Treatment of Persons with Mental Illness in the Criminal Justice System (09/21/2015)

Final
STAFF SUMMARY OF MEETING

TREATMENT OF PERSONS WITH MENTAL ILLNESS IN THE CRIMINAL JUSTICE SYSTEM

Date:	09/21/2015	ATTENDANCE

Time:	01:00 PM to 04:00 PM	Humphrey	X
		Lee	X
Place:	SCR 356	Newell	X
		Woods	X
This Meeting was called to order by		Singer	*
	Senator Martinez Humenik	Martinez Humenik	X

This Report was prepared by
	Amanda King
		X = Present, E = Excused, A = Absent, * = Present after roll call

Bills Addressed:		Action Taken:
Call to Order Presentation by Project EDGE Presentation by The Link Presentation by Arapahoe House Discussion of Future Activities of the Advisory Task Force Committee Discussion and Votes on Motions to Request Bill Drafts Public Comment		Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Witness Testimony and/or Committee Discussion Only Recommendation(s) Approved Witness Testimony and/or Committee Discussion Only

01:02 PM -- Call to Order

Senator Martinez Humenik called the meeting to order. A meeting agenda (Attachment A) was distributed to the committee.

15MICJS0921AttachA.pdf

01:02 PM -- Presentation by Project EDGE

Bill Myers, Chief Community Engagement Officer for Project Early Diversion, Get Engaged (Project EDGE), and Charlie Davis, Community Crisis Connection Program Manager for Project EDGE, introduced themselves. They provided the committee with two handouts about Project EDGE (Attachments B and
Attachment C). Project EDGE is a pilot program in Boulder County that aims to divert individuals who have behavioral health issues from the criminal justice system, and instead engage them in appropriate treatment. Mr. Myers stated that the program is funded through a three-year grant from the federal Substance Abuse and Mental Health Administration. He stated that it is one of three sites nationwide to receive this early diversion grant award. Mr. Myers outlined how mental health professionals engage with law enforcement officers in Boulder County to provide diversion services when an incident occurs. He provided information about the program staffing and reviewed data about the program, which began in March 2014.

15MICJS0921AttachB.pdf

15MICJS0921AttachC.pdf

01:08 PM

Mr. Myers answered questions about the information in the handouts. Mr. Myers and Mr. Davis responded to questions about what happens to people who have an encounter with a Project EDGE worker, but do not seek behavioral health treatments. In response to a question, Mr. Davis listed the criteria that would result in a mental health hold.

01:12 PM

Representative Singer relayed his experience observing Project EDGE. Mr. Myers answered questions about how the program provides cost savings, including reductions in emergency department visits and placements in jails. Mr. Davis discussed the value that police departments find in the program. Mr. Myers stated that program costs are about $525,000 per year, covered both by the federal grant and by Mental Health Partners. Mr. Myers discussed the desire to continue the program after the federal funding expires. He referenced other communities that are interested in participating in the program.

01:21 PM

In response to a question, Mr. Davis outlined how a Project EDGE worker responds to a situation where law enforcement has been called. He relayed the details of a specific case where Project EDGE was engaged. In response to a question about the follow-up services provided by the program, Mr. Davis discussed peer support specialists who are involved in the program who follow up with the clients to provide support and guidance. He listed the charges that cannot be diverted under the program.

01:30 PM

Mr. Davis answered questions about the Project EDGE response times when a call is made to a police department. Representative Singer shared additional details about his experience observing Project EDGE. In response to a question, Mr. Davis discussed the common factors that are prevalent in the Project EDGE cases. Mr. Davis responded to a question about whether the program can be abused to avoid criminal charges. Mr. Davis said that people do not get a second chance to divert charges if they engage once with Project EDGE, but do not seek treatment after the initial contact.

01:38 PM

Senator Martinez Humenik suggested expanding the data collected by Project EDGE. There was discussion about the types of data the committee members would be interested in receiving about Project EDGE. Representative Singer discussed the potential for expanding Project EDGE statewide. Senator Martinez Humenik discussed substance use by teens and young adults. Mr. Davis discussed the potential of expanding Project EDGE by stationing workers in county jails. Mr. Davis explained the training that occurs through the program.

01:51 PM

Committee members continued to dialogue with Mr. Davis and Mr. Myers about Project EDGE. Mr. Myers reiterated that this is a pilot program that has only existed for 17 months. Mr. Myers explained why the program is restricted to Boulder County. Senator Martinez Humenik thanked Mr. Myers and Mr. Davis for their presentation.

01:56 PM -- Presentation by The Link

Lonnie Matz, Program Manager for The Link, introduced himself and provided an overview of the organization, which is a community assessment and resource center for youth and families that serves Adams and Broomfield counties. He provided the committee with two handouts (Attachments D and Attachment E). He stated The Link has seven different programs it provides and outlined the populations The Link serves. Mr. Matz discussed the evidence-based assessment tools used to determine services, the number of referrals made by The Link, and marijuana use by youth. He referenced outcome studies that have been conducted on the program. Mr. Matz answered questions about providing services to homeless teenagers and discussed the partnership The Link has with Shiloh Homes to provide temporary shelter to homeless teenagers. Mr. Matz responded to questions about the availability of additional data about decreased workloads for other local government agencies and other outcome data about the program. He referenced the gang activity occurring in Adams County.

15MICJS0921AttachD.pdf

15MICJS0921AttachE.pdf

02:11 PM

The committee dialogued with Mr. Matz about substance use by teenagers and the number of municipal charges received by youth after being involved with The Link. He discussed the involvement of the program with the court systems. Senator Martinez Humenik asked Mr. Matz to provide follow-up data to staff to share with the committee. Mr. Matz answered questions about whether The Link provides any training to its law enforcement partners and about The Link's engagement of youth who are in the foster care system.

02:19 PM

Senator Martinez Humenik thanked Mr. Matz for his presentation.

02:19 PM -- Presentation by Arapahoe House

Michelle Flake and Caroline Chadima, representing Arapahoe House, introduced themselves. Ms. Flake provided an overview of Arapahoe House, which provides a continuum of accessible, affordable, and effective services for individuals and families with alcohol, drug, and other behavioral health problems. She stated Arapahoe House provides both inpatient and outpatient services. Ms. Flake discussed the Short-Term Intensive Residential Remedial Treatment (STIRRT) Program and provided the committee with a handout (Attachment F) about the program.

15MICJS0921AttachF.pdf

02:22 PM

Ms. Chadima said that there are 12 beds available in the inpatient STIRRT Program. She discussed the two phases of the continuing care provided under the STIRRT Program. She discussed the entities that make referrals to the STIRRT Program, the population served by the program, and the funding for the program. She shared data about the STIRRT Program and its clients. Ms. Chadima answered questions about her caseload and the data she presented.

02:34 PM

Ms. Chadima reviewed the principles employed by the STIRRT Program that were developed by Dr. Edward Latessa. She listed the therapeutic tools and medications used by the STIRRT Program. She discussed the curriculum used in the STIRRT Program.

02:42 PM

Ms. Chadima answered questions about the risk assessment tools used by the STIRRT Program. In response to a question, Ms. Flake said that STIRRT Program is funded through the Office of Behavioral Health in the Department of Human Services. Ms. Chadima and Ms. Flake answered questions about the STIRRT Program and the drugs used by the clients before entering the program. Senator Martinez Humenik thanked the presenters.

02:48 PM -- Discussion of Future Activities of the Advisory Task Force

Camille Harding, Task Force Concerning the Treatment of Persons with Mental Illness in the Criminal and Juvenile Justice Systems (MICJS) Task Force Co-chair and representing the Department of Health Care Policy and Financing, introduced herself. She provided the following four handouts to the committee: MICJS Legislative Oversight Committee Meeting Responses from Tuesday, August 18 (Attachment G), Table of Preferred Formulary Psychotropic Medications (Attachment H), MICJS Jail Recidivism and Behavioral Health Services Focus Group Questionnaire (Attachment I), and The Colorado Opportunity Project Life Stages diagram (Attachment J). She reviewed information related to the preferred formulary psychotropic medications and medication consistency efforts.

15MICJS0921AttachG.pdf

15MICJS0921AttachH.pdf

15MICJS0921AttachI.pdf

15MICJS0921AttachJ.pdf

02:51 PM

Ms. Harding discussed recidivism data from the Department of Corrections, the Division of Youth Corrections in the Department of Human Services, and jails. Senator Martinez Humenik commented on the gaps in available data on recidivism. Ms. Harding discussed the MICJS Jail Recidivism and Behavioral Health Services Focus Groups that will be conducted in October in partnership with the Colorado Regional Health Information Organization. Ms. Harding answered questions about information sharing between various agencies. Senator Martinez Humenik commented on information sharing between jurisdictions and the federal Health Insurance Portability and Accountability Act. Ms. Harding referenced Title 42 of the Code of Federal Regulations and discussed the differing interpretations of those regulations.

03:00 PM

Ms. Harding outlined the strategies for improving access to mental health and addiction treatment services in rural parts of the state. She discussed the Colorado Opportunity Project and the life stages diagram in regards to outcome measures and tracking youth who enter the juvenile justice system. Ms. Harding stated that the Department of Public Safety is still waiting to find out if it has received the Bureau of Justice Assistance grant to develop a statewide interagency strategic plan for a justice and health information exchange infrastructure, as was discussed at the August 18, 2015, MICJS Legislative Oversight Committee meeting. She said that even if the department does not receive the grant a technical assistance request will be submitted to the Bureau of Justice Assistance to seek funds for strategic planning regarding the project. She outlined the counties that have jails that provide jail based behavioral health services. Ms. Harding answered questions about how law enforcement agencies address the mental health needs of prisoners if the agency does not provide jail based behavioral health services.

03:08 PM

Ms. Harding discussed the availability of data regarding juvenile competency evaluations and restoration services. She stated that a work group of the MICJS Task Force met on August 28, 2015, and determined that the task force would like to study the availability of restoration services in the community. There was discussion about the possibility of addressing juvenile competency through legislation. Senator Martinez Humenik commented on the ability of the task force to bring forth legislation in the coming years. Senator Newell shared her experience serving on the committee. Senator Newell discussed the efforts by the task force to address juvenile competency and housing issues. Senator Martinez Humenik expressed the need to make the task force more efficient. Ms. Harding commented on providing better reporting to the committee when issues are addressed in a nonlegislative manner.

03:24 PM

Ms. Harding stated that she is still working on collecting additional data requested by the committee regarding the number of people who are released from the criminal justice system with mental illness who qualify for disability benefits, and how many are veterans. She discussed the MICJS Task Force retreat scheduled for September 25, 2015. Discussion occurred about studying the barriers to workers' compensation for law enforcement officers, corrections employees, and other first responders experiencing post-traumatic stress disorder. Ms. Harding again referenced the MICJS Jail Recidivism and Behavioral Health Services Focus Group Questionnaire that will be used in focus groups being conducted in October and said the report resulting from the focus groups should be available in November.

03:29 PM

In response to a question, Ms. Harding discussed the fragmentation of data and providing services across state agencies. Senator Martinez Humenik thanked the MICJS Task Force for their work. She suggested the task force focus on a few key priorities. Senator Martinez Humenik encouraged the committee members to attend the MICJS Task Force retreat on September 25, 2015. Ms. Harding discussed the importance of data sharing between systems and the ability to reimburse certain programs through Medicaid for providing medically necessary services. Senator Martinez Humenik discussed the number of providers for restoration services.

03:40 PM -- Committee Discussion and Votes on Motions to Request Bill Drafts

Amanda King, Legislative Council Staff, reviewed the interim committee bill drafting deadlines. She stated the committee will meet on October 29, 2015, to take final action on the bill drafts. The committee discussed the procedure for requesting interim committee bill drafts. House Bill 15-1025, concerning competency to proceed for juveniles involved in the juvenile justice system (Attachment K), was distributed to the committee. Jane Ritter, Office of Legislative Legal Services, discussed the interim committee bill drafting guidelines and the importance of providing additional drafting information to the Office of Legislative Legal Services in a timely manner. Ms. King stated that the committee can recommend up to five bills to Legislative Council.

15MICJS0921AttachK.pdf

03:46 PM

Representative Singer discussed drafting a bill addressing mental health impairment, and specifically post traumatic stress disorder (PTSD), parity in workers' compensation for Department of Corrections employees and emergency responders. He referenced House Bill 14-1343, concerning workers' compensation coverage for post-traumatic stress disorder for peace officers, and the resulting report. There was discussion about the scope of the bill and which professions could be included under the bill.


BILL:	Committee Discussion and Votes on Motions to Request Bill Drafts
TIME:	03:47:42 PM
MOVED:	Singer
MOTION:	Moved that a bill be drafted concerning mental health impairment, and specifically PTSD, parity in workers' compensation for Department of Corrections employees and emergency responders. The motion passed without objection.
SECONDED:
		VOTE
	Humphrey
	Lee
	Newell
	Woods
	Singer
	Martinez Humenik

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

03:48 PM

Senator Newell discussed drafting a bill similar to House Bill 15-1025. Ms. Ritter asked if there were any changes to the 2015 legislation Senator Newell would like to incorporate into the bill draft. Committee discussion occurred about the bill and possible suggestions for changes resulting from further discussion with MICJS Task Force members during the September 25 retreat. Committee discussion about the bill idea ensued.


BILL:	Committee Discussion and Votes on Motions to Request Bill Drafts
TIME:	03:54:56 PM
MOVED:	Newell
MOTION:	Moved that a bill be drafted regarding juvenile competency, similar to House Bill 15-1025. The motion passed without objection.
SECONDED:
		VOTE
	Humphrey
	Lee
	Newell
	Woods
	Singer
	Martinez Humenik

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

03:55 PM

Representative Singer discussed establishing a matching grant program for local law enforcement to co-locate the provision of mental health services, similar to Project Edge.


BILL:	Committee Discussion and Votes on Motions to Request Bill Drafts
TIME:	03:56:26 PM
MOVED:	Singer
MOTION:	Moved that a bill be drafted to establish a matching grant program for local law enforcement to co-locate the provision of mental health services. The motion passed without objection.
SECONDED:
		VOTE
	Humphrey
	Lee
	Newell
	Woods
	Singer
	Martinez Humenik

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

03:56 PM

Senator Newell discussed the collaborative management process, established under Section 24-1.9-101, et seq., C.R.S. She discussed ensuring that a mental health professional is included in the collaborative management group. Ms. Harding stated she would work with the MICJS Task Force members and review the current statutes to determine whether there is a needed revision to the statute to address this issue.


BILL:	Committee Discussion and Votes on Motions to Request Bill Drafts
TIME:	03:57:41 PM
MOVED:	Newell
MOTION:	Moved that a bill be drafted to ensure that a mental health professional is included in collaborative management groups established under Section 24-1.9-101, et seq., C.R.S. The motion passed without objection.
SECONDED:
		VOTE
	Humphrey
	Lee
	Newell
	Woods
	Singer
	Martinez Humenik

YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection

04:00 PM -- Public Comment

No members of the public signed up to provide public comment to the committee.

04:00 PM

Senator Martinez Humenik adjourned the committee.