Florida Governor Ron DeSantis Press Conference Transcript August 19: Mental Health & Coronavirus

Ron DeSantis: (00:07) Well, good afternoon. I really want to thank Advent Health for hosting us here in Seminole County. I also want to thank the great group of folks we have assembled here today to talk about some issues that may not have been on the front burner in the public consciousness over these last few months, but I think are going to be very, very significant going forward. Of course we have the First Lady, who's done an awful lot in the field of mental health. Even with a baby up at 3:00 AM, she's still here ready to go. Casey DeSantis: (00:39) [crosstalk 00:00:38]. Ron DeSantis: (00:40) We have Tim Cook, who's the CEO here of Advent Health in Altamonte Springs. I want to thank Tim. I have Sheriff Dennis Lemma, who's just been a champion in terms of fighting substance abuse and supporting programs to help mental health. Two of our warriors in the administration, Chad Poppell at DCF and Simone Marstiller at Department of Juvenile Justice, they've worked incredibly hard. They've been very, very effective dealing with a lot of very significant and challenging issues. I want to thank them. Ron DeSantis: (01:13) We have Maria Bledsoe, CEO of Central Florida Cares Health System, Inc. thank you, Maria, for being here today. Andrae Bailey, CEO of Project Opioid, we've worked together before. Stacy Heath is a Lieutenant, Seminole County Sheriff's Office, is doing great work on these issues. Then Dr. Sanjay Pattani here in the ED at Advent Health, and he has a broken leg, but he's still soldiering on and doing what we need to do. We really thank you. Ron DeSantis: (01:43) We want to discuss the impact that the pandemic has had on mental health, but particularly on substance abuse. If you went back a year, most people would say that the opioid abuse was one of the most significant issues. As we got into the pandemic, it seemed like concerns for that kind of faded. The issue didn't fade though, and the issue didn't go away. While we, of course, continue to deal with the coronavirus pandemic, we should acknowledge that this pandemic has probably made some of these other issues more challenging. These are not issues that are going to go away. They're going to be perennial and they're going to continue to be challenging. Ron DeSantis: (02:24) I will note, I think that if you look in terms of the coronavirus outlook in the state of Florida today, we had for new cases, the lowest percent positive that we've had since the middle of June. If you look at the ED visits for COVID-like illness, they're as low as they've been since the middle of June. If you look at the hospital census, it continues to decline up and down the state in terms of COVID positive patients. Those are all good trends. Those are all positive signs. It's still going to be something that we're going to deal with, but I've put in perspective when you look at what we're talking about with substance abuse. Ron DeSantis: (03:04) Right now in the state of Florida, we've got about 6,000 COVID positive patients who are hospitalized, and not all of them are hospitalized, being treated for COVID. Some are incidentally positive who were hospitalized for something else, but at 21 and a half million people, about 6,000, it's important, we obviously deal with it, but just last month there was, what, 60 some thousand overdoses in the state of Florida. That's up significantly year over year from where we were. We've seen overdose deaths increase over these last few months, and this is having a profound effect and it's affecting a very broad reach of people in the state of Florida. Ron DeSantis: (03:47) We've got to dig in. We've got to be able to juggle multiple balls. We've got to be able to handle more than one problem when it comes to healthcare. I think the hospitals have shown they've handled the coronavirus very well. When they needed something, we obviously helped, but they've done a good job on that. We're going to continue to be supportive on that, but we've also got to be supportive on these other key issues because they're going to be there. Ron DeSantis: (04:11) Now, the First Lady's Hope for Healing initiative is something that has really sought to address mental health in the state of Florida. We have, if you look across all our agencies, over $2 billion get allocated for mental health and substance abuse programs just this year. They're in DJJ, they're in DCF, they're in these different agencies, but it's really important. They were reminding me about the 400,000 that made it through this budget year. Not a lot made it through. I mean, we vetoed a billion dollars because we were at a much different fiscal situation than we were just a few months before I signed the budget, but I think it's a testament that this was something that is viewed positively and is important. We're glad that we were able to do that. Ron DeSantis: (05:05) Here's some statistics for just Seminole County in terms of what we're dealing with here. We've actually seen an increase in suicides by about 35%. We've seen overdose increased by 51% and overdose deaths increase by 15% year to date over and over. It's not just for adults, although there is a lot of adults, but when we had school campuses close, it was a difficult transition for a lot of parents, but also was very difficult on many children. They weren't able to interact with friends, classmates and teachers, extracurricular activities, all those. Accordingly, the Department saw a big decrease in reports of child abuse, because the folks who were there with them every day in the classrooms and in these extracurricular activities are some of the front lines who will report this. I know Seminole County is back in and we obviously support the approach that they've had, but there are just so many different things that are emanating from this that we've got to have really a community-wide approach. I think one of the things that central Florida's done a good job, you guys have had the private sector involved. You're working with your healthcare providers, you're working with community leaders, the law enforcement, understanding that this is not just one part of society deals with it. You really got to have all hands on deck. Ron DeSantis: (06:32) I think you guys had a lot of momentum going before the pandemic. I think you guys were doing it the right way. I think the pandemic has just set us back. Let's regroup and let's go forward and get where we need to go. I'm really happy to be here. I look forward to the discussion. I'm going to kick it over to the First Lady to be able to make some comments, and then we'll go around and hear from everybody. Then maybe after that, we can chat a little bit. Casey DeSantis: (07:02) Yeah, well, I appreciate everybody being here today, of course, the media for being here to cover this, because this isn't getting as much coverage as we would hope. I mean, we're talking about lives. When the Governor invoked 63,534, those were overdoses between July of 2019 to July of 2020. That's an increase. We saw a 28% increase, 63,534. That's 63, 534 souls. Those are lives who are in crisis right now that we need to make sure that they know that there are avenues to help, that they need to know that we're thinking about them, that this too will pass and that we need to make sure that they get meaningful help. Casey DeSantis: (07:48) Just last week, as the Governor, I know many of you know that we are new parents again. We have a four month old baby, who as the Governor evoked a second ago, is still not sleeping through the night. I was up at 4: 00 AM, 3:00 AM, 11:00 AM, reading articles and taking notes, but we also have a three year old and we have a two year old. For us, of course, how this impacts Floridians across the board is something that we think about and talk about frequently. This also impacts, and we think about our children. I mean, what is happening to our children? We need to make sure that that is part of the conversation every day. Coming from two parents of two very small children, this really hits home for us, as it does with so many Floridians across the state. Casey DeSantis: (08:33) Just last week, we were in Sarasota County and we were talking with the Secretary joined us, Secretary Poppell. We were talking about the child crisis hotline. What that is is a hotline for people to call in to report suspected child abuse. While we're seeing a decrease in calls, which some would say over the summer, "Oh, that's typical," but this has been going on since March where they're seeing a decrease in calls. Why is that? Well, that's because our first responders, our wonderful teachers across the state, were not there to watch and protect over these children. When we say we saw a 40% decrease in calls into the child hotline to report suspected abuse, that's 17,000 children that potentially are going unwatched, who are victims of abuse, who are in homes right now with no outlet and no one to help them. When we come here and we're trying to raise awareness about this, we thank the media for doing this because it's without recognizing that there is a significant problem that we won't be able to address it. Casey DeSantis: (09:38) A 40% decrease in the child crisis hotline calls, 44% decrease in child abuse investigations, 32% decrease in sexual abuse investigations, 50% decrease in physical abuse investigations, it's sad when you talk about those numbers, but then when you know that you're talking about a baby and you're talking about children who can't always fight for themselves, it takes on a whole new meaning. Casey DeSantis: (10:05) You couple what we've been seeing with the stress and the fear of COVID, and then you add it to what we're seeing with the CDC. They came out just recently, I think in the last week, with some mental health statistics that were alarming too. We're looking at, I think it was 25% of children ages 18 to 25 who have considered and thought about committing suicide in the past 30 days. Again, you look at the statistics, but then you think about all of our wonderful children who are the future of this great state, that we need to be up here, we need to be fighting for them. Casey DeSantis: (10:42) I have to say that the people around this table have done an exquisite job. Even before this, I've had great relations with the Sheriff, who's just done phenomenal, Project Opioid. Really what the Hope for Healing initiative was all about was this is not just a government problem. This is an everybody problem. We need to make sure we're getting the faith- based communities together, the private sector, the nonprofits, because if we're all going in separate roads, we need to coordinate. We need to make sure we're maximizing resources. We need to make sure that at the end of the day, it's not about the money spent. It's the outcomes, because if we have positive outcomes, that means that people are living happy, healthy and productive lives. That's how we know that we're being successful. Project Opioid, you guys are doing a good thing and really appreciate how you're modeling. We didn't really know each other in the beginning, but our messages are really syncing. I could go on forever, but I won't because there are more important people here at the table to talk about what they're seeing. Secretary Poppell, I know this hits home for you. Chad Poppell: (11:42) Yes, ma'am. Casey DeSantis: (11:42) You are also a strong advocate for our families and children across the state. Talk a little bit about the crisis hotline that you're seeing, and we'll start there. Chad Poppell: (11:55) Oh, absolutely. Thank you for having me. It's an honor to be here. I, too, want to thank the media because I think my central theme for today is we have to get the word out that help is available. The resources are there. There's some alarming trends that we are seeing at the Department that I want to shine a light on here today and hopefully talk a little bit about, but the one we highlighted last week was the decrease to the hotline on abuse calls. We see it every summer when school lets out. It's usually a two month problem. This year, it's five and a half, six months. If you think about a child being stuck in that situation for that period of time, it is heartbreaking. It is heartbreaking. We were happy to promote the message that if you see something, you've got to say something. We need folks to really look out for our kids. We were excited, from the child welfare aspect, for schools to get back going, Governor. Thank you for that. Chad Poppell: (12:50) Some of the statistics that we talked about recently, you talked about overdoses. You talked about the CDC survey on what's going on in terms of mental health. The problem that we're having at the Department is we're not seeing a commensurate increase in demand for services. We have some of these trend lines going in the wrong direction significantly, but when you look at the folks reaching out for treatment, folks coming in in our service networks, and I'll let Maria talk about that a minute, we're not seeing statewide a demand for those services. That is very concerning to us. It really highlights the need for us to get the word out that help is available. Chad Poppell: (13:35) I don't have a degree, and so I'll let you handle this, but you've got to think, two, three months in, you go another couple months in, the situation is not getting better. Abuse is still happening at the house. It's just not getting reported. The mental health needs are still there. They're probably getting worse. Folks just aren't stepping forward and getting the help that they need. The Department is committed to try to get the word out. We do have a significant investment from the federal government, roughly $5 million, to both get the word out, but also bolster our 2-1-1 network. That'll be happening. Governor, in his budget, we got $80 million more in state opioid response grant authority, to really bolster the networks around the state. We have the resources available. We're making the investments. We just need the people to reach out or their friends to reach out and really prompt them to step forward and get help. With that, that's my message for today. First Lady and Governor, very important, so thank you for shining a light on it. Ron DeSantis: (14:36) No, thanks. Thanks for all your hard work. Tim, thanks for hosting us. Do you want to make some comments? Tim Cook: (14:42) I'd be happy to. Thank you again for being here, and the support of our Hope and Healing Center, which is a joint program with the Sheriff's department and the County EMS to have an alternative after folks get caught in an overdose situation, where do they go? They often find themselves at the emergency department. We've realized over the last couple years that we can't just take care of the physical, urgent, acute issue. We have to take care of the whole person. That's really what we're looking at. We've implemented and deployed SUD navigators, substance use disorder navigators, to embrace these folks and try to help them find some of these services and get connected to get on a path for wholeness and wellness. The Hope and Healing Center will be another resource opening later in the year that will be able to be part of that series of services. Tim Cook: (15:31) We have seen an increase, as everybody else. COVID has brought a lot of isolation to people. Our SUD navigators have seen about a 30% increase in the individuals that they've seen who've come into the ED with substance abuse. We see that as a symptom of mental illness, because we know that mental illness is driving a lot of the factors that people are using those substances. It's been an acute problem, but our collaboration really has some momentum. We look forward to continuing to work on that, but we do appreciate the support. All of these things- Tim Cook: (16:03) We need to work on that, but we do appreciate the support. All of these things together, as we pull together, we can do it with a level of resources that's already there in the community by just networking and leveraging the strength of each other. We appreciate working with the County. Ron DeSantis: (16:16) Great. Well, thanks. Simone, you want to go? Been just a fantastic Secretary, really promotes accountability and does it in a very, very effective way. So floor is yours. Simone: (16:31) Thank you, Governor, First Lady. Thank you all for inviting me to the table to talk about this very important issue. Of course, from DJJ's perspective, it's a little bit of a different lens, right? That I look through when I'm talking about substance abuse and mental health issues. When I look across my residential commitment programs, 33% of my kids have substance abuse issues, 55% of them have mental health issues. Now, while mental health is not a risk factor for criminal behavior, and I want to make sure that everybody hears that loud and clear, substance use and substance abuse is a risk factor for criminal and delinquent behavior. And so as we're talking about how we're going to help our citizens and our families and our children, as we're coming out of this COVID period where people are not interacting, kids have not been in school. Simone: (17:34) They can't go to their afterschool programs and things like that. My call to arms is going to be, let's make sure that we are trying to the best of our ability in all of our prevention efforts to educate kids, to catch these issues early on. Because we know that these are factors that very well could lead these children years from now to become one of, what I call, my kids. And Mrs. DeSantis, you said it very well when you were speaking just now that these children are our future. And so we have to take care of them right now to make sure that they don't go down the path to ruination. Forgive the hyperbole, but really we do. And so I'm happy to be part of this conversations. Ron DeSantis: (18:22) Great. Well, thanks for all your hard work. Maria Bledsoe, you want to weigh in? I know you've seen a lot since since March in terms of how things have evolved. So love your perspective. Maria Bledsoe: (18:33) Thank you, Governor and First Lady, for sponsoring this, Mr. Secretary. Yes, as Mr. Secretary indicated the numbers for us are not there. However, the acuity is a concern for our system of care. I would like to stress that the system of care that I manage is for the uninsured population. So we don't have the perspective from the population that is insured. That's a different dynamic. But as individuals have been isolated for six, seven months now, there's factors that go. There's stressors, anxiety, children that have not been with their friends. Maria Bledsoe: (19:19) So we understand that this is going to be something that's going to evolve and what it's going to look like over the course of the next potential six months, especially as schools start to open. And really working together as partnerships in our community, we have a great public private partnership that's going on. And I think that that's going to help as we continue down this path, as the state school continues to open in each of the regions. So from our perspective, as Mr. Secretary indicated, we do have the resources and we're asking individuals that, look in your areas, look for services, and reach out. Thank you, Mr. Ron DeSantis: (20:00) Great. Sheriff? Thanks for all your hard work. Sherrif Lemma: (20:04) Well, thank you so much for being here, Governor, First Lady. We always welcome you back here to Seminole County to engage in really, really meaningful dialogue. And I want to thank all of our media partners, many of which I consider friends who actually cover a lot of these underlying conditions that are present that lead people down the path in the first place. And one of the number one questions that I get is, "Hey, you're a sheriff, you're part of the criminal justice system. Why are you partnering with the hospitals and the doctors?" Because we recognize that people typically don't wake up one day and say that they want to have a career criminal path. It's typically, it's these underlying conditions that need to be addressed that make our community safe, but more importantly, save lives. Sherrif Lemma: (20:45) Before this relationship we've had with Tim Cook, people would typically be taken to the emergency room for overdosing, and then be released back into the same environment that they overdosed in the first place. Increasing the likelihood of overdosing and dying by about 800%. we said, enough is enough. We have to get involved. We have to collaborate and partner with a group of individuals, because it is our collective responsibility to preserve and protect human life. And if we're not careful, the narrative of bending the curve and all of these things that we've heard for the past six months loses our focus on what lingers around the corner for us tomorrow. And that is an unprecedented substance abuse and mental health crisis, particularly affecting those most vulnerable of population, our children. Sherrif Lemma: (21:35) We've seen that decrease, just like the Secretary said, we've seen the decrease here in Seminole County. And it is terribly concerning because it is only because they're not coming in contact with those mandatory first responders and reporters. We've seen domestic violence flatten out. And I can only imagine if you've been a victim of domestic violence in your home, and you were away at work for 40 hours a week where you had the opportunity to report your level of victimization. It has only gotten worse through this pandemic. And then of course our children, with not only moving to a cyber environment, which welcomes in a whole new way for people to victimize. We're trying to teach parents that if your children now have this online footprint that they normally did not have, there's people out there that will absolutely prey on the vulnerable. And we need to make sure that does not occur. Sherrif Lemma: (22:35) And it's not always that cell phone and the text messaging app that we use. It's TikTok and all of these other influencers that are a big part of that. So what we've done is we pulled together this unprecedented group of individuals that come together and collaborate. And I think that we are demonstrating the best model practice as we move forward. None of this would happen without your leadership and inspiration. Because I know from working with you in the First Lady for the past two years, this was your vision in the very beginning. Sherrif Lemma: (23:07) This is why the First Lady put hope and healing effort together. This is why, by executive order, you created the Opioid Task Force for the state and really, really pulled these things together. But when we look at these numbers, especially here in Seminole County, I want to remind everyone. Seminole is one of the most affluent counties in the state, third most densely populated per square mile. But we lose more than 80 people every single year to an opioid related overdose. There's a more than 50% increase in overdoses, and more than a 15% increase in overdose deaths, when almost everybody has now access to Narcan, which is saving lives. We deploy Narcan more than 400 times in this County per year. Or another way to put that, we bring people back to life 400 times. It is a big challenge that lies ahead, but I am confident by partnering with faith-based organizations, our public and private partnership, the business community, and our media partners, that we can get the message out there and be prepared before this crisis hits our front doors any larger than what it has already done. Ron DeSantis: (24:17) Well, thanks. Thanks for your hard work. And I'm going to turn it over in a sec to Dr. Pattani, he works in the ED. But I think it is important also to stress in terms of messaging that if somebody is out there that needs any type of medical care, and obviously we're talking about here with drug abuse, talking a little bit broadly about mental health. But things like heart and stroke, this is a safe place to come and to get care. And we've seen declines in that in March and April. People were fearful about coming in due to coronavirus. Some thought that the hospitals didn't have any space based on, I think, false narratives. But this is a place where you come, they follow all kind of procedures. Ron DeSantis: (24:59) And so if you're concerned about coronavirus in a hospital, you should probably be concerned about just about everywhere else you would be. Because you have probably a higher chance of getting it there than here. And that said, we'll turn it over to Dr. Pattani. Dr. Pattani: (25:16) Thank you, Governor and First Lady, Secretary and distinguished panel here, Sheriff Lemma. What you said is spot on Governor DeSantis. Which is, the healthcare industry has, over the past six months, evolved a way we can take care of patients. But more importantly than that, we usually refer to multidisciplinary as cardiology or gastroenterology, or people who help take care of patients. This is the true multidisciplinary approach to how we take care of patients. We provide them a safe place to seek care, whether you have mental substance abuse issues or whether you have cardiology issues. The message to really keep augmenting and supplement what the community, is that the healthcare arena is a safe place. Dr. Pattani: (26:04) We have established best practices, both from clinical protocols, but more importantly also from safety and infection prevention perspectives. So when we come and we have to deal with patients, and patients have to come to the hospital to receive care, everyone needs to understand, the community at large, it is one of the safest places right now to go to for help. And the mental health substance abuse industry, or patient population, we refer to COVID-19 in many industries as a disrupter. Whether it's financial, or farming and agriculture. In healthcare, the disruption is we saw a paucity in some healthcare that was being sought after. We're seeing a resurgence and a returning of our chronic care patient populations of which the mental health population is one of them. And it's extremely important because we need people to feel comfortable and safe. And we want people to understand that we're not here just for your physical wellbeing, but we're here for your mental wellbeing. And I think that's a keynote for our patients. Ron DeSantis: (27:14) Yeah. No, thank you so much. Really appreciate it. Lieutenant Heath, we appreciate all the work you're doing. And enjoyed getting to brief on some of the stuff you're doing. So you could talk a little bit about that, we'd appreciate it. Casey DeSantis: (27:28) Yes. And thank you, Governor and First Lady for having this panel. I'm so very, very excited to hear about your endeavors, and especially with the hope and healing project. Because I know better than anybody that our juvenile population, if they fall through those cracks then they end up in my correctional facility. So speaking of the people in my correctional facility, we've just recently started the ACT program about a year and a ago, which is accepting change through treatment. It's supports our opiate epidemic, trying to help those individuals combat that substance abuse problem. And one of the things that we recently added to that was our community navigator. And what that community navigator is going to do is support those individuals to remain successful once they reenter into the community. So that's our focus right now, but with the support of the Sheriff we've been doing tremendous work inside of the correctional facility. And I hope that COVID doesn't stop us or prevent us from continuing that work. Ron DeSantis: (28:29) Great. Thanks so much. Andrae Bailey, CEO of Project Opioid, thanks for all that you've been doing on this. And as I had mentioned, some of this stuff has fell off the front burner in the public consciousness, but the problem didn't fall off and didn't go away, and now we're dealing with even more challenges. And so I appreciate you being in that fight. Andrae Bailey: (28:51) Governor, First Lady, thank you so much for your leadership here. Tim, as always, you and your team at Advent Health are the best. And we have the best sheriff in Florida here with Dennis Leema, someone who's fighting the good fight for those in need in this community, and really around the state. My message and the leaders at Project Opioid, business and faith leaders who were involved in the mental health addiction and opioid crisis, is that everyone should be very, very scared of the data that they're seeing on mental health addiction and the overdose crisis here in Florida, in central Florida, and really around America. We throw around the term unprecedented, where it's unprecedented a lot in our society. Words have less value because we use them. That was an unprecedented set of nachos I had last night, they were delicious. But when you look at the data, the First Lady just said that if you have an 18 year old to a 24 year old in this room, I have two of them. I have a 19 year old daughter and a 20 year old daughter. There's a 50% chance, a coin flip, that one of my daughters contemplated suicide in the last few months. If you're in this room and you have a kid anywhere in that age, that is unprecedented. And we have to admit as a community, as a state, and as a nation, that COVID-19, and the lockdowns that we decided to do, let the historians tell the story of whether that was right or wrong. Andrae Bailey: (30:22) I'm not here to do that. But I am here to say that we are facing an unprecedented mental health addiction and overdose crisis. And that as great as government is at shutting society down, only the business community, the faith community, and all of us together can engage at our living rooms, in our living rooms, at our dining room tables, at our places of work, at our places of worship, to have this conversation and to look towards getting people help. Governor, First Lady, I think a lot of folks aren't accessing treatment in a way, because if you reach out for something that's not medically related to COVID-19, maybe you feel bad that... I know a lot of people that just feel bad to even talk about mental health issues right now. I think just starting the dialogue, not about canceling the conversation that we've had about COVID-19 and the medical importance, what we've done as a society medically is important. And I won't take that away. Andrae Bailey: (31:24) But we've got to add to that dialogue the fact that the data says we could see an unprecedented wave of mental health issues, anxiety, depression, suicide, overdoses, and deaths in the months and years to come. And if we're not talking about it, if we're not planning for how we're going to address it, we could see a loss of life in those areas that maybe far exceeds even what we saw medically from COVID-19. So we're so thankful for your leadership, and it starts with a conversation. And we're here to support you any way we can. Ron DeSantis: (32:00) And you attribute- Andrae Bailey: (32:03) We can. Ron DeSantis: (32:03) And you attribute kind of the change with these 18, just the social isolation and some of the things that have happened, obviously, probably some of them have- Andrae Bailey: (32:11) Like, Chad, I'm going to say, I don't have a degree in this, but let me quote, Dr. Phil Toal, who is one of the behavioral health leaders at aspire, where he told me, we were shooting some videos on mental health a few weeks ago, and he said, "Andre, in our circles, in mental health circles, we believe that 40%, up to 40% of Americans will have post traumatic stress disorder when these quarantines are done." 40%, this was not at a press conference. This was just him and I talking. Andrae Bailey: (32:42) Because he said, "Andre for the record, we've never shut society down before, we never shut the world down." I mean, I'm just happy to be here because I haven't been out of my pajamas in three months. But as a society, governor, we've never... This is a social experiment that we've never done before. Andrae Bailey: (33:02) And that our mental health professionals believe, whether or not it was necessary or not, again, I'm not trying to say that, but our mental health professionals believe that the consequences to mental health, substance abuse and addiction, that the data, it's unquestionable that those are skyrocketing now. Ron DeSantis: (33:22) Yeah. And look, I think that you can say that COVID is the most important thing in the world. It doesn't mean that you don't also look at how that approach is affecting other things. And so for example, we very early on, we stopped access to nursing homes because we were concerned about the virus going in. And we did a bunch of other stuff, acquire PPE, send PPE testing, created covert only nursing home. We've done a lot to protect that vulnerable population, and it has saved lives. Ron DeSantis: (33:51) But it also has had big costs in terms of loneliness, mental anguish, the families aren't able to go in and visit their loved ones. And we have people, we focus on COVID, but I mean, there's people that pass away in nursing homes from natural causes or other causes and they may not have had the family members in there, that leaves a lasting mark. Advent, I think has been really good because I think they recognized this. Ron DeSantis: (34:22) And like a lot of the hospitals just weren't allowing the visitors, but for these kinds of critical end of life situations, they've allowed the family members to come in. And I think that that's something, that's a very good decision. I think it sees the whole picture and understands that those types of interactions are critical and to deny that from a family... It's hard enough to lose a loved one, but then to not be able to be there and to say goodbye, that leaves lasting scars. Ron DeSantis: (34:51) And so I think what you've been able to do is really take a tough situation and at least mitigate some of the collateral damage from it. And so I've advocated for all our hospitals in Florida to follow suit. I know some have, some of the systems have, but I think that that's something that's very important. Ron DeSantis: (35:11) Another thing I think, just in terms of how the society has changed, as we're talking about the kids, the kids can develop mental health problems, substance abuse, because the parents are really stressed. The parents may lose jobs or have something really negative, and then that trickles down. Ron DeSantis: (35:33) So obviously we concerned about the parent, if they have problems, we want them to seek help and use the resources, but that can also trickle down to the younger generation. And Tim, you made a point about before we came out here about how we can't just view infection or not as kind of what safety means. Can you talk about that here, and at that point? Tim Cook: (35:58) Sure. Well, I was referencing the fact that right now, when we talk about its safe to come to the hospital, everybody's thinking about everything's clean, people are wearing masks, so you're not getting a COVID infection. But in the world of mental health, there's got to be a psychological safety because people are afraid to let people know, they're afraid they might go to jail, because of the stigma that we've put on it. Tim Cook: (36:18) Some of the things you were talking about. So I think as we continue the discussion, and allow people to understand that this is an illness that people care about and it's key to your wholeness and your life. The physical infection of COVID is important, but if your mental health is off, that's going to have a negative impact on your overall wholeness of health. So I think engaging and promoting this kind of discussion begins to allow a sense of psychological safety that people will hopefully take better access of the services that are there. Ron DeSantis: (36:51) And so Chad and Maria, if you want to... I mean, are you guys confident in the resources that are there? Is it really the most important thing, just getting the message out and telling people that they have the ability to access and they should access? Chad Poppell: (37:07) Yes, Governor. Thank you for the question. I'll start and I'll kick it over to you. One of the things we're really proud of at the agency is through the entirety of COVID, our networks have not lost the ability to provide service in any part of the state. We've had facilities and different things, have a COVID positive issue, but we've been able to resource and we've been very nimble on the ground, and that's a big testament to the leadership of our managing entities. Chad Poppell: (37:31) I feel very confident at this point, having gone through all of that, that the network's in very good shape. We do have capacity. You provided additional resources in the budget. So in my mind, yes, the messaging, getting the word out, getting folks to kind of rally around folks in their lives they know have issues and encourage them to seek help is the number one thing. But I'll kick it over to Maria. Maria Bledsoe: (37:53) Governor, initially in March when especially the first two weeks of COVID, whereas we really transformed an entire network from face-to-face to tele-health, and how quickly the network... We worked with our providers, our partners in the community, and also the partners around this table to change from a face-to-face model to a tele-health model. Medication assisted treatment has specific requirements from week to week, month to month, how that evolved from what we refer to as a drive-by. So that individuals could still continue to get the delivery of the services. Maria Bledsoe: (38:34) So there wasn't an interruption in the delivery of any of the services in our system of care across the state. That has always been there and always available for individuals to access. As we continue to move forward over the course of the next several four, six months, it'll be interesting as the services get access. Again, we have services, we're asking people that if you do need services to reach out. The anxiety, the social isolation, the suicide ideations, we ask people to really seek out for services. We are here to help with the state funds those services, so that we can provide it for individuals. Ron DeSantis: (39:20) It seems like overall, the tele-health has been a big positive, but it does have limitations on some of the treatments that are needed in certain avenues. And some of the mental health stuff, I think is probably one of them. Maria Bledsoe: (39:33) Yes, we've actually gotten very creative in the delivery of the various services. Some individuals weren't open to the telehealth concept. So we have offered them hybrid. We've offered them the ability to still do the face-to-face, whether it could be done at a park, outside, outside of their homes so that there is no interruption in the delivery of the service. Maria Bledsoe: (39:58) We have gotten very creative in ensuring that people continue their care, because that is very critical, especially for mental health services and substance use. And I think that as we continue to evolve, there are going to be changes. As we work with Advent health in the [inaudible 00:40:19] net program. I think that is going to be very instrumental because as this starts to open up, what does it look like when we do open it? Or, you may have a vision, it may change, but you have to be very flexible. These are times when flexibility is very important to ensure continuity of care. Ron DeSantis: (40:37) Sheriff, how's just the general community been doing? How's crime been? Have you seen a change since March, April in terms of any specific types of crimes, either going up or going down? Sherrif Lemma: (40:51) Yeah. So Governor, statistically crime is down. It's down across the state of Florida and in the 107 year history, it's never been as low in Seminole County as it is today. What's frightening about that is criminologists suggest that a fraction of the crime that occurs in our community is actually ever reported to law enforcement. And you can just think for a moment of all of those victims of abuse, neglect, or abandonment that are pre-verbal, that fall at the hands of their caregiver, that nobody knows about it. Or the amount of domestic violence that occurs. Sherrif Lemma: (41:22) And so we're seeing that. And I think it's a blessing because it allows us to look at some of these more complex social issues that we need to address. Even when we talk about the overdoses, I think it's important to mention this. When we talk about overdoses, we reference that in overdoses and overdose deaths. When the fact is most people who are using, don't overdose, that's just a fraction. These are the most severe cases. Sherrif Lemma: (41:47) But, it's incredibly frightening to look at all of these effects, everything that we've heard. I think that rarely do you see us all from our various worlds coming together and actually saying the same thing. I don't know that we could be more aligned on, on what the challenges are and what we need to do as a society, all aspects of society to get us out of this. Ron DeSantis: (42:14) You have anything? Casey DeSantis: (42:14) Yeah. Well, very quickly and talking with a lot of psychologists across the state and just really picking their brain, and they talk to me sometimes about the mitigation efforts. And they'll say, "You realize that there is a value to them, and we understand that, but let's also look at this holistically and the other side." Casey DeSantis: (42:30) And that being, when you're wearing a facial covering or a mask, there is something... You're hiding a smile. And when you smile at somebody or somebody smiles at you, there's serotonin and dopamine that get released into your brain, and those are happy chemicals. And that makes you feel good. So that's been taken away. Casey DeSantis: (42:45) You talk about social distancing, there's something to touch. When you touch somebody, there is a serotonin and dopamine chemical that's released to the brain, that's what studies will tell you. That also increases your mood and helps with mental health. Isolation is not something that's great. Casey DeSantis: (43:01) If you're depressed, being around other people and being able to talk and to vent and to get things off your... That has been taken away. So you just need to look at this holistically and understand that there are ramifications and implications for mitigation efforts. And I've heard that from psychologists and whatnot, that I've been speaking to across the state. Ron DeSantis: (43:19) What do you think about by businesses? I mean, what's there... We obviously have viewed the private sector as being important. This has been a disruption in the last few months, what is their role? Is it going to be the same as it was? Are they going to have to change some of their approach? Andrae Bailey: (43:37) I think the business community, the faith community and others, they have really the greatest opportunity to be a direct connect to families. When you talk about anything related to government, I think it's more complicated. There's a lot of issues that go with putting new programs in government, just common sense limitations there. But when a business owner, the CEO of Red Lobster, Kim Lopdrup wanted to be here today. He couldn't be here. He's based out of Orlando. Andrae Bailey: (44:09) He wanted to get education around Narcan to his 63,000 employees. He called Jewel Taylor, their HR director and said, "Make this happen." And within a few days, their employees through their HR department and their EAP program got new access that they didn't have before. So I think it's going to be key Governor and first lady that we engage a new frontline. Especially in a time when people... The thing that scares me the most that I've heard today is that less people are reaching out for service. Andrae Bailey: (44:42) Because the numbers around people in need are skyrocketing. And if people are not reaching out for help, that means we are creating a really, a situation where 2021 could be a very frightening year from a mental health, addiction, a societal standpoint. So the business community and the faith community has to start a conversation that then... To their employees, to their parishioners, that then trickles down to the family. Andrae Bailey: (45:13) I'm going to go home. I'm telling you right now, I'm going to go home. I'm going to leave this wonderful press conference, and I'm going to go talk to my daughters. I'm not kidding. I'm going to talk to my daughters again, about how you doing? I do this all the time, but I'm concerned now, again, after hearing that stat, no one can talk to my daughters like their father. But sometimes it takes a business, your employer, your faith leader, or someone in your world to give you the information you need. So I think they can be critical. And I think they often are overlooked. And that's why we think that's important. Ron DeSantis: (45:48) Great. Any other parting shots? Anyone else have anything? Simone: (45:53) Governor, [inaudible 00:45:54] shots [inaudible 00:45:55]. So I think I need to take one, and it's not so much a parting shot, but it's a couple of thoughts that I'm having here as a Secretary of DJJ, as I listened to a lot of what I'm hearing and a comment that you made earlier, Mr. Cook, when you were talking about, and I think I heard something as well, that during the pandemic, many of my prevention providers and residential commitment providers as well. But many of my prevention providers have necessarily had to move from in-person contact with the at risk kids that they serve to technology based. Simone: (46:38) And I had a conversation with one the other day. Actually, it was as I was talking to a group that included a prevention provider of mine. And he asked if I, meaning DJJ, am going to change our programmatic requirements after COVID passes? And we know that it will pass. And what I said to him was, "Look, we're talking about children here. They need face-to-face contact. So it's okay to take away the best practices and using technology as we're serving these children. But we can't completely migrate to that and think that we're going to be effective, because as you said, first lady children need to be seen. They're going to need that contact. They're going to need that." Simone: (47:36) And so in my role as partially holding my providers accountable, I'm going to make sure that at the right time, that migration back to face-to-face interactions happens. And I'm certain that that will start happening once school's fully reopened. And those referrals start rolling in and things like that. Simone: (48:03) and those referrals start rolling in and things like that. But I think that's going to be an important piece to making sure that these kids remain healthy and out of trouble. Ron DeSantis: (48:10) Great. Well, I want to thank everybody for what you're doing. Thank you for participating today. I think we know that we're in for a long road ahead, but I think the fact that we're here recognizing some of these trends and committed to be a part of the solution... And I think you guys have done a lot already, and had a good framework in place. This pandemic has just thrown some things sideways, but we got to work hard to get it back and get those trends back in a better direction, and I know that we can do that. And finally, I'll just say we had a primary election yesterday. We had worked hard. Secretary of State helping the supervisors with making sure their systems were good. Ron DeSantis: (48:58) And I think that they did a really good job. We're ready to do it. We'll learn if there is anything to do, offer additional support before the general election. We did have a lot of mail voting in Florida. It's a safe way to do it. You request a ballot, you get it, you send it in. It's not just ballots floating everywhere. So a lot of folks availed themselves of that, and that obviously will be something that will be available in the fall as well. And with that, we'll take some questions. Yes, sir. Ron DeSantis: (49:58) Well, on the second part, I mean, we have gotten a lot of federal dollars. So we do appreciate that. They have been generous on it. You know, I think one of the things that as we... When we were going through the coronavirus, if you go back and look at... I mentioned our positivity as low as it was. And since the middle of June, ED visits for COVID-like illness, low as it's been since middle of June. But if you go back to May, we were having days where we have like 2% positive. Very low number of ED visits. As we started to see this resurge, not only across the state, but across the whole Sunbelt, I was mindful of shutting down the state and having all these problems exacerbated, and we were not going to do that. Ron DeSantis: (50:46) I felt keeping society going... We had Disney come online when this was all going. We had all this stuff, and guess what? The numbers went down from the time Disney opened. So we really focused on keeping society functioning, because I was just... One, if you do the basic things that we've been saying, one Florida, one goal, sanitation, basic physical distancing... If you're closer, wear a mask. Protecting the vulnerable, looking after... If you're doing that, that's going to be effective. You don't need to do these big shutdowns. And so I think we learned from March and April that the costs of doing that, particularly as I looked at other countries and other states, were really significant. So we have a lot we're going to have to deal with in the fallout. Ron DeSantis: (51:30) But I do think that we've done it in a way to mitigate some of the damage that flows from some of those policies, and we did it in a way to do that. Now, in terms of your first part of your question, we have cited what's gone on in central Florida as a model for other parts of the state. But I do think it's probably not something that will be done top down from Tallahassee, but really bottom up from each community. And I think what's happened here is, as we say. You got the business community involved. You have obviously law enforcement. Now look, when you're talking about narcotics, I mean, law enforcement has a role in that, because it's illicit substance, but it's not just law enforcement's job, and you can't prosecute your way out of the problem. Ron DeSantis: (52:14) You could prosecute some of the... And I believe you need to do that, but you still have all these other facets of it. The churches and the faith community, absolutely critical. So doing that, and from a community wide basis, I think is great. So we certainly endorse the framework, but I think it's probably going to look a little bit different in each part of the state depending on the local conditions. It stinks to look at some of those numbers now, because had we not had the pandemic, those numbers would be different. I mean, we all know that, and I think that the approach, everyone was really engaged. And I think people now understand that other problems don't just go away, and we're going to have to continue to deal with these things. And so we're doing this eyes wide open, understanding that this is a full spectrum, but I really think the framework is really good here, and I think the buy-in from the community has been fantastic. Anything else? Audience: (53:17) [inaudible 00:53:17] now met with several bar owners in the counties here. Has he relayed any information to you? Ron DeSantis: (53:24) No. I think the main thing is... Look, I mean, I think he's doing the right thing by meeting with folks. We were in a situation where he was having to play whack-a-mole with these. I know we had the one in Central Florida that got a lot of play because they weren't following the guidelines, and so he had to take whatever action he had to take. But I think that at the end of the day, everyone deserves a seat at the table. They got to be able to make the case. You know, we're not making any changes at this minute in terms of that. I think the next steps for us in the state of Florida will be to work with our three Southern Florida counties about moving them into phase two. Miami Dade County had under 10% positivity for new cases today, the first time probably since sometime in June that that's been the case. Ron DeSantis: (54:14) And if you look at the trends in all of those counties, we've had really significant downward trends, really for weeks now. Palm Beach County, they're settling in at almost 5% positivity. If you look at the hospitalized COVID patients, they're down significantly, and we think that those trends will continue. So we're working with them. We've worked collaboratively, bottom up approach with that part of Florida from the beginning. So I'm in conversations with them about what they feel about the next step. But I think that that's really where we're going to be looking at, and I'm not saying I'm going to do it today, or we're going to do it tomorrow. But clearly, I think you see some of the numbers can be a blip here or there. I mean, these are sustained trends at this point, and I think that that's a good thing. Audience: (55:03) [inaudible 00:00:55:04]. Ron DeSantis: (55:05) I wouldn't say that. I mean, look. You have to also be realistic about this and say, "Okay, if this pub isn't closed, does that mean the behavior is still not going on?" Because people go and they meet, they congregate. The UCF, you may not have that one bar. And look, they were not following... Our guidelines were treat it like a restaurant. Seated service, half capacity, you can do outdoors. When those guidelines are followed, it's fine, there's not been major problems. But I'm also not so naive to think that, "Okay, that's no longer an option. So they're just going to decide to sit there and not do any socializing." That's not the way the world works. I think we know that. So there is, there has been a lot. Ron DeSantis: (55:46) And I would also note that the part of Florida that had the most significant outbreak were our three phase one counties, which did not have, and have not had, pubs open since the middle of March. But I think the obvious inference was a lot of the same socializing was going on. It was just in a private venue. So let's just be honest about it. When people say close this, like it's somehow some panacea that people change their behavior and they do do other things. And I think that's what we've seen with some of that, and I think that that explains why Southern Florida would have had even more of an outbreak than the rest of Florida, even though they didn't have any of those establishments open the whole time. One more. Yes, sir. Audience: (56:29) [inaudible 00:56:29] Are we offering any resources or extra help for teachers or for school districts when it comes to mental health? Ron DeSantis: (57:06) Yeah. So we increased funding $25 million in this budget. So there's now $100 million for schools and for mental health, and so we absolutely want them to utilize those funds. And then as I mentioned in my opening comments, I'm going to look to see what the possible avenues are to use some of our federal CARES Act money to deal with some of the mental health and substance abuse issues. Now, the way that's written is it's got to be related to COVID or have some type of relationship. I would point out, and I could get the sheriff to testify, that the problem we're having to do has been exacerbated because of COVID. We'd be in a different situation if it wasn't for COVID. So I have my folks looking on that. We'll probably have to work with the White House to see if there's any way that we can be helpful there. Ron DeSantis: (57:57) I mean, that'll probably be some targeted approaches around the state, but I think that's... To me, it's like we spend all this money on testing and this and that, and that's fine, but what would probably have more bang for the buck? Testing an asymptomatic 22 year old, or putting some of that money towards mental health and schools, or fighting some of the substance abuse? And I think probably the latter would have a little bit more bang for the buck. And it doesn't mean you don't do all these things in combination, but this is something that's going to be significant. So we're going to look at that, but we are happy. Excuse me. I mean, it was a very tough budget year. I took a billion dollars off the top in budget vetoes. The world changed between the time the legislature finished the budget and the time that I had to sign it in dramatic ways. Ron DeSantis: (58:50) And so we just had to do that, but even with that, we were able to support Seminole County. We were able to support the $25 million increase in the mental health for the schools. So we were able to really get some big wins out of a budget which really was very difficult, and we had to make a lot of very tough choices. So I want to thank everyone again though, for all you're doing. Central Florida is a big engine for the state. I think that you guys have a good approach on this. We're obviously partners, and so we're going to be there with you, and we want to continue to do that. But I really think that you can lead the way on this and really show other parts of the state a good pathway. Ron DeSantis: (59:39) So I appreciate what you've done, and I appreciate you're working with my administration, my secretaries, the first lady. And thanks also for what you've done for the coronavirus response, the thoughtful way that you did it, and the collaboration that you had with the state of Florida. So we really appreciate Advent's partnership during what were some difficult times. But I think that you showed that you guys were, were fit to fight, and that's what you do, and you did it. And we were happy to be supportive in a variety of ways. All right, everybody. Thanks so much. We'll see you soon.