Behavioral Health / Criminal Justice Collaboration in Beaver County, PA

Re-entry Services

Council of State GovernmentsSite Visit: May 15, 2013

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Agenda / Itinerary

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Time Location Focus Area

9:00 - 9:15 AM

BCRC

Arrival and Introductions

9:15 - 10:00 AM Part 1: Overview of CJ/BH Initiatives & Reentry Efforts

10:00 - 10:45 AM Part 2: Process Mapping of Intercepts 4 and 5

10:45 – 11:00 AM Break

11:00 - 11:45 AM Funding and Sustainability

11:45 - 12:45 PM Lunch Roundtable with Community Based Service Partners

12:45 - 1:00 PM Travel to Jail

1:00 - 2:00 PM

BC Jail

Screening and Assessment

2:00 - 2:30 PM Jail-Based Treatment, Educational and Supportive Services

2:30 - 2:45 PM Wrap Up / Next Steps

2:45 - 3:30 PM Tour of Jail

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Semi-rural county located in the southwestern region of the state about 30 miles northwest of Pittsburgh.

Diverse area with pockets of affluence, as well as very poor districts, urban, and rural areas, and varying economic resources.

The approximate population of Beaver County is 180,000– 23% of the population is under the age of 18.

5.0 % of that population lives in poverty.– 11% of the total population lives in poverty

The average annual wage for Beaver County was stated at $25,254, as compared to the average annual wage for the Commonwealth of Pennsylvania of $30,081.

The racial composition of Beaver County is predominantly Caucasian (92.5%), followed by African American (6%), and has not changed significantly in the past 20 years.

Beaver County: Overview

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Beaver County: Overview

Commissioners: Tony Amadio, Chairman; Joe Spanik; Dennis Nichols

Beaver County Behavioral Health: Gerard Mike, Administrator

Services– Mental Health Administration– Mental Retardation Administration– Drug and Alcohol Single County Authority– HealthChoices Medicaid Managed Care Administration– Early Intervention Administration– Human Services Development Fund Administration– State, Federal and Private Foundation Grant Management– Direct Services: Outpatient Assessment Center and Case Management

Behavioral Health Criminal Justice Partners

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County Departments– SIM Subcommittee

Community partners– NHS ETC BBBS– BCRC ROOTS TRAILS– ACP OVR Aliquippa Impact– AHCI BB BS Benefit Specialist– HPW HACB SPA

Beaver County System of Care

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Criminal Justice is a key part of the

Beaver County System of Care

System of Care Management Structure

Stakeholder Group(Provider Representatives, Change Agent Representatives, Subcommittee

Representatives, Consumers, Families, Natural Supports)

Stakeholder Group(Provider Representatives, Change Agent Representatives, Subcommittee

Representatives, Consumers, Families, Natural Supports)

Beaver County:Board of Commissioners

Beaver County Behavioral Health

Residents of Beaver County

Steering Committee(Providers, Change Agents, and Subcommittee Representatives)

Steering Committee(Providers, Change Agents, and Subcommittee Representatives)

BC-HOMESBC LAUNCH

Housing

BC-HOMESBC LAUNCH

Housing

SIM- Criminal Justice

SIM- Criminal Justice

BC SCORESChild Serving Systems

BC SCORESChild Serving Systems

Employment-TransformationEmployment-Transformation

Quality Improvement

Quality Improvement

Leadership Committee(Project Director, Steering Committee Co-Chairs, and Sub-Committee Chairs)

Leadership Committee(Project Director, Steering Committee Co-Chairs, and Sub-Committee Chairs)

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Evolution of COD Programs in the Justice System in Beaver County

Motivational Interviewing

2001 2002 2003 2004 20112009 20102005 2006 2007 2008

Beaver J a il COD Treatment

Seeking Safety for Women

Seeking Safety for

Men

FACT

Reentry Liaison

Adult Court Assessments

Educational/ Vocational

Serv ices in the J ail

Peer Sponsors

Supported Housing

WRAP

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BCBH: Using Evidenced Based Practices

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Motivational Interviewing - 2002 Comprehensive, Continuous, Integrated System of

Care (CCISC) - 2007 Seeking Safety – 2007 Supported Employment - 2008 Supported Housing – 2009 Forensic Assertive Community Treatment (FACT) -

2009 Wellness Recovery Action Planning (WRAP) – 2009 Thinking for a Change - 2010

Publications and Presentations: National and State Arenas

Publications– Corrections Today

(2005 and 2011)– Behavior Science

and the Law (2009)

National GAIN Center (2008)

NASMHD Research Institute Conference (2006)

Forensic Rights Conference (2005, 2008, 2011)

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Contracting Federal Grants

Contractors are provided with a budgeted contractual limit

– Contract fees can be a combination of Fee For Service

– Units of service provided, or– Have begun to “experiment” with outcomes based payment terms on

some grants Cost Reimbursement

– Typically only for out of pocket expenses such as start-up and travel

Contractors are provided a list of deliverables as part of the contract

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Invoicing Federal Grants

Grants are invoiced from providers on a fee-for-service basis– Rates similar to HealthChoices (HC) Rates are utilized

Grants are only invoiced when HC does not cover the services, such as

– Ineligible individuals– Service not covered under HC

Contractors are also permitted to bill grants for items not covered under HC, including:

– Planning, Meetings, Training, Data Collection State funds (County Base) are used for non-HC, non-grant

services

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BCBH: Current Grants

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Grant Name Term Funder PurposeBC-LAUNCH 9/08 – 9/13 SAMHSA Treatment of homeless with COD

TIPS (kids) 4/10 – 6/13 DOJ/PCCD Transition to independent processes

ChancesR 10/10 – 9/11DOJ

Assessment and re-entry services for individuals incarcerated with COD

ChancesR (2011) 10/11 – 9/13

Expanding BBBS Mentoring

10/10 – 6/13 PCCDMentoring Kids with caregivers in the forensic

system

Project Recovery 10/10 – 10/15 SAMHSAPrevention/housing/employment and develop infrastructure for communication of providers

CJAB-SIM 1/12 – 6/13 DOJ/PCCDCJAB Strategic Plan, MHFA training, Screening

in RBC

REACH 10/12 – 9/14 DOJReleased offenders who have a co-occurring mental health and substance abuse disorder

SIM 2 10/12 – 9/14 DOJ MHFA, RBC screens, and IT consulting

Training Summary: 10/2011 – 5/2013

42 Training Programs– EBP’s

Motivational Interviewing Seeking Safety Supported Employment

– Behavioral Health– Peer/Consumer

183.5 Hours of Training More than 1500 Participants 5 MHFA Trainings

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Key Data Systems: Support System-wide Evaluation / Quality Improvement

Aim is:– To support and sustain a data-driven process– Collect and report on consistent measures across

programs or services as opposed to utilizing data collected differently within programs or services

– Develop benchmarks, compare results against targets, implement corrective action plans

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Key Data Systems

HealthChoices (BH Medicaid Managed Care) County Base Probation/Parole Jail Grant-Specific Data Consumer Satisfaction Data

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Data Warehouse

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Electronic Service

Plan (eSP) System

Provides Framework

FOCUS: Increase public safety and reduce recidivism by providing services and supports to Beaver County residents with a substance use disorder (SUD) or a co-occurring substance use and mental health disorder (COD) incarcerated in the Beaver County Jail.

PURPOSE: Provide, both pre- and post-release, COD treatment educational/vocational services, peer support, family mentoring, and assistance with housing.

Reentry: FOCUS and PURPOSE

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Reentry Flow Chart

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Reception

Re-Entry Liaison

administers the GAIN and intake

form.

Transition Re-EntryEngagement Community

Integration

Re-Entry Liaison works with client in the jail..

TRAILS and ROOTS meet with clients in the jail to establish a sponsor relationship.

BCRC begins working with client in the jail on vocational/educational services

Client re-integrates into the community

with housing, along with sponsor relationship, and continues to work

on vocational/ educational skills,

treatment and other supports.

Access to treatment groups in the jail.

Summary of Reentry Services

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Provided by NHS HealthChoices (MA) supplemental Jail-based

– ChancesR – REACH – LAUNCH

Community-based– ChancesR – LAUNCH – REACH – HC – Base

# of positions Assessment – Transition Planning – Follow-up

Available Forensic-Based Services – Throughout Criminal Justice System

Screening and Assessment– Jail, Courthouse and Community

Co-occurring Disorder (COD) Treatment– Jail and Community

Re-Entry Liaison Assertive Community Treatment Seeking Safety / Trauma-Informed Care Re-Entry Sponsor Coordinators Assistance for Youth with an Incarcerated Parent Housing / Outreach to the Homeless Vocational / Educational Services Peer Services

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Sequential Intercept Model (SIM) Planning

Collaboration between the Criminal Justice Advisory Board (CJAB) and Beaver County Behavioral Health (BCBH)

Builds on the key relationships and history of collaboration established with previous projects.

Goal is to enhance the integration of the criminal justice and behavioral health systems for adults and juveniles in Beaver County

Services from ChancesR are integral to the overall integration of systems

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CJAB Representatives

•County Commissioners•Administrative Criminal Court Judge •Magisterial District Judge •District Attorney•Chief Public Defender•Deputy District Court Administrator•County and State Adult and Juvenile Probation•Warden of the County Jail •County Sheriff •Local law enforcement•911 Center

Community and Peer Representatives

•Victim’s Advocate•Family members•Community partners•Peers

Behavioral Health Representatives

•Behavioral Health Administrator •Behavioral health providers•Crisis providers

The task force is a subcommittee of the Criminal Justice Advisory Board

Members represent all major behavioral health and criminal justice partners

ChancesR Partners are represented

CJAB SIM Subcommittee

Criminal Justice System

Behavioral Health System

Sequential Intercept

Model

Community Services and Supports:crisis support, residential and vocational support, SPA, outpatient

Intercept 1

Pre-arrest Diversion

Law Enforcement / Emergency

Services

Intercept 2

Post-arrest Diversion

Initial hearings /

initial detention

Intercept 3

Court/Jail Diversion

Special jurisdiction

courts

Intercept 4

Re-entry from jail

Transitional support back to

community

Intercept 5

Probation / Parole

Community support services

Criminal Justice System

Diversion of appropriate non-violent juveniles and adults throughout CJ system

BHSystem

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Impact People with mental illness require specialized approaches during contact with police, a substantial amount of time is spent on these contacts.

Existing Services

• Existing options for police are detention or 302. 302’s are very time intensive.• Mobile crisis services

Identified Needs

• Identification of people, who are involved with MH system, when police are dispatched• Early assessment• Alternatives instead of criminal justice system• Short-term respite

Potential Interventions

• Cross-training for Behavioral health and Criminal Justice• Training specific for first responders (CIT for police, EMS, and 911)• Explore expanding the 911 system for early identification• Explore a temporary residential option as a diversion to incarceration• Additional coordination with existing crisis services to increase utilization, improve interface with police, and increase diversions

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Impact Many individuals with behavioral health needs have little or no resources & may be detained because they are unable to post bail and are not offered release on personal recognizance. An absence of supervised treatment/support alternatives for these offenders may lead to incarceration instead of more appropriate treatment.

Existing Services

• Medical assessment and clearance by nurse

Identified Needs

• Behavioral health evaluation and assessment earlier in CJ process

Potential Interventions

• Behavioral health evaluation and assessment at booking and preliminary arraignment

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Impact Opportunity for plea agreement and diversion to connect to appropriate community resources

Existing Services

• MH assessment service at courthouse for adults and juveniles• DUI assessment program• Jail-based COD assessments and treatment (mental health and substance abuse)• Additional jail-based services include anger management, parenting, and education classes

Identified Needs

• Not all police and court staff are aware of existing in-house MH forensic programs at courthouse

Potential Interventions

• Additional cross-training on existing on-site MH assessment services to increase awareness of existing diversion options

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Impact Connecting with community services and supports prior to and upon release to reduce recidivism.

Existing Services

• Jail-based assessments and treatment• Re-entry Liaison• Vocational supports• Sponsor programs

Identified Needs

Increase awareness of existing programs

Potential Interventions

Additional cross-training on jail-based services and re-entry supports

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Impact Maintaining individuals in community to reduce recidivism and providing linkage between probation/parole and Behavioral health services and supports.

Existing Services

• Specialized probation officers• Assertive Community Treatment Team that includes forensic specialty• Re-entry Liaisons• Vocational supports

Identified Needs

Probation/parole officers may not be aware of available Behavioral health services that can serve as a diversion to incarceration given a violation of probation/parole.

Potential Interventions

• Training for probation/parole officers on existing crisis / respite services to provide alternatives to incarceration.• Explore a temporary residential option as a diversion to incarceration.• Cross-functional reentry teams that include criminal justice and behavioral health supports

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Contact Information

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• Nancy Jaquette, LSWCompliance OfficerBeaver County Behavioral Health1040 Eighth AvenueBeaver Falls, PA 15010Phone: 724-847-6225njaquette@bcbh.org

 

• Alex Corkos, M.A., L.M.F.T.ChancesR Project DirectorAlex Corkos Counseling & Consulting, LLC4160 Washington Road - Suite 212McMurray, PA 15317

Phone: 412-567-3930alexcorkos@gmail.com