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D R E X E L U N I V E R S I T Y &

U N I V E R S I T Y O F P I T T S B U R G H

Blair County Report of the Cross-Systems Mapping Workshop

June 8th and 9th, 2011

Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System

Blair County, PA Mental Health and Justice Center of Excellence Report, June 2011

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Facilitator

Patricia A. Griffin, PhD, Senior Consultant

Other Support

Sarah Filone, MA, Project Coordinator

Katy Winckworth-Prejsnar, Research Coordinator

Center of Excellence Staff

David DeMatteo, JD, PhD Sarah Filone, MA

Patricia Griffin, PhD Kirk Heilbrun, PhD

Edward P. Mulvey, PhD Marcel Schipper

Carol Schubert, MPH Katy Winckworth-Prejsnar, BA


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Table of Contents

Transforming Services for Persons with Mental Illness in Contact With the Criminal Justice System

Introduction ...................................................................................................................................... 5

Background ...................................................................................................................................... 5

About the Workshop ......................................................................................................................... 6

Objectives of the Cross-Systems Mapping Exercise ....................................................................... 6

Keys to Success ............................................................................................................................... 7

Blair County, Pennsylvania Cross Systems Mapping

Blair County Cross Systems Map .................................................................................................... 9

Blair County Cross Systems Narrative ........................................................................................... 10

Intercept I: Law Enforcement / Emergency Services ........................................................ 12

Intercept II: Initial Detention / Initial Court Hearing ........................................................... 18

Intercept III: Jails / Courts ................................................................................................. 20

Intercept IV: Re-Entry ....................................................................................................... 24

Intercept V: Community Corrections / Community Support .............................................. 26

Blair County Action Planning

Blair County Priorities ..................................................................................................................... 30

Blair County Action Plan ................................................................................................................ 31

Conclusions and Summary

Conclusion ..................................................................................................................................... 41

Closing ........................................................................................................................................... 41


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List of Appendices

Appendix A – Participant List ......................................................................................................... 42

Appendix B – Summary Involuntary Commitments (302b) initiated by the Police......................... 47

Appendix C – Blair County Prison General Statistics 2010-2011 .................................................. 48

Appendix D – Blair County Prison Drug & Alcohol Statistics ..................................................... ...55

Appendix E – Blair County Prison Adult Parole Statistics ............................................................. 56

Appendix F – Mental Health First Aid- Development Plan of Action ………………………………..60

Appendix G – Northstar Support Services What You Need to Know if You are Arrested

Brochure…...……………………………...………………………………………………...………………………...…………63


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Blair County, Pennsylvania

Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System

Introduction

The purpose of this report is to provide a summary of the Pennsylvania Mental Health and Justice Center of Excellence Cross-Systems Mapping workshop held in Blair County, Pennsylvania, on June 8th and 9th, 2011, conducted at The Arc of Blair County. Blair County MH/MR and other stakeholders hosted the workshop as part of an ongoing process of developing collaborative systems of support for individuals who have mental illness and who come in contact with criminal justice. This report (and accompanying electronic file) includes: A brief review of the origins and background for the workshop; A summary of the information gathered at the workshop; A cross-systems intercept map as developed by the group during the workshop; A description of each intercept along with identified gaps and opportunities; An action planning matrix as developed by the group; and Observations, comments, and recommendations to help Blair County achieve its goals.

Background

Jim Hudack, Blair County MH/MR Administrator, and multiple other stakeholders requested the Center of Excellence Cross-Systems Mapping workshop to promote progress in addressing criminal justice diversion and treatment needs of adults with mental illness in contact with the criminal justice system. As part of the workshop, they were requested to provide assistance to Blair County with: Creation of a map indicating points of interface among all relevant Blair County systems; Identification of resources, gaps, and barriers in the existing systems; and Development of priorities to promote progress in addressing the criminal justice diversion

and treatment needs of adults with mental illness in contact with the criminal justice system. Prior to the workshops, the Center of Excellence gathered information about Blair County through a Community Collaboration Questionnaire and gathering of documents relevant to the population. The participants in the workshops included 53 individuals representing multiple stakeholder systems including mental health, substance abuse treatment, human services, corrections, Commissioners, law enforcement, probation and parole, and the courts. A complete list of participants is available in Appendix A (pg.42) of this document. Patricia A. Griffin, PhD, facilitated the workshop sessions. Sarah Filone, MA, and Katy Winckworth-Prejsnar also provided support.


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About the Workshop

Upon receiving a grant from the Pennsylvania Commission on Crime and Delinquency and the Pennsylvania Department of Public Welfare‘s Office of Mental Health and Substance Abuse Services in late 2009, the Pennsylvania Mental Health and Justice Center of Excellence was developed as a collaborative effort by Drexel University and the University of Pittsburgh. The mission of the Center of Excellence is to work with Pennsylvania communities to identify points of interception at which action can be taken to prevent individuals with mental illness from entering and penetrating deeper into the justice system. The Center of Excellence workshops, Cross-System Mapping and Taking Action for Change, are unique services tailored to each Pennsylvania community. These workshops provide an opportunity for participants to visualize how mental health, substance abuse, and other human services intersect with the criminal justice system.

This workshop is unlike other types of consultations or staff development training programs. A key element is the collaborative process. Meaningful cross-system collaboration is required to establish effective and efficient services for people with mental illness and co-occurring substance use disorders involved in the criminal justice system. This makes the composition of the group extremely important. While some workshops involve advertising to the entire provider community, it is essential in the Cross-System Mapping workshops that the organizers gather a group that represents key decision makers and varied levels of staff from the relevant provider systems. Center of Excellence staff works with this group, serving as expert guides to help:

Create a cross-systems map indicating points of interface among all relevant local systems; Identify gaps, opportunities, and barriers in the existing systems; Optimize use of local resources; Identify and prioritize necessary actions for change; and Develop an action plan to facilitate this change. Upon completion of the workshops, the Cross-Systems Map included in the report is provided in both print and electronic formats. It is meant to be a starting point. The electronic files can be revised over time to reflect the accomplishments and changes in the planning process.

Objectives of the Cross-Systems Mapping Exercise

The Cross-Systems Mapping Exercise has three primary objectives: 1. Development of a comprehensive picture of how people with mental illness and co-occurring

substance use disorders move through the Blair County criminal justice system along five distinct intercept points: Law Enforcement and Emergency Services, Initial Detention/Initial Court Hearings, Jails and Courts, Re-entry, and Community Corrections/Community Support.

2. Identification of gaps, resources, and opportunities at each intercept for individuals in the

target population. 3. Development of priorities for activities designed to improve system and service level

responses for individuals in the target population.


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Keys to Success

Existing Cross-Systems Partnerships Blair County‘s history of collaboration between the criminal justice and behavioral health systems is reflected in a number of existing local efforts that were identified prior to the mapping. For example:

Blair County MH Program Director and the Blair County MH/MR Administrator participate on the Blair County Criminal Justice Advisory Board (CJAB)

MH/D&A/CJ Complex Case Review: In September of 2009 a workgroup convened made up of directors/supervisors from the County MH/MR, County Adult Probation, Blair County Drug- & Alcohol, the county MH program sub-contractors for case management Altoona Regional Health System and Home Nursing Agency, Blair County Prison and Prime Care Health began to meet on a regular basis to identify areas for improvement within existing resources to increase access to BH services at the Blair County Prison and to do aftercare plans for complex cases.

o This group continues to meet bi-weekly to discuss and arrange aftercare for complex cases--- The MH Program through the ARHS sub-contract facilitates these bi-weekly meetings

o The MH/D&A/CJ Complex Case Review has been successful at shortening incarceration time for individuals by facilitation of aftercare plans.

o Three case managers have been identified as forensic specialists and through their consultation and formal training we are working to increase the COD capability of all MH and D&A case managers and probation officers.

In July 2010 there was a Meet & Greet held for the County MH D&A Case Management and staff with Adult Probation for the purposes of sharing information regarding their respective roles and responsibilities.

September through December 2010, the County MH Program, through their sub-contract with Altoona Regional Health System (ARHS) provided four two-hour trainings for the persons identified above on the basis of Treatment and Support Services for persons with MH, D&A, and co-occurring MH/D&A disorders.

The ARHS provides law enforcement training on a bi-annual basis on the MH Procedures Act and related topics.

MH/MR provided a first Mental Health First Aid Training and will continue to explore trainings in the future.

Representation from Key Decision Makers in the Workshops

The workshops included wide cross-system representation and involved many of the key decision makers including two County Commissioners, the President Judge, the Sheriff, Warden of the jail, and Chief of Probation.

Opening remarks by Jim Hudack, Blair County MH/MR Administrator, welcomed participants and introduced the facilitators. Mr. Hudack also set the stage and established a clear message as to the importance of the workshop. He noted that there are often ―merged lines between criminal justice and behavioral health‖ that require close collaboration.

Data Collection


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Blair County‘s Criminal Justice Advisory Board has taken great strides in compiling informative data from county prison, parole, and the courts. Some of this data is represented in Appendix B through D.


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Blair County Cross Systems Map


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Blair County Cross Systems Narrative

The Cross-Systems Mapping exercise is based on the Sequential Intercept Model developed by Mark Munetz, M.D. and Patty Griffin, Ph.D.,1 in conjunction with the National GAINS Center. In this workshop, participants were guided to identify gaps in services, resources, and opportunities at each of the five distinct intercept points of the criminal justice system. This narrative reflects information gathered during the Cross-Systems Mapping Workshop. It provides a description of local activities at each intercept point, as well as gaps and opportunities identified at each point. This narrative may be used as a reference in reviewing the Blair County Cross-Systems Map. The cross-systems local task force may choose to revise or expand information gathered in the activity. The gaps and opportunities identified in this report are the result of ―brain storming‖ during the workshop and include a broad range of input from workshop participants. These points reflect a variety of stakeholder opinions and are, therefore, subjective rather than a majority consensus. General Description of Services and Cross-System Collaboration Blair County is located in the Heart of the Southern Alleghenies. As of 2010, the population was 127,089 with the median age of 42 years old. Blair County was formed on February 26, 1846, from parts of Huntingdon and Bedford Counties. Its county seat is Hollidaysburg.

Situated in between Blair and Cambria County is the Allegheny Portage Railroad, the first railroad constructed through the Allegheny Mountains in central Pennsylvania. It was a series of 10 inclines, approximately 36 miles (58 km) long, and operated from 1834 to 1854. Today, the remains of the railroad are preserved within the Allegheny Portage Railroad National Historic Site operated by the National Park Service. The site was established on 1,296 acres (524 ha) in 1964 and is about 12 miles (19.3 km) west of Altoona, in Blair and Cambria counties.

The County has been building a continuum of criminal justice and mental/behavioral health services that provide a basic foundation for continued growth and reorganization on all levels. There are a number of established links, both formal and informal, between the courts, probation, police departments, corrections and the mental health system that include, but not limited to:

Blair County Criminal Justice Advisory Board (CJAB)

MH/D&A/CJ Complex Case Review

Meet & Greet held for the County MH ad D&A Case Management and staff with Adult

Probation

Altoona Regional Health Services (ARHS) and Blair County Mental Health Office provides law enforcement training on a bi-annual basis on the MH procedures Act and related topics

MH/MR provided a first Mental Health First Aid Training and will continue to explore trainings in the future

1 Munetz, M. & Griffin, P. (2006). A systemic approach to the de-criminalization of people with serious mental illness: The Sequential Intercept Model. Psychiatric Services, 57, 544-549.


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The Blair County MH/MR office is located at 423 Allegheny Street in Hollidaysburg. Blair County MH/MR provides local administration for mental health+ mental retardation. This involves program and fiscal monitoring as well as long range planning. This Blair County MH/MR office, by contract, provides state mandated and other mental health, mental retardation services. The Blair County Mental Health Program Office administers the county MH services through contracts with local community agencies. The County MH Office is made up of the MH Program Director and two MH Program Specialists. The state/federal MH allocation contracted to local agencies is prioritized to serve persons in the OMHSAS Adult Target Population #1, and

Child/Adolescent Target Population #1 and #2. In Fiscal Year (FY) 2009/10, the total number of persons served was 4,723. In Fiscal Year (FY) 2008/09, the total number of persons served was 4,711, about 4% less than the prior FY. In FY 2007/08, the total number of persons served was 4,918. This was an 11% increase over FY 2006/07 with 4,519 persons served. Of the total persons served in -09/10:

• -47% (2,207) Male • -54% (2,516) Female • -82% (4,062) Caucasian • 6% (189) Black, Hispanic, American Indian, or Asian • -

26% (1,138) Ages 18 and younger

5% (208) Ages 18 to 20

39% (1,807) Ages 21-44

27% (1,279) Ages 45-64

7% (291) Age 65 and older • -50% (2,331) Adults with Serious Mental Illness • -24% (413) Child/Adolescent with or at risk of Serious Emotional Disturbance

Blair County provides an extensive and detailed network of care website for individuals, families and agencies concerned with behavioral health. It provides information about behavioral health services, laws, and related news, as well as communication tools and other features available at: http://blair.pa.networkofcare.org/mh/home/index.cfm

http://blair.pa.networkofcare.org/mh/home/index.cfm


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Intercept I: Law Enforcement / Emergency Services

911 Blair County 911 is a county-run emergency dispatch service that serves as the 911 call center for the entire county. It provides a county-wide communications system that permits 9-1-1 access to any individual in need of assistance in the County, dispatch of the appropriate police, fire, emergency medical services, emergency management personnel, and other affiliated agencies to emergency incidents by certified tele-communicators. All Blair County 911 staff members attend a bi-annual Altoona Regional Hospital Mental Health training. Blair County 911 is located at 615 4th Street, Altoona, PA 16602.

As of January of 2011, Mark Taylor was hired as the Director of the Emergency Dispatch Center in Altoona and the County's Emergency Communications Network. Previously, Taylor was the long-time Fire Chief in Saxton, Bedford County.

Crisis Lines The Behavioral Health Access Center [(814)889-2279 or 1-

800-540-4690] handles emergency calls from 8 a.m. to 4 p.m. Monday through Friday. Any contact after regular hours is

handled by the Altoona Regional Health System (ARHS) Community Crisis Center [(814)889-2279 or 1-800-540-

4690], a component of the Access Center, that provides 24/7 phone and walk-in support. The Behavioral Health Access Center is located at - - Blair Medical Center, 501 Howard Ave., across from Altoona Hospital campus. CONTACT Altoona provides a 24/7 telephone helpline for listening services, reassurance calls, crisis intervention, and information and referral services to the community. Telephones are staffed 365 days a year by trained volunteers who are prepared to offer stability in times of confusion and to assist people of all ages to resolve their own problems and develop their inner resources. All services are free and confidential.

Family Services Inc. [(814) 944-3585 or 1-800-500-2849] runs four 24/7 crisis hotlines that include: a Crime Victims Hotline, Domestic Violence Hotline, Teen Hotline, and a Hotline for gay, lesbian and bisexual teens [(800) 942-8101].

Law Enforcement Blair County houses 18 police jurisdictions and one State Police Barracks. The largest jurisdiction is the City of Altoona Police Department with 68 officers; while the smallest jurisdictions include several departments that employ one or two police officers.

Law enforcement is trained to transport individuals to the ARHS Community Crisis Center and will initiate involuntary commitment procedures when necessary.

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Screening and assessment procedures to identify people with mental illness and/or co-occurring substance use disorders are conducted at intake and pre-arrest screen by law enforcement.

Crisis Services

The Behavioral Health Access Center is the central point of contact for the Blair County MH/MR Program to arrange services for persons experiencing mental illness and/or drug or alcohol problems. The Access Center serves all persons receiving county funding, state Medical Assistance and those with private-pay insurance coverage for these services. It also serves as a free source of information and referral.

The Altoona Regional Health System (ARHS) has a Mobile Crisis Unit with two full time staff members. The Mobile Crisis Unit is dispatched by the ARHS Community Crisis Center. Mobile staff will frequently ride along with local police as well as go into various Blair County schools. Northstar Support Services provides services and support to people who are eligible for mental retardation services and reside in Blair County. The agency has an on-call staff worker who can be accessed and dispatched through the ARHS Community Crisis Center. Northstar also distributes a brochure entitled ―What to do if you are arrested‖ that provides useful information and support to help guide individuals if they come into contact with the justice system (See Appendix G).

Detoxification and Substance Abuse Services Blair County residents have access to detoxification and treatment services at the Cove Forge/ White Deer Run facilities in Williamsburg and Altoona. Inpatient detoxification is provided by the Williamsburg facility while White Deer Run of Altoona provides various outpatient services. Both are staffed by physicians, RNs, LPNs, and PAs who are all trained in the complexity of the withdrawal of substances. The treatment program at Cove Forge BHS is set amidst 75-forested acres along the Juniata River in Williamsburg and offers patients a setting conducive to recovery. Programs include, Inpatient Non-Hospital Detoxification, Inpatient Residential CD Rehabilitation, Residential Dual Diagnosis Program (MISA), Mental Health Residential Treatment Program (Adolescent), Partial Hospitalization (Adult), Relapse Prevention Group (Specialty), Women‘s Group (Specialty), and Family Program (Specialty). The contact person and number is Tom Callahan at 877.907.6237. The treatment program at White Deer Run of Altoona provides outpatient services that include, CD Assessment, Outpatient Individual, Group and Family Therapy (Adult & Juvenile), Intensive Outpatient Program (Adult & Juvenile), and a DUI Program (Specialty). The contact person and number is Lisa Olander at 877.907.6237. Additionally, Pyramid HealthCare – Detox Center provides clients with safe, medically-supervised detoxification services. Pyramid HealthCare-Detox Center is based on a drug-free model; however, medications are used when they will relieve the physical discomfort of detoxification. Buprenorphine is part of the protocol for the detoxification of opiate-dependent


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clients. A detox specialist offers group and individual counseling to clients who are physically stable and able to begin their recovery program.

Hospitals Blair County houses –four –hospitals located at the Altoona Regional Health System (ARHS), -- Bon Secours-Holy Family hospital- (7th Avenue Campus), Nason Hospital in Roaring Springs and Tyrone Hospital. Acute care services are provided at two hospital campuses: the Altoona Hospital Campus and the 7th Avenue Campus. The hospitals are licensed for a combined 497 beds. Altoona Regional offers more than 200 years of health care experience, over 300 physicians, nearly 4,000 specialized and experienced caregivers, and 600 volunteers. The health system serves more than 20 counties throughout Central Pennsylvania. The Altoona Regional Health System (ARHS) is the largest Outpatient Clinic in Blair County and began as a federally funded Mental Health Center in the 1970‘s. The clinic currently serves approximately 3,500 individuals. In FY 2009/10 ARHS partnered with Primary Health Network (PHN) and transitioned the current OP clinic to a Federally Qualified Health Center (FQHC) to be operated by PHN at the current ARHS location. The FQHC assists our community to recruit and retain psychiatrists and credentialed nurses and therapists to serve the seriously mentally ill and persons with co-occurring disorders who are enrolled with Medicare, Medicaid, Private Insurance, and the indigent. In addition, the ARHS has combined their inpatient psychiatric units. - Often there are no beds available for psychiatric hospitalization at Altoona Regional, and individuals are transferred to out-of-county hospitals (e.g. Universal Community Behavioral Health (UCBH) at the Meadows or Clarion psychiatric centers). Altoona Regional Health System Center for Behavioral Health serves individuals with mental health and substance abuse problems. A treatment team of psychiatrists, psychologists, counselors, nurses and case managers provides a wide range of specialized services to assist children, adults and the elderly and can be reached at 814- 889-2141.

Altoona Regional Health System (ARHS) Clients Served -09/10 Access Center also known as the Base Service Unit

-1,320

Crisis Intervention Services/Emergency Services

-1,284

Outpatient Psychiatric Clinic -2,822 Family Based Mental Health Services -68 Resource Coordination -279 Student Assistance Program -270

Victims’ Services

Family Services Inc. (FSI) provides 12 services to approximately 2,420 individuals and families per year. FSI aims to prevent abuse and victimization, empower those dealing with the results from abuse and victimization. and assist victims of trauma from events or relationships in their lives.


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FSI staff members are available to assist persons who are seeking protection from abuse orders or support during court hearings. Other program workers provide assistance for welfare and medical matters. Services provided for children and adult victims, witnesses to violent crime and their loved ones. Licensed therapists provide therapeutic counseling. Program provides extensive informational and educational presentations about sexual violence, violent crime and related topics. No fees are charged for client services. Services may be accessed during the hours of 8:00 a.m. and 4:00 p.m., Monday through Friday by calling 814-693-0130. In addition, Blair County residents have access to the following statewide victims‘ organizations:

PA Coalition Against Domestic Violence 6400 Flank Drive, Ste. 1300 Harrisburg, PA 17112

daytime: 800-932-4632 website: www.pcadv.org

PA Coalition Against Rape 125 North Enola Drive Enola, PA 17025

daytime: 717-728-9740 24 hour hot line: 888-772-PCAR website: www.pcar.org

PCCD Victims Compensation Program 3101 N. Front Street Harrisburg, PA 17108

daytime: 717-783-5153 800-233-2339 website: www.pccd.state.pa.us

MADD, PA State Office 2323 Patton Road Harrisburg, PA 17112

daytime: 717-657-3911 24 hour hotline: 866-439-6233 (Pittsburgh) 800-848-6233 (Harrisburg) website: www.maddpa.org

http://www.pbpp.state.pa.us/ova/OVA_Redirector.asp?U=www.pcadv.org

http://www.pbpp.state.pa.us/ova/OVA_Redirector.asp?U=www.pcar.org

http://www.pccd.state.pa.us/

http://www.pbpp.state.pa.us/ova/OVA_Redirector.asp?U=www.maddpa.org


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Identified Gaps

Many individuals that come into contact with law enforcement are

intoxicated, which can make it difficult to determine whether an individual

is or is not suffering from a mental illness -

No formal medical detoxification

Police cannot take individuals directly to available detoxification services

Capacity is an issue for the non-medical detoxification services

No formal ‗sobering station‘ option

If an intoxicated individual refuses to go the hospital, law enforcement

often has to ‗babysit‘ him/her

There is not enough funding for all the MH and D&A programs the county

would like to provide

Over the past 5 years, budgets for all programs have been cut

No psychiatrists in private practice currently

Individuals with MH issues are not always identified early in the criminal

justice process

Identified Opportunities

Mental Health First Aid training being developed for law enforcement and

the community

- Positive response to first Mental Health First Aid Training

- Plans to train 30 Mental Health First Aid trainers

Mental Health Procedure Act training

Centralized 911 call center

CONTACT Altoona – nationally recognized model

CONTACT Altoona has a good working relationship with the ARHS Community Crisis Center and work in conjunction with homebound individuals and frequent callers.

Good cooperation between crisis, law enforcement, and the hospital

during commitments

Many long-standing individuals in the county have informal relationships

across systems

Mobile crisis staff will go with law enforcement on calls

Mobile crisis can go into any school in the Blair County area

Altoona Regional Hospital Crisis is very responsive to the needs of

community providers


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Currently Altoona Regional Health System (ARHS) has an inpatient

psychiatric unit at the Altoona Hospital Campus in Altoona. They have

completed the process of co-locating two-units to one site in May 2011.

Many community providers link individuals to crisis services via Voicemail

messages

Suicide Prevention Task Force

Access to Laurel Highlands Crisis Intervention Team Resources located in

Johnstown, PA.

Two different cross-systems collaborative groups to address the needs of

individuals with MH and Substance Use Disorders

Northstar has a brochure entitled ―What to do if you‘re arrested‖ for

distribution

A ‗sobering station‘ is being considered for college students at the Altoona

Campus of the Pennsylvania State University.

The county has been conducting MISA trainings for 5 years

8 full-time psychiatrists with the county


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Intercept II: Initial Detention / Initial Court Hearing

Arrest and Initial Detention When an individual is arrested in Blair County, he/she is taken to a local police station for initial processing.

Preliminary Arraignment The 24th Judicial District of Pennsylvania has a compliment of six Magisterial District Courts within its boundaries, overseen by an elected Magisterial District Judge (MDJ). In Blair County the Magisterial District Judges are the Honorable Paula Aigner, Honorable Jeffrey Auker, Honorable Steve Jackson, Honorable Todd Kelly, Honorable Fred B. Miller, and Honorable Craig Ormsby.

Preliminary Arraignment is conducted by one of six Blair County Magisterial District Judges (MDJs) either via video arraignment technology at the local police jurisdiction or through an in-person arraignment at the office of an MDJ. Sheriff’s Office The Blair County Sheriff's Department provides numerous services and duties to the citizens of both Blair County and the State of Pennsylvania listed below:

Civil Process

Warrant Service

Courthouse Security

County Judge Protection

Enforcement of both Crimes and Traffic Code

Prisoner Transport in county and out of state

P.F.A. Service

Central Court Duties The Blair County Sheriff‘s Department is located at 423 Allegheny St., Hollidaysburg, in the basement of the old part of the Courthouse. Staff includes Sheriff Mitch Cooper, Chief Deputy Holly Hunter, and Robert Archey.


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Identified Gaps

Video arraignment equipment not available at all police stations

No MH training for MDJs

No pre-trial services

There are not a lot of choices for services for individuals with MH and D&A

Law enforcement often feels that defendants are very different on the

streets as compared to when they‘re in front of the courts – this is a

source of frustration


In the process of developing a central booking center in the Prison

All MDJs have access to video arraignment equipment

High instances of co-occurring disorders in women are addressed by an

in-prison education group

Bail supervision is a possibility – particularly with intoxicated individuals

2 different cross-systems collaborative groups to address the needs of



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Intercept III: Jails / Courts

Jail

The Blair County Prison is located at 419 Market Square Alley in Hollidaysburg and has an average daily census of 290 inmates with an average of 2200 admissions per year. The Blair County Prison is currently overseen by Warden Michael M. Johnston.

The Prison receives an average of 6.53 admissions per day, with roughly four requiring detox services. The Warden reports that the number of inmates requiring psychotropic medication has reached as high as 30%.

The Blair County Jail contracts with PrimeCare Medical, Inc. for all medical services. As part of this contract, PrimeCare provides weekly psychiatric teleconferences for psychotropic medication prescriptions and checks. Inmates also have access to a full-time Mental Health Clinician. The MH Counselor refers the inmates to the PrimeCare psychiatrist and provides a brief overview for each teleconference. The Blair County Prison presently operates a selective, yet progressive work release program. Through this program, an inmate is permitted to leave the prison to engage in gainful employment in the community. The inmate returns to the prison immediately following completion of work and subsequently remains there during all non-working hours. In addition to the rehabilitative benefits derived from participation in the work release program, the inmate involved is able to assume his/her financial responsibilities, such as court costs, support, payment for room and board and other legitimate debts. It is through the work release program that the inmate thus begins the readjustment to the demanding responsibilities of community life. Some inmates receive services from a Forensic Case Manager through the Altoona Regional Health System (ARHS) and funded through Medical Assistance and County funds. The Forensic Case Manager receives referrals from jail, probation, and treatment providers. The FCM provides in-reach into the jail in order to help inmates complete Medical Assistance forms (typically 3 weeks prior to their release). Additionally, the FCM provides mental health screening for some court ordered cases. Additional services in Blair County Prison include GED and literacy programming, religious services, Alcoholic Anonymous (AA) groups, a variety of volunteer services, and family support services that includes a women‘s‘ support group and parenting classes.

Intercept 3 Jails / Courts

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Mental Health/ Substance Use Treatment

Men‘s In Prison since 1989 (grant through PCCD) – 5 days a week

Women‘s Education Program – Once a week

Women‘s Outpatient program (In House) – Once a week

Outpatient licensed satellite

Assessments (D&A and MH) and In-reach into the jail

Methadone Treatment for women who are pregnant (transport them out)

15 – 20 women/year

Courts Blair County has an extensive Treatment Court Program including Drug Court, DUI Court, Reentry Court, Family Court, Juvenile Drug Court and Truancy Court. These Treatment Court Programs each consist of a treatment staff with representatives from D&A, Children Youth and Families, Probation, and Mental Health Case Managers.

Certain non-violent (targeting level 3&4) offenses are eligible for Blair County Drug Court as an alternative to the traditional criminal justice structure. This program focuses on drug and alcohol treatment for the addicted offender, in addition to, or in conjunction with, standard sentencing components. Each IP sentence is tailor made to meet the individual needs of each defendant and to hold each offender accountable in the treatment and total recovery process. The sentences for IP Non-DUI offenses typically reduce or eliminate the overall period of incarceration. Offenders are sentenced to restrictive sanctions such as electronic monitoring and house arrest combined with treatment. All applicants are required to obtain a drug and alcohol evaluation by a selected licensed provider and be interviewed by the Drug Court Coordinator. If IP is deemed appropriate, a detailed treatment plan is designed.

Target Population: o Men or Women o Blair County Resident o Level 3 or 4 o Meet the State and Federal definition of non-violent offender

Length of Program: 18 months (average)

Cost: $10.00 per judicial review

Revocation: Can be re-sentenced with no credit for time completed. Not required to honor plea agreement.

Blair County DUI Court, modeled after the National Drug Court protocol of successful Drug Courts, utilizes the 10 key components and general philosophy of effective drug court programming. This program focuses on drug and alcohol treatment for the addicted offender, in addition to, or in conjunction with, standard sentencing components. The sentences for IP DUI offenses typically reduce the overall period of incarceration to one third of the traditional sentence followed by restrictive electronic monitoring combined with substance abuse treatment.

Target Population: o Men or Women o Blair County Resident o 2nd & 3RD offense, high BAC


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o Meet the State definition of non violent offender o No death or serious injury charges o Moderate to severe substance abuse

Length of Program: 18 months followed by regular supervision.

Cost: 2nd offense – $830, 3rd offense – $1890. $10.00 per judicial review

Revocation: Can be re-sentenced with no credit for time completed

Blair County Reentry Court manages the return of offenders to the community from the Blair County Prison. This court applies graduated sanctions and positive reinforcement to promote positive behavior by the returning prisoner.

Target Population: o Men and Women o Blair County Resident o County Sentenced inmate o 4 months prior to release o No flat sentence/max outs o Unemployed o Educational needs o Minimal support system o Cyclical pattern of dysfunction

Length of Program: 18 months (average)

Cost: $10.00 per judicial review

Blair County Family Court provides an alternative process to achieve safe, permanent homes for children through prompt, effective treatment services and access to community resources with an emphasis toward family reunification.

Target Population: o Blair County Resident o Children are dependent in the CYS system o Substance Abuse Issues o Non-violent history

Length of Program: 15-18 months

Cost: No Fee

There is a Program and Support Coordinator located in the Adult Parole Office for coordination of individuals through the specialized programs the courts operate.

Blair County also has an Accelerated Rehabilitative Disposition (ARD) program managed by the District Attorney‘s Office. This program is a one-time alternative to trial, conviction, or possible jail sentence. Upon application and completion of the program, charges are dismissed. There are currently approximately 450 individuals enrolled in the ARD program within a given year. In addition, Blair County has a Minors Diversion program that is used for first-time offenders with under-age drinking charges. There are roughly 150 to 200 participants a year.


23

Identified Gaps

Jail often serves as detoxification service

Approximately 4/6 daily jail commitments require detoxification

Psychiatric services in jail only available via video conference

Two suicides in the jail between 2006 and 2007

Some difficulty getting individuals with previous CJ involvement into the

jail

No one place has complete list of individuals receiving MH or D&A

services (this adds time to the process of checking commitment list for

individuals receiving services)

One barrier to implementation of a Mental Health Court is funding


Peer Support Services in the Jail – provided by a supervisor level

individual. This allows support to go in the jail to help get MA application

completed

In-jail peer support specialist help link individuals to more peer services

upon release

Jail warden is willing to make some exceptions to allow individuals who

have been previously incarcerated in the jail to become forensic peers or

volunteers

Methadone tx for pregnant women is available in the jail



County Jail faxes weekly commitment lists to the Home Nursing Agency

Home Nursing Agency is able to keep cases open for incarcerated clients

ARHA Forensic Case Manager goes into the jail

Home Nursing Agency will also check the commitment list against the list

of individuals that have ever received services (not just current clients)

Several problem-solving courts

All problem-solving courts accept individuals with co-occurring disorders

In the process of planning for a Mental Health Court – have applied for a

grant for this planning

D&A, Adult Probation and Parole, Jail, Children Youth and Family are all

active components of the problem solving courts

D&A has a good relationship with the courts

MH system is at the table for Family Court


24

Intercept IV: Re-Entry

Reentry Services

Blair County inmates are typically discharged any time before 8 pm. Individuals are released with three days of psychotropic aftercare medication.

Re-Entry from Pennsylvania Department of Corrections

Blair County MH/MR, specifically Jim Hudack, receives a monthly inmate list from the Pennsylvania Department of Corrections that includes residents of Blair County and their estimated date of release. Generally, released inmates from DOC will go on to State Parole and are later transferred to a specific in-county Parole Agent. When an individual is transferred roughly 30 to 40 a year will also get assigned to an ARMC forensic case manager.

Identified Gaps

Can be difficult to get individuals back on

Medical Assistance upon release

It usually takes three to six weeks to get

individuals back on Medical Assistance –

in the meantime there is no way to pay for medications and treatment

services

Not enough is done for re-entry – only able to serve a small number of

people who need the services

Stabilization that is achieved in jail is often lost upon release because of a

lack of meds

No prescriptions given upon release

Only 3 days of medication given at release

There is no one available to do pre-release level of care assessments

Difficulty getting psychiatric consultations and getting back on medications

Home plans are difficult to complete because of a lack of housing – many

individuals are maxing out as a result of this

Intercept 4 Reentry

Pri

so

n/

Reen

try

Jail

Re-e

ntr

y


25




In jail peer support helps fill out MA paperwork

County Assistance Office makes a real effort to get Medical Assistance

turned back on quickly

The jail is located on a public bus route

State DOC sends information on inmates with mental illness max-outs to

MH/MR


26

Intercept V: Community Corrections / Community Support

Probation and Parole

Local Adult Probation services are overseen by Blair County Adult Probation & Parole. Probation and Parole conducts an evidence based intake questionnaire that identifies self-reported mental health problems and mental health services individuals are involved in. Currently there is an estimated caseload of 2600 individuals and roughly 25% to 30% have a mental illness diagnosis while 50% to 70% of all individuals served are being treated for drug & alcohol issues.

1.) Incarcerated individuals who need paroled to a mental health facility are handled by health facility are handled by the Transitional Planning Coordinator to coordinate the release from jail to the specific mental health facility.

Probation cases are handled by the assigned Probation Officer who makes the appropriate referrals for agencies for mental health evaluation or drug and alcohol evaluation, and/or other court ordered programs, such as Cognitive Behavior programs and Anger Management.

2.) Some other programs that are utilized are: intensive cognitive behavior program for addicts and another cognitive behavior program for generalized thinking patterns and behaviors. Some other programs that are utilized are: Job skills and Interview skills, resume writing classes, and intensive cognitive behavior program run by the adult parole office designed for addicts. Another Cognitive Behavior Therapy class is held by the Adult Parole Office for generalized thinking patterns and behaviors.

3.) The Parole Office also refers individuals to programs to assist individuals in: dealing with grief and loss, job skills and interview skills, resume writing classes, parenting classes, and relapse prevention classes. The Parole Office also refers individuals to a program to assist individuals in dealing with grief and loss. In addition, motivational interviewing and other evidence-based practices are incorporated into the work of the probation officers. One probation officer has received training in Mental Health First Aid.

SCRAM (electronic monitoring) is also used by Probation and Parole.

Probation and Parole receive an update from providers regarding progress in treatment. Parole

and Probation Officers have a system in place to add conditions to individuals when appropriate. Probation and Parole use graduated sanctions and rewards when appropriate.

Probation and Parole partners with other agencies for educational classes:

Reflections for Life by Kids Peace and Arrow Ministries --- Uses Grief and Loss model

SIFE with Penn State – Altoona for resume writing, job search skills, and interviewing skills

Paro

le

CO

MM

UN

ITY

Intercept 5 Community corrections

Pro

bati

on

Violation

Violation


27

Relapse Prevention with Drug & Alcohol Inc. along with parenting classes

Data from the office is incorporated into the Data Dashboard.

Housing Family Services Inc. provides 12 services to approximately 2,420 individuals and families per year. FSI provides its expertise and support in the following areas: shelter services and specialized housing; prevention of abuse and victimization; empowering those dealing with the results from abuse and victimization; and assisting victims of trauma from events or relationships in their lives.

Domestic Abuse Project -Shelter for Battered Women. Phone: (814) 944-3585 or

1-800-500-2849 A program working with victims of domestic violence that provides a wide variety of services including information and referral, 24-Hour hotline, individual and group counseling, advocacy, assistance filing protection orders, and emergency (protective services) shelter. Domestic violence is defined as a pattern of coercive behaviors and control that includes the use of physical, sexual, psychological and economic abuse by a partner, ex-partner or any other person with whom the victim has an ongoing relationship. Safe shelter is provided for battered women and their dependent children. Services for male victims are available.

Runaway and Homeless Youth Program - Youth Center Phone: (814) 941-0975 (800) 227-8336 Program provides counseling and emergency shelter services for runaway and homeless youth and counseling for their family members and friends. Shelter on a 24-hour basis, located at 3718 6th Avenue, Altoona. Eligibility: 12-18 years of age

EMERGENCY SHELTER PROJECT Phone: (814) 944-9488 Provides shelter, meals, supportive counseling, basic living skills instruction, case management, and Information and referral to those who meet the definition of "Homelessness" as per the Housing Assistance Program requirements. The Emergency Shelter for Men is located at 2005 8th Avenue Altoona.

Intellectual Developmental Disabilities Program Program offers community residential facilities, family living, respite care, alternative day program and in-home services for people with intellectual and developmental disabilities. The programs are licensed by the Department of Public Welfare‘s Office of Developmental Programs. Eligibility: All people served must have a primary diagnosis of an intellectual disability and be authorized for service by Northstar Support Services (946-3657).

Blair Senior Services, Inc. is a private non-profit corporation designated as the Area Agency on Aging (AAA) for Blair County. The Agency is responsible for the planning, coordination, management and administration of community-based services for older persons. Established in 1974, the Agency‘s mission is to enhance the lives of older individuals, their families, and others in need by coordinating support and assistance through a system of quality home and community-based programs and services. In addition to meeting the needs of older adults, the


28

Agency serves residents of all ages through diverse programming and contracts in such areas as; transportation, housing, assessments and volunteering.

The Salvation Army Corps Community Center Home Nursing Agency provides permanent or temporary housing options for individuals with special needs [Phone: 946-5411 or 1-800-445-6262].

Community Resources

Family Services Inc. provides professional therapeutic counseling services for individuals (children and adults), couples and families who have personal, relationship, legal, educational, financial, and related problems. Family Services Inc. also runs a ―Men Helping Men‖ educational and supportive group counseling program for men who want to change their abusive attitudes and behavior towards the women partners in their lives. The group is based on a 16-week program and meets on a weekly basis.

ARHS Behavioral Health-Unit - provides mental health services in a clinical setting specifically designed to serve the needs of the adult and geriatric populations [Phone: 1-800-378-5580]. Home Nursing Agency offers a center for counseling [Phone 946-5411 or 1-800-445-6262].

Northstar Support Services provides services and support to people who reside in Blair County and who are eligible for mental retardation services. Referrals for persons out of high school should be made to Traci Gibboney at (814) 946-3657, ext. 113 or email: [email protected] Catholic Charities of the Diocese of Altoona-Johnstown provides individual, family, group, and marital counseling to those in need, with the goals of reducing stress and tension, improving communication, and providing the client with proven tools with which to address their concerns. Services are provided by skilled, professional staff, many of whom have master's degrees in counseling or social work and are licensed or certified by the Commonwealth of Pennsylvania and other professional organizations. Federally Qualified Health Center (Primary Health Network) provides quality primary care services and access to specialty care commensurate with the needs of the people in Blair County.

Identified Gaps

Large number of transient individuals

Difficulty getting psychiatric consultations and getting back on medications

Sub-acute population is not being well served

Very little funding for housing

Incredibly difficult to get housing for individuals with CJ involvement, D&A

charges, or sex offenses

No homeless shelters will take this population

mailto:[email protected]


29

Target population often has no income, which makes it difficult to qualify

for aid programs

No infrastructure in place to help offenders with severe mental illness

offenders


Two different cross-systems collaborative groups to address the needs of


Well integrated system between probation and the MH/D&A Services

Sense of shared ‗problem-solving‘ values between probation and MH/D&A

Services

State Parole has a specialized parole officer for MH and D&A

State Probation & Parole refers to the forensic case manager

Adult Probation and Parole conducts risk/needs assessments

Adult Probation utilizes motivational interviewing and other evidence

based practices


30

Blair County Priorities

Subsequent to the completion of the Cross-Systems Mapping exercise, the assembled stakeholders began to define specific areas of activity that could be mobilized to address the gaps and opportunities identified in the group discussion about the cross-systems map. Listed below are the priority areas identified by the workshop participants and the votes received for each proposed priority.

Top Eight Priorities

1. Development of a Mental Health Court (20 Votes) 2. Housing (18) 3. Mental Health First Aid (16) 4. Access to medication and psychiatric appointments upon re-entry (15) 5. Sobering Stations (12) 6. Level of Care Behavioral Health Assessments as early as possible in the

criminal justice system (10) a. Determine when assessments are needed b. Disperse assessments to the correct individuals

7. Crisis Intervention Team (CIT) Development (9) 8. Expediting access to Medical Assistance Benefits (8)

Additional Priorities

Expanding the Mental Health Assessment Team (6) Central Booking with behavioral health capacity (5) Increase collaboration with PrimeCare (3) Increase Vets services (3) Development of services for the non-severe and persistent mental illness

(SPMI) populations who are at risk or involved in the criminal justice system (2)

Increase funding options, including grants (1) Integrated BH System (1)

o Even within MH system o ―Address fractures‖ o Better describe how it fits together

Further behavioral health staff development to promote understanding, assessing, and matching stage of treatment readiness to appropriate services

Getting funders to be part of planning process and committed o Need decision makers at the table o Get buy-in


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Blair County Action Plan

Priority Area 1: Development of a Mental Health Court

Action Planning Group: Diana, Theresa, Karen, Wade, Amanda, Judge Kopriva

Objective Action Step Who When

1.1 Evaluate and request current MH courts to determine the most appropriate way to create and operate the court with a focus on the most effective time and manner to deal with the participants in the court.

Court and DA researching Lycoming and York County Courts to report back to specialty court team. Tom and Lisa report after attending CJAB conference

Create a Behavioral Health Subcommittee on CJAB

Amanda will organize a road trip

1.2 Identify a MH Liaison staff position

Blair County MH office identifies the liaison staff member. Teresa and Jim take responsibility for this action. This will be accomplished within 45 days


32

Priority Area 2: Housing Action Planning Group: Jean, Kelly, Cindy, Luann, and Mark


2.1 Building relationships with private landlords and housing providers

Invite more landlords to participate in LHOT

LHOT and rental assistance providers to become more involved in landlord association

County

Providers

LHOT members

Social Services

July (next LHOT meeting)

2.2 Tenant Education In-prison education on how to be a good tenant

More round tables

Operation Our Town has a roundtable on housing issues – involve them more

CIL D&A Northstar HNA Prison Parole/Probation

2.3 Day Reporting Centers

2.4 Increased Emergency Shelter

2.5 Grant Exploration


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Priority Area 3: Mental Health First Aid

Action Planning Group : Donna, Mark Taylor, Dennis, Paul, and Jeannette


3.1 To implement a ―train the trainer‖ class

Recruitment/orientation of potential trainers

To secure funding

Schedule/implement training

MH office

NAMI

HNA

ARHS

Other providers

NOW

Fall (2011) or winter (2012)

3.2 To present MH first aid training in the community

Identify larger groups, Penn State Altoona, Altoona Area School District, Hollidaysburg School district, to be trained

Identify places for training

Identify dates and times

Assign trainers

NAMI

MH Office

Spring 2012


34

Priority Area 4: Access to medication and psychiatric appointments upon re-entry

Action Planning Group: Scott S., Scott M., Amy, Amy, and Renee


4.1 Obtain a 30 day supply of medication by written prescription

Review PrimeCare contract re: 3-day supply

Identify strengths and barriers to achieve this objective

Utilize Walmart formulary for $4 prescriptions

Identify other community supports to pay for meds

403B Pharmacy will be coming into the community—this will help with costs ($7 for 3month supply of common medications)

Scott S.

Scott S. Scott S. Scott S.

4.2 Access psychiatric appointment within 30 days

Explore PHN capacity

Prioritize need

Explore retroactive M.A.

Explore M.A. dept. capacity

Explore reinvestment opportunities

Obtain ―the list‖ from prison to CBHNP to alert providers

Non-SMI will still be a problem….

Amy M.

Amy M. Scott M. Scott M./Amy M.

Within 30 Days

4.3 Increase prison collaborations with


35

other agencies (e.g. urgent care center)


36

Priority Area 5: Sobering Stations

Action Planning Group: Janice, Corey, Tom, Rob, and Warden Mike Johnston


5.1 Gather information from counties who have stations i.e. staffing, target population, security liability Funding

Poll AP chiefs (June 10 meeting)

Poll Wardens

Poll MDJs

Poll local LEO

Tom

Mike

Janice

Rob

ASAP

5.2 Provide a facility for a better assessment for MH by removing drugs/alcohol for BH services

Developing/defining specifics

Bring the right people to the table

CJAB After we gather info


37

Priority Area 6: Level of Care Behavioral Health Assessments as early as possible in the criminal justice system

a. Determine when assessments are needed

b. Disperse assessments to the correct individuals

Action Planning Group: Christine, Donna, Jen, Abby, Ashley, and Lanette


6.1 Identify an entity (e.g. agency, persons) to assess and act as a mobile assessor through Probation Dept, BCP, etc., and to also include ―overflow‖ staff/assessors

Create job description

Determine funding sources

Determine location of office –Probation?

Attain approval for job and complete interview/selection process

8/30/11

8/30/11

1/01/12

6.2 Capture savings that would occur (jail days, etc) if this position were created


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Priority Area 7: CIT Development

Action Planning Group: Commissioner? Diana, Jim, Matt, Kathy W., Chris,


7.1 Research

Oversight committee

Funding

Building consensus

Creating a foundation

Look outside the box funding opportunities

Jim Hudack

Chief Freehling

Sheriff Cooper

Now

7.2 Team activation June 30th meeting with Laurel Highlands (Cambria county) CIT

Meeting will include Jim Hudack, Chief of Police, Sheriff‘s Office, 911, County Commissioners

June 30th

PRIORITY AREA # 7, Continued: Guidance for starting a CIT Program

OBJECTIVE ACTION STEP WHO WHEN

1.1 Establish CIT Oversight Team/Committee

Agency contact on state level

Contact CIT Coalition

Contact other CIT programs (VA)

Identify law enforcement, mental health, and consumer groups

Selection of committee

Varies by area

30 days

1.2. Seek funding for CIT training

Contact DCJS

Federal grants

Department Budget – LE, MH

CIT Coordinator/Agency Representatives

1 week regular monthly reporting

1.3 Complete 40 hour CIT Core Training

Contact 3 leadership programs for slots

Selection of personnel (volunteers)

2 LE/1 MH to each of the

CIT Coordinator(s) 6 months


39

leadership programs

1.4 Complete TTT (Train The Trainer)

Identify core from Objective 1.3

Contact/schedule TTT through 3 leadership groups

CIT Coordinator 6 months


40

Priority Area 8: Expediting access to Medical Assistance Benefits

Action Planning Group: Jim, Noel, Laurie, and Erick


8.1 Suspend, not terminate

Consult on current work being done

Research with M.A. as to whether or not this is possible

CAO liaison with prison?

Jim H.

Erick Amie

Ongoing

July 10, 2011

8.2 Explore options for emergency M.A.

1 appt or a series?

Research this process

Lori July 10, 2011

8.3 Explore COMPASS online system


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Conclusion

Participants in the Cross-Systems Mapping workshop showed much enthusiasm in working together to improve the continuum of resources available for people with severe mental illness and often co-occurring substance use disorders involved in the Blair County criminal justice system. Blair County is poised to tackle a number of critical issues that will greatly improve services for this group. The assembled stakeholders spent time gaining a greater understanding of their shared systems, as well as crafting strategies related to improving the collaborative infrastructure for the group and addressing the gaps and opportunities at each intercept.

Considerable work has already been undertaken to improve services for people with severe mental illness and often co-occurring substance use disorders involved in the Blair County criminal justice system. Law enforcement training, problem solving courts, specialized case management, in-jail treatment programs, and extensive probation initiatives are some examples of current Blair County initiatives. Blair County has also developed thoughtful data across the criminal justice and behavioral health issues to provide a clearer understanding of the issues being discussed. In addition, the Mental Health First Aid countywide initiative that is just beginning is a promising community education effort that generated a good deal of interest during the workshop. Local stakeholders participating in the Cross-Systems Mapping were clearly interested in building on these successes to better serve this population. The expansion of the planning group to tackle the priorities established during the Cross-Systems Mapping workshop is an essential next step in a true systems change process. It will be important to create effective working relationships with other groups that did not attend the workshop, including other police jurisdictions, the Department of Veterans Affairs, prison chaplains, the Social Security Administration, County Administration Office, and other local peers. Regular meetings should be held by this larger group to facilitate information sharing, planning, networking, development and coordination of resources, and problem solving.

Closing

Blair County is fortunate to have the support of the Criminal Justice Advisory Board and County Commissioners in these efforts. A wide range of stakeholders across the mental health, substance abuse, social services, and criminal justice systems made significant efforts to understand and support the challenging issues discussed in this workshop. The Cross-Systems Mapping workshop gave these stakeholders a chance to develop a coordinated strategy to move forward with the identified priorities.

By reconvening and supporting the work of the group in coming months, it will be possible to maintain the momentum created during the Cross-Systems Mapping workshop and build on the creativity and drive of key local stakeholders. The Pennsylvania Mental Health and Justice Center of Excellence hopes to continue its relationship with Blair County and to observe its progress. Please visit the Pennsylvania Mental Health and Justice Center of Excellence website for more information, www.pacenterofexcellence.pitt.edu.

http://www.pacenterofexcellence.pitt.edu/


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Appendix A – Participant List

Robert W. Archey Sheriff Blair County Sheriff‘s Department 814-693-3100

Jeanette Aungst Juvenile Probation Officer

Renee Bambocci Case Manager Blair Co. Drug & Alcohol

Jackie Bernard District Attorney's Office

Annie Bianconi Surveyor Center for Behavioral Health Data Research 207-5665

Lacey Ceshini Family Services Inc.

Christopher Cohn Sergeant University Police- PSU Altoona 814-949-5222

Leisa Cottrell Home Nursing Agency 814-935-4961

Matt Eckley Director Primary Health Network 814-942-1800

James DeFrancesco Chief Public Defender

Jennifer Feathers Case Manager Altoona Regional Hospital

Erick Flaig Supervisor Northstar Support Services

John Flinn Sergeant Logan Township Police 814-949-3364

Jon Frank Supervisor Blair County Juvenile Probation 814-693-3230


43

Mark Frederick Supervisor BHS Altoona Regional Health System 814-889-6717

Dennis George Counselor (MSW) Catholic Charities 814-944-9388

Donna Gority Commissioner

Cindy Harmon Community Service Manager Home Nursing Agency

Jim Hudack MH/MR Administrator Blair Co. MH/MR Program Office

814-693-3023 [email protected]

Karri Hull CJAB Specialist PCCD 814-265-8496

Paul Hunter NAMI 814-695-0582

Michael Johnston Warden Blair County Prison 814-693-3155 [email protected]

Jean Johnstone Executive Director Catholic Charities 814-944-9388

Wade Kagarise District Attorney‘s Office

Karen Kasun Criminal Case Manger Court Administration 814-693-3050

Donna Kensinger Executive Director Home Nursing Agency 814-943-0414

Judge Kopriva President Judge Blair County Courthouse 814-693-3075

Ashley Lantzy Mental Health Clinician Prime Care Medical 814-317-1033


44

Kelly Lutz Housing Coordinator Home Nursing Agency

Amy Marten-Shanafelt Clinical Director Blair HealthChoices

Lynette Martinez Probation Officer Adult Parole 814-693-3190

Marc Masucci Deputy Warden Blair Co. Prison 814-693-3155 x204

Janice Meadows District Court Admin. Blair Co. Courts 814-693-3050

Diane Meling Blair Co. Commissioner Blair Co. Courthouse

Noel Miller Team Mgr, Case Mgmt Home Nursing Agency

Amanda Moore Probation Officer Adult Parole 814-693-3190

Scott Moyer Blair Region Manager CBHNP

Diana Packech Director Adult Services Home Nursing Agency 814-943-0414

J.J. Pratt Lieutenant Altoona Police Dept. 814-949-2497

Lu Ann Rabenstein MH Program Specialist Blair Co. MH/MR Program Office 814-693-3023

Charmayne Raia Forensic Supervisor Blair Co. Drug & Alcohol 814-693-9663

Judy Rosser Executive Director Blair Co. Drug & Alcohol 814-693-9663


45

Theresa Rudy MH Program Director Blair Co. MH/MR Program Office 814-693-3023

Amy Schoen Program Director Pyramid Healthcare

Lori Schultz Norton Diagnostic

Scott Schultz Supervisor Blair Co. Adult Parole

Cory Seymour Supervisor Blair Co. Adult Parole

Tom Shea Chief Blair Co. Adult Parole

Blaine Smith Executive Director CBHNP

Abbie Tate Treatment Supervisor Blair Co. Prison

Jennifer Walters Probation Officer

Kathy Wyland Surveyor CBHDR 814-946-3933

Christine Zernick Special Service Coordinator Altoona Regional Health System


46

Patty Griffin, Ph.D. Senior Consultant Pennsylvania Mental Health and Justice Center of Excellence 8503 Flourtown Avenue Wyndmoor, PA 19038 [email protected] Phone: 215-836-0570

Sarah Filone, MA Project Coordinator Pennsylvania Mental Health and Justice Center of Excellence Department of Psychology Drexel University MS 626, 245 N. 15th Street Philadelphia, PA 19102-1192 [email protected] Phone: 215- 762-8275 Fax: 215-762-8825

Katy Winckworth-Prejsnar Research Associate Pennsylvania Mental Health and Justice Center of Excellence Department of Psychology Drexel University MS 626, 245 N. 15th Street Philadelphia, PA 19102-1192 [email protected] Phone: 215- 762-4257 Fax: 215-762-8825




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Appendix B – Summary Involuntary Commitments (302b) initiated by the Police

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Appendix C – Blair County Prison Statistics 2010-2011

53

Prime Care Prison Data

Nov 2010-March 18th

2011

Jail Inmates Seen By

Mental Health Clinician

Total Suicide

Watch

Total Seen by Dr.

Calvert

Nov 2010 201 23 22

Dec 2010 230 17 24

Jan 2011 168 18 25

Feb 2011 176 19 23

Mar 2011 189 31 20

Total 964 108 114

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Appendix D – Blair County Prison Drug and Alcohol Statistics

56

Appendix E – Blair County Prison Parole Statistics

60

Appendix F – Mental Health First Aid- Development Plan of Action

Train the Trainer class in fall of 2011 or winter 2012

a. Can train up to 30 individuals, open to businesses, agencies and providers in Blair

County. If we do not get 30 participants from Blair County, we will look at our

contiguous counties to fill a class.

b. The 5 day training which would include all materials (teaching kit, participant

manual, teaching notes, flash drive with program power point, handouts, and related

materials.

c. Including bringing certified instructors into the national network after certification,

and adding them to the list serve and technical assistance website, publicly available

instructor listings. Support of ongoing technical assistance and direct support for all

instructors certified for as long as they maintain their certification.

d. Once trained, instructors are required to conduct at least 3 classes per year to maintain

certification. We are requesting that at least one class be conducted free of charge to

the community at large.

Cost for a Train the trainer course:

a. Blair County - $1,150.00 per participant to include all materials, meals and rental of

training facility. The training will be conducted at a local facility within Blair

County. The only additional cost would be the travel to training location.

b. If attending the course hosted by the National Council the cost would be $1,850.00

per person. Travel and lodging is the responsibility of the participant for a cost of

approximately $3,000.00 per person.

NAMI of Blair County involvement:

a. NAMI will be taking on the role of the coordination entity for all community based

classes. They will handle the class set up, logistics, marketing and participants’

registration. This will allow the Trainer to just concentrate on the training. This is

the same operational structure that the Red Cross uses for First Aid and CPR.

b. Collect, analyze and maintain outcome information for courses taught in Blair

County.

c. NAMI will do the marketing of courses including assurance that public recognition of

the sponsoring trainer agency is on any hand outs, promotional materials or

advertisements. Creating a tremendous amount of free publicity for the sponsoring

agency which in a course of a year would more than cover the cost of the train the

trainer class.

Instructor selection:

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a. There are two main pieces a skilled MHFA Instructor has: knowledge/experience

with mental health, either professionally or personally and presentation/facilitation

skills. Typically, most individuals coming in to be instructors are more familiar with

mental health than being a presenter. Given the nature of the course, it is almost

preferable to have an individual whom is a better presenter first, then can learn the

content second.

b. While there are not specific recommendations on the level of individuals sent to

training, since certification is on an individual basis, it is suggested to send those to

be certified that have demonstrated commitment to the entity supporting their

certification to ensure longer term sustainability of the program at a business or

agency.

c. Many organizations have two instructor certified which allows for team teaching and

greater level of sustainability within the organization.

Sponsorship:

a. If a business or agency does not want to have an in-house instructor, they can sponsor

someone else to become an instructor that will be directly tied into NAMI. This

certified trainer will also commit to offering that sponsor’s agency at least one

training per year for its employees.

WHAT’S IN IT FOR ME (US):

a. Increased ability in early identification and prevention of mental health issues for

your employees and customers. Knowledge has always been the key to the

elimination of bias.

b. A decrease in loss of work hours by employees due to mental health issues (cost

savings). Mental Health issues are one of the major contributors to lost work time by

employees. According to the 2011 Healthy County Survey, Blair Countians

responded that 3.9 days per month individuals felt their mental health was not good.

Mental Illness takes a high toll on workplaces, costing business more than $79 billion

a year, $63 billion of it in lost productivity. Each year, 217 million work days are

completely or partially lost due to mental disorders in the United States.

c. A greater understanding by employees of mental health issues and how to better

handle difficult situations that may occur in both their business and private lives.

d. Increased level of customer service by employees that demonstrates a great

understanding and compassion for mental illness.

e. Offering employees an evidence-based education program that has been well

researched and now is becoming a nationwide program.

f. No amount of training can guarantee that horrific acts will not occur, but the better

trained our staff are, the opportunity for more people to be comfortable to step

forward and intervene early can go a long way to lessen the chances.

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If you have you or your supervisor have any questions or need further information, please

feel free to contact Jim Hudack, Blair County MH/MR Administrator at (814) 693-3046

ext. 222 or by email: [email protected]. In the next few weeks, I will be contacting

each of your agencies to assess your interest in Mental Health First Aid and begin the

development of the Train the Trainer course.


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Appendix G – Northstar Support Services What You Need to Know if

You are Arrested Brochure

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