POST BOOKING DIVERSION: Treatment Not Incarceration The Brooklyn Treatment Court Joseph Madonia, LCSW-R, CASAC Director Susan Sturges, MA, MPA Mental Health Coordinator Inception Opened in 1996 as an alternative to incarceration program First drug court in New York State Now over 250 courts in NYS, and 3,000 nationally Judge JoAnn Ferdinand is the Acting Justice of BTC since it started 1
How it works Non-violent felony drug offenders ages19 & over are identified and referred to BTC the next business day Case Managers assess for clinical eligibility Voluntary participation Once court mandate is completed, the case is dismissed Populations Served Adults (Male & Female) Young adults ages 19-24 Veterans Co-occurring populations 2
Program Structure Three phase program Graduated sanctions and incentives provide tools to teach sobriety Certainty of punishment & acknowledging positive behavior On-Site Drug Testing Lab Immediate Placement Top indicator of success Recovery Process Teaches consequential thinking, accountability, and responsibility Clinical Team 3
Supportive Services Kings County Hospital comprehensive psychiatric evaluations Civil Legal Needs Initiative Ed/Vocational Department Partnership with CUNY College of Technology (CityTech) Ancillary Programs to Teach Sober Recreation Community Partnerships Computer Learning Center Success Rates BTC has a 78% success rate Brooklyn Veteran s Court has a 78% success rate (BTC Graduates March 2015) Less than 10% recidivism rate 4
Innovative Approach to Specialized Populations 90 Day Residential Rehabilitation Program (RRP) 5
Medication Assisted Treatment Policy Recovery issue that requires Court oversight New medications Various levels of abuse Minimal risk: Naltrexone High risk: Methadone Court-approved Credentialed Addiction Specialist (ASAM) Intensive monitoring of compliance Creation of Trauma Informed Court High rates of trauma among justice involved individuals. Underreported by trauma survivors. Trauma-related symptoms often not evaluated and go unrecognized and untreated. Symptoms of trauma can be mistaken for symptoms of psychotic or affective disorders 6
Specialized Trauma Track (2012) Trauma Screening and Assessment Post Traumatic Checklist (PCL) Trauma Symptom Inventory II (TSI-2) Trauma Informed Treatment planning Training: Treatment staff and Courtroom staff Trauma Informed Responses Trauma-informed responses: Orientation Waiting-room policy Toxicology screening process Sanctions/Incentives Results: Increase safety Reduce recidivism Promote recovery 7
Brooklyn Mental Health, Trauma, Treatment, Addiction Track (B-MATT) Co-Occurring Disorder Court Specialized Assessment Beck Depression Inventory (BDI) MHSF-III Level of Service Inventory Revised (LSI-R) Trauma Symptom Inventory II (TSI-2) Brooklyn Mental Health, Trauma, Treatment, Addiction Track (B-MATT) Individualized treatment planning Modification to Traditional Phase System Proximal/Distal Goals 3 Main Phases 3 Additional Tiers Interactive Skills Building Workshops 8
B-MATT: Peer Support Certified Recovery Coaches Wellness Plans Home and Community Visits Medication Compliance The Creation of BTC Advisory Boards Clinical Advisory Board Working group to discuss clinical best practices that can be used to improve drug court Alumni Advisory Board Working group to discuss the lived experience perspective on drug courts. 9
Recovery Tree Symbol of the process of change and renewal participants experience Leaves represent changes participants have made Participants add their leaves to the tree during dismissal ceremonies POST BOOKING DIVERSION: Treatment Not Incarceraton The Jericho Project William E. Robilio Supervising Attorney Special Litigation Section Law Office of the Shelby County Public Defender 10
Jericho Project Jericho assists defendants with serious mental illness by linking them with community-based mental health treatment. Linkage to community mental health treatment takes place over 120 days with Recovery Support Specialist assisting client in accessing all eligible community services. Participants spend 99 fewer days in jail per year. Over half of participants are never re-arrested. We are available in all divisions of Court; If the consumer is eligible for probation under the law, we will work with him or her. 11
Jericho Legal Team The consumer s attorney: Completes the Application form; Confirms the current diagnosis and meds and attaches a copy; Provides a copy of the Affidavit of Complaint, arrest history and psychological evaluation with the completed packet; Lets us know if s/he wants to be present when we interview the client. THE JERICHO LEGAL TEAM Reviews the application; Meets with the client; Refers to the Roundtable, if appropriate; Participates at the Roundtable meetings; Facilitates communication among the client, client s attorney, treatment team and Court; Drafts the Orders approving the plan. Attorney Check List Consumer s understanding of Jericho; Review the informed consent form; Consumer s identification of personal and community supports; Consumer s goals; Consumer s identification of substance abuse and mental illness; Consumer s inputs and preferences on treatment; Other health problems identified by consumer; Other needs identified by consumer, including housing, food, clothing and transportation. Consumer s willingness to accept recommendations of the treatment team. 12
Jericho Treatment Team Meets with the client and does a mental health assessment; Determines the recommendations for treatment; Develops the Community Linkage Plan, including housing, treatment and medication appointment; Assigns the Recovery Support Specialist. Community Linkage Plan COMMUNITY LINKAGE PLAN AND TRANSITIONAL CASE MANAGEMENT M**** A******* The following community-based treatment and case management supports have been arranged in consultation with Ms. M**** A******* who with advice of counsel, is willing to participate in the services and supports as detailed below. Transitional Case Management: Ms. A******* will receive transitional case management services through Alliance Healthcare Services (AHS), 2150 Whitney Avenue, Memphis, TN 38127, 353-5440. Her assigned Recovery Support Specialist is, 354-73yy or 643-yyyy. Transitional services are designed to provide support and ensure engagement to long term community behavioral health services and will continue for a minimum of one hundred twenty (120) days. The RSS will have daily contact with Ms. A******* during the initial reentry period. 13
CLP: Outpatient Treatment Outpatient Treatment: Ms. A******* will attend Intensive Outpatient Programming (IOP) at AHS five (5) days per week for the duration of her engagement with Jericho services. IOP provides group therapy to address diverse issues including substance abuse and relapse prevention, psycho-educational awareness of mental health behavior and treatment and bolstering daily life skills. Ms. Xxxxx Xxxxx, LMSW, is the principle contact for IOP and can be reached at 354-yyyy. Additionally, Ms. A******* will be assessed for individual therapy with Ms. Xxxxx and meet as applicable. Ms. A******* has accepted outpatient treatment recommendations at this time and states intent to actively engage in these services. In the event that she experiences a substance abuse relapse or mental health de-compensation requiring a higher level of care, Ms. A******* agrees to work wither RSS to relocate to a residential treatment facility. CLP: Adherence to Plan Adherence to Treatment Plan: Ms. A******* and Her RSS have discussed potential obstacles to full adherence. Ms. A******* is aware that, upon verification of sufficient personal income, it will be her financial responsibility to acquire bus passes to attend mental health/legal appointments. Ms. A******* states understanding that timely attendance to all scheduled appointments is a requirement of her CLP and that poor attendance/participation will not be excused due to transportation issues. 14
CLP: Bridge Medication Adherence to Treatment Plan: Ms. A******* and her RSS have discussed potential obstacles to full adherence. Ms. A******* is aware that, upon verification of sufficient personal income, it will be her financial responsibility to acquire bus passes to attend mental health/legal appointments. Ms. A******* states understanding that timely attendance to all scheduled appointments is a requirement of her CLP and that poor attendance/participation will not be excused due to transportation issues. CLP: Medication Management Medication Management: Ms. A******* will receive psychiatric services and medication management through AHS. Ms. A******* will be assisted by her RSS in accurately identifying medication and ensuring accuracy of taking medication as prescribed. She is scheduled to see Dr. Zzzzz at CCN for her initial psychiatric evaluation on June CC, 2015 at 2:00 p.m. 15
CLP: Housing Housing: Upon release, Ms. A******* will reside at the Halfway House, Number and Street, Memphis, TN 38126. Halfway House provides a supportive living environment where women can pursue increased pro-social supports and resources that encourage successful re-entry into the community. Mr. Manager is the primary contact and can be reached at 355-2727. Ms. A******* states understanding that, upon verification of sufficient income, monies associated with her care, including rent at Halfway House, will be her responsibility. In addition, Ms. A******* states understanding that residency will be dependent on full adherence to housing rules including, but not limited to, sobriety, curfew and sustained participation with The Jericho Project and her community linkage plan. Ms. A******* is aware that terminating engagement with Jericho services, prior to completion of one hundred twenty (120) days of programming, may also terminate eligibility for housing with Halfway House. CLP: Release and Transportation Release and Transportation: The Sheriff of Shelby County shall process the defendant, M**** A*******, for scheduled release to the care and custody of a representative of Alliance Healthcare Services ( AHS ) on June CB, 2015 at 10:00 a.m. CCN representative RSS (354-yyyy or 643-yyyy) will be available to transport the defendant at the scheduled release time. The backup representative is Ms. Director, 354-yyyz. 16
CLP: Benefits Benefits: Ms. A******* reports a recent history of TennCare benefits that should provide funding for mental health services and medical care including prescription assistance. Her RSS will assist Ms. A******* in pursuing financial entitlements with the Social Security Administration as applicable. CLP: Probation Continued Supervision: Ms. A******* s supervision obligations are set forth in a separate court order. Her RSS will provide general assistance to Ms. A******* in meeting reporting requirements to the supervising agency designated by the court and will assist in coordinating initial intake with the supervising agency. Ms. A******* states understanding that her supervision obligations are not terminated by completion of her community linkage plan (CLP) and that her reporting requirements may extend beyond one hundred twenty (120) days of Jericho services. 17
CLP: After Jericho Post Jericho Recovery Services: Following transition to post-jericho services, Ms. A******* will continue mental health care with the agency of her choice and will remain in adherence with the recommendations of her treatment team. Ms. A******* states understanding that the Jericho Project is designed to initially bolster re-entry into the community for one hundred twenty (120) days and, following that period, her continued stability is dependent upon sustained medication management, engagement with case management services, and personal dedication to her path of recovery. CLP: Release of Information Privacy, Confidentiality and Release Authorization: Ms. A******* has given informed consent to participate in this linkage/case management process, to include release authorization for the exchange and distribution of information necessary to support this linkage plan to those individuals and agencies listed in the Fax Distribution List. 18
CLP: Next Court Date Next Court Date: The next court date is, 2015, before Judge Judge, Criminal Court Division L, located on the 5 th floor at 201 Poplar Avenue, Memphis, TN 38103. Ms. A******* will be present and ready for court by 8:30 a.m. Order Approving Plan IN THE CRIMINAL COURT OF SHELBY COUNTY, TENNESSEE FOR THE THIRTIETH JUDICIAL DISTRICT AT MEMPHIS DIVISION I STATE OF TENNESSEE No.:12 00000 vs. Booking No.: 122***** Jail Booking No.: 122***** M**** A*******, Defendant. RNI: ****** ORDER APPROVING COMMUNITY LINKAGE PLAN Release to Jericho Project Effective on Thursday, September 17, 2015 at 10:00 a.m. 19
Order: Comply with Plan Compliance with Community Linkage Plan: During the first 120 days following defendant s release, the Court will set periodic status review dates. Alliance Healthcare Services shall file a progress report and recommendations for long term services for defendant on or before each court date. Material noncompliance with the Community Linkage Plan will also be reported to the Court. For purposes herein, material noncompliance means such behavior(s) or action(s) that CCN believes threatens the overall success of the treatment strategy and viability of the Community Linkage Plan. Material noncompliance may include, but is not limited to, refusal to take medication as prescribed or failure to attend either medical or case management appointments. Fee waiver. Due to defendant s demonstrated indigency and disability which limits her income to federal disability, the probation fees and jail fees are hereby waived. Status Reports Once a month for 4 months; Let the Court know how the client is doing for better or worse on: Medication compliance; Meetings with case manager; Required classes; Treatment issues; Compliance with outpatient or residential treatment requirements. Final status date the court is provided with a transition services plan which shows where the client will continue to reside, get medication and case management/treatment services. 20