2. What is JLSCI?  Started in 2009 in Georgia  3-day Symposium  Delivered in OH, TX, GA and twice in NV  Teams of local justice & treatment leaders  Combines the latest addiction science with change theory and systems planning

3. What is JLSCI?  Creates systemic change resulting in improved management of justice-involved persons with substance use disorders, especially those who are addicted  Follow-up TA available to support implementation  Funded by BJA, CSAT, and NIDA  2011, 2012, 2013 White House National Drug Control Strategy - Model

4. Interested in JLSCI Coming to Your Jurisdiction? Jac A. Charlier Director Center for Health and Justice at TASC jcharlier@tasc-il.org 312-573-8303

5. Making the Case for Systems Change: Integrating Treatment into the Justice System Presented by: Alicia Kusiak Director of Operations, TASC, Inc

6. The Present Tense The System As Is…..

7. Implications Each segment of the system only focuses on their own part and not the full system (Silo Effect) Drug-involved offenders often slip through the cracks with their addictions untreated- offenders will recycle through the system Criminal records build for lower level, drug involved offenders, and so do mandates for increasingly severe offenses or more likely criminal histories Enormous numbers of Substance abuse/use/dependent persons in the criminal justice system: system over- burdened. Size of population demands action.

8. Implications (cont) Existing interventions occur in silos serving small percentages of the population in need and are often duplicated or competing for the same clients. Tendency to “cream” Justice system may not access the full array of available community services or resources, therefore the continuum of care is not available or offered Judiciary may select in-patient/residential treatment as a default because it is deemed to be safest, despite it being an inappropriate therapeutic intervention

9. Implications (cont) Inefficient use of tax payer resources…lower investment in early stages leads to escalating cost for incarceration, contributing to state budget crisis Crowded Court Dockets with insufficient time or resources to address offenders’ substance use or mental health needs Poor outcomes lead to cynicism about treatment ineffectiveness and recovery possibility We Can’t Seem to Break the Cycle

10. The Future Tense A SYSTEM PERSPECTIVE “Whose Job is it Anyway?”

11. How can the justice system organize treatment interventions along its continuum?

12. Effective Systemic Interventions Interventions are of a scale to have a measurable impact: Continuity of care between services and points in the justice system are ensured Intervention matches offender criminal justice supervision needs and clinical service needs in order to be effective Drug-involved individuals diverted as early as possible in the process Risk and needs screening(s) and assessment(s) guide treatment and justice decision making

13. Effective Systemic Interventions Stop the revolving door for current and future generations The 4 R’s: Reduce drug use and criminality; Reduce the total size of the criminal justice population; Reduce jail and prison crowding; Reduce court docket size and pressure Increase public safety and effectively deals with public health

14. The System Roadmap: A Continuum of Decision-Makers Police Bond Court Prosecutor Police Judge Jury Probation Officers Parole Officers Parole Board Corrections Prosecutor Defense Attorney Defendant Jury Judge Sheriff

15. Basic Building Blocks of Systemic Interventions –Screening –Assessment ORAS and Clinical –Treatment Planning –Appropriate Treatment Matching –Clinical/Recovery Case Management –Continued Assessment During Recovery –Motivational Incentives –Appropriate Rewards/Sanctions –Planning & Analysis of Needs and Gaps –Evaluation & Documentation of Efforts

16. Interventions are implemented at all points in the criminal justice process Influenced and Lead By You….

17. What’s Out There? Models to Get the Job Done

18. Illinois Statutory/Administrative Rule Designated Agent for Court/Corrections Not For Profit Agency as Broker Between Chief Judge and Treatment Provides Statewide Uniform Assessment, Case Management Treatment Protocols Executes Court Agreements with each Jurisdiction

19. Alabama University of Alabama at Birmingham Designated as Court/Corrections Broker/Bridge Court Services Specialty Center Provides Screening, Assessment, Treatment Planning, Care/Case Management, Court Reporting Can Administrate Triage Screening At Early Stages in Criminal Justice Supported By County/State Funding

20. Baltimore Centralized Diagnostic Center Available to All Courts with Licensed Professional Centralized Care/Case Management (Professional) Supported by State Substance Abuse Block Grant and Medicaid and City Substance Abuse Funding Agency

21. North Carolina Regional Behavioral Service Structure Regional Designated Specialty Service Organization for Courts and Community Corrections Provides All of Functions above including Statewide Standardized Assessments, Protocols Supported by State Drug Abuse Block Grant, State Mental Health Revenue

22. Practical Simple Solutions What can YOU do now??

23. Exercise Now it’s your turn……

24. Criminal Justice Leaders Change agents – can stimulate public policy discussion Conveners – can make changes in their jurisdiction Consumers – are typically not treatment experts but should become informed consumers Analysts – can identify priorities of changes to implement Advocates – to demand increased resources YOU are the Key to Collaboration

25. The POWER is in your hands Implement the Change you wish to see…

26. The Challenge… “What do YOU do to break the cycle”

27. Questions? Comments Thank you for your participation and attention.

28. Building the System Checklist Identify building blocks: –What current existing programs can we leverage? Prioritize effectiveness and efficiency: –What model will give us the greatest impact for our investment and relieve the justice burden? Identify knowledge base: –What are the research-driven practices and principles which must be the foundation of our strategy?

29. Building the System Checklist Analyze drug-involved offender flow and impact on the justice system and community safety Prioritize points for development of interventions along the justice continuum Work with community prevention and treatment partners to build support for systems change (ROSC) Assess treatment resource access and availability Wherever possible consolidate court access to treatment and case management through a centralized function that covers general courts, specialty courts and specialized probation functions

30. Building the System Checklist Identify funding options: –Local, State, Federal Build for sustainability: –Plan for system intervention across justice continuum –Don’t rely on one funding stream to dictate system plan –Use funding opportunities to help build modules of interventions –Keep plugging in the gaps –Evaluate your effectiveness and revise your strategy accordingly