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The primary features of the CISP service model are: ƒ A multidisciplinary team-based approach;

ƒ Case managers carry out a range of assessment, compliance, reporting, support and referral functions;

ƒ Clients are allocated to the three program levels based on their assessed risk12_;

ƒ Once engaged, a client is the responsibility of a CISP case manager, but other specialists may be consulted;

ƒ CISP provides a range of direct services, with drug, alcohol, ABI and

accommodation service interventions delivered by contracted service providers; ƒ Additional services may be delivered by referral to external agencies, with

brokerage funds available to pay for a range of treatment and support services including emergency accommodation, pharmacotherapy assessment or

treatment, and education or other programs.

Multidisciplinary team approach

The multi-disciplinary team approach is generally regarded by program staff as successful in addressing the complex needs associated with the program’s clients. Workers valued the capacity to consult with other staff members who have more specialized knowledge in particular areas, and to be able to refer clients with particular service requirements to mental health, arbias and housing workers who were on-site. Magistrates commented favourable on the capacity to have defendants’ problems addressed directly and quickly, and to have independent advice to the court on a range of complex problems. Much of the interaction between team members is informal (one spoke of the approach as an “all in together” model), and it is apparent that the level of interaction between case

managers is higher than that between case managers and workers from the contracted

service provider agencies, who often felt that they were in a “twilight zone between being accepted as part of the CISP team and feeling like you were not part of it”.

It was acknowledged that the CISP model had developed substantially over the life of the program, from its origins in the CREDIT/Bail Support Program. Several who had worked on the CREDIT /Bail Support program prior to coming to CISP commented on the advantages of the CISP model. However, the multi-disciplinary approach also poses problems of adjustment for new team members, and in the administration of the

program. Some workers who had come from a service area where they had been in specialized roles found it a challenge to adjust to the more varied demands of CISP. One commented that “if you’re a disability specialist and you expect that your caseload will consist solely of clients with disability issues, then that’s a shock.” Ideally, clients and workers should be matched on the basis of the clients’ priority needs, but high workloads meant that this was not always possible. The high prevalence of drug and alcohol

problems in the client group means that there is a correspondingly high demand for workers with drug and alcohol skills. Those from other areas of specialisation noted that they had to pick up drug and alcohol skills in order to be able to work effectively. Workloads also impeded workers’ capacity to consult with their colleagues about clients’ problems, and a commonly expressed source of frustration was the inability to engage in systematic case reviews for clients with more complex problems.

Weekly allocation meetings involve CISP team leaders, case managers and contracted services were implemented in August 2009. The purpose of the meeting was to assist with the equitable allocation of case load for staff and enhance a collaborative approach to the management of clients. These meetings commenced in the very final stages of this evaluation and we are therefore unable to offer any comment on their impact on these issues.

Workers’ roles

CISP case managers’ work involves a wide variety of roles, including carrying out assessments, reporting to the court, providing direct support to clients, supervision and compliance management, and making referrals to contracted and other services. The role of case manager therefore involves elements of clinical forensic practice in combination with the compliance and reporting responsibilities of a court officer. From the beginning

of the program there has been uncertainty on the part of CISP staff about how these roles should come together. Staff members feel a responsibility to engage with clients directly (a clinical or case manager role) but are also aware that this role is time-limited and will ultimately involve the client moving on to a longer-term relationship with one or more treatment or support agencies (a brokerage/advocacy role). A related issue is that the client-worker relationship that is central to conventional clinical practice must also take into account the responsibilities to the court that are inherent in the CISP case management role.

Workers who had come to CISP from other service areas often found the legal aspects of the program very challenging. The support of Magistrates was seen as fundamental to the success of the program, but it was recognized that different Magistrates had quite different expectations of the program, and that it took some time learn how to manage and respond to these differences in approach. A related problem was that workers felt that there was a lack of recognition of their expertise by other court professionals. In particular, lawyers were inclined to challenge in court recommendations they didn’t like. Typically this involved defendants who were assessed as unsuitable for the program, with the result was that workers were required to justify their recommendations in the

adversarial environment of the court.

Staff turnover has been a significant problem in the operation of the CISP service model. All those consulted in the course of this evaluation (staff members, Magistrates and external stakeholders) commented on the high rate of staff turnover and its

consequences. These consequences included difficulties in establishing stable and cohesive program teams, ongoing requirements for training of new staff, and increased workloads on existing team members. External stakeholders referred to the problems arising from dealing with staff members who were unfamiliar with court procedures or the operations of external services.

Team leaders

The role of team leader is central to the effective operation of the CISP model, and both workers and Magistrates commented on the difference that having an experienced team leader made to the quality of the work. Given the high rate of staff turnover in CISP,

team leaders have to devote a substantial amount of time to the training and

development of new staff, as well as carrying a 50% caseload. Team leaders are also the primary point of communication between CISP and the other court professionals. At the Latrobe Valley and Sunshine sites the line management for the CISP team is through the Senior Registrar, but this role is mainly concerned with administrative issues concerning the team and responsibility for clinical and case management issues rests with the team leaders. While some CISP team leaders came into the role with substantial experience, new team leaders find the role very challenging. While training has been provided to team leaders in case management, assessment, leadership and staff

management, team leaders also report that direct observation and hands-on experience are critical elements in the development of these skills.

Program venues

Some important variations are apparent in the way the three program venues operate. Melbourne is distinguished from Sunshine and Latrobe Valley in that it is a much larger and more complex court environment, with greater work pressure demand on workers and more variation across Magistrates in their expectations about the program. In contrast workers at Sunshine and Latrobe Valley have more direct knowledge of Magistrates and other court staff. One significant variation between the sites is in the way teams are managed. At Melbourne line management is through the Program Manager, which at Sunshine and Latrobe Valley line management is through the Senior Registrar. Both arrangements have their strengths but the existence of both

simultaneously gives rise to uncertainty about who is responsible for the various CISP functions.

Geographical barriers to access by clients are an important issue for the Latrobe Valley site. Many defendants at the Morwell Court come from communities where only limited public transport access is available. The court also sits at other sites in Gippsland like Korumburra, Wonthaggi and Bairnsdale where the program is not available. Some of the referral services available to the program are also located in other communities in the valley, and again this can mean that clients find it difficult to access these on a regular basis.