Update on TAD Evaluation · Milwaukee County Pre-Trial Diversion Annual capacity of 200-300 pre-charging diversion or deferred prosecution of those with a substance abuse and/or co-occurring

Update on TAD EvaluationWhat Have We Learned About TAD Drug Treatment Courts?

Presented at the Annual Meeting of theWisconsin Association of Treatment Court Professionals

Wisconsin Rapids, WIApril 2011

University of Wisconsin Population Health Institute (PHI)Kit R. Van Stelle, Researcher/Co-Principal Investigator

Treatment Alternatives and Diversion Program

TAD Data Thru December 31, 2010 2

Introduction to TAD grant programDescription of TAD drug treatment court projectsDescription of treatment court intermediate outcomesUtilization of evidence-based practices (EBPs) forsubstance abuse treatmentRecidivismStrengths of TAD drug treatment courtsLooking ahead…

TAD Evaluation Presentation Overview

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In 2005, Wisconsin Act 25 (SECTION 90m. 16.964) authorized the WI Office of Justice Assistance to administer “grants to counties to enable them to establish and operate programs, including suspended and deferred prosecution programs and programs based on principles of restorative justice, that provide alternatives to prosecution and incarceration for criminal offenders who abuse alcohol or other drugs.”

Overview of Act 25 TAD Grant Program

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These programs are designed to target non-violent offenders where a violent offender is defined as “a person to whom one of the following applies”:

1. The person has been charged with or convicted of an offense in a pending case and, during the course of the offense, the person carried, possessed, or used a dangerous weapon, the person used force against another person, or a person died or suffered serious bodily harm. 2. The person has one or more prior convictions for a felony involving the use or attempted use of force against another person with the intent to cause death or serious bodily harm. (Section 90m. 16.964 (12)).

TAD Target Population

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Seven Wisconsin sites were funded beginning in 2007

Four drug treatment courts

Three diversion projects

Overview of TAD Projects

TAD Project Sites

TAD Treatment Court Sites

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Project Model Target Population

Burnett County(w/St. Croix Tribe)

Drug Court Annual capacity of 8-10

offenders who are drug-motivated, need long-term treatment, or OWI 4th+

Washburn County Drug Court Annual capacity of 8-10

offenders who are drug-motivated, need long-term treatment, or OWI 4th+

Rock County Drug CourtAnnual capacity of 110

offenders charged with drug-related offenses

Wood County Drug CourtAnnual capacity of 40-50

medium to high-risk offenders with significant drug dependency issues

Dane County Multiple ApproachesAnnual capacity of 20-25

1. pre-trial diversion of low/mod risk2. Drug Court3. Treatment Alternatives Program

Milwaukee County Pre-Trial DiversionAnnual capacity of 200-300

pre-charging diversion or deferred prosecution of those with a substance abuse and/or co-occurring mental health problem

Washington County OWI Diversion and ATRAnnual capacity of 40

second or third offense OWI, and alternative to revocation (ATR)

Overview of TAD Projects


TAD Evaluation Components

Database to document characteristics of project admissions, services, and discharges; Each site uploads data monthly to PHI and receives feedbackDocumentation of project implementation through review of project reports, review of annual site reapplications, annual meetings with site staff, ongoing communication with sites, and survey of evidence-based treatment practicesCriminal justice outcomes of TAD participants

CCAP: new charges and convictionsDOC: admission to state prison


TAD Adult Drug Treatment Court Participant-Level Data

Four complete years of program admissionsTotals to date for the four TAD drug court sites since program start in 2007

Total Admissions = 408Total Completions/Graduates = 176Total Terminations/Drop-outs = 146Total Discharges = 322Overall Graduation Rate = 55% (176/322)

Exceeds the national average of 50% (Sanders et. al, 2006)


Burnett Washburn Rock Wood Overall

Total # Admissions 33 24 277 74 408

# Completions 20 13 112 31 176

# Terminations 7 5 112 22 146

Completion Rate *(percent of all discharges excluding administrative terminations)

74% 72% 51% 58% 55%

• Rock TAD had four administrative terminations which were excluded from completion rate calculations. • Based on four complete years of participant data.

Number Admitted, Completed, and Terminated By TAD Drug Court Sites (2007-2010)

TAD Drug Court Average Length of Stay



Total # Discharges 26 18 224 53 321

Average Days in Program For:

Completions 475 532 310 494 377

Terminations 320 319 132 489 201

• Based on four complete years of participant data.


Case Outcome For TAD Drug Court Discharges By Program Completion Status

Complete/Graduate Termination Overall

(N=176) (N=145) (N=321)

Dismissed/Completed ATR 54% 1% 31%

Reduced Charge 42 1 23

Stayed 1 0 1

Charged/Did Not Complete ATR/ Revoked/Revocation Pending

1 92 41

Other/Unknown 2 6 4* Statistically significant difference between groups at p<.05. Based on four complete years of participant data.

Offenders who complete TAD drug courts are significantly more likely than terminations to have their charges dismissed, their charges reduced, or to complete alternative to revocation (ATR) requirements


Incarceration Averted: TAD Drug Court Discharges


(N=26) (N=18) (N=224) (N=53) (N= 321)

# who avoided anydays of incarceration 17 12 92 30 151

Days Averted (reported by sites)

Total to Date 6,306 6,465 23,253 7,692 43,716

Average* 371 539 253 256 290

Range 122-823 90-1,825 20-1,440 40-1,095 20-1,825* Statistically significant difference among sites at p<.05. Based on four complete years of participant data.

Total incarceration days averted for treatment court sites = 43,716


Incarceration Averted: Graduates and Terminations

An average of 244 incarceration days were averted for each TAD drug court graduate, with an average of five incarceration days averted for each drug court termination

*cases with zero days averted included in average


Evidence-Based Practices (EBPs) for Substance Abuse Treatment

TAD Advisory Committee recommended that the evaluation assess the extent to which the TAD sites were incorporating treatment EBPsPHI developed survey based on a review of the research literature


EBPs Used By TAD Drug Treatment Courts

Evidence-Based Practices for Substance Abuse Treatment

TAD?

Cognitive behavioral treatment

Motivational interviewing Motivational interviewing

Relapse prevention (cognitive behavioral)

Social skills training

Valid criminal risk assessment instrument

Trauma-informed or trauma-specific treatment +

= all sites + = 2 of 4 sites


Treatment Curriculae Used by TAD Drug Courts

Target or Focus Curriculae Used # of Sites

Approaches Cognitive Behavioral TherapyDialectical Behavioral TherapyRational Emotive ThinkingMotivational Interviewing

4 of 42 of 41 of 43 of 4

Treatment models MATRIX modelStages of Change

2 of 42 of 4

Correctional/Criminal Thinking

Cognitive Interventions Program (CGIP) - Criminal thinking

Drug Court Workbook (Change Co)

1 of 4

1 of 4Trauma Seeking Safety 2 of 4

Other Anger ManagementFinancial Management

1 of 41 of 4


Use of Selected Drug Court Practices Shown to be Related to Positive Cost Outcomes (Carey, Finigan, and Pukstas, 2008)

Practices Identified in Carey et. al., 2008 Used by All TAD Treatment Courts1 The treatment representative is expected to attend all drug court sessions. 2 The prosecution is expected to attend all drug court team meetings and all drug court sessions. 3 The defense attorney is expected to attend drug court team meetings. 4 The drug court allows non-drug charges.5 The drug court maintains a caseload of less than 150 clients. 6 The drug court program is expected to take one year or more to complete (except Rock County TAD).7 Drug court has guidelines on the frequency of group treatment sessions that a participant must receive. 8 Drug court has guidelines on the frequency of individual treatment that a participant must receive. 9 In the first phase of drug court, drug tests are collected at least two times per week. 10 Drug court staff generally receives drug test results within 48 hours.11 The drug court requires participants to have more than 90 days “clean” before graduation.12 The judge is assigned to drug court for a term greater than two years (or indefinitely). 13 Participants appear before the judge at least once every two weeks in the first phase of drug court.14 In the final phase of drug court, clients appear before the judge in court at least once/month. 15 The drug court maintains data that are critical to monitoring and evaluation in an electronic database. 16 The drug court collects program statistics and uses them to modify drug court operations.17 The drug court uses the results of program evaluations to modify drug court operations.18 Team members received training in preparation for the implementation of the drug court. 19 All members of the drug court team are provided with training. 20 The drug court team includes a representative from law enforcement (not including probation).


Use of Criminal Risk/Need Assessment Results by TAD Drug Courts

BurnettWash-burn Rock Wood

Judges have access to relevant risk/needsassessment results for sentencing

X X X

Assessment results used to determine…Suitability for diversion X XTreatment plan/intensity X X X XConditions of correctional supervision X X X XAppropriate sanctions to be imposed for violation of supervision

X X X X

All of the sites use a criminal risk/need assessment tool, but use of the assessment results varies by site


Court EBPs: Sentencing PracticesEBPs IN LOCAL JUDICIAL SYSTEM Burnett Washburn Rock Wood

The judges act as a change agent to reinforce voluntary compliance, not to enforce compliance

X X X X

The judges interact with offenders in a way that maximizes positive effects and minimizes negative effects of court process

X X X X

Judges hold offenders accountable for behavior and use controls

X X X X

Positive reinforcement emphasized rather thansanctions

X X X X

Programs are successfully integrated with other sentencing requirements to achieve the multiple sentencing objectives of recidivism reduction,punishment, and offender restraint

X X X X


Challenges Related To Working With Treatment Providers (from EBP survey)

Differences in intensity and quality of treatment among multiple providersCoordinating with a large pool of diverse treatment providersCommunication issues between treatment providers and the justice system/courts in some sites – “…some treatment providers do not like to take the extra time to communicate more frequently with us.”Increase in offenders addicted to heroin has created challenges in addressing specific treatment needs

Recidivism Results

New offenses and convictions

Updated CCAP data is currently being analyzedPreliminary 2011 results presented here

New prison incarceration

Updated DOC data presented here for drug treatment courts onlyPreliminary until report is completed


New Offense and Conviction Results

Preliminary 2011 results on new charges for only TAD treatment court sites presented here for the first timeUpdated results will be available in Fall 2011 – currently conducting analysesThe 2009 report on TAD outcomes for all seven sites is currently available online at: http://uwphi.pophealth.wisc.edu/about/staff/vanstellek.htm


Preliminary 2011 Recidivism Results: Percent With New Charge or Conviction After TAD Admission


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55

37

21

50

34

0

10

20

30

40

50

60

70

80

90

Per

cent

New Charge New Conviction

Graduates Terminations Overall

TAD treatment court graduates are less likely to be charged with or convicted of a new offense after admission than offenders who do not complete TAD

Data on Wisconsin State Prison incarceration was obtained from the Department of Corrections in February 2011 for all TAD participants discharged between 2007-2010


Preliminary 2011 Recidivism Results: State Prison Incarceration

Between 2007-2010, 14% of TAD drug court participants were admitted to Wisconsin state prison after discharge from TAD treatment courts


Preliminary 2011 Recidivism Results: Wisconsin State Prison Incarceration

Overall Admission to State Prison For TAD Drug Court Discharges

Complete/Graduate Termination Overall

N = 175 N = 143 N = 318

Admitted to State Prison After TAD Discharge 21%

4531%

4714% *

Admitted to Prison…

Within ONE YEAR After TAD Discharge 00%

3021%

309%

Within TWO YEARS After TAD Discharge 21%

128%

144%

Within THREE YEARS After TAD Discharge 00 %

32%

31%

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TAD Drug Treatment Courts Strengths and Challenges: What Have We Learned?

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A. TAD treatment courts successfully provide alternatives to prosecution and incarceration for non-violent offenders

B. TAD treatment courts integrate a variety of evidence-based practices for substance abuse treatment into their service delivery models and utilize criminal risk/needs assessment

C. A total of 43,716 incarceration days were averted by TAD treatment courts during the first four years of TAD

D. Offenders who complete TAD treatment courts are less likely to be charged with new criminal offenses than those who do not complete (based on preliminary 2011 data)

E. Offenders who complete TAD treatment courts are less likely to be admitted to state prison than those who do not complete (based on preliminary 2011 data)

Strengths of TAD Drug Treatment Courts

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F. Enhanced collaboration due to the implementation of the TAD program

Collaboration among OJA, DOC, DHS, and the UW to implement and evaluateCollaboration among TAD project sitesCollaboration within county service systemsCollaboration within TAD teams

Strengths of TAD Drug Treatment Courts (continued)

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G. Increased treatment capacity

H. Increased treatment quality and offender monitoring

I. Increased speed of treatment entry for offenders

J. Participation positively impacts case disposition

K. Positive impacts on individual participants

L. TAD projects continue to modify and improve their service models

M. Local community support for TAD

Strengths of TAD Drug Treatment Courts (continued)

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A. Definition of “violent offender” for project eligibility purposes

B. Creating success for alternative to revocation (ATR) admissions

C. Impact of current economy on offender employment

D. Mandatory jail time and suspension of driver’s licenses for OWI offenders

E. Negative impact of uncertainty regarding annual project funding

Challenges for TAD Treatment Courts

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F. Variation in intensity/quality of drug treatment among multiple providers

G. Coordinating services with diverse treatment providersH. Communication with treatment providers in some sites –

“…some treatment providers do not like to take the extra time to communicate more frequently with us.”

I. Increase in offenders addicted to heroin has created challenges in addressing specific treatment needs

J. Staff turnover: Treatment court staff, judges, and/or DAs K. Lack of resources for ongoing staff trainingL. Gender-specific staffing for observing urinalysis testingM. Lack of offender transportation for treatment

participation, drug testing, etc.

Challenges for TAD Treatment Courts (continued)


2011 TAD Outcome Evaluation Report

Analyses will include four complete years of program admission and outcomes data (1/1/2007-12/31/2010)

Have received criminal justice outcomes data from CCAP and DOC to assess recidivism for TAD participants

PHI will be working collaboratively with OJA to prepare the final report to the legislature due in Fall 2011 that will include evaluation results and recommendations, as well as recommendations of the TAD Advisory Committee


Looking Ahead…The structure of TAD is similar to that required for a statewide Community Corrections Act; helping to create the foundationDA John Chisholm proposed a multi-pronged approach to reduce crime and incarceration through local incentives (February 2011, Marquette Law School)

Evidence-based decision-making throughout justice systemAllow judges to impose determinate or indeterminate sentences“Community Justice Reinvestment Act”

“It directly ties the cost of incarceration to local decision makers and rewards those jurisdictions that reduce corrections costs while effectively promoting local safety.”“This proposal suggests that for participating counties would receive $15,000 for every fewer inmate sent to prison.”“The CJRA requires a neutral administrator to be the fiscal agent…and track accomplishments and distribute funds to participating counties.”The administrator would need to “understand each county’s issues and proposed solutions, and negotiate unique contracts based upon each county’s performance.”

http://law.marquette.edu/s3/site/images/events/chisholm-speech.pdf

http://law.marquette.edu/s3/site/images/events/chisholm-speech.pdf


Looking Ahead…Future TAD funding – language in current WI state budget

“Treatment Alternatives and Diversion Program Match: The governor recommends requiring all recipients of a treatment alternatives and diversion grant awarded on or after January 1, 2012 to provide a 25 percent contribution to the grant award. The savings generated must be used to fund new counties interested in participating in a diversion program to divert nonviolent offenders with an alcohol or other drug problem from the traditional criminal justice system.”

February 2011 Federal Funding RequestsSAMHSA Request: $43.8 million for Treatment Drug CourtsOffice of Justice Programs Request: $57.0 million for Drug, Mental Health, and Problem Solving Courts


Looking Ahead…“The challenge now is to extend the reach of adult drug courts without diluting the intervention below effective levels. Any program can be made cheaper simply by lowering the dosage or by providing fewer services to more participants. The difficult task is to maintain effectiveness in the process.”

“Rather than drop essential components of the drug court model, research indicates that the better course of action is to standardize the best practices of drug courts so they can be reliably implemented by a larger number of programs.”

Marlow, Doug (2010). Research Update on Adult Drug Courts. National Association of Drug Court Professionals. December 2010.


Thank you!!

Contact Kit R. Van Stelle at [email protected]

with questions or comments

mailto:[email protected]

Documents

Update on TAD Evaluation · Milwaukee County Pre-Trial Diversion Annual capacity of 200-300 pre-charging diversion or deferred prosecution of those with a substance abuse and/or co-occurring