DBHDD Webinar: 9-8-8 Georgia Rollout Readiness

Recorded July 15, 2022 at 10am ET

Slides are downloadable at the bottom of the page.

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Rough computer-generated transcription:

Commissioner Judy Fitzgerald  02:43

Good morning. And thank you for joining us today. Tomorrow, Saturday, July 16, signals the beginning of the rollout of the 988 National dialling code for suicide prevention and crisis. Tomorrow's activation of the 988 dialing code is the beginning of a long road in transforming Georgia's crisis system, and in making it easier for those experiencing behavioral health crisis to know who to call in an emergency. My name is Judy Fitzgerald, and I have the privilege of serving as the Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities. Joining me today are four members of our in house 988 planning team, and our Director of Behavioral Health, Monica Johnson. In the next half hour, our planning team will provide you with an update on Georgia's progress in planning for the rollout, and review challenges and opportunities ahead. As Georgia begins the long road toward one of the largest federally mandated Crisis Response transformation in decades. These highly qualified and Prudential individuals are working on all aspects of 988 transformation planning from the call center all the way to the local crisis receiving centers. We're also joined by a special guest today, one of our federal partners in this initiative from the United States Department of Health and Human Services. Over the last 20 months, the US Department of Health and Human Services has been providing guidance and benchmarks for all states as they prepare for the 988 rollout. I'm happy to introduce this morning and trellis Tyson who is the regional director for HHS Region four. Prior to joining HHS in March of this year, Regional Director Tyson served as the Director of Business Services and policy for the city of Atlanta's Workforce Development Agency. In this role Regional Director Tyson reestablished the city's federally funded on the job training program by creating, implementing and overseeing every aspect of the employer engagement cycle. Additionally, he served as the agency's top legal adviser to ensure compliance with local, state and federal laws and regulations. As Regional Director for HHS, Director Tyson serves as the primary representative for the Secretary of Health and Human Services, and oversees eight southwest southeastern states, including Georgia, and the region's six federally recognized tribes. We're glad to have him join us today to share a few words about this state and federal partnership that is sure to transform America's crisis system as we know it. Welcome director Tyson.


Director Antrell Tyson, HHS  05:58

Thank you, Commissioner Fisher, for that introduction. And thank you to everyone who joined us this morning in such a timely and important briefing. And then trail ties, and I served as a regional director for region four of the United States Department of Health and Human Services. I would like to give a special thanks again to Commissioner Fitzgerald and the entire team at the Georgia Department of Behavioral Health and Developmental developmental disabilities. For leaders Georgia's transition from the 10 digit digit, Georgia crisis access line to the new 90 Day national suicide crisis lifeline. And I cannot forget my colleagues here in region four, and in our national office of the Substance Abuse and Mental Health Service Administration, and CMS, who have worked diligently with each state in our region, providing guidance during this transition. In 2018, the United States had one death by suicide about every 11 minutes. And for people 10 to 34 years of age, suicide was the second leading cause of death nationally. In response to these startling statistics, in 2020, Congress designated the new non innate dialing code to make it easier for Americans to access the care that they need when they're in the time of crisis. Not any is more than just an easy number to remember. It is a direct, confidential, 24/7 connection to compassionate, accessible care, and support for all who might be experiencing suicidal thoughts, or at risk of suicide, or struggling with emotional distress. So, Tomorrow marks an unprecedented first step to strengthen and transform crisis care in our country. It will create a universal entry point so that no matter who you are, or where you live, you can reach a trained crisis counselor who can help you in that moment. Again, on behalf of the United States Department of Health and Human Services, I would like to thank the Georgia Department of Behavioral Health and Developmental Disabilities, for all the hard work and coordination for making Georgia one of the leading states and ensuring that Georgians have the access and care that they need when they need it.


Commissioner Judy Fitzgerald  08:31

Is we are changing the conversation and reducing stigma about people who are experiencing mental health crises. That's what 988 is, is enabling but we are just getting started.


Commissioner Judy Fitzgerald  08:57

So first and foremost, 988 is a lifeline for individuals in need of support, in need of someone to talk to. Or you might be calling for someone else who is in crisis and you don't know what to do. 988 is going to be that easy to remember, three digit number for people to dial



988 is going to likely be one of the greatest transformations that the public sector behavioral health system is going to experience.


Rachel Holloman  09:33

It is three numbers. It is easy to remember. And it is something that is going to change the landscape of crisis work of mental health and substance abuse work and suicide prevention not only in the state of Georgia, but nationwide. 988 for the rural communities is a really big deal. It is going to bring more services to our rural communities. It's going to be an easier number for them to remember


Dawn Peel  09:56

my role and my office is relatively HDD you is to ensure that that the main parts of the system that there is someone to talk to that there's someone to respond, and there's somewhere a safe place to go for help.


Commissioner Judy Fitzgerald  10:17

I can't say enough about how important the workforce and the capacity is, technology will help. But in the end, this is human business. It's people calling and needing the ear and the compassion and the professional response from another person. So we've done so many different things to try and build the workforce



during the last two years, we had a 24% increase in call volume. And so we have had staffing challenges like the rest of the state has had staffing challenges, in terms of this is a very demanding job.


Commissioner Judy Fitzgerald  10:55

We've done a few short term investments. But I really want to point to the long term investments about the pipeline of the future. One of the ways that we're doing that is through what's called service cancelable loans. So we have to make it easier for people to go to school, and practice and be licensed, and then forgive loans where we can and entice people to stay in this work. I think it's important to acknowledge here in Georgia, we've really had a remarkable experience over the last year, Governor camp speaker Ralston and other elected officials at the highest levels of this state have said, by virtue of legislation that has been passed funds that have been committed committed mental health as a priority in Georgia, we don't expect that system transformation will occur overnight, what we do expect is that we and our partners are doing everything possible to make that call as easy as possible and to make the response as direct as possible to meet individuals needs and know that we are committed to the building work ahead. And in partnership with all of the other entities that are going to be a part of our success. We are committed to getting this right, but just know we've got a long journey ahead together.


Dawn Peel  12:29

In five years, my goal is that the general public will be aware that nine it is out there. And that help is just three digits away. In five



years, I hope to see that 988 is as ubiquitous as 911 or 211. That is a GA and it's just a service that's available to you 24 hours a day, seven days a week, and you can always reach someone who can support you should you be having a behavioral health crisis, and that our system is able to support people as they call


Monica Johnson  12:55

five years from now. One, I would hope that it did have an impact on stigma, that that number is something that is not looked at in a shameful way. That is something that people can be proud of that people can access and share amongst their family and their friends,



I hope to see not a date as a household name. I hope that there is trust and not a date for my Georgia citizens. I hope that we are closer to that future without suicide in Georgia



wellness for mental health, wellness for addiction is achievable. Recovery is achievable. And so with 988 This is just one more step in terms of saying we are creating pathways for hope we are creating pathways for wellness, you can get care in your most critical moments.


Commissioner Judy Fitzgerald  14:10

Well, I want to thank first director Tyson for taking the time to be with us. And really just underscoring how important this federal state partnership has been and will be as we build the crisis system of the future. So thank you, Director Tyson. So you saw our overview video to really communicate to the public about what's happening here. And what we know is this is tomorrow, Saturday, July 16, is just step one. And while a transformation of this magnitude can be intimidating. It's also a really important opportunity to change lives. I'm really proud that our team has done a remarkable job to be ready. I want to acknowledge the hard work and DB HDD and really also express our gratitude to too many individuals and agencies and partners across the state who have joined working groups, and already provided essential input into the planning. Now, to be clear, no state is 100% ready for this movement, because we've never had 988. And because Georgia has been developing its crisis system for the last 15 years, we're confident we have a good blueprint to build our system out to serve our residents. As demand for services rises, we know we're going to need to continue to learn and build. And that's the commitment that we're making today, to be as ready as we can be for the expected and the unexpected. This will this means we will need to learn from those things we got right. And also, of course, expand and improve where we see shortcomings. Our most important commitment is this, that above all, we will keep Georgians in need of crisis response at the center of all of our efforts. We know that each of you will be important partners, as we travel this long road to a new, better and more capable crisis service system. I'm really pleased now to introduce you to the person leading our behavioral health work at DBH DD Monica Johnson, the Director of the Division of Behavioral Health.


Monica Johnson  16:32

Good morning, thank you, Commissioner Fitzgerald, Thank you, Director Tyson, for your opening remarks and for your leadership. My name is Monica Johnson, as was referenced, I'm the Division Director for behavioral health here at gbhdb. I have been with the department for almost 12 years. By trade, I am a licensed clinician, a licensed professional counselor. And that is the core of kind of how I approach everything that I do. I'm excited to talk to you today about the planning work that has been underway for quite some time on this fabulous 988 Eve day. So if we can go ahead to the next slide.


Monica Johnson  17:20

So let me just kind of do take a few minutes to orient everyone to know exactly what this means. You heard the video, and you got to hear some opening remarks. But there are some fundamentals that I want to make sure you take away by the end of this presentation today. There are three fundamental components that the nanay law will require Georgia to do. One of the things about Georgia system is that we're not starting from ground zero. Georgia already has had for many, many years a statewide crisis and access line. So we've had the infrastructure for a call center for individuals to call when they need help for or support for a behavioral health crisis. And so we've been able to build upon that existing infrastructure and that existing capacity, and will continue to do so over the next several years to come. So key component number one is that there must be someone to talk to. We have here in Georgia availability for that to happen now through our Georgia crisis and access line for calls for text and for chat. We also have peer run warm lines that already offer callers emotional support, that are staffed by individuals who are in recovery in recovery themselves. We often refer to these individuals as our certified peer specialist. As one example, individuals that have shared experiences are very powerful in Georgia has led the way in our peer work across the nation, we'll continue to invest in services such as that, so that the first thing that needs to happen, someone to talk to when the person picks up a phone, and dials nine a day that there will be someone on the other end of that line that can appropriately support the individual and their needs in their moment of crisis. The second component that is required is someone to then respond. So based on the outcome of what happens when the individual is in crisis, contacts our crisis line dials nine a day gets the individual rather's appear rather as a clinician when they get the person and if it is deemed that something additional needs to happen, we must be ready to dispatch that type of response. Georgia already has mobile prices that covers statewide so it covers every single county in the state of Georgia. And we'll continue to enhance that over time. But right now that infrastructure is in place and that's important to know. So someone to respond could look like the dispatching of a mobile prices seem, it could look like coordination with 911 or EMS as appropriate, or another type of outpatient community provider response. And then the third component is a safe place for help. So if the individual needs more support more treatment, after the response has happened, then there are an assortment of options that individuals may have access to. In Georgia we have built over time now, infrastructure within our community with crisis stabilization units. We have enhanced those units to include not only beds, but also to include the ability for 24/7 walk in for urgent assessment needs for an individual experience in a crisis. It also has the opponent the the component of a 23 hour observation bed. And together we call that our behavioral health crisis centers. We also have pure wellness respite programs in our state detox and substance use disorder treatment, which is important to note that that is a part of this work as well, inpatient beds as well as outpatient services and other type of crisis intervention. Next slide, please. So SAMSA has put forward a five year vision for nanay day, and we add in GA and at tbh gd r adopting the same vision. So there are three gold areas framed here as horizon one, Horizon two in horizon three. So the first goal area is where I started on the previous slide, which is someone to talk to, we're going to be laser focused on making sure that we have the capacity that there is someone on that phone on the other line of that phone, to be able to have the someone to talk to mission be achieved. So the goal here is that by 2023 90%, or more of all 90 Day contacts will be answered in the state. The second goal area horizon two is related to mobile crisis services to someone to respond as I broke down previously, the goal here is that by 2025 80%, or more individuals would have access to rapid crisis response. In this response, it is important to note for us, we target that to be about 59 minutes, you may see some variation depending on if it's rural or urban areas. But that's an important important thing to note there. And then the third horizon area is stabilization services in this is what I described earlier. And here it is noted as a safe place for health, we often talk about it as a safe place for stabilization to take take place. So 80% or more of individuals would have access to community based crisis care by 20/27. So these are goals that we are going to align with and work very hard to achieve in the state of Georgia. Next slide, please.


Monica Johnson  23:11

So SAMSA also put forward a five year vision for the non aid aid work. These principles are outlined here. I won't read each of them verbatim, but they're here for you. I'll touch on each one, as we plan to use these as the principles that will continue to guide the work that we still have to do. And that's going to take many many years to do so as well. But providing individuals experiencing mental health, suicidal substance use crises, and their loved ones with caring, accessible, high quality support. This is fundamental to everything that we're doing. Ensuring integrated services are available or Christ the prices continuum, building on and making sure we have strong partnerships, providing health first responses to behavioral health crises, and making sure that connections are made to the appropriate levels of care based on what the individual is experiencing, making sure that we are integrating lived experiences across all types of populations, including veterans, LGBTQ populations, individuals that are in rural areas or at risk of high suicide to name a few. And then that we pay close attention to making sure that we are advancing equitable access to crisis services for underserved communities with a focus on tribes and territories. So we will continue to have this as our principles as our team continues to work together, not just amongst ourselves, but with our vast amount of stakeholders and partners across the state and at a federal level. As we begin the hard work ahead to make sure that this vision can come into to fruition. Next slide, please. At this time, I want to introduce you to Don peel our director for the Office of crisis coordination. Don will talk about what we have been doing in terms of planning up until this point. So I'll turn it over to you, Don. Thank you.


Dawn Peel  25:18

Thank you, Monica, and thanks to our earlier speakers as well. As Monica said, my name is Dawn Peel, and I'm the director for the Office of crisis coordination, for GVHD. I'm a licensed professional counselor, and a certified professional counselor supervisor. I've worked in the field of behavioral health for over 25 years, and joined DVH IDI in 2011. My current role involves oversight of the state of crisis system, and the rollout of 988 in Georgia. And previously, I lead the department's DEA of our health work in East Central Georgia, with five CSPs and local providers to enhance access to outpatient and crisis services. So as Monica said, we're going to shift gears now, and give you some information about our response to the 90 day rule out here in Georgia. And as the behavioral health authority in the state, we were the lead agency for the implementation. So we had a number of internal workgroups, a number of internal team members working on this project. But we also recognize the need and the benefit of including external partners as well. So as you can see, the external partners were quite varied, in terms of the different groups that were represented. We had everyone from 911, and law enforcement partners, to health care, behavioral health care providers, advocacy groups, and many others. And we do appreciate the hard work that they did to inform our direction and make sure that we were working in the right way. This group worked very hard to identify some key themes that we need to consider for future planning. Those themes include workforce shortages, training needs, increasing the addressing the increase in demand for services, as well as the need for increased standardization of policies, processes, and protocols, and better collaboration with across different entities. To that end, we've collaborated quite a bit with 911 partners, to better prepare that system for the 98 rollout. We've done a lot of work with both in small groups, as well as the statewide policy academy that allowed us to establish some goals in certain areas to enhance access, and collaboration through our partnership. Next slide, please. Another area that we focused on was ongoing stakeholder engagement. So our coalition that I just referenced, will continue to meet periodically. But more recently, we've engaged a group of stakeholders that represent different constituent groups that are historically at highest risk of suicide. So as you can see here, from this slide, there's a number of different groups represented. When I think about high risk groups, I think about veterans groups, the LGBTQ plus population, as well as young people and folks from rural areas. And so this group has been very active, and has really worked hard to identify some lessons learned, share information and share their feedback, so that we can use that as we move forward. Some of the feedback that we've received from this group is to these sort of engaged faith leaders, because oftentimes, people reach out to their pastor or faith leader when they're having a mental health challenge or substance use challenge before they seek formal counseling, or treatment. And so we recognize the importance of educating our faith leaders about how to direct people for treatment, if, if needed. We also identified with this group, the need to identify and understand how different cultures in different communities Express idioms of distress. So how do they share when they're struggling so that we can use that language and connect with them. And then finally, they identified that we need to identify the resources available are confidential and safe for communities of color, particularly considering historical context. Next slide, please. So I'm going to shift now and talk about some projections. And I want to note that these projections were developed by vibrant emotional health, which is the vendor for the National Suicide Prevention Lifeline. And these projections were developed in 2021,


Dawn Peel  30:19

prior to the guidance coming out from the federal government, to limit some of the mass marketing of 98 until next year. So in FY 21, the Georgia crisis, Texas line received 275,000, calls, texts and texts. And based on the projections, we could receive as many as 564,608 calls, texts, and chat. Next slide please. The downstream effect of those calls is that it will impact our mobile crisis teams as well. And so in FY 21, our mobile crisis teams received over 20,000 calls, or they provided over 20,000 responses, excuse me. And the projections suggest that we could receive or have as many as 56,460 responses in the future. Next slide, please. And then the further downstream impact of all of those calls is the impact on our crisis stabilization units, and behavioral health crisis centers. And so in FY 21, we had over 32,000, admissions to crisis, community crisis beds. And the projection suggests that we could receive over 60,000 or 67,000, admissions, dignity crisis beds in the future. So at this point, I'm going to turn it over to Wendy Ty Green. Thank you.


Wendy White Tiegreen  32:02

Good morning, everyone. I'm Wendy White Tiegreen, and I am with DBH, TD, and I serve as the director of Medicaid coordination for the department. And by training, and in my heart, I am a social worker. And I have been with our department now for 27 years as an administrator and member of of management and am honored to have done so previously, I worked in public mental health, even before that with community mental health centers, and was part of the team that did the original design and procurement of the Georgia crisis access line. So I'm just glad to be with you today. Next slide, please. So we're going to talk to you a little bit about our financial picture as we move into the work we are sharing with you related to non aid aid and the related services that are so crucial to the crisis system. So you see represented here, the same areas that Monica and Dawn have both talked to you about the someone to call someone to respond in a safe place for help. And looking at that in terms of our substantial foundation that we are building upon. So everything at the bottom of the screen in green is a representation of of our current investment by our legislature by our governors and I say governors because it's been a historic build. And by our our department, as well as our partner department, the Medicaid agency who also participates. So we have a substantial amount of funding in this bold green. Additionally, we've had one time funding begin to come to Georgia related to non aid aid from Congress. And they're some of that is included in if it's more permanent in the green, the dark green, but a lot of it is one time funding. And so you see that represented in the first two columns. And then what you see in the lavender is some miles to go that we still have to continue considering as we build towards a more complete and more comprehensive way and approach to providing a crisis infrastructure for individuals who are experiencing this need. So we still are planning for a projected need of about $10 million for someone to call. Closer to 54 million in this someone to respond call Mmm, and about 250 million in terms of a safe place for health. And then to the right what you see as a as a summary and summation barometer for that where we are representing where we are now, which is this 43% investment of our of our total goal. So 213 plus million. But really we're working towards, as you've heard all of us mentioned, we are we're building towards a $497 million projected need for the crisis infrastructure, given the numbers that Don was just sharing with you. Next slide, please.



But we are on our way, right. We are so excited that that investment, just looking at the past 20 months, since we have had the passage of the 988 law federally, we've looked at about a $20.5 million infusion into this capacity, and infrastructure. So we are we've already been expanding the call center staffing, we've been expanding the use of the peer workforce as well in in terms of being prepared to be the someone to talk to on the someone to respond. And this is really important. We've been trying to build our technology and our foundation and our efficiencies so that we can be the most effective system possible. So we've invested here at the front on improving our GPS functionality for our mobile crisis teams. We've expanded our flexibilities for the use of telehealth as we've learned that science over the past year, two years related to the public health emergency. So really trying to expand that use where it's appropriate. And we've expanded in mobile crisis seeing mobile crisis response team stampings. And finally, for a safe place for help. We enhanced our breadboard function. And if you don't know what a breadboard is, it really is an electronic system, which helps us know where there's capacity for crisis beds and crisis stabilization supports geographically so that we are able to be sure that a person in need can get to the right space in place for the needed treatment and supports. And then we are already investing in the future of expansion of bed capacity. So we had a great infusion by our legislature and investment by our legislature this year, in terms of expanding some of our capacity, and doing so with entities that we know can quickly adapt and modify to provide us more supports for individuals immediately so that we're able to move quickly to provide services as we're rolling out this awesome initiative. So with that, I am going to turn the camera and the mic over to my colleague Anna.


Anna Bourque  38:27

i Thank you Wendy. I'm Anna Bourque. I'm the Director of the Office of provider relations and ASL coordination. I am the non social worker, I have a master's in conflict management and I am a Lean Six Sigma Black Belt. I have been in the mental health field for over 27 years and with DBH DD for the last nine. Next slide, please. So currently when you dial the national suicide prevention line and tomorrow when you dial 988, those calls will continue to be routed through the Georgia and crisis access line as they have been for the last five years. Georgia crisis access line is Georgia's national suicide prevention line provider. But what happens when you call so when a crisis line is connected, and you need services beyond talking to the crisis counselor 42% of those people who we spoke with would need to have some sort of short term observation or inpatient service. That's harkening back to the crisis stabilization units in those places that both Wendy and Dawn referenced. 31% of the people would just would need to have a connection to some sort of an outpatient appointment or resource they need additional services beyond the conversation and the referral is made through either a handoff or a warm handoff as is appropriate. And then 27% of the people would require mobile response or an active rescue and we call active rescue when when Georgia crisis access line has to reach out to a 911 operator to have a co response model with a mobile crisis team, I do want to acknowledge that these numbers look a little different than they have previously, some of our improvements have allowed us to take a different look at these numbers than we have in the past. And we've been refining all of our data collection here, so that we can make more data informed decisions. Next slide. So over the last three years, there's been a 24% increase of cost to the GA and crisis access line COVID, hit us, we'll see that it started hitting us around 2021. And we had a large increase in call volume. And from that increase in call volume, in the last three months, we've already started seeing an increase in call volume from the National Suicide Prevention line. And this is prior to the launch of nine ad. So you'll notice the first slide is literally just our growth year over year over the last three years where we've had an increase in call volume. And then the second slide really is related to we're already seeing some of the increase in the national suicide prevention line calls that we're anticipating coming with 988. Next slide, please. So how are we keeping up with the demand? And what is our plan? So we've done a lot of investing in the call center and staffing and in technology. The call center has done a lot of work in determining efficiencies, we are working really hard with them to be able to manage the additional call volume. And you'll see in the slide to the to my right, I hope it's to your right, there's a slide to the right, we struggled with the additional call volume and both our answer rate, which is our we call an average speed to answer that's the indicative of a healthy system, we can answer the call within 30 seconds and our abandonment rate. And over the last four months, we've been able to start driving that number down significantly, in order to shorten both this the speed answer and the abandonment rate so that when someone calls, they get the appropriate response. We expect the card the volume will continue to rise from 988 through this rollout over the next few years. And what we will continue to do and are committed to doing is continuing to monitor this data and ensuring that we're providing any supports that we have available to us. So I am going to turn it back over to Monica.


Monica Johnson  42:45

Thank you, Anna. Next slide. So I'm gonna go ahead and wrap us up, again to kind of just reorienting us to how we started this conversation. So looking ahead for the first six months of 90 day, we're going to be closely monitoring our call volume and response times as you heard Anna just speak to considering options for greater integration of the peer workforce and peer run warm lines, to infuse lived experience and recovery and crisis interventions. We'll be integrating text chat options from non Ad into the G cow platform and working with federal non aid partners on integrating text chat and technology. This will be our biggest area of focus because it's critical to everything else happen. We'll continue to build our mobile mobile crisis response team staffing. Again, mobile crisis is already it is fully in Georgia in all counties of the state. All 159 counties have access to mobile prices. We will be expanding that capacity over time, considering telehealth telehealth options where it is appropriate and clinically warranted collaborating with 911 and SAMSA to continue to refine cross agency processes in behavioral health emergencies. And again, finally overseeing work to expand crisis big capacity, looking in Augusta, Atlanta and Columbus areas. Next slide please. So I want to give you some points of reference of where you can continue to track information. I encourage you to bookmark our website, not eight ga.org We have an ongoing FAQ there we it is updated. as new information comes new questions come in. We update that site consistently and on a regular basis. There are one sheets there other information that you can use for your own reference and to share with others that you may be interfacing with. You can send questions at questions at 988 ga.org and I really encourage you to stay connected with us As we continue to roll this work forward, it's important to note if you are in a crisis right now, stop and pick up the phone. Right now, if you're having a medical emergency, a life threatening emergency or an emergency requiring requiring law enforcement, or EMS or the fire department, you call 911. If you or someone else's in distress, feel like they may be at risk of suicide, or is having a crisis related to mental health or substance abuse, you'll be dialing 988, George's can continue to call the 1-800-715-4225 number, and you're going to reach a trained clinician, or you can still use the Magic Hour app to be used if you want to access those services by text or chat. And I just want to end by underscoring the importance of the non-crisis part of the system. We spent this presentation obviously focused on non aid and the importance of the work happening to be prepared for this in Georgia. But it is important to remember that assistance cannot be built on prices alone, we still must continue to do everything we can for our prevention efforts, earlier intervention efforts, and what happens when the crisis is over. So building the whole system remains a top priority for us while we continue to do this very important initiative. With that, I'm going to wrap up this part of the presentation. And we're going to transition to our q&a. Wendy Tigran will facilitate that part of the session, Wendy?



Thanks, Monica. And thanks to all of you who've been so engaged and been putting questions out there for us to discuss many of them might have been answered as we move through the duration of our time together, but we're gonna just jump in on some of these items. So and I combined some of them and pulled some of them together. If you had similarities, that may not be your precise wording. But the first question, and we're just gonna go ahead and say a lot of people wanted to know about the materials, and the information that we've been discussing today. So again, I think you see boldly on your screen, the 988 ga.org website, and that is the space that we have built for our ongoing communication. So today's a day, right, and tomorrow's Tomorrow's a big day. But ongoing, we're going to have more information, more q&a that are posted, more product available there. So I really encourage you to bookmark that website and use it for future reference. But that is also way we will make materials available post this session. So you can be on the lookout for those. The second question that we have is about the relationships and the referral processes in the partnerships with our 911 partners, or P saps public safety kind of acts, answering points, access points. So with that, I will kind of take give you three headers on that. And then I will let my colleagues Don and Anna, step in if they would like. So we've been working kind of in three major areas with our 911 partners, we've been working on referral protocols. We've been working on a solid script for when we have scenarios where we need to be interfacing with one another so that that's an efficient and effective process. And we've been working on collaborative training together. So with that overview, I will let dawn or Anna chime in and provide any additional information that they would like to share.


Dawn Peel  49:05

Thank you, Andy. We've done a lot of work with our 911 and peace out partners. And some of the exciting work that we did, we were one of five states to be invited to work with SAMSA to collaborate with our 911 partners for enhanced assistance to rollout 911 and 90 day interactions. So that work is ongoing. The main focus is in that area, our standardization of processes, which when you kind of alluded to some of the work that was done with them prior to the Policy Academy, but we're also focusing on access for rural areas as well as resource coordination. Thank you, candidates you have anything to add. Okay, good deal.



Thank you, Don, I actually don't have anything to add, you've covered all the things that we've been working with except to say, again, thank you publicly, to our partners, both the sheriffs associations, both geca the precepts who've showed up to help us, as we have tried to figure out the best ways to partner and ensure that it's a smooth transition every time we have to make a transition between the two services.



Thank you both. So the next question I'm going to be moving quickly is the is will IDD crises still be fielded in this new 988? environment? And so really, I think the best way to answer that is the federal law really designated this as as a behavioral health point of access. And so we've we've been working in terms of federal funds in the light to be sure that we're really lifting that service up. However, in Georgia, we have had through the Georgia crisis and access line, developmental disabilities, crisis supports available through that system for for many years. And so we continue to make that investment with G cow as our partner. And so I will just reinforce that the supports that have been available continued to be available through our G Cal partner. So just be aware of that. The next question, Will services such as mobile crisis be available just in Atlanta or statewide? So statewide, we are very excited that that is we already had many of these services available, the mobile crisis team statewide, the 988 crisis access line has been statewide. And then we have many behavioral health crisis service centers and crisis stabilization units located in a variety of geographic hubs, again, with the hopes that we'll be expanding those in the future. The next question we want to get to is related to young people. There was a question about the my G Cal app that Monica hit right at the end, but we would like to reinforce this one. Um, so the my G Cal app will remain in place. For now. The the 988 system is is not quite prepared to take apps, chats, and text and be able to refer them back to Georgia resources. So for now, as you saw on that last slide, and, again, please hang on to that last slide, the my G Cal app will remain in place, and we encourage young people or anybody else who tends to lean into that technology to continue to use that in in the near term. So donor Anna, is there anything you would like to add to clarify that? Okay, hope that okay. One of the next questions are all are the call respondents trained or certified? So Anna, did you want to take that one quickly?



Yes, our call respondents are trained and certified. We have licensed clinical professionals. We have associate professional levels. We have certified peer specialists who have specialization training in answering crisis calls. So all of our staff are paid professionals with varying levels of credentialing.



Thank you, Anna. And then our next question is about the GPS capacity. There was questions about how we were using GPS with mobile crisis. Don, do you want to take that one? We can't hear you your look like you're off me, but we can't hear you.


Dawn Peel  54:37

Yep. I was double muted. I'm sorry. Thanks for letting me know. Our mobile crisis teams have geolocation type resources that they can use to ensure that the team that is dispatched is the team that is closest to the individual that is in need of a mobile crisis assessment. And so when when decal makes a referral for mobile crisis, the dispatchers use that that technology, and then dispatch the closest team. What we find is that this is this allows the teams to respond as quickly as they can, for those that are available in close to the individual that needs the assistance.



Excellent. And then we'll it we got one last question. The peer, there's some questions about kind of the peer competencies and training. So either dawn or Monica, did you want to feel that one?


Dawn Peel  55:46

Yeah, I can take that one. So in Georgia, we have certified peer specialist trainings that are provided through some of our some of our contracted agencies. And so they have specific training for mental health peers, peers that are specific to substance use. And then we also have training that is for youth peers, and parent peers. So we have several agencies that we work with, that are responsible for that training.



Thank you, Don. And just for everybody's awareness, again, we couldn't get to all the questions today. There's several of them that have, we've tried to get combined and get to as best we could. But we will certainly pick up all the q&a, and we will address them on the 98 ga.org website. And so once again, we encourage you to come back to that site and continue to track on that. And so, here are the last I will say again, my thanks, and I will kick it to Commissioner Fitzgerald.


Commissioner Judy Fitzgerald  56:57

Yeah. Thanks, Wendy. Thanks, team. And thank you, especially to our participants today, and the really robust questions that you've asked, right, as we're on the precipice of this big transformation. So thank you for your questions, you keep hearing repeatedly, we will continue to answer questions, that website is going to be a lifeline. For those of you who want to stay abreast of information, we're gonna keep answering questions there, we're gonna try and remain as transparent as we can about what's happening with the implementation and the transformation in these very early stages. And moving forward. We're so pleased to have so many community partners here on the line with us today, I think it speaks to the interest and the commitment of all of you. And we are grateful to have this opportunity to share information, which again, will be available through the website. And really to let you know, we know this is a partnership. And so you've received a lot of information today. But I hope one of the main messages you heard is that Georgia is at the beginning of a journey of preparation, our crisis build over the last 15 years has us well positioned to take this next step. But together, we're going to learn how 988 is going to work. And I want to make sure you remember one of the things that Monica Johnson brought forward, which is while we continue to build our crisis, services and response, we're going to pay equal attention to the services and supports that keep people out of crisis across the state. So we invite you to remain in partnership with us. And to continue to go to the website, and to inform the people and communities that you are connected to just a reminder, we are not doing broad scale marketing, we are prioritizing high risk populations. For the first four really for the next year, we'll be focused on high risk populations using nine a day as that crisis line. And here in Georgia, we're fortunate to know chi CAL will continue to operate as you have known it to operate. So encourage your friends, partners and community members to continue to use G Cal is needed and know that 988 is available particularly for those in a behavioral health crisis. Again, I want to end with my gratitude for your partnership and your interest today and know that Georgia is going to be in this great transformation together. So with that I say thank you and know that that website We'll be live for you thanks very much


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