Title: Case Management in the Criminal Justice System.
Series: Research in Action
Author(s): Kerry Murphy Healey
Published: National Institute of Justice, February 1999
Subject(s): Criminal justice system, recidivism, drug treatment, probation
and parole, mentally ill offenders, and program evaluations
28 pages
72,000 bytes

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U.S. Department of Justice
Office of Justice Programs
National Institute of Justice

National Institute of Justice
Jeremy Travis, Director

Research in Action
February 1999

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Highlights

Jurisdictions across the country have adopted case management techniques
to combat recidivism, homelessness, and joblessness. Case management is
being used for arrestees, probationers, and parolees who need services
such as batterer intervention, drug treatment, mental health treatment, or to
provide help for mentally retarded offenders. This Research in Action
examines different criminal justice case management models and critical
issues regarding existing case management programs.

The case management of offenders is most likely to be supervised by
probation and parole officers. Based on the social service models of the
late 1960s and early 1970s, today's criminal justice case management
models link inmates returning to the community with drug treatment
programs, mental health services, and social service agencies prior to their
release.

The fundamental activities of criminal justice case management include
engaging the client in the treatment process, assessing the client's needs,
developing a service plan, linking the client with appropriate services,
monitoring client progress, intervening with sanctions when necessary,
and advocating for the client as needed. Case management within a
criminal justice context requires the case manager to take on additional
tasks beyond those assumed by traditional social service case workers.

In the original social work setting, the case manager served exclusively as
a broker of services but did not become involved in counseling the client.
In the criminal justice setting, case managers broker services but also are
likely to provide informal guidance to their clients. Case managers
interviewed for this report consider informal counseling to be a vital
component in their relationship with their clients. A number of
correctional case management programs consciously blur the broker and
treatment roles and emphasize the need for cross-training between case
managers and mental health providers, substance abuse counselors,
domestic violence program counselors, and other social service providers.

Practitioners consider effective offender monitoring and the use of
graduated sanctions for offenders who fail to comply with service plans to
be the keys to successful case management. Because two or more case
managers may be employed to supervise an inmate's probation and
progress through treatment, practitioners interviewed for this report said it
is critical that philosophical differences are ironed out prior to the
intervention. Expectations between, say, probation officials and drug
treatment or mental health counselors must be fully aligned to ensure
uninterrupted and successful treatment for the client.

The case management of offenders raises a number of challenges,
including how to provide continuous service to inmates returning to the
community, how to best use sanctions to maximize service participation
while avoiding unnecessary incarceration, and how to measure program
effectiveness. Uniquely in criminal justice case management, case
managers must develop employment resources for offenders reentering the
community; prepare offenders to find, qualify for, and retain employment;
and help resolve difficult family problems.

While support for case management as a tool for use with criminal justice
populations is strong among experts, administrators, program directors,
and case managers themselves, several interviewed for this report said that
poorly designed programs and overburdened case managers can severely
undermine such a program's performance. Case management programs
require clear lines of communication and cooperation between
probation/parole and treatment staff. Failure to develop this rapport can
result in increased paperwork, lack of managerial control of cases, and
poor supervision of client progress through treatment and court-ordered
sanctions. 

-------------------------------

Case Management in the Criminal Justice System

by Kerry Murphy Healey

Jurisdictions across the country are adapting case management techniques,
a service delivery approach developed by mental health and social services
workers in the late 1960s and early 1970s, to suit the needs of a wide
variety of criminal justice populations. These jurisdictions use case
management strategies to reduce recidivism and address mental disorders,
developmental disabilities, joblessness, homelessness, HIV/AIDS and
other serious medical conditions, and such offenses as domestic violence
and substance abuse among adult and juvenile arrestees, probationers, and
parolees.

Diverse programs and agencies use a variety of case management
techniques with criminal justice populations. Most employ a holistic
service approach that addresses conditions within the offender's life that
could contribute to recidivism, joblessness, homelessness, or substance
abuse relapse. Maintaining service continuity as the client moves through
the criminal justice system and returns to the community is critical.
Today's criminal justice professionals who provide pretrial services,
corrections programming, transitional services for incarcerated offenders,
and probation and parole supervision require expertise in case
management techniques.

The case management of offenders is most likely to be supervised by
probation and parole officers. In a few systems across the Nation, every
probationer and parolee receives some form of case management.
Increasingly, these agencies employ case management strategies to link
inmates returning to the community with drug treatment programs, mental
health services, and social service agencies prior to their release. Pretrial
service agencies frequently apply case management techniques to assure
an arrestee's appearance at trial, tailoring the pretrial supervision of the
arrestee to reduce risk to the community.

WHAT IS CASE MANAGEMENT?

While strategies and practice vary from one setting to another, traditional
case management consists of a social or mental health worker who secures
and coordinates continued social, mental health, medical, and other
services for a client. The roots of the case management approach can be
found in early 20th century social work, but most researchers attribute its
development as a distinct service delivery method to the social reform
movement of the late 1960s and early 1970s.[1] In particular, the
deinstitutionalization of the mentally ill during that period required mental
health social workers to develop new ways to connect clients to
community social service agencies and to monitor clients' use of
services.[2] Similarly, as the numbers of offenders sentenced to
community corrections supervision (in lieu of incarceration) and former
inmates returning to their communities grew, criminal justice workers
began to adapt case management techniques to meet the needs of these
populations. Case management reduces recidivism or relapse, encourages
social reintegration, and enhances public safety.[3]

CASE MANAGEMENT MODELS

Most current literature on mental health or social work case management
has distilled the fundamental functions of the case manager into five
sequential activities: (1) assessing the client's needs; (2) developing a
service plan; (3) linking the client to appropriate services; (4) monitoring
client progress; and (5) advocating for the client as needed.[4] The original
social work case management model cast the case manager exclusively as
a broker of services and precluded his or her involvement with the client
as a counselor or treatment provider.

Two common models are "strength-based" and "assertive" case
management. Strength-based case management assesses the client's
strengths and talents (with special emphasis on those strengths identified
by the client) and builds on them in the treatment and service plan. This
model emphasizes the case manager's unconditional positive regard for the
client and assumes that clients "possess a psychological self-wisdom that
can cause them to discover for themselves their inner strengths and
resources" and "act on normative or socially acceptable choices."[5] In a
criminal justice setting, the supportive, positive regard displayed by case
managers for their clients must be balanced with disapproval of the client's
antisocial attitudes or behaviors.

Assertive case management involves delivering services aggressively to
the client, rather than passively offering services in a centralized office
setting.[6] Assertive case management may require case managers to seek
out the client in his or her home, job, or community for meetings and
counseling or to locate branch offices that provide services in the
communities where clients reside.

Many programs combine or mix both case management models to
maximize the impact on clients. Today, the "mixed model" of case
management, where the case manager serves in a therapeutic capacity and
brokers services, is more common than the pure "service broker"
model.[7] Case managers interviewed for this report regard informal
counseling to be a necessary component in their relationship with the
client. A number of correctional case management programs recognize the
need to blur the broker and treatment provider roles and emphasize the
importance of cross-training between case managers and mental health
providers, substance abuse counselors, batterer treatment program
counselors, and other social service providers whose work they formally
or informally augment.

The criminal justice case manager may function as a member of a team
that creates and implements a service plan for an offender or as one of
several case managers independently creating service plans for an
offender. For example, a juvenile offender who is in the legal custody of a
State department of social services may receive case management services
from that department, as well as from a probation officer or a counselor in
a correctional facility. 

A team of case managers, each with a different responsibility, often
coordinates service delivery and achievement of criminal justice goals for
batterers on probation. A probation officer commonly acts as the batterer's
primary services broker, court liaison, and monitor, while secondary case
managers in domestic violence intervention and substance abuse programs
provide counseling and treatment, as well as referrals to other social
services. Case managers in intervention and treatment programs may also
advocate on the batterer's behalf before the courts if their assessment of the
client's progress or compliance differs from that of the probation officer.

The in-house sharing of clients is another common case management
approach. Probation officers often share responsibilities to ensure that a
client's case management services will continue uninterrupted if one
officer must attend to other cases or is otherwise unavailable--on vacation,
ill, on maternity leave, and so forth. Two or more officers must be familiar
with the client to guarantee continuity of services if the primary case
manager is absent.

Criminal justice case management requires the case manager to take on 
additional tasks that go beyond the traditional "service broker" model.
Enos and Southern have proposed a criminal justice model that
incorporates seven stages: intake, assessment, classification, referral,
intervention, evaluation, and advocacy.[8] The case management tasks
described below frequently overlap, as opposed to being discrete and
sequential.

Intake. This may involve crisis intervention, establishing a rapport with
the client, providing orientation (such as information about how to comply
with a treatment plan and to communicate with case managers and
treatment providers), and a discussion about sanctions for failure to
comply. Intake is best performed face-to-face, but may include printed or
videotaped information.

Assessment. This phase usually involves interviews and history-taking and
may include substance abuse evaluation or specialized psychological
evaluation, home visits, and contacts with family members, employers,
and other agencies with which the offender has been involved. When
specialized assessments are needed, the case manager arranges for or
approves the provider. In general, violent offenders (especially sex
offenders and domestic batterers) require more careful evaluation than
offenders who commit property crimes.[9]

Classification. Traditionally, offenders were classified by their amenability 
to treatment; those judged to be poor candidates for rehabilitation were 
incarcerated and received no services. In some jurisdictions, the
"amenability to treatment" test has been replaced with a presumption that
all offenders benefit from services, even those considered to be at highest
risk for recidivism and those who are incarcerated. Classifications may be
based on risk assessments derived from the offender's criminal history.
More complicated cases may include the written assessments of mental
health experts, social workers, or addiction specialists; the results of
standard psychological evaluation tools, such as the Minnesota
Multiphasic Personality Inventory; or empirically based prediction
models. Based on classification, offenders may be assigned to particular
units within institutional settings or offered specialized services.

Referral. This may take many forms, depending on the status and needs of
the offender. Arrestees awaiting trial may be referred to halfway houses
that provide more stable community ties, substance abuse treatment,
behavior modification programs, and employment training and placement
assistance. Inmates may be referred to in-house educational, job-training,
or mental health programs. Inmates due for release may be referred to
transitional service providers or linked with community-based services,
such as substance abuse treatment or mental health counseling, to ensure
continuity of services. Case managers refer offenders on probation or
parole to community and government agencies that can assist with
substance abuse or domestic violence problems and to obtain health care,
housing, public assistance, mental health counseling, and assistance with
developmental disabilities, HIV/AIDS, or other serious health problems.

Intervention. The case manager matches available resources and 
services to the offender's identified needs. The offender is responsible 
for cooperating with program requirements and changing his or her
behavior.

Monitoring. Practitioners have identified the keys to successful case
management as effective offender monitoring and graduated sanctions for
offenders who fail to comply with service plans. Monitoring may
incorporate graduated, court-ordered sanctions, such as more frequent
court reviews, use of electronic surveillance devices, or short
incarcerations to encourage offender cooperation with case management
goals. Intensive monitoring may include frequent drug or alcohol testing,
weekly (or even daily) phone or personal contact between the case
manager and the offender, and frequent communication with service
providers to track the offender's compliance with court-ordered conditions
or program requirements. The need for intensive offender monitoring
should decrease over time--shifting from a highly structured intervention
with extensive external controls on relapse or reoffense to a less structured
monitoring system that places greater emphasis on personal responsibility
and, eventually, a return of all control and responsibility for avoiding
relapse or recidivism to the offender.

Evaluation. The case manager must determine if the client has received the
services outlined in the case management plan and whether that client has
benefited from those services. The most significant indicator of successful
case management for criminal justice clients is recidivism. Case managers
also may use other measures of behavioral change to gauge response to the
intervention: data provided by the offender; urine drug screening; program
attendance and compliance reports; and information from victims, family
members, employers, or other agencies. Evaluations of case management
programs should consider such factors as overall efficiency of service
delivery, cost effectiveness, and any systemic obstacles to service delivery.
While case managers are unlikely to evaluate programs, they may assist
with data collection. Administrators should share evaluation results with
staff and adjust procedures as needed.

Advocacy. Several types of advocacy are required of case managers in a
criminal justice setting. The case manager may testify or make
recommendations in court on the client's behalf, negotiate pro bono
services for clients, or secure priority placements at programs with waiting
lists. The case manager also may mediate difficult situations for the
offender, such as arranging visitation with children who are no longer in
the client's custody. The case manager must review obstructive
bureaucratic practices and community conditions. For example, case
managers and their supervisors interpret individual and program outcomes
and use the information to advocate change and refinement within the
criminal justice system. Criminal justice case managers may propose 
solutions, such as interagency working groups or task forces that work
outside their departmental jurisdiction, to address systemic obstacles.
Finally, case managers may identify community conditions or parole or
probation procedures that contribute to crime or recidivism. They may
advocate for changes in law or policy that support their work with
offenders. For example, one probation official noted that the majority of
drunk drivers under his department's supervision were arrested after
attending evening "happy hours" at bars. This officer successfully lobbied
the State legislature for legislation banning happy hours, a law that
subsequently reduced drunken driving arrests.

CRIMINAL JUSTICE CASE MANAGEMENT IN ACTION

Because criminal justice populations are so diverse, case management
programs must be diverse. One author and evaluator observed the
following: 

As might be expected with any new practice form, the nature of case
management is unclear. . . . A comparison of settings that [claim] to use
case management reveals diversity rather than uniformity. Patterns of case
management that are similar, however, seem to be associated with settings
that serve similar client populations (mental health, child welfare, physical
disabilities).[10]

Research shows that similarities between programs develop to reflect the
specific population they serve: drug-addicted offenders, mentally ill
offenders, offenders with mental disabilities, and so forth.

One offender, many case managers. Differences in practice are revealed
when coordinating the efforts of two or more case managers. As
mentioned above, a number of programs described in this report use two
case managers--or, more likely, a team of case managers--for each client.
One case manager, housed at a substance abuse treatment facility, might
coordinate all aspects of drug treatment, education, and social services,
while another case manager might be a transitional services worker from
the corrections department or a probation officer who helps the offender
secure transitional housing, employment, or health care insurance and
monitors client compliance with the terms of probation or parole. One
program director observed that in his jurisdiction it was useful to have a
mental health/mental retardation counselor and a probation officer--whose
roles as case managers were "fluid"--provide case management to mentally
ill and retarded offenders. According to the director, "Both provide
services. There can be no division in the ranks, no separation of roles. A
division upsets the clients. The probation officer cannot always be the 'bad'
guy."[11]

By contrast, a formal division of roles between supervision and
rehabilitation services is maintained in a Quincy (Massachusetts) District
Court program that provides intensive case management to batterers.
Probation officers closely monitor probationers' attendance at a domestic
violence program and often require that the probationers make daily phone
or face-to-face contact with the supervising officer, undergo weekly
random drug or alcohol screening, and attend substance abuse programs
where indicated. They also advocate for victims. Counselors in the
batterers' and substance abuse programs provide rehabilitative services to
offenders.

Where should the case manager be located? Case management services are
largely defined by the setting in which they are delivered. In Pima County,
Arizona, probation officers and drug treatment counselors shared office
space at a drug treatment facility (see sidebar "The Pima County, Arizona,
experiment"). Don Stiles, chief adult probation officer for the Superior
Court in Pima County, praises the cooperation that developed between his
offi-cers and the treatment staff due to the increased personal contact.
"Communication worked 10 times better with people in the same building.
Probation officers knew immediately if someone missed treatment. We
had better attendance and better results." 

Other program administrators were similarly enthusiastic about case
management programs that operate within the communities where the
clients live.[12] Assertive case management is easier for both the case
manager and the client when the program is based in a client's
neighborhood, rather than at the probation or social services department's
location.

One advocate for the victims of batterers on probation emphasizes the
importance of service location. Although she considers victim outreach
and advocacy to be a critical component of the case management of
batterers on probation, she declines to provide services to victims if secure 
office space remote from the probation office is not available. "It is not
responsible to ask victims to come in for services if they might meet their
batterer in the hall or elevator," said the advocate. 

Other criminal justice case managers are being trained to assist mental 
health and substance abuse counselors with onsite treatment and therapy in
institutional settings. In the Alexandria (Virginia) jail, case management
teams composed of jail officials and representatives of the local mental
health authority coordinate treatment for inmates in an onsite unit
administered primarily by jail employees (see sidebar "Linking inmates
with local resources: Alexandria jail's Critical Care Mental Health and
Sober Living Units").

The Federal Bureau of Prisons (BOP) organized a pilot program to provide 
substance abuse treatment at six BOP halfway houses around the country.
This arrangement removes the need for dual case managers for offenders
in treatment.

Automated case management systems. A number of software developers
now offer systems designed to assist pretrial service providers, courts, and
probation and parole officers with case management recordkeeping.
Discipline-specific features offered by software systems include tracking
basic case management information (including workload analysis and
scheduling); managing fines or restitution; managing warrants;
maintaining drug-testing, juvenile, and adult records; managing electronic
surveillance; collecting data for research and statistics; and generating
notification letters.[13] 

System costs vary widely according to the sophistication of the services
offered. One basic automated system that helps coordinate the case
manager's workload by tracking offenders' obligations, victims, comments,
aliases, actions, special good time, and payments--and also generates
automatic reports that tell the case managers what specific actions must be
taken when--costs as little as $700. Another system that provides "an
integrated, comprehensive solution to the information needs" of sheriffs,
clerks, judges, court administrators, prosecutors, and probation officers
ranges in price from $7,500 to $150,000.[14]

ISSUES IN CRIMINAL JUSTICE CASE MANAGEMENT

The case management of offenders raises a number of difficult issues, 
including how to provide continuous services to inmates returning to the
community, how to use sanctions to maximize service participation while
avoiding unnecessary incarceration, and how to measure program
effectiveness. Aside from these structural issues, criminal justice case
managers face a number of unique challenges, such as sustaining
consistent levels of service while the offender passes through the criminal
justice system and back to the community; developing employment
resources for offenders reentering the community; preparing offenders to
find, qualify for, and retain employment; and helping to resolve such
thorny problems as family reunification and the substance abuse problems
of other family members.[15]

Providing continuity of services. While the challenge of maintaining
service and staff levels as an offender moves through the criminal justice
system and back into the community is similar to that facing other social
service providers who must track clients moving through hospitals,
schools, and jobs, criminal justice case managers must not only track but
also anticipate and prepare for each client move to minimize the likelihood
of recidivism and the risk to society. The BOP and some local correctional
systems piggyback inmate and community corrections treatment contracts
onto those already held by the local probation authority, providing
offenders with access to the same services upon their release from prison.
When it is impossible to use the same service provider, some parole
officers seek to create a sense of continuity by referring offenders to a
treatment program that is philosophically similar to the one in which the
offender participated while incarcerated. Other institutions offer
transitional services for soon-to-be released inmates that link them with
service providers in the community before release, including scheduling
intake appointments as soon after release as possible.

Successfully reintegrating mentally disordered inmates and probationers
into the community is very challenging. In 1989, the New York State 
Office of Mental Health (OMH) first funded private mental health
contractors who helped parolees with mental disorders qualify for
supplementary security income (ssi), social security disability income
(SSDI), food stamps, and Medicaid. The funding was to assure that the
parolee--with the assistance of the private contractor--would qualify for
income and services from other State and Federal agencies by the time
OMH support payments ceased.[16] The Maricopa County (Arizona)
Adult Probation Department uses the Transitional Living Center (TLC), a
probation-operated residential psychiatric program for offenders with
serious mental illness, to bridge the critical span between release from
custody and independent living in the community. The length of stay is
determined by the time it takes to link clients to community-based mental
health and support services; the average stay at TLC is 60 days.[17]

Sanctions as a case management tool. Case management with criminal
justice populations is also different from case management in other
contexts because compliance with substance abuse treatment or other
provisions of the offender's service plan may be a condition of
probation/parole or part of a court-ordered diversion program for mentally
disordered, developmentally disabled, or pregnant drug-abusing offenders.
Some commentators have suggested that, at the very least, compulsory
substance abuse treatment generally results in higher rates of retention in
treatment and is associated with better outcomes.[18] Some of the
programs described in this report make aggressive use of sanctions and
intensive supervision to promote the goals of the service plan; others
operate without legal coercion. Literature concerning the use of sanctions
as a case management tool emphasizes the need for graduated sanctions
and less rigid enforcement with mentally disordered or developmentally
disabled offenders, who are more likely to have difficulty complying with
treatment goals or the conditions of their release.

Probation and parole officers and service providers must be frank
concerning the criminal justice case manager's enforcement policy.
Service providers and case managers interviewed for this report expressed
frustration over the use of sanctions. Some probation and parole officers
suspect that substance abuse treatment program staff are lax in reporting
violations because they either may be tolerant of some degree of relapse or
have no desire to report client failure and thus risk losing program income.
Conversely, therapists and substance abuse treatment providers expressed
concerns that probation policies often are relatively inflexible concerning
relapse, which is unrealistic. By contrast, batterer treatment program
counselors in some jurisdictions expressed concern that probation
violations concerning domestic violence are not taken seriously by the
courts, and, as a result, sanctions are rare or inadequate.

In other jurisdictions, sanctions are used successfully as a case
management tool. For example, in jurisdictions where batterer treatment
program providers and probation officers meet regularly to discuss case
management issues, a clear policy concerning the use of sanctions has
developed and no conflict arises about the overusage or underusage of
sanctions. The drug court model, which is employed in a number of
jurisdictions nationally, positions the judge as case manager and uses
strict, court-based monitoring and an array of graduated sanctions to 
motivate the offender to comply with court-ordered treatment goals.[19]

Case management evaluations. Questions concerning the case manager's
expectations and attitudes and even the "tone" of the program setting and
how these factors affect outcomes resonate throughout case management
evaluation literature and were a focus of several interviews for this report.
In his evaluation of the Assertive Community Treatment Program, James
Inciardi writes the following:

To a large extent, research on case management is research on case 
managers, since it is often difficult to separate the two. Although there are
different philosophies and techniques to case management, most agencies
appear to expect a fair amount of conformity among managers. Therefore,
the role of the case manager may be crucial to understanding the varied
impact of treatment programs on clients. How do staff members facilitate
the therapeutic process? Does staff effectiveness vary by training,
philosophy, personality, case load, or charisma? Although impact and
outcome analysis will answer some of these questions, it is also necessary
to probe their qualitative aspects as well.[20]

Shelli Rossman of the Urban Institute observes that evaluations of pilot
programs are inevitably affected by the quality of case management being
provided--not just by the type and number of service linkages offered--and
that there is "an extraordinary variation in what masquerades as case
management."[21] She points to the fact that some case managers have
backgrounds in social work, others in mental health, and others have no
special qualifications whatsoever. Clinical psychologist Matthew Ferrara
calls for the creation of an academic specialty to train criminal justice case
managers working in the field of mental health.[22] Another evaluator
echoes Rossman's concerns, predicting that one program would be likely
to produce better results than its structurally identical sister programs
because "the staff got their act together earlier and better than at the other
sites."[23]

WHICH OFFENDERS NEED CASE MANAGEMENT? 

Enos and Southern identify six classes of offenders whom they consider
best suited for case management focusing on behavioral change: juvenile
delinquents; offenders with impulse control disorders (kleptomania,
pyromania); offenders with specific personality disorders (especially
antisocial); substance abusers; all sex offenders; and offenders who
experience problems in personal relationships that affect their ability to
function at work, as parents, in the family, or in society.[24]

These broad classifications cover virtually all offenders. At present, the
criminal justice populations who most commonly receive case
management services are substance abusers, mentally disordered or
developmentally disabled offenders, probationers, and inmates and
parolees needing transitional services to help them reintegrate with their
community.

Substance-abusing offenders. The majority of the criminal justice
populations discussed here receive case management services related to
substance abuse treatment. Researchers and evaluators have attempted to
assess the effect of case management on substance use, risky needle use,
and sexual practices contributing to both HIV infection and recidivism in
criminal justice populations. Existing studies are cautiously optimistic
regarding effects on substance use and recidivism but less encouraging
with regard to risky HIV-associated behaviors.[25] Many factors
contribute to the tentative tone struck by researchers in the early studies;
probably the most important of these was the widely varying quality of
case management services provided to offenders and the evaluators'
inability to gauge the long-term impact. Nonetheless, individual programs
report significant cost savings compared with incarceration, less
recidivism, and longer time until rearrest. South Carolina's "Stayin'
Straight" program, a day reporting center with an intensive substance
abuse treatment component, cost $3.65 per day per probationer to
administer (versus $32 per day for incarceration), reduced rearrest by 20
percent after 22 months, and delayed the average time until rearrest by 137
days compared with program dropouts.

Mentally disordered and developmentally disabled offenders. Some of the
most promising programs work with mentally disordered or
developmentally disabled offenders--the type of client for whom case
management has a proven track record in other settings (see sidebar "Case
management of mentally disordered or developmentally disabled
offenders"). These programs generally use trained personnel and follow
traditional mental health case management models. Project Action,[26] an
intensive case management program for mentally ill offenders in Houston,
Texas, boasted a 5 percent recidivism rate for program participants versus
a 64 percent rate for offenders on regular release.[27] Project CHANCE
[28] (Case management/Habilitation/Advocacy/Networking/
Coordinating council/Education and training), a program run by the 
Association of Retarded Citizens and funded by the Texas Council on 
Offenders with Mental Impairments, reported equally promising results.
The program aimed to reduce recidivism rates through intensive case 
management. Project CHANCE served both adult and juvenile offenders
and accepted referrals from both pretrial services and correctional
institutions. The project, which operated for 7 years, helped
developmentally disabled offenders understand their legal rights and
responsibilities, make informed decisions, set goals (such as ceasing
substance abuse or achieving independent living), and identify the
resources necessary to achieve those goals. Project CHANCE also
coordinated the transfer of services for developmentally disabled offenders
to the local mental health or mental retardation authority and ensured that 
services were not discontinued or duplicated. The program boasted an 11
percent recidivism rate for participants, compared with nearly 60 percent
for comparable groups. The program was cost effective: Services for
incarcerated mentally retarded offenders cost the local authorities 
between $30,000 and $45,000 per person annually, versus $9,000 for
Project CHANCE case management. Even if special services for
developmentally disabled inmates were not included, Project CHANCE
case management costs $32 per day per inmate, compared with $56 per
day for county jail incarceration.

Probationers. Both Federal and local probation directors contacted for this
report were enthusiastic about probationers receiving case management
services and praised the effectiveness of such services with high-risk
clients. Don Stiles, chief adult probation officer for the Superior Court in
Pima County, when asked for a definition of case management, stated,
"That is it. That is what we do here every day. You have just described our
probation department."[29] According to Stiles, the Pima County
Probation Department currently uses its Specialized Offenders Case Loads
Division to provide case management targeting mentally ill, mentally
retarded, and substance-abusing offenders and sex offenders. 

Loren Buddress, Federal chief probation officer for the Northern District
of California, reports that he has 70 officers "doing case management" and
15 providing specialized case management services, such as mental health
counseling, drug treatment, housing and employment assistance, treatment
for batterers, and a cognitive-behavior course for female embezzlers.[30]
Oregon has undertaken a variety of case management-style programs to
provide drug treatment, cognitive restructuring training, and social
services to inmates and probationers. Initial evaluations suggest that the
Oregon approach has had a significant impact on recidivism there.[31]

Inmates due for release. The provision of transitional services to
incarcerated offenders is another area of criminal justice well-suited to the
case management approach. In its broadest sense, case management for
soon-to-be-released offenders could begin with the provision of prerelease
services, including substance abuse treatment, and follow the offender to
community corrections and community-based substance abuse treatment.
(The Federal Bureau of Prisons has a number of programs working on this
model; see sidebar "Case management of addicted inmates: The Federal
Bureau of Prisons' Drug Abuse Treatment Initiative.") In New York City,
the Women's Prison Association draws on public and private funding to
provide transitional services, including individual counseling, discharge
planning, outreach workshops, and transitional housing.[32]

COMMONLY CITED OBSTACLES TO CASE MANAGEMENT

While the majority of experts, administrators, program directors, and case
managers contacted for this report were positive about case management
as a tool for use with criminal justice populations, a few raised concerns
about the structure of programs and the overburdening of case managers.

One proponent of case management made the following observation:

[A] poorly designed case management system will result in increased
paperwork, poor compliance by line staff, and failure to help manage your
agency. However, a good case management system will help you articulate
your priorities to your public policy leaders, give clear direction to line
staff on cases that should receive the most attention, help identify time and
resources required to maintain minimal standards, provide information to
evaluate the effectiveness of programs, and help defend in civil liability
[cases].[33]

The most serious challenge for criminal justice case managers is to
establish open and positive working relationships with the service
providers of choice. Because criminal justice programs may involve more
than one case manager, communication and cooperation between key
professionals is essential. As discussed in a previous section ("Sanctions
as a case management tool"), disagreement between the correctional case 
manager and program or treatment staff over the use of sanctions for
probation or parole violations can create a tense working environment. 

There are several possible causes for friction between correctional and
treatment case managers. Criminal justice case managers consider some
treatment providers to be too tolerant of the cycle of relapse and recovery;
often, both sides differ philosophically over the use of incarceration as
punishment for drug abuse, and case managers have a self-interest to
maintain program participation and perceptions of program success. Some
evaluators also questioned the impact of the strict enforcement of
sanctions on program outcomes. In interviews, several evaluators
suggested that program outcomes measuring client success in absolute
terms--no relapses to drug abuse, no further arrests, no further criminal 
activity--were likely to obscure more subtle successes of case management
with difficult populations, such as longer drug-free periods, lower levels 
of criminal activity, longer time to rearrest, and fewer arrests.

Frequent interagency contact, cross-training, and clear communication
concerning criminal justice expectations should reduce these barriers. One
director of transitional services emphasized the power that community
corrections agencies possess to choose their own service providers should
these efforts fail. "If a treatment program staff is uncooperative, the
probation department can just not renew their contract," he said.

Overburdened case managers. Case managers in some programs must
manage too many cases with too few resources to provide comprehensive
service, says Dr. James Swartz, project coordinator for the National
Consortium of Treatment Alternatives to Street Crime (TASC) programs,
generally well-regarded as one of the earliest and largest case management
experiments.[34] A personnel shortage has forced his Chicago case
managers to restrict their assistance to substance-abusing probationers to
the most basic linking and monitoring activities, instead of expanding case
management services to include educational and vocational training,
psychological services, medical services, and housing and job placement.
Furthermore, as available resources shrink, fewer services are targeted to
high-risk treatment candidates--those whom he feels are most likely to
benefit from the services.[35]

Transfer of offender treatment information. Another challenge for case
managers is passing basic offender information, treatment plans, and
psychological assessments along to the next agency or case manager as the 
offender travels through the criminal justice system. The Federal Bureau
of Prisons Office of Transitional Services is working on ways to ensure
that basic information gathering and assessment is done only once and that
relevant case-planning documents arrive at the receiving agency before the
offender. Information must also flow back to criminal justice case
managers from service providers and treatment programs. Management
structures--such as formal coordinating committees or policy teams
composed of representatives from key criminal justice and service
agencies--are needed to ensure that offender information is exchanged in a
confidential, timely, and efficient manner.

CONCLUSION

While offenders are under the supervision of the criminal justice system, a
unique opportunity exists to intervene in the offender's lifestyle to reduce
future criminal behavior. Case management for criminal justice
populations connects offenders with the specific services and counseling
they need to resist substance abuse relapse and to break the cycle of
criminal behavior.

Various models of case management are being used in a variety of
criminal justice settings. Case management's greatest contribution to date
has been to reduce recidivism and supervision costs for mentally
disordered or developmentally disabled offenders. Case management will
also reduce the enormous social, economic, and bureaucratic barriers that
contribute to recidivism or substance abuse relapse among inmates
returning to the community and offenders sentenced to probation.

While the majority of criminal justice case management programs focus
on substance-abusing offenders, existing evaluations do not present a
consistent pattern of success with this population.[36] Nonetheless, the
impressive reductions in recidivism, time to reoffense, and cost reported
by some programs using day-reporting for substance-abusing probationers
and parolees suggest that intensive case management can have a
significant impact on these high-risk populations and that further research
is needed to define the key program and case management elements
contributing to these successes.[37] In the meantime, developing case
management approaches for those offenders who are part of populations
that have traditionally responded well to case management--for example,
the mentally disordered or developmentally disabled--should be a priority.

-------------------------------

Notes

1. Martin, Steve S., and James A. Inciardi, "Case Management
Approaches for the Criminal Justice Client," in Drug Treatment and
Criminal Justice, ed. James A. Inciardi, Thousand Oaks, California: Sage
Publications, 1993: 84-86; and Falck, Russell S., Harvey A. Seigal, and
Robert G. Carlson, "Case Management to Enhance AIDS Risk Reduction
for Injection Drug Users and Crack Cocaine Users: Practical and
Philosophical Considerations," in Progress and Issues in Case
Management, Research Monograph 127, Rockville, Maryland: National
Institute on Drug Abuse, 1992: 167-180.

2. One early study of the use of case management techniques by social
service workers provides the following definition: "The concept of case
management drew on two historically different emphases in provision of
service delivery to the multi-need client. . . . The 'liaison resource' and
'client monitor' aspects of service delivery both became incorporated over
time into a 'case managing' role for service workers, which was inclusive
of planning, coordinating, advocating, and monitoring of client services
across a variety of settings and client groups." Caragana, Penelope, and
David M. Austin, "Final Report: A Comparative Study of the Functions of
the Case Manager in Multi-Purpose, Comprehensive and in Categorical
Programs," Austin, Texas: University of Texas, School of Social Work,
July 1983. Unpublished report submitted to the Office of Human
Development Services, Department of Health and Human Services,
Washington, D.C.

3. Enos, Richard, and Steven Southern, Correctional Case Management,
Cincinnati, Ohio: Anderson Publishing Co., 1996: 2.

4. Martin and Inciardi, "Case Management Approaches for the Criminal
Justice Client," 83; Falck et al., "Case Management to Enhance AIDS Risk
Reduction," 167; and Roberts-DeGennaro, Maria, "Developing Case
Management as a Practice Model," Social Casework: The Journal of
Contemporary Social Work (October 1987): 466-470.

5. Enos and Southern, Correctional Case Management, 44-45.

6. Telephone interview with James Inciardi, January 1996.

7. Falck et al., "Case Management to Enhance AIDS Risk Reduction,"
167; Peters, Roger H., "Drug Treatment in Jails and Detention Settings,"
in Drug Treatment and Criminal Justice, ed. James Inciardi, Newbury
Park, California: Sage Publications, 1993: 44-80.

8. Enos and Southern, Correctional Case Management, 2-20. These stages,
which refer to the case management of individual offenders, may take
place in the broader context of a "differentiated case management" court
system in which specific types of cases--civil, criminal, drug, property,
sexual assault, domestic violence--receive individualized routing,
scheduling, or disposition to maximize court resources and efficiency. See
Bureau of Justice Assistance, Differentiated Case Management, Fact
Sheet, Washington, D.C.: U.S. Department of Justice, Office of Justice
Programs, November 1995: FS000117.

9. Enos and Southern, Correctional Case Management, 8-9.

10. O'Conner, Gerald G., "Case Management: Systems and Practice,"
Social Casework: The Journal of Contemporary Social Work (February
1988): 97-106.

11. Bruce Horvath, lead case manager and senior officer, Project Action,
Houston, Texas. Funding for Project Action was not renewed by the State
of Texas in August 1998, due to Federal policies prohibiting
reimbursement of criminal justice agencies for case management services.
Federal funds are available to reimburse case management services to the
mentally ill through the Texas Council on Mental Health. The program's
services have been replaced with a mental health-based program, New
Start, supported by the Harris County, Texas, Mental Health/Mental
Retardation Agency, Ethel Perry, director, (281) 863-8170. 

12. Several of the Opportunity to Succeed sites (Kansas City and St.
Louis, Missouri, and Tampa, Florida) experimented with this approach.
Interview with Shelli Rossman, program evaluator, the Urban Institute.

13. Office of Justice Programs, Directory of Automated Criminal Justice
Information Systems, 1993, Vol II: Corrections, Courts, Probation/Parole,
Prosecution, Washington, D.C.: U.S. Department of Justice, Bureau of
Justice Statistics, 1993: 449-459.

14. Ibid, 445-446.

15. The U.S. Department of Justice, National Institute of Justice
(Washington, D.C.), under its Program Focus series, has published five
reports on offender reintegration and education programs across the
country by Peter Finn. They are as follows: The Delaware Department of
Correction Life Skills Program (1998) (NCJ 169589), Texas' Project RIO
(Re-Integration of Offenders) (1998) (NCJ 168637), Chicago's Safer
Foundation: A Road Back for Ex-Offenders (1998) (NCJ 167575),
Successful Job Placement for Ex-Offenders: The Center for Development
Opportunities (1998) (NCJ 168102), and The Orange County, Florida, Jail
Education and Vocational Programs (1997) (NCJ 166820). Other NIJ
publications about case management programs include: Women
Offenders: Programming Needs and Promising Approaches, Research in
Brief, 1998 (NCJ 171668); Work Release: Recidivism and Corrections
Costs in Washington State, Research in Brief, 1996 (NCJ 163706); Project
Re-Enterprise: A Texas Program, Program Focus, 1996 (NCJ 161448);
Drug-Abusing Women Offenders: Results of a National Survey, Research
in Brief, 1994 (NCJ 149261); Managing Mentally Ill Offenders in the
Community: Milwaukee's Community Support Program, Program Focus,
1994 (NCJ 145330); Police Response to Special Populations: Handling the
Mentally Ill, Public Inebriate, and the Homeless, Research in Action, 1988
(NCJ 107273); and Police Response to Special Populations, Issues and
Practices, 1987 (NCJ 105193).

16. Dvoskin, Joel A., C. Terence McCormick, and Judith Cox, "Mentally
Ill Offenders in the Community: Services for Parolees with Serious Mental
Illness," in Topics in Community Corrections, Annual Issue, Washington,
D.C.: U.S. Department of Justice, National Institute of Corrections, 1994:
14-20.

17. Mickel, Kyle, "Mentally Ill Offenders in the Community: A Little
'TLC': Maricopa County's Transitional Living Center," in Topics in
Corrections, Annual Issue, Washington, D.C.: U.S. Department of Justice,
National Institute of Corrections, 1994: 30-32. Also see Conly, Catherine
H., Coordinating Community Services for Mentally Ill Offenders:
Maryland's Community Criminal Justice Treatment Program, Program
Focus, Washington, D.C.: U.S. Department of Justice, National Institute of
Justice, forthcoming.

18. See De Leon, George, "Legal Pressure in Therapeutic Communities,"
Journal of Drug Issues, 18 (4) (1988): 625-640; and Cook, Foster, "TASC:
Case Management Models Linking Criminal Justice and Treatment," in
Progress and Issues in Case Management, Research Monograph 127,
Rockville, Maryland: National Institute on Drug Abuse, 1992: 368-382.

19. For example, Dade County, Florida, or the statewide drug court
program in New Hampshire. For information concerning drug courts,
contact the U.S. Department of Justice, Office of Justice Programs, Drug
Courts Program Office, (202) 616-5001.

20. Inciardi, James A., Howard Isenberg, Dorothy Lockwood et al,
"Assertive Community Treatment with a Parolee Population: An
Extension of Case Management," in Progress and Issues in Case
Management, Research Monograph 127, Rockville, Maryland: National
Institute on Drug Abuse, 1992: 361-362.

21. Telephone interview with Shelli Rossman, February 1996.

22. Telephone interview with Matthew Ferrara, Ph.D., clinical
psychologist, Austin, Texas, January 1996. Ferrara, Matthew, and Sandra
Ferrara, "The Evolution of Prison Mental Health Services," Corrections
Today, 53 (5) (August 1991): 198-203.

23. For a discussion of staffing see Rhodes, William, and Michael Gross,
Case Management with Drug-Involved Arrestees, Research Preview,
Washington, D.C.: U.S. Department of Justice, National Institute of
Justice, January 1996; and Inciardi et al., "Assertive Community
Treatment with a Parolee Population," 350-366; for an exception to
concerns about case management training, see Falck et al. in relation to the
Dayton-Columbus model.

24. Enos and Southern, Correctional Case Management, 2. It should be
noted that Enos and Southern argue that while it might be more 
efficient to provide services only to perpetrators of incest or other
offenders thought to be most amenable to treatment, the rehabilitation of
only one high-risk sex offender could spare multiple victims, making the
effort worthwhile. They also point to the cost efficiency of
community-based treatment versus incarceration.

25. Mackinem, Mitchell, Karen Goodale, and Sally Caughman, "Modest
Program, Modest Gains: An Outcome Study of a Day Reporting
Program/Stayin' Straight: South Carolina's Experiment with Day 
Reporting," South Carolina Department of Probation, Parole, and Pardon
Services, undated manuscript. Also see Rhodes and Gross, Case 
Management with Drug-Involved Arrestees.

26. Information in this section is from a telephone interview with Bruce
Horvath, lead case manager and senior officer, Project Action, Houston, 
Texas, and an undated program brochure titled, "ACTION: A Special
Project of Harris County Community Supervision and Corrections
Department." Project CHANCE and Project Action were evaluated by the
Criminal Justice Policy Council in Austin, Texas, (512) 463-1810. See the
newsletter article, "Mentally Retarded and Mentally Ill Criminal
Offenders: Effectiveness of Community Intervention Programs," Criminal
Justice Policy Council Research Analysis, March 1993, No. 17: 1-4. This
publication is available from the National Institute of Corrections
Information Center. 

27. Telephone interview with Bruce Horvath, January 1996.

28. Information in this section is from printed program materials provided
by the Association for Retarded Citizens and Donna Cole, the interim lead
case manager of Project CHANCE, Austin, Texas. Two programs are
continuing Project CHANCE's work: Victim and Offender Services, Irene
Huq, program director, and Dennis Chapman, project leader, (512) 476-
7044, and Anew-Champ, Don Johnson, executive director, (512) 459-
7637. Funding for Victim and Offender Services is received through the
Austin County Health and Human Services Agency. Victim and Offender
Services currently serves mentally retarded or developmentally disabled 
juveniles but seeks grants to extend services to adult offenders. 
Anew-Champ works with both mentally ill and mentally retarded
offenders to provide case management, discharge planning, individualized
training (rehabilitation, independent living skills, and anger management),
and psychiatric support services. Anew-Champ had served Project
CHANCE's clients on a subcontract basis until August 31, 1998.
Anew-Champ is funded in part by the Texas Department of Parole.

29. Telephone interview with Donald Stiles, January 1996.

30. Telephone interview with Loren Buddress, January 1996.

31. Hall, Frank A., "Oregon Tackles a Tough Issue: Department of
Corrections Strategies to Reduce Recidivism," Alternatives to
Incarceration, Spring 1995: 26-27; Finigan, Michael, "Evaluation of
Oregon Parole Transition Projects, Executive Report," prepared for
Community Programs Division, Oregon Department of Corrections,
October 15, 1993.

32. See Conly, Catherine, The Women's Prison Association: Helping
Women Offenders and Their Families, Program Focus, Washington, D.C.:
U.S. Department of Justice, National Institute of Justice, 1998 (NCJ
172858).

33. Bemus, Brian J., "Implementation of a Case Management System in
Washington State Misdemeanor Courts: An Example of Cooperation and a
Guide for the Future," Misdemeanant Corrections Association,
unpublished manuscript, December 1993: 18.

34. TASC is supported by the National Institute of Justice, the Bureau of
Justice Assistance, Office of Juvenile Justice and Delinquency Prevention,
the National Association of State Alcohol and Drug Abuse Directors
(NASADAD), and State and local agencies. There are approximately 150
programs in 20 States. Contact number: National TASC, Melody Heaps,
president, (312) 787-0208.

35. Telephone interview with Dr. James Swartz, January 1996.

36. See, for example, Inciardi et al., "Assertive Community Treatment
with a Parolee Population,"; Rhodes and Gross, Case Management with
Drug-Involved Arrestees; and Falck, R., R. Carlson, S. Price, and J.
Turner, "Case Management to Enhance HIV-Risk Reduction Among
Users of Injection Drugs and Crack Cocaine," Journal of Case
Management, 3 (4) (1994): 162-167.

37. Mackinem, Goodale, and Caughman, "Modest Program, Modest
Gains": 1ff.

-------------------------------

The Pima County, Arizona, experiment [a] 

The Amity Project, a collaboration between Amity, Inc., and the Pima
County Department of Probation, was funded in 1990 by the Center for
Substance Abuse Treatment of the U.S. Department of Health and Human
Services to target offenders who were at high risk of probation revocation
due to substance abuse. Racial and ethnic minorities, as well as younger
offenders, were included in the program, which incorporated key elements
of a therapeutic community into a day-and-evening program.

The program design incorporated escalating sanctions, including urine
screens and varying supervision levels, case management (assessment and
support), educational or vocational training, family support and
counseling, health services coordination, intensive aftercare, and a
community-based site housing both probation officers and treatment staff.

After 2 years, drug use relapses were reduced and probationer employment
increased. Across the program, positive urine tests decreased by more than
50 percent in the first year, and the employment component was so
successful that the project developed night and weekend services to
accommodate employed offenders. Despite these promising results, the
program was terminated due to lack of funding.

a. Information in this section is from the following sources: a January
1996 telephone interview with Don Stiles, chief adult probation officer for
the Superior Court in Pima County, Arizona; Stiles, Don R., and Rod
Mullen, "Smart Sanctions: Treatment Center, Probation Collaborate to
Improve Treatment and Supervision Results," Executive Exchange,
National Association of Probation Executives, Fall 1993: 1-8; Adult
Probation Department, Arizona Superior Court, Pima County, Annual
Report, 1994; and Adult Probation Department, Arizona Superior Court,
Pima County, Annual Report, 1995.

-------------------------------

Linking inmates with local resources: Alexandria jail's Critical Care Mental
Health and Sober Living Units [a]

Since 1983, the city jail in Alexandria, Virginia, has partnered with the 
Alexandria Department of Mental Health, Mental Retardation, and
Substance Abuse (hereafter, the department) to provide services to
inmates. The idea behind the cooperative effort is that jail presents an
opportunity to link inmates with treatment and social services before they
return to the community. The collaboration, which began with a part-time
health worker assigned to work inside the jail, has grown to include two
in-house programs--one for mentally ill inmates and another for substance
abusers. Both programs use case management techniques that replicate
community-based, intensive residential programs.

The Critical Care Mental Health Unit and the Sober Living Units (which
have 10 beds for female inmates and 29 for male inmates) are staffed
jointly. The department contributes 7.5 full-time staff members to the
effort, and the jail adds 4 trained intake staff; a full-time, special
management sergeant; and 2 case managers who specialize in aftercare
placement for the Sober Living Units. The department provides case
management services for the inmates, as well as any necessary training
and research support. Of the department employees, five are assigned to
the Critical Care Mental Health Unit (two clinical social workers and three
psychological counselors), and five are assigned to the Sober Living Units
(one for female inmates and one for male inmates). Trained jail staff,
designated as "special management deputies" and "unit counselors,"
augment the work of the mental health counselors. Trained jail staff are
responsible for initial treatment, and only the most serious cases are
referred to the mental health department counselors.

Case management for mentally ill offenders includes regular case review by
a behavior management team, which includes security personnel (the
sergeant), classification personnel, and clinicians (both mental health and
medical) who develop a treatment plan integrating the needs of the inmate
and the institution. Approximately 20 percent of the jail's inmates receive
some form of mental health services from the unit.

The Sober Living Units were established in 1987 in response to the
increasing number of drug offenders among the jail population. The units
provide 90-day intensive residential substance abuse treatment in
preparation for return to the community. Treatment includes educational
programs and both individual and group therapy. The Sober Living Units
and the Critical Mental Health Unit link inmates to community social and
health services while they are in jail. Inmates are expected to continue the 
relationship with their case manager upon release from jail.

Staff research indicated that 85 percent of mental health referrals also had 
substance abuse problems. Therefore, in 1990, a full-time substance abuse 
counselor was added to the mental health unit to assist with dually
diagnosed inmates.

a. The information for this section is from the following sources: a January
1996 telephone interview with Bob Gimblette, Alexandria (Virginia)
Department of Mental Health, Mental Retardation, and Substance Abuse;
Fortin, Connie, "Jail Provides Mental Health and Substance Abuse
Services," Corrections Today, 55 (6) (1993): 104-107; Office of the
Sheriff, Treating the Community's Mentally Ill: A Collaborative Approach
to Jail Mental Health Services, City of Alexandria, Virginia, Department
of Mental Health, Mental Retardation, and Substance Abuse, July 1994,
unpublished manual; and Office of the Sheriff, Jail Mental Health
Services: A Training Manual for Deputy Sheriffs and Correctional Staff,
City of Alexandria, Virginia, Department of Mental Health, Mental
Retardation, and Substance Abuse, February 1994, unpublished manual. 

-------------------------------

Case management of mentally disordered or developmentally disabled
offenders: Lancaster County, Pennsylvania, Office of Special Offender
Services [a]

The Lancaster County, Pennsylvania, Office of Special Offender Services
directs four programs that use case management to target mentally
retarded offenders, nonviolent mentally disordered offenders, mentally
retarded juvenile offenders, and at-risk juveniles in special education. Two
factors contribute to the success of the programs, says Director Wayne
Geltz. First, the Office of Special Offender Services is the bureaucratic
equal of both the local social services and probation departments. As an
equal, it is better able to command cooperation from those agencies and to
request funding from the county. Second, criminal justice sanctions
encourage offenders to use services offered by his department. "You need
the enforcement package to go along with the social services," he says.

Established in 1981 jointly by the Lancaster County Court of Common 
Pleas (Probation/Parole) and the Lancaster County Office of Mental
Health and Retardation, the Office of Special Offenders Services provides
intensive probation/parole and case management services to mentally
retarded adults. In the Adult Offenders with Mental Retardation Program,
probation officers and case managers work together to define client
functional levels and case management goals. Intensive supervision and
counseling (provided by the case manager) help the offender develop
self-esteem and confidence; build decisionmaking, social, and independent
living skills; and obtain employment. After successfully completing
probation, offenders in the program are linked with the county's main
mental health/mental retardation department for continued case
management. Contact between offenders and case managers may continue
as needed.

Mentally disordered probationers who have committed nonviolent crimes
and have been diagnosed with certain psychological conditions
(schizophrenia, bipolar disorder, delusional [paranoid] disorders, major
depression, and anxiety disorders) are eligible to participate in the
Offenders with Mental Illness Program. Case management services vary in
intensity (depending on the needs of the client) but may include daily or
weekly monitoring, medication monitoring, day programming,
employment counseling, vocational testing, job placement, and family and
personal counseling. The program attempts to limit incarceration and
hospitalization for nonviolent offenders, to assist in the successful
completion of probation, and to reduce recidivism.

The Juvenile Division of the Office of Special Offender Services addresses
the needs of developmentally disabled juvenile offenders who might
otherwise fall through the cracks of the juvenile justice system. A
specially trained team of probation officers and case workers assists this
population. The program, which is partially funded by the Pennsylvania
Juvenile Court Judges, works to reduce recidivism and the cost of
placement by providing the juveniles with the skills necessary to live
independently or with their family, obey the law, and function in the
community. Case management for juveniles includes intensive supervision
(daily meetings until they are stabilized, then several meetings a week);
meetings with the family, school officials, and employer; and an intensive
educational program that covers drug and alcohol issues, legal rights and
responsibilities, money management, social skills, recreational activities (as
a reward for program compliance), and other training related to daily living
skills. Juveniles spend an average of 9 to 12 months in the program.

Office of Special Offender Services case managers and a probation officer
teach a school truancy prevention program targeted at mainstreamed
developmentally disabled juveniles who may not adequately understand the
law or the criminal justice system. The 3-hour program focuses on
community behavioral standards, personal responsibility, decision-making,
and the consequences of breaking the law. The educational program is
presented two mornings and two afternoons per week.

a. Information in this section is from a January 1996 telephone interview
with Wayne Geltz, Director, Office of Special Offender Services,
Lancaster County, Pennsylvania, and printed program information
provided by that office. 

-------------------------------

Case management of addicted inmates: The Federal Bureau of Prisons'
Drug Abuse Treatment Initiative [a]

The Federal Bureau of Prisons (BOP) has undertaken a number of case
management initiatives related to substance abuse treatment and
transitional services for inmates. Beth Wyman, national drug abuse
program coordinator, emphasizes that BOP drug treatment approaches are
designed to take a holistic or comprehensive approach to inmates' needs.
While inmates are incarcerated, treatment is provided by BOP staff; the
key case management challenge involves transferring information between
agencies as the inmate is released to community corrections, supervised
release, and finally, the community.

According to Jerry Vroegh, transitional services coordinator, case
managers start tracking inmates who are completing residential drug
treatment provided by BOP before they are transferred to community
corrections. In preparation for the transfer, treatment statements are
examined, and referrals to treatment programs are made before the inmates
are released to the halfway house. Once an inmate is at the halfway house,
contact is made with the treatment program within 2 weeks. Transitional
services piggybacks its treatment contracts onto those already held by
local probation officials (the U.S. Probation Office oversees supervised
release for Federal offenders) so that offenders moving through the system
experience as few changes in treatment services and case managers as
possible.

a. Information in this section is from the following sources: a January
1996 telephone interview with Beth Wyman, National Drug Abuse
Program Coordinator, Federal Bureau of Prisons (BOP); an interview with
Jerry Vroegh, transitional services coordinator, BOP; an interview with
Bernadette Pelissier, project director/evaluator, Pilot Drug Abuse
Treatment Programs, Federal Correctional Institution (FCI) Tallahassee,
Florida; FCI Butner, North Carolina; and FCI Lexington, Kentucky;
Murray, Donald, Drug Abuse Treatment Programs in the Federal Bureau of
Prisons: Initiatives for the 1990s, National Institute on Drug Abuse
Monograph: 62-83; Murray, D., "New Initiatives in Drug Treatment in the
Federal Bureau of Prisons," Federal Probation, 55, 1991: 35-41; Hayes,
Thomas J., and Dennis J. Schimmel, "Residential Drug Abuse Treatment in
the Federal Bureau of Prisons," Journal of Drug Issues, 23 (1) (1993):
61-73.

-------------------------------

Prepared under contract OJP-94-C-007 (Research Applications Contract)
to Abt Associates Inc. from the National Institute of Justice, Office of
Justice Programs, U.S. Department of Justice. Findings and conclusions of
the research reported here are those of the author and do not necessarily
reflect the official position or policies of the U.S. Department of Justice.

-------------------------------

The National Institute of Justice is a component of the Office of Justice
Programs, which also includes the Bureau of Justice Assistance, the
Bureau of Justice Statistics, the Office of Juvenile Justice and Delinquency
Prevention, and the Office for Victims of Crime.

-------------------------------

This research was conducted by Kerry Murphy Healey, Ph.D., a consultant
to Abt Associates Inc., Cambridge, Massachusetts.

-------------------------------

This and other NIJ publications can be found at and downloaded from the
NIJ Web site (http://www.ojp.usdoj.gov/nij).

NCJ 173409