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Bob Janes Triage Center and Low Demand Shelter Lee County

Bob Janes Triage Center and Low Demand Shelter Lee County. Kevin Lewis, CEO Southwest Florida Addiction Services, Inc Triage Center Partner Agency k_lewis@swfas.org. Opened April 28, 2008. Pre-Arrest Diversion Program.

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Bob Janes Triage Center and Low Demand Shelter Lee County

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  1. Bob Janes Triage Center and Low Demand ShelterLee County Kevin Lewis, CEO Southwest Florida Addiction Services, Inc Triage Center Partner Agency k_lewis@swfas.org

  2. Opened April 28, 2008

  3. 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

  4. 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

  5. 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)

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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

  13. Number of Triage Admissions 2,070 duplicate client admissions occurred during first three years Facility capacity increased from 22 beds to 58 beds May 2010

  14. Source of Referral

  15. Number of Repeat Admissions • 1,246 unduplicated clients • 2,070 duplicated clients • Average Length of Stay 13 days

  16. 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

  17. Presenting Issues Mental Health12.12% Co-Occurring25.28% Other7.87% Substance Abuse 23.35% None31.38% Based on self-disclosure during assessment 42% report taking medications which includes but is not limited to psychotropic drugs

  18. True Diversion? • 70% have prior arrest history in Lee County • 64% misdemeanor • 36% felony • Most common prior charges are: • Trespass • DUI • Theft • Battery

  19. Impact on Criminal Justice System 16% of time LEO would have taken individual to jail • Diverted 332 charges • 5% 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

  20. 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.

  21. 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

  22. 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

  23. 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

  24. http://triage.leegov.com/

  25. 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

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