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Equity &Inclusion Equity & Inclusion EQUIVALENT ACCESS ASSESSMENT and TOOLKIT Adult Drug Court Best Practice Standard II Equity & Inclusion Adult Drug Court Best Practice Standard II Equivalent Access Assessment ................... 3 Research Brief ............................... 31 Suitability for Treatment Court Survey ............ 39 Age Group Implications for Treatment Courts .......................... 43 Focus Group Protocol for Underserved Groups........................... 47 Information Comprehension Techniques ........... 51 Adult Drug Court Best Practice Standard II While the Equity and Inclusion standard (Standard II of the Adult Drug Court Best Practice Standards) covers all aspects of treatment court, this toolkit focuses on access. Recognize that steps you take to improve access will potentially improve retention, treatment, sanctions and incentives, dispositions, and team training. This is the primary document in the toolkit. It contains links to other helpful documents and tools. We will begin with a focus on the role professional staff play in determining who accesses your program. We will look at how to determine who is accessing your program and who should be accessing it. Then we will look at some factors that may be unintentionally excluding certain groups of individuals from your program. Next the focus will shift to the participants and to viewing your program as a product that you need to market. We will use principles of social marketing to explore how to encourage a behavior—treatment court participation—in your underserved group. 2 Equity & Inclusion: Equivalent Access Assessment and Toolkit Equivalent Access Self-Assessment What are your current strategies for encouraging access by underserved groups? Do you know which group is underserved? If no, go to pages 4-5 At any point in the access process, individuals from a certain group could be unin- tentionally excluded. Do you know how decisions are made at all the points in the access process, beginning with an event that triggers consideration for treatment court (arrest, parole violation, reentry) and continuing through the decision to admit? If no, go to page 6 Screening tools are de- Do you have a written list Do you know why signed to help staff identify of criteria to determine individuals are not being who is most appropriate who might be eligible? referred for a screening? for treatment court. Do you If no, go to page 6 If no, go to pages 6-8 have a screening tool? If no, go to page 8 The screening tool could be a reason that a specific group is underserved if it includes factors that lead to over- or underrepresentation of a group based on race and gender and if it is not used consistently to make decisions regarding who to refer to your program. Is the tool being used consistently by all staff Do you know why individuals to determine suitability, or is the indicated are not being admitted? decision frequently overridden? If no, go to pages 8-10 If it is frequently overridden, go to page 8 You may exclude individuals with certain characteristics associated with either eligibility (generally an objective list of characteristics) or suitability (typically more subjective beliefs). Those characteristics may disproportionately lead to the exclusion of an underserved group. Do you know what kind of Do you have community training would be helpful Are you aware of how partners to help you for the individuals who exclusionary criteria affect better understand and make decisions about who your underserved group? meet the needs of your is eligible, referred for a If no, go to pages 7 and 8 underserved group? screening, and admitted? If no, go to pages 10-13 If no, go to pages 7 and 25 3 Adult Drug Court Best Practice Standard II Identifying Your Underserved Group Often we have the best of intentions but un- Underserved Group: knowingly exclude people from participating What Data Are Collected? in our program. Do you collect and examine data by race, ethnicity, As members of a community, and because of our and gender? work with other professionals, we may have a good sense of who is not accessing our program. Do you include an indicator for individuals that identify as more than one race? Across the United States, African Americans and Hispanics are underrepresented in many Data on mixed race: treatment courts relative to the arrestee • 3% of the U.S. population identifies as mixed population. race, with the largest proportion identifying as white and Native American (U.S. Census, 2010) What anecdotal evidence do you have regarding who is underserved by your program? (from • There is not much research on the signifi- media outlets, community observations and cance of being of more than one race because of the tremendous diversity of individuals who current and past participants) could potentially be considered mixed race We may also rely on statistical analysis to Implications of self-identification: verify if certain groups are being excluded. • Provides an indicator of the cultural orientation and the potential risks and needs associated What empirical evidence do you have of statewide with that group and local trends? • Tends to fluctuate over the course of one’s life n What is being said about the jail population? Arrests? Types of drugs appearing in the community? Implications of “observer” identification: n What do you know about the incarcerated (when someone else identifies an individual’s population and their treatment needs? mixed-race status based on a visual inspection) n What are the trends in cases filed on drug charges? • Can be used to monitor practices for potential discrimination This information gives you a general sense of your underserved group, but you will need some more specific data to identify whether your program is aligned with the trends listed above. 4 Equity & Inclusion: Equivalent Access Assessment and Toolkit Table 1. Example of EIAT results Access Step Black Men Black Women White Men White Women TOTAL Number of Drug Cases Disposed 35 10 35 20 100 Referred 5 1 14 11 25 (14.2%) (10%) (40%) (55%) (25%) Do not forget other underserved groups. Do you To identify whether you have an underserved collect data on the following characteristics that group, use the Equity and Inclusion Assessment could be associated with your underserved group? Tool (EIAT) to track a referral cohort as it pro- n Physical or intellectual disabilities gresses through the different stages of treatment court. Applying the EIAT is a good first step to n Mental health status help you identify whether you have an under- n Sexual orientation served group. n Religious affiliation Table 1 shows an example. n Level of acculturation n Veteran status In this example, black men with a drug case dis- posed have a 14% chance of being referred to treat- n Socioeconomic status (such as professionals, blue collar workers, chronically unemployed individuals) ment court, black women have a 10% chance, etc. If you do not already collect this information, add Note that when you do this statistical analysis, it may some questions to your intake form about self- be easiest to just use drug cases, but other case types identified ethnic culture and other characteristics may be associated with drug-using behavior. One relevant to the local population that could be state found that 33% of treatment court participants served by your treatment court. had a non-drug charge. 5 Adult Drug Court Best Practice Standard II The Access Process “The Long Road to Treatment” is the title of an article reporting on a study of the process individuals go through to enter treatment court. Six programs were studied, and the many steps to admission were identified in each one. The study attempted to explain why so few drug offenders are admitted to treatment courts. The study found that multiple decision makers were involved, multiple formal and informal criteria were used in the decision process, and multiple opportunities for inclusion and rejection occurred. The authors concluded with a recommendation to document referral and admission process- es to better understand and respond to selection effects.1 How Do Individuals Access Your Program? “Eligibility criteria for the treatment Let’s look more closely at the major steps in the court are nondiscriminatory in intent access process and consider each of our roles. Typ- and impact. If an eligibility requirement ically, these steps include paper eligibility, referral for a screening, clinical assessment, and admis- has the unintended effect of differentially sion, and they involve multiple decision makers. restricting access for members of a group What is the event that triggers an initial paper who has historically faced reduced op- eligibility determination? An arrest? A supervision portunities, the requirement is adjusted violation? Another event? Treatment courts gener- ally have a list of criteria related to legal issues that to increase representation unless doing they use to identify who might be eligible. They so would jeopardize public safety or may then further examine the records of those individuals for substance use patterns and other effectiveness.” factors that might indicate that they may benefit — from Standard II from a treatment court program. What information is used to determine initial An eligibility determination will lead to a referral paper eligibility, and who is referred for further or nonreferral for screening to your program. screening? Who is and is not being referred for screening n Is it up to the decision maker’s discretion? to your program? n Is there a list of eligible legal factors and n Why? other criteria? Are referrals for screening an area of concern? Let’s delve deeper. 1 Belenko, S., Fabrikant, N., & Wolff, N. (2011). The long road to treatment: Models of screening and admission to drug courts. Criminal Justice and Behavior, 38, 12, 1222-1243. 6 Equity & Inclusion: Equivalent Access Assessment and Toolkit Assessing Referrals for Screening What should you do if stakeholders disagree with Understand the role of each of the professionals in each other or are misinformed about what the ap- the decision process.
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