The author(s) shown below used Federal funds provided by the U.S. 

Department of Justice and prepared the following final report: 

Document Title: Evaluation of Breaking the Cycle 

Author(s): Adele Harrell; Ojmarrh Mitchell; Jeffrey Merrill; 

Douglas Marlowe 

Document No.: 205002 

Date Received: April 2004 

Award Number: 97-IJ-CX-0013 

This report has not been published by the U.S. Department of Justice. 

To provide better customer service, NCJRS has made this Federallyfunded grant final report available electronically in addition to 

traditional paper copies. 

Opinions or points of view expressed are those 

of the author(s) and do not necessarily reflect 

the official position or policies of the U.S. 

Department of Justice. 
Evaluation of 

Breaking the Cycle 

Adele Harrell, The Urban Institute 

Ojmarrh Mitchell, The Urban Institute 

Jeffrey Merrill, Robert Wood Johnson Medical School 

Douglas Marlowe, The Treatment Research Institute 

This report was prepared under Grant NIJ#97-IJ-CX-0013 from the National 

Institute of Justice. The nonpartisan Urban Institute publishes studies, reports, 

and books on timely topics worthy of public consideration. The views expressed 

are those of the authors and should not be attributed to the Urban Institute, its 

trustees, or its funders. 

research for safer communities 

RESEARCH REPORT February 2003 

URBAN INSTITUTE 

Justice Policy Center 
ACKNOWLEDGMENTS 

The authors of this report are very grateful to the many people who contributed to this research, 

providing support, sending data, and answering endless questions. 

The staff of the National Institute of Justice provided sustained support and inspiration, supplying 

funds for the evaluation, guiding the development and implementation of the Breaking the Cycle (BTC) 

initiatives, and encouraging understanding of the research needs. They include Betsi Griffith, Spurgeon 

Kennedy, Janice Munsterman, Carolyn Peake, Jennifer Wood, and Edward Zedlewski. 

The assistance we received from the BTC staff, partner agencies, and others in the three 

demonstration sites was outstanding. This research would have been impossible without their willingness 

to share their time and data. 

In Birmingham, special thanks go to Foster Cook, Kenneth Garner, Ralph Hendrix, Suzanne Muir, 

and Terri Williams of Treatment Alternatives to Street Crime (TASC) for their help and patience; to Glenda 

Bozle and the late Major Linn Moore of the Sheriff’s Department for their willingness to let us interview 

inmates at the Jefferson County jail; and to Mike Carroll of the Administrative Office of the Courts for 

providing data. We also want to thank the judges of the District and Circuit courts and David Barber, 

District Attorney, for answering our many questions on site visits. 

In Jacksonville, extraordinary help was provided by Jamie Brooks, the BTC project director, and 

Assistant Chief Tara Wildes of the Duval County Sheriff’s Department. They both provided office space for 

interviewers, access to records, and data on key measures for the evaluation. We also appreciate the 

assistance we received from Brian O’Neill of the Pretrial Services Unit, the judges, the Clerk of Court’s 

office, the State’s Attorney’s office, River Region and Gateway staff, and Judy Truett of the City of 

Jacksonville, and the willingness of the Florida Department of Corrections to provide computerized data 

on sample members on probation. 

In Tacoma, the Pierce County Alliance staff, especially Jim Boyle, Terree Schmidt-Whelan, and the 

BTC project directors, Lisa Daheim and Terry Reid, made this research possible by providing data and 

access to partner agencies. We particularly appreciate the efforts of Roxanne Krieg and her staff at the 

Pretrial Services Unit in checking criminal history data and of Larry Gezelius of the Pierce County 

Information Services for providing court records for the evaluation. Thanks also go to Judge Cohoe, the 

District Attorney’s Office, the Sheriff’s Department, and the Department of Corrections for their help. 

Staff at the Urban Institute (UI) and the Treatment Research Institute (TRI) who made major 

contributions to this evaluation include Alexa Hirst, UI’s research associate, who compiled the data, 

visited the sites, and participated in all facets of the project before her move to San Francisco; Shannon 

Cavanagh, who got this project started; Sarah Ring-Kurtz and Patricia Lee, who managed the fieldwork 

for TRI; and the superb TRI field supervisors, Dianne Nakamura in Tacoma and Rhonda Graybeal in 

Jacksonville. We also thank John Carver, consultant to the Justice Management Institute, who prepared 

the early process evaluation report on Birmingham. 

Finally, our deepest appreciation goes to the sample members who were willing to share their 

experiences with us in interviews and focus groups. 

The views expressed are those of the authors, and should not be 

Justice Policy Center attributed to The Urban Institute, its trustees, or its funders. 

URBAN INSTITUTE 

2100 M STREET, NW 

WASHINGTON, DC 20037 

www.urban.org 
Contents i 

Contents 

Executive Summary ......................................................................................................................... Exec - 1

Implementing BTC ........................................................................................................................Exec - 3

Lessons for the Future..................................................................................................................Exec - 5

The Impact of BTC........................................................................................................................Exec - 7

BTC Costs and Benefits ...............................................................................................................Exec - 9

The Broader Implications..............................................................................................................Exec - 9

Chapter 1. Introduction................................................................................................................... Intro - 1

PART I. BTC IMPLEMENTATION .................................................................................... I - 1

Chapter 2. Breaking the Cycle: The Intervention Strategy ......................................................... I - 2

Chapter 3. The Demonstration Sites Before BTC Implementation ............................................ I - 5

Birmingham Prior to BTC..............................................................................................................I - 5

Jacksonville Prior to BTC..............................................................................................................I - 7

Tacoma Prior to BTC ....................................................................................................................I - 9

Cross-Site Summary of the Pre-BTC Resources for Drug-Involved Offenders.............................I - 10

Chapter 4. BTC Implementation .................................................................................................... I - 12

Initial Plans for BTC ......................................................................................................................I - 12

Birmingham................................................................................................................................................I - 12

Jacksonville................................................................................................................................................I - 13

Tacoma ......................................................................................................................................................I - 14

Early Intervention..........................................................................................................................I - 19

The BTC Interventions: Treatment and Testing ............................................................................I - 23

Offender Accountability: Monitoring, Sanctioning, and Judicial Oversight ...................................I - 25

Findings on Drug Interventions for Felony Defendants.................................................................I - 31

Models for Treatment and Monitoring ........................................................................................................I - 31

The Critical Role of Data in Maintaining Accountability .............................................................................I - 32

Managing Collaboration among BTC Partner Agencies ............................................................................I - 34

Lessons for the Future ...............................................................................................................................I - 35

Chapter 5. Changes in Case Processing and Outcomes During BTC Implementation ........... I - 37

Birmingham ..................................................................................................................................I - 37

An Overview of Case Processing in Birmingham ......................................................................................I - 37

Case Handling, Disposition, and Sentencing in Birmingham before and during BTC ...............................I - 41

Summary of Case Processing Changes in Birmingham ............................................................................I - 44

Jacksonville ..................................................................................................................................I - 45

An Overview of Case Processing In Jacksonville......................................................................................I - 45

Judicial Case Processing, Disposition, and Sentencing in Jacksonville before and during BTC ..............I - 45

Summary of Case Processing Changes in Jacksonville............................................................................I - 48

Tacoma.........................................................................................................................................I - 48

An Overview of Judicial Case Processing in Tacoma ...............................................................................I - 48

Judicial Case Processing, Disposition, and Sentencing in Tacoma before and during BTC.....................I - 49

Summary of Case Processing Changes in Tacoma ..................................................................................I - 51

PART II. BTC IMPACT ...................................................................................................... II - 1

Chapter 6. BTC Impact on Drug Use and Crime .......................................................................... II - 2

Reductions in Drug Use................................................................................................................II - 2

Reductions in Criminal Activity .....................................................................................................II - 8

Self-Reported Offenses ................................................................................................................II - 10

Official Arrests ..............................................................................................................................II - 15
Contents ii 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and 

Health Problems ........................................................................................................... II - 23 

Birmingham ..................................................................................................................................II - 25

Jacksonville ..................................................................................................................................II - 27

Tacoma.........................................................................................................................................II - 30

Summary of BTC’s Effects on Employment, Family/Social, and Health Problems .......................II - 32

PART III. BTC COSTS AND BENEFITS ............................................................................ III - 1

Chapter 8. Returns to the Investment in BTC ............................................................................... III - 2

Methodology .................................................................................................................................III - 3

Step One. Estimating the Additional Per-Person Cost of BTC ..................................................................III - 3

Step Two. Estimating the Per-Person Value of Averted Offending ...........................................................III - 4

Step Three. Estimating the Per-Person Value of Averted Arrests .............................................................III - 5

Step Four. Calculating the Cost-Benefit Ratio ...........................................................................................III - 6

Results..........................................................................................................................................III - 6

BTC Cost per Person.................................................................................................................................III - 6

BTC Benefits of Reduced Offending..........................................................................................................III - 8

BTC Benefits of Reduced Arrests ..............................................................................................................III - 9

The Cost-Benefit of BTC............................................................................................................................III - 10

Limitations In Defining Benefits ....................................................................................................III - 10

Conclusions ..................................................................................................................................III - 12

PART IV. REFERENCE LIST ............................................................................................. IV - 1 

Appendix A. Impact Evaluation Methodology ................................................................................. A - 1 

Appendix B. Changes in Case Handling, Disposition, and Sentencing 

in the Evaluation Samples .......................................................................................... B - 1 

Appendix C. Composite Scale Properties ....................................................................................... C - 1 
Contents iii 

Tables 

Executive Summary 

Early Case Identification Procedures in the BTC Sites...................................................................... Exec - 3

PART I. BTC IMPLEMENTATION 

Table 4.1. Early Case Identification Statistics: Based on Monthly BTC 

Site Performance Reports to NIJ .................................................................................... I - 20

Table 4.2. Drug Use among BTC Clients in the Impact Evaluation Sample 

Reported on the Baseline Survey ................................................................................... I - 24

Table 4.3. Drug Interventions reported on the Monthly Performance Reports to NIJ ...................... I - 25

Table 4.4. Compliance and Sanctioning in BTC .............................................................................. I - 27

Table 4.5. General Linear Models of Perceived Fairness at Followup ........................................... I - 28

Table 4.6. General Linear Models of Perceived Certainty of Sanction ............................................ I - 29

Table 5.1. Increases in Quarterly Felony Filings by Charge Category in Birmingham .................... I - 42

Table 5.2. Pre-BTC/BTC Comparison of Case Processing in Birmingham ..................................... I - 42

Table 5.3. Pre-BTC/BTC Comparison of Sentences Imposed in Birmingham................................. I - 44

Table 5.4. Comparison of Defendant and Offense Characteristics in Jacksonville ......................... I - 46

Table 5.5. Pre-BTC/BTC Comparison of Case Outcomes One-Year from Arrest 

in Jacksonville ................................................................................................................. I - 47

Table 5.6. Comparison of Cases Characteristics in Tacoma Before and During BTC .................... I - 50

Table 5.7. Sentencing Outcomes in Tacoma Before and During BTC ............................................ I - 51

PART II. BTC IMPACT

Table 6.1. Self-reported Drug Use in the 30 days Prior to Follow up Interview by Site ................... II - 3

Table 6.2. Impact in Birmingham: Self-Reported Drug Use in the 30 Days 

Prior to Follow-up Interview, controlling for Defendant Characteristics 

and Sample Differences .................................................................................................. II - 4

Table 6.3. Impact in Jacksonville: Self-Reported Drug Use in the 30 Days 

Prior to Follow-up Interview, controlling for Defendant Characteristics 

and Sample Differences .................................................................................................. II - 5

Table 6.4. Impact in Tacoma: Self-Reported Drug Use in the 30 Days Prior to

Follow-up Interview, controlling for Defendant Characteristics and 

Sample Differences ......................................................................................................... II - 6

Table 6.5. Arrests in the Six Months prior to Follow-Up Interview by Site ....................................... II - 9

Table 6.6. Self-reported Offenses in the 6 Months Prior to Interview by Site .................................. II - 10

Table 6.7. Impact in Birmingham: Self-Reported Recidivism in the Six Months 

Prior to Follow-up ............................................................................................................ II - 11

Table 6.8. Impact in Jacksonville: Self-Reported Recidivism in the Six Months 

Prior to Follow-up ............................................................................................................ II - 12

Table 6.9. Impact in Tacoma: Self-Reported Recidivism in the Six Months Prior 

to Follow-up ..................................................................................................................... II - 13

Table 6.10. Official Recidivism in the 12 months Following Sample Entry ........................................ II - 16

Table 6.11. Impact in Birmingham: The Probability of Arrest and Number of Arrests 

in the 12 months After Sample Entry .............................................................................. II - 17

Table 6.12. Impact in Jacksonville: Any Re-Arrests in the 12 months Following Sample Entry ........ II - 18
Contents iv 

Table 6.13. Impact in Tacoma: Probability of Arrest and Number of Arrests in the 

12 months After Sample Entry ........................................................................................ II - 19

Table 6.14. Time to First Re-Arrest in Birmingham (Cox Regression Hazard Ratios)....................... II - 22

Table 7.1. ASI Problem Severity Scores by Group and Interview ................................................... II - 25

Table 7.2. BTC in Birmingham: Changes in Health, Employment, Family/Social, 

and Psychological Problems, controlling for Defendant Characteristics 

and Sample Differences .................................................................................................. II - 26

Table 7.3. Jacksonville Composite Problem Scores by Group and Interview.................................. II - 28

Table 7.4. Impact in Jacksonville: BTC’s Impact on Well-Being ..................................................... II - 29

Table 7.5. Tacoma Composite Problem Scores by Group and Interview ........................................ II - 30

Table 7.6. Impact in Tacoma: BTC’s Impact on Well-Being............................................................. II - 31

PART IIII. BTC COSTS AND BENEFITS 

Table 8.1. Benefit Calculations by Site............................................................................................. III - 9 

Table 8.2. Crime Reduction Benefits of BTC per BTC Participant................................................... III - 10 

Table 8.3. The Ratio of BTC Benefits to Costs: the CBA................................................................. III - 10 
Contents v 

Figures 

PART I. BTC IMPLEMENTATION 

Figure 2.1. The BTC Intervention Strategy........................................................................................ I - 4

Figure 3.1. A Comparison of Felony Case Processing in the Demonstration 

Sites Prior to BTC............................................................................................................ I - 10

Figure 3.2. Demonstration Sites' Offender Release, Supervision, and 

Treatment Services prior to BTC..................................................................................... I - 11

Figure 4.1. Birmingham Plans for BTC.............................................................................................. I - 13

Figure 4.2. Plans for the BTC Intervention in Jacksonville................................................................ I - 15

Figure 4.3. BTC Concept: Pre-Sentencing ........................................................................................ I - 17

Figure 4.4. BTC Concept: Post Sentencing ...................................................................................... I - 18

Figure 4.5. Early Case Identification Procedures In The BTC Sites ................................................. I - 20

Figure 4.6. Per Month BTC Case Identification Activity, by Site ....................................................... I - 22

Figure 4.7. Rating of Fairness of the Judge and Case Outcome at Follow-up ................................. I - 30

Figure 4.8. Rating of Certainty of Sanctions for Drug-Related Infractions at Follow-up ................... I - 30

Figure 5.1. Case Flow in Birmingham ............................................................................................... I - 38

Figure 5.2. Alternative Court Dockets for Drug-Related Cases in Birmingham during BTC ............. I - 41

Figure 5.3. Timelines: Pre-BTC/BTC Comparison of Average Number of Days

to Events in Birmingham ................................................................................................. I - 43

Figure 5.4. Median Days from Arrest to Case Processing Event in Jacksonville.............................. I - 46

Figure 5.5. Median Days from Arrest to Case Processing Event in Tacoma .................................... I - 50

PART II. BTC IMPACT

Figure 6.1. Predicted Probabilities of Drug Use with Covariates Held at the Mean .......................... II - 7

Figure 6.2. Predicted Probability of Any Offense with Covariates Held at the 

Mean Pr(Y=1|x) ............................................................................................................... II - 14

Figure 6.3. Predicted Probability of Drug Offenses with Covariates Held at the 

Mean Pr(Y=1|x) ............................................................................................................... II - 14

Figure 6.4. Predicted Number of Any Offenses and Drug Offenses with Covariates 

Held at the Mean: Jacksonville Pr(Y=1|x) ....................................................................... II - 15

Figure 6.5. Predicted Probabilities of an Arrest with Covariates Held at the Mean 

[Pr(Y=1|x)] ....................................................................................................................... II - 20

Figure 6.6. Predicted Probabilities of a Drug Arrest (Possession or Sales) with 

Covariates Held at the Mean [Pr(Y=1|x)] ........................................................................ II - 20

Figure 6.7. Predicted Number of Arrests with Covariates Held at the Mean [Pr(Y=1|x)] ................. II - 20

Figure 6.8. Predicted Number of Drug Arrest(s) (Possession or Sales) with Covariates

Held at the Mean [Pr(Y=1|x)].......................................................................................... II - 20

Figure 7.1. Predicted Probabilities of Family Problems with Covariates Held at the Mean .............. II - 33

Figure 7.2. Predicted Probabilities of Employment Differences with Covariates Held 

at the Mean...................................................................................................................... II - 33

Figure 7.3. Predicted Probabilities of Other Problem Reductions with Covariates 

Held at the Mean ............................................................................................................. II - 33
Executive Summary Exec – 1 

EXECUTIVE SUMMARY 

This Executive Summary presents the highlights from 

the evaluation of the Breaking the Cycle (BTC) 

demonstration projects, conducted in Birmingham, 

Alabama, Jacksonville, Florida, and Tacoma, 

Washington, between 1997 and 2001. The BTC 

demonstrations tested the feasibility and impact of 

systemwide intervention to reduce drug use among 

offenders by identifying and intervening with druginvolved felony defendants. BTC reflects the widespread 

recognition among criminal justice professionals of the 

link between drug use and crime. Drug users commit 

crimes to get money for drugs, get involved in violence 

over drug deals, and commit crimes while under the 

influence of drugs. Faced daily with drug-abusing 

offenders, many judges, prosecutors, police, and 

corrections officers actively support efforts to reduce drug 

use among offenders and are willing to use the authority 

of the justice system to this end. The BTC strategy was to 

screen offenders shortly after arrest and require those 

found to use drugs to participate in a drug intervention 

while under criminal justice supervision. 

BTC targeted all adult felony defendants and was not 

limited to those charged with drug offenses. Defendants 

were ordered to report to BTC for drug screening as a 

condition of pretrial release; those who reported drug 

use, tested positive for drugs, or were arrested on drug 

felony charges were placed in drug testing and, when 

appropriate, referred to drug treatment or drug education classes. The goal was to expand the 

scope of earlier programs such as drug courts and Treatment Alternatives to Street Crime 

(TASC) by incorporating drug reduction activities as part of handling felony cases. 

The core system reforms called for by BTC model were early intervention, judicial oversight, 

graduated sanctions and incentives, and collaboration among justice and treatment agencies. 

• Early Intervention. The BTC model called for identifying drug-using offenders 

immediately after they were arrested. The rationale for intervention at this point is that 

arrest is a crisis for most individuals and represents an opportunity to assist drug users 

in confronting and acknowledging a substance abuse problem. To capitalize on this 

moment of opportunity, BTC plans included drug testing of all offenders as soon as 

possible after arrest, early clinical assessment, and timely placement in drug treatment 

or monitoring as indicated by the assessment. Operationally, this meant setting up 

ith funds 

i

l

i

anal

The BTC demonstrations were 

supported by the National Institute of 

Justice (NIJ), the research arm of the 

U.S. Department of Justice, w

provided by the National Office of Drug 

Control Policy. The first site, 

Birmingham, received funding in 1997, 

and the next two sites, Jacksonville 

and Tacoma, in 1998. BTC was 

managed by the NIJ w th funds 

provided by the National Office of Drug 

Control Strategy. The NIJ Office of 

Development and Communication 

selected the sites through an extensive 

competitive process, monitored 

program implementation, and provided 

technical assistance to the sites. The 

NIJ Research and Eva uation Branch 

selected the evaluation team through a 

competitive process and gu ded the 

evaluation through a cooperative 

agreement. 

The Treatment Research Institute 

recruited the evaluation samples, 

designed the survey instruments, and 

managed the surveys. The cost-benefit 

ysis was conducted by Dr. Jeffrey 

Merrill of the Robert Wood Johnson 

Medical Center. 
Executive Summary Exec – 2 

procedures for (1) screening every defendant entering the criminal justice system to 

identify drug users and (2) preparing individualized treatment plans and conditions 

shortly after arrest. 

• Judicial Oversight. The BTC model also required close judicial oversight of drug 

treatment participation. The experience of drug courts suggests that close judicial 

oversight can help reduce drug use and criminal behavior among participants, a lesson 

BTC planned to extend to all drug-using defendants under any form of criminal justice 

supervision. BTC planned to use judicial authority to monitor and sanction violations of 

conditions of community supervision, focusing on requirements for drug testing and 

treatment attendance if recommended. Operationally, judicial oversight called for court 

review of compliance and reports on drug treatment performance and drug testing prior 

to hearings. 

• Use of Graduated Sanctions and Incentives. The agencies involved in BTC were 

expected to apply steady leverage to require abstinence and retain offenders in 

treatment. Borrowing from strategies pioneered by drug courts, BTC offender 

management plans specified consistent and timely use of sanctions. The sanction plans 

called for immediate and certain response to offender violations, with punishments 

graduating in severity as needed, and incentives for treatment progress. Operationally, 

these plans required that BTC specify (1) BTC rules and infractions; (2) sanctions for 

each type of infraction; and (3) the staff with authority (and responsibility) to respond to 

compliance and noncompliance. Further, BTC needed to have procedures for ensuring 

that the rules and policies were understood by the offenders, court staff, treatment staff, 

and supervising agents or case managers. 

• Close Collaboration among Criminal Justice and Drug Treatment Agencies. The 

BTC sites were asked to engage in cross-agency planning and management. 

Operationally, key staff members of partner agencies were expected to attend regular 

meetings to develop policies, solve problems, and engage in setting objectives. Partner 

agencies were expected to exchange information on offender status and engage in 

collaborative monitoring of offender compliance in an ongoing and timely manner. 

BTC had an important and lasting effect on the demonstration sites. BTC innovations 

generated considerable local political support and are continuing with substantial local funding 

in all three sites. A major reason for this support is that BTC is seen as an appropriate and 

effective alternative to pretrial detention. This was very important to the sites with overcrowded 

jails. The availability of supervision, drug testing, and penalties for continued drug use increased 

the willingness of the courts to release arrestees while their cases were pending, and offered 

the justice system strategies for addressing a factor that contributes to the risk of reoffending. 

This fact suggests that improvements in the strategies for coordinated intervention to address 

drug use among offenders were valued and that additional work needs to be done to identify 

ways to deliver these services efficiently and consistently. This enthusiasm persists despite the 

challenges, described below, of undertaking such substantial systemwide reforms and appears 

justified by the significant reductions in drug use and crime found by the evaluation. 
Executive Summary Exec – 3 

IMPLEMENTING BTC 

Early intervention proved challenging to the sites, all of which needed to establish new 

pretrial supervision and case management programs. In Birmingham and Tacoma, defendants 

were required as a condition of pretrial release to report to the TASC agency offices for a drug 

test and screening, followed by assessment if needed. In Jacksonville, jail medical staff 

administered drug tests and the TASC agency conducted screening and assessment in the jail 

or at the BTC offices. The procedures used are shown in table 1. 

Early Case Identification Procedures in the BTC Sites 

Birmingham Jacksonville Tacoma 

SCREEN IN G 

When and Where Post-release at BTC Pre-release at jail intake Post release at BTC 

following arrest 

How Self-administered Four screening questions Questionnaire based on 

questionnaire and and Roche TestCup-4 drug the Texas Christian 

EMIT drug test test University Drug 

Dependence Screen and 

Martin Diagnostic 

International Rapid drug 

test 

ASSESSMENT 

When and Where At BTC offices on In jail or at BTC offices At BTC offices, usually 

initial visit (usually (shortly after bond condition following group 

within week of arrest) requiring BTC issued) orientation meeting 

How Clinical interview SASSI (Substance Abuse Clinical Interview 

Subtle Screening Inventory) 

screener & DSM-IV 

assessment for abuse or 

dependence used to 

recommend placement on 

ASAM Level III.5 criteria 

*Screening in Jacksonville is before the BTC order; in Birmingham and Tacoma screening is after the BTC order. 

The average number of defendants screened, found eligible, and given a treatment plan 

each month was 365 in Birmingham, 182 in Jacksonville, and 129 in Tacoma. Thus, annually 

Birmingham assessed about 4,300 defendants, Jacksonville about 2,100, and Tacoma about 

1,500. 
Executive Summary Exec – 4 

The demonstration highlighted the potential advantages and disadvantages of conducting 

the initial screening in jail. 

• In-Jail Screening. One advantage of in-jail screening is that results are available at the 

time of the release decision and can be used in setting release conditions. Another is 

that results can be used to identify detained defendants who should receive treatment in 

jail (if available). This procedure resulted in screening the highest proportion of chargeeligible arrestees. However, in-jail screening wastes resources if drug users do not 

subsequently receive an intervention because charges are dropped, reduced to 

misdemeanors, or shifted to another jurisdiction. Moreover, in Jacksonville, many 

defendants with positive screening results were not ordered to report to BTC as a 

condition of their release. 

• Postrelease Screening. Advantages of postrelease screening are that it does not 

require jail space and staff. It saved resources in Tacoma and Birmingham, where jailbased treatment was limited to weekly Narcotics Anonymous/Alcoholics Anonymous 

(NA/AA) groups. Postrelease screening and assessment allowed case managers to 

make immediate referrals to treatment. However, limiting screening to those released 

may fail to identify the most seriously addicted defendants, who by virtue of their criminal 

history and lack of cash may be less likely to be released. Another potential 

disadvantage is that postrelease screening gives arrestees advance warning of a test 

and a chance to avoid detection by abstaining from drug use prior to the initial test. In 

response to these concerns, Birmingham required defendants arrested on drug felony 

charges to test negative for drugs on weekly tests for at least one month before 

concluding that they were not users and releasing them from BTC. 

BTC sites used the results of the assessments to assign defendants to a level of drug 

intervention based on the severity of their drug involvement. There were differences in drug use 

patterns and severity of abuse across the three sites. In Birmingham, 55 percent of the BTC 

participants in the impact evaluation sample tested positive on their initial drug test, compared 

with 65 percent in Jacksonville and 68 percent in Tacoma. Abuse problems, as measured by 

drug composite scores on the Addiction Severity Index (ASI) (McLellan et al. 1992) above .04 at 

baseline,1

 were reported by 33 percent of the Birmingham BTC sample, 71 percent of the 

Jacksonville sample, and 60 percent of the Tacoma sample. However, the treatment placements 

recorded in the BTC management information systems (MISs) in each site did not parallel the 

apparent need patterns. The portion of BTC participants placed in residential or outpatient 

treatment at some time during their participation was about two-thirds in Birmingham, one-fourth 

in Tacoma, and one in twenty in Jacksonville. It should be noted that Tacoma and Jacksonville 

had serious problems with their MISs and it is likely that not all treatment placements were 

recorded. 

Drug-involved defendants assessed as needing less intensive intervention were placed in 

drug testing, sometimes accompanied by drug education classes. Others were placed in drug 

testing and treatment readiness classes while waiting for treatment spaces. The average 

1 The score of .04 is the ASI cutoff point used by the Treatment Research Institute to differentiate those who need 

clinical intervention from those who do not. 
Executive Summary Exec – 5 

number of drug tests per BTC participant was 9.7 in Birmingham, 2.8 in Jacksonville, and 12.2 

in Tacoma. Most sanctions were for missing or failing a drug test, were delivered by case 

managers or pretrial officers, and were relatively mild. The case manager sanctions in 

Birmingham included an “alert” letter that warned noncompliant clients (received by 60 percent 

of the violators), case review by the case manager (received by 42 percent of the violators), and 

termination from BTC (received by 23 percent of the violators). In Jacksonville, the pretrial 

officer sanctions included warning letters, meeting with the supervising officer, and a violation 

report to the court. Although the infractions recorded for 20 percent of BTC testing participants 

were almost always followed by a sanction, only 19 percent of the positive results on tests 

conducted after BTC entry were noted as infractions. In Tacoma, the impact evaluation sample 

averaged 5.1 infractions per BTC participant and almost all were sanctioned. About two-thirds of 

the sanctions were delivered by case managers and involved letters, meetings, or changes in 

drug testing requirements. 

Judicial monitoring was relatively rare in Birmingham and Jacksonville. Few hearings were 

held to review noncompliance and even fewer judicial sanctions were imposed. A sample of 

data from the program records showed 28 judicial sanctions in response to 8,601 infractions in 

Birmingham and 10 judicial sanctions in response to 458 infractions in Jacksonville. In Tacoma, 

one judge reserved one afternoon a week for review hearings for BTC participants with 

numerous infractions. About one-third (over 700) of the sanctions given to BTC participants in 

the impact evaluation sample were administered by the judge. 

One problem BTC encountered was that plans did not specify what would happen in cases 

of sustained noncompliance or conditions under which participants would be terminated from 

BTC services. There seemed to be an implicit belief that sustained noncompliance would result 

in judicial sanctions that would graduate in severity and culminate in pretrial detention pending 

case disposition (prior to sentencing) or in probation revocation (postsentencing). The influx of 

cases resulted in much higher than anticipated caseloads for case managers and limited their 

capacity to provide close monitoring and deliver sanctions in a timely fashion. This problem was 

exacerbated by the lack of automated data systems linked to other agencies, which would have 

enabled case managers to distinguish inactive BTC clients (in jail or out on warrant) from those 

expected to be reporting regularly and to monitor treatment attendance and drug test results 

easily. 

As this description indicates, BTC implementation fell short of the ideal in all three 

demonstration sites, highlighting the challenge of coordinated efforts to reduce drug use among 

all drug-involved felony defendants released to the community while their cases are pending. 

LESSONS FOR THE FUTURE 

The BTC effort to expand lessons from earlier programs produced valuable guidance for 

future development of programs and policies, particularly in three areas: strategies for 

identifying and responding to a range of substance abuse problems, the data infrastructure 

required to track the progress of individuals as they have contact with multiple agencies, and 

issues in managing interagency collaboration across justice and treatment agencies. 
Executive Summary Exec – 6 

Lesson 1. BTC functioned best when case managers assumed responsibility for both 

managing treatment referrals and responding to drug testing infractions, backed up by 

judicial hearings as needed. 

Two models emerged for managing treatment and supervision. In Birmingham and Tacoma, 

BTC expanded TASC case management capacity and asked case managers to adopt more 

stringent procedures for monitoring compliance with BTC requirements and administering 

sanctions for noncompliance. In Jacksonville, BTC divided these responsibilities between 

treatment providers and a newly created BTC supervision unit. In practice, this model split the 

intervention clearly into coerced abstinence for nonaddicted drug users and treatment for those 

meeting clinical criteria of abuse or dependence. This model was less successful in bridging the 

gap between justice and treatment agencies. Corrections officers tested, supervised, and 

sanctioned defendants, maintained records, and requested violation hearings if needed. 

Treatment agencies provided services for relatively few participants and rarely reported 

noncompliance to the pretrial officers. The plan for judges to review and sanction persistent 

noncompliance was consistently implemented only in Tacoma. Future programs need to engage 

in strategic planning around rules that define infractions, sanctions for responding to infractions, 

strategies for timely response to noncompliance, and work to engage the courts in sanctioning. 

Lesson 2. Automated data systems are essential to ensure offender accountability in 

interventions aimed at large numbers of individuals. BTC helped sites recognize and 

address this need. 

Criminal justice agencies must know the whereabouts of those under their supervision, and, 

in the case of BTC, be able to exchange this information with partner agencies. This proved to 

be very difficult. Lack of access to timely information on defendant release status affected BTC 

services both at screening and throughout the program. Because arrestees could post bond at 

any time and could be picked up on other charges at any time, it was difficult to determine when 

failure to appear for testing or appointments was deliberate noncompliance and when it resulted 

from incarceration. Efforts to exchange information were only partially successful and relied 

heavily on faxing, which was difficult, given the large numbers of BTC clients and their 

constantly shifting criminal justice status. BTC contributed to the solution in Birmingham and 

Jacksonville by supporting the development of MISs and in Tacoma by supporting the 

development of a link between the criminal justice data system and the TASC MIS. However, 

these improvements came very late in the program, and their absence was an impediment for 

much of the demonstration period. 

Lesson 3. A major benefit of BTC, one not measured by the impact or cost-benefit 

evaluation, was building the structure and relationships to sustain coordinated policy 

development and ongoing collaboration among criminal justice agencies themselves and 

with treatment providers. 

BTC, like many other demonstration projects, found that effective joint problem solving and 

strong local leadership were necessary. Two techniques used successfully to facilitate 

collaboration among the agencies in all BTC sites were (1) the development of detailed strategic 

plans that specified needed changes, set deadlines, and assigned responsibility for tasks and 

(2) the preparation of written memorandums of understanding on the purpose of BTC and the 

role of each agency in implementation. In all three cities, the most challenging management 

problem was engaging the state agencies that managed probation in making rather substantial 
Executive Summary Exec – 7 

changes in supervision practices to accommodate the local BTC vision of combining treatment 

and monitoring. These large state agencies have statewide policies, data systems, and 

managerial procedures that make it hard to make changes in a specific jurisdiction. Moreover, 

the top officials were located in other cities and could not attend policy board meetings. This 

situation required extra willingness on the part of the regional directors to take on the challenge 

of training and encouraging their staff to participate in local partnerships. 

THE IMPACT OF BTC 

The findings from the impact evaluation confirm the benefits of BTC strategies, even when 

imperfectly implemented, and indicate that efforts to reduce drug use directed at all felony 

defendants under supervision in the community can produce gains in public safety. 

Finding 1. BTC reduced drug use in two sites. 

The results show that BTC participants were significantly less likely than similar defendants 

arrested in the year before BTC to 

• Use an illicit drug in the 30 days before follow-up (Birmingham and Jacksonville) 

• Use marijuana in the 30 days before follow-up (Jacksonville and black BTC clients in 

Birmingham) 

• Use a stronger drug (mainly cocaine) in the 30 days before follow-up (Birmingham) 

• Engage in heavy drug use in the 30 days before follow-up (Jacksonville) 

However, no reductions in drug use were found in Tacoma. Several factors may explain this 

finding. Drug severity scores, as measured by the ASI composite score for drug abuse, were 

higher for BTC participants in Tacoma than in the other sites. Overall, the demand for treatment 

exceeded the supply, and long waits were common. Tacoma was the only site to have a 

significant problem with methamphetamine, a drug that is particularly difficult to treat. Tacoma 

also had a much higher proportion of white participants, the group that did not show marijuana 

use reductions in Birmingham. 

The observed reductions in drug use were not clearly linked to participation in drug 

treatment. In Tacoma and Jacksonville, the BTC samples reported significantly more days of 

drug treatment in the month before the follow-up interview than the pre-BTC sample (2.1 days 

compared with 0.8 days in Jacksonville and 3 days compared with 1.3 days in Tacoma), but 

significant reductions in drug use were found in Jacksonville and not Tacoma. The pretrial 

monitoring was more aggressive and reached a far larger pool of eligible BTC defendants In 

Jacksonville than in Tacoma, suggesting that the difference in outcomes may have resulted from 

increased drug testing, monitoring, and pretrial supervision. Both of these sites had higher rates 

of stronger drug use (cocaine in Jacksonville and cocaine and methamphetamine in Tacoma) 

than did Birmingham. 

In Birmingham, with its lower rate of stronger drug use, the BTC participants were 

significantly less likely to use drugs. The reductions in marijuana use were larger among black 
Executive Summary Exec – 8 

participants than white participants. There was no significant difference in the number of days of 

drug treatment in the month before follow-up reported by BTC and comparison defendants. If 

the planned duration of drug treatment was short, BTC participants in Birmingham might have 

completed treatment prior to the month before follow-up, as the process evaluation indicated 

that most of those in need of treatment (based on clinical assessment) received it. Delays in 

treatment entry in Tacoma combined with widespread methamphetamine use may have delayed 

or derailed the impact of BTC on drug use. A competing (or complementary) explanation is that 

the heightened pretrial supervision and drug testing in Birmingham and Jacksonville, more 

widespread than in Tacoma where efforts were focused on a smaller pool of drug abusers, may 

have reduced drug use among BTC clients placed only in urine monitoring. 

Finding 2. BTC reduced criminal activity. 

In all three sites, BTC participants were less likely than comparison samples to report 

committing a crime in the six months before follow-up interview. When only drug offenses are 

examined, the results show that BTC participants were less likely to report drug sales or 

possession in the six months before follow-up. These differences were large and highly 

significant. Our validity analysis found that the comparison samples in Jacksonville and 

Birmingham reported a smaller portion of the officially recorded arrests than BTC participants in 

those two cities across the six months prior to follow-up. The difference in willingness to report 

offending suggests that the impact of BTC based on self-reported offending may be larger than 

that observed in this study. 

In Birmingham and Tacoma, the BTC samples were less likely than the comparison 

samples to be arrested within a year of entering the program. In contrast, arrest records in 

Jacksonville showed higher arrest rates (and numbers of arrests) during the year for BTC 

participants than for the comparison group. This finding in Jacksonville is inconsistent with the 

analysis of self-reported offending and with findings in the other two sites for reasons that are 

unknown. One possibility is an overall increase in enforcement during the years of the study, 

which increased the likelihood of arrest independently of a change in offending; another is that 

data systems used to check recidivism were improved. 

Overall, our conclusion is that BTC reduced criminal activity, with the caveat that 

Jacksonville did not conform to this general pattern. 

Finding 3. BTC reduced family problems in all sites. 

BTC participants also reported some improvements in domains of functioning associated 

with reductions in drug use, particularly improved relationships with family members. In all three 

sites, the severity of family problems as measured by the ASI composite score was significantly 

lower at follow-up for the BTC samples than for the pre-BTC samples, controlling for the severity 

of family problems and other factors at baseline. 

Evidence of reduction in other problem areas was mixed. Tacoma BTC participants reported 

greater reductions than the pre-BTC comparison group in the severity of psychological 

problems, employment difficulties, and social difficulties. However, these gains were not 

observed in the other BTC sites. In Jacksonville alone, BTC was associated with a significant 

reduction in employment problems. 
Executive Summary Exec – 9 

BTC COSTS AND BENEFITS 

The analysis of costs and benefits estimated the return to the costs (expenditures and inkind resources) to participating agencies. The cost estimates do not include the routine costs of 

operating the jails and courts, but count only the additional costs of BTC interventions. The 

benefits are confined to outcomes observed during the year after the start of intervention and do 

not count longer term benefits or those not measured by the impact evaluation. The results 

show positive returns to the investment in BTC in all three sites. The ratio of the costs averted 

for each dollar invested was 2.3 in Birmingham, 2.6 in Jacksonville, and 5.3 in Tacoma. Not all 

of these savings can be readily converted into budget dollars for the agencies participating in 

BTC since they represent savings to a host of stakeholders, including potential victims, public 

jurisdictions, insurers, and citizens in general as well as the public law enforcement, court, and 

corrections systems. However, the benefits are consistent with the public safety, health, and 

welfare missions of the investing agencies. 

The results are conservative. Reductions in arrests, physical and emotional morbidity, and 

welfare use may lead to longer term savings not measured by this evaluation. In addition, the 

savings attributable to the reduced arrest rates at two of the sites are very conservatively 

estimated. If BTC has a very large effect on cutting arrests, it might make it possible to reduce 

both jail and prison capacity as well as the size of law enforcement and court systems. One 

large cost saving not captured by this analysis was that in both Birmingham and Tacoma, BTC 

was used to relieve serious jail overcrowding, thus reducing pressure to construct new jail 

facilities. Indeed, in Birmingham, the county commissioners voted continuation funds for BTC at 

the end of federal funding and cancelled plans for a bond referendum on a new jail. 

THE BROADER IMPLICATIONS 

The BTC findings on the positive impact of interventions with drug offenders are consistent 

with other recent studies of programs that use case management with treatment and sanctions 

to encourage abstinence from drug use and crime. For example, 

• In the DC Superior Court, graduated sanctions that are certain and swift were found to 

reduce drug use prior to sentencing and crime in the year after sentencing, 

independently of the frequency of drug testing and judicial monitoring (Harrell, 

Cavanagh, and Roman 1999). 

• Drug court evaluations with strong experimental or quasi-experimental designs report 

significantly lower likelihood of rearrest in the year after entry for participants than for 

control groups. For example, 44 percent of the drug court participants in Baltimore were 

rearrested within a year of entry compared with 56 percent of the control group (p < .10) 

(Gottfredson and Exum 2000). In Orange County, California, 22 percent of the drug court 

participants were rearrested compared with 34 percent of the control group (Deschenes 

et al. 1999). 

• A five-year study of the Clark County, Nevada, drug court showed consistent and 

significant reductions in rearrest for drug offenses at one, two, and three years after 

program entry, but inconsistent results for reductions in arrests for other offenses 

(Goldkamp, White, and Robinson 2001). 
Executive Summary Exec – 10 

• Not all drug courts are equally effective. Differences in the target population 

demographics and risk factors as well as variations in drug court policies and practices 

result in differences in the rates of participation, graduation, and treatment retention as 

well as differences in rearrest rates across courts and over time (Belenko 1999; 

Goldkamp, White, and Robinson 2001; Truit et al. 2001). 

Other studies of using sanctions in criminal justice interventions for drug users stress the 

importance of two practices used by the BTC sites: 

• Making sure defendants understand the sanctions they face. At the heart of 

increased accountability is the forging of an understanding between the court and the 

offender on behavioral requirements and consequences. When drug court defendants 

enter into an agreement with the judge, they accept a "contingency contract" that makes 

them accountable for participating in treatment; they must comply with a known set of 

rules that define sanctions and incentives which they can control through their behavior 

(see Harrell and Smith 1995; Inciardi et al. 1996; Pendergast et al. 1995). The 

importance of knowing rules in advance is likely to apply to offenders on probation and 

parole as well as those in drug courts. 

• Making sure defendants believe that sanctions earned will be delivered. To be 

believable and effective, sanctions must be delivered as promised with a high degree of 

certainty. Somewhat surprising to many people is the finding that severity of punishment 

does not always influence behavior, and its effects may depend on the certainty of 

punishment or the salience of the penalty to the individual (Nagin and Pogarsky 2001). 

Effective responses may include positive incentives or rewards for doing well or 

punishments for noncompliance, and theoretically rewards are more powerful in eliciting 

desired behaviors. However, BTC and most programs for offenders relied on sanctions, 

imposed by case managers or judges. They included assignment to more intensive 

monitoring or treatment, judicial warnings, or short-term incarceration. Sanctions that are 

treatment-oriented (e.g., remand to detoxification or more intense treatment) have been 

shown to hold great promise (Anglin and Hser 1990; Lipton 1994). The critical point is 

that noncompliance should be consistently followed by a penalty that is severe enough 

to make the defendant try to avoid it. 

In the two sites in which defendant perceptions were measured, BTC participants rated the 

risk of receiving a sanction for failing a drug test or missing drug treatment significantly higher at 

follow-up than the comparison group, indicating heightened awareness of the risk of legal 

consequences. However, defendant views of the severity of sanctions were mixed. BTC 

participants in Tacoma rated the severity of sanctions for a drug test failure significantly higher 

than the comparison group did. In Jacksonville, the reverse was true, with the BTC participants 

rating the severity of probable sanctions for these infractions significantly lower at follow-up than 

the comparison group did. This finding is consistent with the higher actual risk of judicial 

sanctions in Tacoma than Jacksonville and the difference in use of sanctions in the two sites. 

BTC efforts to combine sanctions and treatment were consistent with other findings on the 

benefits of using these intervention strategies together. 
Executive Summary Exec – 11 

• Falkin's (1993) evaluation of community-based treatment for offenders found that 

treatment combined with urinalysis and court monitoring with sanctions had higher rates 

of success than treatment alone. 

• The impact of the Washington, D.C., Graduated Sanctions program was strongest for 

offenders who participated voluntarily in NA/AA treatment monitoring (Harrell, Cavanagh, 

and Roman 1999). 

• Intensive Supervision Probation programs in California that combined treatment with 

strict surveillance reduced recidivism by as much as 15 percent more than high levels of 

surveillance alone, leading to recommendations that treatment be included as part of 

efforts to reduce criminal activity among drug felony offenders (Petersilia and Turner 

1993; Petersilia, Turner, and Deschenes 1992). The authors warned that “Putting drugdependent offenders in a program that forbids drug use, provides frequent testing, and 

provides no assured access to drug treatment virtually guarantees high violation rates" 

1993, p. 320). 
Chapter 1. Breaking the Cycle: The Research Demonstration Intro – 1 

CHAPTER 1. 

INTRODUCTION 

This report presents the final results of the evaluation of the Breaking the Cycle (BTC) 

demonstration projects. The BTC demonstrations tested the feasibility and impact of 

systemwide intervention to reduce drug use among offenders by identifying and intervening with 

drug-involved felony defendants. The BTC demonstrations were supported by the National 

Institute of Justice (NIJ), the research arm of the U.S. Department of Justice, with funds 

provided by the National Office of Drug Control Policy. The first site, Birmingham, Alabama, 

received funding in 1997, and the next two sites, Jacksonville, Florida, and Tacoma, 

Washington, in 1998. 

BTC was managed by NIJ with funds provided by the National Office of Drug Control 

Strategy. The NIJ Office of Development and Communication selected the sites through an 

extensive competitive process, monitored program implementation, and provided technical 

assistance to the sites. The NIJ Research and Evaluation Branch selected the evaluation team 

through a competitive process and guided the evaluation through a cooperative agreement. 

The BTC evaluation focused on three aspects of the demonstration: process, impact, and 

cost-benefit. The Urban Institute managed the evaluation, conducted the process evaluation, 

collected data on program services and justice system activities, and analyzed the impact of 

BTC. The Treatment Research Institute recruited the evaluation samples, designed the survey 

instruments, and managed the surveys. Dr. Jeffrey Merrill of the Robert Wood Johnson Medical 

Center conducted the cost-benefit analysis. 

The process evaluation goals were to assess the feasibility of BTC as a model, identify the 

strategies developed and lessons learned at the sites for meeting the challenge of systemwide 

responses to drug use, and document the services delivered as a basis for understanding the 

impact evaluation outcomes. Data for process evaluation were collected from interviews of staff 

of collaborating agencies, weekly conference calls with site project directors, computerized 

information systems of participating agencies, and monthly reports on project activities 

submitted to NIJ by BTC grantees. Part I of this report provides an overview of the process 

evaluation findings to assist in interpreting the impact findings and identify the key 

implementation lessons. Three earlier reports have presented more detailed case studies of the 

implementation process in each site.2 

2

 A.V. Harrell, O. Mitchell, and A. Hirst, Implementing System-Wide Interventions for Drug-Involved Offenders in 

Pierce County, Washington: Evaluation of the Breaking the Cycle Demonstration, Report submitted to the National 

Institute of Justice, June 2000. 

A.V. Harrell, O. Mitchell, and A. Hirst, Implementing System-Wide Interventions for Drug-Involved Offenders in 

Birmingham, Alabama: Evaluation of the Breaking the Cycle Demonstration, Report submitted to the National Institute 

of Justice, June 2000. 
Chapter 1. Breaking the Cycle: The Research Demonstration Intro – 2 

The impact evaluation tested the general hypothesis that BTC would reduce drug use, 

crime, and drug-related problems among offenders; changes in case processing during BTC 

were also examined. The impact evaluation is based on a quasi-experimental comparison of 

defendants in BTC with samples of similar defendants arrested in the year before BTC 

implementation. Data collection included baseline and follow-up interviews with sample 

members, records on court and BTC services and contacts with criminal justice agencies and 

case managers during BTC, and records on arrests before sample entry and in the following 

year. Part II of this report presents the findings of this impact evaluation. Appendix A describes 

the methodology. 

Results of the impact evaluation were used to estimate the return on investment in BTC. 

This was accomplished by documenting the additional costs of providing the BTC services and 

comparing them to costs averted by reductions in drug use and crime observed during the oneyear follow-up period. These findings are shown in Part III. 

A.V. Harrell, O. Mitchell, and A. Hirst, Implementing System-Wide Interventions for Drug-Involved Offenders in 

Jacksonville, Florida: Evaluation of the Breaking the Cycle Demonstration, Report submitted to the National Institute 

of Justice, June 2000. 
PART I. BTC Implementation I – 1

PART I. 

BTC IMPLEMENTATION
PART I. BTC Implementation 

Chapter 2. Breaking The Cycle: The Intervention Strategy I – 2 

CHAPTER 2. 

BREAKING THE CYCLE: THE INTERVENTION STRATEGY 

The BTC demonstration reflects the widespread recognition among criminal justice 

professionals of the link between drug use and crime. Drug users commit crimes to get 

money for drugs, get involved in violence over drug deals, and commit crimes while under the 

influence of drugs. Faced daily with drug-abusing offenders, many judges, prosecutors, police, 

and corrections officers actively support efforts to reduce drug use among offenders and are 

willing to use the authority of the justice system to this end. 

The two primary strategies used to change offender drug use behavior are legal pressure 

and drug treatment. 

• Legal pressure takes various forms, including (1) penalties for positive drug tests and 

failure to attend treatment (graduated sanctions); (2) reductions in sentence or case 

dismissal for success (the plea or diversion offer); (3) incentives for progress (judicial 

praise or small gifts); and (4) reductions in intensity of reporting or treatment 

requirements for progress (such as less frequent drug testing). BTC relied primarily on 

the first of these strategies, using penalties to respond to noncompliance with drug 

testing and treatment requirements. 

• Drug treatment includes programs such as (1) residential treatment; (2) outpatient 

programs, intensive or other; (3) substance abuse education groups; (4) Narcotics 

Anonymous/Alcoholics Anonymous (NA/AA); and (5) methadone maintenance. BTC 

sites used all of the options, although use of methadone maintenance was rare. 

Use of these strategies has evolved over the past 25 years or so, since the DC Pretrial 

Services Agency began drug testing defendants released to the community and the first 

Treatment Alternatives to Street Crime (TASC) programs began accepting referrals from justice 

agencies. Subsequently, criminal justice agencies have tested many programs using a mix of 

these strategies. These programs targeted selected offenders who met program eligibility 

rules—generally a small portion of the drug-using offenders under supervision. The relative 

emphasis on treatment versus legal pressure has varied. 

Some of these programs have relied primarily on monitoring drug use and penalizing 

continued drug use, but could include treatment. Examples include Intensive Supervision 

Probation and the DC Superior Court's Graduated Sanctions Program. Other programs have 

relied heavily on treatment, with legal consequences for failure. Examples include TASC, pretrial 

diversion programs, and prison-based therapeutic communities. More recently, programs have 

emerged that use treatment with graduated sanctions imposed by the courts to respond to 

noncompliance and offer incentives for treatment progress. Drug courts that require treatment 

and judicial sanctioning for noncompliance are an example. The BTC intervention strategies 

were guided by findings that drug courts, community-based treatment administered by TASC 

programs (see Anglin, Longshore, and Turner 1999; Belenko 1999), in-prison treatment with 

aftercare, and specialized drug diversion programs can reduce offender drug use and crime. 
PART I. BTC Implementation 

Chapter 2. Breaking The Cycle: The Intervention Strategy I – 3 

BTC expanded the scope of earlier programs by targeting all drug-involved felony 

defendants and incorporating drug reduction activities as part of standard operations. BTC 

planners envisioned efforts by justice agencies, acting individually and collaboratively, to provide 

services from arrest through probation or post-incarceration supervision, combining drug 

treatment and testing with legal pressure to decrease drug use and increase participation in 

treatment. The vision of systemwide intervention is illustrated in figure 2.1. Systemwide 

interventions encompassed community-based treatment for those released prior to sentencing, 

jail-based programs for those detained, and postsentencing treatment in the community, jail, and 

prison, with interventions of varying intensity and type to meet the needs of all drug users, 

regardless of the type of drug or severity of abuse. The BTC demonstration projects began 

testing this vision by targeting early intervention with felony defendants placed on pretrial 

release. 

The core system reforms called for by the BTC model were early intervention, judicial 

oversight, graduated sanctions and incentives, and collaboration among justice and treatment 

agencies. 

• Early Intervention. The BTC model called for identifying drug-using offenders 

immediately after they are arrested. The rationale for intervention at this point is that 

arrest is a crisis for most individuals and represents an opportunity to assist drug users 

in confronting and acknowledging a substance abuse problem. To capitalize on this 

moment of opportunity, BTC plans included drug testing of all offenders as soon as 

possible after arrest, early clinical assessment, and timely placement in drug treatment 

or monitoring as indicated by the assessment. Operationally, this approach meant 

setting up procedures for (1) screening every defendant entering the criminal justice 

system to identify drug users and (2) preparing individualized treatment plans and 

conditions shortly after arrest. 

• Judicial Oversight. The BTC model also required close judicial oversight of drug 

treatment participation. The experience of drug courts suggests that close judicial 

oversight can help reduce drug use and criminal behavior among participants, a lesson 

BTC planned to extend to all drug-using defendants under any form of criminal justice 

supervision. BTC planned to use judicial authority to monitor and sanction violations of 

conditions of community supervision, focusing on requirements for drug testing and 

treatment attendance if recommended. Operationally, judicial oversight called for court 

review of compliance and reports on drug treatment performance and drug testing prior 

to hearings. 

• Use of Graduated Sanctions and Incentives. The agencies involved in BTC were 

expected to apply steady leverage to require abstinence and retain offenders in 

treatment. Borrowing from strategies pioneered by drug courts, BTC offender 

management plans specified consistent and timely use of sanctions. The sanction plans 

called for immediate and certain response to offender violations, with punishments 

graduating in severity as needed, and incentives for treatment progress. Operationally, 

these plans required that BTC specify (1) BTC rules and infractions, (2) sanctions for 

each type of infraction, and (3) the staff with authority (and responsibility) to respond to 

compliance and noncompliance. Further, BTC needed to have procedures for ensuring 

that the rules and policies were understood by the offenders, court staff, treatment staff, 

and supervising agents or case managers. 
PART I. BTC Implementation 

Chapter 2. Breaking The Cycle: The Intervention Strategy I – 4 

Figure 2.1. The BTC Intervention Strategy 

Released 

Outpatient Day Urine Outpatient Day 

Arrest 

Screening 

Interviews

 and Drug Test 

Detained 

Jail-Based 

Treatment 

Case-Managed 

Community-Based 

Treatment 

Residential Reporting Monitoring 

Case

 Adjudication 

Probation 

Case-Managed 

Community-Based 

Treatment 

Residential Reporting 

Urine 

Monitoring 

Prison 

Treatment 

as Needed 

Jail 

Treatment

 as Needed 

Parole 

Case-Managed 

After-Care 

• Close Collaboration among Criminal Justice and Drug Treatment Agencies. The 

BTC sites were asked to engage in cross-agency planning and management. 

Operationally, key staff members of partner agencies were expected to attend regular 

meetings to develop policies, solve problems, and set objectives. Partner agencies were 

expected to exchange information on offender status and collaboratively monitor 

offender compliance in an ongoing and timely manner. 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 5 

CHAPTER 3. 

THE DEMONSTRATION SITES BEFORE 

BTC IMPLEMENTATION 

Birmingham, Alabama; Jacksonville, Florida; and Pierce County (Tacoma), Washington, were 

selected for the BTC demonstration, following an extensive planning process and site visits 

by NIJ staff and consultants. All three sites had a history of collaboration between justice 

agencies and drug treatment agencies, agreements from the key agencies to engage in 

extensive reforms to implement the core BTC strategies, and strong local leadership. They 

differed in offender demographics, region of the country, drugs abused, state drug laws, 

resources, and local political support for radical change. These differences provide a test of 

BTC’s feasibility and impact in a variety of settings. This chapter describes the sites prior to BTC 

so that the findings can be understood in light of the local context in which reform was 

undertaken. 

BIRMINGHAM PRIOR TO BTC 

In the two-tiered court system in Birmingham, most felony cases were initiated in a lower 

court and waived to a grand jury unless a plea offer was accepted, and, if the defendant was 

indicted, cases were then filed in an upper court. Three District Court judges in Birmingham 

presided over arraignments, conducted preliminary hearings and bond reviews, accepted pleas, 

conducted bench trials, and imposed sentences. Decisions on filing charges (initiated by 

swearing out a warrant) were made by the District Attorney’s office upon review of the 

preliminary charges, bond, and release recommendations. Plea offers were made in District 

Court and accepted by many felony defendants. Those who declined the District Court plea offer 

were waived to the grand jury for indictment. If the defendant was indicted by the grand jury, a 

new case was filed in Circuit Court, the upper tier court. Defendants who accepted a Circuit 

Court plea offer were either sentenced by the Circuit Court judge, or, if eligible, sent back to 

District Court for drug court. If the plea was declined, the case was tried in Circuit Court. 

At the start of BTC, the Jefferson County jail was seriously overcrowded, and a federal 

court order to reduce overcrowding was entered during the first year of BTC. Two pretrial 

services programs, one operated by the jail and one by TASC, assisted defendants seeking 

pretrial release, although lengthy pretrial detention was not uncommon as many defendants 

could not post bond. 

• The Jail Pretrial Program identified defendants who were eligible for pretrial release 

and prepared their bond paperwork. 

• The TASC Pretrial Program identified drug-involved defendants eligible for release to 

TASC for assessment, treatment placement, and case management. The standard 

conditions for release to this program were full-time employment or schooling, random 

drug testing, reporting to TASC, confirmed attendance at NA/AA meetings, a curfew, and 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 6 

attendance at drug or alcohol treatment within a specified time period. Approximately 50 

defendants per month were released to the TASC Pretrial Program in 1996. 

The District Court offered two programs for drug-involved defendants prior to the advent of 

BTC: 

• The Deferred Prosecution Program was started by the District Attorney’s office in 

1991. Run as a joint effort with TASC, the program was open to first-time offenders 

proposed for diversion by their attorneys. Applicants were evaluated for eligibility by 

TASC and were subject to approval by the District Attorney’s office and the judge upon 

review of their case, criminal history, and other characteristics. Participants could have 

the charges dropped (thereby avoiding a felony conviction) if they completed the 

treatment program recommended and were not rearrested for one year. This program 

was suspended just prior to BTC. 

• The District Court Drug Court Program began operation in January 1996 with federal 

funds from the Drug Courts Program Office of the U.S. Department of Justice. In its first 

year, 196 defendants applied to the drug court and 113 were accepted. Referral to drug 

court was often delayed as cases moved slowly from District Court through the grand 

jury to Circuit Court before being determined to be eligible for the program. 

The first opportunity for drug assessment for offenders who did not qualify for drug court or 

deferred prosecution prior to BTC (the large majority) was the Circuit Court presentencing 

investigation (PSI) at the time of sentencing, many months after arrest. The PSI was the first 

comprehensive check of the offender’s criminal history and could include a recommendation 

that the offender be referred to TASC for assessment and postadjudication drug treatment as a 

condition of probation. 

Most felony offenders were sentenced to probation. However, the probation department 

was seriously understaffed. As of April 1997, the Board of Pardons and Parole office had five or 

six positions open and caseloads of 110 to 140 per officer. Although probation officers could 

choose to administer drug tests using hand-held test cups to detect use of cocaine, marijuana, 

amphetamines, barbiturates, or opiates, such tests were rare. Only offenders placed on TASC 

supervision as a condition of their sentence to probation were regularly tested at the TASC 

offices, and officers were notified of results. 

TASC provided case management for all of Birmingham's criminal justice programs for drug 

users. Established through the University of Alabama at Birmingham’s Department of Psychiatry 

in 1973, TASC was responsible for assessing drug-dependent offenders and referring them for 

treatment, monitoring compliance, and reporting progress to the referring justice agency. In this 

role, TASC was responsible for maintaining tracking systems to monitor the offender’s status 

within both the court system (conditions of release, upcoming court dates) and the treatment 

system (including scheduled appointments, compliance in reporting for appointments, and 

progress). Treatment services included (1) intensive and regular outpatient treatment, (2) three 

types of residential treatment (crisis stabilization, short-term treatment, and long-term 

therapeutic community), (3) supportive housing for offenders, (4) recovery homes, (5) 

methadone treatment, (6) women’s services, including pregnant women’s services, and (7) 

other supportive services, including cognitive life skills training, job placement assistance, health 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 7 

screening, and referrals for educational services. In 1995, TASC screened 1,774 offenders; 

1,479 were assessed and referred for treatment;3

 100 were placed in residential drug treatment; 

and 203 were referred for outpatient drug treatment. The majority received services at TASC. 

Offenders sentenced to prison were sent to the Department of Corrections (DOC) for 

assessment. That assessment was used to determine whether the offender would be assigned 

to one of the eight-week substance abuse treatment programs operated by DOC, placed in a 

therapeutic community, or sent to a prison that housed only offenders receiving drug treatment, 

where different treatment options were available. No treatment other than limited access to 

once-a-week AA sessions was available to those sentenced to time in jail. 

JACKSONVILLE PRIOR TO BTC 

Felony criminal cases were heard in a single court, the Circuit Court that served all of Duval 

County. The Circuit Court had six criminal dockets—four general criminal dockets and two 

devoted to repeat offenders. Initial decisions on jail release and bond conditions were made at 

an initial appearance within 24 hours of arrest. Many defendants remained in jail prior to case 

disposition, and those who secured release did not receive pretrial supervision. The first 

appearance in Circuit Court was scheduled for 14 to 17 days after the initial appearance. 

In 1998, 15,905 felony cases were filed in Circuit Court. Filing decisions were made by the 

State's Attorneys’ office. The time between arrest and filing for felony cases averaged 19 days, 

but was longer for some cases, particularly those involving seized substances, which were sent 

out for laboratory tests. Once cases were filed, they moved swiftly to disposition. Our 

experience in recruiting sample members indicated that charges were not filed against 

approximately 35 percent of those booked at the jail. When this percentage was combined with 

cases transferred to county court or filed as misdemeanors, only about half of the arrestees 

initially booked on felony charges become defendants in Circuit Court and eligible for BTC. 

Specialized services available to defendants in Jacksonville prior to BTC included the 

following: 

• Pretrial Intervention (PTI), staffed by the Florida Department of Corrections, served 

adult first-time felony offenders. PTI participants signed a deferred prosecution 

agreement that could include requirements to report to a probation officer, complete 

community service hours, pay restitution, or undergo mental health or substance abuse 

evaluations and treatment. Once the offender successfully completed the program, 

charges were dismissed. If the offender failed to meet the conditions of the PTI contract, 

the case could be rejected from the program and returned to the prosecutor for review 

and appropriate legal action. Cases were generally referred to this program within 20 to 

30 days of arrest. In 1997, 480 defendants in Duval County were referred to the program 

and 302 accepted and signed in to the program. Data were not available on how many 

of these defendants needed or received drug treatment. 

• Drug Court, established in 1991, offered diversion to defendants arrested for offenses 

involving the purchase of drugs, possession of drugs, or nonviolent drug-related felonies. 

3 Program Summary: UAB Substance Abuse Programs, January 30, 1996. 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 8 

To be accepted into drug court, defendants had to meet specific criteria and complete an 

intensive interview and screening process. Defendants who failed to satisfy program 

requirements were rejected from the program and had their cases returned to the 

prosecutor for appropriate legal action. In 1997, 570 defendants were referred to the 

program and 130 accepted and signed in to the program. 

At sentencing, the conditions of probation could include court monitoring and referral to 

community-based treatment programs, including the following: 

• Mental Health Services. In 1997, Duval County had a total of 50 adult crisis 

stabilization mental health beds for inpatient treatment and 67 day treatment slots. 

However, no special arrangements for accepting offenders were in place. 

• Drug Treatment. In 1997, the county had 25 medical detoxification beds, 72 adult 

substance abuse residential beds, and 83 day/night substance abuse treatment slots 

(four hours per day), with no special arrangements for accepting offenders. 

• Court-Monitored Probation/Community Control, established by one Circuit Court 

judge just prior to BTC implementation, used direct judicial oversight and management 

to monitor a defendant’s progress on probation/community control. The program was 

designed to take corrective action prior to a formal violation and rewarded compliance 

with probation requirements. This judge required all defendants who were placed on 

probation/community control and who lived within driving distance of Jacksonville to 

return to court periodically for a status conference (the first being 30 to 45 days after 

sentencing). Defendants who met their requirements were eligible for early termination 

of probation, while those who were not in compliance received sanctions, which could 

include intermediate sanctions such as increased probation requirements or a formal 

probation violation. A relatively small portion of these offenders had drug-related 

conditions of probation. 

Jacksonville, unlike the other two BTC sites, was not facing severe jail overcrowding and 

offered a broad array of treatment and education services in the jail. In 1997, approximately 30 

percent of all arrestees participated in some form of in-jail substance abuse education classes; 

approximately 1,000 people a year completed the classes; and 250 received intensive 

treatment. Programs included the following: 

• Services for Adults. The Duval County correctional system has provided substance 

abuse services to inmates since 1991. River Region Human Services operated a 66-bed 

modified therapeutic community residential treatment program for chemically dependent 

local offenders serving a county sentence. The program, 90 to 120 days long, was able 

to serve dual-diagnosis inmates and offered gender-specific programming. When the 

program developed a waiting list longer than one month, it activated a shorter six- to 

eight-week treatment program with 14 slots for male inmates. 

• Substance Abuse Prevention Classes. Twenty-five substance abuse prevention 

classes were held per week in the jail and were available to all sentenced and pretrial 

inmates. 

• Services for Juveniles. An intensive nonresidential treatment program (16 hours/week) 

served up to 30 adult-adjudicated juveniles between the ages of 14 and 17 housed in the 

jail. It was funded by the City of Jacksonville. 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 9 

Offenders sentenced to prison could receive treatment while incarcerated. However, 

decisions on access to these services were made independently of the local courts and were 

not expected to change following the introduction of BTC. 

TACOMA PRIOR TO BTC 

At the time of the BTC proposal, close to 8,000 persons were booked annually into the 

Pierce County jail on felony charges. Pierce County Pretrial Services worked with the jail staff to 

identify defendants eligible for release by reviewing the charge and criminal history and helped 

prepare the necessary papers. Although most defendants were released on bond within 24 

hours of arrest, the jail was severely overcrowded. 

Charges were screened by the prosecutor's office between booking and arraignment and 

filing decisions were made at that time, generally within 24 hours of booking. Charges were filed 

in over three-quarters of the cases. Felony cases, filed by one of the 41 attorneys assigned to 

the felony division, were assigned to Superior Court. Eleven judges handled over 5,500 cases 

per year in 1998 and 1999, an increase of 25 percent from 4,363 in 1990. Most felony 

defendants requested assigned counsel. In 1998, the assigned counsel handled nearly 5,000 

felony cases, averaging over 230 cases per attorney. Case processing moved rapidly: the 

pretrial hearing generally occurred within two weeks of arrest. Most cases were resolved in two 

months (median days to disposition was 62), but nearly a fifth (19 percent) remained open at the 

end of a year. 

For years prior to BTC, the Pierce County Alliance (PCA) had been providing communitybased chemical dependency services for drug-abusing offenders. When the BTC grant was 

received in 1997, PCA was operating the following programs: 

• The PCA TASC Program had an active caseload of 200 to 300 clients referred either 

from the Pierce County Superior Court or the local DOC Community Corrections 

Officers. Eligibility for TASC required evidence of substance abuse. Defendants were 

excluded for serious violent offenses, sex offenses, mental illness, and medical 

conditions requiring the ongoing use of psychoactive medications. Clients were referred 

to community-based treatment programs as needed and available. The options included 

long-term residential, inpatient, intensive outpatient, and outpatient treatment. These 

clients were required to provide periodic, random urine samples for monitoring purposes. 

• The Pierce County Drug Court started operation as a locally funded pilot project in 

1994 and became fully operational in 1996 under federal funding. Admission was limited 

to offenders diagnosed as substance abusers whose offenses did not include violence-, 

sex-, or weapons-related criminal charges. The program could accommodate 

approximately 300 active clients at any one time. Graduates of the 15- to 18-month 

program had their charges dismissed; those who failed had the maximum sentence 

imposed. In 1999, 242 defendants were admitted. 

Drug treatment services were available prior to the implementation of BTC for some 

offenders incarcerated in state prisons. A modified 40-week intensive outpatient treatment and 

aftercare regimen was provided at most major state corrections institutions, including prisons, 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 10 

prerelease facilities, and work-release facilities. However, there was a continual shortage of 

treatment slots. Priority for available treatment slots was given to offenders identified at 

sentencing under the provisions of the Drug Offender Sentencing Alternatives program. 

Because of overcrowding, drug treatment at the Pierce County jail was limited to weekly NA/AA 

meetings. 

CROSS-SITE SUMMARY OF THE PRE-BTC RESOURCES 

FOR DRUG-INVOLVED OFFENDERS 

Figures 3.1 and 3.2 compare the three jurisdictions in terms of their caseloads, resources, 

practices, and specialized programs prior to the start of BTC. Services for drug-using 

defendants were limited, and only a small proportion of the drug-using felony defendants in 

these jurisdictions were eligible for, or receiving, drug intervention services. None of the sites 

had traditional pretrial supervision units, although TASC provided pretrial case management for 

some defendants in Birmingham. All three had drug courts in operation, and two offered preplea 

diversion programs for selected defendants, but they served relatively small numbers of 

offenders. Only Jacksonville offered jail-based drug treatment. 

Differences in the courts were also found. The number of felony cases filed in Jacksonville 

in the year before BTC was nearly triple the number filed in Birmingham and Tacoma. Case 

processing was relatively rapid in Jacksonville and Tacoma, which both had a single-court 

structure, with cases reaching disposition about two months after filing. Filing was almost 

immediate in Tacoma, but typically occurred several weeks after arrest in Jacksonville, so that 

the period from arrest to disposition was longer in Jacksonville. In Birmingham, case processing 

was slow, primarily because of the two-tier court system, long waits for a grand jury review, and 

delays in filing in some cases. As a result, time for BTC pretrial intervention was quite short in 

Tacoma, somewhat longer in Jacksonville, and quite long in Birmingham. 

Figure 3.1. A Comparison of Felony Case Processing in the Demonstration Sites Prior to BTC 

Birmingham Jacksonville Tacoma 

Criminal Justice System 

Arrests 14,000 in 1996 15,000 in 1998 8,000 in 1998. 

Releases 68%; most within a week Over 70% within 72 hours 45% within a week 

(combines felonies and 

misdemeanors) 

Case Filing Over 5,000 in 1995 Over 15,000 in 1998 Over 5,500 1999; 

Dropped prior A very small percentage About 1/3 dropped; others 23% dropped before or at 

to filing dismissed prior to or at first transferred to county court, initial appearance 

appearance or charged as misdemeanors 

Case Duration 37% felony cases open at 82 days to disposition (19 to 60 to 120 days to 

end of a year filing) disposition 
PART I. BTC Implementation 

Chapter 3. The Demonstration Sites before BTC Implementation I – 11 

Figure 3.2. Demonstration Sites' Offender Release, Supervision, 

and Treatment Services prior to BTC 

Birmingham Jacksonville Tacoma 

Jail-based 

treatment 

Pretrial 

Release 

Services 

Case 

management 

Court 

Programs 

Probation 

Drug 

Interventions 

None 

Not offered 

Jail program identified baileligible and prepared 

paperwork; no supervision. 

TASC case management for 

about 600 in 1995 

Deferred Prosecution 

(on hold); several hundred 

per year referred to TASC 

Drug Court 

(113 entered in 1996) 

TASC screened over 1770 

offenders in 1995 and 

referred nearly 1500 for 

treatment, large majority on 

probation 

About 30% treated 

1000/year completed 

classes; 250 in intensive 

treatment 

None 

None 

Diversion (PTI) for first time 

felony defendants (302 in 

1997) 

Drug Court (130 entered in 

1997) 

Court-monitored probation 

(one of 4 judges) included a 

few defendants with drug 

requirements 

Unknown number 

Weekly NA/AA groups 

Pretrial program identified 

bail-eligible and prepared 

paperwork; no supervision 

None 

Felony TASC 

(569 in 1998) 

Drug Court 

(240 per year) 

TASC pretrial case 

management and probation 

referrals (200-300 clients at 

a time) 

The expansion of services faced different challenges depending on the location: 

• Limited jail space. The jails in Birmingham and Tacoma were severely overcrowded, 

thus limiting options for jail-based intervention. Only Jacksonville had jail-based drug 

treatment prior to BTC. This treatment included group sessions and an intensive 

treatment program. NA/AA groups met weekly in the Tacoma jail, but no treatment was 

available in the Jefferson County jail. 

• Limited drug treatment slots. Drug treatment slots available to offenders without 

insurance or the ability to pay were extremely limited relative to need, requiring that BTC 

either use its limited funds for treatment or compete for spaces with others in need of 

treatment. 

• Limited probation resources. Probation caseloads were large and probation staff was 

oriented toward enforcement rather than intervention, although all three probation 

departments had the option of referring clients to TASC or a local treatment agency. 

In conclusion, in all three BTC sites BTC-like interventions prior to case disposition were 

either quite limited in size and scope, or nonexistent. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 12 

CHAPTER 4. 

BTC IMPLEMENTATION 

his chapter documents BTC plans and implementation in Birmingham, Jacksonville, and TTacoma. BTC implementation fell short of the ideal in all three demonstration sites, 

highlighting the challenge facing coordinated efforts to reduce drug use among all drug-involved 

felony defendants released to the community while their cases are pending. Lessons from the 

BTC experience are identified to assist future efforts to intervene with drug-involved offenders. 

Additional information on the process of implementing BTC is found in the case study reports 

(Harrell, Hirst, and Mitchell 2000a, b, c). 

INITIAL PLANS FOR BTC 

All three sites made an early decision to target adult felony defendants on pretrial release 

who lived within the county or service area and could participate in intervention programs. 

However, there was considerable diversity in plans for implementing the four core BTC 

strategies, which were tailored to local needs and resources. 

Birmingham 

The Birmingham proposal for BTC called for the introduction of the following: 

• Procedures for early intervention, careful case management, and proper treatment 

referrals that would match the level of supervision and treatment to defendant needs. 

• Judicial review of all BTC defendants’ records of treatment participation and drug testing 

at each court appearance as a means of improving treatment retention and compliance 

with drug-testing requirements. 

• Appropriate and consistent use of graduated sanctions to support justice system 

requirements. 

• A continuum of services provided to offenders throughout their period of criminal justice 

supervision. 

• Ongoing collaborative planning by the justice agencies in Birmingham for the design and 

enactment of global change in the criminal justice system. 

The grantee agency in Birmingham was the TASC agency affiliated with the University of 

Alabama. BTC planned to begin case identification with drug tests and screening questions at 

the jail intake medical examination so that results could be available at the initial appearance. 

Drug-involved offenders would be required to report to BTC if released or provided treatment in 

jail if not released. TASC responsibilities included (1) conducting clinical assessments, (2) 

developing treatment plans, (3) random drug testing of released BTC clients, (4) referring clients 

to treatment and monitoring treatment progress, (5) sanctioning infractions of treatment and 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 13 

testing requirements, and (6) submitting reports to the court in advance of each hearing. Plans 

for expanded treatment options are shown in figure 4.1, reproduced from the agency’s proposal. 

Figure 4.1. Birmingham Plans for BTC 

Urinalysis 

i l

il

is 

ing 

i

Pl

Urinalysis 

El

i

is 

El ic 

Moni

i

Urinalysis 

El

ing 

l 

Break the Cycle 

Jail Screening 

Case 

Development 

Arrest 

TASC Case 

Management 

Random 

Urinalysis 

Drug Treatment 

Enhancements 

Jobs Program 

Electronic 

Monitoring 

Pretrial 

Day Reporting 

Deferred 

Prosecution 

Supervised 

Pretr al Re ease 

Ja Treatment 

TASC Case 

Management 

Random 

Urinalys

Drug Treatment 

Enhancements 

Jobs Program 

Electronic 

Monitor

Presentence 

Day Report ng 

Sentence 

anning 

TASC Case 

Management 

Random 

Drug Treatment 

Enhancements 

Jobs Program 

ectronic 

Monitoring 

Drug Court 

Day Report ng 

Community 

Service 

TASC Case 

Management 

Random 

Urinalys

Drug Treatment 

Enhancements 

Jobs Program 

ectron

toring 

Probation 

Day Reporting 

Community 

Serv ce 

TASC Case 

Management 

Random 

Drug Treatment 

Enhancements 

Jobs Program 

ectronic 

Monitor

Community 

Corrections 

Day Reporting 

Community 

Service 

Correctiona

Treatment 

Assessment 

Corrections 

Source: The Birmingham BTC Proposal to NIJ 

Jacksonville 

The City of Jacksonville, the grantee agency, planned to build a network of BTC services by 

contracting with existing justice and treatment agencies, supervised by a project director and 

administrative staff working for the city. Its proposal focused on six areas: 

• Designing effective program procedures for the early identification of drug-using felony 

defendants while implementing effective pretrial supervision, graduated sanctions, 

judicial oversight, and postsentence treatment. Screening and initial drug tests at 

booking, using medical services staff under contract to the jail, would be used to identify 

eligible defendants. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 14 

• Creating an entirely new pretrial services program for drug-using defendants, to include 

monitoring, supervision, case management, and service delivery. The Florida 

Department of Corrections agreed to establish a new Pretrial Services Unit (PTSU) to 

conduct drug tests and monitor compliance with treatment requirements. 

• Providing professional assessment and treatment planning. River Region, the local 

TASC agency, was to provide assessments, prepare treatment plans, and provide 

interim treatment for clients waiting for placement in outpatient or residential treatment. 

The interim treatment consisted of three education classes conducted once a week. 

• Expanding defendant access to outpatient and inpatient treatment. Gateway, a large 

agency that offered outpatient and residential treatment options, was to provide 

outpatient and inpatient treatment. 

• Developing a system for exchanging real-time information among agencies on the 

criminal justice status and drug intervention status of defendants to assist in monitoring 

offenders and encouraging compliance. The City of Jacksonville planned to modify its 

existing integrated criminal justice information system to meet the needs of BTC for 

information sharing. 

• Instituting strategies for planning and implementing changes. Plans included establishing 

a policy board with a steering committee to involve all key agencies in the planning 

process, preparing a memorandum of understanding to be signed by participating 

agencies indicating their commitment to BTC goals, and hiring a full-time project director. 

The flow chart included in Jacksonville’s proposal (figure 4.2) illustrates the points of 

program intervention planned for BTC-eligible cases. The chart presents BTC plans for 

continuous, seamless services from arrest (the drug test and screening questions administered 

as part of the jail medical examination that followed booking) through and after sentencing for 

defendants who are not incarcerated. These plans include jail-based treatment for participants 

held after their first court appearance and postrelease pretrial monitoring. 

Tacoma 

In Tacoma, BTC was led by the Pierce County Alliance, the TASC agency, which planned to 

colocate staff from several BTC partner agencies at a new facility that would provide a primary 

point of intervention. The Pierce County proposal focused on three areas: 

• Integrating the TASC and Drug Court programs with a new BTC Alternative Center to 

serve a much wider range of offenders. The new center, located a few blocks from the 

jail and courthouse, provided space for assessment, treatment planning, and case 

management; a drug-testing laboratory; meeting space for group treatment; offices for 

programmers to manage the automated data system; and space for liaison staff from the 

probation and sheriff's departments. 

• Using increased client supervision and graduated sanctions to ensure offender 

accountability and increase compliance with court and BTC treatment requirements. The 

plans indicated that case managers would use administrative sanctions for some 

infractions and that a single BTC judge would designate docket time one half-day per 

week for review of those in violation. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 15 Figure 4.2. Plans for the BTC Intervention in Jacksonville 

Continues through

criminal justice system

In-Jail Prison 

Treatment 

Negative Drug Court Treatment 

Test &non-drug or PTI as Needed 

arrest 

NOT BTC-ELIGIBLE 

Detained 

Positive Bond Arrest Screening Jail Test or Drug Hearing Sentencing/ Treatment

Arrest (First Disposition and Interview Assessment Booking & Drug Test as Needed BTC-ELIGIBLE Appearance) 

Released 

Probation 

Case Case-Managed Pretrial Dropped or Community-Bas

Services Dismissed Treatment Unit 

Outpatient Urine Residential Monitoring 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 16 

• Developing strategies for sharing resources, information, and responsibilities among the 

partner agencies and for ongoing collaborative management of BTC under the umbrella 

of an interagency Advisory Committee. BTC planned to modify the existing management 

information system (MIS) used by PCA to collect the additional data it needed. 

The Pierce County proposal presented two flow charts that illustrate the points of potential 

intervention in cases eligible for BTC. The first chart, figure 4.3, describes the pretrial case 

processing steps in Pierce County and notes the points at which eligible defendants would be 

identified and placed in BTC case management. The steps indicated screening and initial drug 

testing at the jail by BTC staff from TASC shortly after arrest. Judges would use the information 

to order eligible defendants to the BTC Alternative Center for assessment and placement in 

services. As figure 4.4 illustrates, BTC participation was expected to continue seamlessly 

through and after sentencing for those defendants not incarcerated. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 17 Figure 4.3. BTC Concept: Pre-Sentencing 

0 1 3 18 45-50 60-90 60-120 days 

Found 

Not Guilty 

Out of system

Not Case Found Guilty Guilty A NO Dismissed Plea

R YESR Initial Court Pre-Trial Charges Omnibus E Appearance Conference Sentencing Filed? (Arraignment) NOTE #1 Hearing Trial NOTE #4 S NOTE #2 T 

UA &

Screen UA

positive Judge

Authorizes Guilty Plea

UA BTC NOTE #3

negative Screener Post-sentencing . . . 

prepares Assessment

recommendation & enrollment No Action to the court. in BTC 

NOTE #1 Pre-Trial Conference A pre-trial conference between attorneys, 2-weeks post arraignment. Trial date is set; possible settlement reached in simple cases. Assignment to a BTC component, Drug Court, TASC, or BAC is made. 

Legend 

Judicial Process BTC Process Reports to court Status indicator Decision point Court appearance Process termination 

NOTE #2 Omnibus Hearing (45 days postarraignment) Plea negotiation likely; pretrial legal issues addressed with an Omnibus Order. 

NOTE #3 Guilty Plea Sentencing usually immediately follows; transferred to county jail or DOC, or release. (3-6 weeks, post arraignment) NOTE #4 Sentencing Court options re: “affirmative conduct” (go do this . . .”) limited to first offenders or to those for whom a special finding is entered that the sentence term is a “crime related prohibition” (not affirmative conduct) like “no using drugs & testing can occur to monitor this.” 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 18 Figure 4.4. BTC Concept: Post Sentencing 

Graduated 

State Prison sanctions 

imposed 

NOTE #9 

Sentence >365 days 

NOTE #5 

Post-Release 

Supervision Commodity Custody Up to 1 year Revocation SENTENCED (Alternative CCO Oversight recommended 

NOTE #7 Center)

NOTE #8

Sentence >365 days

YES 

NO Judicial Defendant violates 

Hearing Out of court ordered COUNTY System conditions? JAIL

NOTE #6 Revocation 

Ordered 

NOTE #5 State Prison For incarceration for over 1 year; BTC screening or assessment data can follow prisoner; judge may include need for substance abuse treatment in J&S 

NOTE #6 County Jail Term Up to one year; reduced by up to 1/3 “good time” and possible early release due to overcrowding; Sheriff control both. 

NOTE #7 NOTE #8 NOTE #9 Post-Release Supervision Community Custody Graduated Sanctions Up to one-year supervision Sheriff orders that custody Violations result in administraby a Community Corrections occur in the community with tive graduated sanctions. If Officer (CCO); will monitor regular reporting to necessary, court is notified and compliance with court’s Alternative Confinement a hearing occurs within 3-4 order; extended by time Center (BTC). Work crew, weeks if not in custody; 1-5 during which defendant is classes, work release; working days if in custody. non-compliant. BTC violations=administrative Court can modify sentence by attendance limited to decision to transfer custody converting requirements to jail monitoring for substance back to jailers after time and/or impose up to 60 abuse - no “affirmative graduated sanctions are days jail for each violation conduct” in most cases. tried. No court involvement. proven. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 19 

The following sections describe the implementation of BTC in each site and the lessons 

learned. 

EARLY INTERVENTION 

Plans to identify BTC-eligible offenders shortly after arrest proved difficult to implement in 

two sites owing to jail overcrowding. In Jacksonville, the Sheriff's Department incorporated a 

drug test and four questions into the medical examination at jail intake for all felony arrestees 

who lived in Duval County. However, in Birmingham and Tacoma, jail overcrowding placed 

heavy demands on staff to maintain security, book and release arrestees, and move arrestees 

for court appearances. In these sites, BTC was not able to arrange for jail escorts, secure 

access to bathrooms, and meet other requirements for acceptable testing in jails. After several 

months of trying to conduct initial drug tests and screening at the jail, these sites developed 

bond forms that required defendants to report to BTC offices for drug testing and screening 

within 24 hours of release. To encourage compliance and in recognition of the fact that these 

defendants would be under supervision while on release to the community, the bonds set lower 

cash amounts than had been previously used or increased the use of release without cash 

bond. 

BTC screening procedures at each site are shown in figure 4.5. The sites differed in the 

timing and location of screening and assessment and in the diagnostic tools used. These 

differences played a role in the widely differing numbers screened as assessed. Table 4.1 

presents data from monthly performance reports that the sites submitted to NIJ. Because there 

were changes in reporting forms and data availability issues, the statistics from the monthly 

reports believed to be most complete and accurate are used in this chapter to describe BTC 

implementation. The monthly statistics from Birmingham cover five months, while those from the 

other sites cover six months. These statistics have been converted to monthly estimates and 

used as indicators of service delivery across the period of full implementation. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 20 

Figure 4.5. Early Case Identification Procedures In The BTC Sites 

Birmingham Jacksonville Tacoma 

SCREEN IN G 

 When and Where Post-release at BTC Pre-release at jail intake Post release at BTC 

following arrest 

How Self-administered Four screening questions Questionnaire based on 

questionnaire and and Roche TestCup-4 drug the Texas Christian 

EMIT drug test test University Drug 

Dependence Screen and 

Martin Diagnostic 

International Rapid drug 

test 

ASSESSMENT 

 When and Where At BTC offices on In jail or at BTC offices At BTC offices, usually 

initial visit (usually (shortly after bond condition following group 

within week of arrest) requiring BTC issued) orientation meeting 

How Clinical interview SASSI (Substance Abuse Clinical Interview 

Subtle Screening Inventory) 

screener & DSM-IV 

assessment for abuse or 

dependence used to 

recommend placement on 

ASAM Level III.5 criteria 

*Screening in Jacksonville is before the BTC order; in Birmingham and Tacoma screening is after the BTC order. 

Table 4.1. Early Case Identification Statistics: 

Based on Monthly BTC Site Performance Reports to NIJ 

Birmingham Jacksonville Tacoma 

8/99 –12/99 9/00 – 2/01 7/00 – 12/00 

(5 months) (6 months) (6 months) 

Arrested on Eligible Charges 3,819 6,581 2,312 

Ordered to BTC as condition of release 2,486 1,142 1,410 

Screened by BTC* 1,827 4,331* 882 

Initial drug test 1,470 3,969 683 

Assessed/given treatment plan 1,827 1,093 772 

*Screening in Jacksonville occurs before the BTC order; in Birmingham and Tacoma screening follows the order to report to 

BTC. In all three sites, assessment and preparation of a treatment plan follow an order into BTC as a condition of the release 

bond. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 21 

In Birmingham, the BTC bond condition was widely used. Two-thirds of those arrested on 

eligible felony charges and released were required by their bond conditions to report to BTC for 

screening. Approximately 365 defendants were admitted to BTC each month; no count was 

maintained of the number screened and found ineligible. However, 73 percent of the defendants 

released and ordered to BTC were admitted (48 percent of those arrested on eligible charges). 

The screening consisted of a self-administered questionnaire and a drug test, administered on 

the first visit to TASC (usually within a week of arrest). Defendants who indicated any 

involvement in drug use were then assessed using a clinical interview, and a treatment plan was 

prepared. Defendants facing drug felony charges were placed in BTC drug testing for one 

month even without any indications of drug use and discharged from BTC if all tests were 

negative. After intake, TASC case managers were responsible for implementing the treatment 

plan. One advantage of postrelease screening in Birmingham was that the arrestees who were 

not detained because they posted bond at time of arrest (about one-third of all arrestees) could 

be ordered to BTC at their first court appearance. If screening had been limited to the jail, they 

would have been missed. 

In Jacksonville, jail medical staff screened an average of 722 arrestees per month with an 

initial drug test and four screening questions at jail entry. Thus, like Birmingham, Jacksonville 

screened two-thirds of those eligible by charge. Although BTC hoped that all who screened 

positive for drug use would be ordered to report to BTC as a condition of release, only 17 

percent of the charge-eligible defendants were ordered to BTC. While some of the chargeeligible defendants were not released from jail and others screened negative for drug use, it was 

clear that some magistrates and judges were not setting bonds that required BTC for all drugusing felony defendants. In an effort to increase appropriate early identification, two jail officers 

were stationed in the initial appearance courtroom to help identify BTC-eligible clients at the 

time bond conditions were being set. This helped reduce, but did not entirely solve, the problem. 

The River Region TASC program assessed defendants identified during the screening at the jail 

after they were ordered into BTC, contacting them either in jail or at the BTC offices. 

Assessments and treatment plans were completed for almost all of those who were given a BTC 

bond condition (97 percent). However, assessments indicating treatment needs did not always 

lead to intervention because (1) some were never released from jail and (2) some were 

released with BTC conditions but had their charges dropped by the State's Attorneys’ office. 

In Tacoma, screening and assessments were conducted by BTC case managers assigned 

to defendants when they reported to the BTC Alternative Center. Reporting to BTC was a 

condition of bond for 61 percent of the charge-eligible defendants (1,410 of 2,312). Of those 

ordered in, 63 percent reported to BTC at least once, 48 percent were given an initial drug test, 

and 55 percent were given a treatment plan. Thus, 33 percent of those arrested on eligible 

charges were screened and given a treatment plan. To increase compliance with orders to 

report to BTC, Tacoma developed a warning letter that was hand delivered by a deputy sheriff to 

the homes of those who failed to come in. 

To facilitate cross-site comparisons, the statistics for the sites (available for differing periods 

of time) were converted to the estimates of per-month screening and assessment activities 

shown in figure 4.6. In comparing sites, it is important to remember that in Jacksonville not 

everyone who was screened was ordered into BTC, whereas in Birmingham and Tacoma 

screening and assessment followed the order to report to BTC. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 22 

Figure 4.6. Per Month BTC Case Identification Activity, by Site 

BIRMINGH AM J ACKSONVILLE 

Number of arrestees Number of arrestees 

1,400 1,400 1,316 

764 

294 

0 0 

497 

365 365 

200 

400 

600 

800 

1,000 

1,200 

190 

721 

567 

182 200 

400 

600 

800 

1,000 

1,200 

Charge -- Ordered to Screened Given Given Charge -- Ordered to Screened Given Given 

Eligible BTC Initial Drug Treatment Eligible BTC Initial Drug Treatment 

Test Plan Test Plan 

TAC O MA 

Number of arrestees 

1,400 

1,200 

1,000 

800 

600 

400 311 

52 32 

0 

162 112 200 

Charge -- Ordered to Screened Given Given 

Eligible BTC (and Initial Drug Treatment 

released) Tes t Plan 

The comparison of sites highlights the potential advantages and disadvantages of 

conducting the initial screening in jail. 

• In-Jail Screening. One advantage of in-jail screening is that results are available at the 

time of the release decision and can be used in setting release conditions. Another is 

that results can be used to identify detained defendants who should receive treatment in 

jail (if available). This procedure resulted in screening the highest proportion of chargeeligible arrestees. However, in-jail screening wastes resources if drug users do not 

subsequently receive an intervention because charges are dropped, reduced to 

misdemeanors, or shifted to another jurisdiction. Moreover, in Jacksonville, many 

defendants with positive screening results were not ordered to report to BTC as a 

condition of their release. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 23 

• Postrelease Screening. Advantages of postrelease screening are that it does not 

require jail space and staff. It saved resources in Tacoma and Birmingham, where jailbased treatment was limited to weekly NA/AA groups. Postrelease screening and 

assessment allowed case managers to make immediate referrals to treatment. However, 

limiting screening to those released may fail to identify the most seriously addicted 

defendants, who by virtue of their criminal history and lack of cash may be less likely to 

be released. Another potential disadvantage is that postrelease screening gives 

arrestees advance warning of a test and a chance to avoid detection by abstaining from 

drug use prior to the initial test. In response to these concerns, Birmingham required 

defendants arrested on drug felony charges to test negative for drugs on weekly tests for 

at least one month before concluding that they were not users and releasing them from 

BTC. 

A comparison of Birmingham and Tacoma rates of screening completion for defendants 

released from jail and ordered to BTC suggests that conducting the full clinical assessment at 

the time of first contact will increase the proportion of defendants given a treatment plan. 

Immediate assessment also allows the treatment referral process to begin at once and reduces 

the level of effort required to track down those who have not been assessed. 

THE BTC INTERVENTIONS: TREATMENT AND TESTING 

The interventions offered by BTC sites were divided into categories based on the intensity 

of intervention. The least intensive intervention required drug testing, monitoring, and sanctions. 

Defendants in this intervention were given random drug tests; the tests were conducted weekly 

at first and less frequently later if defendants consistently tested clean. Those who tested 

positive for drugs or failed to appear were warned, reevaluated, and/or referred to court for a 

compliance hearing. Drug users without indicators of abuse or dependence, and, in the case of 

Birmingham, defendants who showed no evidence of drug use but had been arrested on drug 

felony charges were assigned to this intervention. 

All three sites offered educational groups with drug testing for BTC participants. The groups 

were used primarily to ready clients for treatment while they were waiting to get into an inpatient 

or outpatient program and for some clients with a repeat history of drug arrests. Defendants in 

need of more intensive treatment were referred to community-based outpatient and residential 

programs with the goal of matching client characteristics, needs, and type of drug problem to an 

appropriate treatment modality. Although some delays in treatment entry occurred when spaces 

were not available or when clients needed to qualify for public funding, the wait for treatment 

was a serious problem only in Tacoma. The more intensive drug interventions included 

outpatient programs of varying intensity and residential treatment. 

BTC sites used the results of the assessments to assign defendants to a level of drug 

intervention based on the severity of their drug involvement. The drug use reported by BTC 

participants in the impact evaluation samples differed in type and severity of abuse across the 

three sites (table 4.2). In Birmingham, over half (55 percent) of the BTC clients who completed a 

drug test at intake tested positive on their initial drug test, compared with 65 percent in 

Jacksonville and 68 percent in Tacoma. Abuse problems, as measured by ASI drug composite 

scores above .04 at baseline, were reported by 33 percent of the Birmingham BTC sample, 71 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 24 

percent of the Jacksonville sample, and 60 percent of the Tacoma sample (Harrell, Marlow, and 

Merrill 2000). The lower rate of abuse-level drug use in Birmingham is consistent with the 

practice of admitting defendants charged with drug felonies for surveillance testing for one 

month and with the lower levels of drug use found during screening. 

Table 4.2. Drug Use among BTC Clients in the Impact Evaluation Sample Reported 

on the Baseline Survey 

Birmingham Jacksonville Tacoma 

n= 374 n=332 n=382 

Mean ASI composite drug abuse 0.049 0.153 0.120 

score 

 % with an ASI score above .04 36% 70% 64% 

DRUGS USED 

 Methamphetamines 

Cocaine or Heroin, no 

methamphetamines 

Other drugs, none of above 

No drug use reported 

2% 1% 43% 

36% 62% 19% 

36% 28% 14% 

26% 10% 25% 

The drug treatment statistics in table 4.3 for Birmingham come from monthly performance 

reports to NIJ and refer to the initial placement. The numbers in the table can reflect multiple 

placements. Clients often began BTC in drug testing and groups while waiting for placement in 

outpatient or residential programs. Initial placement in outpatient or residential treatment was 

recorded in the Birmingham MIS for 277 participants (12 percent of those given a treatment 

plan). However, when we classified BTC participants in Birmingham by the most intensive 

treatment received over the period of their participation, we found that 12 percent received 

residential treatment, 54 percent received outpatient treatment, and 30 percent received 

urinalysis (UA) monitoring only. Thus, many clients moved from UA placement to more intensive 

intervention over time. The statistics for Jacksonville and Tacoma were based on a special 

review of program records to identify all treatment placements, not just initial placements. In 

Jacksonville, 57 participants (5 percent of those given a treatment plan) received outpatient or 

residential treatment at some time during their participation. In Tacoma, 396 participants (51 

percent of those given a treatment plan) received one of these services at some time during 

BTC. 

The information in the table is based on what BTC sites reported on their monthly 

performance reports, but these records vary in completeness and accuracy. Consistent and 

reliable data on treatment participation and progress were not available because plans to 

implement computerized MISs to track these variables encountered substantial problems in 

implementation and were not used consistently. The numbers reported above may be low if 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 25 

case managers failed to enter services delivered. Because BTC clients were assigned to a large 

number of different treatment providers, we were not able to assess the appropriateness of 

particular treatment programs or the quality of treatment provided. Criminal justice agencies and 

researchers need standardized strategies for measuring treatment appropriateness and quality 

to help in program development and evaluation. 

Table 4.3. Drug Interventions reported on the Monthly Performance Reports to NIJ 

Birmingham 

Initial Placement 

Jacksonville 

Any Placement 

Tacoma 

Any Placement 

8/99 –12/99 

(5 months) 

9/00 through 2/01 

(6 months) 

7/00 through 12/00 

(6 months) 

DRUG TREAT M ENT 

Residential 

Placed 36 7* 85 

Average # days enrolled 51 days NA** 56 days 

(for closed cases) 

Outpatient

 Placed 177 50 311 

Average # days enrolled 

(for closed cases) 

51 days NA** 108 days 

Drug Education/Other Groups

 Placed 175 230 16 

Only UA Monitoring 

Placed 1,576 399 249 

(in 4 months) 

Average # days enrolled 77 days NA** 50 days 

(for closed cases) 

*Based on files for six months. Annual expenditure data showed 175 BTC clients entered treatment at Gateway: 161 received 

outpatient treatment, 6 received residential treatment, 8 received both residential and outpatient treatment. 

**Time in treatment was not recorded in the Jacksonville. 

OFFENDER ACCOUNTABILITY: 

MONITORING, SANCTIONING, AND JUDICIAL OVERSIGHT 

As noted above, the responsibility for surveillance and response to noncompliance during 

pretrial release was assigned to case managers in Birmingham and Tacoma and to a BTC 

Pretrial Supervision Unit in Jacksonville. The case mangers or pretrial officers were expected to 

monitor participants' compliance with drug test requirements and treatment plans, prepare 

reports on compliance prior to each hearing, and administer a set of graduated sanctions for 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 26 

failure to comply. These sanctions, termed administrative sanctions, included warning letters, 

extra appointments, additional drug tests, more intensive treatment, and, when necessary, 

requests for noncompliance review by the judges. 

Although BTC planned to continue the supervision requirements and procedures for 

defendants placed on probation at sentencing, only Tacoma achieved some success in 

sustaining BTC interventions when clients moved from pretrial status to probation. The 

probation departments in Birmingham and Jacksonville had huge caseloads and few resources, 

and they resisted the extra work (and therapeutic orientation) that BTC procedures entailed. The 

result was limited participation in continued intervention following sentencing. Strategies that 

helped Tacoma integrate pretrial and probation services included (1) stationing a liaison 

probation officer at the BTC offices and (2) working with the DOC to implement a new state law 

giving DOC responsibility for probation violation hearings. The new law's endorsement of interim 

administrative sanctions and strong support for BTC from top state and regional corrections 

officials further assisted BTC. 

Data on infractions and sanctions shown in table 4.4 for Birmingham and Jacksonville come 

from the monthly performance reports on BTC participants submitted to NIJ; for Tacoma, the 

MIS data are based on the subset of BTC participants included in the impact evaluation sample. 

In Birmingham, MIS records indicated that 82 percent of the BTC participants incurred an 

infraction, at an average of 8.5 infractions apiece, mostly for skipping a drug test or testing 

positive. Nearly 90 percent of the clients with infractions received a TASC sanction, at an 

average of three infractions apiece. However, multiple infractions (an average of 2.6) typically 

preceded each sanction. The sanctions included an “alert” letter that warned noncompliant 

clients (received by 60 percent of the violators), case review by the case manager (received by 

42 percent of the violators), and termination from BTC (received by 23 percent of the violators). 

Case managers made additional treatment referrals for 10 percent of those who had infractions. 

Increased supervision and increased drug testing were rarely used to respond to compliance 

problems. The time between the first infraction and the first sanction averaged over one month. 

The number of days between the next infraction and the next sanction gradually declined, with 

the second sanction occurring about three weeks after the next infraction, and the third about 

two weeks after the next infraction. BTC case managers in Birmingham provided reports on the 

client’s drug test results, treatment compliance information, and case management compliance 

information before hearings. Judges sometimes referred to these reports and sometimes did 

not. Overall, the court imposed sanctions on 7 percent of all defendants with drug test violations 

and 9 percent of those with other infractions. Sanctions involving jail time were received by 72 

(2 percent) of the more than 3,000 BTC clients in the database. 

In Jacksonville, the PTSU recorded infractions for 20 percent of the BTC clients (233 out of 

1,121). These included 132 positive drug tests and 326 other infractions (such as failure to 

report to PTSU, failure to comply with treatment, or rearrest). Only 8 of the infractions were not 

linked to a sanction, and some received multiple sanctions: 82 were sanctioned twice and 6 

were sanctioned three times. The most frequently used sanctions were a warning letter (181), 

meeting with the PTSU officer (122), and a violation report to the court (102). The average time 

from infraction to sanction was 2.24 days, indicating a swift response to detected infractions. 

However, PTSU apparently failed to detect many infractions. The132 positive drug test results 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 27 

were only 19 percent of the 684 positive results on drug tests conducted after BTC entry. 

Judicial sanctioning during the study period of September 2000 through January 2001 was 

relatively rare. PTSU filed 102 requests for violation hearings. A total of 23 violation hearings 

were held. According to PTSU, no action was taken in 10 of the hearings (no reason was 

recorded), a jail penalty was imposed in 3, and another type of sanction such as referral for a 

TASC reassessment was imposed in 10. No violation hearing was scheduled by the State's 

Attorneys’ office for 74 requests. 

In Tacoma, a review of BTC records for clients included in the impact evaluation sample 

found 1,969 infractions for the 383 BTC sample members—an average of 5.1 per client. The 

large majority of the infractions (71 percent) involved drug test failures. The number of sanctions 

exceeded the number of infractions, indicating that some clients received more than one 

sanction per infraction. One judge reserved one afternoon a week for BTC review hearings for 

clients on pretrial release (postsentencing reviews became the responsibility of the Corrections 

Department) and ordered 761 sanctions. If a client failed to appear at a review hearing, a 

warrant was issued. Tacoma was the only BTC site to achieve judicial monitoring and 

sanctioning as specified in the model. 

Under a state law enacted during the BTC demonstration, responsibility for reviewing and 

sanctioning noncompliance of offenders on probation was assigned to the Department of 

Corrections. The DOC worked with BTC to develop procedures for responding to 

noncompliance using graduated sanctions that were consistent with BTC guidelines. However, 

data on DOC sanctions for probation violations were not available. 

Table 4.4. Compliance and Sanctioning in BTC 

Tacoma 

Birmingham 

8/99 – 12/99 

n=1,827 

Jacksonville 

9/00 through 2/01 

n= 1,073 

BTC clients in Impact 

Sample 

n=383 

Compliance Monitoring 

% positive 23% 43% 30% 

Infractions Number

 Average 

Failed to appear in court 

8,601 

(4.7 per client) 

12 

458 

(0.4 per client) 

NA 

1,969 

(5.1 per client) 

NA

# drug tests 17,715 2,962 4,685

 New Arrest 4 27 NA 

Positive, Missed or Diluted 7,321 132 1,404 

drug test 

Failed to comply with 1,167 49 436 

Treatment 

Other noncompliance 97 250 129 

Sanctions Recorded by 

BTC staff 

Administrative Sanction 750 445 1,416 

Judicial/court Sanction 28 10 761 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 28

The strategies used to convey the message that sanctions would be imposed had a 

significant effect on the offenders’ perceptions of procedural fairness and sanction risk in 

Jacksonville and Tacoma, the two sites in which perceptions measures were added to the 

questionnaires. The perceptions of BTC participants were compared with those of similar 

defendants arrested in the year before BTC. The comparison was based on ratings nine months 

after arrest of the fairness and risk of sanctioning for drug test failures and missing drug 

treatment. General linear models were used to test the hypothesis that there was no difference 

in perceptions between groups nine months after arrest, controlling for similar perceptions 

shortly following arrest and other differences among respondents, including prior arrest. 

The results in table 4.5 show that BTC participants in both Jacksonville and Tacoma rated 

the judges significantly higher on fairness than defendants arrested the prior year. In 

Jacksonville, but not Tacoma, the BTC participants also assigned a higher fairness rating to the 

case outcome than defendants arrested the prior year. Even larger differences were found in 

ratings of the risk of sanctions. BTC participants rated the risks of sanctions for missing drug 

treatment and failing a drug test significantly higher than did defendants arrested the prior year 

(table 4.6). The least square means, shown in figures 4.7 and 4.8, illustrate the magnitude of the 

differences, controlling for the other variables in the models. 

Table 4.5. General Linear Models of Perceived Fairness at Followup 

Of the Judge Of Case Outcome 

 Jacksonville Tacoma Jacksonville Tacoma 

BTC Treatment 17.69 *** 11.83 ** 14.39 *** 0.27 

Age 0.02 0.83 0.08 0.10 

Age Squared 0.00 0.49 0.15 0.46 

Female 0.00 10.71 ** 0.03 0.00 

Black 1.39 3.01 1.45 0.58 

Education 0.00 2.62 1.42 3.46 * 

Marital Status 1.01 3.46 0.00 0.00 

Days Worked 0.12 0.29 0.06 2.42 

Months Incarcerated 2.98 0.48 1.74 3.67 * 

On probation/parole 8.73 * 0.27 0.59 0.00 

Number of Prior Arrests 2.27 1.66 0.29 0.72 

Number of Drugs Used 0.13 2.46 0.64 0.67 

Number of Self-Reported Offenses 2.14 0.03 0.25 4.56 * 

N: 456 461 331 363 

Model F Value: 2.86 *** 2.23 ** 4.03 *** 2.3 ** 

df: 13,442 13,447 13,317 13,349 

R2: 0.08 0.06 0.14 0.08 

*p<.05, **p<.01, ***p<.001 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 29

Table 4.6. General Linear Models of Perceived Certainty of Sanction 

Missed Drug Treatment Failed Drug Test 

 Jacksonville Tacoma Jacksonville Tacoma 

BTC Treatment 184.92 *** 117.22 *** 77.85 ** 113.76 ***

Age 5.92 0.26 42.42 * 0.04 

Age Squared 6.84 1.27 42.76 * 0.06 

Female 53.59 * 7.85 32.29 47.13 * 

Black 9.47 0.52 7.91 20.54 

Education 11.41 3.17 6.97 0.72 

Marital Status 10.65 4.73 11.53 0.28 

Days Worked 17.48 0.03 48.69 * 11.20 

Months Incarcerated 0.04 0.86 0.53 14.29 

On probation/parole 38.79 0.46 44.05 * 0.94 

Number of Prior Arrests 18.55 3.04 7.55 0.12 

Number of Drugs Used 0.18 35.51 * 1.49 68.70 **

Number of Self-Reported Offenses 40.56 28.30 21.07 0.92 

Certainty at Baseline 3.13 156.59 *** 12.98 36.48 * 

N: 413 470 403 461 

Model F Value: 2.94 *** 3.69 *** 2.64 ** 2.87 ***

df: 14 & 398 14 & 455 14 & 388 14 & 446

R2: 0.09 0.10 0.09 0.08 

*p<.05, **p<.01, ***p<.001 

These findings taken together illustrate that BTC increased the perceptions of sanction risk 

in a way that participants perceived as fair and suggest that the process of clearly defining 

expectations for defendants on pretrial release was effective. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 30 

Figure 4.7. Rating of Fairness of the Judge and Case Outcome at Follow-up 

8 

BT C 

7 Com p aris on 

6 

5 4.3

4

3

2

1

+ = p<.10 0

* = p<.05 

** = p<.01 

*** = p<.001 

** 

3.5 3.6 

2.8 2.9 3.1 3.2 

3.9 

*** 

*** 

Jacksonville Tacoma Jacksonville Tacoma 

Fairness of Fairness of 

Judge Case Outcomes 

Least square means controlling for individual characteristics and criminal history at Baseline 

Figure 4.8.

Follow-up 

+ = p<.10 

* = p<.05 

** = p<.01 

*** = p<.001 

Rating of Certainty of Sanctions for Drug-Related Infractions at 

8 

BTC 

Co mp ariso n 6.6

6

5

4

3

2

1

7 6.7 

0 

** 

*** 

4.2 4.4 

3.3 

5.7 

3.1 

5.2 *** 

*** 

Jacksonville Tacoma Jacksonville Tacoma 

Certainty of Sanction

for Missing Drug

Treatment

Certainty of Sanction 

for Drug Test 

Failure 

Least square estimates controlling for sample member risk and perceived certainty at baseline 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 31 

FINDINGS ON DRUG INTERVENTIONS FOR FELONY DEFENDANTS 

Models for Treatment and Monitoring 

Our process evaluation identified two distinct models of intervention. One combined 

traditional case management with duties often assigned to supervision agencies for monitoring 

drug test results, filing reports on noncompliance, and imposing sanctions. The other divided these 

responsibilities between treatment providers and a newly created BTC supervision unit. 

Model 1: The TASC Model of Case Management and Monitoring. In Birmingham and 

Tacoma, the two sites in which the TASC agency administered the BTC initiative, a single 

agency assumed responsibility for screening, assessment, treatment planning and case 

management, drug testing, and compliance monitoring. In those two sites, the BTC intervention 

heavily emphasized case management capacity to develop and implement individualized 

interventions adjusted to a broad range of drug use patterns, from infrequent use to severe 

addiction. In addition to their traditional role of making referrals and monitoring treatment 

progress, case managers were expected to deliver administrative sanctions for noncompliance 

with testing or treatment and report persistent problems to the court. 

• In Birmingham, TASC case managers conducted the assessments at their offices or at a 

new, very small satellite office near the court. Defendants completed a self-administered 

screening questionnaire, followed by a clinical assessment by a case manager if the 

defendant reported drug use on the questionnaire. A drug test followed the screening (or 

assessment if one was done). Decisions on BTC eligibility were made at that time, and 

those who reported drug use or tested positive received a random drug testing 

assignment and an appointment with a case manager for discussion of treatment needs 

and services. Those waiting for treatment placement were often enrolled in group 

sessions at TASC in the interim. 

• In Tacoma, the defendants reported for an orientation to BTC, at which time BTC staff 

described the BTC program requirements, collected basic demographic information, and 

scheduled an assessment and treatment planning appointment with a case manager 

within a few weeks. Immediately following the orientation, defendants were given a drug 

test and placed in weekly random drug testing. To ease the overwhelming demands on 

the case management staff, Tacoma tried using early drug test results to identify those 

who needed assessment and treatment. Selected defendants were placed in drug 

testing for one month prior to entering case management. Those who tested positive 

during this trial period were scheduled for assessment. However, this plan was 

abandoned because most of these clients failed the drug tests and were referred to 

assessment anyway. BTC clients were placed in case management in one of three 

programs: BTC, TASC, or drug court. All three programs were operated by PCA, were 

instructed to use consistent monitoring and sanctioning procedures, and entered data on 

the same MIS. At a client’s first appointment, the case managers conducted an 

assessment, prepared treatment recommendations, and initiated the treatment 

placement process. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 32 

Model 2: Separation of Treatment and Monitoring. Jacksonville developed a model in 

which agencies divided responsibility for the core BTC components. The jail medical staff 

conducted initial screening. On the basis of the screening results, eligible defendants were 

ordered as a bond condition to report to the BTC PTSU within 24 hours of release. PTSU, 

operated by the Florida Department of Corrections under a contract from BTC, assigned clients 

to regular random drug testing, monitored their compliance, and reported continued 

noncompliance to the courts. Under contract to BTC, the TASC agency (River Region) 

conducted assessments either in jail before release or at the BTC offices after release and 

notified PTSU of its treatment recommendations. The TASC agency also held a three-session 

interim treatment program for clients who were waiting for more intensive treatment and was 

responsible for drug testing of clients referred to this program. Clients in need of outpatient or 

residential drug treatment were referred to a large treatment agency (Gateway), which provided 

treatment under contract to BTC. The BTC project director, working for the City of Jacksonville, 

the grantee agency, managed the contracts and the process of interagency collaboration. This 

model built upon the strengths and specialized skills of the partner agencies, but resulted in less 

fully integrated service delivery. 

In practice, this model seemed to split the intervention clearly into coerced abstinence for 

nonaddicted drug users and treatment for those meeting clinical criteria of abuse or 

dependence. PTSU, staffed by probation officers, maintained records and requested violation 

hearings if needed for BTC clients in any intervention tracks. PTSU tested, supervised, and 

sanctioned defendants who used drugs but were not found to need treatment. Such defendants 

proved to be the majority of BTC clients. Although the treatment programs assumed the 

responsibility for drug testing, monitoring treatment attendance, and reporting client compliance 

status to PTSU for BTC clients referred to them, such reports were rare and the focus for these 

offenders was on treatment. 

One problem all three sites faced was that BTC plans did not specify what would happen in 

cases of sustained noncompliance or conditions under which participants would be terminated 

from BTC services. There seemed to be an implicit belief that sustained noncompliance would 

result in judicial sanctions that would graduate in severity and culminate in pretrial detention 

pending case disposition (before sentencing) or in probation revocation (after sentencing). The 

influx of cases resulted in much higher than anticipated caseloads, particularly in Birmingham 

and also in Tacoma, and the high caseloads reduced case managers’ capacity to provide close 

monitoring and deliver sanctions in a timely fashion. This problem was exacerbated by the lack 

of automated data systems linked to other agencies, which would have enabled case managers 

to distinguish inactive BTC clients (in jail or out on warrant) from those expected to be reporting 

regularly and to monitor treatment attendance and drug test results easily. 

The Critical Role of Data in Maintaining Accountability 

The BTC demonstrations highlighted the critical role of automated data systems in 

interventions aimed at large numbers of individuals. In order to ensure offender accountability, 

criminal justice agencies must know the whereabouts of those under their supervision, and, in 

the case of BTC, be able to exchange information on compliance with BTC requirements with 

partner agencies. This proved to be very difficult. Lack of access to timely information on 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 33 

defendant release status affected BTC services both at screening and throughout the program. 

Because arrestees could post bond at any time and could be picked up on other charges at any 

time, it was difficult to determine when failure to appear for testing or appointments was 

deliberate noncompliance and when it resulted from incarceration. Efforts to exchange 

information were only partially successful and relied heavily on faxing, which was difficult, given 

the large numbers of BTC clients and their constantly shifting criminal justice status. 

Birmingham began BTC with no automated record keeping in place for case managers. 

BTC planned to use the MIS developed by the Center for Court Innovation for the Brooklyn 

Treatment Court. However, the system was written in Sybase, and Birmingham faced many 

delays and false starts in locating programmers to adapt the programs to BTC applications. 

Problems in arranging automated downloading of drug test results into the system resulted in 

delays, sometimes substantial, during the project. Once the conversion was finally completed, it 

was used successfully to record screening results, assessments, and treatment referrals, to 

produce reports to the court, and to generate alert letters to clients. Shortly into operations, BTC 

recognized the need for timely access to jail records to determine which defendants had been 

released and were due to report. However, lengthy negotiations with the jail and the county 

agency that maintained the automated jail data failed to produce automated links that would 

facilitate checking on defendant release status. The need for additional hardware to link the 

systems and confidentiality concerns became insurmountable obstacles, due in part to 

reservations about BTC among jail staff. As a result, the only way for BTC case managers to 

determine defendant jail status was to review chronological (not alphabetical) daily release logs 

from the jail. This could not realistically be done for hundreds of clients on a daily basis. 

Jacksonville entered BTC with an integrated data system maintained by the city. The city, 

as the prime BTC grantee, planned to modify the system to use it in tracking BTC defendants. 

However, the system proved more difficult to use than anticipated. Problems included 

incompatible court and jail data and resistance to system changes that would facilitate tracking 

BTC hearings and court responses to violations. In the face of Y2K threats to computer 

systems, the city was unable to devote the needed programming resources. Subsequently, the 

MODIS Corporation was hired to assist in programming an independent, web-based data 

management system for BTC. This system attained operational status but was never used 

consistently by the partner agencies. As a result, the data on agency performance reported 

above were updated and cleaned for use in the evaluation after the end of the demonstration. 

The lack of a functional data system forced BTC to rely on less reliable and more labor-intensive 

communication strategies. Jail staff notified the PTSU by fax of the release of BTC defendants. 

PTSU staff stationed at the court faxed information on BTC hearing outcomes to the supervision 

unit. PTSU relied on treatment providers to notify them of client noncompliance. 

Tacoma began BTC with a plan to have the court transmit copies of BTC release orders 

(bond conditions) to the BTC offices. This alerted the staff to the order, but determining which 

defendants had been released required looking each one up on the jail data system one at a 

time (and presumably each day until release). However, near the end of the study period, 

selected key elements of jail data were integrated into the court data system (Legal INformation 

eXchange, or LINX) and made available to BTC. This enabled the program to download data on 

defendants, reducing data entry labor, and provided data on jail releases. For case management 

and client compliance tracking, BTC planned to adapt the MIS used by Pierce County Alliance 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 34 

for the drug court and TASC programs. However, the MIS was privately owned by the vendor 

that created it, and BTC encountered significant delays in obtaining the new applications it 

needed. These applications were needed to support computerized monitoring of drug testing, 

compliance, and sanctions. Because the vendor was converting the system to a new computer 

language, BTC experienced multiple problems with the new system, including slow processing 

and computer crashes in both the core applications and BTC additions, which were added 

slowly over time. As a result, case managers, faced with recurring program bugs and delays, 

relied heavily on paper files, and BTC had to hire staff to enter data to help them keep up and to 

enter reports on client compliance faxed or sent by probation officers and treatment providers. 

Managing Collaboration among BTC Partner Agencies 

The BTC sites began operations with letters of commitment from judges, prosecutors, 

sheriffs, probation directors, treatment providers, and TASC agencies. Strategies for translating 

these commitments to operations entailed establishing policy boards that met regularly and had 

authority to negotiate changes in policies and procedures that governed internal agency 

operations and interagency relationships. BTC, like many other demonstration projects, found 

that effective joint problem solving and strong local leadership were necessary. 

In Birmingham and Jacksonville, the grantee agency charged with managing BTC (the 

TASC agency and the city, respectively) had to try to reform the justice system from the outside. 

Despite a long history of TASC referrals from the courts and probation in Birmingham, previous 

efforts had not involved joint planning and shared responsibility for offender management, but 

rather had been built on clearly delineated areas of responsibility delegated to each agency. In 

Birmingham, it took some time for BTC to build a working policy board, but leaders there cite the 

legacy of interagency collaboration as a lasting contribution of BTC. In Jacksonville, prior 

collaborations had been led not by the city, but by agencies within the justice system. This fact 

made it difficult to get senior judges and prosecutors involved in decisions on BTC operations 

and to institutionalize BTC operations within the courts. However, Jacksonville's steering 

committee evolved into a strong working team that devoted considerable attention to developing 

procedures for smooth coordination in which each agency understood its role and 

responsibilities. Although the lead agency in Tacoma was also a TASC agency, there was a long 

history of joint problem solving and sharing of resources through policy board meetings 

attended by senior staff of the justice agencies. This history facilitated relatively rapid progress 

during the planning phase. 

Two techniques used successfully to facilitate collaboration among the agencies in all BTC 

sites were (1) the development of detailed strategic plans that specified needed changes, set 

deadlines, and assigned responsibility for tasks and (2) the preparation of written 

memorandums of understanding describing the purpose of BTC and the role of each agency in 

implementation. 

In all three cities, the most challenging management problem was engaging the state 

agencies that managed probation in making rather substantial changes in supervision practices 

to accommodate the local BTC vision of combining treatment and monitoring. These state 

agencies had statewide policies, data systems, and management that made it hard to be flexible 

and make changes in a specific jurisdiction. Moreover, the top officials were located in other 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 35 

cities and could not attend policy board meetings. This situation required extra willingness on 

the part of the regional directors to take on the challenge of training and encouraging their staff 

to participate in local partnerships. 

Lessons for the Future 

Despite the challenges, BTC had an important and lasting effect on the demonstration sites. 

The program generated considerable local political support and is continuing with substantial 

local funding in all three sites. There are several reasons for this. One is that BTC is seen as an 

appropriate and effective alternative to pretrial detention. This was very important to the sites 

with overcrowded jails. The availability of supervision, drug testing, and penalties for continued 

drug use increased the courts’ willingness to release arrestees while their cases were pending 

and provided the justice system with strategies for addressing a factor that contributes to the 

risk of reoffending. These facts suggest that improvements in the strategies for coordinated drug 

intervention are valued and that additional work needs to be done to identify ways to deliver 

these services efficiently and consistently. 

As a feasibility test, BTC was extremely successful in identifying strategies for, and the 

challenges of, interagency collaborations focusing on reducing recidivism and drug use among 

individuals under supervision. Challenges to undertaking the broad system reforms planned for 

BTC were significant in some sites and clearly influenced the extent to which the projects were 

able to achieve their implementation goals. The most serious challenges included the following: 

• Jail Overcrowding. BTC efforts to introduce new testing and screening procedures 

faced serious problems in the two sites with severe jail overcrowding. The new 

procedures placed additional time demands on jail staff, required proper facilities for 

drug testing, involved arranging access to new arrestees by qualified substance abuse 

screeners, and required space for adding jail-based treatment options. 

• Exchange of Information among Key Agencies. The computerized databases at the 

jail, courts, probation, and prosecution offices were not designed to support case 

management of individual defendants. The case management data systems in the 

treatment agencies needed modification to improve monitoring and court reporting for 

BTC. Tracking and exchanging data is critical to program operations. 

• Coordination between Local and State Agencies. BTC involved close collaboration 

among local agencies, each of which was asked to change its practices in some ways. 

When the authority and leadership was local, this was possible. It was a greater 

challenge to change practices and record keeping when decisions rested with state 

agency management located in another city and responsible for statewide practices. 

Thus, getting local probation departments, managed in all sites by the State Department 

of Corrections, to adopt new BTC sanctioning and reporting procedures represented a 

challenge. 

• Resistance to BTC's Therapeutic Orientation and Workload. It was difficult to 

untangle the degree to which judicial and correction officer resistance to BTC monitoring 

and sanctioning plans stemmed from concerns about deviating from the mission of 

enforcement or from concerns about adding to their extremely heavy workloads. 
PART I. BTC Implementation 

Chapter 4. BTC Implementation I – 36 

Other challenges came in the form of unintended consequences of existing practices. In 

one site, many arrestees bonded out before entering the jail, so they were not identified as 

eligible for BTC until the first hearing after the bond hearing. In another site, the decision not to 

file charges often occurred after clients had received a full assessment and started treatment. 

As a result, investments in case identification and assessment did not result in continued 

treatment and testing. In two sites, introducing changes to the practices and record keeping of 

probation officers, who were employed and managed by state agencies located in other cities, 

proved exceptionally difficult. 

Early intervention efforts in BTC also raised an issue of how to target those who could 

receive sufficient intervention while under supervision. While the limited interventions received 

by those who were not prosecuted may have been beneficial, a more efficient use of resources 

for Jacksonville, given local filing practices, might have been to delay full assessments and 

services until decisions on case filing had been reached. In addition, postrelease assessments 

may be the most feasible arrangement when jails are overcrowded and results are not used for 

referral to in-jail treatment. In Birmingham, the relatively lengthy period of pretrial release for 

most defendants allowed sufficient time for intervention for many BTC participants. However, in 

jurisdictions like Jacksonville and Tacoma that dispose of cases within three months of filing, it is 

essential that probation departments be prepared to consistently apply BTC intervention 

strategies—treatment, testing, and sanctioning—for defendants found guilty and placed on 

probation. 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 37 

CHAPTER 5. 

CHANGES IN CASE PROCESSING AND OUTCOMES 

DURING BTC IMPLEMENTATION 

BTC introduced significant changes in criminal justice policies and practices. This chapter 

describes the changes in court system operations during BTC and examines the effects of 

these changes on case disposition, duration, and sentencing in each site. It compares samples 

of approximately 500 felony cases filed in the year prior to BTC with samples of about 500 

cases filed during BTC in each site. The data come from court case processing records and 

provide a limited amount of information on the characteristics of the defendants. To control for 

individual differences among sample members, additional analyses were conducted using the 

samples from the impact evaluation. The results of the detailed analysis, shown in appendix B, 

largely replicate the findings presented below, and differences in the results of the two analyses 

are noted in the text. Throughout this chapter, the unit of analysis is the case. Because a case 

may involve multiple charges, “dismissal” means that all charges were dismissed, while “guilty” 

refers to a finding of guilt on at least one charge. Cases are considered open until disposition of 

all charges. 

In general, few changes in case processing were found. Those that were detected indicate 

improvements in case processing during BTC. In Birmingham, a higher proportion of felony 

cases were disposed of within a year of filing during BTC than before. In Tacoma, the 

percentage of cases pleading guilty increased during BTC, as did the percentage of cases 

reaching disposition within a year compared with the prior year. Although other events were 

influencing case processing during BTC, it seems safe to conclude that BTC did not introduce 

court delays or negatively affect prosecution. Indeed, the enthusiasm for continuing BTC at the 

end of the demonstration in all three sites suggests that BTC was viewed as assisting the justice 

agencies in their work. 

BIRMINGHAM 

An Overview of Case Processing in Birmingham 

The changes in case handling that accompanied BTC must be understood within the 

context of the Birmingham courts. All cases begin in District Court. The three District Court 

judges preside over arraignments, conduct preliminary hearings and bond reviews, take pleas, 

conduct bench trials, and impose sentences. In the absence of an early plea, felony cases are 

waived to a grand jury and the case closed in District Court. If the grand jury issues an 

indictment, a case is filed in Circuit Court. Figure 5.1 illustrates the process felony cases follow 

from arrest to case disposition. 

• Arrest to Release. About a third of those arrested in Birmingham posted bond at that 

time and were released immediately after booking; the remainder were detained and 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 38 

appeared before a duty judge within 48 hours at an initial or “48-hour hearing.” At this 

hearing, the bond and release conditions were determined. Most of those detained 

following arrest posted bond and were released within a week.4 

• Cases Filing. The District Attorney’s office reviewed the preliminary charges, bond, and 

release recommendations and decided whether to file charges (initiated by swearing out 

a warrant). 

• Arraignment. The arraignment hearing in District Court was scheduled to occur within 

seven to ten days of arrest for defendants in need of a court-appointed attorney (about 

65 percent), but could be postponed for several weeks by defendants with a private 

attorney. 

• Preliminary Hearing. A preliminary hearing was scheduled for several weeks after 

arraignment. Attorneys of defendants who wished to accept the plea offer filed an intent 

to plead at that time, and a plea hearing was scheduled for two weeks later. Felony 

defendants who declined the District Court plea offer received a District Court disposition 

of "waived to the grand jury," closing the District Court case. 

• District Court Sentencing. A sentencing hearing followed the formal plea hearing by 

about a month. 

Figure 5.1. Case Flow in Birmingham 

ial 

Hearings 

Di

Hearing 

ing Heari

Circuit 

Court 

Arraignment 

Jury Tr

Grand 

Jury 

Plea 

Arrest/ 

Booked Detained 

Released 

on Bond 

strict 

Court 

Arraignment 

Preliminary 

Sentenc

48-Hour 

ng 

Released 

on Bond 

• Grand Jury Hearing. Owing to large case backlogs, grand jury hearings took place 

three to six months after waiver from District Court. 

• Arraignment in Circuit Court. If the grand jury indicted the defendant, a case was filed 

in Circuit Court, the defendant was arraigned, and a second plea offer was presented. If 

the defendant declined the plea offer, a trial was scheduled in Circuit Court. If the 

defendant accepted the plea offer, the trial took place in Circuit Court. However, if the 

defendant was eligible for drug court or a specialized docket, the case was closed in 

Circuit Court and reopened in District Court. 

4

 A small number were released on their own recognizance. 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 39 

One of the first BTC changes was the development of a release bond that would require 

felony defendants to report to TASC following release. The new bond was a top priority at the 

first Policy Board meeting and was instituted March 2, 1998. The availability of additional 

monitoring of defendants through BTC had the effect of increasing the number of defendants 

released pending case disposition. 

Most of the changes in case processing during BTC resulted from the response to a huge 

backlog of unresolved criminal court cases and severe jail overcrowding. According to a 1998 

report by the Alabama Judicial Data Center (AJDC), criminal judges (both District and Circuit 

Court) in Birmingham had a backlog of 3,000 cases that were more than a year old. The AJDC 

breakout of the cases pending in Circuit Court found that the five judges had more than 8,000 

cases pending and an average caseload of 1,600. About 37 percent of their cases were more 

than a year old. The American Bar Association and the Alabama Supreme Court have held that 

criminal cases should be resolved within 180 days to ensure a defendant’s constitutional right to 

a speedy trial. Judicial response to these findings varied, but some judges faulted the difficulty 

in settling cases involving mandatory minimums (which do not allow judicial discretion, so 

defendants often demand jury trials) and the rising number of capital murder cases, which 

require days or weeks to try. A study, conducted by the National Center for State Courts, of nine 

felony court systems around the country found that Jefferson County was one of the slowest to 

dispose of felony cases. 

The jail crisis came to a head in May 1998 when Jefferson County entered into a consent 

decree after an inspection by the U.S. Department of Justice found severe overcrowding in 

violation of the law. County commissioners agreed to resolve the jail overcrowding, proposing to 

build a new jail (with an 896-bed capacity) by fall 1999 and to find immediate ways to reduce the 

jail population by 400 and to keep the number of inmates in the existing jail near 1,000. They 

then initiated a study of the costs of jail construction and a review of the existing criminal justice 

system. 

While awaiting the results of the system review, the court introduced several new programs 

that used BTC resources to reduce jail overcrowding and case backlogs and advance the goal 

of early identification and treatment of drug-involved offenders. These innovations took place 

between October 1998 and June 1999, the months of full BTC implementation. 

• The Rocket Docket. The “Rocket Docket” was implemented to move the cases of 

pretrial jail inmates through the system and relieve pressure on the jail. It required the 16 

circuit judges from the civil, criminal, and family court divisions to handle the cases of 

nearly 600 inmates, with the oldest cases first. The Rocket Docket ran for two weeks in 

October 1998 and one week in January 1999. Relatively few of the defendants 

appearing on the Rocket Docket were released—most were sentenced to state prison. 

The Rocket Docket reduced the jail population and helped the county comply with the 

consent decree. The process identified issues that the criminal justice system needed to 

address: (1) It was difficult to locate offenders, and especially to identify who was in jail; 

(2) the county lacked the facilities and court staff to handle the caseloads; and (3) the 

backlog problem consisted primarily of cases open in Circuit Court, not District Court. 

• The Expedited Docket. Jefferson County introduced an expedited docket targeted at 

the large number of defendants who rejected the District Court plea offer, opting to wait 

four to five months for a grand jury hearing. It was limited to Class C felonies identified 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 40 

as eligible by the Assistant District Attorney and TASC treatment program. Most of these 

defendants were already on pretrial release, had already been assessed by BTC, and 

had already been participating in BTC for several months at the time the docket was 

introduced. TASC case managers prepared a list of TASC clients whom they considered 

eligible, based on offense (this included most nonviolent felonies) and treatment 

compliance, and their cases were placed on the expedited docket. 

Expedited docket hearings occurred within 14 days of a District Court waiver to the 

grand jury. Defense attorneys for defendants willing to accept a plea that required a 

sentence involving TASC treatment and supervision entered a presworn admission of 

probable cause and waived the right to a grand jury hearing. This process avoided the 

delays in gaining admittance to drug court that resulted from case backlogs and long 

waits for toxicology reports from the state. Between March and August 1999, 76 

defendants on the expedited docket were sentenced to probation, and a smaller number 

were transferred to the diversion program, set for trial, or dismissed, resulting in a 

significant reduction in the number of cases awaiting grand jury hearings. 

• The Diversion Program. The backlog of cases prompted the court to reinstate the 

previously suspended diversion program as part of BTC. The BTC diversion program 

admitted only first-time felony offenders charged with the possession of small quantities 

of drugs (no sales cases or large quantity possession cases). Defendants had to plead 

guilty, with the understanding that if they remained drug-free and had no additional 

arrests, the plea would be set aside at the end of six months. Participants were referred 

to TASC for assessment, treatment if needed, and supervision, but participants were not 

rejected from the program if they did not present evidence of substance abuse. Between 

January and August 1999, 816 defendants entered the program. Of this group, 458 (56 

percent) were already active TASC clients who had entered BTC at the time of arrest. 

Most of these defendants had been released from the jail prior to program entry, 

although a few were still in jail. Some of these defendants had been waived to the grand 

jury and were waiting for a hearing to be scheduled; others had been placed directly on 

the deferred docket for District Court disposition. 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 41 

Figure 5.2. Alternative Court Dockets for Drug-Related Cases in Birmingham during BTC 

Eligibility 

Typical Referral 

Source 

Duration of 

Supervision 

Fee1 

Incentive for 

Compliance 

Related 

Definitions 

Deferred Docket Drug Court Expedited Docket 

Felony drug cases: 

Quantity of substance 

cannot exceed 5 g. 

cocaine, 113 g. 

marijuana, 10 pills of 

any kind, or 10 

individual baggies. 

District Attorney 

determines eligibility. 

Defense attorney 

6 months 

$1,000 

Charge dismissed 

Drug cases excluding Class C felonies 

sales and violent (non-drug and drug cases) 

offenders 

Judge/District District Attorney determines 

Attorney/Defense eligibility 

Attorney jointly 

determine eligibility. 

Judges and/or District Attorney 

defense attorneys 

12 months 6 months 

$1,500 Low-risk - $35/mo. for six months 

High-risk - $500 

Charge dismissed Expedited disposition 

Less costly 

Usually better plea offer 

Low-risk = compliant at the point 

of placement on expedited 

probation; typically “urines only” 

clients 

High-risk = non-compliant (i.e. 

positive UA, not reporting as 

required) at the point of placement 

on expedited probation; typically 

“ten pointers” and/or offenders in 

need of treatment 

While not directly part of the BTC implementation effort, these initiatives, combined with the 

existing drug court, greatly expanded the options for handling drug-related cases and BTC’s role 

in providing early intervention, court-supervised treatment, and TASC case management for a 

variety of drug-related cases. The three specialized dockets are summarized below. It is likely 

that many of the changes in case handling observed during BTC can be attributed to these 

innovations. 

Case Handling, Disposition, and Sentencing in Birmingham before and during BTC 

Data from the Alabama Administrative Office of the Courts were used to examine the 

changes in criminal case processing associated with the introduction of BTC. To assess 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 42

changes, the evaluation compares two samples of felony cases filed in Jefferson County District 

Court. The first sample, the pre-BTC sample, consists of all felony filings (n = 1,491) between 

October 1, 1997, and December 31, 1997 (the period prior to implementation of any BTC 

services). The second sample, the BTC sample, consists of all felony cases (n = 2,024) filed 

between October 1, 1998, and December 31, 1998, during the most extensive implementation 

of BTC services. The data collected on these cases include all court actions by the District and 

Circuit Courts in Jefferson County during the 365 days following filing. The data include all 

actions related to a single incident. 

Table 5.1 compares the charges during the two time periods. The results indicate that the 

number of cases filed increased from 1,491 in the last quarter of 1997 (pre-BTC) to 2,024 in the 

last quarter of 1998 (during BTC). The largest increases occurred in two offense categories: 

cases involving drug charges and cases involving “other” charges, such as bad checks. 

Table 5.1. Increases in Quarterly Felony Filings by Charge Category in Birmingham 

Charge Pre-BTC During BTC Percent Change 

Violent 274 309 +13% 

Property 492 543 +10% 

Drug 564 915 +62% 

Other 161 257 +59% 

Total 1,491 2,024 +36% 

The percentage of cases remaining open at the end of a year dropped significantly during 

BTC (table 5.2). In the pre-BTC sample, about 40 percent of the felony cases were open one 

year after filing. The large majority of the open cases had received a District Court disposition of 

"waived to grand jury" but had not yet been filed in Circuit Court. During BTC, about 29 percent 

of felony cases were open at the end of a year; most of these had been waived to grand jury. 

These reductions in time to disposition reflect the efforts made concurrent with BTC to improve 

the speed of court processing. 

Table 5.2. Pre-BTC/BTC Comparison of Case Processing in Birmingham 

 Pre-BTC 

n = 1,491 

BTC 

n = 2,024 

Case Status One Year from Case Filing 

Open Cases – number (percent of total) 600 (40%) 582 (29%) 

 Waived to Grand Jury – pending hearing 523 (35%) 505 (25%) 

 No Court Hearings One Year after File Date 73 (5%) 12 (<1%) 

 Active 4 (<1%) 65 (3%) 

 

Closed Cases 891 (60%) 1,442 (71%) 

 Dismissed/Nolle Prossed/Acquitted 290 (20%) 597 (29%) 

 Guilty/Convicted 584 (39%) 783 (39%) 

 Other 16 (1%) 62 (3%) 
Average Day of Disposition

PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 43 

Another significant change was an increase in the number of dispositions at the first 

hearing, from 33 percent in the pre-BTC sample to 50 percent in the BTC sample. Efforts to 

encourage early pleas account for this reduction. The introduction of the diversion option 

conversely resulted in some delay in reaching final disposition, as defendants were given six 

months to comply with requirements and earn dismissal of their case. Other changes in case 

processing occurred between these two periods. Figure 5.3 shows the case processing timeline 

prior to BTC (the top line) and during BTC (the bottom line). These lines show the following: 

• A significant reduction in the time between arrest and case disposition for cases closed 

within a year of filing (a growing portion of all cases). Looking only at cases closed within 

a year of filing, the data show that the overall time from arrest to case disposition fell 

from 184 days in the pre-BTC period to 141 days during BTC, a 43-day reduction. 

• Most of the reduction in time to disposition came from a substantial increase in the 

percentage of cases disposed of at the first hearing. In the pre-BTC sample, 33 percent 

of the cases were disposed of at the first hearing. This percentage rose to 50 percent 

during BTC. 

• The growth in the number of cases settled at the first hearing reduced the average 

number of hearings from 1.3 prior to BTC to 1.2 during BTC for cases closed within a 

year of filing. 

Figure 5.3. Timelines: Pre-BTC/BTC Comparison of 

Average Number of Days to Events in Birmingham 

PRE-B T C 

Average Day of Case Filing 

Arrest Average Day of First Hearing Average Day of Disposition 

Day Day Day Day 

1 69 71 184 

BTC 

Arrest Average Day of First Hearing 

Average Day of Case Filing Average Day of Disposition 

Day Day Day Day 

1 5 96 141 

Overall, the time between arrest and first hearing was 23 days longer during BTC than 

before BTC, despite a significant reduction in time between arrest and filing. Before BTC, the 

time between arrest and filing was 69 days, but the first hearing occurred about 4 days after 

filing. During BTC, the time between arrest and filing was only 5 days, but the time between 

filing and first hearing rose to 91 days. This was caused in part by the sharp increase in the 

number of cases filed (see table 5.1). 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 44 

The sentences imposed during BTC also shifted, with substantially more offenders getting 

probation and fewer being sentenced to incarceration only (table 5.3). The percentage of closed 

cases in which the sentence was probation only increased from 42 percent before BTC to 57 

percent during BTC. The percentage of closed cases in which the sentence was incarceration 

decreased from 40 percent to 19 percent. At least some of the reduction resulted from plea 

offers made to defendants on the expedited and rocket dockets. 

Table 5.3. Pre-BTC/BTC Comparison of Sentences Imposed in Birmingham 

Pre-BTC BTC 

Type of Sentence Imposed in Guilty Cases n=584 n=783 

Probation Onlya 244 (42%) 450 (57%) 

Confinement Only 232 (40%) 149 (19%) 

Confinement and Probation 89 (15%) 83 (11%) 

Other 19 (3%) 101 (13%) 

Total 584 (100%) 783 (100%) 

a

 Probation Only includes all sentences involving a term of probation and any sanction other than a period of imposed confinement 

(i.e., a term of probation plus restitution, or fines, etc.). 

Summary of Case Processing Changes in Birmingham 

The introduction of a number of changes in case handling during the period of BTC full 

implementation resulted in a significant increase in the proportion of cases disposed of within a 

year of filing. Overall, the analysis found the following: 

• The average time to case disposition dropped by 43 days, and the percentage of cases 

closed within a year of filing rose from 60 percent to 71 percent. The multivariate 

analysis of the cases of defendants in the impact sample shown in appendix B found 

that the difference in likelihood that cases would be closed within a year was highly 

significant (p < .01). 

• During BTC, the number of felony cases awaiting a grand jury hearing a year after filing 

declined, but one-quarter were still pending an indictment hearing at the end of a year. 

• A substantial increase in case filings lengthened the delay for a first hearing during BTC. 

Thus, despite the dramatic reduction in the time between arrest and filing, the time 

between arrest and first hearing actually grew. This could have been the effect of 

handling the backlog and efforts to reduce jail overcrowding. 

• Although the analysis above shows a substantial increase in the proportion of cases 

disposed of at the first hearing, the difference disappeared in the multivariate analysis of 

the impact evaluation samples (appendix B). This suggests that differences in case and 

client characteristics may account for the lower number of hearings per case during 

BTC. 

• The analysis of the impact samples found that during BTC, cases were less likely than 

before BTC to be found guilty (perhaps due to successful completion of the diversion 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 45 

program) but more likely to result in incarceration if found guilty. This suggests that the 

system was focusing on the more serious cases/offenders, offering alternatives in less 

serious cases, or that defendants either completed pretrial intervention successfully or 

faced the alternative sentence. 

JACKSONVILLE 

An Overview of Case Processing In Jacksonville 

Florida’s Fourth Judicial Circuit, which includes Duval County, had a Chief Judge, 24 Circuit 

Court judges, a State's Attorney, a Public Defender, and 13 County Court judges at the time of 

BTC. Judicial policies were guided by the Florida Supreme Court and Administrative Orders of 

the Chief Judge. A Court Administrator for the circuit performed many administrative duties for 

the court system. In Duval County, felony cases are scheduled in one of six Circuit Court 

dockets. Two are reserved for serious and repeat offenders. The majority of BTC cases were 

scheduled for one of the four general criminal dockets. 

The first hearing after arrest was the bond (J1) hearing, held daily, usually with a county 

judge presiding. Different circuit or county judges rotated assignments to these J1 hearings on 

weekends and holidays. At J1, the judge set the amount of money bonds, specified release 

conditions, and, in some cases, took pleas and passed sentence on misdemeanor cases. Bond 

recommendations were offered by the prosecutor and were based on a review of the 

defendant’s local record (National Crime Information Center [NCIC] criminal histories are not 

available by first appearance). The prosecutor subsequently made decisions on filing the case. 

Judicial Case Processing, Disposition, and Sentencing

in Jacksonville before and during BTC 

In order to determine BTC's effect on judicial case processing in Jacksonville, two samples 

were obtained from the Jacksonville criminal justice system. One sample consisted of the first 

500 felony cases consecutively screened by the Prosecutor's office beginning on March 1, 

1999, the year prior to implementation of BTC. The second sample consisted of 500 felony 

cases consecutively screened by the Prosecutor's office beginning on February 1, 2000, during 

the period of full BTC implementation. The data collected on these cases include all court 

actions during at least the 365 days following initial case screening. 

Table 5.4 indicates that the samples of cases filed before and during BTC were similar in 

the race, gender, and age of defendants and did not differ significantly in number of charges per 

case. In both time periods the largest category of offenses involved drug crimes, followed by 

property and violent offenses. However, sample cases processed before BTC implementation 

included more drug offenses and fewer traffic offenses than the sample of cases processed 

after BTC implementation. 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 46 

Table 5.4. Comparison of Defendant and Offense Characteristics in Jacksonville

 Pre-BTC 

(n = 500) 

BTC 

(n = 500) 

Significance of 

Difference 

Defendant Characteristics 

Gender ns 

Female 15% 12% 

Male 85% 88% 

Race ns 

Black 67% 67% 

Non-Black 33% 33% 

Mean Age 33.4 34.1 ns 

(standard deviation) (9.5) (10.0) 

Offense Characteristics 

Type of Offense** 

Drug Offenses 

Property Offenses 

Violent/Person Offenses 

Traffic Offenses 

Weapons Offenses 

Other/Unknown Offenses 

Mean Number of Charges 

(standard deviation) 

p<.05 

35% 

22% 

15% 

13% 

2% 

13% 

1.7 ns 

(1.0) 

41% 

23% 

17% 

7% 

2% 

10% 

1.7 

(1.0) 

p < 0.05; **p < 0.01; ***p < 0.001; ns = not significant 

Figure 5.4 displays the median number of days from arrest to key case processing events. 

Overall, these comparisons show a consistent pattern of similarity. There were no significant 

differences in time to charge filing, first appearance, or final disposition (for those cases that 

were resolved). Furthermore, similar proportions of cases in both time periods were still 

unresolved one year after initial arrest: 7 percent of pre-BTC cases versus 9 percent of cases 

processed during BTC. 

Figure 5.4. Median Days from Arrest to Case Processing Event in Jacksonville 

Pre-BTC

Arrest Average Day of Arraignment Average Day of Arraignment

Average Day of Charge F Average Day of Charge Filing Average Day

of Disposition

Day Day Day Day

1 19 26 63

BTC 

Average Day of Charge Filing Average Day 

Arrest Average Day of Arraignment of Disposition 

Day 

1 

Day 

20 Day 

Day 

72 

21 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 47 

Table 5.5 compares the two samples on conviction and sentencing outcomes. It should be 

noted that sentencing in Florida is based on the 1998 Florida Criminal Punishment Code. This 

sentencing paradigm provides a uniform evaluation of relevant factors in the sentencing 

decision, while allowing judges to maintain a considerable amount of discretion. Paramount 

among these factors are current offense, prior criminal record, and victim injury. 

The comparisons in table 5.5 continue to reveal a consistent pattern of similarity in the preBTC and BTC cases. The two samples were similar on type of case disposition, proportion of 

cases unsolved one year after arrest, type of sentence received, and average number of 

convictions per case. 

Table 5.5. Pre-BTC/BTC Comparison of Case Outcomes One-Year from Arrest in Jacksonville 

Pre-BTC 

(N = 500) 

BTC 

(N = 500) 

Significance

of Difference 

Case Unresolved after 365 Days 7% 9% ns 

Closed Cases 93% 91% ns 

 Disposition in Closed Cases

8% 9% ns 

Guilty/ 84% 82% ns 

 Dismissed/Nolle Prossed/Acquitted 

Convicted 

 Incompetent to Stand Trial <1% <1% ns 

 Sentences in Closed Cases

 Incarceration 69% 66% ns 

Probation 21% 23% ns 

Other 10% 11% ns 

Mean Number of Conviction Charges in Guilty Cases 1.2 1.2 ns 

 (standard deviation) (0.8) (0.7) 

14.2 

(23.2) 

11.7 

(21.5) 

Mean Months of Incarceration in Guilty Cases ns

 (standard deviation) 

Mean Months of Probation in Guilty Cases 4.1 4.7 ns 

 (standard deviation) (9.6) (10.1) 

a

 Months of incarceration ordered was censored at the 95th percentile because of a few cases that received very long sentences. 

*p < 0.05; **p < 0.01; ***p < 0.001 ns = not significant 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 48 

Summary of Case Processing Changes in Jacksonville 

The findings from the comparison of cases processed before and after implementation of 

BTC suggest that BTC had a minimal impact on case processing in Jacksonville. Cases in both 

periods were found to be similar in regard to several case processing outcomes, including time 

to charge filing, initial court hearing, and disposition. The proportion of convicted offenders 

sentenced to incarceration was also similar, as was the mean length of incarceration for those 

found guilty. These findings were confirmed by the analysis based on the samples included in 

the impact evaluation, which controlled for differences in defendants and case characteristics 

(appendix B). 

TACOMA 

An Overview of Judicial Case Processing in Tacoma 

After arrest and booking, case processing in Tacoma begins with screening by the 

Prosecutor's office to determine whether and which charges to file against an arrestee. In 

Tacoma, the Prosecutor has the power to charge felony cases directly in Superior Court, 

bypassing grand jury and initial case filing proceedings in lower courts. Prosecutors review the 

police report and the arrestee's criminal history before making charging decisions. The initial 

charging decision (i.e., whether and which charges to file) is made between booking and first 

appearance in court, which is most often the day after booking. Thus the charging decisions are 

made quickly, generally within 24 hours of booking. 

At first appearance, the defendant is arraigned, the defendant enters a plea of "not guilty,” 

counsel is assigned for indigent defendants (the vast majority of defendants), bail is set for 

defendants still in custody, and the date of next appearance is scheduled. The next appearance, 

the "pretrial conference," most often occurs 14 days after first appearance. In between first 

appearance and the pretrial conference, the Prosecutor's office shares information about the 

case with the defense attorney, as required by law (i.e., discovery). The primary purpose of the 

pretrial conference is to explore possible resolutions to the case. If a suitable resolution can be 

agreed upon at the pretrial conference, the defendant agrees to plead guilty and a plea date is 

set. If no resolution is agreed upon, then a trial date is set; if trial motions are anticipated, an 

“omnibus hearing date" is set. Generally, on the plea date, the defendant pleads guilty and is 

sentenced by the presiding judge. However, in some cases, the presiding judge will request a 

presentence report, and in a relatively small number of cases, presentence reports are required 

by law. In these instances, a separate sentencing date is set. 

As in most jurisdictions, the vast majority of cases are resolved via guilty pleas, and trials 

are relatively rare. A recent Justice Management Institute study of felony case processing in 

Tacoma found that in 1999, 83 percent of felony cases were resolved by guilty pleas, 13 percent 

were dismissed, and the remainder were resolved via bench and jury trials (Carlson et al. 2001, 

p. 39). Thus, over 95 percent of cases were resolved via guilty pleas. The Justice Management 

Institute's report also found that the case processing in Tacoma is fairly rapid; half of all cases 

filed in 1999 were closed within 59 days of initial case filing and 75 percent within 108 days 

(Carlson et al. 2001, 40). 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 49 

Judicial Case Processing, Disposition, and Sentencing

in Tacoma before and during BTC 

The analysis of changes in judicial case processing in Tacoma during BTC compares two 

samples of cases from the LINX system. The first sample consisted of the first 505 felony cases 

consecutively screened by the Prosecutor's office beginning on March 1, 1998, prior to 

implementation of BTC. The second sample consisted of 501 felony cases consecutively 

screened by the Prosecutor's office beginning on March 1, 1999, during the period of full BTC 

implementation. The data collected on these cases include all court actions during at least the 

365 days following initial case screening. It should be emphasized that the unit of analysis in 

this assessment is the case, not the charge. This distinction is important because a case can 

comprise many charges, each of which can have different dispositions and disposition dates. 

Table 5.6 compares characteristics of the offenders and charges in the two samples. There 

were no significant differences between the BTC and pre-BTC samples in age, race, gender, or 

number of charges. However, compared with the cases prior to BTC, a larger portion of those 

processed during BTC faced drug possession charges and weapons offenses, and a smaller 

portion were charged with drug sales and property offenses. We have no reason to believe 

these differences were associated with the introduction of BTC. 

As figure 5.5 shows, there were no significant differences in median days from arrest to key 

case processing events: arraignment (first appearance), pretrial conference, or final disposition 

(for those cases that were resolved). What this figure does not display is the fact that the 

proportion of cases that remained open (unresolved) after one year was significantly smaller 

during BTC than before BTC. Nineteen percent of the cases filed prior to BTC implementation 

remained open after one year, compared with 9 percent of cases filed during BTC. 
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 50

Table 5.6. Comparison of Cases Characteristics in Tacoma Before and During BTC 

 Pre-BTC 

(N=414)a

BTC 

(N=464) 

Significance of 

Difference 

OFFENDER CHARACTERISTIC 

 Gender ns 

 Female 23% 22% 

 Male 77% 78% 

 Race ns 

 White 74% 77% 

 Non-White 26% 23% 

 Mean Age at Arrest 

 (standard deviation) 

31.8 

(8.7) 

32.1 

(8.9) 

ns 

OFFENSE CHARACTERISTIC 

 Type of Charge p<.05 

 Drug Possession 34% 41% 

 Drug Sales 19% 13% 

 Property Offenses 27% 22% 

 Person Offenses 5% 5% 

 Weapons Offenses 4% 7% 

 DUI/Traffic Offenses 4% 4% 

 Public Order/Other 8% 8% 

 Mean Number of Charges 

(standard deviation) 

1.6 

(1.0) 

1.7 

(1.0) 

ns 

a

 Note: Missing data reduces the total number of cases from 1006 to 878 in this analysis. 

p < 0.05; **p < 0.01; ***p < 0.001 ns = not significant 

Figure 5.5. Median Days from Arrest to Case Processing Event in Tacoma 

Day

1 Day

2

Day

13

Day

62

Arrest

Arraignment

Pretrial Conference Case

Close

Day

1 Day

2

Day

13

Day

62

Arrest

Arraignment

Pretrial Conference Case

Close

Pre-BTC

During BTC Implementation

Day

1 Day

2

Day

14

Day

59

Arrest

Arraignment

Pretrial Conference Case

Close
PART I. BTC Implementation 

Chapter 5. Changes in Case Processing and Outcomes during BTC Implementation I – 51 

Table 5.7 compares the two samples on conviction and sentencing outcomes. Significantly 

more of the cases in the BTC sample than in the pre-BTC sample pled guilty, but there was no 

significant difference in the number of conviction charges or the type of sentence in guilty cases. 

It should be noted that sentencing in Washington State is based on a presumptive guideline 

system, in which the presumptive sentence for each case is determined by the intersection of 

offense seriousness and offender criminal history on the sentencing grid. 

Table 5.7. Sentencing Outcomes in Tacoma Before and During BTC 

Pre-BTC 

(n=414)a 

BTC 

(n=464) 

Significance

of Difference 

Mean Number of Convictions Per Case 1.0 1.1 ns 

 (standard deviation) (0.8) (0.8) 

Method of Disposition p<.05 

 Trial <1% 1% 

Type of Sentence 

Jail 80% 79% 

ns 

84% 89% 

16% 10% 

 Guilty Plea 

 Dismissed 

Prison 19% 21% 

 Probation w/o incarceration <1% <1% 

Mean Length of Incarceration, in days 

 (standard deviation) 

262 

(457) 

273 

(479) 

ns 

a

 Missing data reduces the total number of cases from 1006 to 878 for mean number of convictions per case, method of disposition, 

and length of incarceration (414 and 464, respectively for Pre-BTC and BTC cases), and 762 for type of sentence (347 and 415, 

respectively). 

p < 0.05; **p < 0.01; ***p < 0.001 ns = not significant 

Summary of Case Processing Changes in Tacoma 

During BTC the percentage of cases resolved through plea increased compared with the 

prior year, as did the percentage of cases reaching disposition within a year. This outcome could 

result from an increase in pleas entered as part of drug court or diversion programs; however, 

dismissals did not increase as would be expected in a successful postplea, presentence 

treatment program. Another possibility is that the failure to appear rates at pretrial hearings 

declined as a result of BTC monitoring, shortening time to disposition. No significant changes 

were observed in types of charges, number of conviction charges, and sentences between the 

samples of cases filed before and during BTC. 
PART II. BTC Impact II – 1

PART II. 

BTC IMPACT 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 2 

CHAPTER 6. 

BTC IMPACT ON DRUG USE AND CRIME 

The impact evaluation findings presented in this chapter and the next are based on quasiexperimental comparisons of samples of BTC participants selected shortly after an arrest 

with comparable samples of defendants arrested in the year before BTC implementation. The 

impact analysis is based on interview data and official records. Interview data on personal 

characteristics, drug use history and severity, past criminal activity, and other areas of social 

functioning were collected in baseline interviews conducted shortly after the arrest and in followup interviews approximately nine months later. Official records were used to measure arrests 

before and in the year after the arrest. The procedures used to select the samples, the 

characteristics of the samples, the data collection procedures, and the analysis strategies are 

described in detail in appendix A. 

This chapter examines the central impact question: Did BTC reduce drug use and crime? 

BTC participants in two of the three demonstration sites, Birmingham and Jacksonville, reported 

significantly less past-month drug use on follow-up interviews approximately nine months after 

arrest than did the comparison groups. In all three sites, BTC participants were less likely than 

the comparison groups to report committing offenses on the follow-up interviews. During the 

year after the arrest, official records showed significantly lower likelihood of rearrest and 

significantly fewer rearrests for BTC participants than for comparison groups in Birmingham and 

Tacoma. The evidence is presented below. 

REDUCTIONS IN DRUG USE 

Breaking the Cycle’s impact on drug use was measured by self-reported drug use in the 30 

days prior to the follow-up interview.5 Table 6.1 shows the prevalence of any drug use, any 

stronger drug use, heavy drug use (16 or more days of illegal drug use in past month, summing 

across drugs),6

 any marijuana use, and frequent drinking to intoxication (four or more times) in 

the 30 days before follow-up in the pre-BTC and BTC samples in each site.7 

5 This drug use measure includes use of heroin, other opiates, cocaine, marijuana, amphetamines, barbiturates, other 

sedatives, hallucinogens, and inhalants. 

6

 For example, days of marijuana use plus days of cocaine use plus days of use of other drugs. The sum may count a 

day more than once if multiple drugs were used on that day.

7 The sample is limited to sample members who reported drug use or tested positive for drugs, and excludes sample 

members in BTC only because they had been charged with a felony drug offense. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 3 

Table 6.1. Self-reported Drug Use in the 30 days Prior to Follow up Interview by Site 

Birmingham Jacksonville Tacoma 

 Pre-BTC BTC Pre-BTC BTC Pre-BTC BTC 

(n = 137) (n = 213) (n = 297) (n = 215) (n =247) (n = 260) 

B ASELINE DRUG US E 

Any Drug Use 50% 87%*** 85% 92%** 98% 84%*** 

Stronger Drug Use 34% 39% 59% 62% 88% 68%*** 

 Heavy Drug Use 14% 32%*** 46% 54%* 72% 40%*** 

Marijuana Use 30% 62%*** 61% 69% 53% 47% 

Weekly Alcohol to 23% 26% 39% 40% 25% 17%* 

Intoxication 

FO L L O W U P DRU G U S E 

Any Drug Use 26% 23% 40% 27%** 53% 50% 

Stronger Drug Use 12% 8% 23% 15%* 44% 40% 

Heavy Drug Use 7% 8% 18% 12%* 31% 23%* 

Marijuana Use 16% 10% 32% 22%* 31% 25% 

Weekly Alcohol to 12% 17% 32% 26% 18% 13% 

Intoxication 

D AYS IN CA R C E R ATED IN 3 0 DAYS BEFORE INTERVIEW 

Baseline 15.4 2.8*** 11.1 4.9*** 3.7 12.1*** 

Follow up 11.2 2.1*** 6.8 4.0** 7.6 4.8*** 

NOTE: Only respondents who completed both surveys and had some indication of substance abuse were included in this table. 

* p < .05 ** p < .01 *** p <.001 indicates level of significance of differences between Pre-BTC and BTC samples within sites; Other 

differences were not significant. 

As shown, BTC samples in Birmingham and Jacksonville were significantly more likely to 

report past-month illegal drug use at baseline than the pre-BTC samples, while the reverse was 

true in Tacoma. At follow-up, the rates of drug use were similar in pre-BTC and BTC samples on 

most drug use measures in Birmingham and Tacoma, but are significantly lower in the BTC 

sample in Jacksonville. However, these simple bivariate comparisons conceal significant 

differences in drug use at baseline and in sample characteristics (described in appendix A). 

There were also significant differences in opportunity to use illicit drugs. Although the pre-BTC 

sample members in all three sites spent three to nine days more than BTC participants in jail in 

the month before the follow-up, they were still as likely or more likely to use illicit substances 

during that period. 

To control for differences in the samples, the hypothesis that BTC participants were less 

likely than the comparison sample to report drug use at follow-up was tested using multivariate 

probit models. The models include independent variables to control for differences in the 

characteristics of sample members and were estimated with and without the selection bias 

correction. In addition to the BTC treatment (yes/no), the models include controls for opportunity 

to use drugs (number of days in jail in the 30 days prior to the follow-up interview); demographic 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 4

variables (sex, race, age, and education); prior drug use (in the 30 days before the baseline 

interview); and variables included to control for sample selection differences. Tests of the 

significant interaction between BTC treatment and the other independent variables were 

conducted to assess differences in the impact of BTC across subgroups of defendants. The 

interactions found to be significant terms are shown in the tables. 

In the multivariate results (table 6.2), the Birmingham BTC sample was significantly less 

likely than the pre-BTC sample to report using drugs in the 30 days before the follow-up 

interview and less likely to use a stronger drug (cocaine or heroin) during this time, controlling 

for sample differences and selection. However, the interaction term in the marijuana use model 

shows that BTC had statistically significant and substantial effects on the marijuana use of 

African Americans, but not on the marijuana use of whites. 

Table 6.2. Impact in Birmingham: Self-Reported Drug Use in the 30 Days Prior to Follow-up 

Interview, controlling for Defendant Characteristics and Sample Differences 

Variable 

Any 

Drug Use 

Any Stronger 

Drug Use 

Heavy 

Drug Use 

Any 

Marijuana Use 

BTC Treatmenta –0.303* –0.338* 0.072 –0.021 

Age 0.008 0.029*** 0.015 –0.009 

Female –0.139 0.052 –0.698** –0.635** 

Black –0.043 0.343 0.154 0.357 

Black*BTC Tx — — — –0.821* 

Education –0.064 –0.130** –0.045 –0.038 

Employ Bother –0.098 –0.114 –0.333 0.116 

Days Worked –0.007 –0.007 –0.014 0.006 

Months in Jail 0.004 0.001 0.003 0.007 

On Probation 0.233 0.248 0.299 0.476** 

Serious Offender 0.024 0.016 –0.062 –0.009 

Prior Offenses 0.002 0.004 0.008** 0.000 

Prior Drug Use 0.009 0.007 0.014** 0.018*** 

Days in Jail –0.050*** –0.049*** –0.073** –0.040*** 

Constant 0.037 –0.865 –1.438* –0.642 

 

N 350 350 350 350 

–2LL 39.732*** 34.848*** 30.577  39.876** * 

Pseudo–R2 0.103 0.156 0.165 0.151 

a/Significance tests for this variable are one–tailed. 

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 5

In Jacksonville, the multivariate models indicate a significantly lower likelihood of drug use 

in the 30 days prior to follow-up by BTC participants than by the pre-BTC comparison group on 

three of the four drug use measures—any illegal drug use, heavy drug use, and marijuana use. 

The results did not show significantly lower rates of past-month stronger drug use, which in 

Jacksonville consisted primarily of cocaine use, among BTC participants. 

Table 6.3. Impact in Jacksonville: Self-Reported Drug Use in the 30 Days Prior to Follow-up 

Interview, controlling for Defendant Characteristics and Sample Differences 

Variable 

Any 

Drug Use 

Use of 

Stronger Drugs 

Heavy 

Drug Use 

Any 

Marijuana Use 

BTC Treatmenta –0.269** –0.097 –0.430** –0.265* 

Age –0.007 0.012 –0.185*** –0.107* 

Age Squared — — 0.002*** 0.001* 

Female –0.338* –0.223 –0.435 –0.291 

Black 0.112 0.125 0.128 0.071 

Education –0.022 –0.035 0.035 –0.006 

Married –0.216 –0.063 0.202 –0.832*** 

Days worked, Past 30 –0.007 –0.004 –0.004 –0.009 

Months Incarcerated, lifetime –0.001 0.002 0.006 –0.004 

On Probation 0.136 0.220 0.440* –0.001 

Prior Offenses, Past 6 mos. 0.001 0.000 0.000 0.000 

Prior Arrests 0.007 0.001 0.000 0.016* 

Prior Drug Treatment Episodes 0.047* 0.061** 0.087 0.031 

Age First Used Drugs –0.014 –0.026* 0.005*** –0.018 

Live with Drug User 0.353* 0.105 0.063 0.413* 

Days Used Drugs, past 30 

(all drugs) 0.010** — 0.013** — 

Days Used Methamphetamine, 

past 30 — 0.068* — — 

Days Used Cocaine, past 30 — 0.031*** — — 

Days Used Opiates, past 30 — 0.018 — — 

Days Used Marijuana, past 30 — — — 0.033*** 

Days in Jail, past 30 0.230*** 0.201*** 0.524*** 0.238*** 

Days in Jail, squared –0.009*** –0.008*** –0.045*** –0.010*** 

Time between Interviews 0.001 0.001* 0.000 0.001 

Constant –0.295 –1.502** 0.748 0.726 

MODEL FIT 

N 450 446 450 450 

–2LL 117.060*** 89.700*** 116.650*** 133.440*** 

Pseudo–R2 0.203 0.204 0.308 0.255 a

 Significance tests for this variable are one-tailed. 

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 6

In Tacoma (table 6.4), BTC participants were not significantly less likely than the 

comparison sample to report drug use in the 30 days before the follow-up interview. This finding 

held across drug use measures (any drug use, any use of stronger drugs, heavy drug use, or 

any marijuana use). These results do not change substantively when selection or attrition bias 

corrections are taken into account. Moreover, additional analyses (not shown) revealed that 

there were no significant differences between the two groups when each type of drug use was 

analyzed separately; that is, the two groups did not differ on use of methamphetamines, 

cocaine, opiates, or other drugs. 

Table 6.4. Impact in Tacoma: Self-Reported Drug Use in the 30 Days Prior to Follow-up Interview, 

controlling for Defendant Characteristics and Sample Differences 

Variable 

Any 

Drug Use 

Use of 

Stronger Drugs 

Heavy 

Drug Use 

Any 

Marijuana Use 

BTC Treatmenta –0.075 0.022 –0.064 –0.197 

Age 0.003 0.008 0.003 –0.016* 

Female –0.113 0.118 –0.051 –0.231 

Black 0.129 –0.040 –0.088 0.345* 

Education 0.078 0.155*** –0.046 –0.021 

Married –0.304* 0.037 –0.447** –0.436** 

Days worked –0.011 –0.015 –0.016* –0.004 

Months Incarcerated, lifetime –0.001 0.001 0.002 0.000 

On Probation –0.044 0.001 0.315** –0.101 

Prior Offenses 0.002* 0.003** 0.001 0.001 

Prior Arrests 0.000 –0.001 0.009 –0.008 

Prior Drug Treatment Episodes 0.054* 0.024 0.101*** –0.002 

Age First Used Drugs –0.037** –0.032* –0.023 –0.061*** 

Live with Drug User 0.297* 0.257 0.155 0.008 

Days Used Drugs, past 30 

(all drugs) 

 0.008* — 0.016*** — 

Days Used Methamphetamine, 

past 30 

— 0.023*** — — 

Days Used Cocaine, past 30 — 0.026* — — 

Days Used Opiates, past 30 — 0.030*** — — 

Days Used Marijuana, past 30 — — — 0.008* 

Days in Jail, past 30 0.202*** 0.232*** 0.114*** 0.143*** 

Days in Jail, squared –0.009*** –0.010*** –0.006*** –0.007*** 

Time between Interviews –0.001 0.000 0.000 –0.002 

Constant –0.556 –2.504*** –0.505 1.505 

MODEL FIT 

N 461 461 461 461 

–2LL 128.8*** 165.4*** 116.75*** 90.83*** 

Pseudo–R2 0.202 0.265 0.215 0.165 a

 Significance tests for this variable are one-tailed. 

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 7 

The results show reductions in drug use in Birmingham and Jacksonville, but not in 

Tacoma. Specifically, the BTC sample was significantly less likely than the pre-BTC sample to 

do the following: 

• Use an illicit drug in the 30 days before follow-up (Birmingham and Jacksonville) 

• Use marijuana in the 30 days before follow-up (Jacksonville and black BTC clients in 

Birmingham) 

• Use a stronger drug in the 30 days before follow-up (Birmingham) 

• Engage in heavy drug use in the 30 days before follow-up (Jacksonville) 

Figure 6.1 illustrates the differences between the BTC and pre-BTC samples for those 

differences found to be significant in the multivariate modeling. The values shown are the 

predicted probability of drug use for each group at the mean value of the other independent 

variables in the model. 

Figure 6.1. Predicted Probabilities of Drug Use with Covariates Held at the Mean 

0.4

BTC

Comparison 

0.3 0.27 

0.19 0.2 

0.2 0.18 

0.1 

0

Birmingham Jacksonville Birmingham Jacksonville Birmingham Jacksonville

(p<.10) (p<.05) (p<.10) (p<.05) black only (p<.05)

0.04 0.04 0.05 

0.13 

0.14 

0.09 

0.14 

0.09 

StrongerStronger Heavy (p<.10) 

Any Drug Use Drug UseDrug Use Drug UseDrug Use Marijuana Use 

* All covariates held at mean except days in jail, which is constrained to zero in the analysis of heavy drug use. 

The observed reductions in drug use are not clearly linked to participation in drug treatment 

and may well have resulted from increased drug testing, monitoring, and pretrial supervision. In 

Tacoma and Jacksonville, the BTC samples reported significantly more days of drug treatment 

in the month before the follow-up interview than the pre-BTC sample did (2.1 days versus 0.8 

days in Jacksonville and 3 days versus 1.3 days in Tacoma), but significant reductions in drug 

use were found in Jacksonville and not in Tacoma. In Birmingham, where little difference in days 

of drug treatment was reported for the month before follow-up, significant differences in drug 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 8 

use were found. One possible explanation is that drug treatment was of short duration, with the 

result that BTC participants in Birmingham and Jacksonville had completed treatment prior to 

the month before follow-up. The known delays in treatment entry in Tacoma combined with 

widespread methamphetamine use may have delayed or derailed the impact of BTC on drug 

use. A competing (or complementary) explanation is that the heightened pretrial supervision and 

drug testing in Birmingham and Jacksonville, more widespread than in Tacoma where efforts 

were focused on a smaller pool of drug abusers, may have reduced drug use among the BTC 

clients with less severe drug problems who were placed only in urine monitoring. 

Separate analyses of drinking alcohol to intoxication in the 30 days before the follow-up 

interview (not shown) found no significant difference between the samples. This suggests that 

BTC efforts to reduce illegal drug use through testing, treatment, and supervision had no carryover effect on alcohol abuse. 

REDUCTIONS IN CRIMINAL ACTIVITY 

One of the key premises of the Breaking the Cycle program was that recidivism could be 

reduced if drug-involved arrestees were promptly identified and referred shortly thereafter to 

appropriate treatment modalities. The following analysis uses official arrest and self-report data 

to test the hypothesis that BTC reduced continued criminal activity. The analysis also assesses 

whether BTC reduced the likelihood of any recidivism, and whether BTC reduced the number of 

offenses shown in both the official and self-report data. The measures constructed from 

responses to the follow-up survey include (1) the number of times the respondent had 

committed 14 types of offenses in the six months before the follow-up interview and (2) the 

number of arrests for 14 offenses in the six months before the interview.8

 In addition, official 

criminal justice records were collected to measure any arrest and the number of arrests in the 

12 months after sample entry. Criminal history records could not be located for all sample 

members, and these cases were excluded from the analysis. In Birmingham, 124 cases in the 

BTC sample and 55 cases in the pre-BTC sample were excluded. In the other two sites, where 

recruitment to the sample followed BTC intake, only three cases were excluded, all from the 

pre-BTC sample in Jacksonville, for failing to report drug use or testing positive for drugs. 

Because self-report data on stigmatized behaviors and arrest records are both subject to 

error, we compared the indicators to detect differences that might affect impact evaluation 

assessments. In general, we expect that memory error and misunderstanding of arrest would 

affect all sites and samples equally and thus not explain differences between the samples. 

Instead, differences are likely to be a function of denial of criminality, the inaccuracy of official 

records (or record-checking procedures), or changes in enforcement. Denial, in turn, may vary 

depending on the perceptions of consequences for revealing behavior subject to legal penalties. 

In a pre-postcomparison, official records can be affected by changes in record-keeping or arrest 

policies. 

8 The 14 types of offenses were shoplifting or vandalism; parole or probation violations; drug offenses; forgery; 

weapons offenses; burglary, larceny, or breaking and entering; robbery; assault; arson; rape; homicide or 

manslaughter; prostitution; contempt of court; and any other offenses. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 9 

Table 6.5 compares the average number of arrests based on official records and average 

number of self-reported arrests for the six months prior to the follow-up interview. The detected 

discrepancies can reflect either error in the official records or differences in record-checking 

procedures or error in self-reported data stemming from memory inaccuracy, deliberate denial of 

offending, or misinterpretation of police contacts (e.g., being questioned but not actually 

arrested). The phi coefficients are used to show the strength of the relationship between the 

self-report data and official records. 

Table 6.5. Arrests in the Six Months prior to Follow-Up Interview by Site 

Birmingham Jacksonville Tacoma 

 Pre-BTC BTC Pre-BTC BTC Pre-BTC BTC 

(n = 137) (n = 250) (n = 234) (n = 205) (n =286) (n = 256) 

Any self-reported arrests 32% 14%*** 34% 38% 70% 57%** 

Any official arrest 39% 8%*** 50% 47% 50% 38%** 

SELF-RE P O RT VS . 

O FFI CI AL 

Correctly Reported 

Arrest or No Arrest 

73% 85% 67% 84% 69% 70% 

 Over-reported Arrest 10% 11% 9% 3% 26% 25% 

 Under-reported Arrest 17% 4% 24% 13% 5% 5% 

Phi Coefficient 0.42 0.29 0.36*** 0.69*** 0.41 0.44 

* p < .05 ** p < .01 *** p <.001 for differences between Pre-BTC and BTC samples within sites. 

The differences in reporting accuracy by the BTC and pre-BTC samples were not significant 

in Birmingham and Tacoma. However, a comparison of the two sites shows that both samples in 

Tacoma report more arrests than shown in official records, suggesting that some arrests were 

not reflected in those records. In Birmingham, discrepancies are more evenly divided between 

over- and underreporting. Nonetheless, the similarity in pattern between samples in both sites 

suggests that minimal bias is introduced by willingness to report offending. 

In Jacksonville, the difference in reporting accuracy between the pre-BTC sample and BTC 

sample was significant, with higher underreporting of arrests by the pre-BTC sample. Thus, in 

Jacksonville, possible underreporting of arrest by the pre-BTC sample compared with the BTC 

sample could (if correlated with underreported of offending) result in an underestimate of the 

effects of BTC on criminal activity when measured by self-reported offending. This would occur 

because the observed difference in self-reported offending would be smaller than it would be 

without denial on the part of the comparison sample. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 10 

SELF-REPORTED OFFENSES 

The hypothesis that BTC reduced criminal activity was tested with criminal offenses 

reported on the follow-up interviews. These self-report measures may be a more complete 

record of offending, because official measures of crime record only offenses detected by the 

authorities. The majority of offenses go undetected, so self-report measures provide important 

insight into the effectiveness of BTC. 

The survey instrument asked respondents to report the number of times they had 

committed 14 types of offenses in the past six months. Responses were used to create two 

summary measures of self-reported crime, both covering the six months before follow-up 

interview: (1) number of total offenses committed, regardless of type of offense and (2) number 

of drug offenses (sales/distribution) committed. These measures were then used to create 

dichotomous variables indicating any recidivism and any drug recidivism. 

Table 6.6 displays the number of reported offenses at baseline and follow-up by site. These 

results indicate that BTC participants self-reported considerably less recidivism of all types than 

the pre-BTC sample did, before controlling for other factors. In the analyses that follow, more 

rigorous analytic techniques are employed to control for the sample differences. 

Table 6.6. Self-reported Offenses in the 6 Months Prior to Interview by Site 

Birmingham Jacksonville Tacoma 

 Pre-BTC BTC Pre-BTC BTC Pre-BTC BTC 

(n = 137) (n = 245) (n = 312) (n = 215) (n =286) (n = 255) 

B ASELINE 

Number of Offenses 21.1 3.0*** 22.5 20.4 47.1 42.7 

(standard deviation) (50.1) (11.6) (49.5) (45.8) (63.2) (69.1) 

Number of Drug 

Offenses 

9.9 

(27.2) 

1.3*** 

(6.5) 

12.8 

(31.3) 

10.6 

(29.1) 

20.4 

(37.9) 

23.1 

(38.7) 

F O L L O W U P 

Number of Offenses 13.7 2.1 7.21 2.08 *** 27.6 10.6*** 

(36.9) (14.2) (25.29) (11.16) (55.8) (31.0) 

Number of Drug 8.7 1.3 3.07 1.75 16.6 6.7*** 

Offenses (22.5) (8.8) (15.57) (11.08) (35.1) (23.1) 

F O L L O W U P 

Any Offense 39% 21% 23% 11%*** 45% 26%*** 

Any Drug Offense 23% 10% 10% 6%** 30% 17%*** 

* p < .05 ** p < .01 *** p <.001 for differences between Pre-BTC and BTC samples within sites. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 11

Probit models were used to estimate BTC’s effect on the likelihood of any recidivism. 

Negative binomial estimation was used for the analysis of the number of offenses, a count 

variable with many zero values. Because the number of self-reported offenses has a skewed 

distribution (i.e., most respondents reported no offenses, but a small number reported 

substantial involvement in crime), this variable was recoded to censor the maximum number of 

offenses at the 95th percentile. Additional analyses were performed to determine if BTC 

participation affected the likelihood of drug use because of the substantive interest in BTC’s 

effect on drug crimes. This variable was heavily skewed by the presence of a few high-rate 

offenders so it was also recoded, with censoring at the 95th percentile. 

In Birmingham (table 6.7), the BTC sample was significantly less likely than the pre-BTC 

sample to report any criminal activity in the prior six months and any drug offense in the prior six 

months, after controlling for other variables. However, the number of offenses reported by the 

BTC sample was not significantly lower than the number reported by the pre-BTC sample. 

Table 6.7. Impact in Birmingham: Self-Reported Recidivism in the Six Months Prior to Follow-up 

Variable 

Any 

Offense 

Any Drug 

Offense 

Number of 

Offenses

Number of 

Drug Offenses 

BTC Treatmenta –0.883*** –0.328* –0.444 –0.600 

Age –0.002 –0.009 –0.010 –0.011 

Female –0.181 –0.197 –0.659 –0.701 

Black –0.301** 0.214 0.609 1.397 

Black*BTC Tx 0.788* — — — 

Education –0.072 –0.089* –0.326** –0.413 

Employ Bother 0.356** 0.509** 0.889 –0.360 

Employ Bother*BTC Tx –0.903** –1.085** –2.962*** — 

Days Worked –0.016 –0.014 –0.050** –0.049 

Months in Jail –0.002 –0.001 –0.006 –0.005 

On Probation 0.255 0.060 0.803 0.692 

Serious Offender 0.077 0.058 –0.315 –0.494 

Prior Offenses 0.002 0.007* 0.013 0.015 

Prior Drug Use 0.010* 0.008 –0.002 –0.002 

Constant 0.523 0.075 4.291*** 4.879 

Overdispersion 

Parameter 

— — 7.221*** 14.767*** 

 

N 382 382 382 382 

–2LL 44.87*** 37.64*** 83.88*** 25.52** 

Pseudo–R2 0.100 0.114 0.074 0.039 a

 Significance tests for this variable are one-tailed. 

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 12

In Jacksonville, the self-reported offending data show significantly lower rates of criminal 

activity among BTC participants than among the comparison group in the six months before the 

follow-up interview. The reductions in criminal activity were reflected in four summary measures: 

the likelihood of committing a crime, the likelihood of selling or possessing drugs, the number of 

offenses in the 14 categories combined, and the number of drug offenses. 

Table 6.8. Impact in Jacksonville: Self-Reported Recidivism in the Six Months Prior to Follow-up

Variable 

Any 

Offense 

Any Drug 

Offense 

Number of 

Offenses 

Number of 

Drug Offenses 

BTC Treatmenta –0.509*** –0.308* –1.016*** –0.853* 

Age 0.000 –0.019 –0.033 –0.075** 

Female –0.039 0.201 0.402 –0.069 

Black –0.001 0.297 1.032** 0.895 

Education –0.018 –0.042 –0.028 –0.093 

Married –0.623** –0.469 –2.679*** –1.442 

Days worked, past 30 0.001 0.001 –0.006 –0.001 

Months Incarcerated, lifetime –0.001 0.006 0.018 0.021* 

On Probation –0.016 –0.062 0.652 0.160 

Days Used Drugs, past 30 

(all drugs) 

 0.003 0.012** 0.012 0.023 

Prior Offenses, past 6 mos. 0.006*** 0.004** 0.014*** 0.011** 

Prior Arrests 0.031*** 0.008 0.044 0.052* 

Constant –0.954 –0.966 0.158 0.061 

 13.776*** 14.935** 

 

MODEL FIT 

N 484 484 484 484 

–2LL 61.570*** 37.040*** 39.500*** 28.86*** 

Pseudo–R2 0.138 0.134 0.040 0.063 

a

 Significance tests for this variable are one-tailed. 

*p < 0.10; **p < 0.05; ***p < 0.01 

In Tacoma, the self-reported offending data show significantly lower likelihood of criminal 

activity among BTC participants than among the comparison group in the six months before the 

follow-up interview on the two prevalence measures: any offending and any drug possession or 

sales. However, the number of offenses in these two categories, while lower among BTC 

participants, was not significantly lower than the number reported by the comparison group, and 

the models explained relatively little of the variance in number of offenses. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 13

Table 6.9. Impact in Tacoma: Self-Reported Recidivism in the Six Months Prior to Follow-up

Variable 

Any SelfReported 

Offense 

Any SelfReported Drug 

Offense 

Number of 

Offenses

Number of 

Drug 

Offenses 

BTC Treatmenta –0.367*** –0.303** –0.734 –0.726 

Age –0.121** –0.014 –0.017 –0.055 

Age squared 0.002** — 0.000 — 

Female 0.087 0.051 –0.033 0.151 

Black –0.025 0.097 –0.271 –0.324 

Education in years –0.030 –0.047 0.134 0.126 

Married –0.033 0.017 –0.050 0.983 

Days worked, past 30 –0.002 –0.007 –0.010 –0.003 

Months Incarcerated, lifetime 0.001 0.002 0.004 0.009 

On Probation/Parole 0.054 0.265* 0.386 1.109 

Prior Drug Use 0.010** 0.011** 0.027 0.043 

Prior Arrests 0.054*** 0.015 0.052 0.022 

Prior Offenses 0.004*** 0.005*** 0.008 0.011 

Constant 1.440 –0.432 0.755 0.245 

Overdispersion Parameter 10.324 17.901 

 

MODEL FIT 

N 523 523 523 523 

–2LL 93.16*** 76.24*** 43.76*** 36.15*** 

Pseudo–R2 0.138 0.140 0.019 0.021 

*p < 0.10; **p < 0.05; ***p < 0.01 

The predicted probabilities of reporting an offense in the six months before follow-up, with 

the other variables in the model held at their mean values, are shown for any offense in figure 

6.2. Figure 6.3 shows the predicted probability of a drug offense during this time. Figure 6.4 

shows the predicted number of offenses in these two categories in Jacksonville, the only site in 

which the BTC participants reported significantly fewer offenses. 

Comparing the multivariate results for the three sites shows that the BTC sample was 

significantly less likely than the pre-BTC sample to do the following: 

• Report an offense in the six months before follow-up (p < .01) in all three sites, although 

in Birmingham the significant differences were limited to comparisons of white 

defendants 

• Report any drug offense in the six months before follow up in all three sites (p < .10) 

• Use a stronger drug in the 30 days before follow-up (in Birmingham) 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 14 

In Jacksonville, the BTC defendants reported significantly fewer offenses (p < .01), 

including significantly fewer drug offenses (p < .10). 

Figure 6.2. Predicted Probability of Any Offense with Covariates Held at the Mean 

Pr(Y=1|x) 

50% 

BTC 

40% 39% Comparison 40% 

30% 26% 

28% 

27% 

20% 

20% 

10% 

11% 

9% 

0% 

Any Offense 

White (p<.01) 

Any Offense 

Black 

Jacksonville 

(p<.01) 

Tacoma 

(p<.01) 

Birmingham 

(p<.01) 

Figure 6.3. Predicted Probability of Drug Offenses with Covariates Held at the Mean 

Pr(Y=1|x) 

30% BTC 

25% 23% 

Comparison 

20% 

16% 15% 

15% 

10% 

10% 8% 

5% 4% 

0% 

Birmingham 

(p<.10) 

Jacksonville 

(p<.10) 

Tacoma 

(p<.05) 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 15 

Figure 6.4. Predicted Number of Any Offenses and Drug Offenses with 

Covariates Held at the Mean: Jacksonville 

Pr(Y=1|x) 

2

BTC

Comparison

1.5 1.4 

1 

0.51 

0.5 

0.2 

0.08 

0

Number of Any Offenses Number of Drug Offenses

(p<.05) (p<.10)

Jacksonville Jacksonville 

OFFICIAL ARRESTS 

The analysis first assesses BTC’s effect on the likelihood and number of officially recorded 

arrests in the 12 months after sample entry, controlling for offender characteristics and criminal 

history. Because one of the focuses of the BTC project was to reduce substance-abuse-related 

crime, there is a substantive interest in drug offenses, so separate analyses were conducted to 

ascertain whether BTC had an effect on drug offenses. Probit analysis is used for dichotomous 

outcomes (e.g., any rearrest) and negative binomial models are used in the analysis of court 

outcomes (e.g., number of rearrests). 

Table 6.10 shows the rearrest rates in each site by sample without controlling for 

differences in sample characteristics. The results suggest that, on several measures, BTC 

participants in Birmingham and Tacoma were less likely to recidivate during the year after 

sample entry. These findings were confirmed by the multivariate modeling results. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 16 

Table 6.10. Official Recidivism in the 12 months Following Sample Entry

 Birmingham Jacksonville Tacoma 

Pre-BTC BTC Re-Arrest sample sample Outcome (n = 137) (n = 250)  Pre-BTC BTC Pre-BTC BTC 

sample sample sample sample 

(n = 309) (n = 334) (n =351) (n = 382) 

Any Re-Arresta 59% 24%*** 43% 50% 60% 45%*** 

Number of Re-Arrests 1.28 

(SD) (1.47) 

Any Drug Re-Arresta 25% 

0.38*** 0.63 0.77 1.19 0.82*** 

(0.81) (0.92) (0.97) (1.54) (1.15) 

12%** 13% 25% 32% 26% 

Number of Drug 0.43 0.14*** 0.17 0.33 0.43 0.33* 

Re-Arrests (SD) (0.90) (0.41) (0.50) (0.63) (0.73) (0.63) 

a

 One-tailed Chi-square tests. 

* p < .05 ** p < .01 *** p <.001 for differences between Pre-BTC and BTC samples within sites. 

In Birmingham (table 6.11), BTC sample members were significantly less likely to be 

arrested in the 12 months after entering the study and had significantly fewer arrests during that 

time than the comparison group did. The results show that BTC’s effects on arrest in 

Birmingham varied by race. For both racial groups, BTC participation significantly reduced the 

likelihood of being rearrested; however, this effect was considerably stronger for whites. The 

“average” African American in the BTC sample was predicted to have half as many arrests as 

the “average” African American in the comparison sample; the difference between white sample 

members in the two groups was smaller, but still significant.9 The same results are found 

regardless of whether the selection bias correction is omitted or included. The selection 

correction does not significantly improve the model fit to these data; therefore, the conclusions 

and predicted probabilities are based on the models without the selection correction. 

9

 Note that in the current context, the average offender is an imaginary person who has all of the average 

characteristics of the entire sample. Thus, these estimates do not apply to any one person in the data set, but are 

approximations of BTC’s overall impact. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 17

Table 6.11. Impact in Birmingham: The Probability of Arrest and 

Number of Arrests in the 12 months After Sample Entry 

Variable 

Any 

Arrests 

Number of 

Arrests 

Any Drug 

Arrests 

Number of 

Drug Arrests 

BTC Treatmenta –1.248*** –1.614*** –0.407** –0.915*** 

Age –0.011 –0.017* –0.002 –0.005 

Female –0.054 –0.051 –0.025 –0.307 

Black –0.355 –0.334 0.091 –0.004 

Black*BTC Tx 0.647** 0.907** — — 

Education 0.030 0.026 0.069 0.080 

Employ Bother 0.124 0.160 –0.136 0.012 

Days Worked –0.011 –0.011 –0.009 –0.016 

Months in Jail –0.002 –0.002 –0.001 –0.006 

On Probation –0.182 0.087 –0.206 –0.356 

On Probation*BTC Txb 0.635** — — — 

Serious Offender 0.049 0.169 0.021 0.026 

Prior Arrests 0.018 0.028** 0.020 0.045** 

Prior Offenses 0.001 0.003 0.003 0.003 

Prior Drug Use –0.002 0.002 0.001 0.003 

Constant 0.431 0.301 –1.545*** –1.801** 

Overdispersion Parameter — 0.769*** — 1.689*** 

 

N 387 387 387 387 

–2LL 64.81*** 71.93*** 23.04** 28.71*** 

Pseudo–R2 0.127 0.081 0.066 0.062 

a

 Significance tests for this variable are one-tailed. 

b

 This interaction is mean-centered; i.e., the overall sample mean has been subtracted from any observation. Thus, when this term 

equals zero, the BTC treatment variable is evaluated at the mean level of Probation. 

*p < 0.10; **p < 0.05; ***p < 0.01 

There is no evidence that BTC in Jacksonville reduced the likelihood or number of rearrests 

in the year after program entry (table 6.12). This finding stands in sharp contrast to the lower 

rates of crime reported by BTC sample members than pre-BTC sample members on the followup survey. It also conflicts with the finding that BTC sample members reported more officially 

recorded arrests than the pre-BTC sample members did. It is not clear whether the conflicting 

findings reflect differences in arrest practices, record keeping, or actual differences in 

recidivism.10 Risk of rearrest declined as the number of days of work in the past month 

 

10 Criminal history checks in Jacksonville involved detailed checks of NCIC and local records and included all new 

offenses except traffic violations. However, prior arrests were measured by arrests recorded in NCIC, which could 

have reduced the effectiveness of controls for prior offenses. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 18

increased, and past crime, either prior arrests or self-reported offending prior to the baseline, 

increased the risk of rearrest in three of four models. However, none of the models explained a 

large portion of the variation in recidivism as indicated by pseudo-R2 values of .04 or smaller. 

Table 6.12. Impact in Jacksonville: Any Re-Arrests in the 12 months Following Sample Entry 

Variable 

Any 

Arrest 

Number of 

Arrests 

Any 

Drug Arrest 

Number of 

Drug Arrests 

BTC Treatmenta 0.224 –0.209 0.083 0.733 

Age –0.006 –0.005 0.002 0.003 

Female 0.006 0.060 –0.111 –0.034 

Black 0.011 0.002 –0.005 0.058 

Education –0.015 –0.001 –0.002 –0.008 

Married –0.224 –0.321* –0.159 –0.106 

Days worked, past 30 –0.006 –0.015** –0.012* –0.031*** 

Months Incarcerated, lifetime –0.001 –0.004 0.001 0.000 

On Probation –0.249* –0.226 –0.237 –0.125 

Days Used Drugs, past 30 

(all drugs) 0.003 0.004 0.006 0.006 

Prior Offenses, 6 mos. before 

baseline 0.003*** 

 0.001 

 0.003** 0.003 

Prior Arrests 0.019** 0.019*** 0.002 0.004 

Constant 0.030 –0.137 –0.977** –1.772 

Overdispersion Parameter — 0.249*** — 0.927*** 

Selection Bias Correction — 0.369** 0.324* — 

 

MODEL FIT 

N 643 643 643 643 

–2LL 29.790*** 34.220*** 20.98* 31.860*** 

Pseudo–R2 0.034 0.039 0.034 0.040 

a

 Significance tests for this variable are one-tailed. *p < 0.10; **p < 0.05; ***p < 0.01 

The results displayed in table 6.13 demonstrate that in Tacoma, BTC significantly reduced 

both the likelihood of an arrest and the number of arrests incurred in the 12 months after sample 

entry, controlling for other variables. Before selection bias is controlled for, BTC’s effect on 

recidivism is statistically significant and modest in magnitude; after controlling for selection bias, 

BTC’s effect on recidivism remains statistically significant but increases considerably in 

magnitude. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 19

Table 6.13. Impact in Tacoma: Probability of Arrest and 

Number of Arrests in the 12 months After Sample Entry 

Variable 

Any 

Arrest 

Number of 

Arrests 

Any 

Drug Arrest 

Number of 

Drug Arrests 

BTC Treatmenta –1.284*** –0.934*** –0.909*** –1.028** 

Age –0.079** –0.097** 0.026 0.031 

Age squared 0.001* 0.001** 0.000 0.000 

Female –0.258** –0.314** –0.301*** –0.272 

Black 0.129 0.057 –0.016 0.048 

Education in years 0.022 –0.007 –0.038 –0.030 

Married 0.079 0.091 0.208 0.227 

Days worked, past 30 –0.012* –0.017** –0.014* –0.015 

Months Incarcerated, 

lifetime 

–0.002 –0.002 –0.001 –0.003* 

On Probation/Parole 0.181* 0.026 0.278*** 0.253 

Prior Drug Use –0.008** –0.004 –0.004 –0.002 

Prior Offenses 0.001 0.001** 0.000 0.001* 

Prior Arrests 0.056*** 0.052*** 0.009 0.014 

Constant 1.575** 1.999*** –0.164 –0.955 

Selection Correctionb 0.722*** 0.425** 0.527*** 0.549** 

Overdispersion Parameter — 0.550*** — 0.522*** 

 

MODEL FIT 

N 677 677 677 677 

–2LL –122.67*** –95.07*** 37.950*** 26.120** 

Pseudo–R2 0.131 0.051 0.047 0.024 

a

 Significance tests for this variable are one-tailed. 

b

 In the Bivariate Probit this term refers to the correlation between the error terms (Rho); in the Negative Binomial models this term 

refers to the Inverse Mills Ratio

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 20 

Separate analyses were conducted to test the hypothesis that BTC reduced arrests for drug 

offenses. The dependent variable in the first set of drug rearrest models is the probability of 

rearrest on a drug charge; the dependent variable in the second set of models is the number of 

rearrests on drug charges. BTC was significantly related to lower likelihood of rearrest on a drug 

offense after controlling for selection bias and resulted in fewer arrests for drug offenses in the 

first year after entry. 

Figure 6.5. Predicted Probabilities of an Arrest with 

Covariates Held at the Mean [Pr(Y=1|x)] 

100% 

BTC 

80% Comparison 80% 

65% 

60% 51% 

40% 

28% 26% 

20% 

19% 

0% 

Any Arrest Any Arrest Any Arrest 

Black White (p < .05) Tacoma 

Birmingham 

p < 0.1 

p < 0.1 

Figure 6.6. Predicted Probabilities of a 

Drug Arrest (Possession or Sales) with 

Covariates Held at the Mean [Pr(Y=1|x)] 

100% 

BTC 

Comparison 80% 

60%

45%

40% 

22% 

20% 15% 12% 

0%

Any Drug Any Drug

Arrest Arrest

Birmingham Tacoma 

p < .05 p < .01 

Figure 6.7. Predicted Number of Arrests with Covariates 

Held at the Mean [Pr(Y=1|x)] 

2

BTC

Comparison 1.6 1.44 

1.28 

1.2 

0.93 

0.8 

0.46 

0.4 

0

Num. of Arrests Num. of Arrests Number of 

Black White (p < .05) Arrests

0.26 

0.57 

Birmingham Tacoma 

p < .01 p < .01 

Figure 6.8. Predicted Number of Drug 

Arrest(s) (Possession or Sales) with 

Covariates Held at the Mean [Pr(Y=1|x)] 

2

BTC

Comparison 1.6 

1.2 

0.8 0.61 

0.4 0.344 

0.22 0.138 

0

Number of Number of

Drug Arrests Drug Arrests 

Birmingham Tacoma 

p < .01 p < .05 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 21 

The predicted probabilities of arrest in year after sample entry, with the other variables in 

the model held at their mean values, are shown for any offense in figure 6.5 and for drug 

offenses in figure 6.6 for Birmingham and Tacoma, the two sites in which significant differences 

were found. Figures 6.7 and 6.8 show the predicted number of arrests in these two categories in 

Birmingham and Tacoma during this time. 

The results of the multivariate analysis are as follows: 

• BTC defendants were significantly less likely than pre-BTC defendants to be arrested at 

least once for any offense and for a drug offense in the year after the initial arrest in both 

Birmingham and Tacoma, but not in Jacksonville. 

• BTC defendants had significantly fewer arrests and significantly fewer drug arrests than 

the pre-BTC defendants in the year after the initial arrest in both Birmingham and 

Tacoma, but not in Jacksonville. 

• In Birmingham, BTC effects varied by race. Reductions in the likelihood of arrest and 

number of arrests were significantly greater among white than black BTC participants (p 

< .05). 

BTC was also hypothesized to delay time to recidivism; therefore, the analysis also 

examined time to rearrest. Survival analysis was used to test this hypothesis. Specifically, Cox 

regression was used to estimate time to rearrest for the treatment and control groups, while 

controlling for the same list of factors as in the above analyses of rearrests. The results of this 

analysis are presented in table 6.14. These results show that the time to first rearrest was 

significantly longer for BTC participants than for pre-BTC sample members in Birmingham and 

Tacoma (hazard ratios are below one) but significantly shorter for BTC participants than for preBTC sample members in Jacksonville (hazard ratio above one). The shorter time to first rearrest 

for the BTC sample in Jacksonville was consistent with the finding of no reduction in the 

likelihood of arrest. 
PART II. BTC Impact 

Chapter 6. BTC Impact on Drug Use and Crime II – 22

Table 6.14. Time to First Re-Arrest in Birmingham (Cox Regression Hazard Ratios) 

 Birmingham Jacksonville Tacoma 

BTC Treatmenta 0.404*** 1.395*** 0.267*** 

Age 0.990 0.992 0.901** 

Age squared — — 1.001** 

Female 1.065 0.979 0.765** 

Black 0.996 0.983 1.148 

Education in years 1.048 0.995 1.046 

Married — 0.733 1.140 

Employment Bothers 1.209 — — 

Days worked, past 30 0.988 0.988* 0.982** 

Months Incarcerated, lifetime 0.998 1.000 1.000 

On Probation/Parole 1.121 0.765 1.386*** 

Serious Offender 1.143 — — 

Prior Drug Use 1.019 1.004 0.994 

Prior Offenses 1.002 1.003** 1.001 

Prior Arrests 0.999 1.013* 1.042*** 

Selection Correctionb — — 1.960*** 

MODEL FIT 

N 387 

(245 Censored) 

643 

(344 Censored) 

677 

(333 Censored) 

–2LL 52.96*** 35.12*** 108.46*** a

 Significance tests for this variable are one-tailed. 

b

 This term refers to the Inverse Mills Ratio to correct for the probability of inclusion in the sample as described in Appendix A.

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 23 

CHAPTER 7. 

THE IMPACT OF BREAKING THE CYCLE ON 

EMPLOYMENT, FAMILY, AND HEALTH PROBLEMS 

Participation in Breaking the Cycle was hypothesized to lead directly and indirectly to 

improvements in social well-being. This chapter tests the hypothesis that BTC participation 

led to reductions in medical, psychological, employment, social, or family problems. The severity 

of problems was measured by self-report data collected in interviews using a modified version of 

the Addiction Severity Index (ASI). The analysis examines composite scale scores of problems 

during the 30 days before the follow-up, controlling for problems reported at baseline. 

The results show that, in all three sites, the severity of family problems at follow-up was 

significantly lower for the BTC samples than the pre-BTC samples, controlling for other factors 

and the severity of family problems at baseline. Other findings varied by site. In Tacoma, but not 

in Birmingham and Jacksonville, BTC participants reported greater reductions than the pre-BTC 

comparison sample in severity of psychological problems, employment difficulties, and social 

difficulties. In Jacksonville, but not in other sites, BTC was associated with a significant 

reduction in employment problems. 

The variables used to measure problem severity included the following ASI problem 

severity composite scores: 

• Medical Problems is composed of three equally weighted items. Respondents are 

asked how many days they have experienced medical problems, how troubled they have 

been by these medical problems, and how important treatment is for these medical 

problems. 

• Psychological Problems is composed of 11 equally weighted questions asking if 

respondents have experienced significant psychological problems in the past 30 days, 

how many days they have experienced these psychological problems, how bothered 

they have been by these psychological problems, and how important treatment for these 

problems is. 

• Employment Problems is composed of four equally weighted questions asking 

respondents how many days they have been paid for working in the past 30 days, how 

much money they received from working, and about the respondent’s access to an 

automobile. 

• Family Problems is composed of five equally weighted questions asking respondents 

about their satisfaction with their current marital status, how many days in the past 30 

they have had serious conflicts with family members, how troubled they have been by 

family problems, and how important treatment is for these family problems. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 24 

In addition to these four ASI composite measures, we created two other composite scores 

from the interview items. 

• Employment Difficulties is based on three equally weighted questions: How many 

days have you experienced employment problems in the past 30 days? How troubled or 

bothered have you been by these employment problems? How important to you is 

counseling for these employment problems? Unlike the ASI employment composite 

score, which is concerned with objective measures of employment (e.g., how much 

money respondents earned in the past 30 days), these composite scales measure 

respondents’ perceptions of the severity of their problems. 

• Social Difficulties measures recent conflicts/problems with non-family members, based 

on three equally weighted questions: How many days in the past 30 have you had 

serious conflicts with other people (excluding family members)? How troubled have you 

been by these social problems? How important to you is treatment for these social 

problems? 

The following sections begin with a basic analysis of changes in the composite scale 

scores, comparing the baseline scores, the follow-up scores, and the change scores (follow-up 

score minus baseline score) for the BTC sample with scores for the pre-BTC sample in each 

site. Scores on all composite scales range from 0 to 1, with higher scores indicating more serious 

problems.11 For the change scores, smaller numbers indicate greater reductions in problems. 

The scores illustrate the magnitude of the differences observed directly at each time point and 

the relative rate of change, without adjusting for differences in the samples, noted in earlier 

chapters. All significance tests are two-tailed. 

To adjust for the significant differences in samples, multivariate analysis of the significant 

differences between samples using the procedures described in appendix A follows. This 

analysis tests the hypothesis that the BTC participants had lower problem scores at follow-up 

than did the pre-BTC sample (one-tailed test), using models that control for demographic 

variables, prior criminality, number of days incarcerated in the past 30 days, and other variables 

related to sample differences at baseline. Tobit was used on scores that had a high percentage 

of respondents who did not report any problems and thus violated the normality assumption 

necessary for ordinary least squares (OLS) regression (see Long 1997). 

11 Scale and item means and Cronbach alphas are shown in appendix C. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 25 

BIRMINGHAM 

Table 7.1 compares the six composite scores for the BTC and pre-BTC groups who 

completed both interviews. At baseline, the BTC group had significantly lower scores on three 

ASI composite scales: medical (p < .05), employment (p < .01), and family problems (p < .01). 

At follow-up, significant differences between the two groups remained on the employment and 

family problems scales (p < .01). While the scores indicate a reduction in problems for most 

measures, the severity of employment and medical problems actually rose for the BTC 

participants, and change between the baseline and follow-up was significantly different between 

the two samples on these measures. However, these differences do not control for sample 

differences. 

Table 7.1. ASI Problem Severity Scores by Group and Interview 

Pre-BTC BTC 

ASI Score (n=137) (n=245) 

Medical Problems Score 

Baseline 0.183 0.106** 

Follow-up 0.131 0.114

 Change –0.052 +0.008* 

Employment Problems Score 

Baseline 0.805 0.577*** 

Follow-up 0.754 0.604*** 

 Change –0.051 +0.027*** 

Family Problems Score 

Baseline 0.168 0.076*** 

Follow-up 0.124 0.044*** 

 Change –0.043 –0.032 

Psychological Problems Score 

Baseline 0.222 0.070 

Follow-up 0.108 0.062

 Change –0.114 –0.008 

NEW COMPOSITE ME AS URES 

Employment Difficulties Score 

Baseline 0.289 0.121 

Follow-up 0.216 0.119

 Change –0.073 –0.002 

Social Difficulties Score 

Baseline 0.068 0.023 

Follow-up 0.070 0.026

 Change +0.002 +0.003 

*p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 26

The multivariate modeling in table 7.2 shows significantly greater reductions in family 

problems (indicated by the negative sign to the significant coefficient for BTC treatment) for BTC 

participants than for the pre-BTC sample, once controls for sample differences are introduced. 

Although the reductions in problems in other areas were not significant, the coefficients on the 

parameter estimates for BTC were negative on five of the six scales, suggesting an overall 

pattern of problem reduction. 

Table 7.2. BTC in Birmingham: Changes in Health, Employment, Family/Social, and 

Psychological Problems, controlling for Defendant Characteristics and Sample Differences 

Variable 

Medical 

Problems 

Employment 

Problems a Family 

Problems 

Psychological 

Problems 

Employ 

Difficulties 

Social 

Difficulties 

BTC Treatment –0.019 0.038 –0.084** –0.056 –0.135 –0.108 

Age 0.017*** 0.001 0.003 0.012*** –0.010* 0.003 

Female 0.184 –0.046 0.029 0.076 0.003 0.106 

Black –0.038 0.086*** –0.060* –0.081 0.093 –0.029 

Education –0.027 –0.017*** –0.001 –0.017 –0.004 0.001 

Married 0.252* –0.011 0.024 –0.041 0.181 0.043 

Days worked, past 30 0.000 0.005*** –0.003* 0.000 –0.012** –0.004 

Month Incarcerated, lifetime 0.003 0.000 0.000 –0.001 0.000 0.000 

On Probation 0.072 –0.007 0.040 0.029 –0.103 0.025 

Prior Offenses 0.001 0.000 –0.001 0.001 0.000 0.001 

Prior Arrests –0.010 –0.002 0.000 –0.011 0.001 0.000 

Prior Drug Treatments –0.012 0.019 0.016 0.009 0.094*** 0.043* 

Live with Drug User 0.263 0.032* 0.080 0.190* 0.204 0.058 

Heavy Drug Use –0.005 0.001 0.000 –0.001 –0.002 –0.003 

Prior Medical Problems 0.689*** — — — — — 

Prior Employment Problems — 0.634*** — — 0.146 — 

Prior Family/Social Problems — — 0.329*** — — 0.471* 

Prior Psychological 

Problems — — — 0.580*** — — 

Days in Jail, past 30 –0.018*** 0.008  –0.001 0.001 –0.001 –0.007**  

Time between Interviews 0.001* 0.000 0.000 0.000 0.000 0.000 

Constant –1.149*** 0.213** –0.134 –0.407* 0.174 –0.534** 

Sigma 0.707*** — 0.234*** 0.417*** 0.659*** 0.381*** 

 

MODEL FIT 

N 359 359 359 359 359 359 

Pseudo–R2

 0.130*** 0.527*** 0.226*** 0.155*** 0.076*** 0.133*** 

*p < 0.10; **p < 0.05; ***p < 0.01 

a

 The results from this model are based on an OLS regression; the other models were estimated using Tobit regression. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 27 

The models also show other significant predictors of changes in problems at the time of 

follow-up. Current medical problems increased significantly with age. They decreased as the 

number of past-month jail days increased, suggesting that jail medical care may have been 

received. Somewhat surprisingly, current medical problems were marginally higher among those 

who were married, controlling for other variables in the model. Current employment problems 

had the expected correlates. African Americans had more severe employment problems. Those 

with fewer years of education and few days of employment in the month before the baseline 

interviews also had increased employment problems, controlling for other factors. Similarly, 

current employment problems increased with the number of days in jail in the month before 

follow-up. A history of drug treatment increased employment difficulties. Family problems were 

marginally more severe among African Americans and increased as days of work in the month 

before baseline increased. Psychological problems increased in severity with age and were 

marginally higher among those who lived with a substance abuser. Social difficulties increased 

as days in jail in the month before baseline decreased and were marginally higher among those 

with a history of drug treatment. 

JACKSONVILLE 

Table 7.3 compares the six composite scores of respondents from the BTC and pre-BTC 

groups who completed both interviews. At baseline, the BTC group had lower scores on the 

employment (p < .01) and psychological problems (p < .05) scales. Furthermore, the BTC 

scores on the social difficulties scale were somewhat lower (p < .10). At follow-up, the BTC 

sample had significantly less severe problems than the pre-BTC sample in four of the six areas: 

employment problems (p < .01), employment difficulties (p < .01), family problems (p < .05), and 

psychological problems (p < .01). 

Two findings in table 7.3 are noteworthy. First, all of the change scores are negative for 

both groups, indicating that both groups consistently reported less severe problems on the 

follow-up interview than on the baseline interview. Second, only in the case of employment 

difficulties was the change score for BTC significantly different (and larger) than the reduction in 

problems reported by the pre-BTC sample (p < .10). It is evident that the groups’ average 

reduction in severity of problems was virtually indistinguishable in the areas of employment and 

psychological problems. Although the differences between the groups’ change scores on the 

medical and family problems scales appear large, they are not statistically significant. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 28 

Table 7.3. Jacksonville Composite Problem Scores by Group and Interview 

Pre-BTC BTC 

ASI Score (n=310) (n=215) 

Medical Problems Score 

Baseline 0.198 0.222 

 Change –0.090 –0.104 

Employment Problems Score 

Baseline 0.695 0.595*** 

Follow-up 0.108 0.118

Follow-up 0.638 0.536*** 

 Change –0.057 –0.059 

Family Problems Score 

Baseline 0.149 0.121 

Follow-up 0.090 0.051** 

 Change –0.059 –0.070 

Psychological Problems Score 

Baseline 0.219 0.177** 

Follow-up 0.130 0.084*** 

 Change –0.080 –0.093 

NEW COMPOSITE ME AS URES 

Employment Difficulties Score 

Baseline 0.202 0.205 

Follow-up 0.154 0.102** 

 Change –0.048 –0.104* 

Social Problems Score 

Baseline 0.099 0.073* 

Follow-up 0.046 0.031

 Change –0.053 –0.042 

Significance of difference between the BTC and pre-BTC samples: 

*p < 0.10; **p < 0.05; ***p < 0.01 

The first column in table 7.4 displays the results of the analysis of BTC’s effect on medical 

problems. These results show that BTC did not significantly alter clients’ medical well-being, 

independent of the other variables in the model. Medical problems increased with age, as 

expected, and were more severe among women and those who had received drug treatment 

prior to the baseline. 

The OLS regression analysis assessing BTC’s effect on severity of employment problems12 

found that, independent of other factors, BTC significantly reduced employment problems. 

Employment problems were more severe among African Americans, increased with days in jail 

in the month before baseline, and increased as years of education decreased. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 29

Table 7.4. Impact in Jacksonville: BTC’s Impact on Well-Being 

Variable 

Medical 

Problems 

Employment 

Problems a Family 

Problems 

Psychological 

Problems 

Employ 

Difficulties 

Social 

Difficulties 

BTC Treatment 0.012 –0.058** –0.140*** –0.012 –0.075 –0.145 

Age 0.028*** 0.001 0.002 0.002 0.001 –0.007 

Female 0.505*** –0.001 0.022 0.108* –0.050 0.181* 

Black 0.190 0.092*** –0.003 –0.010 0.298*** –0.054 

Education 0.027 –0.020*** 0.007 0.008 –0.010 0.018 

Married 0.382* 0.018 –0.106 –0.046 0.166 –0.086 

Days worked, past 30 –0.007 0.002 –0.001 0.001 –0.010* –0.004 

Months Incarcerated, lifetime 0.002 –0.001* 0.001 0.001 –0.004 0.002 

On Probation 0.242 0.007 0.015 0.130** 0.375*** 0.063 

Prior Offenses –0.001 0.001 0.001 0.001 0.001 0.001 

Prior Arrests 0.004 0.003** 0.001 –0.002 0.010 –0.003 

Prior Drug Treatments 0.028 0.001 –0.006 0.015 –0.013 0.006 

Age First Used Drugs –0.018 –0.002 0.001 –0.005 –0.006 0.001 

Live with Drug User 0.004 –0.055 0.085 0.015 –0.217 0.064 

Heavy Drug Use 0.011** 0.001 0.002 0.001 –0.004 0.002 

Prior Medical Problems 0.702*** — — — — — 

Prior Employment Problems — 0.482*** — — 0.670*** — 

Prior Family/Social Problems — — 0.348*** — — 0.503*** 

Prior Psychological Problems — — — 0.874*** — — 

Days in Jail, past 30 –0.006 0.010*** 0.028*** 0.004* –0.029*** 0.053*** 

Days in Jail, squared — — –0.001*** — — –0.002*** 

Time between Interviews –0.001 0.001 0.001 0.001** 0.001 0.001 

Constant –2.478*** 0.403*** –0.314* –0.703*** –0.561 –0.490 

Sigma 1.050 — 0.346 0.382 0.745 0.489 

 

MODEL FIT 

N 465 466 457 441 460 466 

Pseudo–R2

 0.142*** 0.398*** 0.104  0.237** * 0.125*** 0.130*** 

*p < 0.10; **p < 0.05; ***p < 0.01 

a

 The results from this model are based on an OLS regression. 

Family problems were significantly lower among BTC participants than the pre-BTC 

sample, controlling for other factors. However, BTC participation had no significant impact on 

respondents’ reports of psychological problems. Psychological problems at follow-up were 

marginally higher among women and significantly higher among those who were on probation at 

the time they entered the sample. 

The last two columns in table 7.4 present the results of the analyses of the employment 

difficulties and social difficulty severity scores. While the analysis of perceived employment 

 

12 OLS regression was used in this analysis because the dependent variable’s distribution resembled the normal 

distribution much more closely than the other dependent variables analyzed in this chapter. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 30 

difficulties in table 7.3 preliminarily indicated that BTC clients exhibited a larger reduction in 

employment difficulties than the comparison group did, this difference disappears once other 

factors are taken into account. The final column shows that BTC participation did not result in a 

reduction in social difficulties. 

TACOMA 

Table 7.5 compares the six composite scores for the BTC and pre-BTC groups that 

completed both interviews. At baseline, the BTC group had significantly lower scores on four of 

the six composite scales: employment problems (p < .10), family problems (p < .05), 

employment difficulties (p < .05), and social difficulties (p < .05). Although both groups reported 

a decline between baseline and follow-up in problems in all areas, the only significant reductions 

occurred in the domains of psychological problems and employment difficulties. 

Table 7.5. Tacoma Composite Problem Scores by Group and Interview 

BTC Pre-BTC 

ASI Score (n=286) (n=256) 

Medical Problems Score 

Baseline 0.295 0.241 

Follow-up 0.279 0.235

 Change –0.016 –0.006 

Employment Problems Score 

Baseline 0.791 0.824* 

Follow-up 0.778 0.813

 Change –0.013 –0.011 

Family Problems Score 

Baseline 0.163 0.202** 

Follow-up 0.094 0.149*** 

 Change –0.069 –0.053 

Psychological Problems Score 

Baseline 0.272 0.284 

Follow-up 0.187 0.240** 

 Change –0.085 –0.044* 

NEW COMPOSITE ME AS URES 

Employment Difficulties Score 

Baseline 0.189 0.248** 

Follow-up 0.180 0.174

 Change –0.009 –0.074** 

Social Difficulties Score 

Baseline 0.121 0.168** 

Follow-up 0.063 0.106** 

 Change –0.058 –0.062 

Significance of difference between the BTC and pre-BTC samples: *p < 0.10; **p < 0.05; ***p < 0.01 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 31

Table 7.6. Impact in Tacoma: BTC’s Impact on Well-Being 

Variable 

Medical 

Problems 

Employment 

Problems a Family 

Problems 

Psychological 

Problems 

Employ 

Difficulties

Social 

Difficulties

BTC Treatment 0.064 0.036 –0.119*** –0.105** –0.143** –0.192*** 

Age 0.007* 0.002* –0.001 0.002 –0.001 –0.004 

Female 0.066 –0.001 0.034 0.016 –0.050 0.140** 

Black 0.034 0.034 0.019 0.004 0.130** 0.074 

Education 0.031 –0.033*** –0.003 –0.038*** –0.023 0.032* 

Married –0.069 –0.041 0.066 0.003 0.060 0.086 

Days worked, past 30 –0.003 0.005*** –0.003 –0.004* –0.003 –0.001 

Months Incarcerated, lifetime 0.002 0.000 0.000 0.003*** 0.002 0.000 

On Probation –0.075 –0.017 0.034 –0.006 0.010 0.038 

Prior Offenses 0.001 0.001 0.001 0.001 0.001 0.000 

Prior Arrests –0.005 0.004* 0.005* –0.002 –0.005 0.010** 

Prior Drug Treatments 0.024** 0.004 0.006 0.001 0.002 0.005 

Age First Used Drugs –0.001 –0.001 –0.003 –0.002 –0.014** –0.014** 

Live with Drug User –0.009 0.011 0.034 0.019 0.157** 0.020 

Heavy Drug Use 0.002 0.001 0.002* 0.001 –0.004** 0.000 

Prior Medical Problems 0.459*** — — — — — 

Prior Employment Problems — 0.565*** — — 0.322*** — 

Prior Family/Social Problems — — 0.372*** — — 0.424*** 

Prior Psychological Problems — — — 0.695*** — — 

Days in Jail, past 30 –0.002 0.007*** 0.023*** 0.004* –0.009*** 0.036*** 

Days in Jail, squared — — –0.001*** — — –0.001*** 

Time between Interviews –0.001 0.001 –0.001** 0.001 –0.001** –0.001 

Constant –0.604** 0.514*** 0.144 0.397** 0.830*** –0.372 

Sigma 0.554 — 0.282 0.349 0.491 0.423 

 

MODEL FIT 

N 515 512 507 488 508 516 

R2

 0.087*** 0.330*** 0.198*** 0.206*** 0.071*** 0.146*** 

*p < 0.10; **p < 0.05; ***p < 0.01 

a

 The results from this model are based on an OLS regression. 

BTC participants had a significantly larger decrease in psychological problems than the preBTC sample did. This decrease may have resulted from their contacts with case managers who 

worked with them to seek drug treatment. However, employment difficulties decreased 

significantly more for the comparison group (for which difficulties were higher to start with) than 

for the BTC sample, possibly because the former were not involved in time-consuming BTC 

requirements. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 32 

The multivariate models that controlled for sample differences found a slightly different 

pattern, but also indicated reductions in problems in multiple areas. BTC participants had 

significantly lower scores on four of the six composite scales: psychological problems, family 

problems, employment difficulties, and social difficulties. The severity of medical problems, while 

not related to BTC, increased with age and the number of drug treatment episodes prior to 

baseline (an indicator of length and severity of drug use). The severity of employment problems 

(the ASI composite score) increased with days in jail in the month before baseline, increased as 

years of education decreased, and increased as days of work in the month before baseline 

decreased. Other findings on factors that affected outcomes independently of the significant 

effects of BTC showed that (1) psychological problems increased in severity as years of 

education decreased and months of prior incarceration increased; (2) employment difficulties 

were more severe among African Americans and those who lived with drug users, increased as 

age of first drug use decreased, and increased as heavy drug use in month before baseline 

decreased; and (3) social difficulties were more severe among women, increased with the 

number of prior arrests, and increased as age of first drug use decreased. 

SUMMARY OF BTC’S EFFECTS ON 

EMPLOYMENT, FAMILY/SOCIAL, AND HEALTH PROBLEMS 

In all three sites, the severity of family problems at follow-up was significantly lower for the 

BTC samples than for the pre-BTC samples, controlling for other factors and the severity of 

family problems at baseline. However, evidence of reduction in other problem domains was 

mixed. Tacoma BTC participants reported greater reductions than the pre-BTC comparison 

group did in the severity of psychological problems, employment difficulties, and social 

difficulties. However, these gains were not observed in the other BTC sites. In Jacksonville, but 

not in other sites, BTC was associated with a significant reduction in employment problems. 

Figures 7.1 through 7.3 illustrate the difference between the BTC and comparison samples 

at follow-up on those composite measures found to differ significantly on employment, 

family/social, and health problems. The estimates show difference in composite scores, holding 

other variables in the model at their average values. 
PART II. BTC Impact 

Chapter 7. The Impact of Breaking the Cycle on Employment, Family, and Health Problems II – 33 

Figure 7.1. Predicted Probabilities of Family Problems with 

Covariates Held at the Mean 

0.14 

BTC 

0.12 

0.12 Comparison 

0.1 

0.08 0.08 

0.08 0.07 

0.06 0.05 

0.04 

0.04 

0.02

0

Birmingham Jacksonville Tacoma 

(p<.05) (p<.01) (p<.01) 

Figure 7.2. Predicted Probabilities of 

Employment Differences with Covariates 

Held at the Mean 

0.4

BTC

Comparison 

0.3 

0.2 0.18 

0.13 

0.1 

0.05 0.06 

0 

Jacksonville Tacoma 

Employment Employment

Problems Difficulty 

(p<.05) (p<.05) 

Figure 7.3. Predicted Probabilities of 

Other Problem Reductions with Covariates 

Held at the Mean 

0.4

BTC

Comparison 

0.3 

0.21 

0.2 0.17 

0.08 0.1 

0.04 

0 

Tacoma Tacoma 

Psychological Social

Problems Difficulty

(p<.05) (p<.01) 
PART III. BTC Costs and Benefits III – 1

PART III. 

BTC COSTS AND BENEFITS 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 2 

CHAPTER 8. 

RETURNS TO THE INVESTMENT IN BTC

This chapter presents the results of a cost-benefit analysis (CBA) of the three BTC sites. The 

CBA documents the costs of BTC, assigns monetary values to the reductions in crime found 

in the impact evaluation of BTC, and estimates the ratio of benefits to the costs for each of the 

three sites. From a public policy perspective, CBA is a powerful analytic tool that can be used to 

evaluate the impact of an intervention (Merrill 1998). The value of CBA stems from the hope that 

for every dollar spent, there are savings that exceed that amount.13 CBA can be used to 

measure the effectiveness of a broad spectrum of programs, such as public initiatives supported 

by government funding or private projects undertaken by an insurance company. Put in 

business terms, a positive CBA affirms that the return on investment is greater than the 

investment itself.14 

The costs of BTC include expenditure of BTC funds, as well as the monetary value of 

agencies' resources required to add BTC services to felony case processing. This strategy for 

measuring costs parallels the impact evaluation, where BTC outcomes were assessed relative 

to outcomes that existed prior to the introduction of BTC. In other words, we are interested in 

the costs and benefits of providing BTC services to felony case processing compared with preBTC services. 

The benefits estimated in this CBA are those resulting from crime reduction. The impact 

evaluation found a reduction in drug use in addition to a reduction in crime. However, none of 

the cost-saving benefits associated with reduced drug use, such as decreased health care costs 

or increased employment and earnings, were detected in the CBA. The failure to observe these 

outcomes may have been due to the relatively short follow-up period of nine months; it may take 

longer to realize these benefits. The impact evaluation also found reductions in family problems. 

However, these benefits are excluded from this analysis in the absence of a strategy for placing 

monetary value on reductions in family problems. In sum, for a variety of reasons, certain 

benefits have been excluded from this CBA. The effect of these exclusions is to underestimate 

the benefits of BTC and, consequently, to err on the conservative side. 

The crime reduction costs were based on two outcomes from the impact evaluation. The 

first was a reduction in self-reported offenses reported on the follow-up survey. Each interview 

took place approximately nine months after the start of the intervention and asked about 

criminal activity during the six months immediately preceding the interview. As described in 

chapter 5, BTC participants in all three sites were significantly less likely to report offending 

during that six-month period. The second outcome from the survey, a reduction in the likelihood 

13 Typically, a CBA estimates costs and benefits either from the perspective of society as a whole or from the 

perspective of funding agencies. This analysis takes the former approach.

14 While the cost analysis literature is still fairly limited with respect to substance abuse interventions, an excellent 

summary of the extant literature exists in Cartwright (2001). 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 3 

of arrest, was measured by official arrest records in the year after sample entry (described in 

appendix A). In Birmingham and Tacoma (but not in Jacksonville), BTC participants were 

significantly less likely to be arrested during the year than were members of the comparison 

groups. 

The CBA shows a positive return on the investment in BTC at all three sites. The value of 

averted crime costs for every dollar of investment was estimated to be $2.30 in Birmingham, 

$2.60 in Jacksonville, and $5.30 in Tacoma. While not all of these savings can be readily 

converted into local budget reductions, since they represent savings to society as a whole 

(victims, public jurisdictions, insurers, citizens, and the criminal justice system, including law 

enforcement, court, and corrections systems), they do show a significant and positive benefit 

from the program. The following sections describe the methods used in this CBA, the results of 

the CBA, and the limitations of the CBA. 

METHODOLOGY 

Calculation of the CBA ratio for each site involved four steps: (1) estimating the additional 

per-person cost of the BTC intervention; (2) estimating the per-person value of averted 

offending; (3) estimating the per-person value of averted arrests; and (4) calculating the CBA 

ratio. 

Step One. Estimating the Additional Per-Person Cost of BTC 

The estimation of the additional costs of the BTC intervention for felony defendants 

included three cost categories: 

• BTC program operating costs15

− Testing and assessment

− Referral and case management 

− Direct services from BTC 

− Ongoing operations of the MIS 

• Costs of treatment outside of BTC 

• Cost to the courts, prosecutors, and defense bar, including sanctions 

In many cost-benefit studies, accounting methodologies (Harwood and McCliggot 1998) or 

economic methodologies (French et al. 1997) are used to estimate program costs. However, 

these approaches were not deemed appropriate for the BTC program, as it was an add-on to 

the existing costs of the TASC program. An economic or accounting approach would require 

separating the costs of the preexisting TASC activities from those of the BTC effort. This would 

have been difficult in all sites, and particularly difficult in Birmingham. Instead, BTC was treated 

as an independent new effort, with its own costs covered by the grants. For example, new staff 

were hired for the intervention, new equipment was purchased, and space was paid for by the 

15 Note that this excludes planning and start-up costs. 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 4 

NIJ and Office of National Drug Control Policy (ONDCP) program funding. Thus, after 

consultation with staff at each site, it was determined that BTC costs were most easily and 

accurately accounted for on the basis of the NIJ/ONDCP funding. In addition, where appropriate 

at each site, costs for services supplied by and to the TASC to operate BTC were included. 

This appeared to be the most straightforward way of presenting cost data to policymakers, 

who have less interest in the intricacies of economic or accounting theory and more concern 

with how much programs are costing them directly. Recent events appear to reinforce this view, 

particularly as it relates to accounting theory and rules, where using more complicated methods 

of accounting have led to varied and idiosyncratic results for a number of public companies. 

A set of site-specific costs were determined for each site based on the local BTC budgets, 

the local TASC costs for BTC, and site-specific treatment and criminal justice costs. The 

average per-person cost was estimated to be the total costs for a defined time period divided by 

the number of persons served during that period. 

Step Two. Estimating the Per-Person Value of Averted Offending 

Estimates of the monetary value of crime were taken from the published literature on the 

social and economic costs of crime (Miller et al. 1996; Rajkumar and French 1997; Roman and 

Harrell 2001). The costs by offense type used in this analysis were based on estimates provided 

by Roman and Harrell (2001). These estimates included direct costs to the public and direct 

costs to the victims of crime. The direct costs to the public included criminal justice system costs 

and were estimated on the basis of arrest outcomes. The direct victim costs included medical 

care, mental health care, lost productivity, and property loss, but did not include compensation 

for pain and suffering.16 Because some “hard to quantify” costs were excluded from the analysis, 

the result is a conservative estimate of the costs of crime. 

Cost per Crime by Type of Offense 

Arson $23,832 

Assault $2,035 

Burglary $1,021 

Drug dealing and 

drug manufacturing $2 

Forgery $72 

Prostitution $28 

Robbery $3,576 

Rape $6,570 

All other $923 

16 Intangible costs, such as pain and suffering, are difficult to estimate reliably. In the absence of a consensus in the 

literature about the magnitude of these types of benefits, intangible costs were not included in this analysis. 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 5 

Criminal offending was measured from self-report data on the commission of crimes, 

regardless of whether an arrest was made. Survey respondents were asked how often they 

committed each of 14 types of offenses during the six months before the baseline and follow-up 

interviews. Survey responses were used to calculate the number of crimes, by crime type, 

committed by the BTC sample and pre-BTC sample during both time periods. 

To estimate the total cost of crime for a survey respondent, the number of crimes in each 

category was multiplied by the cost per crime (shown above), and crime costs were summed 

across the 14 crime types. The distribution of the cost of crime variable was highly skewed, as 

more than half of each sample reported no criminal activity. Using only survey respondents who 

reported committing at least one offense, the costs of offenses committed by lawbreakers were 

estimated using linear regression. This regression model was specified as p(Ofu) = f(p(Obx), Age, 

Race, Education, Gender, Group)17 where the cost of offenses during the follow-up period (Ofu) 

was a function of the cost of offenses during the six months prior to baseline (Obx), age (<25, 

25–44, >44), race (white, black, other), educational level (<high school [HS], HS graduate, 

>HS), gender, and study group (BTC or comparison). The least squares mean for each group is 

the total cost of crimes committed by group members. To estimate the per-person cost, this 

mean was divided by the number of persons in each group.18 

Step Three. Estimating the Per-Person Value of Averted Arrests 

The cost of arrest consists of the estimated days of incarceration following the first arrest in 

the year after the start of the intervention. Other costs of arrests, such as those involving law 

enforcement and the courts, were not included because significant changes in the number of 

arrestees would be necessary to change the number of police or court personnel. 

The daily cost of averted incarceration is based on the discounted value of a day in jail. The 

average daily cost of jail was estimated to be $70 in Birmingham, based on the national 

estimate provided in Roman and Harrell (2001), and a $60 local estimate provided by Tacoma. 

The analysis did not use the full cost of a day in jail, because there are significant fixed costs 

that do not change as the number of inmates changes. To be very conservative, the marginal 

17 Note that a variety of other independent variables were tried in the logistic and linear models without making any 

difference in the results in terms of either the significance or magnitude of the “group” variable. Thus, a simple model 

with basic demographic factors was used throughout. 

18 In Birmingham, propensity score analysis was used to identify two comparable groups of respondents to control for 

selection bias. The propensity scores were estimated using a logistic regression where the dependent variable was 

the dichotomous membership in the control ( = 0) or experimental ( = 1) groups. The independent variables included 

age, race, gender, whether or not the person had been in jail during the 30 days prior to the interview, and whether 

the person had committed a serious crime (homicide, assault, robbery, burglary, or rape) in his or her lifetime. The 

number of days in the past 30 that the person had experienced medical, psychological, drug, or alcohol problems 

(each as a separate independent variable) were specified in the model as well. The model had a Cox & Snell R2

 of 

.287 and successfully classified 80 percent of the cases into the correct group and a –2log likelihood of 529.623. The 

fitted probabilities of membership in the intervention group ( = 1) for each person were calculated and arrayed by the 

propensity scores from the lowest to the highest (this is irrespective of actual group membership) in four quartiles. For 

each quartile, members in the actual comparison and BTC groups were selected to create a matched set of persons 

in that quartile. The results were calculated as the probability of law-breaking for the resulting matched samples of 96 

BTC participants and 74 comparison group members. The costs and benefits were calculated using these matched 

samples and the resulting per-person estimates applied to the full sample size to permit comparisons to the cost 

estimates. 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 6 

cost attributed to jail savings was assumed to be 30 percent of the cost of a full day. This is 

lower than, for example, the variable cost for hospitals, which run at about 60 percent of the 

total. The capital and staffing costs of jails are expected to be less variable than hospital costs. 

To be on the safe side, the marginal savings were discussed with the two sites to ensure 

consensus between the individual programs and the researcher. 

The average duration of incarceration following arrest is assumed to be six months, based 

on statistics from the Bureau of Justice Statistics (1995), Camp and Camp (1996), and Langan 

and Brown (1997). 

Step Four. Calculating the Cost-Benefit Ratio 

Based on the results of the first three steps, the CBA is then calculated as the ratio of the 

total per-person benefits divided by the total per-person costs. If the CBA ratio is greater than 

one, BTC is said to show benefits relative to the investment (Merrill 1999). 

RESULTS 

BTC Cost per Person 

Birmingham. Working closely with the staff of the Birmingham TASC, we analyzed the BTC 

program budgets to identify the costs that should be attributed to the operation of BTC. In 

Birmingham, BTC costs included budget items for screening, monitoring, case coordination, 

treatment provision, and data collection and retrieval. In addition, administrative costs for 

program operation and operating costs of the MIS, considered vital to the operations of the 

entire effort, were included. However, start-up costs for TASC related to BTC and development 

costs for the MIS were not included, since they were deemed one-time costs. 

Using this approach, it was estimated that the direct cost of the intervention was $2.98 

million, out of a total NIJ/ONDCP budget of $3.81 million for BTC. TASC costs estimated to be 

$2.14 million were added (these figures were provided by and discussed with the Birmingham 

TASC), for a total cost of $5.12 million. This covered the costs of the BTC services for 7,566 

persons who either were screened positive for drugs and/or alcohol or indicated that they had a 

substance problem. Thus, the cost per person for the Birmingham site was estimated to be $677. 

The $677 per-person cost was for the entire population. However, the estimates of costs of 

averted crime in Birmingham were based on samples generated using propensity score 

analysis. A legitimate question, therefore, was whether this per-person figure of $677 would 

apply to the matched sample used for the estimates of benefits. The MIS data alone provided 

only limited information to answer this question, but combining them with information from the 

ASI permitted us to estimate the percentage of persons in the total population and in the 

matched samples who had received treatment services that could affect the cost of services. 

While only 13 percent of the total population had received treatment, 34 percent of the 

experimental sample reported receiving treatment. On the basis of the Birmingham TASC 

budget, the total cost of treatment services was $421,183, or an additional $428 per person 

treated over and above the costs of screening, assessment, and monitoring afforded to all 

persons. It should be noted that the average cost of $428 per person for treatment is not the 

total cost of treatment, but the average across all persons who received any treatment, 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 7 

regardless of the amount. Assuming that 34 percent of the population received treatment 

services, instead of the 13 percent of the entire sample, and using the average of $428 per 

person as the cost of treatment, the overall total average cost per each matched sample person 

was raised to $767. 

The cost estimates for Birmingham do not include the costs of judicial monitoring because 

so few compliance hearings were held and the additional cost to routine case processing was 

minimal (see chapter 4). It was determined that while this represented a small added cost to 

BTC, it would make little difference to the CBA. 

Tacoma. Most of the costs associated with the Tacoma site were covered by the overall 

BTC NIJ/ONDCP budget. Tacoma budget documents provided details on the relevant cost 

centers, such as personnel, equipment, testing, communications, travel, and BTC offices. 

Budget documents also specified the time frames in which expenses were incurred. On the 

basis of this information, a 12-month budget was calculated by prorating each of the line-item 

costs to a one-year time frame. For example, if an individual’s cost covered a 36-month period, 

one-third of those costs were included in the budget estimations. 

Other costs outside the BTC budget included court costs, drug treatment, and use of court 

personnel. The court costs of $17,887 included compliance hearings by judges and court staff 

and were based on staff salary levels and amount of time devoted to these efforts. Drug 

treatment costs, which were separate from the NIJ budget, were calculated on the basis of 

services utilization data provided by the Pierce County Alliance (PCA). For residential drug 

treatment, the average number of days of care (56 days) was also provided by PCA. For 

outpatient services, the average number of visits (23 visits) was based on current research by 

the author using data from the Washington State substance abuse agency, and costs of these 

services were also derived from the state data. In addition, the costs for the judges, court clerks, 

and the Prosecutor’s office, including salaries, fringe benefits, and time dedicated to the BTC 

project, were provided by those entities to the PCA. 

Total treatment caseloads, as well as treatment caseloads by levels of care, were provided 

by the PCA. Individuals were considered to be in BTC if they were assessed, were found in 

need of services, and had a treatment plan developed for them by BTC. Caseloads were based 

on six months of data, so the number was doubled to derive annual caseloads. It is assumed 

that the number of persons involved in the intervention represented a nonoverlapping 

population, and individuals were not counted more than once in a year. The total treatment 

caseload in Tacoma for a one-year period was estimated to be 1,544 cases. 

Tacoma BTC Costs 

BTC/NIJ Budget $1,299,614 

Treatment $932,718 

Courts $17,887 

Prosecutor's Office $5,897

Total BTC Costs $2,256,116 

Based on estimated total BTC costs of $2,256,116 and a total treatment caseload of 1,544 

persons during that one-year period, the average BTC cost per person was $1,461. 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 8 

Jacksonville. The costs for the Jacksonville site were estimated following an approach 

similar to that of Tacoma. However, because the costs of treatment were included in the budget 

(as opposed to Tacoma, where they were separate reimbursements), it was a more 

straightforward calculation. In addition to detailed budget information, actual expenditure 

information by cost center and activity was provided. While Jacksonville data were available for 

the entire project period, the budget information used in the analysis covered a specific sixmonth period, from October 2000 to March 2001, when the program was functioning at its 

maximum level of activity. Treatment caseloads were also available for that period, so a cost per 

person could be estimated. For this period, BTC costs were broken down into personnel, 

overhead, and contract services, which included payments to service providers for treatment 

costs. In addition, costs of jail personnel working to assist BTC early identification in the initial 

appearance court and the cost of sanctions were added to create a total six-month cost. 

Jacksonville BTC Costs 

Personnel $198,840 

Overhead $129,192 

Contractual $898,728 

Jail Staff $8,502 

Cost of Sanctions $4,044 

Total BTC Costs $1,239,306 

According to performance tracking information, over the six-month period, 1,093 persons 

were ordered to BTC and received a treatment plan. Based on total BTC costs of $1,239,306 

and the treatment caseload, the average cost per person was estimated to be $1,133. 

BTC Benefits of Reduced Offending 

The next step of the CBA examined the costs of crimes among those who committed 

crimes. Table 8.2 shows benefits estimations for the pre-BTC sample and the BTC sample at 

each site. The number of lawbreakers, the average cost of crime per lawbreaker, and the total 

costs of crimes by lawbreakers are included. Because the difference in total costs of crime 

among lawbreakers between the pre-BTC and the BTC samples was not significant in 

Birmingham and Tacoma, the same average value was used for both the BTC and pre-BTC 

samples ($2,823 in Birmingham and $20,354 in Tacoma). Therefore, in those two sites, the 

benefits reflect solely the lower proportion of BTC participants committing offenses. The total 

costs of crime in each group are divided by the sample size to calculate the per-person cost of 

crime. The last row in table 8.2 shows the dollar estimate of the total benefits of crime reduction 

from BTC for each site during a one-year period (i.e., the cost of crime by the pre-BTC sample 

minus the cost of crime by the BTC sample). The results show positive benefits to BTC in all 

sites, ranging from $479 in Birmingham to $7,324 in Tacoma. 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 9 

Table 8.1. Benefit Calculations by Site 

Birmingham Tacoma 

Pre-BTC BTC Pre-BTC BTC Pre-BTC BTC 

in the impact sample 37 16 60 31 111 51 

a 96 74 312 215 244 277 

Crime cost per 

sample member

Benefit per 

sample member 

a 

Jacksonville 

Number of lawbreakers 

Average cost of crimes 

per lawbreaker $2,823 $2,823 $22,602 $10,036 $20,346 $20,346 

Total costs of crime $104,551 $45,168 $1,356,120 $311,116 $2,258,406 $1,037,646 

Impact sample size

 $1,089 $610 $4347 $1447 $11,071 $3,746 

$479 $2,900 $7,324 

Birmingham sample sizes based on propensity score matched samples. 

BTC Benefits of Reduced Arrests 

In addition to benefits from reduced offending by the BTC sample, benefits were estimated 

as a result of cost savings resulting from reduced arrests in the BTC sample. The estimation is 

based on reduced incarceration following the first arrest during the follow-up year.19 During the 

follow-up year, 39 percent of the pre-BTC sample and 8 percent of the BTC sample in 

Birmingham and 50 percent of the pre-BTC sample and 38 percent of the BTC sample in 

Tacoma were arrested. When these proportions are applied to the full BTC sample in each site, 

reductions of 120 arrests attributable to BTC participation in Birmingham [(387 * .39) – (387 * 

.08)] and 65 arrests in Tacoma [(542 * .50) – (542 * .38)] were estimated. 

Based on 120 arrests, a daily incarceration cost of $70, and 182.5 average incarceration 

days, the total arrest costs avoided in Birmingham were $1.533 million. Multiplying the total 

arrest costs by the marginal costs of arrest (.30) and dividing by the total number in the sample 

(387) produced a savings from reduced arrests of $1,320 per person in Birmingham. Using the 

same approach for Tacoma, but assuming $60 per day for incarceration and a reduction of 65 

arrests, the savings were $394 per person. 

19 Only the first arrest was used because including all arrests would overestimate the savings, since it would 

overrepresent arrests not followed by incarceration. 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 10 

The Cost-Benefit of BTC 

Table 8.2 summarizes the benefits of crime reduction per BTC participant. 

Table 8.2. Crime Reduction Benefits of BTC per BTC Participant 

Birmingham Jacksonville Tacoma 

Per-person Reduced 

Costs of Offenses $479 $2,900 $7,324 

Costs of Arrests 0 

Per-person Reduced 

 $1,320 $394 

Total Benefits 

Per-person $1,799 $2,900 $7,718 

Table 8.3 shows the total benefits per person, the total costs per person, and the resulting 

cost/benefit ratio (total benefits divided by total costs). 

Table 8.3. The Ratio of BTC Benefits to Costs: the CBA 

Birmingham Jacksonville Tacoma 

Total Benefits per 

Person $1,799 $2,900 $7,718 

Benefit to Cost Ratio 2.3 2.6 5.3 

Total Costs per Person $767 $1,133 $1,461 

On the basis of these estimations, each of the three sites showed a positive benefit-to-cost 

ratio in which the return per person exceeded the cost of services for that person. Across all 

persons, these average ratios reflect a consistent finding in terms of the return on investment at 

each of the sites. 

LIMITATIONS IN DEFINING BENEFITS 

While the findings of the CBA were consistently positive, even greater longer term savings 

are possible. Originally, the intent of this analysis was to look at benefits across a number of 

domains and total up these benefits (ΣBd)/C, where Bd would be the benefits in each domain (d), 

in order to calculate the full extent of the CBA. Benefits were to be calculated on the basis of 

comparisons of changes in the behavior of the persons in the BTC and pre-BTC groups by 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 11 

comparing costs for the two groups only during the six-month period before the follow-up 

interview took place. In other words, such items as medical and mental health expenditures, 

welfare costs, income, and arrest data would be assessed to see if the BTC group had lower 

costs over this period than did the pre-BTC group (using the experience of the six-month period 

prior to the baseline interview as a covariate). 

As part of the initial design of the evaluation, specific questions were added to the ASI at 

baseline and follow-up to identify the utilization of services over the six months prior to each 

interview. The number of person hospitalizations or months of welfare benefits could be 

converted into monetary terms so that benefits could be imputed. The areas covered in the 

interview included medical and psychiatric services, arrests, and employment and public 

assistance income. Unlike a cost-effectiveness analysis, in which monetary changes are not 

necessarily calculated, the CBA permitted differences in actual service use to be estimated and 

dollar savings, where they existed and were significant, to be attached to them. By comparing 

the use of such services for the BTC and pre-BTC groups, an assessment could be made as to 

whether, for the BTC group, there were reduced costs in these domains. The following costrelated outcomes were to be analyzed: 

• Medical costs: Number of days of inpatient and outpatient hospital services, emergency 

room visits, and physician and clinic visits over the past six months 

• Mental health costs: Inpatient and/or residential care days and ambulatory visits over the 

past six months 

• Employment income: Number of days employed over the past six months 

• Public assistance: Number of days of receipt of public assistance benefits (e.g., Aid to 

Families with Dependent Children/Temporary Assistance for Needy Families, 

Supplemental Security Income, general assistance) over the past six months 

To convert these outcomes into benefits, local Medicaid rates for medical and psychiatric 

utilization were to be used for either per diem or per visit costs, whichever was applicable. In the 

case of employment and public assistance costs, other data from the ASI permitted us to 

calculate an average income or payment per day over the past 30 days. That per diem number 

was then applied to the number of compensated days over the past six months to calculate the 

employment or public assistance income. 

Unfortunately, this approach proved to be more problematic than originally anticipated, for a 

number of reasons. In many cases, the six-month data for either or both the follow-up and 

baseline periods were too limited in terms of the number of persons who actually endorsed 

some utilization for statistically significant differences to be observed. This problem is more a 

function of the limited time frames involved in the evaluation than of anything inherent in the 

data collection process. Analysis of survey data on several outcomes in the 30 days prior to 

interview indicated significant differences between groups. However, the fact that BTC 

participants appeared to be doing better at follow-up than the comparison group does not 

automatically translate into cost savings for that group. Monetary benefits can only be imputed 

from evidence of a decrease in utilization of services or from a demonstrably lower need for 
PART III. BTC Costs and Benefits 

Chapter 8. Returns to the Investment in BTC III – 12 

public dollars to be expended (i.e., public assistance). The fact that health status might have 

improved does not necessarily lead to a calculation of dollar savings for medical care. 

The effectiveness analysis did demonstrate a significant difference in Birmingham and 

Tacoma between the comparison and BTC groups in terms of arrests during the six-month 

period prior to the follow-up interview. Savings that resulted from this difference are included in 

the estimates, although there are some methodological concerns. While it might be argued that 

this reduction in arrests and incarcerations can be fully converted into a monetary benefit, that 

position may be difficult to defend. This is because reductions in arrests do not necessarily lead 

to decreases in the number of police, court personnel, or corrections facilities. Thus, the only 

savings that can be attributed are the marginal costs of incarceration following arrest and 

conviction. Given the immense fixed costs of the criminal justice systems, these savings are not 

sizable in the short term. While from a cost-effectiveness perspective this is a highly significant 

finding, in terms of a cost/benefit, there is a much less measurable impact. However, in 

Birmingham and Tacoma there were significant enough reductions in arrest rates that some 

marginal cost savings could be calculated and included as marginal savings at those sites. 

CONCLUSIONS 

Despite the caveats included in the above discussion, at each site, significant program 

benefits compared to program costs existed. While not all of these savings can be readily 

converted into local budget reductions because they represent savings to society as a whole 

(the victims, the public jurisdictions, insurers, and citizens, as well as the public law 

enforcement, courts, and corrections systems), they do show a significant and positive benefit 

from the program. In addition, the savings and CBAs did prove persuasive in convincing the 

stakeholders at the sites to continue the efforts. 

Further, most of these benefits were seen at a point only nine months after the initiation of 

the intervention. There is some evidence from the effectiveness analysis that reductions in 

arrests, physical and emotional morbidity, and welfare use may eventually lead to longer term 

direct savings for those in the program, which could then be added to the benefits side of the 

equation. In addition, the savings attributable to the reduced arrest rates at two of the sites were 

conservatively estimated and might lead to even much greater savings, particularly if an 

expanded program has a larger, systemwide effect on cutting arrests, thereby making it possible 

to reduce both jail and prison capacity as well as the size of law enforcement and court 

systems. 

In summary, the results of the CBA associated with the BTC program are encouraging in 

terms of reducing criminal activity and its associated costs to society. Despite all of the 

constraints on the study, each site showed a CBA ratio significantly greater than one. While 

positive, this finding also raises the need for further study at other sites, as well as a longer term 

evaluation of the program at the three existing BTC sites, to determine how much the program 

may be able to save society in terms of reduced criminal justice, health, and welfare costs. 
PART IV. Reference List IV – 1 

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Justice. Washington, DC: The Urban Institute. June. 

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the Research in Progress Seminar, National Institute of Justice, Washington, DC. March. 

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submitted to the National Institute of Justice. Washington, DC: The Urban Institute. June. 

Harrell, A.V., A. Hirst, and O. Mitchell. 2000. Implementing System-Wide Interventions for Drug-Involved 

Offenders In Jacksonville, Florida: Evaluation of the Breaking The Cycle Demonstration. Report 

submitted to the National Institute of Justice. Washington, DC: The Urban Institute. June. 

Harrell, A.V., A. Hirst, and O. Mitchell. 2000. Implementing System-Wide Interventions for Drug-Involved 

Offenders In Pierce County, Washington: Evaluation of the Breaking The Cycle Demonstration. 

Report submitted to the National Institute of Justice. Washington, DC: The Urban Institute. June. 

Harrell, A.V., D. Marlow, and J. Merrill. 2000. “Evaluation of Breaking the Cycle: Preliminary Findings 

from Birmingham, AL.” Briefing at the Office of National Drug Control Policy, Washington, DC. April. 

Harrell, A.V., J. Merrill, and D. Marlowe. 1999. “Breaking the Cycle: Treatment Needs of Drug-Involved 

Felony Defendants.” Presented at the 51st Annual Meeting of the American Society of Criminology, 

Toronto, Canada. November. 

Harrell, A.V. and A. Goodman. 1999. Review of Specialized Family Drug Courts: Key Issues in Handling 

Child Abuse and Neglect Cases. Submitted to the National Institute of Justice. Washington, DC: The 

Urban Institute. February. 

Harrell, A.V., S. Cavanagh, and A. Hirst. 1998. Breaking the Cycle Process Evaluation Report on Phase 

I Implementation in Birmingham, Alabama. Paper submitted to the National Institute of Justice. 

Washington, DC: The Urban Institute. August. 

Harrell, A.V. 1998. “Breaking the Cycle: Lessons on Implementing Systemwide Interventions for DrugInvolved Offenders.” Presented at the American Probation and Parole Association 23rd Annual 

Training Conference, Norfolk, VA. August. 

Harrell, A.V., F. Cook, and J. Carver. 1998. “Cycle of Drug Abuse in Birmingham.” NIJ Journal. 

Washington, DC: U.S. Department of Justice, National Institute of Justice. July. 

Harrell, A.V. 1998. “Breaking the Cycle of Drug Abuse in Birmingham.” Paper presented at the 

Academy of Criminal Justice Sciences, Albuquerque, NM. March. 

Hirst, A. and A.V. Harrell. 2000. “Measuring Perceptions of Procedural Justice among Court-Monitored 

Offenders.” Presented at the 52nd Annual Meeting of the American Society of Criminology, San 

Francisco, CA. November. 
PART IV. Reference List IV – 5 

Lee, P.A., D.B. Marlowe, J.C. Merrill, A.V. Harrell, D.S. Festinger, J. McNellis, and A.T. McLellan. 2000. 

“Methamphetamine Use and Criminal Activity Among Substance Abusers.” Poster presented at the 

62nd Annual Scientific Meeting of the College on Problems of Drug Dependence, San Juan, Puerto 

Rico. June. 

Marlowe, D.B. 2002. “Effective Strategies for Intervening with Drug Abusing Offenders.” Villanova Law 

Review 47(4): 989-1026. 

Marlowe, D.B., A. Elwork, D.S. Festinger, and A.T. McLellan. In press. “Drug Policy By Popular 

Referendum: This, Too, Shall Pass.” Journal of Substance Abuse Treatment. 

Marlowe, D.B., J.C. Merrill, A.V. Harrell, and A.T. McLellan. 2000. “The Role of Judicial Status Hearings 

in Drug Court.” Presented at the 52nd Annual Meeting of the American Society of Criminology, San 

Francisco, CA. November. 

Marlowe, D.B., J.C. Merrill, A.V. Harrell, D.S. Festinger, P.A. Lee, J. McNellis, and A.T. McLellan. 2000. 

“Breaking The Cycle of Drugs and Crime in Three U.S. Cities.” In “Crime, Violence, and Drug 

Abuse,” chaired by D.B. Marlowe and J. Milby. Paper session conducted at the 62nd Annual 

Scientific Meeting of the College on Problems of Drug Dependence, San Juan, Puerto Rico. June. 

Marlowe, D.B., J.C. Merrill, A.V. Harrell, A.T. McLellan, P.A. Lee, and J. McNellis. 2000. “The 

Birmingham ‘Breaking the Cycle’ Demonstration Project.” In “Emerging Issues In Forensic Mental 

Health Policy,” chaired by D.B. Marlowe. Paper session conducted at the 2000 Biennial Conference 

of the American Psychology-Law Society, New Orleans, LA. March. 

McNellis, J., D.B. Marlowe, J.C. Merrill, A.V. Harrell, D.S. Festinger, P.A. Lee, and A.T. McLellan. 2000. 

“Concurrent Validity Of ASI Substance Use And Legal Items Among Felony Offenders.” Poster 

presented at the 62nd Annual Scientific Meeting of the College on Problems of Drug Dependence, 

San Juan, Puerto Rico. June. 

Merrill, J.C. 2002. A Cost/Benefit Analysis of the Birmingham “Breaking the Cycle” Program. Report 

submitted to the National Institute of Justice. June. 

Mitchell, O., A.V. Harrell, and A. Hirst. 2001. “Preliminary Results from the Breaking the Cycle 

Demonstration Project: Pierce County, WA.” Presentation at the 53rd Annual American Society of 

Criminology Meeting, Atlanta, GA. November. 

Mitchell, O., A.V. Harrell, and A. Hirst. 2001. “Assessing the Effectiveness of Breaking the Cycle: 

Birmingham, AL.” Presentation at the 38th Annual Meeting of the Academy of Criminal Justice 

Sciences, Washington, DC. 
Appendix A. Impact Evaluation Methodology A – 1 

Appendix A 

Impact Evaluation Methodology 

The impact analysis tests the hypotheses that BTC reduced criminal involvement, 

substance abuse, and problems related to health, mental health, employment, and family of 

felony drug defendants in the demonstration sites. The evaluation examines the relationship 

between changes in these areas and characteristics of participants, the kinds and levels of 

services and supervision they received, and perceptions of defendants about the justice 

system’s handling of their case. The results are based on a quasi-experimental design that 

compares samples of offenders selected prior to implementation of BTC who would have been 

eligible for BTC if it had existed, with samples of offenders who were ordered into BTC. 

BTC was hypothesized to affect case handling and the length of time required to reach a 

disposition, the number of hearings, and the kinds of sentences imposed. The analysis 

compares these outcomes for samples of cases filed prior to BTC with samples of cases filed 

during the period of full BTC implementation. However, BTC was only one factor influencing 

these changes, and the effects of BTC alone, independent of external events such as changes 

in the law and efforts to reduce jail overcrowding, cannot be determined. Thus, these results 

should be considered in the context of events described in the process evaluation. 

Process evaluation of BTC implementation was conducted throughout the project. The 

process evaluation goals were to assess the feasibility of BTC as a model, to identify the 

strategies and lessons developed at the sites for responding to the challenge of systemwide 

responses to drug use, and to document the services delivered as a basis for understanding the 

impact of evaluation outcomes. The process evaluation was based on quarterly site visits with 

interviews of staff of collaborating agencies, weekly conference calls with site project directors, 

analysis of site data systems, and monthly reports to NIJ on project activities. 

THE DESIGN OF THE IMPACT EVALUATION 

The conceptual framework guiding the study design and choice of data to be collected is 

shown in figure A.1. The evaluation examined the outcomes illustrated in the boxes on the far 

right. Goals for offenders include reductions in drug and alcohol use, criminal activity, and 

health, social, and employment problems. The evaluation also assessed changes in the 

perceptions of offenders concerning the fairness of the hearings and the risk and severity of 

consequences for noncompliance with court orders. System changes examined by the 

evaluation include the number of hearings and number of days between arraignment and case 

disposition, top charge at conviction, and sentences imposed. 

The center column illustrates factors hypothesized to affect offender and system 

outcomes. They include drug treatment placements, type and duration of drug treatment, drug 

testing, frequency of judicial monitoring, intensity of contact with case managers or court 

supervision staff, the types of incentives and sanctions, and the timeliness and consistency of 

sanctioning. 

Offender characteristics that may affect both the type of services received and the 

response are shown on the far left of the exhibit. They include demographic or background 
Appendix A. Impact Evaluation Methodology A – 2 

characteristics of the offender such as age, race/ethnicity, and gender; substance abuse pattern 

and severity; employment and educational status; family status and living situation; physical and 

mental health; prior criminal activity; and current charge. These factors may influence outcomes 

directly or define groups that respond differently to BTC. 

Figure A.1. Conceptual Framework for the Evaluation of Breaking the Cycle 

/

Services Received 

Client Outcomes 

Offender Characteristics 

Demographic Characteristics 

Substance Abuse History 

Employment and 

Educational Status 

Family and Social 

Functioning 

Physical and Mental Health 

Criminal History 

Type and Severity of Charge 

Interventions Services 

TASC Assessment and 

Treatment Planning 

Type and Duration 

of Drug Treatment 

Judicial Monitoring 

Intensive Case 

Management and 

Supervision 

Use of Incentives 

and Sanctions 

Drug Testing Schedule 

and Procedures 

Social and Health 

Outcomes 

System Changes 

The sources of data used to measure the concepts in the framework are shown in figure 

A.2. The data sources include records maintained by the BTC programs and partner agencies, 

arrest records from local and National Crime Information Center databases, and court records 

on filings and case outcomes. Record-based data were collected for all sample members in all 

sites. In addition, interviews were conducted by the Treatment Research Institute (TRI) with 

sample members shortly following arrest (baseline) and again nine months later (follow-up). The 

questionnaires consisted of the Addiction Severity Index (ASI; McLellan et al. 1992), modified to 

include additional questions about illegal activities and participation in drug treatment services. 

In Birmingham, respondents were also given the Risk of AIDS Behavior questions. In 

Jacksonville and Tacoma, these questions replaced questions about perceptions of fairness and 

the consequences of noncompliance with court orders. 
Appendix A. Impact Evaluation Methodology A – 3

Figure A.2. Data Source Matrix 

Category in Conceptual Framework 

BTC 

records 

Arrest 

records 

Court 

records Survey 

OFFENDER CHARACTERISTICS 

 Demographic Characteristics X X 

 Substance Abuse History X X 

 Employment and Education Status X X 

 Family Composition and Living Situation X X 

 Physical and Mental Health X X 

 Criminal History X X X 

 Type and Severity of Charge X X X 

INTERVENTIONS/SERVICES 

 Screening X 

 Assessment/Treatment Planning X 

 Drug Treatment X X 

 Drug Testing Schedule and Procedures X 

 Judicial Monitoring X 

 Case Management X 

 Court Supervision 

 Use of Incentives and Sanctions X 

 Social and Health Services Received X 

OUTCOMES (CLIENT OUTCOMES) 

 Reduced Drug Use X 

 Reduced Criminal Activity X X 

Reduced Problems - employment, health, 

mental health, family 

 X

OUTCOMES (SYSTEM CHANGES) 

 Number of hearings X 

 Days to disposition X 

 Top charge at disposition X 

 Sentence imposed X 

 Alternatives to incarceration X 
Appendix A. Impact Evaluation Methodology A – 4 

Figure A.3. BTC Data Collection Overview 

• 

• 

• 

•

/ •

•

•

•

Baseline Interviews 

Comparison sample 

Treatment sample 

Records on Sample 

Comparison sample 

 Treatment Sample 

MIS System Data 

Performance Indicators 

from Monthly Reports 

Records on Pre-BTC System 

Follow up Interviews 

 Comparison Sample 

 Treatment Sample 

Records on Sample 

 Comparison sample 

 Treatment Sample 

Records on BTC System 

MIS Data 

BTC Services/Contacts 

with Clients Quarterly 

SAMPLE SELECTION AND BASELINE INTERVIEWS 

The sample selection procedures were designed to select individuals who would be 

eligible for BTC services (even if selected prior to BTC implementation). Sample members were 

required to be (1) age 18 or older; (2) residents of the county or BTC service area; (3) facing a 

felony charge; and (4) involved with illegal drugs as measured by a current drug charge, a 

positive urinalysis screen, or self-reported drug use. A small number of potential sample 

members were excluded because of a language barrier, psychiatric impairment, or intoxication 

at the time they were contacted. 

Participation in the evaluation was voluntary. TRI staff contacted potential sample 

members shortly after arrest and asked for their consent. They were guaranteed confidentiality 

and offered financial incentives for participation. Those who agreed signed a written consent 

form agreeing to participate in the study and allow the research team to collect data from 

criminal justice and treatment agencies. At each interview contact, sample members were 

reminded that participation was voluntary and asked formally to consent to an interview. To 

protect the data provided to the study, all research staff signed confidentiality pledges, a 

detailed data security plan was developed for data handling and storage, and a letter from the 

Justice Department extending the protections of a Federal Certificate of Confidentiality was 

obtained. 

Participants were paid $10 for completing the baseline interview (ASI and Deterrence) 

and $20 for the follow-up interview (Follow-up ASI and Follow-up Deterrence). Participants who 

were difficult to reach for follow-up were mailed a letter offering a $10 bonus (for a total payment 

of $30) if they called in immediately to complete their interview. The procedures for contacting 
Appendix A. Impact Evaluation Methodology A – 5 

and interviewing sample members were tailored to operations at each BTC site, as described 

below. 

Birmingham 

The pre-BTC sample was recruited between March 13 and May 2, 1997, by inviting 

arrestees tested for the Drug Use Forecasting (DUF)2 project in the Birmingham jail to take part 

in the study. Following the DUF drug test and interview, a research recruiter invited arrestees to 

be part of the study. Those who agreed (n = 311) signed a consent form that included 

agreement that their DUF drug test results would be provided to the research team with the 

understanding that they would receive a $10 stipend by mail and would be contacted for the 

study if they were found to be eligible. Only those who tested positive for at least one drug (n = 

236, 76 percent of those who consented) were considered eligible and included in the 

comparison sample. Baseline interviews took place approximately a month following consent 

(median = 28 days). Ninety-nine percent were telephone interviews. 

The BTC sample was recruited from the defendants ordered to BTC upon release. Plans 

to recruit them following a drug test in the jail had to be changed when BTC dropped plans to 

screen for program eligibility at the time of arrest. In lieu of in-jail drug testing, BTC required 

defendants charged with felonies to report to Treatment Alternatives to Street Crime (TASC) 

within 24 hours of release from the jail on bond. The defendants were screened at that time for 

BTC eligibility using a drug test and short self-administered questionnaire. Those who tested 

positive, reported drug use, or were charged with drug felonies became eligible for BTC. 

Between September 8 and December 1, 1998, 596 defendants were contacted and 

initially determined to be BTC eligible; 545 of them (91 percent) agreed to participate in the 

study and were sent a payment of $10. However, 171 of them were later found to be ineligible 

because their charges were dropped or reduced to a misdemeanor, or they lived outside 

Jefferson County and thus were not eligible for BTC services, leaving a final sample of 374. The 

BTC sample did not differ significantly from the population of clients served by BTC in 

Birmingham on age, gender, race, marital status, education, public assistance, or criminal 

history (prior convictions and arrests). However, the BTC sample was more likely to be 

unemployed (33 percent) than the BTC clients in general (24 percent). All 374 sample members 

were interviewed in person, usually at the TASC offices on the day of consent. 

Jacksonville 

The pre-BTC sample was recruited between May 5 and September 30, 1999, at the 

Duval County Jail. TRI contacted 2,758 (77 percent) of 3,561 apparently eligible arrestees 

booked on felony charges during the recruitment period. Most of the 808 arrestees not 

contacted were released from the jail before they could be contacted. A small number were 

unavailable for contact because they were in court or the medical or psychiatric unit, or were 

receiving visitors. Nearly half of those contacted (1,306 or 47 percent) signed a consent form 

agreeing to participate in the study. There were no statistically significant differences in race, 

age, or gender between those who consented and those who did not. However, consent rates 

did differ by primary charge, with slightly more defendants charged with drug offenses or theft 

agreeing to participate in the study. Subsequently, 861 of those who consented were removed 

from the study because their charges were later dropped or reduced to a misdemeanor, or they 

had no indications of a substance abuse problem (negative urinalysis and did not self-report 
Appendix A. Impact Evaluation Methodology A – 6 

drug use), or they were sentenced directly to state prison. All of these conditions would have 

made them ineligible for BTC services had BTC been in existence at that time. The final sample 

consisted of 445 individuals. The baseline interviews with the pre-BTC sample were completed 

in person at the jail, an average of 11 days after arrest. 

The BTC sample was recruited between February 1 and July 14, 2000, at the Duval 

County Jail (73 percent) or the BTC office (27 percent). The sample was limited to arrestees 

who had been ordered to the BTC program during this period. Judges ordered arrestees to the 

BTC program based on the same eligibility criteria used to recruit the pre-BTC sample (a county 

resident charged with a felony). TRI contacted 1,117 (87 percent) of the 1,266 ordered into BTC 

during the recruitment period. Consent was obtained from 808 (72 percent of those contacted; 

64 percent of those ordered in). Of those who agreed to participate, 473 were found, upon 

additional checking, to be ineligible and were excluded from the sample. Defendants were 

excluded from BTC if the charges were dropped or reduced to a misdemeanor or if they 

exhibited no signs of drug use (negative urinalysis and did not self-report drug use). A small 

number were excluded because they lived outside the county served by BTC, were already in 

the study, were transferred to another jurisdiction, had an incomplete assessment, or were 

sentenced directly to state prison. 

The final BTC sample consisted of 335 felony defendants. All baseline interviews were 

conducted in person. The average time from arrest to interview was five days. A comparison of 

this final baseline sample with the total population of active or inactive BTC clients showed no 

significant differences on age, race, gender, or type of charge. 

Tacoma 

The pre-BTC sample was recruited between May 6 and September 12, 1999. Following 

booking at the Pierce County Jail, arrestees meeting the following eligibility requirements were 

asked to participate in the study: (1) over age 18 ; (2) residents of Pierce County; (3) charged 

with a felony, excluding certain violent or sexual offenses; and (4) displayed evidence of drug 

involvement as measured by a current drug charge, a positive urinalysis screen, or self-reported 

drug use. 

Of the 1,097 eligible arrestees who were contacted,1

 597 (54 percent) agreed to 

participate in the study. Those who agreed to participate signed an informed consent agreement 

and underwent an approximately 45-minute interview while still in jail, with the understanding 

that they would receive a $10 stipend by mail. There were no statistically significant differences 

in gender, age, or type of charge between those who consented and those who did not. 

However, a small but statistically significant difference was detected on race (consenters were 

more likely to be Asian, Hispanic, or Native American). Thus, the group of arrestees who agreed 

to participate in this evaluation appears representative of the overall population of offenders 

entering Tacoma's criminal justice system during the period just prior to implementation of BTC. 

Subsequently, 176 of those who consented were removed from the study because their charges 

were later dropped or reduced to a misdemeanor, they had no indications of a substance abuse 

problem (negative urinalysis and did not self-report drug use), or they were sentenced directly to 

1

 An additional 498 arrestees met the study's eligibility criteria but the research team was unable to contact these 

arrestees, usually because they were released before the research team could contact them. A small number of 

arrestees were unavailable because they were in court, in the medical or psychiatric unit, or were receiving visitors. 
Appendix A. Impact Evaluation Methodology A – 7 

state prison. All of these conditions would have made them ineligible for BTC services had BTC 

been in existence. 

The BTC sample was recruited between February 1 and August 11, 2000, at the Pierce 

County Jail and the Breaking the Cycle Alternative Center. Initially, the researchers planned to 

recruit the entire BTC sample from the Pierce County Jail; however, the severe overcrowding 

problem at the jail led to many logistical problems in contacting eligible arrestees. In order to 

contact a higher percentage of eligible arrestees, the sample recruitment was moved to the BTC 

offices and took place shortly after release from jail. The sample was limited to arrestees who 

had been ordered to the BTC program. Judges ordered arrestees to the BTC program based on 

the same eligibility criteria used to recruit the pre-BTC sample. 

Of the 564 arrestees contacted, 83 percent (n = 468) consented to participate in the 

study; 62 percent consented while in jail and the other 38 percent consented at the Breaking the 

Cycle Alternative Center (BAC).2

 Those who agreed to participate underwent the same 45-

minute interview as the pre-BTC sample and received the same $10 stipend. However, the BTC 

sample usually was not interviewed immediately after consent; the interview occurred an 

average of 13 days after consent . Eighty-six of the initial BTC sample were subsequently 

dropped because their charges were dropped or reduced to a misdemeanor, they exhibited no 

evidence of substance abuse, or they lived outside Pierce County, leaving a final baseline 

sample of 382. All baseline interviews were conducted in person: 56 percent in jail, 44 percent 

at the BTC office. 

A comparison of this final baseline sample with the total population of active or inactive 

BTC clients reveals considerable similarity between the two groups. The two groups did not 

differ beyond chance levels on gender, race, age, or marital status. However, the BTC sample 

contained significantly more drug offenders and fewer property offenders than did the overall 

BTC population. 

Summary of Sample Selection 

Although the BTC treatment groups and the pre-BTC comparison groups appear to be 

generally representative of their respective populations, it is possible that the sampling method 

and/or changes in the sampling method (i.e., in-jail versus in the community interviews) led to 

significant differences between the two groups. As a result, the full sample (i.e., the baseline 

groups before attrition) and the subsample who completed both interviews were compared on 

various baseline measures. Table A.1 compares the pre-BTC and BTC samples within each site 

and illustrates some of the differences in the characteristics of the BTC clientele across the 

jurisdictions. 

2

 Another 228 eligible arrestees were not contacted, most because they had been in enrolled in BTC for more than 10 

days. 
Appendix A. Impact Evaluation Methodology A – 8

Table A.1. Sample Characteristics by Site at Baseline (Full Sample)

 Birmingham Jacksonville Tacoma

PreBTC3

(n =192) 

BTC 

(n =374) 

 Pre-BTC 

(n = 444) 

BTC 

(n =332) 

 Pre-BTC 

(n=351) 

BTC 

(n=382) 

Male 84% 79% 78% 83% 70% 72% 

African-American 70% 64% 62% 61% 22% 20% 

Unmarried 89% 86% 89% 86% 91% 79%***

Mean Age in Years 32.4 30.4 31 32 31.4 33.0 

Mean Years of Education 11.2 11.5 11.5 11.6 11.5 11.5 

Mean # Days Paid for 

Work, Past 30 

5.3 12.3 8.3 11.7*** 5.3 4.3 

Mean Employment 

Income Past 30 Days 

$272 $629 $477 $738*** $284 $314 

Received Public 

Assistance Past 6 Months 

10% 8% 9% 2% 22% 16% 

Type of offense (target arrest)x 

 Drug 31% 55%*** 40% 69%*** 64% 78%*** 

 Property 33% 21% 32% 17% 27% 14% 

 Person 8% 4% 10% 4% 3% 2% 

 Other 4% 9% 18% 11% 6% 7% 

 Unknown 24% 11% 0 0 0 0 

Prior Arrests 8.4 5.2*** 7.89 6.67** 7.8 6.7** 

Crimes committed - self 

report, Past 6 mos. 

20.6 2.6 21.7 17.6 50.8 43.2 

Days in jail, Past 30 days 16.2 4.1*** 11.5 5.2*** 3.9 12.6*** 

Months Incarcerated - 

self report, Lifetime 

16.9 8.6 2.4 1.3*** 16.7 14.9 

Mean Age First Drug Use 16 16 15.8 16.2 14.3 14.6 

Self-Report Drug Use, Past 30 Days 

 Cocaine 29% 30% 51% 58% 33% 17%*** 

 Opiates 5% 6% 9% 11% 21% 19% 

 Methamphetamines 2% 2% — — 57% 43%*** 

 Marijuana 30% 55%*** 60% 69%*** 56% 42%*** 

 Other 6% 7% 12% 11% 15% 11% 

Mean Baseline ASI Composite Scores (Range from 0 to 1) 

 Medical 0.18 0.10*** 0.20 0.21 0.27 0.30 

 Employment/Support 0.79 0.61*** 0.69 0.60*** 0.82 0.80 

 Alcohol Abuse 0.13 0.11 0.18 0.20 0.13 0.11 

 Drug Abuse 0.08 0.05*** 0.11 0.15** 0.17 0.12*** 

 Legal 0.40 0.40 0.53 0.55** 0.64 0.51** 

 Family/Social 0.17 0.08*** 0.15 0.13 0.22 0.16*** 

 Psychological 0.22 0.07 0.24 0.19** 0.29 0.26 

* p < .05 ** p < .01 *** p <.001 for differences between Pre-BTC and BTC samples within sites. 

** P < .01 ** p < .01 *** P <.001 for differences between BTC and Pre-BTC samples within sites. 

 

3

 The Pre-BTC sample in Birmingham was smaller than samples in other jurisdictions due to limiting sample selection 

to arrestees taking part in the Drug Use Forecasting testing program during the intake period. 
Appendix A. Impact Evaluation Methodology A – 9 

In Birmingham, the pre-BTC sample, compared with the BTC sample, had significantly 

more days in jail in the 30 days before the baseline interview and more prior arrests, indicating 

higher risk levels. However, they were less likely than the BTC sample to report past-month 

marijuana use and had lower scores on the ASI composite scales measuring medical, 

employment, drug, and family/social problems. 

In Jacksonville, the pre-BTC sample, compared with the BTC sample, had significantly 

more days in jail in the 30 days before the interview, worked fewer days in the past month, and 

had lower income levels, indicating higher risk levels. However, they were less likely than the 

BTC sample to report past-month marijuana use. Their ASI Composite Scale scores were 

higher than the BTC sample in some areas (employment and psychological problems) and 

lower in others (drug and legal problems). 

In Tacoma, the pre-BTC sample was significantly younger (by 1.6 years), less likely to 

be married, reported more serious family/social and legal problems, and had more prior arrests 

than the BTC sample. In addition, the arrest that preceded sample entry was less likely to be a 

drug charge for the pre-BTC sample than the BTC sample. Although the pre-BTC sample 

members were significantly more likely to report using cocaine, methamphetamine, and 

marijuana in the 30 days before the baseline interview than the BTC sample, these differences 

(except for cocaine use) are not significant after controlling for days in jail (time at risk for using 

drugs). Results of initial drug tests, available for only a portion of the sample, suggest a different 

pattern, with significantly higher percentages of the pre-BTC sample positive for 

methamphetamines, marijuana, and other drugs. As a result, the models include measures of 

baseline drug use to control for potential sample differences in drug involvement. 

FOLLOW-UP INTERVIEWS 

Birmingham 

Follow-up interviews were conducted by phone (90 percent) and in person (10 percent) 

with 137 members of the pre-BTC sample (71 percent) and 245 members of the BTC sample 

(66 percent). Originally, two follow-up interviews were planned, one at nine months and one at 

fifteen months after sample recruitment. However, analysis of results from comparison sample 

interviews found no significant differences in outcomes measured at the two times, so follow-up 

for BTC sample was limited to the nine-month interview. For the comparison sample, the ninemonth follow-up was used when available (n = 113), and the fifteen-month follow-up used if no 

nine-month follow-up was completed (n = 24). As a result, the actual time between baseline and 

follow-up varied; the average length of time between interviews was 290 days (median = 264 

days). For the pre-BTC comparison sample, the time between baseline and follow-up ranged 

from 92 days (for one respondent whose baseline interview was conducted a long time after 

sample recruitment) to 599 days. For the BTC sample, the time between interviews ranged from 

239 to 428 days. 

Jacksonville 

Follow-up interviews were conducted with 317 (71 percent) members of the pre-BTC 

sample and 218 (65 percent) members of the BTC sample. Pre-BTC interviews were conducted 

48 percent in person, 52 percent by phone. BTC interviews were conducted 39 percent in 
Appendix A. Impact Evaluation Methodology A – 10 

person, 61 percent by phone. For the pre-BTC comparison sample, the time between baseline 

and follow-up ranged from 199 days to 503 days (median = 302 days). For the BTC sample, the 

time between interviews ranged from 181 days to 437 days (median = 233 days). Because of 

this difference in time between interviews, in subsequent analyses time between interviews is 

used as a control variable where appropriate. 

Tacoma 

Follow-up interviews were conducted with 255 (73 percent) of the 351 pre-BTC sample 

participants interviewed at baseline and 286 (75 percent) of the 382 BTC sample participants 

interviewed at baseline. Pre-BTC interviews were conducted 55 percent in person, 45 percent 

by phone. BTC interviews were conducted 46 percent in person, 54 percent by phone. For the 

pre-BTC comparison sample, the time between baseline and follow-up ranged from 199 days to 

503 days (median = 261 days). For the BTC sample, the time between interviews ranged from 

181 days to 437 days (median = 233 days). Because of this difference in time between 

interviews, in subsequent analyses time between interviews is used as a control variable where 

appropriate. 

The detailed analysis of attrition, shown in appendix B, found no evidence of differential 

attrition by group. Furthermore, the interaction between treatment status and attrition did not 

predict baseline ASI composite scores on the alcohol or legal problems scales but did predict 

baseline drug use scores. This finding suggests that differential attrition is not problematic for 

the analysis of alcohol use and legal problems; however, the analysis does offer weak evidence 

of an attrition problem for the analysis of drug use outcomes.4 

Summary 

Table A.2 summarizes the sample recruitment and interviewing experience. As 

described in the text above, the point at which contact was first attempted varied by sample and 

affected rates of consent and the percentage of those found eligible. Difficulty in predicting 

release from jail and final filing decisions meant that many sample members consented and 

were interviewed, only to be found ineligible at a later time. This was the price paid for getting 

true early baseline interviews with defendants who were subsequently found to be ineligible. 

4 The evidence supporting an attrition problem is characterized as "weak" because, while the interaction between 

attrition and treatment group status does predict severity of baseline drug problem, the interaction between severity of 

baseline drug problem and treatment group status does not significantly predict attrition. 
Appendix A. Impact Evaluation Methodology A – 11 

Table A.2. BTC Sample Recruitment and Interviewing Summary 

Birmingham Jacksonvillec Tacomad 

PreBTC 

BTCb Pre-BTC BTC Pre-BTC BTC 

Recruitment Dates 3/13/97 9/8/98 to 5/5/99 to 2/1/00 to 5/6/99 to 2/1/00 to 

to 12/1/98 9/30/99 7/14/00 9/12/99 8/11/00 

5/2/97 

Consented 311 545 1306 808 597 468 

(% of those approached) (na) (91%) (47%) (72%) (54%) (83%) 

Eligiblea 236 374 445 335 421 382 

Baseline Interview 192 374 444 335 351 382 

(% of eligible) (81%) (100%) (100%) (100%) (83%) (100%) 

Follow up Interview 137 245 317 218 255 286 

(71%) (66%) (71%) (65%) (73%) (75%) 

a

 Consenting preceded eligibility determination except for the BTC sample in Birmingham. 

b

 In Birmingham, the BTC sample was first contacted after BTC eligibility was determined and interviews conducted at the time of 

consent. 

c In Jacksonville, research contact occurred at the time of booking and many of those consented were not released or were later 

found ineligible. Because case filing decisions were made an average of 20 days after arrest, most baseline interviews preceded 

final eligibility determination (ie., a pending felony case) and baseline interviews with ineligible respondents were discarded. 

d

 In Tacoma, the BTC was contacted, consented and interviewed prior to final eligibility determination. 

DATA ANALYSIS PROCEDURES 

The analysis uses two strategies to control for differences in the samples at baseline and 

in attrition: traditional multivariate models that incorporate control variables to measure 

observed sample differences and a two-stage estimation procedure designed to capture the 

effects of unmeasured sample differences (Heckman 1979). The two-stage method is used to 

assess whether unmeasured variables, related to both treatment status and the outcomes of 

interest (e.g., recidivism), lead to bias in the estimates of BTC’s effect (Barnow, Cain, and 

Goldberger 1980; Smith and Paternoster, 1990; Winship and Mare, 1992). At the first stage, the 

likelihood of being a BTC sample member was estimated using predictors believed to 

differentiate the two groups. The purpose of this first-stage equation is to obtain a correction 

factor, which in essence is a proxy for unmeasured variables. This correction factor is then 

included in a second-stage equation as an independent variable, along with other variables 

hypothesized to affect the outcome of interest (see Winship and Mare 1992 or Winship and 

Morgan 1999). 

The models used for the first-stage equation were chosen on the basis of the predictive 

power and parsimony in controlling for the sample differences at each site (tables A.3.–A.5). 

The predictors of treatment status were measures of sociodemographic factors, current and 

past employment status, criminal history, and seriousness of substance abuse and other social 

problems. The variables included in the model varied by site and were selected to maximize the 
Appendix A. Impact Evaluation Methodology A – 12

parsimonious prediction of sample membership. The predictive power of the models was not 

improved by additional variables and the selected models did have any indications of collinearity 

problems, as determined by variance inflation factors. The pseudo-R2

 for the sample selection 

model was .38 for Birmingham, .23 for Jacksonville, and .27 for Tacoma. 

Table A.3. Sample Selection Model (First-stage Equation) for Birmingham Analysis 

Variable 

Parameter 

Estimate 

b/Std. 

Error p-level 

Constant 1.40 4.79 0.00 

Female 0.34 1.64 0.10 

Time at current residence –0.01 –1.91 0.06 

Full-time Employment/Studenta 0.56 2.42 0.02 

Part-time Employment 0.57 2.21 0.03 

Days in Jail, past 30 days –0.06 –7.84 0.00 

On Parole/Probation at Sample Entry –0.44 –2.45 0.01 

Lifetime number of prior drug treatment episodes –0.10 –1.48 0.14 

Number of Self-Reported Offenses, past 6 months –0.01 –2.41 0.02 

Days experiencing Drug Problems, past 30 days –0.02 –1.75 0.08 

Days experiencing Psychological Problems, past 30 days –0.02 –2.23 0.03 

Days experiencing Employment, past 30 days –0.03 –2.90 0.00 

 

Model Fit 

Pseudo–R2 0.38 

–2LL 180.93; 11 DF p = 0.0001 

N 382 

a

 The full-time and part-time employment variables are indicator variables; the suppressed category is all other responses, including 

“service,” “retired/disability,” “unemployed,” or “in controlled environment.” 
Appendix A. Impact Evaluation Methodology A – 13

Table A.4. Sample Selection Model (First-stage Equation)for Jacksonville Analysis 

Variable 

Parameter 

Estimate 

b/Std. 

Error p-level 

Longest Full-time Job Ever Held, in Years 0.041 11.206 0.001 

Days Paid for Working, Past 30 Days 0.035 19.303 0.001 

Income from Illegal Sources, Past 30 Days 0.000 4.207 0.040 

Months Paid for Working, Past 6 Mos. –0.088 7.792 0.005 

Severity of Legal Problems ASI Score 1.962 19.609 0.001 

Severity of Drug Problems ASI Score 1.986 11.726 0.001 

Severity of Psychological Problems ASI Score –1.101 17.029 0.001 

Days Used Marijuana, Past 30 Days 0.021 10.220 0.001 

Months Incarcerated, Lifetime –0.007 10.203 0.001 

On Probation/Parole at Baseline –0.587 13.332 0.000 

Days Engaged Illegal Activities for a Profit, Past 30 Days –0.037 12.345 0.000 

Alcohol Problem –0.615 3.703 0.054 

Cocaine Problem –0.992 17.780 0.001 

Marijuana Problem –0.532 6.710 0.010 

Poly-Drug Use Problem –0.171 0.638 0.424 

Alcohol-Drug Problem –0.685 14.915 0.001 

Constant –0.707 6.935 0.009 

Model Fit 

Pseudo–R2

 0.23 

–2LL 173.64; 16 DF p = 0.0001 

Valid N 661 
Appendix A. Impact Evaluation Methodology A – 14

Table A.5. Sample Selection Model (First-stage Equation) for Tacoma Analysis 

Variable 

Parameter 

Estimate 

Constant 1.161*** 

Age 0.016* 

Married 0.563*** 

Full-time –0.310* 

Days Paid for Working, Past 30 –0.026** 

Months Paid for Working, Past 6 mos. 0.106*** 

ASI Legal Composite Score –1.956*** 

Number of Self-reported drug offenses, past 6 mos. 0.008*** 

Prior Arrests –0.032** 

Times Treated for Drug Abuse, Lifetime 0.059* 

Days used Cocaine, Past 30 –0.040*** 

Days used Methamphetamine, Past 30 –0.041*** 

Days used Marijuana, Past 30 –0.013* 

Days used Opiates, Past 30 –0.023** 

Model Fit 

Pseudo–R2

 0.27 

–2LL 216.21*** 

Valid N 698 

*p<.05, **p<.01, ***p<.001 

Dichotomous drug and recidivism outcome variables were first estimated with probit 

models. Then, in order to investigate the effects of selection on these results, dichotomous 

outcome variables were estimated again, this time using bivariate probit models. These 

bivariate probit models simultaneously estimate the sample selection model (discussed above), 

BTC's effect on the outcome of interest, and the correlation between the two error terms (rho) 

from the two outcomes. The inclusion of this correlation term corrects for selection bias (Smith 

and Paternoster 1990, p. 1118). Models with counts as dependent variables (e.g., number of 

arrests) were first estimated with poisson or negative binomial regression. Similar to the 

analysis of dichotomous variables, these analyses were then repeated with the inclusion of 

Heckman's correction term. The results of the selection-corrected models will be reported only 

when the inclusion of the Heckman correction leads to substantively different results than the 

analysis without the correction. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 1 

Appendix B

Changes in Case Handling, Disposition,

and Sentencing in the Evaluation Samples 

In order to explore changes in case processing during BTC more carefully, this appendix 

uses the case files of the defendants included in the impact evaluation sample described in 

appendix A. 

Birmingham 

Of the 566 cases in the two Birmingham impact evaluation samples, 480 were located in 

the Administrative Office of the Courts data. Each case was followed for one year from original 

case filing date. These cases were compared on several case processing measures, including 

closure rate, disposition (guilty rate), and average number of hearings to case closure. The 

findings produced from these analyses follow the case processing trends for the larger sample 

described in appendix A. 

BTC cases were more likely to be resolved within 12 months of original case filing and 

more likely to result in a period of confinement (if found guilty), but defendants were less likely to 

be found guilty, as shown in table B.1. The cases differed significantly on other variables that 

may affect case disposition, such as charge and lifetime number of months incarcerated. A 

logistic regression, controlling for case characteristics, was used to estimate the effect of BTC 

on the likelihood of case disposition within a year (table B.2). The results indicate that the odds 

of a BTC case being closed within one year were 79 percent greater than a comparison case 

being closed in the same amount of time. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 2 

Table B.1 Case and Client Variables for the BTC and Pre-BTC 

Impact Evaluation Samples in Birmingham 

Pre-BTC Sample 

(n = 147) 

BTC Sample 

(n = 333) 

Significance of 

Difference 

Case closed within 12 months of filing 46%*** 61% p < .01 

Found guilty, if closed 69%*** 50% p < .01 

Incarcerated, if guilty 6% 21% ns 

 Mean number of hearings in case 1.63*** 1.44 p < .01 

Type of charge 

Drug distribution 4% 9% ns 

Drug possession 35%*** 53% p <. 01 

Disorder 3% 5% ns 

Person/violent 11%** 5% p < .05 

Weapons 2% 5% ns 

 Property 44% 23% ns 

Offender Characteristics 

 Gender ns 

Female 16% 21% 

Male 84% 79% 

 Race ns 

Black 70% 64% 

 Nonblack 30% 36% 

 Mean age 32.2 31.0 ns 

Lifetime number of months 

incarcerated 

15.1*** 5.7 p < .01 

*p < .10; **p < .05; ***p < .01; ns= not significant 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 3

Table B.2. Logistic Regression Estimates of Case Disposition 

within a Year of Filing in Birmingham 

Variable 

Parameter 

Estimate 

Standard 

Error 

SignificanceLevel 

BTC case 0.58 0.22 < 0.01 

Female 0.46 0.26 0.08 

Black –0.24 0.21 0.26 

Age –0.01 0.01 0.80 

Disorder offense –0.25 0.52 0.64 

Drug distribution offense –1.78 0.43 < 0.01 

Drug possession offense –0.55 0.24 0.02 

Person/violent offense –1.08 0.41 < 0.01 

Weapons offense –0.20 0.53 0.71 

Lifetime months incarcerated –0.01 >0.01 0.01 

Drug use 0.29 0.27 0.28 

Constant 0.42 0.47 0.37 

 

Model Fit 

N 480 

–2 log likelihood (covariates only) 45.861 with 11 DF (p = .001) 

R2 0.07 

However, comparisons of the cases closed within a year of filing did not find significant 

differences between the BTC and comparison samples in the number of hearings per case or 

likelihood of conviction: 

• Poisson regression analysis found no significant differences in the number of 

hearings prior to disposition between BTC cases and pre-BTC cases, controlling for 

other factors (table B.3). 

• Logistic regression showed no significant differences in the likelihood of conviction 

between BTC cases and pre-BTC cases, controlling for other factors (table B.4). 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 4

Table B.3. Number of Hearings to Disposition for Cases Closed 

within a Year of Filing in Birmingham (Poisson Regression) 

Variable 

Parameter 

Estimate 

Standard 

Error 

SignificanceLevel 

BTC Case 0.13 0.26 0.79 

Female 0.04 0.13 0.76 

Black 0.01 0.11 0.92 

Age < 0.01 < 0.01 0.95 

Disorder offense 0.08 0.26 0.76 

Drug distribution offense 0.37 0.25 0.14 

Drug possession offense 0.01 0.13 0.91 

Person/violent offense 0.26 0.24 0.28 

Weapons offense 0.18 0.25 0.46 

Lifetime months incarcerated 0.01 < 0.01 0.16 

Drug use < 0.02 0.16 0.89 

Constant 0.07 0.26 0.79 

Model Fit 

N 273 

–2 log likelihood (covariates only) 5.91 with 11 DF (p < .10) 

R2 0.01 

Table B.4. Disposition of Cases Closed within a Year of Filing 

in Birmingham (Logistic Regression) 

Variable 

Parameter 

Estimate 

Standard 

Error 

SignificanceLevel 

BTC Case –0.36 0.34 0.29 

Female –0.58 0.33 0.08 

Black –0.04 0.29 0.90 

Age –0.01 0.01 0.45 

Disorder offense –1.67 0.65 0.01 

Drug distribution offense –2.22 0.75 < 0.01 

Drug possession offense –1.76 0.34 < 0.01 

Person/violent offense –1.29 0.64 0.04 

Weapons offense –0.79 0.65 0.23 

Lifetime months incarcerated –0.01 < 0.01 0.10 

Drug use 0.08 0.41 0.84 

Constant 1.98 0.69 < 0.01 

Model Fit 

N 273 

–2 log likelihood (covariates only) 53.28 with 11 DF (p = .0001) 

R2 0.14 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 5 

Jacksonville 

In Jacksonville, complete case processing data were retrieved from court records for 429 

of the 444 clients (97 percent) in the pre-BTC sample and 326 of the 332 clients (98 percent) in 

the BTC sample. These case records were compared regarding time to charge filing, first court 

appearance, and disposition, as well as type and length of sentence received in each case. This 

analysis examines case processing while controlling for defendant characteristics including 

education, employment history, and number of prior arrests. 

Table B.5 shows that there were no differences between the two samples on gender, 

race, age, social status variables, or mean number of charges. The samples did differ 

significantly by offense types. Unlike Birmingham, the Jacksonville BTC sample contained a 

higher proportion of drug offenders than did the pre-BTC sample. 

Table B.5. Defendant and Offense Characteristics for the 

Impact Evaluation Samples in Jacksonville 

Pre-BTC BTC Significance of 

(N = 429) (N = 326) Difference 

Defendant Characteristics 

 Gender 

Female 

Male 

 Race 

Black 

White 

Mean Age (SD) 

ns 

17% 

83% 

ns 

60% 

40% 

32.1 (9.8) ns 

21% 

79% 

61% 

39% 

30.8 (9.5) 

Offense Characteristics 

Type of offense p < .01 

 Drug offenses 40% 64% 

 Property offenses 26% 16% 

 Violent/person offenses 10% 3% 

 Traffic offenses 5% 8% 

 Other/unknown offenses 19% 9% 

Mean number of charges (SD) 2.2 (2.1) 2.0 (1.1) ns 

A more rigorous analysis of time to disposition is presented in table B.6. This analysis 

controls for several variables expected to affect case processing decisions and differences 

between the two samples of cases using Cox regression (survival analysis). These variables 

include demographic variables, social status variables, number of prior arrests, and type of 

offense. Type of offense is dummy coded with drug offenses as the reference category. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 6

The survival analysis found no significant differences in time to disposition between BTC 

and pre-BTC cases. Results do show significant relationships between time to case disposition 

and age and race of the defendants. Older defendants and African Americans have a greater 

likelihood of having their case closed on any given day than younger defendants and Caucasian 

defendants. Conversely, defendants with more stable employment histories have a lower 

likelihood of having their case closed on any given day than those with more employment 

problems. Defendants charged with “other” offenses (mostly public order offenses) have a lower 

likelihood of having their case closed on any given day than those charged with drug offenses. 

Table B.6. Time to Case Disposition in Jacksonville (Cox Regression) 

Variable Parameter Estimate Hazard Ratio 

BTC –0.053 0.949 

Age 0.023*** 1.023 

Female 0.058 1.059 

Black 0.213** 1.238 

Years in longest job –0.022** 0.978 

Educational level 0.003 1.003 

Property offense 0.145 1.159 

Violent offense –0.129 0.879 

Driving offense 0.053 1.055 

Other offense –0.122*** 0.643 

Number of charges 0.036* 1.037 

Prior arrests 0.010* 1.010 

Self-reported offending in past 6 

months. 0.000 1.000 

 

Model Fit 

N 733 

-2LL 48.717*** 

*p < 0.10; **p < 0.05; ***p < 0.01 

The sentencing outcomes for the two samples were very similar (table B.7). There were 

no significant differences in number of convictions per case, method of disposition, or type of 

sentence in cases where the defendant was found guilty. However, BTC cases had significantly 

fewer hearings prior to case disposition than the pre-BTC cases. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 7 

Table B.7. Pre-BTC/BTC Comparison of Case Outcomes One Year from Arrest 

Pre-BTC 

(N = 421) 

BTC 

(N = 325) 

Significance

of Difference 

Case unresolved after 365 days 20% 19% ns 

Disposition of closed cases p < .01 

 Dismissed/nolle prossed/acquitted 

 Guilty/convicted 

Other 

5% 

75% 

< 1% 

1% 

79% 

1% 

Mean number of conviction charges in closed cases (SD) 1.1 (0.7) 

Average number of hearings to case close (SD) 8.3 (9.4) 

Type of sentence in guilty cases 

 Incarceration 60% 

Other 1% 

1.1 (0.4) 

6.7 (5.0) 

58% 

1% 

ns 

p < .05 

ns 

Probation without incarceration 20% 22%

A more thorough analysis of incarceration duration controls for group differences and 

other variables expected to affect sentence length, including type of offense, number of prior 

arrests, number of convictions, and social status. Table B.8 presents the results of an ordinary 

least squares (OLS) regression of cases sentenced to incarceration tested for sample 

differences in sentence duration (months of incarceration). Again, the difference between the 

BTC cases and pre-BTC cases was not significant; the months of incarceration specified in the 

sentence remained similar. As expected, the duration of incarceration in the sentence was 

significantly related to the number of conviction charges, number of self-reported offenses, and 

conviction for a violent crime (compared to conviction for a drug offense). 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 8

Table B.8. Length of Sentence to Incarceration in Months 

for Jacksonville Impact Evaluation Sample (OLS Regression) 

Variable Parameter Estimate Significance-Level 

BTC –1.278 0.277 

Age –0.020 0.788 

Female –0.623 0.690 

Black 0.003 0.998 

Tenure of longest job, in years -0.038 0.785 

Educational level 0.162 0.630 

Property offense –1.503 0.317 

Violent offense 8.827 0.000 

Driving offense –1.868 0.474 

Other offense 1.813 0.376 

Number of charges 0.059 0.835 

Number of convictions 2.642 0.015 

Prior arrests –0.004 0.952 

Self-reported offending, past 6 months. 0.026 0.033 

Intercept 1.533 0.730 

 

Model Fit 

N 417 

R2

 0.07 

Tacoma 

In Tacoma, complete case processing data were found on 293 of the 351 clients (83 

percent) in the comparison group and 307 of the 382 clients (80 percent) in the BTC group; the 

remaining cases are either not found or incomplete. These case records were compared on time 

to arraignment, pretrial conference, and disposition, as well as type and length of sentence 

received in each case. This analysis incorporates measures of offense seriousness and criminal 

history score, coded in accordance to Washington State Sentencing Guidelines. 

Table B.9 compares the groups on several pertinent offender and offense characteristics. 

This comparison displays several significant differences between the groups on important 

variables, including age at arrest, criminal history score, and type of charge. There were no 

differences between the groups, however, on gender, race, or mean number of charges. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 9

Table B.9 Offender and Offense Characteristics for Impact Evaluation Sample in Tacoma 

Pre-BTC 

(N = 293)

BTC 

(N = 307)

Significance of 

Difference

Offender Characteristics 

 Gender ns 

 Female 28% 24% 

 Male 

 Race ns 

 White 

 Nonwhite 28% 26% 

 Mean age at arrest (SD) 31.5 (8.4) 32.9 (8.4) p < .05 

 Criminal history (SD) 1.5 (1.9) 1.1 (1.8) p < .01 

Offense Characteristics 

 Type of charge p < .05 

 Drug possession 50% 53% 

 Drug sales 18% 24% 

 Property offenses 24% 14% 

 Person offenses 3% 3% 

 Other offenses 5% 6% 

 Mean number of charges (SD) 1.64 (0.83) 1.72 (1.03) ns 

 Mean offense seriousness (SD) 1.48 (1.64) 1.42 (1.56) 

Table B.10 shows several significant differences between the groups on variables 

thought to affect time to disposition. The analysis below controls for these differences and other 

variables expected to affect time to disposition using Cox regression (survival analysis). These 

variables include demographic variables, guideline criminal history score, number of prior 

arrests, type of offense, and offense seriousness. Type of offense is dummy coded with drug 

possession as the reference category. 

The key finding for the evaluation is that the likelihood of case disposition on any given 

day is 29 percent greater for the BTC group than the comparison group. This means that the 

BTC group’s cases were closed more quickly than those of the comparison group. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 10

Table B.10. Time to Disposition for Impact Evaluation Sample in Tacoma (Cox Regression) 

Variable Parameter Estimate Hazard Ratio 

BTC 0.255*** 1.290 

Age –0.007 0.993 

Female –0.134 0.874 

Nonwhite –0.105 0.901 

Drug distribution offense –0.663*** 0.515 

Property offense 0.330*** 1.391 

Violent offense 0.188 1.206 

Other offense –0.096 0.909 

Number of charges –0.023 0.977 

Criminal history score –0.107*** 0.899 

Prior arrests 0.028*** 1.028 

Offense seriousness level –0.091*** 0.913 

Model Fit 

N 574 

-2LL 97.251*** 

*p < 0.10; **p < 0.05***p < 0.01 

The sentencing outcomes for the two samples did not differ significantly on the number 

of conviction charges per case, method of disposition (table B.11), or duration of incarceration 

ordered at sentencing. While there appears to be a meaningful difference on this measure, this 

difference is largely attributable to one case in the comparison group with a very long sentence; 

comparing the group means on length of sentence omitting this case reduces that difference to 

126 days versus 116 days, a nonsignificant difference. The median for both groups was 60 

days. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 11 

Table B.11. Comparison Sentencing Outcomes for the Impact Evaluation Samples in Tacoma 

Pre-BTC 

(N = 293) 

BTC 

(N = 307) 

Significance

of Difference 

Mean number of convictions per case (SD) 1.1 (0.4) 1.1 (0.4) ns 

Method of disposition ns 

Trial 0% 0% 

Type of sentence 

Jail 91% 95% 

p < .05 

Guilty plea 98% 98% 

Dismissed 3% 2%

Prison 9% 5%

Probation w/o incarceration 0% 0% 

Mean length of incarceration, in days (SD) 141 (371) 116 (193) ns 

The analysis of length of incarceration ordered at sentencing, shown in Table B.12, 

controls for group differences and other variables expected to affect sentence length, including 

offense seriousness, criminal history, and number of convicted charges. The results are based 

on an OLS regression with log sentence in days as the dependent variable; type of offense is 

dummy coded with drug possession as the reference category. This analysis indicates that 

participating in BTC had no meaningful effect on sentence length independent of other factors. 

As expected, offense seriousness level, criminal history score, and number of arrests were 

significantly related to incarceration duration. 
Appendix B. Changes in Case Handling, Disposition, and Sentencing in the Evaluation Samples B – 12

Table B.12. Log Sentence in Days for the Impact Evaluation Samples in Tacoma (OLS Regression) 

Variable Parameter Estimate Significance-Level 

BTC 0.118 0.162 

Age 0.002 0.734 

Female –0.221 0.022 

Nonwhite 0.132 0.167 

Drug distribution offense 1.028 0.000 

Property offense 0.244 0.035 

Violent offense 0.428 0.103 

Other offense 0.358 0.070 

Number of charges 0.018 0.711 

Number of convictions 0.206 0.141 

Criminal history score 0.357 0.000 

Prior arrests 0.039 0.000 

Offense seriousness level 0.118 0.000 

Intercept 2.434 0.000 

 

Model Fit 

N 574 

R2 0.46 
Appendix C. Composite Scale Properties C – 1 

Appendix C

Composite Scale Properties 

TACOMA Baseline Scores 

All 

(N = 733) 

BTC 

(N = 382) 

Comparison 

(N = 351) 

ASI MEDICAL COMPOSITE 

(alpha = 0.898) 0.280 0.292 0.267 

Days experienced medical problems, 

past 30 days 7.116 7.526 6.670 

How troubled by medical problems, 

past 30 days 1.241 1.325 1.151 

How important is treatment for 

medical problems 1.164 1.165 1.162 

EMPLOYMENT COMPOSITE 

SCORE (alpha = 0.658) 0.808 0.798 0.819 

Have valid driver’s license 0.217 0.255 0.177 

Have auto available 0.130 0.155 0.103 

Number of days paid for working, past 

30 days 4.784 4.291 5.319 

Money received from working, past 30 

days 299.705 313.861 284.339 

ALCOHOL COMPOSITE SCORE 

(alpha = 0.863) 0.109 0.070 0.152 

Days used alcohol, past 30 days 5.185 3.052 7.533 

Days used alcohol to intoxication, past 

30 days 3.160 1.942 4.501 

Days experienced alcohol problems, 

past 30 days 1.296 0.963 1.663 

How troubled by alcohol problems, 

past 30 days 0.298 0.178 0.429 

How important is treatment for alcohol 

problems 0.331 0.183 0.493 

Money spent on alcohol, past 30 days 23.302 13.830 33.729 

DRUG COMPOSITE SCORE 

(alpha = 0.596) 0.142 0.120 0.166 

Days used heroin past 30 days 2.012 1.270 2.828 

Days used methadone past 30 days 0.121 0.139 0.101 

Days used opiates/analgesics past 30 

days 0.649 0.589 0.716 

Days used barbiturates past 30 days 0.142 0.037 0.259 

Days used sedatives past 30 days 0.815 0.974 0.641 

Days used cocaine past 30 days 2.515 1.599 3.520 

Days used amphetamines past 30 days 7.305 4.471 10.417 

Days used cannabis past 30 days 5.182 3.809 6.690 

Days used hallucinogens past 30 days 0.077 0.042 0.115 

More than one substance/day past 30 6.226 4.042 8.624 
Appendix C. Composite Scale Properties C – 2

 All 

(N = 733) 

BTC 

(N = 382) 

Comparison 

(N = 351) 

days 

Days experienced drug problems past 

30 days 7.378 7.241 7.529 

How important is treatment for drug 

problems 1.582 1.610 1.552 

LEGAL COMPOSITE SCORE 

(alpha = 0.589) 0.570 0.510 0.639 

Presently awaiting charges, 

trial/sentencing 0.916 0.850 0.991 

Days illegal activities for profit past 

30 days 5.979 3.312 9.015 

How serious are present legal 

problems 3.045 2.865 3.250 

How important is counseling for legal 

problems 3.073 2.836 3.343 

Money from illegal sources, past 30 

days 545.169 475.463 624.773 

FAMILY COMPOSITE SCORE 

(alpha = 0.649) 0.188 0.157 0.223 

Are you satisfied with this situation? 1.373 1.471 1.265 

Days serious conflict with family-30 

days? 2.266 1.680 2.910 

Days serious conflict with others-30 

days? 1.834 1.661 2.023 

How troubled by the family problems? 0.981 0.841 1.134 

Problem get along: mother-30 days? 0.132 0.117 0.142 

Problem get along: father-30 days? 0.095 0.121 0.081 

Problem get along: sibling-30 days? 0.121 0.108 0.131 

Problem get along: spouse-30 days? 0.255 0.269 0.244 

Problem get along: children-30 days? 0.043 0.064 0.032 

Problem get along: other family 

member-30 days? 0.052 0.046 0.055 

Problem get along: friend-30 days? 0.124 0.109 0.137 

Problem get along: neighbor-30 days? 0.068 0.066 0.070 

Problem get along: coworker-30 days? 0.044 0.126 0.017 

PSYCH COMPOSITE SCORE 

(alpha = 0.782) 0.277 0.263 0.294 

Had serious depression, past 30 days 0.464 0.470 0.458 

Had serious anxiety, past 30 days 0.522 0.543 0.497 

Had hallucinations, past 30 days 0.088 0.071 0.108 

Had trouble understanding, past 30 

days 0.302 0.255 0.356 

Had trouble controlling violent 

behavior, past 30 days 0.168 0.134 0.207 

Had serious thoughts of suicide, past 

30 days 0.098 0.063 0.138 

Attempted suicide, past 30 days 0.011 0.008 0.015 

Medication for psych problems, past 

30 days 0.119 0.134 0.102 

# days had psych problems, past 30 

days 9.989 9.485 10.560 
Appendix C. Composite Scale Properties C – 3

 All 

(N = 733) 

BTC 

(N = 382) 

Comparison 

(N = 351) 

How troubled by psych problems, past 

30 days 1.987 1.879 2.111 

EMPLOYMENT DIFFICULTY 

SCORE (alpha = 0.801) 0.204 0.173 0.237 

Days had employment problems, past 

30 days 3.315 2.365 4.349 

How troubled by employment 

problems, past 30 days 0.874 0.751 1.009 

How important is counseling for 

employment problems, past 30 days 1.130 1.010 1.260 

SOCIAL CONFLICTS SCORE 

(alpha = 0.547) 0.149 0.120 0.181 

Days had serious conflicts with nonfamily members, past 30 days 1.858 1.649 2.086 

How troubled by social problems, past 

30 days 0.724 0.641 0.814 

How important is counseling for social 

problems 0.415 0.579 1.077 
Appendix C. Composite Scale Properties C – 4 

TACOMA Follow-up Scores

 All 

(N = 542) 

BTC 

(N= 286) 

Comparison 

(N = 256) 

MEDICAL COMPOSITE SCORE (alpha = 

0.877) 0.258 0.279 0.235 

Days experienced medical problems, past 30 

days 6.453 7.309 5.492 

How troubled by medical problems, past 30 

days 1.215 1.326 1.091 

How important is treatment for medical 

problems 1.022 1.046 0.996 

EMPLOYMENT COMPOSITE SCORE 

(alpha = 0.752) 0.795 0.779 0.813 

Have valid driver’s license 0.203 0.253 0.148 

Have auto available 0.134 0.157 0.109 

Number of days paid for working, past 30 days 5.991 6.064 5.910 

Money received from working, past 30 days 353.784 306.167 405.339 

ALCOHOL COMPOSITE SCORE (alpha = 

0.855) 0.080 0.073 0.087 

Days used alcohol, past 30 days 3.498 3.205 3.826 

Days used alcohol to intoxication, past 30 days 2.155 1.947 2.387 

Days experienced alcohol problems, past 30 

days 1.267 1.254 1.281 

How troubled by alcohol problems, past 30 

days 0.278 0.272 0.285 

How important is treatment for alcohol 

problems 0.229 0.233 0.225 

Money spent on alcohol, past 30 days 17.596 12.247 23.603 

DRUG COMPOSITE SCORE (alpha =0.602) 0.093 0.086 0.101 

Days used heroin past 30 days 1.583 1.448 1.732 

Days used methadone past 30 days 0.186 0.301 0.059 

Days used opiates/analgesics past 30 days 0.749 0.631 0.878 

Days used barbiturates past 30 days 0.006 0.000 0.012 

Days used sedatives past 30 days 0.602 0.477 0.740 

Days used cocaine past 30 days 1.415 1.556 1.260 

Days used amphetamines past 30 days 3.341 2.828 3.906 

Days used cannabis past 30 days 2.805 2.624 3.004 

Days used hallucinogens past 30 days 0.051 0.014 0.091 

More than one substance/day past 30 days 3.129 2.753 3.543 

Days experienced drug problems past 30 days 6.015 5.588 6.484 

How important is treatment for drug problems 1.113 1.022 1.213 

LEGAL COMPOSITE SCORE (alpha = 

0.701) 0.335 0.283 0.393 

Presently awaiting charges, trial/sentencing 0.447 0.371 0.532 

Days illegal activities for profit past 30 days 3.092 2.392 3.884 

How serious are present legal problems 2.321 2.163 2.500 

How important is counseling for legal problems 1.769 1.382 2.208 

Money from illegal sources, past 30 days 301.947 208.505 407.823 

FAMILY COMPOSITE SCORE (alpha = 

0.678) 0.120 0.095 0.149 

Are you satisfied with this situation? 1.517 1.570 1.456 

Days serious conflict with family-30 days? 0.963 0.817 1.127 
Appendix C. Composite Scale Properties C – 5

 All 

(N = 542) 

BTC 

(N= 286) 

Comparison 

(N = 256) 

Days serious conflict with others-30 days? 1.095 0.986 1.218 

How troubled by the family problems? 0.588 0.415 0.782 

Problem get along: mother-30 days? 0.092 0.062 0.129 

Problem get along: father-30 days? 0.073 0.031 0.122 

Problem get along: sibling-30 days? 0.079 0.066 0.093 

Problem get along: spouse-30 days? 0.150 0.109 0.197 

Problem get along: children-30 days? 0.028 0.007 0.051 

Problem get along: other family member-30 

days? 0.021 0.018 0.024 

Problem get along: friend-30 days? 0.061 0.048 0.075 

Problem get along: neighbor-30 days? 0.028 0.021 0.035 

Problem get along: coworker-30 days? 0.039 0.032 0.045 

PSYCH COMPOSITE SCORE (alpha = 

0.825) 0.211 0.186 0.238 

Had serious depression, past 30 days 0.357 0.316 0.402 

Had serious anxiety, past 30 days 0.370 0.335 0.410 

Had hallucinations, past 30 days 0.074 0.051 0.100 

Had trouble understanding, past 30 days 0.261 0.236 0.289 

Had trouble controlling violent behavior, past 

30 days 0.115 0.084 0.149 

Had serious thoughts of suicide, past 30 days 0.073 0.062 0.084 

Attempted suicide, past 30 days 0.010 0.000 0.020 

Medication for psych problems, past 30 days 0.132 0.120 0.145 

# days had psych problems, past 30 days 7.935 7.175 8.775 

How troubled by psych problems, past 30 days 1.464 1.371 1.566 

EMPLOYMENT DIFFICULTY SCORE 

(alpha = 0.759) 0.177 0.180 0.174 

Days had employment problems, past 30 days 3.194 3.570 2.784 

How troubled by employment problems, past 

30 days 0.823 0.888 0.753 

How important is counseling for employment 

problems, past 30 days 0.876 0.791 0.969 

SOCIAL CONFLICTS SCORE (alpha = 

0.567) 0.083 0.063 0.105 

Days had serious conflicts with non-family 

members, past 30 days 1.070 0.979 1.173 

How troubled by social problems, past 30 days 0.420 0.336 0.514 

How important is counseling for social 

problems 0.254 0.290 0.592