Title: Programs in Correctional Settings: Innovative State and Local Programs. Series: BJA Monograph Author: Justice Research and Statistics Association Published: June 1998 Subject: Inmate Programs 123 pages 268,000 bytes Figures, charts, forms, and tables are not included in this ASCII plain-text file. To view this document in its entirety, download the Adobe Acrobat graphic file available from this Web site or order a print copy from BJA at 800-688-4252. U.S. Department of Justice Office of Justice Programs Bureau of Justice Assistance Programs in Correctional Settings: Innovative State and Local Programs U.S. Department of Justice Office of Justice Programs 810 Seventh Street NW. Washington, DC 20531 Janet Reno Attorney General U.S. Department of Justice Raymond C. Fisher Associate Attorney General Laurie Robinson Assistant Attorney General Nancy E. Gist Director, Bureau of Justice Assistance U.S. Department of Justice Response Center 1-800-421-6770 Bureau of Justice Assistance Clearinghouse 1-800-688-4252 Bureau of Justice Assistance World Wide Web Home Page http://www.ojp.usdoj.gov/BJA This document was prepared by the Justice Research and Statistics Association, under cooperative agreement 95-DD-BX-K011, awarded by the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice. The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, and the Office for Victims of Crime. ------------------------------- Programs in Correctional Settings: Innovative State and Local Programs June 1998 Monograph NCJ170088 ------------------------------- Acknowledgments This report is a product of a cooperative effort by the States and the Bureau of Justice Assistance (BJA) as part of the State Evaluation Development Program, which is coordinated by the Justice Research and Statistics Association (JRSA). The National Institute of Corrections and the Colorado Department of Public Safety, Division of Criminal Justice, contributed to the coordination and implementation of this workshop. A special thanks goes to Ida Halasz, Acting Chief, National Institute of Corrections; William Woodward, Director, Division of Criminal Justice, Colorado Department of Public Safety; John Inmann, Program Administrator, Division of Criminal Justice, Colorado Department of Public Safety; Henry Solano, U.S. Attorney, District of Colorado; and George Epp, Sheriff, Boulder County, for delivering welcoming addresses. Special acknowledgment is also due to the outstanding moderators of the working meeting: Ken Robinson, President, Correctional Counseling, Inc., and Nancy Shomaker, Manager, Technical Assistance, National Institute of Corrections. The State Evaluation Development Program relies on the expertise of the States to ensure the success of workshops and publications. The following individuals contributed their knowledge and time to make the workshop and publication a success: Kathi Atkins, Planning and Grants Manager, Division of Criminal Justice, Colorado Department of Public Safety; Jim Barbee, Correctional Program Specialist, National Institute of Corrections; Ruth Cardella, Researcher, New Directions for Families; David Dillingham, Correctional Program Specialist, National Institute of Corrections; Gail Keil, Montana Board of Crime Control; Pat Scholes, Corrections Specialist, National Institute of Corrections; Andrew Tarsy, Consultant; and Beverlee Venell, Grant Coordinator, Criminal Justice Division, Oregon State Police. The Justice Research and Statistics Association prepared this document under the direction of Joan C. Weiss, Executive Director. The following JRSA staff compiled and edited the information in this report under the supervision of Deputy Director Kellie J. Dressler: Tara L. O'Connor, Program Assistant; Marylinda Stawasz, Program Assistant; Andrea G. Richards, Program Associate; Terrylynn Coffin, Program Assistant; and Jason R. Lunsford, Intern. ------------------------------- Contents Introduction State and Local Programs in Correctional Settings Alabama: Jail Assistance Project Colorado: Integration of Polygraph Testing With Sex Offenders Program Colorado: Juvenile Offender Substance Abuse Treatment Project Colorado: Department of Corrections Youth Offender System Delaware: Mentor Program, Inc. Idaho: Ada County Jail Substance Abuse Program Illinois: Department of Corrections Sex Offender Treatment Program Iowa: Centralized Substance Abuse Assessment Project--Iowa Medical and Classification Center Iowa: Statewide Substance Abuse Program Coordination in Corrections Kansas: Chemical Dependency Correctional Counseling Program Kentucky: Integrated Programming for Female Offenders Massachusetts: Stress Reduction and Awareness Training in Corrections and the Criminal Justice System New York: Taconic Correctional Facility Nursery Program Ohio: Oriana House, Inc., Residential Treatment Services Program Oklahoma: Department of Corrections Enid Community Learning and Family Center Oregon: Turning Point Alcohol and Drug Program Pennsylvania: OPTIONS Women's Therapeutic Center Rhode Island: Discovery Substance Abuse Treatment Program South Dakota: Corrections Substance Abuse Program Wisconsin: Rock County Education and Criminal Addictions Program Wyoming: Department of Corrections Honor Farm Wild Horse Training Program ------------------------------- Introduction This monograph reports the results of the Bureau of Justice Assistance (BJA) State Evaluation Development Program working meeting, Programs in Correctional Settings: Innovative State and Local Programs, held November 2-4, 1995, in Longmont, Colorado. The monograph was developed and written for the Bureau of Justice Assistance by the Justice Research and Statistics Association in coordination with the Office of Justice Programs of the United States Department of Justice and the National Institute of Corrections Academy. The working meeting brought together more than 60 State planners and local practitioners, as well as researchers, analysts, and law enforcement officers, who are involved in implementing or evaluating programs to improve the criminal justice system and their communities. This publication describes workshop presentations of programs in correctional settings that focus on improving the criminal justice system at the State and local levels. Although the programs are local in scope, they hold great promise for replication in other communities. The report seeks to aid that process by including important information about the programs' development and implementation. The 21 programs discussed in this monograph are funded under the Byrne Formula or Discretionary Grant programs and were nominated as effective programs by BJA, the Byrne State Administrative Agencies, and local criminal justice program managers. Several have been evaluated extensively at the State and local levels by State and local criminal justice researchers and practitioners using BJA's evaluation criteria and guidance. The results were reported at the Annual Criminal Justice Research and Evaluation Conference and in other forums. ------------------------------- State and Local Programs in Correctional Settings Alabama: Jail Assistance Project Statement of the Problem Alabama is a rural State with few metropolitan areas. Because most local jails do not have the resources to develop proactive corrections programs, historically they have relied on outside agencies for technical assistance. Although the quality of the assistance is satisfactory, there is a need to shorten the length of time involved in producing reports and delivering technical assistance. Alabama jails have been in crisis since the mid-1970s, when, in Pug v. Locke (1976), a Federal court order forbade the State prison system from accepting new inmates until its population no longer exceeded the rated capacity. The result was an instant backlog of State inmates in Alabama's county jails. Overcrowding was exacerbated by the influx of drug offenders into jails, which caused small, local detention facilities to become permanent or semipermanent residences for felons with long-term sentences. The responses to this crisis varied. Some local jurisdictions implemented additional inmate programming, but others simply allowed the situation to continue. "Conditions lawsuits" were filed against many local jails, adding to the burdens on already overloaded systems. Compounding the problem was Wyatt v. Stickney (1972), a court order that effectively deinstitutionalized the Alabama mental health system. Many hospitalized persons were released to community mental health systems ill equipped to deal with them. As a result, many of these persons were reinstitutionalized in local jails. Although the courts emphasized the least restrictive alternative for treatment of mentally ill citizens, those who found themselves bounced from the Alabama mental health system to the Alabama county jail system became victims of the "most restrictive alternative," with few or no resources to provide adequate care. This problem resulted in additional litigation against local jails, prompting the construction of several new county jails. In February 1992, several Alabama counties filed a class-action lawsuit against Alabama's Commissioner of Corrections to force the removal of State-sentenced inmates from county jails, inmates for whom sheriffs receive only $1.75 per day from the State for food. No per diem is provided for housing State inmates in county jails. The State court ordered the commissioner to remove all inmates from county jails within 30 days of receipt of official transcripts. The commissioner eventually was found to be in contempt of the order, but, acting under pressure from the court, reported compliance with the order on October 13, 1992. Nevertheless, the number of State inmates in Alabama county jails continues to grow, and the problem will persist until a better solution is found. Meanwhile, an untenable nontreatment environment has been created for mentally ill inmates who continue to be held in Alabama county jails. The current waiting period for a forensic commitment bed is as long as 6 months, and the Alabama Department of Mental Health petitioned the Federal district court in 1992 to eliminate the standards of care established in Wyatt v. Stickney. That court ruled against the Department of Mental Health, but the department has since filed an appeal to the 11th Circuit Court of Appeals. If the appeal is successful, the Department of Mental Health could continue to send individuals to the "most restrictive alternative." The Alabama jail situation is compounded by several problems that contribute to the overall inability of the jails to house long-term State inmates, mentally ill inmates, or any other class of inmates other than those typically confined to local detention facilities. Foremost among these problems is the condition of the State's local jail facilities, which range in age from 10 to more than 100 years old. Some newer jails are ineffectively designed, and most of the State's jail facilities are underfunded, understaffed, and undermanaged. Government entities responsible for funding the operation of local jails are often reluctant to invest in adequate staffing. Many still view the local jail as the fiscal stepchild of the county, even though Alabama law designates the operation of the county jail as the priority preferred claim against the county. The sheriffs of Alabama, through the Alabama Sheriffs' Association, responded to these problems with the Alabama Jail Assistance Project (AJAP). AJAP began operation on March 15, 1992, with funding from the Bureau of Justice Assistance (BJA) through the Law Enforcement Planning Division of the Alabama Department of Economic and Community Affairs, and with financial contributions from the sheriffs of Alabama. Although the project currently employs a limited staff, it has gained widespread acceptance through its provision of technical assistance in various forms to numerous county and municipal jails. Goals and Objectives AJAP makes multifaceted technical assistance available to Alabama county and municipal jails at no cost. The project's overall goal is to assist Alabama jails, particularly those with few resources, to cope with increasing demands for professionalism in their operations and to resolve both immediate and long-term problems. AJAP's objectives include: o Provision of quick-response technical assistance. o Provision of technical assistance geared to the specific needs of Alabama jails. o Utilization of local resources to resolve local problems. o Increased training for local jail officers. Program Components Inspection and Evaluation AJAP has no authority to inspect and evaluate jail facilities, organizational structure, or programming. However, many such inspections and evaluations are conducted at the invitation of the sheriff or chief of police. Inspections and followup reports focus on strengths and weaknesses of the system and recommend improvements. In most cases, the sheriff or chief of police forwards recommendations that require funding, with a request for implementation, to either the county commission or city council. Training Providing training is an integral component of AJAP's mission, and it is conducted through the University of Alabama Law Enforcement Academy, which is charged by the Alabama Peace Officers Training Commission with providing minimum standards for training Alabama law enforcement officers. Although there are no legally mandated minimum training standards for Alabama jail officers, the academy provides a basic 80-hour jail management training curriculum. Training sessions are conducted at the academy or hosted by a local sheriff or chief of police. The academy conducts approximately six training sessions annually, and participation has been excellent. Many departments now require their jail officers to complete the training, and a large insurance firm in the State pays training expenses for officers from jails enrolled in the policy. AJAP staff members participate in all aspects of curriculum development and instruction. This participation helps to ensure that the training remains focused on the practitioner. Policy and Procedure Development Most rural jails in Alabama have a great need for comprehensive policy and procedure directives. To meet this need, AJAP staff developed sample policy and procedure guidelines specifically for the State's jails. Based on case law, the Alabama County Jail Standards, the Code of Alabama, and sound corrections practices, the guidelines assist local jails in developing policies that, while reflecting each jail's unique operation, maintain consistency throughout the State. Jail Design and Renovation In addition to serving as an adviser to the chief law enforcement official charged with operating the jail, AJAP serves as a consultant to the government funding agency charged with approving and funding the design and construction of new or renovated facilities. AJAP works with funding agencies in planning the development of new institutions, often saving the agency the expense of employing a private consultant. In this role, AJAP staff ensure that jail designs are staff- and cost-efficient and that they conform to State standards. Response to Litigation AJAP staff members are available on request to assist Alabama jail officials and their attorneys with litigation over jail conditions, suicides, medical services, and other issues. The AJAP staff function as consultants to jail officers and their attorneys in developing and presenting a defense. For example, at the request of jail attorneys in the class-action lawsuit against the Alabama Commissioner of Corrections, and with the consent of the presiding judge, AJAP inspected seven Alabama prisons to determine whether space was being used adequately to house State inmates. The subsequent report indicated that space was available in the prisons and that more State inmates could be removed from county jails without interfering significantly with ongoing rehabilitation programs. The Alabama Department of Corrections is now using some of those recommendations to assist in removing State inmates from county jails. Resource and Reference Service AJAP serves as a resource and reference service for Alabama jail personnel. Sheriffs, chiefs of police, and jail administrators call AJAP staff with questions about the legality or appropriateness of an issue or planned action. AJAP provides a rapid telephone response, often followed by a letter or position paper addressing the issue. If needed, AJAP arranges onsite technical assistance. New Issues AJAP serves as a broker for information on new issues relevant to Alabama jails. Information on issues such as the Americans With Disabilities Act, the Bloodborne Pathogens Rule, the Religious Freedom Restoration Act, and recent court decisions is disseminated to Alabama jail officials to inform them of the legal requirements for compliance. Results and Impact Performance Measures Although AJAP's success is based primarily on customer satisfaction, a number of quantitative measures have also been recognized. These measures include: o The number and outcome of lawsuits brought against local jails. o The number of requests for AJAP's policy manual. o The number of officers trained. o The number of service calls from local jails. Implementation Problems and Successes The widespread need for the assistance provided by AJAP, the support of all State and local agencies affected, and the overall satisfaction with the project's work have created a hospitable environment for the project's implementation and daily operation. AJAP has been hampered, however, by its small staff, which currently is one individual, who is on call 24 hours a day, 365 days a year, to respond to all of the State's technical assistance needs. Due to limited resources, the project occasionally cannot respond to requests as quickly as it would like to, nor can it devote large blocks of time to a single local need. However, by providing jail personnel with training and knowledge, AJAP cuts down on redundant calls and often refers calls to other jails that have solved similar problems. Successes and Accomplishments In the more than 5 years it has been in operation, AJAP has become a valuable asset to local corrections jail systems in Alabama and has laid a strong foundation for addressing the increasing demands overburdened jails will face in the future. AJAP has raised awareness of the complexities and needs of local jails throughout the criminal justice system. As a result, local jails are increasingly viewed as an integral part of the system. Whenever possible and appropriate, AJAP provides immediate technical assistance upon request. Formal applications and a waiting period for approval have been eliminated. Having AJAP as a resource has made local jail officials feel more comfortable about requesting technical assistance because they know that assistance will be geared to their needs and will be sensitive to local issues. AJAP training has increased professionalism among local jail officers, and this professionalism has resulted in more statewide involvement in organizations such as the American Jail Association. The Alabama Jail Association has been developed as a professional organization for Alabama's jail practitioners. AJAP has played an important role in the development of an informal network of jail officials throughout the State. Some jail officials, particularly those in rural areas who have been isolated in the past, have been able to network with other jail officials and develop informal partnerships to enhance professional growth. From the project's inception in March 1992 through August 1997, AJAP provided training to nearly 2,000 local jail officers. The demand for training will continue because of the high turnover of local jail officers and the continuing climate of litigation. AJAP, in conjunction with the American Jail Association, will provide sheriffs with specialized training on jail legal issues in the near future. AJAP also has provided a sample policy and procedure manual to each Alabama sheriff and to numerous other jail officials. The manual is especially beneficial to rural jails with few resources for developing such documents. Additionally, AJAP has worked with architects to improve the design of new jails and with numerous attorneys involved in jail litigation. AJAP's efforts have been recognized by members of the Federal judiciary, and AJAP's staff person has been appointed as a mediator and monitor in jail litigation. Prospects for Replication Prospects for replicating AJAP are good if the program has strong backing from two key elements: a supporting organization with a vested interest in the operation of local jails and a cooperative and innovative State grantor agency. In addition, the project should be operated by staff with a background in law enforcement and corrections and include adequate clerical support. Contact Information Michael W. Haley Director of Jail Services Alabama Sheriffs' Association 514 Washington Avenue Montgomery, AL 36104-4385 Phone: 334-264-7827 Fax: 334-269-5588 ------------------------------- Colorado: Integration of Polygraph Testing With Sex Offenders Program Statement of the Problem The National Institute of Corrections (NIC) estimates that the recidivism rate of sex offenders is 60 percent. In 1983, more than 400 paraphiliac sex offenders were studied under a Federal certificate of confidentiality. The study determined that, on average, each sex offender committed 44 crimes per year. In an effort to enhance public safety, corrections systems are looking for ways to reduce recidivism and safely reintegrate sex offenders into the community. Programs that combine offense-specific treatment, specialized supervision and monitoring, and polygraph examination show the greatest promise in reducing recidivism. Although the Colorado Department of Corrections (CDOC) administers offense-specific treatment and specialized supervision for sex offenders, prior to this project it did not have the capability to administer polygraph tests to them. From October 1, 1996, to September 30, 1997, 242 incarcerated sex offenders in the State were released from prison to parole, 249 discharged their sentences, and 54 were released through other means. The majority of these offenders were released directly into the community without specialized supervision or polygraph examination. Goals and Objectives The goal of the Integration of Polygraph Testing With Sex Offenders Program is to reduce the recidivism of sex offenders by enhancing treatment and supervision through the use of polygraph examinations. The following are the program's objectives: o Develop and establish a polygraph policy for CDOC inmates and parolees. o Establish a baseline and 6-month monitoring polygraph testing program for inmates in the Sex Offender Treatment Program (SOTP) Phase II Therapeutic Community and for inmates and parolees under Risk Assessment Management (RAM) community supervision and Approved Treatment Provider (ATP) programs. o Establish a research and evaluation plan to document program participation, effectiveness, and outcomes. Use this information to develop national research products. o Provide technical assistance and in-service training annually to SOTP clinicians, community agents, and parole officers to ensure effective program management. o Establish a statewide list of polygraph specialists who meet ATP's standard criteria to conduct the testing program. o Increase by 10 percent the number of sex offenders receiving community or parole placement before their discharge into the community. o Collaborate with the Colorado Board of Parole on the use of polygraphs as a treatment and supervision tool. o Increase public safety by reducing by 10 percent the rate of reoffending by sex offenders in community or parole placement. o Increase by 50 percent the number of sex offenders receiving polygraph examinations while on parole and in community corrections. o Establish specific standards for polygraphers on the ATP list. o Conduct a baseline and 6-month followup polygraph examination of approximately 90 sex offenders in Phase II of SOTP, 110 sex offenders on parole, and 20 sex offenders in community corrections. Program Components Institutional Use The polygraph test is utilized during Phase II of SOTP. An initial baseline test is administered at 3 months, with periodic followup tests as clinically appropriate. The polygraph test is integrated into Phase II by explaining it in the Phase II Treatment Contract. The Phase II Treatment Contract is signed by the offender prior to enrolling in Phase II. The polygrapher is considered a member of the Phase II treatment team and has access to clinical records and impressions. This role is clarified in the treatment contract. Prior to each polygraph test, the inmate is given an Informed Consent Form that explains that (1) DOC employees are required to report to the Department of Social Services any child abuse that has taken place within the past 10 years and any specific information indicating prior or current child sexual abuse; (2) information about new crimes or Code of Penal Discipline (COPD) violations committed between polygraph tests will be reported to the proper authorities; and (3) information obtained from the polygraph test will be forwarded to parole officers and community corrections agents in a report or personal change contract. Offenders who exhibit deception on their test but do not admit the deception are subject to a retest, group sessions regarding the results of the examination, and identification of the areas of deception on reports and/or personal change contracts that are forwarded to parole officers and community corrections agents. Acknowledgment of reoffending COPD violations during the pretest and posttest interviews on a periodic exam will result in reports to the proper authorities, group discussion and termination from treatment, if appropriate, and revision of the inmate's relapse plan and personal change contract. Offenders who refuse to take a polygraph exam are terminated from treatment. Community Corrections Use The polygraph test is used by community corrections as a treatment/supervision tool. All sex offenders receive periodic polygraph tests. Sex offenders who have not previously taken baseline tests are required to do so while in community corrections. Offenders who deny their crime or are not participating in treatment are viewed as high risk and tested more frequently. The polygraph test is a condition of a community corrections placement. All inmates sign a Release of Information Form to release CDOC case material to the polygraph examiner. Each inmate is required to sign an Informed Consent Form. Offenders who are deceptive on polygraph tests are subject to increased supervision, treatment, and repeat testing. They are not regressed solely on the basis of a finding of deception on a polygraph exam. Upon determination of deception, and when there is no admission of reoffense or violation, the following steps may be taken: retesting, increasing collateral contacts, increasing surveillance and informing law enforcement as appropriate, electronic monitoring, detention (including home detention), and remediation. When an inmate admits during the pretest or posttest interview to a reoffense or violation, a report is made to the proper authorities. The inmate is then charged with a COPD violation, transferred to a more secure facility, and electronically monitored. Refusal to take a polygraph test may result in the filing of Code of Penal Discipline charges. Parole Use The polygraph test is used by parole officials as a treatment and supervision tool. All sex offenders receive periodic polygraph tests. Sex offenders who have not previously taken baseline tests are required to do so while on parole. Offenders who deny their crime or are not participating in treatment are viewed as high risk and tested more frequently. Because the polygraph test is a condition of parole for sex offenders, all parolees must sign a Release of Information Form to release CDOC case material to the polygraph examiner. Parolees must also sign an Informed Consent Form. Offenders who are deceptive on polygraph tests are subject to intensified parole supervision and treatment and repeat testing. Parole will not be revoked solely on the basis of a finding of deception on a polygraph exam. Upon a determination of deception, and when there is no admission of reoffense or violation, the following steps may be taken: retesting, referral to the Intensive Supervision Program (ISP), increasing collateral contacts, increasing surveillance and informing law enforcement' and electronic monitoring. When parolees admit during the pre- or posttest interview that they committed an offense or violation while on parole, the proper authorities are notified, and an arrest is made when appropriate. If there is no revocation, ISP and electronic monitoring are considered. A parole complaint is filed when an offender refuses to take a polygraph test. Results and Impact Performance Measures The program has had an impact on the Colorado criminal justice system in the following areas: o Identifying offenders' risk areas, which contributes to improving personal change contracts (relapse prevention plans); imposing more stringent parole conditions; authorizing parole plans and limiting contact with the victim pool; implementing community supervision plans; selecting an approved treatment provider; and notifying law enforcement. o Tracking the number of offenders receiving treatment. o Increasing parole of sex offenders contingent upon their receiving treatment, enabling the Parole Board to have more knowledge of the offender's history and a more effective monitoring tool for parole. o Increasing public safety by detecting technical parole violators earlier and removing them from the community before they reoffend. o Incorporating knowledge about sex offenders into law enforcement training and victim treatment programs. o Sharing information on the treatment and supervision of sex offenders with the board of the Sex Offender Treatment Program, which sets treatment and monitoring standards for the Colorado criminal justice system. Implementation Problems and Successes The Colorado Board of Parole is unlikely to parole sex offenders. This project offers a safer method to monitor sex offenders in institutions, in community corrections, and on parole. An important question is how to handle the disclosure of past crimes during polygraph testing. CDOC is consulting with sex crime prosecutors to obtain recommendations for reporting past crimes. Successes and Accomplishments The program, which began in October 1995, has achieved several objectives. Criteria for polygraph examiners have been established, and five qualified polygraph examiners have been contracted to provide services. Parole officers, SOTP staff, and polygraph examiners have received training on both the program and cultural diversity, and the State attorney general's office is reviewing the program policy for final approval. The Colorado Parole Board has met with the program's staff to exchange ideas and address concerns, and staff members have shared information with police departments on individual behavior patterns. Data forms have been developed, and sexual history questionnaires are in use. In addition, staff have met with a research consultant to develop and plan data collection. Polygraphing of all sex offenders receiving treatment is now mandatory in Colorado. Prospects for Replication This project could be replicated by other corrections departments in conjunction with sex offender treatment programs, community corrections halfway house systems, and parole divisions. Any polygraph testing program should consider using experienced and knowledgeable polygraph providers, having all procedures and personnel in place before initiating the program, employing a rotating schedule of polygraph examiners, and structuring examinations in ways that prevent offenders from becoming too aware of the procedure. Contact Information Peggy Heil Director Sex Offender Treatment Program Colorado Department of Corrections P.O. Box 1600 Canon City, CO 81215-1600 Phone: 719-269-4506 Fax: 719-275-2859 Bonita McKee Program Administrator Division of Adult Parole Supervision Colorado Department of Corrections 10403 West Colfax, No. 700 Lakewood, CO 80215 Phone: 303-238-5967, ext. 16 Fax: 303-238-0176 ------------------------------- Colorado: Juvenile Offender Substance Abuse Treatment Project Statement of the Problem There is a significant and serious gap in the system of care for substance-abusing youth in Colorado's juvenile detention facilities. Despite a large body of evidence documenting the high incidence of substance abuse among juvenile offenders and the relationship between substance abuse and criminal activity, no treatment is offered to youth in secure or nonsecure detention alternatives. For 4 years, surveys on substance abuse conducted at Zebulon Pike, the El Paso County youth detention facility, have identified substantial numbers of youth in need of substance abuse treatment and intervention, yet these results have never resulted in the provision of treatment services. The following data from Zebulon Pike illustrate the extent of the problem: o Of 1,173 surveys on substance abuse administered to youth in detention in 1996 by the Detention Services for Juveniles (DSJ) program, 275 scored high, indicating substantial dysfunction and im--mediate need for treatment, whereas 286 scored in the middle range, indicating immediate need for intervention. o A survey of Zebulon Pike residents (150 questionnaires) yielded the following information: 41 percent indicated that they use marijuana often, 39 percent indicated that they use alcohol often, and 9 percent indicted that they use hard narcotics often. (Not all respondents answered every question.) o Of youth designated serious habitual offenders, more than 46 percent are known to have substance abuse issues. o At least 536 juvenile arrests in 1992 involved drugs, alcohol, or both. The Juvenile Offender Substance Abuse Treatment (JOSAT) Project was developed to address the problem behind these numbers. JOSAT targets youth brought to detention whose score on a substance use survey (given as part of each youth's intake assessment by detention staff) indicates a need for further assessment and educational and/or treatment alternatives. It is critical for the rehabilitation of these youth that their substance abuse treatment needs be addressed. Most adolescents have not "bottomed out" like their adult counterparts, many of whom have lost their jobs, families, finances, and health. With appropriate treatment and support, adolescents can recover. If they can be reached, they have the ability to heal. Goals and Objectives JOSAT was created to help the large number of juvenile offenders who abuse alcohol and other drugs as part of their criminal activities. Its goals are to: o Provide thorough case management and aftercare for juvenile offenders with substance abuse problems. o Decrease substance abuse by achieving at least a 60-percent decrease in substance abuse among treated youth after 3 months. o Reduce recidivism by achieving a 70-percent decrease in recidivism among youth after 3 months. o Decrease the population of youth in secure detention by annually treating in the community 25 youth who previously would have been detained. To establish these priorities, the following objectives were set: o Assess the treatment needs of all juvenile offenders. o Recommend community-based treatment, rather than detention, whenever possible. o Meet the treatment needs of assessed juvenile offenders through individual and group counseling as part of a program model that adheres to accepted standards of practice. o Establish linkages with case management services provided by the DSJ program. o Develop an appropriate followup plan to take effect upon release from detention or discharge from DSJ. o Develop a committee to plan for continued funding before the project's original grant expires. Program Components All youth brought to Zebulon Pike are assessed by DSJ. Part of the assessment includes a substance use survey. Youth scoring high or at the high end of the middle range are referred to JOSAT. Scores are turned over to two Colorado-certified drug and alcohol counselors who conduct further assessments and complete written treatment recommendations for referred youth. (Both counselors are employees of the El Paso County Health Department, which provides weekly clinical supervision and a training budget.) From this point, linkages between JOSAT Project staff and youth are established through the case manager and meet the specific requirements of the Federal Regulations of Confidentiality of Alcohol and Drug Abuse Patient Records. There are two treatment options for youth recommended for treatment. In conjunction with the DSJ case managers, the possibility of pretrial release into the DSJ program is considered. If the youth meets criteria for community-based services, with a specified level of supervision, a JOSAT Project treatment component is recommended to the court. If the court agrees, participation in the project becomes a condition for release. For these youth, group treatment sessions are offered three times a week at Workout, Ltd., the component of DSJ that supervises released youth. Weekly individual sessions are scheduled as required. In addition, drug testing by urinalysis may be used with youth receiving such treatment. Youth remaining in secure detention at Zebulon Pike participate in weekly educational groups scheduled within the center's educational curriculum and taught by JOSAT counselors. Individual counseling is also available through a recommendation after intake assessment and with the youth's consent. Followup treatment is available for appropriate youth upon release from detention. However, unless mandated by court order as a condition or parole or release, followup treatment is voluntary. In all cases, the needs of the families are considered. If further services are necessary for and desired by families, project staff, Workout, Ltd., and/or DSJ case managers work together to make the most appropriate referrals and assist them with suggestions. Results and Impact Performance Measures The JOSAT Project measures its impact using statistical data, self-reports, and community and agency feedback and input. Statistics are kept on the number of youth originally assessed as appropriate for the project and the number of youth leaving detention with treatment as a condition of release. The overall decrease in secure detention population due to the project is computed. Self-report inventories at 3-month intervals measure decreases in drug and alcohol use and recidivism. When youth agree to a release of information waiver, such data are collected from or verified by officials such as probation officers and case managers. An oversight committee consisting of collaborating agencies, probation officers, and local law enforcement personnel reviews the information and offers feedback on how the program could be improved. Implementation Problems and Successes Implementation of the project was delayed for approximately 4 months due to the participating agencies' difficulty in developing and maintaining a collaborative relationship. However, once these agencies fully understood the project and its implementation plan, the process proceeded smoothly. The project's ability to use programs already in place was partly responsible. Drug and alcohol screening had been conducted by DSJ staff for 4 years before the JOSAT Project's inception, and court officials' full support of the project led to their immediate approval of treatment recommendations as part of release conditions. A continuing problem for the project has been finding an effective approach to followup treatment for youth who are appropriate for treatment but not released to a supervised facility. Unless followup treatment is ordered by the court, JOSAT counselors have no power over youth. As a result, they often have no outside incentive or encouragement to take advantage of treatment opportunities. JOSAT counselors are working with probation and parole agents to encourage them to emphasize continued substance abuse treatment when working with youth in need of assistance. Successes and Accomplishments For the first time, a concrete connection has been found between the project's survey results and further assessment and treatment in both detention and the community. This advance is significant in that it allows the system to respond to the needs of youth and their families. During the project's first 2 years, 404 juvenile offenders were treated. In addition to having access to services, all detained youth were provided with substance abuse education. In total, more than 1,600 youth have benefited from the program. Other accomplishments include: o A decrease in the population of Zebulon Pike Detention Center. o Thorough case management and aftercare for substance-abusing juvenile offenders. o A decrease in substance abuse by treated youth. o A decline in recidivism among treated youth. o The creation of a funding committee. Prospects for Replication Replication of JOSAT is possible if commitment and resources for collaboration exist in the community. Elements contributing to smooth implementation are: o Broad-based support by the justice system. o Collaboration with nonsecure detention facilities, the State's social services agency, probation departments, and group homes to accommodate the aftercare needs of youth released from detention. o Full-time detention staff working to administer and score drug and alcohol screening assessments and distribute them to project counselors. (Counselors can also perform assessments, but only of youth admitted during the hours they are at the facility.) o Facilities for treatment and educational sessions at secure and non- secure detention centers. o A project evaluator and oversight committee to track and evaluate project strengths and weaknesses. o The contribution of local cash matching funds by participating agencies. o Policies and procedures for regular staff training and supervision. o A plan for future funding to ensure the project's continuation. Contact Information Mercedes Harden Director McMaster Center for Alcohol and Drug Treatment El Paso County Department of Health and Environment 301 South Union Boulevard Colorado Springs, CO 80910 Phone: 719-578-3153 Fax: 719-578-3182 ------------------------------- Colorado: Department of Corrections Youth Offender System Statement of the Problem In summer 1993, the Governor of Colorado initiated a 14-point plan for a Colorado Partnership Against Violence. Given the significant problem of youth violence, specifically violence involving weapons, in Colorado and throughout the Nation, a major facet of the plan called for the creation of an innovative program to address youth violence. In response, the Colorado Department of Corrections (CDOC) developed and presented the Youth Offender System (YOS) program to the Governor and to the Colorado General Assembly. The program was passed into law on September 13, 1993, and received its first commitments in March 1994. YOS targets youthful offenders (14 to 18 years of age at time of offense) who have been convicted as adults of a violent, weapons-related offense (class 3 through class 6 felony) or who are designated as chronic youthful offenders. As appropriate, the court suspends the adult sentence on condition that the offender complete a 2- to 6-year determinate YOS commitment. Throughout the sentence, the court retains jurisdiction and can sentence the offender to adult CDOC or order probation if he or she does not benefit from YOS. Additionally, CDOC retains authority to recommend to the court that an unmanageable or intractable youth be transferred by revocation to adult CDOC. Revocation results in the institution of the suspended adult sentence, which is typically significantly longer than the YOS sentence. Goals and Objectives The mission of YOS is to provide youthful offenders with a controlled and regimented environment that affirms the dignity of one's self and others, promotes values of work and self-discipline, and develops useful skills and abilities through an enriched, needs-based, phased program. The program also seeks to provide strict but supportive aftercare to prepare offenders for positive community reintegration. YOS has developed the following objectives: o Provide effective intervention for youth offenders who are not career criminals now but would likely become career criminals or more serious offenders without intervention. o Provide staff models and mentors who promote the development of socially accepted behavior and attitudes. o Create a daily regimen that occupies youth offenders in physical training, strict discipline, education, work, and meaningful social interaction while providing appropriate security and discipline. o Develop an environment of positive peer support and influence that promotes behavioral change. o Provide diagnosis, treatment, and program services (including counseling; substance abuse education and relapse prevention; academic, cognitive, prevocational, and vocational education; and placement assistance) that enable the offender to pursue a course of lawful and productive conduct upon release from legal restraint. o Teach self-discipline by providing clear consequences for behavior. o Reinforce offenders' use of cognitive behavioral strategies that change criminal thinking and teach problem-solving skills that serve as alternatives to criminal activity. o Enhance education, self-care, and parenting skills to improve life-role functioning. o Support offenders' development of employment skills. o Reduce offenders' gang involvement and replace gang principles with values accepted by the community. o Reduce criminal recidivism. o Reduce substance abuse among offenders. o Enable offenders to develop and internalize positive behavioral norms. o Increase offenders' participation in services to establish and maintain program gains. o Give offenders a "second last chance" to learn and develop positive self-concepts and the value of service to others. Program Components YOS is multifaceted, providing core programming to all offenders and additional individual options to meet offenders' special needs. An intake, diagnostic, and orientation (IDO) phase is followed by three program phases. Intake, Diagnostic, and Orientation Phase Typically 1 month in duration, this phase sets the stage for participation in YOS. The intake process establishes the foundation for assessing individual offender characteristics and developing an individual program plan. The subsequent comprehensive diagnostic process, led by a multi- disciplinary YOS team, results in an integrated and individualized program plan designed to maximize positive change. Throughout the IDO phase, all youth, when not involved in orientation or diagnostic activities, are subject to a highly structured regimen based on the traditional military boot camp model. Emphasizing group discipline and group incentives, this regimen establishes the attitudes and behaviors needed to participate effectively in the positive peer culture and programming that characterize Phase I. Phase I. This phase provides intensive residential programming in a secure facility for 8 months to 4 years and 8 months, depending on the determinate sentence. Phase I uses a functional unit approach within the context of positive peer culture. Each unit (up to 16 residents) serves as a small community in which incentives, negative consequences, and peer pressure are used to discourage antisocial thinking and behavior and replace them with prosocial behavior. Each resident participates in a core program, which emphasizes academic education, cognitive restructuring, and prevocational and vocational education. Each youth also participates in supplementary programs tailored to his or her program plan. Phase I is staffed by multidisciplinary teams, with each team member sharing in the responsibilities of security, discipline, education, treatment, and behavior modification. Staff are chosen for their ability to mentor, coach, train, and counsel effectively within these domains. Phase II. A 3-month transition program that supports the progress made in Phase I, this phase establishes the basis for reintegration into the community in Phase III. This phase offers a diversity of program components, including education, life skills, and prevocational training, and engages resident in development of a Phase III plan that encompasses living arrangements, education, employment, community service, and other individual needs. Phase III. A 3- to 9-month community reintegration program, this phase gradually decreases supervision intensity while increasing positive program participation, progress toward defined objectives, and prosocial community involvement. Results and Impact Performance Measures Infrastructures being established to measure outcomes of all phases of YOS will serve a vital function in examining the program's effectiveness. Data will be collected on screening, assessment, diagnosis, program services, reentry to the community, community followup, and 5-year followup. Outcomes, which will be obtained from offender interviews and clinical assessments, will include relapse into criminal behavior, gang membership, and drug and alcohol dependence; the provision of restitution to victims; and psychological, social, and physical impairment. Primary goals of the YOS evaluation component are to: o Determine the program's effectiveness in reducing criminal behavior, arrests, and commitments to CDOC. o Examine the cost effectiveness of the program relative to the costs of institutional commitment and community supervision. o Assess offender progress over the course of YOS in skills development, emotional functioning, and motivation. o Evaluate the community adjustment of YOS offenders in employment, involvement in treatment, and use of community services. o Identify offender characteristics that predict positive outcomes during and following YOS to determine whether program assessments and interventions are provided as intended and according to curriculum program manuals and other program provider guidelines. o Examine changes in YOS over time. Seeking to develop thorough and well-founded research and evaluation approaches, YOS has established liaisons with agencies and organizations, including local universities and other criminal justice agencies, that have recognized experts in the field. In addition, the YOS evaluation program plan includes a range of established procedures and instruments. Implementation Problems and Successes There have been numerous challenges for the many agencies and individuals who are stakeholders in YOS. While implementation problems have, in large part, been similar to those experienced by other programs with nontraditional systems, they have been magnified in scope and intensity because the unique features of YOS extend beyond its immediate legislative, judicial, and correctional environments. YOS has broken new ground nationally. Intensive education and communication have been used successfully to facilitate stakeholders' understanding of the program's mission, goals, objectives, and methodologies; to ensure consistency with the program plan and legislative intent; and to secure and enhance staff skills. In addition, intensive efforts have been required to maintain qualified and experienced staff that meet the programmatic requirements of YOS. Position classifications suited to other employment settings, including the adult CDOC, are not suited to YOS. Although efforts are under way to develop more appropriate classifications, time delays in bringing a full staff on board have made it difficult to implement the entire YOS program. Through patience and persistence, however, YOS has filled nearly all of its staffing needs with dedicated individuals who are qualified to deliver the program's diverse program components. The development of information collection, storage, analysis, and retrieval infrastructures to support accountability, program evaluation, and other vital monitoring functions has challenged limited staff resources. Traditional systems have been found to have limited utility within YOS, making it necessary to modify existing systems or develop new ones. A number of basic systems are currently in place and will provide a sound foundation for future enhancements. YOS requires the delivery of highly diversified program components, and securing established curriculums of a level, scope, depth, and length suited to the YOS population and environment initially posed problems. However, due to substantial investigatory efforts, virtually all major and most supplementary program components have been implemented. Finally, integration of the YOS program phases has presented challenges. A comprehensive program spanning initial incarceration in a highly secure and structured environment through community placement and supervision is central to the program's success. Strong, positive liaisons spanning program phases have been established and continue to facilitate effective redirection. Successes and Accomplishments YOS is innovative in concept and in development. The program integrates components and approaches that research and experience have demonstrated to be among the most promising in redirecting the lives of young and violent offenders. By continually improving its effectiveness by developing quality assurance, process, and outcome evaluation components, the program ensures that it is not only effective but dynamic. To date, the program has accomplished the following: o In 1994, legislation modified the YOS sentencing structure, establishing the program as a sentencing alternative for chronic youthful offenders who meet specified criteria. o YOS has attracted nationwide attention as a model program. o Funding has been secured and contracts finalized to provide Phase I housing and programming for all Phase I females and for males exceeding the 96-bed capacity of the current YOS facility. The project's new facility opened in 1997. o As of May 1997, the total YOS youth population stood at 272. Of those youth, 228 were in Phase I, 15 were in Phase II, and 29 were in Phase III. o Drug and alcohol education and relapse prevention, cognitive restructuring, and postsecondary education programs have been developed, with emphasis on vocational education and job-readiness preparation. Prospects for Replication By legislative mandate and program commitment, YOS is actively establishing the foundations for rigorous quality assurance, program evaluation, and research with the intent of identifying the extent to which YOS supports the effective redirection of youthful offenders toward healthy, productive behavior. The results of these efforts will be used to guide decisions about program replication and to facilitate replication by providing clearer definitions of the YOS program and its components. Contact Information Noble Wallace Director, Phase I Youthful Offender System 10900 Smith Road Denver, CO 80239-8006 Phone: 303-375-2900 Fax: 303-375-2909 ------------------------------- Delaware: Mentor Program, Inc. Statement of the Problem Nationally, a high proportion of women return to prison within their first year of release. Female offenders state that they lack role models and have more obstacles to overcome than men. Participants interviewed expressed very low self-esteem and found no support system upon release. Less than 50 percent have their general equivalency diploma or high school diploma, and most lack marketable skills. Women stated that they had so much anger and pain that it was hard for them to function from day to day. It was this pain and anger that drove them to dependency on alcohol or other drugs, and to maintain their use of alcohol or drugs they resorted to stealing and prostitution. Other women were so involved in abusive relationships with men that if their partners did not beat them, the women thought they did not love them. These women believed they deserved this type of relationship because they had experienced physical, mental, or sexual abuse as children. Goals and Objectives The goals of the Delaware Mentor Program (DMP), Inc., are to reduce, through a self-awareness program, the number of women who return to prison within their first year of release, develop a support system for their transition into the community, and help female offenders compete in and contribute to society. The objectives of the program are to secure funding and office space, recruit a board of directors, secure 501(c)(3) status, develop a self-awareness program, hire an executive director and a Phase I coordinator, recruit professional presenters from the community, recruit women to be mentors, develop a postgraduate phase, and raise awareness through the news media, public appearances, and special events. Program Components A 19-member board of directors conducts the business affairs of the program and oversees finances. The board meets monthly to review accomplishments and develop goals for the future. All program participants are volunteers. During preenrollment interviews, participants discuss why they want to change and their willingness to do so. Guidelines for completion of the course are discussed, and participants are given control over their future choices. They understand that they are accountable for their actions from this time forward. All mentors are selected from the community. They may be graduates of the program with the stipulation that they have resided successfully in the community for a year. The program has three components. Phase I. A self-awareness program designed to allow female offenders to discover who they are and understand how their anger and pain dictates their behavior, Phase I consists of 48 to 53 2-hour workshops over 13 weeks. The workshops are offered in five categories: self-actualization, relapse prevention, relationships, preparation for employment, and educational opportunities. After Phase I is completed, many participants move to work release or remain incarcerated while participating in the postgraduate phase. Postgraduate Phase. Designed to help graduates of Phase I determine individual recovery paths, this phase offers participants the opportunity to understand and change patterns of behavior. The group meets weekly for 2 hours and represents DMP in special events. Sessions are open to residents who have graduated from Phase I until their release from prison. Because they are considered role models for the entire prison population, participants' behavior and willingness to work on personal issues are a top priority. Education and Recruitment. Whenever possible, the executive director and graduates of DMP who are in the community speak to organizations and participate in special events. The program is supported by the University of Delaware, Delaware Technical and Community College, and local corporations and organizations. Members of these organizations serve as presenters, mentors, or board members, and all volunteer valuable time and services. DMP expects graduates to change the way in which they interact in society. The women get involved in support organizations such as Alcoholics Anonymous and women's counseling groups, and they seek to increase their educational levels by obtaining a general equivalency diploma or high school diploma or attending college. Instead of applying for minimum wage employment, graduates seek positions that offer career advancement. Results and Impact Performance Measures Women in the program are tracked through the criminal justice system, and data are updated once a year. Within the coming year, data will be released relating to graduates' housing, education, and employment. Other performance measures include the number of successful graduates helped by the program, recidivism rates, and degree to which participants have separated themselves from negative home environments after release. Implementation Problems and Successes DMP's success has been supported through the efforts of the warden and staff of Delors J. Baylor Women's Correctional Institution (DJBWCI). An important factor has been the program staff's willingness to work as a team with the corrections and judicial systems to help women offenders become contributing members of society. Successes and Accomplishments The program's accomplishments include: o Becoming a 501(c)(3) organization with a full board of directors that meets monthly. o Obtaining four offices and a reception area at DJBWCI. o Obtaining funding for an executive director and a Phase I coordinator. o Completing 15 Phase I classes. o Analyzing and presenting recidivism results. o Securing a Federal grant and State contracts. o Receiving positive reviews by media, including television and newspapers. o Receiving enthusiastic support from the DJBWCI warden, who has observed a noticeable change in demeanor among program participants. o Increasing the ability of the program's graduates to make choices to improve themselves after release from prison by working on core issues, to consider halfway houses instead of returning to destructive past relationships, and to set goals to ensure a secure future. o Creating and implementing a transition phase for women offenders after release from prison. o Receiving the Governor's Outstanding Volunteer Award in 1996. As of June 1996, 170 women had graduated from the Delaware Mentor Program and left the institution for the community. In addition, 15 participants who did not complete the program left the program before that date. First-year recidivism rates for graduates and all participants were 21.8 percent and 22.2 percent, respectively, compared with the 1989 baseline rate of 39.5 percent. Marsha Miller, a statistical consultant and past chair of the program's board of directors, follows all clients through the criminal justice system and provides updated statistics yearly. Prospects for Replication DMP can be replicated in any female institution. Teamwork among the corrections staff, the judicial system, and the community is essential to provide the support incarcerated women need to heal their anger and pain and become productive citizens. Contact Information Linda Forshey Executive Director Delaware Mentor Program, Inc. P.O. Box 11524 Wilmington, DE 19850 Phone: 302-577-3004 Fax: 302-577-5849 ------------------------------- Idaho: Ada County Jail Substance Abuse Program Statement of the Problem Crime in Idaho is connected to drug use and abuse. The most recent statistics indicate that 46 percent of arrests in Ada County are directly connected to drug or alcohol use. Of all arrests involving drugs, 90 percent are for methamphetamine (speed). In the Pacific Northwest, use of methamphetamine is on the rise. Within the past 2 years, use of the drug has risen 400 percent in the region. Generally, inmates with a drug or alcohol problem are treated in State prisons, not in local or county jails. State prisons incarcerate inmates for longer periods than do local jails, and they are typically better funded. Most prison inmates have a record of several arrests and periods of incarceration prior to serving State prison time, and most have served at least one stint as a county jail inmate before becoming a State prison inmate. To stop the drug/crime cycle before drug-abusing offenders reach this point in the criminal justice system, training and education must be offered to them earlier in the process. Goals and Objectives If drug abuse among young first- or second-time offenders can be reduced, the incidence of crime will decrease. Waiting until offenders are incarcerated in the State prison system makes achieving this outcome extremely difficult. The mission of the Ada County Jail Substance Abuse Program is to reduce the use of drugs and alcohol by offenders who are sentenced to incarceration at the local level. Incarceration is an excellent time to provide education and group treatment to offenders. The program provides short-term treatment and, upon release, refers the offender to a community agency for followup treatment. Program Components The 4-week coed program employs 1 full-time instructor to teach approximately 16 inmates, who are in class 30 hours each week. Male and female inmates are housed separately. Participants are encouraged to study together and discuss their assignments with inmates from previous sessions. The program's administrative assistant screens applicants and assigns inmates to upcoming sessions. A psychologist, who serves as the program's administrative head, coordinates program activities and designs the statistical evaluation. The program's first-year budget was funded entirely through a Federal grant. For the second year, one-third of the budget was funded by inmates. Over the next 2 years, inmates assumed 100 percent of program costs. Inmates participate in the program either voluntarily or by court order. Inmates must be compliant, be sentenced to time in the county jail, be able to live in a dormitory setting, and have ties to the local community so that upon release they can be tracked and placed in aftercare. Inmates must have no pending charges and no convictions for violent felonies. Offenders are removed from the program if they proposition or are rude to one another. Upon admission to the program, inmates sign contracts in which they agree to comply with all jail rules and staff instructions, attend the program voluntarily, attend at least 1 year of followup outpatient alcohol and drug treatment after release from jail, stay in contact with the program's staff for 1 year following release from jail, involve their families in follow-up treatment and provide them with followup information, and live in the community after release. After a contract is signed, the inmate's substance abuse is evaluated and a treatment plan is created. Services offered by the program include individual and group counseling, 12-step programs, and classes on relaxation and meditation, legal matters, education, health and nutrition, addiction, financial issues, social and family dynamics, spirituality, communication skills, sexuality and gender issues, relapse prevention, and vocational rehabilitation. Female inmates are treated in separate counseling sessions. In aftercare, which is paid for by inmates, the program links offenders with an aftercare program in the community. Jail staff help inmates make reservations in the aftercare program and perform followup interviews with inmates and their families after inmates have been released. Ada County has also created a program in which offenders go to work, live at home, and attend mandatory classes at the jail. Urine analyses are conducted during their visit, and offenders may be held overnight in the jail if their urine analysis reveals substance abuse. Results and Impact Performance Measures The program was designed with the minimum expectation that graduates will stop using illegal drugs or alcohol or will use them less frequently. It is also expected that graduates will be arrested less frequently. Following release from custody, inmates are contacted by the administrative assistant every 3 months to ensure that they are attending classes and counseling sessions according to their treatment plan. To measure the program's impact, jail staff periodically check the local criminal database to determine if program graduates have been arrested and, if so, whether the arrest is related to drug use. Implementation Problems and Successes The program's most significant problem during implementation was lack of classroom space due to overcrowding in the jail. The situation was remedied, however, when a break in the influx of inmates to the jail created extra space. Successes and Accomplishments Early in 1997, staff determined that they needed access to statewide criminal records to compare the program's recidivism data with that of other jail substance abuse programs. (For the study, recidivism was defined as an arrest, within a 12-month period after release, that led to a conviction.) Nationally, recidivism for offenders charged with drug-related crimes is 50 to 80 percent. Prospects for Replication The program's prospects for replication are excellent. Its essential elements are simple: an instructor, an administrative person, inmates, classroom space, educational materials, and security staff. In addition, these factors are critical: o Inmate payments to help cover program costs. o Linkage to aftercare following inmate's release from jail. o Program instructors with backgrounds that enable them to connect with inmates. o Selection of inmates appropriate for the program. Special consideration should be given to inmates from the local community, enabling staff to track them following release from custody. o Involvement of the inmate's family. o Emotional and financial cooperation of inmates. o Training for jail security staff. o Support from local judges. The placement of an inmate on probation following release from custody is highly correlated with the inmate's participation in programs after release. Contact Information Lieutenant Michael Laky Housing Section Commander Ada County Sheriff's Office 7200 Barrister Drive Boise, ID 83704 Phone: 208-377-6609 Fax: 208-377-7316 ------------------------------- Illinois: Department of Corrections Sex Offender Treatment Program Statement of the Problem Sexual victimization is becoming prevalent throughout the Nation. Studies have revealed that at least one in five children experience at least one incident of sexual victimization. Rape is fast becoming one of society's most plaguing problems. Unfortunately, the frequency of sex crimes is widely believed to be seriously underestimated. Victims of child molestation, rape, incest, and other sexual crimes suffer immediate trauma and serious long-range effects. To respond to this crisis, the State of Illinois found it imperative to explore the application of recently developed therapies to reduce criminal behavior that causes such suffering. The goals of incarceration include both punishing the offender and protecting society. For sex offenders, punishment alone too often is unproductive and increases their pathology, leaving these individuals with fantasies more deviant than those prior to incarceration. Treatment specialists have discovered that such fantasies directly influence sex offenders' actions upon release, as demonstrated by their high rate of recidivism. Research indicates that sex offenders who are denied treatment have between a 50- and 85-percent chance of reoffending, but the odds can be radically reduced through intensive, broad-ranged therapy. Estimates provided by current research indicate that graduates of sex offender treatment programs have only a 15-percent chance of reoffending. A Vermont study on the cost effectiveness of sex offender treatment concluded that treatment saves taxpayers money. For each offender, treatment programs cost one-fifth of prosecuting and sentencing another sex crime. The Illinois program will pay for itself if it prevents one in five offenders from reoffending. However, the cost of victimization alone would seem to justify treatment. In response to sexual victimization, the need to treat sex offenders, and the available research, the Illinois Department of Corrections (IDOC) implemented a comprehensive sex offender treatment program devised by a committee of representatives of all operational divisions in the agency, including clinicians experienced in sex offender treatment. In January 1992, with funding from the Illinois Criminal Justice Information Authority, IDOC established its first residential treatment unit for sex offenders and began creating a pilot sex offender treatment program for parolees. Goals and Objectives The primary mission of the IDOC Sex Offender Treatment Program is to reduce, through treatment, the number of sexual offenses committed each year and thereby the number of victims of sexual offenses. For the purposes of the program, sex offenders are those inmates committed under the sexually dangerous persons law and those who have been criminally convicted of a sexual offense but deemed mentally ill. The program addresses the needs of sex offenders through the following objectives: o Offer programs on sexual orientation for a large population of sex offenders. o Identify inmates who need intensive, specialized attention. o Provide intensive residential treatment that includes the elements determined by researchers and experts to be critical to the treatment of sex offenders. o Provide a monitoring system for offender compliance with treatment upon release. Program Components Nonintensive Sex Offender Programming Although technically not a component of the Sex Offender Treatment Program, nonintensive programming is critical to its success. Of the 26 adult correctional facilities (maximum, medium, and minimum) that are currently part of the program, 24 offer sex offender orientation treatment or educational/therapeutic groups, and all of the facilities offer a combination of 59 supportive treatment groups. The objectives of these programs are to: o Educate offenders on contemporary sex offender treatment. o Break down offenders' fears concerning treatment. o Facilitate positive attitudes toward treatment. o Dispel myths surrounding treatment. o Motivate offenders to seek intensive treatment. o Increase offender awareness of the impact on victims. Initial Assessment This component was developed to provide the program with a uniform and systematic method of identifying and encouraging qualified inmates to invest in their rehabilitation and recovery through intensive sex offender treatment. To be accepted into the program, offenders are required to submit an application and to be interviewed by a mental health professional. A sex offender data collection survey is completed on the applicant's offenses, victim history, background, and mental health history. From this information, an offender's condition and motivation level can be determined. Offenders must also complete a self-report on their behaviors. If, based on the self-report and the mental health professional assessment, an offender is chosen for the program, he or she must sign a contractual agreement that spells out the program's requirements. Intensive Residential Treatment Having agreed to the contract, offenders are sent to one of three intensive residential treatment units currently available in IDOC. In this therapeutic environment, therapists assist offenders through a phase-based system that focuses on retraining arousal patterns, sex education, relapse prevention, and victim empathy. Throughout the phases a variety of recognized treatment techniques are applied. For example, inmates develop disgust for their deviant behavior through correct sensitization, satiation therapy, and noxious odor aversion. After deviant sexual arousal patterns have been reduced, misconceptions and irresponsible attitudes related to sexual activity are dealt with in a group setting. Group psychotherapy techniques are used because they are less costly and more effectively recognize and deal with participants' denials and evasions of responsibility. Because most offenders lack social skills, the group is designed to be a laboratory for learning responsible community living skills. Groups focus on victimization issues, relaxation techniques, learning to assert rights without being aggressive, getting a more realistic view of the world, sex education, and covert conditioning of disgust for deviant sexual acts. Additional treatment is provided through psychoeducational modules on a variety of themes, modern psychophysiological assessment procedures, and individual support sessions as needed. An offender's progress from one phase to another is not necessarily based on his or her ability to recite the information presented, but rather on the offender's conceptualization, assimilation, and application of the information in accordance with the program's primary motto, "No More Victims." Graduation criteria include developing a high level of victim empathy, identifying and recognizing one's deviancy, identifying relapse conditions and preventing relapse, understanding the concept of honesty with oneself and others, and developing a plan for moving successfully through life. Parole Monitoring The final element of the program combines a strong parole component with monitoring of ongoing outpatient treatment. Thus far, it has been successfully implemented in one region of the State. All sex offenders, whether or not they complete intensive residential treatment, are given the opportunity to continue their treatment during parole. A case manager meets with an interested offender 6 months before release to determine treatment needs. After the offender is released, the case manager provides referrals and monitors (with the assistance of the parole agent) the offender's compliance with treatment objectives. Results and Impact Performance Measures Evaluations of the program's performance are based on the following measures: o The number of inmates enrolled in the program. o The number of inmates who complete the program. o The recidivism rate of those who complete the program. In 1993 and 1994, two extensive annual evaluations of the program were conducted. The results of external audit development are as follows: o 1995--Conducted a survey/program audit of Adult Division out patient care counseling and support group services within the 26 adult facilities. o 1996--The survey/program audit was expanded to the Community Services and Juvenile Divisions. o 1995 to Present--Documentation was added to the survey/program plan that monitors monthly the racial makeup of the intensive program participants. Implementation Problems and Successes Training. Mental health professionals, facility counselors, and Pre-Start (parolee) agents at designated facilities received training from well-known clinicians throughout the Nation, and with the opening of each inpatient program, the importance of training became apparent. In the training, mental health professionals expressed legitimate concerns about interacting with and treating sex offenders in a therapeutic environment, and some expressed feelings of disgust and personal bias against the target population. Many sought assistance on performing in a professional manner, given these conditions. A psychoeducational manual was developed and distributed to all mental health professionals and support staff. This manual helped mental health administrators and counselors better prepare their facilities for treating sex offenders. Clinician Relationships. Administrators of the intensive residential programs found that relationships between offenders and sex orientation treatment providers were much stronger than expected. They, therefore, engaged in intense recruitment, stressing to both offenders and clinicians that nonresidential treatment could only go so far and that the residential program was in the best interest of the offender. By educating the parties about the exact nature of the program and encouraging participation, administrators were able to resolve this initial problem. Waiting Lists. Overcrowding in the facilities and the high percentage of sex offenders seeking treatment made waiting lists for the program inevitable. However, program administrators discovered that by making offenders more accountable for their actions, double celling was possible, thereby reducing waiting lists. Those still remaining on the waiting list were provided continuing sex orientation programming. Racial Imbalance. Early on, a significant racial imbalance in program participation (approximately 75 percent white and 25 percent African-American) was noted. A number of factors creating this imbalance were cited, including African-Americans' traditionally negative attitudes toward government-sponsored treatment programs. In response, referral processes were implemented, and sex orientation programs worked to address some of the issues causing the imbalance. Voluntary Programming. At present, all of this initiative's group and intensive sex offender treatment programs are voluntary. However, policymakers and clinicians from outside the facility are calling for the program to be made mandatory. Currently, the only incentive to join the program is each offender's desire to receive treatment. Most program participants are honestly asking for help and are highly motivated to change. Administrators indicate that requiring the program for all sex offenders would destroy its therapeutic and productive atmosphere, creating an environment in which an undercurrent of rebellion and disruption, as well as significant breaches of confidence, would exist. To dissuade this call for mandatory participation, administrators are learning that these problems will make successful implementation of a sex offender program difficult. Community Reaction. Community reaction, frequently an issue of concern when correctional programs strive to "treat" offenders, has not been a problem for this program. The program has avoided negative community reaction by maintaining a low but accountable profile. Interviews are given to provide information to a curious, skeptical, and concerned public. Successes and Accomplishments Since its implementation in 1992, the Sex Offender Treatment Program has accomplished the following: o Approximately 2,200 sex offenders have participated. o Enrollment in intensive residential treatment has increased from 150 to 250 inmates. o The program has increasingly utilized risk assessment scales to measure participants' success. o Six regional training/certification symposiums will be held in February 1998. Invited participants include community-based providers of treatment to sex offenders under the custody/control of IDOC; IDOC mental health professionals who treat sex offenders at IDOC adult and juvenile facilities and IDOC community-based sex offender treatment programs; and IDOC staff responsible for the direct supervision of sex offenders. Prospects for Replication Since the pilot program began in 1992, the Sex Offender Treatment Program has been duplicated at two other Illinois facilities, and IDOC is exploring ways to expand the program. Factors to be considered regarding the program's replication include: o Training that reduces judgmental or biased treatment of sex offenders. o Education throughout the criminal justice system about the nature of the program. o Voluntary participation. Contact Information Linda Dillon Superintendent Training Academy Illinois Department of Corrections 1301 Concordia Court P.O. Box 9277 Springfield, IL 62794-9277 Phone: 217-522-2666, ext. 6605 Fax: 217-522-2666, ext. 6602 ------------------------------- Iowa: Centralized Substance Abuse Assessment Project--Iowa Medical and Classification Center Statement of the Problem Many offenders entering the prison system have drug or alcohol problems. Although all of Iowa's correctional facilities provide some level of substance abuse treatment, no actual substance abuse assessments were made in the past. Because of this, recommendations for treatment were not always made in a consistent manner. Certain programs had long waiting lists, whereas others were not used to capacity. Inmates with very different treatment needs were often referred to the same program. In 1993-94, a research and demonstration project undertaken by the Iowa Department of Corrections (DOC); the Iowa Department of Public Health, Division of Substance Abuse and Health Promotion (IDSA) and Division of Criminal and Juvenile Justice Planning (CJJP); and the Mid-Eastern Council on Chemical Abuse (MECCA) led to the establishment of a centralized substance abuse assessment unit at the Iowa Medical and Classification Center (IMCC). Iowa employs a centralized assessment model in determining placement and treatment needs of inmates entering the prison system. Upon arrival at IMCC, inmates undergo medical, educational, and psychological testing as well as a reception interview. The information gathered is used to determine the inmates' appropriate risk level and appropriate treatment modalities. Goals and Objectives The three primary goals of the centralized assessment project are to assist in decreasing criminal recidivism and substance abuse; expedite inmates' movement through the institutional system, allowing the most advantageous use of treatment resources; and evaluate the effectiveness of referrals made by the assessment unit. Objectives of the project include: o Assessing all inmates entering IMCC with a 10-year or less sentence. o Referring inmates to the appropriate level of substance abuse treatment. o Updating each inmate's treatment summary record on the DOC automated information system to enable institutional classification teams and the parole board to make appropriate decisions. o Providing training for institutional treatment staff on how to use the assessment instrument. o Maintaining communication to ensure that the assessment unit is making appropriate clinical and placement decisions. o Establishing a database to collect demographic information and outcome effectiveness information. o Implementing the program's database. o Producing data reports summarizing treatment needs, referrals, and types of treatment recommended. o Assisting DOC in determining future types of treatment programming. Both institutional and community treatment providers review data reports to determine the need for treatment revision or development. Program Components MECCA developed its assessment tool using the criteria contained in the IDSA's standardized assessment form, but revised it to reflect the characteristics of both the prison population and the treatment available in the institutions. To understand treatment needs and resources, MECCA and IMCC staff visited all treatment programs in Iowa correctional facilities. These visits helped to open lines of communication between assessment staff and treatment staff. Close supervision of the assessment process has ensured consistent treatment recommendations. The key elements of the project are reception, evaluation, classification, and placement. During the reception period, inmates are interviewed by the IMCC assessment staff, who compile substance abuse evaluations according to standards set forth by IDSA. These evaluations form the basis for recommending the most appropriate treatment for inmates during their time in the institution and upon release. Treatment recommendations are considered by the classification manager in light of the risk posed by the inmate and all information from the inmate's psychological and educational profiles. The inmate is then placed in the most appropriate institution for the risk and needs indicated. In the first year of the project, the substance abuse assessment frequently resulted in placement decisions for inmates that differed from those of past years. Each institution has a classification team. Upon arrival, and then periodically throughout incarceration in the institution, each inmate's case is reviewed by the classification team to determine appropriate physical and programming placements. Specific recommendations for substance abuse treatment have been integrated into each team's decisionmaking process. Iowa's State parole board is an autonomous entity. No other department or office has jurisdiction over or influence on the parole of inmates. The parole board receives all inmate information through its computer system. The treatment summary section of this system contains the recommendations from the assessment unit. The parole board can then expedite the review of inmates who are placed in treatment. The parole board has been very supportive of the project and has helped DOC determine the predicted parole review dates of inmates in the target population, helping classification staff prioritize the placement of inmates into limited treatment resources. Inmates who are released from prison to community-based correctional (CBC) programs such as work release or parole are often expected to be involved in some level of substance abuse treatment. The centralized substance abuse assessment is forwarded to the CBC program for use by community-based substance abuse treatment providers. For the past 5 years, DOC has submitted data indicators to the Governor's Alliance on Substance Abuse (GASA) regarding the nature of substance abuse needs in the inmate population. Without specific substance abuse assessment, these indicators are at best approximations. Aside from reporting indicators, data on offender treatment needs can suggest how treatment resources should be allocated and how to match offenders to treatment approaches that are likely to be effective. The creation of a database of treatment records, maintained within Federal confidentiality guidelines, is essential to the success of the program. At present, most data collection and reporting is accomplished through manual compilation supplemented by an existing, limited database system; however, the program is in the process of becoming automated. Results and Impact Performance Measures The program measures its performance using these indicators: o Equal utilization of all treatment programs and facilities. o The length of the waiting lists for admission into treatment programs. o The number of individuals assessed. o The level of interagency cooperation between MECCA and DOC staff. o Demographic information. o Type of treatment recommendations. o Results reported in the project's annual report. o Identification of drug abuse trends. o Collection of data that identify use patterns, relapse issues, and treatment needs. Implementation Problems and Successes As with any new project, the assessment unit had to overcome obstacles during the project's implementation. Startup of the project was delayed by contract negotiations, hindering the ability of the assessment unit to meet its first-year goal of 1,500 assessments. The problem was resolved when GASA approved an increase in the assessment staff for the last 3 months of the fiscal year. When the first evaluations began arriving at the institutions for review by the classification teams and treatment staff, there were cases in which the institutional staff disagreed with the recommendations of the assessment team. This issue was resolved by establishing better communication between institutional and assessment staff. Institutions are expected to follow the MECCA recommendation unless they have a significant reason to suggest an alternative. If another suggestion is made, MECCA staff are consulted. If clinical agreement cannot be reached, the IMCC treatment director and the DOC substance abuse coordinator are consulted to make the final decision. To prevent disagreements, MECCA staff have been familiarized with prison treatment programs so that they are better versed in the services available. Since the implementation of these two actions, few assessment recommendations have been disputed. Another coordination problem, which has always been difficult to solve for the institutions, is the need to predict how much of the inmate's sentence will be served before the parole board will review his or her case. This information is required to ensure that inmates are treated as close as possible to the time of release, increasing treatment efficacy and establishing community aftercare resources. The problem has been resolved somewhat through planning meetings with the coordinator, treatment director, and parole board. The board has given DOC a list of sentence types and likely sentence lengths. The greatest variable to this planning is inmate behavior, but a starting point now exists for determining when it is appropriate to place an inmate in a treatment program. Successes and Accomplishments Much of the project's success can be credited to the positive and supportive working relationship between MECCA and DOC. In general, inmates have cooperated with the evaluation project. Recommendations have been based on consistent criteria and have been well received and followed by DOC staff. The initial project size has doubled, providing the opportunity for an increasing number of inmates to participate in substance abuse assessment. Waiting lists in treatment programs have decreased, and formerly underutilized programs are now operating at capacity. Discussions are under way on how to fill gaps in treatment provision, including relapse prevention services and residential treatment at minimum security institutions. The project has provided a clear picture of the drastic increase in methamphetamine use in the State and identified unique problems accompanying the increase. Although there is a desire to increase data collection capabilities, the current system has provided valuable and relevant information, and this information has been used at a variety of programming and policymaking levels. To enhance data collection, this project has been awarded an additional GASA grant for the purchase of personal computers and software. More than 1,300 substance abuse assessments were provided by MECCA during the project's first year. In FY 1996, 2,800 assessments were conducted. In FY 1997, the number increased to 3,500. Prospects for Replication The primary factor in the Centralized Substance Abuse Assessment Project's success was the cooperation of multiple systems and disciplines. If this level of cooperation can be duplicated, projects of this type in other jurisdictions should be able to achieve similar results. In Iowa, substance abuse assessment was integrated into DOC's existing structure of centralized classification, making the assessment process compatible with the environment in which it is used. Finally, the willingness of all participants to learn from one another, to be flexible, and to be innovative has ensured a comprehensive and consistent approach to treatment provision. Contact Information Lowell Brandt Treatment Director Iowa Medical and Classification Center P.O. Box A Oakdale, IA 52319 Phone: 319-626-4473 Fax: 319-626-6641 Marie Havel Clinical Supervisor Mid-Eastern Council on Chemical Abuse P.O. Box A Oakdale, IA 52319 Phone: 319-626-2391 Fax: 319-626-6641 ------------------------------- Iowa: Statewide Substance Abuse Program Coordination in Corrections Statement of the Problem Substance abuse in the Iowa correctional system is a widespread and complex problem at every level of the system. The State's community-based corrections (CBC) and institutionalized corrections populations are saturated with substance abusers--70 to 80 percent of CBC clients use drugs, as do 80 to 85 percent of prison inmates. These populations are growing quickly and are too large for effective correctional management, let alone management of complicating factors such as substance abuse. Iowa correctional institutions currently oversee nearly 6,000 inmates in space designed for 3,600. Iowa's prison population has grown 12 percent annually for the past 3 years, and resources for providing substance abuse treatment are extremely limited. An adversarial relationship exists between the State's CBC and community-based substance abuse treatment providers, even though community treatment programs receive 65 percent of their referrals from CBC. Community- based treatment providers have not responded to requests for proposals to establish substance abuse treatment programs in prison settings. At the time this report was written, the State of Iowa had contracted with an outside organization to establish managed care for all substance abuse services in the public sector. Conventional managed care strategies often exclude certain clients in prison populations from admission or readmission to needed services. The criteria for exclusion often fall dispropor-tionally on the CBC population. Most significantly, dealing effectively with substance abuse among offenders requires dealing with the complexities of the criminal mind--its duality (substance abuse and criminal/antisocial personality characteristics), resistance to treatment, and chronic, long-term dependence on numerous substances. In Iowa, virtually all substance abuse programs for offenders were designed for noncriminal clientele. Few treatment resources existed for substance-abusing offenders. These problems limit: o The availability of treatment. o Staff tolerance of criminal-addict behavior, resulting in the early discharge of many clients who have finally accessed treatment. o Communication and coordination between CBC, institutions, and community treatment providers. o The efforts of the criminal justice system and community substance abuse programs to rehabilitate mutual clients. Goals and Objectives The main goal of the Iowa Department of Corrections Substance Abuse Program Coordinator is to work with wardens, CBC district directors, the Department of Public Health's Division of Substance Abuse and its managed care contractor, community-based substance abuse agencies, the Treatment Alternatives to Street Crimes (TASC) program, and the Iowa Consortium for Substance Abuse Research and Evaluation. More specifically, the program is designed to: o Evaluate and define the extent and nature of the substance abuse problem among offenders. o Establish a discriminating assessment process that matches chemically involved offenders to the most effective treatment. o Develop treatment approaches that are more likely to have an impact on resistant, extrinsically motivated clients. o Work with the managed care contractor to advocate that criminal justice clients be admitted to and retained in treatment and to promote that the contractor use treatment modalities and levels of care that are effective for this population. o Identify new and existing modalities of treatment that will offer several tiers of treatment at varying levels of intensity within the criminal justice system. o Ensure that qualified individuals operate substance abuse programs. o Identify and pursue additional funding while maintaining present resources. o Coordinate the communication network among institutions/CBC, the Iowa Division of Substance Abuse, and public/private community treatment agencies. Program Components The program is designed to coordinate available interventions as well as develop new interventions to meet the needs of offenders with substance abuse problems. The program seeks to reduce the likelihood that offenders will continue criminal behavior after their release from the criminal justice system. The program is administered by a coordinator within the Administration Division of the Department of Corrections. His duties include working closely with all Iowa State correctional institutions, the eight CBC districts, all TASC programs, the Governor's Substance Abuse Prevention and Education Council, the Drug and Violent Crime Commission, the statewide and eight local corrections/substance abuse task forces, the Division of Substance Abuse in the Iowa Department of Public Health, the Iowa Board of Substance Abuse Certification, the Center for Substance Abuse Treatment and the Criminal Justice Branch in the U.S. Department of Health and Human Services, community-based substance abuse treatment agencies, and the Iowa Consortium for Substance Abuse Research and Evaluation. Results and Impact Performance Measures The program's expected results include: o Networking the eight TASC programs statewide. o Establishing a licensed substance abuse treatment program in each of the State's eight correctional institutions. o Improving communication and coordination between CBC and community substance abuse staff and reducing service duplication. o Implementing new approaches to substance abuse treatment in correctional programs. o Improving the qualifications of counselors currently working in correctional treatment programs to serve as substance abuse counselors. o Reducing waiting lists for substance abuse treatment. o Realizing cost benefits for all parties involved. o Responding to requests for proposals for funding to facilitate these goals. The overall expectation was that the treatment system for criminal justice clients would improve; gaps in programming would close; adversarial staff of other programs would work together; and these programs would better accomplish their missions. Implementation Problems and Successes The biggest obstacle to program implementation dealt with conflicts between community corrections and community substance abuse staff over fundamental treatment issues: the effectiveness of substance abuse treatment for offenders; whether offenders' paramount problem was mental illness, behavioral maladaptation, criminality, immorality, or a primary disease; where and by whom the offender would be most effectively treated; and how resources should be distributed. As a result, the groups' common purpose was overlooked and treatment in the State's prisons suffered. The conflicts led to the formation of a task force through which the program coordinator, with the Director of the State Division of Substance Abuse, established a plan of action to resolve disputes between community corrections and substance abuse staff. Adding to the difficulties, shortly after implementation, State budget cuts and layoffs reduced the size and number of treatment programs in State prisons, lowered staff morale, and reduced the operating budgets of programs not specifically targeted by the cuts. During the coordinator's first 9 months on the job, funding and staffing levels in prison treatment programs dropped dramatically. However, none of the treatment programs closed, and all of the State's original programs eventually expanded beyond their initial capacity. At the time of program implementation, 4 of the licensed programs were funded at 75 percent of capacity through grants. However, through the lobbying efforts of the coordinator and the programs' good reputation, all were funded by State appropriations when their grants expired. The State personnel system, which handles all State employees, further complicated implementation. Although substance abuse professionals are commonly considered to be clinical staff with specific education and training needs, the personnel department felt that these requirements were unnecessary, resulting in a severely deficient applicant pool from which the program was required to interview and hire. Official protests did not improve the situation, but merely delayed filling positions by 6 months. Institutions anxious to fill vacancies often rushed to hire unqualified individuals. Furthermore, the collective bargaining agreement in effect for employees at the institutions prohibited the coordinator from changing minimum qualifications listed for substance abuse professionals. In response, the coordinator enlisted the support of the Governor's Alliance on Substance Abuse and the Director of the State Division of Substance Abuse to encourage the Iowa Department of Personnel to establish a new "advanced " substance abuse professional position that would apply only to corrections institutions and require applicants to be certified by the Iowa Board of Substance Abuse. The current challenge to the program is managed care. Iowa is in the process of moving to private managed care for all publicly funded substance abuse treatment. Concerns over the use of a managed care system revolve around three issues: Will resistant and unmotivated clients be able to access treatment? Will people with a history of multiple treatment experiences be able to access treatment? Will there ultimately be a cost shift from publicly funded community-based treatment to jail- and prison-based treatment? Successes and Accomplishments The program has achieved numerous advances in substance abuse treatment for offenders in Iowa. Although these advances were facilitated by the coordinator, they are largely due to the efforts and cooperation of the key agencies involved. Savings. The time offenders spent on waiting lists for substance abuse treatment dropped from 6 months to 1 week, and the centralized coordination of the program resulted in significant financial savings for the system. Both aspects made the system more user friendly for offenders. The 5-Year Plan. The coordinator created a publication, The Role of Substance Abuse Treatment in Corrections, that discusses the duality of criminality and the disease of addiction, and how they work together in the chemically addicted criminal. The document proposes that the initial course of action for the correctional system must be to establish a seamless continuum of intervention for offenders. The Joint Business Plan. The Department of Corrections and the Division of Substance Abuse developed a business plan to resolve numerous shared issues and needs. The majority of the goals listed in the business plan were accomplished. Centralized Assessment. The first step in achieving a continuum of intervention in the Iowa prison system was establishing a centralized assessment process at the reception center. With this new process, the classification manager has information on the substance abuse treatment needs of inmates before they are classified and assigned to an institution. Inmates can be matched to the most appropriate treatment based on their history, risk level, and so on. Future funding requests for centralized assessment has been built into the State's budget request process. Institutional Treatment. Four prison-based treatment programs existed when the coordinator program was implemented. There are now seven licensed treatment programs--one at each of the State's general population institutions. These programs include a variety of approaches to treatment as well as varying levels of intensity. Six of the programs were initiated through grant funding. Through the lobbying efforts of the coordinator, all seven programs are now funded by State appropriations. Treatment Alternatives to Street Crimes Program. When the coordinator program began, the TASC program had been piloted in three of the State's eight judicial districts. TASC has since expanded into a $1.2 million statewide program using grants the coordinator helped to secure and became the largest substance abuse pilot project ever approved for funding by the Iowa legislature. Coordination is a key element of the TASC program. Each judicial district is autonomous, with its own director and board of directors. The coordinator established a TASC accreditation process through which resource utilization, productivity, and program outcome are evaluated every 2 years. Because the Department of Corrections controls the funding for TASC, the individual programs must comply with accreditation standards to continue operating. The coordinator holds quarterly meetings with TASC supervisors and annual or biannual meetings with all TASC staff. The program has been well received by the State's justice and substance abuse treatment systems. Violator Program. Two institutions in Iowa house male and female violators of probation/parole and work-release program rules. The coordinator was asked to design and implement a culturally sensitive program, known as the Violator Program, to serve these institutions. The program, which provides offenders a 60-day residential stay followed by a 5- to 8-month community-based program, combines substance abuse relapse treatment with cognitive skills programming. At the 30-bed institution for women, the program includes the core subjects described above as well as a number of services specific to women. The 75-bed men's facility also offers services that are gender specific. The Violator Aftercare Program is the community-based portion of the effort, providing close community monitoring and weekly group sessions. The sessions are offered for 20 weeks, but can be extended on an individual basis. A 4-year, grant-funded evaluation by the Iowa Consortium for Substance Abuse Research and Evaluation has recently been completed. Results are not yet available. Counselor Training Program. When the coordinator program began, a number of counselors working in Iowa's correctional substance abuse treatment programs were not sufficiently qualified for their positions. Personnel issues and the policy of promoting correctional officers to correctional counselors had produced these staffing inadequacies. To address the training needs of staff members, the coordinator implemented a program to prepare staff for Correctional Substance Abuse Counselor Certification (IBSAC). The program offers 120 of the 130 hours required for certification, forcing staff members to obtain some training from outside sources. Many of the 30 counselors who participated in the program received counselor certification. Prospects for Replication The prospects for replicating this program are excellent. Every State has key agencies similar to those in this project, and prior interagency cooperation is not a prerequisite. No precedent for such cooperation existed in Iowa before this program was implemented. The program's approach is a relatively inexpensive way to leverage additional resources for correctional substance abuse and to maximize resources already in place. Support from corrections personnel, administrators, and an advisory group to help establish priorities for substance abuse intervention development will enhance the program's success. The coordinator should have extensive experience in the substance abuse intervention field, negotiating skills and the ability to be both diplomatic and assertive, strong writing skills and experience applying for grants, and good training skills. Contact Information Darlene Baugh Community Corrections Service Representative Iowa Department of Corrections 523 East 12th Street, Capitol Annex Des Moines, IA 50319 Phone: 515-281-4811 Fax: 515-281-4062 ------------------------------- Kansas: Chemical Dependency Correctional Counseling Program Statement of the Problem The four northeastern Kansas counties--Brown, Doniphan, Jackson, and Nemaha--are typical of rural counties. Their population totals 41,233 people. The region's predominant industry is agriculture. Personal and family incomes are lower than national and State averages, as are new housing starts and land values. A number of risk factors in these counties have an impact on crime and substance abuse. The Chemical Dependency Correctional Counseling Program was developed to address these risk factors and to serve as a protective factor for communities in this region. The risk factors identified by the program are based on studies that compared empirical field data for this area of Kansas with data for the entire State. The field data present a picture of an area in great need of protective factors. The risk factors are: o A higher than average number of families receiving Aid to Families With Dependent Children payments. o A higher than average juvenile arrest rate. o A higher than average number of persons receiving general assistance welfare payments. o A dramatic rise in local crime rates over the past 10 years. o A higher than average rate of disorderly conduct cases. o A higher than average rate of driving under the influence, vandalism, and drug arrests. o A higher than average rate of unemployment. o A higher than average rate of renter-occupied housing units. o A higher than average rate of population mobility. o A higher than average rate of persons reporting a family history of alcohol or other drug abuse. o A higher than average rate of children reporting that someone in their household uses illegal drugs. o A higher than average rate of school absenteeism and dropouts (in one of the four counties). Before this program was implemented, chemical dependency counseling services were provided to inmates of local jails on a crisis basis. Law enforcement and mental health professionals, however, wanted more intensive services for inmates. The sheriff of Brown County and the chief executive officer of the KANZA Mental Health and Guidance Center, Inc., worked together to secure a grant that funded the Chemical Dependency Correctional Counseling Program. Sheriffs from the other three counties collaborated on developing the program. Goals and Objectives The main goal of the program is to provide chemical dependency recovery counseling to inmates residing in Brown, Doniphan, Jackson, and Nemaha County jail facilities. A secondary goal is to provide consultation and training to law enforcement, dispatch, and jail personnel concerning the inmates' behavioral health. Although there are no quantified data for the number of consultations and in-services provided to these personnel during the program's first year, the certified chemical dependency counselor formally and informally carried out these duties every week. Program Components The program's two components create a strong link between mental health services and law enforcement and corrections agencies in the area. One component is the KANZA Mental Health and Guidance Center, Inc., a licensed, nonprofit mental health and chemical dependency center serving the four counties. The other is the chemical dependency counseling program, which employs one full-time chemical dependency counselor who travels to the four county jails weekly, providing counseling to inmates and consultations to law enforcement staff. Approximately 10 to 15 percent of the counselor's time is spent with jail staff. The counselor is at each institution on specific days. If a crisis occurs at any of the institutions, he or she has the flexibility to rearrange his or her schedule to respond. In addition, a therapist from the KANZA Mental Health and Guidance Center is on call 7 days a week, 24 hours a day. Inmates are referred to the program by the head jailer, law enforcement officers, the sheriff, the client's attorney, family members, or self-referral. On average, inmates stay in the program for 14 sessions. Inmates are treated by KANZA Mental Health and Guidance Center staff and are afforded the same services as mental health clients in the community. All services are paid for by the county. After inmates are released from jail, however, they are responsible for the fees. When appropriate, the counselor treats family members or refers them to the KANZA Mental Health and Guidance Center for service. When an inmate is discharged from the program, the chemical dependency counselor completes a Treatment Success Measure survey describing the client's achievements in the program. The survey's criteria are different for each of the four types of clients served by the program: chemically addicted, psychologically dependent, codependent, and adult and minor children of alcoholics and drug abusers. To successfully complete treatment, a chemically addicted client must meet three of the following four criteria: o Reports abstinence from chemicals during treatment period. o Reports attendance at Alcoholics Anonymous or similar meetings during treatment period. o Is able to discuss the disease of addiction and its concepts. o Reports satisfactory achievement of other counseling goals. A psychologically dependent client must meet four of the following six criteria: o Can discuss his or her chemical use and the degree to which that use is interfering in various aspects of his or her life. o Can identify self-defeating behaviors and express ways to reduce them. o Reports abstinence from chemicals during the treatment period. o Can discuss the disease of chemical abuse and its concepts. o Reports attendance at Alcoholics Anonymous or similar meetings as needed during treatment. o Reports satisfactory achievement of other counseling goals. A codependent client must meet four of the following six criteria: o Can discuss the disease of addiction or abuse and its concepts. o Can discuss the ways in which another person's chemical abuse or addiction has affected his or her life. o Can identify self-defeating behaviors and express ways to reduce them. o Reports making plans for self-improvement. o Reports using self-help groups as needed or as available during treatment. o Reports satisfactory achievement of other counseling goals. An adult or minor child of an alcoholic or drug abuser must meet three of the following nine criteria: o Reports decreased fear or anger. o Reports increased self-esteem. o Understands the effect of chemicals on family or self. o Displays increased self-expression. o Can evaluate his or her addiction or dependency. o Displays an increased level of trust. o Understands his or her feelings. o Knows how to meet his or her own needs. o Can identify his or her addiction or dependency. Successful completion was defined as the inmate's level of cooperation and willingness to engage the counselor during sessions. It does not imply continued sobriety. Results and Impact Performance Measures The goal for the program's first-year completion rate was 60 percent, and this goal was exceeded. Completion rates in the program's second and third years were 97 and 89.5 percent, respectively. Benefits to inmates, law enforcement personnel, and the mental health center are expected to continue. To measure the program's performance, a survey instrument was developed that studied the program's impact in a variety of areas, including recidivism rates of treated inmates versus those of untreated inmates. Implementation Problems and Successes A source of revenue from the program's counseling activities was overlooked during the first year of operation. The four local county jails house contract prisoners from counties outside the mental health center's catchment area, and an opportunity to bill these counties for counseling services was missed. The billings are estimated to be worth only $5,000 annually, but this sum would meet a large portion of the mental health center's required matching funds. Successes and Accomplishments The mental health center directly attributes the following results to the program: o The mental health center receives fewer crisis calls from jails. o Jail personnel perceive a partnership with the counselor and feel more comfortable with prisoners who have behavioral health problems. o Inmates are less agitated by pent-up personal problems, and they perceive a link to the outside. o Jail personnel distinguish between real and manufactured inmate mental health crises. o The mental health center's value to the counties has increased. o Contacts between law enforcement and mental health center personnel concerning matters such as civil commitments and suicide calls have become more positive. During its first year, the program served 54 individuals. Of these clients, 52 were male and 2 were female; 36 were white, 12 were Native American, and 6 were African-American. Clients ranged in age from 19 to 74 years; the average age was 32 years. Inmates' rate of successful completion while incarcerated was 38.4 percent. This figure increases if the completion rate includes inmates who continue treatment after release to the community. From July 1994 to June 1995, 65 individuals participated in the program, with a high percentage continuing treatment after incarceration. From July 1995 to June 1996, 79 participated, and from July 1996 to June 1997, 61 did so. Prior to this project, the region lacked a formal means to arrange postincarceration treatment. Prospects for Replication Replication of the program is relatively simple. Financing, however, will be a challenge for each local area. The program is financed through Federal, State, and local funds, a combination that should be sought by other jurisdictions attempting replication. As with most new programs, obtaining matching funds is the key, and billing other counties for inmates from areas outside the program's catchment area will help meet this match. Contact Information Bill D. Persinger, Jr. Chief Executive Officer KANZA Mental Health and Guidance Center, Inc. P.O. Box 319 909 South Second Street Hiawatha, KS 66434 Phone: 913-742-7113 Fax: 913-742-3085 ------------------------------- Kentucky: Integrated Programming for Female Offenders Statement of the Problem Dismas Charities in Owensboro, Kentucky, is a 100-bed private community center and prison for female offenders. Results of informal studies of the client population at Dismas Charities are startling. Residents of the prison come from violent, abusive homes that lack structure, appropriate guidance, and a nurturing environment. The majority of women at the facility have been abused by their parents and their boyfriends or spouses. It is clear that many women learned poor parenting skills from their parents. They lack understanding of the proper use of discipline, the nature of parent-child relationships, the management of problem behaviors among children, and other parenting issues. Without intervention, residents will likely pass on these parenting deficiencies. Many continue to deal with issues of abuse, and several report engaging in abusive behavior with their own children. Most residents at the facility were convicted of offenses related to alcohol and other drug abuse. Returning these women to their homes without addressing their drug and alcohol dependencies makes it difficult for them to change the destructive aspects of their lives. If dependency issues continue to plague them, they will not be able to find or keep jobs or manage their families effectively. Goals and Objectives The program's goals are to assess programming needs for female offenders, successfully reintegrate female offenders into society, reduce their recidivism rates, reduce the rate of incarceration among the offenders' children, and empower female offenders to become economically independent, productive citizens and parents. To accomplish these goals, the program uses an integrated approach to treatment that addresses all aspects of their lives. Program objectives include: o Educating residents about parenting issues in incarceration. o Developing job skills to establish independence. o Providing onsite supervised visitation of children during incarceration. o Providing onsite counseling for problems that prevent residents from reentering society, holding a job, and managing their families. o Offering materials that teach inmates how to be better parents. Program Components Family-Oriented Programming The program's 8-week parenting course strives to reunite families. Education in developing parenting skills includes