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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 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 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 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 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 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.

Pinellas County Government, the Sixth Judicial Circuit of Florida and a network of community based providers are joining forces to expand and enhance the Pinellas County Veterans Treatment Court (VTC). The primary goal of the Pinellas VTC is to break the cycle of criminal behavior, alcohol and/or drug use, and incarceration or other penalties among U.S. military veterans. Another function of the proposed project is to address gaps in the continuum of treatment for veterans who have substance use disorders or co-occurring substance use and mental disorder treatment needs. The VTC intends to reduce the pervasive, harmful and costly health and social impact of substance use disorders, co-occurring mental health disorders, violence and trauma, in alignment with SAMHSA's Trauma and Justice Strategic Initiative. The population of focus for the proposed project is adult veterans who are diagnosed with substance use disorder as their primary condition. Since post-traumatic stress disorder, traumatic brain injury, military sexual trauma, depression and anxiety are prevalent among men and women who have served in the Armed Forces, an emphasis will also be placed on veterans with co-occurring disorders who are currently or have experienced trauma. Up to 120 U.S. military Veterans will be served over the life of the grant (40 annually). Six enhancements are proposed including: the use of a Risk-Need-Responsivity Model; integration of Duke University's Veteran Culture and Clinical Competencies Model; promoting connections to alternative mind-body therapies for stress reduction and pain management; implementation of a veterans-specific employment services component; and increased engagement opportunities for VTC alumni and military families. The Pinellas VTC aligns with the "Veterans Treatment Court Ten Key Components" and employs evidence-based practices and approaches such as Cognitive Behavioral Therapy, Motivational Enhancement Therapy and mentoring.

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 Fourth Judicial Circuit of Florida will expand and enhance the Clay County Adult Drug Court program's existing coordinated, multi-system approach by incorporating additional effective treatment strategies to break the cycle of criminal behavior, substance abuse and recidivism. This project will address identified gaps in services/resources available to Drug Court participants and will help reduce the pervasive, harmful and costly impact of violence and trauma by integrating trauma-informed approaches. Funding will be utilized to expand the availability of and enhance the quality and/or intensity of services by implementing gender-specific treatment groups, implementing three evidence-based treatment modalities of Moral Reconation Therapy, Traumatic Incident Reduction and Relapse Prevention Therapy, and by increasing the available bed days for residential treatment to 70-90 days per person. Intensive substance abuse/mental health treatment services will be provided along with various recovery support services. This project will operate under the principles of the 10-Key Components of Drug Courts, by providing services that are consumer centered, recovery oriented, evidence-based, quality driven and trauma informed. The population of focus is adults with substance abuse or co-occurring disorders of all ethnicity, ages, gender, and socioeconomic statuses. The population of participants in the pre-trial and post-adjudication Drug Court is that of high-risk/high-needs individuals of high criminogenic risk. This project intends to provide services to an additional unduplicated 50 participants each year for a total of 150 participants over three years. The goals of this project are to: 1) implement the listed evidence-based practices; 2) transition to gender-specific treatment groups; 3) expand the length of time participants can remain in residential treatment; 4) implement Medication Assisted Treatment; and 5) track the effectiveness of each goal modality.

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 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 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 Kentucky Court of Justice's Department of Specialty Courts will partner with Pennyroyal Center to enhance substance abuse treatment services for offenders assigned to the Christian County Drug Court. Partners will fill critical gaps in treatment, recovery support and wraparound services that will assist 40 offenders annually to rehabilitate from addiction, cease criminal behavior, reduce recidivism and retain stability in the community. Project objectives will be accomplished with treatment services enhancements that will include filling existing gaps in evidence-based, trauma-informed, gender-responsive and culturally-competent assessment, substance abuse treatment, case management, recovery supports (including peer mentoring) and wraparound services for offenders assigned to the Christian County Drug Court, which is an existing Adult Drug Court that incorporates the 10 Model Key Components and Standards of a Drug Court. Christian County is among the highest ranked counties in Kentucky for total arrests, drug arrests and DUIs for adults. There is a crime committed in Christian County approximately every hour. Of the total 4,616 reported Group A offenses (most severe offenses) committed in the county in 2014, 1,129 (24.5%) were drug/narcotics violations. The rate of drug/narcotics violations was the second highest in the county. This gives the county a "highest" ranking among all counties, in terms of per capita drug/narcotics offenses compared with the remaining 119 counties in the state. The population of focus includes: adult male and female defendants in Christian County, Kentucky, who are nonviolent offenders who have committed drug or drug-related crimes; are eligible for probation or Class D Diversion; have violated current terms of probation related to substance abuse issues; and can acknowledge drug addiction and be assessed as eligible with a substance abuse clinical assessment. Priority focus will be given to high-risk, high need offenders.

The Kentucky Court of Justice's Department of Specialty Courts will partner with Pennyroyal Center to enhance substance abuse treatment services for offenders assigned to the Hopkins County Drug Court. Partners will fill critical gaps in treatment, recovery support, and wraparound services that will assist 40 offenders annually to rehabilitate from addiction, cease criminal behavior, reduce recidivism and retain stability in the community. Project objectives will be accomplished with treatment services enhancements that will include filling existing gaps in evidence-based, trauma-informed, gender-responsive and culturally-competent assessment, substance abuse treatment, case management, recovery supports (including peer mentoring) and wraparound services for offenders assigned to the Hopkins County Drug Court, which is an existing Adult Drug Court that incorporates the 10 Model Key Components and Standards of a Drug Court. Hopkins County is among the highest ranked counties in Kentucky for total arrests, drug arrests and DUIs for adults. A crime is committed in Hopkins County approximately every 3 hours. Of the total 3,424 reported arrests for Group A offenses (most severe offenses) made in the county in 2014, 928 (25%) were drug/narcotics violations. This gives Hopkins County a "highest" ranking among all counties, in terms of per capita drug/narcotics offenses compared with the remaining 119 counties in the state. The population of focus includes: adult male and female defendants in Hopkins County who are nonviolent offenders who have committed drug or drug-related crimes; are eligible for probation or Class D Diversion; have violated current terms of probation related to substance abuse issues; can acknowledge drug addiction and be assessed as eligible with a substance abuse clinical assessment; and have not previously participated in an adult drug court. Priority focus will be given to high-risk, high need offenders.

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 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 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.

The Massachusetts Executive Office of the Trial Court, in collaboration with University of Massachusetts Medical School, the state substance use and mental health authorities, and its partners, is proposing to improve outcomes in the Quincy and Chelsea Drug Courts by embedding a wraparound treatment model called Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking (MISSION). The MISSION model systematically integrates case management, co-occurring disorders treatment, peer support, vocational supports and trauma informed care into one coordinated delivery approach for court involved individuals with a co-occurring mental health and substance use disorder. Project goals are to reduce criminal recidivism, improve substance use and mental health outcomes and increase access to employment among drug court participants through targeted wraparound support between the Chelsea and Quincy Drug Courts and community treatment providers. MISSION will serve a total of 90 clients over the three-year project period. The case manager and peer specialist teams will deliver the MISSION services in each court as well as link clients to other needed community-based services for sustained recovery. MISSION services will commence in Drug Court Phase 2 at both courts as clients in Phase 1 are mandated to residential care. The University of Massachusetts Medical School (developers of MISSION) will provide training, project coordination and serve as the grant evaluator. This project has received input from the state mental health and substance use authorities, district court judges, other state agencies, providers, consumers and is consistent with and will adhere to the 10 key components of the drug court model. This project will embed case managers and peer specialists teams directly into the two courts to improve coordination between the court, clients and community-based providers to increase overall access and engagement in care.

The Sixth District Treatment Courts (SDTC) Opioid and Clinical Case Management Initiative will enhance its treatment services for participants in its five Treatment Courts in Minnesota's Sixth Judicial District. The project will serve at least 100 participants each year over three years by providing opioid stabilization services, clinical case management services, and referral to testing and education for HIV/Hepatitis C (HCV). The Sixth Judicial District is a geographically large district in northeastern Minnesota, with treatment courts located in St. Louis and Carlton Counties. Approximately 49% of our Adult Drug Court participants self-report as abusing opioid prescription pills and/or heroin. We seek to broaden our range of treatment services to participants identifying as opioid users and participants who present with COD. We will offer the following services as part of this project: 1) opioid stabilization unit - utilizing medication-assisted treatment, developing a 10-bed residential opioid-specific unit with intensive medical supervision, comprehensive assessment, and 24/7 staffing; 2) case management - providing services deemed necessary for a participant (e.g., health care, housing, finances, support groups, vocational services); and 3) HCV and HIV Care Fairs - through a partnership with the Rural AIDS Action Network, we will provide "Care Fairs" that include referrals to risk assessment, pre- and post-test counseling, testing, and immediate linkage to medical case management services. SDTC expects to increase access to COD treatment services, opioid stabilization services, and HIV/HCV testing and education, yielding reductions in criminal justice system involvement and improved well-being for its participants.

The 39th Judicial Circuit, nested in the rural Ozark Mountains located in southwest Missouri, is requesting federal assistance to expand and enhance Adult Drug Court programming to serve high risk/high need offenders diagnosed with substance dependence or addiction. Circuit-wide trend data reveals that from 2013-2015 that 62% of all criminal felony filings involved AOD-related offenses. The population of focus is non-violent, felony repeat offenders, who have committed offenses directly or indirectly motivated by alcohol and/or drug use who are screened with high prognostic risk and high criminogenic need diagnosed with substance dependence or addiction. Majority of active Treatment Court participants do not have health insurance and/or suffer from co-occurring disorders and a significant percentage are unemployed and/or have a history of IV drug use. Local assessment data also reveals that 72% (234/325) of participants served have been impacted by a lifetime history of victimization/trauma. The 39th Judicial Circuit will adhere to the Drug Court Standards and utilize the following evidenced-based strategies to ensure success: 1)standardized screening/assessment tools; 2) cognitive behavioral treatment approaches; 3) procedural and distributive justice; 4) medication assisted treatment; 5) frequent judicial monitoring; 6) trauma-informed practices; 7) recovery support services, aftercare, and 8) community integration; and 8) routine program evaluation. Project goals include: 1) Adult Drug Court expansion circuit-wide; 2) provide substance abuse and mental health treatment services 3) provide recovery support services 4) provide viral hepatitis B and C testing for at risk participants; and (5) maintain an electronic data infrastructure for sound program evaluation. Substance abuse treatment and recovery support services will be provided to an estimated sixty 60 participants 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 Eighth Judicial District Court of the State of Montana seeks SAMHSA funds to expand the adult Treatment Court's capacity from 25 participants to 40 participants. The Treatment Court also seeks SAMHSA funds to enhance services for existing participants by increasing access to medically assisted treatment and case management services. The Eighth Judicial District is located in Cascade County, Montana. The Treatment Court's target population is high risk/high need justice-involved adults with substance use disorders who reside in Cascade County. The target population is relatively evenly split between males and females. The overwhelming majority of individuals served are of a lower socioeconomic background. Participants in Treatment Court are 29% American Indian and 70% white. The average age is 30 years old. The target population often has limited work history, little education and an unstable housing history. Polysubstance abuse disorders are common, and many participants have untreated co-occurring mental health disorders. The Treatment Court reduces crime, enhances public safety, saves taxpayer money and enriches lives. The court accomplishes these goals by facilitating sobriety, treating mental health conditions, improving social relations and promoting lifelong stability. The Treatment Court diligently follows the best practice standards for drug courts and uses evidence-based practices to treat participants. The Treatment Court seeks SAMHSA funds to help participants afford MAT and to increase access to case management services. MAT will allow three participants per year to receive Vivitrol shots, nine total over the grant period, and additional funds are available to help pay for Suboxone and Naltrexone. Forty participants per year, 120 total over the grant period, will receive case management services.

The Chippewa Cree Tribe Adult Healing to Wellness Court Enhancement Project will serve Native American adult (ages 18 and up), nonviolent, substance-using offenders on the Rocky Boy's Indian Reservation. The community experiences extreme poverty, low educational attainment and a high prevalence of substance abuse and substance abuse related crimes. Adult Healing to Wellness Court services will be enhanced by: adding co-occurring treatment intervention for clients with co-occurring disorders where substance abuse is the primary condition; adding two evidence-based treatment programs to existing services; and providing enhancement training for Healing to Wellness team members. The project objectives are to: 1) enhance services for at least forty participants per year by adding two evidence-based treatment models and co-occurring disorders treatment as measured by participant case records, project records and external evaluation results; 2) reduce the recidivism rate of adult drug and alcohol related offenses by at least 25% by providing evidence-based substance abuse prevention and treatment services including collaborative screening and assessment, intervention, treatment monitoring, case management and aftercare services as measured by participant case records, project records and external evaluation results; 3) reduce the number of crimes where alcohol or substance abuse was a factor by at least 10% as measured by the number of arrests where alcohol or substance abuse was a factor for the current reporting period as compared to the number of alcohol or substance abuse related arrests; and 4) increase the number of project graduates by at least 15% per year.

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.

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.