Veterans Treatment Courts Michael Ott, Psy.D.

Veterans Treatment Courts  Hybrid Drug and Mental Health Treatment Courts using the Drug Court Model. Principals of both Drug & Mental Health Courts.  Addition of U.S. Dept. of Veterans Affairs representatives, state and local agencies, and volunteer Veteran mentors.  Target those who haves served in the U.S. Armed Forces.  First Veterans Court opened in 2008 in Buffalo, NY.

Hallmark of most Veterans Courts  VTCs are defined by their ability to connect justice involved Veterans with clinical needs to the appropriate VA treatment, and then monitor their adherence to that treatment over time.  The existing model relies on cooperation with the more than 150 VA Medical Centers (VAMCs) in the nation.  With the help of a Veterans Justice Outreach (VJO) Specialist, Veterans receive treatment at a VA facility.  Many, but not all, Veterans are eligible for free medical care or housing programs.  If VA cannot provide care to a Veteran because he or she does not qualify, including for reasons related to the Veteran’s discharge status, VA can refer the Veteran to alternative providers.

Why a Veterans Court? Military Culture  Veterans are used to: Structure Leadership Loyalty Patriotism Camaraderie Teamwork & Self-reliance Similarity of Conditions Available Resources

Veterans Court Template  There is no defined template, but best practices. This allows significant flexibility in the development of a separate Veterans Treatment Court or the development of a track/docket in an existing court (Tribal Healing to Wellness Courts, Mental Health Courts, etc.).  This may be especially important based upon the diversity within the tribal justice system.

Veterans Court Elements Elements needed to establish a Veterans Court: 1. A justice systems willingness or desire to participate in and support the court. Identification of Judge, prosecutor, defender, and probation officers, court coordinator. 2. Veterans in need of a treatment court. 3. A treatment team: Veterans Justice Outreach (VJO Specialist, Community Providers, Vet Center Representative, etc. 4. Mentors and other community resources

Ten Key Components of VTC  In 2008, the Buffalo Veterans Treatment Court modified the Key Components of Drug Courts.  These Components offer guidance for the successful implementation of a Veterans Treatment Court.

Ten Key Components of VTC 1. VTC integrate alcohol, drug treatment, and mental health services with justice system case processing. 2. Using a nonadversarial approach, prosecution and defense counsel promote public safety while protecting participants’ due process rights. 3. Eligible participants are identified early and promptly placed in the VTC Program. 4. VTC provide access to a continuum of alcohol, drug mental health and other related treatment and rehabilitation services. 5. Abstinence is monitored by frequent alcohol and other drug testing.

Ten Components Cont’d 6. A coordinated strategy governs VTC responses to participants’ compliance. 7. Ongoing judicial interaction with each Veteran is essential. 8. Monitoring and evaluation measure the achievement of program goals and gauge effectiveness. 9. Continuing interdisciplinary education promotes effective VTC planning, implementation, and operations. 10. Forging partnerships among VTC, Veterans Administration, public agencies, and community-based organizations generates local support and enhances VTC effectiveness.

Questions?

Court Roles  Judge or Magistrate – Leader  Prosecutor – Gate Keeper  Defender – Public Defender or Private Defender  Probation – Monitors follow through and compliance  Veterans Justice Outreach Specialist – More to follow  Mentors/Peers – More to follow  Community Resources

VTC Peer Mentor Program  Volunteers with prior or current military service  Roles: - Help Veterans navigate the Court, VA, and treatment systems - Assess “other needs” and help adjust to civilian life - Help the Veteran and Veteran’s family receive the services they need to be productive members of society

Veterans Justice Outreach (VJO) Specialist  Responsible for direct outreach, assessment, and case management for justice-involved Veterans in local courts and jails, and liaison with local justice system partners.  Works to ensure that eligible justice-involved Veterans have timely access to VHA mental health and substance abuse services when clinically indicated, and other VA services and benefits as appropriate.

Justice Involvement and VA Health Care 14  Can provide:  Outreach, assessment, referral and linkage to services  Treatment for justice-involved Veterans who are not incarcerated  Title 38 CFR (c)(5) does not allow VHA to provide:  Hospital and outpatient care for a Veteran who is  Either a patient or inmate in an institution of another government agency  If that agency has a duty to give that care or services

Questions?

Issues to Explore Prior to VTC Development Veteran Population  How many Veterans live in the community?  The number of Veterans living in a geographic area surrounding a community will help determine the potential utilization rate of a VTC program in that community.  Are Veterans in the community using VA resources already? Are they receiving VA benefits? This can help determine the level of interest or need for a VTC.

Issues Cont’d Distance & Location  Is the Veteran population mostly rural or urban?  Serving Veterans in rural communities poses more challenges because of the distance from VA facilities.  Rural Veterans may need transportation from their community to the local VA facility (e.g. VA Office of Rural Health, VA Veterans Transportation Services, and local Veterans Service Organizations).

Issues Cont’d Culture & Tradition  Cultural considerations should be at the forefront of any discussion about the possibility of adopting the VTC model, or elements of it, in a justice system.  If a VTC is consistent with the values and customs of a community, its chance for success is far greater.

Collaboration  Can the Veteran receive services in his/her community using tele-health and tele-psychiatry in tribal or Indian Health Service facilities to access VA Mental Health providers?  Successfully delivering services to a Veteran in his/her community requires collaboration between the VA, the Tribal Government, and possibly the Indian Health Service.

Challenges & Partnership Opportunities Communication  The success of the VTC model, applied in any combination of parts, depends on the communication skills of the parties involved.  In a court, communication is especially important so the judge and prosecutor can identify the Veterans that might qualify for VTC.  All communication efforts serve a singular goal: Providing much needed care to the Veteran.

Questions?

The Pledge of President Lincoln To care for “him who has borne the battle, and his widow and his orphan. (Second Inaugural Address)

VHA Justice Programs: Mission 23 To partner with the criminal justice system to identify Veterans who would benefit from treatment as an alternative to incarceration. VJP will ensure access to exceptional care, tailored to individual needs, for justice-involved Veterans by linking each Veteran to VA and community services that will prevent homelessness, improve social and clinical outcomes, facilitate recovery and end Veterans’ cyclical contact with the criminal justice system.

VHA Justice Programs: Strategic Goals Improve Veteran identification 2. Build staff capacity/skill 3. Match Veterans to appropriate treatment 4. Reduce stigma 5. Develop systems for evaluation, research and knowledge

VHA Justice Outreach Services Justice OutreachPrison Re-Entry 25 − Gain access to the jail − Identify Veterans and Determine Eligibility − Conduct outreach, assessment, and case management for Veterans in local courts and jails − Provide/coordinate training for law enforcement personnel − Linkage to VA and Community Services/Resources  Number of VJO Specialists funded: 173  Number of 3,365 local jail facilities serviced: Not yet known  Number of Veterans receiving VJO services (Oct – present): 58,106  Gain access to the prison  Educate Veterans’ groups about VA and VA services  Identify Veterans and Determine Eligibility  Reentry Planning  Linkage to VA and Community Services  Number of HCRV Specialists funded: 44  Number of state and federal prisons serviced: 1,001 (80%) of 1,254 US prisons  Number of incarcerated Veterans receiving reentry services (Aug present): 53,553

VA/Court Collaboration and Veteran Outcomes Number of Veterans Treatment Courts: >260 operational, more in development Characteristics* of Veterans seen by VHA in VTCs: 93% had spent time in jail or prison (21% of these had spent a year or more) Average: 7 prior arrests; average age at first arrest: 27 Average age when seen: 44 64% charged with drug or public order offenses 40% homeless at least once Outcomes* when Veterans in the courts receive VA care… 88% reduction in arrests (year post- vs. year pre-court participation) 30% increase in stable housing (from baseline to year post-court participation) Other evaluation underway: VJP program evaluation (contract signed, project launched 10/1/13)  3 years longitudinal follow up on Veterans seen in courts, jails and prisons, with annual reporting on recidivism SB 287 passage: Secretary can request recidivism records (DoJ, FBI, BJS)

Resources for Justice-Involved Veterans: A Guide For Tribal Justice Systems  The VA Office of Tribal Government Relations (OTGR) published a resource guide  “The Guide” that provides interested tribal governments with a breakdown of how Veteran  Treatment Courts (VTC) work.  The Guide breaks the VTC model down into movable parts that would allow tribal governments to choose the parts it wants to use in its tribal justice system.   The VTC model is one way for tribal justice systems to identify and connect American Indian land Alaska Native Veterans with VA and community resources that help provide alternatives to incarceration.

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Acknowledgements  Kristi Woodard, LICSW  Sean Clark, National Director  The Buffalo Treatment Court