ORIENTATION TO MEDIATION IN PORTLAND, OREGON

This article describes an orientation to mediation used in the Multnomah County Circuit Court in Portland, Oregon. The role of the judiciary makes this program unique, and the orientation has increased the number of agreements reached. This orientation helps parents make decisions about mediation and use the process more effectively.     

FAMILY COURT COORDINATION OF HUMAN SERVICES, DESCHUTES COUNTY, OREGON

This article describes an innovative program in Deschutes County, Oregon designed to coordinate services both within the court and within the community to assist families in the family court. One of the important features of this system is the employment of a family advocate to coordinate services to families.     

Administration and Justice

Although the existence of plea negotiation as an operative mode of disposition in most criminal court systems has been firmly established, its role in the administration of justice remains a topic of considerable debate. It has been claimed that plea negotiation subverts ideal principles of justice while attending to administrative needs for speedy case settlement. More recent research indicates that disposition by guilty plea is a complex process that incorporates system needs as well as principles of justice. Findings from an exploratory study of the felony disposition guilty plea is a complex process that incorporates system needs as well as principles of justice. Findings from an exploratory study of the felony disposition process in the Multnomah County court system in Portland, Oregon suggest that, under certain conditions, plea negotiation can effect a balance between competing but interdependent domains of action in the criminal disposition process.     

Mothers and children last: the Oregon Medicaid experiment.

In 1989 and 1991, the Oregon legislature enacted a series of initiatives to extend health coverage to uninsured state residents. Among these initiatives is an act that seeks to extend a modified set of Medicaid benefits to state residents with family incomes below the federal poverty level. This act also reduces benefits the state is now required to provide to Medicaid-enrolled women of childbearing age and children. This Article explores the legal context in which the Oregon Medicaid experiment must be evaluated. It argues that by reducing the level of coverage to which tens of thousands of exceedingly poor, Medicaid-eligible women and children are entitled, the experiment falls outside the scope of valid research that the United States Department of Health and Human Services may either sanction or fund. The Article also discusses the implications of the Oregon experiment, if approved, for the future direction of the Medicaid program in particular, and for health care reform for the poor, generally.     

The descriptive epidemiology of unnatural deaths in Oregon's state institutions: a 25-year (1963-1987) study. I. A preliminary analysis of recent incidence rates of suicide in mental and correctional facilities

This paper presents for the first time the annual suicide incidence rates of residents from four Oregon state institutions for a 5-year (1983-1987) period of time. The suicide rate for inmate-patients of the Forensic Psychiatric Program (for the care and treatment of individuals who have been found guilty of serious crime and to be mentally ill) is 820/100,000. This represents a suicide rate 51 times higher than the rate for Marion County or the state of Oregon. This is also one of the highest annual suicide rates ever reported. The suicide rate for patients of the Oregon State Hospital is 289/100,000, which is similar to other reported suicide rates in hospitalized mentally ill populations. This rate is approximately 18 times higher than the rate for Marion County or the state of Oregon. The suicide rate for inmates of Oregon's four correctional institutions is approximately 29/100,000, which is similar to other reported rates for prisoners. This rate is approximately 1.8 times higher than the rate for Marion County or the state of Oregon. The suicide rate for residents of the Fairview Training Center (for care of the mentally retarded and developmentally disabled) is zero.     

Boundary spanning between industry and university: the role of Technology Transfer Centres

Technology Transfer Centres (TTCs) have been analyzed in the last few years by focusing on the relationship between a TTC, provider of knowledge-intensive services, and a firm client-receiver. Less attention has been devoted to a more complex relationship which involves in the dyadic provider-receiver tie a third relevant body, University. We provide both a theoretical and an empirical contribution by studying whether TTCs can bond the academic and industrial system and we define the activities that make-up this role such as: scanning and selection of R&D opportunities, bridge building, semantic translation of domain specific knowledge, co-production of new knowledge. The boundary spanning role of TTCs is discussed drawing on different and complementary theoretical perspectives. Moreover, we test research hypotheses on the antecedents of boundary spanning activity from a knowledge-based perspective. We argue that TTC boundary spanners need to leverage on both technical skills and networking competences. Empirical investigation has been carried out with a survey of the TTC population of North East Italy. The research findings highlight the task coordination activities implied by a boundary spanning role in joint R&D projects and show that the endowment of human capital at individual level and a qualified social capital at individual and organizational level are the main determinants.     

The King County (Washington) Systems Integration Initiative: A First Look at the Kent District Dual System Youth Pilot Program

King County is one of five counties in Washington State participating in the John D. and Catherine T. MacArthur Foundation's Models for Change juvenile justice reform initiative. One key aspect of King County's Models for Change participation involves ongoing “systems integration” work intended to improve how youth who have cross‐over involvement in multiple systems—e.g., juvenile justice, child welfare, education, mental health, and/or others—are handled. These cross‐over cases often present a range of challenges to juvenile courts including substantial risk factors that increase their likelihood of continuing system involvement. This article provides a first look at an emerging pilot project in King County that is intended to improve how cross‐over cases are handled by child welfare and juvenile probation with the longer term goal of improving outcomes for these difficult cases.     

The descriptive epidemiology of unnatural deaths in Oregon's state institutions: a 25-year (1963-1987) study. III. A 25-year overview of unnatural deaths in the mental and correctional facilities.

I document 25 consecutive years (1963-1987) of unnatural deaths within the State of Oregon's mental and correctional institutions in Marion County. This study includes 93 unnatural deaths in the Oregon State Hospital, 18 in the Forensic Psychiatric Program, 52 in the Fairview Training Center, and 45 in the Corrections Department facilities. These institutional unnatural deaths are compared with the 2,618 unnatural deaths that occurred during this same period in Marion County (exclusive of these state facilities). Death rates are shown in five 5-year blocks of time to illustrate death trends. Accidents and suicides were the predominant types of unnatural death in the Oregon State Hospital; suicides predominated in the Forensic Psychiatric Program and the corrections facilities; and accidents predominated in the Fairview Training Center. Extremely high total unnatural death rates were found in the Oregon State Hospital (approximately 520/100,000 or 8.46 times that found in Marion County) and the Forensic Psychiatric Program (approximately 561/100,000 or 9.13 times that found in Marion County). The overall accident death rate for the Fairview Training Center was approximately 119/100,000 or 2.84 times that found in Marion County. The overall total unnatural death rate for the corrections facilities was approximately 75/100,000 or 1.23 times that found in Marion County. I compare these data with those of other investigators in the United States, Canada, and western Europe. The total unnatural death rate appears to represent a valid criterion of violent death within a community.     

The Violent Female Juvenile Offender: An Ignored Minority Within the Juvenile Justice System

Little attention is given to the violent female adolescent. While there is no argument that males commit most of the violent crimes (both juveniles and adults), violent females may demand the attention of policy-makers and administrators. Historically there has been a lack of program offerings for these offenders. This article examines violent female adolescent offenders referred to the Clark County (Las Vegas, Nevada) Juvenile Court Services in two different years (1985 and 1988). This examination includes a review of programs and alternatives for these offenders and a review of what is currently being done by the juvenile justice system to accommodate this population. Dispositions and programmatic treatment offerings for violent adolescent males and females are compared. Recommendations are offered for the juvenile justice system for consideration.     

The WHO European program of health legislation and the Health for All policy

The purpose of this paper is to provide a comprehensive review of the work of the World Health Organization (WHO), begun a decade ago in Europe, in the field of health legislation. This program is the result of the interaction between two important factors: the trends in national health policy and legislation at the country level, and the implementation of the Health for All policy, which has been collectively adopted by the European Member States in various WHO fora. Health legislation has proved to be a valuable tool in supporting National Health Policies in European countries and a key element in international health activities. The paper will be presented in three main parts. The first examines the legislative implications of the Health for All policy and strategy. The second gives an overview of developments in health legislation in Europe, focusing on national achievements in three areas in which change is necessary to achieve Health for All: health care systems, the environment, and lifestyles. The third part gives an account of activities carried out by the Regional Office for Europe of WHO in the health legislation field, recalls the organization of the first WHO medium-term program in this field, and summarizes its four current subprograms on health policy, health situation, exchange of information, and training. The conclusion briefly outlines the prospects for further developments in Europe.     

An Evaluation of a Delaware Teen Court

The Kent County Teen Court Program (teen court) provides sanctions for juvenile delinquency from a panel of a juvenile's peers rather than from a Family Court Judge. Part of the concept behind teen peer courts is that the sanction from one's peers carries more weight than sanctions from adults. The Delaware Criminal Justice Council (CJC) awarded a grant to Delaware ‐ Teen Courts, Inc. to support the operation of the Kent County Teen Court Program. The teen court program was designed to provide participants with hands‐on education in the judicial process, to create a sanction pro‐ gram that will not create a permanent record for a juvenile, and to foster, a sense of community responsibility in the program participants. The teen court program is an adult model teen court in which all of the judicial actors are juveniles with the exception of the judge. This article reflects the results of an evaluation on the Kent County Teen Court program's first two years of operation (Garrison, 2001).     

A Detailed Cost Evaluation of a Juvenile Drug Court that Follows the Juvenile Drug Court Model (16 Strategies)

Although juvenile drug courts (JDCs) have now been in operation for 17 years, there is still no definitive appraisal as to this model's cost effectiveness and in particular, no detailed cost analysis of a JDC program following the 16 strategies until this one. The cost data presented in this paper build on the process and outcome evaluations performed on the Clackamas County Juvenile Drug Court (CCJDC). The criminal justice costs incurred by participants in drug court are compared with the costs incurred by eligible non‐participants. CCJDC participants had far more positive outcomes than those who did not participate in the program. In the two years after drug court entry, CCJDC participants cost the taxpayers $961 less per participant than similar individuals who did not attend the drug court program.     

Evaluation and treatment of insanity acquittees in the community

This paper describes the monitored outpatient treatment program for Psychiatry Security Review Board (PSRB) clients in the largest single community treatment agency in the Oregon system. We describe 161 persons referred to this agency for evaluation and treatment. Ninety-one PSRB clients received treatment and of this group 51% had their conditional release revoked by the PSRB. The most frequent cause of revocation was noncompliance with treatment. There were only 11 crimes committed during the study period, four of which were in the felony range. The majority of PSRB clients are chronically mentally ill persons. We discuss both the treatment approach and our results in light of a recently published research agenda for insanity acquittees.     

Physically violent husbands of the 1890s and their resources

This article applies Goode's Resource Theory of wife beating to Lane County, Oregon from 1891 to 1900. The sample population consists of 56 women who appeared in divorce suits and claimed that their husbands had physically abused them. The study's findings largely support Resource Theory, although biases in the sample population make it more suggestive than conclusive. Wife beaters of the 1890s tended to be relatively low in economic and social resources, particularly when compared to their wives. The violent husbands' resources appear particularly slight when their psychological resources are considered. The article closes by suggesting that Resource Theory is not necessarily at odds with feminist interpretations of wife battering. Social scientists who assert that husbands' physical violence is more likely when their dominance is pronounced rather than fragile need to define more carefully and detect the actual level of power and resources that particular husbands enjoy.     

Parent–child contact problems and family intensive interventions: The crisis of adolescent suicidality and the role of social media

Although clinicians, educators and parents have been alarmed by the decline in the mental health of children and adolescents commensurate with the Covid-19 pandemic, statistics indicate there has been a downward spiral over the last decade. This has been evident in the overall increase in suicide rates for young people. For legal and mental health professionals working in the Family Court system, this has provided unique challenges. Most vulnerable has been those children and adolescents embroiled in high conflict divorces, especially those exhibiting parent child contact problems. This article focuses upon that population exhibiting parent child contact problems, and their treatment, specifically Family Intensive Intervention. Building Family Resilience is an Intensive family treatment program that has had to address this deterioration in child and adolescent mental health and increase in suicidality. The role of social media in both exacerbating and/or ameliorating mental health issues is explored.     

Investigators' and judges' opinions about civil commitment

As part of our work with the Oregon Task Force on Civil Commitment, we surveyed the judges and commitment investigators involved in the state's involuntary treatment program. In Oregon the investigators recommend whether or not a commitment hearing should be held. These mental health professionals indicated that current confidentiality laws restrict their access to important information. The investigators also expressed concern about the lack of resources with which to divert clients out of the commitment system. Judges too felt that relaxing the rules of evidence would improve the quality of commitment hearings. Regarding changes in the system, investigators and judges indicated that outpatient treatment (including compliance with medications) should be required of committed patients. These professionals noted that involuntary outpatient treatment could only be enforced if the system included a mechanism for hospitalizing patients who were noncompliant. Although the investigators believed commitment criteria should be broadened so that their clients could receive treatment before becoming dangerous, judges did not generally endorse this view. We discuss the implications of these findings for new civil commitment legislation.     

Federal influence on state health policy

This paper reports on research that was intended to demonstrate the impact of federal programs on state health policy goals. The sample included four Public Health Service programs (Health Planning and Resources Development, Nurse Training, Cooperative Health Statistics and the Community Mental Health Centers program) in six states (Colorado, Maryland, Michigan, Oregon, South Carolina, and Texas). The authors conclude that, in general, states' political environments tailor program implementation to suit state preferences.     

Recidivism Outcomes for Suburban Mental Health Court Defendants

Mental health courts have recently emerged as one means to reduce the number of persons with mental illness in the criminal justice system. Using a post-test only comparison group design, this study examined rearrest rates for 1 year post discharge among three groups meeting admission criteria for a municipal mental health court. The rearrest rate of defendants who successfully completed the program (N = 351) was 14.5%, compared to 38% among defendants negatively terminated from the program (N = 137), and 25.8% among defendants who chose not to participate (N = 89). This positive result held even when controlling for a range of variables in a Cox regression survival analysis. Factors associated with rearrest are identified for each of the three groups.     

Medicaid rationing in Oregon: political wolf in a philosopher's sheepskin

Although the details of the proposal have shifted since it was first described, the Oregon Medicaid waiver has had one consistent feature: it will reduce benefits to AFDC mothers and children who are currently covered by Medicaid in that state, in the hopes of increasing coverage for other individuals who are now uninsured. Because of the adverse consequences for the AFDC population, there should be strong evidence supporting the purported benefits of the proposal before proceeding with the waiver. One of the most intriguing aspects of the waiver proposal is the claim that the money currently being spent on AFDC beneficiaries could be redistributed to expand coverage to a substantial number of the uninsured. The concept is that far more people could receive the most valuable services if those now being served gave up their coverage of the least valuable services. Other purported benefits of the waiver include enhanced citizen participation in decisionmaking, cost-savings, and improved payment levels and delivery arrangements. Remarkably, this analysis of the proposal reveals that the waiver is likely to achieve none of its stated objectives, and instead will have adverse consequences not identified by its proponents. What the proposal would do is to insulate politicians from visible responsibility for limiting benefits for AFDC children and adults. Finally, the proposal undermines 25 years of Medicaid as an entitlement program. As such, it would establish as a social ethic the principle that the poor can be relegated to inadequate care. Such an extreme measure is not justified by the fiscal situation in Oregon, which is not extraordinarily poor or overtaxed, and does not have a particularly generous or unusually expensive Medicaid program.