Drug Treatment Court Funding Program, Summative Evaluation

4. Findings (continued)

4.3. Outcomes

As discussed in Section 4.2, the DTCFP targets marginalized and high-risk groups with multiple barriers to success, such as extensive criminal backgrounds, lack of education, poor employment history, mental health or other health issues, and past victimization. In addition, DTC participants have addictions to "hard" drugs, such as crack/cocaine, methamphetamine and heroin. Outcomes must be assessed in light of the numerous challenges faced by this population.

4.3.1. Participant-level outcomes

Reducing participant criminal activity

The DTCs have had limited opportunity to demonstrate their impact on recidivism as the majority of the sites have been operating for less than three years. Although findings from interviews with key informants, the stakeholder survey, and case studies with participants suggest that the DTCs are effective at reducing criminal activity, it is difficult for the evaluation to determine the extent of this success. Nonetheless, the evaluation offers several preliminary findings related to this outcome.

Key informants and survey respondents believe the DTCs contribute to reducing recidivism rates. Additionally, almost all or most key informants at several of the DTCs reported that only a few participants have reoffended while in the program. Many of the key informants interviewed, who have familiarity with the traditional criminal justice system, agree with this conclusion. The survey results also collaborate this finding, where 61 percent of respondents believe that the DTCs are effective in reducing criminal recidivism while in the program. However, fewer survey respondents (39 percent) believe the DTCs are effective in reducing criminal recidivism post-program.

Although the case studies did not directly ask participants whether they had reduced their involvement in criminal activity, many of the participants said they had taken courses about criminal thinking patterns. In addition, several spoke of life changes that indicate more responsibility and accountability for their actions. For example, some mentioned that they have a stronger connection to society and care about themselves now. Some were either employed or involved in community work. A few reported learning how to manage and budget their money. The following two quotes represent participants' perspectives of the impact the DTC has had on their involvement in criminal activity.

I haven't done a crime since the day I came into the program. That is weird, bizarre. I never in my life dreamed that. [Graduate]

Yeah, it improved my life even though I didn't graduate. I think I am less likely to get involved in crime now, after being in the program. A lot of my crimes were for shoplifting and car theft. I was doing all of that for money to get high. When I hung out here I was okay for food and things, so I didn't do those other things for money. [Non-completer]

The DTC site evaluations were intended to have been a source of quantitative information on recidivism rates. Although four of the sites attempted to report on recidivism, they did not use comparable measures:

In addition:

Because of these differences in measurement, this evaluation could not roll up the information contained in the site evaluations in any meaningful way. That being said, some of the site evaluations did report positive outcomes. For example:

Toronto did not show a stable pattern of recidivism: 7.1 percent of 43 participants incurred new charges during their first month in the program, followed by a steady increase in the percentage of participants incurring new charges during months 2 to 6, then a decrease in months 7 to 9, followed by another increase in months 10 to 12. As noted in the site evaluation, this pattern may be a function of attrition: most new charges were incurred by participants who absconded and were related to administration of justice (failure to appear at court or comply with probation orders). However, the Toronto evaluation did note that, of the new charges, only four were drug-related and these were for possession.

While these results suggest that the DTCFP is contributing to reduced recidivism, requiring individual sites to enter in-program recidivism data into the DTCIS and providing them with guidelines on how to calculate recidivism rates would enhance the Department's ability to track this outcome more formally. Additionally, requiring sites to follow up with former participants would provide data on post-program recidivism.

Reducing participant drug use

As with recidivism, it is challenging to make definitive statements about the impact of the DTCs on participant drug use, both while they are in the program and after they leave the program. While reviewing these results, it is important to bear in mind that the program does not require participants to immediately abstain from drug use. Conversely, the program recognizes that relapses are part of the recovery process and encourages participants to self-report any use. Therefore, as participants progress through the program, their volume and frequency of use may vary and they may switch from one type of drug to another. For these reasons, one would expect the program data to show inconsistent use during the program. Nonetheless, the data should demonstrate a decrease in use between pre- and post-program involvement. However, post-program use is not currently tracked.

The individual DTC outcome evaluations attempted to report on the program's impact on participant drug use. It is not possible for this evaluation to report aggregate results for the site evaluations because they used different methods of reporting use. Some sites tracked drug use based on the results of urinalysis screens and other sites relied on participants' self-reported use.13 One site used a combination of these methods and it is not possible to determine what measures another site used.

The site evaluations do not yield conclusive evidence about whether the DTCFP is reducing participant drug use. Rather, they suggest different patterns of drug use among DTC participants.

Table 12 specifies the method each site used to track use and summarizes the pattern of use observed.

Table 12: Drug use reported in the DTC outcome evaluations
Site Tracking method Findings
Toronto
  • Participant self-reports of drug use were confirmed by urinalysis results
  • Ongoing substance use is a concern for this site
  • The percentage of participants reporting crack/cocaine use decreased steadily over time (from 40% in month one to less than 11% by month seven), but then increased to almost 40% in months 10 to 12. Interview data suggests that this increase may relate to the prospect of graduation.
  • The percentage of participants reporting marijuana use was fairly consistent over time, but the number of days they used marijuana increased over time.
Edmonton
  • Participant self-reports for internal and external comparison groups
  • Case management reports for current participants
  • Three months after entry into the program, 90.5% of former participants for whom data was available were reported to have been abstinent in the previous week
  • Graduates were more likely to have been abstinent (100%) compared to those who withdrew before completing 28 days of programming (63.6%) and those who withdrew after completing 28 days of programming (77.8%)
  • A comparison of a subgroup of Edmonton participants with court-involved (non-DTC) clients attending the same residential treatment program found that 100% of the program group were abstinent at the three-month follow-up compared to 63.6% of the comparison group
Regina
  • Reported individually on the drug use patterns of eight graduates/ program completers
  • Found that "being clean for some weeks–or even months–is no guarantee of freedom from illicit drugs" (p. 7-7).
Ottawa
  • Not possible to determine
  • IV drug use decreased dramatically
  • Found the daily amount spent on substances used by participants fell by an average of $540.30 per day (comparing prior to entry v. in program)
Winnipeg
  • Did not report on use
  • N/A

Despite the lack of conclusive evidence presented in the site evaluations, key informants and survey respondents believe the program is helping participants reduce their use of drugs.

Key informants indicated that the DTCs have been effective at reducing drug use among participants. They suggested that the following program components contribute to this outcome: random urine screening, the practice of giving positive reinforcement for positive screens, the practice of not sanctioning for positive screens if participants are honest about their drug use beforehand, and the highly structured nature of the program.

Similar to the survey findings on recidivism, 61 percent of respondents believe that the DTCs are effective in reducing participant drug use while in the program, whereas only 38 percent believe they are effective in reducing drug use post-program.

Some key informants cautioned that many participants are facing multiple challenges and therefore complete abstinence may be an elusive goal for them. Nonetheless, these key informants emphasized that a reduction in drug use should be considered a positive outcome.

Although the case studies did not systematically collect data about participants' drug use, participants spoke generally about their use during and after completing the program. As the site outcome evaluations suggested, case study participants confirmed that use varies throughout the program. Just under half the case study participants reported relapsing while in the program. However, all of the graduates interviewed14 are currently clean, although some of them admitted to having at least one relapse since graduating. Nonetheless, several graduates and other case study participants said the program gave them the tools needed to overcome a relapse.

Case study participants reported that staying clean is one of the hardest parts of the program. Although participants believe personal motivation is the key determinant of whether someone will be successful, they identified several features of the program that can help participants on their path to recovery. They reported that encouraging honesty about use and recognizing that relapses will occur are two of the key components of this program that differentiate it from traditional treatment programs. Participants said that in a lot of other programs, you are expelled the first time you relapse. They also said that the length of this program encourages success because it gives participants the time they need to become clean. Other aspects of the program that are helpful are the court sessions (participants don't want to have to tell the judge that they used), the support of the treatment staff, and the coping skills that participants learn through the group sessions. Many participants also said that having access to housing where drugs are not being used and keeping busy are integral to their success.

Case study participants offered the following comments about the impact the program has had on their drug use:

I did really well in this program. They are still shocked that I didn't graduate. I had no use for three months and then slipped once. Then I was clean for like five months. The program taught me tools to change certain behaviours and to identify it before it even happens. You get to a point where you are clean, but you just want more things to happen…there is nothing that the program could have done differently. [Non-completer]

I can walk by a crack house and not knock on the door, with money in my pocket. [Active participant]

Although the impact cannot be quantified, the data collected through this evaluation suggests the DTCFP is having a positive impact on participants' drug use. Once this data is being routinely and consistently entered into the DTCIS, it will be invaluable for tracking participants' use while they are in the program. The collection of post-program data would facilitate analysis of pre- and post-program use.

Enhancing social stability

One of the key intended outcomes of the DTCFP is the enhanced social stability of participants, which is demonstrated through improvements in their housing, education, and employment status. As little quantitative evidence of this outcome is available, the findings in this section are primarily qualitative.

Each of the site outcome evaluations report on the DTC's contribution to participants' social stability (except for Toronto); however, only Edmonton attempted to quantify this outcome. Although the sites used different methods of assessing their achievements in this area, and reported this information for different subgroups of participants, they generally found that the program has helped participants improve their social stability. Table 13 summarizes the key findings from the DTC outcome evaluations.

Table 13: Improvements in social stability as reported in the DTC outcome evaluations
Site Findings
Edmonton
  • A comparison of program graduates, participants who engaged in the program for at least 28 days and then withdrew ("engaged-withdrawn"), and participants who withdrew before completing 28 days of programming ("not engaged-withdrawn") found that:
    • Graduates were the only ones who showed improvements in stability and independence of living arrangements from baseline to follow-up.
    • Unemployment rates improved slightly over time for all groups of participants, with graduates having slightly lower rates of unemployment compared to the engaged-withdrawn group.
    • Half of all graduates initiated an education or training course while in the program, compared to only 10.5% of engaged-withdrawn and 0% of not engaged-withdrawn participants. Three graduates were still enrolled in an educational program at the time of their graduation.
  • Participants reported that the program helped them find housing and employment. However, participants and key informants noted that housing, which is critical to participants' success, is in short supply. Key informants also suggested that the requirement to attend court each week may be a barrier to employment.
  • Participants also reported improvements in health and wellness and credit staff with arranging and transporting them to medical appointments.
Winnipeg
  • Interviews with graduates found that all graduates:
    • Were working
    • Displayed indicators of social well-being and stability, such as improved relations with family, improved job/education, and improved community participation
    • Displayed indicators of psychological well-being, such as positive coping mechanisms and a will to be off drugs
Regina
  • The evaluation reported that of the eight graduates:
    • Four improved their relationship with their family
    • Two improved their living arrangements
    • Two showed improved employment readiness
Ottawa
  • The evaluation reported that of 16 "successful" participants who withdrew or were discharged:
    • All but two had stable housing and a source of income
    • Nine were employed and/or attending school
  • Information for graduates was not available
Toronto N/A

As suggested in the outcome evaluations, most key informants and survey respondents involved in this evaluation also believe the program is contributing to improvements in the social stability of participants.

Overall, most key informants believe that the DTCs have been effective in this regard. Moreover, key informants from three sites indicated that participants are required to demonstrate progress in their social stability in order to graduate. However, key informants at some sites said that a lack of appropriate housing and inadequate educational/training opportunities for participants can hinder progress in this area.

Some 59 percent of the survey respondents believe that the DTCs are effective in improving the social stability of participants.

Case study participants spoke generally about how the program has helped them improve their lives, and some of them provided specific examples of positive changes:

The following quotes from case study participants illustrate some of these changes.

I always used to be so out of it when I was on drugs. People actually come to me now, and that's different. People actually ask me to babysit for them, and I never babysat for anyone before–just for my own. It was a plus when my cousin asked me to watch her newborn for her. It proves that they actually trust me. [Active participant]

I look around and see what I have now compared to what I had before. I have a computer now. I have a nice place to live. My life is so much fuller now. I feel healthy. [Active participant]

It got me off drugs. It got me a full-time job that pays really good. I got a car back, I got my life back, I got my boyfriend back. I have really nice things now and I've never had nice things before. It's made my relationship with my family really good. Also, it's helped me plan for my future. [Graduate]

Although these findings suggest the program is helping participants improve their social stability, it is difficult to draw definitive conclusions based on the information available to this evaluation.

Participant retention and graduation

Quantitative information on the success of the DTCs at retaining participants and producing graduates comes primarily from the site evaluation reports. Although the site evaluations calculated retention and graduation rates in a variety of ways, for the most part they contained enough data to enable the summative evaluation to calculate a retention rate and a graduation rate using a common formula for all sites:15

Table 14 below provides the raw data used for the above calculations. However, caution should be used when considering these results, since they are based on the evaluation's best interpretation of the data contained in the site evaluation reports and may contain some inaccuracies.

The calculations determined that:

Table 14: Overview of DTC participation, retention, and graduation
  Toronto
(April 2007-Sept. 2008)		 Ottawa
(evaluation period N/A)		 Winnipeg
(Jan. 2006-Dec. 2008)		 Regina
(Oct. 2006-Sept. 2008)		 Edmonton
(Dec. 2005-Sept. 2008)
Number of admissions 67 105 78 97 82
Number of graduates  3  8 21  8 14
Number of participants who terminated prior to graduation
(Includes participants who terminated for any reason, i.e., participants who withdrew, absconded or were expelled, suspended or discharged)		 44 64 37 63 37
Number of active participants 20 N/A 20 26 31
Retention rate
(Active participants + graduates / number of admissions)		 34%
(20+3/67)		 N/A 53%
(20+21/78)		 35%
(26+8/97)		 55%
(31+14/82)
Graduation rate
(Graduates / graduates + participants who terminated prior to graduation)		 6%
(3/3+44)		 11%
(8/8+64)		 36%
(21/21+37)		 11%
(8/8+63)		 28%
(14/14+37)

Notes: For Toronto, the number of participants who terminated prior to graduation was calculated by adding the number of those who terminated during the 30-day assessment period (n=24) and the number of those who terminated after being admitted into the program after the assessment period (n=20).

For Ottawa, the total number of active participants during the evaluation period could not be ascertained from the evaluation report. Thus the retention rate could not be calculated.

For Winnipeg, the total number of active participants during the evaluation period was calculated as follows: (2007 admissions - 2007 admissions who did not end their involvement in the program in 2007) + (2008 admissions - 2008 admissions who ended their involvement in the program in 2008). That is: (36-31) + (27-12) = 5+15 = 20.

For Winnipeg, Regina, and Edmonton, the data include all participants admitted since operations began. For Toronto, data are for an 18-month period. For Ottawa, the period of analysis is unclear.

From the site evaluation reports and the interviews with key informants, it is also possible to glean some preliminary insights into factors associated with participant retention and graduation. These factors include:

Access to safe, secure housing

The Toronto, Winnipeg and Edmonton evaluations all reported that access to safe, secure housing is a major factor in retention and graduation. The Toronto evaluation noted that lack of appropriate housing is a major factor in women's attrition from the program in particular, as well as a major factor in attrition in general. Key informants interviewed as part of this evaluation echoed this theme, emphasizing that appropriate housing is necessary to help stabilize participants and provide them with a supportive environment.

Personal motivation

Many of the key informants interviewed as part of this evaluation cited personal motivation as a critical or even overriding factor that affects participants' ability to remain in and complete the program. Some of the site evaluation reports corroborated this based on interviews with program participants.

No criminal history, no history of violence, and low-risk appraisals

Winnipeg reported that participants with no prior criminal record and no history of violence were much more likely to graduate than those with a prior criminal record or history of violence. Similarly, participants who had low scores on the Institutional Security Assessment or the Primary Risk Assessment (two instruments used by Manitoba Corrections to assess risk of reoffending) were more likely to graduate. None of the other evaluations examined these factors, although the Edmonton evaluation has plans to do so (data were not available at the time of the evaluation). In a similar vein, some key informants interviewed as part of this evaluation mentioned that more seasoned criminals or drug users may find it harder to complete the program.

Caucasian ancestry

Toronto reported that ethno-cultural minorities were less likely to be admitted and more likely to abscond from the program. Similarly, Winnipeg reported that minorities–in particular, Aboriginal participants–were less successful in the program than other groups and that being Caucasian was strongly associated with graduation. Regina also found that Aboriginal participants experienced much higher discharge rates than those of other ancestries, although they comprised the majority of admissions into the program. On the other hand, in Edmonton, Aboriginals comprised fewer than half of former participants, but half of all graduates as well as half of those who withdrew from the program before completing 28 days of treatment.

Higher education levels and employment at admission

The Winnipeg evaluation found that participants with higher education levels at admission, and those employed at admission, were moderately more likely to graduate than those with lower education levels or those who were unemployed. Similarly, the Edmonton evaluation found that graduates were more likely than other participants to have completed high school or attended a post-secondary institution. Finally, some key informants noted that the level of life skills that participants bring to the program can affect completion.

Marital status single

The Winnipeg evaluation found that the marital status of single was moderately associated with graduation. Similarly, Edmonton reported that the majority of its graduates were single.

Gender male

Toronto reported that women were less likely to be admitted and more likely to abscond from the program than males. Similarly, Regina reported that most participants were male rather than female, and that slightly more women than men were discharged. On the other hand, Winnipeg reported that while discharge rates were marginally higher for women (with women aged 18 to 29 having a very high rate of discharge compared with men in the same age category), being female was in fact associated with graduation. Similarly, the Edmonton evaluation noted that graduates were primarily females, but conversely, so were participants who engaged with the program for less than 28 days before withdrawing.

As shown in Table 15, the case studies with participants gathered information about the factors that make it easy or difficult for participants to stay in the program. These factors include a combination of program features and personal circumstances. Again, this information was not systematically collected and represents participants' impressions of their experience.

Table 15: Participants' perspectives of factors that make it easy or hard to stay in the program (in order of frequency of mention)

Program features
Factors that make it easy to stay Factors that make it hard to stay
  • Support of the treatment staff
  • Counselling sessions
  • Structure and routine of the program
  • Acknowledgment that relapse is part of the recovery process
  • Support of other participants
  • Ability to spend time at the DTC
  • Housing arrangements
  • Time commitment required
  • Not using drugs
  • Hearing about other participants' use and/or seeing them expelled from the program
  • Repetition of counselling sessions
  • Nothing
Personal circumstances
Factors that make it easy to stay Factors that make it hard to stay
  • Personal motivation
  • Support from family
  • Having to give up friends
  • Having to quit a job
  • Personal ego

Several participants said that the program does everything it can to help participants succeed. They do not believe that the program could do anything differently to increase its retention and graduation rates. The following quotes illustrate participants' perceptions of the program:

I think they do everything they can. Maybe they could have more places for people to stay when they first get out of jail instead of down at the Sally or the Mission where there is just high risk. That's the only thing I can think of. [Active participant]

I'm not sure if there is anything else the program could do to encourage success in participants. I think it mostly has to come from within. The support they offer is a big thing, but you have to really, honestly want it for yourself or it's never going to happen. It's like that old saying, you can lead a horse to water, but you can't make him drink. [Graduate]

Overall, the evaluation found that the DTCs are doing a reasonable job of retaining participants and helping them graduate from the program. However, opportunities to improve retention rates exist, especially for women, Aboriginal people, and people from other ethno-cultural backgrounds. Access to additional housing supports may also help increase retention and graduation rates.

4.3.2. Program-level outcomes

The evaluation found qualitative evidence of some success for each of the three primary program-level outcomes, although there is also room for improvement.

Improve knowledge and awareness of DTCs

Survey results indicate room for improvement in building awareness and understanding of DTCs. As shown in Table 16, Crown are considered most aware, followed by addictions treatment service providers and defence counsel. Other social services are not believed to be very aware of the DTCs. Key informants were more positive, although they all acknowledged that awareness could be improved among certain stakeholder groups. In particular, police, defence counsel, and health care professionals were perceived as having misconceptions such as the DTCs being "hug courts" and not punitive enough or that they forced participants into treatment.

Table 16: Awareness of DTCs
  Overall DTC team DTC governance Other stakeholders
% Aware
(n=88) (n=22) (n=25) (n=41)
Crown prosecutors 52% 55% 52% 51%
Addictions treatment service providers >46% >41% >64% >37%
Defence counsel 42% 41% 40% 44%
Social service providers - housing 22% 18% 28% 20%
Social service providers - employment 15% 9% 24% 12%
Other health service providers 8% 9% 4% 10%
General public 2%  - 4% 2%

Note: Percentages shown represent those who rated the awareness of each group as a 4 or 5 out of 5.

The evaluation found that efforts are being made to increase knowledge of DTCs. Most of the sites reported that they engage in promotional activities, such as training with police, presentations at health fairs, and outreach to the defence bar. In addition, some sites have Crown or police information sheets in every file to ensure that appropriate accused are considered for the DTC. In interviews, several DTCs believe that they have made inroads in improving understanding among certain groups, such as police and defence counsel. Survey results validate the importance of these efforts as most respondents agree that promotion of the DTCs will benefit the program by encouraging referrals (75 percent), increasing public understanding (74 percent), and broadening the range of organizations that will accept referrals from the DTCs (65 percent). As a caution, some key informants worried that if promotional efforts are too successful, the court would not be able to handle the additional clients.

Strengthening community networks

Not all DTCs consider strengthening community networks to be an intended outcome for their program. This is particularly true for those DTCs that use the "one-stop shop" model for service delivery as they are less in need of building a community network of supports. Instead, the primary method for interacting with community supports is through referrals. Some sites have also engaged relevant community organizations in their governance committees. In particular, Toronto and Ottawa have Community Advisory Committees and Winnipeg includes community organizations on its Steering Committee and on its Treatment Committee. In Toronto and Winnipeg, these committees engage community representatives to identify and assist with program improvements.

Survey respondents concur. As shown in Table 16, almost two-thirds (63 percent) of respondents believe the DTCs are effective in making appropriate referrals and about half (52 percent) believe it is effective in building partnerships with other community organizations. Respondents were less likely to agree that the DTCs have been effective in strengthening the network to address drug use in the community (42 percent).

Sharing promising/best practices

The CADTC roundtables and conferences are the main forum for sharing best practices, and are considered useful by those who have attended (see Section 4.2.1). Several key informants also said they will informally solicit advice from their counterparts in other courts as needed. While commending the current avenues available for information-sharing about best practices, key informants suggested that additional opportunities would be beneficial. These suggestions included revitalizing the bulletin board and Web site, sharing evaluation documents across sites and among staff within sites, developing a best practices manual with input from all sites, and distributing a national newsletter.

Although key informants found the sharing of best practices generally effective, few could point to specific examples of using best practices that they learned from other DTCs. Because the 2008 CADTC conference was recent, key informants tended to note that they were considering adopting new strategies that they learned, such as the ideas on contingency management (use of rewards and sanctions to encourage behaviour as part of the treatment program). Survey results reflected this, with 59 percent of respondents agreeing that the DTCs are effective in sharing best practices and lessons learned compared to 50 percent who believe the DTCs are effective in adopting evidence-based best practices.

4.4. Cost Effectiveness/Alternatives

4.4.1. Overview

DTCs offer an alternative to incarceration for people accused and convicted of non-violent drug-related offenses. In the absence of these courts, people convicted of these crimes may receive a prison sentence.

By incurring the cost of a DTC, government and society may realize some potential benefits:

Avoided or delayed incarceration costs.

If DTC graduates do not re-offend, incarceration costs are avoided. If they do re-offend, the costs are not avoided, but are shifted into the future.

Reduced dependence on social services and increased positive economic contribution.

Graduates who resume productive careers or become employed contribute to the economy, pay taxes, and reduce their reliance on social assistance or other social services as well as post-treatment reduction in health care costs.

Quality of life.

General benefits exist to graduates and their families in terms of quality of life by addressing their addictions and criminal behaviour.

Economic benefits from reduced crime.

To the extent that recidivism is reduced, there is also a corresponding reduction to the cost of crime (including incarceration and victim costs) for society as a whole.

The first category of benefit is termed an "avoided cost", which the government realizes by investing in DTCs. By spending on DTCs, the government avoids the costs of future corrections, consisting of court processing, incarceration and/or other sentencing options. If the costs of DTCs are lower than future corrections costs, then one need not consider the other two classes of benefits since, by reallocating resources from corrections to DTCs, the government lowers its overall costs. The investment represents an unambiguous "win". This situation is rare, and one usually needs to include estimates of the other benefits to assess true cost effectiveness.

Estimating the second and third benefit categories requires information on both the pattern of re-offense and what improvements (economic, health, social, etc.) graduates experience in the post-intervention period. These benefits are often quite large, especially if they are calculated over several years. However, limited information on these outcomes is available at the present time as only two of the DTCs have been operational for more than three years. Further, measures of quality of life can be subjective and are not available for this analysis. Therefore, this analysis focuses on what can be learned by examining the cost profiles associated with DTCs in relation to the profile of corrections costs that would exist in the absence of DTCs.

4.4.2. The cost-effectiveness framework

Because consistent and comparable information on outcomes and costs is not available for all of the courts, and uniform corrections data for the provinces in which the DTCs are located is not available, this analysis focuses on exploring the cost profile offered by DTCs for a synthetic scenario, drawing on information of corrections costs and the probability of re-offense (recidivism) from disparate sources. The cost of simply processing all accused/convicted through the regular court system becomes the reference point (comparison state) against which to compare the cost profile offered by DTCs.

To consider the cost effectiveness of DTCs, information is required on the costs of corrections (court, incarceration and probation costs) through the conventional system, the costs of the DTCs, and some estimate of recidivism. Additionally, several simplifying assumptions are needed to frame the analysis:

Court and incarceration costs.

The reference point consists of processing cases through the conventional system to produce a cost per accused of corrections for two years. The first year involves court and incarceration costs, while the second year involves only incarceration costs.16

DTC costs.

Estimates of the annual cost of processing one accused through the DTC are based on the information contained in the Winnipeg DTC's application for funding.17 The costs included in the proposal are based on an active caseload of 40 participants. Accused are assumed to remain in the DTC system for one year before graduating.

Recidivism.

The cost scenarios in the next section assume various recidivism rates for graduates of the DTC. The analysis assumes that the re-offense occurs on the last day of year 1 and that those who reoffend incur the full corrections systems cost for one year.

Time frames.

This is a cohort analysis that compares the costs of the two systems over two years.

4.4.3. Cost scenarios

The cost of processing one accused in the traditional court system includes:

For 40 cases, the annual cost of conventional court is $2,020,400 in year 1, and $1,980,920 in year 2 for a total of $4,001,320.21

The annual DTC cost, based on 40 participants, is $1,180,925. Since programs range in length from about 8 to 18 months, this is an acceptable approximation for year 1 of DTC.

These are striking results, and suggest that DTCs are less costly for government as an alternative to incarceration.

However, if an accused is not sentenced to jail, but rather is sentenced to probation, the DTC becomes a more costly option. Under the traditional system, the cost of court and one year of probation for one individual is $8,287. Compared to this option, the cost of one-year of DTC is 365 percent higher. Thus, the comparative cost of DTCs to the traditional system depends on sentencing patterns.

4.4.4. Qualifications to the Analysis

There are several important qualifications to these results. Selection bias, completeness and scale economies of DTC costs, and long-term recidivism all affect this analysis.

This analysis represents a preliminary attempt to assess the relative cost advantages of DTCs. It suggests that this approach offers important potential cost savings. However, many areas of uncertainty need to be addressed for a more definitive conclusion. This analysis requires information on longer-term outcomes, other potential costs of DTC participants such as social assistance, and the effect of the DTCs on recidivism rates, among other things.

Like the analysis presented above, other studies have shown that DTCs can achieve economic benefits. Cost-benefit analyses find positive net economic benefits (i.e., benefits minus costs) associated with most DTC programs, or, equivalently, report benefit-cost ratios larger than one. A study of three DTCs in Kentucky found that society realizes $3.83 in benefits for each dollar invested in DTC graduates and $2.71 for each dollar invested in all DTC participants23 (Logan et al., 2004). Similarly, a cost analysis found that taxpayers in the State of Missouri realized $6.32 in savings over four years from each dollar invested in DTC graduates, while a study of a DTC in Dallas County found savings of $9.43 to society for each dollar invested (Institute of Applied Research, 2004 and Fomby and Rangaprasad, 2002, respectively). The reader should exercise caution in interpreting these results because of differences in the designs of these studies and in the design of each DTC program, among other factors; however, they illustrate that evaluators have found DTC programs to have net benefits for society in a variety of settings.

Additionally, almost all key informants believe that the DTC is the best approach for multiple offenders with substance abuse problems. They stressed that criminality and drug addiction need to be treated simultaneously. They also reported that the combination of treatment and court is critical as the court component provides leverage to keep participants in the treatment program. The treatment program provides daily intensive supervision and support, which are considered necessary to address substance abuse problems and stop the "revolving door" of the criminal justice system. Key informants pointed out that this level of intensity would not be provided through probation, which is why the DTC is an important innovation.

4.5. Best Practices and Gaps in Programming

Through interviews and surveys of DTC stakeholders, the evaluation identified a number of best practices:

DTC stakeholders also identified a number of gaps in DTC site programming and services: