Substance Use Disorder Treatment Alert!

Deadline Approaching: Review and comment by April 11, 2016

Have you seen the Substance Abuse and Mental Health Services Administration’s (SAMHSA) proposed changes to 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records? If not, we recommend taking a look and commenting as an individual, agency/organizational, or community collaboration. Feel free to share praises and/or critiques about the proposed changes with SAMHSA.

Here are some key highlights:

  • Rewind time to more than four decades ago - 42 CFR Part 2 was conceptualized and approved to provide iPAGE2-COURTROOMndividuals seeking substance use disorder treatment with protections for privacy and confidentiality. It was acknowledged that stigma and fear of potential repercussions (familial, employment; criminal) prevented people from seeking treatment.
  • The last “substantive” update to 42 CFR Part 2 was in 1987 (approaching three decades ago).
  • There have been substantial changes in the way substance use disorder treatment is provided including a greater number of integrated health care centers (primary and behavioral health) and greater use of electronic health records. As such, modernizing 42 CFR Part 2 is necessary.
  • The proposed regulations will continue to apply to federally-assisted “programs“ which “holds itself out as providing, and provides substance use disorder diagnosis, treatment, or referral for treatment.” General medical facilities have always been included as a “program”, but the proposed change adds “general medical practices” to the definition.
  • It proposes if agencies and organizations that have “general designation” on consent form(s) they must provide patients a list of where their information has been shared.
  • Proposes agencies and organizations must have policies and procedures in place to sanitize paper and electronic records.

News from the National Executive Director, March 2016

-sad-tears-cry-depression-mourning-2A critical element of the juvenile justice reform narrative in the past decade has been our elevated understanding of the role that trauma plays in the experiences of young people - particularly those involved with the juvenile justice and child welfare systems. With traumatic events and victimization affecting millions of youth each year, childhood trauma has genuinely become a pressing public health issue.

Weekly News Roundup

Newspapers B&W, © 2011 Jon S, Flickr | CC-BY | via WylioEvery week we round up the latest news on juvenile justice reform, adolescent substance use treatment, and teen mental health. 

Topics: News

A New Resource for Developing Trauma-Informed Systems

Trauma - a six letter word that carries a lot of significance. Depending on your education and experiences the word brings different thoughts, feelings, and reactions. It is a topic that has received a lot of recognition in the past few decades and is comprehensively described in a publication recently released by the National Center for Mental Health and Juvenile Justice Strengthening Our Future(NCMHJJ). Strengthening Our Future: Key Elements to Developing a Trauma Informed Juvenile Justice Diversion Program for Youth with Behavioral Health Conditions provides necessary background and implementation practices for those working in the juvenile justice system.  One aspect I found very helpful was the concrete examples of how jurisdictions have operationalized implementation practices. For example, a case example from Indiana is provided on page 21. As a way to be trauma-informed - Indiana took a procedural approach. More specifically, Indiana started by reviewing and selecting an assessment, integrated it into the electronic information technology system, supplemented the assessment with a trauma specific assessment, and providing training for personnel working within juvenile justice. This publication is a useful resource that can assist in the development of policies and procedures, practices, and training.

Topics: Resources, Trauma

News from the National Executive Director, February 2016

Maria Hernandez, a Santa Cruz Reclaiming Futures participant, with her mom.

It took decades and a mountain of research evidence showing that incarcerating adolescents does little to prevent recidivism before policymakers took notice and began supporting measures to reduce incarceration and invest in community-based alternatives that prioritize treatment and support for youth and their families. Increasingly, over the past 15 years, we have seen the field come together around the common goal of creating a system for justice-involved youth that is more therapeutic, less punitive, less reliant on detention and incarceration, and more thoroughly grounded in research evidence and best practice. The catalyst for this paradigm shift has been a series of significant strategic investments by federal agencies and by major foundations like Annie E. Casey with its Juvenile Detention Alternatives Initiative, the MacArthur Foundation and its Models for Change, and the Robert Wood Johnson Foundation’s (RWJF) investment in Reclaiming Futures. These investments have all paid off in different ways to drive the field forward.

Reclaiming Futures Cuts Crime, Saves Money

National evaluation shows that Reclaiming Futures generated $11 million in cost savings over one year; promoted better outcomes for teens and communities.

Five communities using the Reclaiming Futures model — a national public health and juvenile justice reform framework that promotes effective treatment practices — saved $11 million in one year. The national evaluation showed that juvenile drug courts implementing the Reclaiming Futures model saw significant reductions in crime and delinquency, which drove these notable fiscal savings.

Conducted by the University of Arizona’s Southwest Institute for Research on Women and funded by the Office of Juvenile Justice and Delinquency Prevention through an interagency agreement with the Library of Congress, research examined cost savings over a 12-month period at five juvenile drug courts around the country where the Reclaiming Futures model was implemented. Results show that the savings from implementing Reclaiming Futures are more than double its cost; net savings amounted to $84,569 per teen. Serving a total of 139 teens over the year of the study, these five communities saved more than $11 million in total. Further, average savings were even greater among participating teens with severe clinical problems, amounting to $232,109 in savings per teen.

National Mentoring Month: A Question From the Field

Q: How can our juvenile drug court (JDC) maintain and sustain a mentoring program?

A: Mentoring programs can enhance the success and effectiveness of JDCs. Maintaining and sustaining a mentoring program requires cooperation among JDCs, community, and stakeholders. JDCs must have access to a full range of funding, staffing, and community resources required to sustain a mentoring program over the long term.

The longevity of any JDC program relies upon funding and community support. Courts that have been successful have leveraged cross-system resources and opportunities to obtain more funding from all available state and community resources. Community support increases the adaptability and sustainability of mentoring programs by providing mentors, funders, collaborators, and communication agents. It also increases opportunities for contact between youth and positive environments, provides activities for mentors and youth to engage in, and provides youth a feeling of belonging.

OJJDP Policy Guidance: Girls and the Juvenile Justice System

Girls are increasingly over-represented in the juvenile justice system; particularly girls living in poverty and young women of color, according to the Office of Juvenile Justice and Delinquency Prevention (OJJDP) in their recently released policy guidance: "Girls and the Juvenile Justice System." The significant increase of justice-involved girls over the past two decades was also demonstrated in September by Francine T. Sherman and Annie Balck in their "Gender Injustice" report; girls now account for almost 30 percent of youth arrests. OJJDP's new policy guidance calls for the identification and recognition of known risk factors - which lead girls to the justice system - and the implementation of developmentally informed approaches in order to reduce and divert the involvement of girls in the system. OJJDP's policy guidance aligns with the White House Council on Women and Girls' intention to advance equity for women and girls of color.

Identifying Risk Factors  

OJJDP's policy guidance identifies a number of risk factors which lead to involvement of girls in the juvenile justice system, also referred to as the sexual abuse/trauma-to-prison pipeline

Most States Still House Some Youth in Adult Prisons, Report Says; News Roundup

Every week Reclaiming Futures rounds up the latest news on juvenile justice reform, adolescent substance use treatment, and teen mental health. 

Most States Still House Some Youth in Adult Prisons, Report Says (Juvenile Justice Information Exchange)
A new report from Campaign for Youth Justice finds that most states still house youth in adult prisons, putting them at risk for abuse. Now is a good time to end this practice, according to the report, due to a recent decrease of youth housed in both adult and juvenile facilities.

Topics: News

New Report, Reducing Teen Substance Misuse: What Really Works

medicine-385947_1920A new report, "Reducing Teen Substance Misuse: What Really Works," calls attention to the rising rate of teen overdose fatalities in the United States, the role of prescription painkillers, as well as research-based solutions for prevention and treatment. The report, supported by a grant from the Conrad N. Hilton Foundation, was authored and produced by Trust for America's Health (TFAH), a Washington D.C.-based nonprofit, non-partisan organization with a focus on public health policy and community prevention and treatment strategies. 

Significant Increase in Teen Overdose Fatalities

TFAH finds that youth drug overdose fatalities, among 12 to 25 year-olds, more than doubled in 35 states over the past ten years, particularly among young men and boys. Fatality rates for youth overdose more than doubled in 18 states, more than tripled in 12 states, and more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming). Analyses reveals that, while no state had a youth overdose death rate over 6.1 per 100,000 before 2001, 33 states were above 6.1 per 100,000 deaths by the year 2013.

Teen Drug Overdose Death Rate Doubles Over Last Decade; News Roundup

Every week Reclaiming Futures rounds up the latest news on juvenile justice reform, adolescent substance use treatment, and teen mental health. 

Teen Drug Overdose Death Rate Doubles Over Last Decade (Psychiatry Advisor)
Trust For America's Health released a new report with findings that the American drug overdose mortality rate has more than doubled over the last ten years, and especially among young men between the ages of 12 to 25 years old. Prescription drugs were found to be responsible for many of the overdoses, and were also found to be connected to heroin addictions in young people.

November is Native American Heritage Month

first-nation-908605 (2)President Obama has proclaimed November as "Native American Heritage Month." This is a time to celebrate the many significant historic and contemporary contributions of American Indians and Alaska Natives, a population of 5.4 million people in the United States, according to the U.S. Census Bureau. In the juvenile justice field, this month is not only a time to celebrate Native American heritage, but also an opportunity to make visible the unique youth justice challenges faced by Native American communities, and to highlight steps for collaboratively working with tribal communities to improve conditions for Native American youth and their families.

Though 1990 was the first year "Native American Indian Heritage Month" was recognized as a national legal holiday, according to the U.S. Bureau of Indian Affairs, the pursuit of a holiday to celebrate heritage began in the early 20th century when Dr. Arthur C. Parker - a Seneca Indian and director of the Museum of Arts and Sciences in Rochester, New York - promoted a day to celebrate "First Americans." In May 1916, the first "American Indian Day" was declared by the state of New York, and many states observed a version of this day for years before official national recognition in 1990 for the month of November.

States Look Beyond Incarceration to Rearrest Rates; News Roundup

Every week Reclaiming Futures rounds up the latest news on juvenile justice reform, adolescent substance use treatment, and teen mental health. 

States Look Beyond Incarceration to Rearrest Rates (Juvenile Justice Information Exchange)
The Council on State Governments reports that while juvenile arrest rates are down, rearrest rates are still high, sometimes reaching 80 percent in certain states. As a result, researchers and policymakers urge officials to look for ways to improve the lives of youth after they return to their communities, preventing further contact with the system.

12th Annual Natural Helper Recognition Banquet in Montgomery County, Ohio

On October 27, 2015, Montgomery County Juvenile Court, Judge Nick Kuntz and Judge Anthony Capizzi hosted the 12th annual Natural Helper Recognition Banquet. As one of the ten original RFBanq2015GroupReclaiming Futures sites, this year marked our twelfth year of our Natural Helper program. Our volunteers and community partners that make our initiative a success were recognized for their
achievements. This year’s event was held at the Presidential Banquet Center in Dayton, Ohio. Approximately 200 community leaders, partners, Natural Helpers and Juvenile Court staff were in attendance, including members of the Lucas County Reclaiming Futures team.

The evening started with entertainment provided by the talented Novae A Capella Group, a student cappella group at Centerville High School whose motto is, "Shine like stars, work like bees, and sing like angels." Their performance was enjoyed by all in attendance. Special guest speaker, Brian Jenkins, a local businessman, author and motivational speaker provided a wonderful story of addiction, incarceration, recovery and the impact two special mentors had on his life. One particular part of his message really resonated with the audience: “For all of you who are mentoring and wonder if all of your efforts are ever recognized by the people you are working with, I am here to tell you that they are. Please don’t give up.”

Welcoming NW Ohio: Our New Rural Community Collaborative Site

The National Program Office (NPO) is very pleased to announce Reclaiming Futures' new rural community collaborative site in NW Ohio. The NW Ohio Reclaiming Futures (NORF) Initiative is a collaboration between Defiance, Henry, and Williams Counties, as well as their regionally shared service providers and community stakeholders. As a new example of a Reclaiming Futures rural community collaborative site (the site model also exists in Kentucky and North Carolina), NW Ohio provides an important example of a site tapping into an innovative state justice reinvestment fund in order to join the Reclaiming Futures initiative.

NW Ohio is Reclaiming Futures' fifth site in the state of Ohio. Evan Elkin, Executive Director of Reclaiming Futures, credits the growing presence of Reclaiming Futures in Ohio to the neighborly and supportive tendencies of Ohioans, which creates a grassroots sharing of information. “They share with their communities and around the state - and word of the positive outcomes the existing sites are seeing is getting around,” explains Elkin.

Defiance, Henry, and Williams Counties of NW Ohio provide an excellent example of Ohio's collaborative and supportive nature, and how this quality of working together and sharing resources particularly benefits rural communities. The three counties joined together to propose the NORF Initiative upon recognizing a need in their communities for more consistency and specifically...