Okay.

The last committee meeting of the day.

With the hour having reached 1 p.m., I'd like to call to order the meeting of the Cook County Health and Hospitals Committee roll call.

Commissioner Aguilar.

Commissioner Naia.

Commissioner Britton.

Commissioner Daly.

Commissioner Degnan.

Commissioner Gaynor.

Commissioner McCasco.

Commissioner Miller.

Commissioner Marita.

Commissioner Moore.

Present.

Commissioner Kevin Morrison.

Commissioner Sean Morrison is excused.

Commissioner Scott.

Present.

Commissioner Stamps.

Commissioner Trevor.

Commissioner Vasquez.

Mr.

Mr.

Chair is present.

Present.

Commissioner Stamps is present.

Chairman, you do have a quorum.

We have a number of members absent.

I'll add them once they return.

You do have a quorum.

Thank you.

Any additions to the agenda?

No changes, no remote participation, but you do have two that previously registered to speak.

I don't see them in the room.

George Blake Moore and Jessica Jackson are not here.

That concludes your list of speakers, sir.

And did you have uh Chairman Daly with the uh roll?

Chairman Daly is added to the role.

Thank you.

Thank you.

Commissioner Morris.

Commissioner Commissioner Kevin Morrison.

Morrison will be added as well.

Okay.

Let me respond to those who that did not answer.

Aguilar, Anaya, Gaynor, McCasco, Miller did not respond.

But you do have a quorum.

Thank you.

With that note, the Chairman Daly now moves approval of item 26-1662.

The minutes from the meeting of the Health and Hospitals Committee held on May 12th, 2026, seconded by Commissioner Kevin Morrison.

All those in favor say aye.

Aye.

All those opposed, in the opinion of the chair, the ayes have it.

Commissioner Scott now moves to receive and file item 26-1081, a report titled Cook County Department of Public Health Quarterly Report Q2 2026.

That is seconded by Commissioner Britton.

And we will now have a presentation by CCH.

Who's going to present?

Dr.

Joshi, are you presenting?

Who is presenting relative to the quarterly report?

Apologies.

All right.

Commissioner Aguilar.

Please add Commissioner Aguilar to the role.

Thank you.

All right.

Apologies, uh, Mr.

Chair.

Uh good afternoon, everyone.

I'm here in Joshua, Chief Operating Officer, Cook County Department of Public Health.

I'm so pleased to be with you this afternoon to talk about building healthier communities 2030.

Um, this is a uh community health improvement plan that CCDPH is required to uh required by uh both the state and our crediting body to present um to you all as our board of health every five years.

Um I'm really thankful for the team I have with me today, uh including uh Dolores Walker, Regional Health Officer, and Frankie Shipman Mulow, who is our senior director for community health.

Um this plan is the culmination of uh over a year's worth of work and planning and analysis.

Um so keep in mind as you're hearing about this, we're really only touching the tip of the iceberg with the work, um, much of which is already in process.

So with that, um I'm gonna turn it over to uh my colleague uh Dolores.

Yep, thank you so much, Karen, and thank you everyone.

Good afternoon.

Thank you for allowing us the opportunity um to present to you today our community health assessment and improvement plan, which we call Building Healthier Communities 2030.

Um so before we get into this plan, we wanted to um preface it by talking about a little bit about the successes of our previous plan.

Next slide, please.

Um, and you can go to the next slide.

Okay, so our our plans are in five-year cycle, so our previous plan went from 2025 and now um to 2030, and this current plan builds off the successes of our previous plan.

So we wanted to really highlight some key successes, um, specifically um highlighting that the successes were not that of just C C D PH, being that this is a community health assessment and community health improvement plan, these are the successes also of the community.

So what you'll see before you have highlighted community partners who have been providing providing to the community over the last five years in various areas.

Particularly our last cycle, we had three health priorities, which were improved access to health and behavioral health resources, ensuring safe and healthy environments, and advancing education and economic opportunities.

So the successes that we have that we wanted to just bring your attention to around that were some of the naloxone kits that were distributed through our community behavioral health unit.

We had over 7,000 naloxone kits distributed just in 2023 through 2024 alone.

Several of those doses we know were specifically given and allowed us to prevent uh overdose deaths.

We have a partner, Sisters Working It Out, who partnered with us to provide over 2,060 food boxes for families in need in 2023 alone, and also coordinated over 300 free Uber rides for cancer patients to receive treatment.

One second.

There's a murmur in the room.

And a lot of work and a lot of good work and time goes into these presentations.

So let's let's acknowledge that as we hear from our presenters.

Thank you.

Go ahead, please.

Thank you.

For the the final couple of successes, I wanted to highlight kind of some long-term more systematic successes around shifting dollars towards healthier local institutional food purchasing through our good food purchasing program.

Um and then in the spirit of continuing having a pipeline and continuing public health and reaching back to our youth, we have 14 students who received their community health worker certification through our high school pipeline program as well.

So those are just a few successes from our previous plan.

We look forward to even more success in this current plan coming up.

Next slide, please.

So today we're just gonna give you a brief overview.

As Kieran said, this is just the tip of the iceberg.

This is work that has been ongoing for over two years.

It has been a labor of love.

Um it has been community work with several partners that have worked with us to get this done.

So next slide, please.

So if you're not familiar with Building Healthier Communities 2030, I'll give you a little bit of background on what it is very briefly.

It's our suburban Cook County community-driven roadmap to improve health outcomes over the next five years.

The next plan, like I said before, the plan is in five-year cycles, and the next plan is actually due this month to the Illinois Department of Public Health, which is why we're before you today presenting.

Um, our community health assessment and improvement plan is a unified action-oriented plan that we have come up with several strategies, goals, and objectives that we have heard from the community to that we they believe will improve health outcomes for Suburban Cook County.

Uh, I do want to also call your attention to this that there'd be ongoing monitoring through dashboards and regular progress reporting to drive accountability for our plan.

So this is not just a you know submitted to IDPH and then it's done.

This is a living, breathing, iterative document.

Um, also want to bring your attention to the findings from the community health assessment, which directly inform the Cook County um improvement plan.

So we within our assessments, we do three assessments.

It was two qualitative assessments and one quantitative assessment.

And I'll talk a little bit more about that shortly.

This process aligns the efforts of public health, healthcare systems, community-based organizations, and local governments to address the root causes of poor health, reduce disparities, and promote racial and health equity.

Next slide, please.

So our timeline.

Um, this work started with a comprehensive community health assessment that was grounded in data, but most importantly, it's centered on community voice to understand lived experience and root causes of inequities.

Um, our from there, we moved into priority setting and planning, working alongside community partners to co-create goals, SMARTy objectives, and strategies with a clear racial equity lens.

We then work to finalize and align the plan with the IDPH and FAB standards.

Um, for those of you who may not be familiar, IDPH, I keep using acronyms, Illinois Department of Public Health and Fab, Public Health Accreditation Board standard to assure alignment with other plans, including the CCA strategic plan and also the President's Office policy roadmap as well as the state health improvement plan.

While work is already being done in our priority areas for CCDPH and also our partners are doing work in this area, um, we will reconvene our partners to re-engage them later this year after the plan has been formally approved by IDPH to start implementing those strategies.

Next slide, please.

This is a community plan developed with community for the community.

These are the community partners that we have partnered with and worked with over the last two years throughout this cycle to develop this plan.

I do want to just talk a little bit about how we came to have these partners.

This was not just happenstance like just throwing darts at a dartboard.

This was really intentional.

So partner recruitment was intentional and grounded in the MAP 2.0 framework, which is was developed by NATO, the National Association for City and County Health Officials and approved by IDPH for us to use.

And in that framework, there is a power and interest and power influence grid that we use.

And internally, we looked at the partners that we had.

We looked at the partners that we didn't have also.

And so we leverage the partnerships that we have through our community engagement health education unit as well as some of our other units, but we also understand that there are this is an ongoing process.

And so we recognize that there may be voices at the table, there may be people at the table that people that are not at the table that should be.

And so this is not a closed process.

This is it, these are all the partners we're gonna have.

This is an ongoing process, it's an up and an opportunity for us to invite more voices to the table.

Next slide, please.

We had a lot of partners.

Next slide, please.

And so I mentioned earlier that we have three assessments that inform the community health improvement plan.

And those assessments are community partner assessment, our community status assessment, and our community context assessment.

So the findings from the CHA, which we call a CHA, inform the CHIP, which establishes shared priorities, measurable goals, and coordinated strategies across sectors.

This process aligns the efforts of public health, health care systems, community-based organizations, and local government to address the root causes of inequities.

Also, we are a part of the Alliance for Health Equity through Illinois Public Health Institute, which is IPHI, and we work with them to conduct one of those assessments, the community context assessment, in that we collected surveys and also focus groups to help inform the plan.

And so we also were very intentional.

The alliance in general is very intentional about hearing from communities where we typically don't hear from because they're they've either been made to be vulnerable, their voices have been silenced or minimized.

So just want to call your attention to we were very intentional and will continue to be intentional about who we hear from and how this plan is informed.

Next slide, please.

So the community status assessment collects data about communities such as demographics, health outcomes, and inequities.

And in Suburban Cook County, we found that the population is shrinking and getting older with fewer people moving in and fewer babies being born.

At the same time, there are clear differences across communities with ongoing gaps in access to care, health outcomes, and life expectancy based on where people live and their race andor ethnicity.

Next slide, please.

Our community context assessment collects data about the lived experiences, perceptions, and health priorities of suburban Cook County residents.

In this assessment, we found that mental health, obesity, diabetes, age-related illnesses, and substance abuse were the top at the top of the list for priority health issues among residents of Cook County.

Activities for teens and youth, access to mental health care, housing resources, and healthy food were at the top of the list for needs.

So we see some correlation between what the health issues are and what the needs are.

Next slide, please.

Our community partner assessment.

This was this is the assessment that collects collects data about organizations' capacities.

So we're looking at our partners and what they're able to do, what their focus areas are, and what their public health perspectives are.

And so with that, we found that our partner organizations largely agree on the top health concerns in suburban Cook County, which are mental and behavioral health, access to care and chronic disease topping the list.

And they also agree largely on the top social determinants of health, which were access to healthy food and affordable safe housing as well.

Next slide, please.

So we looked at all of that information.

We surveyed the community, we surveyed our partners, we looked at the data in our robust health atlas that we have that has several data sources in it, and then we brought that information and we wanted to share it with the community.

And so we had in last July, we had a community convening where we had over 50 partners that convened and is built on the current the engagement that we had already had with our steering committee who was driving the overall process.

And so the partners that we had, again, we had the slide already, but also included representatives from several of the commissioners' offices as well.

And during this convening convening participants broke into health priority work groups, and with the facilitation from C C D PH staff began to shape those health priorities goals and objectives that we'll talk about in just a moment.

All of that work that I've been talking about has led to where we are now with Building Healthier Communities 2030, a very robust community health assessment and a very robust community health improvement plan that we are looking forward to working with our community and working with you on implementing over the next five years.

Now I'm going to turn it over to Dr.

Frankie Shipman to continue on and talk about our health priorities, our goals, objectives, and strategies for this plan.

Thank you.

Thank you.

Can we move to the next slide?

So as Dolores mentioned, we had a community needs assessment.

Then we did further assessments, qualitative and quantitative, to assess the priorities.

The community needs assessment.

I think it's important to mention the data sources because one of the biggest changes from our last iteration of this plan is that we have more data from the Suburban Cook County Health Surveys and the YRBS and also excuse me, youth risk behavioral survey, and then also our community, excuse me, our Cook County Health Atlas.

So that really informed the need and why the priorities were issues because the data showed that extensively.

So in these partner assessments and additional assessments that Dolores mentioned, we were able to convene with a vast uh representation, primarily from partners that were servicing those populations, underserved populations and populations at the greatest risk.

And so through these series of meetings, discussions, correspondence, the community established these three priorities.

The first being chronic disease, which I'm going to talk about, the second, maternal child health, and the third mental health and substance use.

So for priority one, chronic disease.

Our partners, along with CCDPH work together to develop three goals.

And the first goal is really talking about access.

It's looking at that access to preventative care.

The second goal is looking at all of the things that would make healthy homes.

And then the third is focusing on nutrition.

Now, of the 16 strategies, we can't go through all of them today, but I am gonna highlight some of them that we're already working on with our partners.

The first is the updated tobacco campaign.

Many of you are familiar with our unfriend tobacco campaign, and this summer we're going to be launching an updated campaign focused on youth that is also focused on vaping.

And this has been something that we're going to be ensuring that our partners are promoting.

We're going to be promoting this extensively as well.

The next strategy that I wanted to talk about is led by Active Transportation Alliance in partnership with us.

And it is to build capacity among municipalities who are applying for state funding to build healthier pathways, bike pathways, and walkways.

That's led by our partner, the Greater Chicago Food Depository.

And we are an anchor partner in that.

Let's go to the next slide.

So the second priority is maternal and child health.

And here we also have three goals and 15 strategies.

So this first goal is talking about equitable access and it's equitable access to that maternal care.

And then the second one is the education and the promotion.

And the third is making sure that our information, that our pediatric care promotion is culturally responsive.

So I want to highlight a couple strategies out of the 15 strategies that we are working on.

First is our healthy beginnings program.

And this is the home-based model that we have that was launched in January.

And it's really striving to develop those referral pathways.

And so with this, we are promoting maternal child health for expectant mothers and also postpartum.

And this is something that we're also promoting and working in coordination with Cook County Health to promote.

The second one we're also working with Cook County Health and then also County Care is working to ensure that our promotion of the different OBGYN services provided by Cook County Health are comprehensive.

We want to make sure that they are accessible to clients and they understand the vast majority of services that they could have access to and then make an informed decision on which service that they want.

So those are just some examples of the maternal and child health strategies.

Let's move on to the next slide.

So the final priority is mental health and substance use.

And in this, we also have three goals and then 14 strategies.

So if we're looking at this first goal, this is all about partnership, strengthening the partnership between treatment providers, government entities, et cetera.

The second is looking at strengthening that crisis care system.

And the third is looking at those structural drivers or upsteam drivers on, excuse me, upstream drivers on why trauma is perpetuated.

So 14 strategies.

I'm not going to get into all of them, but I did want to talk about a few.

The first one is our crisis care report that we developed with our partners.

This was released in November of 2025.

And one of the recommendations was the promotion of the crisis line 988, in which data has shown us that there is a linkage between the inception of 988 in July of 2022 and a decrease in youth suicide rate.

So this is something that we are promoting with our partners.

Another thing that I really wanted to focus on was the CIE, our community information exchange.

This is led by the Bureau of Economic Development, and we are a key partner to strengthen the collaboration and the referral process between treatment providers and community-based organizations.

So those are some of the strategies to highlight that we partner with other organizations to accomplish.

Let's move on to the next slide.

So we've described the data that we collected for the assessment, the data that we collected and worked with partners to develop the priorities.

The next thing to talk about is how we are going to implement this plan.

And what we are going to be doing is forming a community partnership collaborative.

This is going to be in conjunction with partners.

It is shared ownership, and it's also ensuring that we can share data and we can also share progress on our strategies and goals.

So the way that this is going to be organized, we're going to have four action teams.

These action teams will be comprised and led by a partner organization member and a CCDPH staff person.

The first is going to be mental health and substance use, second, chronic disease, and third, maternal and child health.

And so each of these action teams are going to be addressing those strategies and those goals.

But we also have a fourth action team.

And that is allowing any type of priority that the community are raising in order to address it.

While we think that this is going to be important because there may be other priorities that community members and others are raising that we need to address.

So those are the four action teams that we're going to be implementing.

Let's move on to the next slide.

So Dolores went through an extensive timeline.

And around the same time, we're going to launch our community partnership collaborative.

In working together with our partners, we plan on developing reports, the first one being in January, where we're going to give updates on the strategies and goals.

And we're also going to be providing updates to this body along with the public.

Next slide.

This is a summary of what we've discussed.

Dolores went through the process and the highlights that everything that we developed was strategic.

We plan on implementing very soon.

And then once we have final approval, we will submit and launch the implementation plan.

And the last slide is just a thank you.

So we can take questions now.

Thank you.

And before questions, Madam Secretary, if we could add to the role, Vice Chair Anaya and Commissioner Miller.

I think that's that's it.

Okay.

Chairman Daly.

Thank you for this presentation and the hard work that you've done.

I know you mentioned community groups.

And as you know, and you did a tremendous job during COVID.

And we went to areas where we never thought of going before.

So are those community areas groups going into the learning what we did from COVID out into those areas where they weren't served before.

And during COVID, we made an attempt to say, okay, they aren't showing up, they aren't coming here or one of the meeting.

We're going to go to them.

Yeah, the simple answer to that question is yes, but of course, across our activities, we do that in different ways.

Uh let me just keep it simple and say if you're aware of community groups that may be interested in working with us on advancing these strategies, we would love to partner with them.

Um and we are also looking intentionally to establish partnerships in areas and spaces where we may not have been before traditionally.

And thank you, because all these areas of whether it be mental health, uh chronic illnesses, not eating private, not having good food.

Thank you.

Thank you.

Uh before I take the next question, I did just want to uh take a moment to acknowledge uh three individuals uh who play a leadership role uh in the development and implementation of this plan, and that's um Hanakite, who's our uh director of community behavioral health, Amy O'Rourke, director of chronic disease prevention, um, and Diamond Ross, who is uh program coordinator leading our efforts in maternal and child health.

Uh they also are um online to answer questions.

And finally, actually, I want to I'd be remiss if I didn't acknowledge um the um strong and mighty uh Office of Behavioral Health team led by my colleague and friend Dr.

Tom Nutter, who were also in the room.

Thank you.

Commissioner Stamps.

Thank you, Chair.

Uh, thanks for your presentation.

Just it's a simple question.

On one of the early slides, you had an acronym for I think it was S U I D S or something like that.

I just want to know what it meant.

Oh, yes, um, that's SIDS.

Um, so they've added um sudden unexpected infant death syndrome.

Okay, so it's a change in the in and and that this has been an observation before, but just to reiterate that a lot of times when slides are presented, we're not a part of that vocabulary.

So if you guys could just spell that out before you introduce the acronym would be helpful.

Thank you.

Thank you.

I also want to just highlight um a lot of these data that were collected were from the epidemiology unit.

Um, so you have uh Dr.

Alfreda Holloway and also Dr.

Scott Smith.

Thank you.

Thank you.

Vice Chair.

Thank you, Chairman.

Um so just a few questions.

Um can I get uh a little bit of clarity regarding the Chicago, I'm sorry, the community health uh workers model.

So I I heard I caught a little bit of the tail end of of the discussion regarding the training for high school.

So I wanted to know how are we working with city colleges and now they have an official program through authority of the state, or the state gave them authority to be able to formally like certify community health workers.

How are we working with the city colleges?

And um what long-term plans do we have for sustaining that program?

Thanks so much for your question, Commissioner Anaya.

I can um talk a little bit about it and then we can get you some more information.

I'm um not necessarily sure that we're uh for suburban Cook County are gonna be working with the city colleges, but we are working with the suburb, suburban um high schools.

The the thing that I want to emphasize is um we are just starting for this summer.

So um this community health worker training is something that's important to us, but it is um in the process of getting started for the summer.

But I believe we have community health workers now, don't we?

Under the Department of Public Health.

That's exactly right.

So there's there's two buckets of work as I would describe them.

One, we have a very small group of community health workers embedded in our community engagement and health education team.

Um those are folks that go out into the community and and do the community health worker um activities that you would expect, as well as serving as like sort of our internal case management experts if we um have an issue with an individual that maybe needs to be quarantined and has social needs, right?

So that's one bucket.

The other bucket is um collaborating across the um what I would describe as the community health worker ecosystem.

So all the partners that are involved there, um, I believe there's a collaborative that's organized by the um health and medicine policy research group.

Um so they convene a number of partners across the region, um, and that includes folks like us who may employ community health workers, but also folks that are um invested in policy change, um, like things like certification, training requirements, and that sort of thing, um, as well as uh uh community colleges and folks that may provide entities that may provide training to community health workers.

And so I think uh for us it's been uh collaborations with uh if I'm not mistaken, South Suburban College specifically, um, as well as um I believe Frankie mentioned some area high schools.

Okay, but we are partnering up with um those the the colleges.

Absolutely couldn't do without um and then I just uh regarding the extensive um assessment that was that was done.

Um congratulations.

I know it's uh it's a lot of work, uh, but it's so important and it's crucial and it should be core to any strategic planning, any type of you know, um uh area in which we're highlighting priorities.

So, how many touch points did we have with those partners?

Well that's um let's see.

I don't want to get it incorrect.

Um, in terms of our partner assessments, we had focus groups, um, a number of them, um, along with um tremendous amount of surveys.

Um let's see.

We can get an exact number of back to you, Commissioner, but it was a lot.

Okay, it was so it wasn't just that one convening, it was multiple.

Ongoing engagement.

The 40.

Yep, yep, I'll answer that.

Um so it started off in December of like uh not really, but okay.

Um so the touch point started in December with the very first meeting, our steering committee meeting.

And so we had uh I believe 19 members of the steering committee meeting.

And so then that was um to orient them first, but then to also go into that data dive together.

So there were several meetings just with the steering committee.

Then we moved into that um the larger convening of over 50 partners.

And then even from that, it kind of branched it not kind of it branched off into multiple meetings for action teams based on these health priorities.

So from July through September, they were meeting, if not month, at least monthly, some meeting more than others, and then some also subject matter experts were meeting in between that time frame.

And that was just for um our internal needs.

But we also um, as I had mentioned earlier, we're part of the Alliance for Health Equity.

And so with IPHI, there were touch points in terms of the um the surveys that were handed out.

So we partner with them with our CE, our community engagement health education unit with doing outreach events.

So we had, I believe, close to 2,000 within the health alliance, 2,000 surveys that were collected, and approximately 15 to 20 focus groups um that were done within uh Cook County, Suburban Cook County for uh for this assessment.

Oh, great.

Um, was one of your partners um the Chicago uh Department of Public Health?

Yes and no.

So we don't because Chicago and Suburban Cook are you know different different jurisdictions, but we talk to Chicago because a lot of what we see in Chicago is the same thing that we see in Suburban Cook, and a lot of the needs are the same.

So I say yes and no because not formally, but leading up to this, we had the reason why I ask is I mean, we we heard this right during the pandemic, like there are no boundaries sometimes when there are areas of of health and behavioral health has become one that has affected both absolutely suburban and Chicago and some of the strategies and resources put together, go longer way.

So I you know, I I would encourage as we move forward to continue to engage, continue to make it part of um uh our ongoing um process.

To your point, they have their own jurisdiction and the the county has their own, but I think it's always important, especially when we're talking about health.

And behavioral health.

Um and then my last question is in regards to one particular component, the community um context assessment uh seemed good, right?

Because it gives it gets a pulse of where the community and commun and stakeholders are at and some of the priorities.

And I think um to what I mentioned earlier, it it really prioritizes some of the areas.

So I'm just curious on the alignment with Cook County Health and their strategic plan.

That um we have a 2026 to 2028 Cook County Health Strategic Plan, and I'm just wondering I would assume one of the biggest partners in the work that you do.

So, how are we aligning those specifically to ensure that um you know the model of care um is being reflective of the intensive work that you all undertook to highlight and and figure out those uh areas of priority?

Thanks so much for lifting that up, Commissioner.

I mean, I would say it it happens on an ongoing basis at multiple different levels.

Um so first and foremost, there is an item um in the uh Cook County Health Strategic Plan that pertains to this stream of planning.

So that's number one.

Uh number two, we looked very carefully at all of the strategies and uh we're very intentional about ensuring that they were aligned with the strategic direction that our partners on the clinical side of the health system um and uh county care are going.

And so um we included folks from county care and from uh the CCH clinical side of things as we were developing these strategies.

Um and uh all of my peers throughout CCH had an opportunity to review the plan and ensure that they saw themselves in it.

Um I mean, speaking as a public health physician, I would say that Cook County Health as a clinical entity is access, right?

In a way that it is uh that that nobody else in uh Cook County is, and so it's really important uh to ensure that connectivity is there.

Yeah, and I would, if I may, and maybe this is something maybe that I can talk to the chair about.

Um I do believe that this should help their strategic plan as as opposed to the strategic plan helping this, specifically because public health, you have a little bit more information, and again, because you did a lot of of the of the the you have a different lens, I would say.

Yeah, you're looking at the whole of community um suburban Cook County.

You're looking at the those priorities and really uplifting some of that.

So it's a different completely different lens than the access.

The access helps achieve some of our goals, um, I would argue.

Um when I was doing my uh masters in in public administration, I focused heavily on public uh health policy and the need for us to look at it through that lens.

So I would I would definitely say um we should look at the timing of both the strategic plan and this plan to figure out it looks like maybe you all are you all um constrained by okay, yeah.

So it's a little different, and I and I understand that, but I I do believe that um ultimately there should be a lot of coordination.

We uh Cook County Health is the biggest safety net in the region.

We all know this, we talk about it a lot, um, and figuring out how we can you know help guide you know through through what you all are doing, some of the work um that is being done on the other side would be really helpful.

Um so I think um if I'll and again I'll I'll have conversations with the county health about that.

And I know it's different time, but there might be something that that can be shared amongst uh you all to to help guide also the model of care.

Absolutely.

Commissioner, I think we're in complete alignment.

Um one item that I neglected to mention in my earlier comments uh is that while the timelines didn't align perfectly, uh we did try to provide sort of a um uh a distilled version of some early assessment data um to the Cook County Health Board Um early in their strategic planning process, so that could be integrated into those strategies.

That makes me feel so much better.

So thank you.

Yeah, yeah, sorry about that.

Um and one last I'm sorry, I thought it was the last question, but one small um uh maybe comment, maybe it's not a full question, but I did see in one of them there the the um strategies that were highlighted, there was 15, 15, 14.

Um a few of them were things that I believe we currently are already doing.

So, like for example, investing in local food um, you know, producers, um, you know, highlighting good food uh purchasing policy, mitigating, you know, workers' risk, uh chronic uh disease.

So, how does how do we hope to maybe uplift it even further?

Um, if they are things that we're already engaging in, how do we make sure that it's like we're leveling it up to make it more impactful?

Yeah, that's exactly the idea through this plan.

And you'll see um over the course of the year, as you're aware, um, we come to make quarterly uh reports and we're planning to align those reports with the the three priority areas.

So specifically with respect to chronic disease prevention, um, I believe that's up next uh for quarterly reports.

Okay, okay.

Thank you.

Thank you, Chair.

Please add Commissioner McCaskill to the role.

Yes, Commissioner Miller.

Thank you.

And Dr.

Joshi and your team, I just want to thank you for this really in-depth comprehensive report.

Thank you, my lovely server.

Thank you, Sora.

I just wanted to first, I mean, you guys glossed over a lot of really in-depth information, but I do think it's important to highlight that you had 32,000 people complete this survey.

So bravo to you.

That's really tremendous job there.

And to really help guide the work that you're going to be focused on.

So thank you.

Thank you.

Thank you for doing that.

I just had a couple of um questions.

Um, are there any plans to have any PSAs around any of these programs out in the community that seems to be missing on so many levels on just every level that we don't hear a lot of things just for public to consume that type of information?

Yes, um, absolutely, yes.

So tobacco is I would say the thing uh that is um highest on my list, and you should be seeing uh a refreshed tobacco campaign uh coming uh from us later uh short very shortly.

Um the other thing that comes to mind immediately is trying to publicize 988.

Um and so you heard my colleague Dr.

Shipman Amoo mention the importance of that and how um this is uh really a research backed intervention at this stage.

Uh there are less suicides in at following the implementation of 988.

Um, but that crisis line is only as good as people's awareness of its existence.

So I think it's very important to promote that.

There are a variety of other public uh education efforts uh that are also afoot, and we'll surely be sharing those with you in the coming months and year.

Okay, so it is that something that we have to budget for?

I mean, as we go into budget negotiations now, or is that something that is gifted to a public health hospital?

What's how does that work?

It's a mix.

Um, we're funded by uh the state of Illinois through tobacco settlement dollars to do work in the tobacco space.

So we're drawing from those funds uh for that campaign for 988.

We're drawing from our corporate fund, and I'm grateful to the Office of the President and CCH leadership for supporting us.

Okay, great.

So I was gonna mention about the unprenned tobacco campaign.

So the focus is going to be on vaping.

Is there gonna be any focus on the dangers or need to educate parents and students about um cannabis and TCH anything is that combined in that in any way?

The focus of the campaign is tobacco, um, but we're we're tracking uh the rates of um all other substances and their respective uh um use amongst youth and would want to engage with parents and and make them aware in the future.

And school because you did a lot of surveying of for behavior health about high school and so would that be part of that program?

Absolutely, yeah.

We would always want anything we do to be based in um uh evidence and data, um, and so we'd be looking at that survey to guide our efforts.

Well, you know, we've been a huge proponent of the food is medicine type of information, and I know Dr.

Josh's been doing a great job on that.

I just think that now we just have to help educate people too on how do we define healthy food.

Yeah.

So how is that is that part of how is that gonna be implemented or rolled out in some way?

Not not specifically that, Commissioner, um, but I would say our work in this space is largely guided by what you just referenced, which is uh the good food purchasing program.

Um that's more of like an internal facing internal government-facing program, but it does have external components as well.

Um, and so they're looking at the supply chain, working with farmers, uh, more that sort of thing.

Okay.

And you also mentioned equitable access with the FQHCs.

Do we how is that partnership defined?

Commissioner Car, sorry, could you specifically um there was some part of the second presentation where we were talking about or maybe it was with with yours, Dolores about the equitable access um partnering with FQHCs throughout Cook County just for the overall program, I think.

Oh, I see.

Yeah.

Well, I think we partner with FQHCs in various different ways.

I'd say the most direct way that we do it is by engaging them and uh potentially having them refer their patients to our healthy beginnings program.

That's the nurse home visiting program that you've heard us talk about previously.

But are they exactly aligned with our program?

I mean, we can't guide, I guess, what they're exactly doing.

Yeah.

Yeah.

We we we essentially work with them to promote it.

You're correct in it in that we don't have any direct authority over FQHC.

Right.

Okay.

And then my last question is it's great that we're partnering with local employers.

So what does that look like?

How are we part?

Do we go in and give them all of this information, or do they have certain objectives that they might want to meet and we help them meet those?

It's slightly so again, I feel like I'm answering questions in a um sort of scattershot way.

I don't mean to do that, I don't mean to do that.

It's rather that um we work with different entities in different ways across our programs.

Um and so, like one example would be that we work very closely with businesses across Suburban Cook County in our naloxone drop box program, for example.

Um so there may be a uh a barbershop, for example, that's interested in having a loxone drop box um and uh would reach out to us through our website as a result of our campaign, and we would work with them in that way.

There are there are other ways that we work with local businesses too, but again, it differs by program.

Yeah, well, I and for these big programs, like to improve the outcomes, like let's say the healthy eating program.

Do we have an influence with local employers on what that would detail?

Would you I think the biggest is the county health strode?

Yeah.

Yeah, sorry.

So uh my colleague was uh speaking to the partnership that we have with Cook County Health, uh specifically Stroger Hospital, uh, where we've been working really closely with their operations folks on um the kind of food that's being served there.

So that's a really exciting effort.

Right.

Okay.

Well, thank you for all the work in 2030 can't come soon enough.

Well, it can, but um but we wanted to see some really good results, and this is a great framework, so congratulations on great work.

Thank you so much for your questions, Commissioner.

Thank you for the presentation.

There's a motion on the floor to receive and file 26-1081.

All those in favor say aye.

Aye.

All opposed in the opinion of the chair.

The ayes have it.

Thank you.

All right.

Uh Commissioner Marita now moves to receive and file item two six-1208.

A yearly behavioral report presented by the Cook County Office of the Chief Judge for the period December 1st, 2024 through November 30th, 2025, seconded by Commissioner Stamps.

We'll now have a presentation by the Office of the Chief Judge.

Come on up.

Good.

And following this presentation, we'll hear a behavioral health report prepared by CCH.

That'd be followed by a behavioral health report presented by the sheriff remotely.

And then lastly, we will hear uh a or receive a behavioral health report uh by the state's attorney.

So you know the cue.

We actually have three of them, Commissioner.

That's what I want.

Commissioner Trevory, would you please make an announcement about the press conference?

Sorry to get you mid true.

Uh yes, uh we are uh having a Pride Month press conference uh in the lobby at 345 p.m.

Uh we would encourage all of you to join us at the at the press conference.

Thank you.

And also if you haven't gotten it, there is food on the fourth floor.

Thank you.

I'm sorry.

All right.

Good afternoon.

My name is Tamara Stockley.

I'm a section chief probation officer at Cook County Juvenile Court, and I am reporting on updates regarding the fee for service providers that we utilize for behavior health services.

Our mission is to keep all court-involved children in the community where they can receive equitable focused, individualized interventions and opportunities to prevent further system involvement and harm.

The primary objectives are to respond with the plan of action that builds the competency of a minor, redirect negative behavior while promoting accountability, and restore the victim and the community.

At close of fiscal year 2025, the number of adjudicated youth that we were servicing was around 2,577 adjudicated youth, with 87 of those being male, 13% being 87% being male, and 13% being female.

Can you hear me?

The average age is 18, and the race in terms of the population that we serve is primarily 69% being black or African American, with 23% being Hispanic and white percent, and 7% white.

The top zip codes of adjudicated youth and their associated Chicago neighborhoods is the Auburn Gresham, Ashburn, Washington Heights, Little Village, North Laundale, Austin, Roseland, West Pullman, Pullman, Hyde Park, Greater Grand Crossing, and Woodlawn Area.

Referrals for services are made for adjudicated youth and youth on pretrial services.

Officers made approximately 1,666 referrals to services, and those are services that we capture in our case management system.

The number is greater, but we don't have every agency that we work with in our system as of yet, but we're working on that.

Okay, the types of services that the youth are being referred to include substance abuse, diversion, youth development, community-based programming, mental health services, mentoring, and social emotional services.

Pre-trial services also provide screenings, and so as of 2025, um, they conducted 1,100 screenings and office services to youth and their families.

We also utilize family navigators, and so they also provided engagement with youth and families while in the courthouse.

And so they provided services to 1,194 families, and they also provided 491 youth and families with translation services and made service referrals and linkage to community providers for 1,072 youth and their families.

For behavior health services, um, we have partnered with three providers that provide specialized counseling services, and those providers are infant welfare services.

They provide bilingual individual and family counseling.

Um we also utilize a program called NIAP, which is a national youth advocate program.

They provide intensive home-based services and YOS, with which is youth outreach services, who provide individual group problematic sexual behavior services.

We've also partnered with three private clinicians to provide problematic sexual behavior services, and connection to services are based on providers' capacity, a child's home location, um special needs, language, and other considerations.

House services are utilized.

Judges make um court orders for services as well as probation officers are able to make referrals to behavior health services through our fee for service providers.

All providers utilize licensed clinicians who provide specialized services such as individual counseling, family counseling, and PSB problematic sexual behavior services.

Each provider covers all of Cook County.

The number of participants that we've had in these programs include for KNAI, the KNAI program is under NIAP, and KANI stands for constant and never ending improved programming, and this is one program that they specialize in.

But for the KNI services, they have uh provided services to 40 children with 29 closures as of last year, and those closures were categorized as 22 being successful, seven being unsuccessful.

Infant welfare services provided services to 49 children with 35 closures, 21 being successful closures, seven being administrative closures, and seven unsuccessful.

Youth outreach services provided services to 25 children with 10 closures.

Eight were successful and two were two were administrative closed.

And we also use a specialized forensic unit that provided services to one child that was serviced last year, and private clinicians.

The private clinician service 19 children as of last year with 13 closures.

11 were successful and two were administrative closed.

Now, when we speak in terms of closures, successful and unsuccessful, that is determined by the provider themselves.

And success is generally categorized as consistent attendance from the participant, meeting treatment goals, and recognizing their role in the offense or taking responsibility.

Unsuccessful closures include not attending consistently, despite repeated intervention, making no progress or refusing services, and administrative closes include youth that have not engaged with an advocate or a therapist for over one month.

I mentioned specialized forensic unit.

We have begun utilizing this service, which includes professional staff that have doctoral and master level mental health clinicians, and they conduct treatment and thorough detailed evaluations, specifically tailored to answer referrals, referral questions from the courts, the attorneys, and patients that they may have.

Excuse me.

We utilize them as a last result to conduct psychosexual evaluations due to the clinical team being fluent in Spanish, Russian, and Ukrainian.

Okay, just giving a little more details in terms of what services are being provided through these providers.

Infant welfare services, it includes the following.

They provide services in English and Spanish, individual therapy using CBT techniques, which is cognitive behavioral therapy techniques, family therapy and youth exhibiting sexual behavior problematic behavior, family therapy for youth with traumatic experiences.

Next slide.

National Youth Advocate Program, which is NIAP.

This program is a 26-week program that is strength-based, in home treatment program that teaches youth how to live in and respect the community they call home.

It's an intensive home-based services program that also provides group-based sessions and multidimensional approach to counseling.

Youth outreach services.

They provide MST services, which is multi-systemic therapy for youth with problematic sexual behaviors, and home-based individual and family treatment model.

They also provide problematic sexual behavior, cognitive behavioral therapy treatment model as well, and primarily we utilize them for PSB assessments.

After the assessments are complete, we use our three private clinicians that we have worked with since 2019.

These can clinicians provide weekly problematic sexual behavior therapy virtually.

They've been working with NIAP for years, and they found great success.

And so they've coined the dynamic duo, which is two counselors that's been working on a case that have had great success working with our youth.

They were so impressed that the judge has seen so many great outcomes that they wanted to meet these two counselors as well.

So just to let them know that we value their partnership.

And y'all really did a lot.

You played a big part of my life, even though you all got on my nerves a bit.

But I see it was for the better of me.

I'm still out of trouble, no contact with police whatsoever, and just doing me.

Thank you so much.

So that's just to hear from a few people.

We plan to reach out more to see how services are going.

Something new that we have in our department is we have a new unit, which is called the Quality Care Unit.

They provide follow-up services to providers where they do QA of services, they gather feedback and reviews, analyze outcomes with the goal of vetting better services for our youth to increase successful outcomes.

And that concludes my presentation.

Thank you.

Any questions?

Yes.

You've got two other while you're getting it cued up.

Let's go to our previous item, which we approved 26-1081.

It was approved as a receive and file.

Instead, it should be approved.

So is there a motion to approve item 26-1081?

I moved by Commissioner Vasquez.

Second it twice, but we're gonna we're gonna note McCasco as the second.

All those in favor say aye.

All opposed.

All right, 26-1081 has been approved.

Now we'll return to the presentations for 26-1208 by the Office of the Chief Judge.

Hi, good afternoon.

My name is Kelly Gallavan Ila Rasa, and I'm the director of the problem solving courts for the Circuit Court of Cook County.

And I'm gonna give you a little update on what's been going on in our problem solving courts.

So we have 20 problem solving courts, a really a network spread throughout the county and divided into each of the districts.

The problem solving court network is made up of drug courts, mental health courts, and veterans treatment courts.

We're proud to be uh the host of we have our um a model court, it's dubbed and named uh a mentor court, one of 10 across the nation that um exists over at the Leighton Courthouse.

It's a drug court.

Um, and we have one of the very few um split men's and women's mental health courts as well, those are very unique across the nation.

Um, our courts are uh modeled on best practice standards, and we're over are they overseen by the Illinois Supreme Court, and each of these courts goes through a rigorous recertification process every three years.

All 20 of our courts are um currently in good standing with certification, and the certification process takes a look at all practices, including things like timeliness, how long a case takes from referral to entry to placement and treatment, and each of the team members, one of the things that makes our program so unique is that they're non-adversarial programs, so each of our teams are comprised of a judge, a state's attorney, a public defender, a defense attorney, probation officers, clinical case managers, and a court coordinator.

Every person on that team has to undergo recommended training, and it's verified that they've completed that on a yearly basis.

Um, our programs promote community safety, and really what I want to focus on.

I'm sorry, next slide.

I keep talking.

Um, what I want to focus on is the behavioral health aspect.

So the people in the programs have to have a diagnosed either mental health, substance use, um, or both frequently program uh diagnosis, and with that, each person is sent for an assessment, and then together with the clinical case manager who's skilled and trained, they'll develop an individualized treatment plan.

So it's not a cookie cutter program.

None of our programs, none of our courts are.

Each person has a training, I mean, a treatment plan that's unique to them and their needs.

Um next slide.

So one of the things that we've encountered in the last two years, I'll say, or shift in the administration, is a reduction in funding and services available.

So we've had to be unique and we've pivoted.

And some of the things that we've done is we've brought in team members with some of the skills and training required for some of the train the services that we'd like to provide.

One example is seeking safety that's a trauma program, and we offer that both in an individual and group dynamic.

Um, also, I want to talk a little bit about the partnerships.

So one of the other things we've done to pivot and make up for the reduction in services available is that we've gone back out into the community and looked for other partners to provide these and fill these gaps and services.

Next slide.

One of the things I I really am very proud of as far as our partnerships go is that we've recently established a relationship with the Chicago School, and we have some interns coming on, and they're going to assist with assessments and provide some of those group seeking safety sessions.

We also have a strong partnership with the University of Chicago.

And the University of Chicago has a division called the Office for Military Affiliated Communities.

And in short, they they're um they're named OMAC.

So OLMAC has also filled a number of gaps we find for our veterans.

It could be as simple as a pair of warm boots, a coat, they pay rent, things like that.

It's it's really been wonderful, and it's a gateway too for our vets who are in our programs.

They also can take classes to the University of Chicago.

So that's a tremendous partnership.

As far as community partners, we have both contracted partners and then also people who are in kind partners.

And as I said, it's really been a necessity for our programs and vital to keeping the people in our programs supplied with the services and attention they need and the in the continuum of care.

Next slide.

So I really also oh I'm sorry, back one.

I also wanted to highlight the county partnerships, because that's really important and looking at overlap and resources, right?

We have a very strong partnership also with Cook County Health and Hospitals, and that we have a peer mentor program, and I think I shared with you in the past we've received awards for that.

Um but we have a peer mentor who um provides tremendous care and mentorship to the people in the drug courts.

Um he's very invaluable.

And then we also have a renewed partnership with Cook County Veterans Association, um, and they've attended many of our courts and also are gearing up to provide additional services as far as um housing assistance and things like that in the future.

And lastly, next slide.

I just wanted to share this great picture.

So one of our partnerships is with the quilts of valor.

And when our vet our veterans complete the program, um a volunteer from the quilts of valor comes out and quilts our veterans.

Every vet receives a quilt.

It's really an amazing thing to see.

That's it.

Okay.

Thank you.

We're gonna have one more presentation from the office of the chief judge, and then I'll open it up, commissioners, for uh questions or comments.

Thank you.

Yep.

Oh no, that's us.

Um, good afternoon, everyone.

My name is Jordan Bulger.

Um, I'm the executive assistant for the adult probation department.

It's a pleasure to be here.

Um, I'm joined by Karen Holtzberg behind me.

She's with the social service department.

Uh, we're gonna talk through the partner abuse intervention programming services that are offered uh in collaboration between our two probation departments.

Uh next slide, please.

Um, currently the courts' internal groups are operated by the social service department, so this is a um part of their budget.

They have staff dedicated to providing these partner of use uh intervention programming groups.

Um they use two different curricula uh based on best practices in domestic violence interventions.

Um the first is based on the Duluth model, uh which is one of the more common, uh more well-known uh best practices.

Uh the second is based on cognitive behavioral interventions, so changing the way people think um before they act.

Uh the groups that we run internally run for 25 weeks, uh, which is very common with these types of interventions.

Um we have the internal groups that are run, and those are typically used for individuals who um are indigent or they cannot afford to pay the sliding scale fees that are required from some of our external partners.

Uh we also have six uh community-based partners that we contract with who the adult probation department can subsidize uh the uh fee for those individuals if it comes down to um uh a choice of not being able to run the groups because they can't afford them.

Uh the adult probation department can subsidize those groups.

Um we're trying to make sure that cost is not a barrier when you're trying to participate in something that is court ordered.

Um I'm gonna pass it to Karen real quick to talk about what the groups are doing, um, and then I'll talk about the numbers after that.

Good afternoon, everybody.

Thank you, commissioners, for the opportunity to speak with you today.

My name is Karen Holtzberg, and I'm a supervisor with the Social Service Department under the office of the chief judge.

I've dedicated over 25 years to domestic violence services, serving first as a casework officer, and for the past 12 years as a supervisor.

Uh Jordan mentioned that there are You have to go back one.

Uh there are two um distinct modalities that we are offering in our partner abuse intervention program.

Jordan mentioned them briefly.

We have the Duluth model and cognitive behavioral interventions.

Our Duluth model uh focuses on victim safety, power and control dynamics, and shifting core belief systems.

Our cognitive behavioral intervention focuses on restructuring unhelpful thought patterns and developing healthy coping and communication skills while targeting emotion regulation.

Uh, if we compare and contrast both of the models, Duluth views violence as a choice used by perpetrators to dominate.

Accountability focuses on responsibility and rejects excuses by challenging male privilege, power, and control.

Our cognitive behavioral model views violence as a learned behavior influenced by dysfunctional thinking, trauma and emotion regulation issues, and accountability here is learning to take 100% ownership of your distorted thoughts and any actions that follow.

Both models promote skill building.

Duluth builds interpersonal skills to help participants learn how to share power and build equal partnerships.

Cognitive behavioral builds on intra-personal skills, giving participants psychological and behavioral tools to manage their minds, cool their nervous system down.

So we're talking about emotion identification, timeouts, cognitive restructuring, and it's easy for us to say when we're in group, stop looking out the window.

It's time for you to look in the mirror.

Philosophy and goals of our program.

Violence is about power and control.

We know that it is a learned behavior.

We know that it is a choice, not a reflex.

It is the sole responsibility of the person exhibiting the behavior.

Our goals of the program, we want to examine and understand behavior.

We want to identify problem areas, and we are most certainly working towards behavior change.

One of the things that we love to do is share success stories.

He shared participant resistance, not wanting to be in group.

He attended because he had to follow a domestic violence conviction.

Within the first few weeks, he openly expressed deeply negative beliefs about women.

He blamed his partner and her family for everything and stated that he hated women because he'd never been treated well by one ever.

Like many participants entering our program, he was focused on what others had done to him rather than examining his own choices and behavior.

Facilitators worked to better understand the experiences, beliefs, and emotions that shaped Dexter's worldview while maintaining a clear focus on accountability and victim safety.

Through active listening, reflective questioning, and structured group interventions.

They encouraged him to examine the connection between his feelings and his behaviors.

Over time, Dexter disclosed that he was not raised by his biological mother and felt uncared for by the family who took him in as a kid.

He struggled with feelings of abandonment and rejection, as well as depression, suicidal ideation, homelessness, and financial hardship.

Throughout this process, facilitators remained focused on both victim safety and participant accountability while supporting his engagement in group.

And what we know is anger management is not a primary focus of our partner abuse intervention programming, understanding anger as an emotion is.

During one session, facilitators introduced the anger iceberg, which is an exercise that teaches participants that anger is often the emotion visible on the surface, while deeper emotions exist underneath and influence behavior.

Participants learn to identify other feelings such as fear, hurt, and sadness.

And to recognize how those emotions can reshape their reactions and relationships.

This is where we were able to like dial Dexter in.

This was his turning point.

He knew he was angry, but while he was in group, he began to recognize that his anger was rooted in much older wounds.

For the first time, he connected his current behavior to a childhood marked by caregiver instability, neglect, and unresolved emotional pain.

He began to understand that while those experiences influenced him, they did not at all excuse the violence that brought him into the program.

As Dexter developed greater self-awareness, he also began making meaningful changes outside of group.

His communication with his partner improved, and facilitators observed a noticeable shift in how we spoke about women and relationships.

Rather than viewing himself solely as a victim of others' actions, he became increasingly willing to examine his own choices and accept responsibility for them.

By the end of the program, Dexter had re-engaged in mental health treatment, returned to therapy, resumed taking his medication, and literally secured full-time work.

His self-esteem improved, his mental health stabilized, and his relationships became healthier and more respectful.

The young man who entered our programming, blaming women for his problems, completed the program successfully with a greater understanding of his own responsibilities, healthier communication skills, and a renewed commitment to building respectful relationships.

His story demonstrates that a meaningful change is possible when accountability is paired with trauma informed and evidence-based intervention.

Thank you.

Thank you.

All right, so I get to follow that with the cold hard numbers.

Um in our case, um, with the internal groups that we run over the last fiscal year, so fiscal year 25, um, the internal partner abuse intervention groups completed 224 intakes, so that's people coming in to the programs.

Um, that's up 30% from where we were in fiscal year 2024.

So we're seeing some increased capacity, which is great.

Um, the groups also served 613 people during uh FY25, and that's up significantly of 52% compared to FY24.

So again, we're seeing um increased uh uptake from um where we were in previous fiscal years coming out of COVID.

Uh and overall, we had 316 group sessions completed, uh, which is also up again 30 percent from where we were in fiscal year 2024.

Um, so we're seeing uh the groups at social service kind of hit their stride with um getting clients intake um and through the groups.

Next slide, please.

Um, and then the last piece that we have is just some selected outcomes.

Um, so during this uh fiscal year 2025 period, there were 150 participants who were discharged from the groups.

70 of those or about 47 percent were satisfactory completions, meaning they um completed all the terms of the partner abuse intervention programming.

Um, 80 were unsuccessful, uh meaning they dropped out at some point, or they did not complete um the requirements for the group.

Um, we also look at supervision outcomes.

So, this is uh for the people who are on probation or conditional discharge, what their probation outcomes look like, because that's something that the board has expressed interest in in the past.

Um, so during the fiscal year, there were 533 people who had a special condition of participating in these groups who uh finished their probation.

So of those 533, 60 percent successfully completed probation or conditional discharge, so that's um a pretty solid rate.

Um, and then separately, we've seen that about 44 percent of those whose uh cases were closed successfully completed all of their conditions, which if you've ever seen the conditions of probation, there are a lot of them.

It can be very challenging to work through those.

Uh so we're seeing some good support that the folks going through the program um are getting so that they can work towards completing their probation conditions.

Um so in general, we're seeing uh that the folks who go into the partner abuse intervention programs um are making use of the services and they're completing their probation terms successfully.

And that's it for us.

Commissioner McCaskill.

Thank you, Chair.

I had just a couple questions.

So the numbers are really good, and thank you for the very thorough report across all of the um reports that have taken place thus far.

With regard to how the um youth specifically are being brought in, is there any alignment with DCFS and their adjudication process just to make sure we're a little bit more proactive versus reactive?

Alignment with DCFS.

Um we work with DCFS, you know, for cases that um that are dually involved, but every case does not have a DCFS work attached to it.

Now, in those cases that are overlapping or braiding, are those cases followed through until maturity?

So those kids are adjudicated at 18, but they have a record under their DCFS case.

Once they are adjudicated, do you follow them to 25, 26?

Like 21.

Just to 21.

Yes.

Okay.

And then with regard to um.

Also, that was I think you answered my question with that.

When I was going to ask with regard to that number, did how many of those kids actually represent it?

Maybe a dual case.

Do you know?

I don't have that in front of me, but I can get there for you.

And then with problem-solving courts, do people have the opportunity to um refer themselves or asked to be placed in those particular court settings?

Yeah, great question.

Actually, they can self-identify or their attorneys can refer them, a family member can refer them.

A lot of times they're caught at first appearance.

If a person appears in in first appearance court and they seem to have some mental health, behavioral health issue, then right away they'll get flagged, and we try to get them in as soon as possible.

Okay, thank you again for the thorough reports.

Chairman Daly.

Thank you, Mr.

Chairman.

Let me thank you for your presentations.

Um I was had stepped out of the room, and I know we're we have a number of presentations today on this this topic and serious topic.

Um, and by the way, I have attended some of the graduations, they're a great rewarding event to attend.

But as we look forward, um it I might main issue concern would be is there are any duplication, and can we cover what how how can we help each other in the individual the state's attorney, the chief judge?

And uh, are there areas that you're covering that also the state's attorney does or the sheriff but how how we could improve our current reporting, or are the guidelines separate for each individual office?

I know as we look forward to the budget, this will come up probably.

And I think there's very good cooperation now with the individual office as a parent uh on the this reporting.

Um that's a the concern I give as we look forward because as we address future budgets, it's going to be very tight.

Thank you.

Yes, Commissioner Vasquez.

Thank you, Chair.

Um, I had a follow-up question to my colleague, Commissioner McCaskill's um question around um self-identification.

So with first appearance court, you mentioned that if an individual is exhibiting some kind of um I guess um mental health um I'm not a mental health practitioner, so I don't quite know the verbiage to use.

Um who is identifying that perhaps besides the attorney, is there another staff person that you know is mentioning perhaps this individual would qualify for some kind of diversion?

Actually, sometimes it's even the judges.

The judges could say, you know, this this person is going to this next court for that next appearance, but they might be a good candidate for the problem solving courts, and that starts the referral process.

Okay.

So it's not uh necessarily a specific individual that would be the person tasked to refer anybody could be a state's attorney program, but the standards we kind of blew that out of the water so that anybody could make that referral or identify.

But I should I should have I neglected to mention that the problem solving courts are really um targeted to people who are repeat offenders.

So these are people that have had significant history um nonviolent, but it's you know they're more than likely on their second, third felony, if not more.

Um so they're known to the court.

I see.

That's helpful.

Thank you so much.

Okay.

So there's a motion on the floor to receive and file item 26-1208.

All those in favor say aye.

All opposed.

Opinion of the chair, the ayes have it.

Thank you for the presentations.

Commissioner Vasquez now moves to receive and foul item 26-1270, the annual behavioral health report prepared by CCH for the period, December 1st, 2024 through November 30th, 2025, seconded by Commissioner Trevor.

We'll now have a presentation by Dr.

Nutter.

Come on up.

It's moved by Commissioner Vasquez.

Seconder is Commissioner Trevor.

This is this is to receive and file.

Yep.

Commercial.

All right.

Thank you.

Good afternoon, Commissioners, and uh thank you for this opportunity to uh present our annual report.

Uh next slide, please.

I believe you should have all received uh copies uh not only of the of today's slides but also of the full report.

Uh one note about the full report.

Uh since the Office of Behavioral Health doesn't directly provide, essentially doesn't directly provide uh clinical services, there's not an OBH section in the report, uh though our work will be included in this presentation.

Uh next slide, please.

Speaking of the Office of Behavioral Health, uh we are grateful for the support of uh each of the commissioners and for the uh president's office uh and not only um supporting uh our office but having created us in the first place.

Uh we were created uh as you likely know in 2022 uh with really uh of a uh mission to serve two functions.

One is to try to improve and enhance clinical services throughout CCH's systems of care, and the second, and and perhaps slightly more ambitious, uh to improve the behavioral health ecosystem uh countywide.

Uh our current leadership on boarded uh over the summer of 2023 into January of 2024.

Uh at that time we were uh our office was uh seeded by American Record Rescue Plan Act funds, and our first task was to obligate those funds by the end of FY24 in order to assure ensure optimal stewardship of those funds and to maximize public health benefit.

More than 60 percent of those dollars uh were awarded through a competitive process, the stronger together grants, uh and these were awarded to more than 50 community partners providing care uh mostly in disinvested communities.

Uh higher SVI scores were part of the uh uh uh social vulnerability index, I should expect uh per previous conversation.

Uh provide all acronyms uh to ensure uh equity uh and uh awarding into disinvested communities.

Uh while uh working on stronger together, uh concomitantly our office began gathering data from hundreds of community partners and uh uh to create uh the first regional behavioral health strategic plan for Cook County that was released back in May of this of 2025, uh and that provides a common blueprint for all organizations delivering behavioral health services uh throughout the county.

Um all commissioners should have received both uh a copy of the annual report detailing the work of our stronger together partners as well as an annual report uh on the status of implementation of the regional behavioral health strategic plan.

I realize this is could be a little bit of information information overload.

I think we've sent you over 200 pages of documents over the past few weeks.

Um all the information.

Uh and we will try to keep this at a high level today, uh summarizing those 200 pages in uh I think 11 slides of uh content.

Uh also want to mention a number of you attended the uh first behavioral health summit, which was a day of structured listening back in 2024.

Summit 2026, uh driving action to impact, uh, has a date set that that is Wednesday, September the 9th.

Uh you are all uh invited and hope to see many of you there if you can make it.

Next slide, please.

Regarding stronger together, and uh these are the um impacts as of um the end of fiscal year 25.

Uh more than 70,000 residents have been reached, more than 20,000 have been connected to care, and nearly uh 11,000 have demonstrated quantify quantifiably improved outcomes.

That doesn't mean that only 11,000 people have benefited.

Uh simply that uh some projects, uh those with uh pre and post-intervention um uh uh assessments uh are more likely to to be uh demonstrate those quantitative results.

But the impact in terms of the number of lives impacted is certainly significantly greater than that.

Uh to get a uh full sense of the uh of the projects and the and the impact on the area on the regions that you serve.

Uh we recommend uh looking at the uh one pagers uh for each organization that are in the stronger together reports, and at the same time we sent that, we sent um uh a listing of which projects are in which commissioner district.

So as you have questions about that either today or going forward, we are happy to uh address those.

Regarding the NAMI Chicago hotline, um obviously uh we're still in uh what is a behavioral health crisis.

Access is still a major issue, particularly in uh disinvested communities, and so to have a front door that is staffed by folks with a broad database of of hundreds of local organizations providing mental health care, and that's staffed by by folks who have at least a bachelor's degree in social work, uh, are specially trained and can really help folks to navigate the system at a really vulnerable time is uh is critical, and the fact that our partners at NAMI Chicago are also a 988 provider uh is an added benefit.

Um they fielded almost 9,000 calls in 2025, and between uh calls, texts and chats are likely to serve significantly more than that in 2026.

Next slide, please.

I want to say just a little bit about the um regional behavioral health strategic plan implementation update.

Uh again, this was uh created uh or released, I should say, in May of 2025.

And so this is the this is just uh where things stand after the first eight months.

Um I think the theme here is uh gaining momentum and traction uh with uh long way to go over the next two and a half years.

Um the first thing I'd like to high highlight in priority area one is the regional behavioral health collaboratives.

We believe that this is foundational uh to the work that we're gonna be doing, not only the work that we're doing not only now but in the future.

Uh the idea is to divide the county into 11 uh regional uh groups that not only can provide us feedback but can really be um responsible for hyperlocal implementation.

That process gone process has gone uh quite well.

Already all 11 um collaboratives have established charters, elected co-chairs and strategic leads, each has developed an action plan.

Uh we think they're well on their way to that role in being hyper-local uh uh in hyperlocal implementation and information sharing.

Uh this month is the in-person uh meetings for those groups, and there were three last week.

I'm told those went very well with uh quite a bit of enthusiasm.

Uh and folks wanted to meet more than once a year in person, so uh you may hear more about that in uh in the coming days.

And given all of the uh initiatives that are taking place across governmental agencies, we felt like it was important to uh convene an intergovernmental group uh at least once a quarter.

And so not only the groups that you're hearing from this afternoon from county, but also uh the Chicago Department of Public Health and several state agencies uh have been meeting.

This has been going on for more than a year, and we think that process uh is uh foundational and going well.

Regarding uh workforce development, there have been a number of uh initiatives.

Um there are a number of initiatives underway.

I want to particularly highlight uh the behavioral health uh apprenticeship and retention hub.

Um Dr.

Brothers, who who is here today, has been something of a miracle worker in this regard.

We had a grant deadline last year, and within a few days, she had pulled together uh something like 20 local agencies that are providing services and uh potentially uh training staff, uh five local institutions of higher learning, and um already the first two cohorts, one of CADCs uh certified alcohol and drug and drug counselors uh and uh certified peer recovery specialists uh have um already started in 2026.

Uh as funding grows, we anticipate that those programs will grow uh considerably.

Uh under priority area three, behavioral health services for children, youth, and families.

I would again highlight the work of the stronger together grantees uh in uh in meeting those needs, increasing screenings uh and improving access.

Uh under priority four, I mentioned the uh NAMI helpline.

I did not mention uh all the opioid uh death reduction efforts that our office and lots of other offices have undertaken in recent years.

Um the 2025 uh statistics have not been finalized, and though no one wants to report that um uh around 750 um uh Cook County residents died of opioid overdoses in the last year.

So it's been more than a 60 percent reduction uh during that time, and those efforts obviously will continue.

Lastly, with uh uh regard to crisis system enhancement, we've been collaborating with state uh and as well as local agencies to increase system capacity, improve coordinate coordination, and increase public awareness.

And with that, I will uh uh yield the floor to uh Dr.

Joshi.

Thanks so much, uh Dr.

Nutter.

Always a pleasure to be here.

In partnership with you and your your wonderful team.

Um just wanted to briefly share some updates about uh our work in the mental health and substance use space.

Um you can see some top level.

Uh next slide, please.

Thank you.

Um you can see some top level numbers um across the top there with 44,000 individuals served uh in FY25.

Uh and that is uh through the incredibly hard work of the uh 31 community-based partners uh that we're funding.

Um also want to lift up our work in the naloxone distribution space uh with uh 22,000 doses um of naloxone distributed by CCDPH and our partners.

Um we do a lot of work internally inside uh COC County Health as well uh with respect to uh advancing trauma informed care specifically, and have trained uh nearly a thousand staff um at this stage.

Um looking forward to continuing that effort and uh reaching that ever elusive 100 percent.

Um some key highlights below, and I'm just gonna touch on a few here.

Um you're uh I think well aware of some of the reports that we've released this past year, including the crisis system uh assessment or report focused on suicide, uh very proud of that work as it was really responsive to uh requests from the Proviso Township community, which we then broadened to um an assessment of suicide across suburban Cook County.

Um you heard me talk about our community naloxone program.

Um I'm um uh thankful that 24 uh doses that we've distributed were used in an overdose event uh in suburban Cook County over the course of uh 2025.

Um we do think that that is an underestimate.

Um some additional work that's happening here, uh, but I'm gonna now turn it back over to uh my colleague Dr.

Nutter to speak to additional activities that are happening across ECH.

Thank you.

Thanks, Dr.

Joshi.

Uh and on to uh the clinical services.

So next slide, please.

And again, I will try.

Oh, next slide that that's uh thank you.

Um I think the story for uh from our for regarding our services at the jail this year has been that volume remains high, and we continue to see over 40 percent of the uh of the detainees uh within uh Cook County jail.

So that means that uh CCH staff see around uh 2500 uh folks and uh I think their story for 2025 has been hiring both who and how many they've hired.

Um both uh uh Dr.

Bednar's uh our new chief psychiatrist and uh Dr.

Trernan Hughes, who is here today, uh our new mental health director, uh, have been added fairly recently, and both have done uh absolutely outstanding work.

Uh and part of that work has been reducing the vacancy rate from 40 percent down to 10 percent.

Uh you heard that correct.

That is 40 percent down to 10 percent.

Um, and uh Mr.

Strada deserves a lot of credit for that in reclassing a lot of positions so that there would be more uh frontline openings as well as promotional opportunities.

Um not surprisingly with the increase in staffing, uh that's led to an increase in clinical activity.

It's also led to expanded uh therapeutic programming uh through a therapeutic tier in Division IX, that's the maximum security division, uh, and uh a similar unit uh in the RTU, soon to be a third unit.

Um the work of the psychiatrist uh continues to um uh be bolstered by the higher numbers, including uh more patients uh receiving uh orders for involuntary medication.

Uh and lastly, the uh uh the jail maintains uh NCCHC accreditation.

I think the their next upcoming visit is coming soon.

Uh and um they are hoping to also get NCCHC accreditation next year for mental health specifically, and uh in having an opioid treatment program, NCCHC accreditation and NCCHC mental health accreditation, they would be one of the few jails I believe in the nation to have the trifecta should they uh uh accomplish that next year.

Uh next slide, please.

With regard to external reviews, uh uh JTDC has also uh done well.

Uh they are also NCCHC accredited uh and were reviewed uh recently by the administrative office of the Illinois courts and um exceeded um uh state requirements.

Uh I think the story for JTDC uh having visited there last week is that uh they uh understand that of the youth uh detained in JTDC, somewhere around 90 percent are have been victims of trauma.

And so uh you know, everyone talks about being trauma informed.

Uh these are folks who are who are treating the trauma actively through evidence-based interventions, uh trauma-focused uh cognitive behavior therapy, the Sparks program that's been in place for a long time.

And then last year they added uh, or two years ago, I believe, they added hip hop heels to that mix as well.

Uh they continue to do outstanding work.

They had some hiring challenges in 2024 and are um have been rallying in 2025.

I believe they now only have uh five vacancies and uh two with two psychologists soon to on board.

Um also want to highlight that uh there was an external evaluation of the juvenile justice care coordination program in 2025, demonstrating that the recidism rate in in uh among youth in that program was three times uh lower uh than uh in a comparison group.

Uh so we're very proud of that result.

Uh uh all mental health staff not only uh are involved in screening, all youth coming in, uh daily rounds are done on all the pods.

Uh our staff run groups uh and continue to expand availability of individual therapy as well.

We hope to continue that expansion uh in years to come.

Uh next slide, please.

Uh this is uh the Department of Psychiatry, and I'm including uh the uh including ambulatory integrated behavioral health and social work.

Uh these are the bread and butter services of um of outpatient and inpatient care in our system.

So you'll see high numbers of uh visits.

Um I am also proud to report that hiring for both social work and psych and psychology has improved significantly.

Uh and social work has now a structured career pathway uh to develop um uh folks into uh the the uh their fullest license.

So uh LC LSWs and MSWs becoming L CSWs and um LPCs uh to LCPCs.

Um the uh psychology folks have um improved their workflow and are now integrated into five specialty care clinics um throughout the uh throughout the system.

Um psychiatry continues to struggle a bit with with hiring.

Uh we have uh five vacancies at present and we're hoping to uh have better results in the year to come.

Uh next slide, please.

I want to highlight uh I don't believe we've done so in the past, uh, Cook County's HIV integrated programs, and to someone who's still relatively new to the system, uh, it is impressive the no the scope of the of the work that goes on at core and in the HIV integrated programs.

Um there's a statistic on on this slide that more than half uh the people living with HIV in Cook County are served in some ways by by this program.

Uh that is again that's a uh an accurate statistic.

More than half of the folks in within Cook County.

Um they've done amazing work since uh since the time of the AIDS epidemic.

Some of you aren't old enough to remember that, but uh those of us who are remember the abject terror uh that was associated with that, and so um the role of CORE is something that CCH is particularly proud of.

We're also very proud of the work that Dr.

Smith, uh, who is here with us today, has done in building her program, which had largely been staffed by HECTON uh agency staff.

Uh at one point when she started, I believe there were only two people in her uh in her office.

She's now up to 10 serving eight sites.

They now are able to run 15 groups a week uh and are able to not only run uh outpatient mental health programs but also outpatient substance use programs, uh including an IOP uh an IOP program.

Uh very grateful for that work.

Uh next slide, please.

Also very grateful for the work of our um trauma recovery and injury injury prevention team, uh TRIP, formerly known as Healing Hurt People.

Um this is a uh nationally outstanding program.

Essentially it's it's ground zero uh for those impacted by violence in our communities.

Uh this is work that's not for everybody, uh, but the team that does this work is uh nothing short of amazing.

Uh Andy Wheeler, who is the director of that program, is here with us today.

Um recently had a visit from the American College of Surgeons, uh, which cited that work as being exemplary and commented that it is the nation's only such division in an academic department that that could serve as a national model for other trauma centers.

Essentially, these are these are folks who are embedded in the trauma bay in in the emergency room, meeting people in the worst day of their life and then following with them for for months.

Um they offer assessment, first aid counseling, bereavement support, uh the uh house of hospital-based violence intervention program.

They recently received a grant from Kaiser Premanene to Scotty to study the effects of gun violence on women.

Uh and as of uh I believe last week, uh they're now able to bill for some services, which was not able, which was not the case in the past, uh, assuring um uh enhanced sustainability for for this incredibly valuable program for the future.

Uh the last program I would highlight uh is uh are our substance use disorder uh services.

Uh this is the one entity that is probably best integrated across all CCH sites uh run by uh Dr.

Nawinski Konchak uh and Ms.

Elder.

Um their highlights for 2025 including include adding um uh an addiction team uh to the inpatient service.

Uh they call that our DART team, the drug and alcohol recovery team, uh, and they are already seeing uh quite a few patients, um uh 163 as of um uh per quarter as of late 2025.

That number continues to grow.

Uh also continuing to grow is the opioid treatment program at Austin Health Center run jointly with family guidance.

Um very proud of that, and also proud that their retention rates uh at 90 days are significantly higher than national averages.

Uh they also had uh four managers in within their program successfully complete CCH's frontline leadership academy and Commissioner Lowry, uh grateful for your uh help with this, presented at that graduation ceremony back in April.

Uh last slide, please.

Uh next slide.

Thank you.

Uh so again, in conclusion, um OBH grantees, CCH clinical staff uh continue to deliver critical behavioral health services across the region, particularly in disinvested communities.

Uh implementation of the regional behavioral health strategic plan is underway and gaining traction day by day.

Our office, as well as our colleagues at CCDB, CCDPH plan to continue to expand our roles as conveners and coordinators, serving alongside hundreds and hundreds of community partners to improve the behavioral health landscape of the Cook County region.

Our behavioral health council is also working to optimize coordination across all C CH sites, uh providing services uh to enhance both quality assurance and quality improvement processes.

Uh we are grateful for your support, and we'll see you at the summit in September.

Thank you.

Thank you.

Commissioner Stamps.

Good afternoon, Chair, and good afternoon, Dr.

Nutter.

I have a few questions.

You mentioned that there were five vacancies or psychiatric vacancies.

I wanted to know how is that uh vacancies impacting service.

Uh you mean the that you're referring to the there were five vacancies at JTDC and five vacancies among psychiatrists.

You're referring to the latter.

Mm-hmm.

Yes.

Um it's it's very striking coming to CCH with all that Cook County Health does.

And and Cook County Health, uh, Dr.

McKay has presented a slide recently showing uh where uh care is provided for those uh without insurance.

And among the 60 hospitals in Chicago, uh there was something like uh 40 percent of that volume goes to CCH.

Uh so it's a uh it's a high volume system.

And to come into a system like that uh from where I was uh was before at Heinz, where there are 40 plus FTE psychiatrists, and find out that we have 12 point 12.25 FTE and it's only seven staff.

Um they're working hard, they have a very good team, um, but it is a significantly limiting factor in terms of not only the number of patients we can see, but how how much programs can grow.

Uh I'm happy to report that we we had a four year, I'm not happy to report that there was a four-year stretch of not being able to hire any uh psychiatrists.

Uh that has been uh improved in the last couple years, in which three additional hires have been made.

Um but we've also had three losses in that time.

So we've kind of slowed the slowed the the um the overall loss of FTE, but we've still had significant challenges and it is a significant impediment to the work.

If we have one need across the system uh in the next year to address, it would be trying to add more psychiatrists.

Yes, um I'd imagine so I so to what effort um are you putting behind that?

I know that um last year when the American Council of Doctors, I don't I'm I'm saying the name incorrectly, but it's the this the group of African American um physicians held a conference here, and no one from Cook County Health and Hospitals attended as a vendor to recruit um doctors from that.

So what changes are you all making in that effort so that we can eliminate those vacancies?

For not only retention of folks who interview with us, but to try to build the reputation of Cook County Health as an employer.

Uh because I I don't believe that we've been a um we've had the strongest reputation among uh psychiatry departments uh citywide, although we have an excellent staff now.

Um to summarize the answer to your question, it's that we haven't done enough yet.

Uh and uh I am looking forward to working alongside the chair to try to improve that in the next year.

Okay.

So you mentioned one of the departments have reduced their vacancies from 40 percent to 10 percent.

How did they do that?

Well, uh Manny, if you'd like to address that, feel free.

And are you are are you in communication with them to see how they reduce their numbers uh short answer is yes.

Uh Manny, you can come up to the answer.

But um most of the staff he's been uh hiring have been frontline staff rather than um physician, frontline staff, so it's a little it's the recruitment efforts are a little different.

Uh but they've also had more success in recruiting psychiatrists than has been the case uh through the rest of CCH.

So and I do meet with Dr.

Bednar's regularly, uh, who is the new um medical direct uh psychiatry director there.

Uh and uh Go ahead, Manny.

Good afternoon.

Manny Estrada, Chief Operating Officer for CERMEC Health Services.

I wish I could take all the credit for the hiring that we did.

I I was uh advocating and leading the group that we had at CERMAC.

We do have a recent onboarding of Dr.

Bednar's and Dr.

Hughes with which is here with us now uh that have done a tremendous amount of work on um on working on getting our folks done.

I think Dr.

Dunder did a tremendous job in explaining some of the aspects of it.

I can honestly speak for CERMAC that reputationally we're in a different place than we've been in the past.

We're a place now where people actively are wanting to come work with us.

Uh we're innovative in what we do.

Um we do some of the groundwork.

Uh Dr.

Bednar had has uh a network established.

Uh he's been in the field for many years, and he's gone out to the schools, he's gone out to the colleagues, he's gone out to the networks, as has Dr.

Hughes.

Not only has psychiatry been decreased to zero vacancies, but psychology has been decreased to zero vacancies.

Uh so those efforts in combination again, repute from a reputation perspective, we're we're a place that people want to come to.

Um I believe that gradually that in alignment with some of the work that's being done with loan repayment uh because of the advocacy we've had at the federal level from uh some of our uh elected officials, we're looking to now being able to uh have that as a selling point for our positions.

Formerly, we weren't able to have loan repayment for our our clinical positions.

Um there's been a change in uh legislation that is now gonna allow us to do that, and that will also be a recruitment tool that we have for the professional staff that we have in in the environments that we work in.

Um I'll be happy to answer any other questions you may have, but it's been a lot of work coming.

Well, thank you for that.

I'm just curious that you've been successful in securing psychiatrists.

Behavior health has not been successful in securing psychiatrists.

How how do we change that?

How do we inculcate some of your practices on the other end of this you know, behavior health community so that we can have improved outcomes relative to hiring and um maintaining employees?

Um this may be a little more bit more behind the curtain than didn't you want me to go, but uh I do think we've had a lot of successes in hiring across disciplines with the and and psychiatry really is the exception to this.

I would say psychiatry is probably the most challenging.

And the other thing that's gone on in the last uh couple of years within the Department of Psychiatry, and keep in mind this hiring is done through the Department of Psychiatry, our office oversees an influences and uh but the hiring is actually done by uh psychiatry and the uh chief of psychiatry uh fell ill in uh in late March of uh 2025, actually passed away in uh early January of 2026.

Uh and during that time, the interim chair uh has kept, because he's uh the only Spanish-speaking psychiatrist we have, has been uh ensconstant almost full-time clinical work for most of that time.

So his ability to step back and say, what do we need to do as uh as a recruiter has been uh a bit limited.

Uh that is changing uh at present we're um uh in the process, uh the chief medical officer is of hiring uh the new chair, and so we'll be working closely alongside the the uh new chair uh who will likely be named in the next month or so uh to try to remedy this.

And uh there's certainly a lot uh a lot to this.

Uh I will say in my uh previous role uh at Heinz, we probably hired more than 30 psychiatrists over the time that I was there.

So I I think we have uh some experience to draw upon.

I think we know a little bit about the local um uh hiring market and can do better going forward, but it has been certainly uh a problem.

I have a few more questions share.

In one of the earlier slides, it was right after you you spoke about um the calls being staffed by social workers.

You says there have been a substantially declined.

Um and I'm sorry because I didn't write down everything, but I was just like based on what there was a substantial decline.

Uh I may have mumbled something.

I'm not sure what let me look back on that slide.

It was it was like the second or third.

Yeah, I'll look back slide.

Give me a sec.

I may have misspoken because the the the helpline itself has been expanding.

Uh so now that they served uh around eighty eighty, eight hundred folks in 2025.

That number will certainly be higher in 2026.

Uh in May, they almost got to a thousand calls, uh texts and chats.

Uh so I don't know that there was a um decline in there.

That may have just been me misspeaking.

So that's probably on me.

And then I'll I'll email you so that I can get some clarity on it.

I was just curious.

Um uh I know that there have been some cuts to HIV uh mids on the Federal level.

How is that or what is the impact that that's having on the HIV population that we care for?

Dr.

Smith, do you feel comfortable commenting on that?

Uh that's a little bit beyond your scope, I know, but uh do you uh do the patients that you serve is there anything that you'd want to you'd want to say on on that particular topic?

I don't know a whole lot about that, so I I'd have to.

Am I mistaken?

Was that not a part of the presentation?

Am I confusing presentations?

Um Dr.

Smith runs the behavioral health uh services for the uh uh for the core center and and and HIV services, but those those are behavioral health specific and mostly therapy.

Those are behavioral.

Okay, okay.

So no, no, no, no, no.

Not the HIV meds themselves.

That's okay, because then I'm in somebody else's lane, and I just know that in my mind, I know that there's been a lot of talk around the cut to HIV mids.

And so that may not you may not be in an understanding of the same.

Well, it's been a long time since I've uh since I've been the first time.

It's okay.

That's all right because that's the same thing.

My internship was a long time ago.

Um you also mentioned quantifiable outcomes.

Can you talk a little bit more about what are quantifiable outcomes?

Well, what I meant by that is that uh there are certain programs uh among the stronger together grantees like uh Esperanza, which is an FQHC, or the new mom's program or Sister AFIA, where they in which they've done pre and post-intervention surveys and can demonstrate that before the intervention the score was X, and after the intervention the score was Y, demonstrating a clear improvement in outcomes, either in terms of um uh per a patient's sense of uh of the ability to handle a certain situation or reduction in symptoms, something like that.

Whereas other programs, uh and a good example would be uh La Rabita's program, which they had uh school liaison family advocates, and one of their outcome measures, all the all the stronger together uh programs have metrics, but uh one of their metrics has been getting more students uh individual educ individualized education plans, and uh which is a great goal, and as you know, as an educator, something that's likely to be quite helpful to a student, but that's not that's not the same as having a pre and post-evaluation of that individual student showing that they had improved grades or improved uh or reduced depression, something like that.

Similarly, uh Alianza uh is a group that has been involved in the Latin American immigrant community uh providing monthly work groups, social media campaigns, uh mental health first aid kind of trainings, uh and so while they've impacted hundreds and hundreds of people, likely thousands of people, at a time that's been particularly important given all the events of of last year, uh there hasn't necessarily been a group for whom they could say pre-implementation their scores on a depression scale were this, and post uh the intervention uh they were something else.

So that's what I mean.

That some things are more easily quantified than others, but some of the things that aren't quantifiable may be highly, highly value valuable to uh to uh not only a few individuals but to uh hundreds.

And then how then do you capture that information?

Uh there are uh each each awardee uh in conjunction with our team uh with Dr.

Brothers' team uh crafted metrics for each project, and those are tracked uh monthly or quarterly.

I believe most of them are monthly now.

Um so there are for each of the 50, probably five or six, so probably 300 metrics in all tracked in in Gov grants and reviewed with with our team uh to make sure that they're not just saying they're doing good work, but demonstrating in some quantifiable way that they're doing good work.

It's just that some things more uh are more easily measurable in direct individual uh outcomes than others.

So that was a long long-winded way of saying something that was probably fairly simple.

Okay.

I'm just curious as to the ratio of clinicians to detainees and what is the ethnic composition of the of the clinical staff that's seeing the detainees.

Well, that's certainly been an issue at JTDC and something that Dr.

Conan has been trying to address in recent years.

I don't know the specific ratios.

Uh and I you I don't know if you want to comment on the ratios with the chair.

We do have a uh um uh different ethnicities that are representing in our staff.

We have Spanish speakers, uh Latinos, we have uh um if you can help me with this, Dr.

Hughes, we do have uh uh African American uh clinicians, we do have uh Caucasian clinicians, we have a variety uh varied throughout.

Uh some of the most recent hires that we've had have been both the Spanish speaking psychiatrists uh uh both of Latino uh ethnicity.

So it's varied.

Okay, I was just curious as to if there's uh the cultural competency aspect of the clinicians that are seeing detainees that we know are overwhelmingly African American, um, and then secondarily, Latino, uh what the correlation uh might be there.

Um thank you for that.

Oh, lastly, um there was a mention of the naloxone.

Um and I don't know if this is the same thing.

It might be be similar to the other question, but again, I'm just curious about um with funding challenges, uh do we see that impacting the the positive um impact having access to noxinone in various communities?

Are we in danger of that?

And then you know, I'm always curious, and again, correct me if I'm wrong, um, about what are what what are we doing for the next steps?

So you prevent the overdose, what are we doing to wean people off the drugs rather than to just oh I don't know, treat the problem and prevent overdose, but I'm not seeing any conversation that we're having about care about how we're getting people uh weaned, whether it's the methadone or or the opioids, like I hear oftentimes when we're talking about this, I hear that you know we're being very not preventive, but we're preventing deaths.

Yes.

With nalaxalone.

I'm interested in what we're doing to improve the quality of life and get people off the drugs themselves.

Yeah.

Um to the first part of your question with the naloxone and and funding, uh the Federal Government issued um a uh statement last summer, essentially I forget the specific terminology, but uh uh kind of making harm reduction uh a bad word.

And uh then within the few days after that didn't really walk that entirely back, but did say that naloxone isn't included in harm reduction, even though uh by everyone working in the field it's certainly considered harm reduction.

Uh and so since naloxone is inexpensive and uh funded through the state, um any organization within Cook County that becomes a uh a distribution site uh can can get as much naloxone as they need.

So uh Cook County uh I believe uh as a whole distributed something like 116,000 naloxone kits in 2025, and we're hoping to be able to keep that number a high again for um for the life-saving value that it has.

It there are very few conditions for which you can save somebody's life for $18.

And that's literally what we're talking about with with naloxone.

Uh so to the second part of your question in terms of what we're doing for the next steps.

I do think the first phase for us has been let's just save lives.

Let's get people engaged.

But that's also part of really phase two, which is getting folks into treatment.

Uh and I think one of the reasons for nationally for the uh inequity in terms of the number of deaths in the African American community versus in uh other populations uh has been that next been that next step, really getting folks engaged in in care.

And part of that care actually does include uh interventions like uh like methadone and like buprenorphine.

Uh we often think of those things as uh kind of a bridge to getting better, but folks who are in those programs are already able to function at a different level, they can go back and and and instead of spending uh I I usually remind people that for folks who have opioid addiction, your first job every morning is to figure out how you're going to get an op get the opioid, uh, because otherwise you get physically ill.

And so once you are in a program, whether that's providing buprenorphine or methadone, um, that means you are free to uh go about your normal life.

You can maintain work, uh, you can attend to your relationships, folks uh lives are transformed even just uh on uh we we often think of those things as kind of supplements to treatment.

They are actually uh treatment.

And I think the other thing that's important to note is that opioid addiction is such a uh frightening thing that people were at high risk of death even years after being diagnosed.

So we don't want to necessarily discourage folks from going off methadone or buprenorphine.

That having been said, uh a number of people do uh get off uh buprenorphine and methadone successfully, and uh the best way to assure that is to attend to all aspects of that person's healing.

So uh part of that is medication, part of that is making sure folks uh have access to employment, have access to mental health services, have access to uh housing and transportation services, uh solving the kind of the next phase of addressing the opioid epidemic is a multi-pronged effort from a lot of uh a lot of different angles, um of which involve mental health and some of which don't.

But that was again kind of a long answer to your question, but uh it's a complicated question.

Thank you.

Thank you, Dr.

North.

Thank you, Chair.

Thank you.

Chairman Daly.

Thank you, Mr.

Chairman.

And let me thank you for this great presentation.

And Doctor, you referred to uh the core center.

I was honored to be chair of the core center.

And quite honestly, when it was formed, it was as you said, a lot of hate and a lot of fear in the community.

And we resolved that.

I salute all everyone.

Um in reference to the shortage, going back to what the Commissioner stated, have we, and I know we had uh the health system, we have done some work with the U of I.

Is this something and I maybe it should be with the through the chair to see if we're we are short and not able to serve in this department psychiatry?

Are we working with possibly U of I or adjacent hospitals?

Uh we the other departments have done that.

Uh psychiatry, to my knowledge, has not to this point, but um uh I I can't speak for my colleague who is who will be in that role.

But I it's certainly something that's everything's on the table.

Right.

And we should look at it, especially as we go forward.

Yes.

And I know you had mentioned that right now we're being reimbursed at the Federal Government.

Did you say I'm sorry, the Ford in the lock zone specifically?

No, but specifically going back to the education at the uh for the doctors.

Oh, you said you were able to have many.

Loan repayment for our doctors.

Uh so there was a program offered many years ago where we were considered, due to the nature of what we were working at community uh uh critical community.

Uh for a period of time, that ability for our folks to be able to uh to petition for loan repayment was not made viable because we were not a state facility, we're not a federal facility, we're a county facility.

Uh through the advocacy, that's changed now.

So we have that now as a tool in our toolkit.

And it is from the Federal Government.

Yes, sir.

Okay.

It's for the Federal Government.

Okay.

Um has it renewed, constantly being renewed.

And I I believe it's done for a finite period of time you have uh for for I believe it's a four-year period after once you are in.

Okay, thank you.

Commissioner Vasquez.

Thank you, Chair.

Um not a question but a compliment.

Um so I have seen the loxone save lives in my district.

We have some at Humble Park that we installed recently.

And prior to having that installation there, we had uh different comedian organizations provide some to folks who were living in the encampment that was at Humble Park.

And then um, not in my district, but at Jefferson Park Blue Line, we also have um some there, and it quite literally has saved lives.

So many of our um unhoused residents are veterans.

Um a lot of them are also, you know, coming from families that aren't accepting of their sexual orientation and you know all sorts of heartbreaking um instances.

And again, you know, knowing um that it has saved lives through the advocates that we work with.

I can't say how important this work is, and I'm grateful that we're looking to continue down this path in the future.

Thank you.

Thank you.

And again, I'll I'll point out that's not just a uh CCH initiative, uh including C C DPH.

Um state has been uh very supportive in that in that regard.

Uh the Chicago Department of Public Health.

I mean, everyone's on the same team.

Uh and again, they're there.

I can't think of another uh public health emergency that can be solved with an $18 with an $18 uh dose of medication.

Thank you for the presentation.

Now there's a motion on the floor to receive and file item 26-1270.

All those in favor say aye.

All opposed.

In the opinion of the chair, the ayes have it.

Two more presentations.

So Vice Chair and I now move to receive and file item 26-145.

By the office of the Cook County Sheriff for the period of June 2025 through April 2026, seconded by Commissioner Aguilar.

We'll have a remote presentation.

Let's try again.

Who is connected from the sheriff's office?

Good morning or good afternoon.

This is Dr.

Kiana Mohammed, and I am here representing representing the sheriff's office.

Please proceed.

Um, someone is supposed to be sharing the slide deck, so I'm just waiting for that to appear.

Very good.

There you go.

It's up now.

Good afternoon, everyone.

I'll be talking about our annual report data, or today I'll be presenting our annual report data dated from June 1st, 2025 through April 30th, 2026.

Um, next slide, please.

I'll start by talking about some of the programming that we offer in the Cook County Department of Corrections.

We have what we like to call some of our core programs that includes our SMART Thrive MHTC, SOAR, SAVE and CARP program.

Our SMART program was able to service 1,245 people during the reporting time.

And this is a court ordered drug treatment program that services men with substance use and co-occurring disorders.

And the sister program to that program is our Thrive program, therapeutic healing recovery initiative for vitality and empowerment.

This is also a court order program that services women who suffer from addiction as well, and they also focus on treating co-occurring disorders.

We were able to serve about 405 individuals during the reporting period through the Thrive program.

Our mental health transition center program is a voluntary program that services men who are in need of mental health and substance use treatment.

Um they focus on criminal risk reduction and intervention as well as vocational skills training and educational services as well.

An additional component of this program is re-entry services.

We were able to serve about 704 individuals during the reporting period through the mental health transition center.

The SOR program is the Sheriff's Opioid Addiction Recovery Program.

This is a court-order voluntary program that serves incarcerated individuals who are recovering from opioid addiction.

It's typically an extension from our Smart and Thrive program.

So these individuals have participated in an in-custody portion of programming and then are released to the community to have continued re-entry and wraparound services through the SOAR program.

We've been able to service about 47 individuals during that reporting period.

The SAVE program is our sheriff's anti-violence effort.

And this is a voluntary program that serves individuals in custody between the ages of 18 and 25 who are likely to be victims of violence or to perpetuate violence.

And we were able to service about 362 individuals during the reporting period through the SAVE program.

And then our final core program is our CART program.

And this program stands for the Clinical Assessment and Rehabilitation Program.

This is a voluntary program for individuals in custody to assist them with developing a healthier outlook on mental health through evidence-based treatment modalities via co-responder approach and are provided with clinical support.

This program through this program, we were able to service about 489 unique individuals.

Next slide, please.

In addition to some of the core programs that we offer inside of Cook County Department of Corrections, we also launched our community resource center in 2020 as a virtual supportive service initiative.

This program leverages the new and existing community partnerships to serve as a launch pad to link individuals to resources to meet their unique needs.

The goal is to provide individuals leaving the jail or on electronic monitoring or those facing unique issues, such as eviction with whatever supportive services they need.

Any additionally, any individuals who are Cook County residents are able to uh participate in services offered by the community resource center as well.

One of the goals is to increase accessibility to the public release and release individuals.

The CRC operates a community-based center in West Town.

The center is typically staffed with a CRC team member Monday through Friday and other department staff members such as case managers, clinicians, outreach coordinators, and are available to meet with participants at this location to continue providing services upon discharge as needed, or if they're just in the community.

The location is located at Division of Western, and again, it operates by appointment only.

During the reporting period of June 1st, 2025 through April 30th, 2026, the CRC worked with 3,444 individuals and families to provide services in the community.

Next slide, please.

In addition to the CC DOC and custody programs in the CRC, we also have a program that operates under the treatment response team.

The Cook County Sheriff's Treatment Response Team operates under the umbrella of the Cook County Sheriff's Police Department.

The TRT is comprised of licensed mental health professionals who provide law enforcement with tools, interventions, and support with 24 24-7 access to on-call clinicians via phone or tablet interaction.

Additionally, they also offer follow-up support in person.

In December of 2022, the 911 Center began directing non-emergency calls to TRT.

Calls with a mental health and/or substance use component are best addressed by clinicians.

Utilizing TRT for these low-risk calls improves the CCSO response and care provided during during the response.

The CVAP program or the co-responder virtual assistant program provides immediate on-scene mental health co-response to 45 suburban police departments and assists the Chicago Police Department in the 15th and 18th district.

CRT consistently meets with community partners, including Chicago Police Department, Suburban Police Departments, the FBI, and multiple behavioral health providers.

During the reporting period of June 1st, 2025 through April 30, 2026, we were able to work with a variety of participants in unincorporated Cook, the 15th district, 18th district, other suburban Cook areas, Ford Heights, and CTA.

And that concludes our report.

Thank you very much.

Do any commissioners wish to speak to this item?

All right, hearing none, seeing none.

There's a motion on the floor to receive a file item 26-145.

All those in favor say aye.

Aye.

All those opposed, in the opinion of the chair, the eyes have it.

Thank you for the presentation.

Now for our left.

Thank you.

For our last presentation of the day, uh Commissioner McCaskill moves to receive and file item 26-1516.

Behavioral health report presented by the Cook County State's Attorney for the period of December 1st, 2024 through November 30th, 2025, seconded by Commissioner Britton.

The floor is yours.

Thank you for your patience and waiting.

Thank you.

Thank you, Chairman John Horahan, Chief Financial Officer for the State's Attorney's Office.

It's my pleasure to present uh Kayla Johnson, who's our director of victim witness services, and following Kayla, we'll hear from Kristen Piper, who's an assistant states attorney with our uh clinical forensic and behavioral health unit.

Great.

If you give me a moment, Chairman, I'm gonna pull up the please do thank you, Commissioner.

Okay.

Good afternoon, everyone.

My name is Kayla Johnson.

I'm a licensed clinical social worker and I'm the director of our victim witness unit here at the seats attorney's office.

Um, thank you so much for having us today.

I look forward to sharing more about the work that we're doing.

Um, the mission of the Cook County State Attorney's Office Victim Witness Unit is to meet statutory obligations with regard to victim notification and victims' rights information, as well as to provide services to victims, witnesses, and families within Cook County, so that we can enhance our prosecution efforts by having victims and witnesses informed and supported throughout the prosecution process.

A little snapshot of our staffing.

Umit works 365 days a year, including weekends and on holidays.

Our staff is working tirelessly to make sure that victims and witnesses are informed and supported throughout the prosecution of their criminal cases.

And in fiscal year 25, we serve more than 90,000 people in Cook County.

Our staffing is about 80 victim specialists, including six supervisors within our unit, and that is across eight different courthouse locations in Cook County, including the suburban district courthouses, the Leighton Criminal Courthouse, the juvenile courthouse, and the domestic violence courthouse in the Westloop.

About a third of our staff are bilingual or secondary language speaking, really serving the folks of Cook County well and having a diverse representation and language accessibility amongst our staff.

And outside of the staff speaking secondary languages, we also have a language line that really opens up language accessibility in a numerous amount of other languages.

16% of our staff have a mental health license or are license eligible.

By license eligible, I mean that they have just yet to sit for the licensing exam, but they do have all of the things in place in order to be able to do that, or they are completing their master's program while on staff with us in order to have that license.

And so specifically, I'll talk a little bit more about our mental health team, which is comprised of three victim specialists, one team lead, and then our facility dog Hattie, which is pictured on our PowerPoint.

In fiscal year 25, this is just a brief snapshot of the kinds of cases that our team in the victims unit was working.

The largest bar I think it's kind of hard to read due to the font size, but encaptures domestic violence cases throughout Cook County, which far surpasses most of the other categories.

In addition to that, the next kind of highest bars include homicide cases, sexual assault matters, and then also physical assault matters as well.

And just to speak to those kinds of case categories, all of those kinds of cases are violent crimes.

And so that really speaks to how we approach this work in a trauma-informed manner.

And so what trauma informed services means to the folks in our department means that we understand how trauma impacts the mind, the body, and the behavior of the folks that we are serving.

Most times the crime that has happened to them is not the only incident of trauma that folks have been through when they're engaging with our team.

And so, in addition to that, trauma informed services and always mean working just with the people that are our clients, but also with and amongst each other and our colleagues.

So understanding how vicarious trauma really impacts the people that are on our staff, but also even our colleagues, such as prosecutors, investigators, and the work that we're doing, and so how we engage with each other is also really important.

Next slide, please.

A little bit more about our mental health team.

So our mental health team is quite small.

It's three staff.

And the purpose of this team was to fill a critical gap that we were noticing amongst service provision for the folks that we are working with.

And so we were noticing that victims oftentimes were unable to access community-based mental health care due to really long wait lists, due to lack of insurance, or just a general lack of accessibility.

And so that created a need for the mental health team with that is embedded within the victim witness unit.

This team was started out of a grant-funded team and now is funded through corporate funding, but we still continue to do the same level of care and work.

The kind of support that this team can provide kind of comes in a few different ways that I'd like to touch on.

One is through primary support.

What that means is that a referral is made from the victim specialist team anywhere across the county that notes that this person, victim, witness, or family member has is exhibiting acute trauma symptoms or really is struggling with more behavioral health needs than our line victim specialists can provide.

And so they will make a referral to the mental health team.

We will staff that case amongst the mental health team to decide if that is a good fit, what kind of care we can provide, what kind of resources we can put in place, and then we will take that on as the primary victim specialist.

So that includes all the other work that we would do as a victim specialist, but in addition to that, the extra needs and services that come being on the mental health team.

The second kind of support we will offer is secondary support.

That just means that we would partner with the courtroom victim specialist who's working on that case.

That can look a lot of like a lot of different things, but primarily it comes in the form of trial support.

Um, if folks have to come into the courthouse for some purpose, our mental health team would partner with the victim specialist who's been working with that family.

And then finally, we will do case consultations with ASAs, prosecutors, other victim specialists, if they're just not really sure what someone might need, but they're noticing there is a higher level of need there to kind of talk through what that could look like.

And then finally, assisting in crises.

In my time supervising the mental health team, I would say that a crisis usually happens about once a week just between the latent criminal courthouse and the domestic violence courthouse where the staff member on our mental health team is needed just to kind of talk someone through whatever crisis they're presenting with and make appropriate referrals out in the community.

Those team members I mentioned kind of spread themselves thin across the different various courthouse locations, and that's their kind of coverage.

And then Stephanie is our team lead, and then Hattie serves as a facility dog.

Hattie's role really comes into play with child victims and witnesses that may have to present for court, whether that's preps with our team or out in the courtrooms.

And so she has she is also a critical member of our team.

I wanted to acknowledge.

You can see that slice of the orange pie is the team's is the mental health team's caseload.

It's intentionally small because they are providing a higher level of clinical case management to the folks that are on their assigned to this team.

We keep about a 50 max caseload so that they can provide the level of service that is expected if someone is referred to this team.

I also wanted to touch on just a couple of different things that we are doing to mitigate barriers for folks that we engage with.

One of the one of these things is an agreement with Uber that we launched this year to really focus on the transportation barriers that we were noticing people were facing.

And this has really strengthened access to justice for people that we were working with, so that that is one less thing that they need to worry about, and that if they have a transportation barrier to get to any kind of required court appearance meeting anything that is required, we want to make sure that transportation is not a barrier for them to participate in the prosecution process.

And just since that launch earlier this year in January, we have provided over 500 rides to folks to attend necessary court proceedings.

Um then the second partnership I wanted to note was through a partnership with an agency called Relo Share, which is essentially like a hotels.com booking service, but focused for victim serving agencies.

And this has come in really helpful when we have folks that have immediate safety concerns and housing needs so that we can meet that need so that that is also not a barrier so that that they can't participate in prosecution.

And then looking ahead, what is our goals to kind of focus on with this team moving forward?

We want to strengthen the professional development of our staff so we are consistently trained in current best practices within this field of victim services.

We want to continue engaging the public and community partners so that the community is aware of the services that our staff can provide and to streamline referral pathways for victims, witnesses, and families that we're working with.

And then finally, we want to maintain and expand the use of trauma-informed practices in our engagement with victims, witnesses, surviving families, and also internally within our own staff.

And that's what I have for you today.

Thank you, everyone.

Thank you.

Good afternoon.

My name's Kristen Piper.

I'm an assistant states attorney.

I've been an assistant states attorney for over 27 years.

I'm currently working in the clinical forensic forensic and behavioral health unit.

And I just wanted to talk to you briefly about the mental health services that our unit provides.

Initially, we facilitate the mental health writ process, and that's when someone is out in the community suffering from a mental illness and that they are a threat to themselves or others.

Family members can come into our unit, be interviewed by a state's attorney.

We pre um we would then prepare a petition and then provide evidence in front of the court.

And if the judge finds that there is an emergency, the judge can sign an order ordering the police to take this person to a mental health facility for an evaluation.

We also conduct mental health hearings for petitions for involuntary admission and for an involuntary treatment, and that's when a person is inside of a mental health facility.

We will conduct those hearings.

We also coordinate and collaborate with stakeholders regarding the AOT program.

And I just want to talk to you very briefly about that.

An AOT order is an assisted outpatient treatment order, and it's a tool in the toolbox for civil courts, service providers, respondents, custodians to work together to help respondents with serious mental illness who are caught in a cycle of repeat hospitalization due to a history of non-compliance with treatment.

The in these cases when a person is in the hospital and is finally getting the treatment that they need, they work with the psychiatrist and the psychiatrist believes that it's in their best interest, they will contact our office and say that they want to participate in an AOT.

The state's attorney at that time will prepare an order, and then we proceed to a hearing prior to the discharge from the hospital.

And it gives the patient specifics.

The patient, all of their treatment is in the order.

It has the medication that they're supposed to take, the dosage, the time to take it, what their doctor appointment is, so they know exactly what to do.

And then also there's a custodian when there's an AOT hearing, and that's usually a family member that agrees to assist the respondent and helping them go to CVS to get the medication, helps them to take them to the doctor's appointment.

So they have an incredible amount of support when they are a participant in the AOT program.

And the judge will hold weekly, monthly um Zoom hearings where the patient is held accountable about the medication and if they are in compliance.

So it gives a lot of support to a person who is trying to remain compliant.

And I just wanted to give you a quick um st uh uh an example about how this program has worked.

And there was a woman who was out in the community who is a successful banker at one of the large banks in the city.

She raised two children until they went to college, and then she started exhibiting symptoms of mental illness.

She was um having paranoid beliefs that her family was in danger, that she was in danger, she was manic, she ended with spending um excessively, she spent all of their college tuition money in a single um episode, and then she began not taking care of herself and was being violent towards her husband.

She was finally brought to a hospital where she was prescribed medication and refused the medication.

And the doctor then filed a petition, and that's how our office got involved.

And I presented evidence to the judge, um, and the judge then granted the petition to have this woman involuntarily medicated.

And within a very short period of time, she was no longer paranoid, she was no longer manic, she was no longer violent.

And she agreed to be a part of this AOT program.

And for six months, she participated in this program and was supported by the judge, by the state's attorney, by her attorney, by Nami.

And at the end of this program, she and her husband were so appreciative to the group that they were able to help her in such a way.

And it was a great success story on how this and our unit can help people get their lives back on track.

And there are next slide.

There is a grant right now that is from SAMHSA that is so we are using they are encouraging the use of AOTs, and the AOTs have been doubled in the last year in the amount of people that are participating in this program.

Next slide.

And then as to the statistics, when people participate in an AOT program, there's fewer hospitalizations, there's shortened lengths in hospital stays, there's fewer incidents of arrests, lessened incarceration rates, decreased rates of homelessness, decrease in violent behavior, lessened victimization, decrease in illegal substance usage, and a decrease in cost because there's fewer hospitalizations and incarcerations.

So this program is a very important program that we are participating in.

So thank you.

Thank you.

Does that conclude the presentation?

Yes.

Well, thank you.

And again, thank you for your patience.

Chairman Daly.

Thank you.

And let me just congratulate you again on this great work.

Both the is the victim witness presentation as well as this.

In both these programs.

When an individual What is the follow-up?

Do they stay in contact or is it finished?

They can they can agree to do it for another six months, and we've had a number of people that have agreed and said, I've gotten so much out of this program, I want to continue for another six months.

And um, or they can say, I've had enough, and thank you so much for all of your help.

I'm in a great way.

I'm gonna keep going on my own.

I don't need any more help from you.

So in reference to the victim witness, I know that you provide mental health services.

When that program when whether it be a victim of victim or a witness, is there a period of time that our assistant ends?

The assistance will never end.

Um if I'm being honest with you, anyone can reach out to our office at any time if they are involved in services and then it drops off and they need connections.

Of course.

Okay, thank you.

Yeah.

Vice Chair Naya.

Thank you, Chair.

Um question regarding um, so there was a mention that there is uh court victim specialist that sometimes you partner up with.

Um are those under the chief judge or are those separate within your office or jurisdiction?

I apologize, just difference in semantics.

Okay.

Um no, it's just a victim specialist within the victim witness unit that's not on the mental health team.

Okay, but they're in the court.

Okay, are they assigned a caseload or are they?

Okay, yeah.

Um so I'm I'm curious um on how you all identify those individuals that need um assistance, because to your point, there is trauma involved with being a victim witness.

Um there's also trauma with participating.

Um I um have seen how the office operates.

Um I am concerned about small things like you know, both the defendant uh witnesses and victim witnesses being in the same hallway for hours at end, um, being potentially identified later for um being um victim witnesses in a case, uh specifically those that may be violent cases.

Um so what type of mechanisms is office working through to avoid uh re-victimizing the person and also protecting their mental health through the process.

Yeah.

No, that's a great question.

Thank you for the question.

Um one of the core pieces of trauma informed services in that graphic that I had was safety, and so safety is really at the core of being trauma-informed.

And so that safety not only is inside of the courthouse and while they're participating in the prosecution, but also outside of it.

And so safety planning is a very individualized process that our staff is trained and does do with victims and witnesses that we're working with.

And if there is any safety concern, they're always welcome to bring that to our attention.

We will safety plan with them.

We will navigate how to go through those things together.

Umber's partnership has come quite in handy for folks who maybe just don't even feel comfortable driving their vehicle to the courthouse for a necessary court date.

Um we have partnerships internally with our investigations team and externally with the sheriff's department, and we work closely with our partners that if folks don't feel safe coming into the building, that we communicate those needs with our partners so that we can ensure as much safety as we can provide, we do.

Um we also do have some services that are on the horizon that hopefully, if there's ever a concern where someone's physical safety and where they reside is at risk due to their participation in a prosecutor's case that we can provide an extra layer of safety to them as well.

Okay.

Um I'm very interested in knowing if you all are working with facilities management specifically on the safety component, given the fact that um, like I mentioned earlier, there's times where there's a a lot of witnesses in the hallway together.

Um and you most of the time will know who's who.

Um so I think that component in itself is mentally draining for the victim witnesses.

Um I understand why they need to be right outside of the courtroom because of speediency, et cetera.

But that is something that I'm more than happy to work with your team on figuring out because I saw it play out and I don't think it's appropriate to have individuals there for not only eight hours plus a day, but sometimes a whole week or more.

Um so it's very concerning because I do think it does potentially uh re-traumatize individuals, especially that um we need their testimony for certain cases, um, but also we want to ensure safety throughout.

So that's something I just want to make sure um to point out.

Thank you.

Um in regards to the Uber um agreement or um partnership.

Do we get any special discounts of sorts?

Or is there or is it just a partnership that we're gonna cover the expense?

What does that look like?

That might be good for John as the finance man.

Um thank you, Commissioner.

The uh the arrangement is really just to help us have access to the services.

Um we are uh tax exempt, so we do have a slight savings over um uh regular civilian rates because of the county doesn't incur the cost of um state and local taxes uh for these services.

Uh we do not.

Okay.

So that's the the person that's being if they choose to, yes, but we do not uh include that.

And I'll point out this um applies across the country.

So our Uber um arrangement allows for us to book transportation not just locally but anywhere in the country.

So if a victim or witness needs to come to Chicago um get to an airport, get to a bus station or train station in another state, we can book that here to make sure they can make the um make that transportation happen.

Okay.

Um I'm always a big advocate to see if I mean this is technically, although it's not a formalized like RFP process, it's somewhat of a contract with with a government entity.

So um I would uh always, you know, uh like to push for additional savings if need be um with with partners like Uber.

Um but I understand that there might be limitations.

Um my last question is in regards to Spanish speaking victim witnesses um and connection with mental health services.

So not sure how many staff we have that are Spanish speaking, and how many staff we have to connect them to the resources both on uh behavioral mental health through the process and um beyond any other type of services?

Yeah, thank you for the question.

Um of that 34% of folks that are secondary language speaking, all but one of them is actually Spanish speaking.

Um so that Spanish speaking staffing is embedded in every single courthouse location that we have staff at.

Um so the service is definitely there for folks.

Um our domestic violence courthouse just recently I would say made an accomplishment to have one Spanish speaking specialist assigned to every courtroom, which I think is a great feat to improve that access.

As far as outside of the courtroom setting, we are always expanding our partnerships with community-based agencies.

Um and so some of those focus areas for who we are looking for partnership with is their ability to provide secondary language services to people.

And what's the caseload for a bilingual um specialist versus a non-bilingual?

I can't give you the number exactly.

I will say it's comparable, but I can certainly look at that number.

If are you looking for a specific just across the board comparison or at a courthouse?

Okay.

I mean, I I think overall um there's certain courthouses that you wouldn't you may see additional or like a an increase amount of maybe uh bilingual individuals or people that need additional um language access uh services, but if if you have a general number, that would be really helpful.

Um we want to make sure obviously that there's um to your point that they're comparable and and not uh the caseload is not drastically you know, like doubled or whatever the case may be with any of those.

Those are my only questions.

Thank you.

Thank you.

Commissioner McCaskill.

Thank you, Chair.

Is there an actual chart that exists that displays the number per courthouse?

I have an internal organizational chart, yes.

That would be great.

Much to what um Commissioner Naya was just speaking of, just wanting to see what the ratios actually are like one to six, whatever that may be.

And then also as it relates to domestic violence.

Is there an opportunity in this program?

I don't know if we need to need for additional funding, but is there an opportunity for escorting of victims?

Because um we have had cases where for whatever reason the judges have decided not to allow the virtual, so we're having these women or men come into these situations where they're in the room with the abuser.

Um they're leaving unexcorted, they're coming in unescorted and is significantly mentally damaging.

So it's almost like we're living the trauma.

And I'm wondering what proactivity, what proactive steps we're taking to address this because it's happening more now than what we um as far as I can speak to the domestic violence courthouse, but domestic violence is obviously in every courthouse.

Um at the domestic violence court specifically, there are safe rooms embedded into that building next to it that's adjacent to every single criminal courtroom.

Um and safe rooms are accessible by swipe card only, and um that is a separate waiting space that's available to survivors if they do not feel comfortable waiting in the courtroom itself.

I think I'm speaking more so to the actual escorting to the building.

Oh, okay.

And of course, the sheriffs don't know who there's like the expanded courtment.

So what effort can we choose that?

Yeah, um, I will say like our court staff are typically in the courtroom, um, which is unfortunate.

Um, and so to have that extra availability is something that I don't know is is feasible, but also at the same time recognizing that that is a need, and I can certainly take that back to our leadership team and talk more about what that could look like.

Are there any funding opportunities coming out of this department?

Coming out of what department?

I'm sorry, could you clarify?

Out of this particular courtroom.

Uh so when you look at um domestic violence, are there any rent opportunities for organizations?

I've actually been actually solicited a couple of um volunteers that have been escorting some of the women to court, and I find that it is very um is very it helps.

It's um almost detrimental that they don't have escorts, especially in these cases where um people are being released early or um because of safety act, they're being released prior to even being uh they're being adherent or any due process, and so um we need to do something differently.

Yeah, I think that's a great opportunity for partnership too with some of our advocacy partners to see if that is something a gap that we can partner up with together.

Thank you.

All right, Commissioner Vasquez.

Uh my question is short.

Uh thank you for all the information today.

I love the Uber program, that's amazing.

I wanted to know um if there was a flyer sent out to commissioners or how can people book that?

Because in some cases, Mujeres Latinas and Acción and other committee-based organizations that help a lot of victims will reach out to those of us that are involved in rapid response to see if we can drive people to the courthouse.

Um would love to know what the process is to book these rights and if there's a number or something that you can share so that we can put that out to our community organizations, they can work with your office directly.

Yes, all of our staff in the victim witnessena are trained in how to book rides and do all the things necessary to get someone to the courthouse.

So if there is a criminal case pending and there is a victim specialist assigned, which there should be, if there's a criminal case pending and it's a violent crime, um, then all they have to do is reach out to their victim specialists, especially particularly it's for required appearances.

Um so if that's something like prosecution hinges on someone showing up or not, we want to make sure that we fill that gap for anyone that that exists for.

So then just so that I'm clear and I'm able to give the proper instructions.

So um if somebody's calling the day of and they're afraid, um, we can tell them that within whatever paperwork they have, there is a victim specialist number that they can call to book the ride.

Yes, and if they're ever unsure, they can always just reach out to our office at the courthouse in which their case is at, and we will make sure they get connected.

Okay, thank you.

Yes.

Okay, thank you for the presentation.

There's a motion on the floor to receive and file item 26 1516.

All those in favor say aye.

All those opposed, in the opinion of the chair, the ayes have it.

Having no further business before this committee, Chairman Daly moves to adjourn, seconded by Vice Chair Naya.

All those in favor say aye.

All opposed.

We're adjourned.