LEAD SF Policy Committee Meeting #10
April 22, 2019
LEAD SF
Welcome &
Opening Remarks
2LEAD SF Policy Committee Meeting #10 April 22, 2019
Agenda
1 Welcome, Opening Remarks & Introductions
2 Agenda Review
3 Recognition & Moment of Silence for Jeff Adachi
4 Quarterly Communication Updates
5 Program Implementation
6 Evaluation Update
7 Closing & Next Steps
3LEAD SF Policy Committee Meeting #10 April 22, 2019
Remembering Jeff Adachi
4LEAD SF Policy Committee Meeting #10 April 22, 2019
Quarterly Update
5LEAD SF Policy Committee Meeting #10 April 22, 2019
Training Plan Progress
• Past Trainings (since 01/28 meeting) with themes of:
Past
Boundaries and Disclosure – February 28
The Racialization of the Opioid Epidemic: The role of whiteness – February 28
Safe Consumption Sites in San Francisco: Why, How and When – March 8
Clinical & Contemporary Implications of working with LGBTQIQ Clients – March 13
Sex Work & Harm Reduction – March 21
The Commercial Sexual Exploitation of Children and Young Adults – March 26
Verbal De-escalation – April 11
Harm Reduction Case Management - April 19
Future
Legal Issues in Collaborative Courts – May 1
Navigating the Jail Health System – May 10
Harm Reduction 201: Putting it Into Practice - May 14
Safer Drug Use - June 7
2019 Recovery Summit - June 26
6LEAD SF Policy Committee Meeting #10 April 22, 2019
Program Implementation
7LEAD SF Policy Committee Meeting #10 April 22, 2019
Update on pre-booking/social contact referrals
8
• Total of 347 referrals and 153 active participants as of : 4/16/19
Pre-booking Referrals
Social Contact
Referrals 120 (35%) 227 (65%)
History of Contact with SF Jail System
84 (70%) 172 (76%)
Number (Percent)
LEAD SF Policy Committee Meeting #10 April 22, 2019
Referrals and service connections
• Referral agency
(of 347 referrals)
• Connected to LEAD services
(of 153 active participants)
9
SFPD BART Police SFSD
264 (76%) 72 (21%) 11 (3%)
Glide Felton Other
80 (52%) 72 (47%) 1 (1%)
LEAD SF Policy Committee Meeting #10 April 22, 2019
Update on demographics
Neighborhood
(of 347 referrals)
Sex
(of 153 active)
Race
(of 153 active)
10
224
(65%)
123
(35%)
Tenderloin District Mission District
Number(Percent)
FemaleMale
100(65%)
51(33%)
75(49%)
41(27%)
11(7%)
African AmericanWhite Latinx
American Indian: 5 (3%)
Asian: 5 (3%)
Other: 16 (10%)
Transgender/Non-binary2 (1%)
LEAD SF Policy Committee Meeting #10 April 22, 2019
District Attorney & Public
Defender Analysis
11LEAD SF Policy Committee Meeting #10 April 22, 2019
LAW ENFORCEMENT ASSISTED DIVERSION
APRIL 2019
13
FEWER LEAD REFERRALS SINCE LAST POLICY MEETINGComparing Referral Rates Between the Previous Two Policy Meetings
91
80
Oct 1, 2018 - Jan 28, 2019 Jan 28 - April 22, 2019
From January 28th to April 22nd of this year, there
was a total of 80 LEAD referrals (including
refusals) as opposed to the 89 referrals from
October 1, 2018 to January 28, 2019.
This is a 12% decrease in total referrals since
our last policy meeting (compared to the 15.6%
increase between Q6 and Q7).
14
REFERRAL DISTRIBUTION
70 69
1410
7
1
Untitled 1 April
In the most recent period the 80
cases referred entailed:
• 69 Social Contact Referrals
• 10 Misdemeanor Pre-Booking
• 1 Felony Pre-Booking
In the previous period the 91 cases
referred entailed:
• 70 Social Contact Referrals
• 14 Misdemeanor Pre-Booking
• 7 Felony Pre-Booking
10/1/18 to 1/28/19 1/28/19 to 4/22/19
There were 63 Social Contact Referrals
Social Contact Referrals January – March 2019
White50.79%
(30)
Unknown9.52%
(6)
Asian / Pacific Islander3.17% (2)
African American26.98%
(17)
Latinx6.35% (4)
Native American3.17% (2)
There Were 11 Pre-Booking Referrals
Pre-Booking Referrals January – March 2019
White27.27%
(3)
Other9.09%
(1)Asian / Pacific
Islander18.18%
(2)
African American27.27%
(3)Latinx
18.18%(2)
Of the Pre-Booking Referrals: There Were 10 Misdemeanor Referrals
White30%(3)
Other10%(1)
Asian / PacificIslander
20%(2)
African American30%(3)
Latinx10%(1)
Misdemeanor Pre-Booking Referrals January – March 2019
18
PARTNER POLICY MEETINGS
Representatives from the District Attorney’s Office, Office of the Public Defender, and SFPD met on a monthly basis (sometimes bi-monthly) to discuss ways to capture more
and better suited LEAD participants.
19
ITEM #1: NON-REFERRED CASES
20
AGREED
FACTS OF THE CASE
• Arrested in a “Buy-Bust” operation in an area well known by officers for high illegal narcotics sales
• Booked for possession for sale of cocaine
• Has prior arrest for narcotics sales
FACTORS THAT MAKE THIS A GOOD REFERRAL • Limited quantity of drugs -- .7 grams over two bindles
• No other drugs
• $61 in possession
FACTORS THAT MAY HAVE CREATED RESERVATION: • Spat from mouth and tried to put into buyer's mouth.
TRAINING TAKEAWAYS:• Possession of a single drug is a key factor to consider; eligible offenses, even during a “Buy-Bust,”
should be considered for referral at officer’s discretion; the totality of the circumstances have to be considered, weighing both positive and potentially discrediting factors
21
AGREED
FACTS OF THE CASE
• Arrestee was observed selling suspected narcotics by plain-clothes officers near Civic Center BART station
• Booked for sale of Heroin
• Prior arrest; no outstanding warrants
FACTORS THAT MAKE THIS A GOOD REFERRAL • Limited quantity of drugs – 1.1 grams over 5 bindles
• No other drugs
• $182 in possession
FACTORS THAT MAY HAVE CREATED RESERVATION: • None
TRAINING TAKEAWAYS:• Possession of no other drugs is key
22
ITEM #2: HOW TO INCREASE FELONY PRE-BOOKING
REFERRALS
23
CONSISTENTLY LOW FELONY PRE-BOOKING REFERRALS
With the exception of one period (7/23/2018-10/21/2018), felony pre-booking
referrals have repeatedly fallen below five per period.
0 4 10 4 1
1/22/2018-4/23/2018 4/24/2018-7/22/2018 7/23/2018-10/21/2018 10/22/2018-1/27/2019 1/28/2019-4/22/2019
1 out of 11 Pre-Booking referrals were for FELONIES.(January-March 2019)
TL M Total
Sales-related (felony) 0 1 1
Theft-related (felony) 0 0 0
Vandalism (felony) 0 0 0
1170(h) + co-occuring (felony) 0 0 0
Possession & Under the Influence (misdemeanors) 1 5 6
Loitering (misdemeanor) 0 4 0
Total 1 10 11
Of the Pre-Booking Referrals: There Was 1 Felony Referral
Felony Pre-Booking Referrals January – March 2019
Latinx100%
(1)
26
STEPS TO TAKE ADDRESS DECREASE
Several steps to address the decrease in Felony Pre-Booking referrals
1. SFPD will review previous police reports for the 10 felony
referrals made between July 23, 2018 and October 22,
20182. Clarify the felony referral protocol
• Make the referral for eligible offenses and then release per 849(b)
• Warm handoff to case manager with Glide or Felton
• Do not refer individual to LEAD as a pre-booking if that person is going to
be booked into custody
• Sergeants are going to retrain on these steps
3. Refer people arrested for felony thefts at department
stores w/in designated districts.
27
ITEM #3: LEAD REFERRALS DESPITE ARREST WARRANTS
28
MAKING REFERRALS EVEN IF PARTICIPANT HAS TO BE
TAKEN INTO CUSTODY
PROBLEM: Can an officer still make a LEAD referral when the potential participant has
an arrest warrant?
ANSWER: Yes, the officer can refer the individual as a social contact referral.
NEXT STEPS: The PD’s Office will keep track of the other charges (if any) and if filed
the DA’s Office will consider dismissing those charges provided that the individual
completes his/her assessment in a timely manner.
BIG TAKEAWAY: Reinforcing to officers that individuals can still be referred to LEAD
even if they have a warrant for their arrest.
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ITEM #4: REFERRING THOSE WHO WANT TO BE IN LEAD
30
ENHANCING COMMUNITY INTERACTIONS &
EXPANDING RESOURCES PROBLEM: Case managers have expressed a problem of clients accepting LEAD only to
disengage when they find out it’s voluntary.
SOLUTION: Enhance the initial point of contact to draw in the best fits for LEAD and
expand CASC hours (open till 5:00pm everyday except on Tuesdays when open till ~7:00
or later).
NEXT STEPS:
• Draw upon officer’s community policing skills
• Rely more heavily on officers’ relationships with community members
• Enhance engagement of prospective LEAD participants by highlighting the many benefits of LEAD
• Incorporate feedback from case managers about methods for building rapport with prospective
clients
12/16/2019 31
OVERVIEW AND SUMMATIONCONTINUED COLLABORATION FOR LEAD
DECREASED REFERRALS% downtick in LEAD referrals since last
policy meeting.
ENHANCE POINT OF
CONTACTImprove messaging around who LEAD
is for and what it offers.
FELONY REFERRALSThe data demonstrates that felony
referrals have historically been low.
SOCIAL CONTACT AS AN
ALWAYS OPTIONEven when individuals are taken into
custody, they can be offered LEAD.
32
OVERALL GOAL: CONTINUE TO IDENTIFY AND ENGAGE
THE BEST FITS FOR LEAD
THANK YOU
Experiences Spotlight
34LEAD SF Policy Committee Meeting #10 April 22, 2019
Program Continuation
Timeline
35LEAD SF Policy Committee Meeting #10 April 22, 2019
Evaluation Update
36LEAD SF Policy Committee Meeting #10 April 22, 2019
Interim AnalysesService Dates: Nov 2, 2017 – December 31, 2018
© Hatchuel Tabernik and Associates 2019
• Referral, Enrollment & Service Updates
• Behavioral Health Need data
• Provider Referral data
• Self-Sufficiency Data
Source: LEAD SF Referral Logs, Nov 2017 – Dec 2018
© Hatchuel Tabernik and Associates 2019
174
250262
0
50
100
150
200
250
300
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8
# o
f LE
ref
erra
ls
Referrals -Target & Actual
Target Actual
By Q6, referrals had already surpassed the Q8 (end of pilot) target.
Source: LEAD SF Referral Logs, Nov 2017 – Dec 2018
Social contact referrals have exceeded expectations and are being made at 4.5 times the rate expected.
© Hatchuel Tabernik and Associates 2019
34
50
152
0
20
40
60
80
100
120
140
160
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8
# o
f LE
ref
erra
ls
Social Contact Referrals - Target & Actual
Target Actual
Source: LEAD SF Referral Logs, Nov 2017 – Dec 2018
The program is slightly short of meeting target pre-booking referrals.
© Hatchuel Tabernik and Associates 2019
140
200
110
0
50
100
150
200
250
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8
# o
f LE
ref
err
als
Pre-Booking Referrals - Target & Actual
Target Actual
Source: LEAD SF Enrollment Logs, Nov 2017 – Dec 2018
By Q6, enrollments had also already surpassed the Q8 (end of pilot) target.
© Hatchuel Tabernik and Associates 2019
70
100
152
0
20
40
60
80
100
120
140
160
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8
# o
f LE
ref
erra
ls
Enrollments - Target & Actual
Target Total
Source: LEAD SF Client Log, Nov 2017 – Dec 2018
Social contact referrals consistently make up the majority of enrollments in each quarter.
As of Dec 2018, 63% of the enrolled clients were social contact referrals.
© Hatchuel Tabernik and Associates 2019
57
95
0
20
40
60
80
100
120
Q1 Q2 Q3 Q4 Q5 Q6
# o
f LE
ref
erra
ls
Cumulative Enrollments by Diversion Type
Pre Booking Social Contacts
Source: BSCC Quarterly Report data, Nov 2017 –Dec 2018
Average of 24 hours spent per enrolled client on assessment, legal services, and case management and outreach services
© Hatchuel Tabernik and Associates 2019
2.2
7.0 6.77.8
0.0
5.0
10.0
15.0
20.0
(DPH)Assessment & Support
(DA's Office)Legal services
(Public Defender's Office)Legal services
(Felton or Glide)Case management & outreach services
Ho
urs
Services - Average Hours per Client
Source: BSCC Quarterly Report Data , Nov 2017 – Dec 2018
Most of the time spent with LEAD clients is on legal services, such as case review, disposition, case consultation and civil legal assistance
© Hatchuel Tabernik and Associates 2019
9%
29%
28%
33%
Services - Percent of Partner Time Spent per Client
Assessment & Support (DPH)
Legal services (DA's Office)
Legal services (Public Defender's Office)
Case management & outreach services (Felton or Glide)
Source: LEAD SF Client Log, Nov 2017 – Dec 2018
The majority of clients have some mental health need and/or a SUD diagnosis.
© Hatchuel Tabernik and Associates 2019
66%
31%
82%
0
10
20
30
40
50
60
70
80
90
100
Any Mental Health Need Serious Mental Health Need Substance Use Disorder Diagnosis
Perc
enta
ge
Behavioral Health Needs of LEAD Clients
Many clients are connected to Mental Health (MH) & Substance Use (SU) services, if needed.
59% of those with any Mental Health need connected to MH services
77% of those with Serious Mental Health need connected to MH services
87% of those with SUD diagnosis connected to SU services
LEAD Case Manager Service Connections
© Hatchuel Tabernik and Associates 2019
Program Goal: 80% of clients will be connected to MH & SU, as needed
Source: LEAD SF Client Log, Nov 2017 – Dec 2018
Most clients are connected to Housing & Employment resources, if needed.
90% of those with Housing needs connected to Housing resources
96% of those with Employment needs connected to employment services
LEAD Case Manager Resource Connections
© Hatchuel Tabernik and Associates 2019
Program Goals: 50% of clients without housing will obtain shelter50% of clients without employment will be on employment continuum
Source: LEAD SF Provider Data, Nov 2017 – Dec 2018
Source: LEAD SF Provider Data, Nov 2017 – Dec 2018
Overall, self-sufficiency begins to increase at 6-months post-intake
© Hatchuel Tabernik and Associates 2019
2.5 2.5 2.5
2.9 2.9
1
2
3
4
5
Intake(n=108)
30-Day(n=88)
90-Day(n=68)
6-Month*(n=30)
12-Month(n=10)
Mea
n S
SM S
core
LEAD Clients’ Self-Sufficiency (SSM) Mean Scores over Time
*p<.05
Source: LEAD SF Provider Data, Nov 2017 – Dec 2018
• Increases can be seen across ALL 13 domains of self-sufficiency• Five domains show statistically significant increases
© Hatchuel Tabernik and Associates 2019
0
1
2
3
4
5
Housing* Employment Safety Food* Mental Health Substance Use Disability* HealthCoverage*
Legal Mobility Income* Community Adult Education
Mea
n S
SM S
core
Intake 6-Month
*p<.05
LEAD Clients’ SSM Mean Scores from Intake to Six-Months (n=29)
Closing & Next Steps
2019 Policy Committee Meetings:
Quarterly Schedule
Monday, July 22 and Monday October 28
Time: 1-2:30pm
Location: 850 Bryant Street, 2nd Floor
50LEAD SF Policy Committee Meeting #10 April 22, 2019
Information Sharing & Engagement
Dedicated page on DPH website and email:
www.sfdph.org/dph/comupg/knowlcol/leadSF/Law-
Enforcement-Assisted-Diversion-SF.asp
• Public postings of agenda & minutes
• Posting of relevant LEAD materials
51LEAD SF Policy Committee Meeting #10 April 22, 2019