Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
Treatment Improvement Protocol (TIP) Series 23

Personnel Selection

Perhaps the most critical decisions in program implementation are those concerning personnel. Often, many of the decisions about personnel will have been made before the implementation stage, and some key members of the program team will have been involved in the initial planning and program design phases. If so, they will be familiar with the program's goals and planned operating procedures and will have established working relationships with others involved in the program. If not, or if only some members of the program team have been involved in planning and design, then selection of additional members of the team is extremely important for implementation.

Selection of personnel for the program team is complicated by the fact that team members are drawn from different institutions and agencies. Selection of team members is generally not done by a single "program director" but rather by the leaders of the institutions and agencies involved in the program. For example, the judge or judges are often designated by the chief judge of the court; the prosecutor or a senior deputy will select the assistant prosecutor(s) who will work with the team; and the public defender will select the assistant public defender.

It is highly desirable to begin program implementation with staff who, regardless of organizational affiliation, are convinced of the need for and effectiveness of substance abuse treatment for criminal justice populations. When key stakeholders such as the chief judge of the court, the prosecutor, and the public defender have been involved in the planning and design activities, the likelihood of having committed staff members assigned to the program is greatly enhanced.

As noted in Chapter 4, a typical interdisciplinary team includes a judge, prosecutor, defense attorney, screening officer, court clerk or coordinator, assessment officer, case manager, and treatment program liaison officer. It is important to recognize that, although many of the functions performed by these individuals will be new, the positions are not necessarily additions to the existing judicial and agency staff personnel rosters. Rather, because the new program involves cases that would be handled by the court in any event, judges and staff for the program can often be found by reorganizing workflow and revising personnel assignments.

Facilities and Transportation

Optimally, the court will have facilities for assessment and treatment in close proximity to the court. In Little Rock, Arkansas, for example, a substance abuse assessment unit, public health provider, treatment program, and court are all located in one building. In Washington, D.C., where urine screening is a major part of the drug court program, the D.C. Pretrial Services Agency has drug-testing facilities in the courthouse.

When assessment, drug testing, and treatment facilities are not located in or near the courthouse, it is helpful to develop transportation links between the court and the treatment providers. This is especially important during the early stages of a defendant's participation in the program when the defendant may not yet be totally committed to treatment.

In Miami, the court has a van that transports participating defendants directly from court to the treatment facility following the court proceeding at which the defendant was admitted to the program.

Education and Training

One of the clear lessons learned from attempts to introduce major innovations in American courts is that a significant amount of time and energy must be invested in education and training both before and during program implementation. The formal integration of substance abuse treatment and pretrial case processing on a large scale is a relatively new concept in the United States. Those working in a collaborative program involving the justice system and the treatment community must be educated about the underlying concepts and, in some instances, trained to perform new functions.

Education about a program involving the integration of substance abuse treatment and pretrial case processing should focus on

• The purpose of criminal case processing and substance abuse treatment
• The concept of integration of substance abuse treatment and pretrial case processing
• The reasons why the program is being undertaken
• The goals and potential benefits of the program
• The types of cases that will be "targeted" for admission to the program and the reasons for focusing on these case categories
• How the program works operationally and how this differs from current practices, with particular attention to
  • Immediacy of action, rapid screening of cases, and action focused on entry into the program shortly after arrest
  • Ongoing case supervision by the judge focused on the defendant's progress in treatment
  • Open and timely exchange of information concerning individual cases among the court, other justice system agencies, the treatment provider(s), and public health agencies
  • Policies toward defendant "relapses" that incorporate graduated sanctions and that rewards for progress in refraining from substance abuse.

Potential audiences for educational efforts focused on program implementation include

• Justice system, treatment community, and public health system administrators and supervisors
• Criminal justice practitioners who handle cases involving defendants potentially eligible for the program, including
  • Judges
  • Prosecutors
  • Defense lawyers
  • Courtroom clerks/program coordinators
  • Pretrial services and Treatment Alternatives to Street Crime (TASC) program staff members
  • Probation and community corrections department staff members
  • Law enforcement personnel.
• Substance abuse treatment staff members at all levels
• Bar and business leaders
• Legislative and executive branch officials at the municipal, county, and State levels
• Officials and senior staff members in agencies that can provide needed ancillary services (such as hospitals, other health care service providers, schools, and employment services)
• The media
• Community groups interested in criminal justice and substance abuse issues.

The approaches to educating members of these groups will vary from jurisdiction to jurisdiction, and by audience. To a significant extent, education about the program will take place during the planning and program design stages, as members of the planning group become familiar with basic concepts and with information on similar programs in other jurisdictions. Once the detailed program design has been developed and before full-scale implementation, concentrated efforts should be devoted to education directed at the audiences listed above and any others the planning team identifies as relevant to the program's operation. Job-focused training should be provided for the practitioners who will be involved in program operations so that they can learn how to perform specific functions such as screening, docket management, and cross-system liaison and coordination. Such training programs need not be lengthy but should be thorough. Often, a solid program overview, including a question-and-answer period, can be provided in less than 2 hours.

It is helpful to have a resource book, a loose-leaf compilation of materials about the program. Its contents could include

• A written description of the program, including a discussion of how it differs from traditional practices, the different "phases," and the potential benefits to participants and the community
• A statement of the program goals
• Copies of relevant legislation, regulations, or guidelines
• The program eligibility criteria
• A summary of program requirements (a list of the conditions a participant is expected to meet).

Also helpful for education and training is an operations manual describing the procedures to be used for screening, dissemination of information, informing the defendant about his or her options and legal rights, conducting assessments, supervising defendants' progress in treatment, imposing sanctions or rewards when appropriate, terminating defendants from the program when necessary, and acknowledging completion of the program by successful participants.

Finally, a participant handbook should be provided that answers questions the defendant may have about the program and contains

• A summary of the program evaluation plan
• A list of members of the project planning committee
• A list of the names, addresses and telephone and fax numbers of organizations and individuals that are involved in program operations or program oversight
• Copies of press reports about the program and about similar programs operating in other jurisdictions.

Some of the materials should be widely distributed to judges, lawyers, court staff members, treatment providers, and others involved in program operations. This can be done in the context of a special Implementation Workshops held prior to full-scale implementation.

Education and training for implementation should be treated as important ongoing processes, not one-time events, for at least two reasons. First, staff turnover in many courts, criminal justice agencies, and substance abuse treatment agencies is high. In most jurisdictions, it will be only a short time before some positions crucial for program operations are filled by individuals who did not participate in pre-implementation education and training. The newcomers will need to know why the program has been adopted, and how the program works.

Second, it is likely that changes will be made in program scope and operations in light of experience gained in the implementation process and on the basis of information acquired through monitoring and evaluation. Everyone involved in or affected by the operation of the program needs to know about such changes, the reasons for them, and how they affect individual work responsibilities.

Startup Operations

Making the program work as intended often begins with a pilot program, during which operational problems can be identified and resolved before full-scale implementation is under way. Among the problems that jurisdictions with functioning drug courts have identified during the startup period are

• Inadequate funding
• Inadequate range of substance abuse treatment services
• Delays in identification or referral of potential program participants
• Need for support and assistance with specific client problems (such as housing, nutrition, medical, and legal services).

This introductory period gives program leaders and managers an opportunity to become familiar with each other's working styles and with a range of clients and their problems. It also enables managers to

• Develop operational procedures
• Locate and eliminate case processing bottlenecks
• Iron out communications problems
• Identify unanticipated management information needs
• Locate and arrange for needed services not initially planned for
• Refine plans for program evaluation.

Because defendants are accepted into a program gradually, there will be a period of time at the outset when the program is operating at less than full capacity. It is only after the program has been in operation for several months (or even as long as a year) and a "full" caseload has been developed that the dimensions of the docket management problems in the court will become apparent. Ultimately, the judge or judges handling this caseload will be performing two key functions: (1) deciding on program admissions for newly arrested defendants who are eligible to participate; and (2) monitoring the treatment progress and compliance with program conditions of defendants already admitted to the program.

As time passes and the number of active participants increases, supervision of the caseload will be increasingly time-consuming. The startup period provides an opportunity to develop approaches to supervision of defendants in a range of cases and can be used to develop management strategies that will work effectively as the caseload increases.

For many of the key players, this will be a time in which they will encounter new concepts and new terminology, will begin developing working relationships, will start working with new procedures and forms, and will find themselves in unfamiliar professional roles. Almost inevitably, there will be some problems, confusion, and miscommunication during this period, and it will take time to develop smooth and efficient operations. Strong and committed leadership is especially important during this period, and program leaders may need to remind stakeholders (as well as members of the program team) that such problems are to be expected during the startup of any complex multi-organization collaborative effort.

Checking Up on the Program

As the program begins to move from the startup period to full implementation, it will be important to review the initial plans and program design. It is likely that new information acquired during the startup period will point to the need for some changes in program design. If so, key stakeholders and policymakers (as well as members of the program team) should be informed about what has been learned and should be involved in decisions regarding plans for full implementation.

Optimally, this sort of review will be done periodically after full implementation is under way. It is essentially a revisiting of initial policy decisions on the key areas of ongoing operations, case management, and program management based on new information acquired through close monitoring. The following is a checklist of topical areas to be reviewed, with some illustrative questions.

Ongoing Operations

Case Management Checklist

Feedback Mechanisms and Program Adjustments

The checklists in the previous three sections can provide a useful tool for periodically reviewing program operations. Given the environment in which these programs exist, one in which laws and policies regarding substance abuse treatment and health care are rapidly changing and in which financial support for public institutions and programs is always under scrutiny, it is critical for program leaders and managers to seek and use information about program effectiveness. Evaluations are one source of such information, but evaluation reports are not always produced in time to help guide programs through mid-course adjustments and funding crises. Effective leaders and managers will constantly be asking practitioners, program participants, and policymakers for information and ideas about program performance, as well as reviewing management information reports to assess progress and identify problems. They develop both formal and informal feedback mechanisms and use the information, in consultation with staff, knowledgeable consultants, and policy oversight groups, to reshape program operations when necessary and to plan for the future.