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A
A
A
Okay,
now
I
have
a
prior
commitment,
so
I'm
leaving
now
and
giving
the
gavel
to
ken
fleming
I'll
be
back
in
just
a
minute.
I
have
two
committees
going
on
same
time,
so
put
that
on
the
record,
so
ken
here's,
the
gavel.
B
B
Well
what
we
like
to
do
today,
where
this
morning
we're
going
to
hear
from
the
behavioral
health,
development
and
intellectual
disabilities,
and
also
we
have
judge
stephanie
burke,
who
also
provides
some
information
on
her
experience
during
the
I
guess,
the
first,
the
first
phase
of
the
tim's
law,
the
presentation
you
should
have
received
access
to
that
I
think
last
night
or
whenever
it
was
posted,
so
they're
gonna
go
over
that
presentation
and
talk
about
the
tim's
law.
B
If
you
don't
mind,
just
hold
off
your
questions
till
after
complete
and
then
we'll
just
we'll
go
from
there.
So
with
that,
ladies,
if
you
don't
mind,
go
ahead
and
identify
yourself
and
then
you've
got
the
floor.
D
Good
morning
my
name's
tanya
dickinson,
I'm
the
with
the
aot
pilot
project,
assisted
outpatient
treatment,
pilot
project
with
the
department
for
behavioral
health
and
with
me
is
deputy
commissioner
stephanie
craycraft
and
we're
very
pleased
to
to
be
with
you
this
morning
and
to
hopefully
provide
you
some
information,
additional
information
about
the
project
and
answer
some
questions.
If
we
can,
let's
see,
I
think
I
think
I
have
the
ability
to
share
my
screen
and
go
to
the
powerpoint
and
we'll
see
how
that
works
out.
D
And
I
don't
think
we'll
lose
anything
to
lose
too
much
with
the
little
faces
over
there
at
the
side.
But
if
I
have
to
I'll
move
that
later
or
minimize
it
even
further,
if
necessary,
the
substance
abuse
mental
health
agency
for
with
healthcare,
federal
health
and
human
services
awarded
the
department
for
behavioral
health,
an
aot
pilot
project
grant
in
july
2020
it's
to
address
the
assisted,
outpatient
treatment
statute
that
was
originally
known
as
tim's
law.
In
kentucky
it's
a
four
million
dollar
award
one
million
per
year
for
four
years
services
initiated
in
december
2020.
D
We're
projected
to
serve
192
clients
across
two
state
hospital
regions.
Phase
one
which
is
currently
in
operation
is
with
central
state
hospital
region
with
communicare
and
seven
counties.
Community
mental
health
centers
phase
two
will
begin
this
august
in
the
western
kentucky
hospital
region
and
that
will
involve
penny
royal
center
and
river
valley,
behavioral
health,
community
mental
health
center
regions.
D
The
map
there
is
of
the
current
pilot
project
in
its
operations
phase
one
is
in
purple
central
state,
seven
counties
and
communicator
phase.
Two
is
in
green,
which
is
western
state
hospital,
penny
royal
and
river
valley,
and
we
have
requested
that
the
federal
agency
allow
us
to
expand
to
two
more
of
the
community
mental
health
centers
serving
the
western
state
hospital
region,
so
that
the
entirety
of
that
state
hospital
region
is
is
covered
fairly.
Small
counties
don't
expect
too
many
additional
referrals
from
there,
but
wanted
to
make
sure
they
were
all
indeed
covered.
D
We
we
recognize
that
the
some
of
these
individuals
are
the
sickest
of
the
sick,
we're
not
going
to
stop
re-hospitalizations
or
other
consequences
to
them,
but
we
want
to
reduce
them
significantly
through
the
use
of
aot
costs
that
are
covered
by
the
grant
community
mental
health
center
staff
and
limited
client
support
funds,
training
in
assisted
outpatient
treatment,
services,
materials,
development
and
publishing
and
evaluation
treatment.
It
should
also
be
noted
that
while
we
do
cover
some
treatment,
costs
providers
do
bill
third-party
payers
whenever
those
are
available
for
qualifying
services.
D
The
services,
the
pilot,
aot
treatment,
pilot
project,
aot
treatment
services
actually
delivered.
We
have
a
a
really
extensive
flow
chart
available
on
our
website.
This
just
reduces
it
to
its
simplest
elements.
The
state
psychiatric
hospital
initiates
the
aot
petition
with
a
district
court
judge,
the
judge
determines
probable,
cause
and
orders
the
evaluation
and
treatment
plan.
D
After
that's
after
the
completed
evaluation,
the
judge
may
order
aot
for
up
to
360
days
with
regular
reviews
during
the
term
of
the
order
they
could
order
for
a
lesser
period
if
they
chose,
or
they
could
deny.
Ultimately,
they
could
deny
the
petition.
One
of
our
earliest
referrals
was
in
fact
denied.
D
So
we
we
had
20
referrals
last
year,
but
only
served
19
folks
that
then
the
cmhc
after
the
order
provides
services
specified
in
the
treatment
plan,
including
therapy
medication,
support
services
and
support
services
are
just
that
they
are
wide
and
varied
per
each
individual.
They
can
be
everything
from
assisting
with
housing,
which
is
probably
the
highest
need
with
limited
funds
or
no
funds,
sometimes
that
we
have
for
these
folks
to
on
down
to.
D
We
had
a
gentleman
who
was
very
difficult
to
understand
and
could
not
communicate
his
needs
because
he
had
no
dentures,
so
we
ended
up
purchasing
a
set
of
dentures
for
the
gentleman
and
that
has
helped
him
with
his
community
adjustment
immensely.
D
During
that
360
day
period,
the
community
mental
health
center
staff
deliver
treatment
therapy
medications.
They
involve
peer
support,
folks
to
to
with
lived
experience
to
help
the
individuals
come,
learn
a
better
way
to
live
in
the
community.
They
also
collaborate
with
the
other
actors
that
and
stakeholders
that
are
coming
into
contact
with
the
individual
law
enforcement,
frequently
family
and
others
job
development,
as
they
progress,
perhaps
other
health,
community,
health
or
physical
health
providers
to
promote
the
individual's
community's
success.
D
If,
if
things
are
going
well-
and
the
judge
has
a
a
great
role
with
these
hearings
that
they
have
or
meetings
intermittent
supervision,
whatever
you'd
like
to
call
them-
and
they
want
to
work
with
what
the
individual
brings
to
the
table,
if
the
individual
needs,
you
know
a
judge
to
be
stern
and
and
remind
them
of
their
responsibilities
that
that
is
under
that
court
order,
they
can
do
that
or
it
can
be
a
much
more
friendly
touch
base
with.
How
are
you
doing
now
that
you've,
you
know
settled
in
a
little
bit?
D
D
The
evaluation
measures
for
individuals
and
how
successful
are
they
in
the
aot
process
and
in
the
community
are
are
seeking
to
look
at
impact
rather
than
participation,
particularly
we're.
Looking
at
psychiatric
hospitalization
days,
jail
days
homeless
days,
substance
use,
emergency
department,
utilization,
medicaid
utilization,
reported
satisfaction
with
this
process,
and
progress
assessments
are
done
every
six
months
that
an
individual
is
within
the
program.
D
Some
of
those
are
required
by
the
by
the
federal
grant
that
we
have,
and
some
of
them
are
things
that
we
found
to
be
of
particular
use
within
kentucky,
we'll
be
ultimately
they'll,
be
the
university
of
kentucky
evaluators
will
be
accessing
data
from
a
number
of
sources
that
we've
already
contacted
and
told
them
that
that
will
be
coming,
and
everybody
is
very
interested
in
participating
department
for
medicaid
services,
administrative
office,
the
courts,
our
hospitals,
which
are
participating.
Of
course
we
haven't.
Had
anybody
tell
us
no,
that
they
weren't
interested?
D
Everybody
has
seemed
to
believe
this
is
going
to
be
a
very
useful
tool
in
our
toolbox
for
folks
programmatically
we'll
again
be
looking
at
psychiatric
hospitalization
days,
jail
days,
homeless,
days,
emergency
department,
utilization,
medicaid
utilization,
but
probably
more
from
the
from
the
organizational
perspective,
how
those
are
expensed,
how
those
days
happen
when
they're
in
the
psychiatric
hospital
to
prepare
them
for
a
better
referral
when
they
get
closer
to
being
ready
to
be
released.
D
D
So
far,
the
initial
results
of
the
from
the
evaluators
have
been
promising,
but
there
are
no
conclusions
yet
available
the
first
year
they
completed
the
data
analysis,
for
we
served
folks
for
only
nine
months
out
of
that
year
and
that's
the
the
grand
year,
and
I
should
mention
that
the
grant
year
and
the
the
state
fiscal
year
do
not
match
they're
very
close,
but
we're
always
trying
to
talk
about
year.
D
One
grant
statistics,
as
opposed
to
any
exact
fiscal
year
calendar
year
at
the
at
the
end
of
that
nine
month
period.
Only
four
folks
out
of
the
original,
were
even
eligible
for
the
the
reassessment
at
the
six
month
mark.
So
the
evaluators
did
not
even
report
that
information,
because
it
was
of
no
statistical
value
at
that
point
in
time,
let's
say
promising,
but
not
not
as
informative
as
it
needed
to
be
or
clear
as
it
needed
to
be
the
unif
the
year.
D
The
data
that
was
collected
for
the
end
of
year,
the
grant
year
one
is
here,
we're
now
up
to
30.
We
just
had
one
come
in
yesterday.
I
think
we're
up
to
32
or
33,
and
that
puts
us
on
track
for
this
grand
year
to
meet
our
goal
that
we
established
in
the
grant.
D
The
the
the
responses,
the
information
is,
is
likely
a
lot
of
what
you
would
assume
the
most
common
diagnoses
are
is
schizophrenia,
demographics,
more
male
than
female,
a
little
less
disparity,
but
primarily
the
individuals
who've
been
referred,
have
been
white
as
opposed
as
opposed
to
other
racial
groups.
I
don't
think
we
even
had
anybody
in
alternatives
beyond
those
two
categories,
and
I
don't
think
we
had
anything
tracking
his
we.
D
If
not
all
of
them
are,
they
were
asking
the
individual
about
the
past
30
days,
while
they
were
coming
to
the
very
end
of
their
hospitalization,
so
the
we
expect
that
the
six-month
follow-ups
will
have
some
fairly
different
results
aside
from
the
the
age
and
sex.
I
think
any
of
them
could
possibly
change.
Diagnoses
may
change
over
time.
D
Things
may
be
remembered
or
reported
differently
or
researched
by
the
community
mental
health
center
staff
to
get
a
different
answer,
so
we
expect
there
to
be
variation
between
the
initial
and
the
six
month.
Reports
overall,
health
about
half
reported
being
in
good
health,
about
half
reported
being
not
such
good
health
or
having
challenges.
D
Many,
if
not
most
individuals,
regard
reported
quality
of
life
issues.
Also,
as
you
might
imagine,
folks
have
some
coping
abilities,
but
there's
a
lot
of
challenges.
There:
medication
adherence
reporting
always
taking
their
medications
in
the
past
30
days.
That
was
one
of
our
anomalies.
If
they're
currently
in
the
psychiatric
hospital,
we
expect
that
most
of
them
are,
but
we
worry
that
that
might
have
been
the
wording
of
the
question,
but
again
we're
not
in
control
of
those.
That's
that's
a
federal
survey
that
they
use
that
goes
along
with
alcohol
use.
D
The
vast
majority
reported
no
prior,
no
use
within
the
past
30
days.
That
may
be
because
they've
been
in
the
psychiatric
hospital
or
because
of
some
other
bias
when
they're
reporting,
cannabis
use,
cocaine,
use,
methamphetamine
use.
Those
are
all
part
of
the
items
reviewed
by
the
federal
survey
for
incoming
individuals.
D
A
about
a
third
of
the
folks
that
came
into
the
program
reported
having
support
or
having
someone
who
will
support
their
recovery
in
their
lives.
That's
not
a
great
number.
You
know,
folks
have
burned
bridges
with
their
families
and
part
of
the
community
mental
health
center.
Getting
them
to
be
successful
in
the
community
as
time
goes
on
and
they
become
more
stabilized
is
to
help
them
re-establish
those
relationships.
D
We're
not
the
the
experience
are
witnessing
violence
question.
If
that's
of
the
last
30
days
we're
we're,
not
sure
we're,
not
sure
what
that
means.
That's
one
that
we're
following
not
so
much
violence
going
on
in
the
psychiatric
hospitals,
but
individuals
may
have
been
reporting,
you
know
restraints
or
it
may
be
prior
to
entry
again,
we're
not
sure,
and
that's
something
for
us
to
follow
up
on
medical
and
correction
interventions.
D
Another
item
that
we're
that
we're
following
in
that
we're
going
to
follow
long
term
as
well
for
the
fall
for
the
six-month
follow-up
that
we
do
with
folks.
Sorry
for
the
density
on
that
slide.
It
looks
much
prettier
in
the
the
uk
report
that
they
published,
but
trying
to
keep
the
number
of
slides
down
and
keep
it
all
readable
for
you
the
grant
year.
D
One
notes
report
notes
are
from
university
of
kentucky
are
included
here
because
they
refer
back
to
the
report,
but
it's
all
things
that
that
we
we
covered
in
conversation.
I
think,
but
in
case
anybody
printed
this
off
and
and
went
to
take
it
with
them.
We
wanted
to
make
sure
they
had
that
to
refer
back
to
aot
costs.
D
That's
always
the
big
question:
what
does
it
cost
to
to
deliver
this
service
and
and
have
these
programs
in
operation
and
accessible
to
folks?
Each
of
the
cmhcs
serves
as
somewhere
between
seven
to
17
county
area
encompassing
multiple
judicial
districts
and
the
cmhc
expenses
under
the
pilot
project
include
staff
costs,
including
an
aot
coordinator,
who
serves
the
entire
cmhc
region.
D
They
don't
focus
on
the
single
judicial
district,
necessarily
that's
probably
less
important
at
the
time
that
the
petition
is
entered
because
there's
usually
one
court
serving
as
the
location
for
the
petitions
as
they
come
out
of
the
state
hospital
and,
and
then
those
folks
are
sent
back
to
their
home
communities
or
wherever
it
is.
They
wish
to
reside
so
there's
a
transfer
of
supervision
between
the
court
that
orders
it
if
they
live
outside.
Of
that
court's
jurisdiction,
we've
had
a
number.
D
In
addition
to
that
coordinator,
there's
the
the
full
variety
of
professionals
that
are
are
needed
to
serve
individuals
with
serious
mental
illness.
Targeted
case
managers
peer
support
specialists,
other
clinicians
in
clinical
support,
psychiatric
psychological
time.
D
D
The
in
addition
to
the
the
aot
staff,
the
community
mental
health
center
will
refer
individuals
to
other
services,
both
within
their
own
organization.
If,
if
there's
a
specialty
group
within
them-
or
they
might
refer
them
out
to
some
external
source,
some
external
provider,
depending
on
what
it
is,
many
of
the
individuals
that
are
on
aot
receive
some
services
from
the
assertive
community
treatment
or
act
team
that
each
of
the
community
mental
health
centers
have
not
everybody.
D
Some
folks
have
tried
that
before
and
it
was
not
successful,
and
so
those
individuals
generally
aren't
referred
back
to
act,
but
it
again
it's
so
highly
individualized.
It's
difficult,
particularly
with
the
small
number
of
folks
that
we've
seen
so
far,
to
give
you
a
typical
client
or
a
typical
set
of
services
that
they
receive.
D
In
addition
to
the
the
staffing
costs
and
the
structural
costs,
there's
client
support
funds
that
are
included.
We
don't
have
as
much
flexibility
as
we
would
like
to
have
with
those
because
of
the
federal
guidelines
for
grants
fund
spending,
but
they
do
go
to
support
housing,
transportation,
certain
medications
and
medical
services.
D
D
Back
to
that
one
statistic
of
only
a
third
having
a
a
good
support
system-
they're,
usually
not
going
home
to
live
again
at
mom
and
dad's
they're.
You
know
they've
run
out
of
those
general
options
and
housing
costs
can
be
anything
from
rent
to
utilities
and
and
are
can
be
they're
generally,
though,
in
existing
structures.
D
Finding
the
individual
is
a
supported,
housing
apartment
somewhere,
a
hud
202
a
complex,
for
instance.
Communicare
has
a
small
house
where
they
have
folks
that
that
are
able
to
reside
so
really
again,
just
as
diverse
as
the
population.
What
their
needs
are
the
individual
who
needed
dentures.
He
really
needed
that.
So
that
he
could
communicate
with
folks
and
and
be
be
a
little
less
scared
and
a
little
less
scary.
D
Frankly,
behavioral
health
departments
cost
includes
oversight
through
a
project
director
for
fidelity
and
accountability
amongst
the
various
locations,
community,
mental
health,
centers
psychiatric
hospital
staff,
referrals
and
coordination
evaluation
by
the
university
of
kentucky.
D
We
were
planning
to
send
a
number
of
folks
to
the
national
conference
later
this
year
so
that
they
can
get
some
exposure
to
how
this
is
done
in
other
jurisdictions.
Everybody
has
such
different
statutes
that
no
two
are
ever
going
to
match,
but
we,
you
know
you
don't
want
to
reinvent
the
wheel
if
you
don't
have
to
let's
we're
looking
for
the
the
innovative
things
going
on
in
other
jurisdictions
and
how
we
can
best
access
those
and
adapt
them
for
kentucky.
D
The
fiscal
biennium
requests
that
we
have
that
we
have
budgeted
for
and
and
are
hoping
to
have
coming
up
in
state
fiscal
year.
2223
we're
look,
we're
hoping
to
have
500
000
to
initiate
these
services
in
the
eastern
state
hospital
catchment
area
and
its
community
mental
health
centers
to
serve
them
in
the
second
state
fiscal
year.
We're
hoping
to
have
a
million
dollars
added
to
the
budget
so
that
we
can
expand
that
to
appalachian
regional
hospital
and
its
community
mental
health
centers
in
their
catchment
area.
D
This
expand
these
funds
will
expand.
The
pilot
project
kind
of
the
point
of
a
pilot
project
is
to
continue
its
operation
for
a
given
period
of
time,
in
this
case
for
the
grandest
four
years,
so
that
you
can
track
how
the
program
develops,
how
expenditures
develop
and
are
modified
throughout
the
the
period
so
that
you
can
track
the
individuals
participating
on
a
longitudinal
basis,
but
trying
to
keep
the
the
same
set
of
rules
governing
rules
for
for
all
the
participating
agencies,
so
that
we
have
some
comparable
data.
When
we
get
to
that
point.
D
And
then,
as
a
follow-up,
that
is
the
statewide
aot
project
service
area,
it's
very
colorful,
but
all
it
really
is,
is
showing
where
the
four
state
hospitals
are
and
the
community
mental
health
centers
within
their
catchment
areas,
and
that's
about
all
I
have
unless
deputy
commissioner
craig
craft
would
like
to
add
something.
B
B
Okay,
thank
you.
I
would
like
to
have
somebody
who's
on
the
ground
floor
you
mentioned.
Jefferson
county
is
mainly
a
lot
of
the
volumes
going
through
that
I'd
like
to
ask
judge,
stephanie
burke,
to
come
up
and
just
sort
of
give
a
ground
a
ground
work
perspective
on
what
she's
seen
and
what
she's
experienced
and
so
forth,
and
you
know
hopefully
try
to
keep
this
about.
B
10
minutes
or
so
judge
that'd
be
great,
if
you
don't
mind,
just
identify
yourself
for
the
record
and
we
go
from
there
and
then
we'll
come
back
to
you.
Thank
you
very
much,
though.
Miss
dixon.
A
B
Yeah
you
can,
you
can
stop
sharing
the
screen.
That'd
be
fine,
oh
actually!
Well,
you
can
always
come
back
to
that's.
Okay,.
B
F
F
F
So
we're
not
able
to
serve
them
while
they're
incarcerated,
although
I
will
say
that
my
team
does
work
with
louisville
metro
corrections
to
make
sure
that
the
individual's
medications
they're
getting
the
correct
medication
while
they're
incarcerated,
they
stay
in
contact
with
those
individuals
and
are
monitoring
their
cases.
We
have
a
public
defender
assigned
to
our
team
and
so
they're
monitoring
those
individuals
cases
so
that
when
it's
time
for
them
to
be
released,
we've
had
one
person
go
into
custody
and
come
out
of
custody.
F
F
F
He
can
provide
me
any
information
at
any
time
about
the
client,
their
whereabouts.
What's
going
on
with
the
funding
for
the
person's
housing
who's,
the
person
supervising
the
client,
how
many
contacts
the
client
has
had
with
the
team
whether
the
client
has
taken
their
medication
in
that
period
of
time.
F
F
Our
team
goes
to
the
client,
so
our
team
will
go
out
and
sometimes
the
person
will
say
they
don't
want
the
injection
that
day
and
but
they'll
agree
for
them
to
come
back
tomorrow,
and
so
the
team
will
come
back
tomorrow,
and
so,
when
you
heard
mr
talk
about
tailoring
this
to
the
needs
of
the
patient,
that's
exactly
what
the
team
does.
We
have
a
targeted
case
manager
named
adrian's,
chrissy,
she's,
incredible.
F
What
she's
doing
is
amazing.
She
comes
to
the
docket
as
well
and
reports.
All
of
her
contacts
and
communication
with
the
individual
patients-
and
she
is
in
communication
with
all
of
them
all
of
the
time
she
will
a
lot
of
times
spend
time
outside
of
their
homes
because
they
will
so
many
of
them
are
suffering
from
schizophrenia,
so
they
have
severe
paranoia.
F
So
a
lot
of
them
will
come
outside
and
sit
with
her
on
their
porch
and
she'll.
Just
stop
by
to
say
hello,
so
she's,
building
relationships
with
them
to
build
that
trust,
and
as
that
trust
is
built,
they
become
more
cooperative
and
we
are
seeing
great
success
because
of
these
relationships
that
the
team
is
building
with
the
patients
and
some
of
the
patients
initially
were
afraid
of
coming
to
court,
and
we
don't
want
to
pressure
that,
so
what
we
would
do
sometimes
is.
F
We
would
start
by
calling
the
patients
or
getting
them
on
facetime
and
then,
as
they
become
more
comfortable
with
the
team,
they
would
transport
the
patient
to
court.
They
would
drive
them
to
court.
Some
of
them
are
too
afraid
to
get
in
the
car.
So
it's
just
what
is
the
patient's
need?
We
have
some
patients
that
are
happy
to
come
to
court.
They
have
family
members
who
will
bring
them.
Some
of
them
have
had
different
family
member,
bring
them
every
time
so
that
we
can
meet
all
the
different
members
of
their
family.
F
So
we
have
one
gentleman
who
his
mother
has
brought
him.
His
brother
brought
him
over
the
holidays
because
he
was
visiting
another
family
member
brought
him
on
another
time.
So
we've
met
all
these
members
of
this
young
man's
family
with
respect
to
the
the
patients
in
jefferson
county,
most
of
them
of
the
17.
F
F
Many
of
them
have
been
in
and
out
of
the
criminal
justice
system.
So
when
they
get
in
when
they
go
to
jail,
they
often
lose
their
ssi.
So
we
have
to
go
back
through
reapplying
and
helping
them
with
that.
Many
of
them
do
not
have
the
capacity
to
maneuver
that
application
process
on
their
own,
so
my
team
is
excellent
at
assisting
the
patients
and
making
sure
that
all
the
applications
and
so
forth
are
completed.
So
they
get
all
their
benefits
put
back
in
place,
and
so
most
of
our
patients
are
getting
ssi
benefits.
F
We
have
a
couple
who
are
not
one.
We
have
a
young
man
whose
family
is
from
africa.
The
family
is
currently
in
africa.
They
took
him
back
for
the
holidays
for
a
visit
and
he's
not
eligible
for
ssi
benefits,
so
he
does
live
with
the
family.
They
have
the
means
to
provide
for
his
needs.
F
F
A
couple
of
patients
come
out
of
the
hospital
where
we
needed
emergency
housing,
so
we've
ended
up
putting
them
in
a
hotel
briefly
until
we
could
arrange
housing
but,
as
she
said,
housing
is
the
the
number
one
barrier
often
to
to
meaningful
success
in
in
long-term
stability.
So
we
have
to
deal
with
that.
First,
that's
dealt
with
before
coming
out
of
the
hospital.
We
want
to
make
sure
we
have
a
placement
before
they
come
out
and
that's
normal
for
individuals
who
are
in
the
state
hospital,
even
if
they're,
not
in
the
aot
program.
F
F
They
normally
have
some
place
for
them
to
go,
even
if
it's
a
shelter
or
somewhere
safe,
but
they
don't
like
to
release
people
not
knowing
where
they're
going
so
with
aot.
We
try
to
do
a
warm
handoff
to
a
safe
place
where
they
can
start
the
services
right
away.
Our
team
gets
involved
immediately
through
our
targeted
case
manager,
and
currently
we
do
not
have
anyone
hired
specifically
for
the
peer
support
position,
we're
hoping
as
we
grow
that
we
will
have
that
and
as
far
as
additional
services
and
transportation,
some
of
our
team
does
do.
F
Trans
transportation
for
the
individuals
in
the
program,
they'll
drive
them
places
to
appointments
and
things
like
that,
most
of
as
you,
I
believe,
we've
explained
this
in
the
past
that
we're
not
providing
additional
services
through
the
grant
their
their
treatment
is
not
something
the
grant
pays
for.
The
treatment
is
something
that
they
get,
even
if
they're
not
in
this
program
through
their
their
medicaid.
So
it's
it's
through
other
payers.
F
We
don't
want
to
in
aot,
provide
them
with
some
false
source
of
treatment
and
services
that
once
we're
out
of
the
picture
that
would
not
be
sustainable
for
the
patient,
so
we
have
to
be
careful
not
to
get
you
know.
We
wouldn't
want
to
give
them
a
whole
bunch
of
extra
resources
so
that
they
would
be
successful
and
then,
when
their
aot
order
ends
in
in
the
program
goes
away,
that
they
would
then
be
set
up
for
failure.
F
F
F
They
become
more
amenable
to
the
treatment
they
they
like
seeing
the
change
in
their
life.
I
had
a
young
man
in
court
this
past
week,
he's
going
on
about
eight
months
of
being
compliant
and
being
well
about,
as
well
as
he's
probably
ever
been,
and
he's
really
happy
he's
really.
You
know
this
is
life
changing
for
him
and
he's
happy
to
keep
doing
this
and
he's
talking
about
voluntarily
extending
his
order,
and
so
he
likes
the
team.
F
It's
the
relationship
he
likes.
You
know
adrian
coming
and
checking
on
him.
He
likes
talking
to
his
therapist.
We
have
a
therapist
on
our
team
who
also
comes
to
the
court
sessions.
Who
will
tell
me
you
know,
what's
going
on,
you
know
with
each
of
the
patients
and
how
they're
progressing
or
what
they're
struggling
with,
and
this
team
has
created
kind
of
a
it's
just
a
safety
net.
F
If
you,
if
you
bring
the
patient
into
the
program,
while
they're
stable
from
the
hospital,
so
you
catch
them
as
they
come
out,
they
don't
want
to
be
in
trouble.
They
don't
want
to
have
contacts
with
law
enforcement.
They
don't
want
to
go
back
to
the
hospital
you
keep
bringing
them
into
court,
bringing
them
to
see
the
judge.
F
You
build
that
relationship
with
the
judge,
which
is
called
the
black
robe
effect,
and
you
keep
you
know
you
keep
having
these
frequent
contacts
with
them
and
you
see
this
kind
of
light
bulb
go
on
and
the
longer
we
can
sustain
that.
I
can
tell
you.
I've
told
you
before
about
the
initial
patient
that
we
had
in
the
program
prior
to
getting
the
grant
that
gentleman
had
had
50
hospitalizations
in
under
10
years,
when
he
wasn't
in
the
hospital
he
was
in
jail.
F
He
has
a
state
guardian
who
was
kind
of
instrumental
in
him.
Getting
an
aot
order
made
sure
he
got
to
court
every
time
we
supervised
him
for
a
year.
He
didn't
have
any
hospitalizations
or
incarcerations
in
that
year.
This
month
is
the
three-year
mark
for
that
gentleman.
All
those
services
that
he
was
getting
during
that
year
he's
still
getting
through
seven
counties,
he's
not
been
re-hospitalized
and
he's
not
gone
to
jail
in
three
years.
That
year
of
stability
set
him
up
for
success.
F
I
saw
his
mother
in
the
grocery
store
at
christmas
with
the
state
guardian
and
the
conversation
with
this
woman
just
made
every
bit
of
this
completely
worth
it
just
that
one
individual
alone
saving
the
dollars.
If
you
want
to
talk
just
about
the
fiscal
part
of
this,
the
dollars
that's
been
saved
with
that
one
individual.
F
You
cannot
put
a
dollar
figure
on
that,
it's
extraordinary
for
their
neighbors
or
their
families,
the
things
that
they
do,
that
you
know
cause
difficulty
for
others
around
them
and
the
challenge
they
place
for
the
people
who
are
responsible
for
caring
for
them.
He
has
now
became
the
caregiver
for
his
mother.
Who's
battling
cancer.
F
We
need
to
expand
this
statewide
that
the
savings
will
be
extraordinary.
The
more
we
can
do.
This.
I
was
speaking
with
the
folks
in
hardin
county
last
night,
they're
very
excited
about
this
bill
in
the
new
language
and
expanding
the
criteria,
so
that
we
don't
miss
any
of
the
folks
who
need
this.
We
want
to
make
this
a
criteria
more
broad,
so
that
we
can
get
more
people
and
that
need
it
and
that
really
fit
the
criteria
of
who
this
population
is
and
we're
all
very
excited
to
do
this.
So
thank
you.
B
Thank
you
judge,
burke,
for
your
for
your,
I
guess
personal
experience
and
give
us
a
backdrop
on
what's
going
on
on
the
ground
level.
It
gives
us
a
really
good
perspective.
What's
going
on
and
I
pre
and
I
appreciate
you
and
I
appreciate
both
presenters
in
terms
of
giving
us
an
understanding
what's
going
on.
B
Obviously
this
is
a
budget
review
part
of
the
appropriations
revenue
and
so
we're
going
to
focus
on
I
like
to
focus
on
costly,
like
I
am
in
terms
of
trying
to
figure
out
the
the
the
use
of
the
money
and
how
it's
being
spent-
and
I
know
ms
dickerson
mentioned
about
the
cost
analysis
and
so
forth,
and
he
also
said
you
you
have
around
19
people
you're
serving,
but
I
think
the
judge
mentioned
around
30,
and
so
I
want
to
I
guess
before
I
ask
other
members
to
to
jump
in
which
I
know
we
have
several
people
who
want
to
ask
I
want
to.
B
I
want
to
get
an
understanding,
so
it
was
a
million
dollars
a
year
for
four
years.
Can
you
give
me
a
perspective
on
the
total
cost?
That's
that
you've
incurred
at
this.
At
this
time
and
what
those
costs
make
up
you
want
to,
or
do
you
want
me
to.
D
Thank
you.
Go
ahead,
I'll!
Let
deputy
commissioner
craig
craft
do
that,
since
she
of
what
people
are
dollars,
I
didn't
bring
the
latest
number
with
me.
I
brought
the
the
year
one
that
we
that
we
calculated
based
on
almost
400.
E
E
Okay,
I'm
sorry
we're
getting
an
echo
okay,
okay.
Yes,
we
spent
close
to
four
hundred
thousand
dollars
of
that
me
in
the
first
year.
I
think,
as
tonya
mentioned,
I
think
we
didn't
start
serving
folks
until
december
of
that
year,
so
it
was
a
partial
year.
E
The
majority
of
those
costs
are
expenses,
their
payments
to
the
community,
mental
health
centers
and,
as
tanya
listed
in
those
slides
that
those
can
cover
a
number,
the
community
mental
health
center
cost
staff
time
some
of
their
operating
costs,
some
costs
for
individuals
that
are
not
covered
by
insurance
or
other
30
party
payors,
and
so
that's
really
what
most
of
the
funds
was
used
for.
B
E
So
the
the
funds
are
federal
funds,
they
will
carry
forward
and
I
think
miss
dickenson
mentioned
in
her
slide
that
we
have
requested
through
samsa
to
be
able
to
use
those
funds
to
expand
to
the
other
two
community
mental
health
center
regions
in
western
kentucky.
We're
still
waiting
for
approval
for
that.
B
B
I
think
folks
that
will
serve
over
the
four
year
period
if
you
analyze
that
out
it's
50
per
year,
you're
at
my
understanding
around
30
right
now,
thereabouts
you're
still
short
20..
Could
you
give
me
an
explanation
on
how
that
money's
being
spent,
because
I'm
a
little
confused.
D
Let's
see
if
we
can
do
this
without
echo,
there
we
go.
The
the
carry
forward.
Money
is,
is
essentially
a
one-time
carry
forward,
and
then
we
will
be
asked
to
if
we,
if
we
take
on,
if
the
federal
grant
allows
us
to
take
on
two
additional
community
mental
health
centers
with
carry
forward
money
from
one
year
to
the
next,
we
will
have
to
use
we
they
won't.
Let
us
do
that
if
we
can't
incorporate
into
that
one
million
dollar
annual
budget
going
forward,
that
we
can
continue
to
serve
those
counties.
B
I
thought
I
appreciate,
but
but
I'm
struggling
with
with
I'm
struggling
with
your
what
you're
telling
me
I
mean,
I
understand
what
you're
saying,
but
if
you're
looking
at,
if
you're
short
already
the
number
of
people
that
you're
projected
to
serve
and
you're
going
to
have
another
allocation
of
money
that
you're
going
to
try
to
expand
it
further,
it's
to
me
there
seems
to
be
this
service
is
not,
is
not
getting
out
there
as
quickly
as
possible,
and
so
I'm
there's
a
little
to
me.
There's
a
gap.
So
that's
that's.
D
All
of
the
federal
grantees
in
our
cohort
they've
been
awarding
these
funds
for
for
a
number
of
years
and
the
ones
in
our
cohort,
almost
everyone
that
I
was
aware
of
was
was
short
on
their
projected
numbers
for
the
the
period
that
they
received,
that
grant
due
to
a
variety
of
factors,
I'm
sure
in
each
of
the
locations,
but
since
we
did
not
start
taking
clients
on
until
december,
that
was
probably
the
the
biggest
reduction
in
the
number
of
folks,
and
that
was
the
first
year.
D
D
That
was
not
of
concern
to
them
as
far
as
our
numbers
for
this
year,
when
we
should
have
this
year,
we
should
have
a
total
of
35
clients,
and
I
think
we've
had
11
or
12
that
have
been
referred
during
this
grant
year.
Two
that
puts
us
on
track
to
get
our
35.
We
expect
a
dip
around
the
holiday
season,
so
we
expect
that
they
will.
D
The
numbers
will
start
picking
up
again
here
shortly
now
that
that
now
the
holidays
are
passed,
so
we
expect
to
make
our
numbers
of
35
this
calendar
year
or
I'm
sorry
this
grand
year,
okay,.
B
But
okay
I'll
tell
you
what
let
me.
Let
me
I
know,
there's
some
members,
I'm
going
to
give
them
the
opportunity
and
I
have
some
more
additional
questions
because
I'm
I'm
not
getting
what
I'm.
But
I
guess
I'm
a
clear
explanation.
I
think
representative
bowling
had
the
first
question.
Go
ahead,
representative.
G
G
You
actually
asked
a
lot
of
the
questions
that
I
had,
but
a
question
on.
The
last
comment
miss
dickinson
made
was
you
mentioned
35
like
that's.
Your
goal
is
35
patients
and
I
see
like
in
the
original
grant
application
it's
projected
for
to
serve
192
patients
over
four
years,
which
is
48
patients
a
year.
So
there's
been
a
change
of
the
amount
of
patients
that
you're
able
to
serve.
Why?
D
I
think
that
was
the
the
original
grant
application
assumed
that
there
would
be
fewer
people
the
first
year.
I
think
the
first
year's
target
was
27
and
we
ended
up
with
20..
D
G
D
G
G
I
think
two
more
questions,
if
I
may,
what
positions
have
been
fully
funded
out
of
this
grant
and
are
there
any
positions
that
have
been
partially
funded?
Do
you
all
have
a
list
of
that.
D
I'd
have
to
get
a
complete
list
of
that,
but
I
will
tell
you
that
each
of
the
community
mental
health
centers
operates
just
a
little
differently
and
then
also
they
have
a
number
of
folks
who
they're
paying
0.5
f
fed.
You
know
full-time
equivalent,
so
we
have
it's
a
full-time
person
but
they're
only
dedicating
half
their
time
to
the
aot
grant.
That
makes
sense
as
you're
starting
up
a
program,
and
it
also
makes
sense
when
you're
using
the
kind
of
scarce
psychiatric
psychological
resources
you're
not
going
to
pay
for
a
full-time
person.
E
D
Of
that
individual's
time
to
serve
this
given
number
of
clients,
the
the
one
basic
requirement
of
the
grant
was
that
each
community
mental
health
center
have
an
aot
coordinator,
so
that
that
that
is
so.
That
is
that
person
who
is
in
contact
with
the
courts
and
oversees
the
the
general
over
delivery
of
services
and
judge
burke
is
correct.
Aaron
bates
in
seven
counties
is
a
wonderful
person,
a
treasure,
and
he
keeps
all
the
plates
spinning
on
on
the
sticks,
but
he
would
also
be
responsible.
D
D
We've
had
most
of
the
cases
at
hardin,
which
is
obviously
the
largest
metro
area,
but
also
had
one
out
of
owls
lake
county,
and
so
that's
that's
also.
How
we
do
outreach
to
to
judges
is
that
you
know
letting
them
know
about
this
service,
and
it's
easiest
almost
when
it's
easiest
to
get
them
more
information,
more
detailed
information
once
they
have
a
case
before
them.
So
that's:
okay,.
G
You
know
you
have
phase
two
and
further
phases,
I'm
sure,
but
we're
just
looking
at
from
the
state
side
of
you
or
from
the
state's
point
of
view,
how
much
funding
do
we
need
to
allocate
how
many
people
do
they
need?
How
much
funding
is
directly
tied
to
this
aot
program?
And
another
thing
we
didn't
talk
about
is
direct
costs
that
have
been
paid
on
behalf
of
aot
participants.
I
don't
know
what
that
number
is.
G
I
know
you
said
that
if
it's
a
billable
service
or
you
know
you
can
get
paid
from
someone
else,
you
try
to
do
that.
But
then
I
do
realize
that
there
may
be
some
gaps
there
and
we'll
probably
we'll
need
to
know
those
as
well.
B
D
If
there
are
any
other
funds
for
client
needs,
they're
supposed
to
the
programs
are
supposed
to
seek
those
out
and
use
those
elsewhere.
B
Thank
you,
representative,
prunting.
C
Thank
you,
mr
chairman.
I
have
several
questions,
but
there
a
lot
of
them
are
programmatic,
so
I'll
leave
them
for
another
day.
The
financial
questions
are
you
mentioned
that
that
you
don't
have
flexibility
with
some
of
the
federal
center
federal
dollars?
You
don't
have
flexibility,
have
you
petitioned
or
do
you
need
some
petition
toward
to
the
federal
delegation
to
try
to
help
with
that
issue
or.
D
They
want
to
be
good
stewards
of
their
funds,
just
like
just
like.
We
do,
and
you
know
what
what
we're.
For
instance,
we
we
were
discussing
using
incentives
to
incentivize
folks
to
you
know,
attend
their
court
hearings.
For
instance,
you
come
to
five
court
hearings.
You
you'll
get
a
a
gift
card
kind
of
thing
and
while
the
the
project
off
office
allows
some
incentives,
particularly
for
participating
in
samsa's,
required
surveys,
they
won't
allow
incentives
for
other
things
because
of
the
potential
consequences
in
in
sort
of
in
the
treatment
environment.
D
You
know
if
you
pay
people
to
come
to
their
treatment
appointments
then
they're
going
to
come,
but
they
may
not
be
as
honest
as
they
should,
or
they
may
manufacture
reasons
to
come
more
often,
so
they
get
more
incentives,
so
we're
we're
frustrated
by
them.
We'd
always
like
more
flexibility,
but
but
those
are
the
rules
and
and
that
that's
fine.
C
D
There's
going
to
be
more
subsidy
to
that,
but
you
don't
really
save
money
at
at
the
department
level.
Anyway,
you
don't
really
save
money
until
you
could
like
close
a
unit
at
a
state
hospital-
and
I
don't
ever
see
this
getting
to
that
point.
There
will
always
be
a
need
for
for
a
subsidy
level
of
of
you
know
some
baseline
staff
for
activities
that
are
never
going
to
be
covered
by
third-party
payors.
The
time
that
the
aot
coordinator
spends
in
court.
D
That's
not
billable
to
an
insurer,
so
we'll
always
have
to
pay
for
that
time.
The
the
staff
time-
that's
that's
necessary
to
you-
know,
go
out
and
pick
the
individual
up
and
bring
them
back
for
court
is
probably
not
billable
time,
perhaps
for
a
peer
support,
specialist
billable
time,
but
that's
the
the
least
paid.
That's
the
the
lowest
salaried
person
on
that
team.
So
that
would
not
be
much
of
an
incentive
for
the
agency.
C
Yes,
thank
you
for
that
answer.
I
just
think
that
if
we,
if
there
are
huge
savings
across
the
board,
that
could
be
to
the
state's
advantage
as
far
as
for
other
other
things
they
have
to
pay
for.
So
I
get
that
you,
you
wouldn't
have
decreased
costs,
but
there
might
be
savings
for
the
state
and
just
thank
you
for
the
allowing
this
and
I'm
excited
about
it.
C
Coming
to
western
kentucky,
that's
my
district
and
I
know
that
it's
much
needed,
and
so
I
look
forward
to
to
the
to
the
progress
of
the
expansion
across
the
state.
Thank
you
for
your.
D
We
had
planned
to
come
out
and
do
some
advance
work
in
western
kentucky
and
and
meet
with
local
stakeholders,
but
we
got
delayed
by
you,
know
the
tornadoes,
and
so
we
had
to
reschedule
everything
so
that'll
be
a
little
bit
later,
but
we
will
be
sure
to
be
talking
to
you
when
we're
out
there.
Thank
you.
C
Thank
you,
mr
chairman,
and
thank
you
both
of
you
for
your
presentation
and
I'm
not
even
really
sure
who
I'm
directing
this
to
so.
Whoever
feels
the
appropriate
person
to
answer
this.
C
I
know
that
when
tim's
law
and
advocacy
for
that
first
started,
it
was
to
do
exactly
what
judge
burke
has
described
and
to
get
people
out
of
this
revolving
door
of
hospitalization
to
incarceration
to
living
on
the
streets,
etc,
and-
and
we
know
that
there's
tremendous
cost
savings
in
that,
although
it
may
not
be
directly
to
the
department,
as
representative
prenty
also
indicated.
But
I
guess
how
are
we
managing
the
referrals?
F
D
Then
the
hospital
will
file
a
petition
with
the
court,
and
the
community
health
center
will
do
an
evaluation
that
that
sounds
very
clinical
and
clearly
divided.
But
it's
it's
much
it's
as
much
an
art
as
a
science,
and
I'm
not
a
clinician,
and
I
appreciate
those
folks
who
do
that,
because
I'm
not
sure
that
I
would
give
the
best
services
that
that
person
needed
I'm
much
better
at
the
administration
side
but
as
part
of
the
overall
process.
D
Seven
counties
services,
for
instance-
it
meets
on
a
weekly
basis
on
these
and
other
patients
at
central
state
hospital
to
do
their
release
planning.
So
it's
a
joint
effort
between
the
both
of
them
to
identify
who
would
be
an
appropriate
referral
and
a
lot
goes
into
it.
It's
not
just
you
know
the
way
the
current
statute
is
now
is
that
the
individual
has
been
psychiatrically
committed
to
a
hospital
twice
before
in
the
preceding
two
years.
D
It's
it's
a
lot
more
there's
a
lot
more
art
to
it
than
just
reading
that
statute
they
tend
to
look
at,
has
the
has
the
individual
gone
through
the
graduated
steps
of
treatment
that
is
available
to
them?
One
of
the
frequent
comments
that
I
get
from
the
treatment
side
folks,
is
that
if
the
individual
has
not
participated
previously
in
act
or
assertive
sort
of
community
treatment,
they
want
that
individual
and
there's
not
some
other
reason
that
they
shouldn't.
D
They
want
that
individual
to
try
that
as
having
been
a
less
less
restrictive
method
of
providing
fairly
similar,
fairly
intense
services
to
that
individual,
it's
I
think
it's
generalized.
I
think
it's
much
easier
when
you're
providing
treatment
services
to
provide
them
to
somebody
who's
there
voluntarily
and
the
you
know,
making
a
court
order
for
someone
to
receive
services
is
a
significant
step,
even
if
it
is
outpatient.
D
So
they
want
to
make
sure
that
you
know
all
of
the
foregoing.
Steps
have
been
touched,
or
at
least
looked
at
and
if
the
individual's
not
found
appropriate,
then
they
might,
but
they
would
like
them
to
have
tried
those
less
less
invasive
possibilities.
First,
does
that
answer
your
question.
F
A
comment
about
that.
I
think
that
is
unfortunately,
that
that
right
there
that
whole
analysis
of
least
restrictive
is
excluding
many
candidates
who
would
benefit
from
the
actual
work
of
the
team
and
would
benefit
from
the
court
order.
I
think
you
know,
I
think
that
it's
just
a
matter
of
philosophy,
but
I
do
believe
that
in
history
of
seeing
specialty
courts
be
very
you
know
successful.
F
F
C
That
really
does
address
my
question
and
are
we
losing
people
who
would
really
benefit
and
and
I've
you
know,
had
the
privilege,
along
with
several
of
you
guys
of
serving
on
the
severe
mental
illness
task
force
over
the
summer,
and-
and
this
was
one
of
our
top
recommendations-
was
to
expand
court-ordered
assisted
outpatient
treatment
across
the
state
to
western
kentucky,
certainly
but
across
the
state,
and
we
know
that
it's
been
successful
in
you
know
40
or
more
other
states,
and
I
I
guess
I'm
wondering
if
there
are
two
separate
things
going
on.
C
D
C
That's
that's
very
that's
very
clarifying,
so
thank
you
for
that
and
if
I
just
one
more-
and
this
is
sort
of
an
adjacent
topic-
but
I
mentioned
the
severe
mental
illness
task
force
and
one
of
the
top
recommendations,
also
in
addition
to
expanding
tim's
law,
was
smi
waivers
for
supported
housing,
and
I
heard
both
of
you
mention
housing
as
really
being
a
problem
and
a
barrier
to
folks
being
able
to
benefit
fully
from
aot
and
to
benefit
fully.
So
I
I
just,
I
guess
quickly-
would
love
your
thoughts
with
the
tears
indulgence.
F
I
think
it's
critical
to,
I
think,
would
be
a
critical
benefit
to
this
pop.
I
mean
folks
that
we're
seeing
to
get
over
that
hurdle
if
we
could
deal
with
the
housing
issue
more
easily
and
provide
just
that
simple
stability
of
not
having
to
worry
about
that.
Not
only
would
the
cost
savings
be
so
much
more.
F
Particularly
maintaining
outpatient
adherence
when
they
don't
have
a
place
to
stay
a
stable
place
to
stay.
You
know
their
their
care,
their
caregivers
can't
find
them
they.
You
know
when
they're
roaming
around,
they
can't
get.
You
know
when
I'm
talking
about
the
team
being
able
to
go
out
and
give
them
medication
and
coming
to
them.
Even
when
you
have
services
that
are
that
intense.
C
It's
very
clarifying,
and
I
think
it
really
underscores
the
good
work
that
the
task
force
did
and
gives
us
a
direction
for
how
I
hope
we'll
be
proceeding
for
to
address
the
needs
that
you
guys
have
so
clearly
identified
today.
So
thank
you.
Thank.
F
B
Thank
you,
representative
up,
ms
dickinson.
I
wanted
to
ask
a
question
before
I
refer
to
somebody
else
who
wants
to
ask
a
question:
could
you
provide
what
the
cost
is
per
client?
At
this
point,
you
sent
some
information
to
lre
lrc
staff,
and
I
want
to
see
if
you
can
sort
of
define
or
let
me
know
what
the
cost
per
client
is
right.
Now.
D
That
wasn't
and
that
that's
just
that
an
aggregated
cost
the
amount
that
was
expended
divided
by
the
number
of
people
who
had
been
served
during
grant
year
one
and
what
is
that
cost?
I
think
it
was
about
18.
B
Okay,
I
think
it
is
around
18
to
19
000.,
so
the
next
one
you
mentioned
about
housing,
which
is
a
topic
a
few
minutes
ago,
and
in
your
comment
to
the
lrs,
the
lrc
staff.
You
said:
that's
gonna,
that's
gonna,
result
in
significant
costs
and
so
forth,
but
the
judge
mentioned
something
about
most.
These
individuals,
housing's
already
taken
care
of
or
their
their
fine
accommodations,
with
existing
support,
rather
financial
or
from
a
fiscal
point
of
view.
So
where
are
you
coming
up
with
the
six
thousand
dollars
you
estimated
in
that.
D
The
estimate
was
based
on
a
you
know,
a
basic
calculation
to
to
have
the
ability
to
cover
everyone,
because
not
everyone
has
housing
the
moment
that
they
leave
the
state
hospital.
Frequently
the
housing
has
to
be
changed
somewhere
in
the
middle
of
the
course
that
they
live.
They
go
to
live
with
their
brother
and
that
doesn't
work
out,
and
so
they
need
to
find
the
individual
new
housing
immediately.
D
It
wasn't.
It
was
truly
an
estimate,
but
one
that
was
designed
to
cover
the
the
various
costs
that
in
an
average
per
person,
not
that
every
person
would
need
it,
but
that
some
will
need
some
will
need
more
than
others.
Some
will
need
that
family
care
home
type
atmosphere.
B
We
would
be
able
to
cover
all
of
that
all
right
so
based
on
the
six
thousand.
Let's
just
use
your
number,
for
example,
which
that's
probably
less
in
my
opinion,
but
that's
that's
something
else,
but
so
you
got
six
thousand
plus.
You
know
the
eighteen
thousand,
twenty
four
thousand
twenty
five
thousand
dollars.
It's
going
to
cost
that
in
your
application
to
get
this
grant,
you
said,
or
the
information
says,
a
hundred
thousand
dollars
that
individuals
that
incur
costs
to
reduce
the
hospitalization
and
income
incarceration
issues.
B
So
that's
a
significant
savings.
Could
you
could
you
comment
on
that
in
terms
of
what
the
cost
benefit
is
because
you
mentioned
that
in
your
presentation,
but
it'd
be
honest
with
you.
I
haven't
heard
anything
about
that.
I
mean
it's.
It's
I
haven't
heard
and
I
haven't
got
any
any
hard
data
that
I
can
look
at
and
sorry
it's
my
business
perspective
in
terms
of
cost
analysis.
So
you
have
a
hundred
thousand
dollars
that
the
application
says
now
you
have
25
ish
thousand
dollars
over
here.
D
I
I
I
too,
like
cost,
benefit
analyses.
I'd
like
to
be
able
to
point
at
data
and
and
say
you
know,
this
is
what
it
means
there
are.
You
know
a
couple
of
levels.
You
need
to
deliver
the
services
directly,
but
then
you
also
need
to
know
how
much
it
costs
and
is
this
the
best
use
of
our
funds,
and
if
there
is
savings,
how
much
is
it
and
and
where
is
it?
Where
can
you
go
touch?
D
It
kind
of
thing,
I'm
not
sure
that
you'll
always
be
able
to
to
say
well,
we
saved
75
000,
and
so
now
we're
going
to
go,
spend
it
here,
because
if
you
don't
hospitalize,
someone
or
they
aren't
arrested,
you've
you've
saved
that
individual
from
incurring
a
cost
tied
to
that
individual.
D
But
unless
you
can
close
a
wing
at
the
hospital
or
you
can
close
a
a
cell
block
at
a
jail
you're
still
going
to
have
to
maintain
those
facilities.
So
it's
the
reason
that
university
of
kentucky
was
included
to
do
a
cost-benefit
analysis
as
over
the
term
of
the
grant
was
to
determine
those
things
to
determine
both
the
individual
costs
and
benefits.
As
well
as
if
there's
any
systemic
ones,
so
we
can.
B
I
think
that
should
be
applicable
to
to
government
as
well,
because
we're
beholden
to
the
taxpayers
and
making
sure
that
regardless
of
federal,
money
or
state
money,
we
need
to
figure
out
where
we
are
in
any
stage
of
the
game
when
it
comes
to
delivering
the
service
and
I'm
not
hearing
that
that's
been
done.
And
if
you're
looking
at
a
hundred
thousand
dollar
savings
or
a
savings
in
terms
of
hospitalization
and
such
and
I'm
not,
including
all
the
other
ancillary
things
that
come
into
play.
Like
the
court
appearances
by
the
clinicians
by
law
enforcement.
B
All
that
stuff
comes
into
a
pro
forma
and
understanding
what
the
cost
is.
But
I,
but
I'm
not
hearing
that
and
if
we're
looking
at
expanding
this
we've
got
to
figure
out
how
much
potential
savings,
because
the
application
looks
at
around
180
million
dollars
that
we
could
be
saved.
Based
on
17
1800
people,
and
so
to
me
that
to
me
you
that
should
be
a
very.
There
needs
to
be
a
more
of
a
control
and
understanding
of
what's
going
on
where
we're
going.
Where
we're
going
down
the
process.
D
Absolutely
I
agree
with
you
wholeheartedly,
and
that
is
the
intent
of
the
grant,
but
the
grant
is
designed
that
we
have
four
years
to
assess
that.
So
we
have
a
large
enough
number
of
individuals
to
make
some
conclusions
from
that's.
Why
university
of
kentucky
didn't?
Do
a
specific
cost
benefit
analysis
this
year
or
at
the
end
of
this
first
grant
year,
because
that
dailable,
that
data
is
not
there
to
be
reliable
enough
to
make
decisions
on
it's
better.
D
B
I
understand
that
but
I'll
have
to.
I
appreciate
your
explanation,
but
you
sh,
but
there
should
be
an
understanding
of
where
you
start
stand
right
now
in
terms
of
how
this
person
is
going
through
the
program
in
terms
of
what's
going
on,
I
know
you
asked
or
lisa
there's
a
500
000,
that's
in
the
budget,
in
addition
to
the
million
dollars
you
know,
I'm
you
know
I'm
trying
to
figure
out
where
you
know
how
that
money's
going
to
be
used
and
so
forth,
but
we
can
talk
about
that
in
a
second.
A
I
think
most
have
been
answered,
but
let
me
just
mention
first
of
all,
I
think
bringing
those
resources
together.
The
way
you
talk
about
and
being
giving
people
an
opportunity
to
make
it
once
they
leave.
I
think
it's
that's
a
grand
and
that's
the
way
it
should
be
handled
and-
and
I
applaud
you
for
for
doing
that
kind
of
brings
into
my
mind,
though
you
know
a
couple
of
different
times.
There
were
third
party
payer.
A
You
know
I
think
you
mentioned,
and
maybe
somebody
else
that
most
people
had
some
type
of
third
party
payer.
If
not
all
or
nearly
all,
would
that
be
a
correct
statement.
You
know,
as
far
as
for
medical
benefits
and
that
type
of
thing,
but
that
didn't
that's
not
necessarily
true
on
housing
or
transportation.
I
wouldn't
think
as
much
but
but
for
the
most
part
there
are
other
resources
that
you
all
have
used
to
to
provide
those
services.
A
For
the
very
reasons
you
gave
me
right
for
the
most
part
yeah
for
the
most
part,
I
realize
there's
exceptions.
So
I
guess
now,
I'm
thinking
all
right
and
and
this
I
know
this
is
way
too
simple,
and
this
is
a
quick,
quick
answer,
I'm
sure.
So,
if
we
spend
400
000,
I
mean
I'm
just
trying
to
think
in
my
head.
If
we
spend
400
000,
would
you
say
half
of
that
went
to
staff
salary?
The
other
half
went
to
transportation
and
housing.
I
mean
I
don't
know.
A
F
A
F
Paying
staffing
right
and
then
a
very
small
portion
and
just
from
I've,
tried
to
assess
exactly.
F
Spent
very
much
very
little
of
out-of-cost
out-of-pocket
money
towards
the
actual
housing
costs.
So
I
think
that's
a
it's
a.
F
There's
been
some
obviously
we've
had
to,
and
I
know
there's
been
some
in
hardin
county
as
well,
but
I
would
say,
for
the
most
part,
it's
only
a
few
individuals
who
have
got
some
housing
money.
Most
of
it
is
they're
housing.
It's
a
few
of
them.
They're
in
family
care
homes,
like
I
said,
the
one
individual,
but
that
money
was
coming
from
other
sources.
C
F
A
F
A
A
D
That
is
accurate.
It
is
mostly
salaries
is
the
highest
portion
of
the
expense,
because
we're
not
able
to
with
the
federal
funds
pay
for
an
individual's
housing
on
any
kind
of
continued
basis.
We
might
be
able
to
pay
for
with
with
these
grant
funds,
they
have
found.
The
the
practitioners
have
found
some.
You
know
other
funds,
the
olmstead
funds,
some
of
the
act
funds
are
a
little
more
flexible,
so
folks
have
been
able
to
use
that.
D
That's
that's
always
what
you're
chasing
when
you
have
grants
is
flexibility
of
funds
that
that
have
sufficient
ability
to
be
used
for
those
different
things
as
they
come
up
on
a
per
person
basis,
but
yeah.
No,
we
look
at
every
opportunity.
D
A
B
Representative
bowen
has
a
question
and
I
have
a
question
we'll
go
ahead.
We
need
to
go
ahead
and
wrap
it
up.
G
Right
I'll
be
quick
judge,
you
mentioned,
you've
had
31
in
jefferson
county
and
then
12
have
gone
to.
F
G
G
Okay,
and
currently
you
have
17-
you
mentioned
that
you
had
one
that
had
completed
the
program.
Is
that
correct.
G
G
Okay,
I
realized
like
with
just
starting
in
december
of
2020
that
we're
just
now
in
the
14th
month
of
the
program.
How
is
that
individual
doing?
I
don't
know
how
long
it's
been
since
he
completed
the
program.
But
how
is
that
that
individual
doing
and
is
the
program?
Is
it
set
up
to?
I
know.
Ultimately,
we
would
love
to
to
put
people
on
the
right
course
for
the
rest
of
their
lives.
G
But
is
the
program
is
the
ultimate
goal
that
or
is
it
to
save
resources
in
the
meantime
or
both
so
they're.
G
F
Services
they
were
getting
right
and
and
and
maintaining
right.
G
F
F
And
I
thought
you
would
ask
the
question
about
kind
of
what
do
I
see
the
success
rate
and
when
I
spoke
with
hardin
county,
we
kind
of
have
the
same
belief
that
about
one-third
of
the
individuals
are
hugely
successful,
we're
you
know
they're
they're
great
they're,
you
know
they're,
not
hospitalized
they're,
not
having
more
contacts,
they're
doing
really
well
in
their
environment,
the
placement
stable
they're
taking
their
medication.
F
B
F
F
They
had
an
individual
who
is
in
jail.
We
have
two
two
individuals
in
jail,
so
we
we've
had
a
couple.
People
come
into
the
program
who
one
woman
she
she's
not
been
rehospitalized
and
she's
not
gone
to
jail.
She
will
not
engage
with
us.
She
won't
come
out
of
her
house
we're
giving
her
certain
services
and
stuff
kind
of
through
her
family,
making
sure
she's
getting
her
medication
sent
to
her
house
and
things
like
that.
F
We
don't
believe
she's
taking
it,
but
we
know
where
she
is
we're
monitoring
the
situation,
but
she's
not
engaging
with
us.
So
we
kind
of
those
folks
who
just
truly,
we
cannot
engage
they're
kind
of
on
that
end
of
you
know,
they're
not
worse,
but
right.
We
don't
really
feel
like
that's
a
huge
success
for
us
right,
but.
B
I
got
one
last
question:
we'll
go
ahead
and
wrap
up.
I
want
to
ask
miss
dickerson
a
more
of
a
cultural
question
in
looking
at
some
documents,
some
court
documents
a
couple
years
ago.
B
There
was,
I
guess,
a
an
approach
to
implementing
tim's
law
was
rather
just
disconcerting
to
me,
and
I
want
to
see
if
that's.
If
I
guess
I
want
to
get
your
opinion
on
it.
Let
me
extract
just
a
couple
comments.
Basically
in
one
of
the
it's
a
whistle
blower
program,
you
might
be
familiar
with
it.
I
don't
know,
but
there's
a
whistle
blower
case
that
came
out
and
one
of
the
statements
in
the
one
of
the
counts
was
like.
B
The
first
attack
was
to
to
make
sure
all
employees
and
contractors
of
state-run
facilities
be
educated
and
aware
that
tim's
law
was
not
part
of
the
governor's
agenda
and
should
be
avoided
at
all
costs.
The
second
wave
of
attack
was
not
to
fund
this
type
of
a
treatment
to
communicate
to
all
state-run
or
funded
facilities.
That
was
no
mon.
B
The
docket
referred
to
is
in
jefferson
county
and
I
want
to
see
you
get
your
comments
and
thought,
and
I
and
I'm
sorry,
but
it
seems
to
me
that
there
might
be
some
concern
that
maybe
we
haven't
reached
up
to
50.
That's
projected
you
know
I
have
30
starts.
So
is
that
what's
the
culture
there
I
mean
it's?
Is
it
very
open?
We
want
to
help
and
get
this
thing
implemented
in
full
and
be
open
and
transparent.
To
make
sure
this
happens.
E
E
There
were
no,
there
were
no
funds
provided
for
it,
and
so
our
department,
we
always
want
to
serve
individuals
in
the
least
restrictive
environment.
E
So
we
on
our
own
solicited
grant
funds
so
that
we
could
implement
and
what
I
suspect
is
those
were
comments,
and
I
don't
again,
I
don't
know
the
exact
comments,
but
what
I
would
suspect
is
that
there,
those
were
probably
pre
the
grant
funds
that
were
available,
and
so
at
that
point
in
time
we
would
have
wanted
to
make
sure
that
anything
that
was
filed
was
filed
appropriately
and
again.
E
There
was
no
funding
provided
to
provide
the
services,
and
that
is
why
we
solicited
the
grant
was
to
obtain
funds
so
that
we
could
implement
the
law
in
a
pilot
project
and
and
again
we,
you
know
we're
excited
about
the
opportunity
possibly
to
expand
this
to
the
other
regions,
but
our
intent
would
be
over
the
four-year.
You
know
over
the
four-year
period
to
prove
that
there
is
some
savings
involved
so
that
we
can
take
the
program
on
a
larger
scale.
B
Okay
well,
thank
you.
I
appreciate
that
explanation
and
so
forth
and
once
again
this
is
a
budget
review.
We
we
deal
with
with
with
a
budget
and
costs
and
so
forth,
and
we
need
to
have
a
good,
strong
understanding
of
the
cost
benefits
in
order
to
go
to
go
forward
and
there
seems
to
be
a
significant,
significant
amount
of
savings,
but
more
important.
I
think
more
important.
We
are
actually
providing
a
system
of
care
to
those
of
who
are
least
among
us
to
make
sure
they
have
more
of
a
functioning
life.
B
So
with
that,
I
don't
see
any
other
questions
on
my
list.
I
want
to
thank
the
judge
and
the
ladies
from
the
department
to
come
and
and
give
us
a
testimony
and
with
that
we
stand
adjourned.
Thank
you.