JAIL DIVERSION PLANNING ADVISORY COMMITTEE PAC

1

Bexar County City of San Antonio, Texas
Collaboration Criminal Justice and Mental
Health California Mental Health Policy
Forum September 5-7, 2007 Napa Valley, California
Leon Evans, President/Chief Executive Officer,
The Center for Health Care Services, Bexar
County MHMR
2
Service Delivery Systems
Building on Success and Closing Gaps
3
How We Started
Community Partnership
City Government County Government State
Government University Local Private
Hospitals Law Enforcement Criminal/Civil
Courts Advocacy NAMI Consumers San Antonio
State Hospital Mental Health Partners
The Jail Diversion Over-sight Committee
The Jail Diversion Planning Advisory Committee
Community Medical Directors Roundtable
Private Sponsorship Aztrazeneca
4
Transformation Collaborative
The Transformation Team
5
Crisis Care Center Summary
First Year of Operations
Actual Facility Total Seen 7,619 (from Sep 05
to Aug 06)
Opened Aug 30, 2005 Hurricane Katrina
Evacuees Arrive Aug 31, 2005 Full Year
Completed Aug 31, 2006
6
Crisis Care Center Preliminary DATA (continued)

• Then
• Wait times for Medical
• Clearance/ Screening at
• UHS ER - 9 hours, 18 minutes.
• Wait times for Medical
• Clearance/ Screening and
• Psychiatric Evaluation is
• between 12 and 14 hours.

WAIT TIME for LAW ENFORCEMENT

• Now
• The wait time for Medical
• Clearance/ Screening at the
• Crisis Care Center is 45 minutes
• Wait time for Medical Clearance/
• Screening and Psychiatric
• Evaluation is 60-65 minutes .

7
Civil and Criminal
System County City-wide Entry Points
Judicial/Courts Magistrate, County, District
System Level
City-wide
County
Law Enforcement Detention/Jail CIT
Crisis Care Center Jail Diversion Psychiatric and
Medical Clearance Specialty Offender Services
Mental Health Public and Private Providers
Police, Sheriff Probation, Parole
Treatment Continuity of Care
Emergency
Services
Community

• Data exchange through
• Community Collaborative
• Crisis Care Center
• CIT/DMOT
• Jail and Juvenile Detention
• Statewide CARE Match

Dynamic Crisis Jail Diversion Information Exchange
8
POST DIVERSION CLINICAL EXPANSION Palo
Alto Combined Substance Abuse and MH Services
Prison
Client Court Ordered
Parole
Genesis 203 Clients 16 Staff
Substance Abuse Treatment Facility 200 Clients
Manos 100 Clients 8 Staff
Omega (AppleWhite) 65 Clients 13 Staff
Probation
Probationers within SA Treatment Unit
Probationers within Mentally Impaired Facility
9
Law Enforcement
Community Level
Adult JDOC
New Transformation Committees
SA Detox Services Homeless
Adult CMDRT
University Health System
Crisis Care Center Adult Med and Psych
Community
CPS
Childrens Crisis Care Center
SA Metro Health
Mental Health Public and Private Providers
School Districts
Judges Children's Diversion
Research Data Collection
Juvenile Probation
Courts
10
Next Steps

• Childrens Services
• Health And Behavioral
• Health Integration
• Substance Abuse Services

11
.Protecting the Future by diverting Children to
essential Care today!

• Bexar County
• Childrens Diversion
• Initiative

• Sub Committees
• County/City School Districts
• Child Protective Services
• Juvenile Justice - Probation

12
Behavioral Healthcare Integration with primary
and specialty medical care (contd)

• The patients served by the Center and by UHS are
  the same individuals
• We combine functions to integrate care for these
  individuals
• Functional integration is the foundation of the
  best healthcare possible for the people we both
  serve

13
New Generation Medication Program

• Contract with UHS initiated in 2002
• CareLink Patients NGM Cost paid by CHCS with
  General Revenue
• CareLink Patients other Medication costs borne by
  UHS
• Savings to CHCS of between 2.4 2.6 million
• Savings funded the Crisis Services and Jail
  Diversion Initiative

14
Substance Abuse System of Care
Community Patients

• Urgent Care Center
• Front-Door
• Substance Abuse Triage
• Mental Health Jail Diversion

• Haven for Hope
• Homeless Housing
• Initiative

Partial/Day Hospital, Intensive Outpatient
Community Patients
15
The MAP
600 Bed Homeless Residential Facility (4)
CHCS Substance Abuse Outpatient Services (5)
CHCS Detox Center (3)
Community Medical Clinic (1)
CHCS Urgent Care Center (2)
Emergency Psychiatric Screening
County Jail (6)
16
Community SuccessWorking As a Collaborative

• Received the American Psychiatric Gold Award
  for Community Program Innovation
• Received the National Council for Community
  Behavioral Healthcare Directors Service
  Excellence Award
• Visited by 17 State Delegations and two Countries
  (Canada and the Republic of China)
• Continue to produce Publications, Articles and
  News Releases
• Children's Judges Diversion Initiative
• Continued Health and Behavioral Health
  Integration
• Six Year Cost Benefit Study nearing completion
• Substance Abuse Detox Services Expansion for
  Community and 600 Bed Homeless Facility
• Deputy Mobile Outreach Team
• Jail Diversion Planning Advisory Committee
  Established
• Mental Health Docket Re-designed
• Jail Diversion Over-sight Committee Established
• Medical Directors Roundtable Committee
  Established
• Bexar County JD Model approved by JDPAC
• 78th Legislature enacts Jail Diversion Law
• Law Enforcement Partnership/CIT Training
• Crisis Care Center -Psychiatric
  Screening/Medical Clearance 24/7 Established

17
Thank you !
www.chcsbc.org
Leon Evans, President and Chief Executive
Officer, The Center for Health Care Services San
Antonio, Texas For additional information
contact Leon Evans, Ph. 210 731-1300 Email
levans_at_chcs.hhscn.org