Fulton County Justice and Mental Health Task Force A Collaboration of Justice, Behavioral Health, and the Community

Aligns with Fulton County Strategic Plan Stepping Up Resolution approved May 4, 2016 A Call To Action

8X SMART JUSTICE 40 – 70% Mentally Ill State Prisons 17% Adults Entering Jails State Prisons SMI Individuals with untreated mental health and substance abuse disorders are 8 times more likely to be incarcerated, often due to lack of access to appropriate crisis services and ongoing care. Diagnosed with a behavioral Disorder Inmates in prisons in the United States 50% 2,500 Inmates Housed Daily 40 – 70% Mentally Ill

58 CURRENT FUTURE vs 78% $1.6 37K A snapshot of the Fulton County Current State Future State 58 78% $1.6 37K vs DAYS Length of Stay Mentally ill defendants are incarcerated 30 days longer than the general population inmate. Comprehensive Screening Validated Tool 100% of defendants will undergo a validated mental health screening for early identification of SMI which expedite service and reduce the length of stay. Decrease in re-arrests Pre-Arrest Diversion Reduce criminal justice involvement for behaviors related to drug use and mental health. Re-arrests Rate Propensity to Re-offend The jail reports that the re-arrest rate among SMI inmates is approximately 78-80%. A snapshot of the Fulton County Jail population MILLION Housing of SMI Inmates The jail reports a total of 360 inmates per day receiving medication, specifically psychotropic drugs. The annualized cost to the County is estimated at $10M. Access to Treatment Diversion Programs Unified Treatment Diversion Model to include Misdemeanor Mental Health Court and expanded Pretrial services. CONTACTS Mental Health The jail medical provider made contact with more than 2,600 defendants per month. Disconnect to Care Release Navigation Integrated & effective discharge process for SMI defendants to include imminent risk designation.

Justice and Mental Health Task Force Project Funding U.S. Department of Justice, Bureau of Justice Assistance, Justice and Mental Health Collaboration Program (JMHCP) $250,000 Federal Planning Grant (Category I) awarded October 2016 The Superior Court of Fulton County was among 6 national recipients of the JMHCP Category I FY16 grant Other grant recipients in Georgia: Athens-Clarke County, Macon-Bibb County, Newton & Walton counties

Grant Purpose 4 Key Measures The number of people with SMI booked into jail The average length of stay for people with SMI in jails The percentage of connection to care for people with SMI in jail Rates of recidivism Reduce the Prevalence of Individuals with Mental Disorders in Jail 4 Key Measures 1. 2. 3. 4. REDUCE SHORTEN INCREASE LOWER Remember to talk about performance management alignment Can be sustainable performance measures of success in the long term. What does success look like? 4 Key Measures are from the Stepping Up Initiative Framework

Timeline 2 Year Planning Grant Briefing to Fulton County BOC Project Report Complete Stepping Up Resolution Passed Superior Court Applied for BJA Grant Fulton BOC Approves Contract Project Kick-Off Meeting Metro Atlanta Justice Mental Health Symposium Sequential Intercept Mapping Workshop Task Force & Work Group Meetings Begin Prioritize Recommendations Grant Awarded October 2015 May 2016 October 2016 February 2017 April 2017 June 2017 December 2017 March 2018 - This grant was last before the BOC in February 2016 when the commission officially accepted the federal grant. - We are moving faster than the other 6 grantees in our cohort – Better resourced, momentum is key Note: CVIOG work started in May 2017 when our contract was finalized. Task Force time on task is April to December 2017 Fulton County accepts award and finalizes contracts with BJA and UGA 2 Year Planning Grant – Work to be accomplished in 18 months from award date

Task Force Activities

UGA Carl Vinson Institute of Government Project Staff Project Responsibilities Lisa Maye Sid Johnson Holly Lynde David Tanner John Barner Project Management Meeting Facilitation Process Documentation Data Analysis Program Evaluation Technical Assistance

Sequential Mapping Exercise Two (2) day meeting to map the flow of persons with mental illness through the Fulton County criminal justice system Five (5) workgroups were created to work on the priorities the Task Force identified to help safely reduce the prevalence of individuals with mental illness and co-occurring disorders in jail Intercept 1 Law Enforcement and Emergency Services Intercept 2 Initial Detention and Initial Court Hearings Intercept 3 Jails and Courts Intercept 4 Reentry Intercept 5 Community Corrections and Community Supports

Project Organization Fulton County Judicial & Executive Branches Governance Committee Chair/Grant Recipient Judge Doris L. Downs Superior Court of Fulton County Advisory Committee Work Group Chairs, Law Enforcement, Judges, other key Behavioral Health leaders from the Task Force to ensure system components are represented Fulton County Justice and Mental Health Task Force Work Group 1 Pre-Arrest Develop pre-arrest diversion strategies Expand housing options Improve collaboration between courts Refine and expand reentry/community options Improve individual data sharing Need someone from Commission on the Governance Committee Work Group 2 Housing Work Group 3 Court Collaboration Work Group 4 Re-Entry Work Group 5 Individual Data Sharing

Stakeholder Tours, Meetings, and Interviews Grady Hospital Behavioral Health Fulton County Treatment Diversion Court Fulton County Police Chiefs Meeting Fulton County Jail Atlanta City Detention Center Athens-Clarke County Justice and Mental Health Grant/Advantage Behavioral Health Atlanta Police Department Training Academy Fulton County Adult Felony Drug Court Georgia Department of Community Supervision Georgia Crisis Action Line Area West Crisis Collaborative – BHL Re-entry Service Provider Partnership Meeting – MSM Fulton County Public Defender’s Office – Social Work Team Atlanta 911 Communications Center Georgia Regional Hospital at Atlanta Behavioral Health Treatment Court Fulton County Pre-Trial Services – Intake, Court Services, and Supervision Atlanta City Pre-Trial Services Atlanta/Fulton County Pre-Arrest Diversion Initiative Georgia Department of Community Health Health Information Exchange Grady Out-Patient – 10 Park Place JMHCP FY16 Collaborative County Training Summit Center for Health and Rehabilitation (Fulton County DBHDD) DBHDD – Georgia Voucher Housing Program NAMI Northside Atlanta/Georgia Crisis Access Line Fanning Institute of Government Fulton County Department of Community Development

Work Groups and Chairs Work Group Activities Develop Pre-Arrest Diversion Strategies Victoria Roberts, Program Director, Competency Restoration Program, Emory University School of Medicine/Fulton County Jail Collaborative Shedra Jones, Director, Atlanta/Fulton County Pre-Arrest Diversion Initiative Expand Housing Options George Chidi, Social Impact Director, Atlanta Downtown Improvement District, Central Atlanta Progress Improve Collaboration Between Courts Judge Doris L. Downs, Superior Court/Behavioral Health Treatment Court Refine and Expand Reentry/Community Options Violet Ricks, Assistant Chief Strategy Officer, Fulton County Manager’s Office Marcus Carter, Georgia Department of Community Supervision Improve Individual Data Sharing Phenix Ayers-Gaston, Director, Accountability Courts, Superior Court of Fulton County Work Group Activities Meet monthly Improve relationships and partnerships Refine process flow maps Identify existing programs and resources Provide baseline data Identify early wins and long-term priorities

Top Five (5) Recommendations TRAINING: Standardized training for law enforcement officers using Crisis Intervention Training, trauma-informed responses, and other evidence-based crisis models. STRATEGIC DATA MODEL: Explore, create, and implement a network information sharing database and data sharing agreements to be used by all justice and justice-serving entities. VALIDATED INTAKE SCREENING: Standardized process to include a validated jail mental health screen for 100% of bookings in the Fulton County Jail. COMMUNITY CARE: Designate inmates with SMI facing homelessness upon release as being an “imminent risk” triggering care navigation prior to release. TREATMENT DIVERSION: Expand funding for jail diversion services.

CURRENT GAINS/WINS PATH FORWARD Misdemeanor Mental Health Court Model Expanded Accountability Court Clinical Services NAPH-Care & In-House Expertise to create the Validated Assessment Tool Link Project to recommendations of JRI and JCC Medical and Mental Health Pretrial Unit (April Soundings) Best Practices Implementation Academy (April 17th 19th) Provide Trauma Informed Response Training (April 11th – 12th) Final Taskforce Report (March 2018) PATH FORWARD Carl Vinson MOU for Service ($176,000) Creating Design Teams (Improve Overall County Care Model) Pre-Diversion Arrest Center Cost Analysis for Implementation Develop Strategic Data Model Creating Discharge/Care Navigation Systems Application for the Category II Grant (May 2018)

A public website was created as a repository for all project documents and meeting information: www.fultonstepsup.org

Contact Information Superior Court of Fulton County 136 Pryor Street, Suite C-640 Atlanta, GA 30303 Office Number: 404-612-4518 Fax Number: 404-730-5368