Assessing Risk through Multidisciplinary Models

Sarah Henry: Welcome to this DV RISC podcast series on the use of intimate partner violence (IPV) risk assessments and models in different settings.  Today’s episode is focused on assessing and managing risk through multidisciplinary models.  My name is Sarah Henry.  I’m a senior attorney with Ujima, Inc.  And my partner in this podcast, hosting today, is Michelle Toledo Cainas.  She is a Program Manager at the Center for Justice Innovation, and we’re your hosts for today’s episode.  Our guest speakers for today are Beth Meeks, Dottie Davis, Kassondra Seyfert, and Becky Bullard.  

Beth Meeks is the Director of the Capacity Technical Assistance Team at the National Network to End Domestic Violence, NNEDV.  She has spent 30 years working in the field of gender-based violence with both victims and offenders.  She has specialized training in hostage negotiations, media relations, and risk assessment, and has provided expert witness services for the battered women acting in self-defense.

Deputy Chief, Dottie Davis (retired), is a nationally-recognized speaker who previously served 32 years with the Fort Wayne Police Department, where she attained the rank of Deputy Chief and was last assigned as the Director of Training at their police academy.  She implemented and wrote policy for the agency for the lethality assessment program.  As a consultant, she focuses on violence prevention, as well as expert witness testimony. 

Kassondra Seyfert is employed by the Ulster County District Attorney’s Office and has been the Project Manager for the Intimate Partner Violence Intervention (IPVI) at the District Attorney’s Office since 2017.  Kassondra has worked in collaboration with Ulster County partners, including police departments, assistant district attorneys, probation, parole, crime victims assistance program, and various service providers and community members to form the Ulster County IPVI Task Force. Becky Owens Bullard is the Deputy Director of Programs for the Nashville Office of Family Safety (OFS), where she oversees OFS’s two family justice centers’ client services, national and statewide training and technical assistance, and citywide multidisciplinary teams examining high-risk, interpersonal violence cases.  Ms. Bullard is also a consultant for the OVC TTAC and has worked nationally and internationally on issues of interpersonal violence, including creating the Human Trafficking Power and Control Wheel. 

Michelle Toledo-Cainas: We’re going to start off with a broad discussion on multidisciplinary models to assess and manage high-risk IPV cases, and we’re going to start with Beth.  Beth, what does it mean for community and system agencies to come together and manage high-risk intimate partner violence cases?  

Beth Meeks: It means that some configuration of people in the community who are intervening in domestic violence issues come together to reduce the level of risk in cases in their community.  It’s a version of coordinated community response.  There are multiple ways to do it that depend on sometimes the size of a community, their resources that are available to them. It includes a group of people -law enforcement, court personnel, probation, advocacy personnel, sometimes mental health personnel, prosecutors, sometimes child protection personnel-and there are a variety of models.  

Some people do something comprehensive like choose some risk assessment that they implement at certain points in the system that trigger behavior by actors in the system.  This would be a protocol that everyone’s met and agreed to.  Ideally, they would be checking up on whatever system they’re using occasionally, they’d be meeting regularly to do that.

And some people use much more, intensive high-risk management. So you can have a high-risk team that meets every month that has a system for flagging in people that they believe are high risk. Like wraparound case management where the system players would review individual cases, look at the risk factors, talk about interventions that would reduce the risk factors, assign those to various people on the high-risk team, monitor not just the behavior of the offender, but the safety of the victim, resources that the family might need that would reduce some of the risk that they’re facing.  

There’s a broad continuum of how to manage high-risk cases, and it looks slightly different in every community.

Sarah Henry:  Dottie, I think you have some opinions on the benefit of this multidisciplinary approach.

Dottie Davis:  I think by bringing people with different backgrounds and areas of expertise to the table, you have many lenses that the situation will be viewed from.  And when you bring advocates to the table or forensic nurses to the table, just two examples, they have an area of expertise that law enforcement does not possess.  They have the ability to have other resources that law enforcement does not have at their disposal, and vice versa-law enforcement brings to the table a lot of other areas of expertise. 

So, having those individuals at the table to be able to discuss how they see the situation from their perspective, from their training and experience, and then talk about what is in the best interest to protect the survivor of domestic violence from a potential homicide, having that discussion is so much better than officers having to respond when it’s too late. The one thing we’ve learned in law enforcement over the years, yes, we have an area of expertise, but we cannot do this by ourselves. It is a community-wide initiative that successfully works to help our survivors.

Michelle Toledo-Cainas: And on that note, can you let us know why are law enforcement agencies are interested in engaging with multidisciplinary models for high-risk intimate partner violence cases? 

Dottie Davis: Agencies want to know what’s happening in their state, what’s happening in their county.  And so, when you’re able to provide that data to them and you can show them that their homicide rates, their felonious assaults, not only on our victims of intimate partner violence, but also on law enforcement. When you show them how it’s impacting them as a law enforcement officer responding to these calls for service, as well as, we have the initial victim, but we may also have multiple victims within that household.  

So, then, you start talking about the children, you start talking about the correlation with sexual assault and with animal cruelty, all of that information is like an aha moment for law enforcement to see that, there’s so much more to this that we’re not aware of.  We are only seeing this much of it when we’re on the scene for that short period of time.  So having this multidisciplinary approach allows them to see the multiple types of crimes that are correlated with intimate partner violence, it allows them to see the resources that really need to be dedicated, as well as the seriousness that should be afforded to these types of calls for service.  Collaboration is key for us to reduce those homicides in our communities.  Without that collaboration, all we’re doing is responding over and over to a call for service.  And when I have officers tell me, “Oh, I’m just tired of going back to that same house over and over again. “My question always is, so “What are you missing? What aren’t you figuring out, and what resources do you need to get that information?” And that means we have to look at community resources.  

And sheriffs and chiefs will ask me, “What’s this going to cost me?” And my answer always is, it’s going to cost you a lot more when you’re responding to a death.  So front load it with all this stuff from the beginning.

Michelle Toledo-Cainas:  And I think you touched a bit on this, Dottie, but can you give us an example of how we can increase that buy-in through law enforcement agencies who are not interested, in participating in multidisciplinary models?

Dottie Davis: I love to find the example, the agency that’s doing it really well, and show them their success rate.  I’ve also taken agencies that were using a risk assessment tool and was able to demonstrate how their homicide rate, when it related to intimate partner violence, had been reduced by nearly 50 percent, and then they stopped using it, and that year alone their homicide rate related to IPV went up 35 percent.  So when I’m able to show them data, graphs, and it’s reality, chiefs and sheriffs have a tendency to set up a notice.  And if they can speak with another chief or sheriff who has implemented a best practice, that adds a lot of credibility to the work that we’re trying to accomplish. 

Sarah Henry:  Beth, are you seeing any trends in the field when it comes to assessing and managing risk through multidisciplinary models?

Beth Meeks:  Yes.  I think probably one of the main trends that we’re seeing is what motivates a community to begin doing this kind of work.  One of the things that is a major motivator is resources, resource management, there are limited resources. The community sees a lot of these kinds of cases. They want to know where to focus their energy and, and where they can use other sorts of community-based programming.  A lot of this idea of resource management falls on the back of the judiciary.  So we very often see judges who start with the question, “How can I do this better? How do I know who to focus on when I have limited resources and limited time?”

Most communities start with some risk assessment. One of the things that I have noticed in the field over the last 15, 20 years is that risk assessment was pioneered by the social servicing, psychology community, and so there were these long questionnaires that were maybe 40 questions. And the field really heard law enforcement and the judiciary when they said we don’t have this kind of time. If we’re going to assess risk, we need something that is shorter, that is easier to use in the field.  And I do think, now, there have been a couple of models like that that have emerged. So those are more user-friendly to law enforcement, judges, and they’re using those tools.  

We’ve had probation departments writing up risk assessments of offenders, and what we have learned is that many of the general criminogenic risk assessments that we’ve been using for decades do not surface the issues that are prevalent in high-risk domestic violence offenders. So the idea that the community even understands that and knows that they need to be using a more appropriate tool is a corner that a lot of communities are now turning.

Unfortunately, one of the trends is that, even communities that are doing some risk assessment often only move to more intensive high-risk assessment after an incident.  Maybe there’s been a homicide, maybe something has happened in a nearby community. Those are all trends that we see in the field at the moment.

Michelle Toledo-Cainas:  Dottie, from the law enforcement perspective, how can multidisciplinary teams and models better reflect the diversity of the communities in which they are operating in?

Dottie Davis:  Law enforcement agencies that are actively working to build trust and legitimacy with their communities recognize that they have to bring to the table individuals who do not look like them, who may not speak the same language, who have a different cultural lens, so that they understand the needs of the community and how best to respond to calls for service. And building those relationships beforehand helps with successful outcomes with their investigations. 

So through a procedural justice initiative, those agencies that are actively engaged with their community see the benefit of those multidisciplinary teams. They see that if they build those relationships beforehand, they can build not only legitimacy, but they also have community members who are willing to call the police, they’re willing to support the police, and so the multidisciplinary teams become representative of your community through those resources that you’re building through that procedural justice initiative. It’s just such a ripple effect.  

Agencies that are doing it well see the benefits. And I just use the example of civilian police academies. When they bring civilians through that are multidisciplinary, that are from multicultural experiences and backgrounds, it is a much more robust conversation and a learning session that people walk away and they build better relationships that are long-term, not a one and done. They actually practice it.  

Sarah Henry: I’m sure that there are some common questions that are floating around about this topic area. Beth, are you receiving any questions that are similar from community and system agencies wanting to utilize multidisciplinary models?

Beth Meeks: One of the teams at NNEDV is funded to provide technical assistance on confidentiality. And like any sort of multidisciplinary endeavor that’s actually intervening with clients, there are lots of questions about confidentiality and when to share information and how to share information.  

Some of that can be managed by different actors in the system have different confidentiality layers, some of the people in the team might not be able to share as much information and others could about specific cases. Sometimes, some of the people in the room, like a domestic violence advocate, might be there. She or he might not be able to offer a lot of specific information about specific cases. You can go through the process of getting permission from clients to funnel their cases into a high-risk caseload. If you don’t have the specific permission to talk about their situation in one of these multidisciplinary teams, an expert like an advocate can at least be helpful in guiding the team, saying, “Based on what we’re seeing here, here are things that perhaps we should evaluate, here are actions that we should perhaps take or interventions that we should make.” So whether or not some of the people in the room can speak to individual characteristics of a case, they may be useful in other ways for the people who can talk about case specifics.

I have had the question, “If law enforcement are here and mental health people are here, why do we need a domestic violence advocate here?” And the reality is that what law enforcement know and what mental health experts know leaves a gap. There is a gap in understanding about what behavior looks like when it unfolds, the effect of a behavior on a victim. There are a lot of nuances in relationships, and those are not things that mental health experts generally speak to, or law enforcement advocates. And, so, there is a gap in information if you don’t have an advocate who can look at a whole context and provide you some sort of interpretation of what they see happening. 

Dottie Davis: The other thing that really has benefitted by having multidisciplinary teams is you’ve built those relationships with individuals. So, for example, an advocate reached out to me and said, “We’re seeing a problem with officers not understanding predominant aggressor and we’re seeing dual arrests have picked up. And officers seem to have a difficulty with understanding defensive wounds and injuries. Do you know any resources that you could help me with so we could provide that training for our law enforcement officers?” And, so, I was able to immediately respond back with, here are some resources. We have a meeting with this team member on Monday, so it’s going to be a great conversation for us to follow up on it.

Beth Meeks: A Typical question that I get is that a community will make up its own risk assessment, and then send it over and say, “Can we use this”? And I tell people, please do not make up your own homemade assessments, you’re still typically dealing with the court system, and there are rules around the evidence. So what you don’t want to do is use a risk assessment that has no research to it, and then have that thrown out of court and have your ability to manage a high-risk offender also invalidated.

There are a lot of assessments that have been researched and validated, and those are the kind of things that you want to lean on. We don’t want to reinvent the wheel here. When we’re making things up from our own perspective, they are very often not culturally sound and they inherently integrate race and culture bias. So, again, we need to be using risk assessment and management tools that have been tested, and tested in multiple populations so that when we’re identifying people who are high-risk, we’re doing that without compounding all the racial bias that’s already existing in that system.  

Sarah Henry:  Dottie, I think you had some additions here?

Dottie Davis: Yes. Along with the training, is I will have agency heads say, “Do we really have to include advocates in the training?” And I’m like, we’re talking about a collaborative effort to protect our victims, and police officers are not trained in safety planning. We’ve trained them to inform people about how to get a protective order. But those of us who work in advocacy know that maybe that isn’t the best tool for that person’s safety, and so I explain to them, it has to be a collaborative effort.

Sarah Henry:  Thank you, Beth and Dottie, for those fantastic points. I want to shift the focus of our discussion a little bit to include practical examples of high-risk intimate partner violence and multidisciplinary models to include some site perspectives and also to incorporate our other speakers today, Becky and Kassondra.  

Michelle Toledo-Cainas: So with that being said, Becky, can you describe how you’ve been using a multidisciplinary model to assess and manage high-risk intimate partner violence cases in your community?

Becky Bullard: In Nashville, we have a high-risk model that is called our High-Risk Intervention Panel, which is a multidisciplinary team that has been in existence since 2013. And this team model is built off of two assessments that are administered in Nashville, the lethality assessment protocol administered by our police department and the danger assessment that is  administered by our service provider community. And this team involves partners from police, the DA’s office, the courts, probation, social services, children’s services, and all of our non-profit partners who are working on interpersonal violence. 

So cases from the LAP, the danger assessment, and from our partner referrals, all funnel to our panel for weekly case review. And then we also do a monthly case review follow-up on those highest risk cases from our weekly call.

Michelle Toledo-Cainas: Can you describe how you’ve been using a multidisciplinary model to assess and manage high-risk intimate partner violence cases in your community?

Kassondra Seyfert: So we have implemented the Intimate Partner Violence Intervention, which is a strategy that was designed by the National Network for Safe Communities. Our  team consists of law enforcement, prosecutors, crime victims’ advocates, probation or parole, and we meet biweekly to discuss all of the cases that have come in in our respective participating jurisdictions. We discuss all of our high level cases about what is the best way to proceed with this particular defendant based on the charges. And even if there aren’t charges, but we’ve seen these individuals be repeat with no charges. We track that, we engage in conversations about how law enforcement and the partners can intervene, what information everybody that is sitting on this task force has about this particular individual. If need be, we reach out to the crime analyst and we use the crime analyst to run that data to give us some other things that might have been going on. Just so we can paint a better picture of how to intervene.

Sarah Henry: Would the two of you mind sharing the process you went through to select or implement your model?

Becky Bullard: In 2011, Nashville underwent a safety and accountability assessment based on the Praxis model. And during this assessment, it was clear that we needed a better system for our high-risk cases and case review. So, in 2013, our police department decided to create our high-risk intervention panel to meet that recommendation from the assessment. However, the problem was we didn’t have an evidence-based risk assessment at that time. Back then, we had a kind of homemade risk assessment in Nashville. So, what ended up happening in those initial case reviews is we had a handful of cases each month that our police partners would bring that were kind of the cases that were giving them some issues, but weren’t necessarily based on those highest risk indicators.

So, in 2015, my office was created, the Office of Family Safety, also from a recommendation from the safety assessment. And what this gave us was some new initiative around high-risk cases. We were able to secure some federal funding, which hired my position in the office, to implement the lethality assessment with our police partners, and then to also work on our high-risk panel.

So, in my role, I kind of looked at how I could upgrade our panel meetings and I set out to meet with all of our high-risk intervention panel members to talk with them about their feedback on how meetings were going and what we could improve. I also brought in examples from other jurisdictions, because I feel like that’s always a great way for people to understand what kind of options there are out there.

I also went to a training with the Jeanne Geiger Center and heard about their model, and that was really helpful to understand their work. So we looked at how we could kind of shift and what we needed to do to make sure that our model would work and would function for our community.

So, by December 2016, we implemented the lethality assessment. And we realized that, with our lethality assessment, we were seeing over 250 high-risk cases a month in Nashville. So that’s too much for us to review. But we worked with our team and we looked at what our screen-in rate needed to be to be able to get those cases onto panel. For example, we started with a rate of seven or more, which is the rate that you see in the DA-LE assessment, or the DA-LE. And we looked at that rate and said that would still give us 30 cases per week. It was too high for our partners. We had to listen to our partners when they say that’s too much, we don’t have the capacity.

So we settled on screening in those highest risk cases with nine or more yes answers on the LAP. The LAP is an 11-question questionnaire, so that’s a very high rate. But we also screened in cases that came to us based on the discretion of our partners, if they see a case that they felt like needed to be on panel, as well as those cases that screened in in the danger assessment used by our service providers.  

So we shifted our monthly meetings, once the LAP was implemented, to weekly meetings where we’re reviewing anywhere from 15 to 25 cases. And that’s how we’ve been operating the last seven years.

Sarah Henry: How about you, Kassondra?

Kassondra Seyfert:  So the process to select this model is actually an interesting one. The Division of Criminal Justice Services in the State of New York looked at the City of Kingston’s high aggravated assault rate. They dug deep into it and they said, wow, all these aggravated assaults, a lot of them are domestic violence-related. We have this intervention that happened to be the Intimate Partner Violence Intervention out of John Jay College, the National Network for Safe Communities in Manhattan.

So, prior to me getting hired, they all went down to what they call the IPVI University and it was a full team of people from all of the disciplines that I had mentioned before, and they were like, we can do this.  And so they hired me, and then the task was building the team structure, developing protocols for each of the departments. So that there was a system in place and we were creating sustainability if someone moved on from within the organization. And a year later, we were ready to fully implement, and then we started identifying, classifying and notifying offenders. So this intervention is with a large focus on victim safety. When the police officers go to a scene and there’s a domestic incident report that is generated, the sergeants in the station review it and they assign it a classification level. Once that classification level is given, an entire packet, including the DIR, the domestic incident report, accusatory instruments, possibly even the criminal history, gets scanned to and sent to our intimate partner violence intervention email. So all of these partners are on that email, so we’re getting this information in essentially real time, which, in turn, gives everyone an opportunity to respond. If the person is on probation or parole, those officers can respond. It gives the prosecutor the information. If they’re about to get called for a bail argument or they’re, that defendant is going to be in court the next day, they have this whole packet of information to be prepared, and it gives our task force some time to respond. We continuously look at our criteria to improve and adjust to the best of ability so we’re meeting the needs of our community. 

Sarah Henry: Do either one of you want to offer up any information on your selection of project partners?

Kassondra Seyfert: The National Network for Safe Communities has an existing framework. IPVI was born out of their group violence intervention, so they had that structure already in place and they altered it to encompass intimate partner violence.

And, so, we selected the people that were involved in the criminal justice system that could support this intervention holistically.

We also have extended task force members that are not on the calls with us biweekly, which is community members, service providers in the community. We continuously look at that and try to bring those individuals on as well

Becky Bullard: We have our law enforcement partners, our initial partnership was with our domestic violence division, because the domestic violence division was our intimate partner violence focus. But, over time and because of our understanding of the intersections of different forms of abuse, we really wanted to bring in our police partners from our sex crimes division, our human trafficking division, our youth services division, and make sure that we had a kind of cohesive effort there on the law enforcement side, as well as with our prosecutors, making sure that we have diverse prosecutors that are showing up to the table, and our non-profit partner community, as well. So we do have non-profit partners who attend our meetings, and I want to make sure that those are as representative as possible of the interpersonal abuse victims in cases that we’re hearing about.

Michelle Toledo-Cainas: Becky, do you mind sharing with us a bit more what the structure of your model in your community looks like? 

Becky Bullard: So the Office of Family Safety runs our High-Risk Intervention Panel, and we have a High-Risk Intervention Panel coordinator who receives the data from the lethality assessment from our police department every day, and they analyze that data and look for all of those highest risk cases based on their score, and those cases will funnel to panel.

This coordinator also receives referrals from our service providers, and that includes service providers within our office. We have advocates and case managers who are administering the danger assessment to our clients. If those clients screen in on the danger assessment with severe or extreme risk, we automatically ask them about the High-Risk Intervention Panel and if they would like their case to go to panel. We explain what panel is, who’s on panel, what panel can and can’t do. And then they would sign a release of the information, if they’d like their case to be referred.

And then, finally, we can receive referrals from any of our agencies. So let’s say the District Attorney’s Office had a case come before them that was really concerning. It doesn’t have a danger assessment or lethality assessment associated with it, but they would like to review that on panel. So we compile all of those cases and send those out before our weekly call to let everyone prep for those calls. 

And one of the things that happens between the time of the call and when we get the cases is our advocates will reach out to any of the individuals that are listed as victims in the criminal case that we haven’t already served before and ask them if they would like services.  And also inform them about panel. So if they didn’t come through us for a referral to panel, we want to let them know about panel the best that we can. And then we all get together for our weekly call. We have all of the partners that I had mentioned again. Our office reads a summary of the case. Police go next, and they talk about any detective that’s assigned, any contact that they’ve had, the status of warrants. The DA’s office then talks about any court dates, prior criminal record, current probation, any contact that they’ve had.

Our office will then also read out information about any existing or past orders of protection, and this is a really important information bit, because you’ll bring in information that doesn’t exist in that current criminal case. So maybe we’ll find out that there was a sexual assault or the offender is gang involved, so bringing in just as much information as we can.

And then, finally, it’s our service provider’s turn to share any information they have through a release of information. And I wanted to mention, to Beth’s point earlier, the service provider’s role in that room is also to provide their expertise. So they’re there to be able to help the group navigate and understand some of the barriers that person might be having in reaching out for services, even if they’re not able to share. They also can take the information from panel and bring it back from their clients, so it’s a really important role.

Then, all of our partners discuss any action items, ideas for follow up. And then we also will flag cases for a number of different high-risk factors: strangulation; sexual assault; if there is extreme risk; if they’re a repeat offender; if there’s potential trafficking. And then we may refer that weekly case for a monthly review.

So that’s kind of how our panel works, we send out notes, make sure everybody is on the same page and ready to move forward.

Michelle Toledo-Cainas: Kassondra, any thoughts?  

Kassondra Seyfert: Yeah. I know that I had spoken about how the police departments identify, classify and notify the offenders, so what happens on the other end, as soon as that information comes out, our Crime Victims Assistance Program provides a parallel victim notification to let the victim survivor know what their offending status is looking like. And anytime that offender elevates throughout the process, the Crime Victims Assistance Program notifies them. They track their calls to the victim, unless there’s a safety concern, they send out a letter to the victim as well.

And it’s similar to what Becky’s talking about. That’s essentially how our meetings are run. Everybody is present. We contribute the information. We’ve done a lot of brainstorming regarding what sanctioning looks like for an offender, so if we don’t have a criminal case and it’s unprosecutable, what else can we do as a task force to interrupt that violence? What other things are going on with this offender? Do they have other pending cases in the county that we’re going to prosecute? We know this violence is happening, but we don’t have a domestic violence case right now, but we are going to prosecute. Even if it’s a misdemeanor, we’re going to let this offender know that  we’re holding you accountable for your behavior.

Sarah Henry: Thanks for that, to the both of you. I want to pivot just a little bit and ask you, in what ways are the members of your multidisciplinary team reflective of the diversity of each of your communities? Becky, I’ll let you go first.  

Becky Bullard: I think it’s really important for teams to include partners who are doing direct work with people who are experiencing abuse, and also those individuals who are responsible for holding offenders accountable. So you’ll see some teams around the country, whether they’re working on domestic violence or sexual assault or child abuse, that might be really insulated to just a handful of agencies. And I think something really special about our High-Risk Intervention Panel is that it’s expansive. We want to make sure we have a number of people at the table who are working on this issue and who could be covering diverse aspects of the issue.

So I had mentioned this a little bit previously, but we really look at the intersection of intimate partner violence and other forms of abuse. And it’s really important to go beyond intimate partner violence and understand the polyvictimization that our clients are going to be experiencing, making sure that we have agencies at the table that can help us identify that and can also help support those clients. So we have people around our panel table who specialize in sexual assault, in child abuse, in human trafficking, as well as individuals who are coming from the police department now. So it’s important to have a really broad team.

And, then, our service provider community is very diverse in Nashville. We’re really lucky to have our interpersonal violence agencies that have a number of outreach initiatives for vulnerable and marginalized populations. And one of the things that I think is so important about our high-risk panel is that we’re able to flag issues that come up within a number of things – our criminal justice system and our community systems – to see what is it that we might need to understand better as practitioners, about a particular community where these cases are occurring. So how do we collaborate with community partners there to better identify, to provide resources, to bring people into our services at the family safety centers?  So that collaboration is really important, and why it’s really important to have a diversity of service providers at the table.

Kassondra Seyfert: We have started what I would call little subcommittees. More recently, a team of us went down to New Orleans to be trained on how to implement a secondary task force to look at the intersectionality of human trafficking and domestic violence. And so we have this little subcommittee that we had just recently started there. We have another subcommittee where we have started to form conversations in regards to veterans and veteran services. This intervention holds accountable the offender and helps the victim as well.  

And then also mental health. So mental health is a huge issue involved in acts of intimate partner violence. So we have really looked at formulating another subcommittee there.

What we have also done is, because quite often substance use is a part of these cases, and so now we have a detective from our ORACLE Program, the opioid response team. So if we know that either a victim survivor or an offender has a substance related issue that we can at least try to get these individuals into some type of treatment program.

Michelle Toledo-Cainas: So I have heard a lot and I’m learning a lot from your models in your community. So, with that, will you be able to share a benefit and a challenge of the models you are implementing and have shown us today? For example, I have heard a great opportunity for partnerships as a benefit. But does this benefit also bring confidentiality challenges at times?  Becky?

Becky Bullard: There are lots of benefits and challenges with any kind of multidisciplinary team, but especially with a team where you are sharing really in-depth information about very high-risk cases.  

So some of the benefits are obviously the partnership, as Michelle mentioned, and really being able to grow the trust between your partners. So that’s something that has really flourished over the last seven years. In Nashville, we see our partnerships just continuing to increase not only with our panel engagement, but with our co-location at our family justice centers. That’s a huge continued benefit of this team.

It’s also just that consistency of somewhere that is reviewing high-risk cases. So before, in our safety and accountability assessment, no one was consistently reviewing these cases, they were falling through the cracks. So, now, we have a team that our sole responsibility is to look at those highest risk cases and come up with other solutions around holding offenders accountable and keeping victims and survivors safe.

The other piece that I feel like is a real benefit of this team is a shared understanding of risk. We’re talking about risk all the time, every week. We’re all on the same page and we’re all flagging this risk for the entire system in our community.

And then, finally, a really great benefit of these teams is that you’re flagging systems issues and gaps. For example, we have so many more strangulation cases than we have ever known about before, because now we’re seeing over 50 percent of people answering the lethality assessment say that they’ve been strangled at some point. So we went and got training on strangulation, make sure that we now have experts. I do trainings on strangulation regularly for our community, and that’s a gap filled. 

We also flagged an issue of a particular magistrate or commissioner who was setting really low bonds. And we were able to bring attention to that and provide additional training. So lots of great benefits of these teams.  

Challenges, of course, come with benefits. So any team like this will have some challenges. And some of those for us in Nashville is we just have so many high-risk cases that we can’t review them all. So I talked about our funnel. We would, of course, love to review all of the high-risk cases that we see, it’s just not possible. So sometimes I know that can feel overwhelming for our team.

We also will have partner turnover. So when you’ve built that trust, you have your champions in the room, and then they retire or they get shifted to another department or division, that can really disrupt a team. So we’ve certainly seen that turnover and how that infects a team, and it creates these mini rebuilding phases for a team. So you need to really focus on that trust building. 

And then, finally, just keeping momentum going. We’re going through upwards of 25 cases a week, and sometimes we might feel like “What did we do in this meeting? How many real outcomes did we see?”  We see movement with these cases. So really finding those wins and communicating those with the team can be a really important part of that challenge.

Kassondra Seyfert: So similar to what Becky shared, the team collaboration is truly a huge benefit, and the continued growth of the team and trusting each other. When we first started, the team, they had great relationships, but everybody operated in their silos and no one wanted to share information. And over time, when the trust began to develop and everyone saw the work that we all could do if everyone shared what they had was just amazing.

The intervention also provides legitimacy to the community because we are being very transparent with the offenders. We have a form of procedural justice that goes along with the intervention, so we’re notifying you each step of the way of what these repercussions could be for you. So that accountability piece and legitimacy and transparency is pretty amazing within the community.

The challenges, in New York, we did have in 2020, our bail reform, so there were some changes with discovery for the attorneys. So that has really taken a toll on the domestic violence world for us. We only have two misdemeanor charges that are eligible for bail. One is criminal obstruction of breathing and the other one is criminal contempt in the second. So criminal contempt in the second would be the violation of an order of protection at the misdemeanor level.

We even discuss system issues. We’ve had issues in the past with judges not coming out for arraignment, so we brainstormed on our calls about: who do we need to reach out to, up at the state level or Center for Court Innovation and see if they can help us mitigate these issues?

Sarah Henry: I want to round us out with our final question today. I’m wondering if any one of you would have any advice or final thoughts for communities who are looking to use multidisciplinary models to assess and manage high-risk intimate partner violence cases.  

Kassondra Seyfert: Do your research and really try to find someone to provide you with ongoing technical training assistance and guidance. So we have the National Network for Safe Communities, who I meet with twice a week, but they will really help a project manager. You need a project manager. You need someone whose only job is to manage the team, to do the networking, to grow the team, because it is a heavy lift.  At times, you’re going to hit roadblocks with your team, your team is not always going to agree with you, but you’re trying to stick to the fidelity of your own program, and you need that support from the people who are providing that guidance to move in a direction that you should be moving. 

Becky Bullard: I  would just second Kassondra on needing to have a position, that this is their only role, because it is all-consuming.  It’s something you have to have, someone driving the bus all the time, or it will stop and things will really lag. It’s also really patient, persistent work.  So I’ve described how this evolved for us over many years, so being able to slowly increase cases when there maybe wasn’t as much buy-in and being able to give people more information and data and, really dig into the work.

And finding your champions and building trust. You can do that a lot of times by just having fun. We have fun at panel. And I know that sounds odd, because we are reviewing some of the worst things that people do to each other. But to have those moments of levity is so important in our field. So those are things that help your team to carry through.

Sarah Henry: I want to thank our fantastic speakers for lending their expertise to the discussion today. That’s Dottie Davis, Beth Meeks, Becky Bullard, and Kassondra Seyfert. I also want to thank you, the listener, for joining us today.

Michelle Toledo-Cainas: We are joined by a special guest speaker that will be talking about another multidisciplinary model for assessing and managing risk, the Domestic Violence High-Risk Team model, or DVHRT.

We are joined by Jill Smialek. Jill is a passionate advocate for people whose lives are touched by violence and trauma. With over 20 years of experience in local government, Jill currently serves the residents of Cuyahoga County, Ohio, as Deputy Director for Public Safety and Justice Services.

Before becoming Deputy Director, Jill was the manager for Cuyahoga County Services for Victims of Crime, from there, she was the local coordinator for the U.S. Department of Justice Domestic Violence Homicide Prevention Demonstration Initiative and helped launch a high risk team in Cleveland.

Michelle Toledo-Cainas: Can you describe how you’ve been using the DVHRT to assess and manage high risk IPV cases in your community? 

Jill Smialek: Sure. So I work with Cuyahoga County, Ohio, which is the county that includes Cleveland, Ohio. So I’m going to kind of say Cuyahoga County and Cleveland a little bit interchangeably, but just know that I’m speaking of the same project and the same community. 

So we launched our high risk team in 2016, and we, at the time, worked very closely with Cleveland Division of Police to help train them in the use of a risk assessment tool to identify cases of domestic violence that we thought were really high risk. So we knew we wanted to identify these cases and just do better at intervening and providing services to the people who were being victimized.

We convene a group once a month and we do quite a bit of, of work together outside of those meeting times, as well, just building on relationships, coordinating cases, doing kind of the behind the scenes work that allows us to just ensure that we’re doing everything that we can to increase offender accountability and simultaneously keep victims safe. 

Michelle Toledo-Cainas: Thank you, Jill. So I heard you mention you were working with partners. Can you share with us who were those partners? And how, also, did you go through the selection of picking the risk assessment tool?

Jill Smialek: So, first and foremost, we work very closely with our local domestic violence service provider, which I think is a really important element when launching a model like this. I do want to make sure to recognize our local partners at the Journey Center for Safety and Healing, who are our partners in making sure that this model is running smoothly.

But, other than that, we have our victim service provider at the county level, Witness Victim Services, within the Department of Public Safety for Cuyahoga County. We also work closely with Cleveland Division of Police, Cleveland Prosecutor, as well as Cuyahoga County Prosecutor, so both the misdemeanor level and the felony level. We work with probation officers, again, both at the city and the county level. We work with Adult Parole, so if people are sentenced to a prison term, we make sure that we have our partners at the end of the road engaged. And we also work with our sheriff’s department, so that if someone is released from jail, we understand when, we understand how, and where they’re going. Anyone who may touch the case from the beginning of the process, all the way through the end.  

So that’s kind of the core team members that you may expect to see on a high risk team. But then there’s the opportunity to customize the model. So we have a couple of additional partners who sit at the table.

We have a program called Children Who Witness Violence, which is a specialized program. It’s not our child welfare system, it’s a non-profit mental health provider that works with kids who have been exposed. So if there’s a high risk domestic violence incident and there’s a child who witnesses the whole thing, we need to make sure that that child is taken care of and that that child has a safe place where they can heal and  process what they witnessed

We also have a mini agency within our courts that does pretrial assessments of defendants. And, so, that is a group of individuals who we know will have a good feeling of what’s going on with the defendant or the offender pretty early on in the process, they can understand if there is GPS tracking, if there’s a protection order in place, if there’s certain pretrial release terms, that is just beneficial for everybody on the team to understand.  

We use the danger assessment for law enforcement, the DA-LE, which is an 11-question questionnaire. We were provided with that tool through the work that we were able to do through the U.S. Department of Justice. So we were very fortunate in that we were given the opportunity to truly learn it, work with the creators of the tool, work with the technical assistance providers who were instrumental in creating the tool. I don’t want to say we didn’t choose our tool, our tool chose us, but because we were a part of the Homicide Prevention Demonstration Initiative, we were kind of prescribed which model we were going to implement.

But I have to say, we have not been under the Demonstration Initiative for just about four years now, and we haven’t changed. And, so, that is something that I think is a testament to the power of the tool and the power of the high risk team, as well, that we have decided to keep using it. And not only are we still using it, but we’re expanding its use by training additional police departments.

Michelle Toledo-Cainas: Thank you, Jill, for that. So, now that you have mentioned the DA-LE, can you help us, can you share with us how the model works operationally? Once law enforcement does the DA-LE, how is it referred to the high risk team and how do you guys manage those cases through the process?

Jill Smialek: If someone calls the police because they have been victimized by a family or household member or an intimate partner, we ask Cleveland Police to use the danger assessment. If it scores a 7 or higher, so seven yeses out of 11, or higher, it’s marked as a high risk case.

Now, the alternative is that a police officer, based on his or her gut instinct, or previous knowledge or additional knowledge of what happened, they can override the score and they can refer it in as high risk, even if the victim did not answer seven questions or more as a yes. Sometimes there’s just that instinct that something is just not right and they want to do more. So once it comes in as high risk, it’ll go to a centralized domestic violence detective bureau, and they will be marked from the beginning as high risk. So most of the high risk cases go to a specific detective who is in that unit. But we also know that, that detective needs vacations, that detective is going to eventually have a caseload that’s a little too high, and so they are spread throughout the detectives in that bureau.

And as soon as it’s assigned to a detective, it’s also assigned to a victim advocate. And, so, the victim advocate will start reaching out to the victim immediately to do a longer form danger assessment, to do safety planning.

While that happens, the detective is going to start their investigation. And then, hopefully, the case will be charged. So, once it’s charged, then it starts going through the whole criminal justice process.  

The key part of this is that the high risk team is sort of a parallel track to the criminal justice process. And what we do, as the victim advocate component of the process, we give the victim the choice as to whether or not they want their case presented to the high risk team. So they need to consent to have their information shared with all these partners around the table. And they can say no, and we understand some people are hesitant to get involved with the criminal justice process at all. And we don’t want to be yet another person or entity that takes away a choice from someone who has already been victimized.

And so, if the victim consents, we ensure that the case is added to our case list. We share the information amongst all the partners in terms of who is the offender, who is the victim, and then we’ll take it to a meeting. We’ll provide an overview of the police report, of the risk factors, some of the history, if we’re aware of it, and then the additional partners will start chiming in with what they know about the case. And the idea is that we just share information so that we can, again, ensure the offender accountability and the victim’s safety. So if that means that we need to make sure that everybody knows that the Adult Parole Authority has it on record that this person isn’t allowed to have a gun, but we know that a gun was used in the incident, then we’re going to look to the federal side to see if this can be bumped up to federal charges. If there’s a warrant that needs to be executed, can we make sure that our warrant unit is aware that not only was there a gun involved, so for their safety they need to know that this person has a gun? So that’s just a way for us all to work together to advance the case.

Michelle Toledo-Cainas: Thank you, Jill. Could you share with us one benefit and one challenge?

Jill Smialek: I think the benefit is definitely the relationships that are built amongst the different criminal justice partners. I don’t think we had any relationship prior to the high risk team with our Adult Parole Authority. And, now, we’ve done trainings with the Adult Parole Authority staff, and we know them and we can call them and we can figure out what’s going on. So just those relationships and being able to say “I need help with this,”  or just having that person to be with you as a human being, as you’re carrying on this really heavy load of working on high risk cases.

I think too, is just that the high risk team allows you to do an audit of the system in real time. We also have a fatality review in Cuyahoga County, so when there is a domestic violence fatality, we look at that case and we say, “Where did we miss an opportunity to help this person find safety?” The high risk team allows us to do that before it’s too late. So we’re able to look at a situation and say, you know, this is a gap in service, and how can we make sure that this person gets that service? So it’s allowing us to do an audit of the system before there’s a fatality. And that’s really where we want to be.

I think challenge is just timing, because people are so busy in the criminal justice system, and everywhere. And we meet once a month-we had a meeting yesterday, a case could come in today. We’re not going to discuss it as a team, in the team environment for another month, and, so, there are so many things that are going to happen in that case before we have a chance to come together again as a team.

And so, again, we flip back to the benefit, the relationships.  We don’t have to wait until there’s a team meeting to discuss everything.  The advocate is going to confer with the detective. The detective is going to confer with the prosecutor, the prosecutor is going to confer with the court for pretrial and so forth.  So, sometimes, by the time you get to the meeting, much of the coordination has already been done. We want to make sure that we’re meaningfully engaging people and meaningfully bringing people together.

Michelle Toledo-Cainas: Thank you for sharing that. And I heard you mention that one of the benefits is those partnerships. Could you let us know in what ways are the members of the multidisciplinary team reflective of the diversity of your community? 

Jill Smialek: That is an excellent question, that it is one that we struggle with. The High-Risk Team model is meant to be representative of the criminal justice system. The criminal justice system is a very white majority system.  That’s where we are as a nation. Things are changing and I’m hopeful that there are police departments, that there are courts, that there are institutions that are prioritizing the importance of recruiting members of the community to come and be a part of this process, to make sure that the police force is more representative of the community in which it serves, and throughout the entire criminal justice process. And as that changes, I would hope and imagine that our high risk team will also evolve in that way.

When we first launched our high risk team, we made a concerted effort to engage various culturally specific non-profit partners who could help us identify cases, help us with referrals for culturally specific programs or services. Those partnerships still exist, and they’re incredibly important to all of us.

Michelle Toledo-Cainas: And with all that, my final question for you, Jill, is what advice do you have for other jurisdictions that are thinking about using this model? 

Jill Smialek: I think it’s very important to customize the model to reflect partnerships that make the most sense. When we were under the Demonstration Initiative, we really focused on that core group of the criminal justice response, but I think it’s important to honor the makeup of your community. And so, when you think about who should be at the table, I think the people who should be at the table should be the people that you call when you’re at your wit’s end, when you don’t quite know what to do with a case or you know that you need to do more. Those are probably the people that you would end up engaging at some point anyway, so let’s bring them to the table.

Michelle Toledo-Cainas: Jill, again, thank you so much for your time today.

Sarah Henry: If you require technical assistance and you are looking for that for advocacy coalitions, I’d like to direct you to the National Network to End Domestic Violence.  That is NNEDV.org.  If you’re looking for more information on risk assessments, you can contact the Domestic Violence Resource for [Increasing] Safety and Connection. Its acronym is DV RISC, and you may find it at DVRISC.org.  

Thanks for joining us today and we hope to see you on our next podcast.