Somerset County - Center of Excellence

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DREXEL UNIVERSITY & UNIVERSITY OF PITTSBURGH Somerset County Report of the Cross-Systems Mapping Workshop December 6 th & 7 th , 2011 Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System

Transcript of Somerset County - Center of Excellence

D R E X E L U N I V E R S I T Y &

U N I V E R S I T Y O F P I T T S B U R G H

Somerset County Report of the Cross-Systems Mapping Workshop

December 6th & 7th, 2011

Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System

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Facilitator

Patricia A. Griffin, PhD, Center of Excellence Senior Consultant

Other Support

Sarah Filone, MA, Project Coordinator - PA Center of Excellence Katy Winckworth-Prejsnar, Research Coordinator – PA Center of

Excellence

Center of Excellence Staff

David DeMatteo, JD, PhD Sarah Filone, MA

Patricia Griffin, PhD Kirk Heilbrun, PhD Casey LaDuke, MS

Edward P. Mulvey, PhD Carol Schubert, MPH

Katy Winckworth-Prejsnar, BA

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Table of Contents

Transforming Services for Persons with Mental Illness in Contact With the Criminal Justice System

Introduction ...................................................................................................................................... 5

Background ...................................................................................................................................... 5

About the Workshop ......................................................................................................................... 6

Objectives of the Cross-Systems Mapping Exercise ....................................................................... 6

Keys to Success ............................................................................................................................... 7

Somerset County, Pennsylvania Cross Systems Mapping

Somerset County Cross Systems Map ............................................................................................ 8

Somerset County Cross Systems Narrative .................................................................................... 9

Intercept I: Law Enforcement / Emergency Services ........................................................ 11

Intercept II: Initial Detention / Initial Court Hearing ........................................................... 16

Intercept III: Jails / Courts ................................................................................................. 17

Intercept IV: Re-Entry........................................................................................................ 20

Intercept V: Community Corrections / Community Support .............................................. 22

Somerset County Action Planning

Somerset County Priorities ............................................................................................................ 25

Somerset County Action Plan ........................................................................................................ 26

Conclusions and Summary

Conclusion ..................................................................................................................................... 30

Closing ........................................................................................................................................... 30

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List of Appendices

Appendix A – Participant List ......................................................................................................... 31

Appendix B – Somerset 911 Call Totals ........................................................................................ 35

Appendix C – Somerset County Police Agencies .......................................................................... 36

Appendix D – Somerset County Crime Statistics ......................................................................... 37

Appendix E –Somerset County Victim Assistance Guide .............................................................. 39

Appendix F –Somerset County Adult Probation Data .................................................................... 51

Appendix G – The Co-Occuring Disorder (COD) Monthly Update ............................................... 52

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Somerset County, Pennsylvania

Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System

Introduction

The purpose of this report is to provide a summary of the Pennsylvania Mental Health and Justice Center of Excellence Cross-Systems Mapping workshop held in Somerset County, Pennsylvania, on December 6th and 7th, 2011, conducted at the Oakhurst Tea Room, 2409 Glades Pike (Rte. 31) Somerset, PA 15501. Behavioral Health Services of Somerset and Bedford Counties, Inc. (BHSSBC), the county over sight organization for HealthChoices, hosted the workshop as part of an ongoing process of developing collaborative systems of support for individuals who have mental illness and who come in contact with criminal justice. This report (and accompanying electronic file) includes: A brief review of the origins and background for the workshop; A summary of the information gathered at the workshop; A cross-systems intercept map as developed by the group during the workshop; A description of each intercept along with identified gaps and opportunities; An action planning matrix as developed by the group; and Observations, comments, and recommendations to help Somerset County achieve its goals.

Background

Behavioral Health Services of Somerset and Bedford County, Inc. and multiple other stakeholders requested the Center of Excellence Cross-Systems Mapping workshop to promote progress in addressing criminal justice diversion and treatment needs of adults with mental illness in contact with the criminal justice system. As part of the workshop, they were requested to provide assistance to Somerset County with: Creation of a map indicating points of interface among all relevant Somerset County

systems; Identification of resources, gaps, and barriers in the existing systems; and Development of priorities to promote progress in addressing the criminal justice diversion

and treatment needs of adults with mental illness in contact with the criminal justice system. Prior to the workshops, the Center of Excellence gathered information about Somerset County through a Community Collaboration Questionnaire and gathering of documents relevant to the population. The participants in the workshops included 33 individuals representing multiple stakeholder systems including mental health, substance abuse treatment, human services, corrections, advocates, law enforcement, and the courts. A complete list of participants is available in Appendix A (pg. 30) of this document. Patricia A. Griffin, PhD, facilitated the workshop sessions. Sarah Filone, MA, and Katy Winckworth-Prejsnar also provided support.

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About the Workshop

Upon receiving a grant from the Pennsylvania Commission on Crime and Delinquency and the Pennsylvania Department of Public Welfare’s Office of Mental Health and Substance Abuse Services in late 2009, the Pennsylvania Mental Health and Justice Center of Excellence was developed as a collaborative effort by Drexel University and the University of Pittsburgh. The mission of the Center of Excellence is to work with Pennsylvania communities to identify points of interception at which action can be taken to prevent individuals with mental illness from entering and penetrating deeper into the justice system. The Center of Excellence workshops, Cross-System Mapping and Taking Action for Change, are unique services tailored to each Pennsylvania community. These workshops provide an opportunity for participants to visualize how mental health, substance abuse, and other human services intersect with the criminal justice system.

This workshop is unlike other types of consultations or staff development training programs. A key element is the collaborative process. Meaningful cross-system collaboration is required to establish effective and efficient services for people with mental illness and co-occurring substance use disorders involved in the criminal justice system. This makes the composition of the group extremely important. While some workshops involve advertising to the entire provider community, it is essential in the Cross-System Mapping workshops that the organizers gather a group that represents key decision makers and varied levels of staff from the relevant provider systems. Center of Excellence staff work with this group, serving as expert guides to help:

Create a cross-systems map indicating points of interface among all relevant local systems; Identify gaps, opportunities, and barriers in the existing systems; Optimize use of local resources; Identify and prioritize necessary actions for change; and Develop an action plan to facilitate this change. Upon completion of the workshops, the Cross-Systems Map included in the report is provided in both print and electronic formats. It is meant to be a starting point. The electronic files can be revised over time to reflect the accomplishments and changes in the planning process.

Objectives of the Cross-Systems Mapping Exercise

The Cross-Systems Mapping Exercise has three primary objectives: 1. Development of a comprehensive picture of how people with mental illness and co-occurring

substance use disorders move through the Somerset County criminal justice system along five distinct intercept points: Law Enforcement and Emergency Services, Initial Detention/Initial Court Hearings, Jails and Courts, Re-entry, and Community Corrections/Community Support.

2. Identification of gaps, resources, and opportunities at each intercept for individuals in the

target population. 3. Development of priorities for activities designed to improve system and service level

responses for individuals in the target population.

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Keys to Success

Existing Cross-Systems Partnerships Somerset County’s history of collaboration between the criminal justice and behavioral health systems is reflected in a number of existing local efforts that were identified prior to the mapping. For example: Somerset County Criminal Justice Advisory Board (CJAB); Somerset County Board of Family Services Community Based Cross Systems Training; and Children’s Model Workgroup –HealthChoices, Children and Youth Services (CYS),

Probation, Children and Adolescent Services System Program (CASSP), Somerset County Drug and Alcohol Commission (SCA), BH-MCO (CBHNP), Family Members/Advocates, and Intermediate Unit #08.

Representation from Key Decision Makers in the Workshops The workshops included wide cross-system representation and involved many of the key

decision makers. Opening remarks by Tracy Schultz, M.S., HealthChoices Project Manager from Behavioral Health Services of Somerset and Bedford County, set the stage and established a clear message as to the importance of the workshop. Douglas McCall Bell, Magisterial District Judge, welcomed participants and introduced the facilitators.

Data Collection In addition to the information gained during the workshop, the information in this report was

developed from conversations with and questionnaires completed by key stakeholders in Somerset County in preparation for the workshop.

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Somerset County Cross Systems Map

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Somerset County Cross Systems Narrative

The Cross-Systems Mapping exercise is based on the Sequential Intercept Model developed by Mark Munetz, M.D. and Patty Griffin, Ph.D.,1 in conjunction with the National GAINS Center. In this workshop, participants were guided to identify gaps in services, resources, and opportunities at each of the five distinct intercept points.

This narrative reflects information gathered during the Cross-Systems Mapping Workshop. It provides a description of local activities at each intercept point, as well as gaps and opportunities identified at each point. This narrative may be used as a reference in reviewing the Somerset County Cross-Systems Map. The cross-systems local task force may choose to revise or expand information gathered in the activity. The gaps and opportunities identified in this report are the result of “brain storming” during the workshop and include a broad range of input from workshop participants. These points reflect a variety of stakeholder opinions and are, therefore, subjective rather than a majority consensus. General Description of Services and Cross-System Collaboration Created on April 17, 1795, from parts of Bedford County, the written history of Somerset County dates back to the French and Indian War. Its county seat is Somerset. As of the 2010 Census Report, the population was 77,742 with a median age of 44 years old. Most of Somerset County is a high plateau or tableland, located between the crests of the Allegheny Mountains on the east, and Laurel Hill on the west. Elevations range from 1,040 feet in Southampton Township, to the 3,213 feet of Mount Davis, Pennsylvania’s highest point. The county’s land area of 1,085 square miles (seventh largest in the state) lies almost entirely in the Ohio River drainage area. The county's elevation and proximity to the ocean causes snow to fall from late October through early April. Snow has been recorded in Somerset County in every month except July, although local lore has it that even July saw snow in 1816, "the year without a summer." The county has been building a continuum of criminal justice and mental/behavioral health services that provide a basic foundation for continued growth and reorganization on all levels. There are a number of established links, both formal and informal, between the courts, probation, police departments, corrections, and the mental health system that include, but are not limited to:

Memorandum of Understanding (MOU) between Somerset County Probation and Peerstar LLC to facilitate a drug and alcohol treatment and prevention program, in addition to forensic peer support services in the Somerset County Jail;

o Attempting to take it one step further through collaboration with Community Behavioral HealthCare Network of Pennsylvania (CBHNP) and Somerset MH/MR to expand/implement community based forensic peer support services

Trainings and workshops sponsored by HealthChoices (BHSSBC) around how to manage co-occurring disorders; and

MOU between Peerstar LLC and [local jail] around drug and alcohol programming.

1 Munetz, M. & Griffin, P. (2006). A systemic approach to the de-criminalization of people with serious

mental illness: The Sequential Intercept Model. Psychiatric Services, 57, 544-549.

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The Bedford-Somerset Mental Health and Mental Retardation (MH/MR) program is dedicated to ensuring mental health and mental retardation services are easily accessible and affordable to residents of Bedford and Somerset counties. Bedford-Somerset MH/MR provides a variety of services including: administrative case management (mental health case management), crisis intervention services, the Children and Adolescents Services System Program (CASSP), Individual/Family Satisfaction Teams (IFST), and peer support services. There are a variety of mental health and mental retardation service providers in Somerset County. Cornerstone Community Services is the county-operated provider system for a wide range of mental health and mental retardation services to the citizens of Bedford and Somerset counties. All services are designed to promote hope, wellness, and recovery in our communities. Somerset County provides an extensive and detailed network of care website for individuals, families, and agencies concerned with behavioral health issues. It provides information about behavioral health services, laws, and related news, as well as communication tools and other features. This network of care is available at: http://somerset.pa.networkofcare.org/mh/resource/find.cfm

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Intercept I: Law Enforcement / Emergency Services

911

The Somerset County E-911 Communications Center is manned 24 hours per day 365 days per year, providing dispatch service to all public safety agencies in Somerset County, as well as providing enhanced 911 services to all residents, visitors, and travelers in the county.

In 2011, The Somerset County E-911 Communications Center received 24,584 calls. An estimated 5% of these calls involved a mental health issue, and 1-2 calls per day are typically suicide related. For more information on monthly 911 calls, refer to Appendix B (pg. 34) of this report.

Law Enforcement

Somerset County houses 15 police jurisdictions and 2 state police barracks. Approximately 3 of the 16 police departments have full-time coverage. For a complete list of police jurisdictions in Somerset County, see Appendix C (pg. 35) of this report.

Somerset County police officers have access to Crisis Intervention Team (CIT) training through the Laurel Highlands CIT program. CIT trainings are offered once a year. As of December 2011, 18 Somerset County officers have completed CIT training.

Crisis Services

Bedford-Somerset MH/MR Crisis intervention services are available 24 hours per day, 7 days per week by calling 866-611-6467 in both Bedford and Somerset County. This is an immediate service designed to help ease stress for adults, children, and families experiencing emotional, mental, or behavioral problems. Walk-in assistance is also available at their offices from 8 AM to 4 PM on Monday through Friday.

Mobile crisis services are also available in Somerset County. Typically, two mobile crisis workers are scheduled during regular business hours, and one mobile crisis worker is on-call after hours. Approximately 85% of mobile crisis contacts occur in a local emergency room, though mobile crisis workers are also available to meet an individual at his/her home if necessary.

Bedford-Somerset MH/MR Crisis estimates they have between 100 and 150 individual contacts each month (40% of these are law enforcement related), and approximately 15 involuntary commitments each year.

Crisis Lines

The Twin Lakes Drug and Alcohol Access line (1- 800-452-0218) is a 24 hour toll free number that provides human service information and referrals to helping agencies. This hotline is not only a drug and alcohol information source, but also an after-hours contact point for

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MH/MR, Children and Youth Services, Adult and Juvenile Probation and the Area Agency on Aging. In addition, Somerset County residents have access to: a Monday-Friday helpline provided by Bedford-Somerset MH/MR, the Womens Help Center 24/7 hotline (814-443-2824), a 24/7 Meadows hotline, the National Suicide Hotline (1-800-273-TALK (8255)), and the National Veterans Suicide Hotline (1-800-273-8255)

Hospitals

Somerset Hospital is located at 225 South Center Avenue, Somerset, PA 15501 (Main number: 814-443-5170). The hospital’s Department of Emergency Medicine provides level II emergency care by a trained, board certified emergency physician 24-hours per day. This 15-bed department is staffed with critical care trained ACLS and PALS certified nursing staff.

Somerset Hospital’s behavioral health system consists of a 12-bed acute care inpatient unit, as well as outpatient services. Inpatient services include individual, group, and family therapy. Educational information is also offered to families and patients regarding medication and diagnosis in providing a continuum of care. Somerset County residents also have access to the Windber Medical Center (located at 600 Somerset Avenue, Windber, PA 15963), and Conemaugh Meyersdale Medical Center (located at 200 Hospital Drive, Meyersdale, PA 15552). Somerset County also houses a Crisis Diversion and Acute Stabilization Unit. This unit is a voluntary partial hospitalization program designed to stabilize individuals who are experiencing an immediate mental health crisis. The average length of stay in this facility is between 3 and 5 days.

Detoxification and Drug and Alcohol Services The Twin Lakes Center in Somerset County includes a "detox" unit that accepts admissions 24 hours per day, seven days per week. The medical director and nursing staff are trained to safely detox patients from a wide variety of substances. The center also treats various medical and psychological problems that accompany substance use disorders. Additional Twin Lakes services include, short term residential treatment, partial hospitalization, outpatient and intensive outpatient treatment. The Somerset County Drug and Alcohol Commission (SCA) provides the following services:

Care and Case Management All publicly funded clients are evaluated and referred to an appropriate level of care, within SCA policy guidelines. Progress is monitored throughout treatment process, coordinate discharge planning, and develop after care plans that optimize continued sobriety.

Student Assistance Program Somerset Single County Authority for Drug and Alcohol staff meets with school districts Student Assistance Program (SAP) teams to provide consultation and technical assistance. The staff also conducts assessments of children and adolescents who are at risk of drug abuse, and then coordinates referrals to treatment and other services.

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Outpatient Counseling This service develops a recovery plan for alcohol and other drug related problems on an outpatient basis. The intensity of this program can vary from 1 to 12 hours per week.

Residential Rehabilitation A 12-step recovery program is available for adults and adolescents (varying lengths of stay).

Halfway House/3/4 House Post rehabilitation recovery service provides a more structured setting than independent living. Along with continued recovery skills, other services such as life skills, and job seeking skills are stressed.

Transitional Living: This program assists those who are leaving a treatment program and have no suitable living arrangements to which they can return.

Methadone Maintenance As required by the Bureau of Drug and Alcohol Programs, the SCA provides Methadone Maintenance to individuals who met all state and county guidelines for this level of care.

Victims Services The Pennsylvania Commission on Crime and Delinquency’s Victim Resources website provides the following victim services resources for Somerset County. Further information can be found at: http://www.portal.state.pa.us/portal/server.pt/community/find_help_in_your_county/14752

Victim Service Program Type of Program Street Address City

MADD - Western Affiliate

Office

Help victims of impaired

driving crashes

222 W. Cunningham

Street

Butler

Somerset County Juvenile

Court Victim Services

Help victims of juvenile

offenders

300 North Center

Avenue, Suite 100

Somerset

Somerset County

Victim Service Department

Help victims of all

crimes

Somerset County

District Attorney Office

111 East Union Street,

Suite 30

Somerset

Victim Services, Inc Help victims of all

crimes

427 Westridge Road Somerset

The Women's HelpCenter,

Inc.

Help victims of domestic

violence

Scrull Building, Room

214

124 North Center

Avenue

Somerset

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In addition, Somerset County residents have access to the following resources:

PA Coalition Against Domestic Violence 6400 Flank Drive, Ste. 1300 Harrisburg, PA 17112

daytime: 800-932-4632 website: www.pcadv.org

PA Coalition Against Rape 125 North Enola Drive Enola, PA 17025

daytime: 717-728-9740 24 hour hot line: 888-772-PCAR website: www.pcar.org

PCCD Victims Compensation Program 3101 N. Front Street Harrisburg, PA 17108

daytime: 717-783-5153 800-233-2339 website: www.pccd.state.pa.us

MADD, PA State Office 2323 Patton Road Harrisburg, PA 17112

daytime: 717-657-3911 24 hour hotline: 866-439-6233 (Pittsburgh) 800-848-6233 (Harrisburg) website: www.maddpa.org

For additional information on victim resources in Somerset County, please see the Somerset County Victim Assistance Guide (Appendix E, pg. 38).

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Identified Gaps

Only 3 of the 15 police departments in Somerset County operate full time

County MH service providers have to take the initiative to get their information listed in 211

- 211 is a statewide initiative for greater access to mental health services through a toll-free emergency number similar to 911

It is challenging to get Crisis Intervention Team (CIT) training to the smaller police departments within the county

Participants for the Cross Systems Mapping (CSM) were not sure what the protocols are for state police when arresting individuals with behavioral health issues- some thought that they were more likely to begin with pressing charges

- State police in Somerset County have a separate dispatch - More than 50% of cases that the Magisterial District Judges (MDJs) see

are from state police

Police officers often have to “babysit” intoxicated individuals; other than the county jail, Somerset Borough Police Department has the only detention cells in the county (All other departments have temporary holding benches)

In addition, the Somerset Hospital Emergency Room (ER) often “babysits” intoxicated individuals

- The hospital has to wait till the individuals sober up before they can be admitted

Twin Lakes has a detox center, however, there are many liabilities they face with taking in detoxification patients

One participant made the point that “If individuals can’t be admitted to the Psych Center at Somerset Hospital where can they go in the county?”

There is an expressed need in the county for more extensive mobile services

Concern that some areas in the county could use more law enforcement

Identified Opportunities

911 received two hours of Crisis Intervention Team (CIT) training

Exploring the shortened six hour Crisis Intervention Team (CIT) training for 911

Access to CIT training – Two individuals from Somerset County have direct involvement with the Laurel Highlands CIT team

CIT trained officers are well spread throughout the police departments

211 is going live in January

Somerset Hospital utilizes police officers as security within the hospitals

Police departments in Somerset rarely have to transport individuals to the hospital - ambulances often come meet the officers to transport individuals

The county is exploring overnight detention within the jail

Twin Lakes and MH/MR have been trained in the co-occurring disorders

(Footsteps Psychological) Crisis Diversion Acute Stabilization Unit – Average length of stay 3-15 days

- Trying to set up meeting with police departments - There is a question of whether police departments can make referrals - Only available to Medical Assistance eligible individuals

Since the implementation of CIT, relations between crisis and law enforcement has greatly improved

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Intercept II: Initial Detention / Initial Court Hearing

Arrest and Initial Detention

Individuals arrested in Somerset County are initially held in the presence of the arresting officer. The Somerset Borough Police Department contains a secure holding cell for short holding periods (e.g., paperwork processing) at the local jurisdiction. The other 14 jurisdictions in the county utilize temporary holding techniques for brief initial detention.

Preliminary Arraignment

Preliminary arraignment is typically conducted by 1 of 5 Magisterial District Judges (MDJ) via videoconference. After hours, individuals are arraigned by an on-call MDJ.

The preliminary hearing is set by the MDJ for 3-10 days following preliminary arraignment.

Identified Gaps

Some workshop participants expressed the

lack of a formalized system for what you can

and can’t do when diverting an individual with

mental illness during Intercept II

MDJs/the courts lack medical information

pertaining to Serious Mental Illness (SMI)

individuals

MDJs have a hard time accessing whether an individual going to be a threat to

society

Identified Opportunities

Officers go through 12 different categories in a Health & Fitness Assessment

(does include MH questions) and required to communicate that information to the

jail – Explore sharing that information with the judges

MDJs are open to exploring opportunities to gather more information from time of

preliminary arraignment to preliminary hearing (3 to 10 days)

Hoping for a space for overnight detention

Exploring a shortened six hour CIT training for MDJ’s

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Intercept III: Jails / Courts

Somerset County Jail

Somerset County Jail is located at 127 East Fairview Street Somerset, PA. The jail has a capacity of 138 beds, with 90 secure beds and 48 beds in the work release facility or in other less secure rooms. The facility’s average daily population is approximately 96 individuals.

Between 8/01/2010 and 7/31/2011, the Somerset County Jail processed 707 admissions [128 females (18.085%); 579 males (81.78%)]. Of these 708 admissions, approximately 76% were pre-sentencing, and the largest age group was 25-34 (40% of the admissions).

Arresting officers conduct a brief mental health screen of all individuals in custody, and communicate any concerns to the jail at intake. The standard intake process also includes both mental health and substance use questions.

Mental Health/ Substance Abuse Treatment

Somerset County Jail contracts with PrimeCare Medical for all medical and psychiatric services. This contract provides 10 hours with a mental health technician, as well as 3 hours of tele-psychiatry each week. An estimated 40% of the jail population are currently taking psychotropic medication, 60% of which are considered to have serious mental health diagnoses.

The jail also contracts with Peerstar LLC to provide 30 hours of drug and alcohol (D&A) treatment each week. Half of this time is devoted to individual drug and alcohol counseling, and the other half consists of a citizenship group facilitated by a Certified Peer Specialist (CPS). Individuals in this program must have either a drug and alcohol related offense or substance abuse/dependent diagnosis.

In addition, Peerstar LLC donates five hours of Certified Peer Specialist hours each week for individuals with severe mental illness (but without drug or alcohol issues).

Individuals in the Somerset County Jail also have access to weekly Alcoholics Anonymous (AA) meetings.

Work Release

The Somerset County Work Release Program was established to grant individuals sentenced to incarceration at the Somerset County Jail the opportunity to leave the facility for the purpose of maintaining gainful employment, attending a training program, or participating in other rehabilitative activities. When the inmate is not participating in these activities, he or she is confined to the county jail. Approval of work release is entirely within the discretion of the Court, but requires an application and interview process (typically initiated prior to sentencing).

Intercept 3 Jails / Courts

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State Correctional Institutions

Somerset County houses two state correctional institutions (SCIs). SCI Somerset is a medium-security facility for men located at 1590 Walters Mill Road, Somerset, PA. SCI Laurel Highlands is a minimum-security institution for men. This facility also has a separate housing unit for older and/or geriatric male inmates. It is located at 5706 Glades Pike, Somerset, PA. Courts

The Somerset County Courts are courts of general jurisdiction and are part of the Pennsylvania Unified Judicial System.

The Judges of the Court of Common Pleas, 16th Judicial District, are responsible for the disposition of all matters in litigation involving any of the law or legal issues, including: criminal cases; civil cases; family law matters, including support; custody and visitation rights; divorce and equitable distribution; orphans' court matters including adoptions; termination of parental rights proceedings; guardianship proceedings; juvenile delinquency and dependency proceedings; appeals from magisterial district judge convictions and civil judgments; appeals from motor vehicle driver's license suspensions; zoning board rulings; and many other miscellaneous matters.

In addition, Somerset County operates a small Juvenile Drug Court for minors facing drug related charges. This program currently has three participants.

Intermediate Punishment

Intermediate punishment is a sentencing alternative that gives the Somerset County Court another sentencing option between probation and incarceration. An intermediate punishment disposition may include one or a combination of the following: electronic monitoring/house arrest; community service; day reporting; and inpatient drug and alcohol treatment. An applicant for the Intermediate Punishment Program must meet certain criteria in order to be considered eligible. A prior conviction for a violent offense would render an applicant ineligible for intermediate punishment as required by law. The electronic monitor program does permit participants to leave their residence for employment and to attend treatment.

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Identified Gaps

Jail is overcrowded and understaffed

30 year old jail

Currently overcapacity at 94 (capacity is 90 beds)

Over the last several months the population rose from the 70s into the 90s

DOC reports the capacity for Somerset County Jail at 138 - but that number

includes non-secure cells

Not enough psychiatric services in the jail

No physical room in the jail for re-entry services- Re-entry services is currently

very limited

Concerns about reproducing the efforts of the peer support specialist

No screening for military status

Attorneys don’t always take advantage of bond supervision

Tom (Crisis) gets a weekly census report from the jail. Used to go through it and found individuals that had SMI diagnosis and projected discharged dates so that he could meet them on their release date, however, they discovered that those dates were not accurate

Identified Opportunities

Peerstar is donating about five hours a week just to address Serious Mental

Illness (SMI) inmates (no D&A services)

Opportunity to share screening information with probation

Tom (Crisis) gets a weekly census report from the jail

The courts along with the Jail Population Committee get a weekly report from the

jail as well to see if anyone has fallen through the cracks

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Intercept IV: Re-Entry

Re-Entry Services

Individuals are typically released from the Somerset County Jail at 8:00am. If an inmate was taking psychotropic medications in the jail, he or she is provided with three days of medication upon release.

The institutional parole officer can help re-activate Medical Assistance benefits for individuals re-entering the community.

A Veterans Justice Outreach (VJO) Specialist from the James E. Van Zandt VA Medical Center in Altoona, PA, is also available to help link incarcerated veterans to VA benefits and services (see Intercept V, pg. 21).

Re-Entry from State Correctional Institutions

Bedford-Somerset MH/MR receives a monthly list of individuals returning to the community from state correctional institutions.

MH/MR also coordinates with state parole officers to assist with community service linkage.

Intercept 4 Reentry

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Identified Gaps

No prescriptions are given to inmates leaving the jails

A waitlist of three to four months for psychiatric appointments

No MH treatment staff in the jail - There is a large disconnect with MI individuals

getting out of jail (especially setting up psychiatric appointments)

- This creates a lack of linkages in the community. No identified person to

make linkages

Unpredictable release dates

Individuals are released with a large gap until medical assistance is reinstated

30% of inmates just sitting on bond – Referred to as career criminals

No LSCIM

Only three days of psychotropic meds when leaving the jail

Identified Opportunities

State parole officer works with MH/MR in order to coordinate services

Institutional parole officer (probation/parole sentences) as well as SCA track their clients very well

If they have the institutional parole officer there is a mechanism and process for getting individuals on treatment tracks

Tele-psychiatry established in the community (only medical assistance eligible)

Released from the jail at 8am

MH/MR gets a discharge list of MH caseload from DOC

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Intercept V: Community Corrections / Community Support

Somerset County Adult Probation

The Somerset County Adult Probation Office is located at 300 North Center Avenue, Suite 100, Somerset, PA.

The Department has specially trained probation officers that perform the supervision activities of probationers, parolees, and incarcerated offenders. Individual officers specialize in the monitoring of certain types of offenses, or specialize in specific case management functions. Specialization allows the officers to become knowledgeable and efficient in performing their assigned duties. The department also employs probation aides who serve a role within the court system and the community in the form of victim services, community service, collections and educational programming.

Specialized probation officers include: intensive officers, who focus on drug and alcohol, mental health, domestic violence, and sexual offenses (three adult and one juvenile intensive officers); an institutional parole officer; and a victim liaison.

The Somerset Probation Department reports that in 2010, 72 probation/parole violations occurred in Somerset County (33 technical offenses and 39 criminal violations). Of those 72 violations, 55 went to county jail and 17 went to the state correctional institutions (SCIs). For more information on probation data, refer to Appendix F of this document.

Housing

The Next Step Emergency Homeless Shelter provides emergency shelter (up to 30 days) to eligible, low-income families and individuals from Somerset County who, due to situational crisis, are at risk of becoming homeless. The shelter also assists with referral services, information, and assistance to enable guests to find permanent housing within 30 days. The shelter is open to all eligible Somerset County residents and requires guests to follow the rules and regulations that support accepted life-skills and establish a safe environment for all guests, staff, and volunteers.

Community Action Partnership operates a supportive housing scattered-site lease program for those that fall under the Housing and Urban Development (HUD) definition of homeless. The program subsidizes rent for up to 12 months, so long as those enrolled adhere to their goal plan established with their case manager. The case manager will also provide referrals, conduct budget counseling, and assist with personal/household products. Sites must be inspected according to the HUD Section 8 inspection guide. Those applying must prove residency and cannot be transient. Participants in the program cannot have any current or pending criminal charges (resolved charges are acceptable).

Pa

role

CO

MM

UN

ITY

Intercept 5 Community corrections

Pro

ba

tio

n

Violation

Violation

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In addition, Community Action Partnership operates a homeless assistance program. This program assists with security deposits, first month’s rent, or payment to avoid eviction. Those applying must first apply for Emergency Shelter Allowance (ESA) at the Somerset County Assistance Office. Once there is a determination letter for ESA an application can be taken at Tableland Service, Inc., for the difference needed to resolve their emergency.

The Women’s Help Center provides temporary emergency shelter for women and children who have been victims of domestic violence.

Somerset County residents also have access to a permanent supportive housing program. This is a 12-24 month housing program that caters to individuals with substance abuse, mental health, or physical issues.

Veterans Services

The mission of the Somerset County Veterans Affairs Agency is to assist veterans and their dependents in processing claims against the Veterans Administration, such as compensation, pension, widow’s burial, and educational claims. The office is located 300 North Center Avenue, Suite 380, Somerset, PA 15501 (Phone: 814-445-1551 and Fax: 814-445-1446)

Somerset County is served by the Altoona - James E. Van Zandt VA Medical Center (http://www.altoona.va.gov/) located at 2907 Pleasant Valley Boulevard, Altoona, PA 16602-4377. Business hours are Monday through Friday, 8:00am - 4:30pm (Phone: 814-943-8164 or toll free: 1-877-626-2500).

The Altoona VA Medical Center has a Veterans Justice Outreach (VJO) Specialist to coordinate forensic services for veterans in the criminal justice system. Somerset County is served by Bonnie Clark ([email protected]) from the Altoona VA Medical Center. For more information on the Veterans Justice Outreach Initiative and the Veterans Health Administration (VHA), please see Guide 7 – “Information Sheet on Justice-Involved Veterans for Judicial System” located in the Resource Guide Document.

Community Resources

Bedford-Somerset MH/MR provides a variety of services, including: administrative case management (mental health case management); crisis intervention services; the Children and Adolescents Services System Program (CASSP); Individual/Family Satisfaction Teams (IFST); and peer support services. The Christian Missionary Alliance Church operates a Celebrate Recovery Group. This is a faith based recovery program for individuals suffering with substance abuse issues. Beal Counseling and Consulting is an outpatient treatment provider for mental health and substance abuse issues. This provider accepts referrals from referrals come from probation, Single County Authority (SCA), or other providers. Approximately 40% of their clients are involved in the criminal justice system.

Nulton Diagnostic and Treatment Center offers outpatient counseling, tele-psychiatry, and behavioral health services in Johnstown, PA (214 College Park Plaza Johnstown, PA 15904).

Identified Gaps

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Traditional Peer support services have not been accepted in Somerset County (past peer support specialist have not been far enough into their recovery)

More support coming from the criminal justice side rather than the mental health side

Lack of public transportation

Lack of day reporting center

County provider is the only provider of case management services

Issues maintaining housing for this population

Not a lot of housing options for clients with forensic backgrounds

Identified Opportunities

Shortened six hour CIT training for probation (and 911)

In July of 2007 there was a comprehensive weekly half day cross-systems human services training through the County Family Board coordinated by Travis Hutzell (The Family Center)

Somerset County Military Family Support Group does a lot of work with veterans

and veteran support

- CIT officers maintain communication with the group’s members

MH/MR gets a daily census report from the jail

Probation gives an annual report to the courts

The county has showed interest in developing an MH/MR intensive case

management team

Somerset County Probation has a MOU with Twin Lakes and Women’s Help

Center

Tableland Services, Inc./Somerset Community Action Partnership recently

developed a Permanent Supportive Housing program that provides individuals

with 12 to 24 months of housing

The Family Center is a great resource for the county

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Somerset County Priorities

Subsequent to the completion of the Cross-Systems Mapping exercise, the assembled stakeholders began to define specific areas of activity that could be mobilized to address the gaps and opportunities identified in the group discussion about the cross-systems map. Listed below are the priority areas identified by the workshop participants and the votes received for each proposed priority. (Please note that some priorities were changed and/or combined after voting on Day 2)

Top Priorities

1. Diversion prior to incarceration (18 votes) a. Day reporting center (1 vote)

2. Expand upon re-entry (17 votes)

a. Identification b. Better connections c. Gap funding for initial re-entry treatment

3. Expanded and coordinated data effort (7 votes)

a. Identification of mental health population across intercepts (4 votes)

4. Collaboration across intercepts/ Cross Systems training/ Grant writer a. System cost effective solutions (4 votes)

i. Strategies to blend funding ii. Cross Budgeting

Additional Priorities

One person to be ultimately responsible for tracking, coordinating, etc. (6 votes)

Forensic peer specialists across intercepts (4 votes)

Adequate physical facilities (3 votes) o New jail

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Somerset County Action Plan

Priority: Moving Forward

Objective Action Step Who When

CoE Report 1. Draft of map and action plan to group by Monday 12/12/11

CoE Staff By 12/12

Next CJAB Meeting – Wednesday, December 14th at 8:30 AM

Wednesday, December 14th at 8:30 AM

Explore a BH Subcommittee under CJAB Chair Tracy Schultz

Priority Area 1: Diversion prior to incarceration a. Day Reporting Center

Work Group: Brooke M, Justin, Tom, Megan, Joe, Darla, Bonnie, Judge Bell, Nyla, Adele

Objective Action Step Who When

1.1 Prompt evaluation of MH needs (10 day)

Crisis Intervention (mechanism and funding is in place)

Requests from Judges, CIT, and Nyla (state parole)

Within 10 days

1.2 Develop mechanism to identify an appropriate program

Coordination of agencies Case manger? One representative from each discipline (DA, MH, SCA, etc.)

Now

Designate a case manager ?- depending on the team listed above

Following 1st meeting

Therapy Group (regular basis)

Beal Counseling

6 month

Next Steps:

Next Tuesday (12.13.11)– Judge Bell will bring up this priority at the MDJs Meeting

Chief Cox will spread the word at the Chief Association Meeting, as well as bring it to the state police

Crisis and MDJ coordination- A more formalized process for crisis collection to give to the MDJs

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Priority Area 2: Expand upon re-entry

a. Identification b. Better Conditions c. Gap funding for initial re-entry treatment

Work Group: Vicki, Billie, Nancy, Elisaa, Barb, Warden Greg, Amanda, Debbie

Objective Action Step Who When

2.1 Identification of SMI inmates in county jail

Procedure with PrimeCare for list

Warden Greg

(He will talk to Margo about developing that list)

Weekly (today)

Weekly list ->MH/MR with highlights

Warden/Nancy Ongoing

2.2 Better coordination of services through Criminal Justice system

CM assigned as appropriate Nancy Weekly

Obtain ROI for necessary services

Assigned Case Manager

As Needed

Complete MA application while incarcerated

CM/CAO

As Needed

Develop re-entry plan (ref)

CM/PO As Needed

2.3 Expand Jail Population Meeting (monthly)

D/A approach judge to include MH staff and SCA staff to attend meeting

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Priority Area 3: Expanded data/identification of MI/BH population (broad data across systems)

Work Group: Tracy S, Kathy, David, DA, Alison

Objective Action Step Who When

3.1 Develop workgroup to examine:

Definition of populations

What information is already being collected

What information is being shared

Who needs the information and for what purpose

What information needs to be collected

How to collect the information and where

How to aggregate and report data

3.2 Set up conference call with CoE Western Psychiatric folks re: data definitions

CoE will schedule a tele-conference

CoE will connect Tracy with Catherine Kilgore

First draft of Lebanon’s data plan

CoE

3.3 Create a position for an individual to be responsible for coordinating this effort

Possible AmeriCorps position?

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Priority Area 4: Collaboration across systems/ cross-systems training (grant writer)

Work Group: Ronna Y, Chief Fox, Travis, Michelle, Tina

Objective Action Step Who When

4.1 Add criminal justice component to Board of Family Services (BFS) – networking and reporting

Attend BFS board meetings

Add CJ individuals to the meetings (PSP and SCCPA)

Schedule Cross-Systems training – identify “who needs to know what”

PA State Police (PSP) Somerset County Chief of Police Association (SCCPA) Travis

1/19/12 – meeting at 9:30 in the CYS conference room Conference room

4.2 Develop relationship via subcommittee with CJAB

Introduce idea/concept to the board

Attend CJAB

Schedule subcommittee meeting – discuss funding/ cross training

Subcommittee could meet after Board of Family Services meeting

Randy/ Tom Travis/ Ronna

December 2011 CJAB Meeting (12/13) Feb 2012

4.3 Research grant writing opportunities and partner with the data collection group

Share grant funding announcements with group

Check CoE website for funding announcements

Include veterans component

Travis

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Conclusion

Participants in the Cross-Systems Mapping workshop showed much enthusiasm in working together to improve the continuum of resources available for people with severe mental illness and often co-occurring substance use disorders involved in the Somerset County criminal justice system. Somerset County is poised to tackle a number of critical issues that will greatly improve services for this group. The assembled stakeholders spent time gaining a greater understanding of their shared systems, as well as crafting strategies related to improving the collaborative infrastructure for the group and addressing the gaps and opportunities at each intercept.

Considerable work has already been undertaken to improve services for people with severe mental illness and often co-occurring substance use disorders involved in the Somerset County criminal justice system. Law enforcement training, in-jail treatment programs, and crisis services are some examples of current Somerset County initiatives. Somerset County has also developed some thoughtful data to begin to provide a clearer understanding of the issues being discussed. In addition, continued Crisis Intervention Team training and the possibility of a day reporting center are promising community efforts that generated a good deal of interest during the workshop. Local stakeholders participating in the Cross-Systems Mapping were clearly interested in building on current successes to better serve this population.

The expansion of the planning group to tackle the priorities established during the Cross-Systems Mapping workshop is an essential next step in a true systems change process. It will be important to create effective working relationships with other groups that did not attend the workshop, including other police jurisdictions, the Social Security Administration, the County Administration Office, local consumers, and family members. Regular meetings should be held by this larger group to facilitate information sharing, planning, networking, development and coordination of resources, and problem solving.

Closing

Somerset County is fortunate to have a wide range of stakeholders across the mental health, substance abuse and criminal justice systems that have made significant efforts to understand and support the challenging issues discussed in this workshop. The Cross-Systems Mapping workshop gave these stakeholders a chance to develop a coordinated strategy to move forward with the identified priorities.

By reconvening and supporting the work of the group in coming months, it will be possible to maintain the momentum created during the Cross-Systems Mapping workshop and build on the creativity and drive of key local stakeholders. The Pennsylvania Mental Health and Justice Center of Excellence hopes to continue its relationship with Somerset County and to observe its progress. Please visit the Pennsylvania Mental Health and Justice Center of Excellence website for more information, www.pacenterofexcellence.pitt.edu.

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Appendix A: Participant List

Amanda Allen

Homeless Assistance Case Manager

Tableland Services, Inc./Somerset

Community Action Partnership

814-445-9628 extension 211

[email protected]

Adele Bauer

Deputy Warden

Somerset County Jail

814-445-1608

[email protected]

Justin Beal

Therapist

Beal Counseling & Consulting

814-444-9696

[email protected]

Darla Becker

Director

Youth Advocate Programs

814-443-3956

[email protected]

Douglas McCall Bell, Esq.

Magisterial District Judge

District Court 16-3-06

814-634-0614

[email protected]

Tom Bender

Crisis

Bedford/Somerset MH/MR

814-443-4891 x4245

[email protected]

Gregory C. Briggs

Warden

Somerset County Jail

814-443-4891 x4245

[email protected]

Bonnie K. Clark

Health Behavioral Coordinator/Veterans

James E Van Zandt VA Medical Center

814 943 8164 ext. 4201

[email protected]

Michele Countryman

Provider Relations Representation

CBHNP

814-623-0550

[email protected]

Randolph G. Cox

Chief of Police

Somerset Borough Police Department

814-445-4596

[email protected]

Megan Evans

Educational Counselor

Appalachia IU08

814-445-9734

[email protected]

David Fox

911 Coordinator

Somerset County 911

814-445-1525 [email protected]

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Elissa Gies

VP Operations & Forensic Program

Peerstar

814-525-4147

[email protected]

Debby Glunt

Program Manager

CBHNP

814-623-0550

[email protected]

Tina Heinrich

Clinical/QM Director

BHSSBC-HealthChoices

814-443-4891 x4157

[email protected]

Karri Hull

CJAB Specialist- South Central Region

Pennsylvania Commission on Crime and

Delinquency

570-263-0809

[email protected]

Travis Hutzell

Director/Human Services Coordinator

The Family Center

814-662-2721

[email protected]

Allison Krause

QI/Clinical Manager

CBHNP

814-623-0550

[email protected]

Joe Labik

911 Supervisor

Somerset County 911

445-1525 [email protected]

Melissa Lenart

Somerset CASSP Coordinator

Bedford/Somerset MH/MR

814-443-4891

[email protected]

Pam Marple

HealthChoices Coordinator

BHSSBC-HealthChoices

814-443-4891

[email protected]

Brooke McKenzie

Executive Director

Twin Lakes Center

814-443-3639

[email protected]

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Vicki Rascona-Saylor

Chief Probation Officer

Somerset County Probation Department

814-445-1686

[email protected]

Billie Sujansky

Bedford/Somerset MH/MR

814-443-4891

[email protected]

Nyla Shreckengost

Parole Agent

PA Board of Probation and Parole

814-505-1601

[email protected]

Jerry Spangler

District Attorney

814-445-1456

[email protected]

Tracy Shultz

HealthChoices Project Manager

BHSSBC-HealthChoices

814-443-4891

[email protected]

Nancy Svonavec

MH BSU Director

Bedford/Somerset MH/MR

814-443-4891

[email protected]

Albert Torquato

Youth Advocate Programs

814-443-3956

[email protected]

Kathy Unger

Deputy Administrator

Bedford/Somerset MH/MR

814-443-4891

[email protected]

Barb Vasos

Youth Advocate Programs

814-443-3956

[email protected]

Jen Weigle

Case Manager

Somerset SCA for D&A

814-445-1522

[email protected]

Ronna Yablonski

Prevention Education Coordinator

Twin Lakes Center

(814) 443-3639

[email protected]

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Patty Griffin, Ph.D.

Senior Consultant

Pennsylvania Mental Health and Justice

Center of Excellence

8503 Flourtown Avenue

Wyndmoor, PA 19038

[email protected]

Phone: 215-836-0570

Sarah Filone, MA

Project Coordinator

Pennsylvania Mental Health and

Justice Center of Excellence

Department of Psychology

Drexel University

MS 626, 245 N. 15th Street

Philadelphia, PA 19102-1192

[email protected]

Phone: 215- 762-4257

Fax: 215-762-8825

Katy Winckworth-Prejsnar

Research Associate

Pennsylvania Mental Health and

Justice Center of Excellence

Department of Psychology

Drexel University

MS 626, 245 N. 15th Street

Philadelphia, PA 19102-1192

[email protected]

Phone: 215-762-4257

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Appendix B: Somerset 911 Call Totals Call Month, Year 911 Calls CAD Incidents

01 - January, 2011 2454 2457

02 - February, 2011 1956 2417

03 - March, 2011 2315 2872

04 - April, 2011 2672 2771

05 - May, 2011 2375 2984

06 - June, 2011 2524 3056

07 - July, 2011 2553 3186

08 - August, 2011 2702 3063

09 - September, 2011 2591 2954

10 - October, 2011 2442 2779

Yearly Total - 2011 24584 28539

01 - January, 2010 2357 2336

02 - February, 2010 2601 2118

03 - March, 2010 2073 2834

04 - April, 2010 2232 2646

05 - May, 2010 2315 3127

06 - June, 2010 2331 3049

07 - July, 2010 2645 2969

08 - August, 2010 2481 2658

09 - September, 2010 2341 2692

10 - October, 2010 2412 2597

11 - November, 2010 2194 2469

12 - December, 2010 2349 2290

Yearly Total - 2010 28331 31785

01 - January, 2009 2368 2056

02 - February, 2009 2005 2405

03 - March, 2009 2176 2520

04 - April, 2009 2164 2448

05 - May, 2009 2258 2825

06 - June, 2009 2317 2440

07 - July, 2009 2351 2420

08 - August, 2009 2438 2547

09 - September, 2009 2012 2315

10 - October, 2009 2078 2353

11 - November, 2009 2131 2499

12 - December, 2009 2306 2233

Yearly Total - 2009 26604 29061

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Appendix C: Somerset Police Agencies

Municipal and County (16) PA State Police (2)

BERLIN BORO

BOSWELL BORO

CONEMAUGH TWP

ELK LICK TWP

GARRETT BORO

HOOVERSVILLE BORO

INDIAN LAKE BORO

JENNERSTOWN BORO

MEYERSDALE BORO

PAINT TWP

SEVEN SPRINGS BORO

SHADE TWP

SOMERSET BORO

SOMERSET COUNTY DET

SUMMIT TWP

WINDBER BORO

Somerset

Somerset-Turnpike

Source:

http://munstatspa.dced.state.pa.us/EAOReports.aspx?M=P

http://ucr.psp.state.pa.us/UCR/Reporting/Annual/AnnualFrames.asp?year=2008

www.portal.state.pa.us/portal/server.pt?open=512&objID=4541&&level=1&css=L1&mode=2

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Appendix D: Somerset County Crime Statistics

More Somerset-specific information can be found at our website:

http://www.pacenterofexcellence.pitt.edu/counties/somerset/somerset.html

Adult and Juvenile Crimes Reported

Type of Crime Total number reported Percent of Total Rate per 100,000 Pop.

Against Persons - Total 522 17.22% 678.3

Part I 94 3.10% 122.2

Part II 428 14.12% 556.2

Property Crime - Total 1,455 48.00% 1,890.8

Part I 940 31.01% 1,221.5

Part II 515 16.99% 669.2

Alcohol Related 307 10.13% 398.9

Drug Related 105 3.46% 136.4

Public Order 323 10.66% 419.7

Others 319 10.52% 414.5

Total 3,031 100.00% 3,938.8

Data is from PA State Police UCRS Annual Report 2009.

Total Arrests: Adult and Juvenile

Type of Crime

Number of

Juveniles

Percent of

Juveniles

Rate per

100,000 Pop.

Number of

Adults

Percent of

Adults

Rate per

100,000 Pop.

Against Persons

- Total 43 16.04% 278.3 422 25.70% 686.1

Part I 17 6.34% 110.0 107 6.52% 174.0

Part II 26 9.70% 168.3 315 19.18% 512.2

Property Crime

- Total 91 33.96% 589.0 326 19.85% 530.0

Part I 60 22.39% 388.4 208 12.67% 338.2

Part II 31 11.57% 200.7 118 7.19% 191.9

Alcohol Related 19 7.09% 123.0 296 18.03% 481.3

Drug Related 14 5.22% 90.6 84 5.12% 136.6

Public Order 58 21.64% 375.4 316 19.24% 513.8

Others 43 16.04% 278.3 198 12.06% 321.9

Total 268 100.00% 1,734.7 1,642 100.00% 2,669.7

Data is from PA State Police UCRS (PSP) UCR Query 2009. You can run your own queries by clicking here

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Reported Crimes per 100,000 Population

Reported Crimes per 100,000 Population

Against Persons Part

I

Against Persons Part

II

Property Part

I

Property Part

II

Remaining

Crimes

2006 89.2 392.3 835.6 536.3 1193.5

2007 164.4 490.6 995.4 631.9 1573.3

2008 161.4 606.8 1338.9 590.0 1461.5

2009 122.2 556.2 1,221.5 669.2 1,369.7

Type of Crime Definitions

Against Persons Part I: Murder, rape, robbery and aggravated assault

Part II: Non-aggravated assault

Property Crime Part I: Burglary, larceny theft, motor vehicle theft, and arson

Part II: Forgery, fraud, embezzlement, stolen property and vandalism

Remaining Crimes Alcohol related, drug related, public order and others

Appendix E: Somerset County VICTIM Assistance Guide

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Appendix F: Somerset County Adult Probation Data

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Appendix G: The Co-Occurring Disorder (COD) Monthly Update

You can find all issues of the COD Update by going to their website: http://www.bhssbc.us/COD_Monthly_Updates.html