Noon, every good afternoon, everyone.

And welcome back to the Ramsey County Board Workshop Part 2 or Part One.

This morning we had the opportunity to do a workshop on understanding state hospital utilization and rising costs in Ramsey County.

And this afternoon workshop and presentation would be on state operating services, direct care and treatment.

Just a courtesy reminder that this board meeting is recorded and is live stream on Zoom webinar.

There will be no votes taken during this workshop.

So let's start as introductions of commissioners and presenters around the table, then the rest of the room.

So we'll open up with introducing myself, Rainy Moran, Commissioner District 4.

Sorry, Gemin State Commissioner District One.

Nightanjong, Commissioner for District 6.

Virtuary Commissioner District 3.

Sophia Thompson, Social Services Director.

Eric Elson Transitional League Director for Director and Treatment.

Charles Gaff Manager and Social Services.

Ian Zimmerman, Assistant Ramsey County Attorney and the Civil Commitment Unity.

Oh, you have students and services tonight.

Angela Young Right, it's the HMS on the colleagues in the software.

Danny's not today.

Jessica Junior.

Directly behind you.

I'm sure Penny Manager.

Bike over here.

Yep.

Janelle White over soon.

Welcome to thank you all for being here.

I wouldn't be amiss if I don't say welcome, uh, former commissioner Nicole Father.

Good to see you.

Okay.

So this session is a continuation of this morning's workshop on the state operating services.

This afternoon, we'll give an overview of the civic commitment process.

We'll review key trends and rising costs tied to the work, then discuss the challenges we're facing and was and with strategies to address them.

With that, I would like to turn it over to the presenters.

Thank you very much, Chair Moran.

Commissioners County Manager Becker.

Okay.

As was mentioned, we um a reminder our goals for today's workshop.

They were shared at this this morning, and so we're not gonna repeat the all of the goals.

Um, but and but excuse me, they should look familiar.

We hope this that this morning we were able to frame up the county's role and some of the challenges being faced with our state operated services landscape.

In all of this, we hope you hear the importance of improving our system for the residents in need of care.

This afternoon, we're gonna share some of those trends in this excuse me.

We're seeing in this space around the individuals being served and the costs connected to their care.

We'll take a closer look at significant increases in the cost of care as well as the challenges of discharging individuals from state operated services.

So this morning we talked about some of what some of those barriers were.

We'll talk uh a little bit about those when discharging, even when they do technically do not meet um those qualifications.

We have Ann Zimmerman from the Ramsey County Attorney's Office.

Um, we'll review the commitment process and the complexities of those cases.

We have um Eric Adolfson, who is still with us, and he'll talk um a little bit about some of our statistics and Angela Youngerbird.

We'll discuss the work of the priority admissions task force, the steps being taken to address the challenges in our systems and the opportunities for counties to consider for future improvements.

So before we jump into the detailed information about a specific group of our clients and some of the cost information, this is a very brief overview of the commitments.

Now on this slide, you're going to see where we have five different levels of commitments.

This demonstrates the full umbrella as they're related to state operated services.

The next couple of slides will focus on our mentally ill and dangerous population specifically.

So think of this as a it's not a full continuum of care, but there are the options, right?

When a person is civilly committed, these are the options.

And again, Ann will dig into that a little bit more when she talks about her work.

Eric.

Thank you, Dr.

Thompson.

On this slide here, we see the number of civil commitments that have happened over the past decade, where we see the number of civil commitments for mentally ill and dangerous people literally double doubling in a 10-year span.