 of what each other's found and discussed. The other piece that the Interface Working Group has been discussing is the technology piece right now when any call is transferred. It's being done with just voice information. So any information that needs to be relayed, if a 911 caller is determined to be better suited being able to talk to one of the 988 centers, when that call is transferred, it's just like any other transfer with an exchange of information via voice from the Public Safety Dispatcher to the 988 center with no other information behind it. So we talked about the possibilities of being able to once the CRM that's going to be utilized by the 988 centers, when that comes about, being able to electronically take data and be able to transfer it from the 988 center to the PSAP or back and forth, maybe even taking advantage of the data lake project that we already have going on, because that's already a data repository that will touch every PSAP in the state. So you're not having to create new connections, et cetera. And then one of the other things with that is the need for some sort of geospatial data. So the idea is looking at a map where you could look at a particular location on that map and then already know who's the PSAP that covers this, what's the 988 center that covers this, what's the availability of any mobile crisis response teams or other types of services that are available. So that way there's one location to look at as opposed to everybody having access to different data sets that are out there. So that's a summary of what we've discussed up to this point. I'd be interested in hearing from the board members on any other direction we need to be looking at. I know we're gonna be coming up on some timelines here where we really need to produce a product to put forth. So with that, a budget I'll turn back over to you. Okay, any questions from the board for Jeff on his working group? All right, I have an agenda item later on that I'll touch kind of what this board is required to do and potentially leveraging these two working groups to help us achieve what we're legislatively required to do. So we've got that in about five or six slides. So we'll kind of tie this together. Okay, and then the next working group is the Accessibility and Equal Access Working Group. I did not ask you, Dr. Bowie, if you were gonna report out, but I think you said you were, right? All right, so come on up. So for those that don't know, Dr. Anthu Bowie, she was with the Department of Healthcare, DHCS, and has now moved over to Cal HHS as the 988 system director, I think is the, what is the official title of your position there? It is Project Director 988 Crisis Care Continuum. So she should be very familiar to everybody on this group because she's been interacting in this space for a long time. We're super excited that she's part of the project over there at HHS. So I'll turn it over to you to give us an update from that committee. Thank you so much. I am a bit at disadvantage because I'm just playing catch up at Cal HHS. The fourth week there, I also have not been to any of the accessibility, equitable access working group meetings itself. I've talked with the previous co-chairs. So I think if there are board members who have some things to fill in, please do so. But as far as I know, the accessibility and equitable access working group has met three times. The last one was in September. They are playing also catch up to understand how the different pieces of the AB 988 legislation work, including understanding what information and data is being input from the Cal OES side and then versus what DHCS is gathering in terms of data that can help us understand what 98 callers experience, what are the demographic data that information that can be gathered from 98 callers, what accessibility issues they may face, what linguistic needs they may have, what accommodations they may need for their disabilities. So there's a lot of trying to understand what information do we already know and then what are we missing in order to better understand the needs for our communities to access 988. So I think that is really the crux of the work right now and Cal OES and DHCS at the last meeting present information on what data is being collected. I think we wanna highlight as well to keep track of what's happening in the federal space, the National 98. Lifeline has an ASL service that is now available as well as video call for 98 contactors who may have issues with deaf or hard of hearing accommodations. So that's really important that that National Service is now available as well as really looking at what Cal HHS has recently released for the crisis care continuum plan in terms of laying out minimum standards and other metrics and models that we can look at for local service implementation to make sure that we meet the needs of our specific regional communities and communities who have more specific special condition needs. I believe there's a request that at this current meeting that the working group would like to see a demonstration if it's available at some point of the new California contact handling system so that we can understand what is available for accommodations, linguistic needs or other kinds of accommodations. And so that we could provide input into what needs to be built to meet the needs of 98 callers. I hope that's an adequate report and I'm welcome to see if other people have other things that I might have missed. Okay, any questions from the board? Go ahead, Jeff. So you had mentioned that now that from the national side the availability of ASL translation for deaf and hard of hearing. Has there been any discussion about California providing that service specifically because I would hate to just rely on what's available nationally when I really think that we should take some ownership of that. So I have a bullet item down to get with our project team to see how that service could be accessed through our platform that we deploy. We did hear from this board about the foreign languages and the concerns there and we made that contract available. So there is that availability at the national level and we also provided a state availability for the same reasons that you're thinking about what happens if something is going on nationally where that service is not available for California and we didn't want that to happen. So this will be our next step. So we'll certainly look at that. I don't have the question off the top of my head. I've never asked of them, I'm not gonna put them on the spot, but it's a bullet item that will become a lot of work for Kurt who is our project manager. So hi, Kurt. Yeah, for public safety answering points obviously this was one of the things that brought about one of the advantages of text and I'm a one obviously but not everybody who's deaf or hard of hearing communicates that way, they might do video chat or something like that. And I think that the state has a responsibility to make sure that that service is always available to its constituents. Yeah, so we'll definitely look at that. That's a great question. I don't have the answer today but by the next board we will. All right, yeah, more work for Kurt. All right, any other questions from the board? Okay, so on this agenda item, agenda item number four, any questions from the public for any of the three working group reports? Okay, we have one online. So go ahead, go ahead and come off mute whoever that is online with your question. I think there might be more than one of us. I'm not sure. I saw a couple of hands, but this is Sherry. So I'll start, I guess. I was just curious if there's been any more detail or conversations had with the centers about the detailed logistics of routing the 911 calls into 988. There's some specific information that we've noticed from our pilot that's very helpful. And I just wanna make sure that we're still able to get that information and do things in a similar way or at least get the same information as a result. I don't know if this is the place to bring up those details or if there's another place to do that. But I know that some other centers have been asking about it in some of our meetings as well. Yeah, and that those conversations are happening in these working groups and they're the ones that are determining the information that, and there's probably twofold, the information you'd like to have and the information we're able to give you. And those are two completely different things. But yes, that is part of this group. And then the next step on this Sherry is for the working group to make a recommendation for the board and then the board to review and take a look at that policy to see what can be done in terms of guidelines and policy for that. So that's all part of the conversation right now. So will there be an opportunity before those are finalized for the technology that will there be an opportunity for those that aren't on the committee to see those recommendations and make sure that they include everything that people are thinking about? Yes, the committee will produce a report. The report will come to the advisory board. The advisory board will review and obviously at that point it's publicly available as well. And then comments are taken in and the policy will be put in place. That'll be the general process that we follow. Fabulous, thank you. Yeah, which will not be fast, but will be thorough. I like thorough, thank you. All right, so next question, if you wanna just, I don't know who else has their hand up, I can't see. No other hands are up. Okay, any other comments from the public on this item number four? Oh, now there's somebody, go ahead. Hey, budgets, Matt Taylor from DD Hirsch and the program director of the State Pioneer Network from the fall center side. So, yeah, just to sort of follow up on what Sherry was saying there to be to put more specific point to it. I know that some of the Lifeline centers are concerned about wanting to, California 988 centers wanting to be able to track through the OES NGA platform, which 911 diversion calls can flow directly through the NGA platform as opposed to possibly not having to go through the vibrant IVR process, thereby shortening the delays, but being able to track those in the NGA system so that those are essentially attributed to the 988 volume, even though it may not have gone through vibrant and may have passed through OES directly into a backdoor line at the centers. And this all relates to making sure that the accurate volume that the centers are receiving is tracked and reported. And then the bigger question is whether or not AB 988 fees can be utilized for that sort of 911 diversion that may never pass through potentially never pass through the vibrant system on the front end. So great question without going into too much technical detail, the way the contract is written and the technology is designed, if a call comes into 911 and it's determined to be 988, we cannot send it back into the vibrant platform because they route an area code and we could inadvertently send a call somewhere else in the United States, which we would not want to do. The call arrived in 911 center in California with accurate location, we know it's somebody in California. So we've built into the technology, the ability to send that geospatially directly to the correct 988 center and all of the metrics to count that in what we're tracking in terms of the number of calls that a 988 center is also built into the platform. Your final question about fees and is it allowable for that? Probably need to get a legal interpretation of the statute for that, but that's a much longer question. I don't have the answer for you today, but we've certainly built the capacity to support that. And that's something I think we can take back to make sure that we understand that it is an eligible use of the 988 surcharge. And really it's a broader question than that. You also have to account the direct dial lines that are going into those 988 centers because people know I have an out of state area code and if I use that, I'm not gonna get the help I need in California. So I'm calling the center direct. It's absolutely a quote unquote 988 call. It's just that the user is wisely choosing the direct dial number. And we also know that there are some local agencies that are advertising those local numbers as the solution for 98 and their local community for that routing reason. So long answer to your question, Matt. Yes, we're tracking all that and I'll have to get some clarity on the statute and then come back at the next board meeting and hopefully my meeting note takers over there will remind me to do that. Yeah, thank you. I know that the technology is probably working correct or will work correctly in that arena. It's mainly how it relates to the, we hope the funding so that the centers can access the 8988 funds to account for that kind of volume. So thank you. Yeah, and you're not the first center that has brought that question up. Kurt has been going around the state meeting with 988 centers in a recent meeting. If the 988 diversion was put in place by the local center, it would essentially double the volume at the 988 center. So obviously, how are we going to accommodate that in terms of staffing and funding and everything else? So it's front and center. We certainly understand it. I think as the awareness campaigns increase as well, the number of folks that dial 988 is gonna continue to increase and then at some point when the routing is more accurate, that would also drive yet another uptick. And so we are tracking all of that. Good news is to your point, Matt, the technology's ready. We built this thing with plenty of capacity to handle all that. We took triple, actually more than triple the size of the current volume of the state when we designed this and the capability that's being provided can go much higher than that with no change to the technology platform. Obviously you need someone to process the 988 chat call or text and that counselor that's there and the staffing to answer it. But the technology itself is ready and we would not want to be in a place we're waiting for the technology to catch up with the need. So we're out in front of it in the technology side and I think we have some other questions to answer on the capacity side. All right, any other comments or questions online on that agenda item? Okay, seeing none in the room, I'm gonna, yeah. I have a session, go ahead. Not from online, but so an issue that I've identified and have had some discussions with some national partners on and it falls into all three of the work groups. So you need to figure out, I think, how to work on this. And so when someone accesses 988, they're given a menu of options. So some of those go to the 988 services but some also go to the veterans crisis line. Some might go to an LGBT center which may be the Trevor Project or others. And if someone does that and needs to get connected to crisis services or to local service, right now there's no policy or infrastructure for that to happen. And so I wouldn't want, for example, so I also work at the VA hospital in San Diego. I wouldn't want someone to get connected to the, in San Diego, get connected to the veterans crisis line and then not be able to connect to crisis services or VA services there in San Diego. And so this is obviously a practice policy issue. It's an interface because it's transferring your calls and also kind of an accessibility and equity issue because these have been services that have kind of been designed for folks that they think are at higher risk. But we don't want that lead to a dead end. And so I guess the question for you or the work groups and figuring out who can take point on figuring out how to navigate this. So is your question more related to, you arrive at say the veterans crisis line and actual mobile response is needed and how do you get connected with those resources when the veterans line doesn't have that resource but locally in San Diego, there might be that resource. Is that kind of the- If they got connected to the 988 call center, the 988 call center could transfer back to 911 or they could perhaps connect to a mobile crisis team whereas the veterans line wouldn't have that option in the same way. Yeah, so I know for us in our technology once we get to the point where we're aware of the mobile crisis services available, we're not there now but that's the next thing we're looking at. It would be easy for us to expose that information to the suicide, to the veterans hotline. I don't know if they could receive it but we can start to have that conversation. But that would be the intent would be that and I did meet the folks that manage that system and so that would be a really good question for them. What capability do you have if the data is available on our side for us to share with you so that if you get to that point in the process you're not stuck. Worst case, maybe they transfer that call over into our system where we do have the data and now you've got a warm transfer with that counselor also involved in the process that our system would know of that resource. Couple ways to check on this but I'll circle back on that so Kurt you're tracking another check box in your list, right, okay. But we'll ask that question of that. I think it's probably gonna be a capability on their side of what they can receive and interact with us. Yeah, okay. All right, any other conversation on this agenda item? Okay, I'm gonna back up to agenda item number three which is the legislative update, Chris. I'm hoping you've solved your audio issues. I apologize, I could see you all but I didn't hear anything so I thought you're all just like hanging out but yeah, now I'm on my phone so I got you now. Hello everyone, my name is Chris Hacker. I'm with legislative and external affairs at Cal OES. Gonna provide a quick update on legislation relating to basically this is a telco list so it's not all 988 but still be good for everybody to hear about. So we're in between sessions right now and so there's no pending legislations to discuss. There were a couple bills that passed that I wanna brief you on though. AB 44, this is a clets bill for tribal police and it passed, it was signed by the governor on October 10th. It requires CHP to grant access to the system, to law enforcement agency or tribal court of a federally recognized tribe meeting certain qualifications. So that passed, that's in place, starting January 1st. AB 988, this bill requires an entity seeking monies from the funds who also include the number of individuals who use the service and identified as veterans or active military personnel. So that passed, that was signed by the governor on October 8th, so that will go into effect. On the federal front, we got four federal bills, we're still monitoring. Again, federal bills kind of move a little differently, a little slower, work a little differently than state bills but we got HR 369, that's the NIST Wildland Fire Communications and Information Dissemination Act and it requires research on public safety communication coordination standards relating to wildland firefighting. That bill is still in the house. We also have HR 1353, Advanced Local Emergency Response Telecommunications Parity Act. That bill requires the FCC to facilitate the provision of emergency communication services in unserved areas and that bill is in the Senate, so it's in the second chamber. HR 4851, the 988 Implementation Act of 2023. This bill provides for improvements in the implementation of the National Suicide Prevention Lifeline. That bill is still in the house, it's in the subcommittee on health. And finally, HR 498, 988 Lifeline Cybersecurity Responsibility Act. That bill would require the Substance Abuse and Mental Health Services Administration to undertake efforts to protect the 988 Suicide and Crisis Lifeline from cybersecurity threats. That bill is still in the house and that's it for my update today. Penning, any questions? All right, thank you, Chris. Any questions from the board on the legislation that was briefed out? All right, we will send out a list of that to the board members. So if you didn't write down all that information, don't worry, we'll send it out to you. Go ahead, Eric. Hi, Chris, thanks for the list, always helpful. There's one more I wanted to flag for you, which I think will be relevant to the work we're doing. HR 4974, the Local 988 Response Act of 2023. So this would require calls to be routed via geospatial routing to the closest call center without any individualized location data being transferred. Gotcha, yeah, thank you. I think you had a couple of bills we added based on the last meeting too, so I appreciate that. We will add that and brief out for her next time. Okay, hearing no other. You want to turn the volume down in the room a little bit, thank you. All right, so go ahead, Erica. I don't remember the bill number specifically, but there was information about a bill with 911, like public information campaign, and that there would be some subset for the 988 public information campaign. I can't remember the bill. Yeah, let me look that up real quick. I'm familiar with that bill. We're in between sessions, so that's a California legislative bill, that's a two-year bill. So we probably, we'll get you the number, but we probably won't have any more information to the legislators, the legislators are back in sessions. Is it 1270? Was that the number? No, that's AB 296, and that's a two-year bill. It will come up again next year. And there's discussion between what we use these funds for, what we're allowed to use 911, what we're allowed to use 988, including 988 in AB 296. Can we do that? Those conversations are all kind of ongoing, and as a result, the bill was held, but it will come up again. Yeah, that's AB 296 from assembly member Rodriguez. Thank you. Yes, we're still tracking it, but no action since the last time we talked. All right, anyone else have any questions? All right, thank you, Chris. We appreciate you stepping up and being a little patient there. All right, we'll move on to agenda item number five. Oh, I guess I need to make sure there's no comments from the public on agenda item number three. All right, seeing, hearing none. Agenda item number five. So this is a report out. I'm gonna try and go a little quick through this because we've got a pretty substantial report coming from HHS. So if it seems like we're going fast, that's why. But certainly interrupt me if you have questions and we'll certainly work through these items. I kept the QR code up here for anybody that hasn't been tracking and they wanna get the contract for our 98 call handling and 98 customer relationship management software, that's the QR code. Kurt's been doing, he's our project manager on this. He's been doing the bulk of the heavy lift for this and working in conjunction with our contractor. The installs are completed with the backroom and some work station equipment with the exception of Optum Health and they're gonna be a cloud-based install. So that installation looks a little different. We've got a meeting cadence with all 12 centers. Obviously that's really important to us and we're working to identify the requirements for our mobile response software. So we've visited several centers both in California and we visited one in Oregon and will be headed down to Arizona in a couple of weeks just to make sure that we understand a mobile crisis response and what we're learning is it's done differently everywhere and there's different capabilities everywhere. So this is going to be an interesting process for us. So that's what we've been doing, our testing and validation. We know that the equipment, it's installed in our lab. We've validated that the equipment works as per the contract. We were making some really good progress in our testing with Vibrant to be able to ingress chats and calls and text and that entire process came to a complete standstill. We're still trying to work through an MOU process with them and that's ongoing and our next meeting with them is on, believe it's the 29th, November 29th. So I won't have anything new before that. The next thing I've asked Kurt to do along with our contractor, NGA 901 is to go around and begin to sit down with these centers. We had a group session where they all got to see this software. We're calling it, what is it? The Hearts and Love Tour is our name for it as Kurt's going around, really sharing, getting some heartfelt feedback and comments and what is this platform? Will it meet the needs of the center? What are the gaps? Obviously when you look at 200 different technical requirements on paper and then you look at the product that's actually developed, you want to make sure those things align and that's the work that really Kurt has been doing. I've gone to a couple of those but he's been the one doing that. We are on pace to be able to deploy the first six centers in the first quarter of 2024 and the remaining six centers in the second quarter. If we can get the calls, chats and texts sent to us by Vibrant. Obviously if they don't send them to us, we can't deploy, we have nothing to deploy. So that is really where we're stuck. There's been a lot of effort on this and we've engaged with our partners at HHS and at DHCS, SAMHSA, Vibrant, we're all trying to work through this agreement and I think at a high level, there's a transition that's happening from the way things were done before to the way the things are going to be done in the future and that's where the challenge is, how do we get through that transition? We're trying to be very mindful to not disrupt what happens locally at the center and also provide the stats and quality of service, level of service that SAMHSA is requiring at the federal level yet meeting the specific needs of those in California. So it's been an interesting process. All right, I think that's it on that one. Any questions on the call handling or the CRM from the board? Okay, next item that I wanna talk about which is the 9198 interference. I kind of alluded to this. So what I did for this is I put from our statute, it's government code section 53123.2, section C and you see the words up there. What OES is required to do and by extension, this board has some tasks under that is to really take a close look at that interface. The software from a technology perspective will meet the needs. We've made sure that it does that. But we're now at the point where we really need to start looking at beyond that technical interface and what's capable, what can we actually do? So we, OES, it would be very helpful to us if the working groups, mainly best practices in the interface working group were to come together and come up with a guideline that you could recommend to the board that we could then begin to make sure that the technology facilitates that guideline. We wanna make sure there's not a gap there. We also need to align with the work that's being done by HHS and you'll see that presentation from a policy perspective. We're not trying to develop policy here, but we do need to define sort of what information is shared via the technology. We'd hate to have a policy that technology can't support. So, and then validating that workflow that needs to be in place to support that transfer. So I'm looking to Jeff and Tracy, I know you're online. It would be helpful if between now and our next meeting, February, you sort of give us a little straw man of what you're thinking at a high level and then maybe by the May meeting, we actually have a policy that this board could review. We're happy to work with you individually on formatting and all that, but I'm thinking as putting my Cal OES 98 system administrator hat on, that would be helpful information for us. So I wanna see if the board has any concerns or recommendations along those lines to see if we can give that guidance to those working groups. So open it up to the board for discussion. I asked just for clarification. So I'm tracking correctly. So it would include things. This is some of the stuff that my working group has been talking about. Like if a 911 call is transferred to a 988 center, that they would actually be able to see things like the automatic location identifier, things like that. But those are the kind of things you're looking for. Yeah, and questions you might have on the information that the centers are saying they'd like to see. And then we could go do the legwork to see if there's any barriers legislatively, statute or policy-wise that you can't share that information, okay? It's that kind of stuff, right? Yeah, exactly. Any other, go ahead, Erica. I was just gonna point out that the same way that 988 centers would like information from 911, there's information 911 would like from 988 to hopefully that bi-directional desire is something we can investigate in terms of data sharing. Yeah, absolutely. There's a two-way street, because a call can start at 988 and need to go to 911. I've got a couple slides on that later that I'll talk through, but yes, it is absolutely bi-directional and that's the way they're looking at it. Yeah. Okay, so I don't know if we need a motion for the working groups to do that or if y'all can just go do that and report back to us that we need a motion. All right, okay, so working groups, we're all, I mean, everyone's, I see a bunch of heads nodding. So please let us know we're here to help and facilitate your work, but we'll provide the resources and if you run into questions and kind of guides what we're looking at that we're here to help you. So we'd appreciate that support. Okay, next item, the set and a surcharge. I don't have any new information here, okay? So all of these slides are exactly the same, but just know that in a year, the process changes slightly. And the reason why is because in calendar year 2024, by statute, our fee is set at eight cents. So we know the revenue coming in. In calendar year 2025, the surcharge can change and it changes based on the budget that's approved for all the agencies that are using the fund to support either the operations through DHCS or the technology through Cal OES. So between now and when the budget is finalized in July, that will set the authority that will be used to set the fee in 2025, right? So that's what this slide says, but just be very, you know, if you're in a center and you need something in 2025 with funding, it needs to be in a budget request through a state agency between now and July of 2024, or you'll have to wait till 2026 to get what you need unless there happens to be money in the fund and authority in the fund to do it. So that's why we're just right out front letting you know that's the process. So kind of any questions on that? All right, the fund condition statement has not changed from the last time we met and the estimated number of access lines that 46,121, that's what the fee would be set at if we were to do the math today. The next one, implementation milestones. I kind of already talked about this, but the advisory board is set up and that first bullet is what we're really targeting recommend on the feasibility and plan for sustained interoperability between 901, 988. And identifying legal or regulatory barriers to the transfer of 901 calls. That's the work we're looking for you to do in that guideline. And when you come to us and say, hey, we'd like to, if location comes in on 901, we'd like to send that location to 988. Well, this is the question we'd have to go ask, can we actually do that, right? And then develop the technical, which we've already done in operational standards for the system and the coordination of this where that's a work in process. And this last bullet, the creation of standards and protocols for when 988 centers will transfer 908 calls to 901 and vice versa. There's a huge crossover there between that and the policy group that HHS is standing up, but this is clearly right in the lane of this board to do. And we want to start getting this process moving forward. So if you're wondering what kind of information do we need, we need the information to support those decisions. And then this board would take a look at them, discuss them publicly before anything is decided. So this is feedback, but this is right in the lane of what the technical advisory board is supposed to be looking at. And those are copied word for word out of the statute with no edits. All right, any other discussion that you need from Cal OES on the 988 updates and the work that we're doing to support this from the board, right? Any comments from the public on agenda item number five? Okay. The next agenda item, the last time we met, we briefed and shared a funding policy. So those of you that are online right now looking at that, the new statute that Chris just mentioned about veterans and the number of veterans served, that law doesn't go into effect until January 1st. So you won't see that in the policy, but you will on January 1st. That's the only change that this will be. I discussed this as a board from the last time that we met until now. I just received one question. There's a piece in the funding policy about training assistance down to the centers and would we sort of tier that based on the size of the center? We absolutely can do that, but right now the policy doesn't even exist. We don't even know if there's a gap there, but that's something we could certainly look at for larger centers. Aside from that, I haven't received any further comments on this. So I'm looking for a motion from the board to approve this and we'll take a vote and then that'll be our funding policy. So any discussion on that? All right, any motion from the board to approve? I'll move to approve. Motion from Jeff. Do we have a second? I'll second. The second is Jennifer Dwyer. All right, so I'll take a roll call vote. Eric? Yes. Erica? Yes. Kristen? Yes. Jeff? Yes. Tracy? Yes. Jennifer Kenton? Yes. And Jennifer Dwyer? Yes. All right, so the motion passes. We will get this posted, remove the draft watermark and it'll be updated on our website. The only change you'll see is the added veterans metric in there based on the new statute that Chris just briefed out. Okay, we'll move on to agenda item number seven, HHS updates. So Dr. Bowie, I'll have you come on up and I'll probably just hand you the clicker and you can work through your slides. Those of you that have been wondering about AB 988 had specific things that KELOES was going to do and we've been talking a lot about that in this group because that's what this technical advisory board's about and we typically get a lot of questions about, okay, what about the other side and what HHS is doing? So I'm really excited to see the update and to hear from Dr. Bowie what HHS is doing. So I'll turn it over to you. Hello, thank you so much for having me. I'm just quick introduction of myself. I am just coming into HHS as the 98 crisis care continuum project director and there's a lot of work to be done. I just wanna center in the fact that I'm a community psychiatrist working in California for over 20 years in a lot of different county mental health programs and community health centers and really my motivation in this work is making sure that there is availability for help for all of our people in need and the need is very high. We knew it before the pandemic and we know it now and the need is urgent and I really appreciate all the work that you're all doing to help work through this complex issues in California. We are really forging the path for a lot of communities and so no pressure, but really appreciate being able to join in this work for the state. So I'm gonna do a really quick kind of overview of one of the roles and responsibilities that Cal HHS is charged with and where those activities might intersect with the Cal OAS Technical Advisory Board. What can we do together in concert so we don't duplicate our work and really dovetail to get the work done. There's some project highlights that I can tell you what we're doing over an agency and then some discussion items that we may highlight for either today or future discussion. So as you well know, AB 98 has set the 98 State Suicide and Behavioral Health Crisis Services Fund via the fee surcharge. We're here at the Technical Advisory Board and then what we're looking at is what is Cal HHS is doing? We need to actually submit a five-year implementation plan for a comprehensive 98 system. That is to be reported to the state legislature no later than the end of calendar year 2024. In order to do that, Cal HHS will convene a state policy advisory group. We now call it the 98 Crisis Policy Advisory Group to advise us on a set of recommendations. So we've got one year to do this work. Who are gonna be the members on this 98 Crisis Advisory Group? The legislation dictates that it must include California DHCS, member from the Cal OES, member from the California Department of Public Health, representatives of California counties, representatives of employees working for county behavioral health agencies and also agencies that subcontract with county behavioral health to provide the services. It must include 98 centers, health plans, emergency medical services, law enforcement, consumers, family, peers, and other local and statewide public agencies. Just to refresh my memory, I just wanted to see, and I looked enviously last night at the three tasks that you have to do at the State Technical Advisory Board. And I say enviously because we have 14 things that we have to do. So I was just trying to go, okay, where are the intersects? So just pardon my highlights. I couldn't find more subtle colors. The first tasks are highlighted yellow, the second green, the third blue, and these just went over so I won't read them out loud again. And then just trying to again map out where the work might align and intersect. All right, so what do we have to do at agency? Cal HHS and the 98 Crisis Advisory Policy Advisory Group must make recommendations on all the following topics. There are 14 of them. We have to look at national guidelines for operational clinical standards. We need to really make sure that policy comply with state technology requirements or guidelines. We need to look at a state governance structure to support implementation and administration of behavioral health crisis services access through 98. We need to look at 98 staffing training standards. We need to make sure that there is statewide access to crisis counselors through all phone texts and chat modalities 24-7. We need to ensure that there's access to crisis stabilization services and triage in response to warm handouts from both 911 and 98 call centers. And those highlights, as you can see, I tried to map back to the three sets of activities that this technical advisory board should our task with reviewing and looking at. All right, I apologize for the smaller font. There are a number of other things to do, including making sure that there's resources and policy changes to support statewide and regional needs to meet the population need for our behavioral health crisis services. We need to have a public communication strategies that is informed by national guidelines to support public awareness of 98 and behavioral health crisis services. We need to achieve coordination between 98 and the continuum of behavioral health crisis services. We need to really look at how to improve timely response to behavioral health needs and really reduce unnecessary law enforcement involvement in order to reduce really the burden on our law enforcement partners and making sure that our high need populations can access the right behavioral health care at the right time. We need to really look at data to make sure that we have goals and measures that look at how we're making the progress to what we need to do. We really, we are charged with building a better and more ideal crisis response system that is more equitable and can serve the needs of all Californians. And then the last one we, and I'll go over in just a little bit more, but really it has to do with making sure that we comprehensively assess what we have now in our crisis service system, identify where the gaps might be and thinking creatively about how to again, provide response to crisis as well as connecting people to stabilizing crisis services and ongoing care. And then we also need to look at how to fund sustainably this 98 comprehensive system, including looking at where commercial insurance plans can contribute and pay their fair share in the system. All right, so here's my attempt at trying to map the three tasks that this technical advisory board has has been doing to some of the tasks of the CalHHS advisory group. So on the first recommendation, we're really looking at sustainability, interoperability between 98, 9-1-1 and behavioral health crisis services. So we really need to look at what do the state entities do right now? There are several of them that are named in statute and also several state departments that are contributing to implementing 98, even if not specifically named in statute. So how would those state entities work together to make sure that we can implement the minister of behavioral health crisis services 298 also thinking about our county and local entities as well, looking at infrastructure staffing standards, access and then making really recommendations on how to coordinate all of this. The technology piece, it's fantastic that you're all handling this. So I'm going to trust in that technology that will be coming soon. And then really looking at standards and protocols about bi-directional transfers between 98 and 9-1-1, you're all talking about that. And that really is kind of a big part of the work that we would need to put together some recommendations to really achieve this coordination among all these different vast systems. All right, so this is kind of just a visual diagram of the work that we are doing. So we've got the Cal OAS technical advisory board on the right. And at agency, we are convening the advisory group and underneath it, there's lots of work to be done to support these technical advisory board, including forming working groups that will do the deep dive research collection of information and discussion to then collate and consolidate recommendations to feedback to the advisory groups. We also will be through our contractor, Health Management Associate, conducting in-reach to the community to conduct individual interviews, focus groups, in-reach and outreach to stakeholders in order to gain further information and feedback to feed into the work that we're doing. I'm going to take a moment to pause here and see if there's anything that is percolating up right now. Otherwise, we can wait to the end for questions and comments. All right, so let me just shift a little bit into the project highlights of what we've been doing. I briefly mentioned that we have Engage Health Management Associates through a request for proposal. They started their work at the beginning of August. They will be helping us with really a large amount of work. Right now, the policy advisory group selection was based on a number of criteria already outlined through AB 988, but we are really looking for folks that bring... It's going to be no more than 40 members and that's quite a lot of people to work with. And so, we're looking for people who bring multiple representations in terms of diversity, of both lived experience, race, ethnicity representation, geographic representation, and really bringing voices from historically underserved communities to this work. We are really putting the final touches on it and soon you will have a list of the policy advisory group members that will be posted on the website very soon. We are meeting quite in about a month on December 13th in Sacramento from 10 to 3 and by November 29th, we will post the agenda as well as how to attend and a virtual link so that everyone can attend who wishes to. Some questions that I have for you and just to lay it out in terms of... I had some thoughts earlier as I shared with you about the crosswalk between the activities of this advisory board and the Cal HHS advisory board, but certainly would love to hear from you what information would be helpful for us to share across the two boards so that we could collaborate meaningfully and productively. I don't know whether this is a good place to pause or should I just pause all the time? Certainly, no, let's take them one by one. So, I think too for those of us seeing this for the first time, you may not have thoughts today on this, but there is a way to share what you're thinking. We don't have to have a formal board meeting for you to share that with us. We'd just have to be careful we don't have a quorum and talk about it all at once, but you can certainly share information with us over the next month. But in general, what comes to folks' minds in terms of what information should be shared across the two boards and what are you thinking? So any comments from the board on that? I know everything is probably what crosses your mind. That's the thought that went through my head. Almost everything we do is gonna have to be shared, but anything specifically that you think are, go ahead. Yeah, something specific. I was able to attend the CRM kind of software demo that was like a month and over. So it was very helpful. I think that folks that will be on these up and coming boards would also find it helpful to see what information is being translated over and is there a certain information that should be there that's missing or ways that it should be modified to better capture kind of some of the clinical stuff coming through. Okay, and one of the things we've done on the 911 side that's been helpful is to invite a policymaker into the center so they can see firsthand what this looks like for real. It's a little different than what you see on TV. And so to have that might be something as well, I don't know what the rules are on the 98 side, but that'd be something I would think about is, you know, those that are on this policy board, if they've never seen a 988 center or a 911 center in action, it's very revealing in terms of understanding what these counselors are doing on the 98 side to provide the help needed. And similarly on the 911 side, when you see it firsthand, it sort of opens your eyes like, wow. So I know on the 911 side, we can certainly facilitate 911 visits and tours and around the state. And I think 988 would probably be able to do that as well. I'm looking at Erica, is there a problem with somebody coming in and observing that you know of? I would need to get back to the team, but I think one of the big differences, health privacy, so we can look into that. Yeah, and it might just be see a center, not see an actual call, sort of a thing. But anyway, I think that's something that comes to my mind beyond just seeing the technology, actually seeing someone trained using the technology is one step farther. I would dovetail on to that and including talking to the practitioners in those centers for what they experience and the challenges they encounter because I think that will help to directly inform any policymaking and any other technology needs that we might need to support. All right, I think we're ready for your next question. Thank you so much. So this is a bit more complex question. As part of the AB 988 requirements that Cal ACHS has to do, the report has to include really a comprehensive assessment of the behavioral health crisis service system, takes into account current infrastructure projects that are planned and funded. We need to look at all of the following, statewide 98 centers, mobile crisis team services, other existing crisis services and warm lines, crisis of receiving and stabilization services. So we really, although we have access to statewide data and certainly from our departments, we are looking for stakeholders to really help us think about what are we missing? What are the gaps? What are some opportunities for creative thinking that we have not thought of to make sure that we really provide equitable access to all of our community members? If you have any ideas about accessing other kinds of data, for example, behavioral health calls coming through 911, warm lines transfers to 988, what are some other community-based crisis response? Whatever else we're missing, happy to hear it here. Also, we have a email inbox. Please flood us with your ideas. We'll welcome all input. All right, any comments or questions from the board on this discussion item, right? Not seeing any today, but I have a feeling that inbox is gonna get used. Fantastic. So if you need further information, we started a website, 998 suicide and crisis lifeline webpage has a ton of resources on there, including to the national lifeline resource, as well as on the crisis care continuum plan that lays out the vision for a future California crisis system. And more information will be posted on this webpage around the upcoming policy advisory group meeting, how to attend, as well as other resources and materials that you might wish to look at. Okay, thank you. Any questions from the board from, or HHS? Okay, any questions from the public, either online or in the room? You see any hands going up over there? Yeah, thank you for pointing out that we have three tasks. So I'm sure that makes us feel on this board a lot better, but we are here to help and support. We do see the cross pollination between the two boards. And I really think if there's something that the policy board identifies that this group might be better suited to answer, we would certainly be willing to take that as input, address it through either the board members or one of our working groups and provide that information back to the policy group. We see a lot of interaction between the two boards. And when I first read the statute, I was like, ooh, that's gonna be fun. I wonder who's gonna do that? Well, here we are. These are the folks that have to figure out how to do that. So thank you very much for the presentation. I appreciate it. Okay, a couple of additional updates relative to a standing agenda item on FCC and Vibrant and then SAMHSA, and I'll get to them in that order. If you have not been tracking, the FCC chairwoman, Rosa Morsell, did publish a letter encouraging wireless carriers and industry associations to start looking at how we could efficiently and effectively do geospatial routing. There is a document up there on the FCC website. As I said during our last meeting, once the FCC gets to the point to issue a notice of proposed rulemaking, it's generally a six to 12 month process before they finalize the rules. I'm not aware of any statute that needs to be put in place for them to do that process, but the legislation that you mentioned, Eric, what that would do, it could impose a deadline on them, which is something that could potentially get this moving faster and maybe put some clarity and give them clear authority on what they're supposed to determine. But I've read through this document. I've also talked to those that participated in the reference to testing process that went through. And at a high level, essentially it's finding a way to anonymize the location of the 988 caller enough so that you can't identify exactly where they are and disclose private information about the location of the individual, yet enough granularity to properly route the call. Okay, so imagine, I don't know where you are, but I know you attached to a central office for dial tone in Sacramento. Well, if I know you called from a landline in Sacramento, then I'm gonna send your 98 call to WellSpace because they're the folks that service Sacramento. That level of granularity is sort of what they're looking at. And a way to do it geospatially, that aligns with what the carriers are already doing in a 911, next-gen 911-like environment so that in the future, we needed to, you know, you call, you're identified, you need a specific mobile crisis response service and you know that it exists in this area. The system would not need to be updated to even go down to that level of granularity. So really excited about the pilot and what they've done and the work they're doing. Again, until it's a rule, you know, we have a ways to go, but I'm very pleased with the direction it's headed and based on what I see, I'm optimistic. So any questions on that? So if I understand you correctly, it'll just be essentially more accurate for the routing of the 988 call, but not necessarily something that will be accessible under any circumstances as far as the, an accurate location where the caller is. Right, and the challenge here in terms of disclosing the exact location of the 988 caller, when you call 911, you've essentially given up your Fourth Amendment right to privacy because you need emergency services and you got to save your life. 988 does not have that, right? So that's the major difference. So unless the person seeking help discloses voluntarily their location, it cannot be exposed. Yeah, that's why I asked the question because that's a struggle right now when any crisis line would be 988 or any other provider realizes that emergency services needs to be engaged and they don't have a location. There's a lack of understanding, I think, on the crisis line provider's side in thinking that, well, if I just contact the local police department, they can figure out where they are and it's not that simple. And so without something like that, I know you know this very well, but there are... I think you might have read ahead on my slides because I actually have a graphic on, it's called exigent circumstances and that's the term that's used. I have a graphic on that in two slides or three to go over that exact thing. And I think it'll be helpful for this group and I wanted to make sure I brought it to this group so we can understand. Because no matter what we do, Jeff, that challenge, not even a problem, that reality will remain just because of the how the law is written. Yeah, okay. Any other questions on the FCC work? Progress at the speed of federal government. But it's progress. All right, so I've talked a lot about vibrant, really the work we're doing with them is this MOU that we need to get in place in order to transition this service over and be able to ingress these. So let's go ahead. A question on that. Is it an issue, will it be a sense of just how long it will take and what the details actually will be on the MOU or if an MOU will end up happening? Do we have a sense of which it is? All right, so it's, we, I'll say this way, we the state would not be able to enter into a contract with a vendor without a formal procurement process. And the current way that centers enter into this agreement with vibrant is they enter into like a contract with vibrant. We're a state, right? We have a different way of doing that. And so that's really what this is all about. How do we, if they have a method and a methodology proven it's been effective, it's been out there for, I don't know, at least a decade, maybe longer on the relationship with the centers, but we're a state, we're not a 98 center. And so how do we do that in this new world? That that's really what this is about. Fair enough? Yeah. Okay. And we're working. It's new, it's uncharted and we'll figure it out. The next one I want to, the next slide, which I went to an exigent circumstance workshop in DC. And there were a number of experts there, including experts from the carrier space, experts from 911, experts from 988 and policy people at all levels, but from state, local and federal discussing this exigent circumstances. So essentially the space we're talking about a person has called 98 or a warmline, it would work the same. We don't have their location. It's been determined that there's a life at risk here and we need to save that life. So what I'm gonna walk you through is the process on how that happens and what's most important in the information sharing. And I don't think, I think even at the end of the webinar, there were many that were there that were like, oh, I never thought of it that way. So we'll start at the beginning. So someone reaches a lifeline crisis center, either on a 988 call, some other call into the center, a chat, a text, however they've gotten into that center, the counselors working with that individual and they make a determination that, hey, we need to dispatch emergency resources. And whatever the emergency resource is, fire, medical law, the process is the same, right? Why emergency resources needed is not as critical in the process as the fact that we now need the location of the person that the counselor is helping. So the first step is they would call into a 911 center on a non-emergency line. This is a very important part of the process because it's you wait in line behind all the 911 calls that they're serving. So there's an inherent amount of delay here if the center is busy. So this is the first delay in the process because the 911 center has no way of knowing that that call coming in is a life in jeopardy and needs to be answered right now. So they don't have that information. You're simply waiting on an administration line. They may have set up a special 10-digit number where they know this is a lifeline center calling and we have a few of those in the state, but not every center has that set up, okay? So at this point, the exchange of information between the 98 center and the 911 center should focus on why this is an exigent circumstance, okay? Because law enforcement is the only person or the only entity that can validate exigent circumstance. So not all 911 centers are law enforcement. Some are fire, some are EMS. So you've got to get a law enforcement piece involved in the conversation to validate that this is an exigent circumstance. At this point, no other information is really critical until that need can be validated. Once the 911 center of the law enforcement agency determines that it's exigent circumstance, they reach out to the carrier. The carrier is not concerned as to why it's an exigent circumstance. They only want one thing, are you law enforcement? They are gonna validate that you're law enforcement. So their entire conversation centers around that, are you? So it's a validation process between them and the PSAP and the law enforcement agency to validate you really are someone that can tell me this is exigent. They've already gotten past the determination is this exigent or not. The carrier's not concerned about that. They just need to validate your law enforcement. Once that happens, and sometimes in parallel, they're processing to determine that location. Please do not think it's automatic that they just have this magic crystal ball that they look at to figure out where this person is. It's very complicated and can take 10, 20 minutes, half hour or longer, depending on what device the person is calling in, whether it's an IP address, of a voice over IP phone, a wire line phone, a wireless phone, how many towers they're near. I mean, there's a million engineering factors, but just know it takes time. And that time is being typically run in parallel as they're validating that that law enforcement is making the request. Once they know that, they can return the location back to the 911 center. And this is another important point. And in the current way things are done, the 911 center dispatches the resource because the 911 center can't in turn share that location back with the 98 center. They don't have authority to see it. The 911 center does. And this whole process moving as fast as humanly possible takes at least 10 to 20 minutes is the average and sometimes longer, especially if you wait in a queue on a non-emergency line. So anyone who asks about this process, go back to this board when it's a YouTube video, start at what is it, 1115 in the little clip. And this will help them understand why it takes so long. And how the process goes. Go ahead, Jack. I'd like to add a little more information on that. Even with exigent circumstances, the California legislature passed a law, so penal code 1546, that then obligates the law enforcement agency to follow up the request with that information with a search warrant. And so that also puts an extra burden on the law enforcement agency having to make that assessment about the need for the exigency or the exigency existing and then actually following that up with a warrant or else the law enforcement agencies can potentially suffer civil liability. So that's also an important piece of information. So unless that device, the only exception for us in the PSAP environment for 911 is if the device actually called 911 and in this scenario it doesn't. So we would have to, whether it be an IP address or a phone number to obtain that electronic information from the carrier, it has to be followed up with a search warrant. What was that penal code again? That's 1546, I think 0.1. Okay, that's probably something that talking about policy and what HHS might be able to look at because obviously all of these things take time and really slow down the ability to help somebody that needs help. And so it's just an experience in our region in San Diego County. So this was happening with Optum, our access to Crisis Line 988 Center in San Diego. They wouldn't know which law enforcement agency to contact. So they would contact the law enforcement agency they thought they would just usually pick the large one. So San Diego Police and then San Diego PD would be stuck and settled with that search warrant. So even though they determined, oh, this person is calling from this city, you need to contact this city. They still couldn't provide the center with the location information. They could just say contact this agency and then that agency would have to do it all over again. And so it's a complicating process to be able to protect, to comply with the law, protect with the callers rights, but to still be able to provide them the service that they need. And we're talking about exigency and so time now works against us. Yeah, Jeff brings up an important point. The validation between the law enforcement or PSAP and the carrier is to an individual. And if that individual changes, you restart the whole validation process. So if I do an exigent circumstance in Sacramento and I determine no, they're really in West Sac, different jurisdiction and I transfer the call over there, process starts over. Now the location is known probably by the carrier because they've already gone through the exigent process, but they still have to validate that your law enforcement that you have the ability to receive this information. So it's, you know, if you're centers on the 98 side are seeing a delay, this is the reason for the delay. I mean, this is what's happening behind the scenes. Yeah, and then just to add, every carrier is gonna validate law enforcement differently. So sometimes they're getting stuck in that 10 digit queue again. Other times it's faxing you over paperwork that you have to fill out and fax back. And then a lot of things that we ran into too is people don't always know the carrier. So you kind of go with, okay, who are your big players? Let me try them first. And then each time you're having to validate your law enforcement with a carrier till you find it. If I go off shift and we haven't found that person, then I have to call and transfer the validation to a new incoming dispatcher to keep getting the update. So it is very time consuming. Yeah, remember, we don't know the carrier at this point. And obviously you can imagine alphabetically which carrier is chosen most. So they have a procedure where they look up the number and they determine, nope, that's not our number. Here's the number you need to call. That's another delay, right? So it's just, it's not a seamless process. And I was unaware of the penal code that adds yet another layer of complexity to this. All right, now with that backdrop, one thing I wanted to point out is when we move forward with the system we've designed to support 98, we have the opportunity to fix a couple of things in this process. First of all, you will go into the 9-1-1 Center with a priority queue. You come in as a 9-1-1 call. You're not waiting in the 10-digit queue and also that reduces time. And we can immediately identify, hey, this is coming in from a 98 Center. This is absolutely a call where we need to pick it up fast. The other opportunity we'd have, and I used the word automated, I probably should do streamline, but we could probably streamline this validation process. And that was really what this ExigenCircumstance Workshop was all about, is how do you make that loop down at the bottom go a little faster? Because there are ways to streamline the validation that it's law enforcement. Obviously it needs to be done in a cyber secure way because we don't wanna open ourself up to vulnerabilities, but there are ways to solve this now, especially with the technology that we're deploying and the exchange of informations that are credentialed and validated and everything. So this is something that we're certainly looking at trying to improve, but just know that this will take time to make inroads in this space. And we still, there's a couple of tools we can put in place to at least know the carrier. Those typically are publicly available. We could build that into the solution. So we can at least call the right carrier the first time and exchange that information. So, but it's still gonna take, I mean, even best case scenario, 10 or more minutes to figure this out. So that's why we built into the platform. I push you a text, you click the text, it responds back with your exact location. Obviously that doesn't work so well from a wire line, but there's mechanisms that if the person can voluntarily call in, that would be helpful. Or the person next to him calls 911. Okay, now I get it immediately. Oh, that 98 call you're talking about, yeah, I'm standing right next to him on 911. Okay, now I bypass all of this. I've gone straight into the right 911 center the first time. Obviously that scenario cannot always be used when there's only one person there, but there's things like that that we in this group could come out with information that says, hey, if you want to speed this up, here's ways to make it faster. The advantage of 911 is you volunteered your location and that's the huge advantage. So, all right, I thought that would be important to bring to this group any other questions on that? All right, any questions from the public or comments online? It was certainly eye-opening for me. All right, next. Sorry about the quick thing to add. It sounds like the technology will also be able to, once deployed, be able to solve the issue of the 98 center knowing which law enforcement agency or which PSAP to contact. Because right now even with the area codes, it could be like cross state things like that. Maybe, because remember, I still don't know the exact location of the 98 caller. So, if they have not volunteered their location, all I know is the center it came into. And we, of course, have a default 911 center that's working with that center, but it might not be the right one. So, we still might have that barrier. That's especially true where there's concurrent jurisdiction. So, just going back to my region again. So, by the airport in San Diego, that's actually not the San Diego Police Department. Some people would think that it's the San Diego Harbor Police. And so, based on what Budge is describing, it's still probably not gonna be clear enough. So, it'll be better than today's environment, much better than today's environment, but there'll still be, I think, gaps and missing pieces. Yeah. And even once the geospatial 98 routing is in place, it still won't be granular enough to get to the exact law enforcement jurisdiction in all likelihood. Because law enforcement jurisdictions are very complex. They don't follow the natural boundaries. They look very strange. And cell sectors and RF propagation, the way radio waves propagate, they don't respect those boundaries. So, I could be sitting here and I'm on a cell tower two miles away and I move 500 meters that way and I'm on the one right next to me. So, it won't, it'll be way better, but there will still be that challenge. Yeah. Can I ask a quick question? Yes. You brought up that there are specific 911 centers working with the 98 centers. So, like in Santa Clara County, I'm not aware that we have one 911 center that is designated because we talk about it. So, for my agency, we're first alphabetically, but we're also one of the smallest centers, whereas we have the county in San Jose, which is huge. And so, the question that's come up for us that we haven't determined yet and I think something that all of us are gonna need to really think about is, if we don't have this granular address, who's gonna get that 911 call? Who has the resources? Because as we know, 911s drastically understaffed. My center operates with two people. One answers phones, one does police radio. Tying someone up for that 10 to 20 minute is really hard when my 911 lines are ringing for other in progress stuff as well. And it's all very important, but I think identifying that workflow as well until we can unveil the granular when it is transferred into the 911 system, I think that we need to pay attention to that as well. Yeah, and with the issuing of the warrant, that makes it more complex because you've now added a lot more burden on that law enforcement agency, yeah. Yeah, and that's more than just the singular dispatcher that gets it because I don't know if single agency that has their dispatchers write warrants, so it's gotta get to a detective or somebody who knows how to write that warrant and to follow it on. So it is, I totally concur because that's always gonna be the problem with the smaller PSAPs that just don't have the staffing. Yeah, sounds like there's a 15th bullet we just added to the policy working group, maybe. But a good discussion and obviously something that needs more work because the technology side of this is obviously much easier. There's a policy piece of this, I think. And it has to do with the interface between 988 and 911 because that 988 call coming in is now a 911 call in most circumstances this location becomes important, which is why I think it's just something for you all to consider. And I look forward to the work you're doing in your working groups to bring those items that this board needs to look at as barriers. So, absolutely. A bunch before we move on, Jennifer kind of gave me an idea. What about, are the 988s only transferring to primary PSAPs or will they have the ability to transfer to a secondary PSAP? From a technology perspective, secondaries as well, but secondaries can't do this. Right, so I guess my concern is that it comes into a primary who doesn't have the FIRE EMS portion. Right. You're gonna have to stay on the line during the transfer so that you're still capable for the warrant versus just going, let me transfer you to FIRE EMS or pre-arrival instruction. Though I know there's a, in my working group, there has been presented a desire that the 988 centers be able to transfer directly to FIRE EMS if it is a secondary PSAP, which I don't see why that would be a problem because there's no need for me as a law enforcement agency to get the call if all they need is a medic, right? Why have me as the middleman? Unless we don't know the location. But then that's, then we need you as the middleman. So if the location is known, the capability needs to be there, obviously. But then if the location's not known, then yeah, it has to be trapped through the law enforcement agency and then it goes back to which law enforcement agency. And that's the decision loop that we would work on to say, okay, this is how the flow should work. And obviously it's a lot of training on the 988 side to know that process. So yeah, there's steps upon steps upon steps. Yep, absolutely. You all thought it would be easy. Okay, any other questions from the public on that, on agenda item number eight? Nothing online. Okay, the last really formative part of the agenda, agenda item number nine, we were asked to add this to the agenda to have a discussion of the advisory board as a board, writing a letter to the FCC in supporting this geospatial call rounding. And because there's pending legislation, it would probably be wise to generate a generic letter that we could send to whomever we want. So that way, you know, it would come from the 988 technical advisory board and we have a way to do that as an entity. So two ways to go about this. First, we have to decide as a board, do we want to do this, that'd be a motion and a vote. And we could either, you could either give OES, the authority with certain bullets to say write the letter and send it out. And then we would put 988 advisory board on the top and out it goes. Or give us the same bullets, we write that letter, we bring it back to the board the next time we meet and the board looks at the content of the letter before it goes out. So that way, the board itself would be able to see the contents of the letter. We would send it in advance of the next board, but we can't talk about it until the board because then we create a serial meeting and we all remember the class that Meg gave us and that's not allowed. So those are really the two paths forward on this agenda item. So we'll probably start with the discussion of from the board, do we think the letter is necessary? Let's just start there, any conversation on that? I believe it's still necessary. I think that the more that whether it supports federal legislation or the FCC rulemaking they need to understand that we are trying to solve the very problems that they also, the decision or the legislation that moves forward will actually impact us. So I think it's relevant for us to communicate that. How it gets communicated, I agree, probably a more generic like statement of the problem and then statement of what we see as the potential solution would be good. Okay, any other discussion? I just second what Jeff said, I think it's really important that we do something showing our support because this location-based routing has been the question, at least I know in my mind since this all started, so. Okay, any discussion on how you want to accomplish this as a board? Cause we'll talk through that and then look for a motion for somebody to tell us what we're going to do but how do you wanna do it? Do you wanna talk through some bullets and have OES write it? Do you want to talk through some bullets? We write it, bring it back to the board next time. What are your thoughts on how we get this done? And open conversation right now. Well, whatever y'all think, happy to accommodate. When does federal legislation take their recess? I think Chris probably dropped, but if you've tracked the federal legislative process, they have not done much recently unless it's part of a larger package. Individual bills moving through at us for a specific thing are pretty rare. So I don't think legislatively at the federal level we have any urgent need to do something in the next few months. They'll be on recess, they'll be focused on the continuing resolution for the budget and the budget process will be front and center for the rest of this year more than likely. Then they go into next year and you've got, you know, so there's an election, right? Did we have an election year this year? Was that last year? No member, anybody knows? Was this a, was anybody new elected to Congress in November? I don't think so. All right, so it's the same Congress, so they'll be on recess and then they'll come and start work up again. But if you've been tracking the flow of bills between the House and the Senate and it's glacial, fast is not. So I think we're not in a rush time wise, but the bill is introduced. And so there is something to come out in support of. But aside from that, there's no urgency there. The FCC, when the way it works is the different bureaus do work when the chairwoman and the rest of the FCC folks that are on the actual commissioners direct them to do something and they do that via proposed rulemaking. We have not seen anything on an upcoming agenda, which they usually posted one or two in advance of them doing anything, but they can do that rather quickly. They put it on agenda, they make the vote and then the proposed rulemaking comes out. So, you know, I have not seen any timelines there, but that's likely to go faster than what the legislature is. Just my guess, we do have a little time, I guess it's the short answer to your question. It's not urgent. It's not something we need to do in the next month. My perspective is similar to that. I think that folks at the federal level are aware of this issue and this letter is not going to signify their first knowledge that California is struggling with this and as many other states. And so I'd rather have it be something that everyone on the board can review and make sure everyone's happy with it. If there's anything new that we can add during that process that would be helpful for this, then we can make sure that's included. I'd rather have it done comprehensively and well than kind of do it more quickly because I agree with you. I don't think that the urgency of time is there. All right, any other discussion? So, are you proposing that we ask Cal OES to draft it and then bring it to the board for future review and approval? I'm glad you were asking him because I'm not allowed to propose. No, that's why it was. Yeah, I knew the rules, Megan, but you were out of me. Are we, can I make a motion? Are we still discussing? Yeah. Okay, well, I make a motion as what Jeff just mentioned about having Cal OES draft a bill to bring back for revision and vote. Okay, we have a second. I'll second. All right, second from Jennifer. All right, so I'll go down, do a roll call vote then. Eric. Oh, to approve. Erica. Yes. Kristen. Yes. Jeff. Yes. Tracy. Yes. Jennifer Kenton. Yes. And Jennifer Dwyer. Yes. All right, we will bring back a letter. So, thank you for that and... And just a quick question. Do you feel like Cal OES has enough information based on our conversations here to put together a good enough draft? I think we do, but if you have something you want me to consider, just send me an email. Don't send it to the whole board. That would facilitate a serial meeting and we'll get in trouble. But just if you have any thoughts, send them our way. That's totally fine. And then I won't be able to discuss what others have told me, but I can discuss in detail what you tell me. Because that's just between me and you. It's totally fine. So yeah, absolutely. Thank you. And if you want to set up a meeting and talk through it, however we want to do it, your individual feedback we can talk about in great detail, right? Yeah. Okay, I did that right too. Correct. I just like to add that in drafting the letter, it would be helpful to note that California is the largest state by volume, fielding 988 calls and just percentage-wise it's important for our state. And yeah, so I think that would just add to our support. Agreed. I think it's something like 25% of the national volume or something I think is in California. So yeah, yeah, we're by far the largest. So yes. Okay, we'll start to put that together. And again, any of the board members, you have anything that you want me to consider, just send me an email. It's totally fine. And then we can set up and talk about it. And that way the letter will be crafted with the most amount of information possible. And we'll bring it back to you in February, which I think, any other discussion from the public on item nine? Yeah, go ahead. Do you want to just come up here to the mic and that way everybody online can hear you. Just so you know, Tracy, everyone that's speaking is sitting behind your name tag. So you're getting well represented today. All right. I won't. I wish I was there. I'm Rob Bennett, Technology Consultant from WorkManage. When you're drafting this letter to the FCC concerning geospatial call routing, keep in mind that from a technological standpoint in the call routing, only 911 is capable of geospatial routing. If you're going to add something like 988 to do geospatial routing and you're trying to do it in a different way, that would require for all of the agencies involved is a major change to the, what I say, the standards and practices that are inherent worldwide and all equipment worldwide. That process, unless it's championed by somebody generally in Europe will take 10 years and you cannot speed it up because those are worldwide policies. I recommend hardly that you define, as you're saying, geospatial call routing. Geospatial routing in precisely the same way as we currently wrote 911 calls geospatially today. Yeah, that's good feedback. Thank you, Rob. I appreciate that, yeah. We don't want to create a new standard that takes two decades to implement. So we'll never see it. We'll never see it. Thank you, I appreciate that. All right, so there might be a little techno speak in the letter. So those of you on the behavior health side, we'll try and get it right and clear. Okay, any other comments on that agenda item? All right, moving on to agenda item number 10. So talking about when you'll see that letter, obviously February 22nd is our next meeting. We will get the letter to you in advance of that meeting so you'll have the chance to review it. I'll try and get it to you by when we post the agenda, which is 10 days prior. So that would be the, was that the 10th? Or no, the 12th, I guess. So I'll have it out to you by February 12th, if that's not a weekend or whatever, I don't know, but I'll get it to you in advance of that meeting so you've got time to review it. And maybe sooner if I'm not overwhelmed, but I'm typically overwhelmed. So we'll see how that goes. All right, any other board requests for matters on future agendas? This one will stay, obviously, because we're gonna have to talk about it. Anything else you want us to put specifically on the agenda? Are we hitting the mark pretty good on the overviews and the information we're providing or we're missing anything, do you think? All right, and we'll keep the standing item for HHS. We'd probably ask you to report out on the December 12th meeting, kind of give us a summary of where you're at in the process, I think that interaction is gonna be really important, okay? All right, and then we would look for a joint report out from the best practices in the 911 to 98 interface. So you and Tracy can team up and put that together. As a standing or you just want to put that for the February? In the February, yeah, but just when I do that agenda, that it'll be together. Sure. Okay, thanks Tracy. Okay, anyone else have anything for the, any board members have anything for the agenda? All right, any other comments on agenda item number 10 then? Seeing, hearing none. We're a public comment, which we've done all along, but we certainly encourage first board members, anything that wasn't on the agenda that you want to talk about now's your time. Any members of the public have any comment you're gonna do? You have somebody? Okay, go ahead, whoever has public comment. Hi, budge. This is actually a question for Dr. Bowie. If she's still in the room, it's hard to see. She is, and then go ahead. Yeah, this is a question that's been coming up through some emails to me directly during the course of this meeting from other centers. And the question is of the 40 members in the state advisory board, can DHCS comment on how many 988 centers will be represented on that board? And specifically also members of the LGBTQ plus community. So DHCS won't be able to comment, but HHS is in the room, they might be able to. So go ahead, Dr. Bowie. I know it can be confusing because I was at DHCS for the last couple of years, but I am now Cal HHS. So I have to remind myself as well. We're not able to comment right now on the specifics of the policy advisory group. We will be able to vary soon as soon as we finalize some of this and publish it on our website. Okay, and then I would encourage, we'll make our slides available, but if you go back to the overview that Cal HHS put forth, all of those groups you mentioned were specifically included in the discussion and of those on the board. So certainly I know they're gonna take that in consideration. So thank you for the comment. Any other public comments? Anything else over there? You seeing anything, Sammy? All right, okay. We are now on to item 12, adjourn. Do we have a motion to adjourn? On time, by the way. I will motion. I'll take your. All right, is that Tracy? Oh, Jennifer, oh, okay. It's hard in the speakers in the room. I can't hear it coming from that way. All I hear is the speaker. All right, so Jennifer has a motion. Do we have a second? Tracy will second. Tracy seconds. Thank you, Tracy. All right, so we are adjourned. Thank you. It is 1157, very well done. Thank you, and we will see you all in February. Thank you. Thank you.