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Bexar County City of San Antonio Crisis Care Center and Diversion Initiatives. June 29, 2007. Presentation For The California State Sheriffs’ Association. Leon Evans President and Chief Executive Officer, The Center for Health Care Services
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Bexar County City of San AntonioCrisis Care Center and Diversion Initiatives June 29, 2007 Presentation For The California State Sheriffs’ Association Leon Evans President and Chief Executive Officer, The Center for Health Care Services Local Mental Health Authority www.chcsbc.org
Community Wide Jail DiversionThe Problem • Criminalization of Mentally Ill • Inappropriate Cost to Society • 20% + in jail • Increase use of emergency rooms • Homelessness • Public Safety Net • Consumers at risk • Law Enforcement at risk • Public at risk
If No Programs Are In Place • Continued Increase/Overcrowding in Jail Population • Continued Increase/Overcrowding in Prison Population • Increased and Inappropriate Use of Emergency Rooms
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 .
Crisis Care Center Summary Actual Facility Total Seen = 7,619 (from Sep 05 to Aug 06) First Year of Operations
“ Today’s Misdemeanants, Tomorrow's Felon “
“If you want a partner, you have to be a partner”
The Partnership The beginning City of San Antonio Mayor Ed Garza Bexar County County Judge Nelson Wolf
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
Civil and Criminal Adult Jail Diversion System County City-wide Entry Points Judicial/Courts Magistrate, County, District Children's Diversion Initiative In Progress 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 ***DATA DRIVEN*** Research Cost Benefit Study to access Policy Implications Of Jail Diversion
CRISIS CARE CENTER and CRISIS INTERVENTION TRAINING The Crisis Intervention Teams (CIT) Officers trained by Law Enforcement and Mental Health Personnel via a 40 hour curriculum including role play demonstrations. Attends weekly operational meetings with MH and Community Stakeholders • CRISIS CARE CENTER • 24/7 OPERATION • MEDICAL CLEARANCE • 15 MINUTE DROP OFF • FOR PSYCH SCREEN • 60 MINUTE DROP • OFF FOR MED AND • PSYCH SCREEN
National Award for Service ExcellenceBanquet, April 10th 2006 Orlando Florida
CHCS Criminal/Civil Service Units within the Model • Not Guilty By Reason of Insanity Program (NGRI) - Criminal Casemangement Long Term Tracking • Involuntary Outpatient Commitment Program – Civil Casemanagement 78% Reduction in Hosp Bed use • Probation and Parole Case Management Genesis Intensive Casemangement Mentally Ill Offenders Program
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 20 Staff Manos 100 Clients 8 Staff Omega (MIOP) 65 Clients 13 Staff * Probationers within SA Treatment Unit Partners Probation and Parole Probationers within Mentally Impaired Facility Judicial Probation Parole
Recognition • 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) Nice but not done yet …..
X Relapse Medical Detoxification CHCS Detoxification Outpatient Treatment Recovered ! 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
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)
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: levans@chcs.hhscn.org, Ph. 210 731-1300