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

2 SAMHSA’s Mission  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.

3 SAMHSA’S STRATEGIC INITIATIVES 1. Prevention 2. Trauma and Justice 3. Military Families 4. Recovery Support 5. Health Reform 6. Health Information Technology 7. Data, Outcomes & Quality 8. Public Awareness & Support 3

4 Criminal Justice System continues to be the Largest Referral to Substance Abuse Treatment Source: SAMHSA Treatment Data Set (TEDS) Concatenated, % 34.6% State/Fed Court, Other Court Recognized Legal Entity Probation/ Parole DUI/DWI Other recognized legal entity, or other Other 20.6% 4 Diversionary program, 2.5% 10.8% Prison, 2.4%

5 CJ Continuum: Multiple Loci to Address MH/SUDs & Reduce CJ Contacts Community (pre-CJC) Entry Custody Diversion Incarceration Release/Reentry Community (post-CJC)  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 SAMHSA focus areas

6 Veterans involved in the CJ System Judge Robert Russell Buffalo, NY Veteran Court Rand’s “Invisible Wounds of War” reported 19% of returning veterans have PTSD, Depression or both. 2008

7 7 Cross-System Partnerships

8 Key Elements When Dealing with Vets-CJ System Veteran Trauma Exposed In Recovery From BH Condition Justice Involved Trauma Informed Peer Involved Coordinated Across Systems Community Services Engaged

9 SAMSHA and Criminal Justice  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.

10 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

11 SAMHSA Grant Programs – CJ and Vets  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 18 th ! SAMHSA-BJA Adult Treatment Drug Courts - closes May 28!!!

12 FY 2014 Joint Adult Drug Court Solicitation –TI  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

13 Veterans Courts are Eligible to Apply!!  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

14 Jointly Funded Initiative: SAMHSA 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.

15 Program Goals and Objectives  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.

16 Focus on Clinical/Treatment Services  $ 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

17 Using Evidence-Based Practices  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.

18 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!!

19 Veterans Treatment Court Mentor 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

20 Want More Information? CJ Team Contact Information Ken Robertson, Team Leader, CJ Grants Programs Jon Berg, Public Health Advisor, Offender Re-entry/Adult Drug Courts George Samayoa, Public Health Advisor Drug Courts Greg Torain, Public Health Advisor Juvenile Drug Court, Teen Courts, Veterans Treatment Courts

21 Contacts for SAMHSA Vets-CJ Programs  Center for Mental Health Services Justice Programs  Center for Substance Abuse Treatment Justice Programs

22 A Gift for the Audience: Lists of Resources  SELECTED RESOURCES TO ASSIST YOU Contacts Websites Programs Data Information