Agenda 10/14/2014 Item # 16D 3 10/14/2014 16.D.3.
EXECUTIVE SUMMARY
Recommendation to approve and sign the Final Progress Report for the Criminal Justice, Mental
Health, and Substance Abuse Reinvestment Grant Program to be submitted to the Department of
Children and Families.
OBJECTIVE: To successfully closeout the Criminal Justice, Mental Health, and Substance Abuse
Reinvestment Grant Program and submit the required final progress reports.
CONSIDERATIONS: The Criminal Justice, Mental Health, and Substance Abuse (CJMHSA) program
was established by the State to provide funding to counties with which they can plan, implement, or
expand initiatives that increase public safety and avert increased spending on criminal justice. The goal is
to improve the accessibility and effectiveness of treatment services for adults and juveniles who have a
mental illness, substance abuse disorder, or co- occurring mental health and substance abuse disorder and
who are in or at-risk of entering,the criminal or juvenile justice systems.
Collier County's Memorandum of Understanding (MOU) with the Department of Children and Families
(DCF) for the CJMHSA program became effective February 24, 2011 and expired on June 30, 2014. A
requirement of the grant program is that Collier County submit semi-annual progress reports to the DCF
by May 1 and November 1 of each year in addition to a final progress report by the next due date, after
the expiration of the agreement. The final progress report is due by November 1, 2014.
According to the closeout guidance received from the DCF,the final progress report is to be approved by
the Board prior to submittal to DCF to close-out the program.
FISCAL IMPACT: The funding source for the grant is DCF. Total awarded amount was $548,490.00,
with a $524,777.00 match requirement. Current expenses are $496,914.05 and current match is
$51 5,557.86. Funds are available in Human Services Grant Fund 707, Project 33147.
LEGAL CONSIDERATIONS: This item is approved for form and legality and requires a majority vote
for Board approval. -JAB
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with
this Executive Summary.
RECOMMENDATION: That the Board of County Commissioners authorizes the Chairman to approve
and sign the final progress report for the CJMHSA program for submittal to the DCF.
Prepared by: Geoffrey Magon, Grants Coordinator, Housing & Human Services
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.D.16.D.3.
Item Summary: Recommendation to approve and sign the Final Progress Report for the
Criminal Justice, Mental Health, and Substance Abuse Reinvestment Grant Program to be
submitted to the Department of Children and Families.
Meeting Date: 10/14/2014
Prepared By
Name: MagonGeoffrey
Title: Grants Coordinator,Housing,Human &Veteran Services
9/15/2014 2:18:12 PM
Approved By
Name: GrantKimberley
Title: Director-Housing, Human and Veteran S,Housing, Human &Veteran Services
Date: 9/25/2014 4:23:34 PM
Name: SonntagKristi
Title:Manager-Federal/State Grants Operation,Housing, Human & Veteran Services
Date: 9/26/2014 2:45:56 PM
Name: Bendisa Marku
Title: Supervisor-Accounting, Housing,Human &Veteran Services
Date: 9/26/2014 3:09:00 PM
Name: BelpedioJennifer
Title: Assistant County Attorney, CAO General Services
Date: 9/29/2014 11:32:25 AM
Name: RobinsonErica
Title: Accountant, Senior, Grants Management Office
Date: 9/29/2014 2:51:04 PM
Name: CarnellSteve
Title: Administrator-Public Services,Public Services Division
Date: 9/29/2014 3:38:21 PM
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10/14/2014 16.D.3.
Name: KlatzkowJeff
Title: County Attorney,
Date: 9/30/2014 10:44:29 AM
Name: StanleyTherese
Title: Manager-Grants Compliance, Grants Management Office
Date: 10/6/2014 2:16:40 PM
Name: KlatzkowJeff
Title: County Attorney,
Date: 10/6/2014 2:32:49 PM
Name: OchsLeo
Title: County Manager, County Managers Office
Date: 10/7/2014 9:22:23 AM
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10/14/2014 16.D.3.
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:
DWIGHT E. BROCK, Clark
Name: Tom Henning
Position: BCC Chairman, Collier County By:
Section 1. Detailed Progress Summary
Provide a detailed summary of the progress in meeting th gaals;described in your',application.
Using the goalsiobjeotives/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 narrative oon`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 County Attorney
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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
CD
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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.
9
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5. CIT TRAINING:
CIT training • a joint effort by NAMI, DLC and Collier County Sheriffs 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 our Planning Council nembership as stated x n pages'5
and 6 inr he original grant RFC.{per F,- -.794,657(2) (a),1-n?cluding.a test of the.PIalnion
Council ;members Describe, riy difficulti sµyou have k ad�In filling eseE3 nembersfitp
positions. Describelheactiv es, such as meeting frequenc arid types�of collaboration'
,efforts :of your Plan ing� ou�ncil. . a._.... n�, .
r ^:
• • ,...NAME ,.. m 1 vee . d 3 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 's Office ice
John Walsh
Connie Kelly Public Defender's Off Public Attorney 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 Swanso Prison Health Services
Open Position Prison Health Services/First Reintegration Specialist
n
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 Hung er& Homeless Coalition
Table 1. Collier Criminal Justice Mental Health & Substance Abuse Planning Council
0
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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 thatyouu aveencount ere dsinrmeeting your
goa slobjedtivesttaslc$, and how yaa� avo been able o�nar igat+l t r u h these barriers ,„;
Also AleacrihaLsignin40 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 re. uirement. ;'
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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�I Share ear�yn,da#a that you`havecre+�tedpr�aiat� +r�sttip to thr coma outoorne
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' Yatue.-'.,
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,jureniile,detentiod cuter,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'Cente.r. 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 TAO since
2011.
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