JailPrison Reentry and Community Support

1
Jail/Prison Reentry and Community Support

• Program Description and Preliminary Data

2
Forensic Prevention Program(Precursor of FICM,
CJMHSA funded program)

• Historical Context
• Program Description
• Preliminary Data
• CJMHSA funded enhancements

3
Historical Context

• Hillsborough County Criminal Justice/Behavioral
  Health Initiatives
• Small programs, implemented over the past 15
  years, have been used to develop collaborative
  criminal justice/behavioral health programs
  across criminal justice intercepts

4
(No Transcript)
5
Forensic Prevention Program Description

• Criminal Justice Intercepts 4 and 5
• Jail/Prison re-entry and Community support
• Target group is persons with significant
  behavioral heath concerns/needs who are returning
  from prison/jail.
• Located at Criminal Registration Unit operated by
  HCSO

6
Program Description

• Provides three levels of service based on
  eligibility and need.
• Screening/Referral
• All persons referred on basis of initial screen
  by HCSO receive second level screening/referral
  with behavioral health staff
• Engagement/Linkage
• Probable SPMI/SMI and needing services, up to 30
  days
• Longer term case management.
• SPMI/SMI and needing longer term assistance

7
Program Description

• Staff
• Three full time bachelors level staff
• One primary screener, two case managers
• CJMHSA grant provides addition of Masters level
  team leader and two additional case managers
• Optimally 2 staff at CRU during business hours to
  ensure efficient screening
• Multiagency staffing once a week

8
Numbers Served (June, July, August 08)
Screening/Referral N264
Engagement / Linkage N58
Case Management N21
Reintegration/Recovery
9
Program ComponentScreening
Screening n264
Engagement / Linkage
Case Management
Reintegration/Recovery
10
Sequential ScreeningHCSO and Behavioral Health

• All CRU registrants complete the GAINS Brief Jail
  Mental Health Screen (BJMHS, N 3236)
• If positive item endorsement then HCSO refers to
  Northside staff for further screening (n295)
• BJMHS items e.g., have you ever been in a
  hospital for emotional or mental health
  problems? are you currently taking any
  medication for any emotional or behavioral health
  problems?

11
ScreeningBehavioral Health Staff

• Further clarify presence of mental illness and
  determine individuals eligibility (SMI/SPMI) and
  desire/need for specific services
• Brief Interview
• MINI-PLUS and SSI-SA tools
• GAINS Reentry checklist to organize needs
  assessment

12
Screening Results

• Three month sample (June, July, August 2008)
• Of 3236 registrations 295 were referred for BH
  follow-up based on item endorsement on the GAINS
  BJMHS (9)
• 133 of 264 (31 of the 295 failed to stay for BH
  screening) were identified as possible SPMI on
  further assessment (50)
• 92 of 133 possible SPMI identified as Dual
  Diagnosed Quad IV

13
Screening Results
14
(No Transcript)
15
Program ComponentEngagement/Linkage
Screening
Engagement / Linkage n58
Case Management
Reintegration/Recovery
16
Engagement Data

• 58 opened for on-going assistance past three
  months
• Average number of contacts 5
• Most cases open for 20-30 days
• About 20 active engagement cases at any point in
  time
• Preliminary MH Diagnosis
• 17 Psychotic Spectrum
• 13 MDE
• 28 Bipolar

17
What have been the needs of persons engaged?

• Mental Health Follow-Up (85)
• lt 5 had current BH care
• LOCUS Recommended Level of Care
• 25 Recovery Maintenance/Health Management
• 65 Low Intensity Community Based services
• 8 High Intensity Community Based Services
• 90 had BH services (other than this program) at
  end of engagement

18
What have been the needs of persons engaged?

• Psychotropic Medications (55)
• 27 0f 32 needing meds seen at Northside Emergency
  Walk-In within 48 hours of screening
• GCCC Passport to Success
• Income support/Benefits/Employment (80)
• Disability, benefit reinstatement, employment
• 96 reported no income and no entitlement or
  entitlement application at screening
• 44 had income or had made SSI/SSDI application
  at end of engagement

19
What have been the needs of persons engaged?

• Housing (less than 10 homeless at screening)
• BUT over 30 indicate desire for better housing
  options
• No one homeless at end of engagement but not
  everyone had residential stability
• (one arrested, one moved away, one in SA
  residential tx, one with family, one faith based
  shelter)
• Substance Use (less than 10 report need for
  treatment/recovery support)

20
Program ComponentCase Management
Screening
Engagement / Linkage
Case Management
Transition/Reintegration
21
Case Management Data

• 21 cases opened since February 2008
• 18 currently active
• All have SPMI diagnosis, 60 Quad IV
• Most in action stage of change for mental illness
• Precontemplation / maintenance stage of change
  for substance use

22
Re-arrest Data last 90 days

• 38 of 264 persons screened by behavioral health
  staff have been re-arrested
• 28 of arrestees received only referrals
• 10 arrestees received engagement level services
• 5 of 10 arrests drug related, 3 petit theft
• No case managed arrests past 90 days

23
Outcomes

• Baseline data
• Residential status
• Level of care
• Income (work, entitlements, other)
• Health coverage
• Stage of Change MH/SA
• Outcome at termination of service and at 90 days
• Residential status
• Service provided, days/contacts
• Level of Care, recommended Level of Care
• Income
• Arrest/Hospitalization/Days in community
• Health Coverage
• Consumer Satisfaction

24
CJMHSA Enhancements

• Additional Staff
• Current staff are taxed. Case managers have 15-20
  active cases and assist with screening.
• Reinvestment grant will provide three more staff
  
• Additional Support Funds
• Currently have access to approximately 6k in DCF
  support funds for all needs
• Reinvestment grant provides substantial support
  funds for housing, substance use treatment.

25
CJMHSA Enhancements

• Illness Management and Recovery and Substance Use
  groups provided by Masters level team leader.
• Consolidated data management with voucher system
  for purchase of treatment/support/ancillary
  services.
• Continued and additional involvement of
  stakeholders in the development of comprehensive
  diversion/re-entry system