J_MICJS_2016A 07/20/2016 Committee Summary

08:52 AM -- General Overview of Advisory Task Force Recent Activities and Accomplishments



(Note: Due to technical difficulties about the first 15 minutes of the meeting did not record.)



Representative Singer called the meeting to order. A copy of the meeting agenda and the membership list for the Task Force Concerning the Treatment of Persons with Mental Illness in the Criminal and Juvenile Justice System (MICJS) (Attachments A and B) were distributed to the committee. Susan Walton, Advisory Task Force Chair, and Camille Harding, Advisory Task Force Co-Chair, introduced themselves to the committee. Ms. Walton discussed the importance of the task force meetings. She highlighted the activities of the task force subcommittees on housing, data and information sharing, and competency restoration and stated that the subcommittees would be providing full reports later in the meeting.



16MICJS0720AttachA.pdf 16MICJS0720AttachB.pdf





























09:05 AM



Ms. Walton and Ms. Harding responded to questions about the research that the subcommittees are conducting. Senator Martinez Humenik encouraged the task force to review what other states are doing related to various issues. There was discussion about the legislative process. Senator Newell referenced two Legislative Council Staff memos, one concerning housing legislation and one concerning the definition for serious mental illness and screening tools (Attachments C and D). Representative Singer mentioned the lack of staffing for the task force.



16MICJS0720AttachC.pdf 16MICJS0720AttachD.pdf



09:14 AM



Ms. Walton discussed the Medication Consistency Workgroup of Behavioral Health Transformation Council that some MICJS Task Force members also serve on. She discussed the work of the Medication Consistency Workgroup concerning the development of a medication formulary and purchasing options for various facilities. Senator Martinez Humenik and Ms. Walton dialogued about the issues related to medication for inmates. Ms. Harding responded to questions about the interagency involvement in the Medication Consistency Workgroup.





09:21 AM



The committee and Ms. Walton discussed the level of involvement of the various task force members. Ms. Walton discussed the lack of participation by the the task force representatives from the Department of Labor and Employment and the Division of Housing in the Department of Local Affairs. Senator Newell suggested having letters sent to Department of Labor and Employment and the Division of Housing to encourage their participation on the task force. Ms. Walton discussed the pending appointments of a Judicial Branch representative and Bill Martinez from the Colorado Mental Health Institute at Pueblo. Committee discussion about task force member involvement and task force staffing ensued. The committee directed Legislative Council Staff to draft letters to Department of Labor and Employment and the Division of Housing in the Department of Local Affairs concerning the involvement of the departments' representatives in the task force's activities.





09:30 AM -- Discussion of Collaborative Management Program



Representative Singer referenced Senate Bill 16-039, concerning including a mental health professional in the memorandum of understanding relating to a local-level collaborative management process for children and families. Representative Lee discussed Park County submitting its Collaborative Management Program application after the deadline and the potential loss in funding for Park County.































09:34 AM



Ms. Walton discussed the Park County's recent submission of a memorandum of understanding (MOU) for the Collaborative Management Program and the fact that the MOU was submitted nine hours late because one necessary signatory was unavailable to sign the document. She said that due to the late submission Park County could be denied funding in the amount of $80,000 to $100,000 for the year. Ms. Walton discussed the benefits of the collaborative management teams and the impacts of being denied the funding. She referenced the State Board of Human Services rule concerning the Collaborative Management Program and 2014 State Audit that addressed the Collaborative Management Program.





09:40 AM



Dr. Robert Werthwein, Department of Human Services, discussed the 2014 audit that raised the issue of MOUs being authorized after the deadline. The audit can be accessed at: http://bit.ly/1AHReKZ. Mr. Werthwein dialogued with the committee about the State Board of Human Services rule concerning the Collaborative Management Program MOU application process. Mr. Werthwein responded to questions from the committee about the audit and need for specified deadlines for the MOU applications. Committee discussion about the department's process for reviewing rules, the audit, and the MOU process continued. Ms. Walton made further comments about MOU situation that arose in Park County. Committee members commented on the Collaborative Management Program and related MOUs, including the need for an appeals process in the relevant rules. Representative Lee asked for the Department of Human Services to provide an update to the committee about whether there is a mechanism that would allow for the acceptance of Park County's application.





10:04 AM -- Staffing of Advisory Task Force Staffing Needs



Ms. Walton discussed the recent challenges of finding staffing for the advisory task force. She discussed the need for a staff person to prepare minutes, assist with various communications, conduct research, orient new task force members, and prepare legislative updates. Committee discussion ensued about the need for staffing for the task force and the associated funding. Ms. Harding discussed the potential Department of Health Care Policy and Financing staff involvement with the task force. Representative Singer discussed sending a letter to the Joint Budget Committee and the Governor regarding funding for staffing for the task force, to which the committee members agreed.





10:18 AM -- Competency Restoration Subcommittee Update



Sheri Danz, Advisory Task Force Member, and Tariq Sheikh, Advisory Task Force Member, provided an update on the recent activities of the advisory task force's competency restoration subcommittee. Mr. Sheikh stated that subcommittee is almost ready to present recommendations to the task force and oversight committee on the issue of competency restoration. He discussed meeting with Dr. Patrick Fox, Department of Human Services, concerning competency restoration. He discussed the current competency restoration process and referenced the educational materials that are used to restore juveniles to competency. Mr. Sheikh discussed the need for an individualized approach that includes a treatment team and separate restoration provider to restore individuals to competency.





















10:23 AM



Ms. Danz stated that there is no designated provider for restoration services for juveniles in Colorado. She stated the need to outline the guiding principles for restoration services. Ms. Danz and Mr. Sheikh discussed including adults in any potential legislation to offset costs and reduce the backlog for in-patient services. Ms. Danz discussed establishing the most integrated and least restrictive treatment setting, which was a phrase used by Dr. Fox during the subcommittee's discussions with him. Ms. Danz discussed the development of the guiding principles that will be reviewed at the July 21 subcommittee and task force meetings. Senator Newell referenced the Legislative Council memorandums that had been distributed earlier in the meeting. The committee dialogued with Ms. Danz and Mr. Sheikh about competency restoration for juveniles. Ms. Danz discussed the need for uniform standards for competency restoration, while still allowing flexibility for individual and community needs. Discussion ensued about the need for restoration services for juveniles and potential legislation to address competency restoration. In response to members' comments, Mr. Sheikh discussed elements of the juvenile justice systems, including the juvenile sex offender registry. Senator Martinez Humenik referenced the Second Chance Coalition in Minnesota.





10:50 AM



Mr. Sheikh and Ms. Danz responded to comments from the committee about competency restoration and how juveniles access treatment services. Mr. Sheikh discussed efforts by district attorneys to help juveniles who are involved in the juvenile justice system. Ms. Danz referenced prior legislation concerning a juvenile-specific definition for competency. Mr. Sheikh referenced the judicial discretion in determining a management plan for a juvenile. Senator Newell suggested that the competency restoration subcommittee develop recommendation for the committee to inform a potential letter to the Chief Justice concerning judicial trainings on management plans. Mr. Sheikh and Ms. Danz responded to comments about the juvenile sex offender registry. Senator Newell requested a presentation on the juvenile sex offender registry at the next committee meeting. Amanda King, Legislative Council Staff, clarified who had been sent the Legislative Council Staff memorandum referenced earlier in the meeting.





11:16 AM -- Data and Info Sharing Subcommittee Update



Peggy Heil, Advisory Task Force Member, presented to the committee regarding the recent activities of the Data and Information Sharing Subcommittee of the task force. She provided an information packet to the committee (Attachment E). Ms. Heil stated that the subcommittee was formed in response to a request by the Colorado Commission on Criminal and Juvenile Justice for the advisory task force to study the issue of why so many individuals with serious mental illness end up in jails and to recommend possible solutions to address the issue. She stated that there is not good data to evaluate the scope of the problem. Ms. Heil discussed the current lack of sharing of treatment information between facilities and systems and the identified need for a system to allow this type of information sharing between the public mental health systems and the criminal justice systems.



16MICJS0720AttachE.pdf

























Ms. Heil stated that Colorado was one of seven states that was awarded a Bureau of Justice Assistance Second Chance Act Statewide Recidivism Reduction Strategic Planning Program Grant. The mission of the grant is to reduce criminal justice involvement and recidivism of individuals with serious mental illness by implementing a statewide, electronic, criminal justice health information exchange. She reviewed the information in the information packet, including the grant summary, the entities who have been involved in the grant, the jail survey results, and the identified gaps in information sharing. Ms. Heil discussed the definitions of serious mental illness and recidivism that will be used in relation to the grant activities. She stated that there would be a need to develop a consent process for the electronic information exchange. Ms. Heil discussed developing agency agreements to share behavioral health data and engaging attorneys regarding planning recommendations, consent forms, and procedures.





11:27 AM



Ms. Heil stated that the implementation grant application had not been released yet. She said that the implementation grant process would be more competitive than the planning grant process. Ms. Heil said that the subcommittee is exploring other funding options for the electronic information exchange and is coordinating with the Behavioral Health Transformation Council's Medication Consistency Workgroup. She referenced the work of the Medication Consistency Workgroup and stated that Dr. Patrick Fox, Department of Human Services, was actively involved in developing the medication formulary proposed by the workgroup. She discussed the preferred formulary for psychotropic medications and the policy brief on statewide pharmaceutical purchasing in the information packet.





11:31 AM



In response to a question, Ms. Heil said she would provide a list of members for the Medication Consistency Workgroup and discussed the entities who were involved in the workgroup. Committee discussion with Ms. Heil occurred about possible legislation related to the work of the Medication Consistency Workgroup, potential purchasing options for medications for inmates, and how inmates access health care and medications while in jail. In her responses, Ms. Heil referenced possible partnerships with federally qualified health clinics and the utilization of emergency rooms by inmates. Ms. Heil discussed how inmates access necessary medications and other treatments upon their release and the possible utilization of telemedicine options. Committee discussion about the information packet materials ensued.





11:52 AM -- Housing Subcommittee Update



Jennifer Longtin, Housing Subcommitte Co-Chair, provided an update on the Housing Subcommittee of the advisory task force. She provided a handout to the committee (Attachment F). She discussed the research that two interns are conducing on behalf of the Housing Subcommittee. The research includes reviewing legislation and zoning regulation and conducting a multi-state survey to describe model supportive housing and treatment programs. Ms. Longtin discussed existing housing voucher programs and the desire to expand the existing programs to provide housing and companion services for those exiting the criminal justice system.



16MICJS0720AttachF.pdf





















11:59 AM



Matt Domboski, Housing Subcommittee intern, discussed the research about housing programs in other states he is compiling. He stated he also plans to meet with city officials to learn more about the Denver Social Impact Bond Program.





12:01 PM



Kelsey Holder, Housing Subcommittee intern, discussed the zoning issues that often arise when trying to establish housing for certain populations. She referenced an existing apartment complex that is zoned as a congregate home in Aurora that may be a possible model. She discussed Fort Lyon Supportive Residential Community Program.





12:04 PM



In response to a question, Mr. Domboski discussed a potential model program in New York and the state funding for that program. Ms. Longtin discussed the restrictions associated with federal funds for housing. Committee discussion ensued about social impact bond programs for housing, further researching previous legislation in Colorado related to housing for those exiting the criminal justice system, and possibly engaging the National Conference of State Legislatures to assist with the research the Housing Subcommittee is conducting. In response, Ms. Holder stated she has been in conversations with Urban Peak regarding housing issues.





12:16 PM



Ms. Longtin stated that the Housing Subcommittee is developing a white paper to address the issues regarding housing that may require legislation. Ms. Longtin discussed the focus of the Housing Subcommittee on expanding the housing voucher program. Committee discussion with Ms. Longtin ensued about possibly repurposing state buildings in the future to provide housing for persons exiting the criminal justice system. Committee discussion occurred about presentations at the next committee meeting on repurposing vacant buildings. Senator Newell discussed the housing vouchers for the Chafee Foster Care Independence Program.





12:28 PM -- Discussion of Future Committee Meeting Dates and Letters from the Committee



Ms. Harding discussed the Navigating the Mental Health & Substance Abuse Disorder System document and the Quality Health Improvement Project - Improving Access to Key Services for At-risk Children and Families that were distributed to the committee (Attachments G and H).



16MICJS0720AttachG.pdf 16MICJS0720AttachH.pdf





















Ms. King referenced a Legislative Council Staff memorandum that outlines the interim committee bill deadlines (Attachment I). The committee discussed potential future meeting dates, but it was determined that the meeting date would be selected via e-mail.



16MICJS0720AttachI.pdf



The committee discussed which entity should be sent a letter about potential staffing for the task force. Ms. King discussed fiscal note information for previous legislation that provided funding for staff support to the task force. The committee requested that the following letters drafted:

• a letter to the Department of Labor and Employment about representative participation on the advisory task force;
• a letter to the Division of Housing in the Department of Local Affairs about representative participation on the advisory task force;
• a letter to the Joint Budget Committee, the Governor's Office, and legislative leadership concerning staffing for the advisory task force;
• a letter to the State Board of Human Services concerning the Collaborative Management Program and allowing for an appeals process when funding is denied due to an application deadline being missed due to extenuating circumstances; and
• a letter to the Chief Justice regarding including trainings on management plans at judicial trainings.

12:44 PM



The committee adjourned.