Backup Documents 09/26/2017 Item #16D20 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP•L 1 L D 2 0
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO v
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. Rachel Brandhorst Community and Human c4 8/17/17
Services _
2. County Attorney Office County Attorney Office (111-)
3. BCC Office Board of County TT'��
Commissioners Vq-4 / ck,2-1\VA
4. Minutes and Records Clerk of Court's Office
61117 In 3°„ m
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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 Rachel Brandhorst,Grant Coordinator, Phone Number 239-252-4230
Contact/ Department Community and Human rvices
Agenda Date Item was September(,2017 1 Agenda Item Number 16D ✓
Approved by the BCC 11" "LC
Type of Document Final Program Status Report Number of Original 1
Attached Documents Attached
PO number or account
number if document is N/A
to be recorded
INSTRUCTIONS & CH CKLIST
Initial the Yes column or mark"N/A"in the Not Applicable colu ,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman' original ature? RB '
2. Does the document need to be sent to another agency for additional signatures? If yes, -R S4e.„
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. c,� e4:‘.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be RB
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 N/A
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 RB
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 RB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip RB
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 onclOnd all changes made during the
meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable.
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
�a-2)
Chairman's signature.
1: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
Instructions 1 6 D 2 0
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1) Please send 1 original Chairman signed Final Program Status Report to:
Jennifer Benghuzzi
Contract Mananger, Business Operations Unit
Florida Department of Children and Families
Office of Substance Abuse and Mental Health
1317 Winewood Blvd., Bldg. 6, Room 235
Tallahassee, FL 32399-0700
2) Please send 1 copy of Chairman signed agreement to:
Dawn Whelan
RSVP Program Director
Grant Coordinator
Collier County
3339 East Tamiami Trail, Building H, Room 211
Naples, FL 34112
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
16020
MEMORANDUM
Date: September 29, 2017
To: Dawn Whelan , Grants Coordinator
Community & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: FY14-17 Department of Children and Families (DCF) Criminal
Justice Mental Health Substance Abuse Grant Final Program
and Financial Status Report along with specific findings
Attached, for further processing is the original grant document referenced above,
(Item #16D20) approved by the Board of County Commissioners September 26, 2017.
A copy of the document will be held in the Minutes and Records Department for
the Board's Official Record.
If you have any questions, please feel free to call me at 252-8406.
Thank you
Attachment
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Florida Department of Children and Families
Criminal Justice, Mental Health, and Substance Abuse (CJMHSA)
Reinvestment Grant Program
Final Program Status Report
Provider Summary
County Report Period
Collier From: July 1, To: June 30, 2017
Grant Number: LHZ46 2014
Report Prepared By Report Approved By DCF
Preparer's Name: Rachel Brandhorst Approver's Name:
Preparer's Title Grant Coordinator Approver's Title
Preparer's Phone 239-252-4230 Approver's Phone
Preparer's Email: RachelBrandhorst@collier Approver's Email:
gov.net
Date Prepared August 1, 2017 Date Approved
Approval for form and legality: COLLI. ; COUNTY
By: 4
Jennifer A. Belpe /1 Penny T., or, CFjMAN
Assistant County a orney
17
412\ Date: c‘VIL,,1 • -
tt:7-rsST: -
DWIGHT E. BRoe.4, clerk
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Section 1. Detailed Progress Summary EtyI 1
: , A.
„Attest a 401- 04Zonan's,
1. Provide a detailed report of the services and activitiity; : • during the reporting
period. Provide a summary of program achievements -date in meeting the
objectives identified in Section B-3, Major Grant Objectives, of the Grant Agreement.
Include details on the associated tasks and activities during the reporting period as
delineated in Section C-1, Service Tasks, of the Grant Agreement. Identify adherence
or adjustments to timelines outlined in the original grant application. Provide an
electronic copy of all executed MOUs or binding agreements identified in subsections
C-1.1.1 and C-1.1.2. of the grant agreement.
B 3.1- The DLC Centralized Assessment Center (CAC) has been in operation since the
inception of the grant and all staff are appropriately trained in identifying and delivering services
to clients. Clinicians had a Master's degree and many staff at David Lawrence are Certified
Addiction Professionals. Staff members received advanced trauma training, and can assess co-
occurring mental health and substance abuse conditions. Al) staff members were trained in
motivational interviewing and used several Evidence Based treatment modalities. Screenings
were completed by triage clinicians as well as the assessing clinician and both made referrals to
the FIRST program. The feedback from the LS-CMI was not positive and because of Technical
Assistance provided by USF, DLC used three new Evidence Based practice tools: the MHSF III
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which is a mental health screening form, the PCL-5 which is a trauma assessment and the
TCUDS V which screened for substance abuse. These screenings were also used by Armor
staff, who strongly felt this tool was a more valid and efficient tool. DLC planned to discontinue
the use of the LS-CMI as of 6/30/17 and use only the forms mentioned above. The assessment
center has the capacity to provide clinical assessments within 24 hours or on a walk-in basis for
FIRST clients. The clinicians worked closely with the FIRST staff to assure appropriate referral
and linking. Additionally, the director attended staff meetings with various other programs at
DLC to educate new staff on the benefits of this program and is a member of the Community
Resource Panel for CIT Training educated local deputies about the program. Assessments are
provided at no charge for approved FIRST clients. Services provided to clients as deemed
appropriate after screening and clinical assessments were completed to identify areas that may
require intervention. These services assisted clients to remain in the community, improve their
daily functioning and avoid re-incarceration. This process helped to identify appropriate referrals
which enabled our program to achieve and exceed the three-year performance measures.
David Lawrence Center also met with the Pre-Trial program at the Collier County Jail to discuss
a process for referrals. Grant staff went to the jail on Mondays and Fridays to screen potential
clients 30 days prior to their discharge. The case manager assumes responsibility for most
incidental funds spent on behalf of the clients and assures eligibility and contractual guidelines
are met. Flyers were provided to inmates that are released, outlining the services available to
them. The CAC continues to enhance the efficiency and effectiveness of CIT officers seeking to
divert individuals from arrest, incarceration, or prosecution. The CAC hosted a FIRST team that
provided a coordinated jail reintegration team to arrestees with mental health and substance
abuse problems to decrease the likelihood of re-arrest. NAMI supported a Peer Specialist
position. The Peer Specialist provides services such as resource coordination, supported
employment, motivational interviewing, supported housing, group counseling, and assistance
with the attainment of disability benefits.
B 3.2- Members of the FIRST team which include DLC, Armor Correctional Health Services and
NAMI met on a weekly basis at the DLC offices to discuss potential candidates for the program
and address the needs and progress of current clients. The team scheduled new client
orientation meetings each month. Participants in the meetings include Armor Correctional
Health Services discharge planners, DLC case manager, DLC life skills coach, DLC clinician
and NAMI Peer Specialist. The DLC program supervisor and director also attend as needed.
The current priorities remain to identify potential clients while they are still incarcerated, screen
them and be prepared to provide immediate access to services upon their release from jail.
Other topics recently addressed include: Emergency Response, confidentiality of health records
and updates on Benzodiazepine abuse. Additionally, monthly meetings were implemented for all
case managers at DLC and staff at St. Matthew's House to staff cases and provide improved
customer service for our clients. These meetings were very helpful in improving the dialogue
between the two agencies. CCSO/Armor staff are very connected to Veterans, Drug and Mental
Health treatment courts and attend mental health court weekly staff meetings and court and are
always available as needed for the other court activities. CCSO Re-entry staff and ARMOR
meet monthly. Both Armor staff members attend Project Recovery Program staff meetings to
focus on discharge planning with this group.
13-3.3-All clients identified as the Target Population had access to mental health and substance
abuse treatment or both. In December, 2014, when NAMI terminated their agreement, CCSO
provided 4 additional Reintegration Specialists (.65 FTE). The goal remained to screen and
interview the entire jail population. Early identification of individuals with substance abuse,
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mental health issues or both enabled a service and treatment plan to be developed and
available upon discharge. The discharge plan included resources for mental health facilities and
substance abuse treatment centers, available homeless shelters, available medical and dental
clinics, employment assistance, clothing and food pantries and bus schedules and bicycle
resources. The FIRST clinician offers individual and group therapy services using an Evidence
Based model called Seeking Safety. The clinician was also available to provide therapy for
clients if they return to jail for a short period. In addition to individual and group therapy, various
levels of substance abuse treatment are available to all FIRST clients if recommended. All
potential FIRST program participants are screened for Project Recovery, a DCF-licensed
outpatient substance abuse program. If the participant does not meet the criteria for admission,
they will receive an informational packet on substance abuse treatment. NA/AA classes are
conducted in the jail setting and it is recommended that those who meet criteria as a FIRST
participant sign up for this alternative. The Pre-Release program identifies inmates that are due
to be released within 60 days. They are screened by ARMOR and if appropriate, are referred to
DLC within 30 days of release. This allows DLC staff to enter the jail and link the clients to
services if they are willing. The new tele-assessment and tele-evaluation systems in place
between CCSO and DLC allow assessments and evaluations to take place in the jail to better
prepare for a FIRST Program participant's release from custody and into the program. They
continue to be an asset to the team. Expansion of this system will allow for others to be
screened via this technology. NAMI provides a .80 FTE Peer Specialist. The Peer Specialist
provides services such as resource coordination, supported employment, motivational
interviewing, supported housing, group counseling, and assistance with the attainment of
disability benefits.
B-3.4- Reducing the number of arrests for the Target Population continues to remain a priority.
Of the 331 clients served in the FIRST program since July 1, 2014, 69 have been re-arrested for
78% non-recidivistic clients.
B- 3.5- Individualized services are provided to clients as deemed appropriate after screening
and clinical assessments. These services aim to engage and motivate them to remain a
productive member of society, improve their daily functioning, obtain jobs, secure housing and
avoid re-incarceration. Medication management services, mental health counseling including
trauma therapy and substance abuse treatment are all services provided to clients. Additionally,
clients work with the NAMI Peer Specialist where they receive Seeking Safety treatment.
C-1 Service Tasks- Since the inception of the grant, the CAC has been implemented and
FIRST Services are available. Screenings are completed by triage clinicians as well as the
assessing clinician and both can make referrals to the FIRST program. The assessment center
provides clinical assessments within 24 hours or on a walk-in basis for FIRST clients. Clinicians
work closely with the FIRST staff to assure appropriate referral and linking. Assessments are
provided at no charge for approved FIRST clients. The CAC enhanced the efficiency and
effectiveness of CIT officers seeking to divert individuals from arrest, incarceration, or
prosecution. The FIRST team provided a coordinated jail reintegration team to arrestees with
mental illnesses and substance abuse problems to decrease the likelihood of re-arrest.
Identifying potential clients while they are still incarcerated, screening them, and then preparing
to provide immediate access to services upon their discharge remained a priority. The Life Skills
Coach assisted clients with job applications, housing, shopping, and linking with services. DLC
staff visited the jail two times per week to screen inmates before they are released. This assists
with placing them as soon as they are released to begin getting the services they need. The
Peer Specialist at NAMI provided services such as resource coordination, supported
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employment, motivational interviewing, supported housing, group counseling, and assistance
with the attainment of disability benefits.
C-1.1.1- An MOU was established on 7/21/09 between the Collier County Sheriff's Office and
David Lawrence Mental Health Center.
C-1.1.2- On 11/18/14, an MOU was established with the local Homeless Coalition outlining
planning strategies and available housing alternatives. Partners included: Collier County
Sheriffs Office, David Lawrence Center, NAMI of Collier County, Hunger and Homeless
Coalition of Collier County and the Collier County Board of County Commissioners.
C-1.1.3- 100% of the requirement to hire and train relevant staff was met. Upon receiving
NAMI's termination letter during the first year of the grant cycle, Collier County worked with DCF
to reallocate the funds and revise the master agreement and subsequent sub-recipient
agreements. Funds were reallocated to the Collier County Sheriff's Office to support a .65
Reintegration Specialist. The Reintegration Specialists conducted interviews on all current
inmates. The part-time licensed clinician saw clients both in the office and in the jail setting.
NAMI's .80 FTE Peer Specialist provided motivational interviewing, system navigation, linkage,
and support to those identified as meeting Target Population definitions.
C-1.1.4-An ongoing collaborative relationship between the Centralized Coordination Program
and law enforcement, judicial personnel, families and consumers of substance abuse and
mental health services and providers exists within the Planning Council. The Planning Council
met on a quarterly basis while the sub-committee met on an as needed basis. The Planning
Council is chaired by representatives from the Sheriff's Office and David Lawrence Center.
C-1.2- During the first year of the grant cycle a total of 103 law enforcement officers graduated
upon completion of the 40-hour class. In addition, 4 agency partners participated throughout the
week in several sessions. Upon completion of the second year of the grant cycle, a total of 67
officers were trained. A total of 79 officers were trained during the third year of the grant cycle.
250 officers have completed this course over the program lifetime.
C-1.2.1- CIT Trainings were provided on a quarterly basis. 100% of the annual service number
target has been met.
C-1.2.2-All FIRST Team members were trained in Evidence Based practices as appropriate to
the needs of each team member's job description. DLC has staff trained in trauma therapy, DBT
and other Evidence Based programs, and all can assess co-occurring conditions: Mental Health
and Substance Abuse. The FIRST clinician is a licensed clinical social worker and the FIRST
clinical director has a Master's Degree. DLA-20 Training was provided on October 9, 2015. This
training was especially helpful to the Life Skills Coach to assess need and track progress or lack
of progress with these services. The training was attended by grant staff and community
partners. The DLA-20 tool is currently being utilized by the David Lawrence Center.
C-1.3-All agencies involved with the Centralized Coordination Program collaborated to ensure
that program participants received coordinated substance abuse and mental health services
designed to specifically decrease the likelihood of criminal activity and contact with the criminal
justice system. Screening tools to assist staff with assessing needs and criteria for primary
substance abuse clients were developed. Case managers visited the jail twice a week to screen
potential referrals and schedule office hours twice a week for any walk-in clients. Screenings are
completed in the jail to ensure immediate admission, if appropriate, to the FIRST program. The
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16D2 .
assessment center has the capacity to provide clinical assessment within 24 hours or on a walk-
in basis for all FIRST clients referred. Project Recovery is currently being conducted at the
Sheriff's Office. If a participant does not meet criteria, they will receive an informational packet
on substance abuse treatment. Referrals from the pre-release program are made and quarterly
meetings are held to discuss and review access issues. CIT Training occurred on a quarterly
basis and officers were specifically trained in CIT to ensure that they access the CAC as
alternatives to arrest. To further support the operation of the program, the Planning Council met
quarterly. Technical Assistance was provided last year on supportive housing. In November
2015, TA was provided on Screening Tools. Additionally, DLA-20 Training was provided to grant
staff on October 9, 2015. Evidence Based transition-planning, treatment and supports are
provided through the Case Manager and Life Skills Coach. All program staff work together to
provide the necessary services and support to ensure the best possible clinical and social
outcomes to reduce arrests and re-incarceration. CCSO, Armor and NAMI grant staff continue
to set on-going quality improvement goals of increasing the network of community referral
sources for post jail. They continue to attend Mental Health Court meetings as well as having
some involvement with Drug Court and staying closely involved with the evolving Veterans
Court. Monthly and quarterly meetings assist with communication between the team and
meeting program outcomes.
C-1.4-To provide individualized services to engage and motivate individuals in the Target
Population to improve their lives and avoid incarceration, Evidence Based practices are applied
to all FIRST participants. The FIRST licensed clinician provided individual therapy and
substance abuse treatment when indicated. Group therapy was made available if indicated. In
addition to individual and group therapy by the clinician, various levels of substance abuse
treatment were also provided to all FIRST clients if recommended. Clients were referred for
psychiatric assessments and ongoing medication management services if indicated. The Life
Skills Coach actively assisted clients with life skills, job applications, housing applications,
shopping skills and linking with other identified needs. The Case Manager screened and
assessed inmates to determine their immediate needs. The Reintegration Specialist conducted
interviews on all current inmates. The interviews determined the inmate's basic needs upon
release from jail. Eligible clients were linked with Social Security benefits. There were not many
applications completed throughout the lifetime of the grant due to clients already receiving
benefits and others have pending applications and/or involved with legal representation in
accessing benefits. Many clients were not appropriate for disability benefits due to able to work.
The DLA-20 tool, a functional assessment tool which is completed in the jail by staff was also
used by case managers. All clients received efficient access to mental health and substance
abuse treatment.
2. Provide a detailed summary of the achievements to-date in meeting the
Administrative Tasks identified in Section C-2 of the Grant Agreement. For all
subcontractor(s) identified in Section C-2.3, provide an electronic copy of the
executed subcontract(s).
All staffing requirements outlined in section C-2 of the Grant Agreement have been satisfied by
the County as well as each sub-recipient. Collier County staffs a 0.15 FTE Grant Coordinator
responsible for the oversight and reporting of the program. Additionally, an Accountant and
Accounting Tech assist with financial matters. David Lawrence Center has assigned and
maintained the following staff: Case Manager, Master's Level Mental Health Counselor,
Supportive Living, Employment and Life Skills Coach, Outreach Specialist, Coordinator and
Case Manager. The part-time licensed clinician is seeing clients both in the office and at the jail.
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The Collier County Sheriff's Office contributes 2.0 Discharge Planners and 4 Reintegration
Specialists (.65 FTE) to interview and screen a larger jail population. NAMI contributes a .80
FTE Peer Specialist.
Collier County has retained all financial records, supporting documents, statistical records and
any other documents pertaining to the grant. All records and information will be available upon
request. All client records are confidential in accordance with state and federal guidelines. Each
sub-recipient is responsible for submitting monthly and quarterly program reports as well as
other reports outlined in the executed grant agreement. All back-up documents including but not
limited to: timesheets, travel logs, cancelled checks, bank statements, lease agreements,
invoices and other deliverables will be provided each month as a requirement for
reimbursement. A checklist was developed to ensure back-up documents are included in each
pay request.
David Lawrence Center, NAMI and Collier County Sheriff's Office executed subrecipient
agreements have been sent with previous reports.
3. Describe any barriers encountered in meeting the objectives and tasks, and how you
have navigated through these barriers. Also, describe significant barriers that
remain, if any.
Many of the same barriers have remained consistent since the inception of the grant. Each of
our subrecipients have reported experiencing the same, or similar barriers related to housing.
Housing has always remained the county's largest challenge. Clients, who are unable to stay at
the only homeless shelter available, for one reason or another, are often left with the options of
sleeping in vehicles, woods or with others whom are unhealthy or unsafe to reside with. Due to
those types of living situations, the clients are less likely to pursue services and are at higher
risk of relapse. Peer Specialists and Case Managers are faced with unsafe circumstances when
they must track down clients that are not in secure living situations. Since there is a lack of
homeless shelters in Collier County as well as our surrounding counties and much of the
population we serve are unable to utilize the limited space due to past experiences with the
agency, or inability to go with their prescribed medications there continues to not be a solution
to this problem. Halfway houses in Collier County, that would otherwise consider accepting
someone in the target population, disqualify some participants due to significant mental health
issues. Additionally, halfway houses in Collier require income prior to move-in. This creates a
housing barrier for the target population. Incidentals have been used to offset these initial
expenses. Many landlords do not accept tenants with a criminal history and there are a limited
number of units available to house low income felons. David Lawrence Center manages HUD
housing which consists of 9 apartments, each housing 2 clients and a single-family home that
can house up to 6 clients, however the units are full and the wait list is extensive. DLC
established a relationship with a local landlord who had the availability for another 8 beds which
were filled with DLC clients. St. Matthews House and Justin's Place continue to increase their
fees. For recently released clients, this places a burden on them and increased demands on the
incidental budget to assist them. St Matthew's House will work with clients to assist them in
paying their fees and offer work incentives but they do require that all residents seek daily
employment. Case Management staff are now meeting with St. Matthew's House monthly to
review mutual clients and assure all services are being provided. DLC has also worked closely
with USF to develop a homeless survey that focuses on client preferences and needs. Due to
the housing barriers in Collier County, many inmates who might qualify for FIRST services must
relocate to another county to find affordable housing. Grant staff continues to build and maintain
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relationships with the VA, the Homeless Coalition, Goodwill, Career Source of SW Florida and
local churches to assist to assist inmates reentering our communities with housing and
employment.
Income guideline changes have decreased the amount of food stamps clients receive. This has
placed a burden on our clients and increased incidental usage. Food pantries do not stock
perishable items such as milk, eggs, and produce. Also, the new food stamp guidelines may
have an impact on our clients if they are not actively seeking work.
Outreach barriers include locating and visiting clients who are homeless and staying in unsafe
environments with no phone or contact information.
Lack of employment opportunities for those who have felonies is another barrier clients
experience when attempting to go back to work. Because this is a transitional program, clients
who have not secured employment, or social security benefits by the time they have completed
the program find it difficult to pay for Dr. visits, continued therapy, medications and stable
housing. Clients also have a lack of documentation needed to obtain services.
Health issues continue to be a problem for many clients leaving the jail. Dental care has been
non-existent for clients. Medical exams have also been needed. DLC works closely with
Healthcare of SW Florida for reduced rates on medical and laboratory exams. Additionally, they
partner with the Gift of Sight programs for affordable eye care.
Collier County Sheriffs Office reports that some inmates who qualify for the FIRST program
choose not to participate due to their fears of relapsing. They prefer to go into residential
treatment programs and more secure environments. For these inmates, the Reintegration Team
works closely with residential treatment programs, makes referrals and assists inmates with
application and interviews for various treatment programs.
For clients with co —occurring issues, it can take some time to get psychiatric medications when
leaving the jail. Armor gives a voucher for 3 days' worth, however David Lawrence Center is
unable to meet the three days always.
Another consistent barrier throughout the grant period has been offenders who acquire
additional charges while in custody. The Reintegration Specialists continue to look for ways to
identify participants that may fall under this category so that a substance abuse treatment
alternative will allow the inmate to remain in Collier.
Financial challenges remain for many of the clients. Many of them are not eligible for
government benefits as they have some capacity to work but locating work is also a challenge
as many places refrain from hiring staff with criminal backgrounds. DLC recently partnered with
a contractor who is willing to hire clients with criminal histories and some could obtain
employment. Most work is found in the food/service industry due to the seasonal increase in
business. Many clients are stagnant in their attempt to secure government benefits due to the
fact many have attained attorneys to represent them.
A challenge in Pre-Release program experienced was getting clients in for a psychiatric
evaluation as most clients are discharged from jail with only a 3-day supply of medications and
doctor availability in this time frame is not available. Tele-assessments are now being provided
in the jail prior to the client's release so an MD appointment can be scheduled without disruption
of medications.
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There has been an increase in the number of clients accessing treatment services. Securing
employment is a major priority and this often conflicts with treatment services. The team is
addressing this issue and being pro-active in retaining clients in treatment by providing
transportation or offering bus passes. The treatment of FIRST clients has steadily increased
however, both in mental health services and substance abuse treatment.
One barrier that has been overcome and continues to improve is client communication. Most
clients now have cell phones; therefore, staff is easily able to reach them. Additionally, if a client
is on food stamps, then there is access to free cell phones.
4. Describe the composition of your Planning Council membership in compliance with
F.S. 394.657(2) (a), and complete the attached form (Appendix A). Describe any
difficulties you have had in filling these membership positions (Note: this form must
be updated when there is a change in Planning Council members). Describe the
activities of the Planning Council, such as meeting frequency and types of
collaboration efforts.
An ongoing collaborative relationship between the Centralized Coordination Program, law
enforcement, judicial representatives, families, consumers, and county grant staff exists through
the Planning Council. The Planning Council met on a quarterly basis. Co-chairs included a
representative from law enforcement and a representative from the mental health and
substance abuse center. The Planning Council continues to meet under the new grant cycle.
Section 2. Deliverables
1. Provide a detailed summary of the progress achieved in meeting the deliverable
requirements outlined in Exhibit D of the Grant Agreement.
1
During the program lifetime, FIRST services were delivered to a total of 331 clients. The
Centralized Assessment Center screened 11,553 clients for possible FIRST referrals. 250
officers completed CIT Training. All program outcome numbers have been met and exceeded.
• Using the tables below(Summary Service Tables) as an example, provide the
services and the number of participants served for quarterly reporting period,
each program year and program lifetime.
See Table.
2. Using the Performance Measures for Acceptance of Deliverables in Exhibit D, Section
D-4, of the grant agreement, provide the percentage of the target number for each
quarter, as applicable.
D-4.1.1 — An MOU was established 7/21/09 between the Collier County Sheriff's Office and
David Lawrence Mental Health Center. (C-1.1.1)
On 11/18/14, an MOU was established with the local Homeless Coalition outlining planning
strategies and available housing alternatives. Partners include: Collier County Sheriff's Office,
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David Lawrence Center, NAMI of Collier County, Hunger and Homeless Coalition of Collier
County and the Collier County Board of County Commissioners. (C-1.1.2)
100% of the requirement to hire and train relevant staff was met. Each agency fulfilled this
requirement and all staff were adequately trained. Additional training opportunities to expand
practical knowledge of each staff were explored and conducted on an on-going basis. Training
on DLA-20, a tool for measuring activities of daily living for functional assessments was
provided on October 9, 2015 for all grant staff as well as other community and agency partners.
This tool is currently being utilized by our Life Skills Coach. Technical Assistance was provided
in November of 2015 on additional screening tool options. Additionally, grant staff attended
quarterly technical assistance conference calls provided by USF Technical Assistance Center.
(C-1.1.3)
Final Performance Measures:
FIRST Services: 100% of the Service Target has been met
CAC Services: 100% of the Service Target has been met
CIT Training: 100% of the Service Target has been met
Section 3. Performance Measures and Outcomes
1. Using the Performance Evaluation Methodology in Exhibit E, Section E-2, of the grant
agreement, provide actual percentage for the Performance Measures delineated in
Section E-1. In addition, provide the actual numbers used in the Performance
Evaluation Methodology to derive at the performance measure percentages.
E-2.1: Of 331 clients served since July 1, 2014, 415 total arrests were made one year prior
to program admission. Of those 331 clients, there have been 127 arrests made one year
post program admission (30.60%)
E- 2.2: Of 331 clients served since July 1, 2014, 100% have reported they have received
increased access to comprehensive recovery based mental health and/or substance abuse
treatment services that are community based in the one year period post program
admission.
E-2.3: Of 331 clients served since July 1, 2014, 38 clients reported not residing in stable
housing prior to program admission. This includes some type of residence— either
transitional housing/shelter, motel, or with family and friends. Of the 38 clients that reported,
36 of them are now residing in stable housing post program admission (94.74%). Funding
assistance is provided for program fees, shelter fees, etc.
E-2.4: The total number of applications completed since the inception of the grant was 45.
95.56% of the clients who were eligible for, but not receiving, social security benefits at
program admission were linked. Most of the clients already had benefits and were employed
and just needed their benefits re-instated after incarceration or have attorneys involved
representing them in their appeal with Social Security. Many of the more persistent mentally
ill clients were admitted to the Mental Health Court.
9
- ^~
16020
E2.1
Total number of arrests among participants within one year post program admission = 127
Divided by � |
Total number of arrests among program participants one year prior to program
adrnissk»m= 415
Outcome Measure= 90.60%
Met�oa|nfless than orequa|tnS0Y6? Yes
E2.2 ` |
Total number or program participants reporting increased access to comprehensive
cnrnmnunity'basedrecoveryeervhesnneyearpostproQrannodnniss|Vn = 313
Divided by
Total number of program participants not receiving comprehensive community-based
recoveryservicenpdortmpnognannadmnissinn= 313
Outcome Measure: 10096
Met goal of equal to 100%? Yes
E2.3
Total number of program participants reporting that they reside in stable housing one
year post admission= 36
Divided by --------
- Total number or participants reporting not residing in stable housing prior to admission = 38
Outcome Measure = 94.74%
Met goal of greater than or equal to 80%? Yes
E2.4
Total number of program participants eligible for, but not receiving, SSA or other benefits
at admission who are linked to such benefits after admission= 43
Divided by
Total number of program participants who were eligible for, but not receiving, said
beneMtsatppogrannadnnission = 45
Outcome Measure: 95.5696
Met goal of greater than or equal to 80%? Yes
10
� \ ^
� / '
1 6D 2 0
2. 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.
a. Provide comments on the effect of the grant program on the growth and
expenditures of the jail, juvenile detention center, and prison.
b. Provide comments on the effect of the grant program on the reduction of forensic
commitments to state mental health treatment facilities.
c. Provide a summary of the availability and accessibility of services and reduction
of incarceration.
A- The overall goal of the Centralized Coordination Program was to divert individuals from
arrest, incarceration or prosecution. During the three-year grant period, staff reported a steady
increase in the number of individuals screened for potential mental health and substance abuse
issues/concerns. Though only a fraction of those screened ultimately met the initial criteria for
evaluation, the clear majority were assisted with discharge planning and referrals to resources
in the community. Although participants did not receive an altered or reduced jail sentence when
they agreed to the FIRST program, the goal was to ultimately reduce recidivism so that
expenditures for the jail were also decreased. Those who returned to incarceration were
evaluated to focus on continuous quality improvement.
B- During the program lifetime, there were no FIRST participants committed to a forensic state
mental health treatment facility.
C- Over the course of the grant, availability and accessibility of services increased as we
continued to see a decrease in incarcerations in the jail compared to the last several years. The
Collier County Jail population has been gradually increasing. This was mostly due to the 287G
program; where persons arrested for law violations, who are illegally present in the United
States, are held for ICE. Since the average number of arrests per participant had been greater
than six, providing people with access to psychiatric care, intensive case management, peer
supports and assistance in obtaining financial benefits if eligible helped to reduce criminal
activity and jail expenditures.
Section 4. Technical Assistance
Explain what collaboration, if any, you have had with the Florida Mental Health Institute's
Technical Assistance Center(TAC). In accordance with Section C-2.6, Technical
Assistance Requirements, of the Grant Agreement, provide a summary and
documentation, if applicable, demonstrating that the following requirements were met:
1. Primary contact information for the Grantee and each of its subcontracted or
subgrant award partners was provided to the TAC within 10 business days after
execution of the Grant Agreement;
Primary contact information for Collier County was provided to the TAC prior to the
inception of the grant and remains the same.
1 60 2 0
2. Participation in one annual county level technical assistance needs assessments
conducted by the TAC;
The county-level technical assistance needs assessments conducted by the TAC was
completed and submitted on September 24, 2015. The topic of Screening Tools was
requested as the top need and Technical Assistance was provided in November. A
survey was disseminated to our members to determine the best date for the session. A
conference call with Dr. Roger Peters was held on October 7, 2015 to discuss the
elements of the Technical Assistance as well as goals and objectives. The Technical
Assistance was provided on November 12, 2015 and well attended by all key staff. The
tool is currently being used by the David Lawrence Center.
3. Participation in one annual on-site technical assistance visit conducted by the
TAC;
Dr. Roger Peters from the Department of Mental Health Law and Policy at the Louis de
la Parte Florida Mental Health Institute, University of South Florida conducted a
Technical Assistance session on November 12, 2015 on screening tools and
assessments. Around 10 partners attended this training. The partners held a follow-up
meeting on January 14, 2016 to discuss which tool(s) they feel would work best for our
clients. The DLA-20 tool is currently uploaded into the David Lawrence System and is
being utilized by the Life Skills Coach. We did not participate in an on-site technical
assistance during 2016. Our team has expressed interest in TA on the use of Evidence
Based Practices and Fidelity. The Planning Council has decided to wait for TA until the
beginning of the next grant cycle after a needs assessment has been conducted.
4. Participation in program-wide conference calls scheduled by the TAC for all
Grantees under the Criminal Justice, Mental Health and Substance Abuse
Reinvestment Grant program; and
Collier County participated on all but two program-wide conference calls scheduled by
the TAC (6/6/14, 9/4/14, 3/10/15, 6/2/15, 9/29/15, 11/24/15, 3/15/16, 5/24/16, 9/29/16
12/12/16, 3/28/17 and 6/13/17). Grant Coordinator extended invitations to sub-recipients
for their participation as well.
5. Provided program reports and summary service data as requested by the TAC.
The TAC did not request any program reports or summary service data during the
program period.
12
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1 60 2 0
APPENDIX A
CRIMINAL JUSTICE, MENTAL HEALTH &
SUBSTANCE ABUSE REINVESTMENT GRANT
PLANNING COUNCIL
PLEASE PRINT
Richard Montecalvo/Sara Miller/Jennifer
Toussaint Scott Burgess
STATE ATTORNEY OR DESIGNEE LOCAL SUBSTANCE ABUSE TREATMENT
DIRECTOR
Amanda Stokes/Darrow Rexford Scott Burgess
PUBLIC DEFENDER OR DESIGNEE COMMUNITY MENTAL HEALTH AGENCY
DIRECTOR
Honorable Janeice Martin
CIRCUIT COURT JUDGE DCF - SUBSTANCE ABUSE PROGRAM
OFFICE REPRESENATIVE
Honorable Janeice Martin
COUNTY COURT JUDGE PRIMARY CONSUMER OF MENTAL
HEALTH SERVICES
Bill Gonsalves
POLICE CHIEF OR DESIGNEE PRIMARY CONSUMER OF SUBSTANCE
ABUSE SERVICES
Sheriff Kevin Rambosk
SHERIFF OR DESIGNEE PRIMARY CONSUMER OF COMMUNITY-
BASED TREATMENT FAMILY MEMBER
Jay Freshwater Rene Givens
STATE PROBATION CIRCUIT AREA HOMELESS PROGRAM
ADMINISTRATOR REPRENSTATIVE
Charles Crew Traci Foss
LOCAL COURT ADMINISTRATOR DJJ - DIRECTOR OF DENTENTION
FACILITY
Michael Sheffield- Representative Traci Foss
COUNTY COMMISSION CHAIR DJJ —CHIEF OF PROBATION OFFICER
Jeff Nichols/Juan Ramos
COUNTY DIRECTOR OF PROBATION
16