Along with Agnew::Beck Consulting, an Alaska-based firm, HZA conducted a needs assessment in 2014 that aimed to assess the need of Alaskans for publicly funded behavioral health services and the capacity of the State’s behavioral health system to meet that need. The information was used as a base to guide system improvements as well as to prepare for future system change. HZA conducted extensive quantitative analysis of case management and statewide data, including National Survey on Drug Use and Health data, to identify the capacity, need and service gaps of the behavioral health system across Alaska at the state, regional and local levels. Additionally, HZA quantified the current utilization of substance abuse, mental health and co-occurring services across Alaska through analysis of data from multiple agency information systems.
Anchorage and Palmer Coordinated Resource Projects
Between 2007 and 2008, HZA conducted a comprehensive process and outcome evaluation of two county mental health courts in Alaska, one in Anchorage and one in Palmer. The two specialized criminal court dockets are aimed at diverting individuals with severe mental illness from incarceration into a regimen of court-supervised, community based treatment and recovery support services. In addition to qualitative data and court observation, HZA performed cost effectiveness analyses using a quasi-experimental design. Data were collected from outside sources (e.g., Medicaid, Alaska Psychiatric Institute) to gather treatment information while administrative data from the courts were used to measure recidivism. Attaching costs to reduced days in treatment and reduced time incarcerated led to a quantified demonstration of the program’s cost effectiveness.
Evaluation of Fairbanks Juvenile Treatment Court
Fairbanks Juvenile Treatment Court (FJTC) began as an innovative response to youth with mental health and substance use disorders. The Court targets youth whose mental illness likely contributed to the commission of the crime. Like most special purpose courts, the FJTC is managed by a multi-disciplinary team which uses a collaborative as opposed to an adversarial approach. Members step out of their traditional roles to encourage treatment of the juvenile while still promoting public safety.
HZA’s 2013 evaluation of the Court included both a process and an outcome evaluation as well as case studies. HZA used a quasi-experimental, comparative design to examine outcomes from a comparison group of similarly situated youth with mental illness who did not participate in the FJTC. The research design employed a mixed method approach involving a literature review, observations of courtroom practices, interviews, case record reviews, case studies and analysis of administrative data sets.
Evaluation of Mental Health Trust Beneficiaries in the Correctional System
In 2013, HZA was contracted to update and expand its 2007 retrospective study of Trust Beneficiaries (persons with mental health issues) who are incarcerated in DOC facilities. The four-year retrospective analysis of all inmates with mental illness who entered in and/or were released from Alaska’s correctional system provided the agency with a profile of the people with mental illness who have been incarcerated, an analysis of the services available to the population both in the correctional system and in the community, an understanding of the barriers to treatment of this population, research on evidence-based practices for the population and an analysis of cost benefits to implement effective treatment services, as well as potential funding sources. The study matches clients in the correctional system across nine data sets including Medicaid claims data to determine mental health and substance use diagnoses as well as the use of services before, during and after incarceration. The study employed binary logistic regression to identify factors that increased the odds of recidivism so the state could identify high risk groups and target release programming to those groups.
Evaluation of the Palmer Coordinated Resources Project
The Palmer Coordinated Resources Project which serves as the Palmer Adult Mental Health Treatment Court became the second operational mental health court in the state upon receiving its first referral in January, 2005. Covering more than 23,000 square miles, it is a specialized criminal court docket dedicated to diverting non-violent mentally ill defendants from incarceration into a regimen of court-monitored, community-based treatment and social services. The overarching goals of the PCRP are to improve both clinical and criminal justice system outcomes. HZA’s evaluation showed that PCRP has reduced both criminal and clinical recidivism, resulting in a net institutional savings greater than the annual operational costs of the program.
Mulgrew v. State of Alaska
From 2012 to 2013, in response to a court finding in Mulgrew v. State of Alaska HZA evaluated the rates the State pays foster parents, recommended new rates where needed and estimated the financial impact. The project resulted in proposed updates to the three components of the foster care rate structure: base rates, special needs payments and augmented rates. From 2015 to 2016 HZA assisted the State Department of Law in the role of expert witness to defend Alaska’s rate structure.