crisis intervention team program - cit international up 8.25... · 2019-10-01 · •based on an...
TRANSCRIPT
![Page 1: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/1.jpg)
Crisis Intervention Team Program
Miami-Dade County
![Page 2: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/2.jpg)
NEW RESOURCE: Available for Download or Purchase August 26, 2019
http://www.citinternational.org/bestpracticeguide
![Page 3: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/3.jpg)
MIAMI-DADE COUNTYPopulation is 2.8 million (more than 2000 sq. miles)
Approximately 4 million including tourists
5 Public designated psychiatric inpatient units
12 Private designated psychiatric inpatient units
8 Geriatric psychiatric inpatient units
4 Children and Adolescent psychiatric inpatient units
1 Centralized Receiving Facility
1 Mobile Response Team (effective January 2019)
1 Homeless Outreach Mobile Team (24/7)
![Page 4: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/4.jpg)
MIAMI-DADE COUNTY
Children's Crisis Response Teams (CCRT)
Hotlines and Warmlines
Crisis Stabilization Units (CSU) and Private Baker Act Receiving Facilities
Outpatient Centers (Clubhouses, drop-in)
12 Medical Emergency Departments
Miami VA Hospital
Miami-Dade County Sheriff's Department
34 Police municipalities
Miami-Dade Corrections & Rehabilitation
![Page 5: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/5.jpg)
MIAMI-DADE COUNTY PREVALENCE OF MENTAL ILLNESS
• Miami-Dade County is home to the largest percentage of people with serious mental illnesses of any urban community in the United States.
• 9.1% of the population (192,000 adults) experience SMI, yet only 1% (24,000) receive treatment in the state funded community mental health system.
• Rates of serious mental illnesses are 2-3 times the national average in Miami-Dade County.
• Yet, per capita state spending for community-based treatment, ranks 49th nationally among all states and the District of Columbia.
![Page 6: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/6.jpg)
MIAMI-DADE COUNTY HOMELESS POPULATION – POINT IN TIME COUNT
The Point In Time (PIT) Count is a mandatory census consisting of two components:1. a comprehensive geographic count of sheltered and unsheltered persons, and2. the collection of informational surveys from a random sample of the
population.
February 2018 PIT Count results:• Total number of Homeless in Miami Dade County: 3526• Total number of UNSHELTERED homeless in Miami Dade County: 1030 (29%)• 75% of unsheltered persons surveyed were men.• 44% of unsheltered persons surveyed indicated they had no source of income,
compared with 27% of those who were sheltered.• 38% of unsheltered persons and 43% of sheltered persons surveyed indicated
they had a disability, including a mental health, substance abuse and/or physical disability.
For more information, please visit:Miami Dade County Homeless TrustFood and Beverage Tax
![Page 7: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/7.jpg)
IMPACT ON MIAMI-DADE COUNTY JAIL
• Nearly 11,000 jail bookings per year involve people with serious mental illnesses who require treatment while in custody.
• On any given day, approximately 1,400 of the 4,600 (30%) individuals detained in county jail facilities receive psychiatric medications.
• The Miami-Dade County jail serves as the largest psychiatric institution in Florida housing more than half as many individuals with mental illnesses as all state psychiatric hospitals combined.
• Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting in roughly 64,000 bookings annually; and an estimated prevalence of serious mental illnesses among jail detainees of 16.9%.
• The estimated county taxpayer cost to house people with mental illnesses in jail is $250,000 per day, or $90 million annually.
![Page 8: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/8.jpg)
TIMELINE
• The 11th Judicial Circuit Criminal Mental Health Project (CMHP) was established in by Judge Steven Leifman (2000).
• CIT training begins in collaboration with Jackson Behavioral Health Hospital Education Division (2000).
• Jail Diversion Program pre-booking and post-booking program. CIT Coordinator is hired and takes over CIT training (2003).
• Grand Jury Report: Mental Illness and the Criminal Justice System: A Recipe for Disaster / A Prescription for Improvement (Spring 2004)
• Miami-Dade County Mayor’s Mental Health Task Force formed to address findings in Grand Jury Report – 47 community leaders, Judge Leifman, chair (2005)
![Page 9: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/9.jpg)
CRIMINAL MENTAL HEALTH PROJECT
• The 11th Judicial Circuit Criminal Mental Health Project (CMHP) was established in 2000 to divert individuals with serious mental illnesses, away from the criminal justice system and into comprehensive community-based treatment and support services.
• The program operates two components: pre-booking diversion consisting of Crisis Intervention Team (CIT) training for law enforcement officers and post-booking diversion serving individuals booked into the jail and awaiting adjudication.
![Page 10: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/10.jpg)
CRIMINAL MENTAL HEALTH PROJECT
OUTCOMES:
• Among individuals diverted from the jail post-booking, recidivism rates have been reduced by approximately 75% and it is estimated the county has saves more than 25,000 jail bed days, more than 68 years.
• Because of local diversion programs, the average daily census in the county jail system has dropped from 7,200 to less than 4,000 inmates, and the county has closed one entire jail facility at a cost-savings to taxpayers of $12 million per year.
For more information, please visit:
Decriminalizing Mental Illness - The Miami Model
![Page 11: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/11.jpg)
MIAMI-DADE COUNTY GRAND JURY REPORT (2004)
Findings:
“…the Department of Corrections is trying to run a psychiatric hospital in a facility that was designed to house persons who have engaged in criminal behavior. The costs for running this “hospital inside a jail” are staggering.”
“Nothing could have adequately prepared us for the sights and sounds we witnessed on our tour [of the detention facility].”
“…one witness opined that placing an individual with even marginal psychological issues in this environment is probably going to make the inmate’s condition worse…”
“…there are far too [community support] services. Without such services, it will only be a matter of time before the inmate is re-arrested, returned to the jail and recycled through the system.”
For more information: Final Report of the Miami Dade County Grand Jury
![Page 12: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/12.jpg)
MIAMI-DADE COUNTY MAYOR'S MENTAL HEATLH TASK FORCE (2005)
In response to the Grand Jury’s (Spring 2004) findings, Mayor Carlos Alvarez convened the Miami-Dade County Mayor’s Mental Health Task Force.
Task Force members were charged with finding ways to implement the Grand Jury’s recommendations.
1. Improve treatment and services provided to people with mental illnesses who become involved in the criminal justice system.
2. Minimize the inappropriate criminalization of people with mental illnesses.
3. Create a model continuum of mental health care for the residents of Miami-Dade County.
For more information:
Final Report of the Miami Dade County Grand Jury
Mental Health Task Force Final Report
![Page 13: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/13.jpg)
MIAMI-DADE CRISIS INTERVENTION TEAM
The Eleventh Judicial Circuit Criminal Mental Health Project's CIT Program:
• Reduce the number of responses to individuals in crisis from law enforcement to mental health professionals, when appropriate.
• Re-design access and delivery to behavioral health services in the community.
• Safer police responses and interactions with individuals with possible mental illness, in crisis,through CIT 40-hour training, community education, continuing education and collaborative strategic efforts.
• Serve as a platform to facilitate partnerships and collaboration between law enforcement, justice and behavioral health system, county and state-wide.
• Develop partnerships, establish, streamline communication within all entities, partners and stakeholders.
• Remove barriers at all entry points for law enforcement officers and ensure that seamless access becomes standardized.
![Page 14: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/14.jpg)
MIAMI-DADE CRISIS INTERVENTION TEAM
All 36 law enforcement agencies have a partnership with the Miami-Dade County's CIT Program and have trained CIT Officers
Miami-Dade's CIT Program has trained over 6700 law enforcement officers
Miami-Dade's CIT Program has trained over 800 Communications call-takers/dispatchers
![Page 15: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/15.jpg)
FULL-TIME CIT PROGRAM COORDINATOR - Master of All Trades
Mental Health Background is vitalKnowing your audienceIt’s all about relationshipsYou’ve got to be out there!Linking law enforcement to resourcesLinking Individuals or families to resourcesLinking providers to law enforcementLinking medical professionals/community services to CIT programLinking specialty court programs to CIT law enforcementNavigating through the Behavioral Health SystemNeed to be responsiveAdvocate
![Page 16: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/16.jpg)
FULL-TIME CIT PROGRAM COORDINATOR
- Master of All Trades
Troubleshooting – Identifying gaps and barriersStreamliningMediating between all community, government entitiesImproving Cross Systems -CollaborationDeveloping Policy and ProceduresData CollectionCross-Cultural TrainingResource ExpertListening to ALL perspectivesCompassionatePassionateSet Boundaries for your own mental health!
![Page 17: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/17.jpg)
MIAMI CIT TRAINING AND EDUCATION
40-hour CIT training (in-service and police academy)
(17 trainings-2018)
8-hour CIT Advanced/Refresher for CIT Officers
16-hour CIT training for Communications Call-takers/dispatchers
8-hour CIT Start-up kit for police academy recruits/trainees
36-hour CIT 2.0 training (specialized units)
8-hour CIT Collaborative Trainings – (FL Statutes, Executive Order, current topics)
30-minute roll call
![Page 18: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/18.jpg)
MIAMI CIT TRAINING AND EDUCATION
8-hour Train the Trainer (roll-call, refreshers, de-escalation, orientation)
4-hour CIT Police Executive Orientation
2-hour Hospital/Community Mental Health Centers CIT Orientation
2-hour Consumer Network Orientation
2-hour Community CIT Orientation (NAMI, Faith-based, SRO)
2-hour Training for FL Targeted Case-Management 50-hour Certification
![Page 19: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/19.jpg)
MIAMI-DADE CIT PROGRAM OUTCOMES 2010-2017
Miami-Dade PD +
Miami PD
2010 2011 2012 2013 2014 2015 2016 2017 Total
Total CIT Calls 7,779 9,399 10,404 10,626 11,042 10,579 11,799 11,799 83,427
Arrests Made 4 45 27 9 24 10 19 11 149
Diverted from Jail 1,940 3,563 2,118 1,215 1,871 1,633 1,694 1,860 15,894
Transported to
Crisis
3,307 4,642 5,527 3,946 5,155 7,417 8,303 8,541 38,838
• For every 1,000 CIT calls: 466 people received assistance in accessing treatment, 191 diversions from the county jail, and just 1.8 arrests.
![Page 20: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/20.jpg)
CIT TRAINING CURRICULUM – MEMPHIS MODEL
Standard Core Elements of the Memphis Model
Training Instructors: Mental Health Professionals, Law Enforcement and PEERS/Advocates. (screening all instructors)
Knowledge-based:
Intro to Mental Illness, Medications, Veterans/PTSD, Suicide Assess., Co-Occurring, Disabilities, Legal Aspects
Experiencing, Sensitizing, Building Empathy:
Class Exercises, Community Tours, Individual Perspective, Communication Skills
Experiential, Practical Application:
De-Escalation Scenario-based Role Play
Coaches
♥ LEO SELF-CARE SEGMENT
![Page 21: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/21.jpg)
WHO HOSTS THE TRAININGS AND WHAT ABOUT MANUALS?
• Miami Public Safety Training Institute
• Florida Department of Law Enforcement
• All Police Agencies offer
Manuals printed by Sheriff’s Department and other law enforcement agencies.
Want to save cost? Provide on-line manual link, provide hardcopy manual for classroom use only.
![Page 22: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/22.jpg)
MDC CITManaging
Entity
Law Enforcement
Leadership
CIT
LEO
CIT
Police Liaisons
CIT 911
NAMI
Consumers
AdvocatesMobile Crisis
Team
BH Providers
EDs
Judicial
System
CIT Training
Educators
Assisted Living Facilities
Homeless
Assistance
DCF
MDC CIT System of Care Partners
![Page 23: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/23.jpg)
CIT COLLABORATIVE MEETINGS
Executive Order Meetings
CIT Steering Committee Meetings
CIT Police Liaison Meetings
CIT Police Department Meetings
Police Mental Health Collaboration Meetings
Monthly trouble-shooting, policy meetings
Cross-Training Meetings
![Page 24: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/24.jpg)
UNDERSTANDING EACH OTHERS CULTURE
The role of a law enforcement officer
Stigma in both cultures
They're human just like me
LE panel at Consumer Network
Consumer/Peers integral to CIT training
Both sides telling their stories
Ride-along
Shadowing
![Page 25: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/25.jpg)
Annual Report of Baker Act Data Miami-Dade 2017-2018 Involuntary Examinations: 29,280
48.86%
2.69%
48.46%
MHProfessionals
Judges
LawEnforcementOfficers
VariableInvoluntary Examination
Initiations
Type of Initiator Number Percentage
MH Professional 14,188 48.86%
Law Enforcement 14,305 48.46%
Judges 787 2.69%
![Page 26: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/26.jpg)
COMING SOON..Mental Health Diversion Facility
https://www.nasmhpd.org/sites/default/files/Mental-Health-Diversion-Facility-Overview-2016.pdf
![Page 27: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/27.jpg)
FLORIDA STATUTES - SUBSTANCE ABUSE ACTThe Hal S. Marchman Alcohol and Other Drug Services Act of 1993, or more commonly referred to as the Marchman act, provides for emergency assistance and temporary detention for individuals requiring substance abuse evaluation and treatment in the state of Florida.
A person meets the criteria for involuntary admission if there is good faith reason to believe the person is substance abuse impaired and, because of such impairment:
•Has lost the power of self-control with respect to substance use AND EITHER
•Has inflicted, or threatened or attempted to inflict, or unless admitted is likely to inflict, physical harm on himself/herself or another OR
•Is in need of substance abuse services and, by reason of substance abuse impairment, his/her judgment has been so impaired that the person is incapable of appreciating his/her need for such services and of making a rational decision in regard thereto; however, mere refusal to receive such services does not constitute evidence of lack of judgment with respect to his/her need for such services.
For information on involuntary commitment laws in the United States, please visit:
Involuntary Commitment for Individuals with a Substance Use Disorder or Alcoholism
![Page 28: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/28.jpg)
WHAT CIT CAN DO FOR YOUR COMMUNITY…
Miami-Dade CIT facilitated training, networking, resources and platform for Miami Beach Police Department’s Homeless Substance Abuse Initiative.
CIT Collaborative Refresher Training – Substance Abuse Act/Mental Health Act.
Partnership and Collaboration:
• MBPD Homeless Resource Unit
• Managing Entity (Thriving Minds)
New Times Article July 2016 https://www.miaminewtimes.com/news/homeless-people-involuntarily-committed-to-alcohol-treatment-under-new-miami-beach-initiative-8634204
![Page 29: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/29.jpg)
Habsi W. Kaba MS, MFT, CMSDirector of CIT Miami-Dade and
Police Mental Health Collaboration11th Judicial Circuit Criminal Mental Health Project
CIT International Board Member (c) 786-399-8591
Email: [email protected]
![Page 30: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/30.jpg)
TEAM UP for the Homeless
![Page 31: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/31.jpg)
Miami Beach Police Department (MBPD)
The MBPD is a fully accredited law enforcement agency, which is dedicated to pursuing every opportunity and engaging all challenges as part of this organization’s on-going quest for excellence.
With the continued growth in the popularity of Miami Beach as a destination of choice for out of town and local visitors alike, the Police Department is tasked with balancing the needs of the residential population with the huge increase in the amount of visitors to the City.
Mission: Prevent crime and enhance public safety.
Vision: We aspire to be a world-class agency, which protects our diverse community and serves as a model for character, innovation and service to meet the challenges of tomorrow.
Values: Professional, Accountable, Honest and Proud.
![Page 32: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/32.jpg)
South Florida Behavioral Health Network d.b.aThriving Mind South Florida
• In 2004 Florida’s Department of Children and Families (DCF) privatized and created Managing Entities (ME).
• Thriving Mind promotes access to effective, accountable and compassionate care for individuals and families in our community with mental illnesses and substance use disorders. We fund and oversee a safety net of services for uninsured individuals in Miami-Dade and Monroe counties, with a total population of almost 3 million people, supported by Florida’s Department ofChildren and Families and other public and private sources.
• Is a 501(c)(3), private, non-profit organization
• Does NOT provide direct services
• Subcontracts with 36 agencies to provide mental health and substance abuse services to the indigent population
![Page 33: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/33.jpg)
MBPD Homeless Resource Officer (HRO) Unit
The MBPD Homeless Resource Officers (HRO) Unit consists of :
1. Captain Daniel Morgalo2. Sergeant Jerome Berrian3. Officer Ysidro Llamoca4. Officer Kevin Lantigua5. Officer Yoe Merida6. Officer Lazaro Paredes7. Bo Hall – Certified Peer Recovery Specialist - Homeless
Liaison
All members of HRO are CIT Trained.
![Page 34: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/34.jpg)
When you think of Miami Beach…
![Page 35: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/35.jpg)
What about this…
![Page 36: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/36.jpg)
This…
![Page 37: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/37.jpg)
And this…
![Page 38: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/38.jpg)
Florida Marchman Act
The Hal S. Marchman Alcohol and Other Drug Services Act of 1993, or more commonly referred to as the Marchman act, provides for emergency assistance and temporary detention for individuals requiring substance abuse evaluation and treatment in the state of Florida.
![Page 39: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/39.jpg)
Florida Marchman Act
A person meets the criteria for involuntary admission if there is good faith
reason to believe the person is substance abuse impaired and, because of
such impairment:
• Has lost the power of self-control with respect to substance use
AND EITHER
• Has inflicted, or threatened or attempted to inflict, or unless admitted is
likely to inflict, physical harm on himself/herself or another
OR
• Is in need of substance abuse services and, by reason of substance abuse
impairment, his/her judgment has been so impaired that the person is
incapable of appreciating his/her need for such services and of making a
rational decision in regard thereto; however, mere refusal to receive such
services does not constitute evidence of lack of judgment with respect to
his/her need for such services.
![Page 40: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/40.jpg)
Individuals are Selected by the Following Criteria:
No Support System
Are chronically homeless and likely to die on our streets because of their
addiction to substances
Are an extreme strain on public safety resources (i.e. police/fire/code)
Have a history of Marchman Acts and/or Baker Acts & Arrests
![Page 41: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/41.jpg)
MBPD HRO Internal Process
1. Creation of Individual’s Case File
• Client photo and information
• Degradation photos
• Criminal history printout
• Marchman Act/Baker Act & Substance related arrests
• Court/Provider related documents
2. File Petition for Treatment with courts/Court preceding
3. Contact Thriving Mind in reference to treatment bed
4. Continued engagement until treatment bed becomes available
5. Client is transported to treatment facility
6. Weekly follow-ups/case staffing on clients’ progress
7. Area officers are made aware of the clients transitioning into treatment
8. Monthly meetings at police headquarters with Thriving Mind, area police
commanders/City’s Homeless Outreach Team
9. Client “graduates” and is replaced with a new client
![Page 42: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/42.jpg)
TEAM UP Process Flow Chart
![Page 43: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/43.jpg)
Case Example: Pedro
EXTENSIVE CRIMINAL PAST52 ARRESTS: Possession of alcohol,Trespassing, Panhandling, Disorderly Intoxication, Disorderly Conduct, Drinking in Public, Urinating in Public5 MARCHMAN ACTS2 BAKER ACTSCHRONIC MEDICAL CONDITIONS
![Page 44: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/44.jpg)
Case Example: Pedro (con’t)
2009 2013
![Page 45: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/45.jpg)
Case Example: Pedro (con’t)
![Page 46: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/46.jpg)
Case Example: Pedro (con’t)
![Page 47: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/47.jpg)
Treatment timeline: Pedro
8/2016
Thriving Mind receives information on Pedro from MBPD
8/2016
Pedro is admitted to ICU
11/14/16
Pedro is ready for discharge from the hospital. Thriving Mind places Pedro on residential substance abuse waitlist
11/22/16
Thriving Mind secures shelter bed. MBPD transports to shelter, so that Pedro can await placement for residential treatment bed.
11/22/16
Thriving Mind secures shelter bed. MBPD transports to shelter, so that Pedro can await placement for residential treatment bed.
11/28/16
Pedro is admitted into residential substance abuse treatment program.
4/28/17
Pedro successfully completes residential substance abuse treatment program. He is placed in an emergency shelter bed, until an apartment is secured for him.
7/4/17
Pedro is moved in to his own apartment.
1/2018
Pedro has an accident (fall) that resulted in hip surgery. While hospitalized, his apartment is broken into and burglarized. He gets evicted by his landlord.
2/2018
Discharged from the hospital to homelessness and is placed back into a shelter bed.
5/14/18
A new apartment is found for Pedro, he signs his lease and receives his keys.
![Page 48: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/48.jpg)
Case Example: Pedro (con’t)A new beginning…
![Page 49: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/49.jpg)
Case Example: Kenneth
EXTENSIVE CRIMINAL PAST27 ARRESTS: Trespassing, Public Intoxication, Disorderly Conduct, Resisting Officer w/o Violence, Urinating in Public, Robbery, Possession, Drinking in Public 9 MARCHMAN ACTS3 BAKER ACTSCHRONIC MEDICAL CONDITIONS
![Page 50: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/50.jpg)
Case Example: Kenneth (con’t)
2009 2011 2012
2017
![Page 51: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/51.jpg)
Case Example: Kenneth (con’t)
![Page 52: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/52.jpg)
Treatment timeline: Kenneth
3/30/17
Thriving Mind receives information on Kenneth from MBPD
4/21/17
Kenneth is given a bed at a residential substance abuse. individual was transported to the program by MBPD, but later eloped.
4/26/17
MBPD finds Kenneth and transports him back to the program.
5/18/17
First appointment with CarrfourSupportive Housing.
6/6/17
Kenneth is accepted into Carrfour’shousing.
7/7/17
Discharged from residential treatment and moved into independent apartment.
![Page 53: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/53.jpg)
Case Example: Kenneth (con’t)A new beginning…
![Page 54: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/54.jpg)
Before and After: Alfredo
![Page 55: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/55.jpg)
Before and After: Joseph
![Page 56: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/56.jpg)
Before and After: Paul
![Page 57: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/57.jpg)
Treatment Services
• Medical Evaluation
• Lab Work
• PPD/X-Ray (Tuberculosis Determination)
• HIV Test and Education
• Individual Therapy
• Group Counseling
• Random Drug Testing
• Transportation Assistance
• Meals on Wheels
• Home Health Care
• Florida ID Assistance
• Residential Substance Abuse Treatment
• Case Management
• Transitional Vouchers
Best Practices:Care CoordinationHousing CoordinationPeer ServicesSOARVI-SPDATEmployment Services
![Page 58: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/58.jpg)
Pre-enrollment costs (7 individuals)
![Page 59: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/59.jpg)
Post-enrollment costs (7 individuals)
![Page 60: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/60.jpg)
Cost Summary (7 individuals)
![Page 61: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/61.jpg)
Challenges
Lack of Resources
•Officers are reluctant to work with the homeless
•No housing available upon discharge
•Lack of shelter beds
•Length of residential treatment waitlist
•Chronic medical conditions
•Fair Market Rent $1066, SSI payment is $771
Social Engagement
•Poor Engagement = Elopement from treatment
•Elopement could result in jail petition
•Lack of meaningful activities (employment) leads to relapse
Data Sharing
•Limited data sharing with private facilities impairs our ability to fully assess an individuals' needs.
•Lack of jail release notification means that individual returns to the streets and process starts all over again.
![Page 62: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/62.jpg)
Resolutions
Lack of Resources
• MBPD held interviews for open position until the right candidate was found
• Thriving Mind begins housing search immediately
• Thriving Mind contracts with Camillus House for shelter beds
• SOAR process for those not linked to benefits
• Use of blended funding to assist with housing
Social Engagement
• Use of Peer Services instrumental in engagement
• MBPD visits the individual while in treatment to provide additional support and encouragement
• Thriving Mind's Housing Peer facilitates WRAP groups
• Use of drop in centers and clubhouses
• Weekly HRO staffings and monthly meetings
Data Sharing
• Thriving Mind drafted a data sharing agreement with private facilities
• Thriving Mind has met with Dept. Of Corrections to assist with discharge planning
• Thriving Mind has held quarterly meetings with private hospitals to inform them of this project and Care Coordination services
![Page 63: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/63.jpg)
Outcomes
• 32 individuals have participated in the program, 4 are females• 2 individuals are deceased• 2 individuals are currently incarcerated, 1 due to felony crime• 62 % (20) have successfully completed treatment and have been housed
• Housing includes PSH, ALF, ¾ way house, Residential level IV and relocation• 16 % (4) are in treatment and (1) has completed treatment and is pending housing• 79% of all participants are no longer on the streets
There is a clear cost savings of approximately $238,944.48to the community by linking these individuals to treatment and housing services.
The Miami Beach residents/business owners have notified MBPD’s HRO Unit to applaud their efforts as they have noticed a marked difference in the amount of homeless individuals in the streets.
There is an increased awareness of this program’s efforts within the treatment community that has led to increased collaboration to serve these individuals.
HOUSING IS HEALTHCARE!
total housed 62%
total unsuccessful 16%
total pending treatment
6%
total in treatment13%
total pending housing 3%
Chart Title
total housed
total unsuccessful
total pending treatment
total in treatment
total pending housing
![Page 64: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/64.jpg)
PATH and MBPD
• Projects for Assistance in Transition from Homelessness (PATH) funds services for people with serious mental illness (SMI) experiencing homelessness.
• Miami-Dade County has one PATH Team at New Horizon’s Community Mental Health Center.
• PATH Team:- Team of 4 individuals that are outreach/case managers- 1 Housing Navigator- 1 PATH Program Manager- 1 SOAR Specialist- 1 Part-time Therapist
• PATH activities include:- Outreach- Case Management- SOAR- Housing assistance- Coordinated outreach with Law Enforcement and Continuum of Care (CoC)
![Page 65: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/65.jpg)
PATH and MBPD
• First meeting to introduce PATH to MBPD held on August 9, 2018. This resulted in their first outreach case.
• Since August 2018, there are coordinated outreach events at least 3-4 x month.
![Page 66: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/66.jpg)
Lessons Learned
• Establish relationships and communication early in the process; • Having dedicated Homeless Resource Officers is vital to the success of the program; • Relapse is part of recovery. Individuals will likely engage in this process multiple times;• Private facilities should be informed of this process to allow for the coordination of care for the
individuals and MOU creation for data sharing;• Begin the search for housing options early in the process as safe and affordable housing is difficult
to access; • Individuals are likely to elope from facilities unless they are ready to fully commit to treatment,
engagement is key;• Place individuals onto the Substance Abuse Residential Treatment waitlist as soon as the
Marchman Act order is in place;• Coordination with providers and stakeholders (police, hospitals, crisis unit, courts, jails, treatment
providers) is key to treatment planning and success;• The importance of the use of Peers in Recovery;• Buy-in from administration is vital to getting any program off the ground and for ensuring long-term
viability; • Monthly case staffing have been crucial in treatment planning and provision;• Establishing aftercare supports upon discharge from residential treatment leads
to a smoother transition into independent living.
![Page 67: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/67.jpg)
Recognitions
South Florida Behavioral Health Network and its community partner, the Miami Beach Police Department, were honored in early November with the 2018 Homeless Trust "Changemaker Award" for the team’s overwhelming dedication to those in our community who find themselves homeless.
NBC 6 features MBPD and Thriving Mind’s TEAM UP project to help the homeless.
MBPD Tackles Homeless Problem
![Page 68: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/68.jpg)
Partnerships
![Page 69: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/69.jpg)
Questions?
![Page 70: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/70.jpg)
Thriving Mind South Florida
Carol Caraballo
Vice President of Behavioral Health Services
786-507-7468
Contacts
Miami Beach Police Department
Sgt. Jerome “Bear” Berrian
Operations Division, Homeless Outreach Sergeant
305-673-7776 ext. 5039
Ofc. Ysidro Llamoca
Operations Division, Homeless Resource Officer
305-673-7776 ext. 5729
![Page 71: Crisis Intervention Team Program - CIT International UP 8.25... · 2019-10-01 · •Based on an average of 174.4 jail bookings per day between June 1, 2015 and May 31, 2016, resulting](https://reader033.vdocuments.net/reader033/viewer/2022042323/5f0e31987e708231d43e0f2b/html5/thumbnails/71.jpg)