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Emerging Best Practices for Diverting Veterans from Incarceration into Mental Health and Substance Use Treatment. Gregory D. Torain, M.Ed., LCPC Public Health Advisor Center for Substance Abuse Treatment Substance Abuse Mental Health Services Administration

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Gregory d torain m ed lcpc public health advisor center for substance abuse treatment

Emerging Best Practices for Diverting Veterans from Incarceration into Mental Health and Substance Use Treatment

Gregory D. Torain, M.Ed., LCPC

Public Health Advisor

Center for Substance Abuse Treatment

Substance Abuse Mental Health Services Administration

U.S. Department of Health & Human Services

2014 NAMI National Convention

Washington D.C.

September 5, 2014


Samhsa s mission
SAMHSA’s Mission Incarceration into Mental Health and Substance Use Treatment

  • To reduce the impact of substance abuse and mental illness on America's communities.

    • To prevent substance abuse and mental illness where possible,

    • To target effective substance abuse and mental health services to the people most in need, and

    • To translate research more effectively and more rapidly into the general health care system.


Samhsa s strategic initiatives
SAMHSA’S STRATEGIC INITIATIVES Incarceration into Mental Health and Substance Use Treatment

3


Criminal justice system continues to be the largest referral to substance abuse treatment
Criminal Justice System continues to be the Incarceration into Mental Health and Substance Use TreatmentLargest Referral to Substance Abuse Treatment

Other recognized legal entity, or other

Other

20.6%

DUI/DWI

10.8%

Prison, 2.4%

Diversionary program, 2.5%

34.6%

Probation/

Parole

State/Fed Court, Other Court

Recognized Legal Entity

29.2%

Source: SAMHSA Treatment Data Set (TEDS) Concatenated, 1992-2010


Cj continuum multiple loci to address mh suds reduce cj contacts
CJ Continuum: Multiple Loci to Address MH/SUDs & Reduce CJ Contacts

  • Target upstream efforts to reduce initial CJC

  • Coordinate efforts

  • Link resources: Integrate info & efforts

  • Incentivize EBPs including proven medication-based tx

  • Target downstream efforts to support recovery & reduce recidivism

  • Evaluate & improve

Community (pre-CJC)

Entry

Custody

Diversion

Incarceration

Release/Reentry

Community (post-CJC)

SAMHSA focus areas


Veterans involved in the cj system
Veterans involved in the CJ System Contacts

Rand’s “Invisible Wounds of War” reported 19% of returning veterans have PTSD, Depression or both. 2008

  • Judge Robert Russell

  • Buffalo, NY Veteran Court



Key elements w hen dealing with vets cj system
Key ContactsElements When Dealing with Vets-CJ System

  • Trauma Informed

  • Peer Involved

  • Coordinated Across Systems

  • Community Services Engaged


Samsha and criminal justice
SAMSHA and Criminal Justice Contacts

  • SAMHSA’s criminal justice grant activities center around treatment services related to drug courts, offender reentry, early diversion from jails, early intervention to prevent deeper systems penetration, community behavioral health flexibility.

  • CSAT’s criminal justice budget has expanded in the past few fiscal years from approximately $23 M to $75 M; even in present budget cutting mode current budget is $75 M of which approximately $45 M is committed to treatment - drug court activities. CMHS’ budget is approximately $5-6 M.

  • CSAT has committed over $250 M towards grants supporting the expansion and enhancement of treatment services for drug court clients.


Samhsa csat criminal justice grant programs focus on tx capacity expansion
SAMHSA/CSAT Criminal Justice Grant Programs: Focus on Tx Capacity Expansion

There are approximately 215 active grants in CSAT’s criminal  and juvenile justice portfolio:

  • 115 Adult Drug Court grants including FY 2010, 2011, 2012 SAMHSA awards and joint grants with BJA adult drug court grant cohorts.

  • 11 Behavioral Health Treatment Court Collaboratives grants.   

  •   43 Juvenile/Family Drug Court Grants

    • 13 Family Dependency Drug Courts

    • 12 Children Affected by Meth-Family Drug Court grants;

    •    12 SAMHSA Juvenile Treatment Drug Court grants; and

    •    6 SAMHSA/Department of Justice, OJJDP/Robert Wood Johnson “Reclaiming Futures” Juvenile Drug Court grants.

  • 38 Offender Reentry Program grants

  • 10 Teen Courts


Samhsa grant programs cj and vets
SAMHSA Grant Programs – CJ and Vets Capacity Expansion

  • Early Diversion from the CJ System (‘13)

  • Adult, Juvenile, Family Drug Courts (‘13)

  • Offender Reentry Program (‘13)

  • FY 2014

    • Behavioral Health Treatment Court Collaboratives – closed April 18th!

    • SAMHSA-BJA Adult Treatment Drug Courts - closes May 28!!!


Fy 2014 joint adult drug court solicitation ti 14 008
FY 2014 Joint Adult Drug Court Solicitation –TI-14-008 Capacity Expansion

  • Purpose: Allow applicants to submit a comprehensive strategy for enhancing drug court services and capacity and compete for both criminal justice and substance abuse treatment funds with 1 application.

  • Due Date: May 28, 2014

  • Available Funding: Up to $4,500,000 M from BJA; $4,875,000 from SAMHSA

  • Number of Awards: 15

  • Award Amount: Up to $300,000 in BJA; $325,000 in SAMHSA funds (per yr. for SAMHSA $)

  • Length of Project Period: Up to 3 years


Veterans courts are eligible to apply
Veterans Courts are Eligible to Apply!! Capacity Expansion

  • Eligible drug court models include Tribal Healing to Wellness Courts, Driving While Intoxicated (DWI)/Driving Under the Influence (DUI) Courts, Co-Occurring Drug and Mental Health Courts, and Veterans Courts that adhere to the key components in Defining Drug Courts: The Key Components


Jointly funded initiative samhsa and bja
Jointly Funded Initiative: Capacity ExpansionSAMHSA and BJA

  • Applicants are limited to states or state courts applying on behalf of a single jurisdiction; local courts; counties; other units of local government; or federally recognized Indian tribal governments (as determined by the Secretary of the Interior). Indian tribal governments may apply directly or through other public or not-for-profit private entities. Eligible jurisdictions must have a fully operational (at least 1 year) adult drug court.


Program goals and objectives
Program Goals and Objectives Capacity Expansion

  • Overall goal of the Joint Adult Drug Court Solicitation is to expand and/or enhance the drug court capacity of state, local, and tribal levels to reduce crime and substance abuse among high risk/high need offenders. This evidence-based approach includes the key elements of judicially supervised treatment, drug testing, community supervision, appropriate sanctions, and recovery support services.

  • Grant funds must be used to serve high risk/high need populations diagnosed with substance dependence or addiction to alcohol/other drugs and identified as needing immediate treatment. Grant funds may be used to provide services for co-morbid conditions, such as mental health problems, as long as expenditures remain consistent with the drug court model which is designed to serve individuals needing treatment for substance dependence or addiction to alcohol/other drugs.


Focus on clinical treatment services
Focus on Clinical/Treatment Services Capacity Expansion

  • $ to serve high risk, high need populations with SA or CO Disorders;

  • Expand and/or enhance treatment and recovery services.

  • Screen/Assess for Co-Occurring Disorders/Develop Tx approach for those so identified

  • MAT-Up to 20% of funds may be used

  • Encouraged to provide HIV rapid testing ($ up to 5%)

  • Viral Hepatitis testing (Up to $5000)

  • Must utilize all available revenue sources first-Payor of last resort


Using evidence based practices
Using Evidence-Based Practices Capacity Expansion

  • Grants are intended to fund services/practices that have a demonstrated evidence based and appropriate to the population of focus. EBP refers to approaches to treatment that are validated.

  • Applicants need to identify the EBP to be implemented

  • Identify and discuss the evidence that the EBP is effective for selected population;

  • If using more than 1 EBP provide a justification and which modality and population each practice will support; and

  • Discuss the populations the EBP is effective and how it is appropriate to your population. Appendix C =info.


Fy 2013 samhsa treatment drug courts funding off the shelf in fy 2014
FY 2013 SAMHSA Treatment Drug Courts” Funding Off the Shelf in FY 2014

  • Congress provided SAMHSA with additional funding in FY 2014 specifically for treatment services for drug court clients. As many well scored applications were not funded in FY 2013 we are reviewing a large number of these applications with the intention of possibly funding several of these “off the shelf” applications. No funding decisions have been made but applicants were contacted last week so there is a good possibility that additional applications from Veterans Treatment Courts will be funded this year!!


Veterans treatment court mentor court network
Veterans Treatment Court Shelf in FY 2014Mentor Court Network

  • Free onsite visits for courts and/or individuals to learn from these courts

  • Serve as training and technical assistance sites for 3 years

  • Current Mentor Courts:

    • Buffalo (NY) Veterans Treatment Court

    • Rochester (NY) Veterans Court

    • Tulsa (OK) Veterans Treatment Court

    • Orange County (CA)

  • Funded through a grant from the Center for Substance Abuse Treatment (CSAT), SAMHSA

  • For information, contact NADCP – Carolyn Hardin


Want more information cj team contact information
Want More Information? Shelf in FY 2014CJ Team Contact Information

Ken Robertson, Team Leader, CJ Grants Programs

Kenneth.robertson@samhsa.hhs.gov240-276-1621

Jon Berg, Public Health Advisor,

Offender Re-entry/Adult Drug Courts

Jon.Berg@samhsa.hhs.gov240-276-1609

George Samayoa, Public Health Advisor

Drug Courts

George.Samayoa@samhsa.hhs.gov240-276-1622

Greg Torain, Public Health Advisor

Juvenile Drug Court, Teen Courts, Veterans Treatment Courts

Gregory.Torain@samhsa.hhs.gov240-276-1832


Contacts for samhsa vets cj programs
Contacts for SAMHSA Vets-CJ Programs Shelf in FY 2014

  • Center for Mental Health Services Justice Programs

    • David.Morrissette@samhsa.hhs.gov

    • 240-276-1912

  • Center for Substance Abuse Treatment Justice Programs

    • Jon.Berg@samhsa.hhs.gov

    • 240-276-1621


A gift for the audience lists of resources
A Gift for the Audience: Lists of Resources Shelf in FY 2014

  • SELECTED RESOURCES TO ASSIST YOU

    Contacts

    Websites

    Programs

    Data Information