3 Pre-Arrest Diversion Program Voluntary alternative to incarceration and inappropriate emergency room utilizationTargets low level offenses (trespass, open container, disturbing the peace)Primarily for individuals experiencing a behavioral health crisis who are homeless, indigent, and/or intoxicatedCompliments Crisis Intervention Training
4 Low Demand ShelterOpened 22 beds in April 2008 and increased to 58 beds May 2010 using CJMHSA grantProvides safe shelter while conducting medical and psycho-social assessmentsResidents work with case manager to establish goals to accomplishLinks with community treatment programs as beds become available
5 The shelter provides an alternative for police officers and emergency rooms for petty offenders or intoxicated patients who may not need jail or serious medical care.(John David Emmett/news-press.com)
6 Major components needed to open Funding CJMHSA implementation grantBuilding space at mental health center – Lee Mental Health Center unsung heroData system built on existing HMISLocal matching funds from key stakeholdersAgency willing to run shelter componentBuy in of key community partners
7 Data SystemUtilizes Client Services Network (CSN) – Lee County’s Homeless Management Information System (HMIS) to track demographic informationAdmission to facility including Length of stay, referring agency, etc.Referrals for services and housingCriminal history
8 Data System Cross referenced with local jail data system Cross referenced with local hospital dataFlorida Mental Health Institute (FMHI) cross referenced with use of publicly funded behavioral health system and Medicaid
9 Policy Services and Research Data Center at FMHI Phase I Report Concluded that those who completed the program or left Triage for a housing opportunity or a treatment facility experience the following positive outcomes:fewer subsequent encounters with law enforcementfewer subsequent arrestsif arrested shorter length of incarceration.
10 FMHI Review Shows Impact of Triage Center Triage serves highly vulnerable population with history of criminal justice involvement and high physical, mental health and substance abuse needs.Cost benefit of diversion calculated to be $220 less per individual and $68,666 per year (not including court and police time)Provides alternative to revolving door
11 Case Study 22 arrests with 743 jail days in last 13 years 19 hospital encounters in five years6 triage stays in 3 years (longest 354 days)Jail cost $58,771 - Hospital cost $124,811 – Triage cost - $42,626Baker Act and Detox historyQualified for SS disability, food stamps, Medicaid and permanent supportive housing
12 Potential impact on SA/MH System Diverting arrest may prevent person from decompensating and additional charges such as battery on LEOProvides law enforcement alternative to arrestWorks with homeless population most of whom have criminal justice history and MH/SA treatment historyEmphasis on stabilizing, obtaining resources and housing
13 Number of Triage Admissions 2,070 duplicate client admissions occurred during first three yearsFacility capacity increased from 22 beds to 58 beds May 2010
15 Number of Repeat Admissions Unduplicated clients served and program entries and number of repeat admissions (“client entries” categorized by number of intakes). Information from CSN reports. See Eric.1,246 unduplicated clients2,070 duplicated clientsAverage Length of Stay 13 days
16 Who does Triage Center Serve? 77% male population (County jail is 86% male)79% white; 92% non-Hispanic73% between ages of 31-6016% Veterans93% HomelessGender#%Male96577.45%Female28122.55%Total1,246100%Age#%18-20272.17%21-3021217.01%31-4021617.34%41-5035128.17%51-6034027.29%61-70856.82%71-8011.88%80 +20.16%Not ReportedTotal1,246100%Information from CSN reports. See Eric.
17 Presenting Issues Based on self-disclosure during assessment Mental Health 12.12%Co-Occurring 25.28%Other 7.87%Substance Abuse %None 31.38%Reporting of mental health, substance abuse, or both and percentage reporting taking medications information was not on the reports. Information from CSN reports. See Eric.67% of clients reported having a Disabling Condition of this 60.75% were made up of Alcohol, Drug, and Mental Health related conditions. The other 7.87% consists of Developmental Disabilities, Chronic Health Conditions, Physical Disabilities, and Domestic Violence victims.Based on self-disclosure during assessment42% report taking medications which includes but is not limited to psychotropic drugs
18 True Diversion? 70% have prior arrest history in Lee County 64% misdemeanor36% felonyMost common prior charges are:TrespassDUITheftBatteryInformation from CSN reports. See Eric.
19 Impact on Criminal Justice System 16% of time LEO would have taken individual to jailDiverted 332 charges5% of people would have been charged with more than one crimeIf LEO had taken to jail, most common charges would be:TrespassLoiteringDiverted 70 Marchman/Protective CustodyInformation from CSN reports. See Eric.
20 Impact on the Community 64% of time LEO would have taken nowhereProvides access to assessment, shelter, resources and treatment for people who would have otherwise been left on the streets3% of time LEO would have taken to hospitalReduces impact of inappropriate utilization of emergency rooms53% successfully linked with resources44% Had a good exit status.Information from CSN reports. See Eric.
21 Saves Law Enforcement Time 84% of time officers spend ≤ 5 minutes10% of time officers spend ≤ 15 minutes93% of officers are satisfied to highly satisfied with process34% of time individuals are brought by a CIT trained officerInformation from CSN reports. See Eric.
23 Funding Sources CJMHSA Implementation Grant $997,698 (3 year period) CJMHSA Expansion Grant $750,000 (3 year period)Local Match $2 million (3 year period) from Lee County BOCC and project partnersFederal stimulus funds used to expand facilityFDLE Byrne Grant funds operating expensesVeteran’s Administration per diem contractCost is $68 per bed per dayLeft “as is” from 9 month report – assuming this is all still the same.
24 Key StakeholdersLee County BOCC – administers grant and provides local match fundsSalvation Army – operates low demand shelterLee Memorial Health System – provides nursing staff, medical supplies, and some mealsLee Mental Health Center – provides facility, oper. and maint., meals, and intake clinicianSouthwest Florida Addiction Services – provides intake clinicianUnited Way – provides match funds for mealsLocal law enforcementNAMI