PBMS Counting Rules: Potential New and Revised Key Indicators

1. PBMS Counting Rules:Potential New and Revised Key Indicators • Mental Health: Revised • Key Indicator V.1.2 Mental Health Diagnosis Among Number Assessed • Key Indicator V.1.3 Mental Health Diagnosis – Prevalence Among DOC Population • Key Indicator V.1.4 Axis I Mental Health Diagnosis –Prevalence among Assessments • Key Indicator V.1.5 Axis I Mental Health Diagnosis –Prevalence among DOC Population • Organization Characteristics: • Inmates Housed & Inmates Outsourced • Administrative Segregation: • Restrictive Status Housing Policy Guidelines – Potential Key Indicators Document F

2. Mental Health Key Indicators: DSM IV vs. V • Released in 2013 • Multi-axial system has been dropped in favor of a system evaluating psychosocial and contextual factors • (no longer refers to Axis I vs. II) • Revised PBMS counting rules to list specific diagnoses (those previously listed as Axis I).

3. PBMS Mental Health Standard Organization Key Indicators – based on DSM IV • RevisedKey Indicator V.1.2 Mental Health Diagnosis Among Number Assessed • Mental health diagnosis includes a mental disorder as defined in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), except for a diagnosis of substance abuse dependency. • RevisedKey Indicator V.1.3 Mental Health Diagnosis – Prevalence Among DOC Population • Mental health diagnosis includes a mental disorder as defined in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), except for a diagnosis of substance abuse dependency. • Revised Key Indicator V.1.4 Axis I Mental Health Diagnosis -- Prevalence among Assessments • Among the inmates whose mental health needs were assessed by a mental health professional during a given month, the number who were diagnosed with a mental health clinical disorder (i.e., depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, schizophrenia, and psychotic disorders. • Mental health diagnosis includes a mental disorder as defined in the current DSM as a mental health clinical disorder, i.e., depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, schizophrenia, and psychotic disorders. (Include all diagnoses listed as Axis I disorders in the DSM-IV, except substance abuse dependency). • Exclude inmates whose only clinical disorder (Axis I diagnosis) was a diagnosis of substance abuse dependency. Document F

4. PBMS Mental Health Standard Organization Key Indicators – based on DSM IV • Revised Key Indicator V.1.5 Axis I Mental Health Diagnosis -- Prevalence among DOC Population • Key Indicator V.1.5 Axis I Mental Health Diagnosis -- Prevalence among DOC Population: Number of inmates diagnosed with a mental health clinical disorder (i.e., depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, schizophrenia, and psychotic disorders in the custody of the agency as of the last day of a given month. • Data element V.1.5 (numerator). Number of inmates diagnosed with a mental health clinical disorder (i.e., depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, schizophrenia, and psychotic disorders in the custody of the agency. (Include all diagnoses listed as Axis I disorders in the DSM-IV, except substance abuse dependency).   Counting rules: • Mental health diagnosis includes a mental disorder as defined in the DSM V as a mental health clinical disorder, i.e., depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, schizophrenia, and psychotic disorders. (Any mental health disorder listed as Axis I in the DSM-IV, except substance abuse dependency.) • Exclude inmates whose only clinical disorder (Axis I diagnosis) was a diagnosis of substance abuse dependency. Document F

5. Organization Characteristics:Inmates Housed & Inmates Outsourced • Inmates Housed: Number of inmates in facilities operated by the DOC on the last day of a given month. • Do not include inmates housed in other states’ correctional facilities, facilities not operated by the DOC, or parolees. • Include inter-state compact cases and offenders housed in DOC facilities as “safe keepers,” i.e., for an evaluation/diagnostic assessment or as a courtesy for a local facility or law enforcement agency. • Inmates Outsourced: Number of inmates in facilities not operated by the DOC on the last day of a given month. • Include inmates housed in other states’ correctional facilities, facilities not operated by the DOC such as facilities operated by private vendors and county or regional jails. Document F

6. ASCA Resolution # 24 – Restrictive Status Housing Policy Guidelines Principal 11. Collect sufficient data to assess the effectiveness of implementation of these guiding principles; Current PBMS Administrative Segregation Key Indicator: VI.5.1 Average daily population of inmates in administrative segregation during given month at a given facility.

7. Development of PBMS Key Indicators to Track Implementation of ASCA Restrictive Housing Guidelines • Provide a process, a separate review for decisions to place an offender in restrictive status housing; • Number of documented decisions to place offenders in restrictive housing/# offenders placed in restrictive housing during given month at given facility. • Provide periodic classification reviews of offenders in restrictive status housing every 180 days or less; • Number of offenders in restrictive housing for which a 6-month review of his/her restrictive housing status was completed /# offenders in restrictive housing for which a 6-month review of his/her status was due during given month at given facility. • Provide in-person mental health assessments, by trained personnel within 72 hours of an offender being placed in restrictive status housing and periodic mental health assessments thereafter including an appropriate mental health treatment plan; • Number of offenders who received a mental Health assessment within 72 hours of placement in restrictive housing /# placed in restrictive housing during given month at given facility.

8. Development of PBMS Key Indicators to Track Implementation of ASCA Restrictive Housing Guidelines • Provide structured and progressive levels that include increased privileges as an incentive for positive behavior and/or program participation; • TBD – Help!! • Determine an offender’s length of stay in restrictive status housing on the nature and level of threat to the safe and orderly operation of general population as well as program participation, rule compliance and the recommendation of the person[s] assigned to conduct the classification review as opposed to strictly held time periods; • TBD – Help!! 6. Provide appropriate access to medical and mental health staff and services; • TBD – Help!! • Provide access to visiting opportunities; • Number of offenders in restrictive housing that received 2+ visits during a given month /# offenders in restrictive housing during given month at given facility. OR Number of offenders in restrictive housing eligible for visits/# offenders in restrictive housing during given month at given facility.

9. Development of PBMS Key Indicators to Track Implementation of ASCA Restrictive Housing Guidelines • Provide appropriate exercise opportunities; • Number of offenders in restrictive housing that received at least #hour out-of-cell exercise per day during a given month /# offenders in restrictive housing during given month at given facility. • Provide the ability to maintain proper hygiene; • Number of offenders in restrictive housing that received ## showers during a given month /# offenders in restrictive housing during given month at given facility. • Provide program opportunities appropriate to support transition back to a general population setting or to the community; • Number of offenders in restrictive housing that participating in transition programing during a given month /# offenders in restrictive housing during given month at given facility. (Transition programing to include: MH, education, cognitive therapy, anger management, etc.)

10. Development of PBMS Key Indicators to Track Implementation of ASCA Restrictive Housing Guidelines 11. Collect sufficient data to assess the effectiveness of implementation of these guiding principles; • Conduct an objective review of all offenders in restrictive status housing by persons independent of the placement authority to determine the offenders’ need for continued placement in restrictive status housing; and • Number of offenders in restrictive housing for which a 6-month review of his/her restrictive housing status was completed by independent authority /# offenders in restrictive housing for a 6-month review of his/her status was due during given month at given facility. • Require that all staff assigned to work in restrictive status housing units receive appropriate training in managing offenders on restrictive status housing status. • Number of staff assigned to restrictive status housing units who have completed specialized training regarding management of restrictive housing units/number of staff assigned to restrictive status housing units.

11. PBMS Restrictive Housing Key Indicator Development Process • Draft key indicator counting rules (ASCA staff); • Circulate to PMC Members prior to January 2015 meeting (ASCA staff); • Review key indicators and counting rules at January 2015 or Strategic Planning Meeting. • Impact on Participation Map? • Restrictive Housing Key Indicators • Fiscal and Personnel Key Indicators