“Operating with a common communication tool (ServicePoint®), will allow our probation officers and care providers to be able to add to the record as appropriate, to build a coordinated care plan, and
see appointment information and progress status virtually.”
- Barbara Ritter, Project Director, Michigan State Housing Development Authority

Inmates are tasked to return to society as law abiding citizens upon release from jail. However, too many find themselves jobless, with nowhere to live and without a family support system. With these basic needs unmet, returning to a life of crime can become increasingly attractive, if not inevitable.

This reality led non-profit and governmental leaders in Michigan, the state with the third highest jail population in the nation, to come together to support prisoner re-entry by matching prisoners to resources at the local level through a program known as the Michigan Prisoner Re-entry Initiative (MPRI). Reducing the size of the prison population resulted in more people being held longer in local jails, and many of the same society re-entry barriers surfaced for those who exited the jail system because there wasn’t adequate coordination of care.

Like MPRI, the Muskegon Jail Diversion Project is designed to reverse the tide of rising recidivism rates for those exiting long jail stays. West Michigan Therapy, Inc., Muskegon Community Mental Health, 60th District Court, Michigan’s Statewide HMIS, the Muskegon Sheriff’s Department, the 13 HMIS participating service agencies in Muskegon, the National Human Services Data Consortium XML Workgroup, and Bowman Systems partnered to improve client outcomes by providing technology to support the intensive coordination of care that is essential for a successful program.

Barbara Ritter, Project Director, Michigan State Housing Development Authority, spearheaded this complex project. Specifically, Ritter said the goal of the new program is to improve outcomes for homeless persons leaving jail, just as the MPRI program sought to improve outcomes for those leaving state prisons. “The key component is care coordination,” explained Ritter. “It was challenging because our system of care was fractured, which means the client could go to four or five different agencies to have their multiple needs met. This can even lead to multiple disjointed care plans from the various providers. These plans can make it hard for clients to manage the array of uncoordinated objectives.”

Michigan utilizes ServicePoint statewide for its HMIS. “Unlike agency databases, ServicePoint offers a unique ability to share information,” Ritter explained, making it the obvious tool of choice for developing a single community wide care plan and service record for these fragile clients.

“Our vision is to use ServicePoint to create a virtual, real-time communication and coordination of care tool for all partners involved,” explained Ritter. To accomplish this, the group sought to achieve real-time or near real-time sharing among the HMIS partnering agencies and the justice system in a client centered way that addressed privacy concerns upfront. “This project has really tested our ability to combine information from multiple sources and create a common plan using XML,” noted Ritter.

Ritter said the group successfully completed a feasibility study and is in the final process of building the XML bridge between AVATAR (Muskegon’s Community Mental Health Database System), the OSSI (the Muskegon Sheriff’s Department Data System), and the Muskegon HMIS. “Operating with a common communication tool (ServicePoint), will allow our probation officers and care providers to be able to add to client records as appropriate, build a coordinated care plan and see appointment information and progress status virtually,” Ritter explained. “The bottom line is that we are able to use shared data to build bridges between providers and significantly improve outcomes to those we serve.”

Stacey Vandenberg, Chief Operating Officer for West Michigan Therapy, said the project is already proving to be an effective pilot program that is making a difference. “In a difficult economic climate where resources are low and the need is high, this type of program becomes even more important so people don’t fall through the cracks, and there is a system of care to match growing needs” said Vandenberg. “During the most challenging times is when you see even more innovative and creative programs like this one emerge. Our ultimate goal is to screen every individual that enters the jail system for a potential diversion.”

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