All right, it's a good morning everyone. I'd like to call to order the joint meeting of the Social Services Committee and the Health Committee of the clerk for Monday, March 24th, the clerk takes the role. Supervisor Miley? Yeah. Supervisor Tam? Present. Supervisor Fortinotto Bass excused. Supervisor Marquez excused. Supervisor Hal Verdick excused. Okay. Alrighty. So, Super supervisor baths when I be joining us at supervisor tab she's community's community's community for the county and this is our opportunity to share with the social services committee the work that the council completed in the last year. Before I go on to those particular details with the slide deck, I'd like to acknowledge members of the leadership team of the council. I'm not able to help move forward the work of the council without the support of a few very important individuals. I want to make sure we mention today. Caitlin Chen is the executive director for legal assistance for seniors. Benjamin Chen, he's the interim council's and commissions manager for the public health department with Kimmy Wackens Tart. Andrea Dodge is the Director of the Healthy Brain Initiative with the Public Health Department with Kimmy Wackens Tart as well. Julien Schrick is the Director of Older Adult Services with the County's Behavioral Health Care Services and Wendy Peterson is the Director for the Senior Services Coalition. Also we have Amrit Paul Gil. He's in the audience. He is the newly assigned management analyst assistant with the council that is a mutually funded position with health care services or health services agency and the social services agency. We had been without that particular support for many, many months. And we are so excited to have Omrit with us. And he was very instrumental in the work that we've done so far since he's been here. So to get us started. Just for the agenda will give a brief overview. We'll talk a little bit about the council and the five committees that are involved with the council. And then I'll be able to take questions following the closing statement. So just to level set a little bit back in June of 2020, 2014, the Board of Supervisors issued a memo that gave the Social Services Agency and the Health Care Services Agency, now known as Alameda County Health, the charge to engage leaders, consumers, and providers to develop and sustain a community framework that fosters healthy aging. With that mandate, we were clear that we wanted to be responsive to the swelling aging population that is known as the Silver Sunami in a lot of areas. And we hired that, again, management analyst assistant to be able to help us to do that. Next slide. So the Council works a work plan that pretty much tries to be an alignment with a couple of big pieces of information in the state concerning older adults. There are five big goals in the master plan for aging, which was initiated by Governor Newsom. And I'll give you the goals really quickly. Go number one is housing for all ages and stages. Go number two is health reimagined. Go number three is housing for all ages and stages. Go number two is health reimagined. Go number three is inclusion and equity not isolation. Go number four is caregiving that works and go number five is affordable aging. We also look to the Board of Supervisors vision 10x goals and the 2024 countywide area plan to address the needs of the adult community. The countywide area plan is created through the council of the county council of the county council of the county council of the county council of the county council of the county council of the county council of the county council of the county council of the county council of the county council of committee, digital inclusion, embracing aging, which we also referenced as the Healthy Brain Initiative committee, housing committee and the data committee. I'd like to share with you today the work that each of those committees were able to complete in the last year. Next slide. So last year, the county supported state legislation that's relevant to older adult, older adults, I'm sorry, our legislation and advocacy committee worked in partnership with state coders to prioritize 24 bills. 11 of those bills were chaptered including AB 846 protection from rent hikes by capping annual rent increases in low income housing tax credit properties AB 2541 piece officer training on preventing a responding to wandering by people with ADRD and autism AB 2689 voluntary contribution to ADRD research on the California personal income tax return Senate bill 639 dementia training for for licensed physicians. Next slide please. For those bills were enrolled but were vetoed and they were AB 1975, MediCal for medically supportive food and nutrition and for interventions. AB 2428, MediCal Community-based Adult Services Rate Equity, Senate Bill 37, Housing Stability Act Rental Subsidy Pilot Program. Additionally, the Committee and Council worked in partnership to successfully oppose several proposed cuts to state funding for APS, APS Homestay Program, and the older California's Act Modernization Funding that helps fund nutrition and case management services. To pause for a second and speak a little bit about the Home Safe Program, my home safe was initially intended as a pilot program a little bit ago back in 2018. And 24 counties including Alameda County were engaged with the Home Safe Pile Program. It was expanded in 2021 to include all the remaining counties that were interested. The idea of Home Safe is to provide support for older adults that could come to the attention of the adult protective services program APS with interventions to prevent them from experiencing homelessness. You could be eligible for APS services that is 60 years old and up and have a situation in your life where your housing is unstable or you are likely to not be with housing. And the APS program works home safe. Back in 2021, the Budget Act then allocated 92.5 million one time funding. The Budget Act of 2022 allocated the same amount. It was reappropriated in fiscal year 2122 to last through June 2025. And one more time in fiscal year 2223 to last through June 2026. However, that funding was not intended to go any further. The legislation and advocacy committee thought that was pretty significant. We've had a lot of successful outcomes implementing home safe in our county and through Wendy Peterson with the social with the senior services coalition excuse me has gone forward to ask for that money to be extended ongoing for the home safe program with the support of several different CBOs in the state. And we're hopeful that that partnership that we have with senior services coalition through the council and lead to a positive outcome for home safe. We've used it tremendously and we still have money left that we'd like to be able to take advantage of with home safe. Next slide please. Okay, let's shift gears a little bit and talk about our next committee, Digital Inclusion Committee. We're working with stakeholders and partners in the Bay Area, through the Bay Area Digital Inclusion Coalition and other settings to understand the changing needs and give information to support digital inclusion for adults. What I remember, and I like to share with your board, if you can remember, back when the initial shelter in place happened in March of, I believe, 2020, digital isolation for older adults became a really big issue right or right away. The council was pretty significant in its efforts to be able to partner with community-based organizations in the area and other counties as well as engage the state around wanting to make sure older adults could have access to technology number one that it was affordable number two that they were doing it safely number three and that work has continued through our digital inclusion committee when COVID happened in 2020 a lot of the work of the council really shifted towards making sure the very imminent and pressing needs of the older adults were addressed and digital inclusion was one of them. So through our collaboration in 2324, we got the following things done. We developed fact sheets around digital inclusion for older adults in English, Spanish, and Chinese. We convene partners to support proposals for the national telecommunications and infrastructure administrative competitive grants to support digital inclusion efforts for older adults here in our county. We convene partners around the California Department of Technology's upcoming California Digital Equity Plan capacity subgrants. We engaged and refined our policy work to continue supporting that digital inclusion of older adults. Next slide please. Embracing aging, we talked a little bit about this earlier and I want to share with you the importance of understanding as a community whether you are a provider, a first responder, exactly how to engage older adults in a way that takes into accountability. They're very special and unique needs. The Abracing Aging Committee of the Council worked a lot in 2024 to be able to assure that our community education and workforce development was seeping into the actual community. So as an example, UCSF Department of Georeactress gave a grant. And with that grant, we were able to educate staff members, even in social services in the public health department. Children and family services got some training as well. Around the four M's for older adults to make sure that they're engaging older adults properly in giving them the kind of understanding that they need. We've pivoted a bit now, we're moving towards the Healthy Brain Initiative grant through the Public Health Department's effort to make sure that Alzheimer's and Alzheimer's disease and related dimensions are also given that same type of platform for everybody to be aware of it. We were able to use the Embracing Aging Committee to help with the access and functional needs advisory committee to get ready for that grant. And we've offered legislative policy recommendations. We are able through the Healthy Brain Initiative, which sits in this Embracing Aging Committee because that grant has sunsetted it now. We're pivoting to Healthy Brain Initiative. We are able to provide trainings to individuals in the county that work with older adults around this very topic. And if people are interested, they can email hbi.trainings at acgov.org. H-B-I dot trainings at acgov.org. Next slide please. The Housing Committee over the past year has been active in Elevating the Knees of Older Adults and we did the following things, increasing access to CalAIM housing supports, supporting age-friendly shelters, protecting homesafe funding. We talked about that just a little bit ago and expanding IHSS services. Next, please. The data committee had been sunset for a little bit. We did not have enough participation in the council to get the work of the data committee done. And we're excited that we have re-initiated the data committee. So we want to expand the council's understanding of the old redout population to focus specifically on the projects of the council and also to call attention to the needs of the older adults. Supervisor Miley and the United seniors of Alameda County have a saying if it's good for seniors is good for everybody and the data can help show us that we develop live and share the document to track older adult data sources and our focus has been on identifying Data that supports the efforts of the council for this year since we're just standing that council back up We're hoping to continue to focus on supporting the work of the other council committees Housing legislation digital inclusion and healthy brain initiative if they need data to help them push their agendas forward We're hoping that we can gather that data in the data committee to be able to support their efforts and track that data that can augment their efforts to support the older adults. Next slide please. In closing, the county council for age-friendly communities is a long way to say age-friendly community. Remain step-as in our commitment to fostering healthy aging and addressing the evolving needs of the older adults. This work of the council really does not happen without people from outside organizations giving time during their full time jobs to sit on our council to engage our committees and push work forward. The work of the large council happens in the committees. So the more community partners and stakeholders we have on the committees that are interested in partnering with us around these projects, the better we're able to respond to the needs of the older adults in the county and we're grateful for their participation. We look forward to continuing our collaboration with the board and our partners to ensure these efforts create lasting impacts for the older adults in Alameda County. I welcome your questions. Thank you. Supervisor Damm, any questions? Thank you, surprise or my late. Thank you for your presentation on the update. I wanted to commend you on the work that you're doing particularly in partnering with different community groups, try to leverage resources, especially on the digital equity, because that's been something that I know came out of COVID. And right now, a lot of providers rely on that technology to set medical appointments, to do telecare, and having a special older population proficient with the digital access is gonna be key. I did have a question on our efforts with addressing housing and homelessness, particularly with the older adult population. Because I think the data that we get from the healthcare side shows that over half, like 53% of the homeless population in Alameda County or in-house population are African-Americans, that's more than half. And those are newly homeless and those that are returning to homelessness are almost like 59 or 60% and they're also African-Americans. So I wanted to understand how the coordination occurs between AAA because I presume there's also an overlap on those that are older adults that are in that space of unhoused. And so I wanted to understand what was the coordination and how much of that overlap is occurring. Thank you for the question, Supervisor Tam. You know, one of the things that we want the community to understand about the AAA is it really is the Department of Adult Naging Services' first line of defense. By the time we see individuals that are at risk for homelessness in the department, they come to us through our Adult Protective Services hotline. They've missed the opportunity to engage with AAA first. So we'd like to see the older adult population and those that love and support them be more aware of the services that AAA provides and access those services very early on. Once they come to adult protective services without home safe as an example, we are very limited in just our ability to be able to stabilize their precarious housing situations, which is why home safe continuing beyond the current appropriation is really, really important because we've used those dollars to pay individuals back rents. We've used it to temporarily house them while their home is being repaired for some situation that causes to be inhabitable. We've used those funds to be able to keep people's utilities on and even to clean out their homes because they are unsafe for them to be in. So the best overlap as I would think supervisor Tam is to access AAA services very early so that we can identify those areas that might put you at risk for homelessness and not wait until it's gotten so bad that APS comes in. We're kind of limited in what we can do without certainly the financial aspects. The individuals that sit on the council that participate varying organizations, various community based organizations and they do serve populations throughout the county and we do have representation of organizations that serve African-American populations specifically. So the more information we share on the council is kind of like a repository of all the services available in the county, not just from the Department of Adult Naging, but also from the community partners. The more informed they are and they can share that information in the community. I'm frankly a little surprised with how little individuals may know about the services that are available to older adults. So AAA blasting out what we can offer, participating in community events, coming to the board and presenting is all very helpful. Okay, I appreciate that explanation. What I'm looking at is like, let's take the home safe program, for example, because there's funding for home safe, that is separate and apart for funding that we provide for other housing programs. And I'm just trying to understand which, like we're asked right now to sort of triage and try to protect all the various sources of funding. And I just want to make sure that if we protect funding for this one source, it also protects it for another population and I see our healthcare director coming up. Good morning supervisors. I just wanted to add some context around one of the prevention, the prevention framework that the Housing and Homelessness folks are developing. And so one of the pieces in there is taking into account that that population is also aging. And so in hearing what the SSA colleagues are saying, I think we can do some better connection on the front end of that to make sure that we're getting some of those preventive resources out there. I appreciate that. I just want to make sure that if we're providing services for older adults, I mean, they have several issues, right? Not just they have behavioral health, they have obviously they classify because they're older, because they're unhoused and hopefully those resources are being put in a way that's coordinated and not duplicative. Yeah, I think you're touching on a really important point and so some of the work that you know I think we're all doing in the back end and can be improving upon, is that work to have coordinated data sharing as well, so that we know when someone is touching one system, that they can have the appropriate referrals and get access to the right resources. Thank you. Okay, I have a few questions. And it's in first question. It's an alignment with what supervisor Tim was speaking about. I don't understand why there is a deity data here. There's a lot of nice words. Whoa, did the 18 council have any metrics they're trying to meet? We're trying to get X number of seniors housed, X number of seniors, I have homelessness, X number of seniors fed, X number of seniors improved their digital understanding. I mean, I don't see any data here. I just say a bunch of words. Thank you for the question. That in my understanding, the council wouldn't necessarily be able to state that as an example, we could get a certain number of seniors housed because that's not specifically the work of the council. Most of the work of the council is around spreading information about the services that are necessary and educating entities about what could be really helpful to clients that are older adults in the county. The data specifically around that type of issue would likely flow from the adult protection services department program, which is in the Department of Adult Naging Services because we track that more clearly because our clients for home safe have to come through APS. And we have that data, that's a separate conversation. We can certainly provide the board. We have that data and we shared that data when we supported the legislation push from the senior services coalition and our legislation advocacy committee to the state to ask for home safe to be extended. If you want very specific data that the council can give you but leaning on data shares from other places I'm happy to provide that for you. I can do that. Yeah, because maybe we're going to have to revisit the charge of the H friendly council because when I think of H friendly like Supervisor Tamma said we have a lot of older adults who are homeless who are on the streets who are suffering illness, who are hungry, etc. I want to see the council bring together your department, her department, her department, housing and homelessness, and getting tangible results on improving the quality of life for seniors in this county. I want to see the data associated with that. And if the H for New Council isn't doing that because they're not charged with that scope of authority, then I think we're going to revisit the authority of the H for New Council. So you can bring together, because that's what I thought was happening when we brought Kimmy's Department in your department together both of your departments are gonna work together to move an agenda that's making out on the county age friendly I don't see that occurring I might have seen that occurring early on. I don't see that occurring To the degree I'd like to see it occurring presently Understand Understand, the adult protection services program is scheduled to present before the board. That presentation will have that information because we know specifically how many clients we've served at risk for homelessness or were homeless and what the outcomes of those particular clients were in that type of case management, which is what those APS workers do. So I'll be sure to share that with you when they get there. This is just on you, Faith. I want to hear from how's it going to be hopeless this? What have they've done to reduce the population of seniors who are out there on the streets? I want to hear from your department, what how many seniors were getting fed? I want to hear from health, behavioral health. How many seniors are we addressing in terms of their dementia, their mental illness, the social isolation, et cetera? I want to hear from your department, how many seniors have we seen who've improved their digital abilities? They've gotten a device or they've gotten connected to the internet or they are understanding how to use this device. Whatever it might be, that's what I want to see. And I don't know if it's a device or a TAM, is on that opinion. But I think that's going to be much more to our liking. This is great. These words, but I want to see the data behind these words. So supervisor Maile, I know AC Health, the Health Committee's agenda is pretty packed. Would you like to see that they had come back as a joint discussion? Okay. Yeah, I was asking Aaron, when's our next joint meeting? When's our next joint meeting of these two committees? Okay, well, that if we can't turn on the 22nd of May, we'll figure out a date and time for another joint meeting down the road so that the The office is housing and homelessness, the behavioral health department, public health, adult and aging can all kind of coalesce around the data. How have we made Alameda County age-friendly and improve the quality of life for older adults the preceding year when we look back. And once again, if the age-friendly council doesn't have that scope of mission and authority, then I'm going to propose to the board that we change that so they can have a broader mission and authority that looks at that. And Supervisor Malia, if I might add the AAA is also scheduled to have a presentation for the council, I mean for the board, my apologies, and they will also go into detail about the services we provide. Specifically senior nutrition is a part of that, and they'll be able to give very specific data about how many seniors we have served. Yeah, and I don't want to be a dead horse, but we know for a fact with Oakland having its budget crisis, you know, some seniors aren't going to get fed. And I'm not saying the obligation is going to fall in the county, but it's good for us to know what's the winning list for seniors, for nutrition. We've seen over time seniors becoming out of the house. So more have become out of the house, more are male, more African American? How are we targeting that population to reduce the level of homelessness among them? Do we need more money for rental assistance in terms of prevention, etc. So I think that's and I don't super nice to him. Would you find that to be worthwhile? Yeah, I think we're seeing the same thing. We're trying to break down the silos that are occurring with providing these services so that we can collectively say we are an age-friendly county, we provide, we're moving the needle on homelessness with respect to all sectors, particularly the African-American population because they are overrepresented in the unhoused population. Yeah, and you folks know me, you know, I'm a senior advocate, I'm passionate about seniors, so don't be, feel affronted by what I've saying to you but this is kind of my expectation. We have all clad divided what's the relationship between the age friendly council and all clad divided. We've invited them to the council and I believe they have come they participated if I'm not mistaking at the age friendly councils in person meeting that we just had last Friday at the San Lorenzo Public Library, a gentleman named Patrick I believe was with us from Oakland undivided and we use that meeting the plan for the update for the age friendly action plan that we've submitted to ARP and World Health Organization so they are at the table. And that's great. And so, Oakland divided to my understanding, they're providing internet access to low income communities in the city of Oakland. So if we could get from them, how many, if they had this data, if they don't, they don't. But how many older adults have they hooked up to the internet or provided service access to that service? Because I don't think they provide devices, but they provide free internet access. And I'd be very curious to see that as well. You know, obviously I'm concerned about all populations and everybody, but with this age, friendly friendly piece my focus is on older adults So once you this is not all a new faith I See two other department had sitting out there and I don't know where Jonathan is but maybe he's listening Okay, they've all been helpful. It's a collaborative effort. I just happen to be the one in front of the microphone that gets to hear you. Well, maybe they maybe they should have gotten in front of the microphone and I'd you. Yeah. I'm okay. I get all the support I need for them. I'm very grateful. You take it. All right. All right. So let's see if we have. Is there anything else to write a stand before we go to public speakers? Do any public speakers on the side of? I have public speakers. Do any public speakers on this item? I have no speakers on item one. All right. Well, thanks for this update, but we're going to bring this back and get even more into the nuts and bolts. The Navy gritty. behind some of the great work that has been put on paper to kind of see what has been done. That's great. Where the deficiencies in the needs are still occurring that we need to based on your observations from last year as you bring this report forward because I know we're in the midst of working on older adult issues presently for 2025 in this this report is on a calendar year, right? Yes, yeah, not a fiscal year and the other thing is yeah It's some of the agency heads know this I think Andrea Ford and and you can know this. You know, if the board, if the measure W, money's ever gets totally freed up, I need to know, and I think the board needs to know, what are the needs of your department? Not the wants, the needs. So we can determine whether or not any of that measure W, funding, because it is a fine money money needs to go to the trustees of these needs. So if we see that there's a need for you know more seniors getting devices or for see there's a need for more classes for seniors to be trained in improving their online literacy or if we see there's a need for more rental assistance for seniors. I mean that's the kind of stuff I think would help aboard when we ultimately decide how we're going to use, you know, the measure A bodies. I'm assuming the measure W is the muddies. Okay. Thank you, Faith. You're welcome, Supervisor Miley. Always a pleasure. Thank you, supervise with him. And I'll just make a quick announcement. This year's 22nd, the 22nd, A.D.O. Health Living Festival will be held at the Oakland Zoo on September 25th. I believe that's the last Thursday in September. The zoo will be closed to the general public and open to seniors here in Alameda County. And those who the seniors invite to accompany them to the event. Social Services Angie is very excited to partner with you. Supervisor Malay, so tell us whatever you We're happy to help. Yes. Thank you. All right It's good or good or next item. Okay, the next item is also informational I'm the Department of Children and Family Services Michelle love with the assistance of Bud Sealy will present on an item that we also presented on at last month Self-suff committee. But last month we were missing our AC health partners, and they are here to date to answer any questions you all might have in relation to this. I have a good morning. My name is Bud Seely, management analyst and Department of Children and Famous Services, and thank you Supervisor Tam and Supervisor Marley for allowing me to be present here this morning to talk about our system and equipment plan. Next slide, please. What I'd like to cover is to discuss the California Child and Family Services review, the CCFSR, which is the overarching federal process and state implementation and some of its components will get into the most recent county self-assessment that we completed in 2024, and as well as our five-year system improvement plan, which was recently approved by the California Department of Services, and will be reviewed by the board, and discuss some of the goals and strategies from that plan. Next slide, please. So as I was saying, the CCFSR California Child and Family Services Review is the state's implementation of the federal framework. And that was incorporated in the state law back in 2001 through assembly bill 636. And all purposes just to set that framework for outcome based reviews to happen in all of the counties. Monitoring assessing the quality of service provided on maltreated children as well as those children suspected of having experienced maltreatment and following the federal emphasis on safety permanency and low-being next slide, please Yes, so we just completed our county self-assessment in 2024 and that's a comprehensive assessment of our county population quality of child welfare and probation services because it's conducted in collaboration with the Department of probation, looking at all of the outcome measure performance for our department under the CCFSR, and it also includes something called the peer review, which I'll get into in just a moment. That, all of that information we use to develop our five-year system improvement plan and After that is approved by this the California Department of Social Services as well as the board and we are on a annual process where we provide progress reports to the state about our Our sip and make adjustments as necessary Okay As I was saying for the county self-assessment, there's the peer review component and that's where we have a unique process and collaboration with the state. We choose a focus area and reviewing all the outcome measures under this CCFSR and choosing some where we have performance that's relatively short of the state or national standards so we prioritize that for our peer review and that allows us to bring in probation officers and child well-workers from other counties in order to help us interview our own staff in 2024 we interviewed 27 of our staff to look at our focus area of reentry so that's the perman for outcome measure, whether or not children who exited from foster care to permanence through reunification or guardianship, for those kids re-enter foster care within 12 months. And through those interviews of our own staff, we looked at cases where permanency occurred and exit to permanency occurred with there wasn an reentry. So we looked at what went well in that case and what could possibly be replicated in others, as well as cases where reentry did occur and what could have been possibly done differently to avoid a reentry from happening. So that's some of the qualitative information that we get in this CSA, as well as a lot of information that we're fortunate to get from community members through focus groups. This time around we had over we have 19 focus group sessions with over 115 community members providing us feedback on what's working well in the department as well as what could be improved. We heard from child welfare, I'm sorry we heard from foster youth, parents to foster youth. We also heard from our own staff, a resource parents, which are more commonly known as foster parents. We also heard from court partners, that's judges, attorneys, and court appointed special advocates, causes. So I'll share a little bit about what we learned in just a moment. And then there's also the quantitative data that we review. Like I was saying, the permanency for reentry measure, and there's several others that we look at under the CCFSR looking at permanency safety and wellbeing. Next slide, please. Okay, so here are some of the findings and highlights from that CSA. We learned as is common throughout the state and the nation that children in youth who are reported to us and experienced maltreatment are more likely to be under five years old as well as black or Latino, a general neglect is the most common form of maltreatment that children experience. And from the focus area of the C, that the peer review and reentry, we learned about some of the common issues that led to reentry for kids who did come back into care after exiting to reunification or guardianship and that's parenting conflict, housing insecurity that might lead to a lack of supervision of a child, another economic issues leading to family destabilization and compromise child safety. Next line, please. And for some of the information that we got back through the focus groups, we are very fortunate to hear from parents about some impactful and supportive relationships that they developed with parent advocates on their cases. We heard from child welfare workers about their appreciation for parent advocates and how they helped offer bio-parent, orient bio-parents to the system, connect them with resources and help them engage with services. We heard from a focus group participants about the high quality resource parents that we have in the county and how they're often seen as being the right place at the right time. Immediately needs of youth, we heard about how case aids and costs has helped enable visitations while resource parents frequently kept minds of communication open with bio parents assisting youth with their goals and supporting reunification. However, we also heard about sometimes there are lack of local placement options within the county and that can lead to difficulties and hurdles and meeting the needs of youth in their care. If the youth is placed far away from their biological parents or other relatives that can lead to issues and challenges and difficulties maintaining relationships so that youth with family can lead to overuse of our transitional shelter care facility and specific youth needs not being addressed. Particularly for older youth, youth throughout LGBTQ plus and youth of high level or complex behavioral health needs. Both re-sourced parents and youth talked about the need for more caregiver training and helping those caregivers prepare and have skills to meet the needs of particular youth. Again, youth with complex behavioral and mental health needs. We also heard about short-term residential treatment placements, so congregate care settings and how they're often providing much needed support to youth. However, there are occasionally not enough SGRTPs willing to accept youth into the care who need that level of service. We also heard from stakeholders about teaming and the importance of teaming and how we've had recent efforts and successes with our Childland Family Team model, increasing the family involvement and incorporating parent perspective into the teaming process. Many youth told us about how they felt supported, just knowing they have a team, appreciating check-ins, and feeling welcome to contribute to their perspective to the process. However, we also heard about inconsistencies and how some youth didn't have that experience, as well as inconsistencies with a team membership, ideally that's driven by the the voice of the parent and youth and who's involved in their team, including relatives and other folks they have in their life. However, sometimes there's some reluctant, since head and hesitancy to include people in their lives in their child role for a case. Next slide, please. We're very fortunate and now I'm made to county to have a vast array of services proven well resource skilled services ranging from independent living programs to kinship support services to effective combinations of substance abuse treatment and mental health services. However, we also did hear about some significant gaps in mental health services which can lead to barriers accessing both basic therapy to high level behavior, health needs and youth and parents sometimes experience long wait lists and barriers to accessing that care. In addition, there are some gaps in some abuse treatment, especially for parents with kids, services to children who have been commercially sexually exploited, childcare and housing, child transportation issues also can compound these service gaps, and overall the high cost of living, coupled with a lack of affordable housing contributes to permanency delays due to a lack of accessible resource to meet those demands. All stakeholders also talked about the importance of time and how the federal rules and requirements for timing for permanency hearings can lead to parents feeling like they didn't have enough time to work towards reunification with their child. We also heard about multiple stakeholders reporting issues with aftercare and difficulty with resources for families post reunification. And also there is sometimes a misperception that youth will benefit from entering extended foster care. So that's the age at age 18 and older and how there's a misperception that those youth will have access to more resources or services in extended foster care than they otherwise would have. And that can lead to some youth not working towards their parents not having readification with their youth when that may have been possible. And the most frequent and challenging issue that's cited in these focus groups was issues with vacancies and high caseloads with our staff and how we have a very experienced and dedicated staff however sometimes they weren't able to provide the level of services possible for youth and family because of those vacancies and high caseloads. Next slide please. Okay, so after reviewing all this information, we were able to develop some priorities for our five year system improvement plan, and that includes increasing the in-depth knowledge of permanency options of planning, amongst staff, youth and families, improving the permanent connections that youth and foster care have with relatives and victim-kind members, and those things we believe will lead to an increased percentage of youth who exit from foster care to legal permanency. Next slide, please. As I was mentioning earlier, there are several outcome measures included in the CCFSR and after the review of the findings through the CSA, this is one of them that we identified for improvement through our five years system improvement plan. This has to do with the timely permanence exits for youth have been in care for at least 24 months. So it looks at the start of the year, how many of those kids have been in foster care for at least 20 more four months, exited to time and be permanence within the next 12. 12, that's re-enhancation guardianship or adoption. And for context here, our baseline for the SIP, quarter one, 2024. We had 231 kids in our county on April 1, 2023, who had been foster care for at least 24 months. And after 12 months, 23.8% of those kids, that's 55 children, had exited to permanency in order to have met the standard. We needed 32 additional kids to have exited timely to permanency. So that 23.8% is short of a national standard of 37.3%. That's why it's been chosen for inclusion on our sit. Next slide, please. And these next two outcome measures are very similar. They both have, they both deal with a timely investigation of referrals to our department of suspected child abuse and neglect. This first one, even though it's, as you can see in the sit baseline quarter one, 2024, those performance was 89.1%, very close to the state standard, 90%, however, it was included because it's so closely related to the next outcome measure. Next slide, please. They both deal with a timely investigation of sorry, yes, timely investigation of suspected maltreatment. And we believe that any improvements made for this measure will also be reflected in the other one. So I'm sorry, I should have said the previous measure has to do with immediate referrals, and that's when there's a higher risk to the child, a higher assessed risk to the child, so the investigation would occur within 24 hours, or what's most common in Alameda County, it occurs within two hours. And in this case, the 10-day response outcome measure on the screen, this has to do with a lower assessed risks of the in-person response can occur within 10 days. And for context here, our most recent performance, well, it was recorded one, 2024, 509 children were included in the measure requiring a 10 day in person response. That's 162 children who are seen timely 31.8%, which is well short of the state standard of 90%. We needed an additional 296 children to have been seen in a timely manner in the investigation to have met the state standard. Next slide, please. So given all of the peer review information we collected and the focus group feedback, as well as the R review of the outcome measure performance we identified several strategies and action steps in response that we believe will help lead our performance to or above the state and national standards. And this first one has to do a timely permanency for youth. So we seek to increase permane that see options and planning for staff, youth, families and community partners. We have an existing permanency guide in the department. However, it is several years old and also in a format that's PDF and very lengthy over 20 pages long. So we believe that not only does it need updates to make sure that it's accurate and provides the most current information for staff and families, but also we hope to work with youth advocates develop a more youth-friendly version so that when staff have conversations with caregivers and youth about their permanency options, that's in a format that's most accessible for everyone involved. Then a response will be updating our internal policies regarding permanency to make sure that it's a consistent with the updated guide and can support staff in their work. And then as I mentioned, we heard about services and service gaps within the county, but we want to make sure that we are fully making referrals to all of the services available because we did hear of instances when there's a particular service in the county that may have been beneficial for a family, but the referral wasn't made possibly due to caseload issues. And so we'll be promoting the use of referrals among our staff regarding things that we heard about in the CSA. For example, resources to support parenting conflict, supports for youth through LGBTQ plus, some abuse treatment referrals, making full utilization of our interpreters and language line services, and parent and youth advocates. And each of these strategies will include an evaluation component. Next slide, please. Another permanency-related effort is for family-funded engagement. We recognize that given the high case loads and vacancy rates within our department, that family finding engagement will be most effective if we collaborate with some partners, community partners for the service, the support the ongoing case work that child welfare workers are making. So again, I'm connecting with Casey Family programs to make sure that they're providing supported and targeted case identification for the provision of FFE will also be partnering with another FFE agency to make sure that we reach as many youth as possible with family-friendly engagement. And then we'll also work with our staff to make sure that they're trained on these practices by partner agencies and incorporating that content into their case management to ensure that as many connections with relatives and victim key and happen for youth as possible. Next slide, please. And then finally, this strategy is regarding this to be measures, the timely investigation, outcome measures. And we'll be working on our front end protocols to ensure that we're reducing any barriers to timely investigations that's through an eternal process mapping and analysis. We'll be looking at ways to ensure that staff can conduct their investigations without any barriers. And for example, there's some existing documentation barriers right now. Investigation narratives are used to document the investigations of suspected child amount treatment by child welfare workers. However, very little information populates to that in our computer system from the screening process. So we want to make sure to work with our ITD partners to ensure that as much information gets carried over from screening into the investigation document, and that will reduce some of the administrative burden for our staff and free up more time for working on investigations. We'll also be seeking to streamline referral assignments. Right now, a child welfare worker and emergency response gets both 10-day and immediate investigation assignments because of the priority, the nature of immediate referrals that can often lead to conflicts and their work and having to have less time for a 10-day investigation when an immediate is assigned to them. So we're exploring having a 10-day unit where those staff would just have those referrals and would not have a competition on their caseload when an immediate is assigned to them. And we also recognize the staffing levels in the department that currently the vacancy rate for child welfare worker staff is 32.8% that includes CW-1 and two classifications. So we see this and based on the CSA feedback that's one of the most important issues in our department and because of the leadership of Director Ford and the assistant director love we've already in collaboration with the human resources department. Incorporated continuous hiring into our practice, and that's already led to us having additional induction classes in the year that we would normally have. We believe that this among these other efforts are going to help improve our performance. Next slide, please. And again, I'd like to thank Supervisor Tam and my lead for having me here and welcome any questions or feedback. Thank you for that update and the presentation. I wanted to just get clear in my mind the CCFSR, basically, it's the assessment review. That's different than what was requested about a year and a half ago, which is the audit, remember from the state that was on our child welfare system in programs? Is that correct? So they are different. The CCFSR is what's required every five years. Right. The request from the board to CDSS, that was completed, and we've gotten those findings back and presented to the social services committee. I remember that. Yeah. So that's different and it's different than the audit that was requested later. Was there any overlap between the two in terms of between the audit or the CCFSR? Well, basically the CCFSR is the assessment of our welfare, child welfare system and the audit were there elements that came or findings that came out that overlap? No. I think the request to the state at very specific things, CCFSR looks at the system and looks at data to determine what are the weakest areas and ask us to focus on the weakest areas. The request to CDSS was specific about some incidents that were occurring and so it wasn't looking at the system overall. The state is looking at the system overall and how where you are doing and then it picks the items That you are not doing well and then ask you to focus on them for the next five years Okay, so I Don't have the benefit of the prior five year assessment. I this is the current five year assessment So the obviously there's some troubling trends. When you look at the, at least the graphics when we're under, we're below the national standard when it comes to permanency in 12 months. We're below the state standard when it comes to the 10-day response and that's headed in a direction that we don't want to see. We are turning the corner on the timely in-person investigation and it sounds like most of this this in part because of staffing issues in the department. When you have a 32% as she said, vacancy rate. How does that compare with the prior assessment? So if we looked at data for the last five, when we was right at the beginning of the pandemic, we were actually doing quite well in most outcome measures. The impact of staff has had a significant issue. Our focus on the last sip, because that was responsible for that as well. There are four permanency measures, and three of them have to do with timely exits from care. So one looks at kids who have just entered foster care. That's P1 and then another one looks at kids who have been in care at least 12 to 24 months. And then the third one is what we've chosen here that kids who have been in care for at least 24 months. So last time around we had the P2. So that's kids who have been in care at least 12 months, two, 23 months and whether or not they exit it timely to permanence. And because of that, we did have improvements. That's why P1 or P2 wasn't selected this time around because we're performing better in relation to the standard. I don't have the exact numbers in front of me. Okay, well, it's good to know that we were doing better before and we can do better. Going forward, this is my third year on the board now and I've heard about the vacancies during my first year and I'm just trying to figure out when can we expect that corner to turn. So I actually do feel like the corner is starting to turn. We had as high as a 40% vacancy rate for staffing. With the support of under A.R. our agency director and central HR, we've been able to put in place some things that have made a difference. Continuous hiring has made a significant difference for us, bringing in staff as they apply has been helpful. The onboarding process takes a while, so knowing that we've gone from basically one induction class to this year, we're anticipating four to five induction class, slightly smaller but more people overall. We've also added, we've returned to our bachelor's level position, which we had not been utilizing, and we are getting staff applying in the bachelor's level position. So we made up an 8% deficit last year, and if that continues, I expect, and we seem to be stabilizing people leaving, people do leave this work. And there is a national trend of people not being interested in doing child welfare. So the fact that we were able to hold that 8% gain, I think that bowed to well for us this year and going forward. What we're trying to do now with our staff because so many have come in in this last few years is reiterate to them what are the standards that are expected and required by law in terms of the work we do with our clients. I'll often we see clients, what it looks like to really work with parents to return them home, seeing them in person makes a difference versus over Zoom and things of that nature. So I would hope supervisor in the next 18 months you will see some things that stop that skid, especially for like to be the 10 day notice, and things start to move in a better emphasis. I will say on the 2B measures, in our conversations with the state and part of what delayed our sit being improved, the state is more concerned about the immediate because that is when children are most often injured versus our 10-day assignments. We said we would keep both recognizing that our performance in the 10-day was not as it should be so that we could work on both. But we are closer with immediate than we are in 10-day and so we kept both so that we can continue to look at improving our system overall for emergency response. I appreciate knowing that. I know supervisor Halbert and supervisor Marquesne had put together a forum to try to encourage more foster care and families. And that was trying to address some of the issues that came out of the findings in terms of permanency and placement of children in foster care. What are some of the major barriers that you see in terms of our ability to place foster kids in more permanent settings? I think there's a number of barriers. I think it would be an honest assessment to say that our youth have a number of complicating factors and issues that they're addressing that sometimes can lead to stability and placement. I think kids do better with relatives than they do overall with caregivers. I think our research has shown that our kids are more stable and homes with their relatives. We have joined a kinship accelerator with the state to focus on improving our numbers of children placed at home with their parents. Our numbers are better than the statewide average, but we do think their definite room for improvement, including children being placed at home. We are always going to need homes for teens. And anybody that's raised to teen knows that teens are hard, and sometimes it is hard for caregivers to want to put up with what teens naturally go through. A teen with no trauma involved is going to have some ups and downs. It's hard for a caregiver to deal with that team and their trauma and the impact that that has on their behavior. So there are a number of factors. I think what we do is keep looking at each kid and what they need to get them stability and permanency. I noticed that you have some proposals and strategies in terms of trying to address this trend. So is your expectation that the trend would turn around in terms of the permanency, this is on the SIP outcome measure to be? We're hoping so and that's not just my best thinking but it's the best thinking of our partners that work with our youth in these programs and our staff. So we're also asking our parent advocates what do you think would be the best thinking to get the hits back at home and our peers throughout the state. So the beauty of the CSA and the CFSR process is we don't just take our thinking of what we think will improve outcomes. We look at other counties who are doing better and we try to pull some of what they're doing and implement that as well. Okay, if there's things that you think the board can help with, let us know. We appreciate it, Supervisor. So Supervisor Tim, I've covered a lot of questions. And so, I just have a few things here. The County Self Assessment highlights. And then the priorities. Was there any reason why other things were not priorities? Is it because you've addressed them fairly? in terms of the county self-assessment or the CFSR? I think the county self-assessment I think. Well, the priorities for this SIP are determined by the state. They actually go through your day. the Well the priorities for the SIP are determined by the state. They actually go through your data and Say this is the area that you need. Okay. So the system is not playing. Yeah, and the only Days they used to let us say this is what we would like to stay came up with the Priorities. Okay, and these are the three priorities. Yes. From the state. Go ahead. That particular slide, it's a highlight. So it doesn't reflect the priorities also for the timely investigation measure. But if that makes sense. Which one was that? Did that again? This particular slide, the priorities for the SIP, in-depth knowledge of permitting options and planning, et cetera, that one. I just chose that as a, to share some information, some of the priorities in regards to timely permanence, but it doesn't reflect the priorities for the timely investigations. The 2B measures, which were the last two outcome measures slides. Okay, is it different subject? Yeah, before I go too far, what is it? Oh, that same slide. CSA highlights priorities. Second bullet. After relatives, what is that word? Fictive. Pictive kin. So we recognize that children sometimes have strong relationships and there is no blood relationship. So in the African American community, you often hear someone say, talk about their cousin who there isn't really related. Sometimes it could be a teacher or a coach who is offered a Lot of stability or relationship the term the state uses is non related extended family member So Recognizing that all family isn't related by blood All right, you just never saw that word Fictive You know and child welfare sometimes the state makes their own words to fit what they want it to be. Okay. Okay. And it's good that we're making improvements. But it ordered to get to the national standard for permanency, we need to do more Correct. And if it doesn't show the state, how does it... Correct. And if it doesn't show the state, what do we fall with the state on this one? We didn't put the state average on this one. We use the National Guide. We can get the statewide average to you so you can have both. We'll get those to you. They're the same with the immediate response. It's got the California standard. What's the national standard? There's only a state standard for the 2B measures at 90%. Okay. I don't know supervisor. He asked a lot of questions. So we're trending in the right direction. You have a sense of maybe how long it's going to take us to get to a place of either at the state standard or the national standard with these. For P3 for permanence for 10-day response for immediate response for permanence. I don't know how long it's gonna take us to get to the state standard for the 10-day response But I would like to start seeing some trending upwards this year For the immediate we've hovered underneath it. So we tend to fluctuate between 88 and 90 percent, which is the average. So we are trying some things. And emergency response to see if it'll be different. We've put a unit of staff bachelor's level that we'll just look at 10-day. So, one of the things we're piloting, does it help to have some staff only do 10-day response and some staff only do immediate to see if that will improve things. So, we're trying some things on to see if we can find a solution that will help in the immediate. Okay, because I think it's a very asked questions that I don't want to be repetitive. Because I do think the staffing is clearly an issue, but you're working on it. Okay, any speakers? I have no speakers for item two. Okay, thank you. We have a speaker for item two. Alexandra. Hi, my name is Alexandra Kay. As I was preparing my remarks, the website said that my length of time was dependent upon the chair's discretion and here I say I only have two minutes. So I am going to truncate my speech as I go along. My name is Alexandra Kay. During the Social Services Committee meeting of January 27th, Supervisor Tam mentioned she had been getting complaints from constituents regarding the quality of the department's investigations. I am one of those constituents. And I can't play for you what Ms. Love's response to Ms. Tam's question was, but I will say that that was a non-answer. Her answer did not address how the department knew that these grave errors were in my son's investigation narrative. How did they know? I informed the department that the child welfare worker performed an incomplete investigation. They literally had no clue any of this was happening until I told them that it was. So there was no we, it was me. How does she know that these are outliers, anomalies, and are rare? My family never had a hearing so clearly these mistakes occur outside of those circumstances as well. Those are descriptives. Those are her opinion. Those are not quantitative data. The department has no way to know how often this happens because they refuse to measure this type of mistake. And the only reason I came to find out that this had happened to me was because I put in a request for my son's investigation narrative waited nine months for a copy to come through. I had also taken a lot of notes about the dates and times of my conversation so I could look back on it and see the mistakes and put together a timeline. It took additional letters, phone calls, and four attempts by the department at fixing the errors before we had a correct copy of the investigation narrative. And while it's easy to keep laying blame on staffing shortages and too much paperwork, there are six things that I think this SIP needs to pay attention to. Number one, that child welfare workers are not properly investigating cases. The child welfare worker, he did not call my son's doctor. And that doctor conversation unequivocally and totally absolves my husband and I as any and all suspicions. You can finish. Okay, suspicions thank you of abuse. And it took place, that conversation only took place because I called the child welfare worker supervisor and asked why he had it made that phone call. Number two, investigation narratives are incomplete. Once he finally did gather the correct information, the child welfare worker did not rerun risk reports at the end of the investigation, which resulted in further errors. Third, investigation narratives that are riddled with multiple errors, they're not caught by supervisors. My son's investigation narrative was signed off multiple times by more than one supervisor, and they didn't catch anything. Number four, there is no internal or external system to catch fix or measure these errors. When I spoke with Brittany Walker, Petter Groove, the department in August of 2023, she admitted to me she feared this type of thing was happening a lot and that it was, and this was her word, under reported. And yet, Miss Love in January of 2025 calls these anomalies and outliers. So which one is it? And how do we know if we're not measuring these things? Number five, all grievances against child welfare worker conduct go through the department, not through a neutral third party. And so they hide behind this well of confidentiality, but yet the state has lots of ways to monitor report on in-centre individuals like doctors, and police officers, and attorneys, and nurses that keep confidentiality, but also allow the public to be safe and informed. Number six, and finally, no audit trail of any of this exists. And it seems to be this vicious cycle. They don't know that there's a problem because they don't do an audit, but they don't do an audit because they don't know that it's a problem. The department cannot hide behind weak excuses and vague opinions. I'm lucky that I had the inclination, the wherewithal, the means and the problem. The department cannot hide behind weak excuses and vague opinions. I'm lucky that I had the inclination, the wherewithal, the means, and the time to fight this for my family. And even when allegations of abuse are eventually proven completely unfounded, there is a great amount of stigma and shame for families. Because most people don't want to put themselves out there and speak up for fear of what their friends and their neighbors and their employer and their children's teachers and their children's friends might think of them or to put a target on them for future CPS investigations. I am willing to take that risk because I want to make sure that what happened to us never happens to another family again. I want you to see my face, I want you to know my name and I want you to know that this happened to us, it has happened to other families who have not been able to speak up or worse yet. It is happening to families who do not know it is happening to them. So I urge the Social Services Committee to reject the SIP until there is language in it forcing them to measure the impact of this specific issue. Thank you for your time today. I have no additional speakers for item two. Thank you for your comments. Let's see if there's any response from the staff. It just seems to me you've raised some interesting questions. The state audit is currently undergoing practice and emergency response is one of the departments or units that's currently being audited by the California state auditors. So emergency response is being audited as we speak. And that is what's, that we at refer people to the public website, but that is what one of the items that's being audited. Separate from the SIP. The SIP is a system improvement planning, yes, they could be conflated to be is a huge measure, but this is the SIP goes into the state's PIP. It's 58 counties lead up to how the state gets their funding from the fed. So I don't think they're the same, but I think the concerns of Miss Kay will be made more public after the state's audit is complete this year. So the concern she's raised? The concern she's raising about our emergency response will be they are in they are looking at emergency response. So that will be part of their audit. Yes. So Michelle, can you clarify who they are? The California state auditors are looking at it not CDSS, not the department. It went to the J-Lec Committee at the State Legislature, and emergency response is one of the things they are investigating. OK. I just make sure, so she outlined six bullet points. And did you respond to all six? It did not respond to all six, because I don't have all six on the top of my head. I think her several are regarding emergency response. Our situation came out of the 24 hour emergency response but my concern is that there were grave errors in the investigation narrative. The department thought that the investigation narrative was complete and it wasn't until I went back, looked at it, realized these conversations hadn't happened, that there were grave errors. And that is not something that it seems like the department is able to look at themselves. And so my concern has always been the only way I found out about this was because I asked for a copy investigation narrative. It took me nine months to get it and then started the fight to fix it. So families who don't ask for that investigation narrative don't know that these errors are in their house. Is that something that can be provided to families or no? Any family can request their investigation or if they want it. That's current process. After Ms. Case Incident, we did change some things about how our process was done. Investigations now follow the P&O code. So we actually used her incident to change some of what our practice was. I think that'll come out in the CSA audit because that's what they're looking at emergency response. All of the program, not the 2B measures, but investigations and everything. So I think all of that will come out. Okay. I appreciate your testimony and our staffs, you know, they're working on this both locally and them with the state as well. So I hope you continue to monitor what's going on. So ultimately, our SIP is really genuinely improves in our systems of operation when it comes to job protective services. Because we don't want to see it was acknowledged what you brought forth was helpful to our staff as well. And you're right, it's not all about the staffing shortages, but a lot of it is about the staffing shortages and their training and everything else. So, but thank you. Any other speakers? No additional speakers, right? Okay. All right. Let's go to our next item. Okay. The next informational item is a collaborative recording stopped. Recording in progress's a collaborative presentation between a Department of Children and Family Services, and Michael Cole from the National Partner for Child Safety. And again, we also have our AC Health partners and the audience if you have questions for them. And so with your permission, we're going to switch the order of the presentation and ask Michael Cole from the National Partner for Child Safety to present first. I have slides. I don't know. He's driving. Thank you supervisors for having me. I'm Michael Cole. I'm with the Center for the Helping Professions. We're a national nonprofit that works across sectors that sort of work in the space of supporting families, individuals, communities. We work specifically with those agencies within that, those sectors on how to build more safe, effective, reliable cultures generally. We provide the technical assistance and support the national partnership for child safety. National partnership for child safety is a national quality improvement collaborative. It was born of the 2016 within our REACH report that came out from the presidential commission on the elimination of child abuse and neglect fatalities. So it's modeled after similar quality pre-mic collaborative nationally. It functions sort of in the space of safety critical work. So it's places like aviation and healthcare where we bring agencies together. It's a peer-to-peer learning model. These models are typically anchored and I'll describe this in my slides around sharing data on low-based rate events. So for this collaborative, it's fatalities and near fatalities in Shell welfare. So it's that event that is fortunately rare in anyone, Shell welfare jurisdiction that makes it difficult to learn from. And it also, when they happen, they can have an outsized impact on the organization's culture. So there's three primary partners. Our center provides the technical assistance. KC Family Programs was responsible for advancing the recommendations of the 2016 Commission report. They provide all the support for the for the jurisdictions, all the infrastructure sort of for the national partnership. And then because it has a data sharing element, the National Center for Fetagorean Prevention at the Michigan Public Health Institute is our kind of our data partner. They house our data. Next slide. So as I said, the basic idea behind this work came from the recommendation from the National Commission, which was this recommendation to pursue applying safety science in child welfare or child protection context. And so there is a science to safety. It's this idea of bringing a systems perspective to solving problems, to developing safe, effective work inside places where you can't learn by failing when you make a mistake, it can be catastrophic. And in applying this, developing a specific kind of organizational culture that supports safe, effective, reliable care. And so, or aviation, whatever the setting might be. So, very much borrows from places like patient safety work being done in healthcare where they're working to reduce things like pneumonia associated with infections or wrong side surgeries, things that shouldn't happen, medication errors. So,'s bringing that kind of science, those kinds of tactics and techniques to a child welfare context. Next slide. So we think about culture in the work of the partnership in two ways. Cultures about how we do our work, our habits in our workforce, it's also about how we solve problems. And so to the point about how we do our work and habits supporting a culture, I'll speak a minute about some of the workforce stuff that was just being talked about because it's ultimately a big part of what we're doing is trying to help child welfare systems bring strategies that are actually effective at keeping folks in the work. I mean, it sounds like, and our team is just now getting to know, you know, you guys have just joined the partnership. But we do a lot of organizational assessment work, a lot of survey work with child welfare systems. We probably have the largest data set right now of individual responses from child welfare professionals around things like their safety in their organization. We ask some demographic questions. Nationally, it's only about 17% of child welfare systems. They're able to hire social workers. About 17% rather of child welfare professionals have a social work degree. So your ability to hire people with graduate degrees and only now kind of in filling this important gap with your turnover rate right now shifting to opening it up to people. That's where we really are different from some of those other safety critical settings that we are borrowing from or comparing ourselves to, which is that unlike places like aviation and healthcare, we don't pull from a pool of physicians and nurses and pilots who've trained for a really long time, have a license, have a professional overlay. We're oftentimes especially nationally hiring people with a related degree, they're just willing to come to do the work. And so importantly, we need to keep them in the work to build experience because even someone with a social degree or a graduate degree doesn't have a green child welfare, that's not specifically what they're being trained to come out of school and do. So it's really important that we bring strategies to keep people around and And turnover is a national crisis in Shell Wallford. We know that we expose folks to traumatic materials and there's this phenomenon we describe as secondary traumatic stress. We know just by virtue of being sort of in helping professions, this happens in healthcare and other settings, they're extremely high risk for burnout and we know burnout predicts turnover. So on the culture side, sort of on how we work in teams, that's the thing that we're working toward. It's how do we help systems build cultures that support keeping people around? And then on the problem solving side, we're gonna go to the next slide. Yeah, on the problem solving side, it's about bringing a systems approach to thinking about problems. And again, we anchored the collaborative to sharing data on fatalities and near fatalities in child welfare systems. We bring a systems thinking approach to reviewing those events. It's kind of a root cause analysis approach to looking at child fatalities. We know historically in child welfare settings, we've struggled nationally, again, I'm just getting to know Almeda. We've struggled nationally with high profile event happens. There's a lot of shame, a lot of brain, a lot of media attention. It drives our workforce underground. They begin to practice from a place of fear. They're much more conservative in their practice, much more likely to bring kids into care. And so we see foster care numbers spike after high-profile events. And the approach of looking at problems that sort of focuses on who did what, who made what mistake or broke what rule, this sort of bad Apple approach, doesn't help us understand sort of the systems things are going on inside. So we want to build approaches to responding to these events that are focused on learning from where do our system right now and how can it be better next time? Next slide. So it's currently, I think we sit at 40, job welfare jurisdictions. Alameda Riverside County is not yet on the slide, but they believe they're coming in. So, Alameda is the second California County to come in. Generally speaking, shallow for systems around the country, you're organized to either be county run with a state overlay, like you guys are on California or their state run, like where I come from, Tennessee, where the shallow for system is a state entity. The 40 jurisdictions represented in the national partnership, We Partnership were about 65% of all kids in public child welfare. Actually LA County was one of the first cohort of eight jurisdictions that came in in 2019. So from 2019 to 25 we've grown from eight jurisdictions to 25 and as I said this is a national quality improvement collaborative. It's about peer to peer learning. And it's about focusing on those internal QI processes. We can bring some strategies to jurisdictions to help them learn from not just the critical ones since they're involved in, but also bring this different approach to thinking about their workforce. I think that's all the slides I had. Yeah. So any questions? You just saw our county system improvement plan presentation and I was intrigued when you said or quoted from Peter Drucker's book about strategy for breakfast. And we obviously have an opportunity with some potential culture change because of vacancy rate. And we're talking about implementing some system-wide strategies to reverse some of the trends that came out where in terms of emergency response, do you see some of those strategies being implemented in a better situation given the staff change. Because basically you're saying whatever the cultures and habits of your organizations that overrides any strategic thinking we might be trying to implement. Yeah, I think we really came at this early day perspective of it. One, there's not a ton of evidence-based practice in child welfare. It's not like, you know, I compare the work to aviation a lot where, you know, your innovation, the goal is really just overcoming gravity and not a pilot, but it's mostly just about lift and thrust and there's math to tell us how to do that in trouble for overcoming things like intergenerational poverty and substance abuse and trauma. Right, so we don't have a lot of math certainly we don't even have a lot of good evidence based practices but even if we did right now nationally we'd be handing them to a workforce that was ill-equipped to even employ them. So I do think that and frankly it's not getting better not getting better. I think jurisdictions like Alameda are being very smart and are being creative and they're trying to figure out ways to open up the doors and bring in more people. But we are struggling in the public sector to hire school teachers and firefighters and cops and shovel for professionals. So 100% I think that focusing first on building that as you're bringing in your other strategies is critical. Yeah, I very much believe, that's a popular quote, so I use it as a device when I'm giving talks, but I also very much believe it. I think we probably all experienced it, right? We draw up, you know, our best new strategies and strategic plans and then we introduce them to, you know, a culture that's just not really prepared to implement. Okay, thank you be an overview of the Department of Children and Family Services collaborations. Next slide. So this morning I will be going over our collaborative efforts in partnership with Alameda County Behavioral Health, Alameda County Probation, Alameda County Office of Education and the Regional Center of East Bay. I'll be covering the Interagency Leadership Team, our comprehensive prevention plan, our crossover youth committee, and additional collaborations with partners and the National Partnership for Child Safety. Next slide. So the Interagency Leadership Team, the concept of the IOT was created by Assembly Bill 2083 for Children and Youth System of Care. It requires counties to develop a memorandum of understanding outlining the roles and responsibilities of the various local entities that serve children and youth in foster care who experience severe trauma. Require partners are child welfare, behavioral health, regional center, counties, office of education and probation. Our Alameda County MOU was signed in May 22 and is set that to expire in 2027, I'm sorry for the type of there. It's 2027. There's active involvement by all of those partners. The IOT meets twice monthly, I'm sorry, next slide. And we seek to address issues for youth crossing multiple system. For example, young people will sometimes get arrested, will be at juvenile hall, and then they're released. Somebody needs to pick them up and sometimes it's not appropriate for them to go home, but for child welfare, we have to do an investigation. So we have some system gaps about where young people can be in the interim. Currently, one subcommittee of managers to build relationships on multiple levels. So it isn't just my peers at my level. We also have our managers meeting to discuss these same issues so that multiple people are talking and trying to address the concerns. There is an executive leadership team that was formed to create an interagency coordinating council comprised of agency and department leads. So for social services, Andrea Ford is our department lead on that agency lead. Next slide. Our comprehensive prevention plan. The Federal First Family First Prevention Services Act was enacted into public law 1-1-5-1-2-3 in 2018. Am I, it's many components, it creates an opportunity for states to create prevention services programs that allow states the option to access uncap title for e federal financial participation for the provision a specific evidence-based mental health substance abuse and in-home services to children at risk of injury into foster care their parents can care King Care and Garbiter's, and pregnant and parenting youth in foster care. Next slide, please. In California, counties were required to submit a comprehensive prevention plan to access that funding and for expansion of their prevention services. Our plan was approved in October of 2023. We have active participation in that plan by Child Welfare, Prohibition, Behavior Health, and a host of community-based organizations that provide services to children, youth, and families in Alameda County. Members of the CPP have participated in statewide convenings and monthly county meetings. We're in the process of developing electronic resource guide. We have participated in the development of community pathway for services. So for families that don't rate the high risk of child welfare, they now have a community pathway where they can seek services directly from the community without the stigma of child welfare. Next slide, please. We also have our Cross Over Youth Practice Model Committee. The Georgetown University Cross Over Youth Practice Model was created to address the unique needs of youth that are at risk of or are fluctuating between the Chatt Welfare and Juvenile Justice System. These youths are referred to as cross over youth. The committee was created after participation again by Chatt Welfare, probation, Alameda County, Ossova, education, the juvenile court and behavioral health in the Georgetown University CYPM Institute. Next slide please. The committee meetings regularly meet to address the issues that arise for youth between these systems and facilitate improved communication between staff at multiple agencies working with these youth. The committee's membership is again comprised of child welfare, probation, alimony to county office of education, the juvenile court, behavioral health. We have youth advocates, former youth that have been through the child welfare system, parent advocates, parent advocates, or parents that have been through the child welfare system. The district attorney's office and the public defender's office are all part of that committee. The committee has met regularly since 2015. Next slide please. We have additional collaborations with county partners. We have our high need to youth committee. These are quarterly meetings to review and plan for high need to youth who are being served by multiple county agencies. Shall welfare, probation behavior health. We have an interagency placement review committee. Participation in that committee is by Chattwalfaer probation and behavior health. This committee reviews and approves youth being placed in short-term residential treatment facilities. Next slide, please. Additional collaborations with county partners. We have our qualified individual process. Following approval by the Interagency Placement Review Committee, it is required that behavioral health review information and make recommendations to the department and to the juvenile court for the appropriate placement of the youth. We have a subcommittee of juvenile justice, delinquency prevention committee, JJDPC. This is convened to address the issues that arrive when youth are between systems. It's seeking to create a safety net for our youth in the county who are set status offenders. Those are kids who are running away and not going to school. Things of those those types of issues. It's comprised of child welfare, probation, court, the district attorney's office, public defenders office, and the J.J.D.P.C. commissioners. Questions? Thank you, surprise and mildly. I appreciate the background on the interagency leadership team and the public defender's office. I appreciate the background on the interagency leadership team. I appreciate the background on the interagency leadership team and some of the work that they're doing. The collaboration is among agency heads. Is that correct? Since? I'm sorry. For the IELT has two components. There is an executive branch which is comprised of agency and department heads those at under a is level. Andrea and her peers. I don't know who all participates in that. Okay, you can finish the question please supervisor. Pardon? Can you complete your question?. So I think you recall we had a board work session and we involved a number of different providers at their request. And then subsequently, we, the board at their recommendation had requested that audit from the state, but they also requested Some sort continued collaboration with the providers and a lot of those providers we have Multi-million dollar contracts with at the county, you know, whether it's West Coast and Senna that provide child welfare services. So I was trying to understand whether there's some sort of forum or venue in which they could participate and if they have participate, I didn't know. And then it would seem like this interagency leadership team or this collaboration among the different agency heads could be like a good opportunity to be opened up maybe. No, the IOT is prescribed by the state of California for the system partners that are serving the children. It's a bit of a conflict to have contractors in there, developing the services that may go out for RFP. I got it. But on the executive ICC committee, that Andreas, people have. We have a member of the collaborative who participates Matthew Madius, but he represents the collaborative around that table. And he has also been invited to the quarterly assessment center stakeholder meeting. So our assessments are steering committee. So has there been some collaboration subsequent to that meeting we had? There's been a lot of collaboration with those same And as I just Well, not with all the participants. So that meeting was in September 2023. And as I just mentioned, Matthew Maddias participates on the Department Head level committee. He represents many of those, the CBOs who were at that September 2023. Okay, meeting. It's interesting that some of them are asking how come the loop didn't get closed with them following that meeting that we had in September 2023. So were those providers at, you said we're represented at the meetings subsequently? Yeah, so again, I'm based on my understanding. Matthew Maddys from the collaborative was selected to be that person to help close the loop between the providers who were at the September 2023 presentation and what's happening now with IOT and systems improvement center child welfare system here in Alameda County. Again, we were told that he was a representative and he represents the collaborative around a table. So this group was also informed of the requests for the audit and the findings from the audits and the implementation plans. They were informed because largely they requested it. So the letter came from was signed by Supervisor Miley. It was drafted by members who were at that September 2023 meeting slash presentation. So they were aware and I think there was subsequent interview by the State and Department of Health Care Services and California Department of Social Services. They interviewed members from the team that met in September 2023. I think they also received the findings because as part of that Department Head Committee, Richard Koneck is a consultant that was retained by Elise Castro. And he's also like a conduit between the IOT, the department head meeting, and in many ways the collaborative through Matthew Madness. Okay, thank you for that background. Because I think the agencies are listed in this collaboration, the behavioral health, county probation, office of education and the regional center and our agencies are absolutely critical in terms of that coordinated efforts and I want to make sure that there's an understanding that we do meet frequently and regularly and that we do come up with programs and suggestions in response to issues that may have arise and we do take corrective action and I want to make sure that that's communicated I think in the in the broadest way we can and if there are some opportunities that we could do that with the providers, which sounds like there has been some collaboration and some meetings that happened after September, right? Yeah, there have been multiple meetings since September 2023, and we've also had, I think, two or three retreats where additional providers were invited to those retreats in a data stand. Thank you. Sounds like some of the members in the provider group wasn't at those meetings, so they may have not known about it. I will discuss with the Leadership Council how we can better communicate with the larger provider community about our progress in many of these areas. Yeah, so thanks for the presentation. So I was trying to follow all this. So we have by law the interagency of the, it's called the IOT, that's the interagency of the It's a call the ILT That's the inner agency leadership. Okay, correct. And that's prescriptive then From that team we have an executive and from the executive they produce this Quartnating Council that's this coordinating council. That's the coordinating council, yes. Under the executive. There's none of us. The coordinating council is the executive. It's the executive, okay. And then the coordinating council, The other agency, coordinating coordinating council is that the responsible for implementing the comprehensive prevention plan. Oh, they are that was where's that coming to play. The IELT separate child welfare was responsible for gathering our partners together and there was active participation. So that was a county-wide more my level and below that created the comprehensive prevention plan. So okay okay so we got the IELT required by the law and we got the I, I, I, I L T, that's required by the law. And we got the executive. So. So how is all that working in terms of the, the interagency coordinating council. Do you do you have a providers of that? Is that the one with the department heads leadership? It says the executive leadership team was formed to create an interagency coordinating council. So this is just agency and department heads. That's it. Agency department heads, again, at least Castro, Superintendent Alameda County Office of Education. We have Judge Jackson, who's also a member, the probation chief, Brian Ford, Dr. Trouble. Now also a participation before Dr. Trouble, it was former director, Colleen Clannan, I mean, Colleen Chala, Matthew Maddys from the collaborative and myself and I think that rounds out that council. So before I leave that, so what's being achieved through that group getting together? I don't want us to overseen the work of the IOT but I'm just really just staying abreast of what's happening with IELT and the retreats that I previously mentioned moments ago are coordinated by that council. So the retreats that bring together partners that are part of the IELT as well as the community based organizations are invited to that retreat to get a sense of what's currently happening, what can be done better in terms of collaboration and improving not just the child welfare system, but just looking at it and I forgot to mention Kristen Spandles is also part of the committee. Looking at how we can make a difference in youth lives, Kristen was brought on board because of use children 0 to 5. So really just looking beyond just child welfare, how the school system can assist with some of the work that the child welfare system is doing. It's just a number of touch points that we're looking at. And it was the Office of Education, whose dollars actually brought this council together and hired that consultant. And he is, he also has a contract with the California Department of Social Services. So look at the overall system of care. I think is an Alameda County or state of California. The Gantissame is for your connect. And I will ask Dr. Trouble, if she has anything she can add based on one or two meetings that she attended, which at least Castro thought were very instrumental. Do you mean mostly? We mean monthly unless the meeting is canceled. Okay. Thank you Supervisor Carson. Us, excuse me, Miley and thank you Supervisor Tam. On my heart and never for far from my thoughts. I appreciate Director Ford's question. I think to get to the essence of your question, I more recently was added to, I had not participated. But the way that I see it is that is a broader system picture and look and mapping. What happens, I believe, humbly really comes through, for example, some of our here with these are executive leader on our child and youth family system for our entire department. Some of the concrete things that have happened as a follow-up to that have been, we have met jointly with the provider and social services has graciously added a match where we could not or there was some flexible funding with West Coast and other providers. So we're thinking how to nimble do things a little differently. So there have been some concrete work that I'm aware of. I'm a little later to the broader agency and our inter-agency coordination. There's also a lot of meetings that happen, both crisis, some of the legislation that I think that was mentioned in the earlier slides that was presented, required around crisis and immediate action. There's also placement STRTPs, and in some cases, when social services have contracted, we've then stepped in with them because of the coordination that now happens on the ground. So we've also tried to make contracts with the folks that they've contracted with or when they're system gaps. So I think humbly, most of the work, not that leadership is important, but trickles down from that broader agency on a day-to-day basis. And I think those folks, including director LaFanza and others, Michelle Love and others, really are doing the coordination work as a follow-up to that meeting. So I can defer and stop there or defer to Mr. Gibbs if there's questions. And this is part of our system improvement plan. This isn't part of our system improvement plan. No, the system improvement plan is specifically for child welfare. The ILT is just required by the state where the broader system of care for all children. So there's no connection. The SIP has no connection. The SIP is just... So this group of folks who are being... doesn't provide any feedback on system improvement? Well, they were invited to participate in our focus groups. So when we did that CSA, we invited the Court, Avery Health, we invited the CBOs who are actually part of the focus groups for our system improvement plan. So that's how they're included. We get everyone's opinion at the very beginning of the process when we're developing the CSA. The CIP then comes out of, you've gathered all this information. What specifically are you gonna do? So their opinions were asked at the beginning when we started, yes. Because there's, maybe I'm missing it, but with this IALT, this Interagency Coordinating Council, they're looking at the big picture, the responsibilities of all these parties as it relates to youth. So I would say the interagency leadership team, because there's two, the interagency leadership team and the interagency coordinating council. The Interagency leadership team is looking at our broad system overall in terms of services to children and youth. Our goal is to make sure one that we're coordinating well together if issues come up. If we are recognizing there's gaps in our system, how are we fixing the gaps, and our interagency leadership team often utilizes the contracts we have to see if they're gaps we can. Okay, so at least Castro, she's elected official. So how do we know it's coming out of this group of dynamic people that are meeting? Well, the coordinating, so the interagency leadership team is my level supervisor. The coordinating team is on Drea's level. So on Drea is a regular participant in that meeting. So you would hear from her. And I can't say that our agenda is very different from the IOT is just more expanded. So first five is not a signatory on AB 2083, the MOU, but they are part of the coordinating council. As Michelle mentioned, it's not appropriate for a CBO to be on IELT, but it's appropriate to have them as part of the coordinating council. So our role at the coordinating council level is more expanded to try to look a little bit above and beyond what AB 2083 mandates to see how we can address a larger system improvement plan. So suppose you know as an example we're concerned about truancy would both entities be looking at truancy? I think if it were as it currently is if it were that we have to do with the committee. We have to do with the committee. We have to do with the committee. We have to do with the committee. We have to do with the committee. We have to do with the committee. We have to do with the committee. We so right now we have a subcommittee of almost the same partners of IoT, but more court stakeholders where we are looking at the gap. How are we going to fill the gap? And true and see is one of those issues because it doesn't fall in specifically any of our other systems. Okay. Good morning, supervisors. I just wanted to piggyback and add a little more context of what Michelle and Dr. Trouble were sharing about the IOT. So the IOT comes out of AB 2083 legislation back in 2018 and our IOT team we meet twice a month and some of the concrete work that gets done is you know we look through the shared legislation between our agencies and look how to implement that across our agencies. For example AB 1051 has to do with out of county SDRTP placement, short-term residential treatment placementements. So when probation or child welfare has to place a youth out of county, AB 10-51 impacts that behavior health as a managed care plan or mental health plan, we're responsible for providing behavioral health services to foster you from probation youth. So our three agencies have to be able to work together in coordinating those placements and making sure that you when they get placed are receiving services timely. So these are some of the concrete things that the IOT works on. And as Miserl mentioned, we created a subcommittee which is the managers and supervisors who are overseeing the day-to-day work. So as our IOT are analyzing and developing plans and protocols for how to implement the shared mandates and legislations that we have, this subcommittee made up again of those supervisors who are managing that day-to-day work are more involved in the implementation and the troubleshooting of what comes up. Because if things come up, they're able to see it at a day, every day level, and able to troubleshoot those issues or escalate it to our level so that we can help sort out any problems and help manage. Also, we play a big part in case consultation for those high needs you that may get stuck in an emergency room and needing direct-level approval to make sure that they get transitioned out of an ED timely. So those are also some of the key concrete elements that come through the high-altitude. Okay. All right. Let me switch over to the comprehensive prevention plan. You're saying that's just you, but it's under your... The Compreh-Well Chatwell Fair initially led up in partnership with probation and behavioral health. And a host, there's so many community partners that help develop that because the goal of the comprehensive prevention plan isn't that the big three systems are providing services. We're looking to the community to provide the prevention services to the youth and family of Alameda County. So they are also help driving and leading this work. And is there any connection between that and the system improvement plan? There's no connection between the system improvement plan is just going to be chattwalfair. The connection between the system improvement plan is we invited those same partners to come talk to us for our CSA development. They're at the beginning of the process and then it comes just back to the set. It's just ch not welfare. Okay. Then you mentioned where's the crossover fitted? The crossover doesn't fit in. The request for me was to make sure I highlight it for you and supervisor Tam the various ways. The department was collaborating with certain agencies. So that was just one of them. Okay. Viv, so the National Partnership for Child Safety, there are the IOT. They're not on the IOT. They are just one of the collaborations the department has to improve services to children in youth. And we have the opportunity for my coal to come present to you. I think the work that they're doing is dynamic and will help us for critical incidents. So you as the board will see the reflection of what we're learning when we have a critical incident present to you. It just seems like there's a lot of collaboration and conversations going on across the board here. There is. And you know, in my simple mind, I'm trying to figure out, so, where's this taking us? Are we getting into a better place? Because I'm trying to see what the outcomes are. Because of all of this, seems really good. And that's why I was asking about the system of prudent play. Because I thought with child welfare, behavioral health had a role to play in child welfare. And I need to hear from child welfare at all. I mean, we'll be here health and all. We're talking about system improvement, but they don't have any role to play. The system improvement plan really is the child welfare system. That's it. So, those probation habits on? Probation is part of the system improvement plan. Behavioral. But not behavioral health. OK. And so, 10 questions supervisor, I think we're headed in the right direction because there are lots of partnerships and collaborations that need to happen to care for youth here in Alameda County. And as part of what the coordinating council is looking at also is a mapping process of all the meetings that are happening across the agency and who sits at all those different tables to see if there's any duplication. And you only just got a fraction of it today. If you look at all the meetings on the chart that's happening throughout the county, it's probably upwards of 50 between 40 and 50. So the coordinating council is looking to see how we can better leverage some of those conversations and bring about greater efficiency. And I see an emergency coordinating council. Yes. Executive body. Yes. And we're doing that in collaboration with ILT and the community partners. Now, which one of these bodies is dealing with medical? That would be social services and they see AC health. But is it at the IELT or at the coordinating council? To deal with Medi-Cal? Yeah. And what do we expect? Well, the officers of education played a role in that. We have your health. And health care is playing a role in that. And you do too. So who's talking about Medi-Cal? I think in many ways we all are. But what are these entities? All the ones you name because we all have our different roles in a Medi-Cal program. So, you know, social services does enrollment. So when you look at the healthcare infrastructure and its totality, I think everyone has their own individual rights. I don't even talk about that at the Board of the Navy Council. Not in the terms that you're asking, I think. So, for example, one thing that came about medical is that if they're cuts to the medical program, what can we put in place to sort of address some of those cuts? Can we look at some other financing models or what legislation might be driving some of the cuts in medical but not very specific in terms that you're asking? Yes Good I was actually going to say something very similar to what Andrea mentioned Is that any impact that happened to Medicaid from federal policy changes will sort of be a broad system-wide impact on us and providers. And, you know, we'll have to kind of work through that as that comes. But I was going to note, and maybe that's what Dr. Shribble was coming up before, is that within this particular space, you know, behavioral health has a very specific role to play in terms of a benefit that they're still required to provide. And so depending on how things shake out at the state and federal level, there is also a potential for the county to be required to provide certain benefits because they're a part of the Medicaid benefit. But then funding, et cetera, has changed at the state and federal level but it doesn't take away our obligation to provide the services. Right and all I was trying to do is get a sense with these collaborations where's that discussion taking place? It is a taking place. Yes, it is taking place. As I said, I can't comment on prior meetings, but when I was invited to participate, for example, I met with the county supervisor, a superintendent, Caster, yes. And we talked a lot about, so for Hersch, I was appreciative, she felt there was a new learning for her. We talked about how to leverage Medi-Cal, very concretely. What we did was help them to connect to the CalAIM and talk about how the state is changing and using their attempts to leverage school-based funding through Medi-Cal as well as system-wide general Medi-Cal. So we talked a lot about that. What that I think fostered is an example that I mentioned where some of the providers are outreached both to us and then to social services to talk about how they can leverage. The broader discussion is now from what I understand, only now recently coming into the fold. And so we're talking about how all of them will need to bear for MediCal, some of the school-based funding, CalAIM, where they all intersect because we're all looking at some of the impacts potentially to reductions, including image-to-say-improvention, and then how we can coordinate and leverage it. So I believe what they started with was a system map and I believe now they pivoted to look at how the system map then interlays with funding and how we can better coordinate that so that the folks that was mentioned, for example, by Michelle Love and Director Gibbs can actually do the work and without any interruption as well as again the mandates that mandates that we're continuing to do. So I think that is more of a recent discussion from my understanding in terms of the leverage of MediCal and we apologize, we probably brought that in there because it's really on our mind given what the interim director mentioned. So. I know apology, because clearly that's a big topic of concern. Yes. And I just thought with this executive committee in the agency coordinator council that that would be a natural there. I thought, but. I believe it is now being discussed. Yeah. It's newer, but it's well, I think you might hear more about it in your future. And I think also what's missing from this collaboration on paper is the Alameda Alliance because we are a single man. Yes. So I think each one of us are separately having conversations with the alliance around some of these changes that are made. Right. Well, we definitely need to have a follow-up on this down the road to see how things are progressing. Now, one other question I have for Nika, with these collaborations and with these trends and changes, what role is the Center for Healthy Schools in Neighborhoods playing in all of this? So Lisa Erickson our director for that program has been working closely with Director Gibbs, and she continues to be our liaison overall to the Alameda County Office of Ed. And so it's been infused in some of the mapping work that was done, I think she provided support for that, but she's pretty integrated on the back end with our team. But she's not part of the executive no. No, but she's there to support, you know, a doctor's trouble, which she might need. I see. Okay. So I think it would be very helpful in the future. When we have another follow, if this is a mapping that you guys are putting together, you folks are putting together. If you could share that with us, you know, the joint committee. So we're going to flag that for an item down the road as well. Because I want to kind of get it at a better understanding of all these pieces. Right. Yeah, everything else surprises you, Adam, before I see 30 public speakers. Yeah. What I wanted to comment on, I saw some sort of specific benefit from this collaboration recently within my district because a lot of the school districts were being told they had to figure out how to bill for mental health care, behavioral health care in the schools with school-based programs and they were not equipped to do that. So the county superintendent of schools was able to take that on and do the billing for each of the school districts because they had access to services that were provided by behavioral health, other different sources of funding, whether it's school based, medical, and other behavioral health sources. So I think this collaboration is something that it's essential, frankly, as we move into this different way of dealing with CalAIM and also as you will hear later some of the issues that the Alameda Alliance is facing as well. I did have one question and this was something that my chief of staff brought up because she used to be the principal at BayTech School. During the pandemic, she was saying she was having to call child protective services for kids that don't show up, basically true and see. So you're suggesting that she should have called probation instead of child protective services. Yeah, true and C isn't something we actually respond to. So it is like a status offender, a 601 issue. So if there might be some issues that they suspect that might be happening in the family home, they don't call child protective services. If there are other issues that are going on in the family, say it's a little kick, because it's easier for me to think of an example off the top of my head. Say there's a second grader and the mother never gets them up, never gets them food, they're not getting to school. That's child welfare. They should call the child a peace hotline. If it's a teenager cutting classes and not going to school, and the parent is doing what they're supposed to, and the kid just isn't, that isn't a child welfare issue. Thank you for that distinction. Do we have any speakers on this item? No speakers on this item. Okay. So this was a great item where you covered the collaborations to help me have a better understanding. You know, I've been around for a while getting more into the weeds on this is helpful for me with healthcare and then the connection with social services, office of education, in-lients, first five, et cetera. Now I know, supervisor Tan, Tan is our policy expert on all this stuff because she sits on both committees and she's on the alliance. You're not on first five though. So she knows a lot more than I know. But I'm trying to catch up with her to the best of my ability. Okay. We have any speakers on not a gymized items for today. I have no speakers for public comment. Okay. So we're adjourned. Thank you. Thank you. Thank you.