RISK AND NEED TRACKS SAMHSA 2013 Orleans Parish Drug Court Expansion Grant

ORLEANS PARISH OUTCOMES COULD CHANGE DRUG COURT STATUTE TO INCLUDE INDIVIDUALIZED TREATMENT Goals and Benefits

Increase and Improve Access Availability eligibility screening assessment treatment types group types, intervention types modalities programming for men and women individualized treatment provide lower recidivism rates higher retention rates promote public safety individual trauma counseling transportation services childcare vocational training GOALS:

Benefits of Drug Court Track System Increased retention and graduation rates Reduced recidivism Self-efficacy Empowerment Sustainable employment Employment skills Increase in physical and mental health Access to health care Enhanced parenting skills Family relationships Trauma symptom reduction No More One Size Fits All Treatment

Current Process vs Process after Grant Implementation Current Process Intake Screening Form DAST Intake/Accepted into Drug Court Addiction Severity Index Gender Specific Treatment Groups After Grant Implementation Intake Screenin g Form TCUD S-II Nursing Assessmen t RANT Specialized Risk/Need Treatment Tracks Four Question PTSD Screener PCL-C SLES Q Helping Women Recover and Helping Men Recover Curriculum MHSF -III Psychiatric Evaluation Intake/ Accepted into Drug Court Addiction Severity Index Gender Specific Tretment Groups

2 DESIGNATED SCREENING AND INTAKE COUNSELORS ADDED ASSESSMENTS TO CREATE INDIVIDUALIZED CASE MANAGEMENT AND TREATMENT PLANS Screening and Assessment

Screening Court calls for screening prior to sentencing Intake counselor screens for eligibility Risk and Needs Assessment Triage (RANT) Screening completed in the DCCM Outcome: Individualized Case Management Plan: GED Housing Medicaid

Assessment Intake completed in DCCM and GPRA Mental Health Screening Trauma Screening TCU-Drug Abuse Screening Addiction Severity Index (ASI) Outcome: Individualized Treatment Plan: Psych Evaluation (onsite Psychiatrist) Nursing Assessment (onsite nurse) Individual Counseling (onsite trauma therapists) Personalized Treatment Track (Risk and Need) Grief Counseling Anger Management Parenting Groups (NOLA DADS)

HIGH RISK/HIGH NEED HIGH RISK/LOW NEED LOW RISK/HIGH NEED LOW RISK/LOW NEED Risk and Need Tracks

RISK Need Prognostic Risk Re-Offending Career Criminal Revolving Door Criminogenic Need Substance Dependence Rehabilitation Sobriety Risk and Need

Risk and Need Quadrants Standard Drug Court Track (10 Key Components)  Status Calendar  Intensive Treatment  Compliance is proximal  Restrictive Consequences  Focus consequences on treatment and supervision Specialized Track (Treatment emphasis)  Noncompliance calendar  Intensive treatment  Treatment is proximal  Focus consequences on treatment Specialized Track (Accountability emphasis)  Status Calendar  Pro-social rehabilitation  Prevention Services  Abstinence & compliance are proximal Specialized Track (Diversion emphasis)  Noncompliance calendar  Prevention services  Focus consequences on abstinence HighLow High Low

High Risk/ High Need (Standard Drug Court Track) Scheduled Status Hearing with the Judge Intensive Outpatient Treatment with FSGNO Consequences for treatment and supervision Compliance is a proximal goal Graduation Sanction/restrictive consequences Prescribed Medication allowed Generally Substance Dependent Possess antisocial personality features Prior failures in treatment Early onset of Substance Use Unable to be a good parent, hold a job, or attend school Will need vocational skills training’ Treatment and Supervision attendance are proximal goals (short term) Sanctions should be immediate for missing treatment or supervision Before sanctioning for new drug use they need time to be in treatment Response to positive drug tests should be treatment oriented

High Risk/Low Need (Emphasis on Accountability) Scheduled Status Hearing with the Judge Pro-Social Rehabilitation (People, Places & Things) Prevention Services Abstinence and Compliance are proximal Need Social Skills Training and Accountability with close monitoring Scheduled Status Hearings-Judge to monitor and sanction due to high risk of noncompliance with monitoring May not meet dependence criteria and Intensive treatment option may put them at more risk for exposure to drug use Psycho educational groups to provide education of negative effects of drugs and alcohol Education to help re-enter society without drug and alcohol Abstinence and Compliance are short term and attainable goals-sanctions needed for missing treatment and supervision.

Low Risk/High Need (Emphasis on Treatment) Status Hearings only for noncompliance Intensive Outpatient Treatment with FSGNO Consequences focused on treatment Treatment is a proximal goal Prescribed medication allowed Substance Dependant Mental Illness Poor Coping Skills Need Intensive Treatment and Supportive Intervention Regular status hearings are not necessary because they may expose them to high risk behaviors Quick and immediate sanctions are a must Monthly Status Hearings are acceptable Must be in separate groups from High Risk offenders Need vocational and educational services Poor attendance should get a immediate judicial sanction Relapse is a distal goal (long term)-should get a treatment sanction

Low Risk/Low Need Status Hearing for noncompliance Prevention Services Consequences are focused on abstinence Usually productive in life (work, school, parenting) Combining them with HRHN (Drug Court) would expose them to antisocial behavior No scheduled status hearings are necessary-only noncompliance May not require Intensive Outpatient Groups May need psycho educational groups or less intensive treatment Abstinence is a proximal (short term) goal-immediate sanction Treatment plan should include prevention

DRUG COURT VERSUS INTENSIVE PROBATION Who is Eligible???

Drug Court AND Intensive Probation Current Drug Court clients Substance Dependant Active Probation Minimum 3 years probation Current IP clients May be substance dependant May be recreational user Dealers Active/Inactive Probation Eligibility

INTENSIVE PROBATION BECOMES DRUG COURT Program Outline

Currently Options Defendants sentenced to Drug Court receive ALL of the afore mentioned services inclusive of individualized treatment. Defendants sentenced to Intensive Probation receive case management and are NOT ELIGIBLE for any of the afore mentioned services available through the SAMHSA Grant. Defendants that need case management would be sentenced to Court Intervention Services and screened for a treatment track. Cases that would fall into the traditional Drug Court track (High Risk/High Need) will be re-alloted to a felony Drug Court Section and the High Risk/Low Need track would be transferred to Section C for supervision. All others will remain in their sentencing section to be monitored by the Case manager assigned to that track. Drug Court Umbrella