2006-186-Minutes for Meeting December 14,2005 Recorded 3/2/200617-
DeschutesCounty Board of Commissioners
1130 NW Harriman St., Bend, OR 97701-1947
(541) 388-6570 - Fax (541) 388-4752 - www.deschutes.org
MINUTES OF DEPARTMENT UPDATE -
MENTAL HEALTH DEPARTMENT
DESCHUTES COUNTY BOARD OF COMMISSIONERS
WEDNESDAY, DECEMBER 14, 2005
Commissioners' Conference Room - Administration Building - 1300 NW Wall St.., Bend
Present were Commissioners Dennis R. Luke and Michael M. Daly. Also present
were Mike Maier, County Administrator; and Scott Johnson, Mental Health
Department. No representatives of the media or other citizens were present.
The meeting began at 3: 30 p. m.
Please see the agenda and backup documentation (copy attached) for information
on the items discussed.
No formal action was taken by the Board at this meeting.
Being no further items addressed, the meeting adjourned at 4:05 p.m.
DATED this 14th Day of December 2005 for the Deschutes County Board of
Commissioners.
ATTEST:
Recording Secretary
20 6-966iinuiiuuu
DESCHUTES COUNTY CLERKDS CJ 006.186
NANCY
COMMISSIONERS' JOURNAL 03IV41006 3;5939 PM
Dennis R. Luke, Commissioner
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Monthly Meeting with Mental Health Department
3:30-4:30 Wednesday, 5 /)eT. 0~
County Administration Building
Preliminary agenda:
1. Electronic Medical records
• 2006 planning for electronic medical records system - consultant needed
• IT completed survey of several Oregon counties (as requested by BOCC)
• BOCC meeting in January to review survey results, request for $ to help
• Important project - will increase efficiency and improve the bottom line
2. MHO future - Central Oregon option
• Crook County - January 5 meeting
• Jefferson County - topic is being reviewed by consultant and Treleaven
• Go fast go slow dilemma - stating our intent by February 2nd?
• Requires BOCC decision, $97,000 GF transition, enough reserves?
• Potential start 2007 if state ok'd
• Other option: major changes in ABHA supported by 3 CO counties.
3. Drug Court
• Priority project - high interest and support
• County roles - applicant for state funds, grant manager, pick treatment
provider, possibly case management and co-occurring disorders, pursue
federal funds / involve fed lobbyist
• $5.5 million available (2006-2007) through Criminal Justice Commission
4. Bridge Program - I will bring copies of a recent report to the State
• Bottom line: effective and saving money
• 33 of 86 have no new arrest (1,540 bed days in prior year at a cost to the
county of $148,000);
• Add'I 29 reduced their jail days from 2,592 (prior year) to 606. The balance
remained significantly involved with the jail.
• Recommendation: IMP develop a County policy that supports sufficient jail
capacity AND effective, evidence based alternatives to incarceration like
P&P services, the Bridge Program, Drug Court, Mental Health Court and Crisis
Intervention Training
Pending
• Strategic Plan adoption - I am scheduling a briefing per your request
• Trillium site visit with State - follow-up on prior cases, assuring sound practices
• A&D equity - response from OMHAS, critical that we continue to make this a
priority, invitation to Nikkel for visit in 2006.
• Federal Indirect Rate - Maier convening meeting - Counties with indirect
rates: Washington, Clackamas, Lane, Jackson, Linn, Benton, Umatilla,
Klamath, Lincoln
• Staff survey in process - we'll share results with you in late January
• A&D certification - extended to March with site visit
• Custody evaluations begin in January
v-cES c
Mental Health Department
2577 NE Courtney Drive, Bend, Oregon 97701
General Information/TDD (541) 322-7500
FAX (541) 322-7565
Scott Johnson, Director
To: Commissioner Daly, Commissioner Luke, Mike Maier
Michael Sullivan, Presiding Judge, Circuit Court
From: Scott Johnsor~
Date: December 14, 2005
Subj: The importance of alternatives to incarceration.
Information on Deschutes County's Bridge Program
Attached please find a copy of our recent report to the State of Oregon on our Bridge Program.
We receive a small state grant through which Kara Cronin in our Mental Health Department
works with individuals with mental health and addiction issues as they leave the jail. The work is
coordinated closely with Parole & Probation and Jail Services.
Please take a few minutes to look at the data. The program is very successful for many of the
participants in easing the transition, preventing recidivism, and reducing jail costs by reducing
bed need.
I offer this information as we enter into important community discussions about jail expansion. It's
my hope that our public safety initiatives in 2006 will provide for greater accountability through
jail beds as well as concerted efforts to increase use of effective alternatives to incarceration.
These alternatives should include expansion of the Bridge Program, Parole & Probation Services,
Mental Health Court, Drug Court, and Crisis Intervention Training.
I'd welcome opportunities to discuss this further.
Cc Memo only: Kara Cronin, Lori Hill, Becky Wanless
Adult Treatment Child & Family Program Developmental Disabilities Seniors Program Medical Records
Mental Health, Alcohol & Drug Mental Health, Alcohol & Drug PHONE (541) 322-7554 PHONE (541) 385-1746 FAX (541) 322-7567
FAX (541) 322-7565 FAX (541) 322-7566 FAX (541) 322-7566 FAX (541) 330-4642 (Protected Health Information)
Quality Services Performed with Pride
s
Itist►c~
Stan Mazur-Hart
Office of Mental Health and Addiction Services
Oregon Department of Human Services
500 Summer Street NE, E-86
Salem, Oregon 97301-1118
Mr. Mazur-Hart,
10.15.05
This letter is the14th quarterly report regarding the expenditure of MHS 20 funds
received to provide services to adults with co-occurring disorders within the jail and
community corrections system in Deschutes County. These funds continue to be
utilized to support my Mental Health Specialist I (QMHA) position.
Since June 3`d 2002, 212 clients with co-occurring disorders have received
services under this program. Of these clients, the following are current statistics:
Open/Closed: 20 of the 212 clients are currently open and receiving services
from the Jail Bridge case manager.
Gender: Of the 212 clients served, 150 are male and 62 are female.
Ethnic Identity: of the 212 clients served; 4 identify themselves as Native
American, 3 as African American, 3 as Hispanic, and 1 as other. The remaining
and 201 identify themselves as Caucasian.
Age: The age breakdown is as follows:
18-25 = 41 clients
26-35 = 47 clients
36-45 = 34 clients
46-55 = 23 clients
56+ = 5 clients
Referral Sources: Of the 212 clients, 103 clients were referred from Deschutes
County Adult Jail, 90 were referred from Deschutes County Adult Probation, and
19 were referred from Deschutes County Mental Health.
Funding: At the time they were opened for services in the bridge program
• 43=OHP
• 1 =private insurance
• 6 = Medicare
• 162 = no insurance coverage/funding
Vocational: Of the 20 clients currently open under the bridge program, none are
in vocational rehabilitation and 4 are currently working.
Re-arrest/Revocation:
In order to have a better sense of the impact of the bridge program and mental
health treatment on recidivism, I have narrowed the scope to those clients who
have received significant service hours. I have defined significant as: 8 or more
bridge case management hours, and/or, 20 or more total service hours from
DCMH since being opened under the bridge program. As of 10.15.05, 1 have
identified 86 (of 212) clients who meet this criteria. I pulled statistics regarding
jail days for these 86 clients for the 12 months prior to being opened under the
bridge program and the 12 months after being opened under the program.
33 of the 86 have no new arrests in the 12 months after being opened
under the bridge program. In the 12 months prior to bring opened these 33
clients totaled 1,540 bed days in the Deschutes County Adult Jail. It is
estimated that the cost to house an inmate for 1 day at the DCAJ is
$77.00. In the year prior to receiving bridge services these client's
cost Deschutes County $148,000.00.
29 of the 86 reduced their number of jail days.
o In the 12 months prior to receiving bridge services these 29
individuals accounted for 2,529 jail days ($194,000.00). In the
12 months after receiving bridge services these 29 clients
totaled 606 bed days in the DCAJ. Perhaps without intervention
and treatment services these clients would have continued to
offend at the same rate as prior to treatment.
o 9 of these 29 were incarcerated for probation violations only,
and had no new crimes.
• Of the remaining 24 clients whose jail days increased in the 12 months
after being opened under the bridge program:
o 4 of these client totaled 13 bed days for the entire 24 month
period
L '
d
o Of the remaining 20 clients who increased their bed days 9 have
had no incarcerations for at least the last 12 months.
o The remaining 11 clients account for 1447 of the 3455 total jail
days (41 served by bridge clients in the 12 months after
being opened for bridge services.
■ 3 of the 11 are labeled baby armed career criminals by the
law enforcement database
■ 4 of the 11 are currently in prison
■ 3 of the 11 have active warrants
■ 3 of these 11 are currently inmates at the DCAJ
Program Overview
This population of clients faces a myriad of barriers to being successful. In addition
to mental health and drug/alcohol abuse, these clients are also faced with: no
income/employment, homelessness, limited support systems, and limited access to
health insurance. Though my goal continues to be to divert my clients from incarceration
and hospitalization, I have adopted a "harm reduction" outlook on success. It's
important to note that there are a about a dozen of my clients who do not look
particularly successful on paper, but who I believe have made great strides in their
mental health stability and alcohol and drug abuse issues. There is also about another
dozen whose criminality seems to really be the primary factor in their re-incarcerations.
continue to feel the impact of the OHP cuts of 2+ years ago on this population. With
the OHP cuts, state budget cuts, and county mental health cuts; treatment options for
this population continue to dwindle. Housing continues to be a barrier for these clients
maintaining stability in the community. Deschutes County Mental Health is now only
able to serve individuals with OHP Plus, with a severe and persistent mental illness, or
individuals in crisis. Many of my persistently mentally ill clients do not have OHP, and
maintaining these client's on medications is a daily battle.
The multi-disciplinary team continues to meet to review difficult cases referred to the
jail bridge case manager and to review the Bridge Program's effectiveness in general.
The following individuals are members of this team: Pat Tabor (Parole & Probation),
Julianne Fouts, LCSW (Jail), Kara Cronin, QMHA (Jail Bridge Case Manager), and
Elisabeth Huyck, M.A. (DCMH Supervisor). The team meets once a month to discuss
global barriers for this population, individual referrals, the referral process, revocations,
diverting revocations, and treatment planning for the individuals served in the Bridge
Program.
I continue to coordinate care, provide intensive case management, and connect
these clients to treatment services. As stated in previous reports, I continue to assist
with:
• 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 with 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 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.
• Assisting clients coming out of prison in connecting with mental health and
community supports.
• Completing ASAM drug and alcohol assessments in the jail, and make
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 provided us with the ability to improve our services to individuals
with co-occurring disorders who are involved with the criminal justice system. The
Bridge position appears to be increasing the success rate of the client's ability to remain
out of the criminal justice system while remaining in treatment. The Bridge position has
also greatly improved communication and cooperation between agencies.
If you have any question, please do not hesitate to contact me at 541-322-7526
Sincerely,
Kara Cronin, BA CADCI
Bridge Program Case Manager
Deschutes County Mental Health
1128 NW Harriman St.
Bend, OR 97701
(541) 322.7526