I wanted to jump right into questions because they've been coming in throughout. Some of them are real brief and some of them are about specific sites. So one brief one is, are your EOUs licensed? Yes. So Arizona, they're licensed as what is called an integrated clinic. They're outpatient, technically. So they're licensed to the state of Arizona and they are joint commission accredited. And the joint commission never knows what to make of what we do. So we come in and we explain it to them and then they kind of figure out, you know, which standards to use. And then CARF, I'm on the advisory board for CARF, and we just put out some accreditation standards for crisis systems. So you can get a CARF accreditation as well if you want. That's good. Do your CIT officers still carry standard officer equipment like handcuffs, firearms, tasers? They do. However, they like typically it's a, which this is one thing that sort of apparently like some of these things that Tucson Police does, I don't realize how uncommon they are until they explain it to me, but in their standard operating procedure, it actually says that they do not have to handcuff people for mental health transports, which is apparently rare. And most of the patients that they do bring us are not handcuffed. If they are handcuffed, we believe there's a bright line between treatment and in custody. So we don't, you know, ask the officer to stay around and keep them handcuffed while we give injections and things like that. That was happening before we took over and then we stopped that. And also our behavioral health techs worked in collaboration with TPD and worked out a system where our techs have a handcuff key. So they work, you know, in collaboration with the officer, you know, just sort of to figure out the logistics, but it's our staff that will unlock the handcuffs if they do come in handcuffs, which helps send that message that, you know, you're here for treatment. Wonderful. Lots of feedback coming back that they're just really impressive with what you're doing there and the clarity of the presentation. Could you speak further to staffing levels, vacancies, and staff morale? Sure. So we have, as I said, we're 24-7 with some sort of provider, and that's kind of staggered throughout the day, like more in the morning and less in deep nights. Our tech staffing is about one to eight and nursing is one to 10, but there's an LPN that does all the med passing. Our crisis workers, social workers, again, they're staggered throughout the day depending on when the highest demand is. As far as morale goes, I think, well, first of all, everybody, staff everywhere complain, right? But I think what kind of shows that I think we are a good place to work is we have a bunch of staff that will leave, then they come back, because I think we do have staffing levels that they feel are more safe. We do a lot of, like I said, a lot of training based on feedback from our techs. We were looking at staff injuries, which mostly occur during some sort of, you know, restraint or dealing with someone agitated, and they felt that our training, we were using CPI, just didn't meet our need given how agitated our people are and the fact that we don't default to security. So like I'm a quality improvement nerd, so we're very much, you know, we want to work with the frontline staff on improvement projects as much as possible. And so they really spearheaded investigating different trainings and developing a new training program where now everyone in our facility gets what's called therapeutic options, which is the verbal de-escalation that is trauma based, and then the techs get what's called safe clint, which is a much more robust hands-on training, but it has roles for the different team members, and it just much more meets the needs that we have, and they do drills, and we review all the videos. And so they've been very happy with that. Wonderful. So I think this is a really interesting question. So we're in New Orleans. Our state-run hospital, P3, has a behavioral health crisis intervention ER with 29 beds and 60 inpatient beds. Why not just improve what already exists, like work with the hospital instead of reinventing the wheel? We're a poor city in a poor state, and we need to maximize our resources. I agree that there are barriers. Is it possible to remove those barriers? Yeah. I mean, so you, and I'm actually, I just got invited to speak at something in New Orleans in July, so maybe I'll be able to speak more to this then, but yes, every community is different. Like I said, we do consulting around and some places have something that exists, but it's not quite meeting the need. So we've helped them. A lot of times it's that culture issue of, well, we need to figure out how to say yes, and what do you need to be able to handle this higher acuity types of patients in terms of your staffing and your training and maybe some physical plant modification. So yes, absolutely. You don't have to build this from the ground up, you can start with what you have. So I think this is a really, it sounds like a basic question, but you know where it's coming from. She asks, this is another person, how do you collect all that data? And as we know, we need data to be able to push up the need for this to people who can give us money, et cetera. So how do you set up and get all this data? So that has taken a long time. So we have an EHR. We actually just changed our EHR, so now all of our reports are broken, but they'll be fixed soon, hopefully. But it took us over years building. So we determined what our metrics need to be and then worked with, okay, well, how do we make it so our EHR is collecting those things as we do patient care so that we can pull reports on that and clean up the data and then report on it? And that's an ongoing process. Like I said, you have to set the EHR up to do it, which can be difficult. We have a quality department that is able to pull reports from that, but we're always tweaking it. We're always struggling with data not being entered in correctly, and then how do you go back and make sure this data gets entered in correctly so you've got reports of what the errors are so that that gets reported back to the people responsible for entering in the data so that they get feedback on their errors so they can improve their data entry? And so it is a big process, that's for sure. As far as data across systems, because we have a single payer, essentially, for crisis, which is our REBA, that way we can share data with them easily because they're our payer and all the other agencies do as well. So they can kind of coalesce it and combine it and look at it across all the different providers. Wonderful. And we're just getting to the top of the hour. One last quick question. What's the name of the program that replaced CPI? I didn't catch what that was called. So Therapeutic Options is the verbal and then Safe Clinch, C-L-I-N-C-H.

CIT officers

training

staff injuries

data collection

EHR system