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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 HELP US HELP YOU! Please take a moment to complete our Customer Satisfaction Survey: http://monroecofl.virtualtownhall.net/Pages/MonroeCoFL WebDocs/css Your feedback is important to us! Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public record, available to the public and media upon request. Your e-mail communication may be subject to public disclosure. 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. 2 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 1 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 3 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.