Planning a program that integrates substance abuse treatment
with pretrial case processing will vary somewhat across jurisdictions,
reflecting the organizational structure of the particular justice
system, substance abuse treatment system, and public health system.
The program will also reflect the specific legal framework,
traditions, personalities, and "local legal culture" of the jurisdiction.
Yet every jurisdiction must answer six basic questions when planning a pretrial treatment program:
Who will be in the planning group?
How will the planning group work?
What information is needed to develop policy and shape program
goals and objectives?
Who makes up the program's target population and when during
the pretrial process should the intervention happen?
What treatment and other resources will be used?
What will be in the Memorandum of Understanding (MOU) that
incorporates commitments from all the key stakeholders?
For a pretrial substance abuse treatment program to work successfully,
it must have the support-or at least the acceptance-of leaders
in the courts, other criminal justice agencies (especially the
prosecutor's office and the defense bar), the treatment community,
and other institutions. At the county level the level of government
at which most trial courts are organized and at which the pretrial
stage of criminal case processing usually takes place -- the following
stakeholders should be considered for inclusion on a policy
or advisory group to plan a pretrial drug treatment program:
Chief or presiding judges of the general and limited
jurisdiction courts
Prosecutor
Public defender
Representative of the private defense bar
Court administrator
Case management agency administrator
Pretrial services agency director
Chief probation officer/director of community corrections
agency
Sheriff/jail administrator
Substance abuse treatment professionals
Major health institutions/hospital director
Public health agency director
Social services agencies, including child protective services
Local school districts, community colleges, and other educational
institutions
Medical services and community mental health providers
County commission/senior staff (including budget director)
Victims' rights groups
Ex-offender/ex-addict groups
Community anticrime and antidrug coalitions.
In addition to these community stakeholders, there are important
State-level stakeholders as well. Individuals with substance
abuse disorders frequently move across county lines, so State-level
funding and legislative or rule-making support may be necessary.
Further, trial courts function within an organizational framework
in which State appellate courts (especially States' supreme courts)
and the State court administrator's office shape policy and
practice at the trial court level. Moreover, funding and coordination
of substance treatment programs is centered at the State level
in the office of the State Alcohol and Drug Abuse Director (known
in the treatment community as the Single State Agency). Other
key stakeholders at the State level are likely to include
Chief Justice
State Court Administrator
State legislative leaders
Governor
State health and social services department heads.
As a practical matter, it is very difficult for a group this
large to do detailed planning. However, it is possible to elicit
ideas and concerns from all, to take their views into account
in shaping initial plans, and to keep them abreast of developments
in the planning process. The detailed planning can be done by
a smaller, representative group. The composition of such a "subgroup"
is likely to vary from jurisdiction to jurisdiction but should
certainly include justice system and substance abuse treatment
community leaders.
Judges, especially chief and presiding judges, play critical
roles in the planning process because the courts, more than any
other entity, will link pretrial processing with substance abuse
treatment. It is a judge who will make the diversion or "conditional
release" decision to place a defendant in the program. Administrative
personnel in the court will monitor the defendant's compliance
with conditions set by the judge. Also, because they are known
as "neutral parties," judges are in a unique position to bring
the relevant stakeholders together in the planning committee.
Prosecutors are important stakeholders as well. They shape
overall law enforcement policies in their jurisdictions, establishing
policies for filing formal criminal charges. For individual
cases, prosecutors decide what specific charges to file and recommend
conditions of custody or release, acceptable pleas, and components
of a sentence. Sometimes they may also manage diversion programs
through their own offices.
The defense bar (particularly the public defender's office,
if the jurisdiction has one) should also be involved in planning
a drug court program. Defense lawyers may well be skeptical
about advising their clients to participate in a program that,
in terms of its duration and conditions, may seem more onerous
than the disposition that would generally occur. Involving defense
lawyers will help ensure that the rights and interests of those
for whom the program is designed are taken into account.
Substance abuse treatment professionals and the State Alcohol
and Drug Abuse Directors (or their representatives) generally
do not have specialized expertise in criminal justice issues,
but their treatment expertise is essential for planning an effective
drug court program. Often, they have experience working with
health and social services agencies, and in some jurisdictions
they may have a history of working with persons referred to them
by the court. They also will be familiar with many of the funding
opportunities and constraints relevant to program planning.
Planning committee members must commit to meeting regularly
throughout the planning period and during the subsequent implementation
of the program to exchange information and to consider and decide
on specific actions.
The dedication of committee members will be strengthened if
support staff services are available to the planning group.
Dedicated staffing can help the committee coordinate its activities,
develop agendas, keep a record of committee proceedings, gather
the data necessary for planning the program and monitoring implementation,
help develop specific proposals, and assist in ongoing analysis
and administrative support.
How is the planning group staffed? There are at least three
possible approaches:
A staff-level workgroup can be formed, bringing together
senior staff members from the court and other agencies represented
on the planning committee.
If the jurisdiction has a planning commission or criminal
justice coordinating council, this body can assign staff to the
planning committee. Typically, members of these bodies are also
in the drug court planning committee and will already know about
many of the involved agencies and issues.
If the court, prosecutor's office, or a treatment provider
consortium has initiated planning for the program, staff from
that organization could support the stakeholder planning committee.
Any of the three approaches, or a mix that includes elements
of some of them, may be appropriate for a jurisdiction that is
just beginning the planning process.
The relationship between the planning committee and the staff
will be unique in each jurisdiction, but there are some tasks
that every planning group must address. They include
Describing the substance abuse problem in the
jurisdiction and the nature and prevalence of substance abuse
among arrestees who are potential "targets" for treatment program
intervention
Identifying target populations and potential points
of intervention
Determining the case management and treatment services
that will be needed by target group members and locating
potential case management and treatment service providers
Addressing legal issues, including program eligibility
and acceptance criteria
Establishing the goals for the program, including
anticipated outcomes for defendants who participate in the program
and the expected systemic improvements
Ensuring that adequate management information and tracking
systems are in place to enable program monitoring and evaluation
Developing written agreements (Memoranda of Understanding) that reflect the interests of the stakeholders and their
commitments to the program.
In carrying out these tasks, some members of the planning
group will undoubtedly be more involved than others, because
their day-to-day operations will be more directly affected by
the plans that are developed. Trial court judges, treatment
providers, and staff from the court, the prosecutor's office,
the public defender's office, the pretrial services agency, the
case management agency, and the jail, all of which will be involved
in daily program operations, should be primary resources both
in initial planning and in developing the detailed program design
that will follow.
Both the policy-level leaders on the planning committee and
the staff members involved in planning need several types of
information about the jurisdiction to plan effectively. These
include information about
The potential target groups
The type and number of defendants appropriate for diversion
to treatment
A case management agency
Available treatment services
The legal framework including any legal constraints that
could affect program design and operation
Planners must be able to identify appropriate categories of
defendants to be targeted for treatment intervention. This involves
information about resources and political realities, as well
as arrestees' characteristics and treatment needs. Specific
questions to be addressed should include
How much pretrial jail space is currently occupied
by persons who have substance abuse problems, but who do not
have a history of committing violent or predatory offenses?
Is jail-based treatment available for pretrial defendants? If
not, would it be feasible to start a jail-based program?
To what extent do defendants released before trial have substance
abuse problems? What is the frequency distribution by offense
category?
What characteristics of pretrial defendants would be considered
positive indicators for participation in a pretrial substance
abuse treatment program? What is the distribution by custody
status and offense category? How many defendants fall into these
categories in the course of a year?
What prior criminal history or other defendant characteristics
do key stakeholders view as preemptively excluding a defendant
from program participation?
Of the defendants who have substance abuse problems and who
might be considered for participation in a pretrial substance
abuse treatment program
What is the distribution of the substance abuse problems
(including types of substances abused and levels of severity
of abuse)?
What is the frequency and severity of other health problems
such as TB, hepatitis, human immunodeficiency virus/acquired
immunodeficiency syndrome, and other sexually transmitted diseases?
What are the demographics that could affect program design
(such as age, gender, ethnicity, geographic location in the jurisdiction,
employment status/earning capacity, housing, and family situation)?
Possible sources of quantitative and qualitative data to
help answer these questions include
Police departments
Sheriff's office/jail administrator
Pretrial services agency
Arrestee interviews
Court records
Observation/breath and urine testing of arrestees
Treatment and public health agencies
Community anti-drug coalitions
Single State substance abuse agency databases
TASC or other case management agencies
Local college and university researchers
Other criminal justice system practitioners, prosecutors,
defense lawyers, judges, probation department personnel.
Drug court planners need to know about the treatment resources
(including detoxification facilities) that currently exist in
the community, the services that are provided to specific types
of clients, and the gaps that exist in provision of services.
Planning committee members familiar with the community's treatment
system can help with this inventory, as can the office of the
State Alcohol and Drug Abuse Director. Both public and private
providers should be included in information-gathering efforts,
and the inventory should cover ancillary services that, even
though they may not be provided directly by a substance abuse
treatment professional, are important for addressing client needs.
The planning committee can poll the treatment community by sending
a questionnaire to all community providers asking, among other
things, what type of services they provide and how willing they
are to work with clients in new ways. Responses to the questionnaire
help determine interest as well as a compile an inventory of
providers.
The committee should clearly identify the size, philosophy,
and special characteristics of every existing substance abuse
treatment program in the jurisdiction. Some treatment providers
may already have specific services in place that would provide
a good match for potential target populations drawn from the
pool of pretrial defendants. For example, special programs may
already exist for women with substance abuse problems.
From a political or criminal justice viewpoint, it is possible
that the public health activities in which some treatment providers
participate could exclude them from participation in a pretrial
drug treatment program. For example, some providers might espouse
or operate needle exchange programs that could generate negative
publicity or strong community objections. While no hard and
fast rules for inclusion or exclusion exist, the planning committee
must know the operating philosophies and treatment modalities
of each treatment provider in order to anticipate problems.
In addition to developing descriptions of each substance abuse
treatment provider's programs and philosophies, the planning
committee should also inventory the extent to which other services
commonly needed for effective substance abuse treatment are available.
Research and clinical experience have shown that treatment is
most effective when coupled with other interventions that address
the full range of client needs. The availability of such ancillary
services enables the client to benefit more fully from treatment.
Substance abuse treatment clients are likely to have needs
and deficits in one or more of the following areas:
Education
Literacy skills
Life skills (such as parenting)
Physical and mental health
Housing
Vocational training
Employment
Child care
Specific cultural/gender needs
Legal problems (for example, eviction from housing or suspension
or revocation of a driver's license)
Transportation
Domestic violence.
In conducting an inventory of programs and services that can
supplement the needs of clients in these areas, the planning
committee can obtain assistance from substance abuse treatment
providers. Treatment providers are increasingly sensitive to
the need for these services and can usually provide lists of
available community resources. Members of the planning committee
who are affiliated with educational organizations and social
services agencies can also help identify these resources.
In the initial planning stages, there are three types of legal
issues about which planners need information:
To what extent, and in what ways, do existing laws,
regulations, and authoritative court decisions either constrain
or facilitate program design? For example, is there existing
legal authority, either in statute or in court rule, for judges
to refer defendants to a treatment program or to make urine testing
and participation in a substance abuse treatment program conditions
of pretrial release? Conversely, are there any legal prohibitions
against such judicial orders?
What laws and regulations may affect treatment providers'
capacity to treat pretrial defendants and to inform the court
and other justice system agencies about a client's progress (or
lack of progress) in treatment?
What laws and regulations may affect financing for the
program, including laws governing state and local budget processes,
federal grant funding, and reimbursement of treatment costs?
Developing an understanding of the legal framework will give
planners critical information about specific program design issues.
Several of the key legal issues that must be addressed in the
planning, program design, and program implementation processes
are discussed in Chapter 8 of this TIP.
Substance abuse treatment costs money. Reorganization of
the operating procedures of courts and other criminal justice
agencies to link pretrial processing with substance abuse treatment
is also likely to lead to additional costs. Examples of new
resources that may be needed include additional staff (to perform
functions not previously performed) and new computer equipment
to produce the information needed for case decision-making, program
monitoring, and evaluation.
The planning committee must have reliable information about
all of the costs to be incurred in implementing the program.
Optimally, the committee will have information on costs at different
levels of operation, from the time of an initial pilot to full-scale
operation. The committee should examine what sources of funding
are available, both for initial program operations and for ongoing
operations if the program proves successful. The committee should
also seek to identify the benefits of treatment, both to the
community and to the defendant. If possible, estimates of the
economic value of these benefits should be developed. Chapter
7 of this TIP discusses cost and financing issues in more
detail.
Once the planning committee has developed basic information
about the pool of eligible defendants and the treatment resources
available, decisions can be made about what categories of defendants
will comprise the target population for the program.
The size and makeup of the pool of potentially eligible defendants,
program costs, politics, and community standards and values are
among the factors that must be considered in deciding on a target
population.
Drug courts have varied considerably in their choice of target
groups. Although some handle only drug possession cases, some
accept defendants charged of a much wider range of offenses (usually
nonviolent) when the criminal behavior appears to be driven by
a substance abuse problem.
Generally, drug courts have excluded defendants charged with
sale or trafficking of drugs unless they played a minor role
in distribution and an underlying addiction is clearly driving
their participation in drug selling. The Superior Court Drug
Intervention Project in Washington, D.C., is one of the exceptions:
Any felony drug defendant on pretrial release is eligible to
participate, regardless of conviction record. (Violent felony
defendants, of course, would normally be in detention and would
not be in the eligible pool.) The drug court in Portland, Oregon,
also accepts defendants with extensive criminal records, including
violent offenders, but excludes those charged with drug sales
or trafficking. (Note, however, that federal funds are not used
for interventions with violent offenders in accord with federal
policy.)
Decisions about target group composition will be based in
part on what kinds of cases are acceptable from a political standpoint
and in part on the needs of the potential target population and
the availability of treatment resources. With information about
the size and makeup of the potentially eligible groups of defendants,
their treatment needs, and existing treatment resources, the
planning committee can project the size of the program and the
characteristics of the potential participants. Such a projection
will help the committee assess the range of needed services and
develop criteria for participant selection and treatment services.
If the target population is clearly too large or too small,
further refinements in the definition of the target group will
be required.
Target populations will vary depending on the stages in the
process at which the treatment intervention is sought. In general,
the earlier in the process the intervention is made, the stronger
the rationale for targeting defendants whose current charges
and prior records indicate no history of violent offenses or
significant drug trafficking. The more serious the current offense
and prior record, the greater the likelihood that pretrial and
case management staff will want additional information about
the defendant's criminal activity and substance abuse. While
these defendants may not be automatically excluded from a pretrial
drug treatment program, it may be appropriate to ensure that
the treatment take place in a secure setting (possibly including
jail) or to set conditions that include close supervision while
the defendant is on pretrial release.
It is pointless to target a specific population for a drug
court program if appropriate treatment resources are not available
or cannot be developed. The planning committee should carefully
consider the resources of the substance abuse treatment system
in the community and work closely with the community to design
a set of realistic treatment options.
The planning committee's inventory of treatment providers
and ancillary services, coupled with an analysis of the target
group's treatment needs and information about treatment costs,
should provide the basic information necessary to select a primary
treatment provider or a network of providers. Sometimes, no
existing program in the community will meet the needs of the
target population. Under these circumstances, it may be necessary
to negotiate with existing providers to modify their services
or create new ones. Conceivably, it may even be necessary to
ask treatment providers outside the locality to expand their
services.
Initial agreements, in the form of a Memorandum of Understanding
(MOU), is another critical part of the planning process. The
MOU should set forth the goals of the program and should include
commitments from all the key stakeholders and planning committee
members. The memorandum is contractual in nature and should
spell out, to the extent possible, the composition of the target
group and the anticipated contributions and responsibilities
of each stakeholder that is a party to it.
Development of the MOU is a key transition point from initial
planning stage to actual program design. While the contents
of a MOU will vary from one jurisdiction to another, essential
elements of it should include at least the following:
A description of program goals
A description of the target group
A description of program services to be provided, and how
and by whom they will be provided, including
Screening
Assessment
Detoxification
Case management
Substance abuse treatment
Ancillary services.
A description of program organization and management, including
the identity of individuals who will have primary responsibility
for program operations within the justice, case management, and
treatment systems
A description of the management information system reports
that will be available to support program operations, and the
provisions for cross-system exchange of information
A summary of key measures of program performance to be used
for monitoring and evaluation, with sources of relevant data
indicated
A budget showing anticipated expenses and sources of revenue
for all program components
Approvals by the key stakeholders, indicating their commitment
to the plan developed thus far
A description of the processes to be followed in program
review and evaluation and in amending the MOU as necessary.
Site Map
Help
Account
Cart
Home
