 All right, good morning. It is September 16th and this is Senate Health and Welfare. We have a small committee this morning because Appropriations is meeting, but we will go through some of the budget policy language that is in our jurisdiction and so that we can better understand what's there and then perhaps make a recommendation. For those of you who are not here, but out listening and looking in on the committee if anyone is there, we won't be spending the entire morning. We'll work with Katie McClinn and Nolan Langwell and on the budget policy language and then have our short discussion and call it a day. So Katie, thanks for being here. And I know you had said that there were sections of the big bill that contain mental health, embedding in police and some of those issues that we have looked at, also the CCFAP rate information and we will have Commissioner Brown and tomorrow on that so we can talk about whether or not you wanna go through that this morning. So- Okay, I'm working to pull up the document right now. All right, great. Here we go. Okay. Thank you. This is section E314.2 of the budget and this is the language that house healthcare most recently worked on with regard to the proposal that originally had 525,000 going to DPS versus mental health. So as we discussed yesterday, healthcare made the decision to have the funds go to mental health. And as you saw in the memo that that committee wrote, the rationale behind that decision was that mental health crises are a healthcare issue and therefore should be funded through the Department of Mental Health. So you'll see that the money is going to DMH for fiscal year 2021 and that DMH is to collaborate with DPS and other stakeholders, including individuals with lived experience of a mental health condition or psychiatric disability and those whose identities cause them to experience additional marginalization and expanding regional models that strengthen partnerships between law enforcement, mental health and social services through clinical staff positions that address crisis response to mental health emergencies. So that this is what the money is being used for. So we're kind of braiding together response to mental health crises through a law enforcement mental health and social service lens and looking at doing that through clinical staff positions to address crises. The purpose of the program is to- Let me ask a question. Sorry. No, please. I think we should ask questions as we go along because we didn't memorize the memo yet. Thanks for my letters. But my question is this, in the discussion that went on in the house or does this language direct the Department of Mental Health to be responsible for determining which regional programs or how is that being sorted out? Is that something that's happening through the MOU with public safety? Why don't we look at the rest of the language? Okay. That's okay with you. I think that that's good. And then we can, if it's not addressed, remind me again and we can circle back. But I think the rest of the language might help to fill in some of the gaps. So this goes on to say that the purpose is to enhance the statewide response to crisis, reducing involvement of law enforcement when those supports are not necessary for public safety and ensuring strong coordination when those supports are necessary. So again, just a recognition that public safety supports are not always the ideal supports to address the mental health crisis, but there are circumstances when those supports are necessary. And it goes on to say that the purpose of the program is also to improve access to services and supports for mental health needs in the community. And then in subdivision two, it gives some direction that to the extent possible and hiring individuals to carry out the section, DAs and SSAs providing the services shall give priority to qualified individuals with lived experience. So in this section, we learn that it's the DAs and SSAs that are doing the hiring and how they're supposed to prioritize their hiring. In subsection B, this is a status update. So by November 15th of this year, both departments of mental health and public safety together to provide a status report to the Health Reform Committee and Joint Legislative Justice Oversight Committee on plans for implementing the program. And this is what specifically that status update will include. You'll see online 10 subdivision one, this is the MOU. So we don't know exactly what the MOU will look like yet. So this is asking for that on November 15th. What's in the MOU and with the DAs and the SSAs? What does that look like? In subdivision two, the partners and stakeholders involved in planning the program. So who's at the table? In subdivision three, the geographic locations identified for new clinical staff resource coverage. And in subdivision four, the physical location for planned staffing. So if you remember our conversation yesterday in the memo that we went over, there was a recognition in healthcare's memo that this issue of how to address mental health crises is twofold. There needs to be some work moving forward on how to reimagine what the system could look like. And so that is where subsection C comes in. So far, we've been looking at what's happening for this budget cycle. But subsection C kind of turns to the future and asked the Department of Mental Health to coordinate further development of a cohesive statewide approach to mental health emergencies and emergency calls under the leadership of impacted communities in collaboration with the Department of Public Safety, the DAs and SSAs, the Department of Mental Health Standing Committees for adult and children's mental health. And that in doing this, the approach would be consistent with the 10-year vision that this committee received a presentation on earlier in the year. And then there's a report back on March 15th, 2021. The Department is to report on its progress in developing a statewide approach to mental health emergencies and share that with this committee in house health care. Okay. All right, questions, go ahead. I was just gonna say in terms of your question, is there any specificity as to what is in the MOU? There's not a great deal of specificity. It's sort of leaving it up to the Department of Mental Health and all of the stakeholders listed to figure out what the right framework and where the needs are. In terms of specificity, we do know that there's priority given to individuals with mental illness and that we're looking for involvement from a wide range of stakeholders. We're looking to cover geographic locations throughout the state, but besides that, there is a lot of specificity as to the requirements of what the MOU must contain. In some ways, that's probably beneficial to Department of Mental Health and public safety. On the other hand, I don't know. Questions for Katie on this? I'm doing some thinking right now. Any thoughts? Well, it's very... I mean, it's left up to them to really do on the fly, almost, isn't it? That's... But I don't know if... Well, I think, yeah. You know, the thing is that... Right, go ahead. I think that's a good question. The thing is that... Right, go ahead, Senator. Sorry to interrupt. No, I'm sorry. I don't know if we should try to provide more direction or not. I mean, maybe it does need to be done more at the grassroots level as they're seeing what evolves. So when Katie, when you talk about the stakeholders involved in working on the MOU, that is really... The people in charge are DMH and public safety. And then they look to partners and stakeholders to complete their work and to produce an MOU. Is that accurate? The grouping is... It's beyond just DMH and public safety. Sorry, online is 10-11, but their stakeholders, including individuals with lived experience and those whose identities cause them to experience marginalization. So it is casting a wide net to pull in to pull in a bigger group of people than just from the administration and the two departments. Well, as I think about what's actually happening in our municipalities, their municipal government and local police have been very much engaged, but this is more about state police. And so the models that are out there are models that have been developed locally, either between a hospital and a Howard Center or other organization similar like Washington County Mental Health. So those organizations are already working on some collaboration and they have some expertise in how response takes place. Is there anything in here? Well, it does have them scrolled down, I think. It does have them look at current models, right, in the state. No. These are the things that the report back. The report back includes the MOU, partners and stakeholders, geographic locations and physical location for the planned staff. Oh. I mean, for me, it may be that the state police can link in with a current program and that the current program can simply be expanded to cover state police calls in a specific region. So I guess that's the thing I'm thinking about. We already have some ongoing programs and they've been proven to be extremely good and effective. Am I making sense, committee? I mean, do we want to step into this or with some kind of single line about a possible coordination with current programs? That makes sense. I mean, Department of Mental Health further development of a cohesive state. That it talks about a cohesive statewide and impacted communities. That gets to that, Senator Cummings. I think we're stepping into the area of micromanaging. I think that people involved in this work together now, they know they can do this. They don't need us to tell them to look at successful local programs. And I think if we let them work it out on their own, I think we have to trust them at some point. Well, I'm with you on that. My concern is that we don't develop parallel systems all over the state. That's my only concern. And I agree with you that the DMH and public safety are perfectly capable of diving into this. But sometimes things take on a life of their own. And maybe that's the next step, the statewide approach. So the line 18 does say under the leadership of impacted communities. Yeah. So that sort of implies that communities where there are existing programs. Yes. And it will fit in with the Department of Mental Health's 10-year plan. So I'm just trying to make sure we're not leaving something out. I have no interest in doing this work. But I do have an interest in ensuring that what's here is going to won't lead to problems later on. OK. The other question that we probably should answer is going back up to the money, who gets the money and who administers it. And we heard a strong recommendation from Mike Shirling that the public safety needs resources and that they could do the work if they had the resources. But of course, we're a committee on health and welfare. So I lean toward the comments that are here by the Health Care Committee that this is a health care issue and the money should flow through the Department of Mental Health. As the money flows through the Department of Mental Health, Katie, does that do anything to detract from what's available for the program itself? I mean, is it going to take money to administer? Will it take money? Yeah. You're asking if it takes money from an existing program? I'm not the money person. No. No, no, no. No, no. The $525,000 will go for boots on the ground. That's it, right? It'll go. I believe so. I believe it's to hire additional clinical staff. OK. OK. All right. Any questions on that section? I'm asking Senator Cummings and Senator Ingram, do you agree with this iteration that the money should flow through the Department of Mental Health because we're looking at a health care issue? Yeah, I actually feel quite strongly about that. I think that's where the money should go, for sure. Ann, are you OK with that? That's fine. Yeah, OK. I feel that way, too. OK. Senator Lyons? Yes. Is your intent to review this language and make a recommendation to the Appropriations Committee about this? Yes. OK. And did they know you're doing this? Because they're blasting through the budget. I'm sure that they are not. Well, yes. Senator Westman and Senator McCormick should be aware of this. I'm just making sure that everybody's on the same page that there's an understanding. Yeah, well, I'm. Yes, you're right. They'll say, OK, we're going to wait for the recommendation from the committee before we move on this versus they may. They won't. OK. I'm just making sure. Coordinated. Well, thank you. No, thank you for that. I will be in contact with Senator Kitchell. I did not realize that they were meeting this morning. Otherwise, that would have happened yesterday. Well, I'm not sure if they knew they were going to meet this morning. I just know on an accelerated timeline and they're trying to get it out. So I don't know if they knew they were going to be today either. OK. Are we going to be finished this week? Well, so next week is the last week. So in theory, you want to get the budget out this week to give time for a floor and conference and whatever. Well, we have bills that the House has to act on. So if they send us any of our bills back, that would be nice. So I think next week. Yeah, Senator. Excuse me. I just wanted to. That reminds me that I did get an update from our house colleague yesterday about the age 663. They have been told they're not going to. It's not going to the floor in the house. We will not be seeing it. They have been told, apparently, by their leadership that they only want to pass things that are emergency or directly related to COVID. So no contraceptives in the schools or wellness or minstrel products. I've heard that as well. OK. All right. Anything else on Katie, is there anything else in the budget that we should look at? Do you like to look at the CC FAP language or are you doing that with Sarah Penn? I think we are tomorrow. But is there something we can look at? Can you just briefly make us through that? Yeah. Not long. I think we should be able to finish relatively quickly. All right. And that was the health care version. That wasn't the whole, hold on. I'm going to stop share. OK. I'm going to try to correct documents. OK. Take two. So the next section in the budget is E318. And this is the child care provider stabilization grants. And this is 800,000 allocated to expanding infant and toddler capacity. It gives the division of the child development division the authority to award grants to eligible applicants. And then it goes on to define what an eligible applicant is. It can be a new or existing regulated privately owned center-based program or family child care home that's in good standing. The program that participates in CCFAP that provides year-round full day child care and early learning services provides child care and early learning services for infants and toddlers. And the program participates in STARS. And then in subsection C, there's language that center-based programs and family child care homes that receive a grant under this section must remain in compliance with the division's rules, continue participating in STARS, and maintain enrollment of children supported by CCFAP. So once you get the grant, you continue to comport with the eligibility requirements. Next is language pertaining to CCFAP. This states that DCF is to align CCFAP eligibility with the current federal poverty guidelines. And DCF is to align rates of reimbursement for preschool and school-age children participating in CCFAP in fiscal year 2021 with market rates reported on the 2015 Market Rate Survey. So bringing school-age and preschool rates up to the 2015 survey and then maintain rates of reimbursement for infants and toddlers participating in CCFAP in fiscal year 2021, aligned with market rates reported on the 2017 survey. OK, so we're going to hear about this tomorrow. How does this change what we did? I'm trying on the market. I'm trying to remember. I'm trying to remember what the rates were. So this says maintain rates of reimbursement for infants and toddlers to 2017. So that leads me to believe that when That's what we did. Childcare bill last year, you must have done 2017. And the fact that you're moving preschool and children to 2015, it makes me wonder if it was 2014 last year. Don't quote me on that. I have to go back to the bill and see where it changed so many times in so many different versions. I can't remember where the numbers finally landed. Right. I think we've had emails about this. But we'll thank you for looking. Yeah, the emails have to do with the rate surveys done every other year. And so this is asking for an interim market rate survey to see how COVID has affected the market rates. And then if you remember, the child care rules changed two or three years ago. And there was language and a lot of discussion last year and two years ago about creating a variance for child care providers who have been working for a certain number of years. So this language continues that individuals that are operating or employed in a registered family child care home or as a director or teacher associate at a center-based program for 10 or more years prior to September 1, 2016, this allows the commissioner to issue a variance to the division's rules regarding the education experiential requirements allowed to maintain employment in the same role, regardless of whether the provider, assistant director, teacher associate, and tends to attain otherwise necessary educational requirements. It goes on to have eligibility for the variance. The person has to work continuously in a regulated program with a full license and good standing and meet the division's educational experiential requirements that were in place as of September 1, 2016. And the commissioner has the authority to review any violation occurring in a regulated program where a family child care provider, the child care assistant director or teacher associate is under variance and may revoke the variance granted depending on the seriousness or circumstances of a violation. And any variance granted under the section is to be terminated on July 1, 2024. And extensions cannot be granted beyond that date. And then there's language on general assistance, which I'm not familiar with. So that's the end of the child care. This looks like it looks like it's also related to COVID in some way. Is that true? Yes. OK. I think this is the temporary housing in catastrophic situations for vulnerable populations. So I don't know that that's necessarily COVID related. But it's temporary housing for weather, yeah. OK. I think my guess is that is the language that we've been seeing the past few years in the budget around GA housing. Yeah. OK, I'm going to stop the share. Here we go. All right. Questions for Katie? That's good. We're going to dive into some budget stuff tomorrow. And we're looking at stabilization funding and how that's going. So we'll maybe we'll be able to ask some questions then if we have them on this. OK. Anything else, Senator Ingram? Senator Cummings. Is it your understanding that we'll be able to do H-611 today on the floor? That's the. I sent that email to Senator Ash. And I don't know that I don't know whether I've heard back. I did not hear back late last night. And I haven't looked thoroughly at my email since about seven o'clock this morning. So I don't know. OK. Are you ready? Yeah, so let's sit here tomorrow. So I know that we've got we've got 795 is coming up. I know that we've got the Act 250 bill. And there's another bill, 354, I think, on hazard pay. So we've got those bills. And then depending on Howard Wen's feeling, it would be good to get 611 across to the house, back to the house. They're very anxious to have it. So it's interesting that we've gotten all of our work done on all of their bills and sent them over. We haven't seen one of our bills come back, really. Yes, this is this is something we remark on into an education all the time. Well, you know, it suggests to me that we're going to slow down next time. Anyway, not really. We get our work done. Yeah. All right. Committee, is there anything else that we need to do today? OK. I'm thinking that after tomorrow, our week next week is going to be pretty light unless we see something coming back to us. What I'm going to do is work with Nellie and just schedule some committee time on Wednesday and Thursday. Keep your ears open for Tuesday. We won't schedule anything for Tuesday next. But unless we need to, if there are amendments or things like that that we need to pay attention to. But we'll set a committee schedule for Wednesday and Thursday with committee discussion in place and then see what comes up. And we may or may not meet those days. How's that? And that's how your muted, Senator Cummings. I will only be here for a short while, if that long tomorrow. Tomorrow, we have joint meeting with the House. OK. So you won't miss me. OK. I will miss you greatly. We will miss you. OK. OK. Does that sound good, like a plan? I'm going to suggest this. Nellie, I'm going to suggest that we go off live and that if you and Katie and Nolan can stick around, we'll do a quick agenda planning meeting and then that'll be it. Thank you both.