Treatment Track:Treatment as Part of

the Community

Presenters:• Susan Alameda, MSW, State Coordinator, Arizona Supreme

Court, AOC Adult Probation Services• Krista Forster, MA, Program Specialist, Arizona Supreme Court’s

Adult Probation Supervision Division• Harry Earle, Chief of Police, Gloucester Township, NJ

Moderator: Dan Smoot, Director of Drug Prevention and Education, Appalachia High Intensity Drug Trafficking Area (HIDTA)

Disclosures

• Susan Alameda, MSW, has disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.

• Krista Forster, MA, has disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.

• Harry Earle has disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.

• Dan Smoot has disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.

Disclosures

• All planners/managers hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

• The following planners/managers have the following to disclose:– Kelly Clark – Employment: Publicis Touchpoint Solutions;

Consultant: Grunenthal US– Robert DuPont – Employment: Bensinger, DuPont & Associates-

Prescription Drug Research Center– Carla Saunders – Speaker’s bureau: Abbott Nutrition

Learning Objectives

1. Advocate the use of community-based strategies to increase access to treatment.

2. Explain how Arizona agencies are using evidence-based practices in determining appropriate treatment for probationers with behavioral health issues.

3. Describe a police department program that employs professional counselors to assist those at risk of substance abuse and provides certified drug and alcohol counselors in the municipal court room.

Treatment Mapping: Using Collaboration to Maximize Community Based Treatment for

Offenders

Susan Alameda, TREATMENT SPECIALIST Krista Forster, PROGRAMS SPECIALIST

ARIZONA SUPREME COURT ADMINISTRATIVE OFFICE OF THE COURTS

ADULT PROBATION SERVICES DIVISION

Disclosure Statement

Susan Alameda, MSW and Krista Forster, MA, have disclosed no relevant, real or apparent

personal or professional financial relationships with proprietary entities that

produce health care goods and services.

Rural Healthcare• In many rural areas, low population is combined

with a lack of health services, poverty, underserved areas and geographic isolation.

• Transportation issues such as distance, topography, and lack of mass transit

Urban Healthcare• In many urban areas, there are too many

choices. • Standard of Care • “Favorites”• Difficulty finding the most appropriate

treatment

Common Funding Sources in AZ

• Federal Gov’t• Center for

Medicaid/Medicare Services

• SAMHSA• AHCCCS

• State Funding• County, City, Other

State Agencies• Non-TXIX• Crisis Services• Supportive Housing

ADHS

RBHA

Local Provider Network

Administrative Office of the Courts

18%

16%

18%

49%

AOC Treatment budget for probation departments-FY14TOTAL - $5,402,033

CPP DRUG COURT

CJEF DTEF

$973,435

$854,472

$1,004,525

$2,569,601

Treatment Mapping Purpose

What is the purpose:

• What’s out there?• Are there gaps in service?• Are services being provided that meet the needs of specific

counties?• Are providers using EBP?• What are the Barriers to treatment• How can probation departments find the right provider? • Appropriate funding sources• Assumptions

On the Road Again

Travel to the counties Meet with RHBA & Probation staff

Chiefs, Treatment Coordinators, Line Officers See what the county physically looks like Observe Problem Solving Courts

Meet with Local Providers Those who provide direct services to

probationers and work with probation staff Observe modalities

Life is Like a Box of Chocolates

What We Found Each county is unique Issues with transportation Cultural issues affecting treatment needs

and responses to treatment options (language barriers, family involvement)

Training for staff (emerging drug issues, new technology)

Life is Like a Box of Chocolates

Communication gaps InteragencyCoordination of CareOther agencies (ie. jail, providers, DES) Staffing of problem casesProviding referral information (presentence

reports, monthly progress reports)Adherence to Best Practices/Evidence Based

Practices

Life is Like a Box of Chocolates

Service gaps Consistency (staff, funding, participants) Limited funding Lack of treatment programs (IOP, residential, detox, in-

patient acute care facility) Access to treatment/Geographical challenges Specialty services (ie. DV, DUI, Sex Offender)

oStatutorily mandated services Emergency Housing/Homeless Shelters Sober Living, Transitional Housing Sober Support/12 step meetings

Life is Like a Box of Chocolates

Service Gaps (con’t)

CBT/Aftercare/Relapse Prevention Veteran’s Services Automation for data tracking and reporting Mental Health (medication, transitional

services, transportation) Dental Care

The Administrative Office of the Courts and Regional Behavioral Health Authorities have partnered to:

Bridge gaps in treatment services Define roles and responsibilities of each agency Improve communication and information sharing Maximize limited resources Increase resource sharing Improve quality of care to our shared populations Improve lives in our communities

Solution: Partnerships

Communication is Key

Solution Outcomes

Better Communication All parties engage in cross-system education/training All parties communicate concerns regarding providers

and/or services to each other Unified commitment to provide real time solutions

o Point of contacto Probation Protocols

Clarification on funding protocols and limitationso Share the wealtho Funding agreements/expectations

Contracts, MOUs, Agreements

Solution Outcomes

Better Communication (con’t)

Probation and providers understand why they should be talking

Administration works to bridge gaps in services Administration understands need for further

training Administration gets a “big picture” understanding

of the challenges faced in each community Administration works to educate the Court

Solutions Outcomes

Assessment Driven (ASUS-R, OST/FROST) “Guts” are not evidence based

Partnerships Problem Solving Teams Non-traditional resources Community based alliances Sister agencies

Law Enforcement/Probation

Treatment

Social Services

Family Therapy

Government Agencies/Officials

Mentoring Programs Faith CommunityArts

Health

Housing

LiteracyPrograms

Service Organizations

Schools/Colleges/Universities

Recreational/Libraries

Employment/Job Training

Mental Health Services

Community BasedOrganizations

CommunityFoundations

Businesses

Community Map

Where Do We Go From HereProbation Departments Responsibilities:

Participate in training regarding assessments Provide complete referral packets (PSI, assessments) Attend staffings and/or invite providers to department staff

meetings Follow statute, ACJA and policies regarding placement of

probationers in treatment Explore and foster non-traditional resources (sober groups,

churches, non-profits, reentry sites, employment agencies) Complete Program Plans outlining existing and needed

resources for treatment.

Where Do We Go From Here

RBHA’s (funding authority)Responsibilities: Make sure provider agencies follow protocols for

member choices Ensure providers balance need with resources Foster meetings with providers and probation

department Ensure providers are utilizing funding as needed for

treatment clients (ie. SAPT funds) Develop and train on protocols Ensure providers are utilizing current evidence based

modalities

Where Do We Go From HereProvider Responsibilities:

Collaborate with other providers Communicate with RBHA (advise of treatment

needs, funding concerns, oversaturation of providers/programs, need for training)

Communicate with probation departmentsoProvide monthly progress reportsoNotify probation of violations oRequest more information from departments (PSI,

assessments, any information related to offense and reason for being referred to treatment)

Where Do We Go From Here

AOC’s Responsibilities: Report licensing/certification issues Gather data regarding assessments related to treatment needs Foster collaboration with other departments/providers Ensure providers following ACJA code and EBP Provide general support to counties Advocate for resources Provide training opportunities Evaluate need for and use of problem solving courts

Where Do We/You Go From HereGet Out of Your Cubicle

Know your partners Communicate Collaborate Explore Develop Relationships Know the Affordable Care Act (ACA) and its impact on your

community

System Partners

• Think about your system partners

• Ask: Who is part of your system now?• Ask: What do your partnerships look like now?

Long is the road from conception to completion.

Moliere

Treatment as Part of the Community

DISCLOSURE

GOALS

Advocate the use of community-based strategies to increase access to treatment.

Describe a police department program thatemploys professional counselors to assist those at risk of substance abuse and providescertified drug and alcohol counselors in the municipal court room.

THE COMMUNITY OF GLOUCESTER TOWNSHIP

PEOPLE ARE DYING – AND NOT JUST FROM CRASHES

Year Deaths

2010 6

2011 9

2012 5

2013 9

2014 14

CAMDEN COUNTY – 2014/37 2013/31

GLOUCESTER TWP – 2014/2 2013/1

AN EPIDEMIC

PROTECT AND SERVE - TRADITIONS IN POLICING

METROPOLITAN POLICE ACT

1829

PEELIAN PRINCIPLES

…..Prevent crime and disorder……

FACING YOUTH TODAY

WHEN I GROW UP…..I WANT TO BE…..

A BROKEN WINDOW THAT MUST BE REPAIRED

LAW ENFORCEMENT’S NEW VISION

COMMUNITY POLICING

Community policing is a philosophy that promotes organizational strategies,

which support the systematic use of

partnerships and problem-solving techniques, to

proactively address the immediate conditions that

give rise to public safety issues such as crime, social

disorder, and fear of crime.

SOCIAL DISORDER

LAW ENFORCEMENTS NEW VISION

INSPIRING CHANGE

SAVING LIVES

SAVING LIVES

950 UnitsMay 2014

80 UnitsApril 2014

200 UnitsSept. 2014

TOTAL UNITS:

1,230

130 12

6

97%

SAVING LIVES

LAW ENFORCEMENT DRUG ADVOCACY

WHEN I GROW UP I WANT TO BE A DRUG FUELED ROBBER

SAVE ADVOCATE

44 Defendants 41 Engaged

13 CLIENTS 8 CLIENTS

47%

REMAINING 20?

SAVE ADVOCATE – CASE STUDY

Admitted 8-31-14

Discharged9/18/14

CLIENT # 8

SAVE INITATIVES

SAVE - DRUG DISPOSAL

SAVE FOLLOW-UP

SAVE - BUILDING PARTNERSHIPS

FAMILY RESOURCE CENTER

IT’S JUST A RUNAWAY

http://archives.drugabuse.gov/NIDA_Notes/NNVol12N3/Runaway.html

71% Involved Drug

Abuse 2

2

SILENCE

THE RETURN OF THE JUVENILE – CASE OVER?

BRING IT ALL TOGETHER

COMPREHENSIVE APPROACH

JU HUDDLE

CommandersIntelligence Unit

Every Missing Person/Juvenile

ContactComprehensive Review

PROJECT CASEY - SUCCESS

2008-201130%

2011-20145%

Substance abuse and delinquency often share the common factors of school and family problems,

negative peer groups, lack of neighborhood social controls, and a history of sexual abuse.

Source: National Criminal Justice Reference Service: https://www.ncjrs.gov/html/ojjdp/jjbul9712-1/substan.html

GTPD AND THE COMMUNITY IN ACTION

REDIFINING PROTECT AND SERVE

QUESTIONS AND CONTACT INFORMATION

Treatment Track:Treatment as Part of

the Community

Presenters:• Susan Alameda, MSW, State Coordinator, Arizona Supreme

Court, AOC Adult Probation Services• Krista Forster, MA, Program Specialist, Arizona Supreme Court’s

Adult Probation Supervision Division• Harry Earle, Chief of Police, Gloucester Township, NJ

Moderator: Dan Smoot, Director of Drug Prevention and Education, Appalachia High Intensity Drug Trafficking Area (HIDTA)