1. Behavioral Health Community Crisis Services www.SBCounty.gov Community Crisis Services Community Crisis Response Teams –CCRT Crisis Walk In Centers – CWIC SB 82 Triage Engagement and Support Teams – TEST Crisis Residential and Crisis Stabilization Projects Assistant Director, Department of Behavioral Health Veronica Kelley, LCSW

2. www.SBCounty.gov Page 2 Behavioral Health  Community Crisis Response Teams – CCRT. One Children’s Crisis Response Team started 2004. Expanded to three teams 2006-2007  High Desert (Victorville, Hesperia, Adelanto, Barstow, Baker, Needles).  East Valley (San Bernardino, Rialto, Colton, Redlands, Yucaipa).  West Valley (Ontario, Fontana, Chino, Upland Rancho Cucamonga).  CCRT Adult services began in all regions 2008 -2009.  Services expanded to 24 hour coverage in April 2007. Coverage is On-Call over night. Crisis Services in San Bernardino County

3. www.SBCounty.gov Page 3 Behavioral Health  Crisis Walk-In Center opened: In Victorville in September 2007; In Morongo Basin in July 2008; and In Rialto March 2009.  Crisis Intervention Training (CIT) program began at Sheriff Academy in June 2008. Four Trainings a year, 32 hours. 8 hour refresher/Intro Training. Peace Officer Standards and Training (POST) approved. Crisis Services in San Bernardino County

4. www.SBCounty.gov Page 4 Behavioral Health Community-based program. Mobile Crisis Response in Three Regions. Mobile crisis response for psychiatric emergencies. Will have 24/7 staffing (eliminating On-Call coverage). Funded by Prop 63 – Mental Health Services Act (MHSA) and Medi-Cal. Community Crisis Response Teams - CCRT

5. www.SBCounty.gov Page 5 Behavioral Health To provide:  Crisis Intervention in the Least Restrictive Environment;  Alternative to Hospitalization;  Assist Law Enforcement with Assessment, Resources and Transportation;  Provide Education, Referral and Resources;  Crisis Intervention Training for Law Enforcement;  Trauma Response in the Community; and  Not limited to Danger to Self (DTS) or Danger to Others (DTO) criteria. Mission of CCRT

6. www.SBCounty.gov Page 6 Behavioral Health Each Team consists of 20 to 24 employees: Clinic Supervisor; Clinical Social Workers; Marriage & Family Therapists; Drug & Alcohol Counselors; Case Managers; and Peer/Family Advocates. CCRT Multidisciplinary Teams

7. www.SBCounty.gov Page 7 Behavioral Health Law Enforcement; Hospital Emergency Departments; Private Homes; Schools; Group Homes, Board and Care; Other Related Agencies; and Wherever someone in crisis is located within the County of San Bernardino. Where Does CCRT Respond to?

8. www.SBCounty.gov Page 8 Behavioral Health Types of CCRT Calls

9. www.SBCounty.gov Page 9 Behavioral Health CCRT Dispositions

10. www.SBCounty.gov Page 10 Behavioral Health Rialto – County operated M – F 8am -10pm currently Saturday 8am – 5pm (and most Holidays) Victorville – 24 Hour Operation Morongo Basin – 24 Hour Operation Crisis Walk In Clinics - CWIC

11. www.SBCounty.gov Page 11 Behavioral Health  CWIC is an Alternative to Hospitalization;  CWIC Screens for 5150 and 5585 and Provides Crisis Intervention;  Offers Psychiatric Medication Services; and  Offers Crisis Stabilization Services. What is CWIC?

12. www.SBCounty.gov Page 12 Behavioral Health CWIC Dispositions

13. www.SBCounty.gov Page 13 Behavioral Health  SB82 Investment in Mental Health Wellness Act of 2013 Offer Early Intervention to Strengthen Opportunity for Recovery and Wellness; Paraprofessional Staff with “Lived Experience;” Expand the Crisis Continuum of Care; Warm Hand Off to Resources and Services; Provide Timely and Effective Engagement; Reduce Hospital and Jail Recidivism; and Co-Location with Community Partners. Triage Engagement and Support Teams - TEST

14. www.SBCounty.gov Page 14 Behavioral Health  Seven Regional Sheriff Stations: Hesperia, Highland, Fontana, Victorville, Barstow, Big Bear, Twin Peaks;  Two Police Stations: Fontana and Rialto;  Jail Discharge Services: West Valley Detention;  California State University San Bernardino Counseling Center;  Public Defender’s Office;  Probation Offices: Barstow and Morongo Basin; and  Three CCRT Teams. Points of Access in the Community Potentially:

15. www.SBCounty.gov Page 15 Behavioral Health CCRT  24/7 Coverage  Multidisciplinary Teams  Field Calls from Multiple Sources Throughout the County  One Shot Crisis Intervention  Minimal Case Management  Brief Referral and Linkage  Transportation to Hospital TEST  Not 24/7 Coverage  Paraprofessionals  Calls related to Access Point  Referral and Linkage with Follow Up  Warm Hand Off to Services  Intensive Case Management for up to 60 days  Build a Collaborative with Partnering Agencies Program Comparison

16. www.SBCounty.gov Page 16 Behavioral Health  $26.1 Million CHFFA Grant Funds $3,945,906.00 : Round 2 – C risis R esidential T reatment –San Bernardino, Peso Way. $3,054,094.00 : Round 3 – C risis R esidential T reatment –Victorville, Sun Hill Dr. $5,886,185.00 : Round 4 – C risis R esidential T reatment –Fontana, Carob Ave and San Bernardino Ave. $5,330,668.00 : Round 4 – C risis S tabilization U nit-San Bernardino, Gilbert St and Windsor Dr. $4,605,681.00 : Round 5 – C risis R esidential T reatment-Joshua Tree. $3,050,000.00 : Round 5 – C risis S tabilization U nit-Fontana, Merrill and Redwood. C alifornia H ealth F acilities F inancing A uthority

17. www.SBCounty.gov Page 17 Behavioral Health SB82 – Investment in Mental Health Wellness Act of 2013: A competitive grant program for the purpose of developing mental health crisis support programs  Expand the Continuum of Care;  Increase Access to Crisis Services;  Offer Stability in the Least Restrictive Environment;  Assistance in Navigating the Behavioral Health System of Care;  Reduce Hospital and Jail Recidivism; and  Reduce Expenditures for Law Enforcement and Hospitals. S enate B ill 82

18. www.SBCounty.gov Page 18 Behavioral Health Referrals: Crisis Residential Treatment - CRT Law Enforcement Community Emergency Responders DBH Community Crisis Response Teams Hospital Emergency Departments DBH Outpatient Clinics Other County Medical Clinics DBH Crisis Walk In Clinics & Crisis Stabilization Units Psychiatric Hospitals and ARMC CSU

19. www.SBCounty.gov Page 19 Behavioral Health Referrals: Crisis Stabilization Unit (CSU) Law Enforcement Community Emergency Responders DBH Community Crisis Response Teams Hospital Emergency Departments DBH Outpatient Clinics Other County Medical Clinics Self Family Friends

20. www.SBCounty.gov Page 20 Behavioral Health  Having a crisis system in place with savvy, experienced staff and networks with law enforcement and other partners enabled SBC DBH to be effective Behavioral Health First Responder on December, 2, 2015.  Our experience and expertise set the baseline for crisis and recovery services from this Terrorist Attack  First Contact- from the triage site at the Golf Course.  Deployed CCRT staff to the Rock Church- law enforcement interviews, followed by the Hernandez Center- family reunification and finally Hampton Inn- Coroner notification.  300 clinical boots on the ground in the first 48 hours. December 2, 2015

21. www.SBCounty.gov Page 21 Behavioral Health  Developed Liaison teams from other non- crisis staff.  Continue to inform the recovery process as well as the limited role established in publications at state EMS.  Lessons Learned. December 2, 2015

22. www.SBCounty.gov Page 22 Behavioral Health Veronica Kelley, LCSW Assistant Director Department of Behavioral Health Email: vkelley@dbh.sbcounty.govvkelley@dbh.sbcounty.gov Phone: (909) 388-0814 Thank you