Applicant Information Court/Name of Jurisdiction * State Veterans Treatment Court Planning CoordinatorThis person will be the primary contact with Justice For Vets to ensure the timely correspondence of logistical, administrative and programmatic information in preparation for the VTCPI Training. This person is preferably one of the ten individuals who would attend the training. Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * Street Address * Street Address Line 2 City * State/Province Select * Postal Code * Phone Number * Fax Email * Geographic and Demographic Information What is the approximate population of the jurisdiction your VTC serves? * Which best describes your jurisdiction? Rural (less than 50,000), Urban, Suburban, or Mixed * Are you currently operating an existing * Drug Court DWI Court Mental Health Court Veterans Treatment Court or VTC Track If you are currently operating a court, please enter the start dates here * Has your court team previously participated in any Drug, DWI, Mental Health or Veterans Treatment Court training? * Yes No If yes, please list all relevant training: * Indicate your team’s experience in Drug, DWI, Mental Health Court or Veterans Treatment Court planning and exposure to the Drug, Mental Health and/or Veterans Treatment Court concept. * No experience of exposure Limited experience and exposure (attended annual drug court conferences or read articles) Moderate experience and exposure (visited an operational drug court) Extensive experience and exposure (visited an operation drug court and research the topic extensively) Have completed planning and/or have implemented a pilot program or full docket Do you have a Veterans Health Administration located in your jurisdiction, including Vet Centers, and Veterans Clinics? * If your answer is NO – how many miles away is it? Do you have a Vet Center located in your jurisdiction? * If your answer is NO – how many miles away is it? How are you going to identify veterans at arrest and/or probation violation? What questions do you use to identify veterans? * Does your program offer or permit medication assisted therapy (MAT) options? If so, please provide a detailed description of the program's MAT policy and indicate the types of medications available to program participants. * Does your program have a practice/policy in place to examine whether unfair disparities exist within the program for racial/ethnic minority participants? Please describe the policy and explain the measures taken to eliminate identified disparities. * Veteran Data CollectionDescribe the Veteran offender population in your community by: Race * Ethnicity * Age * Service era (time period including dates served in the military) * Gender * Arrest Volume * Crime Patterns (include numbers and types of crimes) * Drug and Alcohol Use at Arrest * Mental Health issues at Arrest * Probation Violations/Violators related to drug and alcohol use * Probation Violations/Violators related to mental health issues * How do you currently process cases in your court? If your VTC is not in operation, how do you process cases in your Drug or MH Court? Specifically, explain the process (including the avg. timeframes) from moving a person from arrest through disposition. * Have you met with your Veterans Justice Outreach Specialist (VJO) to determine his / her ability to assist your Veterans Court in working with your court? * Have you met with staff at the Veterans Healthcare Facility? * Have you met with the Team Leader at your local Vet Center? * Identify the challenges (include data and source, if applicable) experienced in court case processing, specifically related to Veteran offenders addicted to drugs and/or alcohol and experiencing mental health issues. * What are the top three drugs of choice for your clients? * Alcohol Cocaine/Crack Cocaine Heroin Marijuana Methamphetamine Prescription Medication Other(s) Identify the specific drug and alcohol abuse patterns among Veteran offenders in your community. * Describe the current screening process of identifying veterans after arrest. Specifically, how you would utilize the additional resources of the VJO and the Veterans Administration. Explain the process (including the average and realistic timeframes) * What mental health issues are you seeing among Veterans? * Post Traumatic Stress Disorder Traumatic Brain Injury Depression Military Sexual Trauma Other(s) If other, please indicate: Are you seeing Traumatic Brain Injury among Veterans in your area? * Yes No Describe the chemical dependency screening process with the additional services of the Veterans Healthcare Administration. Specifically, explain the process (including the average and realistic timeframes) from referral to provision of treatment. * Ask the VJO and check with your Vet Centers. Describe the mental health treatment process with the additional services of the Veterans Healthcare Administration. Specifically, explain the process (including the average and realistic timeframes) from referral to provision of treatment. * Ask the VJO and check with your Vet Centers. Identify the challenges (include data and source, if applicable) experienced in the substance abuse and mental health treatment referral, intake, screening and assessment processes of Veteran offenders. * From the criminal population and substance abuse/mental health patterns identified previously, describe the Veteran offenders that can most benefit from intensive monitoring/supervision and therapeutic treatment? * How many Veterans are being or will be served in your Veterans Treatment Court (capacity)? * What type of military discharge types does your program accept or anticipate accepting? * What existing court/probation programs offer the same services for the Veteran population? * Does your court have a Veteran Mentor Program? If yes, please describe the vetting, training and supervision protocols for your mentors. * Have you or anyone on your team met with local Veteran Service Organizations in your community to determine their commitment to the Veterans Treatment Court? * Have you identified veterans who would be willing to become volunteer peer support mentors? * Statement of intentAll interested communities must provide responses to the following questions. Narrative responses are limited to 150 words. The review panel will assess the responses to each question and determine the ability of VTCPI to meet your community’s needs. How have the above identified substance abuse patterns and mental health issues among Veterans affected your community? * What is your Veterans Treatment Court offering that differs from the existing programs? * Provide specific data to support the potential impact on the community if you serve the Veterans described above. * Describe the challenges of your current court/case processing system and how the implementation of a Veterans Treatment Court can help resolve these issues. * (Things to consider – what is the prevalence of veterans in your local criminal justice system? What are you currently doing to meet the needs of them? Maximum 150 words) Team informationAll interested communities must provide the name and contact information of each team member to ensure the planning team is comprised of the necessary individuals. Please enter the contact information for each team member below. Please note - The disciplines listed are required to participate: Judge Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Court Coordinator Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Prosecuting Attorney Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Defense Attorney First Name * Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Treatment Provider Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Community Supervision(i.e., Pre-trial Services, Probation, Parole) Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Law Enforcement(Law enforcement does not include jail or prison correctional officers, but instead police officers, sheriff’s deputies, and their equivalent from your local jurisdiction.) Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Evaluator Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Veterans Justice Outreach (VJO) Specialist(The VJO Specialist is a U.S. Department of Veterans Affairs employee usually located in the VA Medical Center that services your area. He/She is tasked with providing VA medical services to Justice-involved Veterans. To find a listing of VJOs, go to http://www1.va.gov/HOMELESS/VJO_Contacts.asp.) Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email * Veterans Mentor Coordinator(The Veterans Mentor Coordinator is the lead individual for your Volunteer Mentor Program. Mentors provide emotional support for Veteran clients and provide assistance in receiving government and private organization benefits and services. The individual serving as coordinator should not fill any other role on the team listed in this application.) Name Prefix - None -Mrs.Ms.Mr.Dr.Hon. First Name * Last Name * Job Title * How long has the person in this role served in this capacity? * Street Address Street Address Line 2 City State/Province Select Postal Code Phone Number * Phone Number 2 Email *
