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Diversion First Stakeholders Group: Jan. 29, 2018

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Diversion First Stakeholders Group: Jan. 29, 2018

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Diversion First Stakeholders Group: Jan. 29, 2018

  1. 1. Diversion First Stakeholders Group January 29, 2018
  2. 2. Tonight’s Agenda • Welcome • Year in Review and Year Ahead • Updates from Last Quarter • Recognition • Comments from Federal Visitors • LFI Program Day • Budget Process – 5-Year Budget Plan • Merrifield Crisis Response Center • Court System • Data and Evaluation • Problem-Solving /Super Utilizers • Communications • Questions, Comments, Discussion • Adjourn 2
  3. 3. Tonight: The Year in Review and Plans in the New Year • Key outcomes from 2017 – This year’s focus was on broadening court efforts • Where we’re heading in 2018 – Continue refining current initiatives – Design pilot for co-responders – Re-entry But first, some updates and announcements… 3
  4. 4. Supervisor John Cook Selected for NACo Peer Exchange 4 http://www.naco.org/node/221565
  5. 5. NACo Maricopa County Site Visit/Peer Exchange The Peer Exchange was organized around the four key measures of the Stepping Up initiative: • The number of people with mental illnesses booked into jails • Their length of stay • Connections to treatment, and • Recidivism 5
  6. 6. “Progress Made Possible” Conference 12/17 • Fairfax team in attendance • Opportunity to learn about the Miami-Dade System • Laura presented on our local Diversion First efforts 6
  7. 7. IACP Highlights Diversion First at Progress Made Possible Conference! 7
  8. 8. Gathering Effective Service Designs to Inform our Local Efforts 8 Also from 2017 (in review): • Best Practices Design Implementation Academy-Fairfax County invited as a best practice community • Fairfax selected to participate in Data-Driven Justice and Behavioral Health Design Institute
  9. 9. Recognition and Welcome Guests Sheriff Stacey Kincaid 9
  10. 10. Congrats! Lt. Redic Morris Distinguished Service Award “It’s staggering to see how many people come to us experiencing a mental health crisis,” said Morris. “This job is one of the hardest I’ve had, but it’s very rewarding. I can leverage the skills I’ve developed over the years to effectively interface with other agencies and organizations. Working collaboratively, we are making progress by getting people into treatment and avoiding or reducing jail time.” –Lt. Redic Morris 10 “Redic has served as a role model throughout his career. His wealth of knowledge, calm demeanor and impeccable judgment have contributed to his well-deserved reputation as a go-to-guy His passion is evident in all of the work he does in the community.” -Sheriff Stacey Kincaid
  11. 11. Welcome to our National Partners! 11
  12. 12. National Institute of Corrections (NIC) The National Institute of Corrections is a center of learning, innovation, and leadership that shapes and advances effective correctional practice and public policy. 12 s Aurora, CO
  13. 13. NIC Strategic Outcomes The outcomes of NIC's activities contribute significantly to the achievement of state, local, and federal correctional goals and priorities: – Effectively managed prisons, jails, and community corrections programs and facilities – Enhanced organizational and professional performance in corrections – Community, staff, and offender safety – Improved correctional practices through the exploration of trends and public policy issues – Enhanced services through improved organizational and staff effectiveness 13
  14. 14. Centers of Innovation NIC Centers of Innovation (COI) Jail Based Promising Behavioral Health Efforts – Crisis Intervention Training (CIT) • Franklin County, Ohio • Broward County, FL • Dane County, WI • Douglas County, NE – Medication Assisted Treatment (MAT) • Louisville Metro Jail • Sacramento County, CA Jail • Middlesex, MA County House of Corrections • Montgomery County, MD Jail • Rhode Island Department of Jail Facility 14
  15. 15. Bureau of Justice Assistance (BJA) BJA supports programs and initiatives in the areas of law enforcement, justice information sharing, countering terrorism, managing offenders, combating drug crime and abuse, adjudication, advancing tribal justice, crime prevention, protecting vulnerable populations, and capacity building. 15
  16. 16. Leadership Fairfax Program Day Sharon Arndt Director, Community Health Development and Preparedness Division, Health Department 16
  17. 17. Leadership Fairfax, Inc. 1/18/18 Diversion First Program Day 17
  18. 18. Budget Updates • Presented a five-year, cross-agency, fiscally constrained Diversion First budget to BOS Public Safety Committee on 11/28/17 – Organized around the intercepts, not agencies • FY 2019 Budget Process – February 20: County Executive releases FY 2019 Advertised Budget – April 10-12: BOS Public Hearings on Budget – April 24: Budget Markup – May 1: Final Budget, tax rate, and school budget transfer 18
  19. 19. Five-Year Proposed Budget • Strengthens operations at the MCRC • Establishes a third Mobile Crisis Unit with a co-responder design • Provides court system resources • Provides needed housing, transport and other resources • Strengthens behavioral health services at needed intercepts 19 Diversion First Multi-Year Proposed Budget FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 14 FTEs 13 FTEs 10 FTEs 9.0 FTEs 5.0 FTE $1,929,049 $2,078,357 $2,207,156 $1,814,832 $848,373
  20. 20. Merrifield Crisis Response Center Abbey May, CSB Lt. Redic Morris, Sheriff’s office Lt. Mike Tucker, PD
  21. 21. Merrifield Crisis Response Center • 2017 Accomplishments Law Enforcement • Increases in volume-ECOs/Law Enforcement involved • 24/7 coverage – Increase in cases transferred • Training • 2018 Goals Law Enforcement • Increase staffing • Training • Co-responder model 21
  22. 22. Merrifield Crisis Response Center • 2017 Accomplishments Emergency Services • Collaboration with law enforcement • Staffing • MCU 2 • Medical Clearance • 2018 Goals Emergency Services • Care Coordinator position – Super utilizers • Fully staffed • Medical Clearance • MCU 3 Co-responder model 22
  23. 23. The Honorable Tina Snee, Judge, GDC Shawn Lherisse, Court Services Marissa Fariña-Morse, EdS, NCC, CAADC, LPC Bob Bermingham, Director, JDRDC Services 23
  24. 24. Court Services 2017 • Court Services – Hiring – MH Unit: 3 new full time hires • 4 Probation Officers CIT trained • Pre-trial Questionnaire Enhancements • Court Services Diversion First statistics • 20% jump in average daily caseload 24
  25. 25. CSB 2017 (Jail Based/Jail Diversion) • CSB Hiring – Jail-Based: 12 new full time hires – Jail Diversion: 7 new full time hires • Jail Based Diversion – Jail-Based ECO/TDO – Jail Diversion “engagement” – Enhanced partnerships / improved processes with GDC, Circuit, JDR and Court Services 25
  26. 26. CSB 2017 (Jail Based/Jail Diversion) • Jail-Based Psychiatric Services – Additional provider (on-site services 4 days/week) – Added full time Behavioral Health Nurse • Veterans Docket • Drug Court • Opioid Epidemic – Medication Assisted Treatment - ADC • Vivitrol • Narcan 26
  27. 27. CSB/Court Services 2017 • Attorney Outreach (CLE) • Release Planning – ECO/TDO’s – SRP Recommendations – Identification of Mental Health Needs • Use of BJMHS • CSB / Court Services Partnership – Faster appointment of Public Defender 27
  28. 28. Where are we going - 2018 • Supervised Release Plan - Reporting • Courthouse - CSB/Court Services Co-location - New Space for Court Services MH Team • Intercept 4 - (Re-entry) Expanded Focus • Mental Health Review Hearings • Length of Stay at the ADC - Recidivism 28
  29. 29. More - 2018 • “High Needs” Caseload – Designated Probation Officer • Expedite Diversion First Placements at Arraignment/Advisement rather than Bond Motion. • Specialized Training of new Court Services Staff 29
  30. 30. Juvenile and Domestic Relations District Court 2017 • GDC staff have begun to conduct interview/assessments on JDRDC cases • JDRDC cases can now be included in the Veterans Docket • Multi-organizational planning to launch Multi-systemic Therapy (MST) and Functional Family Therapy (FFT) initiatives • Continuing progress on juvenile justice system transformation 2018 • Two jail-based JDRDC staff will be on-boarded next month to mirror the GDC assessment process • JDRDC Community Correction Pre-trial Staff are already supervising 30 cases in the community • Continued development on the of MST and FFT efforts 30
  31. 31. Data and Evaluation Team Lisa Potter, CSB Chloe Lee, CSB 31
  32. 32. 2017 Key Accomplishments • Completed a jail behavioral health population analysis • Developed evaluation plans to track outcomes • Established both cross-sectional and longitudinal outcomes for the MCRC population • Instituted tracking processes for the Brief Jail Mental Health Screening (BJMHS) 32
  33. 33. 33 2017 AT A GLANCE 1,931 MCRC LEO cases UP 22% from 2016 1,365 ECOs UP 32% from 2016 584 MCU LEO cases UP 25% from 2016 40% of the total MCRC LEO cases IN THE FIELD CIT TRAININGS ADULT DETENTION CENTER 74% 67%
  34. 34. 2016 MCRC Population (Intercept 1) Longitudinal Outcome Evaluation January 29, 2018 Data and Evaluation Team Chloe Lee, PhD 34
  35. 35. Review: Intercept 1 Evaluation Plan 35 MCRC visitors with LEOs who have SMI, are Fairfax County residents, had potential charges and are over 17 (N=125) Clients who visited MCRC with LEOs To identify trends and changes in the MCRC population To track changes in longitudinal outcomes (criminal justice involvement and CSB services)
  36. 36. MCRC Longitudinal Analysis Overview 36 Population selection Data Tracking- 12 months Predictive analysis Selected 2016 MCRC visitors with LEOs who have SMI, are Fairfax County/City residents, had potential charges and are over 17 (N=125) Tracked both behavioral health care (CSB services) and criminal justice outcomes (arrests and jail incarcerations) for 12 months following the MCRC visit Determined risk factors for criminal justice outcomes
  37. 37. Demographic Analysis: Gender & Age 37 34% Female 66% Male GENDER 7% 12% 15% 24% 42% 60 and up 50 to 59 40 to 49 30 to 39 17 to 29 AGE
  38. 38. Demographic Analysis: Race & Ethnicity 38 16% 7% 6% 24% 47% Other Multi-race Asian African American White HISPANIC OR LATINO 15% RACE
  39. 39. Demographic Analysis: Homelessness 1 in 10 (11%) were homeless. 39
  40. 40. Diagnosis: Mental Health Bipolar Schizoaffective Major depression Schizophrenia 40 34% 22% 17% 12%
  41. 41. Substance Use Disorder (SUD) & Developmental Disability (DD) 41 Non-alcohol Alcohol Use DD SUD 34% 26% 11%
  42. 42. Outcome Analysis: CSB Services 82% of the 125 individuals received services from CSB within 12 months following their MCRC visit with LEOs. % received services: 42 8% 14% 20% 46% 50% 61% Residential Outpatient Treatment Crisis Stabilization Medication Case Management Emergency/MCU
  43. 43. 30% Outcome Analysis: Criminal Justice 43 23% 83% Of the individuals were arrested within 12 months following their visit to MCRC (Fairfax County arrest only) Of the individuals were incarcerated within 12 months following their visit to MCRC Of the individuals who were incarcerated received CSB jail- based services
  44. 44. A Predictive Model of Criminal Justice Outcomes • Predictors used in the model: age, race, gender, SUD (no alcohol), alcohol-related diagnosis, homelessness, jail incarceration history in the past three years • Model with jail incarceration: χ₂=49.6, df=7, p<.001, Cox & Snell R Square=.33, Nagelkerke R Square=.5). • Non-significant predicators: age, race, gender, non-alcohol SUD 44
  45. 45. Risk Factors for Criminal Justice Outcomes • Homelessness: A significant predictor for incarceration [EXP(B)=48.1, 95% CI=7.5 to 305, p<.001] 45 5X 86% were incarcerated within 12 months 15% were incarcerated within 12 months HOMELESS: YES HOMELESS: NO
  46. 46. Risk Factors for Criminal Justice Outcomes • Alcohol use: A significant predictor for incarceration [EXP(B)=3.5, 95% CI=3.9 to 130.1, p=.05] 46 3X ALCOHOL: YES ALCOHOL: NO 44% were incarcerated within 12 months 16% were incarcerated within 12 months
  47. 47. Risk Factors for Criminal Justice Outcomes • Previous jail incarceration history (Past 3 years): A significant predictor for incarceration [EXP(B)=1.6, 95% CI=1.0 to 2.5, p<.05] 47 JAIL HISTORY: YES 55% were incarcerated within 12 months JAIL HISTORY: NO 17% were incarcerated within 12 months 3X
  48. 48. Implications and Future Plans 48
  49. 49. Intercept 1 Interventions Identification of the at-risk population for the implementation of targeted interventions Increase in the number of people who are diverted from arrest & Increase in the number of people who are connected to care Decrease in the number of people with behavioral health needs in jail 49
  50. 50. Outcome Evaluation: 4 Key Measures (NACo) 50 Reduce The number of people with behavioral health /SMI booked into jail Shorten The average length of stay for people with behavioral health/SMI in jail Increase The percentage of connection to care for people with behavioral health/SMI in jail Lower Rates of recidivism Intercept 1, 2, 3: MCRC, Jail, Court, Police, Fire and Rescue Intercept 2, 3: Jail, Court Intercept 4: Jail, Court, Police, CSB Intercept 5: CSB, DFS/DRS, Office to prevent and end homelessness Homeless shelters, etc.
  51. 51. Jail Population Analysis: Review and Plan 51 DAYS Roughly 1 in 3 Inmates with More than half jail inmates have behavioral health issues of the population behavioral health stay 20 days longer recidivate in 3 issues in jail than inmates years without behavioral health issues 2017 Jail Population Analysis will be conducted to compare the changes in the jail behavioral health population
  52. 52. Plans for 2018 • 4 key measures (NACo) • 2017 jail population analysis • Infographic communication tools • Continued focus on automated data integration and data sharing solutions 52
  53. 53. Problem-Solving Team Using Data Findings to Inform Service Delivery Daryl Washington Acting Executive Director Community Services Board 53
  54. 54. Ideas around use of data to shape service delivery changes • Targeting interventions • Focus on people at risk for recidivism • Help with future service need identification Problem-Solving Team • Change of chair • Continued response to family concerns • Back to reviewing low-level criminal arrests for quality improvement • Identification of Super Utilizers to form a collaborative response team • Focus of super utilizers: ADC utilization • Developing data tracking measures 54
  55. 55. Communications 55
  56. 56. Check out the Revamped Website! 56 https://www.fairfaxcounty.gov/topics/diversion-first
  57. 57. Questions, Comments… 57
  58. 58. Next Stakeholders Meeting May 7, 7-9 pm Government Center, Rooms 4 and 5 12000 Government Center Parkway Fairfax, VA 22035 58

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