Syracuse Community Treatment Court Policy and Procedures Manual

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1 Policy and Procedures Manual Public Safety Building 511 South State Street Room 117 Syracuse, New York (fax) Page 1 of 17

2 Table of Contents Overview... 3 A. Eligibility Standards... 4 B. Substance Abuse/Mental Health Standards... 4 C. Operational Standards Case Processing/Enrollment Felony Referral Probation Violation Referral Justice Court Referral D. Courtroom Procedures E. Program Standards F. Data Collection and Program Evaluation G. Treatment Standards Appendices Sample SCTC Contract A Page 2 of 17

3 Overview The (SCTC) was established in January 1997 following more than a year of the planning and preparation. The SCTC is part of a nation-wide effort to integrate criminal justice system processing and substance abuse treatment. Its purpose is to reduce criminal involvement and promote abstinence among drug using criminal offenders. The Drug Court Movement has been supported and disseminated by the U.S. Department of Justice through its Office of Drug Court Programs. In 1995, Syracuse City Court received a planning grant from this office to plan and develop the court; this was followed by an implementation grant that was receive by the SCTC in January The mission of the SCTC is to improve the processing of drug cases through the expeditious entry of eligible defendants into judicially monitored drug treatment. A dedicated, coordinated program with direct judicial management serves as the center of a comprehensive criminal justice service continuum for substance abusing defendants. The SCTC is intended to improve the outcomes for drug dependant offenders, reduce criminality, improve the allocation of scarce criminal justice resources and promote public safety. Page 3 of 17

4 A. Eligibility Standards 1. Eligibility for participation in the is limited to individuals who: a. are charged with a non violent instant misdemeanor or felony offense b. have no prior conviction for a violent felony; c. live in Onondaga County; and c. are found to have a substance abuse problem. Eligibility standards are verified by a review of police reports, rap sheets and a standardization instrument, that confirms chemical dependency. 2. The SCTC Project Director, Resource Coordinator and case managers conduct the preliminary screening for eligibility. Enrollment in the SCTC requires the consent of the defendant, defense counsel, district attorney and the judge. 3. Eligible offenses include both drug and non-drug, non violent felony and misdemeanor offenses. 4. Stages of intervention a. The SCTC operates as a pre-adjudication and post adjudication court. b. In order to participate, pre plea defendants must agree to a waiver of speedy trial with the understanding that failure to successfully complete the SCTC program will result in the return of cases to the regular criminal court docket. c. Admissions or findings of continued drug use as evidenced by positive urinalysis are not used to file new criminal charges. B. Substance Abuse/Mental Health Suitability Standards 1. Assessment Procedures and Processes a. All defendants that are prospectively eligible for SCTC participation based upon instant offense and criminal history must undergo a substance abuse screening and complete psycho social evaluation conducted by a credentialed SCTC case manager. The evaluation will rely on a standardized instrument administered through a face to face interview by a credentialed professional. b. Assessments are conducted within 72 hours, often times sooner, of eligibility determination. Assessments are conducted in the jail or at the Syracuse Community Treatment Court office located in the Public Safety Building. c. The assessment is used to determine treatment modality and specific treatment program. To the extent possible, treatment referrals take into account specific participant needs which may include but are not limited to 1. Mental health issues 2. Pregnancy Page 4 of 17

5 3. Developmental disabilities 4. Medical conditions, including HIV and physical disabilities d. To the extent possible, the assessment is conducted in an environment and in a manner conducive to gaining client trust and support. e. Prior to starting the assessment, the limits of confidentiality are explained and a consent to release confidential information is executed. f. To the extent possible, (self report) information gained during the assessment is verified by information from collateral sources, and a review of past treatment records. 2. Core Assessment Elements a. signs of acute drug/alcohol use including signs of withdrawal b. self report of use: age at first use, drug of choice, pattern of use, negative consequences including changes in family, employment, health. c. family history of use d. prior treatment experience 3. Special Concerns a. Women s Issues: physical and sexual abuse (current, past): pregnancy: parenting and childcare; relationships. b. Medical Issues including HIV c. Mental Health d. Age (adolescence) 4. Gender-specific needs of women a. assessment takes into account gender specific needs documented by research. Assessment of women is an ongoing process that is attentive to issues of physical and sexual abuse that have been associated with addiction in women. b. Assessment and treatment planning for women also addresses family issues, especially those related to children. Assessment, treatment planning and treatment should make every effort to consider child care responsibilities and concerns. These issues will be addressed by referring women to programs that will best accommodate these issues. c. Housing needs are of particular concern to women who may be dependant upon a male partner for support. Related issues are physical safety and domestic violence. d. The assessment of women should take into account the prevalence of mental health problems, notably depression, among female addicts. The assessment should include gender specific questions regarding medication for anxiety and/or depression and women who express symptoms of these conditions should be referred to a medical doctor for further evaluation. e. Assessment should include inquiries regarding pregnancy and prenatal care. Case managers are responsible for ensuring that pregnant women are linked with prenatal care and that obstetrical appointments are kept. 5. Mental Health Problems a. the SCTC strives to include persons with mental health problems; determination of ability to participate in the program is based on the degree to which the condition is able to be managed through medication and/or therapy. Absent major illness, the SCTC will make every effort to include persons with coexisting mental health and Page 5 of 17

6 substance abuse problems. SCTC staff will refer participants to treatment program that can provide services to such individuals as well as ancillary mental health care. b. Preliminary identification of mental health problems is identified through the substance abuse evaluation that queries clients on mental health problems, medications and prior treatment records. c. Indicators of mental health problems that are beyond the capacity of the SCTC include acute symptoms (hallucination, delusion), suicidal thought and behavior. Lack of stabilization on psycho-tropic medication. d. When needed for determination of eligibility, the perspective participant will be referred for further evaluation by a mental health specialist e. Case managers consider mental health issues in making referrals and refer participant to programs that permit the client to remain on prescribed medication. They also identify 12 step programs that are known to be more tolerant and accepting of prescribed medication. 6. HIV and AIDS Prevention a. The assessment should include information about risk factors for HIV and AIDS. b. Where the client indicates a positive status, referral should be made to medical care and HIV related services. c. Clients should be informed of anonymous and confidential HIV counseling and testing options and be encouraged to be tested. C. Operational Standards 1. Case Processing/Enrollment Drug Offense Calendar - Misdemeanor Cases The DOC - Drug Offense Calendar is held each Friday at 9:30 AM in Syracuse City Court. This calendar is presided over by the SCTC judge and is designed to screen all new cases coming to Treatment Court (SCTC). The following is a list of charges that when arraigned are sent directly to the DOC. The DOC is not optional for defendants, anyone arraigned on the following charges will be sent to the DOC even if they have cases with other judges Criminal Possession of a Controlled Substance Criminal Possession of a Hypodermic Instrument Criminal Drug Para-phanelia Criminal Possession Marijuana Criminal Possession Marijuana Prostitution The DOC procedure is as follows: a) Prior to arraignment, cases will be reviewed and flagged for DOC eligibility by the Treatment Court staff. A fluorescent green sticker will be placed on the docket card alerting the judge/clerk that this case should be scheduled for the next DOC date after arraignment. b) Upon completion of the arraignment, files will be forwarded to the Treatment Court office. A criminal history search will be completed. This information will then be available to the judge and district attorney for the subsequent DOC calendar. If, however, the Page 6 of 17

7 defendant remains incarcerated after arraignment, the case manager will screen the defendant in the jail prior to the next appearance date. c) Cases determined to be eligible after they appear on the DOC will be moved to the Treatment Court calendar. Ineligible cases will be handled as usual. d) Once accepted in the SCTC, a complete psycho social assessment will be conducted and a SCTC contract will be executed. It should be noted that this procedure is not limited to the charges listed above. Judges may use the screening process for any case they consider drug driven where substance abuse may be contributing factor to the offense. For example, petit larceny or possession of stolen property, among others. The referral can be made at any time a Judge perceives a need for treatment. It should be emphasized that Treatment Court will be the sole vehicle for drug rehabilitation in Syracuse City Court. Bench Warrant Returns: If a defendant is returned on a warrant that was issued from the DOC calendar they are detained and scheduled on next the DOC calendar. If a defendant is returned on a warrant that was issued from the SCTC calendar they are detained and scheduled on the next SCTC calendar. 2. Felony Referrals: Criminal defendants charged with a non violent felony offense, most often a felony drug or drug driven offense, can be referred for an eligibility determination to the SCTC by the Judge, Defense Attorney, or District Attorneys office. In order to be eligible to participate in the SCTC, the defendant must have a discernable drug addiction and have not been convicted of a violent felony offense. They must also have a local address (Onondaga County). The Treatment Court office should be notified by the Court Clerk or defense attorney of any requests for eligibility determination. The Clerk should notify Kim Kozlowski, SCTC Project Director The Treatment Court staff will review the case for eligibility and notify the Judge in writing of the defendants eligibility status within 72 hours or sooner of receiving the referral. It is the decision of the Judge whether to allow the defendant the opportunity to participate in the SCTC. If the Judge wishes to provide the defendant the opportunity to participate in SCTC and the District Attorney agrees the Judge will take an agreed upon plea to the charge. The Judge will also advise the defendant that the case will be transferred to the Drug Court Judge (sitting as a County Court Judge) who will sentence the defendant upon completion or failure in Treatment Court. The defendant will be required to agree to those conditions. A request for an administrative order to transfer the case to the SCTC will be submitted by the Judge, through his court clerk to the Administrative Judge. The Administrative Judge will sign the order transferring the case to the SCTC. The Onondaga County Court Clerk s Office will send a copy of the order and the case file to Kim Kozlowski for Treatment Court calendaring. Page 7 of 17

8 Upon transfer an in depth psyco-social assessment of the defendant will be conducted and a Treatment Court contract will be signed. If the defendant fails to complete the Syracuse Community Treatment Court the defendant will be sentenced under the original charge by the SCTC Judge. Successful completion of the SCTC will result in a favorable re-sentencing of the defendant or the withdrawal of the defendants guilty plea and dismissal of the charge as outlined in the defendants Treatment Court contract. 3. Probation Violation Referrals: Probation Violation cases will be accepted into the SCTC when the primary or underlying reason for the violation is the need for substance abuse treatment. This can be based on the probationer s continued use, lack of attendance at treatment or refusal to obtain an evaluation and attend treatment. This also could include an arrest on a new charge relating to substance use. Probation violators must have a discernable drug addiction and have not been convicted of a violent felony offense in order to be eligible to participate in the SCTC. Probation violators can be referred for eligibility determination to the SCTC by the Judge, Defense Attorney, Probation Officer or the District Attorneys office. Generally, it will be the Probation Department that will highlight the Violation of Probation as being a case that would be appropriate for the SCTC. The Treatment Court office should be notified by the Court Clerk of any request for an eligibility determination to the SCTC. The Clerk should notify Kim Kozlowski, SCTC Project Director at The Treatment Court staff will review the case for eligibility and notify the Judge in writing of the defendants eligibility status within 72 hours or sooner of receiving the referral. It is the decision of the Judge whether to allow the defendant the opportunity to participate in the SCTC. If the Judge agrees to provide the defendant the opportunity to participate in SCTC and the defendant agrees the Judge will take an admission to the Violation of Probation and advise the defendant that they will remain on probation while participating in Treatment Court. The Judge will also advise the defendant that the case will be transferred to the Drug Court Judge (sitting as a County Court Judge) who will sentence the defendant upon completion or failure in Treatment Court. The defendant will be required to agree to those conditions. A request for an administrative order to transfer the case to the SCTC will be submitted by the Judge, through his clerk to the Administrative Judge. The Administrative Judge will sign the order transferring the case to the SCTC. The Onondaga County Court Clerk s Office will send a copy of the order and the case file to Kim Kozlowski for Treatment Court calendaring. Upon transfer a psyco-social assessment of the defendant will be completed and a Treatment Court contract will be signed. Once a SCTC contract is signed the Department of Probation will re-assign the case to one of two Probation Officers assigned to the court for case management and community supervision. If a defendant fails to complete the the defendants probation will be revoked a sentence imposed on the original charge by the SCTC Judge. Successful completion of the SCTC will result in a favorable re-sentence as outlined in the defendants Treatment Court contract. Page 8 of 17

9 4. Justice Court Referrals In January 2007 the was designated to receive appropriate criminal actions removed thereto from Onondaga County Town and Village courts pursuant to such (4). This allows for the transfer of misdemeanor cases in the Justice Courts to be transferred to the Treatment Court for supervision and disposition. Misdemeanor cases which meet the basic eligibility criteria for participation in drug court (see eligibility standards page 3) should be referred to the drug Treatment Court office for initial chemical dependency screening. After evaluation the Project Director will contact the defense attorney, district attorney and Justice Court to report the findings. If all parties agree that Treatment Court is an appropriate referral the Treatment Court staff will initiate the process for removing the case from the Justice Court to the Treatment Court as outlined in the procedure below. Referral Procedure: 1. Upon motion of the Defense Attorney and with the consent of the District Attorney, the Town/Village Justice will sign an Order of Removal from the City/Town/Village Court. 2. The Order of Removal will be delivered, along with the defendant s case file to the, 511 South State Street Room 117, Syracuse, New York FAX The Court Clerk will prepare an Order of Rejection or Approval by the Syracuse Community Court and submit to Drug Treatment Court Judge, Hon. Jeffrey R. Merrill for signature. 4. Once the case is received the Order of Acceptance and notice of the next Drug Court appearance will be sent to: a. City/Town/Village Justice b. Defendant c. Defense Attorney d. District Attorney 5. The defendant and his/her Defense Attorney will appear in Drug Court on the next scheduled date assigned by the Clerk of the Court. 6. The originating Town/Village Justice will divest all jurisdiction of the case upon transfer. SCTC Contracts: The SCTC contract is signed by the defendant, defense attorney, district attorney and judge at the participants initial appearance on the SCTC calendar. This constitutes formal enrollment into the program. Formal enrollment generally occurs within one to two weeks of referral to the SCTC calendar. The basic contract requirements include: - compliance with directives of the clinical and SCTC case manager regarding treatment and participation in other rehabilitative activities such as education or job training; Page 9 of 17

10 - appearance required at all SCTC hearings - acceptance and fulfillment of any sanctions imposed by the SCTC judge - obeying all laws; and - compliance with other mandates of the SCTC including community service. A sample contract is attached as Appendix C. 5. Status Hearings and Requirements a. Newly enrolled participants are required to attend SCTC orientation and treatment readiness programs as directed by their assigned case manager. This participation constitutes Phase I of the program. b. Participants report to the SCTC as ordered by the judge as guided by the SCTC Phase Schedule. Initial phases require weekly appearances. Appearances are attenuated or increased dependent upon participant progress. c. Progress reports on the participant are heard in regular SCTC sessions. SCTC sessions include appearances by all participants including those under SCTC jail based sanction, new admissions and those appearing for progress report. Those in custody generally appear first. 6. Phases, Sanctions and Incentives a. The SCTC proceeds through four phases: Phase 1, Orientation; Phase II, Stabilization, Phase III, Decision Making and Phase IV Community Transition. Each phase has requirements and benchmarks. b. In keeping with the drug court model, the SCTC uses incentives and sanctions to reward, encourage, motivate and admonish participants. Incentives include, but are not limited to, praise from the judge, applause from the participants and others in SCTC, reduced court reporting, transition to the next phase, tokens of appreciation, graduation and dismissal of charges. Sanctions include admonishment from the bench, increased court reporting, increased urinalysis, work program, jail and termination from the court. c. Sanctions are imposed commensurate with the level of the infraction and are explained to all participants verbally and in writing during a review of the participant handbook at the time of orientation. 7. Management a. The SCTC is a special part of the Syracuse City Court; the Supervising Judge of Syracuse City Court is the lead agent in the operation of the court. b. Day to day operations of the court are the responsibility of the SCTC Project Director and staff. Operational duties include but are not limited to, case screening, verification of eligibility, oversight of the MIS, staff supervision, scheduling, liaison with defense attorneys and the District Attorneys office and treatment providers. These duties are shared with the resource Coordinator and the SCTC case management staff. D. Courtroom Procedures 1. Courtroom Roles a. Representatives from the Onondaga County District Attorneys office and the Page 10 of 17

11 Assigned Counsel Program are present at the SCTC session when the defendant is formally enrolled in the SCTC. These representatives also appear at status hearings: the appearance of the individual assigned counsel is optional unless the individual is facing termination from the court. b. SCTC staff are also present in the courtroom. c. Representatives from treatment programs formally affiliated with the SCTC are also present at SCTC sessions as well as other community partners. 2. Courtroom Procedures a. Prior to formal enrollment of the client, the defense attorney will review the police report, prior criminal history information and other pertinent information. The attorney will discuss legal options, including participation in drug court, legal ramifications of participation, such as waiver of speedy trial rights, with the client. b. Prior to formal enrollment of the client, the Senior District Attorney reviews the case to confirm eligibility including other prosecutorial concerns that would bar the defendant participation. c. Upon determination of eligibility (including instant charge, prior criminal history and documented substance abuse program), the participant, defense attorney, District Attorney and judge all sign the SCTC contract that set forth program requirements and conditions. d. Prior to the SCTC sessions, the SCTC judge conducts a case conference or staffing with the representative of treatment providers and the SCTC staff. e. The SCTC judge individually calls each participant scheduled to appear for a status report and review. Detained or jail sanctioned participants will be called first to accommodate Sheriff transport. The SCTC judge may ask for information from the treatment provider and or SCTC case manager. The SCTC judge may also require the participant to submit a urinalysis. f. Urinalysis is conducted under observation of the case manager using rapid screen tests and alco -sensors. (3 panel). The report is immediately transmitted to the SCTC judge for action as appropriate. g. Commensurate with progress and phase in the program, the participant is scheduled for his or her next SCTC appearance. h. The SCTC judge issues a bench warrant for all participants that fail to appear E. Program Standards 1. Treatment Services a. chemical dependency treatment services are the core services provided by the SCTC. b. CASAC evaluators determine level and modality of treatment based upon the standardized instrument used by the SCTC. c. the kinds of treatment that are available to the SCTC include inpatient, outpatient and residential. (See section G, Treatment Standards) d Treatment providers with whom the SCTC has, through a Request for Participation, established linkages are the preferred provider options. e. Referrals to other treatment providers are made when the SCTC treatment providers do not have appropriate services to meet the needs identified through the evaluation. f. The SCTC refers participants only to programs that are licensed by the New York Page 11 of 17

12 State Office of Alcoholism and Substance Abuse Services. g. Case Managers are responsible for assisting participants in securing Medicaid that may be needed in order to remain in treatment. h. Treatment providers that are formally linked with the SCTC do not discharge a client from treatment without the consent of the SCTC judge. i. Case managers and treatment providers work together to revise the individual treatment plan and develop an effective aftercare plan for participants. j. Sanctions, incentives, movement through phases, termination and graduation are determined by the SCTC judge with input from the SCTC staff and the treatment providers and reflect the integration of treatment and criminal justice systems goals and objectives. 2. Ancillary services a. ancillary services are an essential part of the SCTC and are incorporated into the SCTC program based on the recognition that the effective treatment and relapse prevention must address all areas of life functioning. b. SCTC case managers in conjunction with the treatment providers assist participants in developing a long term client specific plan (CSP) that addresses participant needs strengths and after care elements. The needs addressed include but are not limited to - Housing - Education - employment out job training - mental health and related counseling - medical, health and dental care and other services (including HIV related) - child care and parenting c. Access to these and other ancillary services is done by referring to existing services in the community. Case managers assist participants in scheduling appointment, completing paperwork, compiling documentation and other tasks related to the successful linkage with programs, services and jobs. d. Service linkages are made as appropriate to client needs and stage in program. Emergency needs related to housing, health, mental health and financial support are made as soon as they are identified, regardless of phase in the program. Other linkages are made, again as appropriate, upon completion of Phase I and II. 3. Sanctions a. sanctions are used to hold participants accountable and to bring participants into compliance with the rules and requirements of the court. b. The SCTC recognizes relapse as a part of recovery. As recovery is a long term process, the SCTC anticipates that a significant number of participants may relapse. Sanctions are one means of addressing relapse with the goal of helping the participant regain sobriety. Additionally, relapse may result in a change in the level of treatment. 4. Incentives a. Incentives are used to motivate participant to continue their efforts at recovery and

13 acknowledge achievements and successes. b. The SCTC recognizes that participant progress is incremental in nature and uses incentives to acknowledge small successes and progress. The indicators of participant progress include increasing abstinence as indicated in improvement in urinalysis results, completion of treatment, SCTC phases or other milestones, positive reports from treatment providers, engagement in other positive activities such as jobs, training and education. c. Incentives include verbal praise from the judge, the drug court round of applause, a decrease in court appearances, certificates, recreational opportunities, an SCTC tee shirt, and graduation ceremony and dismissal of criminal charges. 6. Graduation requirements a. Compliance with the directives of the SCTC case manager regarding treatment and participation in other rehabilitative activities such as education or job training b. Appearance at all required SCTC hearings c. Acceptance and fulfillment of any sanction imposed by the SCTC judge d. Obeying all laws e. Compliance with other mandates of the SCTC including community service f. Completion of a graduation survey. g. Documented abstinence 7. Reasons For Termination a. Termination from the SCTC may result from persistent non compliance of sorts over time. New arrests for violent offenses results in an immediate termination from the SCTC. Termination results in restoration of all charges and sentencing or placement back on a pre-trial calendar for prosecution. F. Data Collection and Program Evaluation 1. Management Information System (MIS) a. The SCTC uses the MIS originally developed for the Midtown Community Court and adapted by the Brooklyn Treatment Court, the Center for Court Innovation and the New York State Office of Court Administration. This Universal Treatment Application is required for all New York State drug Courts. b. The MIS maintains data needed to manage the operation of the court, make decisions on treatment needs and monitoring of participant and program evaluation. The data collected include, but are not limited to: client demographics date of enrollment instant offense criminal history drug abuse history treatment history employment status and history financial circumstances education drug test results

14 level and type of treatment compliance scheduled court appearances attendance at court appearances relapse new arrests sanctions imposed and incentives conferred graduation or termination c. Data collection and input is the responsibility of the Program Coordinator and the SCTC staff. 2. Program Evaluation a. Under the implementation grant received from the Office of Drug Court Programs, the SCTC conducted a process evaluation and final report of the SCTC through the use of an consultant with research and evaluation expertise. The evaluator had access to all records, staff, SCTC Advisory Board meetings and court sessions. The evaluator also interviewed a sample of SCTC graduates and professionals associated with the court. b. The process evaluation and final report are used to track progress and make improvements to the program. c. The SCTC also cooperates with the statewide evaluation of drug court through the Office of Court Administration/Special Projects Office and the Center for Court Innovation. G. Treatment Standards 1. Selection of Treatment Provider(s) a. The SCTC refers participants to treatment programs licensed by the New York State Office of Alcoholism and Substance Abuse Services(OASAS). b. Treatment Provider(s) are selected based on a request for participation(rfp) that is used to determine the provider s ability to work in partnership with the court, treatment philosophy, and services offered. Key requirements include: i. A working philosophy that recognizes addiction as a long term chronic condition frequently characterized by relapse; ii. Commitment to work with high risk clients involved in the criminal justice system iii. Commitment to addressing special needs within an environment of culture and gender competence iv. Ability and willingness to conduct drug testing commensurate with court orders v. Willingness to work with SCTC case managers vi. Ability and willingness to provide written and verbal reports to the SCTC regarding client progress. vii. Willingness to provide MIS related information to the SCTC. c. The level and modality of treatment is initially determined by SCTC substance abuse evaluators (credentialed by the State of New York) based upon an evaluation using a standardized assessment instrument.

15 2. Referral to Treatment a. The evaluation is used to determine treatment modality: SCTC case managers refer the participant to the appropriate treatment provider. b. To the extent possible and commensurate with evaluation results, participants are referred to providers that have been selected through the RFP process and are formally affiliated with the SCTC. Participants will be scheduled for intake within one to three days of referral and will be engaged with treatment within one to three days following intake. c. Participants may be referred to providers outside the formal SCTC network as required by their needs (e.g. specialized Dual diagnosis services, long term residential treatment). The SCTC case managers also provide a copy of the evaluation and make arrangements for intake into the program. This may involve the program picking up the participant from jail, the SCTC staff transporting the individual or providing bus fare to ensure that the participant can enter treatment. 3. Levels and Types of Treatment a. The SCTC makes every effort to match participants with the appropriate kind and level of treatment. i. Outpatient treatment typically less than 9 hours per week, with regularly scheduled sessions. ii. Day Treatment generally requires 4 to 5 days a week for 15 to 30 hours per week. iii. Methadone Maintenance is a medically supervised outpatient program that provides counseling and methadone, a narcotic analgesic that substitutes for heroin or other opiates. iv. Inpatient Treatment involves short term residential treatment that generally lasts for 21 to 45 days with follow up in an outpatient program. v. Long Term residential is inpatient treatment that generally lasts from 6 to vi. 18 months. Halfway House/Supportive Living are types of transitional residences that require continued abstinence and incorporate continued treatment through participation in outpatient/and or 12 -step programs. b. Treatment Services Provided i. Detoxification is advised for active drug use may require inpatient care (especially recommended for heroin withdrawal). Outpatient acupuncture has been found to assist persons detoxifying from cocaine. ii. iii. iv. Group Counseling consists of counselor-led groups that involve peers to help clients address personal issues and consequences of drug use. Individual Counseling may be used in addition to or in lieu of group counseling. Individual Counseling is especially appropriate for clients who are withdrawn and socially uncomfortable in groups. It is also useful to provide an opportunity for clients to discuss very personal issues that they may not be ready to disclose in group. Urinalysis is the means to verify abstinence. The SCTC requires a minimum of two drug screens per participant per week during Phase I and II of the program. Treatment providers are expected to test SCTC clients enrolled in their program a minimum of twice weekly. The SCTC randomly test participants at their court appearances. Positive drug tests alone are not a basis for discharge from the SCTC but may prompt a change in

16 treatment level and /or SCTC sanction. The results of urinalysis tests taken while the individual is a participant in the SCTC may not be used to file new criminal charges during or following program participation. Missed drug tests(unless approved absence) and adulterated tests are treated as positive results. v. Acupuncture is used to aid in detoxification and to help reduce cravings, especially for cocaine. This form of acupuncture involves insertion of acupuncture needles in five points in each ear. Aricular or ear point acupuncture requires special certification and can provided in OASAS licensed facilities. Aricular acupuncture may be offered in sites that are not OASAS licensed such the court, only when provided by a licensed acupuncturist. vi. Relapse Prevention refers to special groups intended to help participants maintain abstinence by focusing on trigger and warning signs and strategies to prevent a return use. c. 12- Step Programing or Self-Help Group(on or off site) are peer led support groups used during and following primary treatment. Case managers assist clients in identifying 12-step groups that are most appropriate to client preferences including geography, language, gender-preference, culture and ethnicity. 4. Treatment reports to the SCTC a. Federal Law guarantees the confidentiality of information about persons receiving chemical dependency services. These protections cover persons in the criminal justice system as others. SCTC participants are informed of privacy rights by SCTC staff and treatment providers. Protected information is disclosed to the SCTC by treatment agencies in accordance with the provisions of 42CFR, (part 2) that permits such disclosure after the participant has signed a proper consent to release information form. Enrollment in the SCTC requires that the participant is willing to consent to release information. b. Those treatment providers formally affiliated with the SCTC make weekly reports that are submitted to the SCTC Program Coordinator. The reports include a summary of progress to date, attendance and urinalysis results. c. Prior to regularly scheduled SCTC sessions, treatment providers staff and SCTC Case Managers meet with the Judge of the SCTC and Program Coordinator for case conferencing purposes to review any sanctions or incentives that should be applied at the hearing. d. SCTC staff and treatment provider staff attend the weekly SCTC session to respond to questions that may come up during the session. f. Those treatment providers formally affiliated with the SCTC do not discharge clients without prior notification to and approval of the SCTC Judge. g. Treatment providers and/or SCTC case managers immediately notify the SCTC Program Coordinator if the client leaves the program without permission, commits an infraction serious enough to warrant discharge and/or re-arrest. In these cases, the participant is required to appear at the next scheduled SCTC sessions. 5. Discharge from Treatment a. The treatment provider provides the SCTC with a discharge Summary that includes a summary of participant progress and recommended aftercare.

17 b. The Discharge Summary is used by SCTC managers to revise and enhance Stage IV Community Transition activities.

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