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From YouTube: Severe Mental Illness Task Force
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A
Good
afternoon
we're
going
to
call
the
meeting
to
order
at
this
time-
and
this
is
our
severe
mental
illness
task
force
meeting
number
two
and
I
think
most
of
you
have
the
agenda
in
front
of
you
and
have
a
folder
of
information.
B
A
Well,
we
really
appreciate
you
all
being
here
today.
Thank
you
to
my
co-chair
representative,
bentley
and,
and
again
it
is
amazing,
as
I
looked
around
when
I
heard
who
they
had
put
down
on
the
list
to
serve
in
this
committee,
I
thought
how
ironic
that
all
the
really
good-looking
people
in
the
legislature
were
the
ones
that
were
chosen
to
to
make
up
this
spot
amen,
amen,
absolutely
steve.
A
Oh
I'm
going
to
go
ahead,
and
hopefully
we
have
our
first
guest
with
us,
and
this
is
dr
robert
mccarron
and
he's
professor
and
vice
chair
of
psychiatry
and
human
behavior
at
the
university
of
california
irvine,
and
if
you
can
bring
him
up,
however,
that
occurs.
Does
he
just
snap
up.
C
Thank
you,
madam
chairman.
I
appreciate
that
and
it's
it's
an
honor
for
me
really
and
it's
a
privilege,
dr
mccarron,
and
I
have
probably
known
each
other
robert.
I
don't
know.
Probably
35
years
we
went
to
college
together
and
one
of
my
oldest
and
dearest
friends,
and
it's
interesting
that
a
lot
of
the
guys
that
I
hung
out
with
in
college
wound
up
going
into
medical
or
dental
fields
and
dr
mccarron
is
you
can
see
his
bio
in
our
in
your
packet
senator.
A
C
C
I
know
it
in
rush,
I
believe,
in
chicago
and
kind
of
a
there's,
a
lot
of
combined
residency
individuals,
but
he
did
them
in
both
and
and
found
himself
now
we
went
to
uc
davis
now
at
uc
irvine
and
is
really
the
kind
of
the
department
of
psychiatry
and
behavioral
magazines
assistant
dean
there
at
uci
and
again
he's
a
published
author
on
topics
that
are
important
for
primary
care
doctors
and
that
do
try
to
do
psychiatry
as
well.
C
He
and
I've
had
many
discussions
at
times
about
this
topic
and
about
the
difficulties
that
we
have
in
kentucky
and
in
rural
america,
in
general,
of
trying
to
attract
psychiatrists
and
people
to
do
to
kind
of
handle
severe
mental
illness.
I've
often
discussed
with
him
my
reluctance
to
handle
those
things
as
a
primary
care
doctor
for
years.
C
I
just
didn't
feel
comfortable
with
it
and
he
talked
about
a
program
that
he
had
developed
in
california
that
he
petitioned
the
general
assembly
in
california
to
start
up,
and
I
think
we're
going
to
hear
about
that
discussion
today
and
that
he
claims
he's
doing
very,
very
well.
He's
got
some
good
data
to
present
to
us
and
he
had
asked
me
several
times
he
thought
he
says.
C
I
think
we
can
really
do
a
lot
of
the
same
benefits
we're
seeing
in
rural
california
here
in
kentucky
to
try
to
help
enhance
primary
care
doctors
to
do
and
feel
comfortable
in
treating
individuals
with
moderate
to
severe
psychiatric
diagnoses
and
then
to
help
them
also
teach
their
colleagues
to
do
the
same
thing,
and
so
he's
asked
me
several
times
when
this
task
force
was
established.
Madam
chair,
I
was
very
excited
because
I
thought
this
would
be
in.
C
In
our
first
meeting
we
had
the
discussion,
the
topic
of
the
shortage,
and
that's
when
I
thought
I
would
bring
this
up,
so
I'm
very
excited
to
have
dr
mccarran
presenting
for
us
today
and
so
with
that
madam
chair,
dr
mccarron,
if
you're
there,
if
you'd
like
to
introduce
stuff
for
the
record
and
begin
your
testimony.
D
Thanks
for
the
nice
introduction,
I
really
appreciate
your
you're
helping
everything
you're
doing
in
kentucky
by
the
way
I've
seen
you
you
know
from
from
your
first
campaign
till
now
and
very
proud
of
you
know
about
the
work
that
you've
been
doing
with
kentucky
awesome
work
so
and
it's
a
pleasure
to
to
briefly
speak
with
all
of
you,
and
I
want
to
give
a
special
thanks
to
samir
who,
who
you
know,
arranged
all
of
this
into
the
co-chair
senator
kerr
and
representative
bentley,
as
well
as
the
rest
of
the
task
force
members.
D
It's
really
a
a
real
pleasure
for
me
to
meet
with
you
I'd
like
to
I'd
like
to
just
kind
of
jump
into
to
to
this.
This
brief
sort
of
summary
and
break
it
down
into
two
two
core
areas
and
the
first
area
is
the
problem
or
what
I
think
might
be
the
problem
from
a
statewide
standpoint.
I
can
relate
because
we're
seeing
something
similar
in
california,
although
in
some
ways
different
and
then
I'd
like
to
talk
about
a
possible
solution
for
the
state
of
kentucky,
certainly
not
a
solution.
D
Let's
start
with
fairly
recent
data
from
january
of
2021
from
the
health
resources
and
services
administration,
looking
at
health,
professional
shortage
areas
in
mental
health,
and
if
you
look
at
the
state
of
kentucky
the
blue,
the
blue
is
the
highest
level
of
of
need
and
you
can
see
that
there,
every
inch
of
the
state
has
a
health,
professional
shortage
area
and
mental
health.
Every
every
area,
every
county
and
and
so,
and
certainly
most
of
the
state,
has
a
a
significant
shortage.
D
You
all
know
this
and
I
won't
speak
a
lot
about
it
other
than
to
say
a
few
things.
If
you
look
at
all
of
the
psychiatrists
throughout
the
country,
you'll
see
that
about
70
percent
of
them
are
over
the
age
of
50.,
and
if
you
look
at
data
in
the
state
of
california,
where
we
actually
have
almost
6
000
psychiatrists
for
the
state
of
california,
still
not
enough
right,
we
see
that
the
total
number
of
psychiatrists.
D
If
you
look
at
the
total
number
of
psychiatrists
about
45
of
them
over
the
age
of
60
and
looking
looking
for
retirement,
so
we
definitely
have
a
shortage,
no
question
about
it:
the
solution
nationwide
in
my
lifetime
and
probably
another
lifetime
after
that
is
probably
not
going
to
be
creating
more
residency
programs.
There
certainly
is
a
lack
of
funding
nationwide
and
and
certainly
that,
that's
not
going
to
be
the
the
main
answer
for
a
myriad
of
reasons.
D
If
we
look
at
your
state,
we
see
that
there
are
about
350,
actively
practicing
psychiatrists
or
eight
per
100
000,
ideally
you're,
looking
at
a
need
of
50,
plus
per
100,
000.,
and
and
so
that
you
already
know
this.
I
think
ergo
the
task
force
that
you're
on
there's
a
shortage
and
here's
the
deal.
Even
if
there
wasn't
a
shortage.
Let's
say
there
wasn't,
which
there
is
primary
care
providers
are
the
psychiatric
workforce.
They
make
up
the
psychiatric
workforce
period.
D
D
Two
weeks
is
the
required
amount
of
time
for
physician
assistance.
So
there's
really
a
lack
of
training,
and
I
would
say,
under
two
important
domains-
and
I
know
with
dr
alvarado
has
mentioned-
that
these
both
of
these
domains
are
are
unsettling.
You
know
for
him
and
many
pcps,
probably
because
of
lack
of
training
and
experience.
Those
two
areas
include
primary
care
based
psychiatry
and
chronic
pain
management.
D
Looking
at
the
problem
here,
if
you
look
at
kentucky
this
upper
line
versus
the
united
states,
this
lower
line
here
percentage
of
adults
who
have
been
told
by
a
health
professional
that
they
have
a
problem
with
depression,
we
can
see
the
numbers
are
quite
high,
looking
back
to
2019
25
much
higher
than
the
national
average,
if
you
look
at
the
national
average
and
comparing
different
states-
and
you
look
at
kentucky
in
particular
and
really
that
the
question
is
that
you
know
who
has
the
highest
percentage
of
adults,
reporting,
symptoms
of
anxiety
and
or
depression
during
the
pandemic.
D
In
this
particular
case
for
about
a
month
during
the
spring
of
the
pandemic,
kentucky
reported
the
second
highest
at
35.2
percent.
This
is
national
data,
looking
at
the
share
of
adults
with
mental
illness,
any
type
of
mental
illness-
and
we
see
kentucky
unfortunately
presents
at
on
the
high
side
at
about
24
of
the
patient
population
opioids.
I
won't
go
into
detail
here.
D
This
is
just
cdc
data
looking
at
a
number
of
overdose
deaths
in
kentucky
and
for
fortunately,
we're
seeing
a
little
bit
of
a
downswing
since
about
2018,
but
the
numbers
are
high
and
they're
much
higher
in
kentucky.
Unfortunately,
let's
look
at
opioid
overdose
death
rates
again
per
100,
000
citizens-
and
we
see
kentucky-
is
much
higher
than
the
united
states
again
here.
The
most
recent
date
of
2019
per
cdc
information.
Looking
at
about
25
per
100
000.
These
numbers
are
very
high,
they're,
very,
very
high.
D
If
you
compare
kentucky
with
the
rest
of
the
states,
they're
very
high
domestic
violence,
a
problem
in
kentucky
from
the
data
that
I
see
this
is
increase
during
the
pandemic.
D
Just
one
piece
of
information
to
illustrate
this
about
45
percent
of
women
and
35
percent
of
men
in
kentucky
reported
physical
violence
intimate
partner
violence
during
their
lifetime
kentucky
has
the
11th
highest
femicide
rate
in
the
united
states.
D
Now
a
lot
of
times,
people
will
find
it
easy
to
separate
general
medical
conditions
like
cancer,
obesity,
heart
disease,
et
cetera
for
mental
health
conditions,
but
there's
plenty
of
data
to
show
that
that
that's
that's
really
not
the
case.
In
fact,
general
medical
conditions
are
closely
linked
with
severe
mental
illness
and
that's
why
those
who
have
severe
mental
illness
or
smi
die
two
to
three
decades
earlier
relative
to
the
general
patient
population,
two
to
three
decades.
D
Now
with
that
comes
pronounced
level
of
disability
before
a
premature
death.
These
are
some
state
rankings.
I'm
sure
you
are
probably
familiar
with
some
of
these
again
closely
linked
with
mental
health.
In
many
ways,
smoking
kentucky
is
at
the
top
of
the
list.
Obesity,
diabetes,
cancer,
related
deaths
also
very
high
among
kentucky
residents
relative
to
other
states,
cardiovascular
disease,
uninsured
patients,
kentucky
rigs
number
30.,
and
so
these
general
medical
conditions
again
closely
linked
closely
linked
with
severe
mental
illness.
D
Recently
kentucky
was
ranked
48th
and
49th
among
states
for
the
average
number
of
days
a
person
could
not
perform
work
or
household
tasks
due
to
mental
health
or
physical
health
issues
respectively.
Again,
looking
at
disability
right,
we
do
see
that
depression
is
the
number
one
cause
of
disability
in
this
country.
In
fact,
we
see
from
cdc
data
that
about
a
third
little
over,
a
third
of
those
from
kentucky
will
have
disability
at
least
once
in
their
lifetime.
D
Now
the
problem
again,
to
summarize,
as
I
call
the
5ds,
are
all
connected
under
the
umbrella
of
mental
health
depression
also
often
times
anxiety
with
that
domestic
violence,
drug
use,
mainly
opioids
disability
and
premature
death-
to
go
a
little
bit
further
again
about
about
three
quarters
of
all
psychiatric
care
in
this
country,
probably
more
in
kentucky
is
provided
by
primary
care.
Physicians
and
providers
on
any
given
day
about
40
percent
of
the
pcp's
day
is
related
to
significant
psychiatric
issues.
Now
you
can
refer
these
patients
about
half
the
time
at
least
half
the
time.
D
Those
referrals
are
not
going
to
happen
for
a
myriad
of
reasons,
including
stigma,
poverty,
cultural
issues,
positive
psychiatrists,
etc,
and
so
this
is
a
huge
problem
right
now
I
mentioned
earlier
that
depression
is
the
number
one
cause
of
disability.
Suicide
rates
are
going
up,
and
and
and
unfortunately,
our
providers
in
primary
care
settings
are
just
not
trained
they're,
not
trained
they're
writing
over
80
of
the
antidepressant
prescriptions,
but
they're
not
trained
on
how
to
do
this.
Unfortunately,
about
half
psychiatrists
take
cash
only
probably
more
in
certain
parts
of
kentucky.
I
imagine
bottom
line.
D
This
program
is
a
one-year
program
that
provides
a
very
targeted
overview
on
what
pcpc
most
on
any
given
day
in
terms
of
mental
health
issues.
We
provide
a
quick
and
targeted
overview
on
the
psychiatric
exam
common
psychiatric
conditions.
The
training
is
outside
of
normal
clinic
hours,
so
the
pcp
can
still
be
a
primary
care
provider
and
get
this
training.
The
focus
is
on
improved
health
outcomes.
D
Thank
you.
They
learned
when
to
refer
and
and
then,
of
course,
there's
there's
multiple
hours
with
cme.
The
other
thing
that's
unique
about
this
is
when
these
folks
graduate
from
our
program
they,
if
they
choose,
are
eligible
for
lifelong
learning.
We
continue
the
training
it
goes
on
and
on
for
the
rest
of
their
career
at
no
cost
to
them.
They
get
ongoing
mentorship
ongoing
training.
D
These
are
the
three
main
core
components
of
the
training:
two
case-based
tele-education
learning
modules
per
month,
very
interactive
modules,
two
intensive
weekends
per
year
and
then
at
least
one
hour
of
mentoring
sessions
with
a
faculty
member.
Our
faculty
members
are
duly
trained
in
psychiatry
and
primary
care.
D
D
We
are
likely
to
receive
probably
anywhere
from
seven
to
nine
million
dollars
from
the
state
of
california,
to
train
folks
in
our
state.
We've
received
just
under
4
million
over
the
last
three
years,
thus
far
to
train
and
the
need
remains
high
areas
of
focus.
I
put
in
red
for
kentucky
cultural
issues,
mood
and
anxiety
issues,
pain,
medicine,
motivational
interviewing
as
well.
It's
a
list
of
our
faculty.
We
have
over
35
faculty
throughout
the
state
throughout
the
country,
some
of
whom
are
based
in
california,
so
some
outcomes.
D
We
don't
want
to
just
put
a
program
together
and
say:
hey
here's
our
training
program
right,
so
we
every
year
we
put
out
an
executive
summary.
We
look
at
how
our
fellows
are
doing,
in
this
case,
total
scores
and
attitude
towards
mental
health,
which
have
increased
knowledge
based
looking
at
competency
and
management
of
psychiatric
conditions,
including
psychopharmacology
or
prescription
of
medications.
Looking
at
pre-fellowship
midway
through
fellowship
and
post
fellowship,
also
looking
at
confidence
of
confidence
in
completing
a
psychiatric
interview
and
teaching
psychiatric
topics.
D
D
We
we
have
again
a
large
number
of
dually
trained
faculty.
No
one
else
is
doing
this
in
the
country.
We
have
large
health
plans,
the
state
of
california,
helping
us
support
this
training,
we'd
love
to
have
kentucky
on
board
as
well.
We
also
believe
that
this
training
will
help
with
general
medical
conditions
quickly.
This
is
our
ask
we'd
love
to
train
75
fellows
per
year
for
about
225,
fellows
or
so
over
three
years
to
create
tnt
champions.
Who
could
then
leverage
this
training
and
train
other
folks?
D
This
would
be
about
a
million
dollars
a
year.
We
would,
we
would
recommend
focusing
on
underserved
areas
in
kentucky
with
this
would
come
an
annual
report
of
research
outcomes
for
kentucky
learners.
Specifically,
I
would
also
be
happy
to
do
some
consultation
on
population
health
in
kentucky,
along
with
our
leadership
team.
Long-Term
goal
might
be
to
train
about
a
thousand
pcps
in
underserved
in
rural
kentucky
I'll
end
with
this.
This
is
our
one
of
our
recent
classes
about,
I
think,
200
folks
or
so
you
can
see
they're
all
smiling
and
happy.
D
A
Wonderful
and
thank
you
for
that
presentation
and
we
have
lots
of
professionals
on
this
panel
and
I'm
sure
there's
going
to
be
questions
for
you.
I
haven't
seen
a
hand.
Yet,
though,
does
any
dr
alvarado.
C
Dr
mccarron,
thank
you
and
I
guess.
When
we've
we've
talked
about
this
quite
a
bit,
I
know
you've
often
said
hey,
you
know
we're
getting
really
good
results,
we're
you
know
we're
seeing
people
getting
treated
and
a
lot
of
the
issues
that
you've
gotten
and
people
always
think
of
california
as
big
population
basins
of
la
san,
diego
san
francisco.
You
know
those
kind
of
areas,
and
we
have
to
remind
ourselves
that
in
the
northeastern
parts
in
the
southeastern
parts
of
the
state
are
very
rural,
often
matching
what
we
see
in
kentucky.
C
D
D
Looking
at
this
at
this
data,
we
do
have
data
showing
expansion
of
workforce
and
underserved
areas
like
fresno
inland
empire,
rural
areas
in
california,
and
also
underserved
areas
like
oakland,
for
example,
in
certain
parts
of
los
angeles,
where
it's
really
hard
to
find
both
pcps
and
psychiatrists
and
looking
at
practice
pattern
outcomes.
That's
something!
That's
that
we're
working
on
right
now
with
our
partners
and
large
health
plans
in
california.
C
If
we
were
to,
I
mean
so,
obviously
this
is
something
that
would
take
some
funding
if
it
was
going
to
happen
and
it's
to
produce
a
a
psychiatrist,
I
mean
it
takes
obviously
college
medical
school
residency,
training
and
then
getting
out
it's
not
like.
You
can
pop
a
doctor
out
of
a
gumball
machine.
It
takes
you
know,
10,
12
years
to
to
get
a
professional
set
up,
or
even
in
even
an
aprn
or
nurse
practitioners
who
might
choose
psychiatry
again.
It
takes
several
years
of
training
to
get
them
out
into
the
workforce.
C
This
would
be
a
quicker
result
and
in
terms
of
this,
like
you
said,
the
numbers
is
roughly
1.1
million.
I
guess
per
year,
so
is
that
the
kind
of
funding
would
require
and
how
would
if,
if
we
decided
to
do
something
along
those
lines,
how
would
that
go
about?
If
we
could
allocate
funds
within
a
budget
to
make
that
happen?
Does
it
does
it
have
to
go
through
the
university
of
california
irvine?
Is
that
how
it
would
go
or
or
how?
How
do
we
proceed
with
something
like
that.
D
Yeah
I
mean
this.
This
would
be
basically
contracted
through
uc,
irvine,
university,
california,
irvine
and
yeah,
and
it
and
again
that's
just
my
recommendation
when
looking
at
the
need
in
kentucky-
and
that's
probably
you
know,
from
my
view,
a
good
reasonable
start,
but
we're
certainly
willing
to
go
up
or
down
on
that
either
way.
Again,
I
think
you
know
senator
alvarado,
you
know
I
I
would
love
to
to
to
not
only
make
but
demonstrate
and
publish
a
difference
in
rural,
rural
and
underserved
kentucky.
D
We
have
a
large
research
team,
we're
ready
to
publish
our
first
study
it
it
it.
You
know
within
probably
within
the
next
two
or
three
months,
and
you
know
we-
we
can
definitely
make
a
difference
in
the
state
of
kentucky.
E
Thank
you,
madam
chair.
Thank
you
for
this
presentation.
This
was
really
very,
very
interesting
and
very,
very
helpful.
I
just
you
know
for
folks,
particularly
with
severe
mental
illness.
E
We
know
that
what
works
best
is
a
multi-disciplinary
approach,
and
I
noticed
one
of
your
learning
outcomes
is
when
to
refer
to
a
mental
health
specialist
and
how
best
to
interface
with
mental
health.
Colleagues-
and
I
know
sometimes
folks,
from
different
professions.
Even
if
we
all
have
the
same
goals
of
helping
the
patients,
we
speak
different
languages.
So
could
you
just
talk
a
little
bit
about
that
particular
objective.
D
Yeah,
I
know
thanks
for
the
question
I
I
so
I'm
a
firm
believer
in
in
really
bringing
disciplines
together.
There's
no,
I
mean
it
doesn't
work
better,
otherwise,
and
so,
for
example,
you
know
we
have
a
handful
of
psychologists
as
part
of
our
training
team
psychologists
bring
something
very
different
than
psychiatrists
social
workers
as
well.
You
know,
have
have
been
part
of
our
team
in
the
past,
and
so
we
do
believe
in
a
multi-disciplinary
approach
for
most
effective
treatment.
A
F
Thank
you
doctor
appreciate
the
presentation,
I'm
looking
at
one
of
your
slides,
where
it
has
a
primary
care,
psychiatry
fellowship
and
it
mentions
the
past
fellows-
include
mds
do's
mps
pas
and
clinical
pharmacists.
So
how
do
you
kind
of
for
want
to
bear
to
market
this
program
within
your
home
state?
F
D
So
so
we
don't
market
it.
We
really.
We
really
have
never
marketed
it.
We
we
usually
have
a
waiting,
a
waiting
list
of
folks
each
year
that
we
have
to
roll
over
into
the
next
year.
We
do
our
best
to
find
scholarships
for
pcps
who
you
know
who
want
to
learn
this
stuff
in
terms
of
in
terms
of
finding
different
disciplines.
D
Again,
you
know
we
welcome,
you,
know
all
those
disciplines,
because
we
think
they're
all
very
important
in
terms
of
delivery
of
care
and
also
expanding
what
they're,
learning
and
bringing
it
to
other
colleagues.
So,
interestingly
enough,
we
don't
really
have
a
marketing
campaign.
We
this
is
word
of
mouth
and
and
and
and
we
we
have
a
lot
of
folks
who
want
to
learn
this.
A
F
D
D
So
that's
what
we
want
we're
looking
for,
that
we
want
80
to
90
of
our
learners
from
underserved
areas,
but
the
second
reason
is
a
lot
of
the
money
that
we
get
from
health
plans
cedar
sinai
from
in
la
and
al
also
from
the
state
of
california
in
particular,
share
the
same
mission
and
so
those
those
tuition
dollars
go
go
towards
providers
who
work
in
underserved
areas.
F
Madam
chair,
this
one
of
those
that
appears
to
be
one
of
those
non-brainers
no
brainers,
dr
alvarado
center
alvarado,
made
a
reference
to
the
the
cost
factor.
That
always
seems
to
be
the
stumbling
block
for
everything
we
attempt
to
do,
but
again,
you've
heard
me
preach
about
there's
enough
money
in
the
system.
Already
you
know
not
providing
care
is
the
most
expensive
care
that
you
can
have.
Secondly,
is
providing
inappropriate
care
is
for
the
second
most
expensive,
so
the
funding
is
there.
F
A
And
thank
you
and
thank
you,
dr
mccarron,
for
sharing
your
knowledge
with
us,
and
I
I
feel
like
that.
This
will
open
up
a
lot
of
doors
for
us
to
stay
in
touch
and,
of
course,
with
our
contacts
here
now
with
lrc
and
there,
this
wonderful
staff
and
with
dr
alvarado,
you
know
I
I
think
this
is
is
good
news,
and
so
thank
you,
I'm
sorry.
We
had
to
rush
through
today
but
happy
day
to
you
and
thank
you
for
being
a
part.
A
A
A
A
Is
well,
we
are
paused.
I
didn't
ask
for
an
approval
of
the
minutes.
Thank
you,
senator
meredith
and
thank
you.
B
H
Again,
I
am
steve
shannon
I'm
the
executive
director
of
carp,
clarkson
association
of
11,
of
the
14
community
mental
health
centers.
I
always
start
my
presentation
with
some
information
about
the
cmhcs
where's
my
little
deal
now
there
we
go
right
there.
H
Cmhcs
there's
14
in
the
state
they
have
a
specific
geographic
territory,
ranging
from
five
to
as
many
as
17
counties,
55
000
people
to
a
million
people.
We
serve
about
175
000
people
a
year
about
1
in
25
kentuckians.
We
do
exactly
what
dr
mccarron
talked
about
exactly
where
we're
at.
I
had
a
conversation
with
senator
ronald
about
that
topic
a
couple
years
ago.
H
We
struggle
for
prescribers.
We
clearly
need
that.
So
I
think
it's
an
invaluable
tool
for
us.
We
employ
about
8
000
people,
one
in
200,
working
kentuckians,
employed
by
mental
health
or
economic
force,
wide
range
of
people.
We
have
bachelor's
level,
high
school,
educated,
master's
level,
phds,
attorneys,
accountants,
doctors,
aprns,
a
wide
range
of
people
and
a
piece
we
don't
talk
about
very
often
is
we
have
300
volunteer
board
members
across
the
state.
H
Those
are
individuals
who
give
their
time
to
the
cmhcs
to
provide
guidance,
direction
and
support
for
those
organizations,
and
they
don't
get
a
lot
of
credit
necessarily.
I
really
believe
the
cmhcs
make
all
kentucky
communities
better.
We
are
the
behavioral
health
public
safety
net.
We
are
24
7..
We
are
there
all
the
time
for
your
information.
H
This
is
the
map
of
kentucky.
These
are
the
regions,
there's
14
regions
in
that
map.
There's
a
black
bold
line.
Those
relate
to
the
state
psychiatric
hospitals
that
are
in
operation.
If
you
look
at
the
far
western
part,
they
go
to
western
state
hospital.
It's
four
rivers
penny
royal
life
skills
they've
merged
recently,
but
there's
still
two.
We
count
that
way
and
river
valley
you
live
in
those
counties.
You
go
to
western
state
hospital.
If
you
need
involuntary
commitment.
I
I
H
Bhso
is
a
lookalike
cmac,
it's
a
behavioral
health
service
organization
that
happened
in
2014
when
medicaid
was
expanded
and
they
added
that
licensure
status.
It's
similar
to
a
cmhc,
not
identical
to
a
cmhc
cmhc,
has
to
have
a
medical
director.
Cmhc
gets
state
general
fund
for
services
that
maybe
bhso
doesn't
get
to
also,
I
believe-
and
I
think,
the
the
statute
that
created
the
cmhcs.
H
H
Services,
they
do
the
same
services.
The
rates
are
different
for
some
services,
primarily
because
we
have
that
24
7
364
obligation
that
others
do
not
again.
We
have
to
have
a
physician,
others
do
not.
We
have
to
have
a
medical
records
person,
others
do
not,
so
we
have
different
expectations.
We
have
an
obligation.
This
is
a
big
part
of
what
we
do:
community
mental
health
center.
The
operative
word
is
community
heath.
My
first
board
meeting
to
carp
was
a
month
after
the
heath
high
school
shooting
they
went
and
responded
to
that
floods.
H
H
Senator
alvarado
their
operation
was
not
harmed
in
west
liberty.
They
became
a
hub
for
that
community.
Their
staff
went
there
and
that's
what
and
that's
a
fundamental
difference
between
us
and
other
providers.
I
may
offend
other
providers
by
that,
but
I
really
do
believe
that's
a
statutory
charge.
I
believe
our
assignment
is
given
to
us
by
the
1964
general
assembly.
It
hasn't
been
changed
in
statute
since
then.
I
believe
we
have
an
obligation
to
those
counties.
I'm.
H
H
H
Yes,
both
bill
medicaid.
They
can
both
build
medicaid
the
same
service
we
can
use
a
mental
health
associate,
which
is
a
person
under
supervision,
has
a
bachelor's
degree.
Bhs
can't
use
that
that's
kind
of
a
legacy
service,
so
we
have
some
people
who
have
that
bachelor's
degree
and
they've
been
approved
as
a
mental
health.
Associate,
that's
a
different,
and
some
rates
are
different
between
the
two
models.
Because
of
that.
I
H
If
we
have
cmhc-
and
this
goes
back
to
october
31st
1963
when
president
kennedy
created
us-
it
was
timely
services
close
to
home.
That
was
the
point
where
people
lived
and
I
worked
for
a
guy
for
the
decade
who
helped
design
those
region.
His
plan
was
20
of
them
and
we
ended
up
with
14.
H
pathways
in
your
area.
Is
two
regions
right.
So
that's
how
we
get
to
14
instead
of
15
ad
districts
and
the
intent
was
where
do
people
go
for
services
now,
and
that
was
the
model.
I
tell
people.
The
ad
districts
have
livingston
county
wrong.
It's
an
ad
too
and
mental
health
center
one.
We
got
it
right,
just
because
I'm
biased,
but
it
was
specifically
designed.
Where
do
people
go
to
access
services?
And
how
do
you
get
a
critical
mass
to
ensure
enough
people
to
operate?
H
55,
000
and
comprehend
is
how
many
people
live
there
and
that's
the
smallest
one
we
got
and
and
that
it
functions?
Okay,
so
are
they
in
competition.
H
Until
the
last
four
or
five
years,
specifically
we're
gonna,
just
put
one
of
the
regions
is
operations
in
five
or
six
other
parts
of
the
state.
It
causes
frustration
for
my
members.
It's
not
a
secret,
you
know
and
they've
gone
to
other
places
and
operate
in
other
regions
and
they
operate
in
those
regions
as
a
cmhc
operate
in
those
regions
as
a
bhso
and
life
is
good.
H
H
Proceed
so
that's
that's
the
map
of
who,
who
we
are
and
again
briefly
october,
31st
1963
last
legislation
president
kenny
signed
before
that
fateful
day
in
dallas
dan
howard
says
he
was
there
right.
I
don't
think
anyone
remembers
dan
howard,
unfortunately
passed
away
in
november.
He
wasn't
one.
You
argued
with
right.
H
Dan
howard
played
football
for
bear,
bryant
and
basketball
frey
offer
up
and
worked
with
president
kennedy
on
cmhcs
there's,
no
one
else
that
fits
that
criteria.
In
my
opinion,
he
came
home
and
got
busy
getting
our
system
started
and
created
this.
So
president
kennedy,
when
it
was
signed
a
good
job,
well
done.
I
still
think
it's
a
good
job.
Well
done.
Kentucky
was
the
first
state
to
complete
the
network.
We
had
everyone
covered
under
cmhcs.
H
That's
my
history
lesson!
More
of
that.
Let's
talk!
This
is
the
smi
task
force.
It's
got.
A
definition
before
is
what
smi
is,
and
this
is
samhsa's
definition
and
our
department
of
behavioral
health
definition.
This
you
know
they
just
cut
and
paste
this
information,
but
samsa
talks
about,
and
he
was
18
years
old
age,
older,
a
diagnosable,
emotional
behavior
or
mental
disorder.
H
Not
specific
that
causes
the
decreased
functioning
and
lasts
for
up
to
a
year,
roughly
that's
the
samsara
definition,
but
it
has
age,
it
has
diagnosis,
impacts
functioning
lasts
for
a
year,
kentucky's
definition,
18
years
old.
Again,
diagnosis
is
the
schizophrenia
spectrum,
bipolar
depressive
orders
and
trauma
and
stress
so
we're
more
specific.
I
think
that
narrows
who
we
define
as
personal
mental
illness-
and
it
looks
like
representative
wilmer-
agrees
with
that.
It's
narrower,
but
it
still
impacts
functioning
and
in
kentucky
it's
two
years.
H
So
that's
who
we're
talking
about
that's,
who
we
want
to
focus
on?
That's
what
we
do
cmhcs
serve
about
43
000
people
with
this
diagnosis
annually,
43
of
175.,
about
a
fourth
of
who
we
serve
meet
this
criteria,
it's
about
1.4
of
the
adult
population.
It
needs
assessment
for
another
project
that
needs
assessment
indicated.
H
The
prevalence
rate
for
smi
is
2.4,
so
we're
missing
about
one
percent
of
the
adult
population
to
get
to
that
number,
so
we're
about
60
percent
of
where
we
ought
to
be
so.
There's
people
out
there,
hopefully
they're
seen
by
somebody
else.
We
know
they're
seen
by
primary
care
they're,
not
necessarily
getting
a
full
array
of
services
if
they're
not
accessing
services
or
not
being
seen
by
someone.
These
folks
don't
disappear.
H
They
don't
disappear.
You're,
going
to
hear
from
mental
health
court
they're
there
they're
in
jail
they're
in
er,
waiting
for
services,
they're
in
homeless,
shelters,
they're
on
the
street.
You
know
they're
worse
off
than
that
they're
doing
attempting
suicide,
all
sorts
of
things
if
they're
not
accessing
care
and
that's
what
I
think
this
agenda
is
all
about
today.
How
do
we
access
care?
So
let
me
tell
you:
the
services
cmacs
have
and
they're
in
front
of
you
standard
bhso.
Has
these
services
assertive
community
treatment?
That's
a
team
approach.
H
H
It's
a
really
effective
urban
model,
it's
more
challenging
rural
settings,
but
they
go
out
rural
counties,
a
lot
of
regions
have
it
in
one
or
two
counties,
not
across
the
whole
region.
Yet
that's
a
start,
but
they
go
find.
The
person
give
support
as
opposed
to
waiting
to
show
up
stresses
transportation
addresses
people
not
accessing
services,
which
has
always
been
a
concern
targeted
case
management.
This
is
a
you
know.
We
can't
use
the
word
social
worker
because
not
all
social
workers,
so
they
can't
be
licensed
that
way.
But
these
are
folks
who
work
with
individuals.
H
They
know
where
they
live.
They
interact
with
them.
They
connect
them
to
resources.
Food
bank
renting
supports
whatever
it
is.
These
are
really
the
boots
on
the
ground,
people
at
cmhcs
and
other
behavioral
health
services.
We
have
an
army
of
targeted
case
managers,
communities,
comprehensive
community
sports.
This
teaches
skills,
people
need
to
live
in
the
community,
it
may
be
understanding
their
illness,
it
may
be
accessing
care,
maybe
making
sure
their
bills
or
groceries
are
done.
These
are
skills.
People
may
not
have.
This
is
an
opportunity.
The
next
one
is
peer
support.
H
This
is
just
an
awesome
service.
Let's
expect
to
hear
more
about
that.
Maybe
the
best
example.
These
are
people
in
recovery
who
are
doing
well
well.
Stabilized
functioning
well
been
successful.
Based
on
dr
maron,
you
know
mccarran
doing
that
they're
helping
other
people
who
aren't
there
yet.
The
best
example
is
a
gentleman
who
had
frequent
admissions
to
one
of
the
state
psychiatric
hospitals
we
saw
earlier
went
back
home
got
service
and
support
is
now
helping
people
stay
out
of
the
hospital.
He
went
from
being
admitted
frequently
to
now
keeping
people
out
of
the
hospital.
H
He
has
a
full-time
job
he's
earning
benefits,
he's
a
homeowner
supporting
his
family.
That's
what
fear
support
can
do
for
people
pretty
significant
support
employment,
put
people
to
work,
that's
what
that's
about
not
a
medicaid
service.
These
other
medicaid
services,
state
general
fund
paid
for
that
got
some
grants.
Department,
vapor
health
really
helped
with
that
as
well.
Therapeutic
rehabilitation
is
a
day
program.
Three,
maybe
five
hours
a
day.
Three
five
days
a
week,
you
go
again
setting
you
go
to
a
building.
You
learn
either
just
skills
to
support
yourself
in
the
community
cooking
cleaning.
H
All
those
things
you
need
to
live
on
your
own
independently.
Some
have
changed
from
therapy
publication
to
social
club
drop-in
you
go
and
there's
groups
and
you
learn
skills.
I
think
there's
a
lot
of
sexual
programs
with
that
crisis.
Stabilization
units
mobile
units.
We
provide
those
services
that
makes
us
unique
as
a
cmhc
doing
this
crisis
stabilization.
H
That's
a
24
7
service.
It's
designed
to
keep
people
out
of
state
psychiatric
hospitals.
It's
also
a
step
down
from
state
psychiatric
hospitals,
get
discharged
from
eastern
state
western
state
central
state.
You
may
end
up
at
a
crisis
stabilization
unit
mobile.
Is
they
go
to
where
the
person
is
it's
not
a
building
one
center?
H
It
is
with
children's
services,
their
focus
on
putting
a
staff
person
in
the
home
in
a
crisis
or
putting
the
individual
in
like
an
overnight,
foster
care
couple
nights,
but
their
goal
was
to
keep
the
kid
in
their
school
district,
so
they
didn't
miss
school
12,
14,
15
year
olds
didn't
have
to
explain
to
people
why
they
were
gone
for
a
week,
so
they
kept
the
school.
That's
the
mobile
model,
medication
administration
heard
about
that
outpatient,
individual
kind
of
typical
services.
That's
the
core
services
cmhcs
provide
all
right.
H
H
Your
people
are
here
and
they're,
causing
problems
and
the
guy
I
worked
with
would
always
say
I
don't
have
people
they're,
not
my
people,
but
they're
not
welcome
and
that's
stigma
and
that's
a
persistent,
ongoing
problem
and
people
are
reluctant
to
access
services
reluctant
to
go
places
they're
not
always
welcome
at
primary
care
center
alvarado.
Some
folks
don't
want
to
see
them,
and
you
know
we
work
on
that.
We
try
to
make
that
better
for
folks.
So
that's
the
biggest
challenge.
H
Another
one
is
mcos.
You've
had
a
decade
of
managed
care
in
kentucky
like
a
look
at
the
effectiveness
of
managed
care,
the
prior
authorization
process.
I
know
that's
going
to
be
discussed
tomorrow
that
takes
time
away.
Our
clinicians
are
offline,
getting
services
approved
and
making
sure
this
happened.
Those
were
suspended
during
covid,
that's
wonderful,
they're
still
suspended,
but
prior
we
had
the
best
people
of
our
best
clinicians
offline.
H
Getting
prior
authorizations
approved
it's
a
common
practice.
It's
really
hard.
You
got
someone
who's
in
your
office
for
the
first
time.
It's
a
big
step
to
access
services
and
you
say:
can
you
wait?
You
know
we'd
like
to
start
you
we're
going
to
do
that,
but
we
got
to
make
sure
we
can
do
that.
So
that's
still
a
problem
payment
from
mcos.
I
have
monthly
calls
with
mcos
and
we
struggle
with
payments.
The
worst
situation
are
people
who
are
dual
eligible.
They
have
medicare
and
medicaid.
H
Medicare
is
almost
like
stigma,
doesn't
pay
for
all
services.
Medicaid
pays
for
doesn't
pay
for
all
classes
of
professional.
They
pay
for
psychologists,
licensed
clinical
social
worker,
not
master's
levels
in
psychology,
not
licensed
clinical
counselors.
They
won't
pay
for
that.
They
see
that
person
we're
told
you
have
to
build.
Medicare
medicare
will
not
communicate
with
you
on
an
eligible
on
a
person.
They
don't
support.
They.
H
You
know
it's
not
on
their
their
panel
they're
not
going
to
send
you
anything
on
the
licensed
marriage,
family
therapist,
certified
social
worker
not
going
to
do
that,
they're
not
going
to
send
you
anything
on
targeted
case
management
because
they
don't
pay
for
target
case
management.
They
don't
pay
for
day
programs,
they
don't
pay
for
it.
We
get
nothing
from
it.
So
we've
gone
back
and
forth
with
mcos
on
this
issue,
you're
almost
at
a
disadvantage,
we've
got
two
insurances,
you're
better
off
just
having
one.
We
can
manage
that
better.
H
Hopefully
we
have
that
resolved,
but
I've
been
at
this
thing
for
10
years
now
with
managed
care.
We
don't
know
that's
an
ongoing
struggle
for
us
how
to
make
this
happen.
I
want
to
say
coven
19.
Obviously
you
know,
we've
had
a
really
hard
time
the
expansion
of
telehealth,
sustained
cmhcs.
There's,
no
doubt
that's
the
case.
H
I
suspect
sustained
a
lot
of
providers
that
opportunity
that
were
given
to
us
by
the
cabinet,
medicaid
and
behavioral
health,
to
make
sure
we
were
seeing
people
and
somewhere
on
phone,
which
you
know
I
heard
from
many
clinicians
for
a
kid
in
crisis
or
a
family
member
in
crisis.
A
phone
is
a
great
way
to
communicate
with
the
clinician
as
opposed
to
waiting
to
your
appointment
or
doing
face
time
or
getting
on.
So
I
think
that
really
changed
health
services.
H
Adolescent
boys,
love,
telehealth,
they're
familiar
with
the
technology,
they
feel
good
about
it.
I
also
think
they
didn't
have
to
explain
to
anybody
where
they
went
their
friends
when
they
disappeared,
went
someplace
for
an
hour.
They
didn't
have
to
tell
where
they
were
at.
I
went
home.
Okay,
that's
kind
of
common
thing,
really
a
big
deal.
We
have
to
figure
out
who
is
telehealth
best
for
what
staff
are
most
effective
in
remote
services,
but
telehealth
saved
us.
So
we
hope
that's
going
to
continue.
H
Two
big
opportunities
I
want
to
talk
about
in
closing
one
is
a
certified
community
behavioral
health
center.
This
is
essentially
a
cmhc
in
the
21st
century.
This
is
a
result
of
work
at
our
federal
partners
for
a
long
time
to
make
this
happen
and
what
it
is.
You
have
core
services
you
have
to
provide,
and
those
are
your
lists
in
front
of
you.
We
do
a
lot
of
those
services
now
we
don't
do
nearly
as
well
with
primary
care
stuff.
H
We
do
some
primary
care,
we're
getting
better
at
it.
One
individual
told
me
their
primary
care.
They
have
a
couple
two
or
three
apr
wrenches
fill
in
the
week.
Diagnose
someone
with
cancer
wasn't
happening
before
convince
someone
to
get
the
kovid
shot.
They
were
afraid
of
needles,
don't
trust
anybody
they're
now
accessing
they
got
vaccinated.
These
are
all
things
that
we
now
do
in
pieces.
H
H
Why
do
we
tolerate
that?
A
lot
of
it
really
relates
to
social
terms,
health,
where
they've
lived
in
and
out
of
homeless
shelters.
You
know
exposure
to
hepatitis,
not
taking
care
of
themselves,
not
seeing
a
doctor
on
a
regular
basis.
This
has
been
a
real
barrier.
The
ccbhc
forces
us
to
address
that
we've
talked
about
it,
we've
networked
with
local
primary
care
providers.
This
puts
us
clearly
in
place.
We
have
to
do
this.
This
is
a
big
deal
for
kentucky.
In
my
opinion,
this
all
started
in
24
2015.
H
H
H
H
The
care
coordination
piece
is
significant.
We
want
to
partner
with
kayhi
the
vision
that
we
have
if
someone
shows
up
at
the
er
inappropriately
through
kayhi,
someone
on
call
to
mental
health
center
gets
alerted
they're
at
the
er
shouldn't
have
to
be
there.
That's
what
care
coordination?
Is
you
stop
er
uses
where
people
don't
need
the
er?
You
save
your
money
right,
senator
meredith,
that's
going
to
take
care
of
a
lot
of
that
peace.
A
lot
of
our
folks
show
up
for
no
reason.
H
So
that's
the
pieces,
ccbhc
we
were
hoping
that
would
go
live
october,
1..
It
now
go
live
january,
1.
heard
from
the
cabinet
january
1..
We
have
eight
quarters
of
that.
So
we're
going
to
go
january,
1
of
2022
through
december
31
of
2023
and
those
centers
are
seven
counties:
louisville
north
key
northern
kentucky
pathways
and
ashland
moorhead
and
new
vista
in
lexington.
So
those
four
have
been
working
hard
to
get
this
thing
in
place
to
be
a
ccbhc.
H
Our
objective
is
all
14..
What
has
happened
recently
in
kansas?
They
passed
legislation
directing
their
equivalent
of
a
cabinet
to
create
a
ccbhc
for
their
mental
health.
Centers
to
become
that,
because
what
happens
is
more
people
are
served,
more
staff
is
hired,
more
servers
are
provided
to
people.
The
last
thing
I've
said
this
before
an
smi
waiver.
Hopefully,
you've
all
heard
me
talk
about
an
smi
waiver.
It
goes
back
to
june
of
2019.
H
Hcb
waivers
are
people
who
are
aging
people
with
physical
disabilities,
people
with
brain
injury,
people
with
intellectual
disabilities
and
there's
11
15
waiver
for
people's
substance
abuse.
There
is
no
waiver
for
people
with
mental
illness.
A
waiver
can
provide
services
to
a
targeted
population
and
a
smaller
number.
It
can
include
a
residential
option.
H
People
can
live
three
people
to
a
home
like
in
the
scl
waiver,
with
24
7
supervision,
12
person,
12
hours
in
a
home,
half
time
supervised,
live
with
someone
make
sure
those
things
happen
also
provides
for
employment.
It
really
allows
people
to
have
a
home
and
get
a
job.
The
other
thing
it
does
is
make
sure
medication
is
taken
in
the
sel
waiver.
If
you
are
one
hour
late
on
prescribed
medication.
H
If
your
smi
and
I've
said
this
other
groups,
if
you're
one
hour
late
one
day
late
one
week
late
one
month
late,
no
one
knows
it's
not
working,
it
hasn't
worked.
We
have
to
do
better.
I
tell
you
who
knows
neighbors
know,
families
know
law
enforcement.
No,
we
have
to
do
better
and
I
think
we
can
do
better.
Those
are
two
opportunities
that
will
meet
the
needs
in
a
better
way
than
we
are
now
for.
I
Thank
you,
chair,
lady,
for
the
the
sake
of
the
committee.
What
is
mcc
billing
managed
care.
H
H
H
H
A
I
don't
see
any
other
questions.
We're
glad
to
have.
Senator
berg
know
that
you've
been
in
another
committee
meeting
and
since
we
don't
have
cloning
in
kentucky,
it's
hard
to
be
two
places
at
one
time
in
it.
Steve
thank
you
for
being
here,
and
I
know
that
you're
always
willing
to
keep
the
conversations
going
with.
G
A
Members-
and
I
have
some
really
good
friends
here
with
me
today,
who
are
here
to
introduce
one
of
their
really
good
friends.
I
have
kelly
and
phil
gunning
and
phil
is
the
executive
director
if
y'all
want
to
come
on
up
of
the
national
alliance
on
mental
illness
in
lexington.
Kentucky
and
kelly
is
the
director
of
advocacy
and
public
public
national
alliance
on
mental
illness
and
she's
also
from
lexington,
and
we
have
with
them
today.
Then
one
of
our
infamous
and
very
superior
judges
over
in
lexington
judge
john
tackett
judge.
A
J
Certainly
I'll
go
ahead
and
introduce
myself
sure
news
to
me.
I
was
superior,
I'm
district
court
which,
if
you're
familiar
with
the
district
court,
that's
at
the
very
bottom
of
our
totem
pole.
You
know
so,
but
I
appreciate
the
good
positive
thoughts
about
the
superiority
again.
I'm
john
taken
and
I'm
district
court
judge
fifth
division
of
fayette
district
court.
Now
I
did
want
to
ask
you
senator
how
much
time
do
we
have
to
present.
J
A
So
is
that
what
you
thought
kelly.
A
J
I'll
go
ahead
and
present,
then
thank
you
again.
It's
an
honor
to
be
here
and
it's
a
real
pleasure.
For
me.
The
fayette
mental
health
court
was
founded
upon
a
concept
of
criminal
justice
reform
to
promote
human
dignity,
restore
personhood
and
decriminalize
mental
illness.
These
values
and
actual
goals
are
embedded
in
every
facet
of
our
court
process
through
a
fidelity
to
therapeutic
justice.
Participants
are
accountable
to
our
court,
which
includes
personal
and
societal
responsibility,
to
become
a
leader
in
their
own
lives
and
to
install
a
spirit
of
health
stimulation
sobriety.
J
One
key
difference
between
our
court
and
other
models
around
the
state
is
that
our
court
is
comprised
of
almost
entirely
nami
advocates.
The
same
peer
support
that
mr
shannon
was
speaking
about
earlier,
as
opposed
to
state
court
employees,
a
supreme
court
order
establishing
order,
I
should
say
signed
by
chief
justice
minton
at
the
founding
judge's
request,
allows
for
nami
advocates
to
serve
in
this
capacity.
J
This
allows
for
a
more
specialized
advocacy
from
our
team
beyond
the
restraints
that
state
employees
find
themselves
tethered
to.
Essentially,
this
team
can
advocate
for
participants
where
many
state
employees
cannot.
We
have
been
fortunate
so
far
to
have
this
model
funded
through
the
lexington
fayette
urban
county
government.
Throughout
the
course
of
our
operation.
J
Our
staff,
again
run
through
nami,
receives
referrals
from
law
enforcement,
prosecutors,
defense,
attorneys
and
judges
to
intervene
in
the
lives
of
criminal
defendants
who
suffer
from
diagnosable
and
serious
mental
illness.
An
overwhelming
majority
of
our
participants
are
duly
diagnosed
suffering
from
both
mental
illness
and
drug
and
alcohol
addiction.
Most
of
the
individuals
we
serve
have
been
flagged
by
law
enforcement
because
they
have
long
history
of
criminal,
recidivism
are
unemployed
and
or
unstable.
J
J
A
few
have
been
abandoned
by
family
and
friends
and
have
not
experienced
the
high
level
of
nurturing
and
support
to
become
stabilized
until
they
meet
reach
our
court.
Our
court
is
equipped
to
provide
our
participants
with
wraparound
services
to
address
their
mental
health
needs
generate
recovery
from
their
addiction.
J
Our
aim
is
to
lead
participants
to
a
life
of
stability
and
lawfulness
and
hopefully
gainful
employment.
While
this
court
has
only
been
in
existence
for
a
few
years,
it
has
done
amazing
work
and
provided
stability
to
many
repeat
offenders.
Our
success
rate
is
remarkable.
It
really
truly
works.
Our
participants
often
find
stability
while
involved
in
the
program
for
those
of
you
who
serve
the
commonwealth
but
may
not
be
well
acquainted
with
this
side
of
our
justice
system.
J
I
wanted
just
to
provide
you
with
an
example
of
a
typical
criminal
defendant
with
a
mental
illness,
and,
let's
call
her
ashley
ashley
suffers
from
serious
mental
illness
is
arrested
for
violation
of
a
domestic
violence
order
for
contacting
an
estranged
family
member.
Her
pretrial
report
reflects
she
is
a
high
risk
for
not
coming
to
court,
so
the
judge
will
impose
a
bond
she
cannot
afford.
J
J
Nuvista
recommends
the
judge
sent
ashley
to
eastern
state
hospital
for
a
formal
evaluation
to
be
performed
by
a
licensed
psychologist.
It
takes
two
months
to
obtain
a
formal
competency
report
where
either
ashley
is
at
fcdc
or
eastern
state.
At
approximately
120
a
day,
the
eastern
state
hospital
report
issued
by
the
psychologist
finds
ashley
unable
to
participate
in
her
defense
and
lacking
the
requisite
mental
ability
to
understand
the
criminality
of
her
action.
A
week
later,
ashley's
defense
attorney
and
the
prosecutor
move
as
a
matter
of
law
for
ashley's
case
to
be
dismissed.
J
J
This
court
is
designed
and
meant
to
intervene
in
lives
such
as
ashley's
and
break
that
destructive
cycle.
Our
court
is
run
through
an
intensive
case
management
program
holding
participants
accountable
through
the
black
robe
effect.
Our
team
would
transition
to
participants
such
as
ashley
through
four
phases,
stabilization
treatment,
self
self
motivation
and
wellness,
and
I
can
speak
to
those
in
detail
if
you
all
want
me
to
pursue
that,
but
in
the
interest
of
time
I'm
going
to
skip
and
just
tell
you
that
each
phase
basically
lasts
about
three
months
at
least
a
minimum
of
three
months.
J
Our
team
performs
a
never-ending
array
of
services
tailored
to
the
uniqueness
of
the
client
and
their
needs,
ensuring
that
they
keep
maintained,
doctor's
appointments,
psychiatrists
and
psychologists.
Reportments
help
navigate
insurance
and
government
resources
to
pay
for
mental
health
services
and
medications,
ensure
housing
needs
are
met
and
the
participants
working
towards
stable
housing,
guiding
a
participant
to
group
meetings
in
mental
health
programming.
J
If
unemployed,
we
conduct
court
each
week,
which
involves
two
hours
of
staffing
we,
our
team
is
comprised
of
myself
an
assistant
prosecutor,
team
members
who
are,
as
we
said,
mostly
peer
support
and
nami
nami
advocates
community
licensed
psychologists
and
experts
from
eastern
state
hospital,
new
vista
university
of
kentucky
graduate
students
and
officer
from
our
adult
probation
office.
We
also
work
in
concert
with
cit
trained
officers
from
the
sheriff's
department
and
police.
J
J
As
the
judge
for
the
mental
health
court,
I
am
a
cheerleader
enforcer
advocate
strategist
counselor,
coach
promoter,
but
most
of
all,
I
just
try
to
be
the
very
best
listener
and
encourager
for
our
participants
without
a
doubt,
wednesday's
afternoons
which
can
last
anywhere
from
what
five
to
seven
hours
on
you
know
it
just
depends,
are
the
most
challenging
time
I
spent
in
my
work
week
to
keep
participants
accountable.
We
employ
sanctions,
we
call
them
electives,
they
are
therapeutically,
grounded
and
formed.
J
They
can
range
from
additional
group
meetings
more
frequent
drug
or
alcohol
testing
recovery
related
research.
Unfortunately,
it's
a
sad
reality
that
we
do
have
to
use
incarceration,
but
a
lot
of
times
it's
always
used
as
a
last
resort
and
may
be
employed
just
to
keep
a
participant
safe
because
there's
no
reasonable
alternative
for
placement.
J
If
that
person
is
experiencing
an
extremely
life-threatening
addict,
active
addiction
or
if
the
person
is
at
risk
for
future
victimization,
if
remaining
in
the
community,
so
I
would
just
indicate
that
jails-
you
know
they're
meant
as
punishments
and
are
in
jails,
are
intended
to
have
a
negative
impact.
Naturally,
the
atmosphere
of
detention
centers
runs
counter
to
treatment
or
helping
anyone's
mental
health.
I
certainly
don't
want
to
be
there
and
I
don't
think
you
all
do
either,
so
it
is
viewed
as
a
last
resort.
J
Many
of
our
participants
can
be
engaged
in
this
program
for
longer
than
a
year
upon
successful
graduation.
That
participants
have
been
sober
for
at
least
a
year,
and
the
criminal
charges
are
ultimately
dismissed
and
their
records
are
expunged.
Unfortunately,
to
provide
these
services,
we
are
forced
to
limit
our
capacity.
J
Our
local
defense,
attorneys
and
prosecutors
understand
that
we
have
a
long
wait
list
for
placement.
Additional
funding
would
undoubtedly
expand
this
court's
mission
and
achieve
more
assistance
for
more
defendants.
If
additional
funding
was
available,
judicial
resources
would
be
allocated
to
meet
the
demands
of
more
participants
in
a
bigger
dark
docket.
J
We
see
a
need
for
aftercare
program.
I'll
say
that,
just
briefly
that
we
we
typically
without
that
accountability,
relapse
is
definitely
possible
and
that
would
be
run
through
peer
support
in
our
graduates.
J
Again,
thank
you
very
much
for
giving
me
the
opportunity
to
speak
to
you
all.
I
would
extend
each
one
of
you
that
an
invitation
to
come
visit
us
and
step
into
the
staffing
or
our
actual
court,
or
both
we've
had
a
lot
of
council
members
that
sit
in
and
it's
the
same
invitation
be
open
to
you
and
I'd
be
happy
to
answer
any
questions
after
we're
concluded.
So.
A
A
G
Thank
you
all
for
this
opportunity.
Of
course,
I
get
to
as
usual
follow
these
outstanding
presenters
and
I
need
a
powerpoint
to
to
do
what
I'm
doing.
I
want
to
show
you,
though,
just
a
little
bit
about
some,
the
nuts
and
bolts
and
the
return
on
investment.
G
Okay
judge
mentioned
our
team,
we
have
a
team
of
10,
and
that
includes
judge,
prosecutor
and
public
defender
and
then
seven
folks,
who
are
all
family
members
and
or
consumers
of
mental
health
services,
and
in
addition
to
that,
many
of
them
are
professionals.
We
have
a
a
lot
of
letters
in
our
team,
lcsw's
msws.
G
We
have
people
with
multiple
bachelor's
degrees
and
corrections
and
mental
health.
So
it's
a
it's
pretty
outstanding
team.
But
again
the
fact
that
these
folks
all
have
lived
experience
is
what
we
think
is
the
magic
of
this
model.
G
I
won't
go
into
this
picture
in
great
detail
other
than
to
let
you
know
that
this
was
put
together
by
one
of
our
peers,
who's
on
the
team
and
speaks
to
his
journey
from
old
life
to
new
life,
and
you
see
some
some
things
in
here.
You
know
addiction
and
then
nasw
he's
actually
on
the
board
of
national
association
of.
G
G
You
you
just
can't
be
as
effective
as
somebody
with
lived
experience.
They
can
gain
the
trust
of
folks
where
oftentimes
professionals
cannot.
They
are
professionals,
but
this
slide,
I'm
not
sure
we
had
our
peer
team
put
these
together.
I
think
this
one
just
shows
some
of
the
things
nami
lexington's
involved
in
steve
spoke
to
stigma,
and
this
slide
again
was
put
together
by
our
peer
team.
G
We
think
not
only
is
it
stigma,
that
is
a
barrier
to
access
for
the
participants,
but
it's
a
barrier
to
access
to
funding
for
some
programs
that
are
very
effective,
very
innovative,
but
don't
get
a
lot
of
attention
because
it
is
serious
mental
illness
and
very
honestly,
serious
mental
illness
doesn't
get
a
lot
of
attention
for
funding
and
we
think
that's
because
of
stigma,
so
so
stigma
doesn't
just
relate
to
the
participants.
G
This
one
was
made
by
our
court
coordinator,
she's,
also
a
peer,
and
she
mentioned
that
helping
a
participant
through
this
journey
is
kind
of
like
helping
them
climb.
A
rock
wall,
there's
so
many
different
things
you
have
to
touch
on,
and
you
see
the
mental
health
court
person
down
in
the
bottom,
providing
the
security
and
the
support
for
them
to
go
through
and
and
touch
on
all
these
different
services
and
benefits
that
they
need.
G
G
What
you
don't
see
is
any
connection
between
this
participant
and
these
services
on
this
slide
and
the
next
one
you
see,
spokes
the
mental
health
court
team
helps
the
participants
connect
to
all
these
various
services
and
stay
connected
to
them.
They
teach
them
this.
The
skills
that
it
takes
to
remain
compliant
and
to
stay
in
touch
judge
mentioned
accountability
for
the
participants.
G
This
team
also
is
a
team
of
very
headstrong
advocates,
and
they
make
sure
that
there's
accountability
on
the
service
side,
too
steve
mentioned
some
of
the
challenges
with
the
mcos
and
we're
we're
constantly
testifying
to
those
challenges
because
they're
front
and
center,
you
know
with
our
population
every
day.
G
This
is
a
another
slide
that
came
from
some
of
the
peers
in
recovery,
but
also
from
some
of
the
graduates,
and
I
want
you
to
know
that
just
notice
the
different
language.
G
This
slide
shows
some
of
the
outstanding
outcomes
that
we
have.
I
think,
when
you
have
75
percent
of
participants
coming
into
a
program
unemployed
and
71
percent
leaving
employed,
that's
pretty
outstanding.
G
In
addition,
the
the
rest
of
that
population
are
engaged
if
they're
not
employed,
they
are
engaged
in
volunteer
services.
They
frequently
are
reconnected
with
their
families
and
communities.
That's
cool,
so
yep
many
of
them
back
to
school,
so
their
lives
are
back
on
track.
G
This
speaks
to
an
investment
that
has
an
incredible
return.
We've
been
doing
this
for
20
years
now
kelly
and
I
and
we've
developed
a
lot
of
programs.
This
one
still
blows
my
mind
on
the
money
side
from
july
118
through
december
31
2020,
we
had
a
total
of
455
000
in
funding.
G
G
G
Put
those
two
together,
you're
looking
at
nearly
six
and
a
half
million
dollars
in
savings
on
a
455
000
investment
over
a
two
and
a
half
year
period.
G
Again,
our
graduates
are
not
only
back
on
track
in
their
own
lives,
but
many
of
them
are
providing
mentoring
and
peer
support
services
to
others.
G
They're
contributors
through
their
employment,
they
pay
taxes
they're
members
of
the
community
again,
the
value
that
they
create
is
ongoing.
Just
like
the
savings.
The
cost
savings
are
so
these
numbers
it's
time
to
update
this
again.
We've
just
got
another
quarterly
report
on
in
so
we've
got
six
more
months
of
data.
What's
fun
for
me
is
every
time
I
go
through
and
update
this.
The
numbers
just
get
better.
A
K
Yes,
I
I
just
want
to
speak
to
you
about
how
the
mental
health
court
we
took
two
and
a
half
years
of
a
community
decriminalization
committee
to
develop
with
decision
makers
from
law
enforcement,
criminal
justice,
mental
health,
primary
care-
you
just
you
ask
who
was
there?
It
was
everybody
that
touches
these
individuals.
K
I
want
to
let
you
know
that
in
that
two
and
a
half
years,
connie
milligan,
and
I
and
judge
wilkie,
really
drove
this
train.
We
really
drove
it
to
judge
minton
and
the
honorable
john
landon,
who
helped
us
create
the
regs
for
our
court,
which
are
different
from
a
drug
court.
I
want
to
make
a
very
distinct
difference
between
those
two
things,
even
though
80
percent
of
our
clients,
right
now
in
court,
have
a
co-occurring
substance,
use
disorder
and
serious
mental
illness,
as
outlined
by
mr
shannon.
You
saw
what
those
serious
mental
illnesses
are.
K
They're
on
methamphetamine,
which
is
being
cut
with
fentanyl
they're
smoking,
weed
and
they're
drinking
alcohol,
so
they're,
quadruply
addicted.
That's
poly
substance
use
101
they're,
the
poster
child.
Why?
Why
are
they
using
all
these
drugs?
Because
what
came
first
was
the
serious
mental
illness
or
trauma.
K
K
K
K
How
is
a
kid
that
was
taken
at
three
years
old
and
given
as
a
down
payment
for
drugs
to
a
drug
dealer
ever
going
to
grow
up
normal,
go
to
school,
be
able
to
learn
in
trauma?
What
happens?
Is
your
brain
goes
into
overdrive
in
your
amygdala,
which
controls
your
fight-or-flight
responses
to
life
you're
only
being
driven
by
survival?
K
So
when
you
begin
to
get
old
enough
and
you're
feeling
uncomfortable
and
you're
getting
in
trouble
at
school,
you
start
smoking
a
little
reefer.
You
start
smoking
weed,
maybe
you're
getting
into
the
liquor
cabinet
at
home.
Maybe
you're
really
escalating
quickly
to
hard
street
drugs
you're
not
going
to
have
much
of
a
chance.
K
K
This
is
a
way
of
doing
mental
health
court
that
was
started
by
judge
ginger
learned
wren
in
florida.
I
am
a
disciple
of
hers.
I've
talked
to
her
on
the
phone.
I've
read
her
book.
I've
done
everything
that
she
tells
me
to
do
and
her
words
for
what
we're
doing
are
called
therapeutic
jurisprudence
different
from
a
drug
court,
non-punitive
really
meeting
people
where
they
are
really
finding
out
that
they're
going
to
need
everything
on
that
spoke
wheel.
All
those
community
partners,
this
mental
health
court
in
any
place
in
this
state
will
not
survive.
K
If
there's
not
strong,
cmhc's
representative
bentley,
they
are
the
backbone,
not
the
bhsos,
the
cmhcs
that
know
your
communities
know
your
people,
they're
regional,
they're,
empowered,
they're,
quasi-governmental
they're
not
going
away.
Hopefully
we
can't
operate
without
the
upstream
and
downstream
crisis
services
and
services
that
these
individuals
will
need
for
the
rest
of
their
life,
and
you
look
at
that.
You
go
the
rest
of
their
life.
K
K
So,
yes,
it's
a
lot,
but
look
at
the
money,
we're
saving.
What
what
you
heard
from
dr
mccarron,
what
you
hear
from
senator
alvarado
and
all
of
us
all
the
time,
these
solutions?
Don't
cost
more
money,
they
don't
and
they
have
real
results.
What
we
need
to
stop
doing
is
paying
for
programs
that
don't
work.
K
K
K
K
How
can
we
get
him
out
of
that
system
of
jail
and
prison
and
the
street?
And
back
so?
We
need
this
whole
system
when
you
saw
on
that
slide.
That
phil
showed
you
with
the
the
graphs
of
the
drug
substance,
use
and
abuse.
Where
was
that,
when
I
was
going
to
pull
it
out
for
you
just
real
quick,
you'll
notice
in
the
last
couple
of
years,
those
graphs
weren't
as
big
as
the
first
year
see
that
you
see
these
two,
how
they
go
down
a
little
bit,
they're
still
huge
and
above
the
national
average.
K
But
the
reality
is
that's
a
funnel.
There
are
so
many
addicted
and
co-occurring
and
sick
substance
use
people
out
there
that
they're,
clogging
up
the
treatment
lanes
and
like
what
dr
mccarron
and
dr
alvarado
and
steve
said.
We
don't
have
enough
providers,
then
you
get
someone
with
serious
mental
illness
and
we're
trying
to
make
referral
calls
to
places
that
are
supposed
to
treat
people
that
have
both
co-occurring
and
serious
mental
illness
as
soon
as
they
hear
that
you
have
someone
with
a
paranoid,
schizophrenia,
diagnosis
and
you
want
to
send
them
to
their
treatment
center.
K
K
So
I
would
just
like
to
open
it
up
to
questions.
I
know
I'm
intense,
I
know
I'm
passionate,
but
I've
got
a
fix
for
all
the
other
people.
What
wasn't
in
place
for
me
when
my
family
needed
it?
So
forgive
my
intensity
and
I
won't
apologize
for
my
passion.
You
guys
are
doing
god's
work
with
us.
We
love
you,
we
appreciate
you,
we
know
we
have
huge
advocates
on
this
team
and
we're
right
there
with
you
fighting
every
step
of
the
way.
Thank
you
very
much.
A
A
K
They
will
work.
If
you
build
it,
they
will
work
and
they
will
save
you
money,
they'll,
save
the
detention
and
the
criminal
justice
system's
money.
When
we
went
to
lfucg
for
our
funding,
they
told
us
that
the
detention
center
was
a
black
hole
because
of
the
cost
to
treat
people
with
smi
that
are
incarcerated.
K
F
F
First,
I
want
to
thank
you
for
your
presentation
and
I
don't
think
you
ever
have
to
apologize
for
the
passion
you
bring
to
to
this
committee,
for
particular
with
the
members
that
are
here.
We
share
in
that
passion
and
appreciate
the
work
you
do.
I
I
think
you
may
have
answered
my
question
for
me,
but
I
just
want
to
make
sure
maybe
you
validate
it
first,
I
want
to
congratulate
you
on
your
vision.
F
K
Yes,
sir,
access
to
funding
so
far,
we've
been
fortunate
in
having
fayette
county
lexington.
Fayette
urban
county
government
fund
us,
but
we're
down
to
having
used
three
or
four
different
funding
sources
within
their
government
budget,
and
we
don't
have
a
line
item
in
their
budget.
J
Well,
I
guess
at
the
fourth
run,
you
know
when
I
look
around
the
room
when
I'm
doing
court,
I'm
the
only
aoc
employee
in
the
room.
You
know
I
don't
have
a
clerk
or
anything
like
that,
but
you
know
I've
stressed
the
the
positives
of
that.
You
know
as
far
as
this
peer
support
model
that
we
were
built
upon
administratively,
you
know
we've
made
it
work
I'll
just
say
that
I
think
more
to
the
circling
back
to
kelly's
point.
It's
a
matter.
It's
a
matter
of
the
funding.
You
know.
J
If
the
funding
was
there
to
support
this
model,
we
can
certainly
you
know,
we'd
be
able
to
seize
over
many
many
hurdles
so
and
it's
really
about
our
dockets
too
and
I'll
just
reiterate
the
the
waiting
list.
I
mean
this
is
a
you
know.
Unfortunately,
for
us,
we've
got
folks
it's
a
long
program
and
of
course
you
all
are
familiar
with
mental
health.
It's
fluid
you
know
and
to
get
someone
stabilized,
it's
not
going
to
be
30
days.
It's
not
going
to
be
90
days.
J
I
mean
we're
looking
at
you
know
a
year,
and
so
you
know
it's
common
that
our
people
are
in
the
program
year,
two
years
to
get
stabilized
that
takes
up
the
space
for
a
referral.
So
you
know
we
can
only
help.
So
many
because
we've
got
such
you
know
so
many
resources
to
help
so
many
people,
but
we're
getting
referrals
all
the
time
and
we
just
have
to
say
look
we
have
to
wait,
we
don't
have
a
spot
available
for
you
and,
of
course
you
know
with
funding.
We
could,
you
know,
run
a
second.
J
K
And
we
just
helped
start
the
first
ever
in
the
state,
we'll
be
starting
in
fayette
county,
the
first
juvenile
mental
health
court.
Why
is
that
important?
Because
we
want
to
get
upstream?
We
want
to
start
when
these
kids
are
young
before
they
get
indoctrinated
to
you
know,
gangs
and
drugs
and
violence
and
they've
already
got
huge
trauma
histories.
Their
aces
scores,
which
measure
trauma
are
through
the
roof,
they're
all
tens.
K
So
we
want
to
start
early,
so
judge
lindsey
thurston
is
going
to
be
doing
it
with
judge
melissa,
moore
murphy
will
be
starting
the
first
juvenile
treatment
court
any
minute.
Now
we
were
able
to
secure
100
thousand
dollars
in
startup
funding
for
that
juvenile
treatment
court
through
lfucg,
based
on
the
success
of
the
fayette
county,
adult
mental
health
court.
So
we're
very
thankful
and
excited
about
that.
K
I
will
say
we
started
this
court
with
no
money
was
volunteer,
everybody
from
the
judge
to
every
single
person,
and
we
by
our
first
quarter
stats
were
so
good.
We
were
able
to
go
to
the
council,
then
and
ask
for
money
and
have
a
proven
outcome
record
by
that
point,
and
we
started
that
with
funding
from
the
nami
walk
senator
kerr.
So
you
know,
if
you
build
it,
they
will
come
and
it
will
work.
F
C
You,
madam
chair,
and
thank
you
all
I
mean
passion
is
not
a
concern.
I
mean
people
on
this
committee,
all
pretty
passionate
medical
folks,
that's
what
we're
used
to
and
that's
you
know
we
all
share
in
that.
You
know
when
you
talk
about
people
getting
into
the
criminal
system
and
it's
a
black
hole
generally
society
has
liked
it
that
way.
Right
these.
C
E
C
Something
and
so
for
a
lot
of
folks,
that's
always
been
the
kind
of
standard
it
doesn't
work.
I
mean
it
doesn't
fix
things
and
haven't
been
a
jail
doc
before
you
know,
you
know
and
again
a
lot
of
providers
are
just
uncomfortable
sure.
K
C
In
cmhcs-
and
you
know,
you'd
have
to
have
a
heck
of
a
lot
of
those
to
handle
the
volume
that
we
need.
So
there's
going
to
be
a
you
know,
and
I
think
senator
meredith
kind
of
you
know
kind
of
took
my
thunder.
A
little
bit
is
to
ask
you
know,
bring
these
task
forces.
We
need
to
have
solutions,
we're
asking
people
that
present.
C
What
is
it
that
you
would
like
to
see
happen
because
we'll
have
recommendations
at
the
end
of
this
by
the
by
the
time
we
get
ready
for
the
next
session
and
hopefully
some
bills
to
propose
of
things
that
we
can
do.
Sometimes
those
things
are
hurt
sometimes
they're
not,
but-
and
we
know
that
a
lot
of
investments
in
health
care
is
typically
again
it's
it's
an
ounce
of
preventions
worth
a
pound
of
cure.
C
It's
often
just
convincing
our
chairman
of
our
budget
committees.
You
know
when
they
say
that
they
go
we've
heard
that
before,
and
they
don't
often
believe
it.
But
if
we
have
statistics
to
show
them
to
say,
hey,
look
a
little
bit
of
just
a
little
bit
of
investment
here
is
gonna.
Have
a
lot
of
back-end
benefit.
C
You
know
to
have
those
recommendations
and
again,
if,
if
they're
doing
it
in
fayette
county
for
a
couple
hundred
thousand
dollars,
I
saw
on
that
just
to
manage
this
and
say:
hey
look
if
we
could
open
up
a
bunch
of
regional
mental
health
corps
around
the
state
who
could
help
help
with
these
things,
that'd
be
of
benefit,
and
just
when
you
mention
about
you
know
kind
of
adolescent
or
kid
I
mean
I
remember
just
most
of
us.
Your
schizophrenics
are
showing
signs
at
the
age
of
12.
C
You
start,
you
start
catching.
You
start
seeing
odd
changes,
typically
in
junior
high
and
a
lot
of
those
kids
will
exhibit
behaviors.
Some
states
are
starting
to
take
it
on
themselves
to
also
start
screening
and
identifying
those
kids
early
and
start
interventions
early
and
again,
all
that
takes
investment
and
money
and
that's
always
the
hard
part
of
it.
So
if
you
guys
have
recommendations
to
say
hey
this
much
would
operate
this
many
courts.
We
would
ask
this
much
from
this
committee.
Just
something
in
writing
would
help
us
so.
C
Be
wonderful
if
again,
if
the
courts
could
even
offer
some
of
that,
that
would
be
helpful
just
to
say
this
is
what
it
would
require
and
if
we
have
judges
who
are
willing
to
do
it
and
again
it's
just
a
matter
of
with
today's
testimonies
saying
we
have
to
have
more
providers,
maintain
our
cmhcs
and
more
drug
courts
to
help
with
or
not
checkpoints,
mental
health
courts
to
help
with
a
lot
of
these
things,
I
think
it'd
be
a
tremendous
benefit,
but
thanks
for
your
testimony
on
those
issues,
that's
kind
of
what
I
wanted
to
ask.
C
K
Really
wanted
to
be
sure
before
we
we
did
the
ask
to
make
sure
you
understood
how
much
it
works
for
how
little
money
I
mean,
if
you
see
the
outcomes
for
such
little
investment.
That's
where
a
lot
of
the
stigma
that
steve
was
talking
about
comes
from
in
mental
health
programming
is
that
people
just
think
it's
throwing
money
out
the
window.
Well
now
we
can
really
prove
that
it
isn't
that
there
are
returns
on
investment
when
you
invest
in
in
the
mental
health
of
our
commonwealth,
and
the
other
thing
is
with
covid.
K
The
the
numbers
that
mccarran
put
up
are
a
little
outdated,
they're
low.
You
know,
overdose
is
huge.
Now
it's
through
the
roof,
it's
50
percent
higher
than
it
was
two
years
ago,
madison
county
loans
up
75
percent
we've
got
35
to
40
percent
of
all
school-age
children,
reporting,
serious
symptoms
of
anxiety
and
depression
since
covid.
K
E
Thank
you,
madam
chair,
yes,
and
thank
you
guys
so
much
for
this
presentation
and
and
for
the
work
that
you're
doing,
and
I
mean
I
just
appreciate
what
I'm
hearing
from
my
colleagues
too.
Just
you.
B
E
And
so
you
talk
about
the
return
on
investment
and
the
money,
we're
saving
this
much
money
from
corrections,
we're
saving
this
much
money
from
police
and
to
one
of
you
know,
senator
meredith's
themes.
The
resources
are
there.
We
need
to
have
them
directed
in
the
right
place,
so
as
you're
saving
dollars
from
these
other
agencies.
Has
there
been
any
movement
toward
reallocating
those
dollars
that
you're
saving
into
this
type
of
work?
Phil.
G
We've
had
meetings
and
we
had
discussion.
Timing,
wasn't
our
friend
a
couple
of
times.
G
Our
commissioner
of
public
safety
in
fayette
county
was
recruited
to
go
with
judge
noble
to
to
frankfurt,
and
that
was
right
after
we
thought
he
was
committed
to
funding
the
court
on
behalf
of
the
jail
and
law
enforcement.
G
So
that
kind
of
just
fell
aside
when,
when
he
wasn't
there
anymore,
I'm
talking
about
ronnie
bass
and
then
we
we
had
the
discussion
again
and
coveted
hit
and
it
seems,
like
everything's,
been
sort
of
on
hold.
So
the
answer
is
no.
G
We
haven't
been
able
to
get
there
yet,
but
we
have
had
those
discussions
and
they've
all
been
positive
and
the
people
who
can
make
those
decisions
all
agree
that,
yes,
this
money
needs
to
come
out
of
public
safety
because
that's
where
the
biggest
savings
are
there's
a
lot
of
other
places
where
we
could
identify
savings.
If
we
could
get
data,
but
we
can't
get,
we
can't
get
the
er
data
from
regular
hospitals.
We
it's
very
hard
because
of
confidentiality
to
get
anything
from
the
psychiatric
hospital.
So
there's
a
lot
of
different.
G
You
know
we
think
people
benefiting
from
these
services,
but
it's
really
hard
to
actually
put
that
on
a
slide.
A
J
So,
at
any
rate,
I'll
tell
you
this
in
preparing
for
today
I
went
back
and
looked
at
some
of
our
you
know:
greatest
misses
just
some
criminal
defendants
that
were
really
tough
cases
that
didn't
succeed.
J
K
And
the
ers
are
a
huge
thing
that
we
haven't
been
able
to
quantify,
but
steve,
shannon
and
I,
a
few
years
ago,
did
kind
of
a
mock-up
on
one
of
our
familiar
faces
that
that's
what
the
system
calls
these
people
that
they
see
all
the
time,
and
this
person's
thing
was
every
time
they
would
get
in
trouble
or
or
have
a
psychotic
episode.
They
would
go
to
the
er.
K
J
As
an
attorney
I'll
tell
you,
you
know
speaking
to
you
as
an
attorney
for
15
years
before
I
was
a
judge,
you
know
I
remember,
being
a
criminal
defense
attorney
before
the
mental
health
courts
existence
and
having
family
members
come
and
say
you
know
what
can
I
do,
and
I
mean
it's
just
an
amazing
tool
for
our
defense
bar
for
our
prosecutors
to
send
a
really
troubled
person
to
this
court
to
receive
those
services
in
it
which
didn't
exist.
You
know
seven
or
eight
years
ago.
A
K
A
I
wanted
to
tell
y'all
before
we
adjourn
and
again
thank
you.
Thank
you
very
much
we're
going
to
have
our
next
meeting
on
august
17th
at
3
p.m.
So
I'd
appreciate
if
all
the
members
and
staff
and
others
would
take
note,
and
I
would
now
take
a
motion
for
adjournment.