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B
B
A
C
B
Thank
You
mr.
cloture
any
other
members
of
the
committee
all
right.
If
not,
then
we'll
go
ahead
and
get
started
on
the
first
part
of
our
program,
justice,
reinvestment
overview
regarding
behavioral,
health
and
I.
Just
just
an
opening
comment,
representative
Wilson.
Last
time
in
our
last
meeting
you
talked
about
silos
how
the
government
was
siloed,
and
likewise
our
committees
follow
those
same
sorts
of
silos.
The
the
mental
health
substance
abuse
relative
to
the
criminal
justice
system.
B
It's
been
touched
upon
by
both
by
appropriations
by
judiciary,
judiciary,
looked
at
it
and
then
said:
we've
done
a
much
as
we
can
do
now.
We've
got
to
pass
it
over
labor
health
and
so
we're
siloed
as
well.
So
what
we're
hoping
we're
going
to
do
today
is
is
to
get
an
overview
of
several
years.
Worth
of
work
has
been
done
by
judiciary,
as
well
as
by
mental
health
and
labor
and
health.
Regarding
the
role
of
mental
health,
substance
abuse
counseling
in
the
justice
system,
our
emphasis
today
is
is
just
on
the
outpatient
portion.
B
B
So
with
that
we're
going
to
have
an
overview
from
the
Council
of
state
governments
on
the
justice
reinvestment
project,
which
was
just
just
beginning
when
I
first
entered
the
legislature
five
years
ago,
under
the
auspices
of
the
late
Senator,
John,
Shaffer
and
I
anticipate
that
chairwoman
Wilson
will
be
able
to
give
us
some
assistance
after
the
CSG
presentations
in
terms
of
how
far
her
group
has
come
along
and
their
consideration
of
the
issue.
So
with
that
I
think
who
is
our
presenter
on
this
really
Brody
he's
presenting
them?
I.
B
B
A
D
D
B
D
Okay,
okay,
I
think
we're.
Finally,
good
apologies
about
that
good
morning.
My
name
is
David
de
Moura
I'm,
the
senior
adviser
with
the
Council
of
state
governments,
Justice,
Center
and
I'd
also
like
to
introduce
my
colleague,
Stephanie
Maria,
there's
also
with
the
Council
of
state
governments.
Justice
Center
I've
met
some
of
you
before
and
I
know.
There
are
some
new
folks
this
morning.
D
Thank
you
very
much
for
the
opportunity
to
give
this
report
to
you
and
for
our
ability
to
continue
to
work
with
the
state
of
Wyoming.
We
have
been
working
with
you
now
for
well
over
two
years,
I
have
been
involved
for
about
a
year
and
a
half
at
that
time
and
have
been
consistently
impressed
and
excited
by
the
work
that
is
being
done
there
and
the
deep
sort
of
interest
and
desire
to
make
the
improvements
that
we've
been
discussing
so
Stephanie
with
that
I'll
turn
it
over
to
you
great.
E
D
E
Like
David
said,
I'm
going
to
give
us
a
brief
overview
of
some
of
the
pass
work
that
we've
done
here
in
the
state
of
Wyoming
I
know.
Most
of
you
are
familiar
with
CSG,
but
just
to
give
you
a
brief
overview,
make
sure
we're
all
oriented.
This
is
Chi.
Is
a
region
based
organization
that
fosters
the
exchange
of
ideas
to
help
state
officials
shape
public
policy.
So
we
have
those
four
sections-
the
West
Midwest
east
and
south,
and
we
do
work
across
multiple
platforms,
so
corrections,
justice,
reinvestment,
mental
health
for
injury,
substance
abuse.
E
Many
of
those
subject
areas
we
have
been
working
with
Wyoming
to
help
address
in
the
state.
Currently
we
have
26.
We
have
five
current
states
that
we're
working
in
with
Wyoming
Oregon
Missouri
as
well
as
Vermont
and
Maine,
and
we
have
a
good
history
of
experience
with
past
aids
26
in
total.
This
is
a
collaboration
between
Bureau
of
Justice,
Assistance
and
Pew
Charitable
Trusts
that
we've
been
doing
this
work
to
use
a
data-driven
approach
to
reduce
Corrections
spending
and
invest
those
savings
and
strategies
that
can
decrease
the
recidivism
long
term
and
increase
public
safety.
E
So
it's
really
been
the
focus
of
the
work
here
in
Wyoming
as
well.
Just
to
give
you
a
brief
overview
of
what
we'll
be
covering
today,
so
justice
reinvestment
in
Wyoming.
We'll
take
a
brief
look
at
where
we
are
at
with
some
of
the
very
preliminary
data.
It
is
pretty
early
in
the
process
to
be
looking
at
data
as
a
whole
across
all
of
the
different
areas.
E
We've
been
working
with
Wyoming,
but
we'll
give
you
some
indication
of
what
we
can
see
we
see
so
far
and
then
David
will
give
us
some
behavioral
health
analysis,
findings
and
some
implementation
and
recommendations.
So
some
of
what
we
are
doing
currently
to
address
ata
62
or
HB
31
as
it
is.
So
when
we
started
our
work
in
Wyoming,
we
really
identified
four
key
challenges
for
the
state,
and
that
was
the
prison
and
supervision
population,
growth
and
adequate
victim
into
health
coverage,
ineffective
and
costly
responses
to
supervision
violations
and
inadequate
substance
use
disorder
treatment.
E
We
worked
with
the
state
to
really
help
address
those
issues
through
four
bills:
simin
enacted,
19,
SCA,
50,
HEA,
45
and
HEA
53
SCA
19
really
allowed
the
courts
to
sentence
people
to
unsupervised
probation
and
impose
fines
related
the
offense
reduced
the
terms
of
probation
and
required
courts
to
consider
a
set
of
criterion
when
determining
the
period
of
probation
for
a
modification
of
a
turn.
Sca
50
required
that
do
C,
revise
its
infant
incentives
and
sanctions
system
allows
jails.
E
Sanctions
of
up
to
15
consecutive
days
for
serious
supervision
violations
allows
an
incarceration
sanction
of
up
to
90
days
during
which
evidence-based
services
are
provided.
Prioritizes
submission
into
is
be
based
on
assessed
risk
and
allows
a
person
who
is
revoked
to
receive
credit
for
the
portion
of
time
served
on
parole.
E
So
current
capacity
is
at
two
thousand
two
hundred
ninety
eight
with
projections
with
the
new
changes.
You
keep
that
at
two.
You
sorry
with
that
the
changes
the
jri
impact
would
be
2197,
bringing
you
down
below
the
capacity.
So
where
are
you
at
right
now?
Preliminary
results
show
that
policy
implementation
is
promising.
This
state
has
actually
reduced
the
prison
population
faster
than
the
projected
numbers,
so
at
the
close
of
January
2020,
the
state's
prison
population
was
at
2308,
which
is
really
in
line
with
those
projected
impacts
for
the
state.
E
Next
is
the
supervised
population,
so
the
projection
was
that
the
supervision
population
would
be
reduced
by
324
people
by
fiscal
year.
2024
again,
those
are
some
of
those
long-term
goals
there,
so
we're
a
few
years
out
for
those
results.
But
the
good
news
is
is
that
the
state
is
tracking
exactly
with
projections.
So
we
did
anticipate
that
with
some
of
the
new
policies
that
were
acted,
that
there
would
be
just
a
slight
incline
in
population
on
supervision,
you're.
E
E
In
addition
to
the
for
justice,
reinvestment
bills
passed
in
2019
Wyoming
designated
the
the
interim
committee
to
continue
some
of
that
behavioral
health
policy
work.
So
that's
where
the
joint
Labor,
Health
and
Social
Services
Committee
came
in
and
really
prioritized
mental
health
and
substance
use
as
a
topic
and
committed
to
looking
at
the
substance,
use
and
mental
health
services
being
delivered
in
the
states.
The
criminal
justice
population,
which
really
takes
us
all
the
way
into
Section.
Two
I'll
pause,
though,
if
anybody
has
any
questions
on
some
of
those
preliminary
numbers
from
our
earlier
work.
C
E
C
E
B
Any
other
any
other
committee
members
with
any
questions,
then
I,
just
very
three,
very
quick
one,
Stephanie
and
and
just
concise
answers
will
be
helpful,
slide.
7,
SCA,
50
didn't
that
is
that
the
bill
that's
referred
to
as
having
the
quick
dip.
That
is
that,
if
somebody
is
offending
there,
they're
out
on
probation
or
parole,
they
get
drunk
they
they're
found
in
the
bar.
You
don't
have
to
wait
for,
revocation
by
the
judge.
Kent.
B
B
E
A
great
question,
mr.
chairman
I,
can
definitely
look
into
that
for
you.
Looking
at
the
past
population
kind
of
valleys
and
Peaks,
it
is
from
my
understanding
a
bit
quicker
than
we
were
even
expecting
from
our
conversations,
but
I
can
definitely
get
that
answer
for
you
about.
If
it's
a
student
within
the
standard
deviation,
okay,.
B
B
I
can't
remember
what
it
was
10
percent
or
something,
but
the
net
of
the
combined
two
was
enough
to
absorb
all
the
additional
capacity,
and
somebody
said
so
you're
saying,
because
the
judges,
because
we
built
it,
they
came
and
the
Pew
people
were
very
polite
and
they
said
no.
We
wouldn't
say
that,
but
a
kind
of
sort
of
looks
like
that.
C
E
D
C
D
F
Chairman
I
just
wanted
to
put
a
thought
here
just
for
our
future
consideration
and
carrying
on
to
labor
committee.
There's
some
connection
here
with
the
whole
telehealth
concept.
I
know
here
in
Cheyenne,
and
it's
not
necessarily
specific
to
the
this
sort
of
quick-tip
issue
but,
for
example,
our
the
residential
treatment.
F
Well,
the
the
wing
of
the
hospital
that
has
might
have
psychiatric
stays
or
you
know
mental
health
type
stays
they
have.
They
have
telehealth
capability
with
the
court
and
and
the
court.
The
judges
are
willing
to
do
their
hearings
by
zooom,
as
it
were,
I'm
sure
it's
something
else,
but
to
the
folks,
while
they
are
still
in
an
inpatient
stay.
F
But
so
that's
not
exactly
this,
but
that's
something
that
I
think
and
I'm
gonna
make
a
note
here,
as
we
look
at
the
whole
telehealth
discussion
and
that's
been
a
major
part
of
the
the
mental
health
challenges
throughout
kovat
and
all
that
kind
of
thing
that
we've
had
but
to
find
out
from
and
and
I
know,
Andy
Somerville
I
think
is
due
to
testify
later
today.
She
might
be
able
to
tell
us
whether
the
community
mental
health
centers,
certainly
they
all,
have
telehealth
capability
and
are
working
ferociously
on
that
do.
F
B
Excuse
me,
thank
you.
Anybody
else
before
we
move
on
Stephanie,
just
make
a
note
on
your
on
those
four
bills.
You
should
also
add
to
that.
The
twenty
four/seven
bill
that
was
a
major
justice
reinvestment
bill.
It
was
24/7
for
alcohol-related
offenses
and
in
the
counties
that
have
adopted
at
Campbell,
County
Sheridan.
It's
had
a
big
impact.
It
depends
on
whether
this
sheriff
wants
to
cooperate,
whether
the
judges
want
to
use
it
or
not.
But
that's
that's
another
one
where
you
need
some
consistency.
All
right,
Stephanie
go
ahead
and
read
Thank.
E
D
You,
Stephanie
and
Stephanie
is
going
to
continue
to
control
the
slide
so
that
we
can
limit
any
further
difficulties,
and
so
I
will
just
say
slide
when
it's
time
to
shift.
So
what
we
did
to
take
a
look
at
behavioral
health
needs
in
Wyoming
was,
together
with
the
Department
of
Correction
and
the
Department
of
Health.
D
We
collaborated
with
various
data
folks
within
the
department's
to
analyze
the
overlap
between
the
supervision
population,
the
probation
and
parole
population
and
folks
that
were
accessing
treatment,
and
so
we
were
looking
at
the
supervision
population,
the
population
of
people
accessing
behavioral,
health,
centers
and
then
looking
at
where
that
crossover
was
in
terms
of
the
supervision
population
with
behavioral
health
needs.
We
were
looking
for
the
proportion
of
folks
in
the
justice
system
who
had
known
behavioral
health
needs
and
were
accessing
services
through
the
community.
Centers.
D
Please,
what
we
found
of
course,
is
that
people
with
behavioral
health
needs
are
accessing
treatment
through
the
community,
mental
health
and
substance
use
centers,
that's
not
to
say
that
there
aren't
some
folks
are
accessing
private
providers,
but
the
overwhelming
number
of
folks
who
are
on
supervision
or
accessing
the
community.
Behavioral
health
providers
there's
18
of
them
private
nonprofits.
They
deliver
outpatient
and
or
residential
behavioral
health
treatment.
D
As
you
know,
of
course,
funding
and
some
of
the
Centers
has
been
flat
for
a
number
of
years,
particularly
depending
on
it
being
different
by
Center
having
to
do
in
part
with
specific
populations.
Others
have
had
sizable
reductions
in
their
funding,
so
there's
been
some
of
those
differences
in
both
instances.
The
reality
is
is
that
the
amount
of
funding
that's
available
for
those
who
are
under
community
supervision
has
decreased
about
50,
depending
on
what
part
of
the
state
or
what
Center
50
to
70
percent
of
people
accessing
substance.
D
C
D
So
I
think
that
the
the
issue
is
that
in
some
centers
it
has
been
flat
in
some
centers
there
have
been
reductions.
It
depends
on
the
particular
types
of
populations
they're
serving
it
doesn't
have
to
do
necessarily
with
whether
you
cut
the
budget.
It
has
to
do
with
whether
or
not
the
dollars
that
are
available
match
the
particular
populations
that
different
centers
are
serving.
We.
C
Follow
mr.
chairman
and
so
much
trimmer
and
I
would
just
maybe
request
when
we
get
the
Department
of
Health
on
there.
We
can
get
a
little
clarification
on
that
because
I
think
that's
an
important
component
as
we
consider
prioritizing
populations
and
in
funding
incentivizing
funding
for
those
populations
served
by.
Thank
you.
David.
Certainly.
F
Thank
You
mr.
chairman
I
was
just
going
to
say:
wasn't
it
the
case
and
representative
Larsen
I
think
this
is
the
year
that
you
and
I
went
on
Appropriations
that
when
the
title
25
expenses
were
so
over
budget
I,
believe
appropriations
told
the
Department
of
Health
to
take
that
they
had
authorization,
but
they
had
to
take
it
out
of
their
own
budget
and
didn't
they
take
it
out
of
community
mental
health.
C
B
Well
and
I
think
there
were
changes
the
department
made
to
the
contracts.
There
were
some
mandates
in
in
how
we
directed
their
funding
and
what
they
could
or
could
not
do
with
respect
to
collections
from
private
insurance.
So
we'll
have
the
department
and
the
providers
get
into
that
when
they
they
come
up.
They
understand
it
better
than
we
do
and
they
can
walk
us
through
it.
Okay,
David.
D
Thank
you
as
I
lean,
I
start
to
mentioned.
A
very
large
number
of
folks
that
are
in
the
criminal
justice
system
are
accessing
substance,
addiction
treatment
and
to
turn
that
around
the
other
way,
a
large
number
of
people
that
are
accessing
substance
addiction,
treatment
in
the
Centers
are
folks
who
are
in
the
criminal
justice
system
and,
of
course,
the
characteristics
of
the
population.
That's
seeking
treatment.
Their
assessed
needs
the
level
of
care
they
need
varies
across
the
state
that
that's
not
a
surprise
at
all,
and
it's
typical
of
anywhere
that
one
would
look
next
slide.
D
D
D
The
individual
had
accessing
a
service
based
on
what
types
of
needs
they
had
and
what
kind
of
what
kind
of
money
they
had
to
save,
to
get
something
like
the
addiction
severity
assessment
and
to
determine
what
their
needs
were,
and
so
some
of
the
some
of
the
access
simply
had
to
do
with
it.
Wasn't
there
some
of
it
had
to
do
so.
Somebody
needed,
for
example,
intensive
outpatient,
but
it
might
not
have
been
available.
D
Next
slide,
please,
as
I
mentioned,
they
were
not
connecting
particularly
quickly,
regardless
of
their
level
of
risk.
Again
numerous
reasons
there
might
be
a
delayed
referral
by
the
agent.
In
some
cases
there
might
be
a
wait
list
at
the
center
and
to
be
clear,
a
wait
list
at
the
center
doesn't
mean
that
they
weren't
seen
initially
because
they
would
be.
But
then
there
might
be
a
period
of
time
before
they
could
access
the
actual
ongoing
a
group
work.
D
They
might
be
accessing
services
at
a
private
provider
and
it's
a
fairly
small,
it's
a
very
small
number.
But
there
are
some
of
those
folks
there's
the
issue
of
people
just
simply
not
showing
and
so
the
acts
the
delay
has
to
do
with
the
fact
that
the
client
is
being
difficult
and
not
showing
one
of
the
things
that
we
also
saw
were
revocations
prior
to
appointment
and
part
of
that
again
being
related
to
the
issue
of
how
long
it
took
to
get
in
to
access
and
then
transportation
needs
so
again
a
variety
of
different
needs.
D
But
what
we
found
was
that
if
you
look
at
the
chart
on
the
left
a
significant
number
of
the
population,
it
was
more
than
a
month
before
they
were
accessing
services.
We
know
that
those
first
weeks
in
the
community
are
extremely
important,
and
the
potential
for
failure
in
those
first
weeks
is
extremely
high.
Next
slide,
please
whoops
I'm!
Sorry,
mr.
chairman,
it
looks
like
representative
Larsen,
mrs.
Handan.
D
There
are
multiple
reasons
for
the
waits.
There
is
no
one
reason
that
we
discovered,
as
we
went
around
the
state
as
what
we
did
after
the
initial
looking
at
these
numbers
was
that
we
literally
did
a
roadshow
around
the
state
to
visit
all
the
different
centers
in
some
cases,
and
so
the
reasons
that
you
see
on
the
right
of
this
chart
all
of
these
sort
of
fed
into
this.
In
some
cases
the
delay
had
to
do
with
it
took
longer,
for
the
referral
to
happen
than
we
would
say
should
take.
D
In
some
cases
it
had
to
do
with
the
resistance
of
the
client
and
simply
not
showing
and
and
having
to
be
resent
and
rescheduled
and
get
back
in
again.
In
some
cases
it
had
to
do
with
the
distance.
The
client
lived
from
the
closest
relevant
service
and
the
transportation
needs
were
so
difficult
that
it
was
difficult
to
get
them
there,
and
then
they
this
snowballs
right.
Then
they
fail
then
they're
revoked.
D
In
some
cases,
those
costs
were
zero,
so
that
didn't
play
into
it.
In
other
cases,
those
costs
were
over
a
hundred
or
a
couple
of
hundred
dollars.
There
were
a
couple
of
out
line,
outlier
costs
as
well,
but
that
was
generally
the
range
and
that
person
would
then
take
you
know
would
need
X
number
of
weeks
to
say
about
that
money
in
order
to
do
that,
and
so
that
time
would
pass
and
again
there
would
be
a
delay
so
multiple
reasons.
D
No,
no
one
reason
we
can't
say
it's
because
you
know
the
centers
were
not
responsive
because
they
certainly
were
to
the
best
degree
that
they
could
be.
We
can't
say
it's
because
agents,
you
know
didn't
refer
because
overwhelmingly
they
did,
but
when
you
start
adding
up
all
of
the
different
some
pockets
of
issues,
you
end
up
with
the
series
of
things
sometimes
integrated
together.
D
That
creates
the
wait
list
and
the
time
delayed
with
people
getting
in,
but
the
key,
the
biggest
issue
that
we
wanted
to
start
with
when
we
were
looking
at
this
and
again
we'll
get
to
this
in
a
moment,
was
really
getting
a
smooth
flow
in
terms
of
the
initial
assessment.
Getting
that
to
follow
the
individual
and
getting
there
there
being
no
delay
based
on
waiting
to
determine
what
that
treatment
need
was
that
alone
can
have
a
major
impact
on
access
to
services
and
speed
to
access
to
services.
Although.
C
What
mr.
Truman,
please
sure,
so,
is
that
it's
that
assessment,
that
compass
assessment
that
is
performed
by
Department
of
Corrections,
where,
where
does
the
assessment
come
from,
is
that
through
Department
of
Corrections
or
through
the
Department
of
Health
in
is
there?
Is
there
a
collaboration
there
to
accept
whichever
one
mr.
D
D
It
helps
determine
correctional
treatment
needs
it
identifies
needs
that
are
related
to
particular
criminogenic
risk
factors,
factors
that
make
it
more
likely
for
someone
to
recidivate
the
addiction
severity
index
or
the
ASI
is
specifically
looking
at
substance,
use
needs
of
the
individual
and
what
the
level
of
care
is
that
is
required
for
them
to
do
well
to
get
through
treatment.
The
ASI
could
be
done
by
the
dlc.
If
somebody
is
in
do
see-
and
it
is
done
by
do
see
in
many
cases
it
can
be
done
by
community
providers.
D
It
can
be
done
by
private
providers.
It
is
an
assessment
tool
that
is
not
tied
to
a
particular
department
or
a
particular
group
of
individuals
other
than
in
Wyoming.
You
must
be
a
licensed
clinician
to
complete
the
ASI.
You
don't
need
to
be
a
licensed
clinician
to
complete
the
compass.
You
simply
need
to
be
trained
in
how
to
complete
the
compass.
So
there
are
two
different
tools:
there's
some
overlap,
but
but
there
is
a
different
info,
a
difference
in
focus.
D
B
There
will
be
no,
no,
not
a
dime
of
state
subsidy,
which
sounds
like
a
real
righteous
cause,
except
you
have
people
sitting
in
jail
for
months
waiting
for
an
ASI.
You
know
so
it's
it's!
You
know.
So
they
sit
in
jail
at
80
bucks
a
day,
instead
of
us
helping
them
out
with
the
cost
of
$150
assessment,
all
right
David.
Let's
move
off
for
John
I.
D
D
Key
takeaways
from
the
analysis,
more
than
half
57%
of
the
folks
on
probation
and
parole
supervision
with
an
indicator
of
mental
health
or
substance
use
need
access
to
at
least
one
of
the
community.
Mental
health
and
substance
use
centers
the
rates
of
people
on
supervision,
with
an
indicator
of
need
for
treatment
who
access
the
services
varied
across
the
state,
where
the
rate
as
high
as
66
and
80%
in
some
districts
and
as
low
as
38
and
others.
D
The
targeting
high-risk
people
with
treatment
services
is
associated
with
longer
stays
on
supervision
without
being
revoked
and
likely
positive
net
savings
relative
to
the
cost
of
days
in
isn't.
Mental-Health
treatment,
which
is
mostly
outpatient,
is
less
expensive
and
substance
use
disorder
treatment,
but
it
has
a
weaker
association
with
longer
stays
on
supervision
without
a
revocation.
That's
not
in
any
way
to
suggest
that
it's
not
important
simply
that
substance
use
addiction
causes
a
much
higher
failure
rate
for
individuals.
D
More
analysis
ultimately
will
need
to
be
conducted
to
understand
in
each
specific
area.
Why
folks
are
not
accessing
services,
but
we
were
able
to
really
look
at
the
reality
of
the
differences
in
terms
of
services
not
existing
in
certain
parts
of
the
state
and
people
having
to
go
to
other
parts
of
the
state
to
access
those
services
and
the
distance.
Even
when
there
was
something
local
while
well
I
think
there's
some
continued
need
to
examine
subpopulations.
D
It
is
fair
to
say
at
this
point
that
the
issue
of
distance
and
location
of
relevant
services
are
the
two
overwhelming
issues
in
terms
of
the
issue
of
distance
access,
in
other
words
not
getting
in
and
the
third
one
being
the
issue
of
the
cost,
as
the
chairman
mentioned
in
terms
of
the
getting
the
addiction
severity
index,
completed,
etc.
Next
slide,
please.
D
D
I
need
to
the
minor
caveat
that
final
formal
approval
for
that
funding.
We
do
not
haven't
yet
it
will
be
coming
in
the
next
month,
or
so.
We
have
every
reason
to
believe
that
it
will
be
happening,
but
just
to
be
perfectly
final.
Approval
of
that
for
this
phase
is
about
a
month
away
from
BJ.
We've
certainly
been
told
that
that
is
coming,
but
I
do
want
to
make
it
clear
that
it's
not
quite
here
yet
next
slide.
D
So
if,
in
terms
of
implementing
the
recommendations
next
slide,
so
there
were
an
additional
set
of
implementation
priorities
right,
established
the
quality
assurance
unit
within
VSD
WDS.
They
develop
standardized,
evidence-based
guidelines
for
treating
people
in
the
criminal
justice
system
and
then
expanding
the
sheering
or
the
portability
and
acceptance
of
assessment
results
next
slide.
Please
so
establishing
the
quality
improvement
unit
within
DFCS
to
ensure
statewide
consistency,
ensuring
of
the
addiction
severity
index
or
the
ASI
results.
D
So
the
development
of
the
qi,
a
unit
model
working
with
w
DFC
and
w
da
wdh
to
identify
the
goals
and
expectations
that
they
have,
as
well
as
providers
and
other
stakeholders
in
order
to
design
the
unit
to
meet
the
needs
of
the
system
as
well
as,
of
course,
meet
the
legislative
intent.
And
then
the
second
piece
is
developing
the
policy
and
practice
guidelines
by
developing
quality
improvement
policies
and
procedures
that
are
specifically
related
to
the
assessment
process
and
that's
being
done
in
conjunction
with
wdh.
D
And
I
I
just
want
to
make
a
quick
statement
and
say
that
we
have
now
been
working
for
a
while
with
the
Behavioral
Health
Unit
in
wdh
and
working
with
WBOC.
And
it
has
been,
has
been
a
great
process.
Folks
are
really
very
involved,
very
invested
in
working
very
well
together
and
working
well
with
us,
and
we
have
also
added
representation
from
the
community
providers
so
that
we
truly
have
all
of
the
necessary
components.
D
If
you
will
of
folks
that
are
concerned
with
these
treatment
issues
involved
in
the
development
of
this
model
and
looking
at
what
kind
of
training
will
be
happening
in
the
coming
months,
the
anticipated
outcomes
are
that
there'll
be
a
greater
consistency
of
the
behavioral
health
assessments
that
are
delivered
across
providers.
The
people
in
the
criminal
justice
system
will
be
better
matched
into
treatment
and
receive
the
relevant
programming
to
address
the
behavioral
health
needs
to
reduce
recidivism
increase
in
in
successful
treatment
and
a
decrease
in
revocations
and
returns
to
prison
next
slide,
please.
D
The
second
component
of
that
has
to
do
with
developing
a
standardized,
evidence-based
guideline
or
set
of
guidelines
for
be
treating
folks
in
the
criminal
justice
system,
so
develop
clear
and
consistent
treatment
standards
and
train
providers
on
those
standards.
Our
funding
will
provide
training
for
providers
on
the
theoretical
foundations
of
the
ACM
criteria,
the
Society
for
addiction,
medicine
criteria,
clinically
driven
services,
bio,
psychosocial
assessment,
continued
state
transfer,
discharge
criteria
that
will
be
provided
to
representatives
from
the
community
mental
health
centers,
as
well
as
wdse
providers
and
wdh
representatives
as
well.
D
So
what
we're
attempting
to
do
with
our
training
opportunities
that
were
providing
Wyoming
is
to
provide
a
variety
of
different
types
of
training
related
to
substance,
use
related
to
working
with
the
criminal
justice
population
relating
to
interagency
and
community
and
governmental
agency
collaboration
in
how
to
effectively
respond
to
this
group.
We
anticipate
four
outcomes:
behavioral
health
assessment
and
treatment
practices
to
be
delivered
more
consistently
that
community
treatment
providers
will
be
better
able
to
support
clients
in
the
criminal
justice
system
by
understanding
and
addressing
their
unique
challenges
and
again
looking
to
increase
successful
treatment.
D
Completion
looking
to
decrease
the
cycling
through
W
DLC
and
the
community
providers
and
looking
to
decrease
the
revocations
of
folks.
One
of
the
things
that
we're
very
excited
about
is
that
we're
able
to
provide
funding
for
the
state
to
move
to
a
computerized
assessment
of
the
addiction
severity
index,
and
what
that
will
do
is
that
all
of
the
providers,
the
community
providers
that
are
providing
services
to
these
individuals
will
have
access
to
this
at
no
additional
cost
to
the
centers.
D
We're
looking
at
the
issue
of
expanding
the
sharing
and
acceptance
of
substance
use
disorder,
mental
health
and
co-occurring
assessment
results
requiring
providers
to
accept
asi
assessment
results
completed
within
the
last
six
months.
If
no
significant
life
event
has
occurred
and
again
by
utilizing
this
new
system,
they'll
have
access
to
that
in
a
much
easier
way
than
it
has
been
now
the
difficulty
in
getting
it
even
when
folks
have
been
trying
to
get
it
has
been
significant
in
some
cases.
D
This
second
piece
has
to
do
with
revising
the
policy
regarding
the
sharing
of
the
ASI
again
requiring
providers
to
share
the
results
of
the
assessment
of
the
assessments
in
accordance
with
the
established
QA
policies
from
the
unit
and
then
thirdly,
as
I
led
with
investing
in
the
use
of
the
computerized
ASI.
We
anticipate
that
this
will
lead
to
an
increase
in
cooperation
between
the
state
agencies
and
the
community
providers
and
I
should
say
between
state
agencies
and
between
state
agencies
and
community
providers.
D
D
Two,
it's
part
of
what
related
to
delay
in
access
to
service
and
three,
we
found
inconsistent
results
with
not
a
lot
of
logic
as
to
why
assessment
one
differed
from
assessment,
two,
with
a
period
of
just
a
few
weeks
between
them
and
no
other
significant
life
events
having
occurred,
the
decrease
in
the
amount
of
money
spent
by
clients
and
duplicative
assessments
and
a
decrease
in
the
time
it
takes
for
people
to
get
into
treatment
next
slide.
Please.
D
So
what
are
we
expecting
in
terms
of
looking
at
this
implementation
over
time?
Well,
while
we
should
see,
is
more
folks
successful
in
completing
mental
health
and
substance,
use
treatment,
fewer
folks,
failing
supervision
and
entering
prison
people
accessing
critical
services
more
quickly,
human
providers
delivering
higher
quality,
behavioral
health
assessments
and
treatment
more
consistently
across
the
state
and,
as
I've
always
said,
whenever
I've
testified
to
many
of
your
committees,
I
want
to
make
it
clear.
You
have
a
lot
of
really
good
providers,
we're
looking
to
improve
what
is
an
already
set
of
good
folk
and
I.
D
Don't
want
to
suggest
that
this
improvement
is
because
people
are
doing
bad
things.
That
is
not
the
case.
At
all.
We've
been
very
impressed
with
many
of
your
providers:
a
decrease
in
financial
burden
placed
on
clients,
forced
to
pay
for
duplicative
assessments
and
an
increase
in
the
collaboration
and
cooperation
between
state
agencies
and
the
community
treatment
providers.
Next
slide.
D
D
The
funding
for
will
be
provided,
as
well
as
the
providers
being
trained
in
the
ACM
criteria
by
December
the
development
of
the
treatment
standards
and
guidelines
and
the
providers
trained
in
those
all
providers
by
that
time,
using
the
computerized
ASI
for
folks
in
the
criminal
justice
system
by
January,
community
providers
receiving
additional
training
in
the
structured
decision-making
tool
to
improve
treatment
matching
in
February
of
21
trainings
are
provided.
The
guidelines
will
have
been
finalized,
asi
fidelity
support,
wrapping
up
by
March.
D
We
essentially
will
be
done
in
terms
of
our
ta,
our
direct
involvement,
but
our
we
will
continue
to
do
data
monitoring
forward
after
March
and
April
as
we
collect
the
data
in
conjunction
with
WDS,
D
and
and
wdh
for
reporting
back
to
the
Bureau
of
Justice
Assistance,
the
folks
that
are
funding
all
of
this
and
last
slide.
Thank
you
very
much
for
listening.
C
B
G
Thanks,
mr.
chairman,
so
as
I
kind
of
try
to
consolidate
all
of
this
down,
I
see
three
overarching
issues.
Cost
access
collaboration
seems
like
62
House
bill.
62
is
a
tempting
collaboration
between
why
BOC
and
Department
of
Health
and
the
and
then
with
the
community
health
providers,
cost
we've
already
talked
about
cost.
Being
you
know
how
do
we
make
that
more
fair
and
equitable?
You
look
at
a
county
like
Sweetwater
80%
of
you're,
saying
the
population
has
mental
health
and
substance
abuse
issues.
G
G
Chairman,
Wilson
had
mentioned
telehealth
I
have
for
a
long
time
been
very
curious
about
telemental
health.
Tell
a
counseling
in
this
particular
area
when
we're
talking
about
outpatients
in
the
DLC
system
in
probation
and
parole,
I'm
curious
David.
What
you
see
and
know
from
other
states
in
terms
of
their
use
of
telehealth,
particularly
for
mental
health
and
counseling,
when
I
look
at
Wyoming
I,
think
that
one
of
the
issues
that
we
have
is
is
a
burden.
G
And
it
is
that
we
are
so
rural,
so
we're
talking
about
rural
areas
where
we're
trying
to
get
services
to
to
these
offenders
sitting
in
a
County,
Jail
and
I
saw
your
map
there.
You
had
your
map
where,
obviously
some
have
mental
health,
some
have
substance,
abuse,
treatment,
centers
some
don't
have
anything,
and
so
access
could
be
the
old-school
way.
I
guess
brick-and-mortar
build
a
building.
G
More
community
providers
build
satellites
to
those
community
providers
whatever
that
may
be,
but
telehealth
may
be
a
part
of
the
pie
in
a
huge
solution
for
Wyoming.
So
help
help
me
understand
what
you
know
about
other
states
in
terms
of
their
use
and
success
with
tell
a
mental
health,
counseling,
etc.
In
this
area.
D
What
well,
what
I
can
tell
you
is
that
telehealth
has
exploded
around
the
country
as
a
result
of
COBIT
19
I
am
myself
a
clinician
and
for
the
first
time
in
my
40-plus
years
of
work
have
been
seeing
clients
over
zooom
and
other
appropriate
venues.
If
you
will
and
styles,
there
is
certainly
initial
evidence
that
telehealth
and
then
specifically
telemental
health,
tell-tell
substance
use
treatment
is
a
viable
alternative.
D
I,
don't
think
that,
there's
anything
that
suggests
that
it
is
better
and
I
think
we
also
need
to
look
at
determining
what
kind
of
treatment
is
needed,
and
so
what
telehealth,
of
course
cannot
replace
is
the
need
for
residential
treatment.
If
somebody
has
a
level
of
care
that
requires
residential
treatment,
but
if
you're
looking
at
what
we
would
consider
to
be
general
or
regular,
outpatient
treatment
and
and
in
some
cases,
even
a
slightly
more
intensive
phase
of
that
it
can
be
utilized,
I
would
never
I
would
never
suggest
it
as
the
first
choice.
D
I
would
suggest
it
as
a
reasonable
option
when
you
can't
build
the
bricks
and
mortar
that
are
necessary
and
you
are
not
the
only
state
that
is
in
that
position.
Other
states
with
large
rural
areas
are
using
telehealth
more
and
more
because
they
simply
cannot
physically
create
the
number
of
physical
facilities
that
are
required
to
meet
the
need.
D
What
I
do
think
is
important
is
that
there
has
to
be
a
very
clear
determination
about
what
level
of
care
is
agreed
upon
as
appropriate
when
doing
that,
and
when
that
simply
is
not
sufficient
to
provide
the
appropriate
level
of
care.
So
it's
not
an
it's,
not
an
all-or-nothing.
It's
a
yes.
This
makes
sense.
G
Mr.
chairman,
real
before
we
die
just
oh
sorry,
acquit
it
all
up.
I
wanted
to
follow
up
on
the
offer
David's
offer
to
provide
some
data
and
information
on
what
some
other
states,
particularly
that
look
like
wow
means
rural
setting
are
doing
in
and
then
just
sorry,
I'm
really
sorry
to
cut
you
off
chairman
want
somebody
in
case
you
wanted
to
dive
into
a
different
topic.
I
didn't
want
to
lose.
My
quite
I
only
had
one
question,
which
was
on
cost
and
obviously
there's
an
upfront
cost
to
a
brick
and
mortar
facility.
G
D
Mr.
chairman
represent
also
that's
an
excellent
question
and
I
don't
have
the
answer,
my
fingertips
as
to
that.
We
do
have
folks
that
do
have
that
information
and
are
working
on
that
particular
area
and,
along
with
connecting
you
with
other
states,
I'm
happy
to
gather
that
cost
information
for
you
and
forwarded
to
the
Chairman
and-
and
you
can
forward
it
to
or
to
Elizabeth,
and
they
can
forward
it
to
the
rest
of
the
committee.
F
F
They
can
do
initial
intake
in
person,
but
then
it's
pretty
much
all
I
mean
they've
been
using
that
for
a
long
time,
because
we
have
such
a
shortage
of
psychiatry,
main
challenge
from
my
understanding
and
even
here
in
Cheyenne,
which
of
course
is
less
rural
than
most
parts
of
the
state
is
that
many
of
the
clients
don't
have
either.
They
may
not
have
good
cell
coverage
at
their
house
or
they
may
be
in
a
place
where
there's
no
broadband,
so
the
the
cell
and
broadband
infrastructure
is
really
the
main
challenge
there.
F
Our
mental
health
providers
are
actually
pretty
used
to
providing
the
services
and
I
would
say
that
in
Wyoming
it's
so
I
I
would
suspect
that
there's,
there's,
probably
the
block
grants
to
the
mental
health,
centers
I'm
sure
don't
differentiate
their
insurers
pay
the
same
for
the
most
part
as
if
the
person
is
being
seen
by
by
you
know,
remotely
or
in
person.
So
I
I
think
that
that
that's
probably
not
the
main
issue,
I
think
the
main
issue
from
my
understanding
is,
and
we
can
hear
later.
F
H
Thank
You
mr.
chairman
I
just
had
a
question
to
kind
of
follow
up
with
represented
Wilson
in
terms
of
Cova.
I
wondered
if
these
implement
implementation
milestones.
If
these
dates
are
still
fairly
realistic,
or
do
you
think
that
kovat
will
cause
some
issues
with
with
being
able
to
accomplish
some
of
the
things
that
that
CSG
has
talked
about
Thank
You.
D
The
short
answer
is
we
actually
made
a
number
of
changes
as
a
result
of
copán,
and
so
all
of
the
trainings
that
we're
talking
about
were
originally
scheduled
to
be
in
person
trainings.
They
are
now
all
web-based
trainings
that
are
being
done,
because
it's
the
only
way
to
do
that.
There's
some
possibility
that
the
January
training
would
be
January.
2021
training
would
be
in
person,
but
in
all
honesty,
I'm
just
sort
of
looking
at
the
way
things
are
going.
D
We
anticipate
that
all
of
these
trainings
will
be
web-based,
and
that
is
how
we
will
be
able
to
meet
the
timeline.
It
is
a
tight
timeline.
We
have
a
little
bit
of
wiggle
room
in
that
we
are
able
to
remain
with
you
all
until
the
end
of
March.
So
if
we
do
have
to
push
something
out,
we
have
a
little
bit
of
room,
but
we've
tried
to
account
for
the
coated
issues
by
moving
all
of
these
things
online.
B
B
D
Actually,
it's
better
than
that
because
of
the
fact
that
we
are
able
to
now
provide
the
funding
for
the
ASI
and
that
we
computerized
the
there
does
not
need
to
be
the
kind
of
charges
that
existed
previously.
There
still
is
some
discussion
in
terms
of
what
that
cost
will
be,
but
it
definitely
would
be
a
sliding
fee
scale.
It
wouldn't
be
a
high
flat
rate.
Our
goal
is
to
get
that
and.
B
Okay
and
then
this
is
just
a
note
for
Elizabeth
and
John.
When
we
get
do
a
John,
we
want
to
find
out
that
the
latitude
they've
given
these
providers
for
telehealth
during
covin
will
be
continued
and
if
it's
not
whether
they
need
legislative
authorization
to
do
that,
David
and
Stephanie
I
noticed
I
can't
remember
which
slide
it
was
where
you
were
talking
about.
It
was
like
25,
you
have
the
providers
in
do
see
and
do
H.
You
also
need
on
their
probation
and
parole
the
judges,
law
enforcement
district
attorney,
County
attorney,
multidisciplinary
teams.
B
You
know
you
can
have
the
community.
Many
health
center
can
be
all
dressed
up
and
ready
to
go,
and
if
you
have
a
county
attorney
that
says
I
just
don't
believe
in
that:
okay,
okay:
where
do
we
go
now
or
a
judge
that
says
you
know
that
community
mental
health
center
they
all
they
ever
do-
is
put
people
on
outpatient
I'm
using
this
private
provider
over
here?
Well,
you're
just
you're
dead
in
the
water.
B
At
this
point,
so
they
have
to
be
included
in
your
education
and
then
somehow
you
need
to
Qi
the
behavior
of
the
judges.
The
county
attorneys,
the
prosecutors
I
mean.
Are
they
availing
themselves
of
these
tools
because
the
community
mental
health
centers?
The
providers
can't
do
it
and
because
they're
part
of
a
continuum
of
health
care
and
represent
a
group?
Wilson
will
recognize
that
phrase.
D
Mr.
chairman,
thank
you
for
that
question.
In
fact,
we
didn't
discuss
that
because
we
weren't
particularly
providing
that
ta
with
this
funding.
But
in
fact
one
of
our
recommendations
and
discussions
is
that
as
wdh
and
wdse
get
through
this
training
that
they,
along
with
the
and
the
community
providers,
get
through
this
training
that
they,
the
community
providers,
wdh
wdse.
D
A
couple
of
your
sheriff's
that
are
working
in
this
area
and
a
couple
of
your
judges
that
are
working
in
this
area
provide
a
statewide
training
opportunity
where
they
would
do
this
by
region
over
the
course
of
probably
a
year
to
provide
training
to
those
various
individuals
that
you
just
mentioned,
because
that
is
absolutely
imperative.
It
is
beyond
the
scope
of
what
we're
doing
to
look
at
developing
qi
related
to
those
other
groups,
but
why
only
my
name
all
right,
I,
that's
something
they
want
to
move
toward
all.
B
Right,
thank
you,
so
senator
Bouchard
will
be
here
in
just
a
moment.
Elizabeth
John,
please
make
a
note
when
do
H
comes
on
that
I'd
like
for
them
to
immediately
been
gathering
the
dates
of
the
sheriff's
and
Chiefs
the
county
court
conference,
the
the
district
Judicial
Conference,
the
State
Bar
conference,
all
of
those
and
start
gathering
those
dates,
and
you
might
start
looking
for
panel
time
at
each
of
those
presentations
by
do
H.
B
You've
got
to
start
now
to
get
months
in
advance
to
get
on
those
things
and
then
just
one
more
before
senator
Bouchard
I
would
like
David
or
Stephanie
for
you
to
give
me
a
recap
of
who
you
are
how
the
funding
comes,
it
started
out,
I
thought
it
was
Pugh,
but
I
remember
now
it
was
pule
CSG.
It
was
a
collaboration,
but
there
in
set
outset
of
this
CSG
infuse
said
we're
not
going
to
do
it.
B
I
Thank
You,
mr.
chairman,
you
know
one
thing:
I
just
want
to
make
as
a
comment
that
the
most
important
part
of
some
of
what
we're
looking
at
here
is
the
health
department
and
the
corrections.
Coordinating
so
I
mean
there's
a
lot
of
things,
a
lot
of
moving
parts
when
someone
goes
in
on
addictions
and
then
has
to
come
out
and
I
mean
we
want
to
make
sure
that
there's
a
coordination.
I
I
We
know,
there's
there's
lawsuits
with
assessments
where
we've
had
assessments
that
were
done
on
the
outside
by
a
provider
and
then
when
they
go
into
into
Corrections,
they
have
been
reassessed
and
found
that
there
had
possibly
duis
or
are
there
other
indicators
that
they
know
that
maybe
it
slipped
through
the
crack
on
the
outside
of
the
and
the
outside
of
the
system,
because
the
provider
and
have
access
to
some
of
the
information.
And
so
these
assessments
aren't
across
the
board.
I
Even
so,
we
know
that
there's
problems
with
the
outside
of
Corrections
and
in
the
inside
of
Corrections
and
then
as
I.
Look
at
how
other
states
things
if
I
look
at
Montana,
just
a
simple
search,
I
see
that
Montana
has
a
Montana
Association
of
diction's
professionals
and
they
have
an
affiliate
there.
I
An
affiliate
of
nade,
AK
I,
look
at
Colorado
I
see
the
same
thing,
and
these
are
the
same
things
that
I
keep
bringing
back
into
committee,
that
we
have
states
that
actually
recognize
addictions
professionals,
because
they
are
able
to
use
a
peer-to-peer
model
and
build
trust
with
have
addictions.
Professionals
that
maybe
have
been
through
this.
This
whole
process
of
be
incarcerated
themselves,
becoming
felons
having
it
in
their
heart
to
come
back
into
a
prison
system
or
into
a
local
setting
through
a
community
setting
some
women
and
drug
court
systems
and
in
various
states.
I
But
those
professionals
are
are
more
geared
in
these
other
states
to
what
we're
trying
to
do
here
and
I'm
just
seeing
that
we're
not
doing
the
same
model
here.
So
my
direct
question
is:
how
do
we
fair
doing
this
with
maybe
not
addiction
professionals
just
on
an
addiction
side
compared
to
other
states
that
have
advanced
way
beyond
us,
so
I'm,
just
seeing
not
apples
to
apples
here
on
some
of
this
with
addictions.
D
Mr.
chairman
assured,
there's
no
easy
answer
to
your
question
because
the
there
is
not.
There
is
not
the
consistency
that
you
would
anticipate
from
state
to
state.
Some
states
have
completely
separate
roofings
of
addictions
and
mental
health.
Some
states
have
departments
of
mental
health
and
addiction
services.
Some
states
have
separate
addictions
folks,
some
states
require
you
to
have
the
higher
what
would
be
considered
to
be
a
higher
clinical
level
of
treatment
or
training
in
licensure.
D
I
am
not
aware
of
a
study
that
says
one
is
better
than
the
other
I
have
seen
studies
that
have
shown
every
model
when
implemented
well,
working
well
and
I've,
seen
studies
that
have
shown
when
they're
implemented
poorly
working
poorly.
What
I
would
say
simply
is
this,
regardless
of
how
Wyoming
decides
they
want
to
go
in
terms
of
this.
What
is
important
is
that
there
be
clear
standards
and
training
that
is
required
of
anybody
who
is
seeing
somebody
with
an
addiction
issue.
D
One
of
the
big
failures
that
you
see
are
the
use
of
peer
supports
without
training
and
structure,
and
that
tends
to
be
a
disaster.
The
use
of
peer
supports
with
training
and
structure
tends
to
be
very
effective
when
it's
being
done
in
conjunction
with
whatever
other
treatment
intervention
is
occurring.
D
So
I
don't
have
an
easy
answer:
I,
don't
think
it's
a
one
or
the
other,
and
then
the
last
thing
that
I'll
just
say
about
that
is
the
the
important
piece
is
to
be
clear
about,
regardless
of
again
how
you
determine
the
it
should
look,
whoever
it
is.
That's
providing
these
interventions
also
needs
to
understand
the
issue
of
co-occurring
disorders,
because
the
number
of
folks
substance,
addiction
issues
who
have
a
co-occurring
mental
health
disorder,
is
fairly
significant.
So,
however,
you
structure
it.
D
B
Guard
based
on
what
I
just
heard
there,
it
might
be
a
nice
option
for
you
in
the
interim
to
reach
out
to
wham
sack
and
to
David
and
see,
if
you
might
you,
if
you're
gonna
bring
your
bill
back
to
see,
if
you
might
do
it
in
a
way
that
you
still
have
the
peer
professionals
but
they're
in
that
structured
sort
of
setting
like
David's
talking
about
for
maximum
effectiveness
and
there
might
be
a
win-win
there.
I
don't
know.
I
Chairman
I
mean
the
bill
that
I
brought
was
specifically
inside
of
prisons
and
they
have
a
separate
mental
health
provider
in
the
prison.
So
I
mean
I.
Don't
think
that
really
is
is
the
same
as
well.
Obviously,
the
first
time
I
worked
on
this
I
wanted
to
go
wider
and
make
sure
we
allowed
addictions
professionals
to
work
in
the
state,
so
I
mean
there's
two
different
issues.
So
I
appreciate
that,
okay,
all
right
all
right.
B
Folks,
it's
3:00
I
show
which,
which
in
my
watch
is
going
to
be
most
accurate
955.
We
still
have
three
folks
that
want
to
present.
If
there's
not
any
more
questions,
I'd
propose,
we
take
a
seven
minute
break
any
more
questions
for
David
or
Stephanie
all
right.
According
to
my
clock,
it's
955
I'm
gonna
set
an
alarm
for
seven
minutes
that
gives
everybody
a
chance
just
to
hit.
The
restroom
grab
grab
a
soda
pop
or
whatever
what
Stan
remembers.
B
Okay,
let's
it's
it's
3:00
after
my
alarm,
just
went
off
so
let's
go
ahead
and
resume
so.
B
All
right
well
so
housekeeping
wise
Elizabeth
and
John.
You
can
go
ahead
and
tee
up
Cheryl
and
Andy
and
Paul,
and
let's
set
our
cap
on
a
half
hour
for
these
three
had
be
ten
minutes
each
or,
however,
they
want
to
allocate
the
time
that
may
not
be
realistic,
but
let's
give
it
a
shot.
Okay,
one
two
three
four
five
looks
like
we
have
a
quorum,
yep
who's
who's.
First
up,
oh.
A
J
We
go
thank
you:
Sheryl
Folland
legislative
advisor,
Miami,
Association
of
addictive
professionals
and
independent
private
provider
in
Rollins,
Thank
You.
Mr.
chairman
members
of
the
committee
I
wanted
to
take
a
moment
to
thank
the
committee
for
the
opportunity
to
speak
today
and
for
your
continued
presence
in
addressing
these
topics
that
are
so
important
to
our
members
of
our
state
and
those
that
are
even
by
just
mean
through
as
part
of
our
Corrections
Department
I
did
want
to
address.
J
Their
research
obviously
is
to
the
to
the
Centers
to
the
mental
health
centers
of
the
state.
There
are
many
of
us
in
private
practice
who
see
folks
out
of
the
Department
of
Corrections.
I
personally
have
six
clients
that
are
on
probation
and
parole,
as
are
many
of
my
peers,
and
obviously
many
members
of
our
membership.
I
did
want
to
address
for
representative
Olson
that
as
to
cost
specifically
on
the
ASIS
that
are
provided
by
several
different
providers,
I'm
only
reimbursed
$50
for
an
ASI.
J
So
if,
if
somebody
can
get
me
the
hundred
and
fifty
dollars
the
CSG
proposed,
that
would
be
wonderful,
but
that
doesn't
happen.
We
also
have
a
situation
where
providers
within
the
court
system
specifically
have
to
go
through
the
Department
of
Health
behavioral
health
to
be
an
approved
provider
for
assessments
and
for
programs.
That
is
a
cost
to
us,
and
it
is
kind
of
a
convoluted
process.
J
So
many
of
my
peers
and
colleagues
choose
not
to
participate
because
of
that
process
for
those
of
us
in
private
practice.
So
there
is
a
resource
available
if
we
can
get
through
some
of
the
bureaucracy
of
being
a
certified
provider.
I
did
also
want
to
address
with
representative
Olsen's
comments
on
telehealth
that,
yes,
it
is
a
wonderful
tool
for
us,
as
representative
Wilson
and
Senator
Schuler
also
pointed
out.
Brant
band
with
is
the
biggest
challenge
that
we
see,
especially
myself
and
Rollins.
I
think
we
have
one
cell
phone
tower
within
the
whole
two
hundred
miles.
J
So
I
can't
even
do
telehealth
with
my
plants
that
are
in
bags
or
elk
mountain
Saratoga
is
kind
of
hit
miss.
If
you
get
up
on
the
hill,
you
might
get
a
signal,
and
that
is
very
much
a
challenge
that
does
go
to
failure
to
our
clients
because
they
get
frustrated.
They
can't
access
the
services
that
they
need.
J
Of
course
they
do
the
dual
diagnosis.
We
do
have
the
he'll
occurring
disorders
and
that
does
enhance
a
person's
risk
to
Rhea
fend
her
to
have
a
probation
or
parole
revocation
because
they
get
frustrated.
They
can't
access
the
services
that
they're
told
that
they
have
to
have
one
of
the
other
pieces
that
I
wanted
to
address
very
quickly.
Is
that.
J
The
only
training
required
for
an
ASI
is
basically
online
and
it's
a
do-it-yourself
type
of
a
study
program.
I
did
I've
been
trying
to
trained
in
three
different
states
on
the
ASI
and
with
the
federal
government
when
I
was
at
the
VA.
So
for
me
it
wasn't
a
big
issue:
Wyoming
doesn't
regulate
the
assessments
that
we
use
other
than
just
identifying
them
that
it
has
to
be
in
ASI.
J
The
training
is
hit
or
miss.
There
is
no
real
quality
assurance
to
the
training.
There
is
also
as
Dana
had
identified.
There
are
definite
in
consistencies.
One
of
the
challenges
that
we
have
and
I
believe
senator
Schuler
and
representative
of
Wilson
senator
Bouchard
have
addressed
in
labor
committee.
Is
that
our
licensing
standards
also
play
into
the
delivering
of
these
assessments
as
well.
You
do
not
have
to
have
an
addictions
background
to
deliver
to
provide
this
assessment.
J
B
I
could
if
I
could,
inter,
if,
if
I
could
interrupt
you
for
just
a
second,
so
our
I
think
these
are
addressed
by
their
quality
standards.
That
are
you
endorsing
the
quality
standards
that
they've
been
advancing,
or
is
this
a
deficiency
in
the
presentation
that
we
heard
or
I'm
just
I'm
having
a
hard
time
seeing
where
you're
going
here
help
me
out,
you
got
why
you've
been
talking
for
eight
minutes.
Sorry.
J
J
J
You
representative
Barlow,
mr.
chairman,
the
biggest
component
to
a
good
assessment,
is
number
one
training,
but
number
two
is
the
fidelity
of
the
assessment,
making
sure
that
it
is
being
done
properly
and
we
do
not
have
that
ability
at
this
point
in
time
we
do
have
bachelors
level
people
who
can
be
very
competent,
who
are
addictions,
professionals
who
have
training
and
education
with
this
tool.
J
B
A
L
But
thank
you.
Mr.
chairman,
Andy
Somerville,
representing
wham,
sack
your
community
mental
health
providers.
I
just
have
a
few
brief
comments.
I'll
just
start
out
with
saying
the
process
with
CSG
working
with
Department
of
Health
and
Department
of
Corrections
on
this
project
has
been
wonderful.
I
just
have
to
echo
their
sentiments
about
everybody
being
a
table
and
participating
so
I
want
to
thank
them
for
that,
and
then
I
just
wanted
to
run
through
a
few
points.
A
few
questions
that
were
asked
so
regarding
county
jails
and
telehealth
I.
L
Believe
representative
Wilson
asked
that
question
that
has
come
up
in
discussion
and
I
apologize.
If
my
committees
are
blending
together,
but
I
believe
it
was
in
the
Judiciary
Committee
meeting,
they
discussed
telehealth
funding
for
county
jails
do
see
and
I
don't
know
of
any
bills
that
are
coming
forth
to
provide
additional
funding.
But
I
know
that
that
has
been
discussed
from
our
perspective.
It
does
vary
from
County
to
County,
based
on
the
county
jails
abilities
and
how
they
prefer
to
do
things
in
their
County.
We
do
have
I
believe
for
jail
based
contracts.
L
They
are,
do
see,
contracts
to
the
community.
Mental
health
centers
to
go
in
and
provide
services,
that's
a
relatively
new
thing.
That's
come
out
and
they
said.
We've
only
got
four
of
those
so
far,
but
definitely
a
conversation
in
the
works
as
we
see
that
as
a
way
to
continue
to
provide
services
and
I
just
want
to
clarify.
We
do
have
services
in
all
23
counties,
the
community
mental
health
centers.
L
L
The
question
I
believe
from
representative
Olson
on
the
cost
of
telehealth
versus
brick-and-mortar.
So
we've
been
looking
at
this
for
quite
a
few
months.
We
dived
into
telehealth
prior
to
Kovac,
but
obviously
with
Kovac
we've
ramped
up
that
expectation
of
telehealth
availability
significantly
we're.
What
we're
finding
is
the
actual
cost
to
the
centers
to
provide
telehealth
is
really
not
different.
Right
now
than
brick-and-mortar.
The
bulk
of
the
cost
is
in
the
provider
salaries.
So,
regardless
of
whether
it's
telehealth
or
they're,
seeing
somebody
in
person,
you
still
have
those
costs
moving
to
a
full
telehealth
model.
L
Let's
see
two
co-chairmen
Kinski's
question
about
any
legislation
needed
to
continue
telehealth
practices,
two
things
that
I
wanted
to
highlight
for
you:
one
is
the
insurance
parity
bill
that
was
brought
forward,
I
believe
from
the
labor
health
committee
earlier
to
potentially
go
to
a
special
session.
We
think
that
bill
is
important
with
Kovac
the
insurance
companies
have
stepped
up
and
are
paying
telehealth
visits,
as
they
are
in-person
visits,
and
that's
really
important
because
it
was
really
challenging
before
and
really
varied.
L
So
we
think
that
bill
is
important
to
keep
that
moving
forward,
so
that
telehealth
is
a
viable
tool
in
the
toolbox.
Also,
we've
had
to
request
and
have
been
successful.
Everybody's
been
very
great
about
this,
a
number
of
changes
to
Medicaid
payments
in
terms
of
allowing
both
audio
only
and
then
audio-visual
traditional
telehealth
services
to
be
covered.
Without
consideration
of
where
the
clinician
is
versus
where
the
patient
is,
there
were
some
pretty
strict
rules,
those
have
all
been
relaxed
for
kovat.
L
We
want
to
continue
to
look
at
those
and
keep
the
rules
that
make
sense
and
then
we're
actually
utilized
in
the
future.
That's
a
conversation
both
with
our
state
Medicaid
office
and
then
with
CMS
at
the
federal
level,
because
they
do
provide
a
lot
of
guidance
and
then
the
last
so
to
the
to
be
specific,
because
your
main
kids
key
I'm,
not
sure
if
legislation
is
needed,
I
think
that
that
might
just
be
an
executive
function
of
the
state
Medicaid
office,
but
I'll
follow
up
on
that
and
communicate
with
you.
L
If
that
is,
if
we
do
see
a
need
for
legislation
on
that
and
then
also
we're
working
with
Samsa
right
now,
that's
federal
to
keep
some
of
the
changes
that
they
have
put
in
place
for
kovat.
Things
like
before.
You
had
to
have
an
in-person
visit
before
they
could
be
put
on
a
map
therapy
of
medication,
assisted
treatment,
program,
they've
relieved
they
relaxed
that
during
co,
vid
and
we're
kind
of
tracking.
That
and
looking
at
is
that
effective.
Is
that
a
change
we
should?
We
should
keep
so
we're.
L
Looking
at
all
of
those
things
right
now,
as
I
understand
it,
a
number
of
insurance
companies
had
initially
planned
to
roll
back
their
changes
in
August
I.
Don't
think
that's
still
the
case
right
now,
but
we're
trying
to
follow
that
pretty
closely
and
then,
if
I
can
share
my
screen.
The
last
piece
I
wanted
to
touch
on
was
just
the
question
of
funding
from
co-chairman
Larson
about
what
that's
looked
like
and,
let's
see.
L
Can
you
guys
see
that
yep,
okay,
so
on
the
left,
is
a
presentation
that
I
believe
Department
of
Health
gave
last
year?
That
shows
the
funding
by
source
to
the
community
mental
health
centers?
And
so
you
can
see
we're
pretty
much
in
the
ballpark
for
direct
contract
pieces
since
2013,
but
we
certainly
haven't
seen
a
significant
increase
and
I
want
to
highlight.
There
was
a
significant
decrease.
After
the
2016
year,
the
center's
all
took
a
direct
cut
to
their
contracts
and
then
on
the
right
here.
L
This
is
a
table
from
Department
of
Health
from
earlier
2019
I
believe-
and
this
shows
just
mental
health
and
substance
abuse
funding
in
general.
So
the
community
mental
health
centers
are
included
in
this
they're,
not
obviously
the
total
expenditures
from
the
general
fund,
as
you
can
see,
our
contracts
for
2019,
2020,
total
I
believe
just
over
a
hundred
million
dollars
and
there's
a
hundred
and
sixty
eight
million
in
that
fund.
So
there's
other
programs
there.
But
what
I
wanted
to
overall
highlight
is
back
in
2005.
L
There
was
some
big
investments
here
and
here
and
then
in
2009,
and
then
you
can
kind
of
see
from
2011
moving
down
that
that
that
has
dropped
and
I
also
wanted
to
point
out
these
federal
funds.
Some
of
these
are
block
grant
money
which
come
directly
to
the
centers,
matched
with
state
dollars
to
provide
treatment.
Some
of
them
are
special
grant
programs
like
the
soar
grant
or
the
STR
grant,
as
it
was
previously
known
and
that's
specific
to
opioid
treatment.
B
C
Thank
You
mr.
chairman
Andy,
you
made
a
comment
that
you're
evaluating
and
making
recommendations
back
to
CMS
and
into
the
state
Medicaid,
but
the
reality
of
the
situation.
I
just
want
to
make
sure
we're
on
the
same
page
and
understanding
is
yes:
Medicaid
will
make,
they
don't
give
guidance,
they
make
the
rules
right.
L
C
And
so
as
much
as
we
may
like
to
suggest
that
we'd
love
these
new
programs
as
much
and
that
you're
actively
working
on
that
we're
going
to
have
to
comply
with
what
they
allow
and
we
have
no
indication.
I
appreciate
the
fact
that
you're
saying
that
we're
going
to
tell
them
that
we
like
what
they've
done
for
various
things.
But
at
the
end
of
the
day,
they're
going
to
make
a
decision
in
compliance
that
a
fair
statement.
Aye.
L
H
H
I
know
that
that's
been
kind
of
a
problem
in
the
past
I'm
wondering
if,
if
all
the
community
health
centers
right
now
are
using
that
electronic
version
of
the
SI
and
if
not,
maybe
why
not,
and
and
second
is,
are
we
getting
the
cooperation
that
we
need
from
a
do
see
to
the
community
health
centers
in
terms
of
not
having
to
have
people
test
and
retest
with
the
same
situation?
So
if
you
can
answer
that
for
me,
I'd
appreciate
it.
Thank
You.
L
Mr.
chairman,
senator
Schuler,
yes
overall,
question
I
think
that
it's
moving
in
a
good
direction,
so
most
of
the
centers
used
electronic
ASI,
so
they
buy
a
package
of
tests
from
a
vendor
and
then
and
then
utilize
those
either
on
a
yearly
subscription
base
or
there
by
like
5,000
tests
at
a
time
and
then
kind
of
run
through
those.
There
were
something
that
we're
still
doing
paper
and
pencils.
Sometimes
that
works
better
for
a
client
things
along
those
lines.
But
with
this
program
we
confirmed
just
a
couple
of
weeks
ago.
L
All
of
the
community
mental
health
centers
are
now
signed
on,
for
these
electronic
AAS
is
specific
to
the
DLC
probation,
parole
population.
They
see
the
value
in
it
and
we
think
it's
a
good
step
forward
in
terms
of
getting
everybody
kind
of
on
the
same
playing
field
and,
as
mr.
demora
stated
getting
that
accessibility
so
that
if
they
move
from
Casper
to
Gillette
and
they
go
to
another
community
mental
health
center-
that
they
can
that
committee
mental
health
center
will
have
quick
access
to
it.
L
I,
don't
want
to
paint
the
picture
that
the
commitment
to
health
centers
weren't,
getting
information
from
DLC
or
from
each
other
in
the
past,
but
transferring
records
right
now
is
not
always
the
easiest
thing
with
everybody
on
different
electronic
health
records
and
with
all
the
HIPAA
rules
and
compliance.
So
we
see
this
as
a
good
I
was
a
pilot
project,
but
I
think
this
will
be
a
good
step
forward
to
addressing
some
of
those
concerns
and
then
the
other
thing
that
I
wanted
to
that
I
can
notate
about
the
ASI.
L
A
B
B
Alright,
we'll
try
it
the
old-fashioned
way.
Can
you
hear
me
now
we
can
okay,
so
the
parity,
I'm
gonna
set
mental
health
parity
aside.
I.
Don't
want
to
confuse
that
with
these
other
issues,
getting
private
insurers
to
cover
that's
going
to
be
a
something
that
I
you
should
take
up
with
sue
Wilson
Medicaid.
You
know,
legislation
that
says
if
the
feds
authorize
it,
we
authorize
it,
including
audio-only.
You
know
those
are
all
things
that
are
going
to
have
to
be
not
requiring
an
inpatient
visit
prior
to
ma
p.
B
That's
that's
kind
of
stuff
that
it's
Department
hell
can't
do
it
it's
going
to
require
legislation.
So
then
those
are.
Those
are
things
that
are
worth
pursuing.
So
you
know
obviously
to
see
what
the
Department
Health
says
they
can
or
cannot.
Do
they
can't
I,
don't
know
that
they
can
do
anything
for
private
insurers,
though
that's
something
you're
going
to
have
to
have
legislation
out
of
out
of
US.
Isn't
that
right,
represented
Wilson.
You
agree
with
that.
F
A
Mr.
chairman
I
had
to
step
away
a
couple
times
for
that
call
that
I
mentioned
to
you
before,
but
there's
also
a
another
option
within
Medicaid.
That's
an
adult
mental
health
waiver
that
lying
is
not
are
taken
in,
and
so
that's
another
ID
that
at
least
when
Department
of
Health
gets
here.
Maybe
we
asked
them
to
give
us
a
little
more
background
on
that
we
heard
about
in
our
first
meeting
as
well
as
you
were
mentioning
the
Medicaid
component,
and
there
is
another
option
there
as
well.
That
could
be
explored
Thank
You.
Mr.
chair.
M
Can
you
hear
me
okay,
Thank
You,
mr.
chairman
committee,
members,
I
I'll
be
brief.
I
know
time
is
short
I'm
going
to
share
my
screen
real
quick
to
give
you
a
breakdown
in
terms
of
northerns
criminally
involved,
folks,
how
our
clients
break
out,
which
I
think
will
be
useful
and
there's
one
specific
subset
of
clients.
I
want
to
make
sure
we
don't
forget
about
as
we're
looking
forward
and
then
I
wrote
down
some
things
to
answer
some
of
the
specific
questions
that
that
folks
were
we're
asking.
M
Broken
down
by
on
the
left
side
is
mental
health,
on
the
right
hand,
is
substance,
abuse
and
by
category,
and
so
those
folks
that
were
actually
on
probation
those
folks
that
were
on
parole
and
then
this
red
slide.
That's
the
the
the
cases
that
I
think
we
need
to
give
some
thought
to
and
I'll
explain
why,
in
a
second
out
of
all
of
our
clients,
fifty-seven
percent
of
our
clients
have
involvement
with
DLC
or
criminal
justice
in
some
way
right
and
that's
the
breakdown
of
all
clients.
M
If
you
go
to
mental
health,
well,
71
percent
don't
have
any
and
29
percent
have
some
involvement
and
I'll
send
this
out
to
folks
I'll
get
it
so
everybody
gets
it.
So
then
what
happens
when
I
get
to
sums
of
use
clients?
Ninety-Seven
percent
of
the
folks
we
treated
through
this
fiscal
year
had
some
level
of
involvement
and
I
know
that's
higher
than
what
David
presented
when
he
was
saying,
50
to
70
percent
I.
M
M
Jail
pace,
IOP,
representative
or
co-chairman
larson
northern
is
one
of
the
four
groups
that
is
doing
the
gel-based
IOP
and
that's
the
contract
with
do
C,
B
and
so
DLC
has
a
contract
with
the
jail
and
they
have
a
contract
with
the
mental
health
subs
of
U
Center
to
provide
these
services
and
then
they
bring
folks
in.
We
just
got
started
on
that.
M
Everything
was
coming
together
in
February
and
we
all
know
what
happened
in
March
and
so
things
really
got
kind
of
clogged
up
in
terms
of
transferring
prisoners
and
but
we
were
set
to
go
and
and
still
are
at
at
this
point,
I,
don't
know
whether
they're
going
to
continue
to
fund
that
I'm
waiting
to
see
what
the
governor
decides
on
the
DL
C
cuts,
and
my
hope
is
that
will
continue.
But
I
don't
know
it
could
be
if
they
don't
cut
that
we're
gonna
move
forward
with
it.
M
M
The
jail
capabilities
that
was
limited,
I
think
they
may
be
getting
up
to
speed.
Part
of
the
what
they're,
trying
to
figure
out
is
make
sure
that
when
they're
doing
the
telehealth
and
they're
trying
to
respect
the
privacy
that
the
prisoner
doesn't
have
the
capability
to
you
know
get
elsewhere
on
the
Internet.
M
M
The
reassessments
and
portability
I
think
that,
depending
on
the
practitioners
and
and
I
think
that
that
has
been
some
issues
sometimes
but
I
wouldn't
say
it
was
across
the
board.
Everybody
all
the
time
didn't
accept
an
ASI
and-
and
let
me
clarify
this
too-
certainly
not
the
ASI.
The
ASI
is
just
a
tool
that
the
the
client
fills
out
its
the
ASI
and
then
all
the
criminal
history
and
everything
has
to
be
taken
into
account
and
then
a
clinical
interview.
That's
combined
because
the
ASI
actually
self
filled
out
by
the
the
client.
M
So
it's
it's
it's
more
than
that.
I
think
that
I
really
appreciate
David's
comments
about
regardless
of
licensure
and
everything
we
got
to
have
some
consistency
in
training
and
say:
okay,
everybody.
This
is
these
are
the
elements
in
an
assessment:
here's
you
got
to
use
these
things
and
so
you're
going
to
get
a
higher
integrated
reliability.
If
you
will
on
those
assessments
and
and
I
have
per
and
I,
don't
know,
therapists
and
I
know.
Firstly,
have
any
problem
taking
a
a
SAM
level
is
what
it
is.
M
You
know
the
ACM
placement
level
that's
less
than
six
months
old
because
it
saves
me
work
and
time
and
we
come
in
and
say
they're
supposed
to
come
in
to
medium
intensity
group
or
something
you
put
him
in
there
and
if
it
quickly
becomes
apparent,
they
need
more
or
less
you
just
move
them
to
that
other
level
of
care.
So
the
fluidity
and
levels
of
care
I
think
regardless,
where
a
person
comes
in,
if
you're
constantly
assessing
in
it,
you
can
move
up
or
down.
M
C
Thank
You
mr.
chairman
Paula
and
we've
heard
from
several
people
and
I
just
asked
the
question
once
and
it's
so
this
consistency
or
standardization
on
the
ASI
or
the
the
the
process
for
getting
that
assess.
I.
Think
we've
been
having
that
discussion
yeah
in
getting
those
trying
to
look
at
my
notes
here
on
how
we
do
those
assessments
standardized
and
getting
that
done.
Do
you
see
that
as
being
problematic.
M
Mr.
chairman,
please,
chairman
Larson,
I'm,
not
sure
what
you
mean
by
problematic,
but
I
think
it
can
be
done.
It
sounds
like
they're
gonna
do
some
of
this
stuff
via
telehealth
I
I'm,
all
for
it
I
think
it's
a
good
thing
and
it's
not
just
the
ASI.
It's
people
have
to
be
trained
to
ask
the
right
questions
and
and
to
develop
the
report.
The
other
area
that
has
been
problematic
and
I
don't
know
what
you
do
about.
M
This
is
getting
I
have
to
actually
in
one
County,
send
a
person
to
the
county
attorney's
office
to
look
through
to
get
the
legal
history
and
we
can't
take
anything
out.
We
have
to
write
it
all
down.
We
have
to
so
getting
that
legal
history
is
probably
one
of
the
most
important
elements
and
I
think
that's
probably
hit
and
miss
I.
Don't
know
how
you
deal
without
the
different
counties,
but
that's
a
big
deal.
A
A
B
Okay,
nothing
more
for
Paul,
I!
Think
what
I'd
like
to
do
with
the
committee's
permission
is
I'd
like
to
circle
back
to
David
and
Stephanie
and
see
if
they
have
any
reaction
or
thoughts.
After
hearing
from
those
three
folks
represented
Wilson
I
saw
you
nodding,
your
heads
is
that
something
you
think
would
be
helpful:
okay,
all
right,
so
Stephanie
David,
you
heard
three
different
folks
with
a
lot
of
background,
a
lot
of
expertise.
Anything
there
that
you
care
to
remark
upon
follow
up
on.
B
D
Afraid
I
cannot
control
my
video
I
think
it
may
be
controlled
up
there.
We
go
I've
just
been
given
permission
there.
We
go
I,
certainly
agree
with
both
mr.
dimple
and
with
anti
Seminole
in
terms
of
their
comments
about
the
importance
of
training
and
importance
of
the
interview
being
clinical
as
Paul
indicated.
Ensi
is
one
piece
of
the
tool
in
terms
of
the
overall
assessment
and
determination
of
the
ACM
level,
but
it
is
an
important
one
in.
D
Having
said
that,
it
may
be
that
as
DLC
moves
forward
in
the
development
of
this,
that
they
will
have
a
subset
or
sub
grouping
in
terms
of
how
they
will
look
at
quality
assurance
issues
for
those
clients
being
seen
by
private
providers,
but
that's
beyond
the
scope
of
our
technical
assistance
and
what
we're
able
to
provide
other
than
that.
As
always,
as
I
said
before
you,
you
do
have
a
good
number
of
really
good
clinical
folks
there,
and
that
is
nice.
I.
Don't
see
that
everywhere.
That
I
go
to
be
very
honest.
E
B
County
Attorney
can't
get
the
legal
history,
so
I
think
those
are
all
things
that
need
to
be
and
and
Paul
talked
about
the
or
somebody
he's
used.
The
word
front-loading,
and
so
our
emphasis
has
been.
Our
focus
has
been
on
people
coming
out
of
prison,
but
you
know
the
24/7
its
intended
for
the
Monday
morning.
Conversation
somebody
has,
it
gets
picked
up
for
an
alcohol
or
drug
related
offense
that
Monday
morning
after
they
get
out
of
the
poke
it's
the
conversation
they
have
with
their
attorney
or
somebody
like
Jared
Olsen,
says:
here's.
B
What
you're
gonna
do
you're
gonna
get
hooked
up
with
mental
health
counseling.
Now
we're
gonna
get
you
tested
twice
a
day
now
so
the
by
the
time
the
disposition
comes
up
and
we're
plea
bargaining
with
the
county
attorney
you're
clean
you're,
holding
down
a
job
you
paying
for
your
kids
and
it's
not
happening
in
a
lot
of
areas.
You
know
it's.
B
It's
still
the
same
old
justice
system
where
you
know
they
start
getting
the
help
about
the
time
they're
coming
up
for
sentencing
and
disposition
two
to
three
months
after
arrest
and
by
then
they've
been
arrested
for
something
else.
So
the
timeliness
of
the
intervention
is
right
throughout
the
entire
system
and
if
you
can,
if
you
could
make
notes
of
those
kinds
of
things
and
and
you
know,
maybe
we
have
a
subsequent
conversation
with
you.
What
is
what
is
phase
two
of
your
work
and
and.
L
D
Mr.
German
we're
happy
to
do
that,
and
indeed
in
some
of
our
previous
presentations,
we've
added
a
section
where
we
said
something
along
the
lines
of,
and
here
are
some
additional
things.
We
suggest
that
you
look
at
and
we're
certainly
happy
to
do
that
as
we
put
together
the
final
report
and
additional
information
for
you.
B
B
Okay,
Stephanie
same
same
okay,
all
right!
Well,
thank
you
both!
So
with
that.
Let's
move
on
to
agenda
item
three
overview
of
MHSA
services
through
the
criminal
justice
system.
That's
Department
of
Corrections
Department
of
Health,
and
that's
an
agenda
item
there.
So
we
were
originally
scheduled
to
start
that
at
10:00
we're
about
50
minutes
behind,
but
that's
not
too
bad.
As
things
go.
So
we
have
they're
admitting
now
Department
of
Corrections
and
Department
of
Health.
N
N
Okay,
very
good,
mr.
chairman,
so
just
a
few
brief
comments
from
the
Department
of
Health
and
then
I
will
kick
it
over
to
our
colleagues
at
Department
of
Corrections
on
some
updates
that
were
requested
by
the
committee
and
you
you
had
asked
for
the
Department
of
Health
to
provide
an
update
on
the
House
bill,
31
bill
that
had
passed
in
the
previous
session
and
we'll
certainly
do
that
in
a
bit
more
detail.
N
I
wanted
to
just
briefly
provide
the
committee
with
some
key
takeaways
from
the
analysis
that
the
Department
of
Health
performed
in
conjunction
with
the
Council
of
state
governments.
I
won't
spend
a
whole
lot
of
time
on
this.
Mr.
chairman,
as
David
and
Stephanie
did,
did
allude
to
much
of
this
detail.
N
So
what
we
did
with
with
those
clients
that
were
merged
that
we
could
find
you
know,
leaving
Corrections,
but
also
showing
up
in
the
Department
of
Health
records
of
the
community
mental
health
and
substance
abuse
centers,
we
performed,
what's
called
an
accelerated
failure.
Time
analysis
to
look
at
to
be
able
to
model
recidivism
from
the
community
back
to
Corrections,
based
on
different
variables,
and
what
we
found
was
for
those
do
see.
N
A
Department
of
Corrections
clients
who
had
high
criminogenic
risk
scores
and
a
mental
health
or
substance
abuse
need
that
receiving
care
at
a
community
mental
health
or
substance.
Abuse
center
was
associated
with
an
increased
length
of
stay
in
the
community
for
the
lower
risk
clients.
Those
who
who
had
a
lower
criminogenic
risk
score
I
believe
that
assessment
is
called
the
compass.
There
was
a
less
apparent
impact
in
in
the
analysis
and
in
the
model.
N
I
want
to
be
clear
here
that
the
results
from
from
the
analysis
that
we
performed
they
show
a
correlation
is
certainly
not
causation
so
again
without
doing
or
implementing
our
randomized
controlled
trial.
Were
you
with
a
you
know,
assign
some
of
these
clients
into
a
new
program
with
mental
health
and
substance,
abuse,
treatment
and
others?
Not
there's
really
no
way
to
to
start
to
demonstrate
causation,
but
we
did
see
a
correlated
impact
in
in
basically
less
recidivism
or
a
longer
time
before.
N
N
So,
essentially,
you
can
see
on
the
on
the
axes
here,
your
your
low
and
medium
and
high
risk
score
clients
and
then
on
the
right
side.
Substance
abuse
only
mental
health
only
and
then
both
mental
health
and
substance
abuse
and
then
on
the
on
the
left
side.
The
left
axis,
you
can
see
the
survival
probability
and
essentially
what
that
means
is
not
to
be
particularly
crass.
With
these
terms.
It's
really
just
the
the
analytical
terms.
You
look
at
a
time
to
failure.
N
So
if
you
look
at
the
mental
health
and
substance
abuse
own
excuse
me,
both
mental
health
and
substance
abuse
flags,
so
a
client
essentially
leaving
Corrections
that
has
mental
health
and
substance
abuse
needs
or
it's
part
of
their.
You
know
probation
or
supervision.
You
can
see
those
two
categories
at
the
bottom
right
hand,
side
and
a
much
larger
Delta
between
those
that
receive
services,
those
that
did
not
receive
services
and
their
subsequent
time
to
failure
on
the
on
the
bottom
axis
there.
N
So
that's
really
again,
as
I've
said
before,
to
the
labor
health
committee
into
others
on
this
topic,
where
we
see
impact
is
really
in
the
prioritization
area.
So
if
again,
the
theory
here
would
be,
if
you
prioritize
the
clients
with
the
highest
risk
score,
the
highest
needs,
that's
potentially,
where
you
see
the
reduced
recidivism
and
ultimately,
mr.
chairman,
the
the
goal
of
this
project
with
House
bill
31
and
what
was
essentially
developed
and
put
into
implementation
with
the
judiciary
committee
with
the
Council
of
state
governments
and
with
the
labor
committee
bill.
N
The
ultimate
goal
is
to
reduce
recidivism
and
thus
reduce
cost
in
the
Department
of
Corrections
for
essentially
contracting
for
out
of
state
beds
when
the
when
the
prisons
and
jails
are
full
here
in
Wyoming.
So
where
you
really
see
that
potential
return
on
investment
in
this
model
is
in
investing
in
mental
health
and
substance
abuse
services.
For
that
higher
risk
category.
F
F
F
F
N
Chairman,
if
I
may
representative
Wilson,
no
that's
that's
not
the
correct
way
to
read
this
chart.
The
the
idea
here
is
we're
not
measuring
quality
of
service
or
impact
of
the
person's
life
what's
being
measured.
Here
is
just
those
who
left
Corrections
and
either
did
or
did
not
receive
care
at
a
community
mental
health
or
substance
abuse
center
and
then
they're
associated
modeled
out
simulated
recidivism
time.
So,
in
terms
to
say
that
you
know
any
of
the
clients
that
would
be
in
the
categories
on
this
chart,
you
know
didn't
receive
good
care.
N
Weren't
helped,
that's
really
not
what's
being
measured
here.
It
truly
is
a
time
to
failure,
analysis
specifically
tailored
to
recidivism
back
into
Corrections
and
that
and
its
subsequent
association
with
whether
that
client
received
care
at
a
community
mental
health
or
substance
abuse
center.
So
no
comment
here
on
the
quality
of
service.
Again,
as
we
mentioned
before,
half
of
the
clients
about
half
of
the
clients
that
leave
Corrections
with
a
mental
health
substance
abuse
flag,
do
not
receive
services
at
a
community
mental
health
or
substance
abuse
center.
N
There's
probably
a
variety
of
reasons
for
that,
including
clients
that
might
receive
services
from
a
private
provider
or
a
non
community.
Mental
health
or
substance
abuse
center,
that's
funded
by
the
department
or
leaving
the
state
I
mean
there's
a
variety
of
reasons.
Why
only
about
half
are
captured
in
the
in
the
community,
mental
health
and
substance
abuse
system.
But
to
be
clear
again,
this
this
model
shows
the
the
correlation
between
receiving
services
at
a
community,
mental
health
and
substance
abuse
center
and
the
time,
basically
the
time
in
the
community
before
recidivism.
B
Anyone
else,
okay,
so
before
you
go
on
Stefan
I'm,
going
to
ask
you,
because
you
talked
about
50%,
sought
care,
and
so
somehow
we've
got
to
reconcile
this
data
back
to
what
CSG
had,
which
is
additional
305
days.
And
then
you
know
a
50%
come
out
and
they're
they're
ordered
to
go,
get
care
and
they're
not
going
to
the
mental
health
center.
The
mental
I
think
we
heard
Paul
dimples,
say
no
they're
coming
here:
they're,
not
showing
up
in
all
the
data
that
CSG
had,
but
they're
they're
coming
here
with
very
rare
exception.
B
So
how
is
it
that
you
have
a
50%
number
and
I'm?
Not
I?
Don't
want
you
to
answer
that
now,
I'm,
just
asking
that
you
and
work
with
the
community
mental
health
centers
trying
to
identify
what
the
deficiency
is
in
the
data
because
I'm
with
represent
of
Wilson
I'm
in
that
bottom
right
hand
chart
is
stunning
if
I'm
reading
it
right
1440
months,
it's
almost
four
years.
So
if
you
receive
both
MH
and
si,
you
know
you're
out
four
for
you.
B
It's
50%
probability,
you're
gonna,
be
in
the
community
for
four
years,
which
essentially
means
you're.
Probit
you're
off
your
probation
or
your
parole
and
I
mean
four
years
is
a
good
long
time
versus
twenty
three
percent
probability
will
stay
out
for
four
years.
It's
you
know
it's
more
than
double
the
success
rate.
People
receive
no
services,
so
we
really
want
to
know
that
this
data
is
accurate.
N
Problem
mr.
chairman
I
will
say
this
is
the
data
that
that
CSG
did
use.
So
it's
all
the
it's
all
the
same.
I
will
just
mention,
mr.
chairman,
that
the
denominators
are
different
between
this
in
terms
of
all
clients
that
leave
Department
of
Corrections
and
the
denominator
of
what
you
saw
from
the
community
mental
health
center
and
specifically
northern,
where
yes,
I'm
sure,
90
plus
percent
of
their
clients
on
the
substance.
N
Abuse
side
have
some
Corrections
involvement,
but
that
doesn't
that
doesn't
directly
correspond
to
this
data
coming
from
Department
of
Corrections,
where
all
of
the
clients
leaving
the
Department
of
Corrections
might
not
receive
care
at
a
community
mental
health
or
substance
abuse
center.
So
again,
no
value
judgment
there.
No,
no
quality
or
performance
judgment,
just
a
different
population.
N
Moving
on
mr.
chairman
I'll
be
very
brief
here
and
then
handed
over
to
a
deputy
director
Shannon
from
the
Department
of
Corrections.
The
committee
had
asked
for
updates
on
House
bill
31
from
the
department's
of
health
side,
specifically
the
contract
additions
for
this
next
fiscal
year,
as
it
relates
to
Department
of
Corrections
populations.
N
Those
populations
have
been
added
to
our
mental
health
and
substance
abuse
contracts
with
the
community,
mental
health
and
substance
abuse
centers
as
targeted
populations,
and
you
can
see
the
contract
language
contract
language
here
that
both
includes
probation,
ease
and
and
parolees
I'm
happy
to
answer
any
questions
about
those
contract
mechanisms.
But
we
did
go
over
that
in
the
previous.
The
first
meeting
with
this
committee,
but
I'm
happy
to
stand
for
questions
there
or
I
can
go
ahead.
Mr.
O
Thank
You
mr.
chairman
co-chairman,
Larson
committee
members,
I'm
Dan
Shannon,
deputy
director
for
the
Department
of
Corrections
and
also
with
me,
is
administrator
over
field
services
dawn
sides
with
your
prior
presentation
for
mr.
demora
I
tried
to
take
some
notes
and
maybe
I'll
answer
a
few
questions
and
then
I'll
get
right
into
the
deputy
Johansson's
presentation.
I
want
to
thank
Dave
and
Jia's
staff
for
the
updated
information.
I,
certainly
appreciate
their
guidance
between
our
three
through
the
Department
of
Health
CSG.
It's
my
book.
It's
my
firm
belief,
I.
O
Think
one
of
the
questions
were
being
asked.
Are
we?
Are
we
creating
the
right
frame
working
round
work
after
hospital
31
for
the
potentially
efficiencies
and
streamlining
to
reduce
our
resume
rates?
Our
current
population
on
probation,
parole
on
insane
personally
at
this
time
is
6,000.
120
75%
of
that
population
indicates
a
high
probable
probable
need
for
substance,
abuse,
3504
and
treatment
completed
or
every
been
referred.
We
currently
have
90
919
that
are
in
review
or
waiting
some
form
of
treatment.
O
Success
rates,
beginning
July,
1st
I,
went
back
to
one
question:
was
a
state
between
2009
in
this
past
week
or
indicating
an
increased
success
rate
to
our
actual
replications
was
361
with
193.
Mr.
chairman,
there
was
direct
result
of
substance
abuse
compared
to
the
previous
year,
which
was
481
revocation
so
at
314
directly
to
substance
abuse,
but
there
are
many
factors
and
it
also
over
waiting
to
see
how
this
could
pandemic
weather.
/
supervision
will
pan
out,
and
so
all
of
you
are
aware
of.
Many
of
you
are
aware.
O
We
have
our
out
of
state
inmates
return
now
back
to
our
facilities
or
present
in
current
population
is
2301
representative
Wilson
raised
the
question
regarding
telehealth
since
the
our
judiciary
committee,
Department
correction
has
submitted
application
through
care
Zack
for
updated
telehealth
equipment
inside
our
facilities.
That's
been
completed.
O
Mr.
dimple
raised
a
question
regarding
cutting
budgets
and
and
I
can
tell
you
that
all
items
are
being
reviewed.
There's
been
no
decisions
made,
but
we
are
taking
a
pretty
straightforward
stance.
What
can
we
do
to
still
continue
to
produce
the
best
product
and
reduce
a
mate's
returning,
so
that
means
education
and
treatment
our
highest
priorities.
O
As
mr.
deputy
director
Johansson
indicated,
we
work
together
on
this
slide
and
I'll
present
that
sue
soon.
Mr.
chairman,
I
I've
been
kind
of
overwhelmed
with
kovat
and
in
our
budget
crisis.
So
there's
may
be
questions
I
don't
have,
but
I
will
respond
to
you
in
a
timely
manner,
Department
of
John
to
the
slide
on
the
Department
of
Justice
ever
Awards
being
prepared
allowed
for
the
following
this
under
number
1.
The
assistance
and
development
of
quality
assurance
you
know,
is
really
our
is
really
our
foundations
under
the
supper
award,
where
working
with
a
cji.
O
It's
a
group,
it's
out
of
Colorado
for
this
criterion,
selecting
clinicians
as
I
believe
Stephanie
indicated
that
should
be
completed
by
October
of
this
year,
and
we
believe
this
funding
in
this
election
will
be
able
to.
We
should
be
able
to
bring
on
two
clinicians
to
assist
with
this,
with
the
funding
that
was
provided,
as
indicated
by
through
CSG
and
assistance
in
the
development
of
responsibilities
within
the
audit
responsibilities
and
the
instrument
and
maintenance.
O
The
wdse
also
sir,
purchased
four
thousand
online
substance:
abuse
assessments
for
community
providers,
prison
substance,
abuse
contractors,
a
a
Oh,
a
a
and
clinicians
policies
and
coordination
of
cases
will
be
audited
mechanism
for
the
report
deputy.
Can
you
go
to
the
next
slide
as
far
as
our
a
SAM
criteria,
skill,
building
training?
This
training
is
really
established
from
companies
called
train
the
change
it
will
assist
identifying
the
criminal
elements.
O
There
was
a
key
factor
in
the
previous
discussions,
considering
the
a
Sam's
effectiveness
on
criminogenic
needs
and
it
also
bring
Department
of
Health
and
Department
of
Justice
together
on
a
similar
mission.
In
a
way
we
look
at
it,
we
may
look
at
our
overall
overall
goal.
I,
believe
is
the
same
externally,
though
we
may
come
from
a
different
viewpoint
from
Corrections
and
Department
health
and
I
really
believe
that
training
will
take
place
as
far
as
a
structured
decision
tool
making
for
the
treatment
includes
information
towards
our
ASI.
O
A
Sam's
and
use
of
risk
needs
to
dominate
the
appropriate
placement.
This
matrix,
which
really
involves
up
to
eighty
hours
of
preparation
in
time,
will
incorporate
decisions
regarding
to
identification,
treatment,
levels
and
offender
risk
and
as
well
as
concerns
for
treatment
and
I
noticed,
was
raised
by
Miss
Andy
Somerville
today
and
third,
a
leadership,
development
and
culture
Academy
within
Wyoming
Department
of
Corrections
and
the
Department
of
Health.
This,
because
of
kovat,
has
now
become
a
virtual
training,
is
to
be
completed
by
February.
O
Twenty-One
and
more
proof,
collaboration
between
the
two
agencies
and
it'll
go
back
to
similar
to
what
I
said.
Reach
us
with
the
same
goal.
As
far
as
the
outpatient
deputy
weekly
meetings
continue
to
occur.
Most
are
led
by
dave
with
CSG
department,
Health
Council
state
government,
we're
going
over
to
supper,
award
training
opportunities
and
build
a
communication
platform
on
the
issues
that
are
brought
forward.
On
that
there's
so
many
difficulties
with
external.
O
Proprietary
databases
and
that's
really
what
we're
focused
on
now,
as
mentioned
earlier
executive
director
and
December
bill
is
not
participating
as
liaison
and
we're
meeting
with
why
Sam
by
Sacketts
is
scheduled
now
for
July
10th.
There
are
some
obstacles
w
if
we
can
go
to
the
next
slide
access
the
possession
of
treatment
related
data
as
it
was
brought
up
by
several
members
today.
There
are
many
difficulties:
the
data
basis.
Many
are
proprietary,
we're
also
challenged
by
the
oversight
of
42cfr
on
how
we
can
bring
this
into
one
database.
O
I
know
we're
working
very
diligently,
even
with
our
statistician
here,
and
to
see
how,
if
we
can
come
up
with
some
type
of
coding
to
bring
everyone
together
with
that
number
two
are
a
data
repository
an
outcome
reporting
platform
needs
establish.
Well,
we
need
to
develop
a
reporting
mechanism
that
will
benefit
the
offenders
as
well
as
there's
a
current,
accurate
data.
Without
that
accurate
data,
we're
kind
of
spinning
our
wheels
and
and
everyone's
drawing
from
their
own.
O
We
heard
today
that
there's
different
forms
of
funding
cost
there's
different
forms
of
the
way
the
SIS
are
being
presented
or
or
the
history,
and
the
way
that
they're
being
presented
or
producing
different
outcomes
and
so
to
us.
That's
one
of
the
that's
one
of
the
keys
to
establish
that
data
in
that
database
last
section
that
Department
of
Health
and
DRC
has
been
managing
through
kovin
19
page.
It
has
slowed
to
develop
mobile
to
competitive
base
funding,
as
with
everything,
but
we
are
moving
forward.
O
F
You
mr.
chairman,
I
did
just
have
a
brief
question
for
deputy
Shannon
and
and
I
think
this.
This
population
might
not
be
very
big
part
and
it's
not
really
a
responsibility,
but
it
seems
like
reading
the
paper
that
the
feds
are
having
a
lot
more
involvement
in
you
know
some
of
the
DEA
type
that
various
drug
cases
and
stuff
that
you
see
and
so
I
would
suppose
that
if,
if,
if
people
you
know
go
into
the
federal
system,
you
know
if
there
are
a
Wyoming
person,
then
they're
still
released
out
into
the
community.
F
O
F
So,
just
as
a
follow
up
mr.
chairman,
that
I
think
you
know,
obviously,
if
it's
only
2%
of
the
criminal
correctness
type
people,
then
I
mean
I'm,
not
saying
that
we
don't
want
to
care
about
anybody.
But
but
you
know
if
it's,
if
it's
in
a
couple
of
hundreds,
we
maybe
just
need
to
have
some
other
little
loop
to
kind
of
capture
that
component
yeah
anyway.
That's
all
I
have
on
that.
Mr.
Chu,
no.
B
N
You,
mr.
just
in
closing,
I'll
agree
with
Deputy
Director
Shannon
I
think
the
work
has
has
been
a
very
successful,
especially
on
the
majority
of
what
was
included
in
House
bill
31
with
the
collaboration
pieces
between
the
two
departments.
As
you
see
on
the
last
bullet
point
here,
the
one
you
know
full
disclosure
we
wanted
to
make.
N
There's
just
some
some
caveats
there.
So
we
want
it
to
be.
You
know
upfront
and
clear
with
the
with
the
Committee
on
that.
But
mr.
chairman.
That
concludes
our
presentation.
I'm
happy
to
answer
some
of
the
questions
that
were
noted
by
lso
and
direct
to
the
department
in
the
in
the
earlier
presentations
by
Council
of
state
governments
and
the
other
presenters,
but
I'll
leave.
B
B
I
I
think
we
want
to
go
ahead
and
get
a
follow-up
on
those
items
before
you
leave
this
presentation,
though,
on
this
sub
grant,
that's
not
what
you
called
it.
You
called
it
a
Justice,
Reinvestment
sub-award.
How
much
is
that?
Maybe
you
said
it
and
I
missed
it?
How
much
is
that
four,
and
when
do
you
anticipate
getting
it
and
what's
your
timeline
here
basically.
O
J
B
N
You
mr.
chairman
I
noted
about
four
questions
and
I'm
happy
to
go
into
more
detail.
If
the
committee
needs
the
first,
one
was:
did
the
Department
of
Health
back
in
the
you
know,
2015-2016
period
pay
for
our
title:
25
cost
overrun
with
mental
health
and
substance
abuse
dollars.
The
answer
to
that
is:
no.
We
funded
that
with
for
as
long
as
we
could
with
unspent
money
in
the
department
that
was
obligated
in
other
areas,
but
would
have
been
potentially
reverted.
The
subsequent
biennium
going
into
2017
2018.
N
You
know
budget
reductions
across
the
department
to
the
tune
of
over
a
hundred
million
dollars,
so
that's
potentially,
where
some
of
that
confusion
was
coming
from.
But
we
did
not
move
mental
health
substance
abuse
treatment
dollars
over
to
the
state
hospital
budget
to
pay
for
title
25
when
we
did
have
that
cost
over.
C
N
Mr.
chairman,
co-chairman,
Larson
good
questions
so
back
when
we
prepared
budget
reductions
for
the
2017-2018
biennium
the
treatment
units,
as
we
call
them
across
the
community,
mental
health
and
substance
abuse
programs
were
in
fact
reduced.
It
was
about
an
eight
point:
three
percent
reduction
to
the
overall
budgets
in
that
unit
or
across
those
units,
so
mental
health,
outpatient,
residential
substance,
abuse,
outpatient
and
residential,
which
totaled.
If
memory
serves
and
I
can
get
you
the
exact
details.
N
You
see
in
that
system
we
have
been
able
to
leverage
more
of
those,
but
that's
not
necessarily
equally
distributed
across
across
the
center's.
It
can
be
for
certain
grants
or
certain
programs
that
we
were
able
to
you
know,
get
federal
or
funds
or
use
and
leverage
a
tobacco
settlement
funds,
but
we're
happy
to
provide
you
know
the
full
budget
detail
over
each
fiscal
year
for
those,
but
there
were
certainly
budget
reductions.
Just
some
of
those
over
the
years
since
they
were
implemented,
have
been
added
back
or
added
through
other
funding
sources.
C
N
Chairman
and
co-chairman
Larsen,
yes
and
no
I
would
say
some
of
those
cuts
have
been
replaced.
It's
just
not
a
one
to
one
with
you
know,
eight
million
was
cut
and
eight
million
was
added
back
it's.
It
really
depends
on
the
center.
It
depends
on
various
grants
that
were
used.
But
yes,
it
is
accurate
to
say
that
the
the
budgets
for
those
units
were
in
fact
reduced
for
the
2017-2018
biennium,
but
again
happy
to
provide
that
level
of
detail
to
the
committee
very.
A
N
Quickly,
mr.
chairman
number
three,
you
had
asked
on
any
latitude:
that's
needed
to
continue
telehealth
reimbursement,
the
Department
of
Health
I'll
answer
initially,
I,
don't
see
a
major
need
for
legislation
here
there
was
one
area
that
was
brought
up,
that
I'll
follow
up
with
our
Medicaid
office
on
specifically
reimbursing
for
audio,
only
telehealth
visits,
and-
and
so
we
can
follow
up
with
the
Committee
on
that,
but
in
general,
and
even
prior
to
kovat,
19
Medicaid
has
reimbursed
for
telehealth
at
parity
with
any
other
Envisat.
N
So
it
doesn't
matter
if
the
client
is
at
their
home
and
the
provider
is
you
know
at
the
office?
The
client
doesn't
have
to
go
to
a
specific,
you
know
place
or
provider
to
do
a
telehealth
visit
so
that
reimbursement
parity
is
there
there's
no
legislation
needed
to
continue
that,
but
we'll
certainly
follow
up
as
one
kovat
19
measure
that
we
implemented
was
reimbursing
on
mental
health
visits
for
audio
only
and
I'll
I'll
get
the
committee
information
on
what
the
timeline
is
of
when
that
would
expire.
N
For
example,
if
the
national
public
health
emergency
is
rescinded,
and
that's
just
something,
we
need
to
follow
up
on
so
one
caveat
there,
but
in
general,
mr.
chairman,
no
legislation
needed
on
the
department
side
to
continue
to
allow
and
reimburse
for
for
telehealth
visits
on
behavioral
health.
And
finally,
though,.
B
N
N
H
Clarification
over
on
slide,
8
and
I
may
have
misheard
this,
but
I
believe
you
were
talking
about
the
audit
data
repository
and
you
mentioned
something
about
42cfr,
which
I
have
no
idea
what
that
is.
If
you
could
clarify
that
and
then
secondly,
you
mentioned
that
we
brought
back
all
of
our
out
of
state
prisoners.
Was
that
because
of
kovat
issues
or
I'm,
just
wondering
if
we've
actually
had
a
decrease
in
our
prison
population,
Thank
You,
mr.
chairman.
O
Mr.
chairman,
senator
Soler
Thank
You
42cfr
is
a
federal
oversight
policy.
There
really
determines
how
is
actually
more,
it's
actually
stricter
and
we
have
our
HIPAA
laws,
but
it
really
provides
on
how
data
electronically
can
be
transferred
back
and
forth
between
agencies
and
providers,
and
it
really
restricts
the
guidelines
that,
for
we,
as
a
state
agency,
to
develop
a
database
that
everyone
can
draw
from,
or
at
least
a
baseline
it.
We
really
have
some
tough
guidelines.
I.
Concerning
bringing
our
inmates
back
know.
Our
population
hasn't
dropped.
O
We
lost
approximately
59
inmates
with
our
good
time
jail
bill,
effective
July
1st.
Our
current
population
is
20,
23:01,
I'm,
sorry,
2108,
I'm,
sorry
I
gave
the
wrong.
We
were
originally
going
to
bring
our
inmates
back
at
the
conclusion
of
March
of
this
year,
but
because
of
Ko
with
the
inmates
in
Mississippi,
as
well
as
those
in
the
females
in
Nebraska,
we
brought
our
females
back
in.
We
are
completely
capacity
to
our
Women's
Center
in
Lusk
that
we
are
females
are
now
housed
at
WM
CI,
which
is
compatible
and
set
up
for
that.
O
We
brought
those
individuals
back
and
our
individuals
that
were
in
Mississippi.
We
had
those
housed
up
for
two
reasons:
one
short
staffing
as
well
as
construction
and
those
kind
of
went
together,
and
we
are
progressing
very
rapidly
with
that.
Our
inmates
were
brought
back.
They
were,
we
brought
them
back
in
segments
of
two
week
intervals.
They
were
in
isolation
as
well
as
we
tested
him
for
covin,
and
then
we
got
everyone
returned.
So
to
answer
your
question.
B
Anybody
else
have
anything:
I
want
to
circle
back
to
Stefan.
So
this
is
a
subcommittee,
the
appropriators
just
deal
with
money
and
we're
under
pressure
to
find
20
to
30%
of
the
state
budget,
as
is
the
governor's
office.
We
may
not
have
to
act
if
you
take
care
of
it
all,
but
and
we
see
that
the
health
labor
subcommittees
been
doing
some
good
work
and,
of
course,
there's
been
talk
about
maybe
reducing
expenditures
by
going
to
just
priority
populations
through
the
community
mental
health
center.
So
the
interests
in
Appropriations
is
that
we
don't
do
anything.
N
Yeah,
mr.
chairman,
very
briefly
on
the
budget
reductions
that
have
been
directed
and
requested
by
the
governor
were
in
the
we
have
developed
those
scenarios
nothing's
final,
yet
so
I
don't
want
to
jump
ahead
of
our
chief
executive
who's.
Reviewing
all
of
our
proposals
right
now,
because
any
detail
I
gave
you
on
those
scenarios
would
not
be
final,
but
we
had
have.
We
have
had
to
look
across
the
entire
enterprise,
as
you
mentioned,
we
don't
know
yet
what
the
final
request
is.
N
A
percentage
of
our
general
fund
budget
will
be
for
reducing,
but
we
know
it's
going
to
be
somewhere
between.
You
know,
probably
seven
percent
and
twenty
percent,
like
you
mentioned
I,
think
that's
a
little
bit
fluid
and
evolving,
but
we've
looked
across
the
enterprise,
including
Medicaid,
which
represents
the
majority
of
the
department's
general
fund
budget,
as
well
as
our
behavioral
health
programs,
including
our
community,
mental
health
and
substance
abuse
centers
and
our
developmental
preschools.
N
B
N
Mr.
chairman
I'll
give
you
five.
Actually,
if
you,
if
you'll,
allow
me,
because
these
five
line
items
and
91
percent
of
the
department's
general
fund
budget
and
that's
Medicaid,
which
includes
our
waiver
programs,
mental
health
and
substance
abuse
is
number
two
number
three
is
developmental.
Preschool
is
what
we
call
a
IEP
and
then
the
remaining
two
or
the
State
Hospital
in
the
life
resource
center.
Those
five
areas
account
for
91
percent
of
the
department's
general
fund
budget.
A
B
Anything
else
for
Stefan
before
we
go
to
public
comment,
all
right
thanks
Stefan.
Thank
you
thanks,
Don
and
Dan.
So
we
have
several
people
up
I'm
going
to
take
them
in
reverse
order,
I'm
going
to
start
with
Paul
dimple,
because
I
just
left
off
talking
about
budget
and
the
conversations
between
do
H
and
the
mental
health,
centers
and
I.
Think
I'd
like
to
for
Paul,
probably
has
his
own
presentation.
Do
your
presentation,
but
maybe
then
you
can
kind
of
follow
up
on
the
question.
I
just
put
the
Stefan.
M
M
What
would
the
general
contract
dollars
like
for
for
northern
are
down
from
2016-17,
probably
230,000
or
something,
and
what
the
system
has
done
over
time
is
the
and
the
general
contract
says
you
know
all
the
people
coming
in
and
the
general
stuff
where
we've
had
increase
in
money
is
say
from
the
soar:
grant
the
state
opioid
response
grants
where
we
developed
a
mat
program,
the
we
had
some
äôt
money
for
the
assisted,
outpatient
treatment,
the
gatekeeping
stuff,
where
they
said.
Okay,
we
want
you
to
do
these
special
and
specific
things,
and
so
what
happens?
M
M
The
other
thing
that's
in
there
that
doesn't
get
thrown
in
the
equation
very
much
besides.
Just
the
state
general
fund
dollars
is
the
medicaid
rate.
Cuts
back
then
went
from
87
to
83,
so
like
a
5%
cut,
I
think
and
then
the
caps
on
the
Medicaid
Services
at
20,
which
they
just
recently
in
the
last
year,
increased
to
I
think
30
visits,
knowing
that
20
was
was
difficult.
So
that's
the
complicated
picture
of
how
the
system
has
been
addressing
specific
needs,
while
the
general
contract
dollars
are
actually
down.
F
You
mr.
co-chairman
Paul,
going
back
to
representative
Larson's
noticing
of
the
contract
money
you
know
dipping
down
and
then
more
or
less
being
flat
or
roughly
where
it
was,
but
I
I,
compared,
for
example,
to
like
the
school
systems
getting
ECAs.
You
know
such
that
employees
and
whatnot
get
raises,
and
that
kind
of
thing
so
in
essence,
being
flat
over
ten
years.
F
M
Chairman
representative
Wilson,
what's
happened
over
time,
is
that
this
whole
system
was
built
at
a
time
when
we
didn't
have
computers.
We
didn't
have
data,
we
didn't
have
a
lot
of
these
things,
and
so
what's
happened
over
time.
Is
things
have
become
more
expensive,
I
didn't
have
when
I
you
know.
Thirty
years
ago
we
had
paper
and
pencil.
Now
we've
got
software,
we
have
computers,
we
have
those
and
we're
seeing
continued
in
increasing
software
costs
that
have
become
more
and
more
critical
for
us.
M
So
that's
one
one
area
that
can
be
problematic
but
I
think
every
business
is
has
struggled
with
that.
Obviously
having
competitive
wages
and
I
feel
like
we're,
pretty
competitive
is
important,
but
the
expenses
for
the
benefits
you
know
continue
to
grow,
go
up
which
is
I
know
every
every
business
is
is
dealing
with
those
things
the
the
overall
flatness.
It's
not
just
been
the
flatness
of
the
State
dollars.
You
also
have
a
decreased
years
and
years
and
years
ago
for
the
SPM
I
seriously
persistently
mentally
ill
population.
M
They
were
probably
about
47%
of
those
folks
were
Medicaid
right
now.
I
think
my
last
number
I
ran
was
27%,
so
you
have
fewer
folks
on
Medicaid
than
you
did
before.
You
have
a
decrease
in
funding
there.
So
that's
where
you
can
can
take
a
hit,
so
it's
across
the
board
one
of
the
numbers-
that's
probably
the
easiest,
is
clear
back.
This
is
many
many
many
years
ago
they
had
targeted
dollars
for
seriously
mentally
ill
and
we
got
some
dollars.
Northern
did
to
develop
apartments.
M
These
ten
apartments
and
the
dollar
amount
given
at
that
time
was
266
thousand
five
hundred
dollars
and
I'm
talking
god.
It's
got
to
be
ten
or
fifteen
years
ago
at
least
the
amount
of
dollars
I
get
for.
Those
is
still
206,
six
thousand
five
hundred.
Actually
it's
less
than
that,
because
I
took
that
cutback
in
in
1617.
So
it's
the
combination
of
all
of
the
at
every
place.
We
get
dollars,
it's
it's
been
cut
and
limited,
and
and
and-
and
so
that's
really
the
the
sad
truth,
I
hope,
I.
K
M
Are
I
feel
confident
in
determining
a
path
forward?
You
know
all
know
when
everybody
else
knows
what
the
actual
cuts
are,
but
in
terms
of
moving
forward
from
what
the
system
has
been
overtime
developed
years
and
years
ago,
as
a
community
mental
health
center
system
take
everybody,
everybody
comes
in
escale,
moving
towards
the
new
realities
that
the
conversations
I've
had
with
the
Department
of
Health
I
am
optimistic
that
we're
going
to
be
able
to
sit
down,
given
whatever
the
final
dollars
are
and
try
to
come
up
with
as
I
call
it.
M
The
best
worst
case
scenario
on
on
responding
to
those
budget
reductions,
but
there's
going
to
be
rat
reality
at
the
end
of
the
day
that
is,
gonna
have
to
be
addressed
about
who
can
we
Ford
and
and
the
likelihood
without
and
there's
not
going
to
be
any
new
money
in
the
system?
There's
gonna
be
some
people
that
get
services
and
some
that
probably
don't.
You
know
I
just
what
anybody
wants,
but
it's
our
reality
got.
M
K
M
One
thing
I'll
tell
you
and-
and
the
staff
knows
now
in
preparation
for
our
cuts
and
and
I'll
be
interested
to
see
what
how
some
other
centers
have
adjusted
of
the
upcoming
and
anticipated
cuts.
That
I
had
several
positions
that
we
were
trying
to
fill
so
any
open
positions.
In
the
new
budget
year,
I
cut
I
laid
off
three
folks
had
to
cut
back
pretty
severely
on
psychiatric
I
had
a
a
PRN
who
was
an
employee
worked
full-time.
M
What
I
can
afford
now
is
I've
cut
that
and
I'm
in
a
contract
at
$150
an
hour
for
12
hours
a
week.
My
guess
is
I.
Think
that's
I,
don't
know
what
what
the
system
looks
like
now
with
the
cuts.
That's
going
to
be
important,
but
that's
an
honest
and
with
that
I'm
still
anticipating
about
$200,000
shortfall
next
year,
but
I
can't
you
can
cut
and
cut
until
you
kill
the
patient
right.
M
L
Thank
You
mr.
chairman,
again,
Andy
Somerville,
representing
lam,
sack
and
I.
Just
have
a
just
very
couple
of
few
brief
comments,
because
mr.
dimple
covered
everything
pretty
well,
as
did
do
a
chin,
GOC
I
just
want
a
highlight.
We
spoke
on
the
previous
item
about
that
criminal
justice
population.
That's
not
on
probation
and
not
on
parole.
As
we
look
at
priority
populations
and
funding.
L
That
is
a
pretty
decent
percentage
of
the
clients
that
are
involved
in
his
system
right
now
and
that
that
number
is
similar
across
most
of
the
Centers
as
far
as
budgets
and
contracts
just
to
highlight
again,
the
contracts
being
flat
has
really
put
a
squeeze
on
a
lot
of
the
areas
for
the
center's.
So
representative
Wilson
your
question
about
salary
right
now,
our
community
mental
health
centers
are
not
competitive
with
private
providers.
They
try
to
be
as
competitive
competitive
as
they
can,
but
right
now,
their
salaries
are
not
competitive
with
an
OPC.
L
That's
a
private
provider
that
has
a
thriving
practice,
they're,
not
competitive,
with
a
lot
of
this,
the
salaries
up
at
the
State
Hospital.
If
you
ask
my
Center
in
the
southwest
corner
of
the
state
about
trying
to
retain
their
providers,
it's
really
difficult
right
now,
we're
not
very
competitive
with
some
of
the
federal
facilities
like
the
VA.
L
So
that
is
a
constant
struggle,
but
mr.
dimple
did
highlight
you
know
how
those
increasing
costs
both
in
technology
and
how
business
practices
have
changed.
I
mean
everything
is
kind
of
put
a
squeeze
on
it.
So
I
think
his
comments
were
very
representative
of
the
entire
system
and
then
last
is
just
moving
forward
on
these
conversations
in
regards
to
priority
populations,
how
we
handle
budget
cuts,
who
we
get
services,
we
have
been
in
contact
with
the
Department
of
Health,
we're
working
on
those
conversations
to
be
very
honest
with
everybody.
L
Kovat
19
has
pushed
those
conversations
back
because
everybody
was
kind
of
underwater,
including
us
in
our
centers
and
trying
to
deal
with
the
pandemic,
but
we
think
it's
pretty
important
to
get
that
formalized
work
group
going
forward
with
toh
to
really
dig
into
the
details
as
soon
as
we
hear
what
the
budget
cuts
are.
So
those
conversations
are
twofold:
it's
one!
What
are
we
doing
to
respond
to
the
budget
cuts
that
are
coming
out
right
now
and
number
two?
What
are
we
doing
long
term
in
terms
of
this
system
as
mr.
L
temple
described,
and
something
I
think
you
guys
have
heard
at
least
the
labor
health
committee
has
heard
from
me
before?
Is
that
all
of
these
little
bits
and
pieces,
whether
it's
Medicaid
payment
reductions
or
you
know,
insurance,
parity
issues
or
reductions
in
state
funding
or
grants
disappearing?
You
know
we're
getting
kind
of
a
death
by
a
thousand
cuts
to
the
way
the
community
mental
health
system
operates
right
now,
and
so
that's
kind
of
where
we
are
in
those
conversations
and
with
that
I'd
be
happy
to
stand
for
any
questions.
Okay,.
K
K
J
There
I
am
Thank
You
mr.
chair,
co-chair
and
committee
members.
I
just
wanted
to
provide
a
little
bit
of
information
on
that.
Both
Andy
and
Paul
were
very
direct
on
on
their
centers
reimbursements.
I
will
tell
you
that
private
insurance,
we
just
I,
have
been
getting
some
updates
on
telemedicine,
reimbursements,
Blue,
Cross,
Blue
Shield
of
Wyoming
has
expended
their
telemedicine
benefits
until
8:30,
one
of
20
we're
constantly
seeing
what's
coming
out
from
the
private
insurance
carriers
from
and
also
from
CMS,
who
is
the
center
of
Medicare
services,
which
kind
of
dictates
policy
for
reimbursements.
J
J
So
even
though
I'm
a
mental
health
provider
and
by
law
I'm
able
to
provide
certain
substance,
abuse
services,
I
may
or
may
not
be
in
revert
reimbursed
for
those
services,
so
an
ASI
I
may
or
may
not
be
a
reimburse
for
so
I
feel
a
lot
of
pro
bono
in
that
aspect,
so
the
reimbursements
I
think
are
cost
savings
for
all
other
providers
and
other
sources
of
funding.
J
I
believe
are
available
that
the
committee
may
ask
the
Department
of
Corrections
and
Department
of
Health
to
investigate
through
some
federal
grants
right
now
through
Samsa
and
the
National
Institutes
of
Correction
and
the
other
Bureau
of
Justice
providers.
So
with
that
information,
I
stand
for
any
questions.
K
C
Thank
You
mr.
mr.
chairman,
mr.
Follin,
you
mentioned
in
your
previous
comments
a
little
bit
about
certification
and
then
in
this
this
time
you
talk
about.
Credentialed
had
needin
to
be
credentialed
in
order
to
be
reimbursed
and
I'm,
taking
that
as
reimbursed
by
private
insurance.
But
maybe
you
were
referring
to
Medicaid
but
help
me
to
understand
if
what
their
credential
requirements
are
for
you
to
be
reimbursed.
Is
that
back
to
the
Department
of
Health?
Or
is
this
a
different,
different
accreditation
process,
and
is
that
the
same
one
as
you
referred
to
in
your
previous
comments.
K
Today,
I
would
add,
having
trouble
connecting
up
the
idea
of
what
it
takes
for
you
to
get
reimbursed
with
justice,
reinvestment
and
balancing
the
state
budget.
So
he
tie
that
all
out
for
me.
I'd
sure
appreciate
it,
because
I'm
I'm
having
trouble
I,
understand
reimbursement
difficulties
and
credentialing
difficulties,
I'm
just
trying
to
tie
it
out
to
what
we're
working
on
today.
So
help
me
understand.
J
Thank
You
mr.
chairman
representative
Larson,
so
as
an
independent
provider,
I
the
insurance
companies
and
Wyoming
Medicaid
as
well
require
us
to
be
credentialed
with
with
them
as
a
provider.
In
most
instances
you
must
be
a
master's
level
or
higher
for
those
reimbursements,
but
when
I
provide
those
services,
a
bachelor's
level
individual,
for
example,
in
this
situation,
where
a
csw
or
an
addictions,
professional
handbill
that
they
have
to
bill
under
a
higher
level
provider.
K
J
Sir
mr.
chair,
no,
what
I
am
saying
is
that
that
is
one
of
the
obstacles
for
for
reimbursement
is
that
you
have
a
bachelor's
level.
Individual
has
to
have
someone
higher
up
certifying
those
services.
As
to
your
your
question
about
budget
reductions,
most
of
us
are
very
aware,
because
our
reimbursements
come
from
Medicaid
from
Medicare.
J
C
Larson
Thank
You
mr.
chairman
and
in
Eric,
we'll
probably
have
to
help
me
to
jump
ship
on
us,
but
Cheryl
help
me
remember,
but
if
you
refer
back
to
Medicaid
a
lot
but
for
mental
illness
and
things
of
that
nature,
they
don't
reimburse
for
for
what
is
it
19
to
65
anyway,
which
is
largest
population
that
you
have
there,
and
so
that
I
I
would
say
it
would
seem
to
me
that
Medicaid
reimbursement
back
to
you
would
probably
be
not
the
the
primary
source
of
reimbursement.
J
You,
mr.
chairman
representative,
Larson
you're,
absolutely
right
in
the
number
of
service.
A
number
of
sessions
that
I
can
provide,
as
was
raised
earlier,
has
been
expanded
from
20
sessions
for
an
adult
to
30
sessions.
Juvenal's
under
the
age
of
18
and
certain
adults
in
various
parts
of
the
criminal
justice
system
are
are
in
reimbursement
is
fairly
low,
but
it
is
the
primary
source
of
revenue
to
us.
H
Thank
You
mr.
chairman
yeah,
this
questions
for
sure.
Well,
I
and
I,
don't
know
if
it's
possible
I've
been
thinking
about
the
fact
that
we
know
personnel
costs
are
are
really
the
thing
that
drives.
You
know
the
cost
so
far
up
and
I
wondered
about
as
an
independent
provider.
Do
you
because
I
know
mr.
dimhill
mentioned
about
you
might
go
to
contracting
services
a
bit?
Is
there
a
possibility
that
some
of
those
of
you,
particularly
you
or
others
that
do
independent?
Could
you
contract
more
with
our
mental
health
centers?
H
J
You,
mr.
chairman
senator
Schuler,
yes,
there
are
many
independent
practitioners
who
would
absolutely
consider
contracting
and
assisting
and
you're
absolutely
right.
The
as
Andy
did
bring
up.
They
can't
compete
salary
wise
that
most
of
at
least
my
membership
appears
that
I
work
with
would
be
happy
to
help
and
take
some
of
the
the
clients
that
are
out
there.
That
need
services.
K
Okay,
thank
you
anything
else
for
Cheryl,
alright
Cheryl.
Thank
you
very
much
appreciate
it's
good
to
see
it.
Folks,
we've
it's
just
a
few
minutes.
Before
the
noon
hour,
we've
got
two
more
folks,
one
more
from
Wyoming
association
of
addiction
professionals
and
representatives
Sweeney,
as
a
colleague
I
think,
I'm
going
to
go
ahead
and
take
representative
Sweeney
and,
depending
on
how
long
that
takes
we,
we
may
just
break
for
lunch
at
that
point.
So
representative
Sweeney's
asked
for
an
opportunity
to
present
on
this
topic
overview
of
MHSA
services
through
the
criminal
justice
system.
A
K
C
K
You
know
mr.
Craig
know
that
we're
gonna
pick
him
up
after
lunch
and
let's
just
go
ahead,
I've
got
1156.
I'm
gonna
set
an
alarm
for
thirty
minutes.
We
were
scheduled
for
a
30-minute
lunch.
Let's,
let's
do
that
and
then
hopefully
we
can.
Mr.
sweet
represent
sweetie,
probably
won't
be
available,
but
we
could
fit
mr.
Craig
in
in
five
or
ten
minutes
and
maybe
get
right
back
on
schedule.
Mr.
A
A
K
C
If
I
could
just
just
stumble
on
a
little
bit
over
several
comments
about
the
caps
on
on
Medicaid
Services,
it
was,
it
was
a
20.
Then
it
was
raised
to
30
but
I
believe
the
way
that
is
and
in
chairman
Wilson
or
represented
Bartle,
maybe
help
me
out.
But
it
seems
to
me
like
that,
after
that
cat
that
does
not
eliminate
services
that
they,
the
provider
just
has
to
demonstrate
that
the
patient
or
the
client
needs
continued
services
and
in
an
exception
to
that,
can
be
done
so
I
I.