RISK AND NEED TRACKSSAMHSA 2013

Orleans Parish Drug Court Expansion Grant

ORLEANS PARISH OUTCOMES COULD CHANGE DRUG COURT

STATUTE TO INCLUDE INDIVIDUALIZED TREATMENT

Goals and Benefits

Increase and Improve

• Access• Availability• eligibility screening• assessment• treatment types• group types, • intervention types• modalities • programming for men and

women

• individualized treatment• provide lower recidivism

rates• higher retention rates • promote public safety• individual trauma counseling• transportation services• childcare • vocational training

GOALS:

Benefits of Drug CourtTrack System

Increased retention and graduation ratesReduced recidivismSelf-efficacy EmpowermentSustainable employment Employment skillsIncrease in physical and mental health Access to health careEnhanced parenting skills Family relationshipsTrauma symptom reduction

No More One Size Fits All Treatment

Current Process vs Process after Grant Implementation

Current Process

Intake Screening

FormDAST

Intake/Accepted into Drug Court

Addiction Severity Index

Gender Specific

Treatment Groups

After Grant Implementation

Intake

Screening Form

TCUDS-II

Nursing Assessme

ntRANT

Specialized Risk/Need Treatment

Tracks

Four Question

PTSD Screener

PCL-C

SLESQ

Helping Women

Recover and Helping Men

Recover Curriculum

MHSF-III

Psychiatric Evaluation

Intake/Accepted

into Drug Court

Addiction Severity

IndexGender Specific

Tretment Groups

2 DESIGNATED SCREENING AND INTAKE

COUNSELORS

ADDED ASSESSMENTS TO CREATE INDIVIDUALIZED CASE MANAGEMENT AND

TREATMENT PLANS

Screening and Assessment

Screening

Court calls for screening prior to sentencingIntake counselor screens for eligibility Risk and Needs Assessment Triage (RANT)Screening completed in the DCCM

Outcome:Individualized Case Management Plan:GEDHousingMedicaid

Assessment

Intake completed in DCCM and GPRA Mental Health Screening Trauma Screening TCU-Drug Abuse Screening Addiction Severity Index (ASI)

Outcome: Individualized Treatment Plan: Psych Evaluation (onsite Psychiatrist) Nursing Assessment (onsite nurse) Individual Counseling (onsite trauma therapists) Personalized Treatment Track (Risk and Need) Grief Counseling Anger Management Parenting Groups (NOLA DADS)

HIGH RISK/HIGH NEEDHIGH RISK/LOW NEEDLOW RISK/HIGH NEEDLOW RISK/LOW NEED

Risk and Need Tracks

RISK Need

Prognostic RiskRe-OffendingCareer CriminalRevolving Door

Criminogenic NeedSubstance

DependenceRehabilitationSobriety

Risk and Need

Risk and Need Quadrants

Standard Drug Court Track(10 Key Components)

Status Calendar Intensive Treatment Compliance is proximal Restrictive Consequences Focus consequences on treatment and

supervision

Specialized Track(Treatment emphasis)

Noncompliance calendar Intensive treatment Treatment is proximal Focus consequences on treatment

Specialized Track(Accountability emphasis)

Status Calendar Pro-social rehabilitation Prevention Services Abstinence & compliance are proximal

Specialized Track(Diversion emphasis)

Noncompliance calendar Prevention services Focus consequences on abstinence

High Low

High

Low

High Risk/ High Need(Standard Drug Court Track)

  Scheduled Status Hearing with the Judge Intensive Outpatient Treatment with FSGNO Consequences for treatment and supervision Compliance is a proximal goal Graduation Sanction/restrictive consequences Prescribed Medication allowed  

Generally Substance DependentPossess antisocial personality features

Prior failures in treatmentEarly onset of Substance Use

Unable to be a good parent, hold a job, or attend schoolWill need vocational skills training’

Treatment and Supervision attendance are proximal goals (short term)Sanctions should be immediate for missing treatment or supervision

Before sanctioning for new drug use they need time to be in treatmentResponse to positive drug tests should be treatment oriented

 

High Risk/Low Need(Emphasis on Accountability)

Scheduled Status Hearing with the JudgePro-Social Rehabilitation (People, Places & Things)Prevention ServicesAbstinence and Compliance are proximal 

Need Social Skills Training and Accountability with close monitoringScheduled Status Hearings-Judge to monitor and sanction due to high risk of

noncompliance with monitoringMay not meet dependence criteria and Intensive treatment option may put them at

more risk for exposure to drug usePsycho educational groups to provide education of negative effects of drugs and alcohol

Education to help re-enter society without drug and alcoholAbstinence and Compliance are short term and attainable goals-sanctions needed for

missing treatment and supervision.

Low Risk/High Need(Emphasis on Treatment)

 

Status Hearings only for noncompliance Intensive Outpatient Treatment with FSGNO Consequences focused on treatment Treatment is a proximal goal Prescribed medication allowed

 Substance DependantMental Illness

Poor Coping SkillsNeed Intensive Treatment and Supportive Intervention

Regular status hearings are not necessary because they may expose them to high risk behaviorsQuick and immediate sanctions are a mustMonthly Status Hearings are acceptable

Must be in separate groups from High Risk offendersNeed vocational and educational services

Poor attendance should get a immediate judicial sanctionRelapse is a distal goal (long term)-should get a treatment sanction

Low Risk/Low Need

Status Hearing for noncompliancePrevention ServicesConsequences are focused on abstinence  

Usually productive in life (work, school, parenting)Combining them with HRHN (Drug Court) would expose them to antisocial

behaviorNo scheduled status hearings are necessary-only noncompliance

May not require Intensive Outpatient GroupsMay need psycho educational groups or less intensive treatmentAbstinence is a proximal (short term) goal-immediate sanction

Treatment plan should include prevention 

DRUG COURT

VERSUS

INTENSIVE PROBATION

Who is Eligible???

Drug Court AND

Intensive Probation

Current Drug Court clients

Substance Dependant

Active ProbationMinimum 3 years

probation

Current IP clientsMay be substance

dependant May be recreational

userDealersActive/Inactive

Probation

Eligibility

INTENSIVE PROBATION

BECOMES

DRUG COURT

Program Outline

Currently Options

Defendants sentenced to Drug Court receive ALL of the afore mentioned services inclusive of individualized treatment.

Defendants sentenced to Intensive Probation receive case management and are NOT ELIGIBLE for any of the afore mentioned services available through the SAMHSA Grant.

Defendants that need case management would be sentenced to Court Intervention Services and screened for a treatment track.

Cases that would fall into the traditional Drug Court track (High Risk/High Need) will be re-alloted to a felony Drug Court Section and the High Risk/Low Need track would be transferred to Section C for supervision. All others will remain in their sentencing section to be monitored by the Case manager assigned to that track.

Drug Court Umbrella