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Substance Abuse Services & the Criminal Justice System LME Directors Meeting 9/14/07 NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services NC Department of Health and Human Services Drugs & Crime • 1 in 32 adults are under correctional supervision • SA is disproportionately represented in correctional populations – 80% of parolees – 80% of prison inmates – 67% of probationers • 59% of SA Referrals from CJS NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 Drugs & Crime in NC • 38,423 people in prison – 30,738 need substance abuse services Note: 97% will be released • 117,607 people on probation, parole or post-release – 79,347 need substance abuse services NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 Felonies: Type of Punishment Imposed Active Intermediate Structured Sentencing* 26% 20% 43% 28% 25% 20% 15% 10% 5% 0% Old Law** 47% 37% 50% 45% 40% 35% 30% Community * SOURCE: NC SPAC FY05-06 Report ** SOURCE:1993 Pre-Structured Sentencing Data NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 NC Problem Statement • Limited CJ & Tx resources • Complex clients: challenging behavioral health needs & serious consequences of failure • Recidivism & Relapse are common • Service availability & effectiveness NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 OMM: Balancing Control & Tx • One Offender One Case Plan One Team • Common Goal: Safely manage high-risk, highneed offenders in the community NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 DHHS-DOC-AOC MOA Memorandum of Agreement between the North Carolina Department of Health and Human Services and the North Carolina Department of Correction and the Administrative Office of the Courts ii. i. This Memorandum of Agreement (MOA) and Appendices are entered by and between the Department of Health and Human Services (DHHS), the Department of Correction (DOC) and the Administrative Office of the Courts (AOC) for the purpose of developing a comprehensive offender management model that ensures public safety while addressing the needs of offenders. The Division of Community Corrections (DCC) and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS) are the primary resources involved in community corrections. AOC manages the N.C. Drug Treatment Court Act Program and provides administrative support to the local courts that operate Adult Drug Treatment Courts (DTC). The Division of Alcoholism and Chemical Dependency Programs (DACDP) and Division of Prisons (DOP) impact community corrections through the release of offenders who have received services while in custody or while in a residential facility (DART-Cherry). The purpose of a comprehensive offender management model is to create a seamless system built on the ideals of integrated service delivery and coordination of resources that provide effective interventions for offenders. NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 What is TASC? • A model that bridges two separate systems: justice & treatment • Links treatment & justice goals of reduced drug use & criminal activity • Uses processes that improve treatment access, engagement & retention NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 TASC: Nationally & in NC • • • • • 1978 First TASC Programs in NC • 1993 10 Programs in 20 Counties • 1994 Structured Sentencing Act • 1998 23 Programs in 43 Counties • 2000 SOP; DHHS-DOC MOA • 2002 TASC services available in all 100 counties 1972 first TASC program in Wilmington, Delaware • 2003 TASC Training Institute • 2005 AOC joined MOA 2007 National TASC represents over 200 programs • 2007 15,000+ Offenders Served 1962 Robinson v. California addiction is an illness, not a crime 1970s Federal government develops model to interrupt drug-crime cycle: Treatment Alternatives to Street Crime NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 TASC Eligibility • involved in the CJS or DOC releasee who completed a prison substance abuse program; & • voluntary consent to participate; & • evidence of a history or potential substance abuse &/or mental health issue, including drug-related charges NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 TASC Core Services • Screening & Assessment • Referral & Placement • Care Planning, Coordination & Management • Reporting Progress to Justice System NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 CJS Interface thru TASC CJS = Probation Officer, CJPP staff, Judge, DA, PD/ Defense Atty, DTC staff, DART staff Referral from CJS TASC Screening Assessment TASC monitors & Referral to self-pay services &/or other appropriate community service provider Low-Risk/Low-Need Appropriate Service? No TASC service needed; or No MHDDSAS service needed; Or services refused Referral back to CJS or other appropriate community service provider High-Risk / High-Need (A/CSCJO Target Pop) Common Case Plan, (coordinated w/ CJS) CJS TASC LME Enforcing Special Conditions & Supervision Requirements Organizing community-based services & supports, Urinalysis, Monitoring progress in all services & supports, Adjusting Common Case Plan, Reporting to CJS 90801, Diagnostic Assessment, Community Support, SAIOP, SACOT, Detox, SA HH, SA non-med residential, SA med residential, SA inpatient hospitalization ASCJO & CSCJO Adult & Child Substance Abusing Criminal Justice Offender Target Population (ASCJO & CSCJO) to ensure access to treatment for individuals with a SA diagnosis who present the greatest risk to public safety. Eligibility includes: Diagnostic criteria for a substance-related disorder; and Services approved by a TASC care manager; and CJS Status as an Intermediate Punishment offender, a Department of Correction releasee who has completed an in-prison treatment program, or a Community Punishment violator at-risk for revocation NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 North Carolina TASC Network Region 2 – Andy Miller 412 West Russell Fayetteville, NC 28302 910.321.6796 Region 3 – Michael Gray 516 N. Trade St. Winston-Salem, NC 27101 336.714.7080 Region 4 – Carlene Wood 370 N.Louisiana Ave, Ste. E-3 Asheville, NC 28806 828.210.0535 Region 3 Region 4 24 Watauga Mitchell Avery 24 24 30 A Graham Cherokee 30 A Clay 30A Haywood 30 B Jackson 30 B Macon 30 A Buncombe 28 Henderson 29 Transylvania 29 McDowell 29 Yadkin 23 Alexander 22 Caldwell 25 A Yancey 24 Madison 24 Swain 30 A Wilkes 23 Burke 25 A Catawba 25 B Stokes 17 B Rockingham 17 A Forsyth 21 A-B-C&D Guilford 18 A-B-C-D-E Davie 22 Davidson 22 Iredell 22 Polk 29 27 B Cleveland 27 A Gaston Cabarrus 19 A Stanly 26 A-B-C 20 B Mecklenburg Union 20 B Montgomery Orange 15 B Anson 20 A Moore 20 A Richmond 20 A Hoke 16 A 9 Warren Northampton 6B 6A Halifax 9 Franklin 7A Nash 7B Edgecombe Wilson 7C Johnston 11 Harnett 11 8B Wayne 8A Greene 2 Martin 3A Pitt 8A Lenoir 4A Jones 12 A-B-C Cumberland Sampson 4A Duplin 4A 6B Hertford 1 Gates 6B Bertie Wake 10 A-B-C-D 16 A Scotland Robeson 16 B TASC is organized into 4 regions which reflect the state’s 4 judicial divisions, consistent with the unified court & statewide probation systems. Region 1 Granville Lee 11 19 B 9 Vance 9 19 C Lincoln 27 B Rutherford 29 Person 9 Chatham 15 B Randolph 19 B Rowan Caswell 9A Durham 14 A-B 23 Ashe Region 2 Alamance 15 A Alleghany 23 Surry 17 B Region 1 - Wes Stewart 308 New Street New Bern, NC 28560 252.638.3909 4B Onslow 2 Washington 2 Beaufort 3B Craven 2 Tyrrell 2 Hyde 3B Pamlico 3B Carteret 13 Bladen Pender 5 New Hanover 5 13 Columbus 13 Brunswick TASC Training Institute Dale Willetts 615 Shipyard Blvd. Wilmington, NC 28412 910.202.5500 Dare 1 TASC Statistics • 80% Male • 48% Black 47% White • 60% less than 31yo – 20% 16-21yo • 85% Not Married • 52% No HS Diploma • 32% Unemployed NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 TASC Statistics • Ave. length of stay: 8½ months • $1.35 per client per day • 2000 Recidivism Report to the General Assembly* • 86% had at least 1 previous arrest (mean # 2.6) • 61% were NOT re-arrested within 2 years of discharge * NC Sentencing & Policy Advisory Commission NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 How TASC Benefits Treatment • Increases Client Identification – Improving treatment outreach & access • Provides Independent Assessment of Need • Improves Treatment Engagement – orients clients to tx; reduces “no shows”, increasing tx staff productivity • Improves Treatment Retention & Compliance – improving tx outcomes • Provides Support & Continuity during Tx & CJ Transitions NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 How TASC Benefits Treatment • Maintains clear Roles & Responsibilities – Tx providers focus on client care & Probation officers focus on supervision • Balances Control & Treatment – arranges goals & objectives of Tx, CJS & the client • Improves Communication among Systems about & with Client • Provides addt’l information for Treatment, Judicial & Correctional Decision-Making NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 www.northcarolinatasc.org NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 2007 Legislative Session: Treatment Court Programs Funding for services for existing pre- & post-plea MH courts, DWI courts & adult & family DTCs Funds are expected to be allocated to LMEs w/ Adult DTCs based on the number of Active Participants during CY05-06 In providing DTC services, LMEs shall consult with the local DTC team & select a tx provider that meets all provider qualification requirements & DTC needs. A single tx provider may be chosen for non-Medicaid-eligible participants only. A single provider may be chosen who can work with all non-Medicaid-eligible DTC participants in a single group. During the 52-week DTC program, participants shall receive an array of tx & aftercare services that meets the participant's level of need, including step-down services that support continued recovery. NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 Adult Drug Treatment Courts Madison 24 30 A Graham Cherokee 30 A Clay 30 A Swain 30 A Haywood 30 B Jackson 30 B Macon 30 A Mitchell 24 Yancey 24 Buncombe 28 Henderson 29 Transylvania 29 Surry 17 B Wilkes 23 Yadkin 23 Avery 24 Caldwell 25 A McDowell 29 Burke 25 A Rockingham 17 A Forsyth 21 A-B-C&D Caswell 9A Guilford 18 A-B-C-D-E Davidson 22 Iredell 22 Randolph 19 B Rowan Polk 29 27 B Cleveland 27 A Gaston 9 Orange 15 B Union 20 B Lee 11 19 B Montgomery Anson 20 A Moore 20 A Richmond 20 A 9 Warren Hoke 16 A Harnett 11 7B Edgecombe 8A Greene 8B Wayne 4A Jones Sampson 4A Duplin 4A 2 Martin 3A Pitt 8A Lenoir 12 A-B-C Cumberland 6B Hertford 6B Bertie Wilson 7C 16 A Scotland Robeson 16 B 7A Nash Wake 10 A-B-C-D Johnston 11 1 Gates Northampton 6B 6A Halifax 9 Franklin 19 C Cabarrus 19 A Stanly 26 A-B-C 20 B Mecklenburg 9 Vance Granville Chatham 15 B Lincoln 27 B Rutherford 29 Person 9 Davie 22 Alexander 22 Catawba 25 B Stokes 17 B Durham 14 A-B 24 Watauga Alleghany 23 Alamance 15 A 23 Ashe 4B Onslow 2 Washington 2 Beaufort 3B Craven 2 Tyrrell Dare 1 2 Hyde 3B Pamlico 3B Carteret 13 Bladen Pender 5 13 Columbus 13 Brunswick New Hanover 5 NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 2007 Legislative Session: LMEs & Jails SECTION 10.49.(f) Within available resources, LMEs shall work with county public health depts & sheriffs to provide medical assessments & medication for jail inmates who are suicidal, hallucinating, or delusional. LMEs shall also examine ways to provide addt’l treatment to persons who are determined to be psychotic, severely depressed, suicidal, or who have substance abuse disorders. To this end: (1) DHHS shall work with LMEs, county public health depts & sheriffs to develop a statewide standardized evidencebased screening instrument to be used when offenders are booked. The screening tool shall be implemented by January 1, 2008. (2) LMEs & county sheriffs shall work together to develop all of the following: a. A designated LME employee responsible for screening the daily jail booking log for known mental health consumers. b. Protocols for effective communication between LME & jail staff including collaborative development of medication management protocols between jail & mental health providers. c. Training to help detention officers recognize signals of mental illness. NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015 2007 Legislative Session: Crisis Intervention Teams Provides funding to be used by: • LMEs to develop CITs • DMHDDSAS to develop statewide training capacity DMHDDSAS will: • Release an application for LMEs to request funding for CITs • Provide technical assistance for developing CITs • Fund an annual statewide CIT conference NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services 7/7/2015