Jail Based Behavioral Health Services

 

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The Criminal Justice team offers support to community partners through quarterly workgroup meetings, learning community sessions and roundtable discussions. 

The Jail Based Behavioral Health Services (JBBS) Program has been operational since October 2011 with funding from the Correctional Treatment Cash Fund pursuant to C.R.S.18-19-103 (5)(c)(V). The goal of the JBBS Program is to provide appropriate behavioral health services to inmates while supporting continuity of care within the community after release from incarceration.

To carry out the JBBS program, sheriff departments may partner with local community provider(s) who can demonstrate the ability to provide services within the jail, and the capacity to provide or link individuals releasing from jail to free or low cost services in the community.  This approach should result in shorter jail sentences and decreased recidivism through better identification and treatment of behavioral health needs. 

Download the JBBS Funding Breakdown

 

Putting Coloradans on the Path to Recovery

Not only do JBBS programs provide vital behavioral health services to Coloradans, they also can reduce recidivism and increase chances for successful reentry. Read more than two dozen testimonials from JBBS programs throughout the state. 

Victor King, the State Opioid Response Grant Peer Navigator Supervisor with Mental Health Partners, talks about his experience with Jail Based Behavioral Health Services and how the program put him on the road to recovery.

JBBS in the News

Read how telebehavioral health has become a "game-changer" for county jails that offer JBBS programs in the OBH blog. 


About JBBS Programs
Substance Use Disorder Program

The JBBS substance use disorder program funds provision of evidence-based behavioral health services, with continuity of care extending into the community. Sheriff departments are recipients of these funds, either individually, or as multiple county sheriff departments as a partnership. In accordance with the legislation, all funds are used to provide behavioral health services for adults with substance use disorders or co-occurring substance use and mental health disorders.

Sheriff departments have partnered with local community providers who are currently licensed by OBH to provide services within the jail and have the capacity to provide free or low-cost services in the community to inmates upon release. Most programs have at least a clinician position to offer screenings, assessment and treatment in the jail and a case manager position dedicated to transitional care and a seamless re-entry in treatment services in the community. Treatment providers screen all inmates for presence of substance use disorders, mental health disorders, trauma and traumatic brain injury and identify inmates with active duty or veteran military status.

Participating Counties: Adams, Alamosa, Arapahoe, Archuleta, Baca, Bent, Boulder, Cheyenne, Clear Creek, Conejos, Crowley, Delta, Denver, Douglas, Eagle, Elbert, El Paso, Hinsdale, Garfield, Grand, Gunnison, Jefferson, Kiowa, Kit Carson, La Plata, Larimer, Logan, Moffat, Morgan, Montrose, Montezuma, Mesa, Otero, Ouray, Phillips, Pitkin, Pueblo, Prowers, Routt, San Miguel, Washington, Weld and Yuma.

Funding

The Office of Behavioral Health was allotted $5,256,185 for the Jail Based Behavioral Health Services (JBBS) Substance Use Disorder (SUD) Program for FY 2018-19. The JBBS program supports county sheriffs in providing screening, assessment and treatment for substance use disorders and co-occurring substance use and mental health disorders to people who need such services while they are in jail. The program also creates partnerships for continuity of care in the community for individuals needing services upon release from jail. The is funded through HB 10-1352, and expanded in October 2012 through SB 12-163.

Annual Reports

Download the 2019 Annual Report

Download the 2018 Annual Report | FY 2018 Appendices

Download the 2017 Annual Report

Download the 2015 Annual Report

Statewide Evaluation

This July 2018 JBBS program evaluation examined both process elements of how the program is implemented across the counties as well as the outcomes and impact of the services provided.

Mental Health Services

In May 2018 the Colorado General Assembly passed Senate Bill 18-250, which allocated $5.1 million in additional funding to the JBBS program to address gaps in services for mental health disorder screening, assessment, diagnosis and treatment. The funds support psychiatric prescription services and the purchase of medications. In accordance with the legislation, all funds are dedicated to providing behavioral health services for adults (18 years of age and older) with mental health disorders or co-occurring substance use and mental health disorders. Per SB 18-250 priority was given to rural and frontier counties for mental health services funds.

Participating Counties: Alamosa, Clear Creek, Conejos, Crowley, Elbert, Garfield, Kit Carson, La Plata, Lincoln, Logan, Moffat, Montezuma, Montrose, Morgan, Otero, Prowers, Rio Blanco, Routt, Summit, Washington, and Yuma Counties.

Competency Enhancement Services

In May 2019, the Colorado General Assembly passed Senate Bill 19-223; legislation that mandates the provision of interim mental health services for individuals who have been court-ordered for inpatient competency restoration and who are waiting for admission to an inpatient bed. To compensate for these specialty services, SB 19-223 allocates funding to the Jail Based Behavioral Health Services (JBBS) program to address gaps in services in the jail for those with mental health disorders that are awaiting restoration services.

Competency enhancement funding is used to provide interim mental health services to individuals who are in jail and have been court-ordered to the Colorado Department of Human Services (CDHS) to receive competency restoration services. Funding is also to be used to provide mental health services to individuals who are returning to the jail after receiving restoration services at an Office of Behavioral Health (OBH) designated inpatient restoration facility. Coordination of services with the Forensic Support Team (FST) and Court Liaisons (Bridges) shall occur when a court order has been received for an evaluation and/or when an individual is identified to be in crisis by the jail at the time of booking or while incarcerated.

Participating Counties: Adams, Arapahoe, Boulder, Denver, Douglas, El Paso, Jefferson, Larimer, Mesa and Pueblo.

Pre-Sentence Reentry Coordinator Services

In July 2019, the Office of Behavioral Health (OBH) was granted funds by the Correctional Treatment Fund Board for Pre-sentence Reentry Coordinator position(s) in select jails. This program shall provide services to individuals at county jails who are in need of behavioral health treatment and are on pre-sentence status. These positions will work to enhance and improve care coordination for individuals in county jails with shorter incarcerations (actual length to be determined by individual jails), which may prevent them from receiving more meaningful interventions by behavioral treatment staff. These positions are responsible for facilitating communication and collaboration between judicial and behavioral health systems.

Participating Counties: Arapahoe, Boulder, Denver, Douglas, El Paso, Grand, Jefferson, Larimer, and Pueblo counties.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) pairs anti-craving medications and therapy to treat OUD.

Resources
Mobile Treatment Services
Mobile treatment services have proven to be an effective way to provide treatment to Coloradans in the rural and frontier parts of the state. The Colorado Department of Human Services, Office of Behavioral Health through the State Opioid Response grant, is providing mobile health units specializing in medication-assisted treatment (MAT) to improve access to MAT in rural and underserved areas of Colorado. In addition to these units, mobile treatment options are available through pop-ups at physical sites where the same services are provided.

For more information on services provided and locations and schedules for the mobile health units, visit mobiletreatmentco.org
MAT Policies and Protocol

Medication-Assisted Treatment (MAT) in the Criminal Justice System: Brief Guidance to the States - A brief provided by the Substance Abuse and Mental Health Services Administration.


Senate Bill 19-008 requires a county jail that receives funding through Jail-Based Behavioral Health Services (JBBS) to have a Medication-Assisted Treatment (MAT) policy in place on or before Jan. 1, 2020. Here is a sample MAT policy, protocol, and discharge interview. All of these were developed by the Steadman Group.

Training
Colorado Consortium for Prescription Drug Abuse

The Colorado Consortium for Prescription Drug Abuse has compiled many resources about Naloxone in Colorado and links to trainings.

National Sheriff's Association 

The National Sheriff's Association released this guide on promising practices for jail-based MAT. 

Webinars

The Impact of New Legislation on MAT in Jails
Presented Oct. 24, 2019

JMAT Training Thumbnail

This slide show was used during a live online training covering the requirements and previewing the expected impacts of new legislation and funding on OBH criminal justice initiatives (with an emphasis on opioid use disorder mandated through Senate Bill 19-008). OBH representatives also provided guidance on funding deadlines and next steps.

 

Introduction to MAT in Correctional Facilities
Presented March 22, 2019

Intro to MAT in Correctional Facilities

Dr. Lesley Brooks, Chief Medical Officer with Sunrise Community Health and Assistant Medical Director for North Colorado Health Alliance, presents on the unique benefits to providing treatment for substance use disorders (SUD) in correctional facilities. The presentation details the medications approved by the U.S. Food and Drug Administration and describes the basic pharmacology of medications used in MAT. The session also covers the National Commission on Correction Health Care recommendations for treatment of incarcerated people with SUD. Download the presentation slides.

 

Substance Use Disorder(SUD) Treatment in Correctional Facilities: Initial Steps
Presented April 4, 2019

SUD in Correctional Facilities Initial Steps

Dr. JK Costello, Senior Health Care Consultant with the Steadman Group, walks correctional facilities considering using MAT through initial planning and implementation steps. These include selecting goals for SUD treatment, determining the appropriate medications to reach the goals, evaluating local resources available to assist with treatment, and identifying considerations for assembling a team of law enforcement professionals and community members to realize the program. Download the presentation slides.

Helpful links
Open JBBS positions

OBH will share programs' open JBBS positions below. Please contact the county jail to learn more. 

Resources for County Jails
OBH resources
    JBBS trainings

    Long Acting Injectables (LAI) Training

    In August 2021, JBBS, Sheriffs, and other jail staff participated in a training to increase awareness about LAIs and their utility in preventing mental health decompensation. Following the training, jails participated in a pilot program discussion to learn more and secure resources to support LAIs. After pilot sites have been identified, training will be provided to the Community Mental Health Centers and other interested community partners in an effort to improve jail to community transitions.

    Roundtables

    To better serve our stakeholders, OBH's Criminal Justice Team offers virtual Jail-Based Behavioral Health Services (JBBS) "Roundtables." These 50-minute sessions involve program staff who are available to answer questions related to upcoming deadlines and any operational and administrative changes. All sessions will be recorded and slide decks posted. Click on the following dates to access the recording files.

    Learning Community meeting recordings
    Quarterly Work Group meeting recordings
    JBBS forms and guides
    Legislation affecting JBBS programs 
    HB 21-1211

    HB 21-1211: Regulation Of Restrictive Housing In Jails

    Beginning July 1, 2022, HB 21-1211 prohibits jails with a bed capacity of more than 400 beds from involuntarily placing individuals in restrictive housing if the individual meets certain conditions (please review the conditions below). Affected county jails include Adams, Arapahoe, Boulder, Denver, Douglas, El Paso, Jefferson, Larimer, Mesa, Pueblo and Weld.

    The bill requires a medical or mental health professional to assess any individual placed in restrictive housing within 24 hours of placement. Jails must use an adequate screening tool to complete a health screening of each inmate when the inmate arrives at the jail.

    The bill also requires jails to keep and maintain a record of certain data regarding each individual placed in restrictive housing and certain data regarding each individual with a mental illness or substance use disorder beginning January 1, 2022.

    Conditions that prohibit placing individuals in restrictive housing

    The prohibition applies if: 

    • The individual is diagnosed with a serious mental illness or is exhibiting grossly abnormal and irrational behaviors, or breaks with reality or perceptions of reality indicating the presence of a serious mental illness;
    • The individual has self-reported a serious mental illness or is exhibiting self-harm unless a licensed mental health professional or psychiatrist evaluates the individual and finds serious mental illness is not present;
    • The individual has a significant auditory or visual impairment that cannot otherwise be accommodated;
    • The individual is pregnant or in the postpartum period;
    • The individual is significantly neurocognitively impaired by a condition such as dementia or a traumatic brain injury;
    • The individual is under 18 years of age; or
    • The individual has an intellectual or developmental disability.

    The prohibition does not apply if:

    • Any indication of psychological distress is present and the jail transferred the individual to a healthcare facility to receive treatment and the individual is refused treatment or is determined not to meet the criteria for admission by the healthcare facility; and
    • The individual poses an imminent danger to themselves or others; and
    • No other less restrictive option is available and the individual is not responding to ongoing de-escalation techniques.
    Requirements for restrictive housing

    When an individual is placed in restrictive housing under the above circumstances, the local jail shall:

    • Document the facts and circumstances that led to placing the individual into restrictive housing;
    • Notify its medical or mental health professionals in writing within one hour of placing an individual in restrictive housing;
    • Notify the individual's appointed or retained legal representative, designated emergency contact, or legal guardian within 12 hours of the individual's involuntary placement and removal in restrictive housing;
    • At least every 15 minutes, check on an individual involuntarily placed in restrictive housing;
    • Every 24 hours, assess the individual involuntarily placed in restrictive housing;
    • Provide the individual a clear explanation of the reason the individual has been placed in restrictive housing, the monitoring procedures that the local jail will employ to check the individual, the date and the time, when the individual's next court date is, and the behavioral criteria the individual must demonstrate to be released from restrictive housing;
    • Not hold the individual in restrictive housing for more than 15 days in a 30-day time period without a written court order; and
    • Supply the individual with basic hygiene necessities; exchanges of clothing, bedding, and linen; access to writing letters or receiving letters; opportunities for visitation; access to legal materials; access to reading materials; a minimum of one hour of outdoor exercise 5 days a week outside of the cell; telephone privileges; and access to programs and services.
    Helpful links
    Resources for Veterans
    Resources for reentry
    Criminal justice resources
    Behavioral health resources
    Traumatic brain injury (TBI) resources
    Client resources