This project has been underway since September 2015. This project is focused on building a model of care versus implementing an existing model. To provide historical context, we’ve categorized our build-out in years (see Project Timeline).
The last quarter of 2015 focused an effort to “Define the Mission.” A leadership team was established that consisted of top leaders from Human Services and the Sheriff’s Office. A meeting was held with DHS Assistant Commissioner Jennifer DeCubellis to discuss how the vision for our project may intersect with the department’s vision for the state surrounding mental and chemical health services for legally involved individuals. A gaps analysis was completed, and long-range project goals were established.
A Year of Learning
The entire year of 2016 was dedicated to “Research & Design: Model & Data.” Initial steps to understand the practices of law enforcement and human services resulted in staff collaborating on an individual basis to problem-solve the needs of a few individuals in the jail that had been identified as “stuck” in jail due to individual mental or chemical health needs. A request for funding was submitted to DHS, and was subsequently awarded for 2016 with the understanding that the model formed could be replicable to other counties or regions. With a lofty vision in mind, an Operations Team was formed, consisting of leadership and direct service staff from the Sheriff’s Office and Human Services in order to carry out the mission set forth. A project management platform was developed due to the many individual projects underway, as a way to standardize communication, assure accountability, and track the project’s progress. Significant research was being conducted to find a model that could be integrated with the vision of our project. A state and national search for models indicated that many jurisdictions were investing heavily in crisis intervention training, pre-trial and re-entry programs, with none focusing on this type of diversion. Individual development projects began to take shape throughout 2016, with investments in technology, information systems, and staffing. The Blue Earth County Board also passed a resolution to be involved in the National Association of Counties’ “Stepping Up” Initiative. This has given us an opportunity to connect with projects across the nation.
Community Based Coordinator
On June 1, 2016, a human services staff person was dedicated to the person-level needs of this project on a full time basis. It was identified that there was a link between AMRTC and our jail, given that the majority of individuals being served by AMRTC for our county had been in our jail prior to hospitalization. These are also the individuals who struggled to be discharged effectively from AMRTC, resulting in many Does Not Meet Criteria (DNMC) days. The project worked with AMRTC staff to set up a regular briefing to coordinate care, and this staff acted in the capacity of a Community Based Coordinator. Although this was cumbersome to initially coordinate with AMRTC staff (due to many internal AMRTC changes and miscommunication), the development of this relationship has been highly beneficial to our county and the people we serve (see AMRTC Cost of Care chart). We attribute the decrease in AMRTC expenses to be directly related to implementation of this model of care coordination.
At this same time, the same staff person was instructed to dedicate time becoming familiar with jail practices and the needs of individuals in the jail. Although the goal was to become as proactive as possible, establishing credibility of this worker within the jail system was essential. Relationships with inmates and with jail staff were built, and common languages were developed. It was obvious that the chemical health needs of many inmates were not being addressed, and work was done to bring in additional resources to begin to address some of these needs. 169 individuals in jail were served by this worker during 2016.
Work on establishing a model of care the focused on diversion to prevent unnecessary incarceration continued. A pilot night was conducted in the jail to see first-hand the flow of booking and learn about potential ways to divert to community-based options. Although it was the intention to only observe and practice the screening tools that had been developed, a full diversion was conducted that evening. Weeks prior, this individual had dropped out of college, had lost her family support, received inpatient psychiatric care for a suicide attempt, and had just been introduced to IV drugs by a new peer group. This peer group was the subject of a drug task force raid, and this individual was also arrested, with no prior criminal history. This person refused to cooperate with law enforcement, but although scared, did allow our human services staff to create a plan for diversion to which law enforcement agreed. This person was served at the South Central Crisis Center for a few days and then entered an inpatient chemical dependency treatment program. Aftercare was provided through a halfway house, targeted case management services were provided, and months after the pilot night, this individual has reconnected with a healthy support system and is gainfully employed.
Meeting with MN DHS
Blue Earth County has the pleasure of hosting a full day meeting with Commissioner Piper, Assistant Commissioner Wilson, and Program Consultant Faye Bernstein regarding the progress of the project. A tour of the South Central Crisis Center was given, and a discussion was held stressing the importance of public-private partnerships. A tour of the jail was given, focusing on the pre-booking and intake areas of the jail, signifying the value of the space where negotiations for community diversions can occur. Having just completed the pilot night, the discussion focused on our profound learnings, and a vision for the future was conveyed. A request was made for funding for one more year, as a proof-of-concept year.
Name: The Yellow Line
The Yellow Line name was adopted in late 2016, signifying the yellow line that exists between the pre-booking area and the intake area of the jail. This line is significant, as crossing this line indicates a change in a person’s constitutional rights, or incarceration. Simply stated, the project’s goal is to frontload services ahead of the yellow line so that law enforcement and individuals may be able to consider alternatives to crossing the yellow line. Once crossed, services come in the form of pre-trial, jail-based services and re-entry services. Research has shown that no two jurisdictions look the same when it comes to programming and services. A model was created as part of the Yellow Line Project to indicate the plethora of options that jurisdictions can work with in order to expand the full continuum of care. The Yellow Line Project exists in a space where no services have been prior, in the Pre-booking, Screening and Triage column. (See Continuum of Care Graphic)
Many individual community outreach meetings occurred early in this project to solicit feedback and buy-in. Discussions were held with county commissioners, county administration, corrections, the county attorney, community providers, the hospital, public defender, Brown County Evaluation Center, Mankato Public Safety, the South Central Community Based Initiative, and our Mental Health Center. A large scale community meeting was held on December 2, 2016 to introduce the project to a wider audience and to provide an update to all interested parties. Approximately 60 people were in attendance, which included many other county human services and/or sheriff’s offices, and local legislators. Without these stakeholders working together, the Yellow Line Project would have never had a chance to make this positive change for our community. (View Timeline of Yellow Line Project)