Colquitt Superior Court Substance Abuse/Mental Health Treatment

Transcription

Colquitt Superior Court
Substance Abuse/Mental Health
Treatment Court Program
Manual
Post Office Box 2227
Moultrie, Georgia 31776-2227
(229) 616-7445
ACKNOWLEDGEMENTS
Many thanks are due to the members of the Archway-Healthy Colquitt Coalition
Mental Health Sub-Committee who supported the development and creation of the
Colquitt County Superior Court Substance Abuse/Mental Health Treatment Court. The
names of the members of the committee at the time of this writing appear on the
following pages.
Special thanks must also be given to the Honorable Stephen S. Goss, Superior
Court Judge, who created and presides over the Dougherty County Mental
Health/Substance Abuse Court. Judge Goss was very generous in the sharing of his
time and knowledge to assist us in this project. In addition, he graciously proffered the
Dougherty County Mental Health/Substance Abuse Treatment Court Program manual
for use in the creation of the manual for Colquitt County.
Member Roster
Archway-HealthyColquitt Coalition Mental Health Sub-Committee (revised July 18, 2012)
Stakeholder
Group
Turning Point
Name
Work/Home
Phone
Cell Phone
E-Mail Address
Ben Marion
985-4815
225-8296
[email protected]
Judy Payne
985-4815
336-3642
[email protected]
NAMI
Lynn Wilson
890-3699
891-1725
[email protected]
Georgia Pines
Robert J. Hurn
225-5208
850-212-3988
[email protected]
Tammy Adams
225-5208
[email protected]
Charlene Allen
225-5208
[email protected]
Lana Cason
(Social Worker)
(Mon.) 941-5594
(Tues.-Fri.) 873-3303
460-7410
[email protected]
Lisa C. Hill
(Social Worker)
890-6293
873-9528
[email protected]
Temple Baptist
Wade Hahn
890-1156
873-7193
[email protected]
Rapha
Barry Watson
324-3505
873-5762
indstream.net
Friendship Baptist
Daloanne of Alfred Jones
985-4815
[email protected]
First Presbyterian
Richard Carr
985-3158
[email protected]
Boys and Girls Club
Joseph Matchett
890-8600
[email protected]
District Attorney’s
Office
Brian McDaniel
616-7476
Colquitt County Schools
Clergy
891-5274
[email protected]
Stakeholder
Group
Attorney
Rob Howell
Work/Home
Phone
985-5300
Counselors
Margaret McDaniel
891-2711
921-6049
[email protected]
Medical Community
Cynthia Hernandez
324-2845
891-8343
[email protected]
Patty June
985-7177 - (office)
985-8480 - (home)
[email protected]
Chief Frank Lang
890-5448
[email protected]
Sgt. Rob Rodriguez
873-3138
921-0511
[email protected]
Steven Colgan
890-5452
891-8959
[email protected]
Colquitt County
Sheriff’s Department
Det. Jim Brown
616-7430
529-4736
[email protected]
Federated Guild
Elizabeth Herndon
324-2887
891-4848
[email protected]
Moultrie Service League
Lauren Howell
985-5807
798-5010
[email protected]
City of Moultrie
Dale Williams
890-5409
Archway
Emily Watson
616-7455
507-0759
[email protected]
Hope House
Katrina Bivins
985-4681
891-1802
[email protected]
Serenity House
Blue Hackle
782-5394
873-0481
[email protected]
Crossroads Mission
Robin Poole
985-7194
798-5830
529-3097
[email protected]
Moultrie Observer
Dwain Walden
985-4545
921-8490
[email protected]
DFCS
Kayla Watson
(case worker)
529-9680
529-5558
[email protected]
Probate Court
Wes Lewis
616-7416
921-0681
[email protected]
Moultrie
Police Department
Name
Cell Phone
E-Mail Address
[email protected]
[email protected]
Stakeholder
Group
Public Defender
Name
Ken Still
Work/Home
Phone
616-7070
Cell Phone
E-Mail Address
Community Action
Council
Denise Bell
985-3610
Department of Labor
Ann Barrow
891-7147
[email protected]
YMCA
Greg Coop
985-1154
[email protected]
Family Connection
Lori Glenn
873-3411
454-5530
[email protected]
Hero House Child
Advocacy Center
Shannon Bell
890-5549
296-0739
[email protected]
Moultrie/Colquitt
County Library
Michele Croft
985-6540 (work)
783-7062 (home)
Assertive Community
Treatment (ACT)
Debbie Manganaro
217-4270 (work)
223-9404
[email protected]
Retired Mental Health
Professional
Emily Baron
890-1868
589-2878
[email protected]
[email protected]
589-1790
[email protected]
[email protected]
Mission Statement
The mission of the Colquitt County SA/MH Treatment Court Program is to
enhance public safety and build stronger families and communities by focusing
resources towards treatment of the SA/MH offender. Our goal is to reduce costs,
reduce crime rates, and hold individual participants accountable, while providing them
with a means to become productive, law abiding, citizens.
Vision Statement
We envision our participants being able to live and function at a productive level
in the community. We hope to eliminate or minimize our participants’ further
involvement with the criminal justice system.
Goal
To decrease or eliminate the number of hospitalizations, crisis unit admissions,
and/or arrests of our participants once they enroll in the program.
BACKGROUND INFORMATION
In 2012, meetings were held involving judges, law enforcement officers, probation
officers, lawyers, mental health professionals, disability advocates, and other interested
individuals from the community. The meetings were held to address concerns regarding
repeat offenders who appeared to be suffering from chronic mental health and addiction
issues. Following a planning process, the Colquitt Superior Court Substance Abuse/Mental
Health Treatment Program was started in 2013. This program is for defendants with similar
characteristics, such as a past history of mental health problems and/or substance abuse
disorders. Many of the participants have little or no support systems, minimal income, and
numerous occurrences of arrests, jail stays, and hospital and crisis unit admissions. As a
result of these initial meetings, training has been conducted for local police officers and
others on how to identify and interact with persons in the field that may be in a
decompensated mental state. Through NAMI and the Georgia Department of Human
Resources, local law enforcement officers and others have completed Crisis Intervention
Training (Memphis Model).
AREA STATISTICS
Moultrie, Georgia (population of approximately 14,268) is the county seat of Colquitt
County (population of approximately 45,498). Recent census data shows Colquitt County
population as 67.78 percent Caucasian, 23.47 percent African-American, and 8.75 percent
other ethnic origins.
Southwest Georgia is an agricultural based economy. This area of Georgia has a
shortage of mental health professionals and particularly has problems recruiting and
retaining psychiatrists.
Colquitt Superior Court SA/MH Treatment Court Program
Admission Policy (Legal & Clinical Criteria)
PURPOSE/SCOPE:
The purpose of this policy is to ensure program integrity and to establish specific legal and clinical criteria
that must be met in order for an individual to be accepted into the Drug Court program.
Legal Criteria:
Persons arrested on drug charges must meet certain legal criteria to be considered a
candidate for drug court. Such persons must be facing a charge of one of the following
offenses:
·
·
·
·
Possession of a controlled substance
Possession with Intent to Distribute of controlled substance (where drug use is a
contributing factor)
Prescription drug offenses/Obtain Controlled Substance by Fraud, theft, forgery (or
attempt to obtain)
Property crimes as outlined in the attached addendum
Certain legal factors may exclude one from being eligible for the drug court program. These factors include:
·
·
·
·
·
·
·
·
·
Prior felony convictions (candidate may have no more than one felony conviction)
A severe physical or mental handicap that would prevent program participation,
though an appropriate referral must be made
Conviction of any felony violent offense or sexual offense
Illegal alien status
Felony firearm charges (an individual may reapply at a later date if charges are
reduced)
Sex offenders
Individuals with any gang affiliation
Current felony charge of a more serious nature than drug charge
Pending felony charges in other jurisdictions
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PURPOSE/SCOPE Continued:
Clinical Criteria:
If the Assistant District Attorney deems that a person legally screens for Drug
Court, he/she will refer this individual to speak with the Defense Attorney.
If this person is still interested in Drug Court, he/she will receive a clinical
assessment from a Drug Court evaluator. A Drug Court treatment evaluator will use
multiple screening tools (TCU, AUDIT, MH evaluation, and an individual intake
interview) to rule in /out whether an individual is likely to be drug dependent, a drug
abuser, or neither. If the mental health evaluation indicates that a Drug Court candidate
has moderate to severe mental health concerns, a mental health evaluation will be
scheduled through HELP Court. A Licensed Counselor will conduct the mental health
evaluation and determine if a candidate’s mental health needs would be too severe to
enter Drug Court. If a candidate is deemed appropriate for Drug Court and has mild to
moderate mental health issues, the Licensed Counselor will advise the Drug Court staff
as to any additional mental health treatment that is necessary and assist in setting up
mental health treatment.
PROCEDURE: All individuals meeting the legal screening criteria as determined by the Court will be
referred for a clinical screening to determine substance dependency /abuse presence or absence. This clinical
screening will be conducted by Drug Court staff. This screening will generally take place in the detention
center, though appointments can be made to be seen at the treatment center when it is not possible to see the
offender in jail. The results of the legal screening and the clinical screening are then reviewed with the Drug
Court Team during the weekly status review meeting (held each Friday morning) and a determination is made
by the team regarding entry into the program. New participants must also meet the legal criteria outlined in
the BJA Grant. The Drug Court program is a minimum twenty-four month, five-phase program.
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Colquitt Superior Court SA/MH Treatment Court Program
TERMINATION POLICY
PURPOSE/SCOPE:
The purpose of this policy is to provide a fair and equitable termination process for individuals who are being
recommended for termination.
Any new offenses may result in termination from the Drug Court program.
PROCEDURE:
Depending on the circumstances of new criminal charges, a participant may fall under conclusive termination
or presumptive termination as outlined below.
Conclusive termination: Commission of felony offense (unless the entire team believes that based on the facts
of offenses, termination is not appropriate), sale of a controlled substance or marijuana, trafficking in controlled
substances, second felony arrests subsequent to entry into the Drug Court program, sexual offenses, Family
Violence Battery offenses* and second misdemeanor offenses. Anyone who is AWOL more than 6 months
would also fall under the conclusive termination category.
* FVA Battery and Stalking: these cases will be judged on a case by case basis WITHOUT consideration for
how the participant has done in the program. The team will consider the facts on a case by case basis with a
strong leaning towards termination but exceptions to be made if the facts of the new case are mitigating. If it is
a solid FVA Battery or Stalking, it is a conclusive termination. If the team feels the facts of the new case are
mitigating, we consider the participant to be presumed terminated and then review the participant’s goodwill,
etc.
Presumptive Termination: Misdemeanor Possession of a controlled substance, dangerous drug or drug
related object (substance use related). DUI, Driving on a Suspended License, Obstruction (case by case),
battery and simple battery offenses (non FVA), fleeing and eluding, habitual violator, leaving the scene of an
accident (circumstances will dictate) or any other charges where alcohol or drugs are involved. Anyone who is
AWOL for the 3rd time for less than 6 months will also fall under the presumptive termination category.
Presumptive termination means that participants committing the above referenced offenses or who is AWOL
less than 6 months would be presumed to be terminated unless there are good reasons not to terminate. “Good
reasons” referred to in this paragraph include, but are not limited to, the participant’s time in the program, their
efforts to remain clean and sober, their progress or lack of progress, previous program violations, and the effect
of retaining the participant upon the public perception of Drug Court.
Participants found to be in possession of a substance may be terminated from the Drug Court program. The
longer a participant has been in the program and developed the necessary tools for long term recovery, the less
likely he/she will be retained in the program.
If after considering the circumstances of the case the Drug Court Team decides to terminate a participant from
the Drug Court program, he/she will be served a notice of termination and will be given an opportunity to
address the court during the next calendar court review.
PROGRAM DESCRIPTION
The program's staff consists of the Superior Court Judge, an assistant District
Attorney, an assistant Public Defender, a probation officer, the program coordinator,
treatment providers, law enforcement representative and evaluator. The program is flexible
to ensure that participants are provided access to the most appropriate treatment paths.
Participants are screened and assessed by program staff. Some referrals may be diverted
from the jail and enrolled in other treatment programs to address specific needs on a more
intensive scale. Participants who are enrolled in the post-adjudication probation program
are placed in either the mental health track or the substance abuse track. The mental health
track is utilized for those participants with a primary mental health disability. Many have cooccurring substance abuse disorders. Many times, level of functioning is considered when
placing into a track. Their encounters with the criminal justice system many times coincide
with non-compliance with medications. As a result, there is an increased likelihood the
person will decompensate and become psychotic, delusional, or both.
The addiction track focuses on repeat drug offenders with little or no history of
debilitating mental health issues. This track has a 12 to 24 month completion span. It
focuses on group sessions, frequent drug tests, and 12 step therapy.
The Program Coordinator monitors the participants' progress, works to restore
and/or establish benefits, and oversees other activities pertaining to the participants'
progress in the program.
The program's state probation officer is assigned to monitor all participants enrolled.
He/She not only monitors the activities of the probationers in local programs, but also
monitors those probationers who have been placed in a residential program in other
areas of Georgia. Having a designated probation officer increases training opportunities
and narrows lines of communication.
PROGRAM REFERRALS
Referrals are accepted from other courts, probation offices, the Public Defender's
Office, other attorneys and from the county jail. If family members want to refer a candidate
for consideration, they are encouraged to contact the person's probation officer or attorney.
LINKAGE
Participants are linked with 12-Step programs to address addiction issues. The local
mental health center may be utilized, when there are appropriate services available. If
needed, the Court program may access private practitioners to address those participants
with primary mental health concerns. The Program Coordinator may build relationships with
some of the personal care homes (PCH) in our area where placements could enable the
participants to have continued mental health and medical care when needed. PCH
placements may also play a role in improvement in their overall physical condition and in
addressing homelessness in this group. Contact may be made with faith-based programs
that provide daily living essentials such as clothing and personal hygiene items.
TARGET POPULATION
The Treatment Court program targets adults with substance abuse and/or mental
health issues who have been directed to services. Many of these individuals have a long
history of arrests for technical probation violations including failure to report, positive drug
screens, and misdemeanor offenses coinciding with prescription non-compliance. Virtually
all participants in this program have felony probation or pending felony charges.
GROUP ACTIVITIES
Persons assigned to the substance abuse outpatient group are required to participate
in the treatment court program for at least one year. If all requirements have been met
successfully, the participant is awarded a certificate of completion. The participants are
educated on the effect of substance use on their lives. Films may be shown that enable
the group members to view the addiction process in others. Group sessions give them the
opportunity to discuss their experiences with each other. There is a phase of the program
set aside for updating employment skills. Upon completion of the program, there may be
other positive legal incentives which could include early termination of probation or dismissal
of the charges.
NON-GROUP PARTICIPANTS
Placement depends on the severity of the participant's particular disability. Individuals
are referred to programs in the community that most closely meet their needs. Participants
are monitored frequently for program compliance. If residential placement is determined to
be the most appropriate treatment, the participant is referred to an appropriate long-term
program. An appropriate residential program may run for at least a year, and could include
a transitional phase that allows the individual to gain work and/or educational skills, along
with training on addiction and relapse prevention.
CO-OCCURRING DISORDERS
Treatment for individuals with a co-occurring (dual) diagnosis would be geared toward
establishing a treatment plan with the individual that will address the more acute area of the
participant's disorder. The program seeks integrated treatment where available. As
improvements are made, the treatment plan may be updated and revisited with the
individual after making contacts with the individual, the program that is providing treatment,
family members, and other identified support systems.
ADMISSION
The final decision to accept or deny a referral for enrollment into the postadjudication court program is made by the Judge, with input from the court staff, the
assistant district attorney, assistant public defender, the probation officer and others.
Factors for judicial consideration are the safety of the public at large and how a potential
enrollee with a history of substance abuse and/or a mental health disorder will function in
the community once placed or released to his/her support system. All individuals who are
enrolled in the program have been screened or assessed by the court staff. The probation
officer and the District Attorney's office monitor criminal histories to determine if the
individual is appropriate for the program. For example, sex offenders, drug dealers and
persons with charges involving firearm violence are not enrolled in the core SA/MH program.
Probationers have to return to Court for periodic status review hearings before the Judge.
DISCHARGE
A participant who has been diagnosed with a chronic mental health disorder and a
long history of repeated arrests is routinely monitored by the Court for at least one year.
After that time, the staff will work on transitioning the person out of the program. This could
take several additional months depending on the available resources and whether there is a
support system in place.
If the participants have a substance dependence, but do not require long-term
residential treatment, they will be placed in the addictive disease group and required to
follow other guidelines that are designed to monitor their drug use and probation reporting
mandates. Once they have satisfied all of the program requirements, they will be subject to
release from the program.
ELIGIBILITY REQUIREMENTS FOR CORE SA/MH PROGRAM
The profile of someone who would be considered for enrollment in the
Colquitt Superior Court Substance Abuse/Mental Health Program would be a
person who:
1.
Has been charged with a non-violent felony or convicted of a non-violent
felony in the past and is currently facing charges.
2.
May have either a mental health disorder, an addiction disorder, or both
(dual diagnosed) and is facing charges.
3.
No history/conviction of sale of drugs.
4.
No history/conviction of a sexual charge.
5.
No history/conviction of a firearms charge.
6.
No history/conviction of an aggravated assault.
7.
Has been referred to the drug court by a probation officer, Judge, public
defender, other community program, other attorney or other law
enforcement.
8.
Even though enrollment in the program is voluntary, once enrolled the
person is expected to adhere to all guidelines (see sanctions page).
9.
The Colquitt Superior Court SA/MH Program complies with the "Ten
Essential Elements" for mental health court progress. A copy of this
document can be found in a following tab.
10.
The Colquitt Superior Court SA/MH Program complies with the Ten
Key Components for drug court programs. This document can be found in
a following tab.
SANCTIONS
If you fail to comply with the Treatment Court Program, the Judge may impose
sanctions at his discretion, including but not limited to the following:
% Termination from Treatment Court
% Jail
% House Arrest
% Phase Demotion
% More frequent drug testing
% Additional community service
% Curfew
% Writing Essays
% Or other sanctions determined by the Treatment Court Judge
INCENTIVES
If you comply with the Treatment Court Program, the Judge may, at his discretion,
reward you with any of the following incentives:
% Progression To Next Phase
% Reduction of Fees
% Reduction of Fines
% Reduction of Community Service Time
% Opportunity to Leave Court Session Early
% Certificates
% Gift Cards
INTENSIVE MENTAL HEALTH PROBATION SUPERVISION
As noted earlier, certain criminal offenses are excluded for participation in the core
SA/MH Treatment Court program. In a community with limited mental health treatment
services, a number of clearly mentally ill offenders may be lacking in treatment and many
times end up re-arrested. For example, a person with schizophrenia, off medicines, gets
into a confrontation with a family member. The victim tries to take a kitchen knife away
from the defendant and ends up with five sutures in his/her hand. The defendant is
charged with Aggravated Assault and not eligible for the core SA/MH Treatment program.
additional investigation
investigation and
and consideration,
consideration, aa decision
decision may
may be
be made
made to
to create
create
After additonal
a program track for these defendants. These probationers would be supervised in a
Intensive Mental Health Probation Supervision track. A Probation Officer supervises
mentally ill offenders in the core program. He/She would be CIT certified and supervise
this group of intensive probationers. The participants are linked with mental health
treatment services and case management, much like the core group participants.
Frequent court review hearings are part of the supervision plan. Depending on family
supports or the lack thereof, referrals can be made for case management services to
other agencies.
COMPETENCY DOCKET
The Court may start a competency docket. In all cases in Colquitt Superior
Court where the issue of whether a defendant is currently mentally competent to assist
counsel and stand trial has been raised, the case could be transferred to the Judge
presiding over the Mental Health Court until the competency issue has been resolved.
Psychologists from the state hospital would give the Judge status reports. The docket
would be used to coordinate supervision of these cases so that person is not sitting in jail
or at the state hospital awaiting resolution of this issue. Once the psychological evaluation
of the defendant is performed, if the person is deemed competent, the case would
proceed on the merits. If the evaluation reveals issues of competency, a special
competency trial will be held pursuant to Georgia statutory law. The cases are followed
through resolution and/or civil commitment proceedings, if competency cannot be
restored.
RE:
Georgia’s Drug Courts: Proposed Treatment Standards & Practices
The attached Treatment Standards for Georgia’s Drug Courts were commissioned by the Judicial
Council’s Standing Committee on Accountability Courts. The recommended standards are not exhaustive,
which would be impractical given funding constraints and resources, but are instead a distillation of the
evidence-based practice research and best-practice literature. The recommendations are pared-down to a set
of critical benchmarks for Georgia’s programs and treatment providers. The standards target treatment
practices that promote optimal therapeutic and recidivism outcomes for drug-addicted offenders, and
associated cost savings for the state. Also, the standards are designed to enhance data management and
evaluation of Georgia’s programs with a view toward strong stewardship and transparency.
The standards address 8 key program areas:
1. Screening (legal and clinical)
2. Assessment
3. Level of treatment
4. Addiction treatment interventions
5. Recidivism/criminality treatment intervention
6. Treatment/case management planning
7. Information management systems
8. Oversight and evaluation
The standards provide specific enhancements, justifications, and citations, recommend tools, link
practices to 10 Key Components for Drug Courts (Bureau of Justice Assistance and National Drug Court
Institute), National Institute of Drug Abuse (NIDA) principles for substance abuse treatment with criminal
justice populations, and evidence-based / best-practices treatment guidelines from the Substance Abuse and
Mental Health Administration (SAMHSA). The standards also provide practitioner questions for use in
assessing whether a program is meeting the objectives of a best-practice area.
The recommended treatment standards are specific but were drafted with the idea of allowing
maximum room for program flexibility and innovation in meeting the needs of a given target population.
Programs have the option of using tools and curriculum beyond what is recommended, as long as they meet
the standards. That said certain treatment tools, such as assessment measures, should be standardized across
the state for the sake of data integrity and resource management.
The ability of Georgia’s drug courts to deliver and maintain fidelity to the recommended treatment
standards is tied to adequate and ongoing funding. The standards will require significant expenditures on
workforce development and infrastructure, assessment tools, curriculum, data management, and training.
These costs cannot be borne alone by Georgia’s Drug Courts. The adoption of the recommendations
envisions close coordination with the Georgia Department of Behavioral Health and Developmental
Disabilities (DBHDD), which licenses and oversees state-funded treatment providers. Importantly, the
standards are applicable for all state-funded treatment programs dealing with offenders, not just those serving
Drug Courts.
If adopted, the recommended Treatment Standards for Georgia’s Drug Courts will require a realistic
time-frame to allow programs and providers to ramp-up services. It is advised that the recommendations
serve as a multi-year blueprint for Drug Court training and funding priorities, and inform the development of
a strategic plan with clear benchmarks and oversight. A cost and feasibility analysis is advised to determine
the best course of action.
The Treatment Standards are ambitious but achievable. They set a course to ensure Drug Courts’
long-term success and to establish Georgia as a leader for evidence-based and best practices. On the frontend there are attendant costs, but they will lead to the greater savings: both in terms of lives and criminal
justice costs.
Proposed Treatment Standards for Georgia's Drug Courts: Evidence-based & Best Practices for Treatment Services
Authors: Andrew Cummings, Director, DeKalb County Drug Court, [email protected]; Travis Fretwell, Deputy Division Director, Division of Addictive Diseases, and Director of the Office of Prevention, Georgia
Department of Behavioral Health and Developmental Disabilities; Wendy Guastaferro, Ph.D., Assistant Professor, Georgia State University, Department of Criminal Justice and Criminology, Andrew Young School of Policy
Studies, [email protected].
Practice
Area
Screening--Legal
Enhancement
DC programs should work
with interdisciplinary
team to ensure systematic,
early identification and early
engagement of target
population.
Screening--Clinical DC's will enroll participants
who meet diagnostic criteria
for Substance-Related
Disorder and whose needs can
be met by the program. Brief
screen for mental health
problems should occur.
Notes:
Justification
Recommended
Tools
(Evidence based
practices / best
practices)
Citations
Georgia's programs should enroll
participants with clear indication of
addiction to make the best use of
resources and who are moderate to
high risk for reoffending, as determined
by a risk and needs assessment (see
Assessment section).
Texas Christian University,
Substance Abuse II
(TCUDS)*, Addiction
Severity Index (ASI)-Drug
Use Subscale (ASI-Drug)**,
Substance Abuse Subtle
Screening Inventory-2
(SASSI-2)*. Brief Jail
Mental Health Screen,
National GAINS Center
Treatment Improvement Protocol
(TIP) 44, Substance Abuse
Treatment for Adults in the Criminal
Justice System. Substance Abuse
and Mental Health Services
Administration (SAMSHA), Center
for Substance Abuse Treatment
(CSAT), 2005; Quality
Improvement for Drug Courts:
Evidence-Based Practices
[Monograph Series 9]. National
Drug Court Institute, April 2008.
Simpson, D., 2004, A conceptual
framework for drug treatment
process and outcomes. Taxman &
Thanner, 2007, Risk, need and
responsivity (RNR): It all depends.
BJA / NIJ Research to Practice
(R2P): Seven program design
features, Adult Drug Court (2012)
10 Key
Components of
Drug Courts
1, 2, 3, 4, 6
NIDA
Evidence
Based
Principle
1
Practitioner
Questions
Are we enrolling offenders
who need judiciallysupervised addiction
treatment? Have we
referred participants in
need of mental health
services?
The research points to the need to reserve intensive DC treatment for individuals with the most severe
drug-use problems. http://store.samhsa.gov/product/TIP-44-Substance-Abuse-Treatment-for-Adults-inthe-Criminal-Justice-System/SMA09-4056
03/03/2012
1
Practice
Area
Assessment
Enhancement
Justification
Georgia's programs should be able to
define the target population in terms of
risk of recidivism (focus on moderate to
high) and treatment needs, as well as
other factors, in order to ensure
effective matching of participants to
programming EB and BP elements, and
achieve the best outcomes. DC
treatment and case management
Appropriate assessment
instruments are actuarial tools planning should follow from sound
that have been validated on a assessment. Both efforts should
systematically address those needs that
targeted population, are
promote recovery and reduce the risk
scientifically proven to
of recidivism.
determine a person's risk to
recidivate and to identify
criminal risk factors that, when
properly addressed, can
reduce that person's likelihood
of committing future criminal
behavior.
DC's will employ an
assessment tool that captures
offenders' risk of recidivism
and treatment needs. This
should also include a short
assessment for mental health
needs.
Assessment tool should also be
suitable for use as a repeat
measure. Programs should readminister tool as a measure
of program effectiveness and
offender progress.
Notes:
Recommended
Tools
(Evidence based
practices / best
practices)
Citations
Level of Service InventoryR (LSI-R)*, Correctional
Offender Management and
Profiling Alternative
Sanctions (COMPAS)*.
Flores, A., Lowenkamp, C., Smith,
P., and Latessa, E.. Validating the
Level of Service Inventory-Revised
on a Sample of Federal
Probationers. Federal Probation,
September 2006; Farabee D.,
Zhang, S., Roberts, R., and Yang,
J.. COMPAS Validation Study:
Final Report, August 2010;
Administration [SAMSHA], Center
[CSAT], 2005; Quality
10 Key
Components of
Drug Courts
1, 4
NIDA
Evidence
Based
Principle
3, 4, 7
Practitioner
Questions
Do we know that we are
targeting and responding
to the needs of our
participants that have been
demonstrated to reduce
recidivism? Is our needsassessment designed for a
CJ population? Are we
targeting offenders that
need the intensity afforded
by drug court supervision?
LSI-R is well-suited for use
as repeat measure.
Best used in conjunction with a screening/assessment tool that estimates substance abuse/addiction severity. For example,
Texas Christian University, Drug Screen II (TCUDS). Assessment tools must be normed and appropriate for an offender/CJ
population. http://store.samhsa.gov/product/TIP-44-Substance-Abuse-Treatment-for-Adults-in-the-Criminal-JusticeSystem/SMA09-4056.
Major risk/need factors associated with recidivism that should be targets for change: antisocial personality pattern,
procriminal attitudes, social supports for crime, substance abuse, family/marital relationships, school/work, and prosocial
recreational activities (Bonta & Andrews, 2007).
03/03/2012
2
Practice
Area
Enhancement
Justification
Level of Treatment DC's will offer an appropriate Georgia's programs' level of care,
staffing, and service definitions should
level of treatment for the
comply with nationally- accepted
target population.
American Society of Addiction Medicine
DC's will match participant risk (ASAM) Patient Placement and Criteria
of recidivism and needs with for the Treatment of Substance Abuse
Disorders. Although ASAM criteria
an appropriate level of
have not yet been formally adapted
treatment and supervision.
Ideal length of program is 12- for offender populations, they are
endorsed as an effective method to
18 months.
match substance abusing individuals with
treatment services.
ASAM Level I, Outpatient Treatment is
the minimum level of care for DC
treatment (See Notes).
Notes:
Recommended
Tools
(Evidence based
practices / best
practices)
ASAM Patient Placement
Criteria for the Treatment
of Substance-Related
Disorders (PPC-2R)**.
Citations
(CSAT), 2005; Marlowe, 2009,
Integrating substance abuse
treatment and CJ Supervision;
Quality Improvement for Drug
Courts: Evidence-Based Practices
10 Key
Components of
Drug Courts
4
NIDA
Evidence
Based
Principle
2, 3, 6
Practitioner
Questions
Are we providing the
appropriate level of
addiction treatment services
to achieve optimal
outcomes? Is our approach
clinically-warranted and in
keeping with national
standards? Are our staff
qualified to provide the
necessary level of care?
ASAM Level I, Outpatient Treatment is the minimum level of care for DC's and recommended for target populations assessed as meeting diagnostic criteria for a
Substance Related Disorder (Dimension 1); relatively stable in terms of biomedical conditions (Dimension 2); emotional, behavioral, or cognitive conditions (Dimension 3);
treatment readiness (Dimension 4); relapse potential (Dimension 5); and recovery environment (Dimension 6). However, ASAM Level II.1, Intensive Outpatient Treatment, is
strongly recommended for programs with a target population assessed with significant biomedical conditions (Dimension 2); mild to moderate emotional, behavioral, or
cognitive conditions (Dimension 3); ambivalence about substance abuse or mental health problems (Dimension 4); high likelihood of relapse (Dimension 5); and/or residing
in an unsupportive recovery environment (Dimension 6). It is recommended that DC's treat risk of recidivism as an additional dimension when considering ASAM placement
criteria (See Assessment). Programs that employ an Intensive Outpatient (ASAM II.1) level of care will likely do so for the first phase, and transition to Outpatient (ASAM I)
services in subsequent phases. Importantly, programs should engage in participants in lower-intensity continuing care or step-down care/aftercare, after the initial phase(s)
of treatment. http://www.asam.org/publications/patient-placement-criteria/ppc-2r
03/03/2012
3
Practice
Area
Addiction
Treatment
Interventions
Enhancement
Justification
DC's will use a manualized
curriculum and structured (e.g.
Cognitive Behavior Therapy
(CBT)) approach to treating
addiction.
Georgia's programs should use
treatment practices that are focused on
effective programming to help
participants develop recovery skills.
Manualized curriculums have been
Aftercare services are an
empirically tested in the field and
important part of relapse
provide a map of the offender change
prevention. Aftercare is lower process for treatment providers.
in intensity and follows higherintensity programming.
Notes:
Recommended
Tools
(Evidence based
practices / best
practices)
Relapse Prevention
Therapy (RPT)*,
Motivational Enhancement
Therapy (MET)*.
Citations
Taxman, 2004, Strategies to
improve offender outcomes in
treatment.
10 Key
Components of
Drug Courts
1, 4, 10
NIDA
Evidence
Based
Principle
3, 7, 8
Practitioner
Questions
Have we maximized our
efforts to bring about
change? Do we use a
cognitive behavioral
approach? How is my
provider trained and
monitored to ensure fidelity
to the model? How well are
we helping participants
transition to living in
recovery independently?
RPT is a cognitive-behavioral approach in the treatment of addiction behaviors that focuses on coping strategies and skills to prevent relapse. Ideally, the DC judge
incorporates RPT concepts in engagement of participants (thinking distortions, skills to manage triggers and emotional states, etc.). DC's should require systematic, formal
Relapse Prevention Plans (RPP) as an element of provider treatment planning protocols, and ensure specific feedback to the bench regarding participant progress. RPT,
as well as other evidence-based "therapies" (versus conventional addiction "counseling") require specialized, and often certified staff training: the programming is focused
on skill building and competency, rather than advice and open-ended "group or individual processing." MET is recommended as an adjunct to programming and
especially important for DC's, as offenders typically enroll in services to avoid consequences of addiction (incarceration or conviction), rather than being ready for
change. DC's are very effective at arresting drug use, until treatment gains traction, and MET is a critical tool for decreasing resistance and improving the learning curve
and treatment outcomes. www.dcjs.virginia.gov/corrections/.../cognitiveBehavioral.pdf
03/03/2012
4
Practice
Area
Recidivism /
Criminality
Treatment
Interventions
Enhancement
Justification
Recommended
Tools
(Evidence based
practices / best
practices)
Moral Reconation Therapy
Georgia's programs should employ a
(MRT)*, Thinking for a
manualized, validated cognitive
Change (TFAC)*.
behavioral curriculum that addresses
criminal thinking in order to drive-down
risk of recidivism. Services will be
provided for offenders or target
population assessed as being moderate
Criminal risk factors are those to high-risk for recidivism.
characteristics and behaviors
that affect a person's risk for Programs that target 4-6 criminogenic
needs can produce 30% reductions in
committing future crimes and
include, but are not limited to, recidivism. Programs that only target 1
antisocial behavior, antisocial or 2 needs have had no effect or have
personality, criminal thinking, increased recidivism (Latessa, 2008).
criminal associates, substance
The interdisciplinary team (tx and crj
abuse, difficulties with
members) should be directly involved in
impulsivity and problemsolving, underemployment or development and implementation of
specific sanctions and incentives.
unemployment.
Communication between team members
to support this practice is essential.
DC's will incorporate
programming that addresses
criminogenic risk factors: those
offender characteristics that
are related to risk of
recidivism.
Notes:
Citations
TIP 44, Substance Abuse Treatment
for Adults in the Criminal Justice
System (SAMHSA, CSAT 2005).
Ten Science-based Principles of
Changing Behavior Through the
Use of Reinforcement and
Punishment, NDCI, 2006. CognitiveBehavioral Treatment: A Review
and Discussion for Corrections
Professionals, US Department of
Justice, National Institute of
Corrections, 2007.
10 Key
Components of
Drug Courts
4, 6
NIDA
Evidence
Based
Principle
3, 4, 7, 10
Practitioner
Questions
Have we decreased risk of
recidivism at graduation?
How do we know? Is my
provider trained or
certified on an approach to
do so?
The greatest benefit and cost-savings come from working with offenders who are at moderate to high-risk of recidivism. Importantly, addiction is one of multiple factors
that contributes to risk of recidivism, and criminal thinking is often an attendant and independent factor among moderate to high-risk offenders (i.e., it doesn't necessarily
subside when substance abuse is arrested). Criminal thinking curricula should incorporate a systematic, cognitive-behavioral approach that focuses on "thinking distortions
or errors" and dynamic repetition of skills. The approach follows the RPT paradigm, and like RPT, it typically requires specialized and certified training.
http://store.samhsa.gov/product/TIP-35-Enhancing-Motivation-for-Change-in-Substance-Abuse-Treatment/SMA08-4212; http://static.nicic.gov/Library/021657.pdf
03/03/2012
5
Practice
Area
Treatment / Case
Management
Planning
Enhancement
DC's will use treatment/case
management planning that
follows from assessment and
systematically addresses core
risk factors associated with
relapse and recidivism.
Treatment and case
management planning should
be an ongoing process and
occur in conjunction with one
another.
Notes:
Justification
Georgia's programs should respond to
individual risk factors and needs that
contribute to relapse and recidivism.
There should be close collaboration
between treatment and case
management.
Recommended
Tools
(Evidence based
practices / best
practices)
Citations
(CSAT), 2005; Taxman, 2008,
Tools of the trade: A guide to
incorporating science into practice;
10 Key
Components of
Drug Courts
4
NIDA
Evidence
Based
Principle
3, 4
Practitioner
Questions
Are we individualizing our
approach to tx planning? Is
our approach informed by
a valid assessment? Do we
know what our participants
are doing when not in court
or treatment?
Treatment and case management planning respond to multiple needs of the individual and are not limited to substance abuse. Effective plans follow from initial and
ongoing assessment and are informed by the principle that no single treatment is appropriate or responsive for all individuals. Among participant needs (relapse
prevention, criminogenic issues, mental health or biomedical problems), counselors and case managers should include motivation and readiness for change. It is also
recommended that programs emphasize a "strengths-based" approach Best DC treatment and case management planning practice creates a feedback loop involving the
bench, whereby progress is closely monitored, and compliance is reinforced in the courtroom. Treatment and case management planning should be continuous and vital
throughout the DC phases. http://www.ncbi.nlm.nih.gov/books/NBK64138 http://store.samhsa.gov/product/TAP-19-Relapse-Prevention-with-Chemically-DependentCriminal-Offenders-Counselor-s-Manual/SMA06-4217
03/03/2012
6
Information
Management
Systems
Practitioner
Questions
Enhancement
Justification
Recommended
Tools
(Evidence based
practices / best
practices)
Citations
DC's will employ an
information management
system that captures critical
court and treatment data and
decisions that affect
participants. The data
management approach will
promote the integration of
court and treatment strategies,
enhance treatment and case
management planning and
compliance tracking, and
produce meaningful program
management and outcome
data. Measures of treatment
services delivered and
attended by participants
should be captured.
Georgia's programs should maintain the
highest level of transparency and utilize
solid data management and reporting
strategies to ensure program
accountability and effectiveness.
NA
Notes:
Data management is not a perfunctory exercise for program administrators and treatment staff: it is vital element promoting effective management, stewardship, and
transparency. Drug court interdisciplinary teams are encouraged to review best practices and consult with evaluators in determining core data elements. Strong data
management is a benchmark of effective programming and cost savings. It is also critical for programs writing for competitive grants.
https://www.ncjrs.gov/pdffiles1/nij/grants/223853.pdf
Practice
Area
The DC program is the steward of
judicial, treatment, and case
management data management and
collection.
10 Key
Components of
Drug Courts
6, 8, 9
NIDA
Evidence
Based
Principle
8
Does our data answer
critical questions about
program management,
outputs, and outcomes? Are
our data readily available?
Is our program data in a
format that allows us to
advocate for our
effectiveness and pinpoint
weaknesses for us to
address? Does our
reporting data meet
national standards for
competitive grants and best
practices?
03/03/2012
7
Practice
Area
Oversight and
Evaluation
Enhancement
Citations
Practitioner
Questions
Justification
Recommended
Tools
(Evidence based
practices / best
practices)
DC's are responsible for
oversight of all program
components. Regular
monitoring of judicial status
hearings, treatment, and case
management services should
occur.
Data collected should be measures of
program practices and services that
demonstrate fidelity to program model
and practice standards.
NA
Notes:
The recommended measurement tools vary with a program's target population and goals, but cost-effective, valid measures are readily available. Sound drug court
practice demands close oversight and monitoring protocols for treatment services to ensure fidelity to EBP's and BP's, and overall performance.
http://www.ndci.org/sites/default/files/ndci/Mono9.QualityImprovement.pdf
Evaluation of key performance
measures should occur regularly (#
screened/assessed/enrolled; retention
Meetings with and surveys of in program; sobriety; in-program and
participants to assess program post-program recidivism; units of service
delivered).
strengths and areas for
improvement increases
legitimacy of the process and
leads to improved outcomes.
Performance Measurements of
Drug Courts: The State of the Art,
Nat'l Center for State Courts with
BJA and NDCI (2008).
Performance Management for
Substance Abuse Treatment
Providers, SAMHSA, 2008.
10 Key
Components of
Drug Courts
8
NIDA
Evidence
Based
Principle
NA
For DCA's/program
managers: Have I
conducted site visits to
treatment centers and other
services? Have I attended
court status hearings
regularly? Have I met with
participants to find out how
program is doing? Are we
collecting data that will
demonstrate services
provided?
03/03/2012
8
SCREENING/ASSESSMENT TOOLS
Two assessment tools are used for our participants. The ASI (Addiction Severity
Index) and the LSI-R (Level of Service Inventory-Revised). Necessary training is
provided to the Treatment Provider or any other individual who administers these
assessments.
Through the ASI, the Treatment Provider can identify the extent of an individual’s
involvement in addictive substances, any mental health and/or family issues,
background information and any other support system issues that might be plaguing the
participant. The index also provides an overall rating of problem areas and this aids in
treatment planning.
If any doubts should arise, face to face, short assessments, with each participant
will help document any clinical involvement that might have a bearing on the individual’s
ability to participate in the program.
The LSI-R is a validated risk/need assessment tool which identifies problem
areas in an offender’s life and predicts his/her risk of recidivism. It is a 54-item
instrument which assesses offenders across 10 domains known to be related to an
offender’s likelihood of returning to prison. Addressing need areas through prison
rehabilitative interventions can ultimately reduce an offender’s probability of reincarceration. LSI-R’s are completed by trained assessors who conduct interviews with
offenders and verify the information through external sources, when possible.
Colquitt Superior Court SA/MH
Post-Assessment Follow-up Procedure
The post screening follow-up assessment will be done by the program clinician. The
following assessment is made when it appears that the person referred is experiencing
problems that do not coincide with the person's appearance, actions, body language,
facial presentation or other areas that may signal a more serious problem or concern, or
may be malingering (vague complaint).
Procedure:
1. Date: The current date that the assessment is being done.
2. The consumer's identifying information: This data can be collected from
current records and verified with the consumer once the face to face begins.
3. Demographics: Same as above.
4. History of current problem/Reason for referral: This could vary based
upon what is going on with the consumer. Previously documented
information can be reviewed prior to speaking with the person being
assessed. Information may emerge that could provide insight to the
assessor that may confirm suspected problem areas.
5. Follow-up Areas of Concern: This area will be reviewed more in depth
with the individual in an attempt to identify acute areas that could signal
pending problems. This area may also eliminate the consumer as a
candidate for the court program altogether.
6. Discussion: A summary of the assessor's interaction with the consumer.
This will be more of a subjective narrative of what was noted in the
interview (ex. did the consumer keep bringing the discussion back to
getting out of jail), reports of major depression symptoms by denying past
treatment, or denying a need for seeing the doctor.
7. Findings: Any documentation other than the initial screening. (mental health,
family, criminal records).
8. Legal Charges: Prison, jail, other warrants, lawyer's name, if an attorney is
assigned.
9. Referral Source: Who referred the consumer to the court program.
10. Recommendation: This area will contain ideas for services the consumer
could participate in that could be beneficial to help decrease or eliminate
problem areas.
There will be times when the screening and/or assessment will be presented in the
treatment team meeting.
Apartment Guidelines
Some Substance Abuse/Mental Health Court Programs manage apartments
which are used for routine assignments to individuals who qualify for placement. An
apartment can be kept vacant for emergency placement of someone who may be in a
situation that requires more intense assistance. These apartments can be occupied by
any individual who meets the eligibility for enrollment in the program.
Expectations of anyone living in one of the court program apartments are
that 1) the person must be able to live independently (perform as is) without
assistance from the staff, and 2) be able to obtain and keep employment (see all
apartment guidelines - Attachment #1).
The court program would work with agencies to help acquire the funding for
utilities, rent, phone services, some transportation, and case management.
Residential Program Guidelines
(Supplemental)
1.
I understand that I am being allowed to temporarily live in this apartment, which is provided by the
Treatment Court Program, to further my efforts towards sobriety. The only way that I will be allowed
to live in this apartment is by remaining clean and sober. I further understand that if I should relapse
and choose to use illegal drugs or alcohol (even if I am 21) and fail an emit or breathalyzer test, I will
be given a warning and revised treatment plan will be developed. However, I will be allowed to remain
in the apartment. If I relapse a second time, I could be required to vacate the apartment as a sanction.
2.
I understand that the atmosphere of this apartment should be one of recovery and healing. While I am
allowed to have guests, they are not to be in excess or disruptive to others in the complex. If a
legitimate complaint is made by my neighbors or the rental agency, that I or my guests are being
disruptive - I understand that I will be given one warning, before being required to vacate the apartment
as a sanction.
3.
I understand that my residence in this apartment is based upon my continued sobriety and compliance
with program and probation rules. If a warrant is issued for my arrest, be it for a probation/program
violation or due to having received a new charge, I understand I may not be allowed continued access
to the program apartment. I understand that the locks on my apartment may be changed, or additional
locks may be placed on the doors, limiting or prohibiting my entry in the program apartment until the
warrant has been disposed of.
4.
I further understand that if - after 30 days I still have not addressed this warrant, or made arrangements
(in writing) to have my personal property removed from the apartment (with staff supervision) - any
personal items remaining in the program apartment could then be considered program property, to be
disposed of at the program's discretion.
5.
I understand that if I am incarcerated, or attending a residential treatment program, for more than 30
days, I may be required to vacate the program apartment as a sanction.
6.
I understand that as a condition of living in the program apartment at no cost, I will be required to
perform 20 hours of volunteer work per month in the local community. After I have lived in the
apartment for 6 months, if I am still not working, attending school full time, or disabled, I will be
required to perform 50 hours of volunteer work per month in the local community.
7.
I understand that as long as I reside in the apartment, I am not to have any weapons (i.e., knives,
firearms) on the property. This also applies to my family and my guests.
I have read, or have had read to me, this form and agree to comply with these requirements.
Participant Name/Date
Witness Name/Date
Entrance By Arrest
Arrest
Arraignment/Bond
Appointment
w/PD
Bond Hearing
Legal Screening
Grand Jury
Clinical Screening
Arraignment
Staffing
Motions
Trial
Plea W/drawn
Staff Says No
Participant Declines
Plea
Staff Says Yes
Participant Accepts
Drug Court Track
Entrance By Violation of Probation
Violation/Technical or New Charge
Arrest
Service of
VOP Petition
Back to
Criminal Justice Track
Legal Screening
Clinical Screening
MH Screening
Waiver
Staff Says No
Participant Declines
Staff Says Yes
Participant Accepts
Drug Court Track
ENTRY PROCESS CHART
Referrals to the program may come from any party including the arresting officer, jail officials,
defense attorney, District Attorney, Coordinator, Community Sentencing officials or the
Department of Corrections.
ARREST FOR
DUI/DRUG
OFFENSE
PROBATION VIOLATION
& DRUG MOTIVATED
CRIME BY AGREEMENT
LEGAL SCREENING
Prosecution reviews info.
& determines eligibility using
criteria developed by team
ELIGIBLE
NOT ELIGIBLE
DEFENDANT NOTICE
Prosecutor notifies Public
Defender that Defendant is
eligible for Court and is
willing to pursue this avenue
DECLINES
INFORMATION
NORMAL CRIMINAL
CASE PROCESSING
Public Defender explains
program to Defendant
CLINICAL SCREENING
LSI-R and/or ASI
DIAGNOSIS
NO DIAGNOSIS
TREATMENT COURT
GRADUATION
NORMAL CASE
DISPOSITION
PRISON/JAIL
TERMINATION
PROBATION
MH/SA
Treatment Program
Start
→→→
Consumer is processed
through the Court
↓
Referred to the
appropriate
Program
← NO ←
Accepted into the
Program ?
↓
YES
↓
Return to court to be
Reassessed for graduation or
continuance in program
Referred
To most
Appropriate
Program
↓
↑
←←←
Treatment court Group -1 year, 28 day Program,
Residential Placement per Program Guidelines
(6 months)
Substance Dependent Long-Term
Treatment Track
ColquiTTSuperior
Colquitt
SuperiorCourt
CourtSA/MH
MH/SA
MH/SA
Dougherty
Superior
Court MH/SA
Treatment
Program
START →
ENROLLED IN PROGRAM?
↓
NO →
CLOSE
→
REFER TO APPROPRIATE PROGRAM
FILE
↓
YES →
REFER TO APPROPRIATE
PROGRAM FOR SERVICES
↓
Refer to Outpatient
Treatment
←
↓
→
Case Management assist with
funding (TANF, Medicaid, Social
Security, Disability, etc.)
↑
↓
↓
Release
from
Program
↓
←
Less Severe / Monitoring
up to 15 months
Monitor progress,
report to court, keep
appointments
←
Program Aftercare
(Monitoring)
↑
Release from
Program
↓
←
Place in Personal Care Home,
with immediate Family, or
Willing and capable relatives
←
MENTAL HEALTH TRACK – 2 YEAR
More Severe/ Monitoring
up to 24 months
To achieve the goal of creating a statewide system of Accountability Courts in Georgia, Georgia’s Adult Felony Drug Courts shall adhere to the following standards and recommendations for operation. These standards use the Ten Key Components1 as a foundation and were developed from a review of national research findings and best practices, and analysis of practices and procedures being used in Georgia’s drug courts currently. Updates will be integrated accordingly with the development of research and findings in the field. Program certification and eligibility for state funding will be based on adherence to these standards, and each court will be subject to a performance peer review no less than once every three years. Purpose: To establish standards, practices and a certification process for Georgia’s adult drug courts and adult drug court divisions pursuant to O.C.G.A. § 15‐1‐15. Key Component #1: Drug courts integrate alcohol and other drug treatment services with justice system case processing. 

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




Pursuant to O.C.G.A. § 15‐1‐15, each drug court shall establish a planning group to create a work plan for the court. The work plan shall “address the operational, coordination, resource, information management, and evaluation needs” of the court, and shall include all policies and practices related to implementing the standards set forth in this document. The Drug Court Team should include, at a minimum, the following representatives: Judge, public defender, prosecutor, program coordinator, law enforcement, and treatment provider/substance abuse professional. The drug court team shall collaboratively develop, review, and agree upon all aspects of drug court operations (mission, goals, eligibility criteria, operating procedures, performance measures, orientation, drug testing, program structure guidelines) prior to commencement of program operations. o This plan is executed in the form of a Memorandum of Understanding (MOU) between all parties and updated annually as necessary. o Each of these elements shall be compiled in writing in the form of a Policies and Procedures Manual which is reviewed and updated as necessary no less than every two years. The goals of adult drug court programs in Georgia shall be abstinence from alcohol and other illicit drugs and promotion of law‐abiding behavior in the interest of public safety. All members of the drug court team are expected to attend and participate in a minimum of two formal staffings per month. Members of the drug court team should attend drug court sessions. Standardized evidence‐based treatments, as recommended in the Georgia Drug Court Treatment Standards, shall be adopted by the drug court to ensure quality and effectiveness of services and to guide practice. Drug courts should provide for a continuum of services through partnership with a primary treatment provider to deliver treatment, coordinate other ancillary services, and make referrals as necessary. 1
National Association of Drug Court Professionals, 1997 6/27/2012 – ADOPTED AS AMENDED 1 

The court shall maintain ongoing communication with the treatment provider. The treatment provider should regularly and systematically provide the court with written reports on participant progress; a reporting schedule shall be agreed upon by the drug court team and put in writing as part of the court’s operating procedures. Reports should be provided on a weekly basis and within 24 hours as significant events occur. Significant events include but are not limited to the following: Death, Unexplained absence of a participant from a residence or treatment program, Physical, sexual or verbal abuse of a participant by staff or other clients, Staff negligence, Fire, Theft, Destruction or other loss of property, Complaints from a participant or his/her family, Requests for information from the press, attorneys or government officials outside of those connected to the Court, and participant behavior requiring attention of staff not usually involved in his care. Participants should have contact with case management personnel (drug court staff or treatment representative) at least once per week during the first twelve months of treatment to review status of treatment and progress. Key Component #2: Using a non‐adversarial approach, prosecution and defense counsel promote public safety while protecting participants’ due process rights.  Prosecution and defense counsel shall both be members of the drug court team and shall participate in the design, implementation and enforcement of the program’s screening, eligibility and case‐processing policies and procedures.  The prosecutor and defense counsel shall work to create a sense of stability, cooperation and collaboration in pursuit of the program’s goals.  The prosecution shall: review cases and determine whether a defendant is eligible for the drug court program; file all required legal documents; participates in and enforces a consistent and formal system of sanctions in response to positive drug tests and other participant noncompliance; agree that a positive drug test or open court admission of drug use will not result in the filing of additional drug charges based on that admission; and make decisions regarding the participant’s continued enrollment in the program based on progress and response to treatment rather on legal aspects of the case, with the exception of additional criminal behavior.  The defense counsel shall: review the arrest warrant, affidavits, charging document, and other relevant information, and reviews all program documents (i.e., waivers, written agreements); advises the defendant as to the nature and purpose of the drug court, the rules governing participation, the merits of the program, the consequences of failing to abide by the rules, and how participation or non‐
participation will affect his/her interests; provides a list of and explains all of the rights that the defendant will temporarily or permanently relinquish2; advises the participants on alternative options, including all legal and treatment alternatives outside of the drug court program; discusses with the defendant the long‐term benefits of sobriety; explains that the prosecution has agreed that admission to 2
Each right that will be temporarily or permanently relinquished as a condition of participation in drug court shall be distinguished and explained separately to ensure the defendant fully understands what they are waiving. 2 
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
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

drug use in open court will not lead to additional charges, and therefore encourage truthfulness with the judge and treatment staff; and, informs the participant that they will be expected to take an active role in court sessions, including speaking directly to the judge as opposed to doing so through an attorney. Pursuant to O.C.G.A. § 15‐1‐15, drug courts may accept offenders with non‐drug charges. For any participant whose charges include a property crime, the court must comply with the requirements and provisions set forth in the Crime Victim’s Bill of Rights (O.C.G.A. § 15‐17‐1, et seq.) All participants shall receive a Participant Handbook upon accepting the terms of participation and entering the program. Receipt of Handbook shall be acknowledged through a signed form, developed by the Judicial Council Accountability Courts Committee, with an executed copy placed in the court file maintained locally. Each drug court shall develop and use a form, or adopt the model created by the Judicial Council Accountability Courts Committee, to document that each participant has received counsel from an attorney prior to admittance to a drug court, including the receipt of the local Participant Agreement with an executed copy placed in the official court file maintained locally. The decision to participate in a drug court shall be made solely by the eligible participant. There shall be no coerced participation in a drug court, such as by giving eligible offenders the choice between an onerous disposition and participation in the program. The decision to participate in a drug court shall not be influenced by offering a dispositional alternative more grueling or demanding to eligible offenders than that which is offered in cases where drug court participation is not an option. The judge, on the record, must apprise a participant of all due process rights, rights being waived, any process for reasserting those rights, and program expectations. Terminations from drug court require notice, a hearing and a fair procedure. Not covered by this requirement is when a participant self‐terminates and this situation does not require any type of pre‐
termination hearing. The consequences of termination from a drug court should be comparable to those sustained in other similar cases before the presiding judge. The sentence shall be reasonable and not excessively punitive solely based on termination from drug court. Termination hearings conducted for drug court participants shall include all due process rights afforded to any offender serving a probated sentence under the supervision of the Georgia Department of Corrections. In jurisdictions where the Drug Court Judge will also sit as the Judge performing a termination hearing, this situation needs to be communicated to offenders in writing at the time where program participation is being considered. 3 Key Component #3: Eligible participants are identified early and promptly placed into the drug court program  Participant eligibility requirements/criteria (verified through legal and clinical screening) shall be developed and agreed upon by all members of the drug court team and included in writing as part of the program’s policies and procedures.  Courts may admit eligible participants pre‐plea, post‐plea, or operate under a hybrid model.  Screening for program eligibility shall include the review of legal requirements and clinical appropriateness, including the administration of a risk and needs assessment  The target population for drug courts should be offenders classified as moderate to high‐risk and or need, as determined by a risk and needs assessment; the court should not target a mixed population of low risk and moderate to high risk offenders to be served in a single treatment setting.  Members of the drug court team and other designated court or criminal justice officials shall screen cases for eligibility and identify potential drug court participants.  Participants being considered for a drug court shall be promptly advised about the program, including the requirements, scope and potential benefits and effects on their case  Participants should begin treatment as soon as possible; preferably, no more than 30 days should pass between a participant being determined eligible for the program and commencement of treatment services.  Assessment for substance abuse and other treatment shall be conducted by appropriately trained and qualified professional staff, using standardized assessment tools.  Drug courts shall maintain an appropriate caseload based on its capacity to effectively serve all participants according to these standards.  No potential participant shall be excluded solely based on the basis of sex, race, color, religion, creed, age, national origin, ancestry, pregnancy, marital status or parental status, sexual orientation, or disability. Key Component #4: Drug courts provide access to a continuum of alcohol, drug and other related treatment and rehabilitation services.  A drug court shall require a minimum 18 months of supervision and treatment for felony offenders to be considered as a drug court.  Felony programs should last a minimum of 18 months and should not exceed 24 months. Exceptions to the 24‐month maximum may be made based on participant progress following a 24‐month evaluation and assessment, to be followed up every four months thereafter and not to exceed a total program length of 36 months. A formal report of each assessment following 24 months shall be added to participant file to justify extension of the program.  Drug court programs should be structured into a series of phases. The final phase may be categorized as “aftercare/continuing care”.  Drug court programs shall offer a comprehensive range of core alcohol and drug treatment services. These services include: 4 




o Group counseling o Individual counseling o Drug testing Drug court programs should ideally offer: o Family counseling o Gender specific counseling o Domestic violence counseling o Health screening o Assessment and counseling for co‐occurring mental health issues Ancillary services are available to meet the needs of participants. These services may include but are not limited to: o Employment counseling and assistance o Educational component o Medical and dental care o Transportation o Housing o Mentoring and alumni groups Case management plans shall be individualized for each participant based on the results of the initial assessment; ongoing assessment shall be provided according to a program schedule and treatment plans may be modified or adjusted based on results. Treatment shall include standardized evidence‐based practices (see Georgia Adult Drug Court Treatment Standards) and other practices recognized by NREP. A set of quality controls/review process shall be in place to ensure accountability of the treatment provider. Key Component #5: Abstinence is monitored by frequent alcohol and other drug testing.  Participants shall be administered a drug test a minimum of twice per week during the first two phases of the program; a standardized system of drug testing shall continue through the entirety of the program.  Drug testing shall be administered to each participant on a randomized basis, using a formal system of randomization  All drug courts shall utilize urinalysis as the primary method of drug testing; a variety of alternative methods may be used to supplement urinalysis, including breath, hair, and saliva testing and electronic monitoring.  All drug testing shall be directly observed by an authorized, same sex member of the Drug Court team, a licensed/certified medical professional, or other approved official of the same sex.  Drug screens should be analyzed as soon as practicable. Results of all drug tests should be available to the court and action should be taken as soon as practicable, ideally within 48 hours of receiving the results. . 5 



In the event a single urine sample tests positive for more than one prohibited substance, the results shall be considered as a single positive drug screen A minimum of 90 days negative drug testing shall be required prior to a participant being deemed eligible for graduation from the program. Each drug court shall establish a method for participants to dispute the results of positive drug screens through either Gas Chromatography‐Mass Spectrometry, liquid chromatography‐mass spectrometry, or some other equivalent protocol. Creatinine violations and drug screens scheduled and missed without a valid excuse as determined by the presiding Judge shall be considered as a positive drug screen. Key Component #6: A coordinated strategy governs drug court responses to participants’ compliance  A drug court shall have a formal system of sanctions and rewards, including a system for reporting noncompliance, established in writing and included in the court’s policies and procedures.  The formal system of sanctions and rewards shall be organized on a gradually escalating scale and applied in a consistent and appropriate manner to match a participant’s level of compliance.  Courts should implement a system for a minimum level of field supervision for each participant based on their respective level of risk. Field supervision may include unannounced visits to home or workplace, and curfew checks. The level of field supervision may be adjusted throughout the program based on participant progress and any reassessment process.  Regular and frequent communication between all members of drug court team shall provide for immediate and swift responses to all incidents of non‐compliance, including positive drug tests  There shall be no indefinite time periods for sanctions, including those sanctions involving incarceration or detention. Incarceration or detention should only be considered as the last option in the most serious cases of non‐compliance.  Participants shall be subject to progressive positive drug screen sanctions prior to being considered for termination, unless there are other acts of non‐compliance affecting this decision. Key Component #7: Ongoing judicial interaction with each drug court participant is essential  A single Superior Court judge or Senior Superior Court Judge must preside over an individual felony drug court program and should be committed to serving in this role long‐term o A judge of the Superior Court must preside over a felony drug court program; provided, however that a judge from another class of court may be the presiding judge of a felony drug court program if that judge is specially designated as such by the Chief Judge of the judicial circuit in which the court operates, and is approved for such by the Judicial Council Accountability Courts Committee.  The presiding judge may authorize assistance from other judges, including senior judges and judges from other classes of court, on a time‐limited basis when the presiding judge is unable to conduct court.  The judge shall attend and participate in all pre‐court staffings. 6 




A regular schedule of status hearings shall be used to monitor participant progress. There shall be a minimum of two status hearings per month in the first phase of felony drug court programs and, dependent on participant needs, this minimum schedule may continue through additional phases. Frequency of status hearings may vary based on participant needs and benefits, as well as judicial resources. Status hearings should be held no less than once per month during the last phase of the program. Status review shall be conducted with each participant on an individual basis; to optimize program effectiveness, group reviews should be avoided unless necessary based on an emergency basis3 The judge, to the extent possible, should strive to spend an average of three minutes or greater with each participant during status review Key Component #8: Monitoring and evaluation measure the achievement of program goals and gauge effectiveness.  Participant progress, success and satisfaction should be monitored on a regular basis (including at program entry and graduation) through the use of surveys.  Participant data should be monitored and analyzed on a regular basis (as set forth in a formal schedule) to determine the effectiveness of the program.  A process and outcomes evaluation should be conducted by an independent evaluator within three years of implementation of a drug court program, and in regular intervals as necessary, appropriate, and/or feasible for the program thereafter.  Feedback from participant surveys, review of participant data, and findings from evaluations should be used to make any necessary modifications to program operations, procedures and practices.  Data needed for program monitoring and management are easily obtainable and are maintained in useful formats for regular review by program management.  Courts should use the preferred case management program, or compatible equivalent, as designated by the Judicial Council Accountability Courts Committee, in the interest of the formal and systematic collection of program performance data  Courts shall collect, at a minimum, a mandatory set of performance measures determined by the Judicial Council Accountability Courts Committee which shall be provided in a timely requisite format to the AOC as required by the Judicial Council Accountability Courts Committee, including a comprehensive end‐of‐year report. The minimum performance measures to be collected shall include: recidivism (rearrests and reconvictions), number of moderate and high risk participants, drug testing results, drug testing failures, number of days of continuous sobriety, units of service (number of court sessions, number of days participant receives inpatient treatment), employment, successful participant completion of the program (graduations), and unsuccessful participant completion of the program (terminations, voluntary withdrawal, death/other) 3
Insufficient time based on program census does not constitute an emergency. 7 Key Component #9: Continuing interdisciplinary education promotes effective drug court planning, implementation and operations  Drug court programs shall have a formal policy on staff training requirements and continuing education.  All members of a drug court team shall receive training through the National Drug Court Institute o Completion of the National Drug Court Planning Initiative shall be required prior to implementation in order to attain certification o Existing programs should participate in Operational Tune‐Up as needed  Court teams, to the extent possible, should attend comprehensive training on an annual basis, as provided by the Judicial Council Accountability Courts Committee or the National Association of Drug Court Professionals.  Drug court judges and staff should participate in ongoing continuing education as it is available through professional organizations (ICJE, NADCP, GCCA, etc.)  New team members shall attend formal orientation and training administered by the Judicial Council Accountability Courts Committee, or the National Association of Drug Court Professionals. Key Component #10: Forging partnerships among drug courts, public agencies and community‐based organizations generates local support and enhances drug court program effectiveness.  Pursuant to O.C.G.A. § 15‐1‐15, each drug court shall establish a Planning Group to create a work plan for the court. The work plan shall “address the operational, coordination, resource, information management, and evaluation needs” of the court, and shall include all policies and practices related to implementing the standards set forth in this document.  A local steering committee consisting of representatives from the court, community organizations, law enforcement, treatment providers, health providers, social service agencies, and the faith community should meet on a quarterly basis to provide policy guidance, fundraising assistance and feedback to the drug court program  Drug courts should consider forming an independent 501(c)(3) organization for fundraising and administration of the steering committee  Drug courts should actively engage in forming partnerships and building relationships between the court and various community partners. This may be achieved through facilitation of forums, informational sessions, public outreach and other ways of marketing.  Drug court staff should participate in ongoing cultural competency training on an annual basis 8 U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Assistance
Bureau of
Drug Courts Resource Series
Justice Assistance
Defining Drug Courts:
THE
KEY
COMPONENTS
U.S. Department of Justice
810 Seventh Street NW.
Washington, DC 20531
John Ashcroft
Attorney General
Deborah J. Daniels
Assistant Attorney General
Domingo S. Herraiz
Director, Bureau of Justice Assistance
Partnerships for Safer Communities
www.ojp.usdoj.gov
www.ojp.usdoj.gov/BJA
NCJ 205621
The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also
includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile
Justice and Delinquency Prevention, and the Office for Victims of Crime.
Defining Drug Courts:
The Key Components
January 1997
Reprinted October 2004
The National Association of Drug Court Professionals
Drug Court Standards Committee
This document was prepared by the National Association of Drug Court Professionals under Grant
No. 96-DC-MX-K001, awarded by the Drug Courts Program Office, Office of Justice Programs,
U.S. Department of Justice. Points of view in this document are those of the authors and do not
necessarily represent the official positions or policies of the U.S. Department of Justice.
Notice
In November 2002, the Bureau of Justice Assistance (BJA) assumed responsibility for administering
the Drug Court Grant Program and the Drug Court Training and Technical Assistance Program. For
further information, please contact BJA.
Contents
Key Component #1: Drug courts integrate alcohol and other drug treatment
services with justice system case processing.................................................................................... 1
Key Component #2: Using a nonadversarial approach, prosecution and defense counsel
promote public safety while protecting participants' due process rights .................................... 3
Key Component #3: Eligible participants are identified early and promptly
placed in the drug court program...................................................................................................... 5
Key Component #4: Drug courts provide access to a continuum of alcohol,
drug, and other related treatment and rehabilitation services ....................................................... 7
Key Component #5: Abstinence is monitored by frequent alcohol and other
drug testing ......................................................................................................................................... 11
Key Component #6: A coordinated strategy governs drug court responses
to participants' compliance............................................................................................................... 13
Key Component #7: Ongoing judicial interaction with each drug court participant
is essential ........................................................................................................................................... 15
Key Component #8: Monitoring and evaluation measure the achievement of
program goals and gauge effectiveness .......................................................................................... 17
Key Component #9: Continuing interdisciplinary education promotes effective
drug court planning, implementation, and operations ................................................................. 21
Key Component #10: Forging partnerships among drug courts, public
agencies, and community-based organizations generates local support
and enhances drug court program effectiveness........................................................................... 23
Appendix 1: Drug Court Standards Committee .......................................................................... 25
Appendix 2: Resource List.............................................................................................................. 27
iii
Key Component #1
Drug courts integrate alcohol and other drug treatment services
with justice system case processing.
Purpose
The mission of drug courts is to stop the abuse of alcohol and other drugs and related
criminal activity. Drug courts promote recovery through a coordinated response to offenders
dependent on alcohol and other drugs. Realization of these goals requires a team approach,
including cooperation and collaboration of the judges, prosecutors, defense counsel,
probation authorities, other corrections personnel, law enforcement, pretrial services
agencies, TASC programs, evaluators, an array of local service providers, and the greater
community. State-level organizations representing AOD issues, law enforcement and
criminal justice, vocational rehabilitation, education, and housing also have important roles
to play. The combined energies of these individuals and organizations can assist and
encourage defendants to accept help that could change their lives.
The criminal justice system has the unique ability to influence a person shortly after a
significant triggering event such as arrest, and thus persuade or compel that person to enter
and remain in treatment. Research indicates that a person coerced to enter treatment by the
criminal justice system is likely to do as well as one who volunteers.1
Drug courts usually employ a multiphased treatment process, generally divided into a
stabilization phase, an intensive treatment phase, and a transition phase. The stabilization
phase may include a period of AOD detoxification, initial treatment assessment, education,
and screening for other needs. The intensive treatment phase typically involves individual
and group counseling and other core and adjunctive therapies as they are available (see Key
Component #4). The transition phase may emphasize social reintegration, employment and
education, housing services, and other aftercare activities.
Performance Benchmarks
1.
Initial and ongoing planning is carried out by a broad-based group, including persons
representing all aspects of the criminal justice system, the local treatment delivery system,
funding agencies, and the local community's other key policymakers.
2.
Documents defining the drug court's mission, goals, eligibility criteria, operating
procedures, and performance measures are collaboratively developed, reviewed, and
agreed upon.
1Hubbard,
R., Marsden, M., Rachal, J., Harwood, H., Cavanaugh E., and Ginzburg, H. Drug Abuse Treatment:
A National Study of Effectiveness. Chapel Hill: University of North Carolina Press, 1989.
Pringle G.H., Impact of the criminal justice system on substance abusers seeking professional help, Journal of
Drug Issues, Summer, pp. 275-283, vol 12, no. 3, 1982.
1
3.
Abstinence and law-abiding behavior are the goals, with specific and measurable criteria
marking progress. Criteria may include compliance with program requirements,
reductions in criminal behavior and AOD use, participation in treatment, restitution to
the victim or to the community, and declining incidence of AOD use.
4.
The court and treatment providers maintain ongoing communication, including frequent
exchanges of timely and accurate information about the individual participant's overall
program performance.2
5.
The judge plays an active role in the treatment process, including frequently reviewing
treatment progress. The judge responds to each participant's positive efforts as well as to
noncompliant behavior.
6.
Interdisciplinary education is provided for every person involved in drug court
operations to develop a shared understanding of the values, goals, and operating
procedures of both the treatment and justice system components.
7.
Mechanisms for sharing decisionmaking and resolving conflicts among drug court team
members, such as multidisciplinary committees, are established to ensure professional
integrity.
2All
communication about an individual's participation in treatment must be in compliance with the provisions
of 42 CFR, Part 2 (the federal regulations governing confidentiality of alcohol and drug abuse patient records),
and with similar State and local regulations.
2
Key Component #2
Using a nonadversarial approach, prosecution and defense counsel
promote public safety while protecting participants' due process rights.
Purpose
To facilitate an individual's progress in treatment, the prosecutor and defense counsel must
shed their traditional adversarial courtroom relationship and work together as a team. Once a
defendant is accepted into the drug court program, the team's focus is on the participant's
recovery and law-abiding behavior—not on the merits of the pending case.
The responsibility of the prosecuting attorney is to protect the public's safety by ensuring
that each candidate is appropriate for the program and complies with all drug court
requirements. The responsibility of the defense counsel is to protect the participant's due
process rights while encouraging full participation. Both the prosecuting attorney and the
defense counsel play important roles in the court's coordinated strategy for responding to
noncompliance.
1.
Prosecutors and defense counsel participate in the design of screening, eligibility, and
case-processing policies and procedures to guarantee that due process rights and public
safety needs are served.
For consistency and stability in the early stages of drug court operations, the judge,
prosecutor, and court-appointed defense counsel should be assigned to the drug court
for a sufficient period of time to build a sense of teamwork and to reinforce a
nonadversarial atmosphere.
The prosecuting attorney:
2.
3.
•
•
•
•
•
4.
Reviews the case and determines if the defendant is eligible for the drug court
program.
Files all necessary legal documents.
Participates in a coordinated strategy for responding to positive drug tests and other
instances of noncompliance.
Agrees that a positive drug test or open court admission of drug possession or use
will not result in the filing of additional drug charges based on that admission.
Makes decisions regarding the participant's continued enrollment in the program
based on performance in treatment rather than on legal aspects of the case, barring
additional criminal behavior.
The defense counsel:
•
Reviews the arrest warrant, affidavits, charging document, and other relevant
information, and reviews all program documents (e.g., waivers, written agreements).
3
•
•
•
•
4
Advises the defendant as to the nature and purpose of the drug court, the rules
governing participation, the consequences of abiding or failing to abide by the rules,
and how participating or not participating in the drug court will affect his or her
interests.
Explains all of the rights that the defendant will temporarily or permanently
relinquish.
Gives advice on alternative courses of action, including legal and treatment
alternatives available outside the drug court program, and discusses with the
defendant the long-term benefits of sobriety and a drug-free life.
Explains that because criminal prosecution for admitting to AOD use in open court
will not be invoked, the defendant is encouraged to be truthful with the judge and
with treatment staff, and informs the participant that he or she will be expected to
speak directly to the judge, not through an attorney.
Key Component #3
Eligible participants are identified early and promptly
placed in the drug court program.
Purpose
Arrest can be a traumatic event in a person's life. It creates an immediate crisis and can force
substance abusing behavior into the open, making denial difficult. The period immediately
after an arrest, or after apprehension for a probation violation, provides a critical window of
opportunity for intervening and introducing the value of AOD treatment. Judicial action,
taken promptly after arrest, capitalizes on the crisis nature of the arrest and booking process.
Rapid and effective action also increases public confidence in the criminal justice system.
Moreover, incorporating AOD concerns into the case disposition process can be a key
element in strategies to link criminal justice and AOD treatment systems overall.
1.
Eligibility screening is based on established written criteria. Criminal justice officials or
others (e.g., pretrial services, probation, TASC) are designated to screen cases and
identify potential drug court participants.
2.
Eligible participants for drug court are promptly advised about program requirements
and the relative merits of participating.
3.
Trained professionals screen drug court-eligible individuals for AOD problems and
suitability for treatment.
4.
Initial appearance before the drug court judge occurs immediately after arrest or
apprehension to ensure program participation.
5.
The court requires that eligible participants enroll in AOD treatment services
immediately.
5
Key Component #4
Drug courts provide access to a continuum of alcohol, drug,
and other related treatment and rehabilitation services.
Purpose
The origins and patterns of AOD problems are complex and unique to each individual. They
are influenced by a variety of accumulated social and cultural experiences. If treatment for
AOD is to be effective, it must also call on the resources of pr3imary health and mental
health care and make use of social and other support services.
In a drug court, the treatment experience begins in the courtroom and continues through the
participant's drug court involvement. In other words, drug court is a comprehensive
therapeutic experience, only part of which takes place in a designated treatment setting. The
treatment and criminal justice professionals are members of the therapeutic team.
The therapeutic team (treatment providers, the judge, lawyers, case managers, supervisors,
and other program staff) should maintain frequent, regular communication to provide timely
reporting of a participant's progress and to ensure that responses to compliance and
noncompliance are swift and coordinated. Procedures for reporting progress should be
clearly defined in the drug court's operating documents.
While primarily concerned with criminal activity and AOD use, the drug court team also
needs to consider co-occurring problems such as mental illness, primary medical problems,
HIV and sexually-transmitted diseases, homelessness; basic educational deficits,
unemployment and poor job preparation; spouse and family troubles—especially domestic
violence—and the long-term effects of childhood physical and sexual abuse. If not
addressed, these factors will impair an individual's success in treatment and will compromise
compliance with program requirements. Co-occurring factors should be considered in
treatment planning. In addition, treatment services must be relevant to the ethnicity, gender,
age, and other characteristics of the participants.
Longitudinal studies have consistently documented the effectiveness of AOD treatment in
reducing criminal recidivism and AOD use.4 A study commissioned by the Office of
National Drug Control Policy found AOD treatment is significantly more cost-effective than
domestic law enforcement, interdiction, or "source-country control" in reducing drug use in
the United States.5 Research indicates that the length of time an offender spends in
3Treatment-Based
Drug Court Planning Guide and Checklist, Combining Alcohol and Other Drug Abuse
Treatment With Diversion for Juveniles in the Justice System, TIP #21, Treatment Drug Courts: Integrating
Substance Abuse Treatment With Legal Case Processing, TIP #23. Rockville, MD: Center for Substance Abuse
Treatment, 1996.
4 The Effectiveness of Treatment for Drug Abusers Under Criminal Justice Supervision. Lipton, D.,
Washington, DC: National Institute of Justice, Research Report, November 1995.
5Rydell,
P., Everingham, S. Controlling Cocaine: Supply Versus Demand Programs. Santa Monica, CA: RAND
Corporation, Office of National Drug Control Policy, Policy Research Center, 1994.
6
treatment is related to the level of AOD abuse and criminal justice involvement.6 A
comprehensive study conducted by the State of California indicates that AOD treatment
provides a $7 return for every $1 spent on treatment. The study found that outpatient
treatment is the most cost-effective approach, although residential treatment, sober living
houses, and methadone maintenance are also cost-effective.7 Comprehensive studies
conducted in California8 and Oregon9 found that positive outcomes associated with AOD
treatment are sustained for several years following completion of treatment.
For the many communities that do not have adequate treatment resources, drug courts can
provide leadership to increase treatment options and enrich the availability of support
services. Some drug courts have found creative ways to access services, such as
implementing treatment readiness programs for participants who are on waiting lists for
comprehensive treatment programs. In some jurisdictions, drug courts have established their
own treatment programs where none existed. Other drug courts have made use of pretrial,
probation, and public health treatment services.
1.
Individuals are initially screened and thereafter periodically assessed by both court and
treatment personnel to ensure that treatment services and individuals are suitably
matched:
• An assessment at treatment entry, while useful as a baseline, provides a time specific
"snapshot" of a person's needs and may be based on limited or unreliable
information. Ongoing assessment is necessary to monitor progress, to change the
treatment plan as necessary, and to identify relapse cues.
• If various levels of treatment are available, participants are matched to programs
according to their specific needs. Guidelines for placement at various levels should
be developed.
• Screening for infectious diseases and health referrals occurs at an early stage.
2.
Treatment services are comprehensive:
•
•
Services should be available to meet the needs of each participant.
Treatment services may include, but are not limited to, group counseling; individual
and family counseling; relapse prevention; 12-step self-help groups; preventive and
primary medical care; general health education; medical detoxification; acupuncture
for detoxification, for control of craving, and to make people more amenable to
treatment; domestic violence programs; batterers' treatment; and treatment for the
long-term effects of childhood physical and sexual abuse.
6Field, G. Oregon prison drug treatment programs. In C. Leukefeld and F. Tims (eds.), Drug Abuse Treatment
in Prisons and Jails. Research monograph series #108. Rockville, MD: National Institute on Drug Abuse, 1992.
Wexler, H., Falkin, G., and Lipton, D. Outcome evaluation of a prison therapeutic community for substance
abuse treatment. Criminal Justice and Behavior, 17, pp 71-92, 1990.
7 Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment (CALDATA) General
Report. Sacramento, CA: California Department of Alcohol and Drug Programs, April 1994.
8Ibid.
9 Societal
Outcomes and Cost Savings of Drug and Alcohol Treatment in the State of Oregon. Salem, OR:
Office of Alcohol and Drug Abuse Programs, Oregon Department of Human Resources, February 1996.
7
•
•
•
•
•
3.
Other services may include housing; educational and vocational training; legal,
money management, and other social service needs; cognitive behavioral therapy to
address criminal thinking patterns; anger management; transitional housing; social
and athletic activities; and meditation or other techniques to promote relaxation and
self-control.
Specialized services should be considered for participants with co-occurring AOD
problems and mental health disorders. Drug courts should establish linkages with
mental health providers to furnish services (e.g., medication monitoring, acute care)
for participants with co-occurring disorders. Flexibility (e.g., in duration of treatment
phases) is essential in designing drug court services for participants with mental
health problems.
Treatment programs or program components are designed to address the particular
treatment issues of women and other special populations.
Treatment is available in a number of settings, including detoxification, acute
residential, day treatment, outpatient, and sober living residences.
Clinical case management services are available to provide ongoing assessment of
participant progress and needs, to coordinate referrals to services in addition to
primary treatment, to provide structure and support for individuals who typically
have difficulty using services even when they are available, and to ensure
communication between the court and the various service providers.
Treatment services are accessible:
•
•
4.
Accommodations are made for persons with physical disabilities, for those not fluent
in English, for those needing child care, and/or for persons with limited literacy.
Treatment facilities are accessible by public transportation, when possible.
Funding for treatment is adequate, stable, and dedicated to the drug court:
•
•
•
•
•
5.
To ensure that services are immediately available throughout the participant's
treatment, agreements are made between courts and treatment providers. These
agreements are based on firm budgetary and service delivery commitments.
Diverse treatment funding strategies are developed based on both government and
private sources at national, State, and local levels.
Health care delivered through managed care organizations is encouraged to provide
resources for the AOD treatment of member participants.
Payment of fees, fines, and restitution is part of treatment.
Fee schedules are commensurate with an individual's ability to pay. However, no one
should be turned away solely because of an inability to pay.
Treatment services have quality controls:
•
•
Direct service providers are certified or licensed where required, or otherwise
demonstrate proficiency according to accepted professional standards.
Education, training, and ongoing clinical supervision are provided to treatment staff.
8
6.
7.
9
Treatment agencies are accountable:
•
Treatment agencies give the court accurate and timely information about a
participant's progress. Information exchange complies with the provisions of 42
CFR, Part 2 (the Federal regulations governing confidentiality of AOD abuse patient
records) and with applicable State statutes.
•
Responses to progress and noncompliance are incorporated into the treatment
protocols.
Treatment designs and delivery systems are sensitive and relevant to issues of race,
culture, religion, gender, age, ethnicity, and sexual orientation.
Key Component #5
Abstinence is monitored by frequent alcohol and other drug testing.
Purpose
Frequent court-ordered AOD testing is essential. An accurate testing program is the most
objective and efficient way to establish a framework for accountability and to gauge each
participant's progress. Modern technology offers highly reliable testing to determine if an
individual has recently used specific drugs. Further, it is commonly recognized that alcohol
use frequently contributes to relapse among individuals whose primary drug of choice is not
alcohol.
AOD testing results are objective measures of treatment effectiveness, as well as a source of
important information for periodic review of treatment progress. AOD testing helps shape
the ongoing interaction between the court and each participant. Timely and accurate test
results promote frankness and honesty among all parties.
AOD testing is central to the drug court's monitoring of participant compliance. It is both
objective and cost-effective. It gives the participant immediate information about his or her
own progress, making the participant active and involved in the treatment process rather
than a passive recipient of services.
1.
AOD testing policies and procedures are based on established and tested guidelines,
such as those established by the American Probation and Parole Association. Contracted
laboratories analyzing urine or other samples should also be held to established
standards.
2.
Testing may be administered randomly or at scheduled intervals, but occurs no less than
twice a week during the first several months of an individual's enrollment. Frequency
thereafter will vary depending on participant progress.
3.
The scope of testing is sufficiently broad to detect the participant's primary drug of
choice as well as other potential drugs of abuse, including alcohol.
4.
The drug-testing procedure must be certain. Elements contributing to the reliability and
validity of a urinalysis testing process include, but are not limited to:
• Direct observation of urine sample collection.
•
•
•
Verification temperature and measurement of creatinine levels to determine the
extent of water loading.
Specific, detailed, written procedures regarding all aspects of urine sample collection,
sample analysis, and result reporting.
A documented chain of custody for each sample collected.
10
•
•
5.
Quality control and quality assurance procedures for ensuring the integrity of the
process.
Procedures for verifying accuracy when drug test results are contested.
Ideally, test results are available and communicated to the court and the participant
within one day. The drug court functions best when it can respond immediately to
noncompliance; the time between sample collection and availability of results should be
short.
6.
The court is immediately notified when a participant has tested positive, has failed to
submit to AOD testing, has submitted the sample of another, or has adulterated a
sample.
7.
The coordinated strategy for responding to noncompliance includes prompt responses
to positive tests, missed tests, and fraudulent tests.
8.
Participants should be abstinent for a substantial period of time prior to program
graduation.
11
Key Component #6
A coordinated strategy governs drug court responses
to participants' compliance.
Purpose
An established principle of AOD treatment is that addiction is a chronic, relapsing
condition. A pattern of decreasing frequency of use before sustained abstinence from
alcohol and other drugs is common. Becoming sober or drug free is a learning experience,
and each relapse to AOD use may teach something about the recovery process.
Implemented in the early stages of treatment and emphasized throughout, therapeutic
strategies aimed at preventing the return to AOD use help participants learn to manage their
ambivalence toward recovery, identify situations that stimulate AOD cravings, and develop
skills to cope with high-risk situations. Eventually, participants learn to manage cravings,
avoid or deal more effectively with high-risk situations, and maintain sobriety for increasing
lengths of time.
Abstinence and public safety are the ultimate goals of drug courts, many participants exhibit
a pattern of positive urine tests within the first several months following admission. Because
AOD problems take a long time to develop and because many factors contribute to drug use
and dependency, it is rare that an individual ceases AOD use as soon as he or she enrolls in
treatment. Even after a period of sustained abstinence, it is common for individuals to
occasionally test positive.
Although drug courts recognize that individuals have a tendency to relapse, continuing AOD
use is not condoned. Drug courts impose appropriate responses for continuing AOD use.
Responses increase in severity for continued failure to abstain.
A participant's progress through the drug court experience is measured by his or her
compliance with the treatment regimen. Certainly cessation of drug use is the ultimate goal
of drug court treatment. However, there is value in recognizing incremental progress toward
the goal, such as showing up at all required court appearances, regularly arriving at the
treatment program on time, attending and fully participating in the treatment sessions,
cooperating with treatment staff, and submitting to regular AOD testing.
Drug courts must reward cooperation as well as respond to noncompliance. Small rewards
for incremental successes have an important effect on a participant's sense of purpose and
accomplishment. Praise from the drug court judge for regular attendance or for a period of
clean drug tests, encouragement from the treatment staff or the judge at particularly difficult
times, and ceremonies in which tokens of accomplishment are awarded in open court for
completing a particular phase of treatment are all small but very important rewards that
bolster confidence and give inspiration to continue.
12
Drug courts establish a coordinated strategy, including a continuum of responses, to
continuing drug use and other noncompliant behavior. A coordinated strategy can provide a
common operating plan for treatment providers and other drug court personnel. The
criminal justice system representatives and the treatment providers develop a series of
complementary, measured responses that will encourage compliance. A written copy of these
responses, given to participants during the orientation period, emphasizes the predictability,
certainty, and swiftness of their application.
1.
Treatment providers, the judge, and other program staff maintain frequent, regular
communication to provide timely reporting of progress and noncompliance and to
enable the court to respond immediately. Procedures for reporting noncompliance are
clearly defined in the drug court's operating documents.
2.
Responses to compliance and noncompliance are explained verbally and provided in
writing to drug court participants before their orientation. Periodic reminders are given
throughout the treatment process.
3.
The responses for compliance vary in intensity:
•
•
•
•
•
•
•
•
4.
Ceremonies and tokens of progress, including advancement to the next treatment
phase.
Reduced supervision.
Decreased frequency of court appearances.
Reduced fines or fees.
Dismissal of criminal charges or reduction in the term of probation.
Reduced or suspended incarceration.
Graduation.
Responses to or sanctions for noncompliance might include:
•
•
•
•
•
•
•
•
•
13
Encouragement and praise from the bench.
Warnings and admonishment from the bench in open court.
Demotion to earlier program phases.
Increased frequency of testing and court appearances.
Confinement in the courtroom or jury box.
Increased monitoring and/or treatment intensity.
Fines.
Required community service or work programs.
Escalating periods of jail confinement (however, drug court participants remanded to
jail should receive AOD treatment services while confined).
Termination from the program and reinstatement of regular court processing.
Key Component #7
Ongoing judicial interaction with each drug court participant is essential.
Purpose
The judge is the leader of the drug court team, linking participants to AOD treatment and to
the criminal justice system. This active, supervising relationship, maintained throughout
treatment, increases the likelihood that a participant will remain in treatment and improves
the chances for sobriety and law-abiding behavior. Ongoing judicial supervision also
communicates to participants—often for the first time—that someone in authority cares
about them and is closely watching what they do.
Drug courts require judges to step beyond their traditionally independent and objective
arbiter roles and develop new expertise. The structure of the drug court allows for early and
frequent judicial intervention. A drug court judge must be prepared to encourage appropriate
behavior and to discourage and penalize inappropriate behavior. A drug court judge is
knowledgeable about treatment methods and their limitations.
1.
Regular status hearings are used to monitor participant performance:
•
•
•
Frequent status hearings during the initial phases of each participant's program
establish and reinforce the drug court's policies, and ensure effective supervision of
each drug court participant. Frequent hearings also give the participant a sense of
how he or she is doing in relation to others.
Time between status hearings may be increased or decreased, based on compliance
with treatment protocols and progress observed.
Having a significant number of drug court participants appear at a single session
gives the judge the opportunity to educate both the offender at the bench and those
waiting as to the benefits of program compliance and consequences for
noncompliance.
2.
The court applies appropriate incentives and sanctions to match the participant's
treatment progress.
3.
Payment of fees, fines and/or restitution is part of the participant's treatment. The court
supervises such payments and takes into account the participant's financial ability to
fulfill these obligations. The court ensures that no one is denied participation in drug
courts solely because of on an inability to pay fees, fines, or restitution.
14
Key Component #8
Monitoring and evaluation measure the achievement
of program goals and gauge effectiveness.
Purpose
Fundamental to the effective operation of drug courts are coordinated management,
monitoring, and evaluation systems. The design and operation of an effective drug court
program result from thorough initial planning, clearly defined program goals, and inherent
flexibility to make modifications as necessary.
The goals of the program should be described concretely and in measurable terms to provide
accountability to funding agencies and policymakers. And, since drug courts will increasingly
be asked to demonstrate tangible outcomes and cost-effectiveness, it is critical that the drug
court be designed with the ability to gather and manage information for monitoring daily
activities, evaluating the quality of services provided, and producing longitudinal evaluations.
Management and monitoring systems provide timely and accurate information about
program operations to the drug court's managers, enabling them to keep the program on
course, identify developing problems, and make appropriate procedural changes. Clearly
defined drug court goals shape the management information system, determine monitoring
questions, and suggest methods for finding information to answer them.
Program management provides the information needed for day-to-day operations and for
planning, monitoring, and evaluation. Program monitoring provides oversight and periodic
measurements of the program's performance against its stated goals and objectives.
Evaluation is the institutional process of gathering and analyzing data to measure the
accomplishment of the program's long-term goals. A process evaluation appraises progress
in meeting operational and administrative goals (e.g., whether treatment services are
implemented as intended). An outcome evaluation assesses the extent to which the program
is reaching its long-term goals (e.g., reducing criminal recidivism). An effective design for an
outcome evaluation uses a comparison group that does not receive drug court services.
Although evaluation activities are often planned and implemented simultaneously, process
evaluation information can be used more quickly in the early stages of drug court
implementation. Outcome evaluation should be planned at the beginning of the program as
it requires at least a year to compile results, especially if past participants are to be found and
interviewed.
Evaluation strategies should reflect the significant coordination and the considerable time
required to obtain measurable results. Evaluation studies are useful to everyone, including
funding agencies and policymakers who may not be involved in the daily operations of the
program. Information and conclusions developed from periodic monitoring reports, process
evaluation activities, and longitudinal evaluation studies may be used to modify program
15
procedures, change therapeutic interventions, and make decisions about continuing or
expanding the program.
Information for management, monitoring, and evaluation purposes may already exist within
the court system and/or in the community treatment or supervision agencies (e.g., criminal
justice data bases, psychosocial histories, and formal AOD assessments). Multiple sources of
information enhance the credibility and persuasiveness of conclusions drawn from
evaluations.
1.
2.
3.
4.
5.
6.
7.
8.
16
Management, monitoring, and evaluation processes begin with initial planning. As part
of the comprehensive planning process, drug court leaders and senior managers should
establish specific and measurable goals that define the parameters of data collection and
information management. An evaluator can be an important member of the planning
team.
Data needed for program monitoring and management can be obtained from records
maintained for day-to-day program operations, such as the numbers and general
demographics of individuals screened for eligibility; the extent and nature of AOD
problems among those assessed for possible participation in the program; and
attendance records, progress reports, drug test results, and incidence of criminality
among those accepted into the program.
Monitoring and management data are assembled in useful formats for regular review by
program leaders and managers.
Ideally, much of the information needed for monitoring and evaluation is gathered
through an automated system that can provide timely and useful reports. If an
automated system is not available manual data collection and report preparation can be
streamlined. Additional monitoring information may be acquired by observation and
through program staff and participant interviews.
Automated manual information systems must adhere to written guidelines that protect
against unauthorized disclosure of sensitive personal information about individuals.
Monitoring reports need to be reviewed at frequent intervals by program leaders and
senior managers. They can be used to analyze program operations, gauge effectiveness,
modify procedures when necessary, and refine goals.
Process evaluation activities should be undertaken throughout the course of the drug
court program. This activity is particularly important in the early stages of program
implementation.
If feasible, a qualified independent evaluator should be selected and given responsibility
for developing and conducting an evaluation design and for preparing interim and final
reports. If an independent evaluation is unavailable the drug court program designs and
implements its own evaluation, based on guidance available through the field:
•
•
•
•
9.
Judges, prosecutors, the defense bar, treatment staff, and others design the
evaluation collaboratively with the evaluator.
Ideally, an independent evaluator will help the information systems expert design and
implement the management information system.
The drug court program ensures that the evaluator has access to relevant justice
system and treatment information.
The evaluator maintains continuing contact with the drug court and provides
information on a regular basis. Preliminary reports may be reviewed by drug court
program personnel and used as the basis for revising goals, policies, and procedures
as appropriate.
Useful data elements to assist in management and monitoring may include, but are not
limited to:
• The number of defendants screened for program eligibility and the outcome of those
initial screenings.
• The number of persons admitted to the drug court program.
•
•
•
•
•
•
•
•
•
•
Characteristics of program participants, such as age, sex, race/ethnicity, family status,
employment status, and educational level; current charges; criminal justice history;
AOD treatment or mental health treatment history; medical needs (including
detoxification); and nature and severity of AOD problems.
Number and characteristics of participants (e.g., duration of treatment involvement,
reason for discharge from the program).
Number of active cases.
Patterns of drug use as measured by drug test results.
Aggregate attendance data and general treatment progress measurements.
Number and characteristics of persons who graduate or complete treatment
successfully.
Number and characteristics of persons who do not graduate or complete the
program.
Number of participants who fail to appear at drug court hearings and number of
bench warrants issued for participants.
Rearrests during involvement in the drug court program and type of arrest(s).
Number, length, and reasons for incarcerations during and subsequent to
involvement in the drug court program.
10. When making comparisons for evaluation purposes, drug courts should consider the
following groups:
• Program graduates.
•
Program terminations.
17
• Individuals who were referred to, but did not appear for, treatment.
• Individuals who were not referred for drug court services.
11. At least six months after exiting a drug court program, comparison groups (listed above)
should be examined to determine long-term effects of the program. Data elements for
follow-up evaluation may include:
• Criminal behavior/activity.
• Days spent in custody on all offenses from date of acceptance into the program.
• AOD use since leaving the program.
• Changes in job skills and employment status.
• Changes in literacy and other educational attainments.
• Changes in physical and mental health.
• Changes in status of family relationships.
• Attitudes and perceptions of participation in the program.
• Use of health care and other social services.
12. Drug court evaluations should consider the use of cost-benefit analysis to examine the
economic impact of program services. Important elements of cost-benefit analysis
include:
• Reductions in court costs, including judicial, counsel, and investigative resources.
• Reductions in costs related to law enforcement and corrections.
• Reductions in health care utilization.
• Increased economic productivity.
18
Key Component #9
Continuing interdisciplinary education promotes effective drug court
planning, implementation, and operations.
Purpose
Periodic education and training ensures that the drug court's goals and objectives, as well as
policies and procedures, are understood not only by the drug court leaders and senior
managers, but also by those indirectly involved in the program. Education and training
programs also help maintain a high level of professionalism, provide a forum for solidifying
relationships among criminal justice and AOD treatment personnel, and promote a spirit of
commitment and collaboration.
All drug court staff should be involved in education and training, even before the first case is
heard. Interdisciplinary education exposes criminal justice officials to treatment issues, and
treatment staff to criminal justice issues. It also develops shared understandings of the
values, goals, and operating procedures of both the treatment and the justice system
components. Judges and court personnel typically need to learn about the nature of AOD
problems and the theories and practices supporting specific treatment approaches.
Treatment providers typically need to become familiar with criminal justice accountability
issues and court operations. All need to understand and comply with drug testing standards
and procedures.
For justice system or other officials not directly involved in the program's operations,
education provides an overview of the mission, goals, and operating procedures of the drug
court.
A simple and effective method of educating new drug court staff is to visit an existing court
to observe its operations and ask questions. On-site experience with an operating drug court
provides an opportunity for new drug court staff to talk to their peers directly and to see
how their particular role functions.
1.
Key personnel have attained a specific level of basic education, as defined in staff
training requirements and in the written operating procedures. The operating procedures
should also define requirements for the continuing education of each drug court staff
member.
2.
Attendance at education and training sessions by all drug court personnel is essential.
Regional and national drug court training provide critical information on innovative
developments across the Nation. Sessions are most productive when drug court
personnel attend as a group. Credits for continuing professional education should be
offered, when feasible.
19
3.
Continuing education institutionalizes the drug court and moves it beyond its initial
identification with the key staff who may have founded the program and nurtured its
development.
4.
An education syllabus and curriculum are developed, describing the drug court's goals,
policies, and procedures. Topics might include:
• Goals and philosophy of drug courts.
•
•
•
•
•
•
•
•
20
The nature of AOD abuse, its treatment and terminology.
The dynamics of abstinence and techniques for preventing relapse.
Responses to relapse and to noncompliance with other program requirements.
Basic legal requirements of the drug court program and an overview of the local
criminal justice system's policies, procedures, and terminology.
Drug testing standards and procedures.
Sensitivity to racial, cultural, ethnic, gender, and sexual orientation as they affect the
operation of the drug court.
Interrelationships of co-occurring conditions such as AOD abuse and mental illness
(also known as "dual diagnosis").
Federal, State, and local confidentiality requirements.
Key Component #10
Forging partnerships among drug courts, public agencies, and
community-based organizations generates local support and
enhances drug court program effectiveness.
Purpose
Because of its unique position in the criminal justice system, a drug court is especially well
suited to develop coalitions among private community-based organizations, public criminal
justice agencies, and AOD treatment delivery systems. Forming such coalitions expands the
continuum of services available to drug court participants and informs the community about
drug court concepts.
The drug court is a partnership among organizations—public, private, and communitybased—dedicated to a coordinated and cooperative approach to the AOD offender. The
drug court fosters systemwide involvement through its commitment to share responsibility
and participation of program partners. As a part of, and as a leader in, the formation and
operation of community partnerships, drug courts can help restore public faith in the
criminal justice system.
1.
Representatives from the court, community organizations, law enforcement, corrections,
prosecution, defense counsel, supervisory agencies, treatment and rehabilitation
providers, educators, health and social service agencies, and the faith community meet
regularly to provide guidance and direction to the drug court program.
2.
The drug court plays a pivotal role in forming linkages between community groups and
the criminal justice system. The linkages are a conduit of information to the public about
the drug court, and conversely, from the community to the court about available
community services and local problems.
3.
Partnerships between drug courts and law enforcement and/or community policing
programs can build effective links between the court and offenders in the community.
4.
Participation of public and private agencies, as well as community-based organizations, is
formalized through a steering committee. The steering committee aids in the acquisition
and distribution of resources. An especially effective way for the steering committee to
operate is through the formation of a nonprofit corporation structure that includes all
the principle drug court partners, provides policy guidance, and acts as a conduit for
fundraising and resource acquisition.
21
5.
Drug court programs and services are sensitive to and demonstrate awareness of the
populations they serve and the communities in which they operate. Drug courts provide
opportunities for community involvement through forums, informational meetings, and
other community outreach efforts.
6.
The drug court hires a professional staff that reflects the population served, and the drug
court provides ongoing cultural competence training.
22
Appendix 1: Drug Court Standards Committee
Bill Meyer, Chairman
Judge, Denver Drug Court
Denver, CO
Carlos J. Martinez
Assistant Public Defender
Law Offices of Bennett H. Brummer
Miami, FL
Ed Brekke
Administrator
Civil & Criminal Operations
Los Angeles Superior Court
Los Angeles, CA
Molly Merrigan
Assistant Prosecutor
Jackson County Drug Court
Kansas City, MO
Jay Carver
Director, District of Columbia
Pretrial Services Agency
Washington, DC
Ana Oliveira
Director
Samaritan Village
Briarwood, NY
Caroline Cooper
Director
OJP Drug Court Clearinghouse and
Technical Assistance Project
American University
Washington, DC
Roger Peters
Associate Professor
University of South Florida
Florida Mental Health Institute
Department of Mental Health Law and Policy
Tampa, FL
Jane Kennedy
Executive Director
TASC of King County
Seattle, WA
Frank Tapia
Probation Officer
Oakland, CA
Barry Mahoney
President
The Justice Management Institute
Denver, CO
John Marr
CEO
Choices Unlimited
Las Vegas, NV
Representatives
Marilyn McCoy Roberts
Director, Drug Courts Program Office
Susan Tashiro
Program Manager
23
National Association of Drug Court
Professionals
Judge Jeffrey S. Tauber
President
Marc Pearce
Chief of Staff
Writer and Coordinator
Jody Forman
The Dogwood Institute
Charlottesville, VA
24
Appendix 2: Resource List
Federal Organizations and Agencies Federal Agencies and Organizations
Providing Information and Guidance Providing Information on AOD
on Drug Courts:
Treatment:
The White House
Office of National Drug Control Policy
(ONDCP)
Executive Office of the President
The White House
1600 Pennsylvania Ave., NW
Washington, DC 20502-0002
Tel: 202/395-6700
810 Seventh Street, NW
Tel: 202/616-6500
Fax: 202/305-1367
National Criminal Justice Reference Service
Tel: 800/851-3420
U.S. Department of Health and Human
Services
Alcoholism and Substance Abuse Branch
Indian Health Service
5600 Fishers Lane, Room 5A-20
Rockville, MD 20857
Tel: 301/443-7623
Center for Substance Abuse Treatment
Substance Abuse and Mental Health Services
Administration, Public Health Service
5515 Security Lane
Rockville, MD 20852
Tel: 301/443-5700
National Clearinghouse for Alcohol and Drug
Information
11426 Rockville Pike, Suite 200
Rockville, MD 20852
Tel: 800/729-6686
National Institute on Alcohol and Alcoholism
Willco Bldg., Suite 400-MSC7003
6000 Executive Blvd.
Bethesda, MD 20892
Tel: 301/443-3851
National Institute on Drug Abuse
5600 Fishers Lane, Room 18-49
Rockville, MD 20857
Tel: 301/443-0107
25
Organizations Providing Information Private Organizations Providing
Information on AOD Treatment:
on Drug Courts:
Drug Court Clearinghouse & Technical
Assistance Project
American University
Justice Programs Office
4400 Massachusetts Avenue, NW
Brandywine, Suite 660
Washington, DC 20016-8159
Tel: 202/885-2875
Fax: 202/885-2885
Justice Management Institute
1900 Grant St., Suite 815
Denver, CO 80203
Tel: 303/831-7564
Fax: 303/831-4564
National Association of Drug Court
Professionals
901 North Pitt St., Suite 300
Alexandria, VA 22314
Tel: 800/542-2322 or 703/706-0576
Fax: 703/706-0565
National TASC
8630 Fenton St., Suite 121
Silver Spring, MD 20910
Tel: 301/608-0595
Fax: 301/608-0599
State Justice Institute
1650 King St., Suite 600
Tel: 703/684-6100
Fax: 703/684-7618
26
American Society of Addiction
Medicine, Inc.
Upper Arcade, Suite 101
4601 North Park Avenue
Chevy Chase, MD 20815
Tel: 301/656-3920
Guidepoints: Acupuncture in Recovery
(Information on innovative treatment
of addictive and mental disorders)
7402 NE 58th St.
Vancouver, WA 98662
Tel: 360/254-0186
National Acupuncture Detoxification
Association
P.O. Box 1927
Vancouver, WA 98668-1927
Tel and Fax: 360/260-8620
National Association of Alcohol & Drug
Abuse Counselors
1911 North Fort Meyer Drive, Suite 900
Arlington, VA 22209
Tel: 703/741-7686
National Association of State Alcohol and
Drug Abuse Directors (NASADAD)
444 North Capitol St., Suite 642
Tel: 202/783-6868
Fax: 202/783-2704
National GAINS Center for People with Cooccurring Disorders in the Justice System
Policy Research, Inc.
262 Delaware Ave
Delmar, NY 12054
Tel: 800/331-GAIN
Fax: 518/439-7612
Private Organizations Providing
Information on Community Anti-Drug
Alliances:
Community Anti-Drug Coalitions of America
(CADCA)
James Copple, Executive Director
701 North Fairfax
Tel: 703/706-0563
Drug Strategies, Inc.
2445 M Street, NW, Suite 480
Tel: 202/663-6090
Join Together
441 Stuart Street, 6th Floor
Boston, MA 02116
Tel: 617/437-1500
Partnership for a Drug Free America
State Alliance Program
405 Lexington Ave., 16th Floor
New York, NY 10174
Tel: 212/922-1560
27
Information
For more indepth information about BJA, its programs, and its funding opportunities, contact:
810 Seventh Street NW.
202-616-6500
Fax: 202-305-1367
Web site: www.ojp.usdoj.gov/BJA
E-mail: [email protected]
The BJA Clearinghouse, a component of the National Criminal Justice Reference Service, shares BJA
program information with state and local agencies and community groups across the country. Information
specialists provide reference and referral services, publication distribution, participation and support for
conferences, and other networking and outreach activities. The clearinghouse can be contacted at:
Bureau of Justice Assistance Clearinghouse
P.O. Box 6000
Rockville, MD 20849-6000
1-800-851-3420
Fax: 301-519-5212
Web site: www.ncjrs.org
E-mail: [email protected]
Clearinghouse staff are available Monday through Friday, 10 a.m. to 6 p.m. eastern time. Ask to be placed on
the BJA mailing list.
To subscribe to the electronic newsletter JUSTINFO and become a registered NCJRS user, visit
http://puborder.ncjrs.org/register.
GEORGIA MENTAL HEALTH COURT STANDARDS
Preface
Purpose: To establish standards for mental health courts and mental health court divisions pursuant to O.C.G.A.
15-1-16.
Large numbers of individuals with mental illnesses come into contact with the criminal justice system, often
resulting in poor outcomes such as the ineffective use of law enforcement, jail, court and correctional dollars while
failing to improve public safety. Frequently, people with mental illnesses repeatedly cycle through the criminal
justice system for relatively minor offenses because the underlying factors associated with their criminal activity
have not been adequately addressed. While not originally intended as the primary intervention point for dealing
with mental illnesses, far too often it is the courts which are called on to triage and intercede with this population
due to their criminal conduct. It is estimated that almost 17% of individuals entering local jails are suffering from
some mental illness and half of all jail and state correctional detainees with mental illnesses reported three or
more prior convictions.
Over the past decade, courts have explored new ways of responding to individuals with mental illnesses who
appear on criminal dockets. Using lessons learned from drug courts, mental health courts were established as an
attempt to link mentally ill offenders with appropriate resources in their respective communities, while providing
judicial oversight and supervision.
An advisory group of leading researchers and practitioners met to review best practices as they relate to mental
health courts, beginning in 2008. One product of this series of meetings was the development of the Essential
Elements, a ten point guide to the components considered mandatory for success when operating a mental health
court. This document adopts much of the work as promulgated in the Essential Elements with some modification
throughout to capture guidelines as they pertain specifically to mental health courts in Georgia.
I.
Planning and Administration
A broad-based group of stakeholders representing the criminal justice, mental health,
substance abuse treatment, and related systems and the community guides the planning
and administration of the court.
I.1
Mental health courts are situated at the intersection of the criminal justice, mental health, substance abuse
treatment, and other social service systems. Their planning and administration should reflect extensive
collaboration among practitioners and policymakers from those systems, as well as community members. To that
end, a multidisciplinary “planning committee” should be charged with designing the mental health court. Along
with determining eligibility criteria, monitoring mechanisms, and other court processes, this committee should
articulate clear, specific, and realizable goals that reflect agreement on the court’s purposes and provide a
foundation for measuring the court’s impact (see Element 10: Sustainability).
1
I.2
The planning committee should identify agency leaders and policymakers to serve on an “advisory group”
(in some jurisdictions members of the advisory group will also make up the planning committee), responsible for
monitoring the court’s adherence to its mission and its coordination with relevant activities across the criminal
justice and mental health systems. The advisory group should suggest revisions to court policies and procedures
when appropriate, and should be the public face of the mental health court in advocating for its support. The
planning committee should address ongoing issues of policy implementation and practice that the court’s
operation raises. Committee members should also keep high-level policymakers, including those on the advisory
group, informed of the court’s successes and failures in promoting positive change and long-term sustainability
(see Element 10). Additionally, by facilitating ongoing training and education opportunities, the planning
committee should complement and support the small team of professionals who administer the court on a daily
basis, the “court team” (see Element 8).
I.3
In many jurisdictions, the judiciary will ultimately drive the design and administration of the mental health
court. Accordingly, it should be well represented on and take a visible role in leading both the planning committee
and advisory group.
I.4
Pursuant to O.C.G.A. 15-1-16, each mental health court division shall establish a planning group to develop
a written work plan. The planning group shall include judges, prosecuting attorneys, sheriffs or their designees,
public defenders, probation officers and persons having expertise in the field of mental health. The work plan shall
address the operational, coordination, resource, information management, and evaluation needs of the mental
health court division. The work plan shall include written eligibility criteria for the mental health court division.
The mental health court division shall combine judicial supervision, treatment of mental health court division
participants and drug and mental health testing.
II.
Target Population
Eligibility criteria address public safety and consider a community’s treatment capacity, in
addition to the availability of alternatives to pretrial detention for defendants with mental
illnesses. Eligibility criteria also take into account the relationship between mental illness and a
defendant’s offenses, while allowing the individual circumstances of each case to be considered.
II.1
Because mental health courts are, by definition, specialized interventions that can serve only a portion of
defendants with mental illness, careful attention should be paid to determining their target populations.
II.2
Mental health courts should be conceptualized as part of a comprehensive strategy to provide law
enforcement, court, and corrections systems with options, other than arrest and detention, for responding to
people with mental illnesses. Such options include specialized police-based responses and pretrial services
programs. For those individuals who are not diverted from arrest or pretrial detention, mental health courts can
provide appropriately identified defendants with court-ordered, community-based supervision and services.
Mental health courts should be closely coordinated with other specialty or problem-solving court-based
interventions, including drug courts and community courts, as target populations are likely to overlap.
II.3
Clinical eligibility criteria should be well defined and should be developed with an understanding of
treatment capacity in the community. Mental health court personnel should explore ways to improve the
accessibility of community-based care when treatment capacity is limited and should explore ways to improve
quality of care when services appear ineffective (see Element 6: Treatment Supports and Services).
II.4
Mental health courts should also focus on defendants whose mental illness is related to their current
offenses. To that end, the planning committee should develop a process or a mechanism, informed by mental
2
health professionals, to enable staff charged with identifying mental health court participants to make this
determination.
II.5
Pursuant to O.C.G.A. 15-1-16, defendants charged with murder, armed robbery, rape, aggravated sodomy,
aggravated sexual battery, aggravated child molestation or child molestation shall not be eligible for entry into the
mental health court division, except in the case of a separate court supervised reentry program designed to more
closely monitor mentally ill offenders returning to the community after having served a term of incarceration. Any
such court supervised community reentry program for mentally ill offenders shall be subject to the work plan as
provided for in this document.
III.
Timely Participant Identification and Linkage to Services
Participants are identified, referred, and accepted into mental health courts, and then linked to
community-based service providers as quickly as possible.
III.1
Providing safe and effective treatment and supervision to eligible defendants in the community, as opposed
to in jail or prison, is one of the principal purposes of mental health courts. Prompt identification of participants
accelerates their return to the community and decreases the burden on the criminal justice system for
incarceration and treatment.
III.2
Mental health courts should identify potential participants early in the criminal justice process by
welcoming referrals from an array of sources such as law enforcement officers, jail and pretrial services staff,
defense counsel, judges, and family members. To ensure accurate referrals, mental health courts must advertise
eligibility criteria and actively educate these potential sources. In addition to creating a broad network for
identifying possible participants, mental health courts should select one or two agencies to be primary referral
sources that are especially well versed in the procedures and criteria.
III.3
The prosecutor, defense counsel, and a licensed clinician should quickly review referrals for eligibility.
When competency determination is necessary, it should be expedited, especially for defendants charged with
misdemeanors. The time required to accept someone into the program should not exceed the length of the
sentence that the defendant would have received had he or she pursued the traditional court process. Final
determination of eligibility should be a team decision (see Element 8: Court Team).
III.4
The time needed to identify appropriate services, the availability of which may be beyond the court’s
control, may constrain efforts to identify participants rapidly (see Element 6: Treatment Supports and Services).
This is likely to be an issue especially in felony cases, when the court may seek services of a particular intensity to
maximize public safety. Accordingly, along with connecting mental health court participants to existing treatment,
officials in criminal justice, mental health, and substance abuse treatment should work together to improve the
quality and expand the quantity of available services.
IV.
Terms of Participation
Terms of participation are clear, promote public safety, facilitate the defendant’s engagement in treatment,
are individualized to correspond to the level of risk that the defendant presents to the community, and
provide for positive legal outcomes for those individuals who successfully complete the program.
3
IV.1
Mental health courts need general program parameters for plea agreements, program duration,
supervision conditions, and the impact of program completion. Within these parameters, the terms of participation
should be individualized to each defendant and should be put in writing prior to his or her decision to enter the
program. The terms of participation will likely require adherence to a treatment plan that will be developed after
engagement with the mental health court program, and defendants should be made aware of the consequences of
noncompliance with this plan.
IV.2
Whenever plea agreements are offered to people invited to participate in a mental health court, the
potential effects of a criminal conviction should be explained. Collateral consequences of a criminal conviction may
include limited housing options, opportunities for employment, and accessibility to some treatment programs. It is
especially important that the defendant be made aware of these consequences when the only charge he or she is
facing is a misdemeanor, ordinance offense, or other nonviolent crime.
IV.3
The length of mental health court participation should not extend beyond the maximum period of
incarceration or probation a defendant could have received if found guilty in a more traditional court process. In
addition, program duration should vary depending on a defendant’s program progress. Program completion
should be tied to adherence to the participant’s court-ordered conditions and the strength of his or her connection
to community treatment.
IV.4
Least restrictive supervision conditions should be considered for all participants, especially those charged
with misdemeanors. Highly restrictive conditions increase the likelihood that minor violations will occur, which
can intensify the involvement of participants in the criminal justice system. When a mental health court participant
completes the terms of his or her participation in the program, there should be some positive legal outcome. When
the court operates on a pre-plea model, a significant reduction or dismissal of charges can be considered. When the
court operates in a post plea model, a number of outcomes are possible such as early terminations of supervision,
vacated pleas, and lifted fines and fees. Mental health court participants, when in compliance with the terms of
their participation, should have the option to withdraw from the program at any point without having their prior
participation and subsequent withdrawal from the mental health court reflect negatively on their criminal case.
IV.5
Pursuant to O.C.G.A. 15-1-16, any plea of guilty or nolo contendere entered pursuant to participation in a
mental health court shall not be withdrawn without the consent of the court. In addition, the clerk of the court
instituting the mental health court division or such clerk’s designee shall serve as the clerk of the mental health
court division.
V.
Informed Choice
Defendants fully understand the program requirements before agreeing to participate in a mental health
court. They are provided legal counsel to inform this decision and subsequent decisions about program
involvement. Procedures exist in the mental health court to address, in a timely fashion, concerns about a
defendant’s competency whenever they arise.
V.1
Defendants’ participation in mental health courts is voluntary. But ensuring that participants’ choices are
informed, both before and during the program, requires more than simply offering the mental health court as an
option to certain defendants.
V.2
Mental health court administrators should be confident that prospective participants are competent to
participate. Typically, competency determination procedures can be lengthy, which raises challenges for timely
participant identification. This is especially important for courts that focus on defendants charged with
4
misdemeanors (see Element3: Timely Participant Identification and Linkage to Services). For these reasons, as part
of the planning process, courts should develop guidelines for the identification and expeditious resolution of
competency concerns.
V.3
Even when competency is not an issue, mental health court staff must ensure that defendants fully
understand the terms of participation, including the legal repercussions of not adhering to program conditions.
The specific terms that apply to each defendant should be spelled out in writing. Defendants should have the
opportunity to review these terms, with the advice of counsel, before opting into the court.
V.4
Defense attorneys play an integral role in helping to ensure that defendants’ choices are informed
throughout their involvement in the mental health court. Admittedly, the availability of defense counsel varies
from one jurisdiction to another. In some communities, defendants’ access to counsel depends on the crime with
which they were charged or the purpose of the hearing. Recognizing these constraints, courts should strive to
make defense counsel available to advise defendants about their decision to enter the court and have counsel be
present at status hearings. It is particularly important to ensure the presence of counsel when there is a risk of
sanctions or dismissal from the mental health court. Defense counsel participating in mental health courts—like all
other criminal justice staff assigned to the court—should receive special training in mental health issues (see
Element 8: Court Team).
VI.
Treatment Supports and Services
Mental health courts connect participants to comprehensive and individualized treatment
supports and services in the community. They strive to use and increase the availability of
treatment and services that are evidence-based.
VI.1
Mental health court participants require an array of services and supports, which can include medications,
counseling, substance abuse treatment, benefits, housing, crisis interventions services, peer supports, and case
management. Mental health courts should anticipate the treatment needs of their target population and work with
providers to ensure that services will be made available to court participants.
VI.2
When a participant is identified and linked to a service provider, the mental health court team should
design a treatment plan that takes into account the results of a complete mental health and substance abuse
assessment, individual consumer needs, and public safety concerns. Participants should also have input into their
treatment plans.
VI.3
A large proportion of mental health court participants have co-occurring substance abuse disorders. The
most effective programs provide coordinated treatment for both mental illnesses and substance abuse problems.
Thus, mental health courts should connect participants with co-occurring disorders to integrated treatment
whenever possible and advocate for the expanded availability of integrated treatment and other evidence-based
practices. Mental health court teams should also pay special attention to the needs of women and ethnic minorities
and make gender-sensitive and culturally competent services available.
VI.4
Treatment providers should remain in regular communication with court staff concerning the
appropriateness of the treatment plan and should suggest adjustments to the plan when appropriate. At the same
time, court staff should check with community-based treatment providers periodically to determine the extent to
which they are encountering challenges stemming from the court’s supervision of the participant.
VI.5
Case management is essential to connect participants to services and monitor their compliance with court
conditions. Case managers—whether they are employees of the court, treatment providers, or community
corrections officers—should have caseloads that are sufficiently manageable to perform core functions and
5
monitor the overall conditions of participation. They should serve as the conduits of information for the court
about the status of treatment and support services.
VI.6
Case managers also help participants prepare for their transition out of the court program by ensuring that
needed treatment and services will remain available and accessible after their court supervision concludes. The
mental health court may also provide post-program assistance, such as graduate support groups, to prevent
participants’ relapses.
VII.
Confidentiality
Health and legal information should be shared in a way that protects potential participants’
confidentiality rights as mental health consumers and their constitutional rights as defendants.
Information gathered as part of the participants’ court-ordered treatment program or services should be
safeguarded in the event that participants are returned to traditional court processing.
VII.1 To identify and supervise participants, mental health courts require information about their mental
illnesses and treatment plans. When sharing this information, treatment providers and representatives of the
mental health court should consider the wishes of defendants. They must also adhere to federal and state laws that
protect the confidentiality of medical, mental health, and substance abuse treatment records.
VII.2 A well-designed procedure governing the release and exchange of information is essential to facilitating
appropriate communication among members of the mental health court team and to protect confidentiality.
Release forms should be part of this procedure. They should be developed in consultation with legal counsel,
adhere to federal and state laws, and specify what information will be released and to whom. Potential participants
should be allowed to review the form with the advice of defense counsel and treatment providers. Defendants
should not be asked to sign release of information forms until competency issues have been resolved (see Element
5: Informed Choice).
VII.3 When a defendant is being considered for the mental health court, there should not be any public
discussions about that person’s mental illness, which can stigmatize the defendant. Even information concerning a
defendant’s referral to a mental health court should be closely guarded—particularly because many of these
individuals may later choose not to participate in the mental health court. To minimize the likelihood that
information about defendants’ mental illnesses or their referral to the mental health court will negatively affect
their criminal cases, courts whenever possible should maintain clinical documents separately from the criminal
files and take other precautions to prevent medical information from becoming part of the public record.
VII.4 Once a defendant is under the mental health court’s supervision, steps should be taken to maintain the
privacy of treatment information throughout his or her tenure in the program. Clinical information provided to
mental health court staff members should be limited to whatever they need to make decisions. Furthermore, such
exchanges should be conducted in closed staff meetings; discussion of clinical information in open court should be
avoided.
VIII.
Court Team
A team of criminal justice and mental health staff and service and treatment providers receives special,
ongoing training and helps mental health court participants achieve treatment and criminal justice goals
by regularly reviewing and revising the court process.
6
VIII.1 The mental health court team works collaboratively to help participants achieve treatment goals by
bringing together staff from the agencies with a direct role in the participants’ entrance into, and progress through,
the court program. The court team functions include conducting screenings, assessments, and enrollments of
referred defendants; defining terms of participation; partnering with community providers; monitoring participant
adherence to terms; preparing for all court appearances; and developing transition plans following court
supervision. Team members should work together on each participant’s case and contribute to the court’s
administration to ensure its smooth functioning.
VIII.2 The composition of this court team differs across jurisdictions. These variations notwithstanding, it
typically should comprise the following: a judicial officer; a treatment provider or case manager; a prosecutor; a
defense attorney; and, in some cases, a court supervision agent such as a probation officer. Many courts also
employ a court coordinator responsible for overall administration of the court, which can help promote
communication, efficiency, and sustainability. Regardless of the composition of the team, the judge’s role is central
to the success of the mental health court team and the mental health court generally. He or she oversees the work
of the mental health court team and encourages collaboration among its members, who must work together to
inform the judge about whether participants are adhering to their terms of participation.
VIII.3 Mental health court planners should carefully select team members who are willing to adapt to a
nontraditional setting and rethink core aspects of their professional training. Planners should seek criminal justice
personnel with expertise or interest in mental health issues and mental health staff with criminal justice
experience. Planners should also mental health court is comfortable with its goals and procedures.
VIII.4 Team members should take part in cross-training before the court is launched and during its operation.
Mental health professionals must familiarize themselves with legal terminology and the workings of the criminal
justice system, just as criminal justice personnel must learn about treatment practices and protocols. Team
members should also be offered the opportunity to attend regional or national training sessions and view the
operations of other mental health courts. New team members should go through a period of training and
orientation before engaging fully with the court.
VIII.5 Periodic review and revision of court processes must be a core responsibility of the court team. Using data,
participant feedback, observations of team members, and direction from the advisory group and planning
committee (see Element 1), the court team should routinely make improvements to the court’s operation.
IX.
Monitoring Adherence to Court Requirements
Criminal justice and mental health staff collaboratively monitor participants’ adherence to court
conditions, offer individualized graduated incentives and sanctions, and modify treatment as necessary to
promote public safety and participants’ recovery.
IX.1
Whether a mental health court assigns responsibility for monitoring compliance with court conditions to a
criminal justice agency, a mental health agency, or a combination of these organizations, collaboration and
communication are essential. The court must have up-to-date information on whether participants are taking
medications, attending treatment sessions, abstaining from drugs and alcohol, and adhering to other supervision
conditions. This information will come from a variety of sources and must be integrated routinely into one
coherent presentation or report to keep all court staff informed of participants’ progress. Case staffing meetings
provide such an opportunity to share information and determine responses to individuals’ positive and negative
behaviors. These meetings should happen regularly and involve key members of a team, including, when
appropriate, representatives from the prosecution, defense, treatment providers, court supervision agency, and the
judiciary.
7
IX.2
Status hearings allow mental health courts publicly to reward adherence to conditions of participation, to
sanction non adherence, and to ensure ongoing interaction between the participant and the court team members.
These hearings should be frequent at the outset of the program and should decrease as participants progress
positively.
IX.3
All responses to participants’ behavior, whether positive or negative, should be individualized. Incentives,
sanctions, and treatment modifications have clinical implications. They should be imposed with great care and
with input from mental health professionals.
IX.4
Relapse is a common aspect of recovery; non adherence to conditions of participation in the court is
common. But non adherence should never be ignored. The first response should be to review treatment plans,
including medications, living situations, and other service needs. For minor violations the most appropriate
response may be a modification of the treatment plan.
IX.5
In some cases, sanctions are necessary. The manner in which a mental health court applies sanctions
should be explained to participants prior to their admittance to the program. As a participant's commission of
violations increases in frequency or severity, the court should use graduated sanctions that are individualized to
maximize adherence to his or her conditions of release. Specific protocols should govern the use of jail as a
consequence for serious non compliance.
IX.6
Mental health courts should use incentives to recognize good behavior and to encourage recovery through
further behavior modification. Individual praise and rewards, such as coupons, certificates for completing phases
of the program, and decreased frequency of court appearances, are helpful and important incentives. Systematic
incentives that track the participants’ progress through distinct phases of the court program are also critical. As
participants complete these phases, they receive public recognition.
IX.7
Courts should have at their disposal a menu of incentives that is at least as broad as the range of available
sanctions; incentives for sustained adherence to court conditions, or for situations in which the participant exceeds
the expectation of the court team, are particularly important.
X.
Sustainability
Data are collected and analyzed to demonstrate the impact of the mental health court, its performance is
assessed periodically (and procedures are modified accordingly), court processes are institutionalized,
and support for the court in the community is cultivated and expanded.
X.1
Mental health courts must take steps early in the planning process and throughout their existence to
ensure long-term sustainability. To this end, performance measures and outcome data will be essential. Data
describing the court’s impact on individuals and systems should be collected and analyzed. Such data should
include the court’s outputs, such as number of defendants screened and accepted into the mental health court, as
well as its outcomes, such as the number of participants who are rearrested and re-incarcerated. Setting output and
outcome measures are a key function of the court’s planning and ongoing administration (see Element 1).
Quantitative data should be complemented with qualitative evaluations of the program from staff and participants.
X.2
Formalizing court policies and procedures is also an important component of maintaining mental health
court operations. Compiling information about a court’s history, goals, eligibility criteria, information-sharing
protocols, referral and screening procedures, treatment resources, sanctions and incentives, and other program
components helps ensure consistency and lessens the impact when key team members depart. Developing
additional plans for staff turnover helps safeguard the integrity of the court’s operation.
8
X.3
Because sustaining a mental health court without funding is difficult, court planners should identify and
cultivate long-term funding sources early on. Court staff should base requests for long-term funding on clear
articulations of what the court plans to accomplish. Along with compiling empirical evidence of program successes,
mental health court teams should invite key county officials, state legislators, foundation program officers, and
other policymakers to witness the court in action.
X.4
Outreach to the community, the media, and key criminal justice and mental health officials also promotes
sustainability. To that end, mental health court teams should make community members aware of the existence
and impact of the mental health court and the progress it has made. More important, administrators should be
prepared to respond to notable program failures, such as when a participant commits a serious crime. Ongoing
guidance from, and reporting to, key criminal justice and mental health leaders also helps to maintain interest in,
and support for, the mental health court.
X.5
Performance measurement is considered an essential activity in many government and non-profit agencies
because it provides tools for managers to exercise and maintain control over their organizations, as well as
provides a mechanism for governing bodies and funding agencies to hold organizations accountable for producing
the intended results. A select advisory group of mental health court experts and project staff from the National
Center for State Courts (NCSC) worked together to produce a set of performance measures designed specifically for
mental health courts, which should be used as a guide for data collection relevant to mental health courts. This
guide is provided below:
X.6
In-Program Reoffending — The incidence of in-program reoffending (i.e., whether an arrest occurred, yes
or no). In-program reoffending is defined as an arrest that results in the offender being formally charged
(excluding traffic citations other than DUI) and which occurs between admission and exit. While the date of arrest
must fall between the entry date and exit date, the charge date may come after the participant has exited the
program. This measure serves as an important measure of offender compliance and the level of supervision
received, hence, an indicator for public safety.
X.7
Attendance at Scheduled Judicial Status Hearings — The percent of scheduled judicial status hearings
attended by the participant. The performance measure reflects the level of judicial supervision for each participant.
X.8
Attendance at Scheduled Therapeutic Sessions — The percent of scheduled therapeutic sessions
(defined as services to address mental health and/or substance abuse problems) attended. Therapeutic treatment
is an essential element of mental health courts.
X.9
Living Arrangement — Tracks the progress of mental health court participants toward securing a stable
living arrangement. Specifically, the percent of participants who are homeless or not at exit, by living status at
entry. Adequate housing is a prerequisite for treatment effectiveness.
X.10 Retention — The percent of participants admitted to the mental health court during the same time frame,
who exit the program by one of the following means: Successful completion, administrative closure, voluntary
withdrawal while in compliance, discharge, transfer, and failure/termination. Retention is important in mental
health courts because it is critical that participants receive treatment and supervision of long enough duration to
affect change.
X.11 Time from Arrest to Referral — The average length of time between a participant’s arrest and referral to
mental health court. While the referral process is not entirely under the court’s control, it is an important
component in obtaining relevant and timely information. This is especially true when offenders who are mentally
ill are incarcerated and are at risk for decompensation.
9
X.12 Time from Referral to Admission — The average length of time between the referral to mental health
court and when the participant was accepted into the program. The span of time between referral and admission is
an important part of controlling the length of time it takes to get a participant into treatment. This measure will
help the court identify inefficiencies in the screening and qualification process.
X.13 Total Time in Program — The average length of time between a participant’s admission into the mental
health court and permanent exit. If this time span is very short, participants may not be receiving enough
treatment and care to affect long term improvement. If it is very long, courts may be devoting too great a share of
their resources to difficult cases, denying opportunities to other potential participants.
X.14 Team Collaboration — The percentage of time that information relevant for discussion at the pre-docket
meeting is available to the team. This provides a gauge to the court of the level of collaboration across the entire
mental health court team and allows for the identification of gaps in information sharing. With this measure, courts
can investigate a lack of resources or lack of commitment by individuals/agencies. This is NOT a measure of
attendance at pre-docket meetings.
X.15 Agency Collaboration — The percentage of time that a mental health court representative was notified
within 24 and 48 hours that a participant in the program was arrested. This measure assesses the timeliness of the
basic communication flow between corrections (jail) and the mental health court program so that services and
medication are maintained during time spent in detention. Effective inter-agency collaboration will improve the
effectiveness of the mental health court and its operations. Individualized and Appropriate Treatment
X.16 Need-Based Treatment and Supervision — The goal of this measure is to align participants’ diagnosis
and criminogenic risk with the appropriate treatment and service dosage. The measure provides courts with an
indicator of whether the resources available for supervision and treatment are allocated based on need.
Operationally, it measures the percentage of participants who receive the highest (and alternatively lowest) level
of services and supervision and whether those are the same participants who are designated as having highest
(and lowest) needs. Achieving this will provide the necessary balance for effective use of tax payer money,
ensuring public safety, and improving the welfare of the participant using need-based, individualized, and
appropriate treatment.
X.17 Participant-Level Satisfaction — Perceived fairness of the program by the participant as expressed in a
short 5-question survey. Research indicates that the perception of fairness is often more important than the actual
outcome of the case (see e.g., procedural justice) making this measure important in gauging the perception of the
participant.
X.18 Participant Preparation for Transition — Percent of correct responses by the participant identifying
sources of assistance (e.g., for medication or mental health symptoms) to be used after exiting the program. This
measure provides the mental health court with an assessment of whether participants are prepared for their
transition by ensuring that needed treatment and services will remain available and accessible after their court
supervision concludes.
X.19 Post-Program Recidivism — Percentage of participants who reoffended within two years after exiting the
mental health court. This performance measure is an important measure of the lasting outcomes of the court’s
program as well as public safety. It captures longer-term outcomes, as compared to Measure “In-Program
Reoffending,” and is thus reflective of the effectiveness of the program.
10
Improving Responses to
People with Mental Illnesses
The Essential Elements of a
Mental Health Court
Improving Responses to
People with Mental Illnesses
The Essential Elements of a
Mental Health Court
A report prepared by the
Council of State Governments Justice Center
Criminal Justice/Mental Health Consensus Project
for the
Michael Thompson
Dr. Fred Osher
Denise Tomasini-Joshi
This report was prepared by the Council of State Governments Justice Center, which coordinates the Criminal Justice/Mental
Health Consensus Project. It was completed under cooperative agreement 2005-MU-BX-K007 awarded by the Bureau of Justice
Assistance (BJA), Office of Justice Programs, U.S. Department of Justice. The opinions and findings in this document do not
necessarily represent the official position or policies of the U.S. Department of Justice or the members of the Council of State
Governments. While every effort was made to reach consensus and represent advisory group members’ and other reviewers’
recommendations, individual opinions may differ from the statements made in the document.
The Bureau of Justice Assistance reserves the right to reproduce, publish, translate, or otherwise use and to authorize others to
publish and use all or any part of the copyrighted material contained in this publication.
Council of State Governments Justice Center, New York 10005
© 2007 by the Council of State Governments Justice Center
All rights reserved. Published 2007.
Cover design by Nancy Kapp & Company. Interior design by David Williams.
Contents
Acknowledgments
Introduction
v
vii
Ten Essential Elements
1 | Planning and Administration
1
2 | Target Population
2
3 | Timely Participant Identification and
Linkage to Services
3
4 | Terms of Participation
4
5 | Informed Choice
5
6 | Treatment Supports and Services
6
7 | Confidentiality
7
8 | Court Team
8
9 | Monitoring Adherence to Court
Requirements
9
10 | Sustainability
10
Conclusion
11
iv
Improving Responses to People with Mental Illnesses
Acknowledgments
Many thanks are due to all those at the Bureau of
Justice Assistance (BJA), a component of the Office
of Justice Programs, U.S. Department of Justice,
who supported the development of this publication,
particularly Domingo S. Herraiz, Director; A. Elizabeth Griffith, Deputy Director for Planning; Robert
Hendricks, former Acting Senior Policy Advisor for
Mental Health; Michael Guerriere, former Senior
Policy Advisor for Substance Abuse and Mental
Health; Ruby Qazilbash, Senior Policy Advisor for
Substance Abuse and Mental Health; and Rebecca
Rose, Policy Advisor for Substance Abuse and Mental Health.
Special thanks must also be given to the
National Drug Court Institute (NDCI), particularly
Karen Freeman-Wilson, West Huddleston, and Carson Fox, for their guidance on how this publication
could benefit from, and integrate, their experiences
developing the seminal publication Defining Drug
Courts: The Key Components.
Representatives of the sites awarded grants
under BJA’s Mental Health Court Grant Program
spent considerable time at a national conference
in Cincinnati in 2004 providing valuable feedback to
a draft of Essential Elements. The Council of State
Governments Justice Center thanks them, as well as
a group of leading mental health court experts who
spent a full day at BJA’s conference Mental Health
Courts and Beyond in 2005 in Los Angeles to provide
extensive comments on a subsequent draft of the
document. In addition, representatives of BJA’s Mental Health Court Learning Sites added important
information throughout the review process.
A number of current and former Justice
Center staff members were key contributors to
the document, including director of communications Martha Plotkin, research associate Lauren
Almquist, and project coordinator Daniel
Souweine. The project also benefited greatly from
the advice of Justice Center consultants Barry Mahoney, President Emeritus of the Justice Management Institute, D. Alan Henry, Director Emeritus of
the Pretrial Justice Institute, and Timothy Murray,
Executive Director of the Pretrial Justice Institute.
Finally, Justice Center staff express their gratitude to the hundreds of contributors who reviewed
online drafts. Through a web forum, these respondents provided valuable comments and offered
insights and suggestions that made Essential Elements a stronger, more practical resource.
The Essential Elements of a Mental Health Cour t
v
vi
Introduction
Mental health courts are a recent and rapidly
expanding phenomenon. In the late 1990s only a
few such courts were accepting cases. Since then,
more than 150 others have been established, and
dozens more are being planned. Although early
commentary on these courts emphasized their differences—and their diversity is undeniable—
the similarities across mental health courts are
becoming increasingly apparent. In fact, the vast
majority of mental health courts share the following
characteristics:
• A specialized court docket, which employs a
problem-solving approach to court processing in
lieu of more traditional court procedures for certain defendants with mental illnesses
• Judicially supervised, community-based treatment plans for each defendant participating in
the court, which a team of court staff and mental
health professionals design and implement
• Regular status hearings at which treatment
plans and other conditions are periodically
reviewed for appropriateness, incentives are
offered to reward adherence to court conditions,
and sanctions are imposed on participants who
do not adhere to the conditions of participation
• Criteria defining a participant’s completion of
(sometimes called graduation from) the program
The reasons communities give for establishing
mental health courts are also remarkably consistent: to increase public safety, facilitate participation
in effective mental health and substance abuse
treatment, improve the quality of life for people
1. Essential Elements was developed as part of a technical assistance
program provided by the Council of State Governments (CSG) Justice Center through the Bureau of Justice Assistance (BJA) Mental
Health Courts Program. The BJA Mental Health Courts Program,
which was authorized by America’s Law Enforcement and Mental
Health Project (Public Law 106-515), provided grants to support the
with mental illnesses charged with crimes, and
make more effective use of limited criminal justice
and mental health resources.
As the commonalities among mental health
courts begin to emerge, practitioners, policymakers,
researchers, and others have become interested in
developing consensus not only on what a mental
health court is, but on what a mental health court
should be. The purpose of this document is to articulate
such consensus in the form of 10 essential elements.
About the Elements
This publication identifies 10 essential elements of
mental health court design and implementation.1
Each element contains a short statement describing
criteria mental health courts should meet, followed
by several paragraphs explaining why the element is
important and how courts can adhere to it. Ultimately, benchmarks will be added, enabling courts
to better assess their fidelity to each element.
Although both adult and juvenile mental
health courts have emerged in recent years, this
publication pertains only to adult mental health
courts. There are two primary reasons for this
focus. First, as of this writing, there are only a handful of mental health courts targeting juveniles. Second, the significant differences between the
provision of mental health and criminal justice
services for juveniles and that for adults makes it
difficult to develop a document that encompasses
both populations.
Just as the success of local drug courts
prompted the development of many mental health
development of mental health courts in 23 jurisdictions in FY 2002
and 14 jurisdictions in FY 2003. The Justice Center currently provides technical assistance to the grantees of BJA’s Justice and Mental Health Collaboration Program, the successor to the Mental
Health Courts Program.
vii
courts, Defining Drug Courts: The Key Components, a
1997 publication of the U.S. Department of Justice,
inspired this document. Although there are significant differences between drug courts and mental
health courts, the Key Components document provided the foundation in format and content for
Essential Elements.
Two key principles underlie the 10 essential
elements. First, at the heart of each element is collaboration among the criminal justice, mental
health, substance abuse treatment, and related systems. True cross-system collaboration is necessary
to realize any of these elements and, for that matter,
to successfully operate a mental health court. It is
generally accepted that achieving this type of collaboration is difficult, particularly in regard to breaking
down institutional barriers and eschewing the
adversarial process. Second, the elements make
clear, both explicitly and implicitly, that mental
health courts are not a panacea. Reversing the overrepresentation of people with mental illnesses in
the criminal justice system requires a comprehensive strategy of which mental health courts should
be just one piece.
Though these elements are drawn in large part
from the experience of existing courts, they are not
research-based. Only a few studies have been completed, though more are underway, to better understand the operation and impact of mental health
courts. Proponents of mental health courts hope
that these investigations will substantiate the relative importance of different elements for court
functioning and client outcomes. In the meantime,
these elements should prove useful for communities interested in developing a mental health court
or reviewing the organization and functions of an
existing court program.
The elements described in this document will
not be present in every mental health court. When
2. The first major investigation of mental health courts was “Emerging Judicial Strategies for the Mentally Ill in the Criminal Caseload:
Mental Health Courts in Fort Lauderdale, Seattle, San Bernardino,
and Anchorage,” by John Goldkamp and Cheryl Irons-Guynn, April
2000. Since then, several studies about mental health courts have
been published, including the BJA-sponsored report entitled Guide
viii
the elements are present, they will manifest differently across jurisdictions. In addition, some mental
health court practitioners may disagree with some
of the statements below, identify elements that may
be missing, or argue that some of these elements
are unrealistic. This debate will drive stronger
efforts in the field and maximize the effectiveness
of America’s mental health courts.
Because mental health courts will continue to
mature and new research will become available,
changes to this publication are inevitable. Essential
Elements will periodically be updated to reflect innovative thinking from the field and to include the
benchmarks that mental health court administrators can use to assess their progress in implementing the essential elements in their courts.
Methodology
The essential elements are culled from a variety of
sources, including interviews with former BJA Mental Health Courts Program (MHCP) grantees, on-site
visits to grantee and non-grantee mental health
courts, and a review of the scholarly literature.2 An
original draft of the elements document was prepared
for the 2004 BJA MHCP conference. Comments
from the conference attendees were incorporated into
a second draft, which served as source material for the
Guide to Mental Health Court Design and Implementation, a BJA-sponsored publication.
This latest version was informed by comments
from the field transmitted through a well-publicized
web-based discussion forum. A group of practitioners and experts reviewed and discussed these comments and suggested revisions to the draft. This
version incorporates those suggestions.
to Mental Health Court Design and Implementation, July 2005, and
the Rand study Justice, Treatment, and Cost: An Evaluation of the
Fiscal Impact of Allegheny County Mental Health Court, March 2007.
Readers interested in these and other resources related to mental
health courts should visit www.consensusproject.org/mhcourts.
Ten Essential Elements
1
planning and administration
A broad-based group of stakeholders representing the criminal justice, mental health,
substance abuse treatment, and related systems and the community guides the planning
and administration of the court.
Mental health courts are situated at the intersection
of the criminal justice, mental health, substance
abuse treatment, and other social service systems.
Their planning and administration should reflect
extensive collaboration among practitioners and
policymakers from those systems, as well as community members. To that end, a multidisciplinary
“planning committee” should be charged with
designing the mental health court. Along with
determining eligibility criteria, monitoring mechanisms, and other court processes, this committee
should articulate clear, specific, and realizable goals
that reflect agreement on the court’s purposes and
provide a foundation for measuring the court’s
impact (see Element 10: Sustainability).
Ideally, the development of a mental health
court should take place in the context of broader
efforts to improve the response to people with mental illnesses involved with, or at risk of involvement
with, law enforcement, the courts, and corrections.
Such discussions should include police and sheriffs’ officials, judges, prosecutors, defense counsel,
court administrators, pretrial services staff, and corrections officials; mental health, substance abuse
treatment, housing, and other service providers;
and mental health advocates, crime victims, consumers, and family and community members.
The planning committee should identify agency
leaders and policymakers to serve on an “advisory
group” (in some jurisdictions members of the advisory group will also make up the planning committee), responsible for monitoring the court’s
adherence to its mission and its coordination with
relevant activities across the criminal justice and
mental health systems. The advisory group should
suggest revisions to court policies and procedures
when appropriate, and should be the public face of
the mental health court in advocating for its support.
The planning committee should address ongoing
issues of policy implementation and practice that
the court’s operation raises. Committee members
should also keep high-level policymakers, including
those on the advisory group, informed of the court’s
successes and failures in promoting positive change
and long-term sustainability (see Element 10). Additionally, by facilitating ongoing training and education opportunities, the planning committee should
complement and support the small team of professionals who administer the court on a daily basis,
the “court team” (see Element 8).
In many jurisdictions, the judiciary will ultimately drive the design and administration of the
mental health court. Accordingly, it should be well
represented on and take a visible role in leading
both the planning committee and advisory group.
1
2
target population
Eligibility criteria address public safety and consider a community’s treatment capacity, in
addition to the availability of alternatives to pretrial detention for defendants with mental
illnesses. Eligibility criteria also take into account the relationship between mental illness and a
defendant’s offenses, while allowing the individual circumstances of each case to be considered.
Because mental health courts are, by definition,
specialized interventions that can serve only a portion of defendants with mental illness, careful
attention should be paid to determining their target
populations.
Mental health courts should be conceptualized
as part of a comprehensive strategy to provide law
enforcement, court, and corrections systems with
options, other than arrest and detention, for
responding to people with mental illnesses. Such
options include specialized police-based responses
and pretrial services programs. For those individuals
who are not diverted from arrest or pretrial detention, mental health courts can provide appropriately
identified defendants with court-ordered, community-based supervision and services. Mental health
courts should be closely coordinated with other specialty or problem-solving court-based interventions,
2
including drug courts and community courts, as target populations are likely to overlap.
Clinical eligibility criteria should be well
defined and should be developed with an understanding of treatment capacity in the community.
Mental health court personnel should explore ways
to improve the accessibility of community-based
care when treatment capacity is limited and should
explore ways to improve quality of care when services appear ineffective (see Element 6: Treatment
Supports and Services).
Mental health courts should also focus on
defendants whose mental illness is related to their
current offenses. To that end, the planning committee should develop a process or a mechanism,
informed by mental health professionals, to enable
staff charged with identifying mental health court
participants to make this determination.
3
timely participant identification
and linkage to services
Participants are identified, referred, and accepted into mental health courts, and then linked to
community-based service providers as quickly as possible.
Providing safe and effective treatment and supervision to eligible defendants in the community, as
opposed to in jail or prison, is one of the principal
purposes of mental health courts. Prompt identification of participants accelerates their return to the
community and decreases the burden on the criminal justice system for incarceration and treatment.
Mental health courts should identify potential
participants early in the criminal justice process by
welcoming referrals from an array of sources such
as law enforcement officers, jail and pretrial services staff, defense counsel, judges, and family members. To ensure accurate referrals, mental health
courts must advertise eligibility criteria and actively
educate these potential sources. In addition to creating a broad network for identifying possible participants, mental health courts should select one or two
agencies to be primary referral sources that are
especially well versed in the procedures and criteria.
The prosecutor, defense counsel, and a
licensed clinician should quickly review referrals
for eligibility. When competency determination is
necessary, it should be expedited, especially for
defendants charged with misdemeanors. The time
required to accept someone into the program
should not exceed the length of the sentence that
the defendant would have received had he or she
pursued the traditional court process. Final determination of eligibility should be a team decision
(see Element 8: Court Team).
The time needed to identify appropriate services, the availability of which may be beyond the
court’s control, may constrain efforts to identify participants rapidly (see Element 6: Treatment Supports and Services). This is likely to be an issue
especially in felony cases, when the court may seek
services of a particular intensity to maximize public
safety. Accordingly, along with connecting mental
health court participants to existing treatment, officials in criminal justice, mental health, and substance abuse treatment should work together to
improve the quality and expand the quantity of
available services.
3
4
terms of participation
Terms of participation are clear, promote public safety, facilitate the defendant’s engagement in
treatment, are individualized to correspond to the level of risk that the defendant presents to the
community, and provide for positive legal outcomes for those individuals who successfully
complete the program.
Mental health courts need general program parameters for plea agreements, program duration, supervision conditions, and the impact of program
completion. Within these parameters, the terms of
participation should be individualized to each
defendant and should be put in writing prior to his
or her decision to enter the program. The terms of
participation will likely require adherence to a treatment plan that will be developed after engagement
with the mental health court program, and defendants should be made aware of the consequences of
noncompliance with this plan.
Whenever plea agreements are offered to people invited to participate in a mental health court,
the potential effects of a criminal conviction should
be explained. Collateral consequences of a criminal
conviction may include limited housing options,
opportunities for employment, and accessibility to
some treatment programs. It is especially important
that the defendant be made aware of these consequences when the only charge he or she is facing is
a misdemeanor, ordinance offense, or other nonviolent crime.
The length of mental health court participation
should not extend beyond the maximum period of
incarceration or probation a defendant could have
received if found guilty in a more traditional court
4
process. In addition, program duration should vary
depending on a defendant’s program progress. Program completion should be tied to adherence to the
participant’s court-ordered conditions and the
strength of his or her connection to community
treatment.
Least restrictive supervision conditions should
be considered for all participants, especially those
charged with misdemeanors. Highly restrictive conditions increase the likelihood that minor violations
will occur, which can intensify the involvement of
participants in the criminal justice system.
When a mental health court participant completes the terms of his or her participation in the
program, there should be some positive legal outcome. When the court operates on a pre-plea model,
a significant reduction or dismissal of charges can
be considered. When the court operates in a postplea model, a number of outcomes are possible
such as early terminations of supervision, vacated
pleas, and lifted fines and fees. Mental health court
participants, when in compliance with the terms of
their participation, should have the option to withdraw from the program at any point without having
their prior participation and subsequent withdrawal
from the mental health court reflect negatively on
their criminal case.
5
informed choice
Defendants fully understand the program requirements before agreeing to participate in a mental
health court. They are provided legal counsel to inform this decision and subsequent decisions
about program involvement. Procedures exist in the mental health court to address, in a timely
fashion, concerns about a defendant’s competency whenever they arise.
Defendants’ participation in mental health courts is
voluntary. But ensuring that participants’ choices
are informed, both before and during the program,
requires more than simply offering the mental
health court as an option to certain defendants.
Mental health court administrators should be
confident that prospective participants are competent to participate. Typically, competency determination procedures can be lengthy, which raises
challenges for timely participant identification. This
is especially important for courts that focus on
defendants charged with misdemeanors (see Element 3: Timely Participant Identification and Linkage to Services). For these reasons, as part of the
planning process, courts should develop guidelines
for the identification and expeditious resolution of
competency concerns.
Even when competency is not an issue, mental
health court staff must ensure that defendants fully
understand the terms of participation, including
the legal repercussions of not adhering to program
conditions. The specific terms that apply to each
defendant should be spelled out in writing. Defendants should have the opportunity to review these
terms, with the advice of counsel, before opting into
the court.
Defense attorneys play an integral role in helping to ensure that defendants’ choices are informed
throughout their involvement in the mental health
court. Admittedly, the availability of defense counsel
varies from one jurisdiction to another. In some communities, defendants’ access to counsel depends on
the crime with which they were charged or the purpose of the hearing. Recognizing these constraints,
courts should strive to make defense counsel available to advise defendants about their decision to
enter the court and have counsel be present at status
hearings. It is particularly important to ensure the
presence of counsel when there is a risk of sanctions
or dismissal from the mental health court. Defense
counsel participating in mental health courts—like
all other criminal justice staff assigned to the court—
should receive special training in mental health
issues (see Element 8: Court Team).
5
6
treatment supports and services
Mental health courts connect participants to comprehensive and individualized treatment
supports and services in the community.They strive to use—and increase the availability of—
treatment and services that are evidence-based.
Mental health court participants require an array of
services and supports, which can include medications,
counseling, substance abuse treatment, benefits,
housing, crisis interventions services, peer supports,
and case management. Mental health courts should
anticipate the treatment needs of their target population and work with providers to ensure that services
will be made available to court participants.
When a participant is identified and linked to a
service provider, the mental health court team
should design a treatment plan that takes into
account the results of a complete mental health and
substance abuse assessment, individual consumer
needs, and public safety concerns. Participants
should also have input into their treatment plans.
A large proportion of mental health court participants have co-occurring substance abuse disorders. The most effective programs provide
coordinated treatment for both mental illnesses and
substance abuse problems. Thus, mental health
courts should connect participants with co-occurring disorders to integrated treatment whenever
possible and advocate for the expanded availability of
integrated treatment and other evidence-based practices.3 Mental health court teams should also pay
special attention to the needs of women and ethnic
minorities and make gender-sensitive and culturally
competent services available.
Treatment providers should remain in regular
communication with court staff concerning the
appropriateness of the treatment plan and should
suggest adjustments to the plan when appropriate.
At the same time, court staff should check with
community-based treatment providers periodically
to determine the extent to which they are encountering challenges stemming from the court’s supervision of the participant.
Case management is essential to connect participants to services and monitor their compliance
with court conditions.4 Case managers—whether
they are employees of the court, treatment
providers, or community corrections officers—
should have caseloads that are sufficiently manageable to perform core functions and monitor the
overall conditions of participation. They should
serve as the conduits of information for the court
about the status of treatment and support services.
Case managers also help participants prepare
for their transition out of the court program by
ensuring that needed treatment and services will
remain available and accessible after their court
supervision concludes. The mental health court
may also provide post-program assistance, such as
graduate support groups, to prevent participants’
relapses.
3. Evidence-based practices (EBPs) are mental health service interventions for which consistent scientific evidence demonstrates their ability to improve consumer outcomes. R.E. Drake, et al., “Implementing
Evidence-Based Practices in Routine Mental Health Service Settings,”
Psychiatric Services 52 (2001): 179–182. Other EBPs include assertive
community treatment, psychotropic medications, supported employment, family psychoeducation, and illness self-management.
4. The term “case management” has multiple definitions. Moreover,
specific interventions such as assertive community treatment
(ACT) and intensive case management (ICM) are themselves case
management models. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) “any definition of
case management today is inevitably contextual, based on the needs
of a particular organizational structure, environmental reality, and
prior training of the individuals who are implementing it, whether
they are social workers, nurses, or case management specialists”
(see SAMHSA’s Treatment Improvement Protocol [TIP] #27, “Case
Management for Substance Abuse Treatment”). The definition of a
particular case management approach can be derived from its functions and objectives. Case management functions include assessing, planning, linking, coordinating, monitoring, and advocating.
For example, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) of the U.S. Department of Justice in its publication
Drug Identification and Testing in the Juvenile Justice System, defines
case management as “an individualized plan for securing, coordinating, and monitoring the appropriate treatment interventions and
ancillary services necessary to treat each offender successfully for
optimal justice system outcomes.”
6
7
confidentiality
Health and legal information should be shared in a way that protects potential participants’
confidentiality rights as mental health consumers and their constitutional rights as defendants.
Information gathered as part of the participants’ court-ordered treatment program or services
should be safeguarded in the event that participants are returned to traditional court processing.
To identify and supervise participants, mental
health courts require information about their mental illnesses and treatment plans. When sharing this
information, treatment providers and representatives of the mental health court should consider the
wishes of defendants. They must also adhere to federal and state laws that protect the confidentiality of
medical, mental health, and substance abuse treatment records.
A well-designed procedure governing the
release and exchange of information is essential to
facilitating appropriate communication among
members of the mental health court team and to
protect confidentiality. Release forms should be part
of this procedure. They should be developed in consultation with legal counsel, adhere to federal and
state laws, and specify what information will be
released and to whom.5 Potential participants
should be allowed to review the form with the
advice of defense counsel and treatment providers.
Defendants should not be asked to sign release of
information forms until competency issues have
been resolved (see Element 5: Informed Choice).
When a defendant is being considered for the
mental health court, there should not be any public
discussions about that person’s mental illness,
which can stigmatize the defendant. Even information concerning a defendant’s referral to a mental
health court should be closely guarded—particularly because many of these individuals may later
choose not to participate in the mental health court.
To minimize the likelihood that information about
defendants’ mental illnesses or their referral to the
mental health court will negatively affect their criminal cases, courts whenever possible should maintain clinical documents separately from the
criminal files and take other precautions to prevent
medical information from becoming part of the
public record.
Once a defendant is under the mental health
court’s supervision, steps should be taken to maintain the privacy of treatment information throughout his or her tenure in the program. Clinical
information provided to mental health court staff
members should be limited to whatever they need
to make decisions. Furthermore, such exchanges
should be conducted in closed staff meetings; discussion of clinical information in open court should
be avoided.
5. For information on complying with the Health Insurance Portability and Accountability Act (HIPAA), please visit SAMHSA’s Web
site at www.hipaa.samhsa.gov/hipaa.html.
7
8
court team
A team of criminal justice and mental health staff and service and treatment providers receives
special, ongoing training and helps mental health court participants achieve treatment and
criminal justice goals by regularly reviewing and revising the court process.
The mental health court team works collaboratively
to help participants achieve treatment goals by bringing together staff from the agencies with a direct role
in the participants’ entrance into, and progress
through, the court program. The court team functions include conducting screenings, assessments,
and enrollments of referred defendants; defining
terms of participation; partnering with community
providers; monitoring participant adherence to
terms; preparing for all court appearances; and developing transition plans following court supervision.
Team members should work together on each participant’s case and contribute to the court’s administration to ensure its smooth functioning.
The composition of this court team differs
across jurisdictions. These variations notwithstanding, it typically should comprise the following: a
judicial officer; a treatment provider or case manager; a prosecutor; a defense attorney; and, in some
cases, a court supervision agent such as a probation
officer. Many courts also employ a court coordinator
responsible for overall administration of the court,
which can help promote communication, efficiency,
and sustainability. Regardless of the composition of
the team, the judge’s role is central to the success of
the mental health court team and the mental health
court generally. He or she oversees the work of the
mental health court team and encourages collaboration among its members, who must work together
to inform the judge about whether participants are
adhering to their terms of participation.
8
Mental health court planners should carefully
select team members who are willing to adapt to a
nontraditional setting and rethink core aspects of
their professional training. Planners should seek
criminal justice personnel with expertise or interest
in mental health issues and mental health staff with
criminal justice experience. Planners should also
work to ensure that the judge who will preside over
the mental health court is comfortable with its goals
and procedures.
Team members should take part in cross-training before the court is launched and during its operation. Mental health professionals must familiarize
themselves with legal terminology and the workings of the criminal justice system, just as criminal
justice personnel must learn about treatment practices and protocols. Team members should also be
offered the opportunity to attend regional or
national training sessions and view the operations
of other mental health courts. New team members
should go through a period of training and orientation before engaging fully with the court.
Periodic review and revision of court processes
must be a core responsibility of the court team.
Using data, participant feedback, observations of
team members, and direction from the advisory
group and planning committee (see Element 1), the
court team should routinely make improvements to
the court’s operation.
9
monitoring adherence to
court requirements
Criminal justice and mental health staff collaboratively monitor participants’ adherence to court
conditions, offer individualized graduated incentives and sanctions, and modify treatment as
necessary to promote public safety and participants’ recovery.
Whether a mental health court assigns responsibility for monitoring compliance with court conditions
to a criminal justice agency, a mental health agency,
or a combination of these organizations, collaboration and communication are essential. The court
must have up-to-date information on whether participants are taking medications, attending treatment
sessions, abstaining from drugs and alcohol, and
adhering to other supervision conditions. This information will come from a variety of sources and must
be integrated routinely into one coherent presentation or report to keep all court staff informed of participants’ progress. Case staffing meetings provide
such an opportunity to share information and determine responses to individuals’ positive and negative
behaviors. These meetings should happen regularly
and involve key members of a team, including,
when appropriate, representatives from the prosecution, defense, treatment providers, court supervision
agency, and the judiciary.
Status hearings allow mental health courts
publicly to reward adherence to conditions of participation, to sanction nonadherence, and to ensure
ongoing interaction between the participant and the
court team members. These hearings should be frequent at the outset of the program and should
decrease as participants progress positively.
All responses to participants’ behavior, whether
positive or negative, should be individualized.
Incentives, sanctions, and treatment modifications
have clinical implications. They should be imposed
with great care and with input from mental health
professionals.
Relapse is a common aspect of recovery; nonadherence to conditions of participation in the court
is common. But nonadherence should never be
ignored. The first response should be to review
treatment plans, including medications, living situations, and other service needs. For minor violations the most appropriate response may be a
modification of the treatment plan.
In some cases, sanctions are necessary. The
manner in which a mental health court applies
sanctions should be explained to participants prior
to their admittance to the program. As a participant's commission of violations increases in frequency or severity, the court should use graduated
sanctions that are individualized to maximize
adherence to his or her conditions of release. Specific protocols should govern the use of jail as a consequence for serious noncompliance.
Mental health courts should use incentives to
recognize good behavior and to encourage recovery
through further behavior modification. Individual
praise and rewards, such as coupons, certificates for
completing phases of the program, and decreased
frequency of court appearances, are helpful and
important incentives. Systematic incentives that
track the participants’ progress through distinct
phases of the court program are also critical. As participants complete these phases, they receive public
recognition.
Courts should have at their disposal a menu of
incentives that is at least as broad as the range of
available sanctions; incentives for sustained adherence to court conditions, or for situations in which
the participant exceeds the expectation of the court
team, are particularly important.
9
10
sustainability
Data are collected and analyzed to demonstrate the impact of the mental health
court, its performance is assessed periodically (and procedures are modified
accordingly), court processes are institutionalized, and support for the court in
the community is cultivated and expanded.
Mental health courts must take steps early in the
planning process and throughout their existence to
ensure long-term sustainability. To this end, performance measures and outcome data will be
essential. Data describing the court’s impact on
individuals and systems should be collected and
analyzed. Such data should include the court’s outputs, such as number of defendants screened and
accepted into the mental health court, as well as its
outcomes, such as the number of participants who
are rearrested and reincarcerated. Setting output
and outcome measures are a key function of the
court’s planning and ongoing administration (see
Element 1).6 Quantitative data should be complemented with qualitative evaluations of the program
from staff and participants.
Formalizing court policies and procedures is
also an important component of maintaining mental health court operations. Compiling information
about a court’s history, goals, eligibility criteria,
information-sharing protocols, referral and screening procedures, treatment resources, sanctions and
incentives, and other program components helps
ensure consistency and lessens the impact when
key team members depart. Developing additional
6. The next edition of this document will include benchmarks that
will help courts determine whether this is taking place in their
jurisdictions. For guidance on collecting outcome data, please see
Henry J. Steadman, A Guide to Collecting Mental Health Court
10
plans for staff turnover helps safeguard the integrity
of the court’s operation.
Because sustaining a mental health court without funding is difficult, court planners should identify and cultivate long-term funding sources early
on. Court staff should base requests for long-term
funding on clear articulations of what the court
plans to accomplish. Along with compiling empirical evidence of program successes, mental health
court teams should invite key county officials, state
legislators, foundation program officers, and other
policymakers to witness the court in action.
Outreach to the community, the media, and
key criminal justice and mental health officials also
promotes sustainability. To that end, mental health
court teams should make community members
aware of the existence and impact of the mental
health court and the progress it has made. More
important, administrators should be prepared to
respond to notable program failures, such as when
a participant commits a serious crime. Ongoing
guidance from, and reporting to, key criminal justice and mental health leaders also helps to maintain interest in, and support for, the mental health
court.
Outcome Data, May 2005, published by the CSG Justice Center
and available at www.consensusproject.org/mhcourts/
MHC-Outcome-Data.pdf.
Conclusion
In courtrooms across the country, judges, prosecutors, and defense attorneys are seeing increasing
numbers of defendants who have serious untreated
mental illnesses charged with committing low-level
crimes. Traditional court processes do little to
improve outcomes for many of these people. They
cycle again and again through jail, courtrooms, and
our city streets.
As an alternative to the status quo, court officials, working in partnership with leaders in the
mental health system and local and state policymakers, have designed problem-solving mental
health courts. These courts depart from the traditional model used in most criminal proceedings.
Instead, as a team and under the judge’s guidance,
prosecutors, defense attorneys, and mental health
service providers connect eligible defendants with
community-based mental health treatment and, in
lieu of incarceration, assign them to communitybased supervision.
The number of mental health courts in the
United States has grown significantly. These programs share much in common from one county to
another. There are also aspects of each mental
health court’s design and operation that are unique,
as variation is the hallmark of this country’s criminal justice system, and one of its strengths. At the
same time, experts in criminal justice and mental
health practice agree that there are essential elements to mental health courts, which enable them
to span both the criminal justice and mental health
systems effectively and to ensure that the rights of
participants and community members are
respected. This publication describes and explains
these essential elements of a mental health court.
To design and implement a mental health court
with attention to each of these elements is a challenge for those just starting a conversation about a
possible mental health court, as well as for those
who have operated a mental health court for years.
Yet seasoned and new mental health court teams
alike have demonstrated a willingness to address
such complicated challenges. The essential elements described in this document are written for
them and others following in their footsteps, all of
whom work tirelessly to make communities healthier and safer, promote the efficient use of public
resources and tax dollars, and improve outcomes
for people with mental illnesses who are involved in
the criminal justice system.
11
The Bureau of Justice Assistance, Office of Justice Programs,
U.S. Department of Justice, provides leadership training, technical assistance, and information to local criminal justice agencies
to make America’s communities safer. Read more at
www.ojp.usdoj.gov/BJA/.
The Council of State Governments (CSG) Justice Center is a
national nonprofit organization serving policymakers at the
local, state, and federal levels from all branches of government.
The CSG Justice Center provides practical, nonpartisan advice
and consensus-driven strategies, informed by available evidence,
to increase public safety and strengthen communities. Read
more at www.justicecenter.csg.org.
The Criminal Justice/Mental Health Consensus Project is an
unprecedented national effort coordinated by the CSG Justice
Center to improve responses to people with mental illnesses who
become involved in, or are at risk of involvement in, the criminal
justice system. Read more at www.consensusproject.org.
Council of State Governments
Justice Center
100 Wall Street
20th Floor
New York, NY 10005
tel: 212-482-2320
fax: 212-482-2344
4630 Montgomery Avenue
Suite 650
Bethesda, MD 20814
tel: 301-760-2401
fax: 240-497-0568
www.justicecenter.csg.org
IN THE SUPERIOR COURT OF COLQUITT COUNTY
STATE OF GEORGIA,
vs.
STATE OF GEORGIA
§
§
§
CRIMINAL ACTION
§
FILE NO. :
§
Defendant.
SA/MH TREATMENT COURT CONTRACT
AND SPECIAL CONDITIONS OF PROBATION FOR SA/MH TREATMENT COURT
You are voluntarily entering the drug court program. Read the terms of this
contract carefully, and initial each term of the contract, date and sign the contract.
1. _______ I will pay $50.00 a month as a drug court fee for each month I am in the program,
but not less than $150.00, to cover the initial clinical evaluation.
2. _______ I will not violate the law. However, if I do violate the law, I will report it
immediately (within 24 hours) and I understand such violations may subject me
to sanctions or termination from the drug court program.
3. _______ I will not use or possess alcohol in any form.
4. _______ I will be gainfully employed full time or be a full time student unless the judge
approves otherwise.
5. _______ I will not use any drugs, legal or illegal. I will submit any prescription for drugs
to my counselors for verification and approval. I will not use over-the-counter,
non-prescription medications without permission of the drug court counselor, as
some over-the-counter medications will produce a positive reading on drug
screens and contain substances such as codeine.
6. _______ I will enroll and complete an inpatient/outpatient counseling program as ordered.
7. _______ I will obey all instructions of the drug court counselor and/or state probation
office.
8. _______ I will maintain my residence in Colquitt County and I will allow the drug court
counselor and law enforcement to visit me in my home or elsewhere.
9. _______ I will immediately inform the drug court counselor of any change of address, new
members of my household, telephone number and employment status. I will not
leave the State of Georgia for any reason without first obtaining permission from
the drug court counselor.
10. ______ I will attend the court ordered number of AA/NA (or an approved alternative
program) meetings per week and submit proof of attendance as required.
11. ______ I will give a breath, blood, urine, hair or sweat sample, as required, for drug
testing and may be responsible for payment for such service.
12. ______ I will be responsible for my own transportation and will appear for all drug court
sessions, counseling sessions and meetings as required and comply with any
sanctions imposed.
13. ______ Should I fail to appear for any drug court hearings, counseling sessions and
meetings as required, or otherwise fail to fully participate in or comply with
program terms and conditions, a warrant may be issued for my arrest.
14. ______ I understand that the drug court program will last a minimum of eighteen (18)
months, or longer if all requirements of the program have not been met.
15. ______ I will not possess a firearm, vicious or aggressive animals, or a knife exceeding
six inches (6") in blade length while in the drug court program. I am to bring NO
weapons of ANY kind to the drug court treatment center.
16. ______ I will support any legal dependents that I may have to the best of my ability.
17. ______ I will avoid people or places of disreputable or harmful character. This includes
people currently on probation or parole and people with felony convictions, drug
users and drug dealers.
18. ______ I will submit to a search of my person, motor vehicle, residence, papers and/or
effects (including but not limited to cell phones and electronic devices), without
their having to be probable cause to conduct the search, and without their being a
warrant, any time of the day or night whenever required to do so by a probation
officer, law enforcement officer or drug treatment staff, and I specifically consent
to the use of anything seized as evidence in any hearing or judicial disciplinary
proceedings.
19. ______ I understand the court will impose sanctions for program violations that include,
but are not limited to curfews, additional AA/NA meetings, community service,
in court detention, repeat of a program treatment level, issuance of bench
warrants, jail time, and expulsion from the program requiring me to serve my
sentence.
20. ______ I will follow all other program rules of which I am informed.
21. ______ In return for the court accepting me into the Drug Court program I give up the
right to withdraw my plea of guilty.
22. ______ I understand I will enter the program with a curfew and I will honor any curfew
imposed on me by the court.
23. ______ I understand that depending on my treatment needs, as determined by the court,
my treatment program, treatment schedule and court attendance may be changed.
24.______ I agree that if I do not comply with all terms and conditions while participating in
Drug Court, I will be in violation of this contract and the Court may, in its sole
discretion, declare the contract void and discharge or terminate me from Drug
Court.
25. ______ I understand that complete honesty is required and providing false information to
Drug Court may result in termination from the program.
This
day of
, 20
Signature of Participant
Judge, SA/MH Treatment Court
Southern Judicial Circuit
-2-
.
STATE OF GEORGIA
STATE OF GEORGIA,
vs.
Defendant.
§
§
§
§
§
§
§
Treatment Court program; and
CRIMINAL ACTION
FILE NO.
WAIVER OF RIGHT TO ASSERT SPECIFIED GROUNDS
AS A BASIS FOR MOTION OF RECUSAL
The defendant, and his/her counsel, acknowledge that as consideration for acceptance
and/or continued participation in the Colquitt County SA/MH Treatment Court program:
1. That the above-styled case will be assigned to the substance abuse/mental health
court division of superior court before the presiding Judge of the SA/MH
Treatment Court program; and
2.
should defendant fail to successfully complete the SA/MH Treatment Court program
and be ejected from said program, that the above-styled case will remain assigned
before the presiding Judge of the SA/MH Treatment Court program.
3.
That should defendant be deemed by the SA/MH Treatment Court team to be
unable to participate in the treatment court program and be withdrawn from the
program, the above-styled case will remain assigned before the presiding Judge
of the SA/MH Treatment Court program.
T hat
Understanding that the assignment of this case is to the presiding Judge of the SA/MH
Treatment Court program throughout all proceedings until ultimate disposition of the case,
irrespective of defendant’s success or failure in completing the drug court program, the defendant
hereby waives his/her right to assert as a basis for a motion to recuse the sitting judge:
1.
That judge’s personal involvement with the defendant during his/her participation
in the drug court program;
2.
That judge’s knowledge, both personal and otherwise, of defendant’s
compliance or non-compliance with the requirements of the drug court
3.
That judge’s decision to eject the defendant from the drug court program on
program; or the basis of his/her failure to comply with such requirements.
Defendant hereby freely, voluntarily and knowingly waives the right to assert the
foregoing as grounds for a motion to recuse and acknowledges that he/she does so having
consulted with counsel.
Dated this _______ day of ____________________, ________, in open court, Colquitt
County, Georgia.
__________________________________
Defendant
Participant in Colquitt Co. SA/MH
Treatment Court
________________________________________
Attorney for Defendant (or witness if pro se)
STATE OF GEORGIA
STATE OF GEORGIA,
vs.
Defendant.
§
§
§
§
§
§
§
CRIMINAL ACTION
FILE NO. ________________
WAIVER OF RIGHT TO DUE PROCESS HEARING
The defendant, and his/her counsel, acknowledge that as consideration for acceptance
and/or continued participation in the Colquitt County SA/MH Treatment Court program:
That the above-styled case will be assigned to the substance abuse/mental health court
division of superior court before the presiding Judge of the SA/MH Treatment
Court program; and
That the defendant will waive the right to a due process hearing for positive or missed
drug screens, community service work, failure to pay fees, and other program
violations and allow the Court to impose sanctions, including jail time, without
the right to a hearing.
That if adjudication has been withheld by the Court, the defendant waives the right to a
due process termination hearing prior to sentencing. Termination from the drug
court program will only be used for offenses or violations outlined by the team’s
policy and procedure manual or for chronic non-compliance.
Defendant hereby freely, voluntarily and knowingly waives the right to a due process
hearing as described above, having been advised of his/her constitutional right to said hearing.
Dated this _______ day of ____________________, ________, in open court, Colquitt
County, Georgia.
_________________________________________
Defendant
Participant in Colquitt Co. SA/MH Treatment Court
________________________________
Attorney for Defendant (or witness if pro se)
CONSENT FOR DISCLOSURE OF CONFIDENTIAL
COLQUITT COUNTY DRUG COURT INFORMATION
I, ____________________________________, have read and/or had explained to me the Notice
to Patients Pursuant to 42 C.F.R. Section 2.22, shown below and which is a federal regulation, regarding
the disclosure of my substance abuse treatment information and hereby consent to the release of
substance abuse treatment information among the following:
- Colquitt County SA/MH Treatment Court team or any person or organization that may provide
me treatment or services.
- Judge, Frank D. Horkan, or any other Judge assigned to preside over SA/MH Treatment Court
and other employees of the court.
- The District Attorney and members of his/her staff.
- The Drug Court public defender or my own retained lawyer.
- Colquitt County Probation Office.
- Colquitt County law enforcement personnel.
I further understand and agree that I will appear in court as required for a review of my progress,
that the court is open to the public and that, therefore, others present in court may learn of my treatment
and program compliance.
The purpose of this consent is to permit the court and all other named parties to have the
information they need to determine my initial and continued eligibility and suitability for treatment. This
includes my treatment attendance, compliance or non-compliance with program rules, prognosis and
progress in accordance with the Colquitt County SA/MH Treatment Court criteria.
I understand that this consent will remain in effect and cannot be revoked by me until there has
been a formal termination of my involvement with the Colquitt County SA/MH Treatment Court
program.
I understand that any disclosure made is bound by Part 2 of Title 42 of the Code of Federal
Regulations, which governs the confidentiality of substance abuse patient records and that recipients of
this information may re-disclose it only in connection with their official duties.
_____________________________________
Witness
Date
______________________________________
Drug Court Participant
Date
Notice to Patients Pursuant to 42 C.F.R. § 2.22
The confidentiality of alcohol and drug abuse patient records maintained by this program is protected by
state and federal law and regulations. Generally, the program may not say to a person outside the
program that a participant attends the program, or disclose any information identifying a patient as an
alcohol or drug abuser unless:
The participant consents in writing;
The disclosure is allowed by a court order; or
This disclosure is made to medical personnel in a medical emergency or to qualified
personnel for research, audit or program evaluation.
Violation of federal law and regulations by a program is a crime. Suspected violations may be reported
to appropriate authorities in accordance with federal regulations. Federal law and regulations do not
protect any information about a crime committed by a participant either at the program or against any
person who works for the program or about any threat to commit such a crime. Federal laws and
regulations do not protect any information about suspected child abuse or neglect from being reported
under state law to appropriate state or local authorities.
Colquitt County Superior Court SA/MH Treatment Program
Emit Compliance/Independent Testing Compliance
All participants will be required by the SA/MH Treatment Court Program to provide an
appropriate urine, hair, blood, breath or other specimen as ordered or requested by the
Judge, Treatment Provider, or Probation Officer. For the purpose of compliance with
court and probation guidelines, the participant will submit to testing upon request or
random selection, by the Treatment Provider, as deemed necessary. The Judge,
Treatment Provider, or Probation Officer also reserve the right to have the participant
tested in an independent laboratory if for any reason there is a question of whether the
participant is abusing alcohol or drugs that the Probation Officer is unable to test for any
reason.
Refusal to comply with this statement by refusing to sign will result in removal from the
group program and the Treatment Court Program.
Participant’s Name: _____________________________
Date: _______________
Judge:________________________________________
Date: _______________
Probation Officer: _______________________________
Date: _______________
STATE O
OF GEORGIA
STATE OF GEORGIA ,
vs.
CASE NO.: _______________________
_____________________________________
Consent for disclosure and communication of confidential substance abuse/mental health information for use
among Drug Court Administrator and/or providers.
I, ___________________________________, hereby consent to communication, including ex parte, between the
Judge of the Colquitt Superior SA/MH Treatment Court, the Court Coordinator, the Treatment Provider, the
prosecuting attorney, the public defender, the probation department of Colquitt County, and any other agencies
(including law enforcement), regarding any and all information requested pertaining to me, to include but not be
limited to information obtained through GCIC, NCIC record checks, and information concerning substance use, drug
testing, diagnosis and treatment.
The purpose of, and need for this disclosure is to inform the Court and all other named parties of my
eligibility and/or acceptability for substance abuse or mental health services and my treatment attendance, prognosis,
compliance and progress in accordance with the substance abuse/mental health program’s monitoring criteria.
________ (Participant Initials)
Disclosure of this confidential information may be made as necessary for, and pertinent to hearings and or
reports concerning my current case. ________ (Participant Initials)
Disclosures may also be made in the event of a medical emergency, crimes committed on the program
premises or against program staff and to researchers/outside auditors. However, information will only be disclosed to
researchers/outside auditors if participants are not identified. ________ (Participant Initials)
Disclosures will be made as the result of a valid court order or relevant state law.
I authorize any prison, detention center, county jail or city jail in which I have been confined to release to
the court all information in my records concerning test for HIV (Aids), tuberculosis and hepatitis. I understand that
such disclosures are only authorized as they pertain to my treatment and treatment options within the Substance
Abuse/Mental Health Treatment Court program. ________(Participant Initials)
I release the facility and personnel which releases such information to the court from any and all liability
for complying with this authorization. ________ (Participant Initials)
I understand that this consent will remain in effect and can not be revoked by me until there has been a
formal and effective termination of my involvement with the Substance Abuse/Mental Health Treatment Court
Program, but not to exceed (5) years from this date. ________ (Participant Initials)
I understand that any disclosure made is bound by Part 2 of Title 42 of Federal Regulations, which governs
the confidentiality of substance abuse patient records and that recipients of this information may re-disclose it only
in connection with their official duties. Disclosure outside of authorized context is punishable as a
crime. ________ (Participant Initials)
________________________________
Participant Name/Date
_______________________________
Attorney Name/Date (or witness if pro se)
Colquitt County SA/MH Treatment Court Sanction Matrix
The following sanction matrix is intended as a general guide for sanctions in specific instances.
However, the SA/MH Treatment Court will make the ultimate decision as to sanctions, specified
or unspecified herein, when warranted, considering the opinions of all team members.
Positive/Missed Drug Screens
Missed screens, Could Not Provide (CNP), and Positive screens with admission
Phases 1 and 2
Phases 3 and 4
1st
Admonishment 1st
24 hrs. Jail Sanction
48 hrs. Jail Sanction
2nd
2nd
24 hrs. Jail
3rd
3rd
48 hrs. Jail
5 days Jail Sanction
4th
5 days Jail
4th
5th
7 days Jail
For positive screens with denial at the time of drug testing
Without
7 days Jail
Confirmation
With
14 days Jail
Confirmation Sanction
Community Service Work
First Failure to Original hours are doubled or at direction of Court 24 hr jail sanction; reassigned CSW
complete hrs hours
Second Failure
to complete
24 hr Jail Sanction; reassigned CSW hours
hrs
Termination
48 hr jail sentence
from CSW site
Drug Court Fees
Each Month 8 hrs CSW
Other Missed
Payments Ea. CSW or jail sanction up to 7 days
Mo.
Curfew/Home Visits
Phases 1 and 2
1st Missed
Admonishment
24 hrs Jail
2nd Missed
Sanction
48 hrs Jail
3rd Missed
Sanction
5 days Jail
4th Missed
Sanction
7 days Jail
5th Missed
Sanction
Phases 3 and 4
1st Missed
24 hrs Jail Sanction
2nd Missed
48 hrs Jail Sanction
3rd Missed
4th Missed
Dilution/ Substitution/ Adulteration
1st Offense
7 days Jail Sanction; repeat all or part of phase
2nd Offense 28 day Jail Sanction; repeat all or part of phase
3rd Offense
Presumed Terminated
*Residential treatment may be considered in lieu of repeating Phases.
Job Search/ Employment
Failure to provide Job Verification or failure to notify counselor of the loss of employment
4 hrs CSW
or school
Failure to provide an updated Employment Form to his/her counselor the next business day
4 hrs CSW
after becoming gainfully employed or enrolled in school
2 hrs CSW
Missing job search
Missed Group
Sanctions will be cumulative for Phases 1 and 2 and will RESET in Phases 3 and 4
Excused
Missed
Group
Make-up 2 groups at counselor's discretion (i.e. regular treatment group)
Unexcused
Missed
Group
1st Missed
4 hrs. CSW and make-up 2 group prior to next court review
Group
2nd Missed
Group
8 hrs. CSW and make-up 2 groups prior to next court review
3rd Missed
Group
1 day Jail Sanction and make-up 2 groups prior to next court review (CAN choose the day
in jail, but must be before next court review)
4th Missed
Group
2 day Jail Sanction followed by 7 meeting in 7 days
Possession of Drug Paraphernalia or Alcohol during a Home Visit
Sanctions for finding alcohol in the common area of the home
Admonishment. If this happens again, team may require participant to move to a recovery
1st offense
friendly environment at the discretion of Drug Court
2nd offense
8 hrs CSW; curfew x 90 days
3rd offense
24 hrs in jail
Sanctions for finding alcohol not in common areas of the home
Any offense Sanctioned according to missed screen policy. No admonishment given.
Sanctions for finding drug paraphernalia in the common area of the home
Admonishment. If this happens again, team may require participant to move to a recovery
1st offense
friendly environment at the discretion of Drug Court
2nd offense
Team will discuss possible residential treatment or termination
Release from Residential Facility without Permission
Release
without
28 days jail
permission
If the Drug Court team decides to terminate a participant for being discharged from a residential facility
without permission, he/she will be given a notice of termination letter and given an opportunity to address
the court.
AWOL
1st AWOL
2nd AWOL
Participant will serve 2 days in jail for every day they are gone up to a maximum of 60 days
in jail
Participant will serve a minimum of thirty days in jail. Participant will serve 2 days in jail
for every day gone up to 60 days in jail. After serving the minimum of 30 days in jail, at
the discretion of the team, he/she will serve the remaining time in work release which is
designed to help treatment staff to determine if residential is appropriate. The participant
may or may not participate in groups at the treatment center.
3rd AWOL
Presumptive Termination
STATE OF GEORGIA
STATE OF GEORGIA
VS.
Defendant.
§
§
§
§
§
§
§
CASE #:
PRE-SENTENCING CONSENT ORDER
This defendant has requested and is being placed in the Court's Substance Abuse/Mental
Health Treatment Program. This is being done before sentence with the consent of defendant, his
attorney and the prosecuting attorney. The following are special conditions agreed upon by the
parties:
1.
Defendant shall be subject to random tests for drugs and alcohol at the request of the
probation officer and/or as directed by the Court. Defendant is prohibited from ingesting any
alcohol or illegal drugs while in the Substance Abuse/Mental Health Treatment Program.
2.
If applicable, defendant shall comply with all required mental health/substance abuse
treatment and therapy prescribed through his/her attending physicians, including but not
limited to, compliance with prescribed prescription medicines. Defendant is to regularly
attend and cooperate in all therapy, treatment and counseling, including any programs,
treatment or therapy offered by Southwestern State Hospital, Moultrie Area Community
Services Board, Moultrie Area Mental Health or other drug, alcohol or mental health
treatment facilities and programs as directed by the Court;
3.
Defendant will be required to periodically return to court for judicial review of the case and
treatment compliance, including drug class compliance and report to his/her caseworker.
Additionally, defendant agrees to follow program guidelines and to attend group sessions and
12 step programs.
4.
By signing below, defendant consents and agrees that his/her assigned court officer, the
SA/MH court coordinator for Colquitt Superior Court and the presiding Superior Court Judge
may obtain information, documents and records from any drug or alcohol treatment providers
and any mental health treatment providers (including psychiatrists, psychologists,
psychotherapists, counselors, and clinical nurse practitioners) regarding any court ordered
evaluations, assessments, treatment and counseling so that these court officials can monitor
attendance, participation, and compliance with these programs which are court mandated as
an integral part of the probation order in this case. The documents and information covered
by this release and consent to obtain information include dates of treatment, drug
information, alcohol information, mental health information, individual service plans, history
and __________(initials) physicals, discharge summaries, diagnosis, psychiatric/psychologist
evaluation reports, lab reports, medications and reports regarding program compliance.
This consent for information shall remain in force until completion of this probation order or
further order of the court. The consent is given voluntarily as the probationer has requested to
be placed in the program in order to avail himself/herself of treatment options. This consent is
given pursuant to applicable Federal and State laws and regulations, including but not limited
to, 42 USC 290 dd(2) et.seq.; 42 CFR 2.64 and 2.65; OCGA 24-9-21, People v. Lane, 689
N.Y.S. 2d 325 (1999).
5.
If defendant successfully completes the twelve month drug court including clean Drug
screens, no new offenses, and required attendance at group sessions, 12 step programs and
required treatment, the Court will consider dismissal of the pending case with consent of
the prosecutor.
This
day of
Defendant's Signature
Witness by:
Court Officer
Consented:
Defense Attorney
Prosecuting Attorney
SO ORDERED and made a part of the Order in this case:
JUDGE, Colquitt County Superior Court
, 20
.
STATE OF GEORGIA
§
§
§
§
§
§
§
STATE OF GEORGIA,
VS.
Defendant.
CASE #
ADDENDUM TO PROBATION ORDER
SPECIAL CONDITIONS
This probationer, as part of this sentence, has requested and is being placed in the Court's Substance
Abuse/Mental Health program. The following are conditions of the probation order:
1. Probationer shall be subject to random tests for drugs and alcohol at the request of the probation officer.
The probationer is prohibited from ingesting any alcohol or illegal drugs while on probation.
2. Probationer shall comply with all required substance abuse/mental health treatment and therapy prescribed
through his/her attending physicians, including but not limited to, compliance with prescribed prescription medicines.
Probationer is to regularly attend and cooperate in all therapy, treatment and counseling, including any programs,
treatment or therapy offered by Southwestern State Hospital, Moultrie Area Community Service Board, Moultrie Area
Mental Health or other drug, alcohol or mental health treatment facilities and programs as directed by the court;
3. Probationer will be required to periodically return to Court for judicial review of probation and treatment
compliance;
4. By signing below, probationer consents and agrees that his/her assigned probation officer, the SA/MH
court coordinator for Colquitt Superior Court and the presiding Superior Court Judge may obtain information,
documents and records from any drug or alcohol treatment providers and any mental health treatment providers
(including psychiatrist, psychologists, psychotherapists, counselors, and clinical nurse practitioners) regarding any
court ordered evaluations, assessments, treatment and counseling so that these court officials can monitor attendance,
participation, and compliance with these programs which are court mandated as an integral part of the probation order
in this case. The documents and information covered by this release and consent to obtain information include dates of
treatment, drug information, alcohol information, mental health information, individual service plans, history and
physicals, discharge summaries, diagnosis, psychiatric/psychologist evaluation reports, lab reports, medications and
reports regarding program compliance. This consent for information shall remain in force until completion of this
probation order or further order of the court. The consent is given voluntarily as the probationer has requested to be
placed in the program in order to avail himself/herself of treatment options. This consent is given pursuant to
applicable Federal and State Laws and regulations, including but not limited to, 42 USA 290 dd(2) et.seq.; 42 CFR
2.64 and 2.65; OCGA 24-9-21; People v. Silkworth, 538 N.Y.S. 2d 692(1989); People v Lane, 689 N.Y.S. 2d 325
(1999)
This
day of
, 20
.
Witnessed by:
Probationer
Probation Officer
SO ORDERED and made a part of the Probation Order and sentence in this case:
JUDGE, Colquitt Superior Court
Colquitt County Superior Court
SA/MH Division
Participant or Probationer’s Name and Case Number:
_____________________________________________________________________
You are Ordered to appear at the following locations and times:
1. Courtroom, Colquitt County Justice Center, 200 Veteran’s Parkway North,
Moultrie, Georgia, (229) 616-7430:
_____________________________________________________________________
_____________________________________________________________________
2. Meet with Probation Officer, ________________________________, at the Moultrie
Probation Office, 18 South Main Street, Moultrie, Georgia (229) 891-7270,
on: __________________________________________
3. Drug Test as directed by Court or Team Member:
_____________________________________________________________________
4. Other:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
SO ORDERED,
Copy received:
____________________________
__________________________
Judge, Superior Court
cc:
Coordinator
Probation Office
Clerk’s file
Date
STATE OF GEORGIA
SA/MH DIVISION
CASE NO: _____________
STATE OF GEORGIA
VS.
________________________________
HEARING FINDINGS AND ORDERS:
1. Witnesses and Attorneys present:
2. Summary of Evidence:
3. Order of the Court:
Take in SA/MH Treatment Program
Comply with SA/MH Tx./Counseling/Medication
28 Day Program thru
TAPP
Make/Attend Appointment with
Enroll in 12 Step Program
on
Report to for Dr. Appt.
Outpatient Drug Treatment
Drug Tests
Return to
Jail Drug Program
OR at request of Prob. Officer
Drug Class,
Aftercare
Own Expense
between
No Expense
AM/PM
Report to probation officer
Jail to be notified of Release by
Return to court for follow-up
Continue compliance/Prior Orders
at
Terminate SA/MH Treatment Program
________________________________________
JUDGE,
Staff
SA/MH Treatment Provider
Educational Background:
•
•
•
Work Experience:
•
•
•
•
Current duties:
Provide case management services for substance abuse and dual diagnosed
program participants within the Treatment Court Program. Perform initial assessments on
new program referrals and make recommendations for appropriate level of treatment (outpatient, short-term, or long-term placement.) Work with Treatment Court staff as well as
organizations to determine most appropriate placement for individuals needing residential
substance abuse treatment. Facilitate bi-weekly Phase II substance abuse educational
groups. Strive to maintain open communication with the program participant's family or
support system. Communicate with other treatment court team members through
staffing's and other means. Facilitate placement and supervision of program participants
in program supported housing.
Treatment Court Coordinator
Educational Background:
•
•
•
Work Experience:
•
•
•
•
Current Duties:
Manage all activities of the treatment court office such as assembling records for
newly enrolled participants, updating and filing all clerical information in a
timely manner. Attend all court hearing to document all rulings of the judge to
ensure they are carried out appropriately. Verify and schedule mental health and
other appointments as necessary. Communicate with other programs and their
staff, programs in the private sector, as well as individuals in law enforcement
who are involved in the care of all participants enrolled in the program. Make
sure all forms and documents used by the court program are kept up to date.
Assist with gathering necessary documentation for visiting Learning Site
programs and document activities. Compile and distribute the treatment court
schedule at least one week before each scheduled court date to the appropriate
treatment court staff.
COLQUITT SUPERIOR COURT SA/MH TREATMENT PROGRAM
Other Staff:
The Treatment Court Program has three other staff who, though not hired by the
court program, are assigned to work with the Court to complete the overall makeup of the
program. An assistant district attorney, an assistant public defender and a state probation
officer attend all court sessions and contribute valuable input towards the participant's
progress. In addition to their regular assignments, they also attend individual staffing
sessions and provide input as to the criminal history of new referrals to make certain that
the enrollment guidelines are being met. They attend all other meetings with the judge
and some routine staff meeting with the primary court staff. The treatment court's primary
staff will maintain in frequent contact with them about the status of the enrollee and share
all pertinent information about a new potential referral or enrollee. Whenever possible,
these other staff members will attend workshops with the treatment court staff. These
workshops will focus on services and disabilities relevant to the population that the court
serves.
Judge
Frank D. Horkan
Colquitt County Superior Court
Colquitt County Courthouse Annex
P. O. Box 2227
Moultrie, GA 31776
Office: (229) 616-7445
Fax: (229) 616-7447
Coordinator
Jennifer S. Fabbri
P. O. Box 2227
Moultrie, GA 31776
Office: (229) 616-7445
Fax: (229) 616-7447
[email protected]
Treatment Providers
Charlotte Austin, LCSW
Georgia Pines
1102 Smith Avenue
Thomasville, GA 31792
(229) 225-5208
[email protected]
R.J. Hurn, Outpatient Coordinator
Georgia Pines
1102 Smith Avenue
Thomasville, GA 31792
(229) 225-5208
[email protected]
Lisa Steltenpohl, CSS
Georgia Pines
615 North Main Street
Moultrie, GA 31768
229-251-1995 (cell)
[email protected]
Ben Marion, CEO
Turning Point
3015 Veterans Parkway
Moultrie, GA 31788
(229) 985-4815
[email protected]
Prosecutor
April Senn
P. O. Box 2498
Moultrie, GA 31776
Office: (229) 616-7476
Fax: (229) 616-7479
[email protected]
Public Defender
Isaac Howard
Colquitt County Courthouse
9 South Main Street, Suite 105
Moultrie, GA 31768
Office: (229) 616-7070
Fax: (229) 616-7067
[email protected]
Probation Officer
Rebecca Dalton
18 South Main Street
Moultrie, GA 31776
Office: (229) 891-7270
Fax: (229) 891-7271
[email protected]
Colquitt County Sheriff’s Department
Chris Robinson
P. O. Box 188
Moultrie, GA 31776
Office: (229) 616-7430
Fax: (229) 616-7015
[email protected]
Evaluator
David Mixon
P. O. Box 1132
Lake Park, GA 31636
Office: (229) 559-5901
Fax: (229) 559-6743
[email protected]

Colquitt Superior Court Substance Abuse/Mental Health Treatment

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