Friday, December 11, 2020
2:00 PM – 4:30 PM
Zoom Webinar
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DRAFT Agenda
I. 2:00 PM Welcome & Introductions, Roll Call
- Kathleen Allison, Secretary, California Department of Corrections and Rehabilitation
II. 2:15 PM Approval of October Meeting Minutes
- Brenda Grealish, Executive Officer, Council on Criminal Justice and Behavioral Health (CCJBH)
*** PUBLIC COMMENT ***
III. 2:20 PM MHSOAC
- Toby Ewing, Executive Director, Mental Health Services Oversight and Accountability Commission (MHSOAC)
IV. 2:55 PM ISUDT Program Presentation
- Lisa Heintz, Project Executive, CCHCS – Integrated Substance Use Disorder Treatment (ISUDT) program
- Chris Carlson, Project Manager, CCHCS – Integrated Substance Use Disorder Treatment (ISUDT) program
- Janene DelMundo, Project Manager, CCHCS – Integrated Substance Use Disorder Treatment (ISUDT) program
Q&A Discussion with Council Members
*** PUBLIC COMMENT ***
V. 3:40 PM CCJBH Business Meeting
- Legislative Report Recommendations
- A Year-in-Review
- 2021 Priorities
- 2021 Proposed Dates: Council Meetings and Workgroups
VI. 4:25 PM Announcements
Next Council Meeting Proposed:
Thursday, January 28, 2020 2-4:30PM
VII. 4:30 PM Public Comment
VIII. Adjourn
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.
PUBLIC COMMENT
Public comment is taken prior to a vote on any agenda item as well as at the end of the meeting. If you so choose, prior to making comments, please state your name for the record and identify any group or organization you represent. Depending on the number of individuals wishing to address the Council, the Chair and/or Vice Chair may establish specific time limits on presentations.
**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.
Public Participation: The telephone lines of members of the public who dial into the meeting will initially be muted to prevent background noise from inadvertently disrupting the meeting. Phone lines will be unmuted during all portions of the meeting that are appropriate for public comment to allow members of the public to comment. Please see additional instructions below regarding Public Participation Procedures.
PUBLIC PARTICIPATION PROCEDURES: All members of the public shall have the right to offer comment at this public meeting. The Commission Chair will indicate when a portion of the meeting is to be open for public comment. Any member of the public wishing to comment during public comment periods must do the following:
- If joining by call-in, please email CCJBH@cdcr.ca.gov this will notify the meeting host that you wish to comment. You will be placed in line to comment in the order in which requests are received by the host. When it is your turn to comment, the meeting host will call on your name and unmute your line. The Executive Officer reserves the right to limit the time for comment. Members of the public should be prepared to complete their comments within 3 minutes or less time if a different time allotment is needed and announced by the Executive Officer.
- If joining by computer, press the raise hand icon on the control bar. Pressing the raise hand will notify the meeting host that you wish to comment. You will be placed in line to comment in the order in which requests are received by the host. When it is your turn to comment, the meeting host will unmute your line and announce your name. The Chair reserves the right to limit the time for comment. Members of the public should be prepared to complete their comments within 3 minutes or less time if a different time allotment is needed and announced by the Chair.
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) 479-0445 or CCJBH@cdcr.ca.gov. To view this agenda online, visit our web site at: https://www.cdcr.ca.gov/ccjbh/
CCJBH October Council Meeting Minutes
Thursday, October 29, 2020
2:00 PM – 4:30 PM
Zoom Meeting
Minutes
I. 2:00 PM Welcome & Introductions, Roll Call
Council Members Present: Secretary Kathleen Allison, Stephanie Clendenin,
Tony Hobson, Mack Jenkins, Stephen Manley, Danitza Pantoja, Tracey Whitney,
Jim Kooler
Council Members Absent: Matthew Garcia
Staff Members Present: Brenda Grealish, Executive Officer, Monica Campos,
Angela Kranz, Elizabeth Vice, Sara Dubay-Singh and Sheron Wright,
Brenda Grealish, Executive Officer, Council on Criminal Justice and Behavioral Health (CCJBH)
Announced Resignation of Jessica Cruz—-Resigned week of October 23, 2020.
Announced Vacancy on CCJBH Council.
II. 2:15 PM Approval of August Meeting Minutes
Minutes for approval 08-27-20
Motion to adopt minutes made by Mack Jenkins, second by Danitza Pantoja
Ayes: 7
Nays: 0
Abstentions: 2
Jim Kooler present, but unable to vote due to computer connectivity issues.
Minutes were Approved.
*****PUBLIC COMMENT********
No Public Comment
- 2:20 PM ISMIP Transition Update Presentation
Presenter: Robert Storms, Associate Director (A), Division of Adult Parole Operations (DAPO):
Robert Storms spoke about the audit that was performed on the Integrated Services for the
Mentally Ill Parolees (ISMIP) program by the State Auditor. ISMIP provides services to parolees
With severe mentally ill and homeless. The audit began at beginning of COVID and the report
was issued in August 2020. The program was defunded in the State budget effective the end of
December 2020.
DAPO’s response to the Audit Recommendations:
DAPO is transitioning parolees every week to county services with goal to have six hundred (over 600) parolees in eight counties transition to county services. The effort to transition the ISMIP parolees has grown to be a referral process. DAPO will make rental subsidy payments for ISMIP parolees through January 2021.
Kathleen Allison, Secretary, California Department of Corrections and Rehabilitation, asserted that COVID actually had a positive response on our collaboration with the counties, as it forced the development of transition plans for those being released from prison to both mental health and physical health care ,and noted that she thinks we finally “hit the mark.”
Tony Hobson, PhD Behavioral Health Director, Plumas County asked if there had been any discussion in helping the counties out with fiscal resources.
Robert Storms mentioned that the County Behavior Health Directors Association of California, on behalf of the counties, recommended there should be a longer ISMIP transition plan to allow for time to strengthen agency collaborations within the local care systems. Robert Storms offered collaboration between DAPO outpatient social workers and DAPO psychiatrist (to write prescriptions) with the county system to share, provide and join services. He also spoke of the Pharmacy Outreach Program.
Tony Hobson asked if there was support that counties could expect, explained that counties are already overwhelmed and underfunded, and noted that the ISMIP transition has added to this situation.
Kathleen Allison reminded the Council that during CDCR’s early release program, the Board of State and Community Corrections (BSCC) offered a $15 million grant for reentry housing for this population, matched with $15 million dollars of philanthropy funding, to provide wraparound services. Beds were available to both PRCS and parolees.
Mack Jenkins Chief Probation Officer (Retired), San Diego County, expressed his interest in hearing more about the role of Parole Agents.
Robert Storms asserted that, since he is not a peace officer, he thinks a Parole Administrator or the Director could answer the Parole Agent role question. He spoke about how the training at the Parole Academy now includes mental health case management and resource development. He discussed the county’s preference to have dedicated parole agents to go to team meetings, to be part of the decision-making and having have a hotline. DAPO is also looking at DAPO social workers teaming up with parole agents (e.g., joint home visits).
Mack Jenkins asked Robert a question regarding ISMIP population on psychotropic medication: Does that also include long-acting injectables?
Robert Storms responded that DAPO does have parolees in pharmacy outreach through injection clinics. DAPO does have parolees that are on long-acting injectables.
Judge Stephen Manley, Santa Clara County Superior Court Judge, noted that he has a large parolee reentry court that also serves PRCS offenders. He complimented and commended DAPO on their collaborations with the counties and their work with parolees. He encouraged DAPO to keep up the good work. Judge Manley asserted that parolees need so much support. He said, “out of all of them (that come into my court), the ones that need the greatest support, (they face) the stigma, the rejection, the unwillingness to help them.” Judge Manley asked Robert Storms about the level of funding for the ISMIP budget. He stated these services for mental health parolees is a large financial obligation for the counties to take.
Robert Storms responded that the budget ranged between $18 to $22 million a year, just in staffing. Robert commented that parole periods have been reduced, and that there are opportunities for parolees to discharge from parole earlier.
Tracey Whitney, Deputy District Attorney, Mental Health Liaison, Los Angeles County, District Attorney
Asked about the ISMIP Program and specific service criteria, screen-in/ qualifying criteria. She gave an example of a parolee who was declared incompetent and asked how that parolee could get care.
Robert Storms responded by stressing that due to the budget crisis, ISMIP would be going away December 2020. However, to address her specific question, he highlighted – 600 high impact, serving parolees in eight (8) different locations. Primary screening criteria consists of: 1) those that were considered to have mental illness, 2) Homeless – consider residential stability, 3) community functioning level. Primary referrals were sent to DAPO pre-release. Parolees would have no requirement to participate – it was considered a voluntary program. No requirement that they accept treatment.
IV. 2:45 PM Medi-Cal Utilization Project Update
Angela Kranz, Research Scientist III, Council on Criminal Justice and Behavioral Health (CCJBH)
Q&A Discussion with Council Members
Kathleen Allison wanted to know when she will see the data for 2017 through 2019.
Brenda Grealish responded that we will have longitudinal data to track utilization trends as soon as the data sharing agreement is renewed.
Kathleen Allison offered her support of the data sharing agreement and said Jennifer Brarretto could be of some help in pushing the agreement through.
Mack Jenkins asked if these data are exclusive to parolees or does it also includes PRCS?
Brenda Grealish responded that information could be used not only to inform high-level state oversight and decision-making, but also to inform counties locally on how long it takes to enrollment into Medi-Cal and use Medi-Cal services.
Mack Jenkins stated that he would be interested to see the Medi-Cal utilization broken down into categories, such as the parole and PRCS populations. He stated that it puts us in a position to learn about barriers and processes and the interagency collaboration necessary to connect to the services.
Brenda Grealish concurred that is a great idea so that counties can utilize this information to establish a baseline, and then implement quality improvement strategies.
Mack Jenkins asked Tony Hobson whether or not increased utilization by county behavioral health represents a cost savings for the local Behavioral Health Directors in each county.
Tony Hobson answered that we have a bifurcated system. Tony asked if CCCMS are being served by Medi-Cal Managed Care Plans? Or are they being served by CDCR? If they are all coming to counties, there is no cost-savings, just cost.
- 3:00 PM CSG Housing Project Presentation
Hallie Fader-Towe, Director, Behavioral Health, Council on State Governments (CSG)
Introduced: Charlie Francis, Project Manager, and Katie Harmon, Senior Policy Analyst, and spoke on the intersection between behavioral health and housing. Funding from national housing work is from Melville Charitable Trust, flushing out best practices and developing recommendations. Katie Harmon gave an overview of CSG work to date.
Judge Stephen Manley suggested the development of priority housing consideration for mentally ill persons, similar to those provided for veterans. He asserted the need for making housing programs not only about housing, but about services and treatment and support, and changing the stipulation that they could lose their bed if jailed for 90 days. Judge Manley believes the most terrible outcome is when subsidized housing becomes a zone for crime and repeated arrest and police activity.
Hallie Fader-Towe agreed with the Judge and stated that is one of the things CSG is laying out – different levels of housing and treatment support, housing on-site services, onsite treatment levels; housing and support variations based on need profile through data matching.
Tony Hobson clarified that Judge Manley was talking about the No Place like Home model. He explained that they are now in the planning process, but people are being released, and we can’t rush Housing and Community Development (HUD) and force them to build housing.
Brenda Grealish introduced Matthew Garcia, Field Training Officer (retired), Sacramento Police Department (who joined the meeting during the presentation).
Matthew Garcia, Field Training Officer, (Retired) Sacramento Police Department, agreed with Judge Manley and said that, as a police officer, you only have two options for the mentally ill: jail or the hospital. He asks if there is a focus on PRCS or parole.
Halle Fader-Towe responded that CSG is looking broadly at people leaving CDCR, as well as those leaving the jails.
*****PUBLIC COMMENT********
Kathy Jett: Great meeting; very impressed with parole presentation and kudos Judge Manley gave to CDCR parole. The idea of in-reach really makes a big difference to the inmates prior to release because it is a connection. They know where they are going. Parole does the best they can – in-reach is a way to help.
Robert Forte: What a wonderful meeting, I am here in San Diego, leading case manager for high risk offender (at one point I was a high risk offender). I deal with parole and probation every day. The company I work for is funded by Department of Labor and Department of Justice. As I deal with high risk offenders, getting them jobs and housing trying to get them to reeducate themselves – there are too many cracks in the concrete. Cracks in the concrete are cracks in the contracts that are designed. We are looking for housing. But, there is a waiting list. How can that initial $15 million dollars sent to California be spent – and there is a waiting list to house high risk offenders. From a public safety standpoint it is a complete failure.
David Panish: What a fabulous group. Do we know how many mentally ill parolees leave the institution and are homeless when they leave? Seems like a fairly straightforward question, but, I have never been given answer.
Brenda Grealish responds that there are efforts underway as part of CSG’s Housing Project to try to determine the numbers.
David Panish: When someone is released from institution and we know they have been identified with a serious mental health issue – to give us a sense of the magnitude of the problem – how many are homeless?
Kathleen Allison said that DAPO does maintain data on the homeless and she suggested inviting Guillermo Viera Rosa, Director of DAPO, to the Council meetings. In response to the other question from Mr. Forte, she was told that we did not currently have a waitlist in our program and stated that we definitely need to get answers to both of those questions.
Mack Jenkins commented that housing for PRCS was not a permanent, it was temporary.
Judge Stephen Manley concurred with Mack Jenkins that this is an important question to answer. When he sees parolees every week, 80-90 percent are homeless, so he has to concentrate on finding them housing.
Mack Jenkins emphasized that this is a case management issue.
Tony Hobson stated that people are being released from the jails at 10 pm to homelessness. He suggested that pre-planning and engagement occur before they are released.
Tracey Whitney commented that about 10 years ago there were not this many homeless and wondered what made this problem explode.
Mack Jenkins emphasized that the important point is to define the case management since it is such a broad term. He explained that there has to be a collaborative effort between the multiple entities involved, and that they have to work together, collaboratively.
Brenda Grealish announced that Hallie Fader-Towe posted a link for collaborative comprehensive case planning for those who would like to learn more.
*****PUBLIC COMMENT********
Michael Baldwin: I, myself spent 13 out of my 26 years incarcerated working with those who were mentally ill as an Enhanced Outpatient Program (EOP) Aide. I assisted them in their day-to-day functions and to prepare and complete a parole plan. Seventy to eighty percent were homeless. I did a lot of research as an inmate and as an Aide, trying to find family members who will take them when they get out. In order to accommodate the needs of those incarcerated, mentally challenged and coming out to homelessness without providing wraparound services – you have not provided them the service at all. They (services) need to come before they are released. To think that housing is the solution – the Judge was spot on when he talked about a support system. You have many parolees that can help them. CDCR utilized peers to help manage the mentally ill on the inside. You have opportunity to do something similar once they are released and can be trained as a health aide to help them. To think the parole agent alone will be able to manage by themselves – it is placing too much on the parole agent. I am a consultant, I started my own non-profit business and provide resources while they are inside as well as when they come home and we have set aside specific services for sexual offenders. There is a whole other dynamic when the individual has a sexual offense. Even if they have housing, they may not qualify for housing due to being a sex offender. I would love to work with you all to brainstorm. There is another program, Miracle Messages, where I trained case managers in San Jose how to utilize mediation techniques to bridge the gap and resolve conflicts between homeless individuals and their families. We have been successful. These are all components that can play a part in an individual’s life that can help reduce recidivism, reduce homelessness and provide vital services for those who are mentally challenged.
Brenda Grealish thanked him for his efforts working with the EOP population.
Ryan Youtsey: I have been listening to this great conversation and would like to share some of our current efforts out in community. This is an issue near and dear to us. One that we have been working on. I work as Parole Administrator in reentry services. We are doing a lot out in the community, basically mental health reentry and homelessness working closely with CSG, DRP and other community stakeholders. We are doing a webinar in a few weeks introducing Parole Administrators and program specialists to continuum of care in an effort to set up partnerships and referral mechanisms – to get into a coordinated entry system for our homeless population. DAPO has done a lot of innovations in the last few years. We do in-reach, pre-release programs to form collaborative case planning prior to release. DAPO is a partner to you all, and we are looking at these issues. Anything we can share – what we are doing – we would love to be part of that conversation.
- 3:20 PM CCJBH Business Meeting
- Legislative Report/ Workgroup updates
- Lived Experience Project Update
- Late Breaking Policy Issues
Brenda Grealish announced there was no time to fully discuss the Legislative Report, but provided a copy of the report recommendations to Council members, which were also posted to CCJBH website. She asked for comments and feedback on the recommendations by November 6th, close of business. Brenda explained that over the summer, CCJBH held three workgroups: Juvenile Justice, Diversion and Reentry. From those Workgroup meetings, CCJBH staff developed policy recommendations – one set for Juvenile Justice and another for Reentry/Diversion. Brenda stated the Division of Juvenile Justice will be realigned to counties on July 1, 2021. Brenda then gave a quick overview of Juvenile Justice Legislative Recommendations.
Brenda Grealish asked if the Juvenile Justice recommendations capture what was discussed in the CCJBH Juvenile Justice Workgroup.
Mack Jenkins agreed that her summation of Juvenile Justice Recommendations captured what was discussed in Juvenile Justice Workgroup, and thanked Dr. Bowles, DJJ director, for all her help.
Brenda Grealish gave overview of Diversion and Reentry policy recommendations.
Brenda Grealish asked if the Diversion and Reentry recommendations capture what was discussed in the CCJBH Reentry and Diversion Workgroups.
Judge Stephen Manley agreed that the recommendations do capture what was discussed in the workgroups. He asserted that a third group of individuals, called “pending,” exist due to pandemic, closing of courts and shutting down of calendars. We have thousands and thousands of mentally ill offenders who are never in a position to see diversion. He suggested that we develop a statewide effort in figuring out how we can work with them because they go on month after month with no resolution of their charges, and never knowing what they are supposed to do or have any contact with those that can divert them.
See Legislative Recommendations for both Juvenile Justice and Diversion and Reentry posted on CCJBH Website at CCJBH-October Council Meeting – Proposed Annual Legislative Recommendation
VII. 4:25 PM Announcements
Diversion and Reentry Workgroup, Friday, November 13, 2020 [Tentative] 1 PM – 3PM
Juvenile Justice Workgroup, Friday, November 20, 2020 10AM – 12:00PM
Next Council Meeting:
Thursday, December 11, 2020 2 PM – 4:30PM
VIII. 4:30 PM Public Comment
No Comment
IX. Adjourn
CCJBH October Council Meeting Minutes
Thursday, October 29, 2020
2:00 PM – 4:30 PM
Zoom Meeting
Minutes
I. 2:00 PM Welcome & Introductions, Roll Call
Council Members Present: Secretary Kathleen Allison, Stephanie Clendenin,
Tony Hobson, Mack Jenkins, Stephen Manley, Danitza Pantoja, Tracey Whitney,
Jim Kooler
Council Members Absent: Matthew Garcia
Staff Members Present: Brenda Grealish, Executive Officer, Monica Campos,
Angela Kranz, Elizabeth Vice, Sara Dubay-Singh and Sheron Wright,
Brenda Grealish, Executive Officer, Council on Criminal Justice and Behavioral Health (CCJBH)
Announced Resignation of Jessica Cruz—-Resigned week of October 23, 2020.
Announced Vacancy on CCJBH Council.
II. 2:15 PM Approval of August Meeting Minutes
Minutes for approval 08-27-20
Motion to adopt minutes made by Mack Jenkins, second by Danitza Pantoja
Ayes: 7
Nays: 0
Abstentions: 2
Jim Kooler present, but unable to vote due to computer connectivity issues.
Minutes were Approved.
*****PUBLIC COMMENT********
No Public Comment
III. 2:20 PM ISMIP Transition Update Presentation
Presenter: Robert Storms, Associate Director (A), Division of Adult Parole Operations (DAPO):
Robert Storms spoke about the audit that was performed on the Integrated Services for the
Mentally Ill Parolees (ISMIP) program by the State Auditor. ISMIP provides services to parolees
With severe mentally ill and homeless. The audit began at beginning of COVID and the report
was issued in August 2020. The program was defunded in the State budget effective the end of
December 2020.
DAPO’s response to the Audit Recommendations:
DAPO is transitioning parolees every week to county services with goal to have six hundred (over 600) parolees in eight counties transition to county services. The effort to transition the ISMIP parolees has grown to be a referral process. DAPO will make rental subsidy payments for ISMIP parolees through January 2021.
Kathleen Allison, Secretary, California Department of Corrections and Rehabilitation, asserted that COVID actually had a positive response on our collaboration with the counties, as it forced the development of transition plans for those being released from prison to both mental health and physical health care ,and noted that she thinks we finally “hit the mark.”
Tony Hobson, PhD Behavioral Health Director, Plumas County asked if there had been any discussion in helping the counties out with fiscal resources.
Robert Storms mentioned that the County Behavior Health Directors Association of California, on behalf of the counties, recommended there should be a longer ISMIP transition plan to allow for time to strengthen agency collaborations within the local care systems. Robert Storms offered collaboration between DAPO outpatient social workers and DAPO psychiatrist (to write prescriptions) with the county system to share, provide and join services. He also spoke of the Pharmacy Outreach Program.
Tony Hobson asked if there was support that counties could expect, explained that counties are already overwhelmed and underfunded, and noted that the ISMIP transition has added to this situation.
Kathleen Allison reminded the Council that during CDCR’s early release program, the Board of State and Community Corrections (BSCC) offered a $15 million grant for reentry housing for this population, matched with $15 million dollars of philanthropy funding, to provide wraparound services. Beds were available to both PRCS and parolees.
Mack Jenkins Chief Probation Officer (Retired), San Diego County, expressed his interest in hearing more about the role of Parole Agents.
Robert Storms asserted that, since he is not a peace officer, he thinks a Parole Administrator or the Director could answer the Parole Agent role question. He spoke about how the training at the Parole Academy now includes mental health case management and resource development. He discussed the county’s preference to have dedicated parole agents to go to team meetings, to be part of the decision-making and having have a hotline. DAPO is also looking at DAPO social workers teaming up with parole agents (e.g., joint home visits).
Mack Jenkins asked Robert a question regarding ISMIP population on psychotropic medication: Does that also include long-acting injectables?
Robert Storms responded that DAPO does have parolees in pharmacy outreach through injection clinics. DAPO does have parolees that are on long-acting injectables.
Judge Stephen Manley, Santa Clara County Superior Court Judge, noted that he has a large parolee reentry court that also serves PRCS offenders. He complimented and commended DAPO on their collaborations with the counties and their work with parolees. He encouraged DAPO to keep up the good work. Judge Manley asserted that parolees need so much support. He said, “out of all of them (that come into my court), the ones that need the greatest support, (they face) the stigma, the rejection, the unwillingness to help them.” Judge Manley asked Robert Storms about the level of funding for the ISMIP budget. He stated these services for mental health parolees is a large financial obligation for the counties to take.
Robert Storms responded that the budget ranged between $18 to $22 million a year, just in staffing. Robert commented that parole periods have been reduced, and that there are opportunities for parolees to discharge from parole earlier.
Tracey Whitney, Deputy District Attorney, Mental Health Liaison, Los Angeles County, District Attorney
Asked about the ISMIP Program and specific service criteria, screen-in/ qualifying criteria. She gave an example of a parolee who was declared incompetent and asked how that parolee could get care.
Robert Storms responded by stressing that due to the budget crisis, ISMIP would be going away December 2020. However, to address her specific question, he highlighted – 600 high impact, serving parolees in eight (8) different locations. Primary screening criteria consists of: 1) those that were considered to have mental illness, 2) Homeless – consider residential stability, 3) community functioning level. Primary referrals were sent to DAPO pre-release. Parolees would have no requirement to participate – it was considered a voluntary program. No requirement that they accept treatment.
IV. 2:45 PM Medi-Cal Utilization Project Update
Angela Kranz, Research Scientist III, Council on Criminal Justice and Behavioral Health (CCJBH)
Q&A Discussion with Council Members
Kathleen Allison wanted to know when she will see the data for 2017 through 2019.
Brenda Grealish responded that we will have longitudinal data to track utilization trends as soon as the data sharing agreement is renewed.
Kathleen Allison offered her support of the data sharing agreement and said Jennifer Brarretto could be of some help in pushing the agreement through.
Mack Jenkins asked if these data are exclusive to parolees or does it also includes PRCS?
Brenda Grealish responded that information could be used not only to inform high-level state oversight and decision-making, but also to inform counties locally on how long it takes to enrollment into Medi-Cal and use Medi-Cal services.
Mack Jenkins stated that he would be interested to see the Medi-Cal utilization broken down into categories, such as the parole and PRCS populations. He stated that it puts us in a position to learn about barriers and processes and the interagency collaboration necessary to connect to the services.
Brenda Grealish concurred that is a great idea so that counties can utilize this information to establish a baseline, and then implement quality improvement strategies.
Mack Jenkins asked Tony Hobson whether or not increased utilization by county behavioral health represents a cost savings for the local Behavioral Health Directors in each county.
Tony Hobson answered that we have a bifurcated system. Tony asked if CCCMS are being served by Medi-Cal Managed Care Plans? Or are they being served by CDCR? If they are all coming to counties, there is no cost-savings, just cost.
V. 3:00 PM CSG Housing Project Presentation
Hallie Fader-Towe, Director, Behavioral Health, Council on State Governments (CSG)
Introduced: Charlie Francis, Project Manager, and Katie Harmon, Senior Policy Analyst, and spoke on the intersection between behavioral health and housing. Funding from national housing work is from Melville Charitable Trust, flushing out best practices and developing recommendations. Katie Harmon gave an overview of CSG work to date.
Judge Stephen Manley suggested the development of priority housing consideration for mentally ill persons, similar to those provided for veterans. He asserted the need for making housing programs not only about housing, but about services and treatment and support, and changing the stipulation that they could lose their bed if jailed for 90 days. Judge Manley believes the most terrible outcome is when subsidized housing becomes a zone for crime and repeated arrest and police activity.
Hallie Fader-Towe agreed with the Judge and stated that is one of the things CSG is laying out – different levels of housing and treatment support, housing on-site services, onsite treatment levels; housing and support variations based on need profile through data matching.
Tony Hobson clarified that Judge Manley was talking about the No Place like Home model. He explained that they are now in the planning process, but people are being released, and we can’t rush Housing and Community Development (HUD) and force them to build housing.
Brenda Grealish introduced Matthew Garcia, Field Training Officer (retired), Sacramento Police Department (who joined the meeting during the presentation).
Matthew Garcia, Field Training Officer, (Retired) Sacramento Police Department, agreed with Judge Manley and said that, as a police officer, you only have two options for the mentally ill: jail or the hospital. He asks if there is a focus on PRCS or parole.
Halle Fader-Towe responded that CSG is looking broadly at people leaving CDCR, as well as those leaving the jails.
*****PUBLIC COMMENT********
Kathy Jett: Great meeting; very impressed with parole presentation and kudos Judge Manley gave to CDCR parole. The idea of in-reach really makes a big difference to the inmates prior to release because it is a connection. They know where they are going. Parole does the best they can – in-reach is a way to help.
Robert Forte: What a wonderful meeting, I am here in San Diego, leading case manager for high risk offender (at one point I was a high risk offender). I deal with parole and probation every day. The company I work for is funded by Department of Labor and Department of Justice. As I deal with high risk offenders, getting them jobs and housing trying to get them to reeducate themselves – there are too many cracks in the concrete. Cracks in the concrete are cracks in the contracts that are designed. We are looking for housing. But, there is a waiting list. How can that initial $15 million dollars sent to California be spent – and there is a waiting list to house high risk offenders. From a public safety standpoint it is a complete failure.
David Panish: What a fabulous group. Do we know how many mentally ill parolees leave the institution and are homeless when they leave? Seems like a fairly straightforward question, but, I have never been given answer.
Brenda Grealish responds that there are efforts underway as part of CSG’s Housing Project to try to determine the numbers.
David Panish: When someone is released from institution and we know they have been identified with a serious mental health issue – to give us a sense of the magnitude of the problem – how many are homeless?
Kathleen Allison said that DAPO does maintain data on the homeless and she suggested inviting Guillermo Viera Rosa, Director of DAPO, to the Council meetings. In response to the other question from Mr. Forte, she was told that we did not currently have a waitlist in our program and stated that we definitely need to get answers to both of those questions.
Mack Jenkins commented that housing for PRCS was not a permanent, it was temporary.
Judge Stephen Manley concurred with Mack Jenkins that this is an important question to answer. When he sees parolees every week, 80-90 percent are homeless, so he has to concentrate on finding them housing.
Mack Jenkins emphasized that this is a case management issue.
Tony Hobson stated that people are being released from the jails at 10 pm to homelessness. He suggested that pre-planning and engagement occur before they are released.
Tracey Whitney commented that about 10 years ago there were not this many homeless and wondered what made this problem explode.
Mack Jenkins emphasized that the important point is to define the case management since it is such a broad term. He explained that there has to be a collaborative effort between the multiple entities involved, and that they have to work together, collaboratively.
Brenda Grealish announced that Hallie Fader-Towe posted a link for collaborative comprehensive case planning for those who would like to learn more.
*****PUBLIC COMMENT********
Michael Baldwin: I, myself spent 13 out of my 26 years incarcerated working with those who were mentally ill as an Enhanced Outpatient Program (EOP) Aide. I assisted them in their day-to-day functions and to prepare and complete a parole plan. Seventy to eighty percent were homeless. I did a lot of research as an inmate and as an Aide, trying to find family members who will take them when they get out. In order to accommodate the needs of those incarcerated, mentally challenged and coming out to homelessness without providing wraparound services – you have not provided them the service at all. They (services) need to come before they are released. To think that housing is the solution – the Judge was spot on when he talked about a support system. You have many parolees that can help them. CDCR utilized peers to help manage the mentally ill on the inside. You have opportunity to do something similar once they are released and can be trained as a health aide to help them. To think the parole agent alone will be able to manage by themselves – it is placing too much on the parole agent. I am a consultant, I started my own non-profit business and provide resources while they are inside as well as when they come home and we have set aside specific services for sexual offenders. There is a whole other dynamic when the individual has a sexual offense. Even if they have housing, they may not qualify for housing due to being a sex offender. I would love to work with you all to brainstorm. There is another program, Miracle Messages, where I trained case managers in San Jose how to utilize mediation techniques to bridge the gap and resolve conflicts between homeless individuals and their families. We have been successful. These are all components that can play a part in an individual’s life that can help reduce recidivism, reduce homelessness and provide vital services for those who are mentally challenged.
Brenda Grealish thanked him for his efforts working with the EOP population.
Ryan Youtsey: I have been listening to this great conversation and would like to share some of our current efforts out in community. This is an issue near and dear to us. One that we have been working on. I work as Parole Administrator in reentry services. We are doing a lot out in the community, basically mental health reentry and homelessness working closely with CSG, DRP and other community stakeholders. We are doing a webinar in a few weeks introducing Parole Administrators and program specialists to continuum of care in an effort to set up partnerships and referral mechanisms – to get into a coordinated entry system for our homeless population. DAPO has done a lot of innovations in the last few years. We do in-reach, pre-release programs to form collaborative case planning prior to release. DAPO is a partner to you all, and we are looking at these issues. Anything we can share – what we are doing – we would love to be part of that conversation.
VI. 3:20 PM CCJBH Business Meeting
- Legislative Report/ Workgroup updates
- Lived Experience Project Update
- Late Breaking Policy Issues
Brenda Grealish announced there was no time to fully discuss the Legislative Report, but provided a copy of the report recommendations to Council members, which were also posted to CCJBH website. She asked for comments and feedback on the recommendations by November 6th, close of business. Brenda explained that over the summer, CCJBH held three workgroups: Juvenile Justice, Diversion and Reentry. From those Workgroup meetings, CCJBH staff developed policy recommendations – one set for Juvenile Justice and another for Reentry/Diversion. Brenda stated the Division of Juvenile Justice will be realigned to counties on July 1, 2021. Brenda then gave a quick overview of Juvenile Justice Legislative Recommendations.
Brenda Grealish asked if the Juvenile Justice recommendations capture what was discussed in the CCJBH Juvenile Justice Workgroup.
Mack Jenkins agreed that her summation of Juvenile Justice Recommendations captured what was discussed in Juvenile Justice Workgroup, and thanked Dr. Bowles, DJJ director, for all her help.
Brenda Grealish gave overview of Diversion and Reentry policy recommendations.
Brenda Grealish asked if the Diversion and Reentry recommendations capture what was discussed in the CCJBH Reentry and Diversion Workgroups.
Judge Stephen Manley agreed that the recommendations do capture what was discussed in the workgroups. He asserted that a third group of individuals, called “pending,” exist due to pandemic, closing of courts and shutting down of calendars. We have thousands and thousands of mentally ill offenders who are never in a position to see diversion. He suggested that we develop a statewide effort in figuring out how we can work with them because they go on month after month with no resolution of their charges, and never knowing what they are supposed to do or have any contact with those that can divert them.
See Legislative Recommendations for both Juvenile Justice and Diversion and Reentry posted on CCJBH Website at CCJBH-October Council Meeting – Proposed Annual Legislative Recommendation
VII. 4:25 PM Announcements
Diversion and Reentry Workgroup, Friday, November 13, 2020 [Tentative] 1 PM – 3PM
Juvenile Justice Workgroup, Friday, November 20, 2020 10AM – 12:00PM
Next Council Meeting:
Thursday, December 11, 2020 2 PM – 4:30PM
VIII. 4:30 PM Public Comment
No Comment
IX. Adjourn
Council Meeting
December 11, 2020
Agenda
| 2:00 PM | Welcome & Introductions, Roll Call |
| 2:15 PM | Approval of October Meeting Minutes |
| 2:20 PM | ISMIP Transition Update |
| 2:30 PM | MHSOAC Presentation |
| 2:55 PM | Q&A Discussion with Council Members *** PUBLIC COMMENT *** |
| 3:00 PM | ISUDT Program Presentation |
| 3:30 PM | Q&A Discussion with Council Members *** PUBLIC COMMENT *** |
| 3:45 PM | CCJBH Business Meeting |
| 4:25 PM | Announcements |
| 4:25 PM | General Public Comment |
| 4:30 PM | Adjourn |
Quick Notes:
** Council Meeting is being recorded **
- Use the “raise hand” feature to make a comment
- You will be placed in line to comment in the order in which requests are received by the host.
- When it is your turn to comment, the meeting host will unmute your line and announce your name.
- The Chair reserves the right to limit the time for comment. Members of the public should be prepared to complete their comments within 3 minutes or less if a different time allotment is needed and announced by the Chair.
Email:
CCJBH@cdcr.ca.gov
October Council Meeting Minutes
MOTION TO ADOPT OR AMEND
*** PUBLIC COMMENT ***
ISMIP Transition Update
Division of Adult Parole Operations
Robert Storms, Associate Director (A)
Mental Health Services Oversight and Accountability Commission (MHSOAC)
Toby Ewing, Executive Director
Q&A Discussion with Council Members
*** PUBLIC COMMENT ***
Integrated Substance Use Disorder Treatment Program (ISUDT)
Lisa Heintz, Project Executive
Janene DelMundo, Project Manager
Chris Carlson, Partner at GPS West
Q&A Discussion with Council Members
*** PUBLIC COMMENT ***
CCJBH Business Meeting
Juvenile Justice
Recommendations
Please refer to the handout:
Juvenile Justice:
2020 CCJBH Legislative Report Policy Recommendations
COUNCIL MEMBER COMMENTS
Diversion/Reentry
Recommendations
Please refer to the handout:
Diversion/Reentry:
2020 CCJBH Legislative Report Policy Recommendations
COUNCIL MEMBER COMMENTS
- Step 1: Council Motion to adopt the 2020 Annual CCJBH Legislative Report Recommendations
- Step 2: Public Comment
- Step 3: Council Motion to delegate authority to CCJBH Executive Officer to make updates to the report in order to meet the legislative mandate.
A Year-in-Review
In Calendar Year 2020:
- the Council met a total of six times
- Due to COVID-19 public health emergency, the Council began meeting virtually in April
- Focus shifted to address emerging issues related to the pandemic and racial injustice
Council meetings throughout the year were spent on educational efforts, covering the following topics:
- COVID-19 Response Across all Areas of Behavioral Health and the Criminal Justice Systems
- Housing and Homelessness
- Systemic Racism
- CCJBH Project Updates
In accordance with CCJBH’s mission to support proven strategies that promote early intervention, access to effective treatments, and planned reentry and the preservation of public safety, CCJBH produced the following written briefs and factsheets for use by BH/CJ policymakers and administrative leaders:
- Housing Policy Brief Executive Summary
- Housing Policy Brief
- Housing First Factsheet
- Reduce Preventable Emergency and Inpatient Utilization
- Juvenile Justice Factsheet
- Behavioral Health System Transformation Through CalAIM Factsheet
The Council also responded to the public health and State budgetary crisis by establishing workgroups in the areas most affected by the pandemic:
- Diversion
- Reentry
- Juvenile Justice
Workgroups focused discussion in each area served as a platform to elicit feedback and develop effective recommendations for the
2020 annual report to the Legislature.
A Year-in-Review – 2025 Goals
Goal #1: The prevalence rate of mental illness and substance use disorders (SUDs) in jails and prisons should be similar, if not equal to, the prevalence rate of mental illness and SUDs in the community.
Goal #1 2020 Update:
- Different measures used at the federal, State and local levels, which makes the analysis of behavioral health prevalence rates in incarcerated settings challenging.
- Examination of recent, available data continue to show that a disproportionate number of individuals with behavioral health needs are overrepresented in both California jails and prisons.
- For jails, examination of the COVID-19 PHE releases through a comparison of data for June 2019 and June 2020 shows an exacerbation, rather than improvement, of high behavioral health prevalence in California jails.
- CCJBH will continue to track these data, and will engage in discussions to develop strategies to reverse this troubling trend.
Goal #2: Community-based services, particularly residential, are robust enough to meet demand starting with ensuring that those with multiple needs are not left behind due to their numerous and complex challenges.
Goal #3: Through consistent dedication to workforce development, quality education and training, and on-going technical assistance to an array of service providers and partners, Californians benefit from professionals having core competencies that provide effective integrated correctional and behavioral health services to achieve recovery and reduced recidivism.
Goal #4: Through state leadership to support data-driven practices and policy-making among criminal justice and behavioral health systems, continuity of care and desired public safety and health outcomes improve significantly.
Goal #s 2-4 2020 Update: In 2021, CCJBH will leverage the Medi-Cal Utilization (MCUP) and Public Health Meets Public Safety (PH/PS) Projects to determine how best to establish appropriate, comprehensive metrics
for these goals.
2021 Priorities
Juvenile Justice
In 2021, the CCJBH, through its Juvenile Justice Workgroup, will focus on SB 823 DJJ Realignment, particularly with regard to securing a contractor for the Juvenile Justice Evidence-Based Practices Toolkit/Compendium. Workgroup participants will review and provide feedback on deliverables throughout the year, and share this information at Full Council meetings.
2021 Priorities – Juvenile Justice
Purpose of the Toolkit:
To provide a compilation of information related to best practices and evidence-based programs that have been shown to be effective in serving youth involved in the criminal justice system who have serious behavioral health needs.
The toolkit will support counties in:
- Identifying and understanding the heterogeneous composition and needs of their juvenile justice- involved youth population.
- Knowing and understanding the juvenile justice system agency partners, their roles and responsibilities and potential funding opportunities available through each agency.
- Strengthening and sustaining cross-system partnerships to promote shared decision-making by those most cognizant and well-informed of the unique needs of this population.
- Screening and assessing youth behavioral, behavioral health (including trauma) and criminogenic needs.
- Identifying best practices and evidence-based practices to improve process and treatment outcomes.
Who will it serve:
The compendium/toolkit will serve as a key resource for county probation/child welfare and behavioral health departments
2021 Priorities
Diversion/Reentry
In 2021, CCJBH will focus on supporting the work necessary to comply with the Governor’s Veto Message on Senate Bill 369, which directs CDCR and CCJBH to “engage with stakeholders, evaluate the barriers of reentry, and determine what steps need to be taken to overcome those barriers.”
To meet this mandate, CCJBH staff will initiate this effort through coordination with other CDCR Divisions, as well as the CCHCS ISUDT team, in order to develop this project, which will include strategies to capture stakeholder input.
2021 Proposed Dates: Council Meetings and Workgroups
Council Meetings
| COUNCIL MEETING DATES | MEETING TIME |
|---|---|
| January 29 (Friday) | 2:00 PM – 4:30 PM |
| April 30 (Friday) | 2:00 PM – 4:30 PM |
| July 30 (Friday) | 2:00 PM – 4:30 PM |
| October 29 (Friday) | 2:00 PM – 4:30 PM |
| December 10 (Time TBD) Call to adopt legislative report | 2:00 PM – 4:30 PM |
Workgroups
| JUVENILE JUSTICE | |
| Proposed Dates | Proposed Time |
| MARCH 12 (Friday) | 1-3 PM |
| JUNE 11 (Friday) | 1-3 PM |
| SEPTEMBER 10 (Friday) | 1-3 PM |
| NOVEMBER 12 (Friday) | 1-3 PM |
| DIVERSION/REENTRY | |
| March 19 (Friday) | 1-3 PM |
| June 18 (Friday) | 1-3 PM |
| September 17 (Friday) | 1-3 PM |
| November 19 (Friday) | 1-3 PM |
Announcements:
Next Council Meeting (proposed):
Friday, January 28, 2021 2-4:30PM
**General Public Comment**
Thank you!
Email:
Diversion/Reentry Policy Recommendations
Case Planning/Management, Service Linkages and Ongoing Monitoring
- Case management services should be provided in diversion and reentry programs for at least 365 days post-incarceration, based on individual assessment, to ensure effective use of the services to ensure stability. The COVID-19 pandemic resulted in substantially shorter sentences, especially among people incarcerated in jails. Law enforcement contact and initial detention (Intercepts 1 and 2 of the Sequential Intercept Model) are key points at which people can be connected to care. Case management services should reflect the fact that people released from jail receive different types of criminal justice supervision and monitoring while they live in the community. For example, people released after being held in jail pre-trial are not subject to any formal criminal justice supervision.
- 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 and Behavioral Health Care Services
- 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.
- 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. Information regarding collaborative case plans is available on the CSG Justice Center’s Collaborative Case Plan website. All criminal justice and behavioral health partners should be included.
- 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.
- 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. Note: 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 Screening, Assessment and Intervention
- A criminogenic risk and needs screening and 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. Screening and assessment should take place as soon as possible after intake, and criminogenic risk/needs assessments should take place in addition to, not instead of, clinical behavioral health assessments. There is no standardized risk/needs assessment at this point in time, and it is unknown as to whether there is a need for standardization. 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. For example, collaborative comprehensive case plans are an identified best practice that reflects structured and multi-sector partnership. Information regarding collaborative case plans is available on the CSG Justice Center’s Collaborative Case Plan website.
- 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. A standing meeting or other convening platform at the local level can help to facilitate communication and collaboration.
Diversion/Reentry Workforce
- 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. 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 successfully support those with behavioral health needs who are involved in the criminal justice system.
- All relevant staff must receive specialized training on the unique needs of the BH/CJ population. Criminal justice staff should know when and how to perform a behavioral health screening, as well as how 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.
- 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 and Homelessness
- 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.
- Communities should be equipped with the necessary infrastructure to maintain the shelter capabilities. 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 in order to build capacity and facilitate supporting individuals returning from incarceration.
- 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. Housing is a critical need at release. Where possible, planning for housing at release should begin with the point of arrest and include county behavioral health.
- 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.
- 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
- In addition to health and behavioral health services, and criminogenic risk/needs interventions, it is critical to address the social determinants of health, including the provision of income (SSI/SSDI), 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 and, in particularly, by building out the capacity of local Reentry Councils to assist with establishing/strengthening current transition processes/services.
Additional Considerations for Diversion
- 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 communities to manage their behavioral health conditions while addressing their criminogenic needs.
- 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
- 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 conditions while addressing their criminogenic needs.
- 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
- 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
- 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
- Critical responses in this time of crisis could reveal new ways of operating, including which activities had the greatest impact. As outcome 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.
Juvenile Justice Policy Recommendations
- Given the extensive needs of the youth currently served by the county probation, and the youth population with greater and serious needs that will be realigned to county probation as of July 1, 2021, local probation agencies, and the youth/families they serve, would benefit from (as appropriate):
- Engaging system partners in strategic planning to improve the existing local juvenile justice system and expand to address the unique needs of the transitioning DJJ population. This includes:
- local agency partners, such as physical and behavioral health, child welfare, community providers, courts, probation, education, regional centers, as well as youth, family members, peers, and other youth advocates.
- The State DJJ. Note: if not currently underway, processes should be established to transfer the records of transitioning DJJ youth to local agencies, including probation, health care (Medi-Cal Managed Care Plans), behavioral health, child welfare and appropriate education agencies.
- Ensuring that all youth who are involved in the probation system are screened and assessed for behavioral (e.g., anger management), physical health, behavioral health (i.e., mental health and substance use disorders), trauma (e.g., screening for Adverse Childhood Experiences), as well as criminogenic risk and needs.
- Ensuring that comprehensive, individualized treatment plans are developed to address behavioral, physical health, behavioral health and criminogenic needs, and that all relevant agencies collaborate with the youth and their families, as appropriate, on the identification of treatment goals and recovery, and coordinate on the provision of treatment, as mandated by the Child and Family Team model of care. Criminogenic needs should be addressed using the Risk-Needs-Responsivity (RNR) model.
- Ensuring capacity at all levels of care, including short-term crisis residential treatment options for children/youth requiring intensive treatment.
- Implementing evidence-based practices and programs, as available, and ensuring that all care provided is trauma-informed and based on recovery-oriented practices and service delivery.
- Seeking to identify and develop strategies to address disparities, with a focus on racial justice and race-based trauma. Current efforts, such as the DHCS/California Department of Public Health (CDPH) Community Mental Health Equity Project and Board of State and Community Corrections (BSCC)’s Title II Grant Program: Identifying Effective Interventions and Replicable Strategies for Reducing Racial and Ethnic Disparities, should be leveraged to support this work.
- Leverage peers to support connection and engagement in behavioral health services and interventions to address criminogenic needs.
- Selecting a manageable number of initial, core system-level process and outcome metrics to establish a baseline and track progress in key domains over time. Additional metrics may be added once the core metrics are well-established.
- Leveraging model practices established by DJJ, particularly for youth who would have been remanded to DJJ but will realign to county probation departments.
- Partnering with existing DJJ treatment providers that have established success with treating the juvenile justice population, particularly for youth who have committed serious and/or violent offenses.
- Engaging system partners in strategic planning to improve the existing local juvenile justice system and expand to address the unique needs of the transitioning DJJ population. This includes:
To assist with these efforts, CCJBH shall:
- Seek opportunities and resources to support county justice, behavioral health, education and regional center partners in the identification and implementation of strategies for best serving youth with greater behavioral health needs being realigned to county probation departments.
- Establish a partnership with the Office of Youth Community Restoration (OYCR), and serve as a resource and liaison between County Behavioral Health Directors, local probation departments and youth & family networks.
- Work with State and local partners (e.g., Chief Probation Officers of California (CPOC), County Behavioral Health Directors Association of California (CBHDA), the Department of Health Care Services, and the California Health and Human Services Agency (CHHS)’s Office of Youth and Community Restoration) to develop a strategy to ensure that all youth who are involved in the juvenile justice system are screened for trauma by their health care provider (Managed Care Plan or Fee-for-Service provider), and that the results of their trauma screening are addressed in their behavioral health treatment plan.
- Better understand capacity to provide services at higher levels of care and conduct, in partnership with key stakeholders and providers, an assessment of short-term crisis residential treatment capacity for juveniles as an alternative to juvenile hall. CCJBH can continue to research this area of interest, including current efforts with Continuum of Care reform and the SMI/SED Demonstration that is part of the CalAIM proposal.