NC Department of Health and Human Services LME Directors Meeting 9/14/07 NC Division of Mental...

NC Department of Health and Human Services

LME Directors Meeting 9/14/07LME Directors Meeting 9/14/07NC Division of Mental Health, Developmental Disabilities and NC Division of Mental Health, Developmental Disabilities and

Substance Abuse ServicesSubstance Abuse Services

Substance Abuse Services & the Criminal Justice System

04/21/23

NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services

Drugs & Crime

• 1 in 32 adults are under correctional supervision

• SA is disproportionately represented in correctional populations– 80% of parolees– 80% of prison inmates – 67% of probationers

• 59% of SA Referrals from CJS

04/21/23


Drugs & Crime in NC

• 38,423 people in prison– 30,738 need substance abuse services

Note: 97% will be released

• 117,607 people on probation, parole or post-release– 79,347 need substance abuse services

04/21/23


Felonies:Felonies:Type of Punishment ImposedType of Punishment Imposed

47%

37%

28%

43%

26%

20%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Active Intermediate Community

Old Law**

Structured Sentencing*

* SOURCE: NC SPAC FY05-06 Report

** SOURCE:1993 Pre-Structured Sentencing Data

04/21/23


NC Problem Statement

• Limited CJ & Tx resources

• Complex clients: challenging behavioral health needs & serious consequences of failure

• Recidivism & Relapse are common

• Service availability & effectiveness

04/21/23


OMM: Balancing Control & Tx

• One Offender One Case Plan One Team

• Common Goal: Safely manage high-risk, high-need offenders in the community

04/21/23


DHHS-DOC-AOC MOAMemorandum of Agreement

between the North Carolina Department of Health and Human Services

and the North Carolina Department of Correction

and the Administrative Office of the Courts

i. ii. This Memorandum of Agreement (MOA) and Appendices are entered by and

between the Department of Health and Human Services (DHHS), the Department of Correction (DOC) and the Administrative Office of the Courts (AOC) for the purpose of developing a comprehensive offender management model that ensures public safety while addressing the needs of offenders. The Division of Community Corrections (DCC) and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS) are the primary resources involved in community corrections. AOC manages the N.C. Drug Treatment Court Act Program and provides administrative support to the local courts that operate Adult Drug Treatment Courts (DTC). The Division of Alcoholism and Chemical Dependency Programs (DACDP) and Division of Prisons (DOP) impact community corrections through the release of offenders who have received services while in custody or while in a residential facility (DART-Cherry). The purpose of a comprehensive offender management model is to create a seamless system built on the ideals of integrated service delivery and coordination of resources that provide effective interventions for offenders.

04/21/23


What is TASC?

• A model that bridges two separate systems: justice & treatment

• Links treatment & justice goals of reduced drug use & criminal activity

• Uses processes that improve treatment access, engagement & retention

04/21/23


TASC:Nationally & in NC

• 1962 Robinson v. California - addiction is an illness, not a crime

• 1970s Federal government develops model to interrupt drug-crime

cycle: Treatment Alternatives to Street Crime

• 1972 first TASC program in Wilmington, Delaware

• 2007 National TASC represents over 200 programs

• 1978 First TASC Programs in NC

• 1993 10 Programs in 20 Counties

• 1994 Structured Sentencing Act

• 1998 23 Programs in 43 Counties

• 2000 SOP; DHHS-DOC MOA

• 2002 TASC services available in all 100 counties

• 2003 TASC Training Institute

• 2005 AOC joined MOA

• 2007 15,000+ Offenders Served

04/21/23


TASC Eligibility

• involved in the CJS or DOC releasee who completed a prison substance abuse program; &

• voluntary consent to participate; &

• evidence of a history or potential substance abuse &/or mental health issue, including drug-related charges

04/21/23


TASC Core Services

• Screening & Assessment

• Referral & Placement

• Care Planning, Coordination & Management

• Reporting Progress to Justice System

Referral from

CJS

Referral back to CJS or other appropriate

community service provider

TASC monitors &Referral to self-pay services

&/or other appropriatecommunity service provider

Common Case Plan, (coordinated w/ CJS)

CJS Enforcing Special

Conditions& SupervisionRequirements

CJS Interface thru TASC

TASC

ScreeningAssessment

CJS = Probation Officer, CJPP staff, Judge, DA, PD/ Defense Atty, DTC staff, DART staff

TASCOrganizing community-based

services & supports,Urinalysis, Monitoring

progress in all services & supports, Adjusting Common Case Plan,

Reporting to CJS

LME90801, Diagnostic Assessment,

Community Support, SAIOP, SACOT, Detox, SA HH, SA non-med residential,

SA med residential,SA inpatient hospitalization

No TASC service needed; orNo MHDDSAS service needed;

Or services refusedAppropriateService?

Low-Risk/Low-Need

High-Risk / High-Need (A/CSCJO Target Pop)

04/21/23


ASCJO & CSCJO Adult & Child Substance Abusing Criminal Justice Offender Target Population (ASCJO & CSCJO) to ensure access to treatment for individuals with a SA diagnosis who present the greatest risk to public safety.

Eligibility includes: Diagnostic criteria for a substance-related disorder; and Services approved by a TASC care manager; and CJS Status as an Intermediate Punishment offender, a

Department of Correction releasee who has completed an in-prison treatment program, or a Community Punishment violator at-risk for revocation

Dur

ham

1

4 A

-B

Ala

man

ce

15

A

Alexander 22

Alleghany 23

Anson 20 A

23Ashe

Avery 24

2Beaufort

6 BBertie

13Bladen

13Brunswick

Buncombe28

Burke 25 A

Cabarrus 19 A

Caldwell 25 A

3B Carteret

Caswell 9 A

Catawba 25 B

Chatham 15 B

Cherokee 30 A

27 BCleveland

13Columbus

3 BCraven

12 A-B-CCumberland

Dare 1

Davidson 22

Davie 22

Duplin 4 A

7 BEdgecombe

Forsyth21 A-B-C- & D

9Franklin

27 AGaston

1Gates

30 AGraham

9

Granville

8 AGreene

Guilford18 A-B-C-D-E

6 AHalifax

Harnett 11

Haywood30 B

Henderson 29

6 BHertford

Hoke 16 A

2Hyde

Iredell 22

Jackson30 B

Johnston 11

4 AJones

Lee 11

8 ALenoir

Lincoln 27 B

McDowell 29

Macon 30 A

Madison 24

2Martin

26 A-B-CMecklenburg

Mitchell 24

19 B

Montgomery Moore 20 A

7 ANash

NewHanover5

Northampton 6 B

4 BOnslow

Orange 15 B

3 B Pamlico

Pender 5

Person 9

3 APitt

Polk29

Randolph 19 B

Richmond 20 A

Robeson 16 B

Rockingham 17 A

Rowan 19 C

Rutherford 29

Sampson 4 A

16 AScotland

Stanly20 B

Stokes 17 B

Surry 17 B

Swain 30 A

Transylvania 29

2Tyrrell

Union 20 B

9Vance

Wake10 A-B-C-D

9Warren

2Washington

24Watauga

8 BWayne

Wilkes 23

Wilson 7 C

Yadkin 23

Yancey 24

Pasquotank

Perquimans

Chowan

Currituck

Camden

Region 1

Region 4

Region 3

Region 2

Clay 30A

Region 1 - Wes Stewart308 New StreetNew Bern, NC 28560252.638.3909

Region 2 – Andy Miller412 West RussellFayetteville, NC 28302910.321.6796

Region 3 – Michael Gray516 N. Trade St.Winston-Salem, NC 27101336.714.7080

Region 4 – Carlene Wood370 N.Louisiana Ave, Ste. E-3Asheville, NC 28806828.210.0535

TASC Training Institute Dale Willetts615 Shipyard Blvd.Wilmington, NC 28412910.202.5500

North Carolina TASC Network

TASC is organized into 4 regions which reflect the state’s 4 judicial

divisions, consistent with the unified court & statewide probation systems.

04/21/23


TASC Statistics

• 80% Male

• 48% Black 47% White

• 60% less than 31yo– 20% 16-21yo

• 85% Not Married

• 52% No HS Diploma

• 32% Unemployed

04/21/23


TASC Statistics• Ave. length of stay:

8½ months

• $1.35 per client per day

• 2000 Recidivism Report to the General Assembly* • 86% had at least 1

previous arrest (mean # 2.6)

• 61% were NOT re-arrested within 2 years of discharge

* NC Sentencing & Policy Advisory Commission

04/21/23


How TASC Benefits Treatment

• Increases Client Identification– Improving treatment outreach & access

• Provides Independent Assessment of Need

• Improves Treatment Engagement– orients clients to tx; reduces “no shows”,

increasing tx staff productivity

• Improves Treatment Retention & Compliance– improving tx outcomes

• Provides Support & Continuity during Tx & CJ Transitions

04/21/23


How TASC Benefits Treatment

• Maintains clear Roles & Responsibilities– Tx providers focus on client care & Probation

officers focus on supervision

• Balances Control & Treatment – arranges goals & objectives of Tx, CJS & the client

• Improves Communication among Systems about & with Client

• Provides addt’l information for Treatment, Judicial & Correctional Decision-Making

04/21/23


www.northcarolinatasc.org

04/21/23


2007 Legislative Session: Treatment Court Programs

Funding for services for existing pre- & post-plea MH courts, DWI courts & adult & family DTCs

Funds are expected to be allocated to LMEs w/ Adult DTCs based on the number of Active Participants during CY05-06

In providing DTC services, LMEs shall consult with the local DTC team & select a tx provider that meets all provider qualification requirements & DTC needs.

A single tx provider may be chosen for non-Medicaid-eligible participants only. A single provider may be chosen who can work with all non-Medicaid-eligible DTC participants in a single group.

During the 52-week DTC program, participants shall receive an array of tx & aftercare services that meets the participant's level of need, including step-down services that support continued recovery.

04/21/23


Dur

ham

14

A-B

Ala

man

ce

15

A

Alexander 22

Alleghany 23

Anson 20 A

23Ashe

Avery 24

2Beaufort

6 BBertie

13Bladen

13Brunswick

Buncombe28

Burke 25 A

Cabarrus 19 A

Caldwell 25 A

3B Carteret

Caswell 9 A

Catawba 25 B

Chatham 15 B

Cherokee 30 A Clay

30 A

27 BCleveland

13Columbus

3 BCraven

12 A-B-CCumberland

Dare 1

Davidson 22

Davie 22

Duplin 4 A

7 BEdgecombe

Forsyth21 A-B-C- & D

9Franklin

27 AGaston

1Gates

30 AGraham

9

Granville

8 AGreene

Guilford18 A-B-C-D-E

6 AHalifax

Harnett 11

Haywood30 B

Henderson 29

6 BHertford

Hoke 16 A

2Hyde

Iredell 22

Jackson30 B

Johnston 11

4 AJones

Lee 11

8 ALenoir

Lincoln 27 B

McDowell 29

Macon 30 A

Madison 24

2Martin

26 A-B-CMecklenburg

Mitchell 24

19 B

Montgomery Moore 20 A

7 ANash

New

Hanover 5

Northampton 6 B

4 BOnslow

Orange 15 B

3 B Pamlico

Pender 5

Person 9

3 APitt

Polk29

Randolph 19 B

Richmond 20 A

Robeson 16 B

Rockingham 17 A

Rowan 19 C

Rutherford 29

Sampson 4 A 16 A

Scotland

Stanly20 B

Stokes 17 B

Surry 17 B

Swain 30 A

Transylvania 29

2Tyrrell

Union 20 B

9Vance

Wake10 A-B-C-D

9Warren

2Washington

24Watauga

8 BWayne

Wilkes 23

Wilson 7 C

Yadkin 23

Yancey 24

Pasquotank

Perquimans

Chowan

Currituck

Camden

AdultDrug Treatment Courts

04/21/23


2007 Legislative Session:LMEs & Jails

SECTION 10.49.(f) Within available resources, LMEs shall work with county public health depts & sheriffs to provide medical assessments & medication for jail inmates who are suicidal, hallucinating, or delusional. LMEs shall also examine ways to provide addt’l treatment to persons who are determined to be psychotic, severely depressed, suicidal, or who have substance abuse disorders. To this end:

(1) DHHS shall work with LMEs, county public health depts & sheriffs to develop a statewide standardized evidence-based screening instrument to be used when offenders are booked. The screening tool shall be implemented by January 1, 2008.

(2) LMEs & county sheriffs shall work together to develop all of the following:a. A designated LME employee

responsible for screening the daily jail booking log for known mental health consumers.

b. Protocols for effective commun-ication between LME & jail staff including collaborative development of medication management protocols between jail & mental health providers.

c. Training to help detention officers recognize signals of mental illness.

04/21/23


2007 Legislative Session:Crisis Intervention Teams

Provides funding to be used by:

• LMEs to develop CITs

• DMHDDSAS to develop statewide training capacity

DMHDDSAS will:

• Release an application for LMEs to request funding for CITs

• Provide technical assistance for developing CITs

• Fund an annual statewide CIT conference

NC Department of Health and Human Services LME Directors Meeting 9/14/07 NC Division of Mental...

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