Jefferson County Adult Treatment Train (JCATT):
All community correction clients that are in need of services are placed on the “Treatment Train”. The JCATT supervision component within Community Corrections was developed to capture the population of offenders that were in need of services but weren’t necessarily in need of the intense programming and supervision of regular community corrections client.
In 2000, a grassroots group
comprised of state and local elected officials, judicial representatives, law
enforcement personnel, mental health providers, and concerned citizens was
established to collaboratively address Jefferson County’s alarming substance
abuse rates. The goal of the COCOA, “Continuity of Care of Adults,” was to
develop a network of trusted relationships that would be necessary to stem the
tide of our county’s increasing substance abuse rates.
COCOA’s groundwork led to the development of a continuity of care model specifically designed for implementation in Jefferson County that involves an impressive breadth of services offered by numerous participating organizations and a commitment from each organization to a common “road map” for the provision of evidence-based rehabilitative services. The model requires the following commitments from each participating agency:
1To develop a shared understanding of each organization’s role and responsibility within the system;
- To employ staff who understand their role as twofold, to serve their individual agency and the model as a whole;
- To implement joint case management and a formal information sharing system; and
- To accept responsibility
for shared outcomes and performance.
Following the development
of the model, several passionate members of the COCOA group approached our
legislators about our rates of substance abuse and funding for the model. In
2013, the Jefferson County Adult Treatment Train (JCATT) was included as a line
item in the State Legislative budget. Jefferson County Community Corrections,
the lead agency, received $500,000 a year for 2 years through the Indiana
Division of Mental Health and Addiction.
The JCATT model includes
primary services provided by the following agencies: Jefferson County Community
Corrections, LifeSpring Health Systems, Centerstone and River Valley Resources.
The model also includes essential support services provided by a network of
community organizations providing transitional housing, support groups and barrier
busting services, for example, child care and transportation assistance.
In response to the
program’s demonstrated performance, DMHA extended the JCATT funding for an
additional two years in FY 2016 and FY 2017. The Treatment Train is currently
in Year 4 of operations. Quarterly reports of the treatment train’s performance
have been submitted to the Division of Mental Health and Addiction since the
beginning. Each report outlines demonstrated outcomes, cost savings, and budget
expenditures. Below is a summary of cost savings and services provided over the
past three years from the final report for Year 3:
1. 560 clients served by the Jefferson County Treatment Train.
2. 209 clients successfully completing JCATT program.
3. 23% of recidivism of clients who successfully complete JCATT program – as defined at being arrested for committing a new offense in Jefferson County within 3 years of completion of the program
What services are offered in the Jefferson County Adult Treatment Train program
Prevention Efforts: A Juvenile At-Risk Counseling who specializes in Substance abuse is available at the largest public school district in Jefferson County, Madison Consolidated Schools to provide substance abuse education, counseling and referral services. This counselor works in collaboration with the school’s Resource Officer for these services.
Pretrial Services: If a person is arrested for a crime, the pretrial services coordinator completes a risk assessment and writes a pretrial report that is given to the Judge, Prosecutor and Defense counsel at the initial hearing so the Judge can make an informed decision about release. Jefferson County has been selected as one in eleven counties in Indiana to be a pilot site for this program through EBDM initiative. During this initial assessment, the pretrial coordinator can identify potential candidates for the Drug Court Program, informs them of the program and gives applications for admissions. This has decreased the amount of time between arrest and admissions into the drug court and the Drug Court has increased participation numbers by 75% since January 2017. If a defendant is admitted to and competes the Drug Court Program, his or her charges are dismissed. Both the Pretrial Services Program and the Drug Court Program are part of the Community Corrections Program.
If defendants are released to pretrial supervision the pretrial case manager can refer defendants to mental health and substance abuse services. If defendants choose to take advantage of those services, they can report to the Judge the treatment they have completed at sentencing which may lessen the likelihood of them going to prison depending upon the charge. If the person is placed on community supervision, services completed before sentencing are communicated to Community Corrections which then continue on the treatment train based upon risk and need.
Jail Treatment Services: If the person remains in jail pretrial, the JCATT model prescribes an assessment to assess mental health issues, substance use disorders and co-occurring disorders. LifeSpring Health Systems staff administers the assessments when an inmate is incarcerated 14 days after arrest. All assessments are placed in the inmate's medical file as determined by the Sheriff or designee.
These assessments are used to determine appropriateness for the group counseling services offered in the Jefferson County Jail. A total of four groups are offered in the jail and are defined by gender. Any person referred to groups are assessed using the Texas Christian University Drug Screen V (TCUDS V) and if only alcohol use is indicated the Short Michigan Alcohol Screening Test (SMAST) is administered. Females are assessed for trauma using the Brief Trauma Questionnaire (BTQ). All inmates receiving assessments for group treatment are also assessed for individual therapy.
Inmates in the jail may choose to participate in substance abuse groups which are facilitated by LifeSpring. The male population uses a Substance Abuse-Stages of Change Model which consists of the Trans-Theoretical Model (TTM). The sessions are substance use disorder focused-based therapy sessions that offer strategies on the stages of change, using a motivational approach to invoke change and promoting client motivation. Before entering this group, the inmates are assessed using a Readiness Ruler Stages of Change Assessment to determine which group is appropriate. This data will also be used in evaluating progress throughout the inmate’s participation. There are two components for this group; therefore, two separate groups are delivered weekly.
The first component “Thinking About Changing Substance Use” is comprised of 16 sessions. The target population for this component are those clients in the Pre-contemplation, Contemplation and Preparation Stage of change.
The second component “Making Changes in Substance Use” is comprised of 18 sessions. The target population for this component are those clients at the Action and Maintenance Stage of change. Ideally a client would move from the first group to the second but in some cases, when they have been assessed at the Action-Maintenance Stage of Change, they will be referred to this group.
The female population in the Jefferson County Jail are offered two different groups. The “Seeking Safety” group is provided to those inmates assessed to have a substance use disorder and test positive on the Brief Trauma Questionnaire Assessment.
For those females that complete Seeking Safety and/or are at the Action – Maintenance Stage of Change they will be referred to “Making Changes in Substance Use” which has 18 sessions. This is a Trans-Theoretical Model (TTM) Substance Use Group. The sessions offer strategies based on the stages of change, using a motivational approach to invoke change and promoting client motivation.
Transition to Community Planning Services: With the change in the criminal code, a majority of Level 6 offenders who would have normally gone to the Department of Correction to receive services are now housed in the local jail. Through discussions with the Evidence-Based Decision Making Team and the Jefferson County Adult Treatment Train administrators, this service is vital to our community and a subcommittee has been formed to implement jail services. The Jail Intervention subcommittee which consists of members from both the EBDM committee and the JCATT Administrators worked together to enhance substance abuse, mental health, education, employment, housing, identification, insurance, and other needs to those offenders.
Transition services for incarcerated inmates is a necessary component to ensure a continuum of care for those leaving jail. Inmates will be identified through assessment and their participation in jail programs. Transitional services will be focused on those populations that are identified with having substance use or mental illness. This population is represented nationally in jail systems at a high rate and are a large portion of the population in the Jefferson County Jail.
The Transition Coordinator meets with inmates identified with a release date 30 – 90 days prior to release. The Transition to Community plan identifies the offender’s such as housing, employment, benefits acquisition as well as out- patient behavioral health services. The Transition coordinator provides them with resources to meet their identified needs and schedules all out patient appointments in the community that are necessary to insure a smooth transition into necessary services. Some examples of this include:
Helping people apply for residence in our transitional housing units (Ruth Haven for women and Jefferson House for men). If the person has been accepted into transitional housing before they are released, they can go straight from jail to the home. This is especially helpful for those inmates who are accepted into Drug Court, but have to start out in transitional housing so there are not gaps in service.
- Coordinating inmates into in-patient treatment centers. Some of the waiting lists to get into in-patient facilities are 4-8 weeks so once a bed is available, the court can be notified to have them released.
- The clinical mental health/substance abuse assessment can be completed while the person is incarcerated and the first appointment for services can be scheduled before the person is released so there are no gaps in services.
Transition to community plans are shared with stakeholders who are providing community supervision of the offender when released from incarceration and work collaboratively to facilitate transition.
Diversion Services: These are services in which a participant’s charges may be dismissed upon successful completion of substance abuse treatment or education programs. The Jefferson County Drug Court falls into this category for high risk/high need offenders, and the Evidence-Based Decision Making Team is working on expanding a diversion program for low-risk/low-need first time felony offenders.
Substance Abuse Education Services: For those participants who are not in need of treatment services but are in need of substance abuse education services, the following programs are offered through Jefferson County Community Corrections:
Prime for Life: This program is a 20-hour substance abuse education class for those participants who have committed DUI offenses, who display substance abuse behaviors, or who are in denial of a substance abuse problem. It is a 6-week program normally held on Saturday mornings for three hours. The cost of the program is $25 for the workbook and the Court may order a fee for the class in diversion cases.
Prime Solutions: This program is designed to motivate participants to recognize substance abuse and criminal thinking problems and establish goals for success. This is a 20-session program held twice a week for 1.5 hours at no cost to the participant. There is a $25.00 book fee.
Detox Services: Detox services are currently not available in Jefferson County. The JCATT members utilize Salvation Army in Indianapolis, Wellstone in Jeffersonville or Clark Memorial Hospital in Jeffersonville for detox needs.
Inpatient Services: Inpatient Substance Abuse services are currently not available in Jefferson County. The JCATT members utilize residential substance abuse services through Turning Point- LifeSpring in Jeffersonville and Salvation Army/Harbor Lights in Indianapolis and Fort Wayne.
Out-patient Services: Offenders are referred to LifeSpring or Centerstone for mental health and substance abuse issues. These include:
1. Individual outpatient therapy: The participant works individually with a licensed therapist and/or a care manager to address needs, set goals and work toward recovery along with psychiatric and medication management services.
2. Intensive Outpatient Group Therapy: Participants work together in a group setting facilitated by a therapist using a cognitive-based substance abuse curriculum.
3. Recovery Coaching: Provides life skills and case management services to teach and assist participants to live life sober. This also includes assisting the participant with obtaining insurance and needed benefits, transportation, child care, budgeting, and parenting.
Cognitive-Behavioral Services: Community Corrections provides a number of Evidence-Based Programs that are facilitated by trained staff who receive quarterly continuous quality improvement evaluations and include the following:
Moral Reconition Therapy: This program is for male and female participants (taught separately) that gives a systematic, cognitive-behavioral, treatment strategy designed to develo9p higher states of moral reasoning. The program has 12 stages so the length of the program depends on how motivated the participant is to complete each stage. This class is once a week for 2 hours at no cost to the participant. There is a $25.00 book fee.
Moving On: This program is for female participants designed to help identify criminal thinking, develop healthy relationships, learn problem-solving skills, learn basic social skills, relaxation skills, and stress reduction skills. This is a 25-30 week program held once a week for 3 hours at no cost to the participant.
Stop Abuse For Everyone (SAFE): This is the new domestic violence program that will be starting in May 2017. Community Corrections had previously offered Alternatives to Domestic Aggression but with a turnover in staff, a new program had to be incorporated.
MRT- Anger Management: This program is from the MRT creators and will be coming in the fall of 2017.
Employment/Education Services: River Valley Resources is the agency JCATT clients are referred to for education and employment services. In order to be successful in the Treatment Train, a participant must become self-sufficient. RVR is contracted through the Community Corrections JCATT grant to provide the Rural Works Program.
RVR currently offers 24 hours of daytime and 9 hours of evening High School Equivalency (HSE) classroom instruction per week in Jefferson County. Classroom instruction is supplemented with on-line instructional tools. River Valley Resources makes every effort to help a student earn their HSE in the shortest time period possible.
Graduates from the Adult Education program are offered the opportunity to advance their education by earning a portable, short-term certification in a high demand career. Certifications include: Heating & Air, Dental Assistant, Microsoft Certification, Certified Production Technician (MSSC), CNC, Certified Nursing Assistant, Hospitality Certification, etc. Scholarships may be available for this purpose.
River Valley Resources will offer “Rural Works,” a proprietary poverty-to-self-sufficiency employment program. The Rural Works model is a natural fit for JCATT in that it emphasizes a holistic approach to serving clients with multiple barriers to employment. The goal of the Rural Works program is to prepare and place individuals in employment that pays a self-sufficient wage, with benefits.
Qualified applicants to Rural Works will successfully pass a drug screen and submit to a background check. RVR has a network of “felony-friendly” employers who will employ Rural Works graduates.
The program model is a 4-step process described below.
Step 1: Job
Participants are required to attend a one week, 30 hour workshop. The goal of these workshops is to simulate a real-world work environment. In order to successfully graduate from the Rural Works program, participants must attend and participate in every module, are to be on-time and dressed and behave appropriately.
Step 2: Job Search
The Rural Works program incorporates structured assistance with job search. This includes access to River Valley Resources’ core group of employers (employers who will hire and mentor our graduates), Internet, application assistance and interview feedback until a participant becomes employed.
Step 3: Job Retention
RVR provides regular contact for at least one year with each participant and employer to help ensure employment retention. Re-employment services are provided following job loss.
Step 4: Advancement
Once the Member retains the same job for one year, staff assists with a plan to improve a skill, behavior or educational component to increase marketability and earning power.
Social Services: A number of social services are utilized in the recovery plan of JCATT participants. These services are based upon the individual’s need and are coordinated with a number of local community members. These include (but are not limited to): family therapy and services; Recovery Coaching; budgeting; food assistance; child care; insurance assistance; medication; domestic violence resources; and child therapy.
Community Support: Over the past few months, the community has begun to realize the need for its support in the recovery process of JCATT participants. Through the ENVISION Madison initiative, groups of concerned citizens, health care professions and criminal justice members have met to brainstorm how the community can support JCATT, EBDM, and the local LLC Substance Abuse efforts. These include groups from churches, AA/NA, Celebrate Recovery and other pro-social groups that support sobriety. Some of the action plans include: developing a resource website; educating the public on substance abuse; developing a program to have forms of transportation for volunteers to take people to treatment; and setting up mentoring programs with addicted moms who are going through recovery, etc.
Community Corrections/Correctional Mental Health Liaison Services: All of the services listed above are coordinated by the Community Correction Mental Health Liaison who establishes a communication network among the participant, the treatment providers and the Court.
For more information about the JCATT, please contact JCATT Director, Amber Finnegan at firstname.lastname@example.org or call 812-265-8911.
Resource links: http://www.rivervalleyresources.com/TheClearinghouse.aspx