1. HONORABLE PEGGY DAVIS ROLES AND BOUNDARIES OF SPECIALTY COURT SUPERVISION

2. OBJECTIVES Examine the roles and duties of each specialty court team member. Develop an understanding of the importance of team communication within the specialty court setting. Discuss the laws and rules regarding confidentiality and how communication can take place between the members of the team. Begin to identify emerging research regarding the best practices and standards in drug courts.

3. DRUG COURT KEY COMPONENT # 1 Drug courts integrate alcohol and other drug treatment services with justice system case processing. What team members should attend the drug court staffing/meetings?

4. DRUG COURT KEY COMPONENT # 2 Using a non-adversarial approach, prosecution and defense counsel promote public safety while protecting participants’ due process rights. Does allowing non-drug charges (e.g. violence) threaten public safety?

5. DRUG COURT KEY COMPONENT # 3 Eligible participants are identified and placed in the program as soon as possible. Is it really important to get participants into the program quickly? What does quickly REALLY MEAN?

6. DRUG COURT KEY COMPONENT # 4 Drug courts provide access to a continuum of alcohol, drug, and other related treatment and rehabilitation services. Is it better to have a single treatment agency or to have multiple treatment options? How important is relapse prevention?

7. THE TEAM IS CRITICAL Who do we need on board in order to accomplish 10 Key Component 1 – 4? The Judiciary District Attorney Defense Attorney Treatment Provider Supervision Law Enforcement Ancillary Services

8. Note 1: Difference is significant at p<.10 Drug Courts Where a Treatment Representative Attends Court Hearings had 100% greater reductions in recidivism

9. Note: Difference is significant at p<.05 Drug Courts Where the Prosecutor Attends Staffings had a 171% Higher Cost Savings

10. Note 1: Difference is significant at p<.05 Drug Courts Where the Defense Attorney Attends Drug Court Team Meetings (Staffings) had a 93% Higher Cost Savings

11. Note 1: Difference is significant at p<.05 Drug Courts where Law Enforcement is a member of the drug court team had 88% greater reductions in recidivism

12. Note 1: Difference is significant at p<.05 Note 2: “Team Members” = Judge, Both Attorneys, Treatment Provider, Coordinator, Probation Drug Courts where all team members attended staffings had 50% greater reductions in recidivism

13. Drug Courts That Held Status Hearings Every 2 Weeks During Phase 1 Had 50% Greater Reductions in Recidivism Note: Difference is significant at p<.1

14. Note 1: Difference is significant at p<.05 Drug Courts Where the Judge Spends an Average of 3 Minutes or Greater per Participant During Court Hearings had 153% greater reductions in recidivism

15. SO WHAT IS EACH MEMBER’S RESPONSIBILITY? Overriding goals: Provide a coordinated response to offender behavior, through Shared decision making, docket control, informed and unified responses, and empowerment of the team, Thereby providing an environment in which the offender can address the addiction and related lifestyle issues that brought him or her into the criminal justice system.

16. CORE COMPETENCY JUDGE Interactive discussion with audience in order to explore attitudes, concerns and expectations.

17. CORE COMPETENCY DISTRICT ATTORNEY Interactive discussion with audience in order to explore attitudes, concerns and expectations

18. CORE COMPETENCY DEFENSE COUNSEL Interactive discussion with audience in order to explore attitudes, concerns and expectations

19. CORE COMPETENCY TREATMENT Interactive discussion with audience in order to explore attitudes, concerns and expectations

20. CORE COMPETENCY LAW ENFORCEMENT Interactive discussion with audience in order to explore attitudes, concerns and expectations

21. CORE COMPETENCY SUPERVISION Interactive discussion with audience in order to explore attitudes, concerns and expectations

22. CONFIDENTIALITY/PRIVACY Several rules apply to participants in DWI treatment courts 42 CFR Part 2 – The alcohol and substance abuse treatment confidentiality rule. HIPAA – New federal rules covering all health related information

23. 42 U.S. CODE 290DD 42 CFR PART 2 First issued 1975, revised 1987 Designed to help deal with the stigma of addiction. Requires notification of confidentiality, consent forms, prohibition of redisclosure “I’m sorry I cannot acknowledge whether someone is or isn’t in our treatment program”.

24. CONFIDENTIALITY/PRIVACY 42 CFR (1975) – Encourages treatment – Applies to DWI Court programs – Prevails if conflict with state laws

25. HIPAA Health Insurance Portability & Accountability Act (1996) Protect confidentiality and security of patient information General Rule If DWI Court is in compliance with 42 CFR- it is in HIPAA compliance also (with few exceptions)

26. 42 CFR The 42 CFR General Rule applies – Screening – Assessments – Referrals – Treatment – Diagnosis

27. GENERAL RULE Treatment Programs may only release information or records With a knowing and written consent from the participant, AND Some limited exceptions

28. CONSENT A proper consent can authorize all parties involved in the DWI Court HIPAA prohibits a program from conditioning treatment on a patient signing a consent, but judges, probation etc. can condition participation in the DWI Court program on an offender signing the consent form

29. ELEMENTS OF A CONSENT Who may make the disclosure To whom disclosure may be made Participant’s name Purpose of the disclosure

30. CLIENT NOTICE FORM A second form required by 42 CFR in addition to the Consent form Participants must be informed of privacy rights in writing and given to the Participant to keep

31. PERMITTED DISCLOSURES–NO CONSENT Medical emergency Crimes on the premises Crimes against staff Administration / qualified service programs working with drug court Outside auditors, central registries and researchers No re-disclosures unless permitted

32. MANDATORY DISCLOSURE–NO CONSENT State child abuse laws A valid court order State laws relating to cause of death Duty to protect others, to warn of imminent, serious harm

33. GENERAL ETHICS Everyone on the drug court team has both personal and professional ethical standards At times, these can conflict Word most associated with ethics: dilemma The “rules” can change, or be different in different jurisdictions Seek advice of state experts on ethical dilemmas

34. ETHICAL ISSUES Treatment Providers Consent is permissive, not mandatory Information released must be what is minimally necessary to meet the terms and conditions of the consent Every staffing is a potential ethical dilemma What to do with information about illegal activity? Sexual abuse? Personal health issues?

35. DEFENSE ATTORNEYS Unlike Treatment Providers, no federal statute has provided Defense Attorneys with a consent to set aside attorney-client privilege Participation in staffing could be similar to a Treatment Provider with a consent allowing only the release of information verifying client is in treatment

36. PROSECUTORS Duty to protect public safety Proverbial “rock and a hard place” if confronted with information they should act on ethically, but cannot act on legally

37. JUDGES Cannot outsource their decision to another person or group of persons— must be the final decision maker Cannot raise money Be sure to check your individual state’s Judicial Canons on what is allowed.

38. ABA RULE 2.9 Comment [4] A judge may initiate, permit, or consider ex parte communications …when serving on therapeutic or problem- solving courts, mental health courts, or drug courts. In this capacity, judges may assume a more interactive role with parties, treatment providers, probation officers, social workers, and others.

39. EMERGING RESEARCH Adult Drug Court Best Practice Standards, Volume One, National Association of Drug Court Professionals.

40. QUESTIONS

41. CLOSING COMMENTS