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From YouTube: Severe Mental Illness Task Force (8-4-21)
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A
Good
afternoon
and
welcome
to
the
third
meeting
of
the
severe
mental
health
task
force.
As
a
reminder,
we
have
new
meeting
protocols
in
place
for
the
2021
interim
session.
Remote
access
is
allowed
to
all
meetings
for
the
interim
session.
Members
were
provided
to
zoom
link
to
access
the
meeting
remotely.
A
C
A
President
in
the
room
see
we
we're
quick
to
learn
is
the
assembly.
We
know
already
that
I
don't
have
to
read
that
whether
you're
present
in
the
room
or
remote
from
the
office
or
whatever
so
quick
learners.
Okay,
we
now
need
to
approve
the
minutes
from
the
task
force
meeting
held
july
20th
21.
Do
we
have
a
motion
motion
to
approve
and
the
second
second,
second,
oh
in
favor,
say
aye?
A
A
I
never
asked
how
to
pronounce
that
ashley
boaz.
She
is
executive
director
of
penny
royal
center
members
hold
your
questions
until
after
the
presentation,
please
and
presenters
remember.
We
are
on
a
time
frame
so
be
as
brief
and
short
as
you
can
so
that
everyone
can
present
and
we
can
ask
lots
of
questions.
A
D
Okay,
yes,
sir,
my
name
is
ashley
bose,
I'm
a
licensed
clinical
social
worker
and
the
executive
director
of
the
penny
roll
center,
a
community
mental
health
center
and
located
in
western
kentucky.
I
would
like
to
take
the
opportunity
to
speak
speak
specifically
regarding
limitations
and
barriers
and
providing
services
to
individuals
with
severe
mental
illness.
On
october
31
1963
president
kennedy
signed
the
community
mental
health
center's
act
into
law.
D
Community
mental
health
centers
are
publicly
funded
to
provide
community
services
for
kentucky
kentuckians,
who
experience
issues
associated
with
mental
health,
developmental
and
intellectual
disabilities
or
substance
use.
Cmhcs
are
non-profit
organizations
established
by
krs
chapter
210,
which
serve
residents
in
a
designated
multi-county
region.
D
D
Within
the
eight
county
penny
rural
center
region,
we
served
approximately
10
783
individuals
of
those
individuals,
5
109
were
diagnosed
with
severe
mental
illness.
That's
53.65
of
the
population
served
samsha,
defines
severe
mental
illness
as
someone
over
18
years
of
age
who
have
experienced
a
diagnosable
mental,
behavior
or
emotional
disorder
within
the
last
year.
That
causes
severe
functional
impairment
that
substantially
interferes
with
or
limits
one
or
more
major
life
activities.
D
D
Individuals
living
with
severe
mental
illness
are
not
only
seen
in
our
clinics,
but
emergency
departments,
jails,
colleges,
universities,
they're,
seen
throughout
our
communities
as
mental
health
providers.
We
often
see
family
members
and
community
partners
asking
for
individuals
to
be
hospitalized
when
experiencing
some
sort
of
mental
health
crisis.
D
Involuntary
psychiatric
hospitalization
is
not
always
the
most
appropriate
route
for
treatment.
Specific
criteria
is
used
to
determine
the
need
for
involuntary
hospitalization
according
to
the
202a
status,
so
an
individual
presents
a
danger
or
a
threat
of
danger
to
himself
themselves,
family
or
others
as
a
result
of
mental
illness.
D
They
would,
they
would
reasonably
benefit
from
treatment
and
hospitalization
is
the
least
restrictive
alternative
mode
of
treatment.
So
this
means
that
treatment
will
give
a
mentally
ill
individual
a
realistic
opportunity
to
improve
their
ability,
their
level
of
function
consistent
with
accepted
professional
practice
in
the
least
combining
cert
setting
available.
D
Please
keep
in
mind
that
individuals
who
suffer
from
severe
mental
illness
in
most
cases
are
their
own
guardian
and
have
the
right
to
make
decisions
for
themselves
for
individuals
with
severe
mental
illness.
The
goal
is
to
provide
these
services,
these
direct
services
to
each
individual
in
the
community,
empowering
them
to
make
healthy
choices,
healthy
decisions
for
themselves
to
be
physically
and
mentally.
Well,
those
supportive
services
can
be
wrapped
around
the
individual.
D
They
still
experience
significant
barriers,
transportation,
affordable
housing,
lack
of
stable
income,
employment
opportunities,
as
well
as
access
to
reasonable
resources
within
the
community,
such
especially
in
rural
kentucky
areas
within
the
community
mental
health
center.
There
are
specific
services
that
supports
that
support,
set
up
to
assist
individuals
with
severe
mental
illness
to
be
able
to
live
successfully
in.
D
D
A
It
would
help
us
we
have
paper,
let's
see,
or
someone
can
stay
down
there
and
help
you
if
they.
A
D
So
this
is
where
so,
the
services
that
we
provide
in
the
service
system
that
has
been
set
up
within
the
cmhc,
so
assertive
community
treatment
is
a
treatment
team
approach
designed
to
provide
comprehensive,
community-based
psychiatric
treatment,
rehabilitation
and
supports
to
persons
with
severe
mental
illness
within
the
act
teams.
They
provide
case
management,
initial
and
ongoing
assessment,
psychiatric
services,
employment
and
housing
assistance,
family
support
and
education,
substance
use
services
and
other
services
and
supports
that
are
critical
for
the
individual
to
be
able
to
live
successfully
in
the
community
act.
D
D
Comprehensive
community
support
services
are
activities
necessary
to
allow
clients
to
live
with
maximum
independence
in
the
community
and
consist
of
one
or
more
of
the
following
medication.
Adherence
and
recognizing
symptoms
and
side
effects,
non-therapeutic
behavioral
intervention,
support
and
skills
training,
assisting
in
accessing
and
utilizing
community
resist
resources,
emotional
regulation
skills
crisis,
coping
skills
and
developing
and
enhancing
interpersonal
skills
peer
support
services
is
a
structured
and
scheduled
therapeutic
activity
with
an
individual,
client
or
group
provided
by
trained
self-identified
consumers
within
the
mental
health
system,
employment
and
evidence-based
supportive
employment
services.
D
It's
a
well-defined
approach
to
help
individuals
with
mental
illness
to
find
and
keep
competitive
employment
that
this
service
is
not
reimbursable
for
adults
with
smi
therapeutic
rehabilitation.
Programs
are
goal-oriented
programs
for
adults
with
severe
mental
illness
who
require
care
for
less
than
24
hours
a
day,
but
more
than
outpatient
counseling.
The
purpose
of
therapeutic
rehabilitation
programs
is
to
ensure
that
persons
with
behavioral
health
disorders
possess
those
skills
needed
to
live,
learn
and
work
in
his
or
her
own.
D
Her
own
community
crisis
stabilization
services
are
community-based
services,
which
include
screening,
assessment,
treatment,
planning,
individual
and
group,
and
family
therapy
peer
support
services
all
around
to
stabilize
crisis
and
divert
an
individual
for
a
higher
level
of
care.
Additional
services
include
mobile
crisis
medication,
administration,
outpatient,
individual
therapy
and
group
therapy.
D
Community
mental
health
centers
such
as
the
pitney
rural
center
experience
barriers
ourselves,
crippling
our
ability
to
provide
services
to
individuals
with
severe
mental
illness
managed
care
companies.
So,
though,
pre-authorizations
are
necessary
for
necessary
for
for
some
services
they
can
serve
as
a
significant
barrier
for
individuals
with
severe
mental
illness.
D
Pre-Authorizations
can
lead
to
a
delay
in
service
delivery,
as
well
as
create
paperwork
constraints
on
staff
taking
away
from
direct
client
time
by
history,
reimbursement
rates
have
been
exceptionally
low,
barely
covering
the
cost
of
the
provider's
time.
In
some
cases,
such
as
psychiatric
services,
the
rates
reimbursed
do
not
cover
the
cost
paid
by
the
agency
to
the
provider
to
provide
the
the
service.
So
psychiatric
services
are
necessary,
but
they're
limited
for
this
reason.
D
At
this
time,
a
lack
of
regionalization
of
service
providers.
This
allows
any
willing
provider
to
come
into
a
community
mental
health,
center's
region
and
provide
services,
though
this
may
seem
like
more
providers
the
better.
It
creates
significant
issues
when
it
comes
to
providing
a
continuity
of
care
for
individuals
with
severe
mental
illness.
D
D
In
addition,
these
services
that
are
reimbursed
at
higher
rates
are
usually
services
that
financially
sustain
programs
that
function
at
a
loss
for
cmhcs,
such
as
psychiatry
services
outside
providers
are
not
necessarily
obligated
to
provide
any
type
of
emergency
intervention
after
hours
or
on
the
weekends
as
the
community
mental
health
center.
The
penny
real
center
is
contracted
to
provide
emergency
and
crisis
services
to
individuals
experiencing
a
mental
health
crisis
within
the
region,
yet
they
may
not
be
involved
in
the
continuum
of
their
care.
D
We
are
unable
to
pay
a
competitive
rate,
so
there's
a
constant
turnover
and
a
constant
need.
There
are
ways
in
which
u.s
legislators
can
assist
the
community.
Mental
health
agencies
meet
the
needs
of
individuals
with
severe
mental
illness
in
the
communities
in
which
they
live.
The
legislation
currently
exists
to
assist
with
compliance
of
individuals
who
suffer
with
mental
illness
tim's
law.
There
is
no
funding
that
covers
the
cost
to
actually
impose
this
treatment.
D
Currently,
the
department
of
behavioral
health,
developmental
and
intellectual
delay
has
sumptua
funding
for
the
aot
tim's
law,
which
is
is
being
implemented
in
two
core
courts.
There
are
a
total
of
four
cmhcs
that
are
participating
in
this
communicare
and
seven
counties
started
service
delivery
in
this
fiscal
year.
2021
and
the
penny.
Roll
center
and
river
valley
will
start
serving
clients
in
fiscal
year
2023.
D
At
this
time
there
is
no
long-term
funding
that
has
been
identified
outside
of
the
grant
award
period
as
the
need
to
access
a
need
for
access
of
mental
health
services
continues
to
increase
reimbursement
rates,
continue
to
be
low
and
inefficient
in
covering
the
cost
of
intensive
services
necessary
to
improve
the
individual's
ability
to
function.
An
increase
in
reimbursement
rates
by
mcos
allow
for
expansion
of
existing
services
to
increase
accessibility.
D
With
severe
mental
illness,
have
the
ability
to
live
in
a
healthy,
full,
productive
life,
essential
services
as
described,
are
necessary
to
ensure
maintenance
and
stability
of
symptoms
and
prevent
unnecessary
hospitalizations,
which
would
be
removing
individuals
from
the
community
community.
Mental
health
centers
are
in
need
of
your
assistance
with
the
legislation
to
advocate
for
funding
and
to
ensure
we
are
able
to
continue
to
do
the
necessary
work.
Thank
you
so
much
for
your
consideration
and
your
time
today.
D
A
And
I
want
gretchen
davis
to
come
up
next
and
we're
gonna
combine
your
questions
since
yours
is
on
severe
challenges
to
the
people,
and
hers
will
be
a
challenges
also
to
the
establishment,
health
clinics.
So
gretchen.
Where
are
you.
C
Okay,
thank
you.
I
would
like
to
thank
melinda
parente
for
inviting
me
to
share
my
story.
I
have
a
couple
of
handouts
that
I
sent
in
for
you
all
one
is
the
beginning
of
it's
called
roblox
that
I
have
faced
and
the
other
is
individual
with
intellectual
disabilities
and
co-occurring
mental
health
disorders.
C
I
didn't
prepare
a
powerpoint.
I
just
did
the
handouts,
but
I'm
so
glad
that
she
went
first
because
so
much
of
what
she
said
are
the
challenges
that
I'm
facing
myself.
If
you
want
to
look
at
the
first
handout
I
had
of
the
roadblocks
that
I
faced,
I
started
well.
Actually
I
am
ceo
of
the
muhlenberg
county
opportunity
center,
which
was
for
50
years
before
I
became
a
sheltered
workshop
for
people
within
adults
with
intellectual
disabilities
and,
through
my
experience,
working
with
people,
I've
actually
I've
a
retired
school
teacher
29
years.
C
I
also
had
my
rank
one
in
special
education
and
I
served
the
special
ed
population
for
all
29
years
that
I
taught
so
as
I
started
to
work
there
with
these
individuals.
I
felt
like
that,
there's
more
to
life
than
putting
pieces
parts
in
bags
and
labeling
and
weighing
I.
I
just
felt
like
that.
There
was
something
more
that
we
could
do
for
our
clients.
C
We
started
the
the
director
before
me
started
a
program
with
the
waivers
the
scl
and
the
shell
p
waivers
the
problem.
There
was
that
we
only
had
about
six
clients
eligible
for
those
waivers
and
if
you
know
anything
about
the
waivers
at
all-
and
I
believe
at
the
the
bottom
of
this
page,
it
talks
about
people
that
not,
let's
see
it's
the
very
last
page.
I
guess
people
on
the
waiting
list
for
the
michelle
p
waiver
alone
is
seven
thousand
for
the
sel
waiver.
C
It's
between
two
and
three
thousand
so
you've
got
about
ten
thousand
people
with
intellectual
disabilities
waiting
to
try
to
get
help
and
their
families
get
help.
With
these
waivers
with
us
to
be
able
to
provide
the
waiver,
we
weren't
getting
enough
reimbursement
with
with
six
or
seven
people,
and
we
just
couldn't
hardly
even
break
even
with
it.
So
I
was
introduced
to
the
regulation,
907
kar
15.
C
C
So
I
became
a
medicaid
multi-specialty
group
under
this
regulation
and
you're
talking
with
a
former
school
teacher.
This
I'd
never
done
anything
in
the
medical
field.
I'd
never
done
anything
in
the
mental
health
field,
but
I
felt
like
that.
This
was
worth
my
time
and
effort
to
get
this
going
in
2018
I
presented
before
the
medicaid
oversight
and
advisory
board
of
two
full-time
pages
of
issues
that
I
had
trying
to
get
established
with
a
contracted
credentialed
with
the
different
mcos
and
because
I'd
never
done
anything
like
this.
C
But
what
happened
was
medicaid
does
not
require
prior
authorizations
for
the
comprehensive
community
support
program
that
I
had
in
place,
and
so
I
thought
that
all
mcos
followed
the
same
protocol
as
medicaid,
because
it's
a
medicaid
program,
and
that
was
not
the
case
we
lost,
like
I
said
over
200
000
with
aetna,
I
mean
with
well
care
and
anthem
because
we
didn't
have
prioritizations
aetna,
we
were
able,
they
didn't
require
that.
So
for
someone
like
me,
who's
just
starting
out.
C
That's
a
big
thing
to
know,
and
nobody
tells
you
anything.
I
had
to
learn
everything
on
my
own
when
you
try
to
call
any
of
these
places.
You'll
chase
your
tail
trying
to
talk
to
the
person
who
you
need
to
talk
to,
and
then
some
days
I
end
up
not
even
be
able
to
to
get
with
that
person,
then,
as
as
we
got
that
worked
out
and
got
the
power
of
authorizations
and
everything
going.
C
The
next
thing
that
I
had
was
that
well
care
specifically
was
the
hardest
for
me
to
deal
with.
C
They
would
not
authorize,
but
x
amount
of
units,
and
the
comprehensive
community
supports
does
not
have
a
limit,
so
I
had
to
battle
with
them
for
about
six
months
until
finally,
I
reached
out
to
medicaid
and
they
got
in
touch
with
them
about.
You
know
that
this
wasn't
supposed
to
be
the
case
through
all
that
I
had
three
clients
who
got
well
care
services
and
they
would
not
approve
them
even
though
they
had
documented
mental
illness.
C
They
said
it
was
not
severe
enough,
and
so,
even
though
my
therapist
two
of
them
sent
in
information
to
wellcare,
they
still
would
not
approve
it
with
these
documented
mental
illnesses.
C
We
closed
our
center
in
march
of
2020
because
of
covid
and
actually
we're
closed
this
week
and
next
week
because
of
the
rise
in
cases
we
do
have.
87
percent
of
our
clients
are
vaccinated,
but
only
about
60
percent
of
our
staff
is
vaccinated.
So
we've
decided
to
give
this
time.
C
I'm
muhlenberg
county
and
actually
penny
royal
is
one
of
our
mental
health
centers
in
muhlenberg,
but
they
just
don't
have
enough
staff
to
be
able
to
accommodate
all
the
people
in
muhlenberg
and
that's
why
that
I
have
not
only
with
the
muhlenberg
county
opportunity
center,
but
I'm
in
the
process
of
opening.
My
own
behavioral
health
agency
in
muhlenberg
called
a
luminaire
many
of
the
services
that
you
just
that
she
just
talked
about.
I'm
going
to
be
providing
the
the
biggest
a
problem
right
now
with
that
is
that
contracting
and
credentialing
take
forever.
C
I've
been
waiting
for
almost
three
months
to
get
a
licensed
professional,
clinical
counselor
credentialed
so
that
he
can.
We
can
open
and
start
services
so
those
things
you
know
that
those
things
just
really
take
a
lot
of
time
and
to
be
small.
Like
myself,
I
don't
I
can't
afford
to
to
lose
the
money
like
I
did
at
opportunity
center.
C
You
know
everything
with
my
new
business
is
coming
totally
out
of
pocket,
and
you
know,
thank
goodness
that
I
know
what
I
know
now
as
far
as
the
prior
authorizations
go,
but
it's
a
continued
challenge
every
every
day
I
did
list
you
on
the
pages,
just
some
examples
of
of
things
that
I've
faced
with
the
different
mcos
right
now
with
humana.
C
So
I
don't
really
understand
that
if
I
have
a
nurse
practitioner,
that's
willing
to
to
work
for
me
and
prescribe
non-control
to
me.
That's
that
should
be
her
choice
and
my
choice.
But
you
know
these
are
things
and
they
don't
seem
like
a
big
deal
until
they
start
adding
up.
C
I
have
learned
to
save
every
email
and
every
email
that
I've
sent
this
morning
alone,
trying
to
work
on
my
own
business
with
with
credentialing
I've
had
two
representatives
say
they
never
received
my
request
for
credentialing
and
I
had
to
go
into
my
email
to
prove
that
I
had
done
those
things.
C
So
you
know
just
those
things
you
I'm
not
going
to
read
them
to
you.
You
can
look
over
them
and
just
kind
of
see
some
of
the
challenges
that
I've
had
the
latest
challenge,
and
you
know
I
I've
studied
the
regulations
front
and
back
especially
with
the
comprehensive
community
support,
because
I
definitely
don't
want
to
do
anything
that
would
be
considered
unacceptable
by
medicaid.
C
But
I
have
been
told
by
more
than
one
person
in
the
medicaid
system
that
you
know.
Basically,
I'm
not
using
comprehensive
community
supports
the
way
it's
intended
to
be
used.
C
C
C
A
E
Thank
you,
mr
chairman.
First
of
all,
miss
davis
you're
totally
being
unfair
to
us.
For
that
background,
because
I'll
tell
you
what
my
mind
keeps
going
back
to
the
beach,
so
so,
but
but
I
do
appreciate
the
the
the
the
background,
though
I
have
a
question
to
both
of
y'all
actually
and
miss
davis.
I
I
understand
exactly
where
you're
coming
from.
E
In
fact
I've
talked
to
a
friend
senator
alvarado
on
several
occasions
as
like
you,
I
did
not
know
anything
about
psychology
or
mental
health,
because
I
come
from
a
mapping
background
for
about
a
couple
decades
and
I've
had
a
baptism
by
fire
and
experiences
a
lot
of
the
things
that
you
have
gone
through
and
through
the
senator,
as
well
as
senator
adams
and
and
other
folks.
They
sort
of
helped
me
navigate
this
some
time
ago.
E
But
I
want
to
ask
you
a
question
both
your
question
and
it
seems
to
me,
is
we
got
a
human
resources
problem
or
labor
supply
problem
and
we
also
have
sort
of
a
fair
competition
or
I'm
sorry,
fair
com,
compensation
issue
and
what
I'm
seeing
and
I
suspected
the
case.
E
But
I
wanted
you
to
verify
and
also,
as
the
chairman
said,
we
need
to
have
some
solutions
and
some
ideas
and
suggestions,
so
we
can
go
forward
and
that
is,
we've
got
a
very
thin
supply
chain
of
of
of
your
line
of
work
of
being
a
social
worker
as
well
as
psychologists
as
representative
wilner
is
in
involved
as
well
as
other
ones.
So
we
have
a
very
s,
limited
supply.
E
E
We
have
a
situation
when
it
comes
to
mcos
how
they're
keeping
the
rates
really
down,
but
yet,
since
their
supply,
it's
becoming
a
a
an
employee
or
somebody's
looking
for
employment
market,
I
mean
they
can
basically
demand
their
price
and
how
much
to
pay
them
and
then
being
a
non-profit.
E
I
mean
it's
tough
for
us
to
meet
that,
so
they
can
go.
They
may
go
out
and
do
some
other
things.
So
we've
got
we're
sort
of
in
the
pitch
in
terms
of
having
those
that
line
in
terms
of
cost
and
what
we're
getting
getting
involved,
that
we
might
be
around
15-20
percent
just
to
cover
stuff
and
that's
that
dog
doesn't
hunt
for
as
I'm
concerned.
E
I
want
to
know
what
kind
what
type
of
thoughts
you
have
and
if
not,
I
would
sincerely
beg
you
to
come
up
with
some
some
suggestions
and
thoughts
and
give
it
to
the
chairman
in
terms
of
what
we
can
do
to
help
that
that
situation
out
in
terms
of
the
supply
chain,
but
also
about
the
reimbursement,
how
we
collectively
go
through
and
address
that
now
on
the
other
side,
if
we
go
through
and
look
at
the
mcos
on
medicaid,
obviously
it's
our
it's
our
job.
It's
our
responsibility.
E
We
gotta
figure
out
how
to
pay
for
it
and
what
we're
gonna
do,
but
it
comes
in
priority
in
our
budgets
and
so
forth.
So
what
do
you
have
anything
off?
The
top
of
your
head?
You
can
address
those
two
elements.
D
Oh,
absolutely
yes,
sir
you're
absolutely
correct.
So
for
us
we
are
our
home
office,
is
in
christian
county
hopkinsville
13
miles
from
fort
campbell,
and
we
can't
compete
with
fort
campbell
and
what
they
pay
on
a
federal
level.
A
lot
of
their
work
is
contract
work.
But
what
we
see
now
that
individuals
coming
straight
out
of
college,
they
don't
care
about
retirement,
they
don't
really
care
about
benefits.
D
They
care
about
the
the
bottom
dollar
that
they're
going
to
make
in
their
paycheck
each
week.
So
for
us
that
has
been
a
significant
barrier.
One
thing
is:
we
have
individuals
that
start
working
in
our
organization,
young
in
their
career,
and
they
want
to
go
back
to
school.
D
We
as
a
company
have
no
way
to
financially
assist
them
through
that
process.
Try
to
do
the
best
that
we
can
by
providing
flexibility
to
their
schedule
and
their
time,
so
to
continue
to
empower
them
to
further
their
education,
so
that,
hopefully,
through
that
process
that
we
can
retain
them
at
the
center,
but
it
all
it
doesn't
always
work
out
that
way.
So
I
do
think
the
increase
in
compensation
from
the
or
reimbursement
from
the
mcos.
D
You
know
kind
of
looking
at
it.
From
a
perspective
of
when
someone
is
hospitalized
from
a
psychiatric
on
a
psychiatric
level,
it
cost
an
mco
a
lot
of
money
because
they're
paying
daily
for
their
continual
care
on
a
hospital
level
versus
reimbursement
at
a
higher
rate
than
what
we're
being
paid
now
for
supportive
services
that
the
goal
is
to
prevent
those
hospitalizations
so
the
more
frequent
that
the
services
are
provided.
D
It's
not
that
they
will
have
to
have
those
services
for
an
indefinite
period
of
time
that
intensively,
but
to
start
at
an
intensive
level
and
to
be
able
to
back
those
services
back.
So
I
definitely
think
the
increase
in
rates
then
also
allows
us
to
increase
our
workforce
and
increase
what
we
are
compensating
our
staff.
You
know
we
we
are
based
on.
D
We
use
an
enhancement
type
of
compensation,
so
though
a
salary
may
be
lower
the
more
work
that
an
individual
does,
the
more
clients
that
they
see
after
a
certain
cutoff
point,
they
actually
begin
making
a
percentage
of
what
is
billed
to
the
mco,
but
a
problem
with
that
is
we're
not
always
paid.
So
there
are
services
that
an
mco
may
turn
around
and
deny,
as
she
was
discussing
and
say,
does
it
meet
criteria
for
that
level?
D
We
have
a
pretty
thorough
auditing
system
where
we
are
constantly
going
through
and
evaluating,
and
making
sure
that
services
that
are
provided
are
medically
necessary,
but
there
are
also
times
that
we're
still
paying
back.
So
I
definitely
think
that
you
are
correct.
There
is
an
hr
pros
problem
and
we
do
the
best
that
we
can.
We
probably
try
to
partner
with
universities
in
our
region
to
try
to
take
interns
and
provide
internships
to
hopefully
grow
and
then
retain
staff.
D
D
We
we
try
to
encourage
people
to
participate
in
the
the
federal
repayment
of
loans
and
it's
a
program
that
allows
for
national
health
service
corps
and
it
allows
for
individuals
to
contract
to
work
in
rural
areas
for
a
period
of
time
for
loan
payback.
So
we
try
to
sell
that
as
as
a
benefit
of
being
able
to
in
staying
trying
to
retain
staff.
So
we
we
do
our
best,
but
it's
still
like,
as
she
shared.
D
We
are
the
cmhc
in
her
region
and
I
don't
think
we
would
ever
have
enough
staff
to
be
able
to
to
to
be
able
to
completely
serve
with
ease.
I
mean
I
mentioned:
we've
served
over
10
000
individuals
last
year
alone,
so.
E
Well,
I'd
like
to
I'd
like
to
challenge
challenge
all
and
to
come
up
with
some
solutions,
but
y'all
are
in
the
trenches,
not
in
the
bad
context,
but
in
very
good
context
that
we
need
to
find
out
the
solutions
I'm
there.
I
know
senator
berg
has
experienced
that's
given
she's
in
the
medical
field
as
well
and
we're
seeing
a
lot
of
things
going
on
and
we
need
to
have
some
of
the
solutions
sit
around
and
later
to
go
through
and
address
and
address
address
these
issues.
E
So
but,
in
the
event
one
another
question:
it's
part
of
the
barriers
and
I'd
like
for
you
all
to
come
up
with
a
solution
or
a
thoughts,
and
I
think
representative
wilner
did
the
psychology
reciprocity
last
year.
E
Well,
I
don't
think
that's
a
broad,
that's
not
across
the
board
with
a
lot
of
mental
health
professionals
and
we
need
to
collectively
go
back
and
do
that
that
will
help
the
supply
train
in
doing
that.
So
if
somehow,
we
can
get
to
these
boards
to
be
more
receptive
and
go
through
and
have
some
type
of
reciprocity
or
record
now
and
say
recognition,
but
some
type
of
a
of
acknowledgement
of
that
still
maintain
the
the
quality
of
services
and
credentialing.
A
G
I'm
here
I
I
want
to
apologize
to
ashley
for
not
being
there
in
person,
but
I
I
had
a
health
issue
come
up,
so
I
had
to
stay
home
today,
but
ashley
do
you.
You
were
talking
about
the
cost
of
the
care
and
intensive
hospitalization
versus
the
supports.
Are
there
any?
Do
you
have
any
kind
of
data
that
you
could
share
with
us?
Maybe
send
back
to
us?
Are
there
any
kind
of
comparative
comparative
costs?
You
know
side-by-side.
D
Absolutely
absolutely:
I
can
definitely
get
that.
Of
course.
We
don't.
We
don't
bill
on
that
level,
because
that
in
our
region
that
goes
to
western
state
hospital,
but
but
I
can
absolutely
get
that
data
for
you
for
sure.
G
G
First
of
all,
miss
davis
has
had
the
five
or
six
clients
she's
trying
to
get
all
the
clients.
All
the
special
needs,
students
that
have
these
issues
that
she's
seen
through
the
years
out
in
the
community
having
a
life-
and
I
just
I
can't
say
enough
good
about
what
the
work
she's
doing
and
hopefully
you're
going
to
hear.
A
I
A
Thank
you
melinda.
You
broke
up
terribly
okay,
so
we're
going
to
move
on.
Thank
you
both
for
your
presentations
and
send
us
recommendations
and
thank
representative
parente
for
inviting
you
here
now
at
this
time.
I'm
gonna
invite
representative
wilner
representative
wielder,
who
y'all
don't
know,
is
a
doctor
of
clinical
psychology
and
she's
gonna
present
the
next
speaker.
So
I'm
going
to
give
her
the
gavel
here
for
a
few
minutes
and
we're
going
to
move
on
and
if
you're
presenting
10
minutes,
because
we
got
to
get
everybody
involved
and
on
questions
answered.
G
And
I'm
we've.
We've
talked
a
lot
in
this
on
this
task
force
about
stabilization
through
prescriptions
prescription
and
how
important
that
is,
but
also
the
ongoing
supports
that
are
needed
to
keep
folks
out
of
hospitals.
As
we
heard
from
the
previous
presenters.
And
so
we
can
have
people
leading
their
best
lives
and
being
really
involved
and
engaged
in
the
community.
G
And
so
we're
going
to
hear
from
several
presenters
today
who
have
who
work
with
agencies
where
the
focus
really
is
on
community
supports
and
we're
going
to
start
with
ben
jaggers
and
brad
leady
from
bridgehaven
mental
health
services
in
louisville.
F
J
No,
can
you
hear
me
now:
okay,
yeah,
first
of
all,
just
like
to
say
thank
you
for
the
opportunity
to
be
here
today.
J
So
we're
going
to
switch
up
our
our
presenting
order
a
little
bit
today,
I'm
going
to
provide
some
basic
information
about
bridgehaven
and
then
have
ben
talk
a
little
bit
more
and
bring
this
to
life
through
through
his
story,
and
we
provided
a
two-page
fact
sheet
or
white
paper
that
has
both
a
little
bit
of
information
about
bridgehaven,
as
well
as
some
of
the
data
that
we
were
just
talking
about
with
the
other
presenters,
and
hopefully
this
will.
This
will
help
illuminate
the
discussion.
J
A
little
bit
more
bridgehaven
has
served
adults
with
severe
and
persistent
mental
illness
since
1958.
our
mission
is
to
provide
the
highest
quality,
community-based
psychiatric
rehabilitation
and
recovery
services
education
and
to
support
those
living
with
mental
illness.
The
agency
first
provided
services
in
jefferson
county
to
help
clients
reintegrate
into
the
community
after
being
discharged
from
psychiatric
institutions.
J
We
are
a
psychiatric,
what
used
to
be
termed
as
a
clubhouse
model,
and
we
promote
community
reintegration
following
hospitalization,
but
we're
also
finding
that
that
more
recently
we're
also
using
the
same
services
to
prevent
hospitalization,
we
serve
almost
500
unduplicated
clients
and
the
clients
at
bridgehaven
prefer
to
be
called
members.
So
when
you
hear
that
term,
that's
I'm
referring
to
our
clients,
but
they
they
do
prefer
the
term
members.
It
promotes
more
of
a
and
they're
more
invested
in
the
service.
J
J
The
average
person
receives
about
one
to
three
hours
of
highly
individualized
services
about
four
days
per
week,
because
the
recover
their
recovery
plan
is
person-centered
and
individualized.
The
person
may
attend
more
or
less
days
per
week
and
spend
more
or
less
hours
depending
on
what
they
need
at
that
time.
J
According
to
a
2019
analysis
of
our
therapeutic
rehabilitation,
utilization
rates
and
the
therapeutic
rehab
program
is
what
bridge
haven
specializes
in
members
have
about
57
days
of
this
tr
service
or
therapeutic
rehabilitation
per
year.
J
Bridgehaven
has
secured
and
maintained
accreditation
from
the
commission
on
the
accreditation
of
rehabilitation
facilities
or
with
the
acronym
carf
since
2001,
and
our
most
recent
car
survey,
which
was
in
2019,
resulted
in
no
recommendations
and
that's
an
accomplishment
of
only
about
three
percent
of
carf
accredited
facilities.
That's
they
achieved
that.
So
we
are
very
fortunate
in
that
our
adult
outpatient
and
our
psychosocial
rehabilitation
services
achieve
that
high
rating.
J
We
recently
had
an
an
expansion
in
our
physical
space,
which
we
hoped
would
allow
us
to
serve
more
people,
but
in
the
last
year
it
allowed
us
to
maintain
a
safe
and
socially
distanced
programming
so
that
we
could
continue
the
same
amount
of
services.
We
were
providing
before
kovid
struck
and
we
were
able
to
continue
those
supports
in
our
new
space
you'll
see
with
the
information
that
we
provided
and
I'm
glad
we
had
the
conversation
just
before
this
about
psychiatric
hospitalizations.
J
J
We
found
that
they
only
needed
to
be
rehospitalized
very
briefly
and
for
a
period
of
about
209
days.
In
total,
over
those
five
years,
so
again
it's
a
huge
savings
to
the
commonwealth.
J
Along
with
that,
we
have,
for
the
last
several
years,
had
a
hundred
percent
reduction
in
incarcerations,
meaning
that
someone
came
to
us
from
the
jail
system.
We
were
able
to
keep
them
out
of
the
jail
system
after
they
participated
in
bridgehaven
services,
and
we
also
had
an
85
percent
maintenance
rate
for
housing.
So
if
someone
came
to
us
and
they
were
homeless
before
they
came
to
us,
we
were
able
to
keep
85
of
them
in
stable
housing
following
participation
in
bridgehaven
services.
J
We
also
have
a
new,
relatively
new
program
that
focuses
on
integrative
health
and
physical
health
and
behavioral
health
services.
I
do
have
some
stats
there
and
I'll.
Let
you
take
a
look
at
those
on
their
own,
but
it's
well
documented
in
the
literature
that
people
who
have
behavioral
health
issues
or
that
have
a
severe
mental
illness
also
have
comorbid
physical
health
issues
and,
on
average,
die
25
years
younger
or
sooner
than
their
cohort
or
their
peers
and
their
cohort.
J
We
have
some
other
stats
that
that
I'll,
let
you
take
a
look
at,
but
we
also
do
quite
extensive
outcome
measures
for
people
who
participated
in
our
services
and
we
find
that
that
on
average
they
are
more
stable
and
maintain
their
stability
when
they
leave
services
and
they
don't
require
to
they
don't
require
the
use
of
more
expensive
or
more
restrictive
services
after
they
leave
bridgehaven
care.
J
We
also,
I
would
like
to
just
point
out-
and
there
is
some
information
in
your
packet-
that
we
are
the
only
program
in
kentucky
and
in
this
region
that
utilizes
a
cet
or
cognitive
enhancement
therapy
program.
It's
basically
a
program
that
looks
at
the
neuroscience
of
brain
plasticity
and
helps
to
rewire
the
brain
so
that
symptoms
are
not
as
severe
ben
went
through
that
program,
and
he
can
talk
with
you
a
little
bit
about
that.
J
Time,
that's
fine!
So
basically,
I
wanted
to
just
extend
an
invitation
to
anybody
who
would
like
to
come
and
see
bridgehaven.
We
would
certainly
like
to
have
you
do
that
and
I'll
turn
it
over
to
ben
for
for
his
portion
thanks.
F
Tell
you
a
little
bit
about
my
life
and
some
of
the
hardships
that
I've
had
to
overcome
and
where
I'm
at
today
I
grew
up
in
a
single
parent
household
with
one
sibling.
We
grew
up
in
poverty
where
I
lost
my
mother
at
16,
and
I
started
smoking
marijuana
when
I
was
about
13
and
my
mother
took
me
to
see
a
psych
therapist
and
he
diagnosed
me
with
depression,
and
I
ignored
the
fact
that
I
had
a
mental
illness.
This
would
carry
on
with
me
until
I
was
25
21.
F
F
It
wasn't
until
I
had
gotten
beaten
down
by
drugs
and
alcohol,
mainly
marijuana
and
alcohol,
that
you
know
in
hospitalizations.
I've
been
to
two
of
the
major
hospitals
here
in
kentucky
I've
been
in
two
of
the
major
jails
here
in
kentucky.
You
know
I
was
in
the
foster
care
system.
F
Until
I
was
21.,
you
know
my
whole
life
hasn't
been
bad,
but
you
know
I've
had
some
some
some
challenges
to
overcome,
and
so,
let's
see
when
I
got
out
of
jail
when
I
was
24,
I
I
was
in
louisville
kentucky
and
I
got
connected
with
the
family
health
center
phoenix.
It's
a
homeless,
community,
homeless,
health
care
system
and
they
got
me
connected
to
the
salvation
army
and
then
I
was
able
to
apply
to
the
wellspring
program.
F
It
took
me
about
six
months
from
being
in
the
homeless,
shelter
the
salvation
army
to
get
into
a
transitional
living
home
through
wellspring
I
graduated
and
at
the
time
I
was
at
the
homeless
shelter.
I
had
found
a
fellowship
and
I
started
to
work
on
not
only
my
mental
health
by
attending
bridgehaven,
but
also
I
started
working
on
my
substance,
use
and
my
drug
and
alcohol
problem,
and-
and
so
I
ended
up
getting
a
stance
over
and
I
I
got
into
a
apartment
of
my
own.
F
I
got
off
a
disability
by
working
at
bridgehaven
after
they
provided
me
with
peer
support,
training
and-
and
I
got
off
this
ability-
and
I
ended
up.
I
have
two
cats
now
louie
grace,
and
you
know
that
that
pet
therapy
has
really
helped
me
and
I've
been
stable
on
my
medicine
or
been
taking
my
medicine
as
prescribed
for
seven
years
now,
and
I
haven't
had
any
you
know.
F
You
know
altercations
to
where
I've
had
to
be
in
trouble,
and
you
know,
bridgehaven
has
really
been
a
foundation
in
my
recovery
for
my
mental
health,
it
taught
me
that
I
could
have
a
mental
illness
and
I
could
have
a
drug
and
alcohol
problem
and
and
there's
nothing
wrong
with
me
just
because
of
those
two
factors,
and-
and
so
you
know,
life
is
good
today
because
of
the
things
in
the
community
that
carried
me
through
one
of
the
toughest
challenges
of
my
life.
I've
I've
done
every
bit.
F
I
could
do
to
take
advantage
of
these
things
and
to
keep
moving
forward
and
right
now
I
applied.
I
got
my.
I
went
back
to
school
after
flunking
out
from
the
foster
care
grant.
I
went
back
to
jctc
got
my
associates
in
art,
applied
to
uofl
kent
school,
I'm
studying
to
be
a
drug
and
alcohol
counselor.
Once
I
finish
my
bachelor's
degree,
which
I'm
a
senior
at
the
kent
school-
and
I
wish
I
could
tell
you
all
everything
I
know
we're
short
on
time,
but
I'm
truly
grateful
that
I
have
this
opportunity.
F
G
I
feel
like
we're
the
privileged
ones
to
be
able
to
hear
your
story
and
to
know
what
can
happen
for
folks
when
they're,
given
the
resource
resources
and
the
supports
that
they
need,
and
I'm
so
happy
that
you
were
able
to
find
those
supports
at
bridgehaven,
and
I
just
I
want
to
open
it
up
for
questions.
Do
we
have
anybody
and
I'm
also
told
that
co-chair
alice,
fergie
kerr
has
joined
us
remotely,
so
welcome
alice,
senator
alvarado
yeah.
B
Thank
you
very
much
and
thank
you
all
for
your
presentation.
Just
a
couple,
quick
questions.
Based
off
your
testimony.
We
talk
about
supported
employment
for
a
lot
of
the
folks
that
are
within
these
within
your
organization
there.
Can
you
explain
a
bit
more
about
that
how
that
works?
I
mean
these
individuals
what
they're
getting
paid
as
far
as
a
lot
of
that
supported
employment.
B
I
know
some
of
them
may
have
I'm
not
sure
if
some
of
them
have
disabilities
that
are
already
diagnosed
or
not
or
if
they're
just
you
know,
a
lot
of
them
just
have
mental
illness
backgrounds,
but
I'm
curious
if
you
can
expound
a
bit
more
on
that,
are
they
getting
paid
at
minimum
wage?
How
that
works?
Sure.
J
We
also
that
a
program
also
works
from
a
principle
of
seeking
competitive
employment.
Just
simply
because
someone
has
a
mental
illness
or
intellectual
disability
does
not
mean
that
they
cannot
compete
in
in
the
job
market
and
seek
the
job
that
they
want
at
a
pay.
That
is
fair
for
them.
J
Our
job
coaches
work
with
people
to
understand
both
either
the
benefits
or
the
drawbacks
of
explaining
what
their
particular
challenges
may
be,
but
it's
their
choice.
J
I
don't
have
that
specific
information,
because
that's
they
take
jobs,
they
take
the
jobs
that
they
are
either
offered
or
they
desire
to
take
they
they
should
not
be.
If
they're,
you
know,
we
don't.
We
don't
have
any
control
over
that
we'll
place
them
in
companies
where
they
sometimes
are
concerned
about
their
benefits,
so
they
may
take
jobs
that
that
do
not
pay
as
much
as
other
jobs
might.
But
I
don't
that's
not
necessarily
part
of
our
program
to
decide.
B
That's
a
concern
for
me.
I
filed
the
bill
every
year
for
several
years
to
get
rid
of
that,
so
that
people
that
have
either
disabilities
of
any
type
are
at
least
offered
minimum
wage.
Yes,
that
everyone
else
is
entitled
to.
So
I'm
curious
to
that
I
mean
that's
something
that
it
bothers
me.
I
know,
and
I've
filed
many
times.
That's
always
curious
about
that.
That's
being
offered
as
well.
J
G
Thank
you
for
that
question,
senator
alvarado
and
seeing
no
further
questions.
I
I
want
to
echo
ural's
invitation
for
folks
to
go
visit
bridgehaven.
G
G
G
F
Representative
givensprunty,
she
just
said
gratitude
to
ben
for
sharing
and
good
luck
in
his
studies,
and
she
said
how
has
bridgehaven
been
able
to
be
successful.
J
Several
issues
have
come
up,
but
we
because
of
the
outcomes
we
have
been
able
to
have
very
progressive
and
substantive
conversations
with
the
mcos
to
establish
rates
that
help
to
reimburse
for
our
services.
J
J
The
same
way
that
it
starts
is
what
what's
best
for
the
what's
best
for
the
client
what's
best
for
the
member,
and
we
make
decisions
based
on
that,
and
we
have
found
that,
even
though
we
may
take
a
a
short-term
hit,
certainly
keeping
somebody
out
of
the
hospital
at
twelve
fifteen
hundred
dollars
a
day
has
its
benefits
and-
and
that
comes
back
to
us
in
terms
of
community
referrals
and
and
being
able
to
support
our
are
being
able
to
have
these
this
data
to
support
for
grants
and
other
terms.
G
I
I
I
Yes,
thank
you.
Thank
you
so
much
so
newbie
at
new
beginnings.
Bluegrass.
Our
mission
is
to
help
improve
the
lives
of
adults
with
serious
mental
illness
through
quality,
housing
and
recovery-based
services.
We
were
founded
in
1997
by
a
group
of
grassroots
advocates
who
identified
the
lack
of
supportive
housing
for
adults
with
smi
and
lexington
and
decided
to
come
here
to
frankfort,
make
some
noise
and
do
something
about
it.
And
so,
since
that
time,
we've
continued
to
grow
and
we
currently
provide
supportive
services
to
106
individuals
and
we
own
30
housing
units
across
fayette
county.
I
I
Our
primary
source
of
funding
comes
from
a
contract
with
a
cabinet
for
health
and
family
services,
but
we
also
have
grants
with
through
the
lexington
fayette
urban
county
government,
the
u.s
department
of
hud
and
the
lexington
housing
authority,
and
all
of
our
services
are
based
on
the
permanent,
supportive
housing
model
and
we
utilize
a
housing.
First
philosophy
to
deliver
those
services.
I
So
what
is
permanent,
supportive
housing?
It
is
an
evidence-based
practice
that
is
utilized
to
help
adults
with
serious
mental
illness
obtain
and
maintain
housing.
There
are
two
main
components
to
necessary
for
permanent
supportive
housing
success
and
that
is
affordable.
Housing
partnered
with
voluntary
support
services,
so
in
the
housing
is
permanent.
I
The
key
principles
of
permanent
supportive
housing
are
shown
on
this
slide
and
I'm
going
to
go
through
each
of
those
quickly
with
you
all.
So.
The
first
principle
is
choice
of
housing.
Permanent
supportive
housing
program
aims
to
maximize
the
client's
choice
in
housing
options,
as
well
as
in
regard
to
the
services
that
they
choose
to
receive.
If
clients
are
placed
in
a
setting
that
doesn't
meet
their
personal
needs
and
preferences,
it
is
not
likely
that
they
will
be
successful
in
that
housing.
I
So
it's
vital
to
ask
each
client
their
opinion
on
where
they
want
to
live,
what
kind
of
housing
they
want.
What
area
of
town
that
they
want
to
be
in
the
second
important
component
of
a
successful
permanent
supportive
housing
program
is
functional
separation
of
the
landlord
and
support
service
duties.
I
The
landlord
is
responsible
for
the
rent,
payment
collection
and
lease
compliance
issues
and
the
services
are
there
to
help
the
client
develop
skills,
help
learn
how
to
advocate
for
themselves
and
meet
other
housing
related
needs.
New
beginnings
is
both
a
landlord
and
service
provider.
Some
of
our
clients
live
in
our
housing,
but
don't
receive
our
services.
Perhaps
they
go
to
the
cmhc
or
another
partner
agency
in
town,
some
of
them
we
provide
supports
too,
and
they
don't
live
in
our
housing.
I
I
It's
important
that,
when
we're
assisting
clients
to
secure
housing
that
we
help
them
locate
the
most
integrated
housing
options
as
possible,
we
don't
want
to
direct
all
persons
with
smi
to
a
to
a
specific
apartment,
complex
or
a
specific
side
of
town.
We
want
them
to
be
part
of
the
overall
community.
I
They
should
be
afforded
the
same
options
as
any
other
person
seeking
housing
in
order
to
maximize
integration
in
the
community.
It's
also
important
to
be
mindful
that
we
consider
the
ease
of
access
to
amenities
such
as
public
transportation,
grocery
stores,
convenience
stores
and
parks
and,
of
course,
encouraging
clients
to
connect
or
reconnect
with
their
natural
support
system
is
an
important
piece
in
their
success.
I
We
encourage
it's
important
that
we
have
people
help
people
link
to
housing
as
quickly
as
possible,
with
as
few
barriers
as
possible.
This
means
that
in
our
program
and
in
permanent
supportive
housing
programs,
people
don't
have
to
be
taking
medication,
they
don't
have
to
be
engaged
in
treatment
or
to
be
sober
before
entering
our
program.
There
are
many
programs
out
there
that
require
tenants
to
prove
their
readiness
for
housing.
I
So
we
do
help
people
access
the
housing
first,
but
that
is
not.
We
don't
stop
there.
We
have
to
have
the
second
part
of
the
important
piece
which
is
the
flexible
voluntary
services,
and
so
this
is
the
other
component
that
balances
out
the
affordable
housing
piece
of
the
program
to
ensure
successfulness.
I
I
So
helping
people
advance
through
their
recovery
is
the
most
rewarding
part
of
what
we
do
and
it's
wonderful
to
be
able
to
be
to
be
part
of
that
journey
with
our
clients
in
regard
to
services.
One
size
does
not
fit
all
so
support.
Services
are
designed
to
meet
each
person's
needs
and
preferences,
and,
although
they
vary
widely,
some
of
the
common
goals
I've
got
listed
for
you
here,
we
help
connect
them
with
physical
and
behavioral
health
care
services,
including
substance
use,
supports.
We
help
link
folks
to
vocational
employment
opportunities.
I
I
It's
very
challenging
to
figure
out
what
resources
are
available
at
what
time,
because
there's
in
such
short
supply
right
now
and
we
help
teach
independent
living
skills
such
as
budgeting
housekeeping
and
meal
preparation,
and
we
help
advocate
with
the
landlord
when
there
are
issues
or
concerns
that
the
tenant
can't
handle
themselves
and,
as
I
mentioned,
so,
we
use
a
a
housing
first
philosophy
and
this
this
approach
just
quickly
connects
house
to
folks
to
housing
with
as
few
barriers
as
possible,
but
I
wanted
to
be
sure
to
clarify
that
housing
first
does
not
mean
housing.
I
As
a
an
evidence-based
practice,
there
is
a
wealth
of
data
to
prove
and
stand
behind
the
permanent,
supporting
housing
models,
efficacy
and
so
some
of
the
most
outstanding
results.
I've
included
here
in
this
slide
and
they
include
an
increased
ability
for
program
participants
to
maintain
their
housing
in
the
community.
G
G
Thank
you.
Thank
you,
so
much
so
kathy,
dobbins
and
ivan
garr,
and
when
you
get
seated
if
you'll
introduce
yourselves
for
the
record
and
in
the
meantime
I'm
just
gonna
liz
pointed
out
to
me.
We
had
another
comment
in
the
chat
from
representative
prentie,
suggesting
that
she
would
like
for
us
to
tour
bridgehaven
as
a
task
force,
and
I
people
I
see
some
nods
to
that.
So.
K
Okay,
I'm
going
to
take
this
off
if
that's:
okay,
I'm
kathy
dobbins
and
I'm
the
ceo
of
wellspring,
I'm
a
licensed
clinical
social
worker,
and
I
am
delighted
to
be
here
with
you
today
and
ivan
garr
who's.
One
of
our
peer
support
specialists
is
joining
me.
K
So,
let's
see
if
I
can
get
this
powerpoint
to
work
so
so
wellspring
started
out
as
a
supportive
housing
provider
in
1982
and
we
still
are
primarily
a
supportive
housing
provider.
Although
we
do
provide
other
services
as
well
see.
K
Hit
the
inner
button
that
does
make
sense
and
here's
our
mission
statement
wellspring,
promotes
mental
health
recovery
and
supports
individuals
with
mental
illness
in
building
healthy
and
hopeful
lives
through
behavioral
health,
housing
and
employment
services.
K
K
In
fact,
there
was
really
no
supportive
housing
in
the
state
at
that
time,
but
these
families
were
experiencing
so
much
trauma
in
watching
their
loved
ones,
go
in
and
out
of
hospitals
in
and
out
of,
emergency
rooms,
jail
going
back
home
and
then
creating
hardships
for
other
fam
for
other
family
members.
K
They
had
younger
siblings
and
it
was
difficult,
and
so
these
families
came
together
and
they
pulled
in
some
business
leaders
in
the
community
and
they
brought
in
a
a
couple
of
folks
from
university
department
of
psychiatry,
university
of
louisville
department
of
psychiatry
and
said
you
know
we're
going
to
do
something
our
founder
would
say
you
know
it's
better
to
light
a
candle
than
curse
the
darkness,
so
with
that
they
opened
the
first
transitional
program
operated
by
wellspring
in
1982..
K
We
are
now
licensed
as
a
behavioral
health
services
organization
and
we
are
required
to
be
provide
emergency
on-call
for
all
our
clients
24-7.
So
we
do
do
that.
I
want
to
be
clear
about
that.
That's
in
kentucky
statute,
we're
accredited
by
carf
international.
K
We
carf
accredits
programs,
not
agencies,
and
so
we
are.
Our
areas
are
crisis,
stabilization,
community
housing
and
outpatient,
behavioral
health.
We
provide
an
array
of
services
for
adults
with
serious
mental
illness
in
addition
to
supportive
housing.
We
also
have
like
christie
at
new
beginnings,
affordable
housing.
We
provide
case
management.
We
provide
peer
support
therapy
crisis
stabilization.
We
operate
two
psychiatric
crisis,
stabilization
units.
We
are
the
only
region
in
kentucky
that
offers
that
two
psychiatric
crisis
units,
so
that's
unique.
We
provide
assertive
community
treatment.
K
We
have
an
act
team,
as
our
first
speaker
talked
about
act
being
a
multi-disciplinary
team.
We
have
a
doctor,
psychiatrist
nurse
therapists,
peer
specialists
and
case
managers
on
that
team,
providing
an
intensive
level
of
support.
We
also
offer
supported
employment.
Like
bridgehaven,
we
have
an
ips
program.
Individual
placement
supports
stealing
christie's
line.
Everyone
deserves
housing.
Why
is
supportive
housing
important
in
1982,
and
we
still
had
a
lot
of
people
who
live
in
the
state,
hospitals
and
nobody
lives
in
the
state
hospitals.
K
Rightly
so
today,
most
people
who
have
serious
mental
illness
again,
you
know
making
christie's
point
again.
Have
they
live
at
very,
very
low
income
thousand
dollar
less
than
ten
thousand
dollars
a
year,
so
our
our
fair
market
rate
is
slightly
higher
than
lexington's
at
760.,
but
when
you
and
you
have
it
same
same
level
of
ssi
794
dollars
that
doesn't
buy
mainstream
housing,
so
you
know
it's
just
a
simple
equation:
it
just
does
not
work.
K
You
have
to
have
rental
assistance
and
for
folks
who
have
the
highest
levels
of
disability,
they
absolutely
need
support.
They
need
supportive
services
to
be
integrated
into
our
community
to
be
a
part
of
the
community
to
contribute
to
the
community
and
to
forward
their
own
recovery.
K
I
just
threw
this
slide
in
here,
because
this
this
is
what
this
central
state
hospital.
This
is
what
we
had
in
our
region
of
kentucky
in
1982
when
wellspring
opened
its
first
program
and
when
we
brought
residents
into
that
first
program,
they
were
all
coming
out
of
almost
all
coming
directly
out
of
central
state.
Many
had
been
there
for
lengthy
periods
of
time.
K
K
We
have
17
other
folks
who
are
in
wellspring
known
housing
where
we
provide
flexible
supports,
ranging
from
case
management
peer
support
to
assertive
community
treatment.
We
have
the
lion's
share.
You
can
see
331
people
living
in
scattered
site,
housing
with
rental
assistance,
and
then
the
supports
that
people
receive
is
variable
depending
upon
what
what's
what
they
need.
K
We
also
own
some
affordable
housing
sites
and
we
have
87
units
there,
so
people
living
there
may
or
may
not
have
our
supportive
services
some
get
supportive
services
elsewhere.
Some
folks
may
simply
be
going
to
a
psychiatrist
and
getting
medication
and
doing
fine,
but
they
still
need
that
subsidy
and
they
and
when
we're
looking
for
scattered
site
housing,
you
also
can't
be
assured
that
you're
going
to
find
quality
housing.
So
this
is
one
way
that
we
can
feel
like.
K
K
K
K
You
try
to
move
beyond
nimbyism
they're
scattered
all
over
the
city
and
again
we're
trying
to
go
into
you
know
neighborhoods
that
feel
safe,
comfortable
and
are
close
to
amenities,
some
more
photos
of
housing.
I
I
went
through
that
real
quick,
but
if
you
cut
a
glance,
I'm
not
sure
how
to
go
back
here,
but
there
was
a
one
large
building
apartment
building
which
has
30
units
in
it,
and
we
have
nine
of
those
units
in
that
building.
K
We
do
focus
on
recovery.
It's
in
our
mission
statement.
We
look
at
it
in
a
variety
of
different
ways.
In
our
most
highly
supportive
programs,
we
we
are
identifying
and
trying
to
operationalize
that,
as
looking
at
client
satisfaction
are
people
satisfied
with
with
their
lives.
It's
it's
remarkably
high.
You
have
to
look
at
that
at
the
context
of
people
having
really
reduced
choices,
but
they're
reporting,
89
class
satisfaction.
K
Are
they
competitively
employed?
You
know
it's
a
low,
no
low
number
21
we'd
love
to
see
that
go
up
again.
These
these.
These
are
folks
who
are
more.
Just
in
the
you
know,
the
most
disabled
of
the
pop
sub
population,
really,
the
folks
that
we
serve
and
then
we
also
look
at
how
many
folks
are
engaged
in
work.
Work
programs
volunteer
jobs
at
school
again.
You
know
it
could
be
higher,
but
you
know
there
was
45
in
2019.
It
dropped
down
a
little
in
2020..
K
This
is
one
of
our
affordable
housing
sites.
It's
hud
hud
project
811
has
12
units.
I
won't
go
over
all
this,
because
christie
has
gone
over
most
of
this,
and
I
assumed
this
was
gonna
happen,
which
is
fine.
You
know
that,
but
but
we
we
agree
on
the
the
basic
tenets
of
what
is
supportive
housing
and
how
that
should
be.
Provided.
K
You
know
what
are
the
gaps?
Well,
there's
not
enough
of
the
the
most
highly
supportive
housing
we,
we
are
able
to
work
with
metro
housing
authority,
we're
able
to
work
with
hud,
we're
able
to
get
vouchers
and
and
help
people
get
housing
in
the
community
takes
support
services
to
them,
but
some
people
need
more
than
that
and
and
that's
that's
very
scarce,
and
while
we
do
a
lot
of
the
services
that
I
talked
about
are
medicaid
reimbursable
services.
We
do
bill
medicaid.
K
Some
of
the
the
supportive
services
that
you
offer
in
a
residential
setting
are
not
medicaid
reimbursable
and
we
do
rely
on
some
funds
from
the
department
of
behavioral
health,
but
we
there
are
gaps
there.
We
we
can't
we
we
struggle
to
make
that
work
and
at
times
we've
had
to
reduce
reduce
staffing
significantly
in
order
to
make
the
dollars
work
and
and
that
hurts
the
clients
that
we're
trying
to
serve
the
other
one.
Other
big
issue
that
our
clients
face
is
social
isolation.
K
They
are,
you
know,
for
a
variety
of
reasons.
You
know
they
there's
a
lot
of
loneliness
and
just
not
a
lot
of
social
opportunity.
K
K
Unfortunately,
you
know
some
people
don't
make
it
that
far.
I'm
trying
to
time
myself,
some
people
don't
make
it
that
far
they
you
know
and
that's
unfortunate.
You
keep
working
working
and,
as
brad
said,
you
support
them
forever,
but
there's
not
a
reimbursement
to
help.
You
continue
to
do
that.
So
that's
a
concern.
I
wanted
to
read
you
just
two
real
quick
things.
If
I,
if
I
may
just
give
you
an
example
of
some
of
the
folks
we're
serving
sometimes
this,
this
is
actually.
K
This
was
an
article
written
in
the
by
a
journalist
wave
about
a
client
or
woman
homeless
woman.
Sometimes
an
important
story
happens
right
in
front
of
your
face,
but
you
don't
see
it.
Maybe
you
really
don't
want
to
see
it
every
minute
of
every
hour
of
every
day.
For
weeks
and
then
months,
I
noticed
janet
sitting
under
an
awning
awning
of
a
vacant
building
across
the
street
from
our
television
station
never
moving,
except
to
use
a
bathroom
that
wasn't
there
always
watching
a
world
go
by
that
somehow
left
her
behind
below
zero.
K
On
a
couple
of
nights
in
february
she
lied
under
her
blankets
and
the
icy
white
snow,
blanket
that
covered
everything.
Hundreds
of
people
like
me,
drove
by
every
day
she
accepted
help
from
myself
and
others
passing
by
now,
I'm
in
the
streets
janet
told
me
I'm
trying
to
get
help
after
with
the
housing
with
housing.
After
I
got
illegally
kicked
out,
I'm
not
a
drug
addict
who
had
a
strong
addiction.
They
took
me
to
central
state,
which
is
a
psych
facility.
I
was
offered
a
tent
like
five
times.
I
told
them.
K
You
can't
fix
this
problem
with
a
tent
mind
you,
I
didn't
have
anything
when
I
came
out
of
jail
the
longer
she
talked
the
better.
I
understood
the
real
issue
here.
I
had
to
actually
get
a
mexico
representative
in
this
situation
because
the
u.s
does
not
want
me
want
to
do
anything
for
me.
She
said
they
don't
want
to
get
me
off
the
street,
so
I
have
faith
in
mexico
on
march
10th
she
disappeared,
police
confirmed
to
us.
They
took
her
away
with
a
middle
inquest
warrant.
K
A
couple
of
days
later,
the
building
she
leaned
on
for
months
went
up
in
a
two-alarm
fire
just
a
couple
of
days
after
that
janet
was
back
sitting
in
the
busted
glass.
Next
to
that
building
our
assertive
community
treatment
team
got
engaged
with
her.
At
that
point
they
reached
out
and
working
with
metro
police
department
and
were
able
to
move
her
into
a
motel
and
from
there
she
has
moved
into
her
own
apartment
and,
remarkably,
like
four
months
later.
She
now
has
a
job.
K
So
that's
that's
you
know.
Most
of
our
stories
are
not
quite
that
dramatic,
but
you
know
that's
a
dramatic
story.
Perhaps
a
somewhat
more
typical
story
is
a
fellow
named
kevin
he's
58
years.
K
L
Okay,
I'm
having
peer
support
for
wellspring,
I'm
just
going
to
tell
you
a
little
bit
about
myself
what
I
do
and
how
it
affects
my
recovery.
I
first
came
in
contact
with
wellspring
by
the
ips
program.
It's
an
employment
program.
It's
individual
placement
with
support;
they
help
you
find
jobs,
help
you
find.
What
is
what
you're
suited
for
and
your
interests
are
so
happened-
was
that
I
was
suited
to
be
a
peer
support
specialist
and
had
the
benefit
of
being
hired
by
wellspring
working
for
wellspring.
L
I
worked
for
wish,
which
is
a
wellspring
intensive,
supportive
housing
program,
and
with
that
I
work
with
people
that
have
severe
mental
illnesses
I've
suffered
with
and
we
cover
they
have
coverage
for
seven
days
a
week
two
times
a
day.
I
work
with
these
type
of
people
every
day.
L
Excuse
me,
it
enhances
my
recovery
to
work
with
people
that
have
suffered
the
same
to
suffer
the
same
things
that
I
suffer
and
with
that
I'm
enhanced
by
that
today,
no
longer
am
I
held
hostage
by
my
symptoms
by
drug
addiction
by
slow
self-esteem
by
fear.
No
longer
am
I
held
hostage
to
those
things
today.
Life
is
great.
L
I
live
a
good
life,
I'm
optimistic.
I
look
forward
to
the
next
day.
Even
I
have
a
house
now.
I
have
a
car.
I
have
a
few
coins
in
my
pocket
today,
which
I'm
very
happy
about,
but
even
today
even
be
able
to
speak
to
you.
My
recovery
is
allowed
me
to
speak
to
you
today.
K
G
It's
very
powerful
to
have
you
sitting
here
in
front
of
us
and
and
sharing
that
with
us.
So
with
that
before
we
bring
up
our
last
presenter,
do
we
have
any
questions
in
the
room
or.
G
G
K
A
lot
more,
no
idea,
you
know
it's
hard
to
say
because
you
know
not.
Everybody
with
a
serious
mental
illness
needs
the
supportive
housing
that
we're
talking
about
it's
a
subsection.
K
They
may
have
the
diagnosis.
I
mean
many
more
people
have
the
diagnosis
and
but
may
not
have
the
functional
limitations,
but
it
you
know
it's
still.
You
know
it's
it's
a
lot
of
people
I
mean
in
jefferson
county.
They
say:
32
000
people
need
affordable
housing,
you
know,
but
that's
they're,
not
all
living
on
ssi.
G
K
D
K
D
I
Well,
for
us,
certainly,
I'm
not
sure
of
the
exact
amount,
but
I
would
say
the
majority.
I
think
that
some
of
the
research
shows
that
as
high
as
75
of
adults
with
serious
mental
illness
also
have
experienced
a
co
occurring.
B
I
To
that-
and
I
would
say
that
with
the
folks
that
we
serve,
it
is
probably
that
high
and
the
folks
that
we
have
coming
into
services
right
now
are
also
experiencing
homelessness
about
sixty
percent
of
the
people
that
entered
our
program
last
year
came
from
the
streets
and
oftentimes.
Those
folks
are
the
ones
who
have
are
most
severely
disabled
and
have
co-occurring
substance
use
issues.
So
I
don't
know.
K
No,
I
I
would
absolutely
echo
that
back
in
the
early
days
when
we
brought
people
in
from
the
state
hospital,
you
know
that's
changed
now
most
of
them
are
coming
from
the
streets
and
it's
for
us.
It
is
it's
higher
than
60
percent.
You
know
it's
closer
to
to
85
percent,
maybe
90
percent
of
the
people
we're
serving
are
coming
from
street
homelessness
and
most
of
them
are
coming
with
co-occurring
disorder.
G
Thank
you.
Senator
berg,
representative
prenty
has
a
a
question
you
still
with
us.
G
G
Good
the
same
question
that
I
asked
bridgehaven:
how
do
you
all
make
it
successful
financially.
I
I
As
I
mentioned
at
the
beginning
of
our
presentation,
we
have
several
grants
through
the
lexington
fayette
urban
county
government
through
our
continuum
of
care,
we
have
hud
grants
that
brings
in
dollars
to
support
our
services
and
we've
partnered
with
the
lexington
housing
authority
to
provide
funding
that
is
used
to
subsidize
the
rent
for
the
folks
that
live
in
new
beginnings,
owned
housing,
and
so
it's
really
just
being
creative
blending
funding
and
begging
and
to
make
it
work.
K
And
we
have
a
lot
of
the
same,
although
we
we
do
build
medicaid.
I
mentioned
that
you
know.
That's
that's
about
two.
We
have
about
a
six
million
dollar
budget,
that's
about
2.5
percent
of
our
budget.
I
mean
what
am
I
saying:
2.5
million
almost
half
our
budget
now,
so
it's
pretty
significant
amount.
We
also
get
about
a
million
dollars
from
hud
supportive
housing
programs
specifically
focused
on
providing
housing
for
the
homeless
with
mental
illness.
K
We
work
with
our
housing
authority
for
housing
vouchers,
and
then
we
we
have
a
contract
with
the
state
as
well
with
the
department
of
behavioral
health,
and
we
do
our
own
fundraising
and
you
know
write
it
right
grants.
We
have
a
federal
grant
right
now.
That's
pretty
significant
over
a
five-year
period
to
serve
homeless
with
with
co-occurring
disorders.
So
you
know-
and
we
do
you
know,
we
we're
looking
constantly
to
find
the
funds
to
make
it
work
and
it's
always
a
challenge
and
we
always
run
a
thin
margin.
K
G
Follow-Up
question:
please!
Yes,
if
you
all
heard
ms
davis's
testimony
about
she
didn't
think
the
mcos
understand
what
a
dual
diagnosis
is.
Do
you
all
have
see
that
same
problem.
K
Well,
I
think
she
was
talking
about
dual
diagnosis
of
serious
mental
illness
and
intellectual
disabilities,
and
I'm
talking
about
serious
mental
illness
and
substance
use
disorders.
G
B
You
same
question,
as
you
mentioned
earlier,
I
mean
supported
employment
is
something
that's
obviously
of
interest
to
me.
I'm
curious
about
your
process
of
how
this
goes
about.
I
mean
I've
visited
facilities
that
involve
a
little
bit
of
a
different
sub-population
people
with
intellectual
disabilities
that
I
feel
sometimes
are
taking
advantage
of
and
there's
institutions
that
will
give
them
work.
B
They'll
be
paid
a
sub-minimum
wage.
Some
folks
are
profiting
huge
amounts
from
these
folks
and
it
bothers
me.
You
know
that
at
least
not
at
least
a
minimum
wage
is
being
offered
to
those
individuals
and
again
we're
trying
to
reform
some
of
this
change.
The
approach
we
have,
we
know
we
don't
have
adequate
state
supports
on
some
of
these
things,
sometimes
to
find
that
employment
in
kind
of
mainstream
part
of
the
state
we're
trying
harder
to
get
that
done.
I'm
just
curious
about
the
process
I
mean
you
know.
Are
there?
B
K
K
But
it's
part
of
the
job
of
the
the
staff
is
to
go
out
and
develop
jobs
and
knock
on
doors
and
try
to
develop
employers,
and
so
they
spend
a
fair
amount
of
time
doing
that,
unfortunately,
because
this
is
a
no
barriers
kind
of
program-
that's
a
wonderful
thing,
but
many
of
our
clients,
you
know,
are
really
struggle.
You
know
struggling
with
symptoms
of
their
illness.
K
They're
struggling
with
you
know,
coming
from
homelessness
they're,
you
know
they
may
have
a
co-occurring
substance
use
disorder
and
you
know
the
door
is
wide
open
and
that's
a
good
thing.
The
problem
is
the
way
that
the
program
is
set
up.
You
know
you
only
get
paid
if
they
you
know.
First,
you
go
through,
you
know
a
planning
process
and
then
then
you
get
paid
if
the
person
gets
the
job
and
then
you
get
paid
if
they
hold
the
job.
K
For
I
think
it's
60
days,
then
you
get
paid
to
hold
it
for
90
days
and
you
get
paid
if
they're
there
like
a
year.
Something
like
that
and
you
know
for
many
of
our
folks.
You
know
they
may
not
make
it
that
far
at
least
the
first
time
around
and
you
only
get
paid
once
you
if
you
keep
starting
over
you're,
trying
to
help
people,
because
you
never
want
to
take
away
that
hope
and
that
opportunity.
K
So
you
know
we
lose
a
lot
of
money
on
this
program
and
you
know
we've
questioned
whether
we
could
continue
to
offer
it
because
because
it's
you
know
we
it's,
you
know
we
can't
afford
it,
but
we
we're
trying
to
do
it
because
we
believe
it's
part,
an
important
part
of
recovery.
B
Absolutely
are
there
others
in
your
space?
Do
you
know
of
that?
Do
things
differently,
you're,
requiring
that
at
least
that
which
I
think
is
the
right
way
to
go,
but
I'm
curious
if
there's
others,
because
I
know
others
in
again
a
different
space,
not
so
much
in
what
you
all
do,
but
that
are
doing
some
of
that,
and
that's
a
worry
for
me
and
again
there's
a
lot
of
debate
within
that
whole
some
say:
don't
don't
change
it!
My
loved
one's
doing
great!
B
I
don't
want
anything,
you
know
yet
families
who
say
don't
change
it
we're
trying
to
find
a
way
to
grandfather
those
folks
in,
but
we
want
to
also
stop
kind
of
what
we've
been
doing
in
the
past
and
kind
of
have
a
new
approach
to
this.
Are
there
others
that
you
know
about
without
mentioning
any
names?
I
mean
that
that
do
things
differently.
K
Yeah
not
that
I
know
of
because
this
particular
model,
which
is
called
ips
individual
placement
and
support.
You
know
it.
It
is,
you
know
we
get.
We
do
get
some
money,
fifty
thousand
dollars
from
the
state
towards
operating
that
and
and
then
every
year
the
state
department,
behavioral
health,
send
some
folks
out
to
do
a
fidelity
review.
K
So
they
want
to
make
sure
that
we're
actually
following
the
tenants
of
that
program
and
that
we're
and
they
do
that
for
everybody
who
who's
providing
the
ips
program.
So
you
know,
I
think,
all
of
us
who
are
doing
this
are
following
those
tenants
or
we
we
wouldn't
be
supported
by
by
the
cabinet
the
department.
So
you
know,
I
think
that
everybody
who's
using
ips
is
going
for
at
least
minimum
wage
jobs
very.
G
Thank
you
and
I'm
going
to
invite
jackie
long
up
to
the
table.
Thank
you
all
so
much
for
being
here
really
so
important
to
hear
your
testimony
and
from
from
mr
garr
and
from
mr
jaggers.
I
you
know,
there's
a
saying
in
mental
health
advocacy,
nothing
about
us
without
us
and
I
think,
as
this
task
force,
considers
solutions
that
your
voices
here
today
are
just
so
important.
G
H
You
have
probably
already
seen
the
point
in
time
count:
data
from
2020
that
shows
that,
on
a
single
night
in
january,
we
identified
4011
homeless
persons
in
the
state
656
of
those
persons
self-reported
that
they
had
a
serious
mental
illness.
That
number
is
likely
to
be
much
higher
because
human
nature
doesn't
often
let
us
admit
to
strangers
that
we
have
a
mental
illness.
H
Since
january
1st,
in
the
big
sandy
region,
our
records
showed
that
373
of
our
clients
indicated
at
intake
that
they
were
homeless
or
precariously
housed.
Our
agency-owned
housing
is
only
34
units
and
much
of
our
rental
assistance
resources
are
obligated
or
will
only
support
those
who
are
currently
on
the
streets
or
in
the
shelter.
H
H
There
is
a
severe
gap
in
available
supportive
housing
in
our
region
and
from
my
experience
with
statewide
committees,
I
can
comfortably
say
that
this
is
also
the
case
across
the
state.
The
underlying
problem
is
that
there
are
not
are
not
enough.
Affordable
units
statewide
in
the
big
sandy
counties
which
are
typical
of
other
rural
counties.
H
The
average
of
the
hud
fair
market
rents
for
a
one-bedroom
unit
is
527
dollars
a
month,
which
simply
means
that
the
total
amount
that
they
will
put,
that
hud
will
provide
for
rent
and
utilities,
and
the
landlord
must
agree
not
to
charge
over
that.
When
applying
the
allowances
for
utilities,
the
total
rent
allowable
would
be
about
a
month.
That
unit
doesn't
exist,
except
in
very
rare
cases.
H
There
are
some
programs
that
allow
for
slight
flexibilities,
but
the
funding
provided
from
hud
is
always
based
on
the
number
of
units
at
the
designated
fair
market
rent.
It
is
very
hard
to
find
units
that
meet
these
requirements
and,
at
the
same
time
also
meet
the
hud
quality
housing
quality
standards.
H
The
average
rent
in
our
region
for
a
one
bedroom
apartment
without
utilities
included,
is
about
600
to
six
hundred
fifty
dollars
a
month
for
the
most
basic
apartment.
The
average
ssi
payment
is
794
dollars
a
month.
If
there
are
no
suitable
vouchers
available
for
rental
assistance,
then
an
individual
can
end
up
paying
almost
their
entire
monthly
income
in
out
in
rent.
This
causes
many
persons
with
severe
mental
illness
to
be
doubled
up
with
friends
or
family
or
couchsurfing
from
place
to
place
and,
as
we
have
seen
from
the
data,
can
also
result
in
literal
homelessness.
H
So
how
do
we
encourage
the
development
of
affordable
units?
The
first
and
most
obvious
is
to
invest
in
grant
money
for
development.
The
less
debt
an
entity
has
to
carry
the
better
in
a
perfect
world.
We
need
more
no
debt
projects,
then
rents
can
remain
affordable.
Adequate
staffing
can
be
maintained
as
well
as
proper
maintenance.
H
H
H
There
are
no
funds
that
I
know
of
right
now
available
in
the
state
for
project-based
assistance
to
attach
the
assistance
to
the
unit.
We
create
a
steady
income
stream
and
make
it
much
easier
to
cash
flow,
an
affordable
project
when
that
assistance
is
also
coupled
with
the
substantial
with
substantial
development
funding
at
mountain.
Our
20-unit
development
carries
some
debt
and
does
not
have
project-based
assistance.
It
is
a
struggle
at
times
to
operate
it
because
there
are
limited
section,
8
resources
in
the
community,
and
we
cannot
use
our
rental
assistance
grants
to
pay
ourselves.
H
H
Intensive
services
are
essential
for
successful
housing
for
persons
with
severe
mental
illness.
There's
a
stigma
surrounding
persons
with
severe
mental
illness
that
makes
private
landlords
more
hesitant
to
rent
to
our
clients.
To
engage
these
landlords.
We
need
to
be
able
to
provide
them
quality,
intensive
and
in-home
services.
H
This
team
helps
clients
to
locate,
affordable
housing,
negotiate
with
the
landlord
and
understand
the
lease
and
then
develops
a
housing
stability
stability
plan
and
helps
lead.
The
client
through
the
plan,
referrals
for
case
management
and
peer
support
are
made,
and
we
work
with
the
individual
on
anything
that
may
be
a
barrier
to
them.
Maintaining
their
housing
for
some
individuals
supported
employment
appointment
may
be
appropriate
and
we
also
make
those
referrals
to
maintain
overall
well-being
and
social
socialization
for
the
individual.
We
also
provide
referrals
to
mountains,
therapeutic
rehabilitation
programs.
H
We
try
to
ensure
that
each
individual
is
wrapped
in
a
variety
of
services
so
that
they
are
on
the
road
to
stabilization.
It
is
difficult
to
maintain
this
level
of
services,
as
you
have
heard
in
previous
testimony.
Medicaid
billing
is
often
a
moving
target
right
now,
with
the
concessions
that
are
in
place
due
to
the
pandemic,
we
have
been
able
to
provide
high
quality
services
in
an
intensive
manner
and
I'm
proud
to
say
that
we
have
seen
no
cases
of
coven
19
among
our
housing
clients.
H
This
model
of
service
delivery
promotes
stabilization
and
reduces
hospitalizations
interactions
with
law
enforcement,
emergency
rooms
and
gels
when
services
are
removed
or
limited,
it
decreases
stability
and
creates
a
situation
where
it
is
harder
to
keep
an
individual
housed
at
the
end
of
the
day.
It
is
always
our
goal
to
allow
the
individual
to
lea
to
live
in
the
least
restrictive
environment
of
their
choice.
To
accomplish
this,
affordable
units
with
high
quality
and
intensive
supportive
services
are
essential.
H
Another
missing
piece
of
the
housing
puzzle
is
transportation,
so
many
low-income
individuals,
especially
the
population
we
are
discussing
today,
do
not
have
a
reliable
source
of
transportation
in
the
big
sandy
region,
as
in
other
rural
areas,
there
is
no
public
transportation
at
all.
Consumers
can
get
to
medical
related
appointments
via
medicaid
transportation,
but
they
cannot
get
to
the
grocery
jobs,
pharmacy,
entertainment
or
any
other
service
that
we
take
for
granted
each
day.
H
It
is
not
enough
to
simply
put
a
roof
over
someone's
head,
they
have
to
be
able
to
get
from
point
a
to
point
b
on
any
given
day.
The
lack
of
transportation
creates
a
barrier
to
housing
and
jobs
and
is
extremely
difficult
in
a
rural
area
to
find
affordable
housing
in
an
area
that
is
walkable
to
services
and
jobs.
H
In
my
years
of
working
in
housing
at
mountain,
we
have
seen
many
clients
find
stability.
We
have
had
clients
who
lived
in
tents
and
through
stable
housing
and
intensive
services
were
not
only
able
to
reunite
with
their
family
but
become
stable
enough
to
find
meaningful
employment
and
support
the
family
without
rental
assistance.
H
The
importance
of
having
enough
housing
for
individuals
with
severe
mental
illness
is
not
just
that
it
keeps
them
from
being
on
the
streets.
It
is
that
it
promotes
stability
and
wellness
and
can
very
well
lead
to
a
level
of
stability
where
the
individual
can
maintain
housing
on
their
own.
It's
also
about
human
dignity,
because
everyone
deserves
a
home.
H
So,
while
the
need
is
great,
the
reward
is
greater.
Stable
housing
provides
individuals
with
the
opportunity
for
wellness
and
self-sufficiency
and
creates
a
return
to
the
community
in
reduced
costs
for
hospitalization
first
responders
in
jail.
I'd
like
to
thank
you
for
taking
your
time
to
explore
this
important
subject.
I
hope
we
can
all
work
together
in
the
future
to
create
positive
outcomes
for
the
commonwealth.
G
A
At
this
time,
I
like
to
have
we're
gonna
get
out
here
in
a
few
minutes,
because
the
time's
up
veronica
nunley
she's
worked
for
pathways
in
ashland
for
29
years
and
she's,
our
chief
business
development
officer,
and
she
wrote
the
grant
for
to
go.
So
if
you
can
get
the
first
slide
and
veronica.
Introduce
yourself
for
the
record.
M
So
we
purchased
an
rv.
We
had
it
modified
to
have
two
rooms
where
we
have
telehealth
services.
One
of
the
rooms
will
become
an
exam
room.
We
are
partnering
with
16
community
partners,
including
two
hospitals,
eight
health
departments,
several
university
of
kentucky
grants.
The
healing
studies
grants
the
finding
cases
grants
so
we
it
is
impossible
to
do
this
work
without
community
partners.
We're
also
partnering
with
the
du
bois
community
center
in
mount
sterling.
M
As
well
as
the
new
hope
baptist
church
in
ashland
to
reach
persons
of
color,
so
we
are
at
12
locations,
he
told
me
I
had
three
minutes.
I
have
to
talk
really
fast.
We
have
12
locations,
including
three
low-income
housing
developments.
We
are
going
to
the
dubois
community
center
to
the
new
hope
baptist
church.
We
are
even
parked
at
walmart
in
mount
sterling
in
order
to
engage
folks
into
behavioral
health
services.
M
M
We
having
been
able
to
move
six
people
into
substance,
use
disorder
services.
We
have
been
able
to
engage
one
individual
in
autism
services.
We
have
been
able
to
engage
a
young
man
who
loves
pepsi
into
our
transitioning
aged
youth
program,
where
he
is
preparing
to
be
employed
and
we
engaged
one
family.
A
gentleman
who
came
to
our
walmart
location
with
his
two
children,
whose
wife
and
mother
had
abandoned
the
family
due
to
substance
use
disorder
distraught,
had
to
quit
his
job
couldn't
afford
child
care.
M
We
called
a
therapist
over
was
immediately
able
to
help
him
not
only
with
his
behavioral
health
needs,
helped
get
his
children
into
services
and
wrap
around
services
in
order
to
get
child
care,
as
well
as
to
help
get
him
gainfully
employed.
More
importantly,
with
the
finding
cases
where
we're
doing
hep
c
and
hiv
testing.
On
this
unit,
we
have
been
able
to
test
over
200
individuals.
M
M
These
are
folks
who
will
not
walk
through
our
doors,
so
we're
really
excited
I'll,
wrap
it
up
and
put
a
bow
on
it
to
talk
about
margaret
who
came
to
one
of
our
kickoff
events
to
get
slim
chickens
as
she
did
one
of
our
peer
support
specialists
who
manned
our
vehicle
said,
come,
and
let
us
tell
you
what
we
have
available
margaret
went
on.
The
rv
got
some
narcan
got
information
about
services,
there's
a
study
out
of
the
university
of
boston.
M
That
tells
us
that
every
time
we
can
touch
an
individual's
life
to
give
them
resources,
it
increases
the
likelihood
that
they'll
get
into
services.
So
we
want
those
touch
points
so,
as
margaret
walked
off
the
van
with
needle
marks
upper
arm
to
get
on
her
bicycle
and
leave,
she
turned
around
and
looked
at
me
and
said.
M
Why
are
you
doing
this
and
I
said
because
we
know
that
there's
a
great
need
out
there,
people
who
could
benefit
from
our
services
who
wouldn't
walk
into
one
of
our
locations
who
might
come
and
get
services
here
she
said
you're
so
right
she
said
you
know
I
go
in
the
grocery
stores.
People
don't
want
me
to
touch
them
or
even
be
near
them.
She
said,
I
know
I'm
not
wanted,
and
I
would
never
come
to
your
location,
but
I'll
be
back
here
and
that's.
A
A
This
is
probably
36
feet.
I
have
a
class
a
38
feet,
and
so
we
took
the
pictures
and
two
men
came
up
to
me
with
ptsd,
remember
in
south
shore,
and
they
said
that
they
wouldn't
go
up
to
ashland
the
pathways,
but
they
made
appointments
with
you
from
they
were
both
veterans.
A
This
will
take
the
doctor
to
rural
kentucky.
In
the
back
I
talked
to
phillips
solutions.
Anybody
know
the
company,
I'm
sure
dr
alvarado
does
from
in
doctor.
I
mean
senator
meredith
because
they
deal
with
atypical
anti-psychotics,
but
they
were
talking
about.
They
had
this
program
in
japan
and
they
take
the
doctor
to
that
broadband,
and
so
the
doctor
comes
to
the
patient.
A
But
I
think
this
is
a
really
a
great
thing
for
kentucky.
You
know
two
hundred
thousand
dollars
would
equip
that
thing
and
then
you
could
hit
three
or
four
counties
with
it.
We
can't
get
mental
health
providers,
but
we
can
take
this
van
to
the
patient.
So
that's
really
no
one
to
bring
it
up.
The
last
slide
this
guy
here
looks
like
me.