NACo's 2015 Annual Conference Day 3

Conference kicks into full gear

Four workshop blocks, a three-hour forum on economic development, the Stepping Up Summit, Premier Solutions Sessions, Awards Luncheon and Board of  Directors meeting filled today’s agenda.

The Board of Directors took up 122 policy resolutions. Most passed and will be considered for final adoption by NACo members at the Annual Business Meeting tomorrow. Resolutions on the minimum wage and opposition to life sentences without parole for juveniles were among a few resolutions that sparked a longer discussion by the Board.

The Achievement Award program celebrated its 45th anniversary this year  Achievement Awards are presented in 21 different categories.Twenty-one counties were honored at the Awards Luncheon for achieving best of their category.

Stepping Up, Workshop Round Up

Dr. Nneka Jones Tapia, executive director, Cook County Jail, talks about the transitional housing program within the jail. Dr. Jones is the first clinical psychologist to head a major county jail. She spoke at the Stepping Up Summit today.

Mental illness has become a given in jails, but counties are on the road to change that through their engagement in Stepping Up initiative. By finding ways to divert and treat the mentally ill, counties are aiming for lower recidivism rates and lower cost per inmate as a result of not providing expensive general care that is less effective than conditions require.

“We have inmates that end up costing us $1 million a year,” said Kern County, Calif. Sheriff Donny Youngblood. “If someone in my jail needs to go to the state hospital, they’re going to be waiting for 50-plus days until a bed opens up. In the meantime, there’s only so much we can do for them.”

Youngblood was among the experienced correctional professionals who spoke at the conference’s Stepping Up Summit.

Nneka Jones Tapia, executive director of the Cook County, Ill. Jail, described the transition center within the jail that provides cognitive behavioral treatment and follow-up attention for nonviolent offenders.

Providing a smooth landing by setting up post-incarceration care can be eased by suspending Medicaid coverage while the inmate is in jail, rather than dis-enrolling them, according to Pat Fleming, retired director of Behavioral Health Services for Salt Lake County, Utah.

“Medicaid will be the payer for their services when they get out of jail, and starting them up again will take forever,” he said.

Vets’ Community Connections (VCC) was looking for places to pilot its community-based approach to helping veterans and their families. VCC co-founder Doug Wilson considered San Diego but initially ruled it out — because it already excelled at serving its large military community, where 170,000 active-duty military are based.

But Nick Macchione, the county’s director of health and human services, convinced him otherwise. While the county and service agencies were connecting with vets, there was a missing link: getting the community involved in helping veterans and military families reintegrate into the community. That’s a goal VCC wants to achieve in counties nationwide.

Wilson moderated and Macchione was one of the panelists for the workshop, putting the “Community” into Veterans’ Community Reintegration Efforts.

“Not every veteran coming back from the military has PTSD or has mental health issues,” said Jim Golgart, president of the National Association of County Veterans Services Officers. Vets without those issues still need help to reconnect with the communities that they return to.

San Diego County is addressing the issue with its Courage to Call initiative. It’s an adjunct to the county’s 211 call line, according to Bill York who oversees 211. “It’s partly through 211, but it’s a partnership with multiple agencies, boots on the ground.” Callers get to speak with peer specialists who are veterans about resources available in the community.

Golgart likened such programs that provide entry points into the community to “stone soup.” “We bring the stone; you make the soup,” he said. “We bring the idea, and you do it the way your community needs to have it done.”

A year before a spate of deadly incidents involving law enforcement prompted widespread calls for body-worn cameras use by police, DeWitt County, Ill. already had its sheriff’s office using them.

“When I worked in narcotics, we always wanted to get things on film,” said Sheriff Jered Shofner. “When I became the sheriff and saw that convictions were down, I knew there was a role for video in what we were doing.”

Shofner spoke during a workshop exploring the use of body cameras by county law enforcement officers.

After the August 2014 incident in Ferguson, Mo., Shofner reported his department had a spike in interest from other agencies. And he saw the change in the criminal justice system that body-worn video was affecting.

“Civil and criminal juries really expect to see video,” he said. “I’m not sure what I say as a law enforcement officer means as much, because cases are up to the jury.”

But video can also help avoid juries from coming into the equation.

“If what you have is enough to convince a defendant to take a plea, that’s saving the county money because there’s no need for a trial,” he said.

Shofner’s department spent $21,000 in 2013 on 30 cameras—nearly half of what he had figured to spend on buying new cars, with another $2,000 going to upgrade storage capacity.

Shofner and Carmen Facciolo, a policy advisor with the Bureau of Justice Assistance, warned that storage costs are likely higher than the equipment cost for the cameras.

“I urge you to think, long term, about cost effectiveness in regard to storage,” Facciolo said. “And whether a judge will be able to access the video if it’s in the cloud.”

Facciolo said 3,500 law enforcement agencies in the United States were in some stage of adopting or using body-worn cameras, 45 states had pilot projects and 37 states had legislation pending regarding their use.

He promoted the BJA National Body-Worn Camera Toolkit, available at www.bja.gov/bwc.

Shofner also advised counties not to abandon vehicle-mounted cameras as body-worn cameras proliferate because they could catch footage that the small, pager-sized cameras could not.

Officials from large and small counties shared how they handle inmate medical care in the workshop, Health Coverage in Jails: Important Provisions and Strategies.

Glen Matayabas, chief deputy of the Buncombe County, N.C. Sheriff’s Office, said his approach was to provide medical care 24 hours a day, seven days a week, though he acknowledged such service might not be feasible for all counties.

“As soon as they come in the jail, they have access to complete medical care, including prescriptions, dental and mental health,” he said of his 604-bed facility that processes 13,825 inmates a year. “You need to figure out what your obligation is and what is morally right. What is your philosophy?”

He said his jail has developed relationships with local hospitals to ease transitions to the care inmates will receive when they are released, and because state law allows, the county only suspends an inmate’s Medicaid coverage, rather than eliminating it.

Medicaid played a big part in Cook County’s strategy, and given the scale that a county of that size operates on, it paid off.

Jay Shannon, CEO of the Cook County, Ill. Health & Hospitals System said that in 2012, the county, by virtue of Illinois’ embrace of Medicaid expansion, was able to reach out to half of the 330,000 uninsured adults in the county and sign half up for Medicaid.

“It’s completely inverted our pyramid, from one that was majority uninsured to one in which the majority is ensured,” he said. “It was a game changer. It shrunk our uninsured population, boosted our Medicaid revenues have gone way up and dropped the amount of coverage that is uncompensated.”

That dropped the uncompensated total to $340 million in FY14, compared to $500 million in FY13.

Shannon agreed that the relationships with community care providers was crucial to cutting down on recidivism.

“It doesn’t help to just get them coverage, you have to get them care,” he said. “Get them linked up with a primary care provider. We don’t want to lose that momentum. When you get them what they need, chances are they won’t be back.”

Photo by David Hathcox