Discussions on Alluvion Health proposal for crisis response program ongoing

A group of healthcare providers, nonprofits, law enforcement and government agencies are attempting to create a community wide crisis response program to address mental health.

Alluvion Health has taken the lead and presented their concept to the Cascade County Commission in late February. Those commissioners voted to join the project.

On March 2, Trista Besich, Alluvion’s director, presented during the work session to City Commissioners, who had questions while recognizing the community need.

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The program will eventually come with a cost to the city and county governments, but Besich said that some of that cost has been funded by nonprofits in the community while Great Falls Police Department uses the bulk of the services and that the community is already absorbing the costs through law enforcement and the jail.

Besich said that a jail diversion plan had been in the works in 2020 and was awarded some grants, but the program didn’t materialize.

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There have been attempts over the years to increase access to behavioral health and create a jail diversion program, but most have had limited success due to lack of resources or connections and that the issue requires a wider community program.

The county had attempted to launch a pre-trial program, but without funding for a true program with community monitoring, the effort is essentially dead, according to Cascade County Attorney Josh Racki.

The program being proposed by Alluvion has been in the works for about two years, Besich said, and includes specific goals and the ability to collect and analyze data.

As proposed by Alluvion, the program would include a behavioral health provider at the jail for screenings, coordinating mental health assessments, reintegration services and more, Besich said.

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The program would also include a crisis response team that would be available to the community. Currently, the CRT, which is managed by the Center for Mental Health and staffed by the center and Alluvion, is only available through local law enforcement.

Besich said that $80,000 from Cascade County and in-kind donations from private entities funds the CRT and GFPD uses 93 percent of those services.

“I think that there’s starting to be some pushback at the community level that the other agencies fund the program that city uses the bulk of,” Besich said.

The program would also include staff for the city’s mental health court, which was established by Judge Steve Bolstad and has remained small due to lack of resources.

Besich said she recently hired the mental health court programs director at Alluvion.

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Besich said that large components of the proposed plan are already being done, but the idea is to integrate those agencies and services and formalize a community-wide program.

Commissioner Rick Tryon said that, “I see tremendous potential,” in terms of reducing law enforcement responses for mental health, but had some concern about the duplication of services and cost for taxpayers.

Besich said the plan is a $580,000 estimated scope of work and that they’d secured some funds from a Montana Healthcare Foundation grant and Alluvion was contributing already. The county has also signed on and she said she hoped eventually that the city would be willing to match whatever dollars the county contributes.

Tryon has been discussing concerns over crime in the city and during a January meeting proposed creating a panel to study crime and find solutions.

He’s scheduled to present his proposal during the March 16 City Commission work session, which is at 5:30 p.m.

Commissioner Mary Moe said, “this seems to me like a huge project” and that it was hard to imagine how complex it is and how many different agencies would have to be involved.

Moe said she had concerns about the complexity and since the city hadn’t contributed to these programs in the past, asked Besich what argument she could make to the taxpayer that the city should be funding the program.

Besich said there could be return on investment and cost savings overall through a reduced jail population and lowered recidivism rates.

“Not moving forward is kind of getting to a point of not being an option,” Besich said.

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Mayor Bob Kelly said that, “there’s enough mental health issues in this community to go around for lots of agencies to participate” and said commissioners had a letter that Alluvion had sent March 2 to the Center for Mental Health that Alluvion was no longer able to provide daytime staffing for the existing crisis response team.

Kelly asked why they weren’t leveraging that partner and whether they had the capacity to staff such a team.

Besich said that since Alluvion is proposing to stand up its own mobile response team that would be accessible by all agencies in the county that Alluvion wouldn’t be able to staff the existing team as well.

Kelly said he had concerns about the structure and accountability regarding any taxpayer funds the city would contribute.

Capt. John Schaffer of the GFPD said that they’d been working with the Center for Mental Health and Alluvion for several years with the crisis response team and they’ve seen improved outcomes.

He said that in the forthcoming GFPD annual report, commissioners and the public would be able to see how much mental health impacts law enforcement.

Judge Steve Bolstad of the Municipal Court, said that, “I see right now that this would be probably our best opportunity moving forward.

Sheriff Jesse Slaughter said that many people using law enforcement and mental health services end up in jail, which is a significant impact when it’s overcrowded.

The “jail diversion component is critical” to city and county, Slaughter said.

Throughout the presentation to the city and to the county the prior week, Besich said that the Center for Mental Health had opted out of participating in the plan.

Sydney Blair, the center’s director, told during the March 2 City Commission meeting that to her knowledge, the agency had not refused to participate and had recently sent a letter to the County Commission expressing their desire to participate.

She said the center had recently received a $4 million grant for crisis services and had told the county that they’d be willing to partner and share those resources for this project.

In late February, Slaughter told The Electric that the jail population was 425. The capacity is 372.

He said it was a manageable population, but expects it to trend upward with better weather. The population had dropped to near capacity during COVID.

Slaughter is currently working on implementing a work-release program, primarily for misdemeanor offenses, in a step toward a jail diversion program.

He said the program would involve sentencing offenders to the program, but they’d go home and report to the jail daily for work within county government or community nonprofit agencies. They would not be eligible to work for private companies, Slaughter said.

It’s essentially a community service program with direct supervision from corrections staff, Slaughter said, and as of now, he has adequate staffing.

Slaughter said he would present the plan to local judges since they’d need to agree to sentence people to the program.

Slaughter told The Electric that he’s spoken to City Commissioner Rick Tryon about his plan to establish a panel to study crime in the community and said that it will require a wholistic approach since there are ripple effects of adding more law enforcement officers that impact courts and the jail.

“It all relates,” he said.

County Attorney Josh Racki said that Cascade County has a high number of jury trials.

The county had the highest number of civil and criminal jury trials in the state in 2018, tied Yellowstone County in 2019, and was the second highest after Billings in 2020.

He attributes that to the fact that he tells his staff, “if a case needs to be tried, it needs to be tried.”

Prosecutors consider their ability to win a case when taking it to trial, Racki said, but he encourages his team to take it to trial even if they aren’t sure they can win because victims deserve to have their voices heard.

For court filings, Racki’s data shows:

  • 2019 violent crime cases: 224
  • 2019 crimes against persons cases: 823
  • 2020 violent crime cases: 261
  • 2020 crimes against persons cases: 951

He said search warrants spiked in 2020, but most other case filings are down and mental health cases were steady.

While the number of cases is down slightly, the number per attorney is high, in part because of the way the office divides types of cases and the number of attorneys available, he said.

The total number of open cases is increasing, Racki said, and “I think this part is a direct result of COVID.”

But over all, Racki said, “I don’t think our increase in cases is related to an increase in crime,” since the overall number of criminal cases trended down over the last year.

He’s supportive of the Alluvion proposal since a number of their cases involve mental health and quickly drain county resources.

Racki said that in his last budget, he had $20,000 for mental health evaluations and that fund was exhausted quickly.