New York State Division of Criminal Justice ServicesLaw Enforcement/Mental Health

Crisis Response SummitJune 25-26, 2009

Leon Evans, President/CEOThe Center for Health Care Services

Mental Health Authoritywww.chcsbc.org

levans@chcsbc.org

A Systems Approach to Crisis Care:Outcomes Based, Community Driven

Collaboration: It’s an unnatural act between…

…two or more unconsenting adults.

Law EnforcementDetention/Jail

CIT

Judicial/CourtsMagistrate, County, District

Mental HealthPublic and Private

Providers

Crisis Care CenterJail DiversionPsychiatric and Medical

ClearanceSpecialty Offender Services

CommunityDynamicCrisis Jail Diversion

Information Exchange

Pol

ice,

She

riff

Pro

batio

n, P

arol

e

Civil and CriminalT

reatment

Continuity of C

are

County City-wide

Emergency Services

Data exchange through• Community Collaborative• Crisis Care Center • CIT/DMOT• Jail and Juvenile Detention• Statewide CARE Match

System County City-wideEntry Points

System Level

Point of Contact with Law Enforcement

Magistrate Court

Bexar County Jail

Post-Booking Diversion

Community-based Wraparound Care

CIT/Deputy Mobile Outreach

Team

Genesis Probation, Incarceration,

Parole

Emergency Transport to

Hospital

Pre-Trial Diversion

Referrals to Community Providers

*Pre-Arrest Diversion

Residential Respite

Arrested

The Diversion ProcessThe Diversion Process

Treatment in lieu of Incarceration

24/7 CrisisServices

Crisis Care CenterLaw Enforcement Services

• 24 / 7 Operations

• Medical Clearance

• Psychiatric Services

• Administrator on Call

Then (prior to Sept 2005)• Wait times for Medical Clearance/ Screening at UHS ER - 9 hours, 18 min.

• Wait times for Medical Clearance/ Screening and

Psychiatric Evaluation was between 12 and 14 hours.

Now• The wait time for Medical

Clearance/ Screening at the Crisis Care Center is 45 minutes.

• Wait time for Medical Clearance/Screening and Psychiatric Evaluation is 60-65 minutes.

Impact on WAIT TIME for LAW ENFORCEMENT

Jail Diversion Initiatives

Pre-Trial Services

Mental Health BondInvoluntary Outpatient

Commitment

Genesis – Manos Programs

Parole & Probation Referrals

Omega Program

Intensive 90 day residential probation Court Ordered Program

Palo Alto Forensic ACT Team

24/7 Intensive psychiatric services

CHCS Service Units within CHCS Service Units within the Modelthe Model

The Deputy Mobile Outreach Team – Mental health professionals accompany an MH

trained Deputy Sheriff to calls from the community for assistance involving the mentally ill and the mentally retarded.

CHCS Service Units within CHCS Service Units within the Modelthe Model

The Crisis Intervention Teams (CIT) – Officers trained by Law Enforcement

and Mental Health Personnel via a 40 hour curriculum including role play demonstrations. Attends weekly operational

meetings with MH and Community Stakeholders.

Additional Community Initiatives• CIT Training (40 hours)

• Children’s CIT Training for School Based Officers

• Children’s CIT Administrator Training (School Dist)

• CIT Committee Biweekly

• Community Resource Coordination Group

• Central Magistrate Committee Monthly

• Central Jail Population Committee Monthly

CHCS Service Units within the CHCS Service Units within the ModelModel

Magistrate Screening Program – Addresses the assessment and referral needs of the magistrate before booking and incarceration.

Involuntary Outpatient Commitment Program - On site court assigned case manager liaison monitors IOPC and works directly with Judges

Competency Restoration Program – Restores competency and works to reduce extended jail and State Hospital stays

CHCS Service Units within CHCS Service Units within the Modelthe Model

The Pre-Trial Services Program –Obtains release from jail through a mental health bond (which is free to the consumer) and provides referral with transportation from jail to designated treatment facilities. Reviews and assesses CARE Match daily arrest activity with linkage at release and follow-up.

The Mental Health Court – This docket is the combined efforts of the criminal courts, probation and mental health personnel to advise the court on consumer assessment, treatment and continuity of care. Court ordered referral is direct to intensive case management.

CHCS Service Units within CHCS Service Units within the Modelthe Model

The Genesis Special Needs Offenders Program This unit provides intensive case management, psychiatric services and rehabilitation training for offenders on probation and parole in collaboration with local and state probation and parole departments.

Provides treatment for 60 (MI) and 200 bed (Substance Abuse) residential units operated by Bexar County Probation Department

Genesis

Omega Manos

ProbationProbationers within Mentally Impaired Facility

Client Court Ordered

PrisonParole

Genesis - TCOOMMI

Omega – TCOOMMI, CJAD, CHCS

Manos - AstraZenica

POST DIVERSION CLINICAL EXPANSIONPalo Alto

Combined Substance Abuse and MH Services

FundingSource

Forensic ACTSubstance Abuse

Treatment Facility

Probationers within SA Treatment Unit

FundingSource

Bexar County Treatment FacilityTreatment Alternative to Incarceration Program

Substance Abuse Services

Public Safety Triage Facility

Restoration CenterGrand OpeningApril 15th, 2008

• Detox Facility• Community Court• Outpatient Substance Abuse Services

The MAPThe MAP

CHCS Urgent Care Center (2)Emergency Psychiatric Screening

County Jail (6)

Community MedicalClinic (1)

CHCS Detox Center (3)

CHCS Substance Abuse Outpatient Services (5)

600 Bed HomelessResidential Facility (4)

Haven for Hope

The Community Wide InitiativeHaven for Hope and CHCS

collaborationGoal:

To increase the community capacity for mental health, substance abuse and

detoxification services

Veteran’s Services

Multiple Collaboratives/Initiatives for Veterans based in Bexar County

• The San Antonio Veteran's Affairs Commission • The Military Coordinating Council for Behavioral Health• The Bexar County Veterans Service Office • Texas Resources for Iraq-Afghanistan Deployment, United Way• The Bexar County Veterans Service Office • Family Strong Advocacy

Toolkit

The Center for Health Care Services

Leon Evans, President/CEOThe Center for Health Care Services

Mental Health Authoritywww.chcsbc.org

levans@chcsbc.org