Pierce County Criminal Justice Diversion Strategy: Trueblood Funding Carol C. mitchell Director, Justice Services & Special Projects 253.798.7447 Carol.Mitchell@co.pierce.wa.us

Criminal Justice Diversion Context Shift from State Mental Health Hospital System to Criminal Justice System Evolution away from institutionalized care to community-based care Unintended consequences: Prisons and jails filled with individuals with mental health and substance use disorders 10-15% of all inmates have a serious thought or mood disorder needing psychiatric treatment

Criminal Justice Diversion Context (cont.) Puget Sound Hospital closed in 2010 People with mental illness represent 15-20% of DAC caseload Western State Hospital and DOC release policies Mentally ill are poor, homeless, victims of physical and sexual abuse

Context (cont.) State Studies The Joplin report Groundswell report Washington Office of Financial Management (2016) Lack of competency assessment services Lack of qualified assessment professionals Washington State Department of Social and Health Services (2014) Future of individuals with mental health illnesses is not bright Shorter life spans Lack of resources Lack of access to healthcare Lack of access to housing Social, economic, educational challenges

Criminal Justice Diversion Steering Committee Collaborative model Multi-agency/Multi-departmental Partnering with Behavioral Health providers Diversion strategy development Funding oversight Program design Data collection and sharing Operational protocols Assessment and Quality

Trueblood Case (A.B. by and through Trueblood v DSHS) Each year, thousands of individuals are sitting for weeks and even months for competency services in jails across the state. None of these people have actually been convicted of any crime, but they are held in jails ill-equipped to meet their mental health needs even though a court has ordered that they be admitted to the state hospitals for the receipt of competency services due to concerns with their ability to stand trial. Among those in need of treatment was 27-year-old Ara Badayos, the A.B. in the Trueblood case, who was arrested in March 2014 for slapping a police officer and found incompetent to face the third-degree assault charge. Badayos was evaluated. With no bed available at Western State, Badayos was placed in solitary at the Snohomish County jail, where she refused to take medication. Not surprisingly, she was found incompetent. But instead of quickly getting her treatment to restore her mental health, Badayos waited, and waited, in the Snohomish County Jail. She lingered in solitary confinement — 23 hours a day in an 8-foot-by-10-foot cell — for nearly a month.   Waiting to become sane, she got sicker. In the fall of 2014, her lawyer, Cassie Cordell Trueblood, with Disability Rights Washington and the American Civil Liberties Union filed suit seeking class-action status on behalf of all mentally ill people held in Washington jails for extended periods of time. In short the courts ruled in favor of Trueblood and as a result DSHS is being fined each day until a system is in place that responds timely and appropriately to those that need their competency restored. The Trueblood Court (aka Federal District Court)  has ordered the State of Washington to take immediate steps to reduce the length of time class members are waiting in jail so that no one is waiting more than seven days for admission to a hospital for competency services or fourteen days for a fully completed jail-based competency evaluation. DSHS has been unable to comply with reducing wait times for admission services to seven days or less.  Because of the failure to reduce wait times, the State of Washington has been found in contempt of court. The State is paying daily fines to the Court. So far, the state has been fined around $20 million. The Court has also ordered that the fines be spent on diverting class members out of jails.  This money has been made available through a series of RFPs issued by the court. Pierce County applied for grant funds under the second RFP and was successful in securing $1.4 million to provide services to Trueblood class members. These services will include support through a resource center in collaboration with pre-trial and jail transition services. Also, these services will include a component of housing to help class members stabilize their lives. Next, I’d like to talk about one of our most recent investments.

Trueblood: The key issues Prolonged waiting in jail for services Competency Assessment within 14 days Competency Restoration (inpatient) within 7 days Delay violates an individual’s constitutional rights DSHS sanctioned for delays Court Monitor controls distribution of fines Goal: Reduce wait time at each intercept point

Trueblood Intercepts Sequential Intercept Model Intercept 1 – Law Enforcement/Emergency Services pre- arrest diversion Intercept 2 – Initial Detention/Initial Court Hearings – Post booking diversion Intercept 3 – Jails and Courts diversion programs Intercept 4 – Reentry from jail or prisons – Community Corrections/ Community Support Intercept 5 – Post incarceration/Community Corrections/ Community Support

Trueblood Phase II Budget & Timeline $1,994,828 awarded Launch March 1, 2018 Eighteen Months of funding Data collection and reporting required to the Court Monitor

Trueblood Phase II Staffing Superior Court Case Coordinator (Pre-trial) Prosecuting Attorney DPA and Legal Assistant DAC Social Worker (MSW) Greater Lakes Mental Health Case Managers and Therapists Catholic Community Services Housing Navigator Pierce County Alliance SUD Assessment Rent Subsidies DPA Education (Conference) Administrative costs

Trueblood Phase III Proposed Budget & Timeline $1,410,570.00 recommended by the Review Committee to the Court Launch July 1, 2018 Eighteen Months of funding Data collection and reporting required to the Court Monitor

Questions?