A M E N D E D N O T IC E O F W O R K SE SSIO N

T he D oña A na C ounty B oard o f C ounty C om m issioners w ill hold a W ork Session on T uesday, O ctober 31, 2017, at 9 :00 a .m . in the D oña A na C ounty C om m ission C ham bers, 1st F loor, D oña A na C ounty G overnm ent C enter, 845 N orth M otel B oulevard, Las C ruces:

• P ledge of A llegiance • R oll C all of C om m ission M em bers Present

C O M M ISSIO N C O N V E N E S A S T H E B O A R D O F C O U N T Y C O M M ISSIO N E R S IN O PE N SE SSIO N T O D ISC U SS:

1 . D iscuss the C risis T riage C enter

C O M M ISSIO N M A Y C O N V E N E IN C L O SE D SE SSIO N , to d iscuss a lim ited personnel m atter related to the h iring o f a perm anent C ounty M anager; as authorized by the O pen M eetings A ct, N M SA 1978 , § 10-15-1 (H ) (2).

T H E C O M M ISSIO N M A Y C O N V E N E IN O P E N SE SSIO N to take action, if any, on the closed session item .

C O M M ISSIO N A D JO U R N S A S T H E B O A R D O F C O U N T Y C O M M ISSIO N E R S.

T H IS A G E N D A IS SU B JE C T T O C H A N G EN O T E : D oña A na C ounty w ill ensure effective com m unication w ith individuals w ith disabilities and w ill, upon request, provide auxiliary com m unication aids and services to afford those individuals equal opportunity for participation in D oña A na C ounty sponsored m eetings, events, o r activ ities. A ny request should be m ade to the A m ericans w ith D isabilities A ct C oordinator, in w riting , o r by phone, a t least tw o business days prior to the event w here that accom m odation is needed. If you have any questions regarding exam ples o f reasonable accom m odations, please contact the A D A C oordinator, a t 525-5884 (voice) o r 525-2951 (TTY ), 845 N . M otel B lvd. L as C ruces, N M 88007 .

Spanish language in terpretation services are now available upon request fo r participation in D oña A na C ounty sponsored m eetings, events, o r activ ities. P lease contact the C om m unity & C onstituent Services O ffice a t 525­6163 , a t least tw o business days prior to the event. Servicios de interpretación en las juntas será disponible por petición . Por favor en contacto la O ficina de Servicio a la C om unidad y C onstituyentes 525-6163 por lo m enos dos d ías hábiles por adelantado para pedir este servicio.

AMENDED NOTICE OF WORK SESSION

The Doña Ana County Board of County Commissioners will hold a Work Session on Tuesday, October 31, 2017, at 9:00 a.m. in the Doña Ana County Commission Chambers, 1st Floor, Doña Ana County Government Center, 845 North Motel Boulevard, Las Cruces: • Pledge of Allegiance • Roll Call of Commission Members Present COMMISSION CONVENES AS THE BOARD OF COUNTY COMMISSIONERS IN OPEN SESSION TO DISCUSS: 1. Discuss the Crisis Triage Center COMMISSION MAY CONVENE IN CLOSED SESSION, to discuss a limited personnel matter related to the hiring of a permanent County Manager; as authorized by the Open Meetings Act, NMSA 1978, § 10-15-1 (H) (2). THE COMMISSION MAY CONVENE IN OPEN SESSION to take action, if any, on the closed session item. COMMISSION ADJOURNS AS THE BOARD OF COUNTY COMMISSIONERS.

THIS AGENDA IS SUBJECT TO CHANGE NOTE: Doña Ana County will ensure effective communication with individuals with disabilities and will, upon request, provide auxiliary communication aids and services to afford those individuals equal opportunity for participation in Doña Ana County sponsored meetings, events, or activities. Any request should be made to the Americans with Disabilities Act Coordinator, in writing, or by phone, at least two business days prior to the event where that accommodation is needed. If you have any questions regarding examples of reasonable accommodations, please contact the ADA Coordinator, at 525-5884 (voice) or 525-2951 (TTY), 845 N. Motel Blvd. Las Cruces, NM 88007. Spanish language interpretation services are now available upon request for participation in Doña Ana County sponsored meetings, events, or activities. Please contact the Community & Constituent Services Office at 525-6163, at least two business days prior to the event. Servicios de interpretación en las juntas será disponible por petición. Por favor en contacto la Oficina de Servicio a la Comunidad y Constituyentes 525-6163 por lo menos dos días hábiles por adelantado para pedir este servicio.

DOÑA ANA COUNTY BOARD OF COUNTY COMMISSIONERS

Doña Ana County Government Center 845 North Motel Boulevard

Las Cruces, New Mexico 88007 Telephone: (575) 647-7200 Toll-Free: (877) 827-7200

Health and Human ServicesInitiating Department

Jamie Michael. HHS Department DirectorContact Person Agenda Item Number

PRESENTATION TO PROVIDE UPDATE ON THE PROCESS FOR IDENTIFYING AN OPERATOR TO PROVIDE SERVICES IN THE CRISIS TRIAGE CENTER AND RECOMMENDATIONS FOR FUTURE

ACTION.

TITLE OF AGENDA ITEM TO BE CONSIDERED

Members of the reentry and diversion services advisory committee and the HHS director will present an update on the process for identifying an operator to provide services in the crisis triage center and recommendations for future action.

INCLUDING PRESENTATION OF OPTIONS FOR ACTION and ACTION REQUESTEDSUMMARY OF ITEM TO BE CONSIDERED

DESCRIPTION OF SUPPORTING DOCUMENTATION ATTACHEDAdvisory Committee Report Presentation

SUMMARY OF FINANCIAL IMPACTNone

ADMINISTRATIVE REVIEW AND APPROVAL

County Manager/ Agenda Review

Finance

Assistant County ManagerPurchasing Human Resources

Planning

DOCUMENT CONTROL

Original/s for signature? ___Yes No For Recording?___ Yes No

Return original/s to:

Send copy of recorded original/s (resolution and ordinances only) to: Name

Deadline for return of document/s? Yes, return by:

October 31. 2017Meeting Date

HistoryThe crisis triage center (CTC) was completed in 2013, prior to the completion the county approached three local behavioral health providers, two that served as the core service agencies and the local in-patient psychiatric hospital, to solicit their interest in jointly operating the CTC. They were not interested in operating the CTC, so the county released a request for letters of interest soliciting interest from organizations that operate crisis centers across the United States. Ten proposals were received, ranked, and the top three were selected for further review.

In early 2014 the BOCC narrowed the scope of work to the provision of emergency psychiatric evaluations for people in protective custody. As a result, two of the top three agencies decided to withdraw their proposal. The third agency was La Frontera, Inc. At the time La Frontera served as the state designated core service agency for the county. Contract negotiations began, but prior to signing the contract in 2015 La Frontera ceased operations as the core service agency.

Since that time the county has been working with the state to establish a licensing category and regulations for CTCs and initiating the Stepping Up Initiative. The licensing regulations are being developed by the state and the Stepping Up Initiative provided a strong framework to meet the goal of reducing the number of people with mental illness in the jail. Additionally, in 2017 the BOCC amended the CTC resolution to include reentry and diversion services, which led to the release of the current request for letters of interest (Attachment A). That request for letters of interest was released in July of 2107, it was sent to 30 local recipients and posted in the Sun News and Bulletin (Attachment B). Two organizations responded, iNetMedRx2 and La Clinica De Familia.

Stepping Up InitiativeThe Doña Ana County Board of Commissioners passed a resolution designating our county as a participant in the Stepping Up Initiative. Agencies and individuals came together to lay the ground work for addressing this issue. These groups worked on 1) jail diversion options to avoid incarceration, 2) coordinated community re-entry services to reduce recidivism, 3) comprehensive behavioral health crisis response system, and 4) data collection and tracking tools. The determined scope of work for the CTC was a result of these efforts and will support the implementation of jail diversion and re-entry models.

Through the Stepping Up Initiative technical assistance is available. As part of this learning experience, core principles and practices of modem crisis care have been identified. A national task force looked at crisis systems and recommends these elements be systematically “baked in” to excellent crisis systems. These essential principles and practices are:

• Embracing recovery• Significant role for peers• Trauma-informed care• Suicide safer care• Safety/security for staff and consumers• Crisis response partnerships with law enforcement

Sequential Intercept ModelThe Sequential Intercept Model was introduced to the county as part of the Stepping Up Initiative technical assistance. The model helps communities determine gaps in services and plan for community change. These activities are best accomplished by a team of stakeholders that cross multiple systems, including mental health, substance abuse, law enforcement, pretrial services, courts, jails, community corrections, housing, health, social services, peers, family members, and many others.

A Sequential Intercept Mapping workshop was held in Las Cruces in May of 2015. Forty-five people participated and developed a map that illustrates how people with behavioral health needs come in contact with and flow through the local criminal justice system. The participants in the workshop represented multiple local stakeholder including mental health, substance abuse treatment, health care, human services, corrections, advocates, law enforcement, health care (Attachment C).

The map identifies five (5) intercept points along the continuum. The two intercepts that have the most impact are intercepts 1 and 4. After the workshop two committees were formed to further the efforts associated with intercept #1, which is jail diversion and intercept #4, which is community reentry. These committees set goals, researched best-practice programs, and made recommendations for future action that included the use of the crisis triage center as a safe reentry and diversion facility.

Intended Scope of WorkThe scope of work is based on the sequential intercept mapping process that was done as part of the Stepping Up Initiative. The facility will provide 24/7 services to adults with mental health conditions. Appropriate care may include but is not limited to:1) 23-hour crisis stabilization and observation;2) initial assessment;3) brief intervention; and4) referral coordination, resource navigation, and warm hand-offs.

Proposed services for the operation of a reentry center for people released from the Doña Ana County Detention Center (DACDC) involve the operator working with the DACDC staff, medical providers, and other community organizations to bridge the transition from jail into the community. In future years, the center may also provide services to those discharged from in­patient psychiatric settings.

Proposed services for the operation of a diversion center will focus on people diverted from jail by law enforcement officers. These services will be part of future expansion. The operator will be required to work with county staff and local law enforcement agencies to design a law enforcement diversion program. Initially, this will be pre-arrest diversion, but may expand to post-booking.

These two functions have similar staffing and capacity needs, therefore by combining them it becomes a more cost-effective and efficient operation. Additionally, having the CTC located

near the detention center makes it convenient for law enforcement and accessible for people leaving the detention center.

Reentry and Diversion ServicesIntercept 4: Reentry from Jails and Prisons to CommunityIndividuals with mental and/or substance use disorders involved with the criminal justice system can face many obstacles accessing quality behavioral health services. Too often, many return to drug use, criminal behavior, or homelessness upon reentry into the community. Those with mental and/or substance use disorders have even greater challenges, and many end up cycling back through the system. Appropriate intervention will lead to improved public health and criminal justice outcomes.

Through the work of the reentry committee, the county jail and LCDF piloted a reentry program. Within a very short time it was evident that there is a substantial number of people leaving the jail that need, and are willing to take advantage of, reentry services. It also proved that people often have co-occurring primary care needs such as diabetes management along with a mental illness. Because of the effectiveness of reentry programs, Molina Healthcare awarded the county a grant for $395,000 to work with the local core services agency to provide these services. This was modeled after a program in Bernalillo County.

Intercept 1 Law Enforcement/911 DiversionA productive way to facilitate reaching individuals with mental illness locally is through the implementation and effective use of crisis care services. Crisis care services aim to quickly address psychiatric emergencies in the community. Ideally this diverts people from being involved in the justice system or unnecessary emergency room visits.

An example of a diversion facility is in Miami -Dade County. The purpose of the Mental Health Diversion Facility in Miami-Dade County is to create a comprehensive and cost-effective system of care for individuals with serious mental illnesses who account for disproportionate public expenditures in the criminal justice, homeless services, and acute care medical and mental health treatment systems. The judge responsible for leading this model spoke at the 2015 Domenici Public Policy Conference, providing an opportunity for local leaders to hear his story.

Services focus on the unique treatment needs and crime-related risk factors associated with this population; as well as strategies for cost containment that reduce recidivism and leverage state and federal resources to pay for services. Anticipated outcomes include decreased reliance on local taxpayer dollars, improved public safety and health, decreased chronic homelessness, and improved quality of life for county residents and visitors.

Financial ConsiderationsThere is not a designated, reoccurring source of county revenue for operations of the CTC. However, many of the services that will be performed are billable services under Medicaid, and research has indicated that the majority of the people served will be eligible for Medicaid. As a result, the county has always sought out a partnership with the local core seivice agency. Core service agencies have billing opportunities that other providers do not. In order to maximize

outside funding and reduce the on-going financial commitment from to county to fund operations, partnering with a core services agency is ideal.

Currently, the county has a grant from Molina Healthcare, one of the Medicaid managed care organizations, to provide jail reentry services and work with the core services agency. In order to effectively and appropriately use these funds, the county should begin services as soon as possible.

Advisory Committee RecommendationsCommunity members have contributed throughout the planning, designing, and now implementation of the crisis triage center. A six-member advisory committee reviewed the letters of interest, meet with each agency, and work with HHS and Detention Center staff to consider best-practices (Attachment D).

Although each agency has unique expertise and capacity, neither agency has experience operating a crisis triage center or providing re-entry and diversion services. This is a specialized and fairly new type of service provision. Crisis services for behavioral health emergencies began emerging over the past 10 years. Similar services are not provided in New Mexico. Because of the vulnerable population and the connection to public safety it is essential that services be delivered appropriately, by an experienced provider. Therefore, it is the recommendation of the advisory committee that a third agency with expertise be identified for a short-term contact to build local capacity.

The support of an agency that has a history and experience operating crisis services working alongside local providers will fill the gap in knowledge and expertise, resulting in a more efficient start up and a safer provision of care. One of the original top three agencies is well- know and recognized for providing crisis services and offers consultation services.

The advisory committee also provides the following recommendations.

• Maximize the billing capacity of the core services agency. Core service agencies can bill Medicaid for services other agencies cannot, therefore reducing the amount of subsidy needed from the county.

• Develop benchmarks for evaluation purposes, and continue evaluating as part of the Stepping Up Initiative, led by the NMSU Crimson Research team.

• Maintain and expand the advisory committee to help monitor implementation for at least the first year. The advisory committee should expand to include other agencies, including law enforcement, to help monitor and make continuous improvement recommendations regarding operations.

Attachment A

Resolution

DONA ANA COUNTY, NM Filed: 06/15/2017 02:48:49 PM Instrument#: 1714016 Page: 1 of 2

DOÑA ANA COUNTY RESOLUTION NO. 2017- 52

R ESO LU TIO N A M E N D I N G R E S O L U T I O N 2 0 1 3 - 5 7 CLA RIFY IN G TH E RO LE O F TH E CRISIS TRIA G E CEN TER

W HEREAS, the Doña Ana County Board of County Commissioners is tasked to represent and address the needs of its residents; and

W H ER EA S, a significant number of people in county jails have a mental health disorder or are receiving mental health services; and

WHEREAS, individuals experiencing a mental health crisis are cared for in emergency rooms of local hospitals, a t the Doña Ana County Detention Center, or other appropriate facility as defined by law; and

WHEREAS, Doña Ana County has an active Stepping Up Initiative that involves many community agencies working together to reduce the number of people in the Doña Ana County Detention Center that have a mental health disorder by identifying intercepts where people can safely move out of a criminal justice system into a healthcare system; and

W HEREAS, the Crisis Triage Center is dedicated to facilitating access to community-based care and resources that are specifically designed to provide appropriate care to people with mental health disorders; and

W HEREAS, the Crisis Triage Center is one of the important individual components o f a much larger system addressing those issues in Doña Ana County; and

W HEREAS, the Mission Statement for the Crisis Triage Center, developed with input from the community, is to provide a safe and secure environment for adults with serious mental health issues until they are stabilized beyond the crisis moment, and to establish linkages with services beyond the Crisis Triage Center through collaboration with community services. .. .

? ' • ■

NOW THEREFORE, BE IT RESOLVED that the Doña Ana County Board of County Commissioners, in the interest of the health and safety o f all residents, does hereby direct that: ; ,

v

• The preeminent intent of the Crisis Triage Center is respectful assistance andsupport for individuals experiencing mental health crisis so that they do not harmthemselves or others; and

• Jail and hospital diversion is to be the primary purpose of the Crisis Triage Center; and

• Through the Stepping Up Initiative pre-booking jail diversion and community re-entry programs it has been determined to be effective and well-suited functions of the Crisis Triage Center; and

• Operation of the Crisis Triage Center will be designed to meet the professional standards of law enforcement, and the requirements of law; and

• Doña Ana County will actively support larger community efforts to address mental

ni

Deputy Renee Torres

DONA ANA COUNTY, NM Filed: 07/15/2015 12:15:20 PM Instrument#: 1514828 Page: 1 of 2

RESOLUTION NO. 2015- 41

Resolution Supporting Doña Ana County’s Participation in the Stepping Up Initiative to Reduce the Number o f People with Mental Illnesses in Jails

WHEREAS, counties routinely provide treatment services to the estimated 2 million people with serious mental illnesses booked into jail each year; and

WHEREAS, prevalence rates o f serious mental illnesses in jails are three to six times higher than for the general public; and

WHEREAS, almost three-quarters of adults with serious mental illnesses in jails have co­occurring substance use disorders; and

WHEREAS, adults with mental illnesses tend to stay longer in jail and upon release are at a higher risk of recidivism than people without these disorders; and

WHEREAS, countyjails spend two to three times more on adults with mental illnesses that require interventions compared to those without these treatment needs; and

WHEREAS, without the appropriate treatment and services, people with mental illnesses continue to cycle through the criminal justice system, often resulting in tragic outcomes for these individuals and their families; and

WHEREAS, Doña Ana County and all counties take pride in their responsibility to protect and enhance the health, welfare and safety o f its residents in efficient and cost-effective ways; and

WHEREAS, the Doña Ana County Health and Human Services Department and Detention Center, along with the Sheriffs Department, 3rd Judicial District Attorney’s Office, New Mexico State University, Esperanza Guidance Center, Mesilla Valley Hospital, and Forensic Consortium of Doña Ana County have committed to working together to address this issue; and

WHEREAS, through the Stepping Up Initiative, the National Association of Counties, the Council of State Governments Justice Center and the American Psychiatric Foundation, are encouraging public, private and nonprofit partners to reduce the number of people with mental illnesses in jails;

IT IS HEREBY RESOLVED that the Doña Ana County Board of County Commissioners, do hereby sign on to the Call to Action to reduce the number of people with mental illnesses in our county jail, commit to sharing lessons learned with other counties in our state and across the country to support a national initiative and encourage all county officials, employees and residents to participate in Stepping Up. We resolve to utilize the comprehensive resources available through Stepping Up to: •

• Convene or draw on a diverse team of leaders and decision makers from multipleagencies committed to safely reducing the number of people with mental illnesses in jails.

8

rrett, Chair, District 1

Wayne IIancocfc*Vice-Chair, District 4 fFoj

Dr. David Ga(jjla,

£oiwttFa y i Againstlaniin -L. Rawson, District 3

¡strict 5arte Bena1

Lynn J. L ltiifs

*VA « m . r 1......

Page:2 of 2Instrument#: 151482807/15/2015 12:15:20 PMDONA ANA COUNTY, NM

Collect and review prevalence numbers and assess individuals’ needs to better identifyadults entering jails with mental illnesses and their recidivism risk, and use that baselineinformation to guide decision making at the system, program and case levels.Examine treatment and service capacity to determine which programs and services areavailable in the county for people with mental illnesses and co-occumng substance usedisorders, and identify state and local policy and funding barriers to minimizing contactwith the justice system and providing treatment and supports in the community.Develop a plan with measurable outcomes that draws on the jail assessment andprevalence data and the examination of available treatment and service capacity, whileconsidering identified barriers.Implement research-based approaches that advance the plan.Create a process to track progress using data and information systems, and to report onsuccesses

Adopted this 14th day of July 2015.

BOARD OF COUNTY COMMISSIONERS OFDOÑA ANA COUNTY, NEW MEXICO

/ Against

Via Telephone

Against¡strict 2

0/ Against

ATTEST:

COUNTY OF DONA ANA RESOLUTIONCounty Clerk STATE OF NEW MEXICO PAGES: 2

I Hereby Certify That This Inetrum ent Wae Filed forR ecordO n JUL 18, 2015 12:18:20 PM

W a p ;And We* Duly Recorded as Instrum ent # 1514020Of The Record* Of Dona Ana County

W itness My Hand And Seal Of Office,Lynn J Filins, County Clerk, Dona Ana, NM

Deputy V anessa Herrera

Attachment B

Request for Letters ofInterest

Doña Ana County

F Y 2018 Request for Letters of Interest (LOI)

Re-Entry and Diversion Services for Individuals withMental Illness

Release Date: June 28, 2017

Doña Ana County is seeking Letters of Interest (LOI) from organizations to provide re-entry and diversion services for individuals with mental illness who are involved in the criminal justice system.

BackgroundAs a participating member in the Stepping Up Initiative, the County is actively seeking an agency or agencies to provide services to people with mental illness who are involved in the criminal justice system as a result of their illness. The intended goal of the Stepping Up Initiative is to safely reduce incarceration of people with mental health conditions by providing appropriate comprehensive care. For more information on the Stepping Up Initiative please visit the following link: https://stepuptogether.org.The County has a facility designated as a crisis triage center (CTC). The intended purpose of the CTC is also to better care for people with mental health conditions by diverting them from jail and hospitals. Therefore, the re-entry and diversion services will be delivered in the CTC. The scope of work must meet the intention of the Resolution 2017-52 (attached).

Intended Scope of WorkThe facility will provide 24/7 services to adults with mental health conditions. Appropriate care may include but is not limited to 1) 23-hour crisis stabilization and observation; 2) assessment;3) brief intervention; and 4) referral coordination, resource navigation, and warm hand-offs. The scope of work will include the following:

1) Proposed services for the operation of a re-entry center for people released from the Doña Ana County Detention Center (DACDC) where the Operator will initially work with the DACDC staff and other community organizations to bridge the transition from jail into the community. In future years, the center may also provide services to those discharged from in-patient psychiatric settings.

2) Proposed services for the operation of a diversion center for people diverted from jail by law enforcement officers. These services will be part of future expansion. The operator will be required to work with county and local law enforcement agencies to design a law

enforcement diversion program. Initially, this will be pre-arrest diversion, but may expand to post-booking.

Format for SubmissionLetters of interest must not exceed four pages, and must be Times New Roman 12-point font with one inch margins.Letters of Interest must include the following information:

• Name and contact information for primary representative of interested agency or agencies.

• Brief description of organizational capacity and ability to perform this scope of work.• Clear description of ability to provide access to medical, mental health, and social service

resources.• List of collaborating agencies and their ability to accept referrals for medical, mental

health, and social service resources. Including proposed process for warm hand-offs and type of social support services offered.

• Proposed staffing plan.• Other services not describe above that your agency can offer in addition to this scope of

work if any.

Procurement Officer for this Request for Letters of Interest (LOI) is Donald E. Bullard, 845 N. Motel Blvd, Room 2-148A, Las Cruces, NM 988007, email donb@donaanacounty.org. and telephone 575-525-5927. All inquiries or requests regarding clarification of this LOI should submitted to the Procurement Officer for appropriate responses.

Completed Letters of Interest must be submitted to the Procurement Officer on or before Monday, July 31,2017 at 2:00 p.m. electronically to donb@donaanacountv.org and a hard copy mailed to Don Bullard at the above address. Once all the Letters of Interest are reviewed the County will contact the representative listed in the letter to discuss next steps.

Requests for access to the CTC for tours should be directed to:

Jackie Pacheco at 575-525-5869 or iacquelinp@donaanacounty.org.

Attachment C

Sequential Intercept Mapping Workshop

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Attachment D

Advisory CommitteeBios

Advisory Committee Members

1. Bernadette Pina

I am currently in independent practice in Doña Ana County. Previously, I served as the Director of Healthcare Services with Molina Healthcare of NM. I oversaw all case management services in Southern NM, (everything south of Socorro, NM) with responsibilities to 106 employees. I was also tasked with the Maternal Child Health pillar for the entire state.

I have worked in the healthcare-behavioral health field in Doña Ana County for the last 27 years. My work has focused in serving the most vulnerable of our community, namely the mentally ill. My work in administration enabled me to bring the Core Service Agency designation to bear during my tenure at Southwest Counseling Center in Las Cruces, as well as to implement a mobile crisis team for Doña Ana County which are still in place today. I was privileged to be part of the initial strategic committee when the Crisis Triage Center was just an idea over 6 years ago. The use of the building as a resource center and 23 hour facility is a great use of tax payer’s dollars.

I am a proud graduate of NMSU with a B. A. in Psychology and a M. A. in Counseling and Educational Psychology, with over 12 hours towards my PhD, and several hundred hours of continued educational credits. I am licensed at the Independent level as a Licensed Professional Clinical Counselor and a nationally Certified Case Manager.

I grew up in Las Cruces, attending Bradley Elementary, Court Jr. High, and Las Cruces High School. I continue to strive to make this community a better place to live, work, and play, not only for the current generation, but for generations to come.

2. Susie Kimble

Susie Kimble is a graduate of Texas A&M University with a Bachelor of Science in Marketing/Agriculture Economics. She is the CEO/Owner of Judy Enterprises, Inc. Strategic Information Group. She conducts healthcare information research, client relationship and network development, research on healthcare trends on the national, regional and state level. She also participates in monthly healthcare forums to gather information on changes, innovation and threats to healthcare services. Susie also had experience working closely with community organizations to develop an avenue for communication between agencies, families, providers and individuals struggling with behavioral health issues. She has served as Chair and Vice Chair on the New Mexico Behavioral Health Planning Council, and also served as Chair, Vice Chair, Secretary, Treasurer and Board Member of the Local Collaborative 3(Doña Ana County). She is an attendee of the Medicaid Directors Association National meeting and is also part of the SAMHSA Technical Assistance Leadership Academy. Susie is also familiar with in­patient psychiatric care, having worked at both Mesilla Valley Hospital and Memorial Medical Center.

3. Joe Tomaka

Joe Tomaka, Ph.D. is Stan Fulton Professor of Public Health Sciences and at NMSU and Director of Crimson Research. Dr. Tomaka, Ph.D., received his Baccalaureate degree from Geneseo State University (1987), and his Master’s (1990) and Ph.D. degrees (1993) in Social and Health Psychology from the State University of New York at Buffalo. Dr. Tomaka served as Assistant and Associate Professor at the University of Texas at El Paso where he served as Chair of the Department of Health Promotion, Associate Dean for the College of Health Sciences, and Director of the Interdisciplinary Health Sciences Ph.D. Program. In 2013, he came to New Mexico State University to serve as Associate Dean for Research in the College of Health and Social Services. Across his 25 years’ experience, Dr. Tomaka is or has been PI or Co-I on over 20 extramurally-funded projects and has over 60 peer-reviewed publications in a wide-variety of journals. Project funding has come from numerous sources including government agencies (NIH, SAMHSA) as well as private foundations (Paso Del Norte Health Foundation). He has evaluated a wide variety of health and social programs to include programs for disconnected youth, smoking cessation, SBIRT for alcohol risk reduction, drug/alcohol prevention programs, and drug court programs. He is currently a Program Evaluator for the Dona Ana County (DAC) Assisted Outpatient Treatment (AOT) Program and for the DAC Local DWI compliance monitoring and prevention programs. He has also mentored multiple undergraduate, Master’s, and Ph.D.-level theses and dissertations. His current research interests include assessment of individual differences in stress, appraisal, and coping, and the use brief interventions for health risk reduction.

4. Jason Duran

Education and Training

• B.S.N., New Mexico State University, Las Cruces, NM• New Mexico Association of Counties Medical Auditor• Director of Nursing Mentor• Clinical Trainer for Start-up Team

Professional experience

Health Services Administrator - Dona Ana County Detention Center.Serves as chief on-site administrator, responsible for the delivery of comprehensive contract services, including personnel selection/retention, budgeting, and coordinating care with internal and external resources. Development and implementation of policies, procedures, and protocols resulting in enhanced patient care, staff accountability, and adherence to accreditation standards. Member of NMAC audit team. Medical auditor for Curry, Co. and committee member to update medical accreditation standards.Director of Nursing - Dona Ana County Detention Center.

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Served as nurse manager for DACDC and accountable for the management of nursing practice, nursing education, professionalism and development. Worked with HSA, Site Medical Director, and site providers to ensure quality healthcare services meet the needs of patients and accreditation standards. Member of start-up team for detention centers that elect to privatize medical services. Team member for Visalia, CA, Fresno, CA, Panama City, FL, and Gainesville, FL clinical start up team.

ER Nurse - Memorial Medical Center.Working with physicians, mid-level providers, RNs, and paramedics to ensure quality patient care in a 28 bed emergency department. Charge nurse on night shift, mentor for new hires, preceptor for nursing students.

5. Brandi Gorzeman

I am currently the Director of Nursing for Corizon Health, who is contracted with the Dona Ana County Detention Center to provide medical and mental health services for detainees.

I graduated from NMSU in 1993 with an Associate’s Degree in Nursing. I worked for a Cardiologist for the first 10 years of my nursing career while obtaining my BSN. Some of my duties included working in the Cardiovascular lab, hospital rounds, ran cardiac rehabilitation, pacemaker clinics, in office lab procedures, stress test and other office nurse duties. I completed my BSN in 1997 at NMSU. In 2003 I became a School Nurse with the Las Cruces Public Schools. I was an elementary school nurse for 9 years, a middle school nurse for 2 two years and a high school nurse for a year. While I was a school nurse I chaired the leadership committee, and the CPR committee. In 2014 I started working as needed for Corizon health at Dona Ana County detention center. My duties included charge nurse, juvenile nurse, intake nurse, triage and history and physical examinations. In 2015 I went to work for the Department of Health as a School Health Advocate for the Southwest portion of the state. I was the medical oversight over 150 school nurses. I was part of the Immunization action coalition, teen pregnancy prevention coalition, school base health care centers, I worked on legislation to get emergency medications in schools and worked to get laws started to mandate school nurses in every school.

6. Tenika Sosa-Gonzales

Native New Mexican, lifelong resident of Mesilla Valley.

2007 Dona Ana Community College, Meritorious Associates Degree, General Studies

2009 Dona Ana Community College, Crimson Scholar, Associates Degree, Nursing

2016 Currently enrolled in WGU Master of Science in Leadership and Healthcare Management.

Currently the Director of Behavioral Healthcare Services at MMC.

2010 Behavioral Healthcare Staff Nurse Mesilla Valley Hospital.

2010-2011 Dona Ana County Detention Center Behavioral Healthcare Nurse.

2012-2013, 2015-2016 fulltime and part time Home Healthcare Nurse, service area was rural areas of southern Dona Ana County.

2012-2016 Director of Performance Improvement & Quality Assurance, Risk Management and Infection Control at Mesilla Valley Hospital.

Service lines included Psychiatric Intensive Care, Adult and Adolescent acute, Geriatric Acute, Adolescent Boys and Girls Residential Treatment, Acute Adolescent, Inpatient Substance Abuse Recovery and Partial Hospitalization.

2015- 2016 Served on the NMDOH Performance Improvement Committee for 30 day readmissions as a care provider.

2016- Current Disability Rights New Mexico Protection and Advocacy Advisory Council. Currently Chairperson of the Advisory Council.

APIC-Association of Professionals in Infection Control

NAMI-National Alliance on Mental Illness

NM and American Psychiatric Nurses Association

2016 Nominee for New Mexico Nursing Excellence Award in Behavioral Healthcare

2016 Participant in Stepping up Initiative

2016 Assisted Outpatient Treatment program team member

Reentry and Diversion Services at the CTC

BOCC Presentation October 31, 2017

Crisis Triage Center Presentation

March 14, 2017

Original Intent FundingTimeline of Activities Data Driven Future Action

D o ñ a A n a C o u n r vLas C r a t e s , N “"v Mexico

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Past Work

Site visilloHJM 17Oho LaborTable lop exercise RecommendaltonsEva ua ion P an na ysm Q¡ty/0ounty work

Pilot Menta Hea mStimulus funding S eason 10/2010 HJM 17State funds m m t PromotoraIt i M l ■ kxn ittonTraining 1/2012

2005 2010 2011UM iam i SafetyCommunity strategic S te vis t toConducted focus F sea frittingplanning conference Peoria, Arizona

Management PlanMeetings w ith * City/CountyMonim Hea ththe State and HS Building plans Senate Joint Federal Funding Work S m iMFirst Aid TrainingsSec Hyde Memonal 34 Requests 11/2011n DACCommunity

Resource Centers

BOCC approved 2Mcapital fo r building

Dec 2012

Recent Efforts

2013 2014 2015 2016

Contract with Local Agency La FronteraCounty Slate Licensing MedicaConsultant Collaboralion ContractReso ution ClearanceBuildingCompleted Release CDM Selection of top Community Stepping Up

3 proposals Planning Mtg Initiative

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aCounty Resolutions

• # 2013-57 & 2017-52• Respectful assistance and support for individuals

experiencing mental health crisis so they do not harm themselves or others

• Jail and hospital diversion is the primary purpose• Support community efforts to address mental health « Conduct appropriate evaluations in a secure

environment for persons detained by law

• Through the Stepping Up Initiative pre-booking diversion and community re-entry programs have been determined to be effective and well-suited

• MMC March 2015 - December 2015• People transported to ED by LEOs for

evaluation - 257• 64 (25%) qualified for direct transport to

place other than ED after medical clearance

• Service estimates• 6.4 people/month

functions of the CTC (added)

Data

y

Stepping Up• Jail Diversion

• Pre-arrest

• Post-arrest

• Community Reentry

• Data Driven Initiative

• Policy

Data• Detention Center First Q FY 18

• Monthly average bookings• 864 booking/month

• 378 have MH diagnosis• Reentry services estimates

• 292 people/month (felony)• Diversion services estimates

• 86 (misdemeanor)

Future Use

• How can CTC best serve the community?

Who - Adults diverted from jail orleaving jail

What - Stabilize, triage, & link to services

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Crisis Triage Diversion Center

Safe Reentry Center

Target Population ■ Individuals in crisis■ Deflected by LE

• Individuals released from jail

Prim ary Purpose • Stabilize■ Connect to services• Divert from jail or avoid

em ergency call

* Connect to services and assist with transition

* Stabilize (if needed)* Reduce recidivism

Staffing • Staff to greet/triage• Trained, qualified, and licensed clinicians• Medical oversight• Case managers• Peers

Length of stay ■ 23 hours or less

Linkages to care • Established relationships with treatment and social service providers

• Referrals to timely and culturally appropriate care

Slide provided by TAC 11/16

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Current Challenges

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Advisory Committee Recommendations

• Build local capacity by identifying an expert in crisis care

• Short-term contract to mentor and co­operate

17

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Core Principles and Practices of Modern Crisis

Care

• Embracing recovery• Significant role for peers• Trauma-informed care• Suicide safer care• Safety/security for staff and consumers• Crisis response partnerships with law

enforcement

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Advisory CommitteeRecommendations

Develop benchmarks for evaluationpurposes, and continue evaluating aspart of the Stepping Up Initiative.Continue the work of NMSU sCrimson Research

• Maximize the billing capacity of core services agency.- Medicaid reimburses for peer support

service & comprehensive community support services.

Advisory Committee Recommendations

• Use advisory committee to help monitor implementation for at least the first year.

• Include representatives from other community-based agencies, including law enforcement, to serve on committee.

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Recovery Innovation International

1) Get the facility open - Use the Molina funds to expand the reentry pilot with LCDF and the jail. Begin immediately, use Molina funds before June 30, 2018.

2) Build capacity - Contract with crisis provider to build local capacity then expand scope of service at CTC.

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