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A
Welcome
to
meeting
number
four,
the
house
budget
review
subcommittee
on
Health
and
Family
Services.
The
meeting
materials
were
put
online
earlier
this
week
and
made
available
for
downloading
at
this
time.
We'll
have
a
secretary
call
the
row.
A
A
Second,
please
all
in
favor
say:
aye
opposed
like
sign
minutes
pass
I
want
to
preface
this
meeting
I'm
supposed
to
be
in
three
committee
meetings
at
the
same
time
and
I'm
Mr
bowling,
he's
I
know
he's
in
three
two,
so
I'll
be
up
and
out
so
just
be
patient
with
us
today.
It's
that
time
of
year
first
up
this
morning
and
please
keep
your
presentations
brief
today
for
common
sense
stages,
we're
all
pretty
thin
out
with
I'm
supposed
to
be
a
three
at
one
time.
A
First
of
this
morning
we
have
representatives
from
the
Department
for
public
health
to
give
us
an
overview
of
the
Kentucky
prescription
assistance
program.
You
call
that
kpap
or
Kappa.
Would
you
please
identify
yourselves
for
the
record
and
members
hold
your
questions
till
the
presentation
is
done.
Please.
C
C
Thank
you
again
for
this
opportunity
to
speak
with
you
today
about
the
Kentucky
prescription,
assistance
program
or
kpap.
A
k-pap
is
has
a
mission,
that's
really
twofold.
For
most,
we
consolidate
all
the
national
prescription,
assistance,
programs
or
paps
into
one
location
to
make
all
hundreds
and
hundreds
of
programs
more
accessible
to
kentuckians,
who
need
assistance
accessing
free
or
reduced
cost
medications.
C
So
prescription
assistance
programs
are
typically
provided
by
National
Drug
manufacturers,
discount
medication,
programs
and
pharmacies,
and
each
of
these
programs
has
a
very
distinct
application
process.
That's
complex
for
every
single
drug
that
they
offer
and
what
our
program
does
is
consolidate
that
application
into
one
time,
one
application,
so
that
if
a
person
needs
access
to
say
10
medications,
they
only
have
to
apply
one
time.
C
Individuals
with
different
income
levels
is
a
priority,
but
also
we
work
with
a
lot
of
people
who
may
have
a
inability
to
access
medication
because
they're
in
the
Medicare
donut
hole,
or
they
have
insurance,
but
the
medication
that
they
have
a
great
need
for
is
not
covered
by
their
health
insurance.
If
a
person
is
not
eligible
for
a
drug
that
they
need,
we
also
seek
out
other
opportunities
to
provide
co-pay
assistance
or
even
other
available
programs
that
may
help
them.
C
So
this
work
is
primarily
carried
out
by
about
500
volunteer
Advocates,
that
we
train
and
support
throughout
the
state
and
they
work
one-on-one
with
individuals
who
reach
out
to
us
and
need
assistance
they
meet
with
these
people
interview
them
fill
out
all
of
the
information
that
is
required
by
our
database
and
submit
applications
on
their
behalf.
It's
important
to
note
that
if
they
receive
a
denial
for
accessing
a
medication,
we
do
go
back
and
try
to
work,
to
re-evaluate
and
submit
additional
information
and
then
also
importantly,
it's
not
a
one-time
thing.
C
So
you
can
already
tell
that
this
is
more
than
just
a
prescription
assistance
program.
We
are
an
important
network
of
providers
throughout
the
state.
We
have
a
small
staff,
that's
made
up
of
people
who
train
and
support
all
of
our
Advocates.
We
have
Community
Consultants
that
are
located
throughout
the
state
and
train
and
support
those
Advocates
that
are
located
at
the
local
levels.
We
have
a
hotline,
so
a
1
800
number
that
we
answer
and
assist
folks
with,
and
then
we
refer
them
to
advocates
in
their
communities.
C
Our
kpap
outcomes
are
just
amazing:
we
improve
access
to
free
and
reduced
cost
medications,
but
we
also
improve
medication
compliance
which
thereby
reduces
visits
to
the
emergency
room
and
long
hospitalizations.
We
build
social
networks
and
relationships.
It
empowers
kentuckians
by
eliminating
their
health
care
barriers
and
overall
we
improve
the
way
of
life,
for
so
many
kentuckians
I
did
want
to
share
with
you
a
top,
basically
20
list
of
our
medications
that
are
most
highly
used
in
this
program.
C
C
Now
importantly,
we
run
on
a
shoestring.
Our
budget
is
667
thousand
dollars
a
year
about
half
of
that
is
for
our
personnel,
and
just
a
third
is
supports
the
software
that
we
use
to
make
all
these
important
connections.
So
it's
really
a
small
budget
with
a
mighty
impact
and
when
I
say
Mighty
impact
in
2022
we
saved
kentuckians
46
million
dollars
in
prescription
costs.
C
C
we
are
working
to
make
ourselves
more
accessible.
This
is
the
secret.
We
don't
want
to
keep
so
we
definitely
need
your
help.
Sharing
the
word
with
our
budget.
We
don't
have
spend
a
lot
on
Advertising,
but
we
do
work
on
making
our
web
page
more
accessible,
updating
our
promotional
materials
and
working
closely
with
Advocates
and
leaders
all
across
the
state
and
then
we're
also
working
to
optimize
the
ability
to
access
us
through
search
engines
such
as
like
Google.
D
Thank
you
for
the
presentation
I
want
to
introduce
students
who
are
here
today
from
eku's
global
leaders
unite
program,
a
way
that
us
it's
a
group
of
student
leaders
that
are
part
of
different
Multicultural
groups
such
as
divine
nine
organizations,
BSU
and
LSA
they're
here
today,
visiting
to
learn
about
advocacy
and
attend
the
crown
act
rally
this
afternoon
and
their
advisor
is
my
friend
Martina
Jackson.
Thank
you
all
for
coming.
A
C
A
E
A
Of
us
even
is
similar
because
we've
been
a
lot
has
been
working
on
that
for
several
years.
75
percent
I've
been
to
Lily
before
and
it's
interesting
that
they
store
insulin
and
rotate
it
out
of
a
hidden
place
in
case
we
ever
have
a
national
disaster
and
we
come
out
of
it,
so
they
rotate
it
in
and
out
it's
a
very
responsible
company
on
that
part,
so
if
you're
in
Indianapolis
visit
them
okay,
thank
you
very
much
for
your
presentation
and
I'm
companies
get
information
out,
and
this
is
one
way
of
doing
it.
A
Okay,
Medicaid
reimbursement
for
Pediatric
Behavioral,
Health
Services.
We
have
people
there
for
presenting
a
thank
you
to
the
presenters
and
our
next
presentation
is
from
the
Children's
Alliance
KBC
Behavioral
Health
and
Raymond
Estep
to
discuss
Medicaid
reimbursement
for
Pediatric,
Behavioral,
Health
Services.
So
presenters.
Please
identify
yourselves
for
the
record
and
everybody's
up.
There.
F
F
Will
start
and
I
just
wanted
to
just
put
some
information
in
about
the
Children's
Alliance?
Most
of
you
know
who
we
are
but
you're
more
familiar
with
us,
caring
for
about
half
of
the
children
in
our
out-of-home
care
system,
but
today
we're
here
to
talk
about
those
members
that
provide
Behavioral,
Health
Services,
which
is
a
true
prevention
before
those
kids
come
to
the
knowledge
of
the
CBS,
we're
talking
about
Medicaid,
Behavioral,
Health,
Services
organization
and
multi-specialty
groups,
and
these
are
Behavioral
Health
Services
that
work
out
in
our
communities
that
serve
thousands
of
Children
and
Families.
F
They
predominantly
work
with
those
that
are
very
high
needs
and
in
the
homes
in
the
schools
out
in
our
communities.
Bhsos
and
bhmsgs
have
consistently
been
underfunded
for
years.
The
Kentucky
medic
K
program,
if
you
look
at
their
regulations,
only
reimburses
75
percent
of
the
Medicare
rate
and
that's
for
doctors.
It
goes
down
and
blow
for
that.
We're
consistently
lower
than
our
surrounding
states.
In
some
cases
as
much
as
35
percent
and
and
I
can
say,
West
Virginia,
which
is
bordering
some
of
these
folks.
F
They
pay
42
dollars
an
hour
more
for
an
hour
of
therapy
than
Kentucky
does
for
our
bhso
services.
That's
a
significant
amount
and
obviously
I
know
folks
that
are
on
that
border
are
losing
our
staffs
across
the
border.
So
the
demand
for
Behavioral
Health
is
increasing.
We've
got
more
people
in
our
Medicaid
enrollment
and
our
Medicaid
system.
F
Also,
the
U.S
Surgeon
General
has
reported
that
we're
in
a
mental
health
crisis
for
our
youth,
and
you
can
see
some
of
the
data
anxiety,
depression,
everything
it's
just
it's
going
up
and
it's
going
up
fast
and
when
you
see
these
you're
like
okay
yeah,
that's
the
United
States
what's
happening
in
Kentucky.
These
are
some
numbers
taken
from
and
a
report
that
is
done
in
our
Kentucky
schools
and
127
districts
across
our
our
state.
F
This
is
how
many
kids
25
are
reporting
serious
psychological
distress
in
the
last
30
days,
and
you
can
see
how
that's
gone
up,
feeling
nervous
going
up
suicide
plans
going
up.
F
F
and
you're
thinking.
Well,
that's
not
very
many
licensed
therapists.
That's
not
very
many
therapists
to
care
for
thousands
of
kids.
Most
of
these
programs
have
licensed
therapists
to
provide
supervision
and
then
there's
the
associate
level.
That's
provided
underneath
those
licensed
therapists,
and
so
not
only
are
we
losing
the
license
folks,
and
these
are
Master's
level
with
two
to
three
years
experience
in
their
in
their
field,
we're
losing
the
associate
level,
which
is
just
a
master's
level
and
they're
working
toward
that
license.
F
So
there
may
be
just
recently
out
of
school,
but
but
they're
leaving
and
folks
are
saying
well
they're,
maybe
they're
going
to
the
hospitals
or
schools
or
to
the
mcos
places
that
can
pay
more
and
we've
just
got
a
shortage
of
therapists.
The
problem
is,
is
they're
leaving
to
go
outside
of
our
field,
so
when
the
demand
is
going
up,
unfortunately,
we're
seeing
our
therapists
leave
in
droves.
F
The
Children's
Alliance
did
a
survey
last
year
of
our
members,
so
this
is
a
a
small
portion
of
those
bhsos
and
and
bhmsgs,
but
the
average
salary
for
a
master's
level
was
48
000
and
for
our
masters
with
a
license,
was
52
000
and
you
can
see
our
turnover
rates.
But
I
just
read
the
report
where
DJJ
has
hired
81
new
DJJ
workers,
which
is
great,
but
guess
what
we've
raised
their
salary
to
50..
So
there.
F
Those
folks
who
don't
have
a
master's
degree
are
making
more
than
and
close
to
our
our
masters
with
three
two
to
three
years
experience.
So
it's
just
not
sustainable.
Here's
some
data
again
from
that
survey
of
our
members
that
provide
bhso
services
and
where
they
are
the
waiting
list
42
days
actually
is,
is
really
short
today.
F
So
we
need
to
be
working
to
make
sure
that
we're
seeing
this
folks
in
a
short
amount
of
time,
and
so,
but
many
of
my
agencies
have
waiting
lists.
You
can
see
the
losses
these
agencies
are
incurring
and
so
they're
coming
to
me
and
saying
it's
just
not
sustainable
many
of
them.
Their
boards
are
talking
about
just
just
eliminating
these
programs,
along
with
the
demand
going
up
and
the
supply
going
down.
Our
administrative
services
are
increasing.
F
So
when
you
see
Senate,
Bill
29,
that's
really
where,
where
these
talking
points
really
fit,
we
get
so
much
administrative
burden
on
the
placed
on
on
these
Behavioral
Health
entities
and
from
six
different
mcos,
and
it's
it's
really
again.
It's
increase
our
mini
administrative
services
and
decreasing
the
time
that
we
can
provide
treatment.
F
So
what
we're
asking
is
that
the
general
assembly
require
that
Kentucky,
Medicaid,
behavioral
health
and
substance
abuse
disorder,
folks,
the
bhsos
and
the
bhmsgs
be
paid
a
hundred
percent
of
Medicare
and
what
what
we
know
about
Medicare
rates
is
that
they're
about
80
percent
of
costs.
So
when
you
cut
25
off
of
that
and
give
that's
where
we
start
at
our
highest
again,
it's
just
not
a
sustainable
system.
We
have
to
have
some
kind
of
methodology
where
we
know
and
it
up.
F
It
goes
up
and
down
based
on
our
economy
and
the
market,
and
that's
what
Medicare
does
they?
They
do
those
cost
reports
and-
and
they
have
a
system
to
Define
and
understand
where,
where
these
Services
need
to
be,
but
yet
we're
just
cutting
25
percent
off
kind
of
randomly.
There's
really
no
thought
about
that.
It's
just
a
25
cut
and
what
we
would
say
is
we
need
to
go
ahead
and
reimburse
the
full
400
percent
of
Medicare
when
we
serve
these
children.
So
I
would
say
if
my
parents
can
get
this
service,
why?
F
So
the
reason
why
I'm
here,
because
I
know
it's
not
a
budget
session
but
I
would
say
we're
in
a
really
critical
time
in
a
crisis,
because
I
hear
from
my
members
that
they're
closing
and
for
me,
I've
worked
really
really
hard
with
this,
with
this
body
to
focus
on
prevention
and
we've
really
invested
in
prevention,
and
it's
working,
our
numbers
in
out
of
Home
Care
are
going
down
and
we've
invested
in
programs
like
k-step
and
what's
the
other
family
preservation,
but
those
are
kids
that
come
to
us
after
they're
referred
or
after
they
become
known
to
dcbs.
F
Those
are
children
that
have
not
come
to
into
our
knowledge
or
care
right,
there's
not
referrals
there,
yet,
but
yet
they're
serving
them
in
their
communities
with
their
families
and
preventing
them
from
going
into
higher
level
levels
of
care,
psychiatric
hospitals
at
500,
so
no
no
telling
a
day
they're
keeping
them
out
of
incarceration,
which
we're
hearing
the
DJJ
cost
about
500
a
day
to
incarcerate
kids
foster
care,
that's
at
least
150
a
day
over
on
average
Plus
for
the
for
those
children,
and
so
it
really
does
Save
Our
State
and
it's
better
for
kids
and
families
to
serve
them
in
our
communities.
F
So
I'm
concerned
that
we're
losing
an
infrastructure
and
we're
not
sustaining
a
program
that
we
know
is
effective.
I've
shared
some
success
stories
with
you,
obviously
I'm
not
going
to
go
through
those,
but
just
wanted
to
just
share
those.
You
can
read
those
but
I
wanted
to
bring
my
colleagues
Jared
and
Kelly
here
to
talk
a
little
bit
about
their
programs
and
why
they're
coming
to
me
and
why
it's
important
that
we
come
in
and
share
this
information
with
you
today.
G
Five
minutes:
okay,
thank
you!
So
I'm
Jared
Duncan,
vice
president
of
operations
with
kvc
Behavioral
Healthcare
kvc,
has
over
20
years
of
experience
with
community-based
child
targeted
and
family
focused
Behavioral,
Health
Services.
We
started
as
an
impact
as
an
impact
plus
provider
many
years
ago
until
it
was
discontinued
in
2014,
when
the
behavioral
health
network
opened
up.
G
For
those
that
don't
know,
impact
plus
was
a
Medicaid
carve
out
a
focused
specifically
on
treating
children
in
their
communities,
who
are
at
risk
of
higher
levels
of
care
where
the
children
were
exhibiting
problems
in
the
home,
school
and
Community
settings,
so
lots
of
complex
cases
there,
and
we
continue
to
do
that.
Work
after
the
behavioral
health
Network
opened
currently
we're
also
one
of
the
largest
family
preservation
and
cassette
providers
in
the
state.
G
Those
programs
also
focus
on
in-home
work
with
families
who
are
experiencing
very
complex
needs
and
mental
health
issues
where
we
deliver
in-home,
evidence-based
clinical
practices,
similar
to
what
we
do
in
the
in
the
behavioral
health
world
and
in
fact,
for
kvc,
we
moved
we.
We
took
our
approach
from
our
Behavioral
Health
work
into
our
child
welfare
work,
as
Michelle
mentioned,
we
are
in
a
mental
health
pandemic
for
youth.
Acuity
is
higher
at
all.
Levels
of
care.
G
The
vast
majority
of
these
youth
are
pre-system
involved,
as
Michelle
says.
So
we
know
this
work
is
a
preventative
work
and
it's
it's
very
important.
We
receive
referrals
from
over
a
hundred
unique
referral
sources,
47
of
those
come
from
schools
directly,
who
obviously
schools
have
many
more
mental
health
practitioners
today
than
they
did
just
a
few
years
ago.
But
these
are
referrals
we're
getting
because
they
are
too
complex
to
be
worked
in
the
schools.
Eleven
percent
of
our
referrals
come
directly
from
psychiatric
hospitals.
G
While
all
this
work
is
wonderful,
there's
a
major
problem
as
the
need
for
this
level
of
care
is
increasing.
Based
on
the
stats
Michelle
shared,
the
sustainability
of
services
is
rapidly
decreasing.
Since
fiscal
year
2019,
our
agency
has
averaged
a
17.4
percent
Financial
loss
for
the
last
four
years.
One
caveat
is
that
I
adjusted
fiscal
year
21
because
we
did
receive
some
cares
act
due
to
the
covid
relief
and
so
I
I.
We
adjusted
that
Revenue
just
to
look
at
operational
bottom
line
itself.
G
Meanwhile,
the
world
has
the
need
for
Master's
level.
Therapists
has
greatly
increased
because
of
our
losses.
However,
we
couldn't
increase
salaries
enough
to
compete
and
some
some
stats
in
fiscal
year
2019.
G
We
served
848
clients
in
that
year
and
had
34
therapists
as
as
of
fiscal
year
22
we
serve
488
clients
and
we're
down
to
10
or
10
therapists.
Today
we
have
seven
therapists.
We
cannot
afford
to
invest
in
this
critical
Network
because
of
the
losses
and
the
the
thing
that
we
want
to
do
most
is
invest
grow
our
programs
back
to
what
they
were
and
and
continue
the
the
Prevention
Services.
G
So,
in
order
to
we,
we
also
currently
at
143
clients
on
our
wait
list
that
we
can't
get
to
when
we
do
get
referrals,
we
are
assigning
them
based
on
Acuity,
which
means
generally
it's
the
highest,
need
we're
filling
our
therapist
caseloads
with
the
absolute
highest
need
and
most
complex.
That
is
a
major
burnout
risk
for
our
therapists,
and
we
see
it
every
day,
which
is
also
another
factor
in
the
turnover.
G
E
Hello,
Kelly
McCormick
again
with
Raymond
esta,
the
chief
treatment
officer.
We
are
located
in
Ashland
Kentucky,
which
is
in
Boyd
Northeastern
region,
they're,
close
to
representative
Bentley.
Many
of
the
things
that
I
was
going
to
discuss,
actually
Jared
has
already
shared,
so
I
won't
continue.
Our
history
is
very
similar
to
kvc's
in
regards
to
the
impact
Plus
work
and
that
outpatient
Behavioral
Health
work.
E
We
needed
to
help
the
whole
family
and
not
just
that
child
coming
into
Idaho
care,
and
this
is
the
way
that
we
can
do
that
and
we've
seen
such
great
success
with
that
through
our
prevention,
programming
and
I'll
share
a
very
quick
story
just
to
kind
of
let
this
hit
home.
We
were
called
into
a
school.
E
E
We
do
in-homework,
which
also
is
a
it's
very
tough,
to
do
in
homework
with
the
rights
that
we
have
because
we're
just
not
sitting
behind
a
desk,
seeing
people
we're
meeting
them
where
they're
at
which
means
we
do
less
services
in
a
day,
but
they're
more
quality,
they're
more
meaningful
because
we're
actually
involving
them
and
their
their
place
where
they
are.
So
we
start
working
with
this
family
in
the
home
and
realize
it's
just
chaotic
in
this
child's
home
right.
E
There's
people
in
and
out
of
the
house
all
the
time
you
know
so
he's
not
feeling
safe
to
sleep.
He
can't
do
his
homework
because
he
shares
a
bedroom
with
three
other
children.
So
when
we
got
in
there
and
really
started
working
with
them
and
talked
with
the
school,
we
were
able
to
turn
this
whole
child's
experience
in
his
education
and
home
life
around.
If
we
weren't
doing
that
work,
this
child
would
have
come
to,
he
would
have
been
referred
to
dcbs.
He
would
have
went
to
foster
care.
F
And
I
was
saying:
this
is
Michelle
Sanborn
again
there
I
noticed
on
the
agenda
that
it
says
pediatric.
Obviously
we
are
the
focused
on
children,
but
the
rate
increase
would
include
adults
and
that's
what
we
do.
We
work
with
the
children
and
their
families
to
make
a
holistic
approach,
and
so
just
wanted
to
make
sure
we
clarified
that
that
rate
would
also
include
Adult
Services
as
well.
A
That's
the
reason
I
have
because
I
realize
that
you're
payment
wasn't
keeping
up
with
the
demand.
Actually
no
one's
y'all
come
in.
So
you
know
in
Frankfurt
you
start
now
and
you
get
to
see
results
two
years
later,
so
I
understand
where
you're
coming
from
and
I've
talked
to
Michelle
about
this
many
times
right
now
we
have
a
question
by
representative
Wilner.
H
Thank
you
Mr
chairman,
and
thank
you
for
bringing
in
this
presentation
and
I
think
you
guys
are
largely
preaching
to
the
choir
here
and
we
understand
the
importance
of
prevention.
We
understand
that
the
mental
health
needs
of
our
kids
have
never
been
greater
we're
seeing
it.
You
know
in
behavior,
in
schools
to
your
story,
we're
seeing
it
everywhere
and
trying
to
find
solutions
by
kind
of
harshing
down
on
kids.
H
You
know,
let's,
let's
make
Juvenile
Justice
harsher,
let's
make
schools
less
tolerant
and
it's
the
wrong
approach,
and
certainly
getting
our
therapists
paid
is
to
keep
even
keep
them,
is
the
bare
minimum
of
what
we
should
be
doing.
So
you
know,
please
know
that
you
have
Champions
on
this
committee
who
fighting
for
that
and
then
Jared
I
wanted
to
ask
you
specifically
could
I
get
a
copy
of
your
testimony?
Sure
I'll
take
the
paper
copy
from.
A
F
F
Six:
seven,
no,
usually
two
post
post-secondary
to
get
a
master's.
There
are
some
Advanced
programs
where
it's
a
year
year
and
a
half
where
they're
trying
to
get
get
folks
through
quicker,
so
they're
out
in
the
community
yeah.
A
Think
people
need
to
understand.
That's
the
reason
I
ask
on
Triads
Jared,
who
does
that
triage
for
you?
We
were
talking
about
right.
G
Our
our
Behavioral
Health
director,
that's
one
of
our
primary
responsibilities:
she's
a
licensed
clinical
social
worker
she's
got
many
years,
experience
she's
able
to
do
supervision
and,
as
part
of
her
work
in,
and
we
also
have
other
supervisors
available
to
consult
if
the
if
the
decisions
are
difficult.
But
she
looks
through
reasons
of
referral,
presenting
problems
who
the
referral
source
is
and-
and
it's
we
don't
like
being
in
the
situation
of
having
to
choose
like
that,
how
how
to
who
who
to
extend
services
to,
but
unfortunately
often
it
comes
down
to.
E
I
was
gonna,
actually,
you
know
we're
located
right
there
with
Ohio
and
West
Virginia
and,
like
Michelle
said
we
it's
almost
impossible
to
recruit
new
new
clinicians
in
our
area
and
I
know
that
several
other
the
agencies
are
experiencing
the
same
thing.
E
You
know
we
just
want
to
be
able
to
get
those
good
good
quality
licensed
people
in
our
door
so
that
we
don't
have
those
100
plus
it
like
Jared
said
it
breaks
our
heart
to
be
able
not
be
able
to
serve
them,
but
we
know
that
we
can't
just
continue
to
pile
them
on
to
the
7,
to
the
10,
to
the
20
clinicians
that
we
have
because
then
we're
not
providing
good
care
to
anyone.
So
we
have
to
make
it's
a
it's.
E
A
A
A
That
idea
came
out
of
the
task
force
for
severe
mental
illness,
which
was
I
was
the
chairman
of
part
of
that
and
I
know
that
I
was
with
Pathways
in
Ashland
when
they
had
their
I
call
it
bus
out,
and
we
were
in
my
hometown
at
South
Shore
and
so
two
men
came
up
who
had
PTSD
and
they
said
you
know
I'd
come
here,
but
I
won't
go
to
a
major
city,
but
I'll
go
to
see.
You
know
it's
less
than
1500.,
so
I
know
that
Mrs
Nunley
has
really
good
data.
A
I
Good
morning,
thank
you,
representative
Bentley,
for
the
chance
to
discuss
the
mobile
crisis.
Loan
Fund.
We
appreciate
the
funding
that
we
did
receive
for
988
implementation
and
mobile
crisis
service
enhancement.
Last
year.
It
has
been
incredibly
helpful
as
we've
rolled
out
988
as
well,
and
begin
to
work
on
the
mobile
crisis
response
system
across
the
state,
so
I
am
going
to
provide
just
a
quick
update
and
I
promise
to
be
brief
on
the
mobile
crisis,
Loan
Fund
and
where
we
are
at
this.
At
this
point.
I
So
as
you
mentioned,
the
funding
for
this
mechanism
was
actually
in
House,
Bill,
604
and
then
funded
through
House
Bill
one
and
it
became
a
part
of
krs-210
368..
So
it
was.
The
Loan
Fund
was
established
specifically
to
provide
loans
to
cmhcs
Community
Mental
Health
Centers,
in
order
to
increase
access
to
Mental
Health
Services
and
to
provide
individual
services
to
individuals
who
lack
access
to
transportation
and
who
so
it's
a
two-fold.
I
As
representative
Bentley
stated,
2.7
million
was
appropriated
for
fiscal
year.
23.
3.5
million
has
been
appropriated
for
fiscal
year
24
for
this
mobile
crisis.
Loan
Fund.
These
were
our
portion
of
the
total
monies
that
were
designated
for
the
988
implementation
and
mobile
crisis
service
expansion.
I
I
I
Once
that
process
was
completed,
the
notice
of
loan
opportunity
was
issued
to
our
CEOs
and
to
our
community.
Our
CR
crisis
call
center
directors
at
each
of
our
14
Regional
cmhcs.
That
initial
issue
was
on
October
20th,
with
a
due
date
of
November
10th.
It
was
a
very
expedited
process,
so
it
was.
It
asked
very
few
questions.
It
did
include
a
request
for
them
to
to
work
with
us
to
identify.
Do
it
basically
do
A
needs
assessment
of
their
system
as
they
move
forward
in
order
to
determine
what
needs
they
additional
needs.
I
B
I
We'll
get
this
all
right
at
that
time.
We
also
requested
that
they,
when
we
send
out
the
second
issue,
we
requested
that
they
they
actually
confirm
with
us
by
December,
2nd,
whether
they
were
or
were
not
interested.
In
that
Loan
Fund,
we
did
receive
responses
from
seven
of
the
14
as
a
result
of
the
sucking
offering
all
of
whom
indicated
they
were
not
interested
in
receiving
a
loan.
I
At
that
time,
we
did
not
receive
responses
from
the
other
seven
we
have
since
talked
with
them
and
again
they
reiterate
that
they
are
not
interested
in
obligating
their
centers
for
a
loan.
At
this
point
they
did
indicate
that,
should
there
be,
should
this
be
switched
to
a
grant,
they
would
be
interested
in
reassessing
whether
it
would
be.
C
I
Know
as
I
think,
that's
that's
the
key.
You
know
the
cmhcs
have
all
had
a
very
hard
year.
You
know,
as
as
you've
just
heard.
We
we
too
have
kind
of
a
drain
of
of
licensed
folks
and
and
and
those
working
under
them
and
being
able
to
provide
services
just
being
able
to
access
I
think
the
idea
of
the
vehicle
that
Pathways
has
is
is
an
incredible
idea.
I
We
were
actually
able
to
utilize
that
during
the
disaster
in
Eastern
Kentucky,
when
Pathways
help
backfill
for
Kentucky
River,
they
utilize
the
the
mobile
vehicle
that
they
had
I.
Think
at
this
point
it's
really
they're
looking
at
their
financial
stability,
their
financial
ability
to
repay
and
being
able
to
use
those
funds
for
items
that
would
not
be
reimbursed
by
Medicare.
At
this
point
or
Medicaid.
A
H
Well
and
I
really
just
turned
around
to
look
at
you
just
to
acknowledge
your
absolutely
these
mobile
crisis
units,
it's
so
important,
but
so
many
times
we
understand
what's
needed.
We
have
you
know
leadership
like
this
saying
this
is
what's
going
to
help
our
rural
communities,
but
then
we
don't
step
up
and
pay
for
it,
and
so
you're
right
I
know
the
the
cmhcs
are
in
a
really
vulnerable
positions
financially
right
now,
for
all
the
same
reasons,
we
heard
from
the
bhsos
who.
I
D
Yes,
I
in
addition
to
looking
at
the
funding
model
once
again,
I
wonder
if
we
could
look
at
who
it's
open
to
I
wonder
if
school
districts
would
have
interest
and
police
departments
would
have
interest
in
other
entities
that
interact
a
lot
with
our
youth
someone's
nodding.
So
we
can
have
conversations
about
that.
Might.
I
It
be
possible,
yes,
absolutely
that's
an
option
and
and
I
think
looking
at
you
know.
Some
of
the
some
of
the
other
providers
in
the
region
would
also
be
a
possibility,
as
well
in
the
Region's
rural
areas.
E
Mccormick
again
with
Raymond
Estep,
yes,
so
this
you
know
this
was
unavailable
to
bhsos
like
she
said
just
the
cmhcs
were
available
for
that
original
money.
To
help
with
this
and
I
think
that
I
know
that
there
are
several
bhsos
in
the
state
that
could
also
benefit
and
utilize
these
units
I
think.
Just
a
couple
weeks
ago
we
were
called
to
Boyd
County
high
school.
E
They
had
a
student
pass
away,
so
we
sent
a
whole
team
out
and
there
was
nowhere
in
the
school
for
us
to
to
meet
the
multitude
of
of
children.
You
know
that
needed
our
services
that
day,
and
so
this
would
have
been
a
perfect
example
of
how
we
could
have
utilized
that
on
on
that
day.
So,
yes,
when
you
say
you
know,
could
we
potentially
open
this
up?
We
would
love
to
have
that
opened
up
to
other
providers
who
may
be
able
to
to
provide
those
same
Services
as
well.
A
E
A
Okay,
thank
you
to
the
presenters.
This
is
our
final
meeting
for
this
session
and
thank
you
all
for
all
the
members
for
coming
and
I
think
we've
covered
some
really
good
subjects
now.
The
next
item
is
a
German.
Do
I
hear
a
motion
in
a
second,
so
we
adjourned.