9 8 8 Technical Advisory Board Meeting 20251120 100031 Meeting Recording

001All right. Uh, so we'll go ahead and get started. Good morning everybody and welcome to the fourth 988 technical advisory board meeting of 2025. Um, I'll start off by introducing myself. My name is Steve Yarro. I am the deputy director of public safety communications here at the governor's office of emergency services. Um, so that means I have the 911, the 988, and then uh public safety radio communications also is under my portfolio. So, um I'm pleased to join the advisory uh board here and and and I'm passionate about and inspired by providing technical uh systems that help advance the missions of all of these organizations both in the 988 911 and the radio communications for our public safety professionals throughout the state of California. um you know my history comes out of the technology space

002and delivering you know missionritical systems um for all of the frontline public safety professionals. Uh a lot of what I've done has been in state government um both here at public safety communications but also in some other agencies at the state level uh doing uh more traditional information technology projects. um I have some experience out in the private sector as well. So all of that together I think will you know help um you know in leading this organization to deliver on its mandate to provide some technology solutions in this space. Um, you know, we're going to hear some updates as we go forward today, uh, from the program areas and the working groups that are covering a lot of the continuing activities. And my hope is as we do that, then we can have an

003engaging and and, uh, robust dialogue about some of these things. Um, and, you know, just serve our our mission here as a a technical advisory board to make sure that we're taking in the information and the expertise from all of you. um so that we're, you know, putting that into the design process and making sure that we're producing a a product that serves the needs that you all have who are out on the front lines, um meeting the needs out in the communities. And so um that's you know sort of a preamble to the meeting but I I wanted to sort of take that moment and some of you I obviously have met um prior to this and others I think this might be the first time that we've met and so I'm I'm pleased

004to be here and join you. Um at this time I think we'll turn our attention to the roll call and uh as I read out your name please sound off and let me know if you're here or not. All right. Um, so I'll start off uh with uh Dr. Buouie, >> present. >> Thank you. Sherry Suelski. >> Oh, wait. There we go. Present. Sorry. >> Thank you. Diana Gutierrez, >> present. >> Thank you. Demetrius Sydney, >> present. >> Jeff Abear, present. Tracy Gonzalez, Jennifer Kenton, >> present. >> Thank you. Aaron Riley, Serena Lewis, Dr. Rafa Yuan >> present. >> Thank you. Lon >> present. >> You Joe Sullivan >> present. >> Thank you. >> Terry Galvin >> present. >> And Jamila Fields >> present. >> All right. By my count, we have more than the

005required eight to make the quorum. So, we will uh continue with the with the meeting and conduct all the business pertinent there too. Um so, we'll move on to our next item on the agenda, which is the approval of the uh the previous meeting minutes. The board members have received those meeting minutes in advance. Um, and so for the discussion part, are there any comments or edits from the board to the previous meeting minutes that we need to discuss? All right. Seeing and hearing none, then I'll entertain a motion to approve the meeting minutes as they are currently written. Do I have such a motion from the board members? >> Motion to approve. >> Right. Do I have a second to that motion? >> Second. >> All right. Thank you. Um, okay. So, we will

006then move on to the uh the voting on the motion to approve the meeting minutes. Um, I'll do a roll call vote. Please indicate your agreement or dissent by saying either I or nay as your name is called. We'll start with Dr. Buouie. >> I. >> Thank you. >> Sherry Suelki. >> I. Diana Gutierrez. >> I >> am Demetrius Sydney. >> I >> Jeff Abear. >> I >> Jennifer Kenton >> I >> Dr. Raf Lewan >> I >> Lon Nuin >> I >> Joe Sullivan. >> Hi >> Terry Galvin. I >> and Jamila Fields >> I. >> Right. The vote is unanimous and the motion carries. The minutes are approved and we will post them accordingly on the website. Thank you for that. Uh we'll move on then to the third item on our agenda.

007>> I'm sorry. Pardon me, Steve. >> Yes. Um, I'm not sure if it's just this one person, but I have a colleague that's trying to go online and says they haven't been let in. I just wanted to make sure that we have our online folks in the meeting as well. >> Okay. >> All right. Uh, do we >> Yes. So, the >> Okay, I'll let them know that. >> Yeah. Okay. Um >> yeah. Okay. So, yeah, it sounds like the the environment for the online uh viewing of the the meeting is up and running and so um we're actively monitoring the lobby and making sure that we're adding people as the icon presents itself. So if there if you're having difficulty on the other end of the spectrum, keep uh refreshing the refreshing the window

008and trying to log in. We'll keep doing that. Um uh one point of of procedure I guess is um I think it's worth mentioning um that uh Paul Troxel's retirement and and chief deputy director if you'd like to make a a comment on that point. >> Sure. Um I think a very uh familiar face to all of you and a regular participant here in this meetings um was our former branch chief Paul Trxell. Paul Trxel um is enjoying a muchdeserved retirement. um he um has had a longstanding um professional experience particularly in the 911 space, not only um here in the PSC division, but also in his time working at the PAP. So, we're really going to miss his expertise. Um we are looking for his replacement um now. Um but I trust that all

009of you join me in wishing him well in his muchdeserved retirement. Um, deputy director Steve Yarborough is is a governor appointed position as as a deputy director. The branch chief will be reporting to the deputy director. So, um, we will keep this board apprised as we do our our search and recruitment for that position. So, thank you. >> Thank you for that. Um, okay. So, uh, where we are on the agenda, item number three is public comment for matters that are on the agenda. And this is an opportunity for members of the public to, um, voice their input on matters that are on the agenda. And so, we'll start, uh, with public comment in the room and then we will, uh, look to the online presentation for public there. Please be mindful that many people

010might like to make a comment and therefore I'm asking you to limit your remarks to three minutes a piece. Um and so with that I think we'll turn our attention to the public comment microphone over here. >> Good morning everyone. Thanks for having us. >> Good morning everyone. My name is Nari Dylan. the um president of California 988 consortium which represents the um 988 crisis centers in our state. I think at this time of rising suicide rates in our country, our commitment to working together is going to be key to our ability to serve people in need in California. Um, the 11 centers that make up the California 98 network have been answering the call and serving California residents for years, long before the National Suicide Prevention Lifeline um, transition to 988 in 2022. Some

011of us have been working with the lifeline for over 20 years since its inception in 2005. Our centers know the realities of operating 988 planning, forecasting, and though there's similarities with 911, our hope today with having many of our colleagues speak is to help you better understand the realities of the 988 demands and running a 988 center. We want to be a true resource and partner at this time for both OES, DHCS, and HHS as opposed to having to always be reactive. Um, we hope that by sharing our perspective, we can have a true seat at the table and be partners. Um, and that we see the 98 search charge as a major opportunity. Um, it's a chance for the centers to be through truly resourced to be able to meet the needs of Californians

012who are reaching out to us for help. It's a chance to expand our capacity to actually respond to the thousands and thousands of chats and texts that are currently rolling to the national backup centers. And it's a chance to make the 5-year 988 implementation plan come to fruition, which includes part 911 diversion, mobile crisis dispatch, and many other features that would really make our crisis system more valuable. Um, we appreciate you for for listening and being our partners in this time, especially considering the uncertainty of SAMA funds in upcoming years and also the transition due to Prop 1 that's happening statewide from MHSA to VHSA that is impacting suicide prevention services throughout our state. Thank you. >> Thank you. Good morning. My name is Ben Ay and I'm the chief public affairs officer for Wellspace

013Health. Wellspace Health has been providing suicide prevention services since 1953. We were providing suicide prevention services before the National Lifeline. We were there at the beginning for the National Lifeline. We were there at the beginning of 988, literally walking the halls of Congress advocating for it. Since 988 has come to California, there have been a lot of wonderful conversations. There have been a lot of uh great communication. However, it hasn't necessarily felt like a partnership. The crisis centers in California, we built our network based on partnership. We didn't have state agencies. We we didn't have a lot of support. We built it through partnership. And it was the type of partnership you could count on at 2 in the morning, 3 in the morning on Christmas Eve when someone's life depended on it. And through

014that, we built a true national model that is the envy of large communities across the nation. We want to have that partnership with OES. We want to have that partnership with DHCS. We know there is an interest and intent to have that partnership, but I'll be honest, it it feels a little bit there used to be a saying in the disability community when they were fighting for disability rights, nothing about us without us. It feels like a lot of decisions are being made about us without us. And we know there's communication, but we want to sit at the table. We want to have the conversation. We want to be able to reflect on recommendations before those recommendations become final so that we can make sure it's going to meet the needs of our clients, of

015the people that we serve at 3:00 in the morning on Christmas Eve when everybody else in this room is asleep, but our team is up and answering that call. And I think we have a tremendous opportunity in California. I think California truly can define the 911 988 relationship, but it's going to take partnership because 988 is different than 911. Fundamentally different. Just because it's a three-digit number, it doesn't mean it's the same thing. And if we can successfully work together, and I think that's what you're going to hear from a lot of my colleagues today, is a desperate plea for true partnership. I think we can make that happen. But it has to start with us saying the right people are going to be at the table and we're going to work together. We're not

016going to make decisions about us without us. Thank you. >> Good morning everybody. My name is Matt Taylor. I'm the senior director of crisis line operations at DD Hirsh Mental Health Services and I'm going to provide um some initial comments related to agenda item number six uh which is the funding and searchcharge. Um you know I I want to reemphasize something that Ben just said which is that 988 is a fundamentally different service from 911. If you look at the length of time that our contacts take, especially with chat and text, you know, with the average chat and text extending 45, 55 minutes, it's just a fundamentally different service. And in our case, we are the intervention. Dispatching or connecting with mobile crisis and 911 is a last resort. And in fact, only about 2%

017or less of 90-day contacts actually result in a connection with 911. It's critically important. In other words, the deescalization of crisis and helping stabilize people is what we do. We do it for maybe somebody in this room. We do it for your family members. We do it for your kids, for your kids' friends. And we do so when people are at their oftentimes lowest point in their life. It's a fundamentally critical public safety network that we provide. But as Ben said, we don't have a meaningful seat at the table when it comes to a lot of these funding decisions. And that's somewhat unconscionable given the service that we provide. We are the ones doing the main work of 988. And yet OES, DHCS and DOF are the ones who are either contributing information by which

018funding decisions are made or are making the funding decisions about us without direct input from the 988 centers. We should be asked what our funding needs are, not just for right now, but what we project our funding needs are for next year and the following year, because we're the experts in the service we provide, and we have expertise in forecasting volume and forecasting staffing needs, but that's not happening. A decision has been made to decrease the 988 searchcharge revenues. That's what's going to be announced later today. That's our understanding that the 988 search charge is being lowered from 8 cents a line to 5 cents a line. I'm quite certain that the bill sponsors that put forward AB988 would never have imagined that the search charge amount would go down. And in fact, this would

019represent the first time in the nation's history that any state that has a 988 search charge is actually lowering the search charge cost and lowering it in a time when 988 demand is going through the roof. Our three-month August to October 202 2025 incoming call volume as a consortium as of the 98 centers in California is 25% higher compared to the same time 3 months last year and 56% higher than the same time in 2023. Our chat and text volume has increased 33% compared to two years ago. Last month, October 2025, was the highest volume month on record for calls, chats, and texts combined for 988. And my final point is our 988 call call volume has not surpassed 40,000 in a single month previously, but now has done so in each of the last

020four months. Thank you. Hi, good morning everyone. Uh, my name is Kyle Stfano. I'm the director of crisis programs at Wellspace Health and I also wanted to make a very brief comment about agenda item number six, the 98 search charge. So, Matt and uh, Ben and Nar just gave some great information and good data. I just wanted to also point out that this year alone um we've continued to build out the 988 to mobile crisis response um in Sacramento County and our collaborative approach has resulted in 2,155 connections this year to mobile crisis. So this has benefited the community and solidified the understanding that people in crisis always have not only someone to call but someone to go out and respond to them. So to continue to build this program and meet those the needs

021of those vulnerable community members, um our staffing model must accommodate the extra time it takes to make those connections from the callers and texters and chatters to the mobile crisis team. So we ask that funding must keep the pace with both the increased volume to 988 um and also the increased time it takes to fully respond to those members of our community. Thank you. Hello everyone. I'm CC. I'm the textline program manager of crisis support services of Alama County. I will also be making a public comment on agenda item six, the 98 search charge rate setting. In the last year, our team has expanded our crisis chat and text capacity to by over 156%. Yet, it's discouraging to see over 60% of chats and texts from Californian in need of support continue to go out

022of state due to our inability to increase the systems capacity at the needed rate. Considering a high percentage of chatters and texters are medium to high risk, I believe that we should prioritize supporting these help seekers in state to ensure connection to appropriate resources such as mobile crisis teams. This can only be made possible by making bold investments in the infrastructure needed to grow and expand our CAT chat and text capacity in California. We appreciate your leadership in ensuring all Californians have access to care. >> Good morning. U my name is Jessica Wolfinger and I am the director of crisis services for crisis support services of Alama County and I'd like to just make a few comments regarding um items five and seven ovas nga 911 technology platform 988 centers have been patient collaborative partners

023in this process since 2022 we provided direct feedback about our technology needs our center was part of the initial cohort to help design the platform and yet 3 years later there still is no OES NGA platform fully ready for deployment. More meetings on this are cancelled than held and centers are frequently left in the dark on if or how our feedback is meaningfully uh incorporated. Caloes holds the responsibility of funding technology for 988 centers. Yet centers have had to front the cost for their own technology needs and OES reimbursements to centers have been very slow with the centers still waiting to receive reimbursement. This is a significant financial burden. Over the last year, there have been three changes in OES 988 leadership. And though we are understanding to the challenges that this causes, it's important

024to note the negative impact on our centers. Thank you. >> Thank you. >> Good morning everyone. My name is Leanne. I'm a quality assurance data analyst manager for Crisis Support Services of Alama County. Um, and while I'll be speaking to the scope of our center, um, as someone who has like looked at the trends and is in charge of forecasting and trying to figure out the trends so that we can sustainably meet our needs, I'll be making a comment on agenda item six, the search the 98 search charge rate setting. Um, so 98 funding is one of our few reliable funding streams and our priority remains to meet 988's key performance indicators while scaling our services sustainably to meet demands. As a 98 servicing center, we've made meaningful progress to strive towards those key performance

025indicators despite our historically and even now underfunded capacity across chat and text. Last year, this time um for our center we served 1,8998 calls and ch and texts. This year we served 3,345 and that is at least an 80% increase in volume in one year. And we've made progress towards our performance goals. At the same time, California centers currently have a collective 10% abandon rate. More than 4,000 calls a month, so high answer rates and fast speed to answer are not just administrative metrics. We understand that their direct indicators are of whether or not the system can fulfill its life-saving mission. No one in crisis should be left waiting given the risk of irreversible harm and any reduction in funding will place a significant strain on our already limited capacity supporting the tens and thousands

026of contacts reaching us. Um, as a quality assurance professional, I feel the weight of these figures and see them as an early warning sign of the system being stretched. And I urge all of us to work together to build a more resilient 98 system that can support community crisis care. Thank you. >> Thank you. Right. Any other public comment in the room? Right. How about online? Looks like we have a one. >> I have a a comment. Is it okay to do so? >> Yes, please go ahead. >> Okay. Hi. Hi. Yes. Hi. My name is Ton Hall and um I'm the mother of Miles Hall um who was shot and killed by police, Walnut Creek Police Department in 2019. and I'm here to comment on section five of the agenda um the 988 91

0279 911 988 interoperability working group and um so basically um we've created the Miles Hall Foundation which um was created because my son Miles was killed in a mental health emergency and um we want to um make sure as an organization our dedication is to dedicated to transforming forming crisis response and preventing law enforcement involvement in behavioral health emergencies. And we offer the the following comments and recommendations. We want to revise the threat to life or property standards. The phrase immediate threat to life or property conflates property personal safety with potential property damage which can lead to unnecessarily police involvement in a nonviolent crisis. This is exactly what happened to my son when uh he broke a window and um police was was called for this. So I want to make sure that we know

028property related risk should not automatically trigger a law enforcement response. We need to be clear that that human life is a priority over property. We recommend the following defer deferring to we recommend the following which is to make sure that threats to personal safety and non-threatening behavioral disturbance or or property concerns um which that could be handled through a 988 response. And we also want to make sure that we are um clarifying the criteria for identifying a mental health crisis. We want to make sure that the 911 dispatchers can identify identify if a call involves a mental or behavioral health crisis, but it provides little guidance on how they should make that determination. And we have the following recommendations. We want to make sure there's a clear decision- making criteria or indicators. So, beyond a

029threat to life or property such as maybe disorientation, emotional distress. Um, and then maybe a sample screening question or a decision decision-making tree that can easily be used to one to three minutes during the call to help a dispatcher distinguish between calls that warrant law enforcement versus a behavioral health intervention. And then also um we want to make sure that we emphasize a nonp police crisis response option. So given California's investment in community-based crisis response through AB988 and local programs such as A3 and Contraosta County, the document should reinforce that law enforcement should be the last re resort, not the default. Suggested addition would be when behavioral health when behavior behavioral health mobile crisis teams or community-based responders are available, they should be prioritized over law enforcement or in-person intervention. So, I already submitted a

030public comment um a written comment. So, I have a five-page letter that is sent to you guys. So, I really appreciate if you guys can really take um in account to how serious this is um for someone um in a mental health emergency who needs help um without police. So, this is life- saving. So, I appreciate your time. Thank you. >> Thank you. And I suspect there might be one other one out there. Uh is it a Justin? >> That's right. Thank you so much. Uh, good morning everyone. My name is Justin Lee. I am a crisis line manager at Crisis Support Services of Alama County. Uh, I'll be making public comment on agenda item six, the 98 search charge rate setting. So, in the last year, our center has experienced a 65% increase in

031our call volume. The growing call volume for our center and across the state is a continuation of the trend since the start of 988. This is due to an increase in community outreach, increase in community stress due to federal policies and economic uncertainty and also the significant reduction in capacity for other support services. For example, the California peerrun helpline has reported that their ability to answer calls has decreased significantly after they cut nearly 200 employees earlier this fall. With the implementation of Prop One, our county expects to lose more prevention and early intervention services. It's fair to assume that this will continue to increase reliance on 988 for support and access to care. Our ask uh is that if you consider these dynamics as you plan for the future of the 98 system in California.

032Thank you very much. >> Thank you. Uh one last time, any other online hands raised? >> Yes. Uh this is Juan Troy um with Santa Clara County 988 and I'm one of the leaders there and I'd like to comment um on agenda item uh six the 988 search charge as well. So, um, over the last few years, Santa Clara County 98 has had a significant call volume increase. And I think I'm I'm echoing others that that have spoke about this, but for FY2022 and 23, our call volume was 24,497. And then in the next fiscal year 2324, our volume was 28481. And in our last year FY2425, our volume was 31,372. So this volume represents more than 28% increase in calls, you know, since really for the past three years. In addition to this increase

033in our call volume, we also managed chat and text like others. And the volume increase for the past two years. While it wasn't significant, it was still increased by 1%. Which again, you know, all of this impacts our our staffing. And I'm providing you with these numbers to show that our call volume, the chat and text is steadily increasing and this reduction in the search charge, you know, could possibly impact us from a staffing perspective. Um, so what we're urging you all to do is to ensure that we have full transparency into these allocation process and that we we urge you all to consider, you know, the real world impact of these decisions that have impact not to just Santa Clara County, but it it it really impacts all of the counties. operating currently under

034financial constraints while we try to save lives every single day. Thank you. >> Thank you. Um, how are we looking now? Any any other hands raised? >> Hello. Can you hear me? >> Yes. >> Okay, wonderful. Thank you. Yes, I'd like to give comment. >> Okay. >> Um, good morning. My name is Cassie Dibble and I am making my comments on behalf of ACLU Disability Rights Project and ACLU of Northern California regarding the 911 to 90-day transfer recommendation document that the board will discuss today. I believe at agenda item number five. Um, we thank Caloes for making the revised transfer guidance document available to the public earlier this week. We appreciate that the current draft clarifies that because different jurisdictions operate under different circumstances. The document aims to stimulate discussion and offer preliminary recommendations to

035guide how local jurisdictions formulate their policies. We also recognize and appreciate that this draft removes language that unduly narrowed the circumstances in which a transfer could be permissible based on factors such as the identity of the caller. However, we urge the working group to consider further clarification regarding the applicability of these recommendations in jurisdictions that have mental health crisis teams capable of providing an in-person emergency response. For example, the draft recommendations state that a 988 counselor may transfer a call to 911 when quote welfare intervention via phone is deemed ineffective or insufficient. going on to state that quote to ensure the caller safety the situation should be escalated for in-person intervention through 911. But this guidance would not make sense where a local jurisdiction has crisis response teams that could be dispatched through 988 equipped

036to provide in-person responses. Likewise, suggesting that any threat of property damage should render transfer unavailable and excluding calls made by third parties on behalf of or about someone who meets criteria may run contrary to local jurisdictions efforts to make informed decisions about when calls should receive alternative crisis response. While we recognize that these criteria are permissive rather than mandatory, we urge the board to make explicit that the availability of crisis response teams through 988 should impact how local jurisdictions formulate their local transfer policies and that jurisdictions can and should develop more expansive transfer criteria where there are appropriate resources available through 988 to respond. This aligns with national guidelines which discourage law enforcement involvement in mental health crisis response quotes unless special circumstances warrant their presence. Finally, given that the current draft document being considered

037by the board today was not available on the Caloes website until two days ago, we asked the board to delay taking action on the draft until the public has had adequate opportunity to review and provide input. Thank you for your consideration. Right. Thank you. Any other public comment online? All right, hearing none, uh we will then bring that agenda item to a close. Thank you for all the public comments that were offered and uh they they've been documented in our normal um note takingaking process and and we will consider them and incorporate them appropriately. Um I think uh we'll with that we'll move on to agenda item number four which is the uh Callowas legislative and governmental affairs update. Uh we have our legislative affairs representative come to the microphone please. Thank you Steve. Good

038morning. My name is Paul McInness legislative coordinator for Callowes. Um, I'll just be giving a few um key legislative dates that are upcoming um as well as u go over three uh chaptered state bills and uh four federal bills that we um continue to monitor um for reference for the board. So, the governor's uh deadline to pass all bills was October 13th of 2025. Um, all statutes excluding those that had an urgency clause will take effect January 1st, 26. Uh, the legislature uh will be reconvening on January 5th, 26, and the governor's proposed budget is required to be released no later than January 10th of 26. Um, I'll now go into just a brief overview of um, state and federal bills. Um, as a side note, we um will be making this bill list available

039to the board. Um, and then we also have our our full list of uh bills that Callowas tracks and analyzes on our Callowas legislative affairs page that will also be made available. So, the first bill is AB 330, Assembly Member Rogers. Uh this bill um extended the operation of the local prepaid mobile telefan services collection act until January 1st of 2031. This bill was signed by Governor Nuome on October 10th. Next is AB645, Assembly Member Curio. This bill requires by uh January 1st of 2027 a public safety agency that provides 911 call processing services for emergency medical response to provide pre-arrival medical instructions to 911 callers that are requiring medical assistance. The bill also specifies what medical assistance um they should be trained on. And uh this bill was signed by the governor on October

0403rd. Uh last state bill is AB727. So, this bill starting on July 1st of 26, uh, will require public schools grades 7 through 12 and public institutions of higher ed that issue ID cards to additionally have printed on ID cards the telephone number and text line uh, for a specified LGBTQ plus suicide hotline, which is the Trevor Project. That's al that's in addition to 988 that is already required to be on those cards. Uh that bill was signed by the governor on October 10th. Uh now I'll move to just four uh real quick just four federal bills that we're continuing to monitor. First is HR 540, Congress member uh Norma Torres. This would make certain revisions to the standard occupational classification system uh which would establish a separate code for public safety telecommunicators. Uh, this

041bill is currently in the House Committee on Education and Workforce. Next is HR2937, the Protect 911 Act, Congress member, uh, Robin Kelly, would require Secretary of HHS to improve the detection, prevention, and treatment of mental health issues among public safety telecommunicators. This bill is currently in the House Committee on Energy, and Commerce. Next is S 290. Uh, Congress member Barzo would direct Secretary of Interior to upgrade existing emergency communication centers in units of the National Park System to NextG 911. Uh, this bill is currently in um committee on energy and natural resources. And the last bill is S666, First Responders Wellness Act. Senator Gillibrand uh would increase access to mental health, substance abuse, and counseling services for first responders as well as for other purposes. This bill is in the committee on health, education, labor,

042and pensions currently. So, that concludes my uh state and federal legislative update for today. I'm happy to take any questions from the board. >> Uh any questions from the board members on the legislative update? All right. Thank you, Paul. >> Thank you. Uh, okay. That concludes uh agenda item number four. We'll move on to agenda item number five, the working group reports. Uh, we'll start out um with the 988 911 interface working group. If we could please have the member of the working group give the update. >> Thank you. Um, uh, Jeff Abear. I'm the chair of the uh interface working group. Um we held a working group meeting on October 20th uh with various participants um representing different interests of the PAP community, the 988 community, mental health community, etc. Um the 911 988

043transfer recommendations document that was created by Callowas was presented uh to the members of the working group and discussed and information was gathered and feedback was gathered um as to um the the information that's existing in the document. So, what I'd like to do is present just a highlevel overview of the the comments that were received. Uh the feedback that was received um all the feedback that was received was uh already submitted to Callowas for consideration for inclus uh for revision and inclusion uh in the document. >> Jeff, just real quick, I don't want to derail you, but for the for the board members, this is uh the document in question is in your binder under tab four if you wanted to review that as we go along. >> Thank you, Steve. Appreciate that. Um

044so I'll just begin here with like I said a high level overview. Um there was feedback that the draft needs clear definitions and some of the um terminology that's used and and clarity and consistency talking about for some examples like crisis counselor uh a 988 center what interoperability means transfer things like that. So, the potential for an inclusion of a uh um whether it be a table of definitions or something that provides more clarity so everyone has the same understanding of what those words mean. Um the inclusion of talking about u creating or agreements between 988 centers and their uh served paps. Um removing language that compels thatus be created. um as was talked about during the working group meeting that the the nature of the number of PAPs, the size of the PAPs, the

045jurisdictions served and those 988 centers that they interact with with those jurisdictions can differ um and the creation of certain agreements could be problematic and um and and cautionary for some jurisdictions depending on how they approach it. So talking about more about it being a recommended practice of creating anou and theou including things like uh agreed upon 10-digit phone numbers for making transfers. Um, as was noted during the the meeting that the ability for a 988 center to just transfer a call and dial the number 911 is not necessarily going to get them the appropriate PAP best able to help the individual that needs assistance. um and having the 988 center or the 911 center vice versa um transferring to a publicly accessible tangent line might put the uh transferred call uh in a delayed

046status for being answered. Um some additional comments about uh further clarifying transfer procedures. Um talking about um doing warm transfers or connected transfers to make sure that the transferred caller uh to the other center whether it be 911 or 988 is actually successfully transferred, announced and maybe even some information being being given to the transferred center as to the name of the caller. the situation and other relevant information. Um, discussion about including language access. Um, when you have a caller that calls, for example, 911 that speaks a language other than English, most PAPs are going to necessitate uh engaging a third party translation service and then once a determination is made that the caller needs to be transferred to a 988 center. further clarifying how that handoff is going to occur. Will it will it

047remain with the translation service that was engaged by the PAP or uh on the 988 center to have to now engage their translation service if necessary? Um what information should be shared? uh the comments were received that uh additional documentation or guidance in the transfer document should be documented as far as what u information should be passed along. Um there was a um comment by some of the 988 centers about having the PAP be able to provide an incident number so that way if the the 911 center is transferring a caller to a 988 center uh that they include an incident number if they have it available so that way if the 988 center has to do a follow-up call with the PAP it's easier to use as a reference number as well as being

048able to relay information that's safety related such as weapons intoxication or active threats that are being made. Um, one of the noted gaps that that was mentioned was um there's nothing by way of training talking about what type of training should be um provided to 911 dispatchers as well as the 98 crisis counselors as far as how uh to uh implement their local agency policies and procedures as well as um the procedures needed for making the transfers or even assessing uh the need for a transfer. Uh so being able to include um guidance on some measure of training or or or training standards that should be uh considered. Um and then that was pretty much like I said the high level overview for the feedback that was discussed during the working group meeting. Subsequent to

049the meeting, uh we did receive um uh a letter as was mentioned during the public comment from the Miles Hall Foundation. Um some of those comments uh were already already made during the public comment, but I'd like to highlight some of those. I think it would be important for us to continue um discussing when we talk about the the guidance document. um giving consideration uh to the the current wording that says threat to life or property. Um and revising that to look at the the the property um standard as as maybe not being the requirement for engaging um law enforcement services. um clarifying mental health crisis identification, being able to give better guidance to dispatchers for um identifying potential uh mental health crisis uh or um uh other related crisis. Um prioritizing warm handoffs and

050real-time collaboration between the two centers when those transfers are made. Again, uh not engaging in cold transfers. um emphasizing or highlighting uh the effort to to not engage law enforcement response when it's not necessary. Um training um uh component as was mentioned before. Um and then some questions were posed in that document. Um I'm hoping that maybe we'll be able to make that document available to because I don't think it's in our binder uh to the board for review just for further clarification uh and insight for the board members. Um so that's the high level overview. The information we collected um that information the feedback was uh provided to Callowas. Uh and that's the my report. >> All right. Thank you for that report. um or you know the nature of of these recommendations and

051I think it was mentioned in the uh in the comments leading up to this and again here is it's it can't prescribe all of the possible permutations um that any of the answering centers will run into. um there's some level of sightsp specific protocol that would be needed to guide the actions on a case-byase basis and so this document obviously can't uh carry all of that information in it but having you know the you know higher level recommendations and then deferring to the local areas I think is a way where the the expertise of the local area can be sort of fused with what this recommendation ation sheet um offers as well. So I'm interested in the board's uh insights and thoughts uh advice and recommendations on what has been produced so far. Yes, our

052Mr. Andwen. >> Yeah, I have additional comments uh in addition to our chair uh uh so you know this this workg group has been um created and meeting working for the last two and a half years. uh I and I I I knew because I participated in the very beginning. So I mean we met for over a number of months with uh uh in the committee there's number one representative native representative community members uh uh expert on the subject matters and as a result uh the working group uh draft the so-called candidate recommendations and then posted have not not only discussed among the board but also posted on the OES website since March of 20 2020. 24 and since then throughout 2014 I mean I'm sorry 2024 the community members and the board were also

053invited and given opportunities to provide input and feedback and I think as a result there was a lot of feedback and input that was integrated into the the draft um the the draft language uh and I also remember that toward the end of 2024 we found out that there was a national guidance by NINA and because of that our chair recommended that that we take a look at that NINA language and then also see if we can integrate some of that language into this draft and I believe that that we did a lot of that and OAS also did a lot of integration and as a as a result we met in October went over that and to develop what we have now is a so-cal hopefully a final final recommendation we also know that

054that u that can there can never be a final final recommendations because um unless the board decide there's no longer the need for the working group then then then it's final but otherwise it should be a work in progress. So because of that I I don't think there'll be ever time to be a finalized documents knowing that this is a high level general recommendation guidelines for the local number 198 to work together to come up with what works for them like you mentioned earlier. So I think I mean I hope that that either by the end of this year or early next year that we should committed to really uh take action on whatever recommended knowing that that it'll be never be final final because as as the local centers you know take this recommendation

055develop their own procedures there'll be things that come up and then do because of that you know there'll be the need to you know tune and tweak and so on to make it a a a living and and um document. >> So I mean that's I I I think that just speak for the u transition in S County there was there's been a lot of local agencies waiting for this uh you know guidelines from the state so that they they can use uh to apply to you know to to our local to make it work for all of us. But uh they've been waiting for two and a half years now. Mhm. >> So um so I think it's time that we act on it knowing that there will be additional uh feedback and and

056to see how we can improve the system but we cannot just keep waiting to get more feedback because that would never happen. >> Yeah. Thank you for that. I think uh your point's well taken that we don't ever really reach the finish line on a document like this because the capabilities that are constantly changing out there um would always then need to somehow either be reflected here or in the local operating procedure for wherever um area we're talking about. So it's a I think it's an excellent point. Uh any other comments from the board? Yes. Yeah, I'd like to support what Lon said and also just wanted to add a couple of things. Um there is a lot of good work that is being done already for 911 diversion in in communities across the state.

057And um I think I heard you mention that there really wasn't training for 911 um operators. And I there isn't a a statewide training that I'm aware of that's been, you know, issued across the board, but there's certainly we've developed a lot of training at DD Hershe um that we're working with several PAPs down in in in LA. Um, and it's we're constantly kind of updating it based on feedback from the operators in terms of what their needs are and and how to make it better for them. So, so there are opportunities, you know, to share and learn from each other. Um, and I also wanted to note it's kind of in the document inherently, but I wonder if it's strong enough in my opinion. Um while we absolutely want to partner with the local

058PAPs um to provide uh the opportunity for 911 diversion, um I feel like that one section where it it's it almost reads like they could just go ahead and start transferring to 988. And I in the in the document at the top it says, you know, that that the recommendation is that there's anou first, but I I'm wondering if that should be a little bit stronger. Um just because we've had the experience already at DD Hirsch where uh PAPs have said that, oh yeah, we're we're starting to uh divert 911 calls to you and we're like, well, you didn't tell us that you're doing that. How are you doing that? And if they're just directing them straight to to 988, it's not necessarily going to come to the right center. And so it feels like

059to me maybe that could just be a little bit more clear in this document that you know that PAP should really communicate with their local 988 centers and form anou before they start this uh this work. If >> I can make a few comments on that. So when I was talking about training it's not that training is not available or doesn't exist. Um in the current uh training for dispatchers in the state certified course by post they they actually now have a mental health section and so the training is there. I was talking about the the identified need for what the state recommends the minimum level of training should be both for 911 dispatchers and on the 98 side and it's not just for handling mental health calls but also the process in between the

060interaction between the two centers. So just from clarification there, the other thing is is um that was we we recognize that and that was the discussion uh and the point of anou just like a 988 center can't or should not just transfer to 911 because they might not be getting the right pap should not be transferring to 988. And that's where that clarity of theou is I think necessary between the centers because it's going to vary and differ between jurisdiction and region. And I think that's that's where it's really key here. This document in no way I think can can just be rolled out and say here you go now start transferring. There's this is the the baseline. It's much like what was already stated that that is the building blocks that we start to

061build on and using the experiences like like um other parts like DD HS has had in in LA uh with the interactions of PAPS. >> Yeah. And I and I hear what you're saying. I guess when I it's maybe it's just me, but when I read the document, I'm not sure if that stands out quite enough if somebody was just picking this up and didn't really know much. >> Yeah. >> So, I mean, these are this is a great uh discussion because it sounds like the way it's being addressed, at least down at DD Hirs, is to it, you know, proactively engage and then develop things sort of almost peer-to-peer, right? So that it makes sense for Yeah. It might not even be the same for any two PAPs that would be in the DD

062hir, right? >> Yeah. I mean, the training and protocols are usually fairly similar, but sometimes there's things that we need to adjust or or customize for the PAP there. But there's also been challenges technologically as well, which I know hopefully with the new platform that will be helping. But right now there's a lot of challenges where they try to even if they are working with us directly where the technology there's a lot of kinks to be worked out. I know Kurt's helped us with that in different times. Um and so you know I I I just there there are a lot of individual issues that have to kind of be worked out for every piece. It's not kind of a blanket roll out >> right. Um, so in your experience then are those documented into

063sort of a a a template that could be leveraged as an example that might be an addendum to this document and therefore inform other areas who want to engage in the same process. >> We at DDhurst, we've certainly been keeping a log of all of the lessons that we've learned. Yeah. Um, it would have to be organized in some way to make it a little bit more useful to the public, but absolutely I think that there's there's some lessons learned that we and probably other centers across the the network could contribute to. >> Yeah. Because what I'm thinking is maybe the uh the work group could then you know as a step to advance this uh reach out and get some of that you know boilerplate to generalize it to then make this document and

064have an example of how it might look in their area and then that would put us at a point where we're providing sort of a a a direction for people to follow. we can publish the recommendations and then from there it really does turn into an on the ground coordination process but we've at least not delayed publishing the recommendations that we do have >> understanding that the recommendations will have to migrate uh as new technology and new on the ground circumstances >> sure >> uh go along. So thank you for that. Um, yes. >> Yeah. So, given the additional information and input uh that we receive uh at this meeting, I I'd like to see if the board is willing to commit to having this document uh uh having the work group meet for one

065more time, integrating additional uh suggestions or comment input from the community and various group that that that chair Albert receive. and then and then finalize the document and have it ready for the board to take action by the next meeting. >> So, if I'm understanding correctly, because I think I think I get it and it kind of aligns with what you were saying earlier about wanting to have something uh sort of pinned down and published, but simultaneously the new information included. And I think in keeping I'm sensitive to the comment we heard in the public uh comment area where giving more time to have this document reviewed before the board takes action. So, what I think I'm hearing is that sounded an awful lot like a motion to have that be the plan going forward

066for the board is to have the have the work group meet one more time, incorporate that with the intent of voting on it at the next uh at the next uh meeting. So, um so I will accept that as a motion to propose that as a resolution that we want to undertake as a board. And if I have a second to that, then we could uh take action to have that be our resolution going forward. C >> can I make a comment? >> You may proceed. Yes. >> Thanks. Um I just I wanted to echo and um agree with the comments that are being made on the board right now of being a little bit more clear around theou. I love the idea of the template and guidance tool for um agencies. And then I

067I want to just lift up the comment about mobile crisis teams and modifying that area of the transfer procedure as well and really calling out mobile crisis when available since that is called out in legislation. I think it really is warranted to be within this procedure as well that we would call that mobile crisis prior to a 911 call if the situation calls for such. >> Thank you. All right. So then do I have a second on that resolution that we resolve to finalizing a draft over the next 12-week period? But >> before we do that, sorry. >> Okay. >> Um can I ask to be a a member of the uh working group? >> Yes, absolutely. >> We we need to check because we need to make sure we don't have a quorum of

068this board. >> We already have board members that are participants. So, we'll have to do a count. >> Okay. >> To make sure we don't run a foul of creating a an unintentional quorum of this group and that working group. >> Um, but >> I think I think we'll be fine because I think we we just can't have eight is what it is. Is that the count, Steve? Eight. >> Well, eight for a quorum, but I think Bagley Keane. Uh, so we would like to have our council weigh in on that. I'm going to go ahead and out of sheer precaution just go ahead and do a little bit of research on that before we add anybody to the group just for bagley purposes. >> Right. >> But um I'll I'll get right on that.

069>> Yeah. We we were informed at a prior meeting by council that we couldn't. So if you could get clarity on that would be great. >> Yeah. Yeah. So essentially what it is is California uh calls it the rule of two. So long as you have two board members together that's fine. But with larger board members, obviously you can't have a meeting of a majority, >> right? >> Which again is the eight. So that's fine. We're good there. But there are a couple little ramifications. So I'm just going to double check. >> But I I don't see any like red sirens blaring, >> you know, issues. I just want to make sure. >> All right. So we'll have uh some follow up on that. >> May I make a comment? >> Okay. Thank you. Prior

070to adding >> I previously I had also asked to be to participate and had the the same response. So I would like to also be considered at Wellspace Health. We have been in several pilot programs for 911 988 diversion. We've been doing several things that include mobile crisis to the um people online that have made comments and so I would like um to participate if available. >> Thank you for that. >> Yeah. >> So while the motion is still being entertained, can I second a motion? >> Okay. >> May I make one more request? Um I think one thing that would be nice is to understand the process by which we are um accepting public comment. I'm just kind of wanting to offer something that we do on the health and human services side um

071which is there's processes by which we ask um um vetted or interested um stakeholders or community groups to uh preview the documents and submit written comments to us like state associations um like other state departments uh with this document in the past um cow HHS, DHCS and MSA collectively put in a written comment and submitted the information to the chair and uh of the interface working group and the chair of um this advisory board. So it's all collected one together. Um so I don't know what exactly is the process at OES for incorporating state partners or state associations or local implementation partners to submit comments in in you know in a collective fashion. So, it's all kind of organized and gathered together. Um, and then if there's a an actual public comment period that is

072posted on the website and say this document is open for comments for two, four weeks or however it is. Uh, and then at that time we'll take everything and then we'll work on it. Um, so that's kind of just something that hasn't been quite clear to me uh with this process and I wonder if we can make that amply clear. So I I think the answer or at least part of the answer to that question is that because we're not actually making res regulations of any kind. Um there there really isn't that structured and formal of a you know posted for public comment for a number of days. I think the way we address it here is through the working group and through the public comment phase that we have as part of this group.

073Certainly the recommendations that come up in public comment are taken down and and filtered into the workg groupoup's uh you know issues to resolve and I think um you know as we have this document posted out there and available for review for an extended period of time then more comments will come in and they will be submitted to the to the board itself which will then be funneled over to the working group. So, um, that I I think I hope that clarifies the way public comment works in this case. Um, which I think is a little bit different than what you were describing, um, for the reasons stated before that this is really a set of recommendations rather than a binding, uh, regulation or policy of any kind. So, um, yeah. So with that being

074said, then we were uh we had uh a a motion to resolve to go through that process between now and the uh February meeting. And so I think I was looking to see if there was a second so that we could adopt that as our our stance on this issue going forward. >> So for clarification, the motion is to have the working group meet again Yeah. >> Collect additional information, make revisions, present it to this board for a vote of acceptance by the next board meeting. >> Yeah. With the intent that that would be a document that we could publish as our recommendations with the understanding that it's never a finished product and will be subject to future revision as additional pertinent information arises. >> I'll second the motion. >> All right. Thank you. So,

075we have a motion. We have a second. Uh, I understand that we need to have an opportunity for the public to to weigh in on that proposed motion. And so at this time, are there members of the public who would like to add information to that discussion point before we take it for to a vote? Seeing none in the room, are there any online who would like to make a comment on that point? All right. Hearing none, then we will take the uh the motion on the table to the vote to resolve to over the next 12 weeks incorporate the stated uh changes and resolve to have a vote to finalize the document at our next meeting. All right. So on that issue, I will take the the the roll call to cast the votes.

076I in favor, nay opposed. I'll start. Dr. Buouie >> I. >> All right. Sherry Suelski. >> I. >> Diana Gutierrez. >> I >> Amitrius Sydney. >> I >> Jeff Abear. I >> Jennifer Kenton >> I >> Dr. Rafa Yuan. >> Hi >> Lan. Nuen >> I >> Joe Sullivan. >> I >> Terry Galvin >> I >> Jamila Fields >> I. >> Thank you. The vote is unanimous. Therefore, the resolution succeeds and we will adopt that as our course of action and put it on the agenda for the next meeting. Thank you. Um, okay. Any further updates from the interface working group? >> No. Thank you. >> All right. Uh, we will move on then to the next working group. This is the accessibility and equal access working group. Is there an update from that working

077group? >> Yes. Um this is on to Bu. I'll go first and then I'll hand it over to my co-chair Dr. Rafleon. Um the accessibility and equitable access working group did meet on October 20th. We reviewed the draft 911988 transfer and provided written feedback to the chair of the interface working group as well as the chair of this board. Um, another item that we discussed at the last working group was on the use of augmentative alternative communication. Um and um working group members had wondered how people using those um technology were contacting 911 or 988 and whether we have any kind of resource or guidance for how crisis counselors or dispatchers interact with um um say someone would um intellectually of disorder using augmentative alternative communication uh and what kind of um training crisis counselors

078or dispatchers might need in order to interact with caregivers of um of people who need such technology. I think that's at a high level. Um I do know maybe Dr. Raf Lyon, you might have some comments about what we've been working on in the working group. >> Yes. Um one other thing that I would add is there's been a request from the the working group. We have a number of new members at this point um to better understand the the capabilities including what type of categories of data that the CRM um will be including going forward. In the past, I think perhaps Kurt and or NGA partners had been able to provide a preview of what the interface would look like as well as what those categories were. So at this point, I know it's

079it's been a number of months since since we had that presentation. So the CRM may have have evolved and even if it's still the same, we have a request from our working group members to better under our new members to better understand that the CRM. Yeah, we'll take that as an action item to put on the agenda for next time um to be able to offer that uh preview slash walkth through of of what data elements would be included in there. Thank you for that. All right. Um, any questions or comments from the board on the on the report out from the accessibility and equal access working group? All right. Thank you. Um, seeing none, we'll move on to uh the third working group. This is the 988 consortium working group. And is there an

080update from that working group for the board? >> Yes, I can provide an update. Point of clarification, it is actually the um implementation working group and while we have center representation, we also have a PAP um participant and Callowas obviously is a partner in that and it is a implementation working group and our purpose is to operationalize and track the ch the stages of implementation for the United um unified platform and the CRM system for the crisis centers. So we are an active group and we met both in September and October. We were scheduled to meet in November but we did not have Callowas representation and the meeting is held by Callowas so we were not able to meet um and we didn't know the meeting was canceled but we were prepared to meet. Um

081we would I we spent the last several months understanding the equipment needs of the center and the process by which we are um meeting our technology needs. Currently there is about $45,000 in identified technology needs and outstanding expenditures that have been identified. about $70,000 of that has made its way through the current process um and is waiting for final for an actual reimbursement for final reimbursement. Um the process was formalized this past spring and several centers began the process um around the May time frame. Um we know that about three centers have been unable to submit requests because it's unclear how long the process will take from the initial request to reimbursement. Um we have a variety of size of center and their ability to um make this type of expense have this kind of

082expense outstanding um varies between our centers. Um, so that has led us to wonder if this is the best process for all of the centers to meet our technology needs. That's something we wanted to bring to the board, whether the current process um adequately meets our needs. >> And by process, you're specifically the process for reimbursement. >> The the the Callowas process, the entire process. Yes. from um initial um requests through the Callowas process of of documentation and approval and purchase and final approval and then eventual reimbursement which we don't yet know. So we none of us can say this process takes 180 days because nobody's yet been reimbursed. >> May I ask a clarifying question? Sure. One of the members of the public, I believe it was from Alama, mentioned a reimbursement delay issue.

083Is this the same issue? >> This is Yes, we will are talking about the same process. >> Um, so I will tell you, um, I've written that down as something that we certainly are going to go back and and look into. Um, but I I appreciate the relationship between the two. >> Okay. Um, I think that we as as a working group, I'm wondering about next next steps as far as understanding um what may be next to continue to partner and discuss the center needs. So, um, the process itself is, you're only partly clear on what that is because the second half of the process, the part where the reimbursement happens, hasn't happened yet. >> So, I well, let I think we understand what the pro I think Kurt has and and his team has

084done a great job of explaining all of the steps in the process. >> Okay. What we're not clear on is how long each step might take. >> Okay. >> And then we haven't had a successful reimbursement to be able to say to the consortium, this is start to finish what this looks like. So our other centers who are on the fence and we all have technology needs. Everything you've heard today is about all of the the growth that we have. Um so there's a lot of need. Um, so just kind of the clarity of right, >> this is the process. >> This is the timeline I said I I should say because the process has been made very clear. Curtis has done a great job. >> So I can I can say um I guess

085what I'm hearing my my takeaway from this is not just um you know sharing with folks what the process is, but what I'm interested is if there's opportunities for process improvements. Processes, governmental processes always take longer than I would like. Um, and I'm sure Kurt and Paul have done a wonderful job, but um, I also want to kind of put our our um, our headquarters team on this to see if there's something that we can do to shave off some time. Um, so I'm taking that and we have the deputy director of administration sitting out in the audience and then we'll get together with Kurt and um, but that's we should be able to articulate that to folks. So I think that that's that's on us. >> Okay. I think >> I appreciate hearing that,

086Lisa. I think it has been a struggle for many of the centers and it's not just about, oh, you're we're owed a little bit of money. This is for equipment that's needed for counselors to take 988 calls. And so, you know, when centers can't purchase those that equipment or when they're having to pay those expenses out of pocket and not get reimbursed, it causes a lot of challenges. And and I think um I I think I mean I haven't discussed this with Kurt yet, but I'm hoping that we have data, right, that would give us a sense of how long these centers are having to float, right? Because that's certainly not the intention here. So that will play into kind of the sense of urgency to come up with a process. >> Yeah. If you

087all don't have it, I'm sure we can help you guys to to put that together. >> I'm kind of looking for eye contact with Kirk. So, so we'll make sure that we have what we need to kind of lock something down. >> I I just want to add that because you know we learned that among the 11 centers each center has different capacities and so on while some s for some larger center may be able to wait for three or four months for reimbursement other smaller center might not have that ability to wait for three four months for for reimbursement. So because of that I think even though the the state might has its own timeline about how how long do they have that they have to reimburse three months or whatever you know um

088smaller center might have that three months. Yeah sure. >> Thank you. No. >> So, this is an item we'll continue to be in our implementation workg group and discuss and and even maybe take a look at whether or not there's a different way entirely for us to meet our technology needs and the reimbursements from the partnerships. >> Yeah, that sounds reasonable. And and you can expect that we'll have some uh new information to share uh on that point as we circle back up and and get it figured out amongst ourselves here. um we can see to the chief deputy director's point if there are opportunities there to improve the experience if not the process. So >> Thank you for that. >> That concludes my report. >> All right. Thank you. Any other comments from the

089board on on the uh implementation working groups uh report out? I'm going to go ahead and respond to the uh option of adding additional folks to the working groups. We're going to go with our previous advice and stick to our rule of two for bagley purposes um so that no additional uh implications may be made under the law. >> Okay. So then is there an opportunity for people to submit their thoughts at least to those two? Thank you for for bringing that up. Yes, absolutely. Um, anyone can bring their thoughts to the working groups. You can email the uh any information to the emails that are listed on our agenda just like you would public comment and it can be routed to each working group. Any member of this board can submit >> comments, questions,

090anything like that to the working group. Um, you can do it in you can submit your questions in this meeting. um or you can also have them routed through um staff. >> Thank you for that clarification. So, uh what that means then is we can't add additional members to the group, but they can participate still by having that input into the deliberations of the work group. So, I hope that at least addresses the desire to partake in the discussion if not in a large format uh group setting. So, >> sure. Thank you. I'll let my chief medical officer know. >> All right. Thank you. >> Um Okay. Uh the the fourth working group um or the fourth item under the working groups is um >> Okay, I'll allow it. Step to the microphone, please. >>

091Yeah. Okay, green light on. >> Okay. Uh, hello. My name is Bill McCabe. I am the CEO of Family Service Agency and we provide 988 uh crisis line services to Santa Cruz, Monterey, and San Bonito counties. We've been doing it for 23 years. And the vast history of uh what that looked like is we had somewhere between 67 and 1.25 staff that organized about 20 volunteers and we scraped together 5 $10,000 to make it work. The SAMA money, the tax dollars, this is a tremendous achievement. I just want to say the amount of services happen now is it's amazing. And so everybody in this room, even though I'm here to argue about things that aren't working, that what is working is truly incredible. So, uh, great work everyone. Um, I'm here to kind of build

092on Terry's comments and talk about the reimbursement process. Um, for those of you who don't know how the business works for a 988 center, we work with the Department of Healthc Care Services and we have a large contract that pays everything we do. In their wisdom, they contract an outside party to reimburse us. Every month, we send them a bill, which is what we spend. And about their tremendous AHP, shout out to them. And then they pay us that money, which gives us the money back for what we spend. And it actually works. And we can pay our employees and our rent and everything. Except for a couple years ago it was decided that one line item a significant one our technology specifically our computers would go through a separate process. So DHCS said, "No,

093you can't bill us for that. You have to build Caloes." And so very early on, and it this isn't a new thing. This has been going on for over two years. There was initial draft of a process. It was rolled out as the process. It was pulled back. There was a second draft that was pulled back. Then there was an agreement that NGA would actually buy all our equipment for us. We made these big Christmas lists, sent all that out. months later we were told actually that's not the case and so the current um version you know has been in development for a while. So very early on we were like hey we got to get our money that you know we have to be on this we studied it. I've literally been on the

094phone with Kirk for hours and hours over the last two years and we were trying to get preapproval over two years ago. I think about 27 months I went into the history uh so that we could buy four desktops and five laptops. Uh 6 months later it was clear that we couldn't get the preapproval but we were clearly told that we wouldn't get reimbursed by DHCS. So we went ahead and on Amazon bought $7,900 worth of equipment. On and on it kind of goes. Finally we got to the updated one. Uh Kurt knows that we've been talking about this for a long time. It became my personal mission just for the sport of it to try to get this money. Um and we basically we were told, "Oh, well, you got the you got this.

095We we'll cover you." Kind of like grandfathered in. So we were bypassed the approval. Well, it took four months to actually confirm that. And we were actually the first call center to get approved. Um, we pull you, sir, I'm gonna ask you to truncate your remarks if you will, please. >> All right. Sorry, I get caught up in the story. Uh, short version is, uh, none of the call centers have received any money. Two of them have been approved to. We were approved on 71 the first time for money that has already been expensed two fiscal years ago, supplemented by our donors who would be heartbroken to know that they're supplementing the California government. Um, I asked uh Renee, "Hey, who do I harass now that you've approved it?" No, no, harassed nobody. Four and

096a half months later after our approval, I was like, "Well, what's the deal?" As it was explained to me that the check has to be signed by many people and it's mailed from place to place to place to place and that it will come sometime. So, I just in terms of the data, nobody's ever been paid for any of their technology. What's really going on is people are finding ways to kind of hide that and pay for it in some way um because it's not on board. And we really want to recommend that uh kind of underline what Terry is saying is that really a different process or if there's some way this money could go through DHCS as well. It's just not working. I understand your system set up to allocate millions of dollars

097and so me trying to get my 7900 isn't working. So anyway, thank you for your time and hearing that. Um >> yeah, appreciate it. Yeah, thank you. That sounds like a a concrete example of uh I think what was being described in the workg groupoup report out. So, uh that sort of paints a picture for us of what it's like uh out at one of the uh one of the actual locations. So, thank you, sir. Um okay, so discussion of the of working groups that are needed. And so, I'm going to uh open to the board members here. Um it are there work groups that you have identified that we don't have that we could use for a specific purpose? Um that's sort of the idea here. So, uh, >> I think on that part,

098um, I think the next the next item on the agenda, we're going to talk about the rate setting methodology and then I'll talk a little bit about that. Um, I'm not sure that this is the body where that should be done since we don't alloc we don't determine funding um for that's that's allocated, but I might hand it over to Dr. Buouie from HHS. I don't know if you disagree with me or Dr. Buoie. So, the HHS agency um the HHS agency and DHCS they set the appropriations. So, those determinations are made there. But I'm gonna why don't we revisit this after I make my opening comments on on the next item. >> Right. >> Thank you. >> Uh could I make one clarification? Uh we don't set appropriations. That's the Department of Finance. We

099make requests um for >> Well, I should correct myself. You don't set it, but you there's um I will speak to when I get to the next item. I'm going to talk about the budget process. >> Perfect. Um okay so other work groups that the board members have identified are there any on this side? Any comment on that? Any other comments on work groups from this side? No. Okay. Thank you. So that would then wrap up uh agenda item number five the working group reports. Um we will then advance in our agenda to agenda item number six which is the 988 searchcharge rate setting. Um, I'm going to ask uh Eric Swanson, who's the deputy director of finance and logistics administration at Callowas. >> Okay. The person for public comment online, three minutes uh to

100lodge your public comment. Please proceed. Hi. Yes, I'm Van Hadwall, the director of San Francisco Suicide Prevention Felton Institute and um um just a comment about tracking the implementation of the platform has been very challenging. Only one center is testing the platform despite several years of us all providing feedback about the needs. Um there are many outstanding questions about the platform and how it will meet our current and future needs. Sometimes we hear from OES that you know 988 senders the need isn't the current scope of possibly the work that NGA is currently doing. Um despite the fact that Calo OAS first introduced the unified platform, they pledged to work collaboratively with the centers to develop such an outstanding product that all centers would want to use it. Um can we have a reconciliation of

101all of the requested items compared to what the current buildout includes? Also, um when will the platform scope of work or contract be re-evaluated? And importantly, will this be a public process that contractors besides NGA 911 can bid on? Will other platforms that already work for 988 in other states or currently now here in this state which are free from the national administration of 988 be truly fairly considered? How will the new platform take into consideration advances that have been made since initial requirements were collected three years ago? other platforms have made significant gains since the centers provided input um three years ago. Thank you. >> Thank you. All right. Now, uh yeah, back to uh the current agenda item, search charge rate setting. I've asked the deputy director of finance and logistics to join

102us at the at the table and I'll start off with the chief deputy director and the opening remarks for this topic. Thank you. Um, so much of the public comment was made relevant to this particular item. So, um, before, um, our deputy director of administration kind of goes into how the rate is set, I want to speak more directly, I I'm always trying to listen to try to understand the problem. And as I understand the issue, the issue is about a concern of the level of resources being allocated out to these crisis centers. Um, I know Dr. Buouie is here on behalf of California Health and Human Services Agency and also, you know, DHCS is nested under that agency. So, you've got the key people here that need to hear that. Um, I will go

103back. I'm sure she will report back. I will also reach out at my level to make sure that the HHS folks kind of have heard your public comment. um you're talking to us at the right time at to the state as you are aware because we're developing the budget right every fall the state budget is under development the presentation and the agenda item is about how the rate is developed and so we're going to walk through that but I want to make clear that the rate is developed that it the the level of the rate is a function of the appropriation level. So why does that matter? As he walks through kind of the granular detail, the rate setting is really on the back end after the funding level is determined. And so we want

104to hear you. It's important to be here and have these conversations, but I just want to make sure that that's clear so that you are informed as you're having all these conversations. I do think that we need to be doing a better job at Callowas in making sure that there's transparency on how this rate is set. Um, we are working and I would expect probably within the next week we're going to post online. Um, and and it's probably I think this presentation is responsive and it's and it's going to provide the information, but thinking about but we're going to put something that's a little more public friendly that kind of warmly walks somebody through with some narrative about this process. But that piece is really important the appropriation and so I'm not going to I'm

105not going to pretend that you know you folks are doing important thing. You're not living in state budgeting and appropriation world, right? The appropriation for this program and every program in the state is decided when the the the H for this particular program, our friends at the HHS agency and DHCS are working, I'm sure, with stakeholders. They're going to make a proposal. It's adjudicated with just like every program. It's adjudicated within the executive branch. the governor typically January 10th will be proposing govern uh governor Nuome's budget on January 10th that will be discussed as part of the normal budget process with both the assembly the senate they will make um proposed changes and vote on changes to the governor's proposed budget and then that budget will go before um will go for a vote and

106then go back to the governor and be enacted by July 1st. That sets the appropriation. We don't even start um calculating the rate until we know what that appropriation is. So why this is important is I want to make sure that the timeline is is is that he's going to describe. I want to un underscore the timeline that the rate that's set per statute is based on this appropriation. So, we don't act until we get that appropriation in July. And then I will let him kind of walk through the rest of it. But I I think that that's very key. And in terms of coordination, I want you to know that um we work very closely with the leadership of HHS, um the Department of Finance, um and we we we don't weigh in on

107the funding levels for the crisis centers. we are on the back end in support of the appropriation. So, um, with that, I think I'm going to hand it over. This is the deputy director of administration for Callowas. Um, and then I think I'll help you underscore a couple of of points. Um, and then I think I will when we post, we will post and we will make sure that our partners at the HHS that the HHS agency is comfortable with kind of how of what we're going to put on the website, but we anticipate in doing that within the next week. Okay. All right. With that, Deputy Director Swanson >> on here. There we go. Uh I'm Eric Swanson, deputy director of finance and logistics administration and uh as you know uh the 988 uh

108program is funded through the state suicide and behavioral crisis services fund and um that is uh the revenue for that fund is a monthly search charge on phone connections be it um landlines, cell phones or what other any other kind of uh uh phone line. Um, Callowes uses a process stat set set in statute to determine the search charge rates for both the 911 and 988 system. The methodology takes the approved expenditures included in the final budget act and subtracts any fund balance remaining from the prior year to get the amount needed to be collected in revenue. Callowas then takes the number of phone lines submitted by the phone providers and multiplies it by the proposed search charge adjusting the search charge until the amount of revenue generated is sufficient to cover the amount of

109revenue needed. We identify a sufficient fund balance and generally uh when we've talked to the department of finance that's about 10% of annual expenditures and we adjust the search charge to cover that needed balance. The expenditures approved in the annual budget are the basis for the searchcharge calculation methodology. This methodology does not take into account any proposed program augmentations that have not been approved through the state's budget process. Once a program augmentation has been approved in the state budget, which is starting July 1st, the newly approved expenditure amount will be used to adjust the monthly search charge starting in the next calendar year, January 1st of the next calendar year. and any fund balance will carry over to the next year from the fund condition statement and be used to adjust next year's rate. Steve,

110if you want to. So, this is sort of the calculation we used using those uh the data I just described to come up with the uh search charge for uh calendar year 2026. But if you want to advance the next slide, I can show you. Uh this is the actual uh fund condition statement which is on the department of financ's website. Uh with each update of the budget including the final budget act, we use the data elements I described uh to come to use to come up with this methodology to come up with the search charge amount. >> Can I just add here? So this is a public document. every every every special fund in the state of California has a fund condition. And so when the governor's budget is released in January, what you're

111going to see is those fiscal years at the top change. It'll be 2425 um 2526 and then 2627 in that right-hand column. That 2627 is what's being developed right now right within the executive branch. So the that will be a fund condition based on whatever um if there is whatever the approposed appropriation level is in the governor's budget for this program that fund condition will reflect that. >> Right. And if you as you can see, it's pretty hard to see on the screen there, but uh if you uh they each of the departments that spend out of this fund has an appropriation level that's listed below u from the final budget act. Um but let me take a minute to uh talk a little bit about Caloes um expenditures in this area. Um if we

112can turn to the next slide here, Steve. So under current law, Callowas is responsible for the call handling equipment system of the 988 system. We've implemented a system that is designed to provide software for cloudnative call processing equipment for the 11 Lifeline crisis centers in California. And this technology supports interoperability between 988 and 911. Callowas has 14 positions responsible for 988 integration and support. Um, as you can see from this chart, our spending has been significantly less than authorized on the state budget for 988 implementation, but any amounts not spent from the approved budget are returned to the fund and made available for future program spending and the leftover funding appears as a fund balance when we uh set the next uh 988 search charge. Uh we are working with the department of finance to

113uh look at our budget level authority going forward. There's a lot that's still to do in this area. So we need to account for that. But we also our spending has been less than uh what we were previously anticipating as well. >> Although on this part let me just kind of underscore. So the fund condition that we just went through is is is more about it's the budget, right? These are actual expenditures. So I just am going to kind of underscore with what um Eric just shared. I think the key thing here is that these are actual expenditures. And so as part of the normal budget process this year, we are having conversations about is should we change our appropriation level? Um so we're taking a look at what we anticipate our expenditures are going

114to be for the next fiscal year and if necessary we may adjust that appropriation amount. Now that won't affect the rates because currently that that column all the way all the way to the right is the difference. So that's the amount of money funds that were returned to the fund because they were unspent not returned to Callowas to spend for other things but returned to the fund and it contributed to a fund balance in the fund which then played into the reduction for the need for a rate increase. So while kind of taking a look at our appropriation and if we decide that that we need to reduce our appropriation, it will have no bearing on the rain, but it's just a good governance thing to do. And so um I think we've been at

115this for a few years. We have a better sense of what the appropriation level will be. But that's not something that we do just within Callowas. That would be um a budget action probably. It would require you know uh the public budget action and discussion with the legislature and adoption is part of the July 1st. So part of the normal budget process. Uh I'm not an expert on the um spending on the um the expenditure authority on the health side, but I did want to note that uh um our friends at DHS were started off with a 20 million SAMA mental health block grant as a one-time investment for 988 network capacity building and then they received a SAMA grant and then uh DHS was uh awarded 4 million for local assistance and a one-time

116allocation for 15 million in 2023 24. In 2024-25, there was an annual allocation of about 12 a.5 million for local assistance for the state suicide and behavioral health crisis service fund. And then um last year on a one-time basis there was a um a proposal for 17 and a half million that was uh braided with other funding sources to meet the staffing and operational needs of the 988 centers including SAMA funds and community mental health grant set aides and any future needs as Lisa said any future needs of the program will go through the state's budget process and approved resources will be factored into the next uh search charge. allocation and I apologize it's hard to talk about methodology uh in the middle of a uh task force meeting but uh um appreciate the time

117to talk about that a little bit. >> Dr. Buoie, was there I know that we kind of covered the health and human services and DHCS budget piece. Is there anything that you wanted to add to that? >> Th those were covered already. Thank you. >> Okay, great. Thank you. Right. >> Any questions from the board on that presentation? >> Yes, Mr. Nwin. >> Uh, thank you for the explanation. Uh, it helps us understand more about the um the appropriation process as well as the the difference how that's going to be um reallocated if you will. Um I mean as and this is very high level high level presentation which we appreciate but for those of us who would like to understand a bit more is there um in the future for presentation is there a

118way to be be able to have a broken down for example under total expenditure how the money is being allocated or spent and so on so that we understand more about the operation side. Would that be possible? >> I think we we can do that. Are you talking about um are you're talking about the entire fund and >> for example you know uh in uh fiscal in year 2025 you have to total expenditure like 3 million something like yeah so probably help us understand more about you know how >> the broken down of how that was being spent and things like that. Mhm. >> Yeah, I think we can do that. And one thing to noted that 2025 year is a little bit skewed because we've we're just starting the year. So it doesn't reflect

119a full year of spending yet. >> I have a comment or question actually. Um so I I see and I think that um it was mentioned that there's you there's been under spending um from Callowas and we've had so many questions about the platform and the development of the platform and what will be included um and whether or not there it should be some revision or looking at the existing statement of work and whether what we've planned for three years ago is meeting what we're going to need this next year. And I'm just curious. Um, it seems that there's certainly money for us to have these conversations and make sure we're ending up with the platform that we really need today. Um, and I I've had a hard time. I came in after this process

120had already started. I've been here about two years. Um, but the process predates me, but really trying to understand whether or not um, one we're going to get the product we want. and it seems if it is a matter of funding, there is certainly funding available for us to be very current. So, I would like a little more clarity on that. >> I I'll I'll take a crack at that. Um, yes, the lack of funding has not been an issue. Um if we as we're developing the the budget right now for the the governor's budget for January, if as part of this process, we think that there needs to be a change that might increase the need for funding, then that would be reflected in the Jan in the January or possibly spring budget proposal,

121but that would be a discussion item. I think our commitment to you is that um the next meeting is in February. the next meeting in February, there will at that point be a public governor's budget proposal and we can come back and make sure that this is an agenda item so we can talk about what the proposal is for the fund and what that includes relative to program imple implementation. Uh okay. Um, will we be looking is there a a place where we can look at the current contract that we have for the platform and understand whether or not as it's written or as it's funded or or where we're at with it is going to meet our needs. >> Yeah. Well, the the contract uh as with all contracts is is a public document

122and available uh I think on uh a website, a government website. We can get that information to you. Um likewise, we have a copy of the document that uh Kurt I think can share um to go over what the statement of work is in there. And specifically, I think your point is the technical requirements. Um, so yeah, that's not uh proprietary or secret information. I think what we'll find is that it probably is a summary of what all of the business requirements were through that process where they were gathered. As I understand, there was a a period of time where the team went and had conversations with each of the areas to gather what the need was so that we could then write the statement of work to match that need. So that's my expectation

123of what has happened. um when it comes to you know I think the question was raised earlier does that still match what is currently needed and you know updating a statement of work for a contract that's in flight right now is a challenge you there's an amendment process obviously that needs to go on so some thought would need to go into that but it's not impossible and so the idea here is that we should be collecting requirements based on the technologies that are available now and the needs that are out in the operating theater. Um, and those two should match up. As the needs change or the technology changes, then that opportunity to revisit and amend um is is available for that purpose. uh which I think leads me to another point in all of

124this and it kind of aligns with a conversation we were having earlier about the fact that there really is no finish line to a lot of these things. Technology is one of these areas where it is ever changing. And so even if we produced and delivered a product today, that would just mean that we immediately begin to figure out what gaps still remain and what should be in the follow on to that. So that because there will always be maintenance and operations of the current system, but if there's new feature development that needs to happen to the system, then that's an ongoing workload that should be done so that we never end up in a situation where we're 10 or 12 years behind what is possible um in what's needed. So my challenge to the

125program here is that we need to make sure that we are a good strategic partner for all of the centers knowing and engaging with them what inputs they have into the need that exists and how that differs from the product we currently have so that we can be responsive to changes in both the actions you all take but then the technology that's available. So, I hope that that's kind of a long- winded uh way of talking about my philosophy on information systems, but I think um it directly ties to what you're asking about. >> It does. One of the things from the working group that um is one of our outstanding agenda items is actually to reconcile all of the feedback that has been provided with what is being delivered um so that we can

126see where we have landed. I think that that's really important and so that is an outstanding agenda item and I think Kurt is helping going to help us with that. >> Right. >> Uh I'd like to make a comment and or perhaps ask some questions. Um first of all Lisa and Steve um I'm sorry I forgot your name. Thank you Eric. Thank you for trying to help us to understand this process. Um you know you said that we're busy doing the work. We're not following what's happening in the state budget. Um we've been trying you know we we have had 988 um for almost four years. It'll be four years next year and we have all been desperately trying to understand this process. Um and we're pretty smart people for the most part and we

127haven't been able to figure it out. Um so I'm going to ask some really pointed and direct questions right now and they're in partnership. You know, I've been doing this work for over 30 years. And so when I ask these questions, I'm not trying to point a finger at anybody. I think everybody's trying to do the best job that they can do. But I've sat on the lines with people who are concerned that their children might try to kill themselves this very moment. They're worried about their friends, their family members. You know, we're in a tough place right now in our country and we know that California is not answering all of the cries for help that are coming into this system. And yet we're watching this situation. It's kind of like who's on first,

128you know, we're watching this situation where more money is going to call from the search charge than is going to the centers. Yet the centers really have not received any benefits of the support of what we're supposed to be getting from Callowas. We still don't have a a a platform. We can't get our money when we're trying to get paid for the technology. When we ask questions like meetings are canceled, people don't show up and we're not really sure where to go. I I hear you saying that you guys aren't in charge of the appropriation. And so then I'm going to ask the larger group maybe on two or others, well, who is in charge? Because who would make a decision to not give money to support people in crisis when money is sitting there

129for a technology that's not even being used? I just I don't know how to put all this together in my mind. And so I'd love someone to help me through this. >> So before I hand it over to Dr. Buoie, let me kind of take a crack at this. So, um, you're talking, you know, this is an issue to be passionate about. You've got two state agencies here. You've got Callowas, you've got the Health and Human Services Agency. So, you've got the two right agencies. Callowes merely sets the rate. I think making sure that folks are informed and understand the funding pressures is is an important thing to do particularly this time of year as the budget is being developed. So, so that part is is key. Um, but I you asked something specific. I've

130just kind of blanked on your specific question. You had a specific question. >> I guess what I'm asking specifically >> I I remember. I'm sorry. You asked specifically. you were kind of talking about who make I think what I'm understanding the question to be is who makes these decisions about how much goes to each of the agencies. Can you pull that fund condition up please or can you go back to the fund condition? So, so here's the fund. And so these state agencies, the Health and Human Services, um, Callowes, Healthc Care Services, um, I'm using the wrong glasses, uh, tax and fee. So, those are the folks, um, and those amounts are determined by that state budget on July 1st. So when you talk about who that will be which agency gets which amount of

131funding will be proposed as part of that January budget. It's not finalized and becoming a part of the budget act until July 1st. So that's very intentional and and why I say that you know um people build whole careers on learning the state budget right. So, so I don't expect anybody here to be state budget experts. So, that's why I want to kind of make these points here, right? So, the governor's budget will make a proposal. It'll be discussed before both houses and I assume people um stakeholders will be engaged through that process. And on July 1st, that budget act will be very specific about how much funding comes out of this fund for each agency. Does that answer your question? And and the reason that you see me kind of, you know, making sure

132that I'm deferring a bit to Dr. Buouie so she can speak. The Health and Human Services Agency is the agency under which the delivery of the of the services, the people's side of this and how how funding is allocated through their appropriation out to the service centers. So I don't want to speak for them. Um but but there's a difference between our the our HHS friends as far as being a state agency being part of this board and then also Callas is also a state agency. So we are part of kind of that that state budget process. Is is that helpful? >> Yes and no. I mean I I I'm understanding the process a little bit more. I I'm still unclear. I think I hear you pointing to the next budget cycle and yet >>

133for me I'm wondering we've been saying this for years. Yes. >> And so I guess I'm still uncertain how or why we're even at this place right now. >> Um and and just not clear, you know, we're putting a lot of pressure on you right now because it's the only place that we know to go with our voice. And so if and we've been trying to do that for years. That pressure is not working. So, we need to figure out where we do need to go. And I guess I'm I'm just not sure how or why this message hasn't been heard up until now. >> Um I think you're I I would encourage you to just keep being part of the communication process as a stakeholder. Um particularly the program. I can't speak to you

134know I'm definitely talking our rate is kind of for the the go forward. Um but I think what you folks are also really interested in is the development of the current budget. Right. >> In terms of of why you feel that um that that whatever communication you've had hasn't yield yielded your desired result. I I don't know. I can't I can't speak to that. But hopefully kind of describing the process and all of the key points help you feel informed on on how you can be more impactful in in that process. >> Um and we will also um go back and you know it's our intent to have kind of this more thoughtful conversation about how the rate is set and we will take this and think think about that. I hopefully putting our methodology

135on the website is also helpful. Um, but I thought that it was important to make sure that we're not just answering the question or speaking specifically to the agenda item and asking the question answering the question that was asked, but really kind of speaking to kind of the broader issue um that stakeholders have raised about the desire for funding. >> I could offer some clarification. I'm still learning about the state budget process uh four years now into the state. So it is uh difficult to understand but one thing I do want to highlight uh and thank you Eric for explaining some of the uh items. Um so while July 2022 was the implementation of 988 nationwide um DHCS has historically been the department at the state that has helped fund the 98 uh well previously

136called the national suicide prevention lifeline um for several years um through primarily the mental health services act about 4 million a year but there's also been other bra funding that the state has braided to support the 98 centers and I as I understand Local 98 centers have also braided a variety of sources of funding. So one of the key thing about AB98A is that it's the beginning of the state stepping up to have a dedicated source of funding to support 98A as well as related mobile crisis services. So I think that's a really great step in the right direction, but I suspect it's going to take us some time to get there and find out what is the right thing to do because we're doing both things. Um we are we DHCS designated mental health

137block grant money 20 million as Eric mentioned but uh also 14.4 million from SAMA and then subsequently got a three-year grant of 20 million per year from SAMA which is ending. So the key part to understand is that federal funding is starting to end as well as changes coming from the county funding process because of other kinds of state behavioral health initiatives that are coming up. Um, so I think we're in a place where the state has to sit down and and evaluate where we are at with the system and what are the needs. Um, one of the nice things I'm learning about is that it's not just a Jan budget, but there's a May revise process that allows us to take into account what we didn't account for. So in those two years that

138you can see in 23 and 24 the 19 million was from a May revise process cuz for that fiscal year DHCS was allocated 4 million only for local assistance to the 98 center but because it was seen that we needed more money the may reise um provided a one-time 15 million allocation to make sure everything you know is made whole for that year. Um right now there is an ongoing allocation annually of 12.5 million uh for local assistance for DHCS to go to the 98 center. So there was an additional May revise that was done. Oh well I guess it was just this year but it feels like my goodness a lot of work goes into this. So uh we got an additional 17.5 million one-time allocation again to make whole but that's not the

139entire budget to support 98 centers. CHCS was also able to pull from community mental health block grant crisis set aside in order to meet the funding needs that is being seen. So there's lots of things that we're constantly doing and at this point DHCS has reported to me that we have currently adequate funding for this fiscal year knowing of course there's constant increasing volume right because of natural awareness and public awareness 98 as well as um changing funding needs. So, we've got the Jan budget come up, but we also have a May revise coming up so that we can constantly look at what the needs are and and make sure that we meet every need during the fiscal year. >> Dr. Buoie, you opened by saying that you're not a budget expert and you've only

140been doing this for four years, but you pointed out something very important that I failed to point out. So let me underscore what what she's saying here is that let me this fund condition is only for the state suicide and behavioral health crisis fund. So any it doesn't give you a comprehensive view of the funding that's provided for the centers. It's only this particular fund because it's the fund that that Callowas adjusts the rate for. So, um, so it doesn't give you the full funding, but, um, thank you for Dr. Buoie for clarifying that. >> Uh, good discussion. I I just had one question and I think maybe Dr. Buoie, it might it might go to you actually is so we're here in the technical advisory board, but there's also a counterpart uh set of

141meetings that happen that uh HHS sponsors and I think could you talk a little bit about that and how it would pertain to the programmatic areas. So that's the January and uh I think it's coming up January and April. So maybe that would just help paint the picture a little bit more. >> Um yeah, so let's see. Uh as many of you have participated um uh CO HHS had a 988 crisis um policy advisory group which made recommendations toward a 5-year implementation plan uh which we then submitted to the state legislature earlier this year in January. uh COH HHS plans to reconvene the policy advisory group um January 28th and April 29th uh in order to uh continue the work. Um because in addition to submitting the implementation plan, we CO HS has a responsibility

142to report on the progress of AB9A implementation um at least every year. Um so we plan to um uh retain and and uh solicit uh feedback uh as well as input um from all of our community partners and the advisory group um toward that work. >> So look forward to seeing many of you there. >> Thank you. Yes. Um okay. So >> I have one more comment. I'm sorry. So, that was a lot of information and I'm not really sure that we got to a a conclusion that really makes me feel satisfied that we're going to have the needs met of the people in crisis in the state of California. Um, and so I I just want to to just make one more comment, which is that, you know, we know two things. We know

143that we don't have enough to meet the needs of the of the people that are using this service in this very moment. And we know that volume is only going up. We also know that we have a lot of directives from a five-year state plan that we haven't even taken a look at yet. And so it is obvious that more money needs to be put into this system to sustain it. And I know that all the braided funding is complicated, but I just want to go on record saying that what is there is not sufficient. And I'm really concerned. I know it's already been done and I know it's based on appropriations. I've heard that. But I'm really concerned that decreasing a rate sets the public perception. It lets people think that this system is

144fully funded. As a matter of fact, it's so funded that we can lower the rate. And that's not the case. And and I just think that that puts us in a really precarious place um when we're trying to build a system that meets the needs of people in California. >> All right. Thank you for that. Any any comments from the board uh before we close out the agenda item on setting the rates? >> I would just like to uh agree full fully with what Sherry just said from the center perspective. Like to go on record saying we do not feel that we're fully funded or the need is met at all. All right. Thank you. Um, seeing as how we had the public comment period at the beginning of the meeting for the items on

145the agenda, then uh, we're going to move on to the next agenda item. So, thank you. >> Our current agenda reflects that you can make public comment at the beginning of the meeting for items that are on the agenda. We held that public comment period. Many members, especially those that are in this room, made public comment at that time on varying items. So how does one respond to what's being discussed here on an agenda item prior to being discussed now discussed and now public >> okay look I I'll make this point all right is public comment is different than than question and answer session. So I think and I'm and I am sensitive to the fact that historically things have been conducted a certain way. Okay. So what I'll do to bridge this gap is

146I will allow you to make a public comment this time with the understanding that we're not going to operate the meeting the way we have historically done it going forward. So I will concede a point here to allow you to engage in the in the dialogue because that was your expectation, but I want to set the expectation going forward that that isn't always going to be the case. So we'll thank Mr. Swanson for his uh input into the conversation today and we'll have you step up to the microphone. >> I'd also like to point out that you can always submit public comment via email. That's also available in the agenda. Um and that can be circulated to the board members following any discussion just for your information. >> So again, Matt So again, Matt Taylor,

147senior director of crisis line operations at DD Hirs. Uh there is a real problem here. I really appreciate this notion of explaining the funding situation more thoroughly. What is on the screen is the latest fund condition statement. Um, it makes it look like the California Department of Healthcare Services is getting quite a bit of money on this. This is a one-time appropriation from the governor's office, not guaranteed to be sustained. That was for $17.5 million. On the OES website, there are nine, actually 10 uh records of public meetings that have fund condition statements in it. And what you'll see in all those historical fund condition statements is that OES is being allocated more of the AB988 funds as far as a baseline funding starting point than cal than the 988 centers are through DHCS. So

148back to Sherry's question, somebody is making a decision somewhere that at a baseline starting point OES gets more 988 searchcharge funds revenues than the 988 centers do. That's a problem. And the only reason why there's excess funds right now is because OES hasn't been able to spend your allocations in in a timely and appropriate manner. So there's a real problem that the public can perceive as Sher said that 988 doesn't need as much money as it as is being allocated. Well, we do. Those of us on the front lines need it. And this also sends a message to the country from California, the largest state with the greatest opportunity to sustain 988 through the funding uh through the searchcharge revenues that 988 is not an expensive service. That is not true. It's a very expensive

149service on the front line. OES shouldn't be at the starting point being allocated more money from baseline funding from the AB988 fees than the centers and DHCS's. So, somebody's making that decision and somebody from OES is submitting a budget on the front end that suggests you need a lot of money. That needs to change. Thank you. Okay, that closes out that agenda item. Um, and we will move on to the next agenda item, which is the Callowas 988 updates. Um, I'll ask uh I'll ask my senior engineer to join me um up to the microphone in the event that we need some technical uh explanations given. But I'll start out by giving some information about how things stand right now. So on the on the projects and in operational review front um start with our

150network uh our system uh with our system vendor uh we've deployed network infrastructure to each of the 11 call centers and that includes backroom server racks and equipment establishing network ingress points connectivity to the network cloud and circuit provisioning to manage traffic across the network that creates sort of a transportation layer for uh data packets associated with a call to be properly routed uh based on where the call is coming from and where it needs to end up. Um and also to establish that connectivity uh so that we could potentially transfer calls to and from the 911 system. um as concerns the call handling system and the uh customer relationship management portion of that through a partnership with our system vendor. We've uh developed the cloud call handling system and relationship management uh framework or

151system rather. And so, uh, these systems provide the ability to manage the client information and document the 988 call interactions for the existing Lifeline crisis centers. Um, this solution is in a 60-day pilot evaluation phase at the Buckaloo Center. And currently, the Buckloo Center is successfully receiving calls um, validating interoperability with the NextG 911 platform. the interface uh process here and then and concerning the interface, the milestones and the statewide contract. And this is really at the heart of the interoperability portion of the discussion. We've validated voice interoperability between the 988 and the 911 systems for legacy 911 system traffic. Uh these calls are transferred through an analog interface and rely on the call taker dialing a 10-digit number to reach the public safety answering point. Next generation 911 call routing has been validated in

152the lab and is currently being evaluated in the live environment at the Buckaloo call center under that 60-day pilot. Now, it's worth noting here that the relationship that allows these calls to come through relies on uh this memorandum of understanding with the substance abuse and mental health services administration. Um and we've been working to establish anou that's the memorandum of understanding um with them. And so recently our legal has been engaged with their staff to work out and put some final touches on a document which we believe will be ready to enter into agreement by the parties. That document getting signed and put in place would open the door to then allow uh onboarding other call centers other than the Buckaloo center which is in a pilot phase. there was a an agreement made where

153for the purposes of a pilot they would allow the transfer of information but beyond a pilot we needed to have thisou in place and so thisou is being worked on and we anticipate that we should be able to reach the finish line on thatou opening the door for the possibility to then expand to other call centers. So, um, that's sort of the status and update from the 988 program here, and I'm happy to, uh, hear your thoughts and and, uh, contributions to that discussion topic from the board member. >> Yeah, I'd like to comment on that. Thank you for the update, Steve. It's helpful. Um you know we had a question earlier about how will the um system take into consideration all the things that may have progressed technologically or otherwise over the last 3

154years. And you know there had been some confusion about this system from the get-go. You know, when it was first proposed, it was proposed with the idea that it was going to be the best system ever and it was going to give us everything we needed to be the best 988 call centers that we could be. Um, we haven't seen a lot of evidence of that. And so, I guess I'm just curious, all of a sudden then it was a requirement that we had to be on the system. Um, and so I guess I'm just curious, how will centers be able to ensure that this system is indeed the best system that um meets all of our needs before we're required to join it? >> Uh, yeah, good question. I am not familiar with the

155requirement part of that statement and so that's going to be something I'm going to have to go back and and familiarize myself with. And and I don't know was that a a a requirement that came out of this office or >> it's it's a it's a good question, Steve, because I think we've had a challenge trying to get a clear answer to that as well. >> Okay. >> Uh I think at times it had been presented that it was a choice. At other times it was presented that it was required. I'm not sure if going on this system is the requirement or just being on a combined system, okay, >> is the requirement. I'm not entirely sure. It looks like maybe on two has some thoughts. I'm not sure. Yeah, you do you have information

156that would help us? >> Yes, I can provide some context knowing of course things have maybe changed and progressed. Um there was a point earlier this year I believe around March or April where Samson and Vibrant reached out to state agencies that's Cal HHS co and DHCS asking for clarification because their understanding in working on this statewide platform from California was that the 98 centers will be required to be on one platform. So we had uh at least one or two meetings with them and we co-developed a document um that said uh what the expectations are of developing this platform and I believe that DHCS and AHP put into the contract and that the nine centers will be using a statewide platform. I can't remember the exact wording but once it is operational or you

157you probably know better than I what it says but um stamps environment really needed that guarantee from the state entities in order to continue with thisou relationship and and piloting the the platform. So that's where we were at back in April with that document. Um but you know all these are kind of you know changing situations. So we may need to revisit and discuss with them again at some point. >> Yeah. Yeah. Thank you for that context. I think you know figuring out where some of these ideas originated and whether or not they have force and effect in in statute or uh something formal like that or if it was just a policy decision that was made on the development of the system. Um, I think you know when we talk about theou and and

158sending calls to a certain location, we certainly have the op the ability to parse out which ones to send and which ones not to route to locations. And I think that's being demonstrated here is that we can say this particular call center wants to have the traffic routed to the statewide system before being handed to them. Um so that at least from a technology standpoint implies to me that it isn't a mandate that all or nothing must go. So, it bears some investigation and I think I'll take that back as an action item to find out on that particular point whether or not that is a requirement um or whether it's just a preference. So, um yeah, and then I mean it it it kind of goes into the whole the whole conversation about what

159the requirements are from a business requirement standpoint or a legislative requirement standpoint. Um, so you know I would want to understand what exactly and again it goes to the point about what's in the contract and so we understand what the the requirements are what's in the contract and what the concept was for representing something as a requirement or a mandate. Um so we'll we'll get that ironed out. But um you know I think there is you know work being done here that while not you know resolving a lot of the issues that are being brought up that you're experiencing already. It hasn't essentially you know made the sweeping change for you that you're anticipating. Um I think work is being and we're advancing on that goal. And so I think that was kind of the

160update I wanted to or at least the thrust of the update was to say, yeah, there is work being done. We're advancing towards the goal. And my commitment to this group is that we're going to continue to advance. And it's my expectation that we will be able to articulate, you know, what our rate of advancement can be expected to be. >> And and also that we're advancing towards a common goal. >> Yeah. Well, yeah. I mean, I I wouldn't I wouldn't want to, you know, substitute my judgment for what actually the experts on the front lines would want. Um, so that that should never, you know, be the case as far as us and our development goes. Um, I wouldn't want to put myself in that spot because I don't think that we're the ones

161who are best suited to answer that question. >> Great. >> Do we expect theou to be signed this year? uh referring to 2025. >> Yes. >> Um it's hard to say. You know, obviously there's, you know, two parties to the agreement. Um I think we're on the precipice of being able to send a a revision back to the other party. Um and how they respond to that is a an open question that I don't think I can answer. But my expectation is that the the obstacles are getting fewer and fewer. I don't think it's out of the realm of possibility that it could be done this year, but I just wouldn't want to commit to it being done this year knowing that I don't have it in my control to make that happen 100%. Um,

162but there there will be more more engagement this year and with the goal of removing what obstacles remain Thank you. >> Yeah. Uh any other comments from the board? >> Is there any timeline for implementation once theou is signed to getting the call handling in the centers? >> So no no there's no specific timeline and I think one of the reasons for that has to do with I don't want the team to be dictating terms to the sites themselves. Um, and so I would suggest that it has to be a discussion in partnership with each of the locations. What makes sense for them? >> When does the contract expire for the call handling that they signed with the state? Isn't it at the end of this year? >> So, yeah, the current contract expires uh

163I New Year's Eve of this year. Um, but the contract has built into it opportunities to extend without having to establish a new contract. And so, >> how will decisions about that be made? >> Well, one of the main driving points of that is to to not allow ourselves to end up in a situation where we're out of contract and have no provider whatsoever. And so, uh, I think having a contract in place is better than not having one in place. And with that in mind, it would seem to suggest that um extending would be a prudent course of action. >> Help me understand why having a contract in place is better than not. >> If we want uh the to evaluate the product and potentially roll it out to other locations, then that would

164need to be done under the contract. And so if it expires, we no longer have the opportunity to deploy it. So I mean it's kind of like you know you you and if you want to deploy the product and evaluate it in places and potentially transition over to that as the as the system um the flagship system in place then it would have to be under the under the terms of a contract. So, from my understanding, kind of the last few months were supposed to be like an informal process of us evaluating the product um to determine whether or not the contract would be extended and if it was meeting our needs. And I'm not aware of what the results of that were >> of the informal evaluation period. >> Yeah, that's what we had

165been told that that you know our work was to provide feedback and to see if this product was the product that we needed. And it's just curious to me that, you know, instead of, you know, taking into consideration the feedback that we've been given and the lack of communication that we've been given about it, that the the um platform in in its current state with the current vendor is just, you know, being extended when we've already experienced challenges with it. And so I I guess I'm just curious um you know if there's a more formal process for us to determine whether or not we might put that out to bid for other vendors. >> Well, extending one contract doesn't mean that you're not that you're foreclosing the possibility of of opening another solicitation to another

166vendor. So, um, you know, for example, if I, you know, am driving my car and I'm with one insurance provider, it doesn't mean that I can't shop for another insurance provider and line up a time where I transition to that other provider. So, um, I don't think that is necessarily an obstacle or showstopper. Um now the in I it sounds like you've provided some input on the current uh provider and from the discussion it sounds like your expectation based on that input that you provided would was that this contract would end and go away. >> No, that wasn't my expectation. I I guess the expectation was that we would provide feedback and then you know have some return information about what was the process going to be the next step going to be and so

167I guess you know I would recommend you know I'd perhaps even make a formal resolution that we have some sort of public process where it's clear to the centers and to everyone how will we make a determination if this system is meeting the needs and and when will we say okay it's not let's do something else or it is. But right now it's been going on for three years and we just keep kind of getting drugged along. >> Um yes please. >> I mean thank you. I I understand totally understand you know there's a contracting process contract management continuing process that oes probably would need to continue or abide by and there's a I guess there is also u a contract eval evaluation process to determine should it continue or should it go to RP

168and then while you know even if we determine that it has to go through an RFP we still need to have this contract in place so that when they turn to release it, there's a continuation of of you know services and things like that and and also I think I sound like there is a a a process where native centers was able to provide input to see whether the curtain vendor or platform is really working or not and have that input being part of the contract evaluation with the curtain vendors and and and so so I I guess that's probably is is a missing part where native centers might not be in form of you know where where we are with that as far as at whether the the input from the center being taking

169into consider into consideration of continuing the contract or not I think that's a missing part and um and you you probably get what I'm talking about so to the extent you can comment on that I think be helpful >> I think you know where it gets to be sticky is with the expiration of the contract coming up and you know where we're at. I mean, we're looking at, you know, three, four weeks um before the expiration happens. And again, I I don't want to end up in a situation where we don't have the ability to use the platform because the contract expired. Um, but we also don't have another one in place. So to me at minimum to mitigate risk of not having the ability to use the platform at all then we have to

170remain in contract at least until we have another one in place another option otherwise we go back to the way things were before the development process started. And so, you know, when you look at it from that vantage point, it's it's not a final decision that we're going to go with this particular product and stick with it forever. And it's just leaving open the possibility while we continue the evaluation process and take the input necessary from the people on the front line who have to be using this system. And if it doesn't meet the needs, then I would expect there to be uh a documentation of where where it falls short and that could then be an input into and inform the process going forward of what shortcomings this system had that a future system

171needs to have. Um or something along those lines. So that's kind of how I I'm viewing it is we want to maintain our options while we continue to evaluate and I see >> so I Oh, go ahead. >> Yeah. >> I'm just wondering how long an extension is and how many times we can extend. >> Okay. Um and then I do want to just mention that there are several centers who have developed platforms in this time frame that um we've been able to preview and they're incredibly happy with it and seems to be meeting a lot of our needs and then we know that Vibrant also has a platform um that they have built out. So, I am I'm just wondering um how to actually kind of move through finding out all of this information,

172not only from our feedback that I I understand has been given very generously for the three years, but comparing it to things that people are using that they really are having a good experience with. Also, is that um the cent's responsibility? Is that um Callowas to help us reconcile all of this? What would the actual steps be? But first, how many times can we extend? >> Yeah. So, the number of times possible to extend under this current contract is two. Each of those extensions is valid for two years. So, there's four years of runway in front of us. Uh should we elect to exercise both options? Um in terms of how do we evaluate the need? So you know in in prior life I would employ the services of what's called a business analyst to

173gather and compile use cases and uh you know user experiences to inform what the system would require. It sounds like there's other options available um that don't require us to actually engage with any vendor to develop them because they exist in the in the marketplace right now. And so comparing a homegrown developed solution with solutions that are available on the open market is something that you know finding out all of the business requirements from the frontline users and comparing that with the options that are available. And if none of them are a good enough fit for that set of requirements, then you build something custom to address all of those requirements. If, and I don't know if this is what I'm hearing, but it it's entirely possible that there's a solution available off the shelf

174somewhere that um would meet the needs of some or all of the centers. And if that's the case, I mean that to me is one argument why a mandated solution doesn't make sense is why would we constrain people from choice if the outcome is they're getting something that has fewer features or ease of use than what they could get by buying a commercially available off-the-shelf product. So all of that taken together sounds to me like we're not at a place to be able to come to a final decision on what the course should be. There's more work that would need to go in that which I think is a second part of your question. So how do we do that? Well, I I would suggest that it's probably a workg group that would need to

175be convened to evaluate what the offerings on the market are and compare those with the features and functionality that serve as the business requirements for the end users who will be using the product. And so once that comparison is made then a recommendation could be made that you know here are three that make sense um and you know a center is is is able to choose from among those and um it looks like your finger is on the button. >> Yeah. Yeah. I I just have a clarification question. So, so we talk about these that there's two-year extensions. Um, but a two-year extension doesn't require that that that we are with a vendor for 2 years there. I'm assuming that there's likely a 30-day clause. So, that if if we want to change um change

176paths, we can do that well before the two years. >> Yes, that's correct. And uh thank you for raising that nuance of of procurement and contracting. Um, yes, there's always an opportunity. It doesn't mean you're locked in for that two-year or fouryear period of time. There's an opportunity to then pivot. And that's I think kind of what I was alluding to with my analogy to car insurance is is I can always shop for a better product and you know give notice to my current uh supplier and switch to another one that makes more sense particularly if the one that I have right now isn't providing the features and functionality that I've determined that I need because the marketplace always lags a little bit behind what technology is available. So >> yeah. So, I I'd just

177like to go back to the mo the motion that I previously mentioned, which is that I think we need to create a defined process that does not go for two years. Um, a five-year runway for a system is a very long and ridiculous runway. And and so I I would like to propose that perhaps in the next three months, we convene this group, this interactive group where we're looking at all of the options and making a decision what is going to happen with this platform. So I I hear that motion and as I understand it, it is evaluating features and functionality as well as determining on what basis we will render a decision >> as to whether something suits the purpose or not. >> Yes. >> Right. And so the motion as I understand it

178would be over the the next three months we would convene perform the analysis and have that work group report out to us of the findings from that which would essentially take the form of here is a proposed way of evaluating and making a determination. >> Yes. >> Okay. I have a procedural question. Do we need a second before we can have a comment on that? >> Yes. >> I I'll second that motion. >> All right. We have a motion on the table. >> And then I have a comment. Might Callowas be able to hire that person that you said that you I I don't remember the position you said, but in general, you said there's a position. Yes. To do that for us >> or or work with us. >> Yeah, I will definitely investigate

179that point. Um I I'm not aware of something right now that says yes or no, but more importantly I don't see something that is a complete showstopper on that. So um that's an action item that we'll take back. Um and you know I think we're happy to help obviously with with the compiling and and formatting and and making it you know into a document. So it's um I think this is the way systems should be developed. It's you know in in the information technology world this would be what we call a joint application development uh cycle where you get the stakeholders together and take that input to make sure that the end product reflects their needs. And so I think that collaborative type approach is something that we should model here in this uh venue.

180And as we go forward, I think it will turn into a situation where it feels a lot more like you're having a voice in what is happening. Um because you know I what I've heard here today is is a lot of references to we provided input but then the outcome didn't reflect our input or we don't feel like we've had a seat at the table. And so I think in doing it that way then it makes everybody have a uh you know who has a stake in the outcome also have a voice in the outcome. So I think so we have uh we have a motion on the table that I think we should vote on which is to establish a group that will perform the task of evaluating requirements for the system options that

181are available to to serve those requirements and then a basis by which we can decide whether uh solution meets those requirements or not. And so with that, I think we will uh proceed to the the vote by taking road roll call and you lodging your vote by saying either in favor or opposed to the motion. And so I'll start the roll call now. Dr. Buouie in favor or opposed. >> In favor. >> Right. Sherry Suelski >> in favor. Diana Gutierrez >> in favor. >> Demetrius Sydney >> in favor. >> Jeff Abear >> absent. Jennifer Kenton >> agree. What am I supposed to say? I'm favor. >> In favor. Yeah. >> Thank you. Uh Dr. Rafa Yuan >> in favor. >> Lonwin >> in favor. >> Joe Sullivan >> in favor. >> Terry Galvin >> in

182favor. >> Jamila Fields >> in favor. >> All right. I perceive that uh we have a unanimous agreement that the motion carries. So therefore we will move that forward accordingly. Um all right. Any other input from the board on that agenda item? All right. Seeing and hearing none, we'll move on to agenda item number eight, which is the California Health and Human Services updates. Yeah, here we go. Uh oh. Uh standby. Is there a SLI? Do we have the slides that were submitted? Uh >> oh. Yeah. Can do you have them available to email >> from Stephanie Welch? >> My apologies. We'll get it sorted here. All right, those are on their way over to you as soon as you get them. If you could, they'll have to be scanned by our enterprise security application,

183so that may take as much as 120 seconds to perform. Um, thank you for your patience. My apologies. Uh, while we're waiting Why don't we go ahead and take a 5m minute break if anybody wants to step aside uh and we'll reestablish our presence here in five minutes from now. Thank you. >> All right. Thank you. Uh that uh concludes the five minute intermission. Um thank you for your patience. We've got the technical difficulties ironed out and um with that I think I'll go ahead and turn it over to Dr. Buouie for her presentation. Hello there. This is Antu Buu from CO HHS. Um I'm going to go through I know we're very much over time and some folks have to leave. So just going to give you a quick update on the 98 centers.

184Uh some highlights about the project. Um some FYI for the next um uh Prop One kind of work that will impact 98 communication and what we're doing in the coming year. Um so uh just as a summary you may not know all of this and just as a reminder um all the state investment over the past few years has really resulted in us having uh over 1100 crisis counselors at 11 California 98 centers the majority are now paid staff as opposed to volunteers. Um we've heard that how call volume has increased over the years and we are on track this year to answering about 500,000 calls if the state rem uh if the uh rate remains steady and we are at 89% instate answer rate for phone calls to 988. We've been working really hard

185to increase chat and text capacity by supporting the 98 centers to ramp up staffing. Um so thus far uh we are at 42% instate incident rate for chat and text. More work to be done right to get to that 80% um benchmark but we are up from 27% uh instate chat and text a year ago and the reason why it's important to keep the contact answer within the state is to make sure that we connect health seekers to local resources. Um, okay. So, in terms of some quick project highlight, I want to uh remind you, I spoke about this last time, but the National 98 Specialized Service for LGBTQ plus young people was discontinued by the federal government July 17th. Uh and as such the state has entered a new partnership with the travel project

186in order to uh provide uh tailored enhanced training uh so that our 98 crisis centers will uh continue um to um provide for the needs of LGBTQ plus people as they uh reach out for help through 988. Um so we've been working pretty closely with the Trevor Project and they are they have conducted um uh discovery process surveys and they are developing a training schedule and content that will be tailored to the needs specifically for our crisis counselors in California. The training will be offered December through March. Um we are also working on understanding the landscape of our mobile crisis services. So we are working um at Cal HHS and DHCS with a team of researchers who will launch the second national survey of global crisis programs um and they will provide um a deep

187dive into five states as well as looking at the national landscape and California is one of the deep dive states. The survey is going to launch soon in December. Um and then we will be getting um uh complete uh written products um by June. look forward to learning more about what's happening out there. Um, in terms of communication about 988, um, the state has launched billboards and advertisements starting in September running through the end of January to promote 988. Um, there are hundreds of uh, posted billboards and digital ads in all the major cities in California. So, that's pretty exciting work. um in terms of an FYI in terms of what's happening in about communication about 988. So let me just tell you quickly about what Proposition One is. In last March of last year,

188California voters passed Prop One, which helps to modernize the state's behavioral health care system. We're looking at the behavioral services act uh which will reform behavioral health care funding so that we can provide services to Californians with the most significant behavior health needs. and we'll be focusing on outcomes, accountability, and equity. So that for the California Department of Public Health, they've been charged with administer statewide prevention services. Um so 4% of funding from the behavioral services act will go toward that effort and that state department has released um a um a document for public review. Um the public comment period will close on December 2nd. So, the population-based prevention guide will give us a a view into what CDPH will be planning. And the part that's going to interest all of us um that's specific

189to this work is really um the the 988 communication. So, there's going to be a creation of a new public awareness campaign for 988 beginning in fiscal year 2728. uh CDPH will be working with experts and tribes to provide um training and technical assistance of the needs uh of this grant program and will invest in a statewide outreach campaign to promote 988. Um and we'll be working with um community- based organizations and tribes to um make sure that the communication is tailored to meet the needs of specific populations. And then um we I mentioned before, but just looking forward to the January 28th and April 29th reconvening of the policy advisory group. And that's it. I made it super short and quick so that we can get out. Thanks. >> Right. Thank you for that

190update. Um any any questions on this agenda item from the board members? All right. Hearing none, we will move to our next agenda item. uh which is are there any agenda items for future meetings that would uh the board would like to suggest? I know we've identified a couple during the discussion today, but anything we haven't covered? Oh, seeing and hearing none, um this is an opportunity for public comment uh for matters that are not on the agenda. So, anything that we haven't covered under the agenda today uh that the public would like to make comment on, now is the opportunity to do so. I'll start with the public that's in the room. Any public comment on non-aggenda items? All right, seeing none, how about online? Any public comment online? Looks like we have one.

191You go ahead and unmute your microphone, please. Thank you. Um, my name is Trent Murphy. I'm here representing CADPI, the California Association of Alcohol and Drug Program Executives. Uh, we represent California substance use disorder treatment providers across the state, uh, including the organizations delivering critical 988 crisis services. Um, our behavioral health crisis system is neither fully funded right now nor operating at needed capacity. our providers report are reporting gaps in access to crisis care stabilization services and suicide prevention programs. Um and additionally at the federal level we are already seeing cuts to behavioral health services which is only going to drive increased demand for state funded crisis interventions. Um, so I guess final closing thoughts is reducing the availability of crisis interventions now means fewer resources precisely when demand is rising and federal support is

192falling. Providers and most importantly the consumers who depend on these services um are counting on them remaining available and the cost to them is going to be far greater than any cost savings the state may receive. uh from reductions. So, just wanted to keep that um in mind for the board uh heading forward. Thank you. >> Thank you. Uh any other comments from the public online? Seeing none, uh we'll move to our next agenda item. Agenda item number 11, which is the adjournment of the meeting. Um, this concludes the fourth meeting of the 988 technical advisory board uh for 2025. I thank everybody for the vigorous discussion today and look forward to seeing you in the new year. This meeting's adjourned.