Senate Budget and Fiscal Review Subcommittee No. 5 on Corrections, Public Safety, Judiciary, Labor and Transportation
- María Elena Durazo
Legislator
The Senate Budget Subcommitee number five on public safety, the judiciary, labor and transportation will come to order. Good morning. The Senate continues to welcome the public in person and via the teleconference service. For individuals wishing to provide public comment, today's participant number is 844-291-5491 and the access code is 704-2477 we are holding our Committee hearings in the Capitol. I ask Members to be present in room 112 so we can establish a quorum and begin our hearing. We have 14 issues on today's agenda.
- María Elena Durazo
Legislator
Before we hear presentation on the issues, Madam Consultant, let's establish a quorum.
- Committee Secretary
Person
[Roll Call]
- María Elena Durazo
Legislator
We have quorum. The consultant notes a quorum has been established. Today's hearing will cover the Commission on Peace Officer Standards and Training, the Office of Emergency Services, and the Department of Corrections and Rehabilitation. All items will be held open, and public comment will be taken at the end. We will begin with issue one, which is the peace officer certification hearings. And if we would ask Mr. Manny Alvarez, Executive Director of the Commission on Peace Officer Standards and Training.
- María Elena Durazo
Legislator
And then we will have LAO and Department of Finance following. Good morning. Go ahead, Mr. Alvarez.
- Manny Alvarez
Person
All right. Good morning. Madam Chair Durazo and Senators on the Subcommitee and all the staff. My name is Manny Alvarez, and I serve as the Executive Director of the Commission on Peace Officer Standards and Training, or POST, as we are commonly referred to. Seated to my right is Assistant Executive Director Annemarie Del Mugnaio. Assistant Executive Director Del Mugnaio is responsible for the new Peace Officer Standards Accountability Division within POST. Thank you for the opportunity to testify at this morning's hearing.
- Manny Alvarez
Person
POST is a regulatory agency which sets the minimum selection and training standards for approximately 600 law enforcement agencies and approximately 90,000 peace officers and public safety dispatchers in California. Pursuant to the Penal Code, the Post Commission is made up of 18 Members, 15 of which are appointed by the Governor, two by leadership in the Legislature, and one is a permanent ex officio position for the Attorney General. Today we will speak to where we stand with the execution of Senate Bill 2.
- Manny Alvarez
Person
Our testimony will include implementation steps, the volume of serious misconduct reporting we've received since January 1 of this year, as well as the need for additional funding to support expected expenditures for evidentiary hearings before The Office of Administrative Hearings, hearings which are required pursuant to the legislation. Prior to the Governor signing Senate Bill 2, POST began coordinating implementation should the bill be signed into law. Immediately after the bill was signed by the Governor, post redirected approximately 8% of our existing staff to the implementation project.
- Manny Alvarez
Person
In the spring of 2022, the Commission approved over 20 new regulations for law enforcement agencies to follow. Once fiscal resources were provided to post in the FY 2022-23 budget, POST started hiring for the new division in earnest. We also started training law enforcement personnel across the state. Since July 2022, POST has trained more than 3,200 law enforcement personnel on Senate Bill two on the new regulations as well as procedures to be used by law enforcement departments to report serious misconduct to POST.
- Manny Alvarez
Person
POST also worked diligently and accomplished implementation of a software platform for law enforcement departments to submit data and to enable POST to track investigations and perform overall case management. We've separately trained over 1,700 law enforcement personnel on the use of this new technology. Assistant Executive Director Del Mugnaio will now provide information on the current and expected volume of data on certification actions, and she will detail the need for funding to support the evidentiary hearings before the Office of Administrative Hearings. Annemarie.
- Annemarie Del Mugnaio
Person
Good morning. Chair Durazo and Members of the Subcommitee. My name is Annemarie Del Mugnaio. I am the assistant executive director of the Peace Officer Standards and Accountability Division within POST. Today, the division is in full operation and is comprised of six bureaus, certification intake and disposition and four professional conduct bureaus that are broken into four districts across the state similar to that of the Office of Administrative Hearings.
- Annemarie Del Mugnaio
Person
Since January 1, 2023 the division has received approximately 5,000 reports of serious misconduct from approximately 31% of the 690 law enforcement agencies across the state, which on average is roughly 400 reports weekly. About 59% of those reports received are what we refer to as lookback cases, where the investigations and of findings occurred between January 1, 2020 and January 1, 2023.
- Annemarie Del Mugnaio
Person
Senate Bill 2 included provisions for law enforcement agencies to submit lookback reports of serious misconduct to POST by June 30 of 2023 and POST to act on cases involving excessive use of force likely to cause serious bodily injury or death, cases of dishonesty, and cases of sexual assault. It should be noted that while POST shows that only 30% of the agencies are currently reporting, these are the largest law enforcement agencies in the state and employ roughly 85,000 peace officers.
- Annemarie Del Mugnaio
Person
It should also be noticed that while the largest peace officer agencies in the state are reporting, they are not necessarily reporting proportionately to the number of officers that they currently employ. Given the sheer number of reports, the division has implemented a triage system whereupon initial review of the serious misconduct reports staff assign a priority to these cases according to the serious nature of the act and whether the subject peace officer is still employed.
- Annemarie Del Mugnaio
Person
Currently, the division is actively reviewing 2,000 cases that may result in some form of action. The division has also elevated 15 cases to the Executive Director that have resulted in the issuance of immediate temporary suspension where the subject officer is suspended from serving as a peace officer until full adjudication of the case or until the matter has been resolved through criminal proceedings.
- Annemarie Del Mugnaio
Person
Today, we're before you requesting the 4.5 million from the General Fund in 23-24 and the 3.9 million ongoing to fund the work of the Office of Administrative Hearings. These costs are associated with the adjudication of the Peace Officer Decertification program as required under Senate Bill 2. POST estimates it will receive thousands of cases monthly once all agencies begin to fully report acts of serious misconduct.
- Annemarie Del Mugnaio
Person
The projection is based on analyzing the public complaints previously submitted to the Department of Justice annually, where roughly 3,000 to 3,400 of those complaints involved acts of serious misconduct by peace officers, which may result in some form of disciplinary action, where the officer is afforded due process and a hearing. We do project that about 30% of those cases may be handled through stipulated settlements and not reach a full evidentiary hearing.
- Annemarie Del Mugnaio
Person
That being said, there's still workload associated with these settlement agreements through the Office of Administrative Hearings, including analyzing the complexity of the case, calendaring the matter for a hearing, scheduling and staffing settlement conferences, and consultation on resolution. While POST appreciates that there is a great deal of uncertainty regarding the volume of cases that will result in decertification, we know this workload is ongoing.
- Annemarie Del Mugnaio
Person
We respectfully request your approval of this funding to enable POST to meet the mandates of Senate Bill 2 and to responsibly address acts of serious misconduct by peace officers who pose a threat to the public's health, welfare and safety. Thank you.
- Annemarie Del Mugnaio
Person
Thank you.
- Manny Alvarez
Person
Thank you.
- María Elena Durazo
Legislator
Does that conclude your presentation?
- Manny Alvarez
Person
Thank you, Madam Chair.
- María Elena Durazo
Legislator
Great. Thank you. Thank you both very much. Now we want to move on to the LAO. Is that Mr. Sippel?
- Jared Sippel
Person
Thank you, Madam Chair, Senators, my name is Jared Sippel. I'm with the LAO for this proposal. We recognize there is a funding need here. However, because of the recent implementation of SB 2 and the peace officer decertification process, the number of evidentiary hearings that will be filed with the Office of Administrative Hearings is uncertain at this point of time, and so there's really no actual caseload data to base the ongoing funding level needs on.
- Jared Sippel
Person
In addition, POST is still building its capacity to review and process cases which could affect the number and volume of cases that are filed with the Office of Administrative Hearings. And for these reasons, we make two recommendations for the Legislature's consideration. The first is we recommend that the Legislature approve the funding for three years, as opposed to ongoing, as proposed by the Governor, and require POST to report on its office of administrative hearing cost over that time.
- Jared Sippel
Person
We believe that with that information and after that time, the Legislature would be better positioned to determine what the ongoing funding level needs are for these costs. In addition, our second recommendation is because of the uncertainty around the number of cases and that there may be fewer cases filed with the Office of Administrative Hearings than estimated.
- Jared Sippel
Person
We would recommend the Legislature adopt provisional language that limits the use of these funds to office of administrative hearing cost and requires any unspent funds to revert to the General Fund. That way, in the event that costs are less than estimated, these funds would revert to the General Fund, which we believe is important given the current budget environment. And so with that, I'm happy to answer any questions you may have.
- María Elena Durazo
Legislator
Thank you. And from Department of Finance, Ms. Tomlinson.
- Sarah Tomlinson
Person
The administration acknowledges that the ongoing cost to the commission for decertification hearings represents the best estimates available at this time and that costs in the future could vary. However, the administration notes that this request is based on conservative estimates and the costs and workload associated with these hearings will be ongoing. Accordingly, the administration's position is that ongoing funding for this purpose is the most appropriate and reasonable approach at this time as it pertains to supporting post implementation of SB 2.
- Sarah Tomlinson
Person
The administration does not have concerns with additional reporting. As post can explain in more detail, SB 2 did include a reporting requirement and could be leveraged for this purpose. Thank you.
- María Elena Durazo
Legislator
Thank you very much. Thank you. Colleagues. Questions? Comments? No? I have a couple just with response to the Department of Finance or to Mr. Alvarez. Do you have any, or what might your concerns be from the recommendation from the LAO for limited term funding? You'd get the funding, but limited term. So anybody who wants to address that.
- Allison Hewitt
Person
Allison Hewitt, Department of Finance. Ultimately, I think the administration would be open to working with the Legislature on that. From our perspective, though, this is an ongoing cost associated with the implementation of legislation. I believe, as my colleague from POST shared, the volume of cases that POST is taking in is extreme. And so, in fact, this amount may need to be adjusted up rather than down because we took a relatively conservative approach.
- Allison Hewitt
Person
Ultimately, it will just leave us somewhat with a budget gap in the out years because we think that costs will be ongoing. We would just not have funding programmed in those out years to cover these costs. So we'd have to factor and account for those in future years.
- María Elena Durazo
Legislator
So what if there's a larger workload than anticipated?
- Allison Hewitt
Person
Last year, when we brought forward a proposal to staff post for SB 2, I think we were clear that it was based, and my colleagues can correct me if I'm wrong, but there's no state that is really comparable to us in terms of both the expansiveness of the law and then similarities in terms of operations. So we were clear that this was kind of our best guess. But there may be needs to adjust in the future.
- Allison Hewitt
Person
And just given the volume, I think it's something that we'll be looking at closely. The annual reporting requirements that my colleague alluded to and that POST can speak to in a bit more detail will provide us extensive information on an annual basis in terms of the volume that they're seeing. But we still feel that what we're bringing forward now kind of represents the best that we have, with an opportunity to monitor each year in terms of how the process rolls out.
- María Elena Durazo
Legislator
Okay, anyone want to comment on that?
- Manny Alvarez
Person
We could provide workload the reporting requirements under Senate Bill 2, and Marie could discuss that, obviously concur with Ms. Hewitt's comments. Any funding that we do receive, obviously we will return to the General Fund as LAO's recommendation number two. That is a given for us. Could you go over some of the reporting requirements, Annemarie, please?
- Annemarie Del Mugnaio
Person
So, currently, under Penal Code Section 13510.9, which was part of SB 2, initially, there is a requirement that POST produce an annual report, and it's extensive.
- Annemarie Del Mugnaio
Person
It's unemployment, termination, separations, charges, complaints, allegations of serious misconduct, settlements of civilian claims, civil judgments, the number of law enforcement agencies reporting, number of cases sent to peace officers regarding cases of serious misconduct, number of hearings conducted by the board and the commission, number of hearings conducted by the Office of Administrative Hearings, number of certifications that have been surrendered, suspended, or otherwise revoked, the number of audits and reviews conducted internally regarding the analysis of an investigation submitted by the law enforcement agencies.
- Annemarie Del Mugnaio
Person
And that isn't the full host of that report. So there's quite an extensive reporting requirement currently in the law that POST will report on annually in terms of the workload. I think it's fair to mention that when we looked at historically the number of public complaints submitted in California to the Department of Justice, and again, that's limited, it's not the full expansive nine acts of serious misconduct. There's 16,000 cases reported annually to the Department of Justice.
- Annemarie Del Mugnaio
Person
So again, we feel as though this is a pretty conservative effort or estimate. Also to be noted, unlike other licensing regulatory provisions in the State of California, if a peace officer is revoked there's not an opportunity to reinstate as there is in most professions. Therefore, chances are an individual who feels like they have an opportunity to appeal this decertification finding is most likely going to take this through full adjudication.
- Annemarie Del Mugnaio
Person
Since there's not an opportunity to come back in a year or two and petition the state for reinstatement of that license, they're essentially losing their livelihood for the rest of their career. Thank you.
- María Elena Durazo
Legislator
Okay. Yes, Senator.
- Kelly Seyarto
Legislator
So essentially what you're saying is because this is the first year, we have absolutely no idea how much this is going to cost. So we need some flexibility in funding, including the flexibility to add more so that we can get an accurate read by the end of the year on what this portion with the catch up stuff is going to be.
- Kelly Seyarto
Legislator
And then going forward, we'll probably need another two years of normal operations to figure out where this ultimately lands from a funding and budgeting perspective for every year going forward.
- Annemarie Del Mugnaio
Person
I think that's reasonable, but I will defer to my colleagues at Department of Finance.
- Sarah Tomlinson
Person
Our proposal is just what we included in the budget for last year and this funding. So we would say that this is what we need for now to the extent that we needed more. I guess in some sense we're asking for flexibility in that we want ongoing funding, but I don't think we're asking that there's any language that allows us to augment or anything like that.
- Kelly Seyarto
Legislator
Well, I just want to make sure that you guys have the tools and resources you need to do what this bill says so that we could get an accurate idea of how it's being utilized and how effective it is by the end of the next year and then in the subsequent couple of years after that. That's all. Thank you.
- María Elena Durazo
Legislator
Thank you, Senator. Well, thank you both very much for the presentation. It's a very big task that you have in front of you, but we think you need the resources to be able to do that. So appreciate. Thank you very much.
- Manny Alvarez
Person
Thank you.
- Annemarie Del Mugnaio
Person
Thank you, Madam Chair.
- María Elena Durazo
Legislator
We'll move on now to department overview with Cal OES. We had hoped to have our new Director, Nancy Ward. Unfortunately, she is at a storm recovery event and won't be able to be with us, but fortunately, we have the Deputy Director, Ms. Christina Curry, welcome.
- Christina Curry
Person
Thank you very much. Good morning, Chair Derasso, Members of the Committee. As you stated, my name is Tina Curry. I'm Chief Deputy Director at the Governor's Office of Emergency Services. And joined here with me are Deputy Director of Finance Administration, excuse me, Eric Swanson. I'll just give a very brief overview of the department, and then we'll move to other speakers for your issues on your agenda. Well, 2023, kind of goes without saying, has already been a really eventful year for emergencies and disasters.
- Christina Curry
Person
And our communities in California have been through a lot between atmospheric rivers that started back in late December and January of this year, followed by more cold storms in February, unprecedented snowpack, and then this latest atmospheric river series that has occurred here in March. Cal OES, in partnership with other state and federal agencies, has been coordinating all along through all of these events. The state and local response and recovery all across the state, from corner to corner, has been impacted by these storms.
- Christina Curry
Person
In a nutshell and in short, our role is that of coordination to bring together all of the elements of government and nongovernment organizations that would be needed to contend with a disaster of any type. We're charged with anticipating, planning, and preparing to coordinate critical resources and support to impacted communities, to protect their lives, to protect their property, and ultimately to see them through for the needed support for the recovery from these disasters. Over the last several years, the state has experienced an unprecedented number of emergencies and disasters.
- Christina Curry
Person
We've had catastrophic wildfires, as you're well aware. We've had power grid challenges, outages, extreme heat, earthquakes, the pandemic, and then we swung from a severe drought situation to what we face now with this extreme weather and storms. Fifteen of the most destructive fires in the state's history have occurred since 2015, and seven of those just in the last three years. So as a result of these circumstances, California has moved into a new era, a new chapter of emergency management and disaster response and recovery.
- Christina Curry
Person
We have to do things differently. Emergencies and disasters are more frequent, they're more complicated to respond to, and they involve multiple counties and regions of the state, all at the same time. During the last few years, Cal OES has been before you, discussing the changing and worsening disaster landscape. And with your support, we've made significant investments in creating a stronger Cal OES for our communities.
- Christina Curry
Person
This year, we have proposals to make permanent California's cybersecurity Integration center and expand what we call hazard mitigation, or that risk reduction investment into resilience against future hazards to improve our processes and advance our coordination to individuals who are receiving this important aid. I was asked to touch a little bit on the current storms that we've been facing. In addition to the atmospheric events I mentioned earlier in January and February, California has now faced about 12 of these, one after another.
- Christina Curry
Person
And for the March event specifically, Governor Newsom has declared a state of emergency and has also requested direct federal assistance from the federal emergency management agencies. In 43, I'm sorry. Of California's 58 counties so far, Cal OES, along with our critical state and local partners in FEMA, used technology predictive modeling, all the information that we could garner about these atmospheric rivers, excuse me, in order to preposition resources.
- Christina Curry
Person
So all throughout the state, as we saw these storms coming, we wanted to make sure that life saving resources for rescue, for response to disasters were in place ahead of time so that they could be put to work to conduct those life safety actions.
- Christina Curry
Person
Those included fire engines, what we call incident management teams to oversee the response, swift water rescue teams, high water vehicles through the National Guard, as well as snow removal equipment and essential supplies such as food, water, and sheltering supplies like cots and blankets, et cetera.
- Christina Curry
Person
We're also working closely with FEMA to conduct damage assessments to rapidly while we're still responding, learn what we can assess, where we can access it to understand the impact of this disaster, especially in those hardest hit counties where we know there's damage, to determine if California will meet the threshold for further federal assistance. There are thresholds that California has to exceed in order to be successful in those types of requests, but we're working on that night and day. At the same time we're responding.
- Christina Curry
Person
These storms, like so many other disasters, disproportionately impact the most vulnerable Californians. During this event, state government is taking a new and novel approach to disaster management by prioritizing how we communicate during a crisis to emphasize outreach to those who need it most. We firmly believe that the chances of a Californian surviving a disaster should not depend on their age, their ability, their zip code, and it shouldn't matter what language they speak or how much money is in their bank account.
- Christina Curry
Person
With new funding approved last year by the Legislature and championed by Governor Newsom, the team at OES changed our communication approach for this event to speak directly to those who are too often overlooked and most at risk. We have also established what we call a priority populations task force that is bringing together all of the different agencies and experts and charged with identifying ways to protect Californians who these storms threaten most. Materials were deliberately prepared to be culturally and linguistically inviting, accessible, respectful, and useful.
- Christina Curry
Person
Outreach likewise, was intentionally designed to be people centered and people powered in harnessing the strength of local community groups whose leaders and members know best how to reach their vulnerable communities and importantly, have the trust of their community members and working rapidly on the ground to get the word out. As noted in your agenda, the 2022 Budget Act included a requirement for the department to submit a report to the Legislature next year outlining our emergency preparedness and response planning strategies.
- Christina Curry
Person
This report is a priority for Director Ward, and we look forward to discussing with you in the next year. Today we brought together Cal OES program experts to discuss the items on your agenda. But thank you for your time on that brief overview and happy to answer any questions you have of me at this time.
- María Elena Durazo
Legislator
Thank you very much and appreciate the update and the report. So many millions of people rely on you and your services, so appreciate that. Thank you very much.
- Kelly Seyarto
Legislator
I really appreciate the work that OES has been doing, especially in response to these atmospheric rivers and our snowpack and down in San Bernardino mountains, and we're having issues there. So in the next two months, that snowpack is going to melt and it's going to melt at a rate that we probably haven't ever seen before.
- Kelly Seyarto
Legislator
And what is being done and has it been budgeted in here to deal with rivers and other waterways that we probably have not seen them crest like they're going to, and especially in areas that are lower lying areas, the ones that catch it at the end, which are a lot of in the Central Valley and places like that, is OES budgeting for that? And also is FEMA taking into account?
- Kelly Seyarto
Legislator
Because it's always nice to have their help after it starts, but it's also nice to have their help before it starts so we can get people out of the way because that's the only way we're going to be able to deal with it is allowing people to have enough lead time to get out of the way because that's going, I saw what happened 20 years ago up at the Walker River. It went up the sides of the walls of the Hell Canyon, which is unbelievable.
- Kelly Seyarto
Legislator
And we didn't have half of what we have here. And so I'm really concerned about going forward, not just what happened, but going forward and that we have our eyes on that.
- Christina Curry
Person
Thank you so much for that comment question. I'll try to answer the different things that you brought up. First of all, this incident is still ongoing to your point. We're already working with an important partner, Department of Water Resources and others who do modeling, who understand the historic snowpack that faces and how that's going to present itself. So we don't see ourselves exiting response by any means, but we're also going to be simultaneously working with these communities who've already been impacted on their recovery.
- Christina Curry
Person
Part of what we do is forward planning. It is what allowed us to station these response resources where they were for the current storm. So be looking at things like that. Where do we expect future flood impacts? And then as we go forward, working with FEMA on some type of assistance request, part of what we'll be looking about is what is the incident, if you will, because it's not unlike wildfires that have consequences down the line when it rains.
- Christina Curry
Person
These events with the snowpack that has already fallen will have consequences down the line. So we'll take that into consideration as we figure out what the trajectory of assistance will be. But we will continue to be planning for and responding to what is expected to come with this snow melt and certainly is going to continue to impact our communities. But thank you for that question.
- Kelly Seyarto
Legislator
And I think a big part of that is going to be displacement before people are floating down the river. And so I hope that's in the budget and we certainly support that if it is. Thank you.
- María Elena Durazo
Legislator
Thank you, Senator. Okay. Just a couple of things. You're involved in putting together a strategic plan by next February and just whatever thoughts you have on how that's moving along to be able to get to that plan.
- Christina Curry
Person
Yeah, and I mentioned it briefly, too. We're definitely on track to prepare that and working through, as you can see with my description of the types of things we face, we're an agency that has to be both anticipatory and responsive, given the fact we have all hazards in California we can't predict. So we're going to be thoughtful, work through a lot of the existing constructs we have.
- Christina Curry
Person
But importantly, lessons learned from these disasters because every one of them presents us some way, some learning of how things can work better or capitalize on those things that worked well so that we can continue to do them. So it is a priority for us. And we're going to take a thoughtful approach, especially given everything that we've been through in California and working with you going forward on that important report.
- María Elena Durazo
Legislator
Well, I look forward also to seeing how you juggle the core mission that you have with regards to emergency services, but you also have responsibility over non emergency services like grants and victims services, preventative measures. So how do those all fit in with the core mission? Right?
- Christina Curry
Person
Yeah, absolutely. Well, we have experts in Cal OES s that lend to disaster response. So certainly we're leveraging that. But one of the important investments that you made and that we worked with you was to make permanent our disaster response. We were actually redirecting staff from those very programs you mentioned and you can imagine the balance that that required and some disruption to some of our city state work. So we're very pleased to have that capability now.
- Christina Curry
Person
It has allowed us to respond to these disasters that have impacted us so far and certainly going forward, that is a huge help towards our ability to support California communities with what we need to do.
- María Elena Durazo
Legislator
Okay, thank you. Thank you very much for your presentation. We're going to move on to issue three, and that's implementing a 988 behavioral mental health hotline. And we begin with Budge Currier, as I correct. And Eric Swanson, welcome.
- Eric Swanson
Person
Thank you, Chair. I am Eric Swanson, Deputy Director of Finance Administration at Cal OES. This item on your agenda is a request for four positions and 23.8 million 988 State Suicide and Behavioral Health Crisis Services Fund in 2023-24 and ongoing to support activities required to implement AB 988. This amount includes a request to shift the 6 million in ongoing funding authorized in the 22-23 budget from the General Fund to this new 988 Fund. And with me today is Mr. Currier, who will further describe our proposal.
- María Elena Durazo
Legislator
Thank you. Welcome.
- Budge Currier
Person
All right. Thank you, Madam Chair, and thank you, Members of the Subcommitee. My name is Budge Currier. I oversee public safety communications within Cal OES, which includes 911 and 988. And I'm going to give you a brief update on the progress we've made since we first began this 988 journey. As you may recall, on July 16 2022 988 became the national lifeline and suicide hotline number.
- Budge Currier
Person
That was an effort that was initiated by the Federal Government and we responded to that, requested a BCP, which thankfully, and we appreciate your support, you authorized that to help us to begin the work, to move beyond just the ability to do sort of a basic transfer between 911 and 988 to really implement a system that no matter what choice an individual makes, whether it's calling 988, calling 911, calling what's called a warm line, which are direct lines into some of these centers throughout the state, they have access to the same services, which means we need the ability to move that call and that information between those systems.
- Budge Currier
Person
So we began that work. We're happy to report that we completed a competitive bid process. We selected a vendor, we've conducted kickoff meetings. Initial site surveys have been done at all the 12 centers, and we're starting that initial workflow analysis to roll out that software. Then along came AB 988, as we were in beginning stages of that process, and it added some additional requirements to what we are currently doing. So our next steps were already identified.
- Budge Currier
Person
We know we need to continue to roll out that technology that will support answering the call and providing the information needed for the counselors to be able to service those who are calling in. But it gave us some additional requirements. It established Cal OES as the technical lead for 988 and also gave us the requirement to administer the 988 surcharge. It identified HHS as the policy lead and required us to collaborate. And I'm happy to report that collaboration is going well.
- Budge Currier
Person
We meet weekly, sometimes more frequently, depending on what is going on. And we've also stood up a 988 technical advisory board. That board has met a couple of times. There's some publicly available information on what that board has done so far. We've established some working groups. We've identified a 988 system Director within Cal OES, and it also added some mobile crisis response capabilities and additional requirements down to those centers.
- Budge Currier
Person
And it's those additional workload above and beyond that federal, initial, federal requirement that the budget request that's before you this year is really focused on. And that's the summary that Eric gave. And again, our goal is the same. We want to make sure that no matter what choice an individual makes, they have equal access to all of these services, and we're bringing these systems up together.
- Budge Currier
Person
The next one we'll be briefing out in the next agenda item, next gen 911 is a key part of this technology initiative. So happy to answer any questions.
- María Elena Durazo
Legislator
Thank you very much. The LAO's Office.
- Drew Soderborg
Person
Drew Soderborg, Legislative Analyst Office. We did not raise any concerns with this proposal.
- María Elena Durazo
Legislator
Thank you. And from the Department of Finance.
- Tess Scherkenback
Person
Hi, my name is Tess Sherkenback, and with the Department of Finance, we're here to answer any questions you have, but no comments.
- María Elena Durazo
Legislator
Great. Okay, colleagues, any questions? No. Just if you could explain a little bit about administering the Surcharge Fund, if you could explain that. Take a couple of minutes to do that.
- Budge Currier
Person
Yeah. So initially, the legislation set the surcharge at $0.08. So that's where it is for calendar year 2023 and 2024. It'll be in the year following that that the surcharge would have to be potentially adjusted based on the authorizations we're discussing this year. And of course, next year. The way the fund works is each of the carriers that are out there. This is wireline, wireless, voice-over IP.
- Budge Currier
Person
All of those folks that are providing dial tone are required to report the number of access lines into CalOES, which they do each year by August. We take a look at those number of access lines, we compare that to the appropriations that are authorized to go toward the fund, do the simple math to say the fund needs to be set at this level.
- Budge Currier
Person
We make that recommendation over to CDTFA, they then set the fee at that level, and they begin to collect those fees that are remitted by the carriers, and then it passes from them over to us. Obviously, there's some Administration the CDTFA is doing on their side, and then we monitor that to make sure that what came in aligns with what the carriers reported to us in terms of access lines. So we have some accountability there.
- Budge Currier
Person
And then obviously there'll be a piece, depending on what's authorized for the budget, that goes toward the work effort that's under the statute that CalOES does relative to what Health and Human Services does and their piece on the policy side.
- María Elena Durazo
Legislator
Okay. And is there an amount? I saw about $0.20. Is that the maximum or?
- Budge Currier
Person
The maximum is $0.30. So go from zero to $0.30.
- María Elena Durazo
Legislator
Okay. And right now it's at $0.08. So depending on the need, it could go as high as $0.30.
- Budge Currier
Person
That's correct.
- María Elena Durazo
Legislator
Okay. And what is the role between you and the Department of Healthcare Services or any other entities?
- Budge Currier
Person
Probably at the highest level, if you're thinking technology and administering the fund, that's CalOES. If you're talking policy and procedures, that's HHS. Obviously, there's a blend there because the technology needs to be able to support what they implement in policy, and that's the need for the collaboration, and we've been working very collaborative, not only with them, but with other states that are doing similar initiatives and other agencies that are implementing similar programs around the country.
- María Elena Durazo
Legislator
Great. Thank you.
- Eric Swanson
Person
And just one note, too. It is important to note that any increase or any change of policy that requires an expenditure increase will go before the Legislature through the BCP process. So we sort of, in administering the fund, we're doing sort of a math equation. It's not like we're changing the actual program itself.
- María Elena Durazo
Legislator
So if that number goes up, you'll have to come back.
- Eric Swanson
Person
We have actually an administrative process that we do on an annual basis where we can adjust the fee based on the expenditures that the Governor and the Legislature approve so we can notify the carriers that the fee has gone up or gone down based on that math equation we're doing on the number of lines and the number of expenditures in the budget.
- María Elena Durazo
Legislator
But you said come back. What did you mean by that?
- Eric Swanson
Person
I mean come back in terms of any kind of expenditure increase or policy change that requires an increase would come back to you through BCPs.
- María Elena Durazo
Legislator
Okay, got it. Okay, no more questions. Thank you both very much for the presentation. Appreciate it. We're moving on now to issue four, which is Next Generation 911 and the California Public Safety Microwave Network.
- Eric Swanson
Person
And you get the same two people for this one, too.
- María Elena Durazo
Legislator
That's fine.
- Eric Swanson
Person
In the next item, we're requesting 137.6 million in 23-24 and lesser amounts in subsequent years of State Emergency Telephone Number Account, or SETNA, to support the completion of the California Public Safety Microwave Network buildout, completion of the Next Gen 911 system, and the ongoing maintenance and support of these systems. And Mr. Currier, again, will describe this proposal.
- Budge Currier
Person
Thank you, Eric. I think I'll start just to anticipate the question. I didn't have it by talking points, but this fee is also in SETNA. It has a range from zero to $0.80 and it was really the effort of the Legislature that provided that funding to us. It's been the catalyst that has really enabled us to bring technology into the 911 space. And of course, by extension 988, as I just discussed. That rate is currently at $0.30 and this proposal would not change that rate.
- Budge Currier
Person
It's just asking for ongoing authority to finish a couple of projects that we started. Those two big projects are moving us away from our Legacy 911 system, which was state of the art in about 1980, into Next Gen 911, which is an IP-based technology, and the other project is CapsNet, or the statewide microwave network. We're using that as the backhaul to move those 911 calls up and down the state, and that network supports some other key initiatives.
- Budge Currier
Person
We initially got authorization to start these projects in 2018. Funding didn't come around until a Bill was passed in 2019, so the projects automatically started a year behind. And then this little thing called a global pandemic happened in the middle of our rollout, which you can imagine how that impacted both of these projects, not just in terms of resource, but access to the 911 centers where the work needed to be done.
- Budge Currier
Person
And then the Microwave Network sits on all of our mountaintops, the fires, and the recent snow, and everything is impacting that. So there's been some delays in that project where both those projects are about a year behind, which is good considering we started a year late and all these things have happened. But we've made some significant progress. So Next Gen 911 is live in El Dorado County, Tuolumne County, Imperial County, and L.A. County. And we will be bringing more and more counties online.
- Budge Currier
Person
It's a long process. It will take us another 12 to 18 months to probably completely finish that entire work effort. But we're making some great progress there. We're seeing, too, with the network we've built and some of the single points of failure that exist in the legacy network. When we put in this new system, those systems don't go down like the old one did. So we're seeing some huge gains with Next Gen 911. For CapsNet, we have about 297 sites that we need to upgrade.
- Budge Currier
Person
We've finished 159 of those 297. The remainder of them are all in the pipeline. So we have this phased approach where we're working through this process and we've finished the site survey at a majority of those sites. Probably the biggest challenges there is when we go to that site, if we need power upgrades or additional space, many times we are not the site owner.
- Budge Currier
Person
So we have to work with the site owner and then access to those sites if there's an active fire or 20ft of snow, which is the case right now or other, where the roads are impassable because of excessive rain and stuff, or make it challenging for us. But we're on track if this is authorized for us to finish these projects, sort of the baseline foundation for technology, we need to move all these initiatives forward in California. Happy to answer any questions on those.
- María Elena Durazo
Legislator
Thank you very, colleagues. No. Well, we have from the Lao none. Department of Finance none. Quite a very quiet group today.
- Josh Newman
Person
It's not a good.
- María Elena Durazo
Legislator
Well, I give you credit for it, because if you cover the issues, we don't have any questions? Thank you. Thank you very much.
- Budge Currier
Person
Thank you, Madam Chair.
- María Elena Durazo
Legislator
We'll move on to issue five, which is, Mr. Swanson, you stay here. Issue five, federal funding and grant management. And I think we have. Mr. Ryan Buras. Go ahead.
- Eric Swanson
Person
That's right. Good afternoon. This item is sort of a series of four requests that are loosely connected by federal funds and grant programs. Mr. Buras has been asked by your Committee staff to give an overview of our federal disaster funding process, and he'll do that in just a second. But let me describe the two proposals that are sort of in his area, which are, I think, the second and third on your agenda.
- Eric Swanson
Person
The first is a request for 37 positions, or $9.5 million in 23-24 and a lesser amount ongoing, to establish a resiliency branch within the hazard mitigation section to administer hazard mitigation funding available through various FEMA programs. And the second request is eight positions, or 1.3 million, Federal Trust Fund, 416,000 General Fund to implement the new FEMA validate as-you-go payment process. So I'll turn it over to Mr. Buras.
- Ryan Buras
Person
Thank you, Eric. Thank you, chair and Members. First, I'm going to go over just the federal funding aspect. I'm going to go over hazard mitigation pre and post-disaster, and then public assistance funding post-disaster. Pre-disaster, FEMA has started a new program. It's called the Building Resilient Infrastructure in Communities Grant Program, and also they have their ongoing Flood Mitigation Assistance Grant Program. These are annual grant programs offered by the Federal Emergency Management Agency, and they're allocated at different dollar amounts per year.
- Ryan Buras
Person
It's important to note that these are competitive. So we, as the State of California, is competing against the rest of the U.S. to get these funds in. Here at CalOES, we're required to provide the technical assistance to our local communities to compete and receive that funding. We have two big components of technical assistance.
- Ryan Buras
Person
One is to make sure the projects are eligible once submitted, and two to make sure that they meet the areas of interest that the Federal Government puts in their notice of intent each year. I will say that we have been competitive, and so far, we average about 20% of national funding since this program has been awarded. For post-disaster, we have the Fire Management Assistant Grants called FMEG, and also the Hazard Mitigation Grants Program.
- Ryan Buras
Person
Typically, you get 15% of the estimated cost of a disaster, and you get that into hazard mitigation that you can invest into the state. Here in California, we're actually an enhanced state. We have an enhanced state hazard mitigation plan. So we get an additional 5%. So we get 20% of those allocated funds that we can use to make our state more resilient.
- Ryan Buras
Person
Once again, CalOES is we provide technical assistance to the local communities to submit their applications and administer the funding in compliance with the federal requirements. The federal requirements, there's a lot of them. It's a 600-page document that we have to comply with. So we ensure those local communities understand that we give them that technical assistance so they can submit that funding. It is all hazards, so it includes things wildfire, flood, earthquake, tsunami. Lately, I think everything comes to bear in California.
- Ryan Buras
Person
For FEMA Public Assistance Fund, it's a little different. Once we get a major declaration like we did in December awarded, there's no cap to the Fund, but it does cover things like emergency response costs, overtime, and also public infrastructure to include roads, bridges, facilities. It's important to note that the damage has to have incurred during that incident. It couldn't have been something that was damaged before it had to be damaged during that incident.
- Ryan Buras
Person
It also has to be cost effective and that's things that our team helps them with. I would like to note the projects are long. Rebuilding infrastructure is never easy. It takes several, several years to do that. And every time there's a new disaster, that's just more work that we assist our locals with. In cases like earthquakes, it could take over a decade to overcome that.
- Ryan Buras
Person
I'm going to go right into, and actually I'm going to switch up my order since it's the order that you proposed, Eric, for me, I'm going to first talk about the Hazard Mitigation Program. With a change in climate, things are intensifying, not just here, throughout the nation. And the BRIC Program, as I said, the way the BRIC Program works, the Federal Government awards up to 6% of funding for each fiscal year for the U.S.. So it's not just California, it's all disasters combined.
- Ryan Buras
Person
They offer up to 6% and that's awarded annually, announced annually. And we can compete for those awards. It started about a half a billion dollars. It doubles every year since 20. This past year was over $2 billion announced. It's very technical in nature to get these grants awarded. This proposal is to get those experts into the field so we could be more nationally competitive. My goal is, I think everyone's goal is I want to get every dollar that we can for all of California.
- Ryan Buras
Person
And I don't want to leave anything on the table. This program invests a lot in also the disadvantaged communities that don't have the staff and or the money to compete with larger communities. And our technical assistance is designed to help out those communities. In fact, we assisted a project in Kern County this past year. It was selected to actually get the White House Justice 40 Project, recognizing it's an innovative project for a disadvantaged community.
- Ryan Buras
Person
In that particular community for a drought, it was able to store groundwater and use it in the future for future things for drought. So that was a key program. I'm going to go into the VAGO Program now. VAGO is also new. It's validate as you go. It's new. It's based off the Federal Emergency Management's ruling. So before it was all self-certification, you would do a project in public assistance, you would self-certify that you did something right.
- Ryan Buras
Person
And then FEMA audits at the end, and in some cases they find something, and then that sub-applicant has to give the money back. This new program that's required by FEMA, it's a validate-as-you-go. So it's throughout the process, we actually have to receive things from our locals to make sure that the project was done in accordance.
- Ryan Buras
Person
It's very important that we do this right, because nothing's worse than at the end of a project to go to a local community and ask for money back. It's also we, as the applicant, are responsible to pay back the Federal Government. The FEMA state agreement signed by the Governor says that we have 30 days to return this money back to FEMA. So it's good for all of us if there's nothing on the back end that we have to return.
- Ryan Buras
Person
And that's what this proposal will assist with. So with that, Eric, leave it for any questions.
- Eric Swanson
Person
So I'm going to describe really briefly, I know this is a long issue. The last two requests in the grouping, the fourth proposal on your list, there is really a budget display issue. Our budget request is to separate out or make more transparent disaster-related federal grant or reimbursement funds so that they have their own budget item. Currently, federal disaster funding is commingled with other kinds of federal nondisaster grants. If approved, these new budget items would have enough budget authority for the next fiscal year.
- Eric Swanson
Person
Based on analysis, we'd look back at the past four years of how much we have received. The other important factor to mention is that the state has no discretion as to how much the Federal Government approves for funding in this category. We kind of act as a pass-through for FEMA reimbursements that go to local government agencies, other state agencies, or to reimburse the General Fund.
- Eric Swanson
Person
So we're proposing 1 billion in federal funding, just federal funding authority for state operations and local assistance associated with this new item. There is no General Fund spending impact associated with this request. And finally, we're requesting 55 permanent positions to administer a portfolio of state and federal grants that have increased at overall level, number of sources, and complexity. All of these requested positions will be funded with our existing appropriation authority through federal grant, through federal money, and through some state grants that have already been approved.
- Eric Swanson
Person
OES Grants Management is responsible for administering approximately 100 federal and state grant programs to support local governments, community-based organizations, and nonprofit organizations. From 2014 to 2021, the Homeland Security and Grants Processing Branch has had a 43% increase in funding, and there's only been a 3% increase in permanent staffing. We have likewise statistics for our victim services grants as well, an increase, and that's not the same as we have had in terms of staff.
- Eric Swanson
Person
Grants management has supplemented permanent positions with temporary help, which were formerly called limited term, to continue administering vital funding to the citizens of California. But these temporary help positions have a term of 12 months with a possible 12-month extension with a mandatory expiration after two years. And some of these grants last three to four years, so that we're having to turn over staff in the middle of grants. With that, I'm available for any questions.
- Eric Swanson
Person
Ryan and I are both available for any questions on any of these four proposals.
- María Elena Durazo
Legislator
Okay, colleagues. Oh, I'm sorry. LAO's Office. No questions. Okay. Department of Finance. No comments. Okay. I just have a question about balancing your workload of the Grant Administration with the emergency response responsibilities that you have. How do you balance those?
- Eric Swanson
Person
We do. That's a good question. We do have a grants management program that is only responsible for grants. Now, there is a caveat to that, because CalOES is one team, and as events come up, we do activate some of our folks to help supplement activity to meet the demand of whatever event is coming up. So we actually divert some grant staff, some accounting staff, staff from all over CalOES to help manage the response and recovery activities of disasters.
- María Elena Durazo
Legislator
Okay. Dose that? That doesn't. What kind of impact?
- Eric Swanson
Person
At the same time, though, I think we are, I want to say, one of the most efficient departments in terms of rating and getting rfps out for grants and contacting local agencies, soliciting input, providing technical assistance on some grants, because some of these federal grants are super complicated in terms of applying. And so we do provide that as well. We try to make sure that folks know what they're doing when they're applying.
- Eric Swanson
Person
And we go through these all the time and have a pretty good system down for getting out the funding very fast to locals.
- María Elena Durazo
Legislator
Thank you. Yes.
- Stephen Benson
Person
Stephen Benson, Department of Finance. Just one thought I wanted to add on to that is last year we did, the Legislature approved, the Administration proposed, Legislature approved a proposal to set up some base permanent staffing in the state operations center to help minimize some of that redirection, recognizing some of the draw that that does on it. So it doesn't eliminate it. They still have to do some of that.
- Stephen Benson
Person
But there were some investments in the last couple of years to really help manage and limit that to a certain extent.
- María Elena Durazo
Legislator
Okay, thank you. And you mentioned, Mr. Buras, about underserved, I'm not sure disadvantaged. Could you define that? Is there a definition for that? You know, you gave an example, which is great, about how you serve underserved communities.
- Ryan Buras
Person
Sure. So we do use CDC's Social Vulnerability Index. That's one thing we do look at. We also look at the county and the city's budget as well, just to see if it's fiscally as well. We also look up, there's several different factors to include speak, how you speak. race. And we put all those factors in and it produces a score. And then on most of these programs, we also that tie that to risk as well as they apply for these grants, whether it's fire or flood.
- Ryan Buras
Person
And our outreach is targeted based off of that. So instead of just sending out a notice of intent, hey, the state has $100 million of Hazard Mitigation Grant available. My team personally calls those communities and say, hey, this is available. Are you interested? What do you need? I deploy my team out to these communities to assist them with their grant writing and just more importantly, give them ideas. And one thing that this proposal does is really double down on that expertise and environmental planners.
- Ryan Buras
Person
And how do you plan for tomorrow? Because we know planning for yesterday is not going to get us where we need to be. And the more that we invest these dollars into these communities, which time and time again are the ones that are being hit the hardest and they have the hardest time to recover, that investment is going to prove its worth.
- María Elena Durazo
Legislator
Well, I appreciate you doing that. I think the other suggestion that's come up from different departments is outreach into organizations on the ground.
- María Elena Durazo
Legislator
I'm not sure how that fits into what you do, but these specific local, very local organizations that probably aren't many times on the radar of our government just because we don't know who they are, is to search them out because they really understand, and frankly, many times they set up their own informal system to help each other, and it'd be great if they were called on sooner so that they wouldn't have to do it themselves.
- María Elena Durazo
Legislator
But anything along those lines, I think, would really help reach the people who are vulnerable before the disaster and even more vulnerable and hard hit after.
- Ryan Buras
Person
Absolutely. And programs like the Listos programs that we have, OES is helping that. We are, unfortunately, but fortunately in these communities every month, and we are able to reach out to more of these already stood-up organizations and meet with them. A lot of that's happened on the natural just because of the activity that we've been reacting to, but we are reaching out to groups like that, and it has proved its worth so far, and we continue to hopefully expand that.
- María Elena Durazo
Legislator
Thank you. Okay. Those are all the questions I have. Thank you very much. Appreciate it. We're moving on now to issue six Covid-19 emergency expenditures. Mr. Swanson and I believe, Mr. Green, welcome.
- Marvin Green
Person
Thank you.
- Eric Swanson
Person
Yeah. The final two proposals for CalOES on your agenda are related to the state's Covid-19 response. We're requesting 4.5 million one-time General Fund to continue daily COVID-19 testing protocols at multiple CalOES locations to help ensure we are always prepared to continue emergency response and disaster recovery efforts across California. Specifically, daily testing continues to be mandatory for those who are working in certain locations to maintain continuity of operations.
- Eric Swanson
Person
For example, everyone entering our state operations center, including activated employees from other partner agencies, are required to test on a daily basis. During periods of more serious outbreaks, CalOES also requires other employees to test daily. Our agency needs to be able to respond to multiple emergencies at any time and this level of testing has proven essential to performing that mission.
- Eric Swanson
Person
Because monitoring for emergencies and disaster response and recovery activities also requires more in-person, 24/7 operations than other types of state work, our agency has a more robust testing program than many other state departments. And for the second proposal, I will turn it over to the Department of Finance.
- Tess Scherkenback
Person
Tess Scherkenback with the Department of Finance. So you'll see that there is a proposed General Fund solution. That is a reduction in warehousing operations spending. And that hearkens back to the 2022-23 budget that included 114.3 million General Fund. And that was one time to provide warehousing space, purchase new and replace expiring personal protective equipment, increase commodity supply, and also secure logistics support equipment. So of this proposal, 37 million was for the replacement of a PPE stockpile and also to replace expiring PPE.
- Tess Scherkenback
Person
However, CalOES currently has 125,000,000 masks, and the new Smarter Plan that has been introduced only calls for a stockpile of 75 million masks. So there was no need for CalOES to purchase those additional PPE. And so, therefore, the Administration has determined that we're going to score the current year savings of that 37 million and return this funding to the General Fund. And we would like to note we'll still be fully in compliance with the Smarter Plan. Thank you.
- María Elena Durazo
Legislator
Okay. Thank you very much. LAO? No questions. Okay, colleagues, any questions?
- Josh Newman
Person
I hate to ruin my streak. I do have a question, and it's part of probably a longer conversation, but it's with regard to the reduction in warehouse operations, the money coming back. So I commend you for that. But just very quickly, as we look forward, what is the plan? What's the SOP for maintenance of that PPE supply? What's the assumption? At what point would you assume that it will expire?
- Josh Newman
Person
I, of course, refer to the conditions we found ourselves in the beginning of the pandemic, where we had stockpiles of PPE, but in many cases, it was expired or unusable.
- Marvin Green
Person
Right. Thank you for that question, Senator Newman. The expiration dates for surgical masks are at two years, and we are processing those masks every two years and purchasing behind them. We were able to work with the manufacturer for the n 95 mass and to extend that to five years. And so that's where we're at right now. And having that extension and having serviceable mass to cover that has allowed us to not have to spend the money on going for that.
- Marvin Green
Person
But we do manage lifecycle management on all of the PPE items and the inventory expiration dates so that we prepare ourselves in the upcoming years to be able to deal with any expirations.
- Josh Newman
Person
That's good to hear. Is there a plan of record that OES has put together that outlines all of the protocols and plans moving forward to maintain.
- Josh Newman
Person
In a usable PPE stockpile?
- Unidentified Speaker
Person
Go ahead, Eric.
- Eric Swanson
Person
I think we're looking at, right now, we have funding for our warehouse in current year. We're going to look at all options moving forward on sort of how we fund this warehouse operation in future years.
- Josh Newman
Person
Okay. So we can expect to hear about that in future years. Thank you.
- María Elena Durazo
Legislator
Yes, Senator.
- Kelly Seyarto
Legislator
So four and a half million dollars for Covid testing everybody every day, I think you might have touched on it, but what is the rationale for continuing to test everybody every day? Because when you get tested, if you finally test positive, you're already two days into exposing people. It's more related to how people feel, the initial onset of symptoms.
- Kelly Seyarto
Legislator
And it just seems to be that we should be more focused on that than just spending money on testing, making people think that as long as you get that negative in there, you're good. Because I think the experience up here in the Capitol has been that by the time they figure out you're positive, it's a little too late. And then we haven't had the rapid spread throughout the Capitol when we have had Members that got--including me. So when does that stop? Are we just going to be spending four and a half million dollars every year for testing everybody every day instead of just testing people who are maybe symptomatic?
- Eric Swanson
Person
So I think, first of all, let me clarify. It isn't all of Cal OES it's testing. It's our State Operations Center, which would be great at some point if you could come out and see it, or it sort of looks like mission control.
- Kelly Seyarto
Legislator
I'm aware of--
- Eric Swanson
Person
Yeah. And it has a lot of rooms and spaces where we collaborate with other agencies. So what's rough is, up until, I think, today or the last few days, we've had 24/7 shifts going with Department of Water Resources and other agencies that are involved in disaster response and recovery. And we meet closely, compared to what a lot of departments have done, have moved to sort of a telework sort of status.
- Eric Swanson
Person
It helps from our standpoint when you're dealing with rapid response and recovery, to meet in person right next to each other. We also bring in FEMA. We have them come in and meet with us directly so that we're all on the same page as we deal with these disasters. So all of that, sort of coming to say, because of the critical nature of what they're doing, we feel like this mitigates the risk of a severe outbreak.
- Eric Swanson
Person
And I agree with what we're saying, that there may be a few days missed where transmission occurs. But at the same time, if we have a group of folks that come in and we start getting hits and there's a daily report that goes out to everybody that says these are the daily hits that have occurred positives, then we're taking those people out of the equation and we bring in other people that can help with the response effort. So I don't know when the end date is. This is only a one-year proposal. It's not for permanent funding. At some point, we will have to re examine whether these resources are needed again.
- Kelly Seyarto
Legislator
Thank you.
- Tesha Kombak
Person
If you don't mind, Tesha Kombak with the Department of Finance. I also just wanted to clarify that this request is for one-time funding of 4.5 million dollars. So any future request for funding on this would have to come before the Legislature again for consideration. So I just wanted to clarify that point. Thank you.
- María Elena Durazo
Legislator
Last question covers what I was going to ask, so appreciate good answers, and I understand what the rationale is, and I appreciate that it's only for one year because that question really makes a whole lot of sense. Okay. Thank you. Thank you very much. Thank you, Mr. Swanson. We will now move on to the Department of Corrections and Rehabilitation, Issue Seven: Division of Juvenile Justice Closure. We'll begin with Dr. Heather Bowlds, the Director of the Division of Juvenile Justice at CDCR. Good afternoon.
- Heather Bowlds
Person
Good afternoon, Madam Chair and Members of the Committee. My name is Heather Bowlds. I'm the Director of DJJ. I'm here to provide an update on the progression of the DJJ realignment and the closure of the DJJ facilities. As noted in the agenda, CDCR submitted a budget change proposal to reflect the closure of DJJ facilities effective June 30th, 2023. Beginning in 2024 through 2025, the closure of DJJ facilities will result in an ongoing annual savings of 98.9 million and 631.4 positions.
- Heather Bowlds
Person
The request includes the retention of various positions to complete the temporary ramp-down of activities, maintain DJJ facilities and warm shutdown, and manage ongoing DJJ specific activities and workload, as well as continue the operations of Pine Grove Youth Conservation Camp for local justice-involved youth post DJJ closure. There are little more than three months left until the DJJ closure. These past two and a half years have been difficult for both youth and staff for multiple reasons.
- Heather Bowlds
Person
I mentioned last year we've had to ask for patience and flexibility, and this continues to hold true. The youth have been rightly anxious about what things will be like for them when they return to the counties, and the staff have rightly been anxious about what their future will be after closure. Regardless, our division is still responsible for the youth under our care and our job is to safely guide and support them as they engage in treatment.
- Heather Bowlds
Person
Anxiety leads to challenges, and we have had to constantly problem solve the best way to support our youth and our staff to maintain that mission, even when so many things were yet to be decided and worked through. We continue to take things step by step, working through each item, often in a manner that requires out-of-the-box thinking and unique solutions. Each step has helped to provide answers and decrease that anxiety.
- Heather Bowlds
Person
Still, there are some uncertainties that are just inherently hard to address with this type of large-scale change. That is where we've leaned into providing avenues of support for both youth and staff. As we transition youth back to the counties, I've maintained that the transfer of care requires an individualized approach, a one-size-fits-one. As we know, each youth is unique and each county is unique.
- Heather Bowlds
Person
DJJ's role is to ensure that the counties and court partners have the necessary and most up-to-date information on each youth to inform the local conversations and court hearings that will determine the youth's local placement. The inclusion of probation and case planning for each youth was and continues to be a key component of this transition of care so that staff are aware of the youth's strengths, needs, services the youth received, additional treatment needs being recommended, and educational attainments.
- Heather Bowlds
Person
It also allows for collaboration and further conversations for creating the best plan to move forward to local care and successfully integrate the youth into their new treatment setting. Currently, there are 301 youth remaining under DJJ's authority. Of those, 163 will not be able to discharge prior to the DJJ closure. Youth who have a possible discharge date before June 30th will still be afforded an opportunity to have a board hearing prior to closure.
- Heather Bowlds
Person
Several counties have already begun holding hearings to transition their youth back, which will reflect a steadier decline in our population over the next several months. Based on the current number of hearings counties have scheduled and the estimated number of youth who might be denied discharge between now and June, we are estimating that we could have a range between 100 and 150 youth still by our final month. Those remaining youth will transition back through that month, but no later than June 30th.
- Heather Bowlds
Person
The tremendous gains that DJJ has made over the years to offer interventions and specialized programming to youth has truly been remarkable, and this policy redirection in no way reflects the good work being done by DJJ staff. DJJ remains dedicated to its mission of providing services to youth with the goal of transitioning to a productive future in the community, and we will continue to do so until our very last day. Thank you, and I'm happy to answer any questions.
- María Elena Durazo
Legislator
Thank you. The LAO office, please. Mr. Zavala.
- Orlando Sanchez Zavala
Person
Thank you. Madam Chair, my name is Orlando Sanchez with the LAO. Our findings and recommendations, if you want to follow along, are on pages 26 through 27. I plan to walk through each of the recommendations as it relates to the different aspects of the proposal, but first, I'd like to speak on the proposed reductions. We have no concerns with the proposed reductions to DJJ's budget and recommend that the Legislature approve them.
- Orlando Sanchez Zavala
Person
If the Administration proposes further adjustments in the future, we'll advise the Legislature at that time. The next set of recommendations cover the Administration's request for temporary resources. The proposal includes funding to keep within DJJ's budget about 111 temporary staff between one month to six months to complete the closure. These staff will complete various tasks. An example of this is two lieutenant correctional officers that will be kept for two months to process contraband and take inventory of correctional officer equipment.
- Orlando Sanchez Zavala
Person
We recommend the Legislature withhold action on approving the 111 temporary staff. Given that the proposal was prepared in the fall, we note that the Department will have better information in May as to what tasks are necessary to complete the closure. It is possible that some of the workload associated with these positions could be completed ahead of time and may not be needed. The proposal also includes funding within DJJ's budget for 13 temporary positions between six months and a year to transition youth.
- Orlando Sanchez Zavala
Person
These positions include mental health, education, and parole. We recommend that the Legislature reject these 13 temporary positions. At the time of our analysis, the Department indicated that these positions had not been specifically requested by counties, but since then we've become aware that counties are interested in further support. However, we still find that these positions are unnecessary given that each youth will have a transition plan. In addition to the temporary staff, the proposal increases CDCR's non-DJJ budget permanently for workload to remain after the closure.
- Orlando Sanchez Zavala
Person
The next set of recommendations I'll go over cover these permanent positions. The proposal includes permanent staffing to transition the facilities into a warm shutdown where they'll receive minimal maintenance, and we recommend approving these 15 positions requested for warm shutdown. The proposal also includes permanent funding to process Workers' Compensation claims. These are benefits entitled to workers for work-related injuries or illnesses, and funding for administrative workload to remain after the closure.
- Orlando Sanchez Zavala
Person
We recommend the Legislature approve the resources and positions on a two-year limited term basis rather than a permanent basis as proposed by the Administration. We find that the positions and funding and the workload associated with it is likely necessary in the budget year, but the workload would decline in the future. An example of this is that as Workers' Compensation claims close and no new claims are filed, the need to continue the workload and process the remaining ones will decline.
- Orlando Sanchez Zavala
Person
We also note that the Department can request to retain these resources in the future if the need continues. The Governor's proposal also has requests permanent resources to use DJJ's existing facilities to repair automotive fleet for the California Health Care Facility. We recommend approving the position authority for the requested positions to repair to provide repair services. However, we recommend rejecting the funding because the Department should have sufficient resources for these positions already within its budget from those freed up from servicing the fleet outside off-site.
- Orlando Sanchez Zavala
Person
Then to wrap up, our final set of recommendations are in regards to the Pine Grove Youth Conservation Camp. Under the current contracts in the Governor's proposal, the state would be responsible for over 90 percent of the cost of the camp. We recommend the Legislature require the Department to charge counties a fee that minimizes state cost. We find that the Governor's proposal, which would require the state to cover most of the cost, is inconsistent with the underlying goal of realignment, which would make juvenile justice a county responsibility.
- Orlando Sanchez Zavala
Person
We find in addition, the counties would result in the state--or the contracts would result in the state effectively double paying counties that choose to send realigned youth to the Pine Grove Conservation Camp. This is because the state already provides funding for realigned youth through various programs. And then one example of a fee structure that could minimize the state cost is about an annual fee of about 70,000 per youth. This would roughly cover the cost of Pine Grove.
- Orlando Sanchez Zavala
Person
And lastly, we recommend the Legislature continue to monitor the need for Pine Grove. For example, if it becomes unviable for counties to continue to place youth at the camps, the Legislature could reconsider the cost-effectiveness of maintaining the camp. But to the extent it remains a legislative priority, the Legislature could consider taking additional steps to encourage counties to place youth at the camps.
- Orlando Sanchez Zavala
Person
For example, if cost is the main barrier for counties not placing youth, the state could consider reducing the county share of costs for placing. And thank you. I'd be happy to take questions.
- María Elena Durazo
Legislator
Thank you very much. That was a good summary. Department of Finance?
- Allison Hewitt
Person
Allison Hewitt, Department of Finance. Just want to respond to a couple of the comments from my colleague at the LAO. Regarding the temporary staffing, to be clear, youth are anticipated to be at DJJ until the day of closure. So a lot of the kind of wrapping up activities and activities that are anticipated to take place will need to take place after the last youth leaves the facility.
- Allison Hewitt
Person
While it's 111 positions that are requested--or excuse me--a total of 124, the net total of those positions is 26.1 over, if you annualize that. So it's really 92 positions that are requested for between one and three months, which we think is reasonable given the volume of work that will have to occur after the facilities close and given that there isn't really an ability to start that work until there are no longer youth at those facilities.
- Allison Hewitt
Person
Regarding the county transition team, which is the 13 positions that are proposed to remain for a full year, again, counties have--as the agenda itself notes--counties have concerns about serving the population that will be returning to them following DJJ's closure.
- Allison Hewitt
Person
And so having specialists and providers that have been working with these youth in DJJ's facilities be available to support the transition of youth we feel is kind of a necessary step to allow counties to provide a continuity of care, particularly for youth with serious behavioral and mental health needs, and making sure that those youth return and that the transition is as successful as possible.
- Allison Hewitt
Person
Regarding the operation of Pine Grove, so the first is the fee structure is the same structure that the state already uses when we take adults from county jails into fire camps that are operated by CDCR. So there's generally a thought around having parity with the structure that already exists.
- Allison Hewitt
Person
Additionally, Pine Grove offers the state a benefit because it is a fire protection resource that would still be available for state response. Just to note that SB 823 included specific intent language that Pine Grove continued to operate to serve locally justice-involved youth, and so this is the Administration's proposal, which is that the state bear the larger share of the cost.
- Allison Hewitt
Person
But again, there's benefits both on the job training side and then on the fire protection side. With that, available to answer any questions the Subcommittee may have. Thank you.
- María Elena Durazo
Legislator
Great. Thank you. Senators? Colleagues?
- Kelly Seyarto
Legislator
There it is. So we're going to shut down the remaining state facilities and hopefully we're not going to send them to the LA County, right, because LA County is a disaster right now. This program, this realignment that we came up with seems to be a disaster. And it's not a disaster for us. It's not a disaster for our budget. It's a disaster for the kids that we're hoping to help and get them steered in the right direction.
- Kelly Seyarto
Legislator
And what I see is a severe, severe underfunding of an entire department that needs to be fixed. And these are just band-aids to try and get the responsibility off to somebody else. And believe me, this is no slam on the people that are trying desperately to make a transition that they've been ordered to do good, but this isn't working. This article in the LA Times about the state of the probation and juvenile justice in LA County--it's a big county, folks; there's a lot of people that go there--they're not ready for this.
- Kelly Seyarto
Legislator
They're not ready to have all these kids shifted into facilities that are not ready for the kids at all. They're not going to get help there. So I have a lot of concerns about this whole topic and where we're going with it and where we've been going.
- Kelly Seyarto
Legislator
And it's alarming that it just keeps going down that track, even though at the end of that is a disaster for these kids who, they're depending on us to help them before they turn into adults and keep going down the path that got them there in the first place. We don't take care of our probation officers. Those folks are usually the only normal people in these kids' lives, and we are not funding them.
- Kelly Seyarto
Legislator
So I don't know how we're--this--the Division of Juvenile Justice, the closure, that should be stopped. We need to fix that. It's hard for me to continue to--and certainly, I mean, obviously it's going to go down and get done, but I can't deny the funding for the stuff that you need to close this. But I don't know what happens to these kids afterwards. That's going to be the real disaster here.
- María Elena Durazo
Legislator
Any comments to that? No? Okay. I do want to understand a little bit clearer the timeline that's involved here with moving the youth to county responsible facilities. And if we did the closure of DJJ, which is our state level, right, then why are we turning--keeping Pine Grove, and then keeping it under CDCR? We're supposed to be moving in the direction of it being a county responsibility. We're giving the counties an enormous amount--not enormous, I shouldn't say that.
- María Elena Durazo
Legislator
But we're giving the counties the funding so they could absorb that responsibility. But yet we keep one camp still under the state. Could somebody talk me through that? And then the temporary staff, it is for a maximum, it seems like, whether it's to help the youth transition or to complete the closure, it's a total of maximum of six more months? Is that with the temporary? So I'm trying to get a better idea of this process we're going through.
- Heather Bowlds
Person
So I can start with the timeline for sure, is, all of our youth have to be transitioned back to the county by June 30th. So that is the end day. And we've been working with each county and the court partners on what timeframe works best for that county, given that each county has different resources, each county has a different amount of youth returning to them. But again, they all have to return by June 30th.
- María Elena Durazo
Legislator
I'm sorry, and just one thing. When that was decided was in 2020?
- Heather Bowlds
Person
I believe that was 2021 with SB 92 is where the closure date came from. SB 823 in 2020 initiated the realignment process.
- María Elena Durazo
Legislator
Okay, so that's been almost three years, close to three years that that decision was made to start the process? Okay. I'm sorry. Go ahead.
- Heather Bowlds
Person
Yes. So that's really the timeline that we have, is that last date has to be finalized or the youth need to be out. In terms of the Pine Grove as a part of SB 23, it was specifically called out as something that was an interest to maintain, given the history of Pine Grove, the success of what it's accomplished for youth to be able to train to be firefighters, to be a part of that process.
- Heather Bowlds
Person
So there was a desire to keep that being able to be available for youth in the county as it moves forward. Because of the dynamics of Pine Grove, it worked out better to be run operationally by CDCR, but it is still specific to be a youth camp that counties can contract and send youth as a part of their continuum of care to be able to receive those firefighting skills. For the temporary positions, most of those, yes, are within six months.
- Heather Bowlds
Person
The only ones that we have requested to go beyond six months are the clinician staffing that would be helping with that transition of the youth going back to the counties. And those are youth that are specifically receiving our higher, more intense mental health needs, as well as youth in our Sexual Behavior Treatment Program.
- Heather Bowlds
Person
That longer timeframe was put there in, again, recognition that this is a critical time for those youth who are transitioning, that many counties are working to staff up both county and behavioral health to staff up positions. And so in order to maintain that transition and make sure those youth have the care as they move back, which is a challenge for youth who have been undergoing care--it's a very fragile period of time for them--that we wanted those positions to remain available.
- María Elena Durazo
Legislator
And these positions that will help transition the youth, wherever they are located right now, these positions, that's where they will stay and continue to provide those services? And then eventually the youth physically leave?
- Heather Bowlds
Person
So the youth will still need to physically leave. What we'll be doing, as this proposal has been going through, and that's part of it, is obviously not wanting to get ahead of the proposal and the approval of the proposal, but it will be working with the counties on those youth that are returning to the different counties on what makes the most sense and what resources can we help supplement and provide as those youth are transitioning.
- Heather Bowlds
Person
So there may be some counties where their behavioral health staff, they are rich in behavioral health staff and won't need that direct support, whereas other counties may need that direct support for those youth returning.
- María Elena Durazo
Legislator
And Pine Grove is open right now?
- Heather Bowlds
Person
Yes.
- María Elena Durazo
Legislator
And it's servicing who right now?
- Heather Bowlds
Person
So right now at Pine Grove, there are youth who are still under DJJ's authority there, but they are available for any counties that have contracted with Pine Grove to accept youth that are from the local county system.
- María Elena Durazo
Legislator
Okay, and what's your sense of--what are the factors that would go into do we keep Pine Grove open? When does it continue to make sense and when does it not continue to make sense?
- Heather Bowlds
Person
You know, I think I'll defer as well, but I think a part of it will be just on the interest of the counties to be able to utilize it as one of their continuum of care placement. I think that's really where it's going to have to have the conversations of how many youth are being referred to Pine Grove.
- Allison Hewitt
Person
Allison Hewitt, Department of Finance. I think we'd be open to tracking and reporting out on how many youth are there. But I think because the Administration is seeking to be consistent with SB 823, which says that there's an interest in continuing to operate Pine Grove through a state local partnership, I think with the contracting process, with the fee structure that we're assuming, we're, I think, anticipating and hopeful that we'll have a full capacity of the 80 to 100 youth that can be placed there.
- María Elena Durazo
Legislator
Right now, there are..?
- Allison Hewitt
Person
Twelve.
- María Elena Durazo
Legislator
Twelve now?
- Allison Hewitt
Person
Some of that, as Dr. Bowlds could say, is informed by the fact that they're ramping down, and we are still working with counties to put contracts into place, and I think that work is still in some of its initial stages.
- Heather Bowlds
Person
Yes. There's ongoing dialogue with the counties, making sure that getting information out there, making sure that the counties are aware that this is a possible placement, a viable placement, and looking at the continuum of care, making sure that there's conversations around what that criteria is. And so there's lots of ongoing work to make sure that the counties are working with the counties on getting more referrals for youth.
- María Elena Durazo
Legislator
Okay. Well, it seems like there should be some way to evaluate, right, what it is that would make sense to keep Pine Grove open and not just sort of let it hang out there with whatever number of youth are going. Okay. That's it for me. No more questions? Okay. Thank you both very much. Appreciate it.
- María Elena Durazo
Legislator
Okay, we're moving now to issue eight Cal am technical adjustments. Mr. Reeder?
- Duane Reeder
Person
Yes. Good afternoon, Madam Chair Members. I'm Duane Reeder, Deputy Director of fiscal services for California Correctional Healthcare Services. The Calam proposal is a reduction in positions funding tied to the delayed implementation of the Caleem program. The Caleem program is a Medicaid reimbursement opportunity for the state. It was originally supposed to be implemented sooner, but now it appears that it will not be implemented until April of 2024.
- Duane Reeder
Person
The Department needs to also develop a billing solution to Bill for the Medicaid services with healthcare services in order to collect that reimbursement. The reimbursement is tied to the last 90 days for an incarcerated individual who is Medicaid eligible for qualifying services and then for enhanced care management.
- Duane Reeder
Person
So we are working to do warm handoffs to the counties so the counties have an opportunity to get some of this reimbursement through Calam as well, to ensure we're putting patients in the best opportunity to maintain services as they transition from the incarcerated setting back into their communities. With me today is Lisa Hines, Director of legislation and special projects, to help answer questions, if you have any.
- María Elena Durazo
Legislator
Thank you very much, the LAO's office.
- Unidentified Speaker
Person
Thank you, Madam Chair. We have no concerns with the proposal at this time. Thank you.
- María Elena Durazo
Legislator
Thank you. And Department of Finance.
- Alyssa Cervantes
Person
Hi, Alyssa Cervantes, Department of Finance. No specific comments, but happy to answer any questions.
- María Elena Durazo
Legislator
Thank you very much. Colleagues. Questions, comments? Okay. Given the potential for getting federal dollars and the benefits that it would provide the incarcerated population, maybe. I know you made some reference, but why can't we start this initiative earlier? And what could we do to get past whatever barriers?
- Lisa Heintz
Person
Yeah. Good afternoon. Lisa Heintz, Director of special projects. You know, we were actually a little bit ahead. The Department was on this. We were waiting for the CMS waiver to be approved and working with our DHCs partners. There are a couple of areas that we're really trying to explore, but the CMS waiver is requiring that we are a fully billable and claims entity, which requires an IT solution to link with our electronic health records and some other areas.
- Lisa Heintz
Person
Our pharmacy, originally, we were trying to get the pharmacy and the durable medical equipment and the medications reimbursed prior to becoming a fully medical or fully billable entity on that last 90 days. But the waiver does not allow for that. So we're going to have to be compliant and build the IT infrastructure. Our team has started that process currently, and we're looking to try to get it done, but it will be a pretty big lift to blend all the IT infrastructure.
- Lisa Heintz
Person
I'm really happy that we are the first state to entertain this initiative, and we get a lot of outreach from other states asking how we plan on doing it. We've also tried to reach out to our county partners to see if they had a faster solution, if you will, and they really don't. Right now, our internal team's doing a great job. We're going to look at reprioritizing some of our existing processes and shifting things around to go ahead and comply with this.
- Lisa Heintz
Person
I am a big advocate for Calae. We do the Medi Cal benefits currently in the transition process. This is something we've been asking for for years. Medi Cal benefits will be in place the day that they leave, rather than having to go initiate those. So it'll be better for our county partners when we do the warm handoff as well, allowing us to, rather than just having a referral, actually having a means to pay for the services we're requesting of the counties.
- María Elena Durazo
Legislator
I agree with you.
- Lisa Heintz
Person
Okay.
- María Elena Durazo
Legislator
This is wonderful. This is really good. I saw something about how currently 80% are enrolled in medical. Does that make sense? Yes.
- Lisa Heintz
Person
So we offer medical benefit application assistance to all of our population that's eligible, and the majority of them do accept the benefit application assistance. Again, it's just whether or not it's in a suspend status until they're released into the counties. And I can't thank the counties enough. They're trying to do all they can under calm as well to lift from their side to see what we can do to make sure that our transitions are more effective.
- María Elena Durazo
Legislator
Great. And are you involved or who is involved in the reinvestment plan on how to use the state savings?
- Lisa Heintz
Person
We've been told that DHCs is going to have that opportunity and that the reinvestment would be hopefully to build more utilization. So that's what we're told. Now, I think there's still some discussions that will be had with our state partner.
- María Elena Durazo
Legislator
Okay. Any further knowledge by LAO or Department of Finance? No. Okay, well, I'll keep a secret then. Okay. I think that's it. There's no more questions. Thank you very much. We move on now to issue nine, integrated substance use disorder treatment program. Again, Mr. Reeder.
- Duane Reeder
Person
Thank you, Madam Chair. We started the integrated substance use disorder program roughly three years ago, and we are now coming back and introducing a methodology to adjust our funding and staffing to the population within the program. So we have introduced methodologies that currently will be reducing our budget in current year and budget year. These methodologies are for staffing and other services provided to this population that are population driven.
- Duane Reeder
Person
So we are coming forward to introduce these methodologies and as being new methodologies, they will lead to some refinement over time and we will be revisiting them. But at this point the methodologies will be reducing our budget and position authority tied to the ICDT program I have Lisa Heintz here again to help answer any programmatic questions you may have at this time.
- Josh Newman
Person
Ms. Heintz do you have anything to add or just here for questions?
- Lisa Heintz
Person
Pardon me?
- Josh Newman
Person
Welcome to testify. You're just here for questions. I understand.
- Lisa Heintz
Person
I can do questions or I can give you a brief overview of the program and our current status.
- Josh Newman
Person
Brief overview would be wonderful. Just going on by Mr. Reeder's comments and Senator Durazo will be right back, please.
- Lisa Heintz
Person
Would you like me to proceed, sir?
- Josh Newman
Person
I would.
- Lisa Heintz
Person
Okay. Thank you. Senator Lisa Heintz, Director of legislation and special projects and the project Executive for the ISDT program. I want to thank this legislative body for its support of the department's ISDT program and our efforts to significantly change the way we treat those diagnosed with substance use disorders in our prison.
- Lisa Heintz
Person
Realizing that substance use disorder is a treatable chronic disease as well as a criminogenic factor for recidivism, the opiate crisis facing this nation is unprecedented, resulting in addiction, loss of life, homelessness, and health disparities throughout our communities and disproportionately impacting the incarcerated individuals. The ISD program continues to make meaningful progress in treating and rehabilitating CDCR's most vulnerable populations. Suffering with SUD 99% of our population, or over 94,000 of the population, has been screened for SUD.
- Lisa Heintz
Person
Over 36,000 individuals have been assessed for SUD using the National Institute on Drug Abuse and or the ASaM suite of Tools. Over 16,000 individuals are receiving medicated assisted treatment for their opioid use disorder. Approximately 10,000 participants are receiving rehabilitative cognitive behavioral interventions. Over 23,000 beds are identified as supportive housing to help people maintain a drug free life.
- Lisa Heintz
Person
Over 15,000 participants are receiving enhanced pre release and transition services, with 87% of them being connected to their county for their first appointment upon release, and our naloxone rate is 80% of those leaving receive a naloxone upon release, with 87% of the population that have a mat prescription also requesting naloxone. Overdose deaths continue to reduce over the last three years from a peak by at least 50%.
- Lisa Heintz
Person
Not only is this program saving lives together, we are also offering the population we serve with additional opportunities to change their lives. The Department has expanded the OMCP, or offender mentor correctional program from three prisons to seven prisons, and we are currently working on incorporating the isUDT peer mentor program component to assist the population we serve in becoming certified peer mentors, obtaining pay while incarcerated, and eventually obtaining employment upon release to ensure we continue to save and change their lives.
- Lisa Heintz
Person
I'm happy to answer any questions you may have about the program.
- Josh Newman
Person
I'm sorry. Let me go to the Lao first. I apologize. LAO, do you have any comment?
- Orlando Sanchez Zavala
Person
Yeah, we do. Thank you, sir. As part of last year's IsUDTP expansion, the Department indicated that they would adjust their budget based on population changes of the medication assisted treatment patient population. The proposal before the Legislature is the first time that these adjustments are getting or that there's these adjustments due to population changes, but consistent with other population adjustment recommendations we provide, we recommend the Legislature withhold action, and given that the projections will be revised in May, we also recommend the Legislature direct the Department to revise various parts of their budgeting methodology. We have concerns with some of the calculations used to determine the need of the Department and its staff and resources.
- Orlando Sanchez Zavala
Person
I'll go through each of the specific recommendations at a high level. Based on our assessment, we find that the Department we find that the Department is proposing nursing positions that have workload outside of the program, and this is problematic given that the nursing is already funded elsewhere in the budget. And therefore, we recommend that the Legislature direct the Department to develop a new methodology specifically for these licensed vocational nurses that manage medications for the program that does not include other workload.
- Orlando Sanchez Zavala
Person
Second, the calculations used to determine the number of pharmacists and pharmacy technicians were not clear enough for us to determine whether the adjustments are appropriate. Therefore, we're recommending that the Legislature direct the Department to provide clear justification on how those calculations led to the specific need. And then the Department is also requesting some resources based on how many people would enter and exit CDCR, and this is based on an assumption that 3000 monthly admissions and exits from CDCR.
- Orlando Sanchez Zavala
Person
While this has historically been true, updated data show that this is much lower than that which could potentially leave the Department with excess resources. Accordingly, we're recommending that the Legislature direct the Department to update based on recent data. Then, lastly, as part of the Isudtp program, people are receiving medication assisted treatment or undergo toxicology testing to make sure they're adhering with the medication.
- Orlando Sanchez Zavala
Person
We also want to highlight that the Administration is proposing to change the budgeting for these testing from a rate of about 10 tests per year per patient to 14. And we find that budgeting to 14 makes sense in the near term but could be flawed in the future, given that this could change. And therefore we're recommending that the Legislature direct the Department to better tie resources with actual testing in the future instead of 14 on an ongoing basis. Thank you.
- Orlando Sanchez Zavala
Person
And I'd be happy to speak on.
- Josh Newman
Person
Any other Department of Finance. Any comments?
- Alyssa Cervantes
Person
Yes. So the ISudT methodology is a brand new one this year, and the Department will continue to refine these, similar to our other population adjustments. And as the Lao mentioned, we will be providing updates at the May revision, and some of these updates may address some of the Lao's concerns.
- Josh Newman
Person
Appreciate that. So one quick question then to the Administration. Do you have a reactionary specific concerns about the Leo's proposed modifications to the budgeting methodology, or you anticipate making those modifications in the may revise at this time?
- Alyssa Cervantes
Person
We aren't sure exactly which updates we are making. We are looking closely at the recommendations and also at the adjustments as a whole, and we'll come back with some adjustments at may revision.
- Josh Newman
Person
Appreciate that. Senator Seyarto.
- Kelly Seyarto
Legislator
A couple of questions about the program itself. So an opioid addicted person gets admitted to, gets admitted, enters the system, and then they're treated with medication. Like, what do they use first? Is it suboxone?
- Lisa Heintz
Person
Yeah. We offer all FDA approved medications.
- Kelly Seyarto
Legislator
Right. And that's an opioid also. And it's addictive. Correct.
- Lisa Heintz
Person
Our buprenorphine is the primary substance that we're treating them with, and it also has naloxone in it. So it does also have.
- Kelly Seyarto
Legislator
So it's trying to moderate the symptoms a little bit. Yeah, that's a narcan. Is keeping it correct, moderate, yes. Is the goal of the program to get them off of drugs, or is it to tide them over until they get out?
- Lisa Heintz
Person
That's an interesting question. We're looking at that. It's actually, of course, to help them. It is a chronic disease, so it'll be treated similar to other diseases, diabetes or other things in the event that you need the substance to assist you in transitioning. We also are providing the rehabilitation components for criminogenic factors to help them also with their cognitive behavioral interventions. And we're beginning cognitive behavioral treatment for those that have additional traumas so that we can really look at addressing the root cause. And then, yes, having them be productive, employed citizens when they're transitioned, because that's.
- Kelly Seyarto
Legislator
The part that I'm kind of curious about. When they get out, if we're giving them Narcan. That means they're still on drugs or they're susceptible to going back on drugs, and that's their escape route. If somebody is there to give it to them, how is that going to make them employable?
- Lisa Heintz
Person
You are employable. We have many people who come to work that may be on medicated, assisted treatment through other real life areas like Kaiser or blue Shield. And then the Narcan. In talking with the population we serve, it was kind of interesting. They are taking the Narcan not just for themselves. They're worried about other environments they might be in, including their children.
- Kelly Seyarto
Legislator
Right. Helping others that they may run across.
- Lisa Heintz
Person
Right. We are not trying to supplant one issue with another. We are working on all best practices for this program to really help people who have never had an opportunity. We also do an Isudt insider to educate the population on fentanyl and the inappropriate, the skin infections that they might receive if they think that injections are a habitual way to go, the harm that they're doing to their families. The ISGT insider has. We've gotten over a thousand letters.
- Lisa Heintz
Person
We implemented that during COVID because we couldn't reach out and actually make that connection with the population. And we get a few letters that are not positive, but overall, we have over about 1000 letters of the population saying that we're actually saving their lives. They've never had an opportunity like this before. They've always had to go to other substances that were more harmful.
- Kelly Seyarto
Legislator
Right. And that's it. When we're investing in a program and giving funding to a program, at the end of the day, the object is hopefully to not put them back in the place that got them probably in prison in the first place. Because a lot of the crime that's being committed out there is from people that are trying to feed their and fuel their habit. When they do become incarcerated, we can somehow get them off of those drugs and get them trained to do something.
- Kelly Seyarto
Legislator
And then when they're released, they're clean, and they can get out there and get that job and keep that job. I think that's the goal, and I'm hoping we're meeting that goal. The other question I have is, whenever we have drugs inside the prison, people are pretty creative and they can create businesses for themselves. Do we have any problems like that in the prison system where people are getting a hold of the suboxone and going out and turning that into a business for themselves?
- Lisa Heintz
Person
Again, we're educating the population that the way that we provide the six rights of medication. At the medication line, we actually require the population to lift their tongue and put the. We don't use a pill format, we use a film. Immediately upon the film touching mucosis, within about 10 to 20 seconds, it starts to dissolve. So you never know what you're getting in that film strip.
- Lisa Heintz
Person
We're trying to educate the population that you may be getting a whole lot in naloxone that you think that you're going to melt down and inject, and that's just not a good way to go. So the more I have found, the more we educate our population on what the substance actually is, that they're less inclined to go in that direction.
- Lisa Heintz
Person
We also work with our custody partners and have processes in place that during medication pass or during any other time, that they think that there may be inappropriate activity going on, that they have a mechanism to report that goes through a variety of quality control measures, if you will, through their primary care physician, back through our clinical staff and our nursing, and then also through the CBT program.
- Kelly Seyarto
Legislator
I have heard some horror stories from people in county facilities, state facilities, that drugs are rampant. And I'm curious how that happens. So anyway, I'll follow up with that another day, but thank you for answering those questions. I appreciate it.
- Lisa Heintz
Person
Thank you.
- Josh Newman
Person
Just a quick question on the naloxone. So is this an ongoing program? Is it a new program to issue the naloxone?
- Lisa Heintz
Person
Naloxone, yeah. No, we've been doing that for a while.
- Josh Newman
Person
Is there data on post release use?
- Lisa Heintz
Person
So, no, there's not actually on post release use of the naloxone. We are working with our county partners and trying very hard to get MOUs in place. And the calcium initiative that you just heard about, I think will be helpful towards that end. When we do the warm handoff with the county is actually going ahead and look at that. What we do research is going to be the mortality rate of this population when they leave, also the medical utilization rate when they leave.
- Lisa Heintz
Person
We can work with our DHCs partners on that. We've been trying to do that for quite a long time. SUD is 42 CFR covered. So we have federal regulations we have to overcome, but I think we will. And the cost benefit analysis, to the Senator's point previously, employment really saves the counties in the long run.
- Josh Newman
Person
And that's why, I guess, it's a hard thing to track. Right, but. So mortality is a proxy for the.
- Lisa Heintz
Person
Effectiveness, mortality and medical utilization for the population.
- Josh Newman
Person
Appreciate that. Anything Department of Finance would like to add? Thank you for that. Very good. We'll now move on to issue number 10, Covid-19 direct response expenditures. Staying with Mr. Reeder. You have presentation. Please proceed. And the chair is back.
- Duane Reeder
Person
Good afternoon. The Department is requesting 141.8 million to continue our mitigation efforts for the Covid-19 response. This is one time funding in the budget year that will be used for testing of both staff and incarcerated individuals, medical treatment, PPE overtime, and staffing coverage for individuals that may have Covid and not be able to work. This funding was based on our current year expenditures. So what we've been experiencing in current year, we've carried that forward and used our expenditure trends to estimate our budget year needs.
- Duane Reeder
Person
The Department is currently working with CDPH on our COVID protocols, and we will be looking to update those as far as masking requirements, testing requirements, isolations, and possibly some other areas that could impact these expenditures. But these costs are largely based on our estimates using current year trends. With me today is Madeleine Mclean, Deputy Director, Office of Fiscal Services for CDCR, and we're happy to answer any questions.
- María Elena Durazo
Legislator
Thank you very much. We have the LAO's office.
- Orlando Sanchez Zavala
Person
Thank you, Madam Chair. We recommend that the Legislature withhold action, given that the Department indicates they will submit a revised proposal at the May revision. We also recommend directing the Legislature to direct the Department to provide sufficient justification for all of its requested resources. While they justified some parts of the proposal, not all of them were. For example, the Department indicated that it expects to treat about 32,000 employees per month, but did not provide the information on how it arrived at that monthly estimate.
- Orlando Sanchez Zavala
Person
Without this information, it makes it difficult for the Legislature to determine whether the level of resources is justified. Thank you. Happy to take questions.
- María Elena Durazo
Legislator
Thank you. Department of Finance, Miss?
- Alyssa Cervantes
Person
To address the LAO's concerns, we are happy to provide additional information, and we do anticipate estimates will be revised at May revision as well.
- María Elena Durazo
Legislator
Okay, great. Yes. Mr. Reeder, could you tell me a little bit more about the current testing procedure for the staff and how many staff are up to date with vaccinations, including the boosters? I know this is a different number for the original, and I understand there's only 38% of incarcerated individuals who are completely up to date, again, including the boosters. So what's your thoughts, and how do we get better at that?
- Duane Reeder
Person
Well, we have an employee health program that helps us manage the employees and work with them on getting vaccinated. We are revisiting our vaccination requirements and working with CDPH, but we continue to work with our employees to ensure that they're vaccinated and meeting the current protocols. With the State of emergency, lifting those continue to change. Inmate patients have a right to refuse vaccinations.
- Duane Reeder
Person
The initial round of vaccinations, I think we had about an 80% compliance within them, and then the booster rate has dropped down significantly, probably in line with some of the outbreaks in the institutions. Possibly. But we continue to educate our inmate population on the importance of getting vaccinations, especially in the incarcerated environment where you're in very close proximity and atds are very easy to spread in that type of environment. So we continue to look at vaccinations, the testing requirements. We have testing upon transfers.
- Duane Reeder
Person
We have testing within housing units that have outbreaks in them. As patients test positive employee testing, we do similar. If they are symptomatic, if they come to work and they complain of any sort of symptoms, we refer them to testing. Or if they're working in an area that has had an outbreak, we require testing as well. So our testing protocols, like I mentioned, we're working with CDPH to update those.
- Duane Reeder
Person
I anticipate in the next month we'll be releasing some new protocols on the testing requirements, masking requirements, and the vaccination requirements. So that is all under review. But we do test them as they present or they require.
- María Elena Durazo
Legislator
So you expect. You said over the next month that you're reviewing this to see what you change or don't or why?
- Duane Reeder
Person
Yeah. You know, the State of emergency has changed as well as the response to Covid. It still is an issue within the institutions, but it's not as prevalent as it has been in the past. So as we continue to gain more control, we need to revisit those and fall more in line with CDPH requirements. And so as the emergency has transitioned into. I'm not a Doctor, but more of a normal phase, we're looking to update our protocols on how we respond.
- María Elena Durazo
Legislator
Okay, thank you very much. Somebody else? Okay, that's it for that issue. We move now to issue 11, the comprehensive employee health program. Mr. Reeder?
- Duane Reeder
Person
Yeah. Good afternoon. This request is to continue to maintain our employee health program within CDCR. The program was established during COVID and is to mitigate risks and ensure compliance with federal and state regulations. The employee health program has been implemented in all institutions and is in line with the governor's smarter plan. With me today is Deborah Amos Terrell, assistant Deputy Director of nursing, to provide additional overview and help answer any questions.
- María Elena Durazo
Legislator
Thank you. Welcome.
- Debra Amos-Terrell
Person
Thank you. As Duane said, my name is Deborah Amos-Terrell. I am the assistant Deputy Director of nursing. I am proud to represent and speak on behalf of all of the employee health program staff who have worked tirelessly to mitigate the spread of Covid-19 within the correctional setting statewide. I'd like to just highlight one absolute amazing intervention that the staff were able to provide over across the states.
- Debra Amos-Terrell
Person
So the EHP staff interface with and have implemented the test to taste strategy, thereby eliminating the need to quarantine asymptomatic CDCR staff who were exposed to Covid. This intervention was crucial as it allowed for continued programming for our residents and access to health care for our patients. But EHP's work is not done. Covid-19 exposed the gap and illuminated the additional services that we are obligated to provide and for and protect our staff based upon the Kalosha regulations.
- Debra Amos-Terrell
Person
Although Covid-19 is the most recent public health threat, it certainly will not be the last. The Epidemic Intelligence service, a distinct part of the Centers for Disease Control and Prevention, have surveilled significant communicable diseases since its inception in 1951. Across the time across time, such as smallpox, Influenza, and zika. Of particular concerns are the increasing numbers of airborne and droplet transmitted diseases. Each HP will address other communicable diseases, such as tuberculosis, legionella, seratia, giardia, and shingles, that have recently challenged our institutions.
- Debra Amos-Terrell
Person
CDCR must remain prepared to respond to emerging health threats consistent with the governor's smarter plan, the EHP is essential in identifying and mitigating potential hazards in the workplace, promoting employee work wellness, and ensuring compliance with Kalosha regulations. I respectfully urge the Committee to prioritize ongoing and permanent funding for the employee health program. If ongoing funding is not allocated, the Department runs the risk of losing a competent workforce secondary to limited term funding and the resiliency and readiness of the Department to be proactive in mitigating risk.
- Orlando Sanchez Zavala
Person
Okay Lao office thank you, Madam Chair Orlando Sanchez with the Lao we recommend the Legislature approve the 22.7 million for the Employee health program on a one time basis. Given the ongoing presence of Covid-19 we find it reasonable to maintain the program in the budget year.
- Orlando Sanchez Zavala
Person
We note that these resources should be sufficient for the Department to begin its efforts in addressing other diseases other than Covid-19 but because data is not yet available on how effective this program is, and it is unclear whether these resources are needed in the future, we also recommend that the Legislature direct the Department to provide a report by January 10 of 2024. This report should include three pieces of information.
- Orlando Sanchez Zavala
Person
The first is the amount of workload associated with Covid-19, and the second is the amount of workload associated with the transmission of other diseases. And third is estimates of the benefits of the program. This information would allow the Legislature to be better positioned to weigh the merits of the program in the future. Thank you, and happy to take questions.
- María Elena Durazo
Legislator
Thank you very much. Department finance.
- Alyssa Cervantes
Person
So, first, even with the end of the State of emergency, the Department is taking precautions to prevent both Covid outbreaks and to limit quarantine in order to protect the health and wellbeing of both staff and inmates in order to support regular prison operations. So, more importantly, as the Department mentioned, the pandemic really highlighted the gap that existed in the Department with their approach to health care, and that was staff's health and well being and how that plays within the broader prison infrastructure.
- Alyssa Cervantes
Person
So while EHP has primarily been focused on Covid-19 in response to that, out of necessity, as the Department mentioned as well, they will also be focused on things like tuberculosis, lesionella, shingles, monkey pox, and the flu.
- Alyssa Cervantes
Person
We also note that the Administration is proposing ongoing funding for this in order to be consistent with the overarching smarter plan and in order to have ongoing resources available if and when the next pandemic hits, so that the Department is prepared and maintains a certain level of readiness in order to enhance their capacity to respond to these health related issues.
- Alyssa Cervantes
Person
These resources will help to support a more resilient prison system while also providing an opportunity to promote the health and wellbeing of those that live and work in the prison environment.
- María Elena Durazo
Legislator
Can I just ask you what your thoughts are on the LAO's proposal to approve a one time.
- Alyssa Cervantes
Person
Yeah, so the funding. Sorry about that. The Administration is proposing ongoing funding for this in order to. Not only for Covid in the current year and out years, but also the other health issues that I mentioned as well. In order to maintain the health and well being of both staff and incarcerated individuals in the out years, it's really important that they establish this funding. Ongoing.
- María Elena Durazo
Legislator
Okay, so the violations that have been found over the. Let me see how many, over what length of time over the past five years, the violations have in the workplace, violations and citations from calocia have amounted to about $1.0 million. Could you respond to that? Especially since that was before COVID right?
- Debra Amos-Terrell
Person
That was definitely before COVID Those fines are related to aerosol transmitted diseases, deficiencies in our plans and our practices, as well as the IIPP, well as RPP. And I believe there was one other section that I might have here that the fines were related to. I would just emphasize the point that you're right. It was prior to Covid. And so now we're working on our ATD plans that have been reviewed by Kalosha, by their consulting side.
- Debra Amos-Terrell
Person
We fully expect their enforcement side to come in and ensure that we are implementing what we defined in our ATD plans. And so the EHP staff would be very helpful with ensuring that major parts of that plan are implemented appropriately.
- María Elena Durazo
Legislator
Okay, but can you give us some insight as to what happened, what was going on for the five years that led to all these violations?
- Debra Amos-Terrell
Person
So those violations occurred prior to sort of the. So we have two sides of the house. We have the CDCR side and the CCHS side. We were not necessarily running the program. It wasn't even stood up as you stated before. And so what happens is when everyone is responsible for something, there's not necessarily one person that is responsible. So in the past, what we've had to do was redirect, take individuals from here because we were never funded for the oversight of an employee help program.
- María Elena Durazo
Legislator
Okay. That doesn't seem to add up to this. I mean, oversight, again, this is not something that was triggered by Covid-19.
- María Elena Durazo
Legislator
And so for those kinds of violations to go on for several years and add up to such a large amount of money, we were always expected to.
- Debra Amos-Terrell
Person
Correct.
- Debra Amos-Terrell
Person
Be compliant with the calocia regulations. What I am stating is that we were never given the funding in order to ensure that, number one, our ATD plans were up to speed and implemented our RPP, our IPP, because we never had a line item funded for that oversight. I hope that makes sense.
- María Elena Durazo
Legislator
Well, the laws are the laws.
- Debra Amos-Terrell
Person
Absolutely.
- María Elena Durazo
Legislator
Anyway, I just find that it's hard to understand how that can go on for several years with such a large amount of money being fined. Okay, any questions or comments? Okay, thank you very much.
- Lisa Heintz
Person
Thank you.
- María Elena Durazo
Legislator
We're moving on to issue 12, statewide mental health program regional staffing augmentation. Mr. Reeder?
- Duane Reeder
Person
Yes. Good afternoon again. This request is for staffing in the four regions in our regional offices to support the institution efforts addressing suicide prevention, ensure implementation of correction action plans, quality improvement plans, and utilization management inpatient beds. With me today is Dr. Amar Mehta, Deputy Director of the statewide mental health program. To provide an additional overview and answer any questions.
- María Elena Durazo
Legislator
Thank you. Go ahead.
- Amar Mehta
Person
Thanks. Good to see everyone. Thank you, Senators and colleagues. My name is Amar Meta. I'm Deputy Director of statewide mental health for the California Department of Corrections and Rehabilitation. So this request in this proposal is for 13 positions which are basically three teams of four. We divide our institutions up by four regions going from north to south. And so this is three tasks that need to be done at each regional level. The first one is the suicide prevention experts.
- Amar Mehta
Person
There's obviously a huge focus on that in our departments. One of the most important things that we do is to protect our patients from suicide. And this is really a group of people who will be able to run these institutional audits. As Mr. Reader mentioned, we have two kinds of that. There are the corrective action plans when we've found something wrong, and the quality improvement plans when we're just improving our system.
- Amar Mehta
Person
So we have about 100 corrective action plans a year and about 200 quality improvement plans a year. And the standard is always evolving, so that goes on forever. We're always kind of striving. We are also asking for four regional psychiatrists. These psychiatrists help support the institutional psychiatrists who in the past, we have not had enough staffing to be able to accommodate this group. And it leads to a vicious cycle where the institutional folks don't feel supported, and then we don't have as many people coming in.
- Amar Mehta
Person
And so if we can break that cycle with this group, more support to the institutional folks makes it a better place to work, brings in more people, kind of keeps that going. The last group is for utilization management nurses. So these people help us review, especially inpatients. But really all of the different people, the different patients in our system, review their cases to see if they're at the right level of care and when they've improved to help them get to the next step in their progress.
- Amar Mehta
Person
This really helps by opening up the number of beds we have available at the highest levels of care, so we can use that for other patients that need it, and then also to just make sure that we're not being overly restrictive. If a patient's at an inpatient level of care and they don't need it, we don't want them in that restrictive of an environment.
- María Elena Durazo
Legislator
Okay. Mr. Yes. Lao office we have no, we raised no concerns with.
- Unidentified Speaker
Person
I'll repeat that.
- María Elena Durazo
Legislator
Thank you. Department of Finance?
- Unidentified Speaker
Person
No specific comments on this proposal, but we're happy to answer any questions.
- María Elena Durazo
Legislator
Okay, I have a few questions. So on April 1, the state will start accumulating fines for failing to implement suicide prevention safeguards. That's right around the corner. So how close are you to meeting the remaining 15 court-ordered suicide prevention safeguards? What are some examples of the safeguards the state is not meeting and why is it so difficult to meet them?
- Amar Mehta
Person
Thank you. So these orders are relatively new and we're developing our responses to it. The 15 items are from a list by the court expert on suicide, Lindsay Hayes. So we call them the Hayes Items. They're very wide-ranging and we've been working with Mr. Hayes on these for many years and we were feeling like we were doing pretty well with what we were being asked to do by the court. This order was a little bit of a change in pace for us.
- Amar Mehta
Person
We felt like we were doing all that we were asked and we were following the schedule, and then we kind of jumped ahead a couple of steps. I can give you a couple of examples. Some of the changes require construction, and we've been informing the court for years that this construction would take a certain timeline. The order now just kind of circumvents those past understandings and takes us straight to the fine stage.
- Amar Mehta
Person
One of the examples of the activities that we're really struggling with has to do with nursing checks. So when a patient's at that highest level of care, if they need somebody to check in on them very frequently to make sure that they're doing okay, we have a type of check called Every 11-minute Check so that Every 11-minute Check happens for as long as the patient is there. The nurse. It can't be every 11 minutes exactly.
- Amar Mehta
Person
If it's at 11 22 and 33, we fail. It actually has to be staggered at unpredictable intervals so that the patient doesn't immediately try to harm themselves the last time you walk by. So we do across all of our 33 facilities and crisis beds and all these things, we do about 500,000 of those checks a month. It's a very high-volume thing. It drives a lot of care. So that's six or 7 million a year.
- Amar Mehta
Person
We are required to have 100% compliance in order to pass that Hayes Item. So 7 million times a year a nurse is checking in, and if we fail one, you fail. It's going to take some court negotiation about how to make sure that we're doing everything that is safe for our patients, and I will say we're over 95% in every one of the institutions that are being monitored for this.
- Amar Mehta
Person
And so we're doing really well by our standards, and we want to make sure that we're speaking the same language as the court and that recency of the order is really an effect there. We need to be working with the court. We are, of course, working with the court to make sure that we're all understanding where we are.
- María Elena Durazo
Legislator
Yeah. One problem is that these 15 items were ordered eight years ago, as I understand it. So for eight years, you've been working on these items, and the court just finally said, we're going to start fining you. So I'm not sure when you make reference to conversations or talking to who you're talking to, but this kind of sounds like the court said, enough is enough. We're going to start finding you because you're not doing what's expected of you and what's needed.
- María Elena Durazo
Legislator
So I don't understand when you say, well, we're going to keep talking this through, this sounds like a pretty serious order, a very clear order, and an order that's been in place for years now.
- Amar Mehta
Person
You're absolutely right. And I should say that the 15 remaining items are from a much longer list, but all of the other items we've met and been able to achieve those goals. These 15 remaining items were things that we've been working on for some time, and I don't want to underestimate their importance. They really are a huge priority for our entire organization. It's really a matter of some of these things taking a certain time to complete, like construction where you can't really speed it up.
- Amar Mehta
Person
And the items that we're talking about as well are also evolving. So the order, original order, was eight years ago, but the criteria have changed sometimes during that period, and we're always going for the higher criteria.
- María Elena Durazo
Legislator
So are there any changes that are needed to the resources that you're proposing to make sure that we meet the timeline that's required of these safeguards?
- Amar Mehta
Person
Yeah. The four positions, the suicide prevention experts in this proposal are important, but I will say mental health is a participant in a lot of the different proposals we have here today, including things like CalAIM and ISUDT. And then in a short time, you'll hear about the Gender Minority Support Program as well. All of these things kind of fit together to support different aspects of these populations or different elements of these populations.
- María Elena Durazo
Legislator
Okay, well, do you feel that you have the plan in place sufficient to be able to avoid these fines within a few weeks.
- Amar Mehta
Person
We're working on the full response. As I mentioned, some of the things just simply won't be done. Construction and that kind of thing won't be done at that time. Some of them do require some discussion with the court. What is the cutoff standard for compliance and things like that? Definitely, we are participating in those conversations right now.
- Amar Mehta
Person
The court order also said that at the next audit by Lindsay Hayes, which is a few months out, if we are meeting those conditions, that may retroactively remove the fines from April 1. So we're working to make sure that that's also something that we're able to achieve.
- María Elena Durazo
Legislator
Okay. I hope you're not expecting to have those fines kick in.
- Amar Mehta
Person
No, we're not waiting.
- María Elena Durazo
Legislator
Okay, colleagues, none. Okay, thank you very much. Move on to issue 13, the Joint Commission accreditation.
- Duane Reeder
Person
Yes, good afternoon again. The Joint Commission request is for 6.1 million and 38 positions over a five-year rollout to implement and maintain Joint Commission accreditation at all CDCR institutions. The Department has been able to achieve at least one accreditation program at four institutions, and joint accreditation is the healthcare community standard for hospitals and is based on CMS standards.
- Duane Reeder
Person
With me today is Kenneth Martin, associate Director of licensing and Compliance, to provide additional overview and help answer questions.
- Kenneth Morton
Person
Good afternoon. Again, I'm Kenneth Morton. Joint Commission accredits approximately 22,000 organizations across the U.S. in various accreditation types. They are considered the gold standard. About 80% of hospitals in the U.S. are accredited by them. We feel that we currently have four institutions, as Duane was mentioning, that have at least one type of accreditation. We have one that have three types and one that has two.
- Kenneth Morton
Person
We feel that moving forward with Joint Commission accreditation will supplement our current processes and court litigation requirements and move to a sustainable process as we move forward in the future. Joint Commission looks as a holistic approach to healthcare. It encompasses mental health, dental, outpatient medical services and by developing some sustained processes in a holistic approach, we'll move forward and enhance our healthcare delivery to our patient population. Again, it's a self-assessment process.
- Kenneth Morton
Person
It's a survey process whereby Joint Commission surveys between 9,500 and 10,000 organizations every single year by providing consultation and survey results and immediate processes for improvement. It will help us with the proactive and preventative measures to assist in sustainability and potential improve overall delivery of healthcare. Obtaining and sustaining accreditation assists the organization and system in meeting community standards. Joint Commission's standards are at least twice a year are reviewed and updated so that we can then assess our internal processes to enhance our processes for our patient population.
- Kenneth Morton
Person
Thank you.
- María Elena Durazo
Legislator
Thank you, LAO, please.
- Orlando Sanchez Zavala
Person
Thank you. Madam Chair and Senators, my name is Orlando Sanches with the LAO. We recommend rejecting the Governor's proposal to provide resources to obtain the Joint Commission accreditation. Three main reasons led to this recommendation, and I'll go over those. First, is that we find that accreditation has not been ordered by the courts. Also, the courts have not specifically selected a specific accreditation as the most appropriate.
- Orlando Sanchez Zavala
Person
Our second finding is that accreditation could duplicate oversight already provided by the courts and the Inspector General. It is likely that accreditation would find similar deficiencies already highlighted by these oversight entities, thereby not providing much additional value. And third, we find it more appropriate for the state to prioritize its resources to ending oversight. This is because the state has not yet been able to demonstrate to the courts that adequate care is being provided at all prisons.
- Orlando Sanchez Zavala
Person
But we do note that this proposal could be considered in the future if achieving accreditation is ordered by the courts or to ensure that the quality of care is maintained once the state exits court oversight. Thank you and I'd be happy to take questions.
- María Elena Durazo
Legislator
Thank you very much. Yes, Office of Finance.
- Allison Hewitt
Person
While the Office of the Inspector General does provide some oversight to the Department, their oversight is limited to how well the Department is meeting their own policies and procedures. Whereas obtaining the Joint Commission accreditation is a community standard of care, rather, and it goes beyond the metrics outlined by the OIG. And this can help to show that the level of care provided to the patients within CDCR is consistent with care they might receive outside of incarceration.
- Allison Hewitt
Person
The Joint Commission accreditation will not only help the Department ensure proactive and preventative measures are taken, also has the potential to improve the overall delivery of their healthcare services and provide sustainable compliance to the courts. With that, I'm happy to answer any questions.
- María Elena Durazo
Legislator
Okay, thank you. No questions or comments, colleagues. No. Okay, so have the courts. I think the last thing you said, will achieving this accreditation actually be helpful to the courts. Which then leads to if the Department is not focusing on implementing the current court orders. So how does it help when we're facing these court orders? How does it help us to do this accreditation? And why would we do that when we have so much work to do on the court orders?
- Kenneth Morton
Person
Joint Commission has a structure and that structure is based upon requirements and consultation with various people within the U.S. and the world when they develop their requirements. The Joint Commission requirements, I think they enhance and aid what our court orders are requiring, but it also elevates that. So that value-added for intrinsic for our staff is our healthcare staff really look forward to working in an environment that has high standards and being able to say, I'm Joint Commission accredited, aids in that piece.
- Kenneth Morton
Person
But again, it's an aid. So the court requires X. The Joint Commission is X and Y and you build those sustainable systems together so that when and if the litigation is exited, those systems and processes to maintain the accreditation are already in place. As that, as was mentioned, as the exit occurs or potential.
- María Elena Durazo
Legislator
Okay, that still doesn't make sense to me. Is taking away the focus from resolving the issues and the court orders and paying so much attention to the accreditation. If it's not going to help, then I don't understand why we would be doing it.
- Allison Hewitt
Person
If I may, Madam Chair? Allison Hewiit, Department of Finance. We'll lean on the Department a little bit in this case, but I think we view these efforts as complementary. So we're not looking at taking resources from this location to this location. We think Joint Commission accreditation will help us be able to model statewide at every institution, that the institution is meeting a certain standard of care and that it can sustain that level of care over a period of time within the context of the courts.
- Allison Hewitt
Person
One of the things that the courts are looking for in General is that the Department can not just provide care in any given moment, but that they can sustain a level of care over time.
- Allison Hewitt
Person
So while we can't say that these resources will end court oversight, I think what we're saying is we feel that Joint Commission accreditation will be helpful in proving that the Department is able to sustain compliance over the future by meeting a community standard of care that's regarded outside of the carceral system, but is generally a standard of care that many healthcare entities look to in terms of what's kind of the level of care that they're being provided and both the community standard and really a gold standard, many healthcare entities seek this out just as a matter of course.
- Allison Hewitt
Person
I don't know if my colleagues have anything to add.
- Unidentified Speaker
Person
No, thank you for that. I appreciate.
- María Elena Durazo
Legislator
Wouldn't the issues that we're facing in the court orders, shouldn't those be considered part of or aren't they part of this gold standard, this community standard of service?
- Allison Hewitt
Person
I think that's fair. In Joint Commission, one of the accreditations is behavioral health, which I guess you mean we're talking about a broader than just the mental health program, which is the subject of the Coleman court order. So I think we're looking at care holistically across the different types of accreditations, one of which is behavioral health. So I think within the court order, there's a couple of specifics that are mentioned.
- Allison Hewitt
Person
Staffing, the suicide prevention work and transfer timelines, all of which the Department is working very diligently on and trying to resolve. I think, Dr. Mehta, my colleagues spoke to some of the kind of barriers or challenges, some of which are kind of not easily solvable. I think, though, that these resources are, sorry, speaking from the Administration standpoint, are complementary and would help the Department demonstrate a level of improvement over time as it pertains to mental health. That may assist the court down the line in terms of how it views the mental health program, the medical program, etc.
- Allison Hewitt
Person
Again, looking to my colleagues to weigh in if they have anything to add.
- Kenneth Morton
Person
I would add that again, OAG and the court sometimes look at our policy and the policies that are developed. Joint Commission sets the standard that you look at your policies and your assessments and your risk, and you do mitigation. So again, as Allison was saying, it complements those orders and those reviews by providing a roadmap for the Department to develop sustainable processes, say, for suicide prevention assessments or environment of care areas that cross over the holistic approach to health care.
- Kenneth Morton
Person
It includes our partners in DAI, our custody partners. They really look at leadership and the culture of the environment, of how that affects delivery of healthcare and plans and processes, to really look at the whole approach. And I think that, again, it complements the orders and those things. It complements the receiver's turnaround plan and those kinds of areas.
- María Elena Durazo
Legislator
Okay, well, you know where I'm coming from.
- Kenneth Morton
Person
Yes, ma'am.
- María Elena Durazo
Legislator
I don't think if it's not fulfilling and helping us get through these court orders, then I think we're going to continue to face those. It might even be upsetting to the court. I don't know that we're not really fulfilling. We're not doing what we should under these court orders. And I can appreciate the holistic approach. I think that's great. But we can't even do what the court is asking us to do, and that's a problem. Thank you.
- Unidentified Speaker
Person
Thank you, ma'am.
- María Elena Durazo
Legislator
Thank you very much. Okay, we move on to. Wow. Is it really our last issue? Okay, our last issue, 14, the Integrated Gender-Affirming Healthcare Program. Mr. Reeder.
- Duane Reeder
Person
Good afternoon again.
- María Elena Durazo
Legislator
You've been with us all afternoon.
- Duane Reeder
Person
I know. It's nice.
- María Elena Durazo
Legislator
You like being under the.
- Duane Reeder
Person
This request is for resources to address gender-affirming health care within CDCR and meet internal policies, state law, and provide timely care for this patient population.
- Duane Reeder
Person
The program was established with minimal limited-term resources, and the Department has now identified resources to maintain the program and to address the needs of this vulnerable population. With me today is Dr. Tricia Wallis, Senior Psychology Specialist over the program, to provide additional overview and help answer questions.
- Trisha Wallis
Person
Thank you. Good afternoon, everyone. Madam Chair and Senators and colleagues. My name is Dr. Tricia Wallis. My pronouns are she/her, and I'm a Senior Psychologist Specialist with the Department of Corrections and Rehabilitation. I am a gender healthcare specialist in transgender and gender-diverse care, and I'm a subject matter expert in transgender, non-binary, and intersex care within the departments.
- Trisha Wallis
Person
Thank you for the opportunity to talk about the Integrated Gender Affirming Healthcare Program or IGAHP. In 2021, SB 132, authored by Senator Wiener, also known as the Transgender Respect Agency and Dignity Act, or TRADA, was enacted and which amended Penal Code 265 and 266. As part to assist in implementation of TRADA, a previous BCP acknowledged that the healthcare positions in it were established to, in part, monitor the needs of transgender and gender-diverse patients and population in CDCR and learn.
- Trisha Wallis
Person
And what we've learned is that the vulnerable transgender and gender-diverse population in CDCR has grown and continues to grow, and there are enduring needs that need to be met. We need permanent positions and staffing resources to help meet the needs of TGD people within the custody of CDCR. And this BCP is a multidisciplinary ask that will resolve some of the challenges of the population that is vulnerable and not getting its needs met currently.
- Trisha Wallis
Person
The spirit of the program addresses several things: equitable access to safe and optimal gender-affirming care focused on patient-centered, individualized care and patient safety, and it's in alignment with law, policy, and the current WPATH, or World Professional Association for Transgender Health current standards of care. Gender-affirming care itself is recognized as essential for overall health and well-being for TGD folks. It is part of suicide prevention care for this population, and it is medically necessary care both in the community and in incarcerated systems.
- Trisha Wallis
Person
Gender-affirming care is what our patients in CDCR need, and we are asking for the resources to help address those needs. Thank you.
- María Elena Durazo
Legislator
Great. Thank you very much. LAO Office, please.
- Orlando Sanchez Zavala
Person
We do not raise concerns with the proposal at this time.
- María Elena Durazo
Legislator
Okay. Office of Finance.
- Allison Hewitt
Person
No specific concerns, but happy to answer questions.
- María Elena Durazo
Legislator
Okay. Colleagues. No? Okay. Well, I don't have a question, but just a comment is it's good to see the Department meeting the needs or trying to support the needs of transgender and gender-diverse population taking a thoughtful approach, as indicated in the recent report. I'm sure you know that there'll be areas of improvement and much more that has to do. But in the meanwhile, we're very appreciative of your work in particular, but also, again, commend the Department for taking this step. Thank you.
- María Elena Durazo
Legislator
Okay. Thank you for your presentation. You're free.
- Josh Newman
Person
You're not going to leave, are you?
- María Elena Durazo
Legislator
We could come up with some more questions. Okay. Thank you to everyone. We'll now move to anyone wanting to provide public comment. As a reminder, today's participant number is 844-291-5491 and the access code is 7042477 and we want to begin with witnesses who are here in Room 12. Go ahead.
- Edward Manning
Person
Thank you, Chair Durazo. Good afternoon, Chair and Members. My name is Ed Manning with KP Public Affairs. I'm here for California public television. And I'm here today primarily to thank you, Senator Durazo, and your colleagues, for working with us and Cal OES to ensure that the datacasting technology which helps transmit in the event of an emergency, in particular an earthquake, but beyond that, instantaneously, that we could expand that capability out to six more public television stations and complete the program we started several years ago.
- Edward Manning
Person
We're working with Cal OES now on that, and your personal staff, as well as Budget Committee staff, want to thank them for their work. We had originally asked for 2.3 million this year, one-time. That's now reduced, thankfully, to 1.8 million. And the rest of the money that we're still seeking is for the receiver boxes that can be placed with first responders.
- Edward Manning
Person
Could be placed in senior living facilities and a number of other areas where the receiver would then get the message instantaneously from our towers in the event of earthquake, but also lockdown situations, other emergencies, so that they can instantaneously take actions, things like opening up firehouse doors, stopping a medical procedure instantaneously, et cetera. So again, thank you for all your help.
- Edward Manning
Person
We really appreciate it, and we'd love to see if we can get some receivers out there in practice this year. Thanks.
- María Elena Durazo
Legislator
Great. Thank you. Thank you for your persistence.
- Joshua Gauger
Person
Good afternoon. Josh Gogger, on behalf of the chief Probation Officers of California, briefly, relative to the DJJ realignment and the transition of the remaining youth in state facilities. Probation chiefs want to continue to partner with the state to make sure the final transition is done right. The transition of these youth will approximately double the population of local, secure youth treatment facilities once completed.
- Joshua Gauger
Person
And this is a new population that counties were not resourced for and didn't design systems for as part of the original DJJ realignment legislation. We think a change to the local population of this magnitude must be done thoughtfully to increase chances of success with both the transitioning population and the existing local population. Probation chiefs have identified system gaps, and we hope to partner with the state on a focused effort to fill those gaps in short order.
- Joshua Gauger
Person
As part of this transition, we have shared a letter with this Budget Committee identifying our concerns and system gaps and really appreciate the conversations with the Committee to date. Thank you.
- María Elena Durazo
Legislator
Thank you very much.
- Ryan Morimune
Person
Good afternoon. Thank you. Chair, Committee Members, and staff. Ryan Morimune with the California State Association of Counties, also here on behalf of The Urban Counties of California, as well as the Rural County Representatives of California. And so, as my colleague Josh stated from representing CPAC, I'm here to provide brief comments as it relates to issue seven, DJJ closure.
- Ryan Morimune
Person
Not to sound repetitive, but we're here to highlight that successful reintegration of the population returning to counties not only requires additional funding at DJJ, but also support and resources for the counties that receive them. Whereas SB 823 from 2020 provided funding prospectively for the realigned population, SB 92 and 2021 did not include funding for individuals returning under the statutory deadline. So, that said, we urge the Legislature to provide resources to help ensure appropriate placements and the individualized treatment needs of all returning youth are met.
- Ryan Morimune
Person
And then, lastly, would also like to note, we thank Dr. Bolds and her work at DJJ for their continued commitment and collaboration with counties. Thank you.
- María Elena Durazo
Legislator
Great. Thank you very much. Now we're seeing no more witnesses here in Room 12. Moderator I understand, Mr. Silva. Yes. Would you please prompt the individuals waiting to provide public comment?
- Committee Moderator
Person
Ladies and gentlemen on the phone lines, if you do wish to make public comment on today's presentation, please press one followed by zero. One followed by zero. And nobody has queued up.
- María Elena Durazo
Legislator
Nobody? Nobody?
- Committee Moderator
Person
Not at this time, Madam Chair.
- María Elena Durazo
Legislator
I'm shocked. Okay. Well, that was easy. See, it's all because of the Moderator.
- Josh Newman
Person
It's because of the thorough job you did. Nobody has questions.
- María Elena Durazo
Legislator
Everybody who came today. Well, okay. Well, thank you, Moderator. Thank you for giving me the total number of people waiting to testify. And with no more callers, thank you to everyone who participated today. If you were not able to testify, submit your comments, your suggestions in writing to our Budget and Fiscal Review Committee. Your comments and participation are very important to us. I especially want to thank you for your patience and cooperation.
- María Elena Durazo
Legislator
Want to thank my colleagues on the Committee for hanging in there. And we have now concluded the agenda for today's hearing. Oh, bam.
- Josh Newman
Person
Very nice. Well done.
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State Agency Representative