COURT OF QUÉBEC IN MONTREAL ADDICTION TREATMENT PROGRAM (CQATP)
Table of Contents 1. Court of Québec Addiction Treatment Program (CQATP)... 4 1.1 Philosophy of the court addiction treatment program... 4 1.2 Mission... 4 1.3 Partners... 4 1.4 Players... 6 1.5 Premises... 8 1.6 Target clientele... 9 2. ELIGIBILITY... 9 2.1 Consent of the DPCP... 9 2.2 Eligibility criteria related to the offender... 10 2.3 Criteria related to the alleged offence... 10 3. LENGTH AND PHASES OF THE PROGRAM... 10 3.1 First treatment phase: Treatment under the responsibility of a therapy centre supervised by the Court of Québec... 11 3.2 Second treatment phase: court supervision of the offender's reintegration... 11 4. CONDITIONS TO BE MET BY OFFENDERS ADMITTED TO THE PROGRAM... 12 5. RANDOM TESTING... 13 6. CONDITIONS TO BE MET BY THERAPY CENTRES... 13 7. CONSEQUENCES OF A RELAPSE OR REPEAT OFFENCE FOR KEEPING THE OFFENDER IN THE PROGRAM... 14 7.1 Relapse... 14 7.2 Recidivism... 14 2
7.3 Sanctions and rewards... 15 7.4 Abandonment... 15 7.5 Grounds for exclusion of the program... 15 8. SUCCESSFUL COMPLETION OF THE PROGRAM... 16 9. FAILING THE PROGRAM... 16 10. DESCRIPTION OF THE STAGES FOLLOWING THE ADMISSION TO THE PROGRAM... 17 11. THE PROGRAM IMPLEMENTATION AND IMPACT STUDY... 21 12. TRAINING... 22 3
1. Court of Québec Addiction Treatment Program (CQATP) 1.1 Philosophy of the court addiction treatment program The court addiction treatment program fits well into Quebec's judicial tradition, which has always attached a great deal of importance to rehabilitation and reintegration of accused. By favouring the imposition of sentences that take into account the treatment of offenders, the criminal justice system targets an important cause of crime while making a durable change for the person to prevent relapse and reduce its harmful effects. It also prevents recidivism with a broad view to public safety. The offender and the other stakeholders are engaged in a non adversarial process that is respectful of the participants the purpose of which is to effectively rehabilitate and reintegrate the offender into the community through court supervision and through imposing a just sentence, which takes into account the success and benefits of the treatment. 1.2 Mission The goal of the program is to reduce the number of offences committed because of drug or alcohol dependence by offering structured treatment to offenders who have drug or alcohol problems. By promoting the rehabilitation of offenders who are dependent on one or more psychoactive substances, the program promotes their reintegration in harmony with other sentencing principles and objectives. The program connects the court with members of treatment centres, public safety and rehabilitation centres in the spirit of cooperation. The goal is to establish an individualized treatment program, to report on accomplishments and to assess the success of treatment during sentencing. 1.3 Partners The program is being developed and will be carried out with the help of the following partners: Cour du Québec (Court of Québec) ; 4
Ministère de l'emploi et de la Solidarité sociale (Ministry of Employment and Social Solidarity) ; Ministère de la Justice du Québec (Quebec Ministry of Justice) ; Ministère de la Santé et des Services sociaux (Ministry of Health and Social Services) ; Ministère de la Sécurité publique du Québec (Quebec Ministry of Public Security) ; Agence de la santé et des services sociaux de Montréal (Montreal Health and Social Agencie) ; Association des avocats de la défense de Montréal (Montreal Criminal Defence Attorneys Association) ; Association des intervenants en toxicomanie du Québec (Quebec Association of Drug Addiction) ; Le Centre communautaire juridique de Montréal (The Community Legal Centre of Montreal) ; Centre Dollard Cormier Institut universitaire sur les dépendances (Centre Dollard Cormier University Institute on Addictions) ; Directeur des poursuites criminelles et pénales (Director of Criminal and Penal Prosecutions) ; Direction des services professionnels correctinnels, Support, Liaison et développement du réseau correctionnel de Montréal (Correctional Services Branch, Support, Liaison and development of the correctional network of Montreal) ; Équipe de recherche du RISQ (Recherche et intervention sur les substances psychoactives (Research team for RISQ (the Quebec group for psychoactive substance research and intervention) ; Bureau d aide juridique en droit criminel et pénal de Montréal (Legal Aid office in Montreal criminal and penal matters). 5
1.4 Players Judges of the Court of Québec A group of three judges of the Court of Québec, who have received specific training on court supervised addiction treatment, will be assigned to courtroom 4.07 of the Montréal Courthouse. The Director of Criminal and Penal Prosecutions A team of prosecutors of the Director of Criminal and Penal Prosecutions trained in addiction treatment will be assigned to courtroom 4.07 of the Montréal Courthouse; they will process most of the files of accused who wish to participate in an addiction treatment program. Defence counsel Defence counsel from private practice or the Montréal Legal Aid Centre are called to represent clients who wish to treat their addiction. The Centre Dollard Cormier University Institute on Addictions (CDC IUD) The CDC IUD has already put in place a service for assessing the risk of withdrawal and the level of care needed at the Court of Québec. The members of this team will asses the accused who wish to participate in the program. At an assessment meeting, the CDC IUD professionals will have the accused take an Addiction Severity Index (ASI) test and, possibly, the Global Appraisal of Individual Needs (GAIN). The centre's staff will be able to refer the person to certain types of therapy based on the person's needs. However, in order to preserve the accused's freedom to choose the resource, they will not make a targeted referral. The assessment results will be communicated to the requester and shared with the treatment centre. The CDC IUD staff will confirm to the prosecutor and defence counsel the existence of a condition that requires therapy. During the period of court supervision, at the offender's request, CDC IUD staff may be involved in the development and follow up of the offender's individualized intervention plan. At the end of the program, the CDC IUD staff will have the offender take the ASI again in order to scientifically document the improvement in the scales used to assess the offender. The results will follow with other indicators to note whether the offender has attained the objectives of the treatment program. Correctional services of the ministère de la Sécurité publique The DSPC SLD, in collaboration with the Montréal local committee, has been developing a standard report and a report drafting guide that therapy centres will have 6
to use to report to the court on the progress and monitoring of offenders in their care. The information will therefore be standardized for all centres involved in the program. The drafting guide and the standard report have been presented and validated at a discussion group held in Montréal on January 25, 2012. A probation officer will be designated as a resource person for the program. He or she will meet with offenders when they are admitted and will provide them with all the information about the program. He or she will inform the offender, through a warning, of the limits of professional secrecy, which applies only as part and for the purposes of a clinical and therapeutic intervention and may be lifted in order to prevent an act of violence, including suicide, where there is a reasonable cause to believe that there is an imminent danger of death or serious bodily injury to a person or an identifiable group of persons. In addition, the probation officer will ask the offender about his or her future participation in research evaluation of the program. The probation officer is involved in developing and monitoring the offender's individualized treatment plan throughout the program. He or she will coordinate the follow up on participants' files with the court's activities. In other words, he or she is the program's liaison officer for the stakeholders such as the therapy centres, the offender, the prosecutor, defence counsel, the probation office and the court. Finally, he or she coordinates annual offer of service commitments of the dependence therapy centres. Probation services will prepare a specific standardized pre sentence report for the QCATP in connection with the data collected during the stay at the therapy centre, which will be produced during the court supervision phase. Note that this report will deal with the risk of recidivism and the potential for the offender's reintegration, considering his or her therapy progress. Therapy centres In accordance with current practice, therapy centres will assess accused who wish to stay at their establishment. They will have to justify their acceptance of the candidate upon request. Only therapy centres that agree to meet the mandatory conditions of the program will be able to receive clients from the court. 1 The centres will take on a central role with respect to treating offenders during the first phase of their treatment. They will gather relevant information on the offender's progress throughout his or her stay and will report on it using standardized progress reports. In order to implement the second treatment phase, they will prepare with the offender a release plan adapted to his or her needs. 1 All of the conditions to be met are stated in paragraph 8. 7
Agence de la santé et des services sociaux and the ministère de la Santé et des Services sociaux In accordance with its mission, the Agence must coordinate the putting in place of health services and social services in its region. Among its main responsibilities, the Agence must allocate budgets and grants to establishments such as CDC IUD and community organizations. It must support them in organizing services and promote cooperation and partnership. The Agence is also responsible for issuing certificates of compliance to addiction resources. Rehabilitation centres These centres will provide external services connected the consolidation of objectives reached during the period of internal monitoring. Priority treatment objectives will be relapse prevention and reintegration into the community. Community organizations and self help groups Community organizations will offer complementary services based on their mandate and the offender's needs (Chainon, Pro gam, Crime Victims Assistance Centre (CAVAC), Alcoholics Anonymous (AA), Narcotics Anonymous (NA), etc.). The ministère de l Emploi et de la Solidarité sociale Based on its existing programs, the department participates in financially supporting the program participants when they are in therapy centres with lodging by granting special benefits for the payment of living expenses for social assistance recipients receiving last resort assistance. In addition, if necessary, the department assumes transportation costs for the least expensive transportation mode for admission for treatment and on return to the living environment. In accordance with the 2010 13 government action plan for offender reintegration, it will work on a program through local employment centres (LECs) by giving offenders access to an interview to determine their needs and the availability of employment or educational programs needed for their reintegration. 1.5 Premises Hearings for the program will be held in room 4.07 of the Montréal Courthouse on Tuesday, Wednesday and Thursday afternoons. Offices of the DPCP's prosecutors in 4.10 will be used for meetings before court hearings. The CDC IUD assessment service and the probation service's liaison officer will work in the same office. 8
1.6 Target clientele To be admitted to the program, the accused must have the DPCP's consent to present an application to the court. Consent will be given after the accused is assessed by the CDC IUD staff. The accused's admission is conditional on his or her agreement to follow the rules of the program and on that of the therapy centre that will admit him or her. Finally, the accused must have the court's approval. 2. Eligibility The Court of Québec in Montréal Addiction Treatment Program is part of the program approved by the province under subsection 720(2) of the Criminal Code, authorized by the Minister of Justice and Attorney General of Québec. 2.1 Consent of the DPCP The prosecutor deems it appropriate to use the treatment program and, for that purpose, agrees to postpone sentencing. In order to do so, he or she takes into account the public interest and considers, among other things: public safety and the sentence sought ; the safety, rights and needs of the victim ; the facts that gave rise to the offence, revealed by the evidence, admitted by the offender ; abuse or dependence problems related to the commission of the offence ; the offender's needs and situation ; the offender's criminal history, pending charges, previous relationship with the court ; the treatment recommended by designated addiction professionals and the availability of treatment ; the objectives and criteria of the Court of Québec Addiction Treatment Program. The eligibility to the program depends on the DPCP's consent and the court's agreement. 9
2.2 Eligibility criteria related to the offender Offenders who intend to use a treatment program must meet the following criteria: have a problem with abuse of or dependence on psychoactive substances related to the offence they are charged with ; are not a threat to public safety ; show a true desire to meet the requirements of the treatment program under court supervision and undertake to respect them in writing ; agree to have their sentencing postponed to participate in the treatment program ; waive the right to claim a delay in sentencing attributable to the treatment for their abuse or dependence problem ; agree to the disclosure to the parties and the court of information concerning them and the treatment process ; plead guilty to the offence they are charged with ; do not have a criminal history of serious violence ; are not associated with any organized criminality with the purpose of being involved in criminal activity for the sole purpose of profit or financial gain. 2.3 Criteria related to the alleged offence The offence likely to give rise to court supervised treatment: is caused by the offender's alcohol or drug abuse or dependence ; is punishable by a non custodial sentence or a minimum sentence that may be reduced under the Act or by a conditional sentence that is not excluded by the Act (section 742.1 of the Criminal Code). An offence that is not eligible for a conditional sentence may also give rise to court supervised treatment if the prosecutor deems it appropriate. 3. Length and phases of the program A treatment program offered to an offender, regardless of its success, ends with sentencing. The minimum length of the program is ten months for a person who succeeds without relapse or repeat offence. The experience of other Canadian 10
jurisdictions allows us to anticipate a length of 18 to 24 months. The maximum length of the treatment program within the CQATP is 24 months. A treatment program within the CQATP has two phases. 3.1 First treatment phase: Treatment under the responsibility of a therapy centre supervised by the Court of Québec The program begins when the guilty plea is accepted and the court agrees to send the offender to a therapy centre under conditions of release. For detainees, therapy is usually divided into three two month periods. However, the frequency and pace of hearings are determined by the court. It may adjourn them in order to take the appropriate measure to ensure the supervision needed to accomplish the objectives determined for the offender. Thus, the first period includes conditional release with 24 hour a day presence at the therapy centre. It usually lasts two months, but may be longer depending on the person's learning pace and knowledge. The second period enables the offender who is making positive progress to be temporarily absent from the therapy centre with permission and in accordance with the centre's rules. The offender must convince the court to modify his or her release conditions. The third period allows the offender to progressively reintegrate into his or her living environment. At the end of the residential therapy, having attained the treatment objectives, the offender appears before the judge who authorizes him or her to live outside of the centre. 3.2 Second treatment phase: court supervision of the offender's reintegration The court supervision phase is a testing and consolidation of knowledge phase. During the first three months, the offender appears in court when required to report on his or her achievements. He or she provides the relevant documentation based on specific needs identified in the end of stay report by the therapy centre. The offender visits the local employment centre (LEC), if required by the court, to take advantage of educational and employability measures to prepare him or her and to anchor him or her in activities that are structuring for the offender and the community. 11
On the mere request of the person designated to do so as part of the program, the offender goes to the pre determined place to give the samples needed for screening tests. At the end of these first three months, the sentencing hearing is postponed for the last time to make it possible to verify the evidence submitted. As needed, the court requests that a specific pre sentence report be prepared. The offender will have to take the ASI one more time. At the last hearing, the court notes based on the evidence whether or not the offender was successful in the treatment program. If he or she was successful in the program, a certificate may be issued to the offender. Finally, an appropriate sentence in the circumstances is handed down by the court. 4. Conditions to be met by offenders admitted to the program Undergo an assessment to determine their needs with regard to withdrawal and dependence profiles ; Actively participate in treatment ; Appear in court when required ; Maintain abstinence and undergo random testing ; Comply with the rules of the program and those of the therapy centre ; Abide by the conditions of release imposed by the court ; Accept the imposition of sanctions by the court ; Agree to the saving and sharing of information related to the treatment collected by the program partners ; Optional condition: agree to participate in a criminological study researching the implementation and impact of the program on recidivism. The list of conditions of release adapted to the program is provided in the Appendix (Recognizance or undertaking). 12
5. Random testing During the first six months of internal therapy, the therapy centre where the offender is staying submits him or her to three random tests. Then, during the court supervision period, the court requires the offender to undergo a minimum of another three tests. 6. Conditions to be met by therapy centers The centers undertake to comply with the following rules: hold and maintain certification for therapy centres from the Ministère de la Santé et des Services sociaux and meet the correctional criteria published by correctional services of the Ministère de la Sécurité publique ; take clients to each court appearance and ensure that they are accompanied by a representative of the centre for the entire duration of the program ; prepare CQATP standardized progress reports and send them to the court, to the program liaison officer and to all parties involved three business days before the court hearing ; administer random tests to ensure that the conditions are being complied with and the offender is staying sober. A minimum of three tests will be administered during treatment at the centre. Test results must be included in progress reports ; inform the offender, through a warning, of the limits of professional secrecy, which applies only as part and for the purposes of a clinical and therapeutic intervention and may be lifted in order to prevent an act of violence, including suicide, where there is a reasonable cause to believe that there is an imminent danger of death or serious bodily injury to a person or an identifiable group of persons ; share with the program stakeholders, including the liaison officer, the DPCP, counsel for the defence and the court, information about the offender related to the treatment ; take part in the criminological study on the implementation and impact of the program ; provide therapy that lasts at least six months ; inform the liaison officer if the offender is no longer complying with the conditions set by the program ; 13
accept offenders' freedom of choice with regard to therapy centres ; recognize that only the court can: admit an offender to the CQATP ; impose or modify the conditions of release or supervision ; remove the offender from the therapy centre, among other things, if it loses its MSSS certification or no longer meets the correctional criteria or if the resource does not meet the individual's therapy needs. Offers of service are renewable every year with the Court of Québec. 7. Consequences of a relapse or repeat offence for keeping the offender in the program 7.1 Relapse If a relapse occurs, the court is informed by the therapy centre, liaison officer or offender as soon as possible ; The court holds a hearing to determine whether it is appropriate to keep the offender in the program ; If the court concludes that the program should be maintained, it invites the parties to present their evidence and appropriate submissions to determine whether it should impose a sanction ; If the court finds that the offender failed and terminates the program, it begins the sentencing hearing. It invites the parties to submit their evidence and relevant submissions and hands down the sentence. It may take the offender's efforts into account. 7.2 Recidivism Recidivism is the committing of a new offence by the offender during the program, and it does not necessarily end it ; In case of a repeat offence, the prosecutor uses his or her discretion with regard to laying new charges and the request to revoke bail in any pending file(s) as provided for in section 524 Cr. C. ; Whether the offender is kept in the program or withdrawn from it will be determined on a case by case basis by the court ; 14
The court considers all of the facts of the new offence; it assesses its impact for the short and long term on whether the offender will be kept in the program ; Any new charge will have to be treated in accordance with the program rules. 7.3 Sanctions and rewards 7.3.1 Sanctions The sanctions faced by the offender who does not comply with the conditions of (his or her) participation in the program are as follows: reprimands, an increase in (active or passive) court appearances, modification of the conditions of release, additional tests, community service or incarceration. At a specific hearing, based on the evidence and submissions made by the DPCP and the defence, the court decides whether it is appropriate to impose a sanction and determines the one that is fit and just in the circumstances (ss. 723 and 724 Cr. C.). 7.3.2 Rewards To recognize and validate the offender's efforts in pursuing the objectives of the treatment program, the court uses rewards such as congratulations, spacing out court appearances, awards, spacing out or cancelling tests. 7.4 Abandonment The offender's abandonment of the program does not terminate it as long as the offender gives a reasonable justification and the court rules that he or she should continue the program. 7.5 Grounds for exclusion of the program The offender is excluded from the program if: he or she commits another offence except in exceptional circumstances; he or she repeatedly breaches the conditions of release ; he or she flees or leaves the therapy centre unless he or she demonstrates the existence of exceptional circumstances. 15
8. Successful completion of the program The following factors determine the program's success: the offender has fulfilled the treatment requirements and attained his or her objectives ; the offender shows a significant improvement in his or her physical, psychological and social condition ; the offender has abstained from all psychoactive substances for a minimum of three months before sentencing ; the offender is working, actively looking for work, in training or, being unfit to work, benefiting from a development plan due to illness ; the offender has a fixed address ; the offender accepts the care or social assistance needed for his or her complete reintegration into the community ; the offender has complied with the interim release conditions. Although abstinence remains a key factor in determining the program's success, the court must analyze the file to determine whether abstinence may be weighted by all of the other factors. In certain cases, the court may be able to give the offender a certificate of successful completion of the program. 9. Failing the program The offender fails the program and the program is terminated when: the consideration of all success factors as a whole does not make it possible to find that the program was successful ; the offender abandons the program without reasonable justification. 16
10. Description of the stages following the admission to the program 2 The stages are as follows: 1. Appearance of the detained accused. 2. Investigation on interim release: release with conditions (an orientation date is set) ; detention maintained, a detention order is issued (an orientation date is set) ; release is waived, detention order (an orientation date is set). 3. The accused shows interest in participating in the program. 4. The CDC IUD assessment service determines, among other things, the person's problems, motives and specific therapy needs by means of the ASI. 5. The offender enters into contact with a therapy centre adapted to his or her needs, which meets the program's requirements. The offender prepares to be assessed for admission to the treatment program. 6. The defence counsel asks the prosecutor for an assessment of the accused's eligibility for the program. 7. The prosecution consents to the accused s admission to the program. 8. The parties agree on the following elements: the charges for which pleas will be entered ; suggested sentence(s) if the accused successfully completes the program ; in case of failure, the fact that the parties argue for a sentence on the merits ; everything is recorded on the plea negotiation form and is explained to the accused (Appendix). 9. The court indicates to the accused whether it considers that his or her request to participate in the program is plausible. 2 The offender's pathway based on the progress of his or her treatment may range from 10 to 24 months. 17
10. The accused submits his or her plea and motions. 11. The accused pleads guilty before a program judge in courtroom 4.07 of the Montréal Courthouse. 3 At that time: the parties lay out the relevant facts, particular circumstances of the case, aggravating and mitigating factors ; the judge verifies the plea's validity conditions, namely, the admission of the essential elements of the alleged offence, the understanding of the nature and consequences of this decision, and the knowledge that the court is not bound by any agreement between the accused and the prosecutor (subs. 606(1.1) Cr. C.) ; the judge explains that the court has discretion to determine a fit and just sentence and that, for that purpose, it may adopt the parties' joint suggestion as long as it is reasonable in the circumstances, not contrary to the public interest or likely to bring the administration of justice into disrepute ; the judge verifies the validity of the accused's consent to take part in the program and the accused s wish to end his or her dependence ; the judge explains the main rules and objectives of the program ; the judge accepts the offender into the program and adopts the guilty plea, which marks the beginning of the treatment program. 12. The judge conditionally releases the offender on the recognizance to comply with the release conditions pre determined for the program. He or she adjourns the case normally for two months. 13. The liaison officer meets with the offender and gives him or her information pertaining to the program. The liaison officer cautions the offender about confidentiality and informs him or her of the opportunity to participate in a criminological study. 14. The therapy centre sends the therapy progress report to all stakeholders three business days before the next hearing. 3 A guilty plea may be taken by any type of judge at the court of Québec in accordance with section 669.1(1) Cr. C. The file must then be transferred to courtroom 4.07 in order that a sentencing hearing may be held based on the program rules 18
15. Counsel meet with the liaison officer and share information on the offender's progress. 16. The hearing after two months of therapy: the judge validates with the offender the information contained in the monitoring report. The judge encourages and supports the offender or imposes sanctions following breaches ; the judge modifies the conditions of release to allow for outings with the centre's permission ; the judge adjourns the case normally for another 2 months. 17. The therapy centre sends the therapy progress report to all stakeholders three business days before the next hearing. 18. Counsel meet with the liaison officer, share information on the offender's progress and discuss the offender's specific needs during reintegration. 19. The hearing after four months of therapy: the judge validates with the offender the information contained in the monitoring report. The judge encourages and supports the offender or imposes sanctions following breaches ; the judge modifies the conditions of release to allow for the offender's reintegration ; the judge adjourns the hearing normally for another 2 months. 20. The therapy centre sends the final therapy report to all stakeholders three business days before the next hearing. 21. Counsel meet with the liaison officer, share information on the offender's progress and discuss the offender's specific needs during (his or her) reintegration. 22. The hearing after 6 months of therapy: the judge validates with the offender the information contained in the monitoring report. The judge encourages and supports the offender or imposes sanctions following breaches ; 19
the judge modifies the conditions of release to allow for the court supervision phase ; if needed, the judge orders that probation services prepare a specific report in order to prepare the offender's reintegration into the community. The report targets the offender's needs with respect to education, employability, lodging, financial resources, additional personal therapy or medical care. The report will be produced during the court supervision phase ; the judge adjourns the hearing and determines with the parties how often the offender should be seen ; if required, the offender visits the local employment centre (LEC) in his or her area to receive services adapted to his or her situation. He or she presents a document for that purpose. 23. Preparation of the hearing after 9 months of participation in the program: the offender's assessment and ASI scales are updated by the CDC IUD staff ; counsel meet with the liaison officer and CDC IUD staff with the results of the updated ASI test and documents concerning the follow up that the accused must undergo in order to consolidate his or her learning ; they verify whether the accused has attained specific objectives with respect to his or her completion of the treatment program. 24. The hearing after 9 months of participation in the program: the judge validates with the offender the information in the monitoring documents. The judge encourages and supports the offender or imposes sanctions following breaches ; if needed, the judge modifies the conditions of release ; the judge adjourns the sentencing hearing for another month. 25. The liaison officer receives the specific pre sentence report and sends it to counsel and to the court. 26. Counsel meet with the liaison officer and verify the relevant information and documentary evidence. 20