Add Reorganization Agreement Initials with airSlate SignNow

Add Reorganization Agreement initial

come up you know just feel free to reach out to him to me we can we can continue talking that through but yes you're right that is the purpose of our committee we we want the first thing we learned when we began um was just the sheer volume of contracts that come in and out of the department and so i you know our goal is to try to come up with recommendations to make that as streamlined and and efficient as possible um you know my initial review of that contract excel spreadsheet that wendy was able to get us last year was definitely eye-opening just just enough just an initial analysis of this sheer volume of contracts for tiny little amounts to super large amounts and so if we have that sort of trending data then i think it helps better inform what our recommendations are certainly to the extent that they're helpful and meaningful um to you know increasing your department's ability to streamline um i don't know if anybody else has waiting to add hi no that's helpful carolyn um thank you it's christopher 5th i just have one question michelle um for the next and i can put this in writing too i think one of the one of the issues that um i think this flagged in our work earlier last year in 2024 coded was the need for better maintenance if you will like a better term where the actual contracts are located meaning you could have divisions and employees of division of and there's no real central database of that of those contracts and it's difficult so you know because there's a lot of different levels of the contracting you know you have your you know those that are done through the central office or you know and then other division by division handling them so sometimes you literally could have a contract sitting in someone's drawer not know you know is this being how is that kind of being handled or what's the status of it so i think there was some need to understand better of the the contracts has the department done anything i think i i think it knows in the last because we definitely flagged that as an issue earlier so like so in the last year has there been any important or is are there any plans to update um how all how the department handles all the contracts in terms of how they're stored who um reviews them etc um particularly at this time we have so many people uh having to work from home so not having you know having a contract not physically only physically stored in like a particular location rather than a centralized database makes things a bit challenging so um that's that's my one question that i would like some information for uh the next meeting i could actually give you a partial update now which is we did the department did execute bonfire which is an e-procurement software um in i want to say it was in april or may 2020 not timed with the pandemic but perfect timing in the scheme of getting things electronic so what i will do as part of that is look into how has bonfire changed and addressed some of those concerns so if you send that over i think we have made some progress um and we're moving along getting you know that kind of central maintenance and and e-procurement software moving towards paperless just some of that transparency and ability to store things centrally um it's we're getting there we have made steps so um if you send along your question we'll be able to answer it more thoroughly thank you so much michelin i'll be happy to add in to to reinforce what you were saying i'm not a dsm provider but i would be happy to um you know as you as you said there has been in uh in the ddds side and we are a ddds contracted service provider there has been a lot of change in the past five years in the types of providers the amount of providers um and and movement in terms of who is who is serving the most amount of individuals there were some issues with transparency back in 2019 which required all ddds providers to have to re-enroll essentially in the waiver process and we on the outside didn't get a lot of information about that we were just told to re-enroll but there was a lot of information about how that rfp process went um so i do think having that data does just add some transparency for us uh in terms of who is getting those contracts amount and and how that has changed over time because we know we see it but because we don't have the data to back it up it's hard for us to um you know have numbers to kind of go with that hunch and and i do think that is beneficial shining some light on that is beneficial so thank you carolyn sorry um yes thank you elizabeth that's very helpful um and we weren't just talking about dsam just now we were talking about the department um in terms of all divisions that provide services directly to um um consumers so okay so let's go down then um taylor to the d sam question and i wanted to the answers are pretty robust which is very helpful um i know i've had a couple of questions and michelle i don't think that we're not asking you these questions i don't necessarily think that you're we're not just having this discussion looking for answers from you they're really in the weeds these same questions um i really just wanted the decent providers on the call to be able to help talk through the answers that were given so that if we do have any follow-up questions we can we can submit them and you got you guys can get the appropriate um send them to the appropriate people for follow-up so then i am going to ask you go up a little um to the number three thank you and that's good enough um because i think everybody has the questions already and the answers so i'm going to ask lynn and karen specifically to provide any feedback on the answers specifically um i i mean there's a lot of information here and some of it's very helpful but some of it i think would be more specific and you know i was really hoping with all the spec you know i thought and this is please lynn and karen might know differently but with all this federal money coming in my experience with federal grants or government grants is that the outcomes and the program evaluation has to be really specific as far as data so i was hoping for a little bit more specifics on number of people served or an increase in specific programming a lot of these bullets that are there um i don't know how much of that our services the dsam directly is providing and how many of those things are specifically you know increase in um in options and access in the actual community providers so you know i that's my outsider perspective i have a couple other questions but i don't want to completely monopolize it so i'm going to see if any of you have anything to add to the answers that they that were provided here hi it's dr morrison um carolyn i mean i'm just with you the the specific numbers of and the program names would be helpful uh i think i know what most of them are but just giving a a roundabout kind of one sentence without additional information leaves it leaves it to speculation so yeah so which programs are the state running and what number of people are being served or have they increased the slots by in some cases and the creation of the pathway to legal assistance for clients i don't i don't know what that i don't recall what that is if i was told once i don't remember it so there are brochures for that that kind of thing um would be helpful because there's another part of me that's like oh there's resources that i can get to my clients that i wasn't really aware of so that's my perspective and this is dr fitzhugh and i'm i couldn't agree more with dr morrison i have never heard anything about access to legal assistance for clients certainly not any information that i ever received and um [Music] this doesn't it's a listing of things that doesn't really say a whole lot i mean i know about the bridge clinics which are decent but beyond that who are they and how many services are being delivered that's there's no answer in here i forgot i needed myself um these look like objectives like a list of objectives that went into a grant proposal versus outcomes um that have specifics like number of people serve number of new programs um so and and keep in mind this answer was provided again in march of 2020 there are there's new leadership in d sam right now um we might be able to get additional follow-up information uh so so i want to keep that in perspective as well we just never had a conversation about the answers that were provided and i want to make sure that when we reach out with follow-up that we're being thorough and won't have to go back and forth i want to be respectful of their time as well um and understanding that it is new leadership it might take a you know there's no there's not as much institutional memory there so if you want to go down to the next carolyn i don't think you can see this on the side but senator poorest just joined us and has her hand up oh i'm sorry senator i can only see a strip of people i apologize that's okay no worries hi everyone um before you go into that next question let me just uh thank everyone uh for your time your energy and your devotion to continuing to meet on uh this subcommittee um i can't stress how important it is i know each and every one of you understand the depths of it because you're either work you're working in it you're touching it you're somewhere involved in this um and so i just want to stress that um as we are rounding out this session time and we are looking for reporting it is very important um as as i spoke with the other committee earlier today um to basically just make sure that the guidance that that i want to give to this group is that this is not a personal issue whatsoever to individuals within our department or our division this is very much related to the fact that services are not being addressed the way they need to be and that we can support the department and the divisions individually by making sure that they know what we know on the outside of it whether you're a provider whether you're a client so carolyn um to to some of these questions you know i think that we have ample time uh to flip that back and to basically note that the questions are not answered to to what we need and you know this is just a simple comment this is not this should not be used as anything other than a simple comment but i previously uh had another um task force under guardianship and people did not know what we were missing till we sat at the table and that group of folks i will tell you are just as amazing the people that are sitting on this committee what we found is we were able to do quite a few things in regulation and in a very short period of time only needed at the time one piece of legislation so you know here's the deal we can do this all together or collectively we will then have to run legislation if that's what's needed but i believe that we can get to this by having these conversations and ironing out some of these things uh prior to having to go that route but if we don't have the answers if they're very vague then then we can't do what we need to do in order to give the protection to the people in the state of delaware that need most need these services so carolyn i just want to make sure that i say that because i do think that we have time um and uh and certainly um you may want to talk with uh and farley and uh and also taylor just to see how we can help expedite that for you thank you senator i appreciate that um perspective and yes i mean i agree my i probably said this at nauseum now but you know my whole um all i want i we know from the provider perspective what we see um unfortunately it's there there is that disconnect between what the you know intended strategy is or the intended goal is and then what it actually means to operationalize it on the service provider side and i think anything we can do to sure up those efficiencies increase that communication and really try to flesh out what it means in terms of service provision and quality of service and access to service um is our charge and that's absolutely what we're trying to do here um that's why i think looking back and seeing trend trends over the last couple years is is so important to see where it was and to see where it's going um you know i don't i don't have to say what's happening to services that's a point i mean it's been stated enough at this point but it's concerning and i think that if the outcome is is improved services improved efficiencies and better communication than i think we've done a large part of our job here um does anybody else have anything to add to that before we go jump right back in okay all right so then jumping back in to number four um i really would like dr fitzhugh and dr morrison to give me their feedback on this this is where it gets pretty meaty i know from the outside and i also sit in on every behavioral health consortium meeting that in its existence pretty much the exception of maybe one i miss um so i i've seen the divisions presentations on dtran my question has been from the beginning of this what how many referrals were there before dtran um and what is the data to support the increase now they we have a total number of referrals but we don't know what the referral rate looked like before we spent the money on this system so that's my question they seem to think there's no way to find that answer um from your guy's perspective from your perspectives providing those services here just whatever feedback you guys have on that i guess the first thing i would say is that there's no data in response here so we're trying to get an answer which is data driven and there's no data i mean we can do anecdotal stuff from a from a site-specific you know site specifically i think but even still then it's not aggregated data so i i i this is again i think part of the the challenge with this is as you point out so clearly this is responses that came 10 months ago or so and are not reflective of changes that have happened within the agency in the immediate past 90 days and there are a multiplicity of changes as you all know um so i think when i first heard about dtran and the the and the whole open beds processes it sounds really good and it makes a lot of sense and what ultimately felt like happened here is that how it got operationalized didn't actually align i think with the goals that were put forth by the people who designed the open beds system itself and so was it helpful sort of i mean i don't know dr morrison what your thoughts are on this so i mean sometimes it's helpful but if not everybody's participating in it we don't have a robust system in terms of the full continuum of care and again not every player was necessarily created equal in the system either not everybody used it i still don't think everybody's using it so it's hard to tell there's no data from that side telling us anything in this and so i don't feel like it gives me much of anything um so i'm kind of even going back to before dtran and and looking at when we design or decide to put something out for contract that we have data that supports that there's an issue to begin with um there's a i think there was a lot of assumptions made about how the referral system was prior to and and the dtran was going to solve these problems and and i think that's why karen and i are so anxious to get actual data and for the reasons that karen's data they're sorry dr there's there's not um i don't know how robust that dot is going to be but i think it's better than better than nothing and now that there's been a change in administration i i really wonder if this dtran is going to be continued to be used or not um is it supported by the new administration uh or not because as karen's uh care that's right i'm gonna keep calling you karen mentioned um i wish you would yeah the providers the providers use it um but it there's a lot of easy ways not to use it so it needs to be either fully implemented or not um in order for it to actually give us data that we can use in the state to know whether clients were falling through the cracks um you know getting from one level of care to the next um and that kind of thing that it was intended to do thank you thank you both yeah uh and yeah and i can say that on behalf of just the providers that i interact with as part of my other job my day job um the the none of this is reflective of of providers unwillingness to adapt and change over as as things change and the federal government that fund these a lot of this work changes that's but it it was that breakdown in um execution and opera up for the word i was saying before caroline carolyn if i could just jump in so like this is what i'm hearing we're going to go back and we want to we want this question answered i want to know is d trans still operational and if it's not then you know where is it what are we doing with it and um and if we're not using it what are we using does that sound like a fair question for everybody we just want the answer on it and and what i need to also reflect back on is these issues are not systemic because of the pandemic these happened before and now we're rolling into the pandemic and i understand that we are all overworked zoomed out um you know now it's happy hour on zoom and happy hour occurs at eight o'clock in the morning which good for you god bless uh however we really need to be able to um go back and basically say to um the department we need we need better answers and especially because the administration has changed but i'm not hearing that we've gotten any definitive data to be able for us to say this is where we need to move towards does that sound fair yes my my fear and you're right this is all pre-pandemic this is sort of a snapshotting time from where we all went into our houses and haven't come out again since so but but there but karen's right dr fitzhugh was right there's been a lot of changes um especially with capacity in the last several months we are how many beds down now and we're in sdg services 60 something through 63 less beds um and that's concerning so my thought into your point senator my thought is that a lot of this data doesn't exist and and you're right it's a new administration and they're walking in to there's new leadership there and they're walking into this so so how much we get is still unknown because i i i think that's i think that might be part of it is that there's the data from d trans since d trans been and and this is beyond d trend too um sure there's probably data now but without something to compare it to or without some sort of needs assessment to know what it's not hitting or to dr morrison's point that not everybody is using it then to say that referrals have increased or they've made 20 000 referrals is if you're not have if you don't have anything to compare to it's it's it's just numbers um carolyn if there's no data that's an answer to i mean like that's then it's then we say they say i'm sorry we don't have the data on this and then we know then that's the next action point right great thank you kirsten 100 um so then [Music] again and then the next one can i jump in for a second yes of course please um i'm gonna also ask um our committee members to look through these questions and answers this is homework for everybody and we need to um this is where we can help the ultimate goal with this is look at these questions and answers and within the next week by next friday see if there's any additional specific information that you require or need for our mission and then also let us know what's missing like what specific question do you have that you want an answer to um so that we can get um we can get we can it could be broad it could be specific but um i you know i think that we need to to continue to i almost feel like you know we were we're on the information gathering path and then we had to abruptly stop due to covid but we're back now and let's not you know i think that there there are some other questions that we that we should have that aren't on this list and i have a few myself that i'm going to add to so i'd i'd ask everybody uh within the next week to really pin down some additional ones because now is the time um and we have this opportunity so i think that and i think that will help the department too and that we are getting all of our questions together and and and to get the answers rather than go through another round of questioning later on which we might have to do but but let's try to get them all uh all up front mass just have a request carolyn and taylor there's no chat option can you resend this document this has different answers than the one we had last time and i'm sitting here taking notes and occurs to me if we could just get reset the one with the red writing on it too that way we all are on the same draft thank you yeah that was my the red is my follow-up the red is my follow-up that i just sent on on monday that's what michelle was saying at the beginning of the um of the meeting um and sorry if that wasn't clear i apologize um i based on the conversation we had at the meeting in the beginning of january um i submitted our follow-up a few follow-up questions that's what you see in red as well as the additional you still want this information request um we had not delved into these particular questions so that's why there's not necessarily any any red on somebody's um that's what i was we were hoping to do here i i wanted to be i didn't expect to have submitted it on monday and received some of these more in-depth answers within four days um and that's what michelle was explaining at the beginning was that now they're headed into jfc and and the bandwidth would be once again um less that said we're still on a timeline that i am a rule follower um and i want to be able to meet the objectives that were set um by the full reorganization committee chairs and so and i want to be able to have time for us once we have the information we get to a point where we've asked our additional questions they've given us the information and the answers that they're able to give us that we do have time to digest it and discuss them so that the recommendations we set forth to the full committee are very productive and and very strategic and and well-crafted and i want to make sure that we're not rushed at that point that's why i'm that's the time frame i'm on um and you guys all have day jobs so i want to be respectful of that too and there's a pandemic that everyone's trying to do their best to deal with which all of you that that pertains to not just the department that pertains to all of you as well so um yeah so not too much going on um carolyn this is pam sir can i ask um and i apologize because i'm going to ask this but i've looked everywhere for it when you send out those notes could you go back and pull the survey that that sheila and i presented the powerpoint there's a lot of information about contracts and disparity of contracts that might help guide some of the questions send it to the department or senator well to me um document too and i couldn't and then i did did taylor i swear go to the website and look for the documents and i you know i have it because you know i created it so i'm happy to resend it thank you that would be great thank you so much thank you okay um so the only other thing i wanted to bring up for discussion in this that i thought might generate a particular volume of additional questions are the answers around from dmma around specifically around the aco model since these answers were provided the accountable care um permits or you know they were authorized so there's four aco for approved seos in the state now um mostly primary care and this is where i'm going to ask some of you all to help me out with this there are four that were approved um they are mostly medical primary care one is nemours one is religious oceano one is related to the saint francis and then i believe one has the possibility to add in behavioral health community providers um my issue none of this is necessarily the information that they provided none of this is necessarily things i didn't know um personally my i my main i mean there's a lot of additional questions but my main issue is um as part of their answer on number eight they i think it's c provider interviews conducted under the state state innovation model grant that included primary care providers fqhcs behavioral health providers health systems hospitals seos and as a response for a request for information and i stay on top of things and i didn't know that happened and that's on me that's fine but the continuation of and i don't know i can say this is just dmma it's probably not of lumping in community providers with health systems and you know trying to develop contracting and and services comparing agencies like brandywine or any of your agencies in the same [Music] way as christiana care and saint francis and really large or even just larger healthcare providers and then trying to make a system especially a reimbursement system like this aco model that fits everybody is extremely concerning because it's like trying to put a little league player against a major league pitcher and expecting the outcome and have both equal shot at hitting a home run um and i don't think that's the case that's my analogy i've been spending way too much time watching sports with my my son and my husband lately so um i'd ask any of you to chime in on this that's my major concern with their answers we don't know much more about them we're trying to find out this particular model that layers in ncos with acos that's always been our concern um it is still a concern um there's not you know we asked for data they just said there was data so for the same as senator poor pointed out it's sort of sidestepping actual numbers so i don't know if anybody else has anything else provided we can you'll see if you haven't reviewed this to representative griffith's point your feedback not necessarily now if you want time to digest it but i don't know if there's anything else for those of you who have seen it um i think um you know when sheila and pam did that presentation back when refreshing our memories with that would be very helpful so if we could get that sent out um sheila you said you're going to be able to get that to um to taylor could you do that today by chance yeah i can't do that not not at all wonderful all right and then taylor um if you could send that out to the group and again the other thing that i think will be helpful in addition to any questions that you have for the department i'll list out your top five uh problems uh that you feel exists with contracting what are the things that frustrate you the most be it and i think and recollection from our prior discussions i think you know obviously it's the the payment timing and when when you're not being paid properly and on time i mean that's a huge issue for continuation of services but if you could list out a top five and we will report we will carolyn and i will uh look at all that information share it with you all and try to come up with those issues that are shared across the board i think that will also help us focus our work um what what are your thoughts on that idea everyone could if you could please let me know how you what you think about that i like that yeah that's great i like that idea i send them to taylor or to carolyn um it makes sense if you if you send them to taylor copying um carolyn and i yeah yeah and you know we haven't really delved into post-covered contracting related contracting related coded issues and i i don't want to i don't want to necessarily add but i don't think we can ignore it obviously that's not anything expected um nobody plans for a year-long global pandemic and the contracting issues that may ensue uh from that but certainly if if this whole situation has highlighted or um discovered any other gaps or any other uh contract related issues that while we're here analyzing all this that we're able to help shore up too then i think we should take that opportunity again not to believe it but you know it might as well try to address it all while we're at it so getting that though that getting your just to summarize where we are your feedback on the answers that they did provide um certainly any comments on any of the editions i added again my the blue the black was their original questions they got last march or last february the blue was their original answers in february and the red was my follow-up um earlier this week so do you get all your responses um to presta taylor and i by the end of next week so a week from today and then your top five really you know taking a look at everything we've discussed um and and i and i realized we haven't discussed it for a very long time um and rating that all if we can get at that back in that week then i think we the next time we meet we'll be in a really good starting off point moving forward does that sound reasonable yes hi everybody it's um jeannie i i appreciate the the talk about transparency at the beginning of this conversation and since i raised the point last time about answers for questions um i i think we should be able to say in this group that if there are no answers to questions because there isn't the data that just needs to be said and and and and that's okay because it makes it makes our job easier because they are part of the recommendations that we can give but i would truly appreciate from the department if they would just say we don't have the answer and then we can go forward because this has been now going on for a year and it happened uh but if you don't have it just tell us and then our work becomes a lot easier and we can make recommendations a lot easier so thank you thank you genie yes sometimes the answer is you don't have the answer however um you know for the record the more answers the better um does anybody have i mean the the rest of the answers that they provided are really in the weeds and that aco discussion is medium lengthy and i don't necessarily know that i have anything you know i know what i don't know and i know what frustrates us about this um and what you know the the risk involved to community providers that were struggling before a pandemic and are struggling more now um or not here anymore which is the case um there are there are less providers there are less programs in the state right now than there was a year ago when we all locked down um and those are people not being served so ultimately not to cross over into the work of the services to consumers committee but um there there is a direct connection with our work and and their work so any other thoughts before we move on carolyn this is elizabeth from qma hi everyone again um i would just say if we're saying that there is data here i would want to just start with top sheet data the amount of contracts and the money that's being paid into that contract like when you just look at the entire pie of service for dmma how much of that is now going to acos versus providers and then in that contract amount how many actual individuals are being served right like what we're just looking for i think what would really point us in the right direction because this like you said this only started a couple years ago is just some top top line numbers right i'll be happy to list those out and send them to you because we're we're a little bit removed as a ddds provider we're a little bit removed but if you recall last march i think was like the first or second of march we had a conversation about this if we're just getting into it can we just get out of that pie of money it used to go to private providers this way now this is how much of it's going to that aco right and that way we can just start to paint a picture with that i don't think that would take very long because i think those would be very easy numbers to get we don't have to get deep into the data but that will paint a very clear picture and we can see the effect of that over the past year so i'll be happy to send you those questions it would it would be very beautiful no that's very helpful elizabeth and that's really my question and that was really my point and then in the times i've brought it up and again this might be too oversimplified but if there is a pot of money that is coming into the state for medicaid dollars and now is being split up and more how is that affecting community providers and the money they have to provide services and to my previous point that's why i'm concerned that we're the community providers at all levels across the divisions are lumped in at the same conversations and in the same way as large hospital systems or even larger you know service providers that aren't necessarily providing you know at this at the same level so so yeah i believe me i'm not over complicated i don't overcomplicate much i can't really tend to break things down as simple as possible yeah related to that on the dds side just because we're not really dealing with that we're dealing with a very basic you know pcp level specialist level kind of thing um i'm going to ask my questions about like rep payee status those subcontracts it's the same kind of thing are you giving money to an alternate provider um like for paying for rep payee that started to get talked about right at the end of february last year in march there are sizable chunks of the budget but it's a contract that's not very um transparent um and you're kind of wondering why is that being outsourced to something else so that will be in my questions on the ddds side thank you carolyn i'm so sorry i have to hop off but um if you could keep me updated i'll i'll loop back with you okay everybody i really appreciate getting to be a part of this thank you dr fitzhugh um okay so any last last uh call for questions on what's sitting in front of us right now or or comments on it i mean again if you're if you're giving us feedback in an email we don't have to belabor it right now um but i don't want to cut anybody off if you have anything else to to add while we're here good okay so then the next thing and the directly related is moving forward our timeline um um to develop recommendations so i want to be respectful erase time i know that um jfc is starting and that takes up a lot of the department's time and it actually takes up a lot of my time too it takes everybody here it's going to take up their time um so that being said at the same time carol if i could is jfc time coming up but in a lot of ways that's good because when you're preparing for jfc the numbers should be there yeah and you're going through everything that you've done for the last year or two and so you know we're all kind of laser focused on the on the overall so actually i instead of thinking about like oh we don't want to overload it's actually i think kind of an opportunity sorry michelle um and you know to really be able to say hey like that we do we this is an issue that we have recurring you know so so i think it's uh you know i think it's uh it's a good time to to have this and um our the the problems and issues we have will kind of be front and center so that when we get those details in the next week or so we'll be able to i think really be able to start writing those recommendations at our meeting in february thank you that is a very good point um i guess i have a i guess since you're here senator poor i guess i have a question for you um the original uh timeline um when we first started meeting again and the full committee um gave us through february to develop the recommendations and then i think march presents to the full committee um how firm are you on that so so that's you know how firm am i on it i am not looking to rush anything um because i want us to get it right however the flip side to this is that um i don't i do not want us to leave the 151st general assembly without something and what i mean to that is i again reflecting back to another task force uh that i ran and actually extended is that we were able to clear up things through regulation and it has been and even during this pandemic i ran one bill that was basically coveted related and i've had nothing but feedback about how much it has changed to help our systems and the people that live within the system so we need to do that we need to make sure that we are coming out of here with not just a strategic plan that sits on someone's desk not just guidelines to say hey we should do this it's not about that this is about what are the deliverables back it's also about uplifting a department that we have all heard for years needs some help now in your recommendations let me be very clear if those recommendations include that as an example medicaid needs to be by itself with a dotted line to the secretary then we need to say that if it means that dsim needs to be in and i'm i'm bringing this out don't quote me on this okay because i know we're live streaming this but if it means that we need to move another division somewhere else in order to get the adequate services that we need then we need to have that conversation if it's about regulation about a particular computer system that's not talking to another area then we need to know what does that funding look like and so some of that becomes recommendation some becomes regulation and ultimately if it needs to be some will become legislation so if we compartmentalize it that way now you have a clear go get but ultimately you know um i will say this again i understand we are stretched super thin with covid and i know because i've worked you know closely with a lot of different people in related to the last 10 months of things that need to be i will tell you i get a return call i get it very speedy answers they may not be the answers that i like but i can live with that because i've gotten an answer and i think all of us can collectively agree that you can deal with anything as long as you know what you're dealing with so i can't talk about anything in regards i will say in the last 10 months i've definitely gotten things that i needed in order to get the information out that does not though mean that we've cleaned out in the back end of being able to make sure that we are uplifting our providers making sure our clients are taken care of and making sure that the department has with what it what's needed in order for them to do their jobs um i've heard in some of the other subcommittees some of it comes down to clearly clearly communication i mean honestly that has to be the first thing that comes out that i hear is the communication secondly it's basically the services that we're we're delivering and so what does that look like sometimes it's built around education clearly it's built around communication but sometimes it's education and then from the education it's the revolving door so how do we stop that revolving door so these are all things that you know i'm just putting out there um but certainly this committee has it this subcommittee has its own go gets i need you to not be afraid of anything that you're saying i need you to put it out there and then we need to figure out how we can deliver back for all the time that you have spent in doing this that we actually meet your expectations as well as meeting you know our our folks out in the communities i appreciate that pep talk center for um this is daunting um this is complicated especially the the especially contracts and it's complicated and it doesn't need to be though carolyn no no i understand this is this this is simple 101 business management organization and deliverance if you it you know and that's what it comes down to and we know we've had a revolving door in some of these areas yes and and i i'm i think at least the providers that are part of my membership i i think the communication during the last 10 months has been um better um in many areas um there's definitely a contrast in in some divisions over over others i think the uh that has helped certainly with that those of the ability to get the answers as needed um and you know the fact that there's no road map on how to deal with something like this is uh obviously the um there's gonna be stumbles and and that's fine but um you know i'm in no i'm in no rush my goal is that we all have the information we need that the recommendations we put forth are not just um the right ones but that they're achievable ones too like you know we could have a pie in the sky but i want to be able but but i want those recommendations to have to have to have an outcome associated with it sure but you're not going to know what they're going to be until you actually get them down right until we all put that together and then we can prioritize what that looks like you may be surprised that some of the other subcommittees are going to cross into what you need and so now all of a sudden you've got four subcommittees saying the same thing in certain areas that's that's that's beautiful well not beautiful but it is basically a go get right and oftentimes you know this is why you do audits in your organizations this is why you you know you reorganize in your organizations because you know what sometimes you're so far in the weeds you know you don't realize that it's time to make some of these changes here's what i do know it's been loud and clear loud and clear that that things need to change i give our cabinet secretary a tremendous amount of credit if you all remember in some of our meetings one of the one of the things that came out was hey you need two deputy secretaries at least do something right and i have to tell you i got a call from her and she was like look we're going to take the recommendation i had to laugh though because um i don't know if she remembers but she had said oh we came from our strategic planner came from our consultant i was like you don't need to pay a consultant you've got free services happening right now to tell you how to uplift your your department right i mean because you know that that's a positive we don't need to pay you know half a million dollars or a million dollars up to a million dollars to get a consultant to tell us what we need in save delaware we already know what it is and you've got some really big heavy hitters on these calls that are helping to guide us because you guys are in the weeds and you know what it is that we need it's just that simple it doesn't need to be that difficult but for those of you that don't know let me just clearly state when this started two years ago it is because i sat in multiple meetings with several different division people and none of them knew what they were talking i not that they didn't know what they were talking about they didn't know what the other one was doing and yet i had to sit with several different people to get an answer that should never happen right and it didn't happen once it happened multiple times representative williams was with me for several of those conversations and we would walk out like oh my god what just happened okay and so then there was another bigger issue that took place and so when it came down to what i thought about dhss and i thought about the amount of people when i thought about what we're doing when i thought about medicaid i thought wow this is this this department is way too big so i of course thinking my ideas are always fantastic just in case anybody wants to know they're always fantastic and so um i went for the gusto right i wrote a piece of legislation with help from uh two fantastic people that i have to leave nameless and they were like this is what you're talking about and it was to add another cabinet secretary because in my mind we had a data analytical person what i wanted was an advocate but writing that legislation didn't mean that the governor would deliver exactly what i wanted right god if that legislation had gone through i could have been stuck with two data analytic people in a time of an advocate advocacy time where we're in the middle of a crisis right and so now when he asked me nicole i need you to take a step back would you do a task force i said oh that could be dangerous and you know what it's not dangerous it's probably one of the best things that could have happened because the conversations are happening people know the conversations are happening pay attention because i'm gonna now start just releasing information we're gonna talk about what we need to do and what's been happening in these meetings so that way people are aware that we are making progress it may be baby steps and you know what carolyn it might be that this committee it takes us a little bit longer but we'll deliver a report with not only recommendations regulations that can be changed and also legislation so we we have a path forward but don't don't be you know stay positive on this because we are going to get stuff done if we were in public i'd show you what my mob says but it can't because it's being recorded but it says basically what you just said the last couple words um thank you but again pep talk was very much appreciated um i i think i think we have um the ability especially especially in this subcommittee to really flush out some major rubber meets the road because nobody wants to talk about this side of service provision believe me we we try to do it all the time and engage stakeholders and all the time in it and it's and it's complicated enough and if we're able to flush out and um some of this less you know you it's it's very easy to see when someone's not receiving services or it's even easy to see when a provider closes or a program closes um but getting to the the less interesting uh red tape or just nuts and bolts of why that happened and making sure all the cogs and the wheel work together well um to make the car run i think is harder work because it doesn't sound as flashy um but i think it's so so important and i can't do without people who see the other sides of the contracts which are all of all of you um so thank you if we're gonna be pep talking then i'm gonna uh pass along to to all of you as well um i think that we should talk about our next meeting representative griffith we've been doing every three weeks um that's why at the beginning of the meeting michelle had said she didn't know that is the request i made to them that they get it back to us in time for us to review it before our next meeting which we're following three weeks i think this february um wait what i'm looking at january 19th sorry wrong month um so does that work i'm wondering if we could back it up to the february uh if we could back up to february 18th would that work on the thursday february 18th is a thursday for full disclosure i will do my best to join it um but my daughter turns 21 and she for whatever reason thinks it's a national holiday so she has a lot of things planned that particular day some include me some don't but i'm on basic you know 21 year old uh call well you don't want to well i think the day that you really are gonna have to be careful with that one is the next thing the next day so the 19th will be out for you well she thinks i actually have a pool with the governor and so she wants him to make sure he reopens the bars in particular for that night at least till one and i'm i'm i you know well we gotta you're not gonna be available on the 19th either way you might be holding hair back i have i'm i could do the 19th and the uh at um from 12 i'm available from 12 to 2. um i'm available on the 18th all day um i am fine with either i'm more um we've been doing it on friday so i want to make sure everybody has of that like i want to be i obviously might not get everybody but put mindful of any standing meetings you guys might have on thursdays yeah i find with thursday i can't do thursday but i that's well let's just keep it friday then how about friday the 18th the 19th rather at noon and that works for me carolyn just to confirm you're going to are you going to send resend us the questions and answers and what dr bravo is going to provide um we are yes i tell we will get out both the powerpoint the presentation from last year last year and um this document that taylor had on the screen which is the latest version yes and is would it be beneficial if we were to review the contract list that i don't seem to have but you've referenced it several times i mean it's a big data dump it's a big zip file of excel spreadsheets it's i'm it would have been back sent from wendy um last year i don't even know maybe january of 2020 um i'll be happy to email the group that's fine i had it up during this meeting yeah yeah and and and keep in mind that's a year old now so there's another year's worth of contracts that we are we don't have and i don't necessarily know i'm i want i would i would like to see the the new round of contracts only because i wanted to see in comparison with that trend of where these consulting contracts are going and we're service my concern is that i've heard from several service providers through several different divisions that long-standing contracts that they've had with with various divisions have not been renewed i mean we already know gateway clothes that's 47 45 beds in sud that are gone there's a gdenzia program that closed not the whole pro not the whole organization obviously in delaware but one of their programs closed i've heard from a couple other providers that contracts they've had for years upon years upon years that our service either peer programs or other sorts of service direct service that did not get review renewed maybe that's a coincidence and there's really just those four i don't necessarily think that's the case um and that's the information that i wanted to include i don't remember off the top of my head if it's in that document where my comments are in red um i believe i did include it but it if i didn't for whatever reason it certainly will be moving forward but that is one of my my from where we left off to now concerns that are new um but you'll see the file susannah it's huge okay thank you and my my years of being a investigator at the department of justice um those skills came out of hiding last year when i was out like going through all the paperwork i used to audit for investigations um so yeah that information sparked several concerns which have led to a lot of these questions already so that that information that they gave us is absorbed into into much of these questions okay any else anything else representative griffith no i think we covered it i'm just i'm happy um once here and value your input this is the input that um will make the changes happen so um look forward to hearing your top five and and also re um reviewing sheila's report although i am remembering a lot of those those issues and appreciate that time because you did take the time to survey a number of your organizations and um so we actually have that we have a lot of the data let's not underestimate what we have already and what um you know what we're going to be able to how we're going to be able to complement that data within the next week so thanks so much great okay last call for anything anybody has to say and i'll give you five minutes back to your day happy friday it's friday all right um can i have a motion to adjourn please and we officially open it up for public comments i'm sorry the last spring public comment sorry uh so if any member of the public that wishes to provide public comment please raise your hand right now and i will unmute you i do not see any hands okay i always forget that normally they're in the room it's easier to remember people are watching okay um all right well then i heard somebody