BUREAU OF JUSTICE ASSISTANCE (BJA) DRUG COURT CLEARINGHOUSE/TECHNICAL ASSISTANCE PROJECT

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1 JUSTICE PROGRAMS OFFICE SCHOOL OF PUBLIC AFFAIRS BUREAU OF JUSTICE ASSISTANCE (BJA) DRUG COURT CLEARINGHOUSE/TECHNICAL ASSISTANCE PROJECT FREQUENTLY ASKED QUESTIONS SERIES: Policies Re Fraternization and Socialization Between Participants Subject: From: Date: Policies Re Fraternization and Socialization Between Participants BJA Drug Court Clearinghouse/Technical Assistance Project (March 7, 2006). August 22, 2014 (rev.). May 15, 2015 (rev.) Over the years, requests for drug court program policies regarding fraternization are submitted to the BJA Drug Court Technical Assistance Project. The following three requests were submitted during the past ten years, each with a slightly different slant, along with the responses received at the time. The January 2015 responses focused on socialization. I. In February 2006, Judge Lisa Stark of Eau Claire, Wisconsin, submitted a request for information from other drug courts regarding their experience and perspective on the following two issues: QUESTION What policy, if any, do drug courts have on fraternization between participants? We have one gentleman in particular who seems to be wooing several women in our court. We are aware of the research indicating such relationships interfere with the success of treatment. However, we are not certain whether it is appropriate to ban all dating, or just contact between individuals in court or in treatment. And, if there is to be some type of restriction, how should that be enforced and what sanctions should be imposed if there is a violation? Responses to Judge Stark s inquiry were received from seventeen programs, across seven states: Arizona, Florida, Georgia, Hawaii, Michigan, Oregon, and Vermont, and the District of Columbia. Of the programs that responded, nearly all of them acknowledge the potential danger fraternization can have on the treatment process. A number of programs indicated that they separate the participants (i.e. separate treatment groups and separate court dates). Some indicated, however, that they do not feel it was the court s role to intervene in relationships, but relied on the treatment provider to set policies and determine the best course of action if a relationship was hindering a participant s treatment process. One program (Monroe County, Florida) provided a copy of the program s participant agreement that each client must sign prior to starting treatment in which they agree not to engage in any romantic or sexual relationships with active program participants. II. In July 2014, Ellen Goodman, Program Administrator for the DUI/Drug Court Programs in Thurston County (Olympia), Washington, followed up on Judge Stark s inquiry, requesting insight into how

2 other drug court programs are dealing with the issue of relationships between participants in their programs. Ms. Goodman s inquiry is as follows: QUESTIONS We had a discussion today about participants in our drug court program, a few of whom we think are having a romantic relationship with each other. We currently have a policy in place and a form that participants sign when they first enter our program barring such relationships. However, we know that a few of them are doing this anyway. If we try to enforce this, we think they will just be dishonest about it and/or "take it underground", so to speak. Would you please be kind enough to provide some info about the questions asked below as it pertains to your programs? (1) What is your policy on romantic relationship relationships between drug court participants? (2) How does your program enforce the policy (or not, if you do not have a policy and/or are unable to enforce it)? To date, responses to this inquiry have been received from four programs, all from the state of Washington. Of the programs that responded, two do not have specific fraternization policies in place while the other two do have specific policies in place. The two programs that do not have policies in place, encourage participants to remain single, and one of the program states that if two clients are dating they are not allowed to be in the same treatment group. Of the two programs with policies in place, one prohibits sex between phase I participants and another drug court participant, and the other program states that a relationship between participants is grounds to consider termination if the relationship is having a negative effect on participants treatment. None of the respondents with non-fraternization policies report specific enforcement strategies for their program. III. In January 2015, Rachel Kohn on behalf of the Cheshire County Drug Court in Keene, NH, submitted a request for further information from other drug courts regarding their policies about restricting socialization outside drug court activities. Ms. Kohn s inquiry is as follows: QUESTION There was a discussion thread about fraternization in October, but I wanted to inquire further if other drug courts have implemented policies that restrict socialization outside drug court activities. And if so, would you share them with us and talk about how you monitor and enforce this policy? To date responses to Ms. Kohn s inquiry were received from three programs, across three states: Georgia, Kansas, and Montana. Overall, most respondents; programs do not have fraternization policies in place. The one program with policies in place acknowledges they cannot prevent contact outside the program. Additionally, most programs encourage socialization not involving fraternization amongst participants. One program, however, indicated it believed socialization had led to relapse. Comparing similarities in responses to the three sets of inquiries, there appears to be consensus that fraternization negatively affect the effectiveness of treatment programs. The respondents also agreed, however, that socialization has a positive impact on treatment. Responses to Ms. Stark s February, 2006 inquiry, Ms. Goodman s July, 2014 inquiry, and Ms. Kohn s

3 January, 2015 inquiry are compiled below. Included as an appendix to this FAQ Memo is the Drug Court Program Participation Agreement used in the Sixteenth Judicial Circuit, FL, which includes an agreement not to agree not to engage in any romantic or sexual relationships with active program participants. Kathy Waters (Response to February, 2006 inquiry) State Drug Court Coordinator Administrative Office of the Courts Phoenix, AZ RESPONSES ARIZONA Most standard conditions of probation disallow association with other known criminals and felons during supervision. If there are preexisting relationships, those should be evaluated. As the research shows, associations are a key indicator of risk of re-offending. I would suggest this be disallowed and socializing should only occur in the context of group discussions about the program and perhaps support groups in aftercare. Jo-Ella J. Brooks (Response to February, 2006 inquiry) Family Treatment Court Coordinator D.C. Superior Court Washington, DC Richard L Davis (Response to February, 2006 inquiry) Substance Abuse Specialist Office of Clinical Practice D.C Child and Family Services Agency Washington, DC DISTRICT OF COLUMBIA In dealing with the gentleman who is wooing several women in the court, first is he participating in the program? Or what is his role? If he is in treatment, I would first say the women and men need desperately to be treated separately. This way the focus is exactly where it should be in terms of distractions. Limit their ability to be in the same environment while in treatment except for monitored outings where staff persons can monitor their contact. Now, if he is in treatment and it is a coed facility, the focus of treatment should be on modifying maladaptive behaviors which contribute to continued substance abuse. Relationships or building appropriate, positive relationships are always a struggle and during addiction inappropriate relationships/behavior frequently occur. So to come into treatment for a short while and begin to exhibit predator behavior on vulnerable women is just to me an indicator which says this individual is not dealing with his own issues, and has possibly discovered something about himself which is making him uncomfortable and instead of talking about it, he is dealing with those feeling by utilizing sexual prowess. When men are uncomfortable about some feelings or have self-esteem issues, they convert to what is comfortable or what they perceive as a salve for the ego, which is either something physical or extremely intellectual. With the addicted person, the fears, the insecurities, and low selfesteem, the abuses suffered, and the loss of control of one s life are the things that make men look to sex in order to handle these feelings that have suddenly found their way to the front of their mind. No longer do they have the access to drugs to deal with these issues, so how can they prove to themselves they are

4 okay? Sex, it becomes a mind game of challenging oneself to gain control through manipulation of another. In treatment if this behavior is exhibited, the parties should be discharged because treatment is not a social club, it is a place where individuals of all types and backgrounds want and need healing. In order for that to happen one must be allowed the chance to figure out their issues and obtain information on how to heal. Relationships with women in treatment do not allow the women to grow where they learn to say no to things that are not helpful or healing. They are attempting to learn that all attention isn't good attention, they are dealing with predators from the past which contributed to their sickness in the first place. They are also attempting to learn validation through who they are as people as opposed to being what someone else wants or attempts to force them to be. Most of their relationships during addiction have been harmful, but they didn't all start that way. Over time they were manipulated into certain things. They really don't know how to say no. They are still figuring out how to meet their needs without harming themselves mentally and physically in the long run. A relationship in treatment causes them not to deal with their issues but become concerned with someone else once again. Their cycle continues and the destruction gets worse and the children who have suffered thus far suffer even more and become bitter in the process. This is not what healing is. This is not what treatment is for. When this behavior is discovered both parties should be referred out to separate facilities. If someone displays these things they have shown a disregard for the healing process, an uncertainty to real change, a disrespect for program rules, disregard for structure, and an ongoing desire to continue to manipulate others to remain in a negative contract, reinforcing negative behaviors and infringing on the right to sobriety of others. AA and NA recommend staying out of an emotional relationship 1 to 2 years until a certain amount of internal work and growth is achieved. If clients are allowed out of the facility on weekend passes there is no way to restrict them from outside relationships, but they should not be allowed to date each other. Sanctions can come in the form of the facility regulations or whatever the court deems sufficient. (Clean up details, pass revocations, 2000 word essays to be presented to the facility, encounter groups (appropriate-dealing only with this particular behavior), treatment extensions, jury box assignments, volunteer service hours, discharges, and apology letters --giving the real meaning of what this relationship was all about. This is just a sample of what could be done. Jennifer Grandal (Response to February, 2006 inquiry) State Drug Court Coordinator Administrative Office of the Courts Tallahassee, FL Joseph Stelma (Response to February, 2006 inquiry) Drug Court Coordinator Duval County Drug Court Jacksonville, FL FLORIDA We split treatment times and court appearances. We tell each up front that if they are not living together at the beginning they cannot. The judge encourages each to do this program for themselves and no one else. Strong sponsors also help to encourage separation in addiction. Diane Fineout (Response to February, 2006 inquiry) Drug Court Director Citrus County Drug Courts Inverness, FL

5 We have a policy that drug court participants cannot reside with nor have intimate relationships with other drug court participants. People trade off their addictions to drugs for addictions to other behaviors. It is a treatment issue. We have actually had a married couple in the program and that was difficult to watch. He had to live with his mother. If they work on the relationship, what are they NOT working on? Kathleen Lonergan (Response to February, 2006 inquiry) Coordinator Hernando County Drug Courts Brooksville, FL Our Drug Court rule is "While in the Drug Court Program, cohabitation or intimate relationships with other Drug Court Participants will not be allowed." We ran into a problem with two women sharing expenses by living together when the one woman was evicted from her residence. Although it solved a temporary problem, the relationship between the women deteriorated. Our treatment provider had been opposed to permitting them to live together initially for the very reason that both their recoveries were then jeopardized. We would not permit such a situation again. While in treatment, if the provider discovers participants are developing relationships, she speaks with them individually and reminds them of the rules. We have not had the situation of sanctioning participants who violate the rule. We only have one treatment provider who conducts treatment sessions for all our participants. It would seem to me if the participants had separate treatment providers or counselors that would help. Our treatment provider does not believe it is good for participants to be involved in intimate relationships while they are in early recovery. Some are replacing one addiction for another! Jim Santangelo (Response to February, 2006 inquiry) Coordinator Alachua County Adult Drug Court Gainesville, FL We do not have a policy re: fraternization as a component of the court. The treatment providers have their own protocols regarding relationships and how they can impact treatment outcomes, but from a legal standpoint, we do not feel the drug court program had the authority to tell people who they can and cannot see. Jim Hornsby (Response to February, 2006 inquiry) Manager Polk County Drug Courts Bartow, FL Between clients it is dangerous and unpreventable. If the relationship hinders a client then we put them on different appointments and groups. They are not to date each other or be related in the same group sessions. Jane Isherwood (Response to February, 2006 inquiry) Criminal Court Services Coordinator Monroe County Pre-Trial Services

6 Key West, FL We have the clients sign a participation agreement prior to placement. (See Appendix A: Sixteenth Judicial Circuit, FL Drug Court Treatment Program Agreement of Participation) Occasionally, when love has blossomed, we have asked one member to withdraw from the program, just to try to dissuade them, but we try to work with them. Keep in mind, with our Dependency Court; we have partners coming in together which is permitted. If this guy is just overtly preying on others, I might be inclined to ask him to leave the program. Gary Hilko/Dwight Stevens (Response to February, 2006 inquiry) Drug Court Coordinator/Clinician Broward County Adult Drug Court Ft. Lauderdale, FL Most treatment centers do not allow for relationships between clients. However, we do not address this in our program because we are too large and also: what are you going to do about it? If we find this out, we will separate the two clients and put them on separate caseloads. If there is a pattern with one client dating multiple people, I think this should be dealt with in one-on-one counseling because there may be some other underlining issues. I do not think it is appropriate to kick a client out of treatment because he/she is in a relationship with another client. Then the client is not getting any treatment and you cannot deal with any issues. A final disposition could be a referral to another treatment center if the client continues to defocus in treatment. Jane Martin (Response to February, 2006 inquiry) State Drug Court Coordinator Administrative Office of the Courts Atlanta, GA GEORGIA I think that we all struggle with the issue of participant fraternization. We have a line about it in our contract, and our policy is that "sexual relationships" (purposely broad) between participants will result in discharge, but it remains problematic to police and enforce. We sanction inappropriate, prurient, or predatory behavior with community service work and treatment sanctions with also a strong open-court rebuke from our judge. I do think that the more we emphasize boundaries and non-sexualized relationships in recovery, the better off the participants are. It has to be something that we take on regularly at treatment and from the bench. Language from our contract: 21. I agree that I will not become involved in any sexual relationships with any other participant of the DeKalb County Drug Court program. I understand that if I should violate this provision of the contract, I will be discharged from the program. I also agree that I will not become involved in any inappropriate relationships with any other participant of the DeKalb County Drug Court program. I understand that if I should violate this provision of the contract, I am subject to being sanctioned and/or discharged from the program. Mike Giglio (Response to February, 2006 inquiry) Coordinator Pataula District Drug Court

7 Cuthbert, GA We strongly discourage fraternization among participants. If it causes problems it is addressed by the Drug Court Team and the Judge addresses the problem in Drug Court with recommendations/orders. If the participant does not follow the instruction of the Judge, then there are consequences. We use lots to therapies but we find behavior modification works for our Drug Court. Jackie Roberts (Response to January, 2015 inquiry) Coordinator Mountain Judicial Accountability Court Clarkesville, GA We do not allow fraternization outside of drug court activities. We are a small rural town where everyone knows everyone. Our surveillance officers go to their homes on a regular bases and they have told on themselves, by their behavior and body language. We have it in our contract: I understand that I am not to have any contact with another Mountain Judicial Accountability Court participant outside of Accountability Court activities (unless legally married prior to entering program or working at the same workplace). I am not to provide transportation to any other participant unless given prior permission by the Accountability Court Coordinator. Intimate relationships are not permitted between participants and/or between participants and staff members. We have soft ball games and cook outs in the summer to allow them to interact in a controlled environment, even hosted movie night (family members invited). Jackie Roberts (Response to January, 2015 inquiry) Coordinator Mountain Judicial Accountability Court Clarkesville, GA We are not going to be able to stop contact. Participants attend community support groups (AA, NA etc.), work at the same place, shop at the same stores, and attend the same treatment groups. What we enforce is hanging out together when they first start the program. They need to focus on their recovery, as they progress through the program it is obvious in their behavior and interaction with each other and what phase they are in as to restrictive the interaction needs to be. We have had this problem in our court between participants, it started out as riding together to groups and ended up with using together (needles). They are allowed to start riding together (gender based only) toward the end of their program and with people that have not recently relapsed. Our program requires a give back project in the last phase. Several pending graduates got together and did a presentation at the local high schools on substance abuse. This was very good for them and strengthened not only their recovery but they supported each other. This was supervised by the coordinator and the feedback from the community was amazing. If they start a relationship early in recovery they are not focused on their recovery. They are substituting one addiction for another, looking for that feel good feeling. Unfortunately there is no great answer, just keep enforcing the rules and encouraging them to focus on their recovery first.

8 Janice Bennett (Response to February, 2006 inquiry) Administrator Hawaii Drug Court Program Honolulu, HI HAWAII As usual, programs have such challenging questions. Our program is not large enough to support single gendered groups. Our services are co-ed with the exception of a special women's track for five sessions. Our take is that both men and women have to deal with each other and the attraction to intimate relationships, whether they are same-sex relationships or heterosexual. We prefer to deal with the issues openly rather than separate the clients. We discourage clients from forming intimate relationships early in treatment, and demonstrate some of the problems they have to look forward to by showing 28 Days, the movie, to open the discussion. The clients love the movie and will often ask for plants and ask if their houses will allow pets --mostly in jest, but at least we know they got the point of the movie. We do have couples that "hook up" but mostly because they knew each other on the streets and then got reacquainted in the program. They often get pregnant despite education on how not to. In these cases, they are responsible for finding suitable housing, required to take parenting classes, and monitored to prevent "dumping" the baby on family members so they can continue to go out and party. We have few clients who "troll" for dates and have relationships with more than one client in the program. Once the groups get stronger, clients often "out" them and then the other women or men, depending on the case, will tend not to date them anymore. As long as the "secret" is kept, they can continue to sleep with several people at the same time. We have had sexually transmitted infections passed around because one person had it and slept with more than one client at a time. It only takes one person to feel supported enough to bring it up in group and the relationships stop. KANSAS Libertee D. Thompson (Response to January, 2015 inquiry) ISO II / Reno County Drug Court Coordinator Reno County Community Corrections If participants are helping each other get to recovery related activities we allow that to happen, and we encourage them to have supportive recovery based relationships with each other but we do take care to talk to them individually about being in a relationship and how it will affect their sobriety and focus. There is an unspoken no dating rule in drug court. So far, we haven t had to put any policies in place. We do have a problem however, with clients who leave for residential and come back in a relationship and/or pregnant but none have been between two drug court participants. Mary Bombich (Response to February, 2006 inquiry) Drug Court Coordinator Kalamazoo County Circuit Court Kalamazoo, MI MICHIGAN In the Kalamazoo County Drug Treatment Court, we actually encourage participants to learn how to work together in their recovery. They have shared rides and some have even done some childcare to support

9 client participation. However, the judge has ordered some participants to not have contact with other people who are convicted felons. This is often the case where the participant is struggling with recovery because his or her significant other is not in recovery. About 40% of our population are 'diverted' clients who are not on probation and are governed in the program through a bond condition. The probationers have rules that prohibit fraternization with other convicted felons; however, their agents do not violate them if they are in the company of other recovering Drug Treatment Court participants. In your particular case we would probably call the participant before the judge and order no contact with the opposite sex who is also enrolled in the DTC citing that it was interfering with their recovery. He should not be out wooing anybody, if he is spending his time with this type of behavior; he is not focused on his recovery. MONTANA Mona L. Sumner (Response to January, 2015 inquiry) Principal Addictions Consulting Group, LLC Billings, MT It seems to me that socialization cuts both ways. On one hand, you want folks to be peer supports for each other and to that end, we encourage them to go to coffee together, to meetings etc. We DISCOURAGE and confront any socialization that involves fraternization or male/female hookups. Keeping the issue out in the open and talking about it openly [judge included] is a good way to keep some track of it--others will let us know if it is inappropriate. I would not favor a policy because that eliminates the positive aspects of socialization. Valerie Moore (Response to February, 2006 inquiry) Director InAct Multnomah County Drug Court Portland, OR Deevon Ervin (Response to February, 2006 inquiry) Clinical Supervisor Multnomah County Drug Court Portland, OR OREGON We don't have a formal policy on fraternization between clients. We have had instances where clients have dated or become friends while in treatment. We don't encourage but we don't restrict it either. For some clients, the friends they make here may be the only "clean" persons in their life. We do however discuss with them the challenges of relationships in a small community and the distractions a relationship can bring to their own recovery process. We work to separate the clients into separate groups and different UA numbers as needed. I don't like the idea of sanctions or restrictions for this behavior. I think we can work with those being "wooed" to set limits as appropriate and work with the "pursuer" to honor other people s boundaries. Kim DeBeer (Response to February, 2006 inquiry) Rutland County Drug Court Coordinator Rutland, VT VERMONT

10 We do not have a written policy prohibiting fraternization although it is strongly discouraged. Fraternization or any sexual relationship is discouraged as it shifts the focus from recovery to one s social life. Issues of this nature are treated primarily as recovery or clinical issues. Upon becoming aware of a relationship, our case manager strongly encourages the participant to bring it to their group and recovery support. A typical recommendation from the case manager would be to increase AA/NA requirements as this community would clearly communicate the dangers of fraternization. She would likely require the participant to write a paper addressing his focus outside of recovery to help in his awareness of his behavior. In the case of a gentleman wooing several woman participants, the case manager communicates that her concern would be on the participant s attempt to replace his drug addictive behavior with sexual addictive or obsessive behavior and treat it as a clinical issue making referral for increased treatment. Jennifer Soper-Baker (Response to July, 2014 inquiry) Drug Court Manager Lewis County Superior Court Chehalis, WA WASHINGTON In Lewis County we have had considerable issues with this issue. We have a small recovery community, one treatment provider and a very intensive and tight program. All of this leads to romance within the program. Coupled with the emotional vulnerabilities and susceptibility to strong and intense attachments early in recovery and we are looking at A LOT of relationships. Our current policy - NO SEX between phase I participants with any other drug court participants. Ethical code of conduct of not messing with someone with less than 60 days clean. All other relationships between participants are allowed but must be disclosed. This has been a huge improvement over our former policy of no sex at all- that just promoted lots of lying to staff- NEVER GOOD. Adam Pithan (Response to July, 2014 inquiry) Drug Court Programs Manager Cowlitz County Superior Court Drug Court Longview, WA We do not have a policy regarding this, however, our counselors do promote that they should remain relationship free for the first year of their sobriety, but they do not usually abide by that. If two of our clients start dating we do not usually take action to prevent it or break them up, but we will not allow them to stay in the same treatment group. Usually that will mean one of the clients has to transfer to the other treatment facility. Sandra J Altshuler (Response to July, 2014 inquiry) Coordinator Spokane County Behavioral Health Adult Felony Therapeutic Drug Court Spokane, WA We do have a policy, but it is not focused on having a relationship as it is focused on harming another participant s treatment and recovery. We include it as one (of the many) possible reasons for

11 termination. As we explain every time, no one is ever terminated for having a relationship. But, having a relationship, especially in their first year of sobriety, becomes one of many behaviors that undermine their recovery. In other words, we do not have anyone (other than those who were partnered BEFORE they entered the drug court program, which we do allow) who has been able to maintain a new relationship with another drug court participant and be successful. To consider termination, the judge and BHTDC team may review factors including, but not limited to: Engaging in a relationship with, or otherwise unduly influencing, another Drug Court participant. So, we encourage honesty for sure, AND we encourage avoiding relationships with other participants while they are in the program. Ahney King (Response to July, 2014 inquiry) Court Coordinator Whatcom County Adult Drug Court Bellingham, WA Whatcom County does not have a policy however it is discouraged. Further we like many others encourage our participants to wait a year before getting in any relationship. ************************ We welcome any additional information and/or perspective readers may have on this topic. Bureau of Justice Assistance (BJA) Drug Court Clearinghouse Justice Programs Office, School of Public Affairs American University 4400 Massachusetts Avenue NW, Brandywine, Suite 100 Washington D.C Tel: 202/ Fax: 202/ Web:

12 APPENDIX (A) Sixteenth Judicial Circuit, FL Drug Court Treatment Program Agreement of Participation

13 SIXTEENTH JUDICIAL CIRCUIT DRUG COURT TREATMENT PROGRAM DRUG COURT TREATMENT PROGRAM AGREEMENT OF PARTICIPATION I,, having been released under the supervision of the 16 th Judicial Circuit Drug Court Treatment Program, hereby agree to follow the program conditions as listed below: 1. I will attend monthly Drug Court, participate in my recommended treatment plan, which will include individual counseling, group counseling, and 12-Step attendance. 2. I will not possess, of use, illicit drugs or alcohol, and agree to submit to frequent and random testing of my urine for the presence of alcohol and other drugs. 3. I will not violate laws and I understand that any violation or arrest must be reported to the Drug Court staff within 12 hours. 4. I will follow through on referral(s) recommended by the Substance Abuse Counselor, including the admission to detox or residential treatment if my alcohol or other illicit drug use continues. 5. I understand Drug Court treatment is confidential and I will not discuss or disclose participant information. I understand the Drug Court staff will make reports to the Judge concerning my progress in treatment and that the counselor / patient privileges shall not apply. I agree to release information and permit communication with outside agencies to assist in fulfilling the requirements of the Drug Court Program. 6. I agree to seek medical attention when appropriate. Any prescribed drugs will be reported to the Drug Court staff. 7. I understand for purposes of study or review of this program, confidential information may be disclosed to third parties, but that under no circumstances will this statistical data include my name, address or other personal identifying information. 8. I understand verbal of physical threats of abuse will not be tolerated. I agree not to engage in any romantic or sexual relationships with active program participants. 9. I agree to pay on a sliding scale, cost of supervision, on a monthly basis, for the duration of the program. 10. I understand that I may voluntarily petition the Court for termination from this program. If I fail to comply with the above Agreement of Participation, it will be deemed as a violation for which I may be taken into custody pending a Hearing to Show Cause. If a determination of Contempt is made, termination from the program and a financial bond may be imposed. Participant: SS#: Date: DOB: Witnessed by: Date:

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