Project ECHO

Project ECHO is a unique way to provide substantial training on substance misuse to key audiences, including judges, law enforcement, and others who routinely encounter those facing substance misuse and related mental health and behavorial health issues.

Recently, a select group of judges from across the state and court system were immersed in this new innovative training and education regimen focusing on opioid addiction. Looking to better address addiction in their courtrooms, thirteen judges took part in a pilot Project ECHO (Extension for Community Healthcare Outcomes) initiative, which provided education on issues including the physiology of addiction, evidence-based programming interventions, and medication-assisted treatment. Originally developed for healthcare professionals, this is the first time Project ECHOwas used to train and educate judges. This venture is an initiative of the Appalachian/Midwest Regional Judicial Opioid Initiative (RJOI).

“When I saw a demonstration of Project ECHO, I knew this was exactly what our judges need,” said Judge Duane Slone, chair of RJOI and a circuit court judge in Tennessee’s 4th Judicial District. “This is hands-on, in-depth learning. Addiction has impacted every court in the state and judges are in a position to positively impact many people struggling with addiction issues. Whether it is a criminal case, juvenile case, child custody case or other family law case, a judge has the authority to mandate behavioral health and addiction assessments and treatment. It is essential judges understand addiction and the assessment and treatment options. The ECHO learning platform will increase the competence and confidence of our judges to help people with substance use disorders, particularly opioid use disorders.”

The training was in partnership with the East Tennessee State University Quillen College of Medicine, which has been educating doctors, nurses, and clinicians through Project ECHO for several years and developed a tele-education program for healthcare workers focusing on office-based Medication Assisted Treatment and the prescribing of Buprenorphine containing products. Joyce Troxler, M.D., is the Program Director for the Addiction Medicine Fellowship at ETSU and member of the Project ECHO RJOI. She, along a number of other addiction medicine experts, form the medical cohort of contributors to this innovative pilot project in conjunction with Judge Slone.

“Many of the patients we see with Substance Use Disorder have active legal issues. Whether it is a probation violation, child support, or custody hearings, we see some of the same people as the court does, but for different reasons,” Dr. Troxler said. “Being able to build a better understanding between our respective roles of judicial and medical is a huge benefit for the folks we share. Project ECHO RJOI provides the forum for us to share our knowledge and thus improve outcomes for individuals and communities.”

The participating judges were selected by Tennessee Supreme Court Chief Justice Jeff Bivins after consultation with judicial branch leaders in the fight against opioid addiction. The judges represented juvenile (including Safe Baby Courts), general sessions, circuit, and criminal court judges from across Tennessee who preside over some of the hardest hit areas of the opioid epidemic. The judges were:

  • Judge David Allen, Circuit Court Judge, 22nd Judicial District
  • Judge Andy Brigham, General Sessions/Juvenile/Safe Baby Court Judge, Stewart County
  • Judge Donna Scott Davenport, Juvenile Court/Safe Baby Court, Rutherford County
  • Judge Sandra Donaghy, Criminal Court Judge, 10th Judicial District 
  • Judge Kenlyn Foster, General Sessions/Juvenile Court Judge, Blount County
  • Judge James Goodwin, Criminal Court Judge, 2nd Judicial District 
  • Judge Sharon Green, Juvenile Court, Johnson City (Washington County)
  • Judge Sharon Guffee, Juvenile Court Judge, Williamson County
  • Magistrate Stacy Lynch, Family Preservation Court Pilot, Rutherford County Juvenile Court
  • Judge Michael Meise, Juvenile Court/Safe Baby Court, Dickson County
  • Magistrate Melissa Moore, State Child Support Magistrate, 4th Judicial District
  • Judge Jeff Rader, General Sessions/Juvenile Court Judge, Sevier County
  • Judge Stacy Street, Criminal Court Judge, 1st Judicial District 

“We are continually looking for new ways to educate judges and provide them with the knowledge and tools they need to serve their communities,” Chief Justice Bivins said. “I am grateful to our partners at ETSU for engaging in this new venture with us as well as Judge Slone for his leadership and vision and the participating judges for their willingness to embrace something novel and be the first to try this new learning system.”

Judges in Tennessee typically receive education and training through in-person conferences divided by their jurisdiction – county general sessions court, county juvenile court, or state-level trial court.

The Project ECHO pilot consists of a series of video conferencing sessions during which physicians and other experts will present information to the judges and answer their questions about opioids, addiction, evidence-based programs, and medication for opioid use disorder. Judges will present case scenarios to an expert panel and take part in group discussions on how opioids affect individuals they encounter in their courtrooms and develop strategies to assist and manage these situations. Weekly sessions are scheduled on a variety of topics featuring different experts from around the state.

Future Project ECHO Projects

The SMART Justice Network is currently expanding Project ECHO to other partners and to additional types of participants.