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Description
This is the fourth meeting of the 2021-2022 Interim. Please see the agenda for details.
For agenda and additional meeting information: https://www.leg.state.nv.us/App/Calendar/A/
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A
Welcome
back
folks
getting
ready
to
pick
up
where
we
left
off,
so
we
are
live
and
we
are
gonna
move
right
back
into
our
agenda
items.
Our
next
agenda
item
is
a
number
eleven
right:
okay,
the
demarcation
between
youth
and
young,
adult
services,
gaps
and
challenges,
and
continuation
of
care
and
its
impact
on
youth
in
the
child,
welfare
and
juvenile
justice
system.
A
We
have
quite
a
few
people
here
during
this
presentation
to
either
present
and
or
answer
questions.
So
I
would
ask
that
whoever
is
going
to
get
us
started,
go
ahead
and
introduce
yourself
and
please
proceed.
B
Good
afternoon,
chair
peters
and
members
of
the
committee
for
the
record,
my
name
is
joe
malay.
I'm
deputy
administrator
with
the
division
of
public
and
behavioral
health
and
with
me
today
is
ellen
richardson
adams,
who
will
be
presenting
she's.
The
agency
manager
of
outpatient
clinics
for
southern
nevada,
adult
mental
health
services
and
the
rural
clinics.
B
B
C
Good
afternoon,
members
of
the
committee
ellen
richardson
adams
for
the
record
next
slide,
please
a
broad
overview
of
dpbh
with
clinical
services.
We
serve
the
rural
and
frontier
areas
along
with
urban
clark,
county
and
then
washoe
county.
There
are
16
outpatient
clinics
across
the
12
nevada
counties
in
which
we
serve
children,
adolescents
and
adults
for
southern
nevada,
adult
mental
health.
In
the
urban
areas
we
serve
the
age
of
18
and
over,
but
for
mesquite
and
laughlin.
We
serve
youth
adolescents
and
adults.
Northern
nevada,
adult
mental
health
services
serves
ages
18
and
over.
C
Service
variety
that
is
offered
include
the
following:
medication
management,
counseling
case
management,
bst
and
psr.
There's
psychological
testing.
We
have
some
co-occurring
programs
for
those
that
have
substance,
abuse
and
mental
health
bless
you
benefit
enrollments
such
as
insurance,
food
assistance,
social
security,
disability
and
other
outside
resources.
That
would
be
helpful
for
someone
we
do
have
drop-in
centers
across
some
of
the
different
clinics
and
then
we
also
provide
crisis
stabilization
team
support
in
the
rural
counties
and
there's
a
program
for
youth
and
there's
a
separate
program
for
adults.
C
C
C
C
As
ms
malay
had
mentioned
earlier,
we
do
recognize
the
importance
of
this
age
group.
It's
a
very
it's
a
very
big
time.
Right,
remember,
he
turned
18
and
it
was
like.
Oh
I'm,
a
big
adult
now
and
then
oh
my
gosh,
I'm
an
adult.
Now,
that's
very
scary
right,
and
so
we
really
focus
on
that
age
group
to
help
that
make
it
a
true
transition
for
the
individuals
who
are
hitting
that
big
milestone.
C
C
Well,
all
of
a
sudden,
you
turn
magic
18
and
you
have
decisions
you
have
to
make
on
your
own,
and
services
can
be
voluntary
unless
they're
court
ordered.
So
sometimes
we
do
have
youth.
That
say
thanks,
but
no
thanks,
and
so
we
work
out
a
process
with
them
that
when
they
are
at
that
point
are
interested
in
services.
C
Stamps
and
nams
both
have
legislatively
approved
young,
adult
and
transition
caseloads.
For
the
case
management
side,
it
is
a
15
to
1
case
load
ratio.
Part
of
the
reason
why
that
ratio
is
so
low
is
because
of
the
need
for
intensive
services
and
access
to
their
case
manager.
For
that
dial,
a
friend
to
help
out
with
any
type
of
services
that
they're
seeking
or
for
guidance.
C
So
young
adults
in
transition
for
the
urban
areas
is
a
little
different
than
the
young
adults
in
transition
in
the
rural
areas.
So
I'm
going
to
take
a
minute
to
to
talk
through
the
difference
for
the
urban
areas.
We
begin
that
process
at
about
six
months
prior
to
them.
Turning
age
18,
we
join
as
a
partner
with
their
child
family
team
meetings.
C
C
So
we
really
value
that
piece
and
we
continue
that
engagement
even
after
they
turn
18.
So
we
try
to
keep
those
primary
points
of
contacts
in
place
for
them,
so
that
way,
you
know
it
sustains
their
their
energy
into
wanting
to
be
in
services.
So
some
of
the
strategies
that
we
use
is
like
hey.
Do
you
want
to
come
see
our
place
come
on?
Don't
you
come
take
a
tour
right
and
then
it's
not
happening
to
enter
that
building
by
themselves.
C
They
have
somebody
that's
going
to
guide
them
through
the
process.
You
know
this
is
what
the
doctor's
office
looks
like.
This
is
what
the
counseling
room
looks
like
come
see
the
drop-in
center.
You
can,
you
know,
get
onto
the
computer
and
check
social
media
or
apply
for
a
job
if,
for
whatever
reason,
they're
not
able
to
come
out
and
see
what
one
of
the
residential
homes
looks
like
we
take
pictures
out
to
them.
So
that
way
they
can
see
and
they're
part
of
that
decision-making
process
of
what
their
future
home
may
look
like.
C
If
they're
out
of
state
or
again,
if
they're
not
able
to
meet
face-to-face,
we
have
set
up
different
video
conference
options
so
that
way
again,
that
relationship
building
begins
and
they
can
start
to
meet
their
providers.
That
way,
we
provide
information
on
what
is
adult
services.
What
are
what
are
some
future
things
that
you
want
to
do?
What
do
you
have
dreams
of?
How
can
we
help
get
you
there,
and
so
it
really
is
a
series
of
abridging
for
that
age
and
to
really
hold
their
hand
and
help
them
through
that
process.
C
For
the
rule
areas
it's
slightly
different,
so
one
of
the
positive
pieces
is
because
we
do
serve
youth
adolescents
and
adults,
oftentimes
they're
able
to
stay
with
their
same
provider.
So
I'm
you
know
17
years
11
months,
and
I
have
you
know,
miss
smith
is
my-
is
my
counselor
well
next
month,
when
I
turn
18,
ms
smith
can
still
be
my
counselor,
and
so
that
really
helps
them,
because
there's
again
that
relationship
and
that
counselors
then
they're
helping
them
through
that
process.
C
If
they're
already
in
the
child
welfare
system,
the
team
continues
to
participate
in
those
child
family
team
meetings.
We
cooperate
with
the
different
educational
settings.
So
if
they're
in
high
school
we're
working
with
their
with
their
local
school
that
they
attend
and
then
helping
bridge
those
pieces,
there
is
a
component
on
the
individual
education
plan.
If
somebody
does
have
an
iep
in
which
they
talk
about
right,
age,
14
and
over
what
are
my
educational
plans?
What
are
my
vocational
plans
and
so
we'll
help
participate
in
that
piece
too.
C
So
that
way,
we're
able
to
carry
that
forward
and
it's
not
just
a
document
or
just
a
process
that
ends
at
age
18..
We
can
carry
that
there's
supportive
services
with
transitioning
from
youth
to
adulthood
and
really
helping
with
that.
What
is
my
life
plan?
How
do
I
continue
to
be
forward
thinking
you
know?
Sometimes
I
don't
know
what
I'm
gonna
look
like
at
age:
25,
that's
so
old
right
and
then
helping
them
get
to
that
place.
And
what
do
you
want
to
do
right
and
you'll?
Hear
kids
say
things
like?
C
C
The
again
the
key
piece
is
they're
able
to
maintain
that
behavioral
health
service
provider
and
team
they're
not
starting
over.
I
don't
have
to
tell
you
my
story.
You
already
know
my
story
and
now
you're
just
walking
me
through
that
big
milestone
of
turning
18.
C
C
It's
really
important
that
we
have
that
in
place
for
the
youth
that
are
aging
into
adult
systems.
It
provides
an
introduction,
and
in
that
discussion,
opportunity
for
next
steps.
It
makes
it
not
so
scary
that
I'm
turning
18
and
I'm
now
an
adult
it
helps
to
establish
that
familiarity
of
people,
environments
and
processes
and
really
creates
that
warm
handoff.
C
C
So
we
really
look
at
items
that
are
specific
for
that
age
group
that
will
incentivize
them
to
want
to
come
and
follow
with
their
appointments,
and
so
it's
a
really
great
program
as
a
whole
for
people
who
want
right.
I
come
to
my
appointment.
I
do
what
I'm
supposed
to
do
and
then
they're
like
I
I
get
this
backpack
is
this
for
me
and
they
walk
out
and
I
see
them
from
my
office
windows.
C
So
it's
pretty
cool
and
they
kind
of
strut
and
there's
like
just
this
excitement
about
them,
and
so
we
have
found
that
that
tti
piece
has
been
really
a
great
option.
We
participate
with
clark,
county
juvenile
services
and
we
are
partnered
for
the
harbor,
and
so
we
have
staff
that
are
assigned
down
there.
We
can
also
provide
services
and
supports
for
families
with
resources,
I've
added
their
website
in
case
you're
interested
and
then
through
clark,
county
school
district.
C
They
have
mission
high
school,
and
so
we
have
two
staff
that
are
assigned
down
there
again
as
well,
so
individual
youth
who
have
co-occurring
disorders
and
are
in
recovery
actively
this
specific
high
school,
helps
them
to
maintain
their
recovery
and
the
goal
of
having
on
two
of
our
staff
stationed
down
there
is
it
helps
them
bridge
then
into
adult
services,
and
so
we
can
continue
post
18
that
piece
for
their
co-occurring
and
continued
recovery.
And
again
I
added
the
website
in
case
you're
interested.
C
There
are
some
limitations
with
community
leave
living
transition,
and
I'm
going
to
describe
that
really
quick.
So
if
you're
18
19
years
old,
oftentimes
the
the
housing
that
is
available
as
30
year
olds,
40
year
olds,
50,
60,
80
and
they're,
not
necessarily
seen
as
fun
right
like
I
don't
connect
with
you,
you
don't
understand
my
life
and
so
sometimes
they're.
Just
it's
hard
to
get
that
engagement
and
so
really
looking
at.
C
How
can
we
make
a
specific
almost
like
when
you
would
go
to
college
and
there's
like
a
dorm
in
an
r8
type
of
thing,
something
like
that,
where
there's
opportunities
for
them
to
learn
how
to
do
chores
and
to
have
people
of
their
same
age
group
that
they
can
connect
and
build
a
relationship
in
socialization
with
one
piece
is
as
well
as
adults.
C
The
licensing
is
for
adult
residential
types,
beginning
at
age,
18.,
so
you're
not
eligible
when
you're
age,
17
and
364
days,
you're
not
eligible
to
enter
that
adult
housing
based
on
licensing
until
you
truly
are
18,
and
so
sometimes
there's
that
little
bit
of
overlap
when
somebody's
turning
17
or
sorry
is
17.
Turning
18.,
I
kind
of
talked
already
about
what
those
opportunities
would
look
like
so
really
some
type
of
a
young
adult
housing
type.
C
That
would
really
focus
on
that
age
group
where
they
can
build
friends
and
they
can
build
relationships
and
learn
how
to
do
those
adult
things
like
cooking
cleaning.
You
know
managing
their
money
and
making
those
independent
decisions.
C
I
spoke
to
it
gently,
but
when
an
individual
is
coming
from
an
acute
inpatient
or
prtf,
usually
they
can
only
stay
there
until
their
18th
birthday,
their
18th
birthday
they're
no
longer
meet
eligibility
criteria,
but
just
as
I
kind
of
spoke
to
you
can't
really
enter
that
adult
world
until
you
are
18,
and
so
there's
this
24-48
gap
around
their
birthday,
where
it
is
kind
of
a
state
of
limbo,
and
so
we
do
our
best
to
work
through
that
on
an
individualized
basis.
And
but
it
is,
it
is
a
challenge.
A
A
C
Thank
you,
madam
chair
ellen
richardson
adams,
for
the
record,
so
some
opportunities
would
be
for
us
to
to
really
look
at
what
is
there
another
licensing
type
that
we
could
add
into
into
statute?
Possibly-
and
maybe
it's
a
you-
know,
age,
16
or
17
through
22-
I'm
really
thinking
off
the
top
of
my
head.
C
A
No
that's
great
anna.
I
love
that.
I
think
it's
worth.
It's
definitely
worth
exploring
what
it
might
look
like,
because
we
know
that
that
age
group
right
really
16
to
24
is.
Is
this
group
that
we
consistently
see
having
not
having
the
bridge
right,
that
we
have
services
on
either
side
and
even
in
our
homeless
discussions
and
our
lgbt
youth
discussions
like
this
is
that
age
range
where
we
haven't
built
out
services
that
are
effective,
or
at
least
not
effective
enough
across
the
state
to
capture
those
kiddos?
A
So
I
think
that's
a
great
idea
to
look
into.
Thank
you
for
that
that,
for
that
idea-
and
I
just
as
a
side
note-
I
could
imagine
retiring
and
becoming
one
of
these
people
who
helps
like
here's.
How
you
clean
a
kitchen
here
is
how
you
maintain
your
pots
and
pans.
Here's
how
you
balance
a
checkbook.
I
think
that
there's
a
lot
of
opportunity
there
within
the
community
to
tap
into
resources
who
would
love
to
come
in
and
participate
in
in
a
smaller
setting,
with
specifically
that
age
range
of
kids.
E
A
I
actually
think
about
that
quest
that
that
class
frequently
now
that
I
have
kids
my
cupboards
being
open
and
the
way
you
put
pans
on
your
stove
things
that
I
learned
in
homec
in
middle
school
and
not
I
don't
know
I,
I
would
have
to
look
at
or
talk
to
the
school
districts
about
how
we
teach
that
these
days,
but
it
stuck
with
me
anyways.
I
think,
with
that
we
don't
have
I'm
not
seeing
any
other
questions,
so
we'll
go
ahead
and
close
out
this
agenda
item.
A
A
F
F
F
F
She
was
a
master
of
social
work.
Student
at
the
university
and
through
an
internship
at
a
shelter
in
reno,
discovered
that
the
youth
homeless
population
in
our
community
was
the
fastest
growing
sub-population
of
homeless
in
the
area
and
so
upon.
Graduation
was
able
to
put
together
and
start
our
organization
in
2015.
F
We
did
open
a
drop-in
center
that
was
located
on
east
6th
street
in
reno.
It
was
a
monday,
through
friday
drop
in
center,
from
nine
to
five
for
youth
age
12
to
21
to
access
day
services
in
2020.
We
expanded
to
our
current
facility,
downtown
reno
on
willow
street
and
with
that
expanded
our
drop-in
center
added,
an
emergency
shelter,
a
community
living
program
and
our
transitional
housing
program
that
17
000
square
foot
facility
is
where
we
currently
operate.
F
That
is
a
fully
owned
facility
that
we
have.
We
don't
have
any
debt.
We
were
actually
able
to
purchase
that
facility
thanks
to
a
loan
from
the
housing
division
at
the
state
for
two
million
dollars
that
was
given
to
us
back
in
2018
and
in
july
of
2020,
we
were
able
to
fully
pay
off
that
loan,
which
is
amazing
thanks
to
a
lot
of
community
support
and
and
foundations
in
the
northern
nevada
community.
So
again,
it's
very
appreciative
of
the
state
for
the
funding
to
actually
help
us
begin
that
process
in
2020.
F
We
were
also
recognized
as
an
envision
center
by
a
housing
and
urban
development
by
the
state
by
the
feds.
Excuse
me,
an
envision
center
is
a
identified
central
hub
for
resources
and
support.
We
were
the
first
in
nevada
and
we're
on
one
of
only
100
in
the
country
in
2021
and
granted
2020.
That's
also,
obviously
the
pandemic
we
opened
in
january
and
we're
able
to
to
survive
and
keep
going
and
expand
our
services
throughout
the
pandemic,
which
I
think
is
very
exciting.
F
F
This
is
a
short
view
of
our
continuum
of
services
at
eddie
house.
All
have
our
we
see
as
entry
points
to
our
services,
with
the
exit
points
being
both
diversion
and
independence
to
the
far
right
in
a
situation.
Anybody
that
encounters
us
directly
through
our
outreach
activities,
our
drop-in
center
or
emergency
shelter.
Our
priority
is
to
do
diversion
to
prevent
them
from
actually
accessing
the
shelter
long-term,
to
get
them
into
permanent
housing
or
to
prevent
them
from
becoming
homeless
or
maintaining
their
homeless
situation
long
term.
F
However,
clients
tend
to
skip
around
based
off
of
what
their
needs
are,
and
so
we
really
want
to
make
sure
that
we're
serving
each
and
every
client
right
where
their
you
know
their
needs
are,
and
so,
while
it
is
like
a
step,
stool
or
a
ladder
towards
independence,
we
recognize
that
every
client
will
be
served.
You
know
based
upon
their
specific
needs.
F
Our
outreach
program
is
primarily
street
outreach
to
both
encampments
motels
apartments,
identifying
homeless,
youth
in
our
community
and
providing
them
with
resources,
essential
things
like
fruit,
snacks,
warm
clothing,
hand,
warmers
and
information
about
eddie
house
and
our
services,
so
that
we
can
become
a
hub
for
them
and
a
service
to
them
in
their
time
of
need.
We
also
do
different
partner
outreach
at
other
shelters.
F
For
example,
the
nevada
cares
campus
different
juvenile
justice
court
systems
and
identifying
other
partnering
shelters
where
we
can
do
outreach
again
as
you've
heard
in
previous
presentations
when
it
even
comes
to
housing,
but
obviously
for
shelters,
as
we
are
dedicated
towards
youth,
we're
on
a
more
appropriate
facility
than
youth
who
might
be
at
the
cair's
campus.
F
Our
drop-in
center
is
open
24
hours
a
day.
We
offer
it's
the
basic
essential
services,
like
you
see
here
in
our
presentation,
mail
service
therapy,
laundry
vouchers,
basically
any
essential
service,
that
a
youth
in
who
is
homeless
or
at
risk
might
need
at
the
time
essential
supplies.
Are
things
like
narcan
for
those
who
might
have
an
opioid
addiction
could
also
include
first
aid
kits.
I
mean
anything
that
we
really
need
to
make
sure
that
we're
providing
anything
of
substance
to
the
clients
that
we
serve.
F
Our
emergency
shelter
is
an
overnight
shelter,
cots
and
beds
are
reserved
daily.
We
have
no
sobriety
requirement.
We
have
on-call
support
from
our
therapist
and
our
case
management
team,
24
7,
so
that
any
youth
facing
crisis
has
a
support
system
available
to
them.
Our
capacity
is
currently
approved
for
27
men
and
four
women.
F
Over
the
course
of
our
history.
We
have
tended
to
serve
about
60
to
65
percent
men
over
women.
Although
we
have
seen
our
our
female
numbers
grow
over
the
last
eight
to
nine
months,
we
always
have
additional
costs.
We've
never
had
to
turn
anybody
away,
and
that's
a
great
thing
about
the
very
dynamic
building
that
we
currently
operate
in
our
community
living
program
is
that
next
step
after
the
emergency
shelter,
this
is
a
temporary
housing
program
that
we
also
operate
at
the
same
facility.
F
It
has
the
capacity
currently
for
23
men
and
six
women.
It's
a
six-month
program
that
has
a
higher
expectations
of
the
clients
and
a
higher
level
of
commitment
from
them.
It
is
a
sober
living
environment.
We
try
to
say
it's
a
six
month
program.
Some
clients
move
it
through
it
much
faster.
Some
take
a
little
bit
longer
as
you've
heard
a
lot
today
and
you'll
see
some
more
statistics
from
us
here
shortly.
You
know
our
clients
have
faced
a
lot
of
trauma,
they're
coming
from
a
lot
of
different
backgrounds.
F
F
We
have
a
very
holistic
approach
when
it
comes
to
our
community
living
program,
while
the
goal
of
every
shelter
should
be
trying
to
house
people
as
fast
as
possible.
You
often
hear
that
defined
as
the
housing
first
model
and
that's
what
again
most
shelters
across
the
country
will
say
is
the
standard,
and
while
we
don't
disagree,
we
do
disagree
a
little
bit
in
that.
For
transitional
age,
youth,
just
giving
them
a
job
and
an
apartment
by
themselves
is
not
going
to
fix
the
problem.
F
I'm
not
aware
of
many
18
to
24
year
olds
that
are
employed
and
able
to
afford
to
live
on
their
own
or
have
the
life
skills.
Have
the
mental
health
awareness
know
the
resources
in
the
community
to
be
successful
independently,
and
so
we
focus
on
a
holistic
approach
through
our
programming
in
our
community
living
program
around
these
five
areas.
These
five
areas
were
identified
by
the
university
of
nevada,
dr
kenneth
cole
and
the
counseling
education
program,
and
this
is
the
basis
for
how
we
conduct
our
programming
at
the
eddy
house.
F
So
we
do
a
lot
of
these
things
through
groups
and
strategic
partnerships
with
government
agencies,
other
non-profits
companies,
volunteers
in
the
community.
They
all
together
provide
about
80
percent
of
the
programming
in
groups
that
we
teach
throughout
the
week
with
the
remaining
balance
being
taught
by
in-house
our
own
staff.
F
A
lot
of
the
the
plans
that
the
the
research
is
based
on
comes
from
foster
youth
transition
plans
and
the
foster
youth
connect
network
in
the
washington
area
following
their
graduation
from
the
community
living
program.
Our
clients
are
eligible
to
move
into
our
residential,
I'm
sorry,
our
transitional
living
program.
This
is
transitional
housing
that
these
clients
are
able
to
access
for
up
to
two
years
by
paying
a
small
program
service
fee.
F
Excuse
me
they're,
required
to
check
in
with
cash
management,
on
a
weekly
basis,
with
the
face
to
face
at
least
once
a
month.
The
key
thing
here
is
that
most
youth,
once
they
are
employed
and
while
in
this
age,
are
not
eligible
for
a
lot
of
the
affordable
housing
vouchers
that
we
have
around
town.
It's
no
secret
that
there
is
an
affordable
housing
crisis,
not
only
throughout
the
state,
but
especially
in
northern
nevada
and
in
the
reno
truckee
meadows
area.
F
We
capture
those
youth
who
are
ready
for
independence,
but
not
quite
ready
to
financially
live
independently,
as
there
are
no
other
options
available
and
both
of
the
houses
we
have
again
a
capacity
of
10
between
our
two
homes,
neither
of
our
homes
that
eddie
house
currently
owns
so
we're
also
at
will
of
you,
know
those
owners
for
us
to
even
maintain
those
programs.
One
of
them
is
at
the
kids
cottage
campus,
it's
a
washoe
county
facility
and
one
is
a
home
owned
by
renown.
F
Our
independent
living
home
is
an
independent
living
program
and
you
heard
dcfs
talk
about
that
a
little
bit
earlier
today.
This
is
our
proposed
pilot
program
to
the
washoe
county
human
service
agency,
for
us
to
open
a
home
and
become
a
provider
to
capture
six
residents
who
are
aging
out,
foster
youth.
This
would
be
a
less
than
12
month
program
where
eddie
house
would
handle
all
of
the
programming
life
skills,
everything
we
currently
offer
to
our
in-house
residents
and
they
would
have
specific
case
management.
We
consider
this
a
homeless
prevention
program.
F
F
99
of
the
clients
that
we
served
said
that
they
were
homeless.
It
was
self-identified
as
homeless.
We
provide
over
five
thousand
showers,
twelve
thousand
bed
nights.
A
bed
night
is
every
night
that
a
single
bed
is
filled.
So
it's
not
representative
necessarily
of
a
specific
number
of
youth.
Just
how
many
beds
we
filled
over
the
course
of
the
year
and
again,
some
of
the
other
services
that
we
provide
are
shown
here
in
2022.
F
Some
of
the
exciting
data
that
we've
already
seen
is
we've
had
a
71
percent
success,
exit
rate
from
our
community
living
program
into
a
either
transitional
living
program
or
a
independent
program
or
permanent
housing
situation.
That's
up
from
45
percent
in
2021
and
already
in
the
first
quarter.
F
Those
who
have
exited
from
our
transitional
home
homes
have
100
percent
exited
into
a
permanent
housing
situation,
whereas
last
year
that
number
was
only
70
percent,
and
we
attribute
this
to
our
new
research-based
model
on
how
we
handle
programming
and
development
within
the
youth
that
we
serve.
However,
in
this
first
quarter
of
this
year
already
we
have
identified
and
served
43
new
homeless
or
at-risk
youth
in
the
northern
nevada
community
and
have
served
a
total
of
136
youth
a
little
bit
about
homeless
youth
as
it
you
know,
I
can't
speak
to
all
homeless
youth.
F
44
percent
of
them
were
homeless
before
they
had
turned
18
48
of
the
clients
that
we've
worked
with
became
homeless
between
the
ages
of
18
and
21,
and
only
8
percent
became
homeless
after
the
age
of
22..
I
think
this
indicates
again
that
nature
of
why
this
transitional
age
is
so
important
and
what
the
presentations
that
we've
seen
today
indicate
that
there's
something
happening
there
when
young
people
are
turning
18
and
are
in
that
age
range
of
of
what's
causing
their
situation.
F
48
of
our
clients
attest
that
the
previous
situation
they
were
living
in
was
unsafe,
which
is
why
they
are
at
the
eddy
house
shelter
when
clients
come
and
they
stay
at
our
shelter.
We
ask
them
where
they
had
slept
the
previous
night,
and
I
think
this
demonstrates
the
transient
nature
of
our
youth,
which
you
heard
earlier
in
one
of
the
first
presentations,
it's
very
hard
to
get
a
solid
number
of
how
many
homeless
youth
they
are
because
there
are
because
of
how
they
move
around.
F
So
31
of
the
clients
we
serve
are
actually
couch
surfing
the
night
before
23
were
actually
in
a
home
of
some
sort
and
31
slept
on
the
street.
The
night
before
36
percent
of
our
clients
also
are
members
of
the
lgbt
community.
F
F
These
are
some
of
the
challenges
that
our
youth
face,
that
we
serve,
and
please
note
that
these
are
self-reported,
so
59
of
the
clients
that
we've
served
last
year
or
actually
in
the
last
five
quarters,
have
self-reported
that
they
were
abused,
neglected
or
assaulted.
As
a
child,
55
percent
of
the
clients,
we've
served
have
reported
that
they
were
physically
or
sexually
assaulted.
As
an
adult
10
of
them
report
being
trafficked,
the
reality
is
in
conversations
with
them
in
case
management.
The
reality
is
closer
to
20
percent.
F
35
of
our
clients
had
been
in
foster
care
at
some
point
in
their
life
and
64,
have
their
diploma
or
high
school
equivalency,
and
that
foster
care
number
is
why
we
believe
that
an
independent
living
home
and
these
independent
living
programs
are
so
important
because
it
again
it's
contributing
to
a
third
of
the
clients
that
we
see.
F
F
Our
in-house
therapist
would
estimate
that
that
actual
number
is
about
75
percent
of
the
clients
whom
we
serve
about.
Eight
percent
of
our
clients
receive
psychiatric
referrals,
half
of
whom
will
need
permanent,
supportive
housing
so
that
they've
got
a
mental
health
diagnosis
that
will
require
permanent
support
over
the
course
of
their
lifetime
that
either
don't
have
the
self-awareness
or
insight
to
recognize
that
they
have
a
disability
because
of
their
mental
health,
diagnosis,
they're,
unwilling
to
become
medicated
or
they're
just
unable
to
take
care
of
themselves.
F
F
F
One
is
an
increase
of
mental
health
providers
to
ease
the
licensing
and
reciprocity
that
is
seen
in
other
states
for
to
increase
the
likelihood
that
other
providers
might
move
into
our
state
and
to
incentivize
mental
health
providers
working
in
the
nonprofit
areas
working
within
homeless
and
youth
homelessness,
you're,
often
working
with
a
lot
of
more
high
acuity
clients
than
you
might
in
a
private
practice.
F
That's
very
difficult
for
mental
health
providers
with
their
own
secondhand
trauma
and
boundaries
and
the
things
that
they
have
to
to
live
through
when
it
comes
to
their
their
work
and
professional
life,
and
so
incentive
they're,
less
likely
to
work
at
non-profit
organizations
like
ours
and
so
incentives
for
those
who
would
do
so
would
be
wonderful,
more
transitional
housing
for
homeless
and
foster
youth
again
increased
funding
for
the
ability
to
have
independent
living
programs
more
vouchers
so
that
we
prevent
clients
from
falling
off
a
cliff.
F
F
We
need
a
a
middle
ground
for
our
clients
before
affordable
housing
is
an
option
just
because
of
the
situation
that
they're
currently
in
when
it
comes
to
their
background,
their
level
of
income
and
their
ability
to
actually
compete
with
everybody
else
on
a
housing
voucher
when
it
comes
to
any
of
the
local
housing
authorities
in
our
state,
the
increase
for
more
public
transportation.
Somebody
else
touched
on
this
a
little
bit
today
as
well.
F
Many
of
the
youth
that
we
work
with
rely
on
public
transportation,
but
public
transportation
isn't
widely
available
in
the
northern
nevada
community
and,
quite
frankly,
the
same
thing
in
southern
nevada.
Community,
reliable
public
transportation
is
important
not
only
for
getting
to
work,
but
also
finding
viable
housing
options.
F
So
even
some
of
the
great
housing
options
that
that
exist
across
the
community
may
not
be
as
close
to
public
transportation
as
if
they
need
to
be
or
again
a
viable
job
for
a
youth
to
begin
their
career.
So
it
creates
a
large
challenge
for
them
more
permanent,
supportive
housing.
F
F
Our
clients
show
up
on
our
door
without
any
of
them,
and
so
it
takes
a
long
time
to
secure
a
birth
certificate,
and
then
you
know,
receive
the
social
security
card
and
and
then
finally,
their
nevada
id,
but
some
sort
of
easier
access
to
homeless,
youth
and
the
homeless
community
in
general,
having
access
to
essential
documents
would
allow
them
to
be
on
a
path
to
find
work,
much
easier
and
work,
much
quicker
and
finally,
ending
legal
brothels
and
adopting
an
equality
model.
F
Eddie
house,
specifically,
we
did
apply
for
one
of
the
nevada
recovers,
non-profit
grants
through
the
governor's
office.
We
understand
that
I
think
a
lot
of
those
have
now
been
passed
through
to
the
appropriate
agencies
and
we
intend
to
go
before
the
housing
division
to
ask
for
three
to
six
million
dollars
for
transitional
living
construction
project
that
we
plan
to
begin
this
year.
A
Thank
you
so
much
for
the
presentation
and
for
outlining
some
of
the
great
work
that's
being
done
at
eddie
house.
It's
been
awesome
to
see.
Eddie
eddie
house
really
come
into
the
vision
that
we
we
first
kind
of
learned
about
in
2000.
Well
I
learned
about
it.
I
guess
in
2017-18.
Maybe
it's
pretty
awesome,
though.
I
want
to
take
a
point
of
personal
privilege
to
share
that
between
the
ages
of
19
and
21
and
22.
A
Maybe
I
was
homeless
twice
and
depended
on
friends
and
couches
to
get
myself
on
my
feet
and
figure
out
what
to
do
next,
so
eddie
house
didn't
exist.
Then
we
didn't
have
a
lot
of
options
in
northern
nevada.
At
the
time
I
had
family,
which
was
great,
but
they
didn't
have
the
space
for
me
to
be
a
permanent
resident
there.
So
so
you,
I
guess
I
wanted
to
just
share
that
as
part
of
the
destigmatizing
piece.
A
Are
there
any
questions
from
the
committee?
Before
I
begin
with
some
of
my
questions,
I
see
doc.
Hardy's
dr
hardy's
hand
is
up.
Please
go
ahead
with
your
question.
F
And
thank
you
for
the
question.
Senator
hardy,
we'll
pull
some
more
specific
data
on
that,
for
you
a
lot
of
the
mental
health
providers
that
we
have
spoken
to
have
expressed
that
this
is
a
concern
for
them
as
well
when
it
comes
to
increasing
the
availability
of
providers.
So
we
will
send
that
answer
to
staff.
A
A
Well,
I
have
a
a
couple
of
questions.
First,
I
want
to
ask
about
the
essential
documents
and
how
you
assist
clients
in
obtaining
those
what
some
of
the
barriers
are
for
you
and
then
also.
What's
your
process
around
our
lgbt
and
trans
or
non-binary,
youth
and
potential
name,
changes
that
are
requested
at
that
point,.
F
The
process
to
to
get
the
essential
documents
takes
a
very
long
time,
often
times.
If
there
is
family,
they
may
be
unwilling
to
help
attain
those
essential
documents,
which
is
what
the
obstacle
is
for
our
youth.
We
use
a
few
different
websites
that
that
cost
us,
sometimes
in
the
hundreds
of
dollars,
to
obtain
an
essential
document
and
a
birth
certificate,
because
not
all
the
of
the
youth
were
born
here
in
the
community.
F
They
may
have
been
born
in
other
states
and
it's
what's
navigating
other
counties
and
other
institutions,
even
though
that
client
has
been
living
in
reno
for
for
many
years,
and
so
it's
a
lot
of
waiting,
then
the
issue
is,
we
have
to
send
in
the
birth
certificate
in
to
social
security,
in
order
to
get
the
social
security
card.
F
We
have
one
client
who,
after
three
months
of
us,
submitting
the
application,
we
learned
that
the
birth
certificate
was
lost,
which
caused
the
process
to
start
over
and
so
just
cleaning
up
those
processes
and
and
returning
to
some
in-person
appointments
or
or
again
when
it
comes
to
the
homeless
population,
the
homeless,
youth
population,
some
sort
of
expedition
in
in
getting
appointments
would
be
the
the
benefit
of
you
know
what
we
could
offer
for
our
clients.
Our
case
managers
walk
them
through
each
of
those
processes,
help
them
fill
out.
F
Every
application
make
sure
that
we
have
every
eye
dotted
and
t-crossed
so
that
we
can
get
those
things
done.
We
have
not
had
to
deal
with
a
name
change
or
anything
when
it
came
to
our
transgender
or
lgbt
community.
As
far
as
the
essential
documents
are
concerned,
but
we
are
aware
of
the
processes
and
are
prepared
to
walk
through
those
processes
again
with
the
large
number
of
of
that
community
that
we
serve.
Most
of
them
are
on
the
streets
because
they
were
removed
from
their
home
because
of
that
lifestyle.
A
F
F
However,
with
an
expansion
we
would
also
be
able
to
offer
more
private
rooms,
for
especially
our
community
living
program
and
other
transitional
programs
to
become
more
accommodating.
We
have
non-gender-specific
bathrooms
as
well
as
gender-specific
bathrooms,
so
we
want
to
do
everything
we
can
to
accommodate
anybody,
no
matter
what
their
identity
is.
A
I
love
and
appreciate
that
I
wanted
to
talk
a
little
bit
about
the
tr,
the
transitional
housing
and-
and
I
do
mean
a
little
bit.
Can
you
just
talk
about
the
capacity
of
your
transitional,
housing
and
limitations?
You
broke
down
pretty
well
for
us,
but
what
does
that
capacity
mean
for
your
wait
list?
Do
you
have
a
wait
list
of
of
kiddos
of
our
youth,
who
are
waiting
for
to
be
a
part
of
that
program?.
F
Yeah,
it
causes
a
big
problem
for
us.
We
have
a
great
front
door
in
our
outreach
program
in
our
shelter
and
we
have
a
community
living
program
that
works,
and
then
we
have
a
full
transitional
housing
program
currently,
which
means
there's
no
room
for
them
and
because
it's
a
two-year
program,
it
can
sometimes
take
a
long
time.
F
So
we
explore
other
options
that
are
available
in
the
community
if
we
have
to
refer
to
other
group
homes
or
push
harder
than
is
ideal
for
a
client
to
live
with
roommates
or
in
a
independent
situation,
knowing
that
their
likelihood
of
success
might
not
be
as
great
as
if
we
could
offer
them
a
transitional
housing
spot.
The
hope
with
our
construction
project
is
to
open
a
minimum
of
20
to
25
doors,
so
that
we
could
make
sure
that
we
have
an
exit
strategy
that
is
equal
to
our
entry
in
programming.
A
Great
thank
you.
I
look
forward
to
seeing
that
that
build
out
in
construction.
Are
there
any
other
questions
from
the
committee
for
the
eddy
house?
I
do
not
see
any
so.
Thank
you
so
much
for
coming,
and
your
presentation
would
really
appreciate
learning
more
about
eddie
house.
A
A
H
A
H
The
division
of
welfare
and
supportive
services
administers
several
programs
that
receive
federal
funding
in
the
interest
of
time.
We
will
not
be
able
to
get
deep
into
every
single
one
of
our
programs,
but
we
did
want
to
give
a
high
level
overview
of
each
one
of
these
programs,
as
all
of
our
programs
are
really
designed
to
move
children,
families
and
individuals
out
of
poverty.
H
H
The
fed
the
child
care
and
development
program
provides
financial
assistance
to
income
eligible
families
to
access
child
care
and
help
all
families
find
quality,
child
care
via
children's
cabinet
and
the
las
vegas
urban
league
next
slide.
Please,
on
the
next
slide,
we
wanted
to
point
out
that
we
have
issued
over
99
million
dollars
been
paid
to
providers.
H
Since
april
1st
of
2022,
we
have
expanded
the
income
eligibility
to
85
percent
of
the
state
median
income
to
serve
more
children
and
families,
and
since
that
expansion,
las
vegas
urban
league
processed
244
new
applications
in
the
first
month,
the
change
was
implemented
and
on
the
next
slide,
we're
showing
that,
while
the
total
case
load
has
dropped
slightly,
we
are
anticipating
a
50
percent
increase
of
eligible
children.
H
I
was
notified
that
the
drop
in
the
number
of
children
being
served
is
actually
due
to
excuse
me
due
to
workforce.
The
child
care
centers
are
having
a
difficulty,
onboarding
staff,
but
we
are
working
with
them
and
currently
77
of
licensed
providers
are
participating
in
the
child
care
program
on
the
next
slide.
Excuse
me,
I'm
sorry.
H
On
the
next
slide,
we
want
to
talk
slightly
about
our
child
support
enforcement
program.
The
child
support
enforcement
program
is
designed
to
engage
both
parents
to
make
sure
they're
part
of
the
child's
life,
but
also
to
bring
financial
support
to
the
parents
that
is
caring
for
the
child
and
on
the
next
slide,
we
like
to
show
that
in
2021
we
collected
over
206
million
dollars
for
children
in
nevada,
and
we
wanted
to
really
point
out.
H
The
next
program
I
want
to
talk
about
briefly
was
our
medicaid
program:
medicaid
in
the
state
of
nevada,
the
division
of
welfare
and
supportive
services.
H
The
next
program
I
wanted
to
talk
briefly
about
was
our
snap
program,
also
known
as
food
stamps.
Currently,
nevada
food
stamp
program
is
serving
438
000
individuals
of
those
177
000
or
approximately
40
are
children
between
the
ages
of
0
to
18..
Snap
has
multiple
programs
to
it.
It
does
not
just
provide
a
monthly
benefit,
it
does
provide
that
monthly
benefit,
but
it
also
provides
employment
and
training,
outreach
services
and
snap
education,
and
we
will
talk
slightly
about
those
on
the
next
slide.
We
talk
about
the
snap
education
program
and
the
snap
education
program.
H
We
also
work.
We
also
work
with
child
physical
activity
classes
targeting
school-age
children,
so
the
snap-ed
program
complements
the
snap
program
on
the
next
slide.
We,
I
will
talk
briefly
about
the
outreach
program.
The
snap
program
provides
federal
funds
for
snap
outreach.
We
partner
with
community
partners.
We
have
12
community
partners
covering
all
16
counties
and
one
independent
city
to
reach
those
families
that
are
not
able
to
apply
for
snap
through
the
traditional
sources
of
calling
in
coming
to
our
offices
or
applying
online.
H
On
the
next
slide,
we
talk
about
our
temporary
assistance
for
needy
families.
The
cash
assistance
program
commonly
referred
to
as
the
welfare
program
and
the
welfare
program
has
multiple
aspects
to
it.
Also
also,
the
welfare
program
provides
a
monthly
check
to
those
who
qualify
but
is
really
tied
to
a
work
program
and
those
work
programs
come
with
many
support
services.
H
The
support
services
include
child
care,
transportation,
work
cards,
counseling
vocational
training,
and
we
are
currently
kicking
off
a
specialized
unit
to
focus
on
individuals
who
are
dealing
with
substance
abuse
disorders,
who
can
and
are
able
to
work
at
the
same
time,
they're
dealing
with
those
disorders
on
the
next
slide.
We
wanted
to
talk
about
the
community
programs
that
come
along
with
snap,
so
the
snap
block
grant.
H
Please
workforce
development
and
benefits
to
young
families
with
young
children,
and
those
benefits
can
be
something
as
simple
as
a
diaper
program
that
we
kicked
off
or
we
received
additional
funding
from
the
federal
government
during
the
pandemic,
and
we
used
part
of
that
money
to
send
additional
money
to
our
town
of
customers.
So
they
had
a
one-time
assistance
to
help
buy
school
close
on
the
next
slide.
H
There
are
successes
in
that
program
and
some
of
you
on
this
committee
may
have
heard
in
our
other
committees
that
the
welfare
division
struggled
meeting
some
of
the
work
participation
rates
at
the
measurement
of
the
federal
government.
For
many
years
we
were
facing
penalties
and
the
two-parent
in
the
all-family
work.
Participation
rate
were
required
to
have
so
many
of
these
families
engaged,
and
we
could
not
reach
the
benchmarks
of
the
federal
government
we
are
able
to.
We
have
reached
those
all
families
work,
participation
rate.
H
We
have
met
the
corrective
compliance
plan
and
last
week
we
were
notified
for
the
first
time
since
the
tanf
program
went
into
effect.
We
are
not
facing
a
penalty
for
not
meeting
the
two-parent
work.
Participation
penalty,
that's
for
the
first
time
on
record
the
next
program,
and
the
next
slide
I
want
to
talk
about.
H
H
The
last
program
I
want
to
talk
about
is
not
necessarily
a
program,
but
it
is
our
targeted
outreach
in
the
welfare
division.
This
was
the
brainchild
of
director
whitley.
It
started
about
eight
to
ten
years
ago
and
eight
to
ten
years
ago,
we
took
one
one
of
our
case
managers
and
asked
them
to
go
out
into
the
community
and
start
connecting
with
community
partners
or
individuals
that
we're
not
able
to
get
to
our
offices
for
whatever
reason.
H
Since
that
time
of
the
one
program
one
person
going
out,
we
now
have
42
of
our
case
managers
servicing
a
161
sites.
Thank
you.
161
sites
statewide,
some
of
those
full-time,
most
of
them
part-time
anywhere
from
mental
health
facilities,
correction
facilities
anywhere
that
we
can
go
that
we've
identified
in
need
for
any
of
our
programs
for
people
for
the,
for
whatever
reason,
weren't
able
to
apply.
H
One
of
the
successes
of
this
program
is
that
there
are
90
additional
sites
waiting
to
sign
up
for
us
and
we
are
we,
along
with
the
other
agencies
that
spoke
today.
We've
had
some
trouble,
onboarding
staff
and
bringing
our
staffing
levels
up
to
where
we'd
like
them,
but
as
we
stabilize
and
move
forward,
we
do
plan
on
continuing
this
program
because
the
feedback
from
our
community
has
just
been
fantastic.
H
With
the
support
we've
been
able
to
give
our
community
partners
and
on
the
next
slide,
we
show
the
outreach
data
that
in
2019
we
took
in
28,
000
applications
were
processed
at
those
community
partners
and
we
attended
120
special
community
events
so,
along
with
the
partners
that
we
visit
every
month
or
every
week
or
some
of
them
every
day,
we
went
out
to
community
events
in
2020.
We
had
to
scale
all
of
our
outreach
back.
H
H
The
targeted
outreach
success
is
what
I've
already
talked
about
the,
but
the
implementation
of
that
was
really
an
office
in
a
box.
Our
case
managers
actually
have.
It
looks
like
a
little
rolling
suitcase
that
has
their
laptop
their
wi-fi,
their
telephones,
their
printers
and
everything.
They
need
to
be
able
to
go
out
and
serve
the
community,
and
we
really
hope
to
continue
growing
that
program
and
we'd
be
open
to
any
questions.
A
Thank
you
so
much
for
the
presentation.
Quite
a
bit
of
work
goes
on
under
your
department.
Can
you-
and
maybe
you
don't
have
these
numbers,
because
it's
kind
of
a
broad
base,
but
can
you
just
give
us
an
idea?
The
order
of
magnitude
of
the
number
of
people
that
you
guys
end
up
working
with
in
the
community
under
each
of
under
all
of
these
different
programs,
not
individually
under
the
programs
but
generally.
H
So,
generally
speaking,
on
an
average
we
process,
69
000
applications
per
month,
we
take
approximately
30
000
phone
calls
per
month
and
updates
and
touches
we
we
te,
we
measure
what
our
workers
do
by
task.
Just
and
that's
just
a
touch.
It
can
be
an
application
of
phone
calls,
somebody
moving
in
and
out
of
a
home,
a
child
being
born
income
change,
there's
about
a
quarter
of
a
million
touches
per
month
on
those
those
cases
that
we
work.
H
We
are
currently
serving
our
largest
case.
Load
is
the
medicaid
case
load
and
it
is
over
900
one
in
four
nevadans
over
one
in
four
nevadans
are
being
served
through
our
agency.
This
time,
monthly.
A
Thank
you
for
that.
It's
interesting
that
crossover
of
medicaid
and
your
division.
So
when
you
say
that
you
have
a
quarter
of
a
million,
I
believe
was
the
number
you
used
folks
under
the
medicaid
program.
Can
you
talk
about
a
little
bit
about
what
your
office
does
there
with
that
group
of
of
clients.
H
So
robert
thompson,
for
the
record
just
to
quantify
that
there
are
over
900
000
individuals
receiving
medicaid
per
month.
The
quarter
of
a
million
are
how
many
touches
we
do
per
month
for
all
of
our
big
three
programs:
food
stamps,
medicaid
and
cash
assistance.
A
H
So
robert
thompson,
for
the
record,
when
a
person
needs
to
has
the
need
for
medicaid,
they
can
apply
through
the
division
of
welfare
and
supportive
services.
Click
in
call
in
or
come
in.
They
can
go
through
our
website
to
apply
for
those
services
they
can
come
to.
One
of
our
offices
to
apply
for
medicaid
and
medicaid
is
one
the
only
program
that
we
have
where
a
person
can
apply
via
telephone
and
actually
attest
to
their
signature.
So
we
can
actually
do
everything
verbally
over
the
phone
with
them.
H
It
is
our
job
to
verify
their
income
depending
on
the
type
of
program
that
they
are
applying
for.
Medicaid
has
multiple
programs
and
over
30
sub
programs,
and
we
have
to
determine
what
category
you
are
eligible
for.
We
go
in.
We
make
that
determination.
We
input
it
into
our
system
and
when
we
approve
it,
then
it
transmits
to
the
division
of
healthcare,
finance
and
policy,
and
that
division
takes
over
the
case
management.
H
Our
constant
engagement
with
those
customers
are
that
we
have
to
continually
update
if
their
income
changes
and
that's
very
common
in
nevada
for
income
to
change.
We
must
complete
an
annual
redetermination
for
federal
guidelines.
We
have
to
do
the
paperwork
packet
with
them
once
a
year
or
verbal
over
the
phone.
H
Some
of
our
customers
are
institutionalized
and
living
in
an
institution,
and
that
would
require
monthly
touches
on
those
cases
to
make
sure
the
case
is
up
to
date
and
the
institution
is
receiving
the
the
full
benefit
that
they
may
have
for
those
customers
that
have
additional
benefits
such
as
waivers.
So
there's
more.
That
goes
on
with
the
medicaid
program
and
fifty
percent
of
our
medicaid
customers
also
receive
snap
food
stamps.
H
So
in
those
cases
not
all
states
are
integrated,
but
nevada
is
integrated.
Some
states
require
that
an
individual
go
to
the
food
stamp
office
to
apply
for
benefit,
and
then
they
may
have
to
go
across
town
to
apply
for
the
medicaid
program
in
the
late
80s
or
early
90s
nevada
integrated
those
programs.
So
we
do
it
all
in
one
touch.
However,
that
means
that
we
are
training
our
case
managers
to
work
on
three
different
federal
programs,
often
with
three
different
sets
of
guidelines
in
one
computer
system.
H
So
we
engage
those
customers
often,
and
then
we
have
the
tanf
program,
which
is
also
integrated
into
the
other
two,
the
welfare
program,
which
has
a
different
set
of
guidelines.
It's
one
of
our
smallest
programs
then
separate
from
those
the
energy
assistance,
child
support
and
child
care
are
all
standalone
programs.
They
are
not
integrated
with
the
other
two
they'll.
Do
referrals
back
and
forth
and
we'll
share
information
back
and
forth,
but
they
are
not
integrated
eligibility.
A
A
It
makes
life
much
easier
when
you
just
have
to
touch
one
one
office
to
get
a
bunch
of
work
done
right
to
ensure
that
you're
getting
the
to
the
resources
that
are
applicable
for
you
and
not
having
to
run
around.
Like
you
said
we
know
we
we
end
up
seeing
people
fall
off
when
they
have
to
go
to
multiple
locations
and
talk
to
multiple
people
for
their
different
services.
So
it's
really
an
amazing
feat.
A
H
I
Thanks
son
good
afternoon,
marco
chapel
for
the
record
the
way
that
that
works.
Currently,
in
fact,
I'm
really
glad
you
asked-
because
I
wanted
to
chime
in
to
say
that
we
just
recently
were
awarded
a
technical
assistance
grant
from
the
oh.
I
can
never
remember
what
the
initials
stand
for.
It's,
the
aphs
aids,
the
american
public
health
or
human
services,
associate
thank
you,
okay,
human
services,
association
and
we're
doing
we're
engaged
in
this
six-month
planning
process
to
streamline
and
align
our
services
for
young
families.
I
This
is
targeting
families
that
have
parents
24
years
and
younger,
and
so
one
of
the
mandatory
requirements
for
that
project
was
that
we
had
a
parent
represented
with
that
used
experience,
and
so
we've
got
she's,
not
she's,
not
quite
24
she's
a
little
older,
but
she
was
24
when
she
was
using
our
x,
our
services
and
she
works
for
us,
and
so
we
have
a
lot
of
our
chiefs
of
the
programs
and
ourselves,
our
the
two
of
us
deputies
and
our
agency
manager
for
child
care.
On
that.
I
Looking
at
that,
because
right
now,
child
care
is
done.
The
eligibility
process
is
solely
done
by
funded
partners,
so
it's
done
by
the
children's
cabinet
and
the
urban
league,
which
creates
an
on
kind
of
an
unnatural
barrier
if
you
will
to
services
for
for
those
families,
because
that
we
can
refer
them
through
when
somebody
comes
in
for
through
the
integrated
application
process.
Right
that
we
can
say,
oh,
you
might
be
eligible
for
child
care
and
we
send
them
to
the
children's
cabinet
normally,
but
we
get
all
the
funding
for
that.
I
So
we're
we're
looking
at
how
we
can
integrate
that
and
make
it
easier
for
families
that
come
in.
Did
that
answer
your
question?
Yes,.
A
And
I
think
that
the
only
the
only
piece
that
I
would
ask
to
have
you
expand
on
a
little
bit.
More
is
the
coven
19
funding
that's
come
in
through,
I
believe
your
is
and
how
that
has
been
used
in
our
communities
to
help
with
the
child
care
really
dire
need
of
child
care
services
in
nevada.
Right
now,.
I
Yeah,
marco
chapel
again
for
the
record,
so
we
have
given
two
rounds
of
substantial
amounts
of
funding
to
licensed
child
care
providers
and
our
family,
friends
and
neighbors
that
are
certified
through
our
child
care
development
program.
So
those
are
individuals,
who've
gone
through
a
background
check.
Their
home
is
safe.
I
They
take
care
of
a
child
for
a
family
who's
eligible
for
subsidies,
and
so
that
person
doesn't
have
a
license,
but
we've
gone
in
or
the
children's
cabinet
or
the
urban
league
has
gone
in
and
didn't
checked
and
make
sure
that
they
meet
all
the
standards
of
the
federal
program
for
to
receive
that
money.
And
so
we
sent
an
initial
kind
of
smaller
amount,
ranging
anywhere
from
you
know,
seven
thousand
dollars
to
to
to
six
hundred
thousand
dollars.
I
In
the
first
round
of
funding
that
we
received-
and
I
I
I
don't
remember
what
that
stands
for
chris.
Do
you
remember
what
crsa
stands
for
it's.
A
The
carotid
virus
relief,
supplemental
funds.
I
Coronavirus
relief,
supplemental
funds
were
provided
initially,
and
then
there
was
a
distinct
and
separate,
and
those
of
you
on
ifc
may
remember
this
pot
of
money
that
came
in
for
provider
stabilization
grants,
and
that
was
specifically
a
lot.
A
lot
larger
amount
of
money
we've
distributed
about
half
of
that
at
this
point
through
the
children's
cabinet
and
the
urban
league.
That's
still
in
the
process
of
of
going
out,
we
actually
exceeded
the
requests.
I
We
got
exceeded
the
amount
of
money
we
had,
so
we
had
to
come
up
with
a
way
to
equitably
complete
that
award
process,
which
I
think
we
we
did.
We
we
came
up
with
a
plan
where
we're
giving
we
we
cut
the
highest
requests,
the
most,
and
so
those
larger
centers
are,
are
going
to
receive
a
little
bit
less
than
the
the
the
basically.
I
The
people
who
applied
for
under
500
000
will
see
no
cut
at
all,
but
anybody
who
applied
for
over
a
million
dollars
will
see
a
a
cut
there,
but
we've
given
them
a
lot
of
money
and
and
we're
also
increasing
the
subsidy
rates.
So
I
think
that
that
hasn't
happened
yet,
but
we're
coming
we'll.
We
should
be
doing
that
around
may
1st
and
then
and
then
hopefully,
we'll
have
more
licensed
child
care
providers
participating
in
that
program.
Does
that
answer
your
question.
A
A
We
had
one
week
where
the
entire
school
was
closed
because
everybody
had
co-fed
everybody,
the
teachers,
the
students
there
was
just
no
way
they
could
keep
it
open
and
they
were
able
to
give
us
that
credit
back
and
ensure
that
we
were
not
harmed
by
that
coveted
closure,
as
we
were
trying
to
figure
out
child
care
for
ourselves.
Well,
I
was
still
working
and
we
still
had
kids
in
in
the
public
school.
So
I
thank
you
for
for
that
breakdown.
A
I
think
what
you're,
what
you're
doing
is
going
to
make
a
huge
difference
and
has
made
a
huge
difference
to
families
so
far
as
we
are
in
recovery.
Hopefully
I
that's
all
of
my
questions
that
I
had
regarding
your
programs.
Are
there
any
other
questions
once
again
before
we.
D
A
J
D
Harris,
if
you
don't
mind,
thank
you
so
much.
My
question
is
about
the
integrated
services
and
kind
of
that
single
application
is
lifeline
included
in
the
assessment
you
come
in
yeah,
maybe
you're
applying
for
medicaid
is,
is
lifeline
eligibility
also
assessed
at
that
point,.
H
So
robert
thompson
for
the
record
at
this
time,
the
only
programs
that
are
integrated
are
medicaid,
snap
and
tanf.
H
We
are
working
through
several
partners
and
through
the
department,
the
of
health
and
human
services
as
a
whole,
towards
a
no
wrong
door
platform
to
be
able
to
use
our
website
to
allow
additional
screenings
for
other
programs
to
be
done.
So
that
is
a
futuristic
concept
that
you've
brought
up,
that
we
are
working
on.
But
at
this
time
the
only
in
true
integration
we
have
are
those
three
programs.
D
Okay,
all
right!
Well,
if
there's
anything
we
can
do
to
to
help.
You
know.
Let
let
me
know,
I
think,
especially
since
you
know
covet
happened
right.
The
power
of
communication
is
has
been
thrown
in
our
face
here,
and
so,
if
if
people
can
apply
for
medicaid
and
get
their
lifeline
eligibility
at
the
same
time,
you
know
I
mean
that's,
that's
beneficial
as
you've
you've
noted,
which
is
why
you've
integrated
the
three
programs
you
have
so
thank
you.
H
Thank
you.
So
if
I
may
jump
robert
thompson
for
the
record,
if
I
may
jump
in,
I
missed
one
bullet
point
that
I
think
is
so
super
important
to
throw
out
prior
to
kovid.
We
were
issuing
approximately
48
million
dollars
a
month
in
food
stamps
and
from
our
agency
last
month
we
issued
a
hundred
and
eleven
million
dollars
in
food
stamps.
So
we've
only.
A
That's
a
really
amazing
numbers,
and
I
I
had
questions
and
we
can
take
them
offline,
but
about
how
your
agency
plays
into
our
food
security
networks
and
making
sure
that
we're
identifying
where
there
may
be
food
deserts
and
how
we
uplift
those
communities
in
that
way
and
if
there's
a
correlation
between
snap
beneficiaries
and
food
deserts.
So
that's
a
broader
conversation
we
can
have
in
at
another
time
but
kind
of
speaking
to
how
complex
your
your
division,
particularly
is.
A
E
Thank
you,
madam
chair.
I'm
just
have
a
question
regarding
the
fraud
and
accountability
of
these
coronavirus
funds.
E
Chair
peters
mentioned
the
particular
incidents
with
her
family
and
their
their
preschool,
where
her
children
go
and
just
wondering
if
you
have
a
list
of
the
child
care
facilities
that
received
money
and
if,
if,
if
so,
how
much
and
if
indeed
they
did
when
they
received
that
money
offer
rebates
to
the
families
that
had
paid
them
by
the
month,
for
instance
in
in
my
family,
I
I
I
provide
or
pay
for
a
grandson
to
go
to
a
preschool
and
they
had
shut
down
at
various
times,
and
certainly
I
haven't
seen
any
reimbursement
didn't
expect
any
reimbursement,
but
just
wondering
about
the
accountability
and
following
these
funds.
I
Marco
chapel,
for
the
record,
we
are
following
it
really
closely
through
the
children's
cabinet
who
who
monitored
the
whole
application
process.
We
are
in
the
process
of
have
so
what
we
did
the
process
was.
I
We
gave
them
half
the
money
up
front
that
they
requested
and
we
had
a
formula
for
how
much
they
could
get
based
on
how
many
children
there
they
were
licensed
to
have
and
and
now
we're
in
the
process
of
getting
their
their
requirement
was
to
send
us
a
report
at
three
months
about
how
they
utilized
the
funds,
and
then
we
would
determine
the
final
payout
based
on
you
know
what
was
remaining
the
amount
of
funds
remaining,
as
well
as
what
they
had
done
with
it.
I
There
was
a
a
caveat
if
you
will,
in
fact,
I
went
back
and
forth
with
the
feds
on
this
one,
because
in
the
the
first
round
we
were
the
the
the
providers
had
to
pass
the
costs
along
to
the
families.
The
second
round,
those
providers
provider
stabilization
grants.
The
the
feds
actually
told
us
that
we
couldn't
require
the
providers
to
pass
along
savings
to
the
families,
because
that
was
meant
to
stabilize
the
provider
program,
not
to
support
families,
and
so
we
we
have
not
gotten
a
lot
of
clarity
from
them.
I
Yet
they
haven't
quite
gotten
back
to
me
yet
on
whether
we
can
count
that
or
not,
but
it
may
be
where
we
are
discounting
them,
because
we
originally
required
that
they
provide
to
pay
20
of
relief
pass
on
20
of
their
total
grant
to
families
in
savings,
and
so
we're
kind
of
going
back
and
forth
on
that.
Right
now,.
E
Thank
you
for
that,
and
so,
at
the
end
of
the
day,
will
you
have
a
public
document
that
can
be
reviewed
about
where
this
money
was?
Who
did
you
send
this
money
to
so
that'll,
be
available
to
to
the
public
for
purview.
I
We
have
that
available.
I
am
not
certain
about
the
rules
about
making
it
public.
So
let
me
I'll
just
follow
up
on
that
and
get
back
to
you
on
that.
We
do
have
a
spreadsheet.
We
could
share.
I'm
not
sure
that
we
can
put
it
like
on
a
website
for
everybody
to
see
but
I'll,
follow
up
and
make
sure
that's
illegal,
something
legal
we
can
do.
Thank
you.
A
Thank
you
and
thank
you
for
that
question.
I
had
the
same
question
when
our
school
shut
down
and
I
sent
them
the
link
to
apply
for
this
grant
and
said
you
should
reply
for
this
and
I
hope
you're
paying
your
teachers
while
this
is
shut
down
and
they
did
fall
end
up
following
up
and
saying
we're
following
the
guidelines
we're
ensuring
that
we're
going
to
meet
the
criteria
and
then
we
ended
up
getting
the
letter
or
the
notice
recently.
A
This
happened
back
in
early
january
when
we
came
back
from
from
winter
break,
and
we
just
recently
got
a
notice
that
they're
extending
that
that
savings
cost
savings
on
to
their
their
clients
and
kiddos.
So,
and
thank
you
for
following
up
miss
chapel
mom.
All
right.
Are
there
any
other
questions
from
the
committee
on
these
particular
topics?
A
A
Okay,
we're
going
to
move
on
to
our
next
agenda
item
agenda
item
14
overview
of
the
nevada
home
visiting
program
which
funds
community-based
services
supporting
children
and
their
parents
from
the
prenatal
stage
to
kindergarten
entry
at
targeted
at-risk
communities.
What
a
cool
program!
I
look
forward
to
hearing
how
things
are
going.
Please
introduce
yourself
and
proceed
when
you're
ready.
G
Thank
you,
chair
and
good
afternoon
vicki
ives
for
the
record
deputy
bureau
chief
child
family
community
wellness
bureau
with
the
division
of
public
and
behavioral
health.
Thank
you
so
much
for
the
opportunity
to
give
a
brief
overview
of
the
nevada
home
visiting
program.
You'll
see
it's
really
an
upstream
intervention.
G
K
Thank
you
and
thank
you
for
having
me
here
today.
My
name
is
tammy
kant.
I
am
a
health
program
manager
too,
for
the
division
of
public
and
behavioral
health.
I
am
the
section
manager
for
the
maternal
child
and
adolescent
health
section,
so
I
will
be
giving
you
a
brief
overview
of
the
nevada
home
visiting
program.
K
So
what
is
the
nevada
home
visiting
program?
So
the
program
serves
expectant
persons
and
families
with
children
up
to
age,
5
or
kindergarten
entry
through
which
trained
professionals
visit
the
families
in
their
home,
maintain
a
regular
schedule
of
visits
and
provide
families
with
ongoing
support,
screenings,
education
and
referrals.
K
Nevada
home
visiting
takes
a
two
generation
approach
to
improve
family
circumstances
in
the
present
and
improve
outcomes
for
the
future.
The
rand
corporation
research
research
shows
that
three
to
five
dollar
return
on
investment
and
service
savings
for
every
dollar
spent
in
home,
visiting.
K
K
So
the
primary
source
of
funding
for
home
visiting
is
a
federal
health
resources
and
services.
Administration
grant
called
the
maternal
infant
and
early
childhood
home
visiting
grant,
also
known
as
mcv.
So
this
program
funds
most
of
the
nevada
home
visiting
efforts.
The
program
has
12
programs
in
seven
counties,
both
urban
and
rural.
K
So
the
first
of
the
models
is
the
nurse
family
partnership
model,
also
known
as
nfp,
so
nfp
serves
the
first
time
pregnant
people
and
their
children
child
up
to
two
years
of
age.
The
current
agency,
using
this
model,
is
southern
nevada.
Health
district
who
serves
clark,
county
nfp,
uses
specially
educated,
educated
registered
nurses
to
regularly
visit
their
clients,
starting
before
28
weeks
of
pregnancy
and
continuing
through
the
child's
second
birthday.
K
The
next
model
is
home
instruction
for
parents
of
preschool
youngsters,
also
known
as
hippie,
so
hippie
serves
families
with
children
ages,
two
to
five
years
old,
until
kindergarten
entry
current
agencies
utilizing
this
model
is
children's
cabinet,
who
serves
washoe,
county
and
sunrise
children's
foundation
serving
night.
In
clark,
county
hippie
focuses
on
parent-involved
and
parent-directed
early
learning,
with
targeted
outcomes
of
improving
the
parent-child
relationship,
promoting
positive
parent-child
interaction,
help
underserved
children
achieve
long-term
academic
success,
increase
parental
involvement
in
child
educational
experience
and
create
pathways
for
parents
to
access
economic
and
educational
opportunities
in
their
communities.
K
The
next
model
is
the
parents,
as
teachers
program,
also
known
as
pat
so
pat
serves
pregnant
people
and
families
with
children
up
to
kindergarten
entry.
The
current
agencies,
using
pat
our
community
chess
and
lions
story
and
mineral
counties
lying
county
human
services
in
lyon,
county
european
paiute,
tribe
and
children's
cabinet
in
washoe,
county.
K
The
early
head
start
program
serves
pregnant
people
and
families
with
children
up
to
three
years
of
age.
Current
agencies
using
the
early
head
start
model,
is
the
university
of
nevada,
reno
serving
washoe
county
and
sunrise
children's
foundation
serving
clark
county,
so
early
head
start
is
its
own
program,
but
they
do
utilize.
The
pac
curriculum
which
I
mentioned
previously,
so
it
gives
them
the
opportunity
to
use
the
pac
curriculum,
but
still
access
their
early
head
start.
K
So
that
is
a
very
brief
overview
of
the
nevada
home
visiting
program.
So
any
questions.
A
A
I
don't
see
any,
but
I
don't
see
clark
county.
So
if
you
are
in
grant
sawyer,
please
unmute
yourself.
If
you
have
a
question.
A
Thank
you.
Thank
you.
So
much
thank
you
for
being
here
and
thank
you
for
this
presentation
looks
like
awesome
work.
I
know
that
a
number
of
those
agencies
are
doing
really
great
things
in
their
with
their
programs
for
parents
and
families.
Did
you
have
other
parts
to
present
or
was
that
that
was
the.
G
Thank
you.
It
was
just
the
brief
overview
of
the
models,
but
if
any
additional
information
would
be
helpful
on
performance
measures,
benchmarks
and
anything
would
be
happy
to
provide
it.
Okay,
okay,.
A
That
is
that's
awesome.
Thank
you
so
much.
I
think.
Next
next
meeting
we
may
be
talking
more
about
the
maternal
health
and
early
childhood
metrics,
so
I
might
reach
out
and
ask
for
those
all
right.
Thank
you.
I'm
going
to
go
ahead
and
close
out
the
agenda
item
then,
and
move
us
on
to
agenda
item
15,
which
is
an
overview
of
forensic
mental
health
services
in
nevada.
B
Good
afternoon
for
the
record,
joe
malay,
deputy
administrator
with
the
division
of
public
and
behavioral
health
with
me
today
is
ellen
richardson
adams.
She
is
the
agency
manager
over
southern
nevada,
adult
mental
health
services,
outpatient
programs
and
rural
clinics.
Also
with
me
today
is
dr
shara
bradley.
B
B
B
B
B
Our
hospitals
and
outpatient
clinics
provide
direct
behavioral
health
care.
Civil
admissions
can
occur
as
emergency
admissions
due
to
a
mental
health
crisis,
the
substantial
likelihood
of
serious
harm
to
him
or
herself
or
others
due
to
mental
illness.
This
type
of
admission
is
commonly
called
a
legal
hold
and
it
is
a
72-hour
admission.
B
This
can
be
up
to
a
six-month
admission
when
we
look
at
our
misdemeanor
programs
understanding
that
the
criminal
system
is
not
the
best
option
for
individuals
with
mental
illness
who
have
committed
a
misdemeanor.
The
misdemeanor
diversion
programs
are
alternatives
that
safely
divert
people
with
behavioral
health
needs
into
treatment
that
produces
better
outcomes
for
the
individual,
the
community
and
the
justice
system.
B
Next
slide,
please,
the
division
of
public
and
behavioral
health
has
secure
psychiatric
facilities,
providing
comprehensive
forensic
mental
health
services.
So,
along
with
civil
health
services,
we
also
provide
forensic
services
from
around
the
state.
Individuals
are
court
ordered
to
lakes
crossing
center
in
northern
nevada
and
murray
stein
in
southern
nevada,
for
evaluation
and
or
treatment
for
restoration
to
legal
competency.
B
B
B
B
B
B
Staffing
shortages
play
a
role
in
our
ability
to
serve
our
clients.
Also
nationally
many
staff
are
leaving
psychiatric
units
for
much
higher
pay
and
less
stressful
conditions.
Elsewhere,
the
departures
have
limited
the
capacity
of
state-run
hospitals,
our
evaluators,
which
are
psychiatrists
and
psychologists,
ensure
evaluations
are
done
to
clients
to
adjudicate
through
the
system.
B
B
B
B
This
decision
is
largely
based
on
a
risk
assessment
performed
by
evaluators
at
our
forensic
hospitals
at
least
once
every
12
months.
The
court
reviews
the
eligibility
of
the
defendant
for
conditional
release
these
defendants,
remanded
to
the
custody
of
the
administrator
for
observation
are
known
as
461
patients.
L
L
If
the
evaluator,
considering
these
factors
and
in
consultation
with
the
individual's
treatment
team
opines
that
the
individual
is
a
good
candidate
for
conditional
release,
then
discharge
planning
process
begins.
This
includes
extensive
collaboration
between
the
individual's
inpatient
treatment
team.
The
team
that
would
work
with
the
client
in
the
community
and
other
resources
to
assure
the
individual
would
have
wraparound
services
to
assure
their
and
other
safety
prior
to
a
final
opinion
and
recommendation
to
the
court.
A
division
psychologist
completes
a
risk
assessment,
identify
factors
relevant
to
future
risk.
L
A
hearing
is
set
with
the
committing
court
for
review
of
the
material
and
for
testimony,
if
any,
the
final
decision
to
release
an
individual
on
conditional
release
is
made
by
the
court.
If
the
court
decides
that
the
individual
can
be
conditionally
released,
an
order
is
prepared
in
final
discharge
arrangements
made
if
the
court
decides.
The
client
is
not
currently
eligible
for
conditional
release.
The
individual
remains
at
the
forensic
facility
and
their
case
is
reviewed
again
in
12
months.
M
M
Can
you
actually
switch?
This
slide
to
the
next
slide.
Thank
you.
We
are
committed
to
providing
evidence-based
services
and
so
again
the
as
when
we
meet
as
a
steering
committee.
We
are
able
to
talk
about
things
that
are
working
in
our
hospitals
and
other
programming
that
is
being
developed
nationwide.
To
respond
to
this
growing
need,
we
participate
in
a
forensic
task
force
meeting
that
is
run
through
the
clark
county,
8th
judicial
district
court.
M
Some
of
our
coming
upcoming
projects
and
goals
as
stein
has
been
in
operation
for
nearly
seven
years
now
we
are
probably
like
many
other
places
needing
to
improve
our
recruitment
and
workforce
development.
Improve
our
staffing.
M
So
we
would
like
to
increase
our
visibility
by
developing
web
pages
and
where
people
could
access
what
our
services
are
and
the
various
job
opportunities
that
we
have
attract.
Trainees
to
our
professional
training
programs
to
improve
that
workforce
development
pipeline
having
web
pages
that
improve
our
communication
with
the
court
system
and
with
families
of
patients
is
also
an
aspect
that
we
want
to
work
on.
M
And
finally,
we
are
striving
to
improve
our
data
tracking
look
at
trends
over
time.
Make
predictions
for
things
that
we
need
to
be
doing
in
the
future
program
development.
And
so
we
can
talk
about
those
kinds
of
things
on
a
statewide
basis,
so
that
we
can
look
at
how
things
are
working
in
in
both
hospitals
and
with
that.
B
One
last
thing
I
wanted
to
yeah.
Thank
you
one
last
thing
I
wanted
to
mention
about
our
opportunity.
The
division
acknowledges
the
growing
needs
for
a
forensic
strategic
plan
over
the
following
years,
due
to
our
changing
environment
and
our
rapid
growth.
B
A
Great,
thank
you
so
much.
I
guess
my
first
question
has
to
do
with
that
plan.
Do
you
think
that
those
that
review
of
the
statutes
will
be
available
before
our
deadlines
for
the
next
legislative
session
and
would
that
be
pushed
off
to
the
following
legislative
session?.
B
Thank
you.
That's
a
great
question,
this
company,
that
we
hope
to
work
with
were
kind
enough
to
give
us
their
work
from
other
states
as
well,
so
that
helped
us
with
some
of
the
statutes
that
we'd
like
to
review,
to
improve
some
of
our
process
to
have
more
up-to-date
processes
that
are
nationally
done
as
well
and
are
evidence-based.
A
So
you
have
a
leg
up
on
it:
okay,
cool,
very
cool.
Well,
I
have
I
have
a
question,
but
I'm
going
to
see
if
the
committee
has
questions
before
I
jump
into
mine,
are
there
any
questions
committee
and
I
cannot
see
the
clark
county
folks.
So
if
you
have
a
question,
please
unmute
yourself.
Oh
I'm
sorry,
assemblywoman
gorlo
asked
for
a
question.
Please
go
ahead.
G
I
did
thank
you,
chair
peters.
I
had
a
quick
question
regarding
the
staffing
we're
hearing
this
as
a
theme
that
we
can't
fill
positions.
So
are
there
certain
credentials
or
educational
requirements
for
these
staff
members
and
what
are
they
and
any
suggestions
on
what
we
can
do
to
help
people
meet
those
credentials
and
requirements.
B
Generally
for
the
record,
thank
you
for
asking
that
questions.
Probably
our
licensed
professionals
are
some
of
the
hardest
to
recruit
here
in
the
state.
Dr
bradley,
I
have
to
admit,
has
done
a
phenomenal
job
of
a
psychology.
Internship
programs
in
multiple
levels,
so
working
with
the
universities
and
helping
us
do
that
is
in
order
to
get
those
recruitments
is,
would
be
great
for
us
as
well.
The
probably
one
of
the
others
are
both
are
mental
health
technicians,
although
they
do
have
a
higher
turnover
and
we
do
have
get
more
applicants.
B
B
So
those
are
probably
that
of
the
last
one
are
in
nevada.
It's
rather
unique
in
that
we
use
forensic
specialists,
which
are
category
three
peace
officers
in
our
forensic
facilities,
and
so
those
currently
are
in
high
competition,
with,
of
course,
our
other
law
enforcement
and
our
correctional
institutes
as
well.
G
Thank
you,
a
quick
follow-up.
You
mentioned
the
mental
health
tech.
What
kind
of
educational
background
does
one
need
to
be
a
mental
health
tech?
I
understand
the
doctor
and
those
take
a
long
time
to
grow,
as
I
say,
but
I'm
finding
even
my
full-time
job
that
I
have
we're
looking
for
professionals
in
the
autism
realm
and
I've
been
suggesting
to
our
ceo,
let's
train
from
within,
and
build
that
pipeline.
That
way,
someone
who
already
has
maybe
a
certificate
in
one
discipline
that
could
only
take
maybe
a
year's
worth
of
training.
G
B
Great
question:
thank
you,
jamilay
for
the
record.
Thank
you,
and
that
reminds
me
of
where
we
have
received
help
from
legislators
is
in
our.
We
have
nursing
apprentice
programs
now,
and
so
we
just
started
those
with
approval.
So
thank
you
for
that,
so
they
they
are
bringing
in
nurses
that
are
in
you
know
their
later
years
of
their
training
program
and
will
be
compensated
to
work
alongside
our
trained
nurses,
experienced
nurses
in
our
facilities.
So
that's
you
know.
B
B
The
mental
health
technicians
only
require
a
high
school
education.
They
do
have
to
take
some
college
of
southern
nevada,
actually
classes
in
mental
health
and
behavioral
health,
but
that
those
are
the
only
requirements
that
they
really
have
to
work
with
in
our
facilities.
D
You
know
on
something
where
they
maybe
should
only
serve
two
or
three
days,
but
they
can't
get
a
competency
hearing
to
go
and
see
the
judge
until
you
know
three
months
or
so
out
and
at
that
point
they've
been
held
for
much
longer
than
whatever
the
offense
may
be
seems
to
me.
That
is
a
staffing
issue,
and
so
that's
a
long
way
of
getting
around
to
the
question
of
how
do
we
fix
that?
B
That's
a
great
question
I
think
case
law
does
require
oregon
versus
mink
actually
was
the
federal
case
law
that
requires
that,
due
to
due
process,
we
get
clients
into
our
facilities
for
competency,
restoration,
to
stand
trial
within
seven
days
and
that's
a
quick
turnaround
time.
Seven
days,
you
know
they
have
they've,
have
gone
through
multiple
judicial
processes
that
take
months,
but
yet
we
have
to
admit
within
seven
days.
So
that's
going
to
be
a
challenge.
B
So
one
of
the
things
you
mentioned
along
with
staffing,
absolutely
because
those
evaluators
they
have
to
be
able
to
you
know
evaluate
the
clients
in
order
to
move
them
along,
but
we
also
have
to
keep
a
safe
environment.
So
we
can't
just
keep
admitting
people
you
know
constantly.
We
have
to
ensure
that
one
we
have
enough
beds.
B
So
the
challenge
is,
we
need
civil
beds
and
we
need
forensic
beds
right,
but
one
is
required
by
federal
law
and
statute
and
the
other
is
not
as
required,
and
so
forensic
kind
of
has
been
our
priority
just
due
to
that
federal
law.
So
staffing
would
help
greatly
and
just
more
bads.
We
we
only
have
so
many
beds
right
and
they're
filling
up,
and
what
do
you
do?
You
know,
after
that,
after
all,
the
beds
are
filled
up.
D
Can
you
tell
me
a
little
bit
about
what
the
assessment
process
looks
like?
Is
it
absolutely
necessary
that
someone
be
admitted?
Could
we
station
someone
at
our,
you
know
most
populous
jails
and
they
can
maybe
do
an
assessment
at
that
point
of
contact?
Is
that
too
simplistic
of
a
solution?
I
don't
know.
B
No
that's
a
great
question.
Jim
lay
for
the
record.
I
think
looking
thank
you
because
one
of
the
statutes
we
we've
looked
at
haven't
garnished
a
lot
of
support
for
those
jail-based
competencies
that
does
bring
those
evaluators
right
into
the
jails
like
do
they
need.
You
know,
commitment
to
a
facility
or
are
they
okay?
You
know
if
they
just
stay
on
their
medication.
B
So
that's
a
process
that
has
to
be,
you
know,
approved
by
those
courts
as
well
in
jails
and
so
yeah.
Any
help
you
can
provide.
There
would
be
great.
The
other
is,
I
think,
as
an
evaluator.
B
Dr
bradley
could
probably
explain
a
little
bit
better,
but
I
think
we
know
that
in
1960
the
u.s
supreme
court
had
a
landmark
case
that
really
required
that
a
defendant
have
a
competency
evaluation
prior
to
proceeding
to
trial,
and
they
that
same
court
case
also
outlined
those
standards
to
determine
evaluation
for
competency,
so
that
dusky
standard
has
a
few
elements,
and
I
think
dr
bradley
could
explain
the
dusky
standard
and
why
those
assessments
take
the
length
of
time
that
they
do,
because
I
think
that's
real
important.
Thank
you.
M
M
If,
after
they
come
to
our
programs,
whether
it's
inpatient
or
outpatient,
then
they
require
evaluations
to
move
forward
from
there,
so
whether
they
are
found
competent
or
incompetent
needing
more
treatment
or
not
able
to
be
restored
to
competence.
So
there's
if
they
just
have
the
two
pre-commitment
evaluations
and
then
three
on
the
other
end,
and
that's
all
they
have
that
right.
There
is
five
evaluations
that
need
to
be
done
on
any
given
patient
or
defendant.
M
So
I
think
part
of
your
question
was
what's
required
and,
and
as
joe
mentioned,
the
dusky
standard
outlines
that
we
have
to
look
at
whether
the
person
understands
the
court
process.
Do
they
have
a
rational
and
factual
understanding
of
their
charges?
Do
they
have
the
ability
to
aid
and
assist
their
attorney
with
their
defense
in
a
rational
way
how
each
evaluator
determines
that
may
be
a
little
different,
certainly
through
interviewing
review
of
records?
M
Sometimes
psychological
testing
is
done
collateral
interviews
if,
if
needed,
to
understand
the
person's
history
or
history
of
treatment,
if
they're
not
able
to
give
that
information
to
us
and
then,
if
they're
inpatient,
we
also
use
observations
from
the
staff
that
see
them.
24
7.,
our
are
the
mental
health
techs
forensic
specialist
nurses,
who
are
seeing
them
day
in
and
day
out
on
on
the
units,
so
they
can
be,
they
can
be
relatively
involved
and
time
consuming,
depending
on
each
particular
case.
D
All
right,
thank
you.
I
appreciate
your
your
responses
and
I'll
just
offer
myself
as
a
resource.
If,
if
I
can
and
trying
to
see
how
we
can
get
these
folks
evaluated
a
bit
quicker,
save
us
some
money,
keeping
them
in
jail
and
and
then
we'll
work
on
the
real
problem
of
why
they're
in
jail
in
the
first
place,
thanks.
A
Thank
you.
Thank
you
for
that
offer
senator
harris
as
well.
I
have
I
have
two
questions
that
have
come
up.
Are
there
any
other
questions
from
the
committee,
though,
before
I
jump
in
with
mine,
I'm
not
seeing
any
so
I'm
going
to
go
ahead
and
ask
my
first,
which
is:
how
are
your?
How
are
your
services
funded?
What
are
your
funding
mechanisms?
B
Joe
malay
for
the
record,
thanks
for
the
question,
so
we
are
100
generally
funded.
We
do
ellen
actually
mentioned
earlier,
a
small
grant
that
we
do
receive
for
some
incentives
for
some
of
the
civil
clients
and
the
outpatient
clients,
but
for
our
forensic
facilities,
it's
pretty
much
100
percent
general
funds.
A
B
Generally
for
the
record,
our
civil
population
can-
and
we
in
fact,
enroll
them
when
they're
in
the
hospital
in
in
kind
of
medicaid
or
mco
programming
that
they're
eligible
for
so
we
do
that
and
that's
pretty
successful.
B
But
our
federal
federal
law
does
not
allow
us
to
get
reimbursement
for
hospital
stays
for
those
forensic
clients.
They
are
termed
incarcerated,
and
so
we
do
not
get
reimbursement
for
those
clients
and
we're
the
only
hospitals
that
take
those
clients
under
178
nrs
178.
So
that
really
does
make
us
very
dependent
upon
the
state
funding.
A
Very
interesting:
this
is
not
a
money
committee,
but
I
think
it's
important
to
understand
how
the
how
the
programs,
interplay
with
each
other
and
some
of
the
the
limitations
that
exist
there
now
my
last
question.
Actually
my
first
question
was:
can
you
can
you
speak
to
what
some
of
the
contributing
factors
are
to
the
national
trend
of
the
increase
in
need
for
forensic
services.
B
Timly
for
the
record,
I
can
certainly
start
that
and
then,
if
drew
or
dr
bradley
has
anything
further
part
of
the
part
of
the
trend
is
I
think
that
more
people
are
being
recognized
as
mentally
ill
and
being
screened
for
mental
illness.
B
The
other
really
an
important
intervention,
though,
and
it's
been
mentioned
all
day-
I
don't
know
if
the
agenda
was
prophetic
or
not,
but
it
was
interesting
that
there
was
so
many
interventions
mentioned
for
the
children
and
they
are
so
important
all
of
them,
because
at
the
under
other
end
of
the
spectrum
are
our
adult
forensic
clients
who
unfortunately,
have
become
criminally
involved,
and
so
prevention
is
probably
one
of
the
best
interventions
you
know
earlier
in
life,
but
the
other
is
the
court
system
and
the
jails
have
become
again.
M
I
I
couldn't
tell
if
drew
was
unmuting
himself,
dr
sher
bradley
for
the
record.
So
that
is
a
very
good
question
and
it's
a
complicated
question.
I
don't
think
we
have
the
full
answer
to
that.
M
M
So
if
you
have
patients
who
aren't
receiving,
if
you
have
people
who
are
not
receiving
enough
services
or
services
that
encompass
all
of
their
needs,
then
they
sometimes
end
up
getting
themselves
into
situations
where
they
get
arrested,
so
that
that
I
think,
is
a
is
a
piece
of
it
there
and
then
you
know.
I
do
agree
with
what
what
joe
is
saying
in
terms
of
people
recognizing
mental
illness,
recognizing
the
need
for
competency
evaluations.
M
There
have
been
cases
that
have
been
overturned
convictions
that
have
been
overturned
because
of
failure
to
recognize
competency
or
have
a
competency
hearing.
So
I
think
that
sometimes
attorneys
are
you
know
the
threshold.
Maybe
to
refer
is
pretty
low.
They
really
rely
on
those
pre-commitment
evaluators
to
tell
them
what's
going
on
with
the
person.
M
So
I
think
those
are
some
pieces.
I
think
there's
there's
probably
lots
of
other
pieces
that
connect
to
it,
but
I
don't
know
if
drew
has
anything
else
to
add
to
that.
L
Across
for
the
record,
I
agree
with
both
joe
and
dr
bradley.
Another
contributing
factor
I
would
mention,
would
be
substance.
Use.
A
Thank
you
for
the
response.
I
I
also
just
want
to
tale
on
that
with.
I
think
that
some
of
the
work
that
senator
harris
was
suggesting
we
work
towards
maybe
part
of
the
solution
to
these
indicators,
or
at
least
maybe
unwinding
of
these
indicators
and
what
we
can
start
to
do
to
get
a
handle
on
populations
before
before.
A
Really
the
increase
starts
or
the
need
gets,
gets
out
of
out
of
hand
love
to
not
have
to
build
more
facilities
if
we
can
get
at
it
from
the
beginning
right,
I
don't
see
any
other
questions
unless
I've
missed
some
related
to
this
topic.
Thank
you
so
much
for.
Thank
you
so
much
for
the
presentation
and
for
the
information
we
look
forward
to
working
with
you
on
these
issues.
A
We're
going
to
go
ahead
and
move
on
to
our
last
presentation
agenda
item
16.
If
I
could
read
roman
numerals
correctly.
This
is
our
update
on
the
coronavirus
disease
of
2019
health
crisis.
Interim
study
pursuant
to
senate
bill
209
vice
chair
donate,
has
been
spearheading
this
and
I
believe
we'll
do
the
presentation.
So
please
begin
when
you're
ready.
J
Thank
you
so
much
chair,
peters
and
I'll
go
ahead
and
try
to
make
this
as
quick
as
possible.
Since
I
know,
we've
had
a
very
long
meeting
for
the
record,
I
am
senator
feven
dunya
representing
senate
district
10
and
today
I'm
presenting
an
update
on
the
kova
19
health
crisis
interim
study
pursuant
to
the
senate
bill
209,
which
is
lab's
legislative
session.
J
Before
we
begin,
I
would
like
to
note
that
a
handout
should
be
available
on
the
committee's
website
and
our
committee
staff
have
been
really
instrumental
in
crafting
these
documents.
For
you,
they
helped
coordinate
a
lot
of
these
stakeholder
engagements,
so
I
strongly
recommend
for
you
guys
to
all
look
and
read
on
some
of
the
information
that
we've
collected
so
far
from
this
study.
J
We
held
our
first
round
table
on
march
15th,
so
that
was
last
month
I
invited
several
stakeholders
to
the
first
virtual
roundtable
discussion
and
this
one
focused
on
the
study
requirements
related
to
the
covenant
pandemic
and
in
nevada's
public
health
infrastructure.
Specifically
we'll
look.
We
looked
at
strengths
and
weaknesses
of
the
public
health
infrastructure.
J
We
took
an
analysis
on
state
and
local
governments
and
how
they
responded
and
how
they
delineated
duties
and
jurisdiction
and
how
they
coordinated
between
one
another.
We
looked
at
how
these
items
can
be
improved
for
future
public
health
crises,
and
then
we
also
talked
about
public
health
funding
recommendations
prior
to
the
roundtable
stakeholders
received
an
11
question
survey
and
the
purpose
of
that
was
to
essentially
ask
them
to
be
forward.
Looking
solutions
oriented
on
you
know
what
they
felt
was
most
important
to
prioritize,
moving
forward
from
covet
19
and
for
any
future
public
health
emergencies.
J
In
the
document
that
the
the
committee
staff
prepared
for
you,
a
list
of
stakeholders
who
receive
the
surveys
and
participate
in
a
roundtable
is
provided
and
many
of
them,
including
carson
city,
health
and
human
services,
the
division
of
public
health,
public
and
behavioral
health
and
the
southern
new
nevada
and
washoe
county
health
districts
or
the
ones
that
were
part
of
it
in
terms
of
policy
recommendations,
since
that's
probably
the
most
impactful
part
of
the
things
that
we're
collecting
from
each
of
these
stakeholder
engagements
on
page
two
of
the
handout,
a
summary
of
the
high
level
discussion
and
themes
was
provided
to
you
all,
including
the
strengths
and
challenges
or
weaknesses
of
our
public
health
system.
J
J
Second,
the
greatest
challenge
identified
was
limited
and
lack
of
funding
for
public
health
programs
across
all
levels
of
the
system
and
a
reliance
on
inconsistent
federal
grant
funding
to
sustain
the
system.
So
a
common
example
that
we
exhibited
between
different
folks
was,
as
you
all
know,
there's
different
processes
to
request
funding.
J
J
We've
already
surpassed
a
few
months,
so
that
really
takes
away
from
our
public
health
response
to
the
challenges
that
we
have.
Additionally,
other
policy
recommendations
for
both
the
kova
19
response
and
the
nevada's
public
health
infrastructure
were
also
summarized.
On
page
two,
we
received
many
different
policy
considerations
related
to
the
code
19
response.
J
The
four
stakeholder
conversations
are
so
the
first
one
that
we
just
completed
was
on
government
coordination.
The
second
one
is
going
to
bring
a
business
entities
and
employees
together
to
share
what
we've
learned
from
the
from
the
business
sector.
The
third
one
focuses
on
public
health
infrastructure
and
the
public
health
of
the
workforce
not
to
be
confused
with
the
health,
healthcare
workforce
and
then
the
fourth
and
final
one
will
be
everything
else,
so
the
special
topics
and
health,
equity,
chairpeders
and
committee
members.
A
Thank
you
vice
chairs,
so
much
for
the
information
and
for
this
this
robust
report.
I
look
forward
to
reading,
through
these
recommendations
and
suggestions
and
to
hear
at
the
end
of
your
your
meetings
or
your
engagements.
What
you
guys
come
up
with
as
priorities.
A
E
You
and
thank
you
for
that
report
and
just
wondering
if
you're
going
to
look
into
some
of
the
basic
health
care
outcomes.
I've
been
seeing
some
articles
now
that
we
can
look
back
a
little
bit
and
we're
nevada
ranks
on
deaths,
treatments,
vaccinations
those
kind
of
things.
I
didn't
really
see
that
here.
J
Thank
you
so
much
assemblywoman
titus.
Even
then,
you
have
to
put
the
record
yeah.
So
that's
part
of
the
last
meeting,
so
that's
the
special
topics,
health
equity,
one
that
will
focus
on
outcomes,
special
populations
that
were
disproportionately
affected
from
the
cobra
19
crisis.
J
So
if
you
have
any
recommendations
or
if
you'd
like
to
attend,
I'm
more
than
welcome
to
answer
any
questions
or
even
provide
questions
to
the
stakeholders
as
part
of
our
survey,
I'm
happy
to
happy
to
have
that
happy
to
have
that
as
part
of
the
final
report.
If
that's
something
that
you're
looking
for.
E
A
Thank
you
for
the
question.
Are
there
any
other
questions
from
the
committee
related
to
this
report?
I'm
not
seeing
any.
Thank
you
again
vice
chair
for
the
presentation
and
for
your
work
on
this
study.
We
really
appreciate
your
effort
and
the
effort
of
staff
to
to
complete
this
study.
For
us,
I'm
going
to
go
ahead
and
move
on
to
our
final
agenda
item
for
the
day,
which
is
our
second
public
comment.
A
A
There
is
nobody
in
the
room
in
carson
city,
so
I'm
going
to
see
to
ask
that
anybody
in
las
vegas
please
come
to
the
table.
If
you
are
there
for
public
comment,
I
know
there's
a
little
bit
of
a
delay
in
your
chair
and
I'm
not
seeing
anyone
get
up.
Thank
you
so
much
so
I'm
going
to
go
ahead
and
ask
broadcast
services
to
please
open
the
public
comment
line
and
add
the
first
public
comment
per
caller
to
the
meeting.
N
Good
afternoon,
dear
steam,
joint
interim
standing
committee
on
health
and
human
services
chair
and
members,
my
name
is
dr
tiffany
tyler,
garner
t-I-f-a-n-y
t-y-l-e-r
hyphen
g-a-r-n-e-r,
calling
on
behalf
of
the
children's
advocacy
alliance,
to
thank
you
for
prioritizing
understanding
the
systems
impacting
children
and
families
in
nevada.
Today,
you
have
heard
about
a
number
of
challenges
and
opportunities
to
intervene
on
behalf
of
nevada's
children.
While
we
are
deeply
appreciative
of
recent
investments,
we
implore
you
to
consider
the
needs
yet
unmet.
N
The
work
undone
and
the
growing
challenges
faced
by
children
and
families,
whether
it's
the
number
of
former
foster
youth
experiencing
homelessness,
the
parents
surrendering
children
in
hopes
of
care,
the
growing
mental
health
crisis,
the
lack
of
supports
for
those
undertaking
guardianship
or
the
historically
pervasively
low
reimbursement
rates
that
have
gutted
our
systems
of
care.
It
is
clear
that
more
investment
is
needed.
N
Accordingly,
we
implore
you
to
fully
leverage
your
role
as
legislative
leaders
and
change
makers
to
pull
nevada's
children
out
of
peril.
Please
take
the
next
important
step
of
investing
in
these
systems
and
programs
that
were
mentioned
today,
whether
it's
home
visiting
or
support
for
children
or
families
impacted
by
our
systems.
Like
the
child
welfare
system,
you
can
have
a
hand
in
the
change
that
we
want
to
see
and
ensure
a
recovery
for
nevada's
children
and
families.
Thank
you
for
your
leadership.
A
Thank
you
for
the
call.
I
really
appreciate
that
feedback
are
there
any
other
callers
on
the
public
comment
line
chair.
There
are
no
more
callers
to
public
comment
at
this
time.
Thank
you
so
much
I'm
going
to
go
ahead
and
close
public
comment
and
our
last
agenda
item
is
adjournment.
I
just
want
to
note
that
our
next
meeting
will
be
held
on
may
19th
of
2022
at
9.