One of the big problems facing the AB 109 budgeting process, at the county level, is that it takes a 4/5th’s vote of the Board of Supervisors to block the implementation of budget and recommendations put forth by the Community Corrections Partnership, made up of the various stakeholders in the process.
Supervisor Matt Rexroad expressed regret that he supported the budget back on September 13, “I was very close to voting no, in some ways I wish I had voted no back then.”
Skeptically, he said, “I need people to be able to prove to me that those allocations are reflective of that overall vision.”
Chief Probation Officer Marjorie Rist told the Board that they were able to free up some money by “stopping doing things that don’t work in most cases.” She added, “I like to think about it that we took away the things that didn’t work, so only now are we getting enough staff and the resources dedicated to the training and start up to actually start doing the things that ought to work.”
Supervisor Jim Provenza argued that “if this program is successful we may also reduce the need for jail beds in the long term.”
One of the challenges is the idea of finding non-traditional solutions, while at the same time keeping the proverbial “stick” of the threat to incarcerate, if those solutions do not work.
Ms. Rist said “One of the struggles is that you have to have swift and certain sanctions – they don’t always have to be detention-related sanctions, they can be other sanctions, but at the end of the day you have to have a detention-related sanction available that can be certainly applied.”
She added, “In order to do that you have to control [of] that jail population so that you have that bed available when that sanction is necessary, otherwise it loses its effect.”
However, while perhaps everyone at this time could agree in principle that this was the goal, serious questions were raised about the allocation of funding and budget priorities.
Supervisor Don Saylor expressed concerns and raised questions about the plan.
“What concerns me is that, of the $3.3 million that we initially allocated,” he said, “only $88,000 of that was designated for mental health.”
He expressed concern that there was not nearly enough in this budget for mental health treatment, drug treatment and job placement.
“[We lack funds] to support people in their effort to reacquaint themselves with life in the community. That doesn’t seem to be happening in the budget document that we’re asked to support today,” Mr. Saylor said.
Marjorie Rist reported that there were six people, as of last week, released to the county. We were on track to get 23 for the month – and those are still targeted.
Ms. Rist reported that two of those six had fairly substantial needs, as among them was one who was a “short notice release” who had “severe mental health needs.” “CDCR did not have them flagged as needing mental health,” she said.
The California Department of Corrections and Rehabilitation claims that there are some errors and people who fell through the cracks, but thinks they can reduce the level of surprise.
Don Saylor said, “Whether it’s a surprise or not, what would we do with that person or other people like that with severe mental illness that re-enter the community?”
Ms. Rist responded that they would do the same thing that parole does with such people, “they refer them to local services, and that’s the thing that’s a little bit of a struggle for us.”
Don Saylor quipped, “That worked pretty well, huh?”
Ms. Rist responded, “It didn’t work at all.” She argued just getting a heads-up, which didn’t even happen in this case, is an improvement over the old system.
Mr. Rexroad would then ask whether these are not people we want in the jail.
Ms. Rist responded that you can ask mental health specialists, but the argument that jail is the best place to treat mentally ill people goes against conventional wisdom.
Sheriff Ed Prieto said, “Anyone who is in our facility, once they arrive and get a medical examination,” they get screened and are provided with treatment options. However, their facility cannot force medication against the individual’s will. “We don’t have the certification for that,” he said, which would require a specific nurse and credentials.
He added that he is concerned what will happen with those released, “but those who are going to stay in-house, going to stay in the facility, are going to receive treatment and part of that in my opinion is going to have to be done in the jail.”
The length of stay, as Mr. Rexroad pointed out, is not based on the need for treatment but rather the underlying conviction.
“We would really like to treat this person, but under our guidelines, under the way we implement our system, it’s based on space available, we’re going to let this person go – where they may need mental health care but their underlying [conviction] doesn’t allow them to be able to remain in custody because of those priorities,” the Supervisor said.
“But that limitation is on their conviction, not their need for health care,” he added.
“The interesting opportunity that we have with realignment and funding for us to allocate as we see fit for the best interest of our community, both in the short-term and the long-term public safety, is to allocate in ways that the state hasn’t,” Supervisor Saylor said.
“We seem to be not plush with money for mental health services presently,” he noted.
Yolo County Health Director Jill Cook told the Board, “To me, this is the opportunity to do things differently. To do more of the same that didn’t work well is not a good plan. To do something differently is, and we have some opportunities with this change.”
Mr. Rexroad argued that the best opportunity to get mental treatment is at Monroe.
“I think the comment is accurate but sad,” Don Saylor interjected, “that there is not alternative means to providing treatment that’s lower cost – because, of course, incarceration is the most expensive approach to this solution.”
“I am at this point not able to support this budget as proposed, because at this point I think we are not significantly addressing evidence-based efforts – and it’s about public safety and public safety is not black and white, but a spectrum of efforts,” Mr. Saylor added.
Sheriff Prieto disagreed, arguing that it takes time to train individuals to do the job.
“The longer you delay this process,” he said, noting that the inmates from the state are coming, “so they are going to start coming and if we are not prepared for them… we certainly have to be prepared and have the people on staff.”
The view of many seemed to be that, while we might not have the perfect mix right now, we can adjust things as we go.
Supervisor Don Saylor argued that once we started the new trajectory it would be much more difficult to course-correct.
Those members of the public who spoke had some serious concerns about the approach, going forward.
Jean Forbes from NAMI (National Alliance on Mental Illness) said she hadn’t expected to address the question, “Wouldn’t people receive the best mental health treatment in jail?”
She said that most mental health people at Monroe are in administrative segregation, and “that means they’re locked down alone in a small cell 23 hours a day. The hour that they’re allowed out rotates – they never really know when it’s going to come.”
“Justice system experts working at the federal level and with the council of state governments, commonly pronounce that kind of administrative segregation inappropriate and less than humane for people who have severe mental illnesses,” she said.
“To me, that’s the answer to whether they would be better in the jail,” she said. “The physical circumstances create stressors that makes the symptoms of mental illness worse.”
Debra Shelton, who works for CDCR as an educator, argued that more incarceration is not the answer, that there need to be more resources provided to inmates trying to move them toward alternative custody situations.
She argued that the tragic case of Marco Topete is a case in point.
“I met Topete when he came out of Pelican Bay, and he had no resources available to him,” she said.
“He had a job when he came out, he had a family support system, and when that crumbled he had no resources to go back to but those he had learned as a youth and a person incarcerated in the system.”
“Had he had a little bit more outside resources, we could have helped him find that job,” she continued. “We could have referred him to mental health. We could have done a lot more, instead we lost an officer and we caused a lot of community havoc and a lot of cost, to where he is today looking at the death penalty or life without parole.”
“Officer Diaz’ life is wasted, one that is lost. He could have been a man still on the job,” she said her voice breaking slightly.
Bob Schelen, chair of the Yolo County Mental Health Board, sent a letter to the board.
He told the board, “The budget as it is currently written should be rejected because there does not appear to us to be enough money for treatment programs, for job training programs, and for a number of other programs that are important to the entire process of realignment.”
The plan and program, he argued, was balanced, but the dollars do not reflect that balance.
“We need to put the dollars into the innovative programs that we think would be helpful for this realignment program,” Mr. Schelen added.
“The reason why we’re here,” said retired Public Defender Barry Melton, “is that the state prison system blew it and didn’t spend adequate resources on health and mental health.”
“The whole reason for this creation,” he said, talking about the history of the receivership and the Supreme Court decision, “is that the state prison system got it wrong. They didn’t spend enough money on health and mental health and if we come back here to Yolo County and replicate that model we’ll all get sued, we’ll end up in the Supreme Court and we’ll end up in federal receivership just like CDCR did.”
In the letter to the Board of Supervisors that Mr. Schelen wrote on behalf of the Mental Health Board, “When realignment shifted the responsibilities for probationers from the state to the counties, we had a real opportunity to make a substantial change to the way the correctional system works; to try something different, instead of what we already know doesn’t work.”
“Instead, the Yolo County Community Corrections Partnership plan seems to be more of the same old broken system: using the money for more jail beds, and officers to watch those jail beds,” he added.
Proponents such as Mr. Schelen argue that research proves that treatment is cost-effective.
Unfortunately, these needs are not “met by the proposed plan and budget, which allocates money only for incarceration, tracking, and ‘support for development of evidence-based policing strategies …’ not for evidence-based rehabilitation, which is what the statute requires.”
Martha Flammer, Local Mental Health Board Member, wrote, “Research by various well-known sources has demonstrated that approximately 16% of the prison population have a severe mental illness, and this number is rising due to cuts in community mental health treatment programs.”
She adds, “The law enforcement community is ill-equipped to handle parolees and prisoners with untreated mental illness. This proposal would subject them to use force to manage former mentally ill prisoners, who do not have the same capacity to comply with prison rules as do other prisoners, especially without treatment.”
Ms. Flammer concluded, “This proposal would deny access to treatment and potentially subject Yolo County to Civil Rights violations, therefore, I urge you to reject this budget proposal and request the Chief Probation Officer to work with health and mental health stakeholders to consider an alternative proposal that incorporates a stronger health and mental health treatment program in Yolo County.”
However, Chief Deputy DA Jonathan Raven disagreed with this characterization.
“To say that the CCP plan is emulating CDCR is really just not fair, not true, and a little bit insulting actually,” he said. “CCP understands that the mental health issue is important, unfortunately the pie is not as large as we’d like it to be.”
“That is something that needs to be taken into account. For now, we do need to move forward and give this plan a chance,” he said.
In the end, by a 4-1 vote, the board of Supervisors agreed to approve the budget.
“This is not about how we can be soft on crime,” Don Saylor said in dissent. “It’s about how we protect public safety in the long term. I don’t feel we’re there, the budget is not what I hoped it would be and I’m not going to support it.”
Matt Rexroad said he was voting for the budget reluctantly, “But I agree with Supervisor Saylor’s comment – I actually don’t believe this is data-driven.”
“If we look at our report from September,” Mr. Rexroad concluded, “We would be doing different things if this was data-driven.”
However, Supervisor Jim Provenza said, “I just disagree that we’re starting off on the wrong foot. We’re actually doing something that no one else in the state has done – and that is bring all of the parties together to work on community corrections and to make it work.”
In my brief comments to the Board, I suggested that they really needed to go into the courtrooms themselves and see for themselves what is really going on there.
We talk about not having enough resources to do what we want to do, but the fact is that we have a lot of people in custody for a long period of time, pre-trial and pre-sentencing, who will never end up in the prison system. Those are beds that could be going to people who are true dangers to this community and resources that could be going into programs shown to reduce recidivism and help people successfully re-enter our community.
—David M. Greenwald reporting
Thanks for this update David.
It is rather interesting that we are starting at the wrong end again as a community in addressing this. I am glad to read that there is a hardy discussion however money needs to be at the front door with mental health programs that PREVENT more from entering the prison systems.
The county mental health systems are failing to meet the needs of people with mental health issues. There is nothing accessible to folks needing walk in support, effective evidence based treatment, progressive care structures for people who are already IN THE CRACKS….
I spend much of my “free time” working with adults with mental illness getting them doctors appointments after they have been told there is an appointment 3-6 months out! They are out of medications, cant afford the copay for medications, experiencing symptoms that prevent them from making good decisions and cause them to isolate, become homeless, and turn to drug use to drowned the symptoms they are experiencing.
We currently have too many people with mental illness paying for a place to live with very little treatment offered. They might be called residential treatment however they are being housed and not much more.
“What concerns me is that of the $3.3 million that we initially allocated,” he said, “only $88,000 of that was designated for mental health.”
He expressed concern that there was not nearly enough in this budget for mental health treatment, drug treatment and job placement.
“[We lack funds] to support people in their effort to reacquaint themselves with life in the community. That doesn’t seem to be happening in the budget document that we’re asked to support today,” Mr. Saylor said.
Yes, Mr. Saylor you are right and it is so much bigger than what to offer to reacquaint them living outside a prison, it is how to keep the majority out of the system.
Cayce
I will add my thanks to you David for reporting on this and express strong agreement with what Cayce has written. As a volunteer in various organizations in Davis that deal with homeless issues I can attest that we are seeing more people coming out of prison with significant mental health challenges. These challenges are magnified by lack of treatment options and lack of housing. I have recently spoken to several local folks who were recently released and they acknowledged that prison and jail were the only places in which they received any kind of health or mental health services.
While mental health services have been provided by the County, the reality is that people in need of (shrinking) services live in towns like Davis and thus the lack of services becomes an issue we need to deal with locally (both in terms of prevention and care). Unfortunately we are ill-equipped to do anything and local non-profits, though they have dedicated and tireless staff, are not able to provide what is needed. For this reason I asked the Social Services Commission to request that City Council hold a workshop on the state of mental health care in Yolo County to better understand the gaps and their implications for Davis. I would hope that such a workshop would be followed by a summit–organized by the City–that would include not only local service providers but others who might play a role–including members of the faith communities of Davis who attempt to provide some respite for homeless individuals through the Interfaith Rotating Winter Shelter (IRWS). Such a “summit” would not be held to point fingers at the County but rather to begin to develop a vision for how the City will face the realities emerging as a result of budget cuts and AB109.
[quote]The county mental health systems are failing to meet the needs of people with mental health issues. There is nothing accessible to folks needing walk in support, effective evidence based treatment, progressive care structures for people who are already IN THE CRACKS…. [/quote]
I think this is a very accurate assessment. However, it must be remembered the state is not passing through enough money to the counties for mental health services. Instead the state IS passing through its responsibilities (prisoners) to the counties, without the commensurate funding to go with it. How convenient for the state, but how devastating for counties already strapped for funding…
Thanks for reporting on this David. The comments by the Chief Deputy DA simply reflect the same old attitude. The fact that he finds the comparison to CDCR insulting is good indication of little he understands about the policies that got us here in the first place and the county is now emulating. The attitude that we don’t have enough dollars to at least establish some semblance of mental health treatment for returning parolees or those who we can’t shoehorn into the jail suggests that he has little understanding of their needs and instead is just parroting the same old line that the best protection for the public is to keep these folks in jail – the most costly and least effective way to deal with the issue. Sup. Provenza should be ashamed of himself and I hope his constituents let him have it – at least giving him information that allows him to change his viewpoint.
Treatment does not exist in the county jail. They have a weekly psychiatrist, a wonderful nurse, and a social worker on the weekend. As Ms. Forbes notes, seriously mentally ill inmates are simply put in ad seg and allowed to suffer. It’s barbaric!
Elaine – it’s easy to blame the state. They didn’t do their job and appropriate enough funds. On the other hand, Yolo got over $3,000,000 to get things started and for them to allocate a lousy $88,000 is ridiculous. You can tell who runs the CCP.
I agree with Mr. Canning, I think we got enough money and we could free up more by changing some of the ways we handle people pre-sentence. I got a good statement from the Public Defender for a follow up story later this week.
[quote]I agree with Mr. Canning, I think we got enough money… [/quote]
Enough money? You want a drug rehab program, mental health program, job training program, etc. for $3 million? $3 million doesn’t go as far as you think. Plus you have to house the prisoners while you get these programs up and running. How do you do both at the same time on $3 million? No, I place the blame squarely on the state, for sloughing off their responsibility onto local gov’t, without the requisite funding and TIME to put such programs in place. We’ll have to agree to disagree on this one…
Elaine:
Answer one simple question: what does one year of residential drug treatment cost versus the cost of incarceration at CDCR for a year?
Second point, $3 million is the direct transfer cost from the state. What happens if we change the way we handle custody for people pre-sentencing and that frees up hundreds of cells, can we not realize the savings there by spending it on other efforts? That’s why I say we have a lot more money to play with than just $3 million.
[quote]Answer one simple question: what does one year of residential drug treatment cost versus the cost of incarceration at CDCR for a year? [/quote]
Shouldn’t the question be as compared to county jail?
[quote]happens if we change the way we handle custody for people pre-sentencing [/quote]
Please expand on your point and if I may suggest – you discuss only those programs, tools, “ways” (and the like) of “handling” pre-sentenced persons that are NOT currently in use (no need to duplicate efforts).
If I may: when will mental health professionals set up practices that are low cost/based on ability to pay and most importantly – free of charge? Why does it seem that the faith community is the only group that provides services for those in need using a free-will offering?
Re.. The cost of mental health treatment: there is substantial cost involved in providing effective mental health services to those in need. The impairment associated with severe mental illness is at least that of other chronic illnesses such as diabetes. It takes trained professionals and systems of care that cost a lot. Maybe i am not completely understanding your question, but faith-based organizations are not enough to treat serious mental illness. Maybe you could say more about your concern. (And some of the individuals who suffer severe mental illness and are incarcerated are well beyond the ability of faith-based organizations to provide the kind of care these individuals need. )
Re. Presentencing alternatives: Pre-sentencing alternatives can start even before booking. Teaching police officers how to better recognize the signs of someone with mental illness. Putting in place pre-booking diversion to mental health teams. The use of mental health courts that require treatment and supervision in return for dropping minor charges (many counties have these sorts of programs). Keeping mentally ill people out of jail/prison is a better alternative to putting them in. Treatment in jail is simply lousy and does little to help these folks.
Just fyi, my comment about faith based organizations was not meant to suggest they can or should seek to provide a full gamut of care for mentally ill individuals. I was merely commenting on the reality that they are a stakeholder since they are often a point of contact in the community for people with various needs–including mental health challenges. As such, they should be around the table and their members who deal directly with individuals with mental health problems should be connected to other service providers.
Robb Davis
[quote]Re.. The cost of mental health treatment: there is substantial cost involved in providing effective mental health services to those in need. The impairment associated with severe mental illness is at least that of other chronic illnesses such as diabetes. It takes trained professionals and systems of care that cost a lot. [/quote]
Bingo!
[quote]Putting in place pre-booking diversion to mental health teams. The use of mental health courts that require treatment and supervision in return for dropping minor charges (many counties have these sorts of programs). Keeping mentally ill people out of jail/prison is a better alternative to putting them in. Treatment in jail is simply lousy and does little to help these folks.[/quote]
Agreed. But it does take quite a bit of time and money to put all this in place…
Bingo, schmingo!
There is a system in place already. It’s called the Department of Alcohol, Drug and Mental Health. If we can give the money to the Sheriff and say go hire a few more deputies, why can’t we allocate money for mental health and drug abuse programs and give the money to ADMH who have that expertise. Simply throwing our collective hands up and saying we don’t have time and we don’t know any other way is like putting our heads in the sand and simply saying we have no other choice. Other locales have taken the money they’ve gotten and spread it around to a variety of programs – day centers and the like. The CCP is captive of the Sheriff and the DA. OK, the state is to blame – now, how are we going to best use what they’ve given us? We may not have caused the problem, but we have a responsibility to be part of the solution to said problems.
rdcanning,
“Other locales have taken the money they’ve gotten and spread it around to a variety of programs – day centers and the like.”
Can you cite which locales have done this and to what degree they have been successful?
It seems obvious to me that increased funding and support for such programs would be very helpful. Why do you think there is resistance among local law enforcement? Is it simply about the money or is it a fundamental difference in their approach to crime and punishment?
Elaine, take a look at Fresno County (of all places!). Here is a quote from their 21-page description of their plan: “Community Corrections as detailed in the Realignment Act are non-prison sanctions imposed by a court that move offenders through a system of services that are evidence based and available to those who will most likely benefit from them thereby redeeming both offenders and economies. The magnitude and scope of the legislation has required a paradigm shift for the criminal justice system in Fresno County. The justice partners in conjunction with the Community Corrections Partnership stand ready and competent to provide for public safety services mindful of the realignment focus on evidence based practices and solutions for alternatives to incarceration and reentry joined with public safety services.”
They are establishing day reporting centers, phone reminders for court appearances, risk assessments to determine who best will benefit from services, and other evidence-based practices that will help them keep individuals out of jail who do not belong there. There are other counties but it is late and I can’t find them right now. The words in the Fresno plan that stand out to me are “paradigm shift.” Yolo officials don’t seem to get it – the world has changed and they are hanging on to the old world. Remember, this is a county that has an incredibly high incarceration rate compared to its crime rate. That should give us all a clue who has the power here.
Sorry Elaine, my response was to Superfluous Man, not you. Sorry for the misread.
[quote]The words in the Fresno plan that stand out to me are “paradigm shift.” Yolo officials don’t seem to get it – the world has changed and they are hanging on to the old world. Remember, this is a county that has an incredibly high incarceration rate compared to its crime rate. [/quote]
So it may take some time for Yolo officials to “get it”; but with their tough on crime stance, they may refuse to “get it”… interesting to see what happens over time… and if other cities have some successes that Yolo can emulate…
One problem Yolo County has is that it is a small county, and so is not given the financial resources other counties are given. I think this probably also contributes to Yolo’s unwillingness/inability to make “paradigm shifts”…
Take a look at Tulare County’s plan – they are similar to us. But even Contra Costa County only got 1/3 more than we did ($4.5M).
Superflous Man
“Is it simply about the money the money or is it a fundamental difference in their approach to crime and punishment ?”
From my couple of years experience with folks employed in various different positions at CMF including teachers, psychologists and folks on the correctional side ( the guards) I would say the answer is both.
There is no doubt that prison guards ( CCPOA) is a very strong advocacy group for the financial well being of their members.
However from many interactions that I had with both groups, it was clear that there were two very different schools of thought with regard to the “worth” of the individual’s in their care and custody, with the enforcement/custodial side placing little value on prevention /. rehabilitation, re entry while the educators and psychologists favored a mental health, rehabilitative approach.
rd, the point is why have not mental health professionals (see 1st linen)used said ‘model’ (sorry if I wasn’t clear).
rd re: mental health courts. We agree – they are currently in place. The CA Dept. of Mental Health plays a apart in all of this too…
rd,
“Yolo County Department of Alcohol, Drug, and Mental Health Services provides a range of mental health services to community members of all ages, including adults, older adults, children, and youth. Services are aimed at helping individuals with serious mental illness live as contributing and successful members of their families and communities. Services are provided to clients through outpatient clinics and Regional Resource Centers in Woodland, West Sacramento, and Davis, school-based sites, and through a network of community agencies and independent providers. The Department also provides a range of alcohol and drug prevention and treatment services….”
http://www.yolocounty.org/Index.aspx?page=59
ad – not sure about your points. Mental Health courts are not set up by DMH. (In fact, DMH is being dismantled as we speak.) These types of programs are by local initiative. SF, Marin, Stanislaus Counties all have MH courts. The local court has pooh-poohed the idea and expressed little interest. The DA has never talked about it as far as I know.
ad – Re. ADMH – they can’t provide any additional services for incoming parolees without the funding. Other counties (see my previous posts) have worked with the local mental health departments to provide funding and support for these types of programs. Yolo’s doesn’t.