Webinar presenters Rise Haneberg, Sheriff Kelly Rowe and Sheriff Calvin Hayden answered a number of your questions after their presentation, Stepping Up 101: A Primer for Sheriffs. Here are just a few of their responses.
Audience Question: Substance abuse disorder has been in the DSM-V since May 2013. Regarding addiction, what is the value of providing recovery training to clients while they’re housed?
Sheriff Calvin Hayden: If you look at addiction rates, especially in our county, they’re significantly high, as high as 80% of our inmate population has some form of addiction in the past. Well, this year with bringing in Johnson County Mental Health into our facility, we can start some treatment there. In fact, we’re going to start drug testing in 2020. When they come in the door. Now, it’s voluntary, and we figured we can get a handle on that when they come in, we can help with our core withdrawal symptoms, which some courts have determined to be cruel, unusual punishment if there are methods to relieve that. So, we’re hoping that the sooner we can identify that addiction issues, the quicker that we can offer some forms of treatment for it.
Audience Question: How are the co-responder programs funded?
Sheriff Calvin Hayden: Basically, most of the cities and the county and funds that if you have a co-responder in your city, the city council usually funds them. And it works out great. It’s great. Honestly, probably the best program I’ve seen in my 30 years in law enforcement.
Audience Question: Is there a cost for assisting a community with stepping up and maybe if you could just kind of talk through some of the other related costs that jails might want to be aware of before they start this process?
Risë Haneberg: Nobody really likes it when I say it’s a do it yourself or DIY, but it really, for the most part, we provide all of our training and technical advice through broad-based technical systems. So basically, that means we do a lot of webinars, we have that very robust website. And, we do what we can to assist the counties, on at the ground level, but for the most part, it really centers around creating that planning team and staffing it at the local level. We provide as many materials and directions as we can. Otherwise, if you would want to, seek some other higher level of assistance, and that’s something I could talk individually with counties about, but it would be a cost to the county. Since most counties don’t have the luxury of that, we have done our best to provide the materials and the directions and our website is loaded. If you haven’t been there, just peruse through the various Is resources, all of the webinars we’ve ever done have been taped and loaded there. So for the most part, I want to say it’s free because we do ask at the county level, you create that planning team, and you may look at potentially staffing it or having a more organized approach that would involve some funding. But that’s basically the answer to the question.
Audience Question: What is being done within the context of Stepping Up to include the increase of juveniles and youth with acute mental illness or mental health needs? And she goes on to say that they’re seeing a huge increase in this population, and they’re just not being effectively served recent. Can you talk to that a little bit?
Risë Haneberg: I’m afraid they’re not going to like the answer, but Stepping Up is, at this time geared towards working with adults. And so I think that would be probably my advice would be to look at maybe other kinds of initiatives that are in the juvenile arena and see if that could be more of a resource for the juvenile population.
Audience Question: What are your jail policies as it pertains to individuals with serious mental illness who refuse treatment because they just don’t have the insight that they really do need treatment? And then to kind of follow on to that, and what are your policies and procedures to reinstate a person’s Medicaid before release for that seamless re-entry to talk to that?
Sheriff Kelly Rowe: First and foremost, if there’s an absolute refusal for treatment, we’re going to have to house them accordingly. It’s going to be you know, first and foremost, we’re going to keep safe not only that particular individual the other inmates and of course, our staff. But we have some additional things we can do with the court required medications and some of those types of things if we need to, depending on the particular individual. Generally speaking, I think in most cases we tend to find having the actual mental health professionals on the ground, working inside the facility, we have a lot greater success, having the inmates cooperate with them, unlike just having just pure security staff there, where there’s just not a relationship being formed. So again, we don’t tend to see a whole lot of it as much as we used to, before that, when we didn’t have that embedded, you know, those embedded professionals in the building. But when you still do and it can still happen, again, we have to address that for the facility safety first.
Reinstatement – that’s a big conversation in Texas right now. State Legislature has been working on some things to try to work with the Department of State Health Services on trying to speed up getting those benefits back restored. Currently, we don’t have good methods for that our reentry people work as much as they possibly can with the various state agencies and social security to try to work to get that done pre-release. Right now, there’s a lot of disconnects between the federal systems, the state systems, and of course, the jail’s to not only get those folks identified, get those processes started, which I think you’re the person that asked the question knows well, those are, those are challenging once those benefits have been stopped.
Audience Question: What’s that URL again for all your great handouts and documentation for the program again?
Risë Haneberg: www.stepuptogether.org. Even Google ‘Stepping Up Initiative’. It’ll take you right there.
Audience Question: How are jurisdictions defining recidivism, rearrest, rebooking, reconviction, all that kind of good stuff? Where’re those definitions coming from?
Risë Haneberg: In some other webinars that we have done and then just working directly with sites since. Anybody who’s been involved in discussions around recidivism we all know that there are many ways of going about this. And we recommend for this initiative, because we are trying and the overall goal is to reduce the number of jail admissions or jail bookings, we suggest that to use that is as your definition of recidivism, I know that you could use arrest, I know you could use conviction or, you know, other kinds of ways of going about this. But since the ultimate goal stepping up is to reduce jail admissions that is what we recommend. From there, you’re probably going to want to make some decisions in your planning team in terms of, you want to track that for one year, or one and two years? That seems to be I think the norm, some jurisdictions go farther out.
Audience Question: Janet asks: We have identified that the biggest barrier for people with serious mental illness and co-occurring substance abuse disorders and or core comorbidities. But they just need more than just supportive housing. There’s a lack of long term destinations like secured and unsecured residential treatment facilities. Of the national models, very few take public or private health insurance. Are there any long term diversion facilities that you’re aware of and how are they reimbursed?
Sheriff Kelly Rowe: She’s hitting the nail on the head. Transitional long term housing and care is a great challenge out there. Again, once we’re in that outpatient mode of care That’s where the greatest lacking point is what to do. We’re seeing some folks get very innovative. I know we’ve got one location down in South Texas that I had an opportunity to do to just hear their story and how they’re working with folks down there and have figured out some ways to get that reimbursed through Medicare. So again, it’s possible but I think we’re seeing it. First off, is she will point out, it’s very limited. And again, it’s just a matter of innovation.
Sheriff Calvin Hayden: One of the things we’ve started and done and we’ve always been concerned with care after we released them, we give them a couple of weeks medication. Get everybody balanced out and get them behaving correctly and doing well and back on medication. And then we get into two weeks of medication and send them out the door. But what we’ve done this year, we started with our mental health program being inside of our detention center and they provide a continuum of care and we’re going to see how it goes. It’s our first year doing this. But I think it’s going to be a much more efficient and better way to do it to actually have our county mental health providers inside the facility. There are several private entities throughout the county that like John’s Kind Development Supports, they’ve got houses where they actually buy the house and provide housing for people with some issues. And that seems to be a very, very successful program. So there’s light on the horizon, but you got to have the community involved and thinking collaboratively how to do deal with these issues.