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1
Treatment Alternatives Treatment Alternatives to Street Crimeto Street Crime
The TASC Model
Elizabeth A. PeytonPresentation at the 7th National Conference on Drugs
and CrimeOrlando, Florida, October 2000
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Understanding the ProblemUnderstanding the Problem
The impact of substance abuse on our justice & treatment systems is astounding
High levels of substance abuse in offender populations
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Per cent incr ease in state pr isonPer cent incr ease in state pr isonadmissions between 1980 & 1995admissions between 1980 & 1995
0% 200% 400% 600% 800% 1000% 1200%
Violent Crime
Property Crime
Drug Offenses
Source: Corrections Program Office, U.S. Department of Justice
1100%
85%
50%
4
Only a small percentage of Only a small percentage of inmates receive treatment inmates receive treatment
05
101520253035404550
NeedTreatment
ReceiveTreatment
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Offenders in the community are Offenders in the community are substance involved & substance involved &
Incarceration is expensiveIncarceration is expensive
Costs to incarcerate in state and federal prisons and jails will exceed $41 Billion in 2000 (Camp, 1999)
Many states spend more money on prisons than on higher education (Justice Policy Institute, 1999)
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The use of illicit drugs & alcohol is a central factor driving correctional growth.
Treatment is effective as reducing substance abuse & related criminal activity.
Treatment is cost effective.
Providing adequate services to justice populations is difficult.
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Managed Care is HereManaged Care is Here
In most jurisdictions, the adoption of managed care techniques has reduced access to services
Lengths of stay are shortened
Thresholds for admission to intensive treatment have increased
Referral and admission procedures are more complex, and may involve third-party authorization
8
What is TASC?What is TASC?
A program model and methodology to:
Engage persons referred by the justice system into substance abuse treatment and other services
Collaborate with both justice and treatment to ensure that appropriate and adequate services are available for justice clients
The 13 Critical Elements define TASC
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TASC Provides the TASC Provides the Infrastructure forInfrastructure for
managing substance involved persons throughout the justice process
providing support during transitions
engaging clients at all points in the justice system
integrating services into justice system processing
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Systems Coordination
Organizational
Operational
13 Critical Elements
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Systems Systems Coordination Coordination
ElementsElements
Systems Systems Coordination Coordination
ElementsElements
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A Process to Coordinate Justice, A Process to Coordinate Justice, Treatment & other SystemsTreatment & other Systems
Develop collaborative approaches to integrate treatment & justice to provide a seamless continuum of treatment and accountability
Develop & expand treatment networks
Influence the policies, procedures & priorities of the justice & treatment systems Ensure adequate & appropriate services for
justice clients
Element 1
13
Procedures for Providing Information & Procedures for Providing Information & Cross-Training to justice, treatment & other Cross-Training to justice, treatment & other
systemssystems
Continuously develop skills & relationships
Keep policymakers & practitioners current about status of & effective strategies for managing substance involved justice populations
Element 2
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Organizational Organizational ElementsElements
Organizational Organizational ElementsElements
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A Broad Base of Support from the A Broad Base of Support from the Justice System with a Formal Justice System with a Formal
System for Effective CommunicationSystem for Effective Communication
Establish & maintain a coordinated effort & understanding for referrals between TASC & justice system components
Element 3
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A Broad Base of Support by the A Broad Base of Support by the Treatment & Other Social Services Treatment & Other Social Services
CommunityCommunity
Establish and maintain the linkages & understanding to:Ensure availability & quality
of treatment for justice clients
Make client referralsConduct tracking, monitoring
& case management activities
Element 4
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Organizational IntegrityOrganizational Integrity
Ensure TASC program integrity and organizational capability to carry out the program mission
Ensure objectivity and autonomyOver-identification with either
system can limit TASC’s credibility and functioning
Element 5
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Policies and procedures for Policies and procedures for regular staff trainingregular staff training
Ensure that all staff understand the TASC mission, philosophies & procedures to ensure competency
TASC staff must be experts in all participating systems
TASC staff must have skills to connect with & manage clients
Clinical & non-clinical staff can be effective
Element 6
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A management information A management information system with a program evaluation system with a program evaluation
designdesign
Provide timely and accurate informationfor developing & managing
program servicesfor determining & improving
operational effectivenessfor policymakers & funding
sourcesto meet public information needs
Element 7
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Important Important Data ElementsData Elements
Number of potential clients identified & referred; outcome of referral; reasons for exclusion; demographics; screening &/or assessment information
Demographic & socioeconomic characteristics of all admitted clients by referral source
Client characteristics including justice & substance abuse history & status; screening & assessment results; drug screen results; & mental health status
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Important Data Important Data ElementsElements
Records of all contacts & events that occur at TASC, treatment, other services & the justice system, along with outcomes of those events
Costs associated with delivery of client services
Performance measures, including process & outcome
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Operational Operational ElementsElements
Operational Operational ElementsElements
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Clearly Defined ClientClearly Defined ClientEligibility CriteriaEligibility Criteria
Set clear standards for inclusion & exclusion of individuals from TASC
Justice system involvement
Current &/or previous AOD involvement
Informed voluntary consent
Element 8
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Performing Client CenteredPerforming Client CenteredCase ManagementCase Management
Maintain ongoing connection with each client as he/she moves through various justice processes & multiple programs
Communicate progress & changes regularly to both justice & treatment
Provide the leverage, support & advocacy to encourage treatment engagement & retention
Intervene before behavior results in treatment termination
Element 9
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Case ManagementCase Management
Ties everything together & provides structure in and between systems that aren’t very systematically organized
The mortar that holds everything together
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Primary Functions of Primary Functions of TASC Case ManagementTASC Case Management
Screening & assessment
Referral & linkage to services
Ensuring access to services
Monitoring progress through client contact & chemical testing
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Primary Functions of Primary Functions of TASC Case ManagementTASC Case Management
Communicating with all relevant parties
Providing encouragement & support
Providing advocacy
Maintaining primary responsibility for the client as he/she participates in various justice & treatment programs & interventions
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TASC Case TASC Case ManagementManagement
Can be distinguished from traditional case management by:
its level of assertiveness its ongoing nature its focus on long-term
positive outcomes resulting from multiple interventions
its continual inter-agency & inter- system communication
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Screening Procedures for Screening Procedures for Identification of TASC Clients Identification of TASC Clients
within the Justice Systemwithin the Justice System
Determine appropriateness & suitability for treatment
Determine TASC eligibility
Begin building a plan for treatment & supervision
Element 10
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Documented Procedures for Documented Procedures for Assessment & ReferralAssessment & Referral
Provide a standardized assessment that includes clinical, justice & other information
Referral to an appropriate level of care that is coordinated with justice requirements
Development of a comprehensive case management plan
Element 11
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Assessment and Referral IssuesAssessment and Referral Issues
Assessments should include, at a minimum:
Chemical dependency status Justice involvement & justice
history Social history Agreement to participate in TASC
& treatment - and understanding of confidentiality rules
If treatment is not immediately available, monitoring by TASC should be available for an interim period
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Policies, Procedures & Protocols for Policies, Procedures & Protocols for Monitoring Drug & Alcohol Use Monitoring Drug & Alcohol Use
through Chemical Testingthrough Chemical Testing
Reliably monitor & report client’s use of or abstinence from alcohol & other drugs to encourage compliance & to facilitate the therapeutic process
Element 12
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Competency with Diverse Competency with Diverse PopulationsPopulations
Ensure that TASC & treatment delivery systems are sensitive to & provide relevant services regardless of client race, culture, religion, gender, age, ethnicity or sexual orientation
Treatment engagement & success is dependent on the ability programs & counselors have to connect with the client
Element 13
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Effectiveness of TASCEffectiveness of TASC
TASC programming is effective in:
Identifying populations in great need of treatment
Assessing the nature & extent of drug use patterns & specific treatment needs
Referring to treatment Serving as a linkage between justice
& treatment Providing monitoring services Retaining clients in treatment longer,
with better post-treatment success
Inciardi and McBride, 1991
35
Effectiveness of TASCEffectiveness of TASC
TASC clients remain in treatment six to seven weeks longer than voluntary clients or other criminal justice referrals
Hubbard et. al., 1989
36
Effectiveness of TASCEffectiveness of TASC
Involvement in TASC results in the provision of significantly more substance abuse & other services compared to non-TASC control groups
In study sites, TASC had the strongest effect at reducing drug use & drug crimes with the most problematic offenders
Turner and Longshore, 1998
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Effectiveness of TASC Effectiveness of TASC
Clients diverted to TASC through Maricopa County’s Do Drugs Do Time program had a 22% recidivism rate, compared to 54% of matched clients who didn’t receive TASC services
Hepburn, 1996
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Effectiveness of TASCEffectiveness of TASC
In 1998, New York City TASC diverted almost 2,000 offenders from prison & into treatment.
70% of participants have successfully completed the program since its inception in 1990.
Rearrest rates 12 months after completion remained around 10% in three separate studies.
EAC, 1999
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Benefits of TASCBenefits of TASC
Provides the organizational infrastructure to manage substance involved offenders in a logical, organized & cost effective fashion
Provides the organizational infrastructure to support other programming, including drug courts, re-entry management programs, Breaking the Cycle, networks, mental health courts, & other initiatives to integrate treatment into justice processes
40
Benefits of TASCBenefits of TASC Uses resources efficiently by
screening, assessing & placing justice clients in the appropriate level of care - and ensuring that transitional & aftercare needs are met
Builds the capacity & capability of treatment to serve justice populations effectively through the development of treatment networks
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Benefits of TASCBenefits of TASC
Manages clients to make sure they access & benefit from treatment
Ensures that treatment requirements are coordinated with justice processes
42
Benefits of TASC Benefits of TASC
Improves inter-system communication
Ensures that treatment is available to coincide with or capitalize on the “motivational opportunities” created by justice processing
Augments available services through case management, treatment readiness & chemical testing - and by using justice system leverage to encourage treatment compliance
43
TASTASCC::
ClientClient & & SystemsSystems
ManagementManagement
TASTASCC::
ClientClient & & SystemsSystems
ManagementManagement