The Bronx Treatment Court (BxTC) in New York City provides an alternative to probation and confinement for first-time nonviolent felony drug offenders. The goals of the treatment court are to decrease any delays in case processing and to reduce offenders’ drug dependency and criminal activity while maintaining public safety. The court uses a post-plea model, which means defendants plead guilty to an eligible drug charge before participating in the program. Defendants also agree to a specific sentence should they fail the program. Should defendants graduate from the program, pending drug charges against a defendant may be dismissed or reduced to a misdemeanor.
Defendants are considered paper eligible if they are arrested on nonviolent felony charges, do not have a prior felony conviction, are 19 years of age or older, and are not arrested on charges involving drug sale near school property. Paper eligibility is established through an automatic screening process.
At arraignment, eligible cases are adjourned to the drug court, and a treatment liaison from a local treatment program conducts a clinical assessment of the defendant. The assessment helps determine whether a defendant has an addiction and is clinically eligible to participate in the program. If the assessment determines that a defendant does not have a drug addiction, or suffers from severe medical or mental health issue that could compromise the effectiveness of court-mandated treatment, the defendant is ineligible to participate in BxTC.
Defendants that are found to be eligible must agree to plead guilty to a drug felony in order to participate in the drug court program. Once they become participants of BxTC, all defendants agree to the same treatment mandate.
The treatment mandate involves at least 11 months of participation in drug court, divided into three phases of treatment. The first phase requires 60 days of drug-free participation and compliant time. The second phase requires 5 months of general compliance, and the final phase requires 4 consecutive months of drug-free and compliant time. The first two phases generally focus on compliance (e.g., trying to maintain abstinence, attending treatment, attending all scheduled court appearances, and avoiding warranting). During these phases, the program uses a compliant time clock, which is stopped when a sanction occurs and may be restarted afterwards. The third phase is the only phase that officially requires participants to complete an extended and consecutive drug-free period.
In addition to the time requirements of compliance and abstinence, drug court participants must be working, be enrolled in a full-time training program, be enrolled in school, or have a Supplemental Security Income application pending.
BxTC uses a case management and treatment model where the court maintains a close working relationship with a core group of seven treatment providers. The providers serve as the primary providers of treatment and as the onsite clinical assessment team that reviews new cases. Treatment providers may run outpatient and inpatient programs, residential programs, gender-specific programs for mothers, methadone-to-abstinence programs, or a detoxification-of-methadone program. There is also a treatment provider that works specifically with offenders who are mentally ill chemical abusers. Aside from treatment services, most providers offer individual and group counseling, life skills training, education, job training, and job placement. BxTC refers each defendant to the treatment provider that will best suit the individual’s needs.
The provider-centered model allows the court to rapidly place new participants into a treatment program. Once a defendant agrees to participate in BxTC, for example, they can almost immediately be placed into a treatment slot in one of the core programs (usually that same day). The model also reduces drug court costs because case management functions are incorporated into the responsibilities of treatment providers.
Most of the treatment providers offer outpatient treatment, which reflects the drug court’s preference in using an outpatient modality when possible. Since BxTC is an alternative to incarceration, the overall philosophy is to provide community-based treatment alternatives, allowing participants to remain living at home if possible. Inpatient rehabilitation or residential programs are available only if a participant first tries outpatient treatment and encounters problems.
Participation in BxTC requires appearances before the drug court judge at least twice a month during the first phase of treatment and once a month in subsequent phases. During court appearances, the judge speaks with each defendant about how treatment is going or why there has been a problem, typically observing any progress or noncompliance during these conversations. The judge administers a system of rewards and sanctions based on participants’ compliance with program requirements. Infractions from the program could include a positive drug test, a missed appointment with treatment providers or the court, consistent lateness, or violation of court rules. BxTC has a formal sanctions schedule that indicates which infractions could lead to a particular type of sanction. Sanctions can include time in jail (ranging from 1 to 25 days), returning to an earlier phase of the treatment mandate, more frequent drug testing, or attending more restrictive drug treatment. Compliant behavior can be rewarded with advancement to the next treatment phase, praise from the judge, and applause from everyone present in court.
Participants can fail to graduate from BxTC due to repeated noncompliance, a new arrest, or voluntary opt-out from the program. Usually a participant does not fail due to noncompliance unless terminated from an outpatient program and from at least two inpatient programs. A new arrest may or may not lead to program failure, depending on the specifics of the new case. Program participants who fulfill the time requirements of the treatment mandate, such as completing 4 months of consecutive and drug-free time during the final phase, can have the charges of their case dismissed or reduced from a felony to a misdemeanor.
Treatment liaisons come from each of the core treatment providers. They make regular visits to the court on different days of the week to assess new defendants, find suitable placements for eligible participants, and report to the court on the progress of participants already enrolled in the program.
Three case managers work directly for the drug court. They perform more of a coordinating role in the program by connecting new cases with a treatment liaison and performing initial assessments of defendants only if no liaison is available. One case manager focuses specifically on outpatient cases, while the other focuses on residential cases. Case managers are available to meet with BxTC participants if they need to discuss a problem with treatment. Unlike similar drug courts in New York, participants are not required to meet with case managers on a regular basis. Instead, monitoring, support, and troubleshooting are primarily concerns of the counselors at the treatment providers.
The courtroom members also include the drug court judge, the judge’s law clerk, a Legal Aid attorney, and a representative from the District Attorney’s office. The judge meets with a Legal Aid attorney and a representative from the District Attorney’s office every morning to discuss each case on the day’s calendar.
Recidivism One Year Post-Program
At 1 year after program completion, Rempel and colleagues (2003) found that 16 percent of the Bronx Treatment Court (BxTC) participants had new drug convictions, compared with 29 percent of the comparison group—statistically significant difference.
Drug Recidivism One Year Post-Program
At 1 year after program completion, 12 percent of BxTC participants had new drug convictions, compared with 22 percent of the comparison group—a statistically significant difference.
Recidivism 3 Years After Initial Arrest
At 3 years after their initial arrest (that led to participation in the program), 35 percent of BxTC participants had a new conviction, compared with 50 percent of the comparison group—a statistically significant difference. The 3-year difference means that BxTC generated a 30 percent relative recidivism reduction, compared with the comparison group level.
Rempel and colleagues (2003) used a quasi-experimental design with propensity score matching to evaluate the effectiveness of the Bronx Treatment Court (BxTC). The treatment sample included 375 drug court participants who had been arrested by June 2000 and had at least 2-year postarrest recidivism data available. The comparison group included 374 defendants arrested in the Bronx on a top charge of criminal sale of a controlled substance in the third degree, a Class B felony, in the 4 months prior to the opening of the drug court in March 1999. The comparison group was limited to defendants with this particular charge because this was the predominant charge among actual BxTC participants, accounting for 90 percent of program participants’ cases.
Propensity score matching techniques were used to match members of the treatment group to the comparison group. The propensity score techniques were ultimately modified for a number of reasons, however. First, the initial samples of treatment and comparison groups were contrasted to determine if there were any significant differences between the groups. The assessment looked at prior misdemeanor conviction (yes or no); prior drug conviction (yes or no); sex; age; and race/ethnicity (divided into African American, Hispanic, and other). The bivariate comparisons showed that BxTC participants were more likely to be female and have a prior drug conviction, but there were no other significant differences, meaning that the initial comparison group sample already provided a close match to the characteristics of actual drug court participants. Since only those two dichotomous variables were used in the regression model, there were only four possible propensity scores. This led to the decision to retain the initial treatment and comparison samples in full but to assign to individuals in the comparison group a different relative weight on their propensity scores compared to those in the treatment group. The purpose of the weighting was to make the cumulative weighted size of the comparison group within each propensity score equal to the size of the treatment sample within that same score. This modification to the propensity score matching techniques had the advantage of keeping all available information, because none of the comparison group members had to be removed from the final sample.
After the weighting technique, there were no significant differences between the treatment and comparison groups. The treatment group was 71 percent male, and 49 percent African American and 51 percent Hispanic or other, with an average age of 32 years. The comparison group was also 71 percent male, and 45 percent African American and 55 percent Hispanic or other, with an average age of 31 years.
The study looked at the effect of drug court participation on postarrest and postprogram recidivism, measured as a new arrest leading to a conviction. The postarrest measurement period began from the initial arrest date up to 3 years. The postprogram measurement period began on the date of graduation for drug court graduates, on the jail or prison release date for drug court failures, and on the release date or disposition date for comparison group members, up to 1 year. Recidivism data was obtained from the New York State Division of Criminal Justice Services. The study examined data using bivariate analysis and multivariate analysis. Multivariate analyses were conducted to measure both the probability of at least one reconviction (logistic regression analysis) and the total number of reconvictions (negative binomial regression analysis).
There were some methodological challenges to the analysis, however, because a portion of the treatment sample was unavailable for postprogram analysis for several reasons. As of the analysis date, BxTC participants may not have achieved the required 1 year of postprogram time or reached a final program status (graduation or failure). However, it was important for the analysis to have an accurate count of program graduates and program failures (as graduation/failure status strongly predicts recidivism). Therefore, the final status of all program participants in the treatment group was determined as of Nov. 3, 2002, just prior to the analysis date. For participants who had neither graduated nor failed as of that date, background characteristics were used to predict whether they were more likely to graduate or fail. In other words, baseline information about each drug court participant (including age, employment/school status, and primary drug) was used to estimate whether graduation or failure was the more likely program outcome. Of the 375 members of the treatment group, 48 had not reached final status as of the analysis date, and their final status was predicted based on background characteristics.