Veteran Treatment Court Coordination Act of 2019: Support for Justice Involved Veterans To Improve Health and Wellness Outcomes

First implemented in 2008 by Judge Robert Russell in Buffalo, New York, the VTC originally catered to veterans suffering from drug addiction and/or mental health problems.¹  In other words, the VTCs began as a specialized version of the other treatment courts that were already well-established.²  VTCs of many iterations were formed over the years, and they vary widely in the conditions the veteran must suffer to gain admittance to the program.  Some VTCs enroll only veterans with brain injuries or mental health conditions, particularly post-traumatic stress disorder, that were caused by injuries incurred during service.  Some programs allow veterans to participate with any type of mental health or substance use disorder condition, no matter the etiology.

Because most states lack statutes on how the VTCs should be implemented, courts across the country have created their own rules of court and admission standards for participation, influenced heavily by the resources available for treatment. Sometimes the admission requirements are dictated by grants the VTC may be receiving to operate.³  Because of the varying standards of implementation of these courts, the exact number of VTC courts or dockets is difficult to ascertain.  One 2017 study put the number of VTCs at over 350 across the United States, with hundreds more in the planning stages.⁴ However, this was most likely an educated guess based upon the courts where VJOs participate in the process and those reported to both the National Center for States Courts and Justice For Vets, the leading organizations helping courts to implement these programs.⁵ The Committee Report from the House of Representative’s Committee on the Judiciary cites the number at over 500, which may be a more accurate number.⁶  In research as the reporter for the Uniform Law Commission’s Model Veterans Treatment Court Act and Rules (2017), one of this article’s authors found that even the states’ points of contact for VTCs had no idea how many courts were implementing VTCs in their own jurisdictions.  Regardless, with just over 3,000 treatment courts across the country, 400 to 500 is quite a high number if accurate.⁷

The Impact of Veterans Treatment Courts

It is easy to understand how veterans who were exposed to trauma in service, potentially suffering from traumatic brain injuries or post-traumatic stress disorder, would attempt to self-medicate with drugs or alcohol or fail to appreciate the consequences of their actions.  It is equally logical that these situations could find the veteran committing acts that introduce him or her to the criminal justice system. As Congresswoman Karen Bass (R-CA) stated on the floor of the House, “The Bureau of Justice Statistics estimates that approximately 180,000 veterans were incarcerated in State and Federal prisons between 2011 and 2012. Of those veterans surveyed, 48 percent of veterans in prison and 55 percent of veterans in jail reported that they had been told by a mental health professional that they had a mental health disorder.”⁸ That particularly affects veterans, who come from a shared culture of honor, responsibility, service, and self-reliance, making it difficult for them to seek treatment until it may be too late.⁹

Because of the distinctive issues that veterans face, unique mentorship programs have been implemented in many VTCs across the country, which have an impact on these defendants in terms of success in the treatment programs and overall improvement in quality of life. Partnering veteran defendants with veteran mentors to provide accountability and support is a key component of the implementation for VTCs suggested by Justice For Vets.¹⁰ Successful models for these types of partnerships can be seen across the country, with one well-known example in Tampa, Florida. This court, located in Hillsborough County, reports just a 10 percent recidivism rate among its participants.¹¹ Courts across the country report individualized success stories of their own.  The success of these VTCs also relies heavily on the intense nature of these treatment court programs, in addition to the mentorship component.  Participating successfully in a VTC can even require the veteran to move to live closer to the VTC program providers.  VTC programs normally require hours of counseling, medical evaluations, and testing.  Due to the connection of veterans to these providers as a result of the VTCs participation, veterans often have the opportunity to speak to professionals who understand their unique veteran experience, allowing for more meaningful participation in these activities.¹²

Stable housing has a strong connection to criminality, and often a cycle forms between the two.¹³ Those leaving the criminal justice system face difficulties in securing jobs and being approved for housing. These people may become homeless. Often, these people must then break the law just to survive – whether it be sleeping on a park bench against a city ordinance or holding a sign asking for food and violating panhandling laws. They are issued citations but cannot afford to pay them and are later arrested. If they manage to appear in court, they are typically unable to pay the fine and are sent to jail, re-starting the cycle. Failure to find housing can also lead to employment issues, which can impact the ability to pay fines, child support, and other bills.  These problems cycle and lead to an inability to regain stability.

According to a report from the National Coalition for the Homeless, mental illness was the third largest cause of homelessness,¹⁴ behind insufficient income and a lack of affordable housing.¹⁵ In fact, between 20-25 percent of the homeless population in the United States suffers from severe mental illness. Another study reported that 50 percent of inmates in state and federal prisons and more than 60 percent of jail inmates reported symptoms or diagnoses of mental illness.¹⁶ Equally concerning is the fact that many states ban those with a felony record from federal public benefits such as food stamps, public housing, Social Security benefits, and Temporary Assistance for Needy Families.¹⁷

VTCs aim to end these cycles. The collection of precise statistics on the impact of VTCs for veterans, particularly on health issues, has been spotty in the past. However, in 2018 a study was completed that reviewed over 7,000 veterans nationwide enrolled in VTC programs from 2011-2015.¹⁸  Over one-third of these justice-involved veterans were Iraq or Afghanistan veterans. More than one-third reported symptoms of post-traumatic stress disorder and over half suffered symptoms of substance use disorder.

The study noted that 29 percent of the veterans who began the VTC program without receiving VA benefits obtained those benefits during the VTC process.  Additionally, 39 percent of veterans who began participating in a VTC without stable housing ended the VTC program with individualized housing. In addition, the study found that only 14 percent of the veterans participating in a VTC were incarcerated again within a year of the program compared to 23-46 percent of other justice-involved defendants.

A more targeted but smaller study published in 2015 followed 86 veterans in Ohio who were assigned to a VTC program because they reported symptoms of post-traumatic stress disorder.¹⁹  The veterans served in different eras, with over 37 percent serving in America’s most current conflicts in the Middle East and almost 12 percent serving in Vietnam. Half were combat veterans. Thirty-one percent of the participants in this study found stable housing by participating in the VTC program. Measurable improvements were also seen in the level of depression, substance abuse, self-harm, stability of relationships, social functioning, and emotional well-being.

Implementation and The Model Veterans Treatment Court Act

In recognition of the success of VTCs and the dearth of uniform policies and procedures, sometimes within the same jurisdiction, the Uniform Law Commission published its Model Veterans Treatment Court Act and Rules, in order to allow states, or individual court dockets, to implement standards that will help ensure the success of every veteran within its jurisdiction.²⁰  Working with a number of stakeholders, including Justice for Vets, the National Center for States Courts, and other experts, the Commission built upon the best practices of VTCs across the country and added special attention to protection of a veteran’s due process rights while participating in these programs and the rights of crime victims. The Act also supports allowing all veterans into the system who can and will comply with a treatment program.

However, implementation of these VTCs in practice is still very restricted by monetary considerations.  Providing therapy to veterans costs money, particularly if the VA is not footing the bill.  Due to the statutes and regulations controlling access to VA treatment, many veterans involved in the criminal justice system do not qualify for VA sponsored treatment and would be required to have treatment paid for by the courts or community providers offering services pro bono.  Because of these cost concerns, courts can be constricted from expanding the footprint of their treatment court docket to the veterans in the most need. 

Veteran Treatment Court Coordination Act of 2019

In September 2018, President Trump signed into law the Veterans Treatment Court Improvement Act of 2018. The goal of this law was to fund more VJO positions within the various VTCs. Specifically, it required the VA to hire at least 50 additional VJOs to be placed at a VA medical center that works with a VTC and provides services for justice-involved veterans.

While this law was a huge win for veterans, more had to be done to ensure the continued success of VTCs. Recognizing that need, U.S. Representatives Charlie Crist (D-Fla.), and Elise Stefanik (R-NY) introduced the bipartisan Veteran Treatment Court Coordination Act of 2019. The bill was supported by more than a dozen veterans organizations including the American Legion, Disabled American Veterans, and AMVETS.  It also had over 100 cosponsors, passed both houses without any significant opposition, and was signed into law on August 8, 2020.

The purpose of this law is to implement an office within the Department of Justice that would coordinate training, the provision of grants, and technical assistance to state and local governments in order to further grow these courts. The Act provides that subject to funding, the Attorney General, acting with the Secretary of the VA, shall offer this support to any court system that either already has a VTC program in place or files a notice of intent to implement one with the Secretary of the VA. Importantly, this type of coordination will assist those wanting to start a new program in designing and implementing one successfully, without having to build one from scratch, and also provide necessary support to those already in existence.

The concern for proponents of the successful VTC model who urge its growth is that the Act does not appropriate any funds towards VTCs but allows grants to be distributed as funding is available.  In an era where the government is concerned about funding on many fronts, there is a question about when funds may be available and not already earmarked in quantities large enough to make a difference.  It is too soon to say how this Act will impact VTCs and their ability to deliver treatment and mentorship during the justice process, but the hopes are high that this Act will encourage the creation of more VTCs.  For example, the National Association of Attorneys General supported the Act because it believes VTCs “have emerged as a vital tool to break” the cycle of “recidivism, hopelessness, non-recovery, and sometimes, serious injury or death.”²¹

Conclusion

VTCs provide an important service to veterans who enter the criminal justice system and recent federal laws are helping to support that effort. The passage of the widely supported Veteran Treatment Court Coordination Act of 2019 provides hope that these VTCs will become a permanent and impactful part of our criminal justice system. The change these programs are making in the lives of veterans who have entered the criminal justice system is not only measurable in terms of stability, which leads to improved health and wellness, but also to their reintegration into society.  Recognition of these programs and support from local legal communities will truly be the key to the future success of VTCs for the nation’s veterans. 

1. Russell, R.T., Veterans Treatment Courts, 31 Touro L. Rev. 385, 387 (2015).
2. Other types of treatment courts include drug courts which provide structure and treatment for those involved in the justice system due to substance use issues.  The first of these courts opened in 1989 in Miami-Dade County, Florida. “Instead of putting addicted people behind bars, [the court] invited treatment providers into the courtroom to try a public health approach.” See https://www.nadcp.org/.
3. The Bureau of Justice Assistance is one such organization that gives out grants to VTCs. See https://bja.ojp.gov/taxonomy/term/89761. See also https://justiceforvets.org/resources/record-funding-available-for-treatment-courts/.
4. Huskey, K.A., Justice for Veterans: Does Theory Matter? 59 ARIZ. L. REV. 697, 709 (2017).
5. See https://www.ncsc.org/; https://justiceforvets.org/.
6. Public Law 116-153, Veteran Treatment Court Coordination Act of 2019, 116^th Congress.
7. National Association of Drug Court Professionals, All Rise: 30 Years of Treatment Courts, (2019).
8. Veteran Treatment Court Coordination Act of 2019, 165 Cong. Rec. H8489-H8491 (daily ed. Oct. 28, 2019).
9. Huskey, K.A., Reconceptualizing “the Crime” in Veterans Treatment Courts, 27 Fed. Sent. R. 178, 180–182 (2015) (citing numerous studies showing linkage between post-traumatic stress disorder and behaviors that may lead to misconduct); Pomerance, B., The Best-Fitting Uniform: Balancing Legislative Standards and Judicial Processes in Veterans Treatment Courts, 18 Wyo. L. Rev. 179, 187, 202, 208 (2018); Simcox, S.-R., Mattingly, M., & Marrero, I., Understanding TBI in Our Nation’s Military and Veterans: Its Occurrence, Identification and Treatment, and Legal Ramifications, 84 UMKC L. Rev. 373, 380 (2015); Simcox, S.-R., Flores, L.Y., and Matthews, M.D., Massing Fire on TBI and PTSD: The Importance of Working with Medical and Mental Health Professionals, 1-8 Servicemember and Veterans Rights § 8.03 (Brian Clauss & Stacey-Rae Simcox, eds., 2017).
10. https://justiceforvets.org/mentorcorps/.
11. Najarro, I., Tampa’s Veterans Treatment Court Sets a National Bar, Tampa Bay Times (Nov. 11, 2019), https://www.tampabay.com/news/military/2019/11/11/tampas-veterans-treatment-court-sets-a-national-bar/.
12. Baldwin, J.M., Veterans Treatment Courts: Studying Dissemination, Implementation, and Impact of Treatment-Oriented Criminal Courts, Univ. of Florida, 143 and Table A–46 (2013).
13. Allard K. Lowenstein International Human Rights Clinic, Yale Law School, Forced into Breaking the Law: The Criminalization of Homelessness in Connecticut, (2016).
14. National Coalition for the Homeless, Mental Illness and Homelessness, (2009).
15. National Law Center on Homelessness and Poverty, Homelessness in America: Overview of Data and Causes, (2015), https://nlchp.org/wp-content/uploads/2018/10/Homeless_Stats_Fact_Sheet.pdf.
16. Raphael, S., & Stoll, M., Assessing the Contribution of the Deinstitutionalization of the Mentally Ill to growth in the U.S. Incarceration Rate, 42 J. Legal Stud. 187, (2013).
17. Herbert, C.W., Morenoff, J.D., & Harding, D.J., Homelessness and Housing Insecurity Among Former Prisoners, 1 Russel Sage Found. J. Soc. Sci. 44 (2016). The Temporary Assistance for Needy Families (TANF) program assists families to achieve self-sufficiency by preventing single-mother pregnancies, providing childcare resources, assisting with job preparation, and encouraging marriage and the formation of two-parent families.
18. Tsai, J., Finlay, A., Flatley, B., Kasprow, W.J., & Clark, S., A National Study of Veterans Treatment Court Participants: Who Benefits and Who Recidivates, 42 Adm Policy Ment Health, 236-244 (2018).
19. Knudsen, K.J., & Wingenfeld, S., A Specialized Treatment Court for Veterans with Trauma Exposure: Implications for the Field, 52 Comm. Mental Health J. 127 (2016).
20. Uniform Law Commission, A Few Facts About the Model Veterans Treatment Court Act and Model Veterans Treatment Court Rules, Uniformlaws.org (2017); See also Simcox, S.-R., Veterans Treatment Courts, 7 Stetson J. Advoc. & L. 108 (2020).
21. National Association of Attorneys General, Letter Supporting Veteran Treatment Court Coordination Act of 2019,  https://www.naag.org/naag/media/naag-news/bipartisan-coalition-of-attorneys-general-urges-senate-to-pass-the-veteran-treatment-court-coordination-act.php.

About the Authors

Stacey-Rae Simcox is a Professor of Law at Stetson University College of Law in Gulfport, Florida where she is the director of the Veterans Law Institute and Veterans Advocacy Clinic. She teaches in the areas of veterans benefits law, administrative law, trusts and estates, and legal skills. Professor Simcox joined Stetson in July 2014 from William & Mary Law School, where she was the founder and director of the nationally recognized Lewis B. Puller Jr. Veterans Benefits Clinic. Professor Simcox was the Reporter to the Uniform Law Commission's Model Veterans Treatment Court Act. She is a founding member of the National Law School Veterans Clinic Consortium and served as its President and on its Board for six years. She is also a veteran of the US Army Judge Advocate General’s Corps. She may be reached at [email protected].  

Morgan MacIsaac-Bykowski is the Veterans Law Institute Fellow. She obtained a B.S. summa cum laude from Florida Southern College in December 2016 and a J.D. cum laude from Stetson University College of Law in May 2020. While at Stetson, Ms. MacIsaac-Bykowski served as an editor on the Stetson Journal of Advocacy and the Law and was a teacher’s assistant to Professor Simcox for the Veterans Advocacy Clinic. She may be reached at  [email protected].