Diversion-Oriented System of CareStakeholders Update

October 17, 2016

Tonight’s Agenda

• Good News Announcements• Data & Evaluation Team + Workforce Development • Court Services Launch• Updates from the CSB• Communications Team• Leadership Group• Expanding focus in 2017• Public Comment• Other announcements and discussion

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New Initiative Participation

The Honorable Sharon BulovaChairman, Fairfax County Board of

Supervisors

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White House Data Justice Initiative

• Fairfax County signed on to this initiative!– One of three localities in Virginia– 120 total in USA– Announced nationally on October 13– This initiative will provide ongoing technical

assistance to our diversion efforts

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White House Data-Driven Justice Initiative

Recognition

Tisha DeeghanExecutive Director

Fairfax-Falls Church CSB

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Gary Ambrose: Winner Winner!

Gary Ambrose, 2016 Joseph V. Gartlan Award for Leadership and Advocacy recipient from the Virginia Association of VACSBs

• Chairman, Fairfax-Falls Church CSB• Chair, Diversion First Stakeholders Group • Active member of NAMI of Northern Virginia and Concerned Fairfax• And many, many more areas of involvement!

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Data and Evaluation Work Team

2nd Lt. Myrna Kinney, Sheriff’s OfficeLt. Ryan Morgan, Police Department

Lisa Potter, Community Services BoardDeputy Chief Jason Jenkins, Fire and Rescue

Diverted from Potential Arrest

Instances in which law enforcement officers diverted individuals from arrest and provided an opportunity for mental health services

In the first nine months (Jan. 2016-Sept. 2016): • 1,164 people were transported by law enforcement to Merrifield

Crisis Response Center. • 294 or 25% had potential criminal charges but were diverted to

mental health services.• Includes both voluntary and ECO• Working on a process to quantify broader diversion rate and

include those arrested in the community

• On average, 35% of all LEO transports to the MCRC involved a CIT trained officer

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Data Snapshot

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Jan-Mar., 2016

April-June, 2016

July-Sept, 2016

TOTAL

Jan-Sept, 2016

Police Department Mental health investigations in the field

– Fairfax County Police Dept.

831

916

900

2,647 - Resolved in the field (Fairfax County)1 471 505 479 1,455 - Involved Merrifield Crisis Response Center (MCRC) for all jurisdictions2

360 411 393 1,164

Merrifield Crisis Response Center/Emergency Services Total service encounters 1,296 1,380 1,170 3,846

– General Emergency Services (non-law enforcement involved)

936 969 777 2,682

– Involved Law Enforcement 360 411 393 1,164 - Voluntary transports to MCRC 158 141 127 426 - Emergency Custody Order (ECO) transports to MCRC

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270 266 738

Diverted from potential arrest 103 106 85 294

Unduplicated number of people served at Emergency Services 1,742 Mobile Crisis Unit3

– Total number of services (attempts and contacts) 319 361 415 1,095 - Total number of services (contacts) 215 242 294 751

– Services with law enforcement involvement or referral 79 126 148 353

Unduplicated number of people served (contacts) 408 Office of the Sheriff

– Temporary Detention Orders (TDOs) from Jail 3 13 9 25 – Transports from MCRC to out of region MH hospitals 26 37 28 91 – Jail transfers to Western State Hospital (forensic) 5 2 6 13

1 Officer dispatched and provided a services; no further action required 2 Jurisdictions include (Cities of Fairfax & Falls Church, Towns of Herndon & Vienna, George Mason University, Northern Virginia Community College, Virginia State Police) 3 One Mobile Crisis Unit until Sept. 2016

126% increase in ECOs from 2015-2016

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1st Q 2nd Q 3rd Q Total0

100

200

300

400

500

600

700

800

74 126 126

326202

270 266

738ECO 2015 - 2016 Comparison

2015 2016

MCRC- ECOExchange of Custody

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Crisis Intervention Team Training and Mental Health First Aid

Crisis Intervention Team (CIT) Training• Graduates since September, 2015 – 217 total (18% of patrol offices

trained• Dispatcher training - 38 trained• Coordinating additional classes

Mental Health First Aid (MHFA)Trained to date:• Deputies – 211 (approx. 50%)• Magistrates – 30 (100%)• Juvenile Intake Officers – 23 (100%)• Fire and Rescue- adaptation of MHFA curriculum (120 trained to date)

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Sheriff’s Office Data

Jan-Sept. 2016

• Temporary Detention Orders (TDOs) from jail- 25• Includes those with mental health issues who would be

better served in a psychiatric hospital

• Transports from MCRC to out of region psychiatric hospitals- 91• Transport requires 2 deputies, at least one CIT-trained

• Jail transfers to Western State Hospital (forensic)- 13

• Individuals taken to jail (not bonded out) but need hospitalization due to decompensation

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Sheriff’s Office

• Analyzing data to determine prevalence rates for serious mental illness– Benchmarking national rates– Determine change in these rates over time

• Reviewing data on individuals with serious mental illness who are incarcerated to identify demographics, recidivism, charges, and treatment linkage

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Progress and Next Steps

• Conducted research for program evaluation data measures and benchmarking with diversion programs nationally

• Mapped process flow and data variables for jail, magistrates and court services- other intercepts/intervention points will be mapped next

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Progress and Next Steps

• DIT and third-party evaluator actively involved with data and evaluation efforts; CSB position to manage and analyze data and evaluate diversion efforts coming soon

• Team is participating in White House Data-Driven Justice Initiative

• Planning a pilot to develop the framework for cross system long-term outcomes

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General District Court

The Honorable Michael Cassidy, Chief Judge

Rusty Hefner, Court ServicesGene Whitlock, Court Services

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Research

Early Identification and Intervention

• Local jurisdictions and courts in Pennsylvania, Maryland and The District of Columbia

• National Institute of Justice• Substance Abuse and Mental Health

Services Administration (SAMHSA)• Fairfax Community Services Board

Only in Pre-Trial services, can Court Services impact all of the courts and allow for early interception.

PRE-TRIAL SERVICES

Court Services

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Work Group Goals(launched in March)

• Implement Diversion First Initiative at the Pre-Trial Stage• Adapting our Pre-Trial program to meet the court’s needs.• Utilize existing staff resources within Court Services’ Pre-Trial

Evaluation Unit• Work within the framework of existing workflow and timelines

Court Services Pre-Trial Evaluation Unit

• A single Probation Officer I is on staff 140 hours of a 168 hour work week.

• Evaluations are conducted on all qualified defendants held in the jail.

• Evaluation interviews last 30 to 60 minutes depending on the defendant’s location within the jail.

• A typical interview consists of approximately 63 questions encompassing basic demographics, employment, references, drug history, and criminal history.

• Risk Assessment – 40 questions• Substance Abuse Assessment – 17 questions• Financial Eligibility – 20 questions

• Additional Evaluations:

InitialMental Health Screening

A simple screening instrument will be administered to: Every defendant completing a jail evaluation. Every defendant placed into Pre-Trial Supervision that has not

previously completed a screening

The Brief Jail Mental Health Screen (BJMHS)• An elementary instrument, deployable at the initial intake.• Designed for use by staff with little to no mental health

training.• Eight (8) Questions for use on male and female defendants.• Less than 3 minutes to administer and score.• Validated in a study of 10,330 inmates at 4 jails in NY and

MD.

BJMHS Magistrate – Initial Judicial Review

General District Court

General District Court J&DR District Court

Circuit Court

- Advisement Hearing

- Bond Motion- Bond Appeals

A RECOMMENDATION WILL BE MADE FOR PLACEMENT INTO THE SUPERVISED RELEASE PROGRAM (SRP) WHERE THEY WILL BE SUPERVISED BY COURT

SERVICES AND CONNECTED WITH MENTAL HEALTH SERVICES.

Jail Evaluators

Arraignment Officer

Defense Counsel

Commonwealth Attorney

The Flow

The Next Step: Advanced Screening

Administered to defendants placed into SRP who: Have Mental Health ordered as a special condition of release. Have scored a need for further assessment on the simple Screening.

Administered at intake by a Probation Officer II with mental health training and training on the administration of the advance screening.

15 to 20 minute administration. A qualifying score on the instrument would indicate the need for a

mental health assessment.

Jackson Mental Health Form III Modified Mini Screen

CSB-Mental Health Assessments

All cases placed on SRP with a special condition for mental health treatment will be referred to the CSB, or to their pre-existing treatment provider.

andAll SRP cases where advanced screening indicates a need for a mental health assessment will be referred to the CSB.

Ideally, within 48 hours of release, an SRP referred defendant will have been screened, referred, and scheduled for an assessment or

ordered treatment.

Initial ScreeningPilot Data

July to present

– 59% reported a previous mental health diagnosis– 42% were County Residents, 30% were Virginia(non-county) residents– 22% were placed in the Supervised Release Program

Of 3000+ arrestees, 900 defendants were eligible for interview by Court Services staff and administered the BJMHS.

300 (33%) of the defendants screened were identified by the BJMHS to need further assessment.

Goals

Evaluations for appropriate treatment can be initiated early and monitored with community based supervision, leading to informed disposition of criminal cases.

Costs of incarceration and services can be mitigated by early intervention.

Identify defendants in need of mental health intervention. Through simple and advanced screening administered early after arrest With Pre-trial supervision submitting status reports to the court, CA & DA

Allow Seamless transition from Pre-trial to Probation supervision Same specialized Probation Officer and setting

Stronger collaboration and alignment with CSB to improve response time for mental health and substance abuse assessments.

Consideration of immediate CSB assessment (skipping CSB screening) of all Court screened referrals and improved communication.

Improved data sharing to enhance/target court and CSB service delivery.

Strengthening/Building of private provider pool to provide services to defendants assessed ineligible for CSB services.

Consideration for additional suicidality screening.

Planning for the Future

CSB Updates

Daryl WashingtonCSB Deputy Director

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CSB Updates

• Key positions hired• Additional position hiring processes• Permanent Supportive Housing Funds

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Communications and Public Outreach Team

Presented by:Rhiannon Duck, Supervisor Cook’s OfficeLindsey Doane, Chairman Bulova’s Office

Public Outreach

• Presentations scheduled for local groups that may be interested in Diversion First– Presented to Arc of Northern Virginia staff in Aug. – Upcoming presentations scheduled:

• Arc of Northern Virginia member parents (Oct.)• MVLE (Nov.)• LTCCC (Nov.)• Little River United Church of Christ (Jan. 2017)

• Considering community presentations open to all • Interested groups may email

diversionfirst@fairfaxcounty.gov 32

Website

• Work continues on website, with news and information added as needed

• New data page added• FAQ page in progress

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Outreach Materials

• One-page info sheet developed • Video outlining how to request

a CIT-Trained first responder scheduled

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Moving Forward

• Small communications team workgroups focusing on specific areas:– Outreach and Presentations– Website Updates and Maintenance– Hotline Consolidation and Education– Internal Communications and Wordsmithing

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Leadership Group

Dave RohrerDeputy County Executive

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Leadership Group

• Development of problem-solving team– Core members– Ad hoc members– Method for public to reach out to this group will

become available through website later this year• Budget • Ongoing regular meetings and commitment

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Coming in 2017:Continue with intercept 1 with focus on Expanding

to Intercepts 2 and 3

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Intercept 2- Initial detention and court involvementIntercept 3- Courts and jail

Sequential Intercept Model

Public Comment

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Other updates, announcements, discussion

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Next Stakeholders MeetingJanuary 19, 7-9 p.m.

Reviewing our first year progress and previewing Year 2 priorities

Government Center Rooms 9 & 10

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