1. Bob Janes Triage Center and Low Demand Shelter Lee County
Kevin Lewis, CEO
Southwest Florida Addiction Services, Inc
Triage Center Partner Agency

2. Opened April 28, 2008

3. Pre-Arrest Diversion Program
Voluntary alternative to incarceration and inappropriate emergency room utilization
Targets low level offenses (trespass, open container, disturbing the peace)
Primarily for individuals experiencing a behavioral health crisis who are homeless, indigent, and/or intoxicated
Compliments Crisis Intervention Training

4. Low Demand Shelter
Opened 22 beds in April 2008 and increased to 58 beds May 2010 using CJMHSA grant
Provides safe shelter while conducting medical and psycho-social assessments
Residents work with case manager to establish goals to accomplish
Links 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 grant
Building space at mental health center – Lee Mental Health Center unsung hero
Data system built on existing HMIS
Local matching funds from key stakeholders
Agency willing to run shelter component
Buy in of key community partners

7. Data System
Utilizes Client Services Network (CSN) – Lee County’s Homeless Management Information System (HMIS) to track demographic information
Admission to facility including Length of stay, referring agency, etc.
Referrals for services and housing
Criminal history

8. Data System Cross referenced with local jail data system
Cross referenced with local hospital data
Florida 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 enforcement
fewer subsequent arrests
if 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 years
6 triage stays in 3 years (longest 354 days)
Jail cost $58,771 - Hospital cost $124,811 – Triage cost - $42,626
Baker Act and Detox history
Qualified 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 LEO
Provides law enforcement alternative to arrest
Works with homeless population most of whom have criminal justice history and MH/SA treatment history
Emphasis on stabilizing, obtaining resources and housing

13. Number of Triage Admissions
2,070 duplicate client admissions occurred during first three years
Facility capacity increased from 22 beds to 58 beds May 2010

14. Source of Referral

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 clients
2,070 duplicated clients
Average Length of Stay 13 days

16. Who does Triage Center Serve?
77% male population (County jail is 86% male)
79% white; 92% non-Hispanic
73% between ages of 31-60
16% Veterans
93% Homeless
Gender # %
Male
965
77.45%
Female
281
22.55%
Total
1,246
100%
Age # %
18-20 27
2.17%
21-30
212
17.01%
31-40
216
17.34%
41-50
351
28.17%
51-60
340
27.29%
61-70 85
6.82%
71-80 11
.88%
80 + 2
0.16%
Not Reported
Total
1,246
100%
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 assessment
42% report taking medications which includes but is not limited to psychotropic drugs

18. True Diversion? 70% have prior arrest history in Lee County
64% misdemeanor
36% felony
Most common prior charges are:
Trespass
DUI
Theft
Battery
Information from CSN reports. See Eric.

19. Impact on Criminal Justice System
16% of time LEO would have taken individual to jail
Diverted 332 charges
5% of people would have been charged with more than one crime
If LEO had taken to jail, most common charges would be:
Trespass
Loitering
Diverted 70 Marchman/Protective Custody
Information from CSN reports. See Eric.

20. Impact on the Community
64% of time LEO would have taken nowhere
Provides access to assessment, shelter, resources and treatment for people who would have otherwise been left on the streets
3% of time LEO would have taken to hospital
Reduces impact of inappropriate utilization of emergency rooms
53% successfully linked with resources
44% Had a good exit status.
Information from CSN reports. See Eric.

21. Saves Law Enforcement Time
84% of time officers spend ≤ 5 minutes
10% of time officers spend ≤ 15 minutes
93% of officers are satisfied to highly satisfied with process
34% of time individuals are brought by a CIT trained officer
Information from CSN reports. See Eric.

22. Map provide by Jason K.

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 partners
Federal stimulus funds used to expand facility
FDLE Byrne Grant funds operating expenses
Veteran’s Administration per diem contract
Cost is $68 per bed per day
Left “as is” from 9 month report – assuming this is all still the same.

24. Key Stakeholders
Lee County BOCC – administers grant and provides local match funds
Salvation Army – operates low demand shelter
Lee Memorial Health System – provides nursing staff, medical supplies, and some meals
Lee Mental Health Center – provides facility, oper. and maint., meals, and intake clinician
Southwest Florida Addiction Services – provides intake clinician
United Way – provides match funds for meals
Local law enforcement
NAMI

26. Questions For additional information please contact
Ann Arnall, Lee County Human Services
2440 Thompson Street
Fort Myers, Florida