Behavioral Health / Criminal Justice Collaboration in
Beaver County, PA
Re-entry Services
Council of State Governments
Site Visit: May 15, 2013
1
Agenda / Itinerary
Time
9:00 - 9:15 AM
Arrival and Introductions
9:15 - 10:00 AM
Part 1: Overview of CJ/BH Initiatives & Reentry Efforts
10:00 - 10:45 AM
Part 2: Process Mapping of Intercepts 4 and 5
10:45 – 11:00 AM
BCRC
Break
11:00 - 11:45 AM
Funding and Sustainability
11:45 - 12:45 PM
Lunch Roundtable with Community Based Service Partners
12:45 - 1:00 PM
Travel to Jail
1:00 - 2:00 PM
Screening and Assessment
2:00 - 2:30 PM
Jail-Based Treatment, Educational and Supportive Services
2:30 - 2:45 PM
2
Focus Area
Location
2:45 - 3:30 PM
BC Jail
Wrap Up / Next Steps
Tour of Jail
3
Beaver County: Overview
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Semi-rural county located in the southwestern region of the state about 30
miles northwest of Pittsburgh.
Diverse area with pockets of affluence, as well as very poor districts, urban,
and rural areas, and varying economic resources.
The approximate population of Beaver County is 180,000
– 23% of the population is under the age of 18.
 5.0 % of that population lives in poverty.
–
11% of the total population lives in poverty
The average annual wage for Beaver County was stated at $25,254, as
compared to the average annual wage for the Commonwealth of Pennsylvania
of $30,081.
The racial composition of Beaver County is predominantly Caucasian (92.5%),
followed by African American (6%), and has not changed significantly in the
past 20 years.
Beaver County: Overview
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Commissioners: Tony Amadio, Chairman; Joe Spanik; Dennis Nichols
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Beaver County Behavioral Health: Gerard Mike, Administrator
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Services
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Mental Health Administration
Mental Retardation Administration
Drug and Alcohol Single County Authority
HealthChoices Medicaid Managed Care Administration
Early Intervention Administration
Human Services Development Fund Administration
State, Federal and Private Foundation Grant Management
Direct Services: Outpatient Assessment Center and Case Management
Behavioral Health Criminal Justice
Partners
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County Departments
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Community partners
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SIM Subcommittee
NHS
BCRC
ACP
AHCI
HPW
ETC
ROOTS
OVR
BB BS
HACB
BBBS
TRAILS
Aliquippa Impact
Benefit Specialist
SPA
Beaver County System of Care
Criminal Justice
is a key part of the
Beaver County
System of Care
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System of Care Management Structure
Residents of Beaver County
Beaver County:
Change Agents
Leadership Committee
(Project Director, Steering Committee Co-Chairs, and Sub-Committee Chairs)
Steering Committee
(Providers, Change Agents, and Subcommittee Representatives)
BC-HOMES
SIM
BC LAUNCH
Housing
- Criminal
Justice
BC SCORES
Child Serving Systems
Employment
-Transformation
Quality
Improvement
Family, Youth and Peer Voice
Board of Commissioners
Beaver County Behavioral Health
Stakeholder Group
(Provider Representatives, Change Agent Representatives, Subcommittee
Representatives, Consumers, Families, Natural Supports)
8-12
Evolution of COD Programs in the
Justice System in Beaver County
Supported
Housing
Reentry
Liaison
Educational/
Vocational
Serv ices in the
Jail
Adult Court
Assessments
Peer Sponsors
2001
2002
Beav er
Jail COD
Treatment
2003
2004
2005
2006
2007
2008
Seeking
Safety for
Women
2009
2010
Seeking
Safety for
Men
FACT
WRAP
Motivational Interviewing
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2011
BCBH: Using Evidenced Based
Practices
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Motivational Interviewing - 2002
Comprehensive, Continuous, Integrated System of
Care (CCISC) - 2007
Seeking Safety – 2007
Supported Employment - 2008
Supported Housing – 2009
Forensic Assertive Community Treatment (FACT) 2009
Wellness Recovery Action Planning (WRAP) – 2009
Thinking for a Change - 2010
Publications and Presentations:
National and State Arenas
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Publications
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Corrections Today
(2005 and 2011)
Behavior Science
and the Law (2009)
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National GAIN
Center (2008)
NASMHD Research
Institute Conference
(2006)
Forensic Rights
Conference (2005,
2008, 2011)
Contracting Federal Grants
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Contractors are provided with a budgeted contractual
limit
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Contract fees can be a combination of
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Fee For Service
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Units of service provided, or
– Have begun to “experiment” with outcomes based payment terms on
some grants
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Cost Reimbursement
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Typically only for out of pocket expenses such as start-up and travel
Contractors are provided a list of deliverables as part of
the contract
Invoicing Federal Grants
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Grants are invoiced from providers on a fee-for-service basis
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Grants are only invoiced when HC does not cover the services,
such as
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–
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Ineligible individuals
Service not covered under HC
Contractors are also permitted to bill grants for items not covered
under HC, including:
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Rates similar to HealthChoices (HC) Rates are utilized
Planning, Meetings, Training, Data Collection
State funds (County Base) are used for non-HC, non-grant services
BCBH: Current Grants
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Grant Name
Term
Funder
Purpose
BC-LAUNCH
9/08 – 9/13
SAMHSA
Treatment of homeless with COD
TIPS (kids)
4/10 – 6/13
DOJ/PCCD
Transition to independent processes
ChancesR
10/10 – 9/11
DOJ
Assessment and re-entry services for
individuals incarcerated with COD
ChancesR (2011)
10/11 – 9/13
Expanding BBBS
Mentoring
10/10 – 6/13
PCCD
Mentoring Kids with caregivers in the forensic
system
Project Recovery
10/10 – 10/15
SAMHSA
Prevention/housing/employment and develop
infrastructure for communication of providers
CJAB-SIM
1/12 – 6/13
DOJ/PCCD
CJAB Strategic Plan, MHFA training, Screening
in RBC
REACH
10/12 – 9/14
DOJ
Released offenders who have a co-occurring
mental health and substance abuse disorder
SIM 2
10/12 – 9/14
DOJ
MHFA, RBC screens, and IT consulting
Training Summary: 10/2011 – 5/2013
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42 Training Programs
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EBP’s
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Motivational Interviewing
Seeking Safety
Supported Employment
Behavioral Health
Peer/Consumer
183.5 Hours of Training
More than 1500 Participants
5 MHFA Trainings
Key Data Systems: Support System-wide
Evaluation / Quality Improvement
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Aim is:
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To support and sustain a data-driven process
Collect and report on consistent measures across
programs or services as opposed to utilizing data
collected differently within programs or services
Develop benchmarks, compare results against
targets, implement corrective action plans
Key Data Systems
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HealthChoices (BH Medicaid Managed Care)
County Base
Probation/Parole
Jail
Grant-Specific Data
Consumer Satisfaction Data
Data Warehouse
Electronic
Service
Plan (eSP)
System
Provides
Framework
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Reentry: FOCUS and PURPOSE
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FOCUS: Increase public safety and reduce
recidivism by providing services and supports to
Beaver County residents with a substance use
disorder (SUD) or a co-occurring substance use and
mental health disorder (COD) incarcerated in the
Beaver County Jail.
PURPOSE: Provide, both pre- and post-release,
COD treatment educational/vocational services, peer
support, family mentoring, and assistance with
housing.
Reentry Flow Chart
Reception
Engagement
Transition
Re-Entry
Re-Entry Liaison works with client in the jail..
Re-Entry
Liaison
administers
the GAIN
and intake
form.
Access to treatment groups in the jail.
TRAILS and ROOTS meet with clients in the
jail to establish a sponsor relationship.
BCRC begins working with client in the jail on
vocational/educational services
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Community
Integration
Client reintegrates into the
community with
housing, along
with sponsor
relationship, and
continues to work
on vocational/
educational skills,
treatment and
other supports.
Summary of Reentry Services
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Provided by NHS
HealthChoices (MA) supplemental
Jail-based
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Community-based
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ChancesR – REACH – LAUNCH
ChancesR – LAUNCH – REACH – HC – Base
# of positions
Assessment – Transition Planning – Follow-up
Available Forensic-Based Services –
Throughout Criminal Justice System
 Screening and Assessment
– Jail, Courthouse and Community
 Co-occurring Disorder (COD) Treatment
– Jail and Community
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Re-Entry Liaison
Assertive Community Treatment
Seeking Safety / Trauma-Informed Care
Re-Entry Sponsor Coordinators
Assistance for Youth with an Incarcerated Parent
Housing / Outreach to the Homeless
Vocational / Educational Services
Peer Services
Sequential Intercept Model (SIM)
Planning
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Collaboration between the Criminal Justice Advisory
Board (CJAB) and Beaver County Behavioral Health
(BCBH)
Builds on the key relationships and history of
collaboration established with previous projects.
Goal is to enhance the integration of the criminal
justice and behavioral health systems for adults and
juveniles in Beaver County
Services from ChancesR are integral to the overall
integration of systems
CJAB SIM Subcommittee
The task force is a subcommittee of the
Criminal Justice Advisory Board
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Members represent all major behavioral
health and criminal justice partners
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ChancesR Partners are represented
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CJAB Representatives
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Behavioral Health
Representatives
Community and Peer
Representatives
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Victim’s Advocate
Family members
Community partners
Peers
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Behavioral Health
Administrator
Behavioral health
providers
Crisis providers
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County Commissioners
Administrative Criminal
Court Judge
Magisterial District Judge
District Attorney
Chief Public Defender
Deputy District Court
Administrator
County and State Adult
and Juvenile Probation
Warden of the County Jail
County Sheriff
Local law enforcement
911 Center
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Sequential Intercept Model: Overview
Criminal Justice
System
Criminal
Justice
System
Sequential
Intercept
Model
Behavioral Health
System
Intercept 1
Intercept 2
Intercept 3
Intercept 4
Intercept 5
Pre-arrest
Diversion
Post-arrest
Diversion
Court/Jail
Diversion
Re-entry
from jail
Probation /
Parole
Law
Enforcement
/ Emergency
Services
Initial
hearings /
initial
detention
Special
jurisdiction
courts
Transitional
support
back to
community
Community
support
services
Diversion of appropriate non-violent juveniles and adults throughout CJ system
BH
System
Community Services and Supports:
crisis support, residential and vocational support, SPA, outpatient
Intercept 1: Pre-arrest Diversion
Law Enforcement / Emergency Services
Impact
People with mental illness require specialized approaches during contact with police, a substantial amount of time is
spent on these contacts.
Existing
Services
• Existing options for police are detention or 302. 302’s are very time intensive.
• Mobile crisis services
Identified
Needs
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•
•
•
Potential
Interventions
• Cross-training for Behavioral health and Criminal Justice
• Training specific for first responders (CIT for police, EMS, and 911)
• Explore expanding the 911 system for early identification
• Explore a temporary residential option as a diversion to incarceration
• Additional coordination with existing crisis services to increase utilization, improve interface with police, and
increase diversions
Identification of people, who are involved with MH system, when police are dispatched
Early assessment
Alternatives instead of criminal justice system
Short-term respite
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Intercept 2: Post-arrest Diversion
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Initial Detention / Initial Court Hearings
Impact
Many individuals with behavioral health needs have little or no resources & may be detained because
they are unable to post bail and are not offered release on personal recognizance. An absence of
supervised treatment/support alternatives for these offenders may lead to incarceration instead of
more appropriate treatment.
Existing
Services
• Medical assessment and clearance by nurse
Identified
Needs
• Behavioral health evaluation and assessment earlier in CJ process
Potential
Interventions
• Behavioral health evaluation and assessment at booking and preliminary arraignment
Intercept 3: Jail / Court Diversion
Impact
Opportunity for plea agreement and diversion to connect to appropriate community resources
Existing
Services
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•
Identified
Needs
• Not all police and court staff are aware of existing in-house MH forensic programs at courthouse
Potential
Interventions
• Additional cross-training on existing on-site MH assessment services to increase awareness of
existing diversion options
MH assessment service at courthouse for adults and juveniles
DUI assessment program
Jail-based COD assessments and treatment (mental health and substance abuse)
Additional jail-based services include anger management, parenting, and education classes
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Intercept 4: Jail/Prison and Re-Entry
Impact
Connecting with community services and supports prior to and upon release to reduce recidivism.
Existing
Services
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Identified
Needs
Increase awareness of existing programs
Potential
Interventions
Additional cross-training on jail-based services and re-entry supports
Jail-based assessments and treatment
Re-entry Liaison
Vocational supports
Sponsor programs
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Intercept 5: Probation, Parole, Community Support
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Impact
Maintaining individuals in community to reduce recidivism and providing linkage between
probation/parole and Behavioral health services and supports.
Existing
Services
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•
Identified
Needs
Probation/parole officers may not be aware of available Behavioral health services that can serve as
a diversion to incarceration given a violation of probation/parole.
Potential
Interventions
• Training for probation/parole officers on existing crisis / respite services to provide alternatives to
incarceration.
• Explore a temporary residential option as a diversion to incarceration.
• Cross-functional reentry teams that include criminal justice and behavioral health supports
Specialized probation officers
Assertive Community Treatment Team that includes forensic specialty
Re-entry Liaisons
Vocational supports
Contact Information
• Nancy Jaquette, LSW
Compliance Officer
Beaver County Behavioral Health
1040 Eighth Avenue
Beaver Falls, PA 15010
Phone: 724-847-6225
[email protected]
• Alex Corkos, M.A., L.M.F.T.
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ChancesR Project Director
Alex Corkos Counseling & Consulting, LLC
4160 Washington Road - Suite 212
McMurray, PA 15317
Phone: 412-567-3930
[email protected]
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Beaver County Behavioral Health Beaver County, Pa