Public Health and Safety Transition Committee Report Final
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Public Health and Safety Transition Policy Committee Report Presented to Mayor Alvin Brown August 8, 2011 Committee Members Nat Glover, co-chair Nancy Soderberg, co-chair Charles B. McIntosh, M.D. Larry Osborne Ray Alfred Dr. William Rupp Tommy Chandler William R. Russell, Jr., M.B.A. Tad Delegal Dr. Michael A. Rutledge Kevin Gay Dr. Shelly Thompson Jeffrey Goldhagen, M.D. German Vivas Rev. Tommy Rodgers, staff Alice Checorski, staff 2 Table of Contents Executive Summary Report List of briefers Selected Documents submitted 3 Executive Summary The Committee members thank Mayor-elect Alvin Brown for the opportunity to serve on the Health and Public Safety committee. Our charge was to provide recommendations to him in these areas. Simply put, we must do a better job in both. The City of Jacksonville is a great city in which to live -- but not for all of its residents. The Mayor has a real opportunity to expand the participation of citizens in efforts to improve this city -- and to meet the challenge of making sure the City works better for the minority and disenfranchised citizens who deserve better. While our police and fire personnel are superb, bureaucratic and funding challenges prevent adequate services and put our citizens at risk. The health and well-being of our citizens is shockingly poor in comparison to other communities in Florida and the US. And, health disparities continue to worsen. We can and must do better. One particular challenge is the need for additional revenues in these areas from local, state, and federal levels. We hope these recommendations initiate a frank and honest discussion on how to make Jacksonville a destination city by providing the best in both health and safety for all our citizens. We extend our great gratitude to Reverend Tommy Rogers for his assistance throughout this process as our invaluable staff member, as well as to Alice Checorski for her tireless and accurate note taking. We also want to thank Ryan Clarke who, as a member of the public, provided invaluable assistance to the production of this report. We offer the following recommendations to Mayor-elect Alvin Brown: 1. Public Health 1. Establish a Health Council composed of key stakeholders from all relevant public, private and academic sectors, including consumers. This council should have six areas of responsibility. First, examine opportunities for revenue maximization. Second, generate relevant policy, develop systems-of-care, and position the region to affect optimal health and health-related economic outcomes. Third, support the mission of the Duval County Health Department, local hospitals, and community organizations working towards the total health and well-being of the citizens of Jacksonville. Fourth, support increased access to community-based mental health and substance abuse treatment. Fifth, support increased access to community- based youth mental health and substance abuse treatment. Sixth, review the costs to the City of Jacksonville of the dual-eligibility of public health programs at the local, state, and federal level. 4 2. Appoint a Child and Youth Ombudsperson and launch an effort to certify Jacksonville as a Child Friendly City. Established by UNICEF nearly two decades ago, the Child Friendly Cities movement has transformed cities and the health and well-being of children around the world. The evidence-based precedent and tools required to implement this endeavor are available through UNICEF and hundreds of communities worldwide. Additionally, the resources of the European Network of Ombudspersons for Children are available to develop this position and function, as is the experience of more than 120 countries worldwide. The Child and Youth Ombudsperson would lead this endeavor. II. Public Safety A. Criminal Justice & Safety 1. Establish a Criminal Justice and Safety Task Force composed of key stakeholders from all relevant public, private, faith-based, and academic sectors including private citizens. The ultimate goal will be the development of a “continuum of care” to help insure the successful transition of men, women, and youth as they return from prison or jail. The incorporation of best practices will allow the City to bring in the “best of the best” platforms in re-entry. The Task Force will also be tasked with evaluating the current re-entry structure and make recommendations to the Mayor as to how to create the “national model” for prisoner re-entry. The Task Force should be responsible for the following five key areas: First, lift up re-entry as a priority platform in the new administration by establishing a five-year plan aimed at dramatically reducing recidivism. It should include ways the Mayor can use his statutory authority to reduce barriers to employment, housing, and healthcare for ex-offenders. The Task Force will provide critical feedback during the development of a comprehensive “systems approach” to re-entry. Second, encourage community and faith-based organizations to support this initiative through mentoring and volunteering. Third, explore seeking additional dollars to supplement current and future appropriations requests for the Juvenile Assessment Center (JAC) as a critical element of the Jacksonville Journey. Fourth, explore ways to maximize the efficiency and effectiveness of the delivery of services to victims, which would facilitate the acquisition of public and private resources and cost effectiveness. Fifth, seek opportunities for revenue maximization. 2. The City of Jacksonville (COJ) should utilize any transfer of knowledge and capability concerning Continuous Improvement (CI) methodologies from the Jacksonville Sheriff’s Office (JSO), the Jacksonville Lean Consortium, and the larger CI/Lean community. JSO has enjoyed widespread acclaim and reaped very large benefits from a relatively modest, lightly funded and staffed CI/Lean effort. We recommend that JSO expand and broadly duplicate CI event capabilities from a small expert boutique into all departments, divisions, and units where practical. COJ CI/Lean experience to date has been quite positive but extremely limited. Only a 5 handful of events have been done, but each validated the methodologies. JSO’s experience speaks to the enormous potential for savings in a city-wide, full-scale implementation of these philosophies and practices. Historically, no other combination of measures has produced the ongoing harvest of customer and employee satisfaction, efficiency, effectiveness, and waste reduction of a robust top-to-bottom CI/Lean philosophy. B. Jacksonville Sheriff’s Office 1. Maintain a continuous dialogue between the Office of the Mayor and the Office of the Sheriff, including topical stakeholders and technical experts when necessary. 2. Where safety and savings are impacted, direct purchase authority should be available. 3. Review the fiscal case for having the COJ manage large portions of the JSO/IT infrastructure against the Sheriff’s strong concerns for maintaining both operational control and data security of his second most valuable resource, and the one by which he manages the efforts of the first. 4. To continuously improve data utility, JSO must train managers how to use data to improve efficiency as well as how to provide feedback to the data provider. C. Jacksonville Journey 1. The Mayor should engage personally to maintain and expand the outstanding track record of this program and continue to provide the Jacksonville Journey Oversight Committee (JJOC) the tools it needs to carry out its mission. 2. Seek out additional funds, both through revenue maximization and the vigorous pursuit of additional dollars outside of the general fund to supplement existing funding. In particular expand the Juvenile Assessment Center (JAC), evaluating Miami’s facility as a possible model. The re-opening of the JAC in 2009 has provided a valuable contribution to the success of the Jacksonville Journey. Originally funded by a state grant, it is now funded solely out of the city’s general fund. This highlights the need for the Mayor to maintain a vigorous pursuit of funds to supplement current and future appropriations requests. 3. Reach outside the sphere of current participants and engage more community leaders to ensure the longevity of the Journey. The reach of the program tends to include the usual participants. A broader reaching, more diverse participant makeup of both the committee and the programs would benefit Jacksonville. Therefore, in the interest of the long-term success of the 6 program, the Mayor should make it a priority to expand the pool of stakeholders and bring more perspectives to the table. D. Jacksonville Fire & Rescue Department (JFRD) 1. Pursue additional sources for revenue maximization to fill gaps in fire service, particularly in the area of health. There are federal grants and private funds available which should be sought and utilized. Among these for Jacksonville Fire and Rescue Department (JFRD) are SAFER (Staffing for Adequate Fire and Emergency Response), Fire Prevention and Safety grants, assistance to fire fighters (FIRE Act) which purchases equipment and other such programs. Federal grants are also available for fire station construction. The Obama administration’s elimination of many restrictions and requirements in this area provides a new opportunity for the Mayor to seek additional revenue. 2. Identify and utilize professional and industry standards in setting the priorities of the JFRD. These standards can be found at the National Institute of Standards and Testing (NIST), National