Post on 25-Jun-2020
Presented by:
The Honorable Judge Marcia Hirsch
Crystal Stanton, M.A.
Maritza Karagiorgos, M.A.
The ECM Program is a Substance Abuse and Mental HealthServices Administration (SAMHSA) grant funded initiativethat uses the risk-needs- responsivity (RNR) model toincrease the success of treatment court participants bylinking a risk and needs assessment with treatmentplanning.
This program was established in 2015 when the New YorkState Unified Court System (UCS) collaborated with EAC’sTreatment Alternatives for Safer Communities (TASC)creating the Queens Treatment Court Enhanced CaseManagement Program (ECM).
The population of focus for the ECM project are participantsthat are found eligible for one of the five felony treatmentcourts in Queens County, New York:
Queens Treatment Court (QTC)
Queens Driving While Intoxicated (QDWI) Court
Queens Mental Health Court (QMHC)
Queens Veterans Treatment Court (QVTC)
Queens Drug Diversion Court (QDDC)
All five of these courts are presided over by one Judge, theHonorable Marcia Hirsch in the same court part on differentdays.
QTC- Participants are first time felony substance abusers.
QDWI- Participants are alcohol or substance abusers
charged with driving while intoxicated.
QMHC- Participants have co-occurring or mental health
disorders.
QVTC- Participants are veterans with substance abuse
disorders.
QDDC- Handles defendants with extensive criminal justice
histories and substance abuse disorders who apply for a
judicial hearing regarding diversion to drug court
The Queens treatment courts were initially designed to serve first
time felony offenders with substance abuse issues however in
April 2009, the New York State legislature passed legislation
reforming the state’s harsh drug sentencing laws commonly
referred to as Article 216. (http://criminaljustice.ny.gov/drug-law-
reform/documents/dlr-update-report-may-2014.pdf)
This expanded opportunities for treatment diversion for addicted
offenders by allowing judges to offer treatment alternatives
without approval of the district attorney.
These drug law reforms were intended to reduce unnecessary
confinement for eligible offenders who, historically, would have
been incarcerated. Specifically defendants charged with a felony
drug charge (except class A felonies) or other nonviolent charges.
In addition to the increase in people eligible for diversion,
the NYC Department of Health and Mental Hygiene
reported that from 2010 to 2012 heroin-involved deaths
increased 71% from 3.1 to 5.3 per 100,000.(http://www.nyc.gov/html/om/pdf/2013/edb_unintentional_drug_poisoning_ov
erdose_deaths.pdf)
When hearing these statistics the only question one can
ask is how can I help? How can the treatment courts help?
In accordance with the resolution of the Board of Directors
of the National Association of Drug Court Professionals
(NADCP) certain medically assisted treatments (M.A.T.) for
addiction- including antagonist medications such as
naltrexone, agonist medications such as methadone, and
partial agonist medications such as buprenorphine which
have been proven through rigorous scientific studies to
improve addicted offenders’ retention in counseling and
reduce illicit substance use, re-arrests, technical violations,
re-incarcerations, hepatitis C infections, and mortality.http://www.nadcp.org/sites/default/files/nadcp/NADCP%20Board%20Stateme
nt%20on%20MAT.pdf
In response to these issues an enhancement of services
was required to better serve our participants. The RNR
model is implemented to affect participant behavior change
and treatment success.
Application of the risk principle requires matching levels or
intensity of treatment with the risk levels of the offenders.
High-risk offenders require intensive interventions to
reduce recidivism, while low-risk offenders benefit most
from low intensity interventions or no intervention at all.
Most participants have many needs. However, certain
needs are directly linked to crime. Criminogenic needs
constitute dynamic risk factors or attributes of participants
that, when changed, influence the probability of recidivism.
The responsivity principle refers to the delivery of services
in a manner that is consistent with the ability and learning
style of a participant.
TASC Clinical Case Management including intensive communitycase management for participants identified as medium/highrisk of recidivism.
One-on-one and/or group sessions using Cognitive BehavioralInteractive Journaling to explicitly address criminological factorsand increase self-efficacy.
Identification of health needs and connections to Health HomeCare Coordination for participants with chronic medical disorders.
Individualized case management services for participantsaddicted to opioids who are in need of M.A.T.
Integration of peer support to
facilitate drug court participation
and maintenance of recovery.
In addition to the enhancements, and consistent with the
drug court model, participants will be placed in behavioral
health treatment programs that match identified needs, will
receive trauma-informed case management, receive drug
testing, monitoring and enforcement of sanctions and
implementation of rewards.
100% of participants are screened utilizing the CorrectionalOffender Management Profiling for Alternative Sanctions(COMPAS) validated risk and needs tool.
COMPAS is a computerized assessment tool used to identifyand assess criminogenic needs and risks and to supportdecisions regarding community placement, supervision,treatment and case management.
COMPAS is a 4th generation risk assessment instrumentwhich means it addresses a number of the issues witholder generation risk assessment tools, and moreover, arespecifically designed to be integrated into not only theprocess od risk management, but also the selection ofintervention modes and targets for treatment, as well as theassessment of rehabilitation progress.
COMPAS allows the development of risk and need typologies tofacilitate the goals of specific responsivity and to guide the“matching” of interventions to client needs in the context of theCOMPAS system.
The assessment yields a risk level allowing the program totarget medium-and high-risk offenders,
and measures risk across four
dimensions, while also providing
comprehensive assessment of
health, behavioral, educational,
vocational, family and other
needs and strengths.
Participants with medium and high risks for recidivism will
engage in cognitive behavioral interactive journaling to
address criminogenic thinking in addition to ongoing drug
court services and intensive case management.
Case management and peer specialists journal with the
participants which offers support and builds rapport.
All staff involved in the ECM project have been trained inTrauma Informed Care. The treatment court team receivedtraining from the National Center for Trauma Informed Care(NCTIC) to standardize the screening process and identifytrauma victims. In addition, the GAINS Center worked withTASC to develop and pilot the trauma informed casemanagement curriculum for court case managers ensuringthe ability for a manualized trauma-informed
approach to monitoring and case
management to increase compliance,
reduce misdiagnosis, and increase
better treatment matching.
All participants are screened for trauma utilizing the
following:
➢ Post-traumatic Stress Disorder Checklist-Civilian (PCL-C 5)
A 17-item self-report checklist of the 17 DSM-IV symptoms of PTSD,
administered in this project by interviewer/clinician
➢ Adverse Childhood Experience Survey (ACE)
This is a 10 item questionnaire that can be self-administered and has
English and Spanish versions. (www.acestudy.org)
➢ Trauma History Screen (THS)
A 13-item measure that asks about 11 events and one
general event and follow-up details for those acknowledged
➢ Participants with chronic medical conditions will be assessed by
the Care Coordinator using the FACT-GP/Health Home Functional
Assessment. The tools gather information about the participant’s
physical, social/family, emotional and functional well-being.
Those eligible are referred to a Medicaid Health Home for long-
term Care Coordination even post treatment court completion. A
Health Home is a care management service model
whereby all of an individual's caregivers
communicate with one another so
that all of a patient's needs are
addressed in a comprehensive manner.
Over the past decade, peer support has expanded and is
now recognized as an important element of a consumer’s
recovery process.
A peer provider is a person who uses his or her lived
experience of recovery from mental illness and/or
addiction, plus skills learned in formal training, to deliver
services in behavioral health settings to promote mind-body
recovery and resiliency.(http://www.integration.samhsa.gov/workforce/team-members/peer-providers)
The Many Roles of a Peer
• Instill Hope • Show Recovery is Possible
• Act as a Role Model • Share Experiences
• Help Change Attitudes • Help Change Behaviors
• Build Rapport • Help with Treatment
Engagement
All ECM Peers are trained in all
interventions and work closely with case
management staff to help implement
them.
Any Questions about the ECM Program?