School Board Meeting 6-2-2025 - Work Session

001this month's work session and uh so I'm calling this meeting to order if we could raise and have a moment of silence please folks Bill, will you lead us in the pledge, please? To the flag of the United States of America and to the republic for which it stands, one nation under God, indivisible, with liberty and justice for all. And if I could remind all the board members to please have your mics on when you speak. Uh we don't have any recognitions tonight, so we'll go right to uh public input. Yes, we have one person. One public input person, Mr. Charles Hicks from Jefferson City. Would you please approach the podium and press the button and address the board, please? You have three minutes from the time you start. I guess I better not thank

002you. I didn't have it. If you should just take a moment to thank you all for allowing me here before I start appreciate a couple of you I knowbody else I know, but I do thank you for the honor and I do appreciate what you stand for, for what you do. I'm not here tonight or anything like that. I'm just asking for help. That's all I'm doing. Thank you. In 1968, I started a school in Johnson County. It's as far northeast as you can go. If you don't know where it's at, there's an elementary school called D Valley. And I was raised pretty poor. We grew back from money, had gardens, had some cows. Only thing I knew is the farm. My parents, my dad had a third grade education. My mom had a second

003grade education. Her mom died and she had to raise her three kids. I know that's not the point, but they never cared whether I went to school. Never care whether or not I made good grades. It was all about this farm. What my life was supposed to be. But when I started kindergarten 1968, I remember just like it was yesterday. I remember there was three go into the office and one would say a prayer, one would say read a Bible verse and one would say the place to witness at that time back then two kids would go out and play unfold play and then pull their own flag in that evening that they play back down and over these years I can't tell you much about school almost 62 years old I know very All

004those times that those kids done that I was not a good student. I never had that opportunity to do that. But then when I went in middle school, seventh grade, it went back then all the way through to grade high school. But at that time, the they build a new middle school in Mountain City. I don't know what caused it to stop. I never understood that. I didn't know why it stopped but from then on out that never happened in the school system anymore but about five years ago it started bothering me that or to do something or to try to do something to a board to get school back pray get back in school or anything like that and you know it kind of fell away about two years ago as a lady in

005the church she walked up and she asked me she said I go to Mount W school every morning and I pray she said you would be interested in be doing that with you. That mean you couldn't give me $1,000 and make me feel any more happy because it was like something happened. Something happened. So for two almost two and a half years every morning as I had a doctor's appointment before I go to work and now all of a sudden it has hit me that it's time for you to do something. I'm I'm Charlie Hicks. That's my name. I raised my son up in this school system. I moved here in 1984 and I've been here ever since then. I don't know if you ever heard of corporation when I started working for him. It's

006called Deacon Canes for Bush. Mr. Three minutes is up. I'll grant you another minute. But what I'm trying to tell you is I'm not here to come to say anything except one thing. I would like to have help from this board. And I know it's I know it's a hard thing. I know it's because It's it's hard to handle having to listen to people all the time and down tell you that you need to do this or need to do that. But I'm asking you please think about this and help me in any way that I can start forward. I'm starting here tonight, but I will never give up. I'll never go with an attitude or a personality in a way that people would not want to hear what I say. But I know that

007Jesus Christ is telling me from the bottom of my heart that I heard a preacher say the other day. He said in other countries, they've never had a chance to hear about God. They've never had no kind of literature like a Bible ever read. And we are the United States of America. This county, Jefferson County, has got so many good people. And I know because you're here, you're good people. I know that. And I know it's a tough situation, but I'm not asking. And I'm not trying to be mean. I'm just I'm begging you. Help me. Just give me a chance. Thank you, sir. Okay. Um, moving on. Uh, what we'll be doing here, uh, Tommy and I, uh, if this meets with the approval of the board, kind of, uh, spoke before the meeting

008as to kind of how we're going to or how we'd like to go about this. Um, I think what we're here to do is to piece together something uh that we can bring to the Thursday meeting and vote on. Uh, so probably the best thing to do, unless somebody has a better idea, is for Tommy when we start talking about the memo of understanding to go through it paragraph by paragraph. All right? and for us to um you know if you raise your hand be recognized if you want to add change delete something uh and we can kind of do that at this meeting so that the next meeting we have a template we can vote on prior to that what I think would be the best is if I know there are people on

009the board myself included who have some questions about our our that I'd like to ask our providers if they could come up and we can all take turns asking them the questions we have while they're up here. That way they don't have to come up, sit down, come up again, sit down, come up again, and sit down. So, does that meet everybody's approval? Okay. So, at this point, what I think we'd like to do is we'd like to ask uh if Helen Ross McNat has a representative and if Alli behavioral health have a representative, if you could come up to the mic and then we can go ahead and address some questions to you and uh Mr. Harvey said you were the one who brought the u uh question of theou to this board a

010couple of meetings ago. Uh we'll have you start with the questioning and then kind of work our way around kind of you know Danny will go next the next right up here please. And if if when you're asking questions you'll ask whoever you you'll ask whoever then they can Yes. If I may ask a question of the director, I have in my hand a memorandum of understanding. Uh you put this together along with the board attorney. Correct. Board attorney. Yes. The board attorney put this document together. He did. I've read through it. I I see no need to change this. I mean, I don't understand. And you talk about changing tonight. this the director of school brought us this document. Uh we can't change anything tonight, I wouldn't think, because that's what he presented to

011us. So, we'd have to wait till Thursday night. Somebody have to make a motion on this and then if you want to change something, you'd have to make an amendment. Well, I I You can't amend this document in We're not We're not amending it. We're we're discussing. Okay. And you said make changes. No, we're discussing possible. Did you not say make changes? Yes. All right. If I said it, we're discussing possible changes that could be made at the meeting Thursday night. Thursday night. This is what is going to be in our packet. I don't have anything else but this one here by the director of schools and our lawyer. Uh, and my only problem with this is, uh, they are I'm not a director of schools and I'm not a lawyer. So, we pay them

012to do this, prepare this for us and I would do it. I don't see any need to change it. It's complicated thing, you know. Well, you know, anyway. Okay. I just take my piece. I'm done. Mr. Art, do you have any questions or anybody? Oh, I'm sorry. I didn't I don't see any changes that need to be made when it comes to the place that we as a school board member no more than our attorney does and we pay our attorney big fees and Mr. Arnold put this together. To me, this is a waste of time. Somebody trying an individual to stole their authority. We have somebody in charge. We have Mr. Arnold, we have our school board attorney, which would pay a large amount of money. So, why sit here and and go through

013all this and try to change something that they recommended? And it to me, it just seems like we as an individual is trying to prove to somebody that we know more than our current does. Any other discussion on this? just on this on this question. Yeah. First off, I think that I've actually brought up several uh questions to the attorney that I uh don't see in here that's clarified uh that he was made very a point of making a very big statement about and it's not clarified in theou. So with him saying things that are in theou I do think there needs to be some changes probably need to be made. To what extent I don't know I think that's something important you know to vote. So and I'll be honest nobody has to sit

014here all night and listen. If nobody else wants to make any changes or put input you're welcome to get up and leave. Does any other any discussion on this? Okay, Mr. Harding, if you'd like to ask um Yeah. Can I ask um Miss Peak, I believe, is the one that's representing LA. Miss Peter from ask a question of order. Uh we have I think in our policy board members can only speak for six minutes when we ask for the floor. Six minutes two times, right? But that's that's during our voting. Well, I think that would still f I mean I'd hate for somebody to dominate the meeting for I agree. Yeah. What I'm saying is uh six minutes and then they somebody else turn and then if they want to speak again they Yes. According

015to Robert's rule four, they can do it twice. That's 12 minutes. That's not That's right. As long as I get my answers not stonewalled, I'll be happy. Do as long as my answers don't get stonewalled, then I'll be happy. Still proceed, please. Um, M. How many what was the most amount of students that we've had on waiting list this this year? Do you know? Off the top of my head. Um, I was not asked to present specific numbers this evening. So, I I didn't those um at any given time Rachel who is our director of East Tennessee programs is here and so I'll look to her if she's got an answer that I don't. Um but at the point that you figure in um looking at the specific schedule of each child collaborating with their

016kind of classroom schedule requests from the administration all of those pieces there at max might be as many as 40 students on a wait list. Again I can only speak to that as far as allies portion. Anything that McNav is here I would leave that to them. Okay. So I I know for a fact at one point we had 67 kids on a waiting list to be seen. Um, what if I would like to know who or what determines what kids get to be seen and who gets put on the waiting list? Is there a priority? Is is there a certain crucial point that this happens? Um, I'm mostly trying to understand how to get you the answers you want without stonewalling in that space. Um, in scheduling and especially particularly when we're thinking about

017a weightless birth, what really determines that is time. Um, from their secondary time becomes that student school schedule. So, uh, my understanding is that for both programs, but again, particularly I can speak towards Allan. Um, we work with the administration, we sit down with school counselors, we map out where is the best to like remove a child from the day for services. Generally speaking, that is during specials. And so, if this is a child in fifth grade and every fifth grade spot's already booked, then we're going to look at like what is acuity of me? Um, and then from there make a decision. So, if this is a baby has been referred to us who has some type of additional support outside of the school system got referred for maybe the loss of a pet

018and that spots booked possibly put one. Okay. Thank you. What happens with these students that are seeing that u during say school break, fall break, spring break, do they not get seen by you all? So we engage each parent. So every family gets both phone calls and emails and letters. We send out like contacts via mail. We have a number of families who don't have email. We have some families who also don't have the ability to access the phone. Um so we phone calls, snail mail, whatever it takes, we'll reach out to them and they have the option to choose. So we do offer services during breaks, during the summer for our kids who are on the wait list. You also offer for them to come to the office if that's most convenient for a

019family and that family always chooses what's best for them in their situation. So you so they can either come down or if it's not convenient for them then what happens convenient. Well you you said convenient for that family. I said what is most convenient for them? So in that so if it's not most convenient for them to come down what happens to these students? the parent makes the choice that they like. So they they potentially could go all summer or not see if the family makes that choice. Yes. Is your is your uh operation open at your Jefferson City? Is it open throughout the whole day? Uh we're open from 8:00 a.m. to 6:00 p.m. Okay. Um how many of these kids are diagnosed with emotionally disturbed? So emotional disturbance is a category under IEP.

020So that's a definition under IDA which is the individuals with disabilities educational act. Um so that emotional disturbance in the world of mental health doesn't have a meaning. Um, so for us, we function out of a what's generally referred to as a medical model. So the way that we do things lines up with like pediatricians um or lines up with like yeah primary care physician doesn't really line up the way that schools categorize those things. Um, so, uh, under the way that the system at large is set up, in order to, um, in order to provide services of any kind under a mental health designation, there has to be a diagnosis code. Um, but as a like this means an emotional disturbance, that language doesn't exist. Okay. So, is there a doctor that mental health

021agency has to practice under? So, every licensed meal health facility in the state of Tennessee has to have um a like a I think I refer to them as like an advising psychiatrist. You have to have an MD on staff. So, yes, you do. Okay. Um so, are your therapy sessions are they to help with behaviors? Um therapy sessions at large. And so, let's back up for a second, kind of level set on some wording here. you think about mental health at large, um mental health really for us is defined as this opportunity to like love well and grow well. And so mental health services then are everything that connects to how we help children and adults and families love well and grow well. And so within that kind of mental health system, sometimes we're

022quick to connect that there's like a behavior to an issue. In the mental health world, we often talk about what are called externalizing behaviors versus internalizing. So an externalizing behavior would be like our sweet kiddo today who bit somebody at school and we got called out. Um and so that's an externalizing behavior, right? Like he goes afterward. Internalizing behaviors are things that we often see like anxiety where it gets contained and maybe it doesn't show up in a big way. Um, so when we think about internalizing behaviors, what we'll often see are the kiddo in the sixth grade classroom who got a 94 on their math test and then cried all the way through lunch. Um, or the child who's been incredibly withdrawn and depressed and hasn't really made a friend for the entirety of

023their nth grade year. um we'll often then see those internalizing behaviors if they go untreated for significant amounts of time to then really kind of move towards things like self-injuries behavior or suicidal ideiation. But all of that exists on a spectrum and what could be a quote unquote behavior really is what is disrupting the life of that individual. So So you only deal with the internal behavior parts, right? No, again it's across a continuum and so what we would consider a behavior could look like lots of things. Okay. So, um what qualifications or degree does a therapist that comes into our school? What are they required to have? So again, I can only speak for for allies. There are requirements under the state um as a like designated licensed mental health facility with the state

024um of what is required around um general expectations for education. Um for allied all of our clinicians have a master's degree in a mental health discipline that is lure eligible meaning that they are on track to complete lure through the process required by the state of Tennessee. Okay. But nobody's actually a BCBA then. Correct. We don't do ABA services. Okay. So ABA services is the external side of two totally separate spectrums of services. So ABA generally are provided by BCBA. So these are board certified behavioral analysts or what are called RBT. So they're registered behavior technicians. Um so ABA is a service that is provided um generally to folks where there's been some developmental delays um or that may be a kiddo who's on the autism spectrum. We'll also see ADA with kiddos where there

025may have been like some type of medical complexity where they've been hospitalized for extensive periods of time. So whether that's early childhood cancer, those types of things, those services are not considered under the state of Tennessee to be inherently under the behavioral health system. So a whole separate thing. Yeah. I was I was going to ask you why you actually had behavioral health solutions as your name. Um, so my child, we receive ABA. Okay. Um, and I would go a lot further with the behavioral side of things because a lot of these kids do show behaviors outwardly. Okay. Um, and by doing so, so let me ask you this. If a child is showing behavior, an outward behavior, how do you guys deal with that? Like as far as find like how do you I

026mean what is your success rate on dealing with that behavior that's going to stop to make it stop? Um I pulled the turn my phone. I pulled the data on what our success rate on impact is. Um we track that. Um we track that using a series of standardized validated like screeners. We do that at what's called aggregate level, which means we look at like every child, not like what does this look like for 10year-old Dr. Arnold, right? Like we're looking at it at a programmatic level of like what our impact is. Um, and so if I turn around and grab my phone, I can give you a I'm not looking for the exact rate. I'm just I'm just saying to make things to make a child successful in not producing these behaviors anymore, though.

027I mean, you you you don't actually the actual behavior, you have to address the problem at hand, right? But if the problem is is is at home, which I would probably say most of these problems stem from either something that dealt with at home triggers, but you're dealing with this in the school system. How are you getting inside the house to do this? So, every situation and every family is really different. The the reality is that we're always what is the story of this student in this family in this like generational context within the greater community. Um we do utilize what are referred to as evidence-based practices. Again, ABA is its own um kind of stream of service provision, but so we do things like TFCBT or AFCBT. Um we also use a curriculum called

028Target. All of those are approved through SAMS clearing house for evidence-based practices. so they meet federal best practice guidelines. Within those, one of the key components that we really are very intentional about is ongoing collaboration and communication with families. So, we're constantly in communication again, email, phone. We often will set up family sessions on breaks or after hours. Um, but really the honest truth is that kids spend the majority of their day at school. um this is where children are and not everything that we see is connected back to the family. You know, one of the major things that's in front of of this community, but also like the large part of of East Tennessee and Southwest Virginia and um Eastern Kentucky really is a multigenerational opioid crisis. You know, for those of us who

029who've been here for a really long time, we well remember when that hit, right? Um I was in high school. I can tell you stories on stories about what it looked like when it hit and what that's meant. And you know, um, today I was kind of thinking through and processing with some folks out of state of like what it means for the parents of my generation to have been generation one of that opioid crisis, right? Which makes my generation generation two. My nephews are like high school. They're generation three. We're coming up quickly on generation four. A very significant opioid exposure to this community. So a lot of the kids that we're seeing within school setting may not very well be with their biological parents. A lot of them are with grandparents, great-grandparents, aunts,

030uncles, foster placements that we really are doing multi-generational community focused work to really support and address the impact of what years of of large corporations taking advantage of folks in this region have done. Mr. Could you ask one more question then we'll come back. If somebody else wants to ask some questions I can. No, I'm saying go ahead and ask one more question then we move on and come back. So is it common practice for the therapist to text or call students uh and let's just say the minors 17 or under without parental knowledge outside of school. It is AVHS policy that our AVHS um it's AVHS policy that personal phone numbers of staff are not to be shared with families and or minors and at the point that we become aware that that's occurred.

031That's an incident for termination because it has happened in the past. I couldn't comment on that one. I know it has and go ahead. It's okay. Miss Martin, do you have any questions? Any questions? Cook to start with. M um so you said that roughly there's like on a waiting list around 40 something students, right? Again, I can't pull that number immediately off the top of my head. That would be a general average. Is that something you can give us later? I think we did provide that in a previous but I think that was a snapshot at that moment in time. And so again that changes. We're constantly working um again we're working to see what we can do to pull kids into community based services, outpatient services that that seeing them in the school

032when that's not an option because there are definitely situations where families will say this is our preference and that's not always our criteria. Um so we're constantly working to either like refer out get folks situations, get them to outpatient if need be, get them to intensive in home. And so again, we're constantly working to get that number down. All right. Um, do you happen to kind of have an idea of roughly how many students are being seen right now? Top of my head in this moment at the time that school ended, four ally close to 400. um which if I am correct is a roughly 5% of student body population across Jeff County. The national average um for access to mental health services is about 10. So it's significantly lower than national average. All right.

033Um do you happen to kind of have an idea of how many families not looking for personal information? How many families who do not have email to reach somebody? or 500. Again, I wouldn't know that off the top of my head. Um, on average out of those 400, if we're sending out snail mail, probably 150. Okay. Uh, let's see here. So, of the 400, do you know I know this is a lot of numbers. So, um, what is roughly the number of internal behavioral students? What do you mean by internal? Well, you said that there's there's internal and external behavioral. Internalized behaviors and externalized behaviors, right? We only use that as a term for like conceptualizing that continuum of what you might see from folks who are struggling in that place of of loving well

034and growing well. That's not really a thing that like would ever be counted anywhere of like what does that look like? Um, so like that that isn't typically used for tracking. All right. So um you also mentioned that your clinicians um they have to have a master's degree as required by the state master's degree in a mental health discipline in a licensed eligible field. Okay. Um is there any way to like where we could see what those where they got their master degrees from? Um through the state their master's degrees. I'm sorry. But I mean, is there a way to take a look at where they got their degrees from? Can we see that information? That would be a question that I would be open to our attorney reviewing with the school board's attorney. I

035think there are some pieces there we want to really check on like HR law and what that looks like. Okay. Um All right. So, I won't say no, but I also I think everybody would want some more information on that. All right. So, agreed. Um you said evidence-based practices. Can you go into more detail with that? So evidence-based practices are defined as a modality that has been tested against a control trial group. Meaning at the end of the day, did this modality prove statistically better than doing nothing? So the federal government under SAMA keeps a clearing house. That's what they call it. Like if you Google SAS clearing house, it'll come up. Um that clearing house lists a number of kind of wellressearched well indicated modalities for supporting children and youth and families and adults.

036It's a really broad resource. Um so that is the way that the federal government and I think that was initially done. Um I think that came out in 2018. was just precoid um that that that clearing house was published in a way that the federal government really said like these are the things that we believe have been effective and that the federal government was willing to say we'll put money to. Now in that space that doesn't really dictate like the state of Tennessee doesn't require the use of those evidence-based practices. Um but that's a standard internally that Allied really tries to align ourselves with is to make sure that we're meeting that higher expectation. Okay. Um, so during summer break, and this is probably my last question for now, so let's see here. So during

037summer break, you said that some families, if they choose, they can come to your office. Um, what about any families that don't have insurance or things like that and they're low income or something? So, how are those students still seeing? Are they charged anything or there grants that help cover on any onset costs or anything like that. Um, so for the last two years, Ally has been funded under a Department of Human Services grant to cover all of the costs above and beyond what is reach re insurance reimburseable for students in Jefferson County. And so that meant if a student didn't have insurance or if a student had private insurance and a co-pay that they didn't pay anything out of pocket. Um, under the state like polic around Medicaid. Um, children on Medicaid can never

038be charged for anything. Like we couldn't even sell them a sticker. Um, so in that space, those kids always are able to access services and are never held to a cost. There is for families still the issue of we do virtual services for if families prefer and they have Wi-Fi and a computer and an email address. So that really is not a fit for many families. It's also not a fit for every child. There are a number of reasons we would not do telebehavioral health um with every kid. But in those situations, families still have to like take time off work, pay for the gas. I mean, it's an hour appointment, so they're going to have at least a 30 minute drive in, 30 minute drive out. It's a two-hour commitment from families. Um, and

039so that has its own associated costs that are not directly associated with what we may bill to insurance or bill to a family. So I'm curious uh if there's a family say in Hamley County that would like to come and use your services, do they not qualify for any of the any type of grants or anything like that? They don't qualify for any type of grants. They're more than welcome to come and access outpatient services on their insurance. So again, they may have Medicaid, they might have Etna or any myriad of things, but they would not qualify for the grant that has covered Jefferson County schools to offset out-ofpocket cost to families. So yours is specifically around Jefferson County schools. Um it is a a multi-athway but very specific to Jefferson County. So, it covers

040the school program. It covers intensive outpatient services which occur not at school. Um, and then also covers costs for some kiddos who don't have insurance to access other things. But again, that's above and beyond just the schools. That is provided if you're in our schools, right? No, it's provided if you live in just specifically in this county. Okay. Okay. But, uh, does not extend to any outside counties whatsoever. Not for that grant. Correct. Are there other grants that would allow you guys to be able to accept people from other counties? Um, that is a very large question with not an easy answer. Um, if you're a 22y old who's just out of college and working a job making more than $40,000, no. Um, if you are a three-year-old receiving pediatric services in Claybourne County, yes.

041Um so there are multiple pathways in which things can be worked but there there are clear kind of stipulations of what can be done. Okay. But again that's every family calls we talk through with them. We talk about what their options are highly individual. Okay. I do have a minor minor more procedural questions. I uh something I' I'd kind of like to know and maybe Dr. Arnold, if this question would be what I'd like to know is kind of what's our procedure from the time that a teacher identifies a student with a behavioral problem to the time that um it is referred and taken over by one of our behavioral service uh providers. So, you know, let's say Jimmy is identified as having behavioral problems. What happens at that point kind of what's the procedure

042in the school at that point? So are we referring them to mental health or we talk about Okay. I'm sorry. Okay. So a student is referred, a form is filled out by a school employee and then that comes to kind of the office administrative type um guidance counselor, principal and then they reach out to the parent and notify the parent that a reason for referral and recommendations Um, we let them know um options. Uh, we have a list of providers within the surrounding area that that we give them and and then we just kind of wait and see. But we do make a referral to um the referrals made to Ally if they so choose that or we have parents who choose other providers off that list also. So but a lot of times we

043don't know of what the parents may do. Sure. Sometimes we don't. So I just again I'm just making sure I get this down. a youngster is identified with a behavioral problem. The teacher or the school employee who notices that at that point fills out a form indicating kind of what the what the problem is. And then yeah, they complete a referral form. A referral form and then that referral form goes to the administrative office. The administrative office um uh notifies the parents. parents come in and they the the problem is as explained to them. Then at that point um we indicate that we think that you know the youngster needs help and provide the parent with options for help. Yes. Uh so we either send the referral on to allied or um some of them

044say you know I have a provider or some of them say you know I don't want to pursue this at school. Do you have any other recommendations? So you know we have a list of providers that we I guess my question is we don't refer the youngster to anybody until the parents gives us approval to do that. That's correct. Okay. Yeah. That's kind of what I Yes, that's correct. Okay. Um, and this could be for uh anybody allied McNab from the point that you receive a referral uh a parent saying, "Okay, I I understand the problem. I want, you know, Jill or John seen by somebody." At that point that you actually kind of take them under your wing, what happens at that point? what is what is the procedure as far as um I

045don't want to get into specific treatment but as far as scheduling them um you know setting up a regular schedule for them to be uh counsel I mean kind of what's the what's the situation there why don't you come on up I'm sorry I don't know your name Mary and this is Shel also with McNab center much more the specific detail, but generally when we get a referral, we do an assessment that can either happen in our office. Our um M's level staff, much like Allison's, are mobile, so we can actually go out to the home. A big part of what we do is incorporate the family piece. So, you don't see services stop over um school breaks or long uh breaks over the summer or during holidays. and we're constantly engaging the family. We

046can't do that assessment without the family component. So, we're gathering at that point of referral. Um, we are explaining our services. Of course, we're only in three schools. Is that correct? Um, so, you know, if we got a referral from one of those schools, we would say, here are here are your options. Um, what's most convenient for you? We are also flexible with our hours. We operate from 8 to 5, but our staff can work from 10 to 7. It just it just depends. We really accommodate whatever the family needs. Did that answer your question? Yes. Speak any divergence from that as far as not particularly and I would echo um you know the way that that general process works. there some real like specific state like requirements within TCA and also within the department

047of mental health policies and procedures of like you have to have significant parental or guardian consent before you can move forward in those. Um we are required every year to do the assessment piece that Miss Catus was talking about. You're required to do a process called a treatment plan every six months. It's where you sit down again with the family and say like what do you think? How's it going? What's working? What's not? Let's continue to collaborate. Let's like recalibrate what we're working on. Um those forms have to be recompleted annually. So they're only good legally for 364 days. Um and so yeah, that process looks really really similar across the state. When you say those forms, are you talking about the parental consent forms or Oh, okay. Yeah. Any releases of information and Yeah.

048All of that documentation is only good 364 days. Okay. Uh thank you. That that clarifies things for me a little bit. Do I do either of your firms provide tea health services? Yes, health is an option. Okay, that is an option. And do you same question? Yes, I referenced virtual earlier. So, yes, we absolutely do. Okay. And in your opinion, is there really any major difference as far as results from uh if if someone for whatever reason uh needs to be counseledled via teleaalth versus uh treated versus inerson inerson appointment? There are clinical reasons that we might very well prefer one over the other. Um, you know, there are definite uh depending on a child's age, tellahalth gets quite complex. It's not that it's insurmountable, but it's really difficult. Kind of turn into Miss Rachel

049like on camera. Um, there are also situations where depending on um the cognitive functioning of a child. Um, also depending on the potential like circumstances within a home. Um, I can think of a kid in Middle Tennessee we saw years ago who was like a one of eight foster children in a two-bedroom house that also functioned as a family childcare center. There it wasn't going to work, right? So, there are definite factors in making decisions. Um, so there's the availability, but again, those are decisions that we make in conjunction with the caregiver of what they feel like is best. And we also definitely have families who um who are strictly on outpatient um who do both. They might do virtual this week and in person next week. They might majority of the time be in

050person and then occasionally opt for virtual based on scheduling. So at least in your case, it's not one or the other. They can be mix or the other. Ours can be mixed too, but it's not the preferred method. Um you know, a lot of these kids struggle with isolation already. Um there's just a variety of things that come along with tellaalth. If we do have um a family that has the resources to even do a tellaalth session um we limit those around I mean it's very important to have that face tof face interaction. It's very important to be in environments where people are comfortable like their homes, like schools, like the office um to really get a feel for acquainted with and build relationships with people. Doing that through um a television or monitor is

051not the preferred method to do that. So, that's kind of a fallback position. Yes. And uh if if someone's ill, if they're sick and still want to do their session, we'll use teleaalth for that. If it's going to be detrimental that they miss their session. So there's a variety of ways we can incorporate teleaalth. It's just not our preferred method. Okay. Thank you. We prefer not to do that in school either. Okay. just because you know these kids some you know you do have some kids who have traumatic past and um you know we a lot of times we can't leave a child in a room alone um depending on the age so to pay an employee to sit there and listen to some child's traumatic past is not usually I was thinking more during

052vacation periods and things like Okay, last question. Um, where are you as I understand for ongoing care? All right. Where are you as far as helping out during like emergencies, something that happens at school that we need somebody, you know, of your knowledge to to intervene? Um, Miss Peak, I understand on your website it says you are not a crisis response center and that uh ABHS therapists are not available for emergency crisis calls. Would this preclude you or folks from McNab from or and your on-site therapists from helping out in emergencies at school? No. Um, so crisis response under the state definition is a specific thing. um and often refers either to um services. There are a number of crisis providers across the state and those are people who are their whole job is to

053be on call to go out when there is consideration of like an imminent threat. Often, not always, um often those services get used like if somebody is threatening to harm themselves. Allan does not provide those services. We're not contracted with the state to do that. Um, we also don't have what are referred to as crisis stabilization units. So, those are specific locations. They are buildings um that are intended to defer from psychiatric hospitalization. We also don't have a crisis stabilization unit. That is what that language refers to. So, we're legally required to indicate that we don't provide those services. Um but historically I can think of a number of situations over the years in which there have been a death of a teacher, death of a student. Um significant incidents within a building where we

054will reorient our clinicians for the day pull them in order to be available on site um for whether that is teachers who need to debrief whether that is students who may be quite upset. Okay. So I I guess the question is you can be on site and help out during emergencies. Yeah. But again I would let McN we are part of the mobile crisis response team across this uh in this particular area east and upper east. So we do have mobile crisis clinicians that can come out and respond, do assessments and determine what's needed. Um after the assessment is done. We also our clinicians can definitely respond in situations where the school feels like they need a little bit more support. And then around 5 years ago, we developed what we call a TRP team

055that is specific to school um um trauma that's occurred. So, if you have a suicide of a of a student, if you have a death of a teacher, if you've just had a community situation that's gone on that's impacted a certain school community or multiple schools, we have a team of professionals that are trained in that trauma approach that can come out to the school and do a variety of different things around training. Um, individual short-term kind of uh talk counseling at the time that the situation happened. Um, we can do some stuff with the staff or adults that are associated with that school and or the situation. So, we have a variety of ways that we can respond. Great. Thank you. And we do have CSUs. That ends my question. Mr. Hardy, you said

056you wanted Y. So, sorry, I'm ask. You said you do have a mobile Yes. unit. And I you do not have a mobile unit. All right. Define mobile. We do not provide mobile crisis services. That's a contract and yes, McNav. So that's a difference between the two of us. That's a specific contract service under the state. That is all that team does is go out and respond to um typically clients that that are homicidal or suicidal in nature. and they do a thorough assessment and determine if what type of treatment whether it's acute hospitalization, long-term hospitalization, just a variety of different services that could help that individual move on. So, it's not in a crisis situation. It would be just it's a mobile unit though to like say a say a student over the summer

057and parents both work and they can't make it to a brick and mortar to to get therapy. Is that the kind of mobile unit you're talking about? No, I'm talking about people that are mobile and can respond in a jail, in a detention center, in a school, in a home, in a park, under a bridge. Okay. Yeah. Physical people. Um, I just have a couple couple more questions. It can be for both of you. Um, so what is the earliest that you interviewed uh companies to do therapy for kids. What's the earliest age? So we cover every age across the lifespan. Um so with that that very much also includes very young children. What is that? What's the age? Uh youngest we've ever seen is probably four months old. You do mental health therapy for

058a fourmonth-old uh services for children in that age range and I would love to take all the time in the world to talk about this. That is my area of passion. Um how does the kid respond? So in those situations, those are family centered services. Um so specifically the the situation I'm thinking of where we had and we've had several in this place where um we're looking at really young children. Those are kiddos who are at high risk of either being removed for foster care or that are placed in foster care. And we often see really graphic and intense physical abuse if they're coming to services at that age. Um or there's been some really profound neglect. Um and so with that, they come with their families. Um, so that service of working through that

059child opens up pathways and treatment for that family um, in order to be able to allow for reunification, placement, stabilization, and to keep kids with their parents in their communities, in their homes. Um, and those services really are about making sure that this kiddo is seen and heard. you know, even at a very young age, we will see situations of severe trauma. Um, that you'll have infants who will like projectile vomit hundreds of times a day. Um, and they're going to need a caregiver who's got a lot of support and able to in order to be able to regulate with that. Um, you'll see kids as young as 10 months old who will engage in like self-biting to the point that they'll bleed. Um, it takes a lot of support for a family to be

060able to figure out how to navigate and to help that kiddo to engage effectively when they've lived through some really big horrific things. So, you really give therapy to the family. It's a family based model. Yes. Really trying to have a hard time grasping how how you do therapy for a four-month-old or a six-month old. I have an eight and a half month old granddaughter. I can speaking. I I mean, yeah, I I I mean, I I I get they they show certain things. I I believe I understand very well aware of you know kids go through things even as infants. Okay. But when I when I want those like Okay. So let me let me rephrase this. What's the earliest age you see kids oneon-one? So my answer to that would be that we

061don't just primarily see kids one-on-one. We are always seeing kids with a family component. So our we have a multitude of different programs that can start as early as two. Um, we have a family based model like what Allison was describing that is very much about bonding and attachment with the younger infant. So, there's a multitude of different types of you talk about between the mother and the baby or um the foster mom and the I mean there's all kinds of you talk about the parents and the therapist and the baby. Okay. Yeah. So, but I I would hesitate to ever say that we only see children individually at you guys see our children in school. Yeah. But for us in particular, we also include families in that reach in that u there's family treatment

062that's associated with that. It's not just individual even though we see them in the school individually. Yes. But we've always got the parents. What I want to know is what is the youngest age children you see one-on-one and I understand you work with parents and families too maybe on a different day or afterward oneonone what is the earliest age setting you you work with a child one-on-one a therapist goes into a room one-on-one with the child we have a therapeutic preschool so we can see a four-year-old oneon one so so the a regional intervention program and we can see a 2-year-old What do I want? I I would echo that again in the places like different programs do different things. Um Allied. So, and I think there's a lot of I would offer there's a

063lot of similarities in in McNab's vision and approaches there is to Allies really emphasizing family. Um 8-year-olds are terrible agents of change and so it really does take the space of like having everybody involved. Um for us it's going to be Again, we don't have we don't have the RIP program. We don't have some of those other pieces. Um, and so for us, do you um do either of you do paranal therapy? You do. I mean, do you guys refer out to Planned Parenthood at all for any reason? There's there's two pieces to that question. I It's a yes or no answer. Do you guys work with Planned Parenthood at any point during paranal therapy session? There would be nothing that we would refer for. So the answer is no. Yeah. Okay. So you don't

064work with Planned Parenthood in that situation? No. Okay. There there's not even like there's no situation in which that is even a possibility. I'm saying no. I'm going on record saying no. But I'm going to also confirm over here that there's not been a situation. Understand I'm being recorded. I'm not going to hold you to the fire. I just couple other questions I have. That's all. Okay. So, the answer that okay um that's all the question believe. Does anybody uh for does anybody have any followup questions based upon any of the questions that have been answered? Miss Yeah. Um so so am I understanding correctly that the mobile unit is specific to crisis intervention. Is that right? Yes. Our mobile crisis unit that sends individuals out. Yes. I will say we also have a mobile

065unit that serves death county. So I don't know if that you're may have seen that be getting confused. It's in Jeff County one day we get the family justice center. So it's an outpatient clinic just like we have in hand severe and anybody birth through geriatric can come in there and get outpatient um medication services and individual therapy services. So not specific to just crisis. That is correct. Yes. Okay. Yeah. It's more of your outpatient on wheels. All right. Um um now you also said uh the one to oneonone uh includes a family component. What does that mean specifically? So our school bas talking about schoolbased services and some of our outpatient service I mean we have a v we have a very large continuum especially when it comes to kids um but our schoolbased

066services in particular always have um a family component so we'll go out to the home or meet the family at a coffee shop a park a library wherever it is that they feel comfortable if they don't feel comfortable us going out to their home but we try to do that at least once a month with every family that we So if we're seeing a kid on our case load individually, we are constantly engaging or trying to engage that family to do that family component. Change change agents are the families. So we've got to get we have to help them understand what's happening, what they're dealing with, how to interpret that so we can make family progress. So family component does not necessarily mean there's a family member in the room with the student with the

067clinician correct not for every contact but there would definitely be in a family component we are talking about that there's going to be well I have the privilege of having good knowledge of McNap's work and so with that forgive me in the weed but in that space like allied is really looking at um we want to talk to on the phone. We want emails about what was hard on Friday night. We are going to have them come to the office and sit down. We're going to do virtual on their lunch hour. We're going to see family member and kiddo together in a room. Um and so family component means that not every session is that caregiver there, but they are active members of the process. This is their child. So if the parent wants to

068be I know that not all parents can do this but there are some parents that do not work and they could be there if they wanted to be and if they wanted to be sitting in that therapy session in the school based during the hour or however long these sessions are can that be my answer would be as long as the school administration doesn't have a reason again schools have very different like who gets in the front door and who's allowed in what part of the building, but that wouldn't that wouldn't be an ally decision. We'd check with everybody first. So, here's what I'd say is we are super flexible as long as it's not going to hinder or provide some kind of HIPPO violation. We are very flexible. We are in 120 schools across

06918 different districts. So, we know that each district, we know that each school is different. We know that each administration is different. We know that flexibility is key. So if that's what a school needs, if that's what a family needs, then we're willing to do that. We're willing to work with the school, make sure that there's the least disruption possible in the education process and make it work. That's we've we've done it for 33 years. We know that we are part of that system. We're we're we're just a a piece of that larger system. we are coming into somebody else's territory. So, we understand that and I think our end goal is the same thing is to see these kids progress educationally and if they're not well emotionally, they're not going to progress educationally. We

070know that. Is there anything in our school that prevent a family member from being able to sit in on one of those sessions or maybe all of them? There's not anything that would prevent I mean there's things that would prevent it if they don't u I mean we have all sorts of family members u we have some um parents who have to call the school and and ahead of time and state their reason for coming. Uh it I mean for the majority of parents, no. As long as they didn't just pop in five minutes late, want to run down there and and be in the building unsupervised. So we just don't turn parents loose. So So they happen to be in the area and oh my student's going to be seeing that that therapist or

071that clinician in about, you know, 15 minutes. Let me see if I can get in there so I can be part of that process. Yeah, we would allow that. Yes. Okay. Um question. Um that's it. Uh I have a followup question. Um is McN, you mentioned you're at three schools. Which schools are those? I'm sorry. Um we're at Jefferson High School right now and Patriot Academy. And but we have they're staffed and then we have Jefferson Academy and Jefferson Middle. That is we have those schools but that's vacant right now. Okay. And are you there? Are you only at three schools because we as a school district have only asked you to be at those three schools or because you don't have the manpower to really do anything we' be at any more schools. So,

072the Department of Mental Health funded three positions specifically for Jefferson County Schools. When we are awarded a new or funding for a new staff member, we go to the schools. We go to the administration and say, "What schools would you like us in?" Gotcha. And that's what directs where we go. And that funding comes directly to you from the Department of Health, Department of Mental Health and Substance Abuse Service. It does not come from the school district from a grant that we get. Okay. Okay. All right. Understood. Um and uh I believe that was that was my major my only other question. Did you I remember um so uh in the event that okay first of all are the school-based therapy sessions do they remain fixed on the same day and time all the time

073or do they kind of vary? We try to do that for consistency sake in our outpatient clinics and with school days, but that's going to waver based off what's happening in the school. So, TECAPS, that's going to be different. Like, we take try to take those things in consideration because we don't want to disrupt the child in a in a main class, an important class that they might not be doing well in. So, that may change, but we do try to keep it consistent because the child's going to remember better if it's the same time every week rather than wondering, am I going to get therapy this week? Am I not? So we try to keep it that excuse me. Um our for allies process and procedure we're meeting frequently. Um we aim for every

074week but again that varies based on schedule. Um but we aim for every week to meet with school counselors to be triple checking that the the schedule that has been set out for students continues to work. Um so we do want it to be consistent in a consistent time. But there are times where this kiddo has made progress and they don't need to be seen as often and so we're going to make some changes. Um or it may be that midway through the year they've had an elective change and so we're going to negotiate and make some changes. Um and so it is changes are made in a place of both flexibility but also clear communication with the school and again every school in its own place. Are parents notified immediately if there is a

075change? Oh yeah immediately. Okay. Um and if a parent cannot be there physically um is there any kind of like option to have the parent conferenced in during the session if they want to attend the session and they can't they can't be there in person but they want to be conferenced in during their child's session during the oneonone session during school based I again to Dr. Arnold's comment, it would be a very rare, very specific situation in which we would say no. Like this parent's currently on a restraining order and can't have contact. Like that's going to be a no. But it would be a very random situation where we would tell a parent. Okay. And I will say from our perspective, it very rarely does that happen that a parent request be seen with

076their child in the school because our therapists are communicating with those parents all the time. You know, they're updating them on how the therapy session went. So, the parents already feel that they're included. We very rarely have a parent who says, "I need to be in their therapy session." They know that that communication's open and the therapist is checking on them. Are there new behaviors that you're seeing at home? Is there anything we need to be aware of? And then following up after those therapy sessions. So very rarely parents request that but if they do we we would make it happen as much as possible. Okay. And um uh one last question is is is do you ever run into a situation where maybe you do maybe you don't um the student is let's say

07716 or 17 and the parent says I want to be included in this therapy session but the says they don't want to. I think that happens quite often to be honest with you. Um and it's it takes the therapist having a very um open conversation with the parents and the student as to why it's valuable to have them in. But you can't exclude the parent from all the child's care. So there are things that that 16 17y old going to say they're confidential, but helping them understand that they're a family unit and that child needs their parent to be supportive and so the therapist can help their parent be supportive and the the child needs to know that they can rely on that parent and so including them just like Mary and I understand the

078family unit is very important. So the therapist really has to figure out with that particular parent how they can make that happen. But you don't want that child to not get the services. You know if if they're saying they want the services then you've got to figure out a way how can I include this parent so this child can get services but also that they feel like they're this is a safe place for them. And if there's that disconnect there, then something something's going on. Yes. Well, and I'm referring to like a a healthy parent. Okay. Not one that's like in the system or anything like that. So So, but like where a parent a child might be shy and maybe they're concerned about their parent finding out something, you know. Um and and the

079student maybe doesn't want the parent there, but the parent's the one and the bills. I I would say too that my my mentor often used the phrase it's Chris for the bill, right? Like everything becomes something that you put in that you're going to get out. And so if that's the situation like to what Mary said like that means that is like that is the problem, right? Like you don't want them here and you do and now we've got to talk about it the three of us and we're not talking about anything else until we figure out this. Um the idea of family discord with teenagers is pretty common. Um, but I would say it's rare that we have a family who like really locks down on both sides and can't come to a conversation

080where we figure it out. Okay, thanks. Let's uh let's wrap up the questions. Thank you very very much for being here. We sure appreciate this. Hold on. I'm sorry, Mr. Hardy. One question. Yeah, just just in your qualifications to have a therapist to hire cuz I understand we're not we we have some not we have seven, right? I'm trying to figure out we have seven and then we have one school that's not have do we all have all of our schools covered with therapist then across both organizations to my understanding? Yes. And there are a couple of the schools that that we really collaborate on. Okay. The high school, I imagine, is probably one of them. Okay. Um, so in order, I'm not trying to put you on the spot. I I know how hard

081it is to keep employment sometimes, especially in the healthcare world. The turnover rate though, um, we have a high turnover rate with therapists coming in and out. Um for Allied, what I can speak to, um you know, one of the great benefits I think for our team is that we have a couple of like fully licensed folks. Um it's really difficult in the state of Tennessee to meet the requirements for life surgery. You have to pass exams. You have to show all kinds of like continuing education. I mean, the number of like background checks and all the things you have to do. And so we've got folks on our team who have been here since we began collaborating with Jefferson County. That's pretty remarkable to have a therapist in a position for uh seven years.

082August will be seven years. Um that's a big deal. So our turnover rate again speaking for us is is pretty stable. Um but I will also say to that um in that place behavioral health that to give you all context the workforce lifespan of a behavioral health clinician across the US is 18 months. before they generally turn over to another job. So when I say we've had staff who are here for seven years, that's significant. Yeah. Could you answer that question and that'll be the last question. All right. Yes. Well, I've got a question. Hold on. I'm sorry. No, go ahead. Go ahead. Please answer that. Go ahead. Um, so I would say our turnover rate is probably not high because our vacancy rate has been high. So, we've had more vacant positions um than

083we have had filled for quite some time, but once we've been able to get them filled um our folks have been able to stay there. I mean, would you agree with that? Coach, my question may have been answered. Uh but what was the line when during uh the session that you see the need to involve law enforcement? U so part of the role of behavioral health administration because I know this happened at one of our schools. Yeah, those are two different answers. Um part of the role of behavioral health services is to really work so that we don't get there right. Um you know part of what our job is is to provide folks with the skills they need to deal with life on life's terms and that includes young children. You know, when we

084talk about um like thinking about adult mental health services or particularly substance use, what they will often say is if I had the skills I needed as a child, I would have had other options besides this pack that has led to like pretty significant drug use. So, our job is to keep that in a place where we don't need to call law enforcement um or school administration. Uh for us, there are going to be processes of we're going to start making calls internally of like, hey, this kid's really escalated. And so our team internally is going to be coaching that clinician of like, have you tried this? Have you done this? What's your concern? Right? Or this kiddo's really making a threat that's homicidal or suicidal. And we're going to be coaching from our supervisors

085of like, what have you asked? What have you done? At the point we can't keep someone safe and it's clear there's an imminent risk, we're gonna start notifying people. Okay. Would you respond to that? Uh it's it's the same. If there's an imminent risk, then we're going to get the appropriate either authorities involved the mobile crisis unit to determine what we need to do. But if there's there's a specific threat to the school to anything like that, we are going to notify. Our therapists have been trained to to know when that child possibly could cross the line. Absolutely. Or maybe have already crossed the line. Absolutely. Or even if they're pushing the line. um when it comes to an imminent threat and people's lives are in danger um that's a different I mean we're here

086I mean starting with 1997 I guess it was uh school shootings or I don't know it's I don't understand I grew up in a different time and I you know you know I guess counseling might have but those those people may not be, you know, enrolled in in counseling is the thing. It's hard to identify. So that gets to my question. You've answered it. You your people really train and they know, right? And I would say this board is well aware that that there was an incident in which one of our team recognized that knew what the concern was called the appropriate folks really notified administration and and again this board is aware that there was a very different tomorrow because of that. Yes. Thank you. Sheriff and the principal spoke about that. Yeah. Any

087other questions from especially those who didn't have any? All right. Thank you very much. We'll move on. I do have a question. Sure. Do our doors that are being clear windows like a security window are they closed off? I mean we have a I would say the majority of our doors within the school system have a sight window in them. Um, you know, if if I had to today, you know, if we build a new school, we would not have that sight window indoors. Uh, just do for safety reasons and that that sight window can be broken out. Then someone can, you know, if someone active shooters um, especially active shooter drill, you shoot that out. You reach in there and pop the hand on your end. So, but for today's world, the majority, I

088would say 90% of our doors that are not behind a custodial all custodial room have a sight pane in them. Okay. Um, before we move on, I just want to say, go right ahead, please. that um Mary, Shelly, Alison, thank you all for coming. Thank you. And just for what you do for our community and kids and and just thank you. It's it's not easy work. So, we appreciate it. Well, I'm just going to say thank you right back because it it takes a village. We can't do this work on our own. Uh working in silos is the wrong way to do it. So, thank you. Thank you. I I would echo that place of again, I mean, it's an honor to be in this county, in this community. You know, I said years ago

089when I was in front of you all the last time. I mean, I've been in Jefferson County since I was like uh maybe six, I think. Um, this is home second only to the place I graduated high school from. Um, I mean, my family's had property here since the 90s, right? Um, and so being in this community serving our families for generations is a huge honor. And again, I mean, everybody's here tonight because what we ultimately care about is that kids do well, that families do well, that this county does well. And so, it is just an honor for our team to be able to serve alongside you all in meeting that vision and mission. I I think I think what we're going to be doing here is theou u we that that is not

090a a document that we voted on, we approved. Um So, I think we're going to go ahead. Uh, we're not going to actually change anything in it tonight. However, I would like to go around the table and find out from people what if we were to change something at the next meeting, what they in fact would like to change in it. Um, so that we can give Dr. Arnold a heads up so he kind of knows what we'll be talking about and the rest of us know what we'll be talking about at the next meeting. So I am going to take a some a chairman's prerogative and just ask everybody if they could go around and very quickly site sections uh of theou uh that they would like to change and what they would like

091to change in it. But obviously we're not going to take any votes to make those changes tonight. Mr. Chair. Yes. I'd like to request that this document be on the agenda at our next meeting. I believe it is. Is it not? Not this this just is all it says. Oh, all right. So you want this as presented? Yeah. Okay. That's fine. It' be on the agenda. Yes. Included in the packet. That's fine. Okay. Uh we started going this way this way. So let's start with Miss Mayor and uh if you could site what u uh what section and what subsection you're talking about and uh say what you would like to change, modify, omit, whatever. And let's make this as quick as possible. Uh uh let's not have a lot of cross discussion on this.

092I think our thing right now is just what everybody's concerned about and then we can have most of that discussion at the next meeting. So go right ahead. Um let's see. I'm just refreshing my mind on my meeting last time. So um and this one will hold to the six the six minute. So one of my questions was with the whole section in general. Yeah, I would like to know really why that I mean like section Section 22 contract will provide consultation with classroom teachers to assist in positive trauma informed classroom. Trauma informed classroom. Do we know what that consists of exactly? So you're asking what that term refers to. Yeah. trauma informed classroom that enhances the learning environment and assists the teacher developing effective trauma informed behavior responses. trauma informed classroom. I think more

093in general it's that um that they will include the classroom teacher to assist in the process of you know discussions about as a two-way street. So um we'll provide consultation with the classroom teachers so it's a very broad term right it is a broad term and I think that there needs to be more detail on that so of course there are um just as um Helen Ross McNab and Ally talked about including the family and you heard tonight about um the child spends sometimes the majority of their day in the school setting. Um more time with school than than with family. I think there's an importance to have consultation on whatever. But that is a broad term one that's used. Um do you have something that you would I mean would you want to just

094shorten it to contract will provide consultation with classroom teachers? U not worry about the terminology of what that consultation consists of. Yeah, I think so because it's it's a very broad term. Sure. I think they're kind of open up a can of worms to other things that we know. So that needs to be there's also another thing. This is under section 21 students may be released from class to receive contractor services at the teachers. That seems very broad to me as well. It seems to me like this could be at any time which kind of negates the whole it's going to be at the same time same day every week. So that says at the teacher's discretion. So we currently have that in place. Mr. Rogers has left. But if you call down to Philip

095Easterly's room, who is the German teacher at the high school, and you ask for a student to leave his room, it is at his discretion if he allows that child to leave his room at that time. So So you're saying they're they're contacting the teacher to see if it's okay to pull the students. Correct. It's not the other way around where Jimmy is being disruptive in class and so the teacher's discretion, he or she can. Oh, that is correct. So they work with the teacher to set up um just as you heard them talk about teac. The last thing they want is for a let's say it's someone's birthday and they are having cupcakes. The last thing they want is for that child to come down for a session and miss that event in the

096class and be ticked off and add to. So they want that whole network to be involved. They want it to be at the teacher's discretion. Okay. Um D teachers will notify school counselors of the need for individual referrals to mental health service and staff will appropriate forms to contract. The teachers will notify school counselors of that possible. I think the word possible needs to be added in there. Possible need for individual referrals. I mean, teachers are not qualified behavioral analysts or anything like that. Yeah. They're not making a diagnosis. They're just right. They're making a a referral for an individual referral. So, the teacher does have the ability and the authority to issue a referral. So, the word possible be considered added between that. So a teacher has the authority to issue a referral um

097referral. So teacher will notify school counselors of the need um for individual referrals. So the teacher can issue a referral for a student. Then that refer then that counselor works with the principal administration to notify the families of the referral and then it's up to the families if they choose to seek some sort of um school or seek some sort of mental health. Um also Don one more thing in this round for you please. All right so um in section 22 uh I don't see anything in here for school district responsibilities saying anything about you know student tests and assignments cannot be excused as a result of any behavioral services. Um they still need to make up their full work. I don't see anything in there at all. So, I it makes me wonder if

098I ask, are students being excused from tests or any kind of assignments to do these services? So, this would be a this what you're asking is on the school side of things. Um, so that would have nothing to do with the mental health agency. It's no different than if a if a child is going to a funeral or going to a doctor's appointment, eye appointment, dentist. Uh if a child is in any absence, then they still have the ability to make up even a suspension. Um, a lot of times we offer the child the ability to make up missed assignments, missed test, uh, those types of opportunities. So, that would not be in theou an agreement between the school system and the agency. That would be a procedure and it's actually in board policy about

099absences and makeup work with students. Yep. No problem. All right, folks. I'm good with this one like it is. D, I don't have no questions, but I do have a couple comments. Thank both you companies for what you have done and what you continue to do. Did you hear that? That's what I Yeah. I know there's been a lot of questions asked, a lot of questions answered, but to me, this contract or this agreement, whatever and Thomas went over. Thank you all. Um I just wanted a couple clarifications on something. Um actually is 21F and 22D. Are they the same thing? Basically 21 F 22 D one just talks about teachers and the other one school staff. It's kind of the same thing though, right? Kids either in class or Yeah. So whenever it talks

100about So you see 21 is under the school district responsibilities. 22 is under the contract responsibilities. So 21F says that that is the district's so the teacher has the authority to school comes first. Um, so if something's going on and at that teacher's discretion, the child cannot be released for services at that time, then the teacher has that ability. In 22D, it says that the contractor will coordinate delivery of services with the school staff to minimize disruption. So these two things put the school at the catsburg seat. So, u we're we're in charge. Okay. So, it's just making sure that both sides understand understand the same. Okay. Yeah. We're here to work together, but in the end, somebody's got to be in charge. Just sounded kind of redundant, but I I understand what you're saying.

101Um and when when do we It says contract may provide training to tell me tell me. Oh, I'm sorry. Um 22G I'm just and I'm don't want to change it. I just want to know the contract may provide training LEA personnel regarding a variety of mental health and substance when do they do that? Uh so this would be a lot of times at the beginning of the year we have to have so the state requires us to have u some suicide prevention uh some DCS referral. Um do they do it before the school starts like that week before they go in? Yes starts. Yeah. So we pay our teachers for seven and a half hours of training. state requires is 22 hours. It just keeps growing every year. We try to reduce it but more

102and more requirements of teachers for so some of the providers assist counselors to uh deliver this to to teachers like in service day or that before. Okay. Okay. The only things I'd like to see put in this just because I don't see it in here. Um, and I know that we we discussed this and and I actually spoke with Dr. Arnold about this too. Um, I'd like to see in here where it says that they do not facilitate a class of any kind of subject. I can't find that code. Refer to that name here. And then the other thing would be not to enter any classrooms or other areas with other students that do not see mental health therapy. Um the attorneys that would definitely be a no no for a purpose. as in chilling

103out in the back of a science class just to kill time or whatever. You know, those are my two big things right there. And I do want to ask you when you're done writing that too. I'm sorry. I I was like, I just wanted to clarify one thing with the um number five. Go ahead. on number five. This was about the background checks. Yes. So, when I spoke with the attorney, he said, "Yeah, I guess we have they're done. It's done through the it'll be done through the state, whatever whatever they do, which is what we do. That's what this is is referring to. Correct. Yeah. Okay. Yeah. TCA 495413 is the same requirements that we h our staff um at um so they would have the same requirements that's for their employees that's a

104requirement of department of education the same yes um and the only other thing I don't know how we do this um and I think it kind of Oh um not to schedule appointments that can be scheduled in a mental health office. Uh Mr. Bennett had said that that's something we should not be doing. However, how you kind of line that up to where a student needs to see him versus setting appointments. And it kind of sound like he was kind of not sure where you draw a line on that. And I didn't know if that was in there or how that verbiage was or I I didn't see anything. But I don't want I don't want a child either. I don't I don't want them to. Right. And I think he we talked about the

105sole responsibility of aou um with a mental health provider is not out of convenience. Um and we conducted a RFQ, RFP, RFQ. So, we we've sent out a request for providers to um help Jefferson County schools with an issue that we saw within our school system and to provide services that exceed beyond what our counselors are able to do and to provide to to our students. So, um this is above and beyond just convenience. Um and I think that the attorney was good with that having having that RFP piece associated with there was a reason we went out for this. Um, it wasn't just to, um, you know, I've got a good friend who has a mental health agency. I'm going to let them in the schools and we're going to, you know, do some

106some some work with them. Um, there was a need that that was seen. We provided that reached out to vendors and and they came in to to support. We do have right now two vendors and a list of other agencies that can provide services to our students. Thank you. Okay. Um I will start by saying two of my main concerns at the outgo here has always been number one liability. How the liability of the school district for what our health uh our behavioral health providers provide. That seems to be addressed very well in this and I'm satisfied with that. The other one was parental rights. making sure that the parent parents are are involved from the before any referral takes place before any major decisions are made uh and I I before therapy ends uh

107with what was said tonight as far as the parents if they want to be involved in the therapy sessions other than in very special situations they may be that's even better. So that those two concerns of mine have been have been satisfied. Um I do have some questions. Number one uh uh in uh paragraph one number a I would like to delete the word parters partnership because it it seems to completely go against what's in uh section 17. This reads, "Contractor assumes all duties associated with operating the mental health services partnership with Jefferson County schools at the following schools, whatever." And then in 17 it says, "Nothing herein shall in any way be construed or intended to create a partnership." So it seems like that goes against what number 17 says. So I would like

108to um insert the word program in number one for partnership just so that there's no misunderstanding. Uh again number number two um term this agreement commences on whatever and shall terminate on the June 30th 2020 whatever upon mutual written agreement the agreement may be extended. I would like to say by mutual agreement and review by the school board, this agreement may be extended at the end of each term. So I would like to add the words review by the school board. Number five, um compliance with all federal and state municipal laws. I would like you know add to the end of that uh of the final sentence and shall provide JCS with copies of same. So that um that sentence would read in any right agreement and shall obtain any and all permits and licenses

109necessary to the performance of its duties and shall provide JCS with copies of the same. So in other words, I'd like to have copies of the state whatever you know the state approvals for Allied and McDam on file at the schools. Whether that's necessary or not, I don't know. But I think from a legal point of view that's reasonable of the of the clinicers license. Yes. Okay. Not of the background checks. No, no, no. Okay. I was just making sure because all that's rolled into five. Yeah. Just in case. We don't share those and we wouldn't want to share those. No, that would be in case the parent comes in and said, "I'd like to see the qualifications of the of the person who's going to be seeing my kid." Yeah. And no matter if

110I have those or not, I'm going to refer them to even if I have them, you know, they may not be up to date. I'm going to refer them to the agency. That's fine. Yeah, that's fine. Uh number five, um A&B. Hold on one sec. No. Okay, let me let me Yeah, Paul's already covered that, so I'm not going to cover that. Number nine, that was answered in my questions. Section number 14. Oh, okay. We are uh number [Music] 14 indemnification contractor shall hold harmless and hold harmless JCS officers aids and employees from all right again this is anou this is not a contract so I would like to uh contract is mentioned twice in this uh where tell me again I'm sorry this should be okay One, two, three, four. The fourth line down

111connection with the performance of the contract. I would like that changed to agreement. And contractor shall pay JCS any expenses incurred as a result of the contractor's failure to fulfill any obligation in a professional timely manner under this contract. that I would like that changed to agree number 18. I missed the first one. I'm sorry. I missed the first con. I've got it now. You got it. Yeah. It's like I'm word searches my mama used to do. Number 18, scope of services. Uh I just have a question and and this is probably something We can talk I can talk to you later. I don't know what an a SBBHL that acronym. I I just need to [Music] clarif behavioral health. It's schoolbased behavioral health. School based behavioral health liaison. That's the that term that language

112is the language that the the governor has utilized. If you look under one schoolbased program if you look under one Okay. duties the third line. Oh, okay. For schoolbased behavioral health leaison. So, it is spelled out. Okay, good. Okay. Um, the 21g. Is there a specific verbiage in the per parental permission for services form indicating that the district can provide this info behavioral uh to the health forms? This one this one says uh the principal or principal design may provide contractor with information about student grades and attendance after the contractor has obtained parental permission. Is that prior permission a separate form or is that is that included in the original permission? No, it's a separate form. Uh so we do this with uh several agencies. One in particular is Boys and Girls Club where they

113serve students. They give parental permission and we share things with Boys and Girls Club. But the parents have to sign a separate Yes. permission form for that. They do. We protect those those student records are under FURPA. So we would not share those without a parent consent. Okay. Is there some way we could clarify that that's a separate form and that the parent know that by signing the original parental permission form they're not you know u saying it's okay for this that they would actually have to give specific permission for that. That's just a question. If we can do it fine. I can put it in there. Yeah. Okay. We all know. Um so I will add that to clarify that that is obtaining. So, anything they anything a parent does with um a mental

114health agency does not um they won't share with us u personal information without uh us getting approval from the parents. Same thing as going to a doctor, a doctor's office, anything of that nature. I've exceeded my time, so I'll come back for the rest of my stuff. I don't have much more, but Mr. Mayor, do you have anything else? You do not I presume Mr. Hardy. I'm good. Okay, is everybody through making changes? Well, I have one more thing, but but All right. All right. Uh 22E. Um contractor shall follow the guidelines of the school in obtaining parental permission as necessary prior to the delivery of services to students. Contractor will not see any students under the age of 18 without parental consent. The school staff/counselors will reach out to parents of any student under

115age 18 and obtain parental consent from the guardian/guardians. And I would like to put in written and signed form prior to providing contract with the referral services. We probably do that already. I just like to clarify that that's that's what we do. And that is all I have. Yes. Now, I've already asked for this to be on the agenda. So, this document will be number one under MOU. There's going to be have to be a document with all your changes in it. There's going to have to be a document with all his changes in it. So, there's going to have to be two more documents, two moreus under that heading. This one's number one because I already asked. That's fine. I think, you know, you understand. I'm just trying to clarify. No, no. You know

116where we are. No problem. There be it be just, you know, Sure. make a motion. This don't pass. We got other choices. Unless you all want to combine your, you know, into one document instead of having three separate documents, you could have if that's the case. I don't know if there's a clarity between what you want and what he wants. Yeah. I Mr. Chair, I'd like to see the document that we've added all this stuff. I'd like to see that as a finished form for us to look at to on top of the one that he's Yes. Yeah, that's what you just said. Yeah, I' I'd like to see three separate. I'd like to see it as just one completed. Okay. For us to look at it like that. So, and if anybody else wants

117it separated, that's up to them. But I'm fine with So, what coach is saying is with this is already on the agenda and that will be voted on first. Everything that's been changed will be number two on the agenda. So, and I don't have a problem either way. I mean, you know, with everything being changed, I thought that as soon as we get these people under contract. So, so we understand that prime example is whenever we talked about u bonuses for employees. Yes, we had several options and we ended up choosing a $500 and this and that and there was another option out there. So understand that you know I've got seven people that I work for sure and then also um we are working on agreements with two agencies that need to make sure

118that they are in compliance and then we've got a a board attorney and we've got a meeting Thursday. So, uh, I'll be on I've already informed Bennett, you know, they're aware. I'll send them some information. And, um, you know, I'm sure if they have anything from this conversation that's glaring, they'll reach out and let me know before tomorrow morning. That's why I wanted to have this conversation. Yeah. Okay. Anything else on theou before we move on? I found you have anything more in your director's input? Um, items for information. That's pretty. So, recognitions, we won't hit any more recognitions till school gets back in session. Um, as you see over there on the left, there's no principles here tonight. Uh, there was Yeah, Randy was here. His boys got a game. So they may wander

119in, but um you know they've got a lot of stuff going on. Hardest job I've ever had was a principal. So I told them till we get back in session in school to not feel like they have to be in attendance, they're welcome to come. Um and if we have anything that comes, I mean hopefully we won't have uh anything that arises of great importance. Um but um we we are working on Talbot. You know, I'll update you a little bit there. So, we've got that project out for bid. We'll see how that goes. There's a lot of construction going on. So, um we'll see how that goes. And then we're still working on u contract with blank ship. Um, attorneys are always fun to deal with. Um, right now I'm kind of okay with

120what the contract states. Um, Bill's okay with the contract. We have one hiccup that both the county attorney and our board attorney has an issue with. So, that's where we're at. One one problem. Uh, two lines. Um but it's a sticking point right now. So, but um just to let you know as far as Jefferson Elementary goes, you know, we'll look at having we've talked about that construction manager, that's the RFP that's out now. That's the next group to hire. They'll work alongside the architect. And then down the road, we'll look at an environmental company to help us with testing and and uh ensuring that we've got a safe work environment for our staff and students. So, so that's where we're at. And then also in here is threat assessments. That's a document that we've

121ended the year with. I've sent you information before just on the quarterly report of number of third assessments, but this is a more detailed report in the year that we are submitting to the state. And then um for the upcoming board session, I will bring the document that was presented last month. And then u I will also just label it one. It'll be first on the agenda and then right under it'll be an updated version that'll be on there. That's all I've got. Sir, commissioner, I have a question. MOU of contract. This is a memorandum of understanding. But who are we negotiating with? I mean, you know, like the teachers memorandum of understanding and when the board votes on it, it becomes contract with the teachers, right? It's B. So if if we approve this

122document or your document or whatever, it becomes a contract. They have to follow. So I know I'm just confused. Yeah, it's a little bit of verbiage. A lot of times contracts deal with money uh memorandums like we have a memorandum of understanding with the sheriff's department uh with the use of SRO's uh we have a memorandum of understanding with Carson Newman to use their facility during emergency evacuations and what they'll do and what we'll do. Um we have several memorandum of understandings but you were kind of negotiated with the sheriff department right? Yeah. Yeah. I signed those. Yeah. See so we know. Yeah. But see they weren't involved in the formation of this uh memorandum of understanding. The people who are going to provide these services they had no say in this document. They they

123do have a say in signing it. So they have seen it u of course they've seen it right and a lot of times that's the sheriff presented the memorandum of understanding to me I presented to Carson Newman the memorandum of understanding to them uh and and we came to terms of agreement and u so they they do have a say um in approval of signature. So yeah, I understand that but so a lot of times contract it's a contract. It it is I mean it is a form a memorandum of understanding is a form of a contract. Usually it is less yeah less binding. It is uh doesn't involve money exchanging hands a lot of times. So just in this incident there is no money exchanging hands in here. Okay. Commissioner comments. Mr. Hardy. I

124would like to thank uh both and Ros for showing up tonight and answering questions. I had a lot of questions but I appreciate all the the answering of them. Thank you for coming. M uh Mr. Charles Hicks has presented us with a question about prayer. I'd like he and Mr. Arnold to work together and see what question what we can do. I know last year year before last uh someone said about praying before football game and of course I know the state won't allow that. So whatever you all can work out then present it to us and we'll agree with yeah and you know just to elaborate on on that what you can do I will say that each of our schools um they we have flags within our classrooms u we have students um

125in elementary, middle and high school. You know, every day at the high school, the ROC goes out and and raises and lowers the flag in a ceremony type situation. Um, in elementary school, um, they go out and put the flag up. One day, someone sent me a picture, the flag was upside down. I said, "Well, they're nine. We made a mistake." So it looked good whenever they were hooking it through there and lining it up. Some people are not as forgiving as others. But you know, we we do take that into great pride. Uh we also every morning in all of our schools start our day with a moment of silence. Um so um that is very important to us in in preparing our students for activities of the day to have that moment of

126silence and it is um you know um it's not to be I mean we have everybody within our public school is from different um denominations denominations ations, religions. So, uh, you know, a lot of times various individuals don't want their child to have a certain prayer prayed to them. So, so we give our our students or staff the ability to to have their u their own prayer, their own moment of silence. uh every day over 38 years of teaching I've seen a lot of prayer in school particularly test day and hand out the test there's a lot of prayer going on and I didn't interrupt yeah I I gave a uh my mother-in-law is German she definitely respects the moment of silence because she remembers whenever she was in grade school whenever the cross was

127removed from the school wall and Hitler's picture was placed on the wall in its place. U so she comes here to this country respecting the moment of silence anything I I have just a couple things. First of all uh we don't have any meetings in July. So you know once we have our next business meeting that's going to be it for a while. So, I'm just uh reminding you we do have a joint meeting with the county commission on July 17th at the Patriot Academy. All right. We are hosting it this so the agenda is up to us to set. So, if anybody would like to put anything on that agenda, please contact Josh Cameron who's the chairman of that or Dr. Arnold uh July 17th. Number two, the policy committee is meeting the 25th,

128August 25th. The reason I'm saying that, we will have meetings before that. But if you look at this, take a look at the legislation. It's like all of that was legislation that had to do with education that was passed. Those are all policies that we are going to have to review, add, believe, whatever. So, if you individually as commissioners had any policies you want to have discussed at the policy meeting, please get them to us because if you don't, they're going to get lost in all of this. So, that meeting we might as well bring separate. We probably will end up having two separate meetings. I mean, it it it's amazing what went on. July 26, special call. June, no, June 26. Yes. June 26. June 26. A special call. That's for last minute budget

129amendments for the uh for the budget. Yes. And one personal I want to I think most of you knew that my mother-in-law died uh a couple weeks ago. I want to thank everybody school district commissioners for all the nice uh condolences that you sent to me and especially to my wife. We really really appreciate it. Thank you very much for your concern and and care. And if it if there's nothing else, this meeting is adjourned.