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Anatomy of a Successful TASC Pretrial Diversion Program:

The Maricopa County, Arizona Experience

Presented by:

Mark Saferite, Marrya Briggs, & Alicia Lindsay

TASC, Inc. 2011

What is Pretrial Diversion?

Alternative to prosecution/CJ dispositions Typical pretrial diversion mechanism: deferred prosecution Multiple Benefits 1. Court System 2. Community 3. Offenders

TASC, Inc. 2011

2010 National Drug Control Strategy

(Office of National Drug Control Policy) Stresses developing infrastructure to promote alternatives to incarceration when appropriate. Two of the key actions to accomplish this goal: 1. Enhance and promote diversion strategies 2. Promote TASC model of intensive case management

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National Association of Pretrial Services Agencies (NAPSA) 2010 "Promising Practices in Pretrial Diversion"

Maricopa County TASC Diversion named a model program with:

Operating Memorandum Of Understanding Tailored services and supervision In-house information systems configured to program specifications Established, validated clinical assessment tools Current program data maintained Independent program evaluation

TASC, Inc. 2011

Maricopa County TASC Adult Deferred Prosecution Program (TASC Diversion)

Longevity: self-sustaining program established in 1989 More than 26,000 successful completions Long term recidivism study validation

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Final rate of Survival VS Recidivism for four groups of Demand Reduction Participants (NIJ-ASU School of Justice Studies 56-72 Month Study)

Group #of Cases % survival 45% 48% % for who recidivate 54% 52% TASC eligible, 1,618 Did not enter, filed TASC ineligible, Filed TASC eligible, Failed program TASC eligible, Completed Program 1,389

514

57%

43%

1,096

78%

22%

TASC, Inc. 2011

TASC Diversion has 3 core elements fundamental to its success:

1. Intensive Case Management 2. Drug Testing 3. Substance Abuse Treatment

TASC, Inc. 2011

TASC/Maricopa County Adult Deferred Prosecution Program (Diversion)

Offered to individuals facing first time felony drug possession charge (s) Do not contest their guilt and would likely benefit from a community treatment program Clients who successfully complete Diversion avoid prosecution and criminal conviction Offered to people who qualify under established guidelines

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Maricopa County Criminal Justice Process and Diversion Entry

Police Incident (possible arrest) for Drug Possession and/or paraphernalia County Attorney's office reviews petition for Diversion pre-file eligibility County Attorney's office files Felony charge(s) against defendant

Diversion Eligible

Option Letter1 sent to pre-file offender making Diversion offer EDC2 Initial Appearance (pre-file and post-file cases)

Defendant arrested on Felony warrant for Drug Possession/ paraphernalia charge(s)

Justice Court Initial Appearance

Diversion Eligible

TASC/EDC Liaison assesses eligibility and provides program overview

Prosecution

Refuses TASC Diversion or fails to respond/appear PROGRAM PARTICIPATION (see Maricopa County/TASC Diversion Programs Participation Continuum Chart)

Offender schedules intake appointment

1

Two Option Letter from the County Attorney offering TASC Diversion or prosecution Early Disposition Court expediting drug possession cases.

2

TASC INTAKE

Maricopa County/TASC Diversion Programs Participation Continuum Chart

TASC INTAKE

POND /PODD /ONDF Diversion Program (1 - 2 yrs.)

1

2

3

Possession of Marijuana Diversion Program (3 - 6 mos.)

BEGIN PRE-SCREENING: 30-60 days Test 3x/ weekly until 6 consecutive, clean tests submitted urine

· Urinalysis - once per week until clean, then random once per month · Three hour Drug Education Seminar · Payment of Program Fees

· Urinalysis - once to twice per week · Assessment and Individual Tx Plan · Group Counseling (24 weeks) · 12-step participation · Three hour Drug Education Seminar · Monthly Contact w/case manager ·Payment of Program Fees (fee adjustment if applicable)

Program Compliance

Successful Completion Non-compliance: · Positive Urine Tests · Failure to Test · Failure to attend Counseling/ Seminar/12-step · Failure to make payments

1 2

Non-compliance: · Positive Urine Tests · Failure to Test · Failure to attend Seminar · Failure to make payments

County Attny. notified case dropped or charge(s) dismissed

Possession of Narcotic Drug Possession of Dangerous Drug 3 Obtaining Narcotic Drug by Fraud

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Felony Charges filed or reinstated

TASC/MARICOPA COUNTY ADULT DEFERRED PROSECUTION PROGRAM (DIVERSION) Required Program Components

Narcotic or dangerous drug possession charges: · · · · · Program Length Minimum of One Year Urinalysis/Drug Screening Drug Education Seminar Substance Abuse Counseling 12-Step Participation or other Self Enhancement.

· Monthly Case Management Contact · Payment of Program Fees and Maricopa County Attorney Drug Fund Assessment Fees

TASC, Inc. 2011

TASC/MARICOPA COUNTY ADULT DEFERRED PROSECUTION PROGRAM (DIVERSION) Required Program Components

Marijuana possession charges: · Program Length 6 months with option for early release after 90 days · Urinalysis/Drug Screening · Drug Education Seminar · Payment of Program Fees and Maricopa County Attorney Drug Fund Assessment Fees · Additional fees for counseling if client continues to test positive for marijuana or any other substance

TASC, Inc. 2011

Diversion vs. Probation

Diversion

Probation (Common Terms)

·Criminal Conviction ·Statutory Fines ranging from $750$2000 + 80% surcharge ·Terms ranging from 1-4 years ·Monthly supervision fees ·Installment Payment Fee ·Substance Abuse Treatment Costs ·Community Service ·UA Testing Costs ·Attorney Fees

No Criminal Conviction $150 Intake Fee POM (90 days - 6 months) $150 TASC/$650 Drug Fund PODD (1 year minimum) $1285 TASC/$750 Drug Fund POND (1 year minimum) $1285 TASC / $1500 Drug Fund UA Testing Costs

TASC, Inc. 2011

Critical Components Leading to a Successful Pre-Trial Diversion Program

Case Management

Plays the role of support and rapport vs. enforcement role of probation officer Holds clients accountable for their behaviors and program responsibilities Assistance with community referrals (jobs, housing, intensive out-patient facilities, 12-step meetings) Treatment is more likely to end successfully when client's have the fundamental support from a case manager

TASC, Inc. 2011

Critical Components Leading to a Successful Pre-Trial Diversion Program

Case Management Drug Testing

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Drug Testing Caseload Color Compliance Individual Compliance &Results UA Test Result1 UA Test Result2 THC Level Analysis

TASC, Inc. 2009

Critical Components Leading to a Successful Pre-Trial Diversion Program

Case Management Drug Testing Treatment 80% of clients reported no prior treatment upon entering the TASC Diversion Program

TASC, Inc. 2011

Critical Components Leading to a Successful Pre-Trial Diversion Program

Case Management Drug Testing Treatment 80% of clients reported no prior treatment upon entering the TASC Diversion Program Reporting

TASC, Inc. 2011

Different Reporting Tools

Click on report to enlarge

TASC, Inc. 2009

Critical Components Leading to a Successful Pre-Trial Diversion Program

Case Management Drug Testing Treatment 80% of clients reported no prior treatment upon entering the TASC Diversion Program Reporting Accountability

TASC, Inc. 2011

Accountability

Click on report to open

TASC, Inc. 2009

Maricopa County TASC ADPP Pre-Trial Diversion Benefits

Community Based Early CJ Intervention Education and Prevention Treatment Accountability Court System Costs Reduces Recidivism Research and Evaluation

TASC, Inc. 2011

CLINICAL SERVICES PRESENTATION

A Multisystemic Approach to Clinical Services

TASC Clinical Services

TASC is licensed by the Arizona Department of Health Services, Office of Behavioral Health Licensing, as an outpatient behavioral health clinic for the following services:

· · · · · · Substance Abuse Treatment and Education General Mental Health Treatment DUI Screenings and MVD Revocation Packets DUI Level I Treatment DUI Level II Education Misdemeanor Court Ordered Domestic Violence Treatment

Counseling Services

TASC provides clinical services while working collaboratively with the following referring agencies:

US Federal Probation and Pretrial Bureau of Prisons Arizona Department of Corrections Maricopa County Superior Court Arizona Department of Motor Vehicles Partnership for a Drug Free America Various Unified School Districts , Municipal Courts, Employers, Social Service Agencies, Attorneys, etc.

Counseling Services

· Approximately 25 - 30% of all clients receiving clinical services are participating in the Diversion Program and self-pay for services. · Approximately 25 - 30% of all clients receiving clinical services are privately referred and self-pay for services. · Approximately 25 - 30% of all clients receiving clinical services are under some type of Federal Probation who are generally responsible for making co-pays for services. · The remaining percentage of clients receive schoolbased, community-based, or correctional-based clinical services through contractual agreements.

Counseling Services

TASC Clinical Services are

Evidence-Based Provided with an Analytically-Oriented Treatment Modality (Cognitive Behavioral Therapy ­ CBT) Directed by the involvement of all Systems and Treatment Team Members

Motivational Interviewing

All assessments/evaluations are conducted using a Motivational Interviewing approach. Motivational Interviewing is a directive, client-centered counseling style for eliciting behavioral change by helping individuals to explore and resolve ambivalence. MI focuses on the client's ability to develop a strong sense of self-efficacy. The clinician is directive in helping participants examine and resolve ambivalence. Readiness to change is not perceived, as a trait but rather a fluctuating product of interpersonal interaction. The therapeutic relationship is more like a collaborative partnership than one that rigidly demonstrates the expert/recipient roles.

Clinical Assessment

Before an individual can begin counseling services, he/she must complete an assessment. The assessment can be for Domestic Violence (DV); Substance Abuse (SA); General Mental Health (MH); or both (SA/MH). The assessment is a comprehensive bio/psycho/social evaluation that is comprised of the following:

· · · · · · Questionnaire (the Actual Assessment Form) SASSI-3 (Substance Abuse Subtle Screening Inventory) MAST (Michigan Alcohol Screening Test) Drug and Alcohol Service Level Determination Checklist Mini-Mental Status Exam (Mental Health only) Aggressive Behavior Inventory (Domestic Violence Only)

Clinical Assessment

The questionnaire addresses issues regarding the following factors:

Identifying Information; Chief Complaint (Who referred the client here and why?); Presenting Problem (How does the client perceive the situation? Problematic?); Social and Developmental History, inc. Education /Training, Work History; Social Network and Support, etc.; Family History and Functioning; History of Abuse, Domestic Violence, etc.; Client Social Functioning, inc. Significant Relationships; Legal Involvement History, inc. DUI, Drug-Related Charges, and other Significant Charges, such as Disorderly Conduct, Assault, etc.;

Clinical Assessment

Substance Abuse and Mental Health History; Treatment History and Background; Medical History; Initial Impression, including Strengths and Barriers to Treatment; Disposition (i.e., Results of SASSI-3, MAST, etc.); Diagnostic Impression (Axis I ­ V); Treatment Recommendations

Case Summary for Development of TX Goals

Reasons for Referral Substance Use/Abuse/Dependence Referral to Court History of Positive UAs

Case Summary for Development of TX Goals

Initial Goals/Desired Outcomes

Participants may include: Client Clinician Case Manager AA/NA Sponsor Family Member

Case Summary for Development of TX Goals

Client's Goals for Treatment:

· · · · · Success in Program, as evidenced by Successful Completion Maintain Gainful Employment No New Court Referrals Improve Coping Mechanisms, as evidenced by abstaining from Using Substances Participate in Random Urinalysis Testing (UA)

Case Summary for Development of TX Goals

Case Manager's Goals for Treatment:

· · · · · · Attend Treatment Services Participate in Random UA Testing Maintain Gainful Employment No New Court Referrals Abstain from Using Substances Compliance with Terms of Program.

Case Summary for Development of TX Goals

Systemic Strengths Versus Systemic Weaknesses/Needs

Areas include: Client Family Employer Peers Community

Case Summary for Development of TX Goals

Systemic Strengths The Client is:

· · · · · · · · Ambitious Motivated to Remain Clean and Sober Motivated to Become an AA Sponsor Motivated to Adhere to the Terms of his Program Mechanically Inclined Gainfully Employed (on a Part-Time Basis) Enjoys Playing the Guitar Kind, Considerate, and Caring Charismatic

Case Summary for Development of TX Goals

Systemic Strengths The Client's Family is:

· · · · · · Mother is very Supportive and Loving Family has Reliable Transportation for Client Family is Committed to the Client's Success Client has Regular Contact with his Family (who Reside in Phoenix) Maternal Grandmother Resides with the Family Family Owns and Operates a Successful Painting Company

Case Summary for Development of TX Goals

Systemic Weaknesses The Client has history of:

· · · · Using Alcohol and Other Drugs, as evidenced by Multiple Charges of DUI, Possession/Paraphernalia, etc. Difficulty Maintaining Employment, due to Excessive Absences Reacting Impulsively Obtained Numerous Referrals to Court for Various Charges

Case Summary for Development of TX Goals

Systemic Weaknesses The Peers:

· · Lack of Employment (None are Working) Client Reports Peers Tend to have contact with the Criminal Justice System, as evidenced by Various Charges, etc. Client Reports the Majority of Peers are Actively Using Alcohol and Other Drugs

·

Fit Assessment Finding the "FIT"

Fit Factors: Selected Based on:

· · · Observable Measureable Evidence that they Support or Sustain the Target Behavior

Fit Assessment Finding the "FIT"

Target Behavior:

Substance Use

Fit Assessment Finding the "FIT"

Target Behavior:

Substance Use Fit Factor:

· Low Coping Skills. Evidence:

· The client self-reportedly has a tendency to use alcohol and other drugs, when confronted w/ stressful/unpleasant situations, as opposed to using adaptive coping mechanisms. Information corroborated with the client's Clinician, Case Manager, History of AOD related charges, and other team members.

Fit Assessment Finding the "FIT"

Target Behavior:

Substance Use Fit Factor:

· Lack of Prosocial Peers Evidence:

· The client self-reportedly has a group of friends who have histories of violent behavior (i.e., assault charges, etc.), as well as and also use AOD on a regular basis. Information corroborated with the client's Clinician, Case Manager, History of AOD related charges, and other team members.

Fit Assessment Finding the "FIT"

Target Behavior:

Substance Use

Fit Factor: · Continued Use of Alcohol and Other Drugs Evidence:

· The client self-reportedly has a tendency to experience anxiety, particularly when confronted with stressful/unpleasant situations, which then results in using alcohol and other drugs, as evidenced by positive UAs, AOD related charges, etc. Information corroborated with the client's Clinician, Case Manager, History of AOD related charges, and other team members.

Fit Assessment Finding the "FIT"

Target Behavior:

Substance Use

Fit Factor: · History of Familial Substance Abuse Evidence:

· The client self-reportedly was raised in a household where alcoholism and substance use was prevalent and therefore repeated exposure to this occurred throughout his childhood until the age of 15 when his father (diagnosed with a dependence disorder) was incarcerated. Information corroborated with the client's Clinician, Case Manager, History of AOD related charges, and other team members.

Fit Assessment Finding the "FIT"

Target Behavior:

Substance Use

Fit Factor:

· Maladaptive Cognitive Perceptions (MCP) Client self-reported that he is the "victim" of many situations, as he is "the one who the police always charge and hold responsible for the negative occurrences in his life". Client reported that he is "unlucky", which is why he has had AOD related arrests. Information corroborated with the client's Clinician, Case Manager, History of AOD related charges, and other team members.

Evidence:

Functional Behavioral Analysis (FBA)

Relapse and Resulting Behavior

- C was dropped off, by his friend at his ex-wife's house (1:15 AM). The client reported that he had been out drinking with a groups of friends since 6 PM the evening before. Client also reported that he also snorted "one line of cocaine". - C began to ring the doorbell and pound on the door because his ex-wife was not answering her cell phone. - C reported that he remembers becoming angry because she wouldn't answer the door. As a result, C began pounding louder on the door and yelling. - The C's ex-wife comes to the door and tells him that he needs to leave the premises or she will contact the police.

Functional Behavioral Analysis (FBA)

The C reported that he became angry, as a result of his ex-wife threatening to call the police when he has already been in trouble with the police. He feels like his ex-wife is "f ing with him". The C reported that he began to kick the door. As a result, the client's ex-wife calls the police. The police arrive and arrest the client for Disorderly Conduct.

-

Antecedents & Consequences Analysis

Antecedents:

- Evening before incident client began using AOD because he was reportedly feeling stressed about money and worried about potentially not being able to see his children, as he is currently going through a messy divorce. - The more the client uses AOD, the more agitated he becomes. - The client's friend (identified, as a primary support by the client) uses AOD with the client all evening and then drops the client off at his ex-wife's house.

Antecedents & Consequences Analysis

Client's Cognitions/Thoughts:

- The client feels that is problems go away

when he uses AOD. - The client was angry with his ex-wife and confronted her once his inhibitions were lowered and his judgment was impaired due to AOD use.

Antecedents & Consequences Analysis

Consequences:

- The client is arrested by police and charged with a charge of Disorderly Conduct. - The client violated his program, as he received another charge and was under the influence of AOD at the time of the arrest.

Case Summary

Overarching/Primary Treatment Goals:

- The client will adhere to the terms of program, as evidenced by client and Case Manager reports. - The client will abstain from AOD, as evidenced by urinalysis testing. - The client will not acquire any new referrals to court, as evidenced by Case Manager, client and court reports.

Annex Invitation

We encourage everyone to take a tour of our facility if you are ever in the area. Our Corporate Clinical Office is located at 2302 North 7th Street, Suite B, Phoenix, Arizona 85006. We will show you how clients are processed, clinical protocols and procedures, as well as urinalysis testing requirements for clinical services. Simply give us a call and we'll make sure a Supervisor is free to assist you.

The End

TASC, Inc. 2011

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