County diverting some jail inmates to residential treatment

RAYMONDVILLE — Next to a senior center on Las Majades Ranch Road, there’s a beige building with a smaller façade lined with patio furniture.

It’s a quiet area. The loudest sound is the chirping of cicadas in the nearby brush. Wind turbines rotate at a leisurely pace in the distance.

Inside, there are 16 beds with sea foam green coverlets in eight tidy rooms. Inspired at La Jarra Ranch, as the facility in Raymondville is known, became home to its first five residents this past week as part of an agreement between Cameron County and the mental health services provider Inspired Behavioral Health, Inc.

It’s a first-of its-kind jail diversion program in Texas that people throughout the local justice system hope will curtail the number of people with mental illness, which has ballooned during the past year, who rely on lockup to meet their basic needs.

“The hope is this reduces the recidivism rate for Cameron County, because most of these individuals relapse through the cycle multiple times,” said Brandy Leonhardt, president of Inspired Behavioral Health, Inc. “Once they’re here, the hope is after they’ve completed the conditions of their PR bond, they continue to stay here.”

Cameron County will pay $55 per day for each patient’s first month of residence, she said, compared to the average of $120-$150 it costs to house an inmate with mental health needs in jail. Staff will help patients apply for social security benefits, allowing them to then stay for treatment as long as they need, she said.

That sets the program apart, Leonhardt said, because Medicaid limitations cause most residential mental health programs to require that patients leave after 120-160 days.

At Inspired at La Jarra Ranch, General Manager Fred Ballard said, patients will be cared for 24 hours by nursing staff, see their psychiatrist, get help sticking to their medications and have peer-to-peer support. Patients will be those inmates who suffer from conditions like anxiety, depression, bipolar disorder, schizophrenia and others.

“A lot of facilities can’t treat that without multiple jail or ER visits,” Ballard said.

RESPONDING TO THE NEED

Dean Garza, infirmary supervisor for the Cameron County Sheriff’s Department, said he knew the jail would see an increase in its mental health population when he learned Valley Baptist Medical Center would close its behavioral health facility in August 2017. He sent a mass email for others in the jail to prepare for the influx.

Since the closure of the so-called East Campus, the number of inmates who have mental health needs rose from about 16 percent to nearly 50 percent, he said. Told another way, that’s about 500 out of 1,100 inmates in Cameron County jails. The passage of the Sandra Bland Act requires county jails to ensure that inmates have access to mental health care.

For the first time in 18 years, Garza said, his department ran out of money in its medication budget by June. Some are $4 per pill, he said, and other medications are as high as $1,500 per month.

Garza described how inmates with severe mental illnesses are caught in what seems like an insurmountable cycle. If a judge orders them committed to San Antonio State Hospital or Vernon State Hospital, they are placed on a waiting list that is 12 months to 15 months long.

However, inmates serve their time on misdemeanor charges typically in 60-120 days. Once they’re released, they lose their place in line, he said. The same process starts again if they are rearrested, and they’re not held in custody long enough to make it to a state mental facility.

Garza said the fastest-growing population with mental health needs is veterans who self-medicate with drugs or alcohol.

“There’s really no place to put a veteran who does not belong in jail, especially if it’s a non-violent crime,” he said.

While Garza said he can’t forecast the outcome of the partnership with Inspired Behavior Health, he said the county has to try something.

“I envision other counties calling us and saying, ‘How did you do it?’” he said. We have to go way above to make sure we get these people the help they need.”

LOOKING FOR ANOTHER WAY

Judge Estela Chavez-Vasquez took the bench at County Court-at-Law No. 5 in January. During that time, she has seen some misdemeanor defendants clearly suffering from a mental health issue. The problem for the court system is there is a lack of resources to help stabilize these defendants so that they can understand the consequences of what happens in court, she said.

“I don’t feel it’s delivering justice when someone sits (in jail) longer than most because of the mental illness they have,” Chavez-Vasquez said.

She said many such defendants face trespassing charges or are arrested after they break into a car during winter. Some are charged with resisting arrest when they become aggressive due to their mental state, she said.

Chavez-Vasquez said another concern is that defendants who isolate themselves as a symptom of mental illness may not speak out and ask for an attorney who can argue on their behalf for reduced bond.

“Instead of sitting incarcerated, (they can be) sent to La Jarra Ranch under bond restrictions,” she said. “They can get help taking care of themselves and be productive members of society. The goal is to reduce occurrences of them reoffending and get them on a path to be a law-abiding citizen.”

NEW PATH

Leonhardt said she will be able to work with the jail’s mental health counselor to identify inmates who would benefit from Inspired at La Jarra Ranch and ask them if they would like to participate in the program. Unlike group homes, the facility would help them learn to manage their finances, ensure they stick to their treatment plans and see their doctors.

“If they have side effects or issues with medications, we have access to medical staff to quickly change or alter those medications to help with those side effects,” she said. “More than likely, we are able to prevent a crisis prior the crisis happening.”

Leonhardt hopes to expand the facility to accommodate more patients in the future. It’s a humane approach to helping them transition back to independence, she said.

“But if they can’t, they will always have somewhere to stay,” she said. “They don’t have to go to jail to get meds.”