Drug Court Evaluation Using “Big Data” Presented at the

1. Drug Court Evaluation Using “Big Data” Presented at the Washington State Association of Drug Court Professionals 16th Annual Conference Presented by Jim Mayfield, Senior Research Associate Department of Social and Health Services Research and Data Analysis Division October 18, 2013

2. Our topic today . . . . • Review social service and criminal justice data integration in Washington State • Demonstrate the use of integrated data to evaluate drug courts

3. Washington is one of a few states in the nation with an integrated social service client database

4. That means we can identify costs, risks and outcomes at the state or community level . . . . . . and at an individual or family level

5. Internal DSHS client services data WASHINGTON STATE Department of Social and Health Services INTEGRATED CLIENT DATA BASE Internal DSHS Behavioral Health and Rehabilitation DSHS Aging and Adult Services DSHS Children’s Services DSHS Developmental Disabilities DSHS Economic Services DSHS Juvenile Rehabilitation DSHS Mental Health Services DSHS Vocational Rehabilitation Nursing Facilities In-home Services Community Residential Functional Assessments Assessments Detoxification Opiate Substitution Treatment Outpatient Treatment Residential Treatment Child Protective Services Child Welfare Services Adoption Adoption Support Child Care Out of Home Placement Voluntary Services Family Reconciliation Services Case Management Community Residential Services Personal Care Support Residential Habilitation Centers and Nursing Facilities Food Stamps TANF and State Family Assistance General Assistance Child Support Services Working Connections Child Care Institutions Dispositional Alternative Community Placement Parole Child Study Treatment Center Children’s Long-term Inpatient Program Community Inpatient Evaluation/ Treatment Community Services State Hospitals State Institutions Medical and Psychological Services Training, Education, Supplies Case Management Vocational Assessments Job Skills

6. External client services and outcomes data Dental Services Medical Eligibility Medicaid, State Only Hospital Inpatient/Outpatient Managed Care Services Physician Services Prescription Drugs Arrests Charges Convictions Incarcerations Community Supervision Hours Wages Births Deaths Homelessness Housing Assistance Employment Security Department Employment Security Department Washington State Patrol Washington State Patrol Administrative Office of the Courts Administrative Office of the Courts Department of Corrections Department of Corrections Health Care Authority Health Care Authority Department of Health Department of Health Department of Commerce Department of Commerce WASHINGTON STATE Department of Social and Health Services INTEGRATED CLIENT DATA BASE External External

7. Internal and external sources routinely updated in the Integrated Client Data Base – “The ICDB” Dental Services Medical Eligibility Medicaid, State Only Hospital Inpatient/Outpatient Managed Care Services Physician Services Prescription Drugs Arrests Charges Convictions Incarcerations Community Supervision Hours Wages Births Deaths Homelessness Housing Assistance Employment Security Department Washington State Patrol Administrative Office of the Courts Department of Corrections Health Care Authority Department of Health Department of Commerce WASHINGTON STATE Department of Social and Health Services INTEGRATED CLIENT DATA BASE External Internal DSHS Behavioral Health and Rehabilitation DSHS Aging and Adult Services DSHS Children’s Services DSHS Developmental Disabilities DSHS Economic Services DSHS Juvenile Rehabilitation DSHS Mental Health Services DSHS Vocational Rehabilitation Nursing Facilities In-home Services Community Residential Functional Assessments Assessments Detoxification Opiate Substitution Treatment Outpatient Treatment Residential Treatment Child Protective Services Child Welfare Services Adoption Adoption Support Child Care Out of Home Placement Voluntary Services Family Reconciliation Services Case Management Community Residential Services Personal Care Support Residential Habilitation Centers and Nursing Facilities Food Stamps TANF and State Family Assistance General Assistance Child Support Services Working Connections Child Care Institutions Dispositional Alternative Community Placement Parole Child Study Treatment Center Children’s Long-term Inpatient Program Community Inpatient Evaluation/ Treatment Community Services State Hospitals State Institutions Medical and Psychological Services Training, Education, Supplies Case Management Vocational Assessments Job Skills

8. Drug court participants and study sample (Includes dropouts) *Source: Administrative Office of the Courts, individual drug courts, and DCCM.

9. STUDY TIMELINE: Admissions from June 2007 through July 2009 INDEX Date felony was filed BASELINE PERIOD FOLLOW-UP PERIOD Baseline characteristics up to 10 years prior 3 years after filing date • Age, gender • Race and ethnicity • Employment history • Location • Most serious felony charge • Criminal history • AOD treatment need • Previous AOD treatment • Arrest rate • Incarceration rate • Days incarcerated • Received AOD treatment • Days of AOD treatment • AOD treatment cost

10. Internal and external sources routinely updated in the Integrated Client Data Base – “The ICDB” Dental Services Medical Eligibility Medicaid, State Only Hospital Inpatient/Outpatient Managed Care Services Physician Services Prescription Drugs Arrests Charges Convictions Incarcerations Community Supervision Hours Wages Births Deaths Homelessness Housing Assistance Employment Security Department Washington State Patrol Administrative Office of the Courts Department of Corrections Health Care Authority Department of Health Department of Commerce WASHINGTON STATE Department of Social and Health Services INTEGRATED CLIENT DATA BASE External Internal DSHS Behavioral Health and Rehabilitation DSHS Aging and Adult Services DSHS Children’s Services DSHS Developmental Disabilities DSHS Economic Services DSHS Juvenile Rehabilitation DSHS Mental Health Services DSHS Vocational Rehabilitation Nursing Facilities In-home Services Community Residential Functional Assessments Assessments Detoxification Opiate Substitution Treatment Outpatient Treatment Residential Treatment Child Protective Services Child Welfare Services Adoption Adoption Support Child Care Out of Home Placement Voluntary Services Family Reconciliation Services Case Management Community Residential Services Personal Care Support Residential Habilitation Centers and Nursing Facilities Food Stamps TANF and State Family Assistance General Assistance Child Support Services Working Connections Child Care Institutions Dispositional Alternative Community Placement Parole Child Study Treatment Center Children’s Long-term Inpatient Program Community Inpatient Evaluation/ Treatment Community Services State Hospitals State Institutions Medical and Psychological Services Training, Education, Supplies Case Management Vocational Assessments Job Skills

11. Study timeline and comparison group ADMITTED to Drug Court INDEX Date felony was filed BASELINE PERIOD FOLLOW-UP PERIOD NOT Admitted to Drug Court – but statistically similar

12. The study population characteristics Adults admitted to Drug Courts and a matched comparison group are statistically identical across multiple dimensions

13. *Index charges for the comparison group were randomly selected in such a way as to coincide with the distribution of charge dates of those admitted to Drug Courts.

14. Study timeline and comparison group ADMITTED to Drug Court INDEX Date felony was filed BASELINE PERIOD FOLLOW-UP PERIOD NOT Admitted to Drug Court – but statistically similar

15. Study questions • How do drug courts influence incarceration (prison only)? • What is the impact of drug court on subsequent arrest rates? • How do drug courts influence treatment participation? • What are the costs and benefits of drug court participation?

16. Drug Court participants were less likely to be incarcerated Cumulative incarceration rate over the three-year follow-up period Drug Court and comparison group clients—DOC facilities only 23% Comparison group 17% Drug Court group MONTHS AFTER INDEX FELONY CHARGE

17. Drug Court participants in the community were less likely to be re-arrested Cumulative arrest rate over the three-year follow-up period for individuals in the community Drug Court and comparison group clients Comparison group 85% 71% Drug Court group MONTHS AFTER INDEX FELONY CHARGE

18. Drug Court participants were more likely to remain free of arrest Arrest-free during follow-up period *Adjusted * 2x HIGHER Drug Court Group Comparison Group n = 1,290 n = 1,384 *Based on a multivariate predictive model.

19. Chemical dependency treatment experiences differed significantly Any AOD Treatment received during follow-up DRUG COURT GROUP 97% Received Treatment n = 1,618 3% No Treatment n = 53

20. Chemical dependency treatment experiences differed significantly Any AOD Treatment received during follow-up DRUG COURT GROUP COMPARISON GROUP 97% Received Treatment n = 1,618 54% No Treatment n = 896 46% Received Treatment n = 775 3% No Treatment n = 53

21. Drug Court participants entered treatment more quickly TIME TO TREATMENT Percent entering treatment within 90 days Number of days before entering treatment 64 DAYS EARLIER TO TREATMENT Comparison Group 3x HIGHER Drug Court Group Drug Court Group Comparison Group n = 775 n = 1,618 n = 775 n = 1,618

22. Drug Court participants entering treatment stayed longer DAYS IN TREATMENT Number of days spent in treatment Percent spending 90 days or more in treatment Drug Court Group Drug Court Group 128 MORE DAYS IN TREATMENT 4x HIGHER Comparison Group Comparison Group n = 775 n = 1,618 n = 775 n = 1,618

23. More treatment = higher treatment costs Average monthly chemical dependency treatment cost Drug Court and comparison group clients Drug Court group Comparison group MONTHS AFTER INDEX FELONY CHARGE

24. More treatment = higher treatment costs Total per-person treatment costs Average monthly chemical dependency treatment cost Drug Court and comparison group clients $6,531 NET INCREASE

25. Drug Court cost per participant • 1 DSHS-RDA estimates of chemical dependency treatment costs based on TARGET. • 2 Cost effectiveness of Washington State adult prison offenders, final report, October 2012. Olympia: Criminal Justice Planning Services/KGM Consulting. • 3Barnosky, R., & Aos, S. (2003). Washington State’s drug courts for adult defendants: Outcome evaluation and cost-benefit analysis (Document No. 11-07-1201). Olympia: Washington State Institute for Public Policy. 4 Bhati, A., Roman, J., & Chalfin, A. (2010). To treat or not to treat: Evidence on the prospects of expanding treatment to drug-involved offenders. Washington, D.C.: The Urban Institute Justice Policy Center.

26. Benefits associated with reduced crime Lifetime Benefits Present Values Benefit to Taxpayers TOTAL BENEFIT $29,269 NET BENEFIT $21,987 • SOURCE: Washington State Institute for Public Policy Benefit-Cost Model based on parameters provided by DSHS-RDA. Benefit to Society Additional Cost per Participant

27. Cost effectiveness Lifetime Costs and Benefits Present Values • Benefit-Cost Ratio • = $4.02 • [Benefit of $29,269  Total Cost of $7,282] • SOURCE: Washington State Institute for Public Policy Benefit-Cost Model based on parameters provided by DSHS-RDA. Benefit to Taxpayers TOTAL BENEFIT $29,269 NET BENEFIT $21,987 Benefit to Society NET COST $7,282 Additional Cost per Participant • 1 DSHS-RDA estimates of chemical dependency treatment costs based on TARGET. • 2 Cost effectiveness of Washington State adult prison offenders, final report, October 2012. Olympia: Criminal Justice Planning Services/KGM Consulting. • 3Barnosky, R., & Aos, S. (2003). Washington State’s drug courts for adult defendants: Outcome evaluation and cost-benefit analysis (Document No. 11-07-1201). Olympia: Washington State Institute for Public Policy. 4 Bhati, A., Roman, J., & Chalfin, A. (2010). To treat or not to treat: Evidence on the prospects of expanding treatment to drug-involved offenders. Washington, D.C.: The Urban Institute Justice Policy Center.

28. Summary • RDA is building a foundation for evaluative research of specialty courts • A foundational analysis by RDA demonstrates the cost effectiveness of drug courts statewide • Ongoing, actionable research requires a systematic and consistent approach to reporting court data statewide

29. Questions?

30. Available Report http://publications.rda.dshs.wa.gov/1485/