Meetings, Workshops

CCJBH Meeting-December 4, 2020 (Diversion and Reentry Workgroup)

Friday, December 4, 2020
1:00 PM – 3:00 PM
Zoom Webinar 

Purpose: The purpose of this meeting is to discuss the final recommendations included in the CCJBH Annual Legislative Report and identify the Diversion and Reentry Workgroup priorities for 2021.

To register in advance for this webinar, click the link below:

https://cchcs.zoom.us/webinar/register/WN_9v8fBX9hQ7qxOkA6Cqhrng

Meeting ID: 945 6744 5571

Passcode: 004378

After registering, you will receive a confirmation email containing information about joining the webinar.

Agenda

I. 1:00 PM    Welcome & Introductions

  • Monica Campos, SSM III, Council on Criminal Justice and Behavioral Health

 II. 1:10 PM    Overview of the Diversion and Reentry Workgroup Findings & Recommendations

  • Chief Mack Jenkins, Ret., San Diego County Probation, Councilmember, Council on Criminal Justice and Behavioral Health
  • Hon. Stephen Manley, Santa Clara Superior Court, Councilmember, Council on Criminal Justice and Behavioral Health
  • Tony Hobson, Behavioral Health Director, Plumas County,  Councilmember, Council on Criminal Justice and Behavioral Health     

*** PUBLIC COMMENT ***

III. 2:10 PM    Diversion and Reentry Workgroup Priorities for 2021

  • Chief Mack Jenkins, Ret., San Diego County Probation, Councilmember, Council on Criminal Justice and Behavioral Health 
  • Hon. Stephen Manley, Santa Clara Superior Court, Councilmember, Council on Criminal Justice and Behavioral Health  
  • Tony Hobson, Behavioral Health Director, Plumas County,  Councilmember, Council on Criminal Justice and Behavioral Health    
  • Q&A with Councilmember Advisors   

*** PUBLIC COMMENT ***

IV. 2:30 PM    Next Steps

  • Brenda Grealish, Executive Officer, Council on Criminal Justice and Behavioral Health

V. 2:45 PM    Announcements

THE ORDER OF BUSINESS MAY BE CHANGED WITHOUT NOTICE

Notice is hereby given that all times indicated and the orders of business are approximate and subject to change.

**NOTICE**

Please be advised, in accordance with Executive Order N-29-20, and to minimize the spread of COVID-19 and reduce the risk of infection during the current state of emergency, the Council on Criminal Justice and Behavioral Health will conduct this meeting by remote participation only. Council members and members of the public may only attend this meeting using the teleconference/videoconference options described in this Notice.

The Council on Criminal Justice and Behavioral Health (CCJBH), and any committees thereof, comply with the Americans with Disabilities Act by ensuring meeting facilities are accessible to persons with disabilities, and providing that this notice and information given to the Members of the Council is available to the public in appropriate alternative formats when requested. If you need further assistance, including disability-related modifications or accommodations, you may contact Monica Campos, at CCJBH@cdcr.ca.gov  no later than one day prior to the meeting.

Questions and/or requests for additional information prior to the CCJBH meeting may be referred to Monica Campos at (916) 248-2956 or CCJBH@cdcr.ca.gov. To view this agenda online, visit our web site at: https://www.cdcr.ca.gov/ccjbh/

DIVERSION/REENTRY
WORKGROUP

December 2, 2020

Chief Mack Jenkins, Ret., San Diego County Probation, 
Councilmember, Council on Criminal Justice and Behavioral  Health

Judge Stephen Manley, Santa Clara County Superior Court, 
Councilmember, Council on Criminal Justice and Behavioral  Health

Dr. Tony Hobson, Behavioral Health Director, Plumas County,
Councilmember, Council on Criminal Justice  and Behavioral Health

Brenda Grealish, Executive Officer, Council on Criminal Justice  and Behavioral Health

Agenda Overview

  • Welcome &Introductions
  • Overview of the Findings and Recommendations      
  • Diversion/Reentry Workgroup Priorities for 2021
  • Discussion
  • Next Steps

DIVERSION/REENTRY WORKGROUP

  • CCJBH Mission
    • The leaders in criminal justice and mental health participating in this effort strive to end the criminalization of individuals with mental illness by supporting proven strategies that promote early intervention, access to effective treatments, a planned re-entry and the preservation of public safety.
  • Outcomes and Products
    • Factsheet
    • Legislative Report
  • Recommendations
    • Governor & Administration 
    • California State Legislature
  • Workgroup Goals
    • To prevent individuals who are released from incarceration from returning to jail, prison or state hospitals.
    • Establish innovative and effective ways to continue diversion and reentry efforts in the wake of the public health and budget crisis as a result of COVID-19 public health emergency.

FINDINGS

Diversion / Reentry Findings and Recommendations

Findings:

  1. The COVID-19 pandemic posed unprecedented challenges to the diversion/reentry infrastructure, and ongoing system-wide impacts have major implications for the behavioral health / criminal justice (BH/CJ) population. 
  2. By some estimates, a majority of justice-involved people require mental health or substance abuse disorder treatment. Yet, behavioral health treatment is not consistently integrated into reentry services. For example, reentry councils typically provide support for education, employment, and housing but less often include behavioral health services. 
  3. One consequence of a community-based behavioral health system that inadequately meets the needs of the BH/CJ population is an overreliance on the justice system and correctional facilities to provide behavioral health care. 
  4. A formalized assessment and referral process that utilizes screening tools that are consistent across counties and include criminogenic risks/needs, especially dynamic risk factors, are essential not only for criminal justice outcomes, but also for behavioral health treatment success. 
  5. Workforce development policies that welcome and do not exclude peer providers who can provide support through the lens of their lived experience can help to engage justice-involved people in services. The perspectives of people with lived experience should be foregrounded in quality improvement initiatives and policy changes. 
  6. For the BH/CJ population, successful treatment completion and recovery often requires continued monitoring, follow-up, and a variety services, including health care, behavioral health, criminogenic needs interventions, as well as income educational/vocational, employment and housing supports.

RECOMMENDATIONS

Diversion / Reentry Findings and Recommendations

Recommendations:

Case Planning/Management, Service Linkages and Ongoing Monitoring 

  1. Case management services should be provided in diversion and reentry programs for at least 365 days post-incarceration to ensure effective use of the services to ensure stability.
  2. Monitoring individuals in the criminal justice system who have behavioral health needs is as important as case management.  Peer navigators and Community Health Workers are an important resource that should be leveraged to provide this type of support to ensure engagement in and adherence to treatment.   

Physical Health and Behavioral Health Care Services 

  1. A formal process should be established to transition health and behavioral health treatment from jail/prison to the community for all individuals who are in need of medical or behavioral health services upon diversion/reentry. 
    • This process should include in-reach services to facilitate planning prior to release so that local health and behavioral health departments may have sufficient time to prepare to receive individuals who are reentering their communities.  
    • Since it is often unknown as to how long individuals incarcerated in jails will be in custody before being released, an optimal approach is to begin discharge planning upon entry to prepare for transitions to community treatment to ensure continuity of care, including the provision of medications.
    • Counties should examine the feasibility of establishing a secure electronic information exchange system/process to support this transition. 
  1. To ensure a comprehensive approach, treatment plans should be developed in coordination with the criminal justice system (either CDCR parole or county probation), as well as any other relevant public service agencies with which the individual is involved.   
  2. To facilitate behavioral health treatment utilization, those who are most “at-risk” of substance use relapse or mental health issues upon leaving institutions could be provided with mobile phones in order to access services via telephone or telehealth (if the phone also has internet service).
    • If they are provided with phones at release, and they consent to a provider contacting them directly, then they could immediately initiate treatment.
    • Key emergency numbers could also be loaded into this phone, such as access numbers for behavioral health (main line and crisis) or suicide prevention hotlines. 
  1. For individuals reentering with a behavioral health need, a 30-day supply of medications and mobile phone for medication reminders and access to behavioral health services should be provided upon release from jail/prison.
    • If the jail does not have a pharmacy, at a minimum, a prescription should be provided that may be filled by a local pharmacy at no cost to the reentering individual.
    • Services should be arranged prior to release, including connection and engagement with the outpatient prescriber. 
    • Since jails do not bill Medi-Cal, there should be a plan for Treatment Authorization Request (TAR) circumstances to prevent delays for clients to receive medication while the county waits for TAR approval.

Criminogenic Risk and Needs Assessment and Treatment 

  1. A criminogenic risk and needs assessment should be completed for each individual being diverted or upon reentry from jail/prison, and treatment plans should be developed using the Risk Need Responsivity (RNR) model to address identified criminogenic needs. 
    • To ensure a comprehensive approach, treatment plans should be developed in coordination with behavioral health, in particular, as well as any other relevant public service agencies with which the individual is involved.  
  1. Optimally, all relevant agencies providing services to individuals in diversion programs or upon reentry for those returning home with behavioral health needs (e.g., health, behavioral health, criminogenic treatment, housing) are communicating and collaborating, and ideally creating comprehensive multi-system treatment plans to address the identified needs, and to establish treatment goals with the ex-offender, and coordinate on the provision of treatment. 
    • The recent California Health and Human Services Agency AB 2083 Systems of Care Memorandum of Understanding guidance, designed to address this type of coordination for local child/youth-serving agencies, could be adapted by BH/CJ population-serving agencies to clearly establish how coordination will occur within each county.   

Diversion/Reentry Workforce

  1. Local criminal justice and behavioral health agencies should leverage the Peer and Community Health Worker workforce to support individuals in diversion programs and those reentering from jail/prison in accessing, navigating and engaging with treatment for their behavioral health and criminogenic needs. 
    • Efforts should be made to identify best practices for expanding this workforce, recruitment, job duties, funding, etc. 
    • CCJBH encourages the practice of employing as peers those individuals who have a history of incarceration and behavioral health needs and who are in recovery so that they may apply their lived experience to help others. 
    • Another recruitment approach is to look to the workforce displaced by COVID-19 (e.g., those in the service industry). 
    • Implementation of the recently passed SB 803 Peer Certification bill should be leveraged to ensure proper training for peers that will work to support those with behavioral health needs who are involved in the criminal justice system.
  1. All relevant staff must receive specialized training on the unique needs of the BH/CJ population. 
    • Criminal justice staff should know when and how perform a behavioral health screening in order to refer positive screenings to behavioral health for further assessment. 
    • Behavioral health staff should be trained on the unique needs of the BH/CJ population, including the concepts of criminogenic risk and needs, and how it impacts service engagement and the management of behavioral health conditions. 
  2. To maximize behavioral health service capacity, creative solutions/strategies, particularly the use of peers, should be explored to mitigate the personal and client safety concerns that have been expressed by providers.

Housing 

  1. Expand the HUD definition(s) of homelessness to ensure that individuals who are exiting institutional settings (prison, jail, hospitals) into homelessness have equal opportunities to federally funded housing services that are based on current vulnerability and not chronicity. 
  2. Build on the successes of supporting individuals returning from incarceration. 
    • Communities are equipped with the necessary infrastructure to maintain the shelter capabilities, and hotels and shelters that provide case management and whole person care services have been integral in reducing barriers to successful reintegration. 
    • Long-term, permanent housing should be expanded based on these innovative housing programs.  
  1. A formal process should be established to ensure housing upon discharge from jail/prison to the community.  As with behavioral health, this process should include in-reach services to facilitate planning prior to release so that local housing departments have sufficient time to prepare to receive individuals who are reentering their communities, and discharge planning for those incarcerated in jails should begin upon entry since the length of stay is often unknown. 
  2. Housing programs should not restrict individuals with serious mental illness (SMI) from participating.  In fact, a certain percentage of capacity should be specifically reserved for individuals with SMI, particularly if they are also involved in the criminal justice system, and these dedicated housing programs should include the services and supports necessary to stabilize and retain this population.  This would also fill a critical gap needed for diversion programs. 
  3. Explore new ways to use public/private partnerships to help build local capacity for recovery housing and adult residential facilities.

Income, Vocational and Supportive Services

  1. In addition to health and behavioral health services, and criminogenic needs interventions, it is critical to address the social determinants of health, including the provision of income, educational/vocational, employment and housing supports.
    • This may be accomplished by building upon the successes and lessons learned from existing community-based and State reentry programs
    • In particularly, by building out the capacity of local Reentry Councils to assist with establishing/strengthening current transition processes/services.

Additional Considerations for Diversion 

  1. A statewide template for a standard of care for diversion should be developed based on best practices and evidence-based programs, and should include strategies to address disparities, with a focus on racial justice and race-based trauma. 
    • This plan could then be used by State and local criminal justice and behavioral health system policy-makers and administrators to develop processes that are tailored to local needs. 
    • The goal of this plan is to divert away from the criminal justice system as many offenders who suffer from mental health conditions as possible, at the earliest point in time possible, and instead provide the necessary treatments and supports to assist them in their community to manage) their behavioral health conditions while addressing their criminogenic needs.
  2. Given that the majority of offenders with mental health conditions remain in pre-trial status for multiple months, strategies should be identified (or developed) to divert these individuals at this point in the process to ensure they receive the treatment necessary to stabilize and manage their symptoms.

Additional Considerations for Reentry 

  1. Similar to diversion, a statewide plan for a standard of care for reentry should be developed based on best practices and evidence-based programs, and should include strategies to address disparities, with a focus on racial justice and race-based trauma. 
    • This plan could be used by State and local criminal justice and behavioral health system policy-makers and administrators. 
    • The goal of this plan is to develop specific processes that may be employed to support individuals who suffer from mental health conditions that are returning to their community after being incarcerated in jail/prison, providing them with the full array of treatments and supports to assist them in managing their behavioral health condition while addressing their criminogenic needs.  
  2. Local/regional Reentry Councils should be considered as key partners to support the development of reentry processes since they currently have an existing infrastructure that engages in advocacy and strategic planning to address the needs of individuals reentering their communities from jail/prison.  

Funding

  1. Counties should examine funding streams across delivery systems and blend funding to the greatest extent possible.  Efforts will need to be made to identify all applicable funding sources, understand the parameters/restrictions for each source, ensure the most restricted funds are allocated appropriately, and that the most flexible funds are used to address system gaps.

Demographic Disparities

  1. Counties should identify and develop strategies to address disparities, with a focus on racial justice and race-based trauma.
    • Current efforts, such as the DHCS/CDPH Community Mental Health Equity Project, should be leveraged to support this work. 

Data Reporting 

  1. Critical responses in this time of crisis could reveal new ways of operating, including which activities had the greatest impact. 
    • As outcomes measures are identified, and data are collected across the relevant systems, information should be gleaned as to which strategies employed are most successful.
    • Efforts to evaluate these strategies will provide decision-makers with supporting evidence to determine how to invest critical resources in the coming years (e.g., examination of trends in mental health cases in county jails will help local county agencies and Boards of Supervisors understand the magnitude of behavioral health and criminogenic needs of their incarcerated population so that resources may be allocated accordingly). 
    • The CCJBH Public Health Meets Public Safety and Lived Experience Program projects will be leveraged to determine how best to include the perspectives of the BH/CJ population in the development of new strategies and operational processes. 

Comments


Diversion/Reentry Workgroup Priorities for  2021

(Discussion)


Announcements

Upcoming CCJBH Council Meeting

December 11, 2020   2:00 – 4:30PM

CCJBH is Developing the 2021 Calendar:

  • Council Meeting Dates
  • Workgroup Meeting Dates

Next Steps


Thank you for Participating!

Email:  CCJBH@cdcr.ca.gov

Website: https://www.cdcr.ca.gov/ccjbh/