Speed, reliability, value and trust are now more than ever it all starts with great internet. Wow supports cspan as a Public Service along with these other Television Providers giving you a front row seat to democracy. Democrats on the House Oversight and Accountability Committee will hold a discussion with abortion rights advocates of the impact of republican effort to tighten abortion restrictions in states. That is like today at 4 15 p. M. Eastern on cspan2. You can watch on cspan now are frequently video out ornline at cspan. Org. Now several governors and medical professionals outlined efforts to improve Mental Health and wellness during a discussion at the annual meeting of the National Governors association and Atlantic City. Speakers weigh in on childcare, equity and training people in the field of Mental Health. Welcome to the National Government association 2023 summer meeting peer here to open the session is the executive director of the National Governors association, bill mcbride. [applause] good morning here and im so happy to see so many of you here this morning after that wild flight we had last night. You know, maybe some of you are not here yet, i cant tell. Rn that on behalf of all of us are at the National Governors association, a very warm welcome to all of you and were so excited that so many people made the journey to Atlantic City this year for our annual summer meeting. Since 1908 the nga served as the bipartisan voice of the leaders of the 55 states, commonwealths and territories in the United States, and ancestors were so happy to be here in Atlantic City for the 2023 annual meeting which is 115th annual meeting. [applause] and, of course, id like to think new jersey governor phil murphy, first lady tammy murphy, and leaders from Atlantic City for hosting us. Lets give a warm welcome to the governor of new jersey, governor phil murphy. Thank you, bill. Lets hear from the extraordinary team. At. Welcome to the iconic Atlantic CityNational GovernorsAssociation Annual meeting, i am honored to call this meeting to order. I think if nothing else between last night and this morning, in new jersey we can sing. [laughter] [applause] so governors from across america are gathered here in new jersey this week to further National GovernorsAssociation Want to give a shout out to new yorks governor kathy hochul, great to have you. [applause] and the governor massachusetts, a state in which i grew up in, remain a member of the red sox nation, and joanna are with us click that back. Thank you all, and incredible honor to he have each one of you here. It means a lot to make the trip to Atlantic City. Bipartisan solutions improve americas labs for government and annual meeting terms as a forum to come together to work on urgent issues impacting our , territories and countries. We have to solve problems that affect each and everyr one of or states, no democratic problems are republicanri problems, only unissues that affect real peopl. Out until people went governors talk, we can find consensus because they depend on us to do just that we worked to address our nations complete infrastructure, best practices on schools and communities safr and collaborate on priorities Like Public Health economic recovery. The nga annual meeting offers opportunity for all of us to share best practices and Work Together to solve challenges our states are facing. This recession which will kick off in a few seconds will focus on my initiative is bill alluded to, strengthening himself as well as the effort my wife has been championing to address, eager to unpack this initiative as is transcends party lines is too many young people are struggling right now but before we delve in, i would like you to help me walk him determined Hard Rock International ceo of semel dating jim allen, tremendously grateful. [applause] a different and we are tremendously grateful to him in the entire staff of the have done to showcase the beauty and the Atlantic City. Please help me welcome, jim. [cheering and t applauding] good morning, everyone and welcome. I had the fortune to work with governor murphy six years ago but now we have our first disagreement. I am a yankees fan so god bless but all kidding asidede, i welce the first lady and governors in the audience, a few moments, most important michael and joe last night but even more significantly the tribe of florida who partnered with, the super majority on a global basis. A quickly, its not a casino company, one of the Largest Entertainment Companies in the world. This year we are approaching 9 billion in revenue and we are going to be in 70 countries. We employ over 50000 individuals and heard promises money about memorability they have noticed, is the Worlds Largest collection of music memorabilia. Over 40000 Live Music Events on a local basis. New jersey so proud and last week and in hyde park so we built this on a longterm basis. Also chairman of the ada American Gaming Association on a global basis and is only two slides, i wont be long, very relevant because when i started my career in december of 1979 for them down the boardwalk, it was a real question signed into law but if we look at the business today, it is not casinos as its sole initiative, it is entertainment destinations and 91 off them, one in the United States and almost 2 billion employees in revenue over 260 million and tax and revenue shares of 41 million dollars. We as an industry are your partner. We look as we come into states on how to educate increase jobs to people in all walks of life and we think its very important. Industry has 100 billion in annual revenue and every ten individuals has or is planning to be in a casino environment. Two thoughts. Number one, we as an industry with myself as chairman and ceo or mgm, we are unified one 100 . The biggest challenge we have in the United States is a topic of illegal gaming for the offshore, strip centers with hybrid games and we want to work with you as leaders to eliminate these. We are working with this at the federal level specifically department of justice inl, workg with Law Enforcement agencies but would you see, we know we are in excess 500 billion. Year on buses that are not regulated and all of us are always looking to see how we create revenue. A tremendous Revenue Source and we as an industry are one 100 embracing this to do it right and that something very important on behalf of the association. I leave you with these models, we are a company thats been around two years and todays world and also easily National Governors association to focus on things like mental awareness and how we can help our youth, those things are so important but i think our models can help in that conversation. This is the National Governors association meeting. All is one. Love all, serve all, save the planet and take time to be kind. When we looked at the first years numbers here, we got this building and we all know used to own it and more than 1 billion are used to own. They close it and laid off 3000 people. I kept our Hard Rock Cafe open. The governor and i were referring to because we care. Our first yearwi we set we wanto do something for the employees. There are givenen bonuses to all employees, union and nonemployee, diversity employees are in. Chairman and ceo, i have six females, for people of color, its not all white males. Candidly, it used to be. B as you move forward and just as Business Partners for coming together all as one means something. My only thing today as you leave, go down the escalator and you will see behind it the original handwritten lyrics of john blevins imagine and i stand here this morning, imagine we of all walks of life and parties of politicale belief come together and accept the lyrics of the song. Thankk you so much for allowing me to welcome you to the aesthetic hard rock. Please enjoy. He started his industry 1979 and gambling was legalized outside of nevada so when i say hes seen it all, literally. Thank you. Todays i session serves as the culmination of our Tears Initiative strengthening youth Mental Health. Today is the culmination of maternal and infant health. I want to welcome the great governor of connecticut who just joined us. Great to have you. [applause] when we kicked off this Initiative Last july, we knew this would be a hot topic but ive been blown away by conversations, meetings and visits we have hadst this past year and we have worked to raise awareness about youth Mental Health and develop the playbook to help our nations use. We are honored to unveil the strengthening Mental Health governors playbook. This is intended to serve as a resource governors station policymakers canan use to take steps to address mental challenges andnd no this playbok is needed. Last month the cdc released data showing suicide rates among ten to 24 age group reached 20 year high in 2021 lose your cdc study on mental trends among schoolage students that found a third of teen girls considering attempting suicide is the increase of 19 in the prior decade. Parents seeking treatment for struggling children face waitlist for an appointment if there is even a therapist in the area. School counselors are swamped an Emergency Rooms wouldon seem are overwhelmed. The painful truth is weve all heard thehe stories and we know too many examples from our own lives and communities but rather than losing hope, these stories harden our resolve to address our countrys youth. I believe this playbook stands and was an important tool to governors and states to used to implement effective policies, solutions that strengthen you think you hope and help our youngest residents and their families. The playbook has been developed with last year through a series of roundtable event held across the country when we brought together close to 500 parents, young people, educators, medical and Health Professionals and other experts in the Mental Health field. The playbook unpacks the four pillars cited our cares Initiative Addressing resilient building, increasing awareness and reducing stigma, ensuring access andve affordability and quality treatment and training and supporting caregivers and teachers. It further breaks down four pillars into 13 Priority Areas in each area is broken down into 35 specific policy opportunities for governors and states to focuss. On including ways to allocate funding, support legislative initiatives and engage with stakeholders. This also shares numerous examples of effective policies that have been committed by state, these can serve as a roadmap for other states of policymakers can revoke the pages of somebody elses playbook, replicate ideas and benefit from whats happening and whats working in other states. I want to share two of the many examples taking place across the country. My friend to the left ear and he a vice chair spencer cox here with his first lady, hes worked with policymakers in utah to implement the safe ut act that connects students at the touch of a button providing support and a safe place to report bullying and threats of violence. 1 million interactions last year saving an estimated two lives every single day. In colorado governor garrett is working on bipartisan policies to improve Behavior Health system and give young people the tools they deserve to manage Mental Health including innovative colorado. Org that offers six adult consultations for students. Those are two of many powerful examples in the plates pages of the playbook. The playbook is meant for all americans based developed by experts to provide actionable ideas and policy recommendations that can make a positive difference. In the work of this initiative after todays meeting what makes a group of distinguished panelists to state more about the playbook and work to address youth Mental Health. I would like if i may, take a moment to share the latest video series was created over the past year to help raise america awareness and governors and states are leading to basis challenge so join me in previewing this video. When your chairman of the National Governors association, you get an initiative and this is strengthening Mental Health among our youth. Ew i dont think it has gotten an attention. New jersey governor bill murphy focusing on youth Mental Health. Americans are coming together to prioritize Mental Health for his children. We need to reach people before they are in crisis. So timely the last several years have been rough on all of us especially on this. Theres a disconnect between policy and what is happening. A Mental Health issue today and doesnt care about politics, they dont care what party you belong to, they want hope. How we can make sure the structures they need to succeed, its important. A red state report will state, we got huge challenges. Supporting institutions that will strengthen families and help our youth. You need good ideas and Proven Systems that work so the fact that hes bringing experts in to help educate us and make sure the governors have access to this information so we can pass policies and respective states to meet the needs of young people is critically important. Protecting our kids is the most sacred obligation. As a parent and policymakers. Ve this july in Atlantic City around the country, Salt Lake City utah, detroit michigan, philadelphia, pennsylvania and a lot of work in between, incredibly proud we can present still playbook for all american states on how to tackle and push back against the surge of Mental Health crises among our youth. Everyone is looking for a career to bring Mental Health resources to scale. This will allow us to come together and ensure we have the best resources. Thats why we ares costume support this initiative to strengthen youth Mental Health. This brings together states and governors from across the country to Work Together on an issue of critical importance and americans of all walks of life. A is playbook will be what we needve to galvanize the communiy and state leaders, parents and educators and all those who come in contact to move this forward and make sure they get the care they need. A full years worth and we believe it has all elements any american states need and deploy to get Mental Health of young people strong, i could not be more proud or happy to present thatca playbook. [applause]ib i want to thank all of the governors who took part and many governors who joined us at the roundtables across the country this past year. Isnt it nice to see democratic and republican governors comingl together in these crazy times . [applause] i want to thank everyone is been supporting and working on this companionng initiative supportig maternal and infant health. An outstanding job leading this initiative is also been a focus at each roundtable event we held this past year. The issues this is not a coincidence of Mental Health and maternal and infant Health Shares so much common ground. Many challenges we and our countrys youth Mental Healthyo crisis relate directly to issues that started with struggles related to maternal and infant health and make sense we continue to consider these issues together and develop shared solutions to give children and our states the support they need and deserve to get the best. I want to welcome the great governor of pennsylvania, josh is with us. Great to have you, buddy. [cheering and applauding] i want to acknowledge them on our team foror their work they t in this past year. I want to thank those who have helped us every step of the way. Today we are releasing playbook on governors and states to address and tammy will share more when we are joined by a panel of experts to explore our initiatives and their playbooks. Without further ado,t lets begn with extinguished efforts. The Senior Vice President u. S. Social impact workshop, it explains the characters. The Organization Behind sesame street, she directs the implementation and community ano family with initiatives in her background includes expertise and bilingual reading, Early Childhood education and special education and ongoing work to address physical and Emotional Health involving children that will lend to the conversation on youth Mental Health and maternal infant health. Join me in welcoming doctor and our distinguished panelists. Come on down. Welcome. Me[applause] excuse me. [laughter] thank you,us everyone and thank you for the privilege of being hit, insertable effort in an incredible time. Im joined here by governor and first lady of new jersey, thank you. He also the incredible judgment representing the underground work. Way to start off with the executive Vice President and chief corporate officer for the Blue Cross Blue Shieldi association. The National Federation for independent communitybased locally operated blue shield company, today one in three americans covered by the system as a members of this team, the communication efforts as well as overall accountability. He oversees this initiative including the boys and girls club of america and clinical affairsal innovation for lasting improvements of healthcare, payers and providers. Im going to go to our next panelist thank you, i am sorry. We have indicated we will address this, executive Vice President and chief medical officer of cvs health and leads the Health Medical organization, cvs pharmacy, womens health, advancing highest possible clinical quality and access to care and outcomes and overall healthcaress costs. Im going to stop there for the moment but if we were here, we would spend much more time on this. Im going to start off and take the pleasure your initiative will he started with this focus and ideas, its been a big year end you have learned a lot. What is one thing that stands out most or surprised most integratingg to what is represented in this playbook . Im going to start off with first lady and i share your passion starting with the beginning, maternal and infant . Health. The wealthiest country in the world, i think we should rightly assume every mother and baby has the same chance to be born into and health and sadly thats not the case. United states is 55th in the world for Maternal Mortality rate. We ride behind every other developed country and its only growing. It ise even more dire and as i think about the owners of this hotel, it is even more dire for black, hispanic American Indians and native mothers who have a rate of two to three times that so the worst and best part as we pivot to what we have been doing, 84 of those deaths can be prevented so we have had the luxury of traveling around the country, Salt Lake City to santa monica to detroit, philadelphia and Atlantic City, we have met with moms and experiencesan and many others develop this playbook that some of you have in front of you, 32 action steps and these are tangible works and i am very excited about it. The most surprising piece is not surprising as much as an affirmation of monterey we went and honored the religious background, no matter what community, there is a genuine concern people want to lean in so i am heartwarming to know we as a country all want to fix this. Donna murphy, you also have had some along the way quite a bit. Can you show some reflections . The biggest reaction ive had, and i think this is ultimately a good thing, strengthening use of the house is not doctoral calculus. We know to do. We know exactly what works. The question is, can we share best practices . To initiatives i have no history with and we now do embedded in this playbook along with actions taken in many states. The reality of steps mentioned, four pillars, 35 specific steps, such are the same thing in the infant in maternal side so do we have the will to execute where we need to find, do we have the will to fund . This is where you dont have a vaccine and struggling to find the answer and that is not the case with this. We know what to do, we just have to do it. Also in terms of practices here. What i would like to hear is a little about your program. Im going to begin youth Mental Health, could you tell us about that . Thank you for taking on this important topic so i will diamond you how we are addressing the topics of your celebrating 60 years now and nearly 10000 locations, 85 of americans within 5 miles in addition to aetna putting healthcare benefits, 25 million individuals and in totality, thats one in three americans getting Healthcare Services and we are proud of leveraging those that support improving american so when we talk about Mental Health, part of my role, we go around and talk to clinicians in various clinics and i have a conversation in chicago a few dayspo ago, she brought as we talked about this topic she said i was doing a physical the other day and we go through the issues to make sure the student is in school and at the end of the physical i said who was accompanied by her mother, who was a middle School Teacher that we just talked a lot about your physical health but i wantys you to know you can talk to anyone if you have an issue about what our feeling and we are here to help you. The mother who was a teacher, she loved that, so the next day she went to the class and said the same comment. We are here to take care of youh she didnt think too much about it, she was just doing her part and later on at the end of the day a student came up and said i was thinking about hurtingdt myself and if you hadnt said that, i wouldnt know that i could reach out to my teacher to address my issues so that was powerful for me because with the stigma, it is providing the tools so think about addressing sigma to make sure lgbtq youth are given resources to reach out for counseling and implement a program called Beauty Marked where we are promoting real images of body positivity to ensure individuals no it is okay to be who you are and beauty comes in many forms. We also have something called standout stigma and we highlight overcoming Mental Health to show that story and we shared a story about an individuall overcoming an addiction and was able to overcome the addiction and regain her family and become employed to show that there is another side of addiction. Wele are empowering clinicians with something called echo project will reeducate different tactics and tools and have a Program Company called resource to living provides a program for 40 million individuals across the country and thats for employees but also caregivers and we provide Care Management sizes for children to use analytics and chance of suicide and intensify outreach for those individuals. Last, we created 24 7 mattel service so you can see the counselor 24 7 virtually or in person. Ultimately we put thathe togethr for aetna members, reducing suicide by 20 . We have achieved 18 reduction in our work is not done but by working on stigma, we continue to work toward that goal. Thank you for looking at things so holistically. Im going to turn to you, sean. Thank you for having us the responsibility to partner with 115 million americans. Within the number is this is a personal issue for many of us, not a powerpoint or abstract. This touches us particularly with youth and a lot of personal ways so i come to this conversation more from the perspective of my role as a father and husband and caregiver then as executive Vice PresidentBlue Cross Blue Shield. We feel we have a platform and responsibly of 115 million americans to put the person and stories at the center of this work. Politics which is why i appreciate the work on making this a partisan piece but the thing is start with is a framework you want this work and why this is important. Our Healthcare System was designed around making people come together. The 21st century has to be entirely making the Healthcare System meeting them where they are and where they are today is really different than when the Healthcare System was built over the last century and the architecture of the so this century is shifting and pivoting words a system of going to you and meeting kids they are, not the kids coming to the Healthcare System. Kids go to peers, teachers, community organizations, gray go home to their mothersrs and fathers. Equipping, teaching, educating kids to navigate their Mental Health issues in ways that are different than going to practitioners and offices. Different and fundamental shift to deliver care. Numberer two, we want to create, reduce Mental Health in this country. There are supply issues, they are acute and they are today. Longterm demand reducing Mental Health issues means we go up stream kids are in with the workshop does end up to six years old becomes critical. Going up stream, pivoting going up stream and integrating care and back to her kids. Two weeks ago we announced a Major Partnership thinking about healthcare differently. We need to invest where the kids are in boys and girls club, three and a half million kids who go to boys and girls clubs everyday in this country but we are working investing 12 million over four years toer train 48000 frontline staff to become trauma informed, make the centers, informed so they can equip themselves to deescalate and triage and moveub children withn the Healthcare System more intentionally. That will be a very small piece of a much larger challenge for an example how we try to shift how we think about making people come to us and us going into communities and that is the i reality in every zip code in this country covering 115 million people. We grew up as local community organizations, we didnt start the National Organization and local community organizations, we think we need to use National Scale but pivot to local implementation with local partners like hearing new jersey setting up meeting kids where they are similar to the programs in utah for example where kids are on the phone and how they connect, they connect with peers and teachers not scheduling an appointment all the time so it is rethinking how it is critical and going to them versus us not just with boys and girls clubs for the work across the area. We incorporate the circles careoy and the unity of communiy and going where teachers and individuals and everyone is. It brings the connection, im going to stay with you for a moment and look as the first lady pointed out, looking at the healthcare and look at what you are doing, could you tell us about that as well . The governor mentioned convergence between maternal and infant health and youth Mental Health, that is right. In the case of maternal and infant health, it is a travesty in the country you are two to three times more likely to die as a a mother because you are nt white. That should not exist in thiss country and we have to stop that out. One thing we are doing is who committed over the next five years to reduce severe morbidity. By 50 in this country. The challenges and i will tell you,al the country is going in e wrong direction so one thing we are trying to do putting care to our people are, not expecting them to come to the Healthcare System, Blue Cross Blue Shield minnesota funding do list to be on site,h shoulder to shouldr with birthing people, its critical. You see increased Health Quality costs. S and reduced higher quality, lower cost and it is culturally appropriate. We are partnering nationally to provide nice training inside doctors offices. Thirty states, thousands of physicians, youve seen national headlines, affluent people of colorr passed away, infants passed away or challenged in this process, it is not an issue opdemographically constructed, income restricted. This is an issue across all classes. Over the next five, ten, 15 years we are working to stop out this discrepancy and in someso cases, two to three times is an understatement. We think it could be worse, latino, pacific islanders, native american women, black women, two to three to six to seven times more likely to die simply because of color of their skin. The last piece ill say, you cannot change your major and historically measuring from the clinical perspective, this is challenged in difficult can equate the system when it comes toto capturing the true identity of individuals within the system. To reintroduce and justly lead and partner with government Measurement System in the 21st century versus the last time it was updated in the early 1990s and what better data, we can understand and connect whats happening these outcomes so a broader approach of partnerships, partner resources on the ground, measurement, Blue Cross Blue Shield is attacking this problem but it is critical, not just a private industry solution for State Government solution, not just federal government solution, its haveizing all resources we to take the care of the system into the community sidebyside with people not making people come to an antiquated Healthcare System. Thank you. [applause] equally, i know Healthcare Organization and be in the community you have these systems and approach even though we havent spoken together in this perspective on maternal health. A personal perspective, i practice internal medicine and code blue means somebody is having cardiac arrest and needs resuscitated and when you run down, you go resuscitate an individual with comorbidity in her attack. I remember my second year coming down, a young woman was having cardiac arrest and hypertension during her pregnancy and she passed and i was one of the most shocking moments to see a young woman who wouldnt be there for her child and that happened three or four times a day in the country which just should never happen. We are at a rate worse than russia and we should agree we shouldnt be like russia anything. When we think about how we address this, it starts with familyplanningwh and resources and there are two major levers we are leaning into Blood Pressure control as well as vaccination Enter Services we are able to provide this directly to individuals but we identify which members would be high risk to Blood Pressure or a gap in care you and they have this rotation and others are motivated some people want that so takingun analytics and vaccination rate. Tain addition, identify the individuals and Management Resources and follow and track those individuals to support them through their journey. Lastly, its important to invest in communities targeting these committees with higher rates of mortality to help support these organizations so it wont be just us alone. We see the impact of these issuesss and you share the focus on data, community and gathering uphill or down in communities so thank you. I am now turning back tod the governor first lady and we have heard so much from these organizations. What we hear at state level, it is on the ground but i would love to know more, these playbooks with exciting examples innovation and best practices, youth Mental Health and maternal infant health. Cover and first lady, i would like to i hear the things you ae particularly excited about both from the policy and impact view. You have the foundation and we can cherry pick, you can do one, you can do all 32, it is really up to the states. There are probably three categories, one, no cost. And sure all Emergency Rooms are asking patients when they present how you have you delivered a baby in the last 365 days . Very simple. Thats one. Secondarily, medicaid. Numeroust opportunities always say the next one is expanding medicaid 365 days post delivery. If you havent done that, i hope you consider that. We talked about dubose and reimbursed for dual care for medicaid particularly Community Care because that is culturally sensitive and embedded in the community, very simple. The last one which is my favorite goes handinhand with what sean was saying, 21st century approach to delivering care, universal visitation. This is a game changer, enables a nurse to go into a home, the first two weeks following delivery to not only check on the mom who normally isnt seen but to check on the baby, you take the stress away for mom and baby traveling to an office. You also remove obstacles they would not normally know like is that mom wearing their sunday finest to get to the office . What is there on the ground living existence, do they need connections anday resources whether it is wifi access or Food Security is a way to expand everything available across the states. I hope youll get somebody on your team to see what opportunities there are two change this across the nation. Governor murphy. Want to jump on something you said in just one other take away. The lived experience families that have lived through it and there are many in this room today, there enormous input value but nothing like lived experience. We caught four pillars, 35 recommendations and hard to know where to start but i will give you two simplee ones. Dont assume you can get to this where they are storms, there earlier, which is why these companion initiatives [laughter] secondly, great commissioner and family services, you know, i will give a jersey experience. Reallyby good from long time, te kids who evident Mental Health issues. Its about 2 of our kids. 1. 4 million kids in School New Jersey this is particularly pronounced with the pandemic, casting a wider net of the kids who were not evidencing stress but may havela it bubbling underneath so we are going to change that. 2 hyperfocus but also a broader piece and part of that is a little like the boys and girls clubs, training folks were not Mental Health specialist and educators to spot the signs where they can deal with the challenge and do it the challenge. In cast a wider net and each of those would be in a better place. One of these Opinion Pieces and speak personally in the foster care system. Those arent always the happiest stories. However in the foster care system, i was a lucky one. 80 of kids in foster care about diagnosable Mental Health condition and often the ones left behind in the system. I got lucky. Ive seen the other side and i am thankful and grateful it didnt but those kids oftentimes surround and thats ald place where they directly meet in and have great effect and thank you for raising the issue in the work youve done because it is a population that sometimes it left out and have a real opportunity. [applause] one of the things i would like to highlight on the is presenting a workshop and what we have done so we have the pleasure to help children be smarter, kinder and stronger. Deliver the gaps we often see and they have indicated how we feel the gaps of Early Childhood. One thing we have found for childrens Mental Health is very strong, there is a gap and awareness knowing the foundation providing skills needed for the children to foster their wellbeing. Wellbeing, their emotional wellbeing. And, also as you all indicated, the idea of the tipping points of emotional distress. How did we capture that early and do prevention rather than intervention . We have created resources that we continue to create, resources that are helping those systems that you all have identified. We have also adopted to, how do we get that wonderful image that youve all connected with the brand and sesame street mothers. How do we get into communities and how do we connect . We look at that circle of care, so we look at integrating you within the Health Care System and within the Child Welfare how do we address the Early Childhood system in the Mental Health system. We look forward to being here and having discussions. Bringing our knowledge, evidence, resources and connections. I am going to now turn to the governors and everyone and get some last thoughts here as we are Going Forward because we are a little bit lower on time. I can hear several things that can emerge. That is very much based on what you have indicated in both of your playbooks. The idea of data of connections in this experience and going into communities and equitable access o. Experiences or practices that you are experiencing based on the philosophy and recommendations on the playbook. Thank you. Thank you. [laughter] these are the issues also plaguing our state. In Mental Health care crisis. Seeing really tragic numbers. I just had for those that decide where to take the challenge up, also add on top of these excellent points that the zip code has tended to be as impactful as the medic code these days. Where people are struggling, where our communities are struggling, the zip codes are probably where you will get the biggest bang for your intellectual book as you go deploy resources. People who have been disadvantaged for the opportunity. The zip code seems to be as great or greater but everybody is suffering out there. Thanks for taking these challenges up. Thank you. Thank you to governor and first lady murphy for your courage in taking on this issue. This playbook is incredible. I did want to bring up one issue. We are going through, part of the problem when it comes to Mental Health generally is a lack of workforce in this space. The need is there, we just dont have the workforce. We did a comprehensive review of licensure inn utah. We just have a terrible system. We have 5000 kids graduating in the state of utah every year with bachelors degrees in psychology. They can do absolutely nothing with those degrees. Trying to change and align so that we are giving people, not Everybody Needs a psychiatrist. And yet we have a obrickandmortar structure. A little morepe post pandemic wh Online Business and things like that. Sometimes people just need a friend to talk to. A little bit of training. How to align those pieces better. We will go through that process. I know we will get a lot of pushback. Any time you mess someones licensure, somebody will not like that. If there are other governors that have been through this journey, i would love to hear from you. I think it fits very nicely with what you are doing. Thank you for this playbook. We need this desperately. Let me jump on this. Number one, you are not alone. Exacerbating it even further. Alluding to this in many cases. The psychiatric lane is cash in the barrel. Really limiting in its exclusivity in terms of the actual families that can partake of their services. Llone of the reasons i love this guy, one of the most powerful lived experiences we have lived this year was from him personally. Thank you for hosting us and everything that you do. I think we are curing the same commonalities about how we diversify breach and stigma. Anything else from the governor . I know this is not a shy group. [laughter] you know, i know many of my fellow governors very data driven. We have our challenges on the physical health side. How we compare success rates, looking a lot there. When we look at the Mental Health space, how do we have that accountability for results . There is so much out there, the standards of care are not as tight as they generally are on the physical health side. How do we reward what works, punish what does not work, eliminates moral hazards and focus on outcomes as opposed to the selfperpetuating systems. In the Health Services we use this structure. Outcome measures become very hard to measure equally because of the variability in how we collect that data. But, still, a lot of what the playbook has is implementing these structures. I would say, we need to do a better job and collecting data on the private and Public Sector also recognizing we should not over index the outcomes. Are we implementing these tactics and how good are we at doing that . Heart attack care, that was 20 years ago. D exactly what we did. That, focusing on the process actually lead to better outcomes. This is a good challenge. I think we as a language in our society after start to bifurcate between this term of Mental Health and Mental Health conditions. Not all Mental Health conditions acquire acute prevention. We have to get better at figuring out what our severe and acute, what are lowgrade anxiety. Equipping teachers and frontline providers. Candidly, kids go to peers first. I have twos teenagers. They dont come to me to talk about Mental Health first. They go to their peers first. A way that you and i were trained on cpr. I would love to see a countryds where every child is trained all Mental Health first aid. [applause] again, the supply side, the workforce side, it is sort of an all hands on deck approach. I would add just one second that this idea of looking at the kind of approach, gather lived experiences and we connect with parents and caregivers. Getting information on prevention. Collecting qualitative data is equally responsive to the data. Governor, i know we are going to close. We have seventi seconds. The countdown is on. [laughter] great job. Thank you. [applause]an great job. [inaudible] i think we are going right into the next panel. I hope you all get a chance, i hope that they give you the same benefits that we have seen. We are going to go right into a discussion. The cochair of the Public HealthDisaster Response task force to lead a policy discussion on managing multiple crises at once. His cochair is vermont governor bill scott. Kind of poetic in a sad way that he is not here because he is dealing with a Disaster Response right now in the great state of vermont. With that, i think i will turn things over to governor lamont. Thank you. [applause] democrats on the House Oversight and Accountability Committee will hold a discussion with abortion right advocates on the impact of republican efforts to tighten abortion restrictions and states. That is live today on cspan2. You can also watch on c