Kim Hemmersbach, LPC JJET Liaison Mercy Care Reaching In and Reaching Out: The JJET Approach Juvenile Justice Engagement Team Introduce myself and background. Find out who’s in the room; their familiarity with Medicaid programs and CFT process. Has anyone heard of JJET and worked with team? Kim Hemmersbach, LPC JJET Liaison Mercy Care

Learning Objectives How to build strong relationships with justice partners along with other stakeholders How to effectively coordinate care for justice involved youth Apply to your work the initiatives that promote better outcomes for delinquent/dependent youth

“Arizona Vision” Outcomes Optimizing the talents, resources of young adults Avoid delinquency Have success in school Be connected in their communities Become productive adults Establish foundation by introducing Az Vision

Building Relationships with Juvenile Justice and Other Stakeholders Being proficient in the 3 C’s Share vision Mutual respect and trustworthiness Keep your word – deliver on promises Have an open mind, listen to ideas Address issues when they arise 3 C’s are collaboration, communication, and conflict resolution Self-awareness: Court can create anxiety or provoke intense emotions for family member or even professional. Practice emotional intelligence in finding solutions, problem solve, and avoid anger in stressful situations Share vision Team approach(open mind)

How to Effectively Coordinate Care for Justice Involved Youth

Coordination of Care Detention Roster/JJET referral Detention stay is qualifying event Act timely Collaboration Referral for intake* Oversee service & discharge planning Promote natural settings/least restrictive *Connected 32 detained youth to intake Link the statue to the detention roster process Barriers: cannot reach JPO, CFT stuck on needs identification, promotion of least restrictive, family voice and choice, clinically sound services Allow to reduce recidivism and keep track of planning for TAY youth

Detention Roster & AHCCCS benefits Individuals are not eligible to receive AHCCCS benefits while incarcerated; and suspension, rather than termination, of AHCCCS benefits during any period of incarceration is economically efficient. Additionally, for individuals released from custody, suspension of benefits facilitates continuity of care and minimizes the number of uninsured because reinstatement of benefits is more timely. Retrieved from https://www.azahcccs.gov/AHCCCS/Initiatives/CareCoordination/justiceinitiatives.html AHCCCS suspension: explain criminal vs non-criminal complaint. Entry into detention, not length of stay. Language is important suspension, not termination Explain that meds are covered by County and clinic knows what to do

Coordination of Care Mental Health Block Grant Funding Can be utilized for detained youth when AHCCCS benefits have been suspended Covers the following services: Intake and assessments Therapy Case management Psychiatric evaluation CFT meeting Medication management appointment Any qualifying SED diagnosis qualifies for use of Mental Health Block Grant Funding (MHBG) Explain history of cases being closed in its entirety when youth entered detention now due to JJET program and MHBG cases being kept open to coordinate care, and plan for services Allowed for more reach-in Examples of SED North and South RBHA’s get MHBG funding

Coordination of Care Detention Roster-Statistics (10/01/2018-02/28/2019) Explain what happens to AHCCCS benefits when detained on criminal vs non criminal Total detained 272

Apply to your work the initiatives that promote better outcomes for both delinquent and dependent youth

Crossover Youth Practice Model (CYPM) Multi-System Crossover Protocol for Maricopa County The Crossover Youth Practice Model (CYPM) is a multi-agency collaboration which seeks to improve outcomes for youth who are dually-involved in the child welfare and juvenile justice systems by enhancing communication between agencies, increasing information sharing, and coordinating services intended to stabilize the family unit as early as possible so they can function without system involvement. Additionally, this model seeks to decrease the incidence of youth crossing between these two systems. Retrieved from https://www.mercymaricopa.org/assets/pdf/providers/forms/new-provider-manual-forms-and- attachments/Collaborative-Protocol-with-Maricopa-County-Juvenile-Probation-Department%20Scanned.pdf Breaking down silos Cross system training CYPM is state wide

Crossover Youth Practice Model The Multi-System Approach Justice involved youth Mental Health Services Social Services Education Services Health Services Substance Abuse Services Vocation Services Recreation Services Correctional Services Justice involved youth are typically involved in multiple systems, therefore they necessitate multi-systemic approaches to support them to remain in their community

Crossover Youth Practice Model Why focus on dually involved youth? More likely to experience failure in schools More extensive mental health needs More likely to experience formal court proceedings Younger at the time of first arrest Detained more often for longer periods of time Experience more frequent placement changes Higher rates of recidivism Link between childhood maltreatment and later delinquent behaviors

Georgetown University’s McCourt School of Public Policy (Center for Juvenile Justice Reform) Reduction in the number of youth placed in out of home care Reduction in the use of congregate care Reduction in the number of youth crossing over and/or becoming dually-adjudicated Reduction in the disproportionate representation of color; particularly in the crossover population Crossover Youth Practice Model (CYPM) In 2010, the Center for Juvenile Justice Reform developed the Crossover Youth Practice Model to address the unique needs of youth who fluctuate between and are known to the child welfare and juvenile justice systems. These youth are commonly referred to as “crossover youth http://cjjr.georgetown.edu/our-work/crossover-youth-practice-model/ Retrieved from http://cjjr.georgetown.edu/our-work/crossover-youth-practice-model/

Crossover Youth Practice Model Offense Frequency 2018 General Delinquency Population Dually Involved On average 4.4 offenses in history 49% four + offenses in history (includes VOPs and status) 21% four + delinquent offenses in history (felonies and misdemeanors only) On average 2.5 offenses in history 21% four + offenses in history (includes VOPs and status) 8% four + delinquent offenses in history (felonies and misdemeanors only) As of 02/28/19 455 CYPM since 05/2016. 142 current Data obtained from the Superior Court in Maricopa County, Juvenile Probation Department Based on active youth 06/30/18

Crossover Youth Practice Model Progress – 2018 36% Diversion 37% Probation Of all youth in the delinquency system (n=4,309) 13% Diversion 63% Probation Total 645 Dually Involved Youth (defined as an open delinquency case and an open dependency petition) ****The methodology used was the one used for the monthly active cases EXCEPT that when a youth is on Diversion and another case status, the Diversion case status is NOT counted. This makes it consistent with the prior snapshots. Of all of the dual wards from the snapshot (n=533) Data obtained from the Superior Court in Maricopa County, Juvenile Probation Department Based on active youth 06/30/18

Success Story Justice involved youth Mental Health Services Social Services Education Services Health Services Substance Abuse Services Vocation Services Recreation Services Correctional Services

For Questions/Additional Information Kim Hemmersbach, LPC hemmersbachk@mercycareaz.org 602-918-0226 Paula Krasselt, LPC, Court Services Administrator krasseltp@mercycareaz.org 480-215-8722

Resources Center for Juvenile Justice Reform – Georgetown http://cjjr.georgetown.edu/resources/ National Center for Mental Health and Juvenile Justice https://www.ncmhjj.com/ Annie E. Casey Foundation http://www.aecf.org/work/juvenile-justice/ https://www.azcourts.gov/orders/Administrative-Orders-Index/2017-Administrative-Orders Maricopa County Juvenile Probation Department (MCJPD) Collaborative Protocol https://www.mercymaricopa.org/assets/pdf/providers/forms/new-provider-manual-forms-and- attachments/Collaborative-Protocol-with-Maricopa-County-Juvenile-Probation-Department%20Scanned.pdf Department of Child Safety (DCS) Collaborative Protocol https://www.mercymaricopa.org/assets/pdf/providers/forms/new-provider-manual-forms-and- attachments/Collaborative-Protocol-with-Department-of-Child-Safety%20Scanned.pdf Crossover Youth Practice Model (CYPM) Collaborative Protocol https://www.mercymaricopa.org/assets/pdf/providers/forms/new-provider-manual-forms-and- attachments/Collaborative-Protocol-with-Maricopa-County-Juvenile-Probation-Department%20Scanned.pdf https://www.youtube.com/watch?v=nMS3rJVgH9k

References Transitions out of the Criminal Justice System. Retrieved from https://www.azahcccs.gov/AHCCCS/Initiatives/CareCoordination/justiceinitiatives.html Multi-System Crossover Protocol for Maricopa County. Retrieved from https://www.mercymaricopa.org/assets/pdf/providers/forms/new-provider-manual-forms-and- attachments/Collaborative-Protocol-with-Maricopa-County-Juvenile-Probation- Department%20Scanned.pdf Crossover Youth Practice Model. Retrieved from http://cjjr.georgetown.edu/our-work/crossover- youth-practice-model/

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