Item C34 BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:---July 17, 2013 Division: OMB
Bulk Item: Yes x No Department: Grants Administration
Staff Contact Person/Phone#:-Laura deLoach-Hartle x4482
AGENDA ITEM WORDING: Approval to submit application U.S. Department of Justice for FY 13
Edward Byrne Memorial Justice Assistance Grant Program Local Solicitation award for$12,096 on
behalf of the Monroe County Drug Court and for County Administrator to execute required documents
and contract when/if awarded.
ITEM BACKGROUND: Every year, Monroe County receives a direct allocation from US DOJ for
law enforcement/criminal justice related programs. The County's FY 13-14 allocation is $12,096. This
year, the Drug Court will utilize grant funds for the Monroe County Drug Court Medical Director
Initiative. There is no match requirement. This grant is due July 9th. A draft is attached.
PREVIOUS RELEVANT BOCC ACTION: The County has previously participated in the Byrne
JAG Local Solicitation, direct allocation from US DOJ, grant program.
CONTRACT/AGREEMENT CHANGES: None
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $12,096 INDIRECT COST: BUDGETED: Yes XX No
COST TO COUNTY:- 0 SOURCE OF FUNDS: -US DOJ
REVENUE PRODUCING: Yes— No XX AMOUNT PER MONTH Year
-.1
APPROVED BY: County AtfyOMB/Purchasing_ Risk Management-Ll�_
DOCUMENTATION: Included XX Not Required
DISPOSITION: AGENDA ITEM#
Revised 1/09
Deloach Hartle-Laura
From: Tennyson-Lisa
Sent: Thursday, May 30,2013 5:52 PM
To: DeloachHartle-Laura
Subject: FW: Fiscal Year(FY) 2013 Local Edward Byrne Memorial Justice Assistance Grant (JAG)
Program announcement
Categories: IMPORTNAT
FYI.
Lisa Tennyson
Office of Management and Budget
Monroe County, Florida
305-292-4444
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From: owner-bja.director-list( ojp.usdoj.4ov fmailto:owner-bja.director-list@oip.usdoi.aovl On Behalf Of Justice, BJA
Sent:Thursday, May 30, 2013 5:18 PM
To: Justice, BJA
Subject: Fiscal Year(FY) 2013 Local Edward Byrne Memorial Justice Assistance Grant(JAG) Program announcement
The Bureau of Justice Assistance (BJA) is pleased to announce that FY 13 Local JAG Program
funding information is now available and appears on the BJA JAG web page.
Please note that this email is being sent to a large group of potential Local JAG applicants and does
not necessarily confirm your jurisdiction's eligibility under the FY 2013 Local JAG Program.
Eligible jurisdictions under FY 2013 Local JAG are limited to units of local government appearing on
the FY 2013 Local JAG Allocations list. Please verify your eligibility, and if eligible, review the
associated FY 2013 Local JAG solicitation and submit an application for funding through the Office of
I
Justice Program's (OJP) Grants Management System (GMS) by 8:00 p.m. Eastern on Tuesday,
July 9, 2013.
Please contact the GMS Help Desk at 1-888-549-9901 (Option 3) prior to the deadline if you
experience any technical difficulties with submission. Applications must be submitted by the stated
deadline, regardless of whether the 30 day governing body review requirement has been satisfied.
BJA will hold applications prior to processing until the 30 day governing body review requirement has
been met OR attach a withholding of funds special condition to the award until the governing body
requirement has been satisfied.
For questions related to the JAG solicitation, please contact the BJA Justice Information Center at 1-
877-927-5657, via e-mail to Jl�telesishq.com or by live web chat.
For GMS assistance, please refer to: .hftp://www.oip.usdo*.gov/qmscb or contact the GMS Help Desk
at 1-888-549-9901; Option 3.
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Monroe County Drug CourVJAG 2013/Local
Program Narrative (Attachment 1)
Program Narrative
The Monroe County Drug Court Program located in Monroe County, Florida has been in
continuous operation since 1993. Our circuit operates a Juvenile, Dependency, and Adult
Diversion Drug Court, with sites in Key West, Marathon, and Plantation Key. Monroe County is
the southernmost county in the continental United States. It consists of the Florida Keys, a
string of islands connected by U.S. Highway 1, extending 150 miles southwest of Miami and the
surrounding waters. There are 42 bridges linking the Florida Keys.
Drug courts reduce drug seeking behaviors by treating the underlying addiction of the non-
violent offender, thereby offering a greater chance of breaking the cycle of drug abuse, crime,
and incarceration. Drug Court program participants are closely supervised by a judge who is
supported by a team of agency representatives operating outside their traditional roles. The
team includes a drug court coordinator, case manager, substance abuse treatment counselors,
prosecuting attorneys, defense attorneys, juvenile probation officers, school representatives,
employees of Department of Children & Families, Guardian Ad Litem, community based care
workers, law enforcement officers, and adult probation officers.
Eligible participants for the drug court program are identified and assessed early, and then
placed into a treatment program. During their time in treatment, offenders are given random
drug screening tests, and are required to appear frequently in front of a judge for progress
evaluations. Drug court participants may be rewarded for remaining abstinent and attending
meetings. Following successful completion of the drug court's treatment program, the court may,
set aside or reduce their sentence, dismiss the original charge, or a combination of these.
However, participants may also be sanctioned for violating the program's regulations by being
removed from the program and given their original sentence. In some drug courts, participants
are also provided ancillary services, such as mental health treatment, family therapy, and job
training to increase their probability for success (Casebolt, R., Huddleston III, C.S., Marlowe,
D.B. (2008). Painting the Current Picture:A National Report Card on Drug Courts and Other
Problem-Solving Court Programs in the United States. National Drug Court Institute, 2(1).
It is estimated that every $1 spent on drug courts results in costs savings of anywhere from
$1.74 to $6.32 per participant (Florida Office of the State Courts Administrator, Office of Court
Improvement. (2010). Drug Courts in Florida: Frequently Asked Questions and Quick Facts.).
On average, drug courts cost$4,333 per client, but they save $4,705 for taxpayers and $4,395
for potential victims (National Drug Court Institute. (2009). Research Findings). But even these
costs are minimal compared to the costs of incarceration, which are, on average, $19,469 per
inmate per year (Florida Department of Corrections. (2010). 2010 Annual Report., FY2009-10.
Retrieved from: http://www.dc.state.fl.usloublannuaU09101pdfslAR 09-10 Final.pdh.
A 2005 Government Accountability Office report showed lower percentages of drug court
program participants were rearrested or reconvicted. Drug court program participants also
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Monroe County Drug Court/JAG 2013/Local
generally had longer times to first arrest or conviction than comparison group members. When
comparing the results of treatment through drug courts, and results from standard punishment, it
becomes apparent that drug courts are highly effective in reducing crime and consequently
taxpayer expense (Rossman, Shelli B. etc. (2011). The Multi-State Adult Drug Court Evaluation.
U.S. Department of Justice).
The Monroe County Drug Court Program is applying for a second year of JAG funding for The
"Medical Director Initiative" program, under the purpose area of "Drug treatment and
enforcement programs". The program activities include:
1. Contracting with a local Psychiatrist, proficient in the field of addiction to act as the
Drug Court Medical Director, who will provide a total of sixty hours of psychiatric
services to Adult Division, Family Treatment, and Juvenile Drug Court Program
participants per funded calendar year.
2. The Medical Director will make professional and qualified decisions regarding clients
presenting with prescription drug abuse and dependence issues.
3. The Medical Director will communicate with the treating physicians, assisting in the
diagnosis and prescribing of psychotropic medication to our clients who are
detoxifying and/or present with symptoms of mental health disorders.
4. The Medical Director will work with the clients to explore alternative medications and
make recommendations to the court as a qualified professional.
5. Approximately 25 Monroe County Drug Court participants will receive medical
services (many requiring multiple hours of service) to reduce their prescription drug
abuse and/or to more comprehensively treat their mental health disorders that led to
their involvement in the drug court/criminal justice system.
Following a lengthy Request for Proposal, selection, and contract approval process
beginning in July of 2012, under the supervision of the Monroe County Attorney's Office,
the Medical Director initiated the provision of services for the Drug Court program in
January 2013. The Medical Director attended eight staff sessions with the Drug Court
clinical team, conducted fifty-eight case reviews, performed thirteen assessment
sessions with ten clients, and has educated the team with regards to best practice
treatment techniques. More specifically, the Medical Director assisted two clients to
discontinue the use of Suboxone; provided four clients with benzodiazepine alternatives
to dealing with anxiety issues by recommending effective antidepressants; assisted a
client with traumatic brain injury in understanding of the physiological effects of this
injury, which resulted in a decrease of her lack of impulse control; suggested alternative
medication for a client with an immune deficiency which resulted in diminishing body
sores; shared his medical knowledge with clients, resulting in their reconsideration to
enlist the use of non-narcotic medications to relieve their negative symptoms; and has
worked closely with the Drug Court staff to improve their knowledge and abilities, which
ultimately increases client success.
2
Monroe County Drug Court/JAG 2013/Local
Analysis of Need
The number of referrals to Drug Court with prescription drug arrests are on the increase state
wide. According to the Monroe County Sheriff's office from April 2011 to April 2012 there were
approximately 150 arrests for possession of a controlled substance without a prescription. This
number does not include other criminal activities associated with prescription drug abuse. The
Court and clinical staff hands are tied with regards to being qualified to assess the necessity of
medication for our clients.
The Florida's Prescription Drug Diversion and Abuse Roadmap 2012—2015, released April 4,
2012, by Florida Attorney General Pam Bondi recognizes the strength of existing drug courts
and places them front-and-center in the multi-faceted fight against prescription drug abuse. The
Roadmap recommends two important strategies:
1. Florida must expand drug courts across the state to admit more non-violent prescription
drug offenders. Expanding Drug Courts increase overall savings to the state's budget as
fewer offenders would be sentenced to costly prison time. Expansion of Drug Courts also
decreases crime rates overall by effectively shortening a non-violent offender's emerging
criminal history by intervening earlier with effective drug treatment consisting, in part, of
swift and certain sanctions (Office of Program Policy Analysis & Government
Accountability. (2010). Without Changes, Expansion Drug Courts Unlikely to Realize
Expected Cost Savings. Tallahassee, FL.).
2. Florida must ensure reliable screening processes are established to capture those
offenders whose crimes are grounded in prescription drug abuse, and who would benefit
from a comprehensive treatment program.
Monroe County's Drug Court proposal for JAG funding is directly responsive to the Attorney
General's recommendations. A contractual agreement with a Medical Director will expand the
capacity and expertise of our Drug Court Program to address participants with prescription drug
abuse issues.
A strong nexus exists between crime and drug abuse. If mental health and prescription drug
abuse issues are left untreated, users will typically engage in repeated drug theft, shoplifting,
prescription fraud, burglary, and a myriad of other criminal activities. Law enforcement is
reporting that prescription drug abuse is fueling increases in property crimes, as criminals seek
to acquire powerful pain medications by breaking into pharmacies and homes in order to both
consume and sell pills on the black market (Goodnough, Abby. (2010). A Wave of Addiction and
Crime, with the Medicine Cabinet to Blame. The New York Times, September 23, 2010.
Retrieved from: http://www.nvtimes.coml2010/09l24lusl24daws.htmh.
Our focus on treating prescription drug addiction in the criminal justice system reflects the
scientific understanding that addiction is a result of brain changes caused by repeated drug use.
The United States makes up roughly 5 percent of the world's population, but consumes 80
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Monroe County Drug Court/JAG 2013/Local
percent of its opioids, as well as 99 percent of the world's hydrocodone (Avila, Jim. (2011).
Prescription Painkiller Use at Record High for Americans. ABC World News, April20, 2011.
Retrieved from: htta://abcnews.go.comIUS/prescription-vainkillers-record-number-americans-
pain-medication/storv?id=13421828). It is unclear how much of this consumption is legitimate
and how much is diverted for abuse.
Drug courts remain the most effective means we have for reducing diverted prescription drug
demand by addicts in our criminal justice system.
Anticipated Coordination Efforts
Contracting the services of a Medical Director has improved the Drug Court Program team's
performance outcome by increasing the program's effectiveness and comprehensiveness,
reducing recidivism, increasing participant success rates, and reducing costs to law
enforcement and the criminal justice system. The Medical Director attended eight staff sessions
with the Drug Court clinical team, conducted fifty-eight case reviews, performed thirteen
assessment sessions with ten clients, and educated the team with regards to best practice
treatment techniques. The team includes the drug court judge, criminal court services
coordinator, drug court coordinator, case manager, substance abuse treatment counselors,
prosecuting attorneys, defense attorneys, juvenile probation officers, school representatives,
employees of Department of Children & Families, Guardian Ad Litem, community based care
workers, law enforcement officers, and adult probation officers.
4
Monroe County Drug Court/JAG 2013/Local
Abstract (Attachment 4)
Applicant: Monroe County, Florida, governed by a Board of County Commissioners.
Project Title: "Monroe County Drug Court Medical Director Initiative".
Project Goal: To continue to build the capacity within the Monroe County Drug Court to address
the needs of clients presenting with mental health and/or prescription drug abuse issues.
Allocating funds for the Medical Director Initiative for a second year will significantly improve the
effectiveness of drug treatment and case management activities conducted for drug court clients
presenting with prescription drug abuse and/or mental health issues. This initiative will also
increase the likelihood of recovery success, in addition to diverting clients from continuing
criminal involvement. The allocation of 2012 JAG funds, allowed he Drug Court Program
participants and their employees to reap benefits of working with the Medical Director who has
the expertise to address such issues.
This initiative responds to the "The Florida's Prescription Drug Diversion and Abuse Roadmap
2012—2015; released April 4, 2012, by Florida Attorney General Pam Bondi, which recognizes
the need for existing drug courts to address prescription drug abuse issues. With a Medical
Director, the Monroe County Drug Court will continue to provide professional medical/psychiatric
assistance for clients with prescription drug abuse and/or mental health issues.
Strategies: Continue to contract with a local Psychiatrist, proficient in the field of addiction, to act
as the Drug Court Medical Director who will work with clients detoxifying and/or presenting with
symptoms of mental health disorders to diagnose; explore alternative medications; make
psychotropic medication recommendations to treating physicians when appropriate; and make
recommendations to the court.
The Monroe County Drug Court Criminal Court Services Coordinator, Jane Muir-Isherwood will
work with the Trial Court Administrator, Holly Elomina, continuing to ensure that all aspects are
fully implemented in an efficient manner, in compliance with the Monroe County purchasing
policies, which require two or more written price quotes for the purchasing level of ten to twenty-
five thousand dollars.
Performance measures/outcomes:
• Monroe County Drug Court Program will contract with a local psychiatrist, proficient in the
field of addiction to act as the Drug Court Medical Director to provide the services as
described.
• The Drug Court Medical Director will provide a minimum of sixty hours of services during
the grant year. Medical Director Service hours will be tracked/monitored weekly and
reported quarterly.
• Approximately 25 Monroe County Drug Court Program participants will receive medical
services (many requiring multiple hours of service) to reduce their prescription drug
abuse and/or to more comprehensively treat their mental health disorders that led to their
involvement in the drug court/criminal justice system. Participant numbers will be
tracked/monitored weekly and reported quarterly.
Project Identifiers for this proposed project are: (1) Drug Courts, (2) Drug Offenders, (3)
Prescription Drugs, (4) Substance Abuse Treatment, and (5) Mental Health.