11. Attachment C- Quarterly Reports.docx

Massachusetts Jail/Arrest Diversion Grant Program

ATTACHMENT C

Quarterly Report Forms

J/ADP Quarterly Summary Date J/ADP Location:

Circle one: CIT Co-response Component J/ADP CIT Backfill

1. # of police officers in department.

2. # of behavioral health calls this quarter (should correspond with JDP database).

3. Co-response only: __# of hours of co-response by a behavioral health professional this quarter.

4. # of overall behavioral health calls this quarter resulting in use of force. # of use of force incidents as described by empty hand submission techniques (soft techniques: application of handcuffs, restraint, grabs, pressure points) _________; # of use of force incidents as described as empty hand submission (hard techniques: ex: punches, kicks to control situation) ________; # of use of force incidents as described by less than lethal force techniques (ex: blunt impact, chemical, or CED/taser______; # of use of force incidents as described as lethal_______.

5. # of behavioral health calls this quarter resulting in no use of force because of the employment of CIT tactics such as verbal and crisis de-escalation or empathic police presence.

6. # of behavioral health calls this quarter that resulted in police injury to a trained officer (as described by the officer requiring medical attention).

7. # of behavioral health calls this quarter that resulted in no police injury to a trained officer (as described by the officer requiring medical attention).

8. # of behavioral health calls this quarter that were responded to by a trained police officer.

9. # of behavioral health calls this quarter that were responded to by a trained police officer resulting in use of force.

10. # of behavioral health calls this quarter that were responded to by a trained police officer resulting in no use of force.

11. # of behavioral health calls this quarter that were responded to by a trained police officer resulting arrest.

12. # of behavioral health calls this quarter that were responded to by a trained police officer resulting in diversion from arrest.

13. # of the Department’s officers have completed hours of MH training (circle specific type: MHFA, CIT, Overview, or other _________) this quarter.

14. # of the Department’s Dispatch staff have completed hours of MH training (circle specific type: MHFA, CIT, Overview, or other _________) this quarter.

15. _______/________% Cumulative amount of police and dispatch staff that have received either: CIT or MHFA, Overview, or Other (please circle).

16. # of operations/partners/stakeholder meetings was held this quarter.

17. Agencies that make up regular membership for this JDP program include: (Please note any new partners)

· Local ESP

· Local Behavioral Health provider/s

· Local DMH site staff

· Court staff – court clinic

· Court staff – probation

· Court staff – DA

· Peers

· DYS

· Shelter/homeless outreach staff

· NAMI representative

· CBFS

· Veteran-serving agency

· Other/s:

18. How is your JDP’s diversion data captured?

· CIT officers complete data entry form and gives to person who enters data

· All officers who respond to MH calls complete data entry form for person who enters data

· One person reviews all police reports to identify MH calls & responses and enters data

· Other:

19. Who completes data entry into the DMH statewide JDP database?

· Officer within Department

· Civilian within Department

· Clinician from partner agency

· Other:

20. Have written policies and procedures been developed for this JDP program within the police department?

· Yes, entitled:

· No

21. Have written policies and procedures been developed within partnering clinical agencies:

· Yes, entitled:

· No

22. Does the program use any additional communication tools for the JDP membership (e.g., email distribution list, website, or newsletter)?

· Yes:

· No

23. Other information deemed necessary to provide: _________________________________________

J/ADP Quarterly Summary Date J/ADP Location:

CIT Training and Technical Assistance Center (CIT-TTAC)

1. Number of CIT or other related trainings (ex: dispatch, advanced, youth) held this quarter. Please describe:

Training (CIT or Other Identified): # of Attendees: Date:

Total Number of Hours of Training Provided This Quarter: ________

2. Which police departments, law enforcement agencies, and first responders attended these CIT trainings? Please indicate # from each department. Feel free to add more lines.

3. Other Relevant Attendees of CIT or Other-Related Trainings:

4. Technical assistance provided this Quarter:

a) How has community behavioral health services been engaged in CIT development?

b) How has the TTAC addressed hot cases: either high profile or recurrent?

c) What steps has the TTAC undertaken to engage with new police departments, law enforcement agencies or first responders (including ESP’s)? How do they conspire to have warm hand-offs?

d) Please describe other relevant technical assistance provided to law enforcement and others in regards to using CIT approaches to mitigate crises in the community?

5. CIT Evolution and Development Steps:

Describe the steps undertaken by the CIT-TTAC and the various, identified police departments’ responses to:

a. Development of CIT Policy and Procedures:

Percentage of Police Departments with P and P: _____% ____/____

b. Identification of a CIT Coordinator in particular departments:

Percentage of Police Departments with CIT Coordinator: _____% ____/____

c. Note CIT-specific meetings within CIT-TTAC departments:

d. Identification of a Mental Health Coordinator in particular department:

Percentage of Police Departments with MH Coordinator: _____% ____/____

e. Frequency of Meeting with Regional Police Departments (outside of DMH grantee meetings:

f. Document any meetings the CIT-TTAC had with CIT and/or Mental Health Coordinators this quarter:

g. Frequency of stakeholder meetings: _________________________________________________

h. Describe specific procedures in place through the CIT-TTAC work between police department, behavioral health agencies (including ESP’s) or communication/crisis prevention protocols between the police, family, and those identified as being in an elevated, acute state or crisis?

6. Discuss the review of Use of Force policies with departments the CIT/TTAC is working with?

7. Has the use of force of those with MI decreased in this reporting period?

8. Were there any instances of lethal force used involving those with MI? What was the CIT-TTAC’s response?

9. Were there any serious officer-related injuries from responding to crises or incidents involving those who have mental or behavioral health difficulties? Please explain any and if there is a change from previous reporting period.

10. How is diversion into treatment data captured by the involved police departments?

11. Please list out all changes implemented in your CIT-TTAC designed to bring about positive CIT outcomes since the last quarter?

List all Police Departments and Law Enforcement-Related Programs Your CIT-TTAC is working with:

J/ADP Quarterly Summary Date J/ADP Location:

Co-Response Training and Technical Assistance Center (CR-TTAC)

1. Number of MHFA or other related trainings (ex: dispatch, advanced, youth, specific topic) held this quarter. Please describe:

Training (MHFA or Other Identified): # of Attendees: Date:

Total Number of Hours of Training Provided This Quarter: ________

2. Which police departments, law enforcement agencies, and first responders attended these trainings? Please indicate # from each department. Feel free to add more lines.

3. Other Relevant Attendees of MHFA or Other-Related Trainings:

4. Technical assistance provided this Quarter:

a) How has community behavioral health services been engaged in Jail/Arrest Diversion Program development?

b) How has the TTAC addressed hot cases: either high profile or recurrent?

c) What steps has the TTAC undertaken to engage with new police departments, law enforcement agencies or first responders (including ESP’s)? How do they foster warm hand-offs?

d) Please describe other relevant technical assistance provided to law enforcement and others in regards to using Co-Response approaches to mitigate crises in the community?

5. Co-Response Evolution and Development Steps:

Describe the steps undertaken by the CR-TTAC and the various, identified police departments’ responses to:

a. Development of Co-Response Policy and Procedures:

Percentage of Police Departments with P and P: _____% ____/____

b. Identification of a Program Coordinator in particular departments:

Percentage of Police Departments with a Co-Response Coordinator: _____% ____/____

c. Note Jail/Arrest Diversion-specific meetings within CR-TTAC departments:

d. Identification of a Mental Health Coordinator in a particular department:

Percentage of Police Departments with MH Coordinator: _____% ____/____

e. Frequency of Meeting with Regional Police Departments (outside of DMH grantee meetings:

f. Document any meetings the CR-TTAC had with Mental Health Coordinators this quarter:

g. Frequency of stakeholder meetings: _________________________________________________

h. Describe specific procedures in place through the CR-TTAC work between police department, behavioral health agencies (including ESP’s) or communication/crisis prevention protocols between the police, family, and those identified as being in an elevated, acute state or crisis?

6. Discuss the review of Use of Force policies with departments the CR/TTAC is working with?

7. Has the use of force of those with MI decreased in this reporting period?

8. Were there any instances of lethal force used involving those with MI? What was the CR-TTAC’s response?

9. Were there any serious officer-related injuries from responding to crises or incidents involving those who have mental or behavioral health difficulties? Please explain any and if there is a change from previous reporting period.

10. How is diversion into treatment data captured by the involved police departments?

11. Please list out all changes implemented in your CR-TTAC designed to bring about positive CIT outcomes since the last quarter?

List all Police Departments and Law Enforcement-Related Programs Your CR-TTAC is working with:

J/ADP Quarterly Summary Date J/ADP Location:

Community Planning Grant:

1. # Stakeholder meetings held this quarter.

2. Agencies that make up regular membership for this Community Planning program include: (Please note any new partners)

· Local ESP

· Local Police Department

· Local City/Town Officials

· Local Behavioral Health provider/s

· Local DMH site staff

· Sheriff’s Department

· Court staff – court clinic

· Court staff – probation

· Court staff – DA

· Peers

· DYS

· Shelter/homeless outreach staff

· NAMI representative

· CBFS

· Veteran-serving agency

· Other/s:

5. Identify new resources/procedures and process for behavioral health and crisis response: __________

6. Number of MOU’s developed and obtained in quarter:_______________________________________

7. Number of behavioral health-related calls this quarter: ______________________________________

8. Number of behavioral health calls resulting in arrest or diversion:

Arrest: _____ Diversion:_____ N/A (Non-criminal):_____ JDP Quarterly Summary Date J/ADP Location:

Trainer/Consultant Services:

1. # of total hours of direct service this quarter

2. # of department/municipalities served this quarter

5. # of officers trained this quarter

6. Additional and specific ways you assisted with JDP operations this quarter:

J/ADP Quarterly Summary Date J/ADP Location:

Drop Off Center:

1. # of behavioral health-related calls this quarter in identified region (_________).

2. Police departments involved:__________________________________________________________

3. # Hours of operation.

4. _______________# of referrals/drop-offs.

5. ________________# of refused/unaccepted drop-offs. Indicate reason for drop-off not accepted and any trends of this issue:

8. Reasons for drop off (select primary reason for each dropped off individual who entered the center):

· Mental Health crisis

· Substance misuse crisis

· General behavioral health crisis

· Homeless

· At risk of arrest for vagrancy

· Roommate problem

· Unknown

9. Resolution of referral issue and/or disposition at end of stay at center:

· Mental Health outpatient referral

· Psychiatric crisis referral

· Substance or behavioral health referral

· Referral for housing

· Hospitalization

· Respite referral

· DMH referral

· Unknown

10. Trends/additional Information: