BEST PRACTICES FOR LOUISIANA DRUG COURTS

Louisiana Association of Drug Court Professionals

Best Practices
Developed in cooperation with the Louisiana Supreme Court Drug Court Office and the Louisiana Office for Addictive Disorders

L o u isia n a A sso cia tio n o f D ru g C o u rt P ro fessio n a ls

1 1 0 1 S o u th east B lv d ., B a y o u V ista, L A 7 0 3 8 0 P h o n e 9 8 5 -3 9 9 -5 7 7 7 F a x 9 8 5 -3 9 9 -5 7 7 8

Open letter to members and other Drug Court Professionals

The principals and practices set forth in this document build upon the minimum standards as set forth in the Louisiana Supreme Court Drug Court Offices drug court policy and procedures manual. Louisiana drug courts and LADCP have been on the cutting edge of drug court practice since our journey began in 1996. Again, we break new ground by publishing a set of treatment best practices each developed by a statewide task force. In keeping with the principals of other leading organizations in this field, we intend these best practices to serve as a model for drug court practice in the state of Louisiana. We recognize that different strategies and practices are required with various client groups as well that various resources are available based on the jurisdiction in which any particular drug court is operating. This document is only a road mark in the dynamically changing drug court movement. What we have defined here as best practices will grow and change just as the entire drug court field in the state of Louisiana.

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William D. Hunter, President

Table of Contents
Introduction by the President Acknowledgements for Best Practices Adult Drug Treatment Court Best Practices Definitions (Adult Best Practices) Juvenile Drug Treatment Court Best Practices Definitions (Juvenile Best Practices) 1 3 4 9 10 16

Louisiana Adult Drug Treatment Court Best Practices

The association would like to recognize the efforts of the following individuals who served on the development committee for the best practices series. Committee members gave their time and attention to this task, receiving no compensation.

Dr. Joseph Bowie James Bouleware Nancy Bushnell Paul Cassidy

Don Clausen David Wyman Bill Cheetwood

Lars Levy Dawn Palermo Sandy Record Mike Vidallier

Louisiana Juvenile Drug Treatment Court Best Practices

Carolyn Ashley Chris Bailey Sonya Barbier Cary Heck Sandy Record Rob Carlistle Martin Dykes Ryan Verrette Lars Levy Dawn Palermo Cathy Phlipsen Lance Wallace

LOUISIANA ADULT DRUG TREATMENT COURT BEST PRACTICES The following standards are based on the 10 Key Components as developed and published by the U.S. Department of Justice, Office of Justice Programs. They are modified for use within the Louisiana system with the goal to coordinate treatment delivery with judicial oversight. The Standards are designed to provide the orientation toward treatment and judicial supervision so as to distinguish treatment-based, multi-discipline, full-service drug courts from other programs. PURPOSE: The drug court mission is to reduce offender abuse and/or addiction of alcohol and other mood-altering chemicals, thus decreasing related criminal activity. Drug courts promote recovery through a coordinated response to offenders dependent on alcohol and other drugs. Utilization of a team approach is required, including cooperation and collaboration of judges, prosecutors, defense counsel, probation authorities, law enforcement, service providers, and evaluators. Drug courts employ a multiphased treatment process, generally divided into a stabilization phase, an intensive treatment phase, and a transition phase. I. PRACTICE: Drug Courts integrate alcohol and other drug treatment services with justice system case processing. A. Drug Court Team shall develop and delineate written policy and procedure, reflecting shared goals and objectives for a drug court treatment program. II. PRACTICE: Each Drug Treatment Court Provider will have a separate Collaborative Agreement between the Office of Alcohol and Drug Abuse, the District Attorneys Office and the Public Defenders Office, the Probation Department, and the Judge. A. The Collaborative Agreement will be pursuant to La. R.S. 13:5301-5304, utilizing the standardized OADA Collaborative Agreement form. III. PRACTICE: Eligible participants are identified early and promptly placed in the drug court program. A. Eligibility screening is based on established written criteria and pursuant to La. R.S. l3:53015304. B. Screening is done initially by the District Attorney or his/her staff, knowledgeable in Drug Court Treatment screening criteria. C. Criteria for admission: 1. Individual is charged with a violation of a statute of this state relating to the use and possession of any narcotic drugs, coca leaves, marijuana, depressants, or hallucinogenic drugs or where there is a significant relationship between the use of alcohol or drugs, or both. 2. The District Attorney has reason to believe that the individual who is charged suffers from alcohol or drug addiction. 3. The best interest of the community and the interest of justice would be best served by providing the individual with treatment as opposed to incarceration or other sanctions.

D. Initial appearance before the drug court judge should occur within 30 days of arrest. E. Once accepted by the drug court judge, the individual must report to treatment within 24 hours. F. An approved Consent Form must be completed to provide communication about participation progress in treatment and compliance with the provisions of 42 CFR, Part 2 and La. R.S. l3:5301. G. Assessment for placement in the treatment program shall be performed by certified, professional or licensed alcohol and drug professionals. H. Assessment by treatment providers shall be completed on a timely basis. I. Once admitted to a treatment providers program, all OADA Standards for intensive outpatient programming are applied. IV. PRACTICE: Drug Courts provide access to a continuum of alcohol, drug, and other related treatment and rehabilitation services. Treatment services shall be licensed by OADA and in accordance with La. R.S. l3:5301-5304. A. Staffing requirements/qualifications and treatment components utilized shall be consistent with/and adhere to the OADA Standards for Treatment Service. Drug Court Treatment is a structured therapeutic program. It is an organized service with credentialed personnel that provides a planned regimen of treatment consisting of a minimum of three (3) days per week and a minimum of nine (9) skilled treatment hours (skilled treatment hours include individual and/or group therapy and therapeutic educational sessions) per week during Phase I. Additionally, Phase I should continue for a minimum of two (2) to four (4) months. A minimum of two (2) days per week and a minimum of four (4) skilled treatment hours per week in Phase II. Phase II should continue for a minimum of four (4) to six (6) months. A minimum of two (2) skilled treatment hours per week in Phase III. Phase III should continue for a period of three (3) to six (6) months after which the Drug Court Client should be completed/graduated. The program typically provides at least two skilled treatment services per day in addition to required attendance at self-help support group meetings. Services may be provided in day or evening programming. Treatment Components include: detoxification, inpatient, halfway house, three-quarter way house, outpatient, and intensive outpatient. Advocacy Activities - including, but not limited to, vocational, financial, family, resocialization, recreational, follow-up care, and literacy training; Case Management - including, but not limited to, referrals for continuing education, housing, job placement. Counseling - by a credentialed counselor, addressing goals and objectives as identified in the assessment and developed in the treatment/recovery plan. Drug Screening Urinalysis - by a qualified lab Educational Groups Topics may include HIV and sexually transmitted diseases, chemical dependency, group dynamics (defense mechanisms, rescuing, terminology), living/coping skills, feelings, Twelve Step, grief process, spirituality, relapse prevention; problem solving, de-

cision making, communication, stress management, parenting education and skills, nutrition, leisure activities, assertiveness training, family dynamics/roles, cross tolerance. Family Program - Family members and significant others will receive education and/or therapy regarding the disease of chemical dependency, family roles in the dysfunctional family and introduction to Twelve Step groups or other self help groups. V. PRACTICE : Abstinence is monitored by frequent alcohol and other drug testing. A. AOD testing policies and procedures are based on guidelines established by the Office of Alcohol and Drug Abuse. B. Testing may be administered randomly and at scheduled intervals, but occurs no less than twice a week during Phase I and Phase II of an individuals enrollment. Frequency thereafter will vary depending on participant progress; however, Phase III will include a minimum of weekly testing. C. The scope of testing shall be sufficiently broad to detect the participants primary drug of choice, as well as other potential drugs of abuse, including alcohol. The court is to have breathalyzer capability/accessibility. D. Each Court shall have written policies and procedures for urine sample collection, sample analysis, and result reporting. These shall follow the guidelines established by the OADA. E. Test results are available and communicated to the court and the participant within one working day. The court is notified immediately when a participant tests positive, has failed to submit to AOD testing, has submitted the sample of another, or has adulterated a sample. VI. PRACTICE: A coordinated strategy governs drug court responses to participants compliance. A. Recovery from addiction is a process facilitated through therapeutic strategies aimed at preventing AOD use by teaching participants to manage their ambivalence toward recovery, identify high-risk situations, and develop necessary coping skills to deal with high-risk situations, and maintain sobriety for increasing lengths of time. Plans for addressing participants who test positive at intake and for relapses in the future must be clearly established with outlined treatment guidelines, enforced and reinforced, by the judge. Graduated sanctions are to be in place. A coordinated strategy, including a continuum of graduated responses for non compliant behavior, must be written and available for participants review prior to committing to treatment. 1. Procedures for reporting are clearly defined in the drug courts operating procedure. There will be weekly case review/staffing with representatives from all disciplines of the drug court team present. 2. Responses to compliance and noncompliance are explained verbally and provided in writing to participants before their orientation. Periodic reminders will be provided throughout the treatment process. 3. Responses for compliance or noncompliance will be graduated and consistent with the infraction or accomplishment.

4. Responses for compliance vary in intensity and may include: a. Encouragement and praise from the bench; b. Ceremonies and tokens of progress, including advancement to the next treatment phase; c. Reduced supervision; d. Decreased frequency of court appearances; e. Reduced fines or fees; f. Dismissal of criminal charges or reduction in the term of probation; g. Reduced or suspended incarceration; and h. Graduation. 5. Responses to or sanctions for noncompliance might include: a. b. c. d. e. f. g. h. i. Warnings and admonishment from the bench in open court; Demotion to earlier program phases; Increased frequency of testing and court appearances; Confinement in the courtroom or jury box; Increased monitoring and/or treatment intensity; Fines; Required community service or work programs; Escalating periods of jail confinement (drug court participants remanded to jail should receive AOD treatment services while confined); and Termination from the program and reinstatement of regular court processing.

6. Payment of fees, fines, and restitution is part of treatment. Fee schedules are commensurate with an individuals ability to pay. VII. PRACTICE: Ongoing judicial interaction with each drug court participant is essential. A. The judge is the leader of the drug court team, linking participants to treatment and the criminal justice system. The structure of the drug court demands early and frequent judicial intervention in treatment. Frequent status hearings provide the vehicle for the ongoing judicial involvement, allowing the judge to impose appropriate sanctions and rewards commensurate with treatment progress as defined in Standard VI. The drug court judge is knowledgeable about treatment methods and their limitations. It is important that hearings be under the same judge for the length of participants one-year treatment. Regular status hearings are used to monitor participants performance. B. Weekly status hearings are to be held during the stabilization phase (Phase I); bi-weekly status hearings are to be held during the intensive treatment phase (Phase II) and; monthly hearings during the transition phase (Phase III). C. Time between status hearings may be increased or decreased, based on compliance with treatment protocols and progress observed. D. The court applies incentives and sanctions to match treatment progress as defined in Practice VI.

E. The court supervises payment of fees, fines, and/or restitution. VIII. PRACTICE: Monitoring and evaluation measure the achievement of program goals and gauge effectiveness. A. The goals of the program are to be described concretely and in measurable terms. B. An evaluation mechanism is to be designed prior to program implementation. C. A qualified independent evaluator responsible for developing and conducting an evaluation design and for preparing interim and final reports should be selected. D. Ongoing evaluation and monitoring is required to measure progress in meeting operational and administrative goals, effectiveness of treatment, and outcome toward meeting longterm goals of crime-free and drug-free participants. E. Specific and measurable goals define the parameters of data collection and information management. F. At least six months after exiting a drug court program, follow-up evaluations shall be completed to determine the long-term effects of the program. Additional follow-up evaluations shall be completed annually for two years. G. Information systems must adhere to written policies, consistent with State and Federal guidelines, that protect against unauthorized disclosure. IX. PRACTICE: Continuing interdisciplinary education promotes effective drug court planning, implementation, and operations. A. Operating procedures shall define minimum basic educational requirements and requirements for continuing education, consistent with State certification and licensure requirements. B. Attendance at drug court specific education and training sessions by all drug court personnel is essential. This is to be described and delineated in the established education syllabus. A minimum of 12 hours annually is mandatory. C. An education syllabus and curriculum describing the drug courts goals, policies, and procedures is to be developed. Topics may include: Goals and philosophy of drug courts; nature of AOD abuse, its treatment and terminology; dynamics of abstinence and techniques for preventing relapse; responses to relapse and to noncompliance with other program requirements; drug testing standards and procedures; Federal and State confidentiality requirements. X. PRACTICE: Document partnerships among drug courts, public agencies, and communitybased organizations to generate local support and enhance drug court program effective ness. The drug court is a partnership among organizations--public, private, and community-based dedicated to a coordinated and cooperative approach to the AOD offender.

DEFINITIONS Alcohol and drug abuse program program licensed by the State of Louisiana to provide education, prevention and treatment directed toward achieving the mental and physical restoration of alcohol and drug abusers or addicts. Treatment Program any governmental agency or other entity, licensed by the State of Louisiana to provide substance abuse or addiction treatment on a residential or outpatient basis. Treatment programs shall be certified and approved by the State of Louisiana, and adhere to the standards of practice as established by the Office of Alcohol and Drug Abuse. Monitoring ongoing or periodic observation of program operations to ensure that the program stays on course and that the operational procedures are revised as needed. Evaluation involves periodic observation of operations, but focuses primarily on assessment of a programs effectiveness in achieving its goals. Treatment Services 1. Inpatient service Structured program for clients requiring 24 hour supervision. This may include residential setting, hospital, transitional living settings, or detoxification programs. 2. Outpatient servicean organized continuing care service that provides a planned regimen of treatment consisting of regularly scheduled therapeutic sessions. Intensive Outpatient Serviceincludes a minimum of nine (9) treatment hours, in day and/or evening sessions, delivered in three (3) or more days per week.

LOUISIANA JUVENILE DRUG TREATMENT COURT STANDARDS

Best Practice I: Planning a Juvenile Drug Court Drug Courts integrate alcohol and other drug treatment services with justice system case processing. A. The planning team should include: 1. Drug Court Judge 2. District Attorney or Representative from District Attorneys Office 3. Public Defender 4. School Representative 5. Social Services Representative 6. Law Enforcement Representative 7. Local Treatment Providers Representative 8. Representative from Probation/Parole Department 9. Evaluator 10. Other Community-Based Stakeholders B. The purpose of the planning team is to: 1. Assess the scope and intensity of the programs activities. 2. Develop written policy and procedure which includes a mission statement, program goals and objectives as well as indicators outlining program success. a. The goals and objectives will be measurable and provide accountability for the various stakeholders and policy-makers b. Identify a target population c. Determine the services that will need to be provided (including ancillary services for youth and their families) d. Project the potential impact of the program on other community resources. C. Develop a cooperative agreement and/or memorandum of understanding to be implemented between members of the drug court planning team and other community resources. Issues for Consideration: A. The planning team is to include state, parish, local, and community-based stakeholders who can provide support for program implementation and successful program management. B. Comprehensive, interdisciplinary planning is critical for identifying and securing the community resources and partnerships that can provide ongoing support for the program.

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C. A consensus is to be reached on the following areas during the planning process: 1. 2. 3. 4. 5. 6. 7. 8. 9. Target Population Judicial Supervision Screening and Referral Process Treatment Approach and Interventions Drug Testing Procedures Case Management/Monitoring Criteria and application of Graduated Incentives and Sanctions Graduation/Termination Criteria Evaluation and Follow-up Procedures

Best Practice II: Interdisciplinary Team Requirements An interdisciplinary team will be established as a Juvenile Drug Court Team. A. The Juvenile Drug Court Team will consist of a minimum of the members listed below. While it is recognized that in some instances members may fulfill dual roles, it is imperative that representatives be identified to fulfill the following duties: 1. 2. 3. 4. 5. 6. 7. Designated Drug Court Judge District Attorney/Prosecutor Public Defender/Defense Attorney Drug Court Coordinator Representative(s) from Treatment Provider(s) Case Manager Probation Officer/Compliance Officer

B. The team will meet prior to each drug court hearing to discuss issues and to achieve consensus on client responses and progress. Issues to Consider: A. Beyond the minimum team members listed above, an extended drug court team may include: 1. 2. 3. 4. 5. 6. Law Enforcement Personnel/Detail Officer School Representative Mental Health providers (Psychiatrist, Social Worker, Psychologist) Neighborhood and Business Leaders Faith-Based Leaders Evaluator

B. The judge is the key leader for the juvenile drug court program. The judge oversees not only the juveniles performance and that of his/her family, but also the coordination and delivery of treatment and other core services. The decision-making process is collegial, drawing on the perspectives and expertise of all members of the drug court team. C. Team meetings outside of status staffing are important and necessary (example: team retreats, policy team meetings).

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Best Practice III: Target Population and Eligibility Criteria

Criteria for Eligibility, Suitability, and Feasibility must be established, written and clearly defined.

A. Criteria for eligibility, including age range, mental health status, and types of offenses committed will be established. B. Clients with offenses prohibited by La. R.S.13:5301-5304 will not be accepted. C. The acceptable age range, within 12 years of age and 17 years of age at time of entry into the juvenile system, is defined by the established criteria of individual juvenile drug courts . D. Careful consideration shall be given to those offenses of intent to distribute to ensure a substance abuse problem exists. Issues to Consider: A. Admission of a qualified offender is to be in the best interest of the program and/or the potential participant. B. Transportation ability of the client/family to attend all required services should be considered in screening process. Best Practice IV: Developmentally Appropriate Treatment Services Juvenile Drug Court Treatment Services are to be developmentally appropriate and tailored to meet the needs of adolescents. A. All facilities rendering drug court treatment services are to be licensed by the Department of Health and Hospitals, Bureau of Health Standards, according to the Minimum Licensure Standards for Substance Abuse/Addiction Treatment Facilities (La. R.S. 40:1058.2). B. Individual providers rendering treatment services will be in good standing with their respective boards for licensure/certification. C. Each individual admitted to drug court will have a comprehensive assessment. The assessment will include substance use, medical, psychological, and social information. Additional issues to be addressed may include gender, ethnicity, sexual orientation, special educational/vocational needs, cultural and geographic issues. D. An individualized treatment plan will be developed within 14 days of admission to the program. It is to be comprehensive and address the unique service needs of the juvenile and include ancillary services identified as needed. The treatment plan is to be reviewed/updated periodically as needed to meet the needs of the juvenile but, at a minimum, at each phase change. E. The number of services provided will be defined by phases within the established Policy and Procedure Manual of each individual program. The initial treatment phase does require a minimum of five (5) therapeutic hours per week. Treatment service hours may gradually decrease as the client progresses, but are to be based on the needs of the client and reflected in

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the treatment plan. F. Provision of treatment services will be based on individuals need with successful completion requiring a minimum of nine (9) months. G. Family involvement will be included in all juvenile drug court programs. Family may be defined beyond the traditional family and may include grandparents, a non-relational guardian, aunt (s)/ uncle(s), godparent(s), etc. H. The strengths-based perspective should be applied to all aspects of the program. Issues to Consider: A. The family should be treated as a unit with equal access to all services, including ancillary services (example: substance abuse treatment, recreation activities, vocation counseling services, etc.). Best Practice V: Drug Testing Drug testing is required as a component of drug court. A. Drug testing procedures are to be in compliance with all state and local legislation regarding drug testing. Drug testing is to be administered randomly and frequently enough to identify new or continuous use. B. A full-panel drug test is to be taken as part of the screening process for determination of a baseline of drug presence. C. In the initial phase, clients will be drug screened a minimum of two (2) times per week. D. Appropriate gender-specific drug court personnel will supervise urine collection. Issues to Consider: A. Family members may be tested as necessary to ensure an environment conducive to sobriety. B. Policies for positive drug screens of family members need to be established prior to testing family members. C. Suggested random drug testing methods include: color-code system, drawings, code system, etc. Best Practice VI: Status Hearings Frequent status hearings establish and reinforce the drug courts policy and ensure effective supervision of each drug court participant. A. The frequency of status hearings is determined by the established program requirements and based on individual client needs. B. In the initial phase of treatment each client will have weekly court status hearings. At no time will the time between status hearings exceed one month.

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C. Juvenile Drug Court dockets will be separate from any other court proceedings. D. A designated family member/guardian will accompany the client to each status hearing unless the juvenile drug court judge grants prior authorization. Issues to Consider: A. Drug Court Hearings will be open to all Drug Court participants appearing for court on a particular day. Requests for closed hearings may be granted under special circumstances. B. The use of a courtroom theater to enhance the degree of success through peer pressure must be balanced with the maturity of the child and the sensitivity of the issues to be discussed. Best Practice VII: Confidentiality Issues Confidentiality issues must be in accordance with all federal and state guidelines. A. The confidentiality policy shall protect the privacy of the minor in accordance with 42 CFR Part 2 and La. R.S. 46:1923. Issues to Consider: A. Any additional non-traditional team members must sign confidentiality agreements according to 42 CFR and La. R.S. 46:1923. B. All team members share in the responsibility to maintain confidentiality in accordance with 42 CFR and La. R.S. 46:1923. Best Practice VIII: Participant Supervision Participant Supervision is a requirement for each drug court participant. A. Drug Court participants will be supervised for compliance with drug court requirements by designated personnel at least two times per week for initial phase. (Examples of such personnel may include a probation officer, court compliance officer, case manager, and/or designated police liaison.) B. Compliance/Noncompliance will be reported to the drug court team weekly. Issues to Consider: A. Suggested areas of supervision include: 1. School attendance/performance 2. Curfew 3. Employment B. A service plan encompasses all additional services needed for an individual participant and may be developed in conjunction with the treatment plan.

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C. Clients will be supervised for the duration of the Juvenile Drug Court Program. D. The drug court team should determine the frequency of supervision and decreased supervision should be based on the participants compliance. Best Practice IX: Quality Assurance and Program Evaluation Each court must participate in three types of evaluation: process evaluations, output evaluations, and outcome evaluations. A. Process evaluations will be conducted bi-annually to determine if the operational goals of the court are being met. B. Output evaluations will be submitted monthly to the Louisiana Supreme Court Drug Court Office according to the requirement of participation in the drug court management information system. C. All drug courts will participate in outcome evaluations as mandated by the Louisiana Supreme Court Drug Court Office. Issues to Consider: A. Process evaluations will focus on the following components: 1. 2. 3. 4. 5. 6. 7. 8. 9. Target population Screening and assessment Case management Program length Treatment types and resources Sanctions and incentives Expulsion and graduation criteria Team coordination Implementation

B. Output evaluations focus on the following programmatic components: 1. 2. 3. 4. 5. 6. Number of clients served Previous substance abuse among clients Phase completion Overall program completion Completion of other court requirements Reasons for expulsions

C. Outcome evaluations focus upon the following components: 1. Program completion rates 2. Types of treatment provided 3. Ongoing measures of success a. School participation/employment b. Family status c. Maintenance of mood-altering substance-free lifestyle

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4. Recidivism 5. Cost-benefit analysis Best Practice X: Training and Continuing Education Drug Court staff must receive appropriate drug court trainings and/or continuing education. A. Professional staff must receive continuing education necessary for renewal of their professional licenses or certification. B. Initial and ongoing training will include, but not limited to, adolescent development, legal process, treatment techniques, policy and procedure of the drug court program, disease process, cultural competency, monitoring and evaluation, safety issues, confidentiality and quality assurance. C. Professional staff should be members of the Louisiana Association of Drug Court Professionals and attend LADCP sponsored conference and trainings. Issues to Consider: A. Continuing education should also include: 1. Concept of interdisciplinary drug court team and the need for team building 2. Specific training needs of the individual disciplines within the drug court team. 3. Need for cross training among team members. Definitions

1) Evaluations:

a) Process Evaluations-measure efficiency in the operation of each individual court and can be used to fine-tune those operations. b) Output evaluations are centered on the actual numbers and measure the short-term efficacy of each drug court. c) Outcome evaluations: focus on the long-term effects of drug court on the clients themselves. This type of evaluation allows policy makers to determine both the implicit and explicit cost savings for the drug court program. 2) Random drug screens: testing on a non-scheduled interval with clients having no ability to learn of the scheduling procedure 3) Screening: the process by which a client is deemed appropriate and eligible to the program. 4) Assessment: the procedures by which a counselor/program identifies and evaluates an individuals and families strengths, weaknesses, problems and needs for the development of the treatment plan 5) Therapeutic hour: skilled treatment hour.

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First Edition February 2003 Louisiana Association of Drug Court Professionals 1101 Southeast Boulevard Bayou Vista, Louisiana 70380 Ph: 985-399-5777 Fax: 985-399-5778