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From YouTube: Severe Mental Illness Task Force (11-16-21)
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A
A
Second,
we
have
a
motion
from
senator
alvarado
and
a
second
from
who
did
I
see
representative
our
co-chair,
our
esteemed
co-chair.
Thank
you.
Okay.
I
think
all
of
you
have
also
have
received
a
draft
copy
of
our
findings
and
recommendations
and
an
explanation
of
the
process
for
approving
or
making
a
motion
for
an
amendment
to
the
findings
and
recommend
recommendations
that
were
sent
to
each
member
last
week.
Can
you
show
your
hand
that
you
received
those?
Could
you
just
lift
your
hand
if
everyone
has
seen
that?
Thank
you
as
a
reminder.
A
A
Each
finding
and
recommendation
will
be
considered
separately.
Members
are
asked
to
limit
their
comments
and
discussion
to
the
finding
and
recommendation,
that's
under
consideration
at
that
time.
If
a
member
wishes
to
make
an
emotion
for
an
amendment
to
a
finding
or
recommendation,
the
text
of
the
amendment
should
be
provided
to
staff
in
writing.
A
A
A
A
We
have
a
motion
and
a
second
does
any
member
wish
to
be
recognized
to
discuss
finding
number
two
seeing
no
discussion,
all
those
in
favor
of
approving
finding
two
as
written,
say:
aye
all
opposed.
There
is
no
opposition.
No
that's
how
our
baptist
minister
would
do
it
at
a
business
meeting.
Okay,
so
is
there
any
opposition?
A
A
A
A
We
have
a
motion
and
a
second
does
any
member
wish
to
be
recognized
to
discuss
finding
five,
seeing
none
all
those
in
favor
of
approving,
finding
number
five
say:
aye
all
those
opposed
say.
No,
the
finding
passes
finding
number
six
we're
going
to
begin
our
discussion
on
that.
Do
we
have
a
motion
to
approve
finding
six?
A
Seeing
none
all
those
in
favor
of
approving
all
right.
Thank
you.
All.
Those
opposed
finding
six
passes.
Okay,
I'm
going
to
speed
this
up
a
little.
Unless
you
tell
me
to
slow
down
finding
seven
now
now
we
are
going
to
go
to
it.
Do
we
have
a
second
on
sev?
Second,
on
seven
seconds,
is
there
any
member
who
wish?
Is
there
a
discussion
on
finding
seven.
A
D
Thank
you,
ma'am
chair,
just
knowing
sometimes
the
words
matter
on
the
very
last
sentence.
It
says,
however,
primary
care
physicians
do
not
I.
I
would
like
to
see
the
word
sort
of
do
may
not
because
there
are
a
lot
of
primary
care
physicians
who
are
experienced,
and
I
think
in
our
discussions.
That
was
our
very
first
meeting.
A
D
If,
if
it
makes
the
committee
feel
more
comfortable,
we
could
replace
the
instead
of
primary
care,
physicians,
primary
care
providers
and
maybe
replace
the
term
where
we
see
in
the
entire
clause
there,
due
to
the
shortage
of,
for
example,
in
a
shortage
of
psychiatrists,
primary
care
providers
who
are
providing
up
to
24
percent
of
all
psychiatric
care
in
the
united
states.
Primary
care
providers
may
not
have
the
training
or
expert
or
experience
specularly
diagnosed.
That
might
make
everybody
feel
a
bit
more
comfortable.
A
D
A
D
E
E
A
E
D
Sure
I
can-
and
I
think
when
we
talk
about
it's
not
so
much
healthcare
providers,
which
can
is
much
broader
when
it's
primary
care
providers.
I
mean
that
there's
a
pretty
narrow
group
of
people
that
I'd
say
would
be
involved
with
that
which
would
be
physicians.
Nurse
practitioners,
physician
assistants
are
typically
people
that
are
considered
primary
care
providers
and
can
prescribe
medications
really
in
this
realm.
So
I
think,
by
using
primary
care
providers,
we
encapsulate
those
three
groups.
D
It's
kind
of
the
main
point
of
discussion
I
like
I
said
I
think
a
lot
of
our
discussion
was
on
physicians
because
that's-
and
that's
probably
from
my
own
bias,
because
that's
what
I'm
familiar
with,
but
those
other
groups
are
also
involved
and
do
provide
a
lot
of
that
care,
so
it
might
be
worth
just
like.
I
said
with
the
motion
that
we've
got
the
way
it's
discussed.
I
think
it
involves
those
three
groups
by
using
pcps.
E
A
A
B
A
B
Sheila
schuster,
with
the
mental
health
coalition,
I'm
hearing
from
people
that
are
trying
to
monitor
this.
Those
are
so
much
interest
that
they
don't
have
it
in
writing.
So
when
you
all
are
approving
something,
they
have
no
idea
what
you're
approving.
So
I
wonder
on
the
recommendations
which
is
really
the
heart
of
this.
If
they
might
be
read
before
you
discuss
them,.
B
C
Chairwoman,
this
is
really
a
question
as
we
get
into
these
recommendations.
I
just
want
to
make
sure
have
we
actually
or
are
we
going
to
attempt
to
define
what
we
mean
by
severe
mental
illness?
Are
we
going
to
limit
these
recommendations
to
certain
diagnoses
like
schizophrenia
and
bipolar,
and
you
know
serious
depression
or
are
we
going
to
be
including
things
like
post-traumatic
stress,
disorder
or
borderline
or
personality
disorders,
the
whole
gamut
of
them?
A
Senator
wilner,
my
understanding
is
these
recommendations
are
broad
right
now,
but
they
will
include
whatever
we
put
in
the
definition
of
severe
mental
illness.
When
we
we
write
these
bills,
does
anyone
have
a
different
eric?
Did
you
want
to
come
up
and
talk
say
something
to
me
about
that?
I
didn't
know
if
you
were
raising
your
hand
or.
G
Well,
we
both
have
beards.
So
that's
it
appreciate
the
senator
berger's
position
on
this,
but
in
the
same
token,
I
think
there's
some
advantage
for
being
very
broad
in
nature,
because
I
don't
know
that
we
really
have
a
definition
of
smi
and
I
think
this
gives
us
more
latitude
by
keeping
it
broad
than
trying
to
narrow
it,
because
we
could
miss
something
that
can
be
almost
impossible
to
truly
identify.
So
my
preference
is
to
to
not
reference
it
to
any
particular
disease
or
disorder
and
be
more
generic
in
scope.
B
There
are
statutory
definitions
of
severe
mental
illness
and
I
think
much
of
the
testimony
that
you
all
heard
from
dr
brenzel
from
dr
sussman
for
myself
and
we're
really
talking
about
the
psychotic
disorders,
dr
berg,
senator
berg.
I
think
some
of
the
recommendations
were
very
specific
to
smi
and
some
of
them
are
kind
of
broader
access
to
mental
health
services,
and
I
think
you'll
see
the
difference
as
we
go
through
those
recommendations.
A
C
C
C
C
A
So
now
we
are
number
two
fund
and
I
will
I
will
read
some
of
the
ones
as
as
well
as
I
can
and
summarize
number
two
fund
and
expand
the
use
of
tim's
law
and
assisted
outpatient
treatment
to
all
community
mental
health
center
regions
across
the
state
so
moved.
I
have
a
motion
and
a
second
from
representative
berg.
A
A
Seeing
none
all
those
in
favor
of
approving
recommendation,
number
three
say:
aye,
those
opposed,
say,
nay,
the
recommendation
passes.
We
are
now
on
recommendation
number
four.
I
encourage
the
department
for
medicaid
services
to
make
suspension
of
prior
authorizations
for
behavioral
health
services,
particularly
targeted
case
management
permanent,
and
to
require
managed
care
organizations
to
cover
the
cost
of
long-acting
injectable
medications.
When
appropriately
prescribed.
A
G
Thank
you,
madam
chair,
and
it's
a
little
bit
of
wordsmithing
but
words
to
have
consequences.
As
sentry
alvarado's
noted
I'm
just
that
was
interesting
that
we
use
the
word
encourage
that
seems
rather
lukewarm
to
me
in
particular.
These
are
recommendations.
I
don't
know
why.
That's
not
something
firmer,
such
as
direct.
G
All
of
our
other
recommendations
have
not
all
the
others,
but
many
have
direct,
but
I
think
that's
just
too
lukewarm,
it's
like
yeah.
You
can
do
it.
If
you
want
to
I,
I
would
suggest
changing
that
to
direct
since
the
recommendations,
the
cabinet's
going
to
have
the
latitude
to
do
whatever
they
want
to
anyway.
So
I
think
that
just
gives
a
little
bit
more
teeth.
A
Okay,
so
we
have
a
motion
for
number
four
to
be
cha.
The
amendment
would
be
to
direct
the
department
for
medicaid
services
to
make
suspension
of
prior
authorizations
for
behavioral
health
services
particularly
target
case
management
permanent,
and
to
require
managed
care
organizations
to
cover
the
cost
of
long-acting
injectable
medications
when
appropriately
prescribed-
and
I
believe
we
have
a
second
from
representative
wellner-
all
those
in
favor
of
this
recommendation.
A
As
of
this
amendment,
say
I
okay,
all
those
opposed.
We
have
no
opposition.
So
now
I
believe
we
have
to
vote
on
this
amendment
now,
as
it
is
amended,
and
we
have
a
motion
from
senator
alvarado
in
a
second
from
senator
meredith,
all
those
in
favor
say
aye,
all
those
opposed
say.
May
there
is
no
opposition,
it
passes.
A
A
A
A
D
So
the
definitions
were
not
the
same,
but
include
age,
a
diagnosis
impact
on
functional
activities
in
the
time
frame,
and
so
I
think
those
are
the
definitions
that
were
presented
to
us
in
committee
that
we
heard
and
it's
on
the
powerpoint
presentation.
So
I
think,
by
keeping
it
open
and
by
that
being
what
we
were
referenced.
I
think
it
would
give
the
ability
for
either
definition
to
be
used
by
the
cabinet
in
that
regard.
So
there's
two
definitions,
one
from
samsung,
one
from
kentucky,
so
I
thought
I'd
just
clarify
that.
Thank
you.
A
A
A
F
A
F
A
All
those
opposed
there's
no
opposition,
so
recommendation
number
eight
passes
as
amended
recommendation
number
nine.
We
have
before
us
direct
the
cabinet
for
health
and
family
services
to
assist
if
in-state
programs
currently
providing
psychiatric
primary
care.
Physicians
training
are
sufficient
to
meet
the
need,
if
not
sufficient,
direct
the
chfs
to
contract
with
another
university
or
medical
association
of
its
choosing
to
provide
additional
psychiatric
primary
care.
Physician
training
programs.
A
B
B
D
Thank
you,
I
think
remember
this.
My
colleagues,
dr
robert
mccarron,
came
and
presented
from
the
university
of
california
irvine,
and
so
he
was
talking
about
some
of
the
programs.
They
were
doing
there
to
train
their
yeah
they're
rural
doctors,
that's
what
it
was
from,
and
I
think
this
leaves
it
opens
where
it
can
be
with
any
any
university
or
any
other
medical
association
for
that
matter.
That's
where
that
discussion
came
from.
A
A
F
So
the
psychology
compact,
the
audiology
compact,
the
I'm
blanking
on
what
other
compacts
that
we've
recently
approved,
but
those
have
all
come
from
a
national
organization
and
I
think
for
our
state
board.
For
example,
our
state
board
of
social
work
to
create
an
interstate
compact,
that's
a
hefty
requirement.
I
don't
even
know
how
they
would
do
it.
F
I
like
the
idea
of
requiring
them
to
lift
restrictions
to
make
interstate
practice
easier,
but
I
don't
think
that
one
state
can
necessarily
set
the
national
compact
in
motion.
So
that's
my
only
concern
and
I
just
wonder
if
there's
a
way
to
get
at
the
spirit
of
what
you're
talking
about
rep
fleming
without
requiring
them
to
do
something.
That's
really
beyond
their
capabilities
to
do.
E
Madam
chair,
I
mean,
I
think
it's
I
think,
it'd
be
on
the
board's
shoulders
to
go
out
and
engage
and
engage
and
get
get
those
things
going.
I
know
there
are
several
things
in
process
already
when
it
comes
to
social
workers
and
I
think
something's
coming
up
on
the
licensed
clinical
pro.
I'm
sorry
licensed
counseling
professionals.
E
I
know
that's
that's
in
the
work
in
the
works,
so
I
my
intent
is
to
try
to
get
these
boards
motivated.
They
don't
have
to
do
themselves.
They
are.
They
always
have
the
ability
to
go
outside
and
get
and
encourage
and
get
people
to
get
the
ball
rolling.
I
just
want
to
put
just
use.
Senator
meredith's
terms,
put
some
more
teeth
and
this
isn't
teeth
really
a
teeth
into
the
into
the
process,
and
I
and
I
think
just
given
that
we're
looking
at
a
severe
workforce
issue.
I
think
it's
it's.
F
A
F
F
A
B
G
You
could
have
a
you
could
have
a
interstate
compact,
but
it's
so
cumbersome
that
nobody
wants
to
bother
themselves
and
to
begin
with,
and
don't
we
really
want
to
encourage
all
these
licensure
groups
to
simplify
the
process.
So
I
don't
see
that
it
that
it
costs
us
anything
to
eliminate
the
either
and
rather
than
say,
ease.
Reciprocity
is
simplify
reciprocity
procedures.
D
You
yeah,
so
we
did
the
physician
interstate
compact,
so
you
have
to
have
a
minimum
number
of
states
established
to
establish
a
compact.
So
the
concern
is,
if
you're
going
to
make
it
both
requirements
and,
let's
say
we're
the
first
state.
Let's
say
we
have
a
I'm,
not
sure
all
the
mental
health
boards
that
are
out
there.
But
let's
say
I'm
not
sure
if
the
psychologists
have
a
an
interstate
compact.
If.
F
D
Do
but
if
there's
one
that
doesn't
have
the
required
number
of
states,
you
might
get
three
or
four
other
states
to
agree.
You
don't
have
enough
to
really
make
it
a
true
compact
that
puts
you
in
a
bit
of
a
bind.
If
you're
going
to
be
required
to
do
it
and
we
don't
have
one
that
exists,
you
have
to
have
enough
states
willing
to
put
one
together.
That's
the
only
restrictive
issue
with
that.
D
So
I
think
the
ore
could
give
you
that
out
option,
at
least
for
that,
because
if
you
require
both-
and
we
know,
there's
always
been-
you
know
to
create
that
compact-
you
have
to
have-
I
think,
legislative
authority
to
do
that.
So
we've
had
debates
on
that
issue
and
we
had
a
lot
of
resistance
getting
some
of
our
compacts
set
up
in
the
past.
D
G
A
F
Yes,
and
that's
just
that-
I
don't
know
about
all
mental
health
boards
but,
for
example,
until
passing
the
psychology
interstate
compact,
the
psychology
board
had
no
reciprocity
procedures,
so
there
were
none
to
ease,
so
it
could
say
to
simplify
to
a
staff.
Well,
I
want
to
put
to
establish
because
what,
if
there
are
no
reciprocity
procedures
to
begin
with-
and
I
mean
I
think
our
goal
is
all
the
same-
we
want
to
make
it
easier
to
practice
across
straight
lines:
state
state
lines
so
or
to
establish
and.
A
D
So
I'm
wondering
if
establishing
would
be
it
would
fit
into
the
definition
of
easing
right
if
you're
establishing
one
it's,
I
think
it
would,
it
would
qualify
if
you
don't
have
one.
I
think
that
would
that's
what
I'm
wondering
if
you're
saying,
if
you
don't
have
one
president
want
to
establish
it.
That
would
count
as
easing
reciprocity
procedures.
A
A
A
D
Thank
you,
madam
chair.
I
want
to
commend
everybody
on
this
committee.
I
think
it's
been
a
really
a
lot
of
good
testimony.
We
heard
from
a
lot
of
people
that
a
lot
of
experts,
not
only
in
our
state
but
really
outside
of
our
state
borders,
a
topic
that
obviously
has
hit
us
pretty
hard
here
during
kovid
kind
of
been
accentuated
more
during
covid,
and
I
want
to
commit
all
the
members
there's
a
sense
of
unity
in
this
task.
D
D
Hopefully
some
of
these
things
will
be
filed
and
can
get
accomplished
in
the
upcoming
year
to
make
things
easier
for
this
treatment
and
again
some
of
the
directors
we're
giving
to
the
cabinet,
hopefully
can
be
initiated
rather
quickly,
and
the
federal
government
will
respond
to
those
things
to
start
getting
some
of
these
tasks
done
because
we
need
we
need
the
help
posthaste.
So
I
want
to
thank
all
the
members
of
the
committee
and
madam
chair.
Thank
you
for
your
leadership
on
this
as
well
and
mr
chairman,
as
well
for
your
leadership.
We
appreciate
it.
E
Thank
you,
madam
chair.
I
also
want
to
compliment
you
and
and
chairman
bentley,
for
going
through
this
process
and
when,
when
term
bentley
called
me
some
time
ago,
said
hey
you're
going
to
be
on
it.
That's
like
I'm
going
to
be
on
it,
but
but
he's
right,
I'm
glad
I'm
glad
to
be
part
of
it.
I
appreciate
his
offer
to
help
me
give
me
the
opportunity
to
participate
in
this
very
this
very
important
issue
and
topic.
E
E
E
I
think
the
senator
is
correct.
It's
alvarado
in
terms
of
there's
been
a
lot
of
things
going
on
good
progress
and
when
I
said
that
when
he
said
we
hope
to
have
files,
is
there
any
action
plan
or
any
body
willing
to
take
on
these
things
to
start
pushing
these
things
through?
Because
that's
where
the
rubber
hits
the
road?
And
I
don't
want
us
to
break
from
this
particular
meeting
and
say
hey,
we
did
a
great
job
back
up
each
other
and
go
get
a
beer.
E
E
A
B
B
That
rural
hospitals,
somebody
was
given
a
million
dollars
this
week.
Isn't
that
grade
absolutely
one
percent
in
a
rural
hospital?
Absolutely
in
kentucky!
That's
great!
That's
one
announcement!
Anyway!
We've
talked
about
that.
If
you
have
a
special
interest
in
anything
start
on,
you
know,
so
I'm
okay
go
ahead.
Doctor.
D
D
That
you'd
probably
consult
with
the
chair,
the
chairman
and
the
chairwoman,
to
discuss
some
coordination
of
that.
So
we
don't
duplicate
efforts,
obviously,
and
that
might
be
the
best
way
to
go.
If
somebody
has
an
interest
in
running
something
in
particular
talk
to
the
chairman
chairwoman
and
say:
hey
I'd
like
to
do
this
and
they
can
coordinate
those
efforts.
Probably
the
best
would
probably
be
the
easiest
and
cleanest
way
to
do
it.
A
B
A
G
F
By
having
these
conversations
very
directly,
and
I
also
want
to
say
how
meaningful
it
was
to
me
to
have
folks
with
severe
mental
illness,
testify
in
front
of
this
group
and
the
degree
of
respect
and
dignity
that
was
afforded
to
those
individuals.
It
was
very,
very
powerful,
and
you
know
I
want
to
say
just
you
know
a
real
highlight
of
my
brief
legislative
service.
So
thank
you
to
the
co-chairs
and
really
to
all
of
you
on
this
group.
B
I
appreciate
y'all
having
my
my
constituents
here
and
getting
on
the
conference
call.
I
know
they
appreciate
being
heard
and
I
believe
that
these
recommendations
it's
been
going
on
for
years.
So
to
me,
I
would
like
to
see
them
move
forward
so
that
it
will
help
them
and
reading
the
books
seeing
the
videos
it
was
all
educational
and
because
of
this
I
got
to
go
to
jail.
They
call
my
jailer
called
me
and
asked
me
to
go
to
jail
because
they
had
a
lady
right
then,
and
I
went
and
I
had
an
orange
sweatshirt
on.
B
I
said
just
don't
keep
me,
but-
and
this
is
something
that's
not
really
related-
I
mean
it
could
be
kratom.
I
don't
know
if
y'all
have
heard
of
cradle.
It
was
because
of
cradle
that
they
wanted
me
to
come
and
see
this
and
chair
bentley's
agreed
to
come
down
to
my
jail
and
talk
to
them
when
he's
down
in
the
area.
So
I
mean
there's
more
work
to
be
done,
but
I
just
I
feel
like
let's
not
wait
so
anyway.
Thank
you.
Good.