CCJBH Council Meeting – January 29, 2021

CCJBH January Council Meeting
Friday, January 29, 2021
2:00 PM – 4:30 PM
Zoom Meeting

Meeting & Call in information

Register in advance for this webinar:

Attendees:

Registration Link

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To join this meeting by phone:

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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 December Meeting Minutes

• Brenda Grealish, Executive Officer, Council on Criminal Justice and Behavioral Health (CCJBH)
  *****PUBLIC COMMENT********

III. 2:20                UPDATE: ISMIP Program Transition

• Robert Storms, Associate Director, Division of Adult Parole Operations (DAPO)

• Q&A Discussion with Council Members
  *****PUBLIC COMMENT********

IV. 2:30 PM         CSG Housing Project

•  Hallie Fader-Towe, Director, Behavioral Health, Council on State Governments (CSG)

• Q&A Discussion with Council Members
  *****PUBLIC COMMENT********

V. 3:00 PM         CCJBH Business Meeting

1. Governor’s Budget Highlights
2. Overview of 2021 CCJBH Work Plan
3. Voting items:
   • JJ Toolkit RFP
   • Diversion RFP
4. Behavioral Health / Criminal Justice Data Reporting
   • 2025 Goals
     1. Review 2020 Legislative Report Data
     2. Update on the Public Health Meets Public Safety Project
     3. Update on the Medi-Cal Utilization Project
   • Discussion: Measuring Goals #2-4
5. LEP Status Update
6. Legislation

VI. 4:25 PM    Announcements/ Public Comment

** Written feedback can also be sen in to: CCJBH@cdcr.ca.gov **

Upcoming Meetings

Juvenile Justice Workgroup – Friday, March 12   1-3PM

Diversion/Reentry Workgroup  – March 19   1-3PM

Council Meeting
Friday, April 30, 2021  2-4:30PM

VII. 4:30 PM   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, monica.campos@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: CCJBH Council Meeting December 11, 2020.

Governor’s Proposed State Budget 2021-22 Snapshot

Areas of Interest in the Intersection of Criminal Justice & Behavioral Health Systems

Below are excerpts from the Governor’s proposed budget. To review the full proposed budget summary and related information for 2020-21 visit: http://www.ebudget.ca.gov/.

Since the 2020 Budget was enacted, the economic outlook and revenue forecast have improved. However, risks to the forecast remain higher than usual. Economic inequality has intensified since the pandemic began, and the pandemic exacerbated California’s already existing housing crisis.  Although the budget projects a surplus in Fiscal Year 2021-22, shortfalls are projected for 2022-23, 2023-24, and 2024-25, making fiscal resiliency critical to protect programs in the future.

Key Elements of the $227.2 Billion Proposed Budget:

• Advances investments to improve access to health care, quality education, child care, and economic security
• Reflects a $34 billion budget reserve and surplus that includes:
  • $15.6 billion in the “rainy day” fund for fiscal emergencies
  • $450 million in the Safety Net Reserve
  • $3 billion in the Public School System Stabilization Account
  • $2.9 billion in the State’s operating reserve
• Proposes multiple investments in economic recovery:
  • $2.4 billion Golden State Stimulus Package – a $600 payment to low income workers who received the Earned Income Tax Credit in 2019
  • $1 billion in support for small businesses – $500 million for a COVID-19 Relief Grant Program, $550 million for impacted small businesses and non-profits and $25 million for the smallest impacted cultural institutions
  • $8 billion in housing resources and $2 billion in homelessness resources – $500 million one-time for infill infrastructure, $500 million in low-income tax credits and $1.7 billion one-time funding to purchase additional motels, develop short-term community mental health facilities and purchase or preserve housing dedicated to seniors
  • $1.2 billion ($557.6 million General Fund) in support for increases to the Minimum Wage, to $14 per hour on January 1, 2021 and $15 per hour on January 1, 2022
  • Extension of Eviction Protections in AB 3088 and allocating an estimated $2.6 billion in federal relief funds to low-income tenants
  • $2 billion immediate funding to support California schools to safely bring students back to the classroom and increase educational opportunities, including $4.6 billion to extend learning time through summer school programs and other learning strategies and additional educational investments for transitional kindergarten and for California colleges (Community Colleges, UCs and CSUs)
  • $777.5 million for a California Jobs Initiative to provide incentives that focus on job creation and retention, regional development, small businesses, and climate innovation
  • Climate Change, including advancing zero-emission vehicle goals
  • Preventing and Fighting Wildfires
• Although the federal COVID-19 Relief will provide much-needed support in the beginning of 2021, more federal relief is needed to mitigate the continued impact of the pandemic.

The 2021-22 State Budget Proposes Investments to Address the Impacts of the Pandemic with a Focus on Continuing and Strengthening Housing/Homelessness, Education and Health Care Investments

Proposed Spending by Agency/ Departments of Interest to CCJBH:

I. Health and Human Services

The budget includes $195.1 billion ($64.3 billion general funds and $130.8 billion other funds) for all health and human services programs (does not include all pandemic response costs). New and significant proposals include:

• Addressing Behavioral Health
  • Student Mental Health
    • $400 million in one-time funding to implement an incentive plan through Medi-Cal managed care plans, in partnership with county behavioral health departments, to increase the number of students receiving preventative and early intervention behavioral health services by schools.
    • $25 million one-time Mental Health Services Fund, available over five years, for the Mental Health Services Oversight and Accountability Commission to augment the Mental Health Services Act Partnership Grants between county behavioral health departments and school districts.
  • Strengthening County Behavioral Health
    • Mental Health Services Act:
      • One-year extension on the flexibility to allow counties to spend down their Prudent Reserves without requesting authority from the State.
      • Authorizes counties to spend funds within the Community Services and Supports program component regardless of category restrictions.
      • Allows continuation of existing, approved Three-Year Program and Expenditure Plans if a new plan is delayed due to the PHE.
    • Expanding the Behavioral Health Continuum of Care by providing $750 million one-time General Fund to be administered by DHCS through competitive grants to counties to acquire and rehabilitate real estate assets.  See Department of Health Care Services section below for more details. 
  • 1991 and 2011 Realignment revenues, which are funded by sales tax and vehicle license fees, are projected to increase by 5.6 percent from 2019-2021 and decrease by 1.9 percent from 2020-21 to 2021-22.
• Additional key budget areas for California Health and Human Services Agency (CHHSA or Agency) include:
  • Making Health Care More Affordable
  • Establish an Office of Health Care Affordability
  • Utilizing Health Information Exchange
  • Improving Health Equity
  • Addressing Aging in California

a. Department of Health Care Services

• The Medi-Cal budget is $122.2 billion ($28.4 billion General Fund) in 2021-22. The Budget assumes that caseload will increase approximately 11.7 percent from 2020-21 to 2021-22. Medi-Cal is projected to cover approximately 15.6 million Californians, nearly 40 percent of the state’s population, in 2021-22.

• $1.1 billion in 2021-22, to grow to $1.5 billion in 2023-24, to fund California Advancing and Innovating Medi-Cal (CalAIM), which was first introduced in late 2019, but was delayed by one year due to the COVID-19 public health emergency. The proposed budget offers several promising proposals:
  • Funding for enhanced care management and in lieu of services, which are services that would reach and serve individuals in the intersection of behavioral health, criminal justice and homelessness.
  • Phased-out funding to support necessary infrastructure so successful models like Whole Person Care can be implemented on a statewide basis.

• $750 million in county Behavioral Health Continuum of Care infrastructure build-out competitive grants, funded in part through a reallocation of county jail bonds in order to purchase or modify community mental health facilities.
  • DHCS will provide competitive grants to counties for the acquisition and rehabilitation of real estate assets to expand the community continuum of behavioral health treatment resources.
  • Improves the comprehensive continuum of services by providing short-term crisis stabilization, acute needs, peer respite, and other clinical enriched longer-term treatment and rehabilitation opportunities for persons with behavioral health disorders in the least-restrictive and least-costly setting.
  • The Administration estimates that this proposal will result in the addition of at least 5,000 beds, units or rooms. 
  • These community resources are needed to address individuals experiencing a crisis and are a critical component of an overarching framework to solve and not just mitigate homelessness.
  • Broadens the range of Medi-Cal services provided through CalAIM and the Serious Mental Illness / Serious Emotional Disturbance Waiver in order to reduce homelessness, incarceration, unnecessary hospitalizations, and inpatient stays by appropriately utilizing community-based models of care.
  • Infrastructure is critical to make outpatient treatment options more widely available and to help counties treat individuals in less restrictive, community-based, residential settings of care.
  • The Administration is also exploring repurposing relinquished jail financing to add to this effort (there is currently $202 million available for allocation).

• $94.8 million to make permanent certain PHE telehealth flexibilities, and to add remote patient monitoring as a covered benefit, effective July 1, 2021. 

b. Department of Social Services

• The Budget includes $36.2 billion ($14.4 billion General Fund) for DSS programs in 2021-22.

• $61.1 million to support implementation of Part IV of the Families First Prevention Services Act, which establishes new criteria for non-foster home placement settings eligible for Title IV-E Foster Care maintenance payments.

• Delay/suspend programs addressing various children’s issues, including the Family Urgent Response System, for which the implementation date will be moved from December 31, 2021, to December 31, 2022. The delays/ suspensions will be lifted if the Administration determines through the 2022 Budget Act process that there is sufficient General Fund revenue to support all suspended programs.
• $5.2 million one-time funding allocated in December 2020 by the Administration and Legislature to support youth transitioning back to California from out of state placements, which supports county capacity building to deliver supportive services upon their return, COVID-related costs, and technical assistance costs to support counties with placements.
• $250 million one-time General Fund to counties for the acquisition or rehabilitation of Adult Residential Facilities and Residential Care Facilities for the Elderly with a specific focus on preserving and expanding housing for low-income seniors who are homeless or at risk of becoming homeless.

c. Department of State Hospitals

• The Budget includes $2.5 billion ($2.3 billion General fund) in 2021-22. The patient population is expected to reach 6,361 by the end of 2021-22, including patients receiving competency treatment in jail-based settings.

• The Department of State Hospitals (DSH) will implement a Community Care Demonstration Project for felony Incompetent to Stand Trial (IST) individuals, which includes $233.2 million General Fund in 2021-22 and $136.4 million in 2022-23 and ongoing for three counties to provide a continuum of services to felony ISTs in the county as opposed to state hospitals.  This proposal seeks to demonstrate the effectiveness of streamlining services to drive improved outcomes for individuals with serious mental illness.  This proposal is projected to serve up to 1,252 ISTs in the county continuum of care settings in 2021-22.  
• Expansion of Community Based Restoration (CBR) – The budget includes $9.8 million General Fund in 2020-21, $4.5 million General Fund in 2021-22 and $5 million General Fund in 2022-23 and ongoing to expand the current Los Angeles County CBR program beginning in 2020-21 and establish new CBR programs in additional counties in 2021-22.  This proposal is projected to increase capacity by up to
  250 beds in 2021-22.
• Reappropriation and Expansion of the IST Diversion Program –
  $46.4 million one-time General Fund, available over three years, to expand the current IST Diversion program in both current and new counties.  Additionally, the Budget includes five-year limited-term funding of $1.2 million General Fund annually to support research and administration for the program.  Further, the Budget authorizes the reappropriation of existing program funds set to expire in
  2020-21.
• Expansion of the Jail-Based Competency Treatment Program – $785,000 General Fund in 2020-21 and $6.3 million General Fund in 2021-22 and ongoing to expand the Jail-Based Competency Treatment program to seven additional counties.  This expansion is estimated to increase capacity by up to 31 beds in 2021-22.
• Forensic Conditional Release Program (CONREP) Mobile Forensic Assertive Community Treatment (FACT) Team – The Budget includes $5.6 million General Fund in 2021-22, $8 million General Fund in 2022-23 an 2023-24, and $8.2 million General Fund in 2024-25 and ongoing to implement a FACT team model within CONREP, in lieu of the typical centralized outpatient clinic model, to expand community-based treatment options for both ISTs and non-ISTs in counties and backfill State Hospital beds with IST patients.  This expansion is estimated to increase capacity by up to 100 beds in 2021-22.
• CONREP Continuum of Care Expansion – The Budget includes $3.2 million General Fund in 2020-21 and $7.3 million General Fund in 2021-22 and ongoing to increase the step-down capacity in the community in order to transition more stable non-IST patients out of state hospital beds and backfill state hospital beds with IST patients.  This expansion is estimated to increase capacity by up to 40 beds in 2021-22.

d. Other Health and Human Services Adjustments

• Office of Youth and Community Restoration $3.4 million General Fund in 2021-22 and $3.1 million ongoing General Fund to develop reports on youth outcomes in the juvenile justice system, staff a Child Welfare Council committee focused on improving outcomes for justice-involved youth, and create an Office Ombudsperson.  The Division of Juvenile Justice is expected to close on June 30, 2023.
• Center for Data Insights and Innovation and Equity Dashboard – The Budget proposes to consolidate existing resources to establish a Center for Data Insights and Innovation within the Agency.  The Center will focus on leveraging data to develop knowledge and insights to improve program delivery and drive system transformation across health and human services. The Budget also includes
  $4.1 million ($3.7 million General Fund) in 2021-22 and $2.1 million ($1.6 million General Fund) ongoing for the Agency to further reorient the administration of its programs through the use of data and the development of an equity dashboard.

II. Public Safety

a. Department of Corrections and Rehabilitation

• $13.1 billion in total funding ($12.7 billion General Fund) for the department with an overall adult inmate average daily population of 122,536 projected in the 2020 Budget Act, and projected in the current Budget to be 97,950.
• $3.4 billion ongoing General Fund for health care services programs, which provide access to mental health, medical, and dental care that is consistent with the standards and scope of services appropriate within a custodial environment.
• The state will invest $546.9 million general funds for continued investments in rehabilitative programming that were established in the 2020 Budget Act and the necessary COVID-19 adaptations, including:
  • Reducing reception center processing timelines to allow inmates to begin participating in academic and rehabilitative programming sooner;
  • Changes to good conduct credits to provide greater incentives for inmates to engage in good conduct, such as participating in work and program assignments; and
  • Continuing the Youth Offender Rehabilitative Community at Valley State Prison to create an environment conducive to positive behavioral programming and targeted educational programs.

• $23.2 million General Fund in 2021-22 and $18 million ongoing General Fund for information technology to enhance access to rehabilitative programming, including the purchase of approximately 38,000 laptop computers for use by academic program participants, as well as the expansion of virtualization infrastructure, network bandwidth and the creation of a secure online academic portal that will allow students to complete curriculum outside of the classroom. 

• $21.2 million General Fund in 2021-22, decreasing to $16.1 million ongoing General Fund in 2024-25, to enhance staff development and support for creating safe, secure and rehabilitative prison environments.  These efforts will involve repurposing the former Northern California Women’s Facility into a new hands-on training facility and will focus on effective and realistic training. 
• $4 million General Fund in 2021-22, increasing to $11.6 million ongoing General Fund in 2023-24, to enhance quality management and patient safety by providing staff to evaluate risks and implement best practices to improve the health care delivery system. 
• $33.6 million General Fund over two years for roof replacement projects, $6.8 million one-time General Fund for health care facility updates and $50 million one-time General Fund to address specific deferred maintenance projects at the adult institutions that represent critical infrastructure deficiencies.
• $95.8 million and 665.5 position reduction in 2021-22, and a reduction of $126.9 million and 877.6 positions in 2022-23 and ongoing, to reflect the closure of Deuel Vocational Institution, which is anticipated to close by end of September 2021.
• As mentioned above, the Division of Juvenile Justice will stop the intake of wards on June 30, 2021, with limited exceptions.  The
  2021-22 estimated population is expected to be 729, a reduction of 126 compared to the spring projects, reducing costs by $10.1 million General Fund in 2021-22.  Note:  Pursuant to SB 823, the Board of State and Community Corrections will distribute $9.6 million one-time General Fund for 2020-21 for the Regional Youth Programs and Facilities Grant Program.  In addition, SB 823 included ongoing funding for the Juvenile Justice Realignment Block Grant for county probation departments to take over responsibility for youth who will no longer go to the DJJ, as follows:  $46.5 million General Fund in 2021-22, $122.9 million in 2022-23, $195.9 million in 2023-24 and $212.7 million ongoing beginning in 2024-25.

b. Judicial Branch

• $8.1 million general funds in 2020-21 and $15.5 million general funds ongoing to add court navigators at trial courts to assist unrepresented individuals with navigating the complexities of the court system.
• $12.3 million in 2020-21, increasing to $58.4 million ongoing General Fund to expand the pilot program that reduces fines and fees for eligible participants by at least 50 percent, allows them to make payments over a period of time statewide, and incorporate both traffic and non-traffic infractions.
• $20 million ongoing general funds from 2019 Budget Act to increase total dependency counsel state funding to $156.7 million to continue to invest and implement Federal Families First Prevention Services Act, which allows court-appointed dependency counsel costs to be a reimbursable activity under the federal Title IV-E funding stream. The Budget estimates $57 million in federal reimbursements, bringing the total amount available for dependency counsel in 2020-21 to
  $213.7 million.

c. Probation

• $50 million one-time General Fund in 2020-21 for county probation departments to support previous transitions, including juvenile and adult realignment, the SB 678 California Community Corrections Performance Incentive Act of 2009, and AB 1950 (for probation to provide enhanced services earlier in a the probation term to increase success), requesting that the Legislature take action on this funding in early 2021.
• $122.9 million ongoing General Fund for county adult probation to reduce or maintain low revocation rates due to the impacts of the COVID-19 Pandemic and AB 1950, which caps probation terms at one or two years, thus impacting revocation rates.
• $19.5 million one-time General Fund in 2021-22 for county probation to supervise the temporary increase in the average daily population of offenders on Post-Release Community Supervision as a result of Proposition 57. 

d. Other

• $114.8 million in Proposition 47 savings to be allocated according to a formula outlined in the initiative, which also requires 65 percent to be allocated for grants to public agencies to support various recidivism reduction programs such as mental health and substance use services, 25 percent for grants to support truancy and dropout prevention programs and 10 percent for grants for victims’ services.
• $25 million ongoing Proposition 98 General Fund to fund innovative partnerships with county behavioral health departments to support student mental health services.  This funding would be provided to local education agencies as a match to funding in county Mental Health Services Act spending plans dedicated to the mental health needs of students.

CCJBH December Council Meeting
Friday, December 11, 2020

2:00 PM – 4:30 PM
Zoom Meeting

Minutes

I.  Welcome & Introductions, Roll Call
 

Council Members Present:  Secretary Kathleen Allison, Stephen Manley, Stephanie Clendenin,

Tony Hobson, Mack Jenkins, Danitza Pantoja,Tracey Whitney, Jim Kooler (on behalf of Will Lightbourne)

Council Members absent:  Matthew Garcia

Staff Members Present:  Brenda Grealish, Executive Officer, Monica Campos,

Angela Kranz, Elizabeth Vice, Sara Dubay-Singh and Jessica Camacho

II. Approval of October Meeting Minutes

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

                 Minutes for approval 10-29-2020

Motion to adopt minutes made by Mack Jenkins, second by Judge Stephen Manley

Ayes: 8

Nays: 0

Abstentions: 1

Minutes were Approved.

*****PUBLIC COMMENT********

No Public Comment

                Brenda stated, as a reminder, the California State Auditor published a report on the Integrated Services

for the Mentally Ill Parolees (ISMIP) program and one of the recommendations was for the CDCR,

Division of Adult Parole (DAPO), to provide updates to CCJBH on the process of the transition, which segued into the first presentation.

III. UPDATE: ISMIP Program Transition

Robert Storms, Associate Director (A), Division of Adult Parole Operations (DAPO)

Robert Storms stated that the transition of the Integrated Services for the Mentally Ill Parolees (ISMIP)

Program, in eight different counties, was on track to be completed by December 31, 2020, as required

(budget funding only goes through December 31, 2020). The program had a capacity for 600 parolees

and was at approximately 40% at transition. Several participants were scheduled to transition to the county services by Dec. 31, 2020. Those getting housing subsidies from DAPO would get housing subsidies for January 2021 (paid out in Dec 2020).

Mr. Storms gave an overview of ISMIP program participant’s options. Some choose not to partake in county services; some didn’t meet the bar of specialty mental health based on the screening provided by the county; some participants could move into other mental health services the county provides; and others could choose to stay with DAPO to receive transitional mental health outpatient services working with DAPO social workers and psychiatrists.  He said they are on track and that he will provide another update at the next Council Meeting.

Mr. Storms talked about the different screening and assessment tools used by various counties and how they are different from county to county.  For example, some counties use the Multnomah Community Ability Scale, which is a community functioning tool; and some use the LOCUS, Level of Care Utilization System, which includes psychiatric and addiction services. He expressed hope for a standardized screening and assessment tool that the Behavioral Health Directors Association and the counties approve. If there was a standardized screening tool, DAPO could adopt that tool to assess for pre-release (from prison) and better match individuals to services in the counties.

Mr. Storms also spoke about how DAPO is currently working with Los Angeles County on “test case conferencing”. They have selected parolees who have hard to manage symptoms, low functioning and have a mental health diagnosis. DAPO has been able to identify them and make a referral to the LA Department of Mental Health by getting various multi-discipline providers, such as county mental health providers, DAPO behavioral health, DAPO Parole Agents and other program providers within the county system, bringing many resources together on conference calls to determine what would be the best next step for these individuals, and to try to move them into the appropriate system of care. He reiterated that this is just in the testing mode at this time.

Mack Jenkins, Chief Probation Officer (Retired), San Diego County, asked Mr. Storms to re-state the purpose of the standardized tool, what it is used for and discuss what the intended outcome of the application of the tool.

Robert Storms stated the standardized tool is to determine what level of care is best for an individual, especially on an outpatient level.  The primary purpose is for matching parolees to specialty mental health for Medicaid purposes. Also, to see if parolees meet the criteria, so they can get the services they need, and if there can be some federal draw-downs associated with the level of care.

Mack Jenkins asked if the level of care involves hospitalization or level of intensity of services.

Robert Storms confirmed that the standardized tools can be used for both levels of care – for all those outcomes.

For example, Santa Clara County is now in the process of reworking their screening/assessment tools, leading to hospitalization and higher intensity services.

Judge Stephen Manley, Santa Clara County Superior Court Judge asks, Who is funding all of this? If someone needs crisis residential treatment, who is actually paying for that?

Robert Storms said that there is a pool of different funding sources, such as General Fund dollars, Mental Health Services Act (MHSA) dollars, and Medicaid (Medi-Cal) Specialty Mental Health funds. These funds are available to anyone in the community (not just parolees).

Judge Stephen Manley asked Mr. Storms if he was aware of the challenges this places on counties to fund additional service to parolees without state funding?

Robert Storms said that he has heard about the challenges and he has seen letters from the Behavioral Health Director’s Association representing four counties. He agrees it is a strain on the funding for services, and not just for parolees, but for the overall population.

Judge Stephen Manley said that previously, CDCR was able to devote funding to pay for twenty residential beds in Santa Clara County and asked what has happened to that funding?

Robert Storms said the funding for Evans Lane which paid for the 20 residential beds was funded through ISMIP. Those beds will no longer be contracted/funded after December 31, 2020.

Judge Stephen Manley said that he would like to flag this topic for the Council. As counties are asked to do more in terms of providing treatment for the parolees, the counties are not receiving funding to meet the needs of the parolees. He would like to see more funding provided to the counties to meet the needs of parolees who are now going to be at the county level, in county treatment, and will be competing for limited mental health treatment slots with probationers, those who are in diversion and those who are pre-trial.

Judge Stephen Manley said that in his re-entry court in Santa Clara, he has been able to place parolees into county treatment slots, however, it becomes a great challenge not to be able to provide treatment for everyone else who needs it in the criminal justice system. He feels that the counties and CDCR need to work together to assess what the needs are at the county level to provide for the new population (of parolees) and present to the policymakers, the  legislation, and the governor, who make decisions about how funding is allocated for the state.

Robert Storms stated that we need to work faster together to integrate parolees into systems of care that benefit them while we have a team effort (CDCR, behavioral health and the counties), because as of July 1, 2021, parole periods are going to be shorter.

IV. Mental Health Services Oversight and Accountability Commission (MHSOAC)

Dr. Brian Sala, Deputy Director, California’s Mental Health Services Oversight and Accountability Commission

(Dr. Brian Sala is here on behalf of Dr.Toby Ewing Ph.D., MHSOAC Executive Director, who was scheduled to speak, but who was unexpectedly unable to attend.)

Dr. Brian Sala said that in spring 2020, the MHSOAC reaffirmed its commitment to providing mental and behavioral well-being for all Californians. The MHSOAC sees their mandate as very broad to advise the Governor and Legislature on all aspects of mental health policy, although much of their work focuses on community mental health. Dr. Sala briefly highlighted some MHSOAC initiatives currently underway, such as juvenile justice, reentry and prevention and diversion. He thanked Judge Manley for his collaborative work with the MHSOAC on diversion.   Dr. Sala spoke about a set of initiatives that the Legislature funded over the last two budget years to help kick start some strategies and to launch six multi-county collaboratives:

1. Data Driven Recovery Project – working with five counties to improve their capacity to link criminal justice and behavioral health data locally, and to analyze and utilize that link data for local decision making.
2. MHSOAC Data linkage Project – Link arrest data from the Department of Justice with behavioral health data in the Client and Services Information system from Department of Health Care Services to provide a thorough history of the justice involved.
3. Full Service Partnerships – Mental Health Services Act provides approximately $1.5 billion a year to counties for the Community Services and Supports component of the MHSA. 38% of that is reserved for Full Service Partnerships, which serves the individuals who have the highest mental health need, providing supportive housing, employment services and case management services. Preliminary data shows there is a 50% reduction in rate of arrests for justice-involved individuals who are in a Full Service Partnership.
4. Psychiatric Advanced Directives – working with three counties, focused on the individuals to have a re-statement and commitment into how they wish to be treated in an event of a mental health crisis.
5. Crisis NOW Model Project – working with nine counties on this project. It is about financial stability in crisis response systems.
6. Fiscal Sustainability Project – working with three counties assessing the effectiveness of interventions to reduce justice involvement (partnering with the Department of State Hospitals).

Brenda Grealish announced that the Council members received some MHSOAC handouts beforehand. CCJBH will post those materials on the CCJBH website after the documents are ADA compliant.

Q&A Discussion with Council Members

Mack Jenkins asked if the source of data was regional or statewide that described a 50% decrease in arrests with Full Service Partnerships.

Dr. Sala explained this data is statewide. They looked at the 12-month period before the individual participated in a Full Service Partnership and 12 months after disenrollment from a Full Service Partnership, and found that it appears there was a 50% reduction in arrests that span between 2008 through 2017-18.  They also found the reduced arrest rate was sustained after disenrollment by a rate of approximately 33%. He further explained more details on the project and stated more work still needs to be done.

Mack Jenkins commented that he was very familiar with Full Service Partnerships and how they are the primary treatment providers in the mental health courts in Orange County (and possibly, he suspects, in mental health courts statewide).  He stated that there is a lack of data to measure Full Service Partnership’s impact, so what Dr. Sala shared was certainly useful. He then asked if Dr. Sala could compare service delivery on juvenile wraparound services.

Dr. Sala stated MHSOAC does not have any data on juveniles at this time. They know there are Full Service Partnerships targeted to serve transition age youth, however this particular study did not address any data on juvenile justice. The data is about adult arrests. But, he suspects there is probably some comparability.

Judge Stephen Manley said he was very familiar with the Full Service Partnerships in his county, as well. He asked what percentage of MHSA funding (over 1 billion dollars) for Full Service Partnership slots, go to criminal justice clients vs non-criminal justice clients. 

Dr. Sala stated that he can give a definitive answer to that question – he doesn’t know.

Judge Stephen Manley asked if Dr. Sala could clarify his understanding on the requirements for counties to obtain MHSA funds.

Dr. Sala said the MHSA requires every county to prepare a Three-Year Community Program and Expenditure Plan and update that plan on an annual basis.  He said Brenda Grealish is very knowledgeable about this and might be better suited to have a conversation with him offline about past practices and the management of performance contracts.

Judge Stephen Manley commented how excellent the Full Service Partnership programs are and expressed his concern (and a concern of other judges) on having sufficient funding for the mental health services of the criminal justice clients and making them a priority.  He asked if the MHSOAC in the future will be looking into identifying how much MHSA funding and how many Full Service Partnership slots would go specifically to criminal justice clients.

Dr. Sala explained the challenges in filtering through data provided from the counties at this time. Hesaid the MHSA provides a lot of flexibility for counties to determine what their local needs and priorities are. There is a great deal of variability across the state in how counties have reported their expenditure plans and data. He said that it has been a challenge to get a standardized format in reporting data within the counties state-wide. Currently, they have to filter through 59 county mental health plans with 200 pages of text in PDF format. They are working with the counties to provide a standardized data template and hopes by next year, he would have an improved, standardized, data reporting process in place.

Judge Stephen Manley commented with a 50% reduction in recidivism, the investment in these Full Service Partnerships for the criminal justice population is yielding incredible good returns in comparison to other programs we have for the mentally ill who are justice-involved.

Dr. Sala said that it is at the top of his agenda to figure this out. He is working with a number of state agencies on data linkages to aggregate state-level administrative data and partner with the counties to fuel their ability to learn from each other.

*****PUBLIC COMMENT********

Alexandra Reyes: Are Transition Age Youth (TAY) considered 18-24 year olds? Adults are over 18, hence data should include TAY, correct?

Brenda Grealish stated that Transition Age Youth (TAY) includes 16 to 25 year olds.

Dr. Sala agreed TAY does include16 to 25 year olds. He said the law requires Full Service Partnerships to serve all age populations.

Shira Shavit: Interested to understand why you chose a pre/post model of evaluation.  Did you attempt to have a comparison group? If so, what type of barriers did you face?

Brenda Grealish clarified that Shira’s question pertains to the analysis of DOJ data.

Dr. Sala said that they did think a lot about their control group. This was just exploratory work to take advantage to link the data. He then gave an overview of different funding available through county grants and policy questions that need to be asked about the community of individuals with untreated, undertreated or properly treated mental health needs when they come in contact with the criminal justice system. He said there are a variety of strategies for addressing the criminal justice interface with individuals who have mental health needs.

  *****PUBLIC COMMENT********

No Public Questions

Secretary Kathleen Allison thanked Dr. Sala for his excellent presentation and expressed her appreciation for his time.

Dr. Tony Hobson, Ph.D., Behavioral Health Director, Plumas County expressed his appreciation to the Mental Health Services Oversight and Accountability Commission (MHSOAC) on the work they have been doing. His county benefited from the Data Driven Recovery Project. It showed them where their gaps were. They are also now part of the Crisis Now cohort. The MHSOAC has come up with innovative ways to respond to those in the community in crisis to get them out of jail and out of the hospital.

Dr. Sala expressed his appreciation for the opportunity to work with Dr. Hobson. He said that they are enthusiastic about partnering with Department of Health Care Services (DHCS) and with this Council (Council on Criminal Justice and Behavioral Health, CCJBH) to find ways to improve outcomes for Californians.

Brenda Grealish also thanked Dr. Sala and the work of the MHSOAC. She stated she is really looking forward to continuing this partnership between CCJBH and the MHSOAC.

V. ISUDT Program Presentation

Presenters: Lisa Heintz, Project Executive, CCHCS – Integrated Substance Use Disorder Treatment (ISUDT) program; Chris Carlson, Partner at GPS West, CCHCS – Integrated Substance Use Disorder Treatment (ISUDT) program; Janene DelMundo, Project Manager, CCHCS – Integrated Substance Use Disorder Treatment (ISUDT) program

Lisa Heintz gave an ISUDT Program overview and provided an update on the ISUDT Program including COVID-19 impact in 2020.

Chris Carlson provided an overview of pre-release and transition planning prior to and after the implementation of the ISUDT Program. He discussed transition services pathways with the individual county, and the services the county provides. He identified next steps:

1. High level “summits” to engage key county stakeholders, such as probation, behavioral health and health care.
2. Conduct a county-by-county assessment of organizational structure and services.
3. Refine transition protocols and procedures in the areas of:
4. Data sharing and flow for all stakeholders.
5. Refining Transition Service Protocols – maximize pathways to county services where possible.
6. Review and refine Division of Adult Parole Operations (DAPO) and Post Release Community Supervision (PRCS) transition services.

Secretary Kathleen Allison stated how impressed she was by the ISUDT presentation and with Chris Carlson. She commended Ms. Heintz for finding Chris.

Chris Carlson thanked the Secretary and said that this took 14 months of labor by a lot of people and especially Lisa Heintz, who was instrumental in bringing all the functions together.

Lisa Heintz stated they are a team of “all hands on deck”.

Q&A Discussion with Council Members

Judge Stephen Manley commended Ms. Heintz and her team for their effort. He suggested that she have the courts at the stakeholder table and make the courts a partner. He commented that the reentry courts in California perform a vital function to make sure parolees are connected to services, and the courts do not have access to vital data about the parolee.  He doesn’t know where the shared information is kept. For example, the Medication Assisted Treatment (MAT) information. He doesn’t know if CDCR has started people on Vivitrol or not. He has seen very good outcomes with Vivitrol. The parolee is sent to the courts, and the courts are left to figure it out without having the vital information needed. He asks for her team to consider the question: How can we bring parole (CDCR), probation (counties), and the courts together and include data sharing collaboratively. He urged Ms. Heintz’s team to expand their vision to include data sharing with the courts and make the courts their partner.

Lisa Heintz responded that there is a plan to talk to the counties and include the court system as an intercept area. She said that the team will make it a point to include an evaluation on the court system and address those gaps. They do have some data sharing agreements in place, however, they hope to have data sharing agreements with every county. She will present his request at the next CDCR internal planning and implementation team, which was scheduled for Friday, December 18, 2020.                                                                                                  

Mack Jenkins complimented Lisa Heintz and Chris Carlson because they were integrating and actually applying something that the CCJBH Council has been advocating for some time now. Mack suggested that when they engage with the probation officers, to tell them specifically and “assertively” what is needed from them. Don’t be nice. There are some things probation can do to facilitate a better outcome. Part of the key to successful reentry is reentry planning with multiple assessments, and that involves integrated case planning and (he stresses) collaborative case management. He gave an example of his probation work in San Diego and how they focused on Collaborative Case Planning and on responsivity needs to include housing, employment and continued support. He uses the term “support” instead of supervision purposefully. They would ask the individuals they were serving “What are we hitting on? What are we missing?, What else needs to be done?”  That is a really important part. Mr. Jenkins supports Judge Manley in incorporating the court involvement as part of the collaborative process.  He commended the work that Ms. Heintz’s team is doing has really helped the Council fulfill a mandate.

Brenda Grealish said that we have a specific mandate through the veto message of SB 369 to identify barriers to reentry and find strategies to overcome those barriers. The ISUDT Team, CDCR, Division of Rehabilitative Programs and DAPO have pieces. We as a Council support them.

*****PUBLIC COMMENTS FROM CHAT BOX********

Lee Gibson: Are the clients/patients considered stakeholders? Will they have input?

I agree with the Judge. We need a holistic look using all stakeholders input in order to create the best method of services. Great point Judge! It takes a village. 

Shira Shivat to Lisa Heintz: I am very enthusiastic to hear about the plan for a robust evaluation. Can you list the outcomes you are planning to measure? Have you had any success in linking data to Medicaid claims? Do you know how you are planning measure housing and employment outcomes?

Shira Shivat to Chris Carlson: Regarding support on the healthcare piece, the Transitions Clinic Network (which builds capacity of primary care clinics to care for people impacted by the CJ system – 21 sites across California currently). Would be happy to participate in the Transitions Work Group.

Abraham Preciado: Instead of making new organizations to fill the “Gaps”, are the current organizations that are helping the formerly incarcerated (parolees), such as Friends outside, Anti-Recidivism Coalition (ARC), Los Angeles Regional Reentry Partnership (LAARP), being considered for funding?

Anthony Garcia: Very imperative to encourage inclusivity with the court systems and stakeholders, so we all succeed in the efforts in making reentry healthier.

Kit Wall: Words to Deeds is most happy to assist in any way we can be helpful! Awesome work!

Brenda Grealish said there was a question on outcomes measures from the chat box (asked by Shira Shivat, see above). Ms. Grealish asked Ms. Heintz if it was possible to share a list of those measures.

Lisa Heintz said that she can share the outcome measures with the Council and the Council can distribute as needed. There are several fluid outcome measures that will be updated as they move through the process.

Brenda Grealish stated there has been talk about data linkages and they will be looking at Medi-Cal utilization.

Shawn Rowland said she was the founder of Our Road Prison Project. The Project does reentry work with people who spent multiple decades in prison. Thank you for the amazing work, and just want to reinforce the importance of documents, California Identification cards (Cal IDs), Social Security cards. I think it would be amazing to get Social Security cards while in prison; but, definitely don’t want to hold my breath on that one. But, I do think the closer we get to that, the better. So if people can get their birth certificate and Cal IDs…we can actually put an effort towards legislation that helps people in prison over 10 years to get their Cal IDs. And I feel like the more people who are advocates for us, the better. I think the frustration of the obstacles of getting documents really can lead to relapse, and all kinds of other difficulties. I don’t know if everyone’s is familiar with this, but right now, on the outside, you have to actually send in your original documents, you literally have to mail in your Cal ID. So, it is a pretty challenging process. The more we can get people to have any other documents prior to leaving prison, the better it is. I hope more people will be advocating. So, I really appreciate it being brought up and everyone will be advocating for more focus on documents while people are in prison.

Brenda Grealish thanked ISUDT Team for their presentation and for the foundational work they have done.

VI. CCJBH Business Meeting

              Presenter: Brenda Grealish Executive Officer, Council on Criminal Justice and Behavioral Health (CCJBH)

1. Legislative Report Recommendations

1.1 Juvenile Justice Recommendations

1.2 Diversion and Reentry Recommendations

Q&A Discussion with Council Members

Brenda Grealish stated that the Council and CDCR Division Partners have received and discussed all the Legislative Report Recommendations. She asked if the Council members had any thoughts, questions or feedback on any of the Juvenile Justice Recommendations.

Danitza Pantoja, PsyD, Coordinator of Psychological Services, Antelope Valley Union High School District asked to add the Department of Rehabilitation under (the Juvenile Justice Recommendations #4) state and local partners. She said a lot of those youth, because of mental health issues, may qualify for a disability, and we are talking about helping with job, career and schooling. So, the Department of Rehabilitation would be good partner, as most of them would qualify for an Individualized Education Plan (IEP) or 504 Plan.

Brenda Grealish asked if the Council members had any thoughts, questions or feedback on any of the Diversion and Reentry Recommendations. They had a lot of great recommendations on Diversion and Reentry.

Judge Stephen Manley asked if Ms. Grealish received the Council’s written recommendations.

Brenda Grealish replied that she did receive their great feedback and thanked them.

See Legislative Recommendations for both Juvenile Justice and Diversion and Reentry posted on CCJBH Website at CCJBH December Council Meeting – 2020 Legislative Report Recommendations

Brenda Grealish asked for a vote to adopt the 2020 Annual CCJBH Legislative Recommendations.  A motion was made by Judge Stephen Manley, with a second by Danitza Pantoja.

Ayes: 8

Nays: 0

Abstentions: 1

Motion was Approved.

*****PUBLIC COMMENT********

No Public Comment

        Brenda Grealish asked for a vote to delegate authority to the CCJBH Executive Officer to make updates to the report in order to meet the legislative mandate. A motion was made by Judge Stephen Manley, with a second by Danitza Pantoja.

Ayes: 8

Nays: 0

Abstentions: 1

Motion was Approved.

Judge Stephen Manley complimented Ms. Grealish and said she and her staff did a fantastic job in preparing the Legislative Report. He has been on the Council a number of years and he thinks this is the best report ever produced. He also thinks that it is due to Ms. Grealish’s leadership and said she deserves kudos from all of us for the work she has done.

Mack Jenkins applauded Ms. Grealish and agreed with Judge Manley.

Brenda Grealish thanked the Council for their feedback and said they gave her so much to work with.  She spoke on behalf of her CCJBH Team and said although the work is challenging, the work is our passion.

*****PUBLIC COMMENT********

No Public Comment

2.     A Year-in-Review

          Brenda Grealish reviewed the accomplishments of 2020.

3.    2021 Priorities

          Brenda Grealish reviewed the 2021 Priorities

          See CCJBH December Council Meeting – Meeting Presentation

4.   2021 Proposed Dates:  Council Meetings and Workgroups

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 (Friday) Call to adopt legislative report	Time TBD

       Q&A Discussion with Council Members

WORKGROUPS (Proposed Dates)
Juvenile Justice	Proposed Time
March 12 (Friday)	1:00 PM -3:00 PM
June 11 (Friday)	1:00 PM -3:00 PM
September 10 (Friday)	1:00 PM -3:00 PM
November 12 (Friday)	1:00 PM -3:00 PM
Diversion/Reentry
March 19 (Friday)	1:00 PM -3:00 PM
June 18 (Friday)	1:00 PM -3:00 PM
September 17 (Friday)	1:00 PM -3:00 PM
November 19 (Friday)	1:00 PM -3:00 PM

       *****PUBLIC COMMENT********

No Public Comment

VII. Announcements

Next Council Meeting

Friday, January 29, 2021 – 2:00 PM-4:30 PM

Q&A Discussion with Council Members

Mack Jenkins said there is a group we have not talked about yet – the victim community. By ignoring victims, we do a disservice as a Council.  Historically, the criminal justice system has also ignored crime victims and the impact on them. Victims have a voice and a recognized role. Mr. Jenkins said he will be more specific about it later. In probation work, they were responsible for collecting restitution on behalf of crime victims and he knows when that works well and when it doesn’t. Next year, as they move forward as a Council, they need to make sure they remember that there are victims who are impacted by criminals and delinquent activity that service is owed to.

Judge Stephen Manley agreed with Mr. Jenkins, particularly now in the courts since they are releasing thousands of offenders, and thousands are never brought to trial for months and months; and really have no specific way to have victim input other than through the efforts of the District Attorney. There has been less emphasis given to the importance of considering victims. For example, no one is paying attention to Laura’s Law. So many statutes are making it more difficult for victims to obtain restitution.  He stressed that we need to listen to victims and see where they stand on these issues. It is really important. He agrees completely with
Mr. Jenkins.

Brenda Grealish acknowledged Judge Manley’s and Mr. Jenkin’s comments, and said their comments were duly noted.

Secretary Kathleen Allison complemented Ms. Grealish and her staff and said how impressed she was with how Ms. Grealish manages the Council meetings and creates such beautiful products. She thanked
Ms. Grealish and her staff for all the work they do and thanked Ms. Grealish for her passion.

Brenda Grealish said it is her passion and thanked the Council. Ms. Grealish said her Team on the back end is excited.

Brenda Grealish announced the California Office of the Surgeon General issued a report “Roadmap for Resilience” on Adverse Childhood Experiences, Toxic Stress and Health”. It is available on www.osg.ca.gov. She urged those stakeholders who are interested to take a look at that report. In 2021, the Council will be looking through the lens of trauma and adverse child experiences and address disparities. Brenda noted that adverse childhood experiences is very relevant to CCJBH’s work.

*****PUBLIC COMMENT********

Daniel Bisuano made a comment: He wanted to challenge the thinking on victims and restitution. Ultimately, restitution committees and programs are designed for the community that is formerly incarcerated, but as a formerly incarcerated (person), I wanted to state that I, myself, am a victim. I’m the victim of society. I’m a victim of circumstances. I’m a victim of not being taught what is right and what is wrong as a child. So, for me when that is said (about considering the victim) I’m thinking in my head, well, I was on felony probation. I could not pay $8,000 dollars restitution. It also hindered me from doing things like getting jobs, employment and stuff like that. So when you guys, the committee and programs are focused on transforming the system; that you are more empathetic and therapeutic; leaving the victim out, means that you can focus more on How can we prevent people like me from committing crimes? Because ultimately, we don’t commit crimes because, “Oh, I just want to go hurt people.” We commit crimes because we are hungry; because we don’t know any better; because we weren’t taught how to go and live, you know?  Basically a productive life.

What was the point of probation.  Because of that, I was held back from achieving my goals and dreams because of restitution. Ultimately, the majority of the money is going to court fees, lawyers and government fees and stuff like that. So yeah, I just wanted to challenge your thinking on that because if we have a community that’s uplifting, there won’t be victims anyways.

Brenda Grealish thanked Daniel for his patience in waiting to make a comment and thanked him for sharing.

Daniel Bisuano says I don’t want to keep hearing the same thing over and over again because when I hear victim, I hear that the person on the other side is the victimizer and I’m definitely not a victimizer. I just made some mistakes in my life.

 *****PUBLIC COMMENT FROM CHAT BOX********

Alexandra Reyes: Yes, Allison – ACE.Yes, Daniel! Additionally, court ordered 52 week DV classes plus fines and fees! AB 1869 goes into effect July 1, 2021.

Anthony Baird: I wholeheartedly endorse Daniel’s point of view in the sense that 10 out of 10 offenders I encounter in the system were victims before they became offenders. We failed to recognize them as victims and provide relevant services, and so they progressed to becoming inmates.

VIII. Adjourn