The VJO Specialist in Veterans Treatment Courts: The Glue Holding VTCs Together BJA Drug Court Technical Assistance Project at American University November 9 th , 2016 Thank you for joining us for today’s webinar! • If you experience any technical difficulties, please use the Chat function at the bottom right of your screen to send a message to the Justice Programs Office (host) or email justice@american.edu. • We encourage you to submit written questions at any time during the presentation using the Q&A Panel located at the bottom right of your screen. After typing your question in the space at the bottom, hit the “Send” button and please be sure to direct your questions to “All Panelists” in the “Ask” menu. • This webinar is being recorded. The link to the video, as well as the Power Point slides, will be sent via email as soon as possible. • There is a survey that will pop-up on your screen when the event ends – we encourage you to take a minute to provide us with feedback on today’s webinar . VETERANS HEALTH ADMINISTRATION 0
The VJO Specialist in Veterans Treatment Courts: The Glue Holding VTCs Together Justice Evelyn Lundberg Stratton (ret.), Ohio Supreme Court Ms. Mary Gillette, LISW-S, Veterans Justice Outreach Coordinator, Chalmers P. Wylie VA Ambulatory Care Center, Ohio Judge John Zottola, Allegheny County, Pennsylvania, Court of Common Pleas VETERANS HEALTH ADMINISTRATION
VJO Mission To reduce and prevent criminal justice recidivism and homelessness among veterans by linking justice-involved veterans with appropriate supports and services. VETERANS HEALTH ADMINISTRATION 2
Five Strategic Goals 1. Increase the identification of justice-involved veterans (JIVs) and promote their engagement with VA. 2. Build VJO capacity to serve JIVs through a comprehensive workforce development program that attracts and retains high-quality staff, supports their professional development efforts, and supports succession planning. 3. Match JIVs with the medical, psychiatric, vocational, and social services that will improve health and optimize successful community integration and safety. 4. Optimize community integration for JIVs by removing attitudinal barriers through improving stakeholder understanding of the population. 5. Develop systems for program evaluation and dissemination of knowledge on JIVs. VETERANS HEALTH ADMINISTRATION 3
What is a JIV? A veteran who is: 1. Arrested by local law enforcement who can be appropriately diverted from arrest into treatment; 2. Incarcerated in a local jail, and who either has a pending trial or is serving a sentence after a conviction; or 3. Involved in adjudication or monitoring by a court. Source: U.S. Government Accountability Office. (2016, April). Veterans Justice Outreach Program: VA Could Improve Management by Establishing Performance Measures and Fully Assessing Risks. (Publication No. GAO-16-393). Page 9. VETERANS HEALTH ADMINISTRATION 4
Background • In 2012, 22 million veterans in the US – About 9.3% are incarcerated (50,000 veterans) – This is a decrease of 25% since 2004 • Veterans incarcerated at a lower rate than non- veterans VETERANS HEALTH ADMINISTRATION 5
History of Veterans and Incarceration Names of Wounds of War Civil War Soldier’s Heart WWI Shell Shock WWII Combat Fatigue Present PTSD or PTS Increase in incarceration after each war VETERANS HEALTH ADMINISTRATION 6
Where JIVs served VETERANS HEALTH ADMINISTRATION 7
Veterans in Jails - Statistics • • Types of crimes – 70% are non- 40% little or sporadic work in last violent three years • – Public Order Offenses: 33% 33% retired or disabled • – Drug Offenses: 22% 73% had served during a military intervention (within geographic – Property Offenses: 16% proximity of a military conflict) – Probation Violations: 12% • 40% homeless or unstable • 25% have been in prison two or housing more times – More Vietnam veterans are • 95% male homeless • 52% between ages 18 and 44 – Recent veterans entering • Many older Vietnam vet era homelessness at a faster rate VETERANS HEALTH ADMINISTRATION 8
Housing Situation of JIVs VETERANS HEALTH ADMINISTRATION 9
Health Issues in Veterans • 69% have substance use disorders • 68% have serious mental health issues • Rand Estimate: 300,000 have major depressive disorders (such as Post-Traumatic Stress Disorder) • Rand Estimate: 320,000 have some form of Traumatic Brain Injury • 60% have serious medical problems – 5x higher rates for AIDS – 9x higher rates for Hepatitis C – 4x higher rates for Tuberculosis – Higher prevalence rates for asthma VETERANS HEALTH ADMINISTRATION 10
Eligibility Criteria – Discharge Status • 82% eligible for VA Healthcare services • 65% have honorable discharge • 17% general under honorable discharge • Those with dishonorable discharge but can prove mental health or PTSD, TBI causes can upgrade bad paper but difficult • Discharge for homosexuality being upgraded • While many have significant risk factors, most are eligible for VA services but have never accessed them VETERANS HEALTH ADMINISTRATION 11
History and Purpose of Treatment Courts Development of Veterans Treatment Court Concept 463 VTCs as on June 3, 2016 – only 65 existed in 2010 Veterans served by VJOs in a VTC rose from 1,900 in 2012 to 3,900 in 2015 VETERANS HEALTH ADMINISTRATION 12
Evolution of Concept and Meeting to form VJOs Program • Purpose and extent of VJO outreach • Participation in training for VJOs • Operational in 2009 • Funding made available in 2010 for every VA facility (167 medical centers) • Originally one per facility, now increased to 261 total in 2015 VETERANS HEALTH ADMINISTRATION 13
Progress of VJO Services By 2015: 46,500 veterans served 72% increase in veterans served between 2012 and 2015 VETERANS HEALTH ADMINISTRATION 14
Number of Veterans Served VETERANS HEALTH ADMINISTRATION 15
Challenges • GAO Report suggests performance and risk assessment measures • Challenges posed by diversity of service areas – Rural versus urban – Large population versus small – Jail versus VTC duties • VTC involvement more extensive and longer term, 12-24 months, versus brief jail contacts • Time spent helping to set up a VTC VETERANS HEALTH ADMINISTRATION 16
Challenges • Different priorities of VA hospital facilities both in duties of VJOs and in allocating treatment resources • Increase in usage of Veterans Reentry Search Service identifying many more veterans after arrest • Increase in usage outstripping capacity • Incarcerated veterans at higher risk of homelessness • Handbook for policies and procedures still in progress • No current anticipated increase in funding VETERANS HEALTH ADMINISTRATION 17
Resource and Treatment Challenges • Residential treatment facilities are limited and often full • Limited housing options for sex offender – However, VA making strong push and great strides to end homelessness among veterans generally • Limited transportation options for veterans to get to treatment or court hearings, especially if driver’s license has been revoked VETERANS HEALTH ADMINISTRATION 18
MISSION • To partner with the criminal justice system to identify Veterans who would benefit from treatment as an alternative to incarceration. VJO will ensure access to exceptional care , tailored to individual needs, for justice-involved Veterans by linking each Veteran to a VA and community services that will prevent homelessness, improve social and clinical outcomes, facilitate recovery and end Veterans’ cyclical contact with the criminal justice system. VETERANS HEALTH ADMINISTRATION 19
VISION • Every justice-involved Veteran will have access to the health care and other benefits necessary to pursue and realize a full, meaningful life as a self-reliant, positively contributing member of the community. • Source: Department of Veterans Affairs, 2009 VETERANS HEALTH ADMINISTRATION 20
Risk Factors that increase likelihood of a JIV • Homelessness • Mental Illness • Substance Abuse/Use • Chronic Health Issues • Trauma • Head Injuries • Multiple Life Stressors • Lack of Supports VETERANS HEALTH ADMINISTRATION 21
Service/Treatment Delivery Emphasis • Homelessness prevention • Medical care (including TBI) • Mental health (including Posttraumatic Stress Disorder) and addiction • Cognitive risk (and personality characteristics) • Psychosocial Needs Housing, financial/employment, interpersonal, social VETERANS HEALTH ADMINISTRATION 22
Scope and Demand – Direct VJO Duties • Liaison with law enforcement • Jail outreach • Linkage with and coverage of treatment courts (and other courts) • Catchment area POC – justice involved Veterans • Support of ancillary needs of justice involved Veterans • (e.g. child support, legal, financial stability and benefits) • Documentation and clinical record keeping • Data tracking, monitoring, and reporting • Program planning/development, coordination, and promotion • Linkage development – internal VA, justice partners, community providers VETERANS HEALTH ADMINISTRATION 23
VJOs and JIVs VETERANS HEALTH ADMINISTRATION 24
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