Kate K. V. Lawson, MPADirector of Specialty Court Initiatives

Pima County Attorney’s Office

Right Off the Starting Block:Creating A New Problem Solving Court

Are You In The Right Session? Interested in starting a new

problem solving specialty court? Exploring changes to your existing

mental health or drug court? Looking to expand your court to

focus on co-occurring disorders? Want to learn more about the “10

Key Components” for effective drug courts?

Really into terrible jokes? Looking for the casino and ended

up at a conference? OMG I’m so confused I can’t even

right now

Survey

What field are you in?• Courts• Law Enforcement• Treatment• Probation• Others?

Do you currently have…• A MHC?• Drug Court?• Co-Occurring Court?

Do you follow any guidelines (like state recommendations) or best practice standards (like 10 Key Components)?

Introductions

• Director of Specialty Court Initiatives • Program Director of the Drug

Treatment Alternative to Prison (DTAP) program

• Public Policy • Experience in: problem solving courts

(MHCs especially), corrections, law enforcement

• Co-Facilitator of the Southern Arizona Crisis Intervention Team (CIT) training since 2009

• Did you hear about the two guys who stole a calendar?

Specialty Court Problem Solving CourtCo-Occurring Court

What terminology do you use?

Context

• Pima County has a lot of Specialty Courts!– Felony:

• Drug Treatment Alternative to Prison (DTAP)

• Drug Court • Mental Health Courts

– Misdemeanor:• Mental Health Courts• Homeless• Veterans

These courts have been a conduit to treatment that may have otherwise not have occurred, fostered

recovery, and created life transformations with

countless participants!

But what about if someone doesn’t fit neatly into one of

these boxes?

Active (Ongoing) Case Study

John Doe• Has been booked into the jail 42 times

in the last two years (#1 for county) – Appears to like being in custody

• Charges are typically shoplifting and trespassing (mostly misdemeanor*)

• Not believed to be mentally ill or have a significant substance use disorder (reports history of alcohol and drug use)

• Declines to enroll in AHCCCS, treatment, housing or other support programs

• Total cost to Tucson taxpayers in jail fees alone: $65,000

Solutions?• Does this person belong

in jail?• What specialty court

would you refer him to?• How would you

encourage him to change his behaviors?

• Current status

Why Co-Occuring or Problem-Solving Court?

• There are unique needs to individuals with primary diagnosis of substance use vs. mental health…

• …and certainly within populations like veterans or homeless

• But what about for everyone else, that doesn’t fall into one of these specialty court but still has complex needs that are not being addressed by the “traditional” criminal justice system?

• Addressing these issues:– Improves public safety– Saves taxpayer dollars– Meets the justice system tenant of

“rehabilitation” (and helps to break the cycle)

Big Picture

• Pima County is working to implement a regional Consolidated Misdemeanor Problem-Solving Court (aka CoMPaSs Court)

• Will address:– “Traditional” serious mental illness (SMI) cases– Co-occurring mental health and substance use

disorders, with complications that make them better suited for a therapeutic court

– The ¯\_(ツ)_/¯ cases where they just need HELP

How will Compass Court work?• Disclaimer: This is proposed/draft. Presented here is a

preliminary concept that must be vetted and approved by the impletmentation task force and court leaderhip.

• Estimated timeline: early 2019 for pilot implementation (depending on funding availability)

• Misdemeanor, will accept referrals from all participating limited jurisdiction courts in Pima County– Importance of consolidation: resolves multiple open cases,

economies of scale for resources, “one stop shopping” for treatment providers, experience of court team personnel

• Follow best practice standards, as applicable

What best practice standards are there?

Arizona Mental Health Court Standards

1. MHC teams must work collaboratively

– Multidisciplinary team 2. Pre-defined referral,

eligibility and assessment– Objective criteria

3. Standard program structure– Including phases, benchmarks

and standards for advancing4. Court Proceedings

– Review hearings– Compliance hearings– “Power of the black robe”– Consistency

5. Treatment– Individualized case plan

Arizona Mental Health Court Standards

6. Incentives & Sanctions– Consistent

consequences– Motivating behavior– Jail Sanctions– Termination

7. Confidentiality 8. Sustainability

Adult Drug Court Best Practice Standards(National Drug Court Institute)

1. Target population: high risk/high need population

– See RNR

2. Equity and Inclusion3. Judge is the key!!

– Training, longevity, time spent with participants, staffings

4. Incentives and Sanctions

Adult Drug Court Best Practice Standards(National Drug Court Institute)

5. Treatment integrated into court program

– Peer support, substance use, mental health, MAT

6. Wrap around services7. Drug testing8. Multidisciplinary team9. Caseload size10. Monitoring & evaluation

Risk-Needs-Responsivity (RNR)

Alternative tracks in specialty court based on risk and need

Risk: characteristics that make someone more likely to recidivate (i.e. younger age, early onset substance use, prior felony convictions.)

Need: clinical disorders or functional impairments that require treatment (includes mental illness, substance use disorders, homeless, jobless)

What overarching themes are we seeing here, regardless of drug or mental health court?

Best Practice Themes to Apply to Compass Court

• Multidisciplinary team• Incorporating

individualized treatment plans into court program

• Wrap around recovery services and support

• Equity and inclusion• Importance of the judge• Incentives and sanctions• Differentiated dockets

What might Differentiated Dockets look like?

• “High functioning” (job, housing, transportation)

• No or limited criminal history

• Needs help getting enrolled or re-engaged in treatment

Low

• Beginning to see problems in global functioning

• Moderate criminal history, with signs of escalation

• Significant mental health and/or substance use

Medium • Poor global functioning (homeless,

• Multiple open cases, frequent FTAs

• Significant mental health and/or substance use

High

Level of Intervention Low

• Avoid “overexposure” to the justice system

• Referral to services, enrollment in benefits

• Verification of enrollment or participation in treatment

• Stay out of trouble X months

Medium

• Compliance hearings (lower frequency)

• Coordination with treatment

• Individualized treatment plans

• Drug testing (for substance use disorders)

• Access to wrap around recovery resources and services

High

• More frequent compliance hearings

• Assistance with transportation

• Intensive case management and peer support

• Individualized treatment plan

• Drug testing (if needed)

• Wrap around recovery resources

How will we know which docket they belong?

How do we build this new court?

COMPASS Court

Action Plan

Buy In Funding Program Design Pilot

Funding

Options:Grant fundingRequest funds from

local governmentCourtsLooks for existing

resources, services and programs – avoid new spending as a last resort

• Diversify!!• “We don’t have money”

– Where are we spending money already, and can we redirect that?

• i.e. Jail– Be scrappy, make deals

Tips for Opening the Door

• Know your data!– Especially when there’s $ attached to it. How

many days did this population spend in jail? – Case studies, random sample evaluation, top

utilizers – whatever data you can access

• Know the politics and the community needs• Find your champion (Judges and Electeds)• Put it on paper

Questions?

THANK YOU!

Kate.Lawson@pcao.pima.gov