Introduction to California Veterans Treatment Courts and Penal Code 1170.9 Jude Litzenberger, Coordinator, Veterans Treatment Review Calendar, San Diego Superior Court and Executive Director, California Veterans Legal Task Force; (LCDR, USN (Ret.) Hon. John Lonergan, California Superior Court, Los Angeles County (Col., USAR) Paul Freese, Director of Litigation and Advocacy, Public Counsel Law Center Los Angeles (Veteran, US Army)

VETERANS TREATMENT COURTS Judge Robert Russell – Buffalo City Court 2008 90 (+) Veterans Treatment Courts in U.S. 13 in California -Santa Clara, Orange, San Bernardino, Tulare, Los Angeles, Ventura , San Joaquin, San Diego, Riverside, Santa Barbara, El Dorado, Placer, San Mateo (Sonoma, Kern, Monterey, Alameda, Sacramento, Sierra, San Luis Obispo, Kings) Collaborative Team model – hybrid of drug court and mental health court operation Provide and monitor treatment in lieu of jail/prison Distinctive VTC features – Veteran Mentors & VA care Early returns – Buffalo zero recidivism after two years

VTC Basics Collaborative approach – 3-4 phased program with therapeutic/legal/social focus toward independence Most plea agreements include legal incentives upon completion or at phase intervals as legally permitted Intense scrutiny in probation monitoring Dynamic individualized treatment plan (12-18 mos) Felonies/Misdemeanors (formal/informal probation) Drug/Alcohol testing as required

CA has 9% of the returning war veterans with 110,000 living here now CA has 9% of the returning war veterans with 110,000 living here now. San Diego has the highest number of returning OIF/OEF veterans in the nation. According to a Department of Defense (DoD) report and local VA, there are now over 33000 Iraq/Afghanistan veterans in San Diego. The next largest population in CA is Los Angeles with about 17,000. San Diego is home to over 137,000 active duty troops and 250,000 veterans. There are over 2 million veterans residing in CA. OEF/OIF = Iraq or Afghanistan veteran. OEF stands for Operation Enduring Freedom, which is the war in Afghanistan. OIF, Operation Iraqi Freedom, which is the war in Iraq. Department of Veterans Affairs, Veterans Health Administration (2006). “Guidelines and Recommendations for Services Provided by VHA Facilities to Incarcerated Veterans Re-Entering Community Living.” Undersecretary for Health’s Information Letter, Washington, D.C. http://www1.va.gov/homeless/docs/IV_IL_10200607.pdf

Veterans Combat Experience 36.7% Received small arms fire 56.9% Received incoming artillery, rocket or mortar fire 18.1% Handled or uncovered human remains 34.1% Saw dead or seriously injured Americans 57.1% Knew someone seriously injured or killed 47.4% Saw dead bodies or human remains 45.4% Had a member of their unit become a casualty Source: Office of the Surgeon Multi-National Corps-Iraq, Office of the Surgeon General U.S. Army Medical Command. Mental Health Advisory Team (MHAT) VI OIF 07-09. May 8, 2009.

Cross-Systems Mapping & Taking Action for Change 10/07 National Vietnam Veterans Readjustment Survey (NVVRS) Vietnam Theater Veterans Current PTSD (1986-88) Incarcerated 3,140,000 479,000 (15.2%) 223,000 (45%) 34.2% Misd. 11.5% Felony National Vietnam Veterans Readjustment Survey (NVVRS) Almost half of all male Vietnam theater veterans currently suffering from PTSD had been arrested or in jail at least once -34.2% more than once- and 11.5% had been convicted of a felony. The estimated lifetime prevalence of PTSD among American Vietnam theater veterans is 30.9% for men and 26.9% for women. An additional 22.5% of men and 21.2% of women have had partial PTSD at some point in their lives. Thus, more than half of all male Vietnam veterans and almost half of all female Vietnam veterans -about 1,700,000 Vietnam veterans in all- have experienced "clinically serious stress reaction symptoms." 15.2% of all male Vietnam theater veterans (479,000 out of 3,140,000 men who served in Vietnam) and 8.1% of all female Vietnam theater veterans (610 out of 7,200 women who served in Vietnam) are currently diagnosed with PTSD ("Currently" means 1986-88 when the survey was conducted). Source: National Center for PTSD, Fact Sheet: Findings from the National Vietnam Veterans’ Readjustment Study, 1988 ~

Cross-Systems Mapping & Taking Action for Change 10/07 Extrapolation for OEF/OIF Veterans U.S. and California OEF/OIF Theater Veterans Current PTSD Incarcerated 2,200,000 CA 198.000 770,000 (35%) CA 69,300 346,500 (45%) CA 31,185 National Vietnam Veterans Readjustment Survey (NVVRS) Almost half of all male Vietnam theater veterans currently suffering from PTSD had been arrested or in jail at least once -34.2% more than once- and 11.5% had been convicted of a felony. The estimated lifetime prevalence of PTSD among American Vietnam theater veterans is 30.9% for men and 26.9% for women. An additional 22.5% of men and 21.2% of women have had partial PTSD at some point in their lives. Thus, more than half of all male Vietnam veterans and almost half of all female Vietnam veterans -about 1,700,000 Vietnam veterans in all- have experienced "clinically serious stress reaction symptoms." 15.2% of all male Vietnam theater veterans (479,000 out of 3,140,000 men who served in Vietnam) and 8.1% of all female Vietnam theater veterans (610 out of 7,200 women who served in Vietnam) are currently diagnosed with PTSD ("Currently" means 1986-88 when the survey was conducted). Extrapolation based on data from National Center for PTSD, Fact Sheet: Findings from the National Vietnam Veterans’ Readjustment Study, 1988; and VA published estimates of OEF/OIF veterans’ PTSD rates.

THIRTY YEARS OF LOBBYING Increased Criminality and Consequences Vietnam Era OEF/OIF Era DUI limits were 1.0 % BAC or higher in most states DUI was traffic ticket that only effected driver’s license if repeated No interstate compact – could move to start fresh Domestic Violence was family matter No data mining/criminal records private DUI limits are .08% or less BAC in most states DUI is misd/felony crime with severe driver’s license and employment impact Interstate compact 48 states and federal jurisdictions Domestic Violence misd/felony with major life consequences Data mining/public records

Clinical Implications of PTS Traumatic event is re-experienced (triggers) Persistent Avoidance of Stimuli associated with the event and Numbing of response Hyper-Arousal Symptomology of Interest - Sleep interference - Outbursts of anger - Concentration/focus problems - Unreasonable Fear and Hypervigilence - Exaggerated Startle Response

Practice Tip: TREATABLE Conditions! Post Traumatic Stress (PTS, PTSD, combat stress, military operational stress – watch “disorder”) Traumatic Brain Injury (TBI) Military Sexual Trauma (MST) Depression Substance Abuse/Addiction These become worse with incarceration, treatment resistant with age and chronicity. Early identification and timely treatment yields best results.

Typical Offenses ANYTHING High Risk - Driving offenses/robberies DUI (multiple offenses in short time period) Substance abuse (85% self treat with alcohol) Bar fights/Assaults Domestic Violence (atypical) Possession/Brandishing firearms Look for “weird facts” related to triggers

Penal Code 1170.9 CA Legislative History Formerly PC 1170.8 enacted in 1982 in recognition of Vietnam Combat Veterans involved in felony crimes related to their psychological war wounds Revised in 1984, 2006, 2010 and 2012

What PC §1170.9 Does California Penal Code § 1170.9 allows the court to provide treatment in lieu of incarceration for veterans who suffer from PTSD, TBI, sexual trauma, substance abuse, or mental health problems as a result of having served in the United States military. Encourages treatment as early as possible to make communities safe and restore veterans to health. PC2900.5 (f) allows outpatient treatment in lieu of mandatory custody PREVENT 20 YRS OF LIVING UNDER THE BRIDGE 400 homeless p/ month in our clinic Many are VIETNAM vets who are JUST NOW starting to deal with their PTSD and substance abuse. We don’t want to make the same mistakes with OEF/OIF veterans.

Prerequisites for PC 1170.9 (a) . . . If the veteran alleges the offense was committed as a result of military sexual trauma, traumatic brain injury, post-traumatic stress disorder, substance abuse, or mental health problems stemming from service in the United States military, Before being sentenced to county jail or state prison the court shall, make a determination as to whether the defendant served in the military and whether the defendant may be suffering from [the above].

PC§1170.9 after 1/1/11 Defendant served/serves in the military Defendant pleads guilty or is found guilty Probation eligible/assigned and appropriate treatment is available Treatment can be VA, Vet Center, or other local mental health resources if available and preference given to programs which have a history of treating veteran’s particular assessed condition(s). Custody credits day for day for residential treatment.

AB2371 Changes Effective 1/1/13 Judge monitoring probation/treatment may reduce felony “wobblers” to misdemeanors Misdemeanors, including those reduced, may be dismissed by the judge without prosecutor agreement Unless applying for position in law enforcement, veteran may answer “NO” to questions re: arrest and conviction as related to the dismissed case Can be considered a prior if any new criminal conduct happens after dismissal by monitoring judge

VTCs Save Local and State $$$ Feb 2011-Feb 2012 San Diego VTRC data Two year average is 100 veterans per week booked into county jails (answered yes to “have you ever served in the military?) Diverting 21 veterans in VTRC program saved $530,000 in jail costs (based on $109.30 p/day) VA paid for treatment for the 21 participants, saving the county equivalent of $409,000 for 3500 residential days ($39 p/day) and 1100 hours of therapy ($61.50 p/hr LCSW rate) One new case – 4.7% recidivism (cf 48 cases prior 2 yrs)

California Veterans Legal Task Force (CVLTF)

CVLTF Assistance www.cvltf .org for more information or to donate Recognized non-profit organization under Internal Revenue Code 501(c )3 (funding/grant partnership) Offers free assistance to counties throughout California to help start and expand Veterans Treatment Courts and affordable legal assistance to veterans and their families (website, evaluation) We do not advocate any particular model of VTC, but can educate the local community organizers on models they can look at to decide one for their community Conducting survey on all CA VTCs/Collaboration www.cvltf .org for more information or to donate

Big Thanks to Our Sponsors County of San Diego HHSA, Mental Health Systems, Inc. Courage to Call Program grant Raymond James Charitable Trust Criminal Defense Lawyers’ Club of San Diego Consumer Attorneys of San Diego California Veterans Benefit Fund California Department of Veterans Affairs

Panel Presentation Hon. John Lonergan, Los Angeles Superior Court Paul Freese, Director of Litigation and Advocacy, Public Counsel Law Center, Los Angeles Jude Litzenberger, Coordinator, Veterans Treatment Review Calendar, San Diego Superior Court and Executive Director, California Veterans Legal Task Force Moderator: Miguel Pares, San Bernardino County Probation Department

QUESTIONS? Thank you for helping build stronger communities and restoring those veterans who serve our nation!