2016 JDC On-Site Technical Assistance Delivery REQUEST FORM
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- Rosamond McBride
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1 2016 JDC On-Site Technical Assistance Delivery REQUEST FORM As part of the On-Site Technical Assistance request and planning process, we ask that your Juvenile Drug Court (JDC) use this form to describe your current practices and priorities for technical assistance. When completed, please mail, FAX, or this form to Martha-Elin Blomquist, PhD, at NCJFCJ, P.O. Box 8970, Reno, NV 89507, FAX: (775) , If you have any questions while completing this form, please contact Dr. Blomquist by phone at (775) Date of Receipt INSTRUCTIONS: For the questions that follow, please type in your response or check the appropriate box. General Court & Community Information Please provide information about your court name, address, and contact information: Name of Court: Court Address: Name of Assigned Judge: Primary JDC Team Member Contact: Primary JDC Team Member Address: Primary JDC Team Member Contact Telephone: Primary JDC Team Member Contact Address: Year JDC became operational: Type of community your JDC serves: Rural Urban Suburban Briefly describe the nature of the adolescent substance use dependence problem(s) in your community: 1 P age
2 JDC Participants, Graduates and Terminations Please fill in the table with the appropriate numbers (actual or estimates): Number of JDC program participants Current Year Last Year Overall (Since Program Inception) Number of JDC graduates Number of JDC terminations Graduation Rate (# of graduates divided by the number of total youth who left the program including terminations, aging out, etc.) Termination Rate (# of terminations divided by the number of total youth who left the program including graduations, aging out, etc.) Given your program resources, what is your optimal number of participants? Program Length and Graduation Requirements Please mark X next to the average length of time a JDC participant takes to graduate from your program: 6 months 12 months 18 months 2 years or longer Does your juvenile drug court have a mandatory minimum time requirement for youth participation? Yes No If yes, please mark X in the space provided next to the applicable mandatory minimum time requirement: 6 months or less 9 months 12 months 18 months 24 months Over 24 months other Does your program require that the JDC youth test clean from drugs/alcohol before graduation? Yes No If yes, how long must the youth be clean before graduation? (days) 2 P age
3 Target Population, Eligibility Criteria and Referral Process Who is your target population? Please indicate all of the applicable written eligibility criteria that your program uses for acceptance decisions: Age: Minimum-Maximum Range Gender: Females Only/Males Only/Both Genders Legal Status: Pre-adjudicated/Post-adjudicated/Both Current Offense: Felony/Misdemeanor/Both Previous involvement in juvenile justice system (at least one prior offense) Yes No Current offense: Qualifying offense is a nonviolent offense, a substance-related offense, OR a probation violation Yes No Current offense(s) is considered on a case-by-case basis Yes No Screening: A substance abuse screening tool has been administered and indicates a need for treatment Assessment: An assessment has been administered and the score indicates moderate to high in both the risk and needs sections Other (Please describe) Yes Yes No No Please mark X next to the instrument your JDC uses for program screening, acceptance, and case management planning: GAIN MAYSI SASSI Other (Please specify): 3 P age
4 Please indicate which of the following professionals refer youth to your JDC program and the frequency of their referral: Judge Referral Source Frequency of Referrals Usually Sometimes Rarely Never JDC Coordinator Probation Officer with a JDC Caseload Probation Officer without a JDC Caseload Treatment Provider Defense Attorney Prosecutor Social Services Personnel School Personnel Law Enforcement Personnel Other (please specify) Program Benefits and Buy-In From the prospective participant s perspective, what are the benefits to completing the program? How do you encourage prospective participants to buy in to the program? 4 P age
5 From the prospective caregiver s perspective, what are the benefits to completing the program? How do you encourage prospective caregivers to buy in to the program? JDC Team, Pre-Court Staffing, and Court Sessions Team members and longevity: (Please include in a separate document, a list of the names, professional positions, and contact information for team members.) Team Member Member (Yes/No) How Long Has This Member Been On the Team? Prosecuting Attorney Yes No years months Defense Attorney Yes No years months Judicial Officer Yes No years months Probation Officer Yes No years months Coordinator Yes No years months Law Enforcement Liaison/School Resource Officer Yes No years months School Representative Yes No years months Substance Abuse Treatment Provider Yes No years months Mental Health Treatment Provider Yes No years months Evaluator Yes No years months Other (please specify) Yes No years months 5 P age
6 Participation in Pre-Court Staffing Please mark X in the column that best describes the frequency of each professional s attendance at the Pre-Court (Case) Staffing: Prosecuting Attorney Defense Attorney Judicial Officer Probation Officer Coordinator Law Enforcement Officer School Representative Substance Abuse Treatment Provider Mental Health Provider Other (please specify) Always Sometimes Rarely Never Not Applicable Pre-Court Staffing Meetings, Frequency and Length of Time On what weekday is your Pre-Court Staffing meeting held? Please mark X next to the applicable frequency of Pre-Court staff meetings: Held weekly Held twice per month Held monthly Other Please mark X next to the applicable (average) length of time the team spends in Pre-Court Case Staffing: 0-30 minutes minutes minutes longer than 2 hours Court Sessions, Frequency and Length of Time Please mark X next to the applicable frequency of Juvenile Drug Court sessions: Held weekly Held twice per month Held monthly Other Please mark X next to the applicable (average) length of time of a Juvenile Drug Court session: 0-30 minutes minutes minutes longer than 2 hours 6 P age
7 Phases How many phases does your JDC program have? Please state the duration and goals of each phase: Phases Phase I Phase 2 Phase 3 Phase 4 Phase 5 Other Duration of Phase (minimummaximum) Goals Substance Use Monitoring Type(s) of substance testing administered: (Please check all that apply.) Urinalysis Breathalyzer Other Frequency of testing by Program Phase: (Please check as applicable.) Number of times per week Phase Less than 1X 1X 2X 3X More than 3X P age
8 Are drug tests given at random (random meaning that each day of the week has an equal chance of being chosen to give a drug test at any given time)? Yes No On which days are drug tests typically given: (Please check all that apply.) Weekdays Weeknights Weekends Location of testing: (Please check all that apply.) Court PO office Treatment office School Job Home Other Assessment, Treatment, and Support Services Please mark X in the column JDC Uses next to the instrument your JDC uses for assessment, diagnosis and treatment planning: ASSET Instrument Name Santa Barbara Assets and Risks Assessment Secure Care Psychosocial Screening Victorian Offending Needs Indicator for Youth Washington State Juvenile Court Assessment Youth Assessment and Screening Instrument Youth Level of Service (YLS)/ Case Management Inventory (CMI) Ohio Youth Assessment System (OYAS) Other (please specify) JDC Uses JDC youth must remain in treatment for the duration of the program (through all phases). Yes No The court mandates attendance at AA/NA or other type of support groups. Yes No If yes, number of times per week Are the sober support groups adolescent focused? Yes No 8 P age
9 Treatment Services Offered: Please mark X in the column Available to Your JDC/Youth Participant next to the treatments that are available: Treatment Type General outpatient group treatment General outpatient individual treatment Intensive outpatient Inpatient treatment Detox Other (Please specify) Available to Your JDC/Youth Participant Support Services Offered: Please mark X in the column Available to Your JDC/Youth/Family Participant next to the support services that are available: Support Service Type Adolescent-focused sober support groups Traditional adult-focused sober support groups (AA/NA) Mental health counseling Parenting classes Anger management Life skills Tutoring Mentoring Other Available to Your JDC/Youth/Family Participant Manualized Treatment Programs: Please mark X in the column Available to Your JDC/Youth/Family Participant next to the manualized treatment programs that are available: Manualized/Evidence-Based Treatment Programs Brief Strategic Family Therapy (BSFT) Teen Intervene Adolescent Community Reinforcement Approach (A- CRA) Matrix Model Moral Recognition Therapy (MRT) Available to Your JDC/Youth Participant 9 P age
10 Manualized/Evidence-Based Treatment Programs (continued) Motivational Enhancement Therapy (MET) & Motivational Interviewing (MI) Motivational Enhancement Therapy & Cognitive- Behavioral Therapy (MET/CBT 5 or 12) Multi-Systemic Therapy of Juvenile Offenders (MST-JO) Seeking Safety The Seven Challenges Program Other (please specify) Available to Your JDC/Youth Participant Family-Based Treatment Programs: Please mark X in the column JDC/Youth Participant/Family next to the family-based treatments that are available: Family-Based Treatment Family Support Network (FSN) Functional Family Therapy (FFT) Multi-Dimensional Family Therapy (MDFT) Multi-Dimensional Treatment Foster Care (MTFC) Other (please specify) JDC/Youth Participant/Family Incentives and Sanctions Please mark X in the applicable column next to the practices the JDC follows in developing and applying incentives and sanctions: JDC Practice Always Frequency Some- Rarely times Never Youth complete a youth inventory or survey to provide feedback on motivates them. If response above is always, sometimes, or rarely: The youth inventory or survey covers several domains and is completed with the youth and family. Youth know when they are going to earn a reward and why they earned the reward. Youth know when they are going to be sanctioned and why they are sanctioned (i.e., the youth knows before court that he/she will be asked to write an essay, do community service hours, or go to detention). 10 P age
11 JDC Practice (continued) Always Sometimes Rarely Never Youth receive tangible rewards (e.g., gift card) for positive behavior. Youth receive incentives on a case-by-case basis. Youth receive intangible rewards (e.g., praise from judge/team) on a frequent basis. Youth receive more incentives than sanctions on a regular basis (i.e., 4 incentives to every 1 sanction). Youth are allowed to provide feedback to the team about the use of incentives and sanctions (e.g., through exit surveys or court user surveys). The team uses sustainable incentives (e.g., token economy, point reward system) as a way to motivate youth. The team uses structured behavior contracts to help youth achieve proximal goals. The team tracks incentives and sanctions given. If yes to above, this includes setting benchmarks to reduce the use of detention. If yes to above, this includes setting benchmarks to increase the number of incentives given. Please list the three incentives that your JDC most commonly uses: Please list the three sanctions that your JDC most commonly uses: P age
12 JDC Strengths Please identify your team strengths: Please identify your program strengths: Team Action Planning and Training Please provide the date when the entire JDC team last met to form a strategic action plan and/or review policy: How often does this type of team meeting occur? Have any of your current JDC team members attended workshops or trainings that focus on JDC-related topics and issues? Yes No If yes, please list the topics that team members have received training on: 12 P age
13 Data and Performance Measurement Does your JDC team track recidivism (re-arrest) after a youth leaves (graduates or is terminated from) the program? Yes No If yes, does your JDC track types of recidivism offenses: Substance use related offenses Yes No Other offenses: Yes No Does your JDC team use performance measures (such as number of youth participants that achieved school grade advancement during the program)? Yes No If yes, please list the performance measures: Does your JDC team review and analyze data for program monitoring purposes? (such as average number days that youth are in Phase I) Yes No If yes, please describe the data that the team reviews and analyzes: How often does the JDC team review these data? Does your JDC team review and analyze data for program evaluation purposes (such as number of youth referred to the program who meet eligibility criteria; number of youth who are accepted into the program)? Yes No If yes, please describe the data that the team reviews and analyzes: How often does the JDC team review these data? 13 P age
14 Technical Assistance Priorities and the 16 Strategies How familiar are JDC team members with the 16 Strategies for Juvenile Courts? Not at all familiar Somewhat familiar Very familiar Don t know/not sure Please list the top 3 issues or practices that are the most challenging for your Juvenile Drug Court team that you would like training and/or technical assistance with: How did you learn about NCJFCJ s Juvenile Drug Court On-Site Technical Assistance services? On-Site TA Planning On-site technical assistance visits include observation of court staffing and session, interviews with all team members, and an all-day team retreat. Typical on-site visits take two days. In each of your preferences below, please specify two consecutive dates for the site visit. PLEASE PROVIDE 2-3 SETS OF DATES CONVENIENT FOR DELIVERY OF ON-SITE TECHNICAL ASSISTANCE (Please look at dates days after submission of the TA Request Form). 1 s t Preference: 2 nd Preference: 3 rd Preference: Please also submit a list of team members with their contact and organizational affiliation information and any evaluation materials, policy and procedure manuals, and participant handbooks for your JDC program. Thank you! 14 P age
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