Mecklenburg County Adult Drug Treatment Court

1. Mecklenburg County Adult Drug Treatment Court Dr. Janis Kupersmidt Dr. Elizabeth Jackson Nena Lekwauwa Adam Ross innovation Research & Training (919) 493-7700 www.irtinc.us Process Evaluation Results June 17, 2005

2. OUTLINE • Methodology • Description of STEP Team • Description of STEP Program • Global Impressions • Summary of Recommendations

3. METHODOLOGY • Quantitative data • MIS data • Consumer Satisfaction Questionnaire • Qualitative data • Team member interviews • Participant interviews and focus groups • Observational data • Treatment team meeting • Pre-court meeting and court session (Judge Mercer) • Historical documents

4. DRUG COURT TEAM

5. Strengths Adherence to Best Practices. Roles and responsibilities are well defined and followed Team members well suited to roles and responsibilities Barriers Separation of treatment and court staff Titles and roles in Policies and Procedures Manual do not match actual titles and roles used in STEP DRUG COURT TEAMRoles and Responsibilities

6. Strengths Well qualified team members Team is stable and members are experienced Team dedicated to specialty training Barriers Unmet training needs related to written communication “customer service” principles more continuous training on the recent drug use trends cultural sensitivity training and programming DRUG COURT TEAMTraining and Continuing Education

7. Drug Court TeamRECOMMENDATIONS • Consider tailoring trainings to team requests and needs (if not already done) • Consider integrating attendance at state or national trainings into orientation for new staff members • Provide continual cross-training (MH and CJ) sessions • Evaluate effects of treatment and court separation

8. CURRENT PROGRAM

9. Strengths Suitability and compliance assessed prior to program admission The District Attorney’s Office and STEP program work well together to optimize the number of referrals. Barriers Miscommunication may occur due to admissions procedure PROGRAM COMPONENTSReferrals, Eligibility, Admission andContract Procedures

10. Referral, Eligibility, and AdmissionRECOMMENDATIONS • Explore ways to streamline the admissions process to reduce potential for misunderstandings

11. PROGRAM COMPONENTSTreatment & Ancillary Services Strengths • Treatment requires family involvement • Treatment flexible in meeting participants’ needs • Specialty treatment groups: Dual Diagnosis & Latino groups • Encouragement of team members to establish professional relationships with ancillary service agencies through volunteerism • Excellent educational, technological, and vocational learning opportunities • Assistance with transportation needs • Participant satisfaction

12. PROGRAM COMPONENTSTreatment & Ancillary Services Barriers • Family sessions not beneficial/problematic for some • Treatment sessions may not follow a strict curriculum • Need for important ancillary services • Housing • Employment • Transportation difficult given size of county • Funding changes may affect the structure and content of treatment

13. Treatment and Ancillary ServicesRECOMMENDATIONS • Evaluate whether treatment produces equivalent outcome for all groups (racial, ethnic, gender, drug-of-choice) • If treatment program changes due to lost funding, reevaluate the structure and content of treatment • Evaluate the effectiveness of team member volunteerism

14. PROGRAM COMPONENTSCase Management & Judicial Supervision Strengths • Case Coordinators rated highly. • Efficient team meetings • Effective communication between the treatment and legal team components • Judge fills courtroom role well Barriers • Case Coordinator meetings viewed as inefficient • Unexcused absences from court are reportedly not always sanctioned. • Noise level in the courtroom is high

15. Case Management and SupervisionRECOMMENDATIONS • Consider closer changes in courtroom structure to enhance participant-judge relationship • Reduce noise or amplify speakers

16. PROGRAM COMPONENTSSanctions and Incentives Strengths • Use of a performance and sanctions grid • Grid used flexibly • Participants view sanctions and incentives as fair and appropriate • Variety of “valued” incentives used Barriers • Team disagreement about • sanctions • Delay between non-compliant • behavior and sanction • Too few incentives

17. Sanctions and IncentivesRECOMMENDATIONS • Review content of grid Sanctions and Overall Performance Grids • Establish team consensus regarding current sanctions • Consider establishing a protocol for immediate communication of non-compliance • Consider additional incentives • Consider additional strategies for pursing incentive opportunities with community businesses and organizations

18. Strengths Termination and graduation criteria viewed as fair Participants given every opportunity to succeed: “It takes a lot for a person to be terminated.” Barriers Disagreement over whether to re-admit terminated participants Fee payment affects eligibility for graduation No formal alumni program currently in place. PROGRAM COMPONENTSTermination and Graduation

19. Termination and GraduationRECOMMENDATIONS • Revisit utility of allowing terminated participants to enroll a second time • When possible, use existing MIS data and exit interview information to guide decisions. • Consider a formal alumni program

20. GLOBAL IMPRESSIONS

21. GLOBAL IMPRESSIONSAs Reported by Team Members • Case Coordinators and Treatment providers are vital part of STEP • Accountability measures- drug testing, judicial and Case Coordinator supervision- are crucial to participant success. • Team is knowledgeable, professional, and work well with one another

22. GLOBAL IMPRESSIONSAs Reported by Participants • Nearly all expressed satisfaction and gratitude: • “It saved my life.” • Participants unanimously appreciate and respect the team. • Shared sense that the program does everything possible to facilitate recovery

23. GLOBAL IMPRESSIONSAs Reported by Participants • Most participants found treatment helpful, but some found 12-step programs much more helpful • Program requires nearly unmanageable time and travel commitment.

24. CONSUMER SATISFACTIONQuestionnaire Results • Sample of 10 self-selected active participants, representing the first and second treatment levels • The majority are satisfied or very satisfied with all 14 of the program components included in the CSQ. • At least half of the respondents found 15 of the 18 program requirements included in the CSQ easy or very easy to satisfy. • Majority of respondents found the following requirements difficult or very difficult to satisfy: • Attending court sessions. • Paying court fees. • Paying court fines.

25. OVERALL RECOMMENDATIONS

26. RECOMMENDATIONSDrug Court Team • Continue attendance at national and state DTC trainings in addition to specialized training • Consider cross-training sessions • If needed, update the Policies and Procedures Manual to reflect the roles and titles of team members as they are in day-to-day functioning.

27. RECOMMENDATIONSDrug Court Program • Explore means of streamlining the admissions process. • If funding loss affects treatment program, and consider alternatives. • Consider ways to enhance courtroom experience and more prompt delivery of sanctions • Review the current sanctions and incentives in an effort to evaluate efficacy and establish consensus; update grid. • Revisit the policy that allows terminated participants to re-enter the program. • When possible, use available MIS and exit interview data to inform program decisions.