Diversion First: Diversion-Oriented System of Care Stakeholders Update: Oct. 17, 2016

1. Diversion-Oriented System of Care
Stakeholders Update
October 17, 2016

2. Tonight’s Agenda
• Good News Announcements
• Data & Evaluation Team + Workforce
Development
• Court Services Launch
• Updates from the CSB
• Communications Team
• Leadership Group
• Expanding focus in 2017
• Public Comment
• Other announcements and discussion
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3. New Initiative Participation
The Honorable Sharon Bulova
Chairman, Fairfax County Board of
Supervisors
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4. White House Data Justice Initiative
• Fairfax County signed on to this initiative!
– One of three localities in Virginia
– 120 total in USA
– Announced nationally on October 13
– This initiative will provide ongoing technical
assistance to our diversion efforts
4

5. 5
White House Data-Driven Justice Initiative

6. Recognition
Tisha Deeghan
Executive Director
Fairfax-Falls Church CSB
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7. Gary Ambrose:
Winner Winner!
Gary Ambrose, 2016 Joseph V. Gartlan Award for Leadership and
Advocacy recipient from the Virginia Association of VACSBs
• Chairman, Fairfax-Falls Church CSB
• Chair, Diversion First Stakeholders Group
• Active member of NAMI of Northern Virginia and Concerned Fairfax
• And many, many more areas of involvement!
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8. Data and Evaluation Work Team
2nd Lt. Myrna Kinney, Sheriff’s Office
Lt. Ryan Morgan, Police Department
Lisa Potter, Community Services Board
Deputy Chief Jason Jenkins, Fire and Rescue

9. Diverted from Potential Arrest
Instances in which law enforcement officers diverted individuals
from arrest and provided an opportunity for mental health
services
In the first nine months (Jan. 2016-Sept. 2016):
• 1,164 people were transported by law enforcement to
Merrifield Crisis Response Center.
• 294 or 25% had potential criminal charges but were diverted to
mental health services.
• Includes both voluntary and ECO
• Working on a process to quantify broader diversion rate and
include those arrested in the community
• On average, 35% of all LEO transports to the MCRC involved a
CIT trained officer
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10. Data Snapshot
10
Jan-Mar.,
2016
April-June,
2016
July-Sept,
2016
TOTAL
Jan-Sept,
2016
Police Department
Mental health investigations in the field
– Fairfax County Police Dept. 831 916 900 2,647
- Resolved in the field (Fairfax County)1 471 505 479 1,455
- Involved Merrifield Crisis Response Center
(MCRC) for all jurisdictions2
360 411 393 1,164
Merrifield Crisis Response Center/Emergency Services
Total service encounters 1,296 1,380 1,170 3,846
– General Emergency Services (non-law enforcement
involved)
936 969 777 2,682
– Involved Law Enforcement 360 411 393 1,164
- Voluntary transports to MCRC 158 141 127 426
- Emergency Custody Order (ECO)
transports to MCRC
202 270 266 738
Diverted from potential arrest 103 106 85 294
Unduplicated number of people served at Emergency Services 1,742
Mobile Crisis Unit3
– Total number of services (attempts and contacts) 319 361 415 1,095
- Total number of services (contacts) 215 242 294 751
– Services with law enforcement involvement or referral 79 126 148 353
Unduplicated number of people served (contacts) 408
Office of the Sheriff
– Temporary Detention Orders (TDOs) from Jail 3 13 9 25
– Transports from MCRC to out of region MH hospitals 26 37 28 91
– Jail transfers to Western State Hospital (forensic) 5 2 6 13
1 Officer dispatched and provided a services; no further action required
2 Jurisdictions include (Cities of Fairfax & Falls Church, Towns of Herndon & Vienna, George Mason University, Northern Virginia Community College, Virginia State Police)
3 One Mobile Crisis Unit until Sept. 2016

11. 126% increase in ECOs
from 2015-2016
11
0
100
200
300
400
500
600
700
800
1st Q 2nd Q 3rd Q Total
74 126 126
326
202
270 266
738
ECO 2015 - 2016 Comparison
2015 2016

12. MCRC- ECO
Exchange of Custody
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13. Crisis Intervention Team Training
and Mental Health First Aid
Crisis Intervention Team (CIT) Training
• Graduates since September, 2015 – 217 total (18% of patrol offices
trained
• Dispatcher training - 38 trained
• Coordinating additional classes
Mental Health First Aid (MHFA)
Trained to date:
• Deputies – 211 (approx. 50%)
• Magistrates – 30 (100%)
• Juvenile Intake Officers – 23 (100%)
• Fire and Rescue- adaptation of MHFA curriculum (120 trained to
date)
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14. Sheriff’s Office Data
Jan-Sept. 2016
• Temporary Detention Orders (TDOs) from jail- 25
• Includes those with mental health issues who would be
better served in a psychiatric hospital
• Transports from MCRC to out of region psychiatric
hospitals- 91
• Transport requires 2 deputies, at least one CIT-trained
• Jail transfers to Western State Hospital
(forensic)- 13
• Individuals taken to jail (not bonded out) but need
hospitalization due to decompensation
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15. Sheriff’s Office
• Analyzing data to determine prevalence rates for serious
mental illness
– Benchmarking national rates
– Determine change in these rates over time
• Reviewing data on individuals with serious mental illness
who are incarcerated to identify demographics, recidivism,
charges, and treatment linkage
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16. Progress and Next Steps
• Conducted research for program evaluation data
measures and benchmarking with diversion programs
nationally
• Mapped process flow and data variables for jail,
magistrates and court services- other
intercepts/intervention points will be mapped next
16

17. Progress and Next Steps
• DIT and third-party evaluator actively involved with
data and evaluation efforts; CSB position to manage
and analyze data and evaluate diversion efforts coming
soon
• Team is participating in White House Data-Driven
Justice Initiative
• Planning a pilot to develop the framework for cross
system long-term outcomes
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18. General District Court
The Honorable Michael Cassidy,
Chief Judge
Rusty Hefner, Court Services
Gene Whitlock, Court Services
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19. Research
Early Identification and Intervention
• Local jurisdictions and courts
in Pennsylvania, Maryland
and The District of Columbia
• National Institute of Justice
• Substance Abuse and Mental Health
Services Administration (SAMHSA)
• Fairfax Community Services Board
Only in Pre-Trial services, can Court Services impact all of the courts and allow for
early interception.
PRE-TRIAL SERVICES
Court Services

20. 20
Work Group Goals
(launched in March)
• Implement Diversion First Initiative at the Pre-Trial Stage
• Adapting our Pre-Trial program to meet the court’s needs.
• Utilize existing staff resources within Court Services’ Pre-Trial
Evaluation Unit
• Work within the framework of existing workflow and timelines

21. Court Services
Pre-Trial Evaluation Unit
• A single Probation Officer I is on staff 140 hours of a 168 hour work week.
• Evaluations are conducted on all qualified defendants held in the jail.
• Evaluation interviews last 30 to 60 minutes depending on the defendant’s
location within the jail.
• A typical interview consists of approximately 63 questions encompassing basic
demographics, employment, references, drug history, and criminal history.
• Risk Assessment – 40 questions
• Substance Abuse Assessment – 17 questions
• Financial Eligibility – 20 questions
• Additional Evaluations:

22. Initial
Mental Health Screening
A simple screening instrument will be administered to:
 Every defendant completing a jail evaluation.
 Every defendant placed into Pre-Trial Supervision that has not
previously completed a screening
The Brief Jail Mental Health Screen (BJMHS)
• An elementary instrument, deployable at the initial intake.
• Designed for use by staff with little to no mental health
training.
• Eight (8) Questions for use on male and female defendants.
• Less than 3 minutes to administer and score.
• Validated in a study of 10,330 inmates at 4 jails in NY and
MD.

23. BJMHS
Magistrate – Initial Judicial Review
General District Court
General District Court
J&DR District Court
Circuit Court
- Advisement Hearing
- Bond Motion
- Bond Appeals
A RECOMMENDATION WILL BE MADE FOR PLACEMENT INTO THE
SUPERVISED RELEASE PROGRAM (SRP) WHERE THEY WILL BE SUPERVISED
BY COURT SERVICES AND CONNECTED WITH MENTAL HEALTH SERVICES.
Jail Evaluators
Defense Counsel
Commonwealth Attorney
The Flow

24. The Next Step:
Advanced Screening
Administered to defendants placed into SRP who:
 Have Mental Health ordered as a special condition of release.
 Have scored a need for further assessment on the simple Screening.
 Administered at intake by a Probation Officer II with mental health
training and training on the administration of the advance screening.
 15 to 20 minute administration.
 A qualifying score on the instrument would indicate the need for a
mental health assessment.
Jackson Mental Health Form III Modified Mini Screen

25. CSB-
Mental Health Assessments
All cases placed on SRP with a special condition for mental health treatment will
be referred to the CSB, or to their pre-existing treatment provider.
and
All SRP cases where advanced screening indicates a need for a mental health
assessment will be referred to the CSB.
Ideally, within 48 hours of release, an SRP referred defendant will
have been screened, referred, and scheduled for an assessment or
ordered treatment.

26. Initial Screening
Pilot Data
July to present
– 59% reported a previous mental health diagnosis
– 42% were County Residents, 30% were Virginia(non-county) residents
– 22% were placed in the Supervised Release Program
 Of 3000+ arrestees, 900 defendants were eligible for interview by Court Services staff
and administered the BJMHS.
 300 (33%) of the defendants screened were identified by the BJMHS to need further
assessment.

27. Goals
 Evaluations for appropriate treatment can be initiated early and
monitored with community based supervision, leading to informed
disposition of criminal cases.
 Costs of incarceration and services can be mitigated by early
intervention.
 Identify defendants in need of mental health intervention.
 Through simple and advanced screening administered early after arrest
 With Pre-trial supervision submitting status reports to the court, CA & DA
 Allow Seamless transition from Pre-trial to Probation supervision
 Same specialized Probation Officer and setting

28.  Stronger collaboration and alignment with CSB to improve response time
for mental health and substance abuse assessments.
 Consideration of immediate CSB assessment (skipping CSB screening) of
all Court screened referrals and improved communication.
 Improved data sharing to enhance/target court and CSB service delivery.
 Strengthening/Building of private provider pool to provide services to
defendants assessed ineligible for CSB services.
 Consideration for additional suicidality screening.
Planning for the Future

29. CSB Updates
Daryl Washington
CSB Deputy Director
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30. CSB Updates
• Key positions hired
• Additional position hiring processes
• Permanent Supportive Housing Funds
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31. Communications and Public
Outreach Team
Presented by:
Rhiannon Duck, Supervisor Cook’s Office
Lindsey Doane, Chairman Bulova’s Office

32. Public Outreach
• Presentations scheduled for local groups that
may be interested in Diversion First
– Presented to Arc of Northern Virginia staff in Aug.
– Upcoming presentations scheduled:
• Arc of Northern Virginia member parents (Oct.)
• MVLE (Nov.)
• LTCCC (Nov.)
• Little River United Church of Christ (Jan. 2017)
• Considering community presentations open to all
• Interested groups may email
diversionfirst@fairfaxcounty.gov 32

33. Website
• Work continues on website, with news and
information added as needed
• New data page added
• FAQ page in progress
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34. Outreach Materials
• One-page info sheet developed
• Video outlining how to request
a CIT-Trained first responder
scheduled
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35. Moving Forward
• Small communications team workgroups
focusing on specific areas:
– Outreach and Presentations
– Website Updates and Maintenance
– Hotline Consolidation and Education
– Internal Communications and Wordsmithing
35

36. Leadership Group
Dave Rohrer
Deputy County Executive
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37. Leadership Group
• Development of problem-solving team
– Core members
– Ad hoc members
– Method for public to reach out to this group will
become available through website later this year
• Budget
• Ongoing regular meetings and commitment
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38. Coming in 2017:
Continue with intercept 1 with focus
on Expanding to Intercepts 2 and 3
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Intercept 2- Initial detention and court involvement
Intercept 3- Courts and jail
Sequential Intercept Model

39. Public Comment
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40. Other updates, announcements,
discussion
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41. Next Stakeholders Meeting
January 19, 7-9 p.m.
Reviewing our first year progress and
previewing Year 2 priorities
Government Center
Rooms 9 & 10
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