Diversion Center - Pilot tour of Sobering Center

I'm encouraged to see that Commissioners Shea and Gomez have place the Diversion Center concept on our agenda for Tuesday. This strategy for better serving people experience mental illness, addiction and often homelessness is supported by many in our community but the details of location and scale requires many conversations.  Because of the work already underway on this concept, I respectfully request that the sponsors consider adding the words included in brackets below:
  
Item #30
Consider and take appropriate action on requesting that staff study the potential for and costs of combining a mental health diversion program with the Sobering Center {or other location} in collaboration with the City of Austin {and other partners}.

I'm happy to answer questions.  So please use this message board to legally discuss the item!

Excuse the typos in that last post! My mama taught me better!

I see that the language for Item 30 was updated to remove the specific reference to a location and the language adds mental health stakeholders, so thank you. I want to clarify for our staff that we want a broad look at creating a diversion center, which may or may not result from expanding the scope of the Sobering Center. (I agree that’s an option that should be on the table but it’s not the only option.) So, I’d like to see if it would be a friendly amendment to rearranging the wording a little bit so that we are being clear for our staff.

1. Current Language – requesting that staff study the potential for and costs of combining a mental health diversion program with The Sobering Center in collaboration with the City of Austin and key mental health stakeholders.
2. Amended language - requesting that staff study the potential for and costs of CREATING a mental health diversion program in collaboration with the THE SOBERING CENTER, the City of Austin and key mental health stakeholders.

Looking forward to our discussion!

I’m sharing my observations on the Message Board so that we can build some continuity with others who tour the Sobering Center for the purpose of working together to create a Pilot Diversion Center.
Having toured the Sobering Center on 6/23 and listened to Sobering Center leadership talk about their experience and future plans, I’m hopeful that Travis County and partners can create a pilot or mini pilot of a true diversion center.
As a reminder, copying from the Executive Summary of the draft Diversion Center proposal from ECHO and supported by many in the community:
In support of recent Austin Travis County initiatives to decriminalize mental health and poverty we are asking for a financial investment to support the implementation of a Travis County Jail Diversion program focused on serving individuals with serious mental illness who are frequently interacting with the criminal justice system, homeless continuum of care, and acute care medical and mental health treatment systems.
This project would support approximately 5,000 individuals annually diverted from jail and connect 300 individuals to permanent supportive housing through short term bridge housing units and integrated supportive services.
Purpose
We are proposing a collaborative model in which criminal justice, mental health, behavioral health, primary care, and housing focused services come together to support jail diversion efforts to community-based services over an arrest whenever diversion may safely occur. The proposed model is designed to reduce jail recidivism, frequency of arrest, and incarceration for people with mental and behavioral health conditions. Diverting individuals from jails and connecting them to treatment options, supportive services, and housing focused services improves health outcomes for the individual and our community.

What I heard during the tour -
1. Accessing the 3rd floor is not ideal for someone coming in who needs assessment, medical attention, etc. for a variety of reasons.
2. 3rd floor is currently occupied by the HOST Team, who have recently requested additional space on the 3rd floor.
3. 2nd floor is currently the Sobering Center Admin space, which could possibly be reconfigured.
4. Sobering Center is converting the women’s alcohol room to a Stimulant room so that clients coming in needing activity can be in a separate room from folks needing to sleep.
5. Because of COVID, the number of clients in a room at any one time is limited, but would be increasing as we move away from COVID restrictions. People who are awake need more space and things to do than people who are sleeping.
6. Between the stimulant room and the alcohol room, there might be space to add clients as long as their behavior meshes with the behaviors already being (or planned to be) accommodated in these rooms. (Need to determine what new behaviors could be accommodated and what could not.)
7. Sobering Center is piloting (soon) Level 4, which is people who are waiting for a placement in treatment or housing. This idea is consistent with the Diversion Center concept - diverting people from jail and to whatever it is they need to stop repeating the behavior that could land them in jail. (Example of services: detox, residential substance use disorder treatment, housing, competency restoration program, etc.)
8. Sobering Center is not set up as a residential facility. No kitchen on site so they heat up prepared meals for folks staying over. Would need to explore how to feed more people who are staying for a longer period of time.
9. If the Sobering can be enriched with detox, integrated medical care for behavior, addiction, woundcare, etc. and have access to housing, it could Pilot the Diversion Center all on site.
10. Because of the limited space, lack of kitchen, etc. the Pilot might also consider
a. The Sobering Center as Place #1 to conduct assessments, deal with immediate crisis and help clients determine what they need AND
b. find another location as Place #2 where clients can stay while programs for treatment, housing, etc. are identified or even provided at Place 2.
c. What other locations could be added for the pilot?
11. The Sobering Center sees its greatest demand on the weekends, and only has security thru the night. If we add people there, we will likely need to add security. Security is expensive so this would be an added expense.
12. Sobering Center is limited by the medical authority it is given by the Doctor in charge – he is not on site. The medics that work on site are authorized to do certain things. It might be possible for the Doctor to expand the authority of the medics so they could provide a wider range of services to the clients in the Pilot.
13. Some kind of agreement would need to be reached if the Pilot wanted to add primary care, psychiatry, etc. to services provided at the Sobering Center as envisioned for the Diversion Center. (Most healthcare for the homeless locally is provided by CommUnity Care and Integral Care and Dell Med and some nursing students, as well as in hospital emergency rooms.)
14. Sobering Center has vans for transporting clients.
Should I remember more facts, I’ll share them. And please add your observations. What should our next steps be?

I’m sharing my observations on the Message Board so that we can build some continuity with others who tour the Sobering Center for the purpose of working together to create a Pilot Diversion Center.
Having toured the Sobering Center on 6/23 and listened to Sobering Center leadership talk about their experience and future plans, I’m hopeful that Travis County and partners can create a pilot or mini pilot of a true diversion center.
As a reminder, copying from the Executive Summary of the draft Diversion Center proposal from ECHO and supported by many in the community:
In support of recent Austin Travis County initiatives to decriminalize mental health and poverty we are asking for a financial investment to support the implementation of a Travis County Jail Diversion program focused on serving individuals with serious mental illness who are frequently interacting with the criminal justice system, homeless continuum of care, and acute care medical and mental health treatment systems.
This project would support approximately 5,000 individuals annually diverted from jail and connect 300 individuals to permanent supportive housing through short term bridge housing units and integrated supportive services.
Purpose
We are proposing a collaborative model in which criminal justice, mental health, behavioral health, primary care, and housing focused services come together to support jail diversion efforts to community-based services over an arrest whenever diversion may safely occur. The proposed model is designed to reduce jail recidivism, frequency of arrest, and incarceration for people with mental and behavioral health conditions. Diverting individuals from jails and connecting them to treatment options, supportive services, and housing focused services improves health outcomes for the individual and our community.

What I heard during the tour -
1. Accessing the 3rd floor is not ideal for someone coming in who needs assessment, medical attention, etc. for a variety of reasons.
2. 3rd floor is currently occupied by the HOST Team, who have recently requested additional space on the 3rd floor.
3. 2nd floor is currently the Sobering Center Admin space, which could possibly be reconfigured.
4. Sobering Center is converting the women’s alcohol room to a Stimulant room so that clients coming in needing activity can be in a separate room from folks needing to sleep.
5. Because of COVID, the number of clients in a room at any one time is limited, but would be increasing as we move away from COVID restrictions. People who are awake need more space and things to do than people who are sleeping.
6. Between the stimulant room and the alcohol room, there might be space to add clients as long as their behavior meshes with the behaviors already being (or planned to be) accommodated in these rooms. (Need to determine what new behaviors could be accommodated and what could not.)
7. Sobering Center is piloting (soon) Level 4, which is people who are waiting for a placement in treatment or housing. This idea is consistent with the Diversion Center concept - diverting people from jail and to whatever it is they need to stop repeating the behavior that could land them in jail. (Example of services: detox, residential substance use disorder treatment, housing, competency restoration program, etc.)
8. Sobering Center is not set up as a residential facility. No kitchen on site so they heat up prepared meals for folks staying over. Would need to explore how to feed more people who are staying for a longer period of time.
9. If the Sobering can be enriched with detox, integrated medical care for behavior, addiction, woundcare, etc. and have access to housing, it could Pilot the Diversion Center all on site.
10. Because of the limited space, lack of kitchen, etc. the Pilot might also consider
a. The Sobering Center as Place #1 to conduct assessments, deal with immediate crisis and help clients determine what they need AND
b. find another location as Place #2 where clients can stay while programs for treatment, housing, etc. are identified or even provided at Place 2.
c. What other locations could be added for the pilot?
11. The Sobering Center sees its greatest demand on the weekends, and only has security thru the night. If we add people there, we will likely need to add security. Security is expensive so this would be an added expense.
12. Sobering Center is limited by the medical authority it is given by the Doctor in charge – he is not on site. The medics that work on site are authorized to do certain things. It might be possible for the Doctor to expand the authority of the medics so they could provide a wider range of services to the clients in the Pilot.
13. Some kind of agreement would need to be reached if the Pilot wanted to add primary care, psychiatry, etc. to services provided at the Sobering Center as envisioned for the Diversion Center. (Most healthcare for the homeless locally is provided by CommUnity Care and Integral Care and Dell Med and some nursing students, as well as in hospital emergency rooms.)
14. Sobering Center has vans for transporting clients.
Should I remember more facts, I’ll share them. And please add your observations. What should our next steps be?

Attached is the draft proposal for a Diversion Center from ECHO that I mentioned below.