1. North Iowa Juvenile Detention Services
Adult Mental Health Crisis Stabilization Services
:Mental Heath Evaluations
:Substance Abuse Evaluations
:Medication Evaluations
:Residential
Secure Juvenile Detention Services
:AEA267 Education
:Youth Tracking & Monitoring
: GPS/Guidance Tracking System
:Physical, Substance & Mental Health Assessments
Transportation Services
:Secure non-Secure
:Sheriffs
:Clients
North Iowa Juvenile Detention Services Adult Crisis Stabilization Services
Fiscal Year 2016

2. ACSC

4. Luis E. Cox, BA, MBA Executive Director Board of Directors NIJDS/ACSC
Trinette White BA Supervisor
First Aide/CPR Mandt Instructer
0n-Cal ll
New Employee Orientation
Val Meyerhoff Supervisor
GPS/Tracking & Monitoring
Employee Training Records On-Call Picks Up Needed Supplies
Laura Bouck Statistical Data Analyst
Amber Lacina, APRNP Medical Director
James Hart AA IT Department
Residential Counselor RD Shift Fulltime CPI Instructor
Erik Kalkwarf BA Food Director
Samuel D. Hudson III, BA Assistant Director
Board of Directors NIJDS/ACSC
Payroll Clerk
Billings
Monthly Quarterly Reports
Erica DeGroote Administrative Assistant
OSHA Compliance On-Call GPS Shift Leader
Data Analysis
Resident Counselor
Fulltime 3RD shift

8. ALWAYS OPEN FOR BUSINESS

9. NORTH IOWA JUVENILE DETENTION SERVICES COMMISSION
FISCAL YEAR 2016
Dan Barnes – Allamakee
Frank Magsmen, Chair – Black Hawk
Ken Kammeyer – Bremer
Don Shonka – Buchanan
Rusty Eddy – Butler
Casey Callanan – Cerro Gordo
Tim Zoll – Chickasaw
Larry Gibbs – Clayton
Doug Dabroski – Delaware
Wayne Demmer – Dubuque
Vicki Rowland, Secretary/Treasurer – Fayette
Jim Ross – Grundy
Mark Kubik – Howard
Joel Voaklander, Vice Chair – Mitchell
Floyd Ashbacher – Winneshiek
Dave Haugen – Worth 
Martin Peterson, Attorney – At Large
Greg Fangman WPD – At Large
Bob Amosson, Retired – Ex-Officiate

10. ADMINISTRATIVE PERSONNELL
# YEARS OF SERVICE
Lou Cox, 24 – Executive Director
Amber Lacina – Medical Director
Sam Hudson, 21 – Assistant Director
Val Meyerhoff, 25 – Shift Supervisor
Trinette White, 19 – Shift Supervisor
Erica DeGroot, 3 - Administrative Assistant
FULL TIME RESIDENTIAL COUNSELORS & TRANSPORTERS
# YEARS OF SERVICE *transporters
Lynda Clemenson – 27
James Hart – 16
Erik Kalkwarf – 12*
Laura Bouck – 11*
Susan Feller – 9*
Megan Kalkwarf – 5*
Stonie Gladson – 4*
Luke Lacina – 2*

11. PART TIME RESIDENTIAL COUNSELORS & TRANSPORTERS
# YEARS OF SERVICE *transporters
Kerry Trimble – 27
Paul Pfiffner – 25*
Tony Wilson – 18*
Steve Aiello – 11*
Michael Meyerhoff – 6*
Dakota Cox – 2*
Dakota Feller – 2*
Mark Crawford – 2*
Troy Bussey – 2*
Dexter Cox – 1*
Rachel Schaefer – 1*
Colton Sutton – 1*
Corey Wheelock – 1*
Less than 1 year of employment:
Randy Sutton*
Marcus Buls*
Lauren Bengen*
Jacob Weathermon*
Eboni Jackson*
Juan Henderson*
Edin Tutic* 
Transporters: Glenn Ringheden 4*, Larry Dodd 4*, Jeff Young 1*, Marlee Storey*

12. ANNUAL REPORT FOR FISCAL YEAR 2016
It has been an exciting year at NIJDS and ACSC as we continue to grow with serving more people across the State of Iowa, providing access to mental health services and juvenile secure detention. We also provide services for transportation to and from doctor visits, dental appointments, court hearings etc., as well as providing tracking and monitoring for juvenile who our on In home detention arrest. For the past year and half we have been talking about starting up a mental health subacute facility. We have look at one in Lincoln Nenbraska and the other facility in Rochester Minnesota.
In 1989 North Iowa juvenile detention services open its doors to a 15 bad juvenile detention holding facility. That's all we did back then no transport tracking or monitoring work crew supervision. We were at capacity most of the time which led to building another 15 bed addition attached to the old one. During those days detention center average length of stay was 28. We had no problems with revenues that's why the per diem rate was 125 and still current at 125.
In 2008 Governor Culver signed a proclamation to team up with the Annie E. Caseys Foundations which plan to develop alternatives to detention. Such as community service, in home detention, GPS monitoring, and tracking and monitoring. The goal was to reduce the minority confinement as well as the development tool we use to score youth when in the custody of police which decides a secure hold or less restrictive placement. This was a big success and ended up reducing juvenile incarceration by 50% in Black Hawk County entering the juvenile detention center.

13. Going from an average length of stay of 28 juveniles a year to 15 a year was very demanding reorganizing the down sizing. This caused one wing to be empty as we use it only for carryovers. Difficult decisions were made to cut expenses due to the decrease in juvenile admissions which is are revenues. Nine fulltime staff had to be laid off. This added many other duties not only for the administration team, fulltime staff. We developed new programs and just as we got up and back running,
In 2010 Bob Lincoln approached me and asked if I would be will to develop a adult crisis stabilization center by using the empty wing. At that time I informed Bob that I was not interested at this time.
In 2011 Bob asked me again if I wanted to be the first adult crisis stabilization center in iowa as a pilot for the state. It was a long difficult process and was accomplished February 1st, 2012 as we opened the first Iowa crisis stabilization center in Iowa.
November 2014 Bob Lincoln approach me and asked me if I would be interested in transition the crisis center into a sub acute mental health facility. Many things had to be done legislation changes had to become true. That year a lot lined up and talks were beging regarding piloting a sub acute mental health facility. This would be the first sub acute mental health facility stand alone away from a Hospital. This did not prosper at this time.

14. Black Hawk CountyYouth Shelter
On January 1, 2016 we took possession of the Black County Youth Shelter building just after Black Hawk County gifted the building and land to North Iowa Juvenile Detention Services. It had been vacant since it had closed in 2013 and we immediately began renovations which were justly needed. We painted all walls, replaced the carpet and tile in the main living & office areas, bought new appliances, furnished the main living area, and cleaned & re-sealed the tile in the bedroom wings of the building.
On April 1st, our tenant the County Social Services I-Start team moved into the offices. The main living area is now called the Regional Training Center for CSS and they have held 4 training sessions since they have been here.
At this time we do not have any plan for the sleeping areas. There have been many ideas but nothing is in the works as of yet. We will continue to evaluate what the needs are and what the best use will be for this building.
Benefit Changes
The Board of Supervisors approved a 5% increase for salaried employees and a 3% increase for hourly employees. This increase took effect July 1, 2016.

15. Transportation Services
In Home Services
With the decrease in the detention population we have seen an increase in In Home Services, this includes GPS monitoring, tracking & monitoring as well as tracking for the Sixth District.
The GPS monitoring consist of checking the resident’s whereabouts on a daily basis and if there are issues with the location of the resident their case worker/Juvenile Court Officer are notified. It is then up to the worker to either keep them on GPS monitor or place them in detention for a violation. The Tracking and Monitoring process includes: home visits, transporting to various appointments, curfew checks, tracking hours, UA’s and GPS monitoring.
Transportation Services
Our transportation services have also seen a surge in usage. The majority of the increase has been transporting for local sheriff departments with either juvenile or adult committals. We have gone as far as Ohio, Council Bluffs and Minneapolis for transports. We purchased a new van in fiscal year 2015 to replace the van we bought in 2006.

16. Staff Changes Staff Training
With the continued progression, we have seen the need for additional staff. We promoted 3 part time staff to full time; Erica DeGroot, Stonie Gladson, and Luke Lacina. We also hired Amber Lacina, APMHNP on June 1, 2016 as the Medical Director of NIJDS and ACSC. She will oversee all medical and mental health issues on both units. We have also hired 11 addition part time residential counselors/transporters. Five part time residential counselors resigned their positions for other employment opportunities and we wish them very best.
Staff Training
All staff was re-certified in the David Mandt System, First Aide, CPR, and Mechanical Restraints. One staff member went to Cedar Rapids to become a certified instructor in the Crisis Intervention Training. He held his first training session with a portion of the staff and he will continue training the staff until everyone has completed it. Another staff member was re-certified as a instructor in the David Mandt System. Staff also completed the Mental Health First Aid for Adult and Mental Health First Aid for Children course taught by Bob Lincoln. Also, Suicide Prevention and Safety and Security.

17. Adult Crisis Stabilization Center
With the inception of the Adult Crisis Stabilization Center in 2012, we are the first adult crisis stabilization center in Iowa. When a person that is experiencing a mental health crisis and arrives in the emergency room, a physician examines them and decides what treatment is necessary. If the patient is determined mentally and physically stable, but will need additional services in the community to help them recover, this is when the adult crisis stabilization center is offered. We currently cover the northern region of Iowa and referrals from many hospitals etc.
We have continued to see steady growth in the years we have been in operation. In the beginning we served people in our County Social Services regions which includes: Allamakee, Black Hawk, Butler, Cerro Gordo, Chickasaw, Clayton, Emmett, Fayette, Floyd, Grundy, Hancock, Humboldt, Kossuth, Mitchell, Pocahontas, Tama, Winnebago, Winneshiek, Worth, and Wright counties. But as the need for more Mental Health Services, we have accepted people from as far away as Ringgold County in Southern Iowa and La Crosse, Wisconsin. The Iowa resident was at the Gunderson Lutheran Health Center until we went and picked him up for admission to our facility. We will accept anyone from the State of Iowa if their region is unable to assist them.

18. We have continued to see steady growth in the years we have been in operation. In the beginning we served people in our County Social Services regions which includes: Allamakee, Black Hawk, Butler, Cerro Gordo, Chickasaw, Clayton, Emmett, Fayette, Floyd, Grundy, Hancock, Humboldt, Kossuth, Mitchell, Pocahontas, Tama, Winnebago, Winneshiek, Worth, and Wright counties. But as the need for more Mental Health Services needed, we have accepted people from as far away as Ringgold County in Southern Iowa and La Crosse, Wisconsin. The Iowa resident was at the Gunderson Lutheran Health Center until we went and picked him up for admission to our facility. We will accept anyone from the State of Iowa if their region is unable to assist them.
As we are only allowed to serve ten clients at a time, we often have a waiting list for admission. Unfortunately, the length of stay has increased from 5.0 to 8.3 days and that makes the wait longer for possible admission. Our first full fiscal year (2013) we served 277 clients and billed for 1380 units. In fiscal year 2016 we served 272 people and billed for 3038 units which is an increase of 120% in 4 years (for billed units). The increase is also result of a shortage of beds in long term residential care facilities or low cost housing. As they wait, sometimes the referring agency has no other option but to release the client back into the community without the assistance they want and/or need until a bed becomes available. This year we saved Iowa counties $1,215,200 by using the ACSC rather than the hospitals or emergency room.

19. This year we began accepting court ordered clients. They are people who can be seriously mentally impaired and/or require 24 hour supervision. Some have proven to be very challenging. As we work collectively with their family and case workers, we have seen improvement in their behaviors. We continue to strive by providing mental health evaluations, substance abuse evaluations, medication evaluations and residential stays.
Another increase that we have seen is the admission of clients who have just finished their jail or prison sentences. We work closely with the Community Treatment Coordinator with some of their cases that need additional support in transitioning back into the community. We have had great success with assisting them.
The Board of Supervisors approved an increase in the Per Diem rate from $250 to $300 to help offset the cost of hiring the Medical Director. This increase took effect on June 1st.
With the closing of 2 of the 4 Mental Health Institutes in the State of Iowa the need for more Mental Health Services will continue to grow. We are currently ranked 49th for services in the country which is unacceptable.

20. ACSC INCIDENTS
On the ACSC unit we had 62 written incident reports. As you can tell by the graph above most were written for minor medical issues and medication errors. This can be anything from a cut finger to miss-counted medication. We continue to work on our de-escalation tactics to try and prevent more tantrums but this can be challenging at times.
The first incident, a resident had cut his forearm with a razor blade that he had brought back from Day Hab. He was questioned why he had done this to himself and said he felt like no one cared about him other than the people at ACSC. Second incident was a client was havingn a whole body seizure. Another client was watching tv with him in the kitchen ady area whe he went to the floor and began seizing. Dispatch was called and they sent the paramedic and they transported to the hospital. And the third incident was a client had severe abdominal pain and was taken to the ER due to a pre-existing medical condition.

21. Adult Crisis Stabilization Center Statistics

29. Financial Statistics

30. North Iowa Juvenile Detention Services
The number of juveniles being housed in our facility has risen ever so slightly in the past 3 years. In fiscal year 2016 we admitted 248 juveniles and billed for 3846 units. We have seen an increase of juvenile adult holds from various counties with the most coming from Black Hawk County. We housed 20 adult holds in fiscal year 2016 and in the previous two years we housed 7 each year.
With average per day and length of stay increasing, AEA 267 has re-assigned an aide back to NIJDS. We now have 2 teachers and 2 aides.
That being said, the numbers continue to hold steady. With the continuation of the National Juvenile Detention Alternative Initiative, courts continue to find alternatives to detention.

31. Legislative News
No changes to juvenile detention funding.  We were able to defeat the bill that would have eliminated our funding source without a plan to replace it (and of course, that dedicated funding source continues to keep our funding very predictable and very stable).  Allocations remain the same. (HF 2460)
No changes to juvenile detention bed cap.  There was a push coming from a Jasper County legislator to expand the bed cap, but that was quickly stopped. 
Installment plans for delinquent court debt were passed.  One of the reasons DOT has consistently tried to eliminate civil penalties for non-payment of fines and revocation of driver’s licenses is that they stack up and people are not able to pay them; very low percentages are ever paid.  
Legislation was passed that allows counties to collect through installment plans (SF2316). This will not impact juvenile detention funding.
Juvenile court records will be kept confidential unless a judge orders them open under legislation adopted this year (SF 2288).
Legislators corrected an error made last year in juvenile shelter reimbursements, when they increased funding for reimbursement increases but forgot to adjust the statewide average reimbursement.  Legislation passed this year increased that statewide average by $4.85 (SF 2035). 
DHS was given broader oversight over “boarding schools” in response to the situation at the Midwest Academy in Keokuk.  (SF 2304)

32. Juvenile Detention Incidents
This year we had 43 incident reports written. The majority of them were for rule violations and tantrums. We had one major incident this year. We had a resident (an adult hold from Black Hawk County) escape from our custody. He was in the intake room doing his intake when he proceeded to forcibly push both doors open and escaped in his mother’s vehicle (who was here for a visitation). He was apprehended a few hours later, booked on these new charges and returned to us. On two other occasions, we over heard talk of attempted escape plans. These plans did not pan out for the residents.
We had to use mechanical restraints 2 times this year. One the first occasion, the resident had received a consequence earlier in the evening and he was in his room for the remainder of the night. He was not happy about this and proceeded to start banging and pounding on the door. He kept saying he needed to use the restroom but was saying this to just come out of his room. When entering his room to remove his bedding, he would not give up his top sheet. Staff was continuing to try and get this from him and he just escalated even more. He threatened staff and at that time the decision was made to put him into restraints to move him to room 8 for his and staffs safety.
On the second occasion, a resident assaulted staff. Staff had opened the resident’s door and he was swinging at staff and made contact as they entered his room. Staff put him on the floor and he continued to assault staff. Restraints were then placed on him for a short period of time until he gave a verbal indication he would not hurt staff of himself.

34. North Iowa Juvenile Detention Services Statistics

40. REASON FOR ADMISSION
M F TOTAL TOTAL
# CHARGE CAUC MIN CAUC MIN FY FY 15
1. AIDING & ABETTING
ACCESSORY AFTER THE FACT
JOINT CRIMINAL CONDUC
CONSPIRACY
 2. MURDER 1ST – 2ND
VOL. MANSLAUGHTE
INVOL. MANSLAUGHTER
ATTEMPTED MURDER
3. ASSAULT OF ANY DEGREE
WILLFUL INJURY
ARMED WITH INTENT
4. TERRORISM
HARASSMENT
SEXUAL HARASMENT
5. SEXUAL ABUSE 1ST – 3RD
LASCIVIOS ACTS
INDECENT EXPOSURE
ASSAULT WITH INTENT TO
INFLECT SEXUAL ABUSE
INDECENT CONTACT WITH A CHILD
6. KIDNAPPING 1ST – 3RD
FALSE IMPRISOMENT
7. ROBBERY 1ST – 2ND
8. ARSON 1ST – 3RD
RECKLESS USE OF FIRE
9. FALSE REPORT
DECEIVING AN OFFICER
FRAUD
FORGERY
10. BURGLARY 1ST – 3RD
ATTEMPTED BURGLARY
POSS. OF BURGLARY TOOLS
11. THEFT 1ST – 5TH
POSS. OF STOLEN PROPERTY
12. O..M.V.W.O.C
13.TRESPASSING
CRIMINAL MISCHIEF 1ST – 5TH

41. TOTALS 53 153 29 7 262 218 14. I.W.O.A DISORDERLY CONDUCT
RESISTING ARREST
TAMPERING W/ A WITNESS
EXTORTION
15. ESCAPE FROM CUSTODY
16. POSS. OF AN OFFENSIVE WEAPON
17. PROSTITUTION
18. DRUG & ALCOHOL OFFENSES
19. OWI 1ST – 3RD
20. VIOLATION OF:
COURT ORDERED PLACEMENT
PROBATION AGREEMENT
IN-HOME DETENTION ORDER
21. PENDING PLACEMENT
HELD ON A WARRANT FOR
ANOTHER JURISDICTION
22. DRIVING WITH A
SUSPENDED LICENSE
23. YOUTH READMITTED HERE
AFTER BEING BUMPED OUT
24. TWO DAY DISPOSITIONAL STAY
25. RESIDENTS RETURNING FROM
AN OUTSIDE EVALUATION
26. ADM. AFTER BEING BUMPED
FROM ANOTHER FACIL
27. ADULT HOLDS
TOTALS