1. Pierce County Criminal Justice Diversion Strategy: Trueblood Funding
Carol C. mitchell
Director, Justice Services & Special Projects

2. 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

3. 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

4. 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

5. 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

7. 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.

8. 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

9. 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

10. 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

11. 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

12. Trueblood Phase III Proposed Budget & Timeline
$1,410, 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

13. Questions?