UnGovr Transcript
iHow this transcript is madeUnGovr transcribes the official recording with automated speech-to-text, separates speakers by voice, and matches voices to the seated roster. Names and attributions are AI estimates and may contain errors.Verify any quote yourself: click anywhere in the transcript and the official video jumps to that exact moment, so you can check any quote against the recording.0:00 – 0:038 turns
Good morning. I will call to order the July 18th, 2023 meeting of the Santa Barbara County Board of Supervisors. Madam Clerk please call the roll.
Roll call, called by Clerk of the Board
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Please let the record reflect that Supervisor Nelson is participating in this meeting remotely
All those in favor, please say we need to roll call.
Roll-call vote Passed 4–0 Move approval. All those in favor, please say we need to roll call.
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Motion passes 4-1
CEO's report?
There is no report this morning chair
Madam Clerk are there any announcements or changes to our agenda today?
Chair Williams and members of the board, I do have a few quick announcements this morning. We posted an addendum to today's agenda on Friday July 14th amending the closed session agenda and adding administrative item 42. The closed session agenda was amended to add the additional employee organization under conference with labor negotiators all bargain units unrepresented employees managers and executives Administrative Item 42 was added to the agenda and is from the Human Resources Department. It is to consider recommendations regarding a performance-based salary adjustment for the County Executive Officer.
Prior to the Board acting on Administrative Item 42, in accordance with Government Code Section 54953 Subdivision C3, County Executive Officer Mona Miyasato's salary information shall be summarized verbally County Human Resources recommends that the Board of Supervisors approve a performance-based annual salary increase of 2.5% effective July 24, 2023 based on the CEO's performance in the past year.
By adopting this recommendation, the Board of Supervisors approves a biweekly salary of approximately $13,062. This addendum was posted online and made available to the board in the public. Lastly, for the Board of Supervisors methods of public participation and to provide public comment on general public comment or in an item on the board's agenda please see page two of the agenda. Individuals that would like to provide verbal public comment may do so via Zoom by registering in advance via the link available on page 2. If you have any questions please contact the clerk at the boards office at 805-568-2240. That concludes my announcements for today.
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Now we go to the administrative agenda. I have four items pulled. A15 by Mr. Nelson, A20 by Mr. Nelson, A37 by Ms. Hartman and the public pulled A23. Can I get a motion on the balance of the administrative agenda?
So moved.
Is there a second? Second. And roll call please.
Roll-call vote Passed 5–0 moved. Is there a second? Second. And roll call
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Motion passes unanimously
Let's go to 815
Chair Williams and members of the board administrative item 15 is from the county executive office. It is to consider recommendations regarding a letter of support request for AB 779 groundwater adjudication and AB 560 sustainable Groundwater Management Act groundwater adjudication.
Mr. Nelson or Mr.
Lavagnino? I just pulled this for a roll call vote, Without getting too deep into it, just notice in opposition is many of our agencies dealing with agriculture. I noticed California Chamber's opposed. CSAC is also actually opposed and so I'd just like to call for a roll call vote please.
Appreciate it. The legislative committee did debate this, and really the issue is that right now we have hundreds of constituents in Cuyama who are being essentially litigated against by two very large corporations for their water rights. And the law states that an adjudication cannot frustrate the goals of a groundwater sustainability plan. The details for that are slim to none and this legislation would provide that. And is therefore incredibly important to those, particularly those small landowning residents in the Cuyama Valley whose water is threatened and the renters and people in the township who's water is threatened by this adjudication.
Can I get a motion? Is there any public comment on 815?
Supervisor Nelson also.
Okay, Mr. Nelson.
Yes, a couple things on both of these pieces of legislation. I'm not going to be supporting either and I hope that we actually don't vote to support, especially 560 since the 560 is a two-year bill at this point. I don't think you need to take position on it this early. It's probably gonna be admitted between now and next year But 560 is opposed by CSAC and rural county representatives of California. 560 frustrates SIGMA, it actually gets out ahead of it.
It's kind of the opposite, it's actually the opposite problem what you're having with 779. The Groundwater Sustainability Management Act was historic legislation You know, these rules are put in place for us to work through some of the issues. These long historical issues and some of these fierce basins I think both these pieces of legislation don't go to the ends that we need to work on moving forward with those plans. And adjudication is simply just proving out legal rights and I don't think there's a reason why we should interfere with that unless they're some takings that we wanted to do water rights or property right And if somebody is going to prove those up through a court of law, that is a process that they'll go through. I trust the courts in California State Law Thank you, Mr.
Chair and members of the Board of Supervisors. I just want to say thank you very much for all that you've done over the last couple of days. I think we've worked to benefit of all in that basin, the Quiama Basin. And I hope that occurs. Ms. Hartman.
Move approval for staff recommendation, this is a situation where we have a few large corporations tremendously well funded against a lot of small landowners and tenant farmers and seems to me pretty clear course of action.
Is there a second?
Second.
Roll call please.
Roll-call vote Passed 3–2 Move approval for staff recommendation, this is a situation where we have a few large corporations tremendously well funded against a lot of
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motion passes 3 to 2.
Let's go to A20
Administrative item 20 is from the General Services Department. It is to consider recommendations regarding a professional services agreement for facilities and infrastructure asset assessment and solar feasibility study at the Gaviota Mariposa Arena site, project number 20036. This item requires a forfeits vote.
Mr. Nelson? Yes, I pulled aside because it's the first time. I think that we've got a chance to have something with this property before the Board of Supervisors. It's a property that I'm very interested in and seeing it developed with potential public recreation opportunities and park opportunities for the county. I don't know when it's appropriate in the future to potentially have I just wanted to take the opportunity with this item being forward to mention that.
And I think we should be working towards that. Also, I think it's a great opportunity not only for public access but for potential revenue for the county as well. So very interested in this project and glad to see that we're moving forward with this evaluation.
Supervisor Hartman?
Oh, well I just wanted to say I really appreciate the entire board support and especially Supervisor Nelson. This is just our due diligence trying to understand what are the issues involved there especially related to water access, water treatment so I'm glad that this study it's taken us a little longer to get this underway than we had anticipated but now it's at the starting gate.
So I would move approval
Supervisor caps.
I just want to echo the support for this project Especially the fact that solar and renewables is a part of the scope of it Just a small piece of it, but I would just encourage our team as I've done directly to explore a power purchase agreement Feasibility but very happy to see that solar was included in the potential use for this area. Thank you
Is there public comment on this item
Chair Williams and members of the board, we have no request to speak for this item.
And I also appreciate Ms. Hartman's leadership on this. This is a really important site. Obviously it's very industrial so it's possible to both improve the aesthetics of the site but also have the benefit of renewable power for the whole community and for making sure that we show that we will even create renewable power here on the south coast of Santa Barbara County. And create the recreation activities, recreation opportunities at the same time so it would be very exciting. We do need to due diligence because at sites like this you don't know what kind Ghosts and specters are hiding on the property But but I'm very excited to see the result Can I get a motion?
Move staff recommendation
and a second
Second
Roll call, please
Roll-call vote Passed 4–0 Move staff recommendation and a second Second Roll call, · 1 under review
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motion passes unanimously
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and the public has pulled a 23.
Chair Williams and members of the board administrative item 23 is from the Human Resources Department is to consider recommendations regarding the establishment of ambulance operator job classifications joining us here in person we have Andy Caldwell
Chair Williams, we have a handout for the board and a copy for the clerk of the board. It's also on overhead. As you know, we filed a California Public Records Act over this issue of the RFP and the permit process and everything else. We had stayed out of this issue for a long time. As a result of the California Public Records Act, I got buried in hay and was challenged to find a needle.
We found a couple of needles in the document dump which I think was at least 500 documents but most of what I'm going to share today we didn't get through that document dump. So first off, you've got a purchase order for seven ambulances. The county fire took this to the DAC in May asking for finance but again on the this purchase order was released much earlier than that page 2 You got a purchase order for another 28 ambulances. So the first one was for $682,000, the second one's for 2.7 million dollars. Again you can see the order date in May. The next one you have and again county did not send us this general ledger transactions.
These ambulances were paid for as they were received beginning in May a total of I think it was 35 ambulances for $3.6 million. And finally, we stayed out of this. AMR is a member of CoLab, County Fire's a member of CoLab. We stayed out of this thing but I was watching this and I started commenting on the process through op-eds and the radio show. Stuff started pouring into me from that including the last thing That is ambulances staged at Vandenberg Air Force Base that match the vehicle numbers on the purchase, the general ledger transaction.
So what you have here is a situation where somebody and we don't know who because the document didn't have it. Somebody while the RFP was still alive Ordered $3.6 million worth of ambulances. Before County Fire had a contract, somebody bought ambulances and enough ambulances to serve the whole contract. My 32 years I've never seen anything like this as result of asking for this information a month ago and not getting it We are handing everything over to the DA as of yesterday and have asked him to investigate this.
Where was the board authorization on this? How did somebody have the confidence that County Fire was going to get this contract that they bought 35 ambulances?
Thank you, Mr. Caldwell. What is the Board's pleasure on this? This is A23. This is on a 23. Any other. Request to speak.
Chair Williams and members of the board we have no further request to speak.
We still need a motion
I'll move a 23
second.
All those in will call please
supervisor Labanino supervisor Hartman I supervisor caps I supervisor Nelson. Chair Williams I motion passes unanimously.
Then
in 37 chair
yes.
Because normally we don't respond to public comment, I want to even express even more why I'm not responding to that public comment because of the fact that when you do turn something and I know it's going to be like well, you're not answering this but if you turn something over to the DA's office and you're charging basically your insinuating that there's some sort of Nefarious side to this for us to get into a debate about this in open session is would be Highly out of the realm of what we normally do so with respect to County Council, I think it's smart of us just to move forward and It'll all play out and all come out in the wash so
Thank You. Mr. Lavagnino A37, pulled by Ms. Hartman.
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Administrative item 37 is from the Planning and Development Department. It is to set a hearing to consider the applicant appeal of the planning commission's April 26, 2023 denial of the existing oil lines 901 and 903 valve upgrade project amendment and coastal development permits. Case numbers 21 AMD 0009 and 22 CDP-00048. This project is located within the third and fourth districts.
And this project also grazes the northeast parcel of my property where I live So I need to recuse myself from this matter and the following ones
This is a set hearing can I get a motion on the set here unless there is public comment
Chair Williams and members of the board. We have no request to speak
I move to approve staff
recommendation.
Second. Roll call, please.
Roll-call vote Passed 4–0 move to approve staff recommendation. Second. Roll call, · 1 under review
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Motion passes 4-1 That
concludes it Did somebody vote against that it was is four zero with one with one recusal
Excuse me motion passes unanimously.
Thank you Mr. Dean, Dean of the Board of Supervisors okay we will that wraps up the administrative agenda oh no we have one item to present
Chair Williams and members of the Board, Administrative Item 40 is sponsored by Supervisor Williams. It is to adopt a resolution proclaiming the week of July 16th 2023 through July 22nd 2023 as pre-trial probation and parole supervision week in Santa Barbara County. Joining us here in person we have Probation Chief Holly Benton supervising Probation Officer Sarah Miller, Senior Deputy Probation Officers Jose Macedo, Heidi Henzik and Jody Rutowski I will now read the resolution into the record.
Whereas during the week of July 16th through the 22nd, 2023 probation parole community supervision officers criminal justice and juvenile justice professionals and communities across the nation will join to celebrate pretrial probation and parole supervision week And whereas the probation department today consists of over 324 dedicated professionals working collaboratively with other agencies and community partners to deliver evidence based programs to justice involved individuals and juveniles while focusing on the enhancement of safety, the reduction of recidivism. And racial inequalities, the protection and compensation to victims. The promotion of crime prevention services, intervention, rehabilitation, positive youth development and restorative justice principles.
And whereas probation officers and juvenile institution officers provide an efficient and cost effective use of public resources by supervising approximately 2,500 adults and approximately 230 juveniles within the Santa Barbara County. The probation department conducts pre-trial assessments and currently monitors 611 individuals on pretrial supervision, utilizing the least restrictive options necessary to ensure public safety while allowing them to remain in the community and avoid incarceration. And assist with the reduction of local jail population by providing supervision, assessment and service referral to individuals approved for release on the alternative sentencing program. And whereas during the department's 114 years of service, probation's role has evolved dramatically and probation now serves as an integral partner in local law enforcement and criminal justice system.
The Probation Department serves As an essential connector in the justice system, bridging the gap and maximizing the resources available to reduce recidivism by carefully balancing direct human services with research-based deterrence and intervention. Probation department staff possesses and continues to display a high degree of professionalism commitment and pride in their work that they perform for the courts. In the juvenile justice facilities and in the community while striving to guide and support justice involved individuals towards becoming productive and successful members of the community Santa Barbara County Probation Officers, Juvenile Institution Officers and Pre-trial Service Specialists dedicate their lives to rehabilitation and community safety in order to improve the quality of life for our community.
Now therefore be it hereby ordered and resolved that this Board of Supervisors hereby proclaims the week of July 16th through the 22nd 2023 as Pre-Trial Probation and Parole Supervision Week and recognizes these officers and their significant contribution to making the Santa Barbara County a safer place to live passed and adopted today.
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Good morning Chair Williams, members of the Board. I'm Holly Benton, Chief Probation Officer. Today it's my honor to come before you to represent the officers and staff of the Probation Department. I thank you very much for this resolution which recognizes the important work we do in our community and also symbolizes your board's continued support of this work for which we are thankful.
Our work with justice-involved adults and youth takes many forms, from diversion out of the system entirely to pretrial assessment and to supervision of those who require additional accountability and supports in order to be successful. It also involves collaboration with our many county and community partners to help ensure public safety and empower individuals to change.
With me today are four of our line officers who represent pretrial, juvenile services, alternative sentencing and juvenile facilities. And I'd like to give each an opportunity to introduce themselves and briefly share what they do. Thank you again.
Good morning supervisors through the chair. My name is Jose Macedo. I'm a senior deputy probation officer in the field training and monitoring unit. I'd like to share some of the work we do. I get the opportunity to work with clients who have been placed on GPS. Our unit's officers supervise all clients throughout the county and are available 24-7 to provide coverage, respond to alerts and ensure community safety.
In July 2022 Santa Barbara Probation collaborated with the Santa Barbara Sheriff Department's Alternative Sentencing Unit and began monitoring individuals serving their court ordered I'm pleased to welcome you to the board of Supervisors meeting. We are here today to discuss a new jail commitment via electronic monitoring in lieu of physical incarceration. Santa Barbara sheriffs are responsible for screening all applicants, determining eligibility and rehousing of individuals. Probation is responsible for the supervision of these individuals in the community.
Our officers enjoy working with the alternative sentencing deputies. We have been able to meet the needs of individuals and help them successfully complete custody time outside of jail. I am proud and honored to be a part of this unit, and I would like to recognize my fellow officers for their ongoing commitment and hard work. Thank you very much.
Good morning Supervisors through the Chair. My name is Heidi Henzik and I'm a Senior Deputy Probation Officer assigned to the Pre-Trial Supervision unit in Santa Maria. For those unfamiliar with the roles of our pretrial staff, when someone is booked into county jail, our assessment unit greets the person and conducts an interview. To prepare a thorough report with their findings and a recommendation for court, their pretrial service specialist reviews the arrest report, the person's criminal history, conducts a risk assessment, and contacts the references all while maintaining the presumption that the person is innocent.
If granted supervised pre-trial release, pre-trial supervision officers provide case management and community supervision by ensuring adherence with court ordered conditions. Pre-trial staff meet with individuals upon incarceration and soon after release when they're often vulnerable and emotional and need supports and reassurance during which may be an emotional time in their life. I have personally seen many pre-child staff go above and beyond to help clients while showing compassion and guidance, while helping them on their path to success.
These staff embody teamwork and demonstrate an unwavering commitment to helping others rebuild their lives while allowing them to remain in the community while addressing their core matters. Thank you for the opportunity to highlight them today.
Good morning Supervisors through the Chair. My name is Jody Brutosky, I'm a Senior Deputy Probation Officer in the Juvenile Division and I am pleased to have this opportunity to represent that division today. I have the pleasure of working with youth referred to juvenile probation from those diverted to those in custody having focused a great deal on improving diversion opportunities for youth in recent years This year, we are moving toward better identification of youth at risk for commercial sexual exploitation and identifying and respecting youth's sexual orientation, gender identity, and expression.
We are focusing on including family input to youth case plans using a child and family team model which allows youth to bring the supportive people in their lives into strength-based discussions. In addition, we are creating new opportunities to further engage youth and families through regional family engagement nights and continuing our wellness operations.
Thank you for the opportunity to highlight our juvenile division and staff today.
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Supervisors to the Chair, I'm supervising Probation Officer Sarah Miller currently assigned to the Facilities Division overseeing our camp program. Over the last year one of our main focuses has been on transitioning towards a more therapeutic commitment program design within the Facilities Division. This includes using evidence-based program models that reinforce positive behaviors to affect change within the individual as well as the environment of the facilities.
We identify the needs that should be met for each youth and the individualized programming needed to meet those needs. Eye movement, desensitization, reprocessing EMDR, dialectical behavioral therapy DBT, Rock On to Recovery, which is a music creation opportunity and transitional education programs through Allan Hancock and Santa Barbara City College are just some of the programs we have incorporated to assist the youth. The long-term goal is to affect long term change, incorporate family reunification and introduce the youth to a variety of enrichment programs which they can continue once they return back to the community and so they can be successful once released. Thank you.
Thank you Supervisors.
Well I just wanted to say, I was really proud to sponsor this resolution. Sometimes when there's things always going right with a department it doesn't sometimes that means our attention isn't always directly on or talk about it as often as we should because so much has gone well in the probation department over the last few years And in particular, striking the amazing balance of accountability and compassion that keeps the general public safe. But at the same time provides a path for the clients to be on a different road, to rehabilitation and to another life.
And I just think every bit of evidence I've had over the past six years indicates how amazing the department is doing in achieving that mix of compassion and accountability and I really thank you for it. Ms. Hartman?
I just wanted to thank Chief Benton for bringing the people who do this extraordinary work to talk about it. We don't always get to see that and hear that, so to see the compassion and humanity that is obvious today really means a lot. Thank you.
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Chair Williams and members of the Board, Administrative Item 41 is sponsored by Supervisor Hartman. It is to adopt a resolution proclaiming the week of August 6th 2023 through August 12th 2023 as National Health Center Week in Santa Barbara County. Joining us here in person we have Mohamed Hammami and Paola Hartuto I will now read the resolution into the record.
Whereas every August, the National Association of Community Health Centers sponsors National Health Center Week to celebrate and increase awareness of America's 1400 community health centers. The Santa Barbara County Public Health Department operates five healthcare centers, three shelter-based clinics providing high quality affordable comprehensive primary health care in the county's underserved communities.
And whereas California Government Code Section 26227 Authorizes the Board of Supervisors to expend money from the general fund of the county, To establish county programs deemed by the Board of Supervisors to be necessary to meet the social needs Of the population of the county including but not limited to The areas of health public safety and welfare. And section 26227 further authorizes Officers and employees to use county resources to carry out any such programs established by the board of supervisors And whereas, the County of Santa Barbara Public Health Department has invited over 30 community partners and agencies to join them during the National Health Center Week to host back-to-school health fairs for the communities at Lompoc, Santa Barbara and Santa Maria Healthcare Centers.
And whereas the services offered to those attending these, these specific to fostering the well being of all community members and specifically those who are served by the health care centers. Partners, agencies and county services and programs all located in one area which fosters collaboration between agencies and partners in outreach to the community with a focus on addressing a larger spectrum of needs for those in underserved communities. Now therefore be it hereby ordered and resolved that this Board of Supervisors does hereby proclaim August 6th through the 12th of 2023 as National Healthcare Center Week Find that hosting back to school health fairs on county property serves a public purpose by bringing community partner agencies and the community together in one accessible location, which meets the social needs of the population of the county.
And authorize the County of Santa Barbara Public Health Department to host back-to-school health fairs passed and adopted today.
Thank you, Supervisor Hartman and Mr. Chair. We traditionally celebrate the National Health Center Week on a smaller scale every year at our health centers. What is so special of this year is one it comes as we are coming off of the emergency of the pandemic. We want to go back to the community and it represents a lot of community collaboration where we are now doing it as a back to school. And the flyer just to tell you about the dates, we're starting at Santa Maria on August 8th between 11am-3pm and then the next day on August 9th will be in Santa Barbara between 4pm-7pm And then on August 10th, we'll be in Lompoc at 11 a.m to 4 p.m. There will be smaller scale celebrations at both our clinics in Franklin and in Carpinteria as well. Just to give you a scope of the services, our Assistant Deputy Director Paula is going to tell you a little bit about the services we're providing.
Good morning. So we're happy to announce that we will be having various screenings at the health care centers at Lompoc, Santa Maria and the Santa Barbara Health Care Center. At all three sites we will be having sports physicals. We partnered with various community partners who will be providing resources to patients and community members who participate. We will be at the Santa Barbara Health Care Center offering cancer screening so it'll And we will be giving, there'll be giveaways. We'll have food trucks and so we welcome all to participate during those events. Thank you.
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Ms Hartman? Well,
I just think this is terrific that we're having these and hope all the board members will publicize through our social media. I intend to show up in Lompoc and especially excited about the sports physicals because that's often difficult for families to manage so to make it so easy is terrific.
Thank you for all your work. Now's the time for general public comment, for the public to speak on items that are not on the agenda. Madam Clerk, are there any requests to speak on general public comment?
Chair Williams and members of the Board we have three requests to speak. We will begin via Zoom with Patty Pegling to be followed by Brian Rosen here in Santa Barbara.
Hello, Santa Barbara County Board of Supervisors. Wishing you all a good morning. I want to thank you for all the work you're doing for our communities and the planet. My name is Patty Pageling and I'm here to express support for Brian Rosen who has spoken with you regarding the questionable actions of a trustee for his family's estate. The trustee hasn't released funds to beneficiaries who truly need them. I was with Brian when the trustee was speaking with Brian on June 1st, on the phone which was on loudspeaker.
I heard the trustee say on the phone that he would be releasing money within a month And that it would be a substantial amount. He said Brian would be happy with the amount. The month has come and gone, and now the trustee is still stalling and has not released any funds. And many of us who are friends of the beneficiary are asking for your help to encourage the trustee to do the right thing and release the money to the beneficiaries immediately. And I've been informed of other very questionable actions of the trustee. I sent you all information about that, which you can look over and due to these actions along with other actions that indicate alleged misconduct by this trustee we are concerned that he is not acting in the best interest of the beneficiaries which is required by law and I thank you for your time That's all.
Brian Rosen to be followed by George Alvarez and Santa Maria.
Hi, it's nice to see you all again and I want to thank Doss for having his aide Katie call the trustee and his attorney. And the trustee they gave nothing specific, nothing in writing just in 30 days we're supposed to have a beneficiary distribution agreement or something like that I need something in writing, and I appreciate all of your help. Maybe I could meander around afterwards to all of your offices and share with your staff some of the documents that I have that are pretty clear.
I'm just amazed that they had the gall to represent the House as a teardown in court While we have the very property inspector that gave these documents to DAS saying it's not a teardown, just needs updating. Great property. It's a perfect parcel in Montecito surrounded by undeveloped land that's never going to probably be developed, virgin soil, wildlife habitat, organic farm and they try to list it originally for $2.5 million.
Well, trying to turn it into a teardown was seemingly what they were trying to do because it was so hard to get the trustee to repair the roof. And if it wasn't for Judge Stern, thank God she insisted that roof be covered right before the big January 11th storm and even after Judge Stern insisted on it my attorney and I had to work really hard to get them to cover the roof and barely in the nick of time the house would have been decimated But then in the court, even though they had all those documents and letters and the roofing company and the property inspection report in my emails. The attorney Mr. Randall Fox stated that first time they ever heard of a leak problem So my attorney, of course, refuted that.
So the house finally got sold after we had all the evidence in court and also a possible referral fee scheme that we found out from real estate friends when we found out the trustee was also a broker. The real estate people suspected That there was a referral scheme, he dropped the real estate agent like a hot potato and we had all this evidence on them in court. They didn't want to be ordered by the judge so they just simply did pretty much what we wanted and the house sold for 3.736 million. You can go to 673 Cold Springs Road and you'll see that what I'm saying is true. And I have the original listing agreement here for 2.5 and with the outdated comparables, but I meet a lot of people who have a lot of problem and I go to court and they have $3 million to use against me.
I can get more in debt to my attorney so I'm paying for their attorney and my attorney. It's just not a healthy system and I think it's happening to a lot of people and I really appreciate DASA's help and if I think if they heard from any of you then they would get real scared that I guess AIDS aren't You're all pretty savvy and smart, and they wouldn't know what to do. They would just maybe fold up and do the right thing. But thank you so much for taking the time to listen to me, and hopefully we can resolve this matter, and that we'll have a better, more fair, just court system.
And so the trustees, Mr. Will Jones, if anyone wants to give him a call I'd appreciate it. Thank you very very much again.
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We will now move to George Alvarez in Santa Maria.
Good morning supervisors can you hear me?
Yes, we can please proceed
OK thank you I got Array of things you can bring up to your attention. One of your retired probation officers unfortunately got caught embezzling and got 10-15 years on it, which is embarrassing for the Probation Department along with the theme of embezzlement and fraud. The County of Santa Barbara, the County of San Luis Obispo And various health providers have to pay back $68 million of fraudulent claim during the COVID aspect when they are dealing out with the money.
My concern is if a probation officer is getting time for his embezzlement, isn't it the responsibility of the board members The DA to actually find out who are the persons involved in the embezzlement. One thing is settling out of court with the feds to get the money back. A crime is a crime and today's society I don't accept white collar crimes You break the law, you go to jail. So I wanna find out hopefully by your actions who's gonna be brave enough to find out who these people are and have their heads rolled for what they did from that perspective? We can't have law and order in this community or country if we don't abide by the rules and fair outright balance with all of us from that perspective.
Another issue is I wanna recommend I talked to Assembly Heart yesterday in Guadalupe. My concern basically was the six idiots that voted down the pedophile bill that would allow these guys to get felony charges when they do their hideous crimes and they voted it down, but he assured me that's going to come back and it's going to be voted again Hopefully the six have voted against it. We can wake up and find out that children have the right to have safety as a parent, we protect our children as a society. My God, have we gotten way on the wayside of our moral compass in dealing with these issues? It's alive. I recommend those who haven't seen the movie.
The Sound of Freedom. Excellent movie, it opens your eyes to a lot of things And I'm outraged that our federal government is taking children to different cities by sponsors and me, you, the tax are paying for this activity. And they come in here illegally. How in the hell do they get sponsors? So bring that into your attention. Please see the movie and have self-respect, and like I said it's up to you to make sure the law is abided by and respected by all. Thank you.
Chair Williams and members of the board that was our final speaker.
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We will then move on to departmental item number one
Chair Williams and members of the board, departmental item number one is from the County Executive Office. It is a hearing to consider recommendations regarding amendments to the Cannabis Business Licensing Fee Ordinance.
Supervisors we requested a continuance as we're still working to negotiate the fee with the cannabis CCA so we're asking for you to continue this item.
Is there a motion or comment? Supervisor Hartman.
Do we have a date? Supervisors on the agenda, we have a date of continuing the departmental item to August 22nd.
Move continuance to August 22nd? Is
there a second? And there's a second. Roll call please.
Roll-call vote Passed 5–0 Move continuance to August 22nd? Is there a second? And there's a second. Roll call
Show transcript
Motion passes unanimously.
Take departmental item number two and for the record there was no public comment on the continuance.
Chair Williams and members of the board that is correct Chair Williams, members of the board, departmental item number two is from the Community Services Department. It is a hearing to consider recommendations regarding the consumer price index adjustment for fiscal years 2023 through 2024 special library tax rate for county service areas number three in the greater Goleta.
Good morning chair Williams, members of the board I'd like to introduce Andrew Myung CSD's CFO who will be presenting this item
Good morning Chair Williams, members of the Board. The Community Services Department coordinates changes to the CSA Special Library Tax annually by the Los Angeles Urban Consumer Price Index. The library special tax was approved as part of Measure L and is levied for parcels located in CSA 3 in the unincorporated area outside the boundaries of the City of Goleta. The City of Goleta has a similar process that they do for the parcels located within the incorporated area.
The special tax rates for the fiscal year 23-24 are proposed to be adjusted by 7.4%, which reflects the percentage change in the CPI for the calendar year 2023. The CPI will result in a total assessment of approximately $230,000 all of which goes towards the operation of the Goleta Library and a 16% increase over the prior fiscal year. The recommended actions before you are as follows, to adopt the resolution that confirms the report and increases the fiscal year 23-24 library special tax in the CSA 3 by 7.8% and to determine that these actions aren't subject to CEQA.
That's end of the report.
Ms. Kaps?
Thank you to the staff for presenting this forward. I just want to confirm that this is a routine annual adjustment that happens?
Yes, Supervisor Caps through the Chair. This is an annual routine adjustment that happens every year.
Thank you. Well, I certainly know how important libraries are in Goleta and more money is helpful. And so I appreciate the report.
And that there isn't can you make a motion? Any public comment.
Chair Williams and members of the board, we have no request to speak for this item.
Supervisor
caps
I would be happy to make a motion of accepting staff report with this adjustment
second.
Roll call please.
Roll-call vote 1–0 motion of accepting staff report with this adjustment second. Roll call · 4 under review
Show transcript
Motion passes unanimously.
Departmental item number three.
0:50 – 0:568 turns
Chair Williams and members of the board, departmental item number three is from the Community Services Department. It is a hearing to consider recommendations regarding fiscal years 23 through 24 special tax levy for the County of Santa Barbara Community Facilities District number 2002-1 Orchid Community Plan and for the County of Santa Barbara Community Facilities District 2004-1 Providence Landing.
Hello again Supervisors, Chair Williams and members of the Board. The item before you is the annual update to the Orcutt and Providence Landing Community Facilities District tax levies. The Orcutt CFD was approved by the Board of Supervisors in 2002 for the purposes of levying a special tax on residential and commercial properties in the Orcuttt Planning Area.
Specifically, the special tax is used to offset operational and maintenance service costs associated with the buildup of the Orkut Community Plan. The special tax funds four major areas, Sheriff Protection Services, Fire Protection and Suppression Services, Maintenance of Parks and Open Spaces, and Flood and Storm Protection Services. For fiscal year 23-24, parcels within the CFD will be increased by the Los Angeles Urban Consumer Price Index at 4.93% or 2%, whichever is higher. In this case, 4.93% CPI was applied.
Similarly, Providence Landing Community Facilities District was approved in 2005 to fund the maintenance of a 12-acre community park maintained by the HOA. This fiscal year 23-24, the parcel levy will remain the same since 2006 at $672 per parcel. The difference being the method of apportionment Allows just for full cost recovery and we have adequate fund balances for that district. So there will be no increase to that particular tax levy
Questions from the board Any requests to speak from the public
chair Williams and members of the board? We have no requests to speak
Is there a motion Mr. Nelson?
Orchid's been in my district for quite some time, and so I was really familiar with the Orchids CFD. But also now proud to have the province-landing CFD in my district as well. And I can just really want to thank the group out there, Province Landing, for all the good work they're doing. They've recently installed four freshly done pickleball courts that we're looking forward to unveiling this summer to the community as well.
But focus back on the Orchids CFD for a moment. I'm frustrated by the expenditures here in the Orchid CFD. There's no connectivity between, at this point, the growth and the expenditure of these funds. The fund to go towards the park Are the ones that are probably most beneficial to community because there is a bit of a nexus there because of proximity, but it is a regional park and it's funded not only from the CFD but from other PAC payers in the county. And that makes a lot of sense to me.
But we haven't been able to make a connectivity between the fire and the sheriff cops and services provided. As you guys are all aware, last year you authorized the funding of a CF community resource deputy for Orchid that would be paid for these funds by 5% of that position. That position has not been filled and so we've got another year without having the rate payers in the CFD getting any return for the taxes that they're paying.
Orchid CFD is a unique situation in an incorporated county, the CFD residents are triple taxed Many of the services that people get throughout the county paid for by their sales and property taxes. Those members in the CFD pay an additional tax, it's supposed to offset for growth but we don't get the services that go with it. I'm again frustrated by this At this point, I cannot support the additional increase until we can get a greater nexus between the services rendered.
And the taxation for the residents and orchid who paid New York and CFD tax so I can't support the motion that actually. You know, recommend that we make a motion to keep it flat and working until we can start connecting the actual PACS revenue. The services delivered for the constituents who are paying them so if I get a chance there's a motion I'd like to make but have some support from my
colleagues. Would staff like to answer the question that Mr. Nelson brought up on what is Reason that this is necessary expenses going up as their initiatives to tell us what the
reason As Supervisor Nelson said, on the park side we do have costs in the Orchard area partially funded with general fund and this community facilities district. But I think many of his questions were related to the Sheriff's Department and to that I think Under Sheriff Bonner is here to answer some of those questions
0:56 – 1:0516 turns
Mr. Bonner.
Morning, Chair Williams, members of the board, Under Sheriff Craig Bonner on behalf of Sheriff Brown. As Supervisor Nelson pointed out, obviously we are working through significant staffing challenges. I do want to point out that we have 37 law enforcement deputies in various forms of initial training. We do intend to fill the community service deputy position as quickly as we can get those deputies online As far as the need for an expansion, the Sheriff's Office does not have a need for expansion. However if this is just a normal you know just like the other ones scheduled increase but we don't have a need for an expansion above and beyond what is already budgeted this fiscal year.
Mr. Nelson do you have any questions from Mr. Bonner? I just
know what I've been saying is that we don't have any activity. Mr. Bonner, or under Sheriff Bonner would probably be able to expand on that there's actually no direct nexus between the ORCID CFD and actually the amount of patrols that would be done there. The CFD doesn't pay for an extra patrol or any additional enhancement services that didn't exist prior to the creation of the ORCID CFD.
That's one reason why we wanted to move forward with a community resource deputy for the first time so we actually have enhanced services in the ORCID area I'm not prepared to increase this tax when we haven't begun to deliver those services yet. As far as fire is concerned, the CFD was established prior to the fire tax transfer so For these homes prior to the fire tax transfer, there's a greater justification for using the ORCA CFD to pay for enhanced fire services. But now that it's been transferred through the fire tax transfer, it makes more sense to reevaluate that as well. It's something that my office has been trying to talk or talking to the county about for a couple of years now. I know we had contraction prior to Mr. Bailey leaving on the Community Services Department It's something we're going to continue to work with CSD on too, to make sure that this the Orchid Community Facilities District is right sized to the community.
Whether that needs to be expanded or shrank or either just make sure that we're having tax dollars actually delivered services that are connected to that growth and I don't feel comfortable with raising that this year there's no budget for these funds that show that growth and so you know i'm not saying Get rid of the fee altogether. I'm just saying that at this point there's no justification, I can see for raising it. There's no cost of goods or services that are increasing at this fee. So I would make a motion if we could staff recommendation with the amendment that we have a 0% increase in the Orchid Community Facilities District for 23-24.
Is was that a motion or do we it was emotion? Is there a second
supervisor splint? Let me just ask mr. Myung if that's We understand your direction, but legally can we do that?
So just as a point of Chair Williams, members of the board. Just as a point of clarification, the budget is always affected in arrears and so that's our current budget utilizes the prior year report and so what will likely be impacted are your other funding sources for your next upcoming budget year. For parks it'd likely be a little bit more general fund contribution to cover those costs in ORCUT The same with fire and sheriff, I would imagine. So that's what we're talking about the impacts to the next budget year.
Mr. Myung if what is the timing on this approval in order to make our this not affect us fiscally for next year?
Thank you, Chair Williams. We have to have all of these changes into the auditor's office to get on the tax roll by August, by the beginning of August I would say and so there are no more board meetings between now and then to get on the tax roll. So this is the final meeting to make the decision.
Mr. Lavadino? Well thank you and I completely understand where Supervisor Nelson is coming from I think this might be part of his future plans on maybe a CSD in Orkut or something, and how you get more connectivity to the actual tax dollars that the people pay for. And I would support anything that did not then impact the general fund because if there's no connectivity from the folks that live in Orkutt for these services, there's definitely no connectivity to the people that live in Santa Maria or the San Ynez Valley or Lompoc or Santa Barbara.
So I would be a willing partner with you on how we tackle this moving forward for next year, but being in the deadline that we're in right now. And having no either alternative of either we continue with the path that we've been on or that we go and impact the general fund which then really disenfranchises even more taxpayers. I'd be willing to sit down with you and be your partner on a solution moving forward but not for actually this year.
So procedurally, I will ask if there's any second to Mr. Nelson's motion but it seems like you then would have a substitute motion if there is not. Is there a second to Mr. Nelson's motion to defer the tax increase for this year? Motion dies for lack of a second. Mr. Lavagnino.
I'll make a motion that we receive that we accept staffs recommendation with the caveat that we also And I don't know if Supervisor Nelson would like to have, you know, an item that explains this a little bit better and how these taxes in the CFD are. At one point, I think you were bringing back an ORCID item, and I don't know if this would tie into it, but I just don't know if there's some staff recommendation that staff direction that you'd like as part of the motion because I'd be open to that as well.
Thank you, Chair. I just want to correct the record and it's not that the general fund would be subsidizing some of these services in ORCiT. It's actually that ORCit is subsidizing the general fund by paying for services that they're not receiving, so that's one of my concerns here. I see that it's been budgeted that way, so I understand the concern of the board on how to recover those potential loss funds if they're not done there. But again, it is ORCiT paying extra more than any other Taxpayer in the county for those additional services that subsidize the general fund. So, I just want to correct that for the record. I do appreciate the willingness though to have an ongoing conversation.
On my office and community services to get together to work on trying to potentially reissue the study and come back with a new resolution on your community facilities district on how that would look moving forward. It's, you know, a big concern of mine has been for quite some time and something that it's a little hard to crack It's one of the very few Miller Roost districts in the state that actually paid for services. Most Miller Roost districts actually pay for infrastructure.
I'm definitely a big fan of additional infrastructure and services for the community of Orkut, but right now the Orkutan CFPB is not doing that and so that's why I can't support the motion.
Okay understood. So I will just make staff recommendation then and then we'll have fourth district office continue with staff behind the scenes on how to correct this.
I will second.
Roll call, please.
Roll-call vote Passed 4–1 motion. Okay understood. So I will just make staff recommendation then and then we'll have fourth district office continue with staff behind
Show transcript
1:05 – 1:168 turns
Motion passes 4-1
And just for the record there was no public request for public comment.
Chair Williams and members of the board that is correct
Then we will go to departmental item number four
Chair Williams and members of the board, departmental item number four is from the County Executive Office. It is to consider recommendations regarding a status report on criminal justice partners improvement efforts.
Good morning supervisors I'm going to kick this off as they're getting their PowerPoint put together and put on the screen And it's just that, as you know, over the last three years our justice partners and the county executive office have worked collaboratively to improve the effectiveness, the efficiency and the fairness of our local criminal justice system. And as you know this is a complex system where no one entity is really in charge.
We have the courts, our public defender DA sheriff probation behavior wellness assisted by my office and while the board appropriates money For our county departments, obviously the District Attorney and the Sheriff are independently elected. We've had a lot of consultants contribute to this effort and experts along the way. The board has consistently expressed an interest in expanding enhancement to local diversion options with a priority on those justice-involved individuals with behavioral challenges and also low-level offenders. So as we've done in the past, this is a status report on the goals and strategies of the collaborative efforts of our partners who are here today. And I also just want to say thank you to all of them and also this effort is led by Assistant CEO Tanya Heitman who also was a leader in this initiative as Chief Probation Officer And Nicole will introduce who our other speakers are today, and if you've looked at the packet.
I please look at the packet We've done a great job this year in Articulating all the different strategies so they're attached as an attachment to your board letter with that Nicole
Thank you, Mona. Good morning Chair Williams and board members my name is Nicole Parmelee I'm the fiscal and policy analyst to the county's criminal justice departments and I'm joined by ACO Tanya Heitman and principal analyst Lindsay Walter. Today we'll provide a status update on the goals and strategies of the collaborative efforts currently underway by the Criminal Justice Partners as well as highlighting opportunities to align this work with a jail population management plan that will be developed over the next year Start with some background.
For over three years, the justice system partners including the district attorney, the sheriff's office, probation, public defender, behavioral wellness and the superior court as well as the CEO's office have worked collaboratively to improve the effectiveness, efficiency and fairness of our local criminal justice system. Through this process, the county has also sought input from a number of consultants, industry experts and community stakeholders in supporting these efforts.
And the CEO's office has provided ongoing updates to your board to assist in setting priorities and to ensure the board and the community are aware of the changes and impacts to the criminal justice system. Over the past several years, your board has consistently expressed interest in expanding and enhancing local diversion options with a priority focus on justice-involved individuals who have behavioral health challenges and are facing low level nonviolent charges.
These themes have continued to emerge through last year's jail population analysis conducted by consultant Michael Wilson, as well as in current efforts to address the increased IST population. The need for more residential treatment beds specific to the justice population. Justice involved implementation requirements of CalAME and compliance with the DRC stipulated agreement.
All of these initiatives are intertwined with common goals and target populations, and in fact must be considered as joint efforts that should be leveraged concurrently to accelerate the Board's priorities. So with that in mind, since our last update to your board, the criminal justice partners have worked to align their goals with both the Board's priorities as well as the goals that have been previously established by the CCP. And as a result you will find the alignment of goals as depicted here on this slide.
And we will talk about each of these goals and their corresponding strategies in turn, but it is worth noting first that many of the identified strategies tie directly to the policy levers indicated in Mike Wilson's jail population report as supporting the overarching goal of safely reducing and appropriately managing the jail population. Each of these strategies if successfully implemented is anticipated to assist in further reducing the jail population without compromising public safety.
And now I'll turn it over to Lindsay Walter to walk through each of these initiatives briefly.
Good morning, goal one is to enhance public safety by reducing recidivism. The key strategy is the Familiar Faces Program, which is an initiative focused on serving high-need individuals who are reluctant to engage in services through a multidisciplinary street outreach team. The program will provide daily outreach to those experiencing homelessness with history of justice interaction and ensure intensive case management and linkages to community resources. Currently, staff from Probation and the Public Defender and Behavioral Wellness are meeting to design the program and build out and expand the steering committee which will contribute to this work over the coming months.
Through improved engagement it is anticipated that individuals served will utilize fewer jail bed days and inpatient services as well as experience reductions in overall recidivism. Also to note in the strategy briefs probation has more information on the data to be collected goals and outcome measures. Goal two is to enhance the use of alternative detention. There are two strategies, the first is to expand alternative sentencing. An alternative sentence provides inmates with an opportunity to serve their sentences via community programs instead of through jail time. Since July 2022, probation has provided the responsibility for the supervision component of the program which was previously conducted by the Sheriff's Office. While the Sheriff's Office has continued to oversee the application eligibility determination and booking and rehousing portions of this process.
There is an opportunity to examine the eligibility criteria, screening process, timelines for enrollment, and supervision strategies to ensure that optimal numbers of individuals can be safely enrolled and supervised on the program as well as the expansion of the program if supported by the data. The second key strategy is to expand and enhance diversion opportunities primarily for those community members who experience behavioral health issues.
Oftentimes, persons who are charged with a crime who appear to have a mental health or co-occurring substance use disorder condition may be eligible for a variety of diversion options due to recent legislative changes. The partners are working on a variety of programs which include the Mr. Muneer Community Diversion, Credo 47 pre-diversion opportunities, DISH AB 1810 program which is Department of State Hospital, the county's co-response teams and felony diversions. Also some of these are still in the planning process specifically the felony diversion program.
In addition, recently the Felony Incompetent to Stand Trial Collaborative Work Group has been initiated with a Department of State hospital grant that was funded effective July 1st 2023. The primary goal is to see a reduction of IST commitments for providing recommendations of system interventions and programming to support these individuals. IST process mapping has been completed and data analysis and sequential intercept mapping are currently underway. In collaboration with several state associations, the county continues to advocate for changes to the formula utilized to impose penalties to the counties. We do anticipate that a new formula will be released by the DISH in the coming months Overall, based on the nature of the current discussions it is believed that Santa Barbara County's anticipated penalty will be reduced substantially.
What's not on here is that we initially estimated the penalty at $6.4 million and the updated range through advocacy could be as low as $2.4 million Goal three is a successful and equitable re-entry. The key strategy is creating an assessment and re-entry coordinator funded in the department whose function is to perform coordination, and to ensure all county diversionary pretrial and alternate sentencing release options are maximized and individuals exiting the criminal legal system have a robust discharge plan.
Goal four is to coordinate efforts and enhance efficiency. There are three key strategies. The first is the Digital Evidence Management System, otherwise known as the DEMS, and the Discovery Process Improvement Project which is a technology- and process-based initiative that seeks to improve efficiency and security in distribution of electronic discovery among criminal justice partners, manage the exponential increase in volume of discovery and reduce delays in the criminal justice process by modernizing the intake processing and transmission of electronic discovery.
On March 2023 we just wanted to remind that your board authorized the release of the request for proposals which has commenced. The second strategy is to leverage technology and streamline and automate workflows. For some of those who have been around, they know about the Criminal Justice Data Committee which is the CJDC who was tasked with developing a data exchange infrastructure process in governance between multiple county agencies to enhance the ability to collect and analyze data on shared clients and improve data integration between agencies.
Recently, the committee has been meeting since March 2026 and now is being restructured and renamed to add additional county partners from Health & Human Services. They will include Social Services, Community Services, Emergency Management, and Public Health. The goal of reforming the group is to have ability to facilitate cross-agency sharing so that we can share and get better comprehensive information For decision and policy making as well as enhance efficiencies and improve customer service.
Lastly, with a combination of grant and CCP which is Community Corrections Partnership Funding the Early Representation Pilot Program weaves together resources from the Public Defender Probation Department and Good Samaritan Shelter to provide assessment of needs connection and representation at the earliest stage of a misdemeanor criminal case as many charged individuals in the county require connection to mental health medical or crisis stabilization services.
Studies do indicate that early representation, which involves defense meeting a client prior to arraignment and providing representation at the hearing or at prior appearance that may occur can meaningfully reduce pre-trial incarceration while also improving justice outcomes. Current status of this is that the recruitment for the associated new positions has begun.
Goal five is our last goal and it is to address racial and ethnic disparities. The departments are committed to supporting a systemic approach to studying and addressing racial and ethnic disparities in the criminal justice system. Strategies include coordinating improving data analysis across the multiple, the criminal justice continuum that supports studying and addressing these disparities and staff dedicated toward the Racial Justice Act. I will now turn it over to ACO Tanya Heitman
1:16 – 1:2411 turns
Good morning. As Nicole and Lindsay have shared, there has been and continues to be a tremendous amount of work underway as well as additional efforts planned for the next year. The criminal justice partners continue to meet twice a month to ensure they're communicating and collaborating as they work toward our aggressive timelines. In the fall, the Sheriff's Office and Probation Department will bring forth an annual report on alternative sentencing as well as their plans for expansions and enhancements to the program.
This is a current initiative, but with further refinement could be an even more impactful jail population management strategy. At the end of the year we intend to bring an updated jail population assessment. A year ago, we received a report from Michael Wilson Consulting regarding the jail population and potential policy drivers that could reduce it. Mr. Wilson's analysis was based on jail data that went through the middle of January 2022.
He also identified several factors that could cause the jail population to diverge from his projections. We have now experienced each of them. The Northern Branch Jail is operational, there've been changes in crime rates, we've seen a reduction in the supervised probation population, pretrial services has continued to expand and the pandemic emergency orders have expired and we continue to return to our prior levels of services and activities.
Additionally, we now have 18 months more jail data that can be considered. As we identify our jail population plan, we need to be sure that we are operating with the most current understanding of who is in our jail and how that population may be changing. Our periodic snapshots suggest that our overall jail population continues to include even higher levels of seriously mentally ill individuals and periodically we see elevated numbers of misdemeanors By providing updated jail population analysis as well as preliminary population reduction strategies in December, we anticipate these strategies can then be analyzed and projected reduction estimates attributed to them for presentation to your board in the spring of next year.
In addition to Michael Wilson, we're also working with Kevin O'Connell from O'Connell Research, another well-regarded consultant in the field. Mr. O'Connell will be updating our Sequential Intercept Map or SIM and helping us identify opportunities to develop improved strategies for the mentally ill within the justice system. We'll be looking to incorporate Mr. O'Connell's recommendations as well as feedback from our community so that we are responsive to the latest research and benefiting from other jurisdictions experiences with promising practices that aid in diverting and reducing recidivism with the mental health population.
In May, with the realignment presentation we foresee providing updates regarding the CCP funded strategies as well as identifying any areas that might need further resources or expansion. In addition to these milestones and updates to your board, we will continue to work closely to seize opportunities and focus on system improvements. Moving the local criminal justice system with its conflicting priorities, focuses and perspectives in the same direction can at times seem impossible.
This quote reminds me of what is needed. When it's obvious that the goals cannot be reached, don't adjust the goals, adjust the action steps. We're focused and committed to our goals and we will need to continually analyze our progress and be prepared to adjust our action steps. These updates to your board and the validation by other experts are intended to allow us to adjust our action steps as appropriate to ensure that we continue to make progress and don't abandon our goals.
Thank you for your support and help keeping us all focused on our goal of sustainable long-term public safety. That concludes our presentation, we have representatives from each of the agencies with us today to assist in answering any questions you may have.
Questions from the board? I'll lead off. I just want to understand this is O'Donnell or O'Connell? O'Connell. The recommendations that they will provide, does that include where we might otherwise put folks who are found that are mentally ill in the system? Is that within the scope of those recommendations as alternate facilities?
Chair Williams he wouldn't be planning to look specifically at You know locations within the county for new facilities. That's not necessarily his expertise, but he would Provide recommendations around what types of diversion programs? that would be needed with a particular eye to Where current gaps are or where our current system might not be as robust as it should be
Thank you Any other questions? Supervisor Kaps.
Well I have several questions, I don't know if we want to do public comment but just giving you a heads up,
I have about six questions. Yeah go ahead. Why don't we first do public comment then sure.
Chair Williams and members of the board, we have no requests to speak for this item.
Go ahead.
Well, thank you for this collaboration. You presented it very straightforwardly but I know from speaking with you that there's a—you share this sense of urgency that I know my colleagues and I share that we need to move faster. This population of—I'm focused mostly on mentally ill, severely mentally ill who are incarcerated and the urgency of getting Not just getting partners to work together for the sake of that kind of collaboration, but because it's literally life or death for some of the folks who are severely mentally ill and incarcerated. So to that point I just want to confirm on time frame. I appreciate that that the care law that the legislature passed in 2022.
That means by the end of 2024 at least part of this collaboration is mandated by the state that we need to stop this Literally break this cycle of arrest, jail, court arrest for those suffering from mental illness. So can you just confirm that time frame of December of 2024?
Supervisor through the chair, you're correct in addition to the work that we've already talked about, I'd like work to do with our local courts. I would also note though that another important initiative and perhaps in some ways even more important and expansive is CalAIM. CalAIM will be doing much of the same work that's been talked about here within our local jails. It allows us to have in-reach into the jails to provide much more robust services prior to release, to ensure that there's warm handoffs and that our reentry planning really isn't just a plan within the facility but has significant follow through in enhanced care coordination upon their release. All of these initiatives will aid with that particularly vulnerable population.
Well thank you for bringing up Cal AIM and maybe this is a question for Under Sheriff Bonner, I appreciate his here. Do we currently have 24-7 mental health services at the jail?
1:24 – 1:4021 turns
Under Sheriff Craig Bonner on behalf of Sheriff Brown, Supervisor Capps to the Chair, we do not We have it during normal business hours and then on an emergency basis we can call in be well crisis services to come in.
Is that a priority to change?
It is one of the items that we are looking at obviously, that comes with a cost but it is absolutely something
Thank you. So my second question I believe for you is that, I understand that the sheriff's office has hired a statistician to track inmates with mental health, correct? And I just want to confirm that that's happening and if all these partners that have come together today and are working collaboratively on this work have access to that data?
So just to be clear, and there's been some misinformation pushed out there regarding the statistician. We hired a data unit manager that is coordinating efforts but really what you're talking about is the overall criminal justice data sharing work that was actually headed by Assistant CEO Heitman and is a continuing work that is ongoing. There's a number of things pushed out there as to, you know this statistician was hired specifically for this. What we hired is a data unit manager who is mining our existing data that's out there to try to push it out.
Okay and I know there's been, there's a lot underway here but clearly we've stated and you all share this need to share data as much as possible so okay my third question is just on training. I just want to hear you speak about sort of what the training is For how many incentives we have for mental health response training for sheriff custody staff Especially those higher hired in the past again, and
we're going to address some of the misinformation that's out there our custody staff all receive a 24-hour Crisis intervention training. There's been some misinformation that they have only received eight hours, but that is not correct. It is on the law enforcement side that all deputies have received eight hours and then some of them very specifically that partner up with B-Well have received 40 hour, but our custody deputies have all received 24 hours of crisis intervention training.
Okay, I'm just curious. Is there a state law related to how many hours and are we in compliance? It
is now part of the ongoing initial academy training on both the law enforcement and the custody side.
Well, thanks for clarifying that and my last question for you under sheriff is just on the alternative sentences. I just would if you could speak to wait times who's getting into the program who is being denied interested in sure in the progress there.
The numbers were depressed during the COVID pandemic. That was largely the result of there were fewer people in the jail to start with. The numbers have came back up to pre-COVID times, over 700 people have been through the system last year and we're on track to do the same this year The acceptance rate is about 97% of the applications received, so very few of them.
Obviously they do a risk assessment on them and if a person is at significant risk of reoffense or otherwise harming the community those are the folks that are not going to be released but again 97% success on the applications
Thank you for that. If I may, I would just have a question for the district attorney because I understand and with this goal of diversion, you and I had talked about a pilot project in Los Angeles that seems to be having some success with sort of this pretrial criteria that's established with the partners And signed off unblessed by the district attorney that could keep mentally ill people from trial. Again, I'm just kind of trying to get at how we break this cycle that we've heard repeatedly from the public and from parents and advocates who are trying to keep more mentally ill people out of the jail in the first place. And I'm just curious, I understand that you have a diversion plan. I heard you might have hired or previous district attorney hired a consultant.
Just how that's been going? What's in the works? When do we see the fruits of that labor?
Supervisor Caps through the chair. We are currently developing a felony diversion program we have, we have the program outline we have the initial report on the needs assessment. Now the hard work begins. Actually finally developing and implementing, and this is intended to be a pre-filing program so anybody participating in the program if they in fact are in jail would be released because we would not file charges if they actually participate.
We are working, we need to develop a significant number of service providers and actually the logistics of the program because I believe it is the intent of everybody involved to have a program that is not participant paid. So that is the development, finding community-based organizations to participate. Finding providers who can provide based upon MediCal, Medicaid and the other non-treatment specific portions of it, finding volunteers.
It is a with the program parameters in place and we're working with the Center for Justice Innovation who the county has a long history with at this point. Now I will be reaching out to the probation department and the public defender In helping do the final program design, but we are at the point in time Determining exactly which services to provide and how we are going to provide them without a cost of the participants as far as mental health and other diversion what what we're looking for is is the they're there. We're looking for the actual programs, what we are working for collaboratively and working towards are to actually develop the programs. A diversion implies that you will be diverting somebody to programming.
So what we are trying to establish the programming, the facilities, the providers and I can assure you everybody in this system feels the need to do this sooner rather than later. But what we're trying to develop is actual effective programming versus just a release. What we found in the population of people that are really suffering from severe mental illness, There are effective and at least somewhat effective interventions, but if we don't have those treatment interventions then we are setting those individuals up for subsequent arrest maybe more serious arrests. So what we are looking for are the actual diversion options and that's what we're all working to put together
I appreciate that point about the cost and trying to avoid that it's participant based. What are other jurisdictions? How do they, what kind of, you mentioned one non-profit but how do you piece this all together? I guess I'm just struggling with this sort of chicken array because right now we have too many mentally ill people in jail but if we want to get everything set up before we start How do we get at this and how much, I mean do we have a sense of cost which is actually my last set of questions is related to the fiscal impacts of this. But are you looking at other best practices? Other counties?
We are looking at YOLO's practice and there will be a difference. Somebody suffering from a very severe mental illness probably will not be appropriate for the DA's diversion program But that would be mental health diversion which requires significantly higher level of medical interdiction. What our program, the design of that program is one to remove people from the criminal justice system And ultimately the goal is it is really a driver of reducing recidivism. So what we are, what we are doing is looking forward, reducing jail population, reducing victimization, improving the quality of life not only for the individual participant their family but the community as a whole so the DA's diversion program would be And there will be a mental health and substance abuse component to it because that is a driver for a lot of people when they enter into criminality.
But it won't be quite as extensive as the people that are suffering. Somebody that would otherwise be IST wouldn't be eligible for the DA's program because the DA's program you have to choose, it's a choice. You are electing to take yourself out of the criminal justice system and go into this program.
And could someone do that on your behalf? I mean could a parent or somebody who is
I there there is a mechanism now under the law on the mental health diversion side. Yeah, you take somebody that would otherwise be IST that that in essence is suffering so severely that they can't make choices for themselves and refer them to a program. That requires the participants in the criminal justice system to make that referral, and it requires a program. And what we as a system are trying to do is develop the programming for those individuals.
Thank you. And so what I'm getting at, because I have respect for how hard this is and I have respect for how complicated and different we have literally different departments trying to come at this. But I just want to hear that your diversion program it is fitting into this overall plan and that there's coordination there because again from the outside if you're a parent whose your son is schizophrenic and he has been arrested 16 times as we've heard from testimony here in this room Trying to trying to detangle all of these different players and how this all works. We just wanted to work better, and I'm just hoping that your diversion program is serving this entire purpose and there's as much collaboration as possible and urgency and speed.
Yeah. Again, because of the pervasive nature of certain mental illness my program might not be appropriate for that but it plays into the entire collaboration and a systemic effort to use alternative methods to improve public safety and reduce recidivism. But along with that, as we collaborate farther and we have more defined roadmaps it gives the attorneys involved, the courts involved, the off-ramps. So this collaboration will provide okay what is an appropriate off ramp for an individual given their needs?
Thank you, thank you and I just have one final question. I'm not sure who it should be directed at but just basically what I was looking for more of here and I spoke with Ms. Heitman about this yesterday is just more of the fiscal analysis piece. I believe fervently that these kind of diversion programs and this work is morally and humanely the right thing to do, but I believe it's also fiscally responsible to get key people that are severely mentally ill out of incarceration to work on all of these goals that have been outlined. And I just, I'm lacking that piece of this both here which I understand is you know this is the first report but what's next?
You know how when will we actually see sort Black and white information about the costs associated with incarcerating an individual with mental illness versus treating them the way that I know the values that have been reflected here from this board, but also from those who do this every day want to treat them in a more humane way. Where is that fiscal analysis or when in this work can that be presented to us in the public? I think it's really important.
Supervisor through the chair, thank you for that question. Subsequent to a recent conversation we had about costs I was reflecting on some of work that we did in the past and pulled up a document that I can share. I think it's actually might be posted on the probation department's website still it has been in the past But our county was involved in a project called Results First, and it looks specifically at this question of what is the cost of recidivism for an individual to recidivate within the system versus the cost avoidance or cost savings that could be accomplished if we provided an evidence-based treatment program that would meet their needs. And some of the analysis that was done here dates back to 2017, so it's not based off of our current numbers by any means.
But I was glancing over the report after we spoke and at that time it was over $92,000 per additional conviction that a high risk individual would receive in our county. Santa Barbara County specific costs. So we were able to see very rapidly that a program that reduces recidivism had enormous value in cost avoidance. The consultant that did our jail analysis, Mike Wilson happens to be an economist and he did much of this work with us in collaboration with Pew MacArthur Foundation And then subsequently, CSAC started a support hub. So I am interested in reconnecting with them and finding out to what degree they can assist us in updating some of this information or making it a little bit more specific to the mentally ill population because we were really focusing on general high-risk recidivism before and I think there's an opportunity to dive into it and look at it specifically for our mental health population within the justice system.
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And so just to clarify, that's $92,000 to... Can you repeat that?
Yeah. It's over $92 thousand and that includes the cost of the DA's time on filing it, the arresting officer, potential jail time, the court system probation costs. So it's an average for those clients that are recidivating. Not every one of them gets the same types of disposition but at the time we looked at the totality of what happened And actually, what were the chances if you were convicted of a misdemeanor in Santa Barbara County of getting certain types of punishments versus a felony? And costed out all of those different options and statistically analyzed it to come up with that over $92,000 per new conviction.
Thanks for that information and your due diligence on this. I just think as we're making decisions, budgetary decisions About the jail size, etc. We we have to have this type sort of data and this sort of analysis for us to make smart decisions. We all want to do better. We have to do better. We owe it to those who are suffering and I just want to make sure we can collaborate as much as possible. I appreciate today's step, but I'm looking for a little more meat on the bones in terms of metrics and data and fiscal analysis so thanks for Mr. Chair thank you for allowing me to have the time for those questions.
Thank you and I think it boils down to are we going to spend an awful lot of money on diversion or spend even more amounts of money to incarcerate in a sort of cycle that we ultimately could not dig our way out of. And so I do think there is a lot, not only at stake for the humans involved but there's a lot at stake for the institution whether we can operate Public safety at a level that's sustainable for the public coffers.
I did, there was one thing in the line of questioning that you had that I think wasn't clear but I think I know the answer so I'm just gonna ask Mr. Syvernak to essentially there is already a path for those that are mentally ill to be diverted in misdemeanors or felonies But in certain low-risk felonies, there is not a way to be diverted if you are not. Is that what you're saying? Chair
Williams, the path established by the law for mentally ill is different. What we're attempting to do with the Felony Diversion Program are taking the individuals who are not necessarily suffering from a serious mental illness but are engaging in criminal behavior and trying to redirect, trying to incorporate. Utilizing treatment peer support and restorative principles To essentially bring somebody in individual back into the community and reduce recidivism, it is a diversion program.
While there are other paths, what we're trying to do is create the program that the law allows. In fact this one we're going outside of the law because we're not actually filing the case. Most diversions provided for under the penal code provide for diversion after a case is filed. We are going to take individuals and even eliminate that filed case from their record and divert them.
Whereas some of the mental health diversion and other diversions, there is a provision in the penal code for them. But it requires a plan. And if we don't have sufficient facilities, care providers, case managers, there's no plan. So what The diversion program that my office is proposing in developing is to take people out of the system, to redirect their life and give an individual a chance to engage in life without the burden of a felony conviction on their record. The other ones are the ones where somebody is seriously suffering, are designed to actually take somebody out of the criminal justice system because their mental illness prohibits them from actually participating in it or understanding the quality of their actions and is solely really focused on mental health treatment.
So these are all generally my program is kind of beyond the law. It's not necessarily while there are diversion options in the law, they're all post filing this is attempting to intersect an individual even before that happens
and since part of our problem is the back up in our own criminal justice system, your pre-filing diversion would have sort of more benefits in that it might prevent the further slowdown and therefore the large amount of people in jail that are awaiting trial. So I think that's really commendable. I don't want to neglect Mr. Nelson who has had his hand raised.
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Yes, thank you Chair Williams. I guess I've got a question about the Michael Wilson report and I'm glad that I see in slide number nine that we're going to be doing an updated jail population analysis and preliminary population reduction strategies so When we're going through that process, are we gonna get a chance to look at some of the assumptions that Mr. Wilson made in his report?
I'm really concerned that there may have been some bad data that went into that report initially. I know one of the biggest pieces for me that caused me concern was the idea that there'd be a zero population growth among those in the age demographic likely to commit crime over the next 10 years and I don't think that we're gonna see that move through especially as we see The housing increase increasing throughout the county and especially in the north County, and that's also some of the youngest population in our. Our county or in the center Valley, and we're seeing a significant increase in crime in the center value. And so I think there's just some real faulty assumptions there in the Michael Wilson report that hopefully corrected as we do an updated.
Strategy there, especially since we're using some of the numbers from Mr. Wilson to make big policy and infrastructure decisions for our county. The other concerns I had about that report was that it was depressed by COVID. And we did not know what kind of bounce back or what kind of a crime that we would see after we came out of the COVID era, and I think we're seeing that decrease greater than what was projected in that report. And the last piece was the bookings now that we had a North County branch jail. So for everybody's benefit, The Michael Wilson report was done prior to opening the North Branch Jail and where we had no booking location for any of our North County criminal justice partners for better part of a decade. And that definitely depressed those that were arrested in our communities, and also partly resulted in the amount of crime that we have here.
So Ms. Heitman I'm curious on what kind of updates will be done? And are some of those potential issues with the Michael Wilson Report going to be addressed So I'm going to turn it back over to you. And work with Mister O'Connell.
And a further clarification on miss Hyman, is it that Mister Wilson did not build in population or that he built in population and that are our population is aging so that the number of people in the age group where you have most Demographic will not rise which is a well-documented fact that California's population is aging. Is it?
Chair Williams, Supervisor Nelson Yes, it has to do with what sometimes referred to as the at risk population that It isn't looking at Increases in the very young population because they're not going to end up in your jail for quite some time, and it doesn't look at the aging population. So really looking more intensely at the overall demographics and not just the totality of the number.
But in response to Supervisor Nelson's question yes Mr. Wilson would dig into that Use any updated information that's available and further analyze that, and he can speak to that further in his report. We could ask him to put a particular focus on that. We also are looking at the potential to have somebody come behind him and validate you know his findings we've seen that done in some other jurisdictions around jail population strategies of making sure that they really are meeting the mark and that there have the best analysis behind them. So we could look to have someone come behind him and validate his findings as well if that's something that the board is interested in.
I would note that Mr. Wilson did bring up the Northern Branch Jail coming out of COVID changes in crime rates, those were all concepts that he identified or factors that he identified in his report that would potentially change his projections and as I mentioned those things have happened And now we do need to look at, well did they change the projections? Northern Branch Jail is fully operational now. It is accepting bookings It is positive to note that our population continues to trend lower than it was in our pre-COVID times, so we do see some successes along the way. We also know that our probation population is lower today than it was pre-pandemic and the population in the jail is correlated with the supervised population. So each thing that improves along the way has some impact on that overall population or other trends we have, I think the sheriff put out a press release not that long ago identifying some reductions in crime in some areas of the county So we really have to look at the entire picture.
One area might be seeing some problems that we have to take into consideration, but we have to take it within the context of the entire county and there are some positive things overall that we would be asking him to look at and dig into for his projections.
I can continue.
Did you have a follow-up on that Mr. Nelson?
Yeah, I had a few statements to go along with this conversation. You know, I know we're focusing here on reusing the jail population and I think that's really important. I believe in diversion. I think diversion saves us money and saves lives but we need not forget that our focus really in public safety is to not be as concerned about jail population but it's the amount of crime That exists in our community. And we have a significant amount of crime, especially in the Santa Maria-Lompoc Valleys. We have violent crime. We have shootings on a regular basis.
We're seeing what's going on with the fentanyl crisis and so I want to make sure that we're not so concerned with jail population that we forget that our number one responsibility of governance is to protect the public And that we make sure that, that is the main focus of this conversation and hopefully you know through this new version that we can actually focus on those that are most.
You know the hardest criminals in our community that are doing the most damage. I understand that even though somebody is mentally ill when it comes to crime, there are still victims out there and people who are being victimized by those who are mentally ill. And it can't be a get-out-of-jail-free card just because of a diagnosis. We need to keep communities safe and having a jail is a big piece of that puzzle whether that's a temporary holding or a medium range holding Prior to trial, and then other pieces of the criminal justice system.
In an effort to be a. A deterrent to crime, and that's been one of the big concerns is that you know we haven't had that capacity. We haven't had a lot of our law enforcement partners out there being able to do arrests because they have not been able to have the programs in place make sure that people actually had consequences for actions so all for diversion it leads to Thank you, Mr. Chairman.
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Well I just wanted to pull back to the 30,000 foot level and say that I think this is an extraordinary effort. This began at least in my history in the wake of the killing of George Floyd and we looking at what we could do in our county to address some of the issues that that raised Can't do everything, so we focused on the jail. And we focused on the jail because we believe that people going to jail, while we do the best we can there for rehabilitation it isn't always the best place to be rehabilitated and for many people it's kind of a university for further criminal behavior And so we engaged on this and it's been gaining momentum. And our hypothesis is that with these diversion programs, we can reduce the jail population, reduce the tremendous burden that puts on our county general fund And reduce recidivism and increase public safety.
So it's a big hypothesis, and what we have before us is really how we're going to test that hypothesis. It's the experimental design, and if you look I mean it's got the goals, the outcomes, the funding plan for each of these. The data that we're going to use to test and then the timeline and who's doing it. So this is what we've been asking for, and here it is. And it's coming back next May.
What we're trying to do in this is put the pieces in place test these hypotheses and learn from the process And so I think that's the kind of innovation. That's the kind of Approach that we've been asking our county staff to engage in and that the board has been demanding of ourselves So I really think this is a moment not so much to get lost in the detail but to say what is the big picture here and and Our staff, our criminal justice partners, they've come through working together integrating this into a coordinated plan. So I just think kudos to all of you and really this is what we've been asking. You've delivered and I can't wait to see this unfold.
Supervisor Lavinia. Thank you. I want to piggyback on that because I think that's the tone for the day is We now also have the team in place. I mean with ACO Heitman, all of our justice partners are, I believe have bought in at this point at least and with Supervisors Nelson's comments in mind that we have to try something different what we're doing isn't working so we have to try something different. I kind of equate it to what we're doing with homelessness people come to me and talk about Hope Village and I'm like okay I'm not saying this is going to work, but to do nothing is really a lack of leadership. So I think we've got to try something. We'll find out if this system works, if human nature is better maybe than I think it is and we can reform some folks.
We'll see. I'm all for it to find out like I said because the alternative really has been what we've been mired in for the last 20, 30 years. So I'm excited about this. I'm looking forward with a positive attitude towards it and I appreciate the leadership of the CEO's office and all of our justice partners to try to get outside the comfort zone of this is the way we've always done it so this is what we're going to continue to do because honestly I think we could all admit that there's something wrong with the system We've got to try something different. So I appreciate the report today really looking forward to May and The progress that we make between now and then as well
For my part, I support it not only for the Because in some cases Folks are in jail that don't belong there usually because of mental illness but sometimes other factors but because I believe that the sustainability of proactive policing, the sustainability of our patrol being able to be there to keep people safe depends on not spending unlimited amounts in incarceration. And so to me, this is to achieve the goal that Mr. Nelson articulated which is to keep people safe only by us being able to have the right kind of resources a sheriff's department that is closer to the people, a sheriff's department that can do proactive policing Will we be able to keep people safe? And we won't be able to do that if we're having to draw from those resources to staff incarceration facilities.
So, want to appreciate this presentation. Do you just need a receive and file motion? Can I get a motion to that
effect? So moved.
I will second.
There's a motion in the second roll call please.
Roll-call vote Passed 5–0 motion in the second roll call
Show transcript
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2:17 – 2:3810 turns
Chair Williams and members of the board, departmental item number five is from the Behavioral Wellness Department. It is to consider recommendations regarding a Santa Barbara County behavioral health housing and care continuum update.
Excuse
me, Mr. Chair.
Mr. Chapman.
Start over I didn't know I wasn't on all right let's try this again hello all right good morning take two there we go all right good morning chair Williams supervisors and county staff the Department of Behavioral Wellness appreciates the opportunity to present to you on our Capital Housing and Residential Care Continuum that exists within our comprehensive behavioral system of care, behavioral health system of care. The B-Well team is bringing forth an overview of that branch of our system that involves treatment programming with some component of residential care or access.
Specifically, today's report is to give an update on goals for the residential care continuum previously brought to the board in 2016. We will also provide a brief review of the changing landscape of behavioral health treatment need and subsequent opportunities for growth based on a number of policy and legislative priorities and considerations occurring at the state and federal levels.
In 2016, BWELL came to the Board of Supervisors to present on the then-current capital facilities housing and related programming options that were available within a BWELL system of care. That report came out of a month's long robust countywide stakeholder engagement in what was called the systems change process. During that process, and the community collaborated to identify needs and gaps along the acute and long-term residential care treatment continuum.
That report highlighted goals for the development of capacity in key need areas. In today's presentation, we will follow up on the progress of those goals highlighting some notable gains discussing ongoing gaps and presenting key factors for consideration including pending and future opportunities for funding As we further plan for how to meet the current need and future needs of B-Well's acute placement and residential care continuum.
Different from the 2016 report, today we will also present a comparison of bed capacity needs from data published by both the Department of Health Care Services and the RAND Corporation. And these are based on county population size and expected prevalence rates of moderate to severe behavioral health conditions likely to require inpatient or residential care placement.
All right, so Be Well serves as the mental health plan and drug Medi-Cal organized delivery system for Santa Barbara County and provides specialty mental health services and alcohol and drug treatment services to those To primarily those in our county who are enrolled in entitlement programs. Medi-Cal, Medicare. The one exception of course is within B-Well's crisis response branch where 24 7 and 365 B-Well has an access line that triages calls for service and provides crisis evaluation and as necessary involuntary hold referrals for all county residents.
So An effective, robust system of care provides a full range of programming from prevention and wellness services through to the highest levels of intensive treatment need which often involve inpatient treatment placement or some housing component. When making decisions for care the goal is for clients to receive the treatment they need in the least restrictive environment possible, allowing them to remain active members of their communities and have ready access to build social supports and thriving lives.
The graphic here represents essential components of an effective behavioral health treatment system of care. Although presented in a linear format from prevention through to intensive treatment services It's important to note that stability, recovery and maintenance of behavioral health is not linear. It's not a linear process. And given the severity and chronicity of disorders that B-Well clients often are diagnosed with they cycle through any number of these access care points along this continuum throughout their lives.
So we'll see here starting on the left, prevention and wellness services within our system of care. Those are programs funded primarily through MHSA and also on the drug medical side. Outpatient services represents those traditional core services where someone comes into a clinic once a week, once every two weeks, once a month to receive their care and tend to be more within that moderate range that we serve in specialty mental health The next level of care is peer and recovery services. It's a new specialty within the continuum of care here in the state of California, and Be Well is proud to announce that we have a number of peer staff who have become statewide certified peers and are really bringing this new robust service to our system.
Next, we have the community supports and services as well as intensive outpatient treatment programs. These are many of the programs that are funded under our Mental Health Services Act and include programs that are primarily based out in the community, meeting the needs of people where they're at and includes our full range of the full service partnership system in our continuum.
The next, okay I'm going to have to refer to my slides because that green color doesn't show up very well does it? on the slide, so hang on a minute. So the next one is our SUD treatment continuum as well as crisis services and then intensive services. These last three flags here are the ones that have the facilities attached and the residential programs that we will be discussing today.
A robust and effective continuum of care creates its system for maximum capacity and flow. And when we talk about that, we're specifically identifying that we need to have enough capacity including infrastructure as well as staffing at all level needs within our continuum so that way we have ready access to not only entering into our system at the right level of care at the right time for a person but also having step-down options readily accessible to reduce on both sides waiting times and folks from languishing in higher levels of care as they move to step down.
Adequacy in each part of the system also increases the likelihood that people will get, getting care at the right time and timely reduces deterioration of symptoms as well as the subsequent consequences of incarceration treatment services and throughout our county, such as emergency room visits. All right. Okay. Yep, next slide. So this next slide is a representation of the types of facilities that are in our continuum, the residential care and acute care continuum.
The first one is acute facilities. This is our psychiatric health facility and our contract partners That provide inpatient hospitalization, Vista Del Mar and Las Encinas. These facilities have high intensity level nursing and medical personnel that are available 24-7 for those in the most acute need. Branch of the system is crisis. These facilities are mixed, they have some available medical and nursing support and they're more short-term bridge for individuals from that stepping down from the psychiatric health facilities before then they move on to some more longer term treatment for stability and recovery. Examples of these are the crisis stabilization units and 30 day crisis residential as well as emergency shelter placements The next level is residential care.
And residential, this category includes a broad range of licensed facilities varying in service intensity. Some of them are longer term and these are longer term stays that are categorized as residential treatment facilities, mental health rehab center, boarding cares and skilled nursing facilities. And then finally the lowest level Housing and placement support in our system is independent living under permanent supportive housing options. So these are lower service intensity folks may, once they've become stable and are in housing may only engage in services as needed there is onsite support provided in these sites that we have throughout our county In order to make sure that folks are receiving services that keep them maintained in their recovery and have ready access to mental health professionals and care should they feel like they need to enter back into another part of the system again.
All
right,
so this next slide is a budget slide and it's based on our budget that was brought forth just last month for approval to this board And it lists down at the bottom, of course, is the range of facilities that we'll be talking about today that are within our residential continuum here in Santa Barbara County. The left vertical axis is the total amount of dollars spent each year including a total amount of dollars each year on these programs.
The right vertical axis is cost per day average for each of these types of facilities. And then the bars, as you can see some of them have two colors. The lighter blue or blue kind of periwinkle there is the local match that we provide using realignment general fund contributions and the purple is located in only some of those bars because those are the programs for which we receive Medi-Cal federal financial participation match.
And along the bottom there you will see how much revenue, the cost to us from our local funds and then if they receive Medi-Cal what that contribution is to Medi-Cal. And then across the bottom in the final row gives the exact number, the exact amount of the daily rate, the average rate of each bed in those facilities. So I'm now going to turn it over to Laura Zeitz. She is our branch chief of housing and long-term care as well as oversees the PUF.
Hi, nice to see you all today. What we're going to do in the next set of slides is kind of give you a look back where we started when we did the stakeholder process in 2016. We're going to show you the progress that we have to date and then we're going to do the data comparison where there's direct comparisons for us to the reports that Director Navarro mentioned. So this first slide shows the acute continuum. Our locked in patient, obviously that's our psychiatric health facility that's remained at 16.
We contract right now on average every day for about five folks out of county to meet our inpatient care need. We have included Cottage Hospital here because in some of the comparative data that you'll see later, they did a look at all of the resources that are available for our population and although those beds aren't available to our Medi-Cal population we've included them here for reference so that we have them as we move forward.
We do have in the state hospital in 2016 we only had five folks. We have nine now so an increase there And since 2016, we've established because of the organized delivery system. We've been able to establish and fund acute detox and we pay for that out of county in Tarzana.
Laura could you just pull the microphone just a little bit closer for you? Thank you.
I don't have to go again right? No. Okay so we'll go to the comparison data next. So what we've tried to do here is as directly as we can compare what what the need is and what we have. So, the RAND report that was referenced earlier said in this category we need about 109 beds for our population. The DHCS report which excludes state hospitals they don't have that as part of their consideration said 64 so you can see we add up what's currently available for the population total which again these reports are based on and then What contracted beds we have out of County and our state hospital beds? And so in this particular category acute our range is between 23 and 59 as a shortage It's of note that in our great state of California 45% of the counties don't have any beds in this category of Acute, so this puff and the cottage Hospital that those that level of care doesn't exist in 45 percent of our counties.
So we're inordinately lucky that we have the Facilities that we do, but obviously a shortage in this category and an ongoing need. The next category we'll take a look at is crisis there weren't good There wasn't good comparative data for this so you won't see that slide after this but in 2016 We opened our crisis stabilization unit in the South County And since then the crisis stabilization unit Marion has opened So we've shown to progress in that particular category of eight CRT, we made a significant investment in this. We were able to leverage grant funding from the state. This was a big focus for them in the last five to seven years. We were able to renovate several buildings and purchase one, do some infrastructure improvements and increase our beds in that category by 20.
We also because again of the ODS system organized delivery system for SUD care have added 18 sobering centering beds and in our emergency shelter and bridge housing we have a net loss of four The funding streams for that have changed. We do have one on the horizon called it's a bridge funding That's coming from the state It's in the amount of about nine million dollars for our county So you'll see this number jump up again as soon as we're able to finalize those agreements with the state and get that money out to the community This next slide is for context. Some of the folks we serve and some of them more, some of the folks that we invest in heavily are LPS conservatees. So LPS conservatorship is the legal means by which most often our public guardian takes responsibility for folk's care.
In our county, we have 164 of these folks currently. And we took the comparison counties for all our salaries and everything and took a look at how we compare. And so we are in line with the percentage at 4107% about LPS conservatorship across the state. So that's our average. These individuals have complex needs. They most often require locked settings. We're seeing aging in this population and then increased need skilled nursing facilities and skilled nursing care for them.
So, subacute residential facilities these are this is an in-county representation here so here's our look back in 2016 we didn't have any in county of facilities in this category since then we've contracted for 32 beds we do flex up to 34 times at the Mental Health Rehabilitation Center and that's the Champion Center in Lompoc Currently in our county, we still don't have any skilled nursing facilities with specialized treatment programs. Specialized treatment programs are an overlay to a skilled nursing facility that the Department of Health Care Service certifies so that they can take care of folks with serious and persistent mental illness.
So when we look at comparison data here, we look at RAND primarily. Their take on this is that we need about 103 beds in this particular category so we take our 32 that we have in county and you'll see that the way our county is meeting our needs as we are sending folks out of county far and wide. We have skilled nursing facilities that we contract with. We have specialized programs in that same category of mental health rehab center and IMD And we also have intensive residential step down that we do in Northern California. So if you count the way we're meeting our need out of county and our in-county resources, we still are short in this category.
The next section that we wanted to review for you is the residential treatment facilities. These are the ones that you're more familiar with, like local houses that your board has funded before and increased our numbers of. So these are homes in the county, 24-7 staff. They're licensed by DSS, by community care licensing. So in 2016, we had 32 of these because of investments of your board and other opportunities that were available. We've increased that number And have 65 currently, so we've made some significant progress there. We do have another 12 in development and again leveraging state funding and grants to invest in our own infrastructure or the county on building and since the organized delivery system we Actually have some drug and treatment services that are in the county and that's 62 beds So comparison data for us here again, we look at the round report.
They say we need about 94 in this category when you take all the beds We have and the ones that are in development. We show that were over actually the recommendation in our county however as I'm sure y'all will aware we don't have a The kinds of resources that are available in other counties with a lower cost of living. In other counties with the lower cost of living, we have room and boards, we have single-room occupancy hotels, we have individuals that are renting to people and having them in their homes. And so in this category, although it shows that we're over the recommendation, we have at any time three to five referrals for any of our open residential beds. So there's competition to get into ones we So there are obviously regional differences and this is one category where we think that stands out.
And then in permanent supportive housing, this is something myself and my teammate Abby Zuroski have worked very very hard at over the last few years. We work in concert with a wonderful partner in the County Housing Authority to leverage funds that have come up from No Place Like Home, from HomeKey and other state and federal programs to supply mental health services on-site for permanent supported housing locations. And so in this category, we had 54 when we started in 2016 and so we've made 66 new beds which is incredibly exciting and we have 61 that are coming online. Some of those are almost ready to break ground, some of them are a few years away. We think we'll see those 61 beds though in the next 24 to 36 months.
Not a specific referral range for this, but this is something that we've leveraged heavily in our department and worked very hard. I have to say thank you to Evie Zuroski the CEO's office and Lily Cizek for helping me get all this data together and make this look as nice it does
2:38 – 2:492 turns
Tony, can you use the microphone please? We have a supervisor who's not here. Thank
you. All right so the next slide here we're going to do it a nice little fade-in that will identify where the services are that we just reviewed. So you'll see the key up to the right there that has the red and acute. We have one acute facility in our county down here in South County which is our 16 bed psychiatric health facility. The crisis is denoted by orange, residential treatment facilities by green and the permanent supportive housing projects in blue.
If we did an overlay of the most populated areas in our county this would fit really nicely over that. The B-Well department along with partners in the community has done a really good job of providing the services where people are located. And so the next slide Actually is going to give us a list of all of the programs that provide residential acute or crisis care and permanent supportive housing within our county so I Wanted to note if we go back. I wanted to note that in South County That's a representation of 177 beds and or units of permanent supportive housing All of that combined is about a hundred and seventy seven residences In West County that Indicates 75 beds and or units and in North County We forgot to put the Marion CSU at the very top in orange as well That's two beds, but that represents a number of 162 bed.
So Again, I think the county to date with what we have and the need that we have to date Has done a really good job of balancing in the populated areas and where the need is actually exists in our county Okay, but as discussed a little earlier there are and as the board discussed in the previous presentation today. There are a lot of things happening at both the state and federal level that are bringing forth much legislation policy and funding opportunities for the State of California and County Behavioral Health as the state and the legislature seek to one, reduce the inappropriate incarceration of people with severe and persistent mental illness. And really seek to get them in the right levels of care quickly.
As well as addressing the increasing crisis of the unhoused population. We know that while many people do not come to be unhoused in California as a result of their mental illness or addiction, it is a very short step from living outside, feeling unsafe, having to worry about how you're going to eat, take care of your bodily needs and or stay away from being victimized.
issues with addiction and or mental health symptoms develop rather quickly. And we know that statewide nearly two thirds of persons who are living unhoused are experiencing some level of distress in behavioral health. So as a result, we have a lot of opportunities coming our way the first one of course and many of these intersect so while these are presented in this order in this linear and I will talk about them one at a time. We also talk about how they intersect So the Mental Health Services Act Modernization, that is the currently proposed Senate Bill 326 that the governor's office and legislators are looking to bring to our ballot next March. It will really intentionally focus mental health service dollars on housing supports so it's going to reallocate and really emphasize the need for Mental Health Services Act to be called the Behavioral Health Services to focus its dollars on providing rental subsidies, housing options and payment for boarding cares with about one third of its money.
More immediately we have the State Behavioral Health Bridge Housing Grant coming our way very soon. This is actually not a grant it's an allocation that's been given to every county based on point in time count determination. And Santa Barbara is poised to receive $9.9 million as Laura alluded to earlier We have identified early on a number of opportunities based on the needs that remain from the 2016 report. And Laura and Abby Zuroski have already begun community outreach in the survey to begin engaging with communities, stakeholders and partners to plan for the $9.9 million to ensure that we fill the gaps and create growth where needed as best as possible with this funding. That funding is for transitional housing, and it's a five-year allocation.
And this is for transitional housing that persons can only live in up to two years. So it's part of the housing continuum, not the full continuum. Next, of course we have CalAIM and there's lots of new benefit offerings happening there as some related to working more with justice-involved populations and helping them to divert and stay in community. But more importantly there's payment reform at this point for today's discussion. And what payment reform is bringing forward is that the way we get paid for certain models of care in the residential care continuum have changed. Some have stayed the same the same level of cost we've had. Others have dipped notably, but then there have been others where we are actually receiving a larger allocation than anticipated and we really hope to invest as we look at the ongoing gaps in our system.
We'll be using these new payment reform models to guide us so that we can maximize not only overcoming the gaps and deficiencies Maximizing investment, reinvestment opportunities for our county to then further grow our continuum of care in not only programming but residential treatment and placement. The next two bullet points, the impacts of felony incompetent to stand trial commitments changing legislation and policy as well as the Department of State Hospital's Incompetent to Stand Trial Restoration Infrastructure Project both come again from that focus at the state level here in California to really help Divert folks out of the justice system to ensure that persons who have been identified as having significant and chronic mental health disorders can become home to community, can find programming and housing opportunities so that, as I stated earlier in my presentation, folks have a chance to build a life beyond incarceration and long-term care.
So currently with the Department of State how infrastructure project be well is a part of a group working with a CEO Wade Horton to look at the money that is available to Santa Barbara County and again looking at the gaps and potential growing needs in our community as we plan for how to spend those funds. Next up is Senate Bill 43. This is the bill that seeks to reform Lannerman-Petra's short qualification criteria.
This one bill has the potential to increase our needs significantly in a way that we did not discuss in today's presentation, and so while we will have our eyes on that as we look to these grant opportunities and future funding, we need to really have that in mind in order to begin be assessed for and qualify for LPS, Lanterman Petrus Short conservatorship. A person must start in an acute care setting either an emergency room or the psychiatric health facility. And so with this change in legislation It is likely that we will have more need in those areas and that acute care as folks get referred and are looking to place people on this Lannerman Petrus short conservatorship. On the other end then, as Laura shared with you, that's where folks are at in our MHRC here in Crestwood Champion Center in Lompoc, as well as most of the rest of the remainder of them are out-of-county placement because we do not have those types of facilities in county.
So that would be again a shifting, a growing need that we had not seen before but then a shifting priority into how to house and care for them long term. Next up is California's, it's called Behavioral Health Connect. It's a really long title but what that is, it is a waiver that the state of California is looking to Ask the Center for Medicaid Services to allow for some different programming within our system of care statewide. And the one that is most important to today's discussion, is this includes the IMD waiver exclusion.
So currently acute care hospitals that have over 16 beds are also called institutes of mental disease cannot bill and leverage federal funding under Medi-Cal so if we go back The slide where we had the bars that were kind of periwinkle and purple, you saw that the PUF which is at 16 beds, we are able to receive drawdown federal funds. But the Champion Center is all periwinkle. We do not draw down. With the granting of a waiver for IMD exclusion here in California, we would one be able to expand the number of beds that we can serve at our PUF.
Currently that's very limited because the building is older and has limited space but we could increase it by at least four immediately But then Crestwood could also begin to leverage the federal dollar match, and that would bring in significant dollars for us to continue to reinvest in the residential continuum of care and related programming for the most severe populations in our county.
And then finally there's CareCourt, and ACO Heitman talked about CareCourt a little earlier. The plan and hope for CareCourt has always been that CareCourt and the BHBH, that Behavioral Health Bridge House funding go together. That that bridge house funding really be prioritized for use with the populations that will come through in the CareCourt implementation. Again, that starts for us in January of 2025. And again we'll be using all of these considerations and future policies as we move forward to address ongoing gaps and anticipate growing needs.
So that's the end of our presentation today. And we ask that the board receive and file this presentation, and we have determined that the above actions are exempt from California Environmental Quality Act pursuant to section of the CEQA guidelines. Thank you for your time today.
2:49 – 2:5510 turns
Questions from the Board? Supervisor Kaps.
Thank you, Director Navarro and thank you for the really helpful numbers I think this came up during our budget hearings that we were looking for numbers and you more than provided them and I appreciate how you introduced the topic with the range of care because I know it's second nature to you but to see it spelled out at what that actually means It was helpful for me to understand, and I just have to note that there were very few acronyms in this presentation which helps us comprehend what's actually happening. So I appreciate that. To kind of step back big picture obviously there is way more happening than sometimes people realize when they ask for more beds. There are so many different players, so many different pieces of this.
Looking at this and the RAND report and the areas that we need to improve, what sort of concerns you the most? What keeps you up at night? Where's the biggest priority? If just money came out of nowhere and you could do what you could. What's the highest impact investment that we could have in this area? Well,
there might be two different answers there because I think the most immediate need and Branch Chief Zeitz and I have talked about this is we agree that we need to add to the acute care continuum here in Santa Barbara County. That the 16 bed puff it currently stands is not enough for the need that we have. And if we were to be given the additional funds out of nowhere to build something, that would be a priority for us to make sure that we increase that.
Especially looking at the considerations that are coming our way in that last slide that I showed with Senate Bill 43, possible MHSA modernization and CareCourt. And what we have seen in our county is that we've seen that need growing. What's really important also and I think for high impact is looking at the payment models that we talked about and it's a conversation Today I have here our CFO, Chris Ribeiro is here to answer any questions as well as our branch chief of alcohol and drug programs. But we talk about what would be the highest impact based on the need that we have? And I think we are concerned at the subacute level again for future considerations of what may becoming an expanding in our system primarily some of the discussions around including substance use disorder Persons in the funding that we currently have will increase the need for us to expand in this area.
So, that would be an area of concern and again as Laura talked about when we look at the lack of skilled nursing facilities in our county and those specialized treatment programs for folks who are at that subacute residential level. That is a that's keeps us up at night and keeps Laura on the phone with lots of people outside of our county trying to get more beds and trying to get people to come in County to get more beds for us.
I know that Branch Chief Wilkins has also expressed her desire and her ability to fund more recovery residences for persons with primary substance use disorder in our county, and unfortunately the providers who have signed up to do that cannot find houses that are affordable enough for them to buy as well as then operate something ongoing. So again, it was as Laura spoke to in her presentation, counties with a lower cost of living have a broader range of these mid-level moderate programs that are really important to keep people out of higher levels of care ongoing in their lives.
Thanks for that answer. And Ms. Zietz, did I hear correctly in the introduction that you oversee the PUF? Did I understand that?
So in our... Well, I worked at the... This is my first job as a night nurse at the PUF so yeah, it's in the division that I oversee.
Thank you. I just not too long ago Toured it with councilmember Mike Jordan and my team, and I just want to I mean I was so impressed with the compassion and the dedication of the staff So I just wanted to extend that that gratitude but but as far as I understood you director tomorrow You just mentioned the need to expand the puff But isn't there a funding component with Medicare with? Medi-cal reimbursement that if we go over 16 that changes it dramatically and yeah
That's when we were discussing of the IMD waiver So if we go over 16, then we would not be able to draw down those match dollars and bill Medi-Cal. But if we were to receive the IMD waiver, we could expand our capacity there looking at the current facility by three or four beds at least. But if we got the waiver, then that would mean we could still leverage the payment sources so...
Yeah. Right. So one of the other opportunities we've discussed is, is there another location to do another psychiatric health facility should the IMD waiver not go through? Is there a place to expand? And so we are always looking at those options to find facilities where we may create another PUF in our county. To expand the acute care continuum, but I'm just
to be clear that that's contingent on this waiver or We could have another that we could have another facility that would
we can have another fit without the waiver. We're going to have another facility That was less than six that was 16 beds or under For acute care. And so pending funding and the availability to operate that ongoing, that is definitely a priority for us to increase acute beds in our county. We hope that there will be a waiver that will help us do that more quickly but if not we continue to explore options for sites to create another PUF opportunity for this county.
2:55 – 3:0112 turns
Supervisor Hartman?
Well, thank you for this presentation. It really integrates a lot of things that were flying around unconnected in my mind. I had a question about the Champion Center and Medi-Cal reimbursement. That went by kind of quickly. Could you explain that once again?
So the Champion Center is what is called a Mental Health Rehabilitation Center and falls under the category of Institutes for Mental Disease. It has more than 16 beds, so it is not eligible for Medi-Cal financial participation match for those services. So we pay complete costs for our clients that are placed there.
So we need that waiver, and then the waiver- That would allow us to rec... So that's a really big deal. I mean, I had appreciated the four beds at The Puff, but it's really the Champion Center that would make the most economic
difference. It would make an economic difference and allow for significant reinvestment into our system where then we might be able to also create another acute care site to add to acute care beds. As we know, the Chi-Rio Master Plan We're all very excited about it, but there's still a handful of years away maybe to finalize. And should the IMD waiver be granted we will definitely as we've discussed be looking to design a PUF that is much larger than the one that we have now Take advantage of that waiver.
So I'm trying to pull out what are the big takeaways from this tremendous, it's really been a helpful presentation but that's one of my big ones. The other is as you just talked about the mid-level residential and how we do that in Any more ideas? I mean, besides it sounds like you're dealing with this all the time.
So you mean for the... so two things. One in the subacute category there are some providers across the state that are doing some really creative things to help people get out of locked facilities and that currently doesn't exist in our county. So bringing something like that here would be enormous as well as having...
Could you describe the creative things?
They do a therapeutic community model. It's unlocked, they have intensive services on site. They're programs that help us step down some of our most challenging folks with comorbidities like diabetes and things like that. They're very willing to go the extra mile to provide kind of a whole person care to individuals that are coming out of locked treatment. And so we have a vendor that works in Northern California that we have I think 30 people at right now And that's a huge step down because coming out of a locked facility right into the community of warden care is often too large a jump for folks and they need that intermediate level. So, that's a big part of the continuum that doesn't exist for us. 30 people is a lot of folks that we send out of county for that skilled nursing obviously.
We have had some success The board and care level, you know graciously we were able to find a building that was not Didn't have plans for it on the county campus that we're changing into a board and care Tecolote house that we were able to get funding to Renovate that and create that level of care, but I you know, I think Capital investment is often our problem That we're that week that we don't have funds set aside to do immediate capital investment if we were to find a property if we were find A property that was good for doing substance use rehab or if we were find a property. That would be ideal for board and care The ability of us to move quickly to obtain that property or get funding for it has been
so we need a reserve fund Or something to be able to jump
Thank you very much.
So currently we have a contract with Vista Del Mar and for youth that are placed on what is called the 5585, that is their involuntary hold. We utilize that facility for their duration of their crisis care. Coming back to the county, we do not have any crisis stabilization unit for youth nor placement if you will for youth right? Except for foster youth, we do have those Community type living facilities for foster youth.
We have been, and there's been many discussions with San Luis Obispo who is also challenged by not having crisis stabilization for youth as well. We know that at this point in time we have not, and I think Division Chief John Winkler is here in the audience still. He's still sitting there and he oversaw that branch for quite some time in overseas crisis. And I don't know John if you have comments as to the need For more acute care crisis stabilization for youth if you'd like to come forward and give us a Your thoughts on that. Thank you
3:01 – 3:1216 turns
Good afternoon So as director Navarro mentioned we do not have any inpatient psychiatric beds for youth in County so We do use Vista Del Mar, but we also use many other out-of-county placement options so I don't have an exact number of what the need would be, but we definitely would benefit from inpatient beds in county for youth. We also do not have crisis stabilization or crisis residential for youth in county. There's not a large need for that so that's why we're hoping to partner with another neighbor county Ventura or San Luis Obispo So that we could share beds with them. San Luis Obispo was looking at that I don't know if they're moving forward with it, but that's something that we've been in talks with them about so
So would the Champion Center be appropriate or do we have any places where we would? Have beds and maybe we don't want to talk about specific locations But it seems to me that children in particular are To not have family supportive close, they suffer perhaps more even than adults.
Well we are encouraged by Signet Health in Northern County purchasing a property and their intention is to create a multi-bed facility acute care hospital that will have a wing that is solely for youth. So we are encouraged, they've I think secured the property at this point and opening up for youth. I'm asking you because I know you were at the meeting when they presented and I can't remember their priority timeline for the youth beds.
And that wasn't part of your presentation or did I miss it?
No, we did not present on youth in the children continuum. We only presented on adult today.
Okay. Supervisor to the chair, we haven't received a recent update from Signet Health but they did previously present to us an interest in purchasing a property near Marion Hospital That would allow for a multi-unit hospital inpatient care. They would also have a full continuum of outpatient care available through their clinic there, and it did include not only a unit specifically for youth adolescents It also had a geriatric unit planned, and their intent was to have Medi-Cal billing as well as private insurance. So it would fill an enormous need within our county and could impact what our future for the PUF needs might be if that facility does come to fruition and is designed as they have indicated.
Thank you. So I didn't realize today's presentation was only adults. Could we get a youth presentation at some point? Would that be of any, I mean is there enough? Is it of any value? For me it's really critical because that's where I hear a lot of constituents coming in
saying I'm at my wits end Certainly we can we can certainly bring that forward. Yes, and I do think it's critical because we really are hearing so much about the youth mental health crisis And what are the options so we could we could really come back and present on our youth continuum of care?
Thank
you
Mr.. Lavanya, thank You mr. Chair well It's not just I first off this is the kind of presentation. I love I liked the You know, basically a basic tutorial because we do get caught up into just talking about beds. This gave us a really detailed breakdown where they are, where they're located, who's doing what with 38 different distinct locations you know in the continuum so it's...
So one of the questions I had well while we were talking about the PUF I wanted to give you a chance You know, the last time we heard about the PUF I think was 2011 when we really got beat up and nobody talks about the good things. So let's talk about a good thing. So we recently had an audit because it's not just important that we have these facilities, it's how we're managing them. So can you talk about the recent state audit?
Thank you so much Supervisor Lavinia for giving us the opportunity to share this publicly. As you know, DHCS or maybe you don't know but they show up. They just show up. They're a surprise audit and they come just about every 18 months 24 months and they just show up and so just last month they came knocking on our door about 8am And there they were, and they said we're just here for the day.
They usually stay two days. We're here for the day and so we have a lot of work to do, so all hands on deck. So we said okay. They spent the day with us and in the afternoon it was such a pleasure to talk to them that first of all the PUF staff were and Be Well staff in general facilities medical records quality care management everybody was so responsive and worked really really well together They actually sat in the reviewers. They call themselves reviewers, not auditors.
They sat in on a team meeting. They read charts. They of course toured the facility and asked a lot of questions and also looked at training records and things of our staff. The comments at the end were that they had a couple of limited questions around some of the things we talk about the PUF Governing Board, some medication communications. Concerns that they had but really spoke to the fact that we have a lot of traveling nurses still working there and so when you have high turnover. You got to make sure you have strong communication when new people are hired. So we're working on that, but overall the next reviewer wanted to talk about the general operation and staffing and care of clients and started his conversation by saying I have no concerns and I have no performance issues with this puff.
And then he got really wide eyed and looked in his partner looked at him and he said I've never said that in my entire career With DHCS in reviewing POPs, he said this is an amazing group of a team through your team meeting and your charts. It is clear the level of compassion and care these folks have for the people they serve and that they are on the same page. with taking care of the clients. They were also very impressed with the facilities and how responsive folks were to one another when they needed something, and so it was a great day, and much kudos to Branch Chief Zeitz but also Jen Hidrobo who's the clinical manager and her clinical supervisors there.
Great well thank you for that report I think The way the PUF has run and the turnaround that it's had is really an example for all of us in every government program that we're working on, how to identify problems, identify corrective action, measure against those corrective actions on a monthly basis. And just continue to get better and better and better. So I originally sat on the PUF Governing Board when it was created in 2011 due to the fact that the first audit we had, they were like well where's the PUF Governing Board? We're all like we don't even know.
Who's on it? Oh you guys are supposed to be on it. Okay so we were struggling at the beginning. I was off of it for a few years just came back and the turnaround I just couldn't believe it. minute detail of what is required and how it's tracked and the corrective actions that are taken on just the simplest, minutest detail is what's necessary for the state. But also, the manner in which we treat people that are there is really important to me. So that brought up another question I have is who Who's looking at, who's auditing and who's examining all the lower level places that we have of care? We have so many of them and it seems like that would be a really daunting task.
Who's in charge of that and how does that happen?
Our quality care management team under Branch Chief Jamie Hussing. So they are providing regular monitoring The census, how folks are doing. They meet with folks quarterly or maybe it's a couple of times a year and as needed to review protocols training and I also think that on our fiscal side Chris do you monitor? So CFO Ribeiro is here so do you want to? So fiscal does a once-a-year monitoring, but on the quality care side it is that team. We have a very robust team, many of them clinically trained and so they know exactly what they're looking for when they go in and meet with staff to provide corrective action and training.
Excellent. Last question I have is for some people you know it doesn't matter because all they care about is their person that they're with and how they're being treated, and what kind of services we provide. But it's interesting for me to figure out where do we stack up? And how do we know how we stack up with levels of service with our peer counties? You've come from a different location. I'm just curious now that you've been here for awhile if you could just give us your take on what you see and how we stack up.
Yeah, thank you. Thank you for that opportunity Supervisor Lavagnino and I just want to say to the board first going back to the PUF I just want to say thank you all for your support as well in allowing us to really look at the salaries and how we How we are compensating the workers in that high-intensity program Because it's gonna speak to what I'm gonna talk to now because it's not just about creating programs It's about ensuring that we have We are staffing them adequately and that there is capacity at the staffing as well as the site level To meet the need for folks and that requires oftentimes the support of our board as we ask for changes to budget and staffing ratio So appreciate your support always I think how we that is been what I've seen but again, I also came in right at the tail end of a worldwide pandemic and The largest workforce shortage in our field and so hard to ascertain you know chicken-and-egg But I think the thing that is really clear and I and I emphasize it in my presentation It's about capacity and flow.
It's about making sure that we have not only the right services but the adequate staff within those programs to see people timely so that we can move people through in a flow, that we don't burn out people, that I have strong communication across all branches. Relative to how some other counties have been able to do it. Maybe counties also that have a lower cost of living We may be a little behind their curve, but I think for other counties That are at the same level we are I think we're doing really well And the most important thing that I see being here is the staff that work for be well Not just in the puff But across the board are very committed very dedicated and have high levels of compassion so we're starting Off right, we have the right basic foundation and it's just adding the other pieces that were working on.
3:12 – 3:2015 turns
Just
Chair Williams, two things and I know we have public comments. Our public commenter's been patiently waiting so I appreciate that but a couple of things also that I want to add is Supervisor Lavanino mentioned it and we went through the report but you should be proud of the progress we've made there's a lot still to do but when we had those conversations Supervisor Lavanino and Supervisor Nelson when he was Chief of Staff A lot of the things you see on this, on their list they went through we didn't have. The crisis residential treatment by the time we're done with those in Procts we will have four times the amount that we had in 2016. No, we didn't have the mental health rehab center at Lompoc. We didn't have as many programs. Marion has opened more CSU beds and what I also wanted to say is that if you look at the whole continuum of care what Tony and Laura presented is a lot of things that we are doing In other communities, you also have to rely and we do rely on our partners but the private or non-profit hospitals.
So one of the things that we had discussed earlier is in other communities others are doing the acute beds not just the county government because we are limited to this 16 IMD issue that we can't change. And so if you look at some of our neighboring counties with either if they have a public hospital or nonprofit hospital sometimes they're the ones providing more of the inpatient beds So they have to get Medi-Cal certified as well, and that's difficult sometimes for them to be Medi-Cal certified in physical health but not mental health. And so that is another obstacle we've been working with our Our partners so it's it is a lot that we've done. There's a lot more to do But I just want to set that context one We have done a lot and two then other communities they do rely upon some of the other nonprofit or private hospitals
Let's go to public comment
Actually, can I make a comment? Oh sure Mr. Nelson. Thank you. Um I just wanted to piggyback on some of the comments that were made by Supervisor Labadino about the California County Board I served on that for the previous two years before Supervisor Labadino got on this stint. And I really think a lot of the thanks also goes to Terri Mosnesich, who has really got that back on track. And so I know she's now retired but I think you can have this conversation without mentioning Terri and her work there.
I did have a couple questions for behavioral wellness staff. One was the IMD waiver, maybe I didn't pick up on it but do we have a timeline on when that we might receive that or within a decision we made and then one of my other concerns that piggybacks on that is if we get that waiver is it for a set period of time? Is there chance that that might expire in the future so as we build out Future facilities, you know under the reliance of a waiver. You know is that something that we might lose in the future?
If there's a new administration or new thought process where we're not able to pull down that Medi-Cal billing.
Thank you for your question, Supervisor Nelson. The IMD waiver of the BH Connect is still in its final drafting points and it was originally set to go last winter or January I think and it's been postponed a little bit but I think the hope is that it will be going before in the fall and then that usually is a couple of months turnaround for CMS to review and come back to us with their decision.
In terms of waivers, yes waivers are temporary and they are usually for three to five years I think BH Connect and I'm sorry I need to go back because I have not looked at it in quite some time and I am not recalling that if there was a request for a length of time on this waiver. I do know that we have folks here in the public arena that probably have the answer But I don't but I can get back to you on that. Thank you.
Yeah, so I'm definitely concerned about is making sure that if we do get that waiver and that we build that infrastructure into the patient going above 16 beds If we lose it in the future, what does that mean for future expenditures? So that's a concern of mine. The other one was the crisis stabilization units on slide eight. The county operated units that are in the South Coast I see that we list that as still having aid but my understanding is that we haven't been operational on those crisis stabilization units. Is that correct?
I'm sorry, can you repeat that? I didn't hear the last part of your sentence. I'm sorry.
My concern was about the price and civilization units that were operating in the county and whether we are actually operating those. I see those on slide eight but I'm not sure if those are real beds or not.
All right, so we will be reopening our CSU. And as you know, we're in final discussions as to the options for how to open that to be most maximally efficient for not only the need in our county but fiscally responsible as well. And so we'll be coming back to the board in August more on that when the crisis stabilization unit at Marion is operating and what we learned recently and we are in the midst of amending their contract to improve access and utilization When that contract was originally written for the Marion CSU, it was prior to my coming on board here at B-Well. And apparently the way it was written, the access had to come through only for those persons who were Could only be admitted to their outpatient psychiatric unit if they came through their emergency department.
That has proven to be limiting, and their average utilization is about just a couple of beds a day for their total of eight. So we have already put in a request and began amending the contract to change that language. to allow them to accept referrals, for instance from the Lompoc Regional Hospital which has not had the opportunity to benefit from that program just yet. So we definitely are making adjustments there.
Through that process are we also looking at funding additional beds there at
Marion? So actually Chris how should I answer that question so we have contracted for two beds but certainly any beds that are filled by Medi-Cal recipients I'm going to let, so CFO Ribeiro is going to explain how that funding works.
Yeah, Supervisor Nielsen. So with that contract we fund at a set rate. So anytime we see utilization exceeding what we expect as the average of two beds you know we basically monitor that and we will amend the contract as necessary. So there's no, we're not gonna set a cap. We don't set a cap on those beds and our funding will support that whatever the level is that they use.
Excellent. I just don't want to disadvantage the Dignity Health Group for, you know, going out on a limb where our other hospitals aren't doing that. I want to make sure that whatever revenue that we can send their way to help address those needs are appropriately directed towards them so that's very helpful. Thank you for that. That's all. Let's go to public
comment
Chair Williams and members of the board, we have three requests to speak for this item. We'll begin with Susan Horn here in Santa Barbara to be followed by Lynn Gibbs.
3:20 – 3:286 turns
Good morning. It's been a great morning and I'm just so happy to hear all the information and the progress that has been going on. I'm Susan Horn, I am a member of the work group from the League of Women Voters and CLU that have been working on these criminal justice issues Behavioral wellness is, mental health is so integrated into all the things that are happening in criminal justice. So the problems.
This has been so important and I just want to say that we often speak to the problems that we see and the things that we want to make progress on in the future and things that we're really worried about but this morning It's so clear that the things that are happening, we're on the right path. And the urgency, the intention are all there and I just wanted to recognize the hard work that's been going on and in progress now for future planning. So thank you.
Lynn Gibbs to be followed by Suzanne Rorden
Chair Williams and Supervisors, thank you for the opportunity. We just so appreciate this report. My public policy colleagues in other counties are jealous because they don't have reports that break down the categories of care and what the stock of beds are and so on. So I think it really can be a model for other counties. And we so appreciate the recognition of the need for acute and subacute care beds. I'm representing NAMI Santa Barbara County and Families Act today, and we submitted a written statement with the series of eight recommendations. So I'd refer you to that because I won't have time to cover them all this morning.
And we've been pressing on this need for secure treatment beds for many years. And it's not because we favor involuntary treatment, it's because we know as behavioral wellness does that the full continuum of care has to be available and when we're lacking facilities or treatment at one level of care then it impacts another level So it's kind of complicated because the number of beds you need at one level is influenced by what's going on at another. So we really appreciate all the work that's been done, but we do continue to suffer a most severe lack of inpatient beds and subacute care and we've been talking about that today.
Persons with the most serious illness continue to be incarcerated for lack of acute inpatient beds. That's, in many cases, the only secure setting that can be provided for them because we don't have an inpatient bed to put them in for that level of crisis and dysregulation. And so they wind up in the jail. And then they remain in the jail for lack of the subacute longer-term treatment beds that are secured, that we could divert them to on the outside.
So we need those beds at both levels. Assistant CEO Heidman noted in her report that in July 2019, there were 13 felony IST inmates in the jail. And as of this past June 28th, there are now 52. And this morning I was told that the rate of IST felony cases in the jail continues to exceed the rate at which state hospital beds are available. And so without these programs, all of the programs in the continuum of care but also without the secured beds that we need to plan for won't happen overnight but you know we won't have a sustainable solution to the problem until we're able to do that And I know that the county and the departments in behavioral wellness, in particular, have a real commitment to working on that. I just wanted to mention a couple of our eight recommendations.
One is we would love to see more intensive discussions between the county and Cottage and Marion hospitals to... Lynn
because you're over, I'm just going to ask you why don't you highlight three of your recommendations?
Okay, thank you. The collaboration with the hospitals is very important and so we'd like to see a really strong focus on that. Assembly Bill 531, which is the governor's proposal for $4.7 billion in housing and for housing and treatment beds will go before the voters in March 2024 if this bill was passed but it explicitly excludes acute and subacute beds and it shouldn't It should include the full continuum of care. And CSAC has recognized that and written a letter in that regard, but if we want to change that, we need really strong advocacy to change it. Regarding BH Connect and the IMD exclusion waiver, the waiver was made available to the states more than five years ago now, The new application won't be made before 2024, but hopefully early then.
But it's a full package that entails the county committing to a robust system of outpatient care. and services, and evidence-based practices. And it also then will require a vote by the County Board of Supervisors to adopt it because it's being applied for with the feds as it's going to be an opt in county by county. So we have work to do in order to apply for that. Thank you so much for giving me the time
And now for our final speaker, Suzanne Rohrden.
3:28 – 3:359 turns
Good afternoon Chair and members of the Board. I want to give you, well first of all I am glad that I have lived long enough to see this day and to hear this updated report. And I want to give you a little sense of the history of the process that led up to it and the gnashing of teeth And the intense grassroots advocacy that went into the creation of this particular report. As I hear Tony and Laura rattle off categories and numbers, I am graphically remembering the anguish, the suffering, the deaths that litter the road to this day.
I think it was 2015 or 2016 that Lynn Gibbs and I and Debbie McCoy and many other family members from various organizations, and Frank Thompson the housing expert in our town. Sat in a little stuffy room, meeting after meeting after meeting of a committee that was looking at the need that we saw for more beds and different kinds of beds that were sorely lacking in this community. And we were meeting with a representative most of the time, Laura was there some of the time but it was mainly Cuco Rodriguez, a very well-meaning representative of the ADMHS which was the name at the time of the mental health department And it was like banging our heads against the wall to try to convince Cuco Rodriguez, representing a huge department with millions of dollars that there was dying going on out here.
That there was a desperate need for more treatment options and more residential treatment options at various higher levels of the continuum and so here we are today You know, with this result. The CEO's office we were very pleasantly surprised when they turned all of that process into an actual chart, a report and gave it a name. It was the capital needs report at that time.
I just want you to know what's gone into the creation of this today. And we had to become policy wonks, I mean Lynn Gibbs is a natural policy wonk but the rest of us were getting into the weeds of you know the various categories of group residential this and that and what it meant and you know I didn't think in my life that I was going to have to get Knowing too much about this and knowing so much about how a jail operates. And knowing so much about mental illness and drug addiction.
So, you know the people are with you, the county is now with you, the CEO's office is with you. Lord God we should be able to help a lot of people. And the need has only grown. So thank you so much for your efforts to understand this complex process and for the role that you've played all of you All of you and the CEO's office of this county of Santa Barbara in filling some of the gaps that have caused so much tragedy and so much anguish to the people of Santa Barbara. Thank you.
Chair Williams and members of the board, we have no further requests to speak.
Can I get a motion? I first would like to respond to that, if I could. I just want to say that I've been here that whole time and rarely do we ever have anybody come back from the community and say thank you. And so I appreciate that because you have held our feet to the fire and you know, you had to get educated. We had to get educated We understood I could always feel the pain that you're going through.
So to now validate our activities up here, I really appreciate that because that's rare most people say that's good but you haven't done enough which is also true but for you guys come in and make that today at really appreciate it so I'll be happy to make a motion receive and file this and appreciate all the great work your staff is doing second
Chair Williams, I'd like to second and also extend my appreciation to the advocates who educated me so much just in these last few months. But also just what you've done with your pain and your anguish and you turned it into action. You know the fact that I want to commend staff because to have these two reports It was really helpful for me and I imagine for the public as well because when we look at the numbers, we've acknowledged in our previous discussion that many of our mentally ill people are housed in jails. And I appreciate our sheriff being here and our undersheriff because that's really where the rubber meets the road in this whole challenge. So thank you to our advocates and to my colleagues here for this really constructive conversation today with progress, challenges, gaps, and a strong determination to improve.
Thank you, I'm happy to second.
So my motion is A and B by the
way.
And that's good with the seconder?
That's good with the seconder.
And I will of course support it. I do also want to thank advocates for the ideas and particularly the newer idea which is to use CCP funds, I will vet that. We can maintain sustainability with our programs, which ultimately have a benefit for mentally ill as well. But to see if there's a way to keep sustainability with that but still look at that I as the board's rep to the CCPI will take that one on and I just also want to say that it's sometimes it's not always as Flashy to be looking at the subacute, but the subacute is really the threat to our ability to provide the services Especially if there's going to be more In that population in coming years and so Having in-county subacute beds not only are good fiscally. They're also better results for the patients because they generally then have more visitorship, more people able to be with them that improves their results.
So I just want to put that in this discussion because I definitely think there are various places where we can enhance our continuum of care But I think sometimes we gotta look at the long run, how we can help the most people. And one of those is to invest in sub-acute so that we can invest more in crisis and acute because we won't be as vulnerable fiscally.
Okay, let's do Mr. Nelson did you wanna say anything as a parting shot? Nope, I'm ready to vote. Great, roll call please.
Roll-call vote Passed 5–0
Show transcript
3:36 – 3:367 turns
motion passes unanimously
We will now Return to we will now recess to closed session. Will County Council please read the items for consideration?
Thank you, Mr. Chair and members of the board. The board is scheduled to close session to discuss two items of existing litigation. Torres v. County of Santa Barbara which is a Santa Barbara County Superior Court case. Murray v. County of Santa Barbara United States District Court case in the Central District. Staff could you
keep
it down? We're still
reading out closed session thank you.
And conference with labor negotiators, employee organizations, all bargaining units, unrepresented employees and managers which includes the Santa Barbara County Deputy Sheriff's Association which was previously noticed. The agency designated representatives are CEO Monomi Asato and Human Resources Director Maria Elena Dick-Rivera. And the chair has asked if we could go a little bit more quickly so we're going to try for 45 minutes.
5:23 – 5:243 turns
We are reconvening from closed session. Would you like to report from closed session?
Thank you, Mr. Chair and members of the board. The board met in closed session on two items of existing litigation, Torres versus County of Santa Barbara and Murray versus County of Santa Barbara and conference with labor negotiators with all bargaining units, unrepresented employees and managers, and the board took no reportable action.
We are adjourned Tuesday, August 22nd 2023 in Santa Maria Oh no, yeah. We are adjourned tomorrow at 1030 AM right here.