Familiar Faces Initiative Case Study: Johnson County, Kan.

Key Takeaways

Improving Outcomes through Coordinated Health and Justice Systems in Johnson County, Kan.

BACKGROUND

Johnson County is a Familiar Faces Initiative (FFI) Peer-Learning Site that models effective cross-sector data sharing and familiar faces programming to divert residents with behavioral health conditions from jail to treatment. Johnson County has utilized a Justice Information Management System (JIMS) for decades to coordinate and analyze data on individuals involved in the criminal legal system across law enforcement, the county jail, the court system and community supervision. Johnson County formed a Justice Mental Health Workgroup in 2008 to explore opportunities for alternatives to incarceration for individuals with behavioral health conditions, when appropriate. The Justice Mental Health Workgroup oversees the coordination of services across the county to improve outcomes for familiar faces and other at risk individuals.

MY RESOURCE CONNECTION

Johnson County created My Resource Connection (MyRC) to complement JIMS and share information across human services agencies. MyRC identifies mutual clients between multiple service providers through a SQL server system that inputs and deidentifies all Johnson County human services client data to allow for cross-agency sharing and input of information. Each client in the application is assigned a system identification number to protect their privacy; access to detailed client information is hierarchical based on covered entity access that is set by business user  agreements in compliance with HIPAA and 42CFR Part II regulations. This allows staff from each agency to input information about contacts and case notes into the system without a non-covered entity accessing their notes. Medical providers can access more detailed information, including whether their client is engaged elsewhere in medication management services; however, case managers can only access information on the other agencies their client has interacted with and when, but not details about that contact.

The database also identifies new matches of the identification number across providers daily; if an individual engages with a new service provider, the system autogenerates an email to all providers engaged with the individual. Providers can then choose to connect with the other agencies engaging with their client or use this information in their own case planning. For example, if EMS responds to a call for service, they log an impression of the reason for contact. If the individual is already in the system and has a case manager, that case manager will receive an email the next day to let them know that their client was seen by EMS, but it will not provide the reason for the contact. A medical provider, however, would be able to access the reason for the EMS contact based on covered entity access.

While MyRC is set up as a resource for human services agencies, community supervision also receives notifications if their client has contact with another agency.

Johnson County hired a HIPAA Privacy Officer to protect individuals’ health information and ensure the data are being shared in a manner that is compliant with privacy laws. The HIPAA Privacy Officer coordinates functions and policies between the county’s covered entities, investigates  potential breaches, files required reporting, hosts countywide training and chairs the HIPAA Steering Committee.

Additionally, MyRC has a public-facing service component. Johnson County integrated United Way 211 resource information from the entire state of Kansas and six surrounding counties in Missouri so that individuals or case managers can find and connect clients to resources like food pantries or shelters. The public-facing system also provides access maps and transportation information to all the services. MyRC is accessible to anyone with internet access; county libraries and community service centers offer public computer access to MyRC.

MyRC has been a valuable tool for helping Johnson County not only coordinate care and better serve individuals within the human services system, but also to collect data on gaps, barriers and challenges that inform policy and funding priorities.

JAIL MENTAL HEALTH SERVICES

Following the success of MyRC in serving individuals with behavioral health conditions, the Johnson County Sheriff’s Office implemented the Brief Jail Mental Health Screen (BJMHS) in 2016 to have accurate, accessible data on the needs of people with mental illnesses in the county jail. Using the BJMHS, jail staff report an average of 10 people screening positive for symptoms of serious mental illness (SMI) per day; this is about a third of all people booked. The sheriff used this data as the basis to implement a forensic team to provide mental health services in the jail.  The forensic team is a staff of six—four peer navigators and two administrators—that reviews BJMHS flags and daily bookings. The team has access to JIMS, MyRC, the jail’s electronic medical record (EMR) and the county mental health center’s EMR to identify people with an existing SMI diagnosis. The clinicians visit individuals that day, before first appearance, to determine whether there is a need for services and/or a new diagnosis.

The BJMHS data also served as the impetus for a jail reentry team that targets individuals with mental health conditions leaving the jail. The forensic team and sheriff’s office can make referrals, or individuals can request to meet with the jail reentry team. While the reentry team is geared toward individuals with a mental health diagnosis, it is not a requirement to receive services. Once a referral or self-request is scheduled, individuals meet with the reentry team to plan ongoing services and make appointments with service providers before exiting the jail. Individuals continue to meet with the team at the reentry office in the Community Corrections building next to the jail or in the community.

FAMILIAR FACES WORKGROUP

Johnson County’s Familiar Faces Workgroup was formed in 2022 out of the Justice Mental Health Workgroup to apply MyRC’s applications specifically to familiar faces within the community. The workgroup consists of the county’s programmers, epidemiology team, mobile outreach team,  mental health, corrections and county manager’s office. The Workgroup meets monthly to review and refine the familiar faces data algorithm that serves as the de facto definition of familiar faces, review gaps or barriers identified by the outreach team, engage with partner agencies and  prepare reports for the Criminal Justice Advisory Council and MyRC executive team.

OUTREACH TEAM

The mobile crisis response team (MCRT) is a staff of eight mental health professionals who respond to behavioral health crises within the community and provide targeted outreach and acute case management to familiar faces identified by MyRC. Once MCRT has a referral, they contact  the client by phone, postcard and/or visiting their home address. In 2022, MCRT provided acute case management for an average of 23 days while connecting people to services to ensure warm hand-offs and engagement with community providers. Connections and appointments may be  made with the Johnson County Mental Health Center, substance use disorder treatment providers, insurance, SNAP or other benefit providers and other providers within the community. 

NEXT STEPS

Johnson County has been tracking the number of BJMHS mental health flags since 2017, and in January 2022, the jail forensic team started tracking SMI diagnoses. Judge Robert Wonnell organized a planning summit to design a Behavioral Health Court that will use MyRC or JIMS to notify legal representatives of individuals with a mental health flag of their clients’ potential eligibility for the specialty court. MyRC’s access restrictions will ensure that the county is compliant with all HIPAA regulations by preventing the disclosure of a diagnosis during this referral process. Johnson County plans to launch the Behavioral Health Court in 2023.

NACo would like to thank Mike Brouwer, Criminal Justice Coordinator, County Manager’s Office for sharing information on Johnson County. Mr. Brouwer can be reached at Mike.Brouwer@jocogov.org.

This case study was created with support from Arnold Ventures as part of the Familiar Faces Initiative, seeking better outcomes and lower incarceration rates for individuals who frequently cycle through jails, homeless shelters, emergency departments and other local crisis services.