CTP Improving Adult and Youth Crisis Stabilization and Community Reentry Program (DOJ PIVOT)

The Crossroads’ Turning Points, Inc. proposes to implement the Improving Adult and Youth Crisis Stabilization and Community Reentry Program (PIVOT project). The purpose is to enhance multidisciplinary collaborations which reduce the risk of crisis and improve reentry and recovery outcomes for adult and adolescent patients, ages 14 and older reentering the community from incarceration, who have serious mental illness, substance use disorders and co-occurring disorders in Pueblo County Colorado, with the intent to expand services to 6-rural and frontier counties located in southern and southeastern Colorado in judicial districts 10, 3, 4, 11, 12 and 15. Project activities include sustaining a team of reentry care coordinators, behavioral health counselors and reentry peer navigators that will operate as part of a larger multi-disciplinary team.
PIVOT behavioral health professionals will assess criminogenic risks and needs to comply with probation, parole and/or specialty court requirements; administer screening and assessment for mental illness and substance use disorders, develop case planning and management plans, coordinate care and referrals to help with pre-release and reentry, crisis response and stabilization, cognitive behavioral therapies to address criminogenic risk factors, mental health and substance use disorder treatment, individual placement and support (IPS), outpatient groups, recovery groups, family-based counseling, opioid treatment programs ((OTP) formerly medication assisted treatment), and psychiatric medication management. Reentry care coordinators will act as liaisons establishing networks and collaboration with hospitals, community health centers, state and human service agencies, probation, parole and specialty courts in relation to client services, requirements and needs, document admissions, discharge and discharge planning, and facilitate life skills groups. Reentry care coordinators will organize and schedule referrals to address needs relating to medical and psychiatric issues, assist treatment team with client intake, transfer, and discharge assessments, when appropriate, collaborate with probation, parole and specialty courts to identify patient’s needs that include but are not limited to: food and nutrition assistance, housing support services, employment assistance, faith-based support, vocational training, education and GED support, childcare, transportation assistance, assistance is accessing health care coverage, cultural healing, civil legal assistance, primary health and mental health, and providing linkages as appropriate.
Patients will be supported by reentry peer navigators who will facilitate recovery coaching, recovery support services and mentoring. Expected outcomes include a reduction in incidence of crisis and recidivism. This project expects to serve an estimated 750 patients during the 36-month project period.