Dallas County Behavioral Health Leadership Team Thursday, April 11, 2019

Henry Wade Juvenile Justice Center 2600 Lone Star Drive, Dallas, TX Room 203-A at 9:30am -11:00am.

I. Welcome and Call to Order

• Review/ Approval of Minutes from last meeting*Minutes March 14, 2019*

II. Presentation

• Dallas Behavioral Healthcare Hospital, Terrance O’Reilly, CEO

III. NTBHA Update

IV. Meadows Mental Health Policy Inst. (MMHPI)

V. Dallas County Behavioral Health Housing Workgroup

VI. 1115 Waiver Crisis Services Project Update

• Resolution: 02-2019 CSP Contract Renegotiations

VII. Legislative Update

VIII. Funding Opportunities • Cottages Update • SAMHSA Residential Treatment Grant Update • Community Courts Grant Update (Public Defender’s Office)

IX. Upcoming Events and Notifications

X. Public Comments

XI. Adjournment

* Indicates items requiring approval from Dallas County Behavioral Health Leadership Team The following reports from BHLT Committees are included for your records: ACOT, BHSC, PD Mental Health Stats and North Texas Behavioral Health Authority. Unless action is required, there will be no verbal updates from those committees.

Page 1

Dallas County Behavioral Health Leadership Team

Meeting Notes Thursday, March 14, 2019

https://www.dallascounty.org/departments/criminal-justice/bhlt/

Welcome and Call to Order The meeting was called to order by Commissioner John Wiley Price at 9:33 AM, with a motion from Commissioner Daniel and seconded by Commissioner Koch. In accordance with the Open Meetings Act (Section 551.001), this meeting has been posted on the Dallas County website with the Dallas County Clerk’s Office. The quorum representing the Commissioners Court was; Commissioner Daniel (District 1), Commissioner Koch (District 2) and Commissioner Price (District 3). The Commissioners reiterated that all meetings be posted with the Dallas County Clerk’s Office. Review/Approval of Minutes/BHLT Website The minutes of the BHLT meeting held on February 14, 2019, were included in the meeting packet (pg. 2-4). A motion was made by Commissioner Daniel to accept the minutes and was then seconded by Commissioner Koch. The committee members voted to approve the minutes with modifications to pages 2 and 3. NTBHA Update & Presentation: Carol Lucky, CEO for North Texas Behavioral Health Authority (NTBHA), stated that services are moving forward and NTBHA is currently reviewing Policies & Procedures (P&P) and reviewing their budget. Tenant Based Rental Assistant (TBRA) currently has 20 applicants approved ($40,000/yr.) in Dallas County with 9 individuals housed, 1 pending approval and 1 denied by the State. Kauffman County has 5 individuals approved ($1,000 per month) for housing. Commissioner Price inquired about the housing availability in each county. Ms. Lucky informed the Commissioners that they are currently having issues with the landlords understanding NTBHA and what they represent. Ms. Lucky has also generated a letter of recommendation to the Commissioners for support. Walter Taylor, CSO at NTBHA, stated that there are 4 cities (Addison, Richardson, Desoto and Rowlett) excepting clients (NTBHA Voucher). There will be a soft opening of the Living Room on March 28th. The EOU continues to run well, before the EOU opened the recidivism rate was previously at 22% and now it is at 9%. Jail Based Competency Restoration is moving along; 5 individuals restored to competency, 5 were transferred to a state hospital, 4 clients had their charges dismissed, 2 are currently pending competency assessments, and 3 are pending review for transfer to outpatient competency restoration. Stepping Up Initiative Update/Caruth Grant: Ron Stretcher, Senior Director of Systems Management stated that the Meadows Mental Health Policy Institute (MMHPI) information was included in the packet (page 7). Rapid Integrated Group Healthcare Team (RIGHT) Care continues to be successful with the help of all the partners. The early data on RIGHT Care (RC) suggest that the goals of RC are being met and that time is being returned to the City of Dallas through significant reductions in officer patrol hours. Loopback Analytics’ (Loopback) data feed platform into its treatment planning process, Parkland expanded its role in the Caruth Project and improved screenings of individuals for Level of Care 4. Parkland Emergency Department addition to the EOU and NTBHA care coordinators has agreed to take on identifying and referring emergency room patients who were flagged by Loopback as potential ACT and FACT clients. Mr. Stretcher stated that the Commissioners may want to have the new Irving RIGHT Care Team come give an update on the changes that have may witnessed. Mr. Stretcher informed the members that with more data to come of the first 39 clients seen through RC, the County has saved approximately $1 million. Behavioral Health Housing Work Group (BHHWG) Update: Commissioner Daniel stated that the sub-committee continues to follow through with the inclement weather policy by municipalities. The committee continues to look at barriers to receiving housing and searching for additional landlords.

Page 2

BHHWG is also looking to see how they can be involved in legislation when it comes to increasing affordable housing. The Committee is also working with Charlene Randolph, Dallas County Criminal Justice Director, to look at the data that is being shared from the Criminal Justice Department to make sure information is not being duplicated. 1115 Waiver Crisis Services Project (CSP) Update: Laura Edmonds, Asst. Director of Criminal Justice, reported that CSP is currently working on negotiating contracts and budgets. Ms. Edmonds is also working on scheduling and reengaging the CSP Governance Committee. Legislative Update Janie Metzinger, NTBHA Legislative Coordinator, stated that last Friday was the deadline for filing Bills. There were approximately 500 filed on Wednesday, 945 filed on Thursday and 850 filed on Friday. Several of the Bills were related to preauthorization for Managed Care Organizations (MCO’s). Funding Opportunities:

• Cottages Update: Jennifer Jaynes, Cottages at Hickory Crossing Director, stated that they are in the midst of a data system upgrade. The Cottages currently has 39 housed and 24 in process. The Cottages approved 3 individuals under their new candidate selection process on last month. Out of the 3 individuals approved 1 dropped out, 1 was denied by DHA due to drug charges and 1 individual will be moving in as of next week. All units are ready for inspection; in lieu of the new process DHA has improved inspection time from 30-60 days to 24-48 hours. Bianca Zamora, Clinical Manager for Metrocare, informed the members there were 0 jail admissions and 2 mental health hospital visits in the month of January. Metrocare had approximately 31 individuals who had elected to engage in onsite behavioral health services for the Month of January. There were 22 individuals with engagement agreement contracts who have agreed to weekly, hourly engagement. 100% of the non- engaged Metrocare assigned individuals received monthly outreach, this is applicable for Metrocare clients who have been residing at the Cottages for 181 plus days. The cost savings for January 2018: Metrocare reported that prior to move into the Cottages, there were an average of 2 jail admissions, costing $118, 2017; since move into the Cottages, there were 3 admissions (85 jail days) a savings of $5,015 and 2 years prior (2,109 jail days) totaling $124,431.

• SAMHSA Grant Update:

Sheena Oriabure, Specialty Court Coordinator, stated the first month report for the SAMHSA grant was located on page 14 of the packet. There are currently 11 referrals, 10 engaged in treatment, 2 discharges and 1 pending intake. Please send all referrals to Mrs. Oriabure and Teresa Saulsberry, Treatment Coordinators.

• Community Courts Grant Update (Public Defender’s Office): Lynn Richardson, Chief Public Defender for Dallas County, stated the Community Courts are operating and doing well. The Second Chance Community Improvement Program (SCCIP) is still waiting on their announcement for funding, which will help to expand the program. The Statistics for the PD’s Office was provided in the supplemental packet on page 7. Mrs. Richardson elaborated on the different Specialty and MH courts and announced the judges that oversee each court. The Commissioners Court granted the PD’s office an additional attorney to work the Mental Health Courts. Michaela Himes, Asst. Public Defender, reported on the Bail Review Hearing Stats. There were approximately 281 clients represented, 348 dispositions, 168 PR Bonds granted, and 9 Bond amounts reduced. In January, only a few courts participated in the hearings; however, for the month of March the numbers should increase. Commissioner Price inquired if the PD’s office were able to assess what they are doing and what the court appointed attorneys are doing. Chief Richardson stated that the Prosecutors office should be able to provide that information to the Commissioners. Chief Richardson stated that they do provide the private appointed and retained attorneys MH. Public Comments: Commissioner Price announced that NTBHA & ACOT are hosting another Free Multicultural Competency Training, March 26-28, 2019. Commissioner Price also announced the 530 Committee will be hosting Tall Cop Says Stop, Friday, March 22, 2019. Ms. Cusumano announces that NAMI would be having a kickoff event for NAMI walks. NAMI Walks North Texas 2019 will be held May 4, 2019. Adjournment: The meeting was adjourned at 11:08 am. A motion was made by Commissioner Daniel and then seconded by Commissioner Koch.

Page 3

Dallas County Behavioral Health Housing Work Group Dallas County Administration, 411 Elm Street, 1st Floor, Dallas Texas 75202

March 27, 2019 Minutes

Mission Statement: The Dallas County BH Housing Work Group, with diverse representation, will formulate recommendations on the creation of housing and housing related support services designed to safely divert members of

special populations in crisis away from frequent utilization of expensive and sometimes unnecessary inpatient stays, emergency department visits and incarceration.

Success will be measured in placement of consumers in housing and the decreased utilization of higher levels of care

(hospitals and emergency care visits) and reduced incarceration in the Dallas County Jail. The Dallas County BH Housing Work Group is committed to a data driven decision-making process with a focus on data supported outcomes.

ATTENDEES: Dr. Theresa Daniel, Commissioner; Ben Callaway, Prism Health; Carl Falconer, MDHA; Leah Gamble, Dallas County; Jennifer Jaynes, The Cottages; Traswell Livingston III, AIDS Services of Dallas; Eric McCarty, NTBHA; Jim Mattingly, LumaCorp, Inc.; Keri Stitt, Promise House; Joyce White, DC; Candice Lennox, Dallas County; Blake Fetterman, Salvation Army; Joshua Cogan, Outlast Youth; Ikenna Mogobo, Metrocare Services; Ron Stretcher, MMHPI; Allan Moore, Loopback Analytics; Tzeggabrhan Kidane, Dallas County, Janie Metzinger, North Texas Behavioral Authority, Daniel Roby , Austin Street Center CALL TO ORDER: Minutes approved with no changes. GOVERNANCE Dallas Area Partnership to End and Prevent Homelessness: Dr. Theresa Daniel, Commissioner Commissioner Daniel reported that will be a meeting in late April. Dallas County Citizen Committee Commissioner Daniel reported that the Dallas County Citizen Homeless Committee is doing a county-wide assessment as it pertains to homelessness. Federal and State Legislative Update: Janie Metzinger, North Texas Behavioral Authority (NTBHA) Ms. Metzinger reported that March 8th was the deadline for filing bills, and 3000 bills had been filed this week. Many of the bills are regarding Medicaid, managed care, and some of the contracting issues related to mental health. Quite a few of the bills are a push to improve access to substance abuse treatment. The funding for the local mental health authority has stayed even and is being enhanced with some exceptional items on mental health, substance abuse and psychiatric beds. Dallas is in the pre-planning phase for funding the development of a new state hospital which could be located in the DFW area. They are connecting each new state hospital with medical schools at state supported colleges and universities. UT Southwestern will be connected to the new state hospital, increasing the likelihood it will be located in Dallas County. They will eventually renovate or replace each existing state hospital. Terrell State Hospital and North Texas State Hospital in Wichita Falls are on the list, but are further down in priority. The four hospitals currently on the list, Austin State Hospital, Kerrville, Rusk and San Antonio State Hospital, are beyond the planning stage and are at various stages of development. Ron Stretcher stated that part of the process is that the state wants the medical schools and community to come together to plan around how to utilize the hospitals as opposed to just adding beds for the same system. Additionally, Mr. Stretcher wants to look at the process of using private psych beds for short term. Mr. Stretcher reported that they worked with both Austin and San Antonio and hope to work with UT Southwestern. Mr. Stretcher would like to do a half hour overview, either at Housing Work Group or BHLT; on models they see in other communities and how to apply that here. The discussion would include design and a conscious attempt to get the medical schools to take more responsibility for workforce development and reaching out to services. Mr. Stretcher noted the Panhandle Center as

Page 4

well as the Texas Tech Health Science Center are eager to participate and are already looking at Tele Med for rural areas and school-based programs. Ms. Metzinger reported on a Federal study which showed that there was a 17-year gap of knowledge between the research at medical schools and what is actually happening in the community in practice. She believes that the effort to involve the medical schools will help to address that gap. Additionally, the idea of bringing modern architecture to psychiatric hospitals to make them more efficient and safer is being explored. There is funding for 75 additional psychiatric beds that can be purchased by the community, however those 75 beds will be spread out amongst the 254 counties in the state of Texas. Ms. Metzinger explained that if a state hospital is full and is on divert, it is the responsibility of the county Sheriff to transport the individual to the closest state hospital that has an opening. This is an obstacle for rural area Sheriff Departments which have fewer officers with the expectation that two officers are available for transport. Joshua Cogan reported that there are several bills that revolve around foster care youth and youth experiencing homelessness. State Representative James White has a few bills gaining traction in regard to ID access for minors. These are in tandem to the bill being worked on with State Senator Eric Johnson. A revised draft of that bill will go to hearing next week. Mr. Cogan stated that Senator Johnson’s bill means that if you are ages 16-24 and experiencing homelessness, a case manager or a school counselor can notarize an affidavit to waive the $16.00 state ID fee. In the sub draft they decided to focus on getting the proof of residency requirement waived. There has been some pushback around undocumented immigrants, but a provision would allow a case manager to vouch for a youth’s citizenship. House Bill 2405, Trauma Informed Training for First Responders in Interaction with Homelessness is with State Representative Rhetta Bowers. No hearing is scheduled as of yet. Additionally, Senator West has a bill on finding an alternative to disciplinary action for youth experiencing homelessness in school other than out of school suspension. PRESENTATION Loopback Date System – Ron Stretcher and Alan Moore Alan Moore, Chief Operating Officer of Loopback Analytics gave a presentation on “Loopback Analytics, Addressing At-Risk Populations in Real-Time”. DEVELOPMENT ACTIVITIES Crisis Residential and Respite Services: Blake Fetterman, Salvation Army Salvation Army had a great victory at the city planning commission hearing on March 7th. Over 130 supporters were present, far exceeding expectations. Step two is to do the same thing in front of city council on April 10th at 6pm. They will find out on Monday April 1, 2019 whether or not the property managers will pay to delay the hearing by 30 days. Blake will send out an email with the official date as soon as they hear back. At this point they need a super majority of the Dallas City Council, which is 12 votes, because they have more than 20 percent opposition to the project. Commissioner Daniel requested that each of the HWG members reach out to any connections to any members of the City Council with sentiments of support. The Salvation Army webpage has an overview of what the project is about. If it doesn’t pass the City Council, they will be unable to reapply for zoning again for two years. RESOURCES Shelter Discussions: Commissioner Daniel stated that the meeting on inclement weather should be in April. There will be a follow-up to find out the exact date.

Page 5

Daniel Roby from Austin Street Center reported that there has been work on the Shelter Services Committee with MDHA to seek out overlapping services. They took a snapshot of the number of people who came through Austin Street Center in the quarter from December to February, which was an estimated 1400 people. They found of those 1400 people that 37% received services at The Bridge, less than 7% at the Salvation Army, and less than 4% at all three shelters. It was concluded that there is not a lot of overlapping of services and the system is working as designed. North Texas Behavioral Health Authority (NTBHA): Eric McCarty, NTBHA Mr. McCarty reported NTBHA has secured $936,707 in housing funds. Within Dallas County subsidies are being paid for persons with disabilities and drug & alcohol issues. NTBHA currently has 10 individuals with signed leases, 8 have been approved, but are seeking homes, and 3 applications have been submitted and pending approval. Within the outlying counties there are a total of 6 individuals, 5 for which subsidies are being paid and 1 seeking a home. Mr. McCarty reported successfully housing some individuals and referring others to similar properties. Private landlords have been very helpful in in this regard. Due to quick turnaround of payments, landlords have been requesting referrals and keeping Mr. McCarty updated on any new openings. Mr. McCarty created a list of the properties made available to applicants who are approved. There are currently about 7 or 8 spots open, allowing Mr. McCarty to process additional applicants. Mr. McCarty explained that there can only be 30 applications in the contract system at a time. Once an application receives final approval and becomes active, it is out of the system which allows other applications to be processed. Getting final approval has not been a barrier, but getting all the critical documents, making sure all numbers match and finding property owners who are willing to participate can take time. Housing Navigator: Joyce White, Dallas County Crisis Services Ms. White stated the workshop in February was a success and another is scheduled in April. More information will be provided soon.

The Fuse project application has been submitted and the United Way will be doing a site visit on April 11th. Presenters have been identified and a practice run will be completed next week. Ms. White stated that Loopback will be a part of the Fuse project.

Homeless Jail Dashboard: Joyce White, Dallas County Crisis Services Ms. White reviewed the data in the packet provided. There were changes from January to February, with increases in homeless book-ins which are listed on the last page of the report in the packet. Next month there will be a different format in the data being reported. Commissioner Daniel mentioned addressing what data is being collected, how it is being collected, who gets it and what is it being used for. DHA Housing Solutions: No report.

Caruth Smart Justice First Quarter 2019 Report:

Mr. Stretcher stated the data is in the provided packet.

PROJECTS AND INDUSTRY UPDATES Coordinated Access System (CAS): Carl Falconer, MDHA Mr. Falconer reported the February numbers for the Coordinated Access System (CAS). There were 550 people on housing priority list, 29 people were permanently housed, 70 new people were added, and 11 people were removed for various reasons. In terms of chronic homelessness for people who are disabled and have over a year worth of homelessness, there were 182 individuals on the high priority list, 14 of those individuals were housed from that list, 5 new individuals were added,

Page 6

4 individuals were exited, and no deaths were reported. Mr. Falconer stated that he will research the data further to present a more detailed report. The Cottages: Jennifer Jaynes, The Cottages Jennifer Jaynes reported that as of February that there are still 39 occupants. They have implemented their new engagement system. The first individual moves in today and 4 are waiting on DHA approval. They have 79 applicants year–to-date which is as many as they had in the entire year of 2018. Inspections are happening the same day with DHA. There are 14 in queue for CJ recommendations. There are 43 new applicants waiting to go through the process which should start within the next week. There will be changes onsite with Metrocare, coming up soon. St. Jude: No report Homeward Bound: Doug Denton. No report Youth Housing: Keri Stitt, Promise House Keri Stitt reported that the youth count was recently completed. There were 183 surveys collected with 37% coming from the Mesquite and Seagoville areas. This coincides with Carl Falconer’s report on the numbers being dispersed further outside the downtown area, along with the DISD homeless data. The average age of those respondents were 18-years-old, 60% experienced family violence, and 63 % reported being kicked out contributed to their homelessness. HUD recently released its third Youth Homeless Demonstration Grant which specifically addresses ending youth homelessness. Austin is the only community in Texas that has been awarded this grant, in which they were granted $7 million dollars for their continuum. MDHA will be submitting an application on behalf of the youth committee and that application is due May 15th. MDHA PIT count update: Carl Falconer, MDHA CEO Mr. Falconer stated that the report showed a 9% increase overall, 11.1 % increase in chronic homelessness, and an increase in unsheltered homeless. One of the big trends that the report showed was the age of those experiencing homelessness, particularly the unsheltered population, was lower year-over-year. The largest increase occurred in the age group of 25-44 as opposed to 55 and older last year. The other big trend was finding more homeless individuals outside of the urban core. Some of the cities outlying the Dallas area have never seen large numbers of homelessness and are now starting to count homeless individuals in those areas. Mr. Falconer stated that it’s obvious the population is not just growing, but growing outward as well. Commissioner Daniel reported that Garland and Mesquite have now formed a homeless community committee to address housing and homelessness in their areas. Mr. Falconer cited the City of Irving which implemented such a committee a few years ago. Irving has preemptive services in place and as a result their unsheltered population has decreased. In Collin County the unsheltered population has decreased due to the inclusion of Intermittent and emergency shelter systems. Next Steps Salvation Army will be having a hearing on either April 10th or May 8th; Blake will forward further updates to the group. Support is needed in connecting with City Council members as well as attending the hearing. Follow up with Loopback as to its integration with existing services. Announcements: No announcements.

Next Meeting: April 24, 2019

Dallas County Administration Building, 411 Elm Street, 1st Floor, Allen Clemson Courtroom

Page 7

RESOLUTION

DALLAS COUNTY BEHAVIORAL HEALTH LEADERSHIP TEAM

RESOLUTION NO: 02-2019

DATE: April 11, 2019

STATE OF TEXAS }

COUNTY OF DALLAS }

BE IT REMEMBERED at a regular meeting of the Dallas County Behavioral Health Leadership Team held

on the 11th day of April 2019,the following Resolution was adopted:

WHEREAS, On February 14, 2013, the Dallas County Behavioral Health Leadership Team endorsed the 1115 Healthcare Transformation Waiver DSRIP Project, and development of Behavioral Health Crisis Stabilization Services as alternatives to hospitalization; and

WHEREAS, the Dallas County Behavioral Health Leadership Team is the governing body for the

DSRIP project, known as the Crisis Services Project (CSP); and WHEREAS, the Crisis Services Project is seeking BHLT approval to renegotiate current 1115

Waiver Contracts with Metrocare regarding Forensic Diversion Unit (FDU) services, and with the North Texas Behavioral Health Authority (NTBHA) regarding the 1115 Care Manager position; and

WHEREAS, the purpose of these contract renegotiations is to better define the contract services

to ensure appropriate service reimbursement and to ensure services adequately meet the needs of the Crisis Services Project; and

WHEREAS, all final contractual decisions will be presented to and approved by Dallas County

Commissioners Court.

IT IS THEREFORE RESOLVED that the Dallas County Behavioral Health Leadership Team approves for the Crisis Services Project to engage in these contract renegotiations with Metrocare regarding Forensic Diversion Unit services, and with the North Texas Behavioral Health Authority regarding the 1115 Care Manager position.

DONE IN OPEN MEETING this the 11th day of April, 2019.

________________________ ________________________ Dr. Theresa Daniel J.J. Koch Commissioner District #1 Commissioner District #2 Dallas County Dallas County ________________________ John Wiley Price Commissioner District #3 Dallas County

Page 8

Department of Criminal Justice

FY2019 SAMHSA Grant Project

Dec Jan Feb Mar Apr May June July Aug Sept FY2019 Total

Nexus New Female Admissions 2 0 1 2 5

Nexus Average Days in Jail from Referral to Admission 8 5 0 8 5

Homeward Bound New Male Admissions 0 2 1 2 5

Homeward Bound Average Days in Jail from Referral to Admission 0 4 20 7 8

Successful Treatment Completions 0 0 2 0 2

Unsuccessful Treatment Completions 0 0 0 0 0

Graduated Court Program0

Active In Court Program 0

Active In Inpatient Treatment 8

Active in Peer Recovery Services 2

In Jail 0

0

0

Released to TDCJ or State Jail 0

Active Warrant (Absconded) 0

Re-Arrested and Released to Community

Re-Arrested and Released to Further Treatment

Program Referral Follow-Ups (running total per grant year)

Page 9

1

DALLAS COUNTY, TEXAS Minutes of the Behavioral Health Steering Committee (BHSC) Meeting

Thursday, March 21, 2019

Call to order and Introductions

Judge Kristin Wade called the meeting to order at 8:37 am. 25 staff and agency representatives/providers attended with names recorded on the meeting sign-in sheet. Introductions were done around the room.

Minutes review and approval

The minutes from the last bi-monthly BHSC meeting held on January 17, 2019 (packet pgs. 2-7), were reviewed with motion and second by Patrick Jones and Vickie Rice, respectively for acceptance with one correction presented by Lynn Richardson stating that on page 4 under the Public Defender’s report Michaela’s

last name is Himes and not Eckstein. The motion was unanimously passed accepting the minutes as read with the correction.

BHSC Data and Reports – Judge Kristin Wade

Program and Department Updates: Program/outcome data, updates, and workload reports were presented and accepted via relevant dept./agency staff for the SAMHSA Grant, 530 Subcommittee, BHLT/CSP, Jail reports, Public Defenders, District Attorneys, Provider Reports, and Problem Solving and Specialty Courts (see packet pgs. 8-47 for details). SAMHSA Update (Shenna Oriabure pg. 8): Shenna Oriabure reported that they have received 11 referrals: 2 of those individuals have successfully completed treatment, 8 individuals are in treatment, and one person is being transferred to Homeward Bound. She also stated that treatment usually last up to 60 days. Judge Kristin Wade stated that any specialty court may use this SAMHSA grant funding, which is allocated for both minority males (ages 17-30) and females (any race and age).

530 Sub Committee (Shenna Oriabure pgs. 9-14): Shenna Oriabure stated that they have an action item to be voted and approved by the BHSC committee. 4C Court submitted a request for funding for FY19 incentives of $2,880.00 to cover 192 participants, MHJD/SET submitted a request for $850.00 for inpatient treatment, and Veterans Courts withdrew their request.

Judge Kristin Wade asked for a motion to approve the 4C Court’s request for funding for FY19 incentives of

$2,880.00 to cover 192 participants and MHJD/SET Court’s request for $850.00 for inpatient treatment. The motion was made by Lynn Richardson for approval and second by Laura Edmonds.

The motion was unanimously passed accepting the request without objection.

Judge Kristin Wade explained the purpose of the 530 Committee to the meeting attendees. Shenna Oriabure stated that the committee’s next meeting is scheduled for Wednesday, May 8, 2019 and to contact her at

Page 10

2

Shenna.Oriabure@dallascounty.org to be added to the committee’s emailing list. Last, she stated that the 530 Committee is sponsoring the “Tall Cop” presentation scheduled for tomorrow, Friday, March 22, 2019.

BHLT & CSP Update Laura Edmonds/Adapt (Laura Edmonds pgs. 15-21): Laura Edmonds stated that the reports for various programs funded through CSP are on pages 15-21 in the meeting packet. She reported that CSP is funded through the 1115 waiver. Funding for the waiver will end over the next few years and will be reduced yearly until the grant ends. She stated that the CSP team are viewing various contracts in their budget for next fiscal year. She also stated that they would restart the CSP Governance Committee to receive feedback from community partners regarding contracts, budgets, the various programs, and sustainability ideas. If anyone is interested in being a part of the CSP Governance Committee, please contact her at Laura.Edmonds@dallascounty.org or Joyce White at Joyce.White@dallascounty.org.

Hospital Movement (Janine Capetillo pg. 22): Janine Capetillo stated that the hospital wait time has not improved. For non-maximum secure hospitals, the males average wait times has increased to 101 days and for male maximum-security hospitals, the average wait time is 397 days. She reported that movement to the hospital for January and February 2019 was consistent. The new jail-based competency program has helped with decreasing their wait list and have had some successful completions. Lynn Richardson asked if the success rate of the individuals participating in the jail-based competency program is being tracked and if so, how has it impacted the population of those individuals waiting to be admitted into the hospital. Laura Edmonds answered stating yes and they are tracking the average days for jail-based competency participants that are exiting the program either transferring to the state hospital, found competent, or have stopped participating in the program. She also stated their goal is to help compare those average wait days in jail for those whose competency can be restored in the jail-based competency program or be transition into outpatient treatment to see what the average wait time will be. Last, she stated they would include the report in future BHSC meeting material packets.

Judge Kristin Wade asked Chad Anderson to provide the committee with a brief update regarding the status of the jail-based competency (JBCR) program. Chad Anderson stated that they have had 6 individuals restored to competency, with one being recently restored yesterday. He reported that 5 out of the 6 individuals restored, 4 had felonies charges and 1 had a misdemeanor charge. The average time for competency restoration for felonies was 34 days, and misdemeanors were 47 days, having only one misdemeanor charge. He stated that since there is a 100-day wait time for misdemeanors and 13 months for felony cases to be admitted into the state hospital those individuals whose competency has been restored while in the JCBR program no longer have to wait those timeframes and are released. He reported that the 5 individuals that were transferred to the state hospital arrived with some level of competency restoration education, which should help shorten their hospital stay. Several individuals they meet with may receive a new assessment. For Outpatient Competency Restoration (OCR), they are reviewing how to get individuals considered and have 2 individuals they would like to participate. They have had 38 individuals participate in the program since starting in October 2018. The state is reexamining their standards regarding JBCR programs because of a Health and Human Services Commission (HHSC) audit. He reported that Dallas County’s JBCR program differs from others in the state and HHSC will have to have Quality Management (QM) reexamine how to evaluate Dallas County’s JBCR

program. He reported that other county’s may experience shorter wait times of 5 days compared to when it reaches Dallas County participants, wait times could have reached 305 days. He also reported they understand the program and are collaborating with Parkland Hospital to allow communication between both parties. Last, he reported that jail staff are working well with the JCBR participants and have received 10 new candidates. Vickie Rice stated that they are working to finish approaching the state regarding all new Memorandum of Understandings (MOUs) since the current ones are outdated due to the election of the Dallas County DA, John Creuzot. Last, she stated that the JCBR program information would also be included.

Page 11

3

Homeless Report (Kimberly Rawls pgs. 23-28): Kimberly Rawls reported that from January 2019-February 2019, for “Unique Individuals”, there was a decrease of 13 individuals. “Average Number of Days in Jail”

decreased by 8 days. She stated there was a significant decrease in the “Days in Jail” of 3,602 days. She believes the decrease may be because of the bail reform and that there were significant decreases to the overall general daily jail population stats that Mr. Etho Pugh sends 10 or 11 days in February 2019. Lynn Richardson stated that the PD department has not changed to 24 hours, but the decrease could be because of the impact of hearings from the misdemeanor courts. Lynn Richardson asked Kim Nesbitt to provide feedback regarding the impact of the bail-reform and the turnaround time of misdemeanor cases. Kim reported that due to the bail-reform individuals are rapidly being magistrate and misdemeanor cases are being released within 48 hours decreasing the average length of jail stay. Judge Kristin Wade asked Kim Nesbitt to introduce herself to the committee.

Judge Kristin Wade rearranged the agenda and the Public Defenders report was provided before the Mental Health Case Matches report.

Public Defenders (Lynn Richardson pgs. 30-34): Lynn Richardson stated to refer to their data listed on pgs. 30-34. Vickie Rice stated that the department hopes that future numbers will increase and thanked Julie Turnbull for her help. She stated that for next month they would review the numbers for ATLAS, S.E.T, and MHJD specialty courts to if there has been an increase because of there being a push to use the specialty courts existing programs and dockets. She also stated there might be a shift in Mental Illness court numbers because there is a push to use more PD’s. Last, she stated with the revamping they hope to see all numbers increase.

Mental Health Case Matches (Laura Edmonds pg.29): Laura Edmonds stated that the report shows individuals identified with a mental health flag out of the total number of monthly jail bookins from the JIMI Stella database. She reported that based on the data it continuously shows that about 30-35% of the jailed individuals have an active mental health condition.

District Attorney’s (Provided a Supplemental Packet): Lee Pierson stated to refer to the data listed in the supplemental packet. He stated that it has been 80 days since the new administration has started. He thanked both Dallas County DA, John Creuzot and Julie Turnbull, acting Chief of the Restorative Justice Department for the changes they have implemented. He reported that they have hired Annissa Obasi for the vacant Assistant District Attorney (ADA) position that was in Judge Kristin Wade’s court. He stated that Annissa is working with STAC, Misdemeanor Competency, and Traffic courts. They hired a new felony attorney, Ron Wright and Kendall McKimmey is the new Deputy Chief of the division. SET court is now under the Mental Health division. He expects SET court to have a large number increase before the summer. Audrey Garnett will handle the SET attorney position. He also reported that the PDs and Prosecutors were divided by court distribution and now the PDs joined with individual Prosecutors to help make the process more efficient. Last, he thanked both Lynn Richardson and Vickie Rice for their help during the process.

Provider Reports Judge Kristin Wade rearranged the agenda and the Metrocare report was before

The Bridge report.

Metrocare (Crystal Garland pgs.36-38): Crystal Garland reported that their numbers have been low. She emphasized the importance of having 120 total participates for all specialty courts because each Case Manager’s caseload must have 20-25 participants. She reported that she is reaching out to new Judges to explain the Case Manager’s role and the importance of sending participants to help maintain

Page 12

4

programs and positions. Lynn Richardson stated that with numbers increasing it is important to focus on showing positive client outcomes to maintain program funding. Crystal Garland also emphasized the importance of showing positive client outcomes. Judge Kristin Wade stated the importance of allowing high-risk individuals the opportunity to regain their lives. Vickie Rice stated that the committee previously discussed meeting outside the scheduled BHSC meetings, maybe quarterly to brainstorm and exchange ideas regarding the various court programs success rates and methods that helped them reach successful outcomes. She also stated that Julie Turnbull is very creative with her incentives, charts, and scale of responses and the new PD Case Manager III, LaJuan McGowan made a candy bouquet that peaked clients’ interests. Last, she stated that during the May 16, 2019 BHSC meeting she would like to schedule the first quarterly meeting with the various court program’s to begin the brainstorming process. The Bridge (Kelly Kane pg.35): Kelly Kane stated to refer to the data listed on pg. 35 and their numbers have been consistent. She stated for the point in time count, there were roughly 1,400 unsheltered individuals, a 9% increase from last year. She also reported that they are doing their best to get everyone housed. Judge Kristin Wade asked if she knew the wait time of the Dallas Housing Authority (DHA) waiting list. Kelly Kane answered stating that it depends what number the client is on the wait list. IPS Reports (Jessica Simmons pgs. 39-41): Jessica Simmons reported that their data is on pgs. 39-41 in the meeting packet. For January to February 2019, they had a decrease of participants. For Program Utilization Distribution, most of their clients are in the SUD program (59.66%), Psych 20.68%, Psych Ed (8.84%), SUD-MAT/Detox (6.92%), and Monitoring (3.88%). Both the Gender and Ethnic distributions are consistent (please refer to the data in the packet for a complete breakdown). For Drugs of Choice at Intake (self-report), most client’s list cannabis as their first drug of choice, 2nd is opioids, which increased by 5% and a 3% increase in alcohol use. Outpatient Competency (Janine Capetillo pg. 42): Janine Capetillo stated that their OCR numbers are increasing and in January 2019, there were 11 individuals placed in OCR and for February 2019 7 individuals were placed in OCR. DIVERT (Keta Dickerson pg. 43): No verbal report given. Please refer to the data in the packet. Specialty Courts CSCD (Serena McNair/Rosa Sandles pgs. 44-47): Rosa Sandles stated that they are slowly receiving clients and working to keep up maintenance on cases and individuals outcome after graduation. She reported that ATLAS court numbers are slowly increasing. DDAC Court is consistent within the 20s. Misdemeanor Mental Health is increasing, and STAR Court is slowly increasing. Last, she stated to please send referrals to her at Rosa.Sandles@dallascounty.org. Announcements: Judge Kristin Wade made the following announcements:

Karen Hearod (US Department of Health and Human Services/SAMHSA) could not present due to being called to speak at another engagement. She asked her Director, Fred Schuster to see if he would be available. He too had a prior engagement and could not attend. Karen will present at the Thursday, September 19, 2019 BHSC meeting.

Dr. Michael Ellison, Texas Wesleyan University will present at the Thursday, May 16, 2019 BHSC meeting. Chad Anderson/NTBHA provided his information. Dr. Ellison will present on the effect that the combination of prescription and illicit drugs have on individuals.

If anyone one has any speakers they would like to come and present to the Committee for the July 18th or November 21st, 2019 meetings, please provide Kimberly Rawls (kimberly.rawls@dallascounty.org) with their contact information to get them scheduled.

Page 13

5

Janie Metzinger provided the group with the Texas Legislature update. She reported that the local mental health authority funding is level and anything added will be exceptional items. The House budget has awarded $1 million dollars to build a new state mental health hospital in the DFW area along with at state funded School of Medicine and School of Psychiatry at UT Southwestern. She reported that there is a bill to renovate all beds at Terrell State Hospital and build a new state hospital in the West Texas area. She stated that she would share information regarding bills she found with various committee members who may be eligible to receive upcoming funding opportunities. Judge Kristin Wade thanked Judge La’Donna Harlan for attending the meeting. Ruth Kaiser announced that the “Rally for Recovery” is scheduled for September 21, 2019 at Global Life Park. For questions, email Annie Powell at anniepowell@recoverycc.org. Julie Turnbull announced that the Texas Association of Specialty Courts (TASC) conference is scheduled for April 10-12th 2019 and registration is still open. Lynn Richardson announced that during the previous 530 Committee meeting they discussed organizing a team building activity among all Dallas County specialty courts. If anyone is interested in planning and or participating, please contact the PDs office. She also stated a future goal is to have all specialty court Judges meet monthly, if their schedules permit. Julie Turnbull announced there would be a pool party for Dallas County TASC conference participants Wednesday, April 10th 2019 after the conference.

Adjournment

Judge Kristin Wade adjourned the meeting at 9:21 am. The next meeting is set for Thursday, May 16, 2019, at 8:30am in the same location. A reminder was provided to everyone to submit their monthly stats to Kimberly Rawls at Kimberly.Rawls@dallascounty.org via email by the 2nd Friday of each month for tracking and distribution.

Page 14

Attendees: Walter Taylor (Chair, NTBHA), Charlene Randolph (Co-Chair, Dallas County), Joyce White (Dallas County), Kimberly Rawls (Dallas County), Obie Bussey (ARM), Janie Metzinger (NTBHA), Matt Roberts (NTHBA), Alyssa Aldrich (ACS), Ellen Duke (Hickory Trail), Sherry Cusumano (Medical City Health), Amy Cunningham (CFGC), Jennifer Erasime (Parkland), Ron Stretcher (MMHPI), Nikita Ahmed (MHA Dallas), Sonya Frank (Southern Area Behavioral Healthcare), Marie Ruiz (Metrocare), Alice Zaccareno (The Well Community), Jennifer Torres (Metrocare), Michael Carr (Dallas County), Mary Kate Kohl (MHA Dallas), Jarrod Gilstrap (Dallas Fire Dept.)

1. Welcome and Introductions (Walter Taylor, Chair and Charlene Randolph, Co-Chair): • All attendees were introduced, including all new attendees.

2. Review and approve previous meeting minutes:

• The meeting minutes from the previous month’s meeting were reviewed and approved by Alyssa Aldrich and Amy Cunningham with one correction presented by Sherry Cusumano stating that on page 2 she stated that State Representative Four Price has developed a bill focusing on mental health education in the schools.

3. Presentation: “Fair Housing and Accessing Opportunity: Are We There Yet” Dr. Myriam Igoufe, Director of Housing Services, (DHA)

**** Dr. Myriam Igoufe, Director of Housing Services, (DHA) presented from 12:14pm-1:15pm. She also answered audience questions throughout the presentation and after.****

4. Multicultural Competency Training Update (Matt Roberts, NTBHA) • Matt Roberts stated that the February 2019 training occurred. He stated that they have an

excellent cohort of trainers and individuals interested in becoming trainers. • The next student training opportunity will be March 26th-28th 2019 and is full. • The current training cohort is working with Amy Cunningham to complete the 2019 training

schedule. They will inform the public when it is complete. • Matt Roberts thanked everyone who took part in the training.

5. NTBHA Updates (Walter Taylor, Chair-NTBHA):

• Walter Taylor announced that there would be a soft launch of the “Living Room” later this month.

6. Smart Justice Initiative Updates (Ron Stretcher):

• Ron Stretcher and Jarrod Gilstrap announced that the “Right Care Team” is going well. Jarrod stated that the team should receive another vehicle shortly. Ron stated that they are pushing to expand the project to other areas in the Dallas metro region.

7. Legislative Update (Janie Metzinger, NTBHA): • Janie Metzinger announced that the deadline for filing bills is tomorrow, March 8, 2019. • She stated that during the last session there were about 200 bills relating to Mental Health

that were filed and 3,600 House Bills have been filed. • Ellen Duke asked if there are any bills regarding funding Geriatric Psych care, to allow

nursing homes to treat acute long-term care Geriatric Psych patients instead of sending them to other healthcare facilities such as Parkland Hospital. Janie Metzinger stated that

Page 15

she will check and inform her since bills are being heard tomorrow. Charlene Randolph asked after Geriatric Psych patients are treated at other healthcare facilities such as Parkland Hospital can they return to the nursing home. Ellen Duke answered stating yes, but if that patient has documented uncooperative history with the nursing home, they are not obligated to treat them. She stated that nursing homes are not allowed to treat acute long-term Psych patients because of state licensing restrictions causing patients to be sent and treated at other healthcare facilities such as Parkland Hospital. Sherry Cusumano stated that some Geriatric Psych patients’ levels of aggression are high and in order to safely monitor them nursing homes would have to implement similar levels of treatment standards as other local behavioral health facilities. Ellen Duke stated that some nursing homes would collaborate with other local behavioral health facilities if the state would designate it.

• Janine Metizgner stated that there is a bill to improve all state mental health treatment facilities in the DFW metro area, build a new a state hospital in the DFW metro area, and renovate all beds at Terrell State Hospital. She also stated that there is a bill to build a new mental health hospital in West Texas. Last, she stated that Senate Bill 10 has been filed with Senator Nelson’s office, which will fund $50 million dollars annually toward consortiums encouraging universities to collaborate with local mental health providers.

8. Decide location for ACOT going forward (Matt Roberts, NTBHA)

• Matt Roberts announced that Walter Taylor would email the committee with the next meeting’s local information.

9. Adjourn The meeting adjourned at 1:36 p.m.

Other • The next meeting will take place Thursday, April 4, 2019.

Page 16

Metrocare Services at the Cottages Metric Criteria BASELINE Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 NotesCurrent Cottages Census 45 39 41 41 39

Jail DataAverage number of jail admission baseline 4Average number of days in jail baseline 57

Jail admissions for Metrocare Individuals for the Month 4 1 0 0 0

Jail average length of stay (days) for Metrocare Individuals 1 1 0 0 0

Jail admissions for Non-Metrocare Individuals for the Month 0 0 0 0 0Jail average length of stay (days) for non Metrocare Individuals 0 0 0 0 0Reduction in jail admissions for month from baseline for Metrocare Individuals 0% 75% 100% 100% 100%

Calculated by measuring total jail admissions for the month against jail admissions at baseline

Reduction in average jail length of stay (days) for the month from baseline for Metrocare Individuals 98% 98% 100% 100% 100%

Calculated by measuring average length of stay in jail in days for the month against the average length of stay at baseline

Reduction in jail admissions for month from baseline for NoMetrocare Individuals 100% 100% 100% 100% 100%

Calculated by measuring total jail admissions for the month against jail admissions at baseline

Reduction in average jail length of stay (days) for the month from baseline for Non-Metrocare Individuals 100% 100% 100% 100% 100%

Calculated by measuring average length of stay in jail in days for the month against the average length of stay at baseline

Hospital Data

Average number of Mental Health Hospitalizations baseline 2Average number of Mental Health Hospitalization day baseline 8

Mental Health Hospitalizations for Metrocare Individuals for the Month 0 0 0 2 2Mental Health Hospitalization average length of stay (days) for Metrocare Individuals for the Month 0 0 0 1 1Mental Health Hospitalizations for Non-Metrocare Individuals for the Month 0 0 0 0 0Mental Health Hospitalization length of stay (days) for Non-Metrocare Individuals for the Month 0 0 0 0 0

Reduction in Hospital admissions for the month from baseline for Metrocare Individuals 100% 100% 100% 0% 0%

Calculated by measuring total hospital and/or 23-hour obs admissions for the month against jail admissions at baseline

Reduction in Hospital average length of stay (days) for the month from baseline for Metrocare Individuals 100% 100% 100% 88% 88%

Calculated by measuring average length of stay in hospital in days for the month against the average length of stay at baseline

Reduction in Hospital admissions for the month from baseline for Non-Metrocare Individuals 100% 100% 100% 100% 100%

Calculated by measuring total hospital and/or 23-hour obs admissions for the month against jail admissions at baseline

Reduction in Hospital average length of stay (days) for the month from baseline for Non- Metrocare Individuals 100% 100% 100% 100% 100%

Calculated by measuring average length of stay in hospital in days for the month against the average length of stay at baseline

Treatment Compliance

Metrocare Assigned Individuals 41 34 33 31 33

Defined as Cottages residents who have elected to engage in on-site behavioral health services through Metrocare.

Metrocare Engaged Individuals 17 21 22 22 22Clients with engagement agreement contracts who have agreed to hourly, weekly engagement

Non-Engaged Metrocare Individuals 24 13 11 9 11 No engagement agreement

Percentage of Metrocare assigned individuals who met Engagement Agreement 71% 86% 72% 63% 68%

In February, 2019, 15 of the 22 individuals fulfilled their weekly, hourly agreement.

Percentage of Non-Engaged Metrocare Assigned Individuals with weekly outreach: Applicable for Metrocare clients who have been residing at the Cottages for 1-30 days NA NA NA NA NA

All Metrocare assigned individuals who have been housed at the Cottages for 1-30 days have a signed weekly engagement contract.

Percentage of Non- Engaged Metrocare Assigned Individuals with bi-weekly outreach: Applicable for Metrocare clients who have been residing at the Cottages for 31-180 days 67% 67% 100% 100% 100%

There is 1 individual who fits these parameters and has received bi-weekly services.

Percentage of Non-Engaged Metrocare Assigned Individuals with monthly outreach: Applicable for Metrocare clients who have been residing at the Cottages for 181 plus days 100% 100% 90% 100% 88%

There is 1 individual of the 8 individuals who fit these parameters who did not receive outreach during this month.

Percentage of Individuals with outreach who are not currently assigned to a behavioral health provider 100% 100% 100% 100% 100%

There is currently 1 individual who is not assigned to a service provider. This individual has tenancy over 181 days and received outreach that exceeded the once a month measurement.

Metrocare Services at the Cottages Metrics

*Jail Baseline information calculated by measuring average number of jail admissions of average days in jail for all Cottages clients 2 years prior to move-in date

*Hospital Baseline calculated average number of psych hospitalizations and/or 23-hours observations admissions and average length of stay in days for all Cottages residents 2 years prior to move-in date. Page 17

Last Refresh: 3/31/19 at 8:27:41 PM GMT-05:00DY8 CSP Monthly Report_No Graphs(with LCN)CSP TotalCrisis

ProjectServices

Total Encounters by Type: 2019-01 2019-02 Average: Sum:

Triage 333 337 335 670

Care Coordination 1,834 1,686 1,760 3,520

F2F Encounter 299 287 293 586

Sum: 2,466 2,310 2,388 4,776

Total Unique CID: 589 327 320 323.5 647

Total Unique SID: 326 318 322 644

% Change to DY 4 by CID55.52% 54.33%

PastYearAvg 2019-01 2019-02 Average: Sum:

Total Service Episodes: 768 333 337 335 670

F2F Encounter 2019-01 2019-02 Average: Sum:

MHPR Bond 177 158 167.5 335

Non-MHPR 122 129 125.5 251

Sum: 299 287 293 586

Powered by:

Page 18

DY8 CSP Monthly Report_No Graphs(with LCN)Frank Crowley

Last Refresh: 3/31/19 at 8:27:41 PM GMT-05:00

CrisisServicesProject

2019-01 2019-02 Average: Sum:

Service Episodes: 333 337 335 670

Unique Consumers: 2019-01 2019-02 Average: Sum:

By N* ID 114 119 116.5 233

By LCN 103 85 94 188

By Client ID 110 116 113 226

TOTAL Unique Consumers: 327 320 323.5 647

TOTAL Unique Consumers as %:98.20% 94.96%

Unique F2F: 2019-01 2019-02 Average: Sum:

By N* ID 85 90 87.5 175

By LCN 83 61 72 144

By Client ID 92 86 89 178

TOTAL Unique F2F: 260 237 165.67 497

TOTAL Unique F2F as %: 86.96% 82.58%

Average: Sum:

F2F Percentages:

Powered by:

Page 19

DY8 CSP Monthly Report_No Graphs(with LCN)Frank Crowley

Last Refresh: 3/31/19 at 8:27:41 PM GMT-05:00

CrisisServicesProject

Encounters by Type: 2019-01 2019-02 Average: Sum:

Triage 333 337 335 670

Care Coordination 1,834 1,686 1,760 3,520

F2F Encounter 299 287 293 586

TOTAL Encounters: 2,466 2,310 2,388 4,776

Female: 2019-01 2019-02 Average: Sum:

Black 14 17 15.5 31

Hispanic 4 3 3.5 7

Unknown 1 1 1

White 9 8 8.5 17

TOTAL Female: 28 28 28 56

Male: 2019-01 2019-02 Average: Sum:

Black 68 69 68.5 137

Hispanic 12 7 9.5 19

Other 3 1 2 4

White 28 28 28 56

TOTAL Male: 111 105 108 216

Powered by:

Page 20

Recidivism Summary for 01/01/2019 to 02/28/2019DY8 Recidivism on Triages w F2F [01012019-12312019]Last Refresh: 3/31/19 at 8:43:43 PM GMT-05:00

Triage 12 644

Recidivism 12-12 34

Recidivism 12-12% 5.28%

January February

Year MO 2019/01 2019/02

Recidivism 12-12 9 34

Triage 12 326 644

Recidivism 12-12% 2.76% 5.28%

Page 21

2018-10 2018-11 2018-12 2019-01 2019-02 TOTALBeginning Census 117 121 114 98 102

Referrals 19 21 6 29 29 104

AdmissionsReferred Admitted 7 0 0 0 11 18

No Admit Client Refusal 1 0 0 0 0 1No Admit Criteria 1 0 0 0 0 1

No Admit Structural 0 0 0 1 0 1Pending 10 21 6 28 18 83

Prior PendingPending Admitted 20 9 4 6 3 42

No Admit Client Refusal 1 1 0 0 1 3No Admit Criteria 1 0 0 0 1 2

No Admit Structural 7 2 13 12 5 39

Total Admissions 27 9 4 6 14 60

DischargesSuccess Transfer 5 4 3 1 1 14

DC Midterm Disengage 4 7 12 3 5 31DC Rapid Disengage 6 3 2 0 0 11

DC Structural 8 2 3 0 1 14Total Discharged 23 16 20 2 7 68

Active End Of Month 121 114 98 102 109

Outcome DataTerrell State Hospital Linkages

≤7 Connect To Prescriber 5 9 7 10 3 34Missed ≤7 Day Connect 2 0 0 0 1 3

≤30 Connect To Prescriber 7 9 7 10 3 36Missed ≤30 Day Connect 0 0 0 0 1 1

Total Missed Metric 0 0 0 0 1 1Total Released 7 9 7 10 4 37

Cummulative ≤7 Connect % 71.4% 87.5% 91.3% 93.9% 91.9% 91.9%Cummulative ≤30 Connect % 100.0% 100.0% 100.0% 100.0% 97.3% 97.3%

Missed Metric 0.0% 0.0% 0.0% 0.0% 2.7% 2.7%Unduplicated Served

Monthly Unduplicated 141 95 83 108 103DSRIP YTD Unduplicated Served 141 144 150 172 215

Encounter DataF2F Encounter 757 698 554 768 725 3502

Care Coord 44 19 31 40 42 176Total 801 717 585 808 767 3678

Transicare Reporting Crisis Services Project

Page 22

Forensic Diversion Unit (FDU) ReportJan-19 Feb-19 Mar-19 Apr-19 May-19

Beginning Census: 28 20Number of Referrals Received from CSP:

Adapt 0 4Metrocare 1 1

District Attorney's Office 0 0Public Defender's Office 4 3

Number not accepted due to:Qualified for another LOC 0 0

Did not meet LOC required 1 1Other 0 0

Number of Admissions: 4 4

Service Utilization:Total Face to Face 137.4 135.2

Total Engagement/Service Coordination 16.58 25.83

Number of Higher Level of Care Episodes:Emergency Room (medical) 1 4

23-hour observation (psych) 0 2Inpatient (med/psych) 0 1

Jail Book-in 0 3

Number Discharged: 10 3Reasons for Discharge:

Graduate 1 0Client Disengagement 7 1

Extended Jail Stay (case-bycase basis) 2 1Other 0 1

End of Month Stats:# of Clients waiting to be Released from Jail 4 4

# of Active FDU Clients 18 20Total 22 24

Maximum Census 33 33 33 33

Page 23