CommStat 1/24/19 Everyday I grow stronger Everyday there is a - - PowerPoint PPT Presentation

CommStat 1/24/19

Everyday I grow stronger… Everyday there is a chance.

• Anonymous

CommStat Principles:

• 1. Timely and accurate information and intelligence
• 2. Effective tactics and strategies
• 3. Rapid deployment of resources
• 4. Relentless follow-up and assessment

*Adapted from NYPD’s CompStat

CommStat Ground Rules:

• We will be addressing serious issues; we need to be tough-minded about them
• Work collectively to develop creative, innovative solutions, do not focus on

deficiencies

• Ask direct, difficult questions, but do so respectfully
• Provide candid, honest answers, do not be defensive
• Make space for others to speak
• If you don’t know the answer, it is okay to say “I don’t know” and provide a

timeframe for when you can get the answer

• Celebrate successes!
• Critique ideas and debate issues, not people
• Use evidence not opinions, challenge assumptions and inferences
• Ask for and offer ideas and solutions
• Don’t be afraid to fail
• Be present, no distractions, ringers off. Use breaks for work.

Monthly Data Reports from our Partners Kayla Donohue, MPH

Source: VDH

11 16 16 17 13 17 21 28 10 12 10 13 5 4 3 8 4 3 5 8 10 12 9 1 3 1 5 8 13 20 5 10 15 20 25 30 2010 2011 2012 2013 2014 2015 2016 2017

Accidental or Undetermined Opioid-Related Fatalities Among Chittenden County Residents, 2010-2017

All Opioids Rx Opioid (No Fentanyl) Heroin Fentanyl

2 1 1 2 2 1 4 1 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov* Dec*

Accidental or Undetermined Opioid-Related Fatalities Among Chittenden County Residents, 2018

Source: VDH

* Indicating preliminary data, with 6 pending cases statewide

Source: SIREN, VDH

Source: SIREN, VDH

Source: Valcour

Source: UVMMC

9 10 8 7 16 15 23 11 11 11 8 7

5 10 15 20 25 30

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2018 2015-2017 Average 2015-2017 Min 2015-2017 Max

Monthly Surveillance of Opioid-Related Emergency Department Visits at UVMMC

Data Source: Howard Center Chittenden Clinic

33 1006 960 970 980 990 1000 1010 1020 5 10 15 20 25 30 35 40 45 Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Individuals Enrolled, Admitted, and Waiting by Month at the Chittenden Clinic (Hub)

Waiting Admitted Census

Source: http://www.healthvermont.gov/sites/default/files/documents/pdf/ADAP_OpioidUseDisorderTreatmentCensusandWaitList.pdf

645 100 200 300 400 500 600 700 Sep-13 Dec-13 Mar-14 Jun-14 Sep-14 Dec-14 Mar-15 Jun-15 Sep-15 Dec-15 Mar-16 Jun-16 Sep-16 Dec-16 Mar-17 Jun-17 Sep-17 Dec-17 Mar-18 Jun-18 Sep-18

Number of Medicaid Beneficiaries Treated in Chittenden County Spokes, Sep 2013-Sep 2018

959 all payer patients

• n MAT at spokes with

74 total prescribers as

• f Nov. 2018

General Safe Recovery Statistics

• 5,113 members of the syringe exchange
• Greater than 20,000 doses of Narcan given from December 2013 to

December 2018

• 1,381 reported overdose reversals since December 2013

Safe Recovery by the numbers, fiscal year data 2018

• The syringe exchange was visited 6,926 times
• 1,236 clients visited the exchange
• 6,029 people accessed syringe supplies through secondary exchange
• 303 new syringe exchange clients
• Clients from every county in Vermont accessed our services
• 872 clients were referred to treatment
• 409,198 syringes were safely disposed of at Safe Recovery
• 651,464 syringes were distributed at Safe Recovery

Safe Recovery Services & Statistics

• Number Currently Receiving Prescription – 30 clients
• Number Transitioned to Hub and Spoke – 16 clients
• Chittenden Clinic – 2 client
• Pine Street – 8 clients
• CHCB – 5 clients
• Appletree Bay - 1
• Incarcerated – 1 client
• Declined/Unreachable – 2 clients

Safe Recovery Low Barrier Buprenorphine Program Data (October 22, 2018 – January 15, 2019)

Police Data for Property Crime & Drug-Related Incidents Valcour Agencies in Chittenden County Nancy Stetson

Source: Valcour

Source: Valcour

Source: Valcour

Source: Valcour

Department of Corrections, December 2018

342 new intakes (Initial Healthcare Receiving Screening) 44 OUD Screening

1516 Average Daily Population

594 on Suboxone 78 on Methadone

691 on MAT

19 on Naltrexone

23 referrals to hubs 682 releases (12/5/18-1/1/19) 121 releases of inmates on MAT (12/5/18-1/1/19) 18% of inmates released were

• n MAT

http://annals.org/aim/fullarticle/2708164/next-stage-buprenorphine-care-opioid-use-disorder

Access to Medically Assisted Treatment in Federal Court

Christina Nolan U.S. Attorney

Access While Under Release Conditions

• Two forms of release for federal defendants:
• Pretrial release conditions – the period between your initial

appearance and your sentencing

• Supervised release conditions – post-sentencing supervision, that is,

period of supervision following your prison sentence (often mandatory minimum period of supervision) or period of supervision for those with non-incarcerative sentence

• U.S. Probation Officers supervise defendants on release –

certain officers do pretrial; certain do post-sentencing

• Where offense involved drug use/addiction, conditions include drug

rehab/treatment

Bureau of Prisons

• Traditionally, Bureau of Prisons has not offer MAT to federal

defendants

• We do have Vermont Correctional Addictions Program (cognitive

behavior therapy and motivational interviewing) – partnership with UVM and correctional facilities

• First Step Act – appears to pave the way for MAT in BOP.
• Requires BOP and U.S. Courts to submit reports to congressional

committees regarding BOP capacity to provide MAT to prisoners and, including plans to expand access, then take steps to implement the plan

Pretrial Supervision

• At your initial appearance, Court decides whether you

should be detained as flight risk/danger to community or released on conditions

• Probation officer conducts an thorough investigation to aid

the court, prosecutor, and defense attorney in that decision, and makes a recommendation to all parties on release/detention.

• Includes drug test and interview about drug use history
• Can be on pretrial released with condition of drug

treatment, which may include hub/spoke treatment; if already on MAT and it’s working, continues uninterrupted while on release.

• Will be drug tested by US Probation to monitor compliance

Pretrial Supervision

• Large share of our defendants are severe addicts
• often detained pending (say 3 weeks) a proposed treatment plan

(currently no MAT while detained)

• Treatment plan typically includes residential stay at Valley Vista or

Serenity House, followed by aftercare plan, which probation office

• versees/monitors. Valley Vista will provide MAT.
• If it’s working, MAT through clinic or spoke can continue while on

pretrial release.

• Strict compliance monitoring by USPO, including rigorous drug
• testing. Violation of release conditions can result in pretrial

detention.

• Pretrial supervision usually lasts 6 months – year, depending on case

Post-Sentencing Supervision (Supervised Release/Probation)

• Those who finish the incarcerative term of their prison

sentence or no prison time at sentencing go on supervised release or probation

• Supervised release conditions give probation officer

discretion to require drug treatment.

• Treatment includes strict monitoring, including drug testing
• As with pretrial supervision, defendants on supervised release can

participate in MAT through hub/spokes, if it’s working

• Supervised release for drug defendants typically a

mandatory minimum of three years; sometimes more

• Violations can result in return to prison

Federal Drug Courts

• “Diversion” court in Rutland, run by Chief Judge Crawford
• Those with addiction-motivated offenses plead guilty to felony, and

enter program that lasts 12 months.

• Bimonthly in-court meetings with Judge; Howard Center, defense

counsel, federal prosecutor, US Probation Officer, and Judge work together to aid defendant with sobriety plan, employment, social services, housing, etc.

• Carrots and sticks. Serious violations result in revocation of release

and proceeding immediately to sentencing

• Graduation from drug court will result in sentencing and a non-

incarcerative sentence (just supervised release). Other possibilities include misdemeanor disposition or dismissal

• Those in drug court may opt to avail themselves of MAT, if such

treatment is working for them

Federal Drug Courts

• Burlington re-entry court
• Run by Magistrate Judge Conroy.
• Same structure and stakeholders as diversion court, but this court

aims to transition back to community addiction-driven defendants who have served jail time and are starting supervised release

• Can be on MAT if it’s working for defendant
• Incentive is reduction in term of supervised release
• Serious violations result in revocation of release and return to prison

CRIMINAL JUSTICE OVERVIEW

SARAH GEORGE – CHITTENDEN COUNTY STATE’S ATTORNEY BECKY PENBERTHY – VERMONT PRETRIAL OPERATIONS DIRECTOR STEPHEN VONSITAS – REGIONAL PROGRAM COORDINATOR – TREATMENT COURT

INITIAL CASE DIRECTION/OPTIONS

• ARREST
•  Community Justice Center (Direct Referral / Pre-Charge)
•  Citation for Court
• Flash Cite within a week, regular citation 45 days
• Send paperwork to State’s Attorneys Office
•  Lodge at Correctional Facility
• Send paperwork to State’s Attorneys Office
• STATE’S ATTORNEYS OFFICE
•  Review case for Probable Cause√
• Decline
• Refer to Community Justice Center (within a week of receiving paperwork)
• Diversion (No criminal history) – at ARR.
• Rapid Intervention Community Court (Criminal History/Substance/Mental Health

Needs) – at ARR.

• Charge for Criminal Docket
• Request Pre-Trial Services Order

PRE TRIAL SERVICES ORDER

Court Ordered Monitoring 13 V.S.A. § 7554c – AT ARRAIGNMENT

• This service is for adults with substance use or mental health treatment needs who are going

through the court process and awaiting final case resolution. Monitoring may be ordered by the court. Individuals may also choose to engage with pretrial services. A person’s refusal to engage cannot result in a violation of conditions of release. Pretrial Service Coordinators quickly connect people to substance use, mental health and other supportive community-based services.

• Needs screenings—to measure substance use or mental health needs.
• Risk assessments—to measure risk of nonappearance (for those lodged and held for lack of

bail)

• Connect and support engagement in treatment and recovery services.
• Support individuals to meet conditions of release and attend scheduled court appearances.

REPORTING REQUIREMENTS – The Pretrial Services Coordinators report only the following information, whether someone is ordered or self-referred:

• risk of nonappearance, if treatment is indicated, if the individual participated in a clinical

assessment, if engagement with pretrial services is recommended. No other information may be shared.

PTS DATA

• Pretrial Orders – current total participants = 61
• # of current participants with:
• 1) Alcohol – 8
• 2) Opiates – 10
• Of those – on MAT = 5
• 3) Other Drugs – 10

COURT DIVERSION

• At Arraignment
• Restorative Justice Program
• Youth with Delinquency Petition
• Adults charged with a Crime (First or Second Offense)
• May be referred by Prosecutors before or after arraignment
• Once referred/accepted case becomes confidential
• Must take responsibility for conduct and engage in restorative process

aimed at repairing the harm.

• Service needs are addressed and restitution (if any) is collected

DIVERSION DATA

• Chittenden County 2017
• 219 Referrals
• Chittenden County 2018
• 646 Referrals
• General Success Rate for non-DLS cases = 85%

RICC PROGRAM

• RICC Program 3 V.S.A § 164(b)(2)
• At Arraignment
• Located on 3rd floor of Cherry Street Courthouse
• This restorative justice program is for adults charged with a crime who have a

substance use or mental health treatment need regardless of their criminal history.

• Prosecutors may refer before or after arraignment.
• Pretrial Service Coordinators quickly connect those referred to substance use,

mental health and other supportive community-based services. Participants must be willing to take responsibility for their actions and engage in a restorative process aimed at repairing the harm. Service needs related to the charge are addressed in a restorative agreement. Service needs unrelated to the charge are offered but not included in a restorative agreement.

• Completion of the RICC Program results in a dismissal of the criminal charge.

RICC DATA

• Current total participants = 87
• # of current participants with
• 1) Alcohol – 18
• 2) Opiates – 26
• Opiate users on MAT = 15
• 3) Other drugs – 11

POST ARRAIGNMENT OPTIONS

• ARRAIGNMENT  CONDITIONS OF RELEASE  RELEASED
• Pre-Trial Services Order
• Substance Use / Mental Health Screening
• Substance Use Assessment
• Mental Health Assessment
• Engage in Pre-Trial Services until case resolves
• ARRAIGNMENT  BAIL IMPOSED  INCARCERATED UNTIL BAIL POSTED
• Pre-Trial Services Order
• LITIGATION (MOTIONS, VICTIM OUTREACH/INPUT, NEGOTIATIONS) 3-6

months avg

• DISMISSAL (By Court or by State)
• PLEA AGREEMENT
• TRIAL

DISMISSALS

• Evidentiary by State
• Evidentiary by Court (after hearing)
• By Agreement (in exchange for some action)
• Successful completion of Diversion or RICC
• Potentially successful completion of Treatment Court

PLEA AGREEMENTS

• Fine Only
• Community Service (Probation)
• Reparative Program (With or Without Probation)
• Work Crew (Pre-Approved Furlough/Incarcerative)
• Probation / Deferred Sentence
• Treatment Court
• Home Confinement
• Incarceration  Released  Probation
• Incarceration

TREATMENT COURT

• The Treatment Court dockets are POST PLEA / PRE-SENTENCE
• Individuals with HIGH prognostic risk and high criminogenic need.
• Referrals typically generated by the defense council although referrals can be

submitted by anyone, including prosecutor

• Weekly/BiWeekly accountability – Strict Regimen – Daily Check-ins ETC.
• The Chittenden County Treatment Court follows research based best practice

standards created by the National Association of Drug Court professionals www.nadcp.org

• Since the first Drug Court was founded in Miami/Dade County, Florida, more

research has been published on the effects of Drug Court than on virtually all

• ther criminal justice programs combined. The scientific community ahs put

Drug Courts under a microscope and concluded that Drug Courts significantly

reduce drug abuse and crime and so at far less expense than any other justice strategy.

• (Adult Drug Court Best Practice Standards Vol 1, NADCP

, 2018)

SUPERVISION OPTIONS

• Probation
• Probation/Treatment Court
• Home Confinement
• Incarceration/Furlough/Parole
• CoSA (Circle of Support and Accountability)

PROBATION

• Deferred
• Suspended Sentence
• Split Sentence
• Conditions of Probation (agreed to by all parties, related

to the allegation) to be completed before discharge

• Violations of Probation result in new criminal complaint

TREATMENT COURT

• Chittenden County 2018
• Total # served 95
• Drug Court docket served 62
• Mental Health Court docket served 33
• 23 participants graduated the program in 2018,
• 9 participants were discharged from the program
• 7 were for non-compliance with the programs contracts
• 2 were discharged due to new criminal convictions while in the program that led to

incarceration

• The Drug Court docket was started in 2003 and has served

406 participants

• The Mental Health Court docket was started in 2004 and has

served 198 participants

HOME CONFINEMENT

• Custody of Department of Corrections
• Pre-Approved housing
• GPS Monitoring
• Exceptions (agreed upon by parties)
• Violations result in Incarceration

INCARCERATION / FURLOUGH / PAROLE

• In Custody
• Under specific sentence
• Minimum and Maximum Release Date
• Programming inside and once released, continued

in the community

• Continued supervision levels
• Probation (least restrictive)
• Furlough (newly released)
• Have been released and on furlough for extended amount of time =

Parole

OVERVIEW

• Several Options Post Arrest
• Several Options Pre Charge
• Several Options Post Charge
• Several Options Post Conviction
• Several Options Pre Sentence
• Several Options Post Sentence

** Only aspect that never changes: EVERY criminal justice encounter BEGINS with a Law Enforcement Officer **

Post-Arrest Opioid Risk Tool

Chief Brandon del Pozo Burlington Police Department

Arrest/Citation ORT Screening Moderate or High Risk Low Risk Share resources Bring to Safe Recovery, ED, or

• ther program

Police Officer Embedded Social Worker Decline screening Share resources

Source: Valcour

Source: Valcour

Source: Valcour

Source: Valcour

• 2/28 (Thursday) 8:30-11:00 AM
• Burlington Electric

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