Programs Provided - Clinics and Processes

Mosaic Program

The Mosaic substance abuse program is having a measurable impact on Maricopa County’s moderate- to high-risk jail population.

Statistics for 2017 show Mosaic participants had a recidivism rate approximately 20% below that of two control groups of county inmates who shared similar struggles with substance misuse but who did not go through the program.

“We believed it was going to work, but we really had to see the proof,” said Dr. Dawn Noggle, who until June 2019 served as Correctional Health’s Mental Services Director. “20% reduction in recidivism for a moderate- to high-risk group is considered very, very good.”

Mosaic is a 7-week program run by Correctional Health Services that looks at an inmate’s entire experienceincluding trauma in their past—and then teaches them ways to deal with the emotions associated with it. The idea is to give them skills to replace the substance.

“We were early readers that trauma is really what underlies all of this. So we were addressing trauma as a significant component of Mosaic before it was getting discussed as broadly as it is now,” said Noggle.

The program targets people who tend to return to jail over and over again. In 2017, 42% of Mosaic participants were in jail on drug-related charges; 23% were recently homeless; and 11% were identified as seriously mentally ill. This is not an easy population to reach or keep from coming back.

“One of the programs that they say is impactful to them is the parenting group,” Noggle said. “And that’s exciting. We might not have initially thought that.”

Dr. Noggle believes future Mosaic classes may see even greater reductions in recidivism because of the additional support services participants have available before and upon release, including connections to affordable housing.

Competency Evaluation - Contract Administration

“Forensic” means “for the Court.” Correctional Health Services (CHS) Forensic Services administers a contract of Mental Health Experts who provide forensic evaluations to the Court. Mental Health Experts can be either Psychologists or Psychiatrists, as defined by statute. Forensic evaluations occur on an outpatient basis as determined by the Court, either: in-custody at the Maricopa County Jails or out of custody in the community. Two examples of forensic evaluations are Rule 11 and Restoration to Competency.

Rule 11

Rule 11 is the Arizona Rule of Criminal Procedure that governs competency evaluations. Defense counsel usually initiates the Rule 11 process. In the Rule 11 process, the Court orders two Mental Health Experts to meet with the defendant, conduct competency evaluations, review records, and render opinions on the legal competency status of the defendant in reports submitted to the Court. If the opinions of the two Mental Health Experts are split, the Court usually appoints a third Mental Health Expert as a tiebreaker. Defendants who are found Competent in the Rule 11 process can proceed with their criminal case. “Competent” is a legal standard that means that the defendant has a factual and rational understanding of the criminal proceedings and the ability to work with their attorney to assist in their defense.

Restoration to Competency (RTC)

The Court admits defendants determined Incompetent to proceed with their criminal case during the Rule 11 process to the Restoration to Competency (RTC) program. The Court orders defendants to participate in the RTC program. The goal of the RTC program is to restore the defendant to legal competency to proceed with their criminal case. CHS Forensic Services assigns a forensic team to work with defendants admitted to the RTC program, which includes a Mental Health Expert and a Forensic Restoration Specialist. Forensic Restoration Specialists conduct legal education sessions with defendants for restoration. The Mental Health Expert is ultimately responsible for rendering a final opinion on the defendant’s legal competency status in a report submitted to the Court. Defendants who are found Competent in the RTC program can proceed with their criminal case.

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