OMH Forensic Housing and Care Coordination Prison Reentry Guiding Principles

1.  OMH Forensic Housing and Care Coordination  Prison Reentry Guiding Principles To engage the community-based mental health system and peers in providing pre- and post-release services to inmates with mental health needs To promote access to benefits as an important step toward ensuring continuity of care and promoting full community reintegration and recovery To promote systems integration and cross-systems coordination and collaboration

2. OMH Forensic Housing and Care Coordination Target Population Individuals with Serious Mental Illness (SMI) being released from New York State prisons to local communities statewide. 2,900 inmate-patients with mental illness released to the community from Central New York Psychiatric Center (CNYPC) in 2009 1,000 with Serious Mental Illness

3. OMH Forensic Housing and Care Coordination Overview of Prison Reentry for SMI Comprehensive Discharge Planning (CNYPC) CNYPC Pre-Release Services In-reach Services community provider and peer-run Dedicated Supported Housing Transition to Community-based Services CNYPC Pre-Release Services; county SPOE; NYC Reentry Coordination System; parole Case Management/ACT (ICM / ACT) Forensic Case Management Programs (NYC) Dedicated Parole Mental Health Caseloads

4. OMH Forensic Housing and Care Coordination CNYPC Persons Served Approximately 60,000 inmates in 73 DOCS facilities (NYS DCJS, 2008) About 7,800 on OMH caseload (13%) DOCS releases about 27,000 people per year 2,900 inmate-patients with mental illness released to the community from CNYPC in 2009 1,000 with Serious Mental Illness

5. OMH Forensic Housing and Care Coordination CNYPC Persons Served 1,000 inmate-patients with SMI released annually: 51% upstate; 49% downstate 80% male; 20% female 75% on psychiatric medication Many with co-occurring substance use disorders and trauma histories

6. OMH Forensic Housing and Care Coordination CNYPC Corrections-based Services Community Mental Health Model CNYPC operates mental health services in 29 correctional facilities/mental health units statewide Inpatient hospital located in Marcy, NY Crisis services, residential services, clinic services, medication management Special programming

8. OMH Forensic Housing and Care Coordination CNYPC Pre-Release Services Pre-Release Coordinators 25 dedicated staff, serving 29 facilities/mental health unit Develop comprehensive discharge plans for inmate-patients with a mental health level 1 or 2 (SMI) Benefits and Referrals for SMI SSI/SSDI Medicaid Medication Grant Program (MGP) Mental Health Housing Clinic Appointment Case Management

9. OMH Forensic Housing and Care Coordination CNYPC Pre-Release Services Primary Therapists Develop plans for inmate-patients with a mental health level of 3 or 4 Plans may include: Medicaid, MGP and clinic appointment

10. OMH Forensic Housing and Care Coordination CNYPC Reentry Programming Community Orientation & Reentry Program (CORP) Sing Sing Correctional Facility; 31 participants 90 Day Prior to Release / In-reach Program Community Providers Staff including Peers (Project Renewal, HALI, Howie T Harp) Hands Across Long Island Drop In Center Entitlement Specialist (CUCS) 9/05-8/10: 87% SSI/D eligibility determination

11. OMH Forensic Housing and Care Coordination CNYPC Reentry Programming Safe Transition & Empowerment Project (STEP) Bedford Hills Correctional Facility; 36 participants 90 Day In-Reach Entitlement Specialist 3-6 month intensive case management and psychiatry in community post-release provided by Project Renewal, Inc. Forensic Peer Specialist provided by Howie T Harp Peer Advocacy & Training Center In-reach Community support

12. OMH Forensic Housing and Care Coordination OMH Reentry Programming Parole Support & Treatment Program Jointly funded by NYS OMH & NYS DOP Offers: 50 units of scattered site transitional supported housing A team approach to support services that includes: Part-time Psychiatrist & Nurse Intensive & Supportive Case Managers Residential Counselors Peer Specialists -and- 10 units of scattered site permanent housing for graduates of PSTP

13. OMH Forensic Housing and Care Coordination Parole Support & Treatment Program Serves parolees being released to NYC with a minimum of 12 months on parole, regardless of criminal background 56% have a history of Violation of Parole 82% have been convicted of violent crimes Works in close collaboration with NYS Division of Parole Connects participants to the full range of community based health, mental health, substance abuse, and employment services Assists participants in developing crucial ADL skills, including structuring their leisure time Assists participants in securing long term community based housing

14. OMH Forensic Housing and Care Coordination OMH Reentry Programming OMH Forensic Case Management Team Dedicated team providing transitional (6-9 months) case management to SMI prison releases to NYC 6 Intensive Case Managers � one operating out of Bellevue Shelter dedicated to homeless men 2 Supportive Case Managers Operates out of South Beach Psychiatric Center

15. OMH Forensic Housing and Care Coordination Dedicated Supported Housing (n=186) Project Renewal�s Parole Support and Treatment Program (PSTP): 50 transitional units; 10 permanent graduate units The Bridge�s Iyana House: 16 units Downstate Supported Housing (102 units in NYC) 6 � The Bridge; 6 � Postgraduate Center for Mental Health New 90 Unit RFP Released 4/25/11 Upstate Supported Housing (8 units � 4 Monroe; 4 Orange) Catholic Family Center Occupations Inc. Rehabilitation Support Services

16. OMH Forensic Housing and Care Coordination Forensic Peer Specialist Program NEW!! - Funding FPS Program Coordinator from NYAPRS to develop a statewide Forensic Peer Specialist Program to facilitate linkage of forensic peer specialists to residents of OMH forensic supported housing units. Peers will provide in-reach services as well as peer bridger services in the community

17. OMH Forensic Housing and Care Coordination Dedicated Parole MH Caseloads Memorandum of Understanding (MOU) between OMH and NYS Division of Parole to establish Dedicated Parole Mental Health Caseloads Facilitate cross-training for both parole officers and housing / service providers Establish protocols for coordinating placement of high risk / high need individuals

18. OMH Forensic Housing and Care Coordination Transition to Community Single Point of Entry/Access System (SPOE/SPOA) Work with CNYPC Pre-Release Coordinators NYC Reentry Coordination System (RCS) Director of Community Services/Mental Health Commissioner Conference of Local Mental Hygiene Directors DCJS Reentry Task Forces

19. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) Centralized referral system for individuals with SMI getting released from NYS prisons to NYC. Operates like Single Point of Access (SPOA) Administered by the Center of Urban Community Services (CUCS) for OMH 3 Components RCS for Housing RCS for ACT / Case Management RCS for Outpatient Clinic Appointments

20. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) RCS for Housing (2009) Manages access to dedicated OMH forensic housing in NYC for individuals who are SMI Provides referrals to MH housing for any SMI inmate being released to NYC in need of housing Manages the video-conference interviews to increase access to housing for inmates prior to release

21. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) RCS for CM / ACT / Outpatient Treatment (2010) Manages access to MH Forensic and Community Case Management and ACT services Provides referrals to outpatient treatment at downstate Outpatient Clinics if the Pre-Release Coordinators (PRC�s) were unable to obtain appointment prior to release (April 2011)

22. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) Forensic Mental Health Housing Options 178 dedicated forensic housing units in NYC: Project Renewal�s Parole Support and Treatment Program (PSTP) The Bridge�s Iyana House Postgraduate Center for Mental Health & The Bridge�s FHI units - 90 Forensic Supported Housing Reentry Units---RFP just released 200 units for individuals with SMI Inmate-patients from state prisons are one priority population Other MH housing: 7,100+ units not including NYNY I/II units

23. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) Housing Outcomes 157 Applications Received (7/1/09 � 6/30/10) 58% Housed 79 in supportive housing 8% Pending (waitlisted) 8% Not Released due to PC Admission 26% Refused, Whereabouts Unknown, Re- incarcerated

24. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) CM / ACT Outcomes 112 Applications Received (11/1/10 - present) 59% Enrolled 65 ICM, 1 ACT 25% Pending Release Date assigned 30 days prior to release 10% Closed: Not Eligible, INS Custody, Lost Parole Date, Client Choice to Withdraw 6% Discharged from CM: 3 Graduated/Transferred to other community services 2 Hospitalized 2 Whereabouts Unknown

25. OMH Forensic Housing and Care Coordination Reentry Coordination System (RCS) Key Features of RCS: Guaranteed Housing Interview (Videoconference) prior to release ICM or ACT team assigned prior to release Clinic Appointment Guaranteed within 2 weeks of release Training &Technical Assistance to Pre-Release Coordinators (PRC�s) and Housing Providers Case Planning Meetings if rejected by 3 Housing Providers

26. OMH Forensic Housing and Care Coordination Contact Information Wendy Vogel, OMH wendy.vogel@omh.ny.gov Lori Schatzel, OMH lori.schatzel@omh.ny.gov Suzanne Smith, CUCS ssmith@cucs.org