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Diversion First Stakeholders Group Meeting
September 22, 2020
Welcome!
John C. Cook
Chairman, Diversion First
Stakeholders Group
2
Welcoming
Remarks
Jeffrey C. McKay
Chairman, Fairfax
County Board of
Supervisors
3
Agenda
Welcome
Opening Remarks by John C. Cook, Chairman, Diversion First Stakeholders Meeting
Jeffrey C. McKay, Chairman, Fairfax County Board of Supervisors
Announcements and Updates
Program Updates
Community Response Team- Freddie Pedreira
Diversion First Analysis- Linda Mount
Drug Court, Veterans Treatment Docket, Mental Health Docket- Judge Penney
Azcarate and Judge Tina Snee
STAR Program- Sheriff Stacey Kincaid
Jail-Based Medical and Behavioral Health Services- Laura Yager and Marissa Fariña-Morse
Diversion First Housing- Mike Suppa
Stepping Up Initiative and National Trends
Nastassia Walsh, Associate Program Director for Community Health and Justice, National
Association of Counties
Questions and Comments
Wrap Up
4
Announcement
and Updates
Lisa Potter, Director,
Diversion Initiatives
Office of Strategy
Management
5
2020…a new reality
New ways of doing business
Fiscal constraints
Collaboration and focus on solutions
Updates
2019 Annual Report
Highlights from 2019
Data Snapshot
Future Plans
Fairfax County named Stepping
Up Innovator County!
6
Diversion and Community Re-Entry Center
(Judicial Center Complex)
The Massey Building demolition and site restoration is anticipated to be
complete in Fall 2020. A new master plan will be developed to provide a
coordinated long-term plan to meet the needs of the complex’s multiple
stakeholders.
As conceptualized, this Center would provide:
 Resources for those re-entering the community from jail
 Greater access to services that provide alternatives to arrest
 Integrated behavioral health and care coordination
 Resources for employment, healthcare, benefits and other services
necessary to keep individuals from recurring involvement with the
criminal justice system
 Housing location and stabilization services, along with on-site
housing options
Enhance public safety and promote a healthier community with a more
efficient use of public funding
Anticipated that master plan proposal will be presented in the coming
months
7
Medical Assessment Program
Partnership with Neighborhood Health, a Federal Qualified
Health Center (FQHC) to provide onsite services at the
Merrifield Crisis Response Center (MCRC) for individuals in
need of medical clearance for psychiatric hospitalization or
crisis stabilization admission.
Reduce patient and law enforcement time spent in
Emergency Department and improve experience
Reduce injuries to law enforcement and individuals served
Increase connection to follow up primary care services
Reduce costs for medical assessment in an outpatient
ambulatory setting versus an inpatient Emergency
Department.
Planning for October 2020 launch
8
Sequential Intercept Model (SIM)
A framework to inform community-based responses to the
involvement of people with mental and substance use
disorders in the criminal justice system.
Intercept 0- community-based services designed to
intervene at the earlier possible point, either before a
behavioral health crisis and/or to prevent criminal justice
involvement
 Identified in 2019 county SIM mapping workshop as a
need/priority
 Currently exploring ways to expand these services
9
Community Response Team
Providing outreach and appropriate care and referral
services with persons with unmet needs
FREDDIE PEDREIRA
COMMUNITY HEALTH ANALYST/PUBLIC
HEALTH NURSE, FIRE & RESCUE
DEPARTMENT
10
Current CRT Process and Statistics
11
ACTIVE 13
ACTIVE-OPP 10
TRACKING 157
CLOSED 82
Current CRT Census
Modified response during COVID
Added equipment to vehicle for screening
• Reduce non-emergency ER visits
• Clear police from mental health calls earlier
[Statistics as of 9/1/20]
EXAMPLE: 2019 2020
FRD CALLS 975 693
FRD TRANSPORTS 845 568
FRD SERVICE CALLS - 117
12
CAD
(DPSC/FRD)
iLeads
(LEO)
ImageTrend
(FRD)
SIMS
(LEO)
Collaborative Data Workspace:
13
CRT Online Referral
Application
Emergency Department
Information Exchange
Local Hospital/Health Care
System
New Vehicle
UpdatesOther Community/County
Resources
Diversion First
Analysis
Linda Mount
Director, Analytics and Evaluation
Community Services Board
14
Jail Behavioral Health Population - 2019
15
1,854
1,614
1,492 1,507
1,551
1,000
1,100
1,200
1,300
1,400
1,500
1,600
1,700
1,800
1,900
2,000
2015 2016 2017 2018 2019
22,545
19,337
18,351 18,672
19,205
15,000
16,000
17,000
18,000
19,000
20,000
21,000
22,000
23,000
24,000
25,000
2015 2016 2017 2018 2019
Number of Inmates with Behavioral Health Issues
There was a 16% decrease in 2019 from 2015 of
inmates with behavioral health issues booked into
jail with misdemeanor charges.
16% Decrease in Jail Bookings 15% Decrease in Days in Jail
Total Days in Jail for Inmates with BH Issues
There was a 15% decrease in 2019 from 2015 in the
total days in jail per year for inmates with behavioral
health issues with misdemeanor charges (and no
felony).
2,286
2,632
3,028
3,275
3,536
1,000
1,500
2,000
2,500
3,000
3,500
4,000
2015 2016 2017 2018 2019
55% Increase in Referrals
Inmates Referred to CSB Jail-Based Services
There was a 55% increase in 2019 from 2015 in the
number of inmates referred to CSB behavioral health
program staff in the jail. There was an 8% increase in
referrals from 2018.
Merrifield Crisis
Response
Center (MCRC)
16
340
368
305
148
163
212 210
234
52 47 44
28 38
50 42 46
133 154
145
147
142
137
127
134
0
50
100
150
200
250
300
350
400
Jan Feb March April May June July August
Merrifield Crisis Response Center – 2020
Service Encounters by Type
General Emergency Services (non-law enforcement involved)
Law Enforcement Involved - Emergency Custody Order Transports
Law Enforcement Involved - Voluntary Transports
Diverted from potential arrest
17
Looking Ahead
 Working with DIT on Phase I testing and
validation of Diversion First dashboard to
provide more real-time data
 Defining & refining data collection processes
 Expanding data collection & measurement for
Stepping Up’s Four Key Measures
 Creating use cases for Phase II of the Diversion
First dashboard
Drug Court
Veterans Docket
Mental Health
Docket
Penney Azcarate,
Judge, Fairfax County
Circuit Court
Tina Snee
Judge, Fairfax County
General District Court
18
Current Stats
DRUG COURT VETS DOCKETS MH DOCKET
Participants 19 currently 18 currently combined 18 currently
Demographics
Race
Ethnicity
Age
Gender
40% White
35% African American
15% Other
10% Multiracial
10% Hispanic
Average age is 33.4
75% Male
55% White
44% African American
6% Multiracial
22% Hispanic
Average age is 37
83% Male
52% White
24% African American
24% Asian
24% Hispanic
Average age is 29.5
88% Male
Graduates 3 to graduate in Sept. 21 graduates
4 to graduate in Oct.
3 to graduate in Oct.
19
Recent News
DRUG
COURT
 Part-time treatment coordinator
 Peer Support Manager
 2nd State Probation Officer
 Docket Recovery Challenge
 Randomizing Drug Screens - AIB assisting
VETS
DOCKET
 New BJA grant funding for the Docket
Coordinator; incentives; drug kits,
scram
 Dividing the three dockets
 Pre-sentencing cases
 Directly working with CSB for placement
of clients for treatment and housing
 Docket Supervisor Position through CSB
MH
DOCKET
 State grant to cover some expenses
 Grant for integrating family therapy
 Expanded SRP docket
 Sharing Resources
20
SPECIALTY DOCKETS
Needs
Full Time Treatment Coordinators
Currently part-time treatment coordinators
for Drug Court and Vet Dockets
No treatment coordinator for Mental Health
Docket
Sourcing Drug Screening
Collection, notification, and testing
Non-Profit Umbrella for Donations
Funding for On-Going Operations
Administrative Assistance
21
STAR
Program
SHERIFF
STACEY KINCAID
22
STAR: Striving to Achieve Recovery
Fairfax County Sheriff’s Office
Current participants in STAR unit: 14
• Phase 1 – 18 weeks. Attend 4-5 groups/day.
Develop skills, accountability & connections
needed for a lifetime of recovery.
• Phase 2 – Groups continue. Use assessment tool
to track progress & identify areas in which work is
needed. Develop recovery plan & take part in
family support group.
• Phase 3 – Focus on community re-entry. Plan with
CSB & OAR for post-jail success. Potentially move
to Alternative Incarceration Branch for work
opportunities.
23
STAR yoga class
pre-COVID-19
STAR: Striving to Achieve Recovery
Fairfax County Sheriff’s Office
COVID-related ZOOM Videoconferencing
• 12-step meetings
• Mentors
• CSB clinicians
• Peer recovery specialists (PRS)
In-Person conferencing
• PRS: one-on-one
• Sheriff’s Office re-entry specialist: one-on-one,
providing case management and wraparound
services.
STAR program manual
• Covers eligibility and screening criteria,
three phases, group session options,
program rules, assessments
• Includes evaluation tools to dig deeper and
measure how well the program works.
24
STAR: Striving to Achieve Recovery
Fairfax County Sheriff’s Office
Former STAR unit participants: 25
Of those 25:
• 10 have been released to the community, are still engaged in recovery
services, and have not re-offended, relapsed, or violated probation. (40%)
• 4 are still incarcerated, have completed Phases I and II in the STAR unit and are
currently doing Phase III in the Alternative Incarceration Branch.
• 1 was sent to VA Department of Corrections due to length of sentence.
• 2 are still incarcerated but left the program by their own choice.
• 6 have been released but current status is unknown.
• 2 were released, but relapsed. Of those, 1 died from overdose.
25
Jail-Based
Medical and
Behavioral
Health
Services
Laura Yager
Director, Correctional Health and Human Services
Fairfax County Sheriff’s Office
Marissa Fariña-Morse
Service Director, Diversion and Jail-Based Services
Community Services Board
26
Why Medication Assisted Treatment (MAT) and
Wraparound Reentry Services
Behavioral health issues are chronic health conditions just like diabetes, heart
disease, or asthma. Jails are required to provide medical care for these chronic
conditions.
◦ People in jails have much higher rates of chronic health conditions than the
general population. This includes behavioral health issues.
Surveillance data tells us that rates of relapse, use, and overdose deaths have
increased during COVID-19.
People released from incarceration have 129 times the risk of overdose death
than the general
Rhode Island Dept. of Corrections saw a 61% drop in opioid overdose deaths
after launching jail/prison-based MAT launch contributing to a 12% overall drop
in overdose rates across the state!
Recovery reentry supports are key to a safe and healthy community and
changing the life trajectory for individuals
27
Enhancing
Services at
Intercepts 3 and
4 to reduce
relapse,
overdose
deaths, and
recidivism
Innovation!
Collaboration!
Integration!
Looking Beyond Incarceration
Holistic, integrated care approach under Sheriff Stacey Kincaid’s leadership- Adult Detention
Center Medical, CSB Services, and sworn officers united in collaboration
o Relationships building and culture change
o Information-sharing, and collaborative services
Intensive training by national consultants: prescribing, med administration, understanding
addictions, policies and protocol changes
Like Brief Jail Mental Health Screening, screening for addictions at booking
o Includes validated withdrawal tools to guide clinicians
In-depth medical monitoring for withdrawal and ongoing treatment with MAT beyond
withdrawal!
HIDTA grant- Wraparound supports at release (HIGHEST RISK TIME!!!)
o Sheriff’s Office Recovery Navigator and Reentry Counselor + CSB MAT Coordinator
o Medicaid, Transportation. and Recovery Housing
o Reentry HOT HANDOFFS: CSB Addiction Medicine Clinic, housing, transportation, release
meds to reduce barriers and risk (and it’s working!)
28
What’s on the Horizon: Beyond our Foundation
Going to Scale: Building our medical staff resources and capacity to meet the
growing need and to follow best practice guidelines
oContinued HIDTA partnership including Health Management Associates (HMA)
technical assistance
oOngoing resource development efforts
oPeers! Peers! Peers!
Practice-Based Evidence and Outcomes: Leveraging our current HIDTA grant
resources to demonstrate solid outcomes and build a sustainable, resourced
program
Collaborations:
oDrug Court, Court Services, Re-Entry Council
oLocal MAT community providers
oHMA
oFederally Qualified Health Centers
oChris Atwood Foundation
GMU partnership for Technical Assistance and Training and HMA relationship
29
CSB Services
• Community Based
• Adult Detention Center
• Courts
• Telehealth
FY 2020 Services Provided:
• Jail Based Behavioral Health
2,052 Individuals Served
• Jail Diversion (community-based
case management)
1,034 Individuals Served
Creating
Opportunities
Telehealth
- Reentry Planning
- Clinician Response Time
- Access to Psychiatry Services
Successes
Diversion First
Housing
Mike Suppa
Special Housing and Facilities
Development Manager, Community
Services Board
32
Diversion First Housing
Permanent Supportive Housing for 30
individuals in single occupancy units.
Priority: Homeless individuals; unstably
housed Jail Diversion population.
Contractor is New Hope Housing and CSB
offers: Case Management, Psychiatric
Services, and management of referrals.
35 people served to date
- 86% have maintained housing
33
Diversion First Housing
FY 2019 Outcomes
86% had no psychiatric hospitalizations
79% didn’t require CSB Emergency Services
85% of people remained engaged with CSB
Over 50% less expensive than jail
34
Stepping Up Initiative and
National Trends
Nastassia Walsh | September 2020
#StepUp4MentalHealth
www.StepUpTogether.org
Stepping Up is a national initiative to reduce the number of people with
mental illnesses in jails.
22
22
Stepping Up
Innovator
Counties
Prioritizing System Improvements Along
Four Key Measures
• Police-Mental
Health
Collaboration
programs
• CIT training
• Co-responder
models
• Crisis diversion
centers
• Serving frequent
utilizers
• Expand community-
based treatment
options
• Streamline access
to services
• Telehealth
• Leverage Medicaid
and other federal,
state, and local
resources
• Routine screening
and assessment for
mental health and
SUD in jail
• Pretrial mental
health diversion
• Pretrial risk
screening, release,
and supervision
• Bail policy reform
• Apply Risk-Need-
Responsivity
principle
• Use evidence-based
practices
• Specialized
probation
• Social services, like
housing
1.
Jail Bookings
3.
Connection to
Treatment
4.
Recidivism
2.
Jail Length
of Stay
Five Years of Stepping Up
Wednesday, September 30
2:00 - 3:30 p.m. ET
Register: www.NACo.org/Webinars
Upcoming Webinar
New Resource: Stepping Up Strategy Lab
• An interactive library of over
65 programs, policies, and
practices
• Features over 100 examples
from 40 counties
• Updated every 6 months to
reflect progress and changes in
the field
Nastassia Walsh, MA
Associate Program Director, Community
Health and Justice
National Association of Counties
nwalsh@naco.org
Questions and
Comments
43
Thank you!
DiversionFirst@fairfaxcounty.gov
44

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Diversion First Stakeholders Meeting Sept. 22, 2020

  • 1. Diversion First Stakeholders Group Meeting September 22, 2020
  • 2. Welcome! John C. Cook Chairman, Diversion First Stakeholders Group 2
  • 3. Welcoming Remarks Jeffrey C. McKay Chairman, Fairfax County Board of Supervisors 3
  • 4. Agenda Welcome Opening Remarks by John C. Cook, Chairman, Diversion First Stakeholders Meeting Jeffrey C. McKay, Chairman, Fairfax County Board of Supervisors Announcements and Updates Program Updates Community Response Team- Freddie Pedreira Diversion First Analysis- Linda Mount Drug Court, Veterans Treatment Docket, Mental Health Docket- Judge Penney Azcarate and Judge Tina Snee STAR Program- Sheriff Stacey Kincaid Jail-Based Medical and Behavioral Health Services- Laura Yager and Marissa Fariña-Morse Diversion First Housing- Mike Suppa Stepping Up Initiative and National Trends Nastassia Walsh, Associate Program Director for Community Health and Justice, National Association of Counties Questions and Comments Wrap Up 4
  • 5. Announcement and Updates Lisa Potter, Director, Diversion Initiatives Office of Strategy Management 5 2020…a new reality New ways of doing business Fiscal constraints Collaboration and focus on solutions
  • 6. Updates 2019 Annual Report Highlights from 2019 Data Snapshot Future Plans Fairfax County named Stepping Up Innovator County! 6
  • 7. Diversion and Community Re-Entry Center (Judicial Center Complex) The Massey Building demolition and site restoration is anticipated to be complete in Fall 2020. A new master plan will be developed to provide a coordinated long-term plan to meet the needs of the complex’s multiple stakeholders. As conceptualized, this Center would provide:  Resources for those re-entering the community from jail  Greater access to services that provide alternatives to arrest  Integrated behavioral health and care coordination  Resources for employment, healthcare, benefits and other services necessary to keep individuals from recurring involvement with the criminal justice system  Housing location and stabilization services, along with on-site housing options Enhance public safety and promote a healthier community with a more efficient use of public funding Anticipated that master plan proposal will be presented in the coming months 7
  • 8. Medical Assessment Program Partnership with Neighborhood Health, a Federal Qualified Health Center (FQHC) to provide onsite services at the Merrifield Crisis Response Center (MCRC) for individuals in need of medical clearance for psychiatric hospitalization or crisis stabilization admission. Reduce patient and law enforcement time spent in Emergency Department and improve experience Reduce injuries to law enforcement and individuals served Increase connection to follow up primary care services Reduce costs for medical assessment in an outpatient ambulatory setting versus an inpatient Emergency Department. Planning for October 2020 launch 8
  • 9. Sequential Intercept Model (SIM) A framework to inform community-based responses to the involvement of people with mental and substance use disorders in the criminal justice system. Intercept 0- community-based services designed to intervene at the earlier possible point, either before a behavioral health crisis and/or to prevent criminal justice involvement  Identified in 2019 county SIM mapping workshop as a need/priority  Currently exploring ways to expand these services 9
  • 10. Community Response Team Providing outreach and appropriate care and referral services with persons with unmet needs FREDDIE PEDREIRA COMMUNITY HEALTH ANALYST/PUBLIC HEALTH NURSE, FIRE & RESCUE DEPARTMENT 10
  • 11. Current CRT Process and Statistics 11 ACTIVE 13 ACTIVE-OPP 10 TRACKING 157 CLOSED 82 Current CRT Census Modified response during COVID Added equipment to vehicle for screening • Reduce non-emergency ER visits • Clear police from mental health calls earlier [Statistics as of 9/1/20] EXAMPLE: 2019 2020 FRD CALLS 975 693 FRD TRANSPORTS 845 568 FRD SERVICE CALLS - 117
  • 13. 13 CRT Online Referral Application Emergency Department Information Exchange Local Hospital/Health Care System New Vehicle UpdatesOther Community/County Resources
  • 14. Diversion First Analysis Linda Mount Director, Analytics and Evaluation Community Services Board 14
  • 15. Jail Behavioral Health Population - 2019 15 1,854 1,614 1,492 1,507 1,551 1,000 1,100 1,200 1,300 1,400 1,500 1,600 1,700 1,800 1,900 2,000 2015 2016 2017 2018 2019 22,545 19,337 18,351 18,672 19,205 15,000 16,000 17,000 18,000 19,000 20,000 21,000 22,000 23,000 24,000 25,000 2015 2016 2017 2018 2019 Number of Inmates with Behavioral Health Issues There was a 16% decrease in 2019 from 2015 of inmates with behavioral health issues booked into jail with misdemeanor charges. 16% Decrease in Jail Bookings 15% Decrease in Days in Jail Total Days in Jail for Inmates with BH Issues There was a 15% decrease in 2019 from 2015 in the total days in jail per year for inmates with behavioral health issues with misdemeanor charges (and no felony). 2,286 2,632 3,028 3,275 3,536 1,000 1,500 2,000 2,500 3,000 3,500 4,000 2015 2016 2017 2018 2019 55% Increase in Referrals Inmates Referred to CSB Jail-Based Services There was a 55% increase in 2019 from 2015 in the number of inmates referred to CSB behavioral health program staff in the jail. There was an 8% increase in referrals from 2018.
  • 16. Merrifield Crisis Response Center (MCRC) 16 340 368 305 148 163 212 210 234 52 47 44 28 38 50 42 46 133 154 145 147 142 137 127 134 0 50 100 150 200 250 300 350 400 Jan Feb March April May June July August Merrifield Crisis Response Center – 2020 Service Encounters by Type General Emergency Services (non-law enforcement involved) Law Enforcement Involved - Emergency Custody Order Transports Law Enforcement Involved - Voluntary Transports Diverted from potential arrest
  • 17. 17 Looking Ahead  Working with DIT on Phase I testing and validation of Diversion First dashboard to provide more real-time data  Defining & refining data collection processes  Expanding data collection & measurement for Stepping Up’s Four Key Measures  Creating use cases for Phase II of the Diversion First dashboard
  • 18. Drug Court Veterans Docket Mental Health Docket Penney Azcarate, Judge, Fairfax County Circuit Court Tina Snee Judge, Fairfax County General District Court 18
  • 19. Current Stats DRUG COURT VETS DOCKETS MH DOCKET Participants 19 currently 18 currently combined 18 currently Demographics Race Ethnicity Age Gender 40% White 35% African American 15% Other 10% Multiracial 10% Hispanic Average age is 33.4 75% Male 55% White 44% African American 6% Multiracial 22% Hispanic Average age is 37 83% Male 52% White 24% African American 24% Asian 24% Hispanic Average age is 29.5 88% Male Graduates 3 to graduate in Sept. 21 graduates 4 to graduate in Oct. 3 to graduate in Oct. 19
  • 20. Recent News DRUG COURT  Part-time treatment coordinator  Peer Support Manager  2nd State Probation Officer  Docket Recovery Challenge  Randomizing Drug Screens - AIB assisting VETS DOCKET  New BJA grant funding for the Docket Coordinator; incentives; drug kits, scram  Dividing the three dockets  Pre-sentencing cases  Directly working with CSB for placement of clients for treatment and housing  Docket Supervisor Position through CSB MH DOCKET  State grant to cover some expenses  Grant for integrating family therapy  Expanded SRP docket  Sharing Resources 20
  • 21. SPECIALTY DOCKETS Needs Full Time Treatment Coordinators Currently part-time treatment coordinators for Drug Court and Vet Dockets No treatment coordinator for Mental Health Docket Sourcing Drug Screening Collection, notification, and testing Non-Profit Umbrella for Donations Funding for On-Going Operations Administrative Assistance 21
  • 23. STAR: Striving to Achieve Recovery Fairfax County Sheriff’s Office Current participants in STAR unit: 14 • Phase 1 – 18 weeks. Attend 4-5 groups/day. Develop skills, accountability & connections needed for a lifetime of recovery. • Phase 2 – Groups continue. Use assessment tool to track progress & identify areas in which work is needed. Develop recovery plan & take part in family support group. • Phase 3 – Focus on community re-entry. Plan with CSB & OAR for post-jail success. Potentially move to Alternative Incarceration Branch for work opportunities. 23 STAR yoga class pre-COVID-19
  • 24. STAR: Striving to Achieve Recovery Fairfax County Sheriff’s Office COVID-related ZOOM Videoconferencing • 12-step meetings • Mentors • CSB clinicians • Peer recovery specialists (PRS) In-Person conferencing • PRS: one-on-one • Sheriff’s Office re-entry specialist: one-on-one, providing case management and wraparound services. STAR program manual • Covers eligibility and screening criteria, three phases, group session options, program rules, assessments • Includes evaluation tools to dig deeper and measure how well the program works. 24
  • 25. STAR: Striving to Achieve Recovery Fairfax County Sheriff’s Office Former STAR unit participants: 25 Of those 25: • 10 have been released to the community, are still engaged in recovery services, and have not re-offended, relapsed, or violated probation. (40%) • 4 are still incarcerated, have completed Phases I and II in the STAR unit and are currently doing Phase III in the Alternative Incarceration Branch. • 1 was sent to VA Department of Corrections due to length of sentence. • 2 are still incarcerated but left the program by their own choice. • 6 have been released but current status is unknown. • 2 were released, but relapsed. Of those, 1 died from overdose. 25
  • 26. Jail-Based Medical and Behavioral Health Services Laura Yager Director, Correctional Health and Human Services Fairfax County Sheriff’s Office Marissa Fariña-Morse Service Director, Diversion and Jail-Based Services Community Services Board 26
  • 27. Why Medication Assisted Treatment (MAT) and Wraparound Reentry Services Behavioral health issues are chronic health conditions just like diabetes, heart disease, or asthma. Jails are required to provide medical care for these chronic conditions. ◦ People in jails have much higher rates of chronic health conditions than the general population. This includes behavioral health issues. Surveillance data tells us that rates of relapse, use, and overdose deaths have increased during COVID-19. People released from incarceration have 129 times the risk of overdose death than the general Rhode Island Dept. of Corrections saw a 61% drop in opioid overdose deaths after launching jail/prison-based MAT launch contributing to a 12% overall drop in overdose rates across the state! Recovery reentry supports are key to a safe and healthy community and changing the life trajectory for individuals 27 Enhancing Services at Intercepts 3 and 4 to reduce relapse, overdose deaths, and recidivism Innovation! Collaboration! Integration!
  • 28. Looking Beyond Incarceration Holistic, integrated care approach under Sheriff Stacey Kincaid’s leadership- Adult Detention Center Medical, CSB Services, and sworn officers united in collaboration o Relationships building and culture change o Information-sharing, and collaborative services Intensive training by national consultants: prescribing, med administration, understanding addictions, policies and protocol changes Like Brief Jail Mental Health Screening, screening for addictions at booking o Includes validated withdrawal tools to guide clinicians In-depth medical monitoring for withdrawal and ongoing treatment with MAT beyond withdrawal! HIDTA grant- Wraparound supports at release (HIGHEST RISK TIME!!!) o Sheriff’s Office Recovery Navigator and Reentry Counselor + CSB MAT Coordinator o Medicaid, Transportation. and Recovery Housing o Reentry HOT HANDOFFS: CSB Addiction Medicine Clinic, housing, transportation, release meds to reduce barriers and risk (and it’s working!) 28
  • 29. What’s on the Horizon: Beyond our Foundation Going to Scale: Building our medical staff resources and capacity to meet the growing need and to follow best practice guidelines oContinued HIDTA partnership including Health Management Associates (HMA) technical assistance oOngoing resource development efforts oPeers! Peers! Peers! Practice-Based Evidence and Outcomes: Leveraging our current HIDTA grant resources to demonstrate solid outcomes and build a sustainable, resourced program Collaborations: oDrug Court, Court Services, Re-Entry Council oLocal MAT community providers oHMA oFederally Qualified Health Centers oChris Atwood Foundation GMU partnership for Technical Assistance and Training and HMA relationship 29
  • 30. CSB Services • Community Based • Adult Detention Center • Courts • Telehealth FY 2020 Services Provided: • Jail Based Behavioral Health 2,052 Individuals Served • Jail Diversion (community-based case management) 1,034 Individuals Served
  • 31. Creating Opportunities Telehealth - Reentry Planning - Clinician Response Time - Access to Psychiatry Services Successes
  • 32. Diversion First Housing Mike Suppa Special Housing and Facilities Development Manager, Community Services Board 32
  • 33. Diversion First Housing Permanent Supportive Housing for 30 individuals in single occupancy units. Priority: Homeless individuals; unstably housed Jail Diversion population. Contractor is New Hope Housing and CSB offers: Case Management, Psychiatric Services, and management of referrals. 35 people served to date - 86% have maintained housing 33
  • 34. Diversion First Housing FY 2019 Outcomes 86% had no psychiatric hospitalizations 79% didn’t require CSB Emergency Services 85% of people remained engaged with CSB Over 50% less expensive than jail 34
  • 35. Stepping Up Initiative and National Trends Nastassia Walsh | September 2020
  • 36. #StepUp4MentalHealth www.StepUpTogether.org Stepping Up is a national initiative to reduce the number of people with mental illnesses in jails.
  • 37. 22
  • 39. Prioritizing System Improvements Along Four Key Measures • Police-Mental Health Collaboration programs • CIT training • Co-responder models • Crisis diversion centers • Serving frequent utilizers • Expand community- based treatment options • Streamline access to services • Telehealth • Leverage Medicaid and other federal, state, and local resources • Routine screening and assessment for mental health and SUD in jail • Pretrial mental health diversion • Pretrial risk screening, release, and supervision • Bail policy reform • Apply Risk-Need- Responsivity principle • Use evidence-based practices • Specialized probation • Social services, like housing 1. Jail Bookings 3. Connection to Treatment 4. Recidivism 2. Jail Length of Stay
  • 40. Five Years of Stepping Up Wednesday, September 30 2:00 - 3:30 p.m. ET Register: www.NACo.org/Webinars Upcoming Webinar
  • 41. New Resource: Stepping Up Strategy Lab • An interactive library of over 65 programs, policies, and practices • Features over 100 examples from 40 counties • Updated every 6 months to reflect progress and changes in the field
  • 42. Nastassia Walsh, MA Associate Program Director, Community Health and Justice National Association of Counties nwalsh@naco.org