Stakeholders UpdateDiversion-Oriented System of Care Collaborative

July 11, 2016

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This Diversion First baby is offthe ground!!!!

Tonight’s AgendaDiversion-Oriented System of Care

CollaborativeJuly 11, 2016

Review of Purpose

Good News UpdatesWork Group Report Outs

Leadership GroupCommunications TeamData and EvaluationWorkforce DevelopmentFire and Rescue Juvenile DiversionCSB UpdatesAdditional Updates and what’s coming next quarter

ChallengesCollaborative Updates, Announcements, Discussion

Announcements and Updates from Collaborative

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GOOD NEWS! WOW!

Fairfax County FY 17 Diversion First Budget:$3.89 Million

Sheriff’s Office: 3 MCRC positionsPolice Department: 3 MCRC positionsCommunity Services Board: 8 positions + housing $ + peer support $General District Court: 5 positionsFire and Rescue: Mental health training fundsAnd diversion-related budget:Courts: Salary Supplements $1.2 Million

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MORE Good News!

CIT Assessment Site grant awarded from DBHDS:$624,316 for two years of funding for MCRC• 1 Police Officer• 1 Sheriff Deputy

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EVEN MORE GOOD NEWS!

Fairfax County accepted into the National Stepping Up Justice and Behavioral Health Leadership Academy– One of 15 individuals accepted in the country.– Attendance at an intense two-day conference in

September.– 12 months of intense technical assistance and 1:1

coaching to support local efforts!

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But wait, there may be more!

• By our next Stakeholders Group, we should be able to report on the status of another grant application with the Department of Justice/Bureau of Justice Programs grant totaling $250K.

• All of this points to our commitment to diversify our resources to support our local effort.

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Work Group Report Outs

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Note: to date, no work group has met outside!

Leadership Group

Sheriff Stacey Kincaid

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Leadership Group

• Meeting monthly• MOUs- 4 of 6 completed; 2 pending– These allow for multi jurisdictional exchange of custody– Will also be reaching out to State Police and Metro

Transit Police for MOUs• Chartering and developing internal Problem-Solving

Team (more to come next quarter) – Focus on Quality Improvement in our diversion efforts

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Communications and Public Outreach Team

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

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Writing the Definition of “Diversion First”

• Presented draft definition to Stakeholders Group at April meeting

• Gathered input from stakeholders and public for 30+ days• Considered all input and edited• Presented to Leadership Group• Now sharing the current version of our definition

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Final Definition

“Diversion First offers alternatives to incarceration for people with mental illness or developmental disabilities, who come into contact with the criminal justice system for low level offenses. The goal is to intercede whenever possible to provide assessment, treatment or needed supports. Diversion First is designed to prevent repeat encounters with the criminal justice system, improve public safety, promote a healthier community and is a more cost effective and efficient use of public funding.”

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Defining the “Why” behind Diversion First

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Media Success

• Op-Ed by Chairman Bulova (The Connection Newspapers)– Breaking the Cycle of Crime with Treatment Instead of Jail

• Op-Ed by Supervisor Cook (Fairfax County Times)– Treatment, Not Incarceration, for our Troubled Heroes

• Article by Northern Virginia Magazine– The Guardian/Warrior as Social Worker

• Article by The Connection– Helping People in Crisis: Police Learn to De-Escalate Crisis

Situations– Covering a Police Citizens Advisory Council meeting at

Sully District Police Station

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Other Communications Projects

• FAQs - send us your suggestions

• Presentation “package” for presenters

• Social Media Blitz vs. Listserv

• Seeking Stakeholder input on communications priorities

Email diversionfirst@fairfaxcounty.gov with feedback

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Data and Evaluation Team

Presented by:Lisa Potter, CSB

Lt. Ryan Morgan, FCPDLt. Myrna Kinney, Sheriff’s

Office

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Jan-March, 2016 April-June, 2016 TOTALJan-June,

2016

TOTALJan-June,

2015

Police Department

Mental health investigations in the field - Fairfax County Police Dept. 831 916 1747 1511

- Resolved in the field (Fairfax County) 471 505 976 894

- Involved Merrifield Crisis Response Center (MCRC) for all jurisdictions)

360 411 771 NA

Merrifield Crisis Response Center/Emergency Services

Total service encounters 1296 1380 2676 2439

– General Emergency Services (non-law enforcement involved) 936 969 1905 1822

– Involved Law Enforcement 360 411 771 617

- Voluntary transports to MCRC 158 141 299 417

- Emergency Custody Order (ECO) transports to MCRC 202 270 472 200

Diverted from potential arrest 103 106 209 NA

Unduplicated number of people served 1,742 1,590

Mobile Crisis Unit

– Total number of services (attempts and contacts) 319 361 680 511

- Total number of services (contacts) 215 242 457 404

– Services with law enforcement involvement or referral 79 126 205 134

Unduplicated number of people served (contacts) 408 319

Office of the Sheriff

– Temporary Detention Orders (TDOs) from Jail 3 13 16 NA

– Transports from MCRC to out-of-region psychiatric hospitals 26 37 63 NA

– Jail transfers to Western State Hospital (forensics) 5 2 7 4

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Data HighlightsWhere we are…

Focus on Access, Capacity and Utilization

• Merrifield Crisis Response Center (MCRC) Law Enforcement Officer (LEO) involved– Jan. 2016-June 2016 = 771– 25% increase from same time period in 2015

On average, 35% of all LEO encounters prior to MCRC involved a CIT trained officer

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Data HighlightsEmergency Custody Orders (ECO)

An ECO gives a law enforcement officer permission to take a person into custody temporarily (up to 8 hours) in an emergency situation. This provides time for CSB staff to evaluate the person and locate a treatment facility for them if necessary

The ECO can be issued by a magistrate, or by the law enforcement officer, when it is believed that a person: – Has a mental illness and is highly likely in the near future to seriously harm himself or

others, or to suffer serious harm due to incapacity to protect himself or to provide for his own basic needs,

– Needs hospitalization or treatment, and – Is unwilling or incapable of voluntarily seeking hospitalization or treatment

With an ECO, the person remains in custody until a temporary detention order is issued, until the person is released, or until the emergency custody order expires

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136% increase in ECOs from 2015-2016

ECOs0

50

100

150

200

250

300

350

400

450

500

74

126

200 202

270

472

ECO 2015 - 2016 Comparison

1st Q 15 2nd Q 15 Total Jan - Jun 15 1st Q 16 2nd Q 16 Total Jan - Jun 16

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Data Highlights

Diverted from Potential Arrest– Instances in which the law enforcement officer could

have made an arrest, but provided an opportunity for mental health services instead.

– Jan. 2016-June 2016:• 209/771 (27%) of the law enforcement involved

cases at MCRC were diverted from potential arrest.– Includes both voluntary and ECO– Working to understand “true” diversion rate, to

include those arrested in the community.

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Sheriff’s Office DataJan-June, 2016

Temporary Detention Orders (TDOs) from jail- 16• Accomplished through collaborative partnerships

– Transports from MCRC to out of region psychiatric hospitals- 63• Transport requires 2 deputies, at least one CIT-

trained

– Jail transfers to Western State Hospital (forensic)- 7• Individuals taken to jail (not bonded out) but need

hospitalization due to decompensation

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Where we are going….

• Jail population– Changes over time

• Additional data points (e.g. arrests)• Future focus on demographics, disposition and

outcomes• Data inter-operability – Requirements for data variables– Adherence to confidentiality regulations

• Data and outcome beyond Intercept 1– Involvement of other key stakeholders

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Crisis Intervention Team and Mental Health First Aid Training

CIT Training• Graduates since September 2015 = 170

• Dispatcher training- 18— Coordinating additional classes

• Mental Health First Aid (MHFA) To date:

– Deputies- 201– Magistrates- 30

• 100% of magistrates are trained– Fire and Rescue- 71 – Juvenile Intake Officers- 23

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Fairfax County and Fairfax City Fire and Rescue Department Update

Presented byFire Chief Richie Bowers

Fairfax County Fire and Rescue Department

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Fire and Rescue Department

• Developed specialized mental health awareness training for FRD and pilot scheduled with plans for rollout

• CSB will train staged workforce members throughout July-September approximately 75-100 per month

• Upcoming meeting with Deputy County Executive to finalize protocol for FRD diversions to MCRC

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Juvenile Diversion Efforts

Bob Bermingham,Director of Court Services

Lori Winter,Juvenile Intake

Juvenile and Domestic Relations District Court

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Juvenile Intake Diversion Pilot

• Wrapping up July 30 with Juvenile Intake Unit rollout August 1

• For those eligible, new policies/practices include:– Global Assessment of Individual Needs Short Screen (GAIN-

SSO)- mental health and substance abuse screen to help identify need for further assessment

– Youth Assessment Survey Instrument (YASI) is a risk/need assessment focusing on needs individuals may have and looks at attitudes, community/peer/families, and some MH/SA

– Information gathered through interview and assessments is used to place youth in appropriate level of supervision

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Alternative Accountability Program

• Joint restorative justice effort includes partnership with FCPS, FCPD, JDRC, and Northern Virginia Mediation Services– Promising results so far with only 1 youth reoffending

upon completion of program– 2 FCPD substation and all School Resource Officers are

accessing the program– MOU being finalized for additional program referrals– AAP to be available to all police substations by

September 1, 2016

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Mental Health Program Data

• 49% (n=146) of youth assessed with the pre-screen YASI have some indication of mental health needs

• 58% (n=25) of youth assessed with the GAIN-SS in June 2016, were in need of referral to mental health services

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CSB Updates

Lyn Tomlinson and Jean HartmanAssistant Deputy Directors, CSB

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CSB Diversion First Updates

• Peers at MCRC!– 6 hired and in training at MCRC

• Coming Soon: Diversion First Service Director• Update on Status of 2nd Mobile Crisis Unit• Housing Opportunities– Possible State Funds (in process) for Permanent Supportive

Housing (some will help people diverted) of up to $700K– $500K from FY 17 budget for housing

• $400K for 17-19 units for people diverted• $100K for emergency housing up to 1500 nights

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Additional Updates

Laura YagerOffice of County Executive

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Additional Updates

• Each new Diversion First position will include performance measurements

• Updates will be provided in future stakeholders meetings

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Courts

• Discussions are underway with Court Services staff about new positions and how to align them with Diversion First efforts

• Additional discussions with Veteran’s Docket stakeholders, judges, and others to continue to explore docket

• One of the new CSB positions will align with Courts to support docket or other mental health related work with courts

• Will be bringing together a “thoughts group” to explore the pros and cons of a docket and what will work for our community

• Watch for a future report out on these efforts

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Magistrates

• Evaluation team members will meet with Magistrate’s office to discuss measures and processes that can support diversion at this level

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Data and Evaluation

• Have met with Department of Information Technology about developing a tracking system for longitudinal data that will help us get to effectiveness, recidivism, and other outcomes

• Have develop a list of desired longitudinal measures

• Still have to work through a protocol to share information

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Challenges…

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Challenges

• Goal to reach 24/7 LEO coverage at MCRC• Medical Clearance– CHCN at Merrifield - delays– After hours clearance- still working• Coming discussions with Inova ED and Inova Labs

• Specific data needs (arrests, jail population, etc.)• Getting to outcomes (beyond process measures)– Longitudinal, individual- level– Data sharing protocols and use of releases

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Collaborative:Comments, Updates, Questions and Announcements

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ENJOY THE SUMMER!Next meeting:

October 18, 20167 to 9 p.m.

Fairfax County Government CenterRooms 9-10

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