Maryland Evaluation & Treatment Services System (METS): Leading Change in Juvenile Justice Through Innovative Design, Evidenced-Based Practices & Continuum of Care
In one word, what element comprises a quality case management information system?
Maryland Department of Juvenile Services Improving the lives of our Youth! • Strategic Partnerships • Ongoing Research/Business Process Analysis • Evidenced-based Practices o Risk-Needs-Responsivity Model • State of the Art Information System – METS o Risk & Needs Assessment/Reassessment built into Treatment Service Planning o One Treatment Service Plan Follows a Youth
Presenters • John Irvine - Director, Office of Research and Evaluation, Maryland Department of Juvenile Services • Jill Farrell, Ph. D. - Director of Research and Evaluation, The Institute for Innovation & Implementation, School of Social Work, University of Maryland, Baltimore • Jennifer Conrad – Director, State Business Development, FEI Systems • Kathleen Lester, M.S. – Project Manager, Programming Applications, The Institute for Innovation & Implementation, School of Social Work, University of Maryland, Baltimore
Maryland Comprehensive Assessment & Treatment Planning (MCASP) Reforming Juvenile Justice in Maryland
DJS Reform Focus • DJS: Statewide Agency: Consistent policy, not justice by geography Intake -> Detention -> (Court) -> Probation -> Commitment -> Re-Entry/Aftercare
DJS Reform Focus • Make sure the right youth get the right level and type of services/security • Increase public safety: reduce recidivism • Improve the lives of our youth! • Structured decision-making at each step • Information informs decisions and treatment plans • Real-time management reporting for key policy events and timelines • Diversion, Equity, Family Engagement • Strategic Partnerships – DJS, UMB, FEI, Casey
Maryland Comprehensive Assessment & Treatment Planning - Reform Intake: MCASP Risk Assessment Detention: Detention Risk Assessment Instrument (DRAI), AIM (Court) Adjudicated Youth: MCASP Risk & Needs Assessment Probation: Treatment Service Planning (TSP), AIM Commitment: Facility TSP Re-Entry/Aftercare: Re-Entry Plan Checklists, TSP, AIM SafeMeasures Management Reports
Evidenced-based Practices Ongoing Evaluation to Better Meet the Needs of Youth
What Works to Reduce Recidivism • Therapeutic approaches (counseling, skills training) are more effective than control/coercion-based approaches (surveillance, discipline; Lipsey 2009). • Interventions used with higher risk youth are more effective (Lipsey, 2009). • Mixing low-risk youth with high-risk youth can increase their risk for recidivism (Lowenkamp & Latessa, 2004). • When services are matched to youth’s criminogenic needs, the lower the chance of recidivism (Vieira et al., 2009). • Interventions implemented with high quality are more effective (Lipsey, 2009). 10
Risk-Needs-Responsivity (RNR) Approach 1) High-risk offenders should receive the most intensive monitoring and services to reduce their risk of reoffending, whereas low-risk youth should receive minimal attention ( risk principle ). 2) Only those factors associated with reductions in reoffending (i.e., criminogenic needs) should be targeted for services ( need principle ). 3) Services should be selected after considering the youths’ specific characteristics that may affect their response to treatment ( responsivity principle ). • E.g., learning style, motivation, abilities and strengths • There should be room for professional discretion that can deviate from recommendations in certain circumstances. 11 (Andrews & Bonta, 2010; Hoge & Andrews, 2010)
Effective Practices for Juvenile Case Management • Screening and assessment with validated instruments* • Individualized treatment/service planning (match to needs, use of EBPs when possible)* • Use of community-based services • Collaboration and coordination with service providers and other agencies • Family involvement/engagement • Use of graduated responses (sanctions and incentives)* 12
Risk Assessment in Juvenile Justice • Risk assessments gauge the likelihood that an individual will reoffend. • “Is this youth at relatively low or relatively high risk for reoffending?” • Inform decision-making at several points in the process; reduce subjectivity, bias. • Risk/needs assessment instruments assess what characteristics might be most relevant or responsible for a youth’s continued offending. • Guide intervention planning by identifying and prioritizing criminogenic needs • Instruments are typically comprised of factors related to delinquent behavior/offending. • Risk Factors Criminogenic = Dynamic Risk Factors • Protective Factors Needs • Static vs. Dynamic Factors 13
Risk Assessment in Juvenile Justice • A “one size fits all” tool does not exist. • The appropriate tool depends on the decision point. • Risk assessment ≠ mental health assessment • May also use a screen mental health, trauma, substance abuse, etc. • Instruments must be validated for the population, have good inter-rater reliability. • Use of risk/needs assessment in juvenile probation lead to better intervention practices and conserve resources if a valid risk assessment instrument is used and sound implementation practices are followed (Vincent et al., 2011). • Training, policies, protocols for use/case plans, data monitoring 14
Maryland Comprehensive Assessment & Service Planning (MCASP) Initiative • Martinez- Tjaden’s Integrated Comprehensive Client Assessment and Planning (I-CCAP) model www.i-ccap.com • Derived from two bodies of research: 1. Risk and protective factors related to delinquency 2. What works to reduce recidivism • Assessment instruments based on the Washington State Juvenile Court Assessment 15
De Determine Ris Risk Le Level MCASP Rea eassess ss / De Develop Mea easure Supervis Sup ision Progress Plan lan An Integrated Assessment & Conduct Planning Process Assessment Ass De Develop Treatment Determine De Plan lan / Nee eeds Mon onitor Martinez-Tjaden 16
MCASP Risk & Needs Assessment Domains: - Delinquency History Results: - School Uses: - Use of free time - Risk Level - Recommendations - Peers - Need Levels at Disposition - Employment - Protective Factors - Developing the - Family Supervision & - Mental Health Service Plans - Alcohol and Drug Use - Anti-Social Attitudes - Aggression - Neighborhood Safety 17
Risk & Needs Assessment Output 18
Risk Assessment Validation • Predictive validity – how well a measure can predict future behavior (e.g., recidivism) • Validation analyses: • Correlations between the risk level and recidivism • Area Under the Curve (AUC) indicates the % of correct classifications the instrument will yield overall. • The degree of discrimination attained in outcomes for cases at different risk levels • The distribution of cases throughout the risk levels (NCCD, 2013; Gottfredson & Snyder, 2005) 19
Recidivism by MCASP Risk Level Probation: 19.3% Committed: 18.2% Original Assessment Revised Assessment 50% 50% 43% 40% 40% 30% 28% 30% 26% 30% 25% 23% 20% 18% 17% 20% 15% 20% 12% 10% 9% 8% 10% 10% 0% 0% Probation Committed Probation Committed Low Moderate High Low Moderate High Very High Probation Committed Probation Committed Correlation .138*** .128*** Correlation .247*** .159*** AUC .593*** .588** AUC .664*** .614*** 20
WITS (Web Infrastructure for Treatment Services) The Information System Platform FEI Systems
WITS Platform built by FEI Systems • Founded in 1999 • 400+ Employees • 20% annual growth rate • Social Services Health IT Behavioral Health and Justice • Services • State enterprise solutions Integrated Reporting Platform • Ad-Hoc Reporting in Real Time Integration with Industry Standard Reporting Tools Partnership Approach •
• User Group and Cost Sharing – Agile Development • Modular and Configurable WITS – CANS and other Risk/Needs Assessments Collaborative – Wrap Services – Residential Health Record – Monthly Updates • Secure – HIPAA and 42 CFR Part 2 compliant – Role-based security access • Integrated
Integrated Information System Maryland Evaluation & Treatment Services (METS)
• Moving from paper to electronic • Integrates information to/from existing systems • Reduces redundant data entry • Streamlines business processes In Integratin ing METS • One Treatment Plan follows each youth in in Mary ryla land • High domains of need forward to Treatment Plan • Business flow validations built in • One youth, one treatment plan • Separate reports to meet respective needs • Usability • User friendly/UX design • Dashboards • Staff Buy-in • Committees provide feedback throughout design
Caseload Summary Screen/Dashboard
Client Dashboard
Client Dashboard Context
Flexible Views on Dashboard Can work on two modules at the same time
MCASP Risk & Needs Assessment
MCASP Risk & Needs Assessment Summary/Scores
Assessment Summaries, Somatic Health, Education
Treatment Service Plan
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