National Association of Counties
In concert with the NACo Stepping Up Initiative, the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) has been implementing its NACBHDD ‘Decarceration’ Initiative.
Our first year of this initiative has included focus groups, webinars and direct technical assistance with counties. This work has taught us that we must focus our efforts on “Intercept 0”. This first intercept involves mobilization of county behavioral health programs to address mental health, substance use and intellectual development/developmental disability (ID/DD) issues before a person comes into contact with the police.
Thus, we are very pleased to announce a special pilot project in 2017 to promote the decarceration and full community integration of persons with these conditions.
This pilot project will examine system and service management, care coordination, service configuration, including crisis response services and county drug formularies, as well as any impediments that exist in the correctional or court systems.
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If your county is interested in participating in NACBHDD’s pilot project, please contact rmanderscheid@nacbhd.org or call 202.942.4296
A primary emphasis will be directed toward improving the crisis response capacity of county behavioral health programs to prevent persons with these conditions from becoming engaged or re-engaged with the police or the correctional system.
A range of services comprise a county’s behavioral health crisis response capacity. These services include so-called ‘warm lines’ operated by peers, hot lines operated by professionals, mobile crisis response teams, respite beds for persons with these conditions or their family members, crisis intervention training for police, a restoration or sobering center, effective care coordination for all clients, good outpatient treatment, medication-assisted treatment, community residential care and inpatient hospital care.
Our pilot project will help participating counties to develop the services they need from along this continuum.
The pilot project will identify four medium-sized counties (20,000—200,000 population) and four small, rural counties (fewer than 20,000 population) to participate in the pilot. Counties will be given preference if they are part of the NACo Stepping Up Initiative, if they have identified incarceration as a problem, are motivated to address this problem, and are willing to devote personnel and financial resources to solving it. Participating counties should expect to remain involved in this pilot for up to one year.
For each of the eight counties in the pilot, we also will seek to identify a mentor county that can provide guidance on solving the common problems that lead to excessive incarceration of persons with mental illness, substance use or ID/DD conditions. Mentor counties will work directly with the eight counties participating in the pilot project.
A cadre of senior county behavioral health leaders will offer direct technical assistance to counties participating in the pilot project.
These county behavioral health leaders will form the first cadre of NACo Senior Fellows, a new initiative to deploy the skills of county behavioral health experts when they retire from their county roles. Linkages also will be developed with appropriate federal programs to help counties address issues that require expertise or technical assistance from these programs.
Beyond the pilot project, NACBHDD has also been engaged in a range of additional activities in support of its initiative. These include:
Development of Simulation Models: In collaboration with the Department of Justice (DOJ) Bureau of Justice Statistics (BJS) and Bureau of Justice Assistance (BJA), and the National Association of State Mental Health Program Directors (NASMHPD) Research Institute, we have undertaken a project to develop simulation models to project future jail caseloads, including estimates for persons with behavioral health conditions. Currently, we are identifying pilot sites for this modeling.
Simulation modeling can be very useful to county managers because it permits assessment of the effects of “what if” scenarios before they actually occur.
Collaboration Across Federal Agencies: In the fall of 2016, NACBHDD and DOJ-BJS convened the key federal programs in the Department of Health and Human Services and the DOJ that work at the behavioral health-criminal justice interface. The purpose was to acquaint staff with each other and to share essential information about each program. This initial meeting was so successful that a second meeting is being planned for late in the spring this year. This second meeting will introduce discussion of some key issues and solicit agency support in their resolution.
New Research Center on Criminal Justice: As a long-standing NACBHDD partner, the NASMHPD Research Institute has developed a strong interest in the problem of decarceration of persons with behavioral health conditions.
In 2016, the Institute’s Board approved the creation of a new research center on criminal justice that will undertake research, evaluation, and statistical projects to help resolve the problem of incarceration of behavioral health populations in city and county jails, and in state prisons. This new center will work closely with NACBHDD.
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