OR WHICH HAVE SIGNED RELEASES.
I DO KNOW THAT OUR STAFF WHO HAVE TALKED WITH SOME OF THE CLIENTS THAT HAVE SIGNED RELEASES WERE VERY UNCLEAR ON WHAT THE RELEASES WERE INTENDED TO DO.
THEY UNDERSTOOD THAT IF THEY SIGNED THE RELEASE, SOMEONE WAS GOING TO HELP THEM.
THEY WERE, SOMEONE WAS GONNA HELP THEM GET HOUSING, SOMEONE WAS GONNA HELP THEM GET TREATMENT, WHICH I THINK IS THE OVERALL GOAL, BUT THEY DIDN'T UNDERSTAND THAT THEY WERE AGREEING FOR DATA TO BE SHARED AMONG PROSECUTORS, POLICE, AND TREATMENT PROVIDERS, AND THAT ANYTHING THEY TOLD ANYONE IN THAT PROCESS COULD BE SHARED AND COULD BE USED AGAINST THEM.
AS OF TODAY, THERE'S NO LEGAL PROTECTIONS IN THE, IN THE PROCESS TO PREVENT THAT FROM HAPPENING.
THERE'S NO AGREEMENT, THE STATEMENTS WON'T BE USED AGAINST PARTICIPANTS.
UH, AND, AND SO I THINK THERE'S A LOT OF UNCLARITY FROM CLIENTS THAT WE'VE SPOKEN WITH ABOUT WHAT THESE RELEASES ACTUALLY MEAN TO THEM AND WHAT THEY'VE ACTUALLY RELEASED AND HOW THEY REVOKE IT.
ONE OF OUR REQUESTS WAS A CLEAR POLICY THAT OUR CLEAR MECHANISM TO ALLOW CLIENTS TO REVOKE THEIR, UM, THEIR REQUESTS OR THEIR AGREEMENTS TO PARTICIPATE OR THEIR RELEASE OF INFORMATION.
I DON'T THINK WE'VE YET IDENTIFIED HOW WE'LL PROCESS REVOCATIONS OR THAT NEW RELEASES REALLY SHOULD BE NECESSARY EACH TIME THERE'S NEW CRIMINAL CHARGES, BECAUSE OBVIOUSLY THAT CHANGES THE NATURE OF THE RELEASE.
[01:55:01]
YOU WERE ABSOLUTELY AGREEABLE TO IT BEFORE YOU WERE FACING PRISON TIME.NOW, PERHAPS YOU DON'T WANT THE, UM, ALL THESE AGENCIES COLLABORATING AGAINST YOUR LEGAL INTEREST.
UM, ONE ASPECT OF NO WRONG DOOR IS TO PERHAPS SEEK LEGISLATIVE CHANGES THAT FACILITATE CHANGES TO CIVIL COMMITMENT LAW, MAYBE TO LOWER THE STANDARD.
UM, DO YOU KNOW IF IN TRAVIS COUNTY PUBLIC DEFENDERS ARE PROVIDED FOR, FOR CIVIL COMMITMENT, UH, PROCESSES? THERE ARE TWO STAFF ATTORNEYS THAT ARE LABELED PUBLIC DEFENDERS IN THE PROBATE COURT.
THEY DO NOT WORK FOR THE TRAVIS COUNTY PUBLIC DEFENDER, THE TRAVIS COUNTY MENTAL HEALTH PUBLIC DEFENDER, NOR, UM, FOR THE PRIVATE DEFENDER SERVICE.
UM, BUT THERE ARE ATTORNEYS THAT SHOULD BE PART OF THAT PROCESS.
UM, I DON'T PERSONALLY, WE DON'T REPRESENT PEOPLE IN THOSE CIVIL COMMITMENTS, SO I WOULDN'T WANNA REALLY COMMENT FURTHER BESIDES TO SAY THAT I, I'VE HEARD, UM, TESTIMONY HERE AND I WILL AGREE FROM MY EXPERIENCE THAT ANY KIND OF CIVIL COMMITMENT OR ARREST CAN BE VERY TRAUMATIC, UM, TO FOLKS.
UH, AND SO THERE SHOULD BE LEGAL PROTECTIONS AROUND THAT.
UM, JUST A COUPLE MORE, AND I GUESS I MIGHT HAVE TO PASS BACK TO YOU MAYOR PRO TEM, UM, BEFORE I ASK THE OTHER QUESTIONS.
UM, MR. ARGUS, YOU SHARED WITH MY OFFICE THAT SOMEONE WAS ARRESTED AFTER GETTING A BOLO OR A BE ON THE LOOKOUT THROUGH NO WRONG DOOR.
CAN YOU SHARE SOMETHING ABOUT THAT? YEAH, THAT, IT'S NOT PERSONALLY OUR CLIENT, BUT I'M AWARE OF IT.
IT WAS A CLIENT OF THE MENTAL HEALTH PUBLIC DEFENDER WHO SHARED THAT, UH, EXPERIENCE WITH US.
IT'S A CLIENT THAT'S BEEN TALKED ABOUT QUITE A BIT WITH NO WRONG DOORS.
UM, NO WRONG DOORS WAS INTERESTED IN MEETING WITH THAT CLIENT OR LOCATING THAT CLIENT IN THE COMMUNITY.
SO THEY PUT OUT A, TO MY UNDERSTANDING, A REGULAR POLICE BOLO, BE ON THE LOOKOUT.
UM, A REGULAR STREET OFFICER, NOT ASSOCIATED WITH NO WRONG DOORS, OF COURSE, KNEW THIS CLIENT, THEY'RE A HIGH UTILIZER, AND WENT TO, AND, UH, DETAINED THAT PERSON.
UH, THERE WAS A SEARCH, UH, OF THE PERSON THAT RESULTED IN DRUGS BEING FOUND, AND THAT CAN RESULTED IN A FELONY CHARGE AND AN ARREST INSTEAD OF THE PROPOSED OR HOPED DIVERSION THROUGH, UH, THE MENTAL HEALTH SYSTEM.
SO THAT CLIENT WAS ARRESTED AND CHARGED WITH A FELONY.
UM, BEFORE YOU GO BACK TO YOUR SEAT, ANY LAST, UH, COMMENTS? NO, THANK YOU.
I JUST WOULD LIKE TO SAY THAT, UH, WE REALLY DO SUPPORT THE GOALS AND THE WORK OF NO WRONG DOORS.
UM, YOU KNOW, THERE'S BEEN A LOT OF DIFFERENT PROGRAMS LOOKED AROUND.
SALT LAKE CITY WAS MENTIONED TODAY, PROJECT CONNECT, THAT SPECIFICALLY ONE OF THEIR STAKEHOLDERS IS THEIR PUBLIC DEFENDER PROGRAM THERE.
UH, WE WANT TO BE A PARTNER IN THIS.
WE HAVE CERTAIN RESTRICTIONS AND EXPECTATIONS AROUND PROTECTING RIGHTS.
IT IS OUR GOAL TO SUPPORT THIS.
THESE ARE THE CLIENTS THAT WE WORK WITH EVERY DAY.
THEY NEED HELP, THEY NEED SERVICES, THEY NEED CONNECTION, BUT IT HAS TO BE DONE IN A WAY THAT PROTECTS THEIR LEGAL RIGHTS AND NEEDS AS WELL.
UH, MAYOR PROTEMA, IF YOU JUST ASK, ADD ME TO THE BACK OF THE STACK.
UH, THANK YOU, COUNCIL MEMBER ALTRID.
I APPRECIATE ALL THE INFORMATION TODAY AND, UM, WANNA KINDA TAKE A LITTLE ZOOMED OUT APPROACH AND, AND JUST HAVE A, AN UNDERSTANDING KINDA OF THE SYSTEM, RIGHT? WE'RE TALKING ABOUT A PIECE OF THE SYSTEM, A, A GROUP OF INDIVIDUALS WITHIN THE BROADER SYSTEM WHO ARE USING A LOT OF RESOURCES WITHIN THAT SYSTEM, BUT, YOU KNOW, IT'S TALKED ABOUT PRIORITIZING RESOURCES, MAKING SURE THAT WE CAN CONNECT PEOPLE WHERE WE NEED TO CONNECT THEM.
AND I JUST WANTED TO KINDA UNDERSTAND THAT IMPACT SYSTEMATICALLY.
AND I THINK WHERE THAT STARTS FOR ME, UH, MR. RICHARDSON, YOU TALKED A LITTLE BIT ABOUT THE LENGTH OF CARE, THE TYPE OF CARE SOMEONE WITHIN THIS GROUP MIGHT NEED THAT, YOU KNOW, A COUPLE DAYS IS, IS NOT REALLY GONNA CUT IT.
UM, AND I WANTED TO UNDERSTAND HOW THAT MIGHT COMPARE TO, AND I KNOW THERE'S NO REGULAR OR TYPICAL CLIENT, RIGHT? BUT, BUT MAYBE SOMEONE WHO, UM, HASN'T DECOMPENSATED TO THE LEVEL THAT WE'RE SEEING MANY OF THESE INDIVIDUALS, IS A COUPLE DAYS KIND OF ENOUGH FOR SOMEONE LIKE THAT? YEAH.
I, I KNOW THIS SOUNDS LIKE AN AWFUL ANSWER, BUT IT DEPENDS.
I, BUT, YOU KNOW, I DO THINK THERE, THE, TO ANSWER YOUR FIRST PART OF YOUR QUESTION, WHICH IS PEOPLE THAT ARE, HAVE BEEN OUT OF GETTING ANY KIND OF ACTIVE TREATMENT, UM, ARE PROBABLY STRUGGLING WITH CO-OCCURRING MEDICAL CONDITIONS, UM, HAVE BEEN UNHOUSED.
YOU HEARD MARIS TALK A LITTLE BIT ABOUT THE, REALLY THE TRAUMA THAT SORT OF REINFORCES THIS.
I THINK I, I ALSO WANNA JUST, BEFORE WE GO ANY FURTHER TOO, TALK ABOUT HOW IMPORTANT TRUST IS IN THIS AND THAT MANY OF THE FOLKS THAT WE'RE TALKING ABOUT HERE, UM, HAVE LOST TRUST IN OUR ABILITY TO S- SERVE THEM AND SUPPORT THEM.
SO THERE'S A LOT OF WORK THAT HAS TO BE DONE, BUT IT, ON A, IF SOMEBODY IS AT A, AT A POINT OF BEING UM, POED,
[02:00:01]
MEANING BEING ABLE TO GO TO AN INPATIENT FACILITY AND HASN'T GOTTEN TREATMENT IN AN EXTENDED PERIOD OF TIME.UM, THERE'S REALLY IMPORTANT CLINICAL STEPS THAT YOU KIND OF GO, GO THROUGH THAT IF YOU DO IT WELL, PREVENTS THAT RE - THAT RECIDIVISM, THAT READMISSION THAT HAPPENS.
AND PART OF THAT IS STARTING WITH MAKING SURE AND EVALUATING THEIR OVERALL MEDICAL CONDITION.
AND YOU HEARD A LOT ABOUT THE WORK THAT CENTRAL HEALTH IS DOING.
UM, IT'S ALSO ENSURING THAT THE MEDICATIONS THAT THAT PERSON IS ON ARE PRESCRIBED, ANY NEW ONES, THERE'S A PERIOD OF TIME TO OBSERVE HOW THEY'RE DOING ON THOSE MEDICATIONS.
THERE'S ALSO SOMETHING THAT HAPPENS VERY OFTEN IF SOMEBODY HAS NOT BEEN IN TREATMENT FOR A WHILE AND HAPPENS, AND THIS IS SOMETHING I EX - I, I TREATED FOLKS MY ENTIRE CAREER.
THERE ARE SOME PEOPLE THAT DON'T HAVE A LOT OF INSIGHT INTO THEIR OWN ILLNESS AND HOW IT'S AFFECTED THEIR ABILITY TO FUNCTION DAY IN AND DAY OUT.
SO HAVING AN EX - MORE THAN A COUPLE OF DAYS TO GO INTO AN INPATIENT SETTING AND GO, "JEFF, YOU'RE CURED.
WE HOPE IT ALL WORKS OUT FOR YOU," IS GONNA FAIL FOR THESE FOLKS.
ONCE SOMEBODY LEAVES A HOSPITAL, IT'S THAT STEP DOWN THAT WE TALKED ABOUT TOO.
HAVING THE ABILITY TO BE IN A RESIDENTIAL, NOT A HOSPITAL, BUT A RESIDENTIAL SETTING WHERE THEY'RE GETTING ADDITIONAL SUPPORTS TO HELP THAT LONG RANGE PLAN OF RECOVERY.
WHEN THAT HAPPENS, THEN THIS GOES DOWN A PROGRESSIVE LINE THAT HELPS SOMEONE NOT RECYCLE THIS, THIS REALLY MISERABLE LOOP THAT PEOPLE ARE IN THAT NOT ONLY IS BAD, IT IS, WE'VE TALKED A LOT ABOUT THE RESOURCE STRAIN, BUT IT REALLY IS SOMETHING THAT IF YOU'RE EXPERIENCING THAT, YOUR WILLINGNESS TO GO THROUGH IT AGAIN IS CHALLENGE.
SO A LOT OF THE WORK THAT WE HAVE TO DO IS MAKE SURE THAT WE'RE REACHING PEOPLE WHERE THEY ARE.
AND YOU'VE HEARD SOME COMMENTS EARLIER ABOUT NO WRONG DOOR AND, AND, AND I JUST THINK OUR WHOLE PROCESS HERE AND THAT ALL THE WORK THAT WE'VE DONE TOGETHER HAS BEEN BUILT ON BUILDING TRUST FOR THE, THE PERSON WE'RE SERVING.
THAT WILL BUILD THAT IN THAT, THAT COMMITMENT.
BUT FROM A CLINICAL STANDPOINT, THERE'S A WHOLE PIECE OF THIS WORK THAT WE NEED TO SPEND MORE TIME AND FOCUS ON.
THIS IS NOT A QUICK FIX, BUT IF IT'S DONE IN A PROGRESSION, IT REALLY DOES PAY OFF BOTH FOR THAT PERSON'S ABILITY TO LIVE A SATISFYING, MEANINGFUL LIFE.
WE'VE ALSO SEEN DATA WHEN SOMEONE IS IN ACTIVE TREATMENT AND DOING WELL, THEIR OVERALL, UM, COSTS, THEIR OVERALL MEDICAL HEALTH GOES WAY UP.
PEOPLE ARE WILLING TO TAKE THEIR MEDICATIONS.
YOU KNOW, IF THEY'RE ON HEART MEDICATIONS, DIABETES, ALL THESE THINGS THAT ARE REALLY CRITICAL THAT HAPPEN ONCE SOMEBODY IS GETTING INACTIVE TREATMENT.
AND BOTH THE WORK YOU'RE DOING AND THE, YOU KNOW, GROWTH THAT YOU'RE TRYING TO PROVIDE AS WELL AS DR.
LEE, WHAT, WHAT HE TALKED ABOUT, ARE WE...
I, I KNOW WE'RE NOT THERE TODAY, BUT I GUESS HELP ME UNDERSTAND THE, THE TIMELINE IN BUILDING OUT THAT FULL CONTINUUM OF CARE.
UH, AND, AND THE REASON I'M ASKING THIS QUESTION IS BECAUSE I, I THINK ABOUT, UH, YOU KNOW, WHAT DIRECTOR GRAY, WE'VE TALKED ABOUT FOR A LONG TIME AND, YOU KNOW, A COUPLE YEARS BACK ABOUT HOW WE WERE TAKING PEOPLE WHO HAD PERMANENT SUPPORTIVE LEVEL, PERMANENT SUPPORT HOUSING LEVEL NEED, AND WE'RE PUTTING THEM IN RAPID REHOUSING, KNOWING THAT THAT WASN'T THE LEVEL OF CARE THEY NEEDED.
AND SO IT DIDN'T WORK, RIGHT? THEY, THEY WERE STABLE FOR A LITTLE WHILE, BUT THAT PROGRAM CAME TO AN END FOR THEM AND THEY ENDED UP NOT FAR FROM WHERE THEY STARTED.
AND I WANT TO MAKE SURE THAT IF WE'RE DEDICATING RESOURCES, DEDICATING VERY LIMITED BEDS TO INDIVIDUALS WITH A VERY HIGH LEVEL OF NEED, THAT RIGHT NOW WE'RE PUTTING THEM INTO A PATH THAT IS SUCCESSFUL, NOT JUST SAYING, "OKAY, THIS IS THE BEST WE'VE GOT." BECAUSE IF, IF AT THE END OF THEIR JOURNEY, THEY'RE NOT GOING TO BE IN A PLACE OF SUCCESS, THEN SHOULD WE BE FOCUSED ON THE POPULATION WHERE WE WOULD HAVE THE GREATEST SUCCESS, SADLY TO THE EXCLUSION OF OTHERS, RIGHT? E- EVERYTHING IS, IS FINITE.
UH, AND SO I JUST WANNA KINDA HELP, HELP ME GRAPPLE WITH THAT.
WELL, I'VE BEEN GRAPPLING THIS MY WHOLE CAREER.
THIS IS A CHALLENGE, BUT I DO THINK ONE OF THE THINGS YOU JUST BROUGHT UP, WHICH IS, I THINK OUR PATHWAY, AND I'LL LET DR.
LEE SORT OF HELP ME WITH THIS, BUT IN TERMS OF WHAT WE, WHAT YOU SAW ON THE SLIDE EARLIER FROM CENTRAL HEALTH DESCRIBING THE DIFFERENT STEPS OF THINGS THAT WE FEEL ARE IMPERATIVE TO GET DONE, ONE OF WHICH IS, I MENTIONED EARLIER, WHICH IS THE ABILITY TO EXPAND INPATIENT CAPACITY FOR PEOPLE WHO HAVE LONG-TERM CHRONIC NEEDS, MEANING NOT THAT QUICK THREE-DAY TURNAROUND.
WE'VE, WE, WE'RE DISCUSSING BOTH AT OUR HERMAN CENTER LOCATION, CONVERTING THAT TO AN, TO A, UM, A INPATIENT BEDS, MAKE IT 15, 16 BEDS.
OUR PATHWAY ON THAT IS HOPEFULLY TO DO SOMETHING IN THE NEXT
[02:05:01]
YEAR AND A HALF.UM, BUT IT TAKES TIME, BOTH FROM A REGULATORY, UM, AND YOU, I HATE TO BRING IT UP, BUT MONEY MATTERS HERE, RIGHT? WE GOTTA FIGURE THIS OUT.
SO WHATEVER WE DO, TO YOUR POINT, UM, COUNCILMAN, WE, WE DON'T WANNA SAY TH- THIS IS A FLASH IN THE PAN, THIS IS THIS GREAT, EXCITING PROGRAM, IN TWO YEARS WE RUN OUT OF MONEY.
AND THIS HAS BEEN TRADITIONAL, THE CHALLENGE WE'VE HAD WITH BEHAVIORAL HEALTH IN THE STATE OF TEXAS.
AND SO I THINK ONE OF THE, THE WORK THAT WE'RE DOING WITH, WITH CENTRAL HEALTH AND UNIVERSITY OF UT AND THE COUNTY AND THE CITY IS REALLY THINKING ABOUT HOW WE COULD SUSTAIN THAT.
AND, UM, YOU'VE HEARD A COUPLE OF MENTIONS OF, UH, THE CRISIS CENTER LOOK IN SALT LAKE CITY, BUT THESE ARE ALL OVER THE COUNTRY.
UM, THIS MODEL HAS BEEN BUILT OUT.
THAT'S GONNA TAKE A LITTLE BIT LONGER TO BUILD OUT, BUT THAT'S MUCH MORE COMPREHENSIVE AND, AND, AND DEEPER.
THEN THE THIRD PIECE IS THE ONGOING WORK THAT WE HAVE TO DO TO MAKE SURE THAT THERE'S INPATIENT CAPACITY THAT'S MEANINGFUL FOR THE PEOPLE WE'RE SERVING.
AND THAT'S WORK THAT WE CAN DO NOW.
ANYTHING YOU WANNA ANSWER? THANK YOU, JEFF.
AND THANK YOU FOR THE QUESTION, COUNCIL MEMBER.
UM, YOU MAY HAVE RECALL THAT SLIDE THAT SHOWED THREE PHASES.
SO THE SPECIFIC ANSWER TO YOUR QUESTION, UM, FROM THE POINT THAT WE HAVE AGREEMENT BY ASCENSION TO GO AHEAD AND BEGIN THE EVALUATION AND BUILD OUT PROCESS, UH, FOR THE FIRST PHASE INPATIENT PSYCHIATRIC BEDS AND ED BEDS, UM, HOPEFULLY ABOUT A YEAR BEFORE WE COULD ACTUALLY BE SEEING PATIENTS IN THAT SPACE.
THAT WOULD BE THE EARLIEST SERVICE THAT COMES ONLINE.
THERE HAVE TO BE SOME AGREEMENTS IN PLACE TO START THAT PROCESS.
THE NEXT PHASE WOULD BE THE MENTAL HEALTH CRISIS CENTER, WHICH WE'RE VERY EXCITED ABOUT.
FROM THE POINT THAT WE SAY GO ON THAT PROCESS, THAT'LL BE NEW GROUND CONSTRUCTION.
SO APPROXIMATELY FOUR YEARS, UH, WE WILL BE HAVING FURTHER DISCUSSIONS WITH THE COUNCIL TO TALK ABOUT THE POSSIBILITY OF WORKING TOGETHER AROUND THE SITE OF THAT, UH, CRISIS CENTER.
UM, SOME ASPECTS THERE, IT, UH, OPERATIONALLY, IF IT IS CLOSE TO THE HOSPITAL, THAT HAS AN ADVANTAGE.
AND IF IT IS CLOSE TO KIND OF DOWNTOWN BOOKING, THAT HAS AN ADVANTAGE FOR OUR, UH, JUSTICE COLLEAGUES.
SO LOCATION MATTERS FOR THAT ONE.
UM, THAT'D BE ABOUT FOUR YEARS.
AND THEN THE OTHER COMPONENTS, UM, AROUND STEP DOWN, UM, SIMILARLY, WE COULD PROBABLY BUILD ON THAT FOUR YEAR TIMEFRAME, BUT WE'D IDENTIFY LAND, UH, AND RESOURCES.
AND THEN AWARD ON RESOURCES, THERE'S THE CAPITAL RESOURCES TO BUILD IT, UM, AND THEN THE OPERATING RESOURCES TO, TO RUN IT.
AND THE OPERATING AND STAFFING COMPONENTS ARE SOMETIMES THE MORE CHALLENGING, SO WE HAVE TO LOOK DOWN THE ROAD AND MAKE SURE THAT WE CAN NOT ONLY PUT UP THE RIGHT BUILDING, BUT ENSURE THE RIGHT CARE IS PROVIDED.
UH, AND WE BELIEVE THAT WORKING TOGETHER WITH THE CITY AND THE COUNTY, UM, AND OUR STATE COLLEAGUES, UH, UH, CONTINUE TO SUPPORT TO THE DEGREE THEY DO, UM, THAT'S HOW WE CREATE THE FOUNDATION FOR THAT SUSTAINABLE, UH, FUTURE RESOURCE FLOW THAT WE NEED TO PROVIDE THE CENTRAL SERVICE.
AND IT WAS TOUCHED ON AT, AT VARIOUS POINTS, BUT I WANNA ELEVATE A LITTLE BIT, YOU KNOW, THE, WE TALK ABOUT THE STEP DOWN, WE TALK ABOUT THE CONTINUUM.
WELL, THE END OF THAT PROCESS HAS TO BE HOUSING, RIGHT? I MEAN, WE, WE ALL KNOW THAT IF WE FULLY GET SOMEBODY STABLE, BUT THEN PUT THEM RIGHT BACK ON THE STREET AT THE END, WE'RE GONNA BE RIGHT BACK HERE AGAIN.
AND SO, UM, DIRECTOR GRAY, IF YOU COULD TALK A LITTLE BIT ABOUT WHERE THE HOUSING COMPONENT IS IN THIS PLAN.
I KNOW WE'RE, YOU KNOW, WE'VE DONE A GREAT JOB THE PAST FEW YEARS.
WE HAD A REALLY LONG PIPELINE THAT WE HAVE SEEN MOSTLY COME TO FRUITION, BUT WHAT'S NEXT FOR THAT, RIGHT? WHERE DO WE GO FROM HERE TO ENSURE THAT THIS, ALL THIS INVESTMENT ISN'T FOR NAUGHT? YES, SIR.
YOU KNOW, I, I'LL, I'LL SAY TO THAT, TO THAT PREMISE, I THINK FOR SOME OF THESE NO WRONG DOOR CLIENTS, THE ULTIMATE OUTCOME WILL BE HOUSING, AND THAT HOUSING COULD BE IN A PERMANENT SUPPORTIVE HOUSING COMMUNITY.
UH, IT COULD BE RESIDING WITH FAMILIES AND, AND LOVED ONES THAT ARE CAPABLE AND, AND ABLE TO TAKE SOMEBODY BACK ONCE THAT PERSON IS ON A SUSTAINED, UH, SYSTEM OF TREATMENT AND CARE.
BUT WE ALSO RECOGNIZE THAT FOR SOME OF OUR NO WRONG DOOR CLIENTS, THE ULTIMATE OUTCOME MIGHT BE LONG-TERM INPATIENT CARE, UH, AS PART OF A BELOVED COMMUNITY.
AND, AND THAT'S NOT AN OUTCOME THAT WE HOPE FOR, BUT I THINK THAT IS, IN SOME CASES, THE BEST OUTCOME FOR THOSE FOLKS.
YOU KNOW, I THINK WHAT NO WRONG DOOR IS REALLY GETTING AT IS THE OUTCOME CANNOT BE RELEASING PEOPLE BACK TO THE STREET.
THERE IS NO LIBERTY IN RELEASING SOMEBODY FROM JAIL JUST TO HAVE THAT PERSON DIE ON THE STREET.
AND I THINK WHAT OUR SYSTEM IS DOING RIGHT NOW WITH THE RESOURCES THAT WE HAVE TODAY IS FIGURING OUT HOW DO WE BEST SUPPORT PEOPLE WITH THE BEDS AVAILABLE TO US AND SO WE'RE ABLE TO GET THEM TO THE ULTIMATE OUTCOME, WHICH IS HOUSING.
UH, I WAS NOTIFIED A, A COUPLE OF WEEKS AGO ABOUT A CLIENT THAT APD HELPED GET PERMANENT HOUSING AT COMMUNITY FIRST VILLAGE AFTER THAT PERSON HAD BEEN CYCLING
[02:10:01]
THROUGH OUR SYSTEMS FOR 15 YEARS.I HAVE STAFF WHO WERE IN ELEMENTARY SCHOOL 15 YEARS AGO.
THAT, THAT'S HOW LONG THAT IS JUST TO PUT THAT INTO PERSPECTIVE.
AND SO AGAIN, COUNCILMEMBER, OUR, OUR COMMUNITY AND, AND REALLY YOU AND OTHERS ON THIS COUNCIL HAVE BEEN A HUGE CHAMPION FOR BUILDING HOUSING IN THIS COMMUNITY, FOR PROVIDING THE SUPPORTIVE SERVICES DOLLARS TO SUSTAIN FOLKS WHO MOVE INTO THAT HOUSING AND, AND KEEP THEM ENGAGED IN SYSTEMS OF CARE.
AND WE HAVE NO WRONGDOOR CLIENTS WHO HAVE ALREADY MOVED INTO THOSE UNITS.
UH, BUT AGAIN, WE ALSO RECOGNIZE THAT FOR SOME OF OUR CLIENTS, THE BEST POSSIBLE OUTCOME WE CAN HOPE FOR IS INPATIENT LONG-TERM TREATMENT.
BUT I WOULD ARGUE THAT BOTH OF THOSE OUTCOMES ARE BETTER THAN RELEASING PEOPLE FROM JAILS OR HOSPITALS JUST TO HAVE THOSE PEOPLE PERISH ON OUR STREETS.
I - DAVID, IF I COULD ADD TO THAT, JUST THE ONE OTHER COMMENT, WHICH IS WE HAVE TO START, STOP TREATING CHRONIC, SOMEONE WITH A CHRONIC MENTAL ILLNESS, WHICH IS A MEDICAL DISEASE, LIKE A ONE-OFF SUCCESS.
IF YOU HAVE ANY OTHER CHRONIC DISEASES, WE ALLOW PEOPLE TO GET ONGOING TREATMENT TO HELP THEM BE SUCCESSFUL.
IF WE TREATED DIABETICS THE SAME WAY WE TREAT PEOPLE WITH MENTAL ILLNESS, WE WOULD BE DOING NOTHING BUT SENDING PEOPLE TO THE EMERGENCY ROOM.
SO WHAT WE HAVE TO START THINKING ABOUT IS FOLKS SERVED IN THE NO WRONG DOOR AND OTHERS WHO HAVE A, A CHRONIC MENTAL HEALTH NEED, HOW DO WE ENSURE THAT WE WRAP THOSE SUPPORTS AND MAINTAIN THOSE? SO THEY'RE NOT EPISODIC, BUT THEY'RE THERE HOW AND WHEN PEOPLE WILL NEED THEM AND MAINTAIN THAT OVER A LIFETIME TO HELP PEOPLE NOT NEED THESE MORE INTENSIVE, VERY EXPENSIVE AND DISRUPTIVE AND TRAUMATIC, UH, ENCOUNTERS WITH, UH, THE INPATIENT WORLD, THE POL - YOU KNOW, INCARCERATION.
AND AS, AS, UH, YOU HEARD EARLIER, OUR LARGEST MENTAL HEALTH INPATIENT FACILITY RIGHT NOW IS OUR JAIL SYSTEM.
WE NEED, WE NEED TO MOVE IT AWAY FROM THE JAILS AND CREATE A TRUE SYSTEM OF CARE THAT ALLOWS THAT PEOPLE TO GET THAT TREATMENT.
WELL, IN THE INTEREST OF TIME, I'M GONNA, JUST A COUPLE VERY QUICK HITS, UH, NO RESPONSE NECESSARY, BUT JUST, UM, UH, FOR, I DON'T KNOW WHO, WHO IS THE, THE CREATOR OR THE HOLDER OF THE LIST, UH, BUT TO WHOMEVER THAT PERSON MAY BE, UH, I KNOW THAT A LOT OF THESE INDIVIDUALS ARE LIKELY THE INDIVIDUALS WE SEE DOWNTOWN, RIGHT? WE, WE KNOW THAT THERE IS A, UH, CONCENTRATION OF INDIVIDUALS WHO ESPECIALLY HAVE BEEN CHRONICALLY HOMELESS ARE DOWNTOWN.
UH, THAT BEING SAID, YOU KNOW, I CAN THINK OF A FEW IN DISTRICT FIVE AND I KNOW EVERY DISTRICT HAS THEIR FREQUENT FLYERS OR WHETHER THEY'RE FREQUENT FLYERS WITH YOU, THEY'RE DEFINITELY FREQUENT FLYERS, UH, WITH OUR NEIGHBORHOOD.
SO IF WE COULD JUST KINDA COORDINATE A LITTLE BIT ON, YOU KNOW, THOSE COUPLE PEOPLE, WHERE THEY ARE IN THIS PROGRAM AND HOW WE CAN HELP, I THINK THAT WOULD BE, UH, VERY HELPFUL FOR, FOR ALL OF US.
UM, SECOND, CARRIE MENTIONED, UH, ABOUT WORKING ON LEGISLATION, UH, TO THE DEGREE TO WHICH THERE IS ANY KIND OF SUBCORUM PUT TOGETHER TO DISCUSS THAT THROUGHOUT THE LEGISLATIVE SESSION.
UM, YOU KNOW, WOULD LOVE TO BE PART OF THAT CONVERSATION AS WELL.
UM, AND THAT CONCLUDES MY REMARKS.
I REALLY APPRECIATE, UH, ALL OF Y'ALL TODAY AND WE'LL KEEP CHATTING.
THANK YOU, COUNCILMEMBER ALTER.
UM, FIRST THANKS TO EVERYONE BOTH INSIDE AND OUTSIDE THE CITY WHO CAME TOGETHER TO PUT TOGETHER THIS PROGRAM, TODAY'S PRESENTATION FOR BEING AVAILABLE TO ANSWER EVERY COUNCIL MEMBER O - COUNCIL OFFICE'S QUESTIONS LAST WEEK AND PROVIDING SUCH ROBUST WRITTEN BRIEFINGS IN RECENT MONTHS.
UM, I AM EXCITED THAT WE HAVE 17 AGENCIES AT THE TABLE HAVING SIGNED THE MOUS.
I THINK WE ARE POISED TO GENUINELY STRENGTHEN OUR COLLABORATION ACROSS DEPARTMENTS, AGENCIES IN BETWEEN AUSTIN AND TRAVIS COUNTY.
I AM ALSO GRATEFUL TO ACLU AND OUR PUBLIC DEFENDERS AND OTHERS WHO WROTE AND SPOKE TO US TO ARTICULATE CONCERNS, WHICH MAKES IT POSSIBLE TO ADDRESS ISSUES AT THE MOST EFFECTIVE MOMENT, THE BEGINNING OF A PROGRAM WHEN IT'S BEING PILOTED.
AND SO, YOU KNOW, I'M GONNA, IN THE INTEREST OF MOVING THROUGH MY QUESTIONS AND COMMENTS QUICKLY, I'M GONNA MIX COMMENTS WITH QUESTIONS AND, BUT MY FIRST COMMENT IS I HOPE THAT YOU'LL GIVE GENUINE CONSIDERATION AND I, AND FOR THOSE OF YOU WHO I KNOW, I KNOW THAT YOU ARE THOUGHTFUL IN THE INFLAMMATION, IMPLEMENTATION OF ALL OF THESE PROGRAMS, BUT GENUINE CONSIDERATION TO THE MAXIMUM WAY THAT SOME OF THESE CONCERNS CAN BE ADDRESSED BECAUSE THAT IS THE WAY TO KEEP US AS A COUNCIL FULLY ON BOARD.
SO, UM, KICKING IT OFF THERE, UM, WE HEARD A LOT.
I WOULD LIKE TO BUILD ON COUNCIL MEMBER SIEGEL'S QUESTIONS AS IT RELATES TO PUBLIC DEFENDERS.
UM, GIVEN THAT ONE OF THE, ONE OF THE VERY LARGE GOALS OF THIS PROGRAM IS TO REDUCE, UM, ARRESTS, REDUCE CONTACTS WITH APD AND, UM, AND BEING TIED UP IN THE, IN THE JUSTICE SYSTEM,
[02:15:01]
UM, I WOULD LOVE TO HEAR FROM SOMEONE ABOUT THE EXTENT TO WHICH YOU THINK, FIRST OF ALL, CRITICALLY IMPORTANT TO BE WORKING WITH PUBLIC DEFENDERS, THAT'S PART OF THEIR GOALS AS WELL.SO I THINK THAT THIS IS AN AREA THAT PERSONALLY I THINK NEEDS TO BE STRENGTHENED.
AND I'M, I'D LIKE TO HEAR A LITTLE BIT JUST OF THE EXTENT TO WHICH YOU THINK THAT'S POSSIBLE.
IS THAT THE PATH WE'RE ON RIGHT NOW TO STRENGTHEN THAT RELATIONSHIP AND WORK MORE EFFECTIVELY WITH THE PUBLIC DEFENDERS? THANK YOU FOR THE QUESTION.
UM, AND YES, I, I WANT EVERYBODY TO BE A PART OF THIS PROGRAM BECAUSE IT'S SO IMPACTFUL AND SO MEANINGFUL.
UM, I'VE REALLY TRIED, UH, SINCE WE STARTED THIS PROGRAM TO INCLUDE, UM, AND BE TRANSPARENT WITH OUR FRIENDS, UM, AT THE PUBLIC DEFENDER'S OFFICE AND OTHER ATTORNEYS THAT HAVE HAD CONCERNS.
I HAVE BEEN TRANSPARENT BY RELEASING, UH, THE LIST.
I HAVE BEEN TRANSPARENT GIVING THE MOU, AND I'VE BEEN TRANSPARENT GIVING, UM, THE INDIVIDUAL CONSENT DEGREES.
UH, AND I WILL CONTINUE THESE PARTNERSHIPS.
I PROMISE YOU, UM, MY BACKGROUND, UH, SERVES ME THAT I WILL BE THE LAST PERSON STANDING AT THE TABLE, UM, WAITING, UM, AND HOPING THAT WE CAN MOVE FORWARD TOGETHER BECAUSE I KNOW THAT THAT IS THE BEST PATH FORWARD, UM, AND THIS WORK IS SO COMPLEX, UM, THAT IF WE DON'T ALL WORK TOGETHER TO FIND SOLUTIONS, THEN THESE PEOPLE ARE DYING ON THE STREETS EVERY DAY IN AUSTIN.
AND I JUST DON'T THINK THAT'S ACCEPTABLE.
SO YOU HAVE MY COMMITMENT THAT WE WILL CONTINUE IN THE PATH OF GETTING COOPERATIONS FROM EVERYBODY THAT TOUCHES THESE PEOPLE.
AND MOST CERTAINLY, UM, YOU KNOW, PUBLIC DEFENDERS, ATTORNEYS, UM, DO HAVE A SEAT AT THE TABLE.
UM, AND I, I FEEL AT THIS JUNCTURE THAT WE ARE DOING EVERYTHING THAT WE CAN TO BE TRANSPARENT AND TO PUT GUARDRAILS AROUND, UH, CIVIL RIGHTS AND CIVIL LIBERTIES, AND I WILL CONTINUE TO DO THAT AND WORK TOWARD THAT.
AND I'VE MET WITH, UM, MELISSA SHEER AND KATIE JO, AND THEY HAVE MY PERSONAL CELL PHONE, UM, AND I'VE MADE THAT COMMITMENT TO BOTH OF THEM.
UM, AND - COUNCIL BERLIN, I'M, I'M SO SORRY IF I COULD JUMP IN.
UM, I DID WANNA SAY THAT REALLY OUR BROADER GOAL, I THINK, AT THE COUNTY AND REALLY COMMUNITY-WIDE IS TO FOCUS MORE SO ON DEFLECTION.
SO TRYING TO STOP PEOPLE FROM HAVING TO HAVE THOSE LAW ENFORCEMENT ENGAGEMENTS ALTOGETHER.
UM, AND REALLY, UNTIL WE HAVE A CRIMINAL JUSTICE, UM, CRISIS CENTER, OR SORRY, A MENTAL HEALTH CRISIS CENTER, WE REALLY DO HAVE TO KIND OF COBBLE THINGS TOGETHER.
AND UNFORTUNATELY, THAT DOES MEAN A LOT OF ENGAGEMENT WITH LAW ENFORCEMENT.
AND SO ONCE WE CAN ESTABLISH THAT AND HAVE THOSE ALTERNATIVES TO ARREST, IT REALLY WILL HELP TO FILTER PEOPLE AWAY, UM, AND HOPEFULLY NOT HAVE TO HAVE THOSE, THOSE SORTS OF CONTACTS.
SO IT IS, IT IS A LONG-TERM PROCESS.
WE REALLY NEED TO HAVE A FACILITY IN PLACE FIRST, BUT I THINK AS WE BUILD THAT OUT, IT, IT IS A COMMUNITY EFFORT TO TRY TO FIGURE OUT HOW DO WE WORK AROUND NOT HAVING THE GREATEST RESOURCE THAT WE REALLY NEED TO HAVE.
UM, YEAH, AND I THANK YOU, CHIEF, FOR, FOR ASKING SO MANY, ANSWERING SO MANY OF OUR QUESTIONS BEFORE THIS MEETING, AND I KNOW WE'LL BE FOLLOWING UP AS WELL, AND I APPRECIATE THOSE COMMENTS AS WELL.
UM, I, I AGREE THAT, UM, WE ARE STARTING WHERE WE ARE, AND WHERE WE ARE IS A LOT OF CONTACT WITH POLICE.
AND SO ALICE, THIS IS ONE OF THE COMMENTS THAT I WAS LEADING UP TO IS, UH, YOU KNOW, I READ THE PROCESS THROUGH WHICH, UH, Y'ALL WENT TO ARRIVE AT, WE'RE GONNA LOOK AT EIGHT ARRESTS OR MORE, UH, AND I THINK THAT THAT WAS A REASONABLE PROCESS.
AND GIVEN THAT WE'RE STARTING FROM A PLACE WHERE, AS CERTAINLY IN DISTRICT SIX, MOST CONTACT WITH THE HOMELESS POPULATION UNTIL THE VALIANT EFFORTS OF DIRECTOR GRAY AFTER, YOU KNOW, HE CAME ON BOARD, GOT UP TO SPEED AND BEGAN DOING THAT, BUT THERE'S A LOT OF CONTACT WITH POLICE, AND THAT IS JUST WHERE WE'RE STARTING.
AND SO I THINK THAT THAT IS, FROM WHAT I'VE HEARD AND READ, A, A REASONABLE METRIC BY WHICH TO SIZE UP THIS PROGRAM AND TO MAKE THE MOST EFFECTIVE USE OF DOLLARS IN IDENTIFYING INDIVIDUALS WITH WHOM WE HAVE A GOAL OF REDUCING POLICE CONTACT.
SO, UM, I WANTED TO PUT THAT OUT THERE.
NOW, AT THE SAME TIME, UM, AND I, I MAY HAVE MISSED IT IF WE HAD THIS CONVERS - IF ANYONE BROUGHT THIS UP FROM THE DIAS, BUT I, I'VE DEFINITELY SEEN DISCUSSION IN THE WRITTEN MATERIALS, UM, THIS BEING A PROGRAM THAT FOCUSES ON POST-ADJUDICATION DIVERSION VERSUS PRETRIAL DIVERSION.
AND, UM, YOU KNOW, I, I READ THE LETTER FROM THE MAYOR THAT REALLY PLACED AN EMPHASIS ON POST-ADJUDICATION DIVERSION, AND I READ ACLU QUESTIONING ABOUT THAT.
AND SO, I WILL SAY, UM, THAT I BELIEVE THAT WE ARE MOST EFFECTIVE FIGURING OUT HOW TO, AS MUCH AS POSSIBLE, HANDLE THIS WITH PRETRIAL DIVERSION.
WE'RE STARTING WHERE WE ARE, WHICH IS SOMETIMES GOING
[02:20:01]
TO NECESSITATE POST-ADJUDICATION DIVERSION, BUT I DON'T BELIEVE, AND I SUSPECT MY COLLEAGUES AGREE, THAT THAT'S NOT WHERE WE WANT TO GO, SHOULD WANT TO GO, AND SHOULD, I DON'T THINK THAT SHOULD BE THE BASIS OF HOW WE MOVE FORWARD.WELL, THANK YOU FOR THE QUESTION.
I THINK IT'S AN IMPORTANT ONE, AND I THINK CHIEF DAVIS, UM, HAS REALLY EMPHASIZED OUR COOPERATION, UM, WITH DIVERSION AND DEFLECTION.
WE HAVE ONGOING MEETINGS WITH BOTH THE COUNTY ATTORNEY AND THE DISTRICT ATTORNEY, AND I THINK OUR RELATIONSHIPS ARE REALLY GOOD, BUILT ON TRUST.
AND WE ARE WORKING HARD, UM, ON OTHER PROGRAMS THAT HAVE TO DEAL WITH DEFLECTION AND DIVERSION, AND WE WILL CONTINUE TO DO SO.
I ALSO OFFER, UH, THE NO WRONG DOOR TEAM IS IN A CONSTANT STATE OF DEFLECTION AND DIVERTING PEOPLE OUT OF THE CRIMINAL JUSTICE SYSTEM.
UM, BUT MOST CERTAINLY, UH, I KNOW IF CHIEF DAVIS WAS UP HERE RIGHT NOW, YOU HAVE HER COMMITMENT THAT WE WILL CONTINUE TO TRY TO DEFLECT AND DIVERT AS MANY PEOPLE SUFFERING FROM SEVERE MENTAL ILLNESS AND UNHOUSED WITH, UH, SUBSTANCE ABUSE ADDICTION OUT OF THE CRIMINAL JUSTICE SYSTEM BECAUSE, UH, THAT'S WHY WE'RE ALL HERE, IS BECAUSE THAT'S NOT THE RIGHT SYSTEM FOR PEOPLE TO BE IN.
AND SO WE'RE COMMITTED TO THAT.
I ALSO WOULD LIKE TO SAY THAT SOMETIMES THAT IS NOT POSSIBLE.
UM, EVEN THOUGH THIS POPULATION IS DISPROPORTIONATELY IMPACTED BY CRIME, UM, WE DO HAVE CALLS FROM COMMUNITY MEMBERS, UH, WHEN SOMEBODY HAS COMMITTED, UH, A CRIME, AND SOMETIMES THE CRIMES ARE VIOLENT.
UM, AND SO WE HAVE TO RECOGNIZE THAT, UH, COMMUNITY MEMBERS HAVE A RIGHT TO SEE THEIR DAY IN COURT AS WELL.
UM, BUT WE'RE, WE ALL HAVE THE FRAMEWORK AND THE UNDERSTANDING THAT THIS POPULATION, THIS VULNERABLE POPULATION IS NOT SERVED WELL IN JAIL.
AND SO WE'RE DOING EVERYTHING WE CAN TO DIVERT AND DEFLECT WHILE ALSO WORKING WITH COMMUNITY MEMBERS THAT ARE VICTIMS SOMETIMES, UH, AT THE HANDS OF, OF, UH, SOME OF THESE PEOPLE ON THE LIST.
EVEN THOUGH THAT'S A RARITY, IT'S, IT'S SMALLER IN NUMBER, UM, BUT WE DO HAVE PEOPLE ON THE LIST THAT IF WE DON'T GET INTERVENTION, THEY END UP WITH LONG JAIL SENTENCES, UM, AND THEY DO COMMIT FELONIES, AND THAT'S WHAT WE'RE TRYING TO PREVENT, IF THAT'S HELPFUL, COUNCIL MEMBER.
UM, SO I'M GONNA SHIFT OVER TOWARDS DATA CL - BASELINE DATA, A FEW QUESTIONS RELATED TO THAT.
UM, SO, YOU KNOW, WE STARTED FROM 950 INDIVIDUALS IDENTIFIED BY A CONSULTANT, MEADOWS INSTITUTE, I THINK, AND WE ULTIMATELY DECIDED TO FOCUS ON THE 100 HIGHEST UTILIZERS.
I MEAN, OVER TIME, PEOPLE ARE GOING TO MOVE OFF THAT LIST, HOPEFULLY BECAUSE OF CONNECTION WITH SERVICES AND BREAKING OF THIS CYCLE.
UM, IS PART OF YOUR TRACKING ALREADY, OR IF NOT, COULD YOU CONSIDER, UM, TRACKING ONCE THEY'VE LEFT THAT TOP 100, HOW LONG DO THEY STAY OFF? UM, IF THEY REEMERGE INTO THE TOP 100...
HOW LONG DO THEY STAY OFF? AND THEN ALSO, IF THEY DISAPPEAR FROM THAT LIST, HOW OFTEN IS THAT DUE TO INVOLUNTARY COMMITMENT OR BEING IN JAIL OR PRISON? LIKE, THESE ARE ALL FACTORS THAT I'M HOPING COULD BE PART OF THE DATA THAT YOU'RE TRACKING.
WE ARE TRACKING THAT, AND THAT'S AN IMPORTANT QUESTION.
AND I THINK THIS IS WHERE, UH, WE'RE IN A, WE'RE IN A REALLY GOOD, UH, POSITION RIGHT NOW TO UNDERSTAND THE DYNAMICS ALMOST IN REAL TIME, UM, TO UNDERSTAND EXACTLY THAT.
AND I, I WILL OFFER, UH, THAT DR.
ANDERSON, BEING A RESEARCHER HIMSELF, I AM HOPING, UM, THAT WE REALLY EVALUATE OUR SUCCESS IN A SCIENTIFIC MANNER.
UM, MOST CERTAINLY, WE ARE TRACKING THE INDIVIDUALS.
IF SOMEBODY LEAVES THE LIST, UM, FOR ANY ONE OF THOSE REASONS THAT YOU MENTIONED, UM, WE HAVE A, A, A STANDARD THAT IF THEY COME OFF THE LIST, IF THEY HAVEN'T HAD ANY INTERACTION WITH ANY OF OUR SYSTEMS IN 90 DAYS.
BUT TO YOUR POINT, WOULDN'T IT BE AWESOME IS IF WE TRACK THESE PEOPLE FOR A LONG TIME TO REALLY UNDERSTAND WHAT WORKED, WHAT DIDN'T, UM, AND TO REALLY EVALUATE THE NO WRONG DOOR SO WE'RE MAKING SURE THAT WE HAVE THE OUTCOMES THAT WE WANNA HAVE.
AND I'M, I'M EXCITED BECAUSE I THINK THAT THIS PROGRAM SHOULD BE BROUGHT TO COUNCIL EVERY QUARTER, AND WE TALK ABOUT QUESTIONS LIKE THAT, AND WE'RE ENGAGED WITH COUNCIL BECAUSE THE WORK IS SO VITALLY IMPORTANT TO THIS COMMUNITY.
AND YOU ANTICIPATED ONE OF THE LAST QUESTIONS I WAS GONNA ASK, WHICH IS THE REPORTING
[02:25:01]
CADENCE.UM, AND I DON'T KNOW IF IT WOULD BE TO FULL COUNCIL OR TO A COMMITTEE, BUT I WILL LOOK FORWARD TO APPEARING AT A COMMITTEE IF IT'S NOT ONE THAT I'M ALREADY ON.
UM, UH, I HAVE A QUESTION ABOUT THE...
THIS, UM, SLIDE 36, THE PROPOSED METRICS.
UM, I THINK THIRD FROM THE END.
UM, MINIMIZED REPEAT LAW ENFORCEMENT CRISIS CONTACTS, AND THEN THERE'S A BULLET POINT BENEATH, AND THE FIRST ITEM IS INCLUDING REPEAT CALLS TO THE SAME LOCATION.
AND I'M JUST WONDERING WHAT IN OUR BASELINE DATA COUNTS AS A CALL TO THE LOCATION? IS IT JUST 911? IS IT 911, 311? I REPORT AUSTIN.
IS IT THE SYSTEM THAT OUR COUNCIL OFFICE USE TO REQUEST ASSISTANCE? UM, AND NOT...
I JUST WOULD LIKE TO KNOW WHAT COUNTS AS A CALL TO A LOCATION.
UH, WE CAN TRACK IT, UM, TO THE SPECIFIC POINT THAT SOMEBODY'S CALLING ON.
UM, AND TO YOUR POINT, WE SHOULD BE TRACKING ALL THREE FOR, UM, TO, TO ENSURE THAT WE'RE COVERING ALL METRICS AND ALL CALL POINTS.
SO WE HAVE THE CAPACITY, WE SHOULD BE DOING IT, UM, TO ENSURE THAT WE'RE GETTING E- EVERY DATA POINT THAT WE HAVE AVAILABLE, UH, INTO OUR EVALUATION.
UM - AND COUNCILMAN, IF I COULD JUST BUILD ON THAT BRIEFLY - YES.
YOU KNOW, TO, TO THE ASSISTANT CHIEF'S POINT, I THINK PART OF IT IS OFTENTIMES THESE ARE INDIVIDUALS WHO WE KNOW, AND PART OF IT IS THESE INDIVIDUALS ARE IN THE SAME PLACES, RIGHT? THE SAME KIND OF HOTSPOTS.
I THINK COUNCIL MEMBER ALTER ALLUDED TO THE FACT THAT OFTENTIMES THESE FOLKS WOULD BE IN DOWNTOWN AUSTIN, BUT THEY ALSO EXIST ACROSS THE CITY.
UH, AND SO WHEN WE THINK ABOUT HOW WE HELP THESE CLIENTS AND THE NEIGHBORHOODS IN WHICH THEY'RE RESIDING IN, WE, WE ALSO WANNA BE MINDFUL OF OTHER RESIDENTS, OTHER BUSINESSES, OTHER PEOPLE EXPERIENCING HOMELESSNESS, UH, IN THOSE AREAS AS WELL.
AND SO WHAT THAT BULLET POINT IS REALLY SPEAKING TO IS, ARE WE SEEING A REDUCTION, NOT JUST IN THE NUMBER OF TOUCH POINTS THAT WE'RE HAVING WITH PEOPLE, BUT ALSO ARE WE SEEING A REDUCTION IN HOTSPOTS? CAN WE SAY THAT WE'RE MAKING THESE AREAS SAFER FOR EVERYBODY TO ENJOY? AND SO I THINK LIKE THE ASSISTANT CHIEF SAID, YES, THERE ARE A VARIETY OF, OF SOURCES THAT WE CAN LOOK AT TO KIND OF PINPOINT SPECIFIC LOCATIONS, AND WE DO THAT THROUGH 911 AND 311 OUTREACH DATA, ET CETERA.
UH, BUT THE UNDERLYING PREMISE IS IF WE CAN TURN AN AREA FROM, FROM A HOTSPOT TO A, TO A NON-HOTSPOT, I THINK THAT'S A, A CLEAR METRIC THAT WE'RE HAVING IMPACT, NOT JUST IN THE LIVE OF THE INDIVIDUAL, BUT ALSO HAVING RE - IMPACT IN THE BROADER COMMUNITY.
AND WE'LL, WE'LL DEFINITELY PICK UP THE TYPES OF INCOMING IN OUR FOLLOW-UP CONVERSATION.
UM, SO I, I WANTED TO ALSO MENTION, UM - COUNCIL MEMBER? YES.
COULD WE PAUSE? CAN I COME BACK TO YOU AND, AND, AND GO OVER TO VANESSA RIGHT QUICK AND, AND THEN, UH - SURE.
JUST, UH, IN THE INTEREST OF TIME.
AND, UH, UH, COUNCIL MEMBER, UH, FUENTES.
I THINK FIRST I JUST WANNA TAKE A STEP BACK AND GET A SENSE OF WHEN...
CAN YOU TALK US THROUGH, THIS IS FOR DIRECTOR HAROLD, UM, WHEN NO WRONG DOOR INITIALLY STARTED, HOW LONG HAS NO WRONG DOOR BEEN IN OPERATION AT THIS POINT? I, I FEEL LIKE APPROXIMATELY 10 MONTHS, GIVE OR TAKE A MONTH OR TWO.
UM, BUT THE VAST MAJORITY OF THE WORK, I WOULD SAY WITHIN THE LAST 90 DAYS TO 100 DAYS, UM, AFTER WE HAD THE, UH, MOU SIGNED BY ALL OF OUR PARTIES, UM, A LOT OF IT WAS IN THE VERY BEGINNING, UM, UH, JUST TRYING TO, UH, MIMIC WHAT WE DID IN BOULDER, COLORADO.
AND, UH, THAT TOOK SOME WHILE TO GET THE INFRASTRUCTURE UP.
WE HAD NUMEROUS MEETINGS WITH ALL THE PARTNERS, BUT I WOULD SAY IT'S BEEN THE LAST 100 DAYS OR SO THE REAL WORK STARTED.
SO FOR US, THIS IS THE FIRST TIME WE'RE GETTING A FULL COMPREHENSIVE BRIEFING ON THE PROGRAM OF NO WRONG DOOR, BUT IT'S ONLY BEEN IN OPERATION FOR ABOUT 100 DAYS AT THIS POINT.
OUR MEETINGS HAVE BEEN WITH THE ROBUST PEOPLE THAT YOU SEE IN FRONT OF YOU.
I JUST W - REALLY WANTED TO FRAME THAT, UH, OR PROVIDE THAT CONTEXT BECAUSE THERE'S CERTAINLY A LOT OF QUESTIONS THAT HAVE BEEN SHARED FROM THE DAIS THAT WE WILL CONTINUE TO HAVE, AND I SEE THIS EFFORT AS EVOLVING AND ONGOING.
AND IT'S INCREDIBLE TO SEE THIS MANY PARTNERS AT THE TABLE WORKING TOGETHER.
I'VE BEEN ON COUNCIL NOW FOR SIX YEARS.
I CANNOT THINK OF ANOTHER INITIATIVE THAT IS THIS COLLABORATIVE AND THAT HAS, UM, THIS BUILT-IN FRAMEWORK OF COLLABORATION.
SO, AND I KNOW HOW CHALLENGING THAT IS TO PULL OFF.
SO THE FACT THAT WE'RE EVEN AT THIS PLACE IS SOMETHING THAT I JUST WANNA GIVE MY, UH, DEEPEST GRATITUDE AND, AND CONGRATULATIONS, BECAUSE THAT IS A LOT OF HARD WORK AND A LOT OF EFFORT TO GET US TO THIS POINT.
AND WITH THAT BEING SAID, YOU KNOW, IN, AS THE PROGRAM EVOLVES AND WHAT I WANNA, UM, LAY OUT IS THAT IT STARTED OUT AS AN APD FORWARD INITIATIVE.
AND FROM MY UNDERSTANDING, IT IS NOW...
[02:30:01]
BE AN EMS PARAMEDIC FORWARD INITIATIVE.CAN YOU SPEAK TO THAT, UH, THAT CHANGE AND WHAT WE CAN EXPECT MOVING FORWARD? YEAH.
UM, SO A- AS WE KIND OF STARTED THROUGH THIS PROGRAM, YOU KNOW, YOU KNOW, NAVIGATING, UH, THE DATA AND WHATNOT, YOU KNOW, THE, THE THINGS THAT APD, UM, WAS ABLE TO DO AS WE KIND OF NAVIGATED THE LEGAL, UM, PROCESS AROUND SOME OF THE DATA THAT WE HAVE IN HEALTHCARE, UM, YOU KNOW, APD WAS ABLE TO KIND OF GET STARTED A LITTLE BIT FASTER THAN SOME OF US BECAUSE WE, WE DO HAVE THOSE CERTAIN RESTRICTIONS.
AND SO, UM, AS WE'VE WORKED THROUGH THIS PROCESS OF THE MOUS, OF THE, YOU KNOW, RELEASES FROM, FROM INDIVIDUALS, UM, IT'S KIND OF A- ALLOWED US THE ABILITY TO REENGAGE MORE FROM THE EMS PERSPECTIVE AND TAKE A DEEPER INVOLVEMENT.
UM, AND SO WHAT THAT LOOKS LIKE FOR US MOVING FORWARD IS HAVING, YOU KNOW, REALLY EMS BE THE HOLDER OF A LOT OF THE DATA, WHICH HAS BEEN FROM THE, THE BEGINNING IN TERMS OF THOSE RELEASES, UM, AND, AND KIND OF HELPING TO, TO COORDINATE, UM, HOW TO BRING IN DIFFERENT STAKEHOLDERS.
BECAUSE AT TIMES, YOU KNOW, THERE MAY BE INSTANCES WHERE, UM, THE INDIVIDUALS THAT WE'RE REVIEWING NEED A BROADER SENSE OF SER- SERVICES OR IT MAY BE A LITTLE MORE OF A NARROW FOCUS.
SO, UM, EMS WILL BE HOSTING THE CASE CONFERENCING, UM, BIWEEKLY, UM, WORKING WITH THE, THE INDIVIDUALS, WORKING WITH IDENTIFYING THE APPROPRIATE RESOURCES MOVING FORWARD, UM, AND KIND OF TAKING THAT, THAT LEAD OWNERSHIP OF THE INFORMATION.
AND FROM MY UNDERSTANDING, ALSO PROVIDING YOUR OWN LIST OF INDIVIDUALS WHO ARE HIGH UTILIZERS OF OUR EMERGENCY CARE SYSTEM AND LAYERING ON, UM, DIFFERENT LISTS THAT ARE AVAILABLE FROM THE PARTNERS SO THAT WE'RE GETTING A MORE, UM, HOLISTIC VIEW OF INDIVIDUALS WHO ARE HIGH UTILIZERS OF THE ENTIRE SYSTEM.
IS THAT RIGHT? THAT'S CORRECT.
AND ONE OF THE THINGS THAT WE ARE WORKING THROUGH, UM, AS AN ENS-LED INITIATIVE IS WORKING WITH, UM, DIFFERENT, UM, DATA VENDORS, UM, THAT CAN HELP US THAT HA - WORK THROUGH THE VARIOUS RESTRICTIONS THAT WE HAVE, BECAUSE WE DO RECOGNIZE THAT REALLY, UM, WE HAVE TO BE VERY CAREFUL ABOUT WHO HAS ACCESS TO WHAT DATA.
AND SO, UM, USING THINGS THAT CAN BLIND, UH, DIFFERENT DATA POINTS THAT ARE RELEVANT TO THE DIFFERENT STAKEHOLDERS, UM, TO MAKE SURE THAT, YOU KNOW, FOR EXAMPLE, IF, YOU KNOW, IF, YOU KNOW, IF MY ORGANIZATION OR ANOTHER ORGANIZATION, UM, THAT, THAT IF WE'RE LOOKING AT THIS COLLABORATIVE DATA, THAT THERE'S NOTHING THERE, UM, THAT THOSE PARTICULAR AREAS, WHETHER IT'S CJIS, WHETHER IT'S HIPAA, UM, THAT THAT DATA'S NOT ACCESSIBLE TO THOSE INDIVIDUALS WHO SHOULD NOT HAVE ACCESS TO IT.
AND IN THIS, AND I KNOW YOU DIDN'T, UM, GO OVER THE PROPOSED METRIC SLIDE THAT'S IN THE APPENDIX FOR THE PRESENTATION THAT'S BEEN LAID OUT, UM, BUT DIRECTOR KINGHAM, IF YOU CAN SHARE WITH US, YOU KNOW, WHAT DOES THE DEFINING THE OUTCOMES OF THE PROGRAM, BECAUSE WE BRIEFLY, YOU KNOW, RECEIVED INFORMATION ON ONE OF THE METRICS OF HOW WE'RE JUDGING WHETHER OR NOT THIS PROGRAM IS SUCCESSFUL IS THE INTERACTIONS WITH POLICE OFFICERS HAS GONE DOWN, BUT WHAT OTHER WAYS ARE WE MEASURING, UM, THE PROPOSED SUCCESS OF THIS INITIATIVE? YEAH, I'LL ALSO INVITE ASSISTANT CHIEF HAROLD TO PROVIDE SOME ADDITIONAL CONTEXT, BUT WE LOOK AT IT AS A CONTINUUM.
YOU KNOW, ONE OF THE SLIDES THAT WE SHARED, THERE WAS A DECREASE NUMBER OF CON - UH, OF LAW ENFORCEMENT CONTACTS, BUT AN INCREASE IN, UH, CONTACTS WITH SERVICE PROVIDERS, SAY EMS OR, OR, OR INTEGRAL CARE.
AND SO WE'RE, WE'RE LOOKING AT THIS AS AN ENTIRE ECOSYSTEM WHERE WE'RE GETTING INDIVIDUALS FLOWING THROUGH THE SYSTEM.
AND SO WE WANT TO SEE LOWER CONTACTS AT THE BEGINNING OF THE SYSTEMS WHEN INDIVIDUALS ARE EXPERIENCING MENTAL HEALTH CRISIS AND HIGHER CONTACTS TOWARDS THE END OF THE SYSTEM WHERE INDIVIDUALS ARE RECEIVING THE SERVICES THEY NEED TO ADDRESS THEIR, THEIR, THEIR, THEIR MENTAL HEALTH, UH, CRISIS OR THEIR INTRODUCTION INTO THAT SYSTEM.
AND, UH, EVENTUALLY, LONG-TERM OUTCOMES WOULD BE LESS CONTACTS THROUGHOUT THE ENTIRE ECOSYSTEM TO WHERE THOSE INDIVIDUALS ARE IN A SUPPORTED, UM, UH, UH, ENVIRONMENT WHERE THEY HAVE A HIGHER LEVEL OF, OF SELF-SUFFICIENCY THAN THEY ENTERED THE SYSTEM.
BUT I'D ALSO ASK CHIEF HAROLD TO, UH, PROVIDE ANY ADDITIONAL CONTEXT.
I THINK I WAS JUST PROMOTED TO CHIEF.
UM, I'VE BEEN CALLED AN ASSISTANT DIRECTOR, MARIS.
UH, I'M IN AN AWKWARD SPACE HERE, BUT, UM, BUT HOW WOULD YOU LIKE TO BE REFERRED TO AS IT JUST, YOU KNOW - ANY OF, ANY OF IT'S FINE.
UM, I, I THINK THAT FROM A POLICING PERSPECTIVE, UM, I WOULD LIKE TO MEASURE SOMETHING THAT WE DON'T DO VERY WELL IN THIS COUNTRY, AND EUROPE DOES EXCEPTIONALLY WELL, IS MEASURE REPEAT VICTIMIZATION.
SOME OF THOSE ST- STATS THAT I SHOWED IN THE BEGINNING, UM, BEING A WOMAN, UM, ARE REALLY FRIGHTENING.
AND SO I WOULD WANNA MEASURE, UH, VICTIMIZATION RATES IN THIS POPULATION.
UM, I WOULD WANNA MEASURE, UM, YOU KNOW, JUST THE BASIC NEEDS OF THIS POPULATION.
ARE WE MEETING THEM JUST TO HELP SOMEBODY GET AN ID, UH, JUST TO SEE
[02:35:01]
IF SOMEBODY CAN GET, UM, YOU KNOW, APPLY FOR MEDICAID.UM, IF WE CAN GET SOMEBODY, UH, A BED FOR THE NIGHT SO THEY DON'T FREEZE.
ALL OF THESE THINGS ARE SO IMPORTANT TO MEASURE.
AND THAT'S WHY THIS IS SO EXCITING FOR ME TO BE IN FRONT OF COUNCIL, BECAUSE I, I HOPE THAT YOU GIVE US THINGS THAT YOU'D WANNA SEE.
UM, YOU KNOW, WE'RE JUST SO LUCKY IN THE CITY TO BE PARTNERED WITH RESEARCHERS WHO CAN HELP US DO ALL OF THAT.
AND I CAN TALK ABOUT EVALUATIONS THAT I WANNA SEE, BUT I THINK, I THINK THIS IS SUCH A GREAT PROGRAM THAT WE SHOULD ALL SEE THINGS THAT WE WANNA SEE INDIVIDUALLY, INDIVIDUAL, UM, BECAUSE I THINK THAT WE CAN GET THERE IF WE ALL WORK COLLECTIVELY AND COLLABORATIVELY.
AND I WOULD THINK THAT WE WILL MEASURE SHORT-TERM HOUSING, LONG-TERM HOUSING.
IF SOMEBODY GET, GETS TO GO TO THEIR MEDICAL APPOINTMENT THAT DAY, IF SOMEBODY, YOU KNOW, WHEN WE WERE IN SALT LAKE CITY, I THINK THE, THE MOST INTERESTING THING I HEARD IS THAT SOME OF THESE PEOPLE ARE IN CRISIS BECAUSE THEY HAVEN'T SEEN A DENTIST IN 10 YEARS AND THEY HAVE SEVERE PAIN.
UM, I THINK WE'RE BETTER THAN THAT.
I THINK THAT IF WE WORK COLLECTIVELY, WE CAN GET PEOPLE INTO A DENTIST APPOINTMENT.
WE SHOULD BE MEASURING THINGS LIKE THAT.
UM, AND SO I THINK IT'S JUST UP TO ALL OF US TO SEE WHAT WE WANT TO EVALUATE, AND THEN WE SHOULD HOLD OURSELVES ACCOUNTABLE FOR THE WORK, IF THAT ANSWERS YOUR QUESTION.
AND I THINK THIS IS ALSO A REALLY GOOD OPPORTUNITY FOR US TO INVOLVE OUR COMMUNITY AND STAKEHOLDERS WHO, UM, ARE DEEPLY INVOLVED IN THIS ISSUE AREA AND, AND INVITE THEM TO PROVIDE, YOU KNOW, THEIR FEEDBACK AND INPUT AS TO WHAT THOSE OUTCOMES AND EVALUATIONS SHOULD LOOK LIKE.
AND FOR MY COLLEAGUES IN THE DIAS, YOU KNOW, WE, UM, HAVE A PUBLIC HEALTH COMMITTEE MEETING TOMORROW WHERE THE NO WRONG DOOR INITIATIVE IS ONE OF OUR BRIEFING ITEMS. SO I, I INVITE EVERYONE TO CONTINUE THE CONVERSATION AND FOR THOSE, UM, WATCHING ONLINE, UH, TO JOIN US AND, YOU KNOW, SEND US YOUR FEEDBACK AND INPUT ON, UH, WHAT PROPOSED OUTCOMES WE ALL WANNA SEE OUT OF THIS INITIATIVE.
UM, DIRECTOR HAROLD, AND I'LL CALL YOU DIRECTOR UNTIL I'M TOLD OTHERWISE.
CAN YOU JUST GIVE US SOME CONTEXT AS TO OF THE INDIVIDUALS WHO ARE ON, UH, WHO ARE HIGH UTILIZERS, WHO HAVE BEEN IDENTIFIED FOR THE NO WRONG DOOR PROGRAM, HOW MANY OF THOSE INDIVIDUALS HAVE ACTIVE CASES? AND IF YOU CAN SPEAK TO, UM, A- ACTIVE CASES PENDING BEFORE A COURT, AND IF YOU CAN SPEAK TO SOME OF THE EXAMPLES THAT THE PUBLIC DEFENDER PROVIDED.
WELL, I CAN SPEAK TO THE BOND ISSUE BECAUSE THE, THE BOND ISSUE OCCURRED ONCE AND IT WAS AN EMAIL AND IT MISTAKENLY WENT TO THE WRONG PLACE.
IT WENT TO A JUDGE AND NOT, UH, NOT ANOTHER EMAIL THAT THE OFFICER WAS USING.
SO THAT WAS A MISTAKE THAT HAS BEEN WORKED THROUGH WITH THE, UH, JUDGE.
AND THAT IS THE ONLY TIME THAT I KNOW OF ANY OFFICERS REQUESTING DIFFERENT BAIL, UH, BONDS OR CONDITIONS OF THEIR RELEASE.
UM, THE OTHER CONCERN WAS, I BELIEVE, WITH, UH, BOLOS, UH, BEING ISSUED.
UH, THE NO WRONG DOOR TEAM HAS ISSUED THREE BOLOS, WHICH ARE COMMON PRACTICE IN POLICING.
UM, AND THE ONE THAT, UH, THE GENTLEMAN BROUGHT UP WAS A CASE WHERE THE NO WRONG DOOR TEAM HAD SECURED A BED FOR ONE OF OUR HIGHEST UTILIZERS, BUT THE TIME NEEDED TO GET THAT PERSON INTO THE BED WAS LIKE 24 HOURS.
SO THE NO WRONG TEAM DOOR PUT A BOLO OUT SAYING, "IF YOU SEE THIS PERSON, PLEASE RECALL US, THE NO WRONG DOOR TEAM, SO WE CAN ASK IF THEY WOULD LIKE TO TAKE ADVANTAGE OF THIS BED." UM, AND IN THAT TRANSACTION, WHEN THE OFFICER DID SEE THEM, THEY COMMITTED ANOTHER LOW LEVEL CRIME.
UH, THEY WERE SEARCHED AND, UH, A SIGNIFICANT AMOUNT OF DRUGS WERE FOUND ON THAT PERSON.
UM, BUT WE DIDN'T GIVE UP ON THAT PERSON WHEN THEY WERE TRANSPORTED TO JAIL.
WE CONTINUED TO SEEK, UH, THAT PERSON OUT FOR THE BED.
AND I THINK IT WAS A SUCCESSFUL STORY.
SO THEY WERE, ARE, WILL THEY HAVE ACCESS TO THAT BED? WELL, THEY DID HAVE ACCESS TO IT BECAUSE WE DID INTERVENE BACK AT THE JAIL SYSTEM.
NOW, UNFORTUNATELY, THAT IS ONE OF OUR HARDEST REACH, UH, PERSONS ON OUR LIST.
AND I'M SURE THAT IF I SAID HER NAME AND HER CONDITION, EVERYBODY UP HERE WOULD, WOULD KNOW WHO I WAS TALKING ABOUT.
UM, AND SHE, SHE IS CYCLING IN AND OUT OF THE TREATMENT FACILITIES RIGHT NOW.
UM, BUT FINDING LONG-TERM SOLUTIONS WITH HER IS PROVING VERY CHALLENGING, BUT WE'RE STILL AT IT AND WE'RE STILL DOING THE WORK.
AND SO, AND YOU HAVE SHARED THAT THE PUBLIC DEFENDER'S OFFICE HAS BEEN INVITED TO PARTICIPATE AND YOU HAVE HAD CONVERSATIONS WITH THE OFFICE.
[02:40:01]
YES, MA'AM.AND WITH THE BE ON THE LOOKOUT, THE BOLOS, OR, UH, DO OTHER LAW ENFORCEMENT AGENCIES HAVE ACCESS TO THAT INFORMATION? DO THEY ALSO RECEIVE NOTIFICATION? I KNOW THAT THE COUNTY STRUCTURE DOES, AND I WOULD HAVE TO DEPEND ON, UH, UH, MR. COPPOLA FROM THE LEGAL TEAM.
I DO NOT KNOW IF THEY GO OUT OF OUR COUNTY SYSTEM OR NOT.
I'LL HAVE TO GET BACK WITH YOU ON THAT ONE.
SO THE BOLOS STAY WITHIN THE CITY OF AUSTIN UNLESS IT'S - YES, UNLESS IT'S AN ENDANGERED PERSON.
UM, AND THE OTHER KIND OF AREA I WANTED TO ASK YOU ABOUT, AND CHAIR, LET ME KNOW IF YOU WANNA PASS TO SOMEONE ELSE.
IF, IF YOU WANNA MAKE THIS A FINAL QUESTION AND THEN WE CAN, UH, UM, THANK YOU.
YES, THIS WILL BE MY FINAL QUESTION FOR NOW IS, YOU KNOW, WE HAVE HEARD SOME REALLY INCREDIBLE NEWS WITH CENTRAL HEALTH AND TRAVIS COUNTY'S, UH, INCREASED INVESTMENT IN MENTAL HEALTH, AND THAT'S HUGE.
AND WE THANK YOU, UH, FOR THAT AND ARE EXCITED TO SEE THE NEW INVESTMENT MOVE FORWARD AND KNOW HOW CRITICAL THE COMMITMENT IS TO THE OVERALL MENTAL HEALTH CONTINUUM OF CARE.
KNOWING THAT IT IS A CONTINUUM OF CARE AND THAT, UH, WE WILL BE GETTING THIS NEW INFUSION OF INVESTMENT TO HELP US.
RICHARDSON, CAN YOU TALK US THROUGH, YOU KNOW, WHAT DOES IT LOOK LIKE FOR US TO HAVE A FULLY FUNDED MENTAL HEALTH PLAN WHEN IT COMES TO OUR COMMUNITY? UM, IF YOU COULD JUST GIVE US A SENSE OF, YOU KNOW, KNOWING THE...
I'M JUST TRYING TO UNDERSTAND WITH THE NEW INVESTMENT THAT'S COMING OUT OF CENTRAL HEALTH IN TRAVIS COUNTY, YOU KNOW, WHERE DOES THAT PUT US ON TRACK WITH OUR C3 CLINICIANS, OUR FULLY STAFFED EMCOT, UM, YOU KNOW, WHAT MORE DOES INTEGRAL CARE NEED AT THIS TIME TO FULLY ADDRESS THE MENTAL HEALTH NEEDS OF OUR COMMUNITY? YEAH.
WELL, THANK YOU FOR THAT QUESTION.
I, I THINK THERE'S A COUPLE PIECES TO THAT.
NUMBER ONE, UM, THE INVESTMENTS THAT BOTH THE COUNTY AND CENTRAL HEALTH HAVE DONE AND CONTINUE TO DO TO HELP SUPPORT BOTH EXISTING OPERATIONS AND THESE NEW INITIATIVES, AS YOU SAW IN THAT NICE, UM, ICEBERG SLIDE, IT'S BOTH.
I THINK WE ALSO, UM, YOU KNOW, W- WE, UM, HAVE TO WORK, AS YOU HEARD EARLIER, WITH THE STATE, AND PARTICULARLY ENSURING THAT THEY'RE MAINTAINING THEIR COMMITMENT AND INCREASING IT.
I THINK I WORRY ABOUT THERE, UH, THERE'S ALWAYS GREAT NEW INITIATIVES THAT WE NEED TO DO, AND ALL OF THESE ARE CRITICAL, BUT WE ALSO NEED TO SCALE AND CONTINUE TO GROW EXISTING SETS OF SERVICES TO EXPAND.
YOU MENTIONED A FEW OF THOSE, AMCOT, UM, OUR OUTPATIENT CLINIC ACCESS.
SO MORE AND MORE PEOPLE, WE'RE SEEING A TREND ACROSS TEXAS IS THAT FEWER PEOPLE HAVE ACCESS TO HEALTHCARE.
AND SO PEOPLE ARE RATIONING THEIR NEEDS AND THEIR HEALTHCARE.
SO THERE'S A GROWING DEMAND FOR, UH, SAFETY NET SERVICES LIKE OURS, CENTRAL HEALTH, COMMUNITY CARE, AND SO MANY OF OUR PARTNERS IN THIS CITY.
SO EVEN IF WE DO NOTHING, WE'RE GOING BACKWARDS.
SO THE, THE REALITY IS, IS THAT THESE NEW INVESTMENTS ARE FABULOUS AND ARE ABSOLUTELY WHAT WE NEED TO DO.
AND WE NEED TO MAKE SURE THAT WE'RE CONTINUING TO GROW THE BASIS OF SERVICES, BOTH IN PREVENTION AND ONGOING TREATMENT THAT KEEP PEOPLE OUT OF THESE CRISIS SERVICES TO BEGIN WITH.
LEE, ANYTHING THAT YOU'D LIKE TO ADD ON THAT? UH, THANK YOU, COUNCIL MEMBER.
UM, YOU KNOW, FOR US, WE THINK ABOUT THE, UH, CONTINUUM PREVENTION AND CONTROL.
SO ULTIMATELY, AT THE FAR END OF THE SPECTRUM IS CRISIS IN THE JAIL AND THE STREET AND THE HOSPITAL.
AND THE FURTHER WE CAN MOVE FOLKS UPSTREAM TO A PREVENTION CONTROL, THE BETTER.
SO, UH, WE TAKE A HOLISTIC VIEW.
WE WANNA MAKE SURE PEOPLE CAN AFFORD THEIR CARE.
WE PROVIDE THE COVERAGE THEY NEED, THAT THEY CAN GET THEIR CARE IDEALLY IN A PRIMARY CARE SETTING WHERE, UH, WHEN THEIR BEHAVIORAL NEEDS ARE STABILIZED, THEY CAN HAVE THAT INTEGRATED TOGETHER WITH THEIR PRIMARY CARE, DENTAL CARE, SPECIALTY CARE, WOMEN'S HEALTHCARE, AND SO ON.
UM, AND THAT WE HAVE A SMOOTH AND CONTINUOUS HANDOFF WITH INTEGRAL CARE, EMS, AND OTHERS WHEN FOLKS NEEDS A MORE ACUTE THAN THAT.
UM, I THINK THOSE THREE PHASES THAT YOU SAW LAID OUT IN THE SECOND SLIDE WE PRESENTED, UM, IF WE CAN ACCOMPLISH THOSE THREE PHASES, UM, THAT WILL BE A SIGNIFICANT STEP, UH, TOWARD, UM, CREATING WHAT WE SOMETIMES CALL A SYSTEM WITHOUT EDGES.
A CONTINUOUS PATIENT JOURNEY REQUIRES A SYSTEM WITHOUT EDGES.
UM, WHEREVER YOU FIND THAT EDGE, UH, YOU'LL FIND PATIENTS EITHER FALLING OFF THE EDGE AND GETTING HURT OR BACKING UP IN FRONT OF IT AND WAITING FOR CARE.
AND SO WE NEED TO COMPLETE THAT LOOP, THAT RACETRACK, IF YOU WILL, SO THAT WE CAN, UH, CONTINUE TO MOVE PEOPLE TO THE NEXT STAGE OF THEIR CARE, ALL THE WAY TO HOUSING, AS BEEN SAID EARLIER, WHEN THAT'S THE RIGHT DESTINATION.
UM, SO CRISIS CARE, STEP-DOWN CARE, UH, MORE INPATIENT, UH, AND ED, UH, SITE CARE, UM, THAT'S WHAT WE THINK OF THE, AS THE NEXT STEP.
UM, IT WOULD PROBABLY BE IMPORTANT TO STATE THAT WE SIT WITHIN A BROADER REGION THAT HAS UNMET NEEDS.
[02:45:01]
AND SO WE KNOW THAT THE MORE WE BUILD, UH, THE MORE FOLKS WILL COME.AND SO JUST SAYING THAT OUT LOUD, UM, WE'VE SIZED SOME OF THE INVESTMENTS FOR WHAT WE NEED IN TRAVIS COUNTY, BUT WE UNDERSTAND THAT THERE ARE NO HARD BOUNDARIES.
UM, AND SO, UM, UH, AS THE REGION GROWS, UH, THE NEEDS WILL CONTINUE TO GROW.
AND COLLEAGUES, YOU KNOW, SINCE WE ARE GOING THROUGH A SOCIAL SERVICE RESET AND A LOT OF, UM, OUR FUNDING FOR MENTAL HEALTH FALLS WITHIN THE BEHAVIORAL HEALTH SERVICES, WITHIN SOCIAL SERVICES, UM, AS WELL AS OUR HOMELESSNESS RESPONSE SUPPORTS, YOU KNOW, THIS, I'M REALLY TRYING TO UNDERSTAND, UM, WHAT THE SYSTEM NEEDS OVERALL WHEN IT COMES TO MENTAL HEALTH AND WHAT IS THE CITY'S ROLE AND TO WHAT, AND WHAT IS OUR FUNDING CAPACITY, AND WHERE DOES IT MAKE SENSE TO BEST DIRECT OUR DOLLARS, UM, IN, IN A COLLABORATIVE WAY THAT FEEDS INTO THE LARGER EFFORT HERE.
AND JUST TO BUILD ON COUNCILMEMBER FUENTES, I THINK WE'RE, WE'RE DOING THAT NEEDS ASSESSMENT FOR THE NEXT COUPLE OF MONTHS THAT WE'LL GET SOME ANSWERS HOPEFULLY BY SPRING ABOUT WHAT THAT'S GONNA LOOK LIKE.
I'M CONCERNED, I'VE BEEN CONCERNED FOR QUITE SOME TIME THAT OUR STRATEGY FOR THESE HIGH UTILIZERS WE'VE BEEN TALKING ABOUT TODAY IS BOTH INCREDIBLY, UH, IF NOT SORT OF CATASTROPHICALLY EXPENSIVE AND ALSO NOT EFFECTIVE AT RESOLVING A LOT OF THE UNDERLYING ISSUES OR CONNECTING US WITH LONG-TERM CARE STRATEGIES.
AND SO IT'S, IT'S REALLY CLEAR TO ME AFTER HEARING THE PRESENTATION, THANK YOU ALL, BY THE WAY, FOR ALL THE INFORMATION YOU'VE SHARED WITH US TODAY, THAT DOING NOTHING IS NOT THE ANSWER.
AND IF THERE ARE CONCERNS, LET'S WORK TOGETHER, LET'S ADDRESS THEM WITH INTENTIONALITY.
I KNOW SINCE I STARTED SERVING, I'VE WADED INTO ISSUES AND CONVERSATIONS THAT WERE OTHERWISE KIND OF PERCEIVED AS HIGH RISK AND LOW REWARD, OR MAYBE IN SIMPLER TERMS, UM, MORE TROUBLE THAN THEIR WORTH, THINGS LIKE ON ANIMAL SERVICES AND INVASIVE SPECIES AND SOME LAND USE ISSUES.
AND I GET IT BECAUSE WE, WE'RE ALL HERE FOR A LIMITED TIME AND, AND THAT TIME GOES BY INCREDIBLY QUICKLY, AND WE HAVE THESE LIMITED OPPORTUNITIES TO MOVE THE NEEDLES ON THINGS OR MAKE SIGNIFICANT DIFFERENCE.
AND I REALLY DO BELIEVE THIS IS ONE OF THOSE OPPORTUNITIES.
AND I'VE BEEN ON THE PERIPHERY OF THE NO WRONG DOOR CONVERSATION SINCE I STARTED, UH, TRYING TO WORK WITH REPRESENTATIVE HOWARD AND, UH, AND SENATOR PARKER AND OTHERS TO TRY AND FIGURE OUT HOW TO BETTER APPROACH THE HIGH UTILIZERS OF THE LEGISLATURE.
AND SO WITH APOLOGIES TO MY FRIENDS AT CENTRAL HEALTH, YOU KNOW, WHEN I SAW THE RAPID BUDGET INCREASE, I WAS A LITTLE BIT CONCERNED, UM, PROBABLY NOT A SURPRISE TO ANYBODY.
BUT EXPANDING THIS SPACE MAKES PARTICULAR SENSE TO ME, UH, TO ADDRESS THOSE LONGSTANDING CHALLENGES THAT UP UNTIL NOW WE'VE STRUGGLED WITH FOR HOW TO APPROACH THIS IN EITHER LIKE AN E - YOU KNOW, ECONOMIC WAY, AN EFFECTIVE WAY, OR SIMPLY A WAY THAT'S HOLISTIC.
SO WITH THAT SAID, I WANNA START WITH FIRST GOING BACK TO THE, UH, PRIOR CONVERSATION THAT WE HAD, UH, AROUND CONCERNS RAISED BY THE, UH, PRIVATE DEFENDER SERVICE ABOUT BOND CONDITIONS AND RELEASES AND LEGAL CONSEQUENCES FOR JAIL AND PRISON.
IN PARTICULAR, I'D LIKE TO SEE IF CHIEF AND/OR DIRECTOR HAROLD CAN HELP SPEAK TO SOME OF THAT.
COULD YOU JUST REPEAT THE QUESTION REALLY QUICKLY? SURE.
WE HEARD SOME CONCERNS FROM, FROM THE PRIVATE DEFENDER SERVICE - YES.
ABOUT, UH, BOND CONDITIONS, ABOUT SPECIFIC INSTANCES THEY RAISED, ABOUT SOME LEGAL CONSEQUENCES OF JAIL AND PRISON.
I WAS HOPING YOU COULD SPEAK TO SOME OF THAT.
I ONLY KNOW ONE TIME WHERE ONE OF THE NO WRONG DOOR OFFICERS, AND IT WAS AN ERRONEOUS MISTAKE OF SENDING AN EMAIL TO A JUDGE, AND IT WENT, IT, IT WENT TO A JUDGE INSTEAD OF THE USUAL MECHANISM THAT A POLICE OFFICER HAS, UH, TO DISCUSS THESE ISSUES.
THAT, THAT ISSUE HAS BEEN COMPLETELY WORKED OUT, AND THAT IS THE ONLY TIME THAT HAPPENED.
SO I, I DON'T HAVE ANY CONCERNS THERE.
UM, I REALLY HAVE TRIED TO BE AS TRANSPARENT AS POSSIBLE WITH WHAT WE'RE DOING WITH EVERYBODY THAT TOUCHES THIS VULNERABLE POPULATION.
UM, AND I WANT PEOPLE TO BE INVOLVED AND I WANT, UH, I WANT US TO ALL WORK TOGETHER TO COME UP WITH CREATIVE SOLUTIONS FOR THIS VERY HARD TO REACH POPULATION.
UM, AND IF THERE'S MORE THAT WE CAN DO, I'M MORE THAN WILLING TO DO THAT.
BUT AS FAR AS OUR NO WRONG DOOR TEAM OFFICERS, I HAVE NO CONCERNS FROM A LEGAL PERSPECTIVE OF THE WORK THEY'RE DOING EVERY DAY.
UM, IN FACT, IT'S INNOVATIVE, IT'S CREATIVE, UM, AND I APPLAUD, I APPLAUD THEIR WORK.
[02:50:01]
UM, AND THEY ARE ON THE FRONT LINES OF THIS ISSUE.UM, THE OTHER THING THAT HASN'T BEEN MENTIONED TODAY, TEXAS HAS A VERY, UH, INTERESTING TAKE ON ALL OF THIS BECAUSE A POLICE OFFICER IS THE ONLY ONE IN THE STATE OF TEXAS THAT CAN SIGN AN EMERGENCY DETENTION.
SOMETHING THAT I HAVE NEVER SEEN IN MY CAREER, AND I'VE BEEN DOING THIS A LONG TIME.
UM, WE SHOULD HAVE A BROAD BASE OF PEOPLE SIGNING EMERGENCY DETENTIONS, CLINICIANS, UM, EMS, UH, SPECIALTY, UH, OFFICERS.
UM, THAT BURDEN SHOULDN'T JUST FALL ON US.
UH, THAT SHOULD BE ACROSS SYSTEMS, ESPECIALLY, UM,
UM, I'VE JUST NEVER SEEN A SYSTEM LIKE WE HAVE IN TEXAS, AND I, I WOULD HOPE THAT AT SOME POINT, UH, THE STATE ADDRESSES THAT ISSUE BECAUSE RIGHT NOW, A POLICE OFFICER'S THE ONLY ONE THAT CAN RESPOND IN CRISIS AND TAKE A PERSON TO, UH, THE HOSPITAL FOR TREATMENT.
AND SO I'M HOPING THAT GETS EXPANDED, UH, IN THE NEXT SESSION.
MAYBE IT WILL, MAYBE IT WON'T, BUT I HOPE, I HOPE TO GOD IT DOES, UM, BECAUSE I THINK THAT, THAT'LL JUST PROVIDE A BROADER SAFETY NET AND TAKE SOME OF THE BURDEN OFF OF THE POLICE OFFICERS TRYING TO MAKE THESE DECISIONS, UM, IN REAL TIME.
UM, AND I CAN TELL YOU THAT THE POLICE DEPARTMENT HAS DONE EVERYTHING THAT IT CAN TO MAKE SURE THAT ALL OF OUR POLICE OFFICERS ARE TRAINED IN THIS, BUT IT IS A HEAVY BURDEN, UH, TO HAVE THAT AS THE ONLY PERSON THAT CAN SIGN MENTAL HEALTH HOLDS FOR THIS VULNERABLE POPULATION, IF THAT'S HELPFUL.
AND THAT'S CERTAINLY SOMETHING THAT WE HAVE, UH, ALLUDED TO EARLIER THAT WE HAVE BEEN TRYING TO WORK WITH REPRESENTATIVE HOWARD AND OTHER ON TO, TO CHANGE THE LEGISLATURE.
AND WE'LL TRY AGAIN, UH, PRESUMABLY THIS TIME AS WELL NEXT YEAR.
I'M NOT SURE WHO THE BEST PERSON TO TRY AND ANSWER THIS IS.
UH, BUT IS NO WRONG DOOR ADVOCATING FOR INVOLUNTARY HOLDS? WHO CAN SPEAK TO THAT? SO - MAYBE DAVID, RAY.
YEAH, I, I THINK DAVID, PLEASE.
COUNCILMEMBER, UH, SHORT ANSWER IS NO.
WE'RE, WE'RE NOT SITTING HERE ADVOCATING NECESSARILY FOR INVOLUNTARY HOLDS.
HOWEVER, I DO THINK THAT WE ALSO RECOGNIZE THAT FOR SOME PEOPLE, THE INVOLUNTARY COMMITMENT MIGHT BE THE PATHWAY INTO THE SERVICE THAT THEY NEED.
AND THIS GETS BACK TO THE POINT THAT QUEEN MARIS WAS MAKING A, A SECOND AGO -
WHICH IS THAT, YOU KNOW, I'M GLAD THAT JOKE LANDED WELL.
ANYWAY, BUT, BUT TO THE POINT THAT ASSISTANT CHIEF, UH, HAROLD MADE, UH, THAT RIGHT NOW, POLICE ARE THE ONLY ONES WHO CAN DO THOSE POLICE OFFICER EMERGENCY DETENTIONS.
AND SO, BUT FOR THAT REASON, THEY, THEY ARE GONNA BE INVOLVED.
UH, BUT IF WE CAN GET SOMEBODY INTO A, A SYSTEM OF TREATMENT, UH, INVOLUNTARILY, THAT, THAT'S GREAT.
AND, AND WE WOULD WELCOME THAT TOO.
UH, THE UNFORTUNATE REALITY THOUGH IS THAT FOR SOME OF THE FOLKS WHO ARE ON THESE LISTS, UH, THE LEVEL OF MENTAL HEALTH CHALLENGE THAT THEY FACE IS SO SEVERE THAT THEY CANNOT MAKE THAT INFORMED DECISION FOR THEMSELVES IN THAT MOMENT.
UH, I THINK THAT'S ALSO THE REASON WHY, THOUGH, ONCE THEY ARE ABLE TO, TO GET TO A POINT WHERE THEY, THEY HAVE THE SELF-AWARENESS AND THE ABILITY TO MAKE AN INFORMED DECISION, UH, IT'S AT THAT POINT THAT WE WANNA THEN MEET WITH THEM AGAIN TO SAY, "HEY, THIS IS A PROGRAM THAT'S AVAILABLE TO YOU TO HELP PUT YOU ON A PATHWAY TOWARDS HEALING, UH, NOT MAKE YOU HAVE TO INDEPENDENTLY NAVIGATE THESE DIFFERENT SYSTEMS. WE'RE NOT GIVING YOU A PAMPHLET AND TELLING YOU TO GO TO A COMMUNITY CARE CLINIC NEXT TUESDAY FOR MORE HELP.
UH, WE'RE GONNA WRAP THE SYSTEM OF SUPPORT AROUND YOU IF YOU'RE SO WILLING TO TAKE IT." AND IT IS AT THAT POINT THAT THE INDIVIDUAL WILL HAVE A CHOICE TO MAKE AS TO WHETHER OR NOT THEY CHOOSE TO PARTICIPATE IN THE NO WRONG DOOR PROGRAM.
THANK YOU FOR THE CLARITY ON THAT.
AND, AND I'M GLAD YOU BROUGHT THAT UP BECAUSE THAT'S SOMETHING THAT I'VE BEEN STRUGGLING WITH ALSO.
AND I KNOW THAT WE'VE TALKED IN THE PRESENTATION ABOUT, UH, I THINK OSCAR AND EVE.
I KNOW YOU'VE ALSO BEEN, I THINK, TRYING TO HELP MARY.
AND I'M WONDERING IF YOU'RE ALLOWED TO TALK ABOUT IT, HOW WOULD MARY BE SERVED UNDER THE CURRENT SYSTEM, ESPECIALLY WITH, IN LIGHT OF WHAT YOU JUST SAID, AND HOW COULD SHE BE SERVED THEN UNDER NO WRONG DOOR, ALTERNATIVELY? THANK YOU, COUN- COUNCIL MEMBER.
YES, MARY, UM, MARY'S ONE OF THE MOST COMPLEX AND SADDEST STORIES I'VE EVER HEARD, UM, BOTH FROM A SOCIAL WORK PERSPECTIVE AND A, A POLICING PERSPECTIVE.
UM, MARY'S BEEN LIVING ON THE STREETS OF AUSTIN FOR DECADES.
UM, SHE HAS CYCLED OUT OF THAT HORRIBLE, VICIOUS CYCLE THAT WE'RE ALL TALKING ABOUT.
IT'S HARD TO COUNT HOW MANY TIMES.
BUT WHAT'S SAD TO ME IS WHEN YOU TALK ABOUT MARY, THE DATA
[02:55:01]
ALMOST STOPS A COUPLE YEARS AGO.AND THAT'S BECAUSE EVERYBODY HAS JUST STOPPED THINKING THAT THE SYSTEMS IN PLACE CAN HELP MARY.
AND SO WE WEREN'T RECEIVING A LOT OF CALLS FOR SERVICE EITHER THROUGH A CRISIS POINT, UM, EMS, FIRE.
YOU CAN ALMOST SEE THE DATA JUST TAKE A, A, A CLIFF NOSE DIVE DOWN.
UM, AND SO THE DISTRICT ATTORNEY IS THE ONE THAT ASKED ME TO DO THIS.
HE SAID, "FOCUS IN ON ONE OF THESE HIGH UTILIZERS AND SEE WHERE THE GAPS ARE." AND SO WE PICKED MARY, UM, TO REALLY WALK THROUGH THE SYSTEMS. AND I THINK BECAUSE OF THE WORK THAT WE'VE DONE WITH MARY SO FAR ACROSS THE BOARD, EVERYBODY UP HERE HAS TOUCHED MARY'S LIFE.
UM, WE'RE, WE'RE REALLY SEEING, UM, THE GAP IN ONE MAJOR SYSTEM.
UM, WE HAVE, SHE HAS RECEIVED LONG-TERM INJECTABLES.
UM, WE HAVE HOUSED THANKS TO THE WORK OF INTEGRAL CARE, UM, IN CLINICAL FACILITIES.
UM, AND WE'VE STABILIZED HER FOR A VERY LONG TIME.
BUT NOW SHE'S BACK ON THE STREET.
AND UNFORTUNATELY, MARY IS BEING TRAFFICKED, UM, FOR SEX.
AND, UM, AND SO WE'RE ALL TRYING OUR BEST TO MAKE SURE THAT WE HAVE A LONG-TERM TREATMENT PLAN.
HER FAMILY IS BACK ENGAGED AGAIN BECAUSE OF THE WORK OF NO WRONG DOOR.
UM, SHE IS RECEIVING, UH, TREATMENT EVEN THOUGH THAT TREATMENT RIGHT NOW IS ON THE STREET.
SHE IS BEING, UM, TALKED TO ON A DAILY BASIS.
BUT I THINK IT'S BECAUSE OF MARY'S STORY AND WHAT I SAW WHEN I FIRST GOT TO AUSTIN, THE CONDITION THAT MARY WAS IN, BECAUSE SHE WOULD FIND SOLITUDE ON THE STREETS AROUND THE POLICE DEPARTMENT.
AND I COULD NOT BELIEVE THAT SHE WAS JUST LAYING IN A GUTTER, NOT CLOTHED.
AND SO I THINK THE NO WRONG TEAM HAS USED MARY AS AN EXAMPLE OF WHY THIS WORK IS SO IMPORTANT.
AND I THINK THE NEXT STEP FOR MARY IS GONNA BE, UM, A BED, HOPEFULLY, AT A HO - THE STATE HOSPITAL SYSTEM THAT CAN PROVIDE HER WITH THE COMPLEX TREATMENT PLAN THAT SHE NEEDS AND DESERVES, UM, BECAUSE HER LIFE STORY IS VERY COMPELLING.
AND WHILE I'M SO PASSIONATE ABOUT THIS WORK ALONG WITH EVERYBODY UP HERE, IF THAT'S HELPFUL, COUNCIL MEMBER.
I WANNA SPECIFICALLY HO- HONE IN ON WHAT DIRECTOR GRAY SAID, UH, A FEW MINUTES AGO, WHICH IS WITH SOMEBODY LIKE THIS INDIVIDUAL, ARE THEY IN A POSITION WHERE THEY CAN MAKE SOUND LEGAL OR, UH, CARE DECISIONS FOR THEMSELVES? I MEAN, IS THAT...
H- HELP SPEAK TO THAT ASPECT OF, OF THE INTERVENTION HERE.
SO, SO FOR SOMEBODY LIKE MARY, UH, MOST OF THE TIME, NO, MARY IS NOT IN A POSITION TO, TO DO THAT.
UH, AND SO WHEN APD IS CALLED, OR LAW ENFORCEMENT, IT COULD BE THE CONSTABLE'S OFFICE OR ANOTHER LAW ENFORCEMENT AGENCY, UH, TH- THERE IS ESSENTIALLY A CHECKLIST THAT, THAT LAW ENFORCEMENT PROFESSIONAL WILL GO THROUGH TO DETERMINE WHETHER OR NOT AN EMERGENCY DETENTION IS JUSTIFIED.
UH, AND THERE ARE CASES WHERE OUR LAW ENFORCEMENT PARTNERS HAVE BEEN CALLED OUT TO MARY AND THEY'VE GONE THROUGH THAT LIST AND THEY DETERMINED AT THAT MOMENT OF TIME IT WAS NOT JUSTIFIED TO DO AN EMERGENCY HOLD, UH, BUT WE WERE ABLE TO PROVIDE AID ANYWAY BECAUSE WE KNOW MARY AND, AND A, A LOT OF OUR PARAMEDIC PARTNERS AND A LOT OF OUR STREET OUTREACH PARTNERS KNOW, KNOW THIS INDIVIDUAL.
UH, THERE WERE ALSO TIMES WHEN LAW ENFORCEMENT WAS CALLED AND THEY WENT THROUGH THE CHECKLIST AND THEY DETERMINED THAT THE EMERGENCY DETENTION WAS WARRANTED.
YOU KNOW, I, I, I DO BELIEVE MARY'S PATHWAY INTO NO WRONG DOOR WAS THROUGH, UH, A, A POED.
UH, WHAT I CAN SAY IS THAT MARY HAS CONTINUED TO BE CONNECTED TO THE NO WRONG DOOR PROGRAM.
UH, BEFORE TODAY'S HEARING, UH, I WAS TALKING WITH A COMMUNITY MEMBER AND, AND THEY BROUGHT THIS PERSON UP AND MENTIONED THAT, UH, THEY'VE SEEN A LOT OF IMPROVEMENT IN, IN SEEING THIS PERSON AROUND TOWN, AND THEY'RE NOT PART OF THE NO WRONG DOOR PROGRAM.
AND I THINK THAT'S PROBABLY THE BIGGEST, UH, EVIDENCE OF SUCCESS FOR ME PERSONALLY IS, IS THE PROGRAM STILL, IS THE PERSON STILL CONNECTED TO THE PROGRAM? AND ARE OTHER PEOPLE, UH, WHO DO NOT SEE THE QUIET WORK HAPPENING IN THE BACKGROUND, ARE THEY SEEING THE RESULTS OF THE QUIET WORK THAT'S HAPPENING? UH, AND THAT IS HAPPENING.
BUT, BUT AGAIN, COUNCIL MEMBER, THERE ARE CASES WHERE SOMEBODY LIKE MARY, UH, THE INVOLUNTARY COMMITMENT MIGHT BE WARRANTED.
THERE ARE OTHER TIMES OF THAT SAME DAY WHERE MAYBE IT'S NOT, BUT THE DOORS TO THE PROGRAM ARE ALWAYS OPEN FOR THOSE WHO DID IT.
UH, AND WE ARE NOT GONNA TURN ANY OF THOSE 950 INDIVIDUALS AWAY, UH, IF THEY ARE WILLING TO ACCEPT...
[03:00:01]
OR IF WE FIND THEM IN A STATE WHERE THEY CANNOT MAKE THAT DECISION, UH, AND, AND THAT INVOLUNTARY HOLD IS, IS NECESSARY.THANK YOU FOR EXPLAINING THAT.
MAYBE TIM, I THINK, UH, THAT'S PROBABLY MY TIME, SO TIME WARRANTED MIGHT BE ABLE TO COME BACK AROUND.
UH, UH, THANK YOU, UH, UH, COUNCIL MEMBER.
UH, IF ANYBODY THAT HASN'T ASKED ANY QUESTIONS, UH, I DON'T KNOW IF, UH, COUNCIL MEMBER.
UH, I'M JUST HAVE A COUPLE OF QUICK QUESTIONS AND THEN WE'LL GO BACK TO MIKE AND, UH, CHRIS TO COUNCIL MEMBER SIEGEL AND COUNCIL MEMBER LANE.
UM, WE'VE HEARD, AND I REALLY APPRECIATE THE OVERLAY OF THE PROGRAM, THE GOALS, THE, THE MEASURES, UH, THE, THE PARTNERSHIPS.
UH, I WOULD LOVE TO HEAR, UH, TO UNDERSTAND A LITTLE BIT BETTER ABOUT KIND OF WHAT IT DOES ON A MORE KIND OF DAY-TO-DAY LEVEL.
AND, AND, UH, MAYBE USING THE EVE AND OSCAR EXAMPLES, KIND OF, YOU KNOW, WHAT WAS HAPPENING WITH EVE AND OSCAR BEFORE NO WRONG DOOR AND WHAT IS HAPPENING WITH EVE AND OSCAR NOW THAT, UH, NO WRONG DOOR IS IN EXISTENCE, JUST TO KIND OF GET A BETTER UNDERSTANDING OF THE CHANGES THAT WE'RE TALKING ABOUT KIND OF ON A DAY-TO-DAY BASIS, BOTH SO THAT, YOU KNOW, THE COUNCIL CAN UNDERSTAND AND THE PUBLIC CAN UNDERSTAND WHAT WE'RE TALKING ABOUT.
COUNCIL, I'M, I' HAPPY TO TAKE THE LEAD ON THAT ONE.
UM, SO, SO OSCAR AND EVE, LET'S SAY OSCAR IS THE NO WRONG DOOR CLIENT AND, AND EVE IS NOT.
UH, SO TYPICALLY, UH, EVE WOULD BE A, A PERSON WHO IS HOMELESS, CYCLING THROUGH HEALTHCARE, CYCLING THROUGH THE CRIMINAL JUSTICE SYSTEM, UH, AND ESSENTIALLY AT THE POINT, UH, SHE IS RELEASED, EVE WOULD RECEIVE A PAMPHLET FROM A HOSPITAL OR FROM SOMEBODY AT THE JAIL OR SOMEBODY AT THE SHELTER AND SAY, "HEY, EVE, HERE ARE ALL THE RESOURCES AVAILABLE TO YOU IN OUR COMMUNITY.
IT'S, IT'S SOMEWHAT OF AN ALPHABET SOUP, BUT YOU CAN CALL ANY OF THESE ORGANIZATIONS, UH, AND, AND THEY WILL HELP YOU.
WE HAVE YOUR INFORMATION, THEY WILL HELP YOU." WELL, EVE AIN'T CALLING NOBODY, RIGHT? LET'S JUST BE HONEST.
E- EVE, VERY RARELY IS EVE GOING TO CALL SOMEBODY.
MORE LIKELY THAN NOT, BECAUSE OF EVE'S MENTAL STATE, B- BY THE TIME EVE HITS THE STREET AGAIN, SHE'S STARTING TO REGRESS BACK INTO WHATEVER THAT OLD PATTERN IS, SOMETIMES EVEN WORSE.
AND AS EVE REAPPEARS THROUGH OUR SYSTEM, THIS THING CALLED HER BASELINE GETS RESET.
SO, SO YOUR BASELINE IS ESSENTIALLY YOUR LEVEL OF COMPETENCY.
AND CERTAIN PARTNERS IN THE SYSTEM ARE ONLY REQUIRED TO RESTORE EVE BACK TO EVE'S BASELINE.
UH, AND SO I COULD SAY IF SOMEBODY COMES TO MY ER, I'M GONNA TREAT THEM BACK TO THEIR BASELINE.
I'M NOT GONNA CURE THEM, JUST GET THEM BACK TO THE BASELINE AND THEN I CAN RELEASE THEM.
WELL, THOSE PARTNERS ALSO HAVE THE ABILITY TO RESET THE BASELINE.
SO MAYBE OVER TIME, MUCH LIKE MARY, EVE'S CONDITION GETS WORSE.
AND NOW WE ARE REDEFINING THE BASELINE.
BASELINE'S BECOMING LOWER AND LOWER AND LOWER TO A POINT WHERE WE ALL SAY, "NOTHING WE CAN DO." AND THAT'S EVE'S STORY UNTIL EVE PARISHES ON THE STREET OR EVE COMMITS A CRIME THAT LANDS HER IN JAIL FOR THE REST OF EVE'S LIFE.
UH, THIS MIGHT BE AN IMPORTANT O- OPPORTUNITY FOR ME TO MAYBE RESET A, A COMMENT THAT WAS MADE EARLIER.
NO WRONG DOOR IS NOT AN APD-LED INITIATIVE.
IT'S ACTUALLY AN INITIATIVE THAT CAME OUT OF OUR CITY MANAGER'S OFFICE.
SO THE CITY MANAGER CONVENED, UH, A GROUP OF PARTNERS WHO ARE HERE REPRESENTED TODAY TO SAY EVE'S STORY IS NOT ACCEPTABLE.
WE CANNOT CONTINUE TO HAVE THESE EVES ON, IN, IN OUR COMMUNITY.
IT'S A HORRIBLE OUTCOME FOR EVE.
IT'S A HORRIBLE OUTCOME FOR OUR COMMUNITY.
IT'S A, IT'S A HUGE EXPENSE TO TAXPAYERS AND IT'S INEXCUSABLE THAT OUR AGENCIES CANNOT DO THE REAL HANDOFFS AND WRAP THE CONSTELLATIONS OF SERVICES AROUND THE EVE.
SO NOW YOU FAST FORWARD TODAY TO OSCAR, OSCAR'S STORY.
UH, OSCAR MAYBE IS SOMEBODY WHO IS EXPERIENCING A MENTAL HEALTH, UH, DISORDER, MAYBE HAVING A MENTAL HEALTH EPISODE ON SOUTH CONGRESS.
AND THE GOOD RESIDENTS OF AUSTIN CALL 911 AND THE DOWNTOWN POLICE OFFICERS SHOW UP AND THEY'RE INTERACTING WITH OSCAR.
UH, OSCAR MIGHT BE AT A POINT WHERE HE IS NOT COMPETENT ENOUGH TO, TO, TO QUALIFY FOR, UM, A VOLUNTARY HOLD.
AND SO THE POLICE DECIDE WE'RE GONNA DO AN INTO VOLUNTARY HOLD.
UH, OR THE POLICE MIGHT DECIDE WE'RE GONNA TAKE OSCAR TO THE SOBERING CENTER OR TO A HOSPITAL OR TO ANOTHER PARTNER, UH, IN THIS PROGRAM.
THAT PROGRAM OR THAT PARTNER MIGHT S- START THE PROCESS.
THEY WILL START THE PROCESS OF TREATING OSCAR AND, AND TRIAGING OSCAR'S NEEDS.
BEFORE OSCAR IS RELEASED, AN ACTUAL PHONE CALL IS MADE TO THE OFFICER, TO THE EMS TECHNICIAN, OR TO OUR INTEGRAL CARE PARTNERS TO SAY, "HEY, WE HAVE OSCAR.
WE KNOW OSCAR IS ON THE NO WRONG DOOR LIST.
OSCAR QUALIFIES FOR RELEASE TOMORROW.
DO YOU HAVE A PLACE WHERE WE CAN BRING OSCAR TO? WE ARE NOT GOING TO RELEASE OSCAR TO THE STREET.
WE WANNA MAKE SURE THAT OSCAR HAS REAL OPTIONS FOR US TO TRANSFER HIM
[03:05:01]
INTO ANOTHER SERVICE THAT CAN PROVIDE ONGOING CARE." INTEGRAL CARE MIGHT HAVE A BED AVAILABLE.INTEGRAL CARE ALSO MIGH SAY, "WE DON'T HAVE A BED AVAILABLE TODAY.
THE BED'S NOT GONNA BE ABLE UNTIL FRIDAY." SO THEN WHAT HAPPENS IN OSCAR'S STORY IS WE MIGHT GET THE CALL.
AND THIS IS A ACTUAL PERSON THAT I'M THINKING OF, BUT WE'LL GET THE CALL AND WE SAY, "HEY, WE HAVE A BED AVAILABLE AT ONE OF OUR SHELTERS, MAYBE AT NORTHBRIDGE.
"BUT WE DON'T HAVE THE STAFF TO TREAT OSCAR.
WE CAN PROVIDE OSCAR WITH THE ROOM IF YOU, INTEGRAL CARE CAN PROVIDE OSCAR WITH THE SUPPORT." AND THEY AGREED TO IT.
AND SO NOW WE'RE LEVERAGING OUR SHELTER BED WITH INTEGRAL CARE'S CASE MANAGEMENT TO PROVIDE OSCAR WITH THAT WRAPAROUND SUPPORT.
AND SO OSCAR CAN MOVE INTO THE PROPER INTEGRAL CARE FACILITY TO PROVIDE THE ONGOING TREATMENT.
AND THAT LEVEL OF HANDOFF CONTINUES UNTIL OSCAR VOLUNTARILY DECIDES TO LEAVE THE PROGRAM, WHICH OSCAR CAN DO, IN WHICH CASE WE'RE A SYSTEM OF SECOND CHANCES.
WE WILL ALWAYS WELCOME OSCAR BACK.
OR AS HAS HAPPENED, OSCAR MIGHT TRANSITION, HE MIGHT STABILIZE, GET ON A TREATMENT PLAN AND TRANSITION INTO A PERMANENT SUPPORTIVE HOUSING UNIT OR LONG-TERM CARE WITH FAMILY, UH, OR LONG-TERM CARE IN, IN A HOSPITAL SYSTEM.
BUT I THINK YOU CAN SEE THE LEVEL OF INTENTIONALITY WITH THE RESOURCES THAT WE HAVE IS EXTREMELY DIFFERENT FROM WHAT IT WAS BEFORE THE CITY MANAGER'S OFFICE INITIATED NO WRONG DOOR TO WHAT IT IS TODAY.
THE MISSING ELEMENTS IN THIS STORY ARE THE CRISIS CARE CENTER AND SOME OF THE LONGER TERM TREATMENT BEDS.
AND YOU'VE HEARD OUR COLLEAGUES TALK ABOUT HOW THEY'RE ALREADY TAKING THE STEPS TO FILL IN THEIR GAPS.
WHAT WE RECOGNIZE IS THAT WE, WE COULDN'T WAIT TILL PERFECTION BEFORE WE STARTED MAKING PROGRESS.
WE, WE ABSOLUTELY HAD TO START SOMEWHERE FOR THESE CLIENTS AND FOR OUR COMMUNITY.
UH, I THANK THE CITY MANAGER AND, AND HIS EXECUTIVE TEAM FOR GIVING US THIS CHARGE.
I'M REALLY GRATEFUL FOR MY PARTNERS IN DOING THE WORK AND WE ARE HAVING THOSE REAL OUTCOMES, MAYOR PRO TEM.
ONE LAST THING THAT I'LL SAY IS THAT WE DIDN'T HAVE THE SLIDE TODAY, BUT WE HAVE HAD A S - A SLIDE IN, IN PREVIOUS, UH, THAT WE'VE USED IN PREVIOUS CONVERSATIONS THAT HAS ACTUALLY SHOWED A REAL EXAMPLE.
I KNOW I'M SPEAKING IN A HYPOTHETICAL, BUT WE ACTUALLY HAVE A REAL EXAMPLE OF TWO CLIENT JOURNEYS.
ONE WHO IS NO WRONGDOOR QUALIFIED AND HAS NOT PARTICIPATED, THE OTHER WHO IS NO LONGER QUALIFIED AND HAS PARTICIPATED.
AND YOU CAN SEE EVEN IN THE VERY SHORT TIME THAT THIS PROGRAM HAS INITIATED, YOU COULD SEE VERY REAL OUTCOMES IN THOSE PEOPLE'S LIVES.
AND SO WE'RE HAPPY TO MAKE THAT INFORMATION AVAILABLE TO YOU AND, AND OF COURSE OTHERS, UH, HERE ON THE DIAS IF YOU WOULD LIKE IT.
AND DAVID, IF I CAN JUST ADD TO THAT, JUST AGAIN FROM, FROM THE HEALTHCARE PERSPECTIVE, WE HAVE FOLKS...
INTEGRAL CARE SERVES OVER 30,000 PEOPLE A YEAR.
AND OF THAT, WE HAVE A LOT OF PEOPLE THAT ARE GOING THROUGH TREATMENT RIGHT NOW THAT HAVE BEEN INCREDIBLY SUCCESSFUL.
LINKEDIN, WITH THESE TREATMENT PLANS, LINKEDIN FOR OVERALL HEALTHCARE AND, AND DOING INCREDIBLY WELL.
UM, THIS POINT OF CONTACT AND GETTING PEOPLE ENGAGED IN TREATMENT AND THEN LETTING THE HEALTHCARE FOLKS TAKE OVER IS REALLY KEY.
I THINK THAT WAS A, A REALLY GOOD, UH, EXAMPLE.
AGAIN, JUST TRYING TO KIND OF UNDERSTAND WHAT'S ACTUALLY HAPPENING.
SO WE'RE REALLY TALKING ABOUT COMMUNICATION AND COORDINATION WHEN WE TALK ABOUT NO WRONG DOOR, UH, NOT NECESSARILY KIND OF NEW ARRAY OF SERVICES - RIGHT.
BUT JUST MAKING SURE THAT, UH, YOU KNOW, WE KNOW WHAT INTEGRAL CARE IS DOING, INTEGRAL CARE KNOWS WHAT EMS IS DOING.
AND, AND, UH, YOU KNOW, AND I APPRECIATE THAT.
AND I'LL JUST BRIEFLY, UH, UH, MENTION, FOR EXAMPLE, THE SOBERING CENTER.
UH, I KNOW SOBERING CENTER IS ONE OF THE NO WRONG DOOR PARTNERS, BUT, YOU KNOW, THE, THE, THE BRIDGE, UH, A PROGRAM WHERE, YOU KNOW, THEY WOULD GET SOMEBODY AND THEY WOULD SOBER UP, UH, AND THEY WOULD HAVE THAT, YOU KNOW, KIND OF COME TO JESUS MOMENT WHERE THEY'RE LIKE, "I, I NEED TO STOP.
YOU KNOW, I NEED TO STOP." UH, AND, AND THEY WERE WILLING TO GET INTO TREATMENT, UH, BUT TREATMENT WAS NOT GONNA BE AVAILABLE FOR, YOU KNOW, FOUR DAYS, A WEEK, WHATEVER THE CASE MAY BE.
IF YOU TELL THAT PERSON, YOU KNOW, CALL US ON THURSDAY, YOU KNOW, AND, AND LET THEM OUT THE DOOR, UH, YOU KNOW, THAT, THAT, THAT, THAT FEELING, THAT COMMITMENT, UH, IS GONNA DISSOLVE AND THEY'RE PROBABLY GONNA SHOW UP AT THE SOBERING CENTER AGAIN, HIGHLY INTOXICATED AGAIN, MAYBE IN JAIL.
UM, AND IT WAS THAT, THAT BRIDGE PROGRAM WHERE IT WAS LIKE, "WE'RE GONNA HOLD YOU HERE FOR, YOU KNOW, FOUR DAYS, FIVE DAYS UNTIL WE CAN FIND A BED AND THEN HAVE THAT WARM HANDOFF FROM ONE INSTITUTION TO ANOTHER INSTITUTION SO YOU DON'T HAVE THOSE GAPS." UH, SO ANYWAY, I JUST, I, I APPRECIATE VERY, VERY MUCH THAT EXPLANATION AND IT REALLY DOES DOVETAIL WITH, UH, THE, THE CONVERSATION THAT WE'VE HAD THERE ON THAT, THE SOBERING CENTER BOARD.
SO LET ME, UH, UH, COUNCIL MEMBER SIEGEL.
THANK YOU, MAYOR PARTAM, AND, UH, I GUESS DIRECTOR ROGERS, IF, IF YOU HAVE A COUPLE MINUTES, I'D LIKE YOU TO COME BACK.
UM, BUT COLLEAGUES, I GUESS I JUST WANNA USE MY TIME TO TRY TO MAKE A NUANCED POINT, WHICH IS, UM, THERE'S A TON TO REALLY CELEBRATE ABOUT THIS INITIATIVE, ABOUT THE COLLABORATION, ABOUT HOW HARD IT IS TO GET 17 DIFFERENT AGENCIES TO COLLABORATE ON SOMETHING LIKE THIS, HOW NECESSARY
[03:10:01]
THESE TYPES OF INTERVENTIONS ARE.BUT AT THE SAME TIME, I THINK WE ARE HEARING THAT THIS IS A WORK IN PROGRESS.
AND I JUST WANNA FLAG THAT WHILE THIS IS A WORK IN PROGRESS, WE'RE ALSO SENDING MESSAGES TO LEGISLATURE DEMANDING PRETTY SPECIFIC POLICIES FROM WHAT I'VE READ.
AND SO I THINK THERE'S A BALANCE HERE ABOUT SUPPORTING THE COLLABORATION, CELEBRATING THE INTENTION AND WORK AND RESOURCE FOCUS, BUT ALSO SAYING, "HAVE WE SENT THE RIGHT MESSAGE TO THE LEGISLATURE IN TERMS OF, OF WHAT OUR LEGISLATIVE OFFICE IS DOING?" AND, UM, SO I JUST WANNA SUMMARIZE WHAT I THINK THE COMMUNITY HAS RESPONDED TO AND SPOKEN TO MY OFFICE ABOUT, THAT THERE'S A CONTRADICTION BETWEEN, UM, BASICALLY GOING BACK TO THE TRUMP EXECUTIVE ORDER OF LAST YEAR AND THE CICERO INSTITUTE BEING DIRECTLY OPPOSED TO HOUSING FIRST.
THAT'S LIKE A NATIONAL AGENDA THAT'S FIGHTING HOUSING FIRST.
AND SO WHEN WE HEARD THESE QUESTIONS EARLIER FROM COUNCIL MEMBER CADRE ABOUT COLLABORATION WITH THE CICERO INSTITUTE, THAT IT'S SPEAKING TO THAT CONCERN THAT THERE'S AN AGENDA THAT'S FOCUSED ON, FRANKLY, CRIMINALIZING HOMELESSNESS AND THEN PROVIDING RESOURCES AFTER THE FACT INSTEAD OF INTERVENING BEFORE THE FACT.
AND AS A COUNCIL, WE'VE ENDORSED HOUSING FIRST.
WE EVEN TOOK A STEP LAST DECEMBER THE, TO, UH, ADOPT RESOLUTION, LIKE, CELEBRATING HOUSING FIRST AS A STRATEGY.
BUT THE TRUMP EXECUTIVE ORDER SEEKS TO OUTLAW HOUSING FIRST.
THE CICERO INSTITUTE IS FIGHTING AGAINST IT.
AND THE, UM, LETTER THAT THE MAYOR SENT TO THE SUNSET ADVISORY COMMISSION, UM, THAT WAS INCLUDED WITH THE PUBLIC MEMO THAT WE GOT ON AUGUST 3RD HAS THIS LANGUAGE THAT COUNCIL MEMBER LANE BROUGHT UP.
IT SAYS, YOU KNOW, SENATOR COLKERS, CHAIR OF THE SUNSET ADVISORY COMMISSION, QUOTE, "WITHOUT QUESTION, DIVERSION MUST BE HANDLED WITHIN A POST-ADJUDICATION STRUCTURE IN WHICH A SENTENCE IS DEFERRED PENDING SUCCESSFUL COMPLETION OF AN EXTENDED MENTAL HEALTH PROGRAM." AND THAT KIND OF POST-ADJUDICATION ARGUMENT DIRECTLY CONTRADICTS EXISTING COUNCIL POLICY FOR HOW WE WANNA INTERVENE.
AND WE HEARD IT FROM, FROM THE DISTRICT ATTORNEY A- AND SOME OF THE COUNTY FOLKS.
IF, IF DEFLECTION IS THE GOAL, THEN WE CAN'T ADOPT THIS POST-ADJUDICATION STRATEGY.
SO THIS IS LIKE NUANCE AND, UM, YOU KNOW, THE GRO TEAM HAS SPOKEN WITH MY OFFICE AND SAID THAT WAS BASICALLY NOT INTENDED AS A LEGISLATIVE DIRECTION.
BUT WE'VE, WE'VE ALREADY PUT THAT MESSAGE OUT THERE UNDER, YOU KNOW, THE, THE NAME OF OUR MAYOR, THAT THIS IS OUR GOAL.
AND, AND I THINK WHEN I THINK OF THE LEGISLATIVE STRATEGY THAT WE ADOPTED AS A COUNCIL, IT DIDN'T INCLUDE THAT, RIGHT? UM, AND SO I GUESS I WANTED TO ASK DIRECTOR ROGERS, BECAUSE I KNOW YOU'VE BEEN INVOLVED IN ALL THESE CONVERSATIONS AND THIS IS AN EVOLVING EFFORT, AND THIS IS BY NO MEANS LIKE A, AN ARGUMENT THAT WE SHOULD THROW OUT ALL THIS WONDERFUL WORK BECAUSE WE MADE A MISTAKE HERE.
BUT IS THERE AN A - GOING TO BE AN ATTEMPT TO CLARIFY WITH SENATOR KOLKERS OR LEGISLATURE THAT OUR ADVOCACY FOR SOME SORT OF STATE LAW CHANGE IS EVOLVING AND THAT WE'RE NOT ASKING FOR A POST ADJUDICATION STRUCTURE? THANK YOU, COUNCIL MEMBER, FOR THAT QUESTION.
UM, AS YOU KNOW, THE LEGISLATIVE PROCESS IS A DYNAMIC ONE.
UM, AND YOU INDICATED, AND IT IS TRUE THAT, UH, THE ITEMS THAT WE'RE WORKING THROUGH ARE EVOLVING.
I INDICATED TO YOUR STAFF YESTERDAY IN MOST ANY CONVERSATION THAT WE'VE HAD ON THIS OVER THE LAST SEVERAL WEEKS, THAT THERE WILL BE A NUMBER OF, UH, ONE-PAGERS AND TESTIMONIES AND ADDITIONAL COMMUNICATIONS AS THESE TWO INTERIM CHARGES THAT WERE PICKED UP IN BOTH THE HOUSE AND SENATE ARE TAKEN UP.
UM, MUCH OF THE LETTER THAT WAS, UH, COMMUNICATED TO CHAIR COLCOURSE FOLLOWING THAT SUNSET HEARING WAS INTENDED TO COUNTER SOME OF THE THINGS THAT WERE SAID DURING THE SENATE HEARING, AND I BELIEVE THAT THAT WAS PART OF IT.
UM, I DID DISCUSS WITH YOUR STAFF, UM, PERHAPS THE INCORRECT TERM WAS USED, UM, BUT WE HAD A CONVERSATION ABOUT PRETRIAL, UM, DIVERSION AND DEFLECTION, AND SO I APPRECIATED THAT EDUCATION.
UM, BUT YES, I THINK THERE WILL BE AMPLE OPPORTUNITY, UM, AS WE SAID EARLIER WHEN WE WERE TALKING ABOUT THE LEGISLATIVE ITEMS, IT IS, IT IS DYNAMIC.
UM, THERE IS A GOAL TO HAVE A LEGISLATIVE PLATFORM THAT IS AGREED UP - AGREED UPON ACROSS ALL THE PARTNERS THAT ARE INVOLVED IN NO, UH, INVOLVED IN NO WRONG DOOR.
THERE MAY BE ADDITIONAL RECOMMENDATIONS, BUT THOSE WILL CERTAINLY BE A PART OF, UM, LEGISLATIVE UPDATES AND BRIEFING AND COMMUNICATIONS THAT WE CONTINUE TO HAVE WITH CITY COUNCIL.
BUT YOUR FEEDBACK I- IS NOTED, AND I HEAR YOU, UM, AND YOU HAVE OUR OFFICE'S COMMITMENT TO CONTINUE TO WORK WITH COUNCIL ON THOSE.
THANK YOU VERY MUCH, DIRECTOR.
AND I JUST DID WANNA FOLLOW UP ON COUNCIL MEMER CODY'S QUESTION ABOUT THE CICERO INSTITUTE, BECAUSE IT IS TRUE THAT, THAT YOUR TEAM HAS BEEN MEETING WITH THEM, INCLUDING ABOUT NO WRONG DOOR.
ISN'T THAT RIGHT? UM, UM, BACK IN SEPTEMBER...
I DON'T KNOW IF DAVID'S STILL HERE.
UM, BACK IN SEPTEMBER, UH, TPPF HAD REACHED OUT TO DAVID AS AN OPPORTUNITY TO HEAR,
[03:15:01]
UM, ABOUT DAVID'S WORK AND HIS TEAM'S WORK IN THE HOMELESSNESS STRATEGY SPACE.UM, DAVID INVITED ME TO THAT MEETING, AND AT THAT MEETING, CICERO WAS AT THAT MEETING.
AND SO I WOULD SAY THERE HAVE BEEN, UM, CONVERSATIONS AS NEEDED, CERTAINLY WITH THE TESTIMONY OVER THE SUMMER.
WE COMMUNICATED WITH THEM AT THAT HEARING.
I THINK THAT'S THE ADVOCATE'S CONCERN, RIGHT? IS THAT, THAT THE AGENDA THAT THEY ARE FUNDING LO - IN, IN THE STATE AND NATIONALLY IS KIND OF CONTRARY TO SOME EXISTING COUNCIL POLICIES.
UM, ANOTHER LETTER, ANOTHER ASPECT, UM, OF THE MEMORANDUM PACKET HAD A, A RECOMMENDATION ABOUT THE TEXAS HEALTH AND SAFETY CODE, CHAPTER 574, TO QUOTE, "REDUCE STATE LEGAL THRESHOLD FOR INVOLUNTARY PSYCHIATRIC INTERVENTION." UM, AND SO THIS IS SOMETHING THAT, YOU KNOW, AS A CIVIL RIGHTS LAWYER, W- WAS KIND OF A CONCERN FOR ME, UM, BECAUSE RIGHT NOW, UM, THERE'S A PRETTY HIGH LEGAL BAR TO HAVE SOMEONE CIVILLY COMMITTED.
AND THERE'S EVEN US SUPREME COURT CASES ABOUT, YOU KNOW, 14TH AMENDMENT DUE PROCESS RIGHTS.
AND, UM, AM I CORRECT THAT, YOU KNOW, WE'RE NO LONGER ADVOCATING TO TRY TO LOWER THAT LEGAL THRESHOLD? NO, SIR.
WE ARE NOT ADVOCATING FOR THAT.
THAT WAS IN RESPONSE TO COMMENTS MADE AT THE HEARING OF WHAT IS THE WORLD OF POSSIBLE THAT, UM, UH, THE SUNSET, UH, COMMISSION SHOULD BE STUDYING IN RESPONSE TO HHSC GOING THROUGH SUNSET RIGHT NOW.
IT HAS NEVER BEEN A PART OF OUR LEGISLATIVE PROGRAM, NOR IS IT INTENDED TO BE A PART OF OUR PROGRAM.
UM - MEMBER SIEGEL, IF I COULD JUST INTERJECT A LITTLE BIT.
NO, I, I NEED TO KEEP GOING BECAUSE I WANNA STICK WITH MY TIME, BUT SORRY, MA'AM.
I'M JUST GONNA KEEP GOING WITH DIRECTOR ROGERS, IF THAT'S OKAY.
UM, OR I GUESS THIS MIGHT BE BETTER DIRECTED TO THE CITY MANAGER, UM, BECAUSE I WANTED TO ASK KINDA MORE DIRECTLY ABOUT THE ACLU LETTER AND HOW WE'RE GONNA RESPOND TO THIS.
UM, SO, YOU KNOW, ONE OF THE THINGS THAT, UM, THE ACLU...
SO THE ACLU LETTER IS CONCERNED ABOUT NOTIFICATION OF, OF ATTORNEYS IN REGARD TO, UM, YOU KNOW, NO WRONGDOOR OUTREACH AND WHETHER THAT GENERATES EVIDENCE THAT WOULD BE ADVERSE TO THE PERSON THAT WE'RE, WE'RE INTERVENING TO SUPPORT.
AND, UM, THE, THE MEMORANDUM THAT THE CITY STAFF SENT OUT LAST WEEK SAYS OUR STANDARD OPERATING PROCEDURES WILL REQUIRE NO WRONGDOOR OFFICERS TO MAKE REASONABLE EFFORTS TO NOTIFY ATTORNEYS FOR HIGH UTILIZERS PRIOR TO ANY JAIL INTERVIEW.
AND, UM, MY TEAM LOOKED AT THE SOPS, THE STANDARD OPERATING PROCEDURES.
AND SO, UM, IS THAT, HAS THAT ALREADY BEEN ADDED TO THE SOPS? UH, MAYBE THIS IS A QUESTION FOR MARIS, UM, DIRECTOR/UH, FORMER CHIEF MARIS, UH, HAROLD.
UM, YEAH, COULD YOU SPEAK A LITTLE BIT ABOUT, LIKE, HOW WE'RE GONNA CLEAN UP THIS LEGAL NOTIFICATION ISSUE? YES, IT HAS BEEN ADDED TO OUR STANDARD OPERATING PROCEDURE, UM, AND THAT WE WILL DO DILIGENCE TO ENSURE THAT WE MAKE THE PROPER NOTIFICATION OF WHOMEVER'S REPRESENTING, UH, ONE OF THESE, UH, HIGH UTILIZER PEOPLE.
AND, UH, YEAH, IT, IT'S BEEN IMPLEMENTED.
SO DOES THAT MEAN THAT, UM, BEFORE ANY RELEASES ARE SIGNED, UH, AN ATTORNEY WILL BE NOTIFIED? WELL, I, I THINK AN IMPORTANT, UM, DISTINCTION RIGHT NOW IS THAT THE MAJORITY OF THE INDIVIDUAL RIGHT CONSENT TO, UM, I KEEP WANTING TO SAY CONSENT DEGREE, BUT INDIVIDUAL RIGHTS, UH, CONTRACTS, THE MAJORITY ARE BEING HANDLED BY INTEGRAL CARE, AND THEN EMS IS GONNA TAKE OVER THAT WHOLE SYSTEM.
UM, AND THEN THE ONLY TIME THAT AN OFFICER WOULD TRY TO GET THAT SIGNED WOULD BE, UM, IN A COMMUNITY SETTING WITH OUR PARTNERS, BUT THERE WILL BE TIMES WHEN THEY GO TO JAIL THAT WE WILL TRY TO GET THEM TO SIGN THE, THE AGREEMENT.
UM, AND WE HOPE THAT AN ATTORNEY FOR THEM WOULD BE WITH US.
UM, AND IF NOT, WE STILL HAVE, IN MY OPINION, A LEGAL DUTY TO RESPOND TO THE JAIL TO TRY TO GET THEM TREATMENT.
AND IT IS NOT TO KNOW ANYTHING ABOUT WHAT CRIME THEY COMMITTED, UM, OR PAST CRIMES.
IT IS SIMPLY, "DO YOU WANT TREATMENT? DO YOU WANT HELP? AND HOW CAN WE GET YOU TO THE RIGHT PERSON?" THAT, THAT IS IT.
AND IF WE NEED TO CLEAN THAT UP, I'M MORE THAN WILLING TO, TO DO THAT, BUT THAT, THAT IS WHAT WE'VE DONE THUS FAR.
BECAUSE THE MOU, THE MOU, WHETHER EMS ADMINISTERS THE RELEASE OR OUR POLICE DEPARTMENT, THE MOU HAS INFORMATION SHARING AGAINST, ACROSS ALL THE 17 PARTNERS, RIGHT? SO IF WE'RE CREATING A FILE THAT CAN BE ACCESSED BY THE POLICE FOR PURPOSES OF PROSECUTION, THAT'S, THAT'S KIND OF WHERE THIS CONCERN'S COMING FROM.
UH, WE CAN MOST CERTAINLY ADDRESS SOME OF THOSE CONCERNS.
UM, BUT I, I DON'T KNOW IF IT'D BE HELPFUL TO HAVE CHRIS COPPOLA UP TO, UH,
[03:20:01]
TALK ABOUT THE LEGALITY AND WHAT HE HAS SEEN FROM HIS OFFICE AND OUR WORK WITH THE SOPS, UM, WITH, UH, THE PUBLIC DEFENDERS, UH, AND MAYBE GET HIS TAKE SINCE HE IS THE ONE THAT HAS APPROVED THESE FORMS. UH, GOOD AFTERNOON, COUNSEL.CHRIS COPPOLA WITH THE LAW DEPARTMENT.
UH, SO YEAH, AND, AND IN PARTICULAR, YEAH, WE, WE DID CAREFULLY DESIGN THE RELEASE OF INFORMATION FORM ACROSS ALL OF THE PARTNERS, HAD FEEDBACK INTO IT, INCLUDING THE HEALTHCARE PROVIDERS, ASCENSION, INTEGRAL CARE, ET CETERA, TO MAKE IT A, YOU KNOW, A ROBUST RELEASE THAT WOULD ALLOW INFORMATION SHARING ACROSS THE, THE PARTNERS FOR THE SPECIFIC PURPOSE AS STATED IN THE MOU, TO USE THAT INFORMATION FOR THE SPECIFIC PURPOSE OF COORDINATING CARE.
THE, THE WAY THE MOU READS IS THAT THERE'S A COORDINATION CARE TEAM THAT'S SUPPOSED TO MEET TO DISCUSS THAT INFORMATION.
BUT DOES ANYTHING PREVENT THE POLICE DEPARTMENT FROM USING THAT INFORMATION FOR, UH, A CHARGE? WELL, SO THERE IS A, UH, THE MOU ITSELF DOES, DOES INDICATE THAT THE, THE INFORMATION'S SUPPOSED TO BE USED SPECIFICALLY TO COORDINATE CARE.
UH, THERE'S EVEN A PROVISION IN THERE WHICH SAYS THAT THE PARTNERS ARE MEANT TO, UH, TAKE, UH, LEGAL ACTION, ACTUALLY, TO PREVENT RELEASE OF INFORMATION OUTSIDE OF THE, THE, THE CONFIDENTIAL INFORMATION OUTSIDE OF THE MOU IF THEY NEED TO DO THAT.
UM, IT'S PRIMARILY AN INFORMATION SHARING TOOL.
UH, NO PARTNER, NO, NO PARTNER'S REQUIRED TO PROVIDE ACTUAL MEDICAL RECORDS, FOR EXAMPLE.
UH, THINGS LIKE PSYCHOTHERAPY NOTES ARE SPECIFICALLY EXCLUDED, UM, FROM SHARING.
SO THERE'S SOME, DEFINITELY SOME LIMITS AROUND WHAT'S SHARED AND WHAT KIND OF INFORMATION IS GONNA BE DISCUSSED.
IT'S MOSTLY ABOUT, I THINK, DISCUSSING DIAGNOSES, TREATMENT PLANS, AND THINGS LIKE THAT.
HAVE YOU LOOKED AT THE PROPOSED SAFEGUARDS AT THE END OF THE ACLU LETTER? UM, I GUESS IT'S, UH, PAGE 22 OF THE BACKUP DOCUMENT HERE.
I DON'T HAVE IT IN FRONT OF ME.
I GUESS I DON'T KNOW IF THIS IS A QUESTION FOR THE LAW DEPARTMENT OR CITY MANAGER, BUT, UM, HAS THE CITY TAKEN ANY STEPS TO ANALYZE THE ACLU SAFEGUARDS AND WHETHER, UH, WE CAN ADOPT THEM AS A PART OF THE NO WRONG DOOR PROGRAM? SO, YOU KNOW, LIKE, LIKE I SAID, COUNCIL MEMBER, LIKE, UH, UH, UH, MS. HAROLD SAID, COUNCIL MEMBER SIEGEL, I THINK, YOU KNOW, SOME OF THE, SOME OF THE PROPOSED SAFEGUARDS AS WE'VE BEEN BUILDING THIS PROGRAM HAVE BEEN INCORPORATED INTO THE SOPS.
THERE IS A PROVISION IN THERE, UH, REQUIRING OFFICERS TO MAKE EFFORTS TO NOTIFY ATTORNEYS, FOR EXAMPLE.
YOU KNOW, UH, ONE OF THE, ONE OF THE EXAMPLES THAT I HEARD THIS MORNING, UM, THAT I THINK MS. SHEARER MENTIONED WHEN SHE CALLED IN THIS MORNING WAS SOMETHING ABOUT NOT MIRANDIZING, UH, PEOPLE WHEN THEY'RE INTERVIEWED IN JAIL BY AN OFFICER.
YOU KNOW, THAT'S SOMETHING THAT WAS ANALYZED.
I THINK WE TALKED WITH, UM, UH, PROSECUTORS ABOUT THAT, AND IT WAS DECIDED THAT, UH, FOLKS SHOULD KNOW WHAT THEIR RIGHTS ARE IF THEY'RE GOING TO BE HAVING A CUSTODIAL INTERVIEW WITH A POLICE OFFICER.
SO THEY SHOULD KNOW THEY HAVE THE RIGHT TO REMAIN SILENT, FOR EXAMPLE.
SO THAT DECISION WAS MADE TO CONTINUE TO MIRANDIZE THEM IN THAT SETTING.
SO THERE'S DIFFERENT THINGS WE HAVE LOOKED AT.
IT'S, IT'S AN EVOLVING PROGRAM.
WE'RE CERTAINLY, YOU KNOW, I KNOW THERE'S WILLINGNESS ON MANAGEMENT'S PART TO CONTINUE TO LOOK INTO DIFFERENT SOLUTIONS.
UM, COLLEAGUES, AS YOU CAN TELL FROM MY QUESTIONS, UM, I WANNA MAKE SURE THAT WHATEVER OUR CITY TEAM IS AT, IS LOBBYING FOR AT THE STATE LEDGE, THAT IT'S WITH OUR FULL AWARENESS AND AGREEMENT AS A COUNCIL.
AND I'M NOT SURE THAT'S COMPLETELY BEEN THE CASE SO FAR.
AND SO I'M GLAD THAT PUBLIC HEALTH IS DISCUSSING THIS TOMORROW.
AND I THINK BEFORE THE CITY FILES ANY BILLS, WE SHOULD BE FULLY AWARE AND WE SHOULD BE ON BOARD WITH ANY LEGAL CHANGES THAT WE'RE SEEKING.
THANK YOU, COUNCIL MEMBER TOO.
ANY FURTHER QUESTIONS, COMMENTS? ALL RIGHT.
WE, UH, THANK Y'ALL VERY MUCH FOR THE PRESENTATION.
OBVIOUSLY, THERE'S A LOT OF, UH, INTEREST AND ENGAGEMENT, UH, AND LOOK FORWARD TO CONTINUING THE, THE CONVERSATION AROUND NO WRONG DOOR.
UH, WE ARE GOING TO POSTPONE THE EXECUTIVE SESSION UNTIL THURSDAY WHEN, UH, WHEN THE MAYOR, UH, RETURNS.
UH, SO WITH, UH, NO FURTHER BUSINESS BEFORE THE DIAS, WE ARE ADJOURNED AT 12:23.