Strategic Individualized Remediation Treatment (STIRT) program

The Strategic Individualized Remediation Treatment (STIRT) program is a continuum of care that includes short-term residential treatment and outpatient treatment for adults 18 years of age or older who are involved in the criminal justice system and at risk of returning to jail or prison due to technical violations of the terms and conditions of their probation, parole, or court program.  The residential phase of the continuum is 21 days long and is comprised of therapeutic contact in a safe, highly structured, drug and alcohol-free environment addressing substance disorders and criminogenic behaviors, and mental health needs, as appropriate.  Once the residential phase is completed, the individual has access to up to nine months of supportive wrap-around services in their community.  Currently, there are three STIRT residential providers in the state: Crossroads' Turning Points in Pueblo; Behavioral Treatment Services in Lakewood; and Larimer County Community Corrections in Fort Collins.

The program is comprised of a short-term residential treatment episode followed by six to nine months of outpatient treatment. In addition to substance use and mental health treatment services, participants can take advantage of assistance with transportation, some medication needs, help with reconnecting to family, and engagement in positive social and leisure activities. 

In 2018, the program name changed from Short Term Intensive Residential Remediation (STIRRT) to Strategic Individualized Remediation Treatment (STIRT) to reflect that this is a continuum of care, not just a short-term residential program.

Download the STIRT Referral Form

Download the STIRT Program Description

Download STIRT Curricula

Residential Service Provider Contact Information

Residential Service Program Contact Information

Clients may also be referred to appropriately licensed community based agencies for both male and female Continuing Care Services. 

STIRT Providers List

Download the STIRT Providers list to find providers near you.

Resources for Continuing Care Providers

Download the continuing care providers' reimbursement invoicing template and reimbursement rates. 

Admission Criteria

STIRT Program Admission Criteria

Referrals should be made to both residential and outpatient programs at the same time to assist in a warm handoff transition.

1. Be an adult 18 years of age or older
2. Have a drug and/or alcohol related offense
3. Have one or more current or deferred felony or misdemeanor(s) convictions with no pending or new felony charges, except for Pretrial Navigation Referrals
4. Have been sentenced to problem solving court or are currently in community corrections, on parole, or on probation
5. Have a minimum Level of Supervision Inventory (LSI) score of 25, or a minimum score on the Ohio Risk Assessment System’s (ORAS) Community Supervision Tool (CST) of 23 for males or 21 for females
6. Referrals should be made by a criminal justice or law enforcement entity. Treatment providers may initiate a referral in collaboration with the initial referral source (probation, parole, etc.).
7. Violent and/or sex offenders must meet agency admission criteria. All residential agencies do not accept sex offenders, contact agency prior to referral. Referral source must include PSI and/or criminal history in the application for admission.
8. Individuals with medical or mental health conditions that may interfere with their ability to participate in the program must be stable.
   -If on medication the person must be stable on medication and bring medication with them at admission.
   -Individuals may request assistance with medication as part of their service plan
9. Once an individual has been accepted for admission, the receiving agency will notify both the client and the referral source of the admission date, time, and other conditions.
10. Referring agency is expected to provide all requested documents/information, collaborate and maintain communication with the treatment agency about regarding treatment, individual progress, and next steps.
11. The referral agency should make a referral to STIRT Residential and STIRT CC program at the same time to reduce delays in continuing care placement, promote treatment retention, establish communication between residential, CC programs, and referral agency, and support a successful continuum of care for the individual.
12. If a person is eligible to enter the residential program and no bed is available, they may be eligible to be placed in a Respite bed for a short time while awaiting an opening.

STIRT Continuing Care (CC) Program Admission Criteria

Following graduation from a STIRT residential program, individuals are expected to enroll in STIRT Continuing Care services within 14 days and engage in programming for 24 to 36 weeks, avoiding a potential return to jail or prison.  The length of stay may vary and can be adjusted by the treatment team and is based on assessment outcomes and client progress.

To qualify for STIRT Continuing Care admission and participation Individuals must:

1. Graduate from a STIRT residential program.
2. Transfer from one STIRT CC program to another when appropriate.
3. Meet treatment agency admission criteria if violent and/or sex offenders.  Referral source must include PSI and/or criminal history in the application for admission.
4. Be stable if there are medical or mental health conditions that may interfere with their ability to participate in the program.
   - If on medication they must be stable on medication and provide appropriate information regarding the medication, dosage, etc., to the receiving agency.
   - Individuals may request assistance with medication as part of their treatment plan.
5. Once an individual has been accepted for admission, the receiving agency will notify both the client and the referring agency of the admission date, time, and other conditions.
6. Referral agencies, including residential programs, are expected to provide all requested documents/information, collaborate, and maintain communication with the treatment agency regarding client progress, treatment, and next steps.

Re-entry into the STIRT Residential Treatment Program

Individuals may enter a STIRT Residential program more than once under the following conditions:

• Initial referrals have priority over readmissions and may not be displaced by reentry applicants.
• Persons who graduate the residential treatment program and seeks reentry may be readmitted to the residential program if:
  • They are re-assessed and determined to be appropriate for the program/level of care at the time of their application, and
  • Individuals may be re-admitted to the initial placement program if they are determined to be appropriate based on consultation between the program and the referral agency.
  • If the person is deemed to be inappropriate to return to the initial placement program they may be referred to a different program.  Admission criteria for the new program must be met.
• Persons who begin the program and are discharged due to medical, family, or other emergency reasons may re-start the program at the earliest opportunity as determined by the program.
• All eligibility criteria will apply, and reentry is at the discretion of the treatment program/level of care.

Programs may choose not to readmit persons who are discharged from the STIRT for threatening or violent behavior.

Re-entry into the STIRT Continuing Care Program

Persons may enter a STIRT CC program more than once under the following conditions:

• Initial referrals have priority over readmissions.
• All eligibility criteria will apply, and reentry is at the discretion of the treatment agency.
• Persons who participate in or graduate from the STIRT CC treatment program may re-enter the program if they are re-assessed and determined to be appropriate for the program/level of care at the time of their application.
• Persons who begin the program and are discharged from the program due to medical, family, or other emergency may re-enter the program at the earliest opportunity as determined by the program.
• Persons who begin the program and are discharged for failure to meet program compliance may be readmitted if they are reassessed and determined to be appropriate for reentry into the program/level of care.

Programs may choose not to readmit persons who are discharged from the STIRT for threatening or violent behavior.

Links and Learning

Links and Learning

SAMHSA GAINS Center focuses on expanding access to services for people with mental and/or substance use disorders who come into contact with the justice system - https://www.samhsa.gov/gains-center.

Policy Research, Inc. (PRA) is a national leader in behavioral health and research that, in partnership with a sister non-profit, Policy Research, Inc., offer technical assistance, training, research, and policy services. Content areas Behavioral Health, Homelessness, Benefit Access, Criminal Justice, Juvenile Justice, Service Members, Veterans, and their Families, Recovery Support, Consumers and Family Members, Trauma, Wellness, Child Welfare, and Education - https://www.prainc.com/.

RNR Article:https://www.prainc.com/risk-need-responsitivity/

Frequently Asked Questions

1. What is the STIRT program?
The Strategic Individualized Remedial Treatment (STIRT) program (originally named Short Term Intensive Residential Remediation Treatment) is a continuum of care, comprised of an intensive residential treatment phase followed by a six to nine month outpatient Continuing Care (CC) treatment phase. The program is intended to provide treatment services to men and women, 18 years or older, who are involved in the criminal justice system, and are at risk of returning to jail or prison due to technical violations of probation, parole, or other conditions of release.

2. What are the primary components of the STIRT continuum of care?
The Intensive Residential Treatment phase of the program lasts for three weeks and is comprised of a minimum of 108 hours of therapeutic contact in a safe, highly structured, drug and alcohol-free environment. The Continuing Care (CC) phase is a six to nine month graduated outpatient treatment episode that includes group therapy, psycho-education classes, individual sessions, ongoing care management, support, monitoring, and case management.

3. What are the goals of the STIRT program?
A primary goal of STIRT is to reduce re-incarceration and recidivism rates by addressing criminogenic behavior, substance abuse, and co-occurring disorders prevalent in this population. An immediate objective is to work in partnership with clients and referral sources to increase treatment access and improve compliance with criminal justice supervision. The program provides the treatment, motivation and skills development necessary to help clients stay out of the criminal justice system and become viable members of their community.

4. How long has the STIRT program been in existence?
The program began in 1996, at one Denver Metro area location, as a two week intensive residential treatment program for men, 18 years or older, in an effort to reduce the number of returns to custody due to technical violations and new offenses.

5. Why was the program's name changed?
The original name implied that this is only a short term residential program, however, the program has evolved into a more extensive continuum of care. The name change is intended to better communicate the program's scope and intent.

6. What other changes have been made to the original program?
Over the past 20 years OBH has implemented several changes to the program to improve quality and access. These changes include adding treatment services for females, increasing the number of residential treatment sites from one to three, adding funding for wrap-around support services (i.e., medication assistance, transportation, wellness and recovery activities, limited equipment purchases, and case management), and increased the residential program length of stay from two weeks to three weeks.

7. How much does participation in the STIRT program cost?
The STIRT residential phase is free of charge for those persons who qualify.

Agencies may charge STIRT Continuing Care clients a maximum of $5.00 per group or individual session as part of the client's investment in their treatment.
Clients needing services beyond the scope of this program may qualify for Medicaid funding. Medicaid will not pay for services addressing criminogenic needs. If the client is Medicaid eligible and the services Medicaid billable, clients cannot be charged any additional fees beyond that billed to Medicaid.

8. Why won't Medicaid pay for all STIRT program services?
Many of the services provided by STIRT programs are designed to address criminogenic needs and do not meet the Medicaid criteria of being medically necessary services.

9. Who is eligible for referral to the STIRT program?
Men and women, 18 years or older, with a Level of Supervision Inventory (LSI) score of at least 29, who are involved in the criminal justice system, and are at risk of returning to jail or prison due to violations conditions of release. See eligibility criteria for additional requirements.

10. Can anyone make referrals to the STIRT program?
Eligible persons may be referred to the STIRT program by criminal justice and/or law enforcement representatives such as probation, parole, courts, etc.

11. All of my potential referrals live outside of the Front Range, how can they be referred to this program?
For intensive residential program referrals, may be referred to either of our STIRT providers. Clients will have to travel to the most appropriate residential program location. STIRT provides funding to help the client get to the residential program and back to their home area. Transportation can be coordinated between the client, the referral source, and the admitting program. Following the completion of the residential program phase, continuing care services can be provided by any agency in the client's home area that meet STIRT provider criteria.

12. Do the programs have a waitlist?
Generally, waitlists are associated with the residential treatment program phase start date, and sometimes exist as a staging point for clients waiting for the next three week rotation to begin. Sometimes waitlists exist because the request for admission exceeds the program capacity. The waitlist situation will vary for each residential program.

There have not been any reports of waitlists for Continuing Care program admissions.

13. What treatment is offered in the residential program phase and how does it flow into outpatient continuing care phase?
Currently, most of our intensive residential programs are delivering treatment utilizing the Thinking for a Change curriculum. We recognize that only a small number of community based agencies have been trained on the use of this curriculum creates a mismatch in the transition from residential to community based treatment. The Office of Behavioral Health and the STIRT Advisory committee are working to resolve this issue by identifying and addressing training needs for all STRIT service providers.

14. Who can provide STIRT program services?
All agencies wanting to provide STIRT services must be licensed by the Office of Behavioral Health to provide Services to Persons Involved in the Criminal Justice System. Residential treatment programs must also qualify as an ASAM Level 3.7 service provider. Currently there are three agencies contracted to provide residential treatment program services. There are Outpatient Continuing Care agencies all across the State. Additional requirements may apply depending on the referral source.

15. As an agency, do I have to be DOC ATP approved to provide STIRT services?
This will depend on the referral source. Some referral sources, i.e. DOC, may require that service providers meet specific criteria in order to work with their client population. So to receive referrals from DOC, Adult Parole, etc., you may be required to complete that agency's approval process. Other referral sources may not require ATP approval for service providers.

16. How do I become a DOC ATP approved provider?
Agencies and providers interested in becoming DOC ATP approved can visit the DOC adult parole website at https://www.colorado.gov/pacific/cdoc/adult-parole

17. As a client, how do I get referred into the program?
Persons interested in participating in the STIRT continuum of care can make the request to their probation or parole officer, case manager, or court representative. All STIRT referrals must be made by a criminal justice agency representative.

18. Are there separate programs for men and women?
Yes, there are separate treatment facilities for men and women at two of our intensive residential program sites. The third intensive residential program does not currently offer services for women. Clients any be referred to any of the three residential sites.

If I am accepted into the STIRT program:
1. What can I bring with me?
Each residential program agency has its own admission criteria, which include the list and type of items that are allowed into the facility. Contact the agencies directly for a specific listing.

2. When can I call people?
Because of the short term, and the busy, intense schedule, of the three week residential program phase, there may be little or no time for phone calls. Contact the agencies directly for more information.

3. Can I have visitors?
Because of the short term, and the busy, intense schedule, of the three week residential program phase, there may be little or no time for visitors. Contact the agencies directly for more information.

For the outpatient continuing care phase of the program, agency policies may not be as restrictive as those of the residential programs. However, there are policies in place regarding phone use, and items you can bring onto the agency site. Contact the specific agency for more information.

4. Who will provide treatment for me for the continuing care program phase?
STIRT is working to create a strong collaborative care system that encourages residential and community based agency to work together to insure a high quality of care for our clients.

Following the completion of the residential program phase, continuing care services can be provided by any agency in the State, preferably in client's home area, that meet STIRT provider criteria. If a person was referred to STIRT while enrolled in an outpatient program they may be referred back to that outpatient program, or to any other program that is deemed appropriate if the program meets STIRT criteria. OBH and the STIRT Advisory Committee are currently working to expand the number of agencies available to provide STIRT CC services throughout the State.

Contact

Additional Contacts

For more information about the Strategic Individualized Remediation Treatment (STIRT) Program, please contact:

Program Oversight and Management

Behavioral Health Administration

Webster T. Hendricks, BS, CAC III

Manager I, Persistent Drink Driver Intervention Specialist

3824 W. Princeton Circle

Denver, Colorado 80236

Phone: (303) 866-7499

Fax: (303) 866-7428

webster.hendricks@state.co.us

 

Contracts and Billing

Signal Behavioral Health Network

Kelly McDermott, MS, LAC
Associate Director of Compliance and QI
Signal Behavioral Health Network
6130 Greenwood Plaza Blvd. #150
Greenwood Village, CO 80111
http://www.signalbhn.org
(720) 263-4851 (Office)
(303) 639-9241 (Fax)
kmcdermott@signalbhn.org

The STIRT Advisory Committee

The STIRT Advisory Committee is made up of STIRT Residential and Continuing Care service providers, probation officers, parole officers, and court and other referral sources, OBH, and MSO representatives. The purpose of this committee is to assist with the management, implementation, and improvement of STIRT program processes and services by informing OBH, and other Stakeholders, regarding current and potential problems with programming, management concerns, service delivery, etc. Members of the committee are tasked with providing input on problem resolution, curricula approval, training recommendations, planning, and implementation. Committee members may participate in regularly scheduled meetings either in person or via conference call.