Community Triage Center: Preliminary Baseline Data August 22, 2017 - - PowerPoint PPT Presentation

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Community Triage Center: Preliminary Baseline Data August 22, 2017 - - PowerPoint PPT Presentation

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Community Triage Center: Preliminary Baseline Data August 22, 2017 suzanne.smith@augie.edu INTERCEPT 0 COMMUNITY SERVICES Intercept 0: Community Services Helpline* Human services providers Carroll Institute* Southeastern

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Community Triage Center: Preliminary Baseline Data

August 22, 2017 suzanne.smith@augie.edu

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INTERCEPT 0 COMMUNITY SERVICES

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Intercept 0: Community Services

  • Helpline*
  • Human services providers
  • Carroll Institute*
  • Southeastern Behavioral Health
  • Healthcare providers
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Helpline Calls

National Suicide Prevention Lifeline: 1,538 calls

2016 Identified Needs for Mental Health & Addictions (Summary) Triage Services 756 Substance Abuse 1,128 Mental Health 537 Other (counseling, support groups, etc.) 1,666 Suicide Prevention 2,056 Talklines/Warmlines 3,005 Grand Total 9,148

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Carroll Institute

Clients served annually: 2,000

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The Arch

87 beds: 24 female + 63 male Male waitlist: December Female waitlist: End of September Average length of stay: 60 days Total discharges: 429 (FY16), 551 (FY17)

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The Arch

3% 0% 83% 4% 5% 0% 0% 5% 0%

Referral Sources, FY2017

Alcohol/Drug Provider Community Hospital Court/Criminal Justice Department of Social Services Family/Self/Friend Human Services Center Indian Health Services Other Other Social Services

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The Arch

41.72% 27.51% 26.34% 0.47% 0.47% 1.63% 0.23% 0.00% 0.70% 0.47% 0.23% 0.23% 31.76% 7.62% 26.32% 5.08% 10.89% 9.26% 0.00% 4.36% 1.27% 2.54% 0.54% 0.36%

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00% 40.00% 45.00%

Discharges, FY16 and FY17

FY16 FY17

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New Horizons

2015 2016 Total Admissions 145 63 Average Length of Stay 11.3 9.8 Average Daily Census 6.9 2.4

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New Horizons

2015 2016 To Inpatient 51 13 To Slip Slot 27 16 To Outpatient 45 16 IVC Dropped 6 1 Terminated 20 20 Total Discharges 149 66

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INTERCEPT 1 LAW ENFORCEMENT

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Intercept 1: Law Enforcement

  • Calls for Service*
  • Mobile Crisis Team*
  • Arrests and Charges*
  • Detox and Sobering Center*
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Calls for Service

Total calls in 2016: 127,547

Incident Type Calls % of All Calls Disorderly Subjects 12,462 9.77 Accident 8,988 7.05 Larceny 4,594 3.60 Family Dispute 4,416 3.46 24/7 Violation 4,048 3.17 Check Wellbeing 3,946 3.09 Narcotics Violation 3,738 2.93 Intoxicated Subject 2,769 2.17 Prisoner Transport 2,611 2.05 Vandalism 2,537 1.99 Abandoned Vehicles 2,466 1.93 Assault 2,419 1.90

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Calls for Service

Most calls are resolved on scene.

127,547 79,114 15,145 9,734 1,326 98

  • 20,000

40,000 60,000 80,000 100,000 120,000 140,000 Total calls Necessary Action Taken Arrest / Lodged at Jail Citation Lodged at Detox Lodged at McKennan

Selected Call Outcomes, 2016

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Mobile Crisis Team

In 2016, MCT’s diversion rate was 94.7%.

Calls Received 572 Calls Declined 85 Calls Taken 487 Remained Home 417 85.6% Voluntary Admission to Avera Behavioral Health 30 6.2% Detox / Other Placement 14 2.9% Involuntary Hold 26 5.3%

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Which calls result in arrest?

Incident Type Calls Resulting in Arrest % of Incident Type Resulting in Arrest % of All Calls Resulting in Arrest 24/7 Violation 2,272 56.13% 15.00% Narcotics Violation 2,014 53.88% 13.30% Disorderly Subjects 1,545 12.40% 10.20% Warrant Service 1,352 59.09% 8.93% Assault 922 38.11% 6.09% Shoplifting 848 44.40% 5.60% DWI 842 61.59% 5.56% Runaway 517 31.51% 3.41% Family Dispute 472 10.69% 3.12% Non Hazardous Moving Violations 371 36.92% 2.45% Traffic 337 47.13% 2.23% Intoxicated Subject 293 10.58% 1.93%

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Which calls result in arrest?

12,462 8,988 4,594 4,416 4,048 3,946 3,738 2,769 2,611 2,537 1,545 260 116 472 2,272 62 2,014 293 28 69

2,000 4,000 6,000 8,000 10,000 12,000 14,000 Disorderly Subjects Accident Larceny Family Dispute 24/7 Violation Check Wellbeing Narcotics Violation Intoxicated Subject Prisoner Transport Vandalism

Calls and Arrests by Call Type, 2016

Calls Arrests

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Arrests and Charges

Total arrests in 2016: 11,993

2314 986 474 859 160 341 608 886 799 108 492 77

500 1000 1500 2000 2500 3000 3500 Drug/Narcotic Disorderly Conduct DUI Shoplifting Liquor Law Violations Trespassing

SFPD and Sheriff's Office Arrests, 2016 (Selected Charges)

Alone Plus Other Charges

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Detox

Clients: 241 (165 IVCs) Bed days: 1,552 Average daily census: 4.25

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Sobering Center

Total bookings: 2,621 Bookings per day: 7.18 Average length of stay: 9.7 hours

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INTERCEPTS 2 AND 3 INITIAL DETENTION AND JAIL

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Intercepts 2 and 3: Jail

  • Bookings*
  • Mental health and substance abuse*
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Bookings

24% 76%

All Bookings (2016)

MH or SUD Neither MH nor SUD

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Bookings

Bookings % of all bookings MH or SUD 4,201 24.1% SUD alone 1,942 11.1% MH alone 1,465 8.4% Co-occurring 794 4.5% Neither MH nor SUD 13,256 75.9% All bookings 17,454

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Bookings

10,308 1,039 1,428 478 3,139 240 468 354

2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 Unsentenced (Minnehaha County) Sentenced (Minnehaha County) Contract / Other County All others

Bookings by Legal Status

Neither MH nor SUD MH or SUD

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Bookings

10,455 2,798 1,556 419 2,811 1,390 560 274

2,000 4,000 6,000 8,000 10,000 12,000 14,000 Misdemeanor Felony Violent Probation violation

Selected Characteristics

Neither MH nor SUD MH or SUD

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Length of Stay

331 353 247 434 180 216

50 100 150 200 250 300 350 400 450 500 MH or SUD SUD MH Co-occurring Neither MH nor SUD All bookings

Average Length of Stay (hours)

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Length of Stay

119 757 177 263 279 1,147 264 342

200 400 600 800 1000 1200 1400 Unsentenced (Minnehaha County) Sentenced (Minnehaha County) Contract / Other County All others

Average Length of Stay by Legal Status

Neither MH nor SUD MH or SUD

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Intercepts 2 and 3: Jail

  • Next steps:

– Improve data quality with universal mental health screening at intake – Data matching to identify at booking people known to community-based behavioral health providers – Criminogenic risk assessment tool

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SUPER UTILIZERS

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Super Utilizers

62.1% 17.9% 8.2% 4.2% 2.6% 1.4% 1.1% 0.7% 0.5% 0.2% 0.2% 1.1% 29.4% 16.9% 11.6% 7.9% 6.0% 4.0% 3.5% 2.5% 2.2% 1.1% 1.0% 14.0%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 1 2 3 4 5 6 7 8 9 10 11 12+ Number of Bookings in 2016

Super Utilizers (All Bookings)

People (%) Bookings (%)

n=9,533 n=20,169 Top 5% 490 people 28.3% of bookings Top 1% 102 people 14.0% of bookings

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Super Utilizers

66.9% 12.7% 5.5% 1.7% 2.6% 1.3% 0.6% 0.9% 1.2% 0.3% 0.4% 0.3% 0.1% 0.3% 0.4% 5.1% 19.3% 7.3% 4.8% 1.9% 3.7% 2.2% 1.3% 2.1% 3.0% 0.7% 1.2% 0.9% 0.5% 1.0% 1.7% 48.4%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Number of Bookings in 2016

Super Utilizers (Detox and Sobering Center)

People (%) Bookings (%)

Top 5% 20 people 48.4% of bookings n=782 n=2,708

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Super Utilizers

62.6% 17.9% 8.3% 4.2% 2.5% 1.4% 1.0% 0.7% 1.3% 33.0% 18.8% 13.1% 8.9% 6.7% 4.5% 3.6% 2.8% 8.0%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00%

1 2 3 4 5 6 7 8 9+

Number of Bookings in 2016

Super Utilizers (Jail Bookings)

People (%) Bookings (%)

n=9,203 n=17,461 Top 5% 638 people 25.6% of bookings Top 1% 123 people 8.0% of bookings

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Super Utilizers

18.32% 34.95% 46.93% 54.87% 69.91% 6.52% 13.80% 21.70% 19.49% 29.31% 8.88% 13.01% 12.16% 15.38% 10.66% 2.91% 8.15% 13.07% 20.00% 29.94% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 1 2 3 4 5+ Number of Bookings in 2016

Self-reported SUD and MH Disorders by Number of Bookings

SUD or MH SUD alone MH alone Co-occurring

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Super Utilizers

Compared to those who don’t report problems, people who self-report behavioral health problems are:

  • 2.14 times as likely to have multiple bookings
  • 5.74 times as likely to have 5+ bookings

Multiple (2+) bookings RR RR 95% conf. interval SUD or MH 2.14 2.03 to 2.25 SUD 1.87 1.77 to 1.97 MH 1.26 1.17 to 1.36 COOC 2.18 2.07 to 2.30 5+ bookings RR RR 95% conf. interval SUD or MH 5.74 4.88 to 6.76 SUD 3.28 2.80 to 3.84 MH 1.04 0.82 to 1.33 COOC 5.43 4.68 to 6.31

n=9,203

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COSTS AND CAPACITY

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Super Utilizers

Top 1%

  • 123 people with 9+ bookings in 2016
  • 69 total days in jail per person, on average
  • 8,500 bed days annually
  • 23 beds per day
  • $807,492 annually
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Super Utilizers

Top 1% and self-reported behavioral health problems

  • 106 people with 5+ bookings in 2016
  • 71 total days in jail per person, on average
  • 7,510 bed days annually
  • 21 beds per day
  • $713,427 annually
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Super Utilizers

Top 5%

  • 638 people with 5+ bookings in 2016
  • 58 total days in jail per person, on average
  • 36,781 bed days annually
  • 101 beds per day
  • $3,494,270 annually
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Super Utilizers

Top 5% and self-reported behavioral health problems

  • 446 people with 5+ bookings in 2016
  • 62 total days in jail per person, on average
  • 27,710 bed days annually
  • 76 beds per day
  • $2,632,518 annually
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Estimated Potential Demand

Source Annual Admissions Daily Admissions Length of Stay (hours) Daily Beds Occupied Detox 241 0.66 155 4.3 Sobering Center 2,621 7.2 9.7 3 Pre-arrest triage 2,656 7.3 279 84.6 Redirected from hospital 98 0.3 72? 0.8 Total 5,616 15.46 92.7

Observed length of stay

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Estimated Potential Demand

Source Annual Admissions Daily Admissions Length of Stay (hours) Daily Beds Occupied Detox 241 0.66 72 2 Sobering Center 2,621 7.2 9.7 3 Pre-arrest triage 2,656 7.3 72 21.8 Redirected from hospital 98 0.3 72 0.8 Total 5,616 15.46 27.6

72 hour maximum

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DEMOGRAPHICS

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Sex

29% 71% 0%

Arrests by Sex, 2016 (SFPD & SO)

51% 49%

MCT Calls by Sex, 2016

34% 66%

Carroll Institute Clients by Sex, 2016

Female Male

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Race

51% 26% 17% 1% 0% 5% 0% 0% 56% 25% 9% 1% 6% 3% 76% 9% 4% 2% 4% 5% 90% 2% 3% 1% 2% 3% 1% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

White Native American Black Asian Multiracial Hispanic Other Unknown

Race by Program, 2016

Arrests Carroll MCT Population

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Arrests by Age

100 200 300 400 500 600 700 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 80

Arrests by Age, 2016 (SFPD & SO) 30 years 40 years

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MCT Calls by Age

11.30% 13.30% 31.00% 18.10% 11.70% 9.40% 2.30% 0.60% 0.60% 1.60% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00%

MCT Calls by Age, 2016

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Carroll Institute Clients by Age

0% 7% 13% 38% 24% 12% 4% 0% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45%

Less than 18 18 to 20 21 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 and over

Carroll Institute Clients by Age, 2016

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PRELIMINARY TAKEAWAYS

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Preliminary Takeaways

  • Goals (desired outcomes)

– Shift burden from CJ / ED, or – Increase access?

  • Target population
  • Point of intervention
  • Services
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suzanne.smith@augie.edu