Beta Jail Alternatives/Misdemeanor Probation Referral
Yellowstone: 406-256-3501, 17 North 31st, Billings, MT 59101; Carbon: 406-322-4121, PO Box 1652, Red Lodge, MT 59068; Stillwater: 406-322-4121, PO Box 1050, Columbus, MT 59019
It appears to the Referral Agency that the defendant/client herein qualifies for the Alternatives program(s) specified and MUST contact Alternatives within 24 hours. It is therefore ordered that the defendant/client be subject to the following conditions: 24 HOURS PER DAY ON CALL (406) 281-0825 for after hours intake of alcohol/drug monitoring.
Name: Last Name , First Name MI / Date:Address: Street/APT City , State Zip / Phone:
Referral Agency: Judge/Contact: / DOB:
Docket # Charge: / SSN:
Supervision Services: / Termination Reason Staff Initials /Date:
Misdemeanor Probation $100/month Length of Supervision From: to: / ð Successful
ð Non-Comp/Other:______
Pre-Trial/Revocation Supervision $100/ month Length of Supervision From: to:
Random Testing at discretion of officer / Urinalysis / Breathalyzer
/ ð Successful
ð Non-Comp/Other:______
Interlock Report Supervision: $30/Month (Yellowstone County Justice Court only)
o Length of Supervision From: to: / ð Successful
ð Non-Comp/Other:______
Community Service Hours: Cost: 1-10=$20; 11-50= $30; each additional 50 hours =$30 / ð Successful
ð Non-Comp/Other:______
Detention Days: Cost: $45/day / ð Successful
ð Non-Comp/Other:______
Work Release (Residential screening required. Contracted Courts only) / ð Successful
ð Non-Comp/Other:______
Monitor Services: Days: Length of Service From: to:
SCRAM X $11 or $15(cell) /day
SCRAM House Arrest days:
Result of 24/7 / Remote Breath $6.50/ day
#of random times per day
#of fixed times per day at
GPS $9/day
Please provide exclusion zones and any curfew: / House Arrest $9/day
Allowed to Work/School/Treatment
Lockdown / Curfew:
/ ð Program Name:
ð Successful
ð Non-Comp/Other:______
Random Alcohol and/or Drugs Testing Times:____ per week/month Length of Service From: _____ to: _____
Breathalyzer
1-15-mounth = $37.50/month
16 - Daily = $75.00/month
2x Daily = $150.00/month / Saliva Testing
Drug Panel $25/test
Drug Panel & Alcohol Screen $31/test / Hair Drug Analysis Testing $100/test
Urinalysis Standard Drug 8 panel $21/test / ETG- UA $35/test / Spice-UA $60/test
/ ð Program Name:
ð Successful
ð Non-Comp/Other:______
PharmCheck Drug Patch $65/ Patch Change: 7 days / 8-14 days (with 7 day review)
Length of Service From: to: (circle one)
Treatment Services
Drug & Alcohol Bio-Psych Social Evaluation Following Recommendations -$200
o Early Intervention Level .5 - 6 sessions at $25 per class $20 book
o Alcohol and Drug Treatment Level 1- 12 sessions at $25 per class $20 book
o Aftercare Treatment Level 1- 12 sessions at $25 per class $20 book / ð Successful
ð Non-Comp/Other:______
40 hours Anger management/ PFMA: Violence, Dangerous Assessment & CD Screen ($200) Following Recommendations - 27 session at $25 per class $10 book (male) $25 book (female) / ð Successful
ð Non-Comp/Other:______
25 hours Anger Management 17 sessions at $25 per class $10 book / ð Successful
ð Non-Comp/Other:______
Criminal Thinking Errors/Cognitive Awareness- 12 sessions at $25 per class $20/book
I / II / III
/ ð Successful
ð Non-Comp/Other:______
Shoplifting- 8 sessions at $25 per class $20 book / ð Successful
ð Non-Comp/Other:______
Parenting- 8 sessions $25 per class $25 book / ð Successful
ð Non-Comp/Other:______
MIP Level 1- 4 sessions, and if appropriate, parent class. Cost $100 / ð Successful
ð Non-Comp/Other:______
MIP Level 2- 4 sessions, and if appropriate, parent class. Includes Evaluation and following recommendations Cost $210 (Yellowstone County Justice Court Only) / ð Successful
ð Non-Comp/Other:______
Dangerous Drug Information Course/Substance Abuse Course- 6 sessions $25 per class $20 book / ð Successful
ð Non-Comp/Other:______
Tobacco Cessation Education- 1 day class $100 and $10 book / ð Successful
ð Non-Comp/Other:______
ACCI Self-directed / On-line* Cost $100 per Curriculum
Anger Avoidance*/Youth ACE / Domestic Violence / Offender Responsibility* / Youth/Parent*
Anger Management* / Driver Responsibility* Y/A / Parenting / DUI
Bad Check / Employment* / Youth Self Awareness*
Cognitive Awareness* / MIP 1* Y/A / Shoplifting* Y/A
Contentious Relationships / Offender Corrections* / Substance Abuse* Y/A
/ ð Program Name:
ð Successful
ð Non-Comp/Other:______
Other: / ð Successful
ð Non-Comp/Other:______
Special Conditions:
Any violation of this referral may subject the defendant/client to adverse legal consequences. Defendant/Client is ordered to pay costs of all program(s). Defendant/Client agrees to abide by all rules and regulations set forth by Alternatives, Inc. for the program(s) referred. This Jail Alternatives program(s) is granted as a special condition that you complete all program(s) mandates. By accepting the above Alternatives, Inc. program(s) you are consenting to communication between the referral source, members of the Criminal Justice System, and any other appropriate agencies/person(s) as deemed necessary in the course of your supervision.
______
Authorized Signature Date Client Signature Date
B1244/16