DBHDD Webinar: 988 Demand and Response Times Update & CCBHC Introduction, December 15, 2022

Interim Commissioner Monica Johnson and the 988 Steering Committee provided an update on the data that Georgia is watching closely as our state continues to rollout 988 and evolve the behavioral health crisis system statewide.

and;

A Certified Community Behavioral Health Clinics (CCBHCs) Introduction 

Sarepta Archila, CCBHC Project Director, joined the webinar to provide an update on the work happening across the state to evolve community-based behavioral health care alongside and complimentary to the 988 rollout.

Slides linked at the bottom of this page.

Rough Computer-Generated Transcript:

Monica Johnson 00:04

Good. Morning.

My name is Monica Johnson. I'm the Interim Commissioner here for the Department of Behavioral Health and Developmental Disabilities. I would like to welcome and thank you for your interest in this work, which has been especially important to me personally, I know many of you have been intimately involved in this work yourselves, participated in working groups or listening sessions. And we so appreciate appreciate you for all that you did. Today on our agenda, we will do two things in particular. First, we will update you on the key performance indicators that we are closely monitoring for 988, the National Suicide and Crisis Lifeline. Second, we will introduce you to the work that is happening across our state on certified community behavioral health centers, also known as CCBHCs. I've had an opportunity to speak with our new Commissioner, Kevin Tanner, who starts tomorrow, he shares our commitment to continuing to evolve, improve and improve how Georgia supports our emerging crisis continuum, and continues to develop our system to support major federal initiatives, such as 988 and CCBHCs. In addition to expressing our gratitude to all of the hundreds, maybe even 1000s, at this point of people who have been involved in the evolution of our state's behavioral health system, on a truly impressive timeline, I want to give you some context about how these to do big ideas 988 and CCBHCs relate in our state's vision for behavioral health. And with that, I will turn things over to Anna Borque to kick us off.

Anna Bourque 01:49

Thank you, Commissioner. Hi, my name is Anna Borque and I am the Director of the Office of provider relations. And as coordination ASO is administrative services organization coordination here at DBHDD here at the DBHDD we think about our 988 work and the three buckets that were established by our federal partners, the Substance Abuse and Mental Health Services Administration, or SAMHSA. Those three buckets are someone to call someone to respond in a safe place for help. And that's how I'm going to share our update how we're going to share a day in response times with you today. Next slide. So we have been monitoring call volume here at DBHDD since 2019. And this is the four year seven day rolling average. What you'll notice within this average is that we had in 2020, a large increase in call volume. And that call volume did not go down in 2021. And then in 2022, we had an additional increase in call volume of about 24%. Starting in July with a rollout of 988. The majority of our calls still come through the Georgia crisis and access line. But we are seeing some more calls coming through the 90 day. Next slide please. So from July to October and 2021, there was about 90,000 cars over that same time period in 2022, there was a little over 100,000 calls. Back in 2021 20% of our calls were coming through from the then lifeline. And after the rollout of 988. We've seen an increase of 6% to 26% of our calls are coming through 90 day again, the majority of our calls still come through the Georgia crisis and access line. But we have seen the trend of more calls coming through the 988 or national suicide prevention line as far back as April in May of 2022. Next slide, please. So through the implementation of 988, we've been able to find some additional funding through federal government and some other sources. And so we've been able to increase our staffing. And so we measure success of whether or not we answered the call within 30 seconds. And you'll see right now our average speed to answer is about 10 seconds, just under 10 seconds. In October. We are at this moment. Now able to answer our calls. That means that we're staffed at the correct to meet the current demand. This still really early in the rollout. And we have to continue to closely monitor our performance and response rates as we anticipate the volume will increase. Next slide please. The other thing we really measure is our answer rate. We want 95% Or better answer rate. And so currently through 988 We're answering at 97 Point 12. But through the Georgia crisis and access line where the majority of our calls actually come from, we're at a 98% answer rate. So again, Just like the slide before, these are, these are indications that we are currently staffed at the appropriate levels. Next slide, please. So, previously, I've been talking about calls and now I'm going to talk about episodes. Every call has to be answered. But not every call is an episode. There are a lot of reasons why a call may not be an episode in some episodes have multiple calls. So while we have to answer the phone, and we have to answer the phone, quickly, how we get our dispositions is through their episode data. So from here on out, I'll be talking about episodes. So what happens when somebody calls? Well, 30% of the time when someone calls either the call itself is the intervention, the problems able to be resolved on the call, or we can transfer to a warm line or a peer support line, or we do an outpatient, or we do a referral for community based service, or they just wanted information. And we're able to provide that information 25% of the time, somebody needs to go. And that's either through an active rescue, which I'll talk about in a moment, or that's through a mobile crisis dispatch, which my colleague Dawn Peel will talk about later. And then 45% of the time, an episode results and a person needing a safe place to go. Next slide, please. So active rescue is when the Georgia crisis and access line has to dial 911. And our rule for dialing 911 is a person who is in immediate danger, any person is in immediate danger. So when we dial 911, we keep a record of that. And so we have had less than 2%, which is the national standard of the active rescue is 2%. We're under that right now at 1.3%. If you'll reflect back to when we did this at the 45 day, we told you that it's too early to tell but we suspect that costs are nine a day may result in higher active rescue rates based on on acuity and need. But we're continue to watch this as we are able to respond appropriately. Overall, again, less than 1.3% of the calls require an outreach or coordination with any emergency responder, it's important that we let the public know so that we can continue to ensure folks that when you dial 988, the police do not come out unless there's an immediate threat.

Dawn Peel 07:27

Next slide, please.

Anna Bourque 07:31

So where are the calls coming from? Where are the episodes? This is the map and as you would not be surprised. We're tracking closely on where our calls come from the majority of our calls come from the large urban areas. Next slide please. You'll note that Fulton to cabin but in Cobb, our highest call volumes and then Savannah with Chatham County. So this isn't surprising with the majority of people, the higher call volume. Next slide, please. When we adjust for prevalence when we adjust for population, we realize that the majority of the calls actually, based on prevalence are coming from our rural counties. Nearly all the top 20 counties are in South Georgia. It's too early for us to draw a lot of conclusions because we really don't have enough data yet. But we do know that the suicide rates in Georgia rural area have increased since the pandemic and that in 2020, rural suicides increased by 8.3% While they decreased in the department of public health. Next slide, please. Last time we met we know we pointed out that Webster County, which is a very small county, by prevalence had a lot of calls. So we did do some digging. And we found that this is multiple episodes around a couple of individuals who were having some sort of serious challenges towards the fall. So just to let you know, we've done our due diligence there and we continue to watch that county. Next slide, please. So by gender, we do want to do some more work within this. And we're we're working toward getting enough data to be able to do that we know that men are reaching out to Georgia, Crisis and Access Line at higher rates than females. And so we also know that nationally, males make up 49% of the population, but they're 80% of the suicides. And we also know that men are less inclined than women to seek care through traditional venue or traditional venues. We don't know for sure, but it could be that men are using the crisis line more than women due to the anonymous nature of the call the fact that they don't have to provide information that they don't want to and that we support no matter what so we don't know for sure, but we're continuing to watch episode by. Next slide please. So Again, people have the right to refuse to give us information about their age. Last time we were here, we noted that 9.5% of our episodes were about people under the age of 18. Now we're at 10.5% of our episodes are about people under the age of 18. We're watching this closely, because we know that emergency department visits for mental health related reasons grew by 24%, for really young children, ages five to 11. And that for youth who were 12 to 17, it has grown to about 31%. So we're really watching the youth engagement through the 988, and the Georgia crisis and access line. Next slide, please. Episodes by race, again, we have a large unknown because this isn't a question you don't have to answer. There's no need to answer if you don't want to. We do know that since 2020, suicide attempts and deaths by suicide for African American population has risen and that in 2019, suicide was the second leading cause of death for African Americans 15 to 24. So again, looking at the age looking at the race, we're ensuring that we're looking at all of the data points to see if we can find any code sort of trends or gaps that we can fill. Next slide, please.

Sarepta Archila 11:26

So last time

Anna Bourque 11:27

we met, I didn't have this and I apologize, then, but we are now and we'll be moving forward, able to provide you crisis episodes by ethnicity. So this will be an all of our future releases. You'll notice that a large portion of people choose not to answer the ethnicity questions. And again, that's fine. And our census has 10% of our population being either Hispanic or Latino. And our episodes are at 4.9%. So again, we know that we can reach out more to that community and are working on strategies to do that. And that is all I have. And I will now turn it over to my colleague, Don peeled.

Dawn Peel 12:12

Good morning. Thank you, Anna. And thank you all for being with us here today. My name is Dawn Peel. I'm the director for the Office of Crisis Coordination for DBHDD. Next slide, please. Anna provided is a lot of information about our call center and the impact of 98 on that. And I'm going to shift now and talk about the second category. So I'm going to respond. We're going to share information this morning about our mobile crisis services. And I'm going to give you a little bit of information about what types of circumstances might be in place, that would result in a mobile crisis. So when somebody calls the Georgia crisis and access line, or 988, a trained clinician does an assessment, they determine what's going on with a person. And then they quickly work to determine what's the next appropriate step. As Anna mentioned, sometimes that's a referral to an outpatient provider. But sometimes they need further assessment. And that can occur in a couple of ways. If a person needs a mobile team to come out to their house, or wherever they happen to be, a team can be dispatched him and the team arrive, they can do an assessment, they can deescalate the person if possible. And then again, they make a determination of the next appropriate step. And that next step then might be a referral to an outpatient provider if it's safe and appropriate to do so. Or it might be a referral to community crisis setting like Dave health crisis center, crisis stabilization unit or a private inpatient setting. Next slide, please. So this slide talks about the number of mobile crisis dispatches, and I think it's really helpful to look at this year over year to show growth over time. So as you can see, we've experienced some pretty significant growth since 2020. It's over 37% increase in dispatchers since that time. One of the things that I wanted, I think it's important to know, again, is that the dispatch volume for our mobile crisis services closely mirrors the volume from last year. But it also closely mirrors GCAL dispatch that or GCAL call center data. And that makes sense if you think about it. So the number of people calling in to the Georgia crisis and access line, whether it's through the one 800 Number, text chat, or the 988 line is going to kind of impact how many mobile crisis dispatchers were going to see in the community. I want to give you some information as well about kind of what we expect might happen down the road. So there's A company called Vibrant that administers the 988 Line at the national level. And in April of 2021, five and provided all 50 states with projections of what we might expect could happen once mass marketing of 98 begins. And based on the projections they gave for Georgia, we could expect an increase of mobile crisis dispatches of up to 176%. Once that mass marketing begins. So right now we're not seeing huge numbers, huge increases in dispatches based on last year. But we expect that once mass marketing begins, we could see high levels of increases. Next slide, please. So this data point is new, we've not shared this in our previous mobile crisis in our previous 98 presentations, but I think it's important to bring it forward. So again, this is global crisis response time. And it's year over year from FY 20 Through October of this year. And again, what you can see is that there's been a steady increase in response time with with some spikes. at particular times. What we've seen is based on the increased demand, and workforce shortages, is that the response time has cropped up. And it now kind of is in that 80 minute range. The SAMHSA, our partners at SAMHSA in the federal government, have a horizon a goal for us to achieve by 2025, that 80% or more of individuals in every state will have access to timely crisis response. And so what we recognize is that we need to have some increases in staffing, to meet that demand, as well as to get up to speed and, and bring down the response time for the current demand that we're seeing. Next slide, please. And I'll shift gears again now and talk about a safe place for crisis care. Next slide. So this data focuses specifically on our referrals to state funded crisis stabilization units, and behavioral health crisis centers. And that's both for adult unit and the Children's crisis stabilization units as well. What we can see is that there's not been significant differences in referrals to our CSU nbhc feeds from last year. In fact, a couple of months, there were some decreases from anywhere from eight to 9%. And in some, some months, it was very small differences of less than 1%. We're closely tracking this data to really identify what what the needs might be for BH CCS and CSU down the road. An interesting data point is that the reduction in referrals could potentially be due to influx of privately insured people using the crisis line. Our state funded crisis stabilization units, and behavioral health crisis centers are primarily in place to serve those that are uninsured or underinsured, and have no other way to pay for community crisis care, or inpatient care. So we're going to continue to track that and use this data as we do our strategic planning. And again, with our mobile crisis data, the referral trends are closely tracking the GCAL calls. One other thing I'd like to mention before I turn it back over to Commissioner Johnson, is that our purple projections from vibrant suggests that our CSU and bhbc demand could increase by as much as 105%. Once mass marketing of 98 begins later this year, or sorry, later next year. But we'll continue to monitor this data and bring it forward as appropriate. So thank you again, and I'm going to turn it over to Commissioner Johnson. Thank you.

Monica Johnson 19:11

Thank you, Dawnn and Anna, for that robust update. Next slide, please. So before we move on to our next topic of the day, I want to take a moment to just kind of reflect and just remind folks about the investments that have been made today to achieve the progress that we've had so far, where we are very proud of the strategic thought the planning and investments that have allowed us to improve our answer rate for 988 and GCAL calls to a point that meets and beats national standards and you've heard today. As you will recall, demand for crisis support has been on the rise for the last few years. And in FY 21 It took us on average more than 200 seconds. to answer those calls to GCAL, with the investments that have been made and some adjustments to our policy, we've come a really long way and are able to pick up the phone to people that are in need. Now in less than 10 seconds, we're very proud of that achievement. We're going to continue to watch the data very closely stay in conversation with the governor's office and our federal partners about how we will continue to meet the demand. As federal marketing begins, as you heard Dawn, just reference for the line and call volume increases as a result. As you can see here, we spent much of the first two years preparing and ensuring that we will be able to answer the calls that would come in our priority now is maintaining that progress, but also ensuring that the entire crisis continuum is capable of meeting both current and future demand.

20:58

Next slide, please.

Monica Johnson 21:01

Just want to remind people where you can go to stay connected and to get information such as the slides that are being presented today. previous slides, frequently asked questions, as well as recorded webinars. So please make sure to bookmark not eight gaa.org. So that you can get all the information that you need present and pass certain questions that you may have. So the email provided here questions at 988 ga.org. Next slide, please. So we're about to pivot a little bit from 988 to CCBHC. So in the beginning of this conversation I referenced that we were going to be introducing these two very large federal initiatives. The reason why we want to talk about CCBHC is one because we're doing a lot of work here in Georgia, around building out the certified community behavioral health clinics, I often refer to CCBH C's as being cousins to 988. You cannot have a system that is built on crisis alone. If you've ever heard me speak before, I say that all the time. And I'm going to continue to repeat that a system built on crisis is not a complete system, we have to talk about what happens before a crisis, as we don't want people to only feel that the way to seek help and support for behavioral health issues or challenges is through a crisis. So there are many things that can be done upstream, and we want to focus on that. And then there are things that can be done after the crisis. So you have to have a full robust continuum of care that addresses everything from prevention, early intervention, late intervention, etc. CCB ACS will play a critical role in this work, and you'll see the connections I believe when you hear from our next speaker. At this time, I'm going to turn it over to our project director, our state Project Director for CCBHCs, Sarepta Archila, Sarepta.

Sarepta Archila 23:09

Thank you, Commissioner. Hi, everyone. My name is Sarepta Archila. And I have the pleasure of serving as DBHDD State Project Director for Certified Community Behavioral Health Clinics, or CCBHC, as I will call them throughout the rest of this presentation. I'm excited to introduce you to this work, the things that we have been investing in preparing for and the path that we see moving forward.

23:34

Next slide, please.

Sarepta Archila 23:38

CCBHC is a new model and a new provider type that's designed to improve access and accountability in behavioral health care. The new model was defined in the Excellence in Mental Health Act back in 2014. It continues to have bipartisan federal support, most recently in the bipartisan, Safer Communities Act. This model outlines clinical data and financial expectations, while allowing states to customize aspects to meet their local needs and goals. The result is a comprehensive Person Centered community based care. In return for meeting, the enhanced operations and data collection CCBHC s can be certified by the state and become eligible to receive a new payment rate for services. This rate is specific to each CCBHC because it is based on the actual and anticipated costs instead of a fee for service. As Commissioner Johnson said, CCBHC is our component of a robust behavioral health care system. We heard about 988, addressing someone to call someone to respond, and a safe place to go in crisis. As a provider of comprehensive community based services, a CCBHC can meet the needs of individuals before a crisis occurs by preventing crime SS, the same CCBHC can also serve as a home for behavioral health care for individuals. Assist CCBHC serve individuals and families regardless of their ability to pay. But what exactly do I mean when I say serve? Next slide, please. CCB CCBHC is required to provide nine categories of services in a person centered and trauma informed manner. These services are crisis, crisis intervention services, person centered treatment planning, screening, assessment, diagnosis and risk assessment, outpatient mental health and substance use services, case management, outpatient primary care and screening, care screening and monitoring community based care for veterans peer family support and counseling and psychiatric rehabilitation services. The CCBHC model is aligned with what Georgia community service boards currently provide with an increased emphasis on care coordination. That means that a CCBHC can meet a wide spectrum of needs, both directly and through connection, communication and coordination with partners inside and outside of their agency. Care coordination prevents needs from going unmet due to gaps in a system. A good example of care coordination is primary health care. We know physical health and mental health are very much connected. One of the service category categories that you see provided by a CCBHC is primary care screening and monitoring. CCBHC can identify physical health needs or changes in physical health needs, connect an individual with appropriate physical health care, follow up and assist with any barriers to accessing that care. Next slide, please. In 2017, there were eight states that had at least one CCBHC in them. As you can see, the model has expanded to include almost every state and territory. This has been achieved largely through grants provided by the Substance Abuse and Mental Health Services Administration SAMHSA, directly to providers. Those funds allow for investment in the infrastructure that's required to become a CCBHC. To develop into a CCBHC. An agency must have one staff and resources to provide those nine required service categories to the ability to collect quality data for accountability, and three, the ability to identify and understand costs that are specific to their CCBHC work in order to develop the new sustainable funding the prospective payment rate. Next slide. All of this is accomplished through a path to certification. Phase one is the beginning. Any provider and Phase One has dedicated funds and resources to establishing a work plan toward implementation and certification. These providers have assessed the needs in their community and are preparing to meet those needs. Once they have moved on to phase two implementing these providers have attested to their ability to implement. That includes a review and adjustment of policies, procedures, staffing, their board governance, accreditations and data and reporting abilities. At this phase, the provider has begun increasing access to services already, and they are preparing themselves to apply for certification with DBH TD. Phase three was certification is a completion of a rigorous process. Remember that while a CCBHC candidate might receive startup funding from grants from the federal government or elsewhere, it is up to the state's behavioral health authority to identify and certify the clinics and implement that unique funding system. This phase of certification ensures stakeholders that a provider is capable, competent and accountable to meet the needs of the individuals they serve. Certification involves a review in depth of staffing, availability and accessibility of services, care coordination practices, scope of services, quality and other reporting your organizational authority and their governance and accreditations this stage also includes a review of costs, anticipated costs, and the expected number of individuals to be served in the new model in order to implement that unique and sustainable funding the prospective payment system.

29:44

Next slide please.

Sarepta Archila 29:48

This is where we are currently in the landscape of CCBHC is in Georgia. We have 11 CCBHC candidates. No locations have been certified at this time. Georgia has seven providers In phase one, you can see them they're represented in gold. Five of these received planning and implementation grants pathways viewpoint help to cap CSP, CSP of Middle Georgia, and Chris 182. Additional candidates are in the process of contracting with Department of Behavioral Health and Developmental Disabilities utilizing state appropriated funds. At the same time, we have four providers who have progressed into phase two identified in dark blue. These providers have tested their readiness while continuing to build their infrastructure and provide the services expected. Two of these providers received CCBHC expansion grants from SAMSA. The first was Pineland, followed by advantage. Two are contracted with DBH CD using COVID, supplemental Block Grant funds. These are riveredge and New Horizons, all of our CCBHC is in GA will be held to the same expectations, utilizing the certification criteria that's being developed. We anticipate the next phase phase three certification to begin in 2023. Thank you so much for your time today and your attention, your interest in the topic, and your dedication to the individuals that are being served. To stay connected to this work, please visit CCBHC ga.org. You can sign up for our newsletter, and stay up to date on our progress through that site. Thank you again, and have a great

Monica Johnson 31:30

day. Thank you, Sarepta. So at this point in time, I'd like to introduce Wendy White Tiegreen. She is going to walk us through a q&a segment of this event. So please use the q&a function prayerfully that versus the chat, so that we can manage the questions coming in. Wendy.

Wendy White Tiegreen 31:55

Thank you, Commissioner Johnson. And we are so delighted to be here with you today. I'm Wendy White Tiger and I'm the Director of the Office of Medicaid coordination for the Department of Behavioral Health and Developmental Disabilities. And so we're going to begin with some questions. We have about 15 minutes for our question and answer time. And I'm going to kick us off with a couple of items to reinforce, that you've been probably hearing and seeing off and on. But let me just underscore the slides, as well as the recording of the presentation today will be available on the 988 ga.org website that you saw several times throughout the presentation. And just recall, please, that we are going to use that website for a tremendous amount of communication resources, social media, items that you can use locally with folks and to, to field questions and publish those so that they have some access for individuals who may not join us and events like this today. So those two things, you know, being out there, the the second thing that we want to just say, as a reminder is that there is a great group of participants and stakeholders who help us on a variety of committees on this work. And so I do want to just take a moment to say thank you for our coalition members or other subcommittee members who are on the phone with us today. And to just say, appreciation for not just being here, but also for all the work you do with us on a regular basis helping us shape the body of work for our Georgia citizens. Okay, so we've had a couple of questions, and I'm going to begin consolidating here and creating response for and we've had a couple of folks ask us about Spanish speaking data, or the press to function that happens when you call 988 and require to speak to somebody engage with somebody who is a Spanish speaking respondent. And so what we can say is at this point, we don't have full access to all of that data. We are of course in collaborative partnership with vibrant who was mentioned earlier today. And they have specific call center partners who are fielding some response to that content. So while the Georgia crisis and access line has had a history of of fielding some of those calls with the 988, national rollout. Many of those calls are going to the vibrant call center. And so we will also represent in our national coalition's and conversations that that is a piece of information that that you all want to know more about. And we certainly want to know more about it, as well. And so we will look forward to being able to unpack that data and information in our partnership with vibrant and to bring it back to all of you who have such a great interest in that in the near future. So a second question that we have been asked here in the q&a is about the mobile crisis response service. And whether or not transportation is a part of what the mobile crisis response teams can provide, when they are dispatched and engaged with somebody in the community. And so my colleague, Don is going to feel that question for us.

Dawn Peel 36:14

Thank you, Brandy, and thank you for bringing the question forward. So as it pertains to transportation, our mobile crisis teams are contractually obligated to have an identified mechanism to support transportation of people on tender teen orders. We also work really hard with our providers on the expectation that people should be transported in any safe and appropriate manner. So the way the rules work below works is that a person on a 1013 order does not have to be transferred, transported by law enforcement, a family member of friends, transport, if they have a mechanism to pay for they can go by non emergency medical support. So we really stress all of these other areas, noting that law enforcement transport is a last resort, we recognize that law enforcement has limited bandwidth that limited staffing, and transporting individuals can in fact, put an unnecessary impact on those staff, when there's other ways to get people to a safe place. The other thing that is important to mention, not just from the deputy perspective, but from the individual perspective, it's far better to to go to treatment in a comfortable setting, whether it's a family member that transports you, or a non emergency medical transport than going in a police car. So I hope that answers your question. If not, please feel free to chime back in in the q&a.

Wendy White Tiegreen 37:48

Excellent. So we also have series of questions that are related to CCBHC s. And I will try to handle a couple of those and then also share the screen time with syrup. We have one about our CCB is equal to emergency receiving facilities. And and the answer to that is is no, not by definition. But many of our CCBHC candidates, the the emerging CCBHC is in Georgia, our community service boards who operate what we call in this gets confusing. I'm a behavioral health crisis center, a B H CC. And we understand that it is an acronym in Georgia that we have used for some years bhcc to refer to our crisis service centers and crisis stabilization units. And then nationally, there's an acronym CCBHC, which is the the certified community behavioral health clinic. And those are really two different models. But in Georgia, many of our CCBHC candidates actually do administer under contract with our organization, emergency receiving facilities known as the crisis stabilization units. So that is a lot of acronyms I recognize and just want to be sure that we try to start to provide that clarity here. So to the to Brent, the question or hope that begins to address that particular question. We also have a question about CCBHC zone What is the reason For states with no CC, BH C's. And so I will go ahead and just speak to that as well. Congress just began to define the CCBHC C's in federal law and in the teens. And so many states are just slowly emerging with entities who are willing to flock to BCC BH C's and receive federal grants to become designated as CCBHC s. And the states also simultaneously have to build some infrastructure and capacity to certify CCBHC. So really, I think what we see on the map is just a handful of states who are kind of lagging in their developmental stages. But the sense is from Congress and from state authorities, as well as the federal authorities is ultimately this is a model that is going to be adopted across the country, and fully to kind of create the behavioral health safety net for the future. Okay, and then do the CCB HDS have to accept Medicaid and Medicare, the certification standards for CCBHC is indicate that they are to be kind of like all payer models. And so certainly Medicaid is a mandatory aspect of this. Medicare is a required aspect of this, and then as many private insurance panels as possible, who will work with the CCBHC are expected. And so, again, we look forward to moving ahead with that, that modeling, and really creating a few of these CCBHC. Yes, who are quite comprehensive and their payer mix. Um, so, um, I think on a sustainable funding item, Commissioner Johnson, is that something that you would like to kind of step in and speak to for a moment? Sure, that's

Monica Johnson 42:30

fine. So I've pretty much said a little bit about this earlier. So we're in a phase where we're having ongoing conversations with the governor's office legislators, federal partners, to just continue to monitor the data and see what those needs are. So there's a slide earlier that kind of spoke to it a little bit, where you can see where current investments have been made, and that we're looking at, you know, the information that we have to try to make determinations about what additional funding will be needed. That's pretty much all I'll say about that.

Wendy White Tiegreen 43:07

Okay, thanks. Thank you. Thank you. So there is a question about the vendors who DVH TD works with that offer mobile crisis in Georgia. So we have two contracted vendors with whom we work. And those vendors are behavioral health, Flink, and benchmark. And both of those companies, when you think about their scope of work, and contract in total, cover all 159 counties. Each of them has specific regional areas that they they cover so that we have one vendor for designated geographic area. So we are grateful to work with both of those companies in this very important work. There's a question about the map of CCBHC as the emerging CCB disease, and will there be future funding opportunities? And the answer to that is yes, Congress has continued to identify funds. And there is expected in calendar year 2023 additional federal funds to be made available for local companies all over the countries make application for that. So that is still a pathway that is available. And we also look forward to continuing to work with our local leadership to figure out the ways that DHCD can also stay on to promote the development of additional CCBHC. S.

Dawn Peel 45:05

Um,

Wendy White Tiegreen 45:10

there's a question so wrapped up about when it is expected that we will begin the certification of candidates for cease to become cch sees. She'd like to feel that

Sarepta Archila 45:27

we are expecting to, again, through certification processes with the initial phase two candidates, those four candidates this summer, spring, summer 2023. That's what we're driving towards.

45:43

And there are a couple

Wendy White Tiegreen 45:44

of questions that are related to some data follow ups. And so what we will commit to do is to document those. So a one about some very specific response time. And then there's also a for a unique type of call, and then how, how many particular types of folks are on this call. So we're going to have to get back in and see what we can identify or call out from any of our attendee data on that item. But certainly, there's one other question just about how to file complaints if they say that the VA CCBHC doesn't accept Medicare. Right now, there are no certified CCBHC is in Georgia, they are all in their developmental stages. So there's not really a process right now for that accountability line. So I think it's Stay tuned and continue to watch the development of the CCBHC. Yes. And as Sarepta indicated, we expect certification processes to begin occurring in calendar year 2023. So we have almost, I think, hit our time for did set aside for questions and answers. We continue to document and the questions that are coming in, not just in sessions like this, but questions are actually coming in via the websites. And again, I really just want to reinforce and you can see these addresses here yet again. And so I just want to be sure you recall that you can answer that. But we will get you answers posted to questions that come in via this website. And we encourage you to look at the existing q&a that are already on those sites. And so that I am going to kick it to Commissioner Johnson one more time to wrap this up for the

Monica Johnson 48:07

day. Thank you, Wendy. Thank you for fielding those questions. And thank you team for providing us. I hope that you have found today to be helpful and informative. We are committed to be in as transparent as possible through this process as we continue to grow and learn with the implementation of 988 as well as CCBHC. Yes, thank you for your time meeting is adjourned.

Webinar_Slides_988_Update and CCBHC Intro Dec 15 2022_V2.pdf