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Episode 1049 | Rebuilding Behavioral Health Services In New Mexico

Episode 1049 |  Rebuilding Behavioral Health Services In New Mexico


>>IT HAS BEEN NEARLY FOUR
YEARS SINCE THE MARTINEZ ADMINISTRATION STOPPED
MEDICAID PAYMENTS TO 15 NON-PROFITS THAT PROVIDED
BEHAVIORAL HEALTH SERVICE, ACCUSING THEM OF MILLIONS OF
DOLLARS OF FRAUD. THE ORGANIZATIONS WERE
EVENTUALLY CLEARED OF WRONGDOING BY THE ATTORNEY
GENERAL BUT MANY ALREADY HAVE GONE OUT OF BUSINESS. THE ADMINISTRATION BROUGHT IN
FIVE PROVIDERS FROM ARIZONA, AS YOU MIGHT RECALL, BUT ONLY
ONE OF THOSE COMPANIES IS STILL HERE. SO, WHAT IS THE STATE OF
MENTAL HEALTHCARE IN NEW MEXICO? IN THE FIRST OF A FOUR PART
SERIES, CORRESPONDENT MEGAN KAMERICK LOOKS AT WHERE THE
NEEDS ARE ACROSS THE STATE.>>I AM JOINED BY DEMOCRATIC
STATE SENATOR JERRY ORTIZ Y PINO, MAGGIE MCCOWEN,
EXECUTIVE DIRECTOR OF NEW MEXICO BEHAVIORAL HEALTH
PROVIDERS ASSOCIATION, ELISE PADILLA, A FELLOW WITH THE
NATIONAL LATINO BEHAVIORAL HEALTH ASSOCIATION, AND
NATALIE SMITH, THERAPIST AND EXECUTIVE DIRECTOR OF AWAKE
AND AWARE. THANK YOU ALL FOR JOINING US
HERE.>>JERRY, YOU’RE CHAIRMAN OF
LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE AND YOU
HOLD INTERIM COMMITTEE HEARINGS AROUND THE STATE. WHAT HAVE YOU BEEN HEARING THE
LAST FEW YEARS FROM PEOPLE IN COMMUNITIES AROUND NEW MEXICO
ABOUT ACCESSING MENTAL HEALTH SERVICES?>>ACTUALLY I WAS CHAIRMAN. THIS YEAR IT REVOLVES BACK TO
A HOUSE MEMBER WILL BE CHAIR. WE ALTERNATE EVERY TWO YEARS,
BUT FOR THE LAST TWO YEARS I HAVE BEEN CHAIR AND WE HOLD
HEARINGS — LAST YEAR WE HELD THEM OR TWO YEARS AGO WE HELD
THEM IN THE SOUTHERN HALF OF THE STATE; LAS CRUCES AND
RUIDOSO AND ROSWELL AND ACTUALLY SILVER CITY AS WELL. AND THEN THIS PAST YEAR, IN
2016, WE WERE IN LAS VEGAS, TAOS AND FARMINGTON. NORTHERN PART OF THE STATE. CURIOUS, IN EACH INSTANCE, WE
HELD HEARINGS ASKING LOCAL PEOPLE TO SHARE WITH US WHAT
THEIR EXPERIENCE HAD BEEN UNDER THIS CHANGED BEHAVIORAL
HEALTH SYSTEM. CHANGE IN A NUMBER OF WAYS. NOW WE HAVE THE INTEGRATION OF
PRIMARY CARE AND BEHAVIORAL HEALTH. WE HAVE ALL THE HMO’S
PROVIDING BEHAVIORAL HEALTH, NOT CARVED OUT TO ONE, AND
CHANGED IN THAT MANY OF THE PROVIDERS HAVE BEEN RULED
INELIGIBLE TO PARTICIPATE IN MEDICAID, SO, HUGE GAP IN
SERVICES. AND, IN EVERY COMMUNITY THE
RESPONSE FROM PROBATION OFFICERS, JUDGES, CHILD
WELFARE WORKERS, AND COMMUNITY PEOPLE WAS, WE DON’T HAVE THE
SERVICES WE USED TO HAVE. WE USED TO HAVE THIS
COUNSELING PROGRAM OR THIS ALCOHOL TREATMENT PROGRAM OR
THIS RESIDENTIAL GROUP HOME AND THEY ARE NOT THERE
ANYMORE. WHERE ARE WE SUPPOSED TO FIND
THESE RESOURCES? SO, IT WAS, YOU KNOW, IT IS
ALL ANECDOTES, ALL PEOPLES’ EXPERIENCE, FIRSTHAND
EXPERIENCE, BUT THERE WAS NOT ONE COMMUNITY WHERE WE WENT TO
THAT PEOPLE SAID, GOSH, IT IS SO MUCH BETTER THAN IT USED TO
BE.>>YET, WE ARE HEARING FROM
HUMAN SERVICES DEPARTMENT AND THEY QUOTED A RECENT REPORT BY
MENTAL HEALTH AMERICA THAT OUR RANKINGS HAVE IMPROVED
DRAMATICALLY IN TERMS OF ACCESS FOR FOLKS WHO NEED IT. DO YOU SENSE WHERE THERE MIGHT
BE A DISCONNECT BETWEEN THESE TWO OPPOSING FACTS AND FROM
WHAT YOU HEAR FROM CONSTITUENTS?>>I DO AND I THINK I HAVE
BEEN GIVING THIS A LOT OF THOUGHT BECAUSE ALL LAST
SUMMER WE PULLED IN DR. LINDSTROM, HEAD OF THE
BEHAVIORAL HEALTH DIVISION, AND ASKED HIM AT HUMAN
SERVICE, HOW COULD YOUR NUMBERS BE SO ROBUST WHEN THE
FIRSTHAND EXPERIENCE OF PEOPLE IN THE COMMUNITY IS THERE IS
NOTHING OUT THERE TO PROVIDE TREATMENT? AND I THINK, YOU KNOW, WHAT IT
BOILS DOWN TO IS WE ARE TALKING BEING ABOUT TWO KINDS
OF BEHAVIORAL HEALTH. CORRECT ME, YOU KNOW, BECAUSE
YOU ALL ARE FIRSTHAND INVOLVED IN THIS AND I MAY OVERSIMPLIFY
HERE, BUT IT SEEMS TO ME WE HAVE THOSE PEOPLE WHO HAVE
BEEN DEPRESSED, FEELING ANXIOUS, THEY GO IN TO SEE
THEIR PRIMARY CARE DOCTOR AND HE PRESCRIBED AN
ANTIDEPRESSANT OR PRESCRIBES A MEDICINE TO HELP THEM SLEEP
BETTER AND BILLS THAT OFF TO BEHAVIORAL HEALTH PART OF THE
CONTRACT. SO, THE NUMBERS ARE GROWING
BUT THOSE AREN’T PEOPLE THAT WE ARE SEEING IN THE
BEHAVIORAL HEALTH SYSTEM PREVIOUSLY. THEY WERE PEOPLE SEEN IN THE
PRIMARY CARE SYSTEM, GETTING PRESCRIPTIONS BEFORE. BUT THAT DOCTOR DIDN’T HAVE A
CONTRACT TO DO BEHAVIORAL HEALTH, SO THOSE NUMBERS
WEREN’T REFLECTED IN WHAT WAS — WHAT WE HAD BEFORE WAS
A SYSTEM THAT DEALT WITH THE SERIOUSLY EMOTIONALLY
DISABLED, ONES THAT WERE WALKING ON THE STREET TALKING
TO THEMSELVES OR WHO WERE UNDERGOING SCHIZOPHRENIC
BREAKS, CONTEMPLATING SUICIDE, SO DEPRESSED THEY COULDN’T GET
OUT OF BED IN THE MORNING AND THERE WERE PROGRAMS WORKING
WITH THEM FOR MANY YEARS. THOSE ARE THE PROGRAMS I THINK
BY AND LARGE THAT GOT WIPED OUT AND THOSE ARE THE PEOPLE
NOW EITHER, I THINK, BEING SEEN, IF THEY ARE SEEN AT ALL,
IN JAIL, IN THE HOMELESS SHELTERS BUT NOT IN THE
PRIMARY CARE SYSTEM WHICH IS HOW WE ARE PROVIDING
BEHAVIORAL HEALTH.>>WE HAVE A LINK TO THAT
MENTAL HEALTH AMERICA STUDY ON OUR WEB SITE. I BELIEVE ONE OF THE THINGS
THEY SAY ABOUT DATA, THEY DON’T INCLUDE PEOPLE
INCARCERATED OR PEOPLE HOMELESS AREN’T IN A SHELTER. THERE COULD BE A LOT OF PEOPLE
MISSING IN THAT DATA. ELISE, OUR MEDICAID EXPANSION
UNDER THE AFFORDABLE CARE ACT HAS HELPED REDUCE THE NUMBER
OF UNINSURED IN NEW MEXICO BUT BERNALILLO COUNTY PASSED A
SPECIAL TAX A FEW YEARS AGO TO FUND MORE BEHAVIORAL HEALTH
SERVICES, SANTA FE ALSO LOOKING AT THIS. THAT SEEMS TO INDICATE WE NEED
MORE SERVICES THAN WHAT WE HAVE.>>ABSOLUTELY AND IN WORKING
IN COLLABORATION WITH THE COUNTY AND CITY IN
DISCUSSIONS, THEY HAVE SAID THAT THIS MONEY HAS BEEN
EARMARKED FOR BEHAVIORAL HEALTH SERVICES BUT THEY ARE
HAVING DIFFICULTY FINDING ORGANIZATIONS THAT FULLY
ENCOMPASS THE NEEDS OF THE COMMUNITY. SO, THEY ARE LOOKING TOWARDS
NONTRADITIONAL METHODS, SUCH AS PEER SUPPORT, HEALTHCARE
FOR THE HOMELESS, ST. MARTIN’S
HOSPITALITY CENTER, WHO CAN DO A MORE STREET LEVEL
BUREAUCRACY, STREET LEVEL ADVOCACY FOR THE INDIVIDUALS. BUT THAT IS THE PROBLEM. YOU’RE GOING FROM CLINICIANS
TO PRIMARY CARE TO THE EMERGENCY ROOMS WHERE A LOT OF
PEOPLE WHO ARE IN CRISIS NEED OF SERVICES ARE GOING TO
ACCESS ANY TYPE OF SERVICE TO GET PRESCRIPTIONS, TO GET
HOUSING, BASIC NEEDS MET. SO, WITH THIS TAX MONEY, THEY
ARE LOOKING TO OTHER OPPORTUNITIES, OTHER
ORGANIZATIONS THAT CAN PROVIDE THAT ONLY FOR THE BASIC NEEDS
BUT ALSO THE BEHAVIORAL HEALTH AND TO COVER THE PARODY THAT
IS HAPPENING WITH THE PRIMARY CARE PROVIDERS AND BRINGING
THAT ACROSS TO BEHAVIORAL HEALTH SERVICES.>>MENTAL HEALTH AMERICA
REPORTS THAT HSD HAS REFERENCED — DOES NOTE ONE
SURVEY DOESN’T INCLUDE HOMELESS PEOPLE IF THEY AREN’T
IN SHELTERS, DOESN’T INCLUDE THOSE INCARCERATED OR IN
HOSPITALS. ARE WE GETTING THE KIND OF
DATA WE NEED TO IMPROVE MENTAL HEALTH IN NEW MEXICO? WHAT DON’T WE KNOW? WHAT DO WE NEED TO KNOW?>>I CAN SEE DEFINITELY COMING
FROM SOCIAL WORK FIELD HOW RESEARCH REALLY DOES DEVELOP
THE PROGRAMS THAT WE IMPLEMENT AND THERE ARE ENDEAVORS RIGHT
NOW GOING ON THROUGH THE STATE THAT ARE REACHING OUT TO
INDIVIDUALS, ANYBODY WHO HAS ACCESSED BEHAVIORAL HEALTH
SERVICES WITHIN A YEAR’S TIME FRAME. SO, PEER ORGANIZATIONS, SUCH
AS WHERE I AM CODIRECTOR FOR THE ALBUQUERQUE CENTER FOR
HOPE AND RECOVERY, WE’RE CONTRACTED THROUGH THE STATE
TO BHSD TO REACH OUT TO ANYONE WHO RECEIVED AT LEAST ONE
BEHAVIORAL HEALTH SERVICE WITHIN NEW MEXICO FOR THE
MANAGED CARE ORGANIZATIONS. SO THAT WE ARE REACHING OUT TO
THOSE WHO MAY NOT HAVE A TRADITIONAL MEANS OF
COMMUNICATION, WHO MAY HAVE LANGUAGE BARRIERS, WHO MAY
HAVE VARIOUS BARRIERS, RURAL AREAS AREN’T ABLE TO ACCESS
SERVICES OR AT LEAST GO AND REPORT ON LACK OF ACCESS, SO
THINGS LIKE THIS CONSUMER SATISFACTION SURVEY ARE
REACHING OUT TO THOSE INDIVIDUALS TO FIND THOSE
MEMBERS, BECAUSE IT IS HARD WHEN THOSE THAT ARE
INCARCERATED, THOSE HOMELESS ARE NOT REPRESENTED OVERALL.>>MAGGIE, A NEED SURVEY THAT
WAS DONE BY UNM DIVISION OF COMMUNITY BEHAVIORAL HEALTH
INDICATES THE NUMBER OF PRIMARY CARE PROVIDERS HAVE
INCREASED IN THE STATE WHICH IS GOOD. THE NUMBER OF PSYCHIATRISTS
HAS DECREASED. WHAT ARE YOU HEARING FROM YOUR
MEMBERS ABOUT WHO PROVIDES BEHAVIORAL HEALTH SERVICES
RIGHT NOW. WHERE ARE THE GAPS?>>THE SHORTAGE IN THE OVERALL
WORKFORCE WHICH INCLUDES PSYCHIATRISTS, BUT ALSO MENTAL
HEALTH COUNSELORS, SOCIAL WORKERS, ON ALL LEVELS IS
DRAMATIC. THE SHORTAGE IN NEW MEXICO IS
DRAMATIC. PART OF IT WAS REALLY
EXACERBATED BY IMPLEMENTATION OF THE CENTENNIAL CARE MODEL
WHICH MOVED ALL CARE COORDINATION, FORMERLY KNOW AS
CASE MANAGEMENT, OVER TO THE MANAGED CARE ORGANIZATIONS,
THE INSURANCE COMPANIES, WHO PAY SIGNIFICANTLY MORE THAN
THE NONPROFITS WHERE PEOPLE WERE WORKING BEFORE AND PRETTY
MUCH GUTTED THE WORKFORCE. SO WE ARE HAVING — MY
MEMBERS, MEMBERS THAT I REPRESENT WITH NEW MEXICO,
BEHAVIORAL HEALTH ASSOCIATION ARE HAVING A VERY DIFFICULT
TIME FINDING PEOPLE THAT ARE QUALIFIED, AND ARE WILLING TO
WORK FOR THE SALARIES THAT OUR NONPROFITS ARE ABLE TO
PROVIDE. THERE ARE ALSO MAJOR ISSUES
WITH GETTING MASTERS LEVEL STUDENTS OUT OF GRADUATE
SCHOOL THROUGH THEIR INDEPENDENT LICENSURE, SO WE
NEED MAJOR HELP IN BEING ABLE TO HOPEFULLY, FROM THE
REIMBURSEMENT MECHANISMS, BE ABLE TO PAY FOR SOME
SUPERVISION OF MASTERS LEVEL PROVIDERS, INCREASING THE
RATES.>>IS THAT TROUBLE GETTING THE
MASTERS LEVEL, IS THE PROBLEM GETTING THEM THROUGH THE
MASTERS LEVEL, THEY NEED MENTORING?>>THEY NEED POSTGRADUATE
SUPERVISION BY A QUALIFIED LICENSED INDEPENDENT
PRACTITIONER. SO, THE AGENCY MAY HAVE
SOMEONE, FOR EXAMPLE, WHO CAN PROVIDE SUPERVISION OF THE
STAFF BUT MAY NOT BE QUALIFIED ACCORDING TO THE STATE
LICENSING BOARD, MAY NOT BE QUALIFIED TO PROVIDE THE
INDEPENDENT LICENSURE COUNSELING. ALL OF THAT TIES TO
REIMBURSEMENTS AN AGENCY GETS OR DOESN’T GET. SO, AN EXECUTIVE DIRECTOR
CAN’T HIRE A COUNSELOR, A THERAPIST WHO IS QUALIFIED
LEGALLY TO PROVIDE A SERVICE AND GET REIMBURSED FOR THAT
UNTIL THEY HAVE GONE THROUGH THIS OTHER PROCESS WHICH IS
ABOUT A TWO YEAR PROCESS.>>HOW DID THE SHAKE UP WITH
BEHAVIORAL HEALTH PROVIDERS IN 2013 AFFECT PROVIDERS?>>IT WAS DEVASTATING IN
SEVERAL WAYS. ONE WITH RESPECTS TO CLIENTS
AND WE TALKED ABOUT THE CLIENTS THAT ARE LOST. WE DON’T KNOW WHAT HAPPENED TO
THEM. I THINK EVERYONE KNOWS A
NUMBER OF ARIZONA COMPANIES CAME IN AND THEN FOUR OF THEM
SUBSEQUENTLY LEFT. ALL OF THE ASSOCIATIONS OR
ORGANIZATIONS THAT TOOK OVER FOR THOSE DEPARTING ARE
MEMBERS OF OUR ASSOCIATION AND THEY COULDN’T GET CLEAR
RECORDS OF WHO WAS A CLIENT, WHO WASN’T A CLIENT, WHERE
WERE THEY? I REMEMBER A HEARING IN LAS
CRUCES WHERE THERE WAS THIS HUGE ARGUMENT ABOUT HOW MANY
CLIENTS WERE THERE? THE REAL PROBLEM WITH THAT IS
THAT THOSE ARE PEOPLE WHO RELY ON — WHO ARE VULNERABLE,
FRAGILE AND WHO RELY ON CONTINUITY OF RESOURCE AND
CONTINUITY OF CONTACT. SO, ANECDOTALLY WHAT WE HEARD
FROM MANY CLIENTS AROUND THE STATE IS THEY ARE NOT GOING
BACK BECAUSE THEY GET A CALL FROM A NEW CASE MANAGER SAYS,
I AM YOUR CASE COORDINATOR AND THEY ARE THINKING, WELL, WHO
ARE YOU AND WHAT ARE YOU DOING?>>HOW LONG ARE YOU GOING TO
BE HERE?>>EXACTLY, I THINK THAT IS A
MAJOR ISSUE AND THEN THE OTHER ISSUE THAT I DON’T THINK WE
HAVE REALLY RECOGNIZED IS THAT WE LOST SOME REALLY
SIGNIFICANT FORCES IN PROVIDING QUALITY BEHAVIORAL
CARE. THE NUMBER OF EXECUTIVE
DIRECTORS AND LEADERS IN THE FIELD THAT HAD BEEN
CHAMPIONING THE DEVELOPMENT OF PROGRAMS AND CARE FOR MANY
YEARS IN NEW MEXICO WERE WIPED OUT.>>I WANT TO GO TO NATALIE. YOU’RE A PROVIDER AND YOU
SPECIALIZE ON ISSUES OF TRAUMA. TALK ABOUT THE LEVELS OF
TRAUMA IN NEW MEXICO AND IMPACTS WHEN IT IS NOT
DISCUSSED OR ADDRESSED. YOU HAVE HEARD ABOUT SOME OF
THESE PEOPLE WHO LOST THEIR PROVIDERS.>>RIGHT, I THINK IT OPERATES
ON NUMERIC LEVELS. THERE IS THE GLOBAL VISION OF
THERE BEING HISTORICAL TRAUMAS, WHICH ARE IMPACTING
ACCESS TO CARE AND IMPACTING OUR FAMILIES AND GENERATIONAL
ISSUES ARE BEING PASSED ON, ADDICTION ISSUES, BUT THEN
THERE IS ALSO –>>WHICH WE HAVE.>>WE DO HAVE VERY MANY. AND THAT, GENERALLY SPEAKING,
GOES UNADDRESSED. WE ALL KNOW THAT THERE IS THAT
HISTORY THERE BUT IN TERMS OF IT BEING A REGULAR PIECE OF
THE CONVERSATION OR ABOUT HOW WE ARE GOING TO BE ADDRESSING
IT, THERE IS NOT AS MUCH AS I WOULD LIKE TO SEE PERSONALLY.>>THERE WERE SEVERAL BILLS
INTRODUCED. MAGGIE MCCOWEN HELPED WITH
ONE, I THINK, ALSO SENATOR Y PINO, THAT WOULD HAVE GIVEN
PROVIDERS MORE OF A ROLE IN THE PLANNING PROCESS AND
MANAGING PROCESS IN THE STATE’S BEHAVIORAL HEALTH
SYSTEM AND THERE WAS ANOTHER ONE THAT HAD TO DO WITH
MANAGED CARE MODELS, TAKING BEHAVIORAL HEALTH OUT OF IT. WHY ARE THESE IMPORTANT?>>THE OTHER ONE WAS ONE THAT
WOULD GIVE PEOPLE WHO HAVE BEEN ACCUSED OF MEDICAID
FRAUD, AGENCIES, PROVIDERS, AN OPPORTUNITY TO HAVE GRIEVANCES
AND DUE PROCESS. AND ALL OF THOSE FAILED AND
THE GOVERNOR OPPOSED ALL OF THEM AND I THINK SHE IS VERY
DEFENSIVE AROUND THIS WHOLE ISSUE OF BEHAVIORAL HEALTH. NONE OF THOSE GOT THROUGH. THERE IS NOT A GOOD REASON WHY
THEY DIDN’T GET THROUGH. THEY ALL SHOULD HAVE GOTTEN
THROUGH, I THINK, BUT –>>YOU FEEL THESE CHANGES
WOULD MAKE A DIFFERENCE?>>ABSOLUTELY. CERTAINLY THE DUE PROCESS ONE. WHO IN THERE RIGHT MIND EXCEPT
CURRENT COMPANY EXCLUDED WOULD WANT TO BE A PROVIDER WHEN,
YOU KNOW, SOME HONEST BILLIONAIRE, CAN LEAD YOU TO
BEING FOUND GUILTY OF FRAUD OR ACCUSED — NOBODY WAS FOUND
GUILTY BUT ACCUSED OF FRAUD AND LOSE YOUR CONTRACT.>>COULD THERE NOT BE A
CONFLICT OF INTEREST TO HAVE PROVIDERS INVOLVED IN THE
PROCESS OF TALKING ABOUT HOW YOU CREATE A BEHAVIORAL
SYSTEM?>>WE NEED TO DRAW ON THEIR
EXPERTISE BUT YOU BALANCE IT OUT AND WE HAD THAT WHOLE
DISCUSSION DURING THE HEARINGS ON THE BILL, HOW DO YOU DEAL
WITH THE POTENTIAL FOR CONFLICT? FIRST OF ALL, THE INDIVIDUAL
PROVIDERS CAN SIMPLY IDENTIFY THE FACT THAT, WELL, THIS IS
AN ISSUE THAT WOULD IMPACT MY AGENCY OR MY WORK AT THAT
AGENCY, AND RECUSE THEMSELVES, AS MUCH AS A LEGISLATOR WOULD
DO NOW, BUT, FOR THE MOST PART, YOU’RE TALKING ABOUT
SYSTEM ISSUES AND POLICIES THAT DON’T AFFECT ONE AGENCY
OR ONE INDIVIDUAL; THAT REALLY ARE BROADER.>>DESPITE WHAT WE ARE HEARING
FROM THE DEPARTMENT THAT CENTENNIAL CARE IS WORKING WE
ARE GETTING MORE SERVICES TO MORE PEOPLE, THIS ISN’T WHAT
YOU GUYS ARE HEARING?>>NO. LET ME JUST INTERJECT THAT
CENTENNIAL CARE IS UP FOR RENEWAL. THEY ARE REDRAFTING THE LABOR
PROPOSAL AND I AM HOPING THAT THEY MAKE SOME REAL
IMPROVEMENTS.>>THE CONCEPT PAPER IS POSTED
ON THE HSD WEBSITE.>>ABOUT CENTENNIAL CARE?>>YES, CONCEPT PAPER THAT, AS
I UNDERSTAND IT, IS PRIOR TO RESUBMITTING THE WAIVER BUT IS
THE RESULT OF MANY PUBLIC HEARINGS OVER THE LAST SIX
MONTHS. THAT HAS JUST BEEN POSTED IN
THE LAST DAY OR SO AND THERE ARE MORE PUBLIC HEARINGS ON
THAT. SO, HOPEFULLY — I HAVEN’T
LOOKED AT IT IN DEPTH. WE ARE HOPING THERE ARE THINGS
THAT WE RECOMMENDED.>>THANK YOU ALL FOR COMING
AND TALKING ABOUT THIS. WE’LL HAVE A LINK TO THE
STATEMENT WE GOT FROM THE HUMAN SERVICES DEPARTMENT ON
OUR WEBSITE ABOUT THIS AND WE’LL HAVE A LINK TO THE
DRAFTING CENTENNIAL CARE REVAMP. THANK YOU SO MUCH.>>THANK YOU.

Author Since: Mar 11, 2019

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