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Cook Inlet Tribal Council, Inc. (CITC) proposes the enhancement project, Dual Treatment Drug Court Project. A collaboration with the federal Hope Court and the Alaska Court System’s Anchorage Therapeutic Courts, the project will provide enhanced and expanded substance use disorder treatment services to a minimum of 120 participants over three years in Anchorage, Alaska. While Alaska Native people are disproportionately impacted both by the need for substance abuse treatment and incarceration, this project will serve adults (age 18 and over) of all ethnicities and genders in Anchorage through a coordinated, multi-system approach combining the sanctioning power of treatment drug courts with effective recovery supports and treatment. CITC’s Recovery Services Department operates the most comprehensive continuum of care for substance abuse treatment for adults in Alaska, from Assessment to Brief Intervention to Outpatient and Intensive Outpatient to Residential treatment, and has invested significant effort into incorporating Alaska Native cultural values and practices into our treatment programs. While this is most evident in our residential treatment model, Therapeutic Village of Care (which has achieved Promising Practice status), cultural strengths and trauma-informed care are incorporated throughout all Recovery Services programs. This project will serve 40 participants annually, for a total of 120 participants over three years, with the following goals: Goal 1: Expand the Federal Hope Treatment Court service population to 60 participants over three years. Goal 2: Enhance access to a comprehensive continuum of care for adult substance use disorder treatment for 120 participants over three years through both the Hope Court and the State of Alaska’s Anchorage Wellness Court. Goal 3: Promote recovery through improvement in life domains associated with recovery. These goals will be achieved through the implementation of evidence-based practices such as Moral Reconation Therapy, Trauma-Informed Care, Integrated Mental Health and Substance Abuse Services, and Motivational Interviewing.

ABSTRACT The Cuyahoga County Common Pleas Court (CCCPC) is requesting SAMHSA funds in the amount of $975,000.00 to enhance substance use disorder treatment services in an existing Adult Problem Solving Court. Proposed enhancements to the Drug Court (DC) will enrich client services for non-violent, high-risk/high need participating offenders/defendants that are victims of human trafficking and sexual exploitation presenting with co-occurring trauma–based mental health issues. The goal is to provide a coordinated, multi-system approach designed to combine the sanctioning power of treatment DCs with effective substance use disorder treatment services to decease criminal behavior, substance use, and incarceration. The primary sub-category of the aggregate Cuyahoga County population to be served: 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 to DC. An additional 10% of the targeted population will be comprised of African American females and 5% Hispanic females, all within the same age category. The Court proposes using the Treatment DC Model and strengthening treatment modalities of alcohol & drug and trauma informed approaches throughout health, behavioral health and related systems to provide unmet needs and services to DC participants, using the key components of the DC model: screening/assessing clients for the presence of co-occurring mental & substance use disorders; utilizing information obtained from screening assessments to formulate appropriate treatment approaches for identified clients; access to FDA-approved medications under the care and prescription of a physician; recovery support services; case management; and program coordination.

The Brooklyn Treatment Court (BTC) is requesting funding in the amount of $948,722 from the Substance Abuse and Mental Health Services Administration to enhance our existing Adult Drug Court, Veterans’ Treatment Court and DWI Court through the creation of a Medication Assisted Treatment (MAT) track to provide for the early identification of offenders with an opioid use disorder and prompt intervention utilizing optional pharmacotherapeutic services for those determined to be clinically appropriate. Opioid and alcohol dependent participants currently make up a majority (53%) of BTC participants. Out of the 226 current BTC participants, 65 (29%) are being treated primarily for opioid dependence and 51 (23%) are being treated primarily for alcohol dependence. Among these participants, 55% have been placed in either a 28-day rehabilitation or long-term residential treatment program; 14% have been placed in both. Many opioid dependent BTC participants would benefit from newer pharmacotherapies both in long-term residential treatment as well as outpatient treatment settings were such options available. MAT is the use of medication in combination with counseling and behavioral therapies to provide a whole-patient approach to treat opioid dependent individuals. MAT can be particularly useful in the treatment of these dependencies because it decreases craving and withdrawal symptoms, ultimately enhancing the impact of traditional counseling strategies (SAMHSA (2014). Medication Assisted Treatment (MAT)). While BTC currently utilizes MAT in a 90-day Residential Rehabilitation Program, in partnership with Samaritan Village (SV), BTC now seeks to expand the quality and intensity of our services through the addition of a specialized MAT track within SV’s long-term residential treatment program and continuing with MAT as participants transition to outpatient treatment. This track will provide services to 40 participants each year, totaling 120 unduplicated participants over three years. Starting with an onsite clinical assessment by a licensed Addiction Medicine Physician, appropriate participants will be immediately linked to MAT at a residential or outpatient SV facility. Following the BTC model, the MAT track will include close judicial monitoring, specialized assessment and treatment services, comprehensive case management services, incentives and sanctions, and frequent and random drug and alcohol testing. The MAT Resource Coordinator will be located on the premises of BTC, will work closely with BTC staff, and serve as the primary liaison with SV’s case manager, physician, and program staff. The goal of the proposed project is to streamline the screening, assessment, and referral processes, thereby creating effective linkages between the criminal justice system and comprehensive medical and substance abuse services.

The New York State Unified Court Systems, Syracuse Community Treatment Court (SCTC), is requesting SAMHSA Grant Program funds in the amount of $959,581 to enhance the SCTC, an existing adult drug court, to engage nonviolent young adult males, ages 18-25 years, in successful rehabilitation efforts. The funding will allow the court to refer a total of 135 treatment court participants (40 Year 1: 50 Year 2: 45 Year 3) The grant award will allow SCTC to partner with Crouse Health to enhance existing programming for young adult males identified as high need/high risk. Funding will enable the court to: 1) add additional treatment services staff, 2) train clinicians in trauma informed care and cultural competence specific to the target population 3) fund treatment not covered by insurance and 4) conduct a process and outcome evaluation. SCTC will contract with Crouse Health (1) to enroll 135(40 Year 1: 50 Year 2: 45 Year 3) unduplicated drug treatment court participants into the Healthy Young People Excel (HYPE) program over the 3-year grant period. Crouse Health is a not-for-profit, tax-exempt organization which has served Central New York for more than a century. Crouse Health is the area’s leading provider of substance use disorder (SUD) treatment since 1962 and the only hospital-based opioid treatment program in the region. The primary goal of the project is to positively impact the young men who enter the SCTC by engaging them in specialized services at Crouse Health. This will be met by developing and executing a comprehensive treatment case plan that includes substance abuse treatment and evidence based practices including: Exploring Trauma, Dialectical Behavior Therapy Skills, Contingency Management and Moral Reconation Therapy. Additionally, the use of a smartphone recovery app will be made available to participants who own a smartphone. Success will be measured by improved attendance in treatment, abstinence, increased social functioning skills and successful completion of the SCTC. The SCTC adheres to the Ten Key Components and the Adult Best Practice Standards in the overall program design.

Project Abstract - 15th Circuit Drug Court Enhancement Project The purpose of the 15th District Drug Court Enhancement Project is to enhance the Drug Court’s capacity to provide appropriate treatment and recovery services in order to reduce the effects of substance use-related crime and violence. The goals and objectives of the project follow: Goal 1: Provide a continuum of care for Drug Court participants in order to achieve and sustain recovery. Objective 1.1. Increased identification of SUD/CODs; Objective 1.2. Increased understanding of the impact of participation in recovery support services; and Objective 1.3. Improved participation in recovery support services; Goal 2: Provide outreach and engagement strategies that increase access to recovery and recovery support services that are culturally competent among diverse groups of drug court participants. Objective 2.1. Improvement in abstinence from SU; Objective 2.2. Improved engagement in employment; Objective 2.3. Improvement in % achieving stable housing; Objective 2.4. Improved quality of life; Objective 2.5. Improved retention rate; and Objective 2.6. Decrease in mental health symptoms. Goal 3: Contribute to SAMHSA's collection of standardized core indicators to reduce addiction and related behavioral health disparities and health inequities and comply with all terms of the grant award as specified in the requirements section of the Notice of Award. Objective 3.1. Use evidence-based treatment planning & decision making. The Drug Court’s population of focus are adult drug court participants who are of low socioeconomic status and have chronic SUD/CODs with multiple barriers that inhibit recovery. The 15th District serves five counties in southern Mississippi: Jefferson Davis, Lamar, Lawrence, Marion, and Pearl River. The population served are 14% African American and 86% Caucasian; 52% male and 48% female; and 78% with a high school education or less. The Drug Court will be enhanced by the addition of an evidence-based continuum of care with a menu of services to meet the individual, unique treatment needs of each participant. Additionally, recovery support service planning will be transformed by building the Drug Court’s capacity to implement person-centered planning. PCP is person-centered, fosters self-direction, is collaborative, and culturally competent. This project will serve a minimum of 50 participants each year, for a total of 150.

Abstract: Expanding Treatment Services and the Continuum of Care for Hamilton County Residential Drug Court Clients The proposed project, Expanding Treatment Services and the Continuum of Care for Hamilton County Residential Drug Court Clients, is a collaboration between the Hamilton County Mental Health and Recovery Services Board, Court of Common Pleas Drug Court, Hamilton County Adult Probation, and Talbert House. These partners have worked collaboratively since 1995 to provide a continuum of treatment for drug court clients. This project seeks funds to expand and enhance substance use disorder treatment and recovery support services for residential drug court clients. Significant gaps within the treatment continuum impede its ability to provide accessible and comprehensive services that facilitate recovery. These gaps include limited availability of medication-assisted therapy (MAT) and trauma informed interventions, and lack of key recovery support services, including case management, parent education, and employment services. To address these issues the program will serve 160 residential treatment clients to: Goal 1: Increase access to MAT. Objective 1.1: Provide MAT to 36 clients (12 in Yr. 1, 12 in Yr. 2, 12 in Yr. 3). Goal 2: Increase availability of trauma-informed approaches. Objective 2.1: Provide Seeking Safety to 160 clients (40 in Yr. 1, 60 in Yr. 2, 60 in Yr. 3). Goal 3: Improve the quality of recovery support services by integrating two evidence-based interventions into the drug court treatment continuum. Objective 3.1: Provide Strengths-Based Case Management to 160 clients (40 in Yr. 1, 60 in Yr. 2, 60 in Yr. 3). Objective 3.2: Provide parent education to 100 clients (33 in Yr. 1, 33 in Yr. 2, 34 in Yr. 3). Goal 4: Increase availability of employment services. Objective 4.1: Provide employment services to 160 clients (40 in Yr. 1, 60 in Yr. 2, 60 in Yr. 3). Key interventions include: MAT, Seeking Safety, Strengths-Based Case Management, employment services, and two parent education interventions – Nurturing Father’s Program and Creating Lasting Family Connections. The project’s population of focus is male and female F4 and F5, non-violent, felony drug offenders who are drug dependent and in need of residential treatment. The majority are male (69%) and White (95%). Ninety percent are uninsured at program admission. Primary diagnoses include opioid (89%), other drug (42%), and alcohol (24%). Fifty percent of target clients report a history of trauma. The project will expand access to treatment services – MAT and trauma informed care, and enhance recovery support services through the adoption of case management and parenting interventions and improvement of the reach of employment services. These changes will lead to a comprehensive recovery oriented system of care that supports the recovery of drug court clients and positively impacts substance use and criminal justice outcomes.

The Jackson County 4th Circuit Recovery Court (JCRC) established in 2004, will enhance their program by meeting the following goal: target opiate dependent participants to improve outcomes. Medication Assisted Treatment (MAT) has been chosen as the JCRC evidence-based treatment for program enhancement. The JCRC estimates that 60 opiate dependent participants will be served during the grant period. Project objectives will include other evidence-based strategies and incorporate the 10 Key Components of Drug Courts with interventions designed to improve the graduation rate by continuing to embed recovery support services (R.S.S.) such as recovery coaches, including military veterans coaches, into the ongoing structure of the JCRC. The JCRC has documented an emerging trend where by clients that are opiate dependent have had limited success in the program while the use of opiates is increasing. In the past three years, there have been a total of 219 admissions to the program. Of that number, 83 (38%) were opiate and heroine drug of choice users. Of that group of 83, 30 (53%) successfully completed the program and 26 (31%) are still active. In comparison, during the same time frame, there were 136 non-opiate users, 65 of those participants (48%) graduated. During this time, JCRC also experienced two opiate related participant deaths. Total successful discharges were 95 (70%). The source of this data is State of Michigan Drug Court Case Management Information System (DCCMIS). JCRC will continue to partner with Victory Clinical Services, a local treatment provider that has a state licensed methadone program designed to provide medical and counseling services to individuals who are addicted to opiate drugs. Victory Clinical Services applies a team approach to assist clients in eliminating the negative social, physical, and mental effects of substance abuse. Staffing patterns established to address the resolution of substance abuse problems include physicians, certified substance abuse counselors, and nurses. Treatment planning for clients is based on a holistic problem-solving model that addresses each client as a unique individual with the potential to resolve substance abuse problems in a positive manner. The entrance criteria for the JCRC are individuals meeting sentencing guidelines for an intermediate or straddle cell offender with a SUD diagnosis, non-violent felons who have a SUD diagnosis and are charged with any of the following: an OUIL 3rd, a drug offense (possession and delivery if not for profit but to obtain drugs), or certain select financial crimes such as forgery and uttering and publishing A defendant with a straddle cell score can be sent to prison or just jail and probation at the discretion of the sentencing judge.

Project Summary: The alarming increase in opioid, heroin and synthetic drug use has taxed treatment, housing and other community services. The wait for or between treatment programs can lead to relapse, rearrest or death from overdose. For those with co-occurring disorders or a history of trauma, this wait can seem endless. The project will focus on providing additional treatment and support during these “gap” times and to enhance existing treatment services. Project Name: Filling the Gap: Treatment, Support and an Ounce of Prevention Population to be served (Demographics and Clinical characteristics): Cayuga County is a rural community with a population of 78,288. In 2010, 134 out of every 10,000 residents were admitted to alcohol and substance abuse treatment programs in the County, an increase of 52% increase since 2000. The target population will include criminal-justice involved adults with co-occurring disorders or a history of trauma, with services being provided to those using all substances, with a particular emphasis on those with a history of opioid, heroin or synthetic drug use. Strategies/interventions: The project will use the Seeking Safety counseling model to help drug court participants attain safety from substance use and/or trauma. The project will provide trauma-specific treatment, case management, care coordination and peer mentoring, all aimed at providing support during times of crisis, while awaiting treatment and to enhance existing treatment services. Project goals and measurable objectives: The goal of the project is improve service delivery and outcomes and reduce relapses and recidivism rates for justice-involved individuals with substance use disorders and co-occurring disorders and/or trauma histories. The objectives to achieve the project’s goals include provide training to drug court team members, staff and community agencies on best practices and trauma-informed approaches to integrate such approaches into the various service systems provided to drug court participants; provide trauma-specific treatment using the Seeking Safety model to 40 participants per year; reduce the number of jail bed days and arrest incidents; increase abstinence/reduce the number of incidences of relapse amongst the drug court population by providing additional support services to bridge the gap during times of crisis and increased need. Proposed number of individuals to be served: It is estimated that approximately 40 people will be served per year, for a total project population served of 120.

The Westchester County Drug Court Enhancement Program will provide: (1) Medically Assisted Treatment (MAT) to participants involved in the Westchester County Drug Treatment Court Program (herein referred to WCDTC); (2) increase the number of justice-involved veterans participating in the WCDTC; (3) develop a Veteran Mentoring Program; and (4) conduct a program evaluation of the WCDTC. The Westchester County Drug Court Enhancement Program will coordinate the efforts of four misdemeanor drug courts/veteran treatment tracks located in the city of Mount Vernon, New Rochelle, White Plains and Yonkers in addition to the felony Judicial Diversion. The goal of the project is to expand the WCDTC program capacity by 120 adult male and female participants, 16 years old and older, over three years (40 Year 1: 40 Year 2: 40 Year 3). The objective of the project is to expand clinical services for justice-involved veterans in Westchester County and increase the coordination of MAT services delivery. The mission of the drug courts and the veteran treatment tracks is to offer defendants with chemically dependence, co-occurring disorders the opportunity to change their lives by engaging in an intensive court supervised treatment program modeled after the U.S. Department of Justice 10 Key Components of Drug Court and Veteran Treatment Court.

This ""Bridging the Gap"" project of identifying behavioral health disparities and disproportionalities within the Terrebonne Parish Drug/DWI Court will allow staff to enhance/expand services to the co-occurring and low income populations. The TPDTC will enhance current services and improve quality and/or intensity of services by building the capacity of the program to provide services aimed at strengthening families and reducing the behaviors and consequences associated with substance abuse and related behavioral health disorders. As of July 1, 2015, Terrebonne Parish had an estimated population of 113,972. As reported by race and ethnicity, 71.5% of the population reported their race as White, 19.0% reported their race as Black or African American, 5.8% reported themselves as American Indian or Alaska Native, 1.2% reported as being Asian, .1% identified as being a Native Hawaiian or other Pacific Islander, and 2.4% identified as being two or more races. The Hispanic or Latino population was reported at 5.2%. Present enrollment for Terrebonne Parish Drug/DWI Treatment Court is 125. Similarly, current enrollment of TPDTC by race is representative of the population level of Terrebonne Parish. Presently in the program, 78% reported their race as White, 15% reported their race as Black, 6% Native American, and < 1% Asian/Pacific Islander. Reliable transportation and child care continues to be issues for many of the our clients especially those living outside the transit bus line, without positive family support, and/or lack of funds to pay for transit bus ticket or child care. A review of DCCM documentation over the past six months, May – November 2016, indicated that 28 out of 125 clients (22%) experienced transportation issues that caused them to miss program related appointments at least once. Six out of 125 clients (5%) experienced child care issues which caused them to miss program related appointments. Our goal will be to enhance the screening and assessment process, incorporate additional clinical services for our co-occurring population, and increase ancillary support services for our low income clients. We will utilize the RANT and Modified Mini Screen (MMS) to better assess for appropriate placement and identification and/or history of co-occurring disorders. Establish a Double Trouble in Recovery (DTR) group to provide a more welcoming environment for the co-occurring population. The Family Based Therapy will give our clients the opportunity to reconnect with their families through counseling. We will, with these services being delivered, look to see a decrease in the average number of sanctions per client by 50%, increase in the average number of days in treatment per client by 60 days, decrease in the number of positive drug screens per COD client by 50% in 180 days as measured by Norchem report, and increase in number of program graduates with COD by 100% by end of year 3 grant cycle. We plan to serve 125 clients in year 1, 130 throughout year 2, and 140 throughout year 3. The expected unduplicated population for all three years is 208.

The First Judicial District Court plans to enhance its Adult Drug Court and Treatment Court to better serve its high risk/high needs population and to improve overall graduation and retention rates. The First District is requesting funds to improve both the quality and intensity of treatment and recovery support services designed to assist offenders with successful rehabilitation from the use of drugs and alcohol. The First District Court intends to implement the use of instant EtG testing for all clients in both of its Adult Drug Courts and in its Treatment Court to continue to and to better adhere to the Ten Key Components of the Drug Court Model. It also intends to implement a Mindfulness Based Relapse Prevention curriculum that integrates evidence-based practices from mindfulness-based interventions and cognitive-behavioral relapse prevention approaches. The First District will use these funds to help provide sufficient transportation for those clients in need to improve their participation in and compliance with program requirements. Finally, through this grant, the First District intends to expand the training opportunities provided to its full-time staff. A minimum of 80 clients will be served each year for a total of 240 clients throughout the lifetime of the grant. The First District Court's two Adult Drug Courts and one Treatment Court accept criminal defendants from Los Alamos, Rio Arriba and Santa Fe Counties in northern New Mexico. These defendants have been most often adjudicated on felony-level charges, both violent and non-violent, and have been identified as high risk and high needs. Most have been convicted of property crimes, predominantly burglary; the rest have been convicted primarily of drug charges or DWI. Some clients have already served time in prison. They present significant substance abuse histories, and more than half of them list opioids, specifically heroin, as their preferred drug of choice, followed by alcohol, cocaine, methamphetamine and marijuana. Most have co-occurring mental health disorders, in particular bi-polar disorder, severe depression and post-traumatic stress disorder. The majority of clients, anywhere from 70 to 80 percent, are Hispanic and male, and more than half of them are under the age of 30. The goal of this project -- by enhancing the quality and intensity of the programs' treatment and recovery support services in the ways described -- is to improve the outcomes for this client population, and to improve those outcomes with measurable objectives. Those objectives include increasing each program's retention rate by 5 to 10 percent over the lifetime of the grant, increasing each program's graduation rate by 5 to 10 percent over the lifetime of the grant, reducing overall substance use, particularly that of alcohol, and relapse as measured by urinalysis testing, and increasing client participation in program activities. The First District Court is able to track its progress in meeting these objectives by utilizing a Microsoft Access database that collects the necessary information on performance measures.

Project Abstract Summary Summary. The North Mississippi Commission on MI/MR (d.b.a. Communicare/Region 2 Mental Health) and the 3rd Circuit Drug Court of Mississippi will implement the Addiction Counseling Health Integration Education Vitality Enforcements project addressing gaps in residential treatment capacity and providing trauma-informed service enhancements and peer recovery supports to reduce recidivism and co-occurring disorders and improve successful reintegration into communities. Name of the project: ACHIEVES Populations served: High risk/high need adults 18+ (48% female; 48% male; 4% transgender); 25% African American, 10% Hispanic/Latino 5% Multi-Racial; 70% White (non-Hispanic); 5% LGB; 100% trauma-involved; 100% Co-occurring Disorders; 4% HIV positive and 4% viral Hepatitis positive in need of immediate residential treatment. Project Goal. To provide gender affirming, trauma-informed and culturally and linguistically appropriate behavioral health services reducing crime, co-occurring substance use and mental disorders among high risk/high need, nonviolent offenders who are in need of residential treatment. Strategies/Interventions: ACHIEVES expands residential treatment capacity and enhances treatment dosage and intensity adding state-of-the-science approaches and recovery support services all to meet the individualized needs of drug court participants. The Level of Service Inventory–Revised™ (LSI-R™) is used to match each participant's level and intensity of services to his/her level of risk and relative to his/her needs. Services include: standardized screening/assessment, trauma-informed SUD/MH co-occurring disorders residential treatment coupled with strength-based case management, HIV, viral Hepatitis screening and linkage, and peer recovery support services (ensuring linkages to housing, employment, healthcare and social supports). Use of EBPs from SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP) will help to achieve the measurable objectives yielding optimal results. EBPs: Motivational Interviewing, Seeking Safety, Wellness Recovery Action Plan (WRAP), Living in Balance, Medication Assisted Treatment (MAT) and Trauma Recovery and Empowerment Model (TREM/M-TREM). Measurable Objectives. Of the 150 participants served, 90% will successfully complete the program; 85% will reduce risk of recidivism and substance use; 90% will have higher rates of abstinence from criminal activity and substance use; 85% will reduce antisocial behaviors that trigger criminal activity and substance use; 90% will achieve sustained rates of employment, education and housing stability; 95% will increase in supports and social connectedness; 75% will reduce the frequency of risky behaviors to reduce HIV/AIDS, Hepatitis A, B and C and STIs; and 100% will report greater access and use of peer recovery support services. Number to be served. 50 per year, totaling 150 across a three-year project period.

The Benton County Drug Treatment Court (BCDTC) operates under the jurisdiction of the Benton County Circuit Court and is located in Corvallis, Oregon. BCDTC began operations in November 2001. Our program targets offenders who have admitted probation violations and stipulated to a sentence of incarceration if they do not graduate, as well as persons who are newly charged with a drug and drug-related crimes who will participate in a post plea/pre-adjudication model with a stipulated alternative jail sanction for those who do not graduate. BCDTC has traditionally served 40 to 50 individuals. Participants are required to attend treatment and support groups, submit to random urinalyses, attend Court regularly, and address collateral issues in their lives. Participants are expected to address psychological, educational, employment, housing, and parenting issues, and the staffing team refers participants to appropriate community partners for services in these areas. It is the goal of BCDTC to help participants change their lives by taking a holistic approach to treatment of their addiction and to end their future involvement in the criminal justice system. The Benton County Sheriff’s Office, on behalf of BCDTC, is applying for a grant in the amount of $276,213.63 for the 2017 SAMHSA grant cycle. The purpose of this grant is to (1) develop a Co-Occurring Disorder (COD) track; (2) enhance assessment processes; and (3) provide COD participants with access to integrated substance abuse and mental health treatment services. Implementing this grant will strengthen and enhance BCDTC’s ability to improve positive outcomes within the participant population. In addition, the grant funds will increase our ability to deliver integrated treatment services to individuals with CODs and will allow BCDTC to accomplish the following activities: • Utilize evidence-based practices to develop a COD track and provide integrated treatment. • Create policies that support the implementation of a COD track and make adherence to those standards part of BCDTC’s operating procedures. • Develop specific treatment groups for COD participants. • Improve assessments through the utilization of several evidence-based instruments. • Provide training opportunities for the BCDTC staffing team. • Conduct regular evaluations of the COD track to continually monitor fidelity and outcomes, identify areas of need, and ensure program success.

The New Mexico Second Judicial District Court Adult Drug Court, in collaboration with the Department of Corrections, Bernalillo County Prosecutor and Public Defender’s Offices, Albuquerque Human Services and various criminal justice and community and state partners, propose to develop an integrated, client-driven system of behavioral health care that improves outcomes for justice-involved adults in Bernalillo County with substance use or co-occurring substance use and mental health disorders. NMSJDC will provide administrative and fiscal management of the program. The proposed project will build upon the success of the NMSJDC Adult Drug Court by: • Enhancing co-occurring, trauma informed, and cognitive behavioral treatment services • Enhancing supervision practices to improve responsivity to participant risk/need, specifically for alcohol testing, transportation, and incentives and sanctions • Improving overall program functioning via comprehensive evaluation • Expanding culturally relevant services specific to Native American culture The project aims to improve outcomes by providing a coordinated and culturally appropriate response to justice involved individuals with substance abuse and mental health issues. This will be accomplished by: • Integrating new evidence-based practice (Seeking Safety) into the existing treatment regimen (as measured by program materials, and documented in the evaluation); • Increasing trauma-specific treatment interventions provided for individuals identified as having a history of trauma (as measured by the PCL-C and program records, and documented in the evaluation); • Increasing treatment interventions addressing co-occurring mental health disorders for those participants diagnosed with a mental illness (as measured by treatment and program records, and documented in the evaluation); • Increasing EtG testing for all drug court participants (as measured by program records and Odyssey and documented in the evaluation); • Implementing a Healing to Wellness track for Native American drug court participants (as measured by program records and documented in the evaluation). • Expanding the continuum of care component to include access to a stepdown aftercare services. The project objectives are to prevent and reduce relapse, reduce recidivism, and promote sustained recovery and self-sufficiency among participants enrolled in NMSJDC Adult Drug Court. The NMSJDC requests $325,000 to expand the system of services for justice involved adults with substance abuse and co-occurring mental health disorders, support staff training and technical assistance, develop a spectrum of culturally relevant recovery support services, and evaluate local outcomes. One hundred participants will be served each year for a total of 300 participants over the lifetime of the grant.

The Multnomah County START Court Enhancement project will improve drug court outcomes by integrating comprehensive and evidence-based trauma recovery treatment into existing substance abuse and mental health treatment services. In order to ensure identification and referral of individuals who would benefit from services, assessment protocols will be revised to ensure the PCL-C (for PTSD diagnosis) is administered and introduce the Life Adversities Screen, a validated screening tool used to identify adult anxiety and trauma that falls short of a PTSD diagnosis. All grant-funded services will be trauma-informed and culturally appropriate, with a particular focus on serving African American males, a population with higher revocation rates than their START Court peers. Gender-specific needs will also be assessed and addressed. Grant funding will serve 40 clients annually (120 over the life of the grant) with enhanced and individualized services. Other clients identified with qualifying trauma symptoms will be included in project evaluation activities to determine the effectiveness of funded services. In order to determine anticipated demographics, Multnomah County has used those with a PTSD diagnosis as a proxy, though it is known to be only a portion of the population of focus. It is clear, however, that people of color, particularly African Americans, and women experience trauma more frequently, data consistent with current program outcomes and national literature. As such, anticipated demographics of those to be served are: 63% White, 27% Black, 3.5% American Indian/Alaska Native, 3.5% Hispanic and 3.5% Asian/Pacific Islander. Sixty-three percent will be males and 37% female. Goal 1: Improve outcomes of START Court participants by adding comprehensive trauma treatment as an integrated component of START’s existing substance abuse and mental health service continuum. Objective 1a: Offer comprehensive trauma treatment services to 40 START participants. Objective 1b: Offer culturally-specific trauma recovery treatment services to at least 10 African American clients each year. Objective 1c: Offer peer support/mentoring services to at least 40 individuals identified as trauma-impacted each year of grant funding. Goal 2: Conduct a quasi-experimental evaluation of grant funded services to assess their effectiveness and inform continuous improvement efforts. Objective 2a: Project evaluators and VOA staff will establish a process to implement assessment and program assignment protocols that support the quasi-experimental research design. Objective 2b: Project evaluators will implement data collection protocols on the 40 participants engaged in trauma services. Objectives 2c: Project evaluators will implement data collection protocols to measure program impacts on outcomes for all participants identified through the screening process as trauma impacted. Objective 2d: Evaluation team will provide program outcome updates to the START Court Policy Team on a quarterly basis. Objective 2e: The START Policy Team will complete sustainability planning based on program outcomes and current best practices.

The Northern California Co-Occurring Drug Court Program (CODC) is a comprehensive drug court program that addresses the needs of substance-abusing adult offenders with significant co-occurring disorders who are involved in Tehama County’s criminal justice system. CODC is expanding and enhancing substance use disorder treatment through Tehama County’s existing behavioral health specialty court program which is funded entirely through local and state funding streams. CODC addresses current gaps in the existing specialty court program by providing a comprehensive continuum of treatment for clients with co-occurring substance use and mental disorder treatment needs. CODC will only serve high-risk, high-need individuals diagnosed with a substance use disorder as their primary condition. CODC’s primary goals are to reduce substance use/dependence and subsequent recidivism among adult offenders with co-occurring disorders. 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. CODC, under this initiative, is proposing to increase access and availability of services to a total of 40 clients with co-occurring disorders each per year for a grant total of 120 clients. Simultaneously, CODC is proposing to improve the quality and intensity of treatment and recovery support services. To accomplish this expansion and enhancement, the program will add the following: a) an evidence-based, integrated trauma-informed cognitive processing treatment program; b) medication-assisted treatment (MAT); c) integrated family-based programming; d) Seeking Safety evidence-based program; e) tobacco cessation programming; and f) recovery support services including peer-to-peer relapse prevention, employment/education support, linkage to community support groups, housing, transportation and other needs as identified through ongoing assessment; g) providing specialized services for veterans. The support services are designed to remove barriers to each participant’s successful recovery. CODC’s proposed expansion and enhancements were born out of a self-study of the existing behavioral health specialty court program. CODC will ensure that all of the Adult Drug Court Best Practice Standards and Ten Key Components are implemented. CODC 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) program graduation rates 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. These positive changes in individuals and families will lead to prolonged recovery, decreased risky behaviors, decreased criminal justice involvement, and ultimately significant decreases in recidivism rates.

The City of Phoenix Veterans Court (Veterans Court) in partnership with its primary partners La Frontera Arizona EMPACT-SPC (EMPACT-SPC), and the University of Arkansas, will expand and enhance its current program within the City of Phoenix Municipal Court System by expanding and enhancing substance use disorder treatment services for justice involved veterans who are otherwise unable to access services through either the Veterans Administration, Medicaid or a private health care provider. By working together, this multi-agency project seeks to level the playing field for veterans in Veterans Court and greatly increase the likelihood of every veteran's success regardless of the veteran's ability to pay for treatment. This program, the City of Phoenix and EMPACT Veterans Court Service Expansion Project, requests $907,332.00 in Federal Funding to increase access to treatment for justice involved veterans to address the primary issue of substance use disorders along with other co-occurring disorders, as well as health, medical, and other basic needs. The City of Phoenix established Veterans Court in 2012, and since then an average of 500 veterans participate annually. Veterans Court is inclusive of those defendants who served in the United States Armed forces who are experiencing treatable behavior issues such as substance and alcohol abuse, post-traumatic stress, traumatic brain injury, anger management, and domestic violence. Phoenix Veterans Court promotes sobriety, recovery, and stability through a coordinated response to a veteran’s dependency on alcohol, drugs, and/or management of his or her mental illness. Veterans Court proscribes to the Veterans Treatment Court Ten Key Components and includes a dedicated team including the Veterans Court Judge, Prosecutor, Public Defender, Court Coordinator, Veterans Administration (VA) Veterans Justice Specialist, EMPACT Rally Point member, Veterans Court Mentor Project veteran mentors, and volunteers. This team works collaboratively, combining the sanctioning power of the Veterans Court with effective treatment modalities to reduce criminal behavior, alcohol and/or drug use, incarceration and to increase public safety and veteran wellbeing. The majority of veterans in Veterans Court receive substance use disorder treatment through the VA, Medicaid, or through private health insurance coverage. Between 10-25% of participants experience gaps in treatment either because they are ineligible for treatment from the VA, ineligible for coverage under Medicaid, or they cannot afford treatment in the private sector. In these cases, the veteran incurs costs for treatment with a private provider. Often times these costs can be crippling to the veteran’s recovery and success in the program. Some veterans opt to leave Veterans Court because they are unable to pay for treatment. This program will address this gap by providing Medication Assisted Treatment, Intensive Outpatient Treatment, Intensive Case Management, Forensic-based Cognitive Behavioral Therapy, and Peer Support to those veterans in Veterans Court without access to treatment otherwise. In addition, this expansion and enhancement project will allow for infrastructure development, which will enable us to collect data, measure outcomes, and assess treatment access to properly allocate and coordinate veteran care.

The current proposal, titled ""Expanding Substance Abuse Treatment Capacity in the Waukesha County Drug Court,"" seeks funding under the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (TI-17-001) grant solicitation to enhance the substance abuse treatment capacity of the Waukesha County Drug Court by improving the quality of treatment services, as well as expand the overall capacity of the program from 50 to 60 participants, in order to increase access to the program for a larger number of clients. Waukesha County will serve at least 50 clients annually, serving a minimum of 150 clients by the end of the three-year grant. Through this grant opportunity, substance abuse treatment services for drug court participants will be redesigned to enable the Waukesha County Department of Health and Human Services (DHHS) to perform all substance abuse and mental health assessments, as well as be the primary provider of treatment services for drug court participants, which will ensure that consistent and quality evidence-based treatment services are provided. Waukesha County is applying for this SAMHSA funding opportunity in direct response to an on-site evaluation of our Drug Court program by American University consultants in December 2015. In their written evaluation, dated February 19, 2016, the consultants identified ""Ensuring Consistency in Treatment Services for All Participants"" as their primary recommendation, noting that ""The current services provided by the Waukesha County DHHS and private treatment providers is inconsistent. The majority of services (60%) are provided by private providers for which the court has no oversight. Drug Court leaders need to begin the process of selecting DHHS as their primary treatment provider..."". Waukesha County has been battling the opiate abuse epidemic for several years. According to the Wisconsin Department of Health Services, Crime Lab cases involving heroin increased by 419% from 2008 to 2014. The proportion of opiate-related deaths involving heroin increased from 5% in 2006 to 33% in 2014, with the number of heroin overdose deaths quadrupling between 2008 to 2014, from 70 to 267. The Waukesha County Medical Examiner’s Office continues to report a significant number of drug overdose deaths attributed mainly to prescription opiates and heroin. In 2010, there were 42 drug-related overdose deaths in Waukesha County; in 2011, that number increased to 47. In 2012, drug-related deaths in Waukesha County increased significantly to 59. 2013 saw a drop in overdose deaths to 39, but it increased again in 2014 to 50 drug-related deaths. Experts speculate that the increased use of Naloxone (Narcan) in recent years may be preventing a significant number of overdose deaths. In response to this growing epidemic, Waukesha County implemented a drug court program in March 2012, which serves young (average age is 18-26 years old), high-risk, drug dependent (primarily heroin users) county residents. Initially, the program had 25 slots, and was at capacity within 2 months of operation. The program doubled its capacity in January 2014 to 50 slots, and still maintains a waiting list. Funding from SAMHSA under this solicitation will be used to expand the capacity of the drug court program even further, while centralizing the provision of treatment services for drug court clients in order to ensure quality and consistent treatment, improving the success rate of drug court participants and most importantly, saving lives.

The Colorado Judicial Department 18th Judicial District Wellness Court has developed Project Wellness. The Wellness Court is requesting funds in the amount of $963,169.39 (three year total) to enhance the Wellness Court to better serve adult, dually-diagnosed, high risk/high need, probation revoked, felony offenders with successful rehabilitation from the use of drugs, improved mental health symptomology and reduced involvement in criminal behavior. Project Wellness will serve 61 unduplicated clients over the grant period; 41 in Year 1 (20 new and 21 already admitted into the Wellness Court); 11 new clients in Year 2; and 11 new clients in Year 3. Because clients will be in the program for approximately two years, when the number of carryover clients in Years 2 and 3 are considered (including attrition), there will be approximately 30 clients being served at any given time throughout the project. Each year, a total of 41 clients will be served. The proposed project will allow the Wellness Court to implement the following interventions: 1) Employ a clinical case manager (CM) dedicated to the Wellness Court, 2) Provide SSI/SSDI Outreach Access and Recovery (SOAR) interventions if clients are in need, 3) Obtain funding to provide the necessary treatment services for participants, 4) Obtain funding for the Wellness Court team to attend NADCP Conference, 5) Provide training on historically disadvantaged groups, 6) Provide training and coaching on trauma, organizational trauma, secondary trauma, and resiliency, and 7) Employ a dedicated problem solving court coordinator (PSCC) to facilitate treatment referrals, oversee treatment contracts and ensure team is adhering to best practices. Goal 1: Enhance program operations Objective 1.1: Recruit, hire, and train a 1.0 FTE problem solving court coordinator Objective 1.2: Recruit, hire, and train a 1.0 FTE clinical case manager Objective 1.3: Send Wellness Court staff to NADCP Conference Goal 2: Improve Wellness Court participant outcomes Objective 2.1: Enroll 61 dually-diagnosed participants in Project Wellness over three years Objective 2.2: Ensure 80% of participants receive treatment appropriate to their ASAM level of care needed within two weeks of sentencing Objective 2.3: At least 50% of participants in residential treatment will complete treatment Objective 2.4: At least 60% of participants in transitional residential treatment will complete treatment Objective 2.5: At least 65% of participants will graduate from Project Wellness Objective 2.6 At least 70% of participants will report reduced use, improved mental health and reduced trauma symptoms

The 31st Judicial District Adult Drug Court is requesting funding via the SAMHSA Treatment Drug Courts Grant to expand the drug court capacity and treatment services to reduce crime and substance use among high risk offenders. We ensure that all participants are identified and assessed; ensure all participants receive targeted research-based services; enhance the provision of recovery support services that prevent recidivism; and lower costs associated with this target population. The 31st Judicial District Adult Drug Court serves high risk/high need male and female non-violent offenders with substance abuse issues. The 31st Judicial District is comprised of Allen, Neosho, Wilson, and Woodson Counties in Kansas and serves a rural population of 42,601. The primary race is 95% Caucasian and 3% Hispanic. Substance abuse treatment and mental health treatment for the population of focus is provided by local agencies throughout the district that provide drug/alcohol treatment services: intensive outpatient treatment, outpatient treatment, group therapy, and relapse prevention. Mental health services include: medical services, outpatient therapy/treatment, case management services, and crisis intervention. The purpose of this grant is to address the gap of providing treatment funds for offenders with no other means of getting the recommended immediate treatment needed to reach successful habilitation. The project will serve a total of 120 offenders over the three year grant period (40 in year 1, 40 in year 2, and 40 in year 3). Goal 1 – Increase the availability and expand the provision of comprehensive evidence-based substance abuse treatment for all male and female Adult Drug Court participants. • Treatment providers will screen, identify, and deliver treatment for all male and female offenders participating in the Adult Drug Court. • Treatment providers will deliver comprehensive evidence-based intensive outpatient substance abuse treatment to 120 male and female Adult Drug Court participants. • Develop a responsive system of care for program clients that efficiently and effectively respond to immediate needs and builds a recovery support system. • Project Director will collect and report the required data in GPRA on all male and female Adult Drug Court participants. Goal 2 – Decrease mental, behavioral, and physical health factors frequently associated with substance abuse among all male and female Adult Drug Court participants and enrolled in intensive outpatient treatment. • Treatment providers will screen, identify, and treat/refer for treatment all adult male and female offenders enrolled in the intensive outpatient program with co-occurring mental and behavioral health disorders. • Provide comprehensive evidence-based outpatient mental health treatment to all male and female adult offenders with a mental, behavioral, and physical health diagnosis. • Provide comprehensive crisis prevention plans to 120 offenders enrolled in the intensive outpatient treatment program.

PROJECT ABSTRACT SUMMARY The Benton County Adult Treatment Drug Court (BCATDC) proposes to increase treatment staff and to collaborate with Decision Point, Inc. and Dayspring Behavioral Health to provide an Integrated Substance Abuse and Mental Health Treatment Program to provide enhanced behavioral health services to participants of the BCATDC located in Northwest Arkansas. This is a service enhancement project, primarily designed to enhance the quality and intensity of the treatment and recovery support services available to BCATDC clients with the most complex problems. The overall purpose of this project is to improve the quality and quantity of intensive outpatient services for drug treatment court clients most in need. Additionally, the project will fill gaps in the continuum of care by adding residential and mental health service, thus providing a fully integrated continuum of care. Because this service enhancement project would result in the program being able to provide services at the level needed, it will improve the outcomes of those with the most severe and complex substance abuse problems. This program will specifically target individuals least likely to succeed with traditional treatment approaches – those with the greatest personal vulnerabilities, problem severity, complexity and chronicity, and fewest natural supports. Because of the characteristics of the substance dependent individuals we are targeting, we expect this to include those with trauma, repeat offenders (legal complications as a result of drug/alcohol dependence) and individuals with serious mental health problems (high problem complexity). We anticipate serving 60 clients in year one, 65 clients in year 2, and 70 clients in year 3 for a total of 195 clients over the three year funding period. Project goals include: 1) Increase quality and quantity of outpatient services, 2) add specialized groups, 3) ensure true continuum of care by filling gaps in services including residential treatment, mental health and wrap-around services, 4) improve effectiveness of incentives, 5) Improve staff knowledge through training. As part of infrastructure development, we will establish an Advisory Board comprised of community partners (recovery support service providers, volunteers, clients and their families, AO/Decision Point and Dayspring staff) and the BCATDC staff. Training and technical assistance will be provided on evidence-based approaches for case management and for treating individuals with trauma histories. Seeking Safety, an evidence-based treatment for clients with a history of trauma and substance abuse, is utilized to address the need for trauma-informed services in NW AR. The project will be closely integrated with broader state-level Systems of Care efforts to ensure sustainability for the system. Plans for quality improvement, replication and sustainability will be guided by results from the evaluation of the project.

The Charlottesville-Albemarle Adult Drug Court became operational in July 1997 as a joint effort of the City of Charlottesville and the County of Albemarle under the auspices of OAR-Jefferson Area Community Corrections. The Drug Court Enhancement project is designed to close current gaps in the drug court treatment continuum, support consumer specific cultural and clinical needs and create a supportive environment that connects participants with a broader, community-based system of services and support, bridging the gap between the treatment and recovery communities. One goal of the project is to enhance the various substance abuse/mental health treatments that are currently available to drug court participants through the Region Ten Community Services Program. Region Ten will increase the array of treatment options for participants including adding COPE, cognitive behavioral therapy, medication assisted treatment, and Drug Court Journaling. The second goal of the Drug Court enhancement is to create a supportive environment that connects participants with the community at large and the recovery community specifically. This includes providing interactive journaling to serve as a communication tool between participants and their drug court team and providing recovery support staff to assist drug court participants with barriers to treatment and to develop relationships with their home and recovery communities. We expect the retention, graduation and success rates of participants to increase as a result of these program enhancements. We anticipate serving a minimum of 270 participants over the three years of the project. From the beginning, the Charlottesville-Albemarle Drug Court was supported by a wide range of agencies and services, including but not limited to, Police, Commonwealth Attorneys, Defense Attorneys, Region Ten Community Services Board, Probation and Parole, and the Courts. All of these entities and more continue today to support the efforts of the Drug Court.

The Suffolk County Drug Court Expansion and Enhancement Project is a collaborative effort between the County of Suffolk, New York State’s 10th Judicial District Drug Court, and EAC Suffolk Treatment Alternatives for Safer Communities (Suffolk TASC) to actively intervene and break the cycle of abuse, addiction, and crime in Suffolk County, New York. The Suffolk County Department of Probation representing the unit of local government and the Executive’s Criminal Justice Coordinating Council (CJCC), will oversee the project. The project will expand the number of adult drug court participants who have substance use disorders or co-occurring substance use and mental disorder (COD) treatment needs in Suffolk County from 50 to 75 per year (225 for 3 years) and enhance the capacity of the court to better engage and retain participants by incorporating: TASC clinical case management, providing mapping-enhanced counseling (MEC) and/or interactive journaling (IJ), ensuring access to Medication-Assisted Treatment (MAT), ensuring access to HIV rapid testing and Hepatitis B/C testing and prevention education and providing vocational counseling services. The goals of the project are to: increase abstinence from substance use, increase employment rates, decrease recidivism rates, decrease criminal justice involvement, improve overall health and well-being, increase social connectedness, and decrease risky behaviors.

Kenaitze Indian Tribe's Henu' Community Wellness Court Expansion and Enhancement Project will target 60 total alcohol and/or drug-involved clients for services from 2017-2020. The primary goal of the program is to reduce recidivism among targeted tribal members, Alaska Native/American Indian populations and non-tribal clients who elect to participate in the Wellness Court. Expansion services will include providing services to an additional 20 clients per year for three years; combined with current client caseloads, this means the Court will expand capacity to serve forty clients per year, or 120 clients over three years. Crucial to this expansion in capacity are the services of the Tribal Treatment Specialist, who will enhance referral networks to broaden treatment and recovery options for vulnerable populations experiencing drug and/or alcohol addiction and/or co-occurring disorders. Kenaitze will additionally enhance services by partnering with CICADA, Peninsula Community Health Services, and the Tribe's own Behavioral Health Department at the DWC to provide HIV and Hepatitis B & C screens, and to enhance services for clients who require MAT treatment and/or supportive residential treatment. Finally, enhanced peer supports will be provided in the form of Forensic Peer Support Specialists, who will utilize evidence-based models to reduce re-traumatization among Henu clients, improve social connections, decrease rates of recidivism and broker aftercare supports. The project is three years in length, and will serve Henu Court clients residing in Kenai, Nikiski, Soldotna, Sterling, Cohoe, Salamatof and Cooper Landing.

The Summit County Multi-Jurisdictional Drug Court Project seeks to provide the trauma-informed intervention Seeking Safety, randomized urine drug screening software, peer-support services, and a mobile application that incorporates interactive tools to aid in client recovery and treatment engagement. In addition, the current project will extend services which have been provided to felony drug court clients to those in the misdemeanor drug court. The target population consists of felony and misdemeanor, non-violent adults classified as moderate risk or higher by the Ohio Risk Assessment System; determined by a chemical dependency assessment to have a level of care of IOP or higher; and charged with a qualifying drug-related offense. The target population is a majority Caucasian (90%), male (62%), heterosexual (97%), 30 years of age, and of low socioeconomic status. Almost 94% of misdemeanor clients and 62% of felony clients have a primary diagnosis of opioid dependency/abuse. In total, we anticipate serving 151 clients in the first year and 202 clients per year, year 2 and 3, for a total of 555 unduplicated clients over the three year project. The goals and objectives of the project are as follows: 1. Fulfill GPRA requirements: a) 98% of all clients will complete a GPRA interview at intake; b) 80% of all clients will complete a 6 month GPRA interview; c) 80% of all clients will complete the discharge GPRA interview 2. Maintain 1-year recidivism arrest rates based on 2014 discharges: a) Maintain 1-year no new arrest recidivism rate of 89.4% for successful felony drug court clients; b) Maintain 1-year no new arrest recidivism rate of 92.8% for successful misdemeanor drug court clients 3. Provide treatment services to additional drug court clients: a) Provide services to 165 misdemeanor clients over the 3 year grant period; b) Provide services to 390 felony clients over the 3 year grant period 4. Reduce caseloads: a) Reduce caseload to maintain 36 or fewer clients per caseworker 5. Provide Recovery Coach Services to all clients: a) 70% of all clients will attend one individual session with a Recovery Coach 6. Assess clients to determine need for trauma treatment: a) 80% of clients will be assessed for trauma; b) 100% of clients who are found in need of trauma treatment will be referred for treatment 7. Provide Seeking Safety: a) 70% of clients that begin Seeking Safety will successfully complete the course 8. Increase pro-social connectivity: a) 75% of clients with smart phones will download the mobile application, and 9. Increase randomization and frequency of urine drug screens: a) incorporate more frequent testing during program phases 1, 2 and 3 and increase the number of random tests per client; b) Increase the number of random UDS tests to 25% in year one to 75% by year 3.