AMBER WARD, MSW, MPA, LCSWVETERANS JUSTICE OUTREACH

SPECIALIST

VA Services for Justice Involved Veterans

VA Services for Justice Involved Veterans

Goals of Presentation:POC InformationRole of VJO SpecialistRole of HCRV SpecialistHighlight VA case management and treatment

services offered to justice involved veteransKnowledge of what are appropriate Veteran Justice

Program ReferralsHighlight current programs such as the OK County

Veteran’s Diversion Program, Cleveland County Drug Court and MH Court, and other Veteran Justice initiatives in other counties

VISN 16: South Central VA Health Care Network

3

DEPARTMENT OF VETERANS AFFAIRS

Made of Three Separate Components:1. Veterans Healthcare Administration

VA Medical Center2. Veterans Benefits Administration

Service Connected Disability NSC VA Pension

3. National Cemetery AdministrationBurial and Memorial Benefits

VETERANS HEALTHCARE ADMINISTRATION

Enrollment:Online- https://www.1010ez.med.va.gov/Ebenefits.va.govIn person- Module A at OKC VAMC Paper Application-1010EZDepending on Eligibility Priority Group,

income verification is requiredMUST HAVE A DD214

Must verify Discharge Status and Dates of service

Veteran Justice Outreach Specialists (VJO)

Amber Ward, LCSW Contact Information:

Phone: 405-456-1761 Email: Amber.Ward@va.gov

Omar Rashidzada, LCSW Contact information:

Phone: 405-456-3010 Omar.rashidzada@va.gov

VJO Mission Statement and Goals

Mission: To partner with the criminal justice system to identify Veterans who would benefit from treatment as an alternative to incarceration.

VJO Specialist will ensure access to exceptional care, tailored to individual needs, for justice-involved Veterans by linking each Veteran to VA and/or community services that will address mental health and substance abuse needs, homelessness, employment needs, improve social and clinical outcomes, facilitate recovery, and hopefully end a Veteran’s cyclical contact with the criminal justice system.

VJO Mission Statement and Goals

VJO Goals Increase the identification of justice involved

Veterans and promote their engagement with VA healthcare, benefits, and other services.

Collaborate with the justice system and other community entities to develop opportunities for identifying justice involved Veterans.

Conduct outreach directly to justice involved Veterans and link them to the appropriate VA and community services.

Role of Veterans Justice Outreach (VJO) Specialist

VJO Specialist is to act as a liaison and point of contact between the criminal justice system and the VAMC to help increase access of care for Justice involved Veterans and decrease barriers to treatment.

VJO Specialists conducts outreach to jails and court systems to advocate on behalf of veterans that are involved in the criminal justice system.

VJO provides case management services to veterans while they are involved in the criminal justice system, which may include having pending criminal charges, being in custody in a county jail, or facing a probation revocation.

Role of Veterans Justice Outreach (VJO) Specialist Continued

VJO Specialists assist justice involved Veterans in several ways: Screen Veterans and their legal issues to provide education on

potential programs they may be appropriate for, such as a diversion program, drug treatment court, or mental health treatment court within the county they have charges in. 

Assess Veterans for unmet treatment needs that are impacting their current involvement in the criminal justice system.

VJO Specialist is a member of the Treatment Team for the OK County Veteran’s Diversion Program

VJO Specialist is a member of the Treatment Team for the Cleveland County Drug Court

Services Available to Justice Involved Veterans

SAC AMHC MHICM VRC PIU Family Mental Health Program TDRS OEF/OIF/OND TBI/Poly Trauma SCI Women’s Health Programs Suicide Prevention Homeless Programs

Substance Abuse Clinic (SAC)

A specialized treatment program providing eligible veterans with a continuum of care of substance abuse services. SAC offers comprehensive, integrated medical, psychiatric, nursing, and psychosocial treatment to veterans with active substance use disorders. Services include: Intake/assessment Detoxification/medically supervised Treatment and discharge planning Contract bed placement – Serenity House Intensive Outpatient treatment program (IOP) Sobriety Maintenance Methadone maintenance treatment through the Opioid Treatment Program

(OTP) Aftercare outpatient treatment

Residential Programs

Voluntary Treatment Open Campus Residential treatment options for PTSD, MST, DDx,

SUD, TBI, and DBT Referral to Residential Care (out of state)

Leavenworth ROVER/WISER Topeka Little Rock Temple (MST) Bay Pines (MST) San Antonio (PTSD/TBI) Minneapolis (DBT)

Ambulatory Mental Health Clinic (AMHC)

A multidisciplinary outpatient mental health clinic providing: Medication consultation and management Individual, group, family, and couples psychotherapy Biofeedback and stress management Psychoeducational classes that address a variety of

common mental health concerns Crisis intervention Psychological assessment Trauma treatment addressing combat and sexual

trauma as well as other sources of trauma Daily walk-in emergency consultation service

PIU - Inpatient Psychiatry

A 25-bed short-term psychiatric unit; the purpose of the unit is to admit veterans from the community who are in an acute psychiatric crisis, and to stabilize them as quickly as possible. The most frequent diagnoses include schizophrenia, substance abuse, depression, anxiety disorder, bipolar disorder, PTSD, and personality disorder. Treatment is offered by a multidisciplinary team with major treatment modalities including: Medical evaluation Medication stabilization Individual psychotherapy Various forms of group therapy Milieu therapy Discharge Planning with 7 day outpatient f/u appointment

Mental Health Intensive Case Management (MHICM)

An intensive multidisciplinary team approach to ambulatory case management of veterans with severe and chronic mental illness. An evidenced-based method which is based on Assertive Community Treatment (ACT). Provides care for vulnerable veterans who are frequently admitted to inpatient psychiatry and unable to benefit from traditional mental health treatment. The majority of services are provided in the community. Services include: Medication management Psychotherapy Case Management Support Rehabilitation

Veterans Recovery Center (VRC)

An intensive outpatient treatment program serving veterans living with serious mental illness that significantly disrupts their daily functioning. Services are based on the core components of psychosocial rehabilitation and recovery-oriented care. The focus of the VRC includes: Vet actively involved in own care Individualized services and veteran-centered Identifying and utilizing personal strengths Treatment the whole person, not just symptoms Empowerment through education and support Respect Creating a sense of hope

Services provided: Psychoeducational and skill-building classes both in class and in the community Individual and family therapy

Family Mental Health Program

This program provides a range of services for veterans, their significant others, and other supportive people in the veteran’s life. Individuals do not have to be married and same-sex couples are welcome. Services include: Couples therapy Family therapy Family education Comfort and Renewal with Education and Support (CARES)- a

group for family members of veterans with emotional problems providing education and support.

Journey Through Loss class- for veterans and their family members who have lost a loved one.

Rebuilding After the End of Your Relationship class- for veterans who are in the period of adjustment after the end of a long-term romantic relationship.

Reaching out to Educate and Assist Caring, Healthy Families (REACH)

The REACH program is a research-based educational program for veterans living with PTSD, depression, bipolar disorder, or schizophrenia-spectrum disorders. The veteran’s significant other, adult family member, or other supportive person in the veteran’s life attends the entirety of the REACH program with the veteran. Services include: Single-family sessions Multi-family group classes Many services are held in the evenings

Oklahoma Veteran Centers

Readjustment Counseling Centers Affiliated with VAMC, but off site, and eligibility focuses on

veterans who served during designated period of war Locations Oklahoma City VC

1024 NW 47th St, Suite B OKC OK 73118 405-456-5184

Tulsa VC 14002 E. 21st St, Suite 200 Tulsa, OK 74134 918-628-2760

Lawton/Red River VC 1016 SW C Street Lawton, OK 73501 580-585-5880

Trauma Deployment and Recovery Services (TDRS)

TDRS is a newly combined clinic from the former OEF/OIF/OND Readjustment Program and Post-traumatic Stress Recovery Program. This program focuses on veterans who have experienced a military related traumatic event including combat and military sexual trauma. Services include: Individual and group therapy Psychoeducational groups Psychiatric consultation for medication management

Main emphasis of TDRS is providing evidenced based treatments for PTSD including Cognitive Processing Therapy (individual and group) and Prolonged Exposure (individual).

OEF/OIF/OND TRANSITION AND CARE MANAGEMENT PROGRAM

Staff:

Michele Diesselhorst-Reese, LCSW,CCM, Program Manager 405-456-3215

Waco Blakley, Transition Patient Advocate 405-456-1410

Tanya Gutierrez, LCSW – Lead Coordinator 405-456-3214

Kelly White, LCSW – Lead Coordinator 405-456-5556

Katie Cox, LCSW – Lead Coordinator 405-456-

Sandra Nikkel, LCSW – Caregiver Support Coordinator405-456-5569

Christy Pargeter, LCSW – Caregiver Support Coordinator405-456-5569

TRANSITION AND REINTEGRATION GOALS

THREE CORE SERVICES1. Transition and Reintegration2. Care Coordination and Advocacy3. Proactive Outreach/Education/Training

Honor and serve our OEF OIF OND Veterans through enrollment in the VA

Educate and outreach regarding 5 years of cost-free health care for any injury or illness associated with their service).

Participate in DoD Demobilizations, Post Deployment Health Re-Assessments, and other local military activities.

Partner with Military Treatment Facilities and VA liaisons

CARE COORDINATION & ADVOCACY

Assess and provide appropriate level of case management services to every enrolled OIF/OEF/OND Veteran (Intensive, Progressive, Supportive, Lifetime).

Work with all VA, DoD, and community health care partners to address Veteran’s bio-psychosocial needs.

Provide advocacy services to individual Veterans to address concerns and reduce system barriers to seamless care.

OUTREACH, EDUCATION & TRAINING

Collaborate with all VA/VHA program staff, community partners and Veterans/family/significant others to improve VA services and Veteran health care outcomes, (Focus Groups).

Proactive outreach and collaboration with CBOC’s, Vet Centers, Veteran Service Organizations, law enforcement, community providers, and businesses/employers.

Welcome and educate Veterans, their families and the community regarding VHA services for OEF/OIF/OND Veterans (Welcome Home Event).

Spinal Cord Injury Program

SCI team that consists of a Medical Director, Physician Assistant, Registered Nurse, and Social Worker

Providing Services for Amyotrophic lateral sclerosis(ALS), Multiple Sclerosis(MS), Spinal Cord Disorder(SDC), Spinal Cord Injury(SCI)

Inpatient and OutpatientCoordinates with other services431-Enrolled Patients

Women’s Health Program

Currently have 4178 women enrolledMaternity-31 positive pregnancy tests for 2015Coverage Areas

VA Medical Center OKC North May Annex Community Based Outpatient Clinics Ada, Altus, Ardmore, Blackwell, Enid, Lawton, Stillwater and Wichita Falls

Provides Case Management through the PACT model Maternity Case Management

36 week assessment Postpartum follow-up and screen for postpartum depression Short-Term counseling

Pregnancy depression Postpartum depression Loss of baby

Suicide Prevention

Support Team members with challenging patient-care situations

Eliminate barriers to health care interventionsBuild upon and promote strengths and abilitiesReduce risk for hospitalization or institutionalizationReduces utilization of health care resourcesMonitor Veteran status between provider contactsEnhances Veteran’s connection to the medical centerEducate and motivate Veteran toward health promotion,

disease prevention and management of selfOffer strategies to resolve underlying casual factorsFollow through continuum of health care

Suicide Prevention

Follow up on all calls to the Veterans Crisis HotlineAssure follow-up for patients in crisisMaintain a facility “high risk” list which lists patients who

have deemed to be at riskProvide new staff Operation Save, Be a Hero Save a Hero,

or other approved trainingParticipate in Community Outreach

Oklahoma City VA Suicide Prevention Team

Juanita Celie, LCSW, BCD Team Coordinator(405) 456-4692Bryan Stice, Ph.D. Case Manager(405) 456-5206

Selonda Moseley, LCSW

Case Manager

(405) 456-5736

Alicia Oddi, LPN

Program Assistant

(405) 456-4228

Homeless Programs

Veterans Justice Outreach (VJO)Health Care for Reentry Veterans (HCRV) Housing and Urban Development VA Supported

Housing - (HUD/VASH) Grant and Per Diem Program (G&PD)Health Care for Homeless Veterans (HCHV)Transitional Residence (TR/CWT) “Friendship

House” Compensated Work Therapy Programs (CWT) which

include Therapeutic Work Experience (TWE), Homeless Veteran Supported Employment (HVSE), and Supported Employment (SE)

Homeless Program Mission

To provide comprehensive treatment through education, training, support, case management and therapeutic interventions on an individual basis, with an emphasis on housing first, that enables veterans to return to their community and live independently.

Have a low threshold for referrals and assistance. “Screen In” rather than “Screen Out”Treat each veteran with their own unique recovery plan. Increase collaboration and partnerships with community

agencies and providers. Conduct regular outreach to better identify veteran and gaps

in services. Allow and increase veteran’s choices, such as those outside

the VAMC system.

Health Care for Homeless Veterans (HCHV)

POC is Christine Cleary, LCSW at 405-456-1710 Kevin Acers, LCSW at 405-456-1709

Contract Residential Care: Two locations : Serenity House (10 beds) 7 beds for male veterans, 3 for Female Veterans. Phoenix House 14 beds

VA National Homeless Call Center 1-877-4AID VET (1-877-424-3838) Operates 24/7, 365 days. Callers from the OKC VAMC catchment area are routed to this team. For FY 13 there were 570 referrals. All veterans receiving care through the OKC VAMC are screened at least one time per year for homelessness. If found to be at risk a consult is entered. For FY 13 there were 479 consults received.

Outreach: Street outreach on a weekly basis, to known homeless camps, partner with agencies such as Be the Change. Formal working relationships with City Rescue Mission and Jesus House. Outreach to the West Town Day Shelter and all established homeless shelters in OKC. Multi disciplinary team outreach one time monthly. Establish partnerships with shelters throughout the OKC VAMC catchment area. I.E. Wichita Falls, TX, Lawton, Enid, etc.

HUD/VASH

POC is Pam Stark, LCSW 405-456-5756Jessica Jenson 405-456-1879HUD/VASH is an intensive case management program that comes with a Housing Choice Voucher. This is the only program that a veterans family can be a part of. To be eligible a veteran must be:

Eligible for VA health care Homeless. Priority is given to veterans who identify as chronically homeless.

Priority is also given to veterans with under aged children in the home. Have a need for intensive case management such as a mental health and or a

substance abuse diagnosis.

Currently 286 vouchers assigned to the OKC VAMC. At end of FY 13 90% of the 185 available vouchers were leased in. Of those 69% met the definition of being Chronically Homeless at time of admission. For FY 14 97.33% of the 225 vouchers are in permanent housingThe HUD/VASH team is housed at the West Town Resource center, courtesy of the OKC Homeless Alliance.

TR/CWT - “Friendship House”

POC Fawn Jones 405-456-5758 Began operation as a transitional residence in 1992 for the OKC

VAMC. Is a recovery based, resident driven, 20 bed, coed facility. Residents of the Friendship house must participate in the

CWT/TWE program. To be eligible for admission, veterans must be: Eligible for VA health care Homeless Benefit from a therapeutic environment. FY 2013 there were 41 admissions, occupancy was 83%, the

average length of stay was 151 days FY 2014 there were 40 admissions, occupancy was 88%. The average length of stay is 153 days

Grant and Per Diem Program

POC – 405-456-5759 Transitional Residence Program 31 beds with coed capability. Private Agencies Red Rock Behavioral

Health Services and Phoenix House Recovery Institute operate with annual VA Grants.

To be eligible for admission, veterans must be: Homeless Have a mental health and or a substance abuse diagnosis. A veteran may only have three admissions in a lifetime One admission episode may last up to two years. Must save 50% of income for permanent housing During FY 2013 the average occupancy was 86%, with a total of 97

veterans served, 66% of discharges were positive. FY 2014 average occupancy has been 87%, with a total of 76

veterans served and 69.09% of discharges were positive.

Compensated Work Therapy

Supported Employment (SE) POC is Glen Kierstead, VRS at 405-456-3586

Supported Employment in Oklahoma City serves Veterans diagnosed with serious mental illness. *Works with MHICM Team.

Homeless Veterans Supported Employment (HVSEP)

POC is Robert Miranda, VRS at 405-456 5930

Provides supported employment assistance for veterans in the Homeless program

FY13 - 83 veterans participated with 94% becoming employed

Transitional Work Experience (CWT/TWE)

POC is Rudy Cachero, VRS at 405-456-1885

Provides therapeutic work experience with compensation.

40 positions at the OKC VAMC

FY13 - 85 veterans were served

FY14 - 77 veterans were served

New CEC – Community Employment Coordinator Position to build relationships with community employees

Veterans Justice Outreach Program

Collaborates with numerous criminal justice system partners to identify and assist justice involved veterans.

VJO Specialist works as a team member of the OK County Veteran’s Diversion Program, which is a collaboration between the Oklahoma County District Attorneys Office, the OK County Public Defenders Office, OKC VAMC, ODMHSAS, OESC, and North Care Community Mental Health Center.

There are currently approx. 103 veterans in the OK County Veteran’s Diversion Program.

VJO Specialist works as a team member of the Cleveland County Drug Court, which is expanding their treatment court to include availability specifically for veterans.

There are currently 10 veterans in the Cleveland County Drug Court. Conducts outreach to local county jails and detention centers to provide

case management to veterans currently in custody at a county jail. Assists with treatment and case management referrals at numerous points

of care needed by justice involved veterans – Sequential Intercept Model

Healthcare for Re-Entry Veterans (HCRV)

Tony Kirksey, LCSWPhone :405-456-1762Email: Anthony.Kirksey2@va.govServices include: Outreach to private, State, and Federal prisons within the

State of Oklahoma Pre-release assessment services to target veterans

eligible for release within 6 months Enrollment in VA using the 10-10 EZ form if veteran has

never registered for VHA services Referrals and linkages to VA and Community Resources Transition case management services for housing,

employment, and treatment needs to coordinate care as a veteran is released from DOC custody

Prevention of Homelessness Services

OKC VAMC Providers – Homeless Screening Clinical Reminders for all veterans who receive care through the OKC VAMC. This is a 1x per year screening to identify homelessness or risk of homelessness

Collaborative effort with the SSVF Grantees, Goodwill, Ki Bois and BRRX

Supported Services for Veterans and Families (SSVF) Goodwill is the grantee for Oklahoma Co. and surrounding counties.

Work with agencies and individuals to develop referral sources for safe and affordable housing

Partnered with OKC Homeless Alliance and Zero 2016 initiative in Norman and OKC.

Housing First using an Interdisciplinary team

OK County Veteran’s Diversion Program

The OK County Veterans Diversion Program has been established since July 2011, and is a treatment driven diversion program to incarceration.

It is 13 month to 3 year program. The Goal of the OK County Veteran’s Diversion Program is to reduce

recidivism by addressing unmet treatment needs that are directly influencing a persons involvement in the criminal justice system.

The OK County Veteran’s Diversion Program is a collaboration of Criminal Justice System Partners, which include the District Attorney’s Office, the Public Defender’s Office, North Care Community Mental Health Center, the Oklahoma Department of Mental Health and Substance Abuse, the Oklahoma Employment Security Commission, and the Veteran’s Justice Outreach Specialist from the OKC VAMC.

22 O.S. 305.1-305.6 is the Deferred Prosecution Statute. This statute allows the state of Oklahoma to enter into an agreement with the accused to defer the filing of criminal charges in order to give the defendant an opportunity to successfully complete a program.

OK County Veteran’s Diversion Program

103 Veterans are currently involved in the OCVDP at the end of July 2015

44 are currently under contract with the District Attorney

59 currently have pending applications or probationary contracts

111 have graduated since the beginning of the OCVDP (July 2011)

Total number of applicants to the OCVDP: 733Number of OCVDP Denials/Failures/Withdrawals:

503

Other OK County Programs

Midwest City Detention Center Outreach/Screenings RRBHS

MWC Municipal Misdemeanor Diversion Program RRBHS

OK County Jail Outreach North Care Day Reporting Program ODMHSAS

Care coordination available for Treatment Courts in OK County

Cleveland County Drug/Mental Health Court

Cleveland County Drug Court was awarded a grant from BJA (Bureau of Justice Assistance) to begin targeting veterans to be referred and accepted into the current Cleveland County Drug Court

Intention of the BJA Grant and Cleveland County is to form a separate Veteran Treatment Court Docket

Current Census: 10 veterans. 3 Veterans in Cleveland County mental health court.

VJO regularly visits with Veterans in Cleveland County Jail. Jail does screen for Veterans.

Other Courts/Jail Outreach Efforts

Comanche County Drug Court has 4 Veterans.

Seminole County has a separate Veteran’s docket with approximately 7 Veterans.

VJO outreach to drug courts in over 30 counties in Oklahoma.

VJOs encouraging county jails to screen inmates and determine if they have served in the military, and to notify VJO when a Veteran is identified. Many county jails currently do not screen for Veterans.

Conclusion

Questions and Comments