Recommendation to direct City Manager to work with the Department of Health and Human Services and local mental health providers to explore the feasibility of establishing a more robust infrastructure for mental health services in collaboration and alignment with local mental health providers in Long Beach and the County of Los Angeles.
So, yes, we can do that. Try remember the year do we do that in 2010? 2010. All right. Thank you. Okay. We have next item that was asked to be moved up was item 45. And this is also by Tommy Richardson. I am 45 is a communication from Vice Mayor Richardson. Councilwoman Sunday has Councilwoman Allen recommendation to direct city manager to work with the Department of Health and Human Services and local mental health provider to explore the feasibility of establishing a more robust infrastructure for mental health services. Vice Mayor Richardson. Thank you, Mr. Mayor. Tonight, I want to introduce a proposal about localizing Long Beach's mental health services. It's an important issue impacting our community. Thanks to my co-sponsors, council members Mary's and De Has and Cindy Allen and thanks to our outstanding city staff, particularly in the Health Department and Kelly Kelly Collopy, Paul Duncan and our senior manager Teresa Chandler for their help in the background and helping to shape this proposal. Cities have dealt with a number of issues over the course of the past year. And as we normalize, we have to acknowledge that things have changed. We have a real opportunity to build back and prepare to face new challenges. I want to lead with this quote from our U.S. attorney general. As things start to get normal. The full brunt of the trauma people, people have been through starts to surface in their lives and they have to deal with that. So that's why I think this is the right time for our country to have a conversation about mental health. So in addition to COVID 19 that we've all dealt with over the course of the past year, Long Beach has been dealing with another, less acknowledged epidemic for quite some time. A mental health epidemic is manifested in many ways elevated suicide rates and drug overdose rates. Our rate of E.R. visits due to mental health crisis was was a full 1%, one in 100 residents from 2017 to 2019. Our rate of visits due to mental health crisis. Excuse me? Our rates of hospitalizations due to self-harm and alcohol abuse are well over the L.A. County average. 2000 of our neighbors are homeless, the majority of whom suffer with mental health issues. The COVID 19 pandemic has only made the situation worse by placing our system under additional stress. The percentage of adults. Suffering from anxiety or depression has quadrupled during the pandemic. This still remains three times higher than normal. One in three of us suffers from anxiety or depression. Here in Long Beach. The impacts of this pandemic have also been very unequal. According to the CDC, the mental health impacts of the pandemic have fallen hardest on our youth, and particularly our youth of color. One in 500 children lost a parent during this pandemic, 65% of whom were youth of color. That's why our Racial Equity Reconciliation Initiative under goal for strategy one of advancing health equity calls on the city to increase investment in mental health and trauma services, including facilities, professionals, community responses and culturally tailored resources. As we acknowledge, communities of color face especially high rates of mental illness and psychological trauma. Moving toward a more locally tailored outreach and service provision can help reduce these inequities. So as Long Beach recovers from the trauma of COVID 19, we have a responsibility to deal with the effects of mental health and well being on our residents. It's time to reevaluate our capacity to evaluate, to address mental health, mental and behavioral health crises. And despite all of the challenges I just listed, there's hope. Many of the difficulties in Long Beach mental health care system stem from the lack of a venue for a local collaboration between L.A. County Department of Mental Health, who runs our mental health services. The city and local providers who influence over policymaking, whose influence over policymaking is limited in this area. This slippage makes program navigation more difficult, which falls especially hard on patients who already have a difficult time. Navigation system is. If you're a local resident, it's hard to know where to go for help. According to Long Beach's homeless management system, just 26%. One in four of people experiencing homelessness who have a disability receive disability benefits just one one out of four. These benefits could help them buy food, help them buy clothes, secure housing. But the system is difficult to navigate since it allows too many cracks to slip through. I take a local approach. Collaboratively working more closely with the county and possibly taking some of those services in our own hands. We can reduce redundancy and increase access to the services our residents so badly need in this moment. Now, this is not a pipe dream. Many cities in California and other cities around the country operate different ways than we do. The city, the cities of Berkeley, Claremont, Pomona, Pomona, Laverne all handle mental health services exclusively at the local level, receiving direct funding from the state of California. That option, they enacted that in the past. That option is not available to Long Beach today. But these cities built their mental health departments before California built theirs. But we can learn from their examples and see that this kind of local provision is not just possible. It's practical. Long Beach has also shown that we have the ability to take on a myriad of services independently under our own portfolio. We already have our own local health department, the largest independent health department in the state. In addition to our own continuum of care, our own dispatch center, a rich network of hospitals, local mental health service providers, standout educational institutions, our own prosecutor's office and our own police and fire departments. Our local infrastructure is strong and we can build upon that to tackle these new challenges. In preparation for this proposal, I brought together local providers, hospitals and our health department, together with Tri-Cities Mental Health, Mental Health, the municipal agency that covers Claremont, Pomona and Laverne for Mental Health Services for a roundtable discussion and brainstorm, try. Cities have had a great deal of success in addressing its dual crisis of COVID 19 homelessness. During 2020, there homeless population dropped by 37%. Tri-Cities was able to share a number of his innovative service models with our panel, including their packed themes and nonviolence response model similar to the REACH teams currently in development here in Long Beach . Thanks to all of our attendees that day. Thanks to the Health Department. Cal State. Long Beach. The LGBTQ Center in Long Beach. The Guidance Center. St Mary's Hospital, United Way, Los Angeles Memorial Care and Star Behavioral Group for participating. Since that meeting, we've also engaged with L.A. County Department of Mental Health Supervisor Janice Hahn. Long Beach. City College. Long Beach, Forward Century Villages, Cabrillo, the Black Health Equity Collaborative, MH L.A. and others. We've received letters support from a number of these groups and also from Juan Benitez, chair of the Long Beach Unified School District, our chair of our Equity and Human Relations Commission, Aliza Gutierrez, and Chair of Long Beach City College Board Woodward, Joe Winter. Thanks to all of you for your help and support on this important issue. So the opportunity before us is that this, you know, the stakeholder group highlighted many needs to fill opportunities that we have in the city, on our local on our local level. We can add additional residential mental health facilities by looking at partnerships with Major L.A. and our local planning department, including including hospital stepdown beds. We can add more opportunities for trained social workers and nurses in our own community through expanded internship programs, helping to address the crisis right here on front. We can add opportunities excuse me? We can localize our direct response and improve response times. We can streamline program navigation to make sure patients don't slip through the cracks. We can provide for more robust and localized strategies to address drug addiction in our community. We can improve coordination between existing programs to prevent redundant care and increase access. So I move that we accept this recommendation, ensure that the Health Department identifies the resources needed to engage with local stakeholders and stakeholders and begin this, this study and this process. Cities are already taking on today more than they've ever taken on. And and and the truth is, things have changed. There's no going back to the basics. The definition of what we consider a basic need has fundamentally changed. Local government has to evolve to meet that need, and that's what's required to have a modern, resilient city. In Long Beach is ready for that discussion. And I can't wait to see what we come up with. Thank you. Well, thank you. Bye. Actually, that coming into the next story, that being Comair. Thank you very much, Vice Mayor Richardson and Councilwoman Allen, for bringing forward this item and for letting me join you on this item. First off, I want to thank our Health and Human Services Department for the amazing work that they've been doing to help us and support our families during these devastating times. Our health department is key to helping us move towards a more equitable, healthier and safer city all together. So thank you for all that you do for our city. The topic of mental health has for so long been a taboo in many communities a topic you could not discuss, and therefore a topic and concern you would not address. I'm happy to see a new generation that prioritizes maintaining good health and that encourages addressing mental health issues. This item seeks to make it easier for our residents to access services and for our city to be able to respond. This is especially important to discuss now, since issues such as domestic violence and other mental health issues have been referred to as a pandemic within a pandemic. During COVID era, Long Beach song over a thousand more mental health related nine month long calls in 2020 than in previous years. That is why I fully support this move toward streamlining all of our local mental health resources to make it easy, easier for our residents to be able to be informed of all the resources that that can be accessible to them. What I love most about this item is that it strives to encompass as much as possible. It seeks to find a system in which every individual in need, whether at home, at school, in prison or in jail, can be easily connected with mental health services. And it tailors also to include and blend expansion of social work and nurse training and work opportunities for youth. So again, in it is our investment in our youth that will lead us on the right path. One additional thing I'd like to start to consider, and I'm pretty sure you guys are probably already considering this, but I want to make sure that we stream all these services and to make it in an equitable way so that we have all the residents have access to them in not only English, but Spanish combined and Tagalog. So thank you very much again, Vice Mayor Richardson, for this item. Thank you, Councilwoman Pryce. And I appreciate this item and the opportunity to talk about mental health and some of the issues and challenges that we're facing as a city. This is a conversation that we've been talking about for many years. And so some of the challenges that our health department faces as a result of the necessary coordination with L.A. County have really presented or manifested themselves in some serious quality of life type challenges that we see in the community. But, you know, I would love for us to get to a point where we have a model that similar to the Orange County model that the cities are able to take advantage of with facilities like the Bidwell campus where . Mental health. Immediate acute care is available, that that process has been very, I think, very beneficial for that community. When the report comes back, there are a couple of things that I would love to see included in the report in terms of what our capacity is now and what it could be with more streamlined and direct access to funding. And so I just want to kind of go through them. So in September of 2016, I brought an item to have us look at social impact bonds. And while the response that came back was that it wasn't feasible at the time to initiate, I'm wondering if there's been any movement in that with the creativity of the additional funding that's been infused into local governments. I'd love to see whether or not that's something that the city can perhaps take on independently in 2017. I brought an item that had a lot of possible options for us to consider in terms of some of the issues that we were seeing with substance abuse and mental health education. And specifically, one of the things that I had asked for on there was the feasibility of having our health department staff funds. 24 seven. I'm wondering if there's something that we can do in working with the county that perhaps allows us more direct access to funding to be able to have that staffing available for 24 seven in. In December of 2018, I brought an item asking for an audit of the rehab, medical detox and sobriety beds that we have available in the city and within the region. And I looked for it. But I'm not sure if ATF ever came back, but it may have been a report to counsel at some point that came back. But I would love to see, you know, while we're talking about taking more direct control over mental health services to know what what resources we have available to us, what what natural partners are already out there that would allow us to not be able to to have to do it on our own. And then in 2019, I brought an item that I requested the city do really well, actually was a partnership with CSC Welby to talk about some of our homeless outreach efforts. And they did a lot of analysis on some of the mental health services that we offer that the county offers. And I'm just wondering if some of those proposals specifically could be incorporated into the report that comes back, because I agree with council with Vice Mayor Richardson and Councilwoman, and they have said it would be fantastic for the city to be able to have the capacity to take some of these things on ourselves, because I think we would be a lot more efficient just simply because we'd have a more targeted and limited scope. And I think that would be beneficial for the city. So I appreciate this item and we've been doing we've been talking about this topic for a long time, and the Health Department's been great partners to us, and it would be wonderful for us to be able to have a little bit more control and streamline processes for implementation of these policies. Thank you. Thank you so much, Councilwoman Allen. Yes, thank you, Vice Mayor. I'm very proud to sponsor this and thank you for for bringing this forward. I also want to say thank you to all the residents who regularly share their advocacy for a stronger, more holistic mental health services ecosystem with me. It's also important that we strengthen the entire pipeline of service delivery, coordination and and job training. And I know we're working on making this system stronger. And this will be this would be a good, solid start. So I'd love to see us be able to take more control of our mental health services that we offer to our community and so desperately need it. So thank you so much for bringing this forward. Thank you. Councilwoman Zoro. Thank you. I appreciate you bringing this forward, Vice Mayor. I think it's just so important that we center mental health in this conversation, not just only in the midst of the pandemic pandemic, but just right after our acknowledgment of Veterans Day is making sure that we also dig in a little deeper to serve our community who've experienced trauma, whether it's as a veteran through war, also as refugees who experience war. And I think that it's sometimes treated as an afterthought after people have gone through either physical health care services to even social services. It's that it's a last minute thing that we don't think is important. And I think that we need to center this is a piece in that's connected to a variety of health care issue, to service social services. So I really think it's important that we also include more nonprofits because a lot of the burden falls on their shoulder, even to social service organizations, especially those who are serving in other languages, because there's very little agencies that have the linguistic also the cultural competency to understand the community and their needs and even how to ensure that we're reducing stigma so that people even feel comfortable even acknowledging that they need services. So this has been a constant reoccurring issue when we talk about mental health is how do we reduce the stigma around it in general? And I think that we need to obviously continue to make sure that it's centered and is in the forefront in that that we show that it's important and that we care about it. And I think that doing this feasibility study will allow us to engage in that conversation, especially after the pandemic and where so many of us are experiencing things but is invisible and we're not really talking about it. So that's kind of where I'm supportive of this for that reason, and love to be able to ensure that we have a robust conversation, engagement with all those who are service providers, to those even who have had experience in getting mental health services as well. Thank you. Thank you, Councilwoman Mongo. Thank you. I have a couple of questions. I would like the city manager to let me know or let us know what he thinks is being asked for tonight in terms of the feasibility studies that that we're bringing in a consultant. Is it that you're having current city staff bring together subject matter experts? I, I know that this conversation has happened in some prioritization ideas of supervising, and I'm supporting you as the city manager. But I think this also brings to light that over the last. Five or six years. Lots of different ideas continue to come forward to solve critical issues and to from flaws or feasibility of these other ideas that have come forward. I know come from on price listed a few and I've brought forward a few as well. They were just told to be not feasible. And so as times change, I'm not clear if we look back at those or how we recycle. And then another component of this is prioritization. Mental health is huge and it is an amazing opportunity. It is also a huge undertaking. Having worked in a county department that has taken on MHC funds in the past, it is a heavy lift, the RFP process, the federal drawdown and our city has done great in some cases of drawing down those federal and state funds. But we need to make sure that if we're going to do this, it needs to be something that has the staffing and the long term support and the financial support both from the feds or the states in terms of these grants have very, very little admin and they are very heavy on costs associated with the city taking them on. And we as a body maybe need to even kind of enroll our Fed Ledge committee and our state large committee on discussing that side of it, to advocate for what it really takes to take on some of these programs in the current society and environment. And then I want to close in stating that we often take on major projects that at the time seem manageable. And I would say that there's many cities throughout throughout our region when you purchase your home, the sidewalk in front of your house and the tree in front of your house, the one city property was your responsibility . And somewhere along the line, cities took on these responsibilities but did not have the long term capacity to make sure it was done and done well. And so I want to make sure that this is such a critical service. I really would love to hear from you how you plan to put your arms around the bigger side of it. I recognize that we've closed out a lot of other ideas along the way, and I think it's also time to really talk about how, within the scope of authority that we have in both our PD and our our firefighters and the new model that we're bringing through through racial equity and inclusion for responding to needs. How our mental health services. Transitioning and or being more approachable. So I look forward any comment you have at this time? Mr. MODICA Yes. So those are good questions. A couple of things. We will certainly be building on work that we've done in the past. A lot of this work is going on. Our team knows that mental health is one of the biggest issues that we face as we deal with populations experiencing homelessness. We have department heads coming together to talk about that, about what else we can get access to. I will say we're also looking at some other opportunities with the new community hospital coming on board. That's been a big thing the council have talked about, too, is are there additional services as they go through their transition that they can assist with? We've got additional facilities that have been brought into Long Beach. There's the with the acronym Bump on the Bucket The Buck. The Buck, the behavioral health center that is currently in Long Beach. And so we engage with some of those services already. In terms of doing this, we would certainly go back and look at anything that we've done in the past. So. Consumer prices, right. There's been several items that have explored aspects of this. So we will go look at that. So some of our staff can be pulling together those things. We will be of next step and basically putting together what it would cost to do this feasibility and where are we going to get the resources from. We think we may have some federal stimulus money as well that is coming that may be able to help. But then we believe we'd also need some consulting resources as well to really take this on. So next step is really to understand tonight that the council wants to proceed with this. And then we would put together that feasibility report of how we would address it and then get the funding and then move ahead. Thank you, Councilman Austin. And I think the city manager answered one of the questions that I actually had. I think this is a worthwhile endeavor for us to look at. Obviously, mental health is a crisis that affected our city, but the entire region. I love the fact that, you know, there's an example of of collaboration or model to to look at. I'll just tell you, I went to college in Laverne. I lived in Pomona. We in Claremont as well. This is a very different area than the north areas as well and with different needs, I think. But it's good to have a model. Um, um, and I think it's great to always look at ways to enhance our mission, the mission of our health department. Right. And build upon the work that they do and the great work that they do. I do. I think, you know, something that was said earlier that that jumped out at me. It was talk was mentioned that that, you know, people don't know where to go to get help. And I think we can start there. Our Hope Department should be a clearinghouse of information on mental health. Poor, poor, poor residents to look to opportunities. And I know we have a number of community based organizations and nonprofits that are providing those resources in our in our city as well. And I think they need to be included in that partnership and coordination that we're discussing here. Obviously, funding is an issue, and I want to learn more about where that access and those opportunities are. This sounds like a in a lot of our our goals here at the city council are aspirational. But, you know, if the funding is there, it can be achievable. And so I'm supporting the the item and I look forward to coming back with the feasibility and opportunities to actually act. Thank you, Councilwoman Mongo. Thank you. And just to provide a little bit of context, Councilmember Alston, you asked about funding the MHC funds in the county of Los Angeles in a ten year period, not very recently, but enough to be reasonable. During my tenure with the 15 years, the county went from 700 million a year to their budget went from 700 million to 1.9 billion. So, I mean, the amount of funding is remarkable. The challenge is that these agencies are never given. There's two levels of admin, right? You have the admin from the city side and then you out, you contract that service and then there's the admin within those agencies and the very, very strenuous restrictions. And so I know you're on the state led committee, and I'd ask that almost immediately we start advocating or at least discussing with the. The stakeholders, what does it really take and how do we change that at the state and federal level immediately? Because that's impacting our ability to get services from local providers who are currently contractors through L.A. County. And their ability. The number of people who want to apply to provide these services is also a struggle because they they can't run the agency at the level that are necessary. And then you add in the last two years of inflation, I can only imagine what the challenges are. So I'm not on state ledge, but I'm happy to partner with anyone. That is, I'm not on Fed ledge, but I'm happy to partner with anyone that is, and I'm happy to go to any of the roundtables. This is something that's been a passion of mine for almost a decade, and I really feel strongly that there's so many solutions, but the legislative restrictions on the funding has been challenging. So thank you for your insights. Thank you. And you know, I would just add at that point that, you know, what I envisioned was something similar to what we have in our continuum of care at a local table. We don't even have a local table to bring everybody together. And that table can help, you know, help identify where the gaps are and where the opportunities are. And in terms of funding, there is more funding at this point than there's ever been to address this issue. And, you know, we've been in recovery for so long. Our health department is just now getting back to normal operations. If there's any time to talk about any shifts in how we operate, I think is now. And so I just think it's an incredibly timely conversation. Councilman Austin. Again. Councilmember Mungo always brings up some of the challenges with with just governance and implementing pro programs. The the funding of the I've mentioned may be there. Oftentimes bureaucracy is in the way in terms of implementation. I'm always concerned about staff capacity to be able to study the feasibility of this and what gets put aside and prioritizing , you know, what's important to us. I think it's very, very important that this council really engage in terms of understanding where our priorities are in economics and mental health will probably be a high priority for this council, no doubt, and someone who works with our mental health providers on an everyday basis for several years. I can tell you that there is a shortage of mental health providers and so some of these plans are that are great in terms of theory, but in terms of execution, it may be very difficult to actually find the providers to actually provide this unless we almost really tweak the system. There are shortages of of life, of clinical social workers and psychologists all across the state at this point. And I think in a lot of ways that's going to be part of the crisis that we face, as well as in terms of just making sure that we have the the human resources and capacity to deliver the mental health services that we need. So, again, I'm supportive of this right on my back. Thank you, Mayor, for bringing the vision item before us. Thank you so much to the Council for their conversations. And I see this as in alignment with all the priorities that people have brought forward. I think everyone's contributed. We've talked about homelessness as a top priority. Everyone home identify chronic homelessness and mental health as a significant driver of homelessness. We talked about racial equity and it's in our plan as the number one strategy under advancing health equity. And so these are, in my opinion, they're in alignment. Is there any public comment on this item? Yes, we have three sign up for this item. Well, Desiree Ruth, Mario Ramirez and Rene Castro, please come to the podium. Thank you. Go ahead and state your name and. Yeah, sure. Good evening, Vice Mayor and Council. I am Deborah Ray Rue. I am a licensed clinical social worker and clinical supervisor with century villages of Curio Oasis Residential Services. As Vice Mayor Richardson did. State. Century villages of Cabrillo is in support of this agenda item. Imagine that CVC is a community partner. We provide low income, permanent supportive housing to individuals, families and veterans in Long Beach. Many of our families receive case management and mental health support and other life changing services. So we see firsthand the impact of mental health services and the impact that they have in addressing the behavioral health needs . They show up as hurdles for housing stability. Likewise, we know sex services increase positive physical and emotional outcomes. So we support this proposal because it will serve as a starting point for which to build strong mental health infrastructure in Long Beach. Please vote yes on this very important agenda item. Thank you very much. Thank you. Next speaker, please. Mario Ramirez. Good evening, council members. My name is Mario Ramirez and I am a current MSW graduate student at Cal State Long Beach, and I thought it was important to comment. Lynn My support voiced my support for this item agenda. I am currently doing an applied project and doing a community assessment and the community that my group is doing is assessing is here in Long Beach District one, the 908 13 zip code and through interviews with residents and stakeholders. One of their main concerns was barriers to access and lack of access for services, specifically mental health services. And some of the barriers could be language, fear of public charge or just not enough services out there. And so I think it's this agenda, this item is if it comes at a perfect time and hopefully everyone votes on it. And I think it's only fitting that that that a couple of days before Veterans Day, a group that, you know, faces mental health challenges, that the council votes on it. And also speaking of Cal State, Long Beach, they have an outstanding social work program, which I'm proud to be a part of. And they have future social workers who are eager to serve their community, specifically Long Beach, and where a lot of individuals can fall through the cracks. Those social workers can fill those gaps. Thank you. Thank you. Next speaker, please. Good evening. Members of the council, my name is Rene Castro. Nice to see you all. It's been a long time since I've been up here. I'm a proud resident of the third district, a social worker, faculty member at California State University in Berkeley, Long Beach, for the past 26 years. I'm totally in support of this item, given all the reasons that really can add more than what the council members have added. Mental health, as you all know, is extremely important to our community. We have the resources and capacity to serve our community. We do recognize that there are numerous challenges. This is a huge undertaking. But I will say, as the former chair for Mental Health America, Los Angeles, one of the things that I recognize. It took us four years to get reimbursed by L.A. County, donate on our services. And if we didn't have a $26 million budget at the time, there's no way. I don't know how agencies survive with four years waiting to be paid. So it's an enormous undertaking. But in Long Beach, with the leadership and diligence of our health department and our partners, as we've seen throughout the pandemic, we had the capacity to build a tailored system to address the needs of our local population. Thank you so much for your support of this item. Thank you. Next speaker, please. Good evening. Karen Riverside and I live at 714 Pacific Avenue in a senior building with 200 other seniors. And one of the things that's missing is the attention to older adults. Older adults are still under the stay at home order, and they've been under a stay at home order for almost two years. I literally have people in my building, particularly those that are mobility, impaired or disabled, that have not left their apartment in months. And I was almost punched in the face by a six foot two man because I asked him to put a mask on as I was exiting my building and he was sitting in the lobby of my building. There's so much pent up rage and fury at people having to be so restricted. I really want to suggest that we do something like men's sheds where it's a safe environment for men to talk about this frustration and rage that they have so that people don't get hurt. And it was very traumatizing. Thank goodness I was able to talk to the police and the police were very, very helpful. So I commend them for being sensitive and handling the method. The problem really well. Thank you. Thank you. Thank you. That concludes public comment. Members, please cast your vote. In price. Emotions carry.