Behavioral Health Advisory Board - Oct 28, 2026

Thank you for being here, everyone. It's a great day to be here representing our community. So let's start with an invocation, and I'll go ahead and start if we can bow our heads. Father, we just thank you that we can come and represent those that are in great need, and we're thankful that you have placed such leadership in organizations that care and that have the resources for us to be able to serve our community. So we're thankful. Give us wisdom, direction as we come together today, right now. In your name we pray. Amen. Okay, let us rise and say the Pledge of Allegiance. Pledge of Allegiance to the flag of the United States of America and to the republic over which it stands, one nation, under God, indivisible, liberty. Thank you. Okay. How are we doing with our quorum? Are we good? Good morning, everyone. We have a quorum. We can proceed to the next step. Wonderful. Thank you. Well, at this point, we're going to give opportunity to be heard. We would need to do a quick roll call. Okay. Let's go ahead and do that. Good morning, everyone. Ms. Miriam Stewart? Present. Dr. Tiffany Amrich? Present. Heather Winters? Present. Karen Anunciado? Present. Victoria Millett has her designee, Manny Sierra. Carlos Martinez? I'm here. Laura Narado? Present. Lauren Rabido? Christopher Wing? Present. Dr. Janita DeJesus? Lieutenant Elio Perez? Lourdes Dorado? Present. Claudio Perez? Present. Mr. William Delaney? Alfredo Hernandez? Michelle Fernandez did reach out, requesting to be excused today. Susan Holtzman? Ms. Carolyn Acosta did inform me she'd be a few minutes behind in traffic today. Judge Verde has a representative. Mr. Tim Coffey here. Dr. Joseph Poitier? Present. Gustavo Cruz and Luis Espinosa. Okay? We do have a quorum. We can proceed at this. Oh. And our chairman, Senator Commissioner Rene Garcia? Present. We definitely have a quorum. We can proceed with today's meeting. Perfect. Thank you so much. And I apologize for being late. And it's one of those days I'm going to have an 11 o'clock call that was just scheduled right now about HIV funding. So I'm going to have to take that out. So I may have to step out early. So, Mr. Vice Chair, if you don't mind continuing the meeting when I step out, I will really appreciate that. So, Amanda, where are we next? We're going on, I guess we are in public hearing? Yes. Okay. So this is a time that we give the public an opportunity to speak on any issues. So this is their opportunity. So I think we have three people that have scheduled. And again, as we always move through our agenda, whatever item we're on, the public that's here will always have an opportunity to speak on that as well. Obviously, as long as we stay cordial and respectful of the quorum, that's what I always ask for. And I think everyone here on the commission will ask for the same thing, and we know that we will. Anyway, so with that, we will go to Anthony Acampora. Anthony, if you don't mind stating your name and address for the record and who you're with. My name is Anthony Acampora. I'm the National Director of Faith Services with Banyan Treatment Centers, 950 North Federal Highway, Pompano Beach, Florida. I want to thank Amanda for this invitation. And I've been with Banyan for 11 years. We started a faith-based program in 2015. It's called Faith and Recovery. It's a non-denominational, Christian-based program. It's part of Banyan Treatment Centers. Banyan Treatment Centers was established in 2013. We went from one location. We now have 18 throughout the country. The main programming with the faith-based programming is in Pompano Beach, Florida. It's a non-denominational program. We don't turn anyone away. We get backgrounds, all different type of religious backgrounds, some people with no faith at all. They come into this program. Sometimes they've been in a lot of different treatment centers throughout the country, and they want to try something different. So they come into our faith-based program. It's non-confrontational. It's non-condemning. But it is a Bible-based program. Banyan was founded by Joe Tuttle. Back in 2013, he wanted to put this faith-based program in Pompano. There was a lot of people that didn't want it, but we ended up doing it. Now we've had over 19,000 clients that completed this program in the last 11 years. We were rated by Detox Rehabs as one of the top 10 Christian-based programs in the country. And it's an integration of faith and clinical. So it's not all faith-based. There is clinical programming within the faith and recovery program. Clients have a therapist. They're usually there for about 30 days. We have apartments that they stay at. So it's a PHP level, partial hospitalization programming. And they have a therapist. They have a treatment plan. And we've seen phenomenal results with this program. I run into people all the time that were in the program 5, 6, 10 years ago. And some of them are missionaries. Some of them are working on staff at churches. And some of them are just in recovery and doing phenomenal. We launched a mental health program in 2014, or no, 2024, sorry. That was really a result of the results from the faith and recovery program, which was more geared towards substance abuse. So we had incredible results. Our AMAs, which were clients leaving against medical advice, was very low in the faith-based programming. The length of stays were very high. The levels of hope on surveys were incredible. So it was really our clinical team, our clinical director, our executive director, our clinical supervisor, that wanted to implement the mental health faith program. And it's been absolutely phenomenal. We find that people with substance abuse, addiction, they connect with this programming. But the mental health clients seem to connect at an even deeper level. If you're an alcoholic or if you're dealing with some type of substance, you have some type of camaraderie, some type of community. A lot of times our mental health clients have none. They're just complete outcasts in society. Sometimes their families don't even want to deal with them anymore. So they find community. They find hope. They find God. And it's a beautiful thing to see. So I just was here on behalf of the invitation. If anybody has any questions about this, we'd love to collaborate with you guys. We know that you guys are doing amazing work down here. But I will be here. And also Jorge is one of our business development people. We are here if you have any questions. And I want to thank you for the invitation and thank you for what you guys are doing. Members, any questions? I do. I was corrected some time ago. Instead of using substance abuse, we use substance misuse. I'm not calling you out. I'm just telling you what I learned. But that's one. The other thing is you talked about mental health and substance misuse. I'll get there eventually, making sure that I get it right. Do you marry them both or are they two separate programs? Yeah, they are married. They're together. We combine them. We did that a couple of years ago. And we found that they work very well together. There's no judgment. There's no stigma if someone's dealing with substance versus mental health. They have a common denominator, which is their faith and that community aspect. And then we go to Calvary Chapel in Fort Lauderdale. They love that, celebrate recovery. But it's really just providing hope for people that are hopeless, giving them a voice, giving them an opportunity to heal and to move on with their lives. You said the program is a 30-day program? Yeah, they'll have an anticipated discharge date of 30 days, depending on how they do. Sometimes when you're processing a lot of pain in treatment, you start to feel a little bit worse before you feel better. So it could be a little bit longer, could be a little bit less, but usually 30 days is the ballpark. And is it inpatient or? Inpatient, yep. They stay at residence about three blocks away. The clinical building is at 950 North Federal Highway in Pompano Beach, Florida. So they're at the clinical building from 9 to 4. They have groups throughout the day, and then they go back to the apartments for lunch, and then they come back for a couple more groups in the afternoon, and then they go back to their residence. They have dinner. They go to meetings at night. So that's basically what the day looks like. Medication is administered? Yeah, we have medication. We have a whole medical team at Pompano, and every location that we have, there's medical. So they stay on top of that. We also have a case management team that works with them to get them back into society that helps them with Social Security, helps them with a whole bunch of different things. And then we also have an IOP program, which is a level below PHP, which we just implemented in the end of May of this year, and it's with housing. So when they finish the PHP level, a lot of the clients are very, you know, scared. Some of these people are coming off the streets. They don't know where they're going to go. They don't know if they could afford a sober living. With our IOP program, all they do is switch buildings, and they're able to stay there for 30, 60, sometimes 90 days as they're kind of, you know, getting back into society. Now, one last question for me. The cost. What would be the cost associated with this? It goes through mainly insurances. We take Blue Cross Blue Shield, Florida Blue. So primarily, probably about 80% go through insurance, which usually covers the PHP level and the IOP level. So there's really, as long as their insurance is something that we take, there's really not a lot of cost to the client themselves. And if they're not insured? We refer them to different programs. We have partners that do take clients that are uninsured. You won't take an uninsured patient? We sometimes do scholarships, depending on the situation, where we have brought in people that don't have any resources. But mainly, we'll refer them to places such as Calvary House, which is free, but they work there. Faith Farm is another one that we partner with. But yeah, so we have different partners that we refer to. So they have somewhere to go. But Calvary House just does substance, correct? It's a little bit of both, but mainly substance. Calvary House is part of Calvary Chapel in Fort Lauderdale. It's a discipleship program. It's a year long. So is Faith Farm. So those types of places, you don't pay anything, but you're working there. They have them do stuff there. So it's not like it's free because they're working. And I appreciate it, and I asked a question because if you take insurance, I don't see why we can't do take cash patients if someone wants to pay. Oh, yeah. We do take cash patients. I thought you were talking about, like, just bringing them in. Oh, okay. There's cash pay. It's probably maybe 10%, 15% that, you know, sometimes the families will pay. But it's mainly insurance, cash pay, and then there is scholarship opportunities. What would be the cost for a cash pay? The reason I'm asking these questions is it's important for the public to understand that they do if they – some of these individuals do not have – people don't have insurance. Right. For whatever reasons, families are desperate to get their loved ones into a program, especially one that has both deals with substance and deals with behavioral health or mental health. What would be the cost associated, roughly? Oh, the cost. And if you don't know, it's okay. You can come back to us, but it's – It varies. They do work on a sliding scale. They will work with people, our finance department. So a lot of times it's, yeah, they don't have the insurance. Maybe they were in between jobs. Maybe they don't have a job. We do take private pay, and they do – I know they're very lenient with that. We want to get people help. We want them to succeed. And, you know, our relapse rate, especially in the faith-based programming, is very, very low in comparison to general programming and treatment centers. Thank you. Any other questions? How many beds? There's 102 in Pompano beds. So some of our other facilities are a little bit smaller. We have one in Lake Worth. We have one in Boga. That's all mental health. Then we have one in Stewart, which is a detox residential level. So normally, if somebody's coming in, especially if it's some type of substance, they will go to detox residential level. As soon as that's straightened out and everything's okay medically, then they would step down to the PHP level, which is the one at Pompano. All right. Any other questions? Yes, sir. Presentation. Action Banyan, just for some of the board members, because sometimes we get it confused. I'm glad to hear that you have a strong spiritual program. We know it's important. But you accept all faiths in your program also, right? Yeah. We put it on all our marketing material. It's on our website. We meet clients where they're at on their spiritual journey. And some of them don't even have a spiritual journey. They might not have any faith at all. And some of those clients do phenomenal, because they kind of mix it into the ones that came there for the faith programming. But it's really like a no-judgment zone. And that's kind of how it should be in treatment. The common denominator is they're suffering, they're hurting, they're broken in spirit, and they're looking for hope. And so that's what we try to provide over the past 11 years with this faith and recovery program. Any other questions? Yeah, I have a question. Yes. Thanks again for your presentation. So when you say that the substance use and the mental health are married programs, and it's a 30-day program, at what point do you assess someone for a mental illness while they're going through recovery for substance use in a 30-day period? Because it seems like a short period to me. Is this a joke? It's not me. Thank God it wasn't me this time. Yeah, that's a great question. They get assessed before they even come in. There's a whole process clinically to determine what level of care would be best for them and what their background is. Some of them are more mental health. Some of them are more substance. So that's really determined before they even come into treatment. And they're separated by housing with mental health because there's different protocols. But as far as the clinical day, when they're in treatment, they would have the same therapist as the substance client. They would be in the same type of groups. We did it the other way as well, but we found that just allowing them to kind of integrate together and get to know each other and break down those stigmas and judgments that sometimes happen even within treatment. Sometimes people will be like, well, I just drink, and this guy's doing heroin, or I'm not. You know, we kind of break through that. You don't have that hardly at all, because I know stigma is a major issue with mental health disorders. So we try to break through that. But yeah, they are together, and there'll be different focuses. The mental health clients, their clinical aspect of it, they'll be doing more focus on mental health, and the substance clients more on the substance. But the faith aspect of it is the same. Thank you. I just had a comment. Thank you again for your presentation. I noticed you focused on hope, and so you're doing follow-up surveys, because you made a point to say that. And is that something that you're tapping into with former clients? Yeah. The hope levels, like there's surveys that we do while they're there, and that's something that we look at closely. And the levels of hope, that's one of the questions on the survey. It would go from maybe a two or three to like an eight or a nine after they came into the faith program. And that's really what caught the eye of the clinical team, right? I would always want to expand the faith program. We also send it out virtually to all of our locations. So there is faith-based programming at our other 17 locations, but it's virtual. It's on the screen. But the levels of hope were something that really stood out to our clinical team. A lot of our clinical team initially are not into the faith aspect. They're skeptical. Is this evidence-based? They don't get it. And then usually every time in the past 11 years with many different clinical directors, clinical supervisors, they come to love it within a few months because it really makes their job a lot easier because you don't have the behavioral issues that you do in the general program. You don't have people just leaving. And they stay longer, and we usually get tremendous feedback from the family members as well. That's a key component with this, too. We work closely with the families. So they're not going back to a situation where they're going to end up worse. We try to have those bridges built between the family before they even go. And when the family member is into faith-based, because a lot of times it's the mother, the father, the grandfather that want their son or daughter to do this, the restoration process happens so much quicker. They know that it's not just their son or daughter telling them for maybe the hundredth time that they're going to stay sober. However, now God's in the middle of it, and they love that. And I've seen that firsthand. Those relationships restore quicker because they trust it more. Thank you. It's beautiful. Thank you. Thank you. Great job. I appreciate you. Thank you. Be in touch. Next, we have Alfredo Hernandez. Hello, everybody. Hi. So I'm going to talk a little bit. Name and address for the record. Oh, sorry. Alfredo Hernandez, 3120 Northwest 19 Terrace, Miami, Florida 33125. Yeah, so I'm going to be talking a little bit about my lived experience with psychosis and just general mental health and how I ended up being in the Navigate program from Citrus and a slew of other things that were involved in my story that helped me recover, right? Okay, so I was just, you know, I started off as just a kid who experienced some adverse trauma, right, growing up. I don't want to get too much into it because it's a limited time. But, you know, I grew up and I started experiencing a lot of issues in my social life, in school, and I started becoming a problem child in class. And because of that, teachers took notice. They called my parents and, you know, I started getting diagnosed with a slew of things. First, it was ADHD, started getting a little depressed over time with the treatment that I was taking. I was taking medications and different therapeutic services, but it wasn't really the right fit at the time. So with that being said, essentially, you know, I end up kind of devolving into major depression over time. And I end up experiencing lack of emotion, lack of interest, suicidal ideation, which is huge. It's common. Uh, and I was hospitalized and, you know, there was really no hope for a while for me until, uh, my parents, uh, decided to take me to a different school. Um, and once I was put in a different school, it was like a whole different environment. The environment change was so important. Uh, I began to socialize differently. I spoke with different levels of disclosure, very low disclosure. I, uh, made friends that way, a lot of friends before I was very isolated. And because of that, um, I ended up becoming happier. But basically, this ends up kind of devolving further still. And that's because during that time, uh, I end up kind of like, I don't want to point out names, but I ended up looking for some kind of release of my intrusive thoughts, uh, rapid thinking, you know. Uh, so I ended up joining a yoga group. And within that, uh, I ended up kind of following a holistic lifestyle, right? I decided to stop taking medications because it was, um, very much promoted at the time. Uh, and as soon as I stopped taking those medications, it was held at loose, right? And I'm sorry if I'm using that vocabulary, but I, I almost immediately started experiencing, uh, symptoms of psychosis such as, um, delusions, grand, delusion of grandiosity, spiritual delusion. Uh, um, I heard voices. I saw hallucinations. It was, you name it. Everything that psychosis entails was my experience. And it was so, I had no idea what I was, what I was experiencing at the time. I thought it was just like the next level of like growing up, which doesn't make sense. But to me, I was experiencing it and that's all I understood. So as I came back home from, uh, from a trip that I was taking, um, from that yoga retreat, right? Um, when I came back, it was just, it was just horrible. I started escaping home. Uh, I started stealing from stores, uh, and I started jumping into the gates of people's houses and making a ruckus and the police had to get involved, right? And when police got involved, uh, that's when, um, it was like the beginning of, I would say the improvement of my mental health. And I have to give a huge credit to the police because if the police did not get involved, I don't think I would have ever really started to recover. Um, so with that being said, um, I was actually put into a guardianship, a legal guardianship. I don't know if you guys know what that is probably, but anyway, I was put into a legal guardianship and basically all my rights, all my basic, you know, civil rights were taken away. I couldn't drive. I couldn't work. I couldn't travel. So on and so forth, couldn't own a gun, obviously. Um, but basically with all of that, uh, I was still hospitalized another time and I was put into the navigate program with citrus. And then that was really when everything really, really, really catapulted to like overall betterment of self. Right. Um, they offered wraparound services such as, uh, they call it supportive employment education specialists. They have people who help you get work, go to school. They had therapy, they had psychiatry and transportation services to the places, you know, you name it. Uh, but basically, um, once I had began with work, they helped me go to work by, uh, putting me in a job fair and I experienced work and it was just, it was the biggest change in my life. Like I started to feel like I could function again. Right. And that was huge because I was wallowing at home, getting into arguments and fights with my family all the time. And, you know, I just thought there would never be any hope again. I was, in fact, I had such huge aspirations before all of this, before all of this really, you know, began. And, you know, I started with work again and it was, it was, it was the beginning of something big. So then after that, after I held my job for four years, uh, which was the longest job I'd ever held at the time, um, basically I went back to school and I completed school. I did graphic design and, uh, you know, I, it just, it goes to show just how much, you know, these, these support services and your family being involved in the guardianship and all that stuff really helped promote me to kind of like build upon myself, kind of become a greater version of myself. Right. Um, and, you know, eventually I went to go on, uh, work as a peer specialist, peer support specialist for Navigate after I had graduated from the program. It was a three year, maybe four year program for me. It's really, uh, it depends on the, on the overall improvement of the client, how they see you function. Right. Uh, if you pass the program, but yeah, I worked for them and I still had work to do. I, um, I still had a lot of trauma that I had to go over. So I did trauma therapy and so on and so forth. And I improved over time even more. Uh, but eventually I decided not to work for them because I was still a little overwhelmed. I still had some, you know, things that had to work out. Uh, but now I, uh, actually present with, uh, I don't know if it's okay, but I have a co-presenter right behind me. Uh, Michael Vescones, if it's okay for me to say. Uh, we do CIT crisis intervention team, uh, with the Miami day police and recently I did, uh, CIT international as well. So, you know, there's still a lot of things going on and I'm improving and I just wanted to thank everybody who's been a part of my life and everybody who's supported me, such as, uh, you know, the, obviously the legal process, the guardianship, uh, which now I have pretty much every right except for the right to own guns. Right. So that's a huge thing. I go every year and, um, you know, just everybody, my family navigate the guardianship, even like CIT, like they're huge. So thank you for your time. Well, thank you. Thank you for your testimony and, uh, more importantly for making it public because people like you are the reason that other folks could understand that they do have a path forward and the work that we do up here individually, uh, as institutions and collectively, you're the reason we do this because you are proof of when people come together and we're going to, and there's good programming out there, people can get better and live regular lives. So thank you for having the courage to speak up and speak up on this forum and really appreciate you and God bless you and wish you all the very best. Thank you so much, Senator. God bless you all. Any questions, members? You're the chair. Yes. Thank you for your story. You were so eloquently speaking. And again, your story is what motivates us to do the work that we do. And I think we have a presentation later in the agenda from Navigate. So we'll hear more about the Navigate program and more in depth. Um, but I just wanted to, um, educate my fellow, uh, members here is the Navigate program is fully funded through Thriving Mind dollars. So as we look at best practices like the Navigate program, um, we might want to look at ways to further fund it through county dollars or other dollars because it is an excellent program. And I would hate to not be able to continue the programming because it's maxed out. So thank you. Thank you. Thank you. Thank you. We are now have, uh, George Redondo. Hello everyone. Uh, George Redondo, 4310 Northwest 192nd street. How's everybody doing today? Great. Thank you. Um, uh, my story, uh, I am a four year Navy veteran. Uh, I served from 2012 to 2016 and those years that I served were one of the hardest, darkest times of my life. Like from, uh, uh, I was at the mercy of, you know, other men who were treating us better, us people as like subhuman, so to speak, and that, and all that plus the amount of labor you do because the military is very demanding, but at the same time you can, some people can have like a level of humanity in it, but I didn't get that chance, but don't worry. It's not all gloom and doom. Uh, I, I got out and, uh, I was in a state of, uh, very high anxiety, very, uh, how do you put it, uh, very angry, very, uh, vigilant because of what I did in the service and I started doing drugs and in 2018 is when I started my first episode of schizophrenia and I didn't care about it. I just kept going and I kept smoking and I met, I went to my first, uh, baker, I got, uh, baker acted and I, I got baker acted five times. And, um, after that is when I met Michael for, through the navigate program and Michael has helped me since then with alongside the medication I've been taking to develop my sense of my, my humanity again, essentially, essentially, uh, retrieve my humanity because I, I was in and Michael describes it as like the abyss, like my, my mind was not there. My soul was not there. So to speak, I was just a, a body going through the earth and with the help of Michael, uh, Michael's support and help that he gave me like, we did walks in the park. He taught, he talked to me about, you know, important human things to consider. I don't remember him now, but I, I don't, it was very like, uh, very, uh, I'm sorry. I'm very bad at this. I do apologize. Uh, I, I, I managed with double the medication and Michael's support. I managed to gain my, my humanity back in my social skills back because I was in very bad shape, very, very bad shape. Um, I, I was very irritable to my family, but at the same time, some of my family didn't consider the needs that I have. Now that I, now that I'm better, I noticed that some of my family didn't consider my needs or my necessities and I, I could have gotten some love, you know, but I, I didn't, I got the cold shoulder from some of my family members. And that also, that was also a lot of more pain added to the pain I already had, but you know, it's okay because I look back at all that happened and I knew that I know now at least that God was with me every step of the way through all the trials and tribulations that I faced in the military, anything like, for example, like something that could have gotten me killed, God was there to help me do the procedure correctly and just get it over with. And so, and also, uh, um, it took, he took care of me and all my, my coworkers, whenever there was something dangerous, we had to do a, uh, some maintenance or something on cause in the Navy do maintenance. Um, you know, a lot of people have a working jobs in the Navy and I, I was one of those people who was a maintainer for aircraft. And so a lot of the times when the aircraft needed maintenance, it was, uh, it was dangerous cause it could have, it could have gotten us killed. And when you're, when you're in that state of, of environment, um, you, you kind of get on extremely high alert. So I had to stay alert for that alert for like four years cause I didn't want to get anybody killed. I couldn't live with killing somebody, you know, that's very, that, that, that'll, that'll be a heavy weight on my heart. And so I stayed like that for the four years, but it's been 11 years now since I got out and I can say that I'm very, I'm very relaxed. Thank you. Thanks to the medication and all the help that Michael's given me and the navigate program. And I can say that I'm, I'm very, uh, I'm very at peace with myself and my family. Uh, my mom has been my rock. She's been a very good person to me. She's, she's all the hard times has been mom. And, uh, and mom and dad and my stepfather, those are my three, uh, strongest, uh, supporters and I love them very much. And, uh, yeah, that's about it. That's all I got. Thank you very much. All you got long journey. God bless you, my friend. Thank you so much for, for your testimony. And I to tell you that, you know, the fact that you're up here on a public forum says a lot about you and your strength and your character. And no, never forget that you are a warrior of God going through what you went through. And so do you, I bet. So God bless you. Never forget that. Keep on making people's lives a little bit different and be the example for others in our community that through proper help and, and, um, medication, um, and therapies, you can really, uh, change the direction and pathway of your life. So, and congratulations to your family for, I know sometimes it gets hard because a lot of us appear have struggled with family members who have been ill. Uh, it's a big burden. I'll say a burden. Burn sounds wrong. It's, it's, it's a lot on the family, um, and, um, the family loves, uh, but sometimes it gets to a point where it gets hard. So it doesn't make it any easier for the person that's struggling, but know that I'm happy to see that your family now is your rock and I'm sure they were always your rock, but it's just a process that we all had to go to, to get you to where you are today. So God bless you, my friend. Any, uh, other questions, comments? God bless you, my friend. Thank you so much. All right, um, we're going to go ahead and close public testimony at this point, uh, but again, as we go through the agenda, um, if anyone, anyone in the public has any questions, uh, please be mindful at this point. We'll keep them, uh, to a question or a statement under a minute and a half or two minutes to make sure we get, try to get through the agenda. So Amanda, we're now aware on special presentations. Yes. So the next presentation is the state of Florida's behavioral health funding, um, and the managing entity thriving minds. I will be presented by Mr. Zuckerman. So good morning, everyone. At one of the previous board meetings, you guys wanted to further understand how the state of Florida, um, distributes its funding. So you'd asked us to do a presentation. So you have my CFO, Steve here, um, who's going to walk you through it. Hi, Steve. Good morning. Thank you, Senator Garcia, for inviting me to do this presentation and going again, I'm Steve Zuckerman. I am the CFO for thriving mind, South Florida. And today I want to outline how behavioral health funding originates is allocated and reaches community providers who we are. We are the DCF designated managing entity for Miami Dade and Monroe counties. We manage a DCF budget of approximately $140 million of which 4.2% of the percent is for administration. We're a non-profit, we're a non-profit overseeing a coordinated behavioral health provider network. Our services include mental health and substance abuse prevention, treatment and recovery, as you heard before, um, the presentations and testimony of the Navigate program. That is one of our funded services that we do provide. We primarily serve the uninsured and the underinsured individuals and families. And our funding sources include DCF, other state and federal agencies, Miami Dade County, and other partners. And we do this through a curated, uh, network of providers. We currently fund about 47 network providers. Obviously, I don't do this all alone. I have a great team behind me. I have a fiscal department, which includes my vice president of finance, my assistant controller, and a staff accountant. Some of the key functions that we do is budget oversight and management, contract compliance. We ensure that providers are paid correctly and on time based on delivered services. We, uh, we always, um, thrived on the fact that we do pay our providers within 72, um, hours of a clean invoice receipt. Financial reporting and audit support. We track revenues and expenditures, prepare required financial reports for DCF and other funders, and supports external audits and ensures transparency. And, of course, we participate and provide a fiscal monitoring, uh, along with the programmatic monitoring that goes on as well. The Florida budget and funding flow authority. The governor proposes the state budget and, and, and policy priorities. The legislature passes the general appropriations act and establishes appropriations and proviso requirements. State agencies, including DCF, administers the appropriated funds. Thriving Mind subcontracts with providers that deliver services and report performance and financial data. Accountability is required at each level. Many decisions about permitted uses are established before funding reaches Thriving Mind. Now we're getting into the, the meat and potatoes of the, of the funding. The schedule of funds. Thriving Mind receives a series of schedule of funds, which actually outlines, by category, the dollars that we receive. The schedule of funds is a, is a fundamental component of our DCF contract. It identifies individual funding sources, allocations, programs, and classifications. Other cost accumulators track the specific funding categories and services. And it's critical to note, DCF funding is not one large, unrestricted pool of money. Each allocation has a designated purpose, and many carry state or federal restrictions. Funding, funds available in one OCA cannot automatically be used for another OCA. A surplus in one category does not necessarily offset a shortfall in another. Reallocations must comply with contract requirements and receive any necessary approvals. Total contract funding is not the same as funds legally available for any particular service. The purpose and restrictions of other cost accumulators. OCA's track expenditures for specific services, initiatives, and populations. Some relate to legislative priorities and appropriations. Others to federal grants. They permit separate financial and program reporting. Maintenance of effort helps ensure qualifying state spending is maintained rather than replaced by federal funds. Other eligible state-funded expenditures count towards applicable MOE requirements. Costs must comply with DCF requirements and, when applicable, 2-CFR Part 200. Providers must document expenditures and maintain OCA-identifiable accounting records. These restrictions reflect contract, legislative, and federal requirements, not just internal preferences. Ah, block grant and set-aside requirements. Federal block grants are an important source of behavioral funding. The federal piece of our budget represents about 48% to GR's 52% general revenue. Major streams include the Community Mental Health Services Block Grant and Substance Use Prevention, Treatment, and Recovery Services Block Grant. Certain funds are designated for specific services or populations. Substance use requirements including primary prevention and targeted services for pregnant women and women with dependent children, HIV early intervention, and tuberculosis services. Mental health funds address adults with serious mental illness and children with serious emotional disturbance. Allowable costs, reporting, set-asides, and MOE requirements restrict the flexibility between the block grant funds. This is a sample of a schedule of funds. As you can see, it's broken out with the managing entity operational costs. And as I said, that represents 4.2% of the $140 million. It's followed by mental health services, core services funding, discretionary funding, provisal funding, and targeted services funding. And it's all separated or categorized by specific OCAs, and each of these OCAs has requirements upon themselves. Same thing for substance abuse. It follows the same pattern. In closing, I want to make a couple of things clear. Our responsibility is not simply to manage a budget. It is to ensure public funds are used responsibly, in compliance with applicable requirements, and ultimately to support individuals and families who depend on behavioral health services. As discussed, funding within our overall contract is not unrestricted and cannot always be redirected to other areas of need. We remain committed to working collaboratively with DCF, Miami-Dade County, and our providers to maximize available resources. Thank you, and I welcome any questions at this time. Thank you, Steve and Laura, the whole team. Tremendous work they're doing. Any questions? Through the chair. Yes. I guess it's more of a statement. The restrictions that Steve is talking about are not even done at the DCF level. A lot of them are coming down. The federal funds come down with a lot of those restrictions. And then the Florida legislature makes a lot of decisions as well on how the dollars can be used. Thank you, Steve. That was a very good presentation. Thank you. Excellent. I was through the chair. It was just to piggyback on the comments that Steve made and Lourdes. It's just I know that in this committee we've talked about offsetting costs and, you know, certain pots of money, which is why you guys requested this meeting. And it's not so simple as you're hearing, right? Like if funds come down in a children's category, but we have overproduction in adult, we can't just shift it, right? So it's just for you guys to better understand the landscape and how the managing entity steps in with their funds for the uninsured and the underinsured. But feel free to reach out to either of us, and we're happy to answer any questions you guys may have. Now, that is what you're listening to, all these restrictions and so forth. We've been working with that for years. This actual committee is a testament to the work that has gone on before to get rid of these silos. So remember, we used to have Addiction Services Board, then a Mental Health. So this is a Behavioral Health Board that includes mental health and substance use disorders. Now, as far as payment from the state, what we're talking about, these restrictions, that is a major problem because there's a lot of silos. And like she mentioned, Laura, that you can't just automatically use the funds where they're needed most. So that is being addressed. We continue to work on this. There's innovative things happening right now through the management entity, the governor's office, DCF, to combine these OCAs so that you're able to bill for substance use, mental health, transitions of care under the same OCA. And that's very innovative and very individual-centered type care. That's like value-based care. What they need is what we're going to give them. The other thing that stands out that we need to applaud is that the way they pay providers, that's the management entity in DCF, is unmatched in the industry. When you're billing insurance companies, managed care entities, you know, all the Medicaid and so forth, it is very difficult. You're looking at receivables from anywhere 30, 60, 90 days, and they are actively looking for ways not to pay, not in the management entity situation. So from the leadership all the way up to Tallahassee and down to the management area, they're paying, I don't know if you caught that, within a week of the presented invoicing. So that is unprecedented. That is unheard of in the medical field, one of the true, you know, successes of this system of care. So we've got to continue to work on bringing down those silos and barriers to care, which calls for all these different funding sources. Anything else? Yes, sir. You led your presentation with the statement that 4% of your total budget is administrative. I'm just curious as to is there a federal or a state law or mandate that limits that, or how does that work? Actually, in the federal world, it could be up to 15% for indirect. So we're way below that. We actually come way below the administrative requirements of other entities, right? So managed care is at 20%. So when you're looking at MMA plans and insurance companies, they're at 20%. When you look at other de minimis rates from the federal government, when you have grants, that's about 20% as well. So when you're actually looking for cost-effective administration, the managing entities are a bang for your buck. All of us are under 5%. Well, and it's not only the management entities, the fact that they're overseeing quality and that the funding goes to the community, most of their providers are running under 10% admin, which is, again, something that you will not find in any, you know, nonprofit or for-profit world. 9% admin for the providers, that's where we're at approximately, it is unheard of. And that's a great- All our providers are capped under 10%. Yeah, that is great. Which means, you know, service to the street and the individuals, more dollars are going to services. Again, any other questions? Great presentation. Go ahead. Through the chair, just first off, Steve, nice job. And thank you for your ongoing collaboration with Jackson. We truly value you guys. Just one clarifying point. You said 48% of the budget comes from federal funding? No. Okay, I didn't realize that. So that 48% is at risk to the, I don't want to say the whims of Congress and the president, but- Correct. Through a series of block grants, and it is also the use of the maintenance of effort. Because the more of the maintenance of effort is used, it draws down more federal dollars. Thank you. Which also flows through the department. Absolutely. If I may, thank you for your presentation. Again, wonderful. And my experience with dealing with the patients and the personnel from Thriving Minds has been so positive, so engaged, and so involved. My question would be, it's a very complex process how you manage the funding. Obviously, we're just getting a little bit of it. It's confusing just looking at all those charts, so I'm not going to even pretend there. But could you give us an idea of, then, with the needs that we're identifying in the community that are so large, and we're always finding that you're doing as much as you can, how can we expand additional resources? Is there a plan, a strategy, on how to develop the additional grants or sources of funding? Well, from a managing entity perspective, and Laura could probably comment on this, we submit an enhancement plan every year, which we targeted certain areas of which we feel we need additional funding. And that is required by contract, and we submit that annually. So, yeah, we go through a three-year needs assessment cycle where we identify the community needs. I think, actually, I did a presentation a couple meetings ago on those needs assessments and what was seen in the last cycle. Housing continues to be a huge one for our community, first episode of psychosis, residential care. So, we constantly look at those needs and put it into the enhancement plans. But the reality is that it's a fixed budget, and we've actually experienced cuts over the last three years. So, we've actually seen a reduction of dollars over the last three years. We do look at grant opportunities. The bulk of our budget, like you heard Steve say, is through the department, but we also have funding through the attorney general's office. We have funding through the county on various grants. So, we're always looking at the available grants and other resources to bring in more dollars to our community to expand on services. But the reality is, is that we have more need than the capacity allows. So, I think that's a big discussion for this work group as we, you know, put in our recommendations to the commission, put in the recommendations to the county as to where we're seeing those needs and how we can diversify our county dollars. You have, you're going to have a presentation from Navigate as well as the mobile response team, which are two programs that are excellent programs that are fully funded through the managing entity, yet the entire community is eligible to come in and be served. And right now, you'll hear the presentations and you'll hear the numbers is, they're exceeding their capacity. So, they're, especially with MRT, when you hear the MRT numbers, they are in the thousands now and it's starting to impact their response time. So, we don't want to affect their outcomes. We want to be able to get mobile response teams out there within minutes, not hours. So, it's a conversation for us to have as a work group and make those recommendations and see how we can diversify our funding for our community. Thank you. Let me add, sorry, for the department, the enhancement plans that Steve is talking about, the department is statutorily required to roll those up into a statewide behavioral health assessment report that does go to the governor and the Florida legislature for review every year. So, aside from the LBRs, it is presented to the legislature. Yeah. And then, in turn, they present a budget. So, the governor has a budget. He presents a budget based on all of that, the strategic initiatives, and DCF also presents their requests, and then the legislature, and they all work it out at the end. Thank you, Steve. Any other questions? Great presentation. Okay. We're moving on to the Navigate program. Do we have Mary D'Estasio? Hi. Good morning. My name is Martha Mazzaros. I'm the outreach manager, and Mary D'Estasio is the program manager. She's sitting back here with Silvio Padilla, who's our team leader for one of our second teams. And thank you for having us today. We really appreciate the time that you give us to provide you information about our Navigate program. I'm assuming this is – where's the clicker? Is this one? You're on. Okay, so what is Navigate? The Navigate program is a free two-year evidence-based early intervention program for individuals who have experienced a first episode of psychosis. In Miami-Dade County, we are the only program that provides these types of services for early intervention psychosis. And we've been at Citrus for 10 years. I think we were maybe the pioneers of this type of treatment. It is developed through the RACE study. It was a national study in which they found that if you provide treatment, wraparound services to individuals who have had their first episode of psychosis at the very beginning, then you have a higher probability of them recovering from that diagnosis. So our purpose is to guide individuals and families towards psychological and functional wellness with hope and resilience. And that's a key element of our treatment, resilience. These are some of the schizophrenia spectrum diagnosis that we support the individuals in. So anyone with experiencing psychosis related to schizophrenia, schizoaffective disorder, schizophreniform disorder, which is less than six months of schizophrenia symptoms. So now to the most important part is who is eligible for Navigate? The eligibility stands right now at the ages of 15 to 40. So it's a very large age range, 15 years old to 40 years old. We recently raised it to 40 because it was found through the evidence that we had that the individuals between 35 and 40 were starting to also experience that early episode of psychosis. And so we included them as part of the results of that evidence-based research. They have to have had their first episode of psychosis, a past or current episode, with a strong indication of schizophrenia spectrum condition. The key part is that they have had no more than one year or limit to one year of lifetime treatment with antipsychotic medication. And then other causes have to be ruled out. So no evidence of intellectual disability, autism, or another illness or physical condition. That could be the reason why they have the psychosis. No substance induced because also with this one is a little bit difficult because we know that in some cases the substances might trigger genetic predisposition to the psychosis. So we do, you know, when we do receive referrals for these types of cases, we take a look at them even with a psychiatrist to make sure that, you know, what came first. I always say what came first, the chicken or the egg, right? So we do look at them. But if it was substance induced psychosis and we find that that's the case, so then they wouldn't qualify for our program. And then the most important part is that they voluntarily want to participate. We don't force anyone to participate in the program because, like anything, if they don't have the insight, if they don't want to receive the treatment, it's very hard. So we try to engage them as much as we can to explain to them what the Navigate program is and what we do and how they can better their lives with the program. Some of the common signs of emerging psychosis that you might see in daily life and connection would be, you know, rapid decline at school, at work. We heard from Alfredo, thank you so much for your testimony, that he was experiencing a lot of these symptoms during his school time and his life, you know. So you'll see all of these in that pop up in these daily lives, especially with children. A lot of triggers, red flags of different psychosis or internal stimuli, spending a lot of time alone, social withdrawal, decline in personal hygiene. And then in terms of mood and expression, you know, you will have depression, irritability, flat expressionless gaze, difficulty crying or expressing joy. In behavior and sleep, maybe some will have a bit of insomnia, difficulty dealing with that, hostility, suspiciousness, problems sleeping. What we found in the Navigate program is that a two-step approach is needed. You need medication to treat some of the symptoms of schizophrenia, but then you also need another type of treatment, which is therapy, to be able to deal with other types of symptoms like motivation and thinking. So the medication and the providers work hand-in-hand with our therapist to marry the two. It's not a one-size-fits-all. One of the key elements of our program is that it is a team-based approach. The client is at the middle, at the top of the team, and then everyone else is there to support. We have a treatment team of prescribers, family clinicians, SE specialists, which is a supportive employment and education specialist, and individual therapist, and peer specialist. And so all of these individuals work, professionals work together to help the individual, the client, deal with different parts of their symptoms and their diagnosis. And they have a weekly team meeting where they discuss each of the clients to see what's better. Because sometimes a patient may tell one story to the therapist, and then we'll go to the psychiatrist, and everything is fine and great. So if the provider doesn't know what is really happening behind everything that's being talked about, this is the best way is for them to know, right? So they talk to each other. They're constantly, if the therapist has to be in the appointment with the client, they will be. So there's a relationship between every team member, and I think that's one of the most important parts of the approach that we have. Like I said, we have two providers, a psychiatrist that sees adolescents and a psychiatrist that sees adults. So we have a pediatric psychiatrist and an adult psychiatrist. They will see the patient once a month, depending on, you know, obviously the severity of the patient. Probably at the beginning they'll see them a little bit, you know, sooner or more than just once a month, and then it eventually trickles down to once a month. The idea is to start low and go slow. They pay close attention to side effects. We do take into account their physical health. So we do take their BMI, all of the different physical things that can pop up with different medications. We have someone that makes sure that, you know, we can take down those so that the prescriber knows what to look at as well. There's a questionnaire to monitor the medication adherence that they are taking the medication and symptoms and side effects. And like I said, they see them on a monthly basis. The individual resiliency training aspect of our program is through the therapist. They see the IRT, the individual therapist, once a week, essentially, so weekly meetings. And they're there to identify the strengths of the individual and build the skills for illness, self-management, and recovery. So they'll look at illness, self-management, persistent or emerging symptoms. If they're using substances, substance use, trauma and PTSD, physical health, difficulties in their functioning, persistent or emerging symptoms. There's two. We have, I'm sorry, we have four IRTs. We have two teams of Navigate, and we have four individual therapists. The family education therapists, we have two FEPs. We call them FEPs. And their whole purpose is to strengthen the family relationships, support the roles and social connection between them, reduce stress and burden for the family members. We do recognize that the family is, if without the family and the people that are taking care, the caregivers of these patients, without their support and understanding of what is happening, because it is a very traumatic type of diagnosis to understand as a parent or as someone who's taking care of the person, we try to educate them on what is it that the diagnosis is, what are the red flags, what are the symptoms that they need to be looking after. And that's what the family education therapist is there for. They will see them twice monthly or monthly, depending on what the client's family would like. And then the supported education and employment specialist, they are there to help them in the process of getting back to work or getting back to school. If it's a child that is in school, they will help them with all the process of getting back to the school and the IEPs and all these different processes when they're ready. So like I said, the most important part is the patient being ready for that. We don't rush them through it. Same thing with work. So we'll help them learn how to do a resume, how to do an interview, you know, all these different things. They have gone with them to a store to buy the proper attire for an interview. And so they guide them through it, they hold their hand, and it does not stop at the moment they get the job. So they will actually be there for them if they need any type of support during it. What are their rights? You know, do they have to provide information about their diagnosis? Some of them don't know what that is and if they have that, what are their rights and responsibilities in terms of that, in terms of employment. So these are the things that the SCE is there to help. And we have two SCEs working. In the past 10 years, we have served about 800 individuals in Miami-Dade County. And our snapshot, if you say, it's 80% of our graduates are working or are in school. We've had people who've graduated college, who've gone up to college, who work, you know, are functioning members of society as a result of the treatment that they have received. Like I said, it's a two-year program, but sometimes it can be a little bit longer depending on the patient's, you know, treatment and what they need. So we're there to hold their hand, and then once they're done, then we refer them to, you know, individual therapy and all of these programs that they will need to just still hold their hand through it, but not as intensive as the Navigate program. The National Race Study said the longer engagement in care in the Navigate program is 23 months versus customary care is 17 months. The median time in treatment is around that for 23 months versus someone who just goes to a therapist or goes to a psychiatrist over here, it would be 17 months. Greater improvements in quality of life, symptoms, and work or school participation are the key elements of making sure that they can recover. And they feel like you heard our two testimonials today that I almost cry every single time I hear them because it's very raw to hear their struggles and how they've come from the beginning. So it's important to them to be able to work, to be able to participate in society, and so this program allows them the ability to engage in that and know that there's nothing wrong, right? So we have a diagnosis, and we work with it, and we keep going, and we can live, and we can have a life and have a functioning life, and so that's important for them, and that's what our purpose is. So thank you very much. If you have any questions, oh, one thing, we do have group sessions as well. We do provide them when he talks about them going to the park, and they have the therapy in the park. They do group sessions, yoga in the park. They do painting. They'll do different little groups so that they're able to engage with other members, other patients that have the same diagnosis, and they know that they're all the same. They're not alone in this. So that's one of our main things, and then also in Miami-Dade County, the way that we run our program, it is community-based. So we go to the patient. The only time they have to come to us is when they see the psychiatrist because, obviously, it's a little hard to move a psychiatrist. But in terms of everyone else, we go to them wherever they feel comfortable to meet us. Thank you. Thank you. Thank you, Mark. The great presentation. Is this program unique to Citrus? It is under Citrus Health. It is under Citrus Health. It's the only first episode of psychosis in our county. Like you heard Martha say, it was probably one of the first in the state. But, yeah, right now, Citrus is the only provider providing the service. I can tell you I've had other providers interested in this program, in this model, but I don't have the funds to have another Navigate team. All right. Thank you. Any other questions, members? I have a quick question. In substance abuse, I know that relapse is part of recovery. Is this also the same when it comes to psychosis? Is relapse considered part of recovery? Yes. They'll relapse. There will be times that they'll, if they don't take their medication, if, you know, something triggers the psychosis, they will relapse, and we're there to help them through it. And one more. Do you have any experience with the alternatives to medication, whether it's the magnetic treatment or the electrical therapy or the light therapy or anything along those lines? Is any of that? I know I read about it. I know I read about it. I just want to know. I've heard about it, too. Yes. We do not have any of that type of treatment. The prescriber does prescribe, you know, mostly long-acting injectables if it helps the patient because it's easier for them to not have to keep track of a medication on a daily basis. But we also have the therapy, so our individual resiliency therapy, Michael Vascones, that's the Michael that they've been talking about. He's one of our IRTs, and they do a lot of, you know, alternatives in that sense, but they still, you know, see the prescribers. So if there is a patient, for example, that maybe wants to kind of start letting go of medication, then that's their purpose to kind of, I hope I'm talking correctly, yeah, to help them through how to handle that before they, instead of, so that they know when they relapse what they need to, what they need to look forward to. Anyone else? We're good? One more question, if it's okay. Absolutely. Thank you. Just out of curiosity, you mentioned the various providers that the individuals will see. Are they seeing them on the same day, or are they coming back on different days to see the psychiatrist and the IRT? They might be same day, or they might be a different day. It depends on the schedule of whatever the patient is willing to do. So they might see the IRT on a weekly basis. They might see them at the same day, but usually they try to spread it out, so they'll see the SCE on another day, and they're able to, like, see other people. It's not just all in one day, because it might be a lot. So they do sometimes schedule it out throughout the week, but it's not if that happens to be the case, then yes. Thank you. Question, if I may, being in a chronic condition, what is the transitioning after your program? What are the aftercare plans? So we discharge them to, we do refer them to either an individual provider, like we'll refer them to go to outpatient mental health. There might be some IOPs that we might be able to refer them to, and so we try to find the programs. We don't let them just, we don't leave them there, right? So we make sure that we're still holding their hand through a process of, okay, now we're going to let go. And then at the end, you'll see that at the end of the two years, it gets less of a, it's like a child, right? So you hold their hand at the beginning, and then you start letting go little by little by giving them the tools, and that's the important part. We've got to give them the tools so that they don't end up in the same, you know, situation. So we do refer, and my job is to, you know, provide information about Navigate, but also to get information about other programs in the community that we can work together with and can refer the patients after. If there's, if we can't take them at Citrus for any reason, and if we don't have the correct program for them, then we've put them with the right fit. We try our very best to do that, so we're not just letting go. And they stay around you, too. They have our phone numbers if they need any help. We're there for them. We don't just, you're no longer in the program. We're not going to speak to you. We try to help them as much as we can. All right, thank you, members. I appreciate a great presentation. Thank you. Folks, we're running a little behind schedule, so I apologize for that. Next, we have the mobile response team, MRT. If we can keep that presentation a little tight because we want to talk about the behavioral health building, followed by that. Hi, everyone. My name is Islam Pardinas. Thank you for having me here. I'm the vice president of operations for the Village Southwest Care Operations in Miami, and I've brought the folks that are doing the day-to-day work to do the presentation, but I'm here for questions. Thank you. Thank you very much. Good morning. My name is Doris Garcia. I am the director of the mobile response team, and next to me is my wonderful colleague, Luis Garcia. He's a licensed mental health clinician, as I am, and he's also a clinician with the mobile response team. Again, thank you for your time. An overview of MRT. We are also funded by Thriving Minds. Address is 5605 Northwest 82nd Avenue, Miami, Florida 33166. MRT is a 24-7 mobile response team that serves Miami-Dade County. We evaluate mental health crisis. We meet the patient, the individual in service where they're at. We do go to schools. We have a tremendous collaboration with the community partners, Miami-Dade County Public Schools. Staffing is composed of dispatchers. They are master's level, which helps filter out those calls when they come in. Again, we work with licensed mental health clinicians. We have behavioral health technicians who accompany our clinicians when we have these mental health crisis calls. And we also have certified peer support specialists who do have that live-in experience. So our response time is about 60 minutes. Right now we're averaging about 50 minutes, which is great because we do not have lights and sirens. So various responses. I'm sorry? Nothing. There are various response teams in three different offices. We have a north office, a central office, and a south office. Right now we are waiting for the mental health center to open up so that we can have that fourth location and be able to reach the community in a faster response rate. So Baker acts will be initiated by the MRT licensed mental health clinician if that criteria is met, and there is no age limit. So MRT, again, provides that 24-7 in-person crisis response throughout Miami-Dade County. We have reached an estimate between the fiscal year to date 2023 to the fiscal year to date 2026. An estimate of 10,000 crisis responded that MRT has responded to. About 77% calls are without a Baker Act disposition and around over 2,000 school calls. And that includes Miami-Dade County public schools, charter schools, and private schools as well. So we have seen an increase of 174% of call growth between 2023 to 2026. The call volumes have significantly increased to over 29% over the three full fiscal years. Thank you, Doris, and that's correct. Let's remember, MRT was awarded to the Village South, WestCare, three years ago. And this data shows here that throughout that time we have the previous provider data for the fiscal year 2023, and we also reflect the last three fiscal years for us. We have seen a trend in our data increasing, as Doris says, by 29%. At this point, we're kind of exceeding capacity in terms of the population or the amount of calls and services that we can provide due to that trend, right? We anticipate that this trend will continue, that we will continue to obtain more calls from the communities, from school. And that will put kind of our capacity over. It's important to say that MRT responds to about 10% of approximately 30,000 calls that are received in terms of mental health on a yearly basis. And based on the numbers and the trend that we're seeing, that 10% will be expanded based on the continuity need of the community. You know, some of the questions are, like, how come we're expanding, right? How come we have seen such a huge increase from 2023 with the prior provider and then subsequently with the last four years? And a lot have to do with community outreach. I'm a clinician. I am in the field on a daily basis. And part of it is that there's a lot of outreach that our clinicians do, that our dispatchers provide, our staff, our peers, which are excellent. There's also a lot of healthy communication with the community, community resources with us. And then we all have very, you know, close relationships for the clients. I see it on a daily basis. A lot of the safety plans that clients have when they leave a facility under a Baker Act or just from their private psychiatrist or their private social worker, case manager, therapist, include the information for mobile responsing. So that has shown, you know, that gives us a why we have such an increase. There's more complex to that, but some of the things that I see as a clinician on a daily basis. It's also the demand for schools have increased as well. So we anticipate our capacity to continue increasing. That's when it's most important right now kind of that support and those resources enable to continue expanding the program into the community. In terms of calls, disposition, what happens with this number of calls? Approximately, approximately almost 7,000 calls do not end up in a Baker Act. What that means is that we, the clinicians, go out with a PhD. We assess what is the crisis, what is happening at the crisis, and then determine the appropriate level of care that the individual needs. Our clinicians, you know, I don't want to – I'm a clinician, but they're great. They're amazing, right? They're very dedicated. And our goal is to assist where the crisis is, provide those resources, de-escalate the situation, and also provide a lot of support for the family members as well. We can't forget about families. It's the individuals and the family. It is kind of like a bundle that needs assistance, okay? So, throughout the years, we could see that the number of Baker Acts, of non-hospitalizations, right, have decreased, indicating that we have had a slight increase in hospitalizations. This could be based on the demand, the acuteness of the crises, the complexity of it, right? We're working with a lot of community that provide us with referrals, DCF. Schools has provided us – it's a big demand, and Doris, we're going to go ahead and explain it a little bit. But the complexity of the costs within school settings have increased as well, okay? So, our goal is to provide the appropriate level of care, okay? And then we'll explain a little bit after what happens after we provide those recommendations with our peers. And then just to add to that, we do participate in a lot of – an increase of networking with community partners. We do provide and have that gap and bridge between the community and the resources that our partners offer. So, it is extremely important for us to reach community partners and have them engage with MRT so that our peer specialists are able to connect those individuals and their families with resources, therefore having a decrease in recidivism. Do you have data on the zip code? We do. We do, actually. We do. We also collaborate with HOPSI. Can you get that data to us if it's okay? Absolutely. Yes. Thank you. So, our school crisis response over the three years. Again, previous provider data shows that they were at 148%. Fast forward to year 2025-2026, we can see how it's increased to 769, which is a 38% increase. 69% of all time school calls involved suicide attempt or ideations, and 68% of the fiscal year-to-date 2026 school calls ended without a Baker Act disposition. And what that tells us is that our peers are connecting families to those services. And we do work closely, again, with Miami-Dade County Public Schools. We also keep records in terms of law enforcement involvement or responses within our calls. Right now, we have 80% of our calls for the fiscal year 2026 that have no recorded law enforcement involvement. 89 of these are minors for children and 75 as adults. What this tells us is the effectiveness of the program, right? How effective are our clinicians, our PhDs, our peers, our dispatchers, our entire team in assistance individuals with the crisis that they have at hand and determining what is the next step for them. What is it that they need? How is it that we could help? Okay? I think it's also we have to consider that it's a win-win situation if we look at it, right? In order for us to be able to take this, or we're taking and assisting with these calls and this assessment, that frees in a way law enforcement and those resources in order to be able to utilize them in other calls, safetiness, or as they deem appropriate. Also, it's really important, law enforcement, right? Unfortunately, some clients feel more comfortable with a licensed clinician, right? They feel, like, more safe. They feel like they could talk about it. So this creates kind of a safe haven for them as well to have someone in the home that is able to kind of assist them and meet them where they are at that moment. And then I also want to continue to, and we'll talk a little bit about the ambulance services. It is free of cost to the individual served. Due to this increase of utilization of our ambulance use, again, which is free of cost, it helps, it gives that soft hand transition between utilizing law enforcement, which they'll have to be handcuffed, and a great percentage of our individuals served are minors, and it reduces that re-traumatization or traumatization overall. Ninety-five percent of individuals served have a successful peer connection. Again, these are individuals with lived-in experience. And it's important to note that peer work and having a peer specialist follow-up with the clients is a cornerstone of the crisis response model, right? Crisis doesn't end when the clinician and the BHT determine the next level of care or recommendations. They need support after. They need support with being listened to, motivation, finding linkage to services, you know, being there. And the peers do this amazing job that they use their life experiences to assist the clients. Let me tell you, I'm very proud of our peers. They do an amazing job. They go beyond, above and beyond for their clients. And we see it on a daily basis. We hear it from clients. So it's really important. And we're always coordinating with, like, CIT officers, schools, hospitals, community resource, DCF, to assist as individuals have the access they need to the services that will benefit them from. And with those peer support specialists who are invaluable and making that linkage, there can be a significant time period for getting help. So your peer support specialists, would they maybe meet daily or weekly or as much as needed before that linkage for additional support? That's a great question. Our peer support services contact the clients within the 24 hours after they're assessed by our clinicians. And they continue on a daily basis to follow up with them to get them to those services and to assistance as well. Another part that I forgot to mention was it's not only the client that they assist, it's also the family members. It's very complex sometimes. It's a dynamic. And, you know, family members all need that support and that assistance. So the peers will go ahead and provide them with that as well. Excellent. Thank you. Thank you. Yes, and they're a huge advocate for the community. They also have a world of experience with community partners as well. And so they're able to provide that triage model between MRT, our partners, and the individual being served. Let me ask you, how much more time do you have? Because I want to get to the last presentation. Very short. We're done. Annual ambulance costs increased 75% from fiscal year 2024 to fiscal year 2026. We're seeing a huge deficit in our ambulance utilization, mainly because over 70% of that is being utilized by the schools. And we would like support. We would like to have additional resource so that we can expand and continue to utilize our ambulance services and provide that soft hand transition between a person being in crisis and not being taken by law enforcement and being taken by the ambulance. So it's, you know, something that we look at as that continuation of care. And this is kind of a little kind of summary of everything that we have talked about, kind of one-in-one page. Again, our numbers will continue to go up in terms of the calls. We have a slight increase in Baker Act due to the complexity of the calls and the acuteness of it. And also we have quite a jump in terms of our ambulance services. You know, we have exceeded capacity in terms of the services or the calls that were initially thought that MRT would have, which is great for the community. And we want to continue providing that assistance and that resource to the community because the community really benefits from it. But as Dori said, we need a lot of support and a lot of additional resources to continue with the work that we do. We invite you to keep an eye on this. Go back to that. Keep a good eye on this sheet because this is the one that gives the summary. And you'll see the impact, again, of the years of services that we have to provide with no changes in our budget. All right. Thank you. Thank you so much. Great job. Any questions, members? I think we've got some of the questions out. I wouldn't have a question but a statement. And just to support what the team said, MRT is fully funded by the department as well. It's a community-wide resource regardless of funding or insurance. Everybody uses it. You heard the team present that 30% of their calls are coming from schools. And we also, I think, part of their increase is we had the mental health campaign for the first time this year, at which point MRT was the primary resource being blasted on that mental health campaign. So they've definitely seen an increase, a good increase, right? We want people to be able to be served through the mobile response team. It's an excellent resource, but it is a fixed budget. And so we need to keep an eye towards that to see what we can do to make sure their response time stays under an hour. And we're getting valuable resources to people in a timely manner. I know we're in a rush, but just one more thing. There has been a dip in the number of Baker Acts in Miami-Dade County and statewide in the last three years. And one of the items that we attribute to is the mobile response team. There was an increase in allocation for the teams, and that's how they were able to create the three teams and hopefully soon a fourth team around Miami-Dade County. But the other thing that I think is important to note for the public especially is that mobile response team requirements are in statute. They're in Florida Statute 394. They're part of the Baker Act, as is 988. 988 and MRT have memorandums of understanding. So if somebody's calling 988 and they feel they need to be dispatched, they get dispatched, that's all part of the warm handoff. Look, and I appreciate that. And I know I'm trying to rush a little bit because we have some presentations. We've got a couple of presentations. Today's a day of presentations. But I think it's important for the public to hear what's going on because these are recorded, and this will keep on airing. So I ask for your indulgence a little bit to get through these presentations. I know I'm trying to rush it, but this is why we're doing it. So for the public, and we appreciate the work that you all do, if they need – you mentioned 988. But if it's not a 988 call, how does someone get a hold of the mobile – Super simple number, 1-800-HELP-YOU. Okay, perfect. Through the chair. Yes. I'd be remiss if I didn't thank you guys on behalf of our outreach teams that are in the field and call you guys when they need assistance with somebody. I would also love to see a little bullet point on your presentation next time about how many people you come in contact with that are unhoused. Thank you. Thank you so much. Mr. Chair, one last. This is very important because the resources are being used a lot by the Dade County Public Schools. They have a budget for behavioral health. Now, this is something that we need to take a look at because this is being – these are resources being used for the school system, and the school system has funding for that. So the rest of the community should have the resources coming from behavioral health, from Thriving Mind, to help the community, and the school should be able to contribute toward what the school is using. I have one point. Yes, sir. And I want to make sure I got it right. It sounds to me like this is more cost-effective than utilizing the police and utilizing the Baker Act system. Is that correct? Absolutely. Yes. Okay. That's it. All right. Sorry. No, no. There's no sorry. You guys feel comfortable. I'm fine with it. On the numbers, 1-800-HELP-U. There's one, two – oh, I-O-U. I-O-U. Oh. I was like, what? If there was a letter U, I'm like, the numbers don't add up. So, folks, it's 1-800-HELP-Y-O-U. Okay, so I appreciate that. Before we go to that, maybe this is something that we can tackle on for the next maybe round of promotion or campaign that we do, because this is a great avenue. I think families need to understand that this actually exists. And, Claudio, you brought up a great point as it relates to funding. Yes. Can the county do a little more? Yeah, we kind of can do some more. But if 30 percent of that is coming from the school system, how much funding is the school system investing with you all? None. Zero. It's okay. On behalf of the school system, I just want to piggyback off what she said regarding state statute. And part of it is in our school board policy, I would request, and I have requested, a deeper dive into the data. You mentioned charter schools and private schools. I'd like to analyze the data to see if there's particular areas, certain regions, certain schools. On behalf of the district, we also have an SRO at every school. So I would need to have that conversation with Chief Silva with schools police and really dig a little deeper into that data. This is why the data is so important, and I appreciate you looking into that, because then we will know what direction to do or if we can collaborate more with the school system. And I have full faith in the work that you're all doing, especially with the new administration and leadership. So I think there's ways that we might be able to collaborate. So that would be great to try to break down those numbers or give her the numbers, the raw data, give her the raw data so she can break it. We can break down the numbers, and what I would look at is how many Baker Acts actually happened through the SROs. That's a good question. Yes, that's why you mentioned that. That's important. Okay, perfect. All right, go ahead. Through the Chair, I just had a question about the transportation piece. I know that that's always crucial in speaking with law enforcement. I know they rely on MRT to get that clinical impression when they're doing a Baker Act. But the transportation, it caught me by surprise that you were utilizing ambulance services so frequently. So firstly, is that new? Because I don't recall that being in place from the beginning of MRT coming into our community. And my second question is, do you have a breakdown of how many transports MRT is doing versus Baker Acts versus ambulance? Because that would be interesting to see. Yeah, we definitely have those numbers. Part of our model, since we took over the Village Southwest Care, we had some system improvements that we did. We hired licensed clinicians that would go on every face-to-face call, and they do. We hired peers that would do follow-up. We hired ambulance service that would be trauma-centered treatment. And so many of our cases get the ambulance service because we feel it's more appropriate, especially in the schools, right? The only time we use the law enforcement is when there is danger. So yes, we absolutely utilize. That's why we put it on that slide. It's one of our highest deficits because we did not budget for the amount of utilization of ambulance service. And it's something that I believe the community wants to continue, right? It's something that we don't want. You know, we could say, okay, we can get rid of this piece and save some money, but I think everyone wants to keep that piece. I'm sorry. No. Is there a specific ambulance company that you have a contract with, and do you feel you're getting a pretty good deal on it? MTCI, I believe, is the company. So if I can speak to that, because Izzy might be being a little nicer or politically correct, but I won't be. So there's been increased costs in the ambulance services, not just for the utilization, but there is a uniformed rate that the county requires, if you will. So their costs have increased over the last few years with the increased costs that the county has for the minimum with the ambulance services. Ambulance services, I think, are willing to negotiate with them potentially a lower rate because they realize they don't necessarily need the same life-saving things that go into ambulance services. But because of the uniformed rate from the county, they're not allowed to negotiate. So that's something definitely that we can work with the county to be able to negotiate some sort of differential rate for our MRTs. I'm the one that sponsored that rate. I know. Oops. So, you know, and I asked that question for that reason. So, and the reason we did that was because we were so, it's been years since they had any increases. So I was trying to bring a little bit of parity, and yet they're still below the state average. So it's not, I'm not saying that we're above, but I asked the questions for that same reason. So maybe we, actually, because we can't talk because we're on the same board, but Amanda, if you can help us through our channels, figure out a way that maybe we can open up the lines of communication with these ambulance companies to see if we can negotiate a better rate for this service. Because they can, and we can, actually, we can put a part of the, it could go through the county commission. So, yeah, let's put something together, and I'll be more than happy to start having that conversation. Thank you. That would be great. That's why we're here to provide information. So any other questions that you guys have, we're happy to address them at a later time. All right. Thank you so much. I'm sorry, do we have any more questions up here? Any other questions? No? We're good. All right. Thank you. We're going on to D, to Crisis Intervention Team by Miami-Dade Police Department. So through the board, I would like to just make a correction on the record for the clerk's information. This is just the Crisis Intervention Team for the entire Miami-Dade County. Our presentation is by Hapsi Kaba, who will be presenting today. So I just wanted to make the distinction that it's not necessarily the Miami-Dade Police. It's just our Crisis Intervention Team. Thank you. Thank you, Amanda. Good afternoon, everyone. A pleasure to see you all. I'm so very happy to be here and be among so many already friends and partners. So I'm grateful to all of you. Again, my name is Hapsi Kaba. I'm a licensed marriage and family therapist. I've been in the field now for, and I'm proud to say it, three decades, three decades in the field of behavioral health. I've had the privilege of being at the helm of the Crisis Intervention Team program in Miami-Dade County for 23 years. And so it was just a pleasure to begin really working in the community because I thought, oh, I'm just going to be working with law enforcement, and I am tasked with teaching law enforcement about mental health, and then we're going to get them out there, and they're going to do a great job, and it's going to be all taken care of. And, of course, I was quite naive, quite naive, and what I realized was that, wait, I'm working now initially with law enforcement, and behind that patch is a heart, is a beating heart, a human being. And then I realized, like, wait, this is so much bigger. These are human beings that may also be in crisis. Departments are in crisis. Our community is in crisis. And I realized that we had a lot of alignments and parallels and that we needed to really dive into the community. And so it is so important for you to know, and do we have the, the, this is it. It looks like a little walkie-talkie. And so it is so important to let you know that CIT is a community-based program. And that's what I really learned initially, that CIT is really based in partnerships. And we very quickly created, through the community, our mission. And as you see, these three pillars here are safety, dignity, and access. It's not only about law enforcement being safer out there to keep everyone safer, but it is just overall safety practices that concern everyone. Education is safety, not only for law enforcement, but for our providers, for our community, for all of our community members, and of course, most importantly, those that are in crisis. And really, that's why we are here. CIT, what is it? It is comprised of law enforcement, of behavioral health, of advocates. More importantly, people with lived experiences, bringing everyone together to focus on a transformation of our crisis system. CIT serves as a platform to bring all individuals together. And let me tell you something very important. That Miami-Dade County needs to be very, very proud, because we, CIT Miami-Dade, is an internationally recognized model. We have people come from all over the world, from Spain, from Canada, and throughout other parts of the world, and of course, many, many through the U.S., to learn about what we're doing here. We had our own trials and tribulations. We continue to learn as we go on, but we have a lot to be proud of. And let me walk you through that and tell you why, why we have become so great at what we do. We, along with being a platform in Miami-Dade County to bring all of our partners together, we ensure that we serve as liaisons in the community between law enforcement entities, all first responders, and the behavioral health community. We were all working in silos, and we find that throughout the nation that there are so many great ideas and so many advocates and so many people doing great things, and they have so many similar ideas, but we're not talking to each other. And CIT takes us out of those silos to bring us together. And so that's why our community engagement is so important. And so what we've done is we've identified individuals throughout every law enforcement agency. You will learn that every agency in Miami-Dade County law enforcement have CIT officers. They have all partnered with us. They all have representatives in their agencies, which we refer to as CIT liaisons or CIT coordinators that are the face of their agency out there in the community, in the behavioral community, talking to each other, troubleshooting, streamlining, and really working towards the same goal that we have. And so that's how we move towards that framework of shared crisis response. We're all thinking the same thing, that we need to somehow and in many ways improve the system. But together, of course, we are stronger. And so we serve as that platform to keep talking, to keep getting those, identifying those gaps and talking to each other and coming up with solutions. CIT is not just Miami-Dade. CIT is throughout the country. In fact, it became international in 2008. And it all began with the Memphis model. And it became the Memphis model because, unfortunately, there was a great tragedy. And we lost a person, an adult male, with severe mental illness. And he was experiencing a psychotic episode. And he was cycling through the system repeatedly. And they had called police once again. This time, it really escalated. Unfortunately, this man was experiencing a psychotic episode. And he stood there with a very large knife in his hand, just cutting away, cutting away. And as police surrounded him and drew their guns and shouted commands, drop the weapon, drop the weapon, unfortunately, this man was unable to respond to the commands. And of course, he ended up launching towards the officers. And the officers, well, this man lost his life. This man lost his life. And of course, the community was at an uproar. And they were pointing fingers at law enforcement. Who else was there but law enforcement? But then a wonderful grassroots organization came along, the National Alliance on Mental Illness, NAMI. And they came to Memphis, Memphis NAMI at that time, and said, let us help you. Let's come together. Let's form a mayor's mental health task force. Let's figure out how to do this better and make everyone safer. And what they learned was that law enforcement became the lone responders of responses in the community to people in crisis. And no one was giving them any of the tools and resources and knowledge that they needed to better do and more safely do their job. And that's really how CIT was born. And that's why we call it the Memphis Model. So NAMI is one of our, you know, great partners, along with many, many of you here as well. And then in 2008, actually, CIT International came about. And that's the mothership. And that's so wonderful because it brought us all together. And we have so many different elements that help us to look, to focus, and to move forward. And so training, we're, we're, CIT is so good at training. We're known as the gold standard of training for law enforcement in mental health when it comes to behavioral health. And what we found is that since we became so good at that is that everyone thinks it's just training. CIT is training. But CIT is programming. CIT is continuous quality improvement. CIT is community-based. And it's just so much more than training. Because CIT is born in the classroom. But CIT lives in the community. CIT lives right here with us today. It is part of your board. And it is so important to, I'm just so, so grateful that I'm, I get to be here today and really give you the bigger picture of CIT. Because I know that many of you already know about CIT. But I wanted to introduce the, you know, the bigger picture, remind you of the bigger picture. Now, when we began, we, we asked law enforcement. When we began here in Miami-Dade, we asked law enforcement, if they could start collecting data, could you identify how many crisis calls you have, how many end up in arrests, how many may be involuntary examination? Give us some numbers. Start tracking your numbers. Because we all know that it's all in the numbers. And data can absolutely bring more initiatives and funding. And, well, you know the rest of that. And so, thankfully, some of our agencies began to collect data. So, what we did was take our two largest police agencies and we combined their numbers because they have been excellent in keeping data for actually the last 16 years. And so, what we did today was really just take a snapshot of it, really for, really to dive deep into, for example, Miami-Dade Sheriff's Office. You have Heather Winters here and then City of Miami as well. There is some good diving into their numbers and to really recognize, you know, what is the need in Miami-Dade County. And so, again, this is just a snapshot here. In 2025, combined, these two largest departments, we have over 10,000 mental health-related calls. And look, here's one of the greatest reasons for you to be very proud. 1.7% arrest. That's unheard of. When other communities hear about Miami-Dade 1.7 in one year, that's just, that really doesn't happen. That doesn't happen. And that's not just about the training. It's equally about the partnerships. Because if we don't have the agencies, not only police, but behavioral health on board, what are officers coming back to, right, when they get to the community? The training, well, how are they going to use it effectively if not the entire community is on board? So it reads, it says up here, you know, almost 9,000 connected to some type of treatment, service, care. Even it can go anywhere from providing them the mobile response team, which has been a lifesaver for us. Law enforcement is so grateful to have mobile response team. Because imagine an officer responding to a family who has a six-year-old child who has to be assessed. Is it really a police officer who's the best person to be assessing a child? We don't want that, and they don't want that either. A mental health crisis, assistance should not come in a police car. Oppsy. Yes, sir. 1,100 diverted from jail. That's post-arrest? That is from individuals diverted to jail. So that's pre-arrest. Thank you, doctor, for that question. Yes. So that comes with the education, the training of the officer. So then they become better assessors in assessing. They better understand more clearly the statute, 394, their responsibilities. And so now that they are better able to assess, they may recognize that a person, it may be a nonviolent misdemeanor, and the person is meeting Baker at criteria. An officer may divert to treatment instead of to jail, because now they were better informed. Now they had the greater picture. So they diverted to treatment instead of arresting them for trespassing, for something that we know they needed care first. So yes, thank you for that very important question. If we may, can we just give us the pertinent information? Because I hate that you're the last one, or we can save us for the next one. I know. I got it. Yes, yes, yes. Because we want to get through the rest of the agenda. Absolutely. So if you can just give us the highlights. I think a lot of us here know, I really wanted it for the public. But maybe we can, actually, maybe we can do your presentation at the next meeting. I don't know if you, please be okay with it. What do you need? Of course I'm okay with it. Okay, okay. Let's do that, because you have a lot of good information here, and I think it's important for us to know. But let's do this at the next meeting, finish at the next meeting. Sure, absolutely. I just want you to know that I am available. Most everybody has my number, and I'm happy to assist. And also, I want you to know, because this is this, I don't want to leave without doing this, Senator. Absolutely. So officers, when they do graduate from the 40-hour, they receive a CIT pin, and you'll see that some of our officers wear a silver pin out there, and law enforcement leadership will wear a gold pin. And so, you have so much to be proud of. So, Senator, I wanted to, if it's okay, present you with a CIT pin. May I ask? All right. Thank you. Thank you so much. No, come up. Come up. You don't have to come up. Just go around. You're fine. No, can you get here? I don't know. Oh, well, it's perfect. That works. Very nice. I appreciate it. Thank you. Yeah. I appreciate it. Thank you. Thank you for helping us get through this meeting. But I do, we'll make sure we'll get back to you. And look, folks, and for the public that's watching this, this is all the services that Miami-Dade County has, the, you know, through MRT and the CIT teams and the, with Thriving Minds, the Navigate program from Citrus Health. These are all important information that we have out there. And this is why when we look at the mobile crisis response team, that is something that can really get out to families in a desperate situation before calling the police. We can absolutely call this because I know, listen, through personal experience, sometimes you're so worried about your loved one that you, it's not that you're even fearful for yourself, you're fearful for them, and you rush to call the police when you can actually be calling these crisis and this mobile crisis teams that can really help de-escalate a situation and get them into some form of treatment. So I think it's important to the public to have this 1-800-HELP-U number on your refrigerators because we never know when we're going to need it. And if we can get all the folks on the panel to try to help promote that number through your different websites and social media, it's extremely important. You guys are going to kill me because it's going to increase maybe, hopefully it doesn't increase, but if there's an increase in cost through the promotion of this number, actually it would be a good thing because then we know that it's getting out to the people and we could fight for some funding from Tallahassee and from the county itself. Yes, sir. Yeah, I had one comment. I'm glad you're going to have a follow-up for CIT. I don't believe some of the numbers that are being stated and I'm going to look into my numbers to see what the arrests actually are. It's a lot higher. I can tell you right now it's a lot higher than 137. So it would be important to find out what criteria they're using to come up with that number because if the criteria was that the call was a mental health call, that's very different from what I see, which is a lot of times somebody who is unhoused, the police go out, they interact with that individual, that individual's mentally ill, they don't call a CIT and then they end up arresting that individual and then they come in and we know at the jail, all of a sudden they're in a crisis unit. So they never got diverted. So I want to dive a little deeper because this is really important for us to address this issue. The last thing that I wanted to mention is I would love to be able to get what I asked for two years ago, which was the list of the officers who, from every department, who have gone through the training, the date that they got the certificate, and also whether they got a refresher or not. Because I'm going to bring up a name, Richard Hollis. He was killed. And at the time I was trying to verify because everybody told us that person is a CIT officer. And my client, my former client, was mentally ill. So I want to make sure that we get to the bottom of it. I know that it's done a lot of good over the years and I think it can be better, but I think part of it is going to have to be what accountability do you have? Not just, oh, somebody went through the program, is what's the monitoring? What are the departments doing to make sure that they're getting refresher and to also look at excessive use of force reports because most of the time when we have those issues happens to be one of our mentally ill clients. So that's for the next one. I would love that. All right. So I think there's a motion and a second to have you being voluntoed to look into these numbers for us. So Amanda, if you can, or maybe through a directive of the county commission, we can try to get some of these numbers and clarification, some of these numbers to us so we can look at them as a board itself to see exactly where we are and see what needs to be done. I do, it'll be interesting to see the number of officers. Obviously, we don't need their names. I don't think I want their names. I think we want to redact that. But just to see the number of officers and when the last refresher course was taken, because that in itself is, I think that's the whole purpose of the program, to make sure they keep up to date. Yes. And through the chair, just for clarification purposes, individuals that are coming into contact with a CIT officer that could be potentially diverted, they're not diverting individuals that would otherwise be charged with a felony. They are booking them in jail with the idea in mind that corrections health services through Jackson are going to do the psychiatric triage when they come in. And it is for nonviolent misdemeanors that are potentially divertible. We're good. And through the chair, I would just add one more thing. When we're looking at the CIT trained officers in response, we're talking about law enforcement. We also have some co-responder models, including licensed mental health professionals co-responding with officers, both through Miami-Dade Sheriff's Office and City of Miami PD as well, looking at maybe some of those stats and how that model operates. And do we got that? So through the board, I just want to verify that, because you mentioned a first and a second, just a... I was just messing with him. Oh. I think he's going to do... I think he knows he's going to do the work, look at these numbers, so... But if we need a directive from us, do you want us to have a directive? So I direct you to try to get these numbers. All right. So there's... Claudio is making the motion. Amen. And Alfredo is making the second, I guess. And we'll go from there and volunteer... Huh? Got it. Yep. To volunteer the public defender to look into these numbers and to have you try to pull these numbers from the Sheriff's Office as well, work together with her office. She's been very helpful throughout her tenure. So, and I know she believes in this program, so it's important to make sure that we work well together. All right. We're good. Oh, there's a motion and a second. All in favor, say aye. I'll oppose like sign. Okay. Keeping me on track. All right. Let's move on to approval of minutes. And Kathy, we're going to you next, so we can get you out of here. And I thank you for hanging out with us. So you all have had an opportunity to see the minutes. Is there any questions about the minutes? I move we approve the minutes as stated. Improve the minutes. There's a motion and a second. I'll oppose. I mean, all in favor, say aye. Aye. I'll oppose like sign. All right. With that, we're moving to the mental health center update by Kathy Burgels. And this is the mental health facility that we have. The county is working together to get this building up and running. That was approved by the county commission. And this is where we are. So Kathy is here to give us an update since this commission, this board, has overseeing rights over it, I guess. Senator Garcia, thank you for your advocacy. All of my friends are around the table. And I am happy to report that many of these stakeholders we meet monthly to give updates on the mental health facility because your voices are extremely important to my team as we move forward. But I understand I am what's in between this meeting ending and your lunch. Therefore, I will give you a fast update. First of all, I want to really congratulate my team. Amanda has been the glue to this project. Matias, Eddie, and Amanda, I salute you. I remind our lovely Judge Leifman that it takes more than a dream. It takes a team of professionals coming to the table and really finding ways to respect the work that we all have and the tasks that we have to serve those who are most vulnerable in this community. So today, and I think you've heard from so many of our partners, today the theme is collaboration. It takes an entire village to pull off this plan. Since the passing of the item, and thank you for that, Senator Garcia, as you mentioned at the beginning of this meeting, we have, as a community, really focused on the items within our mental health plan. And some of those items include our WestCare contract, as well as the advocate contract, have been fully executed. Many of you know that that includes our county attorney's office, as well as other partners to make that happen. They have continued to do the onboarding, and they're hiring the staff that will be providing the direct services. Also, the state has approved our land use plan, which means that we're able to fully deliver the components within our mental health facilities. So we're really proud of that work. A huge milestone. So we've been able to meet. The order of the furniture. You all cannot imagine how many hours of visiting the facility, working closely with all of our county departments that that has taken. I do want to give a shout out to both our PIOD, as well as Strategic Procurement Department, for making it happen. Did I mention that it's more than 350 pieces of furniture, have been ordered. And many of you know that we have to have the furniture in place before we can get certified and accredited by ACA, as well as Department of Children and Families. I'm looking at both Lourdes and Laura. Without you, this work could not be done. I was just informed by our OMB, our management and budget department within the county, that we have received approval from the state for the extension of bringing the designated receiving system and transportation plan. What that means is that we will be able to become a part of the providers that are being utilized by law enforcement to transport those who are being Baker Acted, as well as those within the Marchman Act. So we're extremely, extremely proud of that work. Our team will continue to report to this board. And thank you, Senator Garcia. You mentioned at the beginning that you are overseeing and being involved with the mental health facility. The last thing I will say, that we're extremely proud of the work that our mayor and our chief continue to support us in doing. Our mayor has implemented, as part of her strategic priority, the healthy and safe community, which really focuses on a no-wrong-door approach to serving those who are in need, that want, and need services. So thank you so much. Thank you, Kathy. And as I keep on iterating at every meeting, I want to make sure that this building, at some point, starts serving a lot more people than just the jail diversion program that we're trying to service right now. But that is as we move forward. I appreciate your update. When are we looking to see? When is the deadline? Is there a deadline? Are we looking for a date that we're going to start bringing people into the building? Senator Garcia, I would like to first clarify something, and maybe I did not include that in my report. The facility will serve not only those who are awaiting trial and being diverted from the criminal justice system, but it will also serve community individuals who are severely mentally ill. Many of the folks around the table have been involved in our criteria conversation that also includes Judge Verde. I appreciate that, but you say severely mentally ill. I think that a lot of our families are looking for a little bit more than just severely, because I think those severely, a lot of people that we're looking at servicing that need service are people that are unhoused and on our streets. I think it's important that as we get through that first phase, that we continue to see how we can expand to making sure that families have access. So I appreciate the work that you're doing. I'm saying that for a reason. This is something I think a lot of us in this board would like to see moving forward in the future. But I appreciate, I think all of us here have nothing but respect for you and know the work that you're doing and the tightrope that you're walking. So I appreciate you for continuing to be honest with us and for keeping this project moving forward at the best rate that you can. So is there any questions, members? Through the chair, I just want to clarify. There is a living room model being embedded in this facility, which will welcome community members and give an opportunity for an evaluation. I just think that some of the other levels might be earmarked for people that need them due to severe mental illness. But I don't think that that someone that's dealing with stressors is not welcome in the facility right now. Thank you. And through the chair, if I may, since Manny also gave some clarification, Manny, I failed to mention the important work that both you and Vicki, not only with bringing funding to the table, but also being involved in the creation of the model. So I wanted to thank you for that. I appreciate you. I figured it was for your brevity. That was good. You're awesome. All right. Thank you, Kathy. Any questions, members? All right, Kathy. Thank you. Appreciate you. Amanda, let's go through this agenda. Members, thank you for your indulgence and thank you for sticking around. We are now where, Amanda, on an old business, eh? Yes, through the board, the Behavioral Health Board, there was a proposal for a trust fund mentioned in the last meeting in August. And through our chair, thank you, Senator René Garcia, there was delineated, there is a legislative item in Legislature that is currently pending passage by the Board of County Commissioners. The calendar for review by the BCC is currently on November 17th at their next meeting, so this is something that's rapidly approaching. I did include the actual information in your package for review for the next meeting in case you would like to discuss anything. All we're doing is creating a trust fund so we could have folks donate to that trust fund to help see if we can increase some of the services to our community and work through our partners, obviously. And actually, this could be worked through this board. This board is full of our partners, but worked through this board before any disbursement of these dollars were done. So it's just trying to have a mechanism in place to try to raise some additional dollars from the private sector. Amanda, we're in BCC, public awareness campaign, final review? Yes, through the board. There is a document within your agenda packets with the data that was requested in the last meeting of the final numbers. The final list of followings, the final list of interactions with regards to the campaign. But I want to say thank you to each and every single one of you and all the four different subcommittees that have really worked together and collaborated to make this campaign possible. Yourself, Chair, with the messaging and the billboard and all of the different ads, we have received a lot of traction from the community. They are contacting me directly. I'm like a first point of contact, which is great because I can link and provide resources myself. It is very nice. I do see an increase in awareness, and people are talking more, and they're connecting more. But I want to say thank you to each and every one of you for making this possible and for collaborating on such an important initiative. Yes, members, what I've done through the funds of our district office that were approved by the county commission, and I just don't make that allocation myself, but it was approved by the county commission. We did put up a couple of billboards. We did a campaign in the movie theaters. We did a campaign in the movie theaters, and we did one billboards off the Palmetto, which was the Let's Talk campaign, and using the 988 number. But I think moving forward, maybe we should, if we get to that point, maybe at the next meeting, you can help us. Maybe I started doing the 1-800-HELP-YOU, because that would be a great one. I think that is a good number for families, because the other one is a crisis number. They're both crisis numbers, but maybe this is a more directive number that can get folks more in the community to understand that there is more than just the 988 number, too. So just bring that information to the board so you guys can know what we've done on our site. Amanda, we went through A and B, right? We're done, so now we're in announcements. Yes, this is just an announcement for all of the board members. I have emailed you separately in regards to some of the trainings that are required through the clear compiler, so if you're able to please complete those trainings and respond it back to myself and include the clear compiler's email address, I can definitely assist in getting all of the updated trainings finalized. Anything else, members? Okay, Amanda, in the next Behavioral Health Board meeting? Yes, so through the board, the next Behavioral Health Board meeting is scheduled for Monday, December 14th, at 10 a.m. here at the Stephen P. Clark Center, so that would be our next meeting. Is everyone able to attend the next meeting? Please let me know if there's any... Oh, don't ask. That's the meeting. Whoever can't make it, because we won't be able to get out of here. All right, so members, I'd like to have action items. I hate to do this to our public defender, but the action item for our next meeting will be on him. Actually, I don't hate doing it. I like doing it. I like putting him to work. But, Amanda, I think we have some work to do for us so that at the next meeting we can dig deep into these numbers and have a conversation about the school. Actually, you're doing some digging, too, right? So, yes, we have two. We have two that has homework to bring back to us some of these numbers, and then we can have a dialogue and a conversation to see what the next steps are, see if we need to find funding from the... We have a little pot of money left that maybe could help, or if we go to the county just trying to figure out what the next steps are. The CIT program will finish that conversation at the next meeting. I think it's important for us to understand what our police officers are doing, so it's all in conjunction with each other, and then we can come up with an action plan as part of the board. So before I adjourn, we adjourn. I'm going to look around if anyone has any unreadiness, any questions. You guys are hungry, huh? Okay. All right, so with that, Luis Espinosa moves we rise. Thank you, folks. Thank you very much. Thank you. Thank you.