Drug Courts: Overview of Growth, Characteristics, and Results (Chapter Report, 07/31/97, GAO/GGD-97-106).

Pursuant to a legislative mandate, GAO reviewed the effectiveness and impact of federal grants for drug court programs that include court-supervised drug treatment, focusing on: (1) the universe of and funding for drug courts; (2) the approaches, characteristics, and completion and retention rates of existing programs; (3) the extent to which program and participant data are maintained and used to manage and evaluate drug court programs; and (4) the results of GAO's review and synthesis of existing published and unpublished evaluations or assessments of drug court programs regarding the impact of such programs.

GAO noted that: (1) there has been a substantial increase in the number of drug court programs started in the United States and the availability of federal funding to support such programs; (2) between 1989 and 1994, 42 drug court programs were started; (3) since 1994, the total number of operating drug court programs had grown to 161 as of March 31,1997; (4) the number of drug court programs in various developmental stages as of the same date indicates that the number of operating programs will likely continue to grow; (5) over $125 million has been made available for the planning, implementation, enhancement, or evaluation studies of drug court programs from a variety of funding sources since 1989; (6) federal funding, which has increased substantially since 1993, has provided over $80 million of the total; (7) over 95 percent of the federal funding has been provided through federal grants administered by the Department of Justice (DOJ) and the Department of Health and Human Services (HHS); (8) state and local governments, private donations, and fees collected from program participants have provided about $45 million; (9) some programs reported that they deferred prosecuting offenders who entered the program, some allowed offenders to enter the program after their case had been adjudicated, and others allowed offenders to enter their program on a trial basis after entering a plea; (10) with the exception of follow-up data on program participants after leaving the program, most drug court programs surveyed by GAO reported that they maintained various types of data on program participants as suggested by DOJ in its guidance to jurisdictions applying for federal grants under: (a) Title V of the Violent Crime Act; (b) the HHS Center For Substance Abuse and Treatment in its drug court treatment guidelines; and (c) the National Association of Drug Court Professionals Standards Committee, which develops standards and provides guidance to drug court programs, in its drug court program guide; (11) GAO, for several reasons, could not draw any firm conclusions on the overall impact of drug court programs or on certain specific issues raised by Congress about the programs or their participants; and (12) DOJ, in conjunction with various stakeholders in the drug court community, has initiated an impact evaluation, to be completed in 1999, of four of the oldest drug court programs; (12) this evaluation is designed to address some of the factors associated with existing studies that prevented GAO from reaching firm conclusions.

--------------------------- Indexing Terms -----------------------------

REPORTNUM: GGD-97-106 TITLE: Drug Courts: Overview of Growth, Characteristics, and Results DATE: 07/31/97 SUBJECT: Recidivism Drug treatment Drug abuse Courts (law) Crimes or offenses Federal grants Program evaluation Defendants Data collection Offender rehabilitation IDENTIFIER: Correctional Options Grant Edward Byrne Memorial State and Local Law Enforcement Assistance Program Local Law Enforcement Block Grant Comprehensive Communities Program

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Cover ================================================================ COVER

Report to the Committee on the Judiciary, U.S. Senate, and the Committee on the Judiciary, House of Representatives

July 1997

DRUG COURTS - OVERVIEW OF GROWTH, CHARACTERISTICS, AND RESULTS

GAO/GGD-97-106

Overview of Drug Courts

(188626)

Abbreviations =============================================================== ABBREV

AA - Alcoholics Anonymous BJA - Bureau of Justice Assistance CSAT - Center for Substance Abuse Treatment DOJ - Department of Justice DCPO - Drug Courts Program Office HHS - Department of Health and Human Services HUD - Department of Housing and Urban Development JMI - Justice Management Institute LLEBG - Local Law Enforcement Block Grants NA - Narcotics Anonymous NADCP - National Association of Drug Court Professionals NCJRS - National Criminal Justice Reference Service NIJ - National Institute of Justice ONDCP - Office of National Drug Control Policy OJP - Office of Justice Programs SJI - State Justice Institute

Letter =============================================================== LETTER

B-275268

July 31, 1997

The Honorable Orrin G. Hatch Chairman The Honorable Patrick J. Leahy Ranking Minority Member Committee on the Judiciary United States Senate

The Honorable Henry J. Hyde Chairman The Honorable John Conyers, Jr. Ranking Minority Member Committee on the Judiciary House of Representatives

Title V of the Violent Crime Control and Law Enforcement Act of 1994, which authorizes the award of federal grants for drug court programs, requires that we assess the effectiveness and impact of these grants and report to Congress. To assist Congress in its deliberations on whether to fund drug court programs, we provided a preliminary report in May 1995.\1 In response to the legislative mandate and discussions with the Senate and House Judiciary Committees, this report discusses (1) the universe of and funding for drug courts; (2) their approaches, characteristics, and completion and retention rates; (3) the extent to which program and participant data are maintained and used to manage and evaluate drug courts; and (4) the results of our review and synthesis of existing published and unpublished evaluations or assessments of drug court programs regarding the impact of such programs. This report contains recommendations to the Attorney General, Secretary of Health and Human Services, and the Executive Director of the State Justice Institute to help ensure that, to the extent feasible, follow-up data on program participants are collected by drug court programs and considered in future impact evaluations.

We are sending copies of this report to the Chairmen and Ranking Minority Members of other appropriate congressional committees, the Attorney General, the Secretary of Health and Human Services, the Executive Director of the State Justice Institute, the Director of the Office of Management and Budget, and other interested parties. Copies will also be made available to others upon request.

The major contributors to this report are listed in appendix X. If you or your staff have any questions regarding this report, please call me on (202) 512-8777.

Norman J. Rabkin Director, Administration of Justice Issues

-------------------- \1 Drug Courts: Information on a New Approach to Address Drug-Related Crime (GAO/GGD-95-159BR, May 22, 1995).

EXECUTIVE SUMMARY ============================================================ Chapter 0

PURPOSE ---------------------------------------------------------- Chapter 0:1

Since the 1980s, the drug epidemic in the United States and the adoption of tougher drug policies by lawmakers and officials have contributed to an overload of drug cases on judicial dockets. In response to the deluge of drug cases and the cycle of criminal recidivism\1 common among drug offenders, some state and local jurisdictions began in the late 1980s creating drug courts. These are special judicial proceedings generally used for nonviolent drug offenders that feature supervised treatment and periodic drug testing.

Title V of the Violent Crime Control and Law Enforcement Act of 1994 (P.L. 103-322) (hereafter referred to as the Violent Crime Act) specifically authorizes the award of federal grants for drug court programs that include court-supervised drug treatment.\2

The act requires that GAO assess the effectiveness and impact of these grants and report to Congress. In response to this requirement and on the basis of discussions with the Senate and House Judiciary Committees, GAO focused its work on determining (1) the universe of and funding for drug court programs; (2) the approaches, characteristics, and completion and retention rates of existing programs; and (3) the extent to which program and participant data are maintained and used to manage and evaluate drug court programs.

GAO also focused on determining what conclusions can be drawn from existing published and available unpublished evaluations or assessments of drug court programs on the impact of such programs, particularly as they relate to the following specific issues raised in Title V of the 1994 Violent Crime Act and in GAO's discussions with Senate and House Judiciary Committees: (1) criminal profile of program participants compared to similar offenders processed through the traditional adjudication system, (2) completion rates of participants, (3) differences in characteristics between program graduates and dropouts, (4) sanctions imposed on persons who failed to complete drug court programs or comply with program requirements, (5) drug use and criminal recidivism rates of program and nonprogram participants, and (6) costs and benefits of drug court programs to the criminal justice system.

In 1995, GAO issued an initial report\3 on drug court programs, which provided preliminary information on programs operating at that time.

-------------------- \1 GAO uses the term recidivism to refer generally to the act of committing new criminal offenses after having been arrested and/or convicted of a crime.

\2 Under this act, the Attorney General in administering the federal drug court grant program is required to consult with the Secretary of Health and Human Services, who is responsible for providing grants to public and private entities that provide substance abuse treatment for individuals under criminal justice supervision.

\3 Drug Courts: Information on a New Approach to Address Drug-Related Crime, GAO/GGD-95-159BR, May 22, 1995.

BACKGROUND ---------------------------------------------------------- Chapter 0:2

The main purpose of drug court programs is to use the authority of the court to reduce crime by changing defendants' drug-using behavior. Under this concept, in exchange for the possibility of dismissed charges or reduced sentences, defendants are diverted to drug court programs in various ways and at various stages of the judicial process depending on the circumstances. Judges preside over drug court proceedings; monitor the progress of defendants through frequent status hearings; and prescribe sanctions and rewards as appropriate in collaboration with prosecutors, defense attorneys, treatment providers, and others. Although there are basic elements common to many drug court programs, the programs vary in terms of approaches used, participant eligibility and program requirements, type of treatment provided, sanctions and rewards, and other practices.

With the assistance of the Drug Court Clearinghouse,\4 GAO identified existing drug court programs. GAO, among other things, then surveyed and obtained responses from 134 of the 140 drug court programs that were identified as operating as of December 31, 1996. GAO also did an evaluation synthesis of 20 studies\5 that included some relevant information on the impact of specific drug court programs and identified a variety of other documents that described program objectives and operations; provided judicial commentary on these programs; and, in some cases, provided a summary description of a number of programs.

-------------------- \4 The Drug Court Clearinghouse and Technical Assistance Project at the American University, which is funded by the Department of Justice's Drug Court Program Office, among other things, compiles, publishes, and disseminates information and materials on drug courts and provides technical assistance to jurisdictions involved with planning and implementing drug court programs.

\5 GAO's literary search and data collection efforts identified over 80 documents available as of March 31, 1997, that were either published or unpublished evaluation studies; described program objectives and operations; provided judicial commentary; and, in some cases, provided a summary description of a number of programs. Only 20 of these documents met the criteria for inclusion in GAO's evaluation synthesis, including providing some information on the impact and/or effectiveness of drug court programs.

RESULTS IN BRIEF ---------------------------------------------------------- Chapter 0:3

There has been a substantial increase in the number of drug court programs started in the United States and the availability of federal funding to support such programs. Between 1989 and 1994, 42 drug court programs were started.\6 Since 1994, the total number of operating drug court programs had grown to 161 as of March 31, 1997. The number of drug court programs in various developmental stages as of the same date indicates that the number of operating programs will likely continue to grow.

Over $125 million has been made available for the planning, implementation, enhancement, and/or evaluation studies of drug court programs from a variety of funding sources since 1989. Federal funding, which has increased substantially since 1993, has provided over $80 million of the total. Over 95 percent of the federal funding has been provided through federal grants administered by the Department of Justice and the Department of Health and Human Services. State and local governments, private donations, and fees collected from program participants have provided about $45 million.

The drug court programs GAO surveyed were very diverse in approach, characteristics, and completion and retention rates.\7

Some programs reported that they deferred prosecuting offenders who entered the program, some allowed offenders to enter the program after their case had been adjudicated, and others allowed offenders to enter their program on a trial basis after entering a plea. Although all of the programs GAO surveyed reported having a treatment component as a part of their overall program, results from a Drug Court Clearinghouse survey indicated that the type and extent of treatment provided to program participants varied among the programs. Populations targeted by these programs also varied among the drug court programs and included adults and juveniles, nonviolent and some violent offenders,\8

offenders with and without a substance addiction\9 , and first-time and repeat offenders. However, drug court programs most frequently reported that participants were typically adult, nonviolent offenders with a substance addiction. The drug court programs GAO surveyed reported that, since 1989, they had admitted over 65,000 offenders. The completion and retention rates for participants in these programs were reported to range, respectively, from about 8 to 95 percent and 31 to 100 percent.

With the exception of follow-up data on program participants after leaving the program, most drug court programs surveyed by GAO reported that they maintained various types of data on program participants as suggested by the Department of Justice in its guidance to jurisdictions applying for federal grants under (1) Title V of the Violent Crime Act; (2) the Health and Human Services' Center for Substance Abuse and Treatment in its drug court treatment guidelines; and (3) the National Association of Drug Court Professionals' Standards Committee, which develops standards and provides guidance to drug court programs, in its recently issued drug court program "Key Components" guide. In addition, collaborative efforts among drug court program stakeholders have been undertaken to study the feasibility of and suggest ways to overcome obstacles, including cost and legal issues, associated with a recognized need in the drug court community to collect and maintain follow-up and other data on drug court program participants, which some drug court programs and stakeholders have demonstrated to be feasible to collect.

GAO, for several reasons, could not draw any firm conclusions on the overall impact of drug court programs or on certain specific issues raised by Congress about the programs or their participants. For example, many of the evaluations available at the time of GAO's review (1) involved programs that were relatively new at the time of the evaluations and were diverse in nature; (2) had differences and limitations in their objectives, scopes, and methodologies, including (in 11 of the 20 studies) no assessment of program participants after they left the programs, and (in 14 of the 20 studies) no comparison of how participants and nonparticipant arrest rates compared after program completion; and (3) showed varied results regarding program impact and the specific issues raised about drug court programs and their participants.

Justice, in conjunction with various stakeholders in the drug court community, has initiated an impact evaluation, to be completed in 1999, of four of the oldest drug court programs. This evaluation is designed to address some of the factors associated with existing studies that prevented GAO from reaching firm conclusions. However, GAO notes that the outcomes of any future evaluations of drug court programs may be hindered by the lack of available follow-up data, which drug court programs are not currently required to collect. If issues raised by Congress and others about the efficacy of drug court programs are to be addressed, following up on participants and nonparticipants (i.e., eligible offenders who chose not to participate) for some period after they leave the program to find out whether they committed new crimes or relapsed into drug use would be important.

-------------------- \6 This number, which is based on GAO's independent survey and other sources, differs from the 36 drug court programs cited in GAO's prior report (GGD-95-159BR) as started between 1989 and 1994, which was based on information obtained from the Drug Court Clearinghouse at the time.

\7 "Completion rates" and "retention rates" are indicators commonly used in the drug court community to measure the impact of drug court programs. Completion rates refer to individuals who completed or were favorably discharged from a drug court program as a percentage of the total number admitted and not still enrolled. This measure is an indicator of the extent to which offenders successfully complete their drug court program requirements. Retention rates refer to individuals who are currently active participants in or have completed or were favorably discharged from a drug court program as a percentage of the total number admitted. This measure is an indicator of the extent to which a program has been successful at retaining program participants in the program at the time of GAO's survey. Although interrelated, both measures are helpful in assessing program performance. A program that had been operating consistently over a longer period would be expected to have similar completion and retention rates.

\8 Survey responses were based on individual jurisdictions' definitions of a "violent offender," which may or may not differ from the federal definition as defined under the Violent Crime Act to mean a person who (1) is charged with or convicted of an offense, during the course of which offense or conduct (a) the person carried, possessed, or used a firearm or dangerous weapon; (b) there occurred the death of or serious bodily injury to any person; or (c) there occurred the use of force against the person of another, without regard to whether any of the circumstances described in the aforementioned subparagraphs is an element of the offense or conduct of which or for which the person is charged or convicted; or (2) has one or more prior convictions for a felony crime of violence involving the use or attempted use of force against a person with the intent to cause death or serious bodily harm.

\9 According to the Department of Health and Human Services officials and other drug court program stakeholders, persons admitted without substance addictions are likely to include persons with substance abuse problems who were not identified as being addicted during their initial screening. In addition, some drug court programs target special populations. For example, the Jackson County, Missouri, drug court program, in addition to targeting others, targets prostitutes because of the likelihood that their drug abuse is the reason for their criminal behavior. Another program in Las Vegas, Nevada, targets parents or guardians of juveniles who have been identified as having a substance addiction.

PRINCIPAL FINDINGS ---------------------------------------------------------- Chapter 0:4

THE NUMBER OF DRUG COURT PROGRAMS AND THE AVAILABILITY OF FUNDING HAVE INCREASED -------------------------------------------------------- Chapter 0:4.1

Based on GAO's survey, 42 drug court programs were started between 1989 and 1994. Since then, 4 have closed and 123 more have started, bringing the total number of drug court programs operating to 161 as of March 31, 1997. Moreover, an additional 154 drug court programs were in various developmental stages as of the same date, indicating potential future growth in the number of operating courts. Drug court programs were operating in 38 states, the District of Columbia, and Puerto Rico and were being planned or studied in 8 of the remaining 12 states and Guam. About 40 percent of the drug court programs operating were in California and Florida.

Overall, information obtained directly from federal funding sources and 134 of the 140 drug court programs identified as operating as of December 31, 1996, showed that over $125 million in resources was obtained from federal, state, and local governments; private sources; and participant fees for planning, implementing, enhancing, and/or evaluating drug court programs.\10

Federal funding, which has increased substantially since 1993,\11

has provided over $80 million of the funding. From fiscal years 1990 through 1993, federal multipurpose funding sources provided about $6 million in federal grants to support drug court programs. Since then, about $75 million in additional federal funds have been awarded through March 31, 1997. These funds were obtained from existing multipurpose grants and three additional federal funding sources that made funds specifically available for planning, implementing, enhancing, and/or evaluating drug court programs.

Over 95 percent of the federal funding has been provided through federal grants administered by the Departments of Justice and Health and Human Services. Drug court programs reported that about $45 million was provided by state and local governments, private sources, and/or fees collected from program participants since 1989. However, in commenting on a draft of this report, some drug court program stakeholders expressed the opinion that this amount may understate the actual amount of funding provided by state and local governments and other sources because some of the respondents to GAO's survey may have failed to include the state/local jurisdictions' contributions towards the administrative cost of the program staff (judges, prosecutors, pretrial service staff, court clerks, program coordinators, etc.) and/or cost of program facilities (courthouse and other administrative facilities) that are often contributed by the local jurisdiction.

-------------------- \10 The total amount of funding supporting drug court programs is likely understated because (1) some drug court programs were not able to determine the precise amount of funding they received from federal, state, and local governments; private funding sources; and/or participant fees and (2) certain multipurpose federal funding sources, which did not specifically target drug court programs, had not been tracking the funding of drug court programs. In addition, information on the total amount of various federal block grant funding awarded to jurisdictions and used to support drug court programs, as well as Medicaid funding that may have been used by drug court participants to pay for the cost of treatment, was not available from either the funding sources or recipients.

\11 Although GAO did not analyze the extent of increases in state and local funding, it has likely increased during this same time period due to the requirements for matching funds associated with most federal grants.

APPROACHES, CHARACTERISTICS, AND COMPLETION AND RETENTION RATES OF EXISTING DRUG COURT PROGRAMS ARE DIVERSE -------------------------------------------------------- Chapter 0:4.2

In response to GAO's survey, about 44 percent of the drug court programs operating as of December 31, 1996, reported deferring prosecution of drug offenders who agreed to enter a drug treatment program, and about 38 percent said that they allowed offenders to enter the program after being adjudicated. About 10 percent reported that they used both approaches, and the remaining 8 percent said they used some other approach.

All of the drug court programs operating as of December 31, 1996, that were surveyed by GAO reported having a treatment component, and 82 percent reported that participants generally started treatment within a week of entering the program. However, the type and extent of treatment provided to program participants varied among the drug court programs. For example, drug court programs responding to a Drug Court Clearinghouse survey reported using an array of treatment services, with the use of these services varying among programs. In addition, some programs reported that a weekly visit to the treatment provider was required; others a minimum of three visits; and in some more extensive programs, four to five visits per week were required.

The drug court programs responding to GAO's survey reported targeting various populations, including adults, women, juveniles, nonviolent and violent offenders, offenders with and without a substance addiction, first-time and repeat offenders, and probation violators. For example

-- About 16 percent reported that juveniles were eligible to participate in their drug court program.

-- About 6 percent accepted offenders with a current conviction for a violent offense.

-- About 16 percent accepted offenders with a prior conviction for a violent offense.

-- About 17 percent accepted offenders without a substance addiction.

-- About 78 percent accepted repeat offenders.

-- About 63 percent accepted probation violators.

Drug court programs most frequently reported that program participants were adult, nonviolent offenders with a substance addiction.

GAO's analysis of responses to its survey further showed that as of December 31, 1996, 65,921 people had been admitted to drug court programs in the United States since 1989. About 31 percent (20,594) had completed programs, and about 24 percent (16,051) had failed to complete programs because they were terminated or they voluntarily withdrew or died while in the program. About 40 percent, or 26,465 offenders, were reported to be enrolled in drug court programs as of December 31, 1996.\12 The status of the remaining 4 percent, or about 2,800 people, was unknown.\13

The completion rate for participants in 56 of the 62 drug court programs surveyed that were identified as operating as of December 31, 1996, for more than 18 months ranged from about 8 to 95 percent and averaged about 48 percent.\14 The retention rate for 131 of the 134 programs GAO surveyed ranged from about 31 to 100 percent and averaged about 71 percent.\15

-------------------- \12 Of the 26,465 enrollees, about 25 percent, or 6,564, did not regularly attend programs or were wanted on bench warrants for failure to appear as of December 31, 1996. However, the median for the 128 drug court programs that were able to account for the status of enrolled program participants was 5 inactive participants, and 1 drug court program accounted for about 1,200 of the 6,564 inactive enrollees.

\13 Percentages do not add to 100 percent due to rounding.

\14 Completion rates were not applicable for three of the programs because they had retained 100 percent of the program participants admitted at the time of GAO's survey. For the remaining three programs, GAO was unable to calculate a completion rate because complete information on the status of certain program participants could not be provided by the drug court programs surveyed.

\15 GAO was unable to calculate retention rates for three programs, because complete information on the status of certain program participants could not be provided by the drug court programs surveyed.

EXCEPT FOR FOLLOW-UP DATA, MOST DRUG COURT PROGRAMS REPORTED COLLECTING AND USING SUGGESTED MANAGEMENT AND EVALUATION DATA -------------------------------------------------------- Chapter 0:4.3

Guidelines issued by Justice in 1996 require recipients of federal funds from the Violent Crime Act to demonstrate the capability to ensure adequate program management through ongoing monitoring, tracking, and program evaluation. In this regard, the guidelines suggest that, among other things, the following information be collected for drug court participants and, to the extent possible, similarly situated nonparticipants:

-- criminal justice history,

-- history of substance abuse,

-- level of use of controlled or addictive substances at the point of entry into the program,

-- data on substance abuse relapse while in the program,

-- data on rearrest and/or conviction for a crime while in the program,

-- completion/noncompletion of drug court program,

-- follow-up data on substance abuse relapse after completing the program, and

-- follow-up data on rearrest and/or conviction for a crime after completing the program.

In commenting on a draft of this report, Justice pointed out that it does not have the statutory authority to mandate that states or local jurisdictions collect specific program data for drug court programs funded by its block grants.

In its 1996 and 1997 guidance, the Department of Health and Human Service's Center for Substance Abuse Treatment adopted similar suggestions for collecting and maintaining data on program participants. In its recently issued drug court program guide, the National Association of Drug Court Professionals' Drug Court Standards Committee also adopted similar suggestions, including suggesting that data be collected and maintained on relapse and criminal recidivism of program participants after they leave the program and comparative data on similarly situated nonparticipants. However, recipients of other federal funds administered by the Department of Justice, as well as those receiving funds administered by the State Justice Institute\16 are not subject to similar guidance.

Over 90 percent of the drug court programs operating as of December 31, 1996, reported maintaining most of the suggested data to enable them to manage and evaluate their programs. However, about 67 percent of the drug court programs reported not maintaining follow-up drug relapse data, and about 47 percent reported not maintaining suggested follow-up data on rearrest or conviction for a crime once participants leave the programs. GAO's survey results showed that no significant difference was associated with the source of funding (federal, state/local, private, etc.) received and the extent to which drug court programs collected and maintained suggested follow-up data. GAO notes that since its survey was conducted, additional evidence has become available to indicate that collaborative efforts among stakeholders in the drug court community have been undertaken to study the feasibility of and address obstacles, including cost and legal issues, associated with a recognized need in the drug court community to collect and maintain follow-up and other data on drug court program participants.

A significant number of drug court programs and some drug court community stakeholders have demonstrated that it would be feasible to collect and maintain follow-up data on criminal recidivism of program participants, and others have demonstrated that it would be somewhat feasible to collect and maintain follow-up data on drug use relapse. For example, in March 1997, the Department of Justice through a cooperative agreement with the Justice Management Institute sponsored a meeting involving various drug court stakeholders that focused on, among other things, the need for and ways to overcome obstacles associated with obtaining follow-up data on program participants to adequately monitor and evaluate the impact of drug court programs.

-------------------- \16 The State Justice Institute is a nonprofit organization created by federal law and funded through congressional appropriations. Among other things, the State Justice Institute has provided grants for evaluation studies of drug court programs.

EXISTING EVALUATIONS PROVIDE SOME LIMITED INFORMATION BUT DO NOT PERMIT FIRM CONCLUSIONS REGARDING DRUG COURT IMPACT -------------------------------------------------------- Chapter 0:4.4

The 20 evaluation studies that GAO reviewed and synthesized did not permit GAO to reach definitive conclusions concerning the overall impact of drug courts or the other specific issues mentioned earlier that have been raised by Congress and in GAO's discussions with the Senate and House Judiciary Committees about drug court programs and the offenders who participate in them. For example, many of the available studies involved program approaches and characteristics that were diverse in nature, including, among other things, differences in eligible participants, differences in completion requirements, and differences in the type and extent of treatment provided. Also, various differences and limitations were associated with the objectives, scopes, and methodologies of these studies. Among other things, most of the studies evaluated drug court programs that were still in their first or second year of operation, with many of the program participants being evaluated still active in the programs. Most of the available studies involved very short follow-up periods. Eleven of the 20 studies did not include an assessment of postprogram criminal recidivism among program participants, and none of the studies included an assessment of postprogram drug use relapse. Also, most of the available studies (in 14 of the 20 studies) involved no comparison between participants and nonparticipant arrest rates after program completion.

Although GAO cannot draw any firm conclusions on the overall impact of drug court programs or on specific issues that have been raised, GAO does provide some limited information in chapter 5 on these issues to the extent they are addressed in the 20 available studies it reviewed and synthesized.

In April 1997, Justice issued a solicitation for an impact evaluation of four of the oldest drug court programs, which included an assessment of program participants after they leave the program. Also, during a March 1997 meeting involving Justice and various drug court program stakeholders, attention was given to the need for maintaining follow-up information on program participants and using it in any future impact evaluations. Justice expects these efforts to address some of the factors associated with existing studies that prevented GAO from drawing firm conclusions.

RECOMMENDATIONS ---------------------------------------------------------- Chapter 0:5

Congress and others have raised reasonable questions about whether drug court programs are effective. However, these questions have not been answered definitively by the programs themselves or studies done to date, in large part because critical data about program participants after they leave the program or similarly situated non-participants have not been available. Accordingly, to help ensure more effective management and evaluation of drug court programs, GAO recommends that the Attorney General and the Secretary of Health and Human Services

-- require drug court programs funded by discretionary grants administered by Justice and Health and Human Services to collect and maintain follow-up data on program participants' criminal recidivism and, to the extent feasible, follow-up data on drug use relapse.

-- require drug court programs funded by formula or block grants administered by Justice and Health and Human Services, to the extent permitted by law, to collect and maintain follow-up data on program participants' criminal recidivism and, to the extent feasible, follow-up data on drug use relapse. Where no statutory authority exists to impose such requirements, GAO recommends that Justice and Health and Human Services include in their respective grant guidelines language to suggest that drug court programs funded by these sources similarly collect and maintain such data.

To better ensure that conclusions about the impact of drug court programs on participants' criminal recidivism and/or drug use relapse can be drawn, GAO recommends that the Attorney General, the Secretary of Health and Human Services, and the Executive Director of the State Justice Institute require that the scope of future impact evaluations of drug court programs funded by their respective agencies include an assessment of program participants' postprogram criminal recidivism and drug use relapse and, whenever feasible, compare drug court participants with similar nonparticipants.

AGENCY COMMENTS AND GAO'S EVALUATION ---------------------------------------------------------- Chapter 0:6

The Departments of Justice and Health and Human Services, the State Justice Institute, the National Association of Drug Court Professionals, and the Drug Court Clearinghouse provided written comments on a draft of this report. These comments are discussed at the end of chapters 1, 2, and 5. These organizations generally agreed with GAO's findings relating to the growth, characteristics, and results of drug court programs and the conclusions and recommendations relating to the collection and maintenance of follow-up data on program participants and impact evaluations of these programs. However, Justice raised a legal concern about its ability to impose mandatory requirements on congressionally authorized entitlement grants--formula or block grant programs. The State Justice Institute raised concern about its ability to impose data collection requirements on programs for which it only provides short-term funding. Also, Justice and the National Association of Drug Court Professionals indicated that one of the difficulties associated with GAO's recommendation that evaluations of drug court programs include follow-up data and comparison groups is the lack of ongoing technical assistance and sufficient resources available to drug court programs to enable them to develop the capacity for data collection and program evaluation. While Justice reiterated that it has taken a number of steps to develop the capacity for data collection and evaluation among its drug court grantees, Justice notes that it will work with Congress to increase its funding for technical assistance.

GAO revised its recommendations to recognize statutory limitations that may be associated with formula and block grant programs administered by Justice and the Department of Health and Human Services. GAO did not, however, systematically review and therefore cannot comment on the sufficiency and adequacy of technical assistance and related resources that are currently being provided to drug court programs.

The National Association of Drug Court Professionals and the Drug Court Clearinghouse commented that while it may be too early to reach firm conclusions on the impact of drug court programs, the retention and completion rates from GAO's survey results and the differences in recidivism rates revealed in the evaluation studies reviewed by GAO permit a more positive conclusion about drug court programs than GAO arrives at in its report. GAO continues to believe it is essential to emphasize that there are shortcomings associated with many of the evaluations of drug court programs that have been done, and thus there are good reasons for withholding final judgment until more and better data are collected and additional studies are completed.

The Department of Health and Human Services expressed concerns with the lack of a thorough assessment of the adequacy of treatment being provided to drug court program participants in the scope of GAO's study. While GAO recognizes the Department's view that it would be helpful to have a detailed assessment of the quality and adequacy of the treatment component of the drug court program, such an effort would have gone well beyond the objectives and scope of this overview assessment of drug court programs.

INTRODUCTION ============================================================ Chapter 1

Since the 1980s, the drug epidemic in the United States has contributed to an overload of drug cases in many state and local criminal justice systems. The Office of National Drug Control Policy (ONDCP) estimates that each year illegal drugs kill more than 16,000 Americans and cost taxpayers nearly seventy billion dollars, and that more than half of all people brought into the nation's criminal justice system have substance abuse problems. According to the Department of Justice (DOJ), these drug abusers were more likely than nonabusers to be rearrested. In response to the deluge of drug cases in the late 1980s and the cycle of criminal recidivism common among drug offenders, some state and local jurisdictions began creating drug courts.\1 Title V of the Violent Crime Control and Law Enforcement Act of 1994 (P.L. 103-322) (hereafter referred to as the Violent Crime Act) specifically authorizes DOJ to award federal grants for drug courts that have programs offering court-supervised drug treatment. The act does not authorize grants for courts designed solely to expedite the processing of drug cases. Under this act, the Attorney General, in administering the federal drug court grant program, is required to consult with the Secretary of Health and Human Services (HHS), who is responsible for, among other things, providing grants to public and nonprofit private entities that provide substance abuse treatment for individuals under criminal justice supervision.

The main purpose of drug courts is to use the authority of the court to reduce crime by changing defendants' drug-using behavior. Under this concept, in exchange for the possibility of dismissed charges or reduced sentences, defendants are diverted to drug court programs in various ways and at various stages of the judicial process depending on the circumstances. Typically, judges preside over drug court proceedings; monitor the progress of defendants through frequent status hearings; and prescribe sanctions and rewards as appropriate in collaboration with prosecutors, defense attorneys, related criminal justice agencies, treatment providers, and other social service and community organizations. The extent and nature of collaboration depends on local needs and the targeted population being served and, thus, may differ considerably among drug court programs.

The approaches used by and basic elements common to drug court programs, including participant eligibility criteria, treatment requirements, completion requirements, and program sanctions are discussed next.

-------------------- \1 According to DOJ, two types of drug courts have evolved: those that (1) expedite drug cases without court-supervised drug treatment and (2) use court-monitored drug treatment to attempt to achieve changes in defendants' drug-using behavior. This report focuses on the latter, drug treatment courts. Throughout this report, we use the term "drug court programs" to refer to these courts. DOJ defines drug treatment courts as special court calendars or dockets designed to achieve a reduction in recidivism and substance abuse among nonviolent, substance abusing offenders by increasing their likelihood for successful rehabilitation through early, continuous, and intense judicially supervised treatment; mandatory periodic drug testing; and the use of appropriate sanctions and other rehabilitation services.

DRUG COURT APPROACHES ---------------------------------------------------------- Chapter 1:1

According to a report provided by the Drug Court Clearinghouse,\2

drug courts have generally taken two approaches to processing cases: (1) deferred prosecution (diversion) and (2) postadjudication. In the deferred prosecution approach, shortly after being charged, defendants waive their right to a speedy trial and enter a treatment program. Defendants who fail to complete the treatment program have their charges adjudicated. Defendants who complete the treatment program are not prosecuted further or have their charges dismissed. This approach is intended to capitalize on the trauma of arrest and offers defendants the opportunity to obtain treatment and avoid the possibility of a felony conviction.

In the postadjudication approach, defendants plead guilty or are tried and, if convicted, their sentences are deferred and/or incarceration is suspended pending successful completion of drug court program requirements. This approach provides an incentive for the defendant to rehabilitate because progress toward rehabilitation is factored into the sentencing determination. (See app. I for a flowchart of these two drug court approaches.)

According to the National Association of Drug Court Professionals (NADCP),\3 another common approach, the hybrid plea approach, generally allows a defendant to enter a plea; waive rights to a jury trial; and/or admit to evidence entered and enter the drug court program on a voluntary basis for a limited trial period after which time the defendant has to decide whether to remain in the program or serve his or her sentence.

-------------------- \2 The Drug Court Clearinghouse and Technical Assistance Project, which is funded by the Department of Justice's Drug Courts Program Office, began operating October 1, 1995, under a cooperative agreement with the American University, in partnership with the National Consortium of Treatment Alternatives to Street Crime Program. The Drug Court Clearinghouse, among other things, compiles, publishes, and disseminates information and materials on drug courts and provides technical assistance to jurisdictions involved with planning and implementing drug court programs.

\3 This is the principal organization of professionals involved in the development of treatment-oriented drug courts. Organized in 1994 by the 12 original drug court programs, its members include judges, prosecutors, defense attorneys, treatment-service providers, educators, researchers, and community leaders. NADCP acts primarily as an advocate for the development of effective drug court programs and works to provide guidance to the drug court community through its education and training programs. NADCP has no statutory or regulatory authority over drug court program operations.

PARTICIPANT ELIGIBILITY CRITERIA ---------------------------------------------------------- Chapter 1:2

According to the Drug Court Clearinghouse, drug court programs generally accept defendants with substance abuse problems who were being charged with drug possession and/or other nonviolent offenses such as property crimes. Some drug court programs allow defendants who have prior convictions, and others do not. In addition, as discussed in chapter 3, our survey results show that some programs allow defendants without a substance addiction and defendants currently or previously charged with a violent offense. Federal grants administered under the Violent Crime Act are not supposed to be awarded to any drug court program that allows either current or past violent offenders to participate in its program.\4

-------------------- \4 The 1994 Violent Crime Act defines "violent offender" to mean a person who "(1) is charged with or convicted of an offense, during the course of which offense or conduct (a) the person carried, possessed, or used a firearm or dangerous weapon; (b) there occurred the death of or serious bodily injury to any person; or (c) there occurred the use of force against the person of another, without regard to whether any of the circumstances described in the aforementioned subparagraphs is an element of the offense or conduct of which or for which the person is charged or convicted; or (2) has one or more prior convictions for a felony crime of violence involving the use or attempted use of force against a person with the intent to cause death or serious bodily harm."

TREATMENT REQUIREMENTS ---------------------------------------------------------- Chapter 1:3

According to the Drug Court Clearinghouse, in most drug court programs, treatment is designed to usually last at least 1 year and is generally administered on an outpatient basis with limited inpatient treatment as needed to address special detoxification or relapse situations.\5 Many of the programs operate with the philosophy that because drug addiction is a disease, relapses can occur and that the court must respond with progressive sanctions and/or enhance treatment rather than immediately terminate a participant.

The central element of all drug court programs is attendance at the regularly scheduled status hearings at which the drug court judge monitors the progress of participants. Monitoring is based on treatment provider reports on such matters as drug testing and attendance at counseling sessions. The judge is to reinforce progress and address noncompliance with program requirements. The primary objectives of the status hearing are to keep the defendant in treatment and to provide continuing court supervision.

Treatment services are generally divided into three phases and detoxification, stabilization, counseling, drug education, and therapy are commonly provided during phases I and II and, in some instances, throughout the program. Other services relating to personal and educational development, job skills, and employment services are provided during phases II and III, after participants have responded to initial detoxification and stabilization. Housing, family, and medical services are frequently available throughout the program. In some instances, a fourth phase consisting primarily of aftercare-related services is provided. The objectives of drug court program treatment are generally to (1) eliminate the program participants' physical dependence on drugs through detoxification; (2) treat the defendant's craving for drugs through stabilization, also referred to as the rehabilitation stage in which frequent group and/or individual counseling sessions are generally employed; and (3) focus on helping the defendant obtain education or job training, find a job, and remain drug free.

HHS' Center for Substance Abuse Treatment (CSAT), which has provided technical support, guidelines, and assistance to the drug court community, in its 1997 planning guide and checklist for treatment-based drug courts\6 identified the following as critical elements of comprehensive substance abuse treatment:

-- Screening to determine the likelihood of substance abuse;

-- Assessment to determine the individual's biopsychosocial needs, and to develop an individualized treatment plan;

-- Comprehensive, client-oriented treatment to include a range of appropriate modalities, drug testing, cultural/gender specific needs, mental and primary health care, anger management, and other adjunct services (e.g., acupuncture, Alcoholics Anonymous (AA), Narcotics Anonymous (NA), family assistance, housing, and employment);

-- Therapeutic relapse prevention techniques to identify relapsing triggers, and develop alternative responses; and

-- Case management of the client's performance, progress, rewards, and sanctions consistent with the individualized treatment plan.

-------------------- \5 These programs recognize that some individuals will require a longer period to complete the program.

\6 Substance Abuse Treatment Planning Guide and Checklist for Treatment-Based Drug Courts, U.S. Department of Health and Human Services, 1997.

PROGRAM COMPLETION REQUIREMENTS ---------------------------------------------------------- Chapter 1:4

Drug court programs typically require defendants to complete a treatment program in order to graduate. Some impose other conditions defendants must meet after treatment. These conditions could include remaining drug free and not being arrested for a specified period, paying restitution, being employed full-time, or performing community service.

In many jurisdictions, completion of the drug court program leads to a dismissal of charges or termination of prosecution proceedings. In other jurisdictions, the guilty plea can be stricken, the defendant can be sentenced to probation in lieu of incarceration, or the defendant's probation can be shortened. DOJ pointed out that some drug court case records, including arrests, are sealed when defendants complete the program.

PROGRAM SANCTIONS ---------------------------------------------------------- Chapter 1:5

Sanctions for failing to abide by drug court program rules can include (1) verbal warning from the judge; (2) transfer to an earlier stage of the program; (3) incarceration for several days or weeks, generally increasing with the number and severity of the violations; and (4) more frequent status hearings, treatment sessions, or drug tests. Many programs also use graduated sanctions, increasing the severity of the sanction with subsequent violations of program rules.

DOJ also pointed out that most drug court programs use sanctions not to simply punish inappropriate behavior but to augment the treatment process. For example, many drug court programs will place a defendant in residential treatment if he or she is unable to achieve satisfactory progress in an outpatient setting. In addition, many drug court judges incarcerate defendants for the purpose of detoxification rather than for inappropriate behavior. According to NADCP, most drug court programs require some initial period of incarceration.

TERMINATION CRITERIA ---------------------------------------------------------- Chapter 1:6

Drug court programs typically use various criteria for ending a defendant's participation in the program before completion. These criteria may include a new felony offense, multiple failures to comply with program requirements such as not attending status hearings or treatment sessions, and a pattern of positive drug tests. According to DOJ, many drug court programs do not terminate defendants for a new drug possession offense.

Before terminating a defendant for continuing to use drugs, drug court programs generally will use an array of treatment services and available sanctions. There are no uniform standards among all programs on the number of failed drug tests and failures to attend treatment sessions that lead to a participant being terminated. Drug court program judges generally make decisions to terminate a program participant on a case-by-case basis taking into account the recommendations of others, including the treatment provider, prosecutor, and/or defense counsel. Relapses are expected, and the extent to which noncompliance results in terminations varies from program to program. Once a defendant is terminated, he or she is usually referred for adjudication or sentencing.

OBJECTIVES, SCOPE, AND METHODOLOGY ---------------------------------------------------------- Chapter 1:7

Title V of the 1994 Violent Crime Act requires us to assess the effectiveness and impact of federal grants awarded under Title V of the act for drug court programs. In response to this requirement and based on discussions with the Senate and House Judiciary Committees, our objectives for this review were to answer the following key questions:

(1) What is the universe of and availability of funding for drug court programs?

(2) What are the approaches used, characteristics of program participants, type and extent of treatment provided, and retention and completion rates of existing drug court programs?

(3) To what extent are program and participant data maintained and used to manage and evaluate drug court programs?

(4) What conclusions can be drawn from existing published and unpublished evaluations or assessments of drug court programs on the impact of such programs, particularly as it relates to the

-- criminal profile of drug court participants compared to similar offenders processed through the traditional judiciary system,

-- completion rates of participants,

-- differences in characteristics between drug court program graduates and dropouts,

-- sanctions imposed on persons who failed to complete drug court programs or comply with program requirements,

-- drug use and criminal recidivism rates of program participants and nonparticipants, and

-- costs and benefits of drug court programs to the criminal justice system?

To determine the universe of drug court programs, we collected and reviewed information from various units within DOJ, including the Drug Courts Program Office (DCPO), which is responsible for administering the federal drug court program under the Violent Crime Act; NADCP; and the Drug Court Clearinghouse, which provided us with general information that it had compiled on drug courts. To obtain more current and specific information on the drug court universe, we (1) did computerized searches of several on-line databases, including the National Criminal Justice Reference Service (NCJRS); (2) did key-word searches concerning drug court programs on the Internet; (3) sent a questionnaire to 134 of the 140 drug court programs identified as operating as of December 31, 1996;\7 and (4) held structured telephone interviews with state and drug court program officials throughout the United States to identify additional jurisdictions that, as of March 31, 1997, had an operating drug court program, were about to start a drug court program in 1997, were planning a program, or were doing a feasibility study of establishing a drug court program.

We received responses from all 134 drug court programs we surveyed. However, with the exception of some limited verification of information provided on the number of program participants admitted, terminated, graduated, and currently enrolled, we did not verify the accuracy of the data provided to us by the Drug Court Clearinghouse or by drug court programs. Appendix II contains a copy of our survey questionnaire, with summary responses to each question, as appropriate. In addition, we visited two drug court programs in Baltimore and attended several focus group meetings and drug court program conferences in 1996 and 1997 that were sponsored by DOJ; NADCP; State Justice Institute (SJI), a nonprofit organization created by federal law and funded through congressional appropriations, which among other things, has provided grants for evaluation studies of drug court programs; and the Justice Management Institute (JMI), a nonprofit organization that provides training, technical assistance, and other support for justice system agencies and courts in the United States and abroad.

To determine DOJ's responsibilities and plans for implementing the federal grant program and to obtain information on drug court program funding, we met with representatives of DOJ's Office of Justice Programs (OJP), including representatives from DCPO, who were responsible for administering grants under the Violent Crime Act and providing technical assistance and training to Violent Crime Act funded drug court programs; Bureau of Justice Assistance (BJA), who were responsible for administering other DOJ grants, including discretionary and formula block grants that have been used in support of drug court programs or evaluations; and National Institute of Justice (NIJ), who have been primarily responsible for DOJ's evaluation of drug court programs and who have also provided support for evaluation efforts in the drug court field. We also reviewed documents regarding these organizations' responsibilities and plans for implementing and monitoring the federally supported drug court program. We also sought and obtained funding information from HHS' CSAT, Housing and Urban Development's (HUD) Community Development and Block Grant Program, and SJI. In addition, we included a question on the survey sent to 134 of the 140 drug court programs identified as operating as of December 31, 1996, on the amount of funding received from federal, state/local, and private funding sources and fees collected from program participants. With the exception of some limited clarification of the reported sources and amounts of funding received by drug court programs, we did not verify the accuracy of the amount of funding from the various sources identified by the drug court programs.

To determine the approaches used, key characteristics, and completion and retention rates of existing drug court programs, we included in our survey questions on program approaches and characteristics such as when the program became operational; the types of participants eligible to participate;\8 and the numbers of persons who had been admitted, had completed, had failed to complete, and were actively participating in the program as of December 31, 1996. In addition, we interviewed officials from the Drug Court Clearinghouse and NADCP and reviewed documents regarding these issues.

To determine the extent to which program and participant data are maintained by and used to evaluate drug court programs, we included questions about whether the drug court programs had program monitoring, tracking, and evaluation capabilities, and about the types of data on program participants that were maintained and whether the data were computerized. We also spoke to representatives of DOJ's DCPO and BJA within OJP; CSAT, HHS; HUD; NADCP; and the Drug Court Clearinghouse about the guidance for these areas and reviewed the guidelines and standards they have provided.

To determine what conclusions could be drawn from existing published and unpublished evaluations or assessments of drug court programs, we first had to identify these studies. To do this, we used the same multistep process that we used to identify drug court programs. Additionally, in our survey, we asked respondents whether there had been any published or unpublished evaluations of their drug court programs, and if so, to send a copy of the report.

We collected and reviewed information from 20 published and unpublished evaluation studies that were written between 1991 and 1997 and covered 16 drug court programs that began operations between 1989 and 1996. (One program, in Broward County, FL, was covered by three independent evaluations; and two programs, in Dade County, FL, and Los Angeles County, CA, were covered by two evaluations.) A summary of the outcomes reported in the 20 studies and our assessment of them are contained in appendix III. The studies we reviewed represent all of the primary studies we could obtain in time for this report that included, in addition to a description of program operations, an evaluation component (i.e., some information on the outcome or efficacy of the drug court program in preventing relapse into drug use or criminal recidivism). In our search for these evaluation studies, we identified a variety of other published and unpublished documents that described program objectives and operations, provided judicial commentary on these programs, and, in some cases, provided a summary description of a number of programs. This fuller set of materials pertaining to drug court programs is provided in the bibliography.

We used a data collection instrument to systematically analyze and evaluate these studies in terms of the information they provided on program coverage (e.g., admissions criteria and participation rates), program operations (e.g., program length, treatment components, and completions rates), and program outcomes (e.g., drug use relapse and criminal recidivism). We did not attempt to independently verify the information provided in these studies. Each study was read and coded by a social scientist with training in research methods. A second social scientist and other members of our evaluation team then read the studies to verify the accuracy of the items included on the data collection instrument.

Our review was done from October 1996 to May 1997 in accordance with generally accepted government auditing standards. In June 1997, we provided a draft of this report to the Attorney General; the Administrator, Substance Abuse and Mental Health Services, HHS; the Executive Director of SJI; the President of NADCP; and the Project Director of the Drug Court Clearinghouse for their comments. Their written comments are characterized and evaluated in chapters 1, 2, and 5 and are reprinted in appendixes V, VI, VII, VIII, and IX of this report. In addition, all of the agencies and organizations provided some minor technical changes, which have been appropriately incorporated throughout this report.

-------------------- \7 We did not survey six drug court programs because they were not identified by information obtained from various sources as operating as of December 31, 1996, until after May 15, 1997. This was well after the completion of our survey of drug court programs.

\8 The categories used in our survey instrument to gather information on the type of violent offenders eligible to participate in drug court programs asked the survey respondents to use their jurisdiction's definition of a violent offense, which may or may not be the same as the federal definition of a violent offense as defined in the Violent Crime Act authorizing grants to drug court programs.

AGENCY COMMENTS AND OUR EVALUATION ---------------------------------------------------------- Chapter 1:8

In its written comments, HHS expressed concerns with the scope of our mandated study of drug court programs. HHS specifically noted that our study did not include an examination of the clinical aspects of drug court programs and opined that the rate at which drug court programs succeed in their purpose--reducing drug-related crime--is dependent on the quality and effectiveness of the substance abuse treatment provided as a part of the program. In addition, HHS urged that all future studies conducted under this mandate recognize the inter-dependency among the several participating disciplines.

While we recognize HHS's concerns, a review of the adequacy of the drug treatment component would have been well beyond the objectives and scope of this overview assessment of drug court programs.

NUMBER OF DRUG COURT PROGRAMS AND AVAILABILITY OF FUNDING HAVE INCREASED ============================================================ Chapter 2

There has been a substantial increase in the number of operating drug court programs in the United States and the availability of funding to support and/or evaluate such programs. Between 1989 and 1994, 42 programs were started.\1 Since then, the total number of operating programs has grown to 161 as of March 31, 1997. Moreover, the number of new drug court programs is expected to continue to grow, with an additional 154 programs identified as either about to start, being planned, or in the feasibility study stage as of March 31, 1997. On the basis of our analysis of data obtained from federal funding sources and drug court program officials, over $125 million has been made available to plan, implement, enhance, and/or evaluate drug court programs. Federal funding, which has increased substantially since 1993,\2 has provided over $80 million of the funding. Over 95 percent of the federal funding has been provided through federal grants administered by DOJ and HHS. In addition, drug court programs reported that about $45 million was provided by state and local governments, private sources, and/or fees collected from program participants since 1989.

-------------------- \1 This number, which is based on our independent survey and other sources, differs from the 36 drug court programs cited in our prior report (GAO/GGD-95-159BR) as started between 1989 and 1994, which was based on information obtained from the Drug Court Clearinghouse at the time.

\2 Although we did not analyze the extent of increases in state and local funding, it has also likely to have increased due to the requirements for matching funds associated with most federal grants.

GROWTH IN NUMBER OF DRUG COURT PROGRAMS ---------------------------------------------------------- Chapter 2:1

As figure 2.1 shows, the number of operating drug court programs has increased substantially since 1994. Between 1989 and 1994, 42 drug court programs had started. Since then, 4 have closed and 123 more have started, bringing the total number of operating programs to 161 as of March 31, 1997. An additional 32 drug court programs are expected to begin operating in 1997, which would bring the total to 193 operational programs by the end of 1997. Figure 2.2 shows the number of drug court programs started each year since 1989.

Figure 2.1: Increase in the Number of Drug Court Programs Between 1989 and March 31, 1997

(See figure in printed edition.)

Note: One drug court, which opened in 1989, closed in 1994; two drug courts, which opened in 1995, and one, which opened in 1996, closed during 1996. These drug courts closed due to lack of funding and/or because of state/local government decisions not to continue the programs.

Sources: GAO survey of drug court programs operating as of December 31, 1996, and information obtained from the Drug Court Clearinghouse.

Figure 2.2: Number of Drug Court Programs Started Between 1989 and March 31, 1997

(See figure in printed edition.)

Sources: GAO survey of drug court programs operating as of December 31, 1996, and information obtained from the Drug Court Clearinghouse.

As of December 31, 1994, drug court programs were operating in 17 states and the District of Columbia. As figure 2.3 shows, as of March 31, 1997, drug court programs were operating in 38 states, the District of Columbia, and Puerto Rico. About 40 percent of these programs were located in California and Florida.

Figure 2.3: Comparison of Drug Court Program Locations as of December 31, 1994, and March 31, 1997

(See figure in printed edition.)

(See figure in printed edition.)

Sources: GAO survey of drug court programs operating as of December 31, 1996, and information obtained from Drug Court Clearinghouse.

(See figure in printed edition.)

The growth in the number of drug court programs is likely to continue over the next few years. In this regard, our review revealed that an additional 154 drug court programs were identified as either about to start, being planned, or in the feasibility study stage as of March 31, 1997. Also, 8 of the 12 states without drug court programs and 1 additional U.S. territory (Guam) were either about to start, planning, or studying the feasibility of starting a drug court program. Appendix IV provides summary information on the status of drug court programs by jurisdiction as of March 31, 1997.

SOURCES OF AND INCREASE IN DRUG COURT PROGRAM FUNDING ---------------------------------------------------------- Chapter 2:2

Overall, our analysis of funding data and information obtained from various federal and nonfederal funding sources and funding data reported by drug court programs operating as of December 31, 1996, shows that since 1989, over $125 million in resources derived from federal, state, and local governments; private sources; and participant fees have been provided to plan, implement, enhance, and/or evaluate drug court programs.\3

According to our analysis of data obtained from federal funding sources and drug court program officials, federal funding sources, which have increased substantially since 1993, have provided over $80 million in funding.

Drug court programs we surveyed reported that about $45 million was provided by state and local governments, private sources, and/or fees collected from program participants since 1989. However, in commenting on a draft of this report, DOJ, NADCP, and the Drug Court Clearinghouse expressed the opinion that this amount may understate the actual amount of funding provided by state and local governments and other sources because some of the respondents to our survey may have failed to include the state/local jurisdictions' contributions towards the administrative cost of the program staff (judges, prosecutors, pretrial service staff, court clerks, program coordinators, etc.) and/or cost of program facilities (courthouse and other administrative facilities) that are often contributed by the local jurisdiction.

While several of the 134 drug court programs we surveyed were unable to provide precise funding data, as figure 2.4 shows, about 80 percent of the 134 drug court programs we surveyed, reported that they had received federal funding, over 80 percent reported receiving state/local government funding, and about two-thirds reported that they had collected funds from fees assessed on drug court program participants.

Figure 2.4: Percentage of Drug Court Programs Reporting Receiving Various Types of Funding

(See figure in printed edition.)

Source: GAO survey of drug court programs operating as of December 31, 1996.

-------------------- \3 The total amount of funding supporting drug court programs is likely understated because (1) some drug court programs we surveyed were not able to determine the amount of funding they received from federal, state, and local governments; private funding sources; and/or participant fees and (2) certain multipurpose federal funding sources, which did not specifically target drug court programs, had not been tracking the funding of drug court programs. In addition, information on the total amount of HHS CSAT' Block Grants for Prevention and Treatment of Substance Abuse and HUD's Community Development Block Grant funding that were awarded to jurisdictions and used to support drug court programs, as well as Medicaid funding that may have been used by drug court participants to pay for the cost of treatment, was not available from the federal funding source.

FEDERAL FUNDING HAS INCREASED -------------------------------------------------------- Chapter 2:2.1

The amount and sources of federal funding supporting drug court programs have increased substantially since fiscal year 1993. Before the establishment of a new grant program by DOJ and the passage of the Violent Crime Act, there were no specific federal grants for drug court programs. During this time, drug court programs were funded primarily by multipurpose federal grants from the Edward Byrne Memorial State and Local Law Enforcement Assistance\4 (Byrne block grant program) and Correctional Options Grants programs (a discretionary Byrne grant program) administered by BJA,\5 Block Grants for Substance Abuse Prevention and Treatment and other grants awarded by HHS' CSAT,\6 and SJI.\7 The amount of these federal grants supporting drug court programs totaled about $6 million.\8 Other funding was received from state and local governments, private sources, and fees assessed on program participants.

Beginning in fiscal year 1994, additional federal funding sources became available through the Comprehensive Communities Program (a discretionary Byrne grant program), the passage of the Violent Crime Act, and the Local Law Enforcement Block Grants program as authorized by the Omnibus Consolidated Rescissions and Appropriations Act of 1996 (P.L. 104-134). Additional funding was also made available from the previously mentioned federal grant programs and other funding sources. Excluding use of funds derived from HUD's Community Development Block

Grant program and Medicaid, administered by HHS,\9 the amount of additional funds made available from new and existing funding sources totaled about $75 million from fiscal year 1994 through March 31, 1997.

-------------------- \4 The Byrne program was first authorized in the Anti-Drug Abuse Act of 1986 (P.L. 99-570). Federal funding under this program consists of two discretionary programs and a formula block grant program that must be used to improve criminal justice systems in order to reduce violent crime, the demand for illegal drugs, or the availability of such drugs. Discretionary funds administered under this program can be used to, among other things, establish demonstration projects and fund correctional options programs. Under the Violent Crime Act, the Byrne program was authorized an additional $1 billion over fiscal years 1995 through 2000.

\5 BJA, a component of OJP, DOJ, is authorized by Congress to award discretionary grants to public and private organizations for national scope, demonstration, training, and technical assistance programs that strengthen the nation's criminal justice system and assist state and local governments in reducing and preventing violent crime and drug abuse.

\6 Under Title 42 (Sec. 290bb-4(a)) of the U.S. Code, the Director of CSAT is to provide grants to public and nonprofit private entities that provide treatment for substance abuse to individuals under criminal justice supervision.

\7 SJI reported that, in addition to funding other programs and initiatives, it provides grants to support drug court programs' operations and evaluations, which require a 50-percent match.

\8 Recipients of federal funds provided under some of these grant programs are required to provide anywhere from 10 to 25 percent in matching funds.

\9 We were unable to include information on the growth or decline in the use of these funds to support drug court programs because information was not available from federal funding sources responsible for administering these programs.

FEDERAL FUNDING SOURCES -------------------------------------------------------- Chapter 2:2.2

Federal funding intended specifically for drug court programs became available for the first time through DOJ's establishment of the Comprehensive Communities Program in fiscal year 1994.\10

In fiscal year 1995, DOJ's DCPO began administering the Violent Crime Act grants to state and local jurisdictions for drug court programs. One year later, the Local Law Enforcement Block Grants program as authorized by the Omnibus Consolidated Recissions and Appropriations Act of 1996 also made federal funds available for several purposes, including drug court programs.

-------------------- \10 Funding provided to support drug court programs under the Comprehensive Communities Program was derived from $1.2 million in funds transferred in late fiscal year 1994 from the Byrne program administered by DOJ's BJA, and $1.2 million in fiscal year 1995 funding that was transferred from DOJ's DCPO Violent Crime Act funding.

COMPREHENSIVE COMMUNITIES PROGRAM FUNDING ------------------------------------------------------ Chapter 2:2.2.1

In 1994, BJA, under its authority to make grants to states for, among other things, improving the functioning of the criminal justice system, began implementation of a comprehensive community program based on the crime control program in 16 U.S. jurisdictions. The objectives of the Comprehensive Communities Program are to, among other things, develop a comprehensive, multiagency strategy to control and prevent violent crime and drug-related crime and to coordinate existing federal, state, local, and private agency resources to maximize their impact on reducing violent crime and drug-related crime. Funding under this program was directed to be applied to seven local crime control and prevention initiatives, including the planning, implementation, or enhancement of drug court programs; alternatives to incarceration; and prosecution and diversion initiatives. In fiscal year 1994, a total of $1.2 million was awarded to six jurisdictions for drug court programs using discretionary Byrne funds, and in fiscal year 1995, a total of $1.2 million was awarded to six additional jurisdictions using Violent Crime Act funding.

VIOLENT CRIME ACT FUNDING ------------------------------------------------------ Chapter 2:2.2.2

As table 2.1 shows, Title V of the 1994 Violent Crime Act authorized $1 billion over 6 years (fiscal years 1995 to 2000) for drug court programs. Actual appropriations for the first 3 fiscal years have been less than the authorized amount. About $57 million of the $400 million authorized by Congress for the first 3 fiscal years was actually appropriated as of March 31, 1997.

Table 2.1

Schedule of the Violent Crime Act Grant Authorizations, Appropriations, and Awards\a

(Dollars in millions)

Fiscal year ------------------------------------------------------ 1995 1996 1997 1998 1999 2000 Total ------------------------ ------ ------ ------ ------ ------ ------ ------ Congressional $100.0 $150.0 $150.0 $200.0 $200.0 $200.0 $1,000 authorization .0 Congressional 11.9 15.0 30.0 n/a n/a n/a 56.9 appropriation DOJ/DCPO $8.2 $8.4 $16.7 n/a n/a n/a $33.3 awards -------------------------------------------------------------------------------- n/a = No funds were appropriated as of March 31, 1997.

\a As of March 31, 1997.

Sources: Public Law 103-322 and DOJ's DCPO.

Of the $57 million appropriated by Congress, in addition to the transfer of $1.2 million to the Comprehensive Communities Program in fiscal year 1995, DCPO, as of March 31, 1997, had awarded about $33 million in grants to over 150 jurisdictions to fund drug court programs.\11 DCPO can award three types of grants:\12

-- Planning grants are for those jurisdictions that are interested in establishing drug court programs and are in the early planning stage for that effort. In fiscal year 1995, a jurisdiction could receive up to $35,000 for a planning grant. For fiscal years 1996 and 1997, the maximum award was $20,000 per jurisdiction.

-- Implementation grants are for those jurisdictions that have already made a commitment to develop a drug court program and have already identified the target population to be served and the case processing procedures that will be used. The maximum award for implementation grants was $1 million for fiscal year 1995 and $400,000 for fiscal years 1996 and 1997.

-- Enhancement grants are for those jurisdictions with established drug court programs to improve or enhance existing services. The maximum award for enhancement grants was $1 million in fiscal year 1995 and $300,000 for fiscal years 1996 and 1997.

Table 2.2 summarizes grants awarded for this source of funding.

Table 2.2

Number and Amount of the Violent Crime Act Grants Awarded to Drug Court Programs, Fiscal Years 1995-1997

(Dollars in millions)

Fiscal year -------------------------------------------------------------- 1995 1996 1997\a Total -------------- -------------- -------------- -------------- Number Amount Number Amount Number Amount Grants Amount of awarde of awarde of awarde awarde awarde Type of grant grants d grants d grants d d d ---------------- ------ ------ ------ ------ ------ ------ ------ ------ Planning 52 $1.6 0 $0 79 $1.4 131 $3.0 Implementation 5 3.9 9 3.5 38 12.0 52 19.4 Enhancement 7 2.7 7 4.9 12 3.2 26 10.8 ================================================================================ Total 64 $8.2 16 $8.4 129 $16.6 209 $33.2 -------------------------------------------------------------------------------- \a As of March 31, 1997.

Source: DOJ's DCPO.

-------------------- \11 According to DOJ officials, the remaining funds were allocated for management and administrative purposes (at approximately 1 percent of the annual amount appropriated) and to fund technical assistance, training, and evaluations being sponsored by NIJ (at approximately 5 to 6 percent of the annual DCPO appropriation). In addition, DCPO plans to issue additional fiscal year 1997 drug court program awards of approximately $12 million during July-August 1997.

\12 Recipients of federal funds provided by DOJ's DCPO under the Violent Crime Act are required to provide at least 25 percent in matching funds from local sources. In-kind contributions may constitute a portion of the nonfederal share.

LOCAL LAW ENFORCEMENT BLOCK GRANTS PROGRAM ------------------------------------------------------ Chapter 2:2.2.3

The Omnibus Consolidated Recissions and Appropriations Act of 1996 authorized the Director of BJA to make funds available to units of local government under the Local Law Enforcement Block Grants program for the purposes of reducing crime and improving public safety. Grants awarded under this program could be for any of seven purpose areas, one of which was for establishing or supporting drug court programs. For fiscal year 1996, $503 million was appropriated for the Local Law Enforcement Block Grants program, but after deductions for legislatively mandated earmarks and program administration costs, $424 million remained available for distribution to eligible jurisdictions. Of this amount, about $14.5 million was awarded to 93 units of local government in 32 states for use by drug court programs.\13 In fiscal year 1997, $523 million was appropriated, of which about $467 million is available for distribution to eligible jurisdictions. DOJ plans to make grants to eligible jurisdictions in mid-1997, including grants to fund drug court programs.

-------------------- \13 Recipients of federal funds provided under a grant for the Local Law Enforcement Block Grants program are required to provide at least 10 percent in matching funds.

OTHER FEDERAL FUNDING SOURCES ------------------------------------------------------ Chapter 2:2.2.4

In addition to funding specifically designated for drug court programs, other multipurpose federal grants continued to be available and used to support drug court programs. These sources included additional funding totaling about $14 million made available in fiscal years 1994 through 1996 by DOJ under the Byrne block grant and Correctional Options Grants programs and about $8 million from a variety of HHS' CSAT grants for drug court programs that were made available between fiscal years 1994 through 1997, including one new grant initiative, the Criminal Justice Treatment Networks,\14 which provided initial funding in fiscal year 1995, and CSAT's Target Cities initiative, which provided initial funding in fiscal year 1993.\15

SJI, a nonprofit organization created by federal law and funded through congressional appropriations, has provided about $1.6 million in support of drug court program initiatives (primarily funding evaluation studies) since 1990. In addition, some drug court programs also reported receiving funds during our survey period that were derived from other federal funding sources (totaling about $2.1 million) that included, among others, about $104,500 in funds derived from HUD's Community Development Block Grant program and about $49,000 in Medicaid funds. As previously noted, the total amount of HUD grants and Medicaid resources used to support drug court operations was not directly available from either the funding sources or all of the recipients.

Excluding funding that may have been derived from HUD's Community Development Block Grant program and Medicaid, table 2.3 shows federal funding awarded to drug court programs from fiscal year 1990 to March 31, 1997. Fiscal years 1990 to 1993 funding totaled about $6 million, and fiscal year 1994 to March 31, 1997, funding totaled about $75 million.

Table 2.3

Summary of Federal Funding Provided to Drug Court Programs, Fiscal Years 1990- 1997

(Dollars in thousands)

Fiscal year ----------------------------------------------------------------------- Federal funding sources 1990 1991 1992 1993 1994 1995 1996 1997\a Total ------- ------ ------ ------ ------ ------ ------ ------ ------ ======= Departm ent of Justic e\b Byrne $188 $740 $263 $1,658 $2,041 $5,265 $4,532 0\c $14,687 block grants Compreh n/a n/a n/a n/a 1,200 1,200 0\d 0\d 2,400 ensive Commun ities Progra m Correct n/a n/a 500 999 1,100 690 370 n/a\e 3,659 ional Option s Grants Violent n/a n/a n/a n/a n/a 8,216 8,366 16,671 33,253 Crime Act Fundin g\f Local n/a n/a n/a n/a n/a n/a 14,455 0\h 14,455 Law \g Enforc ement Block Grants Departm ent of Health and Human Servic es\i

CSAT Grants for Substance Abuse Treatment in State and Local Criminal Justice System -------------------------------------------------------------------------------- D.C. n/a n/a n/a 799 0 2,307 0 430 3,536 Superi or Court Drug Interv ention Projec t Crimina n/a n/a n/a n/a n/a 1,800 2,568 0 4,368 l Justic e Treatm ent Networ ks

CSAT Grants for Treatment Improvement -------------------------------------------------------------------------------- Target n/a n/a n/a 20 310 578 275 0 1,183 Cities Grants State Justice Instit ute SJI 123 0 228 313 245 410 0 319 1,638 Grants \j ================================================================================ Total $311 $740 $991 $3,789 $4,896 $20,46 $30,56 $17,42 $79,179 6 6 0 -------------------------------------------------------------------------------- n/a = Funds for this program were not applicable during this fiscal year.

Note: The total noted above excludes about $2.1 million in federal funds that were derived from other federal sources not noted in the table. Also, funds provided by DOJ and other federal agencies that may have been used for evaluation, technical assistance, and/or training for drug court programs or officials may not be reflected in the totals. As a result, the total amount provided likely understates the total amount of federal financial support for drug court programs.

\a As of March 31, 1997.

\b Federal funds awarded by DOJ under its various grant programs must be used to supplement existing funds for program activities and not replace funds that have been appropriated for the same purpose.

\c DOJ did not provide information for fiscal year 1997 funding noting, that it is very unlikely that states have begun funding subgrantees, and that it would therefore give a very false impression of the level of funding for the fiscal year.

\d DOJ was unable to provide specific information on the amount of funding for this fiscal year. According to DOJ officials, BJA's Comprehensive Communities Program saw a significant reduction in funding in fiscal year 1996, with no significant increases anticipated in the future.

\e The Correctional Options Grants program was zeroed out in fiscal year 1996, and no additional funding was made available for fiscal year 1997. DOJ officials noted that no further federal support of this initiative is anticipated.

\f The Violent Crime Act also authorized funding for, among other things, program administration and management, technical assistance and training, and a federally funded impact evaluation of the drug court program.

\g Represents the estimated amount jurisdictions reported to DOJ as identified for drug court program use.

\h According to DOJ officials, fiscal year 1997 LLEBG awards will be made by the end of fiscal year.

\i CSAT also provided additional funding between fiscal years 1993 and 1997 totalling about $1.1 million under its authority to award grants for substance abuse treatment in criminal justice systems and its authority to issue Block Grants for Substance Abuse Prevention and Treatment. These grants were provided primarily for technical assistance, publications, and conferences/meetings, and is not included in the totals provided. Given jurisdictional discretion for awarding block grant funds received from CSAT, the total amount of funds awarded under CSAT's block grant program to various state and local jurisdiction was not available from either the funding source or the grant recipient and is therefore likely understated.

\j Grants awarded by SJI have been primarily awarded for efforts to evaluate drug court programs and to support judicial education programs about drug courts. Only small-scale planning, implementation, and enhancement projects have been supported through SJI technical assistance grants. (The 1995 funding included a $355,000 grant to support a National Symposium on Drug Courts conducted by the American University.)

Source: GAO analysis of information obtained from federal funding sources.

As figure 2.5 shows, information obtained from federal funding sources indicates that about 40 percent (or about $33 million) of the identified federal funding for these programs has been derived from the Violent Crime Act funding administered by DOJ's DCPO. Also, DOJ and HHS accounted for over 95 percent of the federal funding supporting drug court programs operations and/or evaluation studies.

Figure 2.5: Percentage of Federal Funding, by Source

(See figure in printed edition.)

Note: Percentages do not add to 100 percent due to rounding.

\a Byrne discretionary grant program.

Sources: GAO survey of drug court programs operating as of December 31, 1996, and information obtained directly from federal funding sources.

-------------------- \14 CSAT's Criminal Justice Treatment Networks focuses on the involvement of three clusters of the U.S. population: adult females, adult males, and juveniles. Funding has generally been provided to jurisdictions with the ability to participate in CSAT knowledge generation activities through cross-site evaluation efforts and contribution of data derived from these clusters.

\15 CSAT's Target Cities grants are intended to, among other things, further knowledge about treatment and facilitate early access to treatment.

STATE AND LOCAL GOVERNMENTS -------------------------------------------------------- Chapter 2:2.3

Respondents to our survey reported that over $38 million was provided by state and local governments.\16 A portion of this amount represents required state/local government matching of federal funds.

-------------------- \16 The total amount of state/local government funding supporting drug court programs is likely understated because some drug court programs were not able to determine the amount of funding they received from their state or local governments. In addition, 21 drug court programs who reported that they were receiving federal grants requiring matching funds did not report required state and local matching funds. We discussed this matter with DOJ officials and suggested that they follow up to determine whether these drug courts are in compliance with the matching requirements for federal funding. We plan to follow up on what actions DOJ has taken.

PRIVATE FUNDING -------------------------------------------------------- Chapter 2:2.4

Respondents to our survey reported that about $3 million of the drug court program funding came from private sources, such as grants/donations from foundations, corporations, or charitable organizations, etc.

PARTICIPANT FEES -------------------------------------------------------- Chapter 2:2.5

Sixty-five percent of drug court programs operating as of December 31, 1996, reported that they charged participant fees for some of the services provided. These programs reported that they assessed a variety of fees, with most assessing fees for drug treatment and drug testing that program participants are required to undergo. Among other things, drug court programs assessed fees to cover administrative and court processing costs, supervision, counseling, housing, and transportation. Some also assessed participant fees as penalties or incentives for improvement. In many of the drug court programs, the reported participant fee amount assessed varied, and in some cases, depended on the ability of the program participant to pay. The reported fees assessed on program participants varied within and across programs from $1 for drug testing in one program to a maximum program fee of $4,625 for certain higher income participants in another program. Participant fees accounted for about $2.5 million of the reported funding.

AGENCY COMMENTS AND OUR EVALUATION ---------------------------------------------------------- Chapter 2:3

In their comments on a draft of this report, DOJ, NADCP, and the Drug Court Clearinghouse expressed concern with our estimate of the proportion of drug court costs that were funded by the federal government. We reconsidered the information we had available to make that estimate, and decided in retrospect not to present the information in the same way. While we were able to derive what we believe to be reliable estimates of federal funds from federal funding sources, we were unable to derive direct estimates of state and local funds, except as they were reported to us by the drug court program officials we surveyed, which in some cases included judges, court administrators, program directors and managers, and/or state and local budget officials. Accordingly, we have deleted parts of our draft report that previously provided a comparative analysis on the proportion of federal funding among all drug court funds, and revised the presentation to focus on levels and sources of funding without comparing them directly to funds from other sources.

APPROACHES, CHARACTERISTICS, AND COMPLETION AND RETENTION RATES OF EXISTING DRUG COURT PROGRAMS WERE DIVERSE ============================================================ Chapter 3

Drug court programs identified as operating as of December 31, 1996, reported using various approaches. Although all the programs responding to our survey reported having a treatment component, results from a Drug Court Clearinghouse survey showed that the type and extent of treatment and rehabilitative services provided to drug court program participants varied among programs. In addition, drug court programs reported that they targeted various populations, including adults, women, juveniles, nonviolent and violent offenders, offenders with and without a substance addiction, first-time and repeat offenders, and probation violators. Drug court programs most frequently reported that program participants were adult, nonviolent offenders with a substance addiction. Since 1989, over 65,000 people were reportedly admitted to drug court programs in the United States. The completion rates for drug court program participants were reported to range from about 8 percent to 95 percent, and the retention rates ranged from about 31 percent to 100 percent.\1

-------------------- \1 "Completion rates" and "retention rates" are indicators commonly used in the drug court community to measure the impact of drug court programs. "Completion rates" refer to individuals who completed or were favorably discharged from a drug court program as a percentage of the total number admitted and not still enrolled. This measure is an indicator of the extent to which offenders successfully complete their drug court program requirements. "Retention rates" refer to individuals who are currently active participants in or have successfully completed a drug court program as a percentage of the total number admitted. This measure is an indicator of the extent to which a program has been successful at graduating or retaining offenders as active program participants in the program at the time of our survey. Although interrelated, both measures are helpful in assessing program performance. A program that had been operating consistently over a longer period of time would be expected to have similar completion and retention rates.

DRUG COURT PROGRAMS REPORTED USING VARIOUS APPROACHES TO PROCESS OFFENDERS ---------------------------------------------------------- Chapter 3:1

Some drug court programs responded that they deferred prosecuting (diversion) offenders who entered their program, some allowed offenders to enter their program after their case had been adjudicated, others used both approaches, and some used other approaches, including allowing offenders to enter their program on a trial basis after entering a plea. As figure 3.1 shows, about 44 percent of the drug court programs operating as of December 31, 1996, reported using a deferred prosecution (diversion) approach to adjudicate drug offenders, about 38 percent said that they use a postadjudication approach, about 10 percent said that they use both deferred prosecution and postadjudication, and about 8 percent said that they use the hybrid plea or some other approach.

Figure 3.1: Various Approaches Used by Drug Court Programs to Process Cases of Program Participants

(See figure in printed edition.)

Source: GAO survey of drug court programs operating as of December 31, 1996.

DRUG COURT PROGRAMS GENERALLY REPORTED VARYING TYPES AND RANGE OF TREATMENT SERVICES ---------------------------------------------------------- Chapter 3:2

All of the drug court programs responding to our survey reported having a treatment component as a part of the overall drug court program. Twenty percent of the drug court programs reported having a waiting list for treatment, and about 82 percent reported that participants generally start treatment within 7 days.

Our survey did not cover types of treatment. However, according to results from a 1997 survey conducted by the Drug Court Clearinghouse of drug court programs, the type and extent of treatment provided to program participants varied among drug court programs. The Drug Court Clearinghouse survey found that the range of treatment and rehabilitation services being delivered by drug court programs were expanding significantly. Treatment providers for 72 drug court programs that responded to the Drug Court Clearinghouse's survey generally reported using an array of substance abuse and individual rehabilitation services, including detoxification, stabilization, counseling, therapy, drug education, and relapse prevention.\2

Other services relating to personal and educational development, such as job skills and employment services, were reported as frequently provided after participants have responded to initial detoxification and stabilization. Housing, family, and medical services were also reported as being frequently available throughout the program. All but four of the reporting programs indicated the use of individualized client treatment plans for drug court participants.\3 About 40 percent of the programs responding to the Drug Court Clearinghouse survey reported that they also used acupuncture as an adjunct to treatment services.

According to the results of the Drug Court Clearinghouse's survey, drug court programs have also expanded their treatment and rehabilitation services to recognize the diversity of both treatment and other needs of program participants and to treat not only the participant's addiction but the numerous associated personal problems most participants encounter (e.g, physical, mental, housing, family, employment, self-esteem, etc.). Results from the Drug Court Clearinghouse survey show that some drug court programs have also established specific ethnic and/or cultural sensitive treatment components and have focused on special classes of defendants (e.g., pregnant women, mothers, fathers, and persons who have been sexually abused).

The Drug Court Clearinghouse survey also showed that drug court programs generally provided treatment in about three or more phases, with the most intensive phase occurring during the first 30 to 90 days. During this phase, program participants are usually subject to (1) frequent visits to a treatment provider, which some programs reported requiring a weekly visit, others three visits per week, and in some more extensive programs, four to five visits per week; (2) frequent drug tests, which some programs reported as required once a week and others twice a week; and (3) face-to-face contact with the drug court judge, which also varied among the programs from weekly to biweekly.

Drug court programs responding to the Drug Court Clearinghouse survey generally reported that, decreases and/or increases in the intensity and length of treatment services for a participant were usually determined by the treatment provider based on criteria similar to that used to make recommendations regarding the movement of participants from one program phase to another (e.g., drug test results, attendance at counseling sessions, and length of time in the program). The Drug Court Clearinghouse survey also showed that most drug court programs require a minimum period of participation and sobriety. Although this requirement also varied among programs, it was generally reported that at least 12 months of participation and being drug free for a period of at least 4 to 6 months was required for program completion.

-------------------- \2 Drug court programs responding to the Drug Court Clearinghouse survey generally reported that they did not maintain the capability to refer program participants to inpatient treatment for more than 30 days.

\3 About 40 percent of the programs indicated that they updated these plans every 30 days, 10 percent every 60 days, and the remaining 50 percent every 90 days.

DRUG COURT PROGRAMS REPORTED TARGETING A DIVERSE GROUP OF OFFENDERS ---------------------------------------------------------- Chapter 3:3

As table 3.1 shows, drug court programs responding to our survey reported targeting various types of offenders, including adults, women, juveniles, nonviolent and violent offenders, offenders with and without a substance addiction, first-time and repeat offenders, and probation violators. About 16 percent of the drug court programs we surveyed reported that juveniles were eligible to participate in their drug court program, about 6 percent allowed offenders with a current conviction for a violent offense, about 16 percent allowed offenders with a prior conviction for a violent offense,\4 about 17 percent allowed offenders without a substance addiction,\5 about 78 percent allowed repeat offenders, and about 63 percent allowed probation violators. However, drug court programs most frequently reported that eligible program participants were adult, nonviolent offenders with a substance addiction.

Table 3.1

Types of Participants Reported as Eligible to Participate in Drug Court Programs

Percent of drug court programs allowing Type of eligible program participants participation -------------------------------------------------- ------------------ Adult males 87 Adult women 88 Juveniles 16 Nonviolent offenders 93 Offenders whose current conviction 6 included a violent offense Offenders convicted of any 16 previous violent offense Offenders with a substance 96 addiction Offenders without a 17 substance addiction First-time offenders 84 Repeat offenders 78 Probation violators 63 Other types of offenders\a 8 ---------------------------------------------------------------------- \a These other types of offenders included child welfare, guardianship, neglect or abuse cases, and violators of court- ordered treatment.

Source: GAO survey of drug court programs operating as of December 31, 1996.

-------------------- \4 Our analysis of drug court programs' responses to our survey showed that about 10 drug court programs that reported receiving grant funds under the Violent Crime Act also reported that certain violent offenders, using their jurisdiction's definition of a violent offender, were eligible to participate in their programs. As discussed previously in this report, the act prohibits grants from being awarded to any drug court program that admits certain violent offenders. We discussed this matter with DOJ officials and plan to follow up with them on this issue.

\5 According to HHS officials and other drug court program stakeholders, persons admitted without substance addictions are likely to include persons with substance abuse problems who were not identified as being addicted during their initial screening. Also, some drug court programs target special populations who may not have a substance addiction. For example, the Jackson County, MO, drug court program, in addition to targeting others, targets prostitutes because of the likelihood that their drug abuse is the reason for their criminal behavior. Another program in Las Vegas, NV, targets parents or guardians of juveniles who have been identified as having a substance addiction.

REPORTED COMPLETION AND RETENTION RATES OF DRUG COURT PROGRAMS VARIED ---------------------------------------------------------- Chapter 3:4

Drug court programs responding to our survey reported that, as of December 31, 1996, 65,921 people had been admitted to drug court programs in the United States since 1989. As figure 3.2 shows, of the 65,921 people admitted, about 31 percent (20,594) had completed drug court programs, and about 24 percent (16,051) had failed to complete the program because they were terminated for various reasons, including drug relapse or criminal recidivism, or because they voluntarily withdrew or died while in the program.

Forty percent, or 26,465 offenders, were reported to be enrolled in drug court programs as of December 31, 1996. Of the 26,465 enrollees, about 25 percent, or 6,564, did not regularly attend the program or were wanted on bench warrants for failure to appear.\6 This rate is slightly lower than the 27-percent rate reported by DOJ for felony drug defendants released before case disposition who fail to make scheduled court appearances.\7

Three of the 134 drug court programs responding to our survey were unable to accurately account for the status of the remaining 4 percent, or about 2,800 offenders, due to loss of data files or inadequate recordkeeping systems. One additional drug court program was unable to provide information for program participants between 1993 and 1994.

Figure 3.2: Status of Drug Court Program Participants Admitted Since 1989, as of December 31, 1996

(See figure in printed edition.)

Note: Less than 1 percent or 100 drug court program participants died while in the drug court program.

Source: GAO survey of drug court programs operating as of December 31, 1996.

-------------------- \6 The median for the 128 drug court programs that were able to account for the status of enrolled program participants was 5 inactive participants; one drug court program accounted for about 1,200 of the 6,564 inactive enrollees.

\7 "Drugs and Crime Facts," 1994. DOJ, Bureau of Justice Statistics.

RANGE OF REPORTED COMPLETION AND RETENTION RATES -------------------------------------------------------- Chapter 3:4.1

As table 3.2 shows, the completion rates for program participants in 56 of the 62 drug court programs we surveyed that were operational as of December 31, 1996, for more than 18 months, ranged from 8 to 95 percent.\8 The average completion rate for these drug court programs was about 48 percent.

The retention rates for 131 of the 134 drug court programs we surveyed that were operating as of December 31, 1996, also varied--ranging from a low of about 31 percent to a high of 100 percent.\9 The average retention rate for these programs was about 71 percent. In comparison, the OJP Drug and Crime Working Group, in a January 1996 report, noted that available research findings indicated that relatively few individuals remained in drug treatment programs, in general, long enough to show reduced recidivism and other favorable treatment outcomes. The study also noted that persons who attended and remained in drug treatment programs for a sufficient length of time showed reduced recidivism and other favorable outcomes.

Table 3.2

Completion and Retention Rates of Drug Court Programs Operating as of December 31, 1996

Jurisdiction of Start Total offenders Completio drug court program date admitted n rate Retention rate ------------------ -------- ------------------ --------- ------------------- Birmingham, AL Jan. 150 n/a 89% (adult) 1996 Birmingham, AL Jan. 105 n/a 90% (juvenile) 1996 Mobile, AL Feb. 542 39% 52% 1993 Phoenix, AZ Mar. \a \b \b 1992 Little Rock, AR June 640 31% 42% 1994 Bakersfield, CA July 1,375 59% 66% 1993 Chico, CA June 375 34% 49% 1995 El Monte, CA July 87 69% 77% 1994 Fresno, CA March 825 n/a 93% 1996 Los Angeles, CA May 1994 404 39% 52% (adult) Modesto, CA June 78 22% 69% 1995 Oakland, CA Jan. 6,579 43% 48% (adult/Diversion 1991 Court) Oakland, CA 1,879 n/a 62% (adult/ Jan. postadjudication) 1995 Pasadena, CA May 1995 30 42% 63% Porterville, CA Apr. 107 n/a 78% 1996 Riverside, CA Sept. 98 n/a 66% 1995 Roseville, CA Sept. 49 n/a 71% 1995 Sacramento, CA Mar. 341 n/a 41% 1996 Salinas, CA July 125 n/a 50% 1995 San Bernardino, CA Nov. 267 65% 72% 1994 San Francisco, CA Mar. 282 32% 60% (adult) 1995 San Jose, CA Sept. 159 n/a 81% (adult) 1995 San Jose, CA Aug. 25 n/a 88% (juvenile) 1996 San Mateo, CA Oct. 304 n/a 47% 1995 Santa Anna, CA Mar. 74 71% 84% (adult) 1995 Santa Barbara, CA Mar. 86 n/a 57% 1996 Santa Maria, CA Mar. 98 n/a 60% 1996 Santa Monica, CA Jan. 75 n/a 35% 1996 Santa Rosa, CA Feb. 88 n/a 77% 1996 Stockton, CA July 357 n/a 44% 1995 Tulare, CA (adult) May 1996 45 n/a 78% Tulare, CA Oct. 147 n/a 62% (juvenile) 1995 Ukiah, CA Sept. 20 n/a 85% 1996 Ventura, CA Apr. 157 35% 61% 1995 Visalia, CA Mar. 31 n/a 32% (adult) 1996 Woodland, CA Mar. 577 35% 59% 1995 Yosemite National 31 68% 71% Park, CA Jan. (Federal Court) 1995 Denver, CO July 2,900 28%\c 68%\c 1994 New Haven, CT July 45 n/a 84% 1996 Dover, DE Apr. 84 n/a 87% 1996 Georgetown, DE Apr. 75 n/a 88% 1996 Wilmington, DE Oct. 980 61% 68% (adult) 1993 Wilmington, DE Sept. 99 n/a 91% (juvenile) 1995 Washington, D.C. Jul. 913 48% 51% (adult) 1994 Bartow, FL Dec. 377 29% 61% 1994 Crestview, FL Oct. 179 50% 65% 1993 Fort Lauderdale, June 4,378 72% 76% FL (adult) 1991 Gainesville, FL Mar. 259 18% 37% 1994 Jacksonville, FL Sept. 325 40% 65% 1994 Key West, Fl May 1993 162 82% 82% (adult) Key West, Fl April 22 n/a 100% (juvenile) 1996 Marathon, FL June 3 n/a 100% (adult) 1995 Marathon, FL May 1996 14 n/a 100% (juvenile) Miami, FL June 11,600 80% 73% 1989 Pensacola, FL June 440 46% 51% (adult) 1993 Pensacola, FL Feb. 30 n/a 93% (parents) 1996 Pensacola, FL April 35 n/a 86% (juvenile) 1996 Plantation Key, FL May 1995 4 n/a 100% (adult) Plantation Key, FL May 1996 24 n/a 75% (juvenile) Tallahassee, FL Jan. 375 77% 85% 1994 Tampa,FL (adult- June 492 67% 68% diversion) 1992 Tampa, FL 3,782 b b (adult- July postadjudication) 1994 Tampa, FL Feb. 88 n/a 89% (juvenile) 1996 Viera, FL Oct. 424 51% 70% 1994 Macon, GA Jan. 268 49% 70% 1994 Honolulu, HI Jan. 147 n/a 84% 1996 Cook County, IL Oct. 37 n/a 95% (juvenile) 1996 Edwardsville, IL March 104 n/a 64% 1996 Markham, IL March 875 62% 89% 1994 Rockford, IL Oct. 28 n/a 82% 1996 Gary, IN June 147 82% 88% (juvenile) 1995 Gary, IN (adult) Sept. 63 n/a 35% 1996 Lake County, IN Sept. 42 n/a 50% 1996 Terre Haute, IN Oct. 31 n/a 90% 1996 Des Moines, IA Sept. 28 n/a 64% 1996 Wichita, KS July 427 n/a 82% 1995 Louisville, KY July 281 33% 66% 1993 Baton Rouge, LA Jan. 567 67% 87% (adult) 1995 Baltimore, MD 827 53% 39% (adult-District) March 1994 Baltimore, MD Oct. 317 8% 44% (adult-Circuit) 1994 Dorchester, MA June 160 39% 71% 1995 Worcester, MA Feb. 57 n/a 72% 1996 Kalamazoo, MI June 306 37% 48% (females) 1992 St. Joseph, MI Oct. 1,884 \b \b 1991 Kansas City, MO Oct. 1,964 21% 35% 1993 Lexington, MO June 10 n/a 90% 1996 Missoula, MT Oct. 8 n/a 100% (juvenile) 1996 Las Vegas, NV Oct. 2,120 51% 55% (adult) 1992 Las Vegas, NV Apr. 195 63% 69% (juvenile) 1995 Reno, NV (family) Aug. 62 69% 82% 1994 Reno, NV (adult) July 438 n/a 74% 1995 Reno, NV July 30 n/a 80% (juvenile) 1995 Camden, NJ April 80 n/a 59% 1996 Albuquerque, NM Sept. 77 n/a 62% 1995 Las Cruces, NM 86 43% 69% (adult- April Magistrate) 1995 Las Cruces, NM 59 n/a 80% (adult- Dec. Municipal) 1995 Mesilla, NM April 19 50% 89% 1995 Brooklyn, NY June 258 n/a 72% 1996 Buffalo, NY Jan. 168 n/a 80% 1996 Rochester, NY Jan. 617 95% 83% 1995 Suffolk County, NY Sept. 62 n/a 90% 1996 Charlotte, NC Feb. 157 45% 73% 1995 Person/Caswell July 25 n/a 88% Counties, NC 1996 Raleigh, NC May 1996 32 n/a 66% Warrenton, NC Dec. 5 n/a 100% 1996 Winston-Salem, NC June 29 n/a 52% 1996 Akron, OH June 251 65% 75% 1995 Butler County, OH Sept. 25 n/a 80% 1996 Cincinnati, OH March 713 37% 73% 1995 Dayton, OH (adult) Jan. 57 n/a 77% 1996 Sandusky, OH April 12 n/a 92% 1996 Guthrie, OK March 40 33% 65% 1995 Stillwater, OK March 214 33% 52% (adult) 1995 Tulsa, OK May 1996 37 n/a 92% Eugene, OR Sept. 445 20% 31% 1994 Grants Pass, OR March 65 n/a 58% 1996 Klamath Falls, OR March 35 n/a 63% 1996 Portland, OR Aug. 3,194 45% 52% 1991 Roseburg, OR Jan. 72 n/a 78% 1996 Arecibo, PR April 69 n/a 100% 1996 Carolina, PR April 27 n/a 100% 1996 Ponce, PR April 107 n/a 96% 1996 Columbia, SC Nov. 12 n/a 75% 1996 Lexington, SC July 28 n/a 71% 1996 Austin, TX Aug. 618 49% 66% 1993 Beaumont, TX March 338 34% 49% 1993 Fort Worth, TX Sept. 102 n/a 76% 1995 Salt Lake City, UT Oct. 128 n/a 88% (juvenile) 1995 Salt Lake City, UT July 124 n/a 66% (adult) 1996 Roanoke, VA Sept. 109 n/a 81% 1995 Seattle, WA Aug. 512 25% 43% 1994 Spokane, WA Jan. 52 n/a 69% 1996 Tacoma, WA Oct. 209 35% 60% 1994 Madison, WI June 16 n/a 81% 1996 ================================================================================ Total/Average 65,921 48% 71% -------------------------------------------------------------------------------- Note: Completion rates (CR) were calculated by dividing the number of participants who have completed or were favorably discharged from a drug court program (G) by the number of participants who had been admitted (A) minus the number of participants actively (P) or inactively (NP) enrolled in the program; that is CR = G/(A-(P+NP)). Retention rates (RR) were calculated by dividing the sum of the graduates (G) and active participants (P) by the number of persons admitted; that is RR = (G+P)/A. In a few of the drug court programs, the completion rate exceeded the retention rate because of the number of persons enrolled but not actively participating (NP). For example, for the Dade County (FL) Drug Court program, where there were 11,600 persons admitted as of the time of our review, 7,770 persons who had graduated, 670 persons who were still actively participating, and 1,200 who were still enrolled but not actively participating, the completion rate was 80 percent (i.e., CR = (7,770/(11,600-(670+1,200))), while the retention rate was 73 percent (i.e., RR = (7,770+670)/11,600).

n/a = The drug court program had been operating for 18 months or less at the time of our survey, or 100 percent of the program participants reported as admitted were still active in the program.

\a We were unable to include a total for offenders admitted to this program because drug court program officials were not able to provide an accurate account of offenders admitted to this program between 1993 and 1994, and the status of those offenders due to a loss of data files and an inability to accurately recreate the information.

\b We were unable to calculate a rate because drug court program officials were not able to determine the total number of program participants who had either successfully completed, failed to complete program requirements, and/or were inactively enrolled in their drug court program as of December 31, 1996 (i.e., persons who did not attend or were wanted on bench warrants for failure to appear).

\c Rate provided may slightly underrepresent the true rate by about 1 to 2 percent because information provided by drug court program officials in response to our survey did not account for the status of 27 program participants identified as admitted.

Source: GAO analysis of data on program participants obtained from survey of drug court programs operating as of December 31, 1996.

-------------------- \8 Completion rates were not applicable for three of the programs because they had retained 100 percent of the program participants admitted at the time of our survey. For the remaining three programs, we were unable to calculate a completion rate because complete information on the status of certain program participants could not be provided by the drug court program surveyed.

\9 We were unable to calculate retention rates for three programs because complete information on the status of certain program participants could not be provided by the drug court program surveyed.

EXCEPT FOR FOLLOW-UP DATA, MOST DRUG COURT PROGRAMS REPORTED MAINTAINING AND USING SUGGESTED MANAGEMENT AND EVALUATION DATA ============================================================ Chapter 4

DOJ and HHS' CSAT, which have provided over 95 percent of the federal funding and/or support for drug court program operations, and the NADCP Drug Court Standards Committee\1 suggest that drug court programs collect and maintain certain data on participants both during and after their participation in the program to help manage and/or evaluate the program. Most of the drug court programs we surveyed reported that they collect and maintain most of the suggested types of data on program participants during their participation. However, about two-thirds reported that they did not collect and maintain follow-up substance abuse relapse data on program participants after they left the program, and almost half of these programs reported that they did not collect and maintain follow-up data on rearrest and/or conviction. Collaborative efforts among stakeholders in the drug court community have been undertaken to study the feasibility of and deal with obstacles associated with a recognized need in the drug court community to collect and maintain follow-up data, as well as other data, on drug court program participants.

-------------------- \1 The Drug Court Standards Committee consists of a diverse group of drug court practitioners and other experts from across the country, brought together by NADCP through a cooperative agreement with DOJ's DCPO. The committee includes representatives from courts, prosecution, public defense, treatment, pretrial services, case management, probation, court administration, and academia and others with drug court experience, including officials from DOJ's DCPO, NADCP, Drug Court Clearinghouse, and JMI. Among others, HHS' CSAT, ONDCP, BJA, and SJI provided information that was used to assist the committee in developing its guidance.

DOJ, HHS' CSAT, AND THE NADCP STANDARDS COMMITTEE GUIDELINES SUGGEST THAT DRUG COURT PROGRAMS MAINTAIN CERTAIN DATA ON PARTICIPANTS ---------------------------------------------------------- Chapter 4:1

DOJ's "Drug Court Grant Program Guidelines and Application Kit" issued in 1996 require recipients of federal funds under Title V of the 1994 Violent Crime Act to demonstrate the capability to ensure adequate program management through ongoing monitoring, tracking, and program evaluation. DOJ's "Drug Court Grant Program Guidelines and Application Kit" suggest that this be done through the design, implementation, and maintenance of an automated data collection system. The guidelines further suggest that the following information be collected and available for impact evaluations on drug court program participants and, to the extent possible, on similarly situated nonparticipants:

-- criminal justice history,

-- history of substance abuse,

-- level of use of controlled or addictive substances at the point of entry into the program,

-- data on substance abuse relapse while in the program,

-- data on rearrest and/or conviction for a crime while in the program,

-- completion/noncompletion of the drug court program,

-- follow-up data on substance abuse relapse after completing the program, and

-- follow-up data on rearrest and/or conviction for a crime after completing the program.

HHS' CSAT, in its 1996 guidance\2 addressing drug court programs, has adopted similar suggestions for collecting and maintaining data on program participants while in the program and, in its 1997 substance abuse treatment planning guidance, refers to DOJ's suggestion that drug court programs collect and maintain follow-up drug use relapse and criminal recidivism data. The NADCP Drug Court Standards Committee in its recently issued drug court program guide,\3 has also adopted similar suggestions, including suggesting that drug court programs collect and maintain data on drug use relapse and criminal recidivism of program participants after they leave the program.

As previously noted in chapter 1, unlike DOJ and HHS, which have provided over 95 percent of the federal funding and/or support for drug court program operations, NADCP has no statutory or regulatory authority over drug court program operations.

Recipients of grants awarded under the Violent Crime Act are also required to submit, in addition to financial reports, semiannual progress reports that describe activities during the reporting period and the status or accomplishment of objectives as set forth in the approved application for funding. These progress reports are due twice a year and must be submitted within 30 days after the end of the reporting periods, which are June 30th and December 31st for the award period. Recipients of HHS' CSAT grants are also generally required to submit quarterly progress reports in addition to required financial reports.

Similarly, recipients of grants awarded by DOJ under the Byrne formula block grant, Comprehensive Communities, and Local Law Enforcement Block Grants programs are required to submit semiannual progress reports and periodic financial reports. Also, recipients of SJI funds, which have been primarily used to study or pilot test innovative court initiatives, such as drug court programs, are generally required to submit quarterly progress reports in addition to required financial reports. However, no specific requirements or suggestions exist under any of these programs for grant recipients to demonstrate the capability to ensure adequate program management via ongoing tracking and monitoring and program evaluation through the collection and maintenance of specific data on drug court program participants, as suggested for recipients of Violent Crime Act funding. In commenting on a draft of this report, DOJ noted that, although the Byrne formula block grants and Local Law Enforcement Block Grants administered by DOJ contain an evaluation component, they do not have the statutory authority to compel the states or local jurisdictions to collect specific program data or to evaluate any particular program(s).

-------------------- \2 Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing, U.S. Department of Health and Human Services, 1996.

\3 Defining Drug Courts: The Key Components, January 1997, supported by a grant awarded by DOJ's DCPO and issued in May 1997 by DOJ's DCPO.

MOST DRUG COURT PROGRAMS REPORTED THEY MAINTAIN ALL BUT FOLLOW-UP DATA ON PARTICIPANTS ---------------------------------------------------------- Chapter 4:2

Over 90 percent of the 134 drug court programs we surveyed that were identified as operating as of December 31, 1996, reported that, with the exception of follow-up data on program participants, they maintained suggested program and participant data that enable them to manage and evaluate their programs. Two-thirds of the drug court programs reported not maintaining follow-up drug relapse data, and nearly half reported not maintaining follow-up data on rearrest and/or conviction for a crime once participants leave the programs. Our survey did not determine the reasons why such data were not collected. However, its results showed that no significant difference was associated with the source of funding (federal, state/local, private, etc.) received and the extent to which drug court programs were collecting and maintaining suggested follow-up data, including those federally funded under the Violent Crime Act, whose program guidance suggests that such data be collected and maintained. Additionally, results from our survey showed small and statistically insignificant differences in the likelihood of postprogram follow-up data on drug use relapse and/or criminal recidivism being collected and maintained between older and newer drug court programs.

About 94 percent of the drug court programs we surveyed reported having a data collection system or some other means in place that can be used to manage (monitor and track) their programs' operations. Regarding how drug court programs track and monitor program participants, about 19 percent of these drug court programs reported that they used a fully computerized data collection system, about 39 percent a partially computerized data collection system, about 15 percent some other noncomputerized means, and about 22 percent both computerized and noncomputerized means. The remaining 6 percent reported that they did not have any means for monitoring and tracking data on program participants.\4 About 93 percent of these programs reported that their data collection systems and/or noncomputerized means had been used to manage their programs.

About 70 percent of the programs operating as of December 31, 1996, reported having a data collection system in place that can be used to evaluate (i.e., assess/study) their programs' operations. About 67 percent of these programs reported that such systems had been used by internal program officials and/or external evaluators to evaluate their programs.

Table 4.1 summarizes the programs' responses and shows the extent to which the data are computerized by type of data.

Table 4.1

Percentage of Drug Court Programs that Reported Maintaining Data on Participants

Percent of Percent of these programs programs with maintaining computerized Data maintained data data ------------------------------------ -------------- ---------------- Program participants Demographic information 92 68 (e.g., age, gender, race, income, and education) Criminal justice history 94 70 (i.e., arrest and/or conviction record) History of substance 90 34 abuse (i.e., controlled or other addictive substances) Level of use of 90 33 controlled or other addictive substances at the point of entry into the program Substance abuse relapse 94 44 Rearrest and/or 90 60 conviction for a nondrug crime Completion/noncompletion 97 71 of the program Follow-up data Substance abuse relapse 33 31 Rearrest and/or 53 65 conviction for a nondrug crime ---------------------------------------------------------------------- Source: GAO survey of drug court programs operating as of December 31, 1996.

-------------------- \4 Percentages exceed 100 percent due to rounding.

FEASIBILITY ISSUES RELATING TO THE COLLECTION AND MAINTENANCE OF FOLLOW-UP DATA ---------------------------------------------------------- Chapter 4:3

Collaborative efforts among stakeholders in the drug court community have been undertaken to study the feasibility, cost, and obstacles associated with a recognized need by the drug court community stakeholders to collect and maintain follow-up data, as well as other data, on drug court program participants. For example, in March 1997, DOJ, through a cooperative agreement with JMI,\5 sponsored a focus group meeting involving various drug court stakeholders that focused on, among other things, the need for follow-up data to adequately monitor and evaluate the impact of drug court programs. During this collaborative effort--which involved, among others, federal grantors, drug court judges, program managers, treatment providers, researchers, and evaluators--stakeholders discussed, among other things, (1) how information (including follow-up relapse and recidivism data) could be obtained to answer key questions about drug court program impacts on participants' behavior and life circumstances, (2) circumstances in which it may be impossible or inappropriate to seek access to otherwise relevant data, (3) strategies for overcoming obstacles to obtaining relevant data, and (4) costs associated with collecting and maintaining such data. Also, during the May 1997, NADCP training conference in Los Angeles that was attended by about 1,500 drug court program judges, administrators, treatment providers, planners, and other stakeholders and interested parties, one of the nine daily sessions was devoted to data collection and program evaluation needs. During these sessions, participants discussed, among other things, the type of information that is needed and legal and other issues associated with the collection and maintenance of program data, including follow-up data on program participants' criminal recidivism and drug use relapse.

In addition, JMI, in doing a feasibility study to assist DOJ in its effort to sponsor multiple evaluations of four of the oldest operating drug court programs, concluded that it was feasible to do an evaluation focusing on offenders who entered these programs prior to 1997. Among other things, JMI concluded that data on new arrests and/or convictions should be "relatively easy to obtain," but that other outcome variables, such as drug use relapse after a participant left the program, would be more difficult to obtain. JMI did, however, suggest the following as possible sources of information on postprogram substance abuse by either graduates or persons terminated from a drug court program:

-- searches of criminal history records that may indicate whether an individual was ever subsequently arrested for a charge involving possession of a controlled substance;

-- searches of probation department files that may indicate whether an individual has had any subsequent presentence investigations or probation violation proceedings that show evidence of substance abuse;

-- state databases that may contain information on persons admitted to treatment programs, although JMI cautions researchers that these databases are more likely to contain information on drug use for an active program participant and little or no postprogram data; and

-- self-reported data obtained directly from former program participants.

However, JMI cautions researchers that obtaining reliable data on substance abuse, other than data obtained through drug testing while an individual is a participant in the program, is likely to be labor-intensive and fraught with methodological problems that will have to be addressed carefully. In addition, JMI notes that some criminal history data, which should be available in electronic form for both drug court participants and comparison group members from a combination of local, state, and the National Crime Information Center\6 databases, should be treated with caution. JMI reported that these records were often incomplete (particularly with respect to conviction) and could be misleading in assessing a program participant because it is not uncommon for a defendant to be arrested long after admission to the drug court program on a warrant relating to an incident that took place prior to program participation.

HHS' CSAT in its 1996 "Treatment Drug Courts," guidance highlights the importance of information sharing between the treatment program and the criminal justice system. However, CSAT also warns that, although the flow of information from the substance abuse treatment program to the criminal justice system and to the researcher/evaluator is critical, those planning or operating programs and research studies must keep in mind that federal laws and regulations protect information about all persons receiving alcohol and drug abuse prevention and treatment services (Title 42 (Sec. 290dd-2) of the U.S. Code and 42 C.F.R. Part 2).\7

DOJ DCPO is also developing a data collection instrument to collect specific information from drug court programs receiving federal funding under the Violent Crime Act. DOJ officials said that they intend to use the instrument to do semiannual progress reviews of these drug court programs. A draft of the data collection instrument intended to collect data during the semiannual reviews included a request for information on several of the data elements noted in table 4.1, including information on criminal recidivism and drug relapse by program participants after they leave the program.

As for comparative data, which we did not address in our survey of operating drug courts, HHS' CSAT in its 1996 guidance provides suggestions for doing comparative program evaluations. One approach suggested by CSAT is to develop quasi-experimental designs that allow for scientifically rigorous examination of outcomes. One type of quasi-experimental evaluation suggested by CSAT is a pre-post design, in which outcomes obtained following a participant's discharge from a drug court program are compared to those obtained prior to participation in the program. For example, a defendant's frequency of drug use, frequency of arrests, or length of time between arrests can be compared before and after admission to the program. CSAT cautions that a drawback to pre-post designs is that they do not take into account other factors that may contribute to the behavior changes they measure.

Another type of quasi-experimental evaluation noted in CSAT's guidance includes studies of one or more comparison groups. Using this design, results from an experimental and comparison group are contrasted. The guidance suggests that comparison groups consist of similarly situated substance abusing defendants who do not participate in (or who do not complete) the drug court program. Suggested as useful comparison groups are defendants placed on a drug court program waiting list, defendants who are eligible for but elect not to participate in the drug court program, or defendants who are discharged from the program prior to completion.

-------------------- \5 JMI is a nonprofit organization established in 1993. JMI provides technical assistance, education and training, research services, and dissemination of information for courts and other justice system agencies in the United States and abroad.

\6 The National Crime Information Center is a centralized, computerized criminal justice information system maintained by the Federal Bureau of Investigation consisting of a coordinated network of federal and state criminal justice information systems that provides users with access to records on various law enforcement matters such as wanted persons, stolen vehicles, and missing persons.

\7 Federal regulations prohibit disclosure of information regarding patients who have applied for or received any alcohol or drug abuse-related services, including assessment, diagnosis, counseling, treatment, or referral for treatment, from a covered program. Federal regulations apply only to programs that receive federal assistance, including organizations that receive indirect forms of federal aid such as tax-exempt status, or state or local funding coming (in whole or in part), from the federal government.

The federal confidentiality regulations permit programs to disclose patient identifying information to researchers, auditors, and evaluators without patient consent, providing that certain safeguards are in place. Research that follows patients for any period of time after they leave treatment presents a special challenge. Under federal regulations, no information that the researcher or evaluator gained from the substance abuse treatment program with the patient's consent or through the research, audit, and evaluation exceptions may be disclosed to anyone else. Yet the researcher must locate the patient to collect follow-up data. Federal regulations also prohibit making inquiries of persons associated with a patient being followed up that reveals the fact that he or she had been in treatment. To avoid doing so, researchers and evaluators trying to locate a patient must do so without disclosing to others any information about the patient's connection to substance abuse treatment, or they must obtain the patient's consent to do so.

Similarly, various state laws and regulations may also prohibit the disclosure of substance abuse client information that could violate their right to privacy.

CONCLUSIONS ---------------------------------------------------------- Chapter 4:4

Although the majority of the drug court programs we surveyed reported that they were maintaining most of the data that DOJ and NADCP suggested they maintain, nearly half of the drug court programs were not maintaining follow-up data on criminal recidivism and two-thirds were not maintaining data on drug use relapse. The extent to which programs were collecting and maintaining the suggested follow-up data did not differ based on funding source, including those funded under the Violent Crime Act, whose program guidance suggests that such data be collected and maintained. In addition, drug court stakeholders, led by DOJ, are beginning to recognize and study the feasibility, costs, and legal ramifications associated with collecting and maintaining information that is needed to adequately manage and evaluate drug court programs, including emphasizing the importance of having follow-up data on drug use relapse and criminal recidivism of program participants after they leave the program. These efforts and the results of our survey seem to indicate that it would be feasible for a drug court program to collect criminal recidivism data. They also indicate that, while collecting drug use relapse data may be difficult, it too is feasible in some cases. As discussed in chapter 5, without such data, it will be difficult for conclusions to be drawn in the future on the overall impact of drug court programs and their effect on program participants.

EXISTING EVALUATIONS PROVIDE SOME LIMITED INFORMATION BUT DO NOT PERMIT FIRM CONCLUSIONS REGARDING DRUG COURT IMPACT ============================================================ Chapter 5

The 20 evaluation studies that were available for us to review do not permit definitive conclusions to be reached concerning the overall impact of drug court programs or on the specific issues raised by Congress in the Violent Crime Act and our discussions with the Senate and House Judiciary Committees. The available studies revealed diverse programs that varied in terms of their eligibility and completion requirements, and in the nature, duration, and intensity of the treatment provided. Also, there were various differences and limitations in the objectives, scopes, and methodologies of these studies.

Partly as a result of the program differences and the differences in study methods, the studies did not provide consistent information from which conclusions could be drawn on the overall impact of drug courts. The authors of these evaluation studies were generally positive in their assessments of drug court operations and outcomes, but many of them portrayed their results as preliminary and tentative since the drug court programs evaluated were in many cases still in their infancy. This chapter provides a general description of the evaluation studies we reviewed, a summary of their principal findings, and our recommendations for subsequent impact evaluations. Additional details of these evaluation studies are provided in appendix III.

DESCRIPTION OF THE EVALUATION STUDIES ---------------------------------------------------------- Chapter 5:1

We collected and reviewed information from 20 published or unpublished evaluation studies written between 1991 and 1997. These studies covered 16 drug court programs that began operations between 1989 and 1996.\1 The studies we reviewed were primary studies we could obtain in time for this report that included, in addition to a description of drug court program operations, an evaluation component (i.e., some information on the outcome or efficacy of the drug court program in preventing relapse into drug use or criminal recidivism).\2

-------------------- \1 One program, in Broward County, FL, was covered by three independent evaluations; and two programs, in Dade County, FL, and Los Angeles County, CA, were covered by two evaluations.

\2 In our search for these evaluation studies, we uncovered a variety of other published and unpublished documents that described program objectives and operations, provided judicial commentary on these programs and, in some cases, provided a summary description of a number of programs. A bibliography of this fuller set of materials pertaining to drug courts is at the end of this report.

VARIOUS FACTORS PREVENT DRAWING FIRM CONCLUSIONS REGARDING DRUG COURT IMPACT ---------------------------------------------------------- Chapter 5:2

Based on the legislative requirements of Title V of the 1994 Violent Crime Act and discussions with the Senate and House Judiciary Committees, we focused on determining what conclusions could be drawn from an evaluation synthesis of the 20 studies on the impact of drug courts, particularly in relation to the following specific issues: (1) criminal profile of drug court program participants compared to similar offenders processed through the traditional adjudication system, (2) completion rates of drug court program participants, (3) differences in characteristics between drug court program completers and noncompleters, (4) sanctions imposed on persons who failed to complete drug court programs compared to those similarly situated but processed through the traditional adjudication system, (5) drug use and criminal recidivism rates\3 of program and nonprogram participants, and (6) costs and benefits of drug courts to the criminal justice system.

However, several factors prevent us from drawing firm conclusions about the impact of these drug court programs. First, the programs the studies evaluated differed considerably in several areas. Second, the studies themselves also differed in terms of their objectives, scopes, and methodologies. And third, the studies showed varying impacts of the drug court programs.

-------------------- \3 We use the term recidivism to refer generally to the act of committing new criminal offenses after having been arrested and/or convicted of a crime. In the evaluation studies we reviewed, this was typically measured by rearrest. Since only a small percentage of offenses result in rearrest, rearrest rates may underestimate the true recidivism rate.

EVALUATION STUDIES REVIEWED REVEALED DIVERSE PROGRAMS -------------------------------------------------------- Chapter 5:2.1

While all but three or four of the evaluation studies we reviewed involved drug court programs that were voluntary, and all of the programs included a treatment component, the programs described varied considerably in terms of eligibility requirements, percentages of eligible offenders who participated in and completed the programs, and the nature of the treatment that was provided program participants. The intended length of the various programs ranged from 5 months to 2 years, though participants in some of the programs where completion was dependent on progress might remain in them for shorter or longer periods. Although all of the programs appeared to involve judicial monitoring (e.g., appearances before the drug court judge) and drug testing, the frequency of appearances and testing appeared to vary substantially. There was also considerable variation in the treatment components of these programs, which included various combinations of drug education, individual and group therapy, acupuncture, attendance at AA, Cocaine Anonymous (CA), or NA meetings, educational and vocational training, and additional support services.

DIFFERENCES AND LIMITATIONS OF OBJECTIVES, SCOPES, AND METHODOLOGIES OF STUDIES -------------------------------------------------------- Chapter 5:2.2

The evaluation studies we reviewed also varied considerably in their objectives, scopes, and methodologies. All but one of the studies assessed the effectiveness of the programs by measuring the extent of drug use relapse and/or criminal recidivism among drug court program participants. Ten of the 19 studies, however, investigated these outcomes while offenders were still in the program, while the other 9 studies measured these outcomes after participants had completed, or been terminated from, the programs.\4 The studies that measured recidivism after program completion varied in terms of the length of follow-up, and in terms of how they measured recidivism; in some cases, studies described rearrests for any offense, in other cases, felony rearrests. Some studies provided data on rearrests for specific offenses (e.g., drug-related and violent offenses).

Twelve of the studies included information on comparison groups of drug offenders, and the nature of the comparison group varied across studies.\5 In some studies, drug court program participants were compared, over the same period, to persons who were eligible to participate but did not, while in other studies, participants were compared to offenders who had been arrested for drugs or other offenses at earlier points in time, before the drug court existed. In two studies, the equivalence of offenders in the treatment and comparison groups was enhanced by design or by random assignment to treatment and comparison groups. Many of the studies that did not control for differences between groups by design also made no attempt to statistically control such differences.

Only 6 of the 20 evaluation studies we reviewed involved a comparison group and an assessment of how participants and nonparticipant arrest rates compared after program completion. The use of comparison groups is standard in evaluation research, as is the assessment of treatment effects after program completion; such approaches may become more common in drug court program evaluations as these programs get better established.

To help ensure that differences in outcomes between drug court program participants and comparison groups are not due to selection effects, it is also essential that programs be evaluated in terms of what proportion of individuals eligible for the drug court programs actually participate in them, and how greatly they differ from individuals who choose not to participate in the programs. Differences in such characteristics must be controlled, statistically, in any analysis of differences in outcomes. Many of the studies that we considered did not include statistical controls.

Moreover, many of these studies only superficially considered the extent to which program participants complied with program requirements (e.g., attended treatment sessions, submitted required urine tests, and attended court hearings). To determine why some programs work better than others, and why some program participants succeeded in avoiding relapse and rearrest while others failed, we would have had to have more information on the extent of treatment that different program participants received.

Another factor that makes it difficult to reach definitive conclusions about the overall impact of drug court programs, or the six issues that have been raised about drug courts, is that it is unclear whether the 16 drug courts evaluated in the 20 studies we reviewed represent the entire population of drug courts now operating. Moreover, some of the studies provided only limited information on the issues raised; on some issues, some of the studies provided no information. Many studies, for example, said nothing about how offenders who failed to comply with program requirements or who were terminated from the programs were sanctioned. Most of the studies said nothing about how program completers differed from noncompleters and about the costs and additional benefits of the drug court program. Table 5.1 indicates which studies provided some information on the six questions or issues.

Table 5.1

Matrix of Studies Showing Which Study Provided Information on Congressional Issues

Q3: Differenc e between program completer Q5: Q1: Q2: s and Q4: Drug use Q6: Evaluatio Criminal Completio noncomple Sanctions and Program costs n study profile n rates ters imposed rearrest and benefits --------- --------- --------- --------- --------- --------- -------------- Maricopa X X X X County, AZ (Deschen es et al., 1996) Los X X X X X Angeles County, CA (Municip al Courts Planning and Research Unit, 1996) Los X X X Angeles County, CA (Deschen es and Torres, 1996) Oakland, X X X X X CA FIRST (Tauber, 1995) Santa X X X Clara County, CA (Peters, 1996) Ventura X X X X X County, CA (Oberg, 1996) Denver, X X X CO (Granfie ld and Eby, 1997) D.C. X X X Superior Drug Court (Harrell and Cavanagh , 1996) Broward X X X County , FL (Terry, 1993; Terry, 1996) Broward X X X X X County, FL (Commiss ion Auditor' s Office, 1995) Broward X X X X County, FL (McNeece and Daly, 1993) Dade X X X X County, FL (Goldkam p and Weiland, 1993) Dade X X X County, FL (Smith, Davis and Goretsky , 1991) Hillsboro X X X ugh County, FL (McNeece and Daly, 1993) Baltimore X X , MD (Gottfre dson, Coblentz , and Harmon, 1996) Clark X X X X County, NV (Choices Unlimite d Las Vegas, 1996) Multnomah X X X X X X County S.T.O.P. , OR (Drug Court Clearing house, American Universi ty, 1994) SODAT- X X X X X Delaware (Reed, 1995) Travis X X \a X X County, TX (Kelly, 1996) Jackson X X X X County, MO (Jameson and Peterson , 1995) -------------------------------------------------------------------------------- \a A subsequent report (April 1996) did provide information on completion rates based on the ethnicity of program participants.

Source: GAO analysis of drug court evaluation studies.

-------------------- \4 None of the 11 evaluation studies that noted that they had received federal funding included postprogram information on drug use relapse, and 7 of the 11 did not include information on postprogram criminal recidivism.

\5 Five of the 11 studies noting that they received federal funding did not include comparative data for similarly situated nonparticipants.

EVALUATION STUDIES REVIEWED SHOW VARIED RESULTS REGARDING DRUG COURT IMPACT -------------------------------------------------------- Chapter 5:2.3

Variation in the results reported in the different evaluation studies also makes it difficult to draw definitive conclusions about the outcomes of these drug court programs. Drug relapse, indicated by positive drug tests, was measured only during program participation, and different studies revealed relapse rates that ranged from 7 percent to about 80 percent for drug court program participants. Criminal rearrest recidivism rates ranged from 0 percent to 58 percent for drug court program participants. While four of the six studies that collected information on rearrests after program completion and compared program participants or graduates with nonparticipants showed lower rates for the former group, the other two studies showed either no difference or small and probably insignificant differences.

Although some of the studies were more sophisticated in their design and more rigorous in their methods, these studies did not appear any more or less likely than the others to indicate positive drug court outcomes. None of the studies we reviewed indicated that drug court offenders had significantly higher relapse and recidivism rates than offenders not handled in drug court programs. Those studies that provided information on the costs and benefits of these programs indicated that there were substantial cost savings and/or additional benefits (e.g., reducing the number of drug cases on traditional court dockets). However, none of the programs have been thoroughly and systematically evaluated in terms of costs and benefits, and more information would be needed on this, as well as on the longer-term likelihoods of relapsing and recidivating, before it can be firmly established whether these courts have diminished costs or simply delayed them.

GENERAL OUTCOMES REPORTED IN STUDIES RELATING TO SPECIFIC ISSUES RAISED ABOUT DRUG COURT PROGRAMS ---------------------------------------------------------- Chapter 5:3

We are unable to provide definitive answers to the six specific issues raised about drug courts based on information from existing evaluation studies. However, not all drug courts have been evaluated, and the 20 studies we reviewed did not in every case provide direct information that bears on the questions raised. Those studies that did provide information varied in terms of how that information was provided, and how much detail they offered. As such, the information provided in the following sections should be interpreted cautiously.

CRIMINAL PROFILE OF DRUG COURT PROGRAM PARTICIPANTS -------------------------------------------------------- Chapter 5:3.1

The evaluation studies varied in terms of how much detail they provided on the criminal profile of drug court program participants, and how similar or different participants were from drug offenders processed through the traditional adjudication system. However, all but one of the evaluation studies provided information on the admissions criteria of the drug court programs they studied. It appears that most of the programs covered in the studies excluded violent offenders, although one evaluation of the Dade County (FL) Drug Court program (Goldkamp and Weiland, 1993) revealed that the program had shown some flexibility in its admissions criteria, admitting some offenders who had prior arrests for serious crimes against persons. Most of the programs excluded offenders involved in drug dealing or trafficking, though the Travis County (TX) Drug Court was reported to have excluded only individuals involved in "significant" drug dealing. In at least one other program (Jackson County, MO, Drug Court), offenders involved in the sale of controlled substances under specified amounts were eligible to participate.

While many of the programs initially targeted first-time offenders with no prior drug or felony arrests, two programs admitted offenders with either an extensive history of arrests (D.C. Superior Drug Court) or a lengthy history of substance abuse (Santa Clara County (CA) Drug Treatment Court). It also appears that some of the courts that were initially quite restrictive have modified their admission criteria to include offenders with prior offenses or offenses that originally resulted in exclusion from the drug court program.

While these admission criteria make it likely that drug court participants are less serious offenders than other drug offenders who do not participate in drug court programs, only a few of the evaluation studies provided comparative information that directly bears on that question. Usually, this information involved a comparison of characteristics of offenders eligible for the drug court program who chose to participate with offenders who chose not to participate, or who were on probation. For example, the Baltimore City (MD) Drug Treatment Court evaluation reported that participants were historically more frequent offenders compared to other eligible probationers. In addition, the Ventura County (CA) Drug Court study indicated that participants were similar, demographically and in terms of drug offenses committed, to offenders who were not accepted into the program.

From the limited evidence provided, it appears that the characteristics of drug court program participants and differences between them and offenders processed in the traditional courts may vary from court to court. Some types of offenders are ineligible for many of the drug court programs, and in the many programs that are voluntary, some of the eligible offenders decline to participate. While the authors of at least one of the evaluation studies noted that drug court participants may be a very selective group of offenders (and therefore quite different from nonparticipants), few of the studies provided a clear indication of what percentage of eligible offenders chose to participate. One study indicated that most of the eligible offenders who were represented by private attorneys opted not to participate in the drug court program.

DRUG COURT PROGRAM COMPLETION RATES -------------------------------------------------------- Chapter 5:3.2

Many of the drug court programs evaluated were still in their first or second year of operation, and many of the offenders who had been admitted to the drug court programs were still active in them. As such, it is difficult to assess what the completion rate of these programs will eventually be, based on these existing evaluation studies. We do provide information derived from our survey on the completion rates for 56 of the 62 drug court programs identified as operating, as of December 31, 1996, for more than 18 months, in chapter 3.

Some of the evaluation studies we reviewed provided information on completion rates for participants who had entered drug court programs a year or more before the study was done, and enough time had lapsed for a reasonably accurate completion rate to be calculated. For example, one of the Broward County (FL) Drug Court studies reported a completion rate of 39 percent for the 787 persons who entered the program in its first year, and another of the Broward County (FL) studies provided data which, when adjustments are made for persons still active in treatment, yields a completion rate of 35 percent over 3 years. The Oakland (CA) (F.I.R.S.T) Drug Court Program study indicated that 54 percent of a sample of drug court program participants admitted during 1991 had successfully completed it.

Based on information available in existing studies, we were able to estimate the completion rates for eight of the remaining programs that provided data on cohorts of participants, among whom many were still active. We calculated a completion rate by deleting the currently active participants and dividing the number who successfully completed the program by the number who were admitted to it (and were not still enrolled). This is consistent with the method we use in chapter 3 to calculate completion rates for drug court programs identified as operating as of December 31, 1996, for more than 18 months. For these programs, completion rates varied from less than 1 percent to more than 70 percent, and averaged about 43 percent. This calculation of the average may underestimate eventual completion rates for the newest programs in which most persons admitted were still enrolled. Completion rates are likely to vary substantially across programs because some programs appeared to be more tolerant of relapses, rearrests, and program noncompliance than others. It is also possible that completion rates may change over time if, for example, these programs were to modify their eligibility criteria, as some have appeared to do after their first year or two of operation.

DIFFERENCES BETWEEN PROGRAM COMPLETERS AND NONCOMPLETERS -------------------------------------------------------- Chapter 5:3.3

Because of the newness of many of these programs and the substantial numbers of offenders recently admitted and still active in them, it is difficult to assess what distinguishes program completers from noncompleters. In some of the programs, many of the noncompleters opted out of the program after beginning it, while in others many of the noncompleters were persons who failed to comply with program requirements (e.g., attending treatment sessions), repeatedly relapsed (e.g., failed drug tests), or were rearrested during their participation in the program.

Only a few of the evaluation studies provided information on differences between offenders who completed the programs and those who did not. The Ventura County (CA) Drug Court Program reported that males and Hispanics were less likely to complete the program. One of the Broward County (FL) Drug Court studies suggested that African-Americans were less likely than others to complete treatment, which was required for program completion. A similar finding was reported in the SODAT-Delaware, Inc., Drug Court Program study, which also indicated that blacks and whites with less severe drug problems were more likely to complete treatment and to graduate, and that program completion was slightly higher for men and for participants who were older, better educated, and employed. The Clark County (NV) Drug Court program study generally indicated no differences in termination rates between ethnic groups and between male and female participants. This same study, however, indicated that termination rates were higher for participants entering the program under the influence or in possession of a controlled substance, particularly cocaine and amphetamines, and that participants 40 years old and over had higher completion rates. One of the Los Angeles County (CA) Drug Court studies also indicated that older participants were more likely to complete the program and that married participants had higher completion rates as well. The same effects of age and marital status were reported in the Multnomah County (OR) S.T.O.P. Program, which also suggested that program completers were more likely to be residentially stable, to have a longer history of drug use, and to more consistently attend treatment sessions. Some of these differences are small and are likely to be statistically insignificant. Moreover, multivariable analysis would have to be undertaken to discern whether some of these variables had no affect when other variables were controlled.

PROGRAM SANCTIONS -------------------------------------------------------- Chapter 5:3.4

Many of the evaluation studies we reviewed said little or nothing about what happens to program participants who fail to comply with program requirements and participants who were terminated from the drug court programs. From the information that was provided in some of the studies, it appeared that how drug court programs responded to relapse and rearrest varied considerably across the programs, as did sanctions for program noncompliance (e.g., failing to show for tests or treatment sessions).

The Broward County (FL) evaluation study by McNeece and Daly indicated that most participants who were rearrested or violated probation were not terminated but were allowed to remain in the program unless a nondrug offense was committed, such as assault. The evaluation study of this same program by the Commission Auditor's Office, however, stated that arrests for driving while under the influence of alcohol or drugs or cannabis possession, or for any felony during participation, resulted in immediate termination. This latter study also indicated that limits had been established with respect to the number of positive drug tests during participation (seven) and the number of missed treatment sessions or court appearances (three). The Santa Clara County (CA) study also indicated that a participant could be terminated for positive drug tests, though it did not indicate how frequently this occurred.

The Oakland (CA) (F.I.R.S.T.) Drug Court study indicated that failure to appear at scheduled hearings could be sanctioned by incarceration for at least 1 week, after which the participant would be reinstated. Only two reinstatements were permitted before participants were to be terminated and had to undergo criminal proceedings. The Denver (CO) Court study noted, without providing specific information, that a "carrot and stick" approach is used "whereby the court uses graduated sanctions in response to violations and grants rewards for program compliance." The Los Angeles County (CA) Drug Courts study by the Planning and Research Unit also alluded to the use of "progressively severe sanctions," which could include incarceration, and noted that termination would result in reinstatement of the original criminal charges and prosecution. The evaluation of this same drug court program by Deschenes and Torres indicated that in all four drug courts in Los Angeles County, offender relapse did not necessarily lead to dismissal from the program.

The Baltimore City (MD) Drug Treatment Court study also noted that incarceration was used to sanction program noncompliance, as did the Travis County (TX) Drug Diversion Court and Maricopa County (AZ) evaluations. The Ventura County (CA) Drug Court study indicated that new crime charges, three positive drug test samples, and other acts of noncompliance could result in termination and offenders being returned to serve their sentences. The Dade County (FL) Drug Court study by Goldkamp and Weiland indicated that "motivational jail" terms of up to 2 weeks were sometimes used to sanction offenders for program noncompliance.

RELAPSE AND RECIDIVISM RATES -------------------------------------------------------- Chapter 5:3.5

Ideally, responding to issues raised by Congress and others and addressing the efficacy of drug court programs would be more effectively determined by following up on participants and nonparticipants (i.e., eligible offenders who chose not to participate) for some period after they leave the program to see if they committed new crimes or relapsed into drug use. Overall, the evaluation studies we reviewed showed some positive results but did not firmly establish whether drug court programs were successful in reducing drug relapse and offender recidivism. Many of the studies involved very short follow-up periods. Some calculated relapse and/or recidivism rates only for program participants, and only for the period during which they were participating in the program. Others compared rates of recidivism or relapse for program participants and program dropouts or with offenders whose arrests occurred prior to the inception of the program.

Drug relapse was less frequently measured in these evaluation studies than recidivism or rearrests and was only measured (by positive drug tests) during the period of program participation. Relapse rates were sometimes calculated by taking the percentage of offenders tested who had one or more positive drug tests, and at other times by taking, for each group tested, the percentages of positive tests out of all tests taken or out of all tests scheduled. In one case, the percentage of offenders in each group testing positive in the month before sentencing was calculated. There was substantial variation across the studies that provided information on drug tests; some showed that fewer than 10 percent of drug tests were positive, or that less than 10 percent of participants tested positive, while others showed that as many as 80 percent of the offenders tested had positive tests.

Recidivism rates were typically calculated by taking the percentage of offenders rearrested in a particular (and widely varying) period, but in one or two cases by taking the mean number of arrests or bench warrants per offender. Table 5.2 classifies each study according to whether it measured recidivism only for program participants or for participants and a comparison group of nonparticipants, and whether recidivism was measured only during program participation or after.

Table 5.2

Evaluation Studies Classified According to Whether They Included Comparison Groups and When They Measured Recidivism

Comparison group? Recidivism measured ---------------------------- ------------------------------- Evaluation During study Yes No program After completion ------------- -- ------------- ------------- ------------- ---------------- Los Angeles x x County, CA (Municipal Courts Planning and Research Unit, 1996)

Los Angeles x x County, CA (Deschenes and Torres, 1996)

Broward x x County, FL (McNeece and Daly, 1993)

Broward x x County, FL (Commission Auditors Office, 1995)

Clark County, x x NV (Choices Unlimited Las Vegas, 1996)

Multnomah x x County S.T.O.P., OR, Drug Court Clearinghouse , American University, 1994)

SODAT- x x Delaware (Reed,1995)

Maricopa x x County, AZ (Deschenes et al., 1996)

Oakland, CA, x x F.I.R.S.T. (Tauber, 1995)

Santa Clara x x County, CA (Peters, 1996)

Ventura x x County, CA (Oberg, 1996)

Denver, CO x x (Granfield and Eby, 1997)

D.C. Superior x x Drug Court (Harrell and Cavanagh, 1996)

Broward x x County, FL (Terry, 1993; Terry, 1996)

Dade County, x x FL (Smith, Davis, and Goretsky, 1991)

Dade County, x x FL (Goldkamp and Weiland, 1993)

Baltimore, x x MD (Gottfredson, Coblentz, and Harmon, 1996)

Jackson x x County, MO (Jameson and Peterson, 1995)

Travis x x County, TX (Kelly, 1996) -------------------------------------------------------------------------------- Note: The Hillsborough County (FL) Court study did not measure recidivism. Program effectiveness was measured by asking participants about the program. All participants reported that they were satisfied, and 96 percent found the program to be effective.

Source: GAO analysis of drug court program evaluation studies.

Four of the studies looked at the effect of the program by assessing outcomes during the program for participants, without providing information on a comparison group of nonparticipants. The Los Angeles County (CA) study by Deschenes and Torres found that a sample of graduates and current participants gave high ratings to the program, and self-reported lower rates of drug use and criminal behavior after entering the program than before. The Broward County (FL) evaluation study by McNeece and Daly indicated that of the roughly 1,000 offenders who entered that program in 1992 (half of whom were still active), 11 percent had been rearrested or incarcerated or had bench warrants issued for their arrest, and that 52 (16 percent) of the 323 offenders tested for drugs had tested positive on one or more occasions. The other two studies, the SODAT-Delaware Program and the Multnomah County (OR) Program, compared program participants or graduates with participants who had been terminated and found that the participants or graduates had fewer positive drug tests and/or rearrests or bench warrants issued during their participation in the program than those terminated.

Three of the studies looked at the effect of the program by assessing outcomes after the program for participants, without providing information on a comparison group of nonparticipants. The Broward County (FL) study by the Commission Auditor's Office, which looked at outcomes both during and after program completion, found that, for a small sample of program graduates, positive drug tests declined with time in treatment, and that, while 20 percent had been rearrested while participating in the program, only 10 percent had been arrested after graduating from the program. The Clark County (NV) study revealed that only 6 percent of program graduates had been arrested on new charges since their release, though the time at risk of rearrest for these graduates was not clear. The Los Angeles County (CA) study by the Municipal Courts Planning and Research Unit found that 11 percent of the program graduates had been arrested after completing the program. Here too, it was not clear how long they were at risk of rearrest.

Six of the studies looked at the effect of the program by assessing outcomes during the program for participants and a comparison group of nonparticipants. Five of the six studies measured rearrests; two of these studies compared rearrests for participants to rearrests for offenders eligible to participate who did not (the Santa Clara County and Ventura County, CA, studies), and three of them made comparisons to groups of offenders from earlier periods the Denver (CO) Drug Court study, the Jackson County (MO) study, and the Dade County (FL) study by Smith, et al.). Four of these five studies found lower rearrest rates among participants, while one study found no significant differences. One of these five studies (the Santa Clara County (CA) study) also reported fewer positive drug tests among the participants. At the time of our review, the sixth study, involving the D.C. Superior Court, did not measure rearrests. However, it found that participants randomly assigned to the drug court treatment program were less likely to test positive for drugs than those in the standard docket during the month before sentencing but more likely to test positive than a third group of offenders randomly assigned to a graduated sanctions docket.

The remaining six studies all employed comparison groups and considered rearrests after program completion. Four of these studies found lower rearrest rates for program participants or graduates than for the comparison groups of nonparticipants, after 6 months (Baltimore City (MD)), 12 months (Travis County (TX)), 18 months (the Dade County (FL) report by Goldkamp and Weiland), and 3 years (the Oakland (CA) F.I.R.S.T. study). Two of them, however, found either no difference or small and probably insignificant differences, in one case after 12 months (Maricopa County (AZ)), and in the other case after 25 to 37 months (the Broward County (FL) report by Terry).

PROGRAM COSTS -------------------------------------------------------- Chapter 5:3.6

None of these studies included a systematic cost/benefit analysis. However, several of them indicated that the drug court programs accrued some savings and enabled traditional courts to better handle violent and other serious criminal offenders. Whether there are long-term savings will depend on how many of the drug court participants end up on probation or in prison after their participation.

One of the Broward County (FL) Drug Court studies reported that the average treatment cost to produce program graduates ranged from $3,215 to $5,834 and compared favorably to the cost of a typical 6-month jail sentence ($8,400). The Oakland (CA) (F.I.R.S.T.) Drug Court study reported that, largely because of the fewer days in custody spent by program participants, a conservative estimate of the savings to the county over the 3-year study period would be $3.0 million. The Denver (CO) Drug Court study estimated a savings of between $1.8 and $2.5 million per year due to decreased presentence confinement. The SODAT-Delaware Drug Court study reported that the cost of treating 219 drug offenders was equivalent to keeping 8 offenders in prison for 1 year. The Ventura County (CA) Drug Court Program, Multnomah County (OR) S.T.O.P. Program, and Jackson County (MO) Drug Court Program studies also suggested there had been cost savings due to reduced incarceration costs. The only study that provided information on costs and did not indicate that savings resulted from the program was the Maricopa County (AZ) First Time Drug Offender Program study, which concluded that the cost of program participation was roughly comparable to the cost of standard probation.

DOJ AND DRUG COURT COMMUNITY EFFORTS MAY HELP TO PROVIDE SOME DEFINITIVE ANSWERS ---------------------------------------------------------- Chapter 5:4

DOJ and others in the drug court community have efforts ongoing that are expected to address some of the factors associated with existing studies that did not permit us to draw firm conclusions about the impact of drug courts.

Under Section 2209, Part V of the 1994 Violent Crime Act, the Attorney General may make arrangements for evaluations of drug court programs that receive grant support from DOJ's DCPO. In carrying out this authority, DOJ's NIJ, in April 1997, issued a solicitation to fund two to four evaluations of four of the oldest existing drug court programs. These evaluations of specific drug court programs are intended to incorporate many of the elements that we have found lacking in a number of the studies we reviewed, including data on comparison groups of nonparticipants; follow-up data; survey data to supplement rearrest records; and data on program implementation, compliance, completion, and costs; and study methods that are to control statistically for differences between program participants and offenders in the comparison groups in assessing program outcomes.

These evaluations of specific drug court programs are intended to take place in two phases, with each phase lasting approximately 1 year. Topics to be discussed under phase I include criminal recidivism, descriptive, historical, and attitudinal data. During phase I, researchers are also expected to develop detailed design plans for answering questions in phase II. Topics to be discussed under phase II include participant retention in treatment, changes in participants' life circumstances and productivity, and cost/benefit analysis. DOJ also plans for the scope of these evaluations to include follow-up information on drug-use relapse of program participants after completion or termination from the program.

In addition to the NIJ studies, as previously mentioned in chapter 4, DOJ's DCPO is developing an instrument to collect information from Violent Crime Act funded drug court programs to help DOJ monitor their progress in various areas, including the collection of follow-up and other data on program participants. Furthermore, drug court community stakeholders have recognized the need for, and are taking some action to encourage the collection of, follow-up data for monitoring and doing future impact evaluations of drug courts.

CONCLUSIONS ---------------------------------------------------------- Chapter 5:5

A substantial number of evaluation studies of drug court programs have been done. However, due to the newness of the programs at the time of the evaluations; the diversity in the programs; and the differences and limitations in the objectives, scopes, and methodologies of these studies, we cannot draw any firm conclusions from our evaluation synthesis on the overall impact/effectiveness of drug courts. For the same reasons, we cannot reach firm conclusions about specific aspects of drug court programs or specific questions about program participants. The studies we reviewed varied in terms of the amount of information they provided and showed varied results about the impact of drug court programs in general, as well as with regard to the specific issues raised by Congress about program operations and participants. Some studies showed positive effects of the drug court programs during the period offenders participated in them, while others showed no effects, or effects that were mixed, and difficult to interpret. Similarly, some studies showed positive effects for offenders after completing the programs, while others showed no effects, or small and insignificant effects. Drug relapse was less frequently evaluated in these studies than rearrests, and estimates of relapse rates varied substantially. None of the studies, however, showed any adverse effect from participation in the drug treatment program.

As we noted above, some variation in the results of these studies might be due to the differences in how the studies were conducted. It is also possible, however, that variation in results across different drug court programs may result from the fact that drug court programs target different populations, operate differently, and some are more successful in producing positive outcomes than others. We believe that, until follow-up data on relapse and criminal recidivism for participants and nonparticipants are collected across a broad range of programs, it will not be possible to respond to issues raised by Congress and others or to reach firm conclusions about whether drug court programs work, or whether some work better than others. With such data, and additional data on program operations and treatment characteristics, researchers would be in a better position to rigorously analyze how drug court program outcomes are affected by participant and program characteristics.

As discussed in chapter 4, although most drug court programs reported that they had the capability to demonstrate adequate program management through ongoing monitoring and tracking of program operations and that they were maintaining most of the data DOJ, CSAT, and the NADCP Drug Court Standards Committee suggested they maintain, nearly half of the programs were not maintaining follow-up data on rearrests, and about two-thirds were not maintaining data on relapse. In addition, many of the evaluation studies we reviewed did not include follow-up information on rearrest and none on relapse after participants left the program, including some that were federally funded. Many of them also lacked comparative data on similar offenders who did not participate in the program. Without such data, it will be difficult to draw conclusions in the future on the overall impact of drug court programs and their effect on program participants.

We recognize the difficulties inherent in collecting follow-up data on criminal recidivism and particularly drug relapse, as well as comparable data on nonparticipants. Drug court program participants, and comparable nonparticipants, may move to other jurisdictions following the completion of the program, or after completing their sentence, and may be difficult to follow. Neither group can be expected to volunteer for drug tests to determine relapse after they have left the court's purview, and arrests for new drug offenses are fallible measures of drug relapse (since not all drug offenses or criminal offenses generally result in arrests), just as arrests are fallible indicators of criminal recidivism in general. Ultimately, drug court programs may have to be quite innovative in their strategies for collecting such data and may need to resort to sampling and surveying participants and nonparticipants. The more that different sources of data are brought to bear on the question of drug court efficacy, the more likely firm conclusions can be made about those questions.

We also recognize that the need for and benefits of having data must be balanced against the cost of collecting and maintaining it, as well as against any logistical and legal implications, including existing statutory limitations. Nevertheless, if meaningful impact evaluations are to be done in the future on the growing number of drug courts, more of them must collect and maintain data on factors affecting program operations and outcomes, including data on participants after they leave the program. Further, whether drug court programs are effective would be demonstrated more definitively by following up on participants and nonparticipants (i.e., eligible offenders who chose not to participate) for some period after they leave the program to see if they committed new crimes or relapsed into drug use.

In addition to its planned evaluations of selected drug court programs, DOJ, in conjunction with various stakeholders in the drug court community as noted in chapter 4, is undertaking efforts that are expected to address some of the factors associated with existing studies that did not enable us to draw firm conclusions. However, the outcomes of these efforts and any future evaluations of drug court programs may be hindered by the lack of available follow-up data. Drug court programs currently are not required to collect such data, and studies of drug court programs generally are not required to assess participants' postprogram recidivism or drug relapse or compare participants with similar nonparticipants. Moreover, certain statutory restrictions may limit DOJ's authority to require drug court programs receiving funding from formula or block grants to collect critical follow-up data.

RECOMMENDATIONS ---------------------------------------------------------- Chapter 5:6

To help ensure more effective management and evaluation of drug court programs, we recommend that the Attorney General and the Secretary of HHS

-- require drug court programs funded by discretionary grants administered by DOJ and HHS to collect and maintain follow-up data on program participants' criminal recidivism and, to the extent feasible, follow-up data on drug use relapse; and

-- require drug court programs funded by formula or block grants administered by DOJ and HHS, to the extent permitted by law, to collect and maintain follow-up data on program participants' criminal recidivism and, to the extent feasible, follow-up data on drug use relapse. Where no statutory authority exists to impose such requirements, we recommend that DOJ and HHS include in their respective grant guidelines language to suggest that drug court programs funded by these sources similarly collect and maintain such data.

To better ensure that conclusions about the impact of drug court programs on participants' criminal recidivism and/or drug use relapse can be drawn, we recommend that the Attorney General, the Secretary of HHS, and the Executive Director of SJI require that the scope of future impact evaluations of drug court programs funded by their respective agencies include an assessment of program participants' postprogram criminal recidivism and drug use relapse and, whenever feasible, compare drug court participants with similar nonparticipants.

AGENCY COMMENTS AND OUR EVALUATION ---------------------------------------------------------- Chapter 5:7

Agencies and other organizations commenting on a draft of our report generally agreed with our findings, conclusions, and recommendations relating to the collection and maintenance of follow-up data on program participants and impact evaluations of these programs. However, DOJ, SJI, and NADCP raised some concerns with our recommendations.

DOJ expressed concerns about its ability to impose mandatory requirements on congressionally authorized entitlement grants--formula or block grant programs. DOJ said that drug courts are among many programs that can be funded under the BJA Byrne formula block grant and Local Law Enforcement Block Grants programs. Although BJA requires an evaluation component for all programs funded through formula grants and supports these efforts through an array of policies and practices, BJA does not have statutory authority to compel states to collect specific program data or to evaluate any particular program or programs.

Given DOJ's concerns about its authority, we have modified our recommendations for data collection and maintenance to accommodate any statutory limitations that may be associated with formula and block grant programs. In response to DOJ's comment relating to drug court program evaluations, we modified our recommendation to make it clear that we are recommending that DOJ require the scope of any evaluations of drug court programs funded by grants administered by DOJ to include an assessment of program participants' postprogram drug relapse and criminal recidivism and not that DOJ require drug court programs or states to evaluate such outcomes.

Similarly, SJI expressed concerns about its ability to impose requirements on programs for which it only provides short-term funding, commenting that there are practical limitations associated with how much of the recommended information can be collected under any SJI grant. SJI officials noted that they have sponsored two ongoing drug court program evaluations that are attempting to collect short-term recidivism data, but commented that obtaining a more thorough and meaningful assessment of recidivism and relapse data would require a much longer grant period and, accordingly, a much larger grant than SJI resources permit.

We acknowledge SJI's efforts to collect short-term recidivism data. However, adequately designed evaluation studies should enable longer term recidivism and drug use relapse data to be obtained by assessing postprogram outcomes of drug court participants who have already completed a drug court program(s). Such an approach should better enable evaluators receiving short-term funding to gather more long-term research data without having to monitor or follow the progress of currently enrolled program participants and then subsequently assessing the outcome of the participants 12 to 24 months after completing the program.

SJI also notes that once a grant-supported project ends, SJI can encourage the jurisdiction operating the drug court to maintain the requisite data, but it no longer has the authority to require it. We are not recommending that SJI require any drug court program and/or jurisdiction funded by an SJI grant to collect or maintain follow-up data on drug court program participants. Rather, we recommend that SJI require that the scope of any future impact evaluations of drug court programs that are funded by SJI grants include postprogram data on criminal recidivism and drug use relapse, which we deem to be critical elements to providing Congress and other interested parties with answers to questions relating to drug court program impact and effectiveness.

DOJ and NADCP also indicated that one of the difficulties associated with our recommendation that evaluations of drug court programs include follow-up data and comparison groups is the lack of ongoing technical assistance and sufficient resources available to drug court programs to enable them to develop the capacity for data collection and program evaluation. NADCP stated that drug court programs and courts in general often lack the resources, funding, and expertise to both collect and evaluate program data and pointed out that it will be necessary either to provide funding for professionally implemented evaluations or to assist local jurisdictions in developing the capabilities to do them. DOJ noted that ongoing technical assistance and guidance in the area of data collection and evaluation are greatly needed in the drug court community and that DOJ must address these technical assistance needs if drug court programs are to be expected to develop the capacity for data collection and to produce effective impact evaluations. DOJ reiterated that it has taken a number of steps to develop the capacity for data collection and evaluation among its drug court grantees, and DOJ stated that it will work with Congress to increase its funding for technical assistance.

Although we identified various sources of technical assistance available to the drug court community and guidelines suggesting that certain data on program participants be collected, maintained, and made available for future impact evaluations, we did not systematically review and cannot comment on the sufficiency and adequacy of technical assistance and related resources that are currently being provided to drug court programs or research evaluators planning to do future impact studies.

NADCP and the Drug Court Clearinghouse also commented that, while it may be too early to reach firm conclusions, results from our survey and evaluation synthesis in their views permit a more positive conclusion about drug court programs than we arrive at in our report. NADCP stated that the data from our survey, from the evaluation studies we reviewed, and from more recent unpublished preliminary findings involving the Maricopa County (AZ) and D.C. Superior Court drug court programs, were consistent with a preliminary finding that drug court programs are having a positive impact. As evidence of this, NADCP offered information on (1) the numbers of studies, overall and among those that employed comparison groups, that showed positive results; (2) the numbers of studies that reported cost savings; and (3) the retention and completion rates derived from our survey, which NADCP asserts favorably compare with other programs in the treatment community. The Drug Court Clearinghouse pointed out that the average retention rate for drug court program participants, resulting from our survey of 134 operating programs, is significantly higher than program retention rates noted for nondrug court program participants and that the average completion rate, also coming from our survey of these programs, is more than twice that encountered in traditional treatment programs. The Drug Court Clearinghouse also noted that it is important to draw on additional evaluative measures to assess societal benefits drug court programs are achieving in addition to reductions in recidivism and drug usage. As evidence, the Drug Court Clearinghouse stated that over 400 drug-free babies have been reportedly born to drug court program participants; that families have been reunified, including situations in which former drug-using parents have regained custody of their children; and that drug court program graduates are required to have at least a high school diploma or general equivalency degree certificate.

We note in this report that many of the studies we reviewed provide positive evidence of the merits of drug court programs. We do not believe, however, that all of these studies are equally sophisticated in their design and methods, or that the results of these studies can be simply summed to provide firm conclusions. Many of these studies are lacking in comparison groups, and those that include them are often lacking in necessary statistical controls between groups compared, or lacking follow-up data. Therefore, we continue to believe that the shortcomings associated with many of the evaluations of drug court programs that have been done provide good reasons for withholding final judgment on the overall effectiveness of drug court programs and aspects of the program until more and better data are collected and additional evaluation studies are completed.

FLOWCHART OF TWO DRUG COURT APPROACHES =========================================================== Appendix I

(See figure in printed edition.)

\a Judges may reward progress and impose sanctions for noncompliance with program requirements.

Source: Drug Court Clearinghouse.

(See figure in printed edition.)Appendix II SURVEY OF DRUG COURT PROGRAMS =========================================================== Appendix I

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

OUTCOMES REPORTED IN AND GAO'S ASSESSMENT OF AVAILABLE EVALUATIONS OF DRUG COURT PROGRAMS ========================================================= Appendix III

MARICOPA COUNTY FIRST TIME DRUG OFFENDER PROGRAM (DESCHENES ET AL., 1996) ------------------------------------------------------- Appendix III:1

PROGRAM START DATE --------------------------------------------------- Appendix III:1.0.1

1992.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:1.0.2

The program was limited to first-time offenders convicted of drug possession or use (not selling) and sentenced to 3 years of probation. Participants were randomly assigned to one of four groups: (1) the drug court program, which involved testing, treatment, and sanctions; (2) standard probation with no drug testing; (3) standard probation with random monthly drug tests; and (4) standard probation with testing scheduled biweekly.

PARTICIPATION RATE --------------------------------------------------- Appendix III:1.0.3

Participation was determined by random assignment. Of the 176 persons assigned to the drug court program, only 19 (11 percent) never received the drug court program.

PROGRAM LENGTH --------------------------------------------------- Appendix III:1.0.4

Six to 12 months.

PROGRAM COSTS --------------------------------------------------- Appendix III:1.0.5

The drug treatment court program costs were similar to the costs of standard probation, which were estimated at $2,795 per offender per year; the original first-time drug offender drug court cost was $2,541 per offender per year, but under a new contract with Maricopa County Adult Probation, it increased to $2,926 per offender per year.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:1.0.6

The drug court program was designed to include status hearings before the drug court judge every 2 months, but the judge could increase or decrease the frequency of hearings at each hearing. It was also designed to include at least one drug test per month, though anecdotal evidence suggests that tests were not done on a scheduled basis, and averaged one test every 2 months. The treatment program consisted of three phases (orientation, stabilization, and transition) and included drug education, social skills training, relapse prevention, and attendance at 12-step meetings and process group meetings.

GRADUATION RATE --------------------------------------------------- Appendix III:1.0.7

At the end of 12 months, 18 percent were still active in the program; among those not still active, 49 percent had graduated and were discharged from the program. The primary reasons for failing to complete the program were technical violations, new arrests, bench warrants, and absconding. Some of the offenders with technical violations or arrests may have returned to the program later, as technical violations and arrests do not necessarily mean they were terminated from the program.

EVALUATION --------------------------------------------------- Appendix III:1.0.8

Our 1995 report\1 described an earlier version of this evaluation, which at that time involved a 6-month follow-up and showed no significant differences across groups in rearrest rates and technical violations. This evaluation shows similar differences (or lack of differences) after 12 months. Thirty-one percent of the drug court program group had been rearrested versus 30 percent to 37 percent in the standard probation groups. Thirty-nine percent of the drug court program group were involved in technical violations versus 40 percent to 55 percent in the standard probation groups. While the likelihood of at least one technical violation did not differ across groups, the average number of technical violations for the drug court group was lower than for the other three groups. Roughly half of the offenders in each group involving drug tests tested positive at least once over the 12-month period.

-------------------- \1 GGD-95-159BR.

ASSESSMENT --------------------------------------------------- Appendix III:1.0.9

The design here, involving random assignment to groups that varied in terms of testing and treatment, is quite strong. These results, especially those involving recidivism, fail to establish strong effects of testing and treatment. Part of the reason for this may be due to the fact that the various programs were not always implemented as designed.

LOS ANGELES COUNTY DRUG COURTS (LOS ANGELES COUNTY MUNICIPAL COURTS PLANNING AND RESEARCH UNIT, 1996) ------------------------------------------------------- Appendix III:2

PROGRAM START DATE --------------------------------------------------- Appendix III:2.0.1

Los Angeles Municipal Court, May 1994; Rio Hondo Municipal Court, July 1994; Pasadena Municipal Court, May 1995; and Santa Monica Unified Municipal and Superior Court, January 1996.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:2.0.2

The drug court program was restricted to nonviolent felony drug offenders. Defendants charged with drug trafficking or sales, or who had prior convictions for those offenses, were not eligible.

PARTICIPATION RATE --------------------------------------------------- Appendix III:2.0.3

Participation was voluntary. No information was provided on the percentage of eligible offenders who chose to participate.

PROGRAM LENGTH --------------------------------------------------- Appendix III:2.0.4

At least 12 months.

PROGRAM COSTS --------------------------------------------------- Appendix III:2.0.5

No information was provided.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:2.0.6

Program participants made frequent appearances before a designated judicial officer and were subject to random drug testing. The three-phase treatment program included individual and group counseling, attendance at 12-step programs such as NA, and vocational and educational guidance.

GRADUATION RATE --------------------------------------------------- Appendix III:2.0.7

Between May 1994 and June 1996, 413 offenders were admitted to the drug court program. One hundred sixteen offenders were still in the program. Of the remaining 297 offenders, 86 (29 percent) graduated, and the others were terminated. Married participants and participants between the ages of 40 and 49 were the most likely to complete the program. Information provided in the report suggests that terminations were more frequent in 1994 than in 1995 and 1996. Dismissal from the program resulted in reinstatement of the original criminal charges and prosecution.

EVALUATION --------------------------------------------------- Appendix III:2.0.8

No information was provided on drug relapse, and no comparisons are made to program nonparticipants. To describe recidivism, the report compares the first 47 defendants who graduated from the Los Angeles Drug Court program to a group of 47 defendants who were terminated from the program. Five of the 47 (11 percent) graduates had been rearrested, compared to 30 of the 47 (64 percent) offenders who were terminated.

ASSESSMENT --------------------------------------------------- Appendix III:2.0.9

Comparisons of graduates and nongraduates are of limited value. This particular comparison is difficult to assess because no information was provided on whether the two groups were at risk of rearrest for the same amount of time and whether rearrest was a factor in terminations.

LOS ANGELES COUNTY DRUG COURTS (DESCHENES AND TORRES, 1996) ------------------------------------------------------- Appendix III:3

PROGRAM START DATE --------------------------------------------------- Appendix III:3.0.1

See Planning and Research Unit report, 1996 (above).

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:3.0.2

See Planning and Research Unit report, 1996 (above).

PARTICIPATION RATE --------------------------------------------------- Appendix III:3.0.3

Like the Planning and Research Unit report, 1996 (above), this report notes that the program was voluntary, but provides no information on the percentage of eligible offenders who chose to participate.

PROGRAM LENGTH --------------------------------------------------- Appendix III:3.0.4

While the Los Angeles County Municipal Courts Planning and Research Unit report on these same drug courts indicates that the program length was 12 months, this report indicates that the treatment might have been as short as 6 months. See Planning and Research Unit Report, 1996 (above).

PROGRAM COSTS --------------------------------------------------- Appendix III:3.0.5

No information was provided.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:3.0.6

See Planning and Research Unit report, 1996 (above).

GRADUATION RATE --------------------------------------------------- Appendix III:3.0.7

This report states that 504 offenders were admitted to the 4 Los Angeles County drug courts between May 1994 and May 1996. It does not disclose how many offenders were participating at the time the report was written, nor does it allow an accurate estimate of graduation rates. It does note that there were 64 graduates at the time the study began and that the termination rate was relatively high. It also notes that there were a myriad of sanctions available for program noncompliance, that sanctions were progressive, and that all four courts seemed to be tolerant of relapse among participants.

EVALUATION --------------------------------------------------- Appendix III:3.0.8

This evaluation looks at a subsample of 35 individuals from among 79 current program participants and 16 graduates interviewed by the authors. Self-reported drug use and criminal behavior were found to be significantly higher in an unspecified number of months before entering the program than after entering the program. Also, both graduates and current participants gave high ratings to the drug court program.

ASSESSMENT --------------------------------------------------- Appendix III:3.0.9

The sample employed here is primarily representative of current program participants, and the number of graduates for whom data were collected (n = 16) is too small to generalize. The evidence provided is preliminary, based on potentially biased self-reports, and insufficient to establish program effectiveness.

OAKLAND (F.I.R.S.T.) DRUG COURT (TAUBER, 1995) ------------------------------------------------------- Appendix III:4

PROGRAM START DATE --------------------------------------------------- Appendix III:4.0.1

Fall 1990.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:4.0.2

The program targeted felony drug defendants. There was no information about whether certain offenders were excluded.

PARTICIPATION RATE --------------------------------------------------- Appendix III:4.0.3

Participation in drug diversion was statutorily mandated for defendants in California who were eligible. In January and February of 1991, 87 percent of defendants referred were granted diversion.

PROGRAM LENGTH --------------------------------------------------- Appendix III:4.0.4

The diversion term was 24 months, and the treatment component of the diversion program appeared to involve roughly 5 months.

PROGRAM COSTS --------------------------------------------------- Appendix III:4.0.5

This report states that a conservative estimate of savings to Alameda County law enforcement agencies during the 3-year study period would be $3,000,000. Two-thirds of this savings was accounted for by the 33,869 fewer days in custody spent by program participants. Also noted was that the County Sheriff's Department was able to rent unused jail cells to San Francisco and the U.S. Immigration and Naturalization Service at $60.80 per day.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:4.0.6

The program consisted of three phases: phase 1 (3 days) involved diversion placement, phase 2 (2 months) involved intensive evaluation and supervision, and phase 3 (3 months) involved supervision and treatment. During phase 2, offenders were required to attend five group probation sessions, take three urine tests with negative results, and attend four drug education and one AIDS class. During phase 3, offenders were required to attend eight group probation sessions and to meet individually with the probation officer twice, to take four urine tests with negative results, and to participate in community counseling for 8 weeks.

GRADUATION RATE --------------------------------------------------- Appendix III:4.0.7

Fifty-four percent of a sample of drug court program participants admitted during 1991 successfully completed the program and earned diversion dismissals. The only reason indicated for program failure was failure to appear for report hearings, which could be sanctioned by incarceration for at least 1 week, after which the participant was reinstated. Only two reinstatements were permitted before termination from the program. Terminees had criminal proceedings reinstated.

EVALUATION --------------------------------------------------- Appendix III:4.0.8

The first 110 defendants referred to the F.I.R.S.T. Diversion Program in January and February of 1991 were compared to the first 110 defendants referred to diversion between January and March of 1990, before the F.I.R.S.T. Program. Relapse rates are not reported, but after 3 years the average number of new felony arrests per defendant was 44 percent lower for the F.I.R.S.T. Program participants (.75 per defendant versus 1.33 per defendant), and the average number of days in custody on felony offenses was 44 percent lower as well (44 days versus 78 days).

ASSESSMENT --------------------------------------------------- Appendix III:4.0.9

While the length of follow-up is considerably higher here than in most studies, it is not clear how similar the two groups of divertees being compared were on characteristics relevant to recidivism, and there was no information on drug relapse.

SANTA CLARA COUNTY DRUG TREATMENT COURT (PETERS, 1996) ------------------------------------------------------- Appendix III:5

PROGRAM START DATE --------------------------------------------------- Appendix III:5.0.1

September 1995.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:5.0.2

The program included both felony and misdemeanor narcotics offenders, and targeted offenders with a lengthy history of substance abuse and criminal involvement, and a history of unsuccessful abuse treatment or lack of prior treatment. Violent offenders and offenders with other pending cases were excluded.

PARTICIPATION RATE --------------------------------------------------- Appendix III:5.0.3

Participation was voluntary; the percentage of eligible offenders who chose to participate is not indicated.

PROGRAM LENGTH --------------------------------------------------- Appendix III:5.0.4

Twelve months.

PROGRAM COSTS --------------------------------------------------- Appendix III:5.0.5

No information was provided.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:5.0.6

Participants appeared before the treatment court team "frequently" and were subject to drug tests on a "frequent" basis. (Specific times or intervals are not specified.) Both residential and outpatient treatment were provided, and treatment included counseling and therapy, educational and vocational training, and acupuncture.

GRADUATION RATE --------------------------------------------------- Appendix III:5.0.7

This preliminary study was done 9 months after the beginning of the program. Eighty-seven percent were still participating. No offenders had graduated. Offenders could be terminated for positive drug tests; sanctions for those who failed to complete the program were not specified.

EVALUATION --------------------------------------------------- Appendix III:5.0.8

In considering rearrests, 87 treatment court participants were compared to 24 randomly selected defendants who were eligible to participate but declined. None of the treatment court participants were rearrested after 9 months, compared to 21 percent of the comparison group. These same two groups were compared with respect to real jail time served during the 9 months; treatment participants averaged 56 days, while the comparison group averaged 122 days. Treatment court participants were also compared to defendants under formal probation and in intensive supervision, electronic monitoring supervision, and general supervision over a 3-month period, with respect to drug relapse rates. In the treatment group, 7 percent of drug tests were positive. Among formal probationers, the percentage of positive drug tests ranged from 14 percent (intensive supervision) to 28 percent (general supervision).

ASSESSMENT --------------------------------------------------- Appendix III:5.0.9

While these results appear promising, the small number of drug court participants (87), the smaller number in the control group (24), and the short time of follow-up (9 months), preclude firm conclusions about the effect of the drug court on recidivism. Moreover, the fact that no drug court participants had been rearrested results partly from the fact that participants who were terminated from the program as a result of rearrests (3 percent of participants) were excluded from the comparison.

VENTURA COUNTY DRUG COURT (OBERG, 1996) ------------------------------------------------------- Appendix III:6

PROGRAM START DATE --------------------------------------------------- Appendix III:6.0.1

April 1995.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:6.0.2

Nonviolent offenders charged with a misdemeanor drug offense.

PARTICIPATION RATE --------------------------------------------------- Appendix III:6.0.3

Participation was voluntary. The percentage of eligible offenders who chose to participate is not indicated. The report states that drug court offenders were similar, demographically and in terms of drug offenses committed, to the comparison group of offenders who applied for entrance into the drug court program but were not accepted.

PROGRAM LENGTH --------------------------------------------------- Appendix III:6.0.4

Twelve months.

PROGRAM COSTS --------------------------------------------------- Appendix III:6.0.5

No systematic cost/benefit analysis is provided, but the study reports that "as of April 1, 1996, participants in the program have been ordered to serve a total of 4,981 days in custody, resulting in a savings of 4,839 days and a tremendous cost savings in incarceration costs." (p. 24.)\2

-------------------- \2 Page references in this appendix refer to pages in the specific evaluation study cited.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:6.0.6

Offenders appeared before the drug court judge monthly, met with probation officers on a regular basis, and submitted to random drug tests. The treatment phase of the program lasted about 8 months and involved counseling and attendance at AA/NA meetings. Both residential and outpatient treatments were employed.

GRADUATION RATE --------------------------------------------------- Appendix III:6.0.7

This report evaluated the first 8 months of a 12-month program, so none of the offenders had graduated. Of the 75 offenders accepted into the program between April and December 1995, 26 (35 percent) had been terminated. Terminations resulted from new crime charges, three dirty urine samples, and other acts of noncompliance with program guidelines. Terminees served their sentences. Males and Hispanics were reportedly less likely to complete the program.

EVALUATION --------------------------------------------------- Appendix III:6.0.8

Of the 966 drug tests submitted by the 75 drug court participants during the first 8 months of the program, 86 (9 percent) were positive. In terms of recidivism, 9 of the 75 drug court participants (12 percent) were rearrested during the 8-month period. By comparison, over the same period, 32 percent of a control group of offenders who had applied for but not been accepted into the drug court program were rearrested. The report also notes that fewer of the arrests of drug court offenders involved drug-related offenses (58 percent versus 75 percent in the control group).

ASSESSMENT --------------------------------------------------- Appendix III:6.0.9

While these results are positive, they are restricted to offenders who were still in the program and offer no information on what recidivism and relapse looked like after program completion. Also, it is not clear whether the drug court offenders and the control group were similar with respect to time at risk of rearrest.

DENVER DRUG COURT (GRANFIELD AND EBY, 1997) ------------------------------------------------------- Appendix III:7

PROGRAM START DATE --------------------------------------------------- Appendix III:7.0.1

July 1994.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:7.0.2

This report does not indicate what types of offenders were included or excluded from the drug court program.

PARTICIPATION RATE --------------------------------------------------- Appendix III:7.0.3

The drug court was established in response to Colorado House Bill 91-1173, which mandated that all persons convicted under the Controlled Substances Act be evaluated for substance abuse. It appears that participation in the drug court program was mandatory.

PROGRAM LENGTH --------------------------------------------------- Appendix III:7.0.4

Twenty-four months.

PROGRAM COSTS --------------------------------------------------- Appendix III:7.0.5

The report states that the Denver Drug Court had reduced case processing time by more than half, and significantly reduced the amount of time offenders spent in presentence confinement. "At an average of $60 per day in jail, the court is saving between $360 to $840 on each drug offender. Multiplying these individual savings by the total dollar value saved for 3,000 drug offenders brings the total savings to between $1.8 to $2.5 million per year." (p. 32.)

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:7.0.6

Treatment was individualized, based on offenders' drug use patterns and levels of criminal risk. Treatment varied across seven levels. Level 1 involved judicial supervision but no treatment; level 2 involved the use of education and intense urine testing; level 3 entailed weekly outpatient treatment and acupuncture; level 4 required intensive outpatient treatment, including group therapy; level 5 required intensive residential treatment; level 6 required the use of therapeutic communities; and level 7 involved intensified surveillance but no treatment. Most participants in the program fell into the first 5 categories. Offenders appeared "frequently" in front of the drug court judge. The frequency with which they were required to submit to drug tests is not indicated.

GRADUATION RATE --------------------------------------------------- Appendix III:7.0.7

This report does not indicate the numbers or percentages of offenders who graduated from the program.

EVALUATION --------------------------------------------------- Appendix III:7.0.8

A random sample of 100 drug court defendants from December 1994 to March 1995 was compared to two control groups, consisting of 100 subjects each, from predrug court years 1992/1993 and 1993/1994. Twenty-two percent of drug court offenders, compared to 15 percent and 14 percent of the 1992/1993 and 1993/1994 offenders, had revocations for violations of probation after 6 months, and 58 percent of drug court offenders, compared to 53 percent and 58 percent of the 1992/1993 and 1993/1994 offenders, were rearrested in 12 months. None of these differences were statistically significant.

ASSESSMENT --------------------------------------------------- Appendix III:7.0.9

Data for the evaluation were for participants who had not had time to complete the program, and the short follow-up time precluded firm conclusions.

D.C. SUPERIOR COURT DRUG INTERVENTION PROGRAM (HARRELL AND CAVANAGH, 1996) ------------------------------------------------------- Appendix III:8

PROGRAM START DATE --------------------------------------------------- Appendix III:8.0.1

1992.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:8.0.2

Drug felony defendants, some of whom had an extensive history of arrests and convictions and faced high risks of incarceration if convicted, were randomly assigned to one of three dockets: (1) the treatment docket, which included regular drug testing, judicial monitoring of drug use, and "intensive day treatment"; (2) the sanctions docket, which included drug testing, judicial monitoring of drug use, and referrals to treatment; and (3) the standard docket, which included drug testing and judicial monitoring. The report offers no information about whether violent offenders, or other types of offenders, were excluded from the program.

PARTICIPATION RATE --------------------------------------------------- Appendix III:8.0.3

Participation in the treatment and sanctions dockets was voluntary. Of offenders who were sentenced before October 15, 1996, 37 percent of eligible offenders chose to participate in the treatment docket, and 75 percent chose to participate in the sanctions docket. Participants in the sanctions docket were older than participants in the treatment docket and the standard docket. Participants in the treatment docket were less likely to be male and employed than nonparticipants; participants in the sanctions docket were more likely to be older, unemployed, and stronger drug users than nonparticipants.

PROGRAM LENGTH --------------------------------------------------- Appendix III:8.0.4

The six-stage treatment program for offenders in the treatment docket lasted at least 6 months, depending on the speed with which offenders met the criteria for progressing to the next stage. On average, offenders in the sanctions docket were in the program for 5 months.

PROGRAM COSTS --------------------------------------------------- Appendix III:8.0.5

No information was provided.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:8.0.6

Offenders in the sanctions and standard dockets were tested for drugs twice weekly, and those in the treatment docket were tested three times weekly. All dockets involved judicial monitoring, but how often offenders appeared before the judge is not indicated. The daily treatment for all treatment docket participants included acupuncture, structured treatment activities, and additional support services. Thirty percent of the offenders in the sanctions docket were referred to community-based treatment, though the nature of the treatment they received is not described. Seventy-four percent of the sanctions docket offenders were sanctioned during their participation; 71 percent spent 3 days in the jury box, 44 percent spent 3 days in jail, 30 percent were sent to detoxification, and 14 percent spent a week or longer in jail.

GRADUATION RATE --------------------------------------------------- Appendix III:8.0.7

Nineteen percent of the 88 offenders who entered the treatment docket graduated from it. The large majority of the offenders who did not complete the program were rearrested, discharged for lack of progress, or dropped out. Sixty-five percent of the 194 sanctions docket program participants remained in the program until sentencing. Terminees were either doing poorly in the program or rearrested.

EVALUATION --------------------------------------------------- Appendix III:8.0.8

The program was a pretrial program, which was evaluated in terms of the likelihood of offenders assigned to the three dockets testing clean in the month before sentencing. Twenty percent of the defendants assigned to the treatment docket, 32 percent of the defendants assigned to the sanctions docket, and 13 percent of the defendants assigned to the standard docket tested clean. Multivariate analysis reveals that sanctions program participants were four times as likely to test clean in the month before sentencing as standard program participants, while treatment program participants were twice as likely. Differences between offenders who chose not to participate in the treatment and sanctions dockets and those participating in the standard docket were not significant.

ASSESSMENT --------------------------------------------------- Appendix III:8.0.9

While the multivariate analysis undertaken here is as sophisticated as any we uncovered, the outcome is restricted to relapse in 1 month, and does not take into account whether program participants graduated from the programs they were participating in. The authors note too that the apparent positive effect of sanctions may entirely disappear once defendants are not facing sentencing.

BROWARD COUNTY DRUG COURT (TERRY, 1993; TERRY, 1996) ------------------------------------------------------- Appendix III:9

PROGRAM START DATE --------------------------------------------------- Appendix III:9.0.1

July 1991.

PARTICIPANT RESTRICTIONS --------------------------------------------------- Appendix III:9.0.2

The program targeted first-time offenders arrested for possession or purchase of cocaine. It excluded violent offenders, offenders involved in drug trafficking, and offenders with prior drug or felony arrests, or prior felony arrests or convictions that resulted in (a) disposition by adjudication and sentence, (b) probation, or (c) participation in pretrial intervention. It also excluded offenders with prior felony charges who had appeals pending at the time of their current arrest.

PARTICIPATION RATE --------------------------------------------------- Appendix III:9.0.3

Participation was voluntary. The percentage of eligible offenders who chose to participate was not indicated. The average age of program participants was slightly higher than for all persons arrested for drug offenses in the county, and participants were somewhat more likely than all persons arrested for drugs to be female and white.

PROGRAM LENGTH --------------------------------------------------- Appendix III:9.0.4

Twelve months.

PROGRAM COSTS --------------------------------------------------- Appendix III:9.0.5

No information was provided.

TREATMENT COMPONENTS --------------------------------------------------- Appendix III:9.0.6

The treatment program consisted of three phases (phase I = 3 weeks, phase II = 23 weeks, phase III = 26 weeks), which varied in terms of treatment type and intensity. Offenders appeared at probation monthly and submitted to urine tests five times per week during phase I and three times per week during phase II. Treatment included group and individual therapy, fellowship meetings, and acupuncture.

GRADUATION RATE --------------------------------------------------- Appendix III:9.0.7

Seven hundred eighty-seven persons entered the program in its first year; 307 (39 percent) graduated. Many offenders failed to complete the program because the cases against them were dropped, they were transferred to other districts, they requested trials or regular probation, or they no longer met eligibility criteria. No clear information is provided on how many offenders failed to complete the program due to program noncompliance, nor whether they faced sanctions. The report notes, however, that almost two-thirds of the program noncompleters left because the state attorney decided to drop the case against them.

EVALUATION --------------------------------------------------- Appendix III:9.0.8

The evaluation compares rearrest rates for persons who were admitted to and graduated from the program in its first year and to persons who met the eligibility requirements of the program but did not participate. After 25 to 37 months since entering the program, 39 percent of the persons admitted, 25 percent of the graduates, and 30 percent of the nonparticipants had been rearrested for a new felony. Fifty percent of the persons admitted, 48 percent of the graduates, and 43 percent of the nonparticipants had been rearrested for a new felony or misdemeanor. Some differences in the types of offenses committed were found, with treatment graduates being somewhat less likely than nonparticipants to be rearrested for new drug offenses and violent offenses. There were also some differences in the timing of arrests between groups.

ASSESSMENT --------------------------------------------------- Appendix III:9.0.9

There is no systematic evaluation of treatment effects in terms of drug relapse in this study, though the 1993 report indicated that 79 percent of the persons who graduated from the program or were still active in it had at least one positive cocaine test. The lack of significance tests and possibility of selection bias in the report makes it difficult to evaluate the rearrest differences presented.

BROWARD COUNTY DRUG COURT (COMMISSION AUDITOR'S OFFICE, 1995) ------------------------------------------------------ Appendix III:10

PROGRAM START DATE -------------------------------------------------- Appendix III:10.0.1

See Terry, 1996 (above).

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:10.0.2

See Terry, 1996 (above).

PARTICIPATION RATE -------------------------------------------------- Appendix III:10.0.3

Participation was voluntary. The percentage of eligible offenders who chose to participate during the 3 years (July 1, 1991, through September 30, 1994) covered by this report is not clearly indicated, but it appears that as many as 27 percent of offenders may have declined treatment.

PROGRAM LENGTH -------------------------------------------------- Appendix III:10.0.4

See Terry, 1996 (above).

PROGRAM COSTS -------------------------------------------------- Appendix III:10.0.5

This report indicates that the cost to complete the 12-month drug court program ranged from $3,215 to $5,834 (with the treatment portion of this cost ranging from $247 to $449 per month). The report's authors offered, as a point of reference, the cost of a 6-month jail sentence, which was $8,400.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:10.0.6

See Terry, 1996 (above). This report states that the extent of treatment may have been overstated due to the ongoing failure of defendants to attend treatment, though this finding appears to be based on a very small sample of defendants.

GRADUATION RATE -------------------------------------------------- Appendix III:10.0.7

Adjusting for the defendants remaining in treatment, this report indicates a 35-percent graduation rate over the 3 years, which is similar to Terry's estimate for the first year (see Terry, 1996, above). Contrary to McNeece and Daly, however, this report states that arrests for driving under the influence, cannabis possession, or any felony while participating in the program resulted in immediate termination.

EVALUATION -------------------------------------------------- Appendix III:10.0.8

This report provides information on rearrests for a random sample of 30 drug court graduates who had graduated between 4 and 25 months before the arrest search. Six of the 30 (20 percent) were rearrested during the program and 3 of the 30 (10 percent) were arrested after graduation. This report also shows, for a sample of 29 drug court graduates and similarly small samples of probation and nonprobation drug court participants, that positive drug tests declined with time in treatment. No comparisons were made to nonparticipants.

ASSESSMENT -------------------------------------------------- Appendix III:10.0.9

Small samples and the lack of comparison data make these results difficult to assess.

BROWARD COUNTY DRUG COURT (MCNEECE AND DALY, 1993) ------------------------------------------------------ Appendix III:11

PROGRAM START DATE -------------------------------------------------- Appendix III:11.0.1

See Terry, 1996 (above).

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:11.0.2

See Terry, 1996 (above). This report states that at some point eligibility requirements were modified to include drug offenders involved in drugs other than cocaine (such as possession of marijuana and barbiturates), and those with previous felony drug convictions.

PARTICIPATION RATE -------------------------------------------------- Appendix III:11.0.3

Participation was voluntary. The percentage of eligible offenders who chose to participate during the year of operation described by this report (1992) is not indicated, but the report notes as a disturbing trend that almost all clients with private attorneys chose not to participate. It also notes that many clients requested transfers to other courts, where they were almost certain to receive probation with no treatment.

PROGRAM LENGTH -------------------------------------------------- Appendix III:11.0.4

See Terry, 1996 (above).

PROGRAM COSTS -------------------------------------------------- Appendix III:11.0.5

No information was provided.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:11.0.6

See Terry, 1996 (above). This report indicates that during Phase III of treatment, urine tests were performed once a week and that treatment during this phase emphasized educational and work skills. Vocational evaluation, on-the-job training, and job skills and readiness classes were also provided.

GRADUATION RATE -------------------------------------------------- Appendix III:11.0.7

This report notes that of the 1,008 defendants who appeared in this drug court in 1992, only 48 (or 5 percent) graduated. This figure greatly underestimates the graduation rate, however, as roughly half the participants entering in that year were still active, and about a third were either not accepted or were transferred to other courts. While rearrests appeared to be responsible for some portion of terminations, the report notes that, in most cases, rearrests did not lead to dismissal from the program. The report notes that African-Americans were less likely than others to complete treatment.

EVALUATION -------------------------------------------------- Appendix III:11.0.8

This report provides information on rearrests for the 1,008 offenders who appeared in the court in 1992, but is not clear about how long they had been at risk of rearrest. (Since half were still active, we can assume that for many offenders the time at risk was less than 1 year.) Eleven percent were rearrested, jailed, sent to prison, or had warrants issued for their arrest. Eleven percent also had one or more violations of probation while in the program. Drug test results were available for only 323 of the 1,008 participants; 52 (16 percent) were "dirty" on one or more occasions.

ASSESSMENT -------------------------------------------------- Appendix III:11.0.9

This information does not distinguish graduates from program terminees in assessing rearrests and relapse, nor does it compare program participants with nonparticipants. Also, the length of follow-up was short, and for some participants involved only a matter of months.

DADE COUNTY DRUG COURT (GOLDKAMP AND WEILAND, 1993) ------------------------------------------------------ Appendix III:12

PROGRAM START DATE -------------------------------------------------- Appendix III:12.0.1

1989.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:12.0.2

The drug court was initially designed to accept offenders charged with third-degree felony drug possession who had no prior convictions, but has shown some flexibility in its admissions criteria. This study focuses on a sample of offenders (n = 326) admitted in August and September 1990. Among them, one-third had prior felony arrests, and 11 percent had prior arrests for serious crimes against persons.

PARTICIPATION RATE -------------------------------------------------- Appendix III:12.0.3

Participation appeared to be voluntary. The percentage of eligible offenders who chose to participate is not clearly indicated. It appears that the drug court participants were more likely than eligible offenders who chose not to participate to be male and to have fewer prior arrests, including drug arrests.

PROGRAM LENGTH -------------------------------------------------- Appendix III:12.0.4

Twelve months.

PROGRAM COSTS -------------------------------------------------- Appendix III:12.0.5

No information was provided.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:12.0.6

Judicial monitoring and drug tests were components of the program, which proceeded through three phases: phase 1 (detoxification), phase 2 (counseling), and phase 3 (educational/vocational assessment). On average, participants took 24 drug tests while in the program; how frequently they appeared before the drug court judge is not indicated. Acupuncture was used on a voluntary basis.

GRADUATION RATE -------------------------------------------------- Appendix III:12.0.7

Of the 326 offenders in the study group, 28 percent were still active after 18 months, and 14 percent had their charges dropped or were transferred out of the program. Of the remaining 189, 110 (or 58 percent) graduated or successfully completed diversion. The report states that "motivational jail" terms of 2 weeks were sometimes used to sanction offenders who failed to comply or were rearrested. Roughly half of the drug court defendants failed to appear in drug court at least once, compared to from 6 to 10 percent of other felony offenders who were not assigned to the drug court program.

EVALUATION -------------------------------------------------- Appendix III:12.0.8

The 326 offenders admitted to the drug court program were compared to four other samples: (1) felony drug defendants in the same period who were not eligible for the program because of more serious offenses (n = 199), (2) nondrug felony defendants in the same period (n = 185), (3) felony drug defendants from a period several years earlier (n = 302), and (4) felony nondrug defendants from a period several years earlier (n = 536). Data were collected from a fifth comparison sample of offenders who were assigned to the drug court but did not participate. These data, however, were not employed in the evaluation involving rearrests. After 18 months, drug court defendants had a significantly lower rearrest rate than the other 4 groups (33 percent versus 40 percent to 53 percent), and a significantly longer period before rearrest (median of 235 days versus 52 to 115 days for the other groups).

ASSESSMENT -------------------------------------------------- Appendix III:12.0.9

These results are quite positive but, as we stated in our previous report, must be viewed with caution as a result of a lack of comparability between groups, especially in terms of offense seriousness and criminal history.

DADE COUNTY DRUG COURT (SMITH, DAVIS, AND GORETSKY, 1991) ------------------------------------------------------ Appendix III:13

PROGRAM START DATE -------------------------------------------------- Appendix III:13.0.1

June 19, 1989.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:13.0.2

See Goldkamp and Weiland, 1993. This report notes that eligible offenders had to admit to having a drug problem for which they wanted treatment. The report also notes that eligibility requirements were relaxed over time.

PARTICIPATION RATE -------------------------------------------------- Appendix III:13.0.3

Participation was voluntary. This report does not indicate what percentage of eligible offenders chose to participate. It does note that of 1,100 cases that had been referred to the drug court, 300 were transferred out, 200 were nollied, 100 resulted in bench warrants, 100 were prosecuted in some other way, and 411 (or 15 percent) "received the 'drug court' stamp. Thus, those who made it to the drug court are a very select group." (p. 5.)

PROGRAM LENGTH -------------------------------------------------- Appendix III:13.0.4

This report states that while a 12-month program was envisioned, the length of time it took an offender to complete it varied, depending on the individual's progress.

PROGRAM COSTS -------------------------------------------------- Appendix III:13.0.5

No systematic cost/benefit analysis is provided. The report states that the drug court treatment program cost $700 per year compared with the $17,000 cost of housing inmates in the local jail, and that the county paid the cost of treatment.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:13.0.6

See Goldkamp and Weiland, 1993. This report notes that in general, offenders appeared before the drug court judge every 30 to 60 days. It also indicates that individual and group counseling, and attendance at AA/NA meetings, were frequently employed.

GRADUATION RATE -------------------------------------------------- Appendix III:13.0.7

No information was provided on the percentage of offenders who completed the drug court program.

EVALUATION -------------------------------------------------- Appendix III:13.0.8

The evaluation involves a comparison of rearrest rates for persons assigned to the drug court in January 1990 through March 1990 (n = 318), and a subgroup of persons assigned to the drug court who actually participated in it (n = 148), with a sample of predrug court narcotics cases from early 1988 (n = 99). Persons assigned to the drug court were similar to predrug court offenders with respect to rearrests (32 percent versus 33 percent), while the participants had lower rearrest rates (15 percent).

ASSESSMENT -------------------------------------------------- Appendix III:13.0.9

The authors note that the differences between drug court participants and predrug court cases should be viewed cautiously, due to the selective nature of the latter group.

HILLSBOROUGH COUNTY DRUG COURT (MCNEECE AND DALY, 1993) ------------------------------------------------------ Appendix III:14

PROGRAM START DATE -------------------------------------------------- Appendix III:14.0.1

June 1992.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:14.0.2

The program was targeted for first-time offenders charged with simple possession or purchase of cocaine. The report states, however, that in actual practice offenders charged with other types of drug offenses and who had previous records could be considered.

PARTICIPATION RATE -------------------------------------------------- Appendix III:14.0.3

Participation was voluntary, but the percentage of eligible offenders who chose to participate is not indicated. The report states, however, that self-selection could have been at work, as African-Americans were underrepresented among program participants. While they accounted for 54 percent of all drug arrests, they comprised only 33 percent of drug court participants.

PROGRAM LENGTH -------------------------------------------------- Appendix III:14.0.4

Twelve months.

PROGRAM COSTS -------------------------------------------------- Appendix III:14.0.5

No information was provided.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:14.0.6

The frequency with which participants appeared before the drug court judges varied, depending on progress and ranged from once every 2 to 4 weeks to once every 2 or 3 months. The treatment program consisted of three phases. During phase 1 (first 3 weeks), random urine tests were done three times a week, and treatment consisted of acupuncture and individual and group counseling. During phase 2 (weeks 4 through 12), random urine tests were done twice a week, participants received acupuncture and attended group therapy sessions, and were encouraged to attend AA/NA meetings. During phase 3 (weeks 13 through 52), random urine tests were done three times a month, and participants were required to participate in a structured aftercare support group, encouraged to attend AA/NA meetings, and given individual counseling as needed.

GRADUATION RATE -------------------------------------------------- Appendix III:14.0.7

The report states that as of November 1993, only 23 participants had been discharged from the program (thus implying that all but those 23 participants were still active in the program). Twelve (52 percent) were discharged as successful. The 11 terminees were discharged due to new drug arrests (2), new nondrug felony arrests (2), or persistent noncompliance (7).

EVALUATION -------------------------------------------------- Appendix III:14.0.8

The program had not been formally evaluated, but the report states that it had been selected for a longitudinal study to track relapse and recidivism among participants over a period of several years. The only evaluation provided here involves responses from a random sample of program participants interviewed, the size of which is not indicated. Sixty-three percent and 37 percent reported being very satisfied or pretty satisfied with the program (only one participant was dissatisfied), and 70 percent and 26 percent found it to be very or somewhat effective.

ASSESSMENT -------------------------------------------------- Appendix III:14.0.9

The lack of systematic information on what percentage of offenders eligible for the program entered it, the very preliminary information on the percentage who successfully completed it, and the absence of information on relapse and rearrests after program completion for participants and a comparison group makes it impossible to determine the efficacy of the program. It is not indicated whether the planned longitudinal study was to include a comparison group of nonparticipants.

BALTIMORE CITY DRUG TREATMENT COURT (GOTTFREDSON, COBLENTZ, AND HARMON, 1996) ------------------------------------------------------ Appendix III:15

PROGRAM START DATE -------------------------------------------------- Appendix III:15.0.1

March 1994.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:15.0.2

The program was targeted toward nonviolent offenders with drug abuse problems. The "instant" offenses that led to assignment to drug court were most often drug-related or property crimes.

PARTICIPATION RATE -------------------------------------------------- Appendix III:15.0.3

It appears that participation was voluntary for some offenders but not for others. Offenders were diverted from prosecution contingent upon an agreement to participate in a drug treatment program. Others who were not deemed eligible for diversion from prosecution were required to participate in a drug treatment program as a condition of parole or probation. The percentage of eligible offenders who entered the drug court treatment program is not indicated. The report notes that drug court clients were historically frequent offenders compared to other eligible probationers and that the offenses for which they were convicted were as serious or more serious in nature than those in the comparison group.

PROGRAM LENGTH -------------------------------------------------- Appendix III:15.0.4

Not indicated.

PROGRAM COSTS -------------------------------------------------- Appendix III:15.0.5

No information was provided.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:15.0.6

The report states that intensive supervision and frequent drug testing were used but does not provide specific information on frequency of contacts with the courts or drug tests. The program services (treatment) may have included education, unspecified substance abuse treatment, job readiness and placement, life skills training, and housing assistance. Graduated sanctions and incarceration were used to induce program compliance.

GRADUATION RATE -------------------------------------------------- Appendix III:15.0.7

The program completion rate is not indicated. Incarceration could be imposed when offenders failed to comply with program requirements. The nature and extent of sanctions were not examined.

EVALUATION -------------------------------------------------- Appendix III:15.0.8

To determine whether the drug court program services were more effective than those provided under traditional probation and parole, 145 offenders who were assigned to the drug court treatment in its first year of operation were compared to offenders not assigned. Rearrests after 180 days were compared, separately for offenders from (1) the district court (n = 84 in the treatment group and 351 in the control group), (2) the circuit court (n = 34 in the treatment group and 125 in the control group), and (3) the district court for violations of probation (n = 27 in the treatment group and 53 in the control group). Twenty-three percent, 26 percent, and 18 percent of the district, circuit, and violations of probation treatment cases were rearrested, respectively, compared to 27 percent, 30 percent, and 30 percent of controls. While none of these differences were statistically significant, a significantly lower rearrest rate among drug court cases emerged when other factors affecting rearrests (i.e., criminal history, characteristics of the instant offense, and demographic variables) were statistically controlled.

ASSESSMENT -------------------------------------------------- Appendix III:15.0.9

These preliminary results appear positive, but firmer conclusions await a lengthier follow-up with a more diverse group of treatment court participants, including those who enter through the diversion track.

CLARK COUNTY DRUG COURT (CHOICES UNLIMITED LAS VEGAS, 1996) ------------------------------------------------------ Appendix III:16

PROGRAM START DATE -------------------------------------------------- Appendix III:16.0.1

October 1992.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:16.0.2

Initially, most participants were offenders charged with possession of a controlled substance or under the influence of a controlled substance, who had no prior felony convictions and no noncriteria offense currently in the system. Persons who wished to participate but did not meet admissions criteria could be allowed to conditionally participate. Such persons might not receive a dismissal of underlying criminal charges and might be required to pay treatment costs. It appears that many participants in the most recent year covered by the report (1995-1996) were charged with possession with intent to sell, low-level trafficking, and nondrug-related property offenses such as burglary. The report is unclear about whether violent offenders were excluded as well.

PARTICIPATION RATE -------------------------------------------------- Appendix III:16.0.3

Participation was voluntary. The percentage of eligible offenders who chose to participate is not indicated.

PROGRAM LENGTH -------------------------------------------------- Appendix III:16.0.4

Twelve months.

PROGRAM COSTS -------------------------------------------------- Appendix III:16.0.5

No information was provided.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:16.0.6

Participants appeared in the drug court frequently--between weekly and monthly--depending on progress. Urine tests were taken every other day in the first phase of the program, and periodically in phases 2 through 4. Participants could not proceed from phase 1 to 2 or from phase 2 to 3 until they had five consecutive negative tests, could not proceed from phase 3 to phase 4 until they had 6 months of negative tests, and had to test clean for a minimum of 3 months to graduate. Treatment components varied by phase and included detoxification; individual, group, and family counseling; wellness education sessions; and job training.

GRADUATION RATE -------------------------------------------------- Appendix III:16.0.7

As of April 1, 1996, 1,544 offenders had been referred to the program. Seventy-eight offenders never actually started treatment, and 795 offenders were still active in the program. Of the remaining 671 offenders, 382 (57 percent) had graduated. Reasons for termination included new arrests, positive urine tests, and noncompliance with program requirements. Similar termination rates among ethnic groups and between male and female participants were reported. However, termination rates were higher for participants entering the program under the influence or in possession of a controlled substance offense, particularly cocaine and amphetamine. The report does not indicate what happened to program terminees.

EVALUATION -------------------------------------------------- Appendix III:16.0.8

The only evaluation component of the report involved a calculation of rearrests among the 382 graduates over the 42 months of the court's operation. Only 24 (6 percent) of the graduates had been rearrested on new charges since their release.

ASSESSMENT -------------------------------------------------- Appendix III:16.0.9

While the absence of a control group makes the rearrest information difficult to interpret, the 6-percent recidivism rate seems remarkable, especially since many graduates would have had substantial periods at risk of rearrest. It is not clear whether these figures included arrests during program participation, or whether such arrests automatically triggered termination.

MULTNOMAH COUNTY S.T.O.P. PROGRAM (AMERICAN UNIVERSITY COURTS TECHNICAL ASSISTANCE PROJECT, 1994) ------------------------------------------------------ Appendix III:17

PROGRAM START DATE -------------------------------------------------- Appendix III:17.0.1

August 1991.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:17.0.2

The S.T.O.P. (Sanction-Treatment-Opportunity-Progress) program was targeted for defendants charged with felony drug possession offenses with no involvement in significant drug dealing, no holds from other jurisdictions, no other felony or Class A person misdemeanor charges pending, and no driving under the influence charges in the same charging instrument. A defendant's criminal history was no barrier to participation provided other qualification criteria were met. Since the program was first implemented, criminal history requirements were relaxed and gang affiliation was abandoned as a restriction on program participation. The report indicates that because of the relaxed eligibility criteria and Oregon's relatively lenient sentencing provisions, the drug court handled a significantly larger percentage (26 percent) of the total drug caseload than most courts. "Drug courts programs in other jurisdictions generally account for less than five percent of their jurisdiction's total drug caseload."

PARTICIPATION RATE -------------------------------------------------- Appendix III:17.0.3

Participation was voluntary, but the percentage of eligible offenders who chose to participate is not indicated.

PROGRAM LENGTH -------------------------------------------------- Appendix III:17.0.4

Twelve months.

PROGRAM COSTS -------------------------------------------------- Appendix III:17.0.5

While the report states that "costs per case for STOP cases . . . have been substantially reduced compared with the costs per cases handled in the traditional adjudication process," dollar values were left blank in the draft of the report we reviewed.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:17.0.6

S.T.O.P. program participants appeared before the program judge monthly during this four-phase program. In phase 1 (4 weeks), they submitted six drug tests per week and received acupuncture and drug education classes. During phase 2 (4-1/2 months), they submitted to random drug tests, acupuncture, and group counseling three times a week. In phase 3 (approximately 6 months), they submitted to random drug tests and counseling tailored to their needs. Phase 4, added in the program's second year, involved biweekly urine tests and participation in AA/NA meetings five times a week for 2 months.

GRADUATION RATE -------------------------------------------------- Appendix III:17.0.7

Between August 1, 1991, and June 9, 1994, 1,611 defendants were admitted to the program. Seven hundred three were still active, and of the remaining 908, 367 (or 40 percent) had graduated. There is no indication of what factors were primarily responsible for failure to complete the program (i.e., rearrests, positive urine tests, etc.), though it is noted that, on average, program completers had longer histories of drug use and were older, more likely to be married and residentially stable, and more likely to have consistently attended acupuncture and other treatment sessions. Program completers had their criminal indictments dismissed, while terminees stood for trial before the S.T.O.P. program judge at the same status hearing in which the termination occurred. Failures to appear were sanctioned by program suspensions, appearances before the court, and bench warrants.

EVALUATION -------------------------------------------------- Appendix III:17.0.8

The evaluation provided is very preliminary, and it appears that many of the numbers provided were in need of updating or verification. The information provided involves a comparison of 105 S.T.O.P. participants who had graduated from the program and 78 participants who had been terminated, and is restricted to numbers and percents in the two groups who had positive drug tests and bench warrants. It appears that, in each of the four phases of the program, graduates were more likely than terminees to show for drug tests, and in at least the second and third phases, less likely to test positive (i.e., dirty). There was also a smaller average number of bench warrants issued for program graduates (0.73) than terminees (2.15).

ASSESSMENT -------------------------------------------------- Appendix III:17.0.9

These results are preliminary. It is not clear why the evaluation done involved only 105 of the 367 graduates, and only 78 of the 542 terminees. It appears that the urine tests and bench warrants were considered only for the period of their participation in the program, so these figures provide no information on long-term effects. The study also provides no information on nonparticipants.

SODAT-DELAWARE, INC. DRUG COURT DIVERSION PROGRAM (REED, 1995) ------------------------------------------------------ Appendix III:18

PROGRAM START DATE -------------------------------------------------- Appendix III:18.0.1

April 1994.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:18.0.2

Participants were first-time drug offenders with no prior drug convictions. Offenders who were excluded are not indicated, except for repeat drug offenders.

PARTICIPATION RATE -------------------------------------------------- Appendix III:18.0.3

Not indicated.

PROGRAM LENGTH -------------------------------------------------- Appendix III:18.0.4

Five to 6 months.

PROGRAM COSTS -------------------------------------------------- Appendix III:18.0.5

The only information on cost savings from the program was the statement that "For the cost of keeping just 8 offenders in prison for 1 year, SODAT has successfully diverted and treated 219 drug offenders in the community and started them on the road to recovery from their addictions."

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:18.0.6

Participants appeared before the drug court judge, usually once a month, and were required to submit to random urine screening throughout their stay in the program. Treatment was not well described--"three counselors provide active substance abuse counseling." (p. 1.)

GRADUATION RATE -------------------------------------------------- Appendix III:18.0.7

After 1 year, 71 percent (90 of 127) of the program participants who were not still active in the program and had not been transferred to more intensive treatment had graduated. Men had slightly higher graduation rates than women, and whites and blacks with less severe drug problems had higher completion rates. The report also states that age, education, and employment were related to program success.

EVALUATION -------------------------------------------------- Appendix III:18.0.8

Approximately 80 percent of program participants had been drug tested during the program, and roughly half of those tested had one or more positive urines. Program graduates were less likely than nongraduates to have one or more positive urines (35 percent versus 80 percent). Only 4 percent of program participants, and 8 percent of participants not still active in the program, had been discharged due to rearrests. Participants were not compared to offenders who did not participate in the program.

ASSESSMENT -------------------------------------------------- Appendix III:18.0.9

This program was just 1 year old at the time of this report, and the few details offered about program effects do not permit firm conclusions.

TRAVIS COUNTY DRUG DIVERSION COURT (KELLY, 1996) ------------------------------------------------------ Appendix III:19

PROGRAM START DATE -------------------------------------------------- Appendix III:19.0.1

August 1993.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:19.0.2

The Travis County SHORT (System of Healthy Options for Release and Treatment) Program was modeled after the Dade County Drug Diversion Program and targeted drug offenders who exhibited evidence of addiction and had a limited criminal history. It excluded offenders who were involved in significant drug dealing, had holds from other jurisdictions, had prior felony convictions for violent crimes, or had other felony charges pending.

PARTICIPATION RATE -------------------------------------------------- Appendix III:19.0.3

Participation was voluntary. The report notes that a significant number of eligible defendants either refused entrance or failed to participate from the outset. No information was provided on the percentage of eligible offenders who chose to participate.

PROGRAM LENGTH -------------------------------------------------- Appendix III:19.0.4

Twelve months.

PROGRAM COSTS -------------------------------------------------- Appendix III:19.0.5

No information was provided.

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:19.0.6

While the report indicates that court appearances and urine testing were components of the program, it does not indicate how frequently either occurred. The treatment program consisted of three phases, which varied in terms of intensity of supervision and treatment. Treatment components included counseling, acupuncture, and AA/NA and drug education meetings.

GRADUATION RATE -------------------------------------------------- Appendix III:19.0.7

Four hundred fifty-five defendants had entered the program since its inception; 232 were still active, and of the remaining 223, 74 (or 33 percent) had graduated. The primary reasons stated for not completing the program were failure to appear, requesting to withdraw and have their case indicted, failure to comply with the program, and rearrests. The report states that noncompliance (including positive urine tests, missed meetings and court appearances, and rearrest), was tolerated in an effort to retain program participants. Noncompliance was sanctioned in a variety of ways, including by increasing urine tests, court appearances, and jail time.

EVALUATION -------------------------------------------------- Appendix III:19.0.8

The evaluation involves only information on rearrests, for a small sample of 22 program graduates and a sample of 27 individuals who were arrested before the program was established but would have been eligible for it. After 1 year, 6 of the 22 program participants (27 percent) had been rearrested, compared to 16 of the 27 individuals (59 percent) in the comparison group.

ASSESSMENT -------------------------------------------------- Appendix III:19.0.9

These preliminary results are positive, though the authors note problems in the comparability of the two groups, in the small sample sizes, and in the short period of follow-up.

JACKSON COUNTY DRUG COURT DIVERSION PROGRAM (JAMESON AND PETERSON, 1995) ------------------------------------------------------ Appendix III:20

PROGRAM START DATE -------------------------------------------------- Appendix III:20.0.1

October 1993.

PARTICIPANT RESTRICTIONS -------------------------------------------------- Appendix III:20.0.2

The report states that individuals charged with possession of drugs or drug paraphernalia, sale of controlled substances (under specified amounts), fraudulent prescriptions, and prostitution were presumed to be drug users and eligible to participate. Other offenders were eligible if they and/or their family, friends, or attorney stated that they were a drug user or tested positive for drugs at the time of arrest. Relative to persons admitted to the Jackson County Department of Corrections, the program may have been overrepresentative of blacks and females.

PARTICIPATION RATE -------------------------------------------------- Appendix III:20.0.3

Participation was voluntary. The percentage of eligible offenders who chose to participate is not indicated.

PROGRAM LENGTH -------------------------------------------------- Appendix III:20.0.4

Twelve months.

PROGRAM COSTS -------------------------------------------------- Appendix III:20.0.5

While no formal cost/benefit analysis is provided, the report states that, "if it assumed that the 257 active clients would otherwise have been incarcerated for 21 days . . . the savings to the county may be estimated to be approximately 5,400 inmate days at a minimum cost savings of $246,000."

TREATMENT COMPONENTS -------------------------------------------------- Appendix III:20.0.6

This was a three-phase program. Phase 1 (3 weeks) involved assessment. Phase 2 (14 weeks) included acupuncture; individual, group, and family counseling; and attendance at AA/NA/CA meetings. Finally, phase 3 (36 weeks) included reduced treatment and continued meeting requirements. Judicial monitoring and drug testing were included throughout; participants met with the drug court judge monthly and submitted urine tests twice weekly during phase 2. (Frequencies are not given for the other phases.) The report notes that compliance rates (the percentage of appointments made that were kept) varied by program components, from 34 percent for 12-step meetings to 49 percent for acupuncture to 81 percent for diversion management sessions.

GRADUATION RATE -------------------------------------------------- Appendix III:20.0.7

Of the 450 offenders processed in the first year of operation of this 12-month program, 257 were still active. Of the remaining 193 cases, only 1 (0.5 percent) had graduated from the program. The majority of participants terminated were for noncompliance with program requirements (52 percent); 19 percent opted out of the program after beginning it and took their cases through the traditional criminal processing procedures.

EVALUATION -------------------------------------------------- Appendix III:20.0.8

Negative (clean) urine test rates were indicated for program participants and shown to vary by phase; phase 1 (22 percent), phase 2 (53 percent), and phase 3 (81 percent). Rearrest rates for the 450 program participants were compared to rearrest rates for a group of 4,755 offenders admitted to the Jackson County Department of Corrections between 1991 and 1994 who had comparable eligibility and were at risk of rearrest. Four percent of the program participants versus 13 percent of the comparison group were rearrested after roughly 6 months.

ASSESSMENT -------------------------------------------------- Appendix III:20.0.9

It is unclear whether urine test rates refer to the percentage of negative tests or the percentage of participants with negative tests. It is also unclear whether program participants were included among the comparison group, which would diminish slightly the difference in rearrests between groups. It is not clear how many of the program participants rearrested were still in the program at the time of their rearrest, and it is too early to tell how different program completers would be from noncompleters and eligible nonparticipants in the long-term.

SUMMARY DATA ON THE STATUS OF DRUG COURT PROGRAMS BY JURISDICTION AS OF MARCH 31, 1997 ========================================================== Appendix IV

Start date Status Funding sources ----------- --------------------------------- ---------------------- Stat About Being Studying e/ Jurisdic Actu Plann Operati to plann feasibili Feder Loca Priva Fe tion al ed ng start ed ty al l te es -------- ---- ----- ------- ------ ----- --------- ----- ---- ----- -- Alabama

Atmore (juvenil e/ Creek tribe)

Birmingh 01/ am 96 (adult)

Birmingh 01/ am 96 (juvenil e)

Cullman

Mobile 02/ 93

Montgome ry

Tuscaloo 03/ sa 97

Alaska

Gambell\ 12/ a 95

Juneau

Arizona

Globe (juvenil e)

Peach Springs (Hualapa i tribe)

Phoenix 03/ 92

Sacaton (Gila River Indian Communit y)

Scottsda 10/ le 97 (Salt River Pima- Maricopa Indian Communit y)

Tucson 07/ (adult) 97

Tucson (juvenil e)

Yuma

Arkansas

Little 06/ Rock 94

Californ ia

Bakersfi 07/ eld 93

Chico 06/ 95

El Cajon

El Monte 07/ 94

Eureka\b 02/ 97

Fairfiel 03/ d 97

Fresno 03/ 96

Hayward\ 07/ b 97

Huntingt 05/ on 97 Park\b

Indio

Inglewoo 05/ d\b 97

Kern 02/ County- 95 East Municipa l\b

Kern 07/ County- 94 North Municipa l\b

Laguna 01/ Niguel 97

Los 05/ Angeles 94 (adult)

Los Angeles (juvenil e)

Martinez

Modesto 06/ 95

Oakland 01/ (adult/ 91 diversio n)

Oakland 01/ (adult/ 95 postadju dication )

Pasadena 05/ 95

Portervi 04/ lle 96

Prosserv 04/ ille\c 96

Redlands 04/ \b 95

Richmond 01/ \b 97

Riversid 09/ e 95

Rosevill 09/ e 95

Sacramen 03/ to 96

Salinas 07/ 95

San 11/ Bernardi 94 no

San 03/ Diego\b 97

San 03/ Francisc 95 o (adult)

San 10/ Francisc 97 o (juvenil e)

San Jose 09/ (adult) 95

San 08/ Jose 96 (juvenil e)\d

San Luis Obispo

San 10/ Mateo 95

Santa 03/ Ana 95 (adult)

Santa Ana (juvenil e)\b

Santa 03/ Barbara 96

Santa Cruz (juvenil e)

Santa 03/ Maria 96

Santa 01/ Monica 96

Santa 02/ Rosa 96

Stockton 07/ 95

Tulare 10/ (juvenil 95 e)

Tulare 05/ (adult) 96

Ukiah 09/ 96

Van Nuys Regional \b

Ventura 04/ 95

Visalia 03/ 96

Vista 01/ 97

Woodland 03/ 95

Yosemite 01/ National 95 Park- Federal Court

Colorado

Denver 07/ 94

Connecti cut

Bridgepo 07/ rt 97

Hartford

New 07/ Haven 96

Delaware

Dover 04/ 96

Georgeto 04/ wn 96

Wilmingt 10/ on 93 (adult)

Wilmingt 09/ on 95 (juvenil e)

District of Columbia -------------------------------------------------------------------------------- Washingt 07/ on 94 (adult)

Washingt on (juvenil e)

Florida

Bartow 12/ 94

Crestvie 10/ w 93

Daytona\ 07/ b 97

Fort 06/ Lauderda 91 le (adult)

Fort 10/ Lauderda 97 le (juvenil e)

Gainesvi 03/ lle 94

Jacksonv 09/ ille 94

Key West 05/ (adult) 93

Key 04/ West 96 (juvenil e)

Marathon 06/ (adult) 95

05/ Marathon 96 (juvenil e)

Miami 06/ 89

Moore Haven

Ocala 04/ 97

Opa- Locka

Orlando 06/ (adult)\ 97 b

Orlando 07/ (juvenil 97 e)

Panama 01/ City\b 97

Pensacol 06/ a 93 (adult)

Pensacol 02/ a 96 (parents )

Pensacol 04/ a 96 (juvenil e)

Plantati 05/ on Key 95 (adult)

Plantati 05/ on Key 96 (juvenil e)

Sarasota 02/ 97

Tallahas 01/ see 94

Tampa 06/ (adult- 92 diversio n)

Tampa 07/ (adult- 94 postadju dication )

Tampa 02/ (juvenil 96 e)

Viera 10/ 94

Georgia

Atlanta 03/ 97

Brunswic k

Covingto n (juvenil e)

Macon 01/ 94

Guam

Agana (juvenil e)

Hawaii

Honolulu 01/ 96

Idaho

Boise\b

Illinois

Blooming ton

Chicago 05/ (adult)\ 89 b e

Chicago 02/ (neighbo 97 rhood model)\b

Cook 10/ County 96 (juvenil e)

Decatur

Edwardsv 03/ ille 96

Kankakee 02/ (adult)\ 97 b

10/ Kankakee 97 (juvenil e)

Markham 03/ 94

Peoria

Rockford 10/ 96

Saint Charles

Indiana

Fort Wayne

Gary 06/ (juvenil 95 e)

Gary 09/ (adult) 96

Lafayett 04/ e\b 97

Lake 09/ County 96

Lawrence burg (juvenil e)

South 02/ Bend 97

Terre 10/ Haute 96

Iowa

Des 09/ Moines 96

Kansas

Wichita 07/ 95

Kentucky

Bowling 04/ Green 97

Frankfor t

Hickman

Louisvil 07/ le 93

Louisian a

Alexandr ia

Baton 01/ Rouge 95 (adult)

Baton Rouge (juvenil e)

Franklin 01/ 97

Gretna 06/ 97

Harvey (juvenil e)

Lafayett e

Lake 02/ Charles\ 97 b

Monroe 01/ 98

Monroe (Ouachit a)

New Orleans

Oberlin

Thibodau x

Vidalia (juvenil e)

Maine

Alfred

Maryland

Annapoli s\b

Baltimor 03/ e 94 (adult- District )

Baltimor 10/ e 94 (adult- Circuit)

Baltimor 10/ e 97 (juvenil e- Circuit)

Montgome ry County\b

Massachu setts

Dorchest 06/ er 95

Framingh am (juvenil e)

Franklin 01/ County 97 (family) \b

Lawrence

Lynn

New 12/ Bedford 97

Salem (juvenil e)

Springfi eld\b

Worceste 02/ r 96

Michigan

Detroit

Kalamazo 06/ o 92 (females )

Kalamazo 01/ o 97 (males)\ b

Kalamazo o (juvenil e)

Mt. Clemens

Pontiac\ 03/ b 93

St. 10/ Joseph 91

Minnesot a

Minneapo 01/ lis 97

Mississi ppi

Gulfport

Jackson 07/ 97

Jackson (juvenil e)\b

Missouri

Benton (juvenil e)

Clayton\ b

Jefferso n City (juvenil e)

Kansas 10/ City 93

Lexingto 06/ n 96

St. 04/ Louis 97

Montana

Browning (Blackfe et tribe)

10/ Missoula 96 (juvenil e)

Nebraska

Omaha 04/ 97

Nevada

Las 10/ Vegas 92 (adult)

Las 04/ Vegas 95 (juvenil e)

Reno 08/ (family) 94

Reno 07/ (adult) 95

Reno 07/ (juvenil 95 e)

New Jersey

Camden 04/ 96

Jersey City (juvenil e)

Long 07/ Branch 97

Newark 05/ (superio 97 r)

Paterson

New Mexico

Albuquer 09/ que 95

Aztec (juvenil e)

Las 04/ Cruces 95 (adult- Magistra te)

Las 12/ Cruces 95 (adult- Municipa l)

Mesilla 04/ 95

Santa Fe

Sunland 02/ Park\f 95

New York

Amherst\ 09/ b 96

Bronx

Brooklyn 06/ 96

Buffalo 01/ 96

Ithaca

Lackawan 01/ na\b 96

Manhatta n\b

Niagara Falls

Oswego

Queens

Renssela er (juvenil e)

Rocheste 01/ r 95

Rockland County

Suffolk 09/ County 96

Syracuse 01/ 97

North Carolina

Charlott 02/ e 95

Cherokee (juvenil e/ Cherokee tribe)

Person/ 07/ Caswell 96 Counties

Raleigh 05/ 96

Warrento 12/ n 96

Wilmingt 05/ on\b 97

Winston- 06/ Salem 96

Ohio

Akron 06/ 95

Butler 09/ County 96

Canton

Chillico the (juvenil e)

Cincinna 03/ ti 95

Clevelan 08/ d 97 (juvenil e)

Clevelan d (adult)

Dayton 01/ (adult) 96

Dayton (juvenil e)

Mansfiel d

Saint Clairsvi lle (juvenil e)

Sandusky 04/ 96

Toledo

Uhrichvi lle

Youngsto wn

Oklahoma

Canadian County (juvenil e)\b

Chickash a\b

Claremor e

Drumrigh 05/ t 97

Elk City (juvenil e)

Guthrie 03/ 95

Muskogee

Oklahoma City (adult)\ b

Oklahoma City (juvenil e)

Okmulgee (Muscoge e Nation)

Pontotoc 07/ County\b 97

Seminole 07/ 97

Stillwat 03/ er 95 (adult)

Stillwat er (juvenil e)

Tahlequa h

Tulsa 05/ 96

Oregon

Eugene 09/ 94

Grants 03/ Pass 96

Klamath 03/ Falls 96

McMinnvi lle\b

Pendleto n (Confede rated Tribes of the Umatilla Indian Reservat ion)

Portland 08/ 91

Roseburg 01/ 96

Pennsylv ania

Philadel 03/ phia 97

Pittsbur gh\b

Williams port

York

Puerto Rico

Arecibo 04/ 96

Carolina 04/ 96

Ponce 04/ 96

San Juan 08/ 97

South Carolina

Charlest on (juvenil e)

Columbia 11/ 96

Lexingto 07/ n 96

Orangebu rg\b

South Dakota

Flandrea u (juvenil e/ Sioux tribe)

Lower Brule (Sioux tribe)

Pine Ridge (Oglala Sioux tribe)

Tennesse e

Clarksvi lle

Decaturv ille (juvenil e)

Maryvill e

Memphis\ 02/ b 97

Nashvill 05/ e 97

Texas

Austin 08/ 93

Beaumont 03/ 93

Conroe

Dallas 06/ 97

Fort 09/ Worth 95

Houston

Utah

Provo

Salt 10/ Lake 95 City (juvenil e)

Salt 07/ Lake 96 City (adult)

Vernal

Vermont

Montpeli er

Newport\ b

Virginia

Charlott 07/ esville 97

Frederic ksburg

Newport News

Richmond (juvenil e)

Roanoke 09/ 95

Suffolk

Washingt on

Mount Vernon

Olympia

Port Angeles

Port Orchard

Seattle 08/ 94

Spokane 01/ 96

Tacoma 10/ 94

Wisconsi n

Madison 06/ 96

Milwauke e

Wyoming

Gillette

Sheridan

================================================================================ Total 161 32 112 10 -------------------------------------------------------------------------------- \a Drug court opened 12/95, closed 06/96.

\b No specific information on funding available.

\c Drug court opened 04/96, closed 11/96.

\d Drug court program or jurisdictional official reported no specific drug court program funding.

\e Drug court opened 05/89, closed 05/94.

\f Drug court opened 02/95, closed 06/96.

Sources: GAO analysis of its survey of drug court programs and information obtained from federal agencies and the Drug Court Clearinghouse.

(See figure in printed edition.)Appendix V COMMENTS FROM THE DEPARTMENT OF JUSTICE ========================================================== Appendix IV

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

The following is GAO's comment on DOJ's letter dated July 9, 1997.

GAO COMMENT -------------------------------------------------------- Appendix IV:1

1. DOJ commented that this report does not distinguish between the OJP drug court discretionary grant program authorized by the Crime Act and the two BJA formula and block grant programs. We have modified chapter 2 of our report to identify which grant programs are formula, block, or discretionary grant programs. Since nearly 60 percent of the federal support has been derived from federal grants other than those administered under the Violent Crime Act, and formula and block grant programs have contributed a significant portion (at least one-third) of the federal funds, we have chosen to include them in the scope of our recommendation intended to improve data collection and maintenance and the scope of future impact evaluations of drug court programs. We have modified our recommendation to consider any statutory limitations.

(See figure in printed edition.)Appendix VI COMMENTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES ========================================================== Appendix IV

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

The following is GAO's comment on HHS' memorandum dated July 10, 1997.

GAO COMMENT -------------------------------------------------------- Appendix IV:2

1. In commenting, HHS referred to our next mandated annual report on treatment-based drug courts. However, we were only mandated under Title V of the 1994 Violent Crime Act to do a one-time study of the impact and effectiveness of federal grants administered under this act.

(See figure in printed edition.)Appendix VII COMMENTS FROM THE STATE JUSTICE INSTITUTE ========================================================== Appendix IV

(See figure in printed edition.)

(See figure in printed edition.)

The following are GAO's comments on SJI's letter dated July 7, 1997.

GAO COMMENTS -------------------------------------------------------- Appendix IV:3

1. SJI commented that the report should describe it as a "federally funded private organization." We have modified the report to reflect this comment.

2. SJI raised concerns with the presentation of SJI's level of funding in support of drug court program operations. We have revised our graphic presentation of funding in chapter 2 to show SJI's percentage of the federal sources of funding and have further clarified that, with respect to drug court programs, SJI has provided grants primarily in support of evaluation studies of drug court programs.

(See figure in printed edition.)Appendix VIII COMMENTS FROM THE NATIONAL ASSOCIATION OF DRUG COURT PROFESSIONALS ========================================================== Appendix IV

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)Appendix IX COMMENTS FROM THE DRUG COURT CLEARINGHOUSE AND TECHNICAL ASSISTANCE PROJECT ========================================================== Appendix IV

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

(See figure in printed edition.)

The following are GAO's comments on the Drug Court Clearinghouse's memorandum dated July 8, 1997.

GAO COMMENTS -------------------------------------------------------- Appendix IV:4

1. The Drug Court Clearinghouse suggested that we include commentary in this report on the complexity and urgency of maintaining follow-up data on program participants. In chapter 4 of this report, we provided information on the complexity of collecting and maintaining follow-up data on drug court program participants. We also recognized the need on the part of the drug court community to work together to identify and take steps to collect and maintain such data. In addition, we provided information on legal and regulatory restrictions associated with accessing confidential information, including a discussion of exceptions granted to researchers, auditors, and evaluators.

2. The Drug Court Clearinghouse commented that it was unaware of any drug courts that accept participants with current violent offense charges. Information presented in chapter 3 of this report was derived directly from drug court program officials responding to our survey questionnaire, which in some cases included judges, program coordinators/directors, and/or court administrators. The responses only indicate the programs' policies regarding accepting violent offenders and not the extent to which they actually have such participants, if any, in their programs.

3. The Drug Court Clearinghouse commented that it did not know of any drug courts that permit individuals to participate who do not have substance abuse problems. We have corrected chapter 3 of this report to accurately reflect that 17 percent of the 134 drug court programs we surveyed said that they would admit offenders without a substance addiction.

4. The Drug Court Clearinghouse commented that it believed the level of funding contributions provided by HHS in support of drug court program operations to be lower than we presented. Information presented in our report was derived directly from HHS' CSAT.

5. The Drug Court Clearinghouse suggested that this report be revised to distinguish between drug courts that received federal support and those that did not; and, of those drug courts that received federal support, those that received funding under the Violent Crime Act and those that received other federal funding. Because Violent Crime Act funded programs were just emerging and relatively few studies, if any, had been completed at the time of our review, we reached agreement with the Senate and House Judiciary Committees to expand the objectives and scope of this review to include an overview of growth, characteristics, and results of drug court programs, including assessing all sources of funding.

6. The Drug Court Clearinghouse commented that Violent Crime Act funded drug court programs may be in a better position to more readily provide available data to support recidivism and sobriety goals than other programs because they have had the benefit of more systematic planning, training, and technical assistance. As noted in chapter 4, the results from our survey showed no significant difference between the collection and maintenance of data for Violent Crime Act funded drug court programs and those receiving other sources of funding. Additionally, as we point out in our conclusions presented in chapter 5, until post-program data on program participants outcomes (criminal recidivism and/or relapse) are made available for future impact evaluations, and/or until the scope of impact evaluations includes post-program assessments, program officials, researchers, and/or evaluators will not be able to adequately provide Congress and other interested parties with answers on the overall impact and effectiveness of drug court programs in comparison to other traditional adjudication systems. Therefore, as we conclude and recommend in chapter 5 of this report, it is essential that follow-up information be collected and maintained not only for Violent Crime Act funded programs but all federally funded drug court programs, regardless of federal funding source.

MAJOR CONTRIBUTORS TO THIS REPORT =========================================================== Appendix X

GENERAL GOVERNMENT DIVISION, WASHINGTON, D.C. --------------------------------------------------------- Appendix X:1

Daniel C. Harris, Assistant Director Charles Michael Johnson, Evaluator-in-Charge Barry J. Seltser, Supervisory Social Science Analyst Douglas M. Sloane, Supervisory Social Science Analyst David P. Alexander, Senior Social Science Analyst Stuart M. Kaufman, Senior Social Science Analyst Pamela V. Williams, Communications Analyst Thelma Jones, Writer-Editor George H. Quinn, Computer Specialist Katherine M. Wheeler, Publishing Advisor Jena Sinkfield, Administrative Assistant

OFFICE OF THE GENERAL COUNSEL, WASHINGTON, D.C. --------------------------------------------------------- Appendix X:2

Jan B. Montgomery, Assistant General Counsel Ann H. Finley, Senior Attorney

BIBLIOGRAPHY =========================================================== Appendix 1

STUDIES USED IN GAO'S EVALUATION SYNTHESIS --------------------------------------------------------- Appendix 1:1

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Choices Unlimited Las Vegas. "Clark County Drug Court 42 Month Summary." Apr. 1996.

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Goldkamp, John S. and Doris Weiland. "Assessing the Impact of Dade County's Felony Drug Court." (Final report) National Institute of Justice Research Report. Aug. 1993.

Gottfredson, Denise C., Kris Coblentz, and Michele A. Harmon. "Baltimore City Drug Treatment Court Evaluation: A Short-term Outcome Evaluation of Baltimore City Drug Treatment Court Program." University of Maryland Department of Criminology and Criminal Justice. June 1996.

Granfield, Robert and Cindy Eby. "An Evaluation of the Denver Drug Court: The Impact of a Treatment-Oriented Drug Offender System." University of Denver Department of Sociology. Jan. 1997.

Harrell, Adele and Shannon Cavanagh. "Preliminary Results From the Evaluation of the D.C. Superior Court Drug Intervention Program for Drug Felony Defendants." Urban Institute. (Undated)

Jameson, Robert and N. Andrew Peterson. Evaluation of the First Year of Operation of the Jackson County Drug Court. Ewing Marion Kauffman Foundation. Apr. 1995.

Kelly, William R. "The Travis County Drug Diversion Court: A Preliminary Outcome Evaluation." Submitted to Travis County Pretrial Services. Jan. 16, 1996.

McNeece, C. Aaron and Charles M. Daly. "An Evaluation of the Broward and Hillsborough Counties Drug Courts." Florida State University. Dec. 1993.

Multnomah County Department of Community Corrections. "STOP: Drug Diversion Program/Program Impacts and Evaluation." Apr. 1994.

Oberg, John C. "An Initial Evaluation and Analysis of the Ventura County Drug Court Program." (Draft) Apr. 1996.

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Reed, Emily A. SODAT-DELAWARE, INC.: Drug Court Division Program Annual Report. Apr. 1995.

Roberts-Gray, Cindy. "Process Evaluation IV: SHORT's Treatment Component." (Draft) Travis County, Texas. Apr. 1996.

"Santa Clara County Courts Treatment Court Nine Month Progress Report (Sept. 11, 1995-June 11, 1996)." (Undated)

Smith, Barbara, Robert C. Davis, and Sharon R. Goretsky. "Strategies for Courts to Cope With the Caseload Pressure of Drug Cases." (Draft) The American Bar Association, Criminal Justice Section. Oct. 1991.

Tauber, Jeffrey S. "An Evaluation of Oakland Drug Court After Three Years, (Fast, Intensive, Report, Supervision and Treatment) FIRST." Presented to the National Association of Drug Court Professionals, Las Vegas. Jan. 9, 1995.

Terry, W. Clinton, III. "Broward County Drug Court: A Preliminary Report." Nov. 1993.

Terry, W. Clinton, III. "Felony and Misdemeanor Rearrests of the First Year Cohort of the Drug Court in Broward County, Florida." (Draft) Mar. 1996.

STUDIES OF SEVERAL DRUG COURTS OR SUMMARY EVALUATIONS --------------------------------------------------------- Appendix 1:2

Belenko, Steven. "Comparative Models of Treatment Delivery in Drug Courts." New York City Criminal Justice Agency. Mar. 1996.

Belenko, Steven. "Treatment-Oriented Drug Courts: Issues and Challenges." New York City Criminal Justice Agency. July 18, 1994.

Belenko, Steven and Tamara Dumanovsky. "Special Drug Courts." Bureau of Justice Assistance Program Brief. Nov. 1993.

Campaign for an Effective Crime Policy. Low-Level Drug Offenders: Lessons From the Drug Courts. Nov. 1994.

Cavanagh, Suzanne and David Teasley. Drug Courts: An Overview. CRS Report for Congress, 95-1155 GOV, Updated. Washington, D.C. Oct. 4, 1996.

Cavanagh, Suzanne and David Teasley. Drug Courts: An Overview. CRS Report for Congress, 95-1155 GOV. Washington, D.C. Nov. 29, 1995.

Cooper, Caroline S. Drug Courts: An Overview of Operational Characteristics and Implementation Issues. Vol. 1. BJA Drug Court Resource Center. American University. June 1995.

Cooper, Caroline S. Drug Courts: 1997 Overview of Operational Characteristics and Implementation Issues. Volume One: Preliminary Report. Part One: General Program Information. OJP Drug Court Clearinghouse and Technical Assistance Project. American University. Washington, D.C. May 1997.

Cooper, Caroline S. Drug Courts: 1997 Overview of Operational Characteristics and Implementation Issues. Part Six: Drug Court Treatment Services. OJP Drug Court Clearinghouse and Technical Assistance Project: American University. Washington, D.C. May 1997.

Cooper, Caroline S. Drug Courts: 1997 Overview of Operational Characteristics and Implementation Issues, Preliminary Report. Executive Summary Report. OJP Drug Court Clearinghouse and Technical Assistance Project. American University. Washington, D.C. May 1997.

Cooper, Caroline S. "Expedited Drug Case Management." BJA Courts Bulletin. July 1994.

Cooper, Caroline S. and Joseph A. Trotter, Jr. Drug Case Management and Treatment Intervention Strategies in the State and Local Courts. Vol. 1 (Revised). BJA/SSI Drug Case Management and Technical Assistance and Training Project. American University. Oct. 1994.

Goldkamp, John S. "Justice and Treatment Innovation: The Drug Court Movement." A Working Paper of the First National Drug Court Conference, December 1993. Oct. 1994.

Jacoby, Joan E., Edward C. Ratledge, and Heike P. Gramckow. "Expedited Drug Case Management Programs: Issues for Program Development." National Institute of Justice Research in Brief. Oct. 1992.

Juvenile Drug Courts: Preliminary Report. Drug Court Clearinghouse and Technical Assistance Project. American University. Oct. 15, 1996, and May 1, 1997.

McColl, William D. "Baltimore City's Drug Treatment Court: Theory and Practice in an Emerging Field." Maryland Law Review. Vol. 55, No. 2. 1996.

Prendergast, Michael L. and Thomas H. Maugh, II. "Drug Courts: Diversion That Works." Judges Journal. Vol. 34, No. 3. Summer 1995.

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Tauber, Jeffrey S. "Drug Courts: A Judicial Manual." CJER Journal. Summer 1994.

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What We Are Getting for Our Federal Drug Control Dollars?, Drug Strategies. 1995.

OTHER STUDIES REVIEWED --------------------------------------------------------- Appendix 1:3

Bailey, Cheryl and Ellen Talley. "Study of Drug Treatment Court." State of Maryland Department of Public Safety and Correctional Services, Division of Parole and Probation. Feb. 29, 1996.

Bureau of Justice Assistance. Drug Night Courts: The Cook County Experience. Aug. 1994.

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Cooper, Caroline. "Multnomah County STOP Program Evaluation." Memorandum to various individuals. American University Courts Technical Assistance Project. July 5, 1994.

Deschenes, Elizabeth Piper and Peter W. Greenwood. "Maricopa County's Drug Court: An Innovative Program for First-time Drug Offenders on Probation." Justice System Journal. Vol. 17, No. 1, pp. 99-115. 1994.

Deschenes, Elizabeth Piper and Sam Torres. A Process Evaluation of Los Angeles County Drug Courts. Oct. 1996.

Deschenes, Elizabeth Piper and Sam Torres. "An Evaluation of LA County Drug Courts." (Undated)

Deschenes, Elizabeth Piper, Susan Turner, and Peter Greenwood. "Drug Court or Probation?: An Experimental Evaluation of Maricopa County's Drug Court." RAND. June 1995.

Doerner, John P., Edwin T. Zimny, Jr., and Steven V. Berson. "Case Model & Operations Review, Second Judicial District, Denver Drug Court." Aug. 16, 1996.

Drug Courts Program Office, Office of Justice Programs, U.S. Department of Justice. Defining Drug Courts: The Key Components. Jan. 1997.

Drug Courts Program Office, Office of Justice Programs, U.S. Department of Justice. Drug Court Grant Program Fiscal Year 1996: Program Guidelines and Application Kit. (Undated)

Finigan, Michael. "Social Outcomes & Cost Savings of Drug & Alcohol Treatment in the State of Oregon." Office of Alcohol and Drug Abuse Programs, Oregon Department of Human Resources. Feb. 1996.

Finn, Peter and Andrea K. Newlyn. "Miami's `Drug Court': A Different Approach." National Institute of Justice Program Focus. June 1993.

Florida Department of Community Affairs, Division of Housing and Community Development, Bureau of Community Assistance. "Drug Treatment Programs for Florida's Offenders Funded by the Drug Control and System Improvement Grant." Aug. 1994.

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Gottfredson, Denise C., Kris Coblentz, and Michele A. Harmon. "A Short-term Outcome Evaluation of the Baltimore City Drug Treatment Court Program." Perspectives, pp. 33-38. Winter 1997.

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Tapia, Frank. "Summary of the FIRST Drug Diversion Program." Presented to the National Drug Court Conference. Miami. Dec. 1993.

Tauber, Jeffrey S. "The Importance of Immediate and Intensive Intervention in a Court-Ordered Drug Rehabilitation Program: An Evaluation of the Oakland Drug Court After Two Years (Fast, Intensive, Report, Supervision and Treatment." Presented to the President's Commission on Model State Drug Laws. Mar. 10, 1993.

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