Diversion First Stakeholders Group: May 7, 2018

1. Diversion First Stakeholders Group
May 7, 2018

2. Tonight’s Agenda
May 7, 2018
• Welcome
• Announcements and Recognition
• Housing Updates
• Data and Evaluation Team: Jail Population
• Merrifield Crisis Response Center and Co-Responder
Model
• Courts and Re-Entry
• Discussion
• Adjourn
2

3. Communications Team
Andi Ceisler, Sheriff’s Office
3

4. Communications Team
4

5. Annual Report Now
Available!
https://www.fairfaxcounty.gov/topics/diversion-first
5

6. Recognition
Sheriff Stacey Kincaid
Chief Ed Roessler, FCPD
6

7. MCRC Law Enforcement Staff
Recognition of Service
7
PFC Janelle Colie, Office of the Sheriff
Lt. Mike Tucker, Fairfax County Police Department

8. Thanks for a job well done!
“I just want to recognize (these staff)
for their outstanding work…on a really
complex situation in the emergency
room…The degree of helpfulness and
compassion they demonstrated to the
patient and family was truly above
and beyond…Their medical acumen is
getting really good too! Talk about
having the right people on the job! I
feel lucky to work alongside them.”
--Inova Fairfax Emergency
Department Doctor
• PFC John Embrey, Office of
the Sheriff
• PFC Tonya Trivett, FCPD
8

9. Announcements and Updates
Laura Yager, Office of CoEx
9

10. Budget
May 1 - Board of Supervisors approved the
FY 2019 budget, including:
 $1,929,049 Diversion First funding across intercepts
 14 positions
 Additional funds for housing assistance
10

11. FY 2019 Funding Highlights
• 2 additional officers at MCRC
• 2 positions to begin 3rd MCRC and Co-Responder Model
• 2 Deputy Sheriffs to support transportation needs
• 2 JDR Counselors to expand diversion focus to JDR
Court
• 1 Recovery Support Program Support Specialist to jail
• 1 CSB staff to support court efforts
• 4 additional CSB staff to expand jail diversion (transition
to community) services
11

12. Site Visits from Around
the Country
12
• April 26-27: DuPage and
Lake Counties, Illinois
• May 24: NACo and
multiple national justice
and law enforcement
organizations visit

13. Exploration of New Recovery
Programming in Jail
• Site visits to Chesterfield County Jail to learn about
the Heroin Addiction Recovery Program (HARP)
–Peer-led and jail-based program
–For inmates with substance-use disorders interested
in/seeking recovery
–Supplemental behavioral health and trauma supports by
CSB staff
–Includes focus on community supports for successful reentry
–Collaborative planning underway with Sheriff’s office, CSB,
and GMU
13

14. Resource Applications…
• NACo “Advancing Cross-Systems Partnerships Leadership
Lab”
• Selected counties will come together to develop and test a
strategy to transform how county justice, health, and
human services systems use and maximize data
• The goal will be to move beyond recidivism measures and
improve the social, health, and economic circumstances and
outcomes for justice-involved (AKA diversion) populations
• Up to four counties will be selected to participate in this 15-
month program
• Notification will occur later this month
14

15. Resource Applications…
• Justice and Mental Health Collaboration Program Competitive
Grant
• Up to $750K for 3 years
• Can support law enforcement, prosecution, court-based,
corrections, or P&P initiatives designed to reduce recidivism
among high risk individuals
• TA call is tomorrow to determine alignment with funding
requirement with Fairfax identified need related to co-
responder model
• Notification of award will be announced later in the summer
for funding to start Oct 1
15

16. Housing Updates
Daryl Washington, CSB
16

17. Diversion First Housing
Updates
• 26 Individuals have obtained Diversion First Housing
–85% (22) remain in housing
• Original Diversion First housing funds have been
retooled to increase capacity to 30!
• Additional individuals are being screened and
considered for these housing unites
• A Special Assistance fund has been established to
assist with move-in expenses, housing stability, and
eviction avoidance
17

18. 2017 Jail Behavioral Health
Population Analysis
Data and Evaluation Team
Lisa Potter & Chloe Lee
18

19. Evaluation Plan
19
Inmates with
behavioral health
issues
Inmates with SMI
who are Fairfax
County residents and
who did forensic
intake during the
current incarceration
and were released
during the period of
data collection

20. Four Key Measures
20
Reduce
The number of
people with
behavioral health
issues booked into
jail
Shorten
The average length
of stay for people
with behavioral
health issues in jail
Increase
The percentage of
connection to
care for people
with behavioral
health issues/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.

21. Methodology
• Jail population analysis: Only the inmates who were booked into
jail in the same year were included
• Average length of stay analysis: Only the inmates who were
booked and released in the same year were included to make the
number of people consistent over time
• CSB clients (i.e. “behavioral health population”) were identified
from both referred and non-referred jail populations
21
Inmates who
were
referred to
CSB=3,077
(25%)
Inmates with
behavioral
health
issues=3,983
(32%)
Inmates
booked into
jail =12,394

22. Behavioral Health Population
Booked into Jail: 2015-2017
There was a decrease in the percentage of inmates with
behavioral health issues booked into jail from 2015 to
2017 (p<.001)
22
35.2%
34.5%
32.1%
2015 2016 2017
3%

23. Referral to CSB from Jail:
2015-2017
There was an increase in the referrals of inmates from
jail to the CSB from 2015 to 2017 (p<.001)
23
7%
17.5%
20.9%
24.8%
2015 2016 2017

24. GENDER
20%
Female
Demographic Analysis of the
2017 Jail Behavioral Health
Population
24
80% Male
0.6%
0.2%
3.6%
38.3%
57.3%
0% 20% 40% 60% 80%
Unknown
American Indian
Asian
Black or African American
White
RACE

25. Homelessness
7.6% of the inmates with behavioral health issues were
homeless
25
7.6% 5.5%
BH No BH
1.4X

26. Jail Behavioral Health
Population: Diagnosis
(N=3,077)
26
01
DEPRESSION
11.2%
02
MOOD DISORDER
6.7%
03
BIPOLAR DISORDER
5.5%
ANXIETY DISORDER
5.5%
PTSD 5.5%
50%
14.7%
53.9%
ALCOHOL OPIOID OTHER SUD

27. Most Serious Charge of the
Year: 2015-2017
Among the inmates with behavioral health issues, the
percentage of inmates with misdemeanor/ordinance
charges has decreased over time
27
41.8%
37.8% 38.4%
2015 2016 2017
4%

28. Average Length of Stay in
Jail: 2015-2017
On average, inmates with behavioral health issues
stayed 12 days longer in jail than the inmates with no
behavioral health issues
28
17.3 18.4
18.8
6.5 6.9
6.5
2015 2016 2017
12
DAYS
BH
No
BH

29. Average Length of Stay by
Referral to CSB: 2015-2017
29
The difference in the length of stay between the inmates
who were referred from jail to the CSB and those who
were not has decreased over time
23 22
18
8 9 8
2015 2016 2017
REFERRED
NOT REFERRED
Difference in the length of stay
decreased: 15 to 10

30. What predicts the average
length of stay in jail?
Predictors in the model: Gender, Race, Charge,
Hispanic/Latino Ethnicity, Homelessness, Behavioral
Health Issues, Age (R=.29, R Square=.072, p<.001)
–Gender: Male>Female (+4 Days)
–Race: Minority>White (+1 Day)
–Age: Younger>Older
–Charge: Felony>Misdemeanor/Ordinance (+10 Days)
–Behavioral Health Issues: Behavioral Health Issues> No
Behavioral Health Issues (+10 Days)
30

31. What predicts the average
length of stay in jail?
BH Population
• Alcohol-related diagnosis: Inmates with alcohol-
related diagnosis stayed 5 days less in jail, compared
to those without the diagnosis (p<.001)
• Opioid-related diagnosis: Inmates with opioid-
related diagnosis stayed 7 days longer in jail,
compared to those without the diagnosis (p<.001)
31

32. Release Analysis: Bond
Inmates with behavioral health issues were less likely to
be released on bond, compared to the inmates with no
behavioral health issues
32
BH:
35%
No BH:
45%
FELONY MIS/ORD
BH:
60%
No BH:
78%
1.2X 1.3X

33. Release Analysis: Pre-trial
Supervision
Inmates with behavioral health issues were more likely
to be released to Pre-trial Supervision, compared to the
inmates with no behavioral health issues
33
FELONY MIS/ORD
BH:
22%
No
BH:
12%
BH:
16%
No
BH:
5%
3.2X1.8X

34. Recidivism
Inmates with behavioral health issues were
approximately 2.4 times more likely to recidivate to jail
within 2 years, compared to the inmates with no
behavioral health issues
34
2.4X
BH NO BH
52% 22%

35. The Next Step
Longitudinal outcome tracking with a subset of the jail
behavioral health population: connection to care,
criminal justice outcomes
35
Inmates with
behavioral
health issues
Inmates with SMI
who are Fairfax
County residents and
who did forensic
intake during the
current incarceration
and were released
during the period of
data collection
Question 3.
Increase
The percentage
of connection to
care for people
with behavioral
health
issues/SMI in
jail
Question 4.
Lower
Rates of
recidivism
Next Step

36. Data and Evaluation Team
• Next Steps
–Further exploration/analysis of jail population
linked to NACo’s key measures
–Ongoing work with DIT on data warehouse
development
–Exploration of “beyond recidivism” outcome
measures
36

37. Merrifield Crisis Response Center
Jason Jenkins, FRD
Dewayne Machosky, FCPD
Abbey May, CSB
Redic Morris, Sheriff’s Office
Mike Tucker, FCPD
37

38. Merrifield Crisis
Response Center (MCRC)
• Law Enforcement Updates
–CIT Coordinator – Mike Tucker, FCPD transferring to
Mason District
–New CIT Coordinator – Dwayne Machosky, FCPD
–MCRC law enforcement activities
–Continuing CIT and Mental Health First Aid Training
–Community Outreach
38

39. MCRC Data Updates
Data Snapshot Highlights- January 1-March 31, 2018
• Law Enforcement Officer (LEO) involved cases at Emergency
Services- 556
54% increase from 2016
– Emergency Custody Orders (ECOs)- 388
92% increase from 2016
– Voluntary transports- 168
6% increase from 2016
– Diverted from potential arrest- 128
24% increase from 2016
• Mobile Crisis Unit (MCU)
– Services- 425
33% increase from 2016
– Services with law enforcement involvement- 145
84% increase from 2016
39

40. MCRC
• Co-responder Model (Public Safety and CSB
responding to non-emergency calls together)
•Workgroup launched
– Pilot
– Research on best practice models
– Operations
– Current collaboration on EMS super utilizers
» Multi-disciplinary meetings and home visits
40

41. MCRC
• Medical Clearance
• Super Utilizers
– Youth peer-run walk in group launch May 17th
– Super utilizer calls
– Care Coordinator
» Outreach connection with services
» Identifying and tracking
» Additional support
41

42. MCRC
• Coordination with Court Services, Jail Based,
and Jail Diversion
 Training of certified pre-screener
 Presentation from Court services
 Triage and collaboration with Jail Diversion
 Referral coordination
42

43. Tina Snee, Judge, General District Court
Susan J. Stoney, Judge, General District Court
Penney Azcarate, Judge, Circuit Court
Shawn Lherisse, Court Services
Marissa Fariña-Morse, CSB
43

44. Intercept 2
• Magistrates role in the Diversion First Initiative is
influential. It can aide in getting individuals to the
appropriate treatment level and reduce the rate of
recidivism /financial burden on the Criminal Justice
System
• The Acuity of Individuals coming to the Magistrate’s
Window can be broken down into three levels:
– High Mental Health Acuity
– Intermediate Mental Health Acuity
– Low Mental Health Acuity
44

45. Magistrate Training
• CSB Jail Based/Court Services/Judge Snee -
Conducted two trainings for all Magistrates
• Goal
– Provide support and education about Diversion
First Initiatives and Mental Health
– Intervene (Divert) before waiting for advisement
45

46. Intercept 4 Reentry
• Sheriff’s Office Inmate Reentry Programs
– Opportunities, Alternatives and Resources (OAR), Fairfax
County Public Schools, Fairfax-Falls Church Community
Services Board and faith-based organizations.
• Fairfax Reentry and Collaboration Council
– Provides collaborative approach to address issues and
maximize opportunities for former offenders returning to
communities
• State Probation and Parole
• OAR
• Opportunities for Reentry
– Resource access/Website
46

47. Court Services
• Court Services training with CSB Emergency
Services (ES)
–Distinguish ES vs. Entry (non-emergency) referrals
• Green Sheets
–Used in resolution of the case at court
–Incorporates Mental Health information
–Status Reports on initial contact with CSB (first
assessment)
–provided to both Defense and Commonwealth Attorney
47

48. Court Services - Updates
• Pretrial Investigation Unit now operational 24/7!
• Pretrial Officer at South County Building 3 days a week
• Violation Notice Changes
• Court Services (room 215) fully staffed and operational which
allows for
– more intensive supervision,
– increased court presence, and
– meetings with treatment providers in a quiet and comforting environment
• Pretrial Release
– 53% increase in the total number of Pretrial placements at Advisements (from the
First Quarter of 2017 to the First Quarter of 2018)
– 40% increase in the total number of defendants placed on Pretrial with mental
health conditions at Advisement (from the First Quarter of 2017 to the First Quarter of 2018)
48

49. Merrifield Coordination
Released from
ADC
Referred to
Merrifield
Entry and Referral
Monday – Friday
9am-5pm
Emergency
Services – Risk
Assessment
24/7
Emergency
Custody Order
49
Follow Up:
Other CSB Providers
Court Services
Probation

50. Jail Based/Jail Diversion
• Referrals to Merrifield – meetings/trainings
–Not always clear if individual sent for ES or to be seen by
Assessment
–Enhance process, minimize barriers to service
–Jail Diversion Staff ES point of contact for referrals from the
ADC
• Emergency Services Care Coordinator
• High Utilizer CSB Wide Consultation
• Drug Court Trainings
• Veterans Treatment Docket – Updates
50

51. Jail Based
• Moral Reconation Therapy Group
• Courthouse Assessments/Partner with Court
Services
• Opportunities for process enhancement with
ADC Medical Electronic Health Record
• Jail Transfers – NVMHI (Pilot)
51

52. Discussion
52

53. Next Stakeholders Meeting
September 10, 2018
7 - 9:00 p.m.
Fairfax County Governments Center
Rooms 4 and 5
53