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2005-563-Minutes for Meeting March 07,2005 Recorded 3/22/2005DESCHUTES COUNTY OFFICIAL NANCY BLANKENSHIP, COUNTY COMMISSIONERS' JOU NAL 00 -563 RECORDS CLERK 03/22/2005 10:03:36 AN DESCHUTES COUNTY CLERK CERTIFICATE PAGE This page must be included if document is re-recorded. Do Not remove from original document. Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org MINUTES OF MEETING LOCAL PUBLIC SAFETY COORDINATING COUNCIL MONDAY, MARCH 7, 2005 Commissioners' Conference Room - Administration Building, Second Floor 1300 NW Wall St.., Bend Present were Mike Dugan, District Attorney; Jacques DeKalb, Defense Attorney; Ernie Mazorol, Court Administration; Judge Michael Sullivan; Scott Johnson and Susan Battles, Mental Health Department; SheriffLes Stiles; Hillary Saraceno, Commission on Children & Families; Becky Wanless, Parole & Probation Department; and Roger Olson (of the County Road Department), President of NAMI (National Alliancefor the Mentally Ill). Also present were Anna Johnson, Commissioners' Office; Lt. Mike Whitney, dail; Steve Wellborn, Oregon Department of Corrections Chaplain — "Coming Home for Good" Program; Randy Johnson, BestCare; Tammy Baney, Commission on Children & Families'Board; Carl Rhodes and Tom Kipp, Oregon State Police; Bob Warsaw, Oregon Youth Authority citizens Pam and Bob Marble; and citizen representative Jack Blum. No representatives ofthe media attended. 1. Call to Order & Introductions. The meeting was called to order at 3:30 p.m., and the attendees introduced themselves. Judge Sullivan explained that the issues discussed at the last LPSCC meeting gave him a lot of insight on how difficult it is for the families of the mentally ill to deal with the system, especially when the mentally ill person clashes with law enforcement and the nature of the person's problem is not apparent to the authorities. Minutes of LPSCC Meeting Monday, March 7, 2005 Page I of 10 Pages 2. Approval of February 7, 2005 Meeting Minutes. Becky Wanless moved approval, and Les Stiles seconded. The minutes were unanimously approved. 3. Criminal Justice and Mental Health Items (continued from the February 7 meeting). These topics of conversation were continued from the February 7 meeting, and included a discussion of the following items. • Deferred Sentencing Program • Jail Trends, Statistics and Services 0 Where do we go from here? Sheriff Stiles thanked Pam and Bob Marble for sharing, at the last LPSCC meeting, their experiences regarding their son and his struggles with mental health issues. Sheriff Stiles assured them that things are handled differently here from what their son had experienced in another state. Sheriff Stiles said that at the last meeting Rob Burch (Mental Health Specialist at the Jail) gave a profile of a "typical" offender, and then began an overview of the history of how mental health issues are handled within the Jail. Lt. Mike Whitney of the Jail was to continue the overview today on behalf of Mr. Burch. He said that one item detailed in a handout distributed last month showed the history of the use of psychotropic medications that are administered at the Jail. These drugs represent at least 75% of the total cost of drugs for the Jail. He added that it is often hard to diagnose mental illness, because it can be hard to differentiate between mental illness and methamphetamine use. More of this problem is being seen, and it is often hard to know how to treat the person. Sheriff Stiles added that the community must work together to address housing and transition issues for mentally ill offenders. Jail is not the appropriate place for the non-violent mentally ill person, but at least 15% of the jail population has a mental health issue. Amphetamine cases are now more common than alcohol abuse cases. In regard to housing, St. Charles Medical Center has stated that five beds in the emergency treatment center will be available by November,, but the space situation in the Crisis Resolution Center is still unknown. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 2 of 10 Pages Mike Whitney gave an overview of the "typical" offender with mental health issues, which had been provided by Dr. Burch. The person is "typically" a male about 28 years old, Caucasian, with a I oth grade education or maybe a GED, unemployed and perhaps on disability through the State. The charges against this person are often for criminal trespass or harassment, because the person sometimes does not realize why they are being asked to leave. Many are diagnosed with bipolar or psychotic problems, some of which have resulted from meth use. Arresting officers are not necessarily trained to identify these problems, and often have to arrest the person and bring them to the Jail. The booking staff conducts a brief pre -booking mental health screening, and if it is apparent there is a mental health issue they will contact a crisis worker or an on -duty psychiatric consultant. At that time it is determined whether they should be kept at the Jail or sent to the hospital. The problem is, if they remain at the Jail, where to keep them. There is just one holding cell for males and none for females. This situation is disruptive to the booking area, but there is no good way to handle the problem. As a rule, anyone in the Jail who may have a mental health issue is evaluated every two weeks. Sheriff Stiles summarized that a recommendation has been made to the legislature by the Partners in Crisis group that there be a minimum of forty hours of in-service training for police officers on how to deal with mental health issues. This is a valid recommendation, but the challenge is who would pay for the training. An additional step is medication stabilization and assessment, and then locating an appropriate facility for the person to be placed. He said he hopes effective alternatives to incarceration can be found. This situation is a time bomb, since every time someone with mental health issues is booked into the Jail there can be serious problems, including violent behavior. This could happen any time of the day or night. He stressed that there couldn't be a worse environment for someone with mental health issues,- and the current Jail was not designed as it would be if it were built today. Pat Tabor explained that since jails are the new asylums for offenders with mental health issues, and some of the parolees have mental health problems, supervising this specialized case load is very difficult for Parole Officers. It is important to look at housing and mental health treatment alternatives. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 3 of 10 Pages There has been success in locations where these programs have been implemented, and it has been found that housing persons with these issues is less expensive than maintaining them in the jails. A long-term, supervised housing program is desperately needed. Existing drug and alcohol abuse programs do not address those people who also suffer from mental illness. There is currently a 120 -day wait for an indigent bed. Parole & Probation receives these individuals from the courts and jails, and many have to be connected with the appropriate treatment services, if available. It is important that these offenders are able to successfully negotiate the social services system. If the offender ends up on the street without making the right connections, they become transient and there is no place for them to stabilize. Some can stay at the Bethlehem Inn if they are stable and have their medications. There are many others that are too symptomatic who often end up back in jail. The transitional housing program is very helpful, but space is limited. It is better than these people being on the street, but it is not a suitable arrangement if the person is delusional or psychotic. Sageview will open soon, but it lacks a safe, supervised setting for these individuals. One need is a homelike setting, with staffing similar to what was available at Park Place, so people can stay long enough to obtain medication and get stabilized. Such a resource needs to be available, since these individuals don't come from the courts or the jail stabilized. An important question to ask is what the courts and Parole Board expect to happen. A psychotic individual needs to get the appropriate medication and be placed in a secure location for anywhere from one to five weeks. This allows for an appropriate diagnosis and treatment, and helps to assure that they are stable before they are released to a shelter or transitional housing, or whatever placement can be arranged through social services. Otherwise they will keep ending up in the Jail and the courts. If the groundwork is not set, they can't even handle the paperwork needed to obtain appropriate social services. There is transitional help in place for generic offenders, and the same type of help is needed for those individuals with mental health issues. Although the cost would be high, it would not be any more expensive than homelessness, the courts and incarceration. Minutes of LPSCC Meeting Monday, March 7,2005 Page 4 of 10 Pages Randy Johnson added that the individuals are supposed to come to his organization, BestCare, stabilized. Often it takes at least three months to achieve the right balance of medications. Methamphetamine use seems to relieve some of the users' disorders, but makes everything else worse. The alternative is $800 per day in a hospital, or whatever it costs per day in the Jail. Pat Tabor stated that Park Place used to allow only three days to two weeks, but that usually wasn't enough time for someone to adjust and become stable. Some could take a month,, others up to six months; but thought must be given on the cost of putting them in jail. Mr. Johnson said that the public needs to be educated on the overall problem, alternatives and costs. Pat Tabor said that Park Place handled up to eight people; a facility that could handle twelve people could be adequate for a while. It would have to be staffed similarly to transitional housing. The residents' medication would need to be monitored and they should stay until they are stable, otherwise they may violate and end up in jail. A typical stay could be three to six months. Sometimes it appears that clients don't have insight into their illness,, but even the most psychotic person would rather stay in this type of setting than go to ajail. This program could be developed as a partnership with the Mental Health Department. This issue is just as important as housing the homeless at Bethlehem Inn and providing transitional housing to newly released offenders. Judge Sullivan said that as quickly as the area's population is growing, it should accommodate more than twelve people. Jack Blum noted that if the program could be shown as successful, the public would be more willing to expand it. Sheriff Stiles said that this is part of the proposed Jail expansion plans. In Lane County, if someone is brought in with a mental health issue he or she is immediately separated from other inmates. However, there is no long-term place for them to stay; they are sentenced to the jail. He added that no jail will ever be designed to handle aggressive mental health issues, but at least these offenders could be kept separate for a while. Scott Johnson pointed out that operating costs is a big issue, even if the facility was built. Judge Sullivan added that staffing, is the biggest expense over time. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 5 of 10 Pages Ernie Mazorol asked where the cities stand on this issue, and how many people in the Jail with mental health issues are brought in from within the city limits. Sheriff Stiles replied that bookings are about 50% from within the City of Bend, and probably 80% of those with mental health issues are from within the City. There aren't many from the rural areas. Mr. Mazorol suggested that LPSCC send a letter to each of the city councils, asking them to be an active part of addressing this situation. Sheriff Stiles stated that as of March I he has had to matrix out 170 individuals; at this rate, it will be more than 1,000 by the end of the year. It is clear that something needs to be done. If Deschutes County did what other counties have done, there would be five beds for these people, but this is merely a convenient band-aid — a short-term solution. He said he doesn't want to see these offenders back on the street. Mike Dugan added that recently an offender was sentenced to forty days but due to matrixing was out in two hours. Judge Sullivan stated that these individuals need an immediate sanction and medications. A structured sanction program would save on bed space. Hillary Saraceno explained that the meth problem is having a huge negative impact on caseload, clientele and resources. A comprehensive effort is needed to address this issue. (She provided a handout with more details.) It is important to engage the business community. Funding to handle the problem has been decreasing, but the number of addicted people has greatly increased and has now surpassed the numbers of those with alcohol abuse problems. Children in school are now looking at using meth as a way to lose weight — girls are calling it the "Jenny Crank Diet". There has been a 25-30% increase in meth class 2 filings, and often children are present when meth is being used or manufactured. The Oregon Department of Human Services has indicated that every termination of parental rights last year noted meth use as a root cause; this results in more children in the foster care system. The good news is many organizations are working together in a grassroots effort to get communities mobilized. People with meth problems require long- term treatment and relapse is a reality. Thirty-five of the thirty-six counties are pushing for equity for mental health funding from the State. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 6 of 10 Pages The coalition would like to handle these problems as one, and hopes to obtain federal treatment dollars. Mr. Johnson said he spoke with Judge Sullivan and the Board of Commissioners, and it is strongly felt that the idea for a program should come from LPSCC. He added that it is so significant that he feels it deserves consideration in the County's general fund process. He stated that the cities should also be a part of the solution. Figures show that this problem is worsening each year. Based on population figures, Deschutes County receives far less funding from the State than other counties. Items to be addressed are expanding deferred sentencing and creating a drug court, but the treatment component is missing. Housing and treatment services could be viable alternatives to jail. NAMI has identified training as a pressing priority. This is challenging, as it takes about forty hours per person. Another issue is the treatment of juveniles. Resources need to be developed, and the legislature must be urged to correct the dramatic funding inequities. Randy Johnson said that meth use is widespread. About 75% of the users are employed, so they need to get help while they still have jobs and insurance. If the business community is involved in having drug-free workplaces, and the public is made aware of the problems associated with meth use, it starts to make a cultural statement. It is very clear that if the problem is caught at the workplace there is a savings in productivity, insurance costs, etc. Typically random drug testing isn't done by most companies, but it is now being determined if random drug testing would be cost effective. If workers comp claims and insurance premiums can be reduced, it would make financial sense. Ernie Mazorol said that LPSCC has multiple issues to address. Everyone in LPSCC has a vested interest in this issue. There is uncertainty as to where the funds would come from, and in the meantime the problems get worse. Judge Sullivan pointed out that this is a long-term issue that will need to be addressed indefinitely. Efforts can't be spread so thin that nothing gets accomplished. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 7 of 10 Pages Scott Johnson said that the cities should be approached. Sheriff Stiles agreed that action needs to be taken to involve the cities, and that CODE (Central Oregon Drug Enforcement) isn't the answer to the problem. He stated that 80% of the property crimes in the area are related to meth use. He and the Police Chiefs of Redmond and Bend are rolling out the street crimes group, whose members had to come from the Patrol and Detective Divisions. The problem needs to be prioritized. The only way to get a handle on the problem is to focus on how to address specific issues. Mr. Mazorol explained that resources should be developed, and the mayors should receive a letter from LPSCC asking them to participate. Jacques DeKalb suggested that each area of concern should be studied by a small committee, and the information could be brought together to determine what it will take to address that problem. At that time the group can decide what the next steps would be, what resources are needed,, and so on — in essence,- develop a strategic plan. Mike Dugan said that LPSCC can recommend that funds go to specific programs, but has no authority over budgeting or funding. He asked how LPSCC can defend moving funds from one program to another. Sheriff Stiles noted that Community Corrections funding might be available. Judge Sullivan emphasized that if LPSCC doesn't do it, who will? Mental health issues are critical to public safety. He stressed he does not see any other vehicle in the community besides LPSCC to deal with it. He said that this group needs to have a basic plan in place — this is something that can't just be discussed; action needs to be taken. A consensus on the primary issues is needed, and the limited resources available need to be coordinated. He asked for ideas on how to prioritize the issues. Sheriff Stiles stated that there are other organizations in the community, such as social services and religious groups, that are interested in addressing the meth problem. Perhaps they could attend future LPSCC meetings. NAMI should have a seat at the table, as should the meth coalition. Then subcommittees could be formed to address the different aspects as prioritized. Any actions taken will be more powerful if others who are working on the problems are included. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 8 of 10 Pages Mr. Mazorol reiterated that there should be a concerted effort to include the cities. He suggested that NAMI help get the cities on board. Scott Johnson said that he would support two committees — one to deal with mental health issues related to public safety, and the other to deal with the meth problem. He would like to focus on alternatives to incarceration, if perhaps someone else can focus on the meth issue. Hillary Saraceno stated that she will coordinate gathering information on the meth issue, with the help of the staff of BestCare. Sheriff Stiles said Ruth Jenkin or Mike Whitney could work on the incarceration portion, and he will focus on the meth problem. Ms. Saraceno stated alternatives to deal with both problems are needed. Mr. Johnson will have someone work on the issue of people self -medicating inappropriately. Sheriff Stiles explained the OMNI study should be completed by the end of March. Judge Sullivan stated the two committees (addressing incarceration of those with mental health issues, and addressing the meth problem) should have information gathered and available by the April 4 LPSCC meeting. Before that date the cities should be invited to attend and get involved. The group will then try to prioritize long-term efforts that will do the most good so that the work and resources are not spread too thin. By that time there should be more information available on the money issues from the State. There was no other inputprovidedfor the next agenda. 3. Other Business None was offered Being nofurther items addressed, the meeting adjourned at 5: 10 p. m. Minutes of LPSCC Meeting Monday, March 7, 2005 Page 9 of 10 Pages Respectfully submitted, Recording Secretary Attachments Exhibit A: Sign -in sheet (note: not everyone at the meeting signed in) — I page Exhibit B: March 7, 2005 meeting agenda - I page Exhibit C: Proposed Mental Health priorities — 3 pages Exhibit D: February 7, 2005 meeting agenda and attachments — 10 pages Exhibit E: Information on NAMI — 3 pages Minutes of LPSCC Meeting Monday, March 7, 2005 Page 10 of 10 Pages z 0 V5 LLJ LU —i a. W) C14 cc V 0 V -N tj -41 CD CD Co Cl) Z. CL rA io Li 0) -E c 0 m (D cn cu (D a- 0 cd Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org MEETING AGENDA LOCAL PUBLIC SAFETY COORDINATING COUNCIL 3:30 P.M., MONDAY, MARCH 7,2005 Commissioners' Conference Room - Administration Building, Second Floor 1300 NW Wall St.., Bend 1. Call to Order & Introductions 2. Approval of February 7, 2005 Meeting Minutes 3. Criminal Justice and Mental Health Items (continued from the February 7 meeting) • Deferred Sentencing Program — Judge Tiktin, Susan Battles • Jail Trends, Statistics and Services — Ruth denkin, Rob Burch • Parole & Probation Services and Needs — Pat Tabor • Other Recent Developments; Where Do We Go from Here? • Priorities for Action 4. Other Business Exhibit - Page --3— Of Deschutes County Local Public Safety Coordinating Council Proposed Mental Health Priorities March 2005 Mental health and substance abuse treatment and prevention are essential elements of an effective public safety and justice system in Deschutes County. The Deschutes County Public Safety Council and its members endorse a long term community effort to develop and implement effective prevention and intervention programs and projects that help provide for public safety, present alternatives alternatives to incarceration q.nd, better serve, treat and hold accountable individuals with mental illnesses and /or addiction issues. - The Council is currently completing a review of services a I will be to sustain current efforts where effective and to fb� several years. The following priorities are endorsed bY, Commissioner's for adoption as mental health / public s County's 2005 Mental Health Strategic Plan and the Des& Proposed 2005-2007 Increase alternatives to incarceration - a) Create a Drug Court. Expand our Count� people, emphasizing accountability and" Drug Court with sufficient, timely treatm,er address our community's growi prevention and treatment effbi County's human service reia'te'( (sufficient for program size) anc d) parole ['probation. capacity 'trends i ta, 0, Kcommunity. Our goal on a t' 6r6 e te' "agenda for the next Council, referr, � to the County fy�,,priorifies and fo'e':.ihcIusion in the , s:Counfy 10 -Year Comm1unify Plan. Pri xp 0-d1,,,the,De1f1erred Senf6ncing Program and b) 'Deferred Sentencing Program to serve more 1�afmenf and servic ' e coordination. Create a pilot and support. bamph6tarnine - Develop I a comprehensive effort to methamphetamine problem including effective Essential cdmponents��recommended by Deschutes epartments`V-x6) D�ru­ g Court, b) treatment on demand fensive case management, c) accountability (jail access), d,,,e) prevention (public education / involvement. insmure intervennon iraininq - u hpIp'first responders in Deschutes Cou and sustain this evidence -based training to ctively work with individuals in crisis. Strengthen Juvenile Sex Offender Treatment - A community planning process is nearing completion. A report of findin 's'and recommendations on this critical issue will be presented 9 to the Public,Safety Council, in" he next 90 days. Sustain Key Pro!Lucts, specifically the Mental Health Bridge Program and -Parole / Probation work with adults"'with, mental illness or addiction issues. Expand as able. Develop Resources, -'Special emphasis on state financing equity, especially with respect to addiction treatment, federal, state or county financing to the greatest degree possible and maximizing billable revenue Specia/ note: this agenda should be advanced in a manner that compliments the current Jail Needs Assessment Committee process which includes a goal of creating / expanding alternatives to incarceration. If other priorities emerge from that process, recommendations will be brought to LPSCC for consideration. Deschutes County: Commission on Children & Families, Health Department, Juvenile Department, Mental Health Department, Parole & Probation Department. Exhibit C Page \ of Methamphetamine Project Deschutes County Human Service Departments February 28, 2005 METHAMPHETAMINE: Facts m # of drug cases prosecuted by the CODE District Attorney increased by 16.7% in 2003. Source. CODE. Serious health consequences to users AND non-users. Source, Health officials. Children present in 1 of 4 meth labs. Source. OSP 2002 Meth Lab /Drug Activity Ppt. Contributes to domestic violence, child abuse, and spread of infectious disease. 40% of kids at KC: parents have meth abuse. Source. KIDS Center. Methamphetamine: Improving our County's response 1. Community Consensus: this must be Prevention addressed now. 2. Treatment Limited public involvernnt. Arrests /production up. Wait time for Tx 3. Justice #1 addiction issue. Services bevastating effect Lack of jail space All need addressed Public cost METHAMPHETAMINE: Facts * Highly addictive - The most popular illicit stimulant in Oregon. Source. HIDTA 2003 Threat Assessment. * Deschutes: I of 7 counties designated High Intensity Drug Trafficking Area. Source. HIDTA document. * # of patients addicted to meth has increased 16% in 2002. Source. HIDTA Needs Assessment * 43 % of patients treated for substance abuse by Deschutes County meth-depende,0. Source: DCMH. METHAMPHETAMINE: Facts Requires long-term treatment, relapse is the norm. Source. Best Care Treatment Services Oregon has highest treatment admission rate. Source. Oregon Partnership.. - We lack treatment. 3511 of 36 counties in state tx. funding per capita. Source. State of Oregon. Due to limited resources & capacity, CODE focuses on major meth distributors (> 5 lbs). Source. CODE. - Most of the cases where parental rights were terminated lost yea r eth involved. Source. Craig Campbell, Governor's Off�, we e m ce. Recommended Actions (under construction) Priorities: Next Steps ... • Community involvement m Pefer to LPSCC to • Methamphetamine finalize priorities. treatment on demand n BOCC adoption of • Drug Court operational County priorities • Jail bed for Drug Court m Reflect priorities in accountability 2005-06 budgets and programming. Exhibit 0— Page —Z of� Oregon Funding of Alcohol and Other Drug Treatment Services 2003-2005 A&D$ County Per Capita July'04 Pop % of Pop. % Tx. $ AD66 AD60 Total Josephine $17.51 78,600 2.19% 4.57% $709,609 $666,538 $1,376,147 Morrow / Wheeler $17.18 13,300 0.37% 0.76% $228,514 $228,514 Columbia $16.67 45,650 1.27% 2.53% $171,060 $590,130 $761,190 Wallowa $15.52 7,150 0.20% 0.37% $110,962 $110,962 Harney $14.91 7,650 0.21% 0.38% $114,090 $114,090 Grant $14.53 7,750 0.22% 0.37% $112,630 $112,630 Lake $14.52 7,500 0.21% 0.36% $108,874 $108,874 Multnomah $13.04 685,950 19.15% 29.68% $7,627,622 $1,315,618 $8,943,240 Mid -Columbia** $12.90 48,750 1.36% 2.09% $471,384 $157,426 $628,810 Malheur $12.36 31,850 0.89% 1.31% $393,602 $393,602 Klamath $12.20 64,800 1.81% 2.62% $504,008 $286,320 $790,328 Douglas $11.34 102,350 2.86% 3.85% $722,950 $437,776 $1,160,726 Baker $11.18 16,550 0.46% 0.61% $184,950 $184,950 Umatilla $11.07 72,250 2.02% 2.65% $477,568 $322,080 $799,648 Curry $10.14 21,150 0.59% 0.71% $214,438 $214,438 Lincoln $9.29 44,400 1.24% 1.37% $329,490 $82,790 $412,280 Jackson $8.85 191,200 5.34% 5.62% $898,856 $793,332 $1,692,188 Benton $8.71 81,750 2.28% 2.36% $439,472 $272,240 $711,712 Yarnhill $8.49 89,200 2.49% 2.51% $465,574 $291,986 $757,560 �'k Marion $7.62 298,450 8.33% 7.55% $1,974,856 $300,000 $2,274,856 Jefferson $7.12 20,250 0.57% 0.48% $144,132 $144,132 Crook $6.62 20,650 0.58% 0.45% $136,620 $136,620 Lane $6.17 333,350 9.30% 6.83% $1,761,276 $295,276 $2,056,552 Linn $5.76 106,350 2.97% 2.03% $387,852 $224,821 $612,673 Clatsop $5.61 36,400 1.02% 0.68% $204,358 $204,358 Washington $5.56 480,200 13.40% 8.87% $1,553,346 $1,118,544 $2,671,890 Tillamook $5.38 24,950 0.70% 0.45% $134,220 $134,220 Union $4.86 24,850 0.69% 0.40% $120,764 $120,764 Clackamas $4.09 356,250 9.94% 4.83% $978,268 $477,710 $1,455,978 Coos $3.78 62,700 1.75% 0.79% $188,730 $48,114 $236,844 IDeschutes $3.04 F-1351450 3.78% 1.37% $411,692 $411,6921 Polk $2.54 64,950 1.81% 0.55% $165,118 $165,118 County Sub -Total $8.41 3,582,600 100% 100% $22,446,885 $7,680,701 $30,127,586 S:\Mental-Health\Scott\Substance Abuse\A&D 66 and 60 by County.xIs Exhibit C_ Page _�'s of MENTAL HEALTH ISSUES Local Public Safety Coordinating Council February 7, 2005 Intro,duction—Les Stiles, Scott Johnson I eferred Sentencing Program—Judge Tiktin, Susan Battles ATTACHMENT A Family Perspective—The Marble Family Jail Trends, Statistics and Services—Ruth Jenkin, Rob Burch ATTACHMENT Parole & Probation Services and Needs—Becky Wanless, Pat Tabor ATTACHMENT Other Recent Developments; Discussion Other materials attached: DCMH Bridge Grant Information Sage View Information Exhibit D Page I of Deschutes County Mental Health Deferred Sentencing Program PROGRAM OBJECTIVES: These are the identif ied objectives of the Mental Health Def erred Sentencing Program. • Protect public safety. • Reduce the frequency with which those suffering from mental disorders encounter the criminal justice system. • Decrease the inappropriate use of institutionalization for people with mental illness. *Improve the mental health and well-being of the defendants who come into contact with the Deferred Sentencing Program (05P); *Develop greater links between the criminal justice system, mental health and other social service agencies in order to better coordinate and enhance the overall delivery of mental health and chemical dependency services; Expedite case planning and processing. CRITERIA: *Any non -person misdemeanor committed by a ' person who has a major mental illness (The DA may consider other cases for inclusion in the program on a case-by-cose basis) *The individual is diagnosed with a severe and persistent mental illness (i.e. Schizophrenic, Bi -polar Disorder, and/or Major Depression) and collateral sources indicate that there is a history of a severe and persistent mental disorder. Potential participants in jail will be screened initially by the adult jail Mental Health Specialist, with recommendations made to the district attorney, public defender and the Court Liaison regarding whether they are appropriate for the program; *The Court liaison will make recommendations to the district attorney and the public defender, for potential participants in the community if they are brought to the attention of the liaison and they meet the criteria to participate in the program. *The participant's mental illness is treatable in a community setting; *The person is legally competent and voluntarily consents to participation in the alternative track; *The individual has a stable local address. PEFERRAL FOR SCREENING: *Those defendants lodged in the jail are eligible for a referral for screening. *The arresting officer notes any abnormal behavior and documents. Information regarding the subjects abnormal behavior is passed on to the jail deputies by the arresting officer. *If the arresting of ficer believes the individual might be appropriate for the DSP program the arresting off icer should mention this to the jail deputy and note it in the police report. *Referrals to the Court Liaison at the Deschutes County Mental Health and the jai I Mental Health Staff can be initiated by the Court, the District Attorney's off ice, Community Corrections, County Jail staff, the Public Defender, the Mental Health Department, Community Police, family members, or by the consumers themselves. PROCESS: After a defendant has been referred to the Mental Health Professional at the jail or the Court Liaison the following will occur: *The Mental Health Professional at the jail or the court liaison will determine whether the individual is clinically appropriate for the Def erred Sentencing Program. *The DA will determine whether the person is legally appropriate for the program. *If the defendant is deemed appropriate for the program treatment recommendations are prepared and submitted to the court, the DA and the PD. *The individual will then go through the D5P court process. Exhibit D pplo'e. fT _ofir-) Deschutes County Sheriff's Office COMPOSITE PROFILE OF A DESCHUTES COUNTY CITIZEN WITH THE CO- OCCURING DISORDERS OF MENTAL ILLNESS AND DRUG ABUSE, INVOLVED IN -THE CRIMINAL JUSTICE SYSTEM Identifying Information a. Age: 28 b. Sex: M c. Ethnicity: Caucasian d. Education: 1 oth grade High School; participated in GED classes. e. Employment: Unemployed; Disability Application in Process 11. Charges a. Criminal Trespass b. Menacing c. Harassment Ill. Diagnoses a. Bipolar Disorder; with Psychotic Features b. Amphetamine Abuse c. Epidemiological data indicate the high prevalence of co morbidity for substance abuse disorders and mental disorders in the general population'. IV. Points of Identification / Intervention a. Arresting Officer (CIT Crisis Intervention Training)* b. Pre -Booking Mental Health Screening* c. Post -Booking Intake Medical Screening d. Jail Mental Health Appraisal e. Court Arraignment Hearing (Possible Mental Health Court)" V. Deschutes County Adult Jail Mental Health Services a. Crisis Intervention b. Medication Stabilization c. Assessment and Referral to Mental Health and Chemical Dependency Treatment Services d. Counseling e. Case Management 1 U.S. Department of Health and Human Services; Substance Abuse and Mental Health Services Administration (2002). Report to Congress on the Prevention and Treatment of Co -Occurring Substance Abuse Disorders and Mental Disorders. *possible pre -booking diversion **possible post -booking diversion Exhibi Paize �5aof �1� w L) M LL 0 EL LL w LLJ C/) z D 0 U Cl) LLJ 1�- D C.) (1) w a z 0 cn z 0 ui 0 L) CO) U) F- LLI Cl) V) L) CO z 0 L) w F - z w 2 't C) 0 T; :E 2 Exhibit_v_ Page U of I n 0 0 C14 0) 0 00 Cf) In le cl M C*4 M 04 M 0 04 ui 't mou-immm C', 0 "'1' co 0 Oc" "T 00 0 "0 CO 't — m 0 04 rl- r- 't (.0 N r– m m (D (0 "t (D CO N 00 00 co C14 co 0) CD 00 "t co — CO U) 0) co (0 CY) m 00 It r– 00 00 M 0) 0 C,4 C) m W C,4 C'I CD LO m 04 N C� 04 U) 0 U) Z CO U) 0 0 U 0 CL 0 (n 0 U) 0 M 0 (D 0 0 (n cu c: 0 z 0 c CU (13 3 m 0. 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CD C6 M > 6%6% 0 z w p 0 w Lu < W w w m D'UCOZW<W:5 mow 0 . in , in 0, IL, ca E m 2) 0 0 0 PaRe (t) of I U) < < w w -OR, -0 OR co �011 OC) m < U) U) < < C) CN U) Lu to z co 0,0 :� 06 LO C', C4 w -0 D- (-) -10, N M >- LO lot OD U) Ul) C*4 E 0 z PaRe (t) of I MENTAL HEALTH ISSUES IMPACTING PAROLE AND PROBATION DEPARTMENT Mentally ill offenders under supervision., 60 Percentage male 75% Percentage female 25% Average age 35 Diagnosis: from mild depression and anxiety to paranoid schizophrenia Needs: housing, medication, speedy access to psychiatric care P and P staff dedicated to supervision of mentally ill offenders 1 .00 FTE Salary and benefits per FY $80,000 Subsidy dollars spent on mentally ill offenders per FY $ 5,000 Exhibit D Page --7 of Deschutes County Mental Health Bridge Grant MHS 20 ftinds continue to be utilized to support a Mental Health Specialist I (QMHA level clinician), who provides services to adults with co-occurring disorders within the jail and the community corrections system in Deschutes County. This position acts as a liaison between DCMH, Parole and Probation, and the Jail, providing intensive case management services such as: • Setting clients up with the Self Sufficiency Program, the Seniors and Persons with Disabilities Program, the Social Security Administration, Vocational Rehabilitation, Central Oregon Regional Housing Authority and Central Oregon Community College. • Assisting clients in connecting with psychiatric and medication management services. • Working closely with the local hospitals, crisis staff, jail mental health staff, and Parole and Probation to find the least restrictive option for the clients. • Diverting from emergency hospitalization/incarceration through intensive case management and outreach services. • Working closely with clients who have been released from the state hospital (and have ties with the correctional system) in order to give the client added support to reduce the chance of decompensation. This includes some individuals released under the jurisdiction of the PSRB (Psychiatric Security Review Board). • Assisting clients coming out of prison in connecting with mental health and community supports. • Completing ASAM drug and alcohol assessments in the jail, and making appropriate referrals to inpatient drug and alcohol treatment facilities. • Working with many at -risk offenders and their families struggling with mental health issues and addictions. • Facilitating a weekly treatment group for individuals with co-occurring disorders. • Working in combination with family court and Ready -Set -Go to help establish a treatment plan for helping these clients regain custody of their children by helping them follow through with recommended treatment/classes. Deschutes County Mental Health and our partners believe implementation of the bridge position has improved our services to individuals with co-occurring disorders who are involved with the criminal justice system. Unfortunately, with the OHP cuts, state budget cuts, and county mental health cuts, treatment options for this population continue to dwindle. Lack of prescription drug coverage has made it very challenging to keep clients on their medications, and only the most severely and persistently mentally ill are able to receive mental health services. Exhibit P A or e 4?"k 0 _fl 0 Sage View is a 15 -bed acute psychiatric facility that will be initially licensed as a residential psychiatric facility under the ORS. It is a free-standing facility on the campus of St. Charles Medical Center - Bend. Sage View was constructed with donations from a variety of sources including a Community Development Block Grant, Lottery Dollars through the Central Oregon Intergovernmental Council, Ford Family Foundation, jeld-Wen, Collins Foundation, Deschutes County Mental Health, St. Charles, National Alliance of the Mentally III (central Oregon Chapter), and many others. The facility has one loan from Deschutes County that the hospital will repay. Sage View has also received a large operational grant for three years from the Northwest Health Foundation. initially fon-ned as a partnership with Deschutes County and the Central Oregon Regional Housing Authority, Sage View is fully owned and operated by Cascade Healthcare Community, the parent company of St. Charles Medical Center – Bend and St. Charles Medical Center – Redmond. Central Oregon is the last region of the state to develop acute mental health resources. For years, citizens have traveled hundreds of miles for care that can now be delivered safely in their own region. Sage View utilizes the latest research and evidence -based practices including: • Home -like environment with private rooms, each with a view of nature. The facility has a classroom, day room, dining facilities and outdoor recreation area all within a secure environment • 24-hour RN staff, Master's level clinicians, Bachelor's level technicians, Recreational Therapist and psychiatry services • 24-hour intake and admissions, including a secure area for police holds Sage View will be a non-violent environment. Research shows that the utilization of seclusion and restraint is not therapeutic, and contributes to the trauma experienced in these settings, Sage View has applied for a variance from the State to open without a seclusion/restraint room. Caregivers and patients will agree to behave within the bounds of this culture, and if a more secure environment is needed, accommodations are available at St. Charles Medical Center – Bend. Sage View serves as the central mental health resource for the region. The following additional services have been developed, are in implementation, or are planned for the near future: • Horizon House—a 14 unit transitional housing complex built by Central Oregon Regional Housing Authority (CORHA) with federal HOME funds and grants from St. Charles and Deschutes County located next door to Sage View • Emma's Place—an 8 unit permanent housing complex built by CORHA and staffed by Deschutes County Mental Health (DCMH) located in Bend • Prairie House—an 8 unit permanent housing complex under construction by CORHA and staffed by Crook County Mental Health located in Prineville • Barbara's House—an 8 unit permanent housing complex under development by CORHA and staffed by DCMH located in Redmond • TBA—an 8 unit permanent housing complex under development by CORHA and staffed by Jefferson County Mental Health located in Madras St. Charles was also recently awarded a $450,000 federal Rural Utilities Service grant to fund and implement a teleconferencing network throughout 25 rural mental health settings in Central and Eastern Oregon, placing state-of-the-art units in each clinic, connected through a bridge at St. Charles, with the hub at Sage View. We are in negotiation with OHSU to begin development of a rural telepsychiatry program to service this much needed population. it is the hope of St. Charles and the development team of Sage View that this model of care can be adopted as the preferred resource for development in the future. Exhibit D Paize (A o f Exhibit Page 10 of I nami Oregon WHO WE ARE ... WHAT WE DO ... HOW WE HELP... NAMI - the National Alliance for the Mentally III - is a grassroots, self-help, support, education, and advocacy organization dedicated to improving the lives of all those affected by serious mental illness. This includes consumers diagnosed with a mental illness; their family members, relatives and friends; mental health professionals; and all who share NAMI's vision and mission. NAMI welcomes as members all who share our mission to advocate on behalf of consumers and family members, to promote research into the causes of and treatments for mental illnesses, and to combat the stigma and discrimination faced by consumers and their families. Consumers are an essential and growing part of the NAMI membership and leadership. NAMI, founded in 1979 by 254 people, now has more than 210,000 members in over 1,200 affiliate groups in all 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, American Samoa, and Guam. NAMI is getting stronger every day. In fact, Worth Magazine recently ranked NAMI in its "Top 100 charities most likely to change the world." Millions of Americans, involving an estimated one in four families, are living with mental illness. Most NAMI members are either a consumer or family member whose life is personally touched by a severe brain disorder such as: Schizophrenia and other schizophrenia spectrum disorders Bipolar disorder Major depressive disorder Severe anxiety disorders, including panic disorder and obsessive-compulsive disorder NAMI Oregon is headquartered in Portland and comprises a statewide network of 22 (county) affiliates and over 1,500 members. Following are several of the ways NAMI Oregon provides support, education and advocacy for those affected by mental illness. Statewide, our toll-free Helpline offers support and is staffed primarily by trained volunteers who can answer general questions about mental illness, provide referrals to local affiliate support groups and services, and offer a supportive, listening ear. NAMI also provides up-to-date brochures and fact sheets about mental illnesses and treatment options. Education: Family to Family 12 -week education classes bring hope and understanding to families dealing with mental illness. Visions for Tomorrow is an education program for direct caregivers of children and adolescents with brain disorders. Other educational and outreach programs include In Our Own Voice, From Discovery to Recovery, Latino Outreach Program, In a Different Light, and Breaking the Silence. Advocacy priorities include seeking an end to discriminatory health insurance and the unjust incarceration of people with mental illness; also critical are improving community services such as housing, employment, and access to treatment and medications. NAMI Northwest Walk For the Mind of America is a 2.8 mile walking event for all people dedicated to improving the lives of those affected by mental illness and is a primary fundraising event every May. 3550 SE Woodward Portland OR 97202 503-230-8009/800-343-6264 www.nami.ouVoregon namioregon@qwest.net Exhibit E Page __�_ of NAMI—Oregon n R M I Educational and Outreach Programs The Natloa*s Voice on Mental Illness 1-800-343-6264 Family—to—Family Family—to—Family is a series of 12 weekly classes structured to help family members understand and support their ill relative while maintaining their own wellbeing. Families learn personal coping skills and about resources in their community. Volunteer teams of trained NAMI family members teach the classes. There is no fee to families taking the classes. Participants learn about schizophrenia, bipolar disorder, depression and obsessive compulsive and panic disorders. Visions for Tomorrow Visionsfor Tomorrow is an education program for direct caregivers of children and adolescents with brain disorders. The focus is on symptoms, not diagnosis. The curriculum covers more than a dozen major diagnosis and the basics of day-to-day skills building. A team of two teachers are themselves primary caregivers. These trained family members have experienced first-hand the rewards and the challenges of raising children with brain disorders. The course offers caregivers an opportunity to share mutual experiences and learn valuable lessons from one another. In Our Own Voice In Our Own Voice is a recovery�education program in which people living with mental illness are trained to speak directly to community audiences about their experiences with brain disorders, treatment and recovery. Two people from Clackamas County who are living with mental illness are so extraordinary in their presentation that they are included in the national NAMI's video used in this program. The educational and healing power of In Our Own Voice enriches the audience's understanding of how people with serious mental disorders cope with the reality of their illnesses. Recovery and reclaiming productive lives is a powerful message for anyone whose life has been touched by mental illness. A videotape of an Oregon presentation is available to share with groups. From Discovery to Recovery From Discovery to Recovery is a five -session seminar that presents an overview of mental illness, treatment and medication, latest research, coping techniques, community resources and successes. NAMI—Oregon plans to continue to expand the From Discovery to Recovery seminars to families and health professionals throughout the state. Latino Outreach Program This outreach program is a series of 12 weekly Family—to—Family classes, taught by bilingual teachers, for Spanish-speaking families and bilingual mental health professionals. Culturally sensitive and appropriate materials have been developed. This groundbreaking program is the first time educational classes have been offered for Spanish-speaking families in Oregon. Support groups may also be offered as more people complete the classes and as more teachers are recruited. Requests for this Latino Outreach Program come from families and mental health professionals all over the state. NAMI—Oregon plans to continue to expand this outreach to the Latino community. In a Different Light In a Different Light is a theatrical production with cast and crew composed mainly of people living with mental illness. The name for this group was chosen as an appropriate name for seeing people "in a different light" or differently, as capable, talented performers. In a Different Light has changed the perception of mental illness for our cast and crew AND the audiences who have seen us perform. This talented group is an example of how recovery can happen. Breaking the Silence Breaking the Silence teaches the warning signs of mental illness and needs to be part of every child's education. The program is for use in upper elementary, middle and high school. It contains fully scripted lesson plans, games, posters and suggested activities created to break the silence about mental illness in our schools. The course is designed to be taught by any teacher regardless of knowledge about brain illnesses. Local NAMI members serve as resource persons to the schools. Exhibit Page _ of 0 nami Oregon 2005 LEGISLATIVE PRIORITIES Mental Health Recovery = Money Well Spent Health Insurance Parity Position: NAMI Oregon supports private health insurance policies providing the same benefits and coverage for mental illnesses and substance abuse disorders that they provide for physical illnesses. Stable and Adequate Funding for Mental Illnesses Position: NAMI Oregon supports stable and adequate funding to maintain and enhance mental health services for both children and adults that adequately address their needs for treatment and support. Oregon Health Plan Position: NAMI Oregon supports the Oregon Health Plan, with mental health treatment services and prescription drug benefits for those with serious mental illness and without co -payments, premiums, and enrollment caps that serve as barriers for accessing needed mental health treatment. Access to Medications Position: NAMI Oregon supports the use of the most effective psychiatric medications, including, without limitations, newer medications such as atypical anti -psychotics, anti- depressants, anti -convulsants, and anti -anxiety medications in the treatment of major mental illnesses. End the Criminalization of the Mentally III Position: NAMI Oregon supports efforts to end the criminalization of the mentally ill, including implementation of both pre -booking and pre-trial diversion practices; specialized training of law enforcement, intensive and integrated community mental health services and housing, and pre-release planning that includes connection to entitlements. Oregon State Hospital Position: NAMI Oregon supports remediation of the current critical conditions at Oregon State Hospital. NAMIOREGON 3550 SE Woodward Portland OR 97202 503-230-8009/800-343-6264 Fax 503-230-2751 www.nami.org/oregon namioregon*qwest.net Exhibit E Page of 13��