Wake Teen Diversion Program Shows Promising Results

At the end of its first year the Wake Teen Diversion Program is showing promising results in keeping teens faced with school-related nonviolent misdemeanors out of the Wake County adult court system.

The Wake Teen Diversion program works with youth ages 16 to 18 by diverting them from adult criminal court to alternatives like Teen Court and mediation if they adhere to a diversion plan, which also addresses behavioral health needs. Students who successfully complete the program do not face criminal charges or have an arrest record. Once in the system, kids face increasing barriers to education, employment, and housing, ultimately hurting their chances to become a productive member of society, a problem known as the “school to prison pipeline.”

The program is administered by Alliance Behavioral Healthcare, the managed care organization (MCO) for public behavioral healthcare for the citizens of Durham, Wake, Cumberland and Johnston counties. It is part of Alliance’s School-Based Care Coordination initiative, in which Care Coordinators use a “wraparound” model to improve student connections with the services they need to reduce the severity of their behavioral health symptoms. In turn, student absences are reduced and academic performance improves.

“The School-Based Care Coordination initiative is just one example of Alliance’s efforts to reach into our communities to the places where we can be proactive in identifying people who are at risk of the negative impact of behavioral health challenges,” said Dr. Beth Melcher, EVP of Alliance’s Care Management Division. “That allows us to intervene with treatment and support to help ensure they can avoid serious consequences and continue living satisfying lives.”     

Alliance is the only North Carolina MCO with a pre-charge, school-based diversion program. During the 2016-17 school year the program received 143 referrals with 84 youth active or waiting for an intake in the program. To date 22 students have successfully completed the program. Included in that number are two kids who were able to keep their college scholarships by successfully completing their diversion plan.

North Carolina is the only state that treats teenagers as young as 16 as adults regardless of the severity of the offense. As a result, every year thousands of North Carolina youth enter the criminal system for first time, low-level offenses. Over 400 Wake County students were referred to the adult criminal justice system during the 2014-15 school year with students of color making up the majority of suspensions and arrests.

The Wake program has received widespread support from school, court, mental health, law enforcement and social justice leaders. “The biggest benefit of this diversion program, which is unique to the other diversion programs we have, is that these children undergo a thorough assessment to identify underlying issues that give rise to criminal behavior and allow those needs to be addressed,” said Wake County District Attorney Lorrin Freeman. “This should prevent further criminal activity by these individuals and play a big role in building them into successful members of our community.”

The diversion program is limited to school-based offenses and holds students accountable for their criminal conduct, identifying programs and services that give them the help they need. Students complete the diversion in six months without court contact, allowing them to chance to “make things right” without the negative effects a pending criminal case has on college and work opportunities.

The program also ensures minor criminal offenses committed at school are handled consistently across the county, providing consistency and predictability for school staff, students, and parents because they know what to expect when a case arises. School Resource Officers can refer cases to Alliance without leaving campus and avoid spending time in court.

“Court time is being used for more serious cases, instead of processing low level diversion cases,” said Katherine Edmiston, Wake County assistant district attorney. “Any increased efficiencies in court resources benefit all of us in Wake County.”

The Wake Teen Diversion Program is the result of a community collaborative between Alliance, Wake County Public Schools, and representatives from the Wake County Sheriff’s Office, the Raleigh and Cary Police Departments, Wake County Legal Aid and Wake County Public Defenders. Key support for the program came from Judge Vince Rozier, District Attorney Lorrin Freeman, Wake Public Schools Assistant Superintendent Brenda Elliott, and School Board member Christine Kusher.

“WCPSS is pleased to work with our various partners on this initiative,” said Elliott. “The district was seeking restorative ways to address low level criminal offenses that happened in schools and instituting a diversion program that provided support and not just consequences to students and their families just made good sense.”

Public Input Sought on Medicaid Reform

The NC Department of Health and Human Services is seeking additional public input on the transformation of the Medicaid and NC Health Choice programs (also known as “Medicaid reform”). Ideas and comments can be submitted through May 25, and a public input session will be held in Raleigh on May 16 at 6:00pm. Learn more, including how to submit input and the address and time of the public input session.

Listening Session/Public Forum on NCI

The Division of Mental Health, Developmental Disabilities, and Substance Abuse Services is releasing NCI to public domain and providing information about the process. They will host a listening session/public forum on May 11 in Raleigh to field questions from providers using a restrictive intervention, LME/MCOs, consumers, and other interested stakeholders. The transition process will be explained in detail. Learn more.

Alliance Names New Head of Clinical Operations

Dr. Courtney Cantrell has been named Senior Vice President for Clinical Operations for Alliance Behavioral Healthcare. Dr. Cantrell spent almost four years at the NC Department of Health and Human Services, including two as Director of the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services.

Dr. Cantrell is a clinical psychologist with a doctorate from Florida State University. She is a veteran of the U.S. Air Force, where she was particularly active in enhancing the emphasis on whole person integrated care. At DHHS she promoted a focus on the people being served by the behavioral healthcare system in the making of policy decisions, and continued her emphasis on integrating both physical and behavioral health issues in plans for system improvements. She comes to Alliance from Care Management Technologies/Relias Learning, where she counseled health homes and managed care organizations on the use of data analytics to enhance the effectiveness of care coordination and integration.

As part of the Care Management Division at Alliance, Dr. Cantrell will apply her broad clinical experience and expertise in the use of data, whole person health care and population health analytics to support an increased focus on population health, innovative practices in care coordination, implementation of the Traumatic Brain Injury waiver, and Innovations waiver changes.

“Dr. Cantrell’s broad clinical and leadership experience at the state level, combined with her familiarity with whole person integrated care and data analytics, makes her an excellent choice to lead Alliance’s Clinical Operations, said Rob Robinson, Alliance CEO. “We are excited to welcome her to the Alliance team.”

“While at the State I was always impressed with Alliance as a compassionate, steadfast and trustworthy leader in public behavioral health services and with the organization’s outstanding leadership,” Dr. Cantrell said. “That is what attracted me to Alliance. I look forward to working with the Alliance team in their work to further integrate the use of population health data and clinical data in increasing the quality of healthcare, ultimately resulting in better outcomes and healthier lives for the people we serve.”

Alliance Tapped to Head New Programs

Alliance Behavioral Healthcare has been awarded funding to implement two new programs, one involving Child Tiered Case Management and the other enhancing Facility-Based Crisis Services for children and adolescents. Funding for the Case Management pilot comes from $20 million directed by the North Carolina General Assembly in the FY17 State budget to support recommendations made by former Governor Pat McCrory’s Task Force on Mental Health and Substance Use to help North Carolinians with mental health and substance use issues. The Task Force, which included experts from the justice system, healthcare provider community, recovery community, county leadership, non-governmental entities and private sector professionals, presented its recommendations in May 2016. Funding for the Facility-Based Crisis program was allocated in the FY17 State budget from the Dorothea Dix Hospital Property Fund.

As the managed care organization (MCO) for public behavioral health services for the citizens of Durham, Wake, Cumberland and Johnston counties, Alliance serves a total population of over 1.8 million people.

“These initiatives will help us build on our progress to divert people in mental health and substance use crises from emergency departments and county jails into the treatment they need,” said Interim Senior Director of Mental Health, Developmental Disabilities and Substance Abuse Services Jason Vogler, Ph.D. in speaking of the whole array of initiatives funded by the budget. “They also give youth and adults much needed support to be successful in recovery and integration into their communities.”

As part of the Child Tiered Child Case Management pilot, case managers will work closely with juvenile justice and child welfare offices to provide assessments, develop person-centered plans of care, and link children and youth and their families in Durham County to other recovery supports. This approach is designed to help prevent youth from moving deeper into the justice system. Alliance has chosen Youth Villages, an organization with extensive experience in providing comprehensive, community-based services for youth, to administer the pilot.

In this tiered program, the primary focus population is youth who are transitioning from out-of-home placements related to their involvement with the juvenile justice system. They will be provided with intensive case management and “high fidelity wraparound” services. High fidelity wraparound is a process led by a facilitator where multiple systems come together with the child, youth, and family to create a highly-individualized plan to address complex emotional needs.

Lower-intensity services will be available for young people with less serious needs as well, including access to family and youth peer support, and caregivers called Family Navigators placed in juvenile justice and child welfare offices to help connect families to community resources.

According to Dr. Beth Melcher, head of the Care Management Division at Alliance, anticipated outcomes for young people participating in the program include enhanced engagement with school and behavioral health services, reduced use of crisis facilities, increased success living at home, and no new contact with the judicial system.

The Facility-Based Crisis program will provide a community-based, non-hospital residential setting that serves as specialized and cost-effective alternatives for children and youth who are in crisis. This facility will offer short-term intensive evaluation, treatment, or behavioral management to stabilize crisis situations.

Alliance plans to locate inpatient beds for youth and behavioral health urgent care capacity in the same building, using the same provider, creating a one-stop crisis shop for youth people and their families. Like urgent care facilities that have become an increasingly common source of physical healthcare, behavioral health urgent care allows quick, easy access to care.

To administer the Facility-Based Crisis Pilot program, Alliance has chosen KidsPeace, a national provider of a broad continuum of children’s mental and behavioral health services.  KidsPeace’s wide range of programming includes inpatient psychiatric hospitalization, residential treatment programs, therapeutic foster care operations in North Carolina and six other states, and educational services.

“It is critical to serve children and youth in crisis in a specialized setting equipped to respond to their unique needs in a safe environment,” said Dr. Melcher.

These two programs will join an array of other evidence-based and promising practices employed by Alliance network providers to help serve young people in their communities, including family focused treatment for children with behavioral challenges and serious family conflicts, and therapeutic foster care, a family-based service for youth at risk for placement in an intensive residential setting.