HomeMy WebLinkAbout12-05-17 PSCC Meeting MinutesDESCHUTES COUNTY
PUBLIC SAFETY COORDINATING COUNCIL
Tuesday December 5, 2017; 3:30 PM, Allen Room
Deschutes Services Building, 1300 NW Wall, Bend, OR
Agenda
I Call to Order & Introductions
Chair Commission Tammy Baney
II October Minutes Attachment 1
Chair Baney
Action: Approve May minutes
III Public Comment
Chair Baney
IV Debrief the Eclipse Nathan Garibay
Discuss lessons learned
V NACo Stepping Up Initiative Attachments 2-5
Chair Baney
Brief Council on initiative
VI Deschutes Stabilization Center Update
George Conway
Provide update with Holly Harris, Dr. Berry and Captain McMaster
VII Other Business Attachment 6
Chair Baney
Attachment 2
2017
N
Attachment 3
JANUARY
Reducing the Number of People
with Mental Illnesses in Jail
Six Questions County Leaders Need to Ask
Introduction
Risë Haneberg, Dr. Tony Fabelo, Dr. Fred Osher, and Michael Thompson
ot long ago the observation that the Los Angeles County Jail serves more people with mental illnesses than any single mental
health facility in the United States elicited gasps among elected officials. Today, most county leaders are quick to point out
that the large number of people with mental illnesses in their jails is nothing short of a public health crisis, and doing something
about it is a top priority.
Over the past decade, police, judges, corrections administrators, public defenders, prosecutors, community-based service providers, and
advocates have mobilized to better respond to people with mental illnesses. Most large urban counties, and many smaller counties, have
created specialized police response programs, established programs to divert people with mental illnesses charged with low-level crimes
from the justice system, launched specialized courts to meet the unique needs of defendants with mental illnesses, and embedded mental
health professionals in the jail to improve the likelihood that people with mental illnesses are connected to community-based services.
Despite these tremendous efforts, the problem persists. By some measures, it is more acute today than it was ten years ago, as
counties report a greater number of people with mental illnesses in local jails than ever before.1 Why?
After reviewing a growing body of research about the characteristics of people with mental illnesses who are in contact with local
criminal justice systems; analyzing millions of individual arrest, jail, and behavioral health records in a cross-section of counties
across the United States; examining initiatives designed to improve outcomes for this population; and meeting with countless people
who work in local justice and behavioral health systems, as well as people with mental illnesses and their families, the authors of
this brief offer four reasons why efforts to date have not had the impact counties are desperate to see:
There are insufficient data to identify the target population and to inform efforts to develop a system-wide
response. New initiatives are frequently designed and launched after considerable discussion but without sufficient local data. Data
that establish a baseline in a jurisdiction—such as the number of people with mental illnesses currently booked into jail and their
length of stay once incarcerated, their connection to treatment, and their rate of rearrest—inform a plan’s design and maximize
its impact. Furthermore, eligibility criteria are frequently established for diversion programs without the data that would show how
many people actually meet these criteria. As a result, county leaders subsequently find themselves disappointed by the impact of their
initiative. Counties that recognize the importance of using this data to plan their effort often find the data they need do not exist. It
is rare to find a county that effectively and systematically collects information about the mental health and substance use treatment
needs of each person booked into the jail, and records this information so it can be analyzed at a system level.
Program design and implementation is not evidence based. Research that is emerging on the subject of people with
mental illnesses in the justice system demonstrates that it is not just a person’s untreated mental illness but also co-occurring
substance use disorders and criminogenic risk factors that contribute to his or her involvement in the justice system. Programs that
treat only a person’s mental illness and/or substance use disorder but do not address other factors that contribute to the likelihood of
a person reoffending are unlikely to have much of an impact. Further, intensive supervision and limited treatment resources
are often not targeted to the people who will benefit most from them, and community-based behavioral health care providers are
rarely familiar with (or skilled in delivering) the approaches that need to be integrated into their treatment models to reduce the
likelihood of someone reoffending.
2
The initiative is small in scale. Due to scarce resources, diversion programs or improvements to reentry planning are
frequently launched as pilots, rarely taken to scale, and as a result unable to serve many of the people who would be eligible for
them. And community-based treatment and other supports are frequently stretched so thin that they are only able to reach a small
fraction of the people who need them.
The impact of the initiative is not tracked. County leaders making a significant investment in community-based services
and supervision for people with mental illnesses should know what impact that investment has had on these four key measures:
reducing the number of people with mental illnesses booked into jail, reducing the length of time people
with mental illnesses remain in jail, increasing connections to treatment, and reducing recidivism. But few
counties have benchmarked these numbers, and capacity to collect and analyze data is so limited that many county leaders are
unable to get data on how many people received treatment and other services or how many people completed a program. Without
outcome data, however, it is hard for the people who administer programs and services to focus on clear targets. Similarly, it is hard
for county leaders to hold program administrators accountable for desired results.
The Six Questions Counties Need to Ask
Despite these challenges, many counties have made significant strides toward reducing the number of people with mental illnesses
in their jails. Other counties are just starting their efforts or may be unsure of efforts already underway in various parts of their
systems. To assess their community’s existing efforts to reduce the number of people with mental illnesses in jail, county leaders
should ask themselves the following questions:
1. Is our leadership committed?
2. Do we conduct timely screening and assessments?
3. Do we have baseline data?
4. Have we conducted a comprehensive process analysis and inventory of services?
5. Have we prioritized policy, practice, and funding improvements?
6. Do we track progress?
Leaders in counties across the U.S. who scan these questions will readily respond affirmatively. Indeed, there are many counties
that can provide excellent examples of what successfully addressing one or more of these questions looks like. But few counties have
taken the steps necessary to satisfy all the above questions. Doing so is hard—extraordinarily hard. These issues are complex.
Resources are limited. And a host of independently elected officials and a tangled web of private and not-for-profit service providers
must set aside their own agendas and collaborate extensively.
What Does “Mental Illness” Mean?
The term “mental illness” is defined by The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, as “a
syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior
that re flects dysfunction in the psychological, biological, or developmental processes underlying mental functioning.”2
For the purposes of the Stepping Up initiative, “people with mental illnesses” should be understood also to encompass people
with co-occurring substance use disorders, as well as “serious mental illness” (SMI) or “serious and persistent mental illness”
(SPMI), which are defined as a mental, behavioral, or emotional disorder that is diagnosable within the past year, is chronic
or long lasting, and results in a significant impairment in social, occupational, or other important areas of functioning.3 Some
states use SMI and SPMI interchangeably, while others differentiate between SMI and SPMI based on the severity of the
associated functional impairment.
Some states specify the diagnoses that they accept as qualifying for an SMI, including schizophrenia, schizoaffective disorder,
bipolar disorder, and severe forms of major depression and anxiety.
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 3
To be clear, this brief does not assume that the number of people with mental illnesses in jail can be reduced only when counties have
addressed all of these questions. But county leaders will find that thoughtful consideration of each of these six questions will help
them determine to what extent their efforts will have a system-level impact, not only resulting in fewer people with mental illnesses in
jail, but doing so in a way that increases public safety, applies resources most effectively, and puts more people on a path to recovery.
1. Is Our Leadership Committed?
Are county policymakers—such as commissioners, supervisors, or managers—and key leaders from the criminal justice and
behavioral health fields fully invested in the goal of reducing the number of people with mental illnesses in jail?
Why it matters
Reducing the number of adults with mental illnesses in jails requires a cross-systems, collaborative approach involving a county-wide
committee or planning team. Strong leadership, including the active involvement of people responsible for the county budget, is essential
to rally agencies reporting to a variety of independently elected officials. The designation of a person to coordinate the planning team’s
meetings and activities and to manage behind-the-scenes details pushes the project forward and ensures that the work gets done.
What it looks like
✓ Mandate from leaders responsible for the county budget: The elected body representing the county (e.g.,
county commissioners) has established a clear mandate in the form of a resolution or other formal commitment for
behavioral health and criminal justice system administrators to implement systems-level reforms necessary to reduce the
number of people with mental illnesses in jail.4
✓ Representative planning team: The planning team comprises key leaders from the justice system, such as the
sheriff or jail administrator, judges, prosecutors, defense bar, law enforcement executives, and community supervision
officials; key leaders from the behavioral health system, such as the director of mental health services, other community-
based behavioral health care providers, such as substance use treatment providers, and health care financing experts;
representatives from the community, including organizations representing people with mental illnesses and their families
(e.g., National Alliance on Mental Illness [NAMI]); and representatives from county government, such as commissioners
or a county manager, and representatives of municipal government, such as the mayor or police chief. The planning team
might be part of an existing criminal justice coordinating council or task force.
✓ Commitment to vision, mission, and guiding principles: The planning team is clear on the mandate, and is
committed to making the necessary agency-level changes. Formal agreements, such as memorandums of understanding
(MOUs), are in place to effectuate team function and document the initiative’s vision, mission, and guiding principles, as
well as to formalize the expectation that top decision makers will be in attendance for planning meetings.
✓ Designated planning team chairperson: The chairperson is a county elected official or other senior-level
policymaker who is in routine contact with leaders responsible for developing the county budget and administering the law
enforcement and behavioral health systems, and who can engage the stakeholders necessary to the success of the initiative.
County leaders have charged the chairperson with holding agency administrators accountable for the implementation of the
plan. These agency administrators are aware that the chairperson must provide routine updates to county leaders, often in
an open forum, such as a commission meeting.
✓ Designated project coordinator: The planning team has assigned a project coordinator to work across system agencies
to manage the planning process. The project coordinator—who might also be the county’s criminal justice coordinator—
facilitates meetings, builds agendas, provides meeting minutes, and organizes subcommittee work as needed. The project
coordinator also assists with research and data analysis, and is in constant communication with planning team members.
4
Adopting a Definition of Mental Illness
When establishing its definition of mental illness, a county may decide to focus on the population with SMI, which is defined by
the state and denotes the population with the most severe impairments who are often eligible for publicly funded services. The
planning team may adopt the state’s definition, or may choose another definition based more on local considerations. In any
case, the definition is one that both criminal justice and mental health professionals can understand and use with confidence.
Although this may at first seem a simple task, many planning teams struggle with this exercise. The focus needs to remain on
the practical use of the definition to determine the target population of the initiative. For example, a county may agree to use the
state’s definition of SMI but describe it in more detail to include a diagnosis established through an assessment process that,
without treatment, impairs the day-to-day functioning of the individual.
Because many people are released from jail within 24 hours, screening immediately at booking for mental illness based
on the county’s established definition casts the widest net to include people with mental illnesses of varying degrees of
severity, thus capturing the true prevalence of mental illness in the jail.
2. Do We Conduct Timely Screening and Assessments?
Is screening for mental illness and substance use conducted for everyone booked into jail, along with full, follow-up assessments,
as time allows, for people who screen positive for these conditions? Are assessments measuring a person’s risk of flight and risk
of reoffending while awaiting trial also conducted and combined with screening information to guide decision making from the
pretrial phase through final case discharge?
Why it matters
To reduce the number of people with mental illnesses in jail, counties first need to have a clear and accurate understanding of the
prevalence of mental illnesses in their jail populations. This requires the universal screening of every person booked into jail for
mental illness, as well as for other behavioral health needs, such as substance use. Additionally, assessing for criminogenic risk
(or the likelihood that someone will commit additional offenses) further informs release decisions, such as whether to require
supervision or services to reduce the risk of reoffending. Without this foundational information, counties are ill equipped to track
whether the number of people with mental illnesses in jail is actually being reduced, and if those identified with behavioral health
needs are getting connected to the right types of interventions. [See Figure 1]
What it looks like
✓ System-wide definition of mental illness: The county has established a definition of mental illness that is
consistently applied throughout the local criminal justice and behavioral health systems. At the state level, a definition
of mental illness and/or serious mental illness (SMI) exists to determine eligibility for treatment and services funded by
the state. In many counties, health officials use the state’s definition to guide service-delivery decisions, but that is not
the case in every county. Health care providers working in the jail often use a definition of mental illness that is distinct
from what local or state health officials use. For example, a jail may screen only for suicide risk rather than screening
for mental illness based on a system-wide definition of mental illness. Judges may receive pretrial release and sentencing
recommendations concerning behavioral health needs that are not based on formal screening. Or mental health clinicians
working inside the jail may describe a person’s mental health needs in terms that do not align with the state’s definition of
who qualifies for publicly funded mental health services. Adopting a single definition of mental illness that is consistently
used by local behavioral health systems, as well as the jail, courts, and community corrections, ensures that all systems are
using the same measure to consistently identify the population that is the focus of the initiative’s efforts.
✓ System-wide definition of substance use disorders: The planning team agrees on a consistent definition of
substance use disorders, a definition that may include substance use disorders that co-occur with mental illnesses. It is
critical to be aware of the presence and severity of a substance use disorder both to identify a clinical need and to address
the condition as a risk factor for reoffending.
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 5
✓ Validated screening and assessment tools for mental illness and substance use: To ensure the accurate
identification of the behavioral health needs of everyone booked into jail, the county has implemented validated screening tools
and assessment processes.5 The Brief Jail Mental Health Screen and the Texas Christian University Drug Screen V (TCUDS V) are
validated mental health and substance use screening tools that are available in the public domain, are easy and efficient to
administer, and do not require specialized staff such as a sworn officer or a mental health professional to conduct.6
✓ Efficient screening and assessment process: The development of a screening and assessment process requires
the planning team to determine the best party to conduct the screening. In some jurisdictions, jail personnel do the
screening; in others, it is a contracted or embedded medical or behavioral health care provider. The logical time and
place for screening for mental illnesses and substance use disorders is at booking into the jail, and within this churning
environment, quick and efficient processing is necessary. If a person screens positive for a mental illness, a full clinical
assessment by a mental health professional is necessary to confirm the screening result. Because an individual may be
released from jail before the assessment can be completed, a process is in place to connect him or her to a mental health
care provider to complete the assessment process.
✓ Validated assessment for pretrial risk: Many jurisdictions do not screen for criminogenic risk until after a
defendant’s case is adjudicated. It is also essential, however, to conduct a pretrial risk assessment to inform decisions about
a defendant’s pretrial release, eligibility for pretrial diversion, and conditions of pretrial supervision. Such screenings are
conducted prior to a person’s first appearance/arraignment in order to inform the court of pretrial risk of failure to appear
and risk for new criminal activity.7 Mental illness in and of itself is not considered to be a risk factor, but is considered in
relation to release and case-planning decisions.8
✓ Mechanisms for information sharing: The planning team has developed information-sharing agreements for
agencies that protect the individual’s privacy and support the need to share behavioral health information. The results of
screening and assessments are used to inform key decisions related to pretrial release, diversion, discharge planning, and
specialized pretrial and post-conviction community supervision. Jurisdictions often create a flag process that serves as an
indicator of the need to connect a person to services and to gather the necessary releases to enable discussing the case. A
data match of all people booked into jail and the behavioral health system’s database identifies people who have previously
received behavioral health care services and may require reestablishment of services.
Key Considerations for Information Sharing
Good communication is at the heart of effective collaborations between criminal justice and behaviora l health systems, but
often concerns about confidentiality and privacy laws, as well as incompatible information systems, often hamper best
efforts to share information effectively. Counties need to develop the information-sharing policies and protocols necessary
to facilitate system analysis and case management, while adhering to professional codes of ethics and privacy law. Some
key considerations are:
• Identi fying information: A discussion with interagency stakeholders about what information is needed to inform
decision making and case planning and how this information will be used can help address concerns about
confidentiality and build trust across agencies. Identifying the minimum necessar y information to share helps keep
the flow of information manageable and also adheres to the principles underlying privacy law.
• Agreements: It’s critical to understand relevant federal and state law relating to privacy and information sharing,
and to develop appropriate interagency agreements (such as MOUs) and local protocols (such as release-of-
information forms) when protected information is involved.
• Training: Ongoing staff training must be a priority when collecting, sharing, and analyzing information.
• Regular reviews: Regular reviews are necessary to identify opportunities to improve information-sharing processes
and data analyses and to ensure confidentiality and privacy requirements are being met.
6
FIGURE 1. THE CRIMINOGENIC RISK AND BEHAVIORAL HEALTH NEEDS FRAMEWORK
Group 6
II - H CR: med/ high
SA: low
MI: med/ high
Group 7
III - H CR: med/ high SA: med/ high
MI: low
Group 8 IV - H CR: med/ high SA: med/
MI: med/ high
Group 4
IV - L
CR: low
SA: med/ high MI: med/ high
Group 2
II - L
CR: low
SA: low
MI: med/ high
Serious
Mental
Illness
(med/high)
Low
Severity
of Mental
Illness
(low)
Serious
Mental
Illness
(med/high)
Low
Severity
of Mental
Illness
(low)
Serious
Mental
Illness
(med/high)
Low
Severity
of Mental
Illness
(low)
Serious
Mental
Illness
(med/high)
Low
Severity
of Mental
Illness
(low)
Substance
Dependence
(med/high)
Low Severity of
Substance Abuse
(low)
Substance
Dependence
(med/high)
Low Severity of
Substance Abuse
(low)
Medium to High Criminogenic Risk
(med/high)
Low Criminogenic Risk
(low)
The Criminogenic Risk and Behavioral Health Needs Framework
Wi th mounting research that demonstrates the value of science-based tools to predict a person’s likelihood of reoffending,
criminal justice practitioners are increasingly using these tools to focus limited resources on the people who are most likely
to reoffend. At the same time, mental heal th and substance use practitioners are trying to prioritize their scarce treatment
resources for people with the most serious behavioral health needs. A person who screens positive for mental illness and/
or substance use should be connected to appropriate treatment at the soonest opportunity; however, when that person is
also assessed as being at a moderate to high risk of reoffending, connection to t reatment is an even higher priority, along
with interventions such as supervision and cognitive behavioral therapy to reduce the risk of recidivism.
The framework depicted in Figure 1 outlines a structure for state and local agencies to consider how information about
risk of reoffending, and substance use and mental health treatment needs can be considered in combination to prioritize
interventions to have the greatest impact on recidivism.
In Practice: The Screening and Assessment Process in Salt Lake County, Utah
Salt Lake County, Utah, screens for mental health, substance use, and criminogenic risk at booking for everyone charged
with a class B misdemeanor or above. This process was implemented in December 2015, and county officials are tackling
challenges such as information sharing and staffing needs, as well as coordinating with a statewide data bank. Moving
forward, an accurate assessment of prevalence will better inform Salt Lake County of the servi ce and supervision needs of
people booked into jail, as well as provide a baseline to measure p rogress in reducing the number of people with mental
illnesses in their jail.
Group 1
I - L
CR: low
SA: low
MI: low
Group 3
III - L
CR: low
SA: med/ high
MI: low
Group 5
I - H CR: med/ high
SA: low
MI: low
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 7
3. Do We Have Baseline Data?
Has the county established baseline measures of:
• The number of people with mental illnesses booked into jail
• Their average length of stay
• The percentage of people connected to treatment
• Their recidivism rates
Why it matters
Baseline data highlight where some of the best opportunities exist to reduce the number of people with mental illnesses in the jail,
and provide benchmarks against which progress can be measured. Knowing the current number of people with mental
illnesses admitted into the jail helps county leaders determine whether new prevention and diversion strategies are resulting in
fewer jail bookings of people with mental illnesses. Calculating the average length of stay for people who screen positive for
mental illness helps the county recognize whether people with mental illnesses are especially likely to languish in the jail. Tracking
connections to treatment illuminates to what extent there is continuity in care, post release. Without a baseline recidivism
rate, the county cannot assess whether investments in community-based supervision and treatment are reducing the rearrest and
reincarceration rates among people with mental illnesses released from jail.
What it looks like
✓ System-wide definition of recidivism:
The planning team agrees on how it is
measuring recidivism, recognizing that rearrest,
convictions for a new crime, or the return to
custody for violating conditions of release (i.e.,
technical violations) are each important, but
distinct, ways of measuring whether a person
engages in criminal activity and/or how law
enforcement, the courts, and corrections respond
to the behavior of someone released from jail
and/or under community supervision. Agreeing
on a definition of recidivism also requires using a
consistent time period for reporting recidivism
data (e.g., one, two, and/or more years).
✓ Electronically collected data: Data
that draw on results of screening and assessments that are conducted for each person admitted to jail are collected
electronically to support ongoing analysis. In many cases, this analysis requires access to multiple databases. Some counties
have navigated this situation by creating an integrated data management system. Others use a more “home-grown” data
warehouse system, and still others may rely on a master spreadsheet approach. The end goal is to have the capacity to
capture and analyze key data effectively.
✓ Baseline data on the general population in the jail: Data must be collected for people with and without mental
illnesses, to provide a point of comparison that can be used to determine whether disparities between these populations exist
in bookings, length of stay, or recidivism rates. These comparisons can be especially useful when data on both populations
are disaggregated further by risk level, race, or gender.
In Practice: Adopting a Definition of
Recidivism in Bexar, Dallas, El Paso,
Harris, and Tarrant Counties, Texas
The five most populous counties in Texas follow the state’s standard
measure of recidivism as rearrest within one, two, and three years of
release from jail. These counties use the same recidivism definition
to measure recidivism for people diverted to community-based
supervision or other alternatives to incarceration. These counties
also frequently measure recidivism in additional ways, such as
reincarceration for a violation of a condition of release, but agreeing
on a common measurement of recidivism allows for consistency,
which is critical for the purposes of this work.
8
In Practice: How Baseline Data Inform Planning
When a county analyzes the number of people with mental illnesses in the jail, the average length of stay in jail for this
population, rates at which they a re connected to treatment, and their rearrest rates—or determines whether this information
can even be assembled—the findings help illuminate strategies that will deliver the greatest return on investments.
✓ Routine reports generated by a county agency, state agency, or outside contractor: Reports containing
information about the number of people with mental illnesses in jail, length of stay in jail, connections to treatment, and
recidivism should not be a one-time deliverable. The baseline data should be generated with the understanding that this will
be a report that is updated at least annually, using consistent definitions to track changes year to year.
Jurisdiction Metric Finding Action Taken
Bexar
County,
Tex as
The number of people with
mental illnesses in jail
County does not know how many people
with mental illnesses are in the jail.
Bexar County established universal
screening for mental illnesses.
New York
City,
New York
Length of stay People with mental illnesses stayed in
jail 112 days on average as compared
to 61 days for those without mental
illnesses.
New York City implemented early
pretrial diversion options to move
people with mental illnesses out of jail
in a timely way.
Franklin
County,
Ohio
Connection to care post-
release
More than one in three of people who
had contact with the behavioral health
care system in the year prior to their
incarceration did not have contact with
the behavioral health care system in the
year following their release from jail.
The local Alcohol Drug And Mental
Health (ADAMH) board established
a jail liaison team to provide in-reach
service to get follow-up appointments
within two weeks of release.
Salt Lake
County,
Utah
Recidivism rate One out of three people on pretrial
supervision and one out of two people
on county probation did not fulfill the
requirements of their supervision.
Salt Lake County recommendations
included establishing intensive
supervision caseloads for people who
are assessed as being moderate to high
risk of reoffending and who are also
assessed as having an SMI.
Key Considerations for Developing an Integrated Data System
County officials must know the number of people booked into jail. For most counties, collecting and analyzing data, and
doing so on a regular basis, is challenging, to say the least. It is not unusual for jail admission and release data to be in
one information system maintained by the county, while arrest data may be found in a statewide database, and gathering
information about people who have received community-based health services requires the cooperation of behavioral
health care agencies. The gold standard for a system that enables a county to establish baseline data, share information,
and track progress is an integrated system that allows multiple agencies to enter as well as access the data. A single,
integrated information system also enables rich reporting that includes connections to treatment or other data related to a
person’s experience after he or she returns to the community. Some jurisdictions in the country have implemented a fully
integrated system, while others have developed progressive systems that store and share date across agencies.9
It is essential for information technology (IT) staff to be involved in the planning discussion about developing an integrated
data system. For some counties the IT staff may be a stand-alone department, for others it is a single person in the Sheriff’s
Office, and for others it might be a private contractor or local university research partner. The IT staff can assist the planning
team to develop a programming solution to the challenge of tracking the flow of people with mental illnesses as they move
through the criminal justice and behavioral health systems and receive treatment in the community. The system should also
provide the ability to track recidivism for this population and to identify high utilizers of justice, behavioral health, and other
social services.
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 9
4. Have We Conducted a Comprehensive Process Analysis and Inventory of
Services?
Has the planning team completed an exhaustive, end-to-end analysis of the system’s processes from the point of law enforcement’s
contact with a person with a mental illness through final case discharge? Does the analysis go beyond the sequential intercept
mapping exercise familiar to many counties that have reviewed what programs and services exist at arrest, booking, pretrial
detention, release, and community supervision? Are decisions and actions—as well as failures to act—that contribute to the high
prevalence of people with mental illnesses in jail flagged? Are existing services and supports in the community identified, along
with those that are missing?
Why it matters
In every county, there is a timeline that includes the moment when a 911 call center receives a mental health call for service,
or when a person identified with having a mental illness is booked into jail, or when defense counsel receives the results of that
person’s mental health screening–each an opportunity to improve the response to the person’s mental health needs. Counties
must create policies and processes that ensure that a person’s mental health needs are accurately identified and the right type of
information is shared appropriately and efficiently to inform key decisions related to diversion, pretrial release, specialized probation
supervision, and connection to community-based services.
Without completing a comprehensive process analysis, these opportunities are often not identified and thus are missed. Timely
information is not generated or shared appropriately, or perhaps a defense counsel, judge, or probation officer receives this
information but does not use it to inform their decisions. The detailed, point-by-point system review helps county leaders determine
where these breakdowns in process occur and where improvements can be made. Recognizing that successful implementation of
a plan hinges on the accessibility of community-based treatment, which typically is in limited supply (if it exists at all) in most
counties, it is important that an inventory of services and supports also be conducted.
What it looks like
✓ Detailed process analysis: The county planning team, perhaps organized into subcommittees, traces each step of a
person’s involvement in the justice system, from the moment when police receive a mental health (MH) call for service to
the person’s admission to jail to the person’s release from jail and connection to community-based treatment, services, and
supervision. At each decision point, the team asks questions such as:
• What is the process associated with the decision?
• Is the process timely and efficient?
• What information is collected at that point in the process?
• How is that information shared and with whom?
• How is that information acted upon?
• Are the people involved in each decision point trained in their role?
✓ Service capacity and gaps identified: The planning team identifies what options exist at each decision point,
including crisis services, diversion opportunities, and community-based treatment, services, and supervision. The team also
identifies what services are not available, or exist but do not meet capacity needs.
✓ Evidence-based programs and practices identified: County leaders are provided with a detailed description
of existing services and gaps in services that apply the latest research about what works to meet the needs of people with
mental illnesses and reduce the likelihood that they will commit a new offense. This scan of service capacity also reflects
historical data or best estimates related to demand for these services.
10
FIGURE 2. A COUNTY’S PROCESS ANALYSIS FOR THE ARREST/BOOKING STAGE
FLOW OF DEFENDANTS THROUGH A COUNTY SYSTEM
1
WARNING
CIT training of law
enforcement is not
comprehensive;
protocols vary
by agency
Yes:
arrest
Police respond to call;
determine whether to No make an arrest
2
WARNING
Law enforcement
is often unable to locate a facility
with capacity for
APs with acute
MH needs
Arrested Person (AP)
taken into custody
For specificed
jurisdictions
• AP can be diverted to services
with referral, with AO supervisor’s
approval (misdemeanor only);
• Or AP can be released out of
psych facility
If Municipal Police
23 municipalities
Hospital/psychiatric facility is
not appropriate, AO may take
individual to shelter
AO verifies ID of AP Booking information is
completed and entered
electronically/manually as
IT capacity allows
3
WARNING
“Shakedown” process by
booking officer; personal
information entered
electronically
Medical professional screens
for medical or mental
health issue; can refer
for special services
Medical assessment becomes
part of police report
Detention officer completes
“case routing form” and
enters information on
Central Intake screen for
suicide, medical, and
mental impairments
4
WARNING
Automated information system
data entry happens
at various times
5
WARNING
AP brought to city jail if
Misd. C or lower; AP can
bond out or be released
from city detention center
If in crisis and no offense or
Misd C or lower, arresting
officer (AO) may take the person
to hospital or psychiatric facility
Exit out of
criminal justice
system
Lack of standardized policies
at the various detention
facilities across the county
“Case routing form,”
Central Intake assessment,
and housing recommendation
completed
Medical staff cross check jail
booking information with
local hospital(s) system to
check MH history; info is not
shared with county jail Arrest and Booking
AP brought to county
jail for booking
AP with Misd. B or higher
brought to county jail
for booking
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 11
5. Have We Prioritized Policy, Practice, and Funding Improvements?
Do key findings from the system analysis inform the development of action items? Are these action items realistically prioritized
by county leaders to maximize the impact of existing resources and to identify new resources to reduce the number of people with
mental illnesses in their jail?
Why it matters
County leaders should provide guidance to the planning team on how to make policy recommendations and budget requests that
are practical, concrete, and aligned with the fiscal realities and budget process of the county. Routine communication with the
people responsible for the county budget (e.g., county commissioners and other officials) engages these leaders in the planning
team’s ongoing efforts and increases the likelihood that the recommendations will be received favorably.
Recognizing the limitations (and opportunities) that distinct funding streams present is critically important. The planning
team’s budget proposal should identify external funding streams, including federal programs such as Medicaid, federal grant
opportunities, and state block grant dollars as the first source for funding. Opportunities for local philanthropic support should also
be considered. The final gaps in funding will represent new county investments.
What it looks like
✓ Prioritized strategies: For a county to reduce the prevalence of mental illness in jail, it must accomplish one or
more of the following: reduce the number of people with mental illnesses admitted to jail, reduce their
length of stay, increase their connections to treatment, and reduce recidivism. Drawing on the system
analysis described earlier, the planning team determines the most achievable ways of accomplishing one or more of these
goals, with an emphasis on strategies that impact people with the most serious behavioral health needs who are also at the
highest risk of reoffending. [See Figure 1]
✓ Detailed description of needs: Per county leaders’ guidance, the planning team submits a proposal to the county
board related to its identified priorities. If necessary, the planning team’s proposal identifies the need for additional
personnel, increased capacity for mental health and substance use treatment services and support services, such as housing
and employment, and infrastructure improvements, such as information systems updates and training. All programming
requests include evidence-based approaches that are carefully matched to the particular needs of the population. The
proposal addresses implementation considerations regarding staffing requests such as staff placement and supervision,
whether personnel are sworn or unsworn, whether mental health clinicians are behavioral health agency employees who are
embedded in the jail or community supervision agencies, or if outsourcing to private providers is an appropriate option.
✓ Estimates/projections of the impact of new strategies: At a minimum, the plan projects the number of people
to be served and explains to what extent new investments made will affect one or more of the following key measures:
• Reduce the number of people with mental illnesses booked into jail
• Reduce the length of time people with mental illnesses remain in jail
• Increase connections to treatment
• Reduce recidivism
The county commission does not endorse a plan that does not set out to meet these requirements. If policies or programs are
adopted that that do not address the key measures, the county cannot expect to reduce prevalence rates. The proposed strategies
include an impact analysis that describes the number of people to be served and the estimated improvement in services.
12
In Practice: How Process Analysis Informs Planning
Jurisdictions that have completed an analysis of their jail population have identified key findings and related system-wide
responses that can potentially help to reduce the number of people with mental illnesses in their jails.
✓ Estimates/projections account for external funding streams: The plan describes to what extent external
funding streams can be leveraged to fund new staff, treatment and services, and one-time and ongoing costs. These external
funding sources may include:
• Federal program funding, including Medicaid, veterans’ benefits, and housing assistance
• State grants for mental health and substance use treatment services
• Federal and state discretionary grants
• Local philanthropic resources
✓ Description of gaps in funding best met through county investment: Per budget process guidelines, the
planning team’s proposal should include specific suggestions for how county funds can meet a particular need, or fill a gap
that no other funding source can.
Identified
Gap
Data
Illustrating
Gap
Objective Measure
Addressed
Projected Cost and
Identified Sources of
Funding
Data to be
Tracked
Crisis Intervention
Team (CIT)-
trained officers
are not available
to provide 24/7
coverage
Number of mental
health calls for
service that did
not have CIT-
trained officers
Increase level
of trained CIT
officers to
achieve 24/7
coverage
Measure #1:
the number
of people
with mental
illnesses
booked into
jail
Cost: Specialized one-week
training of 25 officers at a time;
overtime (OT) costs for the
officers; training materials
Funding: Local law enforcement
assumes the cost for OT, all other
costs shared by participating
agencies on pro-rated formula
Number of mental
health calls; percent
of calls responded
to by CIT-trained
officers; number of
calls disposed of
without jail booking
Compare against
baseline data of the
number of people
booked into jail who
are screened for
mental illness
Specialized
probation
supervision
alternatives are
not available for
people identified
with SMI and
moderate-to-
high-criminogenic
risk
Number of
probation
revocations for
this population,
including
for technical
violations and
new crimes
Develop
specialized
caseload
that is co-
supervised
by probation
staff and a
mental health
professional
Measure #4:
recidivism
Cost: Full-time probation officer
and mental health professional
sta ff; other staff-related needs,
such as space and equipment
Funding: Determine whether low-
risk caseloads can be consolidated
to create capacity for specialized
caseloads; identify potential grant
opportunities; determine whether
Medicaid funding can be utilized for
case management
Track the number of
probation revocations;
track successful
probation completion
rates; track recidivism
rates for people
assigned to special
caseloads
Key Considerations for Training
Training is an ongoing process that is critical to implementing and sustaining new policies and programs. The implementation
of evidence-based practices, such as risk assessment or curriculum-based interventions, necessitate adherence to training
requirements to ensure fidelity. If a program or practice is implemented without a plan for quality assurance that includes
training, the anticipated outcomes of the intervention will be jeopardized. A county’s training plan should include a regular
check for current certifications, refresher training, and internal coaching to maintain quality and consistency. Many “off-the-
shelf” curricula include web-based training that can help a county provide necessary training on a meaningful scale.
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 13
6. Do We Track Progress?
Is there an established process for tracking the impact of the plan on the four key outcomes (the number of people with mental
illnesses booked into jail, their length of stay in jail, connections to treatment, and recidivism)?
Why it matters
Once planning is completed and the prioritized strategies are implemented, tracking progress and ongoing evaluation begin.10 The
planning team must remain intact and the project coordinator must continue to manage the implementation of the new strategies.
Monitoring the completion of short-term, intermediate, and long-term goals is important, as it may take years to demonstrate
measurable changes in prevalence rates. Showing evidence of more immediate accomplishments, such as the implementation of
new procedures, policies, and evidence-based practices, contributes to the momentum and commitment necessary to ensure this
is a permanent initiative. Tracking outcome data also gives the planning team the justification necessary to secure continuation
funding and/or additional implementation funding. Outcome data should be included in any budget requests to provide
justification for continued or additional funding.
What it looks like
✓ Reporting timeline on four key measures: County leaders receive regular reports that include the data that is
tracked, as well as progress updates on process improvement and program implementation.
✓ Process for progress reporting: The planning team continues to meet regularly to monitor progress on implementing
the plan. The project coordinator remains the designated facilitator for this process and continues to coordinate
subcommittees involved in the implementation of the policy, practice, and program changes, as well as to manage unforeseen
challenges. As it may take several years to demonstrate significant change in prevalence rates, it is important to capture
incremental progress, including policy and system improvements, such as implementing screening and assessments,
establishing connections to treatment, and developing data tracking capacity. In addition, the planning team remains abreast
of developing research in the field and the introduction of new and/or improved evidence-based strategies for consideration.
✓ Ongoing evaluation of programming implementation: The evidenced-based programs adopted by the county
are implemented with fidelity to the program model to ensure the highest likelihood that these interventions will achieve the
anticipated outcomes. A fidelity checklist process ensures that all program certifications and requirements are maintained,
and that ongoing training and skills coaching for staff are provided.
✓ Ongoing evaluation of programming impact: Particularly for curriculum-based programming and screening and risk
assessment, it is important to assess whether the activity is achieving what was intended. Many counties establish a relationship
with a local university to assist with research and evaluation, as well as with the validation of screening and risk tools.
14
✓
In Practice: Using Data to Sustain Your Program in Johnson County, Kansas
In 2008, Johnson County, Kansas, began an effort to reduce the number of people with mental illnesses in its jail with
the establishment of a Criminal Justice Advisory Council (CJAC) that, as a first project, studied how people with mental
illnesses moved through the county’s justice system. After process mapping and data analysis was completed, the county
decided to pilot a “Co-Responder Program” to deploy a mental health professional to respond to law enforcement calls for
service involving people with mental illnesses. The program was funded through a 2010 federal Justice and Mental Health
Collaboration Program (JMHCP) grant that supported a collaborative effort among the City of Olathe (Kansas) Police
Department, the Johnson County Mental Health Center, and the Johnson County Sheriff’s Office. Upon completion of the grant
in 2013, a comparison of 2010/2011 data (the year prior to the implementation of program) to 2011/2012 data showed:
• 808 contacts were made by the co-responder; 10 resulted in a jail admission
• Hospitalizations decreased from 54 percent to 17 percent
• Referrals to services increased from 1 percent to 39 percent
Over the period of the grant, repeat calls for service to the same address are estimated to have decreased 20 percent. Through
a survey, Olathe Police Department officers reported marked improvement in their ability to respond to the needs of people
with mental illnesses. It was the top priority of the Olathe Police Chief, Steven Menke, to fully fund the co-responder position,
which was approved by the Olathe City Council.
In 2013, a JMHCP Expansion Grant was awarded to expand the program to the City of Overland Park, Kansas. On completion
of the grant, a comparison of 2013/2014 data (the year prior to the implementation of the program) to 2014/2015 data showed
significant improvements:
• 1,281 contacts were made by the co-responder; 25 resulted in a jail admission
• Hospitalizations decreased from 35.1 percent to 3.1 percent
• Officer surveys showed a 59-percent increase in officers feeling prepared to respond to calls involving people
with mental illnesses
The Overland Park City Commission approved fully funding the co-responder position upon completion of the grant. The use
of data to demonstrate the effectiveness of the Co -Responder Program proved essential to establishing continuation funding,
as well as to efforts to grow the program county wide.
Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask 15
Bexar County
Pre-Smart Justice Initiative
Bexar County
Today
Basic Flow through Central Magistration Four question screening tool used
by Law Enforcement at CMAG intake
to facilitate direct diversion to
community treatment, or, if booked
at CMAG, to prioritize MH assessment
County Law Enforcement Crisis
Intervention Training (CIT), but no
standard screening tool
No universal screening for MH. More
than 8,000 potentially mentally ill
persons went unidentified in 2014
Universal MH screening at CMAG
intake started in July 2015
Specialized mental health public
defenders advocating at pretrial,
and clinical information is
transmitted to all parties using
E-Discovery system
No transmission of MH screening
or assessment to district attorney
and defense
Clinicians from the local mental
health authority (LMHA) on site
to conduct assessments Mon-Fri,
16 hours a day, and Sat-Sun,
8 hours a day in July 2015
No clinician available for
timely assessment
Comprehensive treatment plans
provided for all detainees presented
to the magistrate for MH
release to treatment
No treatment plans for eligible MH
diversions at CMAG
No explicit and transparent agreement
by judges and district attorney on the
utilization of mental health bond
Written agreement between PD,
district attorney, and judges
regarding criteria for MH PR Bonds
Judiciary agreed in their application
for Texas Indigent Defense
Commission funds to increase
the target number of MH
diversions to 2,000+
Between April 2014 and February
2015, only 125 of over 7,000
potentially mentally ill persons were
diverted to the LMHA for treatment
Risk assessment tool available at
pretrial, but not validated with local
population
Risk assessment tool validated and
redesigned to facilitate computerized
scoring in the future
In Practice: A County Demonstrates Progress
Below is an example of findings and the resulting responses that have taken place in Bexar County, TX.
Apprehend Person
Intake at Central
Magistration (CMAG)
Magistration
MH Personal
Recognizance (PR)
Bond
Community MH
Treatment
16
Endnotes
1 https://w w w.hr w.org /news /2006/ 09/05/us-number-mentally-ill-prisons-quadrupled.
2 Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C.: American Psychiatric Association, 2013.
3 http://w w w.nimh.nih.gov/health/statistics /prevalence /serious-mental-illness-smi-among-us-adults.shtml.
4 Resolutions may need to follow the county’s prescribed template; alternatively, see the Stepping Up template.
5 Validation of a screening tool requires completing a study based on data analysis to confirm if a tool is accurately screening for the need to conduct an
additional assessment. Validation of a risk and needs assessment tool requires completing a study based on data analysis to confirm if a tool is predicting
for the intended result (i.e., risk of reoffending), based on the characteristics of the population being assessed in the jurisdiction. As populations may
change over time, it is important to validate this tool periodically. A properly validated tool should be predictively accurate across race and gender.
6 For information about the Brief Jail Mental Health Screen, see http://w w w.prainc.com /?product=brief-jail-mental-health-screen. For information about
the Texas University Drug Screen V, see http://ibr.tcu.edu /wp-content/uploads /2014/11/TCUDS-V-sg-v.Sept14.pdf. Stepping Up does not endorse the use
of any specific tools; the Brief Jail Mental Health Screen and the Texas Christian University Drug Screen are examples of tools that are available for use
without proprietary requirements.
7 Fader-Towe, H. and Osher, Fred C. Improving Responses to People with Mental Illnesses at the Pretrial State: Essential Elements. (New York: The
Council of State Governments Justice Center, 2015)
8 The Council of State Governments Justice Center and the American Psychiatric Association Foundation, “On the Over-Valuation of Risk for People with
Mental Illnesses.” (New York, The Council of State Governments Justice Center, 2015).
9 Jurisdictions considered to have fully integrated data systems include Johnson County, Kansas, Multnomah County, Oregon, and Hennepin County,
Minnesota. Jurisdictions with progressive systems include Maricopa County, Arizona, Salt Lake County, Utah, and Camden County, Utah. See Borakove,
Elaine M., Robin Wosje, Franklin Cruz, Aimee Wickman, Tim Dibble, and Carolyn Harbus. “From Silo to System: What Makes a Criminal Justice System
Operate Like a System?” MacArthur Foundation, 2015.
10 For information on implementation strategies and examples, go to w w w.stepuptogether.org /toolkit.
This project was supported by Grant No. 2012-CZ-BX-K071 awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a
component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office
of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, the Community Capacity Development Office, and the Office
of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. Points of view or opinions in this document are those of
the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.
To learn more about the Bureau of Justice Assistance, pl ease visit bja.gov.
Stepping Up: A National Initiative to Reduce the Number of People with Mental
Illnesses in Jails–which is sponsored by the National Association of Counties,
the American Psychiatric Association Foundation, and The Council of State
Governments Justice Center, in partnership with the U.S. Department of Justice’s
Bureau of Justice Assistance–calls on counties across the country to reduce the
prevalence of people with mental illnesses being held in county jails.
Attachment 4
NATIONAL SHERIFFS’ASSOCIATION SUPPORTS THE STEPPING UP
INITIATIVE TO REDUCE THE NUMBER OF PEOPLE WITH MENTAL
ILLNESSES IN JAILS
WHEREAS, the National Sheriffs’ Association recognizes jails have become de facto psychiatric facilities
nationwide with more than 2 million individuals with serious mental illnesses admitted each year; and
WHEREAS, an estimated three-quarters of individuals with serious mental illnesses in jails also have
substance use disorders; and
WHEREAS, jails spend two to three times more on individuals with mental illnesses, yet fail to see
improvements to public safety, recidivism rates, or individuals’ recovery; and
WHEREAS, keeping individuals out of jails and on the road to recovery requires a collaborative approach
between all criminal justice agencies and mental health and substance use treatment agencies; and
WHEREAS, the Stepping Up Initiative encourages county leaders to designate or convene a diverse team of
leaders and stakeholders to carry out a six-step planning process that can yield measurable reductions in the
number of adults with mental illnesses cycling through the nations jails; and
WHEREAS, the Initiative provides sheriffs, others with jail authorities, and other team members with no-cost
distance-learning opportunities, peer-to-peer exchanges, expert guidance, and a suite of resources to carry out
these county-led plans; and
WHEREAS, the Initiative promotes crisis intervention team training and other specialized law enforcement
responses that are supported by community-based resources; and
WHEREAS, the Initiative brings together not only state and local policymakers and purse-string holders, but
also ensures the voices of people with mental illnesses and their families are heard; and
NOW, THEREFORE BE IT RESOLVED, that the National Sheriffs’ Association actively supports the
work of the Stepping Up Initiative that is led by the National Association of Counties, the Council of State
Governments Justice Center, and the American Psychiatric Foundation to make more effective use of strained
budgets and safely reduce the number of adults with mental illnesses in jails by connecting them to
community-based treatment and services when possible; and
BE IF FURTHER RESOLVED, that the National Sheriffs’ Association strongly urges county elected
officials to pass a resolution or proclamation that signifies their commitment to joining the Stepping Up
Initiative.
Attachment 5
“Stepping Up to Reduce the Number of People with Mental Illnesses in Jails”
WHEREAS, counties routinely provide treatment services to the estimated 2 million people with serious
mental illnesses booked into jail each year;
WHEREAS, prevalence rates of serious mental illnesses in jails are three to six times higher than for the
general public;
WHEREAS, almost three-quarters of adults with serious mental illnesses in jails have co-occurring substance
use disorders;
WHEREAS, adults with mental illnesses tend to stay longer in jail and, upon release, are at a higher risk of
recidivism than people without these disorders;
WHEREAS, county jails spend two to three times more on adults with mental illnesses that require
interventions compared to those without these treatment needs;
WHEREAS, without the appropriate treatment and services, people with mental illnesses continue to cycle
through the criminal justice system, often resulting in tragic outcomes for these individuals and their families;
WHEREAS, [INSERT YOUR COUNTY’S NAME] and all counties take pride in their responsibility to
protect and enhance the health, welfare, and safety of its residents in efficient and cost-effective ways;
WHEREAS, [INSERT COUNTY-SPECIFIC INFO/DATA TO HIGHLIGHT (e.g., Bexar County has
developed its Restoration Center, which helps people stay out of jail by offering mental health and substance
use disorder treatment)]; and
WHEREAS, through Stepping Up, the National Association of Counties, The Council of State Governments
Justice Center, and the American Psychiatric Association Foundation are encouraging public, private, and
nonprofit partners to reduce the number of people with mental illnesses in jails.
NOW, THEREFORE, LET IT BE RESOLVED, THAT I, [INSERT NAME & TITLE OF CHIEF
ELECTED OFFICIAL], do hereby sign on to the Call to Action to reduce the number of people with mental
illnesses in our county jail, commit to sharing lessons learned with other counties in my state and across the
country to support a national initiative and encourage all county officials, employees, and residents to
participate in Stepping Up. We resolve to utilize the comprehensive resources available through Stepping Up
to:
• Convene or draw on a diverse team of leaders and decision makers from multiple agencies committed
to safely reducing the number of people with mental illnesses in jails;
• Collect and review prevalence numbers and assess individuals’ needs to better identify adults entering
jails with mental illnesses and their recidivism risk, and use that baseline information to guide decision
making at the system, program, and case levels;
• Examine treatment and service capacity to determine which programs and services are available in the
county for people with mental illnesses and co-occurring substance use disorders, and identify state
and local policy and funding barriers to minimizing contact with the justice system and providing
treatment and supports in the community;
• Develop a plan with measurable outcomes that draws on the jail assessment and prevalence data and
the examination of available treatment and service capacity, while considering identified barriers;
• Implement research-based approaches that advance the plan; and
• Create a process to track progress using data and information systems, and to report on successes.
Attachment 6
Central Oregon
MAC
August 16-23, 2017
Why MAC?
•Regional Event
•Same Resource Pool
•Existing Mutual Aid Agreements
•Economy of Scale
•Same Media Market
•Interdependent Communities
Characteristics of MAC
•Common Operating Picture
•Agency Administrator Alignment
•Effective Prioritization
•Resource Allocation
•Coordinated Response
•Unified Public Messaging
Components
•Operations –Coordinated by function
•Planning –Tracked info and resources
•Logistics –Supported MAC needs
•Intelligence –Tracked & Analyzed Info
•Joint Information Center
•Auxiliary Communications
•Establish Situational Awareness and Common
Operating Picture
•Establish and maintain interoperable
communication with the region
•Ensure high level coordination with all regional
operational partners (local, state, federal, &
non-governmental)
•Facilitate priority setting for limited resources
throughout the region
•Ensure effective and timely public information
throughout the event
Objectives
State Emergency
Coordination Center MAC Group
USFS/BLM
COFMS
ODF
OSP
ODOT
Crook County
Crook County Sheriff
Crook County Fire Defense
Board
Deschutes County
Deschutes County Sheriff
Deschutes County Fire Defense
Board
Jefferson County
Jefferson County Sheriff
Wheeler County Sheriff
Cities
Multi-Agency
Coordination
Center
Fire
Law Enforcement
EMS
Health
Public
Works/Transportation
Air Medical/SAR Air Ops
Central Oregon MAC
Central Oregon
Joint Information
Center
County Dispatch
Centers
Crook County
Deschutes County
Jefferson County
Frontier Regional
Central Oregon
Interagency Dispatch
Central Oregon MAC
@COEmergencyInfo
@COEmergencyInfo
coemergencyinfo.
blogspot.com
Key Events
•Symbiosis
•Early Traffic Congestion
•Milli Fire
•Madras Plan Crash
•Traffic planning
•Fuel Scare
Successes
•Great training opportunity
•Very efficient decision-making
•Good situational awareness
•Satisfied customers
•No silos
•Conflicts were resolved
Challenges
•Equitable Cost Share
•Pre-planning required travel
•Expectation Management
•Marathon vs. Sprint
•Meeting management
•Unified Coordination/Command