BOCC Work Session 12/17/25, 2 PM – Behavioral Health Services Multi-Year Funding

BOCC Work Session 12/17/25, 2 PM – Behavioral Health Services Multi-Year Funding

Good afternoon everyone. Today is Wednesday, December 17th, 2025. We are here this afternoon for a work session and our discussion item is an update on behavioral health services multi-year funding development efforts. I’m Kristen Stevens, chair of the board of county commissioners. With me are my fellow commissioners, Commissioner John Kafales and Commissioner Jod Shadek McN. We have our um Lorenda Vulkar, uh our county manager with us today. And I will turn things over to um Amy Martonis, uh our behavioral health services director, uh for uh the update. And welcome everyone who’s in the room. Thank you. Hello, commissioners, county manager Vulkar, colleagues in the room, and community members, and others who may be joining us online. My name is Amy Martonis, and I serve as the behavioral health services director for Lmer County. With me in the room are colleagues that have been vital in developing the work that I’m sharing with you today. I’ll invite them to introduce themselves in a moment and wanted to note that online we also have members from the Corona Insights team who will also introduce themselves shortly. They have been our vendor that has supported the work that we’re sharing with you today. With that, I’ll invite my colleagues to introduce themselves. >> Hello, commissioners. My name is Maline Novie and I serve as the communications coordinator for Lur County Behavioral Health Services. >> Good afternoon. My name is Jessica Plamer and I serve as the program manager for behavioral health services. and I’ll invite our Corona colleagues who are virtual with us today to also introduce themselves. >> Hello, this is Kate Darwin. I’m a principal at Corona Insights. I’m >> uh I’m Matt Bruce, also a principal at Coronites and a Lur County resident. >> Hi, I’m Jim Perich, a director at Corona Insights. >> Hi, Paul Collier here, also a director at Coron Insights. and Katherine Rocky, senior associate at Corona. >> Thank you, Corona team, for introducing yourselves. We’ll hear from them a bit further uh a bit later in our discussion. So, in this hour together, we have a lot to share with you about the multi-year funding planning efforts and community engagement that has been underway since May. Our agenda today includes sharing the desired outcomes for this time together, providing context for the multi-year funding initiative, summarizing the stakeholder engagement, reviewing multi-year funding fiscal considerations, summarizing the options for multi-year funded investments, and discussing investment prioritization and any questions that you might have about this effort. All of the work that we are sharing with you today is grounded in our department’s vision that Lamur County is a community where people are empowered and supported in accessing a full range of behavioral health services that promote well-being for all. The multi-year funding framework is also rooted in our core values of stewardship, partnership, and community. We recognize that this work is made possible by our community’s investment in behavioral health and that collaboration is essential to this work moving forward. Our collective efforts are focused on strengthening the behavioral health system so that every individual in our community benefits. The desired outcomes for this work session include sharing about the rigorous stakeholder engagement process facilitated by Corona Insights and what we learned from our community about the current funding priorities for multi-year investments as well as discussing and determining investment prioritization which will guide the next phase of our departmental efforts to implement multi-year funding in 2026. Given the diverse strategies used in our department to reinvest the sales tax dollars into our behavioral health system, it’s important to ground this conversation in the purpose of multi-year funding. Multi-year funding is a new investment strategy at the system level. It’s a way to deepen our communitydriven investments in systemwide changes, bring multiple organizations together to solve complex community challenges, affect the greatest impacts across the behavioral health system, and honor what our community and advisory groups have been asking for as part of the sales tax investment. Multi-year funding is not a replacement of the annual impact fund grant program that our community is well aware of with seven years um under its belt. And it’s also not a way for single organizations to get multiple years of funding for the good work that’s already happening in our community. On this slide is a visual representation of our department’s community investment strategies that have evolved and expanded in response to community priorities. The short term is our annual impact fund grant program. These funds are invested at the organizational level to support continuum of care efforts from prevention through recovery. The midterm is what we’re currently developing together with multi-year funding for system level investments in alignment with community priorities. The long-term investments reflect our departmental operations and the acute care facility at the Long View campus, which includes an array of crisis care services. As a reminder to our community, the acute care facility is open 24 hours a day, 7 days a week, 365 days a year to provide care for those who might be experiencing a self-defined behavioral health or substance use crisis, regardless of insurance status or ability to pay. It’s a tremendous resource that we have in our community because of this sales tax. Now that we’ve grounded this conversation in the purpose of multi-year funding and how it fits within our community investment approach, I’d like to invite our partners at Corona Insights to talk through the stakeholder engagement process. And I’ll turn it over to Kate. >> Thanks, Amy. Um, so uh I’m here with uh Corona Insights. We are a small business um that’s based in Denver and we provide research, learning, evaluation, strategy, and facilitation for purpose-led organizations. Um so I’m really excited to talk about the stake stakeholder engagement process um that we used. Um before I jump into the details of the process, I just wanted to take a step back um and acknowledge that when we started this project, there were a lot of recent plans um that were relevant. So the community master plan for behavioral health for Larur County, the community health improvement plan for Lmer County, the mental health and substance use alliance strategic plan, etc. Um so all of these plans have come out recently and a lot of them included um a lot of great community engagement um research and insights about what the behavioral health needs of the community were. Um so given that we number one didn’t want to duplicate that research um there already seemed to be um pretty foundational understanding of what the community needs were. Uh but then number two this process was really focused on developing solutions that could be supported with a multi-year funding framework. And so for that reason, we focused on engaging with behavioral health um system stakeholders. So those who work and have intimate knowledge about the behavioral health system. And I’ll talk about that a little bit more um on this next slide. Um so uh at the beginning of this process, we uh defined roles of different um stakeholders. We also presented this information at all of our sessions this past year. Um so at the top here, county leadership, obviously it’s commissioners um who prioritize the investment strategies, which is what um we’re doing today. Um Lmer County Behavioral Health Services. We worked closely with them and their role is really to um given all of the stakeholder input um develop the final um investment options and figure out what the funding framework needs to be to best support those. Um as I noted um previously the behavioral health community um this really focused on people who have intimate knowledge of the behavioral health system. So um we included uh we engaged with a number of people who have lived experience with behavioral health but also a number of people who are um health care providers who work at hospitals, emergency services, nonprofits, businesses etc. We also convened a small consultation group. So this was a group made up of behavioral health leaders who because of their role had a more systems level perspective when it comes to behavioral health and were able to speak to different solutions and how they might impact the overall behavioral health system. And then finally Corona we were the outside consultant um who designed this engagement. Um so on the next slide, this is just an overview of our stakeholder engagement process. Um as I noted earlier, there were um several plans, relevant plans that had just come out. Um and so we started out this process by reviewing those and um summarizing the key community needs identified in those plans. At the brainstorming session, we presented those um common needs identified across the plans um to get a sense of whether those were still relevant or whether there were other emerging needs um that we needed to um be aware of. Overall, um at those sessions, the behavioral health stakeholders reconfirmed those same community needs. So the needs from those plans were things like um addressing issues of health equity, uh a need for better coordination of efforts to address behavioral health across the county, a focus on supporting non-clinical approaches to behavioral health, a need for better data alignment and sharing across organizations. Um and then finally a need for workforce development and support for behavioral health. So at these brainstorming sessions we invited the behavioral health stakeholders to generate um ideas, those solutions, potential project ideas that they thought would have the greatest impact on behavioral health and also be the best candidates for a multi-year funding framework. um we had over I believe 120 um ideas which we then coded um to come up with 10 solution areas. So we presented those solution areas to the consultation group in September. We had them help us um refine those so that the different solution areas felt distinct. They also helped us um uh develop uh criteria that we would use at a prioritization session. So then in September, we had a prioritization session where the behavioral health stakeholders um went through those 10 solution areas and ranked them on different criteria. Um we crunched the numbers and then presented them with the results. Um there were three um key solution areas that really rose to the top. Um that was summarized in one of our memos in your packet. Um then in uh November and December we uh worked with the consultation group um to initially develop um proposals for each of the top three solution areas. um we had them roughly rank those as well. Um we then uh refine those with behavioral health services. We presented those back to behavioral health stakeholders in November to get their feedback on the different options to ask questions um and then again to roughly um give us a sense of their preference for different um uh proposals. Then in October and November um BHS staff um further refined the top proposals into um the three proposals that you see today. We did present those to the consultation group as well to get their input um before those were delivered to commissioners. Today we’re presenting um those to county commissioners, the funding proposals. Um and then in the beginning of 2026, we’ll be working to finalize the funding framework, also to begin the evaluation design um and to give updates to commissioners. And then in quarter two we plan to implement the funding framework um and implement the evaluation which for this project is um very collaborative where corona will be working with the fundies um to figure out uh the best metric for the evaluation. I covered um I believe a lot of this but on this slide you can just see in the um wordcloud a list of the organizations that were involved with this process. Um we had great engagement um from organizations that um work across the county. Um we tried to offer both online options and in-person options so that um people from across the county could give input along the way. Overall this process um people were very engaged. Um I feel like we heard a lot of amazing ideas. Um I also wanted to be clear that while BHS was um you know involved with uh this process at the actual sessions they would present um on the funding framework concept but then they were there to observe not to insert themselves or you know sway the conversation any um specific direction. Um and then finally I just wanted to note that uh what came out of this process mirrors so much of what we saw in other plans um what is coming up from um behavioral health services strategic planning process and so that’s always comforting when data kind of reconfirm other data. So, I think whatever choice you make today, these are all great options that could have a really big impact on Leur County. Um, I’m going to be handing this off to Amy um momentarily, but the top three solution areas that came out of our prioritization process were um behavioral health workforce. So how do you um develop, recruit, retain and also support the behavioral health workforce? Um number two was crossorganizational incentives. So how do you incentivize um organizations to work with each other and especially um create collocation of services? So like a one-stop shop. Um and then finally system navigation. So, this was um specifically from a consumer side. So, how do you u make it easier for residents of Lur County to find behavioral health care? Um and so with that, I’m going to turn it back over to Amy. >> Thank you for sharing that summary, Kate. So with this um engagement summary in mind, let’s turn to the multi-year funding investment options. Beginning with the fiscal due diligence that our department has completed to inform these recommendations and this work. Our multi-year funding efforts to date have been shaped by our core values of stewardship. From the beginning, our goal has been to maximize reinvestment of the sales tax dollars while using conservative and long range fiscal forecasting to ensure fiscal stability throughout the life of the tax. Because of skilled fiscal management over the past several years and the current strength of our departmental fund balance, behavioral health services is well positioned to responsibly invest in and expand these community investments and alignment with stakeholder identified priorities that we’re sharing today. Our fiscal planning is informed by a dynamic funding model that looks holistically at our resources and our obligations. This includes our fund balance trajectory, 5-year average sales tax performance, operating performance and thirdparty billing offset trends at the Long View Acute Care Facility, our stable commitment to the annual impact fund grant program, and our projected departmental budget. We’re aligning our desire to grow investments with a long range fiscal plan that keeps us conservatively above our minimum reserve target through 2038 the year that the sales tax will expire unless it is renewed. This approach ensures that we honor our commitment to stewardship responsibly for years to come while reinvesting meaningfully in our behavioral health system. Today, our team will be bringing additional specific budget requests and further financial planning details to the board through the regular annual budgeting process. But our aim today is to highlight that this multi-year funding strategy does fit within our broader financial picture as a department. Now, we’ve reached what I think of as the exciting part, and that’s sharing more details with you about what our stakeholders have prioritized for multi-year funding. What you heard briefly about and what’s fortuitous is that this community engagement process was happening alongside but parallel to and separate from our team’s development of the first departmental strategic plan for behavioral health services. We’re excited to share details of that with you further in a work session in 2026. But we wanted to note that in strategic planning we had already identified that attracting and retaining a highly skilled behavioral health workforce is key to moving our system forward. And when these community engagement efforts began, this was confirmed over and over again. Behavioral health workforce initiatives were the number one prioritized need identified through the multi-year funding engagement process. It became clear that one of our multi-year investments must then be in our workforce if we want the other potential investments to be successful. So with that, I’m going to walk you through how our work is progressing in that priority area. Then I’ll give you an overview of the other two investment options for multi-year funding, which are crossorganizational incentives or system navigation. As we review the multi-year funding options in more detail, I do want to note that choosing a next community investment isn’t a zero sum choice. Each option strengthens the system in unique ways and also carries specific risks, but both have broad base of stakeholder support. While the slides offer a highle view, more detailed information about each of the investment options is available in your packet. This includes how each investment option aligns to things like the community health improvement plan, our community master plan for behavioral health, and those other foundational documents that Kate mentioned. So, first is our investment in workforce. And in kicking this off, I I just want to give a shout out to our colleagues in economic and workforce development as their support and contributions have been vital in how we’ve identified workforce as a priority area and they’re in support of this work moving forward. Currently, we’ve repurposed an existing and vacant FTE within our department and we’re hiring for a behavioral health workforce manager position. That recruitment is open with strong interest and we anticipate having this team member on board with us in February. They’ll work closely with our colleagues in economic and workforce development as well as with community partners across the behavioral health system. The framework for these efforts will be in place when this person joins the team and their work will be rooted in our theory of action. If we strategically invest in the behavioral health workforce through recruitment, development, and retention, then we’ll build a stable and skilled workforce that can meet community needs and sustain highquality behavioral health services over time. Some of the possible outcomes that we anticipate with workforce being prioritized include reduced provider burnout and improved workforce resilience, stronger retention of skilled behavioral health staff, clear pathways for entering and advancing in the behavioral health field, increased professional development and credential attainment, expanded internship, apprenticeship and supervision opportunities, and collaborative int retention incentives across organizations. having more local providers living and working in Lamar County, which will help us grow a sustainable and coordinated behavioral health workforce ecosystem. As Kate shared earlier, the community engagement process generated over 120 ideas that were categorized and further distilled by the stakeholder feedback until the top three priorities were identified. BHS staff and the small consultation group alongside the Corona team used all of that feedback to come up with the more specific drafted plans you’re seeing today. Our next focus area is crossorganizational incentives, which means bringing providers together in shared community spaces and with some shared resources. The theory of action here is straightforward. If organizations work together in shared community spaces with aligned processes and staffing supports, then behavioral health care becomes more coordinated, efficient, and accessible. Implementation would start by identifying the services that would benefit most from collocation and then determining the locations and setups that would best support delivering those services. This lays the groundwork for the projected outcomes you’ll see on the next slide. Some of those projected outcomes include having a significant reduction in travel, referrals, stigma, and system friction in accessing care, more consistent access to care in daily community settings, better alignment across organizations with fewer duplicated services, higher satisfaction among staff and community members, increased sustainability for organizations with braided funding streams, more res more residents accessing care earlier, potentially reducing severity. service duration and need for crisis care. We also envision that developing a collocation model could be something that becomes replicable and expanded to other locations. The final investment option focuses on a consumer access portal, an easytouse tool that anyone in the community could use to connect with behavioral health providers and services. The theory of action here is if we pres pro provide an easy to access tool or portal that anyone in the community can use to connect with providers and services then we will get people to the right care at the right time in the right way and at the right cost. Some of the anticipated outcomes for this investment strategy would be quicker communitywide access to care options, reducing stress on caregivers attempting to navigate the system, and a shared understanding of resources available in our community that support care coordination across the county. This also supports increased coordination between both public and private providers and higher quality referrals. To make the portal effective, we envision care coordination capabilities that go beyond a static directory and ensuring that the system stays current and useful for our community. So to summarize, our stakeholders identified clear priorities for strengthening the behavioral health system in Lammer County, meeting community needs and alignment with several existing countywide and collaborative plans that have underpinned this work. There have been a lot there’s been a significant alignment between work that came before this effort and that was echoed through this effort. The three areas that were prioritized are behavioral health workforce, crossorganizational incentives, and the consumer access portal. Each strengthens a different part of our behavioral health system and moves progress forward in transforming our system of care. As we transition to discussion, we’d like to pose a critical question to guide our next steps. and with your insights. Of the two investment options, which should BHS prioritize now to have the greatest systemwide impact on behavioral health for our community? With that, we’d like to open it up for discussion and we’re eager for your questions. >> All right, questions or discussion? Commissioner Kos. >> Thank you, Madam Chair. Thank you, Amy. Amy and colleagues, I have a few questions that would help inform my responses to the overarching questions. Maybe I’ll do one or two and then we can share the love. Um, >> well, I guess this might be for the consultant folks. So, Kate, >> sure. if we could get more details and and I think it’s somewhere in another document more details about the stakeholder engagement and the perennial question that we often ask is what about rural areas uninccorporated areas it seemed like what I remember from one of the documents there were a couple of in-person sessions and one virtual session but both in-person sessions were in Fort Collins and it just seemed Fort Collins centered so that would be one question overarching question regarding um how did we engage some of the more rural areas whether in all three districts um and how did we go beyond being Fort Collins centered? >> Yeah, thank you for posing that question and I’m happy to kick off the discussion and invite uh the Corona Insights team to share further if they would like to. I think one of the important things to note about this engagement effort was that it built on the efforts that were part of the community master plan and the community health improvement plan um as well as the county strategic plan and all of those had a broad research base with representation across the community of of community voice and community members. Um specific to this engagement process, we were um collaborating closely with behavioral health stakeholders. So meaning folks that are working within or receiving care within the system, but primarily service providers that would um have insights to the the care system gaps and needs at a system level of where we should prioritize efforts to strengthen the system. Um so we leveraged the existing research that had been done that centered community voice in making recommendations and that was the starting point for the follow-up work we did through this engagement process. So, our efforts to extend that reach did include hosting a virtual session, using online surveys to provide feedback for folks who couldn’t make it to in-person sessions, um, and having an open communication loop through our communications coordinator and the communitywide um, updates and invitations that we have been distributing throughout this process since May. I think I’d also like to add with the organizations that were represented during the engagement process, we had some including those from the town of Estus Park, those that provide services within the Estus Valley. Um we have organizations that serve individuals in Wellington um in John’stown. And so we had a mix of both leaders in those areas as well as providers. Um and then we have across the different organizations those that serve different populations. So we have some that serve LGBTQIA plus community. We have those who um support individuals with disabilities, those who uh support um older adults within our community. So we were uh hoping through the list of represented groups uh that it would address uh what you’re speaking to, Commissioner. And you are correct in your um materials that we sent over and we can share them again. Um last week we provided a full summary of Corona Insights uh work in the engagement process. So all of the data for each of the sessions um all of the compiled data um and analysis related to the surveys um as well as a full list of organizations um that participated uh and were represented in the process. If I if I may, Madam Chair, just a followup to that response and then I’ll hold off on any other questions so we can take turns or whatever whatever you think is best. Thank you. Uh, and all of the areas that you mentioned are all incorporated municipalities. What about places that are not incorporated like one of my favorite places, Red Feather Lakes, Liverour, um you know, places that are more remote both on the south end of the county and certainly on the north end of the county. >> I will say connected to this effort, but also separate from it, our department has been making intentional efforts um to reach Red Feather and to grow our network there. Um recently Jessica Palmer spent all day with um members of our health department and the CHIP efforts in making connections in Red Feather to support additional behavioral health outreach and we learned some interesting new things like there being a dedicated space in the library to support folks for teleaalth appointments and ways to access behavioral health care. So we are um as a department committed to um forging and continuing to strengthen those relationships and invite representation into these processes whenever possible. Um, thank you for now. Thanks, Commissioner Shelly. >> Um, thank you all for being here and thank you to Corona Insights. Um, I’m looking at all this and my mind spinning thinking about that first conversation we had. um and how many voices in the room and um and it was very busy um lots of of talk and um and I appreciate um capturing you know kind of who was there and how we um how we talk about this um and uh there’s like I didn’t know we had a letter Medicaid advisory council so that was something new for me so I’m just you know curious about that um I look when I look at this for my first question when I look at this u word cloud um and this leads to my question is I see like certain words a lot like arula three times that’s pretty large and some others and I don’t know what a rula is and I’m wondering my my question is we had some folks who came that might have represented one um organiza or like we had multiple individuals me um or representing one organization and even on your small group you have someone who um sits on the board of that organization and you had the executive director of the organization. So I my question is um how do you keep a balance of all voices and and thoughts across the whole district and I’m not sure what a rule is but I you know I think you and I Amy and I have talked about this is um you know it when the time of scarcity and we get some of the nonprofits who are very concerned and and areas just want to make sure that we’re keeping the resource scarcity out of it and maybe focusing on what you what we trying to do is investing in system changes that we need to really move the needle. And so that’s my first question. I don’t know who wants to tackle that. >> Yeah, thank you, Commissioner. I’m happy to. I appreciate the question. One of the things that I found really valuable about the engagement process that Corona Insights designed was that at every step of the way, the ideas that were generated from folks that were in the room were pressure tested and reassessed by the group of community stakeholders again. And that those multiple steps in the process of of reiterating here’s the feedback we received. Now, we’d like the group to weigh in on how we’re distilling that information, what we hear as the priorities, and give layers of insight and follow up with each round of recommendations and as as they were being distilled. Um, I think I would share that concern if there was one pass of feedback and it went towards implementation. But this was several rounds over months of discussion and dialogue where there were numerous ways for folks to engage and test the ideas, challenge the ideas, provide new ideas um into the conversation to really hone in on what was amplified as community priorities. Um, and in the representation across all of the engagement, um, I didn’t see a trend where one interest area across the continuum of care was amplified or highlighted more than others. It was a broad base of strategies and solutions. >> Right. If I my next question, venture um, let you um um, something in and challenge. So I >> pressure testing. >> Pressure testing. Yeah. I I appreciate that very much. Um my next question is um well I guess twofold. Um we have almost two full years of data of folks coming from into Long View >> and they’ve come and I know we’ve collected where they’re coming from and some when we talked about the rural um outreach we’ve seen some really encouraging numbers coming from some of our more remote rural areas. Um is there any information when we talk about lived experience gleamed from are we also utilizing um that those users and clients um our residents who have accessed who have driven up and basically I mean that’s the majority of them right how are we also using those experiences to help maybe guide I I mean I have no I have no concerns about these I I will ask my next question will be about these options but how are we also using that to help guide some of these um priorities. >> Absolutely. Thank you for the question, Commissioner. When we think about the overarching options that we’re presenting today and what it will mean to move from the ideas of what the investments could be to the implementation phase, that data will be critical in highlighting on the colloccated services side, what services and care coordination postacute crisis are most needed to centralize in our community. And on the referral hub um option, that’s a vital service that’s provided from acute care. What’s the care that comes next? How are folks accessing it? And how is it being coordinated? So that data will be really critical as we think about what implementation starts to look like with either investment option will be a critical part of the puzzle. And and to build on that a little bit, that’s, you know, after the fact or after intervention, are we also using that to maybe backtrack and see how we could um upstream to maybe delay or or maybe even mitigate um intervention by early access and intervention. I’m just curious about that. >> Yeah, I think that would be a telling data story and inform efforts on the coordination side ahead of an acute crisis. Um, and I know that care trends and how folks are accessing care is some of the data that Summit Stone provides in looking at how folks eventually um, receive care at Long View. And I think we’re missing pieces um that we can glean further from a broader base of our our providers across the community for folks who have private insurance or or not represented in receiving care through the safety net system and the services that Summitstone provides. But all of that utilization data would provide a comprehensive picture of that further inform where those gaps are and how either of these efforts would strengthen the continuum and hopefully avoid the need for crisis care in some cases by having that wraparound and coordinated support throughout. >> I love your your answer. Thank you very much. And I one more question then I’ll put my other one in the parking lot because maybe you’ll have my colleagues have the same question. But um you’re asking us to make comments on two options but also um when you talked about the three top uh strategies was there’s three the work. So workforce we know that has been something we talked about before the building was even built. It’s something that even with um but wildfire mitigation the workforce and the skills um are um very important. So it seems like you’ve all identified this is something we should invest in. So that’s not an option. Um so my question about this because for me there’s seems to be a lot of um um Johnny come lately. Oh this is the new career of the year so we’re going to offer this little short six week um to get qualified as our or our peer-to-peer navigator. And so as we’re investing in the workforce, we’re thinking about that are we also looking to help our partners who are maybe educating what kind of criteria or what kind of skills. So we’re not we’re getting really um I think it’s really important area to have really home skills even with peer-to-peer um to help them also not have the burnout. So, how how are we helping maybe um shape or influence kind of what um this workforce is learning or how they’ve come um prepared because the landscape’s changed. Yeah. >> And the reason I asked my the reason I’m I’m interested in this question. I’ve been listening to um inside the brain um on NPR and they’ve been talking about um with a Stanford researcher who also found that she had something she wasn’t aware of about addiction that she fell into it and it kind of impacted her career was reading a books >> um a certain type of book and so it was very fascinating but there it was really um interesting to me that talking about where we’re at currently in our society and um and how smartphones and everything it’s almost like at I mean, immediate access to something that could be uh influencing our our mental health, our behavioral health on a daily basis. And you and we’re glued to these things, right? And so um I found it very fascinating about that. So I think now we have the need for better train or more um comprehensive thinking about how we live in different times. So, um, how are we looking at in influencing this to to make sure we get kind of the behav the workforce we need? >> Yeah, thank you for that question, Commissioner. Any workforce effort is going to take a tremendous amount of collaboration across professionals that are part of the equipping, training, mentoring um components, our um training institutes, institutes of higher education, our community college partners who have launched the micro credential of the qualified behavioral health certification that supports the peer workforce and that lenture process as well as more traditional academic training programs in psychology, human development and family studies. ities, social work, counseling. Um, and while some of those programs are governed by specific accreditation bodies that structure the curriculum, our community has strongly engaged providers that offer tremendous amount of real world experience to help shape and inform and make the transition from content and curriculum over into practice. And so by building a network where that is uh intentional collaborative effort, I think it strengthens the mentorship opportunity um and provides some some critical partnership and launching the workforce. But one of the other things that we’re really excited about when in thinking about the workforce is an opportunity to reframe and redefine what retention looks like. And we hear from our organizational partners how they’re struggling with it at an organizational level and what an opportunity to define retention at the county level and structure. If you’re interested in behavioral health, here’s why Lammer County is the place to be. You can know your entry point into the workforce. You can know which organizations are for beginning professionals, which are for licensed professionals, and which are for advanced professionals. So to think about having an opportunity where I can envision my career continuum um and reframe what retention looks like and make it countywide instead of in an organizational silo seems like a tremendous opportunity that we feel well positioned to take on in supporting our workforce from that education and training side all the way through the career pipeline. Phenomenal. Love and I will leave my last question about navigation and unless my colleagues have other questions, I’ll pass and and hopefully maybe we have the same question. So, >> thank you, Commissioner. >> Thank you. Um, so I just have a couple questions. Um, how many years do we um mean when we say multi-year? That’s a great question and I think it will be in part defined um by the implementation phase when we develop a more specific project plan, a more nuanced budget forecast and understand the scope of what the work will require. We do know that both of these options have a long tail in terms of it’s going to take a building phase to initiate implementation then a period of it being active refining and testing. But we see this as being systemchanging efforts. So multi-year anywhere from 3 to 5 to 10 years through the life of the tax. >> And then um you know with regard to some gaps that um are becoming more evident as we kind of move through the year around um in different programs for example like I’m thinking about um permanent supportive housing and some of the dollars that they’ve lost um and um and just other programs. I mean, Medicaid being, you know, the uncertainty around Medicaid and stuff like that. Um, you know, when we’re obligating and I I don’t know about the about obligating, you know, dollars, you know, I mean, year after year, I mean, what what are some of the parameters around that? >> So, there is caution around obligating future boards to current expenses. But what I think what they’re looking for here is direction that it’s okay to plan over a series of years. obligating is something different. That’s part of the budget process that Amy talked about. That is uh that’s where we put the money to the program. Um but knowing that we in theory have a program that will last over time and that we will try to fund it appropriately over time barring something else happening, I think that’s the direction we’re looking for. Okay. Um, so I I guess thinking about tying up some of these dollars, not necessarily obligating is maybe not the right term, like how um I mean it it does it prohibit our ability or you know lower our ability to be able to pivot when different things come up. And I just think about, you know, whether this is like people losing, you know, Medicaid funding or or that or maybe having to um there’s a recession. I mean, you know, I’m I’m assuming that like the what you’re talking about with your budget um is that you you’ve planned for some recessions and other kinds of things to happen, but um I guess I just the flexibility of the dollars once we we kind of go down this path. Yeah, thank you for the question, Commissioner. I recognize how fiscally uncertain these times are. Um, and one of the things that our department appreciates in the community’s decision to pass the sales tax in 2018 is that our dedicated funding stream is um the oversight of that is the ballot language that directs the the funds to be invested in and supporting the continuum of behavioral healthcare. So within that awareness, we feel confident in looking at our average sales tax performance um and the third party billing offsets at Long View in forecasting the the comfortable margin that we have to make these additional community investments. I’d give a shout out to our accountant Shauna Costa. He has developed a responsive funding model where essentially we earmark and propose a funding minimum to support the framework of these programs and then using all of those factors that I mentioned earlier depending on sales tax performance performance at Long View um other fiscal trends. It adjusts the maximum amount per year with our long-term fund balance through 2038 in mind. So in real time, we can adjust those numbers and know how much we need to shift the target while still bringing forward a budget recommendation of a minimum amount to fund this new additional investment strategy. So, we’re excited to share more about that model with the county finance team and through the budgeting process, but there’s been a tremendous amount of effort that’s gone into how do we stay flexible in these uncertain times and to be responsive to emerging community priorities while still gaining ground on moving the needle in our behavioral health system. >> No, I appreciate that. And um you know, I think it’s smart to keep looking forward. Um not but I mean filling in holes at some point is is also important so we’re not losing ground. Right. >> Absolutely. >> And so um thank you. You know I guess it’s it remains to be seen kind of where we you know I don’t know not to be bleak but I mean you know there’s a lot of things that are coming up lately where we’re just seeing these you know these gaps. And I’m sure your nonprofits are seeing that as well too. And so um and just people’s you know you know I mean the whole insurance you know it’s not just Medicaid it’s people that might be not be able to afford their um Affordable Care Act insurance in in the coming year too. So, um, I guess, you know, I mean, everybody in this room is aware of that. And so, I guess it’s just, you know, I want to make sure that that as we think about this, we’re we’re sort of, you know, making sure that we have dollars to address some some real needs in our community that we might see. >> And I think, you know, the the tax was passed to add to to be additive to what was already existing in the community. And what’s happening now is we’re seeing a bit of a loss in some of those. And so shoring up the loss um may not help us push forward, but it can help us hold our ground kind of. And I think that’s maybe what we’re talking about here is flexible enough to say, “Wow, we never expected this to happen. We now need to back up and make sure we maintain the foundation before we add more to the to the top layer.” So, >> thank you, Lorenda, for saying it better than I ever did. But, um that’s kind of what I’m getting at. Exactly. And if I may add, I think what’s unique about our uh investment strategy is that we have the suite of the short, mid, and long-term investments. And so what I hear underlying in in your your question um and what you’re posing, Commissioner, is we have these system we have dollars to be able to make systemwide change that we may not ever be able to do again in our careers. um that could last for decades. And in the meantime, we have things like the annual grant program that can be more responsive to needs. You know, in the 2025 grant cycle, we have the family housing network and we have housing catalyst and we have all of these different groups that are living every day responding to the needs in the community. And so we have by structuring our investments the way we have the ability to pivot, not only keep things moving at this high level, but meet the needs that are coming up here every day. Um, and so that’s that’s where I find solace of thinking, wow, we actually can can do this in a responsible way and meet those dynamic needs. >> Thank you. Other questions? Commissioner Kafales. >> Thank Thank you, Madam Chair. Thank you once again colleagues just to stay try to stay focused on this resource discussion. I appreciate all the comments and and I’m wondering you know regarding this model that allows us to adjust fund balances you know in the long term through the life of the the sales tax and I I guess based on what I’m hearing from Commissioner Stevens you know can it be adjusted? Can this model adjust if we have to backfill you know funding you know for Summit Stone because there’ll be we know there are going to be Medicaid uh cuts over the next 10 years there are different work requirements uh the mention of um people that are getting um private you know private insurance through the affordable care act or what’s what’s left of it I suppose so can the question there is uh c can the the model that you speak of uh adapt or adjust not just a sales tax performance but other things and then in the spirit of here’s an idea maybe by some chance you haven’t thought about it which I kind of think is unlikely but I’m wondering since one of back to the workforce thing uh one of the needs of course is regarding a pediatric care you know little ones who need uh behavioral health services and given that we just the voters just approved referendum 1B is there the potential for leveraging resources is uh because a chunk of their area one of their focus areas is workforce. >> Could could there be a collaboration where money that we have from our our sales tax could be used with money from the 1B sale tax to maybe train hire um you know folks who are focused on pediatric care. So >> yeah, thank you for the question, Commissioner. Of >> course, >> it is a core value of our department to center stewardship and how these sales tax dollars are reinvested and we will explore every opportunity to leverage existing funding funding within county resources as well as community resources in thinking about the um additional sales tax ballot measure that was passed. Thinking about our partners at CSU that have been awarded workforce support dollars through the BHA for funding. um collaborative partnerships and and having multi-stream investments supporting this work will be vital to the sustainability planning. So we will certainly center that in thinking about implementation. >> No, and I appreciate that. I’ll stop after this, but I’m wondering as we work towards developing finalizing the contract for the delivery of services as a result of 1B, can there be or should there be some specific provisions in there that create uh some intentionality perhaps around this? You know, the the the braided, you use the term braided funding. Could could this be a potential source of braided funding? >> I would welcome additional uh followup with county leadership and exploring those possibilities. Certainly. >> I’m done for now. >> Thank you, Commissioner Shadic. Male. So, back to what you had asked us about today. Um, so certainly um the workforce is not surprising for me. There was a lot of great ideas, but I think the workforce was is definitely um something I understand I need because we can’t provide services. We don’t have um specially trained folks. But when I go back to thinking um about um option one or two um when you’re that’s what you’re asking um you know that’s you know I hate to have to choose from two of them but I was just thinking about this just for um some feedback is one thing that we have with impact grants um we do have some of that flexible funding for emerging emerging technologies and we just did just remind folks we did the ex um the shortcut for folks who have had mult five years of funding and so it was a little easier but we still have that and that was targeted but we still have some room for some emerging technologies or flexibility so that’s still there so there’s some flexibility there so I wanted to highlight that but one of our um focuses is allowing um or focusing on collaboration and and cross um um partnerships and and working so that I think that’s maybe kind of embedded throughout everything we’re pushing so I I was my thought as I was seeing thinking cuz I was trying to think about with your question is organically maybe that might happen with that organically with with um as we’re going along. So if we’re going to if we’re going to think about what might be the one we we can invest in I was thinking system navigation because and I don’t know how that looks. It could be an app. It could be a a like a no wrong door kind of philosophy or a phone call someone can pick up or crisis, you know, and direct them into certain ways because whether it’s an older adult and when you’re in crisis, you can’t think straight. You don’t know if you should use your app, your phone, drive, what, whatever. But like kind of some no wrong door in that system navigation. And I’ve heard this a lot. They a lot of folks don’t know um or even for providers, right? How do we get someone help right now or or how do we get them into a warm handoff for that next um layer of care and then the next layer of care? So that might be needed going forward especially as folks are running out of options um with with insurance and things like that. So maybe building a system because I know this is a discussion with the youth mental health task force as well. Having the school districts coordinate to having one system for how teachers and parents get there’s how they how we access help for students or youth. So this seems like this kind of overlaps or is happening at the same time. And so um because that was I think it ended up being one of the top three or four, right? if correct me Amy because we’re both in those means um building a system countywide to help bring because our landscape is dramatically different since 2016 2018. So how do we help everyone work together and and maybe build this system that everyone can access and then I’m thinking organically even though we we have to choose one option or something this might happen organically. That’s just kind of my initial if because I know we’re almost out of time. That’s my initial thought. Um, this has been bouncing around in my brain a lot because it just seems like every day we’re learning. I mean, I’m just learning something new about the human services stuff um that’s happening. So, I I guess that’s where I would go right now is I feel like I’ve heard this a few different the youth mental health task force and we’ve heard this here and I’ve heard this here like the regional opatement. So, I I feel like maybe that would be across sectors or across organizations. That might be if we if we built um and I don’t know what it looks like, but I know what you’re thinking. I’m thinking an app for some folks, a phone call. Um but how do we do that to help um someone uh in crisis or someone who is trying to avoid a crisis get um so there’s no wrong door there and not say, “Oh, well, sorry we can’t help you. It pairs phone number.” So, I’m just that’s kind of where I’m leaning. So, I hope that’s helpful. Thanks. >> Thank you, Commissioner. >> Thank you, Commissioner Falls. Did you want to answer that question at all around options, the two options? >> Thank you, Madam Chair, and I am not prepared to answer that question at this time. I have uh quite a number of other questions and I don’t want you to get the wrong idea in the Corona Insights. I think this has been a terrific process. I I I think it’s great, but I’m afraid I do have questions and I’m going to suggest that um if if you all we can find a specific time to meet maybe for an hour, you know, either with Lori or some of you folks so we could have that conversation. Sometimes I do better one-on-one and we don’t have any time >> to the Corona folks. Thank you. And to you, thank you. I think this is really a terrific process. >> Thank you, Commissioner. I think each of the commissioners may have a different set of questions and so I wonder if some one-on-one meetings might be the next best step and we can work with Melissa to get an hour scheduled for each of you um to go through some of these ideas and the history. Yeah, I think that that would be really helpful as we’re running out of time and you know I think that um I I hear what Commissioner Shadak McN says and yet you know I sort of love this idea you know in reading through some of this of you know kind of identifying duplication and gaps and things like that that would happen with the colloccated behavioral health services. So, um, probably just a little more information before we kind of give you and also really want to hear, you know, what you’re thinking because this is not my, uh, field of specialty and, you know, I don’t, um, I would hate to, to suggest the wrong solution here. So, um, we’ll look forward to those conversations then. Um, and then we’ll, it’s 2:59, so we’ll adjourn for the day and and to be continued. Thank you. >> Thank you so much.