Moving forward together creates successful ventures

In the Fall 2016 issue of County Lines, AAC Chief Counsel Mark Whitmore explored the need for in-jail services, crisis intervention training and crisis services in the state of Arkansas.

By Mark Whitmore
AAC Chief Legal Counsel

Ronnie Baldwin, deceased, served more than 30 years in law enforcement prior to becoming executive director of the Arkansas Sheriffs Association (ASA) in 2012. Ronnie passed away Aug. 28, 2016, but his legacy lives on. Ronnie had many endearing qualities: loyalty, off-the-chart-work ethic, dedication, tenacity, vision and kindness. Ronnie was not just a leader. He was an effective leader. He was passionate in everything he undertook. His efforts will endure for years to come.

Ronnie served as Cross County sheriff from 1999 to 2008 and spent more than 15 years working for the Wynne Police Department as patrolman, lieutenant and as a criminal investigator. Ronnie also was the Brinkley chief of police from 1995 to 1997. He was a board member of the National Sheriffs Association (NSA) and served on several committees. He was also a board member for Victims Information and Notifications Everyday (VINE), a national organization focused on victim notification. He was a loving husband, father and grandfather. He truly was a great friend.

He had several major legislative priorities that are currently left unfulfilled. One priority was for the state of Arkansas to quit warehousing hundreds of citizens with mental illness in our county jails. Another priority was the management of the state prison and local jail overcrowding. These priority matters along with other tools like telemedicine and specialty courts are interrelated.

In 2014, Ronnie was awarded the President’s Award from the Mental Health Council of Arkansas (MHCA) for his leadership in creating the Law Enforcement and Mental Health Coalition. Ronnie had served on the board for Mid-South Health Systems, Inc. and knew well the level of service a community mental health center (CMHC) was capable of providing. After becoming ASA director, he immediately spearheaded efforts for better services for the mentally ill in Arkansas.

In-Jail Services, Crisis Intervention Training and Crisis Services
Ronnie organized a series of meetings throughout the state at the various 13 CMHC catchment areas with Arkansas Department of Human Services (DHS), sheriffs, prosecutors, CMHC directors and other stakeholders to assure the level of services conveyed by DHS and the CMHC were acceptable statewide. Then he led regional meetings with members of the General Assembly and the same stakeholders in Sebastian, Union, Craighead and Washington counties. These meetings sought support for crisis intervention training (CIT) for law enforcement and the establishment of regional crisis stabilization units in Arkansas. Prior to Ronnie’s advocacy, there were no efforts underway for establishing crisis stabilization units in Arkansas. Now, Gov. Asa Hutchinson has recommended additional funding for regional crisis units in the DHS budget recommendations. Prior to Ronnie’s advocacy, CIT for law enforcement in Arkansas was rare; only Craighead County had received the requisite 40 hours of CIT under the Memphis model. Members of several law enforcement agencies, such as Pulaski County, Little Rock, North Little Rock and Sebastian County, have completed the appropriate level of CIT training. In addition, the Arkansas Law Enforcement Training Academy (ALETA) is seeking additional funding statewide for cadets to receive eight hours of CIT during their basic training at the academy. If ALETA obtains the funding, which is recommended by Gov. Hutchinson, ALETA will offer the 40-hour CIT (via train the trainer) statewide.

Ronnie knew that success required the building of a coalition between mental health advocates, law enforcement, prosecutors, CMHC directors, county judges, sheriffs, the Association of Arkansas Counties (AAC), legislators and the governor. He knew Arkansas is small enough that we can get things done — if we act together. One unlikely coalition was created between the sheriffs and the American Civil Liberties Union of Arkansas (ACLU). The sheriffs in Arkansas are strong advocates for the mentally ill.

Ronnie was always beating the drum for change — seeking the implementation of these urgent priority needs. He reiterated again and again that the state of Arkansas has an affirmative duty under the Arkansas Constitution, Article 19, Section 19 to provide for the treatment of the insane. He educated policy makers about our urgent needs: in-jail services, crisis services and CIT. As a result, the Quorum Courts’ Association of Arkansas, County Judges’ Association of Arkansas (CJAA) and the Arkansas Sheriffs’ Association (ASA) each have adopted resolutions in support of better in-jail services, CIT for law enforcement and regional crisis units.

At the AAC Conference on August 25, 2016, the governor announced his support for funding for CIT and regional crisis stabilization units in Arkansas. The governor recognized that CIT is necessary so law enforcement officers can identify the mentally ill. He further noted the importance of regional crisis stabilization units so there is a suitable location to take the mentally ill for emergency behavioral health treatment. The governor underscored the key: currently our law enforcement officers have no other options. All too often the mentally ill end up in our emergency rooms or our jails. Emergency rooms and jails are not equipped and not intended to provide emergency behavioral health or crisis services.

Many of you will recall the horrific tragedy in Dallas this summer. Many of you heard the pleas of David Brown, the chief of police for the Dallas Police Department, following the tragic loss of life of five law enforcement officers and injury of two civilians. “Every societal failure, we put it on the cops to solve … We are asking cops to do too much in this country. Not enough mental health funding. Let the cops handle. Not enough drug addiction funding. Let’s give it to the cops… We have a dog problem in our city. Let the cops chase the dogs… Policing was never meant to solve all those problems, help us,” Chief Brown said during his July 11, 2016, news conference.

“We are putting our lives on the line. Do your job. You want us to be Superman but we are not. We need help,” Chief Brown said to legislators.

More mental health funding is a national issue. If we move forward together, we will get the job done.

At the request of state Sen. Jeremy Hutchinson and Rep. Matthew Shepard, chairs of the Legislative Criminal Justice Oversight Task Force, the AAC hosted on Oct. 4, 2016, the first-in-the-nation Statewide Summit on Mental Health and Criminal Justice Reinvestment. Andrew Barbee, research manager with the Council of State Governments (CSG), presented the CSG’s recommendations on a prudent and affordable means to achieve the urgent needs in behavioral health services. He also explained other recommendations on justice reinvestment.

Other presenters included DHS officials and staff, Arkansas Department of Corrections and Community Corrections officials and staff, sheriffs, AAC staff, and members of the MHCA. The summit was attended by more than 30 state legislators and more than 120 representatives from various stakeholder groups, including hospitals and the Arkansas Hospital Association, prosecutors, law enforcement, judges and others.

Over the past year, the CSG gathered extensive data from the field, conducted dozens of meetings with stakeholders. As a result, the CSG made recommendations on the affordability of crisis stabilization units through leveraging of Medicaid. CSG also provided information on the ways in which to set up crisis stabilization units.

Click here to view the CSG report.

The data is compelling. The number of detainees in our county jails has grown from approximately 5,000 in 2000 to now in excess of 7,600. Seventeen percent of the jail population has serious mental illness and approximately 68 percent has substance abuse disorders (alcohol or drugs). Most jails are not equipped to provide treatment and programming. Other states have realized that the costs of treatment of the mentally ill can be leveraged with Medicaid. Those costs are much less than the costs and burden to the criminal justice system. Plus, the societal outcome is a healthier and safer community.

Barbee further noted that the lion’s share of growth in the number of state inmates is not from new charges, but from parole revocation. Richard Wilson, deputy director of the Arkansas Bureau of Legislative Research, made an eye-opening presentation on the historic growth in the budgets of the Arkansas Department of Corrections and Community Corrections from 1981 to date and projections to 2023.

Click here to view the presentation.

In essence, the general revenue budget for Community Corrections has grown from $27 million in 1997 to more than $78 million in 2016. The budget for Community Corrections is projected to exceed $98 million by 2023. Meanwhile, the Arkansas Department of Corrections’ general revenue budget has gone from $120 million in 1997 to more than $336 million in 2016. The budget for Arkansas Department of Corrections is projected to grow to more than $400 million by 2023. The state inmate population growth in Arkansas is ranked among the highest nationally. Also, Arkansas ranks among the highest in the rate of recidivism. Diversion of the mentally ill from our criminal justice system is an absolute imperative.

Recently, Arkansas Legislative Audit produced a special report regarding the justice system in Arkansas, including state and local revenues and expenditures. It concluded that statewide the counties’ annualized expenditure on the courts was more than $64 million while revenues retained by counties was $18 million. The counties are therefore burdened with $46 million in excess spending each year on the courts. So the savings seen from the diversion of the mentally ill would save not only costs of incarceration, but also result in savings to the justice system as a whole.

Click here to view the special report on Arkansas' justice system.

Criminal Justice Coordinating Committees
During the CJAA Fall 2016 conference, the county judges tackled in depth two other matters that may be tools in the intersection of behavioral health and the criminal justice system: criminal justice coordinating committees (CJCCs) and mental health courts. AAC Law Clerk Sarah Giammo provided the following presentation to the CJAA:

CJCCs are a tool for efficient allocation of the highly expensive resources of the criminal justice system. CJCCs facilitate communication, the gathering and use of data and implementation of state and local initiatives to divert the mentally ill and low-level drug and alcohol abusers to treatment instead of jail. Best practice suggests representation on the CJCC of various stakeholders: legal professionals such as judges, prosecutors, and public defenders; county officials and law enforcement; medical and mental health professionals; and local community leaders. Data collection of certain data points is recommended, as well as setting up routine regular meetings and establishment of operational bylaws.

Click here to review a copy of the legal memorandum on CJCCs.

Specialty Courts (Mental Health Courts)
Specialty courts seek to reduce the use of the criminal justice system and divert low-level offenders to treatment or programing. Craighead and Crittenden counties in the Second Judicial District established a mental health court program in 2009. It was initially funded by a grant from the Bureau of Justice Assistance (BJA). The grant provided funding for the first two years of operation, starting in 2010. Circuit Judge Victor Hill presides over the court. The Craighead and Crittenden counties’ Mental Health Court team also includes prosecutors, mental health counselors, public defenders and probation officers. The team meets weekly on the status of participants to determine if the court needs to address infractions, progress and new referrals. The court entertains recommendations from the team members and then issues its orders on treatment or sanctions. A mental health court entertains referrals of candidates for participation by team members. A participant that is competent to enter a plea and is treatable, enters a plea — misdemeanors in district court and felonies in circuit court — and commences treatment immediately.

Under Arkansas Supreme Court Administrative Order No. 14 and Ark. Code § 16-10-139, Arkansas circuit courts and district courts are permitted to establish special courts, including mental health courts, drug courts, veteran’s courts, juvenile drug court, “smarter sentencing” court, “HOPE” court, DWI court and a mental health crisis intervention center. The law also allows the establishment of pre-adjudication programs as provided by Ark. Code § 5-4-901 et seq. and the Swift and Certain Accountability on Probation Pilot Program under Ark. Code §16-93-1701. The Arkansas Supreme Court must approve any specialty court program operated by a circuit court or district court in the state. Its plan must be submitted under Arkansas Supreme Court Administrative Order No. 14. Many of these specialty courts operate with similarly trained and equipped staff. The key to launching a specialty court in a judicial district is a willing and able judge.

Click here to view a copy of the legal memorandum on specialty courts.

Citizens in jail have unique challenges gaining access to medical doctors and behavioral health professionals. Arkansas Medical Board regulations provide that the doctor-patient relationship may be established by telemedicine — through an examination conducted in real time using audio and visual technology that provides at least as much information as the doctor could obtain though an in-person examination. There are a few successful uses of telemedicine for detainees for medical and behavioral treatment in Arkansas. We hope to facilitate more use of telemedicine throughout Arkansas — in particular for the treatment of citizen-detainees in our local jails.

Sebastian County held a regional summit in Spring 2016. County Judge David Hudson and Sheriff Bill Hollenbeck, along with Prosecutor Dan Shue and other community leaders, conducted the summit, and they have been working on criminal justice coordination. Also, Sebastian County is launching the Hope Campus — a location for serving the community, homeless, and those in need of medical treatment and behavioral health care. They are actively refurbishing a location for their operations. With the collaboration of the local community health center, a local hospital and DHS, the Hope Campus could serve as a site of a regional crisis stabilization unit. Craighead County, Pulaski County and other areas are actively looking for suitable locations for the establishment of a regional crisis stabilization unit.

Inevitable growth in the number of state inmates & regional jails
The number of state inmates in the Arkansas Department of Corrections has grown from 14,832 in 2012 to 17,973 in 2016, an increase of 21 percent. These numbers are reflected in a chart from page 32 of the report of CSG (linked above). The chart also reflects the current projections of the growth in state inmates of 21,345 by 2023. That’s a growth rate of 19 percent. Plainly, we cannot build our way out of this problem. The CSG report has several recommendations of best practices to reduce growth in the number of state inmates. They made their presentation of recommendations at the AAC conference and again at the statewide summit. However, please note that even with implementation of the CSG recommendations, the projections show growth in the number of state inmates in the Arkansas Department of Corrections to 20,077 by 2023. At the AAC conference the Arkansas Association of Quorum Courts adopted a resolution in support of the ASA and CJAA resolutions. They join the call for the state to respect a maximum threshold to the total number of state inmates from the Arkansas Department of Corrections and Community Corrections to be backed up into the county jails.

County officials may foresee savings that can be made from a regional jail. Several counties could close their local jails and partner in the creation of a regional jail. Some of the counties or cities would operate small holding facilities but partner in a commitment to support a regional dentition facility. Likewise, the participation in a regional jail offers savings to the state of Arkansas. The cost of the operation of a regional jail is projected to be far less than the operational costs of our state prisons.

The governor and general sssembly are active and engaged on these issues. As Ronnie Baldwin demonstrated throughout his successful career, “Moving forward, if we work together, we will succeed.”

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