1. ‘The courts and prisons’

2. The Courts: 1.Court Integrated Services Programs (C.I.S.P) 2.Court Referral & Evaluation for Drug Intervention & Treatment Program (C.R.E.D.I.T)

3. Purpose: The C.I.S.P. and C.R.E.D.I.T Programs seeks to provide early intervention and access to drug treatment, accommodation and material aid and support, as required, to facilitate the needs of the defendant. C.R.E.D.I.T also seeks to enhance the likelihood of a defendant being granted bail and then successfully completing the bail period..

4. THE OBJECTIVES OF THE C.I.S.P. and C.R.E.D.I.T PROGRAMS INCLUDE: Provide access to accommodation, welfare, legal and other community supports. Provide clients and the Court with monitoring and support of clients on the program for a period of 3-4 months. Minimise harm to the client and the community by addressing the issues related to substance abuse. Provide early treatment and access to drug treatment/rehabilitation programs. Reduce risk of re-offending.

5. THE OBJECTIVES OF THE C.R.E.D.I.T/BAIL SUPPORT PROGRAM INCLUDE:. Reduction in the number of defendants remanded due to a lack of accommodation or treatment/support in the community. Long term reduction in involvement of defendants in the criminal justice system. Successful placement of defendants in drug treatment/rehabilitative programs. Successful completion of bail by defendants who would otherwise be remanded in custody.

6. WHO IS ELIGIBLE FOR THESE PROGRAMS?. Any defendant eligible. For those seeking bail, to be admitted to a period of bail they may be referred to the C.R.E.D.I.T/Bail Support Program for assessment.

7. The range of services provided to clients on bail (C.R.E.D.I.T) has included the following: Assessment, treatment & support plan, support & monitoring whilst on bail & follow up (up to 4 months). Case management, court reports, brokered treatment through COATS for access to drug treatment services including: Detox & rehabilitation programs; drug & alcohol counselling..

8. Continued…. Referral to short term crisis accommodation. Passport photos for identification & medical purposes. Referral to pharmacotherapies. Referral to outreach services for clients requiring intensive support..

9. Referral to employment programs for training/employment assistance. Travel cards, food vouchers and access to material aid, payments where required and court date reminders/diaries..

10. Opiate Substitution in Prisons: National Methadone Policy 1997 –Prisoners special client group –Pose a risk to themselves and health and safety of community upon release Recommended that specific assessment criteria & processes be established to improve access to methadone treatment in prisons for prisoners to: –Continue their community Rx in prison. –Commence Rx in prison for those who are: –Using illicit opioids –At high risk to heroin relapse upon release.

11. Victorian Prisons Program Aims to: –Reduce drug use among prisoners –Reduce transmission of BBV’s –Prevent/reduce overdose deaths in prison & upon release to community –Reduce drug related recidivism upon release Objectives –Improve pharmacotherapy access to prisoners: Prescribed community methadone & buprenorphine across the system Using illicit opioids in prison At risk to heroin relapse upon release –Minimise standover & diversion of these treatments

12. Extensive consultation process Established Working Party Inclusive approach due to: –A multi provider health system –High volume movements through the system –Need for clinical & operational program integrity –Gain buy in from Health Department Program developed over 2 years.

13. Lack of consistent clinical practice can lead to: –Poor access to treatment –Missed doses –Opioid withdrawal –Drug use / needle sharing –Potential for overdose & BBV transmission –Over & under prescription of treatments & other medications –Lack of continuity of care to community

14. Development of comprehensive Policy & Procedures that set service delivery standards across a multi provider system detailing: –Identification of community treatment – –Confirmation of treatment – –Informed consent –Dosing procedures –Prescribing guidelines –Treatment monitoring & review –Transfer procedures –Pre release discharge planning.

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17. Successful Implementation Based On: 1.Setting clinical & operational standards across the prison system 2.Contracting prison providers & health services –In accordance with the standards 3.Monitoring: –Adherence to the standards across the prison system –Program progress –Commercial arrangements with providers

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