Anchorage
Wellness Court: 2001-2002 Summary of Facts
April 18, 2003
Principal
Investigator:
Tessa De Long
Graduate Student
Masters of Public
Administration
University of Alaska
Anchorage
Faculty Adviser:
Sharman Haley, Ph.D.
Associate Professor
of Public Policy
Institute of Social
and Economic Research
University of Alaska
Anchorage
Executive Summary
The purpose of this research was to conduct a program
evaluation of the Anchorage Wellness Court, measuring the effects of the
Court’s treatment modalities on program participants. The research methodology focused on
evaluating and measuring how recidivism rates of Wellness Court participants
and non-participants compare.
Additionally, the methodology attempted to measure the cost-savings of
the Anchorage Wellness Court for the general public. The research was primarily quantitative, but
also included qualitative analysis. The
quantitative data for this analysis was collected from information and records
made available by the Alaska Judicial Council, Alaska Court System, Alaska
Department of Corrections, Department of Health and Social Services, Division
of Alcoholism and Drug Abuse, ASAP Misdemeanor Services and the Municipality of
Anchorage, Department of Law, Prosecutor’s Office (collectively “Wellness Court
sources”).
The project took 13 weeks and approximately 450 graduate
student hours to complete. Final
conclusions are provided in this report, and will also be summarized in an oral
presentation to the University of Alaska, Anchorage Masters of Public
Administration Capstone class participants on April 18, 2003.
The primary conclusions of the program evaluation are as
follows:
1. The
Anchorage Wellness Court is helping program participants to overcome their
life-long addiction to alcohol and providing them with the skills and therapies
necessary to become active citizens in their communities.
2. The
analysis of Anchorage Wellness Court participants in 2001 and 2002 indicates
that graduates are benefiting, at least in the short term, from the positive
components of the Wellness Court treatment methodology.
3. Graduates
and Wellness Court participants have lower incidences of recidivism in
comparison to individuals who were eligible for, but declined entrance to, the
Wellness Court program and national recidivism averages.
4. The
costs associated with the Anchorage Wellness Court are markedly lower than
those for traditional incarceration.
The primary recommendations of the program evaluation are as
follows:
1. Partners
for Progress should develop a program database to track program participants
and compile necessary data for further review and analysis.
2. A
more detailed evaluation of the Anchorage Wellness Court should be
conducted. This analysis should include
the complete prior history of all participants, including any offenses
committed and time served in other states, and attempt to find the correlation
between Wellness Court enrollment and successful completion and demographic
variables such as age, race, and gender.
Statement of Work
There is a great deal of information about therapeutic
justice and drug courts and their role in larger court system. There is also a wide array of literature and
academic research on the effects that alcohol and drug abuse have on the
economy both nationally and regionally.
In Alaska, a comprehensive study of the costs associated
with alcohol and other drug abuse was prepared for the Advisory Board on
Alcoholism and Drug Abuse, Department of Health and Social Services. The study, “Economic Costs of Alcohol and
Other Drug Abuse in Alaska, Phase Two,” was conducted by the McDowell Group in
November 2001. The study claims that
9.7% of Alaska’s population is alcohol dependent. The cost of this alcohol dependency to the
Alaska economy is estimated to be $453 million during 1999. The study also claims that 17,100 arrests in
1999 were attributed to alcohol or other drug abuse. Costs attributed to crime-related alcohol and
other drug abuse in the state was $102 million.
While there is a great deal of information and evaluation at
the local and state level, the Anchorage Wellness Court is relatively new and
has only been partially evaluated.
Complete data on program participants has only recently been collected
(data is available for calendar year 2001, 2002 and year-to-date for 2003).
An initial analysis in 2001 suggested that Wellness Court
participants who graduated from the program were less likely to re-offend than
individuals who chose to opt-out of the program. This analysis was somewhat inconclusive
because it was conducted on a very small population, and lacked a comparison
group. What is not yet known about the
Wellness Court, and what this project seeks to determine, is whether the
initial findings indicating a causative relation between the Wellness Court
experience and reduction in recidivism is supported
by an additional year of data and by data from a comparable group of offenders
who did not participate in Wellness Court. As a result, the research question guiding
this program evaluation is:
Does an individual’s participation
in the Anchorage Wellness Court increase his/her chances of maintaining
sobriety, reduce recidivism rates and reduce the public costs?
Existing Information
The data for this analysis was collected from information
and records made available by the Alaska Judicial Council, Alaska Court System,
Alaska Department of Corrections, Department of Health and Social Services,
Division of Alcoholism and Drug Abuse, ASAP Misdemeanor Services and the
Municipality of Anchorage, Department of Law, Prosecutor’s Office (collectively
“Wellness Court sources”). Both demographic and offense history information was
collected. The Department of Corrections
data contains all previous history (within the state of Alaska only), current
Wellness Court charge and any recidivism occurrences. There is an abundance of robust data, however
it has not been holistically analyzed and compared in previous evaluations.
New Information
New information was generated in the following categories:
1) Wellness
Court participants, graduates and opt-out demographics
2) Comparison
group demographics. The comparison group
was made up of individuals who were eligible for Wellness Court and were given
the option of opting into the Wellness Court, but chose not to enter the
program.
3) 2
year comparison of Wellness Court participants and graduates with the
comparison group
4) Comparison
of total costs associated with Wellness Court participants, graduates and
opt-outs and the comparison group
Scope of Work
The following tasks were completed in the course of this
program evaluation:
1) Met
with Partners for Progress Executive Director, Robyn Johnson, and Center for
Therapeutic Justice Program Manager, Jill McLeod, to refine the research
question and reach a written agreement on the program evaluation approach
2) Obtained
necessary data from Department of Corrections and Wellness Court sources
3) Analyzed
data
4) Wrote
and submitted a final program evaluation report
Wellness Court Program – History in Brief
In 1999 Partners for Progress, a 501(c)(3) non-profit
organization whose mission is “to assist alcoholics and alcoholic misdemeanants
in making changes needed to achieve a better life,”
assisted Judge James N. Wannamaker in starting the Wellness Court as a pilot
project.
The Wellness Court is for municipal misdemeanor defendants
who are addicted to alcohol and want to overcome their addiction. The purpose of the Wellness Court is to assist
alcoholic offenders in overcoming their addiction and maintain sobriety. A defendant is eligible to participate in the
Wellness Court program if he/she has been charged with an alcohol-motivated
misdemeanor offense and is an alcoholic.
Admission to the Wellness Court is not automatic. Cases are reviewed
on an individual basis, and some people are refused admission because of a
record of violence or factors indicating lack of motivation to change. Participation in the Wellness Court is
voluntary.
Once a defendant has successfully “opted-in” to the Wellness
Court he/she follows the basic structure of the Court Treatment Plan:
- Alcohol
treatment and counseling,
- Prescribed
the prescription medication Naltrexone for 120 days. ( Naltrexone reduces or stops and
individual’s cravings for alcohol),
- Frequent
court appearances before the Wellness Court judge,
- 12
step meetings (e.g, Alcoholics Anonymous)
- Nalgroup®
meetings (A support group for individuals taking Naltrexone),
- Moral
Reconation Therapy® (A cognitive behavior training addressing moral
reasoning, decision making and faulty, irrational beliefs in addicts),
- Compliance
logs for all treatment plan requirements
- Monitored
for sobriety (e.g, urinalysis, Sobrietor®, Anchorage Police Department
home visits, etc.),
- Obtain
employment and/or attend school,
- Maintain
sobriety for 18 months,
- Recognition
for progress and sanctions imposed for non-compliance.
After four years of apparent successes in treating alcoholic
misdemeanants, Partners for Progress desired to know if the Anchorage Wellness
Court had actually caused participants and graduates to reduce their recidivism
rates and maintain sobriety.
Statistical Analysis
Wellness Court
Participants
Wellness Court participants and members of the comparison group
are predominantly middle-aged males. A
majority of the participants have a history of dropping out of treatment, or
failing prior treatment. The following table provides demographic
details on the 2001 and 2002 Wellness Court participants, as well as the
comparison group. Figure 1 details the
number of percentage of opt-outs, graduates and enrolled participants in 2001,
2002 and cumulatively (2002 participant group includes 21 individuals who
“carried-over” from 2001).
|
|
2001 Wellness Court
|
2002 Wellness Court*
|
Comparison Group
|
|
Total participants
|
34
|
45
|
30
|
|
Gender
|
11 female (32%)
23 male (68%)
|
15 female (33%)
30 male (67%)
|
5 female (17%)
25 male (83%)
|
|
Average Age of all
participants
|
41
|
43
|
40
|
|
Average Age of male
participants
|
42
|
43
|
39
|
|
Average age of
female participants
|
39
|
42
|
46
|
|
Total Graduates
|
8 (24%)
|
4 (9%)
|
N/A
|
|
Total Opt-Outs
|
5 (15%)
|
11 (24%)
|
N/A
|
|
Total retained
participants
|
21 (61%)
|
30 (67%)
|
N/A
|
*2002 participant total includes 21 individuals who were
carried over from 2001. There were 24
new participants in 2002.
Wellness Court Participants: 2001, 2002 & Cumulative
|
Figure 1
The ethnicity of
Wellness Court participants in 2001 and 2002 was predominantly Alaska Native
and Caucasian. Ethnicity data was not
available for the comparison group participants. Figures 2 and 3 provide ethnicity data on
Wellness Court participants.
2002 Wellness Court Participant
|
Figure 2 Figure 3
Partners for Progress have received several questions
regarding the ethnicity of their graduates.
The Wellness Court was not developed to be culturally relevant to any
particular ethnicity. Some individuals
may suggest that because of that, it may not work as effectively for
individuals of a particular cultural background e.g. Native Alaskan
heritage. Initial findings from this
report refute such an assumption that Alaska Natives might not succeed. While the number of graduates is arguably
small, Figure 4 demonstrates that Native Alaskans have succeeded at a higher
rate then other ethnic groups in the Wellness Court program.
Ethnicity
of Wellness Court Graduates
|
Figure 4
The majority of Wellness Court participants lack financial
resources to hire their own attorneys and are represented by the municipal
public defender firm.
Approximately 80% of Wellness Court participants and
comparison group members enter Court on a DUI/DWI charge. Others are charged with assault, disorderly
conduct, domestic violence and child abuse (neglect). The majority of participants, in each of the
three groups, have extensive records of alcohol-related crime, ranging upwards
of 55 prior convictions. Cumulatively,
the 2001 and 2002 participants had spent approximately 116 years in jail before
they entered Wellness Court. In today’s
dollars, that amount of jail time cost the public approximately $4.8 million in
direct jail costs. The comparison group
participants had spent approximately 50 years in jail before they were eligible
to enroll in Wellness Court. In today’s
dollars, that amount of jail time cost the public approximately $2 million in
direct jail costs. Neither of the
estimated figures for Wellness Court participants or comparison group
participants includes all associated costs of court and police time, failed
treatment, health care, lost wages, property damage, and societal and family
harm.
Jail Days/Prior
Offenses
Figure 5 depicts the number of jail days, both prior and
post, for 2001 and 2002 Wellness Court participants and comparison group
members.
Total Jail Days: Prior and Post Wellness Court
|
Total Prior DaysCourt
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|
Figure 5
Prior DUIs and prior “other” offenses were calculated and
compared for each of the three groups.
Prior DUIs are of particular interest to Partners for Progress, as a
majority of Wellness Court participants enter Wellness Court on a DUI or
DUI-related charge.
For the 2001 Wellness Court group 30 (94%) individuals had a
total of 102 DUIs, and averaged 3.4 DUIs per individual. For the 2002 Wellness Court group 41 (91%)
had a total of 168 DUIs, and averaged 4 DUIs per individual. For the comparison group 25 (83%) individuals
had a total of 56 DUIs, and averaged 1 DUI per individual. The comparison group has far fewer total and
average DUIs than both the 2001 and 2002 Wellness Court participant
groups. These findings may suggest that
individuals who have committed more DUI offenses, and are faced with more
lengthy incarceration sentences are more likely to opt-in to Wellness Court,
than first time DUI offenders.
Figure 6 details the prior offense history for all three
groups including both DUI and prior
“other” offenses.
Figure 6
Incidences of recidivism were
calculated in two ways for 2001 and 2002 Wellness Court participants (during
Wellness Court or after Wellness Court
opt-out). The following table details
this computation, and provides further recidivism information for each of the
three groups:
|
|
2001
|
2002
|
Comparison
|
|
Total number of
participants who recidivated
|
12 (35%)
|
9 (20%)
|
19 (63%)
|
|
Total Number of
Recidivating Graduates
|
2 (100% after Wellness Court opt-out)
|
0
|
N/A
|
|
Total Number of
Recidivating Opt-Outs
|
2 (100% after Wellness Court opt-out)
|
4 (13%during Wellness Court enrollment) 4 (13% after Wellness Court
Opt-Out)
|
N/A
|
|
Total Number of
Recidivating Retained Participants
|
8*
|
1
|
N/A
|
|
*Each of these 8 individuals were carried over into the
2002 Wellness Court group.
|
Figure 6 displays the total incidences of recidivism for the
2001 and 2002 Wellness Court participants in comparison to the comparison
group, and the national recidivism average.
Wellness Court participants, both graduates and opt-outs, have
significantly lower incidences of recidivism than their comparison group and
national counterparts. Figure 7 displays the total incidences of recidivism for
each of the three groups. The comparison
group has a significantly greater rate of recidivism than the 2001 and 2002
Wellness Court groups. Nationally, in
2000, 67% of all released individuals are rearrested within 3 years of release
from incarceration.
Recidivism Rate Comparison
|
Figure 7
Cost Analysis
Figure 8 details the total cost of Wellness Court, per
participant for 18 months, based on data provided by Partners for
Progress. Figure 9 details the
percentage of contribution for Wellness Court costs made by Partners for
Progress (PFP)/Offender and the State of Alaska. Figure 10 provides a detailed schedule of
Wellness Court Costs, including the percentage of specific individual’s salary
directed towards Wellness Court activities, and specific costs related to
Naltrexone and therapy for 2002 (costs calculated for 45 individuals).
Wellness Court Costs Per Participant for 18 months
|
Figure 8
Figure 9
Figure 10
Department of Corrections estimates that the average cost of
incarceration, in traditional jail facilities in the state of Alaska is $113
per day. Figure 9 details the difference
in cost, on an individual basis, between Wellness Court participation and
traditional methods of incarceration.
Calculations are based on the 18 month cost associated with Wellness
Court ($11,708) versus 18 months in jail (547 days) @ $113. These figures demonstrate that the cost of
Wellness Court is less than 10% of the cost of traditional incarceration. Furthermore, the State of Alaska pays
approximately half (52%) of the $11,708 per individual in Wellness Court, but
pays 100% of the cost of traditional incarceration.
Figure
11