Category: Drug Treatment

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Offenders and the Affordable Care Act-The Urban Institute

April 17, 2015 by CSOSA

Offenders and the Affordable Care Act-The Urban Institute

DC Public Safety Radio

http://media.csosa.gov

Radio show at http://media.csosa.gov/podcast/audio/2014/07/offenders-affordable-care-act-urban-institute/

LEONARD SIPES: From the nation’s capital this is DC Public Safety. I’m your host Leonard Sipes. Ladies and gentlemen, today’s topic, Offenders and the Affordable Care Act, something of real importance to those of us in the criminal justice system and throughout the country. It’s a real pleasure to have Kamala Mallik-Kane; she is a research associate, Justice Policy Center for the Urban Institute, www.urban.org, www.urban.org. Kamala Mallik-Kane, welcome to DC Public Safety.

KAMALA MALLIK-KANE: Hi, Len. I’m glad to be here.

LEONARD SIPES: Hi. This is exciting, because we have a new study that Urban is going to come out with next week talking about the Affordable Care Act and offenders, how many enroll, and what happens. Tell me about that.

KAMALA MALLIK-KANE: Sure. This is a study that is funded by the National Institute of Corrections, and we are very excited to be doing this work, because it gives us an important preview of what might be happening under the ACA as states are expanding their access to Medicaid. In our study we look at two states that were early adopters of Medicaid expansion. We’re looking at what these states did before 2014, so that we can have some insights about what may happen as Medicaid expansion moves forward post-ACA.

LEONARD SIPES: Now, those of us in the criminal justice system, this is the Holy Grail, and I’ve seen that term “Holy Grail” used in a wide variety of articles. We have said for decades, those of us throughout the criminal justice system throughout the United States, that people in the criminal justice system, offenders, people on supervision, are not getting mental health treatment, they’re not getting substance abuse treatment. I’ve seen surveys that put it at 10% or less within some state correctional systems. People on the outside, again, are not getting substance abuse treatment; they’re not getting mental health treatment. We all see the potential of the Affordable Care Act as being something that’s going to revolutionize the way that we deliver services. Is there a snowball’s chance in Hades of that actually happening?

KAMALA MALLIK-KANE: I’m optimistic. I think there’s a good chance of that happening. I think it’ll take a while, but I think that this is definitely a step in the right direction. We know that so many people in the criminal justice system suffer from substance abuse problems, mental illness, and various chronic physical conditions, and we know that before the ACA, in most places, that they would be released from prison without health insurance. So what would happen is somebody comes into prison or jail, they get a certain level of treatment while they’re in prison or jail, they get stabilized and they manage these conditions, then they get released without health insurance. And so within a couple of months they are no longer receiving treatment for these conditions and they can spiral out of control.

LEONARD SIPES: When I was with the Maryland Department of Public Safety for 14 years the staff there explained to me that mental health treatment was designed to do nothing more than stabilize their experience while in prison or while in jail, it had little to do with stabilizing that experience in the community. So that’s what you’re talking about in terms of in many cases getting access to mental health treatment in prisons or in jails. It’s not designed for them to transfer to the community and for some sort of services to follow. It’s purely to help them maintain their sanity in the correctional facility.

KAMALA MALLIK-KANE: Right. My understanding is that many prison and jail systems provide people with a small supply of what they like to call walking meds, and sometimes may set people up with a prescription to get a refill at a community-based pharmacy, but we all know if you don’t show up at a pharmacy with insurance this going to cost you an outrageous amount of money.

LEONARD SIPES: Yes.

KAMALA MALLIK-KANE: And so having insurance is a key step for people to be able to get those medications in an affordable way.

LEONARD SIPES: Now, there is I think a dollar amount stipulation, that they have to earn less than a certain amount every year to be eligible for the Affordable Healthcare Act.

KAMALA MALLIK-KANE: Right. With the ACA that is 138% of the poverty level and to qualify for the subsidies for the ACA exchanges I think you can be up to 400% of poverty. And programs in the States vary with respect to what their income thresholds are, because Medicaid is a combined federal state program, and so the states have some discretion too in setting those limits.

LEONARD SIPES: I’ve seen figures like 16,000 dollars, 18,000 dollars, less than that, and I would imagine it does vary from state to state, because, as you said, it’s a combined federal-state program.

KAMALA MALLIK-KANE: Right. That sounds about right to me. And certainly in the pre-ACA time period that we studied the thresholds for the two states that we looked at, Oregon and Connecticut, were quite different.

LEONARD SIPES: Again, and it’ll be the last time I’ll beat this point to death, is that we see, those of us in the criminal justice system are so excited about Urban, the fact that you’re coming out with this report next week. I’d really urge everybody to go to the website at the Urban Institute, www.urban.org, www.urban.org, because this whole idea is, again, we in the system understand that they need treatment, we in the system understand that oftentimes the experience throughout the United States is that they’re not getting treatment. We believe that if they got treatment they would do a lot better, recidivate less, cost taxpayers fewer dollars, cost victims of crime – there would be fewer victims of crime. We see this as a huge win for people in the criminal justice system and our ability to control cost.

KAMALA MALLIK-KANE: Right. I think there’s a lot of research out there showing things like substance abuse treatment with aftercare being effective at engaging people in treatment after release and keeping their reoffending rates lower and similar things with mental health treatment. I think that what we tend to see in the justice system are pretty small-scale programs that are effective but serve a pretty small slice of the total population coming out. But we know there’s such a lot of unmet need. And that’s what makes the potential under the ACA very exciting is that insurance can be extended to a huge swath of individuals who are returning. As long as they meet the program eligibility requirements this is something that doesn’t affect 1% or 2% of people coming out but the majority.

LEONARD SIPES: Okay. So we know that the, I would say the majority of people caught up in the criminal justice system have substance abuse history, certainly. I’ve seen self-reporting studies that say 55% self-report mental health issues in the past. I’ve seen studies that say; suggest that 16%, up to 16% of people have diagnosable histories of mental health problems. But physical health problems, if you throw all that in, I think we’re talking about certainly the majority and probably more than that of people caught up in the criminal justice system.

KAMALA MALLIK-KANE: At Urban we did a study called Returning Home several years back that interviewed people as they were leaving prison and then followed up with them in the community at several times over the course of a year. And when we did interview them in prison we found that when you looked across the spectrum of the types of issues that someone could have it was eight in ten men had at least one chronic physical or mental or substance abuse condition, it was like nine in ten women. So it’s really a huge swath of the population. Of course the severity of these conditions can vary, but in some of the, in some other data that I’ve seen I’ve seen numbers I think around something like 60% having conditions that require active treatment or management.

LEONARD SIPES: Okay. So they leave prison, they’re typically uninsured, and their health deteriorates, right?

KAMALA MALLIK-KANE: Right.

LEONARD SIPES: Okay. And so the bottom line in all of this is, we in the criminal justice system care, but I’m not quite sure the average person out there sees this as that big of an issue, but it really is to them, is it not, in terms of holding down costs of correctional care, holding down re-victimizations?

KAMALA MALLIK-KANE: Sure. I think that the most obvious connection that you can make for an average layperson who’s looking at this is to think about substance abuse and relapse. When someone is clean they are not stealing or victimizing people or doing other harmful things just for the purpose of being able to obtain more drugs. When somebody has relapsed they slide into those behaviors again. I’m not saying that everybody who’s addicted does these things, but it’s a common enough pattern that substance abuse is one of these key drivers of this revolving door phenomenon that we see in the justice system.

LEONARD SIPES: So we all agree that this could have a huge impact. I said I would not bring that topic back up again. What can be done on the part of the criminal justice system? I mean what we have to then, and I’ve seen in some articles where jails and prisons are actually creating staff to help the men enroll, that they’re being very proactive in terms of getting as many people enrolled as possible, but this involves a lot of effort on the part of the criminal justice system in terms of discharge and release planning, treatment referrals, care coordination, so this, the criminal justice system should take an active role in terms of enrolling as many people as possible.

KAMALA MALLIK-KANE: Yeah. I agree with that. And I think that states and localities are doing a number of these various things. They’re engaged in some level of release planning. They make treatment referrals for individuals. I think some of this is triaged so that you’re putting more resources into the people that have greater needs. But Medicaid enrollment is something that is being implemented into release planning curricula or programming in criminal justice systems around the country.

LEONARD SIPES: Okay. The report that’s coming out next week – is this, do we have specific findings in terms of how many enroll and what happens? Or what is the purpose of the study? It is it describing what it is that you’re doing or will it have impact findings?

KAMALA MALLIK-KANE: Sure. So our study has two broad goals. One of them is to understand more about the enrollment process, how do you get inmates connected to Medicaid, what are some of the challenges that systems and individuals face, and what are the rates of enrollment when people have the opportunity to apply for Medicaid. So that’s the first part of our study. The second part of our study is a little further down the road. We’re looking at impacts post-release with regard to when people get enrolled in Medicaid, do they utilize Medicaid health services, and are there impacts post-release, one to two years later on employment and recidivism.

LEONARD SIPES: You and I were talking before we hit the record button is that I remember a national researcher, I’m sorry, a national reporter reporting for a national publication was trying to do an article that he was calling ObamaCare and Offenders or ObamaCare and Inmates, and he said he found a general reluctance on the part of those of us in the criminal justice system to talk about this, because we don’t know what the impact will be, we don’t have a clear understanding as to whether or not this will have a huge impact. What he was heard on an off the record basis from so many people was that just because you have health insurance doesn’t mean you act on it, doesn’t mean that you go out and get the mental healthcare that you need, doesn’t mean that you go out and get the substance abuse care you need. You may use it to fund your physical infirmaries, but not necessarily mental health or substance abuse. So we really don’t know what the impact is and we won’t know until your research is completed, correct?

KAMALA MALLIK-KANE: That’s right. I think that’s a very valid point, just because you have insurance doesn’t mean that overnight you change the way that you seek services or get care or take care of yourself. But having insurance I think is a necessary first step to being able to use preventative health services, to be able to use mental health treatment services and substance abuse treatment that’s out in the community.

LEONARD SIPES: And this study that you all are doing is in Oregon in terms of the prison stage and a jail study in Connecticut.

KAMALA MALLIK-KANE: That’s right.

LEONARD SIPES: And how – was it difficult to get them involved in this?

KAMALA MALLIK-KANE: Well, in Oregon what we did was we looked historically at an effort that the Department of Corrections had implemented. In Oregon before the ACA Oregon had a very interesting Medicaid program for what’s called childless adults. Have you heard that phrase or should I talk through that?

LEONARD SIPES: That’s fine.

KAMALA MALLIK-KANE: Okay. Just that historically Medicaid had been a program for children and parents and people with disabilities and people with some specific eligibility criteria in addition to being low income. And before the ACA Oregon had expanded its Medicaid program to be more broadly a low income adults program, but because of limited funds in the state what they did was to have a lottery process so that it would be fair who they could provide this to. And so they had been doing this lottery process from about 2008, and we looked at what was going on in the prisons in 2010 and 2011 with respect to signing up for this lottery process, and then if people were selected at random to apply for Medicaid, how many of them did apply given that opportunity.

LEONARD SIPES: We’re more than halfway through the program. What we’re talking about today, ladies and gentlemen, is offenders and the Affordable Care Act. At our microphones is Kamala Mallik-Kane; she is a research associate with the Justice Policy Center at the Urban Institute, www.urban.org, www.urban.org, coming out with a new study report next week talking about what they plan on looking at in terms of how many enroll in the Affordable Care Act and what happens afterwards, correct?

KAMALA MALLIK-KANE: That’s right.

LEONARD SIPES: And that’s exciting, because we in the system are really, really looking forward to these findings. Okay. Some of the challenges of getting and keeping inmates enrolled in Medicaid, now, again, you’re talking jail, you’re talking prison, you’re not talking about necessarily community supervision, but some of the releases could be on community supervision at the same time, right?

KAMALA MALLIK-KANE: That’s right.

LEONARD SIPES: Okay. Tell me about that.

KAMALA MALLIK-KANE: About community supervision in particular or –?

LEONARD SIPES: Well, federal, the federal and state Medicaid rules. You’re not allowed to use Medicaid while incarcerated, a few states let you stay covered but suspend your benefits, so some of this gets technical in terms of the challenges of getting and keeping inmates enrolled in Medicaid.

KAMALA MALLIK-KANE: That’s right. The timing really matters, timing it appropriately with release so that – the Medicaid rules don’t permit people to be, to receive Medicaid benefits while they’re incarcerated. And this is an old provision in the Medicaid program and one that’s really intended to guard against Medicaid billings that are inappropriate.

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: But what happens when –

LEONARD SIPES: So they get double billing because they’re already getting healthcare within the prison setting.

KAMALA MALLIK-KANE: Right. And I think as a way of sort of ensuring that there’s not a community provider that’s billing for somebody –

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: That’s not out in the community.

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: But I think the difficulty for people who are frequently in and out of the justice system is that the information technology systems that are out there aren’t particularly good at keeping track of when people are in and out of jail. And so this is an issue that a lot of states are grappling with. I believe that there’s funding through the ACA for Medicaid systems to upgrade their information technology systems for a whole lot of reasons. But places that are attuned to this issue of correctional populations and their need for Medicaid and the challenges of timing things correctly so that the Medicaid system is aware of when people are being released from prison so that they can have benefits when they’re in the community is –

LEONARD SIPES: Okay. But this is specifically – we’re not talking about necessarily medical care within a correctional facility. We’re talking about giving them access to Medicaid so they can get treatment in the community.

KAMALA MALLIK-KANE: Right. Because in general inmates receive healthcare from the correctional system when they’re in, and so Medicaid is not – the purpose of the Medicaid is to have continuity of care from the prison or jail setting to the community so that –

LEONARD SIPES: Okay.

KAMALA MALLIK-KANE: They can continue that care when they’re in the community.

LEONARD SIPES: Well, that’s an important distinction. But what if they don’t get like say mental health treatment or substance abuse treatment while in prison, because the studies I’ve seen put that figure pretty low, at around 10% or lower, for most state systems. So what if you’re getting a, what if you’re getting mental health treatment or substance abuse treatment in prison, would Medicaid still provide funding for those particular programs while in prison?

KAMALA MALLIK-KANE: For mental or for substance abuse treatment in prison?

LEONARD SIPES: Uh huh.

KAMALA MALLIK-KANE: No. I don’t believe Medicaid funds that.

LEONARD SIPES: Okay. All right, so we’re talking about getting them enrolled and when they get out to the community and seeing what happens, and your study is looking specifically at one jail and one prison.

KAMALA MALLIK-KANE: We’re looking at prisons in Oregon and we’re looking at some jail facilities in Connecticut.

LEONARD SIPES: Okay. The level of interest, so we find folks in the criminal justice system are really interested in this, what about the offenders themselves?

KAMALA MALLIK-KANE: Right. In Oregon what we saw was that given the opportunity – so, again, let me just go back to what I was saying about –

LEONARD SIPES: Sure.

KAMALA MALLIK-KANE: The way you had to apply before the ACA in Oregon was you had to two stage process. The first stage was that you put your name what they called a reservation list, and so about half of the inmates who were leaving Oregon prisons at the time of our study put their names on that reservation list. Then the state did a random drawing and then based on who they invited at that point then people got mailed a Medicaid application and then they had 45 days to fill out the application, turn in their documentation, and then get it reviewed by the Medicaid agency. What we found that was very interesting in Oregon was that about 4 in 10 of the inmates that got invited turned in their application and this was identical to the level of participation in the general population in Oregon.

LEONARD SIPES: So 4 in 10, and that was indicative of the population across the board that was eligible, not necessarily for people caught up in the criminal justice system.

KAMALA MALLIK-KANE: Right.

LEONARD SIPES: And, okay, findings on Medicaid impacts. So you’re working on this data and you’re collecting this data. Are you aware of anybody else out there in terms of your literature review who has looked at this issue previously?

KAMALA MALLIK-KANE: We’ve seen smaller studies from a couple of years back –

LEONARD SIPES: Okay.

KAMALA MALLIK-KANE: Looking at specific subpopulations. So I know that there are studies of people who are seriously mentally ill and their rates of Medicaid enrolment and how that impacts arrest, for example.

LEONARD SIPES: Do we have any findings?

KAMALA MALLIK-KANE: I believe that they found a lower rate of rearrest among the people that were enrolled, but I don’t remember too, too clearly to talk about it more than that.

LEONARD SIPES: Okay. But in essence, as long as they meet guidelines, as long as they meet the state Medicaid guidelines they’re eligible, as long as they’re under a certain – I know the percentage of gross poverty, whatever – it’s even confusing to me. If they make, what I’ve seen commonly thrown out in newspaper throughout the country, if they make less than 16, 18,000 dollars, it depends upon it at state level, they’re eligible. And so there’s no question about eligibility. You’ve just got to be under that threshold.

KAMALA MALLIK-KANE: Right. And when we looked at the applicants in Oregon we found that when people got their applications into the Medicaid agency that about 8 in 10 of them qualified, and that was higher than in the general population, because there was more poverty –

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: Among the people who were leaving prison.

LEONARD SIPES: So 8 in 10 are eligible. And so that gives us hope that those of us in the criminal justice system can find sources of funding for substance abuse treatment and mental health treatment.

KAMALA MALLIK-KANE: Right. This gives people a ticket to be able to –

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: Access those services in the community.

LEONARD SIPES: So what is the sense between yourself or your peers at Urban in terms of what the impact could be down the road? I mean you’re talking to people, again, specifically in Connecticut and Oregon, but you’re probably talking to other people throughout the country. You were quoted in a rather extensive article, ObamaCare for Ex-Inmates: Is Health Insurance an Antidote to Crime?, and I think that was from the Christian Science Monitor, a very powerful article talking about how people around the country feel about the Affordable Care Act and what its potential could be. So what are your perceptions from talking to people?

KAMALA MALLIK-KANE: I think there’s a sense of a lot of potential and a lot of work ahead of us. I think, yeah, I like to think of having the insurance card as being sort of a ticket that you need to enter, but you need to do a whole lot of other things in order to make the change happen. I think some of the challenges are getting people to use healthcare differently, and I think that involves education.

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: One of the things in our Connecticut study was as they were doing enrollment there was an eligibility worker who talked with individuals about what kinds of services they could go out and get in the community. But another thing that we saw as we observed these recruitment sessions in Connecticut was that there was some confusion about the program, there was confusion about whether people had Medicaid or not. We had people in our sessions that we felt we had screened and thought them to be needing Medicaid who said, “No, no, I already have it. I don’t need to stay here and I don’t need to apply for this.” So I think people knowing what their status is and knowing how their perception affects what they do out in the community, that’s an important thing for us to figure out.

LEONARD SIPES: So there’s an educational process on the part of the system. This is not going to be an easy process for those of us in the criminal justice system. It’s going to take a lot of work to explain what the rules are, to figure out if they are eligible, to sign them up, to, and, again, try to encourage them to participate if they have funding. So it’s a multi-step process between correctional facilities and community correction facilities and parole and probation agencies, so this is going to involve a lot of work.

KAMALA MALLIK-KANE: And I would add that also community based health organizations have to be a partner in these conversations, because I think some of the disconnect that we may see are that there are treatment providers that have been serving the criminal justice population that have not been previously Medicaid providers and they may need to do things about the way they run their organizations in order to be qualified Medicaid providers so that the insurance can actually be used to pay for services in those facilities.

LEONARD SIPES: I didn’t even think about that. So not only must the criminal justice system gear up in terms of implementing this, the providers need to gear up to implement it.

KAMALA MALLIK-KANE: Right. There was a story in the New York Times recently about an old Medicaid rule about just which types of residential substance abuse treatment facilities they could reimburse or not. And so I think there needs to be that exchange between the provider network that’s out there and the Medicaid structure to figure out whether these are going to be reimbursable services.

LEONARD SIPES: Why is that a question though? I thought it would be pretty much straightforward.

KAMALA MALLIK-KANE: I would’ve thought that too. But I think that these kinds of details, you have a population that’s been receiving typically non-Medicaid services –

LEONARD SIPES: Right.

KAMALA MALLIK-KANE: That are now coming into the Medicaid world, and so I think these details haven’t yet been worked out.

LEONARD SIPES: And we need to remind the audience that only half the states are involved in the Affordable Care Act provision, so half the people in the country listening to this are going to say, “Well, yes, this applies to me.” but half it doesn’t apply to the offenders within their states.

KAMALA MALLIK-KANE: Right.

LEONARD SIPES: And so what’s the final analysis? In the final minutes of the program, I mean we in the criminal justice system do have to gear up, correct? We probably have to add staff; we probably have to add training. A significant burden falls on us to be sure that people who are eligible enroll. But that’s going to require a lot of effort and probably staffing and training on our part.

KAMALA MALLIK-KANE: Right, and a certain amount of coordination with the Medicaid agency. A lot of what we observed in our Connecticut Study and a lot of what was possible in the Connecticut Study was the result of a year’s long collaboration between the Department of Corrections and their Department of Social Services to establish procedures and workarounds that would let the correctional population enroll.

LEONARD SIPES: Okay. And that’s the other part of it is that we need to need to reach out to all the providers out there, because some who may be eligible to be providers may not want to take upon an offender based population. So we need to do a lot of work on our part to convince people who are the providers to get involved in this and to be sure that they are attuned to our needs and the needs of the people coming out.

KAMALA MALLIK-KANE: Yeah, absolutely.

LEONARD SIPES: And what else? What is the general sense to the public that they need to understand? You’re talking to aides to mayors, aides to governors through this program. What do they need to understand?

KAMALA MALLIK-KANE: Sure. I think that this is a great opportunity, because I think for years we have all known that substance abuse and mental illness are problems that have been feeding this revolving door cycle that we’ve had in our justice system, and you’ve had people coming in with problems, the problems don’t get resolved, and then they get released without any resources to deal with them. So I think that this is a great opportunity to begin addressing those problems that can slow down this revolving door of recidivism.

LEONARD SIPES: I couldn’t agree with you more. Our guest today has been Kamala Mallik-Kane; she is a research associate, Justice Policy Center, the Urban Institute, www.urban.org, www.urban.org. Ladies and gentlemen, this is DC Public Safety. We appreciate your comments, we even appreciate your criticisms, and we want everybody to have themselves a very pleasant day.

Filed Under: Budget Issues, Corrections-Prisons, Drug Treatment, Mental Health, Reentry Tagged With: Affordable Care Act. offenders

Drug Court in Washington, D.C.

March 27, 2015 by CSOSA

Drug Court in Washington, D.C.

DC Public Safety Radio

http://media.csosa.gov

Podcast at http://media.csosa.gov/podcast/audio/2015/01/drug-court-washington-d-c/

LEONARD SIPES: From the Nation’s Capital, this is DC Public Safety. Welcome to the first radio show for DC Public Safety for 2015. I’m your host Leonard Sipes. The program today is the Superior Court’s Drug Court’s Program here in Washington, D.C. We have two individuals by our microphones. We have the Honorable Gregory Jackson, Associate Judge, Superior Court of the District of Columbia. He is the Presiding Judge at Judge Court. And we’re going to have Gene and we’re just going to use his first name. He is a graduate of the Drug Court Program here in Washington, D.C. to talk about everything drug court. And to Judge Jackson and to Gene, welcome to DC Public Safety.

HONORABLE GREGORY JACKSON: Thank you for having us here.

LEONARD SIPES: Well, Judge Jackson, drug courts are immensely important throughout the United States. It is really something that’s picking up steam within the last couple years. The Washington, D.C. Superior Court was one of the first to implement drug court programs, correct?

HONORABLE GREGORY JACKSON: That’s correct. We started our program in 1993. This is now our – going into our 22^nd year of operation. We’re one of the oldest courts in the United States.

LEONARD SIPES: And you work in conjunction with our sister agency here at the Court Services and Offender Supervision Agency, Pretrial Services Agency plus a lot of other agencies, correct?

HONORABLE GREGORY JACKSON: That’s correct. It is very much a collaborative effort on the part of all of the criminal justice agencies that operate here in the District of Columbia, the U.S. Attorney’s Office, the Public Defender’s service, obviously Pretrial Service Agency, the Criminal Defense Bar, the U.S. Marshal Service and the Department of Corrections, the D.C. Department of Corrections.

LEONARD SIPES: And for the uninitiated give a 30-second laymanesque overview as to what drug court is.

HONORABLE GREGORY JACKSON: Drug court is a sanction and incentive-based program. It’s an alternative to the traditional case processing that takes place in court with criminal cases. We’re one of the few programs in the country that’s a pretrial program. Most of the drug court programs around the country are post-adjudication, that is the defendant is convicted or pleads guilty and then is given the opportunity to participate in a drug court program. In our program once a defendant is arrested and charged with an offense, if he or she qualifies for the program they’re given an opportunity to voluntarily participate in the program. Treatment services are primarily provided by the Pretrial Service Agency. If you have a qualifying misdemeanor offense, you successfully complete the program, that offense at graduation, that case at graduation is dismissed.

LEONARD SIPES: Considering how long the program has been going, you’ve literally seen, what, hundreds if not thousands of people go through drug courts since the mid-1990’s?

HONORABLE GREGORY JACKSON: For the program itself there have been thousands of people who have gone through the program.

LEONARD SIPES: Amazing.

HONORABLE GREGORY JACKSON: In the two years that I have presided over the program, we’re probably well into the hundreds. I’m not sure that I’m at a thousand yet but well into the high hundreds.

LEONARD SIPES: And the recidivism rate is pretty good, which means that literally hundreds, if not thousands, of people who would have continued throughout the criminal justice system stopped being involved in the criminal justice system because you provide both drug treatment through pretrial services and other partnering agencies and the sanctions process. You know, if they do well or if they screw up they see you. You are very personally involved in these cases.

HONORABLE GREGORY JACKSON: I’m directly involved with each individual. In the beginning those people who come into the drug court in the first phase and there are four phases to the program, in the first two phases of the program I see them every two weeks. They have to come to court every two weeks to essentially check in with me. I get status reports on how they’re doing, whether there are problems and if there are problems we talk collectively as a team about how best to address the problem. If they need other services, if we can’t provide them, we do referrals. And if they’re doing well, of course, we acknowledge and congratulate them and we have little token gifts that we actually give as incentives for those people who are doing well.

LEONARD SIPES: And the D.C. Superior Court has really taken the lead for the country in terms of specialty courts. There’s an endless array of specialty courts within the Superior Court structure within the District of Columbia. So it’s just not drug courts, there’s family courts, there’s a lot of different courts.

HONORABLE GREGORY JACKSON: That’s absolutely correct.

LEONARD SIPES: Okay, I want to go over to Gene. Gene, you’re a graduate of the Drug Court Program and I want to get your sense as to how you felt about your participation in the process. I mean, having the presiding judge here is extremely important, but I think more people are interested in what you have to say than what I have to say or what Judge Jackson has to say. So give me your perceptions about your participation in the Drug Court Program.

GENE: Well it was almost like the last straw for me, you know. At my age at the time I caught a charge and, you know, and I had a real drug habit and I was trying to get rid of the drug habit, you know. And I was just tired out there in the street and couldn’t keep my urines clean and the caseworker, the court referred me to Drug Court and I can say that’s one of the best things that happened to me. At first I didn’t know what I was getting into by going to drug court, you know, going to these meetings and once I withdraw from the use of drugs and alcohol I felt a little comfortable in the group. Cause when I first came to groups I couldn’t even hardly talk, you know, because I was going through a lot of withdrawals. You know, but one of the things is the caseworker they understood me. A lot of the people went through the same thing that I had went through, so that was a great help to me, you know, and I looked forward to coming down here, you know, because it was so much information that was given to me. And it’s like I was on my last straw.

LEONARD SIPES: Did you have a long drug history?

GENE: Yes I did. Yes I did.

LEONARD SIPES: Did you have a long involvement within the criminal justice system?

GENE: In and out of the criminal justice system, no, I was in and out – almost like a career nuisance, you know, and all my charges was drug related.

LEONARD SIPES: Now you were involved in treatment before, correct?

GENE: Yes.

LEONARD SIPES: Okay, so what was the secret sauce with Drug Court, I mean, am I right, quickly tell me if I’m wrong, but am I right in suggesting that you did not do well within previous treatment programs and then you got to Drug Court and then you did well.

GENE: Well for one thing, what I like about Drug Court, you know, and it was surprising to me, all the staff members always say Mr. or Mrs., they call you Mr. or Mrs. You know, and they treated you like you was a human being. In the other treatment programs, not putting them down, it was like, you know, they was like trying to force things on you but here it was more like a mild case of treatment, you know. And if you had a caseworker that, you know, and I came real close to my caseworker that I can go to her and talk to her almost about anything. And, you know, and I still consider her as my caseworker today.

LEONARD SIPES: So you were able to establish a personal relationship between the treatment providers provided by pretrial services, you were able to establish that personal relationship and that helped you.

GENE: Yes, yes, cause, you know, one thing, you know, every time I’m down this way I stop in and I talk to her and still call her my caseworker and her supervisor and a lot of the other staff. You know, because I need all the support I can though, you know, I don’t say I have it made so that’s why I continue to come down here when I’m not working cause I am a productive member of society today. You know, so whenever I get a chance to come down here, you know, the graduation or just stopping in and saying, look, I’m doing okay or even, you know, even if I have a problem or situation going on with myself I have these people I can come and talk to and that’s a great thing for me, you know, cause this is one of the things I didn’t do in the past was to tell people my problems. You know, I tried to resolve them myself, but now I know if I’m down this way and I got a problem I can call them or either stop in and that’s a great thing for me.

LEONARD SIPES: Now here’s the question I have for you. Having Judge Jackson up at that bench and interacting with the Judge, was that a factor in terms of your clean participation in the program, your full participation in the program? Because I’ve talked to a lot of people about drug courts in the past 25 years by doing radio and television shows and they told me or suggested to me that having that judge sitting up there and interacting with you on a regular basis, you did not want to disappoint the judge, you did not want to go through that process. So is there something that judges bring to the table that the rest of the system cannot bring to the table that gives you that extra push to get involved in treatment and make it work?

GENE: Well Judge Jackson wasn’t my presiding judge at the time but the judge that it was, was similar to Judge Jackson, you know, they gave you some guidance. And all at the same time it’s like when you do something wrong and your mother spank you, if it’s like, you know, you get chastised and things and, you know, give you a lecture. But you really have to be at your lowest point though, you know, to really, to say, hey look, I’m going to listen to what this judge say and the rest of the staff say because I’m tired of using drugs and alcohol.

LEONARD SIPES: I’m sick and tired of being sick and tired. But I’ve talked to so many people who have said to me throughout the course of my history and my career, I’m sick and tired of being sick and tired yet they find themselves in the criminal justice system. What’s the secret sauce behind Drug Court? What do you think is the real key ingredient that makes Drug Court work?

GENE: For one thing, you know, I can’t say enough about the staff. The way they treat you. You know, and I only can talk about myself, you know, the relationship that I had with my caseworker. And I feel that everyone needs someone to talk to you and especially a drug abuser or alcohol, that we need someone to talk to and establish a relationship with your caseworker and then the rest of the clients, you know, you establish a relationship with them, people who are serious about recovery. And, you know, you get their phone numbers and if you have any problem you can talk to them about or, you know, mostly you bring it to groups. But it’s so unique, it’s hard to try to explain these meetings that we go to or went to because I just can’t say enough about Drug Court.

LEONARD SIPES: Your Honor, I’m going to go back to you. Now, both of us have been involved in the criminal justice system for a long time. I find the stories of Gene and other people who have been through Drug Court and specialty courts inspiring. We’ve been exposed to so much failure within the criminal justice system. It’s nice to be exposed to this amount of success. How does it affect you personally?

HONORABLE GREGORY JACKSON: Well, you can’t help but be motivated and inspired and moved by the change that occurs in people and in their lives when they successfully complete the program. During the course of the time that I’ve been on the program I’ve seen people physically change. They go from being very unhealthy to being so healthy at times that when their attorneys see them later on they don’t even recognize them. We see people who have poor relationships with their families, with their friends, now all of a sudden their family and friends are back involved in their lives again. We see people who are very talented but their talent is masked by the use of drugs and all of a sudden that talent emerges. And we have people who are poets and artists and can do – capable of doing all kinds of things and they start to do that again. We have people who haven’t worked in years, if at all, now all of a sudden they’re employed and they’re doing well and they’re being productive in the community. So the Drug Court experience is a life-changing experience and I’m just honored to be able to be a part of that and to be able to participate in helping people change and improve their lives.

LEONARD SIPES: Because, the question can go to either one of you, we’re not just talking about the individual, we’re not just talking about Gene, we’re not just talking about Judge Jackson. We’re talking about that individual’s family, that individual’s friends, whether or not he or she works, whether or not he or she is a tax burden or a tax payer, whether or not the kids are taken care of properly cause virtually everybody caught up in the criminal justice system has kids to one degree or another. So this is not just a program, this is a life-changing event in the lives of people who otherwise could go on to be not just a pain in the rear to society but possibly a danger to society and possibly a danger to their own kids. This is where the rubber meets the road. This is fundamentally a changing experience in the lives of these individuals.

HONORABLE GREGORY JACKSON: That’s absolutely right. I routinely tell people who are before me that not only do they suffer from their addiction, but everybody around them, everyone close to them suffers from that addiction as well. And so as they get better everyone around them, the community gets better, the families get better, everyone gets better. And that’s one of the reasons why this process is so very important. The other thing that I think it’s important for people to understand is that one of the things that I think makes our program successful and probably works in other programs as well, we look at the underlying causes of the addiction. We talk and work with the individuals to identify what their triggers are. What we’ve discovered, or certainly what I’ve discovered since doing this in the last two years, that trauma and mental health play a big part in the addiction. So that as part of our program we’re not only working on people in terms of their addiction, we’re working on them to address sometimes trauma that hasn’t been diagnosed and treated forever, mental health issues that have never been diagnosed or treated. And so it’s a multifaceted process when we talk about the treatment that most of the program participants undergo.

LEONARD SIPES: I do want to get involved or explore that question a little bit more because I’ve been talking to people who have been through these sort of programs for years and they describe it as the hardest thing that they’ve ever had to do because they had to confront all those triggers that have lead them to be involved in a substance abuse issue. But we’re more than halfway through the program. Let me reintroduce both of you. Ladies and gentlemen, we’re doing a program today on Drug Courts, the Superior Court Drug Court Program here in Washington, D.C. We have before our microphones the Honorable Gregory Jackson, Associate Judge of the Superior Court of the District of Columbia is the presiding judge of Drug Court. And we have Gene, we’re just using his first name, he is a graduate of the Drug Court Program, again, here in Washington, DC, www.dccourts.gov, www.dccourts.gov and for our sister agency Pretrial, www.psa.gov. Those are the websites for the two agencies involved. Gene, I’m going to go over to you for that question that I asked right before the break. Is that people who are involved in substance abuse and go through the treatment process describe it as one of the scariest things they’ve ever had to encounter. People don’t understand how difficult drug treatment and mental health treatment is because you have to confront all of the things that you went through in life that triggered your addiction. Am I right or wrong?

GENE: That’s true. And the first thing, to start off, you have to be honest to yourself, that’s one thing, and be willing to talk about yourself and feel comfortable with the person who you’re talking to about yourself. Because we as drug addicts we don’t like to talk about ourselves. You know, we, I’m going to say myself, I put up a big image, you know, that everything is okay, you know, but it’s not. You know, so I found – that’s why I talk about my caseworker, how I got so close to her and this was a woman, that I became close to that me and her used to talk about everything. And when I came in I was broken down. I was broken down. I had a lot of health issues and had to miss some groups and everything but I went to her and I explained to her, look here, I got a doctor’s appointment and she said, okay, we’ll make up for this group. And, you know, she understood, you know. The way people look at me now when I came in I was a shade darker and me and her laugh at this now, when I came here I came in with my hair all knotted to my head, like I said I was a shade darker, I had a rope for my belt and I was dirty and I was stinky, but she didn’t turn her back on me. You know, so when I felt comfortable talking to this woman, you know, I got to telling her about everything.

LEONARD SIPES: But it’s the demons, I mean, how many demons did you have to face in life to get successfully through the process of completing Drug Court. I mean, all the triggers, all the different things that contributed to your substance abuse history, confronting those is a scary process.

GENE: Yes it is. Yes it is. You know, I was at my lowest point. I feel that what worked for me, you know, I was willing to do it. You know, I was the type person I used any type of drug it is. I don’t care what type of drugs it is, you say it would change my mood I would use it.

LEONARD SIPES: Right.

GENE: Because I didn’t want to deal with Gene.

LEONARD SIPES: Right.

GENE: But today, you know, I have people in my life that I can talk to, you know, so that’s really helping me to face a lot. Because it ain’t going nowhere, the same thing is out there but it’s the way I deal with it today.

LEONARD SIPES: So we’re not talking about criminal justice policy as much as we’re talking about, Your Honor, saving human beings. I mean, in decades before Drug Court Gene would have filtered in and out of the system endlessly. He would have picked up a stretch, a ten-year stretch and he would have gone off to prison and taxpayers would have had to pay that amount of money. And we can intervene in the lives of human beings through mental health treatment, through drug treatment, through other interventions and we can successfully take people who are struggling and who are either a danger or a pain in the rear to society and stop that process. We stop the revolving door. Is that right or wrong?

HONORABLE GREGORY JACKSON: I think that that’s right. And I think it’s important to recognize that over the years that science has taught us that addiction is, in fact, a disease.

LEONARD SIPES: Yes.

HONORABLE GREGORY JACKSON: And for a long time we treated it as just a behavioral choice. And so the thought was well someone’s choosing to behave this way. If we tell them not to and we punish them for doing it that will encourage them or force them to change and everything will be fine. Now we understand that, in fact, it is a disease. And you have to treat the disease of addiction just as you would treat any other type of disease. And so the emphasis has shifted, we now are focused on the individual. Our treatment process is individualized. Even in court, when I hold a hearing and I have individuals in front of me, each individual is treated separately and based on their unique situation. And so, and we try to allow for that, we try to accommodate that and we try to identify what’s different about this individual and what’s different about their needs and the way the disease is impacting them and how best can we provide the treatment they need to be better.

LEONARD SIPES: But I don’t want to oversell the process at the same time, you, as the presiding judge, need to be on that bench and read more than just a couple people the riot act. Because when they turn in that drug positive or that second drug positive or that third drug positive or they don’t show up at the meetings or they show up the meetings and they don’t contribute or they show up the meetings and act as a detriment to the group process. I mean, you’ve got to sit at that bench and look at that person eyeball to eyeball and start asking that person a series of very hard questions.

HONORABLE GREGORY JACKSON: That’s exactly right. And I think it’s important that I get an opportunity to do that. One of the big differences between Drug Court and what happens in a normal criminal courtroom is there is not that interaction between the judge and the defendant. In fact, in a regular criminal courtroom the judge will not talk to the defendant. The judge talks to the defendant’s lawyer. While there’s a defense attorney there, there’s a prosecutor there, they actually say very little. I’m able to actually personally engage the defendant because we’re not talking about their case. We’re talking about what’s going on with that individual. And I think that that helps, one, it lets the individual know that I’m engaged, involved and interested and concerned about their treatment and their recovery. It also lets them know that they’re a person, they’re a human being. And Mr. Gene’s point is very important because we do want people to know that they can participate in the program, that they have dignity, we do respect them and we’re there to help them and they’re safe.

LEONARD SIPES: They’re safe but at the same time the secret sauce in so much of the success in terms of the specialty courts seems to be the judge, seems to be the judge who gets personally involved in the life of that person. And also at the same time I think judges carry a greater sense of power than those of us in the rest of the criminal justice system. Police officers can say what we want to say, pretrial folks can say it, parole and probation agents, what we call community supervision officers here in the District of Columbia, can say it, but there’s something about the judge saying it that sometimes scares the bejebees out of people and makes them take their treatment process serious. Do you agree with that?

HONORABLE GREGORY JACKSON: I absolutely agree. And sometimes I have to remind individuals that I am the judge and that I have the power and the authority –

LEONARD SIPES: To send them away.

HONORABLE GREGORY JACKSON: To send them away. And it’s necessary to do that. It doesn’t actually, you’d be surprised, it doesn’t happen often, that they get it and I don’t have to remind them of it. But there are sometimes individuals, particularly in their early stages of the program who have to be reminded of the fact that this is a courtroom, I’m the judge and I do have the authority to impose significant sanctions if they don’t participate.

LEONARD SIPES: I’ve just been told by other drug court graduates, not just here, but in the state of Maryland and elsewhere that it was the judge, Gene, that s was there and simply said if you don’t comply here are the consequences. You’ve had three positives, I will not accept a fourth. That seems to carry more cache, that seems to carry more weight than coming from a parole and probation agent or a pretrial supervision officer’s point of view. Having the judge say it seems to carry the word of I don’t mean to be blasphemous here, but the word of God.

GENE: That carries weight.

LEONARD SIPES: Yeah.

GENE: That carries weight when the judge says that and that is very scary. Then you have the choice to make, do I want to continue using drugs or do I want to go to jail, you know. One thing I have to say this also though, right, you get, in Drug Court, and the judge don’t always talk about jail, he’s giving you instructions towards life, what you can do to better yourself. And even the caseworkers give you the same – they’re giving you instructions, you know. It’s not so much of we’re going to lock you up though, it’s so much instruction of how you can better yourself. And that’s where pursued it, you know, and that’s what helped me because I was at my, like I said, I was at my lowest point and I was willing to change.

LEONARD SIPES: Five minutes left in the program. Your Honor or Gene, where do we take the discussion in terms of Drug Court? You know, the sense that I get is that we could, if we doubled, tripled, quadrupled the opportunity for people to be involved in Drug Court, we could substantially lower the rate of recidivism, we could lower the burden on taxpayers tremendously. The District of Columbia has had a fairly significant reduction in crime over the course of the last ten, 15, 20 years and some people have attributed that to the fine work of the metropolitan police department and other law enforcement agencies. Some people have attributed that to pretrial and court services and offender supervision agency, but I get the sense because of the specialty courts within the Superior Court that you guys can take a lot of credit for the crime reduction within Washington D.C. Am I right or wrong?

HONORABLE GREGORY JACKSON: I’d like to think that that’s true, although it is very much a collaborative effort on the part of all the different agencies that you’ve named that has resulted in, I believe, the reduction of crime in D.C. But hopefully we’re playing an important role and we think that we are. I think that it’s important that, again, we go back to the point of as the people who participate in the Drug Court Program get better, their families get better, their communities get better. Other people see them and the example that they now set in terms of the lives that they lead and they too want to get better. So it has a ripple effect on the whole of the population that is effected by the addiction that we encounter.

LEONARD SIPES: Because the average person within the criminal justice system, if you take a look at national statistics, they don’t get drug treatment, the average person caught up in the criminal justice system, the average person on parole and probation, the average person on pretrial, the average person incarcerated. I was just taking a look at data the other day is saying that the great majority of people in prison who have mental health problems do not get mental health treatment. And you provide mental health treatment as well as drug treatment.

HONORABLE GREGORY JACKSON: We do. And we look at healing the whole individual. So when you talk about addressing an individual’s addiction you have to talk about all of the things that are contributing to and impacting that addiction and very often there are health issues. We have had people who because of physical conditions were using drugs to kill the pain, dull the pain. And so we refer them for medical treatment and once they start to take better care of their health, then their need for painkillers, for the drugs, it goes away.

LEONARD SIPES: Gene, in the final minute and half of the program, what would you say to other people who are going through life and considering the Drug Court Program if they have an opportunity to be involved in the Drug Court Program, what’s your advice to them?

GENE: Give yourself a chance, you know.

LEONARD SIPES: So many people have given up. So many people say I cannot shake my addiction.

GENE: Well, you know, a lot of people would say it because they don’t want to. But, you know, one of the biggest problems, I think a lot of people revert back to drugs and alcohol is because of employment, you know, that’s one of the biggest problems.

LEONARD SIPES: Lack of employment?

GENE: Lack of employment.

LEONARD SIPES: Okay.

GENE: You know, because they figure that, you know, hey, these people is not going to hire me because of my background, but you can’t give up. I didn’t give up though and you’ll be surprised where I’m at as far as job wise today. So that’s what I would say, one of the biggest problems is employment, you know, and I’d like to say something about what Judge Jackson said. It brings your family back to you, you know, because it brought my family back. My daughters were out of my life for years and my daughters are back into my life, you know, and I wouldn’t give this up for the world, you know.

LEONARD SIPES: Judge Jackson, the final word. So for everybody listening to this they should invest in Drug Courts, that’s the bottom line.

HONORABLE GREGORY JACKSON: I would encourage the various jurisdictions that don’t have Drug Court Programs to really get serious to starting a Drug Court Program.

LEONARD SIPES: Ladies and gentleman, we’ve done a program today about Drug Courts here in the District of Columbia through the superior court. Our guests today have been the Honorable Gregory Jackson, Associate Judge, Superior Court of the District of Columbia. He is the presiding judge for Drug Court and Gene, we didn’t use Gene’s full name or last name but he’s a graduate of the Drug Court Program. To both of you, thank you very much. Ladies and gentlemen, this is DC Public Safety, we appreciate your comments and we even appreciate your criticisms. And we want everybody to have yourselves a very, very pleasant day.

Filed Under: Drug Court, Drug Treatment Tagged With: drug court

Reinventing the Criminal Justice System-Justice Reinvestment-Urban Institute-DC Public Safety

March 7, 2013 by CSOSA

Welcome to “DC Public Safety” – Radio and television shows, blog and transcripts on crime, criminal offenders and the criminal justice system.

The portal site for “DC Public Safety” is http://media.csosa.gov.

Radio Program available at http://media.csosa.gov/podcast/audio/2013/01/reinventing-the-criminal-justice-system-justice-reinvestment-urban-institute-dc-public-safety/

[Audio Begins]

Len Sipes: From the nation’s capital, this is DC Public Safety. I’m your host, Leonard Sipes. Today’s program, ladies and gentlemen, is Reinventing the Criminal Justice System, Justice Reinvestment; I think one of the more important topics that we’re going to be discussing and one of the more complicated topics we are going to be discussing this year. Dr. Nancy La Vigne, Director of the Justice Policy Center for The Urban Institute is our guest today. – www.urban.org. We’ll be making reference to that website throughout the program because, ladies and gentlemen, this is, again, an extraordinarily difficult concept to understand, complicated but unbelievably important to the future of the criminal justice system. I’ll try to summarize it and then turn the entire program over to Nancy. Number one, states and locales all throughout the country are complaining of budget cuts, and it really has impacted the criminal justice system. And I’ll read a passage, a quick passage from a publication, “What can county and city managers do reduce these costs without compromising public safety, they can engage in Justice Reinvestment. Justice Reinvestment can help prioritize local justice spending for those who pose the greatest risk to public safety while also informing which individuals would be better off in the community, where services and treatment are more readily available.” And then bottom line, I’m thinking, about Justice Reinvestment are the savings. If there are savings, a portion of those savings go back to the states and local jurisdictions to even provide more programs. Nancy, am I somewhere in the ballpark of even beginning to describe what Justice Reinvestment is all about?

Nancy La Vigne: Yes, you are, and you did it quite succinctly, I will say. It’s a multi-step process and so it does take some time to explain but perhaps we should start with a little bit of history. You did refer to the fact that the impetus behind a lot of states and localities getting on the Justice Reinvestment bandwagon is because of the budget shortfalls, and that’s definitely accurate, but there were other issues as well. First of all, as I think we all know, a lot of those budget shortfalls are being fed by rising criminal justice costs. They may not be the entire – as a matter of fact they’re a rather small, 8% to 10% of the total state budget in any given state but still we’re talking about hundreds of millions of dollars so with states and localities thinking, “What can we do? How can we save money? How can we deal with these budget shortfalls,” it’s a natural inclination to look at the criminal justice system because those costs continue to rise because the populations have been rising historically. Now you may be aware of recent studies that show that state prison populations are on the decline but actually, as my colleague Jesse Jannetta recently blogged about, that’s driven almost entirely by California.

Len Sipes: By the state of California, that’s right, and those overall declines are not all that dramatic.

Nancy La Vigne: They’re marginal, but states realize that this is an issue and they’ve been grappling with it for a while, and many have tried different efforts to control the growth of the prison population that have been maybe mildly successful but not sustained over time, and arguably it’s because they haven’t engaged in this Justice Reinvestment process which requires a couple of things to be place. First, you need to have all the people in the system, all the key stakeholders at the table and on board. If you only work one end of the system, it’s just going to bulge out somewhere else kind of like squeezing a water balloon so you need everyone at the table. At the state level, it’s critical that you have representation from both sides of the aisle, and you’ve got the support of the Governor and the House leadership, the Senate leadership, minority, majority, as well as the Head of the Department of Corrections, and parole and probation and so forth, and judges, prosecutors, everyone who drives the system. If you don’t have them all on board, it’s not going to work because either changes will be made and they’ll be fought and they won’t get through or they won’t be sustained over time because you don’t have this joint buy-in.

Len Sipes: You’re as good as your weakest link.

Nancy La Vigne: Exactly. Exactly. Some of those weak links are quiet powerful, as you may know.

Len Sipes: Yes! Yes!

Nancy La Vigne: So there’s that. It’s having the right people at the table. And then it’s guiding the decision-making process with hard empirical data, and that data is often supplied by the state or the locality but typically in the Justice Reinvestment model, it’s analyzed by a technical assistance partner, funded by the Bureau of Justice Assistance, U.S. Department of Justice, Office of Justice Programs —

Len Sipes: Thank you.

Nancy La Vigne: — in partnership with the Pew Center on the states for the state-level initiative, they together have funded this initiative and supported four technical assistance providers, two that work with states, two that work with localities. I can share who those are if you wish.

Len Sipes: 17 states are doing this?

Nancy La Vigne: 17 states right now are engaged in this process. Some states early on have already engaged in the process and declared victory and moved on. A lot of people point to Texas as an example of that. They were the earliest adopter I can think of, and they were looking towards the future and had planned to spend billions of dollars on new prison construction —

Len Sipes: And did not.

Nancy La Vigne: — and did not. They chose not to.

Len Sipes: And the crime rates have basically gone down in Texas.

Nancy La Vigne: And they took some of the money they would have spent on prisons and funded treatment beds.

Len Sipes: And that is the heart and soul of Justice Reinvestment, is it not? – Using data, doing things differently. If there’s cost-savings, those cost-savings are shared with the states and localities, and they buy more treatment options for people in the criminal option system.

Nancy La Vigne: That’s the way it’s been playing out, not only treatment options or programming. Sometimes it’s to shore up supervision. In some states they’ve identified that the wrong people are being supervised and some people are not being supervised at all so, you know, folks who are maxing out and are exiting after often serving time for pretty serious crimes without any supervision, and of course with supervision comes support. It’s not just about surveillance; it’s about support and providing the necessary programs and services, so shifting who gets supervised, how long they get supervised. You know, some low-level offenders perhaps shouldn’t be supervised at all or certainly shouldn’t be supervised for the length of time that they are. That can save money. But also with those savings, putting it into implementation of graduated sanctions to prevent revocations and other best practices that are supported by evidence.

Len Sipes: One other person – I won’t name this person – this is what he told me, not knowing it, but he said it with all the conviction in the world, that every governor in every state in the United States has had a discussion with his or her Correctional Administrator basically saying that costs have to be reduced. That was his proposition.

Nancy La Vigne: So do you know what I find really frustrating about that?

Len Sipes: Please.

Nancy La Vigne: The assumption that the head of the DOC has control over that population. I mean yes, they are housed within his or her domain or control but that suggests that they’re the ones that drive the growth in the population, and what we’ve learned from the experiences in the states is that’s not really the case.

Len Sipes: True.

Nancy La Vigne: Revocations, often technical revocations, are driving that growth.

Len Sipes: That’s why everybody’s got to be on board.

Nancy La Vigne: Sentencing decisions, sentencing low-level drug offenders, low-level property offenders to increasingly lengthy terms behind bars – that’s not under the control of the head of the DoC. That’s a decision that prosecutors and judges make.

Len Sipes: But after 42 years in the criminal justice system, we are stodgy. We are bureaucrats. We are round-peg in a round-hole kind of people. We’re not used to people coming along and saying, “We’re going to basically readjust/reinvent/change the way that you conduct business.” The criminal justice system, when I joined when I was 18 as a cadet for the Maryland State Police, is basically 90% of the criminal justice system I see as I’m looking at the end of my career.

Nancy La Vigne: Yeah, and I agree with that. You are stodgy. However – however – when you look at this process, how it plays out in action, it’s a wonder to witness. The Urban Institute is in a role as the oversight coordination and assessment entity for this project so we get to kind of go to all the states and localities and observe how this works, so the Counsel of State Governments, for example, they’ve been leading the charge on the state side. They literally embed people in a state and develop the relationships and share the data and engage in intensive policy conversations and work a tremendous amount of time behind the scenes, getting people on board, educating people, identifying folks that may be reticent to get on board, and finding ways to persuade them that it’s not just in their best interests but in the best interests of the system. They are that neutral outside entity that can speak with authority based on extensive experience working in many states, and presenting the data that can just kind of dispel a lot of the anecdotes that you hear that nay-sayers often argue based on stories rather than fact. They can demonstrate how it is a system-wide problem not just owned by one player, and that can really nudge some stodgy people into action.

Len Sipes: Yeah. Yeah. Let’s give some examples because I’m afraid some of our listeners possibly could be confused with the process. We are talking about in essence focusing our resources on those people who pose the greatest risk to public safety and doing “something else” with those people who do not necessarily pose a great risk to public safety.

Nancy La Vigne: Well, that is one of the many interventions that states have chosen to implement. Really, the interventions should be guided by the identified drivers of population growth so in some states it may be one driver and in some it might be another, and across the 17 states, the most common drivers are revocations, both probation and parole revocations, and a high, high percentage of them being technical.

Len Sipes: In your report, you cited one state with 50% as having histories of parole and probation revocations coming in through their prison system. I spent 14 years with the Maryland Department of Public Safety and Correctional Services. At one point for us it was 70%.

Nancy La Vigne: 70%.

Len Sipes: 70%, yes it was.

Nancy La Vigne: Well, I would call that low-hanging fruit. There’s a lot that could be done there. So certainly with the revocation issue, the response to that is to look at what sanctions are in place, do people need to be returned to prison for technical violations, can you create graduated sanctions, can you create incentives for not engaging in technical violations, can you return people for shorter periods of time or return them to local jails rather than to state facilities. All of that saves a ton of money.

Len Sipes: And Project Hope basically said those short, meaningful interventions of a day or two days or three days were effective enough to dramatically reduce recidivism, dramatically reduce technical violations. It was wonderful across the board. So Project Hope is the epitome of an example as to the effectiveness of that approach.

Nancy La Vigne: That’s exactly right, and several of the states who are grappling with high revocation rates did choose to implementation Hope models or Hope-like models. That’s exactly right. But then there’s other drivers, and I mentioned before, sentencing practices and the incarceration of low-level offenders. In Louisiana, for example, non-violent, non-sex offenses represented over 60% of prison admissions so, you know, what can we do with that population? Some may need to go, some may could be diverted, and also what’s stunning to me is that there’s also been a trend in many states of increased lengths of stay for these low-level, non-violent, property and drug offenders So that’s another place where you could look to see making changes. Sentencing reform is tremendously challenging.

Len Sipes: It’s a huge issue.

Nancy La Vigne: It’s very challenging, so most states don’t choose to go the sentencing reform route. They usually look at some kind of back-end way to – although some do pass statutes to change the thresholds by which people should be —

Len Sipes: The research on specialty courts has been very encouraging, diverting people out of the prosecution prison route and going into the specialty courts, and specialty courts have had good returns basically in terms of recidivism and cost-savings.

Nancy La Vigne: Um-hum, uum-hum. It’s true, and then another common driver we observed across states is the issue of delays in parole processing or reductions in the parole grant rate, and these too are relatively simple changes, figuring out what’s slowing things down and how can you speed them up, or how can you change or guide parole boards in a way that they’re incentivized to make decisions to grant parole, perhaps supported by evidence, and the most obvious evidence would be a risk assessment that gives them more comfort in knowing who they should release. In other cases, the parole grants get stalled because people don’t have a home plan. Well, that is an issue of resources often behind bars. If you don’t have a case manager that can help line up a home plan then no one gets released, and then you have this backlog which is really unnecessary.

Len Sipes: And the interesting data in terms of parole is that those paroled have consistently much less of a rate of recidivism than those not paroled, so fewer people coming back to prison, once again, as long as they are released with conditions and those conditions are enforceable.

Nancy La Vigne: Exactly.

Len Sipes: So what else?

Nancy La Vigne: What else?

Len Sipes: It’s very complicated.

Nancy La Vigne: Yes. Well, so what’s complicated about it is how long it takes to explain why it’s called Justice Reinvestment because up till now what we’ve discussed is data-driven, collaborative approaches to reducing the prison population and saving money through identifying the drivers and developing responses to the drivers. Where does this word “reinvestment” come in?

Len Sipes: Yes.

Nancy La Vigne: That comes in at the very, very end with the anticipated savings associated with making all these changes. Now this is very complicated because the savings might not be hard cold cash that you have in your hands and you can put elsewhere, as a matter of fact it’s rarely that. A lot of the savings are projected savings that aren’t realized until several years into the future however the process still encourages states to think about upfront reinvestment. So in looking at prison projections had they done nothing and then the projections associated with the changes that they plan to make, they can anticipate that, you know, five years down the road they’re going to save however many millions of dollars – why not reinvest some of that upfront into programs, supervision, services that help support the entire system and reduce recidivism?

Len Sipes: So the reductions in terms of the cost outlays to the criminal justice system are actually reinvested to make the system even better, so it’s a win-win situation across the board.

Nancy La Vigne: Um-hum.

Len Sipes: All right. Let me reintroduce you, and ladies and gentlemen, we’re a little bit more than halfway through the program. We’re talking about reinventing the criminal justice system – that’s my title – Justice Reinvestment, Nancy La Vigne, Director of the Justice Policy Center, Urban Institute, www.urban.org – www.urban.org. Again, we reemphasize that this is a joint project of the Bureau of Justice Assistance, the Office of Justice Programs, U.S. Department of Justice, the Pew Center on the states and the – I’m sorry, the Centers for State Government, correct?

Nancy La Vigne: The Counsel of State Governments.

Len Sipes: The Counsel of State Governments, I’m sorry, my apologies, but this is a massive undertaking on the part of 17 states, a lot of different jurisdictions, with the understanding that people have been talking about reinventing the criminal justice system, doing “something different” with the criminal justice system for a multiple of reasons but budget, in my opinion, seems to be the principle driver behind all of this. People are more than welcome to disagree with my assessment but I do think it’s budget that’s pushing an awful lot of this, and this is exciting stuff because what it does is bring an awful lot of people in one room, data-driven, taking a look at an awful lot of data and saying, “What can we do to reduce the amount of people flowing through the criminal justice system without having an adverse impact on public safety and saving money and taking those savings and reinvesting those savings in terms of either more prosecutors, more parole and probation agents, more programs, more resources for the criminal justice system so they can do a better job to begin with so it can be data-driven in the future so we can continue this philosophy down the road, right?

Nancy La Vigne: That’s right – data-driven and evidence-based.

Len Sipes: Right.

Nancy La Vigne: Before we continue, I do want to acknowledge all of our partners in this initiative.

Len Sipes: Please. Please. Please.

Nancy La Vigne: We mentioned, of course, the Bureau of Office Assistance and the Pew Center on the States are the funding partners. The Counsel of State Governments and the Vera Institute of Justice have both been working with states, and the way that works is that the Counsel of State of Governments helps identify the drivers and the policy options, and gets states to the point where they pass legislation, and then Vera comes in and helps implement. And then at the local level, it’s the Center for Effective Public Policy and the Crime and Justice Institute that are working with counties across the country.

Len Sipes: Oh, lots of different people, lots of jurisdictions involved in this.

Nancy La Vigne: Yeah, a lot of players, a lot of very, very seasoned criminal justice professionals, often former practitioners and/or data analysts that come into states and localities and, as I said before, really embed themselves in the system, develop the relationships and the trust, and really make things happen.

Len Sipes: This is, in my mind, the most significant story of the criminal justice system as we move into the 21st century and yet it gets zero coverage. There’s nobody from the Boston Globe, there’s nobody from the New York Times, there’s nobody from the Washington Post, there’s nobody looking at this systematically, and yet this, in my mind, is a fundamental change in terms of how we within the criminal justice system operate. Why is that? Is it just a bunch of policy wonks sitting with a bunch of budget-cutters and saying, “Hey, what’s the best way we that can rearrange the deck chairs?” or is this really a substantive, hard-nosed examination of the fact that we can do this better without imposing so much of a fiscal burden on the states and counties and cities?

Nancy La Vigne: It’s definitely the latter because it’s not just budget-cutters and policy wonks. It’s all the key players in the system that have a shared interest in doing things differently and getting more bang for their buck. I mean, the return on investment has been really poor. If you look at the increased expenditures on corrections across the country —

Len Sipes: Massive.

Nancy La Vigne: — massive, with no real discernible change in the recidivism rate.

Len Sipes: But isn’t it interesting of how you take a look at conservative politicians – not to touch upon politics in any way, shape, or form – but conservative politicians are demanding that the criminal justice system prove its cost effectiveness, demanding that we get a bigger bang for our criminal justice dollar. I mean, I find that to be interesting.

Nancy La Vigne: This is why it’s been so popular an initiative, it’s because it garners support on both sides of the aisle. The left has always been more sympathetic to rehabilitation spending and perhaps diverting people from prison. The right has observed that this is not just a wise use of taxpayer dollars, and they do, they want to see a better return on the investment and that’s what we’re seeing. You know, we talked at the end of the first segment about the projected savings and how they get reinvested. Across the 17 states that are currently engaged in justice reinvestment, they’re projecting between 9 and 438 million dollars in savings.

Len Sipes: That’s amazing. Now is that per state or is that total?

Nancy La Vigne: An average of $163 million per state.

Len Sipes: An average of $163 million cost savings per state.

Nancy La Vigne: Yes. Um-hum. Yeah. It’s huge!

Len Sipes: Who’s getting the Nobel Prize for this?

Nancy La Vigne: I’d love to see it. Well, we have to see those savings, realized, right?

Len Sipes: Of course. Of course.

Nancy La Vigne: A lot of these are projections and we hope they’re accurate but even if they’re off by 50%, that’s still a tremendous savings. Across all the states, in five years the projected savings is $2.12 billion.

Len Sipes: $2.12 billion.

Nancy La Vigne: And that speaks volumes, I think.

Len Sipes: Well, it does speak volumes if we can hold down the rate of recidivism, if we can ensure public safety, if we focus on those people who pose a clear and present danger to our well-being.

Nancy La Vigne: Well, the beauty of this model is that a lot of the policy responses to the drivers of growth embody those principles. Every single state that engages in Justice Reinvestment is refining their risk assessment tools and validating them, and using them to guide decisions on diversion, on supervision, on everything including on needs and who should great treatment, and everything in between; and that is evidence-based, and we know that that’s tied to better outcomes in terms of recidivism rates.

Len Sipes: In essence what we’re saying is that there’s a certain portion of the population that comes into the criminal justice system, again, recognizing there’s been an almost continuous 20-year decline in crime per the National Crime Survey in crimes reported to law enforcement agencies and through the FBI, there is still a certain portion of the population coming to the criminal justice system that is better served from a public safety point of view and from a recidivism point of view not to process them in the way that we did ten years ago.

Nancy La Vigne: Um-hum. I think that’s right.

Len Sipes: And that’s taking risks, and that’s why a lot of the people at the local level, at the country level, are saying, “Well, why should we take those risks? Those risks have a way of blowing up in our face.” I think that would be the greatest point of reluctance. Why change it? Why take that risk? Why not simply incarcerate that person for a year or six months instead of putting that person into drug court?

Nancy La Vigne: Well, because it’s just not sustainable, that’s why. There’s just not enough room. There’s not enough money to build more prisons and so if you don’t make these hard decisions now, essentially you’re not making strategic decisions about how to use that space most wisely. You want to free up that space for folks who are really a danger to society but if you don’t make hard decisions about who needs to be in and who shouldn’t be in, those decisions should be backed up by risk assessment tools, then you’re actually engaging in really bad practice.

Len Sipes: And isn’t California the poster child for this whole movement where the courts have ordered the release of tens of thousands of offenders from their prison system in California because of the fact that they could not fund properly their health care system? – And they’ve released massive numbers of offenders, and that’s what we’re trying to avoid.

Nancy La Vigne: Right. Exactly. When you said “poster child” I paused for a section. “No, no, don’t hold up California as the example of Justice Reinvestment!”

Len Sipes: No, no, no, I’m not. I’m not.

Nancy La Vigne: No, this is what could happen to you if you don’t engage, yes. Right. Absolutely.

Len Sipes: If you don’t. Right. Right. Right. There are consequences for not managing your population better. There are consequences for not managing your dollars better.

Nancy La Vigne: Exactly.

Len Sipes: And states, I mean, and one state that you looked at in terms of one of our reports, 12% of their overall budget was the state correctional system. That’s astounding!

Nancy La Vigne: That’s right, I think that was Oregon.

Len Sipes: That’s astounding, that 12% of the budget is Corrections. It raised from I think 4% to 12% in terms of the various states but you’re talking about billions of billions of dollars, and if you can divert individuals from coming back into the criminal justice system, you are saving literally billions dollars in terms of future prison costs, building and operating those prisons. That doesn’t have to happen if you manage your population carefully.

Nancy La Vigne: Couldn’t have said it better myself.

Len Sipes: Okay, but we can, through a data-driven process, assure people that this is not going to have an adverse impact on their public safety.

Nancy La Vigne: Again, states, localities, are using risk-assessment tools – some, not all. The ones they are using are not always validated which means they’re not always accurate. By using these tools, and using them in a way that can guide decision-making, I think that they should have confidence. I have confidence that this is no threat to public safety, in fact it’ a wiser and more efficient use of scarce criminal justice resources.

Len Sipes: Right, and the alternative is billions, billions, billions more or the alternative is what’s happening in California with tens of thousands of offenders court-ordered release so if we don’t manage our resources carefully, if we don’t make data-driven decisions, evidence-based decision, we’re not serving the public.

Nancy La Vigne: That’s right, and getting back to the concept of reinvestment, the ways in which states and localities are looking to reinvest a fraction of the savings is in evidence-based programs that are designed to reduce recidivism so you really are getting at recidivism reduction in two ways. You’re getting at it through better use of risk and needs assessments and you’re getting at it through enhanced programs to help people succeed on the outside.

Len Sipes: Um-hum, and that goes all the way from who do you prosecute to what programs do you provide at the end of it because the criminal justice system has done basically a terrible job in the opinion of many in terms of I think, what, 10%, 12% of people get substance abuse treatment while in prison. The numbers for mental health treatment are even smaller. The percentage getting mental health and substance abuse treatment on community supervision is also small, and that’s come back to bite us.

Nancy La Vigne: Yeah.

Len Sipes: To a certain degree, that’s not cost-effective.

Nancy La Vigne: Agreed.

Len Sipes: And the numbers need to drive that in terms of that larger policy discussion with hard-bitten criminal justice people like myself.

Nancy La Vigne: That’s right. We’ve got to get you out of your stodgy ways, Len.

Len Sipes: I would love to do a bit of the fly-on-the-wall for so many of those meetings where people are saying, “Hey, if we don’t do this, we just have the courts release lots of people, and we don’t have the money to continue doing what we’re doing.”

Nancy La Vigne: Right.

Len Sipes: Yeah, it’s a fascinating thing. I really applaud Urban, I really applaud all the partners, and I applaud the Department of Justice of really trying to take a really unique and different approach, and this is why I called the program Reinventing the Criminal Justice System through Justice-Free Investment. Ladies and gentlemen, this is DC Public Safety. Your guest today has been Nancy La Vigne, Director of the Justice Policy Center of the Urban Institute, www.urban.org – www.urban.org. And we thank everybody for their time and efforts in terms of all the input that you provide for the radio shows here at DC Public Safety. We appreciate your calls. We appreciate your letters. We appreciate your emails, and we want everybody to have themselves a very, very pleasant day.

[Audio Ends]

Filed Under: Audio Podcast, Budget Issues, Corrections-Prisons, Courts, Drug Court, Drug Treatment, Education and Vocational Assistance, Employment, High Risk Drug Offenders, Interviews with Policy Makers, Mental Health, Parole and Probation, What Works Tagged With: Justice Reinvestment, Urban Institute

What Works in Offender Reentry-The Urban Institute-DC Public Safety Radio

November 20, 2012 by CSOSA

Welcome to “DC Public Safety” – Radio and television shows, blog and transcripts on crime, criminal offenders and the criminal justice system. We currently average 90,000 page views a month.

The portal site for “DC Public Safety” is http://media.csosa.gov.

Radio Program available at http://media.csosa.gov/podcast/audio/2012/10/what-works-in-offender-reentry-the-urban-institute-dc-public-safety-radio/

[Audio Begins]

Len Sipes: From the nation’s capital this is DC Public Safety, I’m your host, Leonard Sipes. Back at our microphones is Nancy la Vigne, she is the Director of the Justice Policy Center for the Urban Institute. www.urban.org We’re here today to talk about what works in reentry and the fact that there are now, for the first time, actual websites, databases, that really do summarize the state of the art in terms of research in a variety of areas, what we have is crimesolutions.gov from the Office of Justice Programs, which gives research on a wide variety of criminal justice topics, including reentry but now we have another website that’s focusing specifically on reentry. It was launched by the Urban Institute and a Council of State Governments. The website is the “what works” clearinghouse for reentry. It’s at www. nationalreentryresourcecenter.org/whatworks .Nancy La Vigne, welcome back to DC Public Safety.

Nancy La Vigne: Thanks, it’s great to be here.

Len Sipes: Wonderful website. Is it in competition with crimesolutions.gov?

Nancy La Vigne: Not at all, in fact it’s very complimentary and bear in mind, both websites are funded by the Office of Justice Programs.

Len Sipes: There you go.

Nancy La Vigne: So we worked very closely with the developers of Crime Solutions to talk about methodology and the ways in which the sites will be different and not duplicative and in fact, they’re not, Crime Solutions, as you said, covers a wide array of crime and justice topics.

Len Sipes: Law enforcement, corrections, juvenile justice courts –

Nancy La Vigne: Right, right, exactly.

Len Sipes: You focus on reentry.

Nancy La Vigne: Yeah, we take more of a deep dive approach and whereas Crime Solutions only looks at what they’re calling brand name programs, we’re looking at all evaluations across a wide array of programs related to reentry. And as you know, reentry is a very broad topic in and of itself, so we’re looking at a wide array of different types of reentry interventions and summarizing the research findings across those types. So: employment, mental health, housing, juvenile justice.

Len Sipes: Nancy, you’ve been around for quite some time. I mean, you are the Director of the one of the most prestigious research organizations in the country, if not the world. Why did it take us so long? I remember talking to the former Assistant Attorney General, Laurie Robinson, who said that we are going to do this, we are going to start summarizing the research, we’re gonna start making it easy for practitioners. Why did it take us decades to do this?

Nancy La Vigne: Well, I think in the case of the reentry topic, it took a real awareness and sense of urgency by members of Congress to fully fund reentry in all its aspects and that came with the Second Chance Act. And the Second Chance Act funded the National Reentry Resource Center, which of course, is run by the Council of State Governments and when we partnered with the Council of State Governments, we knew that CSG, as they’re called, was very well equipped to provide technical assistance and that we could provide some research value and the way we saw the best way to add value was to cull all the research on reentry and make it accessible to practitioners. So that’s what we set out to do.

Len Sipes: I just want to state, for the record, that I think that it’s been very frustrating for those of us in the practitioner community because we’ve been waiting decades for this and it’s here. In terms of crimesolutions.gov and in terms of your website, I mean, it’s taken a long time to make it easy for practitioners and policy makers to follow the research.

Nancy La Vigne: I think that’s right and you know, when you look back, even a decade ago, there were two statements that were made as fact. One is: we don’t know what works. And the other was: well, we might know what works but the “we that know it” are a bunch of academics that do nothing more than talk to each other and publish for each other.

Len Sipes: Right.

Nancy La Vigne: I was of that second school of thought, which is that, you know, being an academic myself, I was aware of what was out there, I knew that there were evaluation studies that showed that certain types of reentry programs worked, but they were largely inaccessible. Sometimes inaccessible to me. You know, the methodology’s extremely complicated, the way the studies are presented are really more to show off the methodology off and rather than to illustrate the findings and the implications of the findings for policy and practice.

Len Sipes: My heavens, that’s a bias I’ve had for years. I’m glad you expressed it. Here’s the example that I give to everybody else. I remember being the Director of Public Information for the Maryland Department of Public Safety and the Secretary of Public Safety comes in with a sour look on his face and he’s got a document from the Department of Justice, and he plops it on my desk. And he goes, “Sipes, I want a one page summation.” And then he goes to the doorway and turns around and points his finger at me and goes, “Now did you hear me? A one page summation. I don’t care about the methodology, I don’t care about the literature review, I don’t have time to wade through this. I simply want to know, did this work, what are the policy implications and how we can implement it here. One page.” And he reminds me, again, “One page.” So simplicity is next to Godliness in terms of the transfer of information.

Nancy La Vigne: Yes, exactly. And you know, and one page is often, for a busy decision maker, too much. They want the bottom line, and that’s what we need to give them.

Len Sipes: And I think that’s what the both organizations, both websites do, is provide that summation. www.nationalreentryresourcecenter.org/whatworks So, did we cover the website enough or are there more points that you want to make before getting into what the research says?

Nancy La Vigne: Well, sure, no, I would like to talk a little bit about the website and the methodology because I don’t want to overpromise on what this is.

Len Sipes: Please, okay.

Nancy La Vigne: And the reason I can’t overpromise is because I think that the research community has largely failed us and I say that because of the work that we had to do to winnow through all the evaluative research out there to get this much, much smaller subset of studies that we felt met methodological rigor enough that we could include them. And so, just to give you a few statistics, we identified roughly 2500 individual publications –

Len Sipes: Oh my heavens! 2500?

Nancy La Vigne: That called themselves evaluations and were on various topics of reentry which is to you know, prepare people for release from prison or jail, and tracks reentry outcomes. So it doesn’t just track infractions behind bars, for example. Of those, we screened out almost 1500 as irrelevant for a variety of purposes.

Len Sipes: Okay.

Nancy La Vigne: They weren’t really serving a reentry population; they weren’t really relevant outcomes for a reentry topic.

Len Sipes: Right, right.

Nancy La Vigne: Some other reasons, so we have around 1000 that were potentially relevant. Of those, only 276 met our standards for rigor.

Len Sipes: 15000 to 276?

Nancy La Vigne: Yeah.

Len Sipes: That’s amazing.

Nancy La Vigne: Now, there’s more that we’re still in the process of reviewing, but I would say that for every, easily every 10 we review, eight get winnowed out because they’re just not strong enough as studies.

Len Sipes: Okay, and without getting into a methodological review or discussion, it’s just that, that the findings and the way that they went about getting their findings just wasn’t strong enough to hold the confidence of their findings.

Nancy La Vigne: Right, but how do you know this if you’re a practitioner trying to figure out what works?

Len Sipes: Right.

Nancy La Vigne: You just go to you know, you find a study online, you find a series of studies, they say that they have positive outcomes and then they take it at face value, and why wouldn’t they?

Len Sipes: Sure, of course.

Nancy La Vigne: So I feel like that’s one way we’re really adding tremendous value is to winnow through all of this supposed knowledge –

Len Sipes: Amazing.

Nancy La Vigne: Down to really what we can say with confidence, seems to be the findings. Now, not all of those studies, once you winnow them down, show that reentry interventions work.

Len Sipes: Right.

Nancy La Vigne: Many are inconclusive and a lot of our findings suggest that more research is necessary.

Len Sipes: Right.

Nancy La Vigne: But, so I want to be clear. It’s a lot of work that boils down to you know really just, you know, tens of studies that end up on the website. The ones that you see will be relevant, will have met these methodological standards and you can have faith in that they’re saying something meaningful. So I think that that’s really important and I wanted to make sure that your audience understood both the value of the website but also the limitations because of the lack of good quality research that’s out there.

Len Sipes: So the bottom line in terms of what’s there, it can be trusted.

Nancy La Vigne: It can be trusted.

Len Sipes: Okay, the larger issue, I talked to a couple reporters a couple weeks ago, and we were talking about the state of research in terms of offender reentry and one of them said that, “You know Leonard; there are a lot of failed research programs out there.” And I said, “Well, you know, there’s a lot of hope and there’s enough evidence, there’s enough good evidence that we believe that we’re moving in the right direction, that we believe that if you take a look at drug courts in particular and you take a look at GPS in particular, you take a look at substance abuse, if you take a look at preparation in prison, that, that you’re getting fairly consistent, good findings that are methodologically correct, well done evaluations.” So I think there’s enough promise that leads us to believe that we can cut recidivism rates and I’m not saying 30% or 40% but at the moment, somewhere between 10 and 20%. But I point out that out of 700,000 people coming out of the prison system every year, if you cut that down from 15 to 20%, you’re saving billions of dollars and you’re saving victims from hundreds of thousands of victimizations.

Nancy La Vigne: That’s right, and I would agree with you. There’s certainly enough evidence out there to suggest that these programs are worth continuing to fund and support.

Len Sipes: But what do we say to practitioners when they go to your website, because they go to crimesolutions.gov, they go to your website and what it does seem to say is that promising, promising, promising, promising and you’ve got three or four at the top with the green indicators saying that they did reduce recidivism and you have some down at the bottom with the red – you have a color coded system, which makes it real easy, and some fairly prestigious evaluations didn’t seem to have that much of an impact.

Nancy La Vigne: That’s right.

Len Sipes: The Serious and Violent Offender research comes to mind. So the person takes a look at this and again, the word promising comes to mind.

Nancy La Vigne: Yeah, I mean I think that’s right. And I think that much depends on the population and the nature of the intervention and the fidelity with which it was implemented, which was something that we’re having a very difficult time assessing based on the studies. The studies rarely look at issues of the design and implementation of the program. So if you don’t do that, and you say a program doesn’t work, you don’t know if it doesn’t work because the concept was flawed, or because it wasn’t implemented properly.

Len Sipes: Right, right.

Nancy La Vigne: And so we’re saying it doesn’t work, which is really an unfair indictment on a concept that could be very theoretically sound and could work under better circumstances.

Len Sipes: So we’re going to repeat what Joan Petersilia of Stanford said that what we do too much of at a National Institute of Justice conference, was that we overpromise and deliver too little in community corrections. That seems to be true to some degree, but people need to understand that this Rome was not built in a day. I mean, these are thousands of pieces of research, cumulatively speaking, seem to be saying that we’re moving in the right direction. So for those out there who are saying, hey, we can dramatically cut recidivism, that doesn’t seem to be supported by the literature but I’m talking about 30% and above. That’s not supported by the literature.

Nancy La Vigne: No, it’s not.

Len Sipes: And we shouldn’t be, as advocates –

Nancy La Vigne: It’s an unrealistic goal, and if we have goals like that, we’re setting ourselves up for failure and that’s just no way to go.

Len Sipes: And that was her point. I think her point was was that don’t overpromise because there’s a certain point where the States are going to be well funded again and then they’re going to have to make a decision as to whether or not to continue to build more prisons and if we overpromise, we inevitably invite our own demise.

Nancy La Vigne: Well put.

Len Sipes: But I mean, that’s serious stuff, but at the same time, you know, I travel throughout the country, I work with principally public affairs people, they’re enthused about this. They’re enthused. Most of the people representing parole and probation agencies, most of the people representing correctional agencies, I was doing some training for the National Institute of Corrections and had a chance to talk to directors of public affairs for various states who not only do mainstream prisons, but they also do parole and probation. They’re very happy to be exploring opportunities of doing something else besides putting the person away for 20 years. They’re not saying, you know, “Let’s let’em out.” They’re not saying, “Let’s not incarcerate them.” But what they are saying is is that we certainly can really have an impact in terms of them coming back. So there’s an enthusiasm and and optimism out there nevertheless.

Nancy La Vigne: Oh, I would say so, and it’s interesting. You referenced how long I’ve been in the field. Thanks for showing off my age to your audience.

Len Sipes: I thought you were 25.

Nancy La Vigne: But you know, we’ve both been around for a while, and when you think about it, if you look back, even, you know, a decade or you know, 15 years ago, I would say the large majority of directors of departments of corrections across the country did not view it as their responsibility to do anything to prevent people from returning to their prisons.

Len Sipes: We were told, when I was with the Maryland Department of Public Safety, we had three correctional systems, we were told our mission was to constitutionally incarcerate. The parole and probation side of it, we were told that our mission was to enforce the provisions set by the courts and to enforce the provisions set by the Parole Commission. That was it. There was no mention of recidivism, there was no mention of best practice and there was no mention of intervention. None.

Nancy La Vigne: Yeah, we’ve come a very long way.

Len Sipes: Where the average correctional administrator wants to do these things, for a variety of different reasons. So the whole idea is to supply programs that are meaningful and evidence based within the correctional setting and to continue that when they come out.

Nancy La Vigne: Yep.

Len Sipes: And there is evidence that shows in some cases, you get some fairly decent reductions and I’m saying again, to be on the safe side, somewhere between 10 and 20%.

Nancy La Vigne: I think that’s safe to say.

Len Sipes: I wanted to give the resource center, the address one more time. We’re halfway through the program. www.nationalreentryresourcecenter.org www.nationalreentryresourcecenter.org My guest today is Nancy la Vigne. She’s the Director of the Justice Policy Center of the Urban Institute, www.urban.org. www.urban.org, and I do also want to talk at the same time about the Crime Solutions data base, funded by the Office of Justice Programs of the US Department of Justice. They are at crimesolutions.gov, and again, Office of Justice programs supports this particular reentry resource center endeavor as well. Where do we go to from here in terms of the research? I mean, part of it is the frustration that the research hasn’t been good enough, hasn’t been rigorous enough and so the message needs to go out to the research community to do better?

Nancy La Vigne: Absolutely. And they need to be incentivized to do better and I’m not sure how to do that, because you know, as I said earlier, you know, researchers spend a lot of time publishing to communicate with each other and not with the world outside of academia. So I think that there is a share of academics out there that really care about making a difference and that we need to get to them and explain that you know, while you’re publishing and trying to get tenure, also think about ways that you can do good work that’s of a high quality, that also is accessible.

Len Sipes: That withstands scrutiny. That, that people can depend upon.

Nancy La Vigne: Yeah.

Len Sipes: But the practitioner community, unto themselves, I mean, the only thing that they want, is again, a la the Secretary of Public Safety who I used to work for, they just want it simple.

Nancy La Vigne: The bottom line, yeah.

Len Sipes: They just want the bottom line, they just want, you know, want to know the policy, they want to know the results and they wanna know what the policy states and they want to know if they can implement that policy within their jurisdictions, that’s pretty much it.

Nancy La Vigne: Right. Yeah, now let me tell you a little bit more about how the website is set up. I mean, unfortunately, this is a radio show so we can’t do a webinar and have visuals, but it’s tiered in such a way that for those very busy decision makers, it is indeed just the bottom line. But then you can click down and get more and more information.

Len Sipes: Right.

Nancy La Vigne: And so what it starts out is a description of each category of type of intervention. So under employment it might be a literacy program. Or a vocational training behind bars. And then it has a summary of the finding across all studies that address that intervention. So that’s the bottom line, right?

Len Sipes: And it’s a fairly quick description.

Nancy La Vigne: Yeah. But, if you click, it unscrolls a long, detailed, not as detailed as anything you’ll see in a journal article, but detailed description of the population that participated in the program, the geographic location, the nature of the program, and all those other nuances that I think are really critical. Because you have the busy decision maker, right? And he or she just wants to know the bottom line, but ultimately, if they’re going to use that bottom line to develop or alter a program, there’s gonna be someone who is tasked with doing that, and that person is going to need to know these details so that they don’t take, God forbid, the cookie cutter approach of just saying, “Okay, so we’re gonna do vocational programming.” Without thinking through who it works best with, why it works with this population, some of the details behind the program that might have made it more likely to achieve it’s intended results –

Len Sipes: Right.

Nancy La Vigne: Those types of details we felt, really had to be somewhere on the website and easily accessible, but the average viewer that goes there is not confronted with all that detail; they can chose to unveil it at their will.

Len Sipes: Do we have in this country any sense of training for the practitioner community that they understand everything that we, you and I just talked about? I mean, isn’t the natural inclination to say that if they did substance abuse treatment, if they did mental health treatment and if they did job placement, it worked in Milwaukee, it reduced recidivism by 17%, so it will work Baltimore, so we’re going to do the exact same thing. But it’s not the exact same thing. It all depends upon the population, it all depends upon high risk, low risk, it all depends upon what you mean by treatment.

Nancy La Vigne: Exactly.

Len Sipes: I mean, and I think a lot of people in the practitioner community don’t quite understand that it’s not a cookie cutter approach; it depends upon your particular set of circumstances.

Nancy La Vigne: Right, I think that’s right. And we try to communicate that in the website, but that’s not our primary goal. However, bear in mind, this is just one part of the larger, National Reentry Resource Center website, which does I think, a very good job at that, where they talk about best practice and you know, how to tailor a program to your local jurisdictions and needs and population so there’s a lot of complimentary guidance and information that should be used in concert with the stuff that’s on the reentry website.

Len Sipes: And nationalreentryresourcecenter.org, people should go to there and explore the entire website –

Nancy La Vigne: Absolutely.

Len Sipes: As well as crimesolutions.gov. But the, in terms of reentry specifically, pretty much everything you need to know is at the National Reentry Resource Center.

Nancy La Vigne: I would say so.

Len Sipes: I mean in terms of guidance, in terms of what to do –

Nancy La Vigne: its one stop shopping.

Len Sipes: Right, right, right, because different people come to me and they say, “Oh, my Congressman–he’s now interested in this reentry issue. Where do I go? What do I do?” And they search the internet and they come to one of my television shows or one of my radio shows and they think I know the answers and I don’t. I say, go to the National Reentry Resource Center, go to OJP, go to NIJ.

Nancy La Vigne: Right. So the Resource Center has been up and running for what – five years, four years? Something like that.

Len Sipes: About.

Nancy La Vigne: So we, you and I, used to field those inquiries all the time. I still am to some extent, but I can’t tell you how much more time I have in my life, now that people are referred to this website. It’s got an added bonus of freeing me up to do more research.

Len Sipes: You don’t have to go through the endless explanations. Before ending the show, I do want to talk about what, in your opinion, seems to be the principle findings and we haven’t really talked about that. So we know about the website, we know about the National Reentry Resource Center, we know about the Office of Justice programs, we know about how you got to where you are in terms of going from 15000 studies to 276 studies, so people are sitting back and going, “Well, shut up Leonard, and tell ‘em what works.”

Nancy La Vigne: Well, you know, we did not set out to synthesize across all of the research that we presented. We present it by topical areas so that people can look and make their own decisions about what seems to work, based on different intervention categories. But I can say that just based on the content we have up right now, which is not fully up there, we have covered just a handful of the topics, housing and employment –

Len Sipes: A work in progress.

Nancy La Vigne: And so forth. . . There are some findings that perhaps won’t surprise you at all. Chief among them is the importance of aftercare, or what’s called the continuum of care. So across all the topics that we’ve explored all ready, the ones, the programs that seem to have an impact are surprise, surprise, the ones that start in an institutional setting –

Len Sipes: Right, within prison.

Nancy La Vigne: And continue out into the community and this I’m sure is a no-brainer for many in your audience but it’s nice that sometimes research can confirm what we know to be true, so. . . that’s a big one.

Len Sipes: Well, we have a captive audience, no pun intended, so there is an opportunity for them to get their GED, there is an opportunity for them to get their welding certificate, there is an opportunity to go to, I don’t think there’s a lot of drug treatment or mental health treatment within prison systems, so the research that I’ve looked at somewhere in the ballpark of 10 to 15% but there are groups in there. So they come out, whatever they get, they come out and it’s supposed to continue seamlessly in the community.

Nancy La Vigne: That’s right. We’ve also found rather mixed results on the topic of employment, even though I know in my heart that employment can work, we found it in our own research at the Urban Institute, but if you look across the studies that we felt met the threshold of rigor, we found very mixed results. Some, some work programs or employment readiness programs worked and others did not. Again, this gets back to the missing piece of data for us, which is how well were those programs implemented?

Len Sipes: Right.

Nancy La Vigne: And we largely don’t know that. So if I were to conjecture, I’d say that the ones that worked were implemented well, and those that didn’t weren’t, or were not focused on the right population who could best benefit from. . .

Len Sipes: A good history of research in terms of substance abuse, SAMHSA, has had decades to look at what works and how it should be implemented so what do we have in terms of the correctional literature?

Nancy La Vigne: We are still in the process of coding and assessing all the substance abuse studies so. . .

Len Sipes: Ah, okay.

Nancy La Vigne: Which is actually the largest body of research of any category that we have.

Len Sipes: Right, and it’s been around for decades, but I mean, what we have now is again, promising. I mean, there does seem to be some fairly decent findings, because substance abuse research or programs do seem to be coupled with cognitive behavioral therapy and for the average person listening to this program, getting a person to rethink how they live their lives and how they make decisions, so those seem to be coupled, but most of the drug treatment that I’ve been exposed to was cookie cutter. It’s not designed for that individual; it’s designed for anybody with any drug history, with any drug of choice.

Nancy La Vigne: Yeah, there’s often a mismatch on who gets access to the substance abuse treatment behind bars and in some of our own research we found that often it’s just based on your crime of conviction. So if you’re convicted of a drug related crime, you automatically go into some kind of substance abuse treatment program you know, regardless if you’re a trafficker and you might be very successful as a trafficker because you don’t engage in any substance use at all. So, I know that departments of corrections are a lot more savvy about that now but you know, even a decade ago we saw a lot of examples of that. So. . .

Len Sipes: Mental health is an issue that’s just emerging. I saw a piece from the Bureau of Justice Statistics about five or six years ago talking about self reports and the self reports were somewhere in the 55% range of people who self reported a problem with substance, I mean, a mental health problem. I’ve seen more and more literature in terms of self reports and assessments that indicate that very large numbers of offenders have histories of substance, I’m sorry, mental health problems but treatment is far and few and in-between and it’s really tough to deal with schizophrenia within a correctional setting. It’s really tough to deal with depression within a correctional setting.

Nancy La Vigne: That’s right, and disentangling studies that look at certain types of mental health treatment programs that are more about counseling and you know, clinical counseling, separate and apart from medication, is very difficult. It makes it very challenging for research studies, because you can’t withhold that type of treatment so finding a good comparison group is very. . .

Len Sipes: No, you cannot do random assignment when it comes to health related issues.

Nancy La Vigne: Right, right, right.

Len Sipes: Right, right.

Nancy La Vigne: Which is why we found so many or so few examples of rigorous studies in health – just physical health. We had none to include at all which is kind of disappointing, but in part, some of those end up in a larger category of what we’re calling holistic reentry programs.

Len Sipes: Right.

Nancy La Vigne: So it’s very rare to only address physical issues in a study on reentry.

Len Sipes: And we’re talking about holistic, it seems to be for, it seems to be substance abuse, it seems to be mental health, it seems to be job related, and it seems to be cognitive behavioral therapy, which is again, how to think your way through situations. Those seem to be the four key, core areas of the research that I read.

Nancy La Vigne: That’s right.

Len Sipes: And those, then the comprehensive programs are designed to deal with all four of those issues.

Nancy La Vigne: That’s right, and if they’re good, they’ll bring in the family component you know, that’s a favorite topic of mine.

Len Sipes: Yes it is a favorite topic and a very important topic at the same time. So in the final analysis, what we have is an understanding as to the key components. I mean, I think housing is certainly an extraordinarily important component and I read about different, you know, projects around the country that are providing housing, but in Washington DC, which is one of the United States and world’s most expensive housing markets, we’re not gonna be able to provide a lot of housing regardless to how much money we get. I mean, I would imagine a housing program in the middle of the country in a rural area, they can probably stretch their dollars, so that’s, that’s really problematic.

Nancy La Vigne: And that’s right, and really there were very few studies on housing that met our criteria and they were entirely about halfway houses, so. . .

Len Sipes: Yes, right. So in the final analysis it seems those are the four key areas and that people can now have places, a place to go to that will be populated to a much larger degree than it is now, a place to go to in terms of offender reentry and to get all those research summations in one place.

Nancy La Vigne: That’s right.

Len Sipes: And for the future, you’re going to be putting more and more and more in?

Nancy La Vigne: That’s right, right now we have housing and employment and a few other topics and then we’ll be adding substance abuse, cognitive behavioral therapy, sex offender treatment, some special populations topics, like juveniles and so forth.

Len Sipes: Nancy, I really appreciate you being here. Ladies and gentlemen, our guest today is Nancy La Vigne, Director of the Justice Policy Center for the Urban Institute – www.urban.org The National Reentry Resource Center, boy that’s a mouthful. The National Reentry Resource Center, their website, in terms of what works, is exactly that – www.nationalreentryresourcecenter.org/whatworks and don’t forget crimesolutions.gov. for all the criminal justice topics. Ladies and gentlemen, this is DC Public Safety. We really appreciate all the interaction, all the emails, all the comments, all the criticism and I want everybody to have themselves a very, very pleasant day.

[Audio Ends]

Filed Under: Audio Podcast, Drug Treatment, Education and Vocational Assistance, Mental Health, Reentry, What Works Tagged With: Offender Reentry, Reentry, research, Urban Institute, what works

National Recovery Month and Parole and Probation-DC Public Safety Radio

November 20, 2012 by CSOSA

Welcome to “DC Public Safety” – Radio and television shows, blog and transcripts on crime, criminal offenders and the criminal justice system. We currently average 90,000 page views a month.

The portal site for “DC Public Safety” is http://media.csosa.gov.

Radio Program available at http://media.csosa.gov/podcast/audio/2012/09/national-recovery-month-and-parole-and-probation-dc-public-safety-radio/

[Audio Beings]

Len Sipes: From the nation’s capital, this is DC Public Safety; I’m your host, Leonard Sipes. Ladies and gentlemen, the program today is on National Recovery Month and we have three individuals who really know their stuff in terms of National Recovery Month. We have Kevin Moore, a Supervisory Treatment Specialist for my agency, Court Services and Offender Supervision Agency, Renee Singleton who’s also a Treatment Specialist here at CSOSA, and we have Ronald Smith, he is a graduate of the Secure Residential Treatment Program. He’s been out of that program and for about one year and he’s doing wonderfully. We’re here to discuss National Recovery Month and I do want to remind everybody that there are 700,000 people who leave the prison systems all throughout the United States and the federal system every year. Eighty to 90% of them have substance abuse histories. The question is, if they got the treatment, if they got, whether it’s mental health treatment or substance abuse treatment while in prison, and if they got the mental health and substance abuse treatment out in the community, how much crime could we reduce, how much money can we save tax payers and how many victimizations could we prevent? So the all those questions for Kevin Moore, again, Supervisory Treatment Specialist, Renee Singleton and Ronald Smith. To all three, welcome to DC Public Safety.

Ronald Smith: Thank you.

Renee Singleton: Thank you.

Kevin Moore: Good afternoon. Thank you.

Len Sipes: All right, Kevin, you’re going to start off first. National recovery month is put on by SAMHSA, correct?

Kevin Moore: That’s correct.

Len Sipes: And explain to me what SAMHSA is?

Kevin Moore: SAMHSA is a Federal Agency responsible for various treatment initiatives, establishing national protocols and standards for treatment providers and to ensure that there are services in the community to assist with eradicating the use of illicit substances.

Len Sipes: They’re the Substance Abuse and Mental Health Services Administration. I could never get that right. I’ve been, I’ve been receiving SAMHSA materials for the last 25 years and I always screw up the acronym. Substance Abuse and Mental Health Services Administration under the Department of Health and Mental Hygiene, US Department of Health and Mental Hygiene. So every month they, every year they do Recovery Month. It’s now into its 23rd year, and it highlights individuals who have reclaimed their lives and are now living happy and healthy lives in terms of long term recovery. But this issue of substance abuse, this issue of mental health treatment, substance abuse treatment, it’s not the easiest sell, considering the fact that there are budget reductions all over the country. I mean, convincing individuals that treatment is in their best interest, in society’s best interest, in the best interest of the person caught up in the criminal justice system; sometimes that can be a tough sell.

Kevin Moore: Yeah, absolutely. And just as you said in your opening, you know, we have 700,000 individuals returning to the communities each year and you know, one of the things that we feel here at CSOSA is that if we give folks an opportunity at treatment services, then we are providing opportunities to these folks to reclaim their lives, but more importantly, to reduce the possibility of continued criminal lifestyles.

Len Sipes: Right, but this is a national effort, that’s one of the things that I want to make clear, the first issue I want to make in the program. We celebrate recovery, not just here at CSOSA, but all throughout the United States, all throughout the Territories, the whole idea is to get people to understand that recovery is possible and recovery is in society’s best interest.

Kevin Moore: Absolutely. And with this year’s campaign, you know, we just want to reemphasize that prevention works, treatment is effective and people can and do recover, providing they are giving opportunity to the services that are out there.

Len Sipes: Now you’re a Supervisory Treatment Specialist, which means that you head up a team of people providing treatment services. This is probably the most difficult job on the face of the earth. I’ve done this, by the way, I ran group in a prison system, I did Jail or Job Core where the judge said, “Go to jail or go to Job Corps.” And I was also a gang counselor in the streets of the city of Baltimore. I know how tough this is to get people off of substances. And so you head up a team of people who face this issue every single day.

Kevin Moore: Absolutely, absolutely. We, I have a team, a staff who are dedicated to working with individuals who, some are motivated, some aren’t motivated, but they, meaning the Treatment Specialists, do what they can, using their clinical skills to guide our clients to entering into treatment and to give them that opportunity to reclaim their lives, deal with their addiction, deal with their mental health issues.

Len Sipes: And you know, interestingly enough, ladies and gentlemen, we have Renee Singleton who is a Treatment Specialist from my agency, the Court Services of Offender Supervision Agency. Renee, we supervise 16,000 offenders on any given day, 24,000 offenders in any given year. Eighty to 90% have histories of substance abuse, so this is a tough task.

Renee Singleton: It is an extremely tough task. That’s why I think it’s one of the great things is that CSOSA offers so many different treatment options for our offenders. Not only do they have the opportunity to participate in treatment services, in outpatient treatment centers, they can also go to our Reentry and Sanction Center and be assessed and be introduced to some evidence based treatment practices and be placed within a residential treatment placement. And we also have our secure residential treatment program which is inside the institution as well as our new After Care and Relapse Prevention Groups.

Len Sipes: One of the things that I want to crow about, because it’s my agency and I guess I’m paid to promote my agency, but whether I’m paid or not, I say this to everybody, we’re an evidence based agency. We’re a best practices agency, so we look at the guidance given to us by the Substance Abuse and Mental Health Administration. We look for them to tell us what the state of the art is and we apply that state of the art here at CSOSA. What we do is we really figure out who that person is through a batteries or a series of tests and we match that person to the right treatment – correct?

Renee Singleton: Correct. We used the Addiction Severity Index to conduct assessments. We also use a risk assessment on the supervision side which looks at violence, weapons and sex, there’s substance use history, revocation history, so it takes into consideration all of those factors and within some of the treatment programs there are different assessments that are also used to gauge a person’s response to treatment.

Len Sipes: Because I think that that’s unusual. In my experience, and my 42 years within the Criminal Justice System I’ve seen the vast majority of treatment programs out there and other Criminal Justice Agencies and they’re cookie cutter. They just pile a bunch of people under supervision into a program. We create specialized programs for that individual offender, that person under supervision. I think that’s what makes us unique. Correct?

Renee Singleton: Absolutely. You want to have treatment services that are going to address the client’s needs and to apply a cookie cutter approach is not going to, actually address that individual client. So if you take a program that’s going to meet the client where he’s at, it’s evidence based, and help him to look at his thinking errors, cognitive distortions, substance use history and factors along with that, then that will help the client be successful, not only in treatment recovery, but also on supervision.

Len Sipes: The other unique thing is that we have money for about 25% of our population. Most parole and probation agencies in this country, they don’t have a dime. They don’t have a dime towards treatment. They just basically refer to the local treatment services provider. Now what we do is focus on what, the high risk offenders? That 25% for the people who pose an obvious risk to public safety or have histories of substance abuse, severe histories?

Renee Singleton: Yes, the auto screener takes the risk assessment. So you want to take that risk assessment because we want to look at the overall public safety.

Len Sipes: Right.

Renee Singleton: So in terms of substance use, you want to look at the risk, potential risk for public safety, as well as provide substance abuse treatment for an offender who’s in need.

Len Sipes: Okay. And we have an array of programs, anywhere from detox to residential to, to 28 day stay in terms of an assessment center that we built and then they go into designed, treatment designed specifically for them, correct?

Renee Singleton: That is right. I believe its 45 days for the women and 28 days for the men.

Len Sipes: Okay. And we have an array of other programs here at CSOSA in terms of anger management, educational assistance, vocational assistance, so we try to target the high risk offender, the offender who poses an obvious risk to public safety and we try to target our services, a wide array of services to that person.

Renee Singleton: That’s correct. There are, there is anger management program, which is also offered through CIT, and there’s DVIP, there are Reentry and Sanction Center, which is the 28 day assessment center, or 45 days for men. VOTEE, which offers educational services and vocational placement services. You have the faith based initiative, which also provides services.

Len Sipes: Oh, thanks for bringing that up.

Renee Singleton: And offers training sessions for our offenders.

Len Sipes: Because that’s a key issue. I mean, we have 100 faith institutions in Washington DC and I think the total number the last time I looked was 500 people under supervision have gone through the faith based program. I mean, that’s wonderful, the idea. Kevin, did you want to take this?

Kevin Moore: Yeah.

Len Sipes: That’s wonderful, the idea that you come out of treatment and you’re matched with a mentor.

Kevin Moore: Yeah, absolutely and I just wanted to add that you know, because we only have probations for 25% it’s very important that we use our faith based partners to help us deal with the issues that our clients face, whether it’s addiction or mental health and that mentoring component is very significant in helping the client sustain his productive path as he or she tackles their recovery.

Len Sipes: And we also, the ones that fall outside of the high risk, we refer over to [PH 00:10:41] APPRA, which is the Washington DC’s organization to provide substance abuse treatment and we also rely upon the faith based community. Sometimes they provide treatment and there is Salvation Army, there is the Veteran’s Administration, there’s all sorts of places that we can refer other people to that don’t fall under the category of high risk offender. Wait a minute, just let me get an answer to that question and we’re going to get right over to you in a second, Ronald. So, is that correct?

Kevin Moore: Yes.

Len Sipes: Okay. Ronald.

Ronald Smith: Hello.

Len Sipes: I’ve been looking forward to talking to you.

Ronald Smith: How you doin’?

Len Sipes: You know, get closer to that microphone, get right on top of that mike. You know, you and I were talking before the program; you’ve had quite a drug problem from a fairly early age, correct?

Ronald Smith: Yes.

Len Sipes: Okay.

Ronald Smith: You know, I was, I was 14 years old and I was boxin’ and then I got on marijuana, started with marijuana and then I graduated from PCP to heroin.

Len Sipes: Right. Were you involved in criminal activity all throughout that time?

Ronald Smith: Yes, to support my habit.

Len Sipes: Right.

Ronald Smith: What y’all were saying about the programs that Washington DC have – CSOSA, when I was in the Federal System, them guys are like, they goin’ home to Philadelphia and New York and Florida, South Carolina, North Carolina, they don’t have the programs that the residents of Washington DC have.

Len Sipes: Right.

Ronald Smith: And it’s a blessing.

Len Sipes: Yeah.

Ronald Smith: You know, and I’m . . .

Len Sipes: I do want to explain in terms of the Federal Prison concept that since we had a change in Washington DC in August of 2000, all people, DC offenders, not just necessarily Federal Offenders, but all DC code offenders now go to Federal Prison, so for somebody listening in Albuquerque, New Mexico, I want to be sure that they understand your reference to Federal Prison.

Ronald Smith: Yeah, because they closed Norton down –

Len Sipes: Right.

Ronald Smith: And now they sent us to Federal Institutions.

Len Sipes: Well you know, Ronald, look. You’re a success, and thank God you’re a success. It makes the rest of us in the Criminal Justice System celebrate the fact that you’re a success. But today you’re representing all the different people caught up in the Criminal Justice System who have been able to get by drugs. Now you spent how long in the, the, you’re a graduate of the Secure Residential Treatment Program. That was a jail based program, correct?

Ronald Smith: Yes, that’s a six month program.

Len Sipes: Okay, so you graduated from that and why did you go into drug treatment?

Ronald Smith: Why?

Len Sipes: Why.

Ronald Smith: Because I got tired of being homeless. Homelessness – and my treatment specialist, she helped me point out my weaknesses as far as being homeless.

Len Sipes: Right?

Ronald Smith: So with that I learned, it’s, I already had knew what she was teaching me, but I just wasn’t using it and when I was out there, on drugs and drinking alcohol.

Len Sipes: Before the program you said you weren’t ready before and you have to be ready. Anybody entering these sort of programs needs to be ready to make a change, correct?

Ronald Smith: Yes.

Len Sipes: Tell me about that.

Ronald Smith: That’s automatic, because if you don’t want it, then you going to have reservations. You going to be, like you be in jail, they going to [INDISCERNIBLE 00:14:36]. So if you have reservations, then it’s not going to work.

Len Sipes: If we had sufficient money, if we had now, like in CSOSA we have, we can treat 25%, we refer people to other organizations in terms of drug treatment and mental health treatment and other services and its employment services as well, we have partners. Without partners we can’t exist. But if we had not 25% but 35%, 45%, if every person who had a drug history or mental health history, who are caught up in the Criminal Justice System, if they had services for that in prison and when they got out in the community, would it substantially reduce crime?

Ronald Smith: Yes it would. Because you building your foundation while you’re incarcerated. So when you come home, you still got that motivation.

Len Sipes: Right.

Ronald Smith: And when you have that motivation, you can’t be stopped. So every day that I wake up, I thank God for waking me up, and then I go on with my day. Every Monday I call my treatment specialist to check in. You know, I’m not in the program no more –

Len Sipes: Right.

Ronald Smith: But I still check in and she part of my support system.

Len Sipes: Right.

Ronald Smith: And I build a, I mean, my support system is awesome right now and I stay in contact with these people every day, every week.

Len Sipes: That’s cool, that’s cool. Relapse prevention is part, a big part of the SAMHSA program, part of the CSOSA program, but ladies and gentlemen; I wanted to reintroduce everybody one more time. We’re halfway through the program. Kevin Moore, Supervisory Treatment Specialist, for my agency, Court Services and Offender Supervision Agency, we’re a Federal Parole and Probation agency providing services here in the nation’s capital. Renee Singleton, she’s a Treatment Specialist, and Ronald Smith is a proud graduate of one of our programs, still under supervision. He’s been out for one year and he’s working and doing fine. Okay, let me go back to you, Ronald.

Ronald Smith: And 22 months clean.

Len Sipes: And 22 months clean. That is so important.

Ronald Smith: It is very important.

Len Sipes: How difficult was it to kick drugs? I mean, you know, people tell me it is one of the most difficult things in the world to kick both drugs and to kick the corner.

Ronald Smith: Yeah, like, it’s, it was a mental, it was mental.

Len Sipes: Right.

Ronald Smith: It’s mental. But I know that I’m addicted to the lifestyle –

Len Sipes: Right.

Ronald Smith: So. . .

Len Sipes: You’re not just addicted to drugs, you’re addicted to the lifestyle.

Ronald Smith: Lifestyle too.

Len Sipes: Yeah, yeah, yeah.

Ronald Smith: So I stay away from the lifestyle.

Len Sipes: That’s it.

Ronald Smith: You know what I’m saying? I spend time with family and I have a son and I have a little bouncing little grandson that’s a month.

Len Sipes: Congratulations.

Ronald Smith: So you know, I’m busy.

Len Sipes: And it’s, and now you’re a meaningful part of the lives of your children and your grandchildren instead of being this person who floats in and out of their lives because they’re using drugs.

Ronald Smith: Yes. When my son told me, when I came home, he said, he said, “Dad, when you going to stop goin’ to jail?”

Len Sipes: Yep.

Ronald Smith: I had to, you know, think about that.

Len Sipes: If treatment wasn’t available to you where would you be today?

Ronald Smith: If I didn’t take my treatment seriously?

Len Sipes: Yes.

Ronald Smith: I’d be back in jail or dead.

Len Sipes: In jail or dead or still committing crime?

Ronald Smith: Yes.

Len Sipes: Still using drugs?

Ronald Smith: Yes.

Len Sipes: And you know, Kevin, I’m going to go with you for a second in terms of this larger issue. Again, it is the SAMHSA which is the, under Health and Human Services, Substance Abuse and Mental Health Services Administration. They’re setting up National Recovery Month; we’re participating in it as we always do. We feel very strongly about this issue because you know, talking to Ronald, if these programs weren’t available, people would still be committing crime, people would still be victimizing people and it would still be costing taxpayers literally hundreds of millions of dollars a year.

Kevin Moore: Absolutely. You, Mr. Sipes said, it costs more to incarcerate an individual than to treat the person for their addiction and you know, I’m thankful that this initiative has been in existence for 23 years, but I’m more thankful that CSOSA has embraced recovery month and that we are providing various activities to acknowledge individuals who are in recovery. And you know, SAMHSA, about two years ago, redefined what recovery means and simply put, they states that recovery is a process through which individuals improve their health and well being, that they live a self directed life, and that they attempt to maximize, or they strive to maximize their full potential. And just listen to what Ronald is saying –

Len Sipes: Right.

Kevin Moore: It sounds like he has taken advantage of that and I’m glad that CSOSA was a part of providing that opportunity for him.

Len Sipes: And you know, all of us in this room, we’ve talked to literally, throughout our careers, thousands of people who have crossed the line, who have crossed the bridge. They’re now tax payers, they’re not tax burdens, they’re now supporting their kids, they’re now you know, doing the right thing, they’re full members of their community but they were none of this until they got mental health treatment, until they got substance abuse treatment. Renee, you want to take a shot at that?

Renee Singleton: Yes, I think Mr. Smith is a prime example of how treatment works in regards to just maintaining his recovery and being in compliance with supervision. It’s definitely been a change in how he responded to supervision prior to treatment and now, and he can best attest to that, in regards to being on intensive, maximum, and now minimum supervision.

Len Sipes: Right, he’s come down, he’s worked his way down the chain in terms of how intensely we supervise him.

Renee Singleton: That’s correct, and that’s not also, not just in regards to supervision, but in regards to drug testing as well. So you may start off at a higher level of drug testing, because of your substance use history, and then work down to spot testing and not being required to drug test as frequently. Also, Mr. Smith has been quite modest. He’s taken advantage of a lot of services that CSOSA offers and all of those services have helped him be successful on supervision and in the community. He’s now a taxpayer, he maintains his own house or he’s maintaining housing, stable housing, he’s not in violation in supervision, so he is a prime example of how treatment works.

Len Sipes: Right, he’s everything we want him to be, he’s everything society wants him to be.

Renee Singleton: Now that he’s successful [OVERLAY]

Len Sipes: And then congratulations go out to all of you. Okay, so why is it so dag gone difficult to find money for substance abuse treatment programs? You know, the last survey that I saw, that in prison now, not under community supervision, but in prison, that 80 to 90% of people in prison have histories of substance abuse. 10% are getting treatment. Now, I’ve seen others surveys that said 13%, I’ve seen other surveys that said 16%, it’s a small number that get treatment. Okay, why do we have this dichotomy? If we have individuals who have histories of mental health issues, substance abuse issues, then why aren’t we treating them in the prison system? What’s going on? Why is it a matter of convincing society that this is something that we need to do? We need to give up the money? Any one of you can answer that question.

Kevin Moore: Well, I’ll take a shot at it Mr. Sipes, and you know, within the Criminal Justice Systems, you know, we go through various shifts. You know, every decade or so the philosophy changes. One, we go from rehabilitative concept to the punitive, punishment concept. I think now we are moving back towards the rehabilitation, we’re looking at evidence based practices.

Len Sipes: Right.

Kevin Moore: And so we are educating folks more, but you know, substance abuse and mental health, you know, still poses a stigma to folks and the community has a difficult time of embracing that. I think that you know, though we celebrate National Recovery Month every September for the past 23 years, we need to have a better or more established campaign throughout the year to promote the successes of folks who have recovered from substances and mental health disorders.

Len Sipes: Is it because people just hear bad news about people under supervision and just don’t hear the good news? I mean, what Ronald has done is phenomenal. I mean, I’m looking at an article right now that was written up by somebody in terms of his transitional housing, a Reverend Deborah Thomas Campbell and who just absolutely, absolutely is glowing in terms of Ronald’s recovery, but as he says, if he didn’t have the treatment programs there, the other programs there, he may be dead, he may be in prison, he may be back doing drugs, he may be back doing crime and additional victims are going to have to suffer through those consequences. They don’t have to suffer through it now because he’s sitting by our microphones clean and sober for how many years?

Ronald Smith: A year and 8 months.

Len Sipes: That’s a long time Ronald. Congratulations.

Ronald Smith: Thank you.

Len Sipes: So what are you, so what do you say to the larger society? What message do you give to people who are saying, “Look Leonard, you know, we can’t fund our schools, we can’t fund programs for our elderly, we’ve got 10 tons of people out of work, you know, and you’re now telling me to give more money to substance abuse and mental health treatment programs.” What do you say to that person? Closer to the mike. . .

Ronald Smith: I would tell’em, okay, I’m part of the community.

Len Sipes: Yeah.

Ronald Smith: And I helped mess it up, so you can help straighten it up and then be a mentor to the kids because the generation coming up now, they need some mentoring.

Len Sipes: Yeah, they do.

Ronald Smith: And that’s what I want to do. That’s what I want to do, because I used to box. And drugs, alcohol destroyed my career. That’s ‘cause I wanted to go into the Marines.

Len Sipes: Right.

Ronald Smith: And box in Olympics. But that dream was shattered and I just want to, I want to give back.

Len Sipes: Right.

Ronald Smith: Because same thing with the NANAA, you learn it and then you give it back. So that’s, that’s my philosophy.

Len Sipes: But what people are listening, more from you than from the three of us sitting in this studio right now, they’re saying, “Okay, this is possible. If I give more money, if I support more treatment: either mental health treatment, substance abuse treatment, vocational treatment, if I support this, I’m creating a safer society.” Is that right or wrong?

Ronald Smith: That’s right. Because the kids can go out and play. People can go to the store without being robbed.

Len Sipes: Right.

Ronald Smith: I mean, you know, back in the day, DC used to be a nice town but now you can’t, you got to lock your door. Back in the day you used to have your door unlocked. But now you gotta lock it.

Len Sipes: Right.

Ronald Smith: So, times have changed you know.

Len Sipes: And we’ve got to change with those times.

Ronald Smith: Right.

Len Sipes: And provide the substance abuse and treatment services necessary. Kevin, go ahead.

Kevin Moore: Yeah, I was going to say, Mr. Sipes, you know, it’s a windfall if we invest more in treatment. You know, some of the society benefits would include you know, increased productivity of these individuals. As we know, Ronald now is working, he’s a taxpayer.

Len Sipes: Right.

Kevin Moore: You know.

Len Sipes: Right, he’s paying our salaries. Thank you Ronald.

Kevin Moore: Yeah, yeah.

Len Sipes: Thank you Ronald.

[Laughter]

Kevin Moore: You know, with treatment you know, we minimize premature deaths. As Ronald said, if he were to continue on this path to destruction, he would either be incarcerated or dead and also the criminal activity. You know, we reduce the crimes committed in our communities and also we reduce the substance abuse related illness. You know, as we prepare for the Recovery Month, you know, we uncovered some staggering stats and one of the things that stood out to me is that 40% of all the emergency room visits are substance abuse related here in the District of Columbia.

Len Sipes: Right, so we’re talking about reducing the cost of medical care. That would be an obvious benefit.

Kevin Moore: Absolutely. Absolutely. In addition to that, what was even more staggering is that 50% of all the vehicular incidents here in the District of Colombia are related to substance use.

Len Sipes: Abuse, yes.

Kevin Moore: Yeah, so again, you know, by investing in treatment and helping folks recover, we minimize these instances of increased healthcare, premature death, yeah. . .

Len Sipes: Renee, I mean, you’re going to have the final word in this program. What does the Substance Abuse and Mental Health Services Administration, their guidance, their research, their promotion of the state of the art, what does that mean to us as treatment providers?

Renee Singleton: Definitely provides us with evidence based treatment approaches so we can best assist our clients with being successful in recovery. It also offers us a lot of research and information to train ourselves so we can become more efficient Treatment Specialists and counselors for our clients.

Len Sipes: And the bottom line is, they give us the guidance we need and we implement that guidance.

Renee Singleton: Correct, we do implement the guidance, we use them as a great resource. They provide trainings, information, and so we use them to assist us with our work.

Len Sipes: Renee, you’ve got the final word. Ladies and gentlemen, I really do appreciate you listening to our program on National Recovery Month and how it applies to my agency, the Court Services and Offender Supervision Agency. Our guests today have been Kevin Moore, Supervisory Treatment Specialist with CSOSA, Renee Singleton, a Treatment Specialist again, with CSOSA, and Ronald Smith, who I now like an awful lot, who is a very successful person who is now working, a taxpayer, proud grandfather and father and Ronald again, congratulations on your recovery.

Ronald Smith: Thank you.

Len Sipes: Ladies and gentlemen, this is DC Public Safety; we appreciate your criticism and comments. We really do thank you for listening. Our website is www.csosa.gov www.csosa.gov. Please have yourselves a very pleasant day.

[Audio Ends]

Filed Under: Drug Treatment, Education and Vocational Assistance, Interviews with Offenders, Interviews with Staff, Parole and Probation, What Works Tagged With: criminals, CSAOA, drug treatment, national recovery month, Offenders, parole, Probation, treatment

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Reinventing the Criminal Justice System-Justice Reinvestment-Urban Institute-DC Public Safety

What Works in Offender Reentry-The Urban Institute-DC Public Safety Radio

National Recovery Month and Parole and Probation-DC Public Safety Radio

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