Presented By: Maureen McDonnell Director for Business Development TASC, Inc. TIPPS Conference Dallas, TX June 14, 2010 Substance Abuse & the Criminal Justice

Presented By:

Maureen McDonnellDirector for Business Development

TASC, Inc.

TIPPS ConferenceDallas, TX

June 14, 2010

Substance Abuse & the Criminal Justice System:

Looking Back, Looking Forward

TASC, Inc.

Designated Agent to provide substance abuse assessments for felony offenders

Designated case management provider for parolees Services include assessment, advocacy and clinical case

management services. We do not provide substance abuse treatment. We serve approximately 25,000 offenders each year in Illinois. We work with all publicly funded treatment programs in the state. We work at all points in the CJS: Diversion, Sentencing Alternatives

including Drug Courts, Probation, Jail/Prison pre-release and Re-Entry We also provide services in the juvenile justice and child welfare

systems. Advocate nationally for productive policies Provide training and technical assistance on these issues

Addiction: Public Health & Public Safety Challenge

In 2008, 2,319,258 prisoners were held in federal or state prisons or in local jails 1,596,127 in prison, 723,131 in local jails

1 out of every 100 citizens for the first time in history

The number of adults who were being supervised on probation or parole at the end of 2006 reached 5,035,200 4,237,000 were on probation (84%)

798,200 were on parole (16%)

Source: Pew Center for the States, Bureau of Justice Statistics

Drugs are a Major Factor

The justice system is largest catchment area for people with addictions In 2006, alcohol and other drugs were involved in

these inmate offenses: 78 percent of violent crimes; 83 percent of property crimes; and 77 percent of public order, immigration or weapon

offenses; and probation/parole violations. Between 77-84% of these offenders were substance-

involved

As many as 87% of arrestees tested positive for at least one illicit drug & 40% for more than one drug

Source: BJS Arrestee Drug Abuse Monitoring Survey 2008; CASA, "Behind Bars II", February 2010

Effective Treatment is a Necessary Alternative

The criminal justice system is a “revolving door” – too many people cycle through the system too often Over 2/3 re-arrested w/in 3 years of leaving prison Avg. cost per inmate per year to states in the U.S.

= $22,650

Successful CJS supervision and community based recovery results in return to productive, healthy citizenship No re-arrests No re-incarceration Building durable recovery Building a pro-social life in the community

Sources: West & Sabol, 2008; Langan & Levin, 2002; Glaze & Bonczar, 2008; Mumola, 2000, Stephan, 2004

Major National Trends: 2000 - 2010

Countervailing Forces Through the Decade

Move Toward More Sensible CJS Policies & More Effective Practices

Expansion of “Therapeutic Jurisprudence”

Economic Recession: Pressure to Reduce Prison Populations and Rehabilitative Services

““Tis the set of the sail that Tis the set of the sail that decides the goal and not the decides the goal and not the storm…” storm…”

-Ella Wheeler Wilcox-Ella Wheeler Wilcox


Dramatic increases in penalties for drug possession slowed from previous decade Not reduced, but leveled out Reductions in penalties for marijuana possession Exceptions

Trend to making DUI/DWI cases felony offenses (increases penalties)

Escalating penalties for methamphetamine

Impact: Stopped escalating sentences, slowed the growth of incarceration


Expanded focus on “Therapeutic Justice” Focus on reducing recidivism through combined

court supervision and mandatory treatment Proliferation of Specialty Courts More drug courts – more than 2,500 nationwide New in this decade:

Mental Health Courts – more than 300 nationwide Veterans Courts – new since 2008 DUI Courts – growing interest

Impact: Strong results, but overall reach a small percentage of people in the CJS who could benefit from treatment


Expanded Focus on Successful Reentry Focus on reducing recidivism through

In-prison treatment Post-release treatment & supervision

New in this decade Comprehensive, full-scale models in place

Sheridan and Southwestern Illinois Correctional Centers Includes in-prison treatment, post-release treatment & case

management, vocational programs pre- and post-release Graduates 85% less likely to return to prison than control

group Use of graduated sanctions as alternative to re-incarceration

in case of parole violations


New types of providers and partners for offenders Recovery homes, faith-based providers and other non-

traditional community-based organizations Created diversity of options and some expansion of capacity As yet no research that demonstrates improved outcomes

Focus on community partnerships to sustain reentry and recovery Community Re-Entry Councils

• Texas: Travis, Tarrant & Bexar Counties Expansion of Treatment Capacity Run by CJS

Greater control Addresses gaps in the system May not establish long-term community support for

recovery


Return to System Thinking: Courts/Diversion Proposition 36 – California

Approved November 2000 Required that non-violent drug offenders be sentenced to

probation with treatment Few penalties for non-compliance Overwhelmed the treatment system

Evidence-Based Probation Pilots (NIC) Based in criminological research Substance abuse as one of 8 factors determining risk Increased focus on probation officer as agent of change,

not just compliance


Economic analysis resulting in greater interest in more cost effective strategies, economic crisis driving solutions. Justice Reinvestment

www.justicereinvestment.org Second Chance Act

www.ojp.usdoj.gov/BJA/grant/SecondChance.html Focus on the aggregate impact of decision-making

“One in 31”www.pewcenteronthestates.org/report_detail.aspx?id=49382

Disproportionate Confinement of Minorities

State budget crises create pressure to reduce prison populations

Figures from September 8, 2009Figures from September 8, 2009Figures from February 25, 2010Figures from February 25, 2010

(Center on Budget & Policy Priorities, 2009, 2010; Vandivort, 2010(Center on Budget & Policy Priorities, 2009, 2010; Vandivort, 2010))


Much Better Understanding of What Works in Offender Treatment and Rehabilitation National Criminal Justice—Drug Abuse Treatment

Studies (CJ-DATS) – Multisite research program Texas Christian University IBR

Aimed at improving the treatment of offenders with drug use disorders and integrating criminal justice and public health responses to drug involved offenders

Goal: Establish a research base that definitively supports “what works” in substance abuse rehabilitation with offendershttp://www.cjdats.org/Wiki%20Pages/Home.aspx

Now & Next 5 Years

Economic pressure at the state and county levels will continue Focus on reducing prison populations

Creates more opportunities to build services that divert people from prison to treatment in the community

At sentencing and on violations Tremendous pressure on treatment system funding

Some balance from federal programs Second Chance Act SAMHSA Offender Reentry Programs Drug Court Enhancement & BJA partnerships Access to Recovery

Health System Developments

New Parity Law Requirements Changes in the treatment system will impact CJS access Implementation: Paradox

Could result in a “race to the bottom” with shorter stays, less care

With proper advocacy, could result in better standards of care

National Health Care Reform Medicaid Expansion for people under 133% FPL (2014) Could result in major changes to services offered & providers Need to partner with CJS to say what is needed

Local cross-system planning State level advocacy

What Services Will be Covered?

Assess &Link to Service Residential Part of RTPrimary PS Treatment Employment SupportPrevention & Screening Drug Free RecreationStress Management Drop In Centers Family/Relationship Groups Peer CounselingRole Modeling & Mentoring Housing in Oxford &

TCsRecovery Coaching

Medical Model Social Services

Instead of Disease Model, Need Health/Wellness Model

Source: Vandivoort, Rita M., SAMHSA, “Health Care Reform and Its Implications for Treatment of Substance Use Disorders”, 2010 (Modified based on conference call, 3/5/10)

Best Case Scenario

Communities will use new funds to build capacity Ensure rapid entry into the right level of care Virtually all alcohol and drug-dependent offenders would have funding to

go to treatmentCommunities will design better systems

Expand use of high-quality services Effective at keeping people safe, healthy drug- and crime-free in the

communityCommunities will establish systems to integrate the criminal

justice and treatment systemsCommunities will establish better integration with medical care

providers Federally Qualified Health Centers

New Strategies: Medication-Assisted Treatment

MAT is an evidence-based treatment practiceOne of the treatment strategies endorsed by NIDA

and SAMHSA*Includes current medications for:

Opiate addiction (Methadone, Buprenorphine, Naltrexone) Alcohol dependence (Vivitrol) Medications are under development to treat cocaine addiction

Manages cravings so people can participate in treatment

Psycho-social rehabilitation is still necessary, especially for drug-involved offenders

*Principles of Drug Abuse Treatment for Criminal Justice Populations - A Research-Based Guide http://www.nida.nih.gov/PODAT_CJ/

New Strategies: SBIRT

SBIRT = Screening, Brief Intervention and Referral to Treatment

Developed in SAMHSA Model developed to identify substance abuse in

primary care World Health Organization – screening tools

Extensive demonstration projects in the U.S. since 2003

ONDCP is interested in its application to the criminal justice system

How Would This Work in the CJS?

Screening at all feasible points to get as close to universal intervention as possible Police lock-up Jail Bond court In courtrooms Probation

Brief Intervention by specialized staff, again in all settings Option: Require participation in alcohol/drug education

classes State’s Attorney’s Drug Abuse Program (Chicago) 85% of people are not re-arrested within 3 years

Presenter Contact Information

Maureen McDonnellDirector For Business DevelopmentTASC, Inc. [email protected]

www.tasc-il.orgwww.centerforhealthandjustice.org

Documents

Presented By: Maureen McDonnell Director for Business Development TASC, Inc. TIPPS Conference Dallas, TX June 14, 2010 Substance Abuse & the Criminal Justice