Bob Janes Triage Center and Low Demand Shelter

Lee County

Kevin Lewis, CEOSouthwest Florida Addiction Services, Inc

Triage Center Partner Agencyk_lewis@swfas.org

Opened April 28, 2008

Pre-Arrest Diversion Program

Voluntary alternative to incarceration and inappropriate emergency room utilization

Targets low level offenses (trespass, open container, disturbing the peace)

Primarily for individuals experiencing a behavioral health crisis who are homeless, indigent, and/or intoxicated

Compliments Crisis Intervention Training

Low Demand Shelter Opened 22 beds in April 2008 and increased

to 58 beds May 2010 using CJMHSA grant Provides safe shelter while conducting

medical and psycho-social assessments Residents work with case manager to

establish goals to accomplish Links with community treatment programs as

beds become available

The shelter provides an alternative for police officers and emergency rooms for petty offenders or intoxicated patients who may not need jail or serious medical care.

(John David Emmett/news-press.com)

Major components needed to open Funding CJMHSA implementation grant Building space at mental health center – Lee

Mental Health Center unsung hero Data system built on existing HMIS Local matching funds from key stakeholders Agency willing to run shelter component Buy in of key community partners

Data System

Utilizes Client Services Network (CSN) – Lee County’s Homeless Management Information System (HMIS) to track demographic information

Admission to facility including Length of stay, referring agency, etc.

Referrals for services and housing Criminal history

Data System

Cross referenced with local jail data system Cross referenced with local hospital data Florida Mental Health Institute (FMHI)

cross referenced with use of publicly funded behavioral health system and Medicaid

Policy Services and Research Data Center at FMHI Phase I Report Concluded that those who completed the

program or left Triage for a housing opportunity or a treatment facility experience the following positive outcomes: fewer subsequent encounters with law

enforcement fewer subsequent arrests if arrested shorter length of incarceration.

FMHI Review Shows Impact of Triage Center Triage serves highly vulnerable population

with history of criminal justice involvement and high physical, mental health and substance abuse needs.

Cost benefit of diversion calculated to be $220 less per individual and $68,666 per year (not including court and police time)

Provides alternative to revolving door

Case Study 22 arrests with 743 jail days in last 13 years 19 hospital encounters in five years 6 triage stays in 3 years (longest 354 days) Jail cost $58,771 - Hospital cost $124,811 –

Triage cost - $42,626 Baker Act and Detox history Qualified for SS disability, food stamps,

Medicaid and permanent supportive housing

Potential impact on SA/MH System Diverting arrest may prevent person from

decompensating and additional charges such as battery on LEO

Provides law enforcement alternative to arrest Works with homeless population most of whom

have criminal justice history and MH/SA treatment history

Emphasis on stabilizing, obtaining resources and housing

Number of Triage Admissions

2,070 duplicate client admissions occurred during first three yearsFacility capacity increased from 22 beds to 58 beds May 2010

Source of Referral

Number of Repeat Admissions

1,246 unduplicated clients 2,070 duplicated clients Average Length of Stay 13 days

Who does Triage Center Serve?

77% male population (County jail is 86% male)

79% white; 92% non-Hispanic

73% between ages of 31-60

16% Veterans

93% Homeless

Age # %18-20 27 2.17%21-30 212 17.01%31-40 216 17.34%41-50 351 28.17%51-60 340 27.29%61-70 85 6.82%71-80 11 .88%80 + 2 0.16%Not Reported 2 0.16%Total 1,246 100%

Gender # %Male 965 77.45%Female 281 22.55%Total 1,246 100%

Presenting Issues

Based on self-disclosure during assessment

42% report taking medications which includes but is not limited to psychotropic drugs

None31.38%

Substance Abuse 23.35%

Co-Occurring25.28%

Mental Health12.12%

Other7.87%

True Diversion? 70% have prior arrest history in Lee County

64% misdemeanor 36% felony

Most common prior charges are: Trespass DUI Theft Battery

Impact on Criminal Justice System

16% of time LEO would have taken individual to jailDiverted 332 charges5% of people would have been charged with more than one crime

If LEO had taken to jail, most common charges would be:Trespass Loitering

Diverted 70 Marchman/Protective Custody

Impact on the Community 64% of time LEO would have taken nowhere

Provides access to assessment, shelter, resources and treatment for people who would have otherwise been left on the streets

3% of time LEO would have taken to hospital Reduces impact of inappropriate utilization of

emergency rooms 53% successfully linked with resources 44% Had a good exit status.

Saves Law Enforcement Time

84% of time officers spend ≤ 5 minutes 10% of time officers spend ≤ 15 minutes 93% of officers are satisfied to highly

satisfied with process 34% of time individuals are brought by a

CIT trained officer

T o w n o fF o r t M y e r s

B e a c h

B o n i t a S p r i n g s

F o r t M y e r s

S a n i b e l

C a p e C o r a l

41

75

7541

Triage Center Law Enforcement ReferralsChar l o t te Glades

Hendry

Co l l i e r

Sources:

Triage Data - Lee Cnty Dept of Human Srvcs

Gul f

o f

Mex ico

0 2 41

Miles

Date: May 2010

Legend

Triage Center

LCSO

Ave. Dist. 7.35 Miles

123 Pick Ups

FMPD

Ave. Dist. 3.24 Miles

538 Pick Ups

CCPD

Ave. Dist. 9.64 Miles

51 Pick Ups

Other Agencies

Ave. Dist. 6.47 miles

7 Pick Ups

Funding Sources CJMHSA Implementation Grant $997,698 (3 year

period) CJMHSA Expansion Grant $750,000 (3 year

period) Local Match $2 million (3 year period) from Lee

County BOCC and project partners Federal stimulus funds used to expand facility FDLE Byrne Grant funds operating expenses Veteran’s Administration per diem contract Cost is $68 per bed per day

Key Stakeholders

Lee County BOCC – administers grant and provides local match funds

Salvation Army – operates low demand shelter Lee Memorial Health System – provides nursing staff,

medical supplies, and some meals Lee Mental Health Center – provides facility, oper. and

maint., meals, and intake clinician Southwest Florida Addiction Services – provides intake

clinician United Way – provides match funds for meals Local law enforcement NAMI

http://triage.leegov.com/

Questions

For additional information please contact

Ann Arnall, Lee County Human Services

2440 Thompson Street

Fort Myers, Florida 33901

239-533-7920

arnallam@leegov.com