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B
B
C
I
was
going
to
say
it
it's
a
sort
of
a
50
50..
I
took
a
walk
around
outside
while
we
were
on
break
and
the
sky
is
finally
blue.
Today,
it's
been
really
smoky
for
quite
a
while
kind
of
yellow
gray
sky
for
days,
but
today
it's
blue
sky
because
there's
a
really
stiff
wind
out
of
the
north,
so
it's
it's
51
degrees,
blue
sky
and
a
stiff
wind
from
the
north.
B
B
C
Heard
you
guys
talking
about
forest
fires,
how's
the
fire
going
down
there
in
albany
area,
big,
really
big,
and
the
wind
last
couple
days
is
just
making
it
even
bigger.
C
C
C
Yeah
he's
he's
a
district
ranger
in
the
wasatch
cache.
E
B
E
B
B
The
committee
we'd
like
to
welcome
director
schmidt,
with
department
of
family
services
and
her
crew
with
us,
lindsay
it's
nice
to
see
you
and
we'll
turn
the
time
over
to
director
schmidt
to
our
first
item
here
is
to
review
that
of
the
adolescent,
mental
health
and
substance
abuse
disorder,
services,
and
so
I
think
that
that
would
probably
go
along.
You
give
us
an
updated
handout
this
morning
and
then
it
looks
like
we're
going
to
go
to
your
screen,
who's
running
the
show
chairman
or
director
schmidt,
you
or
mrs
schilling,.
E
E
Mr
chairman,
you
remarked
about
the
updated
system
overview,
it's
a
handout
that
we
provided.
We
made
a
few
corrections
to
it,
also
per
the
committee's
request.
There
are
two
documents
regarding
the
boys
school
in
the
girls
school,
which
describes
the
services
that
were
that
are
provided
there
and
then
last
just
as
an
additional
piece
of
of
information,
we
provided
an
adolescent,
behavioral
health,
complex
cases
brief,
and
this
is
a
document
that
we
shared
with
members
of
the
joint
labor
health
and
social
services
committee
at
their
last
meeting.
E
Before
I
get
too
far
into
it.
I
really
want
to
thank
you
all
for
the
opportunity
to
talk
about
adolescent
behavioral
health.
E
It
is
something
that
I
think
is
just
as
complicated,
if
not
more
than
the
conversation
you
had
this
morning
regarding
outpatient
mental
health
and
substance
abuse
services
provided
by
community
mental
health
and
substance
abuse
centers
just
to
quickly
go
back
to
that
conversation,
I
wanted
to
make
a
plug
for
the
services
provided
to
not
just
adolescents
through
that
system,
but
also
the
families
that
are
involved
with
dfs
the
parents
of
children
who
are
removed
from
the
home
because
of
abuse
and
neglect.
E
The
majority
of
children
who
are
removed
from
the
home
are
removed
because
of
neglect
and
of
that
that
comes
with
mental
health
and
substance
abuse
issues.
So
I
would
ask
you,
as
you
think,
about
those
population
buckets
that,
in
addition
to
the
population
bucket
called
adolescent
health,
behavioral
health,
you
also
think
about
a
bucket
called
families
involved
with
dfs
and
most
of
the
families
that
we're
involved
with
come
to
us
because
of
court
actions.
E
So
you
hit
on
it
a
little
bit
with
the
court
action
conversation,
but
I
noticed
in
the
document
that
was
brought
up
that
showed
what
the
conversation
was
with
wamsack
and
the
department
of
health
that
there
were
some
more
specific
components
around
dfs
populations
and
just
maybe
thinking
about
carrying
those
over
into
the
conversation.
You'll
continue
to
have
around
community
mental
health
and
substance
abuse
services
provided
by
those
contracts.
B
B
Okay
committee,
so
if
you,
if
anyone
has
a
question
and
mr
coach,
you
see
somebody
I'm
missing,
if
you
let
me
know
please
and
we'll
just
we'll
just
address
the
questions
as
we
go.
E
The
next
slide,
the
slides
that
we'll
be
showing
you
today
somewhat
follow
the
order
of
the
conversation
in
your
system
overview
about
adolescent,
behavioral,
health.
The
handout
is
more
detailed
than
what
we'll
do
so
there's.
It
describes
a
little
bit
better,
some
of
the
nuances
of
the
system,
but
for
the
most
part,
if
you're
looking
at
the
document
following
the
slides,
they
should
pretty
much
fall
in
the
same
order.
E
So
who
are
we
talking
about?
As
we
tried
to
think
about
organizing
this
conver?
This
conversation?
We
broke
it
into
buckets
of
populations,
services
and
then
payers,
and
this
conversation
really
was
kicked
off
very
well
in
a
joint
labor
meeting
where
representative
clem
had
provided
an
overview
of
the
payer
system
in
the
in
the
children's
system
and
tried
to
describe
in
in
a
chart,
format
and
you'll,
see
that
chart
format
coming
up.
Who
pays
for
what
and
when.
E
E
Also,
in
the
conversation
something
to
remember
is
who
has
custody
of
these
adolescents
is
custody
still
with
the
parents
or
the
caregiver,
or
has
custody
been
given
to
the
state
placed
into
dfs
for
placement
and
those
custody.
Conversations
are
important
because
it
oftentimes
separates
a
lot
of
who's
eligible
for
what
services,
under
what
payer
source.
E
So
what
are
the
services
we'll
talk
about
the
services
in
three
basic
settings?
Outpatient,
which
is
a
lot
of
the
conversation
you
had
this
morning?
That's
where
a
child's
at
home
and
services
are
provided
to
that
child
and
family,
most
typically
in
a
clinician's
office,
sometimes
in
the
family
home
itself,
but
they're,
basically
at
home
with
family
receiving
outpatient
services,
then
residential
is
when
a
child
has
a
higher
level
of
care
and
a
child
is
placed
in
a
facility.
E
E
Perhaps
they're
behavioral
it's
to
address
behavioral
issues
that
may
or
may
not
have
something
to
do
with
mental
health
or
substance
abuse
issues.
But
certainly
it's
the
behavioral
issues
that
have
come
to
the
tension
and
need
to
be
treated
clinical,
which
then
is
a
formal
diagnosis.
There's
been
an
evaluation,
a
level
of
care
has
been
determined
and
then
there's
a
treatment
plan
or
clinical
plan
that
ensues
and
then
correctional,
which
is
just
what
it
sounds
like.
It's
detention
for
adolescents
and
often
times
detention
does
not
necessarily
come
with
mental
health
services.
E
E
For
adolescents,
the
primary
detention
facility
for
juveniles
is
in
casper,
it's
the
juvenile
detention
facility,
regional
juvenile
detention
center.
I
think
so
the
accurate
name
and
then
there
are
some
county
jails
that
will
accept
juveniles
so
for
specific
purposes
of
juvenile
detention.
We
have
it
in
casper,
but
there
are
community
county,
sheriff's
departments
that
will
take
adolescents,
have
sight
and
sound
separation
and
meet
requirements
to
house
children.
The
youth
adolescents
in
the
in
their
detention
center.
E
D
E
Mr
chairman,
mr
co-chairman,
I
don't
know
what
the
length
of
stay
at
a
juvenile
detention
center
would
be.
I
know
that
they
like
to
limit
those,
but
a
juvenile
detention
center
is
just
like
jail,
the
boys
school
and
the
girls
school.
However,
I
think
you
could
kind
of
compare
it
to
more
of
the
honor
farm
or
newcastle's
boot
camp,
it's
not
as
secure
as
rollins
or
even
torrington,
but
it's
for
placement
after
the
fact,
after
after
the
child's
been
adjudicated
in
title,
14.
E
So,
on
the
left
hand
side
you
can
see
the
the
services
that
are
based
through
the
continuum
of
care
as
we
recognize
it
for
adolescents.
It
starts
with
the
least
restrictive,
which
are
community-based
and
goes
to
the
most
restrictive.
To
get
to
your
point,
senator
kinski,
which
is
a
juvenile
detention
center
in
between,
are
a
variety
of
services
and
the
services
that
are
provided
are
oftentimes
based
on
funding,
source
or
eligibility
of
the
child.
E
So
to
start
at
the
that
the
first
one,
mental
health
and
substance
abuse
services
that
are
provided
on
an
outpatient
service,
outpatient
basis,
a
lot
of
these
services
are
provided
by
the
community
mental
health
and
substance
abuse
centers.
However,
there's
also
private
practitioners
in
many
communities
that
accept
medicaid
and
or
accept
private
payment.
E
There's
also
a
group
of
providers
that
we
really
didn't
discuss,
or
you
didn't
mention
in
the
previous
conversation
that
the
adolescence
adolescent,
behavioral
health
system
relies
heavily
on
and
that's
the
youth
serving
facilities
or
the
youth
serving
providers
and
many
of
your
communities
have
a
youth
service
provider.
They
provide
some
outpatient
services
through
mentoring
through
parenting.
E
Maybe
some
outpatient
clinical
services,
but
they
also
provide
some
of
them,
provide
an
array
from
outpatient
all
the
way
up
to
a
residential
treatment,
center
level
of
care.
They're,
a
combination
of
for-profit
nonprofit
providers
and
I'll
go
through
each
of
the
levels
of
care.
A
little
bit
more
and
kind
of
highlight
who
provides
what
so
on.
The
next
level
is
crisis.
E
Stabilization
services,
we
are
funded
with
state
general
fund
and
we
use
federal
funding,
match
town
of
dollars
to
provide
to
communities
access
to
emergency
services
that
can
be
overnight
for
a
night
or
a
few
for
adolescents
who
are
maybe
experiencing
some
sort
of
crisis.
So
it
may
be
a
family
crisis.
It
may
be
their
own
mental
health
crisis,
but
it's
a
place
where
families
can
safely
place
their
children
in
a
limited
stay
and
services
can
be
provided.
E
The
child
still
goes
to
school
at
their
regular
school,
and
the
child
does
not
need
to
be
in
state
custody
to
access
these
services.
The
way
that
these
services
are
set
up.
It
really
is
a
community-based
service
available
to
all
who
need
it
at
the
right
age
levels.
E
Well,
mr
chairman,
in
your
community
you
have
crisis
services
through
the
fremont
county
group
home
and
through
the
wind
river
group
home.
So
many
of
the
group
homes
also
provide
crisis
services.
B
I
I
guess
what
I
was
asking
is
just
get
give
me
an
idea
of
the
situation,
because
it's
voluntary
so
is
this.
Is
this?
Is
this
a
parent
in
child
that
recognize
that
there's
some
challenges
going
on
and
in
the
best
interest
of
both
parties
they
reach
out
to
this
facility,
or
I'm
just
trying
to
understand?
I
understand
the
group
home
and
how
it
works,
but
I'm
just
trying
to
understand
this
crisis
portion
of
it.
E
Mr
chairman,
yes,
exactly
if
there's
some
sort
of
dynamic
going
on
at
the
home,
where
the
child
needs
a
time
out,
families
need
a
break
from
a
child.
This
is
an
option.
Optional
services
that's
available
in
many
of
the
communities.
Sometimes
schools
may
suggest
it.
Law
enforcement
may
encounter
a
child,
that's
picked
up
and
maybe
a
runaway,
and
rather
than
taking
the
child
home,
takes
the
child
to
the
crisis
center.
E
Moving
to
the
next
level
of
care
and
that's
the
board
of
cooperative
cooperative
education,
service
boces
and
in
the
state,
we
have
three
boces
providers
that
are
residential
and
they
take
children
with
educational
needs
and
with
behavioral
needs.
I
believe
all
three
provide
residential
based
services
for
educational
purposes,
oftentimes
for
children
with
really
high
needs,
so
that's
in
gillette,
thermopolis
and
in
jackson.
E
D
Thank
you,
mr
co-chair.
So
boces
is
a
it's
a
mill
levy
and
it
has
to
be
for
anything
over.
A
half
mil
has
to
be
approved
by
vote
of
the
voters,
so
this
boces
service
is
limited
to
just
those
counties.
Those
three
teton
and
some
others
have
funded
it.
What
what's
the
counties
that
have
not
elected
to
establish
a
boces,
where
does
their
funding
for
students
with
behaviors
and
qualifying
educational
support
needs
come
from?
Is
that
coming
out
of
the
general
fund
out
of
the
school
foundation
program?
Do
you
know.
E
Mr
chairman,
mr
co-chairman,
no
I
do
not
know,
then,
what
those
districts
how
they
provide
those
services
to
those
kids.
D
Mr
co-chair,
please
I've
been
asked
if
we
could
have
a
follow-up
on
that.
It
seems
unfair
to
the
counties
that
have
not
established
a
boces.
If
that
funding
has
come
out
of
the
general
fund
or
or
out
of
the
school
foundation
program,
there's
there's
a
bit
of
an
inequity
there
I
just
like
to
under.
Potentially
I
just
like
to
understand
that
that
stream
better-
and
I
don't
quite
know
who
to
ask
about
that-
that's
all,
mr
chairman,
if
corrine
can
get
us
more
information,
I'd
appreciate
it.
C
Yeah,
thank
you,
mr
chairman,
just
to
give
you
a
mr
senator
kinski,
just
a
little
follow
up
a
little
bit
that
I
know
in
our
county.
C
We
do
have
a
boces,
but
we
don't
have
a
facility
like
the
the
ranch
up
in
in
jackson,
so
we
do
have
some
students
that
end
up
going
there,
but
we
also
have
another
program
that
has
only
been
in
existence
a
couple
of
years
and
it's
sort
of
an
alternative
school,
but
it's
provided
through
the
boces
meal
money
and
it's
under
the
auspices
of
our
school
district
as
well.
So
it's,
I
don't
think
any
of
the
money
comes
out
of
the
general
fund
for
it.
C
But
it's
been
a
nice
alternative
rather
than
sending
it
all
the
way
up
to
jackson.
We
actually
have
a
facility
in
our
community
that
takes
care
of
those
tiny
kids.
I
don't
know
if
that
answers
your
questions
or
question
or
not.
Thank
you.
B
D
Thank
you,
so
I
I
would
ask
senator
scheuer,
then,
students
that
do
go
to
jackson
out
of
your
county.
They
must
jackson,
must
be
getting
reimbursed
out
of
the
boces
mill
levy.
Is
that
correct.
C
Mr
chairman,
thank
you.
I
believe
they
get
funds
from
both
from
from
our
boces
local
boces,
and
I
think
our
school
district
as
well
both
provide
some
funding
for
those
students
that
end
up
going
up
there.
B
And
and
co-chair
mckinsey,
I
believe
that
if,
if
one
of
our
students
from
fremont
county
number
one
goes
to
one
of
the
boces,
they
have
to
pay
them
for
that
education.
That's
that's
the
reimbursement
they
get.
They
have.
They
have
to
pay
them
for
the
for
the
room
board
and
services,
which
is
a
little
bit
different
than
if
it's
placed
out
of
dfs
and
my
question
so.
D
Mr
mr
co-chair,
I
get
that,
but
following
up
on
what
senator
schumer
said,
she
thinks
it's
paid,
partly
through
the
postseason,
partly
through
the
school
district.
If
it
I
mean
effectively,
school
district
funding
is
general
funding
anymore
because
and
if
it's
not
it
soon
will
be.
So
if
the
school
some
school
districts
are
taking
it
out
of
their
resources,
whether
it
comes
from
the
school
foundation
program
or
well,
it
comes
out
the
school
foundation
program
that
gets
refilled
from
a
variety
of
sources.
D
More
and
more
of
the
general
fund.
It
just
it
doesn't
seem
fair
those
counties
that
are
fully
carrying
the
cost
of
boces,
but
there
must
be
a
formula
of
some
kind
and
we
can
get
more
information
on
that.
I
don't
want
to
get
us
too
distracted
from
the
larger
cause.
I
just
would
be
nice
to
have
some
more
information
on
it.
E
Mr
chairman,
we
will
use
boces
for
placements
if
we
have
a
child
that
has
behavioral
health
and
intellectual
disabilities
or
developmental
disabilities.
It.
The
decision
on
where
to
place
a
child
really
comes
from
a
group
of
professionals
who
know
the
child
and
then
make
recommendations
to
the
judge,
and
occasionally
we
do
play
set
of
boces,
it's
not
as
frequent
as
what
as
placing
children
at
a
residential
treatment
center.
E
But
when
we
do
place
out
of
boces,
then
the
court
order
placement
statutes
take
place,
which
is
for
the
purposes
of
dfs.
We
see
boces
as
a
placement
option,
I
think,
for
purposes
of
education,
it's
a
little
bit
of
a
different
animal,
but
we
can
certainly
work
with
the
department
of
education
to
get
some
more
information
about
how
educational
placements
are
paid
and
made
and
paid
for
if
it's
for
a
school
district
outside
of
the
county,
that's
assessing
the
levy.
E
Okay,
mr
chairman,
next
is
our
group.
Homes
and
group
homes
are
placements
available
for
children
in
state
custody,
and
this
is
a
low
level
of
care
for
children
who
maybe
do
not
need
a
high
level
of
residential
intervention,
but
rather
aren't
ready
to
go
home
and
home
may
not
be
ready
for
the
child
to
come
back
oftentimes.
E
This
can
be
used
as
a
step
down
from
a
higher
level
of
care,
but
children
placed
in
group
homes
go
to
regular
school,
they
receive
outpatient
mental
health
services
and
there
could
be
a
potential
private
placement
made
there,
but
that
would
be
an
agreement,
then,
between
the
parent
and
the
provider
and
whatever
funding
source
that
pays
for
that
child
residential
treatment.
Centers
are
residential.
Now
we're
going
up
the
line,
it's
behavioral
and
clinical.
E
Medicaid
can't
pay
residential
treatment
centers
in
the
way
that
it
pays
for
psychiatric
residential
treatment
facilities.
It's
a
different
level
of
care,
so
oftentimes
residential
treatment,
centers
enroll
in
medicaid
as
a
provider,
and
then
when
they
provide
some
sort
of
clinical
service
to
a
child.
That's
on
their
campus.
They
will
bill
medicaid
for
those
services.
E
E
Issue
with
it
with
an
adolescent
that
requires
immediate
attention,
it's
very
high
level
and
it's
not
intended
for
long
term.
If
a
child
needs
long-term
psychiatric
care,
then
what
becomes
available
is
a
psychiatric
residential
treatment
facility.
A
prtf
and
a
prtf
requires
a
diagnosis
and
admission
by
a
medical
physician
or
a
medical
provider.
E
It
has
to
have
a
doctor
saying
that
this
level
of
care
is
appropriate
for
this
child,
and
then
we
kind
of
go
into
the
boys
school
and
the
girls
school,
which,
from
a
juvenile
detention
or
from
a
juvenile
delinquency
standpoint,
is
a
high
level
of
care,
but
it
doesn't
really
fall
in
line
with
treatment,
so
the
boys
school
and
the
girls
school
are
both
operated
by
the
department
of
family
services.
Their
budget
exists
in
our
budgets
and
they
received
children.
Who've
been
adjudicated
as
delinquent
under
title
14.
E
and
title
14
is,
is
something
that's
very
specific
to
dfs
and
I'll
get
to
that
in
just
a
second
but
the
the
wyoming
boys
school,
the
wyoming
girls
school,
are
for
high
for
high
level
offenders
on
the
sanction
level,
they're
placed
at
the
boy
school
in
the
girls
school.
For
services,
educational
services
primarily
and
they
also
receive
a
milieu
of
behavioral
services,
in
addition
to
both
boys,
school
and
girls,
school
have
provider
agreements
with
local
mental
health
professionals
that
provide
mental
health
services
on
campus.
E
So
the
campus
is
not
necessarily
secure,
but
certainly
adolescents
placed
at
the
wyoming
boys
school
in
the
wyoming
girls
school
are
not
free
to
roam.
E
Juvenile
detention
centers
can
also
serve
kids,
who
have
been
charged
in
an
adult
court.
So,
for
example,
if
you
have
a
misdemeanor
of
a
youth
that
went
through
circuit
court,
that
circuit
court
judge
can
order
that
child
to
a
juvenile
detention
center
and
that
child
may
or
may
not
ever
come
to
the
attention
of
dfs.
E
D
Thank
you
corinne.
That
was
that
was
good.
Thank
you,
and
so
that
last
comment
that
you
know
a
judge
sends
a
kid
off
to
a
juvenile
detention
center
and
may
or
may
not
come
to
dfs's
attention.
I
assume
dfs
is
paying
the
bill,
but-
and
so
it's
just
it's
sort
of
a
question
I
have
on
all
of
these
levels.
D
Is
this:
we
just
leave
this
up
to
judges,
county
judges
and
district
court
judges,
or
is
there
some
triage
where
somebody
who's
responsible
for
the
footing?
The
bill
says
wait
a
minute.
Why
are
you
sending
this
one
to
the
girls
school?
You
know
everything
we
see
in
this
case,
the
group
home
setting
ought
to
be
appropriate
who,
who
makes
sure
that
these
people
are
considering
the
most
cost
effective
option
in
in
all
of
these
instances?
Do
you
have
a
say
so
or
does
the
court
order
it?
You
just
have
to
write
a
check.
B
E
Mr
co-chairman,
when
a
youth
is
ordered
to
a
juvenile
detention
center
through
the
circuit
court,
the
county
pays.
So
that's
not
a
dfs
charge
unless
the
child's
in
our
care
and
custody.
So
the
county,
of
course,
has
been
a
lot
of
stake
in
who's
placed
into
their
juvenile
detention.
Centers.
The
the
juvenile
justice
system
has
a
single
point
of
entry,
where
many
of
those
decisions
are
made
by
the
local
county
attorney.
D
Mr
coach,
here
please
so
again:
excluding
juvenile
detention,
centers
who's,
looking
over
the
shoulder
of
the
county
attorney
and
the
single
point
of
entry,
folks
to
look
at
their
determinations
in
sort
of
a,
I
guess
for
one
of
a
better
word
utilization
management
role
to
say:
wait
a
minute.
You
know
we
don't
think
this,
and
I
assume
that
there's
differences
amongst
them
as
to
how
many
of
them
go
to
the
more
expensive
treatment
settings
and
how
many
have
managed
to
divert
them
off
to
least
expensive
or
lesser
expensive
settings.
D
E
Mr
chairman,
mr
co-chairman,
so
when
I,
when
a
county
attorney-
and
I
think
I'm
going
to
try
to
answer
your
question
so
stop
me
if
I'm
not
getting
there
when
a
county
attorney
makes
a
decision
about
where
to
charge
the
case,
they
can
charge
it
in
one
of
the
you
know
the
adult
courts
circuit
court
or
district
court,
or
they
can
file
a
petition
in
juvenile
court
and
there's
three
actions
associated
with
juvenile
court.
There's
abuse
and
neglect
actions,
child
native
supervision,
action
and
a
juvenile
juvenile
delinquency
action.
E
If
the
judge
accepts
the
case
under
title
14
under
the
juvenile
court
statutes,
then
that
opens
the
door
then
to
what
you
just
referenced
as
the
multi-disciplinary
team.
So
the
judge
can
then
appoint
a
multi-disciplinary
team
which
consists
of
it's
it's
supposed
to
consist
of
professionals
who
have
knowledge
of
the
child
in
the
child's
case.
So
it
can
be
education,
a
mental
health
therapist.
If
there's
one
in
place,
the
dfs
worker,
the
county
attorney.
E
E
The
mdt
will
look
at
what's
going
on
with
that
youth
and
make
a
recommendation
to
the
court
about
what
they
think
is
the
the
best
placement
or
disposition.
So
the
mdt
may
recommend
placement
at
a
residential
treatment
center.
If
the
child
has
more
of
a
therapeutic
need
and
a
behavioral
need,
they
may
suggest
a
group
home
if
there
isn't
a
lot
of
issues,
but
certainly
the
child
or
the
family
need
a
break
from
each
other,
often
times.
If
the.
E
So
the
the
once
you
bifurcate
the
system
once
that
decision
is
made,
whether
it's
an
adult
court
system
or
juvenile
court
system,
the
adult
court
system,
then
I
think
just
occurs.
There's
some
diversion
programming
available
in
some
communities
and
we'll
touch
on
that
at
the
very
end
of
the
presentation,
or
they
come
into
the
larger
juvenile
court
system,
which
involves
a
lot
of
attorneys
therapists,
educators,
dfs
etc.
D
I
I
think
you
did
corrin
with
the
exception
that
I
didn't
hear,
that
your
department,
the
one
writing
the
checks
is
at
any
point
consulted,
has
an
opportunity
to
weigh
in
on
what's
what's
the
most
appropriate
placement
and
how
much
money
would
be
spent
and
it
sounds
like
you're
not
involved.
We
trust
the
mdt's
to
and
the
judge
to
write
the
best
solution.
E
Mr
chairman
and
mr
co-chairman,
we
are
a
member
of
the
mdt,
so
our
recommendations
are
made
we're
part
of
the
group
that
that
makes
the
recommendations
and
yes,
we
ultimately
in
combination
with
the
department
of
ed
and
the
department
of
health
pay
for
the
services
then
provided
to
that
child
and
family.
So
we
do
have
some
say.
However,
if
there's
no
money
in
the
system
for
that
placement,
we
also
have
statutory
statutory
authority
to
stand
up
and
say
there
is
no
money.
We
can't
pay
for
this
placement.
E
C
You
would
only
be
paying
if
the
child
ends
up
in
df
in
state
custody.
Right
I
mean
I
would
assume
that
many,
maybe
most
of
cases
where
a
youth
is
let's
say
you
know,
arrested
for
you
know
whatever
burning
down
his
classroom
or
something
or
whatever,
that
they're
not
in
dfs
custody,
they're
still
in
their
parents
custody.
And
so
then
I
suppose
the
county
pays
for
them
to
go
off
to
wherever,
like
any
other
person
who
is
an
adult
who
is
found
to
be
a
criminal.
C
So
what
what
percentage
of
youth
who
end
up
in
a
sort
of
a
a
a
court-ordered
situation
end
up
in
dfs.
E
Custody-
mr
chairman,
representative,
wilson,
I,
if
I
can,
can
I
maybe
restate
that
to
see.
If
I
understand
it
correctly,
are
you
talking
about
all
children
that
come
to
the
attention
of
the
legal
system
or
children
who
come
to
the
attention
of
the
juvenile
court
system.
B
C
C
Dfs
and
you
are
paying
for
it,
but
unless
they're
in
state
custody
beforehand,
just
because
they
end
up
in
some
sort
of
correction,
I.
C
Mean
so
are
you
saying
that
I
mean,
I
guess
I'm
perhaps
I'm
confusing
the
idea
of
custody,
but
I
mean
when
you
know
cust,
are
we
talking
custody
in
the
sense
of
like
you're,
a
prisoner
in
the
custody
of
rollins,
or
that
your
parents
have
lost
parental
authority
over
you?
I
could.
Could
we
just
clarify
that
because
I
guess
I'm
not
understand.
E
E
E
So
the
county
attorney
makes
a
decision
and
there's
a
lot
of
ways
that
the
case
can
come
to
the
attention
of
the
county.
Attorney's
office
law
enforcement
can
bring
it
dfs
may
bring
it.
The
schools
may
bring
it,
but
the
county
attorney
has
to
make
a
decision
about
what
to
do
with
the
case.
If
the
county
attorney
decides
to
file
that
in
juvenile
court,
then
all
of
the
laws
and
requirements
around
juvenile
court
start
to
take
hold.
So
in
any
of
those
situations,
the
ju
the
court
may
decide
to
take
custody
of
the
child.
E
E
If
it's
a
child
and
needed
supervision,
they
may
need
a
placement,
some
level
of
psychiatric
placement
or
residential
treatment
placement
or
a
delinquent.
So
a
delinquent
could
go
on
probation
or
if
the
mdt
makes
the
decision
that
maybe
the
delinquent
needs
to
go
to
some
sort
of
higher
level
of
care
and
then
the
the
services
that
are
on
the
screen
start
to
play
in,
but
the
the
importance
of
a
child
coming
into
state
custody
means
that
it
opens
the
door
to
dfs
money.
F
B
Before
before,
we
completely
leave
that
when-
and
it
goes
back
to
senator
kinski's
point
when
you
aren't
aware
of
the
jew
that
somebody's
being
placed
in
a
juvenile
detention
center,
is
that
a
problem,
or
does
that?
B
E
Mr
chairman,
you
know
in
so
many
of
our
communities,
they're
small
enough-
that
I
think
there's
a
lot
of
conversations
between
the
county,
attorneys
and
dfs,
but
we
do
have
some
situations
where
you
have
minors
that
commit
serious
crimes
that
are
going
to
go
to
detention
and
in
those
situations
it
really
is
up
to
the
county
attorney
to
determine,
what's
the
best
place,
to
serve
that
youth,
whether
that's
in
a
you
know,
an
adult
criminal
court
or
that's
through
a
juvenile
court
which
is
more
family.
Centered
typically
has
rehabilitation
in
mind.
E
So
it
really
is
the
discretion
of
the
county
attorney
and
depending
on
the
community,
we
may
or
may
not
know
about
it.
E
So
there's
consistency
and
application
of
the
laws,
rather
than
perhaps
it
just
kids
showing
up
in
municipal
court
and
kids
showing
up
in
circuit
court.
So
wyoming
is
a
little
bit
different
in
in
that
we,
our
juvenile
justice
system,
is
kind
of
bifurcated.
It
shows
up
in
our
adult
court
system
and
then
it
shows
up
in
our
juvenile
court
system,
which
is
where
dfs
plays
a
major
role.
E
So
going
into
funding.
Mr
chairman
members
of
the
committee
court
ordered
placements
is
a
place
where
you
see
the
department
of
health
department
of
family
services
and
the
department
of
education
get
together
to
pay
for
the
placement
of
a
child
so
for
children
in
dfs
custody,
so
they're
in
juvenile
they're
under
the
jurisdiction
of
the
juvenile
court.
The
the
statute
provides
for
the
coverage
of
rtc's
residential
treatment,
centers
group
homes,
day
treatment
and
juvenile
detention
facilities
for
kids
in
our
custody.
E
E
That's
statute
21-13-315
also
21-13-336
is
the
medical
necessity,
medical
necessary
medicaid
placements
and
those
are
for
psychiatric
residential
treatment
facilities.
It's
medicaid
pays
for
the
room
and
board
and
the
treatment,
but
works
with
the
department
of
education
to
cover
education
costs.
Dfs
does
not
pay
for
anything
when
it
comes
to
a
psychiatric
residential
treatment
facility
placement,
and
then
there
are
community-based
services.
E
There's
some
funding
from
dfs
that
goes
to
some
providers,
for
parents
who
may
not
qualify
for
medicaid
or
don't
have
a
payment
source
and
and
then
medicaid
for
most
of
the
or
for
any
of
the
children
in
our
care.
E
Mr
chairman,
dfs
does
not
pay
for
any
of
the
prtf
services.
It's
a
medicaid
paid
for
service
and
a
department
of
ed
paid
for
service.
So
in
that
situation
it
placements
do
not
come
out
of
our
budget.
B
So,
on
on
any
so
on,
your
court
ordered
placements
your
the
first
one
you
talked
about
where
medicaid
covers
that
through
foster
care,
the
majority
of
those
would
be
four
eligible
for
reimbursement,
I'm
assuming
and
then
take
me
down
with
a
similar
question
on
the
prtf
side
of
that
is.
Are
those
medicaid
covered
expenses
reimbursable
or
not?.
E
So,
mr
chairman,
to
go
to
the
court
ordered
placements,
the
fourier
funding
that
you
mentioned
is
federal
funding
that
we
receive
for
foster
care
and
in
order
for
us
to
receive
4e
e-reimbursement,
the
child
must
first
be
4e
eligible,
which
is
a
financial
criteria,
and
then
the
service
must
be
4e.
Reimbursable.
B
E
4E
is
a
whole
other
discussion.
We
do.
We
do
not
have
very
many
kids
that
are
eligible
because
of
the
financial
criteria
so
for
a
work.
Our
state
does
not
collect
a
lot
of
4e
funds
for
services
to
children.
Our
state
does
collect
foreign
funds
for
our
administrative
costs,
but
but
that's
a
different
criteria.
E
So
basically,
we
hover
around
30
of
the
kids
that
come
into
our
care
are
4e
eligible,
which
isn't
a
whole
lot
when
you
get
to
higher
levels
of
care
like
a
group
home
in
a
residential
treatment
center.
That
number
drops.
E
Mr
chairman,
at
the
state
rate,
but
I
believe
that
they
can
also
discuss
with
the
particular
provider
any
enhance
rates
if
necessary.
Okay,.
E
And
then
at
the
last
is
that
insurance
status
and
custody
status
really
funding
really
then
is
dictated
by
where
the
child's
living,
whether
child's
living
at
home,
or
whether
the
child's
in
state
custody
and
then,
if
the
child's
at
home,
what
kind
of
insurance
do
they
have
and
the
benefits
do
they
receive.
E
So
for
those
of
you
on
joint
labor,
this
is
going
to
probably
look
a
little
familiar.
We
took
the
information
that
representative
clem
had
provided
and
we
broke
it
out
into
a
few
different
slides
to
kind
of
show
you
on
from
a
visual
who
pays
for
what.
When
so.
Under
this
scenario,
a
child
has
been
placed
via
the
court
ordered
placement
statutes,
and
then
you
can
see
at
a
glance
who
pays
for
what.
E
So
if
a
child
comes
into
dfs
custody,
dfs
and
their
their
sh
dfs
will
pay
for
room
and
board
at
a
boces,
medicaid
will
pay
for
outpatient
treatments
and
education
pays
for
education,
the
same
thing
with
residential
treatment
centers.
You
can
go
across
and
see
who
are
the
payer
sources
for
that
service
prts
that
just
gets
at
the
conversation
we
were
having.
E
E
D
Mr
coach,
here
please
so
the
child,
because
they're
in
custody
is
medicaid
eligible,
but
the
services
are
not
reimbursable
because
of
what
they
call
the
corrections
exception
on
medicaid.
They
won't
pay
for
any
medicaid
services
for
somebody
who's
in
a
correctional
facility.
So
because
the
girls
school,
the
boys
school,
are
categorized
as
correctional.
B
Right
what
what
I
heard
director
schmidt
saying
is
medicaid
will
pays
for
that,
but
because
it's
correctional,
they
don't
and
just
maybe
better
said,
was
the
services
qualify
for
medicaid
payment
because
it's
a
correctional
institution
we
have
to
pay
for
it
out
of
general
fund.
Is
that
right?
Yeah?
Okay,
so
going
back
up
there,
director
schmidt
to
your
prts,
who
is
medicaid
pain
for
room
and
board
as
well.
B
E
And
mr
chairman,
just
one
clarification
under
the
rtc's
and
the
psychiatric
residential
treatment
facilities
when
we
say
wde,
sometimes
the
local
district
will
also
pay.
There's
statutes.
That
say
who
pays,
depending
on
the
agreement
between
the
department
of
ed
the
department,
the
local
school
district
and
who
provides
the
services.
E
D
E
E
So
what
that
means
is
that
those
levels
the
levels
of
care
are
available,
but
they're
going
to
come
because
of
a
different
custody
issue
or
a
different
legal
issue.
E
Okay,
so
medically
necessary,
medicaid
placements.
This
is
when
a
child
is
on
medicaid
and
needs
either
acute
psychiatric,
stabilization
or
psychiatric
residential
treatment
facility
level
of
care,
and
so
when
it's
medically
necessary
under
the
statute.
These
are
the
services
that
are
available,
and
this
is
who
pays.
E
Mr
chairman,
typically
there
isn't
education
provided
because
it's
supposed
to
be
a
short-term
stay.
It
should
be
a
stabilization,
not
a
long-term
placement.
B
Yeah,
I'm
just
just
trying
to
to
make
sure
that
I
understand
what
the
requirements
are,
because
I
think
you
could
get
into
a
predicament
depending
on
where
you
play
filed
that
you're
not
providing
them
the
services
that
they're
expected
so
perhaps
you're
putting
them
into
an
institution
as
you're
denying
them
their
education,
free
and
appropriate
education
needs,
and
so
I'm
just
trying
to
understand
is
that
come.
B
Is
that
the
the
local
school
district
and
how
that
or
or
the
the
individual
school
district,
that's
just
say
that
it
come
from
sheridan
to
another
place
would
be
the
sheridan
district,
because
this
child
is
a
member
of
their
district.
The
page
for
that
is
that
you're
just
trying
to
understand
that
a
little
more
and
then
when
it
really
is
necessary.
C
Mute,
I
went
the
wrong
direction.
I
I
you
may
want
to
have
director
schmidt
answer
that
first,
because
mine
is
a
different
question,
I'm
just
being
want
to
be
clear
here
that
these
are.
These
are
only
children
who
are
on
medicaid.
I
I
mean
if
the
family's
income
is,
you
know
70
000
a
year
and
whether
they
have
insurance
or
not,
as
far
as
I
so,
the
child
doesn't
just
suddenly
become
eligible
for
medicaid
when
they
need
to
psychiatric
hospitalization.
C
E
Mr
chairman,
please
representative,
wilson,
correct.
So
what
who
we
haven't
talked
about
are
children
whose
families
have
insurance
or
maybe
have
no
insurance,
but
they
don't
qualify
for
medicaid,
which,
at
the
end
of
the
conversation,
comes
back
around
to
some
of
the
issues
that
we
have
with
high
needs.
Children
with
behavioral
health
placements,
there's
lack
of
services
and
lack
of
funding.
E
Mr
chairman,
just
a
a
comment
about
your
question
around
the
role
of
the
school
district.
Education
is
required
for
longer
term
stays.
This
is
according
to
shelly
hamill
at
the
department
of
education.
E
However,
depending
on
how
the
child's
place,
the
district
they'll
have
to
be
a
conversation
with
the
district
about
whether
the
district
pays
and
how
that
that
how
those
services
educational
services
are
provided.
So
it
comes
back
to
the
district.
E
And
then
to
the
larger
point,
mr
chairman:
these
are
private
placements.
So
if,
if
my
my
son
needed
services,
this
is
what
would
be
available
to
me
as
a
as
a
parent
room
and
board
at
a
crisis
for
crisis
stabilization,
the
the
schools
would
continue
to
pay
the
services.
E
E
The
reason
why
local
is
yes
on
here
is
because
this
particular
service
is
already
paid
for
by
dfs
and
it's
open
to
anyone.
So
it's
a
local
service
that
the
department
of
family
service
provides
money
for
local
providers
to
to
give
to
kids.
So
it's
very
much
local.
If
you
look
through
the
rest
of
this
chart,
private
insurance
policies
dictate
what
services
are
allowed
and
what
services
we
can
access.
C
Thank
you,
mr
chairman
yeah
direct
comment.
I
when
I
looked
at
this
slide-
and
maybe
I
just
don't
understand,
but
the
I
figured
if
they
had
private
insurance,
why
would
dfs
still
have
to
pay
room
and
board
at
the
crisis?
Stabilization
services
is
that
because,
because
they
may
have
put
them
up
there
themselves
right,
the
parent
I
mean
they
may
have
placed
them,
not
not
necessarily
court.
Is
there
a
reason
for
that?
Thank
you.
B
E
Chairman
senator
schuler,
it
goes
back
to
the
general
philosophy
that
we
want
to
have
those
services
available
to
everyone,
no
matter
what,
and
so,
if
we
don't
determine
eligibility
based
on
an
income
scale,
that
service
is
open
to
all
community
members.
However,
we
do
ask
for
some
basic
financial
information,
because
half
of
those
services
are
paid
for
with
tanf
money,
so
we
we
do
ask
for
it,
but
it's
not
a
criteria
for
accessing
it.
B
E
E
So
the
dfs
complex
cases
are
the
high
need
youth
for
whom
no
appropriate
placement
can
be
secured,
regardless
of
the
state's
ability
to
pay,
and
this
is
where
we
struggle.
We
have
about
12
to
14
cases
a
year
where
we
cannot
find
a
placement
for
a
child
because
maybe
their
age,
their
their
needs.
Their
behavioral
needs
their
mental
health
needs
and
while
the
state
may
have
funding
to
pay
for
this,
there's
no
provider
that
will
take
them,
whether
that
provider
be
in
state
or
out
of
state.
E
E
One
of
the
biggest
difficulties
we
have
in
this
area
is
that
everyone
can
tell
us.
No
so,
unlike
title
25,
where
there's
an
institution
that
is
designed
strictly
for
people
with
severe
mental
health
needs
to
go,
get
treatment
in
the
adolescent
and
child
system,
we
rely
on
a
private
provider
system,
whether
it's
in
state
or
outs
out
of
state
and
even
our
own
two
facilities,
the
boy
school
and
the
girls
school.
E
E
So
this
is
something
where
we're
working
with
a
group
of
stakeholders
and
providers
and
partners
to
talk
about
how
do
we
best
serve
these
these
children-
and
this
was
a
conversation
we
had
with
folks
with
committee
members
on
joint
labor,
we're
we're
really.
We
spend
a
lot
of
time
and
energy
trying
to
figure
out
the
best
place
for
these
kids.
E
Unfortunately,
they
oftentimes
end
up
in
juvenile
detention,
because
there
we
just
cannot
find
anybody
where
those
children
can
be
safe,
whether
they're
a
harm
to
self
or
a
harm
to
others.
It's
not
therapeutic.
It's
awfully
hard
on
the
detention
facilities,
because
they're
not
equipped
to
take
care
of
severe
mental
health
or
behavioral
needs,
but
at
the
end
of
the
day,
dfs
can't
serve
these
children.
In
our
offices
we
really
do
have
to
find
a
provider,
and
providers
can
tell
us
no
another
hole
in
the
system.
Is
that
it's
more
of
a
prevention
orientation?
E
Somebody
had
mentioned
family
first,
a
little
bit
earlier
at
this
time.
We
do
not
receive
any
federal
money
for
reimbursement
for
services,
for
families
outside
of
our
care.
So,
if
we're
working
voluntarily
with
a
family
they're,
not
there
is
no
court
order.
There's
no
court
involvement,
but
they
need
our
help.
We
then
pay
a
100
state
general
fund
for
those
services,
and
we
do
not
have
a
lot
of
money
to
do
that.
In
fact,
we
in
2016
as
part
of
those
budget
reductions,
prevention
services,
were
eliminated
and
again
you'll
hear
from
lindsay
schilling.
E
As
a
result
of
the
most
recent
budget
reductions
funding
for
step
down
services
for
medicaid
youth,
it
doesn't
exist
so,
if
medicaid,
if
a
child's,
not
in
dfs
custody,
but
the
child's
medicaid
eligible
and
they're
at
a
prtf,
the
only
option
is
discharge
to
home
or
community
medicaid
does
not
pay
for
residential
treatment
centers,
and
if
the
child
is
not
in
our
care,
then
there's
no
payer
source.
E
Certainly
parents
can
can
pay.
However,
if
you're
on
medicaid
chances
are,
you
can't
afford
a
private
placement,
and
then
I
mentioned
already
the
adolescents
with
behavioral
challenges
that
are
placed
in
detention
again,
not
a
huge
population
12
to
14,
but
certainly
one
that,
where
we
just
really
on
every
single
case,
has
to
do
our
best
to
piecemeal
the
services
together,
so
that
we
hope
to
find
an
appropriate
place
for
that
child
to
get
treated.
B
E
So,
mr
chairman,
if
a
child's
in
a
residence,
a
psychiatric
residential
treatment
facility
that
medically
necessary
level
of
care
and
they're
ready
for
discharge,
there
isn't
a
medicaid
payment
option
of
a
residential
treatment
center
unless
the
child's
in
our
care.
So
if
it's
just
a
private
medicaid
placement.
B
B
So
let
me
shift
gears
just
a
little
bit
and
ask
you
for
some
examples
to
help
the
committee
understand.
So
what
what
I've
heard
in
with
my
my
involvement
in
in
some
of
this
issue
over
the
last
couple
of
years
is
this
number
of
12
to
14?
Individuals
are
across
the
state
and
we
have
what
I
would
call
young
adolescents
who
often
are
being
placed
in
detention
facilities.
Is
that
fair
and
for
an
extended
period
of
time,
because
nobody,
we
can't
find
a
place
for
them.
B
D
E
So,
mr
chairman,
one
of
the
handouts
that
we
provided
was
the
complex
cases
brief,
and
if
you
turn
to
page
two,
what
you'll
see
is
the
characteristics
of
this
is
just
a
sampling
of
what
we've
experienced
over
the
past
year.
E
The
age
range
is
from
10
to
18,
so,
yes,
we
have
young
kids
that
need
these.
These.
These
major
interventions,
most
of
them,
need
an
rtc
or
a
prtf
level
of
care,
often
times
our
providers
in
state
are
equipped
to
take
some
of
these
children
and
then,
when
we
start
looking
out
of
state,
we
run
into
some
of
the
similar
problems.
Maybe
our
payment
isn't
substantial
enough
that
a
provider
would
take
the
child
or
for
whatever
reason,
the
child
doesn't
meet
their
criteria.
E
So
this
is
very
much
a
case
by
case
there's
no
systems
approach
to
these
children.
It
really
is
case
dependent
based
on
the
needs.
We've
had
older
children
that
have
been
in
and
out
of
our
own
facilities
that
go
to
hospitals
that
eventually
turn
18
and
then
are
subject
to
title
25.
B
So,
can
you
tell
me
how?
Because
we,
it
appears
to
me
that
we
could
very
easily
find
the
responsibility
of
these
children
lying
between
your
your
department,
department
of
education
and
department
of
health,
and
is
there
a
system,
a
coordinated
policy
between
those
three
state
agencies
to
address
these
few
numbers
of
children
on
on
in
a
coordinated
effort
to
find
services?
For
them?
Tell
me
how
you
do
that.
E
E
Lindsay
schilling,
joined
us
from
medicaid,
and
so
she's
been
a
really
big
asset
in
being
able
to
make
all
those
connections
between
the
department
of
ed
and
the
department
of
health
to
to
secure
a
placement
for
this
child.
But
no,
we
don't
have
a
coordinated
effort
so
to
speak.
As
I
mentioned,
there
was
a
a
group
of
folks
who
have
expressed
a
lot
of
interest
in
this
high
needs
area,
so
we
had
an
organizational
meeting
about
a
month
ago
and
broke
into
work
groups.
E
There
are
three
work
groups,
then
that
will
be
tackling
the
issues
surrounding
these
complex
cases.
The
first
are
the
policies
and
I'll
I'll
speak
to
that
in
just
a
second
and
then
the
second
group
is
what
you
mentioned:
it's
it's
an
organization
of
the
payer
sources
to
talk
about
what
are
the
police?
What
are
the
program?
Policies
that
happen
at
each
of
the
of
the
agencies,
and
is
there
a
better
way
to
organize
those
so
that
we
can
ultimately
find
a
placement?
It's
not
that
nobody
wants
to
help.
E
Yes,
mr
chairman,
lindsay
if
you
want
to
move
to
the
next
slide,
so
what
is
what
is
dfs
doing?
There
are
three
work
groups,
as
I
mentioned,
the
system,
policy,
development,
pair
coordination
and
juvenile
detention
as
a
side.
Note
we're
working
with
group
homes
and
rtc's
lindsay.
Do
you
want
to
kick
one
more
please?
E
And
so
so
what
this
is
really
the
policy
conversation.
I
think
that
you're
getting
at
mr
chairman
is
who
are
the
state's
priority
adolescent
populations,
and
you
went
through
the
exercise
just
with
community
mental
health
and
substance
abuse
services,
and
we
think
that
that's
a
conversation
maybe
to
have
again
but
for
adolescent
behavioral
health
needs
and
what's
the
role
of
the
state
in
ensuring
access
and
then
how
can
those
priority
populations
be
funded?
E
So
we
have
options
available
to
us.
You
know
we
we
have
money,
we
we
have
not
a
lot.
I
don't
mean
to
say
that
in
terms
of,
but
we
do
have
funding
sources
that
can
help
pay
for
these.
It's
a
matter
of
finding
what
really,
what
is
the
best
option
for
these
kids?
We
could
rely
solely
on
the
private
sector,
meaning
the
prior
private
provider
group
and
look
to
incentivize
them
so
that
they
can
consistently
serve
these
children
in
state.
E
We
could
look
at
our
own
state-owned
facilities
across
the
state
and
develop
a
program
that
would
hopefully
meet
the
majority
of
needs,
or
we
can
continue
just
struggling
through
every
year
with
12
to
14
kids,
looking
for
the
best
options
and
and
do
a
better
job
of
coordinating
those
services,
but
somewhat
maintain
the
same
system
we
have
now
and
then
and
then
the
funding
that
comes
back
to
the
incentivizing,
our
private
provider
system,
isn't
funded
at
a
level
to
provide
some
of
the
services
that
these
kids
need.
E
Some
kids
need
24-hour
watching,
maybe
two
on
one
and
at
the
rates
that
we
provide.
That's
not
contemplated.
So
all
of
those
are
policy
discussions
that
will
be
searching
through,
and
I
hope
at
some
point.
We
can
bring
recommendations
back
to
this
group
or
to
to
the
legislature,
in
whatever
form.
E
I
just
appreciate
the
focused
conversation.
I
know
that
we
spend
a
lot
of
time
talking
about
title,
25
and
the
needs
of
adults,
but
from
a
systems
perspective.
E
I
believe
that
these
services
are
more
important
than
necessary
as
a
way
to
prevent
further
entrance
into
the
adult
system,
whether
that
be
through
title
25
or
correctional,
but
it
does
come
with
a
lot
of
different
players.
It
comes
with
pairs,
it
comes
with
families,
it
comes
with
parents,
there's
a
lot
of
advocates
in
this
system,
which
requires
a
different
level
of
coordination.
B
So,
director
smith-
it
just
if
you
could
again,
let's
just
saw
the
scenario
of
somebody
that
would
maybe
need
to
be
placed
in
a
prtf
or
a
boces
facility
that
could
handle
behavioral
things,
that
they
didn't
feel
that
they
could
adequately
take
care
of
the
person.
What
would
be,
what
are
the?
B
E
Mr
chairman,
I'm
going
to
look
to
lindsay
to
see
if
she
can
shed
a
little
bit
of
light
at
the
rates
that
we
pay
in
out-of-state
placements,
but
we
have
not
done
a
comprehensive
analysis
of
what
would
be
the
cheapest
remedy.
At
this
point,
what
we
look
for
is
who
can
take
care
of
the
child.
E
We
did
encounter
one
case
which
was
extremely
cost
prohibitive
and
then
found
an
alternate
placement
at
one
of
our
state
facilities,
one
of
our
state-owned
facilities,
but
the
the
placement
of
that
youth
would
have
been,
I
think,
approximately
200
to
300
000
a
year.
We
did
not
pay
for
that.
The
child
stayed
in
state
with
with
some
services,
but
as
a
whole.
Lindsay.
Can
you
please,
if
you
can
shed
some
light
on
the
rates
for
out-of-state
providers.
F
Certainly,
corn
and
chairman
in
terms
of
dfs,
placing
in
out-of-state
facilities.
We
would
look
for
residential
treatment
centers
and
we
do
have
several
in
colorado
that
we
use
for
specialty
service
programs,
specifically
like
the
institute
for
reactive
attachment
disorder
down
in
denver,
and
we
do.
We
do
have
to
negotiate
higher
rates,
but
those
rates
usually
land
somewhere
between
200
and
250
dollars
a
day.
So
they
are
approximately
25
to
50
dollars
higher
per
day
than
our
in-state
rtc
rates.
B
F
Chairman
larson,
I
don't
have
that
number
with
me,
but
I
can
certainly
get
it
to
you.
I
know
in
pulling
historical
data,
we
were
averaging
between
10
and
15
children
per
year.
B
E
E
Okay,
mr
chairman,
thank
you
and
now
I'll
turn
it
over
to
lindsay
schilling,
who
is
going
to
discuss
with
you
quickly
the
step
two
budget
reductions
taken
by
the
department,
as
it
relates
to
mental
health
and
substance
abuse
services.
F
Certainly,
I'm
just
checking
my
mute
good
afternoon.
Everyone.
F
So
related
to
our
step,
two
budget
reductions
and
impacts
to
mental
health
and
substance
abuse
services.
There
were
two
actions
taken
that
we
feel
have
the
potential
to
impact
those
particular
lines
of
services.
The
first
one
was
a
2.7
million
dollar
reduction
in
our
local
services
budget.
F
F
So
in
direct
services,
we're
talking
about
our
foster
care,
monthly
payments,
rtcs
group
homes,
any
mental
health
evaluations
therapy
services
that
wouldn't
otherwise
be
covered
by
by
medicaid
or
other
payer
sources,
so
that
2.7
million
biennial
reduction
is
in
that
budget.
Right
now,
we
have
not
moved
forward
with
any
specific
rate
cuts
or
service
coverage.
Eliminations
we're
really
hoping
to
be
able
to
manage
that
reduction.
F
Things
such
as
family
counseling,
mental
health
assessments,
and
these
would
be
services
provided
to
clients
that
are
uninsured
under
underinsured
or
for
whatever
reason,
there's
not
another
funding
source
for
those
particular
services.
So
dfs
is
contribution
to
those
diversion.
Programs
will
be
zero
starting
july
1
of
next
year.
C
Thank
you,
mr
chairman.
Things
are
going
back
to
the
local
services
budget,
though
my
understanding
from
testimony
at
labor
committee,
though,
has
been
that
the
number
of
child
protective
referrals
is
down
pretty
significantly
x,
or
at
least
maybe
not.
Maybe
it's
coming
back
up
now
that
school
is
back
in,
but
that
that
was
way
off
because
of
the
school
closures
and
all,
and
that
it
was
thought
that
that
may
balloon
up
again
with
a
backlog
in
the
fall
as
we
get
back
into
schooling.
C
So
I
I
wonder
if
you
could
just
talk
about,
I
mean
I
guess
I'm
just
wondering
whether
your
hope
to
not
have
to
actually
do
anything.
There
might
not.
Last
for
very.
F
Long
chairman,
absolutely
that
is
something
we're
going
to
be
monitoring.
I
think,
if
I,
if
I
liken
this,
you
know
every
every
case
that
comes
into
dfs
is
a
little
bit
different
requires
different
funding
sources.
Some
cases
can
be
managed
as
in-home
cases
versus
kids,
that
come
into
care.
So
it's
just
really
this
mix
of
cases,
the
mix
of
the
services
that
each
of
the
cases
require
that
really
want
that
create
the
the
annual
expenditure.
F
B
I
think
we'll
go
to
public
comment.
Elizabeth,
can
you
share
with
us
who
we
have.
A
Mr
chairman,
we
have
andy
somerville,
but
she
has
notified
us
that
she
does
not
have
any
comments
at
this
time.
We
also
have
an
individual
who
is
in
the
waiting
room
we
are
uncertain
as
to
who
that
is.
We
did
have
one
under
other
individual,
mr
brooklyn
signed
up,
so
I'm
unsure.
If
we
should
admit
that
individual
or
not,
I
leave
that
to
your
discretion.
B
No,
and
and
we
need
to
find
out
who
the
one
is-
it's
a
phone
number.
I
know
you've
reached
out
to
him,
but
I
we're
just
we've:
we've
found
that
that's
become
problematic.
We
need
to
know
who
you
are
in
by
a
real
name
and
we
hate
to.
A
Mr
chairman,
if
that
is
the
case,
if
that
person
is
listening
on
the
youtube,
if
you
could
contact
lso
myself,
elizabeth
martino,
either
through
email
or
phone,
that
would
be
greatly
appreciated.
B
It
would
we're
interested
knowing
what
what
it
is
you
have
say,
and
then
you
know
for
for
people
as
a
whole.
As
you
monitor
these
prone,
these
programs,
we
kind
of
have
a
deadline
trying
to
figure
out
who
to
allow
on
the
public
comment,
and
so,
generally
speaking,
if
you
make
an
attempt
to
do
a
public
comment
on
the
day
of
the
of
the
zoom
meeting,
it'll
be
rejected,
so
we
unfortunately
that's
kind
of
how
we
live
in
this
world
today.
If
it
was
in
in
person,
it'd
probably
be
a
bit
different.
B
So
what
I'm
going
to
suggest
back
to
lso
staff-
and
I.
B
Is
that
the
person
that
the
two
individuals
are
that
were
wanting
to
provide
public
comment
if
they
would
provide
that
public
comment
in
written
form
back
to
you
at
lso
and
then
to
get
that
sent
out
to
the
committee
so
that
we
can
review
it?
It's
it's
important,
but
the
dialogue
we
we
need
to
have
a
little
bit
of
control
of
it.
So
that'll
be
my
request
as
chairman.
B
Okay,
senator
kinski,
that's
a
we've,
got
a
report
from
lso
staff
on
any
outstanding,
john
elizabeth,
anything
that
we
need
to
follow
up
on
there.
A
A
If
you
want
to
know
what
centers
are
providing
services
to
what
counties
that
might
be
the
best
source
of
information
that
we
have
right
now
and
then
there
was
a
question
that
we
had
about
sole
provider,
and
so
that
was
a
really
it's
a
bit
of
a
tricky
ask,
because
there
is
no
centralized
database
for
that
information,
and
so
your
lso
staff.
A
We
did
a
proxy
analysis
to
kind
of
show
you
where
there
are
mental
health
and
substance
use,
disorder,
professionals,
statewide,
and
so
you
have
based
on
board
of
psychology
and
mental
health
licensing
boards
data.
So
that's
kind
of
the
first
memo
for
you
just
kind
of
gives
you
an
idea
of
what
services
or
professionals
are
located.
A
That
was
actually
one
of
the
limitations
of
the
data
set
chairman
that
I
had,
which
is,
it
doesn't
tell
us
what
types
of
services
they're
providing
only
their
license
or
certificate,
nor
does
it
show
us
who
they're
providing
so
they
might
provide
services
for
multiple
counties.
We
would
be
happy
to
reach
out
to
try
and
get
that
information.
This
was
just
kind
of
a
high
level
to
see
what
interest
you
may
have
before.
We
kind
of
delve
down
into
that
that
level
of
detail.
B
Well-
and
I
think
I
think
the
genesis
for
the
question
is-
we
were
trying
to
determine
around
the
state
where
our
community
mental
health
providers
might
be
the
sole
source
of
mental
health
services
in
a
in
a
rural
area
or
in
any
area,
and
if,
if
some
of
these
professionals
are
licensed
through
the
school
district
or
perhaps
even
through
a
child
development
center,
do
they
provide
services
to
the
community
or
is
it
so?
I
just
trying
to
determine
how
accurately
it
reflects
on
the
services
within
those
counties,
particularly
those
more
rural
counties.
B
Well
and
and
committee-
I
I
guess
my
question
on
that
is
one
of
the
questions
we
heard
this
morning
is.
Is
this
question
on
general
access
and
if
there's
no
kind
of
goes
back
to
representative
olson
and
representative
bartlett's
question?
If
there's
not
services
in
the
county,
then,
but
all
the
counties
with
this
document
would
imply
that
there
are,
but
if
they're,
if
the
significant
number
of
those
services
are
tied
up
in
school
districts
and
aren't
serving
the
public
as
a
whole,
then
that
kind
of
highlights
that
question
on
general
access.
B
A
B
B
It's
not
as
you
get
back
there
a
little
bit
further.
You
lose
the
substance,
abuse
and
it
just
becomes
mental
health,
and
is
that
then
this
it's
hard
to
track
them
separately?
I
guess
is
that
right.
A
Mr
chairman,
that
is
correct.
My
understanding
and
I,
of
course
defer
to
the
department
of
health
if
they
have
any
additional
information,
was
that
at
one
point
they
were
accounting
for
those
together
and
so
in
the
more
recent
years
they
started
to
separate
them.
So
there'd
be
a
better
way
of
looking
at
that
data,
but
that,
before
that,
split
that
you
see
when
it
goes
into
those
individual
units,
they
had
just
put
it
all
together.
A
Yes,
sir,
the
division
is
the
like
the
behavioral
health
division,
it's
like
the
big
broad
over
umbrella
and
then
the
units
are
the
programs
under
that
division.
B
D
Question
for
elizabeth,
please
elizabeth:
can
you
push
that
back,
maybe
to
the
turn
of
the
century?
The
reason
I'm
asking
is
it's
my
understanding
that,
just
about
the
time
this
data
series
begins
was
about
the
time
that
senator
shipper
and
simpson
had
legislation
that
profoundly
impacted
the
amount
of
mhsa
funding.
D
I'm
curious
before
this
0.405
what
the
level
of
funding
was,
because
my
understanding
is
the
run-up
really
began
about
the
time
that
this
data
sequence
begins
and
I'm
curious
how
much
funding
we
got
by
with
prior
to
the
to
the
simpson
shipper
bill.
A
B
A
Mr
chairman,
senator
kinsey
I'd
be
happy
to
add
about
2000
through
2000
and
send
that
out
to
the
committee.
B
G
You
thank
you,
mr
chairman,
so
to
that
point
this
summarizes
the
bills
and
it
does
not
take
into
account
when
cuts
were
made.
So
just
because
this
is
additive
does
not
mean
that
in
2012
or
2016
dollars,
weren't
taken
out
of
the
system,
the
the
exercise
I
was
when
I
brought
this
forward
when
I
was
chairman
of
labor
health.
G
That
was
the
legislature
giving
direction.
Now
how
much
money
we
give.
I
mean,
that's
that's
a
different
question.
In
my
view,
and
and
the
co-chairman
kinski
is
correct.
This
was
when
senator
schiffer,
what
one
our
state
funds
were
much
different
and
two
senator
schiffer
was
there,
but
none.
Almost
none
of
this
is
codified
law.
G
This
is
all
non-codified
law,
and
that
is
the
point
I
think
what
this
exercise
is
is
if
we
want
to
have
a
discussion
and
build
a
baseline,
what
we
expect
for
community
mental
health
and
what
what
that
safety
net
is
that
we
should
start
having
a
conversation
about
what's
there,
what
it
was
intended
for
and
if
we
want
to
actually
codify
some
of
that
saying
this
is
our
priorities.
G
Instead
of
just
having
a
pot
of
money
that
becomes
amorphous
after
whether
it's
5
years,
10
years
or
100
years,
it
becomes
an
amorphous
pot
with
allowing
the
executive
branch
to
use
it
as
they
prioritize.
That
would
be.
That
was
the
genesis
of
where
this
this
discussion,
or
at
least
my
effort
to
have
this
discussion,
was,
I
guess
now,
four
or
five
years
ago.
Thank
you,
mr
chairman.
D
Mr
coacher,
please
so
represent
barlow.
I
don't
know
if
I
said
something
that
got
you
exercised.
If
so
I
apologize,
I
I
I
just
was
reacting,
I'm
on
the
same
track
as
you.
My
understanding
is
that
that
not
just
the
level
of
funding,
but
the
programs
to
which
the
funding
was
directed
changed.
You
know
405
as
a
result
of
simpson
shipper,
and
I
don't
I
have
to
confess
I
don't
understand
it
all.
Quite
yet,
and
I'm
with
you
it's
I
I
agree.
D
G
Thank
you,
mr
no,
I
wasn't
an
exercise
just
wanted
to
make
sure
we
were
clear
on
some
of
the
consequences
of
that
two
thousand
five.
Six.
Seven
legislation
was
actually
you
know
direct
directives.
Here's
money
go,
do
this
with
it,
but
how
that's
changed
over
time,
whether
we're
still
doing
those
things
or
whether
the
same
level
of
funding,
whether
you
go
forward
or
backward,
is
there.
That
is
what
that
is.
What
is
unknown.
G
Why
did
we
what
changed,
programmatically
and
funding
wise,
and
where
are
we
now
and-
and
I
believe,
a
lot
of
that
we
have
been
hands
off
and
we've
allowed
it
to
be
in
the
hands
of
the
executive
branch,
and
that's
where
I
think
the
discussion
we're
trying
to
have
is
is
what
are
we
getting
and
what
do
we
need
and
what
level
are
we
willing
to
fund
it,
and
so
I
think
we're
on
the
same
page.
I
just
want
to
make
sure
that
nuance
of
we
don't
have
any.
G
B
Thank
you
thank
you
and
I
do
think
we're
on
the
same
page.
So
elizabeth
can
we
go
to
page
15
of
that
document,
and
so,
as
I
read
the
title
page
of
this,
this
it
would,
it
would
suggest
that
it
would.
This
document
was
going
to
show
the
appropriations
made
in
that
in
a
specific
year
for
these
respective
divisions
or
units,
and
so
on,
page
15.
A
These
would
be
the
budget
reductions
or
reductions
the
agency
offered
in
its
budget
books
and
so.
B
A
That
is,
that
is
correct,
sir.
That
would
be
the
total
appropriation
for
that
biennium,
because
that
what
that
that
appropriation,
that
amount
in
20
that
for
that
biennium
would
have
been
reduced
by
this
1.2
million.
B
A
Last
but
not
least,
we
have
memo
number
three
that
we've
prepared,
and
this
is
simply
we
had
been
asked
to
reach
out
to
ncsl,
to
look
for
some
other
states.
Examples,
particularly
for
those
non-expansion
states
and
what
they're
kind
of
doing
with
their
adult
populations
for
those
kind
of
handoffs
to
communities,
and
so
one
of
the
things
that
we
discovered
when
we
reviewed
the
material
that
was
provided
by
ncscl
is
that
they
didn't
really
have
a
very
clear
delineator
of
expansion,
state
versus
non-expansion
state.
A
The
documents
really
just
were
examples
of
policy
areas
that
individuals
such
as
could
consider
and
then
examples
of
states
that
are
having
these
practices
and
so
throughout
the
materials.
There
were
examples
from
georgia
and
from
some
of
the
north
carolina
some
of
the
other
non-expansion
states,
but
there
was
not
any
consistent
information,
so
we
went
ahead
and
just
summarized
the
information
they
gave
us
to
you.
A
Those
two
documents
in
particular
were
what
john
and
I
felt
were
some
of
the
better
policy
examples
that
you
might
consider
in
your
discussions
and
just
listed
those
right
out
for
you
for
the
time
being
and
then,
if
you
did
have
anybody
you
wanted
us
to
pursue.
For
example,
there
are
a
couple
examples
out
of
jordan,
georgia
that
looked
interesting.
B
Co-Chairman
kinski,
I
think
that
this
was
something
that
you
had
expressed
interest
in
would
be
happy
to
if
you'd
like
them,
to
follow
up
more
on
that
or
if
you
want
to
digest
that
a
little
bit
and
then
maybe
reach
out
to
them.
That's
fine
as
well.
D
Okay,
the
real
meat
of
it,
the
real
meat
of
it
is,
mr
chairman,
is,
is
in
the
two
I
think
in
some
of
the
attachments
to
that
memo,
particularly
the
the
first
one
guidelines
for
successful
transition,
the
last
leg
of
which
talks
about
continuity
of
care
and
assuring
that
there's
a
handoff
of
these
folks,
which
harkens
back
to
our
discussion
with
the
fellow
from
gateway.
What
was
his
name
craig,
mr
craig,
and
it
harkens
back
to
the
data?
D
We
heard
that
of
those
that
are
released
that
are
ordered
to
receive
substance,
abuse
and
out
drug
counseling
mental
health
from
prison,
though
we
only
had
a
record
of
50
of
them
showing
up
in
the
community
mental
health
centers,
which
means
either
records
deficient
or
they're
going
somewhere
else
or
not
receiving
the
treatment
so
that
that
continuity
of
care
conversation
and
the
handoff
at
each
point
in
the
system
remains
of
concern.
It
looks
like
we've
got
all
the
pieces
in
place.
It
just
doesn't
look
like.
D
They
know
they're
supposed
to
counsel
them
for
mental
health
and
substance
abuse
the
clients
involved
in
the
justice
center
and
they
can't
get
enough
information
out
of
the
rest
of
the
system,
whether
it's
the
county,
attorney's
office
or
the
correct
department
of
corrections
in
order
to
make
a
successful
transition.
So
I
think
that
continuity
of
care
conversation,
mr
craig,
just
sent
a
medal
through.
D
And
I
think
our
great
hope,
mr
chairman,
is
probably
going
to
be
this
conversation
between
doc
and
d.o.h
on,
on
whatever
it
is
that
that
they've
been
asked
to
coordinate
with,
I,
I
think
it's
treatment
and
care
throughout
the
the
justice
system.
I
don't
do
we
are.
We
do
for
a
report
on
the
progress
on
that.
G
C
Mr
chairman,
thank
you
they've.
They
have
been
reporting
throughout
this
interim
senator
kinski
to
the
labor
committee,
so
we
did
hear
a
report
at
the
august
meeting
that
they
they're
continuing
to
work
on
it.
Obviously,
things
have
been
somewhat
slowed
down
with
all
the
other
things
that
department
of
health
has
been
doing
this
interim,
but
yeah
it's
in
progress
and
we're
hearing
from
them.
D
Mr
co-chair,
please
chairman
wilson,
is
a
reason
for
hope.
C
I
thought
they
seemed
quite
hopeful
frankly,
there's
several,
of
course,
there's
other
people
from
senator
schuler
senator
bouchard,
representative
barlow
are
also
on
labor
committee,
so
they
may
have
some
other.
F
D
Here
the
one
thing
that
I'd
be
curious
is
if
there's
anything,
there's
they're
going
to
hit
a
limit
as
to
what
they
can
do
administratively.
At
some
point,
they'll
need
legislative
authorization
or
direction
like
the
simplest
that
I
heard
out.
Mr
craig
was
just
being
able
to
access
the
record
prior
to
discharge
for
whoever
the
community-based
treatment
provider
is
supposed
to
be,
and
if
there's
some
legislative,
if
there's
some
legal
reason,
why
doc
can't
do
that,
then
that
I
guess
that'd
be
a
labor
health
bill?
B
C
Oh
yeah,
so
thank
you,
mr
chairman,
so
so
right
now
they're
following
the
directions
of
last
sessions
house
bill,
31
and
certainly
we
would
anticipate
if
they
need
further
further
guidance.
C
I
I
have
not
heard
I
don't
remember
them-
reporting
any
particular
need
for
further
legislation
on
that
that
issue
at
the
last
meeting,
but
there's
probably
more
to
come.
I
I
I
and
I
could
make
some
hypotheses
on
that,
but
I'd
probably
be
over
my
skis,
as
we
said
so
I
I
won't
hypothesize
on
things
that
have
not
actually
been
reported
to
me.
D
Okay
and
mr
co-chair,
just
just
one
other
thought
along
those
lines,
is
elizabeth,
and
this
is
a
conversation.
This
coach
here
you
and
I
had
with
the
csgp
folks
where
I
said
so
much.
This
justice
reinvestment
was
supposed
to
be
a
collaborative
effort
across
agencies
and
somehow
it
ends
up
too
often
being
a
legislative
initiative,
and
the
series
of
documents
were
forwarded
that
I
I
think,
would
be
good
if
the
committee
hasn't
received
them
to
receive
them
and
what
they
are.
D
Is
it's
the
original
letter
that
was
signed
by
speaker,
harshman
senate
president?
I
think
it
was
viva,
then
governor
meade
getting
them
to
come
in
and
promising
a
an
effort
that
would
involve
all
agencies
and
all
stakeholders
who
come
up
to
be
at
the
table.
D
I
don't
know
that
that's
happened
and
then
an
overview
of
how
it's
supposed
to
happen,
but
I
just
don't
know
that
the
judiciary
has
been
involved
in
that
conversation.
I
I
don't
know
if
the
county,
attorneys
and
prosecutors
have
been
involved
in
that
conversation,
and
I
don't
know
how
we
as
a
legislature
would
say
we
really
need
to
have
a
broader
conversation
to
to
really
make
any
any
headway
on
this
intersection
of
judiciary
and
mental
health.
C
Thank
you,
mr
co-chairman.
I
was
just
going
to
say
that
the
judiciary
committee
did
work
on
that,
for
I
think
it
was,
and
probably
representative
olsen
can
say
before
he
went
on
to
appropriations,
but
that
was
certainly
a
project
that
lasted
several
years
and
then,
when
management
council
the
year
before
last,
sent
it
into
the
labor
committee
for
the
community
component.
C
C
D
D
The
question
is:
is
not
what
we
as
a
legislative
body
are
doing
or
what
we
have
prodded
department
of
health
and
doc
to
do
but
where's.
What
is
the
process
by
which
the
balance
of
the
justice
system
is
at
the
table?
In
the
conversation,
the
judiciary,
the
prosecutors,
the
county
attorneys,
the
circuit
court
judges,
that's
when
you
see
the
documentation
from
csg
you'll
see
an
ideal
that
has
yet
to
be
realized,
we're
making
progress,
but
we're
not
there.
Yet.
I
don't.
C
Thank
you
so,
mr
chairman,
thank
you.
Sorry.
It
took
me
a
bit
to
find
my
button,
so
our
our
next
labor
committee
meeting
is
monday
and
tuesday,
the
5th
and
6th
of
october,
and
then
our
last
meeting
of
the
interim
will
be
the
5th
and
6th
of
november.
Just.
B
B
A
A
B
Well-
and
we
understand
that-
and
I
hope
that
we
we
appreciate
his
perseverance
and
effort
to
join
us
in
this
process.
So,
mr
birkeland,
when
you
I
don't
know
if
it
looks
like
we're
trying
to
connect
your
audio,
if
you
can
hear
me
once
you
once
you
come
on,
if
you
just
announce
who
you
are
and
who
you
represent,
if
anyone
and
we're
excited
to
hear
your.
B
H
We
hear
you
thank
you,
my
apologies
for
the
confusion,
I'm
joining
also,
I'm
bruce
birkland,
I'm
with
the
wyoming
youth
service
association
and
our
members.
The
list
of
services
provided
by
director
schmidt.
Our
members
provide
many,
if
not
most,
of
those
services
on
that
list,
and
I
think
her
presentation
covered
those
services.
Well,
I'm
happy
to
answer
any
questions.
A
couple
of
things
that
would
just
clarify.
H
Would
be,
I
just
wanted
to
mention
that
that
crisis
shelter
services
that
I
think
there
was
some
discussion,
but
I
mean
on
that
continuum.
The
lower
end
of
the
continuum
does
get
used
as
many
more
cases
than
anything
as
you
go
up,
so
our
crisis,
shelter
services
serve
many
more
kids
than
the
others.
Represe
senator
schuler
wondered
about
insurance,
paying
on
those
the
type
of
services
offered
at
a
crisis.
H
Shelter
generally
would
not
qualify
under
insurance
payments
and
having
that
open
to
one
and
all
is
very
effective
prevention
services
and
keeps
80
to
85
percent
of
the
kids
that
come
in
through
christ
shelters
into
moving
any
higher
in
the
system.
So
it's
proven
very
effective
over
the
years
and
helpful
the
gaps
in
services.
I
would
just
mention
those
high
need:
children,
private
providers.
H
In
some
cases
those
children
have
been
or
attempted
to
be
held
in
private
provider
facilities
and
have
blown
out
of
those
or
not
been
able
to
be
served
successfully
in
those
services
and,
in
addition
to
private
providers
like
limited
in
terms
of
physical
plant
and
in
facility,
there's
also
a
much
higher
risk
for
the
private
providers.
In
terms
of
liability
of
what
we're,
having
both
for
the
welfare
of
that
child
for
the
other
children
we
serve
and
for
staff
in
terms
of
the
other
gaps
and
services.
H
There's
always
been
an
issue
I
think
for
services
is
that,
as
director
schmidt
had
talked
about
in
terms
of
difficulty
of
getting
service,
if
you
either
have
to
go
through
court
and
a
parent
gives
up
custody
or
you
have
to
have
the
right
insurance
plan
which
will
allow
you
access
to
the
higher-end
services,
but
not
the
full
continuum
of
services.
So
that's
been.
H
A
gap
forever
will
continue
to
be,
and
the
step-down
services
from
a
high
level,
the
prtf
going
directly
home
from
that
service
can
be
very
difficult
and-
and
especially
when
the
case
once
the
kid's
been
out
of
state,
we
have
been
working
with
department
of
family
services
and
they've
been
a
great
helper,
we're
getting
much
closer.
H
We
think
and
hope
to
have
an
agreement
where,
where
group
homes
can
be
able
to
take,
fill
more
of
those
gaps
by
taking
kids
and
having
funding
where
it
doesn't
have
to
be
a
court
order,
but
there's
a
black
funding
that
will
make
it
available,
particularly
for
step.
Downs
will
still
provide
in
number
one
priority
will
be
the
court
ordered
cases
and
kids,
but
if
and
when
available,
we
could
provide
service
to
those
youth
that
are
being
stepped
down
or
perhaps
even
have
yet
and
wouldn't
have
to
go
to
court.
H
We
understand
there's
going
to
be
reductions,
we
greatly
appreciate
the
department's
not
reduced
rates,
but
if,
if
if
access
to
care
and
needed
care
is
has
to
be
ratcheted
down,
that's
a
great
concern
also
both
for
the
child
and
the
present
system
of
being
paid
on
a
per
diem
basis.
That
would
affect
the
agency
financially
the
same
again.
H
Developing
those
black
funding
proposal
that
we're
working
on
with
dfs
would
help
address
that
and
alleviate
that,
and
then
I
would
just
mention
the
it's
understandable.
The
community
juvenile
service
block
grants
had
to
be
eliminated
or
will
be,
but
again
that's
prevention,
programming
in
a
lot
of
communities
and
keeping
kids
out
of
court
and
out
of
other
services,
we
understand
there's
cuts,
we
just
we'll
be
working
on
just
providing
people
with
more
information
of
what
that
actually
looks
like
in
means
and
communities.
So
with
that,
I
would
oh,
I
would
mention
one
other
cut.
H
The
department
of
health
mentioned
the
medicaid
limiting
of
30
visits
caps
for
medicaid
payments,
our
residential
treatment
centers
are
those
are
considered
outpatient,
as
director
schmidt
had
explained
in
terms
of
how
medicaid
works
for
rtcs
and
paying
for
the
therapy
and
30
visits
goes
very
quickly
if
you're
doing
a
family
visit
an
individual
and
three
group
sessions
a
week
within
six
weeks
that
30
visits
has
been
met,
we
can
and
will
continue
to
request
medical
necessity.
It'll
just
be
something
more
we
need
to
take
on.
So
with
that,
I
will
stand
for
any
questions.
B
Thank
you,
mr
birkeland
committee.
Any
questions
for
for
bruce
on
this
ed
and
also
thanks
for
your
help
on,
I
believe,
you've
been
participating
in
those
calls
with
director
schmidt
on
some
of
the
adolescent
crisis
gaps
that
we
have
and
appreciate
that
very
welcome.
Mr
chairman,
any
questions
for
mr
birkeland.
B
Okay
with
that,
I
think,
unless
I
see
any
objections,
we
will
put
this
meeting
to
to
rest
for
the
day,
any
any
objections.
Thank
you.
This
meeting
is
adjourned
thanks
to
all.