Backup Documents 10/14/2014 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP A D
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 3
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Jennifer A. Belpedio, ACA County Attorney Office Job 3/14-
2.
/1G-
2. BCC Office Board of County
Commissioners Ay/c, /3/% 9
3. Minutes and Records Clerk of Court's Office
((An(14 Z pnk
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Geoffrey Magon Phone Number 239-252-23
Contact/ Department
Agenda Date Item was 10/14/2014 Agenda Item Number 16D3
Approved by the BCC
Type of Document Final Progress Report Number of Original 1
Attached C' -.vY.'1/4•rNCIL\ V SkNc.e-) Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? N ice. ote.i ,i NA LGM
2. Does the document need to be sent to another agency for additional signatures? If yes, NA V
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be GM V
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's NA
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the IA
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's GM
signature and initials are required. f
7. In most cases(some contracts are an exception),the original document and this routing slip GM ✓
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines! /
8. The document was approved by the BCC on 10/14/2014 and all changes GM N/A is not
made during the meeting have been incorporated in the attached document. The an option for
County Attorney's Office has reviewed the changes,if applicable. 'stli_
9. Initials of attorney verifying that the attached document is the version approved by the ,,
BCC,all changes directed by the BCC have been made,and the document is ready for the / or
Chairman's signature. e71.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
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Martha S. Vergara
From: Martha S.Vergara
Sent: Monday, October 20, 2014 2:53 PM
To: Magon, Geoffrey
Subject: Final Progress Report
Attachments: Geoffrey Magon.pdf
Geoffrey,
If you need an original I can certify a copy for you.
Just let me know..
Thanks,
Martha Vergara, BMR Senior Clerk
Minutes and Records Dept.
Clerk of the Circuit Court
&Value Adjustment Board
Office: (239) 252-7240
Fax: (239) 252-8408
E-mail: martha.vergara a,collierclerk.com
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Criminal Justice, Mental Health, & Substance Abuse
Reinvestment Act— Implementation Grant Progress Report
Collier County
FINAL REPORT
Section 1. Contact Information
Report Submitted By: Geoffrey Magon, Grant Coordinator, Collier County
Person Completing Report: Beverly Belli, Director of Adult Community Services, David
Lawrence Center
County: Collier
Address: 6075 Bathey Lane, Naples, FL 34116
Telephone: 239-455-8500
Email: beverlyb(a�dlcmhc.com
Certified By: ATTEST:
Name: Tom Henning
D GHT E. CIC, Clerk
Y .. ?
Position: BCC Chairman, Collier County B Attes as to Litw,,,,u,1 t
signature OfIy;;
Section 1. Detailed Progress Summary
Provide a detailed summary of the progress in meeting the goals described in your application.
Using the goals/objectives/tasks as delineated in your application as a reporting framework,
describe your achievements to-date in each area. Identify adherence or adjustments to your
timeline. Within your progress summary, make sure to include narrative on the following items:
The following goals and objectives were cited in the application:
Goals
Treatment access and retention.
Reduce days in jail for people with mental illnesses and co occurring disorders
Attainment of permanent, stable housing
Improved social connectedness
Reduction in crime/recidivism/use of forensic institutions
Demonstrate program effectiveness, improved partnerships Approved as to form and legality
Assistant Coun orney
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Objectives
Complete risk assessments for 80% of participants by the end week one of admission.
Maintain a FIRST:participant ratio of maximum of 1:15
Obtain disability benefits for 80% eligible participants within one year of application.
Adhere to evidence-based practices as demonstrated by score of 79+ on fidelity scale.
Number CIT trained annually.
Complete process and outcome evaluations annually.
Complete partnership Memorandum of Understanding by end of Year 1.
Progress
Progress toward achieving the goals and objectives is summarized in the discussion below:
GOALS
1. Treatment Access and Retention:
Corizon and DLC completed LSIR screenings for all persons referred to FIRST. After
screening, clients may be: (1) admitted to FIRST, (2) referred to Drug Court or Mental Health
Court, (3) deemed ineligible due to diagnosis, or (4) declined services (team still engages using
Motivational Interviewing). Clinical assessments were completed on all clients admitted to the
FIRST Program to ensure treatment recommendations to meet the client's needs are initiated
and monitored for treatment compliance.
Additonally, DLC has the ability to scan NAMI treatment records to the DLC electronic medical
record, ensuring continuity of care and peer services are documented.
2. Reduce days in jail for people with mental illnesses and co occurring disorders
Admission into the FIRST Program occurs when the client completes their jail sentence as
Collier County Sheriff's Department does not reduce their sentence based on admission to the
FIRST Program. Corizon completed the LSI-R risk assessment on all potential clients during
their incarceration. FIRST Program staff attempt to complete screenings and engage clients
while the client remains incarcerated. If FIRST Program staff were not able to complete the jail
screening, the client is seen immediately upon discharge for the FIRST screening. After the
FIRST Screening, clients are referred to the DLC Assessment Center which provides clients
immediate access to receive a clinical assessment. All clients admitted to the FIRST Program
received a clinical assessment.
The FIRST Program serviced 162 participants during the length of the contract through June 30,
2014. Eighteen (18) of the one hundred and sixty-two (162) were re-arrested. Eighty-nine
percent (89%) of participants served in the FIRST Program were not re-arrested.
3. Attainment of Permanent, stable housing
From November 2011 to February 2013, seven FIRST clients received housing vouchers
through collaboration of David Lawrence Center, Collier County Housing Authority and Collier
County government. These HUD vouchers are no longer available through HUD housing. The
FIRST Program assisted clients in securing stable housing in St. Matthews House, a local
transitional living facility, and secured housing in two (2) sober living facilities (Naples House
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and Jacobs House). The FIRST team developed collaborative communication with sober living
landlord to better and more efficiently serve these clients. The FIRST Program has been able to
maintain clients through the use of incidental funds to assist with rent. Clients can also work for
rental assistance vouchers or the daily labor pool to offset the cost of rental fees.
4. Improved Social Connectedness
The NAMI peer specialist was instrumental in assisting clients to engage in peer groups, which
she provided through NAMI. She encouraged participation in their drop in center, as well as
other NAMI support groups. Clients were encouraged to engage in twelve-step and faith based
support/recovery and peer groups. Project Help offered our clients trauma based support.
FIRST clients also participated as a group in the annual NAMI walk.
5. Reduction in crime/recidivism/use of forensic institutions
No FIRST Program clients were admitted to forensic institutions. Recidivism/reduction was
significantly reduced by participating in the FIRST Program. Eighty-nine percent (89%) of
participants served in the FIRST Program were not re-arrested.
6. Demonstrate program affiliation/improved partnerships
During the process of developing access for services, DLC FIRST Program staff have
significantly enhanced collaborative efforts with Corizon Health, NAMI, St. Matthew's House,
Naples House and Jacob's House. DLC staff, NAMI and Corizon staff met weekly to staff all
clients for admission into the program. In addition, this team staffs active participants as needed
to address any pending issues, and discuss potential FIRST Program referrals. The FIRST
team often maintained daily contact with community partners to enhance continuity of care,
advocate for client needs and enhance the collaborative partnership. Additionally, bi-monthly
meetings occur with St. Matthew's House staff and DLC staff to identify and resolve barriers to
placement, treatment, and service needs. DLC staff participated in CIT training with NAMI and
work with various NAMI peer specialists to enhance services.
OBJECTIVES
1. Complete risk assessments to 80% of participations
LSI-R, a risk assessment tool, is completed on all clients prior to admission to the FIRST
Program. In addition, all clients accepted into the FIRST Program receive a clinical assessment
by a Master's Level clinician where once again risk factors are assessed. DLC policy requires
staff to continually assess for ongoing risk to clients and provide services necessary to mitigate
risk factors, reduce harm and optimize functioning.
2. Participant ratio of maximum 1:15
The FIRST team did not exceed the 1:15 participant ratio during the length of the contract. The
average participant ratio was 1:12.
3. Obtain Disability Benefits for 80% of eligible clients within 1 year of application
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FIRST team members (DLC case manager and NAMI peer specialist) are SOAR certified and
have assisted FIRST clients in completing SOAR applications when eligibility criteria appear to
be met. During the length of the contract, ten (10) SOAR applications were completed and filed
with Social Security.
The FIRST team currently has nine (9) clients linked with local benefit attorneys as their initial
filing was denied by Social Security. Prior to admission to the FIRST Program, several clients
had a pending Social Security application.
The FIRST Program had four (4) clients approved for benefits and eighteen (18) are currently in
a pending status.
It should be noted that many FIRST participants are capable of working and do not meet the
criteria for social security benefits. Additionally, some participants chose to work and declined
assistance in applying for benefits.
4. ADHERE TO EVIDENCE-BASED PRACTICES:
Transition Planning. Collier FIRST uses the APIC (Assess, Plan, Identify, and Coordinate)
model, a best practice approach to community re- entry for inmates with co-occurring disorders
as the basis for transition planning from jail to the community. The Level of Service Inventory-
Revised scale (LSIR-R) is completed during the initial screening visit and provides valid, reliable
risk assessment information to assist the FIRST team and criminal justice staff to determine
criminogenic needs, and to predict potential for violence, recidivism and probation violations.
Supported Housing and Supported Employment. Housing First evidence-based practice,
Florida Guidelines for Supportive Housing, and SAMHSA Supported and Supported
Employment Toolkits provide direction to the FIRST services for program participants. Florida
Gulf Coast University provided interns from its Community Health program for several months
but has not been an active participant 12/11.
Forensic Intensive Case Management. The FIRST Program follows an intensive case
management model. In the ICM model, individuals receive supports of an interdisciplinary,
community-based team with an optimal staff to participant ratio of 1:15 or fewer. The average
ratio is 1:12.
Disability Benefits. SOAR, (SSI/SSDI Outreach, Assessment and Recovery) FIRST employs
SOAR practices for eligible participants.
Motivational Interviewing (MI). All FIRST staff members have been training in Motivational
Interviewing and utilized motivational interviewing techniques in an ongoing basis.
Cognitive Behavior Therapy & Trauma Informed Treatment. The FIRST/DLC counselor currently
provides CBT and is trained in Trauma Informed Care to help meet the diverse and complex
needs of the population.
Seeking Safety: A model of counseling to help improve coping skills. It was originally developed
for trauma, substance abuse, and/or posttraumatic stress disorder (PTSD). It is also applied
broadly to increase coping and stabilization.
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5. CIT TRAINING:
CIT training is a joint effort by NAMI, DLC and Collier County Sheriff's Office to train law
enforcement personnel to recognize individuals who may suffer from mental illness and develop
appropriate crisis intervention skills to respond to this population. There are approximately five
(5) CIT trainings offered each year.
a. Describe the composition of your Planning Council membership as stated on pages 5
and 6 in the original grant RFA (per F.S. 394.657(2) (a), including a list of the Planning
Council members. Describe any difficulties you have had in filling these membership
positions. Describe the activities, such as meeting frequency and types of collaboration
efforts, of your Planning Council.
NAME Agency/Affiliation
Sheriff Kevin Rambosk Collier County Sheriffs Office
David Schimmel: Co-Chair David Lawrence Center, CEO
Honorable Janeice Martin Mental Health Court and Drug Court Judge
Michael Sheffield Collier County Assistant Administrator
Domenico Lucarelli Private Law Firm
Sara Miller State Attorney's Office
Connie Kelly Public Defender's Office
John Walsh Public Defender, Mental Health Court
Cmdr. Kevin McGowan Collier County Sheriff/Corrections
Sgt. Brandon Barley Collier County Sheriff/Corrections
Sgt. Bill Gonsalves Naples Police Department, CIT
Susan Golden Collier County Sheriff/Grants
Maurianna Swanson Prison Health Services
Open Position Prison Health Services/First Reintegration Specialist
Jay Freshwater DOC Probation
Charles Crews Collier County Court Administration
Louise Pelletier County Housing & Human Services
Mark Engelhardt Florida Mental Health Institute, CJMHSA TAC
Bonnie Fredeen David Lawrence Center, COO
Kristin Long David Lawrence Center/FIRST Therapist
Katie Burrows David Lawrence Center/Forensic Services, Drug Court
Ashley Swan David Lawrence Center FIRST Case Manager
Kathryn Hunter NAMI of Collier County
Ron Stanford NAMI/DLC CSU/Certified Peer Specialist
Eileen Streight NAMI/ FIRST Certified Peer Specialist
Kathy Ray Family Member/Advocate
Larry Wilcoxson Family Member/Advocate
Debra Mahr Collier Hunger& Homeless Coalition
Table 1. Collier Criminal Justice Mental Health & Substance Abuse Planning Council
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Although there have been several changes to the Planning council over the 3 year period, the
Planning Council continues to meet at least annually to review progress and make appropriate
recommendations to enhance the program.
b. Describe any barriers that you have encountered in meeting your
goals/objectives/tasks, and how you have been able to navigate through these barriers.
Also describe significant barriers that remain, if any.
Despite the FIRST Program's collaborative efforts with our community housing partners,
housing remains the biggest challenge. Many landlords will not accept tenants with felony
histories. To address this issue, the team is working with the local landlords who provide low
rental unit in attempt to provide education regarding mental illness, impact of incarceration and
how the coordination of FIRST Program services can enable these individuals to be stable in
the housing making them a viable tenant. In addition, the transitional living facilities do charge
fees and our clients often are unemployed negating their ability to secure adequate housing.
Employment for our clients also remains a challenge due to the fact many employees will not
hire applicants with criminal histories. The majority of employed FIRST Program clients are
employed in the food industry.
According to the Reinvestment Grant application, Collier County agreed to use the Florida
FACT Guidelines as its guide for enhancement funds. In general, this is working well for most
of the clients needs. However, FIRST team members find cell phones necessary to track high
risk, high need individuals once they leave jail. Cell phone payments are not an allowable
expense per Florida FACT guidelines.
At least a dozen individuals served by the team were closed after a period due to the team's
inability to contact them and thus, provide services and coordinate care. Once the person finds
permanent housing, arrangements can be made to secure landlines. In the meantime, the team
members identify access to cell phones is crucial. Without access to a phone, safety may be
compromised and/or people will fail to reintegrate successfully in the community due to lack
communication and access to FIRST team members and with other support systems, treatment
providers and employers. Further, this poses a challenge for employment as employers often
cannot contact the individual for work issues which frequently occur in the types of employment
FIRST clients are involved in; taxi driving, day labor, and the food industry.
c. Identify if you have been able to leverage additional funds for this initiative (beyond
the matching funds requirement) since receipt of grant award/funds. Note: this was
not a requirement.
Seven (7) FIRST clients received housing vouchers from November 2011 to February 2013
through the collaboration of David Lawrence Center, Collier County Housing Authority and
Collier County government. Incidental funds are used to assist with rents and program fees
when clients reside in transitional living or sober living houses. Clients have on occasion been
able to work for rental vouchers.
Section 2. Outcomes
Describe the effect the grant-funded initiatives have had on meeting the needs of adults
and/or juveniles who have a mental illness, substance abuse disorder, or co-occurring
mental health and substance abuse disorders.
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1. Share early data that you have collected in relationship to the core outcome
measures that were identified in your grant application.
FIRST members met each week to conduct staffing to review eligibility criteria for potential
referrals to the program. In addition, the team members discuss barriers to community
integration for participants.
The FIRST Oversight Committee meets quarterly. At this meeting supervisory and program
level personnel are present. These meetings are intended to ensure active involvement in
program level decision making and to ensure the team is on target for meeting contract goals.
This includes but is not limited to the following: staffing levels, housing status and needs, use of
enhancement funds, reporting, and barriers.
Since the grant inception, the following admissions have occurred through June 30, 2014.
Item Value
Total referrals/screening 419
Male 213
Female 206
Total number served 162
Ave LSI-R score 66.94
Ave#previous arrests 6.34
2. Provide early comments, if possible, on the effect of the grant program on the growth
and expenditures of the jail, juvenile detention center, and prison.
The Sheriff's office states that an inmate with a mental illness costs the jail roughly twice the
amount of other inmates. Inmates do not receive reduced or otherwise altered jail sentences
when they agree to receive FIRST Program services. FIRST participants will have a long-term
impact by reducing recidivism especially since the average number of previous arrests per
participant is greater than six. Providing FIRST Program participants with access to psychiatric
care, intensive case management, mental health and substance abuse treatment services, peer
supports, employment opportunities and housing will increase stable and independent
functioning, reduce criminal activity and recidivism resulting in reduced jail expenditures.
Section 3. Technical Assistance (if applicable)
Explain what collaboration, if any, you have had with the Florida Mental Health Institute's
Technical Assistance Center. Has this partnership been successful?
At contract inception, the FMHI TAC has been an invaluable partner in Collier County's efforts.
They (John Petrila and Mark Engelhardt) provided the 2-day system mapping using the
Sequential Intercept Model prior to the grant application in July of 2010. In August of 2011, Mark
Engelhardt returned, at the Planning Council's request, to assist with a system map and
strategic plan review and revision. The FIRST Program has not needed to utilize TAC since
2011.