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From YouTube: Child Welfare Oversight and Advisory Committee (9-13-22)
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B
A
Here
at
this
time,
I
will
entertain
a
motion
to
approve
the
previous
minutes.
You
should
have
had
the
chance
to
look
over
those
those
were
in
your
packet.
It
was
sent
to
you
earlier.
We
have
a
motion
in
a
second
all.
Those
in
favor,
please
signifies
saying
aye
all
opposed,
nay,
motion
carries
and
minutes
are
adopted.
We're
gonna
go
ahead
and
get
started
and
move
through
this.
We
have
a
lot
on
the
agenda
today
and
I
think
that
is
Dr
Milner
with
us.
Now
all
right,
we
have
Dr
Jerry
Milner
with
us.
A
I
have
heard
Dr
Milner
speak
at
several
national
conferences
and
I
wanted
him
to
come
and
speak
to
us
about
what
I've
heard
him
speak
about,
especially
with
preventative
Services.
I
know
that
that
is
a
passion
for
many
of
us
in
this
room
and
something
that
we
have
pushed
very
hard
for
for
the
past
few
years,
but
I
enjoy
his
his
comments
on
that
when
we
go
to
the
the
conferences,
but
not
only
just
the
preventative
Services,
but
making
sure
that
we
are
using
the
appropriate
and
the
correct
preventative
Services.
D
D
I've
been,
let
me
go
ahead
and
just
ask
that
we
advance
to
the
next
slide.
If
that's
okay,
I've
been
told
real,
clearly
I
I
don't
need
to
convince
this
group
of
of
why
prevention
is
is
important,
so
I
won't
try
to
do
that
for
for
some
context,
however,
and
and
some
basis
for
the
things
I'll
say,
I'll
I'll
run
through
just
a
few
things
to
make
sure
we're
all
thinking
about
this.
D
From
the
same
starting
point,
you
know
we
we've
got
over
400
000
kids
in
foster
care
across
across
the
country.
Right
now,
most
of
those
kids
are
in
foster
care
solely
due
to
whatever
it
is
that
we
call
them
neglect,
not
necessarily
abuse
physical
abuse,
sexual
abuse,
other
kinds
of
abuse
and
a
lot
of
those
children
come
from
families
where,
with
proper
supports
in
place,
they
could
remain
safely
together.
D
Another
part
of
that
that
troubles
me
greatly
is
just
the
subjective
and
nebulous
nature
of
the
term
child
neglect.
It
may
mean
something
totally
different
in
Kentucky
than
it
means
in
other
states.
I'm
sitting
in
Florida
I
have
some
of
a
sense
of
what
it
means
down
down
here,
but
it
varies
from
state
to
state
I.
D
Actually,
when
I
was
thinking
about
this
just
just
realized
a
couple
of
years
ago,
that
I
was
what
now
we
would
call
a
free-range
child
could
maybe
have
been
picked
up
and
put
in
foster
care,
not
because
I
was
being
neglected,
but
because
my
dogs
and
I
would
spend
entire
days
Roman
roaming
around
the
countryside,
where
I,
where
I
live.
We
do
pick
kids
up
and
put
them
in
foster
care
in
some
places
in
the
country
for
that
and
call
it
lack
of
lack
of
supervision.
D
The
problem
is
worse:
if
you're
a
black
child
you're
about
two
times
as
likely
to
enter
foster
care
as
a
white
child,
if
you're
indigenous
you're
about
three
times
as
likely
and
if
you're,
poor,
you're,
always
more
likely
to
in
our
foster
care.
If
you're
one
of
those
20
000
young
people
who
age
out
of
foster
care
at
eight
18
or
21
every
year,
you
are
at
Great
risk
of
homelessness,
not
going
to
college
or
even
completing
more
fundamental
education.
D
You
are
at
Great
risk
of
going
into
the
justice
system
not
being
employed
and
if
you're,
a
young
woman
you're
at
a
much
greater
risk
of
becoming
pregnant
at
a
very
early
age.
But,
more
importantly,
I
think.
The
kids,
who
are
emancipating
from
my
foster
care
system
are
most
at
risk
of
carrying
the
trauma
that
they've
experienced
in
their
lives
into
the
lives
of
their
own
children
and
own
families,
and
and
have
a
perpetuating
cycle.
D
I
My
Philosophy
is
that
our
most
substantial
funding
for
child
welfare
should
absolutely
be
on
the
prevention
side
so
that
we
can
help
to
avoid
so
many
of
these
painful
and
traumatic
experiences
that
that
our
families
experience
when
I
was
at
the
Children's
Bureau
for
in
Washington.
For
the
last
four
out
of
out
of
five
years.
D
Every
year
we
were
able
to
get
into
the
president's
budget
proposal
a
potential
piece
of
a
proposal
for
legislation
that
would
allow
states
to
have
the
flexibility
to
use
our
largest
pot
of
federal
funding
for
Prevention
Services.
In
addition
to
the
costs
associated
with
foster
care,
we
were
never
able
to
get
that
picked
up
and
sponsored
and
moved
forward,
but
we
have
real
opportunities
there.
D
If
that's,
where
we
put
our
put
our
energies
and
and
put
our
investment
of
time
there,
maybe
we
could
move
on
to
the
second
slide.
If
that's
okay,
I
I,
think
prevention
is
something
that
we
should
all
be
concerned
about.
The
issues
that
it
raises
are
important
or
of
importance
to
all
of
us
whether
we
are
a
part
of
the
child
welfare
system
or
not.
D
When
I
talk
about
prevention,
I
am
talking
pretty
specifically
about
the
prevention
of
child
maltreatment
in
the
first
place,
not
necessarily
the
prevention
of
a
reoccurring,
male
treatment,
although
we
don't
want
that
to
happen
either.
But
if
we're
going
to
break
some
harmful
Cycles
reduce
the
trauma
that
our
families,
our
young
people,
our
children
experience.
D
We
need
to
have
into
place
those
kinds
of
supports
out
there
that
will
prevent
the
initial
occurrence
of
maltreatment,
particularly
where
we've
got
an
opportunity
to
do
that
with
the
many
many
families
that
are
charged
with
neglect
every
year.
I'm
also
talking
about
prevention
of
the
trauma
that
often
follows
our
our
responses.
D
D
Despite
knowing
this
I'm,
still
amazed
that,
at
least
on
the
federal
level,
we
tend
to
find
a
separation
of
families
that
exponentially
higher
rates
than
we
are
willing
to
find
prevention
and
most
of
the
funding
comes
late
stage
in
child
welfare,
in
involvement
by
by
families,
I
I,
don't
know
of
any
other
field
that
serves
Children
and
Families
out
there.
Where
that's
the
case.
Certainly
Health
Care
has
has
put
a
focus
on
on
prevention.
Otherwise,
why
would
we
get
a
flu
shot?
D
Why
would
we
get
a
covet
shot
or
other
kinds
of
immunizations?
The
education
field
is
is
very
strongly
oriented
towards
prevention,
kinds
of
things,
even
the
Auto
industry
and
putting
in
safety
factors
out
there.
But
that's
not
generally
the
case.
In
our
child
welfare
system.
We
we've
always
been
in
a
full
force,
Fix-It
mode
than
we
are
in
a
mode
of
trying
to
trying
to
prevent
the
the
trauma
of
maltreatment
and
family
separation.
We
can
move
to
the
next
slide.
That's
okay!
D
D
Let's
move
to
the
next
slide.
If
that's
okay,
one
of
the
things
I
I,
wanted
to
spend
a
little
bit
of
time
talking
about,
is
how
do
we
actually
do
this
again,
I
I?
My
sense
is
that
the
members
of
this
committee
know
why
it's
important
and
agree
that
we
need
to
support
families
before
bad
things
happen.
D
The
first
thing
we
always
have
to
do
is
to
address
the
values:
the
judgments
about
families
who
are
involved
in
child
welfare
that
tend
to
impede
our
investment.
Our
commitment
to
supporting
them
I
believe
with
all
my
heart
that
the
reason
we
couldn't
get
flexible
funding
in
child
welfare
through
even
introduced
really
in
in
into
Congress.
So
it's
around
basic
bad
use
in
judgments.
D
We
have
to
ensure,
as
I've
just
said,
parent
and
parent
and
youth
voice.
I've
sat
down
with
with
parents
who've
been
a
part
of
the
child
welfare
system,
young
people
in
almost
all
of
the
states
now
and
and
heard
repeatedly
the
stories
of
of
what
worked
well,
what
did
not
work
well,
and
it's
become
an
essential
part
of
my
approach
to
doing
the
work
and
and
not
making
assumptions
that
I
know
better
than
they
do
about
what's
going
to
help
their
families.
D
As
some
examples,
the
Washington
State
Governor,
just
within
the
past
few
weeks,
I
I,
believe
signed
legislation
authorizing
the
creation
of
Family
Resource
Centers
there,
as
as
a
community-based
prevention
effort.
New
Jersey
has
around
85
Family
Resource
Centers
throughout
the
state
and
provides
a
safe
haven
for
families
to
to
get
the
kinds
of
supports
that
they
need
without
child
welfare
involvement.
New
York
City
is
following
that
example,
and
is
putting
into
place
Resource
Centers
that
are
totally
designed
and
run
by
the
communities.
Other
states
are
doing
it
as
well.
D
That
may
be
happening
in
Kentucky
as
well
and
I'm.
Just
not
really
aware
of
it.
One
of
the
ways
we
move
toward
prevention
is
that
we
provide
alternatives
to
mandatory
reporting.
Well
I'll,
be
clear
and
say
if
a
child
is
being
abused,
severely
neglected
if
there
is
an
imminent
risk
of
harm,
a
threat
to
that
child's
safety.
D
I
want
a
mandatory
reporter,
calling
that
in
to
the
child
abuse
and
neglect
hotline,
that's
not
the
case
with
most
of
the
reports
that
come
into
the
hotline
most
of
the
reports
either
don't
rise
to
the
level
of
needing
actual
intervention
or
they're
a
plea
for
help.
We
have
school
teachers,
Health
Care,
Professionals,
others
out
there
who
can
see.
Families
who
need
help
and
the
only
place
they
know
to
go
is
a
child
abuse
and
neglect
hotline.
What
often
triggers
a
full
investigation
and
that
in
itself
can
be
pretty
traumatizing
for
families.
D
Back
to
a
family's
lack
of
income-
and
maybe
it's
been
allowed
to
go
unchecked
for
so
long
that
other
kinds
of
problems
are
emerging
as
a
result
of
that.
But
the
bottom
line
is
we're
still
removing
kids
for
things
like
homelessness
and
inability
to
provide
for
for
basic
needs
which
are
all
in
some
way
tied
back
to
to
poverty.
D
Have
it
in
place
what
I
would
call
substantive,
reasonable
efforts?
We've
had
a
reasonable
efforts
requirement
on
the
books
at
the
federal
level
for
a
number
of
years,
at
least
25
years,
now
that
that
states
have
to
make
reasonable
efforts
to
keep
a
family
together
before
they
separate
them.
Unfortunately,
what
I
see
happening
and
I
was
vocal
about
this,
even
while
in
DC
that's
a
checklist,
it
often
just
becomes
a
perfunctory
exercise
to
say
yep.
You
made
reasonable
efforts,
because
you
did
you
offered
what
you
had
available,
maybe
not
what
a
family
really
needed.
D
I
I
think
we
need
to
look
very
carefully
at
our
state.
Definitions
of
child
neglect,
not
child
neglect,
but
reasonable
efforts
to
make
sure
that
we're
requiring
the
level
of
effort
that's
needed
to
help
families
Stay
Together
safely,
before
we
resort
to
separating
them
a
listed
home.
Visiting
programs
is
an
example.
I'm
sure
that
Kentucky
has
some
of
those
programs
in
place.
D
I've
been
fortunate
enough
to
visit
a
number
of
those
across
the
country
who
sit
down
with
parents
who
I'm
absolutely
certain
would
have
had
child
welfare
involvement
because
of
all
the
vulnerabilities
the
risk
factors
that
were
there
for
them
had
they
not
had
the
opportunity
to
connect
with
a
homeless
and
nurse
or
some
other
supported
person
from
the
time
of
that
child's
birth.
You
know
throughout
the
early
childhood
and
development
of
the
child.
D
Unfortunately,
a
lot
of
the
families
I
talked
to
are
afraid
to
go
the
home
visiting
route
because
they
are
also
home.
Visitors
are
also
mandatory.
Reporters
and
families
are
afraid
that,
if,
if
they
do
something
wrong,
they'll
be
reported
to
child
welfare
for
Bernie
black,
but
it
hasn't
dampened
my
enthusiasm
for
the
programs
and
the
support
that
they
can,
that
they
can
offer
to
families.
Universal
community-based,
supports
I.
Think
is
one
of
the
primary
things
that
we
can
do
to
to
support
families
before
child
welfare
involvement
is
actually
needed.
D
I
I
think
those
kinds
of
supports,
and
some
of
the
best
examples
I've
seen
around
the
country
are
open
to
anybody
in
the
community,
not
just
somebody
who
has
had
a
report
made
on
them
or
who
may
be
at
the
doorstep
of
their
children
and
are
in
foster
care,
but
but
trying
to
ward
off
those
things.
Those
risk
factors
before
they
turn
into
a
crisis
or
escalate
into
very
intensive
involvement
by
by
child
welfare.
D
I
also
believe,
even
though
I
was
a
State
Child
Welfare
director
and
spent
25
years
in
Interstate
child
welfare
system,
including
carrying
caseloads
myself,
I
I,
don't
believe
Public
Child
Welfare
can
really
be
the
bay
the
face
of
community-based
Prevention,
Services
I
think
we
can
be
partners
in
that
effort.
We
have
to
be
partners
in
that
effort,
but
but
the
base
of
support
really
has
to
be
Community
groups,
formal
and
informal,
that
children
and
families
can
trust
and
groups
that
reflect
the
culture.
D
D
Civil
legal
representation,
I
think
is,
is
essential
for
families
we're
able
to
get
Federal
funding
in
place
for
legal
representation
of
families
involved
in
the
child
welfare
system.
I
very
much
like
to
see
Federal
funding
become
available
to
support
civil
legal
representation
in
areas
such
as
evictions.
Getting
new
utilities
turned
off
access
to
Services
those
kinds
of
things
that
where
families
often
are
pretty
helpless
and
can
easily
end
up
in
the
child
welfare
system.
D
D
D
D
The
other
one
I
wanted
to
mention
I'm
about
to
head
back
out
to
Nebraska
I
visited
with
them
a
few
times,
but
to
meet
with
a
group
called
bring
up
Nebraska,
which
is
really
a
public
private
partnership
and
in
many
respects,
is,
is
everything
I've
talked
about
in
terms
of
bringing
the
community
in
for
Solutions
for
approaches
to
serving
families?
20
years
ago,
Nebraska
had
one
of
the
highest
rates
of
children
in
foster
care
in
the
in
the
whole
country,
but
the
legislature
there
implemented
a
prevention
approach.
D
It's
called
Community
response,
which
is
a
part
of
bring
up
Nebraska,
and
the
rate
of
foster
care
placements
has
has
been
steadily
decreasing
every
year
since
or
about
the
last
dozen
years.
It's
really
based
on
a
premise
that
all
families
all
of
us
will
experience
challenges
and
and
adversity
at
some
point
in
our
lives
and
having
early
support
by
the
community.
He
can
prevent
some
of
those
from
from
becoming
crises.
A
E
D
Yeah
I
love
the
point
that
you're
making
it's
it's
absolutely
true
that
you
know
a
huge
proportion
of
the
children
who
come
into
our
foster
care
system.
Right
now
are
coming
from
families
where
that
kind
of
historical
trauma
it
exists.
I
talked
to
parents
every
week
who
suffered
incredible
trauma
themselves,
didn't
have
the
kinds
of
supports
that
they
needed
and
now
they're
going
through
this.
D
If
it's,
if
it's
going
to
happen,
despite
our
best
efforts
out
there
as
far
as
your
your
thoughts
about
the
community,
I
couldn't
agree
with
you
more
I
think
that's
where
we
have
to
go
and
all
any
of
these
examples
that
that
I've
shared
with
you
today
have
begun
with
the
community.
That's
that's
where
I
think
we
need
to
put
our
resources,
our
efforts
and
our
support,
and
you
know
I,
wouldn't
even
go
so
far
as
to
call
it
an
intervention.
D
I
I
think
what
child
welfare
does
is
is
an
intervention
after
something
has
happened,
or
a
report
has
made
or
something
like
that.
But
when
we
start
with
the
community,
we
start
to
put
into
place.
You
know
the
kind
of
supports
the
kind
of
environment
where
our
families
have
a
chance
to
deal
with
some
of
that
trauma.
Some
of
the
unresolved
issues
in
their
lives
in
a
real
non-threatening
non-stigmatic
way
so
I
I,
couldn't
agree
more
that
beginning
with
the
community
is,
is
where
we
absolutely
have
to
have
to
go.
B
Thank
you.
I
was
particularly
appreciative
of
seeing
this.
This
recommendation
of
universal
community-based
supports.
Of
course,
we've
got
families
facing
generational
poverty,
but
I'm
really
interested
in
the
fluidity
of
poverty
and
families
who
sort
of
come
in
and
out
on
a
weekly
or
monthly
or
annual
basis,
I'm
sure
coming
up.
We
all
had
many
of
us.
We
had
big
Christmases
and
we
had
very,
very
small,
Christmases
right
and
so
I
wanted
to
to
ask
you
how
you've
seen
these
sorts
of
supports
work.
D
Yeah
yeah
well
I,
I
I'll,
address
that.
Let
me
say
as
far
as
the
families
who
come
in
in
and
out
of
poverty,
I
I
think
some
of
that
is
almost
a
little
bit
artificial.
There's
an
article
that
has
come
out
within
the
week.
Two
articles
I
think
in
the
New
York
Times
around
the
great
decreases
that
we've
made
in
poverty
and
I
applaud
that
over
the
last
25,
Years
or
or
so.
D
You
know
as
far
as
how
this
this
works.
Yeah
I've
talked
some
of
the
examples
and
ways
that
I've
talked
about
is
having
what
I
would
call
a
place
based
kind
of
a
an
approach
out
there
almost
a
safe
haven
for
families
to
admit
their
their
their
vulnerabilities
I
I.
Just
recently
wrote
published
an
article,
it's
called
all
I
needed
was
a
little
help
and
they
took
my
kids
away,
and
that
was
a
quote
from
a
mom
I
spoke
with
in
a
in
a
state.
D
She
finally
mustered
up
the
courage
to
go
in
and
say
you
know:
I,
don't
have
a
a
suitable
place
for
my
family
to
live.
She's
lived,
she
had
escaped
from
a
domestic
violence
situation.
She
said:
I,
don't
have
enough
money
put
food
on
the
on
on
the
table
and
to
get
my
kids
what
they
need
to
go
to
school
and
as
a
result
of
that
shinza,
her
kids
end
up
in
foster
care
system
and
I
I.
Think
where
we've
got
safe
places
in
communities
trusted
places.
D
D
Getting
the
parents
engaged
involved
so
much
peer
support
that
that
makes
it
seem
okay
for
families
to
go
in
and
ask
for
help.
Now.
I've
visited
those
kinds
of
centers
in
multiple,
multiple
States,
like
that.
One
of
the
you
know
in
terms
of
how
it
would
really
look
if
we're
serious
about
things
being
Community
Driven
and
giving
decision
making
power
to
communities.
D
It'll
probably
look
a
lot
different
and
a
lot
play
in
a
lot
of
different
places,
rather
than
having
a
standard
model
that
we
think
is
going
to
work
for
for
everybody,
but
I
think
it
has
to
begin
with
us
engaging
with
our
communities.
At
some
point
we
have
to
be
able
to
find
those
efforts,
but
we
also
have
to
trust
communities
to
know
what's
best
for
their
families
and
and
their
children.
A
Well,
Dr
Miller,
thank
you
again
and,
as
you
were
speaking,
I
really
appreciate
the
part,
as
representative
Raymond
said,
of
empowering
local
communities
that
there
are
many
local
programs
out
there
and
and
I
think
that
they
need
to
be
included
in
this
as
well,
but
also
that
I
think
that
includes
Faith
communities.
They
can
play
a
big
part
in
this
as
well,
and
we
need
to
have
more
of
a
partnership
with
those
different
organizations
in
those
local
communities.
A
We
started
down
a
path
in
2018
and
putting
together
a
program
that
will
work
very
closely
with
local
communities
and
that
that
just
kind
of
stalled
the
last
couple
years
but
I
hope
that
we
will
put
more
of
a
focus
on
that.
Kentucky
does
rank
first
in
abuse
and
neglect
and
there's
several
times
in
the
in
our
friends
in
the
media
want
to
leave
out
the
last
two
words
of
that
and
neglect.
They
want
to
say
that
we
rank
first
in
abuse,
but
about
75
percent
of
the
children
in
our
welfare
system.
A
A
She
focused
on
that.
She
redefined
neglect
to
say
that
poverty
is
not
an
excuse
and
we're
hoping
that
we
we
can
work
closer
with
the
cabinet
to
provide
these
resources
for
those
those
families.
Even
those
families
who
are
suffering
from
drug
abuse
I
know
that
many
times
they
fall
into
that
they
want
to
care
for
their
children,
but
they
fall
into
that
addiction
can't
get
out
of
it
and
we
need
to
continue
to
provide
resources
for
them
like
Volunteers
of
America
and
the
family
scholar
house
who
hold
those
families
together
while
getting
them
drug
treatment.
A
B
F
All
right:
well,
we
have
been
working
diligently
on
907kr
3160
and
on
the
Senate
Bill
8
implementation
that
we
were
that
we
needed
to
do
when
the
bill
passed
in
April.
So
we
have,
we
started
out
working
on
various
various
ways
to
implement
the
the
legislation
contains
a
requirement
that
we
do
a
true
and
actual
cost
for
the
child,
advocacy,
centers
and
so
in
our
world.
F
Typically,
what
we
would
do
is
we
would
Implement
an
interim
reimbursement
rate
and
then
we
would
at
the
end
of
the
year
and
starting
in
January.
We
would
do
a
cost
settlement
with
these
facilities
and
there's
some
real
danger
with
doing
that.
We
determined
that
when
we
started
speaking
to
the
centers
and
then
also
as
we
started
researching
it,
that
if
we
do
a
true
and
actual
cost,
that
is
a
interim
rate
and
cost
settlement
process
that
they
would
have
the
potential
to
be
exposed
to.
F
You
know
maybe
hundreds
of
thousands
of
dollars
of
Medicaid
paybacks.
We
would
be
trying
to
recapture
overpayments
at
the
end
of
the
year,
so
we
have
been
attempting
to
develop
a
new
reimbursement
methodology
that
will
satisfy
the
requirement
of
a
true
and
actual
cost
and
will
also
protect
these
centers
now
and
in
the
future
as
they
go
forward.
F
So
we
will
have
a
specialized
fee
schedule
that
we
will
be
using
for
the
first,
probably
six
to
12
months
as
we
implement
the
the
legislation
and
then,
after
that,
we
hope
to
use
a
prospective
payment
system
rate
which
will
utilize
all
of
their
costs
from
the
pre
prior
year
and
then
give
them
a
payment
going
for
the
for
the
next
year.
And
if
we
do
it
this
way
they
will
not
be
at
any
risk
for
having
to
pay
a
lot
of
money
back.
F
These
are
non-profit
centers
and
we
were
just
very
concerned
they're,
non-profit
centers,
and
they
have
a
low
overall
patient
volume.
So
we
expect
their
costs
to
really
fluctuate.
The
the
other
issue
is,
and
these
are
all
good
changes
we
we
are
excited
about.
Senate
Bill
8
excited
about
implementing
it,
but
we
we
wanted
to
make
sure
that
we
do
it
right
and-
and
that's
that's,
why
there's
been
a
little
bit
of
a
delay,
we
wanted
to
also
mention
that
we
will
be
able
to
pay
them.
F
We're
able
to
reach
back
to
July
1st
and
pay
them
for
their
full
costs.
Over
the
you
know,
starting
with
July
1st
for
initially
the
enhanced
fee
schedule
and
then,
hopefully,
as
we
get
our
cost
survey
process
down
and
work
with
them
to
do
the
cost
surveys
that
that
they
will
be
able
to
get
their
full
full
reimbursement
without
the
danger
of
them
having
to
do
a
lot
of
paybacks,
and
we
we
think
that
that
could
be
devastating
to
them.
F
D
F
Administrative
burdens
we're
going
to
require
the
mcos
to
follow
our
cost
surveys
that
we're
going
to
do
we're.
So
we're
going
to
be
doing
the
majority
of
the
work
with
working
with
the
child
advocacy
centers,
establishing
a
PPS
rate
and
we'll
be
requiring
the
mcos
to
pay
the
pay,
the
rate
that
we're
able
to
determine-
and
so
we
we
really
want
there
to
be
a
a
steady
amount
of.
F
You
know
a
a
lesson:
administrative
burden
for
the
centers
going
forward,
and
then
finally,
we
think
that
they're
going
to
have
a
really
good
opportunity
here
to
we're
going
to
expand
their
outpatient,
Behavioral
Health
Services.
So
we've
identified
at
this
point
nine
services
that
we
anticipate
that
they
will
be
adding
and
services
such
as
individual
Outpatient,
Therapy,
family
therapy
group
therapy
crisis,
stabilization,
intensive
outpatient,
peer
support
services.
F
So
we
think
there's
a
good
opportunity
for
them
to
begin
to
provide
ongoing
mental
health
treatment,
we're
going
to
treat
that
separately,
we're
going
to
require
DMS
and
the
mcos
to
reimburse
at
100
of
our
fee
schedule,
or
at
least
at
100
of
our
fee
schedule
going
forward.
So
that
that's
that's!
A
initial
look
at
some
of
the
changes
we'll
be
making
I
also
wanted
to
mention
we'll,
be
adding
physician
assistance
and
we'll
be
expanding
a
child.
F
G
This
timeline
that
you
gave
to
the
members
of
the
committee
is
word
salad.
It
talks
about
how
you
sent
an
email
or
you're
working
on
a
concept
you
have
known
since
July
of
2021,
with
testimony
before
this
committee
that
these
child
advocacy
centers
were
woely
underfunded
and
they
needed
this
increased
Medicaid
reimbursement.
G
He
was
stating
to
every
member
in
the
Commonwealth
of
Kentucky
that
he
believes
that
this
to
be
a
priority,
and
the
fact
that
we're
sitting
here
on
September
14th
with
nothing
in
front
of
us
is
absolutely
I.
Think
a
dereliction
of
Duty
on
Girls
part
and
I'm,
just
so
frustrated
and
very
rarely
do
I
get.
This
worked
up
about
an
issue,
but
our
children
and
our
child
advocacy
centers
deserve
the
attention
that
Senate
Bill
8
has
placed
upon
our
situation
in
this
state.
F
I'll
simply
say
that
it
has
been
very
difficult
for
us
to
determine
how
to
use
the
true
and
actual
cost
and
that
we
have
sought
to
examine
a
couple
of
different
ways
to
establish
a
reimbursement
rate
that
will
protect
these
centers
going
forward,
and
we
do.
We
do
not
want
to
expose
them
to
extensive
costs
at
the
end
of
every
year.
We're
concerned
that
some
of
them
could
end
up
having
to
close
if
they
had
substantial
Medicaid
overpayments.
And
so
that's
that's.
Why.
F
So
it
since
the
service
is
unbundled
and
we
are
introducing
three
new
provider
types,
we're
introducing
sexual
assault,
nurse
examiners
or
introducing
aprns
or
introducing
Pas.
We
expect
the
front
end
costs
to
have
some
fluctuation.
We
also
see
that
there's
going
to
be
seven
new
services
that
they
will
be
able
to
Pro
to
bill
for
individually,
but
also
call
a
child
medical
evaluation.
F
So
there's
going
to
be
a
lot
of
fluctuation.
So
if
we
determine
an
interim
rate
that
is
too
high
and
they
come
to
January
and
they
have
to
pay
half
a
million
dollars
back
to
the
Medicaid
Program,
we're
concerned
that
some
of
them
might
close
in
that
environment.
So
we
want
to
make
sure
that
we
give
them
a
a
rate
that
reflects
their
their
true
costs
that
reflects
their
costs,
but
does
not
expose
them
to
the
danger
of
closing
at
the
end
of
every
year.
G
And
just
for
the
record,
we've
already
had
our
first
advisory
meeting
of
the
newly
created
board
with
Senate
Bill
8,
and
this
was
a
month
ago
and
I
asked
the
cabinet
at
that
board
meeting.
Where
are
we
on
this
increased
reimbursement
rate
and
nobody
from
the
cabinet
could
give
me
an
answer?
That's
why
I
was
shocked
to
see
the
word
salad
that
you've
sent
out
an
email
or
that
you
contacted
somebody.
G
B
Thank
you,
Mr
chairman
and
I
too
appreciate
you
coming
forth
and
giving
us
this
information
minimal
as
it
is,
but
you
know
just
to
add
on
to
what
Julie
Senator
Adams
said.
In
July
of
last
year,
we
had
some
child
advocacy
centers
that
testified
that
the
reimbursement
rate
was
actually
25
percent
of
their
actual
cost,
and
so
I
can
only
assume,
with
the
current
recession
and
inflation
rates,
that
that
reimbursement
rate
is
even
less
so.
B
F
Well,
this
is
a
priority
of
our
organization
and
we
are
working
diligently
to
get
this
regulation
filed.
We
have
a
finalized
version
that
we
plan
to
share
with
the
child
advocacy
centers
on
Monday
we've
had
meetings
with
them
at
the
meeting
that
that
you
attended.
Last
month,
we
had
already
been
meeting
with
the
child
advocacy
centers
and
sharing
our
draft
reg.
F
H
H
Okay,
talking
about
this
I'm
going
to
go
through
this
a
little
bit
if
I
may
Mr,
chairman
April
1st,
the
bill
was
signed,
correct
into
law.
Yes
in
May,
it
says
originally
assessing
then
in
May
and
June
strategy
remained,
then
emails
were
exchanged
in
August,
still
anticipating
dropping
down
still
in
August,
it
says
assessing.
H
Then
you
go
down
into
just
below
that.
It
says
still
in
August,
hashing
out
reimbursement
rates,
September
still
discussing
reimbursement
models,
September
9th.
What's
going
on
discussing
dropping
on
down
to
the
bottom
third,
two
thirds
of
the
page
discussing
next
steps.
What
does
it
end
discussing?
H
F
The
regulation
is
drafted.
We
also
have
to
do
a
state
plan,
amendment
process
with
this,
where
we
will
be
forwarding
information
to
the
federal
government
so
to
to
approve
the
regulation
or
that
the
reimbursement
changes
and
to
approve
some
some,
the
additional
providers
that
will
be
required,
the
unbundling
of
the
service
from,
but
we
through
all
of
this
there
has
been
drafted
regulations,
documents
that
have
been
shared
and
exchanged.
It's
it's
not
I
I
do
apologize
with
the
use
of
the
word
discussing
there.
F
It
it
has
been
a
priority
since
it,
since
it
came
through,
we've
just
had
a
little
bit
more
difficulty
than
we
expected
in
us
and
determining
the
reimbursement
rates
and
then
how
the
costs
are
going
to
fluctuate
with
the
introduction,
with
the
with
the
unbundling
of
the
service
and
the
introduction
of
the
new
providers.
So
it's
it
has
not
been
a
simple
process
for
us
to
determine
what
a
what
what
a
good
interim
reimbursement
rate
would
be.
So
we
you
know,
protecting
the
facilities
going
forward
is
an
important
consideration
for
us.
A
A
This
committee,
and
even
with
the
general
assembly
in
general
of
we
are
passing
laws
and
that
many
times
the
cabinet
and
the
administration
are
not
implementing
and
we
are
going
to
have
to
figure
out
a
way
just
to
to
force
the
issue
on
that
and
so
I
apologize
that
you
took
the
brunt
of
some
of
that
today.
I
think
that,
even
though
the
commissioner
may
have
had
something
come
up
there,
there
should
have
been
someone
from
the
administration
that
should
have
been
here
today
as
well
and
not
throwing
this
off
on
YouTube.
C
I
I
I
appreciate
the
opportunity
chairman,
Marine
chairman
Rocky
Adams,
to
talk
about
the
work
we
do
and
how
we
do.
It
I
think
it's
it's
an
important
work,
I'm
a
relatively
newbie
to
the
group
last
four
or
five
years,
but
it's
really
is
the
most
challenging
thing.
I
engage
in
on
a
regular
basis,
so
we're
going
to
talk
about
who
we
are
who's
on
the
panel.
This
is
the
first
slide.
We
are
chaired
by
a
Fayette
County
circuit
court,
judge
I,
call
her
3M
Melissa
Moore
Murphy,
judge
Murphy.
I
We
also
have
another
judge,
a
family
court
judge
on
as
well
judge
Messer.
So
we
really
have
the
judicial
piece
Commissioner
of
dcbs,
commissioner
Straub
participates
as
well.
Significantly,
we
have
five
Physicians
that
participate.
They
participate
on
a
regular
basis
and
we're
going
to
five.
It's
a
big
number
out
of
22,
including
Dr
Howard
from
UK.
Our
good
friend
Dr
Curry
from
uofl
I
learned
more
from
Dr
Curry
on
this
issue
in
three
and
a
half
hours
a
month.
I
I
just
can't
imagine
what
she
endures
on
a
daily
basis
for
what
she
has
to
do,
and
we
appreciate
that
Dr
Ralston
participates.
He's
the
he
skipped
one:
didn't
you
you're
getting
ahead
of
me.
Sorry,
the
State
medical
examiner.
We
also
have
Dr
Jamie
pettinger,
who
is
with
who's
at
UK
as
well,
but
she's
to
prevent
child
abuse
Kentucky.
So
we
have
those
five
folks.
We
also
have
other
advocacy
groups.
We
have
the
domestic
violence
coalition
participates
all
right.
Thank
you
myself.
I
I
The
reality
is
previously
to
Senate
Bill
97,
which
was
passed
a
session,
the
chair
of
the
Senate
Health
and
Welfare,
and
the
chair
of
the
house.
Health
welfare
of
Family
Services,
served
on
the
panel.
We
changed
that
in
90
in
Senate,
Bill
97
sponsored
by
Senator
Carroll,
to
allow
any
other
member
of
the
general
assembly
to
participate,
and
that's
why
it's
vacant
that
process
hadn't
been
completed
yet
they
both
have
participated.
You
know
we
but
twice
in
person.
I
You
know
the
hybrid
thing,
which
is
the
no-brid
thing
in
my
opinion,
but
you
know
we
had
those
participate
via
zoom
and
that's
useful.
The
other
folks
are
still
looking
for
members,
the
the
where
to
go.
The
prosecutor,
person
retired
rotate
it
off.
We
had
another
retirement,
Family
Resource
your
service
center,
rotate
it
off
so
they're
being
filled,
so
we're
going
to
get
all
these
spots
filled
it's
important,
but
that's
who
we
are
go
ahead,
and
this
is
what
we
do,
and
this
is
really
the
panel
process.
I
Initially,
our
statute
requires
us
to
meet
quarterly.
We
meet
monthly.
Now
it's
about
a
three
and
a
half
hour
meeting
every
month.
My
own
personal
experience,
my
wife,
can
tell
you
when
I
attend
these
meetings,
it's
a
little
somber
evening
that
night
different
thing.
So,
but
how
do
we
get
cases
they
come
from
dcbs?
They
make
recommendations
to
us
for
cases
not
every
dcbs
case.
I
C
I
I'm
learning
new
language
every
day,
so
that's
you
know
so
so
that's
how
we
get
our
cases.
2020
I
think
we
looked
at
200
cases,
80
fatalities,
120
near
fatalities.
So
that's
how
we
get
them
data
collection.
This
group
collects
more
data
than
anybody.
I
know
and
the
reason
for
that
is
pretty
significant
and
I
thought.
Dr
Curry
can
explain
it,
but
I
can
we
want
to
understand
how
we
get
these
cases
and
what
happens
to
families
and
children.
I
I,
think
Dr,
Milner's
dead
on
We
Wish
prevention
worked
we're
the
opposite
end
of
prevention
and
if
prevention
really
worked,
we
could
go
back
to
quarterly
meetings.
Maybe
have
a
longer
lunch,
you
know,
but
reality
is.
This
is
where
we
live
and
it's
really
the
opposite
end
of
the
prevention
process,
but
we
try
to
collect
as
much
data
as
we
can
about
the
composition
of
the
family,
the
child.
The
events
I
think
there's
200
data
points
across
22
areas,
so
we
have
a
lot
of
information,
we're
collecting
and
using
and
sharing.
I
The
other
thing
we
do
is
we
discuss
every
case
yesterday.
I
think
we
had
14
on
our
agenda
and
we
met
for
four
and
a
half
three
and
a
half
hours,
and
we
didn't
get
to
one
case,
so
we
only
we
missed
our
mark
because
we
spent
so
much
time
discussing
the
cases
and
the
discussion
is
powerful
because
it's
a
diverse
group
of
people
bringing
forth
different
ideas.
I
come
from
a
mental
health
substance
use
perspective
and
I
ask
questions
about
that.
I
We,
but
we
look
at
those
things
and
we
try
to
understand
what
takes
place
in
the
meeting
and
we
rely
on
our
physicians.
Our
Judicial
System
have
a
state
police,
they
have
access,
information,
I,
didn't
know
existed,
and
they
can
tell
us
exactly
where
things
are
going
and
what's
happening
and
that's
really
helpful
to
us
and
those
investigations.
So
that's
important.
I
We
also
look
at
the
category.
There's
23
factors
that
look
at
the
category
of
what
takes
place.
Some
of
these
are
abusive
head
trauma.
All
right,
blunt
force
trauma
gunshot,
accidental
homicide
and
suicide.
These
are
things
we're
trying
to
figure
out
and
discern
correct
me
when
I
make
a
mistake.
Yes,
sir,
all
right,
physical
abuse,
suicide,
we
have
the
smoke
inhalation,
sexual
abuse,
human
trafficking,
those
things
happen
in
Kentucky
on
a
regular
basis
and
we
pay
attention
and
we
try
to
figure
out
what
that
is.
I
Okay,
I
love,
Dr,
Miller
prevention,
Community
Based,
because
the
first
family
characteristic
we
have
is
bystander
issues.
Did
someone
else
know
about
what
was
taking
place
or
was
suspicious
about
what
was
taking
place
and
that
didn't
get
shared
with
somebody
else.
So
it's
really
our
bystander
issues,
and
quite
often,
in
the
case,
you'll
hear
afterwards
well.
I
wasn't
so
sure
that
the
father
was
really
taking
good
care
of
the
babies
and
apparently
it
sometimes
appeared
rough
got
that
information
two
months
earlier.
Our
statistics
could
be
different.
We're
also
looking
at
domestic
violence,
Financial
struggles.
I
Poverty
is
not
a
reason
to
be
here,
but
poverty
is
real.
You
know,
and
families
really
struggle
who's
the
caregiver,
a
lot
of
single
moms
out
there
work
in
really
low
paying
jobs
and
I've
said
this
other
committees.
They
have
a
boyfriend
called
a
Paramore
I
dabbled
in
French
at
one
time,
Paramore
is
by
love.
I
It
is
the
worst
named
relationship
you
can
imagine,
because
in
our
cases,
there's
very
little
love
displayed
by
these
folks
who
at
times
are
taking
care
of
kids
and
have
no
business
taking
care
of
kids,
because
there's
not
another
option
for
the
mom
who's
working
fast
food.
You
know
five
o'clock
to
midnight,
so
you
have
a
dad.
You
know
acting
like
a
dad
who
is
no
position
to
provide
those
services.
So
we
see
that
we
identify
that
lack
of
family
support
system.
I
You
know
we
had
family,
we
had
friends
who
would
help
us
with
our
kids
when
they
were
growing
up,
doesn't
always
happen,
paying
attention
to
that
substance,
abuse
from
the
child,
substance,
abuse
and
a
caregiver
substance
abuse
in
a
home,
because
there's
people
in
the
house
who
aren't
unrelated
to
the
child
who
are
viewing
substances.
Those
are
just
a
few
one
thing.
I've
learned
more
about
is
unsafe,
sleep
and
I'm
going
to
say:
I
was
a
victim,
not
a
victim.
My
daughter
was
a
victim.
I
was
a
perpetrator
of
unsafe
sleep.
I
She'd
get
up
in
the
middle
of
the
night.
I'd
learned
I
can
go
to
recliner.
Put
her
next
to
me
and
I
could
rewind
Snow
White
in
my
sleep,
so
she
would
be
quiet
that
is
unsafe
sleep.
No
one
told
me
about
that.
You
know
she's.
Okay
now!
Well,
maybe
not,
but
you
know
she's
fine,
but
unsafe.
Sleep
is
a
real
thing
and
that
happens
on
a
regular
basis.
It's
another
characteristic
that
takes
place.
Then
we
make
a
determination
of
what
happened.
I
You
know
and
those
are
13
items
neglect
by
the
impaired,
caregiver
neglect,
inadequate
absent
restraint,
motor
vehicle,
a
bad
car
seat
or
no
car
seat
right,
medical
neglect,
not
meaning
the
physician
was
neglectful,
but
the
child
had
health
care
issues
that
weren't
addressed
didn't
go
for
some
reason.
What
is
the
answer
to
that
and
our
goal
is
to
gather
data.
I
The
last
one
is
torture.
Torture
happens
to
kids,
a
young
girl
was
locked
in
a
room.
This
was
a
case
just
from
last
month.
Her
mom
would
give
her
I,
don't
know
two
ounces
of
water
every
hour
and
food,
that's
torture,
that's
what
torture
is
and
we
actually
are
debating
the
definition
of
torture,
I
think
I
know
when
I
see
it,
but
that's
the
real
issue.
I
So
those
are
what
we're
trying
to
do
and
gather
this
information
all
right
case,
reviews
findings
and
when
we
get
to
the
real
meat
of
the
substance,
recommendations,
I'm
going
to
hand
it
off
to
Dr,
because
I
think
I've
been
on
my
head
already.
Let's
look
at
case
reviews.
Oh
annual
report.
Sorry
forgot
any
report
that
is
due.
It
was
due
December
1,
Senate
Bill
97,
moved
it
to
February
1,
which
fits
our
work
schedule
better.
You
know
we
pick
up
two
months.
I
One
time
is
it
going
to
be
12
months
after
that,
so
we
have
that
extension.
Also,
the
annual
report.
We
have
made
recommendations
for
the
last
several
years
and
they
kind
of
go
nowhere.
You
know
some
dcbs
look
at
them
discuss
them.
There
is
no
accountability
to
our
recommendations,
so
obviously
that
creates
some
frustration
for
people
who
work
hard
on
those
recommendations.
Senate
Bill
97,
passed
by
you,
this
past
session
results
in
us.
The
panel,
probably
Mitch
Mahoney,
sending
those
recommendations
to
the
appropriate
agency
and
the
appropriate
agency
has
90
days
to
either
say.
I
I
So
that
is
a
significant
change
to
our
annual
report
process
and
it
really
creates
an
opportunity
for
what
we
see
and
what
can
be
done
in
a
more
effective
manner
now
case
reviews
just
a
map
of
Kentucky,
no
surprise
here:
120
counties
that
green
color
13
in
2014-19
13
counties.
We
did
not
review
a
case
from
I
wish
to
tell
you
those
13
counties,
kids
were
safe
there.
The
cases
just
didn't
get
to
us
in
those
counties,
I'm
sure
of
that
but
13..
I
But
if
you
look
at
two
to
four
cases
or
five
plus
Jefferson
County
is
going
to
be
way
more
than
five,
but
that's
just
how
we
did
our
data
you're,
looking
at
a
total
of
89
counties,
had
two
plus
cases
over
that
period
that
we're
looking
at
for
sure
this
is
pervasive.
This
is
not
a
rural
issue.
This
is
not
an
urban
issue.
This
is
pervasive
across
you
know
all
120
counties
and
I
suspect.
I
If
our
data
was
through
September
13th
of
29th
of
2022,
we
would
not
have
we'd
have
fewer
than
13
at
this
point.
We'd
have
more
so
this
happens
a
lot
and
there's
no
pattern.
There's
no
guessing.
We
don't
know
what
county
they're
in
the
data
people
do,
but
it's
across
the
state
there's
no
surprise
go
ahead.
I
These
are
the
age
of
the
individuals
we're
looking
at.
These
are
the
ages
less
than
a
year
old,
less
than
a
year
old,
bad
things
happening
to
a
nine-month-old
31
of
our
cases,
Lesson
Four,
one
to
four
years
old,
37
percent
of
our
cases,
so
68
of
our
cases
are
less
than
four
years
old
68,
and
these
are
the
cases
that
get
to
us
again.
No
reflection
of
the
other
dcbs
cases,
the
other
ones
we
look
at
68
of
200
is
a
hundred
and
thirty
six
of
200.
I
cases.
That's
what
we
look
at,
that's
what
we
do
and
we're
trying
to
figure
out
trying
to
understand,
trying
to
make
recommendations
that
we
believe
it
can
impact
these
numbers
go
ahead.
These
are
our
findings.
Okay,
dcbs
history
and
it's
important
to
note
and
Dr
Miller
touched
on
this.
The
intergenerational
and
cinderberg
did
the
dcbs.
History
is
families
that
had
prior
encounters
with
dcbs
we've
had
cases
where
the
adult
had
dcbs
cases
as
a
child.
We've
had
the
grandmother
who's
now
carrying
a
dcbs
cases.
I
B
I
Half
had
substance
abuse
in
the
home.
You
know
we
all
hear
about
it.
This
is
just
a
real
way
to
look
at
it
in
measurement
half
dcbs
issues,
and
this
is
a
really
hard
one
and
I
think
my
good
friend
Mr
Clark
when
he
was
at
dcbs.
There
was
some
tension
between
this
group
and
dcbs
and
and
I
think
that
was
fair,
I
think
at
times
we
were
not
collegial
in
our
approach
with
dcbs
and
fortunately,
we've
moved
away
from
that,
and
we
identified
these
issues,
it's
solely
for
the
purpose
of.
I
Can
we
address
issues,
we
don't
want
to
point
fingers
we're
not
the
dcbs
overseer,
but
were
there
situations
that
maybe
dcbs
could
have
done
something
different
and
maybe
a
different
outcome,
but
we
don't
want
to
be
critical.
I've
said
many
times
the
worst
hardest,
most
challenging
difficult
job
in
state
government
is
the
dcbs
caseworker
they're
doing
really
hard
things
on
a
regular
basis,
additional
support,
smaller
caseloads,
that's
happened.
Right,
we've
added
money
in
the
budget
for
staff.
Can
we
get
those
people
hired
and
trained?
So
those
issues,
half
again
supervisional
neglect?
I
These
are
who's
responsible
for
the
child.
You
know
who's
doing
that,
half
of
those
cases,
three
out
of
five
62
of
abusive
head
drama
cases,
substance
abuse
by
the
caregiver
again
about
a
caregiver
blunt
force,
trauma
or
motor
vehicle
right,
impaired,
caregiver,
drunk
driver
half
of
those
cases
that
we
identify
in
our
process
of
categorization
physical
abuse,
right
62,
three
out
of
five
again
with
a
criminal
history.
C
Thank
you.
Thank
you,
Mr
Shannon
and
thank
you
to
the
committee
and
to
the
chairs
for
giving
us
this
opportunity
to
share
our
findings
and
our
recommendations
with
you.
Today,
I'm
going
to
go
through
the
2021
recommendations
as
efficiently
as
I
can
and
I'm
going
to
start
with
substance
abuse
issues.
As
you've
heard,
the
panel
made
six
recommendations
regarding
substance
misuse
and
issues
facing
Kentucky
families.
Nearly
half
of
all
cases
reviewed,
found,
substance,
misuse
in
the
home
and
a
caregiver
was
identified
as
having
a
substance
misuse
issue
at
almost
the
same
rate.
C
So
this
is
a
tremendous
problem
and
there's
no
question
I,
don't
think
any
of
us
are
ignorant
to
the
to
the
destructive
impact
that
substance
misuse
has
on
child
and
family
well-being.
That's
been
well
documented,
so
the
panel
recommended
that
the
administrative
office
of
the
courts
develop
a
budgetary
proposal
to
expand
family
drug
courts
throughout
Kentucky.
Family
drug
courts
have
been
shown
to
be
extremely
effective
at
managing
the
the
substance
misuse
issue
and
as
well
as
having
the
children
involved
in
the
child
welfare
system
and
actually
having
collaboration
around
that
and
checks
and
balances.
C
The
Kentucky
opioid
advisory
committee
should
examine
this
proposed
budget
and
provide
the
additional
required
funding
for
implementation
and
to
speak
to
what
Mr
Shannon
just
mentioned
about
our
recommendations.
This
is
the
sixth
year
in
a
row
that
the
panel
has
recommended
a
full
implementation
of
family
drug
court
in
Kentucky,
so
risk
factors
such
as
mental
health
concerns
poverty,
domestic
violence
and
criminal.
History
are
very
common
among
the
panel
cases,
as
you
can
see
here
in
this
graph
risk
factors
are
found
at
significantly
higher
rate
among
families
where
substance
abuse
has
been
identified.
C
So
if
you
have
substance
abuse
in
the
family,
you
have
other
risk
factors
too.
Families
with
child
welfare
involvement
and
substance
use
issues
require
holistic
Services
delivered
in
a
multi-disciplinary
strength
based
and
collaborative
environment.
Kentucky
currently
has
several
evidence-based
and
nationally
recognized
models
like
the
Stark
teams
and
k-step.
The
panel
strongly
supports
these
efforts,
but
we
have
serious
concerns
that
they
do
not
meet
the
existing
need
across
the
Commonwealth,
and
we
recommend
expansion
of
these
services.
C
The
panel
documented
33
cases
in
which
children
were
exposed
to
substances
prenatally
10
of
those
had
a
reported
diagnosis
of
either
neonatal
abstinence
syndrome
or
neonatal
opiate
withdrawal
syndrome.
This
is
very,
very
common,
so
we're
talking
about
plans
of
safe
care,
we're
talking
about
high
risk
babies,
leaving
the
hospital
with
no
safety
net
and
that
safety
net
is
federally
mandated,
but
we
have
no
one
taking
responsibility
for
it
here
in
Kentucky.
C
C
The
nas
registry,
the
neonatal
abstinence
syndrome
registry,
reported
over
a
thousand
cases
in
2019.,
so
that
gives
you
a
sense
of
the
percentage
that
we're
seeing.
So
the
panel
has
recommended
that
the
department
for
Behavioral,
Health,
Department,
Developmental
and
intellectual
disabilities,
in
conjunction
with
the
department
for
public
health,
should
accept
responsibility
for
implementing
a
plan
of
Safe
Care
and
develop
strategies
to
assure
Statewide
implementation
of
collaborative
plans
of
Safe
Care
that
are
consistent
with
the
federal
mandate.
C
C
Medication
assisted
therapy
for
substance
use
disorder
is
an
evidence-based
practice
and
it's
an
important
treatment
option
for
individuals
with
substance
use
disorder.
The
most
commonly
ingested.
Substances
that
children
are
ingesting
have
been
the
the
buprenorphine,
which
is
the
narcotic
that
is
in
Suboxone
and
other
opioids,
including
Fentanyl,
we're
seeing
overdose
ingestions
increase,
as
you
can
see
by
the
chart
here,
and
these
are
just
the
near
fatal
and
fatal
cases.
This
is
not
counting
all
of
the
ingestions
of
illicit
substances.
C
It's
important
to
recognize
that
sometimes
the
children
are
ingesting
the
Suboxone
of
their
parents
who
are
in
Legally.
You
know,
mandated
or
or
legally
approved
substance.
Medication,
assisted
therapy
programs,
but
a
lot
of
times
the
Suboxone
is
off
the
street
and
so
it's
illicit
Suboxone
that
has
been
purchased
to
be
misused
and
that's
what
the
children
are
getting
into.
C
So
there
are
definitely
opportunities
for
improvement
that
we
have
noted
with
medication,
assisted
therapy
primarily
related
to
the
needs
of
clients
with
young
children.
So
educating
those
clients
about
safe
storage
of
medication,
giving
out
lock
boxes,
helping
them
understand
the
grave
risk
that
these
medications
pose
if
they
end
up
in
the
hands
of
a
toddler.
So
the
Kentucky
opioid
abatement
advisory
committee
should
consider
funding
medication,
lock
boxes
with
educational
material,
to
mat
providers
for
their
clients,
with
young
children
in
the
young
children
in
the
homes
and
the
Cabinet
for
Health,
Health
and
Family.
C
Services
should
convene
a
study
group
to
develop
Regulatory
and
contractual
framework
to
support
best
practices
for
mat
providers
serving
clients
with
young
children.
One
of
the
one
of
the
things
that
isn't
mentioned
here,
but
that
I
think
is
important,
is
we
have
a
gap
in
communication
when
folks
are
in
medication,
assisted
therapy
and
they
have
young
children
in
the
home,
they're
regularly
drug
tested.
C
That
should
be,
in
my
opinion,
in
my
professional
opinion,
the
cabinet
or
some
other
member
of
the
plan
of
Safe
Care
around
that
young
child
needs
to
know
that
there
has
been
a
relapse
in
that
that
child
is
now
at
risk,
and
there
needs
to
be
a
plan
for
keeping
that
child
safe,
may
or
may
not
need
to
involve
dcbs,
but
there
needs
to
be
collaboration
and
communication.
There
and
I
think
it's
confidentiality
issues
that
get
in
the
way.
C
So
here's
a
case
study.
We
have
a
one-month-old
infant
who
died
as
a
result
of
being
overlaid
by
mother,
meaning
she
she
laid
on
top
of
the
infant
in
bed.
Mother
had
overdosed
on
heroin,
so
father
called
9-1-1
after
finding
the
mother
and
the
child.
Father
admitted
that
both
he
and
mother
used
heroin
around
one.
In
the
morning,
drug
paraphernalia
was
located
in
the
bedroom,
which
included
a
razor
and
heroin
residue.
The
incident
occurred
at
a
relative's
house
where
the
couple
had
been
staying.
C
No
criminal
charges
were
filed
against
father
the
infants
post-mortem
blood
toxicology
was
positive
for
Fentanyl,
so
an
infant
was
able
to
get
adequate
exposure
to
fentanyl
whether
it
was
in
powder
form
or
whether
it
was
being
inhaled
and
the
infant
breathed,
the
air
that
had
the
fentanyl
in
it.
The
infant
was
exposed
to
amphetamines,
buprenorphine,
which
is
the
the
narcotic
and
subutex
and
Suboxone
and
nicotine
in
utero,
and
was
diagnosed
with
neonatal
abstinence
syndrome.
C
C
C
A
psychological
autopsy
is
a
tool
that
involves
a
detailed
review
of
the
circumstances
of
death,
including
a
review
of
medical
records,
records.
Excuse
me
and
structured
interviews
with
family
members,
friends
and
Health
Care
Professionals.
It
basically
helps
us
understand
what
happened
so
that
we
can
better
prevent
it
from
happening
from
other
to
other
children.
The
psychological
autopsy
is
conducted
by
a
trained
investigator,
who
is
certified
by
the
American
Association
of
suicidology,
and
the
panel
is
aware
of
only
two
individuals
in
Kentucky
currently
trained
on
how
to
conduct
a
psychological
autopsy.
C
Next
is
safe
sleep
in
state
fiscal
year
2020
the
panel
reviewed
20,
sudden,
Unexpected,
death
and
infancy.
Cases
understand
that
we
do
not
review
all
of
these
cases
only
the
ones
where
there
is
an
allegation
of
maltreatment
involved
and
many
of
those
come
from
our
Public
Health
referrals,
because
they
review
all
of
those
cases.
C
Many
of
these
cases
are
not
reported
to
dcbs
or
are
not
accepted
for
investigation
families
in
poverty,
struggling
with
substance,
abuse,
mental
health
issues
and
domestic
violence
were
identified
at
greater
rates.
In
these
cases,
60
percent
of
the
sewage
cases
reviewed
by
the
panel
had
Financial
issues
half
as
you've
already
heard,
had
substance
abuse,
almost
half
had
mental
health
issues
and
30
percent
domestic
violence.
So
these
sleep-related
deaths
are
not
occurring
in
a
vacuum.
C
There
are
other
risk
factors
that
are
present
as
well,
so
the
recommendation
is
that
the
Cabinet
for
Health
and
Family
Services
should
develop
a
plan
to
fund
and
Implement.
Excuse
me,
Implement,
a
safe
sleep
campaign
specifically
targeted
to
reach
high-risk
populations.
I
do
want
to
point
out
that
the
cabinet
is
currently
working
on
this.
They
are
in
the
process
of
training,
foster
parents
and
CPS
staff
on
safe
sleep,
education
and
we'll
be
expanding
that
going
forward.
C
C
C
So
we
need
better
training
there.
Additional
training
required
for
coroners
the
Kentucky
coroners
association
should
enact
best
practice
for
reviewing
the
child's
death
in
both
the
county
of
residence
and
the
county
of
death.
This
creates
a
significant
challenge
when
a
child
is
injured
in
one
County
and
then
is
life
flighted
to
another
County
for
hospitalization
dies
in
that
county.
Where
does
the
child
death
review
occur?
B
I
just
want
to
thank
you
very,
very
much
for
everything
that
you
do
and
I
know,
you're
appreciated,
which
I'm
sure
many
days
you
don't
feel
appreciated
it
just
thinking
out
loud
thinking.
What
we
could
do
is
there
anything
that
we
could
publicly
do
with
commercials
and
and
things
like
that
to
educate
people.
I
think
you
know
I
think
about
what
we
do
around
abortion.
Then
I,
look
at
this
and
I
just
want
to
just
crack
myself
in
the
head.
I
I,
guess
I'm
looking
for
answers,
I
don't
have
any
your
recommendations
were
great.
Thank.
C
You
in
answer
to
your
question:
yes,
I,
think
there's
a
lot
that
we
can
do
as
far
as
educating
communities
and
I
think
Dr
Milner
hit
the
nail
on
the
head
that
it
needs
to
be
Community,
Based
Community
generated
Community
owned
so
that
the
messaging
is
done
in
a
in
a
manner
that
can
be
heard
and
and
actually
affect,
behavioral
change.
You
know,
I
think
we
do
a
great
job
of
talking
at
people
and
telling
people
what
they
shouldn't.
C
I
I
think
the
safe
sleep
is
just
a
low-hanging
fruit,
I,
really
think
and
and
I
talk
about
it.
You
know
to
the
embarrassment
of
my
family,
but
you
know
I,
don't
ask
strangers
I
just
you
know,
but
people
I
know.
I
doesn't
take
me
long
to
ask
that
question
so
I
think
that's
something
we
can
all
do
you
don't
have
to
be
an
expert.
I
I
I
knew
that
meant
Scotland
sent
mom's
home
with
a
sturdy
box
that
could
be
used
as
a
crib,
not
sleeping
on
the
Bed
full
of
supplies.
They
take
it
seriously.
We
don't
take
it
seriously.
I
didn't
hear
about
it.
Two
daughters
born
97-99.
No
one
ever
mentioned
safe
sleep
to
me,
never
happened.
Our
cribs
were
full
of
crap.
That's
a
bad
thing.
No
one
told
us
keep
your
stuff
out
of
the
grip,
so
I
think
for
me,
the
low-hanging
fruit
is
clearly
that
one.
I
B
I
J
K
I
J
I
C
J
C
That's
that's
a
good
question.
An
impaired
caregiver
is
any
caregiver
who's
under
the
influence
of
a
substance
and
is
therefore
unable
to
make
adequate
and
safe
decisions
for
the
child,
so
that
could
be
alcohol,
marijuana,
methamphetamine
know
any
number
or
a
combination
of
all
of
them.
So
an
impaired
caregiver
in
order
to
label
it
an
impaired
caregiver.
We
have
to
have
evidence
that
they
were
using
at
the
time
of
the
death
or
around
the
time
of
the
death,
as
opposed
to
it
just
being
an
ongoing
issue
with
the
family,
because
sometimes
the
family
has
substance.
F
C
E
Thank
you
guys.
This
is
always
a
very
difficult
meeting
and
and
honestly
I
never
look
forward
to
it.
I
have
a
two
questions:
if
that's
okay,
the
first
goes
back
to
mandatory
reporting
and
and
when
I
first
presenter
said
that
he
is,
is
not
a
proponent
of
mandatory
reporting.
Might
I
mean
the
hairs
went
up
on
the
back
of
my
head
because
I
have
always.
It
has
been
just
inundated
into
me
throughout
my
career.
E
How
important
mandatory
reporting
is-
and
that
gets
me
to
the
other
side
of
the
question,
which
is
what
happens
when
a
child
or
a
family
is
reported,
and
you
know
we
may
be
approaching
this
whole
thing
backwards.
I,
don't
know,
I
mean
we're
not
obviously
making
significant
strides
and
fixing
the
problem,
but
I
can
tell
you
my
personal
experience
in
this
state.
Is
it
child
protective
services
doesn't
go
far
enough
that
they
look
into
a
family
and
from
the
outside?
They
think?
E
Well,
it's
not
the
worst
case,
we've
ever
seen
and
they
walk
away
or
we
have
cases
where
they
say.
They've
already
investigated
this
family,
they
don't
open
another.
You
know
so
trying
to
find
the
balance
there
who's
right,
how
much
harm
do
we
do
with
these
investigations
versus
how
much
good,
who
should
be
reported?
Who
are
we
reporting
to
all
of
these?
Are
questions
that
I'm
just
like
floating
around
in
my
head,
but
but
quickly
can
I
assume
that
the
panel
is
in
strong
support
of
continued
mandatory
reporting,
absolutely.
C
E
E
C
We
don't
have
a
lot
of
information
about
it,
because
we
aren't
doing
the
psychological
autopsy,
which
is
where
we
would
find
out
that
information.
The
statistics
are
very
clear
that
children
with
gender
differences,
lgbtqia
plus
Community,
have
a
much
much
higher
risk
of
suicide,
so
that
is
very
real
and
that
exists
here
in
Kentucky
as
well.
Alicia.
B
Correct-
and
we
reviewed
eight
cases
last
year
that
were
suicide
cases
now
keep
in
mind.
We
only
receive
we
only
review
a
small
subset
of
all
the
suicides
in
Kentucky.
There
has
to
be
that
abuse
or
neglect
element
in
order
for
it
to
get
referred
to
us
and
then,
if
there,
if
there
are
any
mental
health
issues
or
any
concerns,
we
track
that
in
our
data
as
well.
But
again
it
has
to
be
present
in.
E
A
Are
there
any
further
questions?
I
do
have
one
question
for
you:
I'll
go
recently.
We
had
two
fatalities
with
children
that
were
in
state
care.
Residential
facilities
are,
do
you
all?
Are
you
all
reviewing
those
cases?
Do
you
get?
Those
cases
that
of
children
who
are
in
caring,
not
just
in
their
home,
would
be
the
follow-up
question
that
as
well.
C
In
that
case,
I
can
tell
you
that
in
my
program
in
pediatric
forensic
medicine
at
uofl,
Norton
children's,
we
do
get
those
cases
of
children
who
die
or
nearly
die
in
residential
facilities,
and
it
can
be
very
challenging
to
get
accurate
information
out
of
those
investigations.
I
will
tell
you
you
know
from
a
professional
standpoint.
I
have
serious
concerns
about
allowing
residential
facilities
to
do
their
own
investigations.
A
And
then
so,
I'm
gonna
have
one
more
question
which
you
may
not
be
able
to
answer,
but
I'm
going
to
ask
you
to
see
if
you
can
point
me
in
the
right
direction.
So
if
I
wanted
to
get
information
on
some
of
those
cases
or
someone
else,
committee
wanted
to
get
information
on
some
of
those
cases.
Who
is
the
person
we
should
be
directed
to
talk
to.
C
A
L
L
Since
the
passage
of
house
bill
one,
we
have
been
conducting
Regional
Community
forums
across
the
state
at
least
twice
a
year.
So
far
we
have
done
44
forums,
and
these
forms
are
for
members
of
the
public
to
discuss
areas
of
concern
regarding
the
foster
care
system
and
to
identify
barriers
to
timely
permanency
well-being
and
safety
for
children
and
out
of
Home
Care.
L
Initially
we
had
these
forums
in
person,
but
since
the
onset
of
the
pandemic,
they
have
become
virtual
and
we
do
those
via
Zing.
But
what
we
saw
with
that
change
is
a
significant
increase
in
attendance,
specifically
with
representation
with
our
current
and
former
foster
children.
Our
bio
parents
foster
parents
and
relative
caregivers.
L
Thank
you,
and
so
the
next
several
slides
are
just
showing
you
our
dates
and
locations
of
our
community
forums
for
fiscal
year,
2022.,
so
September
14th
of
21.
We
were
in
Western
Kentucky
area
September
of
17.
We
were
in
Eastern,
Kentucky,
September
22nd
of
21.
We
hit
bullet
Fayette
in
Jefferson
counties
in
September
24th.
We
were
in
Central
and
Northern
Kentucky
June
6
of
2022.
We
were
back
in
Western
Kentucky
in
June
8th.
We
were
in
eastern
June
14th.
We
were
in
Northern
Kentucky
and
June
16th.
L
L
Some
suggestions
for
these
barriers
was
unconscious
by
bias:
training
for
child
welfare
staff
and
caregivers
diversity
among
Guardian
ad
litems
foster
parents
and
DCPS
staff
partnering
with
minority
communities
to
recruit
more
minority
foster
homes.
So,
just
basically
to
summarize
these
slides,
they
stress
the
significance
of
having
representation
in
the
communities
that
we
serve
regarding
supports
and
services
needed.
L
The
findings
stated
that
biological
parents
need
more
detailed
information
about
what
resources
are
available,
need
more
fatherhood,
support,
revisiting
Independent,
Living
rules
and
regulations
to
ensure
children
are
being
served
appropriately
and
are
Foster
and
adoptive
parents
are
also
wanting
more
information
on
resources
and
the
exact
Services
they
provide.
So
basically,
we
have
a
lot
of
our
parents
who
are
just
not
familiar
with
what
services
might
be
already
readily
available.
L
More
findings
where
the
lack
of
peer
support,
Transportation
education,
Mental,
Health
Services
for
Families
in
foster
care
those
those
continue
to
be
barriers,
The,
increased
access
to
therapists,
trauma,
focused
programs,
family
preservation,
Services
crisis,
stabilization
beds
and
short-term
psychiatric
beds,
and
then
the
need
for
increased
Broadband
Services,
particularly
in
rural
areas,
and
so,
and
we
know,
with
the
significant
amount
of
Youth
being
impacted
by
mental
health
issues
distressing.
The
fact
that
supports
and
services
need
to
be
prioritized.
L
Delays
in
court
process
for
child's
permanency
by
continuing
the
DNA
case,
when
parents
have
a
criminal
case,
staffing
issues
within
DCPS
and
private
Contracting
agencies,
which
has
led
to
some
families
being
on
waiting
lists
when
needing
services
and
then
obligations
and
case
plans
and
or
court
orders
that
are
sometimes
not
flexible
enough
for
parents
to
fulfill
obligations
needed
to
get
their
children
back.
Parents
are
often
required
to
maintain
employment
and
housing
while
attending
Court
assessments,
treatment,
case
meetings,
various
classes
or
programs,
and
these
continue
to
be
major
barriers,
especially
in
the
rural
areas.
K
K
Hey
sorry
about
that,
one
of
our
we
are
statutory
required
to
present
CF
crb
legislative
recommendations
and-
and
this
first
one
is
the
We've
historically
regarding
regarded
the
Statewide
expansion
of
Family
Court
as
a
high
priority.
And
although
you
know
that
has
been
expanded
in
recent
years,
there's
still
many
counties
that
don't
have
access
to
Services
provided
provided
by
Family
Court
and
to
further
this
cause.
K
And
the
next
recommendation
is
to
amend
krs-620
.190
and
it's
a
more
of
a
housekeeping
issue
to
allow
non-dcbs
employees
of
Cabinet
for
Health
and
Family
Services
to
serve
on
local
boards.
The
suggested
language
that
we
recommend
is
to
change
it
from
employees
of
the
cabinet
to
employees
of
the
Department
of
community
services,
so
that
other
cabinet
members,
not
directly
involved
with
the
dcbs,
could
serve
on
local
citizen,
foster
care
review
boards.
K
These
plans
should
include
reviewing
and
updating
criteria
that
identifies
youth
with
risk
factors
that
may
lead
to
negative
activities
such
as
gang
Recruitment
and
involvement,
and,
and
this
speaks
to
a
more
of
a
preventive
Avenue,
as
as
opposed
to
fixing
it
creating
and
promoting
strength-based
asset
building
services
and
trainings
to
assist
families
and
youth
affected
by
these
behaviors
and
see.
Collecting
and
sharing
data
related
to
these
activities.
K
And
our
next
recommendation
and
it
came
as
a
direct
result
of
the
forums,
the
continuance
of
special
services
and
service
extensions
for
transition,
age
youth.
Until
the
conclusion
of
the
covet
state
of
emergency
Kentucky
cfcrb
recommends
this
continuation
of
special
services,
because
those
were
some
gaps
and,
and
especially
those
kids
that
are
18
to
21,
that
that
age,
out
and
or
kind
of
left,
without
Direction
and
and
support.
B
K
Well,
when
we
get
a
case
to
review
it,
it's
it's
already,
it's
gone
to.
Has
a
court
assignment
it's
it's
already,
the
child
has
been
removed
and
and
then
as
we
as
as
reviewers
our
volunteer
boards.
The
reason
for
removal
is
listed,
it's
either
abuse
neglect
dependency
and
it
there
is
a
description
in
the
case
of
what
happened.
K
You
know
how
it
happened
and
what
what
led
to
their
removal
and,
of
course,
in
our
reviews,
when
we
review
it
and
we
may
have
biological
parents
foster
parents,
Casa
volunteers-
that
of
course,
the
caseworker
Guardian
ad
litems
Aetna
Sky
program
representatives
are
or
what
have
you
there
and,
and
we
re
revisit
that.
You
know
and
clarify,
what's
in
writing
for
us
and
and
we
call
them-
we
refer
to
them
as
IPR
interested
party.
K
K
B
Thank
you,
Mr,
chair
and
obviously
thank
you
very
much
for
being
here.
I
appreciate
your
presentation,
so
this
is
a
particular
interest
to
me:
I'm,
the
founder
of
a
Sierra's
house,
which
is
in
Brandenburg,
which
is
a
transitional
home
for
women
that
have
been
previously
incarcerated.
So
one
of
the
things
that
I
see
in
here
is
that
and
I
love
these
the
legislative
recommendations
love
these.
B
But
by
chance
do
you
also
have
executive
recommendations,
because
I
think
that
there's
potentially
some
latitude
that
the
executive
branch
has
that
could
help
in
this
area,
especially
with
the
reluctance
I'm
just
going
to
say,
reluctance,
not
necessarily
from
the
executive
branch,
but
from
society
as
a
whole
to
incarcerate
people.
You
know
a
lot
of
the
times.
The
neglect
and
the
abuse
that
we
see
as
we've
talked
about
before
was
calls
from
substance
use
disorder,
and
so
it
appears
to
me
like
that.
L
I
was
going
to
say,
we
don't
necessarily
provide
recommendations
to
the
other
Branch,
but
we
do
have
some
programs
that
we're
going
to
be
initially
implementing.
But
it's
going
to
be
looking
into
some
of
those
concerns
and
issues
I'm,
not
sure
if
you're
familiar
with
the
Kentucky
judicial
Commission
on
mental
health,
and
so
when
you
said
something
about
how
we
have
women
that
are
have
been
previously
in
dealing
with
substance
use
and
those
kind
of
concerns.
K
E
E
E
Has
anybody
given
any
thought
to
how
the
state
needs
to
prepare
for
these
children
that
we
know
are
coming
at
us
and
are
going
to
be
coming
out
as
hard
and
fast
very
soon
from
women
who
are
incapable,
from
their
circumstances
of
actually
being
safe,
effective
mothers
either
because
of
poverty
abuse,
a
dependency
or
whatever
issues
that
they're
coming
from
that
they
would
have
chosen
to
terminate
that
pregnancy?
Do
we
have
an
idea
of
what
we
need
to
prepare
for.
L
So
I
mean
to
answer
your
your
question
honestly
as
a
review
board
program.
That's
something
we
anticipate
it's
more
conversation
about
what
we
can
do
as
a
program
to
prepare
for
that
kind
of
situation.
So,
honestly
we
we
tried
to
collaborate
a
lot
with
with
the
CBS,
but
as
far
as
being
in
a
place
where
we're
I
think
prepared
yeah
for
I
I,
don't
know
if
we're
at
that
point
and
just
being
completely
transparent
does.
K
And
to
further
answer
your
question
about
your
first
question
about:
are
all
of
these
cases
being
reviewed.
The
the
the
statute
requires
us
to
review
them
at
least
every
six
months.
Some
we
will
review
as
often
as
two
months
or
four
months
down
the
road.
If,
if
the
circumstances
at
the
time
we
review
them
and
and
we
interview
these
people
and
write
our
findings
record
our
findings
and
write
our
recommendations
to
the
judge,
and
that
goes
to
the
judge.
K
We
can
Market
attention
judge
if
it's
urgent-
and
we
may
bring
that
case
back
in
two
months-
three
months,
four
months,
depending
on
what
our
recommendations
are
to
make
sure
that
that
has
happened
in
that
timely
basis.
We
don't
want
to
wait
six
months,
you
know
so
and
by
virtual
platform
we
we
did
not
miss
a
case
in
in
in
20,
beginning
in
in
at
the
beginning
of
the
pandemic,
so
the
it
enabled
us
to
make
them
all
and
to
comply.
E
A
Well,
thank
you,
I,
don't
think,
there's
any
other
questions.
Thank
you
all
again
for
being
here.
You
all
have
given
us
recommendations
and
you
have
been
actually
part
of
legislation
over
the
past.
You're
part
of
house
bill,
one
you're
part
of
some
of
the
legislation
we've
done
over
the
past
few
years.
We
have
taken
your
recommendations.
We've
worked
hard
to
put
more
emphasis
on
kinship
care
and
and
for
them
to
be
given
the
same
considerations
foster
parents.
We
put
that
into
a
couple
of
bills.
The
guardian
Adel
item
program,
we
know,
has
several
issues.
A
We
have
started
looking
at
the
legislation
for
that,
but
we
know
also
that
Justice
Lambert
has
been
working
on
that
program
to
try
to
revamp
things
there
as
well,
so
that
the
the
legislature
doesn't
have
to
get
involved
in
that,
but
we've
added
Family
Court
judges
and
we
judges
and
we've
done
legislation
to
give
children
to
foster
parents
more
voice
in
that
court
process,
so
we're
trying.
But
as
we
pass
that
legislation
again,
it
has
to
be
followed
and
so
that
that
burden
is
placed
on
someone
else.
K
We
thank
you
thank
you
and,
and
FYI
representative
me
the
the
subject
of
our
September
forums.
We
have
four
scheduled.
This
September
is
going
to
be
we.
We
always
have
a
a
focus
on
each
one
of
those
forums.
It's
going
to
be
on
kinship
care
and
some
of
the
changes
that
are
coming
about
and
get
the
feedback.
So
it's
a
it
it
we
get
feedback.
We
also
try
to
educate
as
well.
You
know
so
so
that's
that's
the
subject
of
the
upcoming.