Sequential Intercept Mapping Pasco County, Florida

Sequential Intercept Mapping Pasco County, Florida

May 11, 2017

Facilitated by: The Criminal Justice, Mental Health, and Substance Abuse Technical Assistance Center Department of Mental Health Law and Policy Louis de la Parte Florida Mental Health Institute College of Behavioral & Community Sciences University of South Florida

Pasco County Sequential Intercept Mapping Report Abbreviations

Below is a list of abbreviations that may be helpful when reading the Pasco County Sequential Intercept Mapping (SIM) narrative and map.

General List of Abbreviations

ACT ALF ARF BA CIT CJMHSA CJMHSA TAC

CoC CRF CSU DCF EBP EMS ER FACT FACT FDLE HCV HIPAA HUD HUD-VASH

LE LMHP LPN MA MD MH MHFA MOU NAMI

Assertive Community Treatment Team Assisted Living Facility Addictions Receiving Facility Baker Act Crisis Intervention Team Criminal Justice, Mental Health, and Substance Abuse Criminal Justice, Mental Health, and Substance Abuse Technical Assistance Center Continuum of Care Central Receiving Facility Crisis Stabilization Unit Department of Children and Families Evidence-Based Practice Emergency Medical Services Emergency Room Florida Assertive Community Treatment Team Forensic Assertive Community Treatment Team Florida Department of Law Enforcement Housing Choice Voucher Health Insurance Portability and Accountability Act of 1996 U.S. Department of Housing and Urban Development U.S. Department of Housing and Urban Development- Veterans Affairs Supportive Housing Law Enforcement Licensed Mental Health Professional Licensed Practical Nurse Marchman Act Medical Doctor Mental Health Mental Health First Aid Memorandum of Understanding National Alliance on Mental Illness

RNP SAMH SIM SMI SOAR SU USF VA VOP

Registered Nurse Practitioner Substance Abuse and Mental Health Sequential Intercept Mapping Serious Mental Illness SSI/SSDI Outreach, Access, and Recovery Substance Use University of South Florida U.S. Department of Veterans Affairs Violation of Probation

Pasco County Abbreviations

ACTS ASAP BCBH CARE CFBHN CHAT C.O.R.E. DCPD ECA FDTC IOP ISU MCT NPRPD NTBH PATH PCSO PHP PRPD PSCC TN24 VTC ZPD

Agency for Community Treatment Services, Inc. Alliance for Substance Abuse Prevention BayCare Behavioral Health, Inc. Citizen Addiction Recovery Effort Central Florida Behavioral Health Network, Inc. BayCare Behavioral Health's Community Health Activation Team Challenge Overcome Restore Empower Dade City Police Department Eckerd Community Alternatives Family Dependency Treatment Court Intensive Outpatient Program Integrated Stabilization Unit Medical Center of Trinity New Port Richey Police Department North Tampa Behavioral Health Hospital Project for Assistance in Transition from Homelessness Pasco County Sheriff's Office Partial Hospitalization Program Port Richey Police Department Public Safety Coordinating Council The Next 24 Veterans Treatment Court Zephyrhills Police Department

Table of Contents

Introduction..................................................................................................................................... 1

Background............................................................................................................... 1 Objectives of the Sequential Intercept Mapping................................................................ 2

Keys to Success ........................................................................................................ 2

Pasco County Sequential Intercept Map Narrative .......................................................................... 3

Intercept 1--Law Enforcement & Emergency Services ...................................................... 3 Intercept 2--Initial Detention & First Appearance ........................................................... 9 Intercept 3--Jails & Courts ....................................................................................... 10 Intercept 4--Reentry .............................................................................................. 12 Intercept 5--Community Corrections ......................................................................... 14 Across Intercepts--Gaps and Opportunities .................................................................. 15

Pasco County Priority Areas ........................................................................................................... 16 Pasco County Action Plan .............................................................................................................. 16

Action Planning Process ............................................................................................. 16

Summary and Recommendations................................................................................................. 21 Sequential Intercept Map: Pasco County, Florida ....................................................................... 22 Appendix A: Participant List .......................................................................................................... 23 Appendix B: Resources page ......................................................................................................... 25

Pasco County, Florida: Transforming Services for Persons with Mental Illness and Substance

Use Disorders in Contact with the Criminal Justice System

Introduction

This report provides a summary of the Sequential Intercept Mapping (SIM) in Pasco County, Florida on May 11, 2017. The SIM provided a strategic plan for a targeted population, namely adults with substance abuse and/or mental health disorders (SAMH) involved in the criminal justice system in Pasco County, FL. The SIM is an integrated tool that can facilitate other community plans, such as behavioral healthcare, criminal justice, or plans to end homelessness. The SIM, hosted by BayCare Behavioral Health, Inc., was convened at the Pasco Utilities Building located at 19420 Central Boulevard, Land O'Lakes, Florida, 34637.

This report includes:

? A brief review of the background for the SIM ? A detailed summary of the information gathered at the SIM, presented by intercept ? A sequential intercept map developed by the group during the SIM ? An action planning matrix developed by the group ? Observations, comments, and recommendations to assist Pasco County in achieving its goals

Background

BayCare Behavioral Health, Inc. (BayCare), Criminal Justice, Mental Health, and Substance Abuse (CJMHSA) Reinvestment grantee for Pasco County, requested the SIM as a top priority in the implementation of a new one-year planning grant awarded by the Florida Department of Children and Families (DCF) SAMH. The SIM will assist BayCare and Pasco County with the activities and products listed below.

? Creation of a map of the current criminal justice system indicating points of "interception" where jail diversion or reentry for individuals with SAMH disorders can be developed and implemented

? Identification of resources, gaps in services, and opportunities within existing systems of behavioral healthcare, law enforcement, and the judiciary

? Development of a strategic action plan to implement plans in addressing the criminal justice diversion and treatment needs of adults (18+) with SAMH disorders involved with the criminal justice system

The SIM was comprised of 31 participants representing cross-systems stakeholders including SAMH treatment providers, human services, corrections, advocates, family members, law enforcement, county courts, and the judiciary. A complete list of participants is available in Appendix A at the end of this report. Mark Engelhardt, Karen Mann, and Katelind Halldorsson from the University of South Florida (USF) Criminal Justice, Mental Health, and Substance Abuse Technical Assistance Center (CJMHSA TAC) facilitated the mapping. Sarah Cobelli of BayCare organized the logistics of the mapping and provided valuable background information.

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Objectives of the Sequential Intercept Mapping

The SIM has three primary objectives:

? Development of a comprehensive map of how people with SAMH disorders flow through five distinct intercept points of the Pasco County criminal justice system: Law Enforcement and Emergency Services, Initial Detention and First Appearance, Jails and Courts, Reentry, and Community Corrections.

? Identification of resources, gaps in services, and opportunities at each intercept for individuals (18+) with SAMH disorders involved in the criminal justice system (target population).

? Development of priorities to improve the system and service level responses for individuals in the target population.

The Pasco County SIM map is on page 22.

Keys to Success Existing Cross-Systems Partnerships

Pasco County's history of collaboration between the behavioral healthcare and criminal justice systems is reflected in a number of existing local efforts that were identified prior to and during the SIM. Examples include:

? Criminal Justice, Mental Health, and Substance Abuse (CJMHSA) Planning Council ? Public Safety Coordinating Council ? Pasco Regional Council ? Behavioral Health Consortium ? Alliance for Substance Abuse Prevention (ASAP) Coalition ? Domestic Violence Task Force ? Coalition for the Homeless of Pasco County ? Juvenile Justice Circuit Board Meeting ? Juvenile Justice Provider Meetings ? Sixth Judicial Circuit Problem-Solving Courts

o Adult Drug Court, Family Dependency Treatment Court (FDTC), Dependency Drug Court, and Veterans Treatment Court (VTC)

Representation from Key Decision Makers

The SIM included broad cross-systems representation and involved many key decision makers. Opening remarks set the stage and established a clear message as to the importance of the SIM and commitment to an action plan.

? Rich Jenkins, Representing the Public Safety Coordinating Council? ? Bill Major, Representing the Sixth Judicial Circuit Public Defender's Office ? Christopher LaBruzzo, Sixth Judicial Circuit, Assistant State Attorney

Sarah Cobelli of BayCare welcomed the participants to the SIM.

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Data Collection

BayCare Behavioral Health, Inc. gathered a variety of data prior to the mapping to complete the SIM Planning Data Collection Tool. Information and data contained in this report was derived from that tool and from participants during the mapping. Recommendations contained in this report are based on information shared by participants during the SIM.

Pasco County Sequential Intercept Map Narrative

The SIM is based on the Sequential Intercept Model developed by Patricia Griffin, Ph.D. and Mark Munetz, MD for the National GAINS Center for Behavioral Health and Justice Transformation funded by SAMHSA. During the mapping, the facilitators guided participants to identify resources, gaps in services, and opportunities at each of the five distinct intercept points of the criminal justice system. Additionally, there was a brief discussion regarding Intercept "0" or early intervention services, which addresses prevention and the civil, voluntary, and involuntary Baker Act and Marchman Act systems.

This narrative reflects information gathered during the one-day mapping and often verbatim from the participants or local experts. This narrative is a reference guide to navigate the Pasco County SIM map, especially with regard to abbreviations used on the map. The county's CJMHSA Planning Council may choose to revise or expand information collected and presented during the mapping.

Intercept 1--Law Enforcement & Emergency Services Emergency Services and 911

911 ?

? ?

If an individual is in an apparent behavioral health crisis and involved with a possible law violation, Pasco County Emergency Communications (the 911 center) is the first point of emergency contact and system response. Requesting a Crisis Intervention Team (CIT) officer is possible when contacting 911, but does not guarantee the dispatch of a CIT-trained officer. Pasco County has a 211 information and referral resource, which is a call system for nonemergency social services.

Initial Contact ? Upon arrival to the scene, the law enforcement officer determines if the individual in crisis meets the standard for involuntary commitment in accordance with the Baker Act (Chapter 394, F.S.) or Marchman Act (Chapter 397, F.S.). This determination is often at the discretion of the officer. ? If the individual does not meet the Baker Act or Marchman Act criteria but meets the criteria for an arrest, they are transported to the Pasco County Jail. o Many of the initial contacts are the result of a citizen call-in based on the behavior of the person. ? If the individual has not committed a law violation, law enforcement will transport the individual to the nearest Baker Act receiving facility or to the nearest detoxification facility for screening, assessment, and treatment.

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Transportation ? Law enforcement provides the majority of Baker Act and Marchman Act transports in the county. ? Pasco County government does not contract with a private transportation company transport individuals for a Baker Act or Marchman Act assessment. ? Fire and rescue also provide transportation. ? Law enforcement's policy is to handcuff an individual during transportation to a receiving facility. ? Law enforcement is required to transport an individual to the nearest Baker Act receiving facility. However, when an individual needs to visit an ER for medical clearance, the officer may be required to remain at the ER to ensure safety. Law enforcement's preference is to transport the individual to a facility that is secure so the officer can return to his/her other duties. o When law enforcement transports an individual to a hospital (for medical clearance), the hospital becomes responsible for the secondary transportation.

Law Enforcement

Pasco County is served by five law enforcement agencies. Four police departments have jurisdiction in the municipalities of Dade City, New Port Richey, Port Richey, and Zephyrhills. Pasco County Sheriff's Office (PSCO) serves the unincorporated areas.

Sheriff's Office: ? Pasco County Sheriff's Office

Municipal Law Enforcement:

? Dade City Police Department ? New Port Richey Police Department ? Port Richey Police Department ? Zephyrhills Police Department

Crisis Intervention Team (CIT) Training ? PCSO is expanding the number of CIT-trained officers in the county. o The goal of PCSO is to train all law enforcement officers in the county. o The number of instances in which a citizen requests a CIT-trained officer during a 911 call is not currently being tracked (data is not collected on requests for CIT-trained officers). ? PCSO is in the process of training dispatchers to recognize that a caller is requesting a CITtrained officer and to make a note of the request. ? There are five CIT classes scheduled for 2017. An average of 15 officers attend each class. o PCSO hosts the CIT training, which is open to all law enforcement officers in the county. o Conflicts with officers' work schedules may prevent them from attending the 40-hour training.

Number of CIT-trained officers as of 2016 (excluding those officers assigned to support functions):

? Officers: 260 ? Detention: 64 officers ? Civil: 3 officers ? Bailiff: 7 officers

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