Designing a Health/Legal System: A Manual

Jones, R. K. (Ralph K.); Joscelyn, Kent B.; McNair, John W. · 1979 · ROSA P / United States. National Highway Traffic Safety Administration

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Summary

This report presents a manual designed to assist state, county, and local organizations in improving their case-disposition processes for individuals arrested for drunk driving. The research addresses the need to integrate traffic law systems, which utilize punishment and deterrence, with public health systems, which focus on diagnosis and treatment. While the health/legal approach had become more formalized following the National Highway Traffic Safety Administration’s (NHTSA) Alcohol Safety Action Projects, the authors note that the approach remains experimental. Although evidence suggests legal approaches can reduce alcohol-related crashes, the specific impact of the health component on crash reduction has not been definitively proven, necessitating careful design and evaluation. The methodology involved a comprehensive analysis of existing health/legal systems across the United States. The authors conducted telephone contacts with 32 former Alcohol Safety Action Projects and 54 randomly selected non-ASAP jurisdictions to gather broad descriptions of system attributes. From this data, ten representative jurisdictions were selected for in-depth case studies through on-site interviews. These jurisdictions included Washtenaw County, Michigan; Phoenix, Arizona; Multnomah County, Oregon; Pulaski County, Arkansas; the states of Maine and Washington; Park Forest, Illinois; Columbus, Ohio; Lafayette, Louisiana; and Greenville, South Carolina. The Washtenaw County system served as a test bed for developing the case study methodology. The manual employs a functional analysis approach, breaking down case-disposition processes into component activities to optimize performance relative to highway safety objectives. The findings classify operating health/legal systems into four generic case-disposition types: reduced-charge, probation, reduced-sentence, and administrative processes. Reduced-charge processes trade charge dismissal for treatment participation and are efficient but may hinder the diagnosis of repeat violators. Probation processes, the most common type, condition treatment on probation but are often costly and prone to delays. Reduced-sentence processes offer suspended sentences in exchange for treatment but may lack intensity in health functions. Administrative processes use nonjudicial agencies and license suspensions as inducements, offering uniformity and high diagnostic rates but less flexibility. The authors identify common characteristics across these systems, including the use of inducements for treatment, availability of startup resources, provision of critical diagnostic information, and favorable institutional climates. No single system is optimal for all jurisdictions; each must be tailored to its unique operating environment. The significance of this work lies in providing a structured framework for designing, planning, and evaluating health/legal systems. The manual outlines a three-step method for system improvement: identifying problems and their causes, developing alternative strategies, and selecting a preferred strategy for implementation. It emphasizes the necessity of rigorous evaluation, recommending true experimental designs where practical, or quasi-experimental designs otherwise, to measure the impact of system changes on performance and crash risk. By offering tools for describing current systems and analyzing their performance, the manual aims to help jurisdictions create more effective, humane, and scientifically evaluated approaches to managing alcohol-crash risk.

Key finding

The manual classifies health/legal systems into four generic case-disposition types (reduced charge, probation, reduced sentence, and administrative) and provides a structured framework for designing and evaluating these systems to optimize the combination of punishment and treatment for drunk drivers.

Methodology

review

Provenance

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