naco jan 2010 justice and public safety conference
TRANSCRIPT
Integration, Restoration and Transformation: A Systems
OverviewPresentation for the National Association of
Counties Conference; “Restore the Partnership for Community Corrections, Reentry,
Reinvestment and Public Safety” January 21, 2010
Leon EvansPresident and Chief Executive OfficerThe Center for Health Care Services
Mental Health and Substance Abuse AuthorityBexar County
San Antonio, Texas [email protected]
www.chcsbc.org
Kathryn JonesDirector, Substance Abuse Services
Aaron DiazDirector, Crisis and Jail Diversion Services
Gilbert GonzalesDirector, Communications and Diversion Initiatives
The Center for Health Care Services210 731-1300
Collaboration
Integration
Restoration
Transformation
Chapter I: Involvement with the Mental Health Systemo Introduction: Involvement with the Mental
Health Systemo Policy Statement 1: Access to Effective
Mental Health Services Chapter II: Contact with Law Enforcement
o Introduction: Contact with Law Enforcemento Policy Statement 2: Request for Police
Serviceo Policy Statement 3: On-Scene Assessmento Policy Statement 4: On-Scene Responseo Policy Statement 5: Incident Documentationo Policy Statement 6: Police Response
Evaluationo Conclusion: Contact with Law Enforcement
Chapter III: Pretrial Issues, Adjudication, and Sentencingo Introduction: Pretrial Issues, Adjudication
and Sentencingo Policy Statement 7: Appointment of Counsel o Policy Statement 8: Consultation with Victimo Policy Statement 9: Prosecutorial Review of
Chargeso Policy Statement 10: Modification of Pretrial
Diversion Conditionso Policy Statement 11: Pretrial Release /
Detention Hearingo Policy Statement 12: Modification of Pretrial
Release Conditionso Policy Statement 13: Intake at County /
Municipal Detention Facilityo Policy Statement 14: Adjudicationo Policy Statement 15: Sentencingo Policy Statement 16: Modification of
Conditions of Probation / Supervised Release
o Conclusion
Chapter IV: Incarceration and Reentryo Introduction: Incarceration and Reentryo Policy Statement 17: Receiving and Intake of Sentenced Inmateso Policy Statement 18: Development of Treatment Plans, Assignment to
Programs, and Classification / Housing Decisionso Policy Statement 19: Subsequent Referral for Screening and Mental
Health Evaluationo Policy Statement 20: Release Decisiono Policy Statement 21: Development of Transition Plano Policy Statement 22: Modification of Conditions of Supervised Releaseo Policy Statement 23: Maintaining Contact Between Individual and Mental
Health System Chapter V: Improving Collaboration
o Introduction: Improving Collaborationo Policy Statement 24: Obtaining and Sharing Resourceso Policy Statement 25: Sharing Informationo Policy Statement 26: Institutionalizing the Partnership
Chapter VI: Training Practioners and Policymakers and Educating the Communityo Introduction: Training Practitioners and Policymakers and Educating the
Communityo Policy Statement 27: Determining Training Goals and Objectives o Policy Statement 28: Training for Law Enforcement Personnelo Policy Statement 29: Training for Courts Personnelo Policy Statement 30: Training for Corrections Personnelo Policy Statement 31: Training for Mental Health Professionalso Policy Statement 32: Educating the Community and Building Community
Awarenesso Policy Statement 33: Identifying Trainerso Policy Statement 34: Evaluating Trainers
Chapter VII: Elements of an Effective Mental Health Systemo Introduction: Elements of an Effective Mental Health Systemo Policy Statement 35: Evidence-Based Practiceso Policy Statement 36: Integration of Services o Policy Statement 37: Co-Occuring Disorderso Policy Statement 38: Housing for People with Mental Illnesso Policy Statement 39: Consumer and Family Member Involvemento Policy Statement 40: Cultural Competencyo Policy Statement 41: Mental Health Workforceo Policy Statement 42: Accountabilityo Policy Statement 43: Advocacy
Chapter VIII: Measuring and Evaluating Outcomeso Introduction: Measuring and Evaluating Outcomeso Policy Statement 44: Identifying Outcome Measureso Policy Statement 45: Collecting Datao Policy Statement 46: Disseminating Findings
www.consensusproject.org
Intercept Points
Collaboration: It’s an unnatural act between…
…two or more unconsenting adults.
Graphic by Seth Godin
Sheriff’s Office
SAPD
CHCS
Metro Health
UniversityHealth System
AdultProbation
EMS
CPS
APS
SASH
NAMI
FIRE
DACounty Judge
Area Hospitals
University of Texas Criminal Justice
Veterans Administration Pre Trial Services
GI Forum
DSHS
ConsumersAnd Families
MagistrationFacility
City of San Antonio
Bexar County Commissioner’s Court
LawEnforcement
MentalHealthPartners Medical
DirectorsRoundtable
Children'sDiversion Collaborative
JuvenileProbation
Criminal Courts
Probate Courts
TexasA&M
DAPASAMM Ministries
PatricianMovement
Connecting Community
Leveraging Outcomes
CMAGScreeningLaw
Enforcement
MH NO
MH YES
Refer to Sherry (UHS Nurse)
RoutineEmergent
Urgent
MH
IOP Frio
CD
Release w/Referral – Bus
Pass
History
Unstable
MH/CD
Stable
24/7 CCC-CTUPresa – Business
Hrs.
Release W/Referral Bus Pass
IOP-Frio Release W/Referral
CD
MH
Detox Sobering
24/7CCC
Presa
CTU
? SP5Orig. OP
Unit
Jail Re-Entry
FACT
OP
CCC UHS-ER
UHS Nursing
Psych Eval
Agressive
Recommend ED
Find Bed
Private Hospital
ACCESS
ER CCC Jail
CD MH/CD MedicationUHS
Nursing
YES
NO
Bexar County Adult Detention
Center
Pre-Trial
UHS
PR Bond
CC12
Judge Carruthers -NGRI/IST
Eligibility
MH Court
Docket
NO
Yes
Jail Re-entry
Community
CCC
CTU
Fact
Access
Outpatient
Jail Re-Entry
CCC CTU
Mental Health Forensic Flow
a work in progress…
Point of Contact with Law Enforcement
Magistrate Court
Bexar County Jail
Post-Booking Diversion
Community-based Wraparound Care
CIT/Deputy Mobile Outreach
Team
Genesis Probation, Incarceration,
Parole
Emergency Transport to
Hospital
Pre-Trial Diversion
Referrals to Community Providers
*Pre-Arrest Diversion
Residential Respite
Arrested
The Diversion ProcessThe Diversion Process
Treatment in lieu of Incarceration
24/7 CrisisServices
Circa 2002
Law EnforcementDetention/Jail
CIT
Judicial/CourtsMagistrate, County, District
Mental HealthPublic and Private
Providers
Crisis Care CenterJail DiversionPsychiatric and Medical
ClearanceSpecialty Offender Services
CommunityDynamicCrisis Jail Diversion
Information Exchange
Pol
ice,
She
riff
Pro
batio
n, P
arol
e
Civil and CriminalT
reatment
Continuity of C
are
County City-wide
Emergency Services
Data exchange through• Community Collaborative• Crisis Care Center • CIT/DMOT• Jail and Juvenile Detention• Statewide CARE Match
System County City-wideEntry Points
System Level
Circa 2004
The Crisis Care CenterPsychiatric Screening
Minor Medical Clearance
24/7 Access for Law EnforcementCirca 2005
Then (prior to Sept 2005)• Wait times for Medical Clearance/ Screening at UHS ER - 9 hours, 18 min.
• Wait times for Medical Clearance/ Screening and
Psychiatric Evaluation was between 12 and 14 hours.
Now• The wait time for Medical
Clearance/ Screening at the Crisis Care Center is 45 minutes.
• Wait time for Medical Clearance/Screening and Psychiatric Evaluation is 60-65 minutes.
Impact on WAIT TIME for LAW ENFORCEMENT
Public Safety Triage Facility
Restoration CenterGrand OpeningApril 15th, 2008
• Detox Facility• Community Court• Outpatient Substance Abuse Services
Circa 2008
The MAPThe MAP
CHCS Urgent Care Center (2)Emergency Psychiatric Screening
County Jail (6)
Community MedicalClinic (1)
CHCS Detox Center (3)
CHCS Substance Abuse Outpatient Services (5)
600 Bed HomelessResidential Facility (4)
GI Forum
Veterans Residential
1,000
Show me the DATA !!!
Forensic Court Programs
1. Outpatient Competency Restoration 1. Outpatient Competency Restoration
2. Forensic Outpatient Commitments 2. Forensic Outpatient Commitments
3. Mental Health Court 3. Mental Health Court
4. Drug Court 4. Drug Court
Haven for Hope
The Community Wide InitiativeHaven for Hope and CHCS
collaborationGoal:
To increase the community capacity for mental health, substance abuse and
detoxification services
Veteran’s Services
Multiple Collaboratives/Initiatives for Veterans based in Bexar County
• The San Antonio Veteran's Affairs Commission • The Military Coordinating Council for Behavioral Health• The Bexar County Veterans Service Office • Texas Resources for Iraq-Afghanistan Deployment, United Way• The Bexar County Veterans Service Office • Family Strong Advocacy
Toolkit
Alternatives to Incarceration
• Crisis Care Center and Restoration Center
• Involuntary Outpatient Commitment (IOPC)
• Outpatient Competency Restoration
• Mental Health and Drug Courts
• Veterans Initiatives
• Adult Parole/Probation Partnerships
CIT
SAVE THE DATEFirst International CIT
Conference(Formerly the National CIT Conference)
June 1 - 3, 2010On site registration May 31,
2010
San AntonioCIT - Deep In The Heart of
Texas!For Information and Registration : http://chcsbc.org/cit
Gracias !
For Additional Information on this presentation please contact:Leon Evans, President and Chief Executive Officer
The Center for Health Care Services210 731-1300, Email: [email protected]
www.chcsbc.org
Thank you for visiting !