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The Rural California Drug Court Program (RCDCP) is a comprehensive drug court program that addresses the needs of substance-abusing adult offenders, including those with co-occurring disorders, who are in Tehama County. RCDCP is expanding and enhancing substance use disorder treatment under this proposal. RCDCP's primary goals are to reduce substance use/dependence and subsequent recidivism among adult offenders. These goals are accomplished through: a)evidence-based, immediate, continuous, and intensive judicially-supervised treatment; b) regular random computerized drug testing; c) interagency supervision and monitoring; d) graduated sanctions, incentives and restitution; and e) mental health services for co-occurring disorders. RCDCP has in the past only served non-violent offenders, but will increase access and availability of services to include serving 15 violent offenders each year of the grant, for a total of 70 per year. RCDCP will improve the quality and intensity of treatment and recovery support services by adding the following: a) an evidence-based, integrated trauma-informed cognitive behavioral treatment program; b) medication-assisted treatment (MAT); c) integrated family-based programming; d) Seeking Safety; e) tobacco cessation programming; and f) recovery support services including peer-to-peer relapse prevention, employment support, education support, linkage to community support groups, housing, transportation and other needs. RCDCP is not only increasing the number of individuals that can be served, but will also increase measurable outcomes pertaining to: a) abstinence from substance use; b) effectiveness of MAT; c) employment rates; d) housing stability; e) individual and family functioning and well-being; f) social connectedness; and g) decreased number of re-arrests post-graduation.

The project entitled "Enhancing and Optimizing Re-entry Court," seeks to enhance the effectiveness of problem-solving courts by increasing ability to treat eligible adults who are required to serve time in prison. This grant will provide participants with treatment at one centralized location, implement Medication-Assisted Treatment (MAT) and continue to provide wrap services that ensures a continuity of care from incarceration to the community. Grant funds will allow drug court services to be provided to 28 adult males in year one, 45 in year two and 50 in year three who were previously disqualified due to legal constraints. These men often have persistent justice involvement, typically for non-violent drug offenses, and Re-entry Court may be seen as a 'last resort' in light of the prison time they could face through traditional justice processing. The goals of this enhancement are to: 1) connect justice-involved persons with individualized treatment; 2) ensure public safety and reduce the number and degree of violence of participants' contacts with law enforcement; and 3) promote recovery and increase participant overall functioning through increased collaboration among court, counsel, state and local government agencies, and community services. Re-entry Court will enroll clients in substance abuse and trauma-informed treatment, implement MAT, expand the use of peer support specialists to promote recovery, promote abstinence from alcohol and drugs, track recidivism, provide treatment interventions that address criminogenic factors and thinking, provide individualized, culturally-competent, trauma-informed, evidence-based services based on participant's level of need, reduce the number of relapses, increase social activity and supports, and increase the number of days of employment and/or maintenance of income.

Catawba County S.T.A.R. DTC has been in operation for the past 12 years. Since 2012, it has sustained services on a voluntary basis by a group of dedicated servants within the community. The team continued to promote public safety and reduce cost to community and State with a mission to help participants achieve long-term sobriety, improve their quality of life, including improved familial and community relations; and become responsible and productive citizens. The DTC team focuses on those identified at the highest risk levels while continuing to promote the overall mission to protect the community. High risk meaning: individuals using injectable substances; pregnant females; offenders at high risk for recidivism; and offenders with health issues associated with drug use and risk of overdose. Currently the S.T.A.R. DTC program serves 20 participants with 5 currently on track to graduate in the next six months. The strategies of the S.T.A.R DTC model are designed to follow the evidence based best practices for North Carolina drug treatment courts. The team is committed to participant recovery in addiction and shared decision making. Interventions include: trauma integrated approaches; comprehensive case planning; intensive monitoring; individualized graduated incentives and sanctions; and protection of due process rights. The goals are as follows: increase participant capacity; increase access to Buprenorphine MAT; and increase community collaborative supports. The measurable objectives are the number of participants entered into the DTC program, success through all Phases, levels of recidivism and the participants own autonomy. The DTC has served 83 people from 2012-2015 and aspires to increase numbers by 80 or more participants within the next 3 years.

The Allen/Simpson Drug Court Service Enhancement Project seeks to enhance substance use and mental/physical health services offered within the already existent Adult Treatment Drug Court. Allen and Simpson counties are located in rural western Kentucky. This area has increasing substance abuse and criminal justice problems with diminishing financial resources to meet the growing need. At the present funding level, drug court clients are not receiving the minimum recommended clinical service hours. While this drug court has been operational for approximately 10 years, funding is limited and services are restricted to those offered by the community mental health center. Goals/objectives for this project focus on the Ten Key Components and include: 1) enhancing services offered to develop an effective, comprehensive system of care to help individuals with substance abuse problems involved within the criminal justice system; 2) enhancing and strengthening treatment services to increase abstinence and decrease recidivism as a way of enhancing future functioning potential; and 3) ensuring project implementation/evaluation adhere to objectives and facilitate continuous quality improvement. Project objectives include implementing intensive Assertive Community Treatment (ACT) and increasing staffing support (e.g., counselor/case manager and peer recovery specialist). This will allow for enhanced treatment activities (i.e., individual/group counseling/case management) to offer a complete array of mental health, substance abuse treatment and recovery support services. Additionally, funding for this project will allow for the purchase of services identified by the ACT team as critical to meet client's treatment goals, but are not currently available including both mental and physical health services. This project will serve 40 high risk/high needs persons annually.

The Delaware Drug Court Expansion and Enhancement Program (DDCEEP) will expand and enhance drug court services for individuals involved in the Delaware criminal justice (CJ) system who also have a substance use or co-occurring mental health and substance use disorder. DDCEEP will be a multi-agency cooperative effort that includes the offices of the Attorney General, the Public Defender, the private bar and the Delaware Division of Substance Abuse and Mental Health. This statewide project will serve adult individuals referred to the Delaware Drug Court through the Delaware specialty courts program. The goal of the program is to increase access to and availability of services to a greater number of CJ clients, increase engagement of and treatment for CJ individuals with substance abuse and co-occurring disorders, and improve the quality of substance use disorder services through the implementation and evaluation of three evidenced-based practices: Risk-Need-Responsivity, Enhanced Motivational Interviewing and Forensic Cognitive Therapy. The objectives of DDCEEP include: expansion of the Drug Court to increase the number of individuals served; implementation of RNR to improve the referral, engagement, tracking and supervision of CJ participants; reduction of substance use; reduction of CJ recidivism; increase public safety by providing services that will help offenders reconnect with their families and the community, including employment, counseling, education, health and mental health, thereby increasing their community tenure; increased housing stability; decreased CJ involvement; improved individual and family functioning and well-being; increased social connectedness, increased employment; and decreased risky behaviors; and reduction of costs associated with high risk/high needs clients. DDCEEP will serve 87 individuals annually.

The Trauma Informed Transformation Project, 12th Circuit Drug Court of Mississippi, is to reduce the pervasive, harmful, and costly health impact of violence and trauma upon the recovery of drug court participants. The project's population of focus is drug court participants who have been exposed to complex trauma and have a substance use disorder which contributed to their arrests. The 12th Circuit Drug Court serves two counties in southern Mississippi, Forrest and Perry. The project will build the drug court's system of care's capacity by becoming trauma-informed and offering trauma-focused and trauma treatment using a combination of two evidence-based models under the auspices of SAMHSA TIP 57: 1)Relapse Prevention and 2) Cognitive Behavioral Therapy. Priority populations are based on the severity of traumatic events and severity of substance use, prioritizing those individuals who are veterans, LGBT or are a racial minority. The project will achieve a trauma-informed provider network of behavioral health and court agencies consistent with SAMHSA TIP 57 through the following goals: 1) create a trauma-informed workforce of behavioral health and court direct and support service providers; 2) provide outreach and engagement strategies that increase access to trauma specific services that are culturally competent among diverse groups of drug court participants who have experienced or been exposed to trauma or violence; and 3) contribute to SAMHSA's collection of standardized core indicators to reduce trauma and related behavioral health disparities and health inequities and comply with all terms of the grant award. The project will serve a minimum of 50 participants each year.

The McHenry County Adult Drug Court Service Enhancement Project aims to create the McHenry County Treatment Network and expand access to residential, intensive outpatient and medication-assisted treatment. The project will also address case management, recovery support services, skill building, HIV and Hepatitis B and C testing with referrals for coordinating medical treatment, for participants with a primary diagnosis of substance dependence, co-occurring mental illness and trauma. The project goal is to increase stable recovery for participants leading to improved quality of life, while reducing recidivism rates within the community. While aiming to expand access to appropriate treatment, the project includes recovery support services, which will link participants to programs including group trauma therapy, cognitive therapy support groups aimed at users of heroin and opioids. McHenry County's Adult Drug Court began in 2011 and continues to uphold the Key Components of Drug Courts. Participants of Adult Drug Court meet primary diagnostic criteria for substance dependence, while also being nonviolent felony offenders, which may include drug offenses, and probationable felony drug related charges. Participants also have to meet other eligibility criteria set forth in the Illinois Drug Court Act. Many of the participants live in poverty and have inadequate education. According to the 2010 U.S. Census data, McHenry County is now the sixth-largest county in Illinois by population. Since 2010, McHenry County's growth stayed relatively flat and reached 307,409 residents. Of those residents, a 2014 Healthy Community Study found that 83.7% was non-Hispanic Whites. Hispanics (of any race) comprised the second largest race/ethnic group at 12.4%, followed by non-Hispanic Asians at 2.8% and non-Hispanic Blacks at 1.4%. McHenry County Drug Court will serve 50 participants per year over the next three years.

The Cuyahoga County Court of Common Pleas Drug Court serves Cuyahoga County, Ohio. According to the Ohio Department of Health, overall drug overdose deaths in Ohio in 2014 increased from 2,110 to 2,482 in 2015, with fentanyl related deaths increasing almost 500% from 84 to 502 during this period. In Cuyahoga County opioid related deaths increased from 235 to 390, with fentanyl related deaths climbing from 39 to 192, an increase of 548%. The primary subcategory of the aggregate Cuyahoga County population to be served by this proposed drug court expansion will be suburban females ages 18-36. It is estimated that females will be significantly and disproportionally over-represented, with white females accounting for up to 60% of offenders served by the proposed expansion on Drug Court. An additional 10% of the targeted population will be comprised of African American females and 5% Hispanic females. Statistics for Cuyahoga County are indicative of the rampant increase in the use of opioids across this community. According to Cuyahoga County Treatment Alternatives to Street Crimes (TASC), the percentage of Substance Use Disorder (SUD) assessments with opioids identified as the primary drug of choice has increased from 24% in 2012 to 33% in 2015. Additionally, heroin/opiates were the primary drug of choice in 78% of the 112 TASC assessments specifically completed for Drug Court eligibility determination for cases originating in the suburbs of Cuyahoga County. Ninety-two percent of Drug Court participants are recommended for residential treatment based upon SUD diagnosis.

The 18th District Drug Court (18DC) Service Enhancement Project seeks to enhance substance use and mental/physical health services offered within the already existent Adult Treatment Drug Court. The 18DC is comprised of Harrison, Nicholas, Pendleton and Robertson counties and are rural/Appalachian and located in the north central Kentucky region. This area has increasing substance abuse and criminal justice problems with diminishing financial resources to meet the growing need. At the present funding level, drug court clients are not receiving the minimum recommended clinical service hours; thus receiving funds for this service enhancement project are of critical need. This drug court has been operational for approximately 6 months and funding is limited and services are restricted to those offered by the community mental health center. Goals/objectives for this project focus on the Ten Key Components and include: 1) enhancing services offered to develop an effective, comprehensive system of care to help individuals with substance abuse problems involved within the criminal justice system; 2) enhancing and strengthening treatment services to increase abstinence and decrease recidivism as a way of enhancing future functioning potential; and 3) ensuring project implementation/evaluation adhere to objectives and facilitate continuous quality improvement. The project objective includes implementing intensive Assertive Community Treatment (ACT) and increasing staffing support. All goals/objectives are assessed via outcome data and process evaluation data collected by the Evaluation team. ACT has been selected as the evidence-based practice to achieve project goals/objectives because it addresses fragmented systems of care by a more coordinated effort and focuses on a continuous care strategy. This project will serve 40 high risk/high needs persons annually.

The Birmingham Municipal Drug Court Treatment Project will enhance treatment services for individuals enrolled in the Birmingham, Alabama Municipal Drug Court. The project will serve 100 clients per year. The population of focus will be low-income and/or uninsured adults with a substance use disorder or co-occurring substance use and mental disorder. Aletheia House, a community-based nonprofit organization with more than forty years of experience, will provide the treatment services. The project will use evidence-based practices including: cognitive behavioral therapy; integrated services for individuals with co-occurring substance use and mental disorders; medication-assisted treatment (MAT); recovery support services; tobacco cessation services; and services that address the specific needs of returning veterans and their family members. The project's goals include: 1) clients will decrease their use of drugs and alcohol; 2) clients with co-occurring substance use and mental disorders will experience a decrease in behavioral health problems; 3) clients who are assessed as being appropriate for MAT, and who choose to use MAT, will experience a decrease in behavioral health problems; 4) clients will increase their use of recovery support services, 5) clients will decrease their use of tobacco; and 6) returning veterans and their family members will experience a decrease in behavioral health problems.

The Erie County NY Drug Court MISSION-CJ Initiative is an expansion and enhancement proposal that will implement the MISSION-CJ (Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking for Criminal Justice). MISSION-CJ is comprised of an integrated set of evidence based practices and it applies the Risk-Need-Responsivity framework to identify treatment needs and monitor progress. Progress is achieved through the use of: Critical Time Intervention case management, Dual Recovery Therapy, peer support and trauma informed care as the core treatment services to meet the client needs, including many of the criminogenic needs and to enhance responsivity to treatment and criminal justice oversight. The project will serve individuals charged with a non-violent misdemeanor and/or felony offense, which is related to their substance abuse. New drug court policies and procedures will be developed to identify and target those at high risk for opioid overdose (OD). The Erie County Department of Mental Health (DMH) currently funds a pilot drug court navigation program, the Healthy Outcomes Partnership & Education (HOPE) program. With DMH funding, this SAMHSA proposal will enhance the HOPE program by fully adopting the MISSION-CJ, using both the 6-month and the 12-month model, depending on risk for opioid OD. The goals include: 1) expand Drug Court Navigation Program for drug court participants that are currently not eligible for existing navigation services, but are high-risk for opioid OD; 2) enhance existing Drug Court Navigation Program; 3) integrate behavioral health treatment with medication-assisted treatment and medical management of addiction; and 4) reduce opioid OD among drug court participants.

The Muscogee County Adult Drug Court is expanding its current program to include an additional 200 unduplicated participants over the life of the project and enhancing its current treatment model to include transitional housing and beginning a medication assisted treatment program. All of these program expansions and enhancements work to create a well-rounded program targeted at treating high risk/ high need participants including those with opioid dependence. The population of focus is adults ages 18-65 charged with felonies or probation violations, non-violent in nature, motivated by addiction and not profit. This project will serve those with addictive diseases and co-occurring disorders. The Adult Drug Treatment Court is a five-phase, court supervised, intervention program that supplements existing community resources and services. In addition to weekly court appearances, clients participate in an individual drug court program plan which includes intensive court supervision, individual and group counseling, Twelve Step recovery or similar self-help program meetings, and community agency linkage. Additional services provided can include residential treatment, intensive outpatient treatment, individual psychotherapy and family treatment. In order to reach program goals, the project will use evidence based practices to include: screening assessment and pre-treatment planning, MET, the Matrix Model, relapse prevention therapy, recovery support services, Seeking Safety, case management, MAT and Addictive Disease Semi Independent Residential Services. The goals of the project are to: 1) increase the number of participants by 40 individuals per year; 2) increase the number of individuals receiving MAT; 3) increase the number of individuals receiving Semi-Independent Residential Services; 4) increase the number of successful completions through improved staff training; and 5) reduce recidivism rates among graduates.

The Circuit Court of Cook County (Circuit Court) RAP/WRAP Drug Court Enhancement Program aims to increase the number and percentage of participants who achieve stable recovery and graduate successfully from one of the largest drug courts in Illinois, by expanding client's access to community based treatment, expanding offender services and expanding medication assisted treatment. The Circuit Court established the Rehabilitation Alternative Probation (RAP) Drug Court Program for men in 1998 and the Women's Rehabilitation Alternative Probation (WRAP) program in 2001 to divert individuals with substance use disorders into treatment. The RAP/WRAP Drug Court Program is currently one of the largest drug courts in Illinois, with approximately 225 participants supervised each year. Cook County, the primary funding entity for the Circuit Court, has demonstrated substantial commitment to the Circuit Court's alternative supervision programs. While RAP/WRAP was initially supported with early federal drug court grants, the project is currently supported through funding from Cook County. The Circuit Court is deeply committed to all RAP/WRAP participants. Through this proposal, the Circuit Court's RAP/WRAP Drug Court Service Enhancement Program aims to increase the number and percentage of participants who achieve stable recovery and graduate successfully from RAP/WRAP. This will be accomplished by: expanding clients' access to community based residential substance abuse treatment; incorporating motivational interviewing, moral reconation therapy and medication-assisted treatment for opiate dependent clients; and expanding peer and trauma support services. The RAP/WRAP court team and treatment provider staff will fully leverage participant eligibility for Medicaid and private insurance to cover treatment to provide other needed recovery support services to this population.

The Orange County Adult Drug Court (OCADC) program proposes to provide enhanced treatment, including recovery services, case management and program coordination. The OCADC program seeks to address gaps in the continuum of treatment for drug court participants whose primary diagnosis is a substance abuse disorder through enhancements with the addition of three new positions: 1) Peer Support Engagement Specialists, 2) an In-Home Family Support Specialist, and 3) a Healthcare Navigator. Implementing enhanced navigator and case management services will improve access, service use and outcomes of minority populations that are utilizing the program at disproportionate rates from the incarcerated population. By assigning each person from a disproportionately represented population a peer-support specialist we anticipate engagement to be increased and access to ancillary services such as housing and education to be improved. By providing a family engagement specialist to persons in these populations we anticipate seeing increased engagement in treatment services by enabling the family as a whole to effectively support an environment conducive to recovery. Finally, by utilizing a health care navigator we will be able to help clients engage in insurance services to continue their treatment after they have completed the OCADC program. Two evidence-based interventions that will be incorporated into the treatment services are Motivational Interviewing and Motivational Enhancement Therapy. The program will serve a minimum of 75 individuals at highest risk for non-compliance each year. The services are specifically designed to meet the complex needs of individuals with substance use and co-occurring disorders.

The Nevada County Probation Department, in conjunction with its community partners, wishes to expand the existing Adult Drug Court through the Adult Drug Court Expansion Grant as the need for this court and the growing mental health issues in the community are not being efficiently addressed. The goal of this grant is to expand the capacity of the court from its current maximum population of 15 to a maximum of 25 participants while enhancing services to those with co-occurring disorders who are being underrepresented in the existing structure of the Nevada County Drug Court. The concept of the Nevada County Adult Drug Court is to increase the level of accountability to high risk offenders by requiring them to participate in treatment combined with education, judicial accountability, testing and formal supervision. The Nevada County Adult Drug Court functions through a rich collaboration of several agencies including the Superior Court, Probation Department, Behavioral Health, the Public Defender's Office, the District Attorney's Office, local law enforcement agencies and local treatment providers. If successful, the Nevada County Adult Drug Court Expansion Grant would properly expand capacity of this alternative court, enhance the level of service to program participants, apply funding to address co-occurring disorders appropriately and improve the level of community safety provided for this type of repeat drug offender. Additionally, the high need for medication assisted treatment (MAT) has been ignored due to funding and an inability to find a suitable provider to assist the clients with the highest need. As the medical community has begun to embrace MAT, lack of funding is the only barrier preventing Nevada County from being able to assist clients with this new method of treatment. Additionally, this grant would allow for other medical care needs which are innate to the needle using drug offender: Hepatitis C and HIV.

The Early Assessment, Intervention and Treatment Program (EAIT) integrates evidence-based principles to address a growing need for co-occurring substance abuse and mental health treatment in the 10th Judicial District Drug Court system. Implementation of EAIT is needed to expand on co-occurring substance abuse and mental health services to facilitate treatment provision for 65 clients annually. The EAIT Program is designed for the needs of the co-occurring disorder population with mild to moderate mental health issues such as schizophrenia, schizoaffective disorder, bipolar disorder, major depression or anxiety. This population has been found by the 10th Judicial District Drug Court to be more able to appreciate personal consequences for actions leading to criminal justice involvement and take personal responsibility for recovery. Expansion of effective treatment mechanisms and service options will decrease cost and excessive service utilization associated with this group and ultimately, reduce taxpayer burden. The goals of this project are to reduce recidivism resulting from co-occurring substance use and psychiatric symptomology, improve daily functioning, quality of life, systems of social support and mainstream resources, to provide effective co-occurring disorder recovery coordination and treatment, to decrease societal costs associated with criminal-justice involved dually-diagnosed clients and to increase appropriate utilization of community services and be measured by data collected in baseline, 12 month and 18 month assessments.

Mifflin County will expand the number of participants and enhance treatment services in its already existing Adult Treatment Court (ATC). The ATC provides a coordinated, multisystem approach which combines the sanctioning power of the court with effective substance use treatment to divert non-violent offenders with substance use disorders from incarceration. The ATC currently serves 15 participants. This number will be increased to 25 each year of the grant for a total of 75 participants over a three year period. This project will serve residents of Mifflin County, a rural community located in central Pennsylvania, with an overall population of 46,486. As with other parts of the country, this community has experienced an unprecedented opioid epidemic. It is estimated at least 75% of the inmates housed in the Mifflin County Correctional Facility have substance use disorders. Mifflin County will enhance the ATC to improve both the quality and intensity of drug/alcohol treatment services being offered. Substance abuse intervention and treatment services have proven to have a profound benefit on society. When court mandates are combined with substance abuse treatment services to provide an opportunity for substance abusing adults to be accountable for their actions while receiving treatment, the results have proven to be very effective. The evidence-based program will be added to the treatment protocol which will address the unmet needs of the target population. The enhancement of the program will break the cycle of substance use by providing an evidence-based program, therapeutic tools, education, skill development and other supportive resources to decrease alcohol and/or drug use among participants. The primary goals and objectives of the Mifflin County ATC are to: 1) reduce recidivism rates; 2) reduce substance use among participants; and 3) rehabilitate participants.

The Wake County Adult Drug Treatment Court Program (DTC), in collaboration with Wake County Human Services will serve a post-adjudicated urban adult population involved with Adult Drug Treatment Court through enhancement of the program by improving mental health services, offering medication assisted treatment, screening and assessment for mental health disorders, providing program and case management, and enhanced drug and alcohol monitoring. The population of focus includes high risk/high need chemically dependent non-violent adult criminal offenders, many with co-occurring substance use and mental disorders. This enhancement project will focus efforts on addressing gaps in the continuum of treatment for participants who need medication assisted treatment with an objective to serve 20 participants yearly. DTC can serve a daily census of 75 participants and aims to enroll 75 participants yearly throughout the project. Another objective is to serve at least 50 participants yearly who struggle with co-occurring substance use and mental health disorders in the behavioral health outpatient clinic. Strategies and interventions to achieve this include implementation of Moral Reconation Therapy and Dialectical Behavior Therapy. The project will expand recovery support services by hiring a peer support specialist, increase drug and alcohol testing for treatment and recovery purposes for program compliance, supervision, therapeutic intervention through the purchase of drug testing supplies and complete a program evaluation through a local university.

The 13th Judicial Circuit, Administrative Office of the Courts/Hillsborough County, Florida, in partnership with the Drug Abuse Comprehensive Coordinating Office, the James A. Haley Veteran's Hospital, and the University of South Florida's Louis de la Parte Florida Mental Health Institute is proposing a drug court enhancement. The proposed enhancement focuses specifically on Veteran's Treatment Court clients (males and females) who have substance abuse dependence requiring placement in residential treatment services and who may have post-traumatic stress or another mental health disorder. The proposed enhancement project will provide a multi-system approach to extend residential, intensive outpatient, outpatient, and recovery support services using evidence-based practices to40 clients per year over the grant period. The population of focus is in need of substance abuse treatment, mental health treatment, related recovery services and wraparound services including veteran mentors to break the cycle of criminal behavior, alcohol and/or drug use and incarceration or other penalties.

Unified Community Services (UCS) is part of the treatment court team for three courts in Grant and Iowa Counties in rural southwest Wisconsin. UCS will be able to enhance and expand services by providing an intensive outpatient program, funding residential treatment, helping participants with transportation issues, and increasing capacity in the treatment courts. Grant and Iowa Counties are both rural counties and have a combined population that is approximately 75,000. UCS has been a part of the team for the Grant County OWI Treatment Court since 2010, the Grant County Drug Treatment Court since 2014, the Iowa County Drug Treatment Court since 2015, and has been the treatment provider for the Iowa County Intensive Supervision Program (OWI). UCS will provide enhanced services to participants through Intensive Outpatient Program and residential treatment facilities in the Madison area when needed, as there are no residential treatment facilities in the two-county area. Participants often miss treatment appointments or court appearances because of transportation needs. Grant funds will allow the courts to provide some relief to participants with transportation barriers. The Grant County 2014 Community Health Needs Assessment identified the following needs and three top concerns: "access to mental, dental, and primary health care," "transportation," and "substance abuse/drug treatment center and residential facilities". The increased staffing, enhanced treatment options, and assistance with transportation will allow the three courts to increase participants from the current 32 to 52 during the grant period, increase graduation rates, decrease drop-outs and expulsions, and reduce sanctions.

The 31st Judicial District Behavioral Health Treatment Court Collaborative Young Adult Enhancement is a program to serve young adults, ages 18 to 26 who are involved in the criminal justice and experiencing symptoms of addiction or co-occurring disorders. Young adults have specific treatment and recovery needs, and their success requires programming to meet those needs. The addition of mentoring and medically assisted treatment will provide additional innovations and address the opioid addiction trends being experienced in rural Tennessee. Remediation of recidivism and increased community safety by approaching services in an individualized, risk-appropriate, and developmentally appropriate process supported by a strong community-based collaboration is the overarching goal of this project. The 31st Judicial District of Tennessee covers Warren and Van Buren Counties. Both are very rural communities in Central Appalachia with limited availability and access to recovery-oriented resources. The project plans to enroll a minimum of 60 individuals in services per year. The planned enhancements for the program include a mentoring program to assist all participants in achieving long-term recovery. The project will be guided by the Behavioral Health Treatment Court Collaborative Workgroup, ensuring a focus on developing and accessing resources for young adults experiencing addiction and co-occurring disorders. This project will increase tenure in the program and increase completion rates among young adults. In addition, it will significantly reduce the incidents of recidivism in the local jail system, impact re-admission rates for treatment of psychiatric and addictive disorders, as well as reduce overall criminal justice involvement among individuals participating in the project.

The Washington County Drug Court seeks a Capacity Expansion Grant for our Adult Drug Treatment Court to assist nonviolent offenders to successfully rehabilitate from the use of drugs and/or alcohol. The program mission is to "address drug-related crimes by reducing recidivism and promoting public safety through the implementation and management of a cost-effective, community based intervention and treatment program, and to improve the lives of participants." This project will address the following goals and objectives: Goal 1: to increase partner knowledge of the program and consideration of the drug court program as a viable option in the interventions for drug-related offenders in the criminal justice system. Objectives will strive toward a 200% increase in referrals and overall admissions so that a minimum of 40 participants will be served annually. Goal 2: To reduce substance use and recidivism among a higher capacity of identified offenders through intensive treatment, community and judicial supervision. Goal 3: Improve individual and societal accountability among participants. Goal 4: Reduce drug related costs and workload volumes on Washington County's criminal justice system. This will be accomplished via implementation of the 10 Key Components. Within those components we will offer an array of quality behavioral health services to address substance use and any co-occurring mental health needs of participants. Consistent and swift interventions to address compliance/non-compliance, along with intensive judicial interaction are key change strategies and interventions utilized to help create life change for participants. These interventions have proven effective for our target population of men and women, largely between the ages of 18 and 49, all with a DSM-V substance use disorder diagnosis and a history of criminal involvement who are living in Washington County, Virginia, a rural, high poverty area.

The Superior Court of California, County of Solano proposes to enhance its existing Adult Drug Courts with new tracks to serve two specific subpopulations: a co-occurring disorders (COD) track to serve participants with both a mental health diagnosis and a substance use disorder diagnosis, and a medication-assisted treatment (MAT) track to serve participants addicted to opioids. The program enhancement will serve100 unduplicated clients over the life of the grant. This "Solano Integrated Treatment Services" project will serve non-violent adult offenders of all ethnicities in the existing Adult Drug Courts located at the courthouses in Fairfield and Vallejo. Our current drug court model does not adequately meet the needs of our two proposed subpopulations as they are in need of specific medical services and/or integrated treatment. Traditional approaches currently utilized may not be efficacious for the COD population and other remedies must be offered. The target population to be served by the COD track includes male and female adult residents of Solano County who have an active criminal case, are addicted to drugs and/or alcohol, and have a moderate to severe mental illness diagnosis. The target population to be served by the MAT track includes male and female clients addicted to opioid drugs, including prescription and illicit drugs. The target populations of both tracks are of any race, ethnicity and sexual orientation who are high risk and who have high needs, as determined by evidence-based assessment tools. The goals of the project are: 1) to improve access to integrated mental health and substance use treatment services for participants with a COD; 2) to improve access to medication-assisted treatment to participants addicted to opioids; and 3) to build drug court program infrastructure in Solano County. The Solano project will employ several evidence-based practices in these two new tracks.

The Pierce County Superior Court (PCDC) proposes an expansion and enhancement of services to address a growing population of offenders with an opioid use disorder that are deemed appropriate for medication assisted treatment (MAT). In addition to therapies for both substance use and co-occurring mental health disorders, the program will provide additional staffing and resources needed to establish a specialized treatment track that incorporates patient coordination, administration, medications and qualified medical assistance to comprehensively address the challenges of opioid dependence. The program will use cognitive behavioral therapy, that is fully integrated with the judicial process, incorporating a number of evidence-based enhancements to include motivational interviewing techniques, dialectical behavior therapy, moral recognition therapy and the "Living in Balance" program. The PCDC has implemented the risk and needs triage, an improved means to tailor treatment based on the individual's level of risk and level of need for treatment. The measureable objectives of the program are to: 1) expand an existing caseload of 100 drug court participants to serve 172 individuals, to include 72 opioid-dependent individuals with chemical dependency treatment and patient coordination services through a special, MAT track; 2) sustain a 60% successful graduation rate for the MAT participants; and 3) successfully reintegrate MAT graduates into the community as demonstrated by a criminal recidivism rate of less than 40% after one year, post-graduation. The attainment of these program objectives will be measured primarily through the GPRA system, to include analysis of intakes and discharges and the data related to employment and education, community connectedness, and risky behaviors.

The Bronx District Attorney's Office, in collaboration with the Court and EAC's Treatment Alternatives for Safer Communities (TASC) case management, proposes to expand prosecution coordination with the Bronx Adult Drug Treatment and Co-Occurring Disorders Court and enhance its treatment and wrap-around services for non-violent felony defendants with alcohol and drug abuse/dependence and defendants with co-occurring mental disorders (COD). Sixty new clients per year will be served thru the Bronx Enhancement Project. The project will utilize: 1) TASC Clinical Case Management to incorporate the use of the validated COMPAS risk and needs assessment instrument to provide individually targeted enhanced services for participants using the risk, needs and responsivity model to increase the success of participants by linking a risk and needs assessment with treatment planning; 2) randomized toxicology testing; 3) one-on-one and group sessions using Interactive Journaling to explicitly address criminological factors and increase self-efficacy; 4) individualized case management services for participants addicted to opioids who are in need of medication assisted treatment; 5) integration of peer support for mentoring in the community to facilitate drug court participation and maintenance of recovery following court completion; and 6) vocational counseling and job placement support for defendants as they achieve recovery.