HomeMy WebLinkAboutR-2009-143 CWCMH Behavioral Health Diversion Program, Agreement for Cost-Sharing with Yakima CountyRESOLUTION NO. R 2009-143
A RESOLUTION authorizing and directing the City Manager of the City of Yakima to execute an
Agreement with Central Washington Comprehensive Mental Health (CWCMH),
and Yakima County Department of Human Services whereby the City of Yakima
agrees to cost -share with the County to fund the CWCMH Behavioral Health
Diversion Program for a six-month period
WHEREAS, the Yakima Unit of CWCMH has developed a behavioral health diversion program
to provide crisis intervention to persons with mental illness as authorized by SSB 5533, Chapter 375,
Laws of 2007, Criminal Behavior—Individuals with Mental Illness; and
WHEREAS, the CWCMH Behavioral Health Diversion Program provides crisis stabilization and
clinical staff to triage, assess and treat individuals referred for mental illness and co-occurring
substance abuse. CWCMH staff will additionally complete substance abuse assessments and as
applicable refer these individuals for services as appropriate. These services may include but are not
limited to outpatient mental health services, crisis residential services, dual -diagnosis treatment,
chemical dependency services, and inpatient dual diagnosis treatment; and
WHEREAS, inmates with a history of mental health illness tend to be housed longer in jail than
inmates similarly situated without mental health illness, lose entitlements while in jail, and receive no
treatment for mental health issues while housed in City and County jail facilities; and
WHEREAS, the Behavioral Health Diversion Program allows an officer to take an individual to
the crisis stabilization unit, in lieu of jail, for assessment and treatment when an officer has reasonable
cause to believe that an individual has committed acts constituting a non -felony crime that is not a
serious offense and that the individual has a history of mental illness; and
WHEREAS, the cost to continue the program for an additional six months is $216,461, and the
City of Yakima and Yakima County will share that costs based on each entities historical use of the
program; and
WHEREAS, the City Council deems it to be in the best interest of the City of Yakima to execute
an Agreement whereby the City of Yakima will cost share with Yakima County the Behavioral Health
Diversion Program, now, therefore,
BE IT RESOLVED by the Council of the City of Yakima, Washington:
The Yakima City Council authorizes and directs the City Manager of the City of Yakima to
execute an Agreement with Central Washington Comprehensive Mental Health whereby the City of
Yakima will cost -share with Yakima County to fund the Central Washington Comprehensive Mental
Health Behavioral Health Diversion Program for a six month period.
This Resolution shall be effective after its adoption.
ADOPTED BY THE CITY COUNCIL this 20th day of October, 2009.
ATTEST:
cim/CWCMH behavioral Diversion Program
CIT AGREEMENT BETWEEN
YAKIMA COUNTY,
jCITY OF YAKIMA, AND
CENTRAL WASHINGTON COMPREHENSIVE MENTAL HEALTH
This AGREEMENT, entered into this ID day of I\104 2009 by Yakima County
Department of Human Services (hereafter referred to as the County) whose address is 128
North 2nd Street, Room 102, Yakima, Washington 98901-2639, the City of Yakima (the City)
whose address is 129 North 2nd Street, Yakima, Washington 98901-2613, and Central
Washington Comprehensive Mental Health (the Contractor) whose address is PO Box 959,
Yakima, Washington, 98907-0959, whose signatures are reflected on this Agreement.
PURPOSE
The purpose of this agreement is to provide crisis intervention to persons with mental illness as
authorized by SSB 5533, Chapter 375, Laws of 2007, Criminal Behavior — Individuals with
Mental Illness.
TERM OF AGREEMENT
The term of this Agreement shall be October 1, 2009 through March 31, 2010. This Agreement
may be extended, by mutual written consent of the parties
CONSIDERATION
In consideration of the Contractors' performance of the responsibilities as defined in the
Statement of Work, the City and County agree to cost -share the Behavioral Health Diversion
Program as follows: the City shall contribute $132,041 and the County shall contribute $84,420
for a total of $216,461. The Contractor shall assume full responsibility for payments of Federal,
State, and local taxes or contributions imposed or required under the Social Security, Workmen's
Compensation, and Income Tax laws for persons other than County or City employees
performing services pursuant to this Agreement.
GENERAL TERMS AND CONDITIONS
1. Definitions: The words and phrases listed below, as used in the Agreement, shall each
have the following definitions:
a. "Agreement" means this Agreement and any Exhibits and other documents
attached or incorporated by reference, between the Contractor and the County and
City.
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b. "CFR" means Code of Federal Regulations. All references in this Agreement and
any Program Agreement to CFR chapters or sections shall include any successor,
amended, or replacement regulation. The CFR may be accessed at
http://www.gpoaccess.gov/cfr/index.html.
c. "Debarment" means an action taken by a Federal official to exclude a person or
business entity from participating in transactions involving certain federal funds.
d. "Personal Information" means information identifiable to any person, including,
but not limited to, information that relates to a person's name, health, finances,
education, business, use or receipt of governmental services or other activities,
addresses, telephone numbers, social security numbers, drivers license numbers,
other identifying numbers, and any financial identifiers.
e. "RCW" means the Revised Code of Washington. All references in this Agreement
to RCW chapters or sections shall include any successor, amended, or
replacement statute. The RCW can be accessed at http://slc.leg.wa.gov.
f. "Subcontract" means a separate Agreement between the Contractor and an
individual or entity ("Subcontractor") to perform all or a portion of the duties and
obligations, which the Contractor is obligated to perform pursuant to this
Agreement.
"USCA" means United States Code Annotated. All references to USCA chapters
or sections in this Agreement, or any Program Agreement, shall include any
successor, amended, or replacement regulation. The USCA is accessible at
http://www.gpoaccess.qov/uscode/.
h. "WAC" means the Washington Administrative Code. All references in this
Agreement to WAC chapters or sections shall include any successor, amended, or
replacement regulation. The WAC is accessible at http://slc.leg.wa.gov.
2. Amendment: This Agreement, or any term or condition, may be modified only by a
written amendment signed by both parties. Only personnel authorized to bind each of the
parties shall sign an amendment.
3. Assignment: The Contractor shall not assign rights or obligations derived from this
Agreement to a third party without the prior, written consent of the Contracts
Administrator and the other parties to this Agreement. Any authorized assignment will
include a written assumption of the Contractor's obligations by the third party.
4. Billing Limitations: Unless otherwise specified in this Agreement, the County and the
City shall not pay any claims for services submitted more than 30 days after the calendar
month in which the services were performed.
5. Compliance with Applicable Law: At all times during the term of this Agreement, and
any Program Agreement, the Contractor and DSHS shall comply with all applicable
federal, state, and local laws, regulations, and rules, including but not limited to non-
discrimination laws and regulations.
g.
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6. Confidentiality:
a. The parties shall use Personal Information and other information gained because
of this Agreement only for the purpose of this Agreement. Yakima County and
the Contractor shall not disclose, transfer, or sell any such information to any
other party, except as provided by law or, in the case of Personal Information,
without the prior written consent of the person to whom the Personal Information
pertains. The parties shall maintain the confidentiality of all Personal Information
and other information gained because of this Agreement and shall return or certify
the destruction of such information, as authorized by law, if requested in writing
by the party to this Agreement that provided the information.
b. The Contractor shall comply with all confidentiality requirements of the Health
Insurance Portability and Accountability Act (42 CFR Sections 160 - 164).
7. Debarment Certification: The Contractor, by signature to this Agreement, certifies the
Contractor is not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded by any Federal department or agency from
participating in transactions (debarred.) The Contractor also agrees to include the above
requirement in any and all Subcontracts into which it enters. The Contractor shall
immediately notify the County and the City if, during the term of this Agreement, the
Contractor becomes debarred. The County and/or the City may immediately terminate
this Agreement by providing the Contractor written notice if the Contractor becomes
debarred during the term of this Agreement.
8. Disputes: A Dispute Board shall determine disputes between the parties in the following
manner: Each party in the dispute shall appoint one member to the Dispute Board. If
additional members are needed on the Dispute Board, the members appointed shall
jointly appoint an additional member to the Dispute Board. The Dispute Board shall
review the facts, agreement terms, and applicable statutes and rules and make a
determination. This process shall constitute the final administrative remedy available to
the parties. Each party reserves the right to litigate issues and matters in court de novo. A
Program Agreement may supplement, but not contravene, this section.
9. Nondiscrimination: The Contractor ,agrees that it shall not discriminate in violation of
any applicable federal, state and/or local law or regulation on the basis of race, creed,
color, religion, national origin, sex, sexual orientation, age, marital status, disability,
political affiliation or belief', honorably discharged veteran or military status, pregnancy,
or the presence of any sensory, mental or physical handicap, and any other classification
protected under federal , state and local law. This provision shall include but not be
limited to the following: employment, upgrading, demotion, transfer, recruitment,
advertising, layoff or termination, rates of pay of other forms of compensation, selection
for training, and the provision of services under this Agreement. In the event the
Contractor violates this provision, the County and/or the City may terminate this
Agreement immediately and bar the Contractor from performing any services for the
County and/or the City in the future.
10. Entire Agreement: This Agreement, including all documents attached to or incorporated
by reference, contains all the terms and conditions agreed upon by the parties. No other
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understandings or representations, oral or otherwise, regarding the subject matter of this
Agreement shall be deemed to exist or bind the parties.
11. Governing Law and Venue: The laws of the State of Washington govern this
Agreement. In the event of a lawsuit by the Contractor against the County and/or the City
involving this Agreement or a Program Agreement, venue shall be proper only in Yakima
County, Washington. In the event of a lawsuit by the County or the City against the
Contractor involving this Agreement or a Program Agreement, venue shall be proper
only as provided in RCW 36.01.050.
12. Independent Contractor: The parties agree that, for the purposes of this Agreement, the
Contractor is an independent contractor and neither the Contractor nor any employee of
the Contractor is an employee of the County or the City. Neither the Contractor nor any
employee of the Contractor is entitled to any benefits that the County or the City provides
its employees. The Contractor is solely responsible for payment of any statutory workers
compensation or employer's liability insurance as required by state law.
13. Inspection: The parties may request reasonable access to other party's records and place
of business for the limited purpose of monitoring, auditing, and evaluating the other
party's compliance with this Agreement, any Program Agreement, and applicable laws
and regulations. During the term of any Program Agreement and for one year following
termination or expiration of the Program Agreement, the parties shall, upon receiving
written notice, provide the other party with access to its place of business and to its
records, which are relevant to its compliance with this Agreement, any Program
Agreement, and applicable laws and regulations. This provision shall not be construed to
give either party access to the other party's records and place of business for any other
purpose. Nothing herein shall be construed to authorize the parties to possess or copy
records of the other parties.
14. Maintenance of Records:
a. During the term of this Agreement and for seven years following termination or
expiration of this Agreement, or if any audit, claim, litigation, or other legal
action involving the records is started before expiration of the seven year period,
the records shall be maintained until completion and resolution of all issues
arising there from or until the end of the six year period, whichever is later. The
Contractor shall maintain records sufficient to:
(1) Document performance of all acts required by law, regulation, or this
Agreement;
(2) Demonstrate the accounting procedures, practices, and records that
sufficiently and properly document the Contractor's invoices to the
County and the City, and all expenditures made by the Contractor to
perform as required by this Agreement; and
For the same period, the Contractor shall maintain records sufficient to
substantiate the Contractor's statement of its organization's structure, tax
status, capabilities, and performance.
(3)
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15. Indemnification and Hold Harmless:
(1) The Contractor agrees to protect, defend, indemnify, and hold harmless
the County and the City, its elected officials, officers, employees, agents,
and volunteers from any and all claims, demands, losses, liens, liabilities,
penalties, fines, lawsuits, and other proceedings and all judgments,
awards, costs and expenses (including reasonable attorneys' fees and
disbursements) resulting from death or bodily injury to any person or
damage or destruction to a third party or third parties to the extent caused
by any negligent act and/or omission of Contractor, its officers,
employees, agents, volunteers and/or subcontractors, arising out of the
performance of this Agreement.
(2) The City and County agree to protect, defend, indemnify, and hold
harmless the Contractor, it's officers, employees, agents, and volunteers
from any and all claims, demands, losses, liens, liabilities, penalties, fines,
lawsuits, and other proceedings and all judgments, awards, costs and
expenses (including reasonable attorneys' fees and disbursements)
resulting from death or bodily injury to any person or damage or
destruction to a third party or third parties to the extent caused by any
negligent act and/or omission of Contractor, its officers, employees,
agents, volunteers and/or subcontractors, arising out of the performance of
this Agreement.
If the County or the City and the Contractor are found to be joint and
severally liable for damages as a result of an act or omission arising from
the performance of this contract, each party shall be responsible for its
proportionate share of damages.
(4) The County, the City and the Contractor agree to notify the attorneys of
record in any tort lawsuit involving the performance under this agreement,
if either the County, the City or the Contractor enters into settlement
negotiations. It is understood that the notice shall occur prior to any
negotiations, or as soon as possible, and the notice may be either written
or oral.
(3)
(5)
16. Insurance:
Nothing contained in this Section or this Contract shall be construed to
create a liability or a right of indemnification in any third party.
a. The County and the City certify that they are part of a risk pool and shall pay for
losses if they are found liable.
b. At all times during performance of the Services, the Contractor shall secure and
maintain in effect insurance to protect the County and the City from and against all
claims, damages, losses, and expenses arising out of or resulting from the
performance of this Contract. The Contractor shall provide and maintain in force
insurance in limits no less than that stated below, as applicable. The County and the
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City reserves the right to require higher limits should it deem it necessary in the best
interest of the public.
(1) Commercial Liability Insurance. Before this Agreement is fully executed
by the parties, the Contractor shall provide the County and the City with a
certificate of insurance as proof of commercial liability insurance and
commercial umbrella liability insurance with a total minimum liability
limit of Three Million Dollars ($3,000,000.00) per occurrence combined
single limit bodily injury and property damage, and Three Million Dollars
($3,000,000.00) general aggregate. The certificate shall clearly state who
the provider is, the coverage amount, the policy number, and when the
policy and provisions provided are in effect. Said policy shall be in effect
for the duration of this Agreement. The policy shall name the County and
the City, their elected officials, officers, agents, employees, and volunteers
as additional insureds, and shall contain a clause that the insurer will not
cancel or change the insurance without first giving the County and the
City 30 calendar days prior written notice. The insurance shall be with an
insurance company or companies rated B+ or higher in Best's Guide and
admitted in the State of Washington.
(2) Commercial Automobile Insurance.
i. If the Contractor owns any vehicles, before this Agreement is fully
executed by the parties, the Contractor shall provide the County and
the City with a certificate of insurance as proof of commercial
automobile liability insurance and commercial umbrella liability
insurance with a total minimum liability limit of Three Million Dollars
($3,000,000.00) per occurrence combined single limit bodily injury
and property damage. Automobile liability will apply to "Any Auto"
and be shown on the certificate.
ii. If the Contractor does not own any vehicles, only "Non -owned and
Hired Automobile Liability" will be required and may added to the
commercial liability coverage at the same limits as required in that
section of this Agreement, which is Section 12.2 entitled "Commercial
Liability Insurance".
iii. Under either situation described above., the required certificate of
insurance shall clearly state who the provider is, the coverage amount,
the policy number, and when the policy and provisions provided are in
effect. Said policy shall be in effect for the duration of this Agreement.
The policy shall name the County and the City, their elected officials,
officers, agents, employees, and volunteers as additional insureds, and
shall contain a clause that the insurer will not cancel or change the
insurance without first giving the County and the City 30 calendar
days prior written notice. The insurance shall be with an insurance
company or companies rated A -VII or higher in Best's Guide and
admitted in the State of Washington.
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(3)
Directors and Officers. Before this Agreement is fully executed by the
parties, the Contractor shall provide the County and the City with a
certificate of insurance as evidence of Directors and Officers Liability
Insurance with coverage of at least One Million Dollars ($1,000,000.00)
per occurrence and an annual aggregate limit of at least One Million
Dollars ($1,000,000.00). The certificate shall clearly state who the
provider is, the amount of coverage, the policy number, and when the
policy and provisions provided are in effect. The insurance shall be with
an insurance company rated A -VII or higher in Best's Guide. If the policy
is on a claims made basis, the retroactive date of the insurance policy shall
be on or before the inception date of the Agreement, or shall provide full
prior acts. The insurance coverage shall remain in effect during the term of
this Agreement and for a minimum of three years following the
termination of this Contract.
17. Order of Precedence: In the event of an inconsistency in this Agreement, or between its
terms and any applicable statute or rule, the inconsistency shall be resolved by giving
precedence in the following order:
a. State statutes and regulations;
b. Other applicable federal, state, or local law.
18. Ownership of Material: Material created by the Contractor and paid for by the County
and the City as part of this Agreement shall be equally owned by the County and the City
and shall be "work made for hire" as defined by Title 17 USCA, Section 101. This
material includes, but is not limited to: books; computer programs; documents; films;
pamphlets; reports; sound reproductions; studies; surveys; tapes; and/or training
materials. Material which the Contractor uses to perform the Program Agreement but is
not created for or paid for by the County or the City is owned by the Contractor and is not
"work made for hire"; however, the County and the City shall have a perpetual license to
use this material for County and/or City internal purposes at no charge to the County or
the City, provided that such license shall be limited to the extent which the Contactor has
a right to grant such a license.
No report, device, thing, or document of whatever kind or nature, produced in whole or in
part in connection with the project shall be the subject of an application for copyright or
patent by or on behalf of the Contractor without prior written approval of the County or
the City.
Supplies and equipment (such as computer equipment, office supplies, etc.) provided by
the County or the City for use during the course of this Agreement remain the property of
the loaning entity and may be utilized by the loaning entity in any manner, which is
deemed appropriate
19. Severability: The provisions of this Agreement are severable. If any court holds any
provision of this Agreement, including any provision of any document incorporated by
reference, invalid, that invalidity shall not affect the other provisions of this Agreement.
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20. Subcontracting: The Contractor may subcontract services provided under this
Agreement, unless otherwise specified in a Program Agreement. Any subcontractor shall
be required to indemnify and hold harmless the Contractor and maintain adequate
liability insurance, comparable to the insurance maintained by the Contractor pursuant to
this agreement.
The Contractor shall not subcontract with an individual provider or an entity with an
individual who is an officer, director, agent, or manager, or who owns or has a
controlling interest in the entity, and who has been convicted of crimes as specified in 42
USC 1320a.
21. Subrecipients:
a. General: If the Contractor is a subrecipient of federal awards as defined by Office
of Management and Budget (OMB) Circular A-133 and this Agreement, the
Contractor shall, unless otherwise indicated in the Special Terms and Conditions:
(1) Maintain records that identify, in its accounts, all federal awards received
and expended and the federal programs under which they were received,
by Catalog of Federal Domestic Assistance (CFDA) title and number,
award number and year, name of the federal agency, and name of the pass-
through entity;
(2) Maintain internal controls that provide reasonable assurance that the
Contractor is managing federal awards in compliance with laws,
regulations, and provisions of contracts or grant Agreements that could
have a material effect on each of its federal programs;
Prepare appropriate financial statements, including a schedule of
expenditures of federal awards;
(4) Incorporate OMB Circular A-133 audit requirements into all Agreements
between the Contractor and its Subcontractors who are subrecipients;
Comply with any future amendments to OMB Circular A-133 and any
successor or replacement Circular or regulation;
(6) Comply with the applicable requirements of OMB Circular A-87 and any
future amendments to OMB Circular A-87, and any successor or
replacement Circular or regulation; and
Comply with the Omnibus Crime Control and Safe streets Act of 1968,
Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation
Act of 1973, Title II of the Americans with Disabilities Act of 1990, Title
IX of the Education Amendments of 1972, The Age Discrimination Act of
1975, and The Depaitinent of Justice Non -Discrimination Regulations, 28
CFR Part 42, Subparts C, D, E and G, and 28 CFR Part 35 and 39. (See
www.oip.usdoj/gov/ocr for additional information and access to the
aforementioned Federal laws and regulations.)
b. Single Audit Act Compliance: If the Contractor is a subrecipient and expends
$500,000 or more in federal awards from any and/or all sources in any fiscal year,
(3)
(5)
(7)
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the Contractor shall procure and pay for a single audit or a program -specific audit
for that fiscal year. Upon completion of each audit, the Contractor shall:
(1) Submit to the County and the City contact person, listed on the first page
of this Agreement, the data collection form and reporting package
specified in OMB Circular A-133, reports required by the program -
specific audit guide (if applicable), and a copy of any management letters
issued by the auditor;
(2) Follow-up and develop corrective action for all audit findings; in
accordance with OMB Circular A-133, prepare a "Summary Schedule of
Prior Audit Findings."
c. Overpayments: If it is determined by the County or the City, or during the course
of a required audit, that the Contractor has been paid unallowable costs under this
Agreement, the County and/or the City may require the Contractor to reimburse
the County in accordance with OMB Circular A-87.
22. Survivability: The terms and conditions contained in this Agreement, which by their
sense and context, are intended to survive the expiration of this Agreement, shall so
survive. Surviving terms include, but are not limited to Confidentiality, Disputes,
Inspection, Maintenance of Records, Mutual Indemnification and Hold Harmless,
Ownership of Material, Termination for Default, Termination Procedure, and Treatment
of Assets Purchased by the RSN, and Treatment of Property.
23. Termination due to Change in Funding: If the funds upon which either the County or
the City relied to establish this Agreement are withdrawn, reduced or limited or if
additional or modified conditions are placed on such funding, the County or the City may
terminate this Agreement by providing at least five business days' written notice to the
Contractor. The termination shall be effective on the date specified in the notice of
termination.
The County and/or the City shall give the Contractor such advance written notice of
termination as the notice of withdrawal, reduction, or limitation received by the County
or the City will permit.
24. Termination for Convenience: Except otherwise as provided in this Agreement,
Yakima County Representative or the City of Yakima Representative may terminate this
Agreement, in whole or in part, when it is in the best interest of either of the parties by
giving the Contractor at least 90 calendar days' written notification by certified mail. The
Contractor may terminate this Agreement for convenience by giving the County and the
City at least 90 calendar days' written notification receipt by certified mail addressed to:
Yakima County Department of Human Services
128 N 2nd Street, Room 102, Yakima, WA 98901-2639
City of Yakima, City Manager
129 N 2nd Street, Yakima WA 98901
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The effective date of the termination shall be the last day of the calendar month in which
the ninetieth day occurs.
This Agreement may also be terminated in whole or in part by either party, upon thirty
days advance written request to terminate, with the written consent of the other party, in
which case the two parties shall devise by mutual Agreement the conditions of
termination including effective date and in the case of termination in part, the portion to
be terminated.
25. Termination for Default:
a. The Yakima County Representative and/or the City of Yakima Representative
may terminate this Agreement for default, in whole or in part, by written notice to
the Contractor, if the County or the City has a reasonable basis to believe that the
Contractor has:
(1) Failed to meet or maintain any requirement for contracting with Yakima
County;
(2) Failed to perform under any provision of this Agreement;
(3) Performed any of the Contractor's obligations under this Agreement in a
manner that comprised the health or safety of any individual with whom
the Contractor had contact;
(4) Violated any law, regulation, rule, or ordinance applicable to the services
provided under this Agreement, including those pertaining to health and
safety; or
Otherwise breached any provision or condition of this Agreement.
(5)
b. Before the County and/or the City may terminate this Agreement for default, the
County and/or the City shall provide the Contractor with written notice of the
Contractor's noncompliance with this Agreement and provide the Contractor a
reasonable opportunity to correct the Contractor's noncompliance. The
complaining party shall provide a copy of the written notice to the other party of
this agreement. If the Contractor does not correct the Contractor's noncompliance
within the period of time specified in the written notice of noncompliance, the
complaining party may then terminate this Agreement. The Yakima County
Representative and/or the City of Yakima Representative, however, may
terminate this Agreement for default without such written notice and without
opportunity for correction if the County and/or the City has a reasonable basis to
believe that an individual's health or safety is in jeopardy or if the Contractor has
violated any law, regulation, rule, or ordinance applicable to the services provided
under this Agreement.
c. The Contractor may terminate this Agreement with either the County, or the City,
for default, in whole or in part, by written notice to the County and the City, if the
Contractor has a reasonable basis to believe that the County and /or the City has:
(1) Failed to meet or maintain any requirement for contracting with the
Contractor;
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(2) Failed to perform under any provision of this Agreement;
(3) Violated any law, regulation, rule or ordinance applicable to work
performed under this Agreement; and/or
(4) Otherwise breached any provision or condition of this Agreement.
d. Before the Contractor may terminate this Agreement for default, the Contractor
shall provide the County and the City with written notice of either parties'
noncompliance with this Agreement and provide the noncomplying party(ies) a
reasonable opportunity to correct the noncompliance. If the noncomplying party
has not corrected the noncompliance within the period specified in the written
notice of noncompliance, the Contractor may then terminate this Agreement.
26. Termination Procedure: The following provisions shall survive and be binding on the
parties in the event this Agreement is terminated.
a. The Contractor shall cease to perform any services required by this Agreement as
of the effective date of termination and shall comply with all reasonable
instructions contained in the notice of termination which are related to the transfer
of individuals, distribution of property, and termination of services. Each party
shall be responsible only for its performance in accordance with the terms of this
Agreement, rendered prior to the effect date of termination. The Contractor shall
assist in the orderly transfer/transition of the individuals served under this
Agreement. The Contractor shall promptly supply all information necessary for
the reimbursement of any outstanding Medicaid claims.
b. The Contractor shall immediately deliver to the County and City contact person
(or to his or her successor) listed on the first page of this Agreement, all loaned
County and City assets (property)to the owner agency in the Contractor's
possession, including any material created under this Contract. The Contractor
grants the County and the City the right to enter upon the Contractor's premises
for the sole purpose of recovering any of their respective property that the
Contractor fails to return within 10 working days of termination of this
Agreement. Upon failure to return County or City property within 10 working
days of termination of this Agreement, the Contractor shall be charged with all
reasonable costs of recovery, including transportation and attorney's fees. The
Contractor shall protect and preserve any property of the County and the City that
is in the possession of the Contractor pending return to the respective party.
c. The County and the City shall be liable for and shall pay for only those services
authorized and provided through the date of termination. The County and the City
may pay an amount agreed by the parties for partially completed work and
services, if work products are useful to or usable by the County or the City.
d. If the County and/or City Representative(s) terminates this Agreement for default,
the terminating party may withhold a sum from the final payment to the
Contractor that the terminating party determines necessary to protect the
terminating party against loss or additional liability. The County and/or the City
shall be entitled to all remedies available at law, in equity, or under this
Agreement, including consequential damages, incidental damages, legal fees, and
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costs. If it is later determined that the Contractor was not in default, the
Contractor shall be entitled to all remedies available at law, in equity, or under
this Agreement, including consequential damages, incidental damages, legal fees,
and costs.
e. The County and /or City Representative(s) may direct assignment of the
Contractor's rights to any interest in any subcontract or orders placed to County
and/or the City. The County and/or the City may terminate any subcontract or
orders and settle or pay any or all claims arising out of the termination of such
orders and subcontracts.
27. Waiver: Waiver of any breach or default of any provision of this Agreement shall not be
deemed a waiver of any subsequent breach or default. Any waiver shall not be construed
to be a modification of the terms and conditions of this Agreement. Only the County
and/or City Representative(s) or designee has the authority to waive any term or
condition of this Agreement, on behalf of their agency.
STATEMENT OF WORK
The Contractor shall:
1. Administer and staff a Crisis Triage Center (CTC) where client assessment, referral to
community services, and crisis treatment services will occur over a period of up to 12
hours as contemplated in SSB 5533 — an act relating to procedures for individuals who are
mentally ill and engaged in acts constituting criminal behavior, attached as Exhibit A.
A. This program shall be known as the Behavioral Health Diversion Program. The
Crisis Triage Center shall provide a means for law enforcement officers of the City
of Yakima, Yakima County Sheriff's office, and officers of County Probation to
deliver individuals believed to meet the criteria for the Behavioral Health Diversion
Program to the facility and to, as quickly as is feasible, accept the individual for
evaluation.
B. The Contractor warrants that it is certified by the Washington State Mental Health
Division as the Emergency Evaluation and Treatment provider for Yakima County,
that it is a Washington State Licensed Community Mental Health Center authorized
to provide the contemplated services, and that it is a Washington State certified
chemical dependency treatment provider.
C. The Contractor shall be accredited by the Joint Commission on the Accreditation of
Health Care Organization (JCAHO). The proposed facility is licensed by the
Washington State Department of Health as a Residential Treatment Facility (RTF).
2. Provide initial screening and assessment for admission to the diversion program.
3. For individuals accepted into the program, coordinate crisis, involuntary, outpatient, and
residential treatment services based on the individuals needs; develop initial service/
treatment plans and coordinate placement and other community services including, but not
limited to, housing placement, income supports, and medical services.
Page 12 of 14 CMH CIT 09
A. Monitor participants for treatment compliance.
I. Individuals who fail to follow treatment plans or recommendations at any time
within the first two weeks of referral will be referred back to the referring law
enforcement agency and the appropriate prosecuting authority for further
disposition.
4. For individuals not accepted into the program, refer the individual back to the referring law
enforcement agency and the appropriate prosecuting authority within 12 hours of the
individual's arrival at the Crisis Triage Center for further disposition.
5. Utilize the Referral for Treatment Standards (attached as Exhibit C) developed by Yakima
County and City of Yakima prosecutors as criteria for admission to the program.
A. Should modifications to this document be necessary, assist the Yakima County and
City of Yakima prosecutors to develop client offense level criteria standards to
determine appropriate referral of clients to the CDC.
6. The Contractor will provide regular orientation training to law enforcement personnel at
mutually agreed upon times and locations (e.g., musters, Department training events). The
Contractor will make law enforcement aware of CIT training events it sponsors and
provide registration materials. Because these training events are funded by other sources
admission to any particular class cannot be guaranteed.
7. Based on a mutually agreed upon data dictionary, contractor will collect and report data
using approved intake and assessment tools, and documentation of client services and
referrals, including law enforcement contact reports and service data. Currently collected
data is attached as Exhibit D. The contractor will staff and participate in a Data Collection
and Monitoring Committee, which incorporates representation from all parties to this
agreement. This committee will coordinate evaluation of the outcomes and effectiveness of
the program.
8. Develop, staff, and participate in the Program Oversight Committee, comprised of
stakeholders, who meet regularly to discuss program development, implementation,
systemic integration of services, staffing, training, and public education regarding the
program.
9. Develop, staff, and participate in the Administrative Oversight Committee, comprised of
Criminal Justice, County and City officials, and program stakeholders, providing program
implementation reports and recommendations.
****************
THEREFORE, Yakima County, the City of Yakima, and Central Washington Comprehensive
Mental Health agree to the terms and conditions of the Agreement and its exhibits as listed above
by signing below:
Page 13 of 14 CMH CIT 09
CITY OF YAKIMA
4
Richard Zais, Jr., City anager
Date
Approved as to Form:
AI/9
BOARD OF COUNTY COMMISSIONERS
J. Ralliott, Chairman
Jeff Cutter, City Attorney
Date
CITY CONTRACENO. Q4-123
RESOLUTION NO: R sa /AV - /4/3
CENTRAL WASHINGTON
COMPREHENSIVE MENTAL HEALTH
Rick Weaver, President and CEO
10/1_9 o 9
1
Date
Michael D. Leita, Commissioner
n J. B ► ' ey, Commissioner
Approved as to Form:
y\ A w
Deputy Prosecuting Attorney
LbSbf 03S401
CONTRACT AUTHORIZATION
Attest:
\\\,3•.. WAS L'O& /,moi
o:tic' y GA •
o
w . cD Z
Christina S. Steiner, Clerk oft e Brkai.d • c, �
1,
MOVtlJd 2_c V '''"„II1110s
Date
Page 14 of 14 CMH CIT 09
•
BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No.
For Meeting of October 20, 2009
ITEM TITLE: Consideration of legislation regarding a Behavioral Health Diversion Program:
A. A Resolution authorizing and directing the City Manager of the City of Yakima to
execute an Agreement with Central Washington Comprehensive Mental Health
(CWCMH), whereby the City of Yakima agrees to cost -share with Yakima County to
fund the CWCMH Behavioral Health Diversion Program for a six month period.
B. An Ordinance amending the 2009 budget and making an appropriation in the 000 —
General Fund.
SUBMITTED BY: Chief Sam Granato, Yakima Police Department
Cynthia Martinez, Senior Assistant City Attomey
CONTACT PERSON/TELEPHONE: Cynthia Martinez, 575-6033
SUMMARY EXPLANATION: A couple of years ago, Central Washington Comprehensive
Mental Health (CWCMH) received a grant to create and implement a Behavioral Health
Diversion Program. The program is now fully operational and provides a location to serve
as a crisis stabilization unit and clinical staff to triage, assess and treat individuals referred
for mental illness and co-occurring substance abuse. CWCMH staff also complete
substance abuse assessments and as applicable refer individuals participating in the
program for services as appropriate. These services may include, but are not limited to,
outpatient mental health services, crisis residential services, dual -diagnosis treatment,
chemical dependency services, and inpatient dual diagnosis treatment.
Continued on the next page:
Resolution X Ordinance X Other(Specify)
Contract X Mail to (name and address): Central Wash. Comprehensive Mental Health
PO Box 959, Yakima, WA 98907-0959 Phone:
Funding Source General Fund R es --$132,041 for a 6 month pilot program
APPROVED FOR SUBMITTAL:
City Manager'
STAFF RECOMMENDATION: A. Adopt Resolution.
B. Read the attached Ordinance by title only at the October 20, 2009 meeting. Pass ordinance
after second reading at the November 3, 2009 Council Meeting.
BOARD/COMMISSION RECOMMENDATION: The Yakima City Council Public Safety
Committee unanimously approved this item.
COUNCIL ACTION:
Continued from the first page:
The City benefits from the Behavioral Health Diversion program because it allows an officer
to take an individual to the crisis stabilization unit, in lieu of jail, for assessment and
treatment when an officer has reasonable cause to believe that an individual has
committed acts constituting a non -felony crime that is not a serious offense and the
individual has a history of mental illness.
Without this program these individuals would be booked into the jail and typically incur
medical costs at the City's expense. Defendants with active mental health illnesses
typically spend longer in jail than similarly situated defendants without mental health illness,
due to lengthy legal procedures mandated by statute, which often result in the dismissal of
charges. The lengthy stay in jail leads to other problems for the mentally ill individual such
as the loss of social entitlements and further decompensation due to lack of treatment
which increases the chance of further interaction with the criminal justice system. For the
reasons stated above, participation in the CWCMH Behavioral Diversion Program saves
the City money.
The City of Yakima has been able to utilize this program at no cost; but, because the grant
funds have been fully expended, the City of Yakima and Yakima County are being asked to
fund the program. The six month cost of the program is $216,461 and the Agreement
provides that Yakima County and the City of Yakima will cost -share in proportion to each
organizations past use of the program. The City of Yakima's portion has been calculated
at $132,041. The attached appropriation increases the 2009 General Fund budget in• the
Intergovernmental Department for 3 months of the contracted period (October through
December), or $66,021. The balance of the contracted amount will be added to the final
2010 budget. Since this program was anticipated during budget development,- this
expense is already considered in the expenditure/reserve calculations for General Fund.
This contract period is being considered a 6 (six) month pilot project and CWCMH will be
monitoring City and County usage to determine costs• saved by the program. The current
budget situation makes it difficult to predict whether the City will be in a position to continue
to fund the program at the end of this six month period.
City Of Yakima
2010 Budget Requests
For Agencies Requesting Funding Through General Funds
General Background,
Requesting Agency
Name: Central Washington Comprehensive Mental Health
Address: PO Box 959 (402 S. 4th Avenue), Yakima, WA 98907
Contact Person: Rick Weaver, CEO
Agency's Primary Service
Central Washington Comprehensive Mental Health (Comprehensive) is a private, non-profit
501(c)(3) Washington corporation. Comprehensive began operations in. 1972. As a community
mental health center it serves children and their families, adults and seniors in Yakima, Kittitas,
Klickitat and Benton Counties in rural south central Washington State. More than 400 highly
trained and qualified mental health professionals serve the three county area of over 290,000
population. Comprehensive provides a full range of outpatient, residential and inpatient
mental health, chemical dependency treatment, crime victim advocacy and veteran's services.
A major service provided by Comprehensive is a national award-winning twenty-four hour
mental health and chemical dependency crisis response outreach service. This. service responds
wherever crises occurs in the community and provides for connection to services including
involuntary treatment. Since November 2007, this service has included the first behavioral
health jail diversion program in the State of Washington. This service diverts non-violent
misdemeanants suffering from mental illness or co-occurring mental illness and substance
abuse from jail and into treatment.
Is Applicant Organization A Governmental Agency Created By Statute, By Yakima County Or City Legislation?
Yes ❑ No ® .
If answer is "yes", cite the applicable RCW Section or Chapter, or enclose with this application for a
copy of the County or City legislation which created the agency.
If answer to #3 above is "no", answer questions #1 and #2 below:
1. Describe the legal organization of applicant, such as nonprofit corporation, etc.
Comprehensive is a private, non-profit 501(c)(3) corporation. It is licensed by the
State of Washington, DSHS, Mental Health Division as a Community Mental Health
Center. Comprehensive is also licensed by DASA to provide outpatient, detox and
residential chemical dependency treatment services. All twenty-four hour
residential treatment services operated by Comprehensive are licensed by
Department of Health. Comprehensive is voluntarily accredited by the Joint
Commission on the Accreditation of Health Care Organizations.
2. Has applicant, entered into a contract with the State of Washington, Yakima county or the
city of Yakima, pursuant to which applicant performs a function on behalf of the state,
county or city?
Yes ® No ❑
If answer is "yes", enclose with this application a copy of that contract.
Comprehensive has multiple contracts with Yakima County to provide outpatient
mental health and chemical dependency treatment services to residents of Yakima
County.
Has Applicant Previously Received A Grant Or Other Financing From The State Of Washington, Yakima County, Or
City Of To Finance Applicant's Operation?
Yes® No❑
If answer is ."yes", indicate the source of funds and the fiscal period for which such grant or other
financing was or is applicable.
Source of Funds: Yakima County Fiscal Period: July 1, 2007 through June 30, 09
GEOGRAPHICAL AREASERVED
Total Number Of Citizens By Your Agency
Actual ------- Projected
2007 2008 2009 2010
Within Yakima 12,873 13,017 14,580 16,328
Outside Yakima 2,206 2,274 2,342. 2,389
Total 15,079 15,291 16,922 18,717
INFORMATION ON PROGRAM TO BE FUNDED
Specific Program Or Project You Are Requesting To Be Funded Through General Funds
Behavioral Health Jail Diversion Program
Description Of Program Or Project
Please address these areas of concern in detail:
• Program or project objective
• Program or project scope
• Justification - necessity of program
Program Objective:
•Program or project activities
• Results expected from programs or projects
• Rank projects in order of priority
As part of its effort to provide a full continuum of care to individuals with serious
mental illness, Comprehensive has, since 2004, offered a Behavioral Health Diversion
service. Beginning in November 2007, the current pre -booking diversion program has
served the City of Yakima and Yakima County. The goal of the program is to divert
non-violent misdemeanants and probation violators with behavioral health problems
out of jail and into treatment. Many times the crime is a reflection of an individual's
mental illness rather than a criminal intent. These individual in most cases spend
substantially longer periods in jail than non -mentally ill persons committing the same
offense. There are significant costs to process and incarcerate these non-violent people.
Repeated incarceration does not appear to break the cycle of recidivism. Behavioral
Health Division offers a treatment alternative which is more compassionate and is a cost
effective alternative to serving time in jail.
As part of the Behavioral Health Diversion Program, Comprehensive offers Crisis
Intervention Team (CIT) Training for law enforcement and other first responders. CIT
is a national movement within law enforcement that recognizes sheriff, police and
probation officers as the first point of contact with individuals in a behavioral crisis and
empowers them with skills to effectively manage these difficult interactions. Its goals
are to:
1. Increase the feeling of safety in the general community
2: Increase law enforcement officer safety
3. Increase mental health consumer safety
4. Assist law enforcement in handling crises involving people with mental illness
5. Divert the mentally ill out of the legal system and into needed treatment
6. Make the mental health system more understandable and accessible to law
enforcement officers.
Program Scope:
Comprehensive and Yakima County first began exploring the possibility of post-
booking diversion in 2002 and submitted a grant proposal to SAMHSA. Yakima
County received the SAMHSA grant in 2004. The initial three year grant period held
many challenges but much was learned about what worked and did not work. Effective
partnerships and working relationships were developed. It became clear that diversion
after a person got booked into jail was difficult and savings were not substantial.
A no -cost fourth year extension was granted under the grant. During the first part of the
4th year, law enforcement, elected officials and Comprehensive staff began learning
about pre -booking diversion models and observed them in action. Comprehensive
began offering Crisis Intervention Team (CIT) Training to local law enforcement in 2007.
Funds from local fund raising and small grants have sustained and grown this program
over time. In 2007, the Washington State Legislature passed SB 5533 which authorized
pre -booking jail diversion. To date, our local Behavioral Health Diversion Program is
the only full implementation of this statute in the state.
Using remaining funds from the SAMHSA grant, Comprehensive began a pilot
implementation of a pre -booking diversion program. Yakima County and the City of
Yakima were the pilot partners. The pilot operated from November 2007— March 2008.
Currently the Behavioral Health Diversion Program is still operational and being
utilized by Yakima Police Department (YPD), Yakima Sheriff Office (YSO) and Yakima
County and City probation staff. Mentally ill individuals who have committed a non-
violent misdemeanor or individuals at risk of probation violations resulting in return to
jail are brought to Comprehensive's Crisis Triage Center in the City of Yakima. At the
Crisis Triage Center individuals are evaluated to determine if they meet Prosecutor-
developed criteria for diversion and are willing to accept mental health and/or chemical
dependency treatment as an alternative to being placed in jail. Individuals meeting
criteria and willing to accept treatment are placed into the diversion program.
In many cases these individuals are not on state or federally sponsored welfare
programs meaning that they would not qualify for publicly funded mental health
treatment under the state's Medicaid program. Additionally, the lack of income
supports in many cases means the individual is without funds for housing. This places
them at risk of being homeless. Comprehensive's diversion staff work with participants
to gain access to income and medical supports while the individual is in the program
and receiving ongoing treatment. Comprehensive has made housing available for
participants through its extensive array of residential services.
•
Individuals in the diversion program are connected to treatment services e.g., case
management, individual therapy, medication management, housing and other necessary
supports to assist them in remaining out of the criminal justice system. Should an
individual in the program choose not to participate/cooperate with treatment
appointments or recommendations, law enforcement or probation is contacted and they
determine the individual's disposition.
Justification - necessity of program:
A recent national study determined that approximately seventeen percent (17%) of the
national jail population is seriously mentally ill and that many more have co-occurring
mental health and chemical dependency disorders. Data collected by Comprehensive's
Jail Mental Health team indicates that this percentage appears to hold true for the
Yakima County Jail. Anecdotal evidence indicates that mentally ill individuals arrested
in the City of Yakima tend to be placed in the County jail due to their challenging needs
and the presence of mental health services there. In addition, research indicates that
individuals with serious mental illness are forty percent more likely to be arrested for
non-violent misdemeanors than the general population. Behavioral Health Diversion
makes available the specialized treatment that the serious mentally ill require while
remaining in the community and avoiding being re -arrested.
The initial pilot of Behavioral Health Diversion was quite successful. Seventy-six (76)
individuals were referred. Of the'76 referred, 73 entered the program (2 did not meet
criteria and 1 would not comply). None on the participants were re -arrested in the pilot
period. The Following is a summary of the programs services from November 1, 2007
through May 30, 2009:
• 291 individuals were referred to the program.
o 2 did not meet criteria for admission into the program
o 5 did not show for the initial process into the program as
agreed.
• 61% of the individuals served have been referred based on charges
originating in the City of Yakima
• Individuals referred ranged in age from 18 to 69 years old.
• Gender for individuals referred
o 42% were Females
o 58% were Males
• Ethnicity for individual referred
o 6% African American
o 78% Caucasian/White
o 11% Hispanic
o 5% Native American
• Of the individuals referred 68% initially came into the program
without any income or medical supports to cover housing in the
community, personal needs, or primary healthcare, mental health or
chemical dependency care.
• Of the individuals referred 87% had a prior history of chemical
dependency treatment.
• Of the individuals referred 72% had a prior history of mental health
treatment.
• A broad range of mental health and chemical dependency disorders
were served. 48% of the referrals had a co-occurring mental health and
chemical dependency disorders.
Program or project activities:
The Behavioral Health Diversion program provides for:
• Twenty-four hour a day, seven day a week availability for referrals by law
enforcement and probation officers.
• Quick assessment of individuals referred to the program to determine
compliance with criteria and the individual's willingness accept treatment as an
alternative to jail. In most cases, this assessment is completed within ten to
fifteen minutes and gets law enforcement officers back on duty in the
community.
• Staff assist participants with,
o obtaining income and medical supports such as GAU, SSI or SSDI,
o finding housing if the individual is homeless and has no community
placement,
o enrollment into ongoing mental health and/or chemical dependency
treatment services,
o ensuring that the individual keeps and maintains scheduled
appointments with mental health and/or chemical dependency services,
o accessing supportive services provided by other organizations e.g.,
medical services.
The program also offers nationally approved CIT training to law enforcement as a
means of educating officers about mental health and how to engage persons with mental
illness and the advantages of Behavioral Health Diversion.
Results expected from programs or projects:
CIT appears to be the most effective tool in generating referrals for Behavioral Health
Diversion. So we would expect to increase training to law enforcement officers. In
doing so we should see increased referrals to the program thus expanding the beneficial
effects of diversion. DSHS data indicates 10-20 individuals with a DSHS identified MH
history are still being booked into the Yakima City and County jails each week. The
Behavioral Health Diversion program can continue to generate approximately $4.66 in
savings for every $1 spent for individuals diverted from the jail.
Rank projects in order of priority:
This program should be considered high priority since the program will be without a
secure source of funding as of June 30, 2009. Comprehensive cannot continue to operate
the program at its current level without replacement funding.
(Attach additional sheets of same size if more space is necessary)
Number Of Citizens Served In The Program
Actual Projected
2007 2008 2009 2010
Within Yakima (Began Nov 1, 07) 10 120 178 196
Outside Yakima
Total 10 120 178 196
Program Is:
New ❑ Current
Specific Allocation Requested:
For 2010: $
$ 264,081.96 (61% of base program cost)
If this is a multiple year request, please identify the following: This is for one year of operation
Tota! Amount
City Funds Other Sources Funds for Project
Year Project Cost Requested Source Amount
FY 2010 $ 432,921.24 $ 264,081.96 Yakima County $ $ 168,839.28
Additional costs for CIT training and housing supports will be generated through local fund raising and
small grants.
Total $ 264,081.96 $
IF YOUR REQUEST SHOULD BE APPROVED FOR 2010, HOW WOULD You OPERATE PROGRAM IN 2011 WITHOUT IT?
The program will require on-going support since diversion operations are not allowable
under the Medicaid program. If funds do not continue in FY 2011 program operations will
have to be curtailed or discontinued to the level of fund reduction.
DETAIL THE TOTAL EXPENSE BUDGET FOR PROGRAM(S) PROJECTS IN 2010, OR CALENDAR PERIOD OF REQUEST AS FOLLOWS:
Operating & Maintenance Expenses Amount
See Attached
Operating Revenue — Identify Primary Source(s)
1. $
2.
3.
4.
•
Total $
Capital Improvement Expenses— Identify Each Individual Project And Cost: N/A
1. $
2.
3.
4.
Total $
Resources/Grants — Identify Source Of All Existing And Proposed Primary Sources, Matching Funds Available, Etc:
1. Small grants have been made available from the Washington State Mental Health
Transformation Grant, the Criminal Justice Training Commission and similar sources for the
provision of CIT Training. We expect the availability of such funds to continue
2. Yakima County has provided funding through grants and other sources. We expect the County
to continue to support the program proportional to their utilization
3. Comprehensive continues utilize agency developed funds to support CIT and housing
supports for participants
Total
Other Agencies Providing Similar Services (To Your Knowledge)
No other organization or agency is providing Behavioral Health Diversion within Yakima County.
Comprehensive's Behavior Health Diversion/CIT is the only fully operational program in the
state. Other communities and law enforcement agencies throughout the state have looked to
Yakima for CIT training and consultation on how to operate a Behavioral Health Diversion
Program.
This Funding Request Is Not Approved, What Alternative Programs And/Or Funding Have Been Considered?
There are no other known resources for funding this program. The SAMHSA grant had an
expectation that the program would be self sustaining through saving created by diversion of the
mentally ill individual out of jail. If funding is not approved Comprehensive would have to limit
access to only those jurisdictions participating financially or close the program completely.
What Other Agencies Or Programs Might Be Affected If This Request Is Not Approved And In What Manner Would
They Be Affected?
If request is not approved the jail would continue to be utilized to manage mentally ill individuals
committing non-violent misdemeanors. Prosecution, court personnel and probation officers
would also have increased caseloads.
How Do You Coordinate Programs With Other Agencies?
Comprehensive has a long and successful history of coordinating with other agencies in the
community. We accomplish this by collaborating with these agencies in order to learn and
understanding their needs along with educating them about Comprehensive. Comprehensive
views community organizations/agencies as significant partners to help us carry out our goal of
providing behavioral health services to individuals in our community. We look to these
organizations/agencies to provide us feedback about how we are coordinating so we can make
improvements to better serve them and individuals in treatment services. Our efforts at
coordinating with other community organizations/agencies have lead to collaborative agreement
to foster increase services. For example Comprehensive has had an eight year relationship
with the Yakima School District to provide behavioral health services to students in the schools.
Comprehensives long collaborative relationship with Yakima Valley Memorial Hospital has been
a key to coordination of care for individuals which has aided in saving to reduce over utilization
and cost of the state hospital and keep individuals in our community.
Please attach any additional information you feel would be helpful in reviewing your request, and submit
this form, together with any attachments by September 12, 2008 to:
•
Certification
Cindy Epperson
Deputy Director of Accounting and Budgeting
City of Yakima
129 No. 2nd Street
Yakima, WA 98901
I certify the above information to be
true and factual to the best of my knowledge.
Signed: Rick Weaver,
Title: CEO
Date: July 2, 2009
If your funding is approved, a quarterly on-site audit and inspection of your financial records may be
made by the City of Yakima Finance Department.
•
CWCMH
Diversion Program 02=01-03-250
July 1, 2009 thru June 30, 2010
Projection
FY 2010
Salaries Staff %
Admin
Diversion Pilot Coordinator 18% $ 11,800.00
Division Director 5% $ 6,400.00
Diversion - SAMSHA CIT
Mental Health Asst -Peer Support 100% $ 26,100.00
COP/CDMHP 100% $ 48,200.00
MHP Extra Shifts @$200 event
20% $ 12,900.00
20% $ 15,100.00
Crisis Case Management MHP 100% $ 36,000.00
Crisis Case Management MHP 100% $ 32,100.00
CDP Counselor 100% $ 27,900.00
Support Staff 100% $ 26,800.00
Management Accountant 3% $ 1,500.00
MHP 100% $ 7,000.00
MHP 100% $ 5,200.00
MHP 100% $ 1,300.00
MHP 100% $ 14,400.00
MHP 100% $ 17,800.00
MHP 100% $ -
MHP 100% $ 1,500.00
Case Coordinator 100% $ 2,600.00
Total Salaries $ 294,600.00
Benefits @ 28.11%
Prescriber
Total Personnel
$ 82,812.06
$ 51,421.68
$ 428,833.74
Other Expenses
SAMHSA Supplies & Expenses
Office Supplies - CWCMH CWCMH $ 87.50
Client Care (Crisis Beds, etc) CWCMH $ 450.00
Printing CWCMH $ 50.00
Cell Phones CWCMH $ 1,500.00
Travel CWCMH $ 2,000.00
Total Other Expenses $ 4,087.50
TOTAL DIRECT SERVICES $ 432,921.24
GRAND TOTAL $ 432,921.24
ORDINANCE NO. 2009
AN ORDINANCE amending the 2009 budget for the City of Yakima; and making
appropriations of $66,021 within the 000 -General Fund to
provide for a behavioral health diversion program operated by
Central Washington Comprehensive Mental Health.
WHEREAS, the amount of $66,021 must be appropriated within the 000
General Fund for expenditure during 2009 to provide for. the Professional Services
Agreement to conduct a a behavioral health diversion program operated by Central
Washington Comprehensive Mental Health (CWCMH).
WHEREAS, atthe time of the adoption of the 2009 budget it could not
reasonably have been foreseen that the appropriation provided for by this ordinance
would be required; and the City Council declares that an emergency exists of the type
contemplated by RCW 35.33.091 and that it is in the best interests of the City to make
the appropriation herein provided, now, therefore,
BE IT ORDAINED BY THE CITY OF YAKIMA:
Section 1: The amount of $66,021 is hereby appropriated from the
Unappropriated Fund Balance in the 000 -General Fund Account 000-095-411-0000-
562.29-410 titled CWCMH Professional Services as a 2009 appropriation to provide for
111 a behavioral health diversion program.
Section 2: This ordinance is one making an appropriation and shall take effect
immediately upon its passage, approval and publication as provided by law and .by the
City Charter.
PASSED BY THE CITY COUNCIL, signed and approved this day of
, 2009.
ATTEST:
CITY CLERK
First Reading:
Publication Date:
Effective Date:
Cje CW Comp Mental Health Approp Ord 0910/15/2009
DAVID EDLER, MAYOR
Yakima CIT Program
Program Components
Program Component: Crisis Intervention Training (CIT)
. Description: Law enforcement is often the first point of contact for people in crisis. Since the
initial interaction with persons with behavioral health problems is so critical to determining
outcomes, this diversion strategy relies heavily on well trained officers who are knowledgeable
regarding the nature of behavioral disorders and resources available in the community. The
Crisis Intervention Team (CIT) program is a community partnership involving law enforcement,
mental health providers, mental health consumers, and family members. It is coordinated and
financially supported by CWCMH. Officers are provided with a 40 hour; active participation
training experience with the result being certification as a CIT officer. Other first responders
such as fire department personnel, EMTs and ambulance personnel, corrections officers, and
emergency room staff are also invited to attend. Shorter 1 and 2 day introductory CIT classes are
also made available through the year. This program component is funded by other sources and
access to any particular training event cannot be guaranteed.
Potential Savings: CIT training has been shown, national research to reduce the incidence of
officer and civilian injuries resulting from contact between law enforcement and persons with
mental illness or chemical dependency problems. CIT training for officers may also assist in risk
management and/or premium savings for Iocal jurisdictions.
Program Component: Crisis Response, Triage, and Linkage
Description: Operating under a cooperative agreement and according to criteria defined by the
Yakima county and City prosecutors per SSB 5533, designated staff receive and evaluate
potential behavioral health diversion participants. Staffing consists of designated mental health
professionals, chemical dependency counselors, bilingual mental health assistants, a chemical
dependency counselor, a case manager, a peer support specialist, support staff, and their
supervisors. Following evaluation, a diversion/treatment plan is developed and, if the participant
accepts the plan, it is implemented. If a potential participant refuses to participate, law
enforcement and prosecution are notified for consideration of filing charges.
Team staff members are available 24/7 to actively triage and intervene with participants. The
program is housed in the existing CWCMH crisis triage center.
Potential Savings: The Crisis Response,. Triage, and Linkage component is the core of the
behavioral health diversion program. It allows officers to quickly offer an alternative to .
incarceration resulting in decreased down time from line duties. Diversion from jail also results
in a host of cost reduction and cost avoidance outcomes including potential reductions in court
and legal caseloads, reduced jail medical costs, reduced outlays for jail bed rental, potential
availability for increased jail rental income, etc.
Page 1 of 4
CMH CIT 09
Exhibit B
Program Component: Mental Health/Chemical Dependency Co -Occurring Disorder
Treatment (aka MICA or COD services)
Description: • Co-occurring disorder refers to the presence of both a severe mental illness and
substance use disorder. Nearly 1 00% of the participants in the CIT program have either a
chemical dependency or co-occurring mental health and chemical dependency disorder.
Integrated dual disorders treatment has been shown to work effectively for both disorders. People
with dual disorders have a better chance of recovery from both disorders when their mental
health practitioners provide combined mental health and substance abuse treatments.
People with dual disorders are at high risk for many additional problems such as incarceration,
symptomatic relapses, hospitalizations, financial problems, family problems, homelessness,
suicide, violence, sexual and physical victimization, serious medical illnesses, such as HIV and
hepatitis B and C, and early death.
Sending people with dual disorders to substance abuse treatment programs or to self-help groups
such as AA, without offering substance abuse treatment in the mental health setting, is not an
effective approach. Providing effective integrated dual disorders treatment involves the
following:
• Knowledge about alcohol and cfrug use, as well as mental illnesses: Clinicians know the
effects of alcohol and drugs and their interactions with mental illness.
• Integrated services: Clinicians provide services for both mental illness and substance use
at the same time.
• Stage -wise treatment: People go through a process over time to recover and different
services are helpful at different stages of recovery.
• Assessment: Consumers collaborate with clinicians to develop an individualized
treatment plan for both substance use disorder and mental illness.
• Motivational treatment: Clinicians use specific listening and counseling skills to help
consumers develop awareness, hopefulness, and motivation for recovery. This is
important for consumers who are demoralized and not ready for substance abuse
treatment.
• Substance abuse counseling: Substance abuse counseling helps people with dual
disorders to develop the skills and find the supports needed to pursue recovery from
substance use disorder.
CWCMH is a national leader in providing co-occurring disorder services. CWCMH was one of
the original 13 demonstration sites (beginning in 1987) for what is now considered an evidence -
based best practice. These services are made available through Federal, State and County
programs for mental health and chemical dependency treat and are subject to the restrictions of
those programs. Participants in the Behavioral Health Diversion Program are given priority
access to programs they are eligible for.
Page 2 of 4
CMH CIT 09
Exhibit B
Research consistently indicates that consumers with co-occurring disorders account for as many
as 70% of the chronically mentally ill individuals served in the community mental health system.
. These individuals are often chronic recidivists, returning to hospital ERs; psychiatric inpatient
facilities, and jails. Integrated co-occurring disorder treatment is one of six SAMHSA "best
practices." A recent review of the patients at Washington's state hospitals indicated that 60
percent suffered from co-occurring disorders. These patients are among the most difficult to
place and that they often remain in the hospital longer than they might if alternatives such as
these were available. It is highly likely that reductions would occur in the use of local psychiatric
inpatient and.E&T facilities, ERs and jails.
Potential Savings: Reduced utilization of state hospitals, reduced use of community psychiatric
inpatient and E&T beds, and reduced utilization of ERs. Improved outcomes in chemical
dependency treatment.
Program Component: CIT Housing
Description: CWCMH operates an apartment building to provide housing for participants who
are homeless or at the risk of being homeless. This apartment building is intended to provide an
integral piece of a pilot project to divert persons suffering from mental illness, chemical
dependency and co-occurring disorders from incarceration in city and county jail. When these
individuals come into contact with law enforcement as a result of the commission of a non-
violent misdemeanor crime, they are frequently homeless and in need of intensive case
management assistance. The availability of these units allows staff to "wrap" services around a
participant while services are developed to allow a more permanent placement. These services
are made available through funds developed locally by Comprehensive.
Potential Savings: There is significant research indicating that having decent, affordable, and
safe housing is a key determinant of the success of a behavioral health patient in the community.
Clients living in supported are substantially less likely to experience recidivism to hospitals,
jails, etc.
Program Component: Mental Health Treatment for CIT Participants
Description: CIT participants require a Wide range of mental health services including
evaluation and assessment, psychiatric and medication management services, case management,
group and individual therapy, crisis services and residential services. CWCMH provides an
extensive range of services to meet these needs. These services are made available through
Federal, State and County programs for mental health and chemical dependency treat and are
subject to the restrictions of those programs. Participants in the Behavioral Health Diversion
Program are given priority access to programs they are eligible for.
Potential Savings: Successful engagement in treatment is documented to reduce utilization of
high cost services including jails, hospitals, etc.
Page 3 of 4
CMH CIT 09 •
Exhibit B
Program Component: Outpatient Chemical Dependency Treatment for CIT Participants
Description: CIT participants require a wide range of chemical dependency treatment services
including assessment, group and individual therapy, crisis services and residential services.
CWCMH provides an extensive range of services to meet these needs. These services are made
available through Federal, State and County programs for mental health and chemical
dependency treat and are subject to the restrictions of those programs. Participants in the
Behavioral Health Diversion Program are given priority access to programs they are eligible for.
Potential Savings: Successful engagement in treatment is documented to reduce utilization of
high cost services including jails, hospitals, etc.
Page 4 of 4
CMH CIT 09
Exhibit B
MENTAL HEALTH CRISIS STABILIZATION UNIT
(Crisis Triage Unit)
REFERRAL FOR TREATMENT STANDARDS
Authority: Chapter 375, Laws of 2007 (SSB 5533).
Statement of Authority: Section 2 of Chapter 375, Laws of 2007 adds a new section to RCW
10.31, which, in subpart (2) provides that police officers are to be guided by standards mutually
agreed upon with the prosecuting attorney. These are the standards mutually agreed upon:
Statement of law: When a police officer has reasonable cause to believe that the individual has
committed acts constituting a non -felony crime that is not a serious offense as identified in RCW
10.77.092 and the individual is known by history or consultation with the regional support
network to suffer from a mental disorder, the arresting officer MAY take the individual to a
crisis stabilization unit and be held up to 12 hours.
In deciding whether to refer the individual to treatment, the officer shall be guided by these
standards.
Types of crimes covered: Any non -felony crime EXCEPT the following:
1. Any DV crime;
2. DUI, Physical control, Hit and Run (attended), Reckless driving;
3. Non felony violations of RCW 9.41 (firearms issues) or an equivalent city ordinance;
4.. Assault with injuries, stalking, harassment or intimidation that involves threats of harm to
person and/or property; and
• 5. Any sex offense.
Criminal history: The individual may not be referred if they have the following criminal history:
1. There should be no recent history of serious assaultive behavior.
Mental health history: The statute requires consideration of the mental health history of the
individual (if known). Due to state and federal privacy laws, this will typically not be known. It
will be up to the knowledge and discretion of the officer handling the case. If the officer believes
or knows that the individual has a history of mental health issues and the officer believes that the
individual would benefit from referral to treatment and otherwise would qualify for this option, it.
is within the discretion of the officer to so do.
Page 1 of 2
CMH CIT 09
Exhibit C
Circumstances surrounding commission of alleged offense: The statute requires consideration of
the circumstances surrounding the commission of the alleged offense. Some offenses will appear
to be strongly related to instances of mental illness. Such offenses and their relationship to any
issues of mental illness will be up to the knowledge and discretion of the officer handling.the
case.
Yakima County Prosecuting Attorney City of Yakima Legal Department
Date Date
Yakima County Sheriff City of Yakima Chief of Police
Date Date
Central Washington Comprehensive Mental Health, CEO
Date
Page 2 of 2
CMH CIT 09
Exhibit C
•
•
Behavioral Health Diversion Program
Data Dictionary
1. Excel Spreadsheet Collects:
.a. CWCMH lA
a. Client Number
b. CIient Name (First, Last, Middle)
c. Medical Record Number
d. Ethnicity
e. Hispanic Origin
f. Client Priority
g. Handicap Status
h. Previous Mental Health Outpatient Services
i. Previous Psychiatric Hospitalization
j. Substance Abuse TX
k. Referral Source
1. Axis 1 Diagnosis
m: Axis II Diagnosis
n. Axis III Diagnosis
o.. Residential Status
2.
b. Law Enforcement Tracking Form:
a. Nature of Incident
b. Threats/violence/weapons
c. Prior Contact
d. Dx reported by client
e. Drug/Alcohol Involvement
f. Complainant Relationship
g. Behavior noted during intervention
h. Incident Injuries
i. Law enforcement Response
j. Disposition of Case
c. Probation Tracking Form: Referral
a. Court Ordered Services
b. Nature of the Charging Incident (Charge leading to arrest, conviction and
probation services)
c. Known History of Violence
d. Prior Probation
e. Drug/Alcohol Involvement
f. Current Medication
g. History of Probation Compliance.
• h. Imminent Risk of Violation
PsychConsult (CWCMH Practice Management Software) Collets:
a. Required state and federal data dictionary including:
Page 1 of 2
CMH CIT 09
Exhibit D
i. Services received
ii. Clinical assessment information
iii. Medication history
iv. Involuntary Treatment services received
v. Housing and employment status
3. COmmunityOS, formerly Tapestry:
a. Collects information on all homeless clients for Yakima County
Page 2 of 2
CMH CIT 09
Exhibit D
•
•
Yakima Herald Republic Online - Printer Friendly Page 1 of 5
From the YakimaHerald.com Online News.
Jail diversion an alternative for offenders with mental health issues
by Phil Ferolitio
Yakima Herald -Republic
2 . hotos I View the. , alle
SARA GETTYS/Yakima Herald -Republic
Torie Harding, left, wipes ice cream off the face of her daughter, Elizabeth, 3. Harding lives with her
kids in transitional housing, a program that she decided to participate in rather than facing jail time for a
probation violation. Harding and her kids spend some time every day with Harding's mother, who lives
near the transitional housing.
Advertisement
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1. Jail diversion an alternative for offenders with mental health issues
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3. Teamwork touted at water supply forum
4. Sunnyside road work a welcome inconvenience
5. Account set up for plane crash victim
6. Lottery winners feeling 'grateful'
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More Stories: Today's News I This Week
YAKIMA, Wash. — Haunted by memories of a time she thought she'd forgot, Torie Harding began
drinking.
http://www.yakima-herald.com/stories/print/20954 7/1/2009
Yakima Herald Republic Online - Printer Friendly Page 2 of 5
"I didn't know what was happen-ing to me," she said of memories she didn't want to discuss. "It was like
I was living the past all over again and I didn't know how to handle it."
Her drinking led to her being jailed twice last year on domestic violence charges after she allegedly hit
her brother. Then, she became separated from her husband and two children and lost her rental home in
Yakima.
Later, she was diagnosed with post-traumatic stress disorder and depression. Her drinking continued and
she moved from one motel to another without telling her probation officer, a probation violation.
Rather than being jailed a third time, Harding entered a diversion program in Yakima that allows
misdemeanor offenders suffering from mental illness to get help rather than be locked up.
She is just one of more than 40 people currently in the program run by Comprehensive Mental Health
and Yakima County.
Law enforcement officers can take suspects accused of committing misdemeanor crimes, such as public
intoxication, trespassing or shoplifting, to a 16 -bed triage center at 402 S. Fourth Ave.
There, people are assessed and offered treatment for substance abuse and mental illness. If the person
complies with the terms of diversion, the misdemeanor charge is dropped.
The program -- one of only two in the state -- not only saves the judicial system money by keeping these
offenders out of jail and courts, but also helps them improve their lives, supporters say.
Harding, 32, is receiving both mental health and alcohol counseling. She has also been placed in clean
and sober housing, where she resides with her 3 -year-old daughter and 10 -year-old son.
More than 300 people have been diverted from jail and into mental health services and drug and alcohol
treatment since the program began in November 2007.
"We strongly support jail diversion," said Ron Honberg, legal director for the National Alliance on
Mental Illness in Arlington, Va. "There is a lot of data and evidence that they work."
Since the 1950s, beds at mental hospitals nationwide have been reduced from more than 500,000 to
about 58,000, sending many people who suffer from mental illness into the streets and jails.
The push to reduce the number of beds available at state hospitals came in part by efforts to have these
patients treated at smaller community-based centers, said Chris De Villenueve, director of Lower Valley
services with Comprehensive Mental Health.
But federal and state funding was insufficient, and the smaller centers lacked beds, he said.
"Essentially, 30 percent (of the mentally ill) were fundamentally homeless," he said.
Trouble without treatment
Without treatment, many end up getting into trouble. Nationwide, stories abound of how their run-ins
with police sometimes end tragically.
http://www.yakima-herald.com/stories/print/20954 7/1/2009
Yakima Herald Republic Online - Printer Friendly Page 3 of 5
Yakima has stories of its own.
On Oct. 3, 2008, 19 -year-old William Murray was found hanging in his cell at the Yakima County Jail.
He was being held on arson charges in an incident in which he tried to kill himself in a fire.
On Oct. 17, 2005, Gerry Holman, a black -belt in karate who scuffled with police, shook off the effects
of three Taser shocks, escaped officers and drowned in nearby Aspen Lake.
And on Aug. 11, 2003, police shot and killed 38 -year-old Elvis Wayne Wilson after he lunged at them
with a knife, urging them to shoot and kill him.
Police admit that the "take 'em to jail" attitude doesn't always work with the mentally ill. Now, officers
are undergoing training to respond to such incidents.
Nearly a third of more than 60 deputies with the Yakima County Sheriffs Office and about 70 percent of
roughly 135 Yakima police officers, including some dispatch officers, already have been trained to
respond to such incidents.
Officers receive 40 hours in crisis intervention training to identify basic mental illness symptoms, such
as depression, mania and hallucinations, and learn how to defuse potentially dangerous situations.
Officers say the training, which was made possible through a three-year, $240,000 state and federal
grant, fosters new perspectives.
"I think the ability to learn -- it's not all about going out there and kicking ass and taking names -- it's
going out there and learning about the public," said Deputy Bob Locatti.
He said his partner at first didn't think the training had anything to offer.
"His idea was 'there's nothing they can teach me that I don't already know,' he said. "By the end of the
first day, he was like 'we need more training.'
Officers' discretion
Law enforcement officers have discretion to offer suspects diversion if they appear to be suffering from
any mental illness. Often it's simply a matter of asking certain questions and paying attention to
behavior, said Locatti.
"Every officer that I have talked to after they have diverted somebody said exactly the same thing:
'When I offered them diversion, they said yeah,'" he said.
The diversion center is staffed 24 hours and allows officers to drop off suspects any time.
There, suspects can stay up to 30 days.
The Triage Center not only serves as a central. hub for services -- such as mental health, housing and
drug and alcohol treatment -- it also helps people receive help faster than they would if they were to go
to each agency individually, said Marcy Treat, who does chemicaldependency assessments at the
center.
http://www.yakima-herald.com/stories/print/20954 7/1/2009
Yakima Herald Republic Online - Printer Friendly Page 4 of 5
Social service agencies usually operate independently, but the triage center offers a form of one-stop
shopping.
"Here, assessments are done within 24 hours and a client can be seen by a prescriber within a week,
depending on the need or crisis," Treat said, something that could take up to a month elsewhere. "The
objective of our program is to keep them out of jail -- it's the revolving door that we're trying to stop."
The program also saves money.
It costs $71.25 a day to house one inmate at the Yakima County Jail, which has an annual budget of
about $30 million. About 18 percent of the roughly 1,100 inmates incarcerated there daily suffer from
severe mental illness, said jail supervisor of mental health Michael Aquilino.
Medication for the mentally ill runs the jail about $15,000 a month, he said.
"It's not just about locking up the bad guys," he said of the county jail. "It's taking care of some of the
sickest and worst -off people in the county. I don't think the public realizes how much time we spend
taking care of the sick."
Operating the diversion program is much cheaper -- about $433,000 a year.
Comprehensive Mental Health vice president Jack Maris says the average cost of incarceration is about
four times that of diversion.
He and others view the triage center as a better public investment because mentally ill offenders are
often arrested more than once.
A federal grant supplied the funds to get the diversion program started and to train law enforcement
officers on how to deal with the mentally ill. When the federal money ran out for diversion services,
Yakima County agreed to finance it this year. But that money expired this week.
Now, both county and city officials are talking about how to keep funding going to continue the
diversion program and training for officers.
"I do believe that it's a critical program and all of us are concerned about funding right now," said
Yakima Mayor Dave Edler. "We're going to look at everything we possibly can. We have a good track
record of looking for and pursuing grants for policing."
For Harding, who spent Christmas and New Year's Day in jail and away from her family, the program is
giving her another chance at life.
Now she's learning how to combat post-traumatic stress disorder and depression.
"I feel like there is hope and I'm learning every day to where before I didn't understand what was going
on," said the former preschool teacher. "The big part is learning that I'm not the only one and that there's
help out there."
* Phil Ferolito can be reached at 509-577-7749 or pferolito@yakimaherald. com.
http://www.yakima-herald.com/stories/print/20954 7/1/2009
Yakima jail diversion for mentally ill offenders Page 1 of 4
*attleeattle Maintethil ensu
r
http://www.seattlepi.com/loca1/6420ap_wa 'ail diversion.html
p p_wa _1
Last updated July 1, 2009 10:48 a.m. PT
•
Yakimajail diversion for mentally ill offenders
By PHIL FEROLITIO
YAKIMA HERALD -REPUBLIC
YAKIMA, Wash. -- Haunted by memories of a time she thought she'd forgot, Torie Harding began
drinking.
"I didn't know what was happening to me," she said of memories she didn't want to discuss. "It was like
I was living the past all over again and I didn't know how to handle it."
Her drinking led to her being jailed twice last year on domestic violence charges after she allegedly hit
her brother. Then, she became separated from her husband and two children and lost her rental home in
Yakima.
Later, she was diagnosed with post-traumatic stress disorder and depression. Her drinking continued and
she moved from one motel to another without telling her probation officer, a probation violation.
Rather than being jailed a third time, Harding entered a diversion program in Yakima that allows
misdemeanor offenders suffering from mental illness to get help rather than be locked up.
She is just one of more than 40 people currently in the program run by Comprehensive Mental Health
and Yakima County.
Law enforcement officers can take suspects accused of committing misdemeanor crimes, such as public
intoxication, trespassing or shoplifting, to a 16 -bed triage center at 402 S. Fourth Ave.
There, people are assessed and offered treatment for substance abuse and mental illness. If the person
complies with the terms of diversion, the misdemeanor charge is dropped.
The program not only saves the judicial system money by keeping these offenders out of jail and courts,
but also helps them improve their lives, supporters say.
Harding, 32, is receiving both mental health and alcohol counseling. She has also been placed in clean
and sober housing, where she resides with her 3 -year-old daughter and 10 -year-old son.
More than 300 people have been diverted from jail and into mental health services and drug and alcohol
treatment since the program began in November 2007.
"We strongly support jail diversion," said Ron Honberg, legal director for the National Alliance on
Mental Illness in Arlington, Va. "There is a lot of data and evidence that they work."
Since the 1950s, beds at mental hospitals nationwide have been reduced from more than 500,000 to
about 58,000, sending many people who suffer from mental illness into the streets and jails.
http://www.seattlepi.com/printer2/index.asp?ploc=t&refer=http://www. seattlepi.com/local/6... 7/1/2009
Yakima jail diversion for mentally ill offenders Page 2 of 4
The push to reduce the number of beds available at state hospitals came in part by efforts to have these
patients treated at smaller community-based centers, said Chris De Villenueve, director of Lower Valley
services with Comprehensive Mental Health.
But federal and state funding was insufficient, and the smaller centers lacked beds, he said.
"Essentially, 30 percent (of the mentally ill) were fundamentally homeless," he said.
Without treatment, many end up getting into trouble. Nationwide, stories abound of how their run-ins
with police sometimes end tragically.
Yakima has stories of its own.
On Oct. 3, 2008, 19 -year-old William Murray was found hanging in his cell at the Yakima County Jail.
He was being held on arson charges in an incident in which he tried to kill himself in a fire.
On Oct: 17, 2005, Gerry Holman, a black -belt in karate who scuffled with police, shook off the effects
of three Taser shocks, escaped officers and drowned in nearby Aspen Lake.
And on Aug. 11, 2003, police shot and killed 38 -year-old Elvis Wayne Wilson after he lunged at them
with a knife, urging them to shoot and kill him.
Police admit that the "take 'em to jail" attitude doesn't always work with the mentally ill. Now, officers
are undergoing training to respond to such incidents.
Nearly a third of more than 60 deputies with the Yakima County Sheriffs Office and about 70 percent of
roughly 135 Yakima police officers, including some dispatch officers, already have been trained to
respond to such incidents.
Officers receive 40 hours in crisis intervention training to identify basic mental illness symptoms, such
as depression, mania and hallucinations, and learn how to defuse potentially dangerous situations.
Officers say the training, which was made possible through a three-year, $240,000 state and federal
grant, fosters new perspectives.
"I think the ability to learn -- it's not all about going out there and kicking ass and taking names -- it's
going out there and learning about the public," said Deputy Bob Locatti.
He said his partner at first didn't think the training had anything to offer.
"His idea was 'there's nothing they can teach me that I don't already know,' he said. "By the end of the
first day, he was like 'we need more training.'
Officers' discretion
Law enforcement officers have discretion to offer suspects diversion if they appear to be suffering from
any mental illness. Often it's simply a matter of asking certain questions and paying attention to
behavior, said Locatti.
"Every officer that I have talked to after they have diverted somebody said exactly the same thing:
'When I offered them diversion, they said yeah,'" he said.
http://www. seattlepi.com/printer2/index.asp?ploc=t&refer=http://www. seattlepi. com/local/6... 7/1/2009
Yakima jail diversion for mentally ill offenders Page 3 of 4
The diversion center is staffed 24 hours and allows officers to drop off suspects any time.
There, suspects can stay up to 30 days.
The Triage Center not only serves as a central hub for services -- such as mental health, housing and
drug and alcohol treatment -- it also helps people receive help faster than they would if they were to go
to each agency individually, said Marcy Treat, who does chemical dependency assessments at the
center.
Social service agencies usually operate independently, but the triage center offers a form of one-stop
shopping.
"Here, assessments are done within 24 hours and a client can be seen by a prescriber within a week,
depending on the need or crisis," Treat said, something that could take up to a month elsewhere. "The
objective of our program is to keep them out of jail -- it's the revolving door that we're trying to stop."
The program also saves money.
It costs $71.25 a day to house one inmate at the Yakima County Jail, which has an annual budget of
about $30 million. About 18 percent of the roughly 1,100 inmates incarcerated there daily suffer from
severe mental illness, said jail supervisor of mental health Michael Aquilino.
Medication for the mentally ill runs the jail about $15,000 a month, he said.
"It's not just about locking up the bad guys," he said of the county jail. "It's taking care of some of the
sickest and worst -off people in the county. I don't think the public realizes how much time we spend
taking care of the sick."
Operating the diversion program is much cheaper -- about $433,000 a year.
Comprehensive Mental Health vice president Jack Maris says the average cost of incarceration is about
four times that of diversion.
He and others view the triage center as a better public investment because mentally ill offenders are
often arrested more than once.
A federal grant supplied the funds to get the diversion program started and to train law enforcement
officers on how to deal with the mentally ill. When the federal money ran out for diversion services,
Yakima County agreed to finance it this year. But that money expired this week.
Now, both county and city officials are talking about how to keep funding going to continue the
diversion program and training for officers.
"I do believe that it's a critical program and all of us are concerned about funding right now," said
Yakima Mayor Dave Edler. "We're going to look at everything we possibly can. We have a good track
record of looking for and pursuing grants for policing."
For Harding, who spent Christmas and New Year's Day in jail and away from her family, the program is
giving her another chance at life.
http://www.seattlepi.com/printer2/index.asp?ploc=t&refer=http://www.seattlepi.com/loca1/6... 7/1/2009
Yakima jail diversion for mentally ill offenders Page 4 of 4
Now she's learning how to combat post-traumatic stress disorder and depression.
"I feel like there is hope and I'm learning every day to where before I didn't understand what was going
on," said the former preschool teacher. "The big part is learning that I'm not the only one and that there's
help out there."
Information from: Yakima Herald -Republic, http://www.yakima-herald.com
http://www. seattlepi. com/printer2/index. asp?ploc=t&refer=http://www. seattlepi. com/local/6... 7/1/2009