Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Yn ystod yr amser, mae'r gweithwyr yn mynd i'r cyfnod a'i gynhyrchu. Great House. Mr. John Moses. Here. Ms. Margaret Pesciano. Here. Dr. Mark Woods. Present. Ms. Kimberly Baird. Here. Ms. Connie Neal. Here. Mr. Dale Sanders. Here. And Dr. Matt Webster. Here. We have a quorum. Thank you so much, Carmen. If you'll look at the packet that you have in front of you, we do have an opportunity now for the adoption of the agenda for today. So if you'll take a moment to look through, and then I'll receive a motion for approval. I move to approve the agenda. Is there a second? Second. And if you would, if you'll say your name for the Secretary when you're making motions and secondings please. It's been moved and seconded. It was moved by the Vice Chair, and seconded by Commissioner Evans. All those in favor? Aye. Anyone opposed? Motion carried. Thank you so much. In your packets you have the minutes from our August the 9th meeting. And so we can take the time now to peruse through the minutes. Okay. Commissioner Evans, I move for approval of the minutes. I'm sorry? I move for approval. I just said my name. Is there a second? Sierra seconds. All right. Is there any unreadiness? All right. Let us hold for just a moment. What is your unreadiness? None? All right. Are we ready for the vote? All those in favor? Aye. Anyone opposed? Anyone abstaining? Motion carried. All right. I want to, for just a moment, discuss our Executive Board meeting that we had. And I think we had a very robust meeting when we met on September the 5th. And I'm thankful for the members of the Executive Board that come together. And in that meeting we talked about the Recovery Ready updates, which we'll talk about just a little bit later on in this meeting today. But we gave the breakdown of the scores. And I'll tell you, I was excited as being a part of the Recovery Ready's Community Advisory Council, I was excited when I saw the scores that we received. And so if you'll notice the scores in the packet, and I just want to go through them here again, just to let you know that we do have a plethora of resources in the Fayette County area as it relates to dealing with the opioid epidemic. And not just that, but a lot of other services. And so our total score was 277. And the breakdown of the scores, we had a 91 in prevention. We had 100 in the area of treatment. And we had an 86 in the area of recovery support. And all of these scores were a range of 100. And so I don't know about you all, but I kind of puffed my chest out just a little bit when I saw these scores. And the motion, well, I'm not going to put it out there yet, I'll just wait. I'll let, I just need you to know that we did well as it relates to the services that we do have here in the Fayette County area. And so that announcement has been made, and I'll let Carmen Combs talk to us about that in just a minute. We did follow up with our meeting with the mayor and the clarifications regarding the expectations related to recommendations for the use of the funding that we have received and will be receiving. And one of the things that we talked about was the fact that we had mentioned, and the mayor is in agreement with this, and I'm real thankful for that. Is that with some of the monies coming in, and we talk about having sustainable outcomes as it relates to who we're going to be funding. We are looking at setting aside some funds, don't have the full name of it at this point. Because we don't know what it's going to be named, so that they can bear interest or gain interest so that we can have that money in years to come. And as it relates to the recommendations, and Carmen and anybody on the executive board, if I forget something, if you'll help me. But we don't have to worry about so much a dollar figure. The main thing that we need to do is make recommendations. The council, the mayor and the council will take care of all of that. And when we make the recommendations, there will be a format that we will use that we're going to come up with. As it relates to the agency and the summary, a summation of what they do and the recommendation itself. All right, did I leave anything out, guys? As far as that template is concerned. Go ahead, Mark. No, I just wanted to make maybe one comment to support some of the things you said earlier about the scores. And I think it was noted that the group that gave these scores said that this was the highest score that they had given to anyone in our category. Yes. So it's not just us saying this looks really great. They were saying that this was the highest score they've given so far. Yeah. So some affirmation. But we know we've got a lot of work that we want to do to improve and continue that work. So good starting point. Yes. And thank you, Mark, for bringing that up. I'm sorry, Dr. Woods. But, you know, when you talk about the categories, the categories are identified based on the number of people that we have in our county. And so we were category two. So you ought to put a smile on your face. And I'm very appreciative of all the work, especially Carmen and her team and everybody else that has come together to make this come to fruition. Are there any other comments from the executive board as it relates to some issues that we were discussing at our executive breakout? I think I've talked about the recommendations. We don't want to make just one recommendation at a time and send it, but we want to have, you know, a few to present to the mayor. And we also talked, I did talk with counsel, legal counsel, Brittany Smith, as it relates to the work groups. And the work groups are open to the public, just like this particular meeting is and our executive board. We can have the meetings online. We just have to set it up to where it's enough notice for others to be able to be in attendance. It could possibly be hybrid, but we can talk about that. And each work group chair will have the flexibility to establish the structure. And, of course, we will hear from the chairs of our work groups in just a few moments. And so that is the gist of our executive board meeting. And I will be getting with the chairs at some point to talk about expectations. All right? Are there any questions from this commission? Or any other comments? No? All right. Carmen, you're up. All right. Good morning. So everybody, last Wednesday, yes, we went to Frankfurt for the recovery day. That's an awesome day, an event, by the way. And as you can see in the picture right here, I was with Dr. Stack and the governor, and we were awarded our recovery ready certificate. So I just wanted to share this with everybody. Thank you to the commission and all of our community partners. We were able to receive this and become recovery ready. And it is my hope that not only were we recognized on this day in Frankfurt, but hopefully in weeks to come we can have some sort of recognition slash celebration to include all of our community partners and those that were in on these efforts, application and site visit and all that. So, yeah, I think you wanted to take a picture with the commission. Yes, I do want to take a picture with the commission. So if you can come, let's kind of come to the front real quick if we can. I'm going to ask someone if they would, Larry, if you would come. Thank you. I have everybody. But that's it for that. As far as the date, there has not been a date. So we're just kind of throwing that up in the air, and it will be based on availability of the locations we decide as well as the availability of you guys and the mayor. So that's it. As far as the celebration slash recognition, hopefully that will be within the next. I would like to do it October, like the later part of October, but that depends on the availability of the location that we choose as well as the mayor's time, what she has available. All right. Okay. Thank you so much, Carmen. You're welcome. The commission, if we could, let's give Carmen and her team a round of applause. She does a lot of hard work behind the scenes, and I don't know where we would be without her, so we appreciate it. All right. As you all know, we have selected chairs for our work groups, and I want to at this time yield to John Moses and also Sierra Baldwin and talk about the work groups. All right? Welcome to the next phase of your development. Thank you, Sierra Baldwin. Bowman. Let the record reflect it's Bowman and it's not Baldwin. I've known her for a long time. All right. So this week I wanted to get out an e-mail to everybody, and I procrastinated a little bit, but then I lost access to my e-mail yesterday, and I still can't get into it. So I was trying to do it from my phone this morning, and I just don't have everybody's e-mails in my phone, but you're going to get this e-mail today at some point. It's basically just saying that the work groups are going to try to meet back-to-back if possible, so if there are immediate needs or urgent messages that need to go back and forth, that can be done. We're hoping that it can go all virtual. If we have to have an in-person option, we certainly can try to work something out along that. I've got just a few dates or not dates, but days and times of day to offer to start to kind of get us going and see what everybody's availability will be. Some of it's the first and third Monday or something like that, or Thursdays, 2.30 to 3.30 or whatever we have. We have a few options. We know that I'm sure scheduling this meeting was a nightmare even just with so many people, and so we're going to do our best to work around everybody. It's not set in stone that they have to be back-to-back or anything, but if we can do that, that would be great. And I'm just shooting for the moon on this and hoping that we can find something within the time frames that we've put together. If not, we can do a doodle poll or some other kind of scheduling poll and get on the same page. We're also coming up on the holiday season, and so I don't want anybody to consider the holidays when you're deciding if you can meet or not, because we understand that on top of it already being difficult, holidays would just probably end the work groups altogether. So be thinking of it like January moving forward as far as when your real availability would be. Like I said, if this doesn't work, we'll take a poll and whatever. But if you have any thoughts on how the meeting should go or how they should be scheduled, please let us know. I've asked for your availability in this email as well as any thoughts or concerns that you have and how excited we are to actually get rolling on this. I feel like now we're actually getting into the work of the commission, and we've done so much process along the way that this is going to be refreshing. So I'll just say it out loud so that you have what we are starting with, but we're thinking any Monday from 10.30 to 11.30 is good. The second or third Wednesday of the month from 2 to 3. Thursdays, any Thursdays really, 4 to 5 p.m. Or the second and fourth Friday of every month from 1 to 2, which the second would follow this meeting, correct? The second Friday? Yeah, it would follow this meeting. Yeah. So ours goes until 12, and then we have down 1 to 2 if possible. So those are just very few options, but we're going to be open to whatever we can do, and we'll base it around what's best for the whole group. I have a feeling we're going to have to take a few stabs at this before we really get it nailed down. But open to suggestions, and then I'm definitely looking forward to meeting with you, Dr. Ragland, to really discuss while we have the authority to structure the meetings how we want, we'll need guidance on the main points that we need to accomplish each meeting. All right. Thank you so much. Did I do okay on that, Sierra? You did great. The only thing I wanted to add, because my work group is about families and support, and I should have said this in the email, John, but we might have to have some afternoon sessions if we are open this up so that families, even though it is Zoom, folks do work until 5, 6 o'clock. So I just wanted to put that on record, and I'm not saying that it has to be all the time we do an afternoon, but I do just want to make sure that we have at least an afternoon portion, especially for my work group because of the clientele that we'll be working with. Okay. So let me ask a question. I thank you for the work that you're already doing. I'm very appreciative of it. I think you all are going to do great. So the email that you sent out the other day, that was just for the family committee, subcommittee, correct? Correct. Okay. And so if I heard correctly, we're going to try to tie this group and that group together, or the commission and the work groups? What are you? I just want to clarify. Neither, really. Okay. The first one, I'm sorry, back us, each work group back-to-back, and that one option just happened to be an hour after the commission meets on that particular option. Okay. Yeah, and I think that's really good, Sierra, that we can do that. And if we have to go to hybrid, we're open until 7 on Wednesdays, and I could probably host the meeting as well as do virtual from the health department. I don't know. I can certainly inquire about that if a Wednesday is an option. And, Dr. Ragland, the email that I sent, because I was trying to be ahead of the game, and I put that disclaimer once John and I talked, and that's when we kind of were like, well, maybe we should do it together. So I wanted to come with some days just in case, but I will go back to the team to say, like, hey, do you all want to go with these days that John offered or kind of go with the days that I originally sent out? Yeah, and let me know that, too, and we can work around all of that. Okay. Because this was just something I was going to send out on behalf of both of us, so we can look at that again and make sure we're on the same page. Okay. All right. All right. Any questions or comments from the full commission? No? Now is the time to ask questions if you have them or comments or input to these chairs as they are planning. My comment would be thank you all for planning for us. Yeah. Yeah. I second that. Yeah, I have no expectation that this is going to go easy scheduling this, but we'll do the best that we can, and, you know, you get what you get. We're going to trust the process, right? It will work itself out. And, you know, we've been going at this for a while now, and I know that, you know, folks were asking when we're going to do some work. Well, now the full commission has an opportunity to do some work, and my hope is that these subcommittees will come together and be committed that when we do meet, and I know that we all have conflicts that come up because we all work and have other obligations, but if we have it set in stone, I'm a firm believer if we set it in stone way in advance, then it gives us time to plan, and still, even with the planning, there may be times that folks are not able to be there. But while we're there, my hope is that we will do the work that we've been assigned to do. All right. Vice Chair, do you have anything? Nope. She never talks. Bumped her eye. All right. Is there any discussion as it relates to the work groups? We know our marching orders. There's no questions or comments from anybody before we move forward. Just really think January moving forward. We'll meet before then, I'm sure, but just for permanency, think January. All right. And, again, I want to thank and chime in, too, with Vice Chair, and say that I appreciate you all for stepping up and agreeing. You didn't have to, but you did, and I appreciate it. And I think, again, that you'll do an excellent job in leading us. So we appreciate you. All right? All right. We have an opportunity now to hear a couple of presentations, and so I'm glad that we have the Blue Grass Harm Reduction Alliance here with us today. And so I'm going to ask that Olivia Mason and Thomas Ralston would come and present to us at this time. Before they start, commission, you have packets in front of you. Okay. Hello. Good morning. Thank you all so much for having us. We really appreciate it. Okay. My name is Thomas Ralston, and I'm the co-founder of the Blue Grass Harm Reduction Alliance. As a person with a substance use disorder, my life has been marked by unique challenges and resilience. Today I'm here as a passionate advocate for harm reduction. I'm a former corrections officer and currently a family support case auditor for the state of Kentucky. I also have a personal history of opiate addiction, and I use my experiences from rural Paris, Kentucky, where I've seen friends die from overdose, including one who I lost earlier this year in July. My wife, our founder, Olivia Mason, has also had her own difficult journey. She's a former sex worker, foster youth, and substance user experiencing firsthand the stigma and dangers associated with drug use. These experiences shaped our understanding of the vital need for compassionate, evidence-based support systems for those struggling with substance use. Through recovery and perseverance, we have dedicated our lives to ensuring others receive the help they need. Next. Our mission. At the Blue Grass Harm Reduction Alliance, we are committed to creating a safer and healthier community in Lexington, Kentucky, through harm reduction strategies. We are launching several key initiatives, including a post-use monitoring center, which is a critical resource that will support individuals after substance use, reduce overdose fatalities, and improve overall public health. We also want to establish virtual supervision via an app for 24-7 overdose monitoring in partnership with Never Use Alone and the University of Kentucky, and among others. We want to provide a mobile outreach services, including wound care, harm reduction, supply distribution, and to reach vulnerable communities who otherwise face barriers to access. We have partnerships with numerous organizations for harm reduction, HIV, hepatitis testing, community referrals, youth outreach, including Voices of Hope, Recovery Cafe, and the UK College of Social Work. We represent a team of individuals with lived experience and expertise in harm reduction. Our diverse backgrounds allow us to effectively reach the most vulnerable populations, those often facing the greatest barriers to treatment and support. With your help, we can continue to provide services such as the needle and trash cleanups, hepatitis C and HIV testing through community partnership, harm reduction supply distribution, our virtual drug supervision and post-use monitoring, our mobile outreach units, the operational costs for mobile outreach and the harm reduction supplies, funding for staff, including doctors, nurses, and peer supports, technology development for the virtual supervision app. Next slide. Next slide. Okay, this is our, if you look here, this is our, what we have found for the RV unit. This is about how much they cost. What we would like to do is to take these into areas that don't have the access to getting, because there's a lot of people who are houseless and living in encampments, and they don't have the ability to get to certain places. In the vending machine, I have made contact with an organization who is. Primary purpose. Primary purpose, no, this is something else. The vending machine is, I've made contact with an organization who gives funding to put vending machines in cities. And so I'm working right now to try to get a Naloxone Narcan vending machine for the city of Lexington. And I was hoping maybe at some point if I can actually get that, you all could help me find a place to put it. Next slide. Okay, so this is what is a post-use monitoring center. It's a facility where individuals can be monitored for adverse effects after using substances. Basically what the post-use monitoring center would be is people can come in and they be, if they're on drugs and need a place to stay, to be supervised to make sure they don't overdose. We would provide that for them. We would not allow people to use drugs on the property. That's not what we're advocating for. But what we are advocating for is since there are so many facilities that have abstinence as a barrier to a day center, I would like to provide that for the city. We would provide medical supervision at some point. It's in year five is when we want to actually have the actual center. The first four years what we want to do is do the virtual supervision. We're going to have Rita Hub in the College of UK Social Work. They're going to do the research of our outcomes and do program evaluation to see where we need to go. And we also, okay, so why Lexington needs a post-use monitoring center. Kentucky ranks among the highest in the opioid-related deaths in the United States. In 2022, Kentucky reported 1,964 overdose deaths with Fayette County experiencing a significant share. Emergency room visits due to drug overdose have surged by 30% in the past five years. And most of the shelters that are available in Lexington have an implement of a zero tolerance policy for substance use. Yeah, and this right here, I don't know if you can see this. This is our location we have picked out. And right here it says it's $1,850 per month. Which we have included in the budget. Yeah, we have a budget. The folders that you all have, they have our sustainability plan and also the budget in it. So I can go over the budget with you guys and the sustainability plan if you would like. Okay. First, I want to start with some positive impacts on the community. We can enjoy reduced emergency room visits. A study in British Columbia found 67% reduction ambulance calls related to overdoses when post-use monitoring was available. Lower overdose deaths. Similar facilities have seen a 35% reduction in overdose fatalities. And it will improve overall public health, including decreased transmissions of infectious diseases such as HIV and hepatitis C due to safer practices and education. And at this facility, we want to provide MAT, MOUD referrals, HIV hep C testing with Target for University of Kentucky, post-use monitoring, peer support, community referrals for job placement with Voc Rehab and Medicaid services, community needle and trash cleanup, music distribution, mobile distribution, harm reduction supplies, and haircuts. So currently, we have a program where we work with Arbor Youth and a couple different organizations within the community. We give them guitars and we try to foster like a sense of community through music therapy. Another thing on here, we work with a lot of organizations in the community, including the state of Kentucky. And we recently had a DCBS day where we brung in the workers so people could directly apply for benefits. We're all about reaching people where they are and we bring them to them. And we connect people with the resources directly where they are at. And this is actually, can you click on that to watch the video? This is, my friend is a program manager in Massachusetts for BAMSI. Is it not clicking? Okay. You can skip that. Okay, so here is our supporting data and statistics. Over 70% of opioid overdose survivors do not receive treatment. States with comprehensive harm reduction services report 50% fewer overdose deaths compared to those with such services. Emergency room visits related to opioid overdoses cost the U.S. healthcare system over $11 billion annually. New endocritis wing at UK has been due to the amount of people with infection caused by IV drug use. This is, we did a, we have a partnership with Target 4 and they let us know that the xylosine wounds that are necrotic, they're having to do a whole wing due to the opioid epidemic. And UK has just started that. And this is the part where the budget, first we're going to go over the sustainability plan. Okay. Okay. Yes. We're going to go ahead and show you a video so you all can get a vision of what this could look like in our community. Here we go. In recent years, we've seen growing recognition around the importance of harm reduction and the healthcare system and the need for accessible and effective support services. As a result, quality and compassionate care is becoming more readily available for individuals struggling with substance abuse, mental health and housing. But even with more awareness and resources available to help those in need, experts say accessing this care and treatment is often not an easy road to travel. Substance use disorders and experiencing homelessness is not designated to one group of people. It can happen to anybody. It doesn't just automatically turn them into bad people. They're still the same person that they were before they started using substances. They still deserve to be loved, even if they're actively using. They deserve to be supported. Founded in 1975 and headquartered in Brockton, Massachusetts, BAMSI is a nonprofit organization which offers a full continuum of evidence-based mental and behavioral healthcare services delivered in a caring and compassionate manner. BAMSI impacts the lives of more than 50,000 individuals each year, driving change and creating equal opportunities for individuals with developmental disabilities and mental and behavioral health challenges. The mission here at BAMSI is a very simple one. It really is to meet people where they're at and help them learn and thrive and grow. We're not dictating people's treatment here at BAMSI. We're helping. We're a passenger in a vehicle that they're driving. And we're accepting the disease or the issue that they have and then helping them in a direction towards recovery. BAMSI recognizes the diverse needs of individuals with mental health concerns and offers a variety of supports tailored to their specific requirements, including counseling and therapy, community outreach and education and peer support. Another key approach often used is harm reduction. An evidence-based method that is critical to engaging with people who use drugs and equipping them with life-saving tools and information to create positive change and potentially save their lives. Harm reduction services are services that support people who may not be ready to receive treatment, people that are actively using and aren't ready to abstain from drugs or to go into treatment yet. Harm reduction services include syringe distribution and collection, which helps prevent the spread of disease, providing free condoms and other safe sex supplies. We give out clothing, blankets, water, food. We provide free Narcan. It is a life-saving medication used to treat an opioid overdose. We also provide HIV, hepatitis C and STI testing at the COPE Center. And we provide linkage to care and follow-up afterwards. So here at Plymouth COPE, you know, we're a suburban beach town where the deaths and the danger is hidden, unlike in Brockton where it's a cityscape and people are dying on the streets there. So we have the same issues, but ours is sort of like out of sight, out of mind. As a person in long-term recovery myself, the gift that I can bring to doing this work is just I can be my authentic self, you know, have the experience and I just know that people need help. I needed help. Everybody needs help. The access to clean needles is a huge thing. Access to clean cookers, cottons, anything that's going to keep you free of HIV and hepatitis. I didn't really have access to those things when I was younger. I didn't know that programs like this existed at the time. And so I was sharing needles, sharing things not knowing. And to be able to offer these things to people so they aren't sharing needles is monumental. Harm reduction has this stigma around it where, you know, I've been called an enabler and this should be illegal what we do, but everything that we do is to keep people alive and healthy. And how it's not enabling because these aren't new behaviors. These are behaviors that every human has a right to. Every human has the right to health care. Every human has the right to feel safe in whatever they're taking part in and free of judgment. An individual does not present with a particular disease or issue. They're an entire human being and a holistic approach to care. One door where people can come and say I need help without judgment and with the ability to feel as if they are cared for means that everything else can be dealt with. We are a full service agency here at BAMSI and we're really, really proud of that. For people in need of mental and behavioral health treatment, the right supportive environment of acceptance and understanding can guide them toward healing and self-discovery. Learn more today about BAMSI. Meeting each person where they are so they can learn, grow, and thrive. For program information or to learn how to donate, go to BAMSI.org or call 508-580-8700. Okay. Now that we have discussed what we need, I would like to also present you with a plan for actions that will keep our organization in line with our initiatives. Our sustainability plan. First part of this is revenue generation. Grants and funding pursue local and federal grants from SAMHSA Kentucky and the Office of Drug Control Policy and others. Fundraising initiatives. Charity runs, auctions, crowd funding, and corporate sponsorships from companies like Lexmark and UK Healthcare. Donations and memberships. Website donation platforms for individual contributions with reoccurring donation options and exclusive membership benefits. We currently do our donations through Zephy. Comprehensive harm reduction services. Mobile outreach unit. Provide wound care harm reduction supplies and resources to remote communities. Naloxone distribution and texting kits in collaboration with Voices of Hope and Remedy Alliance. We distribute naloxone and drug testing kits to help reduce overdose risk. Needle and trash cleanups. Conduct regular cleanups to keep public spaces safe and reduce the spread of infectious diseases like HIV and Hep C. And it also fosters a sense of community. We like to go work with the recovery community and do that. And it kind of provides that connection between the past where they were and where they are now. Virtual supervision app. Provides 24-7 post-use monitoring through video calls and ensuring immediate medical intervention if needed. Another part of this app we want is we want them to be able to make a safety plan to go over with them before the phone call starts. So they actually know who the person is that they want them to call in case of an emergency. Cost management. Operational efficiency. Invest in energy efficient infrastructure. Adopt digital tools for communication and seek in-kind donations for supplies. We have several suppliers that supply us with free supplies. Financial oversight. Using accounting software like QuickBooks and conduct quarterly reviews to track expenses and adjust budgets as needed. We already have the QuickBooks and we have the Zoom. So the cost that we've included in the budgets is the cost to keep that sustainable. Local partnerships. Healthcare and social services collaborate with the University of Kentucky on research and program evaluation and partner with hospitals and government agencies to coordinate care. We currently work with Rita Hub at the University of Kentucky as well as Target for which we've mentioned for the HIV and Hep C testing. Rita Hub is specifically which is their school of public health and medicine and health education want to collaborate with us to have this be like a pilot research project. Local partnerships. Healthcare and social services collaborate with the University of Kentucky on research and program evaluation and partner with hospitals and government agencies to coordinate care. Community organizations continue partnerships with Voices Hope, Recovery Cafe and A New Way to Live for engagement and outreach. Educational institutions work with UK and Eastern Kentucky University to offer internships, research opportunities and training programs, marketing and outreach. Public relations which is my expertise as a communications major. Build relationships with local media for coverage of events and milestones. Digital presence. Maintain active social media profiles and ensure the website is updated with program and donation information. It currently is. Community engagement. Host workshops that offer continuing education credits and involve the community in harm reduction training and events. Again, trying to give people another path. And then I'll get into our five year plan which is the final part of this presentation. Our five year strategic plan for harm reduction post use monitoring support year one includes community outreach and awareness. Our first initiative will be raising awareness about harm reduction services and connecting communities with resources. The impact we hope to have would be increasing visibility and acceptance of harm reduction practices. The actions we would take would be to conduct outreach events in high risk areas, distribute harm reduction supplies such as naloxone test strips and educational materials. Establish partnerships with local organizations and community leaders to build a network of support. Develop and launch public awareness campaigns on harm reduction and safe practices. Some budget considerations are the initial cost of outreach materials and staff training and event logistics. Initiative two, naloxone and harm reduction supply distribution. Objective, expand access to naloxone and other harm reduction tools to prevent overdoses. Impact, states with comprehensive harm reduction services report 50% less overdose deaths. Actions, increase distribution of naloxone drug testing strips and wound care kits via mobile outreach units and vending machines. Partner with local pharmacies and organizations such as Remedy Alliance and SmokeWorks for supply chain support. Develop protocols for post-use support and iterating year four's research. Begin tracking outcomes for future expansion of plans. Our final initiative will be public and national advocacy, disseminating findings to inform national policy and replicating the model in other states. The impact will be position Kentucky as a leader in harm reduction and post-use monitoring. Some actions are publishing and presenting findings at the national conference to advocate for broader implementation of post-use monitoring centers. Partner with organizations such as Satterproof and other harm reduction organization advocates to push for national policy supporting post-use monitoring harm reduction practices. The focus of this five year plan is on building a robust evidence based framework for reducing opioid related harm through our community outreach, prevention, and comprehensive post-use monitoring. Each initiative is designed to tackle critical factors in overdose prevention, building towards a sustainable and scalable harm reduction model that can be replicated across the state and country. Wrapping up, by supporting our initiative, you are directly contributing to reducing overdose fatalities. The presence of medical supervision can mean the difference between life and death in an overdose situation. Without an overdose prevention center, your city becomes an unsupervised overdose center. Improving public health by providing clean supplies in safe places, we reduce the spread of infectious diseases such as HIV and hepatitis C. And finally, building a supportive community, offering a compassionate care fosters a sense of belonging, encouraging individuals to seek help and embrace recovery. Thank you for your time. Thank you so much for sharing with us today and presenting here. And thank you for your commitment to your own personal journeys. I want to take this opportunity to open it up for the commission if they have any questions at this time. I do. Thank you both for coming today and thank you for your passion and commitment to harm reduction. I've done a lot of reading on harm reduction. And from everything I've read in the statistics outside of the United States, a safe use site is the holy grail of harm reduction. And the statistics are remarkable on the overdose death prevention that when they've opened them up, that it is accomplished. But as an attorney, I'm also aware that there is a need for a safe use site. I'm aware that there are some legal issues that we face in this country with the Controlled Substances Act, which has been interpreted to mean that you cannot operate a center for illegal drug use. And that's been interpreted by several federal courts to apply to efforts to open up a safe injection site. And so I'm reading through your materials and wondering, do you have a plan to overcome that? The Zoom, the virtual monitoring seems like that may, I'm fascinated by that, particularly if you could link it to monitoring of the person who is calling in via some Zoom link to be monitored. But the post-use monitoring center is not that really the same thing as a, it is not. But I don't see how that, unless they used in their car right outside and then walked in. That happens. It does happen. And they use bathrooms, people use everywhere. So we're a post-use monitoring, so we're after the drug use. So that's kind of the way we're trying to navigate those laws. There are several safe consumption sites that actually already exist within the United States. We've made contact with several of them, including One Stop in New York, and another harm reduction organization in Denver, and another one in Massachusetts. As far as navigating legal landscape, so the whole point of this pilot is to prove to people that this works. With research, a lot can happen as far as lobbying to get certain things changed. But right now, there's already kind of a platform for it. There's Never Use Alone that does the phone calls. But a lot of times, their people are having to get on the phone and do video calls with people anyways, because that's what people want. And we're all about filling in those gaps where people have need. We want to meet them where they're at. And that's one of the ways we want to show up for them. Well, good luck with the research. I'm terribly, terribly interested in seeing where this goes. Thank you. My name is Dale Sanders, and I thank you both for coming so much. I appreciate your heart for this. And I just wanted to say from the beginning of my journey of losing a family member to opioids, several of us have here, I started out with listening about harm reduction, and I was against it. And my mindset was terrible because I thought exchanging needles was enabling. I was wrong. I have a friend, John Moses and others, who explained to me that your goal is to not only save a life, but to make people well. I think that's the ultimate goal. And I had to get my mindset right. So keep it up. Do good work. My quick question for you is I'm very interested in what are you doing with music therapy? I've been hearing a lot about music and how that's going to work. How's that working with you all? I've played guitar for 25 years. My cousin donated a guitar. I overdosed in front of him when I was 15 years old. And he bought a guitar for our organization so that I can go into different places and play guitar with people who don't have a guitar to play. We've donated a guitar to Arbor Youth and also to the Recovery Cafe. And I'm going to go in and play guitar with the people. On our public benefits day, I took my guitar and I was able to play with one of the participants during the public benefits day. I also want to go to Arbor Youth and play guitar with some of the kids. And also meditation was another thing I don't think we mentioned. I'm going to take meditation into at-risk populations. In October, I'm going to be going to Arbor Youth to show the kids how to meditate. Yes, and that's one thing about us. We like to bring our unique skill set. See, I'm a communications minister and I'm also an artist. He practiced under several meditation practitioners within the Buddhist practice, and he also plays guitar. So we like to bring those kind of soft skills for people to have, like coping skills for people to have and learn. Thank you both. I know that you felt like you were in a little rush to try to get through this today, so I'm going to study your packet. Thank you both for what you're doing. Thank you. I also wanted to mention about how we would navigate the laws. We have a technical assistance provided by Van Ingram. So he's going to be the ‑‑ I'm sure you guys know who he is. He's going to provide technical assistance. And so is Dr. Kerry Oster from the sociology department at UK. So we're not just going to go out there and do stuff. We've got people in place to make sure we're doing and following the laws. I've worked for the government for ten years, so I can't lose my job. I'm not trying to do anything illegal, I promise. Any comments or questions? I'll comment. I think that it's pretty amazing what all you have been able to accomplish in, I believe, a fairly short period of time. And that passion has driven this. I, too, am fascinated by the idea of you consume where you consume. And we can watch you on video to know if we can send medical help if needed without any liability for me to sit there and watch you. That's pretty much what Never Use a Loan is. We tell people. if you're going to use, have someone there that's not using the same thing and watch you. And so this would just be an avenue for everybody to have that opportunity to have someone to watch them. But I'm familiar with BAMSI, and so that whole idea of a full service agency where everything that you all have talked about today is in one place is kind of amazing. You think of you seeing the building with a big halo over top of it, like this is it. This is everything. I'm sure you're familiar with the hub down around Lee County and the amazing work they do. If there was a way to put all of this into a recovery housing project as well, that might be the gold standard for how we provide services. I actually don't know if I mentioned this in the presentation, but all the shelters in town have zero tolerance policies. And what I found when we did the survey with Catholic Action Center to get a better account of homelessness, that presents a major barrier to why people can't have housing. And our program would give them some structure to be able to get that and get connected to those services to get that. I think you all are doing great work. The resources are amazing. And I couldn't be prouder of people doing harm reduction in Lexington because that's my thing. And I think you all are doing amazing work and have hit all the right pockets of who the experts are in the different areas and you've made all the connections. So I'm real happy for you and happy to see where you go. Thank you. I just want to say thanks again for coming to our Overdose Awareness Day and providing resources. So you are very well received. We had a great turnout and a lot of people visited your table, so thank you. Anyone else? All right. Again, we want to thank you for coming and presenting with us today and thank you for the work that you do. I did notice that in your package you have a couple of several support letters. But I just want to reiterate that presenting in this meeting does not signify your package. You have a couple of several support letters. But I just want to reiterate that. But I just wanted to reiterate that, again, this presentation is not for funding purposes but for you to come and give us information. And we're looking to make recommendations, but we just are not doing that at this time. We're just having people to come and present. But I do appreciate your time and the package. We do have it. So we just wanted to make sure that you understood that. Okay? I'm good. You're good? Okay. All right. Thank you so much again for your work. Thank you for your personal recoveries that you've alluded to today. And keep up the good work. We appreciate you. Thank you so much. Thank you. All right. Let me make sure I say your name correct. Salisbury. Did I say that correct? Leela Salisbury, yes. Leela, with the Kentucky Center for Grieving Children and Families are glad to have you here. Thank you. The floor is yours. Yeah. Here we go. There's the clicker. All right. So just to give a little context to who we are and why we started, pretty much every state with the exception of I think four states in the country has child and family focused bereavement centers. Kentucky was one of the last. We are ahead of West Virginia, which is number one in the nation in child bereavement and still does not have a center. So we formed in 2020, started active operations in 21. This is the current data showing the issue and impact for Kentucky childhood bereavement. We're number six. So 11% of our children are going to be affected by this. Current numbers of children who have experienced a death loss, a parent or sibling would fill rep arena twice. Models projecting forward for Kentucky indicate about over 250,000 individuals by the age of 25 will have lost parent or sibling. I always like to contextualize that CDC related data with that doesn't count impacts of deaths of kinship caregivers. You know, I know you all are familiar with kinship care is a significant issue in Kentucky. So many cares, grandparents, great grandparents, aunts, uncles, raising children. And so this data does not count the deaths of those caregivers, which to the children and their care is tantamount to the death of a parent. It's also not looking at peer deaths. Our youth of color, African American population specifically, are exponentially more likely to experience death losses at an earlier age and multiple death losses earlier than their peers. So looking at unsupported grief, SSA has done a little bit of modeling looking at some of the outcomes. And one of the data points that most struck me when we started this work was the highly negative impact on school outcomes. So nearly 20% of our bereaved children suspended, expelled, or repeat a grade. And we know that also connects to lower overall educational attainment, which connects to lower lifetime incomes, poor health outcomes, and also connects to substance use. After we started looking at some of this larger state data, we asked the organization that does this data modeling to do a report specifically for Kentucky looking at substance-related deaths. And the data they came back with was that of parental deaths, 25% of those deaths for parents were substance-related. We also increasingly, with our school-based services, are working to support kids with the grief of loss, not just non-death loss. So it may be parental absence due to substance use, incarceration, mental health issues, a variety of things. We've also been working with Aetna to create a set of trainings and supports for foster families. And many of those children are also impacted by substance use of parents. So today is just a general overall presentation. I can supply you with all kinds of data making the connection between early death loss and later substance use, doubling substance use risk in case of multiple losses, which for a lot of the kids that we've been serving in our school-based programs, we see probably upwards of 25% of the children we're serving have multiple losses. There's also some really eye-opening data connecting childhood bereavement with juvenile justice involvement. There was a study of 1,000 newly incarcerated juveniles in Chicago, and when they did an inventory of recent life events, they found that 90% of those newly incarcerated had had a significant death loss within the previous 12 months, and for many of those individuals it was multiple losses as well. So this is just a little bit about us. Again, there's a nationwide network of programs, so the good news is we did not have to invent some wheel. There is a good-looking wheel out there. We just needed to figure out what does this particular wheel look like for Kentucky and what are the needs of our various communities. So we were very grateful to start with a two-year pilot program in Fayette County Public Schools, kind of a proof of concept that took advantage of some of the state funding coming through to the Family Resource Centers, and they have been absolutely incredible partners for us. I know Sierra is here, and she was one of our first partners as well. So that gave us kind of a testing ground for, you know, what impacts can this kind of preventative support for kids with death loss have. So I'll just show you, this is the pilot data from our FCPS. The 54% pretty closely matches the overall enrollment data for Fayette County, and for over 40% of our participants were low-income households. We do get parent permission for these groups that we're running in the schools. The demographic data, we don't totally have complete data, you know, this is self-reporting, so often on the income question, participants will decline to say. So my guess is this estimate, this 40%, is probably on the lower side for that. And this, sorry about the way this looks, so you get a sense of the income and racial demographics of who we were serving during this initial pilot. So for the first two years, this is who had died, and I think you see a lot of the impacts of grandparent losses too, and I think in many of these cases, they're either grandparents that were living in the home very close to these kids, or were serving, folks that were serving as kinship carers for the children. And it was interesting to me to see sort of the differences in the, you know, what kinds of issues we were serving children for. I should not have been, but was surprised, nearly 35% of our kids in the first year of our pilot had experienced overdose-related death of parent. So it was a big percentage. The second year, you see that large prefer, the green prefer not to say at the bottom. Usually when folks decline to respond to that question on the family intake, it is usually the case that they are either homicide, overdose-related, or suicide deaths, you know, the stigmatized deaths. So we worked with, we spent a year on a data and assessment initiative with Judy's House and the JAG Institute, which are the folks who put together the national and state-level data modeling. So we knew from the beginning we wanted to be able to measure program impact. For our first pilot, we were measuring anxiety, depression, and stress. So here's the aggregated pre- and post-test data. So we were seeing clinically significant decreases in anxiety, stress. High school, you know, that data is always mitigated. I frequently see the family intakes, and it is, I am always shocked when I read these things. I'm not sure how these youth are functioning at all. They detail multiple losses. They are often put into cases where they are acting as the adult at home for a lot of different reasons and carrying huge loads of responsibility. So when I see these still high anxiety and depression scales, you know, I'm able to see a little bit of the stories behind those, and the fact that there is reduction at all is good news. And then stress, again, you know, just high levels, and this work all dovetails with the mental health issues that schools are reporting and that we're seeing, especially in teens, but increasingly even in older elementary age students. So and this is the depression scale. So, you know, we were, these groups were having a positive impact. The groups are 11 weeks. We use a curriculum developed by a hospice in Tennessee that is based in social and emotional learning, essentially. So it's coping skills. We chose this curriculum because it is not death specific. It allows students to work on any challenging situation, such as also, you know, parental separation, incarceration, divorce of parents, any of those kind of family upheaval issues. So and one of the things we really like about this is it does several things that connects the students. Grief is incredibly isolating, and what the students consistently say are, I don't know who I can talk to about this because people get very uncomfortable when I talk about what's happened, and that is especially true for students with stigmatized loss. I find they are consistently punished in many ways in schools for their bereavement because the behaviors come out, but there's not necessarily the context. So many times on these intakes I see the students write, I'm so angry and I don't understand why. And, you know, I understand why. Anger is one of the chief emotions associated with grief. So part of the things that the groups can do is really address the emotions the students are having and figure out safer things to do with them. I think one of the issues, especially for youth of color, is it has been made very clear to these young people, anger is not an acceptable emotion, especially from a person of color. And I think the groups can help reframe to say it's normal to be angry after you've had this kind of experience. What's something different you can do with that? So I think increasing coping skills and creating a community of support is something important that the groups do. Any group, any school site where we're operating, we also offer any number of trainings that the school will let us come in and do because I think part of the disconnect sometimes is with teachers, classroom teachers, and not to criticize them because they are having to deal with so many different things in any given day. But the trainings can help them understand a little bit more of what's behind the behaviors they're seeing. So maybe there's a support plan that they can put in place with the student rather than automatically sending them to SAFE or for some behavioral punishment where the student can say, I'm feeling really anxious right now. You know, when I raise my hand, can I go see the school counselor? Can I go see somebody in the support office? So with state-level funding from the Kentucky Opioid Abatement Commission, we were able to resume services in Fayette County from the first pilot through the current pilot. We're at 19 different school sites within FCPS and you'll see a difference. The school sites that we've really been focusing on now are schools who are actively asking us but also we are reaching out to schools in neighborhoods and parts of the community where we know there are high levels of loss. So this data is going to look a little bit different because now with the state funding, we're able to be even more intentional about which new sites that we're bringing on. So you'll see the differences here. And again, a lot of parental loss, which is significantly disruptive to these kids' lives. What we're seeing a lot more in these new school sites that we're serving, again, undisclosed illness often can tie into overdose. This work is also a window on the stigma that also still exists around substance-related deaths and suicide in particular, but also gun violence. So we're seeing a larger percentage in this more recent work with students also impacted by gun violence. And then again, increasing people who are disclosing suicide-related losses. So for this pilot, we are still measuring anxiety and depression instead of stress because we realize there is so much consistent stress for these kids. That was not necessarily as meaningful a measure. So we looked at resilience. I think when we talk to schools, talk to communities, funders, resilience in the face of adversity is a key skill and something that these students need. They're going to have hard things happening. So this is what we were measuring this time and really focusing a lot of the work on that. So we did see increases in the resilience. And again, with this pilot for Fayette, to be honest, we were serving a lot more students with a lot more trauma. So there are statistically significant increases, but we're also serving a slightly different and much higher need population in this. But we also believe that's where we need to be because these students are the students who are least likely to get support outside of the school day and they're dealing with a lot of challenges. So kind of going through again, we're still seeing the program efficacy through these slides. So our conclusions from these pilots, the Frisks and the school counselors at the school level have really been remarkable. And they are the ones who help us identify the students, work with the families to kind of socialize what this is. Occasionally, there is some hesitancy on the part of the family, especially in cases of stigmatized losses, to participate in the Frisks have been really key in helping mitigate some of those concerns. I will tell you, I still see on family intakes, so we have the caregivers fill out an intake and we also ask the students to tell us a little bit about why they're there. And often we see a different set of answers. And I can't tell you how many times students will write on the intake, and sometimes these are middle and high school students, will say, I don't know how my mom died. There's kind of a breakdown of family communication and from our perspective, those are usually students with stigmatized and traumatic losses. There is a disconnect we see with the caregivers and parents. Oftentimes they're open to having the students supported in their grief, but they are not willing to open their adult Pandora's box yet, so that's something that we continue to work with the schools. And we also offer school-based programs, our largest program, but we have an active ongoing community-based program here that meets twice a month, and that's a program for children and their caregivers. I will say, I work hard on recruiting some of the school families to also transition into the community-based groups, because the community groups are where we can help support the caregivers in their grief. And we have a, it's a variety of families, we've got everybody from young widow to great grandparent raising grandchildren and their substance-related deaths, suicides, you know, and then cancer deaths and some of our other public health challenges. So it's really a wide-ranging group, and that is an ongoing free program. Most of our families who started with us in that program more than two years ago are still coming, which I think, you know, and this is voluntarily, and they're often, you know, having to coordinate the schedules of multiple kids. So I think that's a measure of, you know, they're finding good support in that engagement. So looking at, and again, I realize this is just, you know, a presentation generally and not a specific funding request, so I think our larger needs are figuring out how to consistently fund services to FCPS, you know, that is where I think we're engaging with some of the youth who are most at risk for later substance use and are experiencing a lot of traumatic loss. So I think we need, you know, more runway, this is a newer project for FCPS, I do think there are SAMHSA and OJJDP, other kinds of grants that we could work with FCPS on over the long term to help, you know, build the sustainability piece. But I think in the shorter term, these are the kinds of funds that could keep this project going and thriving. The other piece of the need, I think, more generally we've got in the community is for a specialized therapeutic space. So, you know, nearly all of these other centers have a building that is essentially a giant playhouse. So these pictures are all from other grief centers, we're a member of the National Alliance for Children's Grief, so every summer when there's our national conference, we go and tour one of these centers in different parts of the country. So most of these photos, I think, come from Judy's house in Denver and the Center for Grieving Children in Orlando, Florida. And those are two great examples of how inviting and cool these spaces can be. I think there is the challenge of, you know, when a family hears, you know, come to a grief support group or event, automatically you think that has got to be the worst thing ever. I do not want to go to that. I think it's a bunch of people sitting around crying. So, you know, we're dealing with kids and teens, so we realize, you know, we need to make it fun. And also, especially for our younger grievers, they really process through play. So this summer I had the opportunity, usually I work with the adult group, but there were several times this summer I was in with our three to six-year-old group. And there was a three-year-old walking around. We're currently at Tate's Creek Christian Church. They let us use their basement facilities. And she's walking around with a little play phone and says, I'm going to make a call. Ring, ring, ring. I'm trying to call Dad. He's not answering. He's dead. And when, you know, we understand, because, you know, this is the work we do and our volunteers know not to go over and say, oh, you poor thing, you know, your world must be terrible because that sort of reinforces the idea that, you know, you are broken, damaged. The volunteers are like, oh, I'm sorry you didn't answer. Tell me about your dad. You know, that's kind of the approach we're using. And one of the things, again, especially education for early childhood, Head Start, we've been talking to Community Action about some training work we can do with their teachers and caregivers because, again, children are smart. And they see, when they say things, you know, they can read. If it makes an adult uncomfortable, they understand, oh, this is not something I'm supposed to be talking about. You know, shame and guilt are very strong with young grievers, and they pick up on the cues they get. So our goal is to create inviting healing spaces where shame and guilt are not in the mix and they're supported in wherever they're coming from. So I would love a sand tray therapy room. Those of you who work in schools and have seen schools and child therapists work with sand trays, again, allowing younger kids to process through play when they may not have the language or the ability to verbalize. And the emphasis on the younger grievers is important. Before I went into this work, my perception was a teenager losing someone is like the most vulnerable age, and they're open to the worst outcomes. The research actually shows it's the younger a child loses somebody, the worse the outcomes. Children reprocess grief at every developmental stage, so what it means is a child who loses somebody at the age of two is reprocessing the loss, you know, five, seven, ten times as they hit different developmental understandings, you know. They understand the permanence of death between eight and ten years old. I've seen this with my own daughter. Her father died by suicide when she was five, and basically every couple years she has a different understanding of what that means, and even as a 17-year-old this last year getting ready to go off to college, she came to me and she said, you know, now I'm old enough to understand what suicide must have looked like, you know. She understood the visceral nature of suicide. So for these kids, unfortunately it's not just we've had this conversation once, you know, and we're done talking about it and you're done struggling with it. It is a lifespan issue for these kids, so our services are also very open-ended. Kids, I know my daughter and I, we started as clients of a center like this in Jackson, Mississippi, and, you know, we went for a few years and then we went back later when my daughter was struggling, so our services are open-ended. It does not matter how long ago the loss was, and I think that's the space that is not served by other organizations, Bluegrass Care Navigators, and some of those folks who do incredible work, but their services are time-limited of necessity, you know, for bandwidth. So we want to make sure our services are ongoing for whenever there is a struggle over the loss, our services will be available. Again, complimentary therapies, you know, we talked about music earlier in the presentation. I want to give our youth access to a lot of different healing resources. It could be music, it could be mindfulness. We've got a woman who has done jinchinjitsu, which is acupressure, teaching children finger holds that are calming, you know, giving them a set of tools to say, when I am struggling, here's something I can do for myself that is healthier. And I realize, especially for lower-income families, they are lucky if they have access even to a therapist through school, much less all these other complimentary kinds of programs we're starting. The Horse Park reached out to us and offered their services. One of their education staff was bereaved as a young person, and like many, she says, if I had had a program like this when I was young and lost my person, my life would look very different today. So on October 13th, we're going to go hang out with the horses at the Horse Park and invite families from our community groups, our school programs. So I want to help families build new memories and also give them the tools for connective conversations. You know, I would like to see less of the, I don't know how my person died, because those are the situations in which those youth are struggling with a very heavy weight alone, and they feel a lot of responsibility. One of the stories from a school group that always stands out to me was a group, I believe over at Lee's Town Middle, and it was all young women who had lost mothers to overdose. And one of, the facilitator called me on the way home, she said, today was heavy, I just need to process. And she said, one of the group participants had said, you know, I knew my mom's friends were using, and I should have stopped her going out, and I didn't, and it's my fault that she's died. And if we think about, you know, the deep connectivity between death loss and later substance use, and particularly death loss by substance use and later substance use of those children, you know, it is probably more appealing to use the substance than to sit with the belief that you have killed your parent or a significant person. So I definitely hear the stories all the time, and folks who are in recovery, you know, we'll be at a lot of these events, and we're chatting, and I talk about what we do, and they'll say, you know, we're about five minutes into their story, and then they'll say, oh, and this person died, and then I started using, you know. So we've got the research that says that, but anecdotally, this is the story I hear from adults so many times. So really, you know, preventative work, and again, helping the caregivers, giving them the support and space to know how to support themselves, giving them resources, referrals, and then how they can, you know, have their family be a little healthier. So again, these are pictures. These spaces are so great. And I feel like the children of Lexington with death loss absolutely deserve this, and this would be transformative for many of them. I think overall, school-based, maintaining both community-based and school-based work is the perfect prevention partnership. Again, we tend to serve different kinds of families in each of those programs. You know, decades of studies really specifically connect substance use with low educational levels, higher rates of unemployment, family dysfunction, psychological and psychiatric problems. So I think if we can work early with a lot of these kids and teens, you know, have them do goal setting, have them understand, you know, these deaths are not their fault. They are free to make their own healthy choices. One of the other things that we're working on more recently is helping socialize. There is a child survivor's benefit through Social Security. Children who lose a parent, and if the child is under 18, they're eligible for a per month benefit, if the deceased parent has a work history and has paid it all, into SSA. The national data shows that less than 50 percent of parentally bereaved children get this benefit. SSA is sitting currently on $50 billion of unclaimed assets for that. So I think part of the work we can be doing is to help socialize that to, you know, LFUCG Youth Services, the Frisks, helping build the family financial stability piece that also ties into substance use and outcomes for the kids. You know, one of the stories that I think most about that happened very early in our work. It was a 15-year-old who was in one of our school groups, and her mother had died of an overdose in their front yard. And this 15-year-old was the only person in that family who was functional enough to plan her own mother's funeral. And our facilitator, you know, worked with her, and she just was talking about how nearly impossible that process was. I mean, as an adult, we have a hard time planning our parent's funeral. I cannot imagine, you know, a 15-year-old who is put in that position. So, you know, I think about this work as some of the best prevention investments we can make, you know, reducing long-term burdens, hopefully, on the court system, law enforcement. Again, this all ties into juvenile justice involvement often because of drug and substance use. So my sense is over time, some of the state-level abatement funding is going to shift to different kinds of initiatives. So it is my hope that for these locally-based services that we want to keep providing, there can be an investment through this local committee. You know, overall, I would just say I think this is one of the best prevention investments you can make. Intervention is a lot cheaper than intervention, as I don't have to tell you, and I think it's a very specific set of supports and interventions for the students who are going to be at exponentially higher risk for later substance use. So I feel like it's very targeted in that way. So I would love to answer questions. I can also, there's tons of data, research, infographics. I just didn't want to overwhelm everybody with all of that now, but we are happy to be a resource in any way that's useful. And again, building as many connections with our community partners, with the city, I think will help keep this work growing and vibrant. So I'm happy to answer any questions. Thank you so much for your presentation, and thank you for the work that you do. And I wanted to ask the question, I know we're talking about prevention, but in the, with the work that you do with the children and youth today in dealing with the trauma, are there any of those children who are already suffering with substance use disorder? Probably, typically we are not necessarily in the community group level. I suspect, especially now as we are beginning more of our work, to be honest, high school services, especially in the first year or two, were a challenge for us. Elementary is an easy sweet spot. School staff know much more about what's happening in the family and are able to refer and work with caregivers. We still had pretty good success in middle school. High school, the high schools are so big, and in those cases, school counselors and school staff may have 600 plus students that they're working with, so they don't necessarily know. And unfortunately, these are students who are not necessarily knocking on the school counselor's door saying, hey, I'd love to be in a grief support group. So for Fayette County, what we started doing is working with some of our alternative schools. So we started a group at the Learning Center. We started that last year. We're going to be back there this fall. We're starting services this semester with the Audrey Grievous Center. And I suspect those school sites, we do the Success Academy actually, just we connected with them in the last couple of weeks, and they said, yes, how do we get started? So I think that is likely where we may see some of this. Again, building up the trust, this is not formal, billable therapy that we are doing. So I will say, we often will work very closely with school staff to say, hey, I think this individual student needs one-on-one, here's a resource. So in some ways, we're an extra support and set of eyes and ears for the schools in that way. Thank you. Thank you so much. Awesome presentation. Thank you. Thank you. I will say, since we did pilot through Henry Clay, there were students that suffered with whether it was vaping or different things that we kind of knew about. So that's how we also knew some of the students to identify, because once they were in trouble, we do an assessment, and a lot of information got told to us, and that's when we knew who to refer out to certain groups. I just wanted to throw that out there. And that's true. And we've seen that also, I know, at Bryan Station High School, which was one of our other sites. We did, over time, work with the youth services coordinator for, unfortunately, some of the students they were referring were these students with the highest need. But what we found, especially at Bryan Station, likely probably was the case at Henry Clay, those were also students who had issues with chronic truancy. You know, they're the kids who have the most challenging set of things going on all at one time. So I think our decision to try to work with some of the alternative sites is just that those sites offer a lot more case management, a smaller student ratio, they're very active case plans, that's how those school sites are designed. Again, we catch who we can, but I think there's still some definite disconnects. We think a lot about those disconnects and are always trying to figure out how we can narrow that gap. Thank you. Yes. Yes. Thank you for the presentation, but no, I just wanted to, I appreciate the question that you asked, because something like what we're dealing with, or what we're tasked to do, I think it would have to be targeted towards a certain population. And I think children who might be using would probably be the most appropriate. But I do, I know someone who has their children going through this program, and it's a great program. I would just like, if, you know, thinking about this body in particular, and it's not my committee, so I'll let you all handle that, but just my two cents for what it's worth, I think it would be most helpful to kind of target those juveniles who probably are using based on grief. Right. That's a, so that's that, but you did mention two other, and I don't mean to be cheeky about this, but you mentioned two other agencies that have very deep pockets, and that would be Community Action Council and Fayette County Public Schools, and I think this would be very helpful within the school system, so I appreciate the context that you're making with that. And I think you'd mentioned, I think Lafayette might have a program that it's maybe a safe deterrent, and you'll know more than I do, but I just remember someone, a friend of mine subbing in one of the public schools that it's just like what you said, look, I just need a moment, you know, I can't go to class right now, but that's like a whole other kind of program, and I think we would need that a lot more in schools just based on, you know, the juveniles that my office has to deal with, so that would be very helpful, but I do appreciate the presentation, but I think, you know, if you could find the juveniles who have a substance abuse issue that's related to grieving, I think that would be really helpful as we consider our recommendations later on. And that was one of the reasons that I intentionally reached out to Audrey Grievous, because, and I would be thrilled, one of the things I've been talking about for a couple of years, I think there is definitely, you know, we a couple years ago had FCPS, and we had some conversations with CDW about putting together groups for some of those work. I think we absolutely should be working with the Juvenile Treatment Court, some of those kind of early intervention programs through the Office of the Courts and the County Attorney. I guess our challenge has been we can't find the right person who's willing to, like, explore that with us, so I would love to hear, you know, from anybody in those spaces, because I do feel very passionately about that. But elections are coming up, so I'm just saying. So good. Please. No, again, that is a piece of the program that has been in our long-term plan to build and needs to be built, so as you say, I think that would be an especially important piece of, you know, what this committee had purview with. Yeah. Leila, thank you for your presentation and the great work that you do, and building on that last comment, from my perspective, it's not only potentially targeting children who are driven to substance use from bereavement, but children who are suffering from bereavement, from an overdose loss, because I think that is a consequence of the opioid epidemic. And as a parent who lost a young adult to an overdose and participated in the Voices of Hope grief group, our collective group all commented that going to other grief groups where there was a mix of losses was not as productive, because we felt stigmatized in our loss. And together we could share commonality of issues that we experienced as a parent who lost a child to an overdose, but also reflected back in the weeks, years, sometimes a decade of struggling with that use. And so I wondered if your organization has, and woven through your discussion was an acknowledgment of stigmatized loss. Do you offer or is there a plan or desire to offer individualized services for that group of individuals, rather than mixing them in with cancer loss, MBA losses, because I do think it is a special hell? I agree with you, and that's one of the things we talked to other centers around the country. It's sort of a 50-50, whether they offer mixed groups or kind of birds of a feather loss groups. The bandwidth to do the birds of a feather groups, I'm very open to that, because I realize especially I think loss of child in all of those losses together is probably what's pointed out as the most specialized and different kind of loss that needs a room of people who have experienced that very same thing to be the most useful for folks who come. I do think in our current mixed groups, again, which is what we've got the bandwidth for, I am very intentional. Stigmatized loss obviously is very close to me, and I want those groups to feel safe and open for everybody. And probably about 50% of the families who join at one point, it was more like 70, 75%, are there for stigmatized losses. That makes me feel good, because I know if this space can feel safe for those families, then it is doing what we need to do. But to your point, I agree. There is an infinite need, and we grow the pieces and parts. And Ms. Evans, to your point, I agree. There are people out there with deep pockets. They don't necessarily want to open, we have asked, trust me, open it. Each large organization has their own particular priorities when it comes to dollars. So I will keep asking them, but, you know, yes, I think it may take a little bit more time. You know, I specifically asked this spring about applying for a federal multiyear grant, and they said, well, we're busy with some other things. So again, I think if we can keep knocking on the door, so we just, to your point, more runway until, you know, we can more deeply integrate some of that. Yeah. Thank you. Yeah. I'll just make a quick couple of comments. This is a slam dunk. I mean, this is the type of stuff that often goes unnoticed, unrealized, and are the forgotten pieces. And I would agree that certainly we need to target people that, you know, these children that may have a substance use thing going on, but it's, we're trying to prevent some of this, right? And we know that that's a major piece of it. So one of the challenges, I think, to Angela's point is that, you know, this is money for Fayette County, this is money for, you know, the opioid abatement. So we'll have to be really, I think, very coordinated in your efforts to make sure that it's, you know, this money or any monies that we're given would be provided for that. But I'm inspired by this. I'm inspired every time I see you and I know you well enough to know that I don't know her anywhere else outside of just seeing her everywhere. Like she is constantly at the situation table this week. She's at, she's everywhere. And so I say that only because I want to be able to recognize that I know your organization is going to continue to grow and to continue to provide services that sometimes we don't always realize as being so necessary. And you know, you're always in front of somebody talking to somebody or whatever. And so I wanted to recognize that, but also recognize just how important this is. And I say it's a slam dunk because I think one key piece to bring out is that a lot of those other organizations are, it's therapies. It's how they're getting reimbursed. It's how they're, this is not therapy, but make no mistake. This is therapeutic. Right. Exactly. Very different. And we don't fund that here in America. Yes. Thank you. Thank you for pointing that out. I do think, you know, there is incredible benefit to this work in creating connections, decreasing loneliness. You know, we've had kids write in, you know, many bereaved children are bullied and I have no doubt there's data between, you know, being bullied and later substance use. You know, we had several kids write in on their like end of group forms. You know, we asked them, what did you like? What didn't you like? What was helpful? And many of them wrote, I made a friend in here. And I was talking to our clinician. I said, to your average person, you're like, yeah, you made a friend. But to these kids who need connection and understanding and support, that is a huge piece of the prevention. You know, there are the newer studies, I think, I can't remember if they call them PACES, it's the preventative factors combating the childhood ACEs. And so many of the components of our group, you know, the connection, the goal setting, you know, emotion, identification and regulation, like all those things combat the other things that have happened. So I think that, you know, the prevention, unfortunately non-billable piece, you know, which is why I am at all these places, because I believe passionately that this work can change trajectories for kids and, you know, stop some of this potential use before it starts. But again, the funding piece is, you know, always challenging. But I do know, you know, I'll end, I could go on all day, and I know you have many other things, but I want to talk about a young man from our community group. He was a student at Lafayette, came to us after the death of his second parent. Dad had died in the military when he was 9 or 10. Mother died of a sudden illness when he was 17. And he came to us with his aunt, who was, his older sister had custody, but aunt was really helping him connect with resources and taking him places. And so he would show up a couple times a month at our group. First time we saw him, you know, hoodies over the head. We could barely get his name out of it. He couldn't tell you what school he went to, how old he was. Again, you know, I think this child is an orphan at this point. And so our volunteer just kind of hung out with them. They'd play cards, they'd talk. About month 8 or 9, and again, this is why I'm a believer in the long-term nature of this work. You know, I love our school programs. I'm not under the illusion that 11 weeks fixes anything. You know, it lays some seeds, which is why I love having multiple programs that the families could transition into our community program. So about month 8 or 9, suddenly our volunteer who was working with this young man came in and said, I don't know who this kid is. He will not stop talking. He opened up. I think, you know, it took a while to build up enough trust to, you know, be open about a situation. And we were able to support Ant. I will give so much credit to this aunt. She told the high school, he needs to have a do-over of the senior year. That's the only way this is going to work. This was a young man of color. And the story for him most times would have been he dropped out of school, you know, and a host of things that no one wants to see would have happened afterwards. You know, due to this amazing volunteer of ours and his aunt in particular, he graduated. He joined the Marines. I just got a photo of him and his aunt at the boot camp graduation on Paris Island. And before he left for boot camp, he came back to our community group and sat in with the adult group and talked to them about what he'd been through, how that support helped him understand that he still could have a good and meaningful life going forward. And I just, that was the happiest day because I know, you know, this is the unicorn story, but it happened. And that is the unicorn I would like to see running around Lexington much more often. So, yeah. Thank you. I really appreciate your time. Let me just say to you again, thank you for coming and sharing with us today. I want to say that, you know, a lot of times we hear or I hear presentations and I hear a salesman giving information, but what I heard today was a person who has compassion, a true servant who wants to be of help. I'm not going to put my preacher's hat on, but I feel it. But I just want to thank you because I hear it. I see it in your mannerisms. And you know, the one thing that we know and understand is it doesn't matter about, you can have all of the therapy techniques and theories in the world to use, but one of the most important thing when we're working with clients is building that rapport with the client, that alliance. And when we can do that, then they begin to trust us. And I hear that in several of the stories that you said today. So, thank you for your work, for your compassion. It sounds like it's not just work, but it's a ministry for you. And I appreciate that. It is. I think about these babies a lot and I just, they and their families are so special and they deserve the same chances that all kids deserve. And so, yeah, that's why I show up everywhere because it's just... Let me say, I'm familiar with your work and I'm so grateful. Well, and I appreciate everything you do, especially with the kinship care. You know, again, that's a huge and not always seen piece of how, you know, the work we do and the work that a lot of other agencies do. So I love, you know, this is all interconnected. You know, the longer I do this work, the more I see that. So I just, I want us to be, you know, one of those puzzle pieces in making that, you know, healthier future puzzle for everybody. Thank you. Thank you. Thank you so much. We appreciate you being here today. All right. Anything else from this commission today? All right. Before we close, I just want to remind us that Helene is here and the wind gusts are up at 58 miles per hour at this time as we speak. And so as you leave today, please be careful going home. You know, we're all precious gifts. And so please take care of yourself and drive safely on your way home today. I'll entertain. Yes. Dr. Woods. I just wanted to mention one more thing for those people that might be interested. The Kentucky Opioid Symposium in Louisville is on October 21st and 22nd. So a lot of really good stuff they're going to be presenting. October, can you say it again? October 21st and 22nd. And I'm happy to send out to the group some links. All right. All right. Anything else before this commission today? Hearing none. Is there a motion to close this meeting? Oh, y'all want to stay? Is there a second? Second. All right. All those in favor? Aye. Meeting adjourned. Have a great rest of the week and be safe.