The Familiar Faces Leadership Network is a cohort of 13 elected officials. Over the next year, the Leadership Network will participate in peer exchanges, technical assistance and other learning opportunities exploring the systems at play in the behavioral health and justice continuum and the level of interaction required to achieve a supportive care model for familiar faces.

These brief leader profiles are part of a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to improve outcomes for familiar faces of justice, health and human services systems. As part of the Familiar Faces Initiative, NACo’s Familiar Faces Leadership Network is generously supported by Arnold Ventures.

Hon. Candace Andersen

Candace Andersen is Supervisor of District Two in Contra Costa County, California, which is located an hour east of San Francisco. Previously, Supervisor Andersen worked as a lawyer, beginning her career as a prosecuting attorney in Hawaii. After moving to California, Supervisor Andersen served as Mayor of Danville, Calif. and was elected county supervisor in 2012. Supervisor Andersen is dedicated to promoting and protecting community safety, exercising fiscal responsibility and protecting standards of living across the county. Supervisor Andersen was integral to the adoption of the Stepping Up Initiative and implementing Laura’s Law (Assisted Outpatient Treatment). In addition to her elected role, Supervisor Andersen serves on several county committees and boards including the Mental Health Commission and the Public Protection Committee and Street Smarts, a road safety program. Supervisor Andersen believes in the importance of supporting community members with compassion and recognizing that broken care continuums within the county prevent individuals with behavioral health conditions from accessing effective care.

As a member of the Familiar Faces Leadership Network, Supervisor Andersen looks forward to learning from other jurisdictions about engaging county partners as Contra Costa County builds the infrastructure for data integration and analysis across departments.

Hon. Adriann Barboa

Adriann Barboa is the Chair of the Bernalillo County Board of Commissioners in New Mexico. Bernalillo County is home to nearly 680,000 residents, as well as Albuquerque. In addition to her elected role, Chair Barboa is the Field Director of Strong Families New Mexico (SFNM). SFNM is an advocacy organization working to address issues like equitable access to health care and police accountability across the state. As a native New Mexican, Chair Barboa is dedicated to supporting her community through building cross-sector relationships, improving public safety through supporting first responders across the county, expanding health care and veterans’ services, protecting the environment and growing Bernalillo County’s economy through creating new jobs. Under Chair Barboa’s leadership, Bernalillo County recently approved budgets for the Medical Sobering Center; this center will provide non-emergency medical assistance to individuals with substance use disorders.

Chair Barboa is committed to supporting familiar faces in her county through establishing a data-sharing infrastructure and continuum of behavioral health care. One of the barriers facing the county is a lack of connection and collaboration between agencies – an issue Chair Barboa aims to solve through investing in data-sharing structure. By joining the Familiar Faces Leadership Network, Chair Barboa looks forward to learning about creating data-sharing systems.

Hon. Carlo Esqueda

Carlo Esqueda is the Criminal Justice Council Chair and the Clerk of Courts for Dane County, Wisconsin. Dane County is home to nearly 562,000 residents and the state’s capital, Madison. Previous experience in the data sector uniquely positions Clerk Esqueda to lead collaborations between the county’s Criminal Justice Council (CJC), Department of Human Services and Department of Information Management. The Dane County CJC represents cross-sector leadership working to create stronger care continuums. Clerk Esqueda oversees the CJC’s behavioral health, pretrial and racial disparities subcommittees. The CJC relies on data-sharing across departments to inform the Community Restorative Court and the Safety and Justice Challenge Innovation Fund; both of which aim to reduce disparities in the Dane County criminal legal system and decrease recidivism. Clerk Esqueda also led the creation of a pilot program that sends alerts to the Department of Human Services when clients are booked into custody. In addition to booking notifications, the pilot program supports providers in identifying the most appropriate treatment and services for participants.

Clerk Esqueda plans to implement best practices learned from participating in the Familiar Faces Leadership Network as he and fellow Dane County leaders work to improve communication between justice and behavioral health service providers. His goal for Dane County is to ensure care continuums are responsive to individuals’ needs.

Hon. Wendy Jacobs

Wendy Jacobs is the Vice-Chair of the Board of County Commissioners in Durham County, North Carolina. Durham County is home to nearly 325,000 people and is a corner of North Carolina’s Research Triangle. In addition to serving as Vice-Chair, Commissioner Jacobs is on multiple committees and boards including the Criminal Justice Advisory Board, Durham County Social Services Board, the NACo Health and Human Services Steering Committee and the Triangle J Council of Governments (TJCOG) Smart Growth Committee. TJCOG is an advocacy organization made up of Durham, Orange, Chatham, Moore, Lee, Wake and Johnston counties, working with communities to enhance statewide cross-sector collaborations in policy development and technical assistance. Commissioner Jacobs is passionate about addressing racial and economic disparities across the county and excited to learn more about peers’ innovative approaches to tackling the sources of these inequities to promote long-term solutions. Her passions are reflected in her priorities as an elected official; Commissioner Jacobs is dedicated to building stronger Cradle-to-Career continuums across Durham County and creating jail diversion strategies that prevent individuals from entering the criminal legal system.

Durham County currently partners with Duke University on Data+, a program that analyzes trends between justice and health systems’ data points. While Data+ is led by Duke University, Commissioner Jacobs hopes to enhance the county’s use of Data+ and incorporate analysis into municipal service delivery. As a member of the Familiar Faces Leadership Network, Commissioner Jacobs hopes to collaborate with fellow leaders on strategies that improve data sharing and diversion efforts. Commissioner Jacobs’ long-term vision is to unite county leaders across North Carolina in better serving familiar faces by sharing these strategies and best practices.

Hon. Peter Koutoujian

Peter Koutoujian is Sheriff of Middlesex County, Massachusetts, located 20 miles outside of Boston. Sheriff Koutoujian is a former Massachusetts state representative, having served as Chairman of the Joint Committee on Health Care, the Joint Committee on Public Health and the Joint Committee on Financial Services. As a state representative, Sheriff Koutoujian advocated for families and vulnerable populations on issues including mental health, domestic violence prevention and substance use. His efforts to address these areas motivated the Sheriff to create two state commissions – the Commission on Oxycontin and Other Drug Abuse and the Commission to End Racial and Ethnic Health Disparities. As Sheriff of Middlesex County, he led the county as a founding member of Data-Driven Justice (DDJ, now Familiar Faces Initiative) and as one of three pilot sites funded by Arnold Ventures to enhance data collection. This role positioned the county to develop and expand collaborative strategies for analyzing data from across the county’s criminal legal system. As a result of his leadership, the Middlesex County Restoration Center will open in 2023, underscoring the dedication to providing behavioral health support services in the community as an alternative to involvement in the criminal legal system. The Restoration Center will create an ecosystem of care for individuals identified through data sharing to implement long-term solutions beyond jail diversion.

Through his collaboration with the Familiar Faces Leadership Network, Sheriff Koutoujian is working to standardize data-sharing approaches that create lasting positive change for familiar faces. Sheriff Koutoujian hopes to bring Middlesex County’s data-sharing strategy to a national stage and facilitate conversations on evidence-based best practices and lessons learned in the county.

Hon. Sharon Meieran

Dr. Sharon Meieran serves as Commissioner for District One of Multnomah County, Oregon. Commissioner Meieran is a former lawyer, an emergency physician and a volunteer for Portland Street Medicine, an organization that provides medical care to individuals experiencing homelessness. Since her election in 2020, Commissioner Meieran has put mental health advocacy, homelessness, environmental preparedness and digital equity at the forefront of her agenda. Commissioner Meieran championed the statewide expansion of the Emergency Department Information Exchange (EDIE), a familiar faces alert and information exchange system for hospital emergency departments. She also worked closely with the Corporation for Supportive Housing (CSH) to implement FUSE (Frequent User System Engagement) in Multnomah County and identify frequently utilized services for additional investment. She has led community engagement assessments of the county’s mental health services and established the Behavioral Health Emergency Coordination Network, a regional crisis triage and stabilization center.

Commissioner Meieran’s diverse professional experience pushes her to advocate for better data integration across government, criminal legal systems and health care service providers. Working with the Familiar Faces Leadership Network, she hopes to explore building integrated care systems that improve outcomes for familiar faces.

Hon. Mary Lou Pauly

Mary Lou Pauly serves as the Mayor of the City of Issaquah, Washington. Issaquah is located in King County, about 20 minutes south of Seattle. Previously, she served on the City Development Commission, the City Council and outside of elected roles as a civil engineer and environmental consultant. Mayor Pauly strives to meet her community where they are to serve and support a diverse population. Her dedication to the community fostered the establishment of the Issaquah Behavioral Health and Homeless Outreach program and the CARES program, both of which have reduced repeat behavioral health-related 911 calls. The Behavioral Health and Homeless Outreach program provides navigators that make referrals, share appointment reminders and, if necessary, provide transportation to and assistance at appointments. The CARES program was piloted seven years ago by the local fire department chiefs to address underlying needs of repeat callers to local emergency medical services. The CARES and Outreach programs are rooted in cross-sector communication and information sharing, bringing Mayor Pauly to the Familiar Faces Leadership Network.

Mayor Pauly convenes city leaders to build consensus and improve fragmented systems. By joining this network, Mayor Pauly looks forward to learning about how peers are fostering buy-in from their county leaders and joining training opportunities around building better care continuums.

Hon. Vickie Raines

Vickie Raines is County Commissioner of District Three in Grays Harbor County, Washington. Grays Harbor County is located roughly two hours south of Seattle and is home to about 80,000 residents. Commissioner Raines has served as an elected official for decades, having previously served as mayor of Cosmopolis, a city in Grays Harbor County, for 12 years and as a city council member for three years prior. Commissioner Raines also serves as Chair of the Great Rivers Behavioral Health Administrative Services Organization Board. Commissioner Raines is passionate about establishing efficient government practices and improving public safety and health systems. As a county leader, Commissioner Raines has worked to establish the Grays Harbor Justice Center Collaboration in addition to expanding emergency medical services. In her role as a member of the county health board, Commissioner Raines has worked diligently to create collaborative systems between criminal legal and public health officials that have enabled officials to make evidence-based decisions surrounding familiar faces.

Nationwide, county leaders recognize the importance of building collaborative, cross-sector care continuums. Commissioner Raines looks forward to learning best practices in program development and messaging from partner counties to improve care systems in Grays Harbor County.

Hon. Shannon Reid

Shannon Reid is County Commissioner of District Two in Douglas County, Kansas. Douglas County is home to nearly 120,000 individuals and located an hour south of Kansas City. In addition to her role as a county official, Commissioner Reid is the Court Advocacy Coordinator at The Willow Domestic Violence Center, where she helps individuals and families navigate the legal system. Commissioner Reid has also served as a volunteer advocate at the Sexual Trauma and Abuse Care Center. Her experience working with these organizations has shaped her approach to leadership, centering her efforts in empathy and compassion. Commissioner Reid believes in the importance of investing in affordable housing, transforming the criminal legal system through innovative, people-centered measures and making government more accessible to under-served or vulnerable individuals. Under her leadership, Douglas County recently opened a Treatment and Recovery Center, which connects community members to behavioral health resources.

As a member of the Familiar Faces Leadership Network, Commissioner Reid looks forward to learning more about the successes of other counties and gaining opportunities to advocate for changes in state legislation to create better outcomes through data sharing.

Hon. Susan Schafer

Susan Schafer is a Board Member of McLean County, Illinois, representing the county’s ninth district. McLean County is two hours south of Chicago and home to nearly 170,000 residents. Board Member Schafer is a member of the McLean County Executive and Justice committees, chair of the Health Committee and vice chair of the Legislative Subcommittee. Since elected in 2010, Board Member Schafer has worked diligently to create positive changes in McLean County’s behavioral health system. In 2015, she led efforts to create and implement the county’s Mental Health Action Plan and has since led efforts to update this plan. She utilizes her council connections to facilitate communication across different county agencies to encourage data-sharing and coordination throughout McLean County. Board Member Schafer believes in the importance of developing long-term solutions to create lasting outcomes benefiting the community. For example, to address shortcomings in qualified behavioral health and justice service providers in McLean County, Board Member Schafer and others worked with Illinois State University to develop a post-graduate program for nursing students in behavioral health services. This workforce pipeline has enhanced the county’s ability to expand and strengthen public health and safety initiatives.

Board Member Schafer advocates for the importance of providing care continuums to everyone; joining the Familiar Faces Leadership Network, she hopes to gain insight into how to address issues that require a solution, but don’t often attract funding or media attention. She also looks forward to sharing how McLean County is navigating obstacles in implementing innovative data sharing programs and services.

Hon. Janet Thompson

Janet Thompson serves as County Commissioner of Boone County, Missouri, which is home to 190,000 residents. Prior to her election, Commissioner Thompson served as a Public Defender in Missouri for nearly 25 years and an arbitrator for the Financial Industry Regulatory Authority. In addition to her elected role, Commissioner Thompson serves on many boards, including the Boone County Family Resources (BCFR), Criminal Justice Administration and the Judicial and Law Enforcement Task Force. Commissioner Thompson actively supports Boone County’s efforts to address systemic gaps by participating in local initiatives that identify growth areas, including Stepping Up and the Functional Zero Task Force (FZTF). FZTF is a collaborative effort between government agencies and service organizations to end housing insecurities. Commissioner Thompson plays an active role in researching effective practices and maintaining connections with partners to support building care continuums. As a result, Boone County recently expanded its mental health staffing structure through the creation of two new positions, a Community Mental Health Liaison and a Justice and Behavioral Health Coordinator.

As part of the Familiar Faces Leadership Network, Commissioner Thompson hopes that increased exposure to nationwide models and practices will encourage health care systems to provide data sets to help counties and service providers have a higher-level view of cross-system issues. Commissioner Thompson has found that meaningful progress does not come easy, but that the wide-reaching impacts of positive care continuums is proof that even small systemic changes are worthwhile.

Hon. Jenny Wilson

Jenny Wilson serves as Mayor of Salt Lake County, Utah. Salt Lake County is home to nearly 1.2 million people. Prior to being elected Mayor in 2019, Mayor Wilson served on the Salt Lake City Council for ten years and was the first woman to have been elected to the Salt Lake City Council. As a council member and now as Mayor, she has heralded initiatives around ethics and criminal legal reform, environmental preservation and increasing government efficiency. Mayor Wilson’s focus in establishing ethical and criminal legal reform resulted in the establishment of the Criminal Justice Advisory Council (CJAC). CJAC is a committee consisting of individuals from the criminal legal and justice systems who collaborate to structure county policy and initiatives. Under Mayor Wilson’s leadership, Salt Lake County recently implemented a Jail Reentry Resource Program, a collaborative effort between the public defender and criminal legal services that supports individuals as they transition from jail back into the community. The Justice Resource Reentry Program strengthens partnerships between county government, nonprofits and the criminal legal system to reduce recidivism. In addition to her efforts in jail diversion, Mayor Wilson also co-established the Salt Lake County Opioid Taskforce to coordinate efforts and solutions to the opioid crisis.

As a member of the Familiar Faces network, Mayor Wilson hopes to work with peers to develop strategies to enhance coordination between justice, health and human service systems.

Hon. David Zook

David Zook serves as Mayor of Cache County, Utah, located an hour north of Salt Lake City with a population of approximately 150,000. Prior to his election, Mayor Zook served as the City Manager of Nibley, Utah and as a member of the Hyde Park Planning Commission. Throughout his tenure as a public servant, Mayor Zook has prioritized improving public safety, enhancing economic development, preserving Cache County’s natural landscape and improving internal county operations. Although Cache County is a smaller, rural county, Mayor Zook is dedicated to ensuring residents receive high quality services on par with those in larger jurisdictions. Since elected, Mayor Zook has created a public defender’s office, increased the number of ambulances in the county and opened a Children’s Justice Center to foster healing in the community. As the chief executive for Cache County’s health, mental health and homeless coalitions, Mayor Zook is uniquely positioned to implement best practices and solutions across the county, creating more effective and efficient care continuums.

By participating in the Familiar Faces Leadership Network, Mayor Zook hopes to learn about other counties’ cross-system data-sharing models and strategies to divert individuals from the criminal legal system.

This Familiar Faces Initiative Community Portrait is the seventh in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to improve outcomes for familiar faces of justice, health and human services systems. This interview was edited for brevity.

Ms. Susan Schafer has served as a Board Member for McLean County, Ill. since 2010. In this role, Board Member Schafer helped to create McLean County’s Mental Health Action Plan and the 2022 Update, which addressed the gaps in services for community members with behavioral health conditions. Her experience in service and making strong connections with community partners enables Board Member Schafer to advocate for familiar faces through data-sharing and health initiatives.

Q: What drew you to the work you are currently doing as a Board Member for McLean County, Ill.?

I had a strong desire to serve my community. Before coming into this role, I was heavily involved in my community through activities with my children, like the youth symphony. I have always had a passion for serving and problem-solving, so I enjoy developing solutions to promote better outcomes in the community.

Q:What are the most pressing issues concerning behavioral health and justice in McLean County and what is the county doing to address these issues?

Our biggest issue is retaining a behavioral health and justice workforce, which seems to be a problem facing many communities right now. Finding and attracting qualified mental health professionals to support behavioral health programs is challenging. Our local institutions of higher education are helping develop the workforce we need. Illinois State University created a pipeline for nursing students, including a new post master’s program Psychiatric Mental Health Nurse Practitioner Certificate (PMHMP) to aid in the lack of psychiatrists, and Heartland Community College has developed a peer program. This work is critical to our county’s ability to build and expand our behavioral health and justice initiatives.

Q: McLean County has an impressive data-sharing system. How does the platform support the county’s programs and initiatives?

Our data system is huge. It’s managed by our county IT office and enables McLean County to share data among our disparate legal systems. Our Integrated Justice Information System (IJIS) collects data from law enforcement officers, prosecutors, public defenders, probation and parole officers and the jail. We also matched IJIS with the Homeless Management Information System (HMIS) to analyze the intersections between impacts of the criminal legal system and homelessness. Once we identify the individuals who are regularly cycling between these systems, we can provide targeted assistance.

We are currently working on improving the system so that individuals can be matched across IJIS, HMIS and health care and medical services systems. The update was projected to take 5 to 10 years, but the county has devoted ARPA funds to the project, allowing us to expedite it and update our system in the next few years.

Q: Tell us about some of McLean County’s successes in assisting familiar faces.

In 2019, we worked with CSH (Corporation of Supportive Housing) through the Frequent Users System Engagement (FUSE) program to develop a tool that would match people who have been impacted by the justice system and were also experiencing homelessness to services. Through this work, we reduced shelter days for those experiencing homelessness and reduced emergency department visits. In the 18 months following the start of our FUSE program, we saw a reduction of 51 emergency department visits. By the end of 2020, we had only 1 emergency department visit by a FUSE program participant. In that same time, program participants’ number of contacts with the criminal legal system decreased from 30 to 5. (More information about this FUSE program is available in NACo’s case study on McLean County).

Also, McLean County opened a triage center in 2020. The center operates on a living room model, meaning we offer individuals a safe, calm environment to access when they are experiencing a mental health crisis. A lot of clients self-refer to the triage center, although law enforcement can also bring people into the center as an alternative to hospitalization or a jail booking. Our local crisis call center is also aware of the triage center; enabling them to refer callers experiencing a mental health crisis to the triage center when appropriate.

Q: How are you supporting youth and young people with mental health conditions in your community?

Our county has a robust continuum to support familiar faces, and this has allowed us to turn our attention to preventive efforts that keep people from becoming familiar faces in the first place. We have counselors embedded in nine of our county’s schools to promote the mental wellbeing of students and the principles of violence prevention.

The McLean County Criminal Justice Coordinating Council (CJCC) is also focusing on our ‘emerging adult’ population, encompassing the 18-24 age group. The county is using IJIS to collect and analyze data on individuals who were previously placed in the juvenile detention center and have migrated to adult detention centers. We are specifically looking at how individuals who were flagged with having behavioral health conditions while in the juvenile detention center are operating as adults in terms of their mental health and wellbeing. This data analysis informs us of the gaps in our behavioral health continuum, how to best address individuals’ needs and enables specialized casework through probation.

Q: Can you tell us about McLean County’s preparation for the Lifeline transition to 988?

Our local crisis call center, PATH 211, is the crisis call center for 43 counties in Illinois and has been providing 24/7 National Suicide Prevention Lifeline service for decades. PATH 211 is expanding into PATH Inc. and has been designated to provide 24/7 Lifeline service to areas of Illinois not currently covered by a local Lifeline call center – which is 80% of the state. PATH, Inc. will also provide statewide backup service and text and chat.

Q: What advice do you have for elected officials who want to initiate innovations within the justice and mental health field in their county?

First, understanding that everything is not going to happen overnight. It takes a long time to build an integrated data system and to use that data system to connect familiar faces to the resources they need. A crucial part of these initiatives is building relationships with law enforcement, crisis teams and community organizations. It is a continuous effort that requires honest and open dialogue. Having honest conversations with potential partners will allow you to find the strongest and most supportive partners for your county’s initiatives.

Second, models are models and something that works in one county may not always work in another. Someone can look at a model of what a Familiar Faces Initiative county is doing and want to implement it in their county, but it must be adjusted to fit local laws, demographics, resources and populations. Model programs should be a foundation to build upon, rather than a step-by-step guide.

Finally, stakeholders across the county must be engaged and willing to support the initiative. A data-sharing system is not cheap, so building these partner relationships and ensuring that partners stay up to date and supportive of the initiative is essential.

 

NACo would like to thank Board Member Schafer for speaking with us about McLean County’s efforts. She can be reached at susan@schafer9.com.

This community portrait was created with support from Arnold Ventures as part of Familiar Faces Initiative, a project that strives for better outcomes and lower incarceration rates for individuals who frequently cycle through jails, homeless shelters, emergency departments and other local crisis services.

This Community Portrait is the sixth in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to respond to the needs of frequent utilizers of justice, health and human services systems. This interview was edited for brevity. 

Ms. Beya Thayer is the Executive Director of the Yavapai Mental Health and Justice Coalition in Yavapai County, Ariz. Beya works to develop and implement strategies that lead to the long-term and sustainable involvement of county agencies, organizations and individuals within the intersections of justice and behavioral health with the goal of addressing partnership and systems change. Beya’s career has given her the opportunity to create partnerships and collaborations with diverse communities, professions and agencies throughout Arizona to affect change. Beya has a master’s degree in Social Work from Arizona State University and has worked in the social services arena for over 25 years.

Q: What brought you to your role in Yavapai County?

First and foremost, I’m a systems-level social worker, and I’m passionate about working with different agencies and multi-disciplinary players. We live in a world that relies on government and private roles, but they don’t always work in our favor. For example, a person may be sent to jail for a low-level crime only to learn more serious criminal behavior while incarcerated. These systems have great intentions, but sometimes the cogs aren’t flowing in the way that we need them to flow. I like to look at the broader view and find out where we can meet the needs of our community on a collaborative, systemic level.

Prior to this position, I worked as the justice liaison for the Arizona Medicaid Regional Behavioral Health Authority, which covers a huge area across six counties. I was the bridge between behavioral health providers and the criminal justice system, trying to initiate conversations, procedures and protocols that could benefit all parties. The justice and behavioral health systems speak completely different languages; it was great to be a liaison there.

Before I joined the Yavapai County Sheriff’s Office, the county’s jail was at capacity. The sheriff and jail captain were already identifying why this was happening and how they could better serve people with serious mental illnesses who were incarcerated. The Sheriff’s Office started a partnership with the public defender to determine how they could start a post-arrest diversion program for people with low-level felonies, who were eligible, but financially unable to bond out of jail, and had disclosed behavioral health concerns. The Sheriff’s Office and public defender needed the help of the behavioral health system to implement this type of program.

The sheriff worked with members of the state legislature to write a jail reentry coordination bill that included formalizing the Yavapai Justice and Mental Health Coalition and looking at the entire spectrum of incarceration prevention. The bill included support for screening all individuals upon booking, identifying those with continuing needs and connecting them to community services immediately upon release, as well as funding for a full-time position to support the Coalition. When the bill passed, the Sheriff’s Office launched the Reach Out Initiative, formalizing the screening and reentry processes, and I was hired as the executive director of the Coalition to help coordinate the initiative. I was asked to take on this role because of my history and knowledge of the Medicaid and behavioral health systems, as well as my relationships with the justice and community partners.

Q: Tell us more about the Coalition.

The Coalition is led by an Advisory Council that is chaired by the sheriff and made up of leaders throughout the justice, behavioral health and social service systems; this includes our elected county attorney, public defender, police chiefs, behavioral health leaders, the probation department, the juvenile justice director and the school system. The Coalition meets regularly and hosts quarterly meetings that are open to the public.

The Coalition started as a mechanism to report out to the community and other justice and county leaders regarding availability and progress of programs within the Sheriff’s Office, but it has evolved into a bigger role. Early on, the Advisory Council conducted a community assessment through a Sequential Intercept Mapping exercise to identify gaps in services and determine shared goals that collectively impacted multiple coalition members. As a result of this exercise, we created working groups to help address different parts of these goals. The key to our success is having multiple system stakeholders embedded in the Coalition, which allows us to strengthen partnerships, identify where a gap exists and determine appropriate, collective remedies.

Q: How does the Coalition collect data and function in Yavapai County?

The members of the Coalition serve as partners to the county’s Reach Out Initiative, which aims to identify people with mental illness and co-occurring substance use disorders at the earliest possible criminal justice intercept and link them to care. The Sheriff’s Office built a cross-system database for the Reach Out Initiative that tracks pre-arrest deflections and an individual’s mental health, substance abuse and social determinants of health needs as they move through the justice system. This data is then used in developing release coordination plans and supporting post-release treatment engagement.

The 11 law enforcement agencies across the county and their dispatchers have access to the pre-arrest portion of the database. Law enforcement also adds information to the database, inputting when a person is deflected from arrest and whether they are provided resources or intervention. This information can support law enforcement across jurisdictions to make future deflection decisions if they encounter the same person. Additionally, as data is reviewed, the Coalition can create a small “staffing” of key stakeholders if an individual is repeatedly deflected and needs increased support.

Information for the database is also collected when an individual is booked into detention and our inmate services release coordinators meet with them to screen for symptoms of mental illness and/or substance use disorders, social determinants of health needs and assess risk factors. A post-screening report is generated, which states the person’s risk level and the services the individual is willing to engage in if released. The initial appearance judge can choose to use the reports and the County Attorney’s Pre-Trial Diversion program relies on the reports to assist in determining whether a defendant may be eligible for the county attorney’s diversion opportunity. Additionally, the coordinators use the reports to develop release plans with the best connections and support ready at the time of release, which is essential in supporting high-risk community members with serious mental illness.

Our community behavioral health providers also have access to the database and utilize the screening and release coordination information (for those individuals who have completed a Release of Information form), which can be beneficial to their treatment plan. The providers input treatment engagement data into the database at 30- and 90-days post release, providing critical information in understanding program fidelity.

The Coalition has partnered with Northern Arizona University’s Center for Health Equity Research for semi-annual, third-party evaluations of the Reach Out database program. The evaluations report on the county’s recidivism statistics for specific demographics and risk levels. We use this data to understand the risks and needs of the people within our justice system, the quality of connections made upon their release and to work with our community partners to increase collaboration and service provision in a deliberate manner to reduce recidivism.  

During this past legislative session, the Arizona Legislature was able to leverage the success of the Yavapai County data-sharing program and appropriated additional funds to expand jail re-entry coordination programs to other counties as well as to replicate the database for counties statewide. The Arizona Legislature appropriated $1 million to the Arizona Criminal Justice Commission to oversee the database expansion project. This is exciting as it meets the needs of our counties but also allows for a complete picture of the state and comparison of similar data across counties. For example, we can compare Yavapai County to Pinal County, and further, look at services that individuals have received across counties to continue referring them to the most appropriate care.

Q: What was the driving force in getting this partnership and programming off the ground?

It takes that leadership piece. Having somebody take the lead is so important, and the power behind an elected sheriff sticking his neck out was exponential. When the sheriff showed his support and investment, everybody who played a role in the system was willing to give a little bit more.

Q: How does Yavapai County use the Data-Driven Justice Playbook to help guide these efforts?

The Sheriff’s Office really leaned on the Data-Driven Justice Playbook, because county leaders and elected officials are looking at their whole community from a big-picture perspective and the playbook is at the 30,000-foot level, so it’s attractive to county leaders. Our first responders find the Playbook is helpful because instead of telling you what your case plan and screening should look like, it provides ideas as to how to start these conversations and who should be involved.

The DDJ Playbook and the Coalition helped us create the space to talk about what we’re seeing so we could identify gaps and try something new. It’s not easy because each new project demonstrates more gaps and more barriers. The Data-Driven Justice project and Playbook are impactful as we move toward systemic policy change and reform.

Q: How else is Yavapai County supporting frequent utilizers?

Our community has a Crisis Stabilization Unit (CSU), which is a 24/7 observation and stabilization center that is staffed by mental health professionals, peer support specialists and medical professionals. The CSU provides crisis assessments, counseling, medication and referrals to on-going services to anyone in crisis. The CSU opened around the same time that two different behavioral health providers launched mobile crisis teams. These teams are immediately available to respond to law enforcement, hospitals and community members. One goal of the CSU and the mobile crisis teams was to create an option for law enforcement that is easier than bringing a person to the jail. Following these developments, the service providers of the CSU and the mobile crisis teams provided the Coalition with data on clients referred to them by law enforcement. With this data, we were able to show that the number of people referred to the behavioral health crisis providers from law enforcement closely matched the decrease in jail admissions from the previous year. We could see the CSU and mobile teams were working to reduce jail admissions and improve access to care.

In addition, the Reach Out team and Yavapai County Adult Probation have partnered to coordinate release plans, including early release from jail to residential treatment for people with mental illness and/or substance use disorders. Within the first six months of this effort, the Sheriff’s Office and probation reported a reduction of 1,110 jail days. As a result, probation hired a specialized officer to work with Reach Out program participants. With the additional staff and continued coordination with the Sheriff’s Office, the Yavapai County Jail reduced 2021 jail days by 8,876 days through coordinated release to treatment for people on probation.

Q: Where does your passion for helping people involved in the criminal justice come from? What pushes you to keep going day after day?

Community members with complex conditions—in some cases relating to past trauma—rely on county and community services for support in meeting basic needs. It’s heartbreaking when their needs are not met as effectively as possible, or worse, when people wind up caught in a system that perpetuates their trauma. For instance, a call for assistance relating to a behavioral health crisis may end in an arrest, which does not address a person’s need and instead feeds a cyclical pattern. That is why I like working on the system level that takes everything into consideration. Addressing this cycle is my personal drive.

 

NACo would like to thank Ms. Beya Thayer for speaking with us about her and Yavapai County’s efforts. She can be reached at Beya.Thayer@yavapaiaz.gov.

This Community Portrait is the fifth in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to respond to the needs of frequent utilizers of justice, health and human services systems. This interview was edited for brevity. 

Dr. Errol D. Toulon, Jr. is the Sheriff of Suffolk County, New York on Long Island. He was born and raised in the Bronx in New York City, and his father and brother were both wardens on Rikers Island. As such, Toulon learned about the criminal justice system from a very early age; in 1982 he joined the New York City Department of Correction where he had a 22-year career in uniform serving in various positions in the Emergency Service Unit, Firearms & Tactics Unit and Compliance Unit.  He retired as a captain due to health reasons. In 2014, he returned to the Department of Correction as the Deputy Commissioner of Operations overseeing the Intelligence Unit, Training Academy, Applicant Investigations Unit, Emergency Management and Compliance Units. Taking office in January 2018, Sheriff Toulon is the county’s first African American person to be elected to a non-judicial countywide office. He received his bachelor’s degree in Business Administration from Monroe College, a master’s degree in Business Administration and a doctorate in Educational Administration from Dowling College.

Q: Where do you get your passion for helping people involved in the criminal justice system? 

When I was a child, my father told me that his job as a warden was about rehabilitating people who were incarcerated; however, he also used the same moniker of “bad guys” that needed to be in jail. When I was a captain on Rikers Island, I would often tour our various facilities, talk to the people in our custody and find out why they became incarcerated and if they experienced substance abuse and/or mental health issues. I believe 85 percent of men and women that come into our facilities are individuals that have mental health and substance abuse issues, or they just made some poor choices. Many come from areas and families that experience multi-generational trauma due to community and family violence.

When I became sheriff, I used this experience to affect change in my community. We can assist those men and women with the treatment they need and can connect them with resources in the community to continue care post incarceration. I am extremely passionate about ensuring people continue to receive this level of care while involved with the justice system.

Q: What are some of the initiatives you’ve started to help people with mental illness and/or substance use disorders involved in the justice system?  

Here in Suffolk County, we created The Sheriff’s Transition and Reentry Team (START), where we work with the judicial system, The Legal Aid Society and The Criminal Bar Association to offer case management and support to help address the needs of people in our custody and upon release.

The START Resource Center is located at our Yaphank Correctional Facility and staffed by correctional officers. In our jails, we start reentry on day one of incarceration. We interview inmates at jail admission and have them complete a packet of information where we assess their needs and life goals. Officers and our partners support people with substance abuse treatment, education, job and resume assistance, social services enrollment, driver’s license and identification issues, transportation, food, housing and clothing. We also provide referrals to community-based services upon release. We help people create resumes and conduct job searches and provide business attire for job interviews. We also provide transportation for interviews, as transportation can be a huge barrier in Suffolk County. We have identified employers who are willing to hire a formerly incarcerated individual and work with social services agencies in various communities to connect people to health care and continue treatment. We are trying to address structural barriers to reentry, and the staff has truly built trust among our community members involved in the justice system. In fact, with START, more than 350 people have returned to our resource center or reached out for further assistance who are no longer involved in the justice system.

We also have a serious addiction treatment program and are very much involved in the drug court. We continue to talk to judges and defense attorneys on how we can improve. We can always do better, and I push my staff so that our office can mitigate crime before it occurs and reduce our jail population.

Lastly, we partnered with Stony Brook University School of Social Welfare on our family reunification project to bring graduate-level interns to the jail to work with inmates and their families to improve relationships while people are incarcerated and when they are released. We know that family involvement can be key to a person’s success once they are no longer in our custody.

Q: Who have been some of your most valuable partners in this work?  

We have worked with many community partners who have helped identify individuals with mental health or substance abuse issues. We created a satellite facility partnering with one of our service providers, Spin the Yard, to assist with transportation and networking with other programs to make sure people are receiving the assistance they need.

In addition, since many of our female inmates are victims of human trafficking and have substance use disorders, The Empowerment Collaborative of Long Island is another important community partner, particularly for women and children. We also partner with many local advocacy groups and monitor data to understand where in Suffolk County there are hotspots of people suffering from mental health and substance abuse issues and how to best address it. We also use data analysis in our schools through a program called Deconstructing the Prison Pipeline, which seeks to improve policy and craft initiatives to prevent youth from getting involved in the justice system by helping to identify root causes of youth delinquency.

Q: How is your office working with the community to address race equity for people involved in the justice system?  

First, I am always looking at data to help us understand the problem. As Sheriff, I have made it a priority for our office to use data to identify community members at risk of incarceration. We focus on factors such as demographics and ethnicity, education level and employment type. Do they have children? With these variables, we see where certain trends are occurring and can drill down to the root causes of some of the issues that our residents face before and after incarceration.

Since last year (2020), we started a training course for fair and impartial policing not only for our deputy sheriffs and correctional officers, but also civilian personnel. We have implemented customer service training for sworn and civilian personnel that are interacting with the public. I do not, however, believe that a training course will really allow us to understand our own biases, so we have made it incumbent upon our supervisors to reinforce this training throughout our daily work. Since it is very difficult to change someone’s inherent views in just a couple training sessions, we conduct them regularly to at least recognize these biases and reinforce the need for change.

There needs to be a basic understanding of respect from law enforcement to the people in our community and those that are incarcerated. The death of George Floyd was a tragedy, and law enforcement needs to find a balance when interacting with the community between who is an actual threat and who may be experiencing a mental health or substance abuse crisis.

Q: What more can Suffolk County do to help people living with mental illness and/or substance use disorders? 

What is needed not only for Suffolk County, but our nation, is investment in social services. People need help before they interact with law enforcement. By the time someone is incarcerated, the individual has most likely shown many red flags. The pandemic has caused a mental health and substance abuse crisis in this country and with so much trauma and disruption in our society today, the government needs to focus on increasing funding in our communities for social services. This would certainly lead to fewer negative interactions with law enforcement and less incarceration. We may be able to save not only a lot more lives but change people’s lives so that families and communities are safer.  

Q: What inspires you about this work?  

I’m a two-time cancer survivor, so I probably shouldn’t be here. My second battle was with pancreatic cancer and it has made me feel that I’m here for a purpose. I was a deputy commissioner at Rikers Island for 25 years and I didn’t have the direct impact that I have now. I have been a resident of Suffolk County now for 31 years and I can see the impact I have on my staff and the individuals that are incarcerated in the community. This is what gives me joy because I can affect real change and help people. It motivates me every day.

Q: Do you have any recommendations for other communities or advice for your peers? 

You can never have enough partners in this, whether it’s NACo or law enforcement agencies, community partners or community members. I engage with our community to understand what various populations in Suffolk County are dealing with so I can understand what we need to do and identify potential and changing trends. As a sheriff, it is important to talk to law enforcement agencies and community partners throughout the country to see what they are dealing with and how to best prepare. Finally, humility is crucial. You need to talk to everyone and can never have enough engagement with people. There is much to learn from other people’s experiences.

 

NACo would like to thank Sheriff Errol Toulon for speaking with us about his and Suffolk County’s efforts. He can be reached at Suffolk_Sheriff@suffolkcountyny.gov.  

This Community Portrait is the fourth in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to respond to the needs of frequent utilizers of justice, health and human services systems. This interview was edited for brevity.

Juleigh Nowinski Konchak, MD, MPH, has spent her life working at the intersection of equity, health and policy. She is the program director for Public Health/General Preventive Medicine Residency Program with Cook County Health (CCH) and a physician advisor for CCH’s substance use disorder programming. In this role, she sits in the Center for Health Equity and Innovation leading the substance use disorder programing while continuing to work in preventative medicine. Juleigh graduated with honors from The University of Illinois College of Medicine and earned her Master of Public Health and Certificate in Healthcare Quality and Patient Safety from Northwestern University.

Q: How did you get into this work?

I studied social policy in college; after I graduated, I joined the Obama senate campaign. He won, and I took a position in Senator Obama’s D.C. office working on health, education and veterans affairs. I was really drawn to the health side of the job and started to really focus on health policy. My supervisor at the time was a medical doctor, and I had been pre-med in undergrad, so I decided to go to medical school to really understand the inner workings of health care. Not long after I started medical school, I took a leave of absence to go work at the U.S. Department of Health and Human Services for the Obama administration, really diving into the world of policy and how it interacts with public health. I always envisioned that I would return to the policy world, but I find it really rewarding to work on the “little p” policies within Cook County government and at Cook County Health. I didn’t expect to stay clinically active or stay at Cook County Health, but substance use is an area where there are so many inequities. It spoke to me from a public health perspective that there was an opportunity to be involved in building up a system and use data to inform our policies and programs – so, I never left!

Q: How is the health side of the DDJ work structured in Cook County?

Cook County Health is the largest social safety net provider in the Chicago region. We have two hospitals, over a dozen community health centers, the Core Center – an HIV and hepatitis specialty center and CountyCare – one of the largest Medicaid providers in Illinois. We also serve as the public health department for the majority of suburban Cook County and as the health care provider at Cook County jail. We have a very broad reach. Cook County Health has been working in the substance use disorder space for a long time, but within the last decade we have made a more concerted effort to expand access to evidence-based care across all our sites. We coordinate internally between outpatient, inpatient, jail and emergency department settings, and coordinate with other county government partners, including Adult Probation and the Sheriff’s office, and the State’s Attorney’s office on trainings and care for people involved in the justice system.

Q: What is Cook County working on in this space right now?

When we started working through the data from the overdose crisis, it brought newfound energy to the work we do in Cook County. We have started using a lot of qualitative data points to help support the mission. We surveyed patients and presented those stories to clinicians and leadership to encourage patient centeredness and reduce stigma around substance use. We also used patient interviews for advocacy materials to elevate the patient voice internally, with the state’s attorney’s office and the probation department to highlight the complexities of navigating substance use disorder when you are involved with the criminal justice system. That has been powerful and effective. We have also been trying to educate internally to encourage providers to be more patient-centered and use other indicators of success besides the absence of drug use. When we think about diabetes or obesity we don’t think about perfection as the only indicator of success. There is a spectrum of improvement and progress. We are trying to mirror that highlighting other improvements for drug use such as less pain interference or improved ability to engage in social roles and activities.

Through a research grant with Northwestern University and the Agency for Healthcare Research and Quality, we are working to create a regional learning health system around substance use disorder. We are hoping to use data to drive partnership and work to improve how the probation system connects patients to care. We are working with the state to pilot the use of an information system to optimize access to recovery homes for those seeking help. With partners, we will use data integration to build out this regional learning network, with an initial focus on probation and electronic monitoring. As an example, we recently linked data on opioid overdose from the Cook County Medical Examiner with data on engagement in Adult Probation to estimate opioid-related mortality for this population. There is a lack of data and information on the elevated overdose risk from being on probation, and we are hoping that making this information accessible can help drive policy and systems changes to improve SUD care for people involved in the justice system.

Another project we have been working on is “no wrong door” for our health centers. We launched this effort in 2014 to enable all our health centers to provide evidence-based substance use and recovery support services for opioid use disorder. In-depth analysis has allowed us to see gaps in the system, and we have been able to adjust. The tracking of progress helped maintain engagement from key stakeholders and leadership.

Q: Can you describe some of the racial and ethnic disparities work being done?

Cook County has always served a diverse population. While the national conversation around opioid use and misuse has been centered on non-Hispanic white overdoses, the increase in overdoses in Cook County has consistently been among African American males in the 40- to 60-year-old range. One of the things we have been doing to address this racial disparity is looking more concertedly at our patient population to make sure that we are reaching the people that we are trying to serve and that our population reflects the demographics of Cook County. We are trying to make sure that when we do new work, we lift everyone up and allow them to benefit from our programing.

The jail is another place where we see a lot of health racial disparities. Non-Hispanic Black and white individuals use substances at a similar rate, but non-Hispanic Black individuals are incarcerated at a much higher rate. We are doing what we can to address those disparities. Our follow up occurs in neighborhoods that people we are serving can easily access. Now we are trying to review our data with an equity lens to build out equity in every facet of our system.

Q: What keeps you motivated to do this work? What gets you out of bed in the morning?

Still seeing patients keeps their stories and struggles clear in my mind when the bureaucracy and other tasks and difficulties that are part of this job take over. The glaring injustice when it comes to substance use, especially for those involved in the criminal justice system, keeps me motivated. I always want to be making better policies and making sure we, as public servants, are doing all we can. Until inequity is not a problem in our health or criminal justice systems, I will continue to be motivated to do this work and stay working on these systems.

Q: What advice do you have for others looking to start this type of work in their communities?

Whenever it is possible to engage the people who we are hoping to benefit, it is vital that we do, and that we continue to include them at every stage. If you can have the people you are hoping to serve as stakeholders and truly listen to their input, that is invaluable to the work and its impact. They don’t just have great ideas, but ideas that can translate to real impact.

Collaboration in general is also key. Whenever things can be “win-win,” that is when partnerships continue to function and thrive. Incorporating data can drive these partnerships and feelings of “everybody wins,” because everyone has tangible numbers in their hands on how their facet of the system has improved. Approaching collaboration with genuine respect goes a really long way. We all are working in the public sector because we want to improve society and so we all strive to do that more efficiently.

 

NACo would like to thank Dr. Juleigh Nowinski Konchak for speaking with us about her and Cook County’s efforts. She can be reached at jkonchak@cookcountyhhs.org.

This Community Portrait is the third in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to respond to the needs of frequent utilizers of justice, health and human services systems.

Mike Brouwer has spent his career working to better behavioral health and criminal justice systems in Kansas. He is the Criminal Justice Coordinator for Douglas County’s Criminal Justice Coordinating Council (CJCC). In this role, he organizes reforms to the criminal justice system and manages the intersection with health systems. Mike has an undergraduate degree from MidAmerica Nazarene University and a Masters of Science in Education, Transition and Career Development from Kansas University. In addition to his criminal justice and behavioral health reform work, he worked part-time as a basketball and soccer referee for almost 30 years, only recently laying down his whistle.

Q: How did you get into this work? 

My background is in community mental health. For seven years I worked in county mental health systems with transition age young adults. Youth at that age dealing with mental health issues tend to have a lot of involvement with the criminal justice system. There’s going to court, dealing with probation officers and house arrest. It was an intersection I found very rewarding. So when I was approached to work on a project more squarely in the criminal justice space, I absolutely jumped at the opportunity. In that role, I was utilizing neighboring Johnson County’s criminal justice database to flag people who needed mental health treatment in jail so that probation staff and the residential center would be able to plan for transition, treatment and services when folks re-entered society.

I have worked in Douglas County since 2012, first as the Reentry Director and now as the Criminal Justice Coordinator. Most of my job is keeping key players engaged and informed with what’s going on in our community, what best practices are and what is being tried in other communities. I also work with our data analyst to be able to show the impact of the work and gaps in data that we have.

Q: What led Douglas County to join Data Driven Justice (DDJ)?

Initially, mental health concerns drove these efforts. There was a rise in the jail population of those with serious mental illness and a very strongly held belief that the jail was overcrowded because the state had decreased mental health services and cut state hospital beds. These were the initial motivations for getting involved in DDJ. After seeing a presentation by Johnson County, Iowa, we wondered what frequent utilizers were costing the county and really wanted to understand that population better. We realized that although we have a significant investment in social services in Douglas County, our services were disconnected, we did not fully understand who our high utilizers were and we lacked a unified method to track and serve them.

All of our focus on frequent utilizers started with a need for screening and assessment at the jail. But then we saw that we were missing people and catching the issues too late. This led to a contract with a neighboring county (Johnson County, Kan.) to implement a shared 211 response system and a partitioned case management database that we call My Resource Connection. So if your client goes to Catholic Charities and utilizes their food pantry, it’s going to show you as the primary case manager in My Resource Connection. If your client is in the county jail, it is going to give automated alerts by email, letting you know that your client has been arrested.

It took over a year to get the green light from all parties, but in the meantime, we were identifying frequent utilizers by hand and using that information to get support. In December 2020, we finally got all of our key partners to sign business user agreements to allow our data analyst to analyze the data, identify high utilizers and begin directing services and interventions to them. Now, on any given day, I can see how many people in the jail have a serious mental illness; I can tell you what percentage of people with serious mental illness are being booked into jail and the data dashboards on our website can show the public that same information.

During the COVID-19 pandemic, having this basis in data allowed us to use CARES Act funding for temporary housing right next to our Mental Health Center, allowing us to supply people with winter housing and provide outreach services in close proximity. We were also able to fund two different projects renting out hotel rooms for folks in need of housing. We had the data to know where the needs were and use funding effectively.

Q: How is the DDJ work structured in Douglas County?

Our CJCC is made up of our criminal justice stakeholders, county and city commissioners, staff members from University of Kansas, staff at relevant organizations and agencies, community members and those with a lived, personal experience of the criminal justice system. The CJCC has six different work groups focusing on everything from racial disparities to crisis intervention. After starting the process of building a crisis center, it became obvious that there was a need for a coordinating council on the behavioral health side. A Behavioral Health Coordinator was hired as my counterpart and we meet twice a week – there’s a lot of collaboration. In addition, the sheriff has been very committed and involved in integrating mental health clinical staff and programming in our jails, which has enabled Douglas County to do much more expansive and effective criminal justice reform work.

Q: Can you describe your racial and ethnic disparities work? 

For some time, our community has wanted to look at racial disparity data. This has been difficult because the databases are massive and the information is incomplete; they are not searchable or entirely accurate. Our data scientist, Matt Cravens, introduced the idea of using regression analysis to look at data so we can control 10 or 12 data points that allow us to comfortably say whether or not we have found a correlation. Now we’re analyzing all of our decisions in our criminal justice system based on race, which has been very revealing.

What we’ve learned is that we are arresting Black people at an almost four times higher rate than white persons. We also found that if you are Black, you would stay in jail about 20 percent longer than a white person. We are really trying to challenge ourselves to understand why and build safeguards against these inequalities occuring. This led to a study with Northeastern University, where we are logging every law enforcement contact into our criminal justice database to determine where and why these inequalities exist. We’re expecting to get the report from Northeastern University in winter 2022 with recommendations on how to curb the biases in our system. We have begun to focus on other decision points in the criminal justice system as well. Our key decisions are clearly creating a lot of disparities, and we hope that having more and better data on this will help us change this.

Q: What keeps you motivated to do this work? What gets you out of bed in the morning?

I love the people I work with. We really do all of this work collectively. We’re a large enough county to have enough money to make big changes but small enough to not have a ton of red tape, which makes it an exciting place for work when you are trying to improve people’s quality of life. We are a tight knit county so the people we are serving I see at the grocery store and at our children’s soccer games. I’m thankful that the work I get to be involved in has a hand in changing people’s lives.

Q: Do you have any advice or recommendations to other counties that are implementing efforts to innovate within the justice and mental health space? 

In Douglas County, the sheriff wanted to understand why people with mental illness were in our jail. To answer that question, we created two councils and numerous alternative programs that have helped change the conversation about mental illness in our entire system. Even if you only have two or three people, someone from the jail, someone from the mental health center and a community leader – that’s a fantastic place to start. All you need is a few people to start getting together and talking about how to solve these problems. We began with just a few folks who felt strongly that conversations about frequent utilizers needed to be happening regularly. Within three months we had 42 people in this group. Just start. Just start getting people together. I also tell people who are just starting this work in other places to get on the DDJ calls and listen and ask questions. Folks in other counties will be happy to help and there are a lot of resources there for you. There is so much support available.

NACo would like to thank Mike Brouwer for speaking with us about his and Douglas County’s efforts. He can be reached at mbrouwer@douglascountyks.org. 

This Community Portrait is the second in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to respond to the needs of frequent utilizers of justice, health and human services systems.

Sonya Harper has spent her career working on criminal justice reform and addressing racial and ethnic disparities. She is a native of North Carolina and currently resides in Mecklenburg County as the director of the Criminal Justice Services Department. Sonya didn’t always know she wanted to work in the criminal justice space. She started college as a biology major but one elective criminal justice class inspired Sonya to switch her major to criminal justice. That decision led Sonya to a master’s degree in public administration and a career dedicated to criminal justice reform. Mecklenburg County has a history of investing in criminal justice reform at the county level which has allowed Sonya and the Criminal Justice Services Department to implement broad and innovative reforms.

Q: Every county is a little bit different in the way that they are run. How would you describe the role of the Department of Criminal Justice Services (CJS) in Mecklenburg County? 

A: We are very unique in comparison to other places in North Carolina and in the rest of the country as well. I believe that we are the only county in North Carolina that has a fully established county department dedicated to this work. There are roughly 65 of us in the department right now, and we have six units. I see Criminal Justice Services (CJS) as the neutral ground of the local criminal justice system. We have core programs and services that we offer to justice-involved individuals and our data capacity permits us to serve as the entity that’s keeping a finger on the pulse of what’s happening in the local criminal justice system. As a result, we are able to work with the other criminal justice partners on the development, launch and implementation of a variety of different strategies and initiatives.

Q: You obviously have many different programs and many different priorities. How were you involved in helping Mecklenburg County leaders decide to join Data-Driven Justice (DDJ)? Was there a specific issue you were trying to solve?

A: When I arrived in Mecklenburg County, it was right at the point where we were joining DDJ. Data plays a big role in the identification of strategies and initiatives within the jurisdiction and allows us to monitor the overall health of our local criminal justice system. It (DDJ) allows the opportunity to partner with other organizations and to connect with other places in the country that have similar initiatives. It is important for data to be part of any conversation in criminal justice whether it’s related to policy or programming and it is important to craft those policies in response to what’s occurring and what the extent of the issue is that you’re trying to address.

Q: How would you describe your role and the role of the research and planning team within the department of criminal justice services? 

A: My role is to oversee the department. In Data-Driven Justice, I serve as a liaison for our research and planning team to make contributions and to carry things over that we can implement within our local jurisdiction. We participate in the events and things that NACo holds, and we were able to tap into additional resources through DDJ. Through DDJ we were also able to connect with partners through University of Maryland and The University of Chicago to have some of our analysts within our research and planning teams participate in a long-term workshop to really build data capacity.

Q: How do your elected officials play into local DDJ efforts?

A: Our Board of County Commissioners champions our work and has recognized the need to have these criminal justice investment services in place. It has been through their support that we have built out a number of things within our department including our data warehouse.

Commissioner George Dunlap, in particular, has served on NACo’s Justice and Public Safety Policy Steering Committee, which has been another outlet for us to be further engaged with the work. When it comes to DDJ, our commissioners agree that we should be making decisions based on what we see in the data. We are always able to provide the data to back up whatever it is that we’re putting out there.

Q: What steps are being taken in your community to assist individuals who are frequent utilizers?

A: Frequent utilizers are a population that every jurisdiction struggles with and in Mecklenburg County, we’re no exception. We have an active Stepping Up Committee (STEP) that’s able to bring forth recommendations based on what the partners see happening in the community. We discovered early on that we needed a better mechanism in place to identify, direct and avert frequent utilizers out of the criminal justice system. Through our Board of County Commissioners, we made investments to create jail diversion programming within the department; that rests within our forensic evaluations unit (FEU), which is a team made up of psychologists and licensed clinicians. These psychologists and clinicians, with our FEU, conduct appropriate screenings and assessments and then make recommendations based on their findings to the court and community-based service providers. They also make connections with community-based services so that we can get frequent utilizers released and then treated within the community.

We’ve also invested in social worker positions within our public defender’s office. A couple of years ago, we started a SSI/SSDI Outreach, Access and Recovery (SOAR) program within CJS specifically targeting frequent utilizers. We recognize, with frequent utilizers, that homelessness is often an area of concern; through our work with SOAR and with clinicians from within our department and within the community, we’ve been able to connect them with Social Security and disability benefits, which in turn opens the door for them to be eligible for Medicaid, housing assistance and many other things.

Another thing that we’ve created is a program called Homeless Outreach and Prevention (HOP). HOP serves as a forum for police officers who are encountering these frequent utilizers in the community – including those experiencing homelessness – and who know that arresting them is not the appropriate response. Police can staff cases with this group, allowing this team to start working with those individuals and getting them connected so that we can try to head off that criminal justice contact as early on as we possibly can.

We are also in the process of expanding to add another clinician within the department that will work specifically with our pretrial services group and help us to identify and connect those who are coming through on the front end of the system with appropriate services. The hope is to get them out of the criminal justice system or at least prevent them from moving further or deeper into the system.

Q: The calls for defunding the police cause concern that positive programs like HOP and partnerships with law enforcement on supporting frequent utilizers are at risk of being cut. How is your department promoting the positive work that you all are doing for this population?

A: I think emotions are very high right now amongst members of our community, particularly our communities of color and it is important for those in government, specifically those of us that are in criminal justice, to be open to hearing from folks in the community and being open to change. We’ve been trying to utilize those opportunities for community conversation to highlight the positive work that is happening. The City of Charlotte has a new police chief that just started this month who is open to conversations on whether there are more appropriate places for certain types of programs to rest.

An important thing for people to know and understand, regarding behavioral health and mental health, is that the criminal justice system has become the catch-all for a lot of societal ails. It has been challenging to address a lot of the things it was not necessarily designed to address nor resourced to address. This begs the question, is the police department really the right partner to take on behavioral health programs? Or would those programs be better served in another place? Answers will vary depending on jurisdiction. Right now, we are just trying to take advantage of the opportunities to interface with the community and have those discussions about these pieces of work that are happening that a lot of people just historically have not known about. The community conversations that are happening have served as a conduit to get messaging to reach people we have not reached in the past.

Q: Do you have a racial and ethnic disparities (RED) working group or do you have any targeted programs or data through your research and planning that’s specifically looking at RED?

A: Yes. We have a RED Workgroup. Formally established in 2018, that group started as a result of more than a year’s worth of conversation on racial disparities and we have made quite a bit of progress in that area. RED is a topic that is very uncomfortable for a lot of folks and many challenging conversations have resulted from that workgroup. We knew those disparities and disproportionalities existed because we saw it every day when looking at who was in our jails and courtrooms. The vast majority of people going through those doors are people of color. We partnered with the W. Haywood Burns Institute to do an actual disparities and disproportionality data analysis which gave us an indication as to what those disparities look like in our local justice system. This enabled us to discuss what needs to change with the way that we do work at different touch points within our system. Through the support of our RED Workgroup and through the coordinated criminal justice council which we call our Criminal Justice Advisory Group (CJAG), we just recently released this curriculum on unconscious bias which was designed specifically for criminal justice professionals.

With RED, we have to get to a point of being comfortable with being uncomfortable. When we first started delving into the data, there was that hesitancy about running this data, having it in front of us and seeing exactly how bad the situation was. Before we started, we had that conversation and came to the acceptance that the data was going to be bad. You must understand that RED work is years long work and it’s not a short-term project. You must be dedicated to doing the work for an extended period of time if you’re truly really interested in making change within your system that ultimately, you’ll be able to produce outcomes from.

Q: What inspires you? What gets you out of bed every morning?

A: I have been working in criminal justice in some capacity or another for over 20 years. I recognize the decisions that we make and the things we do have an actual impact on people’s lives. If done well, it affords us the capacity to make significant lasting change for folks in the community. It’s knowing that the work provides the opportunity to make a difference, to do something positive and to be an agent of positive change, especially for those in the community who need it most.

Q: What advice or recommendations do you have for county leaders like yourself who are contemplating or making efforts to advance and innovate within the justice and mental health field?

A: To have significant change and reform, you need multiple partners at the table. If you don’t already have a coordinated council, make plans to build one or at least have a forum where you’re creating safe spaces to have these open discussions with your leadership. Not everyone will agree with each other all the time, but at least you’re having the discussion. The other thing is that you need a lot of patience as change takes time. Understand that these aren’t short term projects and that you have to be in it for the long haul. Lastly, data should be part of every conversation, initiative and strategy, and you need to be willing to respond to what you see in the data.

NACo would like to thank Sonya Harper for speaking with us about her and Mecklenburg County’s efforts.

This Community Portrait is the first in a series highlighting individuals who are championing cross-systems collaboration and data sharing within their jurisdictions to respond to the needs of frequent utilizers of justice, health and human services systems.

Janet Thompson was first elected as Commissioner for District 2 in Boone County, Mo., in 2012. Commissioner Thompson is a fierce advocate for the residents of Boone County and is passionate about issues related to justice and advancing the health and well-being of county citizens, particularly children and members of vulnerable or underserved communities. She served as an Assistant Public Defender for the Missouri State Public Defender System for almost 25 years. Commissioner Thompson is a liaison for the county’s Community Services Department, Criminal Justice Administration, Boone County Family Resources, the Disproportionate Minority Contact Committee and the Judicial and Law Enforcement Task Force, as well as many other departments and organizations. She also serves on NACo’s Justice and Public Safety Policy Steering Committee and was part of the NACo-NSA Joint Task Force on Pre-Trial Detainee Health Care in Jails. NACo is spotlighting Commissioner Thompson in its inaugural community portrait for its Data-Driven Justice (DDJ) project because of her leadership in championing the county’s efforts to assist frequent utilizers.

Q: County commissioners have a lot on their plate and frequently face competing priorities. How did you and your county decide to prioritize justice issues?

A: The determination to focus on justice issues really began by examining the core responsibilities we have as public officials – ensuring public safety, wisely using resources and appropriately and efficiently applying them as best as we can to benefit the community. When we started to scrutinize those concerns, particularly the amount of money we were spending on the justice system, we started to question if we as officials were applying the right approach. We began to grapple with whether we were focusing our resources in the right places and helping individuals, families and our community in the best way possible. Were we efficiently using those dollars that we had been entrusted with to improve the lives of those we serve? After analyzing all those factors, it was an easy decision to say that we needed to prioritize justice issues especially when considering its impact on the community and the budget.

Q: Why did your community decide to join Data-Driven Justice? Was there a specific issue you were trying to solve?

A: As a county, we wanted to participate in initiatives with an evidence-based approach so that we could objectively identify strengths and gaps within our justice system. Joining the Data-Driven Justice project was a part of that strategy, with the goal of improving the coordination between health and human services and the justice system. We wanted to better support our frequent utilizers of those services and increase their access to treatment. Prior to joining DDJ, Boone County joined the Stepping Up initiative and completed a sequential intercept mapping project, which established an impartial, systematic method to understanding what resources are in our community to help people experiencing a behavioral health crisis. It was also a way to substantiate changes we were making to our voters. Projects like Stepping Up and DDJ allow us to respond to interconnected issues from a data-driven perspective, as well as ground us in reality, rather than simply relying on anecdotal evidence.  Participating in these initiatives has given us an opportunity to align our resources so that we can better serve people.

Q: What steps are being taken in your community to better assist individuals who are frequent utilizers of justice, health and human services systems? 

A: The county has taken steps and put resources in place to address frequent utilizers. A large number of our frequent utilizers are individuals who not only cycle in and out of our jail system but have also been identified as members of our homeless community. One of the first steps we took was to establish a baseline understanding of people who are linked to both homeless services and the jail system.  Boone County received a grant from the Corporation for Supportive Housing (CSH) in partnership with the University of Chicago to pilot a data tool that compared data from agencies providing homeless services with information from the justice system. Based on the work being done through the grant, the county has developed a screening tool for everyone entering the Boone County Jail, so that assessments of an individual’s mental health history can be captured and used to support that individual in the future going forward.

We also got all our law enforcement agencies across the county to participate in the same data platform for records management and jail management systems. This enables all law enforcement departments to be informed and alerted to any mental health histories of people they encounter and allows for officers to respond appropriately. In addition, our Sheriff’s department has received crisis intervention training, therefore officers encountering people experiencing a mental health crisis have the skills to effectively address the situation.

Another step we’ve taken is to participate in the Functional Zero Task Force (FZTF), which is a collaboration between city and county agencies and organizations that provide direct services to people experiencing homelessness. The task force coordinates efforts across multiple organizations to implement strategies and best practices for ending chronic, family, youth and veteran homelessness. For example, staff at Harry. S. Truman Veterans’ Hospital are involved in the FZTF and actively identifying veterans who cycle between justice and human services systems. They are working to provide needed resources to our veterans.

All of these actions have helped us gather more data and have helped elevate our understanding and response to our frequent utilizers.

Q: What is your specific role in your DDJ efforts?

A: My role often involves understanding best practices, sharing available resources, facilitating connections and communicating so that everyone has useful information to drive decision-making.  I often lean on my experience and relationships to help advocate on issues and encourage positive change. In that effort, I have used NACo’s network to connect people within the county who may otherwise be reluctant to change or to step outside established procedures to peers in other counties. For example, we wanted to understand how to better monitor cases in our county jail that involves people with a mental health history. We reached out to NACo to understand if there was another county conducting mental health staffings. As a result, we were connected with Johnson County, Iowa.  Based on that relationship, we developed our own mental health staffing structure. We often look for other county examples or contacts if we are considering making significant changes to better understand best practices and established models to help us accomplish our goals.

Q: What successes has your community achieved with assisting frequent utilizers? What do you see as the opportunities in your community for advancing justice and mental health?

A: A recent success we have experienced is the addition of the Community Mental Health Liaison position dedicated for the county. Previously, this was a state position, funded by our state mental health care provider. However, our county was sharing this position with nine others, which meant that it wasn’t able to deliver the impact we needed. A full-time position staffed within the county is an enhancement that we fiercely advocated for because it will provide the county with dedicated support to assist individuals experiencing a behavioral health crisis out in the community.

Some of the opportunities we’re pursuing include setting up a co-responder program that will help law enforcement guide individuals in crisis to appropriate services. We are also working on developing a Justice and Behavioral Health Coordinator position to leverage and maintain established justice and behavioral health initiatives. Lastly, depending on funding, the county will be developing a 24-hour access center for crisis care.

Q: What advice or recommendations do you have for other communities that are contemplating or making efforts to advance and innovate within the justice and mental health field?

A: To make advancements, entities need to get buy-in from stakeholders and obtain community support. It takes time and you need to find those advocates and champions within agencies and organizations to bolster your efforts. You will find them; it just does not happen overnight.

Progress does not always come easy or quickly but the work that we’re doing is too important to give up. There are too many people we haven’t served well and if we can change the trajectory of those lives that’s a gift, not just to them and their families, but the whole community. You have to be patient and persistent because if you can affect those lives, then all of the effort is worthwhile. Any change that you make to improve the lives of others is a change for the good, so keep going and don’t get discouraged by not being able to do the big things or focusing on what you can’t do. Do what you can with what you have. Don’t be afraid to reach out to other communities, who may be able to serve as a model for the changes you want to make and know that you are not alone.

Q: What are the qualities or characteristics that make your community unique or special?

Boone County is composed of a group of people who listen well to others. We’re still interested in community here. I think the key is having an understanding that together as a community we can thrive. When we get too concerned about one group to the detriment of another, it can contribute to an imbalance where resources become much scarcer and the ability to affect change becomes less likely. So, I think we understand that and function more as a collective body. We really are a group of people that wants to raise the quality of life for our community and that applies more broadly than solely being concerned about ourselves or our families.

NACo would like to thank Commissioner Janet Thompson for speaking with us about her and Boone County’s efforts.