Mental health court information system

Mental Health Court Information System

This page was last updated on Friday, January 27, 2017. Check back for more updates throughout the semester.

This is the semester long project. There is more information here than you need. You would need to decide what to include and what to exclude. Here you can find extensive information about what is a mental health court, how does it operate, what paperwork is used by court staff, and what decisions do court staff need to make.

Project Final Report

The design should include:

A list of decisions to be facilitated by the database.
A list of use cases documented in detail that correspond to decisions.
A logical design that meets first, second and third Normal forms. The logical design should include at least 5 tables and their relations and should correspond to use cases.
A physical design of the database.
Enter three rows of data in each table in the database.
Create sample queries and show their utility in the context of use cases.
Prepare a narrated Power Point presentation making the case for your design. Give the scenarios of how the database will be used and show key design elements.
- A microphone is necessary to narrate your slides. The preferred microphone should have a USB connection, sit on the head and not the desk top. Please do not rely on built in microphones for portable computers.
- You can capture screen shots and insert it into your slide presentation using Command and Print Screen keys. MAC Users►
- Narrate your slides How►
- Microsoft users are encouraged to use one of the following links: Use Free Cam-Studio► Download free Cam-Studio► Convert with Camtasia► SWF► You Tube► Download Camtasia►
- MAC users are encouraged to use the following links. You Tube► Web Conversions►
Here are some examples of work by different students:
- Maria discusses the development of a database for tracking Malaria care You Tube►
- Jessica discusses database design for fraud detection You Tube►
- Karen and Veronica discuss a database for subscription to shoes You Tube►
- Philip discusses database for ride sharing for rural veterans You tube►
- Hooman discusses database for patients like me algorithm You Tube►
- Laura and Elliot design for a tennis reservation system You Tube►

Overview of Mental Health Court

The following insert is taken from: http://www.courts.state.md.us/district/archive/mental%20health.pdf

"Increasingly, large numbers of mentally ill people are entering the criminal justice system each year–a trend that poses a growing social problem that burdens both the criminal justice system and the public mental health system. It is estimated that 16 percent of the incarcerated population suffers from a serious mental illness, and at least 75 percent of them also have a substance abuse problem. The traditional approach to processing criminal cases often creates a barrier that prevents the court from identifying and responding to the unique needs of the mentally ill offender. “These offenders frequently spend unnecessary time in jail, and lacking access to mental health treatment services on release, tend to be re-arrested and recycled through the system,” said Baltimore City District Court Judge Charlotte M. Cooksey. “The needs of the community are not addressed, the costs to the taxpayer escalates, and the defendant continues to have the same problems and associated risks.”

Baltimore City’s Pilot Program In Baltimore City, where the mentally ill offender population is large and the problems are extreme, a partnership was formed in 2002 to create a Mental Health Court pilot program. The goal of the program is to improve outcomes for this special population, while increasing public safety. The program began with the consolidation of all cases in which a competency evaluation was ordered –approximately 250 each year. “Previously, these cases were scattered among nine different criminal courts and multiple judges, prosecutors and defense attorneys,” said Judge Cooksey, who heads the program. “Consolidating these cases onto a single docket allows for case processing by a dedicated team of individuals, trained in mental health law, who follow each case throughout the process.” As partners, the Office of the Public Defender and the Office of the State’s Attorney provide resources to the court, and the Division of Parole and Probation and the Division of Pretrial Detention and Services each dedicate an agent to the project. A key role in the project is played by FAST (Forensic Alternative Services Team) staff, master’s-level clinicians who assist with the identification, assessment, planning, and in some cases, monitoring of the defendants.

Police departments from Baltimore City and Baltimore County also participate in the effort by agreeing to expedite the execution of any warrants that are issued. In order to enroll in the program, the defendant must be a Baltimore City resident who is eligible for public mental health services. There must be a diagnosis of an Axis I serious mental illness and/or a trauma related disorder. The charge may not be a domestic violence related offense, and the defendant may not have any prior convictions of a crime of violence. Defendants may be referred to the program from a variety of sources. Defendants who remain in custody are often referred by court commissioners, Pretrial Detention and Services investigators or jail medical staff. Police, attorneys, family members, advocacy groups, clinicians and probation officers are also potential referral sources."

Actors

There are numerous people involved in the design of this database. The include:

The judge
The mental health funding agency
The FAST clinicians, including a disabled clinician.
The FAST clerk
The University faculty and consultants
Probation agent
Mental health providers
Substance abuse treatment providers
Employment agencies
Shelters
Hospitals
Other providers

Sequence of Events

'The process starts when a client is referred by central booking to one of the FAST clinicians. FAST clinicians request a report from FAST clerk who reviews State and Federal arrest records and Faxes her findings to the clinicians. The fax typically includes client demographics and arrest records and convictions. FAST clinicians exclude violent offenders from the program and interview the remaining clients. They approach the client to review and document presumed diagnoses and treatment needs. Clients who are non-violent and mentally ill are admitted to the FAST program, some of whom are admitted to the Mental Health court based on the client's willingness to participate. The information collected by the clinicians are entered into the form and sent back to the FAST clerk who enters it into the database.

The FAST clinician prepares a plan that includes court ordered mental health treatment, substance abuse treatment and residential requirements. The court releases the client to the community to follow the court ordered plan. To follow-up, clients are asked to show in court, where their progress is reviewed. Clients visit various providers who initiate assessment and treatment. In addition, the probation officer works with the clients to monitor their progress in the community. From time to time, clinicians are expected to write to the court regarding the client's progress. Clients who participate in treatment and complete it are released.

Purpose of the Database

The initial request for help came from the mental health court judge who wanted a better understanding of the effectiveness of her court. The mental health agency funded a pilot project to create a database for FAST team to collect information about who receives services and what are the outcomes of these services. The funds for the pilot were provided by the mental health agency to the University, who approached a consultant to establish the database. Different people have articulated different purposes for the database:

To evaluate the impact of the mental health court
To evaluate the impact of FAST and other diversion programs
To enable mental health agency to report on diversion by the FAST program
To collect more systematic outcome information from clients of FAST
To prepare for a proposed study to National Institute of Drug Abuse for evaluating the effectiveness of a nurse practitioner managed clinic for treatment of addicts with Buprenorphine.

Existing System

The existing system is more than 10 years old and is not compatible with modern relational database systems. The following six tables existed in the current information system:

Table name: Program Demographics
Field name	Field name	Field name	Field name
Client ID	School number	Discharge status	Relation 1
Program	School type	Admission time	Relation 2
Site	DJJ involved	Admission type	Ref required 1
Program group	DSS involved	Referred to	Ref required 2
Admission date	Custodian	Hospitalization	Co-pay 1
Discharge date	Homeless	Plan code	Co-pay 2
Primary staff /team	Foster care	Pay source 1	Update date
Presenting problem	Foster care placement	Pay source 2	Entry date
Referred from	Furlough	Payer 1	User name
Target population	Crisis bed requested	Payer 2
Axis I (a)	Last ITP date	Insurance type 1
Axis I (b)	Treatment plan date	Insurance type 2
Axis II (a)	Dr order date	Policy number 1
Axis II (b)	Last assessment date	Policy number 2
Any Axis III	Discharge type	Effective 1
Axis IV	Hospital discharge date	Effective 2
Axis V / GAF score	Final agreement date	Expiration 1
Legal problem	First contact	Expiration 2
Alcohol problem	Referral date	Policy holder 1
Drug problem	Discharge referral	Policy holder 2
Table 1: List of Fields in the Program Demographics Table of Existing Database

Table name: Admission/Discharge
Field name	Field name	Field name
Client ID	Axis I (b)	Annual income at discharge
Program	Axis II - a	Hourly income at discharge
Site	Axis II - b	Alcohol problems at discharge
Program group	Alcohol problem	Drug problem at discharge
Admission date	Drug problem	Hospitalization
Admission time	Assessment date	Discharge type
Admission type	Crisis bed requested
Referral date	Discharge date
Referral from	Axis I-a at discharge
Presenting problem	Axis I-b at discharge
Employment status	Axis II-a at discharge
Education	Axis II-b at discharge
Residential arrangements	Discharge status
Living arrangement	Referred to
Annual income	Residence arranged at discharge
Hourly wage	Living arrangement at discharge
Target population	Employment at discharge
Axis I (a)	Education at discharge

Table 2: List of Fields in the Admission/Discharge Table of Existing Database

Table name: Client demographics
Field name	Field name	Field name
Client ID	Income source I	PASS
Last name	Income source II	Responsible relation
First name	Family size	Responsible name
Middle initial	Dependent children	Responsible address
Address	Client annual income	Responsible city
City	Family annual income	Responsible state
State	Employment status	Responsible zip
Zip code	Hourly wage	Responsible driver license
County code	Social Security Income	Responsible SSN
Home phone	Social Security Disability Income	Responsible date of birth
Work phone	AFDC	Responsible employer
Birth date	Veteran Administration income	Responsible family size
Social security number	PAA	Responsible dependent children
Gender	Other unearned	Responsible family annual income
race	Wages/ salary	update date
Hispanic origin	SSA railroad retirement	date of entry
Marital status	Other earned	User name
Residential arrangement	Total monthly income
Living arrangement	Hours worked per week
Veteran status	SSI/SSDI status
Education	SSI/SSDI start date
Special education level	Medicaid status
Student status	Medicaid start date
Father's name	Medicare status
Mother's name	Medicare start date
Legal signer	Pharmacy status
Care taker	Pharmacy start date
Relation	Food stamp status
Benefits assignment	Food stamp start date
Signature source	Food stamp amount
Medical assistance number	HUD section 8 status
Medical assistance date	HUD section 8 start date
Medical assistance expiration date	HUD section 8 amount
Medicare number	Federal food status
Medicare effective date	Federal food start date
Medicare letter	Federal food amount
Table 3: List of fields in the Client Demographic Table of Existing Database

Table name: Service Tickets
Field name	Field name	Field name
Client ID	Charge	User name
Program	Plan
Site	Co-pay
Progra group	Staff time
Service date	Start time
Staff	Pay source 1
Time code	Pay source 2
Location	Insurance type 1
Location/csa	Insurance type 2
Visit type	Payer 1
Service type	Payer 2
Minutes	Activity 1
Participant 1	Activity 2
Participant 2	Activity 3
Participant 3	Activity 4
MHP/MA CPT	Billed
MHP charge	Group number
General CPT	Update date

Table 4: List of Fields in the Service Thicket Table of Existing Database

Table name: FAST Admission or discharge
Field name	Field name	Field name
Client ID	Financial	Legal status on admission
Program	Medical	Release date
Site	Stable housing	Compliance status at discharge
Program group	Mental health	Discharge reason 1
Admission date	Substance abuse	Discharge reason 2
Legal status on discharge	Other needs
Shelter	Initial trial date
Table 5: List of Fields in the FAST Admission/Discharge Table of Existing Database

Table name: FAST Program Specific
Field name	Field name	Field name
Client ID	Judge	Homicidal
Program	Monitoring legal status	Hisotry of homicidal
Site	Sentence	Assultive
Program group	Compliance with mental health treatment	History of assualtive
Admission date	Compliance with medication	Court charge
Offense	Compliance with alcohol abuse treatment	History of court charge
Weapon	Compliance with drug abuse treatment	Had any case manager
Enrolled in Mental Health court	Compliance with case management	Case manager contact
Enrolled in mental health case management	Compliance with housing	Service avoid S.H.
Incarceration date	Compliance with benefits	Hospital type
Initial trial date	Compliance with other	Disposition
Legal status	Compliance with other (explain)	Time of call
Court site	Projected discharge date	time call completed
BCDC	Caller phone	Call type
FAST number	Patient's location	Drug/alcohol use
Release date	Significant medication problem	Log number
Referral date	Has client medication cleared
Table 6: List of Fields in the FAST Program Specific Table of Existing Database

Paper Flow

The director of the FAST program reviewed existing forms and made suggestions regarding how she would like the forms to change in the new database. These suggestions as well as the forms are available below:

Limitations

Both the mental health agency that has funded the project and the FAST leader believe that the system must be simple otherwise it will go unused. A previous system went unused because it was "more of a medical record system" than a "case management" system. The funding agency objects to large scale projects that connect with other databases or provide Internet functionality or enable community providers to enter information directly. They insist on something that is practical and doable with small funding.

Some of the FAST clinicians have disabilities that prevent them from using the computer.

Except for the Veteran Administration, most of other providers do not have electronic medical records. The state system is electronic but does not allow transfer of data. The Federal probation agency has an electronic information system for probation officers but the system is not currently available to States.

University Consultant's Suggestions

The University faculty suggested that the evaluation of the court should include collection of standardized data, typically used in program evaluation:

Assessment Information Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Assessment
2	34	LSI (Level of Service Inventory)
4	32	ASI (Addiction Severity Index)
0	36	CAR (Client Assessment Record)
0	36	ASUS (Adult Substance Use Survey)
8	28	Competency Evaluation (Competency Assessment Instrument)
5	31	GAF (Global Assessment of Functioning)
General Demographic Information Collected at Admission.

Current Data Collected at Various Courts

The following data items are currently collected at various courts around the nation:

Proposed Information Collected at Referral

Number of Courts Collecting This Information	Number of Courts Not Collecting This Information	Variables
17	19	Referring Agency (for each referral)
19	17	Accepted; if Yes, then give date
17	19	Declined; if yes, then give date
18	18	Denied; if Yes, then give date
17	19	Give reason for denial
12	24	Who denied entry

Demographic Information Collected

Number of Courts Collecting This Information	Number of Courts Not Collecting This Information	Variables
20	16	Last Name, First Name
6	30	Maiden Name
18	18	Date of Birth
16	20	Social Security Number
19	17	Gender
18	18	Race/Ethnicity
16	20	Marital Status
18	18	Employment Status
17	19	Living Arrangements
17	19	Education Level
16	20	County Residence
0	36	Client's image

Outcomes Measures Collected

Number of Courts Collecting This Information	Number of Courts Not Collecting This Information	Variables
9	27	Times arrested and booked by police
2	34	Number of police who responded to each arrest
2	34	Number of times transported by police
7	29	Number of days spent in jail
2	34	Number of times transported to court from jail
5	31	Number of days spent in prison

Outcomes Measures Collected

Number of Courts Collecting This Information	Number of Courts Not Collecting This Information	Variables
7	29	Number of times seen in the ER for mental illness
1	35	Number of times transported by ambulance to ER
7	29	Number of days hospitalized for mental illness
3	33	Lost job due to arrest/mental illness
1	35	Number of workdays lost due to incarceration/mental illness
3	33	Lost housing due to arrest or mental illness

Outcome Measures Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
1	35	Dropped out of school due to arrest/mental illness
1	35	Number of days of school missed due to arrest/mental illness
3	33	Approximate costs attendant to crime(s) (stolen merchandise, etc.)
4	32	Number of weeks medication compliant
13	23	Active in mental health treatment

Mental Health Treatment History

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
9	27	Psychological treatment history of participant’s family
14	22	Hospitalization for psychiatric treatment of participant
11	25	How many times has the participant been hospitalized
11	25	Reasons the participant has been hospitalized for treatment
3	33	Has the participant attended specialized schools for persons with mental illness

Mental Health Treatment History

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
13	23	What type of medication is the participant currently taking
9	27	What types of medication has the participant been prescribed in the past
20	16	Does the participant have a co-occurring disorder
16	20	What disorders are involved

Criminal History

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
10	26	Date of Arrest
17	19	List prior felony offenses and the number of occurrences
15	21	List prior misdemeanor offenses and the number of occurrences
5	31	At the time of each offense had the participant been diagnosed with a mental illness
6	30	How old was the participant at the time of the first offense

Criminal History

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
6	30	Does the participant have a history of juvenile delinquency
5	31	What offenses were committed and at what age
4	32	How many times was the participant taken into custody or admitted into detention as a juvenile

Mental Health Diagnosis and Criminal Information Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
18	18	Provide any mental health diagnosis with which the participant has been diagnosed
13	23	At admission was the participant taking medications as prescribed
13	23	Current felony charges and date
15	21	Current misdemeanor charges and date
11	25	Conviction status
9	27	Sentence Agreement

Other Information Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
9	27	AIDS, Hep. B and C, and STD
10	26	Chronic Medical Condition
8	28	Education Level
4	32	List the type of courses in which the participant is enrolled (personal skills (self improvement), further education, etc.)
9	27	Provide the type of relationships in which the participant is involved
6	30	Provide a list of hobbies of which the participant is involved
10	26	Describe any community involvement of which the participant is involved

Proposed Information Collected During Court Other Information Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
11	25	Violations
13	23	Sanctions
9	27	Incentives
3	33	Reasons for Incentives
Also collected during court are general demographics, inpatient treatment days, treatment plan and compliance.

Proposed Information Collected at Exit Assessment and Other Information Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
9	27	Inpatient Treatment Days
4	32	Provide the type of relationships in which the participant is involved.
4	32	Provide a list of hobbies in which the participant is involved
6	30	Describe any community involvement in which the participant is involved
General Demographic Information Collected at Exit.

Other Information Collected

Number of Courts Collecting this Information

Number of Courts Not Collecting this Information

Variables

Recidivism (after completion of the program and post program at various intervals)

Participant Survey (a survey designed to determine the participant’s views of the program and the process)

Outcome Measures Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
8	28	Times arrested and booked by police
3	33	Number of police who responded to each arrest
3	33	Number of times transported by police
9	27	Number of days spent in jail
3	33	Number of times transported to court from jail
7	29	Number of days spent in prison

Outcome Measures Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
5	31	Number of times seen in the ER for mental illness
2	34	Number of times transported by ambulance to ER
8	28	Number of days hospitalized for mental illness
2	34	Lost job due to arrest/mental illness
3	33	Number of workdays lost due to incarceration/mental illness
3	33	Lost housing due to arrest or mental illness

Outcome Measures Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
3	33	Dropped out of school due to arrest/mental illness
3	33	Number of days of school missed due to arrest/mental illness
3	33	Approximate costs attendant to crime(s) (stolen merchandise, etc)
5	31	Number of positive drug screens
5	31	Number of times missed appointment with probation officer

Outcome Measures Collected

Number of Courts Collecting this Information	Number of Courts Not Collecting this Information	Variables
6	30	Number of times missed court
5	31	Number of weeks not medication compliant
5	31	Active in mental health treatment

Sample questions to be asked from client directly on a weekly basis

It is conceivable that the system can call the clients in the community and ask them a select number of questions. If so, the system could ask the following questions:

1. How have you been feeling (can adapt questions from the **Subjective Opiate Withdrawal Scale (SOWS, Handelsman et al. 1987) here…)?

Do you feel anxious? Do you feel like yawning? Are you perspiring? Are your eyes tearing? Is your nose runny? Do you have goose flesh? Are you shaking? Are you having hot flashes? Are you having cold flashes? Do you bones and muscles ache? Do you feel restless? Do your fell nauseous? Do you feel like vomiting? Do your muscles twitch? Do you have cramps in your stomach? Do you feel like shooting up now?

** The SOWS consists of 16 symptoms rated in intensity by clients on a 5-point scale of intensity as follows: 0=not at all, 1=a little, 2=moderately, 3=quite a bit, 4=extremely. The total score is a sum of item ratings, and ranges from 0 to 64.

2. Have you been keeping your appointments?

3. Are you taking your medication?

4. Have you stayed out of trouble (any re-arrests, problems, trips to hospital and/or ER, how are they doing)?

5. Are you employed now?

6. Do you currently have a place to stay?

7. Are you lonely?

8. How are you doing financially?

9. Follow up from previous review (quality of life, visiting with children)?

10. Do you feel that your treatment plan is working?

11. Have you experienced any recent stressful life events?

12. Are you happy with your treatment provider?

Timing of Data Collection

Possible Mental Health Court Variables	Point of data collection
	Referral	Admission	Throughout	Graduation termination
Client Identification Number	X	X	X	X
Referring Agency (for each referral	X
Accepted; if Yes then give Date	X
Declined; if Yes then give Date	X
Denied; if yes then give Date	X
Give reason for denial	X
Who denied	X
Status of the participant			X
Phase #			X
Phase start date			X
Phase completion date			X
Demographics
Last Name	X	X	X	X
First Name	X	X	X	X
Maiden Name	X	X	X	X
Date of Birth	X	X	X	X
SSN	X	X	X	X
Gender	X
Race/Ethnicity	X
County of Residence	X
Marital Status	X
Provide the level of education that the participant currently holds		X		X
I the participant currently enrolled in any form of school		X		X
Type of courses the participant in enrolled in (to better personal skills, further education, etc.)		X		X
Is the participant currently employed	X			X

Possible Mental Health Court Variables	Point of Data Collection
	Referral	Admission	Throughout	Graduation termination
Provide what type of employment (full time, part time, temporary, etc.)	X			X
What type of employment does the participant currently have	X			X
Living Arrangements	X			X
Relationships
List the number and types of lasting relationships the participant is involved in		X		X
Hobbies
List any hobbies that the participant may have		X		X
Community Involvement
List any type of community involvement that the participant may be involved in and to what degree the participant is involved in each		X		X
In the Year Preceding Admission to MHC
Times arrested and booked by police		X		X
Number of police who responded to each arrest		X		X
Number of times transported by police		X		X
Number of days spent in jail		X		X
Number of times transported to court from jail		X		X
Number of days spent in prison		X		X
Number of times seen in ER for mental illness		X		X
Number of times transported by ambulance to ER		X		X
Number of days, times and reason hospitalized for mental illness		X		X
Lost job due to arrest/mental illness, yes/no		X		X
Number of workdays lost due to incarceration/mental illness		X		X
Lost house due to arrest or mental illness, yes/no		X		X
Dropped out of school due to arrest/mental illness, yes/no		X		X
Number of days of school missed due to arrest/mental illness		X		X
Approximate costs attendant to crime(s) (stolen merchandise, property damage)		X		X

Possible Mental Health Court Variables	Point of Data Collection
	Referral	Admission	Throughout	Graduation termination
Number of weeks medication compliant		X
Number of positive drug screens				X
Number of times missed appointment with probation officer				X
Number of times missed court appearance				X
Number of weeks non-medication compliant				X
Active in mental health treatment (makes 80% of appointments)				X
Active in mental health treatment, yes or no	X	X
Provide any mental health diagnosis that the participant has been diagnosed with	X	X
LSI (Level of Service Inventory)		X		X
ASI (Addiction Severity Index)		X		X
Competency Evaluation		X		X
Other Assessments (GAF (Global Assessment of Functioning), GAINS (Global Appraisal of Individual Needs), etc)		X		X
Does participant have a guardian		X		X
Mental Health Diagnosis
At admission was the participant taking medications as prescribed		X
What types of medication is the participant currently taking	X
What types of medication has the participant been prescribed in the past	X
Does the participant have a co0occurring disorder?	X
Medical
HIV/AIDS, Hep B and C, and STD		X		X
Chronic Condition (does the participant have a physical disability)		X		X
Provide the number of days the participant has been in an inpatient setting		X	X	X

Possible Mental Health Court Variables	Point of data collection
	Referral	Admission	Throughout	Graduation termination
Criminal History
List prior felony offenses and the number of occurrences	X
List prior misdemeanor offenses and the number of occurrences	X
At the time of each offense had the participant been diagnosed with a mental illness	X
Criminal Information
Current felony charges and date of arrest	X
Current misdemeanors charges and date of arrest	X
Conviction Status		X
Sentence Agreement		X
Violations
List the types of violations that the participant had for this phase			X
List the date of the violation			X
Is the participant taking medication as prescribed currently			X
Is the participant following all facets of the treatment plan as directed by the MHC			X
Is the participant following all the rules of probation as required by the plea agreement			X
Sanctions
List the types of sanctions that the participant has received in this phase			X
Give the date of the sanction			X
Incentives
List the type of incentives that the participant received during this phase			X
List the date of the incentive			X
Give the reason that the participant received an incentive			X
Participant Survey satisfaction with program and treatment	After Completion of Program